,transcrib]'s notes ,?is is d]iv$ f ! ,int]net ,ar*ive3 http3_/_/www4ar*ive4org_/details_/essays 9pa/ora#jjwalsgoog ,page numb]s 9 ?is book are indicat$ by numb]s enclos$ 9 curly braces1 e4g4 #ii4 ,!y h be5 locat$ :]e page breaks occurr$ 9 ! orig9al book4 ,obvi\s spell+ errors h be5 correct$ b inv5tive & inconsi/5t spell+ is left un*ang$4 ,end ,transcrib]'s notes iii ,,essays ,,9 ,,pa/oral ,,m$ic9e ,,by ,,au/9 ,,omalley1 ,m4,d41 ,ph4,d41 ,,ll4,d1 ,,pa?ologi/ ,,& ,,oph?almologi/ ,,to ,,sa9t ,,agnes',s ,,hospital ,,philadelphia & ,,james ,j4 ,,wal%1 ,m4,d41 ,ph4,d41 ,,ll4,d4 ,,adjunct ,,pr(essor ,,( ,,m$ic9e ,,at ,,! ,,new ,,york ,,polycl9ic ,,s*ool ,,= ,,graduates ,,9 ,,m$ic9e2 ,,pr(essor ,,( ,,n]v\s ,,diseases ,,& ,,( ,,! ,,hi/ory ,,( ,,m$ic9e ,,=dham ,,univ]sity1 ,,new ,,york ,,longmans1 ,,gre51 ,,& ,,co4 #ia ,,& #ic ,,fif? ,,av5ue1 ,,new ,,york ,,london ,,& ,,bombay #aijf iv ,copyright1 #aijf ,by ,longmans1 ,gre51 & ,co4 ,all rights res]v$4 ,,! ,,univ]sity ,,press1 ,,cambridge1 ,u4 ,s4 ,a4 v ,,preface ,! t]m ,pa/oral ,m$ic9e is some:at difficult to def9e because x comprises unrelat$ mat]ial rang+ f dis9fection to foeticide4 ,x pres5ts t "p ( m$ic9e :i* is ( import to a pa/or 9 8 cure1 & ^? divisions ( e?ics & moral !ology :i* conc]n a physician 9 8 practice4 ,x sets =? facts & pr9ciples :]eby ! physician himself or 8 pa/or may direct ! op]ator's consci5ce :5ev] m$ic9e takes on a moral quality1 & x also expla9s to ! pa/or1 :o mu/ (t5 m9i/] to a m9d diseas$1 c]ta9 m$ical tru?s :i* w s(t5 h>% judgm5ts1 & o!r facts1 :i* may be indiff]5t morally b :i* assi/ him 9 ! prop] conduct ( 8 "w1 especially z an educator4 ,pa/oral m$ic9e is n to be confus$ ) ! code ( rules commonly call$ m$ical e?ics4 ,! mat]ial ( pa/oral m$ic9e requires con/antly r5ew$ discussion1 because m$ic9e 9 g5]al is progressive en\gh frequ5tly to devise bett] me?ods ( diagnosis & treatm5t1 & ?us ! po/ulates ( ! moral que/ions involv$ are *ang$4 ,?is discussion1 h[ev]1 is n easily made4 ,! facts ^u :i* ! e?ical "p ( pa/oral m$ic9e re/s are furni%$ by ! physician = ! consid]ation & judgm5t ( ! morali/--! physician educat$ aft] mod]n me?ods kn[s little or no?+ ( e?ics & c n himself make accurate moral decisions4 ,! morali/1 on ! o!r h&1 is commonly a poor c\nsellor to ! physician1 because long tra9+ 9 m$ic9e is ne$$ be=e ! physical data ( ! moral decisions is compreh5d$4 ,! physician1 !re=e1 is at a loss to det]m9e :at he may or may n d 9 vi cases t involve ! greate/ moral responsibility1 & ! prie/ is a hesitat+ guide because ! moral !ologies d n conv9c+ly pres5t ! doctr9e 9 ^! cases4 ,n[ & !n su* subjects h be5 propos$ = discussion to a gr\p ( physicians & morali/s1 b usually no practical conclusion has be5 rea*$ because "o side did n und]/& ! o!r4 ,9 #ahih !re 0 a s]ies ( articles on ectopic ge/ation 9 ! ,am]ican ,ecclesia/ical ,review1 9 :i* morali/s l ,lehmkuhl1 ,sabetti1 ,a]tnys1 & ,hola9d1 & "s ( ! lead+ gynaecologi/s ( ,am]ica consid]$ ! que/ions b arriv$ at no decision4 ,! physicians did n und]/& c]ta9 que/ions1 o!r que/ions 7 on obsolete m$ical practice1 ess5tial que/ions 7 omitt$1 & f ! data ! morali/s came to oppos$ conclusions4 ,we f9d also 9 moral !ologies d$uctions drawn f false m$ical s\rces4 ,reasons are giv51 = example1 to ju/ify ! use ( a l>ge quantity ( alcoholic liquor at a dose 9 cases ( great pa91 typhoid fev]1 snake-poison+1 & o!r diseases1 9 ! supposition t su* doses w b5efit or cure ! pati5t1 :]eas ! physician t w\ld foll[ t treatm5t w\ld be guilty ( malpractice4 ,!re 0 rec5tly 9 ,am]ica a discussion on ! relation ( oeophorectomy to ! imp$im5tum impot5tiae4 ,"o side held t a lack ( ov>ies con/itutes impot5ce2 ! o!r side1 t x does n4 ,! discussion 0 useful because x incid5tally ga!r$ ! full doctr9e ( ! morali/s on ?is subject1 b f ! m$ical po9t ( view !re is no connection :atev] betwe5 ^! conditions4 ,a small numb] ( books on pa/oral m$ic9e h be5 writt5 by cl]gym5 t 7 n physicians1 & a few ,g]man books by physicians t 7 also morali/s4 ,^? by ! physicians draw conclusions f antiquat$ m$ical practice1 or !y are m]e popul> treatises on hygi5e2 ^? by ! cl]gym5 h "s value on ! e?ical side1 b !y are incomplete because ! au?ors _h n ! necess>y m$ical k4 ,! essays (f]$ 9 ?is book by no vii means cov] ! entire field ( pa/oral m$ic9e1 b z f> z !y g we h endeav\r$ to (f] ! m$ical doctr9e ( ! pres5t day on ! que/ions consid]$1 & t z completely z is necess>y to draw ! moral inf]5ces4 ,s9ce1 !n1 s _m ( ! que/ions ( pa/oral m$ic9e are n def9$1 physicians are likely to foll[ ! doctr9e ( ! /&>d m$ical books1 :i* )\t exception advise !m to take ! life ( a dang]\s foetus almo/ z unconc]n$ly z !y might prescribe an active drug1 or 9 any case to put utility be=e ju/ice4 ,!re is1 !re=e1 an urg5t necessity t compet5t m5 fix t %ift+ "p ( e?ics & moral !ology call$ pa/oral m$ic9e1 & ^! essays are pres5t$ z a tempor>y bridge to s]ve 9 cross+ a corn] ( ! bog until bett] eng9e]s lay d[n a p]man5t causeway4 ,"s may ?9k t ! au?ors are incl9$ t[>d an exagg]at$ *>ity 9 sugge/+ ! measure ( responsibility = _m human actions1 b ! physician t is br\ght mu* 9 contact ) ^? suff]+ f m5tal defects ( v>i\s k9ds soon le>ns h[ easily complete responsibility becomes m>r$4 ,responsibility is dep5d5t entirely ^u free w2 & :ile ! great pr9ciple ( free w rema9s solid 9 tru?1 no two m5 are free 9 exactly ! same mann]4 ,physical conditions h n a little to d ) modifications ( fre$om ( ! w4 ,to po9t out ?is fact to ! cl]gyman & ! physician has be5 our int5tion1 = a prop] appreciation ( x w wid5 ! b\nds ( *>ity & save _m t are m s9n$ aga9/ ?an s9n+ f ! injury ( griev\s misjudgm5t4 ,x is bett] to run ! risk ( exculpat+ a few individuals ^: responsibility is n entirely cle> :5 ! application ( ! same pr9ciples lifts _m o!rs above ! ra% judgm5t ( ^? t c be ( mo/ help to !m4 viii ix ,,cont5ts ,! ,au?or%ip ( ! respective ,essays is indicat$ by ! signature at ! end ( ea* ,essay4 ,*apt] ,page ,i4 ,ectopic ,ge/ation #a ,,ii4 ,pelvic ,tum\rs 9 ,pregnancy #dj ,,iii4 ,abortion1 ,misc>riage1 & ,premature ,lab\r #dh ,,iv4 ,! ,caes>ean ,section & ,craniotomy #ee ,v4 ,mat]nal ,impressions #fj ,,vi4 ,human ,t]ata & ! ,sacram5ts #fi ,,vii4 ,social ,m$ic9e #hh ,,viii4 ,"s ,aspects ( ,intoxication #aje ,,ix4 ,h]$ity1 ,physical ,disease1 & ,moral ,weakness #abj ,x4 ,hypnotism1 ,sugge/ion1 & ,crime #abi ,,xi4 ,unexpect$ ,dea? #ace ,,xii4 ,unexpect$ ,dea? 9 ,special ,diseases #aej ,,xiii4 ,! ,mom5t ( ,dea? #afd ,,xiv4 ,! ,prie/ 9 ,infecti\s ,diseases #afh ,,xv4 ,infecti\s ,diseases 9 ,s*ools #ahg ,,xvi4 ,s*ool ,hygi5e #bjb ,,xvii4 ,m5tal ,diseases & ,spiritual ,direction #baa ,,xviii4 ,neura/h5ia #bcj ,,xix4 ,hy/]ia #bce ,,xx4 ,m5/rual ,diseases #bdj ,,xxi4 ,*ronic ,disease & ,responsibility #bde x ,,xxii4 ,epilepsy & ,responsibility #bea ,,xxiii4 ,psy*ic ,epilepsy & ,second>y ,p]sonality #bei ,,xxiv4 ,impulse & ,responsibility #bff ,,xxv4 ,crim9ology & ! ,habitual ,crim9al #bga ,,xxvi4 ,p>anoia1 a ,/udy 9 ,cranks #bhb ,,xxvii4 ,suicides #cjf ,,xxviii4 ,v5]eal ,diseases & ,m>riage #caa ,,xxix4 ,social ,diseases #cag ,,xxx4 ,de ,imp$im5to ,matrimonii ,dirim5te ,impot5tia #cbf ,,app5dix4 ,bloody ,sweat #cdg ,,index #ceg #a ,,essays ,,9 ,,pa/oral ,,m$ic9e ,i ,,ectopic ,,ge/ation ,ectopic ge/ation is ge/ation 9 ! ut]9e adnexa1 ! p]itoneal cavity1 or ! horn ( an abnormal or rudim5t>y ut]us4 ,x is oppos$ to natural ut]9e ge/ation1 &1 s9ce x includes pregnancy 9 an abnormal ut]us1 x is a m compreh5sive t]m ?an extraut]9e pregnancy4 ,9 ?is article ! morality involv$ 9 ! surgical treatm5t ( ectopic ge/ation is consid]$2 & to h ! data requisite = judgm5t x is necess>y to describe 9 outl9e ! anatomy ( ! ut]9e adnexa & ! gr[? ( ! foetus2 to expla9 ! v>ieties1 effects1 diagnosis1 & treatm5t ( ectopic ge/ation2 to pres5t ! cases ( ?is condition1 or r ?is disease1 z !y occur 9 m$ical practice2 to set =? "s ( ! moral pr9ciples or laws t gov]n m$ical practice1 especially :]e !re is "q ( life & dea?2 & f9ally to apply ^! pr9ciples to ! cases (f]$ = inve/igation4 ,! ut]us is 9 ! pelvic cavity1 betwe5 ! bladd] & ! rectum & above ! vag9a1 into :i* x op5s4 ,x is a holl[1 pe>-%ap$1 muscul> organ1 some:at flatt5$1 & ab\t ?ree in*es long1 two in*es broad1 & "o in* ?ick4 ,! base or fundus is upw>d1 & ! neck is d[nw>d4 ,pass+ out horizontally f ! corn]s or horns ( ! ut]us1 :i* are at its base1 are ! two ,fallopian ,tubes1 "o on ei!r side4 ,^! are ab\t five in*es 9 l5g? & some:at convolut$4 ,!y are true tubes1 op5+ into ! ut]us1 & !y are ab\t "o-sixte5? ( an in* 9 diamet] along ! great] "p ( _! ext5t ,! ends f>!/ #b f ! ut]us are fr+$ & funnel-%ap$2 & ?is funnel-end1 call$ ! ,infundibulum or ! ,fimbriat$ ,extremity1 op5s into ! abdom9al or p]itoneal cavity4 ,ne> ! ,fimbriat$ ,extremity ( ea* tube is an ,ov>y1--an oval body ab\t "o & a half in*es long by ?ree-qu>t]s ( an in* 9 wid?4 ,illu/ration ,! ,ut]us & its ,adnexa ,f ,u1 ,fundus or ,base ( ! ,ut]us4 ,f ,t1 ,p ,t1 ,fallopian ,tubes4 ,on ! left ( ! read] ! ,fimbriat$ ,extremity ( ! tube is lift$ up to %[ x4 ,o1 ,o1 ,ov>ies4 ,b ,l1 ,b ,l1 ,broad ,ligam5t4 ,r1 ,rectum4 ,b1 ,bladd]4 ,= conv5i5ce 9 description1 ea* tube is divid$ into f\r p>ts3 7#a7 ! ,ut]9e ,portion1 :i* is t "p includ$ 9 ! wall ( ! ut]us itself2 x ext5ds f ! out] end ( ! horn into ! upp] angle ( ! ut]9e cavity1 & its lum5 is s small x w admit only a v f9e probe2 7#b7 ! ,i/hmus1 or ! n>r[ "p ( ! tube :i* lies ne>e/ ! ut]us2 x gradually op5s into ! wid] "p call$ 7#c7 ! ,ampulla2 7#d7 ! ,infundibulum1 or ! funnel-%ap$ end ( ! ,ampulla4 ,?is "p is fimbriat$1 z has be5 said1 & "o ( ! fimbriae--! ,fimbria ,ov>ica--:i* is long] ?an ! o!rs1 =ms a %all[ gutt] :i* ext5ds to ! ov>y4 #c ,! ut]us1 tubes1 & ov>ies lie 9 a septum :i* rea*es across ! pelvis f hip to hip4 ,?is septum is call$ ! ,broad ,ligam5t4 ,if a man's s(t felt hat1 ( ! k9d call$ a ,f$ora hat1 is held cr[n d[nw>d ) "o h& at ! front & ! o!r at ! back ( ! rim1 x w repres5t ! pelvic cavity1 & ! fold along ! cr[n ( ! hat com+ up into ?is cavity is v l ! ,broad ,ligam5t4 ,z ! cr[n is held d[nw>d1 ! ut]us w\ld be 9 ! middle1 its fundus upw>d1 &1 ( c\rse1 altoge!r outside ! hat1 b 9 ! cr[n fold4 ,! tubes & ov>ies w\ld also be outside ! hat & 9 ! cr[n fold1 & ! fimbriat$ extremities w\ld op5 by holes into ! hat's int]ior4 ,! ovum breaks ?r\gh ! surface ( ! ov>y1 passes1 probably on a capill>y lay] ( fluid1 into ! fimbriat$ extremity ( ! tube1 & !n is mov$ along sl[ly ?r\gh ! tube into ! ut]us4 ,ovulation & m5/ruation occur ab\t ! same "t1 b (t5 "o ant$ates ! o!r a few days4 ,9 exceptional cases !y may occur indep5d5tly4 ,if ! ovum produc$ is n fecundat$1 x gradually %rivels up1 & passes (f ?r\gh ! ut]us & ! vag9a4 ,fecundation ( ! ovum r>ely occurs 9 ! ut]us1 b ord9>ily 9 ! ,fallopian tube1 accord+ to ! g5]al op9ion ( physiologi/s4 ,aft] fecundation ! ovum is pu%$ on into ! ut]us 9 f five to sev5 days1 :]e x fa/5s to ! wall & develops4 ,hyrtl 7,kollmann's ,lehrbu* d] ,entwickelungsges*i*te des ,m5s*51 ,j5a1 #ahih7 speaks ( a case 9 :i* ! ovum appe>$ to rea* ! ut]us 9 ?ree days4 ,if ! fecundat$ ovum is block$ or held 9 ! ,fallopian tube1 ! embryo gr[s :]e ! ovum /ops1 & we h a case ( ,ectopic ,ge/ation4 ,! av]age "t ( normal human ge/ation is t5 lun> mon?s or =ty weeks4 ,at ! mom5t ! pronucleus ( ! sp]matozoon fuses ) ! pronucleus ( ! ovum 9 ! ,fallopian tube & makes ! segm5tation nucleus1 9 my op9ion1 ! s\l ( ! *ild ent]s1 & p]sonality exi/s z absolutely z x does 9 a *ild aft] bir?4 ,x is z mu* a murd]1 z su*1 to unju/ly de/roy ?is microscopic fecundat$ ovum z x is to kill ! *ild aft] bir?4 ,?is is ! op9ion ( e embryologi/ ,i h consult$ on ! #d subject1 ) ! exception ( "o :o said he did n "k :5 ! s\l ent]s4 ,te*nically ! product ( conception is call$ ! ,ovum = ! fir/ two weeks ( pregnancy2 dur+ ! ?ird & f\r? weeks x is call$ ! ,embryo1 & aft] ! fif? week ! ,foetus4 ,dur+ ! f\r? week ! embryo beg9s to draw n\ri%m5t f ! mat]nal blood ?r\gh its umbilical vessels1 b be=e t "t x obta9s n\ri%m5t by osmosis4 ,! foetus at ! end ( ! eigh? week is ab\t "o in* 9 l5g?2 at ! end ( ! f\r? lun> mon? x is f f\r to six in*es long1 & its sex may be di/+ui%$4 ,at ! end ( tw5ty-f\r weeks1 if ! normal foetus is born x w attempt to brea! & to move its limbs1 b x dies 9 a %ort "t4 ,at ! end ( tw5ty-eight weeks ( ge/ation if x is born x moves its limbs freely & cries weakly4 ,x is ne>ly fifte5 in*es 9 l5g? & weighs ab\t ?ree p\nds4 ,su* an infant might be deem$ viable1 b its *ances = life are extremely prec>i\s1 ev5 9 mo/ exp]t h&s & ) ! help ( an incubator4 ,at ! end ( ?irty-two weeks ( ge/ation a foetus if born may be rais$ ) skilful c>e1 b ! *ances are n promis+4 ,x is viable4 ,at ! end ( =ty weeks ! *ild is at t]m4 ,9 #ahgf ,p>ry collect$ #ejj cases ( extraut]9e pregnancy f m$ical lit]ature1 b :5 ,tait 9 #ahhc fir/ op]at$ on a case ( ruptur$ tubal pregnancy att5tion 0 call$ to ! subject4 ,x 0 bett] und]/ood z coeliotomies 7op5+ ! abdom57 became common1 & 9 #ahib ,s*r5ck collect$ #faj cases t _h be5 report$ dur+ ! prec$+ five ye>s4 ,kue/n] alone has op]at$ on #aje cases 9 five ye>s4 ,!re has be5 mu* discussion among physicians z to ! causes t arre/ ! f]tiliz$ ovum 9 ! tube1 b :atev] ^! causes may be !y d n affect ! moral que/ions :i* come up 9 ?is article4 ,!re may be me*anical ob/ruction f p]itoneal adhesions1 or abnormal conditions result+ f inflammatory diseases ( ! tubes1 ov>ies1 & ! pelvic p]itoneum1 b no g5]al cause t w expla9 all cases c be ascrib$4 #e ,tait d5i$ ! possibility ( ,ov>ian ,pregnancy1 or a pregnancy :]e ! ovum fa/5$ to ! ov>y itself & develop$ !re1 b five fully e/abli%$ cases ( ?is k9d h be5 report$4 ,dr4 ,j4 ,:itridge ,williams1 pr(essor ( ,ob/etrics at ! ,johns ,hopk9s ,univ]sity1 9 8 textbook on ,ob/etrics 7,new ,york1 #aijc71 collects tw5ty-five cases ( ov>ian pregnancy1 :]e five cases are c]ta9 diagnoses1 ?irte5 highly probable1 & sev5 fairly probable4 ,9 ^! tw5ty-five cases t5 foetuses rea*$ full t]m1 b f\r ( ! five c]ta9 cases ruptur$ at e>ly p]iods4 ,x 0 =m]ly ?\ght t prim>y abdom9al pregnancy is q common2 t is1 t ! ovum is implant$ on "s organ )9 ! abdom5 itself1 ap>t f ! ut]9e adnexa4 ,?is is n[ look$ ^u z v d\btful1 & su* cases are probably second>y2 t is1 second>y to a pre-exi/+ tubal pregnancy :i* has ruptur$ )\t great mat]nal hemorrhage & let ! foetus gr[ )9 ! p]itoneal cavity4 ,! common =m ( extraut]9e pregnancy is ! ,tubal ,pregnancy4 ,! ovum may be /opp$ 9 any "o ( ! ?ree p>ts ( ! tube1 & we f9d ,int]/itial1 ,i/hmic1 or ,ampull> ,pregnancy4 ,f ^! prim>y types1 by rupture1 second>y =ms sometimes arise1--,tubo-abdom9al1 ,tubo-ov>ian1 & ,broad-ligam5t ,pregnancy4 ,! int]/itial =m1 t is1 :]e ! ovum is arre/$ 9 t "p ( ! tube :i* passes ?r\gh ! wall ( ! ut]us itself1 is ! r>e/ ( ! tubal pregnancies4 ,ros5?al 7,e9 ,fall intrantural] ,s*wang]s*aft4 ,c5tralbl4 f4 ,gyn4 #abig-acje7 f\nd x 9 only ?ree p] c5tum ( #acbd cases ( tubal pregnancy4 ,"s deem ! ,i/hmic v>iety ! commone/4 ,dr4 ,h[>d ,kelly 7,op]ative ,gynaecology7 says he nev] met a case ( ,int]/itial or ,ov>ian pregnancy 9 8 practice4 ,! int]/itial =m is especially liable to rupture ) sudd5ly fatal hemorrhage4 ,ab\t "o-f\r? ( ! cases ( tubal pregnancy end )9 ! fir/ twelve weeks by rupture ( ! ,fallopian tube4 ,if ! embryo is implant$ 9 ! int]/itial end ( ! tube1 ! rupture 7into ! ut]us1 or into ! abdom9al cavity1 or into ! broad ligam5t7 takes place lat]1--ab\t ! f\r? mon?1 or ev5 consid]ably aft] t "t4 ,! reason = #f ! delay "h is t ! ut]us gr[s ) ! foetus4 ,if ! foetus breaks into ! ut]us 7a v r>e occurr5ce71 x is ei!r expell$ ?r\gh ! vag9a almo/ imm$iately or x goes on l a normal pregnancy4 ,tait 0 ( ! op9ion t e case ( tubal pregnancy results 9 a rupture ( ! tube n lat] ?an ! twelf? week1 b ?is op9ion is no long] held4 ,v r>ely a tubal pregnancy goes on )\t rupture to full t]m1 z 9 ! cases report$ by ,williams1 ,saxtorph1 ,spiegelb]g1 ,*i>i1 & a few o!rs4 ,?ree-f\r?s1 ab\t sev5ty-eight p] c5tum1 ( ! cases ( tubal pregnancy result 9 :at is te*nically call$ tubal abortion in/ead ( rupture4 ,9 tubal abortion ! connection betwe5 ! embryo & ! tube-wall is brok5 by effusion ( blood4 ,if ! sep>ation is complete ! effus$ blood pu%es ! embryo out ?r\gh ! fimbriat$ end ( ! tube into ! abdom9al cavity1 & !n ! hemorrhage ( ! "m commonly ceases4 ,su* an extrusion ( ! foetus is call$ a complete tubal abortion4 ,if ! connection betwe5 ! foetus & ! tube-wall is only p>tly sev]$1 ! ovum rema9s 9 ! tube1 & ! mat]nal hemorrhage goes on4 ,?is is call$ incomplete tubal abortion4 ,9 incomplete tubal abortion ! mat]nal blood may sl[ly trickle f ! fimbriat$ extremity ( ! tube into ! abdom9al cavity1 become encapsulat$1 & ?us =m an haematocele4 ,if ! fimbriat$ extremity ( ! tube is block$1 ! blood accumulates 9 ! tube & makes an haematosalpynx4 ,9 complete tubal abortion ! foetus dies2 9 incomplete tubal abortion ! viability might dep5d on ! injury done ! plac5ta1 b 9 almo/ e case ( ev5 incomplete tubal abortion ! foetus dies z a result ( its sep>ation f ! tubal wall1 or f compression aft] ! ble$+4 ,9 cases ( rupture ( ! tube 9 extraut]9e pregnancy1 if ! foetus ) its atta*m5ts is expell$ f ! tube into ! p]itoneal cavity or into ! broad ligam5t1 ! embryo dies4 ,if ! foetus or embryo itself alone is expell$ into ! abdom9al cavity & ! plac5ta rema9s atta*$ to ! wall ( ! tube & communicates ) ! foetus by ! umbilical cord :i* runs ?r\gh ! te> 9 ! tube1 ! foetus may #g possibly live1 provid$ ! "m does n die f hemorrhage4 ,if ! foetus goes on gr[+ 9 ?is case1 we h an abdom9al pregnancy4 ,"o su* case is report$ by ,bo? :]e a fully develop$ foetus 0 f\nd 9 ! abdom9al cavity ev5 lack+ all its membranes1 :i* _h be5 left 9 ! tube1 b a foetus w n live ap>t f its membranes )9 ! mat]nal body4 ,:5 an embryo or foetus ruptures ! tube & goes into ! broad ligam5t1 x may live or die accord+ to ! injury done its atta*m5ts to ! tubal wall1 b x ord9>ily dies4 ,sometimes su* a broad-ligam5t pregnancy ruptures aga9 into ! abdom9al cavity4 ,because ! ble$+ is m likely to be conf9$ )9 ! folds ( ! broad ligam5t1 ! imm$iate dang] ( mat]nal dea? f hemorrhage is less 9 ?is ?an 9 o!r =ms ( rupture4 ,conc]n+ tubo-abdom9al pregnancy ! only rem>k to be made is t1 ow+ to adhesions1 x is (t5 surgically difficult to remove su* a gr[?4 ,if ! foetus is expell$ aft] rupture into ! p]itoneal cavity x dies1 & if ! hemorrhage does n kill ! "m ! dead foetus if small is absorb$2 if l>ge x becomes mummifi$1 or x h>d5s into a li?opo$ion1 or x turns into a yell[i% greasy mass call$ adipoc]e1 or x putrefies4 ,a li?opo$ion may be c>ri$ = ye>s4 ,!re are m ?an ?irty cases report$ :i* 7 c>ri$ f tw5ty to ?irty ye>s 9 ! abdom51 & "o case :]e a li?opo$ion 0 c>ri$ = fifty ye>s4 ,if ! foetus putrefies x causes fatal septicaemia 9 ! "m1 or a p]=at+ abscess1 unless x is successfully remov$4 ,!re are v>i\s abnormalities ( ! ut]us1 & 9 ^! pregnancy resembles 9 effect extraut]9e pregnancy4 ,an abnormal ut]us may be unicornis1 didelphys1 pseudodidelphys1 bicornis duplex1 bicornis septus1 bicornis subseptus1 bicornis unicollis1 or bicornis unicollis ) a rudim5t>y horn4 ,! impregnat$ ovum may fa/5 9 ! rudim5t>y horn & be block$ !re2 !n ! usual result is rupture )9 ! fir/ f\r mon?s1 ) fatal hemorrhage unless ! ble$+ is imm$iately *eck$ by coeliotomy & ligation4 #h ,z to diagnosis 9 ,ectopic ,ge/ation1 ,williams 7op4 cit471 "o ( ! au?orities at pres5t on ! subject1 says3 ,a positive diagnosis is occasionally made be=e rupture1 b 9 ! va/ majority ( cases ! condition escapes recognition until symptoms ( collapse po9t to ! probability ( rupture or abortion4 ,9 advanc$ cases c>eful exam9ation w usually disclose ! real condition ( affairs1 & :5 full t]m has be5 pass$ ! hi/ory is s *>act]i/ic t mi/akes %\ld h>dly occur4 ,9 ! ,am]ican ,ecclesia/ical ,review = ,janu>y1 #ahih 7vol4 ix41 n4 i71 ,fa!r ,r5e ,i4 ,hola9d1 ,s4 ,j41 publi%$ ! answ]s ( _m physicians to six que/ions conc]n+ extraut]9e pregnancy4 ,among ^! physicians 7 ,?omas ,addis ,emmet1 ,b>ton ,cooke ,hir/1 ,h[>d ,a4 ,kelly1 ,w4 ,t4 ,lusk1 ,t4 ,galli>d ,?omas1 ,mordecai ,price & 8 bro!r ,joseph ,price1 ,william ,goodell1 & ,lawson ,tait1--all em95t au?orities on ?is subject4 ,! second "q submitt$ 03 ,dur+ pregnancy1 at :at "t & by :at means c a diff]5tial diagnosis be made betwe5 intra & extra-ut]9e pregnancy1 & betwe5 abnormal ge/ation & pelvic or o!r tum\r8 ,9 answ] to ?is "q ,dr4 ,emmet said3 ,!re c be no absolute c]ta9ty z to ! exi/5ce ( pregnancy 9 any case until ! pulsation ( ! foetal he>t c be detect$4 ,aft] ! eighte5? or tw5tie? week ( ge/ation4 4 4 4 ,a diagnosis is difficult 9 all cases ( abnormal pregnancy1 b an exp]t c1 )9 a reasonable degree ( c]ta9ty1 arrive at a k ( ! exi/+ conditions betwe5 ! second & ?ird mon?4 ,dr4 ,hir/ said3 ,9 almo/ all cases ( advanc$ ge/ation ! diff]5tial diagnosis c be made4 ,9 e>ly cases x is n always possible unless conditions be fav\rable4 ,dr4 ,h[>d ,a4 ,kelly said3 ,! diff]5tial diagnosis betwe5 intra & extraut]9e pregnancy c usually be made f ! six? week up to ! end ( pregnancy4 ,x is m easily made f ! t5? to ! twelf? week on4 ,writ+ 9 ! ,am]ican ,text ,book ( ,ob/etrics 7,philadelphia1 #ahif71 he says3 ,9 ! atypical cases1 on ! contr>y1 a positive diagnosis is (t5 difficult or ev5 impossible4 4 4 4 #i ,! diagnosis ( ectopic ge/ation aft] ! dea? ( ! foetus is l>gely dep5d5t ^u ! cl9ical hi/ory2 if ?is be defici5t1 ! diagnosis is frequ5tly impossible4 ,dr4 ,lusk said3 4444 ,! frequ5t discov]y ( ! dead ovum 9 a tube :5 !re has be5 no suspicion ( pregnancy %[s ! difficulty ( a diagnosis4 ,9 8 text-book 7,! ,sci5ce & ,art ( ,midwif]y1 ,new ,york1 #ahij7 is ?is rem>k3 ,sometimes ! diagnosis c only be decid$ by ! introduction ( ! s\nd or a f+] into ! ut]us1 ! physician assum+ ! risk ( premature lab\r1 %\ld he f9d 8 supposition ( extraut]9e pregnancy an error4 ,?is means t sometimes ! diagnosis is impossible )\t runn+ ! risk ( caus+ abortion ( a normal ut]9e pregnancy4 ,dr4 ,?omas said1 ,aft] ! second mon? ! diagnosis is p]fectly possible4 ,?is 0 also ! op9ion ( ,dr4 ,mordecai ,price2 & ,dr4 ,joseph ,price holds t ! diagnosis c be made aft] ! ?ird mon?1 by exclusion4 ,dr4 ,john ,f4 ,rod]]1 quot+ ,lawson ,tait1 says t ! diagnosis betwe5 intra & extraut]9e pregnancy c n be made ) c]ta9ty be=e rupture1 nor c x be det]m9$ exactly :e!r an enl>gem5t ( ! tube is ei!r an ectopic pregnancy or "s =m ( tum\r4 ,dr4 ,goodell's op9ion 01 ,a diff]5tial diagnosis c r>ely be made positively at any /age ( extraut]9e pregnancy4 ,! diagnosis1 !n1 is difficult2 & = ! ord9>y practition]1 ! av]age physician1 :o does p]haps n9ety-five p] c5tum ( ! m$ical "w ( ! _w1 ! diagnosis is (t5 impossible4 ,!re is no great] exp]t ?an ,dr4 ,?omas ,addis ,emmet1 & he says ! diagnosis is difficult4 ,o!rs hold t ! diagnosis c be cle>ly made1 & !y speak truly z reg>ds !mselves1 b ord9>y skill f9ds ! diagnosis almo/ impossible 9 _m cases4 ,mordecai ,price 7,! ,p5nsylvania ,m$ical ,j\rnal1 vol4 viii4 p4 #bbc7 9 "o ye> saw f\r cases :i* he & o!r physicians diagnos$ z ectopic pregnancies ) rupture ( ! tube4 ,:5 ! abdom5 _h be5 op5$1 ut]9e pregnancy 0 discov]$ ) a ruptur$ tube 9 ea* case1 & all ! wom5 di$4 #aj ,! fir/ positive diagnosis ( unruptur$ tubal pregnancy 0 made by ,veit 9 #ahhc1 & ! fir/ "o made 9 ,am]ica 0 by ,janvr9 9 #ahhf1 eight ye>s be=e ,fa!r ,hola9d's article 0 writt54 ,be=e #ahhc1 only elev5 ye>s 9 advance ( ! same article1 :5 ,lawson ,tait p]=m$ ! fir/ coeliotomy = ! purpose ( *eck+ hemorrhage f a ruptur$ tubal ge/ation1 extraut]9e pregnancy 0 z my/]i\s z ! old inflammation ( ! b[els1 :i* turn$ out aft]w>d to be app5dicitis4 ,h5ce common skill 9 ! difficult diagnosis ( ectopic ge/ation c n be look$ =4 ,! doctr9e giv5 9 all ! lead+ m$ical works at pres5t conc]n+ ! treatm5t ( extraut]9e pregnancy is ?is3 #a4 ,z soon z an extraut]9e pregnancy is discov]$ remove ! foetus ?r\gh an op5+ made 9 ! "m's abdom9al wall4 ,d n use electricity or ! injection ( poisons into ! foetal sac1 or ! inc&esc5t knife4 ,emmet & a few o!rs approv$ ( ! use ( electricity at times1 b ?is is aga9/ ! tea*+ ( ! great majority ( writ]s at pres5t4 ,! reason = remov+ ! foetus at once is t x is apt at any mom5t to cause rupture & fatal hemorrhage be=e surgical aid c be effective4 #b4 ,9 a case ( rupture ) free hemorrhage & collapse ! only op]ation advis$ is an imm$iate coeliotomy to /op ! ble$+ by ligatures4 ,! rupture %\ld n be approa*$ ?r\gh ! vag9al wall accord+ to ! common doctr9e1 b ?r\gh ! abdom9al wall4 #c4 ,if !re is a rupture 9 :i* ! ble$+ is conf9$ & !re is no collapse1 d n op]ate at once unless ! haematocele increases /eadily or %[s signs ( suppuration4 ,sometimes evacuation ( ! haematocele ?r\gh ! vag9al wall is possible4 #d4 ,9 ! lat] mon?s ( an extraut]9e pregnancy1 :e!r ! case is intraligam5t\s or abdom9al1 p]=m coeliotomy z soon z ! diagnosis has be5 made1 & remove ! foetus1 because !re is always dang] ( sudd5 & fatal hemorrhage be=e ! surgeon c rea* ! s\rce ( ! ble$+4 ,:at is to be done 9 a case :]e ! surgeon is c]ta9 be=e op]at+ t ! foetus is #aa dead1 has int]e/ only = ! physician1 & x involves no moral "q4 ,op]at+ = extraut]9e pregnancy maybe a simple coeliotomy1 if any coeliotomy is really simple1 b x commonly is ! mo/ dang]\s op]ation = ! "m t ! gynaecologi/ is call$ ^u to p]=m4 ,! discussion ( ! moral que/ions t arise 9 cases ( ectopic ge/ation :i* began 9 volume ix4 ( ! ,am]ican ,ecclesia/ical ,review 0 v valuable1 b z ! morali/s _h n full data to "w on _! decision z a :ole is n satisfactory4 ,! orig9al cases pres5t$ are 9 "p obsolete 9 ! m$ical practice ( to-day1 & important physical conditions 7 n disclos$ 9 "s ( ! o!r p>ts ( ! cases4 ,fa!r ,hola9d t5tatively agre$ ) ,fa!r ,lehmkuhl 9 "o decision1 ,fa!rs ,es*ba* & ,sabetti directly attack$ ,fa!r ,lehmkuhl's reasons1 & ,fa!r ,a]tnys indirectly oppos$ ,fa!r ,sabetti's *ief argum5t4 ,^! m5 are all em95t au?orities1 b z ea*1 except ,fa!r ,hola9d1 0 dissatisfi$ ) ! argum5ts advanc$ by ! o!rs1 & z _! data 7 incomplete1 we c n re/ ! case on _! decision4 ,9 ,fa!r ,hola9d's fif? "q1 if ,i und]/& x correctly1 he seem$ to ?9k x possible to baptize a foetus ?r\gh ! op5+ 9 ! "m's abdom9al wall :ile x lies 9 ! abdom9al cavity be=e surgical removal4 ,he m5tions antiseptic precautions 9 ! baptism1 :i* w\ld h no mean+ if ! foetus 7 out ( ! abdom54 ,baptism w\ld n be possible 9 t case3 ! prie/ c\ld n get at ! foetus1 he ord9>ily c\ld n ev5 see x1 & c]ta9ly no surgeon w\ld p]mit ! attempt4 ,!re w\ld be no "t = ! attempt 9 a rupture case1 ev5 if ! foetus c\ld be se52 & !re w\ld be no advantage ga9$ by baptiz+ ! foetus 9 ! abdom9al cavity :]e ! conditions gave "t to d s4 ,if x is alive x w live long en\gh = baptism aft] removal f ! abdom51 provid$1 ( c\rse1 x is baptiz$ imm$iately 9 ! op]at+ room4 ,t x does n brea! is no pro( ( imm$iate dea?4 ,x is n unusual = a full-t]m *ild n to brea! = ev5 an h\r or long] aft] bir?4 #ab ,if ,fa!r ,hola9d _h n 9 view baptism )9 ! abdom9al cavity1 ! "q has ?is mean+3 ,:at is ! mo/ effective me?od aft] ! foetus has be5 remov$ f ! abdom5 to op5 its envelop+ membranes s z to give x a *ance = a life la/+ long en\gh to all[ baptism8 ,! be/ me?od is to slit ! membranes ) a scalpel or scissors z quickly z possible4 ,! envelopes1 cord1 & plac5ta are ess5tial p>ts ( ! foetus itself1 & !y gr[ f itself1 n f ! "m4 ,!y take ! place ( ! lungs & ! alim5t>y tract1 :i* d n come into action until aft] normal bir?4 ,x w\ld be wor? discuss+ :e!r a baptism on ! intact foetal envelopes is valid1 7 x n t we may n apply probabilism 9 su* a case4 ,! rema9+ matt] br\ght out 9 ,fa!r ,hola9d's que/ions w be consid]$ 9 ! c\rse ( ?is article4 ,be=e pres5t+ ! cases ( ectopic ge/ation t occur 9 m$ical practice1 ! fundam5tal e?ical pr9ciples t are to be appli$ 9 judg+ ! morality ( ! surgeon's int]f]5ce %\ld be giv54 ,! morality ( any action is det]m9$1 7#a7 by ! object ( ! action2 7#b7 by ! circum/ances t accompany ! action2 7#c7 by ! end ! ag5t _h 9 view4 #a4 ,! t]m object has v>i\s mean+s1 b "h x means ! de$ p]=m$ 9 ! action1 ! ?+ :i* ! w *ooses4 ,t de$ by its v nature may be good1 or x may be bad1 or x may be indiff]5t morally4 ,9 !mselves to help ! afflict$ is a good action1 to blaspheme is a bad action1 to walk is an indiff]5t action4 ,"s bad actions are absolutely bad1 !y nev] c become good or indiff]5t 7blasphemy or adult]y1 = example72 o!rs1 z /eal+1 are evil because ( a lack ( "r 9 ! ag5t3 ^! may become good by acquir+ ! miss+ "r4 ,o!rs are evil because ( ! dang] necess>ily connect$ ) _! p]=mance1--! dang] ( s9 connect$ ) !m1 or ! unnecess>y p]il to life4 ,an action to h ! moral quality mu/ be volunt>y1 delib]ate2 & m]e repugnance 9 do+ an act does n 9 itself make ! act involunt>y4 #b4 ,circum/ances sometimes1 ?\gh n always1 c add a #ac new elem5t ( good or evil to an action4 ,! circum/ances ( an action are ! ag5t1 ! object1 ! place 9 :i* ! action is done1 ! means us$1 ! end 9 view1 ! me?od obs]v$ 9 us+ ! means1 ! "t 9 :i* ! de$ is done4 ,if a judge 9 8 (ficial position tells a %]iff to hang a crim9al1 & a private citiz5 gives ! same comm&1 ! actions are v diff]5t morally because ( ! circum/ances ( ! ag5t giv+ ! comm&4 ,! object--x *anges ! morality ( ! de$ if a man /eals a c5t or a ?\s& doll>s4 ,! place--:at might be m]ely a fil?y action 9 a h\se might be a sacrilege 9 a *ur*4 ,! means--to support a family by lab\r or by ?iev]y4 ,! end 9 view--to give alms 9 ob$i5ce to div9e comm& or to give !m to buy votes4 ,! me?od obs]v$ 9 us+ means--k9dly1 say1 or cruelly4 ,! "t--to d manual lab\r on ,sunday or on ,monday4 ,"s circum/ances aggravate ! evil 9 a de$1 "s ext5uate x4 ,o!rs may s col\r a de$ t !y specify ! de$1 make ! action "s special virtue or vice4 ,! circum/ance t a murd]] is ! son ( ! man he kills specifies ! de$ z p>ricide4 ,! end also det]m9es ! morality ( an action 7see ,/ ,?omas1 ,sum4 ,!ol4 ,i4 #b41 q4 xviii41 a4 #d & #g74 ,s9ce ! end is ! fir/ ?+ 9 ! int5tion ( ! ag5t1 he passes f ! object wi%$ = 9 ! end to *oos+ ! means = obta9+ x4 ,)\t ! end ! means c n exi/ z su*4 ,!re are occasions :5 an end is only a circum/ance3 = example1 if x is a concomitant end4 ,:5 an end is a1 f9is extr9secus op]antis1 :5 x is 9 keep+ ) "r reason or discordant !reto1 x may become a det]m9ant ( morality4 ,9 e volunt>y1 or human1 act !re is an int]ior & an ext]ior act ( ! w1 & ea* ( ^! acts has its own object4 ,! end is ! prop] object ( ! int]ior act ( ! w2 ! ext]ior object act$ ^u is ! object ( ! ext]ior act ( ! w2 & z ?is ext]ior act specifies ! morality1 s does ! int]ior object--:i* is ! end--specify x1 & ev5 m importantly ?an ! ext]ior object does4 ,! w uses ! body z an in/rum5t on ! ext]nal #ad object1 & ! action ( ! body is connect$ ) morality only ?r\gh ! w4 ,we judge ! morality ( a bl[1 n by ! physical /roke1 b f ! int5tion ( ! /rik]4 ,! ext]ior object ( ! w is1 9 a way1 ! matt] ( ! morality1 & ! int]ior object ( ! w1 or ! end1 is ! =m4 ,ari/otle 7,e?ics1 lib4 v41 cap4 #b7 says3 ,he t /eals t he may commit adult]y1 is1 absolutely speak+1 m an adult]] ?an a ?ief4 ,! ?iev]y is a means to ! pr9cipal end1 & x is ?is pr9cipal end t *iefly specifies or in=ms ! action4 ,! means us$ to obta9 an end are v important 9 a consid]ation ( ! morality ( an act4 ,!re are f\r classes ( means1--! good1 ! bad1 ! indiff]5t1 & ! excusable4 ,good means may be absolutely good1 b commonly !y are liable to become vitiat$ by circum/ances1--almsgiv+ is an example4 ,"s means are bad always & inexcusable1--ly+1 = example4 ,! excusable means are ^? :i* are bad1 b ju/ifiable ?r\gh circum/ances4 ,to save a man's life by cutt+ (f 8 leg is an excusable means4 ,! exi/5ce ( excusable means :]eby "s good actions are effect$ does n e/abli% ! ass]tion t ! end ju/ifies ! means4 ,! end sometimes may incrim9ate or sanctify indiff]5t means1 b x does n 9 itself ju/ify all means4 ,! means1 l o!r circum/ances1 are accid5ts ( an action1 b !y are 9 an action j z mu* z col\r is 9 a man4 ,col\r is n ( a man's ess5ce1 b y c n h a man )\t col\r4 ,! effect ( an action1 ! result or product ( an effective cause or ag5cy1 may 9 itself be an end or an object or a circum/ance1 & x has influ5ce 9 ! det]m9ation ( morality4 ,sometimes an act has two effects1 "o good & ! o!r bad2 & t su* an action be lawful x is necess>y 7#a7 t ! action itself be good or indiff]5t2 7#b7 t ! good effect be int5d$ & ! evil effect be n int5d$ 7*os57 b only reluctantly p]mitt$2 7#c7 t ! evil effect be n a means to secure ! good effect2 7#d7 t !re be pres5t a motive suffici5tly grave to excuse or c\nt]balance ! bad effect4 #ae ,/4 ,?omas 7,sum4 ,!ol4 #b4 #b4 q4 #fd1 a4 #g7 ,speak+ ( kill+ a man 9 self-def5ce1 says3 ,nihil prohibet unius actus esse duos effectus1 quorum alt] solum sit 9 int5tione1 alius v]o sit praet] int5tionem4 ,morales autem actus recipiunt speciem secundum id quod int5ditur1 non autem ab eo quod e/ praet] int5tionem1 cum sit p] accid5s4 ,t an act1 !re=e1 be morally good1 or ju/ifiable1 7a7 ! :ole tra9 ( ! t5d5cy ( ! w mu/ be good2 t is1 7#a7 ! object1 7#b7 ! end1 7#c7 & ! circum/ances mu/ be good2 or 7b7 ! int5tion %\ld be good1 & ! rema9+ elem5ts 9 ! tra9 ( w-t5d5cy are to be indiff]5t4 ,t an act be morally bad x is en\gh t ! object1 ! end1 or ! circum/ances be inexcusably bad4 ,!re may be hone/ d\bt z to ! exi/5ce ( evil 9 ! circum/ances or ! end1 & "h ent]s ! matt] ( probability2 b ap>t f ?is1 "s g5]al rules ( morality t gov]n all cases may be =mulat$3 #a4 ,an int5tion or end :i* is gravely evil always makes ! entire action evil & unju/ifiable4 #b4 ,an int5tion or end :i* is slightly evil1 if x is ! entire end ( an action1 makes ! :ole action evil b n gravely evil--makes x1 say1 a v5ial s9 & n a mortal s94 #c4 ,if an int5tion or end :i* is v5ially evil accompanies second>ily a good int5tion or end1 & is r a motive ?an ! real effective ag5t 9 attract+ ! w1 ?is v5ial evil does n vitiate ! :ole goodness or righte\sness ( ! ma9 action4 ,comp>e ! rem>ks made above 9 discuss+ an action t has a d\ble effect1 p>tly good & p>tly bad4 #d4 ,circum/ances t are gravely evil practically vitiate ! entire action1 b circum/ances :i* are v5ially evil d n always vitiate ! entire action4 ,mu* might be said "h conc]n+ consci5ce z a judge ( ! morality 9 an act1 b ?is discussion is n necess>y = our pres5t purpose4 ,l o!r m51 physicians (t5 confuse consci5ce ) incl9ation1 or at be/ ) unf\nd$ op9ion4 ,:5 consci5ce is to be a rule ( action x mu/ #af h at ! lea/ moral c]titude2 or1 :at is diff]5t b practically ! same ?+1 ! op9ion ( consci5ce mu/ be at ! lea/ g5u9ely probable4 ,! t]m probable is us$ "h 9 a te*nical s5se1 & x w be s us$ ?r\gh\t ! rema9d] ( ?is article4 ,! doctr9e ( ,probabilism is connect$ ) ! promulgation ( law4 ,a law1 accord+ to ,/4 ,?omas 7op4 cit4 ,i4 #b41 q4 #ij1 a4 #d7 is3 ,ord9atio rationis ad bonum commune ab eo qui curam habet communitatis promulgata4 ,sometimes x is n evid5t :e!r or n a law b9ds 9 a p>ticul> case1 & 9 su* a condition1 t is1 9 :i* !re is "q solely ( ! exi/5ce1 int]pretation1 or application ( a law1 we may foll[ a probable op9ion :i* assures u ! act is licit1 al?\gh ! op9ion :i* says ! act is illicit may be j z probable or ev5 m probable4 ,?is is ! fundam5tal proposition ( ,probabilism1 :i* is ! doctr9e especially ( ,/4 ,alphonsus ,liguori1 b x 0 held c5turies be=e 8 "t4 ,z ! *ur* has nev] condemn$ ?is doctr9e1 b r tacitly approv$ ( x1 ,ca?olics may safely foll[ x1 & ^? t are n ,ca?olics w f9d x v reasonable4 ,a law :i* is d\btful aft] hone/ & capable inve/igation has n be5 suffici5tly promulgat$1 & !re=e x c n impose a c]ta9 obligation because x lacks an ess5tial elem5t ( a law4 ,:5 we h us$ su* moral dilig5ce ( inquiry z ! gravity ( a matt] calls =1 b /ill ! applicability ( ! law is d\btful 9 ! action 9 view1 ! law does n b9d2 & :at a law does n =bid x leaves op54 ,probabilism is n p]missible :5 !re is "q ( ! wor? ( an action z comp>$ ) ano!r1 or ( issues l ! physical consequ5ces ( an act4 ,if a physician kn[s a rem$y = a disease t is c]ta9ly efficaci\s & ano!r t is probably efficaci\s1 he may n *oose ! probable cure1 at ! lea/ 9 a grave illness4 ,probabilism has to d ) ! exi/5ce1 int]pretation1 or applicability ( a law1 z ,i said1 n ) ! diff]5tiation ( actions4 ,! t]m probable means provable1 n guess$ at1 or jump$ at )\t reason4 ,!re mu/ be s\nd reason #ag adduc$ to con/itute probability4 ,! d\bt mu/ be f\nd$ on a positive op9ion aga9/ ! exi/5ce1 int]pretation1 or application ( ! law4 ,x mu/ be m ?an m]e negative d\bt1 m ?an ignorance1 m ?an vague suspicion1 especially mu/ x be m ?an a s5tim5tal impression4 ,!re is a m5tal condition1 :i* easily passes ov] into disease1 :]e9 a man habitually c n make up 8 m9d4 ,?is flabb9ess has no?+ to d ) ,probabilism4 ,! op9ion aga9/ a law to con/itute ,probabilism mu/ be solid4 ,x mu/ re/ ^u an intr9sic reason f ! nature ( ! case1 or an extr9sic reason f au?ority1--always suppos+ ! au?ority cit$ is really an au?ority4 ,_m m5 sitt+ ^u ! supreme b5* 9 ! ,c\rt ( ,sci5ce & call$ au?orities by fri5ds & newspap]s1 are only fools 9 good company4 ,! probability mu/ also be comp>ative4 ,:at seems to be a v good reason :5 /&+ alone may be v weak :5 comp>$ ) a reason on ! o!r side4 ,:5 we h weigh$ ! argum5ts on bo? sides1 & we /ill h good reason left = /&+ by our op9ion1 our op9ion is probable4 ,! probability is1 moreov]1 to be practical4 ,x mu/ h consid]$ all ! circum/ances ( ! case4 ,! pr9ciples pres5t$ "h h be5 arrang$1 z we said1 ) a view t[>d application 9 judg+ ! morality ( actions t may occur 9 cases ( ectopic ge/ation1 & we %all apply ! doctr9e ( probabilism 9 ! "q1 does ! comm&m5t ,?\ %alt n kill b9d 9 c]ta9 cases ( ectopic pregnancy8 ,x is also necess>y to add ! pr9ciples und]ly+ our duty to pres]ve human life4 #a4 ,x is nev] lawful directly or indirectly to kill an innoc5t man4 ,insontem et ju/um non occides 7,exod4 xxiii4 #g74 ,an innoc5t man is "o t has n by any human act done h>m to ano!r man or to society comm5surate ) ! loss ( 8 life4 ,directly means to kill ei!r z an end1 say1 = rev5ge1 or z a means t[>d an end4 ,a man is a p]son1 an intellig5t be+1 !re=e free1 & autoc5tric2 he belongs to no "o except to ,god1 :o made #ah him2 he is by t v fact di/+ui%$ f brutes or ?+s :i* may belong to ano!r4 ,n[1 if y kill a man1 y de/roy 8 human nature by sep>at+ 8 s\l & body1 y subord9ate & sacrifice him :olly to y\rself1 make him entirely y\rs1 :i* is unju/4 ,ev5 ! /ate has no "r to kill an innoc5t man4 ,a foetus 9 ! womb1 only a few h\rs old1 is z mu* a human be+ z a man fifty ye>s ( age1 & ?is natural law holds = ! foetus z = ! man4 #b4 ,x is1 h[ev]1 lawful indirectly to kill a man provid$ ?is man is an unju/ aggressor4 ,c>d9al de ,lugo 7,de ,j4 et ,jure1 #aj1 #adi7 & o!rs hold y may ev5 directly kill an unju/ aggressor4 ,indirectly "h means incid5tally4 ,an effect happ5s indirectly :5 x is nei!r int5d$ z an end nor a means1 b happ5s z a circum/ance unavoidably atta*$ to ! end or means int5d$4 ,we may n1 h[ev]1 kill an innoc5t man ev5 indirectly1 because no end is proportionate to ! sacrifice ( an innoc5t man's life1 b ! case ( an unju/ aggressor diff]s f t ( an innoc5t man4 ,by an unju/ aggressor is meant "s "o t outside ! due c\rse ( law ?reat5s y\r life or ! equival5t ( y\r life1 or ! life ( "s "o y %\ld or may protect4 ,y may /op su* an aggressor1 & if y happ5 to kill him :ile try+ to /op him1 !re is no moral wrong involv$4 ,?is aggressor may be =mally or only mat]ially unju/3 he may be a normal man ) a =mal int5tion to kill y or y\r w>d1 or a murd]\s lunatic t tries to kill y or y\r w>d1 b he mu/ be unju/ ei!r =mally or mat]ially4 ,x is natural = e be+ to ma9ta9 itself 9 exi/5ce1 to resi/ de/ruction4 ,?is is a prim>y law ( nature4 ,z ,fa!r ,hola9d well said 7,am]4 ,eccl4 ,rev41 ,janu>y1 #ahid73 ,! e?ical f\ndation ( self-def5ce is ?is3 ,ju/ice requires a sort ( moral equation1 & if a "r prevails x mu/ be sup]ior to ! "r :i* x holds 9 abeyance4 ,at ! outset bo? ! aggressor & 8 int5d$ victim h equal rights to life1 b ! fact ( ! =m] us+ 8 own life = ! de/ruction ( a fell[ man places him 9 a condition ( juridic inf]iority ) reg>d to ! latt]4 ,if we may be #ai all[$ s to express x1 ! moral p[] ( ! aggressor is equal to 8 inborn "r to life1 less ! unrighte\s use :i* he makes ( x1 :il/ ! moral p[] ( ! int5d$ victim rema9s 9 its integrity & has consequ5tly a high] juridic value4 ,:5 ! p]son assail$ _c def5d himself1 8 "r c & sometimes mu/ be ex]cis$ by ^? :o are b\nd 9 ju/ice or *>ity to protect ! innoc5t4 ,at ! dawn ( human life ! physician or surgeon /&s z ! natural protector bo? ( ! "m & ( ! *ild2 he is behold5 to bo?4 ,! "r ( self-def5ce is n annull$ by ! fact t ! aggressor is irresponsible4 ,! abs5ce ( k saves him f moral guilt1 b x does n alt] ! "* ( ! act1 consid]$ objectively & 9 itself2 x is yet an unju/ aggression1 & 9 ! conflict1 ! life assail$ has yet a sup]ior juridic value4 ,! "r ( kill+ 9 self-def5ce is n bas$ on ! ill w ( ! aggressor b on ! illegitimate "* ( ! aggression4 ,n[1 an aggressor is at lea/ mat]ially unju/ :5ev] he p]petrates an act de/ructive ( ! "r ( ano!r4 ,m>k ! words "r ( ano!r1 at ! end ( ! quotation4 ,9 a case ( pregnancy at t]m 9 a woman ) a contract$ pelvis ! foetus w\ld be a contribut+ in/rum5t ( dea? to ! "m1 suppos+ !re 7 no artificial means ( deliv]+ h]1 b su* a *ild is n an aggressor ev5 mat]ially unju/4 ,! *ild itself is normal1 x has a natural "r to be :]e x is1 x did n put itself :]e x is2 ! "m's contract+ ut]us cru%+ ! *ild aga9/ h] n>r[ pelvic ar* is ! direct ag5cy t kills ! woman1 & ! *ild is only an in]t in/rum5t us$ by ! contract+ ut]us4 ,9 su* a case ! "m might be consid]$ an aggressor mat]ially unju/ aga9/ ! life ( ! *ild r ?an t ! *ild is ! aggressor4 ,lehmkuhl 7,comp5dium ,!ologiae ,moralis1 #ahia1 p4 #bch7 says3 ,m$icus gravit] peccat 444 si m$ia abortus procurat3 nisi qu&o ad salv&am matrem ex probabili op9ione liceat4 ,on page #ahh he says3 ,ex consulto abortum induc]e1 etiam lic]i videtur 9 praes5ti vitae #bj mat]nae discrim9e1 quod p] solam foetus immaturi ejectionem av]t6 possit 4 4 4 ,idque videtur applic>i posse ad matrem quae t>n arcta e/ ut tempus praematuri p>tus exspect>e non possit4 ,by foetus immaturus "h he means an unviable foetus1 z is evid5t f ! context4 ,if ?is probabilism ( ,fa!r ,lehmkuhl's /&s 7b x does n71 a decision 9 mo/ ( ! cases t occur 9 ectopic ge/ation w\ld be easily made1 b ev5 he himself w\ld n take responsibility 9 ! matt]1 & t be=e ! decision ( ! ,holy ,(fice :i* def9$ abortion4 ,s9ce ?is decision1 made ,july #bd1 #ahie1 ,lehmkuhl has entirely )drawn 8 op9ion4 ,on ,may #d1 #ahih1 ! ,holy ,(fice publi%$ ! foll[+ decree1 :i* 0 approv$ by ! ,pope3 ,,beatissime ,,pat]1--,episcopus ,s9alo54 ad p$es ,s4 ,v4 provolutus1 humilit] petit resolutionem insequ5tium dubiorum3 ,i4 ,eritne licita p>tus accel]atio quoties ex muli]is arctitud9e impossibilis evad]et foetus egressio suo naturali tempore8 ,,ii4 ,et si muli]is arctitudo talis sit1 ut neque p>tus prematurus possibilis c5seatur1 licebitne abortum provoc>e aut caes>iam suo tempore p]fic]e op]ationem8 ,,iii4 ,e/ne licita lap>otomia qu&o agitur de pregnatione extra-ut]9a1 seu de ectopicis conceptibus8 ,f]ia iv1 die #d ,mali1 #ahih4 ,9 ,congregatione habita1 etc 4 4 4 ,,ee4 ac ,,rr4 ,patres rescrib5dum c5su]unt3 ,ad ,i4 ,p>tus accel]ationem p] se illicitam non esse1 duromodo p]ficiatur ju/is de causis et eo tempore ac modis1 quibus ex ord9>iis cont+5tibus matris et foetus vitae consulatur4 ,ad ,,ii4 ,quoad primam p>tem1 negative1 juxta decretum1 ,f]ia iv41 #bd ,julii1 #ahie1 de abortus illiceitate4--,ad secundam v]o quod spectat3 nihil ob/>e quom9us muli] de qua agitur caes>eae op]ationi suo tempore subjiciatur4 ,ad ,,iii4 ,necessitate cog5te1 licitam esse lap>otomiam ad extra-h5dos e s9u matris ectopicos conceptos1 dummodo et foetus et matris vitae1 quantum fi]i pote/1 s]io et opportune provideatur4 ,9 sequ5ti ,f]ia vi41 die #f ejusdem m5sis et anni 4 4 4 ,s,smus responsiones ,,ee4 ac ,,rr4 ,patrum approbavit4 #ba ,! ?ird "q propos$ by ! bi%op is3 ,is lap>otomy licit :5 p]=m$ = extraut]9e pregnancy or ectopic ge/ation8 ,! approv$ answ] ( ! ,holy ,(fice to ?is "q is3 ,9 a case ( necessity1 lap>otomy = ! purpose ( remov+ an ectopic foetus 7conceptus7 f ! abdom5 ( ! "m is licit1 provid$ ! lives ( bo? ! foetus & ! "m1 z f> z is possible1 are c>efully & fitly gu>d$4 ,! expression1 dummodo et foetus et matris vitae1 quantum fi]i pote/1 s]io et opportune provideatur1 is capable ( v>i\s translations & int]pretations4 ,! words might h ?is mean+3 ,9 a case ( necessity y may d lap>otomy & remove an ectopic ge/ation1 provid$ y d n kill ei!r ! "m or ! foetus4 ,if t is ! int]pretation1 ! decree means t we may nev] remove an unviable ectopic foetus :5 we "k t ! foetus is alive1 because removal w kill x4 ,! s5t5ce c also be translat$ 9 ?is s5se3 ,9 a case ( necessity1 y may d lap>otomy & remove an ectopic foetus f ! "m1 provid$ y take full c>e to save "m & *ild if t is possible4 ,if t is ! signification1 x is evid5tly v diff]5t f ! fir/ int]pretation4 ,x w\ld mean3 d ! lap>otomy1 remove ! foetus1 & if y possibly c save bo? "m & foetus d s1 b if y c n1 take ! be/ means y c to save "o or ! o!r4 ,if ! decree ref]s only to cases 9 :i* ! foetus is viable1 x w\ld appe> to be unnecess>y--we ne$ no decree ( ! ,holy ,(fice to let u d a lap>otomy to remove a viable foetus4 ,if x does n ref] to a viable foetus1 x ref]s to an unviable foetus1 b to remove an unviable foetus is to ei!r kill x or to ha/5 its dea?4 ,g5icot 7,in/itutiones ,!ologiae ,moralis1 ,l\va91 #aijb1 vol4 i4 p4 #ceh7 has ?is int]pretation ( ! decree3 ,9 conceptione extra-ut]9a licebit sane recurr]e ad lap>otomiam similemve op]ationem1 qu&o aliqua etiam t5uissima spes affulget salv&i infantem1 simul ac mat] f]e c]to lib]abitur4 4 4 4 ,ubi v]o nulla spes hujusmodi #bb affulget1 neque 9 hoc casu licebit abortum directe induc]e1 etiamsi foetus c]to moriturus sit antequam 9 lucem edatur1 et baptismum recip]e nequeat4 ,et5im ,s4 ,inqu41 dum provocat ad responsum #ai ,augu/1 #ahhh1 satis indicat abortus inductionem a se hab]i tamquam op]ationem directe occisivam foetus ideoque semp] illicitam4 ,!re is no "q ( an abortion 9 a lap>otomy = extraut]9e ge/ation2 abortion is altoge!r a diff]5t op]ation 9 me?od & nature4 ,secondly1 ! o!r decree ( ! ,holy ,(fice to :i* he ref]s speaks ( a direct kill+ ( ! foetus1 b !re is no direct kill+ ( ! foetus 9 ! op]ation = ectopic ge/ation1 nor is ! indirect ha/5+ ( ! foetus's dea? a means to an end4 ,! decree on abortion is s cle> x leaves no room = d\bt4 ,c>d9al ,monaco1 9 ! ,epi/ola ad ,ar*iepiscopum ,cam>c5sem1 ,augu/ #ai1 #ahhi1 says ! ,holy ,(fice decre$ t ,9 s*olis ca?olicis tuto doc]i non posse licitam esse op]ationem *irurgicam quam craniotomiam appellant1 sicut decl>atum fuit die #bh ,maii1 #ahhd1 et quamcumque *irurgicam op]ationem directe occisivam foetus vel matris ge/antis4 ,note ! words directe occisivam4 ,craniotomy is a direct kill+1 & a direct kill+ us$ z a means to an end2 moreov] x is an altoge!r unnecess>y kill+4 ,artificial abortion 9 ! case ( an unviable foetus is also a direct kill+ z a means to save ! "m's life1 b ! removal ( an unviable ectopic foetus is nei!r a direct kill+1 nor is x a means t[>d any end4 ,s9ce ! mean+ ( ! decree conc]n+ lap>otomy 9 extraut]9e pregnancy is by no means cle>1 we may discuss ! "q until ! law has be5 fully promulgat$1 ready to con=m to ! real mean+ ( ! decree :5ev] x is expla9$4 ,9 t _s we may n[ consid] ! cases t occur 9 ectopic ge/ation4 ,case ,i4 ,a surgeon is call$ 9 to treat a woman & he f9ds h] 9 a /ate ( collapse4 ,he makes a diagnosis ( tubal pregnancy1 :i* has gone on to rupture ) hemorrhage1 & ! ble$+ w evid5tly be fatal to ! "m unless x is *eck$4 ,practically ! only *ance ( sav+ ! #bc "m's life is coeliotomy & ! ligation ( h] op5 art]ies4 ,dr4 ,h[>d ,kelly 7,op]ative ,gynaecology1 vol4 ii4 p4 #dcg7 says3 ,:5 ! hemorrhage is sudd5 & excessive ! pati5t falls 9 collapse2 b1 9 spite ( ^! al>m+ symptoms1 %e may survive a succession ( simil> attacks & ! foetus & sac may cont9ue to develop4 ,?is exception complicates ! case slightly4 ,if ! surgeon 7 absolutely c]ta9 t ! only possible *ance to save ! woman's life is coeliotomy & haemo/asis1 ! case w\ld be some:at diff]5t f "o 9 :i* !re is "s *ance ( escape by spontane\s haemo/asis4 ,t *ance1 h[ev]1 is s slight1 & s f> beyond any means we h = =eca/+1 t x is m]e luck1 & x is to be neglect$4 ,! surgeon may safely consid] ! pati5t 9 ! grave/ actual dang]4 7a7 ,be=e he op5s ! abdom5 he c n tell :e!r ! foetus is alive or n2 b ! /rong] probability is t x is n1 & ! c]ta9ty is t x has no *ance at all to rema9 alive m ?an a few m9utes or h\rs1 unless ! surgeon is will+ to tru/ to %e] luck 9 ! expectation t he may happ5 to h "o ( ,dr4 ,kelly's exceptions be=e him4 7b7 ,! op]ation to save ! "m is ?is3 z quickly z possible he makes a v]tical slit f f\r to six in*es long ?r\gh ! woman's belly-wall4 ,!n commonly ! free blood beg9s to run out1 or x may ev5 spurt out "s feet into ! air4 ,! surgeon c see no?+ = ! blood & ! pres5ce ( ! entrails4 ,if ! blood is n fre%ly well+ up he bails x out ) 8 h&s or a ladle2 if x is spurt+ he at once ?ru/s 9 8 h&1 feels = ! foetal sac1 lifts x up1 & puts on clamps ne> ! ut]us on "o side & ne> ! pelvic brim on ! o!r4 ,?is /ops ! hemorrhage1 & he c !n "w m leisurely1 b un=tunately ?is also /ops ! fl[ ( blood to ! foetus4 ,he c n fir/ exam9e ! foetus & !n /op ! hemorrhage4 ,he c n back out ev5 if he f9ds a live foetus )\t lett+ ! "m die on ! table4 7c7 ,if ! plac5ta is already loose f ! ,fallopian tube ! *ild is dead or x w die 9 a few seconds or m9utes4 ,if x 0 n loose ! lift+ out may te> x loose1 & ?is #bd te>+ loose w ha/5 ! dea? ( ! foetus a few m9utes 7b give a *ance = baptis+ x74 7d7 ,if ! lift+ out does n te> loose ! suppos$ly fix$ plac5ta1 ! foetus ei!r w die anyh[ if ! "m dies1 or x w die if ! "m lives1 because to save h] ! surgeon mu/ put ligatures j :]e ! fl[ ( blood w be %ut (f f ! foetus4 ,commonly !re is no "t to ev5 look = ! foetus until aft] ! mat]nal art]ies h be5 clos$4 7e7 ,! same conditions c\ld exi/ 9 ! rupture ( a pregnancy 9 a rudim5t>y ut]9e horn z 9 a rupture 9 tubal ge/ation4 ,:at is ! surgeon to d 9 a case l ?is8 ,fa!rs ,hola9d 7,am]4 ,eccl4 ,rev41 ,janu>y1 #ahid1 9 a note on p4 #ci71 ,lehmkuhl & ,sabetti say3 d coeliotomy1 ligate ! "m's art]ies1 remove & baptise ! foetus4 ,! analysis ( ! case is ?is3 7i7 ,! action is ! /opp+ ( a fatal hemorrhage 9 a woman1 & possibly1 ?\gh n c]ta9ly1 an indirect incid5tal ha/5+ ( a foetus's inevitable dea?4 7#b7 ,! object ( ! action is ! haemo/asis1 :i* is good1 & ! possible indirect ha/5+ ( ! foetus's dea?1 :i* is evil1 b1 z we %all see1 excusable evil4 7#c7 ,! end ( ! action is to save ! "m's life--a good end4 7#d7 ,! circum/ances are3 7a7 t possibly1 ?r\gh m]e luck1 ! woman's condition is n necess>ily hopeless3 a few wom5 h escap$ 9 ?is seem+ly imm95t p]il--b t *ance ( escape is n s\ndly probable2 ! /rong] probability by f> is on ! side ( a fatal issue2 !re=e ! *ance = escape may be neglect$1 & ! woman's case may be reg>d$ z hopeless if op]ation is =egone4 7b7 ,! quicke/ possible "w on ! surgeon's "p is necess>y1 & !re is no "t or *ance to exam9e ! foetus's condition be=e ty+ ! mat]nal art]ies4 ,be=e he op5s ! "m's abdom5 he c tell no?+ :atev] ( ! foetus's condition1 b ! probability is all 9 fav\r ( ! fact t ! foetus is already dead or moribund4 7c7 ,! means are coeliotomy1 & ! ligation ( ! #be ut]9e & ov>ian art]ies to /op ! "m's ble$+4 ,?is ligation1 9 ! cont+5cy t ! foetus is /ill atta*$ to ! ,fallopian tube1 w also %ut (f ! blood f ! foetus1 yet ! unc]ta9 %utt+ (f ( ! foetal blood-supply is n int5d$ by ! surgeon z a means t[>d 8 end 9 any degree direct or indirect1 b x is an evil circum/ance associat$ ) ! action :i* may ha/5 ! foetal dea?--ev5 "h ! ha/5+ is unc]ta94 7#e7 ,! action has two effects1--"o1 ! sav+ ( ! "m1 is directly int5d$ & evid5tly good2 ! o!r1 ! possible indirect ha/5+ ( ! foetus's dea?1 may or may n be evil4 ,! moral c5tre ( ! :ole case is ?is possible ha/5+ ( ! foetus's dea?4 ,if t possible ha/5+ is licit ! :ole action is licit2 if x is n p]missible x w vitiate ! entire action4 ,suppose t !re is no d\bt t ! ligation ( ! mat]nal art]ies 9 ?is case really ha/5s ! foetus's dea? "s m9utes3 x w\ld /ill be an indirect volition4 ,fa!r ,lehmkuhl also calls x indirect & licit4 ,fa!r ,sabetti d5i$ t x is indirect1 b he held t x is licit = ano!r reason4 ,sabetti said 7,an]4 ,eccl4 ,rev41 ,augu/1 #ahid73 ,x is evid5tly false to say t a means :i* is directly adopt$ = obta9+ an end is only indirectly conta9$ 9 ! int5tion ( ! ag5t :o s adopts x4 ,t is true1 b ! m9or proposition 9 a syllogism drawn f t /atem5t is to be emphatically d5i$4 ,! cutt+ (f ( ! foetal blood is a fact associat$ ) ! means1 n a means direct or indirect t[>d ! end1 :i* is to save ! "m--! means to save ! "m is ! /opp+ ( h] ble$+4 ,?is is n hair-splitt+ 9 ! opprobri\s s5se ( t t]m4 ,! bases ( all s9s are absolutely ab/ract pr9ciples1 & because ab/ract pr9ciples c n be p9*$ or weigh$1 !y h (t5 little mean+ = ! opposition 9 an argum5t4 ,!re is only ! wid? ( a hair betwe5 ,heav5 & ,hell at _m places along ! fronti]1 & !re is only ! diff]5ce betwe5 a direct or an indirect volition sep>at+ murd] & a good de$4 ,! be/ e?ics frequ5tly consi/s 9 delicate hair-splitt+2 & despite ! prote/s ( s5tim5tali/s1 "o ( ! mo/ valuable b5efits ( ,moral ,sci5ce is #bf to %[ u h[ to h&le moral poisons = good purposes1 z a physician uses ! mat]ial poisons1 opium & aconite4 ,if ! foetus 9 ?is case ( rupture 9 ectopic ge/ation 7 a mat]ially unju/ aggressor on ! "m's life1 ! indirect ha/5+ ( its dea? w\ld be ju/ifiable accord+ to all morali/s1 & ! direct ha/5+ w\ld be licit accord+ to ,c>d9al de ,lugo1 :o 01 9 ! op9ion ( ,/4 ,alphonsus1 po/ ,d4 ,?omam int] alios !ologos facile pr9ceps 7,?4 ,mor41 lib4 #d4 n4 #eeb74 ,sabetti held t ! foetus is a mat]ially unju/ aggressor4 ,8 reason = ?is op9ion is t ! extraut]9e foetus is n 9 a position 9 :i* x has a "r to be4 ,if x 7 9 ! ut]us1 its natural position1 x w\ld h a "r to its position4 ,ectopic ge/ation is a disease1 n a physiological condition4 ,fa!r ,a]tnys 7,am]4 ,eccl1 ,rev41 ,july1 #ahic7 d5ies t ! foetus is an aggressor mat]ially unju/4 ,he says3 ,nequaquam enim mortem int5tat matri1 s$ actione1 quam non ipse s$ corpus matris producit1 conatur ad lucem p]v5ire1 et i/e conatus non nisi ex naturali concursu r]um fit matri causa mortis4 ,infans ergo non e/ aggressor et multo m9us e/ aggressor inju/us4 ,h9c nego p>itatem cum hom9e m5te capto1 qui delirans alt]i mortem int5tat2 hic enim agit motus a sua voluntate1 licet absque culpa1 et ponit actiones 9 se inju/as1 utpote ad nec&um directe int5tas4 ,9 ! same p]iodical 7,janu>y1 #ahid7 :ile repeat+ ?is /atem5t he says3 ,sive 9 ut]o exi/at sive alibi reconditus sit sc4 foetus1 nequaquam mortem int5tat matri1 siquidem non ipse actione propria conatur egr$i1 s$ corpus matris infantem expellit et haec expulsio a matre emanans fit matri causa mortis4 ,:at ,fa!r ,a]tnys says 9 ^! two passages is true ( an intraut]9e foetus1 b x is altoge!r errone\s :5 appli$ to an extraut]9e foetus1 ( :i* alone !re is "q "h4 ,9 extraut]9e pregnancy ! ut]us or any o!r "p ( ! mat]nal body does n try to expel ! foetus2 ! ut]us has no?+ at all to d ) ! case--! v "n ( ! condition is extra-ut]9e pregnancy4 ,if an ectopic ge/ation #bg goes on to t]m 7a v r>e happ5+71 !re w be false lab\r & ut]9e contractions1 & ^! cease aft] a "t )\t effect "o way or ! o!r2 b 9 all cases ( rupture & ! l ! ut]us is outside ! "q & ! "m is passive4 ,!re is no attempt by ! "m 9 extraut]9e pregnancy at expulsion ei!r be=e rupture or at any o!r "t unless ! dead foetus putrefies1 & ! mat]nal tissues try to expel x z a =eign body by break+ d[n into an abscess4 ,! foetus simply gr[s1 & its bulk bur/s ! tube4 ,if x 7 9 ! ut]us1 ! ut]us w\ld enl>ge syn*ron\sly ) ! foetus & !re w\ld be no rupture1 b ! tube w n give beyond a c]ta9 po9t1 !re=e x bur/s4 ,9 normal ut]9e pregnancy at t]m ! ut]us & o!r mat]nal muscles are ! active factors 9 expell+ ! foetus--! foetus is passive4 ,9 ectopic ge/ation ! foetus is active1 ! "m is passive1 & !re is no attempt at expulsion f ei!r side4 ,9 ?is case ! foetus 9 ! tube ?r\gh ! action ( its own vital pr9ciple draws n\ri%m5t f ! "m & gr[s gradually l>g] till x bur/s ! tube 7x may ev5 move its arms & legs if advanc$71 & ?is rupture te>s op5 art]ies :]e?r\gh ! "m ble$s1 commonly to dea?4 ,?is is evid5tly mat]ial aggression4 ,fa!r ,a]tnys says ! foetus diff]s f ! murd]\s lunatic 9 ?is1 t ! madman is mov$ by 8 w1 al?\gh blamelessly1 9 do+ unju/ actions directly int5d$ z homicidal4 ,! fact t ! lunatic uses 8 w has no weight :atev] 9 p]mitt+ me to def5d my life aga9/ him1 x is an accid5tal ?+ outside ! "q2 b ,fa!r ,a]tnys 9 m5tion+ ! madman's w means solely1 if ,i und]/& him1 t ! madman is really an active aggressor4 ,! foetus1 h[ev]1 is also an active aggressor )\t us+ its w4 ,i might fall f a height t[>d a man & c]ta9ly endang] 8 life :ile ,i 0 n us+ my w at all1 n consci\s ( ! man's pres5ce "u me1 or ev5 :ile ,i 0 us+ all ! p[] ( my w aga9/ ! result4 ,9 any ( ^! cases ,i %\ld be a mat]ially unju/ aggressor2 & if 9 try+ to prev5t my body f kill+ him ! man kill$ me1 he w\ld be blameless4 #bh ,n[1 9 ! fir/ place1 ! tubal foetus is an aggressor2 & s9ce1 secondly1 its position is unnatural1 mon/r\s1 a disease1 a ?+ n int5d$ by nature1 x has no "r to its position1 & x is !re=e a mat]ially unju/ aggressor4 ,s9ce x is an aggressor on ! v life ( ! "m 9 a place :]e x %\ld n be1 ! surgeon !re=e may at ! lea/ /op ! fatal ble$+ x causes4 ,if ! foetus dies z an unwi%$ =1 ?\gh p]mitt$1 consequ5ce ( ?is haemo/asis1 ! surgeon may lam5t ?is result1 b he is blameless4 ,! foetus 0 block$ 9 its unnatural position ?r\gh a defect 9 ! "m1 nev]!less x rema9s a mat]ially unju/ aggressor4 ,if ,i by an accid5tal bl[ _h made a man insane1 & lat] ?is lunatic tri$ to kill me1 ,i1 or my legitimate protector1 might lawfully kill ! lunatic 9 def5ce ( my life4 ,?is is an exact p>allel to ! case ( ! "m & ! extraut]9e foetus4 ,! extraut]9e foetus is n l a foetus 9 a craniotomy case4 ,:]e !re might be "q ( craniotomy ! foetus is n an unju/ aggressor ev5 mat]ially1 z has be5 said3 fir/1 because x is n an aggressor 9 any mann]1 x is altoge!r passive2 secondly1 x has a p]fectly natural "r to be :]e x is4 ,9 ectopic ge/ation ) fatal rupture ! foetus is1 fir/1 an active aggressor2 secondly1 x has no "r to be :]e x is4 ,9 craniotomy ! foetus is kill$ z a direct means t[>d ! end t its head may be r$uc$ & extract$ & ! "m sav$2 9 extraut]9e ge/ation ) fatal rupture ! foetus is incid5tally kill$ z a consequ5ce ( ! haemo/asis1 & n z a means 9 any s5se ( ! t]m4 ,9 craniotomy ! *ild is wantonly kill$ s9ce !re are o!r means ( sav+ ! "m2 9 extraut]9e pregnancy ) fatal rupture ! ha/5+ ( ! dea? ( ! *ild is un=tunately associat$ ) ! only possible means we h to save ! "m4 ,9 ,case ,i41 !re=e1 we h an action t has an object p>tly good & p>tly1 v probably1 n evil2 ! end int5d$ is good2 ! circum/ances are ju/ifiable or indiff]5t2 consequ5tly 9 ,case ,i4 ! surgeon may d coeliotomy1 tie ! ut]9e & ov>ian art]ies1 & if ! foetus #bi happ5s to be alive he may reluctantly & indirectly p]mit ! ha/5+ ( its dea? aft] attempt+ to baptise x4 ,case ,,ii4 ,! conditions pres5t$ 9 ,case ,i4 are ! ord9>y & mo/ common t ! surgeon meets ) 9 treat+ ectopic ge/ation1 b o!r conditions may be f\nd4 ,suppose ! surgeon1 be=e op]ation1 diagnoses a case ( ectopic ge/ation1 b t he c n tell :e!r or n ! foetus is alive4 ,! probability leans t[>d ! side t ! foetus is alive1 because !re is no indubitable hi/ory1 z physicians say1 ( mat]nal symptoms t indicate rupture4 ,m$ical au?orities tell him to d coeliotomy at once1 ligate ! ut]9e & ov>ian art]ies1 & remove ! foetus4 ,w\ld he c]ta9ly or probably be ju/ifi$ 9 foll[+ out ?is m$ical doctr9e8 ,! "m is 9 actual1 v probable dang] ( dea?1 b n 9 actual1 c]ta9 dang] ( dea?4 ,%e may possibly escape if op]ation is def]r$2 %e has a negligible *ance ( escape if no op]ation is p]=m$ aft] ! dea? ( ! foetus2 coeliotomy & ligation ( ! ut]9e & ov>ian art]ies give h] by f> ! sure/ *ance ( escape1 s sure an opportunity = escape :5 p]=m$ e>ly t x c sc>cely be call$ a m]e *ance4 ,if op]ation is def]r$ ! *ances = rupture are ab\t #bb p] c5tum1 say1 "o & a half 9 five *ances1 & all ruptures are n necess>ily fatal4 ,! *ances ( ! "m's dea?1 h[ev]1 are mu* high] ?an t1 because dea? c come 9 ectopic pregnancy f causes o!r ?an rupture4 ,f #fc4a to #fh4h p] c5tum 7say1 #ff4c p] c5tum7 ( ectopic ge/ations treat$ by ! expectant me?od result 9 dea? to ! "m--j two-?irds ( ! wom5 die4 ,a4 ,m>t9 9 a s]ies ( #bfe cases ( ectopic ge/ation :]e ! expectant treatm5t 0 employ$ f\nd a mat]nal mortality ( #fc4a p] c5tum2 ,p>ry 9 #ejj simil> cases f\nd a mortality ( #fg4b p] c5tum2 & ,s*auta 9 #bda cases a mortality ( #fh4h p] c5tum4 ,9 ! #hg ye>s betwe5 #ahji & #ahif1 #gg cases ( coeliotomy = ! deliv]y ( viable ectopic foetuses 7 report$ #cj 9 all m$ical lit]ature ) a mat]nal mortality ( ab\t #eh4c p] c5tum4 ,betwe5 #ahji & #ahhh !re 7 #cg coeliotomies ) a mat]nal mortality ( #hf4e p] c5tum4 ,betwe5 #ahhi & #ahif !re 7 #dj su* op]ations1 ) a mat]nal mortality r$uc$ to #cb4e p] c5tum by mod]n surgical me?ods4 ,! results z reg>ds ! *ildr5 7 almo/ ! same 9 ! two s]ies1 & p]haps a little bett] 9 ! latt] s]ies4 ,9 ! fir/ s]ies ! #cg *ildr5 7 alive at deliv]y3 ! l5g? ( "t 9 :i* ?ree ( ^! *ildr5 liv$ is n giv52 ?ree m 7 alive b !y did n brea!2 ! o!rs liv$ f a few seconds to days1 weeks1 mon?s or ye>s4 ,"o 0 well at six mon?s1 ano!r at "o ye>1 ano!r at sev5 & a half ye>s1 ano!r 9 its f\rte5? ye>1 ano!r 9 its fifte5? ye>4 ,9 ! second s]ies ! results z reg>ds ! *ildr5 71 z has be5 said1 almo/ ! same4 ,! #dj cases t 7 report$ f #ahhi to #ahif are ! /&>d = ?is phase ( ectopic ge/ation1 because !y come "u ! diagnosis & treatm5t ( ! pres5t day4 ,!y repres5t closely all su* cases t occurr$ 9 ! entire _w betwe5 #ahhi & #ahif1 because physicians report ^! op]ations to m$ical societies1 & active physicians are almo/ )\t exception memb]s ( su* societies--outside ! civilis$ _w ^! op]ations d n take place4 ,9 ! sev5 ye>s !re 7 annually less ?an six cases ( coeliotomy = ectopic ge/ation at t]m 9 ! _w1 !re=e op]ations at t]m may be neglect$ 9 discuss+ ,case ,,ii41 & ! argum5t may be conf9$ to ! ord9>y cases ( expectant treatm5t4 ,s*r5ck 9 #ahib collect$ #faj cases ( ectopic ge/ation :i* _h be5 report$ betwe5 #ahhg & #ahib2 dur+ ! same "t !re 7 #bc cases 7less ?an #d p] c5tum7 ( op]ations = ! deliv]y ( viable foetuses4 ,if ! physician t has made ! diagnosis 9 ?is ,case ,,ii4 leaves ! pati5t1 %e may h a fatal hemorrhage at any mom5t4 ,dr4 ,h[>d ,kelly reports 7,op]ative ,gynaecology1 vol4 ii4 p4 #dch7 a fatal hemorrhage 9 two days f rupture :]e ! foetus 0 only z l>ge z a ,lima bean4 ,! hemorrhage may be s sudd5ly fatal t ! woman drops #ca to ! floor unconsci\s j z if %e _h be5 %ot4 ,dr4 ,h>ris 7,int]national ,cyclop4 ( ,surg]y1 vol4 vi4 p4 #ghd7 tells ( a case :]e ?ree ( ! be/ ob/etricians 9 ,philadelphia met 9 consultation daily = #af days expectantly wat*+ developm5t1 b ! woman di$ f hemorrhage 9 ?irty m9utes be=e any ( ^! physicians c\ld be call$ to h] aid4 ,dea? may be br\ght ab\t by anaemia aft] repeat$ hemorrhages4 ,"s hemorrhages c be mi/ak5 = colic by ! physician1 & ?is error w def] until too late ! treatm5t = hemorrhage4 ,if ! woman is liv+ 9 a hospital :]e !re is a resid5t surgeon ) in/rum5ts ready1 %e has a bett] *ance ?an if %e is 9 h] own h\se4 ,ev5 if %e has a surgeon )9 call ! outcome ( ! case = h] w dep5d l>gely on 8 skill1 8 pres5ce ( m9d1 ! prep>$ness ( 8 in/rum5ts1 ! g5]al condition ( ! pati5t1 & _m o!r circum/ances4 ,! in/rum5ts1 ligatures1 gauzes1 solutions1 dress+1 etc41 = coeliotomy are multitud9\s1 & all mu/ be /]ile1 or ! woman w be kill$ by septicaemia ev5 if ! hemorrhage is /opp$4 ,x is almo/ impossible to keep a set ( in/rum5ts & ! o!r ?+s us$ 9 a coeliotomy always /]ile & ready = in/ant use4 ,! sk9 surface ( ! pati5t's abdom5 mu/ be /]ilis$1 or pus infection w get into ! p]itoneum ?r\gh ! w\nd4 ,9 all ord9>y coeliotomies ?is surface is c>efully /]ilis$ by a long process ! night be=e ! op]ation1 a protective dress+ is put on1 & ! /]ilisation is repeat$ ! next day j be=e ! op]ation4 ,?is is s important t its volunt>y omission is malpractice4 ,9 ! hurri$ op]ation = tubal rupture !re w\ld be no "t = /]ilisation ( ! abdom9al sk9 surface1 & probably no "t to /]ilise ! in/rum5ts & o!r ?+s us$1 especially ! surgeon's h&s4 ,! surgeon to d any coeliotomy ne$s assi/ant physicians--"o to anae/hetise ! pati5t1 & at ! lea/ "o o!r to "w ) him 9 ! op]ation4 ,he %\ld h ?ree or f\r physicians & "o or two nurses4 ,he c n d a coeliotomy alone4 ,h5ce ! pati5t 9 a ruptur$ #cb extraut]9e pregnancy mu/ h at ! v lea/ two physicians )9 call4 ,! woman1 !n1 9 ,case ,,ii4 be=e op]ation has "o *ance 9 ?ree ( life if no op]ation is done until ! *ild is viable1 & if %e rema9s alive till ! *ild is viable 7:5 %e mu/ be op]at$ ^u7 h] *ances = life w be no bett]1 judg+ f mod]n /ati/ics4 ,at any mom5t1 !re=e1 %e is 9 actual p]il ( dea? by two *ances 9 ?ree1 & probably m if all special circum/ances are consid]$4 ,! foetus is a mat]ially unju/ aggressor 9 ?is case be=e rupture or o!r simil> mi%ap1 z x 0 9 ,case ,i41 b n to ! same ext5t4 ,9 ,case ,,ii4 x is a mat]ially unju/ aggressor z two is to ?ree2 9 ,case ,i4 x is a mat]ially unju/ aggressor z ?ree is to ?ree4 ,if a lunatic is j ab\t to fire ?ree c>tridges at me1 ,i may "k ! *ances are only two 9 ?ree1 or ev5 only "o 9 ?ree1 t he w hit me fatally1 nev]!less ,i may licitly kill him to /op ! fir+ & save my life4 ,! "m 9 ,case ,,ii4 is 9 exactly simil> dang] ( life4 ,! objection t ! dang] to my life f ! action ( ! lunatic exi/s hic et nunc & t ! dang] to ! "m's life does n ?reat5 hic et nunc1 is n ( any weight4 ,%e is 9 actual dang] hic et nunc1 ev5 :ile ! surgeon is 9 ! room exam9+ h]4 ,moreov]1 ! matt] ( "t "h is accid5tal4 ,if y give a man a poison t may kill him 9 t5 h\rs1 or "o t may kill him 9 t5 days1 ! action is ess5tially ! same4 ,i am ( ! op9ion t if ?is second case 7 propos$ to moral !ologians _m ( !m w\ld decide t ! surgeon %\ld expla9 ! case fully to ! pati5t or h] family1 & if imm$iate op]ation 7 insi/$ ^u he %\ld )draw f ! case4 ,nev]!less1 z f> z ,i c see1 he has s\nd probabilism on ! side t op]ation is ju/ifiable4 ,b1 x may be object$1 9 ,case ,i4 ! surgeon ligat$ ! ut]9e & ov>ian art]ies to /op an actual hemorrhage1 & he p]mitt$ ! dea? ( ! foetus2 9 ,case ,,ii4 !re is no hemorrhage yet1 !re may possibly be none at all4 ,i answ] #cc t 9 ,case ,,ii4 if he op]ates he ties ! two art]ies to =e/all an imm95t hemorrhage :i* might beg9 )9 ! next h\r if x 7 n securely %ut (f1 & to =e/all sepsis by leisurely & prop] precautions1 & exactly z 9 ! fir/ case he p]mits ! dea? ( ! foetus1 he indirectly kills an unju/ aggressor4 ,if ! lunatic is aim+ at me ,i d n h to wait until he beg9s fir+ to licitly %oot at him4 ,! soon] ,i %oot1 s]vato mod]am9e inculpatae tutelae1 ! m prud5t my action4 ,to put x 9 ano!r =m--9 ,case ,,ii4 ! surgeon is /&+ be=e a dam 7! /ret*$ ,fallopian tube7 t is ?reat5+ to break at any mom5t & cause dea? to a woman bel[ x1 because !re is a lunatic 7! foetus7 beh9d x te>+ away ! masonry4 ,if ! surgeon %unts (f ! wat] j above ! dam 7! ligation ( ! art]ies71 he w sudd5ly let ! lunatic :o is te>+ away ! masonry fall d[n to ! rocks at ! bottom ( ! dam & be kill$4 ,may he let ! lunatic fall8 ,c]ta9ly he may4 ,b p]haps ! lunatic w n succe$ 9 te>+ away ! masonry4 ,he is well provid$ ) tools to d s2 ! *ances are ev5 two 9 ?ree t he w succe$4 ,is he or ! woman to be giv5 ! b5efit ( ! d\bt8 ,! woman1 by all means2 %e has a d\bt wor? 9 juridic value at ! lea/ twice z mu* z t :i* ! lunatic has4 ,9 any case ( ectopic ge/ation ! foetus has a v fa9t *ance inde$ ( ev5 liv+ long en\gh = baptism if ! expectant treatm5t is employ$4 ,we h se5 t betwe5 ,novemb] #ahji & ,novemb] #ahif !re 7 report$ #gg cases ( op]ation = ! deliv]y ( viable foetuses4 ,elev5 ( ^! *ildr5 surviv$1 #fg di$ )9 a few mon?s1 & _m ( ^! di$ j aft] deliv]y4 ,/ill1 probably all might h be5 baptis$4 ,judg+1 h[ev]1 f ! geographical di/ribution ( ! cases 7see ,kelly's ,op]ative ,gynaecology1 vol4 ii4 p4 #deh7 & ! names ( ! op]ators1 only ab\t #ad ( ^! *ildr5 receiv$ baptism4 ,n[1 s9ce ,s*r5ck f\nd #faj ectopic ge/ations report$ 9 five ye>s1 ?is indicates t ! av]age numb] ( cases ( ectopic ge/ation :i* occur 9 ! civilis$ _w is at ! lea/ #abb a ye>1 = _m m 7twice z _m1 at ! l[e/ #cd e/imate7 are n diagnos$ or n report$ :5 diagnos$4 ,9 ! #hj ye>s1 !n1 betwe5 #ahji & #ahif !re 7 at ! lea/ #igfj cases ( ectopic ge/ation 9 ! civilis$ _w2 9 ! uncivilis$ c\ntries !re 7 c]ta9ly z _m m ) n a *ild sav$1 or ev5 br\ght out ( ! pelvic cavity4 ,to be sure1 by reject+ p]haps a ?ird ( ! cases ?r\gh bad diagnoses & neglect ( reports1 !re 7 #bj1jjj cases2 & 9 all ^! h>dly #bj *ildr5 baptis$--"o 9 a ?\s&4 ,mod]n surgical me?ods & improv$ diagnosis w d little to bett] ! condition1 f ! nature ( ! disease4 ,betwe5 #ahic & #ahif !re 7 #ba cases ( op]ation = ! deliv]y ( viable foetuses report$1 & ?is li/ is approximately correct1 because ! surgeons t op]ate on su* mat]ial are m5 t z a rule report _! "w ev5 :5 x is to _! discr$it4 ,9 ^! #ba cases1 #f mo!rs1 #bh p] c5tum di$1 #gb p] c5tum recov]$4 ,ev5 if mod]n surg]y %\ld save all ! mo!rs :o _h escap$ until ! foetus 0 viable1 & %\ld br+ all ! *ildr5 to baptism1 !re w\ld n be m ?an ab\t #g su* cases 9 ! _w annually4 ,increas$ skill 9 diagnosis w\ld raise ! numb] ( *ildr5 br\ght to baptism1 b x w\ld m ?an proportionately raise ! :ole numb] ( ectopic ge/ations discov]$4 ,if #aj foetuses 7 br\ght f ! pelvic cavity alive 9 ! #acj cases ( ectopic ge/ation ( ! ye>1 ! *ances = an extraut]9e foetus to only rea* baptism at a viable age 7n to live aft] baptism7 are only #g 9 #ajj at a mo/ lib]al e/imate4 ,/ati/ics are unreliable1 ( c\rse1 b ,i am giv+ odds ( two to "o4 ,! foetus has a mu* bett] *ance = baptism if ! coeliotomy is done z e>ly 9 ! pregnancy z possible1 b x has a negligible *ance ( life 9 any case4 ,s9ce ! creation ( man !re h be5 less ?an #ae extraut]9e *ildr5 sav$1 & ( ^! #ae f\r 7 less ?an a ye> old :5 report$1 & ?ree "u five ye>s ( age3 ! olde/ 0 fifte5 ye>s ( age1 & all 7 weakl+s4 ,! practical rule1 !n1 is t ! ectopic foetus w die anyh[1 & op]ation only indirectly 7m>k ! ^w7 accel]ates ! inevitable dea? ( a mat]ially unju/ aggressor1 #ce :ile x gives ! "m ! be/ *ance = h] life1 :i* is 9 v grave p]il4 ,case ,,iii4 ,! surgeon be=e op]ation diagnoses ) ! help ( consultors extraut]9e pregnancy1 b he or !y c n tell :e!r ! foetus is alive or n4 ,:at %\ld he d8 ,9 my op9ion he may op]ate ) mu* m solid probability ?an t :i* exi/s 9 ,case ,,ii4 ,if ! argum5t is m = ! dea? ( ! foetus ?an = its life1 ?is1 ( c\rse1 /r5g!ns ! p]missibility ( ! op]ation4 7#a7 ,! dang] to ! "m is exactly ! same1caet]is p>ibus1 z 9 ,case ,,ii42 7#b7 ! foetus is only probably alive4 ,an actual dang] to life is oppos$ to ! probable life ( a mat]ially unju/ aggressor2 !re=e ! surgeon may probably op]ate at once4 ,probable "h is us$ 9 ! te*nical s5se ( ! t]m4 ,case ,,iv4 ,! foll[+ case is giv5 because a simil> "o 0 propos$ 9 ! articles 9 ! ,am]ican ,ecclesia/ical ,review1 b x is n a practical case4 ,! surgeon1 aft] consultation1 does n "k :e!r ! gr[? 9 a woman's pelvis is a malignant tum\r or a sac conta9+ an extraut]9e foetus4 ,if ! gr[? is a malignant tum\r1 ! woman is 9 actual & c]ta9 dang] ( life1 h] dea? is a m]e matt] ( "t if a malignant tum\r is n remov$1 & ! soon] ! tum\r is remov$ ! bett]4 ,if op]ation is def]r$1 meta/ases ( ! tum\r w h occurr$1 & op]ation w be too late4 ,! indication :5 we f9d a malignant tum\r is1 if x is n already too late to op]ate1 to take x out at once4 ,if ! surgeon ?9ks t ! gr[? may possibly be a foetus1 & he puts (f ! op]ation until a "t :5 c]ta9 signs ( pregnancy %\ld be pres5t to e/abli% a diagnosis ( ge/ation1 or _! lack to e/abli% a diagnosis ( tum\r1 x w\ld almo/ surely be too late to op]ate 9 ! ev5t ! gr[? turn$ out to be a malignant tum\r4 ,z has be5 said1 ! case is n practical1 because malignant tum\rs ( ! tube are s v r>e t !y are n to be look$ =1--only "o or two h be5 obs]v$4 #cf ,malignant tum\rs ab\t ! tube %\ld be diagnos$4 ,suppos+1 h[ev]1 ! case to /&1 x (f]s 9 fav\r ( op]ation a probabilism /rong] ?an t 9 any case except ,case ,i41 because ! "m's dang] is grav]1 & ! argum5t conc]n+ ! foetus is ! same z t 9 ,case ,,iii4 ,case ,v4 ,suppose a d\btful case l ,case ,,iii4 or ,case ,,iv41 b aft] ! surgeon has op5$ ! abdom5 he f9ds a foetus evid5tly alive4 ,?is is an improbable b a possible case4 ,case ,v4 !n becomes l ,case ,,ii4 ) ! addition ( ano!r grave dang] to ! lives ( bo? ! "m & ! foetus1 :i* is ! coeliotomy already p]=m$4 ,! sugge/ion t ! surgeon c leave ! woman1 back out ( ! case1 is absurd4 ,if he closes ! abdom51 ! coeliotomy may cause tubal abortion1 ! w\nd might h to be op5$ aga9 9 a few h\rs or a few days1 & ! "m w\ld be left 9 mu* great] p]il ?an %e 0 9 ,case ,,ii4 ,= ! reasons already giv51 he %\ld g on ) ! op]ation4 ,case ,,vi4 ,suppose a case l ,case ,v4 9 e p>ticul> except t :5 ! surgeon f9ds ! foetus he c n tell :e!r x is alive or n4 ,he %\ld1 a =tiori1 f9i% ! op]ation4 ,case ,,vii4 ,a case ( ectopic ge/ation is diagnos$1 ! conditions are expla9$ to ! woman1 & %e refuses to be op]at$ ^u4 ,is %e ju/ifi$8 ,! probability is "o to two t %e w escape dea? if %e waits1 & mu* less ?an "o to two if %e f9ally refuses op]ation4 ,! morali/s w\ld tell h] %e may refuse op]ation4 ,case ,,viii4 ,let u suppose a case :]e a ,fallopian tube ei!r has its lum5 s n>r[$ by a gonorrhoeal inflammation t al?\gh ! sp]matozoa may pass ?r\gh & fecundate ! ovum ?is fecundat$ ovum c n get out to ! ut]us2 or1 secondly1 t ! gonorrhoeal infection has completely %ut ! tube1 yet migratory fecundation has occurr$ ?r\gh ! r\te ( ! o!r tube & ! passage along ! fundus ( ! ut]us to ! ov>y ( ! infect$ side4 ,9 ei!r case an ectopic ge/ation beg9s4 ,! fir/ case is improbable f a m$ical po9t ( view1 #cg & ! second is b>ely possible4 ,gonorrhoeal infection ( ! tubes is common en\gh1 b :5 x occurs x usually %uts ! tube up p]man5tly4 ,9 *ronic salp+itis at times ! ov>ian end ( ! tube is n :olly clos$ at once1 & s9ce ! body ( ! ov>y is v r>ely affect$ by gonorrhoea1 !re is a possibility wor? consid]+ ( a tubal pregnancy ?r\gh migration to occur4 ,9 su* a condition ! woman might h be5 infect$ ) gonorrhoea1 fir/1 be=e h] m>riage ?r\gh =nication or accid5t2 second1 aft] h] m>riage ?r\gh adult]y or accid5t2 ?ird1 aft] ! m>riage by h] husb&4 ,if %e _h be5 infect$ ?r\gh =nication or adult]y1 %e is acc\ntable = ! =ese5 consequ5ces ( h] s91 & %e has put an imp$im5t = :i* %e is responsible be=e ! embryo4 ,suppose ! physician kn[s ^! facts4 ,!n ! excuse = indirectly ha/5+ ! dea? ( ! foetus does n1 at fir/ sight1 seem to exi/1 because ! foetus is app>5tly n a mat]ially unju/ aggressor4 ,x c\ld easily happ5 t a surgeon's refusal to op]ate 9 a case l ?is w\ld cause ! dea? ( ! "m & foetus4 ,%\ld he let bo? p]i%8 ,is he to let ! "m die = ! sake ( /av+ (f = a half-h\r ! c]ta9 dea? ( a useless embryo ! size ( a pigeon's egg8 ,x is n a useless embryo ! size ( a pigeon's egg1 b a human be+1 ! mo/ important ?+ on e>?1 & a human be+ %ut (f f life & baptism z a direct consequ5ce ( t woman's brutal s5suality4 ,b ! woman may be ! "m ( o!r helpless *ildr54 ,:at is to be done8 ,let u recur to ! example ( ! homicidal maniac4 ,if ,i accid5tly by a bl[ make a man insane & t insane man aft]w>d tries to kill me1 ,i or my protector may p]mit 8 dea? to save my life4 ,if ,i malici\sly make a man insane & he aft]w>d tries to kill me1 may ,i or my protector kill him 9 my def5ce8 ,"s may say t ,i may n because ,i h lo/ all juridic sup]iority ov] ! madman z a consequ5ce ( my s9 aga9/ him4 ,t position1 h[ev]1 does n seem to be correct4 ,if x is correct1 p>ity makes ! ass]tion true t ! foetus 9 ! case suppos$ above may n be indirectly #ch kill$ to save ! "m4 ,if x is n true1 ! foetus may be indirectly de/roy$4 ,does my s9 aga9/ ! insane man give him a "r to kill me8 ,by no means4 ,no?+ b def5ce ( life or its equival5t gives any private individual ! "r to kill ano!r4 ,! man might kill me be=e ?is aggression ( m9e1 9 def5ce ( 8 sanity1 b aft] ! fact su* a kill+ w\ld be m]e rev5ge1 or an actus hom9is1 n a "r4 ,! woman1 we suppose1 has malici\sly put ! foetus 9 its position ( mat]ial aggressor1 b has ! foetus ! "r to kill h]8 ,no2 ! foetus is an individual n act+ 9 self-def5ce1 x is m]ely gr[+4 ,has ! woman or ! surgeon1 h] protector1 ! "r to p]mit ! dea? ( ! foetus to def5d ! woman's life8 ,i ?9k !y h1 because ! foetus "h also is1 f its unnatural position1 a mat]ially unju/ aggressor4 ,b1 y say1 ?is is a vici\s circle4 ,y ju/ify ! p]mitt$ dea? ( ! foetus 9 ,case ,i4 because x is a mat]ially unju/ aggressor1 & x is a mat]ially unju/ aggressor because x is 9 an unnatural position :]e x has no "r to be2 b 9 ! pres5t case ! "m put x 9 ! unnatural position1 & x !re=e has a "r to be :]e x is4 ,no3 ! consequ5ce does n foll[4 ,! fact t ! "m put ! foetus 9 its unnatural position does n give ! foetus a "r to be 9 t position1 al?\gh x con/itutes a gr\nd = h] puni%m5t by prop] au?ority4 ,y object aga91 if ?is woman has a "r to p]mit ! dea? ( ! foetus to save h] own life1 h[ may %e be puni%$ = t dea?8 ,%e w n be puni%$ = ! actual coeliotomy :i* indirectly caus$ ! dea? ( ! foetus1 b %e w be puni%$ = ! s9 ( putt+ t *ild 9 a position 9 :i* x _h to be kill$4 ,?is seems to be a di/9ction )\t a diff]5ce4 ,z f> z ! "m is conc]n$1 transeat 2 b x is a real di/9ction z f> z ! surgeon is conc]n$4 ,if ! woman's condition is a result ( accid5tal infection be=e or aft] m>riage1 ! case goes into ! class ( ^? discuss$ above1 & op]ation is ju/ifiable4 ,if h] infection comes aft] h] m>riage adult]\sly1 h] #ci s9 is ! great]1 b ! op]ation is ju/ifiable = ! reasons :i* 7 giv5 9 ! case ( culpable infection be=e m>riage4 ,if %e _h be5 infect$ by h] husb&1 ! op]ation is ju/ifiable--! fa!r is acc\ntable = ! foetus's dea?4 ,=tunately ! entire case is s ne>ly hypo!tical t x is little m ?an m]e words4 ,,au/9 ,,omalley4 #dj ,,ii ,,pelvic ,,tum\rs ,,9 ,,pregnancy ,tum\rs ( ! ut]us & its adnexa at times1 ?\gh r>ely1 complicate pregnancy1 & !y may involve c]ta9 moral que/ions t h be5 little discuss$4 ,! tum\rs t cause difficulty are ov>ian & ut]9e4 ,cy/ic ov>ian tum\rs commonly d n prev5t impregnation1 if !re has be5 an abs5ce ( inflammation4 ,:5 ^! cy/s are small !y may n di/urb pregnancy or deliv]y2 l>ge cy/s c1 h[ev]1 become a s\rce ( dang]4 ,!y may s9k into ! pelvis & block ! *annel ( deliv]y ne$$ by ! *ild at t]m2 !y may h _! p$icles twi/$1 & ?us become gangr5\s & septic4 ,big cy/s ( ! ov>y may dur+ ! gr[? ( ! pregnant ut]us press ^u ! portal ve91 or ! diaphragm1 or !y may bur/ or cause sepsis4 ,litzman1 9 #ef cases ( ov>ian tum\rs complicat+ pregnancy1 _h only #aj normal deliv]ies2 & ,remy held t #bc p] c5tum ( ^! cases1 :5 left unt\*$1 result 9 dea? to ! mo!rs4 ,/ratz says ! mortality is #cb p] c5tum1 & x has gone z high z #dj p] c5tum4 ,"s physicians tea* t any ov>ian cy/ f\nd complicat+ pregnancy %\ld be remov$ surgically4 ,o!r au?orities hold t !y %\ld all be treat$ expectantly3 if !y ?reat5 ! life ( ! "m1 !y %\ld be tapp$ by a troc> ?r\gh ! belly-wall or ! vag9a1 & remov$ only aft] lab\r4 ,?is second op]ation is safe1 & ,i ?9k x %\ld prevail4 ,su* cy/s h (t5 be5 remov$ dur+ pregnancy4 ,orgl] report$ #adf ov>iotomies 7removal ( ! ov>ies7 p]=m$ dur+ ge/ation ) only f\r mat]nal dea?s--#b4g p] c5tum4 ,if ! op]ation _h n be5 p]=m$ #da ab\t #cb p] c5tum ( ^! wom5 w\ld h di$4 ,! *ance aga9/ sav+ ! *ild 9 su* an op]ation is ! crux4 ,if !re is no op]ation #ag p] c5tum ( ! cases result 9 abortion & ! loss ( ! *ild1 z ,remy f\nd f a consid]ation ( #cba cases4 ,9 ,orgl]'s s]ies ( #adf ov>iotomies1 :]e he lo/ only #b4g p] c5tum ( ! mo!rs1 & sav$ ab\t #cj p] c5tum t w\ld h di$ 7#ig p] c5tum 9 all72 he lo/ #cb *ildr5 ?r\gh abortion caus$ by ! ov>iotomies1 or #bb4e p] c5tum2 :]eas by ! expectant me?od 7)\t tapp+7 only #ag p] c5tum ( ! *ildr5 7 lo/4 ,bovee ( ,wa%+ton1 h[ev]1 report$ #ch cases ( removal ( ! ov>ies dur+ pregnancy ) "o mat]nal dea? & only f\r abortions1 or #ab4f p] c5tum4 ,t is consid]ably less ?an ! loss by ! expectant me?od )\t tapp+4 ,z ,bovee succe$$1 o!r m5 n[ d1 b x w\ld be f> bett] to attempt tapp+ fir/4 ,! e>li] 9 ! pregnancy ei!r tapp+ or removal is done ! bett]4 ,fibroid tum\rs ( ! ut]us1 complicat+ pregnancy1 occur 9 ab\t #j4f p] c5tum ( pregnancies1 & !y usually g on )\t caus+ tr\ble2 b aga9 ^! tum\rs may block ! pelvic outlet1 !y may dang]\sly press ^u abdom9al visc]a & ! diaphragm2 "s writ]s hold !y may become inflam$ & deg5]ate ) sl\gh+ & gangr5e1 & ?us br+ ab\t sepsis & dea? to ! "m & *ild4 ,t !y become gangr5\s mu/ v r>ely happ52 ! increas$ blood supply %\ld prev5t gangr5e1 b cause an increase 9 ! size ( ! fibroma4 ,a gr\p ( gynaecologi/s ma9ta9 t :5 fibromata cause dang]\s symptoms 9 pregnancy ! ut]us %\ld be tak5 out 9 "p or :olly if ! tum\r is s deeply involv$ 9 ! ut]9e wall t x c n be sep>at$4 ,?is op]ation1 ( c\rse1 kills ! foetus4 ,at times ! *ild is viable1 & a prec$5t caes>ean section w save x4 ,surgeons d n remove fibromata m]ely z a precaution1 z !y sometimes d 9 ! case ( ov>ian cy/s4 ,o!r surgeons say x is safe to wait4 ,if ! *annel ( deliv]y is block$1 ^! m5 wait till t]m & !n d caes>ean #db section2 9 o!r cases ! tum\r w (t5 be lift$ up out ( ! way dur+ ! lat] /ages ( ge/ation or lab\r4 ,9 ^? v r>e cases :]e x is necess>y to remove ! ut]us :olly or 9 "p be=e ! *ild is viable1 & !reby also to kill ! foetus1 ! op]ation at fir/ glance seems 9 no wise to diff] 9 nature f a craniotomy ^u a liv+ *ild4 ,! condition1 h[ev]1 is commonly worse ?an "o 9 :i* a craniotomy is indicat$1 because 9 ! latt] condition we h a viable *ild1 & ! caes>ean section to solve ! difficulty1 b 9 ! =m] we h a *ild n viable1 & !re=e ! caes>ean section w\ld be useless1 except = ! opportunity x might give = baptism ( ! *ild4 ,9 su* a case mu/ ! surgeon let ! "m die le/ he ha/5 ! dea? ( a non-viable *ild8 ,! action r$uces to ?is1 t ! surgeon by op]at+ w\ld p]mit a ha/5+ ( ! inevitable dea? ( ! foetus :ile sav+ ! "m's life1 b ! *ild is n an unju/ aggressor1 n ev5 a mat]ially unju/ aggressor4 ,x has a "r to be :]e x is4 ,! only excuse = ha/5+ its dea? is to save ! "m's life1--!re is no "q ( self-def5ce2 b delib]ately to ha/5 ! dea? ( a human be+ a second ( "t1 except x be done by an individual 9 self-def5ce aga9/ an unju/ aggressor1 or by ! /ate = legitimate cause1 is murd]4 ,x seems probable1 h[ev]1 t !re is some?+ to be said 9 fav\r ( ! unavoidable hy/]ectomy 7removal ( ! womb7 9 a pregnancy complicat$ ) ut]9e fibromata t und\bt$ly endang] life4 ,su* cases diff] f craniotomy1 or ! direct kill+ ( a foetus 7:i* 7 =mally =bidd5 by ! ,holy ,(fice on ,may #bh1 #ahhd1 & ,augu/ #ai1 #ahhh1 & always =bidd5 by ! natural law7 9 sev]al factors3 fir/1 9 craniotomy ! *ild is directly kill$1 al?\gh x is n an aggressor1 9 ! hy/]ectomy x is p]mitt$ to die1 x is indirectly kill$2 secondly1 9 craniotomy !re is a viable *ild1 9 ! hy/]ectomy1 an unviable *ild2 ?irdly1 9 craniotomy !re is a kill+ t is a means t[>d ! end ( sav+ ! "m's life1 9 ! hy/]ectomy !re is a p]mitt$ ha/5+ ( ! foetus's dea?1 & ?is is only a circum/ance insep>ably jo9$ to ! act2 f\r?ly1 9 craniotomy ! kill+ is utt]ly #dc uncall$ =1 because ! caes>ean section1 or symphyseotomy 7a tempor>y divid+ ( ! pubic jo9t to get m room7 w d in/ead1 9 ! hy/]ectomy1 because ! *ild is n viable1 !re is no alt]nate way out ( ! difficulty2 fif?ly1 =mal judgm5t has be5 pron\nc$ by ! ,holy ,(fice 9 craniotomy1 no =mal judgm5t has be5 made z reg>ds ?is hy/]ectomy4 ,suppose ,a & ,b are on a boat hoi/+ a weighty object to a %ip2 ! tackle breaks1 ! fall+ weight mortally hurts ,b1 & w$ges him fa/ to ! wreck$ boat4 ,! boat is ab\t to s9k & dr[n bo? m51 b if ,a tips (f ! weight1 & ) x unavoidably ! entangl$ ,b1 ,a c float to safety4 ,a w indirectly ha/5 ! inevitable dea? ( ,b by ?r[+ (f ! weight :i* w drag him d[n4 ,may ,a d s8 ,v probably he may4 ,two swimm]s1 ,a & ,b1 are try+ to save ,c1 :o dies 9 ! wat]1 & z he dies he grips ,a & ,b s tightly !y c n %ake ! corpse (f4 ,a is weak1 & he w soon s9k & dr[n ow+ to ! weight ( ! corpse2 ,b also w lat] g d[n ) ,a & ,c4 ,a1 h[ev]1 cuts 8 clo?+ loose f ! grip ( ! corpse 7or "s "o 9 a boat does s :o c d no m7 & ,a is sav$2 b ?us imm$iately ,b is dr[n$1 ow+ to ! fact t ! full weight ( ! corpse is ^u him4 ,is ,a1 or ! man 9 ! boat1 ju/ifi$8 ,probably !y are4 ,a is ! "m1 ,b ! foetus1 ,c ! diseas$ ut]us1 ! man 9 ! boat is ! surgeon4 ,! "m has h]self cut away f ! ut]us & ! foetus's dea? is ha/5$4 ,aga91 take an example us$ by ,fa!r ,ricaby 9 8 ,moral ,philosophy1 p4 #bje 7,london1 #aija74 ,he supposes a visitor to a qu>ry to be /&+ on a l$ge ( rock :i* a qu>ryman _h occasion to bla/1 & ! qu>ry man saw t unless t piece ( rock :]e ! visitor /ood 7 bl[n up in/antly1 a cata/rophe w\ld happ5 else:]e1 :i* w\ld be ! dea? ( _m m51 & if !re 7 no "t to w>n ! visitor to cle> (f :o c\ld blame him if he appli$ ! explosive8 ,! means ( av]t+ ! cata/rophe w\ld be1 n t visitor's dea?1 b ! bl[+ up ( ! rock4 ,! pres5ce or abs5ce ( ! visitor1 8 dea? #dd or escape1 is all "o to ! end int5d$3 x has no be>+ !reon at all4 ,if ^! examples ( indirect kill+ are all[able1 :y may n ! surgeon 9 ! r>e example pres5t$ "h remove ! ut]us & indirectly p]mit ! ha/5+ ( ! foetus's dea?8 ,t ha/5+ ( dea? is n an end1 nor a means t[>d an end1 b a circum/ance only reluctantly & indirectly will$4 ,! end is to save ! "m's life1 & ! means is ! removal ( a septic or impact$ ut]us4 ,x may be object$ t an artificial abortion :]e9 ! womb is empti$ ( an unviable foetus to save ! "m's life is only an indirect ha/5+ ( ?is foetus's dea?1 b !re is a diff]5ce3 9 abortion ! removal ( ! foetus is ! means :]eby ! end is atta9$1 9 ! hy/]ectomy ! removal ( ! tum\r is ! means :]eby ! end is atta9$4 ,?is argum5t is advanc$ only t5tatively & ) diffid5ce1 t ! matt] may be discuss$ & settl$ by au?ority4 ,sometimes c>c9oma 7a canc]7 complicates pregnancy--once 9 #bjjj cases is above ! av]age4 ,a c>c9oma is a malignant tum\r1 & ! malignancy is made mu* worse by ! /imulus ( pregnancy ) its increas$ blood supply4 ,! mat]nal dea?s f c>c9oma ( ! ut]us dur+ pregnancy is1 accord+ to ! late/ & mo/ fav\rable /ati/ics1 #cj p] c5tum4 ,! mortality ( ! *ildr5 is f #ej to #fc p] c5tum4 ,n[1 fir/1 if an artificial abortion is induc$ :ile ! foetus is unviable1 ! foetus is lo/ & ! "m's condition is n mat]ially improv$4 ,secondly1 if curettem5t 7a scrap+ away ) a %>p spoonlike in/rum5t71 caut]ization1 or amputation ( ! ut]9e c]vix are p]=m$1 ! "m is help$ v little1 if at all1 & consequ5t abortion is frequ5t4 ,?irdly1 if caes>ean section is done at t]m ! *ild has a good *ance 7,sang] sav$ #af ( #ah *ildr5 ?us 9 "o s]ies3 ov] #hh p] c5tum71 b ?is op]ation ne>ly always kills ! "m :5 canc] is pres5t1 unless ! entire ut]us c be remov$1 & (t5 x c n be remov$2 t #de is1 ! case is inop]able & removal is useless ow+ to ext5sion ( ! canc] into ! surr\nd+ tissues4 ,f\r?ly1 if ! "m's condition is hopeless1 a caes>ean section gives ! *ild a *ance = life1 b ! op]ation w ha/5 ! "m's dea? 9 ne>ly e case4 ,! fir/ & second cases "h are n practical4 ,if ! surgeon c remove ! ut]us at t]m aft] a caes>ean section1 t is ! mo/ reasonable op]ation = ! "m & *ild1 & x (f]s no moral difficulty4 ,if ! "m's condition is s bad t ! ut]us may n be remov$1 ! *ances are t h] dea? w be ha/5$ by caes>ean section1 b if caes>ean section is n done1 f #ej to #fc p] c5tum is ! ratio aga9/ ! sav+ ( ! *ild4 ,i d n ?9k a g5]al rule c be giv5 z reg>ds ! c]ta9ty ( ha/5+ ! mat]nal dea?3 ! reckon+ is to be made to meet ! p>ticul> condition4 ,x seems1 h[ev]1 probable t 9 e case ( inop]able c>c9oma ( ! ut]us complicat+ pregnancy a caes>ean section w\ld ha/5 ! mat]nal dea?4 ,%e w die anyh[ f ! canc]1 b 9 c]ta9 cases %e may live long] if ! section is n done4 ,if1 aga91 a c>c9oma ( ! ut]us is inop]able at t]m1 ! deliv]y ( ! *ild may be impossible )\t caes>ean section1 f ut]9e in]tia1 or ! opposition ( ! d5se inflam$ tissues1 or ! friability ( ^! tissues4 ,9 su* a case )\t ! section %e w\ld die1 & die probably soon] ?an ) x4 ,! op]ation w\ld possibly slightly prolong h] life1 by1 say1 a few h\rs or days1 & x c]ta9ly w\ld give ! *ild a v good *ance = its life4 ,%e may1 ( c\rse1 die ^u ! op]at+ table1 b %e w\ld die 9 *ildb$ )\t ! section4 ,! case is diff]5t f ! ord9>y caes>ean section done because ( a n>r[ pelvic bony girdle4 ,9 ! latt] condition ! *ances t ! "m w live are v high if ! surgeon is compet5t1 b 9 ! c>c9oma case %e w die no matt] :o ! surgeon may be1 & v probably1 or almo/ c]ta9ly1 h] dea? w be ha/5$ by ! op]ation 9 ! majority ( cases4 ,if ! condition is su* t ! woman c n be deliv]$ #df )\t ! section1 ,i see no difficulty aga9/ op]ation1 because ! surgeon c n1 z f> z ,i "k1 say positively :e!r he w ha/5 ! mat]nal dea? or n1 & 9 ! circum/ances he may take advantage ( ! d\bt4 ,if ! woman ) an inop]able c>c9oma ut]i may be deliv]$ )\t section1 %\ld su* a deliv]y be *os5 al?\gh x raises ! *ances ( mortality z reg>ds ! *ild f ab\t #ab p] c5tum to at ! lea/ #ej p] c5tum8 ,x is a matt] ( a v probable ha/5+ ( ! "m's dea? z weigh$ aga9/ ! safety ( ! *ild--! *ild has ab\t "o *ance 9 two ( life )\t ! section1 &1 say1 sev5 *ances 9 eight ) ! section4 ,! op]ation is f> pref]able z reg>ds ! *ild alone1 b n pref]able z reg>ds ! "m alone4 ,is x !n all[able8 ,9 ! hy/]ectomy = fibroma already consid]$1 ! "m is sav$ & ! *ild's inevitable dea? is c]ta9ly ha/5$2 9 ! caes>ean section ! *ild is mo/ probably sav$1 & ! "m's inevitable dea? is mo/ probably ha/5$2 we might say1 9 "s cases1 t h] dea? is und\bt$ly ha/5$4 ,if 9 ! c>c9oma case "h ! *ild _h no *ance :atev] = deliv]y except by ! caes>ean section1 :ile ! "m's dea? w\ld be probably or c]ta9ly ha/5$1 %e might legitimately cons5t to ! op]ation or %e might legitimately refuse ! op]ation4 ,! *ild1 h[ev]1 has1 z we said1 "o *ance ( deliv]y 9 two )\t ! section1 :ile ! "m's dea? w v probably be ha/5$4 ,if ! "m's dea? w\ld c]ta9ly be ha/5$ by ! section1 h] dea?1 al?\gh x w\ld be a circum/ance & indirect1 n an end nor a means1 w\ld n h c\nt]balanc$ aga9/ x necess>ily ! sav+ ( ! *ild's life1 because ! *ild has "o *ance 9 two 9 any ev5t4 ,9 su* an hypo!sis ! op]ation seems to be unju/ifiable4 ,if1 h[ev]1 ! ha/5+ ( ! "m's dea? is only probable & n c]ta91 may we oppose t probability to ! advantage t mu/ accrue to ! *ild ?r\gh ! section8 ,if ! d\bt t h] dea? w be ha/5$ is s\ndly probable1 ! woman may cons5t to ! op]ation4 ,%e risks ?r\gh *>ity ! ha/5+ ( h] own dea? = a great #dg advantage to ! *ild1 b %e may risk legitimately imm$iate dea? 9 major surgical op]ations = an advantage less ?an ! sav+ ( life itself4 ,%e may h h] skull op5$ = ! removal ( a depress$ bone t is caus+ p>alysis1 %e may h h] knee-jo9t op5$ = ! wir+ ( a patella to prev5t lam5ess1 b bo? ^! op]ations always imm$iately endang] life4 ,%e may g into a burn+ h\se1 jump into a riv]1 & s on1 to save h] *ild f possible injury4 ,,au/9 ,,omalley4 #dh ,,iii ,,abortion1 ,,misc>riage ,,& ,,premature ,,lab\r ,if pregnancy ends 9 ! empty+ ( ! ut]us be=e ! sixte5? week ( ge/ation1 ! condition is call$ an abortion2 if ?is happ5s betwe5 ! sixte5? & ! tw5ty-eigh? weeks1 x is misc>riage2 if ! *ild is born aft] ! tw5ty-eigh? week b be=e full t]m1 ! bir? is premature4 ,! t]m abortion 9 ! popul> m9d c>ries ) x ! notion ( crim9al int]f]5ce1 & ! ^w misc>riage is us$ = bo? abortion & misc>riage by ! laity2 physicians1 on ! o!r h&1 commonly use ! t]m abortion = bo? abortion & misc>riage4 ,^! conditions may occur spontane\sly or !y may be induc$ artificially4 ,spontane\s abortions are v frequ5t2 p]haps "o 9 e five or six pregnancies is ! proportion3 ! writ] has kn[n a s+le physician1 n a speciali/ 9 ob/etrics1 to be call$ to ?ree 9 "o day & t 9 private practice4 ,f #aej to #bjj *ildr5 9 e #ajjj t are conceiv$ nev] get a *ance = baptism4 ,9 ! e>ly mon?s ( pregnancy ! foetus is usually dead be=e expulsion takes place4 ,twi/+ ( ! cord1 hydramnios1 syphilis1 an acute infecti\s disease 9 ! "m1 poison+s ( ! "m by metals & ! l sub/ances1 mat]nal c>diac & r5al diseases1 *ronic inflammations & displacem5ts ( ! womb1 & viol5t emotions are "s ( ! causes ( abortion4 ,9 c]ta9 wom5 a slight ex]tion1 a mis/ep1 a fall1 a ride ov] a r\gh road1 ! debitum conjugale1 & simil> causes br+ on abortion2 9 o!r wom5 almo/ no %ock is en\gh to make !m misc>ry4 ,inflammations & displacem5ts ( #di ! womb cause mo/ ( ! abortions 9 ! fir/ f\r mon?s1 & aft] t "t syphilis & ,bright's disease are ! *ief =ces at "w4 ,if a woman 9 e>ly pregnancy beg9s to lose blood f ! ut]us1 & has pa9 9 h] back & l[] abdom51 abortion is ?reat5$2 if ?is hemorrhage is m>k$1 & ! c]vix is dilat$1 ! abortion w v probably occur2 & ! escape ( ! liquor amnii r5d]s ! abortion unavoidable4 ,9 ?is latt] case ! vag9a & ! c]vical canal are pack$ ) /]ile gauze to *eck ! hemorrhage1 & aft] tw5ty-f\r h\rs x is remov$4 ,!n commonly ! entire ovum comes away ) ! gauze1 or :at rema9s ( x is tak5 out ) a curette4 ,valvul> lesions ( ! he>t 9 pregnancy make a mat]nal mortality ( ab\t #bh p] c5tum1 accord+ to ,gu]>d1 & :5 comp5sation is lo/ ! mortality may run f #dh to ev5 #ajj p] c5tum ) diff]5t physicians & diff]5t cases4 ,! prognosis is good z long z comp5sation is reta9$1 b v bad if ?is fails4 ,9 ! latt] condition premature lab\r is indicat$1 or ! e>ly removal ( ! viable *ild4 ,ca?olic physicians may n induce artificial abortion ( an unviable foetus4 ,! decree ( ! ,holy ,(fice conc]n+ ?is matt] is z foll[s3 ,beatissime ,pat]1--,/ephanus 4 4 4 ,ar*iepiscopus ,cam]ac5sis 4 4 4 ,quae sequuntur humilit] exponit3 ,titus m$icus1 cum ad praegnantem gravit] decumb5tem vocabatur1 passim animadv]tebat le?alis morbi causam aliam non subesse praet] ipsam praegnationem1 hoc e/1 foetus 9 ut]o praes5tia1 una igitur1 ut matrem a c]ta atque imm95ti morte salv>et1 prae/o ipsi erat via1 procur&i scilicet abortum seu foetus et ejectionem4 ,viam hanc consueto ipse inibat1 adhibitis tam5 m$iis et op]ationibus1 p] se atque imm$iate non quidem ad id t5d5tibus1 ut 9 mat]no s9u foetum occid]5t1 s$ solummodo ut vivus1 si fi]i posset1 ad lucem ed]etur1 quamvis proxime moriturus1 utpote qui immaturus omn9o adhuc esset4 ,jamv]o lectis quae die #ai ,augu/i1 #ahhh1 ,sancta ,s$es ad ,cam]ac5ses ,ar*iepiscopos rescripsit3 tuto doc]i non posse licitam esse quamcumque op]ationem directe occisivam foetus1 etiam si hoc necess>ium =et ad matrem salv&am3 dubiis ha]et ,titius circa #ej liceitatem op]ationum *irurgic>um1 quibus non r>o ipse abortum hucusque procurabat1 ut praegnantes gravit] aegrotantes salv>et4 ,qu>e ut consci5tiae suae consulat supplex ,titius petit3 utrum enuntiatas op]ationes 9 repetitis dictis circum/antiis in/aur>e tuto possit4 ,f]ia iv1 die #bd ,julii1 #ahie4 ,9 ,congregatione g5]ali ,s4 ,romanae et ,univ]salis ,inquisitionis 4 4 4 ,emi ac ,rmi ,dom9i ,c>d9ales 4 4 4 respond5dum decrev]unt3 ,negative1 juxta alias decreta1 diei scilicet #bh ,maii1 #ahhd1 et #ai ,augu/i1 #ahhh4 4 4 4 ,sanctissimus ,dom9us no/] 4 4 4 approbavit4 ,o!r docum5ts ref]r+ to ! same matt] are ! foll[+3 ,epi/ola ad ,ar*iepiscopum ,cam]ac5sem4 4 4 4 ,anno #ahhf1 ,amplitud9is tuae ,pra$ecessor dubia nonnulla h9c supremae ,congregationi proposuit circa liceitatem qu>umdem op]ationum *irurgic>um craniotomiae aff9ium4 ,quibus s$ulo p]p5sis1 ,em95tissimi ac ,rev]5dissimi ,patres ,c>d9ales una mecum ,inquisitores ,g5]ales1 f]ia iv1 die #ad curr5tis m5sis1 respond5dum m&av]unt3 ,9 s*olis ca?olicis tuto doc]i non posse licitam esse op]ationem *irurgicam quam craniotomiam appellant1 sicut decl>atum fuit die #bh ,maii1 #ahhd1 et quamcumque *irurgicam op]ationem directe occisivam foetus vel matris ge/antis4 ,idque notum facio ,amplitud9i tuae1 ut significes pr(essoribus facultatis m$icae ,univ]sitatis ca?olicae ,insul5sis4 4 4 4 ,romae1 die #ai ,augu/i1 #ahhi4 4 4 4 ,r4 ,,c>d4 ,,monaco4 ,! date ( ?is response "h is #ahhi1 b 9 ! prec$+ decree x is giv5 z #ahhh4 ,9 ! ,acta ,sanctae ,s$is ! date is #ahhi4 ,ano!r lett] f ,c>d9al ,monaco is ?is3 ,eme et ,rme ,dne1--,emi ,,pp4 mecum ,inquisitores g5]ales 9 ,congregatione habita f]ia iv1 die #bh lab5tis ,maii1 ad exam5 revoc>unt dubium ab ,em95tia tua propositum--,an tuto doc]i possit 9 s*olis ca?olicis licitam esse op]ationem *irurgicam1 quam ,craniotomiam appellant1 qu&o scilicet1 ea omissa1 mat] et infans p]ituri s9t1 ea e contra admissa1 salv&a sit mat]1 infante p]eunte8 #ea --,ac omnibus diu et mature p]p5sis1 habita quoque ratione eorum quae hac 9 re a p]itis ca?olicis viris conscripta ac ab ,em95tia tua h9c ,congregationi transmissa sunt1 respond5dum esse dux]unt3 ,tuto doc]i non posse4 ,quam responsionem cum ,s,smus ,d4 ,n4 9 audi5tia ejusdem f]iae ac diei pl5e confirmav]it1 ,em95tiae tuae communico4 4 4 4 ,r4 ,,c>d4 ,,monaco4 ,romae1 #ca ,mail1 #ahhd4 ,emo ,ar*iepiscopo ,lugdun5si4 ,ano!r decree conc]n+ abortion is 9 "p z foll[s3 ,beatissime ,pat]1--,episcopus ,s9alo54 ad p$es ,s4,v4 provolutus1 humilit] petit resolutionem insequ5tium dubiorum3 ,i4 ,eritne licita p>tus accel]atio quoties ex muli]is arctitud9e impossibilis evad]et foetus egressio suo naturali tempore8 ,,ii4 ,et si muli]is arctitudo talis sit1 ut neque p>tus praematurus possibilis c5seatur1 licibitne abortum provoc>e aut caes>eam suo tempore p]fic]e op]ationem8 4 4 4 ,f]ia iv1 die #d ,mail1 #ahih4 ,9 ,congregatione habita1 etc4 4 4 4 ,,ee4 ac ,,rr4 ,patres rescrib5dum c5su]unt3 ,ad ,i4 ,p>tus accel]ationem p] se illicitam non esse1 dummodo p]ficiatur ju/is de causis et eo tempore ac modis1 quibus ex ord9>iis cont+5tibus matris et foetus vitae consulatur4 ,ad ,,ii4 ,quoad primam p>tem1 negative1 juxta decretum ,f]ia iv1 #bd ,julii1 #ahie1 de abortus illiceitate4 ,ad secundum v]o quod spectat2 nihil ob/>e quom9us muli] de qua agitur caes>eae op]ationi suo tempore subjiciatur4 4 4 4 ,9 sequ5ti ,f]ia vi1 die #f ejusdem m5sis et anni 4 4 4 ,s,smus responsiones ,,ee4 ac ,,rr4 ,patrum approbavit4 ,pyelonephritis 7an inflammation ( ! kidney :]e pus is pres5t71 f ! pressure ( ! pregnant ut]us1 is a condition :i* sometimes obliges ! physician to br+ ab\t premature lab\r to save ! "m4 ,! symptoms usually appe> 9 ! latt] half ( ge/ation4 ,*orea 7,/4 ,vitus' ,dance71 :5 x develops dur+ pregnancy1 has a mat]nal mortality ( f #ag to #bb p] c5tum4 ,x may cause dea? be=e ! *ild is viable1 & to empty #eb ! ut]us w /op ! symptoms4 ,"h ! decrees ( ! ,holy ,(fice w occasionally prev5t ! ,ca?olic physician f int]f]+4 ,if a grave surgical op]ation is imp]atively indicat$ dur+ pregnancy1 & may n be put (f until aft] deliv]y1 x %\ld be und]tak5 9 _m cases1 because mod]n te*nique commonly does n br+ ab\t an abortion2 b1 9 g5]al1 no rule c be giv5--ea* case mu/ be judg$ sep>ately4 ,if a pregnant woman has at ! same "t consid]able album5 9 h] ur9e & a l[ excretion ( urea1 h] condition is v dang]\s4 ,to empty h] ut]us w1 9 mo/ cases1 relieve ! r5al tr\ble1 b 9 any case premature lab\r is n to be induc$ ra%ly3 _m wom5 escape1 :5 by all ! rules !y %\ld die4 ,eclampsia is a v grave complication ( pregnancy1 & x 0 =m]ly suppos$ to be uraemia4 ,! disease is *>act]iz$ by convulsions1 loss ( consci\sness1 & coma4 ,x occurs1 commonly1 9 ! second half ( ge/ation1 b x has be5 obs]v$ z e>ly z ! ?ird mon?4 ,ab\t #gj to #hj p] c5tum ( ! cases are 9 primip>\s wom54 ,! convulsions may come on altoge!r unexpect$ly1 b commonly ! attack beg9s ) symptoms ( toxaemia4 ,eclampsia may occur be=e1 dur+1 or aft] p>turition4 ,:5 x comes be=e t]m x usually ends 9 spontane\s or artificial abortion1 b at times ! woman dies undeliv]$4 ,n[ & !n %e may recov] & be deliv]$ at t]m4 ,! kidneys are usually affect$1 ev5 9 ^? cases 9 :i* album9\s ur9e is n f\nd4 ,!re is also a hemorrhagic inflammation ( ! liv]2 & o$ema & conge/ion ( ! bra91 ) or )\t apoplexy1 are o!r symptoms ( ! disease4 ,!re are o!r lesions1 b ! *ief are 9 ! kidneys1 liv]1 & bra94 ,! aetiology ( ! disease is n yet kn[n1 & !re are v _m !ories (f]$ to expla9 x4 ,! prognosis is always s]i\s1 & ! condition is "o ( ! mo/ dang]\s f\nd 9 pregnancy4 ,! mortality v>ies1 b x is ab\t f #bj to #be p] c5tum 9 ! wom51 & f #cc to #ej p] c5tum 9 ! *ildr54 ,x is impossible to det]m9e #ec ! prognosis 9 p>ticul> cases1 b a l>ge numb] ( quickly recurr+ convulsive seizures1 ) a weak1 ?ready pulse1 & a high temp]ature usually indicate a fatal end+4 ,apoplexy1 o$ema ( ! lungs1 & p>alysis also1 z a rule1 end 9 dea?4 ,if ! ut]us is empti$ dur+ ! convulsions1 ^! cease ei!r imm$iately or soon aft] deliv]y1 9 f #ff to #ic p] c5tum ( ! cases1 & ! mat]nal mortality !n is ab\t #aa p] c5tum4 ,) ! expectant treatm5t1 9 convulsive cases1 ab\t #bh p] c5tum ( ! wom5 die1 al?\gh a use ( aconite 9 ^! cases may bett] ! prognosis4 ,p]nici\s vomit+ 7hyp]emesis gravid>um7 is ano!r complication ( pregnancy1 :i* sometimes results fatally if ! ut]us is n empti$4 ,!re are cases1 especially ^? ) high fev]1 :i* end 9 dea? despite all treatm5t4 ,"h1 aga91 ! aetiology ( ! disease is n kn[n4 ,!re is commonly an elem5t ( hy/]ia 9 ! condition1 & 9 su* a case moral sugge/ion (t5 has a curative effect ,any bodily irritation is to be remov$4 ,eye-/ra9 alone is en\gh to cause p]si/5t vomit+4 ,x is v difficult to decide :5 premature lab\r is absolutely indicat$1 because "s v bad cases recov] spontane\sly :5 all hope is lo/4 ,hydramnios1 or an excessive quantity ( liquor amnii1 may s di/5d ! ut]us z to cause grave dang] to mat]nal life1 & if ! *ild is viable ! ut]us %\ld be empti$4 ,intraut]9e hemorrhage br\ght on by a premature sep>ation ( ! plac5ta is a v dang]\s condition3 #cb to #ej p] c5tum ( ! mo!rs die1 & #he to #id p] c5tum ( ! *ildr54 ,9 a m>k$ hemorrhage ! only way to save ! "m is to empty ! ut]us1 s t x may contract & ?us close ! patul\s vessels4 ,plac5ta praevia is a plac5ta implant$ 9 ! neighb\rhood ( ! int]nal os ( ! ut]9e neck4 ,?is is a v p]il\s condition1 call+ = ! induction ( premature lab\r4 ,! m$ical treatm5t is artificial abortion z soon z ! condition is diagnos$ 9 any /age ( ge/ation2 b ?is is1 ( c\rse1 9 conflict ) ! decrees ( ! ,holy ,(fice4 ,"u expectant treatm5t ab\t #dj p] c5tum ( #ed ! mo!rs die1 & #ff p] c5tum ( ! *ildr54 ,^? *ildr5 t are born alive commonly die )9 t5 days aft] deliv]y4 ,! great foetal mortality is due to premature bir? & asphyxiation4 ,skilful ob/etricians get mu* bett] results1 b skilful ob/etricians are un=tunately r>e4 ,:5 ! grave complications enum]at$ above occur 9 ! e>ly mon?s ( pregnancy1 be=e ! foetus is viable1 ! ,ca?olic physician1 s9ce by ! natural law & ! decisions ( ! ,holy ,(fice he is =bidd5 to induce artificial abortion1 mu/ )draw f ! case4 ,if !re is no o!r physician to att5d to ! woman1 he mu/ let h] die4 ,he c n )draw )\t explanation1 & 9 _m cases ! explanation ( ! condition w promptly result 9 ! call+ 9 ( a physician :o has no scruple 9 induc+ ?is abortion1 no matt] h[ reputable he may be4 ,! univ]sal m$ical doctr9e is to induce abortion 9 cases :]e abortion w save ! "m's life & ! foetus is too "y to am\nt to any?+4 ,?is is look$ ^u z legitimate abortion by ! v be/ m5 t d n recognise ! au?ority ( ! ,holy ,(fice3 !y deem ! position ( ! ,ca?olic physician 9 ^! cases z altoge!r errone\s1 or ev5 crim9al4 ,! position ( ! ,ca?olic morali/s on craniotomy has turn$ ! att5tion ( _m non-,ca?olic physicians to ! immorality ( ! act1 :i* =m]ly 0 deem$ entirely p]missible4 ,probably ! same good result w be effect$ 9 ! matt] ( abortion4 ,,au/9 ,,omalley4 #ee ,,! ,,caes>ean ,,section ,,& ,,craniotomy ,9 ! caes>ean section ! infant is deliv]$ ?r\gh an incision 9 ! abdom9al or ut]9e walls4 ,! op]ation1 accord+ to "o op9ion1 takes its "n f ,caius ,julius ,caes>1 :o1 x is said1 0 br\ght into ! _w 9 ?is mann]1 a caeso matris ut]o2 ?is1 h[ev]1 is a my?4 ,up to #ahgf ! mat]nal mortality f ! op]ation 0 ab\t #eb p] c5tum4 ,betwe5 #aghg & #ahgf 9 ! city ( ,p>is !re 0 n "o successful caes>ean section z f> z ! mo!rs 7 conc]n$4 ,at pres5t on an av]age less ?an #aj p] c5tum ( ! wom5 are lo/1 & exp]t surgeons h bett] results4 ,up to ab\t #aijb ,zweifel _h made #gf su* sections ) only "o dea?1 & ,reynolds1 #bc ) no dea?4 ,leopold has p]=m$ ! op]ation f\r times on ! same woman1 & ,ahlfeld & ,birnbaum h report$ in/ances :]e ! same woman has _h five caes>ean sections p]=m$ ^u h]4 ,! op]ation is1 ( c\rse1 capital1 & always mo/ s]i\s1 ev5 9 city hospitals4 ,! indication = ! op]ation is *iefly a n>r[ pelvis1 :i* blocks ! deliv]y ( ! *ild4 ,!re are no reliable /ati/ics z to ! frequ5cy ( n>r[ pelves 9 ! ,unit$ ,/ates2 b ,dr4 ,williams1 ( ! ,johns ,hopk9s ,univ]sity ,hospital1 9 a s]ies ( #bacc cases f\nd #f4i p] c5tum 9 :ite wom5 & #ah4hb 9 negroes4 ,normally ! av]age female pelvis1 at its n>r[e/ diamet]1 is #aa c5timetres wide4 ,?is "p is call$ ! conjugata v]a1 & x is ! diamet] f ! promontory ( ! sacrum beh9d to a po9t on ! inn] surface ( ! symphysis pubis 9 front4 ,9 deliv]y mu* dep5ds ^u ! size ( ! *ild1 & 9 ea* case ! ob/etrician waits until he sees t deliv]y #ef is impossible by natural means be=e he resorts to ! caes>ean section or o!r op]ative int]f]5ce4 ,( two wom5 ) pelves ( ! same contraction "o may require ! section & ! o!r may h a normal lab\r4 ,a bisis*ial diamet] at ! outlet ( ! p>turi5t canal ( #g c5timetres or less is an indication = section2 s are c]ta9 tum\rs t block ! deliv]y ( ! *ild4 ,:5 ! conjugata v]a is less ?an #g c5timetres 9 flat pelves1 or #g4e c5timetres 9 g5]ally contract$ pelves1 ! treatm5t v>ies 9 ! cu/om>y m$ical practice accord+ z ! *ild is alive or dead1 & x v>ies z ! condition ( ! "m4 ,! common m$ical doctr9e w fir/ be giv5 "h be=e ! moral que/ions t may be involv$ are m5tion$4 ,if ! de=mity is diagnos$ dur+ pregnancy1 ! woman is s5t to a hospital1 ! caes>ean section is p]=m$1 & ?us all ! *ildr51 & ne>ly all ! mo!rs1 are sav$4 ,:5 ! n>r[ness ( ! pelvis is discov]$ only dur+ lab\r1 ! treatm5t v>ies ) ! condition4 ,if ! woman is n septic1 & has n be5 repeat$ly exam9$ by ! vag9a1 & if ! surr\nd+s are fav\rable1 caes>ean section is done2 if %e is septic1 ! indications are = ! section1 or symphyseotomy or craniotomy4 ,:]e ! conjugata v]a is bel[ #e c5timetres 9 l5g?1 ! caes>ean section is ! only me?od to get ! *ild out1 dead or alive1 & aft] ! *ild has be5 deliv]$1 ! ut]us1 if septic1 is remov$4 ,if ! conjugata v]a is at ! lea/ #g c5timetres long1 symphyseotomy may be done2 if ! conjugata v]a is above #e c5timetres1 ! "m septic1 & ! *ild dead or dy+1 craniotomy is indicat$4 ,ev5 if ! *ild is n dy+1 "s ob/etricians w d craniotomy4 ,9 cases :]e ! conjugata v]a is above #g c5timetres 9 flat pelves & #g4e c5timetres 9 g5]ally contract$ pelves1 ! treatm5t c n be r$uc$ to g5]al rules4 ,deliv]y )\t op]ation occurs 9 _m ( ^! cases1 b commonly ! condition is obscure to ! physician = "s "t4 ,we c measure ! pelves1 b ! size ( ! *ild's head is n satisfactorily measurable4 ,if ! conjugata v]a is f #aj to #i c5timetres1 or f #eg #i4e to #h4e c5timetres1 lab\r )\t op]ation is ! rule1 & ! *ild c usually be deliv]$ by =ceps4 ,%\ld ! *ild die dur+ lab\r 9 ^! cases1 x is be/ deliv]$ by craniotomy1 unless ! long] diamet] ( its head has already pass$ ! n>r[e/ "p ( ! pelvis4 ,:5 ! conjugata v]a is f #h4i to #g4e c5timetres1 ab\t #ej p] c5tum ( ! wom5 w be deliv]$ ) =ceps1 b ! o!r half w n4 ,aft] ab\t two h\rs ( ! second /age ( lab\r deliv]y by =ceps is tri$1 b prolong$ traction is n appli$4 ,occasionally deliv]y w come :5 lea/ expect$1 b (t5 x w n4 ,if ! head /icks1 caes>ean section is done 9 fav\rable circum/ances1 & craniotomy 9 unfav\rable circum/ances4 ,if !re is gr\nd = suppos+ t septic infection ( ! "m has begun1 ! conditions are expla9$1 & if %e wi%es to h ! caes>ean section done ! risk is left to h]4 ,:5 ! bree* or face ( ! *ild pres5ts 9 contract$ pelves1 ! condition is especially unfav\rable = ! *ild4 ,!re are v _m v>ieties ( de=m$ pelves1 b ! same rules apply to !m z to ^? already m5tion$1 except t ! caes>ean section is (t5] indicat$4 ,difficulty also n seldom occurs 9 wom5 ) normal pelves f an excessive size 9 ! *ild ?r\gh prolong$ pregnancy1 bigness ( "o or bo? p>5ts1 or ! advanc$ age or multip>ity ( ! "m4 ,! *ild's head alone may be ( excessive size4 ,"s mon/]s (f] difficulty 9 deliv]y f size or %ape1 b1 ( c\rse1 !y are human be+s1 & are to be consid]$ z su* 9 deliv]y4 ,! te*nique ( ! caes>ean section has only a m$ical signification1 & x ne$ n be describ$ "h4 ,symphyseotomy is an op]ation 9 :i* ! jo9t ( ! pelvis at ! symphysis pubis is cut1 & ! pelvis is all[$ to gape s z to let out ! *ild4 ,! op]ation has fall5 into disrepute4 ,! mortality z reg>ds ! "m is ab\t ! same z 9 ! caes>ean section1 b ! mortality ( ! *ildr5 is high]4 ,9 symphyseotomy ! infantile mortality is ab\t #i p] c5tum1 :ile 9 ! caes>ean section x is practically no?+4 ,if 9 symphyseotomy an error is made 9 e/imat+ ! size ( ! pelvis or ! *ild's head--& #eh su* an error is (t5 possible--! *ild w be kill$1 b 9 ! caes>ean section ^! errors make no diff]5ce4 ,aft] ! caes>ean section ! woman recov]s promptly2 aft] ! symphyseotomy %e recov]s v sl[ly1 & %e may receive p]man5t injury4 ,craniotomy is an op]ation :]e9 ! head ( ! *ild is r$uc$ 9 size to r5d] deliv]y possible4 ,! skull is p]=at$ & ! bra9 is brok5 up & remov$ or cru%$ out4 ,embryotomy is a simil> op]ation :]e9 ! visc]a ( ! *ild are remov$ ?r\gh an incision made 9 its ?orax or belly 7evisc]ation71 or ! head ( ! *ild is cut (f 7decapitation74 ,!re are num]\s in/rum5ts & me?ods = p]=m+ craniotomy & embryotomy1 b !y all op5 ! skull or belly1 remove ! bra9 or visc]a1 & !n extract ! *ild's body4 ,if ! infant is hydrocephalic & is alive1 ! advocates ( ! op]ation w>n u to be c>eful aft] op5+ ! head to pu% ! p]=ator into ! base ( ! skull & /ir x ar\nd well1 s z to be sure ! *ild w n be born alive4 ,p]nice has rec5tly report$ a case ( hydrocephalus :i* 0 deliv]$ by craniotomy1 b ! op]ator did n "w 8 p]=ator effici5tly1 & ! *ild recov]$1 & grew up an idiot4 ,a simil> case occurr$ 9 ,baltimore4 ,! indications = craniotomy among ^? t advocate its occasional use 7& !y are _m7 is 9 ^? cases 9 :i* ! woman is s infect$ t caes>ean section is dang]\s1 or :]e a *ild is hydrocephalic1 or :]e an aft]-com+ head is jamm$ 79 ?is case ev5 a caes>ean section w n effect deliv]y71 or 9 ! case ( a n>r[ pelvis & a moribund *ild1 or f9ally 9 ! practice ( a c\ntry physician1 :o c n 9 an em]g5cy get an assi/ant to d a caes>ean section4 ,"o man c d craniotomy1 b x requires ?ree to p]=m ! caes>ean section4 ,if ! woman's n>r[ pelvis has a conjugata v]a ( five or m c5timetres1 craniotomy1 if prop]ly done1 is n dang]\s to ! "m4 ,) a conjugata v]a less ?an #e c5timetres x is m fatal ?an ! caes>ean section4 ,if ! wom5 are septic1 ! mortality 9 #ei craniotomy is f #aj to #ae p] c5tum2 9 caes>ean section ab\t #be p] c5tum4 ,z to ! morality ( craniotomy on ! liv+ or moribund *ild1 x is n p]missible "u any possible circum/ances3 a consid]ation ( ! e?ical pr9ciples set =? 9 ! article on ,ectopic ,ge/ation w make ?is ass]tion cle>4 ,! ,congregation ( ! ,holy ,(fice on ,augu/ #ai1 #ahhh1 decre$ t ,9 s*olis ca?olicis tuto doc]i non posse licitam esse op]ationem *irurgicam quam ,craniotomiam appellunt4 ,!y gave a simil> decision ,may #bh1 #ahhd1 & !y repeat$ ! prohibition1 ) ! papal approbation1 on ,july #bd1 #ahie4 ,! text ( ^! decrees may be f\nd 9 ! article on abortion1 misc>riage1 & premature lab\r4 ,! ,porro op]ation consi/s ess5tially 9 a removal ( ! ut]us aft] caes>ean section to prev5t fur!r conceptions4 ,z a means to prev5t conception x is altoge!r unju/ifiable1 because repeat$ caes>ean sections 9 ! same woman1 if ! surgeon is at all compet5t1 are practically no m dang]\s ?an normal lab\r4 ,,au/9 ,,omalley4 #fj ,v ,,mat]nal ,,impressions ,!re is a wide-spread p]suasion t a *ild1 :ile c>ri$ 9 ! womb ( its "m1 may be m>k$ z ! result ( incid5ts t produce viol5t impressions ^u h] n]v\s sy/em4 ,?is is s old a conviction 9 ! human race & w\ld seem to be sub/antiat$ by s mu* evid5ce t x is extremely difficult to conv9ce p t !re is no sci5tific basis = x4 ,z a matt] ( fact1 h[ev]1 !re is some?+ my/]i\s ab\t ! way 9 :i* c]ta9 ?+s t happ5 to ! "m seem to affect ! *ild 9 ut]o4 ,z ! result ( ! common belief 9 ! tru? ( mat]nal impressions1 mo!rs sometimes are prone to blame !mselves = n hav+ be5 suffici5tly circumspect dur+ ! "t ( _! pregnancy1 & accord+ly !y may seek advice & consolation 9 ! matt] f cl]gym54 ,wom5 sometimes become v mu* depress$ z a consequ5ce ( an un=tunate ev5t ( ?is k9d1 & z ! simple tru? is ! be/ possible s\rce ( consolation1 x w\ld seem t a special *apt] %\ld be giv5 to ! subject 9 a "w ( ?is k9d4 ,! evid5ce = ! tru? ( ! !ory ( mat]nal impression is almo/ entirely due to peculi> co9cid5ces4 ,james ,i4 ( ,engl&1 ! son ( ,m>y ,que5 ( ,scots1 c\ld nev] /&1 accord+ to ,sir ,walt] ,scott1 ! sight ( a drawn sword ) equanimity1 & x is said ev5 t he ne>ly fa9t$ at 8 coronation because ( an unexpect$ glimpse ( "s nak$ blades 9 ! h&s ( c\rti]s4 ,?is peculi>ity 0 attribut$ to ! fact t 8 "m1 :ile c>ry+ him 9 ut]o1 _h witness$ ! viol5t dea? ( h] secret>y1 ! un=tunate ,david ,rizzio4 ,!re h be51 h[ev]1 any #fa numb] ( m5 :o pal$ at ! sight ( a drawn sword be=e & s9ce ,james ,i41 ) reg>d to :om no su* circum/antial /ory c\ld be told to acc\nt = x4 ,!re h be5 any numb] ( wom5 t h witness$ bloody murd]s "u circum/ances q z he>tr5d+ z ^? surr\nd+ ,m>y ,que5 ( ,scots & h] secret>y1 & yet _! (fspr+1 ?\gh at ! "t 9 ut]o1 h n be5 di/urb$ at ! sight ( drawn swords1 nor ( blood or any o!r circum/ance connect$ ) ! deep impression t mu/ h be5 produc$ on _! mo!rs4 ,!re is1 ( c\rse1 a /rik+ in/ance relat$ 9 ! ,old ,te/am5t1 :i* seems to make x v cle> t a belief 9 mat]nal impressions exi/$ f ! v e>lie/ times among ! ,israelites4 ,! /ory ( ,jacob is well kn[n3 ,jacob took him rods ( gre5 popl> & ( ! hazel & *e/nut tree & pill$ :ite /reaks 9 !m & made ! :ite appe> :i* 0 9 ! rods1 & he set ! rods :i* he _h pill$ be=e ! flocks 9 ! wat]+ tr\ghs :5 ! flocks came to dr9k1 & ! flocks conceiv$ be=e ! rods & br\ght =? cattle1 r+-/reak$1 speckl$ & spott$4 ,9 ?is case x seems evid5t t ,jacob 0 n look+ = a miracle1 b 0 expect+ t a law ( nature w\ld be fulfill$ 9 ! matt]1 ! influ5ce ( ! unusual sight ^u ! animal mo!rs prov+ suffici5t to h a def9ite effect ^u _! unborn (fspr+4 ,! mo/ ard5t advocates ( ! p[] ( mat]nal impressions w\ld sc>cely conc$e ! exi/5ce ( z mu* influ5ce z ?is ( ! "m's m9d ov] ! *ild unborn1 o!rwise !re w\ld surely be a v absurd collection ( anomal\s bir?s 9 ! race4 ,on ! o!r h&1 x is g5]ally conc$$ t ! "m's habitual temp] ( m9d & ! ?\ghts ) :i* %e occupies h]self may influ5ce h] unborn (fspr+ to a mo/ m>k$ degree4 ,! /ory is told ( a *ild-murd]] :o delight$ 9 fi5di% de$s ( cruelty & _h murd]$ _m p 9 cold blood1 t 8 "m1 ! wife ( a but*]1 _h delight$ 9 wat*+ ! op]ation ( slaught]+ dur+ ! c\rse ( h] pregnancy4 ,!re are any numb] ( wom51 h[ev]1 :o h1 by ! necessities #fb ( _! occupation1 _h to witness ! %$d+ ( animal blood "u su* circum/ances & yet )\t any special effect be+ noticeable 9 _! (fspr+4 ,x has be5 said t ! opposite is also true1 & t if a woman occupies h]self ) high & l(ty ?\ghts1 ) noble de$s & unselfi% devotion to o!rs & if %e occupies h] m9d & s5ses ) ! great works ( art1 a correspond+ly b5eficial effect w be not$ ^u ! "* ( ! foetus4 ,^! are1 h[ev]1 ab/ruse speculations lead+ to conclusions n f\nd$ ^u actual obs]vation1 b ^u !oris+ ov] ! suppos$ fitness ( ?+s4 ,co9cid5ce plays su* a l>ge "p 9 ! matt] ( suppos$ mat]nal impressions t x is impossible to decide h[ mu* !re is ( fact & ( consequ5ce 9 ! _m /ories t are told4 ,mo/ wom5 are a little afraid1 z ! "t ( _! lab\r approa*es1 le/ some?+ or o!r--usually ( an indef9ite nature--t has happ5$ dur+ _! pregnancy1 may cause ! m>k+ ( _! *ild4 ,:5 !y f9d t ! *ild is p]fectly normal1 !y brea! a sigh ( relief & =get all ab\t x4 ,if any anomaly is not$1 h[ev]1 !n !y are sure to connect x ) "s incid5t dur+ pregnancy1 & imag9ation is apt to l5d details t confirm ! suppos$ connection4 ,on ! o!r h&1 !re are n a few cases 9 :i* su* anomalies h occurr$1 & good1 s5sible mo!rs h be5 unable to recall any?+ t might possibly s]ve to acc\nt = ! peculi>ity notic$ 9 ! *ild1 ?\gh correspond+ peculi>ities 9 o!r *ildr5 7 suppos$ to be readily traceable to mat]nal impression4 ,ev5 :]e !re has be5 no =ebod+ ( evil results1 some?+ or o!r t has occurr$ dur+ ! pregnancy w (t5 be magnifi$ en\gh by memory to acc\nt = ! suppos$ mat]nal impression4 ,doctors are v famili> ) ?is t5d5cy to make up /ories to acc\nt = v>i\s de=mities4 ,x us$ to be consid]$ t hip-jo9t disease & ,pott's disease 7 ! result ( injuries 9 e>ly life4 ,!y are n[ kn[n to be due to tub]cul\s processes n necess>ily & inde$ only v seldom connect$ ) injuries ( any k9d4 ,mo!rs are #fc ne>ly always able to acc\nt 9 "s way1 h[ev]1 = ! beg9n+s ( ! disease 9 "s accid5t t has happ5$4 ,"y *ildr5 are apt to h s _m falls t "s "o ( !m is pick$ out z ! probable cause ( ! disease t subsequ5tly manife/s itself 9 ! jo9ts4 ,x is j ?is /ate ( affairs t occurs ) reg>d to suppos$ mat]nal impression4 ,"s incid5t t w\ld be o!rwise un?\ght ( is magnifi$ into an accid5t t caus$ a s]i\s n]v\s %ock1 & consequ5tly l$ to ! m>k+ ( ! *ild4 ,9 g5]al x may be said = ! cl]gyman's direction1 t if wom5 h1 z is sometimes ! case1 a morbid s5se ( _! guilt9ess ) reg>d to "s mat]nal impression t has set a m>k ^u _! *ild1 su* a /ate ( feel+ may v well be r5d]$ less poignant by a frank /atem5t ( ! pres5t attitude ( m9d ( mo/ physicians ) reg>d to ! possible effects ( mat]nal impressions4 ,scepticism is mu* m ! rule ?an x us$ to be1 & z "t goes on few] & few] ( ! cases t us$ to be consid]$ s inexplicable 9 ! direct relation%ip t seem$ to exi/ betwe5 mat]nal impression & de=mity 9 ! *ild are report$4 ,fifty ye>s ago ne>ly all ! au?orities on ?is subject 7 agre$ 9 consid]+ t mat]nal impressions did play "s "p1 ?\gh !y c\ld n expla9 j h[1 9 ! production ( c]ta9 de=mities4 ,n[ we v5ture to say t mo/ ( ! ?9k+ physicians :o h occupi$ !mselves ) ?is subject w\ld sc>cely hesitate to say t !y 7 utt]ly incr$ul\s ( any su* effects be+ produc$4 ,! lack ( any direct n]v\s or blood connection betwe5 "m & *ild is ! basis = su* disbelief1 & is ( itself ! be/ argum5t aga9/ ! old tradition4 ,) reg>d to m5tal defects1 z a rule1 n s mu* is said z = bodily defects4 ,bodily de=mities are not$ at once aft] bir?1 & !n ! "m recalls "s incid5t ( ! pregnancy to acc\nt = !m4 ,m5tal defects are1 h[ev]1 notic$ mu* lat]1 & are n s likely to be consid]$ z connect$ ) incid5ts ( ! pu]p]al p]iod4 ,!re is no d\bt t if ! "m has _h to pass ?r\gh a s]ies ( emotional /ra9s1 or has suff]$ f sev]e #fd %ocks1 *ildr5 are likely to be born ) dim9i%$ m5tal capacity4 ,?is is1 h[ev]1 n difficult to und]/&1 s9ce su* incid5ts produce di/urbances ( ! n]v\s sy/em ( ! "m1 & consequ5tly also ( h] nutrition1 & ?is is prone to be reflect$ 9 ! *ild's condition1 especially 9 t mo/ delicate "p ( ! *ild's organism1 ! bra94 ,h5ce x is t *ildr5 born dur+ ! siege ( ,p>is1 or %ortly aft]1 7 defective to su* a m>k$ degree t !y 7 spok5 ( z *ildr5 ( ! siege1 & ?is 0 consid]$ to be q suffici5t explanation ( n]v\s peculi>ities lat] 9 life4 ,b>on ,l>rey1 ! di/+ui%$ ,fr5* surgeon1 made a report ) reg>d to ! *ildr5 born aft] ! siege ( ,l&au 9 #agic4 ,( #ib *ildr51 #af di$ at bir?1 #cc di$ )9 t5 mon?s1 #h %[$ m>k$ signs ( m5tal defects1 mo/ ( !m to ! ext5t ( idiocy1 & two 7 born ) sev]al brok5 bones4 ,9 ?is case1 h[ev]1 x is well kn[n t besides ! %ock ( ! dang] consequ5t to ! siege & ! fe> & di/ress ( ! wom5 ) reg>d to _! husb&s & relatives1 !re 7 add$ _m privations & physical suff]+s4 ,! nutrition ( ! mo!rs 0 s]i\sly di/urb$ by ^!1 & x might well be expect$ t ! *ildr5 %\ld suff] sev]ely4 ,! /ati/ics ( su* ev5ts are n available 9 g5]al1 & :5 an ef=t is made to e/abli% a cause = idiocy "u o!r circum/ances1 none is usually f\nd4 ,out ( ne>ly five hundr$ cases ( idiots ^: hi/ories 7 c>efully trac$ 9 ,scotl&1 9 only six 0 !re any "q ( mat]nal impressions hav+ be5 ! cause ( ! condition4 ,( c\rse !re are _m v wond]ful co9cid5ces t seem to confirm ! idea t impressions made ^u ! "m's m9d are sometimes communicat$ to ! *ild 9 h] womb4 ,t !y are n m ?an co9cid5ces1 h[ev]1 is r easy to demon/rate 9 mo/ cases1 s9ce1 z a matt] ( fact1 at ! "t :5 ! incid5t occurr$ :i* is suppos$ to h caus$ ! de=mity 9 ! foetus1 ! /age ( developm5t ( ! intraut]9e *ild has pass$ long beyond ! p]iod :5 =mative defects c\ld occur4 ,= in/ance1 x sometimes happ5s t ! *ild-be>+ woman #fe sees an accid5t especially to ! fa!r ( ! *ild involv+ ! loss ( a limb4 ,if1 by *ance ! *ild %\ld be born ) a miss+ memb]1 z sometimes happ5s1 !n !re w\ld seem almo/ to be no d\bt ( a direct connection betwe5 ! accid5t witness$1 ! effect produc$ ^u ! "m's m9d1 & ! consequ5t de=mity4 ,we "k n[ t ! =mation ( ! limbs ( ! foetus is complete by ! end ( ! ?ird mon?4 ,at ?is "t ! woman is sc>cely m ?an consci\s ( ! fact t %e is pregnant1 & x is n dur+ ?is e>ly p]iod1 z a rule1 b dur+ a mu* lat] p]iod1 t mat]nal impressions are suppos$ to h _! influ5ce4 ,x is only su* mat]nal impressions z occur v e>ly 9 pregnancy1 be=e ! t5? week z a rule1 t c\ld possibly h any effect 9 ! production ( su* de=mities4 ,x is by no means infrequ5t1 h[ev]1 to h *ildr5 born lack+ "o or bo? limbs4 ,sometimes no?+ b ! /umps ( limbs rema94 ,9 su* cases x is n[ well kn[n t intraut]9e amputation has tak5 place4 ,"s ( ! membranes t surr\nd ! *ild1 especially ! amnion1 become sep>at$ into b&s :i* surr\nd tightly ! gr[+ memb]s ( ! foetus & by %utt+ (f ! blood supply ?r\gh con/ant pressure1 lead to ! dropp+ (f ( all t portion ( ! memb] ly+ bel[ ! b&4 ,n infrequ5tly x happ5s t :5 a *ild is born ?us de=m$1 ! "m1 by c>efully se>*+ h] memory1 c f9d "s dreadful /ory t %e has read1 "s accid5t t %e has se5 or he>d (1 & t has produc$ a s]i\sly depress+ effect ^u h] at ! "t1 to :i* %e n[ attributes ! de=mity t has occurr$4 ,until ! un=tunate appe>ance ( h] *ild 0 report$ to h]1 %e _h no idea ( any possible connection betwe5 ! /ory & ! bodily /ate ( h] intraut]9e *ild4 ,9 n a few cases1 h[ev]1 ! mo/ fai?ful se>*+ ( ! memory fails to %[ any?+ :i* c\ld1 by any possible connection1 be made acc\ntable = ! de=mity2 & ^! cases1 we may say at once1 are 9 a majority4 ,n a little ( a popul> notion ) reg>d to ! influ5ce ( mat]nal impression is due to ! repetition ( c]ta9 #ff village gossip :i* by no means loses its po9t or effectiv5ess pass+ f m\? to m\?4 ,on ! o!r h&1 mat]nal impressions h be5 exploit$ by noveli/s1 :o h f\nd t ! morbid curiosity ( wom5 p>ticul>ly ) reg>d to ?is subject may make _! /ories m widely read4 ,lucas ,malet1 :o1 9 spite ( ! app>5tly mascul9e pseudonym1 is really ! late ,rev4 ,*>les ,k+sley's daught]1 has rec5tly call$ r5ew$ att5tion to ?is subject by h] novel ,sir ,ri*>d ,calmady4 ,9 ?is ! h]o is born ) bo? 8 l[] limbs miss+ f j bel[ ! knees4 ,! au?or has be5 c>eful1 h[ev]1 ) reg>d to ! details ( ! suppos$ mat]nal impression to :i* ?is de=mity is attribut$4 ,a "y m>ri$ woman 9 ! e>ly "p ( h] fir/ pregnancy has h] husb&1 :om %e loves v de>ly1 br\ght back to h] ) bo? 8 limbs tak5 (f by a %ock+ accid5t :i* result$ fatally4 ,x is n impossible1 "s physicians might ?9k1 to consid] t s sev]e a %ock c\ld produce a v delet]i\s effect ^u ! foetus4 ,t ! result %\ld s exactly copy ! sc5e :i* 0 br\ght "u ! eyes ( ! "y "m is1 h[ev]1 beyond cr$5ce4 ,occasionally su* /ories1 suppos$ly on m$ical au?ority1 f9d _! way into ! newspap]s1 usually f di/ant p>ts ( ! c\ntry4 ,c]ta9 p>ts ( ,texas p>ticul>ly seem to be a fruitful s\rce ( su* /ories = newspap] correspond5ts :5 !re is a de>? ( o!r news4 ,f>m]s 9 ?9ly settl$ p>ts ( ! c\ntry lose a foot 9 a reap+ ma*9e or a h& 9 ! hay-cutt+ ma*9e :5 !re is no "o ne> to help !m b _! wives1 ) ! result t ! %ock to _! wives proves ! occasion ( a simil> de=mity 9 an z yet unborn *ild4 ,c>eful inve/igation ( su* cases1 h[ev]1 has inv>iably %[n t ei!r !y 7 completely false or t ! details %[$ t :atev] _h happ5$ 0 at mo/ a co9cid5ce & nev] a direct causative factor 9 ! subsequ5t de=mity4 ,! greate/ difficulty 9 ! m9d ( ! m$ical man1 ) reg>d to ! possibility ( mat]nal impression be+ communicat$ 9 any way to ! foetus1 is1 z we h said1 8 k ( ! anatomy ( "m & foetus4 ,:ile x is #fg g5]ally suppos$ t ! "m is v intimately connect$ ) h] *ild 9 ut]o1 ! actual connection is by no means s direct z might be expect$ f ! popul> impression4 ,x is usually consid]$ t ! "m's blood fl[s 9 ! *ild's ve9s2 b ?is is absolutely false4 ,! *ild's blood is =m$ indep5d5tly ( ! "m's blood q z is t ( ! *ick 9 ! egg4 ,at all times ! blood ( ! *ild rema9s q diff]5t 9 con/itution to t ( its "m4 ,x conta9s _m m r$ cells ?an does h] blood & diff]s 9 o!r v easily recognisable ways4 ,"m & *ild are connect$ by means ( an organ kn[n z ! plac5ta1 :i* is atta*$ v closely to ! ut]9e wall & f :i* ?r\gh ! cord ! blood ( ! foetus circulates4 ,?is plac5ta con/itutes ! s-call$ aft]bir?4 ,! "m's blood fl[s 9 "o portion ( x1 t ( ! *ild 9 ano!r1 & !y always rema9 di/9ct & sep>ate f ea* o!r4 ,! gases necess>y = ! *ild's life diffuse ?r\gh ! membrane :i* sep>ates ! two diff]5t bloods1 & ! salts & soluble proteids necess>y = ! *ild's nutrition1 z well z ! wat] necess>y = its vital processes1 all pass ?r\gh ?is membrane1 b at no "t is !re any direct blood connection betwe5 "m & *ild4 ,inde$1 = a l>ge "p ( ! =mative p]iod ( ! foetus life1 t is1 dur+ ! fir/ two mon?s ( its exi/5ce1 ! ovum is n v closely atta*$ to ! ut]us at all1 b gr[s by means ( ! vital p[] :i* x has )9 itself4 ,nor is !re any direct n]v\s connection betwe5 "m & *ild2 inde$1 !re are no n]ves at all 9 ! plac5ta1 & none 9 ! cord ?r\gh :i* all communications betwe5 "m & *ild mu/ pass4 ,x seems impossible to expla91 !n1 h[ mat]nal impressions c s effectively pass f "m to *ild2 & inde$1 ! :ole subject1 :5 look$ at 9 ?is way1 is apt to be consid]$ leg5d>y1 & ! facts adduc$ 9 support ( ! !ory ( mat]nal impressions are practically sure to be ?\ght m]e co9cid5ces4 ,a little k "h might seem to ju/ify _m ?+s t m complete k fails to be able to f9d any reasons =4 #fh ,!re is no d\bt1 h[ev]1 t ! "m's environm5t dur+ pregnancy is 9 g5]al v important = ! p]fect developm5t ( ! intraut]9e *ild4 ,_m m de=m$ bir?s are report$ aft] times ( /ress & trial1 z1 = example1 aft] ! sieges ( great cities1 notably ! siege ( ,p>is 9 #ahga1 & su* sc5es ( desolation z occurr$ dur+ ! ?irty ye>s' w> 9 ,g]many4 ,^! are1 h[ev]1 n direct1 b indirect effects ( mat]nal impressions4 ,! developm5t ( ! human be+ 9 ut]o is an extremely complicat$ process4 ,any di/urbance ( x1 h[ev] slight1 is sure to be foll[$ by s]i\s consequ5ces4 ,di/urbances ( nutrition1 su* z are consequ5t ^u ! deprivation t has to be endur$ 9 times ( w> or dur+ sieges1 is ( itself suffici5t s]i\sly to di/urb ev5 ! ut]9e life ( ! *ild4 ,9 ^! cases1 h[ev]1 !re w be no traceable connection betwe5 ! =m ( ! mat]nal impression & ! type ( de=mity t occurs4 ,?is is1 h[ev]1 ! ess5ce ( ! old !ory ( ! direct effect ( mat]nal impressions1 & consequ5tly t !ory mu/ fall to ! gr\nd4 ,f all t has be5 said1 h[ev]1 x becomes v cle> t z f> z possible wom5 %\ld be %ield$ f ! effect ( v>i\s n]v\s %ocks dur+ _! pregnancy1 & t !y owe x to !mselves & _! (fspr+ to be c>eful ) reg>d to any morbid manife/ations ( feel+ t !y may detect 9 !mselves4 ,,james ,j4 ,,wal%4 #fi ,,vi ,,human ,,t]ata ,,& ,,! ,,sacram5ts ,t]atology 7,greek text1 a mon/]7 is a "p ( biology t treats ( deviation f a normal developm5t 9 man & ! l[] animals4 ,! "n 0 adopt$ 9 #ahbb by ! eld] ,sa9t-,hilaire1 :o !n attempt$ to sep>ate ! results ( mod]n exact me?ods ( rese>* f ! my?s & loose descriptions ( mon/]s f\nd 9 ! writ+s ( old au?ors4 ,cic]o 7,de ,div9atione7 d]ives ! t]m mon/] f ! prop] pret]natural signification look$ = 9 ! occurr5ce ( ^! abnormal be+s3 ,mon/ra1 o/5ta1 port5ta1 prodigia appellantur1 quoniam mon/rant1 o/5dunt1 port5dunt et pr$icunt4 ,at ! end ( ! sev5te5? c5tury ,malpighi & ,grew discov]$ t plant tissue is entirely made up ( microscopic spaces enclos+ fluid2 !y call$ ^! spaces cells4 ,diff]5t inve/igators f\nd t animal tissue is also compos$ ( cells2 & betwe5 #ahce & #ahci ,s*wann & ,s*leid5 =mulat$ ! law t e metazoic organism is made ( cells1 & />ts f a cell4 ,9 #afgb de ,graaf discov]$ ! mammalian ovum1 9 #afge ,ludwig ,ham f\nd sp]matozoa1 9 #ahbg von ,ba] recognis$ ! human ovum1 b n until #ahge 0 ! important fact e/abli%$ t f]tilisation is effect$ by ! fusion ( ! male & female pronuclei4 ,?is 0 demon/rat$ by ,osc> ,h]twig f obs]vation ( ! ova ( />fi%es4 ,mammalian ova1 ow+ to an almo/ complete lack ( yolk1 are all small4 ,! egg ( a :ale is ab\t ! size ( a f]n-se$1 b ! yolk$ eggs ( birds are l>ge--t ( ! great auk 0 #g4e in*es long4 ,9 man ! ovum is f #j4ah to #j4b mm4 9 diamet]1 sc>cely visible to ! #gj nak$ eye1 & ! sp]matozoon is extremely m9ute4 ,! human sp]matozoon is only fifty-f\r ?\s&?s ( a millimetre 9 l5g?1 & f =ty-"o to fifty-?ree ?\s&?s ( a millimetre are tak5 up by its flagellum4 ,! ess5tial "p is f f\r to six ?\s&?s ( a millimetre 9 l5g? 7,dr4 ,l4 ,n4 ,bo/on1 ,j\rn1 ( ,appli$ ,microscopy1 vol4 iv4 p4 #acfj74 ,a l9e ( #ah human sp]matozoa w\ld rea* only across ! head ( an ord9>y p94 ,^! sp]matozoa h ! p[] ( locomotion 9 alkal9e fluid4 ,h5le f\nd !y c travel "o c5timetre 9 ?ree m9utes4 ,! human ovum & sp]matozoon are s+le cells1 & ! pr9cipal p>ts ( a typical cell are ! cytoplasm 7call$ also ! protoplasm71 &1 )9 ?is1 ! nucleus & c5trosome4 ,! c5trosome is effici5t 9 ! process ( cell-division4 ,a few cells h also an out] envelope or membrane1 & ?is "p is well develop$ 9 ! ovum4 ,! nucleus is ! c5tre ( activity 9 a cell4 ,9 ! re/+ /ate x is surr\nd$ by a membrane1 & )9 ! membrane is an intra-nucle> network made up ( *romat9 & l99--! *romat9 is an important elem5t4 ,! me%es ( ?is network are probably fill$ ) fluid4 ,dur+ ! /ages prep>atory to ! mitotic1 or indirect1 division ( a cell into two cells 7"o ( ! me?ods ( reproduction7 ! *romat9 segregates 9 typical cases into two gr\ps ( loops1 & ea* gr\p has equal portions ( ! *romat94 ,:5 ! *romat9 is 9 ?is %ape1 a loop is call$ a *romosome4 ,! *romosomes are v important4 ,!y occur 9 con/ant def9ite numb]s 9 ! somatic cells ( ! v>i\s species ( _m animals & plants1 & x is probable t ea* species ( plant & animal has its own *>act]i/ic numb] ( *romosomes4 ,wilson 7,! ,cell 9 ,developm5t & ,inh]itance1 ,new ,york1 #ahij7 gives a li/ ( #gb species 9 :i* ! numb] has be5 det]m9$4 ,man has probably #af *romosomes 9 ! somatic cell1 & ! mature male & female g]m cells 9 man contribute eight *romosomes ea* to ! nucleus ( ! impregnat$ ovum4 ,! *romosomes transmit ! physical bases ( h]$ity f "o g5]ation to ! next1 & ! h]itages f ! two p>5ts are equal except 9 cases ( prepot5cy4 ,e cell #ga 9 ! human body is d]iv$ f ! fa!r & ! "m equally4 ,! fact t ! woman c>ries a *ild = mon?s 9 h] womb means only t %e employs a peculi> me?od ( fe$+ & protect+ x4 ,aft] its bir? %e fe$s x f h] brea/s1 be=e bir? ?r\gh its umbilical vessels1 b %e orig9ally gives only ! eight *romosomes z ! fa!r does1 & ! *ild's vital pr9ciple builds up ! body f ?is f\ndation4 ,! popul> notion t ! foetus 9 ! womb is =m$ ?r\gh "s process ( lit]al ab/raction f ! mat]nal tissues is no m true ?an t ! infant is s built up :ile x is suckl+2 bo? processes are m]ely diff]5t me?ods ( fe$+4 ,all ! *romosomes f ! fa!rs ( at lea/ #bjj m5 c\ld fit simultane\sly on ! head ( "o p91 yet virtually1 n m]ely pot5tially1 half ! bodily sub/ance ( t multitude1 & all ! physical *>act]i/ics d]iv$ f ! #bjj fa!rs1 are indubitably conta9$ 9 ^? *romosomes & n[h]e else1 unless by a special creation !y are infus$ ) ! new s\l1 :i* seems to be an altoge!r unreasonable alt]native4 ,?is /atem5t conc]n+ ! m9ut5ess ( ! *romosomes is n speculation--!y c readily be se5 & measur$ ) ! aid ( ! microscope4 ,a human be+1 !n1 obta9s eight microscopic *romosomes f 8 fa!r & eight f 8 "m1 positively no?+ m except food2 yet he develops into a man ) a body made up ( c\ntless millions ( cells :i* exp& into m ?an #bjj bones 9 ! skeleton & ov] #bjj muscles1--into ! fascias1 ligam5ts1 t5dons1 ! great & small gl&s1 ! lymph & blood sy/ems1 ! respiratory & alim5t>y tracts1 ! sk9 & its app5dages1 & a n]v\s sy/em1 :i* alone furni%es mat]ial = ye>s ( /udy if we w\ld le>n its anatomy fully4 ,n only all ?is1 b ! man commonly closely resembles 8 fa!r or 8 "m1 or "s o!r ance/or1 9 p]sonal appe>ance1 9 c]ta9 physical t5d5cies1 9 graces or blemi%es2 & fur!rmore1 he %[s inh]it$ racial *>act]i/ics4 ,if a fa!r is prepot5t1 he may h a great] effect 9 produc+ ! =m$ *ild ?an ! "m has1 & vice v]sa1 z :5 a son closely resembles 8 fa!r or 8 "m4 #gb ,prepot5cy1 moreov]1 may ext5d d[n ?r\gh g5]ations & c5turies4 ,9 ! /reets ( ,pal]mo to-day typical ,normans may be se51 despite ! int]m>riages ( c5turies1 :o are ! desc5dants ( ^? male ,normans t w5t d[n to ,sicily ) ,tancr$4 ,!re are ,romans !re1 too1 & ,s>ac5s4 ,:5 ! ,belgae--a race ( tall1 r$-be>d$ m51 ) elliptical skulls--w5t f ! cont95t ( ,europe to ,irel&1 probably six c5turies be=e our era1 !y conqu]$ ! aborig9es1 a g5tle1 brune race ( l[] /ature4 ,^! ,belgae became ! ance/ors ( ! *iefta9 class1 & _! physical type p]si/s until to-day2 s does t ( ! ,picti% aborig9es4 ,daniel ,o',connell _h a typical ,belgic body4 ,o!r big1 blond ,iri%m5 are ,norse or ,dani% 9 remote orig94 ,h[ is ! extremely complex human body ) its v>i\s physical *>act]i/ics built up f ! nucleus ( a fecundat$ cell1 ! ovum8 ,! endeav\r to answ] ?is "q has br\ght out mo/ +5i\s speculation f ne>ly all ! great biologi/s ( mod]n times4 ,! "q is ! f\ndation ( ! !ories ( h]$ity1 & x is also fundam5tal 9 ! !ories ( evolution4 ,! human ovum is a flatt5$ sph]ical cell1 made up ( a v delicate cell-wall1 call$ ! vitell9e membrane2 outside ?is is a comp>atively ?ick membrane1 ! zona pellucida1 :i* is prop]ly n a "p ( ! cell4 ,)9 ! vitell9e membrane is a granul> cytoplasm1 ! vitellus 7yolk71 & 9 ?is lies ! nucleus1 :i* 9 ! old text-books 0 call$ ! g]m9al vesicle4 ,?is nucleus conta9s a nucleolus4 ,! human sp]matozoon consi/s ( a flatt5$ head :i* has a ?9 protoplasmic cap ext5d+ d[n two-?irds ( its l5g?4 ,9 ! head is ! nucleus ) ! *romat94 ,beyond ! head is ! neck1 :i* conta9s ! ant]ior & po/]ior c5trosomes4 ,beh9d ! neck is ! tail1 or flagellum1 9 ?ree p>ts1--! middle piece1 ! pr9cipal "p1 & ! end piece4 ,f ! neck to ! end ( ! tail c5trally runs a bundle ( fibrils1 ! axial filam5t4 ,9 ! middle piece ^! fibrils are wrapp$ )9 a s+le spiral filam5t :i* w9ds f ! neck d[n to ! annulus at ! beg9n+ ( ! pr9cipal "p1 & lies 9 a cle> fluid4 ,)\t ! spiral filam5t1 along ! middle piece1 is ! mito*ondria1 a f9ely granul> protoplasmic lay]4 ,! pr9cipal "p ( ! tail consi/s ( ! axial #gc filam5t enclos$ 9 an involucrum1 & ! end piece is made up ( ?is filam5t )\t ! involucrum4 ,! head & neck ( ! sp]matozoon1 :i* conta9 ! nucleus & c5trosomes1 are ! ess5tial p>ts1 & ! middle piece & ! rema9d] ( ! tail appe> to be us$ solely = locomotion & p5etration4 ,:5 ! head p5etrates ! ovum1 ! tail is deta*$ & reject$4 ,our k ( ! initial /ages 9 ! developm5t ( a human embryo is d]iv$ indirectly f ! obs]vation ( o!r mammals4 ,!re are n9e e>ly human embryos report$1 & ! av]age probable age ( ^! is twelve days4 ,breuss' specim5 0 probably t5 days old 7,wi5] m$4 ,wo*5blatt1 #ahgg74 ,pet]s 7,e9bettung des m5s*4 ,eies1 #ahii7 f\nd a small] embryo ?an ?is4 ,! ,breuss ovum 0 #e mm4 9 l5g?2 ,pet]s' 0 #c by #a4e by #a4e mm41 b ! probable age 0 n giv54 ,!re h be5 num]\s embryos m ?an twelve days old obs]v$1 & s9ce ! process aft] ! twelf? day is id5tical 9 man & ! high] mammals1 !re is no d\bt t ! fir/ /ages are also ! same4 ,! segm5tation t makes new cells is complicat$1 & ! outcome ( ! division is a ball ( cells4 ,9 eggs :i* h a l>ge yolk1 l ^? ( birds1 ! cells =m a r\nd body re/+ on ! surface ( ! yolk1 b 9 mammalian ova a holl[ ball ( cells1 or a ,morula1 results1 :i* l9es ! int]nal surface ( ! cellul> envelope4 ,! ovum absorbs moi/ure by osmosis & enl>ges1 & ab\t ! twelf? day aft] ! g]m-nuclei h begun to divide1 ! ,morula1 or holl[ ball ( cells1 call$ also ! ,bla/od]mic ,vesicle1 is =m$4 ,! next /age 9 developm5t is ! e/abli%m5t ( two prim>y g]m9al lay]s1 call$ toge!r ! ,ga/rula1 ,! out] lay] is ! ,ectod]m or ! ,epibla/1 & ! inn] lay] is ! ,endod]m or ,hypobla/4 ,9 a ,morula ! small] cells1 :i* conta9 less yolk-mat]ial1 gradually gr[ ar\nd ! l>g] yolk-conta9+ cells to =m ! ,ga/rula4 ,betwe5 ! ,ectod]m & ! ,endod]m a lay] ( cells call$ ! ,mesod]m or ,mesobla/ is next =m$1 & f ^! ?ree lay]s all ! p>ts ( ! embryo are built up4 ,f ! out] ,ectod]m & ! inn] ,endod]m ^? organs arise :i* are 9 ! body1 out] & inn]1--z ! n]v\s sy/em & ! out] sk9 f ! ,ectod]m1 ! inn] entrails1 ! lungs & liv]1 f ! ,endod]m4 ,f ! ,mesod]m come ! inn] sk91 ! bones & muscles4 ,by ?is "t ! embryo is a m9ute longitud9al /reak at ! #gd surface ( "o pole ( ! ovum4 ,! ,primitive ,trace is l a long inv]t$ lett] ,u1 ! legs ( :i* are 9 apposition4 ,! ,primitive ,trace becomes a circul> flatt5$ disc2 & x gr[s into a cyl9drical body by ! juncture ( ! free m>g9s :i* fold d[nw>d & inw>d & meet 9 ! m$ian l9e1 & ?is closes 9 ! pelvic1 abdom9al1 ?oracic1 ph>yngeal1 & oral cavities4 ,! legs & arms bud f ?is cyl9d] lat]4 ,:ile ! v5tral cyl9d] is gr[+1 ano!r longitud9al cyl9d] is =m$ along ! upp] surface ( ! embryo1 :i* w conta9 ! bra9 & ! sp9al column4 ,! subsequ5t developm5t ( ! embryo & foetus ne$ n be kn[n = an und]/&+ ( ! mat]ial consid]$ 9 treat+ "h ( t]ata4 ,human t]ata occur 9 c]ta9 r def9ite1 types ( errone\s developm5t1 & ! classification ( ,hir/ & ,pi]sol 7,human ,mon/rosities1 ,philadelphia1 #ahia71 :i* is a comb9ation & *ange ( ! classifications ( ,ge(frey ,sa9t-,hilaire1 ,klebs1 & ,fo]/]1 is ! mo/ satisfactory4 ,!re are f\r great gr\ps ( abnormally develop$ human be+s3 7#a7 ,hemit]atic2 7#b7 ,het]otaxic2 7#c7 ,h]maphroditic2 7#d7 ,mon/r\s4 ,hemit]ata are giants1 dw>fs1 p]sons %[+ anomalies 9 %ape1 9 col\r1 9 closure ( embryonic clefts1 9 abs5ce or excess ( digits1 or hav+ o!r defects4 ,?is gr\p does n come "u discussion "h1 b att5tion %\ld be call$ to ! fact t wom5 :o are dw>fs are to be w>n$ be=e m>riage t !y _c be deliv]$ normally1--t ! caes>ean section or symphyseotomy w be necess>y1 or t c]ta9 physicians w practise craniotomy 9 deliv]+ !m4 ,! ,het]otaxic gr\p comprises p]sons ^: left or "r visc]al organs are rev]s$ 9 position ?r\gh abnormal embryonic developm5t2 ! liv] is on ! left side1 ! he>t po9ts to ! "r1 & s on4 ,( ! next gr\p1 ! ,h]maphroditic1 x may be said t a true h]maphrodite1 9 ! full s5se ( ! t]m1 has n be5 f\nd2 b !re h be5 sev]al examples ( individuals :o _h an ov>y & a te/icle1 & o!r rudim5t>y sexual organs t belong$ to bo? male & female4 ,=ms ( app>5t d\bl+ are common1 & 9 case ( d\bt z to sex ! probability leans t[>d ! #ge mascul9e side4 ,z to m>riage 9 su* cases1 que/ions may arise t are to be settl$ by ! anatomi/4 ,9 deal+ ) d\ble mon/]s x is sometimes difficult or impossible to det]m9e :e!r we h to d ) "o or two individuals1 & ?is difficulty has s]i\s weight1 especially 9 ! adm9i/ration ( baptism4 ,x is improbable t !re is a d\bl+ ( p]sonality 9 h]maphrodites4 ,a /rik+ *>act]i/ic ( comp\nd t]ata is t ! individuals are always ( ! same sex2 moreov]1 ! embryonal developm5t ( reproductive organs 9 g5]al is su* z almo/ to preclude a "q ( duality ( p]sonality4 ,t]ata1 m prop]ly s call$1 are divid$ into s+le1 d\ble1 & triple mon/]s4 ,s+le mon/]s may be autositic1 or indep5d5t ( ano!r embryo or foetus2 or !y may be omphalositic1 t is1 dep5d5t ^u ano!r embryo or foetus1 :i* is commonly well develop$1 & :i* supplies blood = bo? ?r\gh ! umbilical vessels4 ,:5 an omphalosite exi/s1 ! o!r foetus is call$1 9 ?is case also1 ! autosite4 ,! fir/ ord] ( autositic s+le mon/]s conta9s f\r g5]a ) eight species1 & "u ^! species are ?irty-f\r v>ieties4 ,!y may h imp]fect limbs1 no limbs1 "o eye 9 ! middle ( ! =ehead 7cyclops71 fus$ l[] limbs 7sir571 & s on4 ,"s ( ^! mon/]s %[ a /rong resemblance to l[] animals1 b !re is no record t is 9 any degree sci5tific ( a hybrid betwe5 a human be+ & a l[] animal4 ,!re are two g5]a ( ! omphalositic s+le mon/]s1 ) f\r species4 ,"o ( ! tw9s1 ! autosite1 is commonly a normal *ild2 ! o!r1 ! omphalosite1 may be z small z a *ild's fi/1 & be v mu* de=m$4 ,( ^! omphalosites ! p>acephalus has an imp]fect head1 commonly no he>t1 & ! lungs are abs5t or rudim5t>y4 ,! acephalus has no head1 & commonly no arms2 ! asomata is a head m or less develop$1 ) a sac bel[ conta9+ rudim5ts ( ! trunk organs4 ,! ,acephalus is v r>e--! r>e/ ( all mon/]s except ! ,tricephalus4 ,!re is a f\r? k9d--! foetus anideus4 ,?is is a %apeless mass ( fle% cov]$ ) sk94 ,!re may be a #gf slight prom95ce ) a tuft ( hair on x at "o end ( ! mass to indicate ! head4 ,9 ?is mon/] !re are m traces ( bodily organs ?an might be expect$4 ,^! f\r k9ds ( omphalosites are ei!r dead :5 born1 or !y die z soon z ! plac5tal circulation is cut (f4 ,if !re is any probability ( life1 ! physician %\ld give !m baptism be=e ! plac5tal circulation is /opp$4 ,no?+ satisfactory is kn[n conc]n+ ! etiology ( s+le mon/]s4 ,l&au1 & o!r au?orities z great z he is1 reject ! !ory t mat]nal impressions f fright or exposure to ! sight ( hide\s de=mity are ! cause ( t]ata4 ,i ?9k ! fa!r is acc\ntable = t]ata z (t5 z ! "m is4 ,b>nes1 an ,engli% physician1 & o!rs claim !y f9d t t]ata are frequ5t 9 consangu9e\s m>riages1 b ,i h n be5 able to v]ify ! ass]tion4 ,x seems a !ory may be (f]$ to expla9 ! s+le t]ata4 ,9 #ahhh ,r\x ( ,breslau by punctur+ "o bla/om]e ( a frog's egg 9 ! two-cell /age kill$ ! punctur$ bla/om]e )\t affect+ ! o!r4 ,! punctur$ bla/om]e rema9$ inactive1 b ! o!r develop$ into a complete half embryo4 ,crampton by sep>at+ & isolat+ ! bla/om]es 9 ! two-cell /age obta9$ a half embryo2 & ,zoja by isolat+ bla/om]es ( ! m$usae1 ,clytia & ,laodice1 got dw>f$ l>vae4 ,wilson succe$$ by ! sep>ation ?r\gh %ak+ ( ! bla/om]es 9 ! two-cell & f\r-cell /ages 9 develop+ ,amphioxus l>vae1 :i* 7 half ! natural size = ! two-cell bla/om]es1 & commonly half ! normal size f ! f\r-cell bla/om]es1 yet 9 ! latt] "s ( ! l>vae 7 ( ! normal size b imp]fect ,f ! eight-cell /age he got only imp]fect4 l>vae4 ,simil> results 7 obta9$ by o!r op]ators ) v>i\s eggs4 ,dries* & ,morgan by remov+ "p ( ! cytoplasm f a f]tiliz$ egg ( ! ct5ophore1 ,b]oe1 produc$ imp]fect l>vae %[+ c]ta9 defects :i* repres5t ! p>ts remov$4 ,9 ^! cases ( injur$ & isolat$ bla/om]es we h1 x seems to me1 a plausible !ory = ! etiology ( s+le t]ata4 ,! bla/om]es 9 ! human ovum may p]haps be injur$ 9 "p by tox9s f ! "m1 or !y may be defective ?r\gh disease 9 ! ovum or ! sp]matozoon4 ,!y also may possibly be displac$ traumatically1 b ?is seems to be d\btful4 ,!re are ?ree !ories conc]n+ ! orig9 ( omphalositic #gg t]ata4 ,ahlfeld 7,missbildung5 des ,m5s*51 ,leipsic1 #ahhb7 holds t ! autosite is /rong] ?an ! omphalosite1 & z a consequ5ce ! foetal circulation 9 ! omphalosite is rev]s$1 & developm5t is ?us *eck$4 ,d>e/e 7,production artificielle des mon/ruosites1 ,p>is1 #ahgf71 ,panum 7,beitrag zur ,k5ntniss d] physiol4 ,b$eut4 d] angebor5 ,missbildung51 ,vir*['s ,ar*iv41 #ahgh71 ,p]ls 7,lehrbu* d] allgem4 ,pa?ologie7 & ,breus 7,wi5] m$4 ,jahrbu*1 #ahhb7 ma9ta9 !re is an inh]5t orig9al defect 9 ! omphalositic *ild :i* prev5ts developm5t ( ! blood-vessels1 & t ,ahlfeld's !ory ( an indirect umbilical connection ( ! omphalosite to ! plac5ta is n probable2 if x 71 omphalosites w\ld be v common1 because "o ( tw9s is ne>ly always /rong] ?an ! o!r4 ,hir/ & ,pi]sol 7op4 cit7 comb9e ^! !ories4 ,?is k9d ( mon/] is c]ta9ly an imp]fectly develop$ human individual1 & ev5 ! ,foetus ,anideus %\ld receive at ! lea/ conditional baptism4 ,! next gr\p comprises ! composite mon/]s4 ,normal tw9s may arise f ! f]tilisation ( "o ovum & ( two di/9ct ova4 ,9 #ejf cases exam9$ by ,ahlfeld he f\nd t #ff tw9 bir?s came f s+le ova4 ,tw9s f a s+le ovum are always ( ! same sex1 & !y are n easily di/+ui%$ "o f ! o!r4 ,triplets may arise f "o1 two1 or ?ree ova4 ,! eld] ,sa9t-,hilaire ?\ght t composite mon/]s arise f ! fusion ( two impregnat$ ova1 b ?is op9ion is n[ g5]ally reject$4 ,composite t]ata 9 e in/ance arise f a s+le ovum4 ,!re is a div]g5ce ( op9ion1 h[ev]1 z to ! orig9 ( a composite mon/] 9 ! s+le ovum4 ,"s au?orities ma9ta9 t ^! mon/]s arise f ! union ( two orig9ally sep>ate primitive traces4 ,?is supposes primitive duality foll[$ by fusion 7,v]wa*sung/heorie74 ,o!r writ]s hold t !re is orig9ally "o primitive trace1 & t composite t]ata are ! product ( a m or less ext5sive cleavage ( ?is s+le bla/od]m4 ,?is supposes primitive unity foll[$ by fission 7,spaltung/heorie74 ,"h1 z 9 ! case ( normal developm5t1 ! argum5t is f\nd$ on analogy4 ,! e>lie/ /age 9 ! developm5t ( a human d\ble mon/] obs]v$ 0 at ! f\r? week aft] f]tilisation--,ahlfeld's case4 ,b4 ,s*ultze 7,u4 anomale ,duplicitaet d] ,ax5organe1 ,vir*['s ,ar*iv47 & ,panum & ,d>e/e 7op4 cit47 hold ! fusion !ory-- #gh ! fusion ( two sep>ate bla/od]ms 9 "o ovum4 ,panum & ,d>e/e h se5 two sep>ate normal bla/od]ms on "o ovum4 ,all5 ,?ompson 9 #ahdd 7,london & ,ed9burgh ,mon?ly ,j\rnal ( ,m$ical ,sci5ce71 ,wolff1 von ,ba]1 & ,rei*]t also obs]v$ two embryos 9 "o ovum4 ,d>e/e is ( ! op9ion t ! fusion ( two sep>ate ova is impossible4 ,! fission !ory--! fission ( a s+le bla/od]m to make a composite mon/]--is support$ by ,wolff1 ,j4 ,f4 ,meckel1 von ,ba]1 ,j4 ,muell]1 ,val5t9e1 ,bis*(f1 & o!rs1 especially by ,ahlfeld4 ,ahlfeld says t ?is s+le bla/od]m is split by pressure4 ,g]la* also 7,die ,ent/ehungsweise d] ,doppelmissbildung51 etc41 ,/uttg>t1 #ahhb7 admits fission1 b he cont5ds t x is n s simple a process z ,ahlfeld ?9ks x is4 ,x is n a passive cleavage1 b a result ( a =ce 9 ! cell-mass exi/+ be=e diff]5tiation4 ,g]la* calls fission at ! ant]ior or head-end ( ! s+le bla/od]m1 bifurcation2 & he has actually obs]v$ su* bifurcation 9 a *ick embryo ( sixte5 h\rs 7,u4 d4 ,ent/ehungsweise d] vord]5 ,v]doppelung4 ,deuts*e ,ar*iv4 f4 kl91 ,m$41 #ahhg74 ,9 ?is case ! fir/ *ange notic$ 0 a broad5+ ( ! ant]ior end ( ! primitive /reak2 next a =k$ div]g5ce appe>$1 & ?is became m pron\nc$2 until by ! tw5ty-six? h\r ! bifurcation 0 half z long z ! undivid$ po/]ior "p4 ,f ea* ant]ior end ( ! div]g+ bran*es a di/9ct head-process ext5d$4 ,all5 ,?ompson 7loc4 cit47 9 #ahdd saw a goose-egg1 :i* _h be5 incubat$ = five days1 9 :i* 0 a d\ble mon/] divid$ to ! neck4 ,beyond ?is obs]vation by ,g]la* we h ! fact1 :i* seems to make = ! fission !ory1 t no matt] h[ unequally n\ri%$ or h[ v>iable 9 ext5t1 ! union betwe5 ! halves ( d\ble mon/]s is always symmetric--exactly ! same p>ts ( ea* tw9 are jo9$4 ,?is seems to exclude a =tuit\s gr[+ toge!r ( dissimil> areas or cell-masses1 = non-p>asitic d\ble t]ata at ! lea/4 ,born 7 ,u4 d4 ,fur*ung des ,eies bei ,doppelbildung51 ,breslau] ,a]ztl4 ,zeits*r41 #ahhg71 9 a /udy ( fi% ova1 f\nd t ova :i* produce d\ble mon/]s beg9 ) a segm5tation l t ( ! s+le normal ovum4 ,if fission is complete homog5e\s tw9s are ! result2 ^! tw9s are ( ! same sex & v simil> 9 appe>ance4 ,incomplete fission1 z has be5 said1 gives rise to d\ble or triple t]ata4 ,if "o ( ! t]atic tw9 embryos is /rong] ?an ! o!r1 ! v>i\s comb9ations ( enclosure & p>asitism may result1 al?\gh ! orig9 ( p>asitic d\ble t]ata is n conv9c+ly cle>4 ,a triple #gi mon/]1 accord+ to ! fission !ory1 arises f a d\ble incomplete cleavage ( ! primitive trace4 ,dr4 ,ephraim ,cutt] has obs]v$ t]atic composite sp]matozoa :i*1 he ?9ks1 probably h influ5ce 9 produc+ composite mon/]s4 ,!re are ?ree ord]s ( ! d\ble autositic mon/]s3 ,t]ata ,katadidyma1 9 :i* ! embryonal fission 0 at ! c]ebral end2 ! ,t]ata ,anadidyma1 divid$ bel[2 ! ,t]ata ,anakatadidyma1 divid$ above & bel[1 b jo9$ at ! middle ( ! body4 ,!re are f\r g5]a ( ! ,t]ata ,katadidyma ) _m species4 ,! fir/ g5us is ! ,diprosopus1 ! d\ble-fac$4 ,! d\bl+ v>ies f ! f9d+ ( two complete faces to a slight trace ( duplex =mation 9 "o head4 ,fo]/] 9 #ejj human mon/]s obs]v$ #bi cases ( diprosopi4 ,!re are six species ( diprosopi3 #a4 ,d4 ,dioph?almus1 :i* has only two eyes1 b !re is a d\bl+ ( ! nose4 #b4 ,d4 ,di/omus1 :i* has two m\?s1 two l[] jaws1 two tongues1 "o ph>ynx1 & "o oesophagus4 #c4 ,d4 ,trioph?almus1 :i* has ?ree eyes1 & ! d\bl+ ( ! face is m complete4 ,!re are only two e>s4 #d4 ,d4 ,tetroph?almus1 :i* has f\r eyes & two well-sep>at$ faces4 #e4 ,d4 ,triotus is l ! la/1 b x has ?ree e>s4 #f4 ,d4 ,tetrotus has f\r e>s1 f\r eyes1 & !re is "s d\bl+ at ! ph>ynx4 ,two oesophaguses ent] "o /oma* 9 ?is species commonly4 ,d4 ,tetrotus is r>e--only "o example 9 man is kn[n4 ,9 all diprosopi !re is only "o trunk1 "o pair ( arms1 & "o pair ( legs4 ,sir ,james ,paget _h a photograph1 made 9 #ahef1 ( a liv+ diprosopus1 ! second face ( :i* _h a m\?1 nose1 eye1 "p ( an e>1 & a bra9 787 ( its own4 ,! two faces act$ simultane\sly1 suckl$1 sneez$1 yawn$ toge!r4 ,are diprosopi tw9s8 ,an answ] to ?is "q w be cle>] aft] a description ( o!r composite t]ata4 ,! second g5us ( ! ,t]ata ,katadidyma is ! ,dicephalus4 ,?is g5us comprises five species1 :i* h 9 ea* case two heads1 ) sep>ate necks commonly4 ,!re are two v]tebral columns1 :i* usually are sep>ate d[n to ! sacrum1 & !y conv]ge at ! l[] end4 #hj ,9 ! int]ior organs d\bl+ w be f\nd correspond+ to ! degree ( sep>ation ( ! trunks4 ,9 all ! species ( ?is g5us !re are "o umbilicus & "o cord4 ,! fir/ species ( ! ,dicephalus is ! ,dicephalus ,dibra*ius--a two-arm$1 d\ble-head$ mon/]4 ,9 ?is species mo/ ( ! visc]a are s+le1 b ! "r & left halves ( ea* viscus are suppli$ by ! respective foetuses1 & ! entrail does n become indi/+ui%ably s+le until ne> ! l[] end ( ! ileum4 ,!re may be two ord9>y kidneys & a ?ird small] "o1 two pancreatic gl&s1 & two gall-bladd]s4 ,su* a mon/] may be monau*5\s or diau*5\s4 ,! next species is ! ,dicephalus ,tribra*ius ,dipus--two heads1 ?ree arms1 & two legs4 ,!re is also a ,dicephalus ,tribra*ius ,tripus 7?ree arms & ?ree legs71 ,d4 ,tetrabra*ius ,dipus 7f\r arms & two legs71 & ,d4 ,tetrabra*ius ,tripus 7f\r arms & ?ree legs74 ,9 all ^! cases !re is no d\bt ( ! pres5ce ( tw9s1 unless !re might be "s d\bt z to dual p]sonality 9 ! ,dicephalus ,dibra*ius4 ,9 ! ,dicephalus ,tetrabra*ius ,dipus & ! ,dicephalus ,tetrabra*ius ,tripus !re is almo/ complete duplication ( ! int]nal organs1 & ! halves ( ! composite body belong evid5tly to individuals di/9ct 9 ?\ght1 volition1 & "*4 ,ea* bra9 controls only its own half ( ! body4 ,!re are f\r lungs1 two he>ts 7sometimes 9 "o p]ic>dium71 two /oma*s1 two inte/9al canals d[n to ! colon or l[]1 two liv]s 7sometimes jo9$71 f\r kidneys 7or ?ree1 "o ( :i* is small71 two bladd]s1 empti$ at diff]5t times ?r\gh a common ure?ra4 ,dicephali are some:at common4 ,fo]/] f\nd #adj among #ejj specim5s ( mon/]s4 ,!y are r>ely born alive4 ,! be/ kn[n cases ( dicephali t liv$ = any l5g? ( "t are3 #a4 ,pet] & ,paul1 ( ,flor5ce1 born 9 #acaf1 liv$ ?irty days4 #b4 ,! ,scot* ,bro!rs1 born 9 #adij1 liv$ tw5ty-eight ye>s4 ,!y 7 at ! c\rt ( ,james ,,iii4 ,above ! po9t ( union ! tw9s 7 indep5d5t 9 s5sation & action1 b bel[ ! po9t all s5sation & action 7 #ha common4 ,"o di$ be=e ! o!r1 & ! second succumb$ to infection f putrefaction a few days lat]4 #c4 ,! ,wu]temb]g ,si/]s1 born 9 #adih4 #d4 ,! tw9s1 ,ju/9a & ,doro!a1 born 9 #afbg1 liv$ six weeks4 #e4 ,boy tw9s at ,padua1 born 9 #afia1 liv$ to be baptis$4 #f4 ,rita-,cri/9a1 born at ,sass>i 9 ,s>d9ia 9 #ahbi4 ,!y liv$ eight mon?s4 ,^! *ildr5 _h a common trunk bel[ ! brea/1 "o pelvis1 & "o pair ( legs4 ,rita 0 feeble & quiet1 ,cri/9a vigor\s & lively4 ,!y suckl$ at diff]5t times2 & s5sation 9 ! heads & arms 0 individual1 b bel[ ! junction x 0 common4 ,rita di$ ( bron*itis1 & dur+ ,rita's f9al illness ,cri/9a 0 heal?y2 b :5 ,rita di$1 ,cri/9a1 :o 0 suckl+ at ! "t1 sudd5ly expir$4 ,!y _h two he>ts 9 "o p]ic>dium1 ! dige/ive tracts did n fuse until ! l[e/ ?ird ( ! ileum 0 rea*$4 ,! liv]s 7 fus$1 ! v]tebral columns 7 di/9ct ?r\gh\t4 ,^! tw9s 7 baptis$ sep>ately4 #g4 ,m>ie-,rose ,dr\91 born 9 ,montreal 9 #ahgh4 ,!y liv$ sev5 mon?s4 ,m>ie di$ ( *ol]a infantum2 & ,rose !n di$1 al?\gh %e _h n be5 directly affect$ by ! disease4 ,^! tw9s 7 l ,rita-,cri/9a anatomically except t !y _h no legs4 ,! respirations & he>t-pulsations diff]$1 & "o *ild slept :ile ! o!r *ild cri$4 #h4 ,! ,tocci boys1 born 9 ,tur9 9 #ahgg4 ,9 #ahhb !y 7 /rong & heal?y1 & !y may be liv+ /ill4 ,!y resembl$ ,rita-,cri/9a anatomically 9 e respect4 ,ea* boy _h control ( ! leg on 8 own side1 b n ( ! o!r leg1 consequ5tly !y c\ld n walk4 ,_! s5sations above ! juncture 7 di/9ct1 & _! ?\ghts & emotions diff]$4 ,9 ! ,p>is ,l'union m$icale !re is an acc\nt ( a bicephalic /ill-born mon/]1 born at ,alex&ria 9 #ahdh1 :i*1 accord+ to ! report1 _h on "o side a typical negro head & on ! o!r side a typical ,egyptian fellah head4 ,?is report is probably n au!ntic2 b if x is1 x w\ld be difficult to reconcile x ) ! fission !ory4 #hb ,suppos+ ! report true1 ! case w\ld h to be "o 7#a7 ( sup]impregnation :]e9 7#b7 a sp]matozoon f ea* s\rce p5etrat$ ! same ovum1 7#c7 a bicephalic mon/] result$1 ) 7#d7 di/9ct racial *>act]i/ics4 ,all ?is is extremely improbable4 ,sup]impregnation has happ5$4 ,!re are cases :]e negresses h giv5 bir? to tw9s1 "o ( :i* 0 a negro & ! o!r a mulatto4 ,in/ances are cit$ 9 books on ,legal ,m$ic9e l ^? ( ,tidy & ,beck4 ,9 ,fl9t's ,physiology a case is record$ 9 :i* a mulatto woman 9 ,k5t ,c\nty1 ,virg9ia1 m>ri$ to a negro1 gave bir? to tw9s1 9 #ahfg1 "o ( :i* 0 a negro mu* black] ?an ! "m1 & ! o!r a :ite *ild1 ) long1 light1 silky hair1 & a brilliant complexion4 ,! :ite *ild's nose 0 %ap$ l ! "m's1 b !re 0 no o!r resemblance4 ,ev5 suppos+ ?is to be a case ( sup]impregnation1 t does n fully expla9 ! extreme :it5ess ( "o *ild & ! extreme blackness ( ! o!r4 ,sup]foetation is also possible4 ,tidy 7,legal ,m$ic9e7 gives a case3 ,m>y ,anne ,bigaud1 at ?irty-sev51 on ,april #cj?1 #agdh1 gave bir? to a full-t]m mature boy1 :i* surviv$ its bir? two & a half mon?s1 & to a second mature *ild 7girl7 on ,septemb] #af?1 #agdh1 :i* liv$ = "o ye>4 ,! second *ild 0 born f\r & a half mon?s aft] ! fir/1 & bo? 7 n9e-mon?s *ildr54 ,x 0 prov$ aft] dea? 9 ?is case t ! "m _h n a d\ble ut]us1 & ! report is v\*$ = by ,pr(essor ,eis5man1 & by ,l]i*e1 surgeon-major ( ! ,/rasburg ,milit>y ,hospital4 ,sev]al o!r cases ( sup]foetation are giv5 by ,bonn> 7,ed94 ,m$4 ,j\rn41 ,janu>y1 #ahfe74 ,! ?ird g5us ( ,t]ata ,katadidyma is ! ,is*iopagus4 ,^! tw9s are divid$ s mu* f above d[nw>d t ! heads are at almo/ opposite ends ( ! d\ble body4 ,!y are jo9$ at ! coccyges & sacra1 & ! sp9al columns h ne>ly ! same axis4 ,! trunk organs are complete & sep>ate1 except t !y are commonly fus$ 9 ! pelvis4 ,!re may be two1 ?ree1 or f\r legs1 giv5 (f at "r angles to ! pelvis4 ,?is k9d ( mon/] is n r>e4 ,fo]/] collect$ tw5ty cases1 & n9e new examples #hc 7 report$ 9 ! ,index ,m$icus betwe5 #ahgi & #ahic4 ,is*iopagic tw9s 7 born 9 ,c\nty ,roscommon1 ,irel&1 9 #ahbg1 & baptis$ sep>ately4 ,! ,jones ,tw9s1 born 9 ,typhon ,c\nty1 ,indiana1 9 #ahhi1 liv$ = ab\t two ye>s2 !y 7 is*iopagi1 & !y _h ! v unusual quality1 x is said1 t !y diff]$ 9 complexion & ! col\r ( eyes & hair4 ,a case 0 report$ 9 ,am]ican ,m$ic9e1 ,septemb]1 #aijc4 ,class$ ) ! ,katadidyma is ! g5us ,pygopagus1 al?\gh x has f\r legs4 ,?is =m is v r>e4 ,! tw9s are jo9$ only by ! lat]o-po/]ior aspects ( ! sacra & coccyges1 s t ! two individuals are plac$ almo/ back to back4 ,! trunk organs are indep5d5t1 except = "s fusion ne> ! po9t ( juncture4 ,examples ( ?is class are ! ,hung>ian ,si/]s1 born at ,szony 9 #agja1 :o liv$ to womanhood2 ! negresses ,millie-,*ri/9e1 born 9 #ahea1 & :o 7 rec5tly liv+ 9 ,nor? ,c>ol9a2 & ! ,blazek ,si/]s ( ,bohemia4 ,! negresses _h common s5sation 9 ! legs1 b ,millie c\ld n localise :at "p ( ,*ri/9e's legs 0 t\*$1 & vice v]sa4 ,! second gr\p ( ! d\ble autositic mon/]s are ,t]ata ,anadidyma--t]ata divid$ f bel[ upw>d4 ,! fir/ g5us is ! ,dipygus4 ,?is has a s+le body above1 b a d\ble pelvis ) d\ble l[] extremities 9 ! typical cases4 ,!re is an exact description ( a d\ble mon/] ( ?is k9d 9 ! ,gaelic ,annals ( ! ,f\r ,ma/]s z e>ly z ! ye> #gbg ( ?is era4 ,! *ronicl] says 9 t ye> on ,dalkey ,isl& ne> ,dubl91 ,!re 0 a c[ se5 :i* _h "o head & "o body z f> z h] %\ld]s1 two bodies f h] %\ld]s h9dw>d1 & two tails4 ,%e _h eight legs1 & %e 0 milk$ ?ree times a day4 ,a p]fect human ,dipygus ) two equally develop$ pairs ( legs is unkn[n4 ,ca!r9e ,kaufmann1 :o 0 born 9 #ahgf1 & :o di$ 9 #ahgh1 _h a d\ble pelvis ) d\ble pelvic organs 9 "p1 b %e _h only "o pair ( legs4 ,!re is a simil> anomaly said to be liv+ 9 ,philadelphia at pres5t4 ,blan*e ,dumas1 born 9 #ahfj1 _h a d\ble pelvis1 d\ble pelvic organs1 & ?ree legs4 ,mrs4 ,b41 born 9 #ahfh1 #hd _h f\r legs--! two inn] ones 7 small] ?an ! out] pair4 ,h] sp9al column 0 divid$ up to ! ?ird lumb> v]tebra4 ,h] d\ble pelvic organs act$ indep5d5tly4 ,!re are liv+ male examples ( ?is =m ( mon/]4 ,! next g5us is ! ,syncephalus1 call$ also ,janus & ,janiceps4 ,its l[] body is d\ble up to ! umbilicus1 ! trunk s+le above t po9t2 ! head %[s signs ( d\bl+1 & !re are f\r legs & f\r arms2 ! bodies gr[ front to front4 ,! head usually is l>ge1 !re=e ?is mon/] is born dead4 ,ano!r g5us is ! ,craniopagus--tw9s jo9$ only by ! skull or scalp4 ,!re are ?ree species1 nam$ f ! place ( union--,craniopagus ,frontalis1 ,c4 ,p>ietalis1 & ,c4 ,occipitalis4 ,a ?ird gr\p ( d\ble autositic mon/]s are ! ,t]ata ,anakatadidyma1 :i* are divid$ above & bel[1 b jo9$ f ! navel to ! head4 ,!re are ?ree g5]a4 ,! fir/1 ! ,prosopo?oracopagus1 is jo9$ at ! upp] abdom51 ! *e/1 & ! faces2 ! sp9al columns are sep>ate4 ,! faces are imp]fect1 ! jaws are unit$2 !re is a broad neck ) "o oesophagus1 & !re is "o /oma* & "o duod5um4 ,?is is a r>e =m1 & x c n exi/ out ( ! ut]us4 ,a second g5us1 ! ,?oracopagus1 has a ?orax 9 common1 & ! inn] legs may be unit$4 ,x is1 z a rule1 /ill-born4 ,! next g5us is ! ,omphalopagus1 9 :i* ! tw9s are jo9$ f ! navel to ! bottom ( ! *e/4 ,?is d\ble mon/] has ! slighte/ union ( all1 & x is v r>e4 ,! ,siamese ,tw9s 7 omphalopagi4 ,!y qu>rell$2 "o became a drunk>d & ! o!r rema9$ temp]ate4 ,!y m>ri$ two wom51 & ,*ang _h t5 *ildr51 & ,eng twelve4 ,*ang di$ :ile ,eng 0 asleep1 & ! latt] di$ two h\rs aft] he _h wak$ & le>n$ ( 8 bro!r's dea?4 ,!re is a g5us1 ! ,ra*ipagus1 ! examples ( :i* are jo9$ beh9d l ! class ,t]ata ,anakatadidyma t are jo9$ 9 front4 #he ,f\r kn[n attempts h be5 made to sep>ate d\ble mon/]s surgically1 b all fail$ ow+ to crude surg]y2 mod]n me?ods might be successful 9 "s cases4 ,! second ord] ( d\ble mon/]s comprises ! p>asitic class4 ,!re are ?ree g5]a ( ^! t]ata1 ) five species & sev5te5 v>ieties4 ,! *ief ( ^! only w be m5tion$4 ,! ,het]otypus is a p>asitic *ild :i* hangs f ! abdom9al wall ( ! pr9cipal subject4 ,v>ieties ( ?is species are ! ,het]opagus1 :i* is a p>asite ) head & arms2 ! ,het]odelphus1 :i* has no head2 ! ,het]odymus1 :i* has a head1 neck1 & ?orax4 ,! ,het]alitis is a second species1 9 :i* ! p>asite is ins]t$ at a di/ance f ! navel ( ! autosite4 ,! ,epicomus is ! only example1 & x consi/s ( a p>asitic sup]num]>y head4 ,! ,polypna?us is a p>asite atta*$ to ! jaw ( ! autosite4 ,:5 fa/5$ to ! upp] jaw1 x is an ,epigna?us2 at ! l[] jaw x is an ,hypogna?ns4 ,ano!r gr\p is made up ( t]ata hav+ p>asitic legs :i* are atta*$ to diff]5t p>ts ( ! autosite1--to ! pelvis1 ! head1 ! abdom51 & s on4 ,f9ally1 !re is ! ,endocyma1 :i* is a p>asite enclos$ )9 ! body ( an autosite4 ,p>asites are n\ri%$ ?r\gh ! blood supply ( ! autosite1 & ! p>asites usually are incapable ( motion4 ,! autosite c feel :5 ! p>asite is t\*$1 & 9 "s cases ! autosite c localise ! t\*4 ,9 ,india1 9 #aghc1 a *ild 0 born :i* _h a sup]num]>y head atta*$ to ! autositic head1 cr[n to cr[n2 x liv$ f\r ye>s4 ,! p>asite's eyes 7 always p>tly op51 b !y appe>$ to be incapable ( intellig5t vision4 ,!y contract$ "u /rong light1 & :5 ! autosite 0 sudd5ly awak5$ bo? sets ( eyes mov$4 ,g\ld & ,pyle 7,anomalies & ,curiosities ( ,m$ic9e7 give an acc\nt ( an ,italian boy1 ag$ eight ye>s1 :o _h a small p>asitic head protrud+ f ne> ! left ?ird rib4 ,s5sibility 0 common4 ,ea* ( ! heads receiv$ baptism 7"o 0 call$ ,john & ! o!r ,mat!w71 & !re 0 "q z to :e!r extreme unction %\ld be adm9i/]$ to ! p>asitic head4 ,a simil> case occurr$ 9 #hf ,engl& 9 #ahhj 7,briti% ,m$4 ,j\rnal71 & ! p>asitic head c\ld be p9*$ )\t attract+ ! att5tion ( ! autosite4 ,t]atologi/s n[ exclude ,d]moid ,cy/s f ! li/s ( t]ata4 ,! hair1 tee?1 & p>ticles ( bone f\nd 9 ^! cy/s are look$ ^u z ! developm5t ( abnormal ectod]mic & endod]mic cells1 r ?an z evid5ce ( a sep>ate p]sonality4 ,!re is only "o well-au!nticat$ case ( a triple mon/]1 & ?is happ5$ 9 ,italy 9 #ahca4 ,! mon/] _h a s+le broad body ) ?ree di/9ct heads & two necks4 ,x 0 kill$ 9 deliv]y4 ,9 ,katadidyma 7t]ata divid$ f above d[nw>d71 :5 we h dicephali1 is*iopagi1 or pygopagi1 !re are evid5tly two individuals pres5t4 ,is ! ,diprosopus1 h[ev]1 ! two-fac$ mon/]1 possess$ ( "o or two s\ls8 ,! cases v>y1 z we said1 f examples ) two di/9ct faces & f\r e>s to cases t h m]ely two noses4 ,:at portion ( a human body is requir$ to conta9 a new s\l8 ,t is an int]e/+ "q = ! psy*ologi/ & a v practical "o = ! morali/1 & no morali/ has yet attempt$ to solve x4 ,! pres5ce ( a bra9 is n ess5tial1 because acephal\s mon/]s develop )\t bra91 & !y are born alive2 !y h a vital pr9ciple :i* is id5tical ) ! s\l4 ,among ! ,t]ata ,anadidyma 7divid$ f bel[ upw>d7 ! ,syncephalus & ! ,craniopagus are unque/ionably two p]sons4 ,is ! ,dipygus 7s+le d[n to ! navel1 d\ble bel[7 "o or two p]sons8 ,mrs4 ,b41 ! example already giv51 0 z d\ble bel[ ! navel z any ,dicephalus is above t po9t4 ,%e _h features s well ord]$ 9 unity t %e 0 a pretty woman1 b t unity ceas$ at h] wai/4 ,0 h] husb& unkn[+ly a bigami/8 ,i ?9k he 04 ,aft] a consid]ation ( ! fission ( t]ata1 & ! non-ess5tial quality ( ! bra91 :y %\ld fission t />t$ at ! feet diff] f fission t />t$ at ! head8 ,9 ! ,rituale ,romanum ,pauli ,v4 7tit4 ii4 cap4 i4 nn4 #ah1 #ai1 #bj1 #ba71 ! foll[+ directions = ! baptis+ ( t]ata are giv53 #hg #ah4 ,9 mon/ris v]o baptiz&is1 si casus ev5iat1 magna cautio adhib5da e/1 de quo si opus fu]it1 ,ord9>ius loci2 vel alii p]iti consulantur1 nisi mortis p]iculum imm9eat4 #ai4 ,mon/rum1 quod humanam speciem non praesef]at1 baptiz>i non debet2 de quo si dubium fu]it1 baptizetur sub hac conditione3 ,si tu es homo1 ego te baptizo1 etc4 #bj4 lllud v]o1 de quo dubium e/1 una ne1 aut plures s9t p]sonae1 non baptizetur1 donec id disc]natur3 disc]ni autem pote/1 si habeat unum vel plura capita1 unum vel plura pectora2 tunc enim totidem erunt corda et animae1 hom9esque di/9cti1 et eo casu s+uli seorsum sunt baptiz&i1 unicuique dic5do3 ,ego te baptizo1 etc ,si v]o p]iculum mortis imm9eat1 tempusque non suppetat1 ut s+uli sep>atim baptiz5tur1 pot5t m9i/] s+ulorum capitibus aquam infund5s omnes simul baptiz>i1 dic5do3 ,ego vos baptizo1 9 nom9e ,patris1 et ,filii1 et ,spiritus sancti4 ,quam tam5 =mam 9 iis solum1 et 9 aliis similibus mortis p]iculis1 ad plures simul baptiz&os1 et ubi tempus non patitur1 ut s+uli sep>atim baptiz5tur1 alias numquam1 licet adhib]e4 #ba4 ,qu&o v]o non e/ c]tum 9 mon/ro esse duas p]sonas1 ut quia duo capita et duo pectora non habet di/9cta2 tunc debet primum unus absolute baptiz>i1 et po/ea alt] sub conditione1 hoc modo3 ,si non es baptizatus1 ego te baptizo 9 nom9e ,patris1 et ,filii1 et ,spiritus sancti4 ,,au/9 ,,omalley4 #hh ,,vii ,,social ,,m$ic9e ,! influ5ce ( ! cl]gyman or ! *>itable visitor 9 matt]s ( heal? & sanitation c sc>cely be ov]e/imat$4 ,! removal ( prejudices ) reg>d to sanit>y regulations = ! prev5tion ( disease & mod]n advances 9 ! treatm5t ( disease is an important social duty4 ,!re is no d\bt t if ?is influ5ce be prop]ly direct$1 sanit>y measures ( v>i\s k9ds w be mu* m readily en=c$ & ! precautions necess>y to prev5t ! spread ( s]i\s infecti\s ailm5ts m fai?fully obs]v$4 ,z ?is amelioration ( sanit>y conditions w affect ma9ly ! poor1 less5+ _! suff]+ & add+ to _! possibilities ( happ9ess1 its accompli%m5t becomes a great ,*ri/ian duty1 obligatory on all ^? :o are int]e/$ 9 ! uplift+ ( ! poor] classes4 ,pr(essor ,vir*[1 ! di/+ui%$ ,g]man pa?ologi/1 us$ to say t popul> m$ic9e 0 9 all ages at lea/ fifty ye>s beh9d sci5tific m$ic9e4 ,he _h himself discov]$ ! pr9ciples ( cellul> pa?ology ne>ly half a c5tury be=e 8 dea?1 yet he decl>$ t ! popul> m9d /ill believ$ 9 ! old doctr9es ( humoral pa?ology1--t is1 t ! conditions ( heal? & disease dep5d$ on ! con/itution ( ! fluids ( ! body 7! blood1 ! bile1 ! mucus1 & s =?71 & _h n g5]ally accept$ mod]n advances 9 m$ical k ( ! und]ly+ basis ( disease 9 ! solid tissues4 ,!re is no d\bt t _m old-fa%ion$ notions long s9ce discr$it$ by physicians are /ill v g5]ally accept$ by ! popul> m9d1 & ev5 ! intellig5t classes sometimes h>b\r convictions ) reg>d to ! good or evil effects ( habits #hi ( life1 diet1 & ! op]ation ( drugs ( v>i\s k9ds t are entirely contr>y to pres5t-day m$ical k4 ,x is extremely important1 !n1 t ! cl]gyman or *>itable visitor1 9 giv+ views on m$ical matt]s1 :i* are sure to h mu* m weight ?an he p]haps attributes to !m himself1 %\ld be c>eful n to make /atem5ts = :i* he has n good au?ority 9 mod]n m$ical sci5ce4 ,x is v easy1 9 a matt] ( ?is k9d1 to /ate pr9ciples t are n ! result ( education1 prop]ly s call$1 b are glean$ f e>ly false impressions obta9$ "o kn[s n h[ or :]e1 entirely )\t def9ite consci\sness z to _! real orig94 ,! physician himself f9ds t he is compell$ to be c>eful ( ?is same t5d5cy to put too mu* /ress on traditions ) reg>d to heal? :i* he imbib$ be=e he began to /udy m$ic9e4 ,x is p]haps n s surpris+1 !n1 to he> physicians compla9 (t5 t cl]gym5 in/ead ( be+ a help are sometimes a h9drance to ! en=cem5t ( mod]n hygi5ic rules1 because !y /ill cl+ to old-fogy notions ( hygi5e & sanitation reta9$ f a defective e>ly tra9+4 ,ow+ to ! influ5ce t ! cl]gyman is sure to ex]t1 ?is becomes an extremely important matt]4 ,great h>m may be done & ! physician discr$it$1 almo/ )\t a realisation1 on ! "p ( ! cl]gyman1 t he is int]f]+ 9 ano!r's dep>tm5t4 ,sympa!tic coord9ation ( cl]ical & m$ical ef=ts w\ld accompli% mu* good t is n[ un=tunately left undone4 ,!re is no d\bt t = ! important crusade aga9/ tub]culosis1 = in/ance1 ! aid ( ! cl]gyman w accompli% mu* = ! r$uction ( ! dea? rate f ?is disease4 ,:at is ne$$ at ! pres5t mom5t is a univ]sal conviction t tub]culosis is n an h]$it>y b a communicable disease4 ,?is does n mean t x is virul5tly contagi\s & t z a result suff]]s f tub]culosis mu/ at once be segregat$ f o!r memb]s ( ! family & f ! community g5]ally2 b x does mean t c>eful precautions mu/ be tak5 ) reg>d to ! disposal ( sputum1 ) ! en=cem5t ( ! mo/ exact+ cleanl9ess on ! "p ( consumptives !mselves4 #ij ,x also means t ! p]son suff]+ f ! disease %\ld n sleep ) ^? z yet unaffect$1 nor be all[$ to live 9 v close contact1 especially ) *ildr5 or susceptible individuals4 ,! p]suasion t tub]culosis is n h]$it>y w d mu* to enc\rage pati5ts suff]+ f ! disease to feel t !y are n hopelessly doom$4 ,at ! pres5t "t x is n unusual to f9d pati5ts s disc\rag$1 :5 told t !y h tub]culosis1 t x is almo/ impossible to secure a fav\rable reaction to any mode ( treatm5t4 ,!y h se5 memb]s ( families die "o aft] ano!r1 or !y h he>d /ories ( ! inevitable way 9 :i* consumption wip$ families out ( exi/5ce1 & !y give up hope & become q ca/ d[n4 ,ne$less to say1 :ile 9 ?is condition any treatm5t is practically hopeless4 ,on ! o!r h&1 ! conviction t tub]culosis is only an infecti\s disease1 q curable 9 ! majority ( cases if tak5 9 "t1 is ( itself a mo/ important aid 9 ! treatm5t ( ! disease1 s9ce c\rage & fai? are ! pr9cipal requirem5ts = successfully combat+ ! affection4 ,we h _h any numb] ( newly inv5t$ rem$ies = consumption 9 ! la/ tw5ty-five ye>s4 ,sc>cely a ye> has pass$ 9 :i* "s new =m ( treatm5t1 (t5 ev5tually prov$ to be ! resugge/ion ( an old !rapeutic me?od1 has n be5 h]ald$ z a positive cure = consumption4 ,9 e case ! fir/ pati5ts treat$ by ! discov]] ( ! new rem$y h rapidly improv$ "u 8 c>e4 ,9 ! h&s ( o!rs1 h[ev]1 su* results h n be5 obta9$1 or only = a v %ort "t at ! beg9n+ ( ! treatm5t4 ,aft] a "t ! new rem$y fail$ 9 its inv5tor's h&s4 ,! true reason = ! improvem5t 0 !n se5 to be1 n ! rem$y sugge/$1 b ! fav\rable influ5ce on ! m9d ( consumptives produc$ by ! fai? ( ! inv5tor 9 8 rem$y1 & _! reaction to ?is p[]ful sugge/ion :5 !y 7 put "u prop] conditions ( an abundance ( fre% air & a pl5tiful diet4 ,?is %[s1 too1 ! reasonabl5ess ( ! mod]n treatm5t ( consumption1 :i* consi/s n 9 ! giv+ ( #ia drugs1 b 9 secur+ = ! pati5t a pl5ty ( fre% air = _m h\rs a day & ! enc\ragem5t to consume a lib]al am\nt ( nutriti\s food4 ,mo/ ( ! mu* adv]tis$ rem$ies = consumption are really h>mful r ?an b5efic5t4 ,_m ( !m are ord9>y c\gh mixtures conta9+ consid]able opium1 :i* less5s ! c\gh1 x is true1 b also less5s ! appetite & locks up ! b[els4 ,besides1 ! c\gh is nature's me?od ( remov+ mat]ial f ! lungs :i* has become dis9tegrat$1 & if all[$ to rema9 w c]ta9ly br+ ab\t ! spread ( ! infection 9 ! pulmon>y tissues4 ,c\gh is a natural protective reaction to be enc\rag$1 & is n 9 itself a s\rce ( evil ne$+ to be suppress$4 ,if c\gh is bo!r+ ! pati5t s mu* at night z to cause loss ( sleep1 !n x is necess>y to make a *oice betwe5 two evils & some:at to suppress ! c\gh1 ev5 ?\gh x involves c]ta9 o!r inconv5i5ce to ! pati5t4 ,all ^! s-call$ consumption cures conta9 mat]ials t are almo/ sure to di/urb ! appetite & upset ! /oma*4 ,! fate ( a consumptive pati5t absolutely dep5ds on 8 /oma*2 j z little1 !n1 ( m$ic9e mu/ be employ$ z possible4 ,?is w indicate ! necessity = cl]gym5 r advis+ aga9/ ?an 9 fav\r ( ^! propriet>y m$ic9es :i* h be5 def9itely kn[n to d s mu* h>m 9 rec5t ye>s4 ,_m a pati5t delays an appeal to m$ical aid s long1 z ! result ( tru/+ to su* m$ic9es1 t a curable case ( consumption becomes incurable1 or else develops to su* a condition z to require ye>s ( treatm5t on ! fre%-air1 abundant-food plan1 :]e mon?s w\ld h suffic$ be=e4 ,a v int]e/+ phase ( social m$ic9e is ! ease & confid5ce display$ by p1 (t5 ( m ?an ord9>y intellig5ce1 9 recomm5d+ v>i\s propriet>y m$ic9es ( :i* !y "k no?+ except ! fact t someone says he1 or m (t5 %e1 0 cur$ ( some?+ or o!r by _! use4 ,a *ance rem>k l ?is to a suff]] becomes a high recomm5dation4 ,! h>de/ problem ! doctor has be=e him is to f9d out :at is really ! matt] ) 8 pati5ts4 ,n infrequ5tly p hav+ app>5tly ! same set ( symptoms are suff]+ f q diff]5t #ib ailm5ts4 ,a symptom l a sore ?roat1 = in/ance1 may v well be due to any "o ( at lea/ a half-doz5 ( causes1 mo/ ( :i* require _! own peculi> treatm5t4 ,:5 ! affection "u consid]ation is z indef9ite z a tir$ feel+1 or indige/ion1 or "s "o ( ! _m ailm5ts includ$ "u ! t]m bili\sness or kidney tr\ble1 f :i* p are suppos$ to suff]1 !n ! diagnosis problem becomes by f> ! mo/ s]i\s "q 9 ! case1 & is (t5 v difficult4 ,! tra9$ physician prud5tly hesitates1 b ! inexp]t 9 m$ic9e /eps 9 & q volubly ann\nces :at ! ailm5t is 9 8 op9ion1 & :at w probably d x good4 ,a little k is inde$ a dang]\s ?+ 9 m$ical matt]s4 ,if x be rememb]$ t !re is a v g5]al impression among m$ical m5 n[1 z ! result ( rec5t acquisitions ( sci5tific in=mation ) reg>d to ! orig91 pa?ological basis1 & c\rse ( disease1 t v probably m h>m ?an good has be5 done by ! adm9i/ration ( m$ic9es 9 ! pa/1 n only ! futility ( lay 7or cl]ical7 prescrib+ w be manife/1 b also some:at ( ! am\nt ( h>m t may be done4 ,x is (t5 a matt] = pa9ful surprise1 !n1 to f9d t cl]gym5 & memb]s ( religi\s communities all[ _! names to be us$ 9 ! recomm5dation ( rem$ies ( ^: composition !y "k no?+1 = a disease ( :i* !y "k less1 if possible4 ,?is evil becomes especially poignant :5 ! columns ( our reputable religi\s press are all[$ to be us$ = ! purpose ( exploit+ ! public 9 ^! matt]s4 ,! rem$ies mo/ (t5 recomm5d$ are ! s-call$ tonics4 ,^! are be/ repres5t$ by ! s>sap>illas1 & by v>i\s cures = cat>rh1 indige/ion1 & k9dr$ indef9ite ills1 ( :i* !re are a great _m on ! m>ket4 ,^! are n secret rem$ies1 s9ce _! composition is well kn[n by ^? ( ! m$ical pr(ession :o c>e to secure ! in=mation4 ,"s six ye>s ago an analysis ( mo/ ( !m 0 made by ! ,massa*usetts ,/ate ,bo>d ( ,heal?4 ,footnote #a ,footnote #a3 #bh? ,annual ,report ,mass4 ,bo>d ( ,heal?2 food & drug inspection1 #ahig4 ,! pr9cipal active ag5t 9 all ( ^! rem$ies 0 #ic f\nd to be alcohol4 ,9 mo/ ( !m x exi/s 9 a proportion ab\t equal to t 9 :i* x is suppos$ to occur 9 ord9>y :iskey4 ,"s ( !m are ev5 /rong] 9 alcoholic cont5ts ?an ! :iskey usually sold 9 our l>ge cities4 ,?is matt] has seem$ s important t we give ! (ficial figures ( ! ,bo>d ( ,heal?4 ,,table ,f ! ,report ( ! ,massa*usetts ,bo>d ( ,heal? ,tonics & ,bitt]s ,! foll[+ 7 exam9$ = ! purpose ( asc]ta9+ ! p]c5tage ( alcohol 9 ea*4 ,"s ( !m h be5 recomm5d$ z temp]ance dr9ks6 ,p] c5t1 ( ,alcohol 7by volume74 ,be/ ,tonic #g4f ,c>t]'s ,physical ,extract #bb4j ,hook]'s ,wigwam ,tonic #bj4g ,ho(l&'s ,g]man ,tonic #bi4c ,hop ,tonic #g4j ,h[e's ,arabian ,tonic1 n a rum dr9k #ac4b ,jackson's ,gold5 ,seal ,tonic #ai4f ,liebig ,company's ,coca ,beef ,tonic #bc4b ,m5sman's ,peptoniz$ ,beef ,tonic #af4e ,p>k]'s ,tonic1 purely vegetable1 recomm5d$ = inebriates #da4f ,s*5ck's ,sea ,we$ ,tonic1 entirely h>mless #ai4e ,atwood's ,qu99e ,tonic ,bitt]s #bi4b ,l4 ,t4 ,atwood's ,jaundice ,bitt]s #bb4c ,moses ,atwood's ,jaundice ,bitt]s #ag4 #a ,baxt]'s ,m&rake ,bitt]s #af4e ,bok]'s ,/oma* ,bitt]s #db4f ,br[n's ,iron ,bitt]s #ai4g ,burdock ,blood ,bitt]s #be4b ,c>t]'s ,scot* ,bitt]s #ag4f ,colton's ,bitt]s #bg4a ,copp's ,:ite ,m\nta9 ,bitt]s1 n an alcoholic bev]age #f4j ,drake's ,plantation ,bitt]s #cc4b ,fl9t's ,quak] ,bitt]s #ba4d ,goodhue's ,bitt]s #af4a ,gre5e's ,n]vura #ag4b #id ,h>t%orn's ,bitt]s #bb4b ,ho(l&'s ,g]man ,bitt]s1 entirely vegetable & free f alcoholic /imulant #be4f ,hop ,bitt]s #ab4j ,ho/ett]'s ,/oma* ,bitt]s #dd4c ,kaufmann's ,sulphur ,bitt]s1 conta9s no alcohol4 ,z a matt] ( fact1 x conta9s #bj4e p] c5t1 ( alcohol & no sulphur #bj4e ,k+sley's ,iron ,tonic #ad4i ,langley's ,bitt]s #ah4a ,liv]pool's ,mexican ,tonic ,bitt]s #bb4d ,pa9e's ,cel]y ,comp\nd #ba4j ,pi]ce's ,indian ,re/orative ,bitt]s #f4a ,puritana #bb4j ,port]'s ,/oma* ,bitt]s #bg4i ,pulmon9e #af4j ,ru%'s ,bitt]s #ce4j ,ri*>dson's ,conc5trat$ ,%]ry ,w9e ,bitt]s #dg4e ,secor's ,c9*ona ,bitt]s #ac4a ,%onyo's ,g]man ,bitt]s #ba4e ,job ,sweet's ,/r5g!n+ ,bitt]s #bi4j ,?ur/on's ,old ,cont95tal ,bitt]s #aa4d ,walk]'s ,v9eg> ,bitt]s1 conta9s no _s #f4a ,w>n]'s ,safe ,tonic ,bitt]s #ce4g ,w>r5's ,bili\s ,bitt]s #ba4e ,:eel]'s ,tonic ,%]ry ,w9e ,bitt]s #ah4h ,:eat ,bitt]s #ac4f ,fai? ,:itcomb's ,n]ve ,bitt]s #bj4c ,dr4 ,williams' ,vegetable ,jaundice ,bitt]s #ah4e ,:iskol1 a non-intoxicat+ /imulant1 :iskey )\t its /+ #bh4b ,cold5's ,liquid ,beef ,tonic1 recomm5d$ = treatm5t ( ! alcoholic habit #bf4e ,ay]'s ,s>sap>illa #bf4b ,?ay]'s ,comp\nd ,extract ( ,s>sap>illa #ba4e ,hood's ,s>sap>illa #ah4h ,all5's ,s>sap>illa #ac4e ,dana's ,s>sap>illa #ac4e ,br[n's ,s>sap>illa #ac4e ,corbett's ,%ak] ,s>sap>illa #h4h ,radway's ,resolv5t #g4i ,! dose recomm5d$ ^u ! labels ( ! =ego+ prep>ations v>ies f a teaspoonful to a w9eglassful1 & ! frequ5cy also v>ies f "o to f\r times a day1 increas$ z ne$$4 ,_m s-call$ tonics n on ?is li/ are also kn[n to conta9 alcohol1 #ie ?\gh n z yet (ficially analys$ s z to give exact figures4 ,mo/ ( ! cure-alls = wom5's ills conta9 alcohol 9 notewor?y am\nts1 ?is be+ 9 fact usually ! only active +r$i5t 9 !m4 ,z ! analy/ ( ! ,/ate ,bo>d ( ,heal? ( ,massa*usetts is a ?or\ghly compet5t *emi/1 & z ^! figures h n[ be5 be=e ! public = ov] five ye>s )\t any contradiction on ! "p ( ! manufactur]s ( ^! rem$ies1 ?\gh x is evid5t h[ undesirable ! tru? ( ! matt] is f an adv]tis+ /&po9t1 !re c no long] be any "q z to ! au?oritativ5ess ( ! proportions ( ! alcohol 9 ! rem$ies z giv54 ,x is r sad to ?9k ( mo!rs giv+ ^! rem$ies to _! *ildr51 hopeful ( ! good !y may accompli%1 :51 z a matt] ( fact1 x w\ld be s mu* simpl] & j ! same 9 ! end1 to give !m1 in/ead ( a tablespoonful ( ! fav\rite s>sap>illa1 :atev] x might be1 a tablespoonful ( dilute :iskey4 ,z 0 not$ 9 ! volumes on ! ,physiological ,aspects ( ! ,liquor ,problem publi%$ rec5tly by a sub-committee ( ! ,committee ( ,fifty = ! inve/igation ( ! liquor problem1 n a few prom95t total ab/95ce advocates h put !mselves on record z recomm5d+ ^! rem$ies1 ?\gh !re c be no possible d\bt ( ! great h>m likely to arise f _! use4 ,!re are _m physicians :o feel sure t "s ( ! alcoholic habits 9 wom51 ^: orig9 x has be5 h>d to acc\nt =1 7 really contract$ dur+ ?is secret tippl+ process "u ! =m ( a tonic rem$y4 ,ev]yone kn[s t any tonic1 9 ord] to be effective1 has to be gradually increas$1 s x is n surpris+ t 9 _m cases physicians h he>d ( pati5ts tak+ six to t5 tablespoonfuls ( "s tonic rem$y e day4 ,?is w\ld be ! equival5t1 9 "s cases1 ( f ?ree to five ounces ( :iskey--a r lib]al all[ance ev5 = a confirm$ :iskey dr9k]4 ,z not$ by ! ,massa*usetts ,bo>d ( ,heal?1 ! dose recomm5d$ ^u ! labels v>ies consid]ably1 b practically all agree 9 sugge/+ t ! am\nt ( ! rem$y tak5 %all be increas$ z ne$$4 ,a simple pres5tation ( ?is subject w surely be suffici5t to ar\se cl]gym5 #if to a prop] s5se ( _! duty 9 ?is matt]4 ,s5ators1 judges ( ,supreme ,c\rts1 ,congressm51 & ev5 univ]sity pr(essors & tea*]s may be s b5efit$ by dilute :iskey1 tak5 e>ly & (t51 z to be tempt$ to furni% te/imonials = !m 7= a due consid]ation usually71 b cl]gym5 %\ld at lea/ "k some?+ ( ! consequ5ces ( _! act be=e committ+ !mselves4 ,an almo/ precisely simil> /ate ( affairs obta9s ) reg>d to ano!r class ( fav\rite popul> rem$ies4 ,a numb] ( s-call$ blood-purify+ rem$ies h be5 recomm5d$ at v>i\s times1 & "h1 z 9 o!r ?+s1 x is surpris+ to f9d h[ _m intellig5t p l5d !mselves to ! exploitation ( ! public 9 ! int]e/s ( ! propriet>y v5d]1 :o c>es only to sell1 & c>es v little :at effect 8 rem$ies may produce4 ,mo/ ( ! s>sap>illas are said to be blood purifi]s4 ,x is surpris+ :at vogue ?is ^w s>sap>illa has obta9$4 ,a little m ?an half a c5tury ago a ,g]man *emi/ & ph>maci/ ann\nc$ t ! s>sap>illa plant conta9$ c]ta9 pr9ciples t c\ld be extract$ by boil+1 & t =m excell5t rem$ies = atonic & anaemic conditions4 ,?is ann\ncem5t 0 receiv$ by ! m$ical pr(ession v k9dly1 & imm$iate te/s z to ! efficacy ( ! new rem$y 7 made4 ,z a result ( ^! te/s1 )9 a few ye>s ! inefficacy ( s>sap>illa became v cle>4 ,x is almo/ entirely )\t effect ^u ! human sy/em4 ,9 ! meantime1 h[ev]1 ! ^w s>sap>illa 0 "o to conjure ) = ! popul> m9d1 & ! s>sap>illa rem$ies began to be manufactur$4 ,millions h be5 made on !m & out ( ! public4 ,! only active ag5t z reg>ds tonic qualities :i* !y conta9 is1 z we h said1 alcohol4 ,mo/ ( !m h[ev]1 conta9 at lea/ "o o!r well-kn[n drug likely to be at lea/ z h>mful z alcohol4 ,?is is iodide ( pota%4 ,v few ( ! s-call$ s>sap>illas are )\t a notable proportion ( ?is /rong m9]al salt1 z ! ,massa*usetts ,bo>d ( ,heal? said4 ,) b few exceptions !y conta9 a consid]able p]c5tage ( a v active & p[]ful rem$y1 ! iodide ( potassium4 ,! sale ( su* an article 9 unlimit$ #ig quantities by druggi/s1 groc]s1 & o!rs is c5surable4 ,m ?an ?is1 ! me?od ( its sale is di%one/1 s9ce ! unw>y pur*as] is l$ to believe t he is pur*as+ a h>mless vegetable rem$y1 namely1 s>sap>illa4 ,x may be s]i\sly que/ion$ :e!r ! blood ( p]sons :o take iodide ( potassium cont9u\sly is n decid$ly impov]i%$1 in/ead ( be+ purifi$1 z is claim$ by ! manufactur]s4 ,x is n uncommon to f9d p]sons :o h us$ cont9u\sly six1 eight1 or t5 p9t bottles ( "o ( ^! prep>ations4 ,unlike s>sap>illa1 ! iodide ( potassium is class$ among poisons by ne>ly e writ] ^u toxicology4 ,practically all ! propriet>y rem$ies h _! mo/ pot5t pr9ciple 9 ! suppos$ my/]y ( _! composition4 ,z a matt] ( fact1 all are simple prescriptions1 well kn[n to physicians1 & ow+ _! successful treatm5t ( _m ills mu* m to ! pr9t]'s ink us$ to secure _! sale ?an to any ph>maceutical +r$i5t :i* !y conta94 ,no important rem$y has ev] be5 put on ! m>ket by adv]tis+ me?ods4 ,exposure ( ! *>latanry ( su* me?ods w n1 h[ev]1 cause an int]ruption ( _! sale4 ,long ago ,b>num said t p wi% to be humbugg$1 & !re is no d\bt t !y h be51 are1 & w be humbugg$ j to ! ext5t to :i* !y lay !mselves op5 to ! allur+ me?ods ( ! adv]tis]4 ,x does seem too bad1 h[ev]1 t ! influ5ce ( ! cl]gym5 & ( religi\s z well z *>itable visitors--an influ5ce acquir$ because ( ! confid5tial position !y occupy & ! feel+ ( good fai? _! mode ( life inspires--%\ld be abus$ = ! enc\ragem5t & ext5sion ( :at is manife/ly a great evil4 ,alcohol & iodide ( pota% are n ! only drugs likely to d h>m t are incorporat$ 9 propriet>y m$ic9es4 ,great compla9ts h rec5tly be5 made ) reg>d to ! spread ( ! coca9e habit 9 ?is c\ntry4 ,n a few ( ! rem$ies t are suppos$ to give imm$iate relief to colds 9 ! head conta9 coca9e 9 dang]\s am\nts2 & !re seems no d\bt t 9 _m cases ! drug habit = ?is sub/ance has be5 acquir$ innoc5tly & #ih unconsci\sly at fir/ by ! use ( su* prep>ations4 ,^! are only ! m notable evils likely to result f ! indiscrim9ate employm5t ( m$ic9es ( ^: composition !re is complete ignorance1 & ( ^: effect !re c be only ! judgm5t dep5d5t ^u ! subjective feel+s ( ! pati5t4 ,x mu/ n be =gott5 t ! pati5t's feel+s are = ! mom5t (t5 fav\rably influ5c$ by "s sub/ance t may d no good to ! ailm5t1 ?\gh mak+ ! pati5t less s5sitive to any symptoms f :i* he 0 suff]+2 b 9 ! end do+ positive h>m1 because ( ! contraction ( ! alcohol or "s drug habit1 or because ! suppression ( symptoms may be ! v wor/ ?+ = ! pati5ts1 s9ce x all[s ! und]ly+ ailm5t to progress to a s]i\s /age )\t =c+ !m to h x treat$ 9 radice4 ,^! are only a few examples t %[ v well ! inadvisability ( recomm5d+ 9 any way m$ic9es ( :i* "o does n "k ! exact cont5ts4 ,! pres5t writ] has _h "o example ( h[ utt]ly dis+5u\s1 ?\gh "o feels mu* m l call+ x rascally1 ! manufactur]s ( s-call$ pat5t m$ic9es or propriet>y rem$ies may be4 ,"o ( ! rem$ies widely adv]tis$ = ! cure ( epilepsy1 or fits1 is ann\nc$ always z conta9+ no h>mful drugs1 no bromide ( pota%4 ,! manufactur] ( ! rem$y 0 ask$ h[ he c\ld say any su* ?+1 s9ce x 0 v evid5t ev5 to ! ta/e t ! rem$y conta9$ bromides4 ,oh1 he said1 yes1 x conta9s sodium bromide1 b n bromide ( pota%4 ,almo/ ne$less to say1 sodium bromide is at lea/ z h>mful z potassium bromide1 & ! adv]tisem5t is entirely = purposes ( deception4 ,! poor epileptics h be5 a s\rce ( rev5ue = quacks & *>latans z long z hi/ory runs4 ,at ! pres5t "t "o n infrequ5tly f9ds te/imonials f conv5ts1 asylums1 re=matories1 & ! l1 ass]t+ ! value ( "s p>ticul>ly adv]tis$ rem$y = ?is disease4 ,all ^! rem$ies conta9 bromides4 ,! treatm5t ( epilepsy is n[ bett] und]/ood by physicians & x is g5]ally recognis$ t ! two ?+s t epileptic #ii pati5ts ne$ are outdoor air & z f> z possible all fre$om f responsibility4 ,bromides w1 = a "t1 control ! numb] & frequ5cy ( ! attacks1 b if us$ indiscrim9ately1 & especially if employ$ )\t any prop] realisation ( _! possibilities = h>m1 ^! salts are almo/ sure to make ! condition ( ! pati5t mu* worse ?an be=e1 to br+ on a /ate 9 :i* m5tal symptoms pr$om9ate ov] physical1 & 9 :i* ! pati5t may g into dem5tia1 or "s =m ( m5tal ali5ation4 ,especially is ?is true ) reg>d to epileptic *ildr54 ,cont9u\s dos+ ) drugs ( any k9d is sure to d !m h>m r ?an good4 ,c>e = _! diet & re/ & ! removal ( all s\rces ( di/urbance ( _! dige/ive tract is m important ?an any o!r me?od ( treatm5t4 ,! poor *ildr5 h to suff] _m ?+s f _m p4 ,p hesitate1 z a rule1 to accept recomm5dations ) reg>d to ! adm9i/ration ( drugs to _! animals :5 ! p]son :o gives ! recomm5dation is kn[n n to be an exp]t 9 ! matt]4 ,almo/ any sugge/ion1 h[ev]1 ) reg>d to ! dos+ ( _! *ildr5 is likely to be foll[$ by lov+ b indiscreet mo!rs4 ,x is well kn[n n[1 & 9 _m cases is admitt$1 t ! s-call$ soo?+ syrups s (t5 giv5 to *ildr5 conta9 opium 9 q appreciable quantities4 ,ne$less to say1 no?+ mu* worse ?an ?is c\ld possibly be giv5 to *ildr54 ,! *ild soon becomes accu/om$ to its daily dose ( opium & craves ! repetition ( x4 ,x w n sleep )\t x1 & z ?is adds to ! sales ( ! rem$y1 ?is special +r$i5t cont9ues to put money 9 ! pockets ( ! manufactur]s1 b at ! exp5se ( ! n]v\s /ability ( ! *ild1 & lack ( resi/+ p[] lat] 9 life4 ,x w\ld be h>d to say h[ _m ( ! n]v\s wrecks s commonly met ) 9 "y adults n[ are to be attribut$ to ?is un=tunate /ate ( affairs e>ly 9 life2 b und\bt$ly ?is evil has _h mu* to d ) ! noticeable increase 9 ! n]v\sness ( our p4 ,! m n]v\s ! h]$ity ( ! *ild1 ! m x mu/ be gu>d$ aga9/ su* mi/ak5 me?ods ( induc+ sleep1 or ! result is sure to be s]i\s4 #ajj ,sc>cely too mu* c be said 9 condemnation ( mo/ ( ! propriet>y rem$ies = con/ipation1 ?\gh x is 9 ?is dep>tm5t ( m$ication t ! non-m$ical are free/ ) _! advice4 ,fir/1 ! *eape/ possible drugs are select$ by ! manufactur]s ( su* rem$ies4 ,secondly1 ^? drugs especially are employ$ :i*1 :ile produc+ ! desir$ imm$iate effect1 are always foll[$ by a reaction :i* requires fur!r use ( ! m$ic9e4 ,"o f9ds te/imonials1 h[ev]1 f all classes ( ! community1 ev5 f cl]gym51 ) reg>d to su* rem$ies1 ?\gh at ! la/ int]national m$ical congress x 0 confid5tly ass]t$1 by ?ree ( ! mo/ prom95t speciali/s 9 dige/ive diseases 9 ! _w1 t ! mod]n problems 9 dige/ive di/urbances are s mu* m intricate ?an !y us$ to be1 & ! affections :i* develop are s mu* m difficult ( treatm5t1 because ( ! use ( ^! unsuitable rem$ies1 & ! consequ5t habituation to drugs1 :i* has be5 acquir$ dur+ ! prolong$ p]iod ( _! employm5t4 ,9 rec5t ye>s cat>rh has become ! ^w t is suppos$ to attract popul> att5tion mo/1 & accord+ly is ! wat*word ( ! propriet>y m$ic9e manufactur]4 ,a long "t ago1 t is1 ab\t half a c5tury ago1 cat>rh 0 suppos$ really to mean some?+ 9 m$ic9e4 ,^? 7 ! days ( humoral pa?ology1 :5 di/urbances ( secretion 7 suppos$ to be ! basis ( all disease4 ,accord+ly1 :5ev] !re 0 an excessive dis*>ge f ! nose1 a pati5t 0 said to be suff]+ f cat>rh1 & z ! nasal secretion 0 suppos$ to be connect$ 9 "s way ) ! bra91 x is easy to und]/& h[ significant su* a pa?ological condition might well be ?\ght4 ,9 m rec5t ye>s1 ! ^w cat>rh has /ill be5 employ$ by physicians :o ?\ghtlessly employ t]ms t !y ?9k w be bett] und]/ood by ! laity1 ow+ to _! famili>ity ) !m1 ?\gh !y h be5 outliv$ 9 m$ic9e4 ,f repres5t+ an affection ( ! nose1 cat>rh1 z a consequ5ce1 has come to be employ$ = an excess ( secretion f any muc\s membrane4 ,accord+ly we he> ( cat>rh ( ! /oma*1 cat>rh ( ! bladd]1 or cat>rh ( ! #aja bile-ducts1 & !re has come to ! g5]al public a notion t cat>rh is an all-p]vad+ affection ^: ravages mu/ be prev5t$1 at all haz>ds1 & ^: beg9n+ mu/ be ! signal = prompt m$ical treatm5t4 ,z a matt] ( fact1 cat>rh1 :5 x means any?+1 means only t /age ( inflammation 9 :i* !re is an increas$ secretion & :i* repres5ts an inflammatory condition s mild z (t5 to be describ$ z only hyp]aemic1 t is1 due to an increase ( blood 9 ! "p4 ,x is r easy to und]/& t if m blood fl[s ?r\gh a muc\s membrane1 !re w be great] secretion f x ?an w\ld normally be ! case4 ,?is is :at happ5s 9 ! production ( cat>rh4 ,z a rule1 x is only a pass+ conge/ion )\t any la/+ *anges 9 ! tissue4 ,cat>rh may1 h[ev]1 cont9ue to be pres5t if ! irritation1 :i* orig9ally caus$ ! conge/ion1 be all[$ to cont9ue4 ,x is ?is irritation1 h[ev]1 :i* ne$s to be treat$1 & n ! cat>rhal inflammation1 :i* is only a symptom ( x4 ,! ?ree mo/ us$ words 9 popul> m$ic9e1--cat>rh1 rheumatism1 & g\t1--:5 trac$ to _! etymological signification1 mean ! same ?+4 ,cat>rh means a fl[+ d[n1 rheumatism a /ate ( fl[+1 bo? be+ =m$ f ! ,greek v]b ,greek text1 to fl[1 :ile g\t is d]iv$ f ! ,lat9 ^w gutta1 a drop1 :i* h9ts at ! excess ( fluid t is suppos$ to be ! basis ( ! disease4 ,= ^! ?ree diseases1 h[ev]1 ! mo/ v>i$ rem$ies h be5 propos$1 & practically entirely )\t success1 :5 te/$1 9 a l>ge numb] ( cases4 ,z a matt] ( fact1 "u ! two words cat>rh & rheumatism1 !re is gr\p$ a s]ies ( affections v diff]5t f "o ano!r1 & requir+ v diff]5t treatm5t4 ,! important ?+ is n s mu* ! sugge/ion ( a rem$y z ! recognition ( ! p>ticul> cause :i* 9 "o case is produc+ an excess ( secretion & 9 ! o!r is giv+ rise to ! s-call$ rheumatic pa94 ,:5 ! exact cause c be f\nd1 x is usually n s difficult to succe$ 9 prev5t+ ! recurr5ce ( ! tr\blesome symptoms4 ,x is ) reg>d to ^! two diseases1 h[ev]1 t 9 non-m$ical circles ev5 intellig5t m5 are ready to give advice4 ,!y con/itute #ajb ! mo/ puzzl+ problem t ! physician has to deal )1 b ! non-m$ical m9d waives ! difficulty & sugge/s ! rem$y4 ,9 ?is matt] "o is =cibly rem9d$ ( a fam\s expression ( ,jo% ,bill+s1 :o us$ to say1 ,x is n s mu* ! ignorance ( mank9d t makes !m ridicul\s z ! kn[+ s _m ?+s t are n s4 ,cl]gym51 lawy]s1 memb]s ( ,congress1 & ( v>i\s /ate legislatures1 all p]mit _! portraits to appe>1 adv]tis+ ! m]its ( "s trump$-up cure = cat>rh or rheumatism4 ,x is int]e/+ to realise1 !n1 t 9 mo/ cases1 accord+ to exp]t te/imony1 ! rem$y !y recomm5d s highly consi/s ( no?+ m ?an dilut$ alcohol flav\r$ s z to ta/e l m$ic9e4 ,! only real effect is ! alcoholic exhil>ation :i* foll[s its +e/ion & gives ! s5se ( well be+1 because ( :i* ! te/imonials are provid$4 ,z "o ( ! m$ical j\rnals said rec5tly1 x w\ld be v int]e/+ to make a li/ ( ! m5 & wom5 ?r\gh\t ! c\ntry :o1 by p]mitt+ _! portraits & recomm5dations to be us$ 9 ! adv]tisem5ts ( v>i\s pat5t m$ic9es1 h practically confess$ t !y l to take _! :iskey r dilute b mix$ ) a little bitt]s4 ,! :ole "q illu/rates ! t5d5cy ( ! propriet>y m$ic9e man to exploit "s phase ( m$ic9e long aft] x has ceas$ to be ( int]e/ to ! m$ical pr(ession4 ,) reg>d to all ( ^! ?+s cl]gym5 may d a great humanit>ian "w by protect+ ! poor f ! ef=ts ( adv]tis+ rem$y-mak]s to get _! h>d-e>n$ money4 ,x is sometimes said t long ye>s h be5 sp5t 9 ! prep>ation ( a rem$y4 ,?is n only is nev] true1 b nev] has be5 true 9 ! hi/ory ( propriet>y m$ic9es4 ,"s "o :o has an eye to bus9ess gets hold ( a prescription ( :i* he kn[s no?+1 b ( :i* 8 adv]tis+ ag5ts are able to say mu*1 & ! result is sometimes a =tune = ! adv]tis]4 ,!re is always a pret5ce ( philan?ropy1 b x is ! mask ( he>tless hypocrisy4 ,un=tunately _m ( our religi\s j\rnals are tempt$ by ! promptly paid bills ( su* manufactur+ conc]ns to pr9t _! adv]tisem5ts4 ,!y are aid+ 9 a #ajc delib]ate sw9dle1 & if ?is 7 bett] und]/ood !re w\ld be mu* less suff]+ & few] va9 hopes4 ,! be/-manag$ newspap]s & magaz9es 9 ! c\ntry are n[ absolutely refus+ all m$ical adv]tisem5ts4 ,?is is ! only prop] attitude 9 ! matt]1 = !re is a place to adv]tise m$ic9es1 if !y are wor?y1 & t place is ! m$ical j\rnals4 ,if ! popul> adv]tis+ c\ld be r$uc$1 we %\ld soon h mu* less ( ! propriet>y m$ic9e evil4 ,!re are _m ways 9 :i* cl]gym5 by _! example1 _! advice1 & _! influ5ce c be ( great assi/ance to practition]s ( m$ic9e4 ,x is v sad1 !n1 to f9d t "s ( !m1 hav+ elab\rat$ !ories ( _! own on c]ta9 subjects1 or hav+ tak5 up ) peculi> notions1 are 9 opposition to ! accept$ m$ical tea*+ ( ! _w4 ,occasionally !y are f\nd among ! ranks ( ! anti-vacc9ationi/s1 ?\gh if !re is any?+ t has be5 demon/rat$ to a c]ta9ty1 x is t vacc9ation has practically eradicat$ smallpox1 consid]+ ! frequ5cy ( ! disease a c5tury ago1 & t x w\ld absolutely eradicate x1 if ! practice c\ld be made univ]sal4 ,/ati/ics are at h& to demon/rate ?is beyond all possibility ( d\bt4 ,!re are a c]ta9 numb] ( p1 h[ev]1 :o app>5tly1 out ( a desire = s+ul>ity z mu* z any?+ else1 refuse to accept ! evid5ce4 ,x is v un=tunate to f9d cl]gym5 among !m1 = x t5ds to br+ ! cl]ical judgm5t into disrepute4 ,ne>ly ! same ?+ might be said ( antitox9 = diph!ria4 ,cl]gym5 seem to consid] x necess>y = !m to h _! m9ds made up z to :e!r ! use ( diph!ria antitox9 is advisable or n4 ,if !y h once committ$ !mselves to ! expression ( ! op9ion t antitox9 is ( no value1 !n no am\nt ( evid5ce w succe$ 9 *ang+ _! op9ion4 ,"u ^! circum/ances x becomes extremely difficult at times = physicians to succe$ 9 hav+ families p]mit !m to treat _! pati5ts aft] ! mann] 9 :i* !y are conv9c$ ! treatm5t %\ld be c>ri$ on4 ,if su* cl]gym5 w\ld only realise t ! cl]gyman has1 z a rule1 mu* less "r to express #ajd op9ions on m$ical subjects ?an has ! physician to air views ) reg>d to !ological pr9ciples1 !re w\ld be mu* less friction1 & x w\ld be bett] = pati5ts 9 ! end4 ,!re are c]ta9 sanit>y regulations t cl]gym5 %\ld n only n oppose1 b endeav\r1 by e means 9 _! p[]1 to h ^? :o respect _! op9ions foll[ out z c>efully z possible4 ,su* sanit>y regulations h 9 ! pa/ tw5ty-five ye>s practically cut d[n ! dea? rate ( our l>ge cities a half4 ,!re is no great] s\rce ( alleviation = ! physical evils1 at lea/ ^? :i* afflict ! l[] classes1 ?an ! due en=cem5t ( mod]n sanitation4 ,!re are prejudices1 h[ev]1 t mu/ be ov]come1 & ! cl]gyman %\ld be f\nd beside ! doctor1 help+ him r ?an oppos+ him1 z is sometimes ! case4 ,,james ,j4 ,,wal%4 #aje ,,viii ,,"s ,,aspects ,,( ,,intoxication ,!re are v>i\s drugs t1 ?r\gh acute or *ronic poison+ f _! use1 cause m5tal di/urbance1--alcohol1 *loral1 cannabis indica1 somnal1 sulphonal1 p>aldehyde1 e!r1 *lor(orm1 antipyr91 ph5acet91 trional1 *loralamid1 iod(orm1 atrop9e1 hyoscyamus1 salicylic acid1 qu99e1 lead1 ars5ic1 m]cury1 opium & morph9e1 ! bromides1 coca9e1 & o!rs4 ,( ^! intoxicants alcohol always has be5 mo/ commonly us$ by we/]n nations1 b ! moral aspects ( alcoholism h n be5 %[n ) suffici5t insi/5ce4 ,!re are _m sots 9 human society mu* less repreh5sible ?an to ! unskill$ obs]v] !y appe> to be2 o!rs are m blamewor?y4 ,morality1 z f> z ! ag5t is conc]n$1 ap>t f ! nature & circum/ances ( ! de$1 supposes1 fir/1 volunt>y acts1 or acts t proce$ f ! w ) a k ( ! end t[>d :i* ! acts t5d2 &1 secondly1 free acts1 or acts t "u giv5 conditions may or may n be will$4 ,if by unavoidable *ance "o /umbles aga9/ a man /&+ at ! edge ( a :>f1 knocks him into ! wat]1 & dr[ns him1 ! act has no elem5t ( morality 9 x1 because x is n volunt>y & free4 ,if a m9d is diseas$1 &1 impell$ by a mad notion ( p]secution1 x br+s ab\t a l kill+1 !re is no "q ( morality1 because ! ag5t is n free1 & :5 fully analys$ 8 action is n volunt>y4 ,an act is m or less volunt>y & free1 & !re=e m or less moral1 z ! ag5t is affect$ by ignorance1 passionate desire1 fe>1 or disease4 ,ignorance1 fe>1 & disease may be su* z to remove all quality ( morality f an act4 #ajf ,c]ta9 diseases or pa?ological conditions1 especially ( ! n]v\s sy/em1 c take out ( an act ! elem5ts ( volunt>9ess & fre$om t are necess>y to make ! act moral or immoral1 provid$1 h[ev]1 ^! pa?ological conditions are n br\ght on ?r\gh ! fault ( ! subject 9 :i* !y exi/4 ,if a man volunt>ily becomes drunk ) alcohol1 or "s o!r drug1 he is1 ( c\rse1 acc\ntable = ! evil he may unconsci\sly d :ile "u ! influ5ce ( t drug1 & if he begets an idiot or a crim9al imbecile 9 8 drunk5ness1 he mu/ atone some:]e = ! bl9d$ s\l ( 8 *ild4 ,"h1 aga91 !re are c]ta9 ext5uat+ circum/ances1 because v few drunk>ds are fully consci\s ( ! ext5t ( ! evil 9 alcoholism4 ,ap>t f ! o!r requirem5ts t g to make an act moral1 ! ag5t mu/ be sane2 t ! act be immoral1 he mu/ be sane or insane1 ei!r tempor>ily or p]man5tly1 ?r\gh 8 own fault2 t x be devoid ( morality an act mu/ be a m]e actus hom9is1 or x mu/ be ! act ( a p]son blamelessly insane4 ,if a man kn[s t an alcoholic is liable to beget a crim9al imbecile solely because ( ! alcoholism1--& mo/ m5 are aw>e ( t fact1--?is fa!r or gr&fa!r is m or less acc\ntable = e l>c5y1 rape1 & murd] done by ! imbecile4 ,! law1 !re=e1 %\ld put ! imbecile into safe keep+1 !n seek out ! fa!r & hang him4 ,insanity is a common condition1 b x has n be5 satisfactorily def9$4 ,x supposes an appreciable uns\ndness ( ! w1 memory1 & und]/&+1 or ( "o or two ( ^! faculties1 b no ali5i/ has giv5 a %ort diff]5tiation ( t uns\ndness4 ,:]e %all we draw ! l9e betwe5 ! weak b responsible w & ! insane w8 ,:at degree ( opacity betwe5 intellect & ! _w sep>ates ! ignorant man f ! lunatic8 ,! extremes ( sanity & insanity are readily recognisable1 b ! int]m$iate degrees are n cle>4 ,!re is no te/ to apply to all cases2 ea* mu/ be diagnos$ f its peculi> symptoms1 b ! w ( an insane man is always weak4 ,x c n d5y or def] ! gratification ( a desire1 nor c x keep up an ef=t4 ,ev5 9 its lighte/ =ms insanity is selfi% & #ajg impolite1 because x lacks ! =ce ( w necess>y to take tr\ble4 ,x =egoes great future b5efit = slight pres5t gratification4 ,! insane man is idle1 or busy only 9 "w t he likes1 9 pleasurable activity4 ,a m>k$ quality ( sanity is ! capacity = su/a9$ "w1 & ! man t %irks "w m]ely because he does n l x is gratify+ himself dang]\sly4 ,^! defects are f\nd commonly 9 sane p]sons1 b ! lunatic c n rise f !m1 & he adds to ! defects ( w a w>p$ intellect4 ,he c n adju/ himself to 8 surr\nd+s1 & ! fault is 9 himself1 n 9 ! circum/ances4 ,8 intellect may be brilliant1 b x soon] or lat] %[s a ta9t4 ,! insane man is n a free1 rational ag5t4 ,alcoholism readily passes ov] into unmi/akable insanity1 & x almo/ always is ! cause ( n]v\s deg5]ation 9 ! *ildr5 born )9 its influ5ce4 ,?is1 is a phase ( ! evil n suffici5tly insi/$ ^u by ^? t plead = total ab/95ce4 ,*ronic poison+ by alcohol induces h>d5+ & calcification 9 ! walls ( ! art]ies1 deg5]ation ( ! n]ve cells & d5drites1 wa/+ or ov]gr[? ( ! he>t muscle1 & fatty deg5]ation ( ! liv] & kidneys4 ,! n]ve c5tres t control ! circulation ( ! blood are p>alys$ by x1 &1 z a sequ5ce1 ! art]ies & capill>ies are dim9i%$ 9 calibre4 ,?is /ate 9 turn ob/ructs ! fl[ ( ! blood1 & ! body is n n\ri%$1 nor are ! wa/e & poison\s results ( metabolism c>ri$ (f z !y %\ld be4 ,alcohol prev5ts ! haemoglob9 ( ! blood f do+ its (fice1 :i* is to supply oxyg5 & remove c>bon dioxid4 ,x absorbs ! necess>y wat] f ! tissues1 & ?us x acts z a corrod+ poison4 ,x is also a functional tox91 because x depresses ! activity ( organs by injur+ ! inn]vation4 ,! poison affects ! bra91 & z ! c]ebral gray matt]1 especially its pyramidal cells1 are ! physical in/rum5ts ( ?\ght1 w1 & memory1 or ! means ( communication betwe5 ! s\l & ! out] _w1 ! ex]cise ( ^! spiritual functions is *eck$ or inhibit$ by x4 ,a t5d5cy to excess 9 ! use ( alcohol commonly #ajh manife/s itself be=e ! ?irtie? ye>1 & 9 "s cases x may be remov$ at ! alcoholic climact]ic1 :i* is f ! =tie? to ! sixty-fif? ye>4 ,^? t become drunk>ds are usually ( a neuropa?ic con/itution1 ?r\gh inh]itance or abuse4 ,sev]e diseases1 l influ5za1 syphilis1 typhoid2 injuries to ! head1 sun/roke1 %ock1 worry2 ! di/urbance t may accompany pub]ty1 pregnancy1 lactation1 & s on1--cause a n]v\s depression :i* is soo!d by alcohol1 & ?us a habit is fix$4 ,! reckless prescription ( alcohol by "s physicians is ano!r cause ( ! habit1 & ! use ( propriet>y m$ic9es is a /ill m prolific s\rce ( drunk5ness & ! consequ5t mis=tune4 ,cid]1 be]1 ale1 & port] conta9 f #d to #f p] c5tum ( real alcohol2 light w9es1 r$ & :ite1 & natural %]ry1 #aj to #ab p] c5tum2 /rong %]ry & port1 #af to #ah p] c5tum2 br&y1 #ci to #dg p] c5tum by weight1 or #df to #ee p] c5tum by volume2 & :iskey1 #dd to #ej p] c5tum by weight1 or #ej to #eh p] c5tum by volume4 ,! effect ( ^! liquors on ! body is due prim>ily to alcohol1 & second>ily to e!real d]ivatives ( alcohol4 ,"s owe a "p ( _! effect to non-volatile sub/ances1--be] f :i* all alcohol has be5 boil$ c /ill affect ! body 9 a m>k$ degree4 ,! *emi/ ( ! ,massa*usetts ,/ate ,bo>d ( ,heal? 7,docum5t ,no4 #cd7 gives ! p]c5tage ( alcohol 9 ! common propriet>y m$ic9es1 & ^! p]c5tages w be f\nd 9 ! article on ,social ,m$ic9e4 ,! weake/ ( ^! comp\nds are twice z /rong 9 alcohol z be]1 & !y trea*]\sly br+ ab\t ! habit ( drunk5ness 9 dispos$ p]sons :o may be v desir\s to avoid su* a calamity4 ,"s m5 & wom5 are quickly de/roy$ by alcohol2 o!rs resi/ x m or less successfully = a lifetime1 z f> z m]e exi/5ce is conc]n$4 ,alcoholism is "o ( ! commone/ causes ( insanity1 b x is (t5 an effect ( insanity4 ,x may be an e>ly symptom ( p>esis1 or a "p ( ! maniacal /age ( circul> insanity4 ,9 poison+ by alcohol ! high] n]ve c5tres are fir/ affect$ & ! #aji l[e/ la/4 ,! s5se ( human dignity & ( morality1 ! ex]cise ( ! intellect1 are m or less inhibit$ be=e ! motive muscles are affect$4 ,! usual effect ( alcoholic poison+ is boi/]\s exaltation ( m9d1 b !re is a depress$ type ( drunk5ness :i* weeps4 ,"s pati5ts at once are subject$ by halluc9ations & delusions1 o!rs are s depress$ t !y h a suicidal t5d5cy1 o!rs may h a maniacal fr5zy t is de/ructive or homicidal4 ,9 ^! neuropa?ic conditions muscul> co-ord9ation is commonly well pres]v$--! pati5t is drunk 9 ! head & sob] 9 ! legs4 ,9 alcoholism ! m5tal *anges are gradual & progressive4 ,! intellect is blunt$1 ! judgm5t becomes fooli%1 ! moral s5se is dull$4 ,! drunk>d is always a li>4 ,delusions n infrequ5tly occur1 & x is "o ( ! common symptoms ( alcoholic insanity to suspect a wife or husb& ( conjugal infidelity4 ,if a man t is a drunk>d accuses 8 wife ( infidelity1 ! *ances are fifty to "o t %e is innoc5t & t he is 9 ! fir/ /ages ( insanity4 ,?is symptom is *>act]i/ic also ( coca9e intoxication4 ,ano!r m5tal di/urbance ( acute alcoholism is delirium trem5s1 :i* is inexactly call$ mania a potu by "s writ]s4 ,delirium trem5s is n a =m ( mania1 b an acute halluc9atory confusion1 9 :i* ! consci\sness is mu* m impair$ ?an x is 9 a mania4 ,mania a potu is a real mania1 & x is transi5t commonly1 al?\gh x may leave p]man5t m5tal weakness ) delusions4 ,9 *ronic alcoholism a p>anoid condition may occur1 & ?is (t5 is incurable4 ,?is psy*osis may come on sudd5ly or gradually4 ,9 true p>anoia ! delusions are sy/ematis$1 b 9 ?is alcoholic pseudop>anoia ! enfeebl$ intellect c n build up coh]5tly ev5 a delusion4 ,! alcoholic halluc9ations are visual & auditory1 & we f9d delusions ( p]secution1 especially ( a sexual nature4 ,! pati5t he>s all k9ds ( insult+ rem>ks made by voices4 ,^! voices (t5 come f 8 own belly4 ,8 enemies s5d poison\s or f\l od\rs into 8 room at night1 & ! gr\ndless suspicions ( 8 wife's infidelity take mo/ outrage\s =ms ( expression4 ,he w swe> #aaj he has se5 h] misde$s4 ,(t5 ! baseless suspicions ( 8 wife beg9 be=e any o!r noticeable impairm5t ( intellect1 & are n recognis$ z delusions4 ,! fir/ /ep a prie/ %\ld take 9 inve/igat+ accusations ( conjugal infidelity is to f9d out :e!r ! accus] is a tippl] or n4 ,! delusions ( p]secution lead to attacks on ! suppos$ enemies :i* (t5 are homicidal4 ,occasionally alcoholic insanity takes on a p>etic =m1 or x may be epileptic4 ,t5 p] c5tum ( alcoholics are epileptic4 ,:5 ! *ildr5 ( alcoholics are epileptic1 ! convulsions beg9 9 ^! *ildr5 ab\t f\r ye>s e>li] ?an 9 *ildr5 t are epileptics f o!r causes4 ,if epilepsy is lat5t1 alcoholism w />t x into action4 ,alcoholism sometimes produces a condition ( wak+ trance foll[$ by amnesia 7lack ( memory74 ,9 su* a /ate ! drunk>d may transf] prop]ty1 c>ry out complicat$ pr(essional actions1 commit crime1 take long j\rneys1 travel = days1 & s act t no "o notices 8 disord]$ m5tal condition4 ,!n sudd5ly he awak5s & he has no recollection :atev] ( :at has happ5$ dur+ ?is trance4 ,he appe>s to be consci\s1 b to h no memory ( 8 consci\sness4 ,!re is ano!r alcoholic amnesia1 f\nd especially 9 ^? t dr9k mu* dur+ ! morn+ h\rs1 :]e !re is in/antane\s =getfulness4 ,if y ask "o ( ^! m5 to %ut a door1 = example1 he w =get betwe5 8 *air & ! door :at he />t$ to d4 ,?is condition is difficult to cure ev5 aft] ! use ( alcohol has be5 rel9qui%$4 ,dipsomania is a =m ( impulsive deg5]ative insanity1 & x is probably epileptic 9 orig94 ,aft] a few days ( insomnia & loss ( appetite = food1 !re is an irresi/ible impulse to dr9k alcoholic liquor & to indulge 9 o!r excess4 ,! pati5t dr9ks until all means ( gett+ alcohol are exhau/$4 ,he w take crude alcohol1 bay rum1 cologne1 ! alcohol t is ab\t pa?ologic specim5s 9 a hospital museum4 ,! attack la/s f "o to two weeks1 & is foll[$ by depression & a feel+ ( remorse4 ,! onsets are irregul> 9 occurr5ce1 & betwe5 !m ! pati5t may #aaa be temp]ate or h ev5 an extreme di/a/e = alcohol4 ,?is =m ( disease is n infrequ5t among pr(essional m5 & cl]gym51 & x is impossible to f9d out j h[ f> ! pati5t is responsible = 8 condition4 ,if bi%ops w\ld inve/igate ! alcoholic t5d5cies ( ! families ( c&idates = sem9>ies1 & reject all t h ?is ta9t1 !re w\ld be mu* less sc&al4 ,x is a s]i\s error ( judgm5t to orda9 a sem9>ian t has ev5 once be5 "u ! influ5ce ( alcohol1 & ^? sem9>ians t cov] up ! tippl+ ( a companion1 because he is a good fell[1 are guilty ( f>-rea*+ crime4 ,! fact is wor? inve/igation :e!r or n a liquor deal] :o nev] dr9ks alcohol1 b :o lives = ye>s 9 ! pres5ce ( volatilis$ alcohol1 has mu* ( ! alcoholic deg5]acy & a t5d5cy to beget neurotic *ildr54 ,c]ta9ly ! fumes ( wood alcohol h kill$ workm5 t w5t d[n only once into a vat conta9+ ^! fumes1 & o!r alcohols 9 ! =m ( vap\r %\ld h delet]i\s effects4 ,f]e produc$ mon/]s 9 *ick5s by expos+ eggs to ! vap\r ( alcohol4 ,9 judg+ a drunk>d1 x mu/ be rememb]$ t 9 _m =ms ( alcoholism1 aft] ! condition is well e/abli%$1 ! pati5t has little m fre$om ( w ?an a brute has4 ,if he is acc\ntable = ! habit1 he is blamable = ! crime t foll[s4 ,if he is n acc\ntable1 & x is (t5 v difficult to prove t he is1 he is to be treat$ z a blamelessly insane man4 ,9 prop] surr\nd+s1 & ) skilful direction1 a *ild born ) a t5d5cy1 or m exactly a temptation1 to dipsomania or o!r alcoholic neurosis c be sav$1 b commonly ! circum/ances ( su* a *ild's life are ! wor/ imag9able4 ,^! *ildr5 mu/ nev] take alcohol1 ev5 z a m$ic9e1 & !y mu/ n be pu%$ 9 s*ool to n]v\s exhau/ion4 ,a t5d5cy to un*a/ity c run 9 families1 l a disposition t[>d alcoholism1 b ! disgrace 9 yield+ to ?is vici\s bias keeps _m su* un=tunates clean4 ,x is to be regrett$ t public op9ion c n give ! same aid 9 alcoholic pr$isposition4 ,a confirm$ alcoholic %\ld be prev5t$1 if possible1 f m>riage1 because 8 s9s w be visit$ ^u 8 po/]ity4 #aab ,! fir/ *ildr5 ( an alcoholic may be m5tally s\nd1 ! y\ng] *ildr5 are m or less m5tally weak1 ! y\nge/ are n uncommonly imbeciles1 or idiots1 or "u %ock !y gr[ insane4 ,=tunately _m ( ! *ildr5 ( alcoholics die at an e>ly age1 & ! family ( a drunk>d v seldom la/s beyond f\r g5]ations4 ,9 ! fir/ g5]ation moral depravity & alcoholic excess are f\nd2 9 ! second1 *ronic drunk5ness & mania2 9 ! ?ird1 melan*olia1 hypo*ondria1 impulsive & homicidal ideas2 9 ! f\r?1 idiocy1 imbecility1 & ext9ction ( ! family4 ,! l[] ! social ca/e ( ! drunk>d1 ! great] ! liability ( meet+ ^! blights4 ,prie/s %\ld take a deep int]e/ 9 societies e/abli%$ = ! promotion ( temp]ance1 & ! only temp]ance = mo/ p]sons is total ab/95ce4 ,no man kn[s :at lat5t t5d5cy to alcoholism he may h1 especially 9 ,am]ica1 :]e great gr&fa!rs are unkn[n & ! climate & life are try+ on ! n]v\s sy/em4 ,! adult]at$ liquors sold ev]y:]e at pres5t make ! dang] great] ?an x ev] 04 ,:atev] may be ! tru? z reg>ds h]$ity1 !re is no d\bt conc]n+ ! /rong influ5ce ( environm5t2 !re=e get into ! temp]ance societies ! *ildr5 ( alcoholic p>5ts1 ( p>5ts t are %iftless1 hy/]ical1 irritable4 ,if a man has a viol5t temp] or if he is un*a/e1 get him & 8 *ildr5 into ! society to *eck ! d[nw>d drift4 ,a bad temp] is a neurotic ta9t1 & x commonly is a fir/ /ep t[>d alcoholism4 ,d n =get to w>n ! p aga9/ pat5t m$ic9es t conta9 alcohol4 ,if y g ov] ! li/ ( ! families 9 a p>i%1 x is />tl+ to f9d h[ few !re are )\t "o or m black %eep4 ,! human black %eep1 9 a good environm5t1 is always physically imp]fect1 & nev] s black z ! gossips pa9t him4 ,he may be a p[]ful football play]1 b !re is some?+ wrong ) 8 gray matt]4 ,he is morally deaf1 he 0 born s1 & he is to be excus$ if he c n always he> ! /ill1 small voice4 ,?is may s\nd l lax doctr9e1 b x is true1 nev]!less4 ,we mu/ recognise t moral weakness is v (t51 #aac p>tly at lea/1 a physical defect1 & !re is no su* /ate z moral insanity :]e ! intellect is normal4 ,n[1 ,i d n wi% to be quot$ z hold+ t all moral depravity has a physical basis2 mo/ ( x is ! unalloy$ /uff2 ! ,lombroso crim9al is n a sci5tific fact2 b !re is a moral condition v frequ5tly met ) :i* is l>gely physical 9 orig94 ,giv5 s _m gra9s ( coca9e or morph9e or s _m ounces ( alcohol1 & y c make a li> ( a man once on ! way t[>d sanctity4 ,giv5 an attack ( hy/]ia 9 a holy nun1 & %e at once becomes a li>1 an altoge!r blameless li>1 b no influ5ce t does n remove ! physical cause w cure ! ly+4 ,! morally weak d n at pres5t obta9 en\gh religi\s in/ruction4 ,_! religion is m a matt] ( inh]itance & habit ?an ( positive en]gy4 ,x is 9 ! bones1 sometimes 9 ! fi/s1 r ?an 9 ! s\l4 ,!y pref] ! ,sunday newspap] to ! ,sunday s]mon4 ,! rem$y "h seems to be 9 mak+ ! ,sunday s*ool solidly int]e/+ & its tea*+ impressive4 ,alcoholism 9 ! p>5ts1 especially drunk5ness at ! mom5t ( conception1 is "o ( ! *ief causes ( idiocy 9 *ildr54 ,f]e1 z 0 said be=e1 by inject+ a few drops ( alcohol b5ea? ! %ell ( h5s' eggs1 or by expos+ ! eggs to ! vap\r ( alcohol1 c\ld produce mon/]s almo/ inv>iably4 ,9 #ajjj cases ( idiocy at ! ,bicetre1 ,b\rneville f\nd a hi/ory ( alcoholism 9 #fbj1 or #fb p] c5tum3 9 ! fa!rs ( #dga1 9 ! mo!rs ( #hd1 9 bo? p>5ts ( #fe2 & 9 "o-half ( ! rema9+ #ch p] c5tum no hi/ory 0 obta9able--probably mo/ ( ^! also _h ! alcoholic ta9t4 ,! adm9i/ration ( alcohol to infants1 ( g9 & :iskey1 ( ess5ces ( pepp]m9t & anise1 to relieve colic or induce sleep1 & ! dos+ ) opiates l p>egoric1 are also well-e/abli%$ causes ( idiocy4 ,! idiot is practically dead1 except = ! tr\ble he gives 9 c>+ = him2 b ano!r un=tunate1 ! imbecile1 mo/ commonly ! (fspr+ ( alcoholics1 is (t5 capable ( great mis*ief4 ,! high] grades ( imbeciles1 ^? ne>e/ ! normal1 are almo/ inv>iably crim9als4 ,n all crim9als1 ( c\rse1 are imbeciles1 b a va/ numb] ( petty & brutal #aad crim9als are imbeciles4 ,we keep ^! un=tunates mo/ ( _! lives 9 jail1 :ile we f9e _! drunk5 fa!rs1 ! cause ( ! imbecility1 five doll>s & co/s4 ,imbecility has grades1--f m>k$ lack ( intellectual p[]1 a /age little beyond idiocy1 up to ! pres5ce ( a m9d capable ( fair education1--b 9 all cases !re is real defect1 ei!r ( intellect or ( w4 ,sometimes1 :]e ! w is s weak t ! pati5t becomes a crim9al 9 spite ( all tra9+1 ! intellect is practically normal to ! sup]ficial obs]v]4 ,! grades ( imbecility c n be cle>ly m>k$ (f f "o ano!r1 b1 r\ghly speak+1 !re are ?ree4 ,! l[e/ grade ( imbeciles und]/&s simple comm&s1 & has a slight manual dext]ity4 ,!y express !mselves by signs & 9 monosyllables4 ,!y c n conc5trate att5tion ^u any?+1 nor c !y be taught to read or write4 ,c>eful tra9+ c advance !m s f> t !y may d r\gh1 m5ial "w1 & !y are indu/ri\s :5 direct$ by a pres5t sup]ior4 ,!y are incl9$ to ma/urbation4 ,if !y are n teas$1 !y are quiet2 if annoy$1 !y may become dang]\s4 ,imbeciles ( ! middle grade c conv]se 9 a n>r[ vocabul>y1 & !y commonly /amm]4 ,!y may be taught to read monosyllables2 !y c n d ev5 ! simple/ sum 9 addition1 yet !y %[ a c]ta9 %rewdness4 ,!y are irritable & qu>relsome1 incl9$ to ly+ & /eal+1 & !y h no s5se ( %ame4 ,!y w n d any regul> "w1 b *ange f "o occupation to ano!r4 ,!y may h sexual in/9cts & cause tr\ble on t acc\nt4 ,!y are sl[ to und]/&1 _! memories are defective1 & !y are always v va94 ,_! belly & :at !y %all we> are ! *ief ?+s 9 _! lives4 ,!y are less crim9al ?an ! highe/ grade ( imbeciles4 ,! ?ird class1 ! high-grade imbecile1 is ! mo/ important1 because he is commonly a crim9al4 ,8 intellect is bel[ ! av]age1 & 8 w is v flabby4 ,he le>ns little at s*ool1 & :at he does le>n is acquir$ sl[ly4 ,he reads & writes badly & he may be able to add simple #aae columns ( numb]s1 b he c n multiply or divide4 ,sometimes su* an imbecile has a rem>kable facility 9 gett+ a speak+ k ( two or ?ree languages1 & he may le>n a trade4 ,!re is a high-grade imbecile t is cunn+ & %rewd1 b he has no w1 & he is a crim9al4 ,z imbeciles approa* ! normal 9 intellect !y rec$e f x 9 abnormality ( w4 ,autopsies on imbeciles %[ an infantile developm5t ( ! =ebra94 ,imprisonm5t does no good 9 ^! cases4 ,!y are n taught any?+ 9 prison1 n ev5 a trade1 because ! lab\r organisations & ! protect$ indu/ries w n p]mit prison lab\r4 ,!y %\ld be conf9$ s t !y w n p]v]t y\? & propagate _! k9d4 ,x is impossible to say h[ f> a giv5 imbecile is morally acc\ntable = :at he does1 b ! acc\ntability is n full 9 ! be/ cases4 ,a neura/h5ic1 h[ev]1 is n to be mi/ak5 = an imbecile4 ,a neura/h5ic p]son may h a t5d] consci5ce1 an imbecile has no consci5ce4 ,9 imbecility ! fault is 9 ! w1 r ?an 9 ! intellect1 9 ! middle & highe/ grades4 ,_m wom51 especially1 t are hopeless fools intellectually h /rong wills1 b an imbecile nev] has a /rong w except 9 ! s5se t /ubbornness is /r5g?4 ,/ubbornness is p]v]t$ /r5g?4 ,morph9e & ,coca9e ,intoxication1--,morph9e1 an alkaloid ( opium1 is us$ v ext5sively z an intoxicant4 ,s9ce #ahij ! importation ( opium into ! ,unit$ ,/ates has increas$ f\rfold1 al?\gh physicians are n[ us+ less opium ?an !y =m]ly did4 ,! insomnia1 worry1 moral di/ress1 :i* br+ on ! alcoholic habit 9 "s p]sons1 lead to morph9ism 9 o!rs4 ,"s physicians1 by c>elessly prescrib+ morph9e = neuralgia1 migra9e1 dysm5orrhoea1 or any pa91 make _! pati5ts slaves ( ?is drug4 ,! deg5]ative effects ( morph9e are n s great nor s rapid z ^? ( alcohol4 ,x does n %ort5 life s mu* z alcohol does1 nor are ! *ildr5 ( a p]son addict$ to ! use ( ! drug s liable to idiocy & imbecility4 ,! m9d is enfeebl$--sl[ly 9 "s cases1 rapidly 9 o!rs4 ,! pati5t w resort to almo/ any means to obta9 ! #aaf drug1 if he is depriv$ ( x4 ,au?orities hold t he w lie )\t reason1 m]ely = ! p]v]se pleasure 9 deceiv+1 t he is unc]ta9 & trea*]\s1 ) a dull consci5ce & morbid impulses4 ,!re are exceptions to ?is 9 cases :]e ! drug is easily obta9$ by ! pati5ts4 ,opium & morph9e dim9i% ! sexual appetite 9 males1 ev5 to impot5ce4 ,! bodily *anges are sl[ b pr(\nd4 ,:5 a us] ( morph9e has be5 depriv$ ( ! drug = f t5 to fifte5 h\rs1 he becomes s weak he c n /&2 he gets di>rhoea ) cramps2 he sweats1 trembles1 & collapses4 ,lat]1 m5tal di/urbance comes on4 ,he gr[s deliri\s1 sees insects & small animals1 z ! delirium trem5s pati5t does1 & 8 suff]+ is v great4 ,x is extremely difficult1 & commonly impossible1 to cure ! morph9e disease aft] x has be5 firmly e/abli%$1 & a delib]ate acceptance ( ! habit is evid5tly a grave vice4 ,:]e a pati5t has become addict$ to ! use ( ! drug1 ?r\gh ! fault ( a physician1 or ?r\gh ignorance1 ! treatm5t f ! social po9t ( view ( su* a pati5t is commonly cruel4 ,coca9e intoxication is mu* worse ?an morph9ism4 ,x is a new excess1 :i* 0 unkn[n be=e #ahhf4 ,_m us]s ( morph9e c c>ry on bus9ess1 b ! coca9e habitue c n d s4 ,he is always extremely busy do+ no?+4 ,he writes long lett]s :i* are nev] f9i%$4 ,he *anges f "w to "w1 & ev5 8 conv]sation w&]s4 ,8 bodily weight decreases rapidly1 ev5 "o-?ird ( 8 :ole weight may be lo/ )9 a few weeks4 ,! sk9 hangs 9 folds & is ( a dirty yell[ col\r1 ! facial appe>ance is t ( extreme di/ress1 & ! muscles are feeble4 ,fa9t+1 irregul> c>diac action1 sweat+1 & insomnia are o!r symptoms4 ,insanity is an occasional sequ5ce1 ) halluc9ations1 especially ( he>+4 ,su* a pati5t he>s ro>+ noises & voices2 8 secret ?\ghts are %\t$ out1 he ?9ks1 to cr[ds2 l\d screams1 %rieks ( murd]1 & simil> noises appall him4 ,aga91 he sees sw>ms ( flies1 ants1 roa*es1 :i* cov] him & crawl into 8 m\?1 no/rils1 #aag & e>s4 ,he feels bugs crawl+ "u 8 sk91 & he has a multitude ( simil> int]e/+ exp]i5ces4 ,su* pati5ts gr[ homicidal4 ,l alcoholics1 !y are jeal\s & suspici\s ( _! wives1 b1 unlike ! alcoholic1 ! coca9e us] is commonly retic5t2 he is n will+ to talk ( 8 tr\bles4 ,! prognosis is always bad1 ev5 9 ! be/ cases4 ,?is drug c be )drawn f a pati5t m rapidly ?an is possible 9 *ronic poison+ f morph9e1 b a relapse is to be expect$4 ,9 dipsomania1 morph9omania1 & o!r drug habits1 & 9 ! cases ( vici\s & deg5]ate *ildr51 _m enc\rag+ly good results h be5 report$ f ! use ( hypnotism4 ,=el1 ,vois91 ,ladame1 ,tatzel1 ,hirt1 ,nielson1 de ,jong1 ,liebeault1 ,b]nheim1 van ,e$51 van ,r5t]ghem1 ,hamilton ,osgood1 ,wett]/r&1 ,s*r5ck-,notz+1 ,kraft-,ebb+1 ,francis ,cruise1 ,lloyd ,tuckey1 ,k+sbury1 ,woods1 & o!rs h und\bt$ly cur$ dipsomania by hypnosis4 ,wett]/r& alone cur$ #cg ( #ea cases ( morph9ism by hypnosis4 ,"o ( ^! pati5ts _h be5 us+ morph9e = f\rte5 ye>s & morph9e ) coca9e = an additional f\r ye>s4 ,all 8 cases except "o 7 treat$ at home--!y 7 n oblig$ to g to a hospital or sanit>ium4 ,z to vici\s *ildr53 ,liebeault 9 #ahhg record$ #gg cases1 #de ( :om 7 boys & #cb girls4 ,by hypnosis #ef ( ^! 7 cur$1 #i improv$1 #ab 7 n affect$4 ,z to ! s-call$ dang]s ( hypnotism 9 ! h&s ( skill$ physicians1 !re are none4 ,=el said3 ,liebeault1 ,b]nheim1 ,wett]/r&1 van ,e$51 de ,jong1 ,i myself1 & ! o!r foll[]s ( ! ,nancy s*ool1 decl>e absolutely t1 al?\gh we h se5 _m ?\s&s ( hypnotis$ p]sons1 we h nev] obs]v$ a s+le case ( m5tal or physical h>m caus$ by hypnosis4 ,travell+ m\ntebanks t hypnotise 9 public c d h>m1 & !y %\ld be prev5t$ f s do+4 ,on ! cont95t ( ,europe only physicians are p]mitt$ to use hypnosis4 ,= a bibliography ( hypnosis z a curative ag5t1 see ,allbutt's ,sy/em ( ,m$ic9e1 vol4 viii4 p4 #dbh 7,! ,macmillan ,co474 #aah ,9 ,g5icot's ,!ologiae ,moralis ,in/itutiones1 vol4 i4 p4 #afb 7,l\va91 #aijb71 is ! foll[+ passage3 ,videtur licitum ebrietatem induc]e ad morbum depell5dum1 si qu&o practicum e/1 ex gr4 ad typhum depell5dum1 vel ad co]c5dam vim v55i quod e s]p5tis morsu hau/um sit 7,sabetti4 ,n4 #adi74 ,similit]1 p] se licebit s5sus sopire ope ebrietatis ad magnos dolores lev&os3 nullum enim discrim5 morale videtur int] hoc m$ium et alia1 ex gr4 *lor(ormium1 quae adhib]i sol5t4 ,t is1 ,fa!r ,g5icot p]mitt$ alcoholic intoxication to cure typhus or typhoid 7typhoid is call$ typhus abdom9alis 9 ,europe7 & snake bite1 or to quiet great pa91 z *lor(orm is us$1 9 8 op9ion4 ,?is doctr9e w\ld be correct morally if f a m$ical po9t ( view alcoholic intoxication cur$ typhus1 typhoid1 or snake bite1 b x does n4 ,alcoholic liquors are necess>y 9 "s /ages or =ms ( typhus & typhoid1 & !y mu/ be adm9i/]$ skilfully2 b to induce alcoholic intoxication 9 any pa?ological condition is always to add a grave poison to ! disease already at "w4 ,! v "n ( ! condition is intoxication1 poison+4 ,y c end a too?a*e by remov+ a man's jaw1 b ! practice is n to be enc\rag$4 ,9 ,am]ica1 :5 a p]son is bitt5 by a rattlesnake or copp]head1 ! fir/ aid to ! injur$ is commonly a p9t ( :iskey4 ,y might bett] rub milk on ! pati5t's boo!els1 because ! milk is h>mless1 b ! p9t ( :iskey is any?+ b h>mless2 & "o is z good z ! o!r z f> z cur+ ! snake bite is conc]n$4 ,:iskey is popul>ly suppos$ to be a good m$ic9e 9 all ! ills ( humanity4 ,x is a good m$ic9e 9 c]ta9 cases & a v bad m$ic9e 9 o!rs4 ,a snake bite is a />tl+ evil1 & :ile f> f a physician ! e>ly settl]s gave ! pati5t ! only m$ic9e !y _h1 :iskey1 & if a little is good a great deal is bett]4 ,z ! bite ( ! ,nor? ,am]ican snakes is frequ5tly n fatal1 "s e>ly victims grew well 9 spite ( ! snake v5om & ! add$ :iskey poison+2 !re=e a p9t ( :iskey cur$ !m1 po/ hoc ergo propt] hoc4 ,?us ! cure became fix$ 9 ! popul> ignorance1 & "s moral !ologians1 )\t inve/igat+ ! #aai matt]1 fix$ x deep]4 ,! v5om ( ! ,ea/ ,indian cobra & ( o!r tropical & subtropical snakes w\ld n be affect$ 9 ! slighte/ degree by all ! :iskey 9 ,k5tucky4 ,! only hope 9 su* cases1 is 9 ,calmette's antitox91 adm9i/]$ )9 an h\r or two aft] ! poison+4 ,snake v5om p>alyses ! muscles ( respiration1 & ! pati5t ceases to brea!4 ,a little :iskey may d good--:iskey pu%$ to intoxication is v injuri\s4 ,artificial respiration1 if ne$$1 z 9 a case ( attempt$ resuscitation aft] p>tial dr[n+1 ) skilful /imulation by a physician1 & ! use ( an antitox91 are ! ma9 p>ts ( ! treatm5t 9 snake poison+2 b to p\r a p9t ( :iskey into ! victim is cruel ignorance4 ,pati5ts (t5 come into disp5s>ies %[+ bitt5 w\nds :i* are /uff$ ) hair f ! dog t did ! bit+2 :iskey causes a man to see snakes1 !re=e use hair f ! dog t bit y4 ,?is may be good homoeopa?y1 b x is n m$ic9e4 ,! mak+ a man drunk ) alcohol to remove great pa9 is a treatm5t n us$ by reputable physicians3 !re are _m correct m$ical me?ods ( remov+ pa91 b a big draught ( :iskey is n "o ( !m4 ,ev5 9 a case :]e a physician c n be f\nd1 x is usually que/ionable :e!r ! effect ( alcoholic intoxication w\ld n be worse ?an ! irritation ( ! pa92 & if x 7 n1 :]e is ! l9e to be drawn8 ,"s male & female old ladies c "w up great pa9 f a colic4 ,! bigg] & /rong] a man is1 especially if he has nev] be5 ill be=e1 ! great] 8 agony :5 he is hav+ a too? fill$4 ,,au/9 ,,omalley4 #abj ,,ix ,,h]$ity1 ,,physical ,,disease1 ,,& ,,moral ,,weakness ,h]$ity is a v vex$ "q1 ) reg>d to :i* mo/ v>i$ op9ions are held ev5 by ^? app>5tly ju/ifi$ 9 hav+ op9ions1 s t x is evid5t we are z yet only cross+ ! ?re%old ( def9ite k & are n ne> any?+ l ! cle> view t _m p h imag9$4 ,! mo/ /rik+ pro( ( ?is in*oat5ess ( sci5tific k ( h]$ity is ! fact t )9 five ye>s ! "w ( a monk 9 ,au/ria1 done ab\t =ty ye>s ago1 :i* has la9 utt]ly unrecognis$ ev] s9ce1 has come to be accept$ z ! mo/ /rik+ bit ( progress made--almo/ ! only real sci5tific k ) reg>d to h]$ity t 0 acquir$ dur+ ! :ole n9ete5? c5tury4 ,fa!r ,gregor ,m5del's "w ,footnote #b 0 done ) reg>d to ! pea plants 9 8 mona/]y g>d51 & x revolutionis$ all ! suppos$ly sci5tific ?9k+ ) reg>d to h]$ity t has be5 curr5t 9 biology = half a c5tury4 ,footnote #b3 ,see ,am]ican ,ecclesia/ical ,review1 ,jan4 #aijd2 ,wal%1 ,a ,new ,outlook 9 ,h]$ity4 ,?is s]ves v well to %[ h[ f> 9 advance ( obs]v$ facts !ories ( h]$ity h gone4 ,!re is und\bt$ly a v significant influ5ce ex]t$ ov] life & its functions by ! special p[]s t are transmitt$ by h]$ity4 ,h[ f> ?is influ5ce ext5ds1 h[ev]1 & h[ mu* x may be said to rule details ( exi/5ce1 ( action & 9 human be+s1 t complex ( elem5ts we call "*1 is entirely a matt] ( conjecture1 & ! #aba belief 9 its ext5t1 or limitation1 dep5ds absolutely on ! t5d5cy ( ! individual m9d to accept or discr$it c]ta9 !ories 9 h]$ity :i* h _h great vogue4 ,until )9 a v few ye>s x 0 consid]$ a matt] ( common exp]i5ce & obs]vation t "u "s circum/ances1 at lea/1 acquir$ *>act]i/ics 7 transmitt$ by h]$ity4 ,t is to say1 x has be5 def9itely ass]t$ z probable1 & by _m ev5 intellig5t p consid]$ absolutely c]ta91 t modifications ( a liv+ be+ und]gone dur+ ! c\rse ( its exi/5ce might influ5ce ! prog5y ( t be+ 9 v>i\s b v def9ite ways4 ,x 0 n1 ( c\rse1 ?\ght t if a man lo/ an arm & subsequ5tly begot a *ild1 ! *ild w\ld be born )\t an arm1 b slight] modifications ( ! organism 7 someh[ suppos$ to be transmissible2 &1 on ! o!r h&1 modifications :i* affect important organic /ructures ( ! body 7 someh[ ?\ght to h a def9ite effect1 by transmission1 ^u correspond+ portions ( ! prog5y4 ,:5 ?is !ory is /at$ ?us baldly1 v few p confess _! belief 9 x1 yet h[ _m !re are :o f9d ample ju/ification = su* expressions z1 ,8 fa!r suff]$ f rheumatism & x is n surpris+ !n t he %\ld h x2 ,h] "m _h he>t tr\ble & we've always be5 afraid %e w\ld suff] 9 ! same way4 ,we are only j beg9n+ to get beyond ! p]iod 9 :i* consumption 0 ?\ght to be directly & almo/ inevitably inh]it$4 ,) reg>d to m5tal ailm5ts ?is 0 frankly conc$$ by ne>ly e "o4 ,if ! direct ance/ry suff]$ f m5tal disease ( "s k9d1 !n x is n consid]$ surpris+ t ! imm$iate desc5dants %\ld be m5tally affect$ 9 "s way4 ,physicians are q z prone z ^? )\t m$ical tra9+ to make loose /atem5ts ( ?is k9d4 ,( c\rse !re is a reason = ! confusion t exi/s 9 ?is matt]4 ,oliv] ,w5dell ,holmes once said t he c\ld cure any pati5t t came to him = treatm5t1 if he b appli$ to him 9 "t4 ,= prop] success1 h[ev]1 he consid]$ t _m ( 8 pati5ts w\ld h _h to come to him 9 ! p]sons ( _! great gr&fa!rs4 ,z #abb a matt] ( fact1 _m ( ! suppos$ h]$it>y influ5ces t are trac$ only to a fa!r or a "m are family conditions t h exi/$ _m g5]ations1 & t 7 probably orig9ally acquir$1 b ! mom5t ( ^: acquisition _c be def9itely det]m9$4 ,we "k t ! ,hapsburg lip has be5 a di/+ui%+ feature1 a p]si/5tly recurr+ peculi>ity1 9 "s ( ! memb]s ( ! ,au/rian rul+ family 9 ne>ly e g5]ation = sev5 c5turies4 ,h[ mu* f>!r back ?an t x goes we h no way ( det]m9+4 ,x is a family affair1 a *>act]i/ic :i* became a matt] ( h]$ity p]haps t5 c5turies ago1 b ! mode ( its orig9al acquisition is a my/]y4 ,!re is no really great sci5ti/ 9 biology at ! pres5t mom5t :o tea*es ! h]$it>y transmission ( acquir$ *>act]i/ics4 ,modifications ( ! organism t become matt] = h]$ity h exi/$ = _m g5]ations & we _c tell j h[ !y began4 ,!re is no d\bt t !re is "s h]$it>y influ5ce1 = insanity 9 ! same family is likely to keep recurr+ 9 successive g5]ations4 ,m ?an ?is1 affections ( c]ta9 less important organs are evid5tly a common trait 9 c]ta9 family /ra9s4 ,!re is no d\bt t 9 "s families /oma* affections are ! rule 9 successive g5]ations4 ,x is v h>d to say1 h[ev]1 j :5 su* defective organisation became a family trait4 ,! t5d5cy to n]v\s affections is und\bt$ly a simil> family affair4 ,c]ta9 affections h be5 h]$it>y traits = _m g5]ations4 ,an excell5t example ( ?is is ! s-call$ ,hunt+don's *orea1 :i* sev]al g5]ations ( ,am]ican doctors1 ( ! "n ( ,hunt+don1 by foll[+ c>efully ! hi/ory ( c]ta9 families on ,long ,isl&1 succe$$ 9 trac+ ?r\gh f\r g5]ations4 ,! habits ( life ( a fa!r or a gr&fa!r may s weak5 ! physical con/itution ( 8 desc5dants z to make !m less capable ( resi/+ infections 9 ! physical ord]1 or 9 ! moral ord] ( )/&+ trials & temptations1 & ! allurem5t to abuse ( n]v\s excitem5t to :i* !y may be subject$4 ,t "s acquir$ pa?ological condition1 h[ev]1 z /oma* tr\ble1 or he>t #abc tr\ble1 or affection ( ! liv] or ( ! bra91 %\ld be directly transmitt$1 is q z nons5sical z t ! loss ( an arm %\ld be a subject = h]$it>y transmission4 ,on inve/igation x w be f\nd t ! pa?ological conditions ( imm$iate ance/ors are !mselves only a manife/ation ( family traits t h exi/$ = _m g5]ations4 ,! possibility ( inh]itance mu/ !re=e always be borne 9 m9d4 ,we are utt]ly unable z yet to und]/& h[ su* family traits are orig9ally develop$1 s9ce1 9 ord9>y exp]i5ce1 at lea/1 acquir$ *>act]i/ics are n ! subject ( inh]itance or transmission1 & consequ5tly x becomes difficult to und]/& h[ !y ev] became impress$ ^u ! family con/itution4 ,not)/&+ ?is g5]al pr9ciple ) reg>d to h]$ity1 !re are a numb] ( /rik+ obs]vations :i* %[ t ev5 unimportant peculi>ities may occur f g5]ation to g5]ation1 ?\gh x is n always easy to decide :]e ! peculi>ity orig9at$4 ,! well-kn[n example ( ! occurr5ce ( six toes has already be5 m5tion$1 & is an (t-quot$ bit ( evid5ce z reg>ds h]$it>y transmission4 ,an extra f+] on ! h&1 or "s portion ( an extra f+]1 at lea/1 comes 9 ! same category4 ,n long s9ce x 0 po9t$ out t h>elip is ano!r ( ^! peculi>ities t readily l5ds itself to h]$it>y transmission4 ,rec5tly !re 0 ! report ( a family into :i* !re 7 born f\r girls ) h>elip & cleft palate1 & ?ree boys n %[+ any trace ( ^! de=mities4 ,(t5 :5 9 su* cases !re is no def9ite hi/ory ( h>elip1 x is f\nd t 9 ei!r "o ( ! p>5ts !re is a v high ar*$ palate & a ?9 upp] lip1 %[+ t ! normal occlusion ( ! cleft :i* exi/s "h dur+ foetal developm5t is n q p]fect1 & ?is peculi>ity may be trac$ = sev]al g5]ations back1 ) an occasional occurr5ce ( h>elip z an exagg]at$ example ( ! faulty t5d5cy n to produce suffici5t tissue 9 ?is neighb\rhood = ! prop] closure ( ! embryonic cleft4 ,an ev5 m /rik+ manife/ation ( a physical anomaly1 z a family trait1 is ! condition kn[n z hemophilia4 ,?is #abd t5d5cy to ble$ easily1 s t a slight scrat*1 or ! pull+ ( a too?1 may give rise to fatal hemorrhage1 occurs1 z a rule1 only 9 males1 b is transmitt$ ?r\gh ! female l9e4 ,x is 9 ! "m's male relatives t ! hi/ory ( its previ\s occurr5ce is f\nd1 & ! t5d5cy usually c be trac$ ?r\gh sev]al g5]ations1 until x is lo/ 9 vague tradition4 ,x is no wond]1 ) su* examples be=e !m z six-to$ness1 h>elip1 & hemophilia1 t physicians h be5 ready to accept h]$ity ( qualities 9 ! moral ord]1 traits ( "* & disposition1 & pa?ological t5d5cies to crime or passion or indulg5ce4 ,"o ( ! mo/ frequ5tly discuss$ conditions ( suppos$ pa?ological inh]itance ( ?is ord] is dipsomania4 ,ev]yone has he>d x said1 ,poor fell[1 h[ c he help x2 8 fa!r 0 a drunk>d be=e him4 ,z we h already said1 9 su* direct cases inh]itance is absolutely unprov54 ,an alcoholic fa!r may transmit a v weak physical con/itution to 8 *ildr51 & ?is may prove inadequate to enable !m to )/& ! emotional /ra9 & worry ( mod]n great city life1 &1 z a consequ5ce1 !y may take to alcohol = consolation until ! habit is =m$1 & !n ! crav+ = /imulants supplies ! place ( any h]$it>y influ5ce t may be suppos$ to be ne$$4 ,( c\rse !re are cases ( ! dr9k habit 9 :i*1 aft] a numb] ( g5]ations ( family hi/ory ( alcoholism1 an individual seems to h ! crav+ = /imulants born 9 him4 ,9 su* cases x is n unusual to f9d t ! pati5t1 = su* he mu/ be consid]$1 is able to avoid indulg5ce 9 liquor entirely1 except at c]ta9 times4 ,e physician ( any l>ge exp]i5ce has _h "u 8 c>e dipsomaniacs :o _h no difficulty 9 keep+ away f liquor = weeks1 or ev5 mon?s1 b :o _h regul>ly recurr+ p]iods1 sometimes z f> ap>t z e ?ree mon?s1 :5 !y _h an irresi/ible crav+ = /imulants come ov] !m4 ,! regul>ity ( ! int]val 9 ^! cases is (t5 v rem>kable4 ,"h1 ( c\rse1 we may be 9 ! pres5ce ( "s z yet n well-und]/ood p]iodical law ( cell life1 ) consequ5t depression1 & !n ! irresi/ible crav+ = /imulation4 #abe ,z a rule1 h[ev]1 x w\ld seem t 9 mo/ ( ^! cases sugge/ion has great influ5ce4 ,z we h said else:]e1 ) reg>d to suicide1 :5 a man has con/antly be=e 8 m9d's eye ! fact t a fa!r1 p]haps a gr&fa!r1 or o!r memb]s ( ! family1 h committ$ suicide1 he is likely to be mu* m easily l$ to ! ?\ght ( ?is way ( escap+ h>d conditions 9 life ?an are o!r individuals4 ,! man :o kn[s t ! fact t 8 fa!r indulg$ too freely 9 /imulants w be look$ ^u by _m z an excuse = 8 deviations 9 ?is matt] is likely to be m easily l$ to take an occasional dr9k at mom5ts ( depression1 or = fri5d%ip's sake1 ?\gh he realises t x s weak5s 8 w p[] ov] himself t he is likely to take too mu* be=e he /ops4 ,! passage 9 ,julius ,caes> 7,act4 ,i4 sc4 #b7 9 :i* ,cassius says3 ,! fault1 de> ,brutus1 is n 9 our />s1 b 9 ourselves1 illu/rates "o phase ( ! subject4 ,!re are1 ( c\rse1 _m o!r ?+s besides ! dr9k habit1 ) reg>d to :i* m5 are prone to f9d excuses 9 h]$ity1 & to consid] t someh[ _! ance/ral t5d5cies make !m n q responsible = actions commonly consid]$ ! result ( malice or passion1 r ?an h]$it>y influ5ce1 & our great ,engli% poet1 kn[+ m5 s well1 has /at$ ! tru? =cibly4 ,9 ,k+ ,le> !re is an (t5 quot$ passage :i* prop]ly /igmatises ! op9ion 9 ?is matt] held by ^? :o w\ld f9d excuses = wrong-do+ 9 h]$it>y qualities3 ,?is is ! excell5t fopp]y ( ! _w1 t1 :5 we are sick 9 =tune1--(t5 ! surfeit ( our own behavi\r1--we make guilty ( our disa/]s ! sun1 ! moon1 & ! />s2 z if we 7 villa9s by necessity2 fools by heav5ly compulsion2 knaves1 ?ieves1 & trea*]s by sph]ical pr$om9ance2 drunk>ds1 li>s1 & adult]]s by an en=c$ ob$i5ce ( planet>y influ5ce2 & all t we are evil 91 by a div9e ?ru/+ on2 an admirable evasion ( :ore-ma/] man1 to lay 8 goati% disposition to ! *>ge ( a />6 #abf ,"o phase ( ! "q ( h]$it>y t5d5cies to inebriety is extremely int]e/+ f a physiological & sociological po9t ( view4 ,z ! result ( c>efully ga!r$ /ati/ics1 !re seems to be no d\bt n[ t :5 *ildr5 are conceiv$ :ile ! p>5ts1 or ei!r ( !m1 is 9 a /ate ( drunk5ness1 ! (fspr+ is v likely to be ( l[-grade physical con/itution & (t5 ( v neurotic t5d5cies4 ,9 ,france1 p>ticul>ly 9 ! case ( a numb] ( insane *ildr5 & idiots1 hi/ories ( ?is nature h be5 obta9$ 9 confirmation ( ?is un=tunate factor z an elem5t 9 deg5]acy4 ,9 g5]al x may be said t ab\t "o-?ird ( ! admissions to homes = *ildr5 ( l[ intellig5ce1 z well z to insane asylums1 are due to ?is cause4 ,!re is 9 ?is1 ( c\rse1 an add$ motive = temp]ance1 & x w\ld seem t p>5ts %\ld be w>n$ ( ! dang] to :i* !y are subject+ _! (fspr+ by excessive indulg5ce 9 alcohol1 :5 x may be foll[$ by su* s]i\s & la/+ results to ! be+s on :om _! love & affection w be exp5d$ 9 ! future4 ,?is phase ( alcoholic excess has nev] be5 taught z insi/5tly z its importance w\ld dem&1 p]haps because ( ! delicacy ( ! subjects :i* x involves2 b x is too significant a factor 9 mak+ or m>r+ progress 9 ! developm5t ( ! race to all[ any pusillanim\s motives to prev5t ! spread ( preci\s k4 ,footnote #c ,footnote #c3 ,! pres5t conditions t obta9 ) reg>d to ! celebration ( m>riages are v prone to h a c]ta9 am\nt ( intoxication z _! result4 ,p]haps1 !n1 x is a =tunate ?+1 z has (t5 be5 said1 t ! fir/ *ild is n born until "s consid]able "t aft] x might normally be expect$4 ,x has be5 said m ?an once1 h[ev]1 t fir/ *ildr5 are a little m likely to h c]ta9 deg5]ative defects ?an are o!rs1 & a connection has be5 f\nd betwe5 c]ta9 abuses ( /imulants & incid5tal exhau/ion to acc\nt = ?is4 ,"o ( ! mo/ amus+ ?+s to ,li ,hung ,*ang1 on 8 travels ?r\gh our c\ntry1 0 ! curi\s publicity we give to ev]y?+ connect$ ) m>riage1 :ile presumably our ,*ri/ian ideas %\ld r c\nsel a veil+ ( ! my/]ies1 religi\s & physical1 connect$ ) x4 ,c]ta9 x is t ! pres5t t5d5cy t[>ds f>ewell d9n]s at clubs1 & o!r fe/ivities ( v>i\s k9ds1 are n at all likely to result 9 b5efit to ! presumably hop$-= (fspr+4 ,! only real light t has be5 ?r[n on ! puzzl+ details ( h]$ity has come f "w 9 ! same field 9 :i* ,m5del made 8 gr\nd-break+ obs]vations4 #abg ,de ,vries1 ! pr(essor ( botany at ! ,univ]sity ( ,am/]dam1 has succe$$ 9 %[+ t new species ( plants may be made to arise by c>eful att5tion to c]ta9 anomal\s plants :i* occur f g5]ation to g5]ation4 ,^! plants bre$ true1 t is1 ma9ta9 _! own peculi>ities4 ,to beg9 )1 !y are q diff]5t f ! p>5t plants1 & ! diff]5ce is p]petuat$ by inbre$+4 ,s f> ! problem ( ! orig9 ( species has be5 suppos$ to dep5d ^u ! normal v>iation t is notic$ 9 plants & animals4 ,all liv+ ?+s diff] f "o ano!r1 ev5 ?\gh !y may belong to ! same species1 & diff] sometimes 9 rem>kable degrees4 ,?is cont9u\s v>iation 0 suppos$ to acc\nt = ! orig9 ( new species :5 x became excessive4 ,x has become well recognis$ n[1 h[ev]1 t su* diff]5ces gradually disappe> 9 ! c\rse ( ! normal multiplication ( plants & animals4 ,! t5d5cy is mu* m t[>ds ! disappe>ance ?an ! ma9t5ance ( peculi>ities4 ,!re are c]ta9 discont9u\s v>iations1 h[ev]--sports1 z !y are call$--9 plants :i* diff] v m>k$ly 9 "s quality f o!rs1 & ^! h ! t5d5cy to p]petuate !mselves4 ,j :y ^! sports occur is n kn[n1 nor h[4 ,!y occur 9 a c]ta9 small p]c5tage ( all normal plants1 b may die out1 ?\gh x takes b little enc\ragem5t to succe$ 9 help+ !m to ma9ta9 !mselves4 ,x is ?is t ,de ,vries has done1 & ?us has succe$$ 9 rais+ :at w\ld be call$ new species ( plants4 ,?is same ?+ w\ld seem to occur 9 human be+s4 ,"s def9ite v>iation occurs z a consequ5ce ( a peculi> embryologic process4 ,?is becomes /amp$ ^u ! g5ital mat]ial & appe>s 9 ! subsequ5t g5]ations4 ,x does n occur z a consequ5ce ( pa?ological *anges nor ( m]e embryonic faults2 x is almo/ z if x 7 some?+ introduc$ f )\t4 ,once hav+ f\nd an entrance1 h[ev]1 x affects ! g]m9al mat]ial & ?us p]petuates itself4 ,) reg>d to plants1 x has be5 sugge/$ t ! only explanation available = ! occurr5ce ( sports is t !re is a purposeful introduction ( !m z ! result ( ! laws ( nature1 & t x is ?us t evolution is int5tionally #abh br\ght ab\t4 ,?is is1 ( c\rse1 a sci5tific rev]sion to teleology once m1 b ! "q ( teleological influ5ces has be5 discuss$ m s]i\sly 9 ! la/ few ye>s 9 biological circles ?an ev] be=e4 ,un=tunately = ! co9cid5t evolution argum5t involv$ 9 human be+s1 ! peculi>ities introduc$1 :i* become ! subject ( inh]itance1 d n make = ! developm5t1 b r = ! deg5]acy1 ( ! race4 ,ev5 su* peculi>ities z six toes c sc>cely be said to add any special feature ( advantage to man 9 8 /ruggle aga9/ 8 environm5t4 ,x is agre$ by _m ( our be/ au?orities 9 biology1 zoology1 & botany1 by su* m5 z ,pr(essor ,wilson ( ,columbia ,univ]sity1 ,pr(essor ,?omas ,hunt ,morgan ( ,bryn ,mawr1 ,pr(essor ,ca/le ( ,h>v>d ,univ]sity1 ,pr(essor ,bailly ( ,cornell ,univ]sity1 ,pr(essor ,mi*ael ,guy] ( ! ,univ]sity ( ,c9c9nati1 ,pr(essor ,spillmann1 :o is ! ,agro/ologt/ ( ! ,unit$ ,/ates ,gov]nm5t1 & ,pr(essor ,bateson ( ! ,univ]sity ( ,cambridge1 ,engl&1 t ^! pr9ciples ( h]$ity enunciat$ by ,fa!r ,m5del w und\bt$ly revolutionise ! mod]n k ( ! subject4 ,9 ! meantime1 h[ev]1 all ! old !ories are 9 abeyance4 ,d>w9's "w & ,weissmann's brilliant !ories & obs]vations mu/ give way1 :ile ! application ( ^! new laws is be+ work$ out to _! fulle/ ext5t4 ,:ile ! influ5ce ( h]$ity c n be d5i$1 !re is und\bt$ly a t5d5cy to ov]e/imate ! influ5ce on ! physical be+ ( ! p[] ( h]$it>y transmission1 &1 on ! o!r h&1 to und]e/imate ! influ5ce ( ?is same =ce z reg>ds disposition & "*4 ,!re is no d\bt n[ t ! physical basis influ5ces ! ex]cise ( ! w1 & t consequ5tly responsibility is n infrequ5tly modifi$ by ! hamp]+ influ5ce ( un=tunate physical qualities4 ,?is tru? makes = t l>g] *>ity 9 ! judgm5t ( ! actions ( o!rs :i* enables physicians to realise h[ mu* m5 are to be piti$1 :ile its failure ( recognition by ! unco guid n only causes suff]+1 b 9 ! end adds to ! am\nt ( evil4 ,,james ,j4 ,,wal%4 #abi ,x ,,hypnotism1 ,,sugge/ion1 ,,& ,,crime ,9 rec5t ye>s a quasi-unconsci\s /ate1 induc$ by sugge/ion & call$ ! hypnotic trance1 has come to occupy a v important place 9 ! popul> m9d4 ,hypnotism1 z ! g5]al consid]ation ( ?is /ate is kn[n1 has attract$ n a little att5tion1 z well f physicians z f ^? int]e/$ 9 psy*ology4 ,! hypnotic 7,greek1 ,greek text1 sleep7 trance is a condition 9 :i* volunt>y bra9 activity is almo/ completely 9 abeyance1 ?\gh ! m9d is able passively to receive _m impressions f ! ext]nal _w4 ,!re are v curi\s limitations 9 ! effect ( ! hypnotic /ate ^u ! v>i\s s5ses4 ,:ile visual s5sations1 &1 z a rule also1 impressions f ! tactile s5se1 lose _! significance1 or are translat$ accord+ to ! w ( ! p]son active 9 produc+ ! hypnotic /ate1 or ( "s p]son pres5t mak+ sugge/ions1 auditory s5sations are q normally p]ceiv$4 ,! pati5t has all ! appe>ance ( be+ asleep1 ?\gh motions1 & ev5 locomotion1 are (t5 possible1 & are p]=m$ z if ! pati5t 7 walk+ 9 sleep4 ,! hypnotic /ate is a p>tial sleep1 !n1 ( ! motor side ( ! n]v\s sy/em & ( portions ( ! s5sory n]v\s sy/em4 ,c]ta9 ( ! high] intellectual p[]s1 h[ev]1 are entirely awake1 & capable ( be+ impress$ ?r\gh ! he>+1 & ?us hypnotic sugge/ion has a place4 ,= a "t1 "u ! influ5ce ( ,*>cot & 8 disciples1 !re 0 a v g5]ally accept$ op9ion t ! hypnotic trance 0 a pa?ological condition1 some:at alli$ to ! cataleptic phase ( major hy/]ia4 ,x is well kn[n t p]sons suff]+ f sev]e attacks ( hy/]ia #acj may1 :ile app>5tly unconsci\s1 yet receive sugge/ions ?r\gh ! he>+4 ,on ! o!r h&1 ! production ( cataleptic & o!r /ra9$ attitudes1 9 ! ma9t5ance ( :i* fatigue seems to play no "p1 is possible by means ( hypnotic sugge/ion 9 susceptible individuals4 ,fur!r inve/igation1 h[ev]1 seems to h %[n t ! hypnotic /ate is r to be consid]$ z a quasi-physiological condition1 some:at relat$ to sleep1 all ! my/]y ( :i* is n z yet und]/ood4 ,?is is n surpris+ :5 we realise t su* a normal & absolutely physiological condition z heal?y sleep is yet )\t a satisfactory explanation on ! "p ( physiologi/s4 ,hypnotism is recognis$ n[ z hav+ a c]ta9 limit$ p[] = good1 ?\gh ! b5efit d]iv$ f x is apt to be tempor>y1 & ! op]ator loses 8 p[] aft] a "t1--n s mu* fail+ to produce ! hypnotic condition1 z fail+ to h 8 sugge/ions fav\rably accept$ by ! subject ,:ile ! ,nancy s*ool ( hypnotism insi/$ t mo/ p 7 susceptible to ! hypnotic trance1 x is n[ g5]ally consid]$ t some?+ less ?an #dj p] c5tum ( ord9>y individuals c be br\ght "u its influ5ce4 ,mu* has be5 said ( ! dang]s ( hypnotism4 ,!re seems no d\bt t v n]v\s p]sons are likely to be hurt by repeat$ rec\rse to ! hypnotic condition4 ,aft] a "t !y are likely to live mo/ ( _! lives 9 a half-dreamy condition1 9 :i* initiative & spontane\s activity becomes m difficult ?an be=e4 ,:]e p]sons h be5 hypnotis$ by means ( ! fla% ( a bright object1 or by "s o!r special means1 x sometimes happ5s t accid5tally "s simil> object may s5d !m into hypnotic trance4 ,aft] a "t1 too1 auto-hypnotism becomes possible1 & mu* ( ! individual's wak+ "t is occupi$ ) ef=ts to keep himself f go+ into ! hypnotic trance4 ,^! are1 h[ev]1 v extreme cases1 likely to occur only 9 ^? :o are n ( /rong m5tality 9 ! beg9n+4 ,un=tunately ^! are ! individuals :o are mo/ likely to be made ! subjects ( repeat$ & prolong$ hypnotic exp]im5tation on ! "p ( unscrupul\s *>latans4 ,= ! great majority ( ^? t are susceptible to ! #aca hypnotic condition1 !re is v little dang]4 ,we n[ h on record ! exp]i5ces ( m5 :o h s]i\sly devot$ _m ye>s to ! /udy ( hypnotic ph5om5a4 ,!re is entire agreem5t among ^! m5 t ! possible dang]s ( hypnotism h be5 exagg]at$4 ,inde$1 x may be z well to say at once t mo/ ( :at has be5 writt5 ) reg>d to ! dang]s ( hypnotism has come f ^? :o h lea/ practical exp]i5ce ) ! condition4 ,dr4 ,milne ,bramwell1 :o1 = a qu>t] ( a c5tury1 has _h a v ext5sive exp]i5ce ) hypnotism 9 its _m phases1 9 8 rec5t book on hypnotism1 delib]ately speaks ( ! s-call$ dang]s ( hypnotism4 ,he has nev] se5 any evil effects1 ?\gh he has be5 practis+ hypnotism v freely on all k9ds ( pati5ts = ov] tw5ty ye>s4 ,x is on ! exp]i5ce ( su* s]i\s1 dis9t]e/$ obs]v]s t we mu/ rely = our ultimate conclusions z to hypnotism1 r ?an on ! claims ( pseudo-exp]ts :o l to magnify _! own p[]s1 or on popul> magaz9e articles1 or /ill less ! ,sunday newspap]s1 ! writ]s = :i* are ma9ly int]e/$ 9 produc+ a s5sation4 ,x seems probable t 9 ! next few ye>s hypnotism w occupy a less prom95t place 9 popul> int]e/ ?an x has 9 ! rec5t pa/4 ,int]e/ 9 hypnotism runs 9 cycles1 rea*+ a maximum ab\t once a g5]ation1 & we are on ! d[nw>d sw+ ( ! la/ wave ( popul> att5tion to ?is subject4 ,a subject t has attract$ mu* att5tion1 :5ev] hypnotism has be5 "u discussion1 has be5 ! possibility ( crime be+ committ$ "u ! influ5ce ( hypnotic sugge/ion4 ,! be/ au?orities 9 hypnotism seem to be agre$ t subjects c n be br\ght by hypnotic influ5ce to p]=m actions t are directly contr>y to _! own feel+ ( "r & wrong4 ,! suppos$ exceptions to ?is rule are r newspap] s5sations ?an real compell$ crimes4 ,!re is no d\bt1 h[ev]1 t a t5d5cy to ! p]=mance ( c]ta9 wrong actions1 s t ! normal dis9cl9ation to _! p]=mance becomes mu* less ?an be=e1 may be cultivat$ by a s]ies ( hypnotic z well z by wak+ sugge/ions4 ,:]e ! individual influ5c$ is #acb already *>act]is$ by weakness ( w 9 c]ta9 directions1 ! add$ weight ( ! motives furni%$ by hypnotic sugge/ion may prove suffici5t to turn ! scale ( responsibility4 ,x is probably because ( su* influ5ce t a rec5t case 9 ,france has attract$ _w-wide att5tion4 ,9 g5]al1 h[ev]1 x may be said t normal individuals c n be br\ght to ! commission ( crime by hypnotic sugge/ion1 & ! plea ( irresponsibility1 = ?is reason1 is n wor?y ( consid]ation4 ,!re are phases ( ?is important problem1 h[ev]1 :i* require fur!r c>eful /udy4 ,und\bt$ly "s ( ! s-call$ inh]it$ t5d5cies to ! commission ( crime are really in/ances ( ! influ5ce ( auto-sugge/ion t has kept ! possibility ( "s crim9al act con/antly be=e ! m9d4 ,"s ( ! cases ( h]$it>y dipsomania are almo/ surely ( ?is "*4 ,p]sons ^: p>5ts h be5 ! subject ( inebriety lose some?+ ( _! own w p[] to keep away f intoxicat+ dr9k by ! reflection t x is hopeless = !m to /ruggle aga9/ an inh]it$ t5d5cy4 ,a s]ies ( cases h be5 report$ 9 :i* suicide has occurr$ 9 successive g5]ations 9 ! same family at ab\t ! same "t ( life4 ,!re seems no d\bt t sugge/ion mu/ h great influ5ce 9 su* cases4 ,9 "o well-au!nticat$ report1 m5tion$ 9 ! *apt] on suicides1 ! memb]s ( ! family 7 (fic]s 9 ! ,g]man army1 & ! elde/ son1 ! family repres5tative1 committ$ suicide )9 ! same five ye>s ( life1 9 f\r successive g5]ations4 ,! la/ memb] ( ! family _h refus$ to m>ry1 because ( ?is doom hang+ ov] ! h\se1 & _h (t5 ref]r$ to ! possibility ( suicide 9 8 own case4 ,9 8 e>ly ye>s he seem$ to h ! idea t he might escape ! family fate1 b aft] middle life he settl$ d[n irretrievably to ! p]suasion t he w\ld inevitably g l ! o!rs4 ,"h1 9 ,am]ica1 a r /rik+ example ( ?is has rec5tly be5 ! subject ( s5sational newspap] reports4 ,a notori\s gambl]1 ^: c>e] _h se5 _m ups & d[ns1 f9ally f\nd himself 9 a condition :]e1 /range z x may seem1 legal re/riction made x impossible = him to #acc cont9ue 8 usually lucrative pr(ession4 ,?ree memb]s ( 8 imm$iate family1 two bro!rs & 8 "m1 _h committ$ suicide4 ,to fri5ds he _h sometimes spok5 ( ?is sad hi/ory ( family self-murd]1 b always ) a calm rationality :i* seem$ to indicate t he hop$ to avoid any su* fate4 ,:5 well on 9 ye>s1 h[ev]1 ) 8 means ( livelihood tak5 f him1 he1 too1 took ! family pa? out ( difficulties & %ot himself at ! door ( ! man :o _h be5 mo/ in/rum5tal 9 tak+ away f him 8 occupation4 ,x seems n unlikely1 f ! circum/ances ( ! case1 t a d\ble crime1 homicide1 z well z suicide w\ld h be5 report$1 only = ! =tuit\s circum/ance t ! o!r man 0 n 9 at a "t :5 usually he 0 to be f\nd at 8 (fice4 ,9 su* cases z ^! x seems reasonably cle> t long-cont9u$ famili>ity ) a giv5 idea produces an auto-sugge/ion :i* f9ally ov]comes ! natural abhorr5ce ev5 ( suicide4 ,some?+ c be done = su* un=tunates by sugge/ion 9 ! opposite direction1 & by tak+ c>e t z f> z possible !y are n all[$ to brood ov] ! fate !y consid] imp5d+4 ,at times ( /ress & emotional /ra91 relatives & fri5ds mu/ be p>ticul>ly c>eful 9 _! wat* ov] !m4 ,x is nev] advisable t !y %\ld take up su* pr(essions z ^? ( brok] or politician1 or speculator1 s9ce ! emotional /ates connect$ ) su* occupations are likely to prove too mu* = _! m5tal equilibrium4 ,practically all physicians t h giv5 any att5tion to ! subject are conv9c$ t n a few ( ! suicides1 :i* are n[ s al>m+ly on ! increase 9 ?is c\ntry1 are due to ! frequ5t read+ 9 newspap]s ( ! acc\nts ( suicides4 ,z we h said else:]e1 brood+ ov] ! details ( ^! is v likely to less5 ! natural abhorr5ce ( self-murd] 9 p]sons t are pr$ispos$1 by melan*olic dispositions1 to su* an act4 ,! publication ( cases ( suicide c d no possible good1 :ile x und\bt$ly does1 9 ?is way1 "w incalculable h>m4 ,?is is especially true ) reg>d to suicides among "y p1 t is1 individuals "u tw5ty-five ye>s ( age4 ,! sadde/ feature ( rec5t #acd /ati/ics ) reg>d to suicide is t ?is crime has become proportionately mu* m frequ5t among "y m5 & "y girls1 & ev5 *ildr51 ?an x 0 two or ?ree decades ago4 ,x has be5 not$1 too1 9 _m cases t a previ\s suicide 9 ! family seems to h famili>is$ ! "y m9d ) ! idea ( self-de/ruction & ?us sugge/$ its commission4 ,on ! o!r h&1 among "y p especially1 x has be5 not$ t !re is frequ5tly an imitative elem5t 9 suicides4 ,?ree or f\r suicides1 practically ) ! same details1 w occur1 )9 a few days ( ea* o!r4 ,suicides at all ages are especially likely to occur 9 gr\ps1 & are (t5 cit$ to exemplify ! tru? ( ! old axiom t evils nev] come s+ly4 ,x is especially among "y p1 h[ev]1 t ?is relation%ip to previ\s suicides c be trac$1 & !re is no d\bt t x is ! un=tunate publicity giv5 to suicide1 ) ! consequ5t sugge/ive influ5ce1 :i* con/itutes ! mo/ important factor 9 ^! cases4 ,all ! influ5ce t cl]gym5 c ex]t1 !n1 mu/ be wield$ to suppress ?is1 z well z ! _m o!r evils :i* fl[ f s5sational j\rnalism4 ,,james ,j4 ,,wal%4 #ace ,,xi ,,unexpect$ ,,dea? ,unexpect$ dea? & its problems con/itute ! pr9cipal reason :y !re %\ld be a pa/oral m$ic9e1 & :y ! cl]gyman mu/ keep himself 9 close t\* ) advances 9 m$ic9e4 ,to h an ail+ memb] ( a congregation die unexpect$ly1 t is1 )\t ! rites ( ! ,*ur*1 :5 p]haps !re has be5 "s w>n+ z to ! possibility ( su* an accid5t1 c n b be a s\rce ( ! grave/ conc]n 9 pa/oral "w4 ,sudd5 dea? c be anticipat$ 9 _m diseases t are acute1 :ile 9 *ronic =ms ( disease ! suff]] c be prep>$ = its possibility by ! adm9i/ration ( ! sacram5ts at regul> int]vals4 ,!re is1 h[ev]1 an old prov]b :i* says t dea? always comes unexpect$ly2 & ev5 ) all ! mod]n advance 9 m$ic9e1 ?is /ill conta9s a modicum ( tru?4 ,z an unprep>$ dea? is an occasion ( ! mo/ poignant regret to ! fri5ds ( ! deceas$ & to ! att5d+ cl]gyman1 x is ) ! idea ( furni%+ "s data by :i* ! occurr5ce ( dea? )\t due anticipation may be r5d]$ m infrequ5t1 t ! foll[+ m$ical po9ts on ! possibilities ( a fatal t]m9ation 9 c]ta9 diseases h be5 br\ght toge!r4 ,un=tunately1 ev5 ) all our progress 9 mod]n m$ic9e1 !y mu/ be f> f adequate = all cases4 ,ne$less to say1 ! only rational /&po9t 9 ?is matt] mu/ be t x is bett] to be sure ?an to be sorry4 ,! impression is v preval5t n[ t at lea/ ! sacram5ts ( ,p5ance & ! ,holy ,eu*>i/ %\ld be adm9i/]$ to ! sick :5ev] !re is ev5 ! possibility ( a fatal t]m9ation ( ! illness4 ,extreme ,unction is m usually delay$ until !re is "s positive sign ( #acf approa*+ dissolution4 ,delay 9 its adm9i/ration1 h[ev]1 n infrequ5tly leads to ?is sacram5t be+ giv5 :5 ! pati5t is unable to appreciate its significance4 ,?is w\ld seem to be v f> f ! int5tion ( ! ,*ur*4 ,! idea has be5 con/antly kept 9 m9d1 !n1 s to advise ! cl]gyman ) reg>d to ! liability ( a fatal t]m9ation z to secure1 if possible1 ! adm9i/ration ( ,extreme ,unction :ile ! pati5t is /ill 9 ! full possession ( 8 s5ses4 ,assur$ prognosis1 t is1 positive =esight z to ! c\rse ( any disease1 is ! mo/ difficult problem 9 m$ic9e4 ,ne>ly #bdjj ye>s ago1 :5 ,hippocrates wrote 8 *apt] on ! progress ( diseases1 he /at$ t ! h>de/ "q to answ] 9 ! practice ( m$ic9e is1 w ! pati5t live8 ,t special *apt] ( 8 book rema9s1 accord+ to our be/ au?orities1 d[n ev5 to our own day1 a valuable docum5t 9 m$ical lit]ature4 ,x c be read by "y or old 9 m$ical practice ) pr(it4 ,:ile our k ( ! c\rse ( disease has advanc$ v mu*1 ! wise old ,greek physician anticipat$ mo/ ( ! pr9ciples on :i* our pres5t k ( prognosis is f\nd$4 ,?is fact 9 itself w s]ve to %[ h[ unsatisfactory mu/ be any absolute conclusion z to ! t]m9ation ( any giv5 disease4 ,our =eca/s are f\nd$ on empirical data1--t is1 !y are ! result ( a s]ies ( obs]vations1--& ! und]ly+ basis ( all ! ph5om5a is ! individual human be+1 ^: con/itution x is impossible to "k adequately1 & ^: reaction to disease x is impossible1 !re=e1 to /ate ) absolute c]ta9ty4 ,) ?is w>n+ z to ! elem5t ( d\bt t exi/s 9 all prognosis1 we may proce$ to ! consid]ation ( c]ta9 organic affections :i* make sudd5 dea? frequ5t4 ,at ! beg9n+ ( ! pres5t c5tury1 ,bi*at1 a di/+ui%$ ,fr5* physician :o revolutionis$ m$ical practice1 said t heal? & ! fav\rable or unfav\rable t]m9ation ( disease dep5ds on ! condition ( ?ree sets ( organs--! bra91 ! he>t1 & ! lungs4 ,?is 0 :at he call$ ! vital tripod4 ,x 0 n until ne>ly ?irty ye>s aft] ,bi*at's dea? t ,bright1 an ,engli% #acg physician1 taught ! m$ical pr(ession to recognise kidney disease4 ,s9ce 8 "t we h le>n$ t ev5 m important ?an ,bi*at's vital tripod1 z reg>ds heal? & ! t]m9ation ( disease1 is ! condition ( ! kidneys4 ,we %all consid] affections ( ^! f\r organs1 & _! influ5ce on ! human sy/em & int]curr5t disease1 9 ! ord] ( _! importance4 ,:5 kidney disease exi/s ! individual's resi/ive vitality is mu* l[]$4 ,! kidneys are ! organs :i* s]ve to excrete poisons t f9d _! way into ! circulation4 ,:5 ! kidneys fail to act1 ^! poisons are reta9$4 ,z a result o!r important organs1 notably ! n]v\s sy/em & ! he>t1 suff] sev]ely because ( ! irritat+ effect ( ! reta9$ poison4 ,a pati5t ) kidney disease runs a v s]i\s risk 9 any infecti\s fev]1 no matt] h[ mild1 & su* pati5ts %\ld always be completely prep>$ = a fatal t]m9ation :5 !y acquire any ( ^! diseases4 ,nephritic pati5ts be> op]ations v badly4 ,! %ock to ! n]v\s sy/em incid5t ^u op]ation always ?r[s a c]ta9 am\nt m ?an usual ( excrem5titi\s mat]ial into ! circulation4 ,diseas$ kidneys d n fulfil _! function ( remov+ ?is at once1 & ! result is an irritat$ & fatigu$ n]v\s sy/em4 ,anae/hetics1 t is1 *lor(orm & e!r1 are n well tol]at$ :5 nephritis exi/s1 & ?is adds to ! dang] ( op]ation 9 su* pati5ts4 ,no matt] h[ simple or %ort ! op]ation t is to be p]=m$ on a p]son suff]+ f kidney disease1 if an anae/hetic is to be adm9i/]$ x w\ld be well to prep>e ! pati5t = an unt[>d ev5t t may occur4 ,kidney disease is (t5 extremely insidi\s4 ,x may develop absolutely )\t ! pati5t's k1 ev5 ?\gh he might be deem$ to be 9 a position to h at lea/ "s suspicion ( its exi/5ce4 ,! /ory is told ( m ?an "o pr(essor ( m$ic9e :o has pres5t$ 8 own ur9e to 8 class = exam9ation 9 ord] t !y might h ! opportunity ( /udy+ normal ur9e1 only to f9d to 8 pa9ful surprise t album5 0 pres5t & t he 0 ! subject ( lat5t ,bright's disease4 ,9 ^! cases x is #ach impossible to =esee results4 ,!y con/itute a l>ge numb] ( ! cases 9 :i* pati5ts1 seem+ly 9 good heal?1 succumb r easily & unexpect$ly to "s simple disease1 l grippe or dys5t]y4 ,x is well to take ! precaution1 !n1 to ask ! att5d+ physician :at ! condition ( ! kidneys is 9 su* cases4 ,if !re are anomal\s symptoms1 ?is precaution becomes d\bly necess>y4 ,ev5 su* simple infecti\s diseases z mumps or *ick5-pox may cause a fatal issue :]e ! kidneys are n 9 a condition to d _! normal "w ( excretion4 ,an important class ( cases = ! cl]gyman are ^? :i* are pick$ up on ! /reet4 ,z a rule1 ^! pati5ts are comatose because ( ! pres5ce ( kidney disease4 ,a c]ta9 proportion ( !m are unconsci\s because ( apoplexy4 ,v (t5 ! pati5ts h _h "s prelim9>y symptoms ( _! approa*+ collapse1 ?\gh ^! 7 n suffici5t to make !m ?9k t any s]i\s dang] ?reat5$4 ,z a consequ5ce1 !y w n infrequ5tly h _h rec\rse to "s /imulant4 ,x seems un=tunately to be almo/ a rule1 :5 su* cases are pick$ up1 if !re is ! od\r ( alcohol on _! brea?1 to consid] t ! condition is due to alcoholism4 ,e ye>1 9 our l>ge cities1 "s dea?s are report$ 9 ! cells ( ! /ation h\ses because a s]i\s illness 0 mi/ak5 = alcoholism z a result ( ! od\r ( ! brea?4 ,ne$less to say1 !n1 ! od\r ( alcohol on ! brea? ( a p]son 9 coma %\ld n det] a cl]gyman f wait+ = a "t to be sure 8 m9i/rations may n be ne$$ = some?+ mu* m s]i\s ?an alcoholism4 ,pati5ts suff]+ f kidney disease be> extremes ( cold & heat v badly4 ,9 cold wea!r ! fact t ! blood is driv5 f ! surface ( ! body less5s ! excretory function ( ! sk91 & ?is ?r[s ! "w ( ?is important organ1 s helpful an auxili>y 9 excretion1 back ^u ! kidneys4 ,besides1 conge/ions ( int]nal organs are n infrequ5t dur+ cold1 damp seasons1 & ^! br+ on exac]bations ( previ\sly exi/+ ailm5ts t may make fatal complications4 ,9 summ] int5se heat leads to _m m *anges 9 ! tissues1 & s provides m mat]ial to #aci be excret$ ?an 9 temp]ate wea!r4 ,pati5ts pick$ up on ! /reet1 !n1 at su* "t1 w usually be f\nd to be suff]+ f kidney disease4 ,?\gh 9 pr(\nd coma1 su* pati5ts seldom die )\t recov]+ consci\sness4 ,n infrequ5tly1 aft] ! prim>y /roke ( ! coma1 !re is1 9 an h\r or two1 a p]iod 9 :i* ! pati5t becomes almo/ completely rational4 ,?is p]iod ( consci\sness does n la/ long1 9 _m cases1 & %\ld be tak5 imm$iate advantage (1 yet )\t unduly di/urb+ ! pati5t4 ,!re is a well-kn[n t5d5cy 9 kidney disease to ! production ( o$ema1 t is1 to ! outfl[ ( ! wat]y con/itu5ts ( ! blood into c]ta9 loose tissues ( ! body4 ,?is is easily recognis$1 & con/itutes a valuable sign ( kidney disease 9 ! swell+ ( ! eyelids & ( ! feet1 t occurs s (t5 9 pati5ts suff]+ f kidney tr\ble4 ,! usual rule is1 if ! o$ema beg9s 9 ! face1 x is due to ! kidneys2 if 9 ! feet1 to ! he>t4 ,! cause 9 ! latt] case is ! sluggi% circulation due to ! weakness ( ! he>t muscle1 :i* delays ! blood s long 9 ! extremities t its wat]y elem5ts f9d _! way out into ! tissues4 ,9 kidney disease ?is t5d5cy to o$ema con/itutes a di/9ct dang] t may involve sudd5 dea? 9 c]ta9 affections4 ,9 pati5ts suff]+ f kidney disease any acute sore ?roat involv+ ! l>ynx & caus+ ho>s5ess may be foll[$ by :at is call$ o$ema ( ! glottis4 ,?is is (t5 fatal 9 a v %ort "t4 ,! glottis is ! op5+ betwe5 ! vocal cords ?r\gh :i* respiration is c>ri$ on4 ,?is op5+ is b small1 & swell+ ( ! surr\nd+ tissues readily encroa*es ^u x1 & soon causes difficulty ( brea?+4 ,if ! swell+ is n reliev$ )\t delay1 dea? takes place f asphyxiation4 ,?is 0 probably ! cause ( dea? 9 ,george ,wa%+ton4 ,9 almo/ ! same way any acute affection ( ! lungs t occurs 9 a pati5t suff]+ f kidney disease may be foll[$ by o$ema ( ! lungs4 ,! outfl[ ( s]um f ! blood vessels into ! loose tissues ( ! lungs s encroa*es ^u ! space available = brea?+1 & at ! same "t s r$uces ! ela/icity ( lung tissue1 t #adj respiration becomes impossible1 & dea? takes place 9 a few h\rs4 ,?is is (t5 ! cause ( unexpect$ dea? aft] op]ations4 ,! kidney affection 9 ! pati5t is s slight z to h be5 unsuspect$1 or to h be5 consid]$ ( n suffici5t importance to r5d] ! op]ation especially dang]\s4 ,aft] kidney disease ! mo/ important factor 9 ! production ( unexpect$ dea? is he>t disease4 ,9 ab\t #fj p] c5tum ( ! pati5ts :o die sudd5ly1 9 ! mid/ ( seem+ly good-heal?1 dea? is due to he>t disease4 ,all =ms ( he>t disease may be consid]$ "u two heads--! cong5ital & ! acquir$4 ,! cong5ital =m ( he>t disease usually causes dea? 9 e>ly ye>s4 ,if su* pati5ts survive ! f\r? or fif? ye>1 !y are usually c>ri$ (f by "s slight int]curr5t disease %ortly aft] pub]ty4 ,a few cases ( cong5ital he>t disease1 h[ev]1 live on to a good old age & seem n to be s]i\sly inconv5i5c$ by _! he>t tr\ble4 ,mo/ ( ! acquir$ he>t disease1 t is1 at lea/ #fe p] c5tum ( x1 is due to rheumatism4 ,all ( ! infecti\s fev]s1 h[ev]1 may cause he>t disease1 & sc>let fev] especially is prone to d s2 he>t complications occurr+ 9 ab\t "o out ( e t5 cases4 ,! probabilities ( sudd5 dea? 9 a case ( he>t disease dep5d on :at valve is affect$ & :at ! condition ( ! he>t muscle is4 ,mo/ ( ! cases ( sudd5 dea? occur 9 disease ( ! aortic valves1 t is1 ( ! valves t prev5t ! blood f fl[+ back f ! he>t aft] x has be5 pump$ out4 ,diseases ( ! o!r side ( ! he>t1 ! mitral valve1 cause l+]+ illness until ! he>t muscle becomes diseas$1 :5 sudd5 dea? usually closes ! sc5e4 ,diseases ( ! aortic valves ( ! he>t cause visible pulsations ( ! art]ies1 especially ( ^? 9 ! neck4 ,?is readily attracts att5tion if "o is on ! look\t = x4 ,dea?s 9 he>t disease1 :e!r sudd5 or 9 ! mid/ ( app>5t heal?1 or z ! t]m9al /age aft] conf9em5t to b$ because ( weak he>t1 are apt to occur p>ticul>ly dur+ cont9u$ cold or hot spells4 ,ea* ( ! blizz>ds t we h _h 9 rec5t ye>s has be5 ! occasion = a #ada m>k$ly increas$ mortality 9 all =ms ( he>t disease4 ,! cold itself is exhau/ive1 & ! heavy fall ( sn[1 by delay+ c>s & modes ( conveyance g5]ally1 is v apt to give occasion = consid]ably m ex]tion ?an usual4 ,besides1 cold closes up ! p]iph]al capill>ies & makes ! pump+ "w ( ! he>t mu* h>d] ?an be=e4 ,at times ( cont9u$ cold1 9 our l>ge cities p>ticul>ly1 ! ord9>y arrangem5ts = heat+ ! h\se fail to keep x at a con/ant temp]ature1 & ?is proves a s\rce ( exhau/ion to c>diac pati5ts4 ,heat$ spells1 if prolong$1 always cause an increas$ mortality 9 su* pati5ts1 because heat is relaxant & ?is leads to exhau/ion4 ,pati5ts :o h be5 nurs$ fai?fully ?r\gh a sev]e w9t] w sometimes succumb to ! fir/ few successive days ( hot wea!r t are likely to come at ! end ( ,may or ! beg9n+ ( ,june4 ,! dea?s t occur dur+ ! hot spells ( ,july & ,augu/ are m look$ = & accord+ly prove n s unexpect$4 ,! w>n+ symptom 9 he>t disease t ! pati5t is giv+ out is ! developm5t ( irregul>ity & rapidity ( ! pulse4 ,on ! o!r h&1 :5 a pulse has be5 runn+ rapidly = weeks & !n drops to bel[ ! regul> rate1 to #ej or #fj1 a fatal t]m9ation may be look$ = at almo/ any "t1 ?\gh1 ( c\rse1 ! pati5t may rally4 ,! prognosis ( he>t cases is extremely difficult4 ,conf9$ to b$ & evid5tly s]i\sly ill1 !y may cont9ue 9 reasonably good condition = mon?s1 & !n "s indiscretion 9 diet1 :i* causes a dilation ( ! /oma* ) gas1 pu%es ! diaphragm up aga9/ ! he>t1 adds a me*anical imp$im5t to ! physical difficulties ! organ is already lab\r+ "u1 & a sudd5 t]m9ation may ensue4 ,z a rule1 l+]+ he>t cases t]m9ate sudd5ly & (t5 ) little w>n+ ( ! approa* ( dea?4 ,an int]e/+ set ( he>t symptoms1 = ! physician z well z ! cl]gyman1 are ^? :i* occur 9 :at is call$ ang9a pectoris1 he>t pang1 or he>t angui%4 ,s]i\s ang9a pectoris occurs 9 eld]ly p ^: art]ies are deg5]ate4 ,its ma9 symptom is a feel+ ( discom=t :i* develops 9 ! praecordia1--! region ov] ! he>t4 #adb ,?is discom=t may (t5 increase to positive cutt+ pa94 ,! pa9 is (t5 ref]r$ to ! %\ld]1 & runs d[n ! left arm4 ,?is set ( symptoms is accompani$ by an int5se s5se ( imp5d+ dea?4 ,:5 ! pati5t's art]ies are deg5]at$1 ?is tra9 ( symptoms mu/ always be consid]$ ( om9\s significance4 ,a readily visible sign ( art]ial deg5]ation c sometimes be not$ 9 ! tortu\s prom95t temporal art]y j above ! temple4 ,heb]d51 an ,engli% physician1 a little ov] a c5tury ago1 po9t$ out t !re exi/$ 9 cases ( true ang9a pectoris a deg5]ation ( ! coron>y art]ies4 ,^! are ! art]ies :i* supply ! he>t itself ) blood4 ,z might naturally be expect$1 _! deg5]ation s]i\sly impairs ! function ( ! he>t muscle4 ,! fir/ pati5t 9 :om ! condition 0 diagnos$ dur+ life 0 ! di/+ui%$ anatomi/1 ,john ,hunt]4 ,hunt] 0 ( a r irascible temp]am5t1 & aft] he _h _h sev]al ( ^! attacks1 & a consultation ) ,heb]d5 conv9c$ him ( _! significance1 he is said to h rem>k$1 ,i am at ! m]cy ( any villa9 :o r\ses my temp]4 ,sure en\gh4 ,hunt] di$ 9 a sudd5 fit ( ang] )9 ! ye> aft] mak+ ! rem>k4 ,*>cot1 ! di/+ui%$ neurologi/1 suff]$ f attacks ( ang9a pectoris1 & 0 ask$ by 8 family to consult a di/+ui%$ he>t speciali/ = !m4 ,he said3 ,ei!r ,i h deg5]at$ he>t art]ies1 or ,i h n4 ,i believe t ,i h n1 & t my attacks are due to a n]v\s condition ( my he>t4 ,if ,i %\ld consult ! physician y m5tion1 & he 7 to tell me t my attacks are due to deg5]ation ( ! he>t1 he w\ld advise my giv+ up "w4 ,t ,i am n ready to d1 & s ,i pref] to take my own assurance 9 ! matt]4 ,a few ye>s lat] he 0 f\nd "o morn+ dead 9 b$4 ,9 _m ( ! cases ( dea? 9 b$1 especially :]e "s compla9t ( pa9 has be5 he>d dur+ ! night1 dea? is due to t condition ( ! he>t art]ies :i* causes ang9a pectoris1 ?\gh x may be ! fir/ attack :i* proves fatal4 ,!re is a condition simil> to ang9a pectoris1 sometimes call$ pseudo-ang9a1 or false he>t pang1 :i* occurs 9 individuals f fifte5 to ?irty ye>s ( age4 ,x is (t5 a #adc s\rce ( great worry4 ,x occurs 9 "y p]sons ( a n]v\s temp]am5t :o h be5 ov]work$ or ov]worri$ & h run d[n 9 weight4 ,!re are always accompany+ signs ( ga/ric di/urbance4 ,! casual factor ( ! symptoms seems to be a m or less sudd5 dilation ( ! /oma* ) gas4 ,z ! /oma* lies j bel[ ! he>t1 only sep>at$ f x by ! comp>atively ?9 lay] ( diaphragm1 ! he>t is pu%$ up & its action int]f]$ )4 ,9 heal?y individuals ?is causes no m ?an a pass+ s5se ( discom=t & "s he>t palpitation4 ,t x is :i* s5ds s _m "y pati5ts to physicians ) ! p]suasion t !y h he>t disease1 :5 !y h no?+ m ?an indige/ion4 ,9 n]v\s individuals1 h[ev]1 ?is int]f]5ce ) ! he>t action di/urbs ! n]v\s me*anism ( ! he>t1 :i* is v intricate & delicate1 & gives rise to ! symptoms ( false he>t pang4 ,"o ( ^! symptoms is always1 z 9 true ang9a pectoris1 an imp5d+ s5se ( dea?4 ,?is c n be %ak5 (f1 & is n m]ely an imag9ation ( ! pati5t4 ,pseudo-ang9a is1 h[ev]1 n a dang]\s affection4 ,pati5ts c usually be assur$ t !re is no dang] ( dea?4 ,?is assurance is n absolute1 h[ev]4 ,= "s ( ^! cases h cong5ital defects 9 _! coron>y art]ies1 & ! n]v\s sy/em ( ! he>t itself1 :i* make !m liable to sudd5 dea?4 ,x is sometimes impossible to diff]5tiate su* cases ( organic he>t defects f ! ord9>y functional he>t di/urbance due to indige/ion1 :i* causes simple curable pseudo-ang9a4 ,"y pati5ts may usually be disabus$ ( _! n]v\sness 9 ! matt]1 b absolute assurance c n be giv5 until ! case has be5 "u obs]vation = "s "t4 ,aft] ! he>t1 ! head is ! mo/ important factor 9 sudd5 dea?4 ,! mo/ frequ5t =m ( dea? f intra-cranial causes is apoplexy4 ,apoplexy1 z ! "n indicates--a break+ out--is due to a rupture ( "o ( ! art]ies ( ! bra91 & a consequ5t fl[+ out ( blood into ! bra9 tissue4 ,! pres5ce ( ! exud$ blood causes pressure ^u important n]ve tracts1 & s gives rise to unconsci\sness1 to p>alysis1 & to ! o!r symptoms :i* are #add not$ 9 apoplexy4 ,!re are a numb] ( symptoms t act z w>n+s ( ! approa* ( apoplexy4 ,fir/1 x occurs only 9 ^? beyond middle life1 t is1 9 individuals ov] =ty-five1 & 9 ^! only :]e !re is m>k$ deg5]ation ( art]ies4 ,! deg5]ation ( ! art]ies c be easily not$1 z a rule1 9 o!r p>ts ( ! body4 ,! condition kn[n z art]io-scl]osis1 t is1 art]ial h>d5+1 c be detect$ by ! f+] at ! wri/1 or by ! eye 9 ! bran* ( ! temporal art]y1 :i* c s frequ5tly be se5 to take its s9u\s c\rse on ! =ehead beh9d & above ! eye4 ,at ! wri/ ! ?ick5$ art]y is felt z a cord t c be roll$ "u ! f+]4 ,x is n /raight z 9 heal?1 b is tortu\s1 because ! ov]gr[? 9 ! walls1 :i* makes x ?ick1 has also made x long] ?an normal1 ?us produc+ tortuosity4 ,besides ^! objective signs1 z !y are call$1 !re are c]ta9 subjective signs1 t is1 signs easily recognis$ by ! pati5t himself1 :i* %\ld put him on 8 gu>d1 & at ! same "t s]ve z a w>n+ to ! cl]gyman1 %\ld he he> ( _! pres5ce4 ,^! signs are recurr+ dizz9ess1 or v]tigo1 n cle>ly associat$ ) ga/ric di/urbance2 t5d5cy ( ! limbs1 & especially ! f+]s & toes1 to g to sleep easily1 & :5 !re is no ext]nal cause = ?is condition2 t5d5cy to fa9tness & to dizz9ess :5 ! pati5t rises 9 ! morn+1 especially if he assumes ! erect position sudd5ly2 t5d5cy to v]tigo :5 ! pati5t /oops1 z to tie a %oe1 or pick up some?+ f ! floor1 & ! l2 f9ally1 c]ta9 *anges 9 ! pati5t's disposition1 ) a loss ( memory = ?+s t are rec5t1 ?\gh ! memory may be reta9$ = ! happ5+s ( ye>s be=e4 ,:5 sev]al ( ^! symptoms occur1 pati5ts :o are well on 9 ye>s %\ld take w>n+ ( ! fact t !y are liable at any "t to h a /roke4 ,ne$less to say1 ?is has no ref]5ce to ! cases ( "y n]v\s p]sons :o may readily imag9e t !y h "s or all ( ^! symptoms4 ,apoplexy is typically ! disease ( ^? ov] fifty ye>s ( age4 ,!re may ev5 occasionally be slight losses ( p[] 9 ! h& or foot t po9t to ! occurr5ce ( small hemorrhages 9 ! bra91 t is1 slight prelim9>y /rokes4 #ade ,pati5ts t h _h ^! symptoms %\ld n1 z a rule1 be all[$ to leave home unatt5d$4 ,if ! apoplexy occurs 9 ! /reet !y are liable to be mi%&l$ by ^? ignorant ( _! true condition4 ,! cl]gyman is usually summon$ at once 9 ^! cases & may rea* ! /rick5 individual be=e ! physician4 ,"s words1 !n1 ) reg>d to ! g5]al managem5t ( su* pati5ts w n be out ( place4 ,z a rule1 :5 a pati5t is tak5 ) "s sudd5 illness :i* causes him to fall d[n unconsci\s1 ! fir/ ?+ done is to da% wat] 9 8 face1 =ce a /imulant d[n 8 ?roat1 put 8 head l[ d[n1 & loos5 ! clo?+ ar\nd 8 neck4 ,mo/ ( ^! proce$+s are ! v wor/ ?+s t c\ld be done = a pati5t suff]+ f apoplexy4 ,! r\gh h&l+1 p>ticul>ly1 & ! adm9i/ration ( a /imulant1 w surely d h>m4 ,! wat] on ! face w c]ta9ly d no good4 ,apoplectic pati5ts c be recognis$ f ^? :o are m]ely 9 a fa9t+ fit1 fir/1 by ! fact t !y are usually old1 :ile ! fa9t]s are "y2 & secondly1 by ! mann] ( ! brea?+4 ,9 a fa9t ! brea?+ is %all[ & fa9t1 n easily se54 ,9 apoplexy x is apt to be deep & long4 ,x may be irregul>1 & x is always accompani$ by a bl[+ outw>d & inw>d ( ! *eeks1 & especially ( ! side ( ! face :i* is p>alys$1 z a consequ5ce ( a hemorrhage into ! bra94 ,! lips are =c$ outw>d & drawn inw>d dur+ ! respiration4 ,9 su* cases ! pati5t %\ld be mov$ z little z possible2 /imulants %\ld be avoid$1 & ! head %\ld be plac$ high] ?an ! re/ ( ! body1 s z to make ! hemorrhage into ! bra9 z small z possible1 by call+ 9 ! assi/ance ( gravity to keep ! he>t f s5d+ too mu* blood into ! head4 ,besides ?is plac+ ! head high1 !re is only "o o!r helpful measure t ev5 ! physician c practise1 except 9 r>e cases1 t is1 to put an ice-bag on ! head4 ,= ?is a clo? dipp$ 9 cool wat] may be us$ 9 an em]g5cy4 ,( c\rse1 z soon z ! doctor arrives1 ! pati5t %\ld be left entirely to 8 c>e4 ,! art]y t ruptures 9 ! bra91 9 cases ( apoplexy1 #adf is practically always ! same4 ,its sci5tific "n is ! l5ticulo-/riate art]y1 b x is (t5] call$ by ! "n giv5 x by ,*>cot--! art]y ( c]ebral hemorrhage4 ,! reason :y art]ies 9 ! bra9 rupture r ?an art]ies 9 o!r organs is t 9 ! bra91 9 ord] to avoid ! demoralis+ effect ( too sudd5 *anges ( blood pressure ^u ! n]v\s sub/ance1 ! c]ebral art]ies are t]m9al1 are n connect$ directly ) a network ( f9] art]ies z 9 ! re/ ( ! body1 b gradually become small] & small]1 & end 9 ! capill>y network :i* is ! beg9n+ ( ! v5\s vascul> sy/em4 ,?is special art]y ruptures1 because x is almo/ on a direct l9e f ! he>t1 & s blood pressure is high] 9 x ?an 9 o!r bra9 art]ies4 ,! tradition t p ) %ort necks are a little m liable to apoplexy ?an are ^? ( long] c]vical developm5t has a c]ta9 am\nt ( tru? 9 x1 ?\gh n ne> s mu* z is (t5 claim$ = x4 ,ano!r pr$ispos+ elem5t to apoplexy is und\bt$ly h]$ity4 ,families h be5 trac$ 9 :i*1 = five successive g5]ations1 !re h be5 attacks ( apoplexy betwe5 fifty-five & sixty ye>s ( age4 ,%ort-neck$ p1 ) any hi/ory ( apoplexy 9 ! family1 %\ld especially be c>eful1 if !y h any ( ! symptoms--dizz9ess1 sleepy f+]s1 etc4--t we h already not$4 ,!re is a tradition t ! ?ird /roke ( apoplexy is always fatal4 ,?is is )\t f\ndation 9 exp]i5ce1 ?\gh ( c\rse ! liability ( dea? increases ) ea* /roke1 & few pati5ts survive ! ?ird attack4 ,i rememb] see+ 9 ,m5del's cl9ic1 9 ,b]l91 a man :o 0 suff]+ f 8 sev5? /roke & promis$ to recov] to h ano!r4 ,ea* successive /roke is mu* m dang]\s to life ?an ! prec$+ "o1 h[ev]4 ,9 g5]al1 ! prognosis ( an apoplexy1 t is to say :at ! ultimate result w be1 is impossible4 ,! pati5t may come to 9 an h\r or two1 & may n come out ( ! coma at all4 ,!re is no way ( decid+ h[ l>ge ! art]y is t is ruptur$1 nor h[ mu* blood has be5 effus$ into ! bra91 nor h[ mu* damage has be5 done to important n]ve c5tres4 ,nor is !re any #adg effective way ( /opp+ ! effusion1 ?\gh c]ta9 ?+s seem to be ( "s b5efit 9 ?is matt]4 ,we c only wait1 assur$ t1 9 mo/ ( ! cases1 ! pati5t w h a return ( consci\sness1 at lea/ = a "t4 ,next to apoplexy1 injuries ( ! head are mo/ important4 ,! symptoms pres5t$ by ! pati5t w (t5 be ne>ly ! same z ^? ( apoplexy4 ,if ! skull is fractur$1 & ! depress$ bone is ex]t+ pressure ^u ! bra9 sub/ance1 !re is a simil> /ate ( affairs to t :i* exi/s 9 apoplexy4 ,any return to consci\sness mu/ be tak5 advantage ( = ! adm9i/ration ( ! ,sacram5ts4 ,z a rule1 x is impossible to tell ! ext5t ( ! injury or to =eca/ ! ultimate result4 ,a v *>act]i/ic set ( symptoms develops sometimes aft] injuries 9 ! temporal region or j above x4 ,= a %ort "t up to an h\r or two aft] ! injury1 ! pati5t is unconsci\s4 ,!n he comes to = a :ile1 b relapses into unconsci\sness1 f :i* he w usually n recov] except aft] an op]ation4 ,! explanation ( ?is succession ( symptoms is t ! prim>y unconsci\sness is due to %ock--concussion or %ak+ up ( ! bra94 ,! injury has1 h[ev]1 also caus$ a rupture ( an important art]y :i* occurs 9 "o ( ! membranes ( ! bra9 9 ?is region1 ! middle m5+eal art]y4 ,dur+ ! /ate ( %ock blood pressure is l[ & hemorrhage is n sev]e4 ,:5 consci\sness is rega9$1 blood pressure goes up & ! lac]ation ( ! middle m5+eal art]y1 already spok5 (1 provides an op5+ = ! exit ( consid]able blood1 :i* clots 9 ?is region & presses ^u ! bra91 caus+ ! subsequ5t unconsci\sness4 ,z a rule1 ! pati5t's only hope is 9 op]ation ) ligature ( ! torn art]y4 ,! condition is always v s]i\s1 & complete precautions z to ! possibility ( fatal t]m9ation %\ld be tak51 z soon z consci\sness is rega9$ aft] ! bl[1 9 any case :]e ! head injury has be5 sev]e en\gh to cause m ?an a mom5t>y loss ( self-possession4 ,no "o c tell :e!r !re may be fur!r *ange or n1 & if ?is happ5s x w be 9 ! =m ( an unconsci\sness gradually deep5+ until reliev$ by op]ation or end$ by dea?4 #adh ,tum\rs ( ! bra9 (t5 produce dea?1 b usually give abundant w>n+ ( _! pres5ce4 ,! symptoms by :i* ! physician diagnoses ! pres5ce ( a bra9 tum\r are v]tigo1 heada*e1 vomit+1 usually "s eye tr\ble1 & frequ5tly "s int]f]5ce ) ! motion ( "s "p ( ! body1 because ( pressure ex]t$ ^u ! n]ve c5tres :i* preside ov] its motions4 ,bra9 tum\rs are especially liable to develop 9 two classes ( cases--9 pati5ts :o are suff]+ f tub]culosis 9 its t]m9al /ages or f syphilis4 ,:]e pati5ts are kn[n to h ei!r ( ^! diseases & pres5t any two ( ! symptoms ( bra9 tum\r t ,i h m5tion$1 x is well to sugge/ at lea/ ! prelim9>y prep>ation = a fatal t]m9ation4 ,sometimes /ates ( int5se p]si/5t pa91 or ( m5tal di/urbance1 develop 9 ^! cases & make ! adm9i/ration ( ! ,sacram5ts unsatisfactory4 ,m5+itis is a fatal affection :i* sometimes causes sudd5 dea?1 b m frequ5tly produces unconsci\sness )\t v mu* w>n+1 & ! unconsci\sness la/s until ! dea? ( ! pati5t4 ,m5+itis is se5 mu* m frequ5tly 9 *ildr5 ?an 9 ! adult4 ,ord9>ily x is due to tub]culosis4 ,sometimes1 h[ev]1 !re are epidemics ( c]ebrosp9al m5+itis--spott$ fev]1 z x us$ to be call$4 ,9 ab\t "o-half ! cases ?is affection is fatal4 ,un=tunately ?is disease gives v little w>n+ ( its approa* 9 _m cases be=e unconsci\sness sets 94 ,we h _h r5ew$ epidemics ( ! disease 9 ! ea/]n "p ( ! ,unit$ ,/ates 9 rec5t ye>s1 & ! affection is likely to occur m frequ5tly = "s "t to come4 ,! fir/ h9t ( ! onset ( ! disease dur+ an epidemic %\ld be ! signal = ! adm9i/ration ( all ! rites ( ! ,*ur*4 ,( late ye>s we h le>n$ t ! pneumococcus1 t is1 ! bact]ium :i* causes pneumonia1 may produce a fatal =m ( m5+itis4 ,! fir/ symptom ( m5+itis is usually a /iffness ( ! muscles at ! back ( ! neck4 ,if ?is /iffness becomes v m>k$ 9 a pati5t suff]+ f tub]culosis1 or :o has1 or has rec5tly _h1 pneumonia1 or at a "t :5 !re is any reason to suspect t epidemic c]ebrosp9al m5+itis exi/s 9 a neighb\rhood1 ! #adi prognosis ( ! case is always v s]i\s4 ,e precaution %\ld be tak5 to prep>e ! pati5t = ! wor/4 ,unconsci\sness may ensue at any mom5t & no opportunity = satisfactory adm9i/ration ( ! consolations ( religion be aft]w>ds af=d$4 ,:ile ,bi*at put ! lungs d[n z "o ( ! vital tripod on :i* ! cont9uance ( life dep5ds1 affections ( ^! organs v seldom lead to sudd5 or unexpect$ dea?4 ,pulmon>y affections usually run a v *ronic c\rse4 ,acute bron*itis1 h[ev]1 occurr+ 9 a pati5t ) kidney tr\ble1 may lead to ! developm5t ( o$ema ( ! lungs1 & dea? w usually ensue 9 a few h\rs4 ,x may be well to note "h t individuals :o h :at are call$ clubb$ f+]s1 or z ! ,g]mans picturesquely put x1 drum/ick f+]s1 t is1 f+]s ) bulb\s ends1 ! f+] beyond ! la/ jo9t be+ l>g] ?an ! prec$+ "p1 ne>ly always h "s *ronic affection )9 ! ?orax4 ,?is means t !re is "s organic affection ( ! he>t or lungs :i* has la/$ = _m ye>s4 ,! exi/5ce ( su* condition makes !m di/9ctly m vuln]able to any s]i\s int]curr5t disease1 & ?is sign alone may be en\gh to put ! att5d+ physician on 8 gu>d z to ! possibility ( fatal complications 9 ! case4 ,,james ,j4 ,,wal%4 #aej ,,xii ,,unexpect$ ,,dea? ,,9 ,,special ,,diseases ,besides ! g5]al sy/emic conditions 9 :i* sudd5 dea? may occur )\t anticipation1 !re are c]ta9 specific diseases ( :i* unexpect$ dea? is sometimes a feature4 ,= ! cl]gyman to "k ! condition 9 :i* ! sudd5 fatal t]m9ation is liable to occur is to be =e>m$ aga9/ ! possibility ( dea? )\t ! ,sacram5ts1 or _! en=c$ adm9i/ration 9 ha/e1 :5 ! recipi5t is 9 a v unsatisfactory condition ( m9d & body4 ,x has be5 said t if a normally heal?y individual rea*es ! age ( tw5ty-five he is reasonably sure to live to a good old age1 provid$ he does n meet ) an accid5t or cat* typhoid fev] or pneumonia4 ,pneumonia is an extremely important affection z reg>ds its prognosis4 ,f #ae to #bj p] c5tum ( suff]]s f ! disease die2 t is to say1 ab\t "o 9 six ( ^? attack$ by ! disease w n recov]4 ,x is a little m fatal 9 wom5 ?an 9 m54 ,x is especially s]i\s = ! v "y & ! old4 ,heal?y adults 9 middle life v r>ely die f ! disease4 ,! prognosis ( any individual case1 x has be5 well said1 dep5ds on :at ! pati5t takes ) him into ! pneumonia4 ,s]i\s affections ( important organs ne>ly always cause fatal complications4 ,if ! he>t is affect$ be=e ! pneumonia is acquir$1 !n ! prognosis is v unfav\rable1 & a fatal t]m9ation is almo/ inevitable4 ,if ! kidneys are s]i\sly diseas$ be=eh&1 dea? is almo/ ! rule4 ,pneumonia develop+ dur+ ! c\rse ( pregnancy is fatal 9 m ?an "o-half ( ! cases4 ,at "o "t x 0 sugge/$ t premature deliv]y ( pregnant #aea pneumonia pati5ts might save at lea/ ! "m's life4 ,exp]i5ce 9 ,g]many1 h[ev]1 has %[n t1 f> f mak+ ! prognosis m fav\rable1 ! induction ( premature lab\r makes ! outlook a little worse = ! pati5t4 ,previ\s affections ( ! lungs1 emphysema1 or tub]culosis1 are prone to make ! prognosis ( pneumonia mu* m unfav\rable ?an "u ord9>y circum/ances4 ,det]iorat$ conditions ( ! blood1 anaemia1 *lorosis--su* z occurs s commonly 9 "y wom5--is prone to make ! outlook 9 pneumonia m s]i\s4 ,pneumonia ( ! upp] lobes ( ! lungs is m apt to be foll[$ by complications1 & is !re=e m s]i\s ?an pneumonia ( ! l[] lobes4 ,second>y pneumonia--t is1 inflammation ( ! lungs :i* develops z a complication ( "s o!r disease--is mu* m unfav\rable ?an prim>y pneumonia :i* develops 9 ! mid/ ( heal?4 ,! am\nt ( lung involv$ is ( c\rse a s]i\s factor 9 ! prognosis4 ,if ! :ole ( "o lung is consolidat$1 or if consid]able portions ( bo? lungs are ?us affect$1 ! prognosis becomes extremely unfav\rable4 ,9 p]sons ( alcoholic habits ! result ( pneumonia is always to be dread$4 ,! m lib]al has be5 ! consumption ( alcohol1 z a rule1 ! less hope is !re ( a prompt1 uncomplicat$ recov]y4 ,/imulants are ( ! greate/ importance 9 pneumonia1 & ! less ! pati5t has tak5 ( !m be=e ! developm5t ( 8 pulmon>y affection ! m effective are !y :5 ! crisis ( ! disease comes4 ,! less ! alcohol t has be5 tak5 habitually be=e ! developm5t ( pneumonia1 ! m surely w x d ! "w expect$ ( x dur+ ! c\rse ( ! pneumonia4 ,x mu/ be borne 9 m9d t cases ( pneumonia t occur 9 in/itutions1 asylums1 hospitals1 & ! l1 & 9 cr[d$ qu>t]s 9 t5em5t h\ses or lodg+ h\ses1 h a di/9ctly worse prognosis ?an ^? treat$ 9 private h\ses1 & ! prie/ mu/ accord+ly be m on 8 gu>d & give ! ,sacram5ts e>ly4 ,9 pneumonia1 z 9 typhoid fev]1 s-call$ walk+ cases always h a s]i\s prognosis4 ,!y occur 9 v /rong pati5ts :o resi/1 n ! invasion ( ! disease1 b its #aeb weak5+ influ5ce1 & keep on _! feet = sev]al days1 despite ! pres5ce ( symptoms t require !m to be 9 b$4 ,:5 a pati5t walks into a doctor's (fice 9 ! ?ird or f\r? day ( a pneumonia ) mo/ ( "o lung consolidat$1 exhau/ion ( ! he>t & ( ! n]v\s sy/em1 "u ^! unfav\rable conditions1 w usually h made 8 resi/ive vitality v l[4 ,su* cases %\ld be giv5 ! ,sacram5ts e>ly1 :ile 9 ! full possession ( _! s5ses4 ,conditions sometimes develop r unexpect$ly 9 :i* ! adm9i/ration ( ! ,sacram5ts becomes unsatisfactory1 because ( ! collaps$ /ate ( ! pati5t4 ,?is same advice holds ) reg>d to walk+ cases ( typhoid fev]4 ,:]e /rong pati5ts suff]+ f ! disease h insi/$ on be+ ar\nd on _! feet = f six to t5 days at ! beg9n+ ( ! affection1 ! prognosis becomes v unfav\rable4 ,complications1 su* z hemorrhage or p]=ation ( ! inte/9e1 occur ab\t ! beg9n+ ( ! ?ird week1 & (t5 prove fatal4 ,all typhoid fev] pati5ts %\ld receive at lea/ ! ,sacram5ts necess>y to give a s5se ( security to ! prie/ & _! fri5ds dur+ ! c\rse ( ! second week1 ev5 ?\gh !y may seem+ly be 9 excell5t condition4 ,:5 typhoid fev] is fatal ! complications occur sudd5ly1 (t5 )\t mu* w>n+2 & if inte/9al p]=ation1 = in/ance1 takes place1 ! p]itonitis :i* develops makes ! pati5t's condition v unsuitable = ! reception ( ! ,sacram5ts 9 a prop] /ate ( m9d4 ,typhoid fev] pati5ts sometimes die sudd5ly 9 collapse :5 !y are convalesc5t4 ,! tox9e ( ! typhoid bacillus (t5 affects ! he>t1 & causes :at is call$ cl\dy swell+ ( its muscul> fibres4 ,?is decreases v notably _! functional ability4 ,any sudd5 ex]tion1 ev5 sitt+ up 9 b$1 may cause ! he>t to /op "u su* circum/ances4 ,! mod]n cu/om 9 hospitals is n to all[ typhoid pati5ts to sit up 9 convalesc5ce until ! head ( ! b$ has be5 rais$ gradually = sev]al days s z to accu/om ! he>t to pump+ blood up ! hill to ! bra94 ,prie/s mu/ be c>eful1 !n1 :5 !y call to see convalesc5t typhoid pati5ts1 n to p]mit !m to sit up #aec to greet !m4 ,! doctor's directions 9 ?is matt] %\ld be foll[$ v c>efully4 ,?is sudd5 fatal collapse may occur aft] any ( ! infecti\s diseases4 ,x is se5 n infrequ5tly aft] diph!ria4 ,x occurs m r>ely aft] sc>let fev]1 & ev5 aft] "s ( ! mild] *ildr5's diseases4 ,9 rheumatism1 especially :]e a he>t complication has occurr$1 ?is rule ) reg>d to sudd5 movem5ts is extremely important ,rheumatism is itself n a fatal disease1 yet !re are c]ta9 cases 9 :i* v high temp]ature sets 91 causes delirium1 & dea? ensues at times be=e ! pati5t recov]s consci\sness4 ,:]e rheumatic pati5ts %[ a t5d5cy to run high temp]atures1 t is1 #ajd deg4 or high]1 x is well to be prep>$ = ?is em]g5cy4 ,app5dicitis is v mu* talk$ ab\t 9 our day2 b ! fatal affection repres5t$ by ! new ^w is no m frequ5t ?an x 0 half a c5tury ago1 or1 = t matt]1 tw5ty-five c5turies ago4 ,p di$ ( inflammation ( ! b[els & p]itonitis !n2 & z ! app5dix 0 n kn[n z ! orig9 ( ! tr\ble1 ! fateful "n 0 n ! spectre t x is n[4 ,practically all abdom9al colic--& ?is means #ij p] c5tum ( all ! acute pa9 :i* foll[s ga/ro-inte/9al di/urbance 9 "y or middle-ag$ adults--is due to app5dicitis4 ,x comes on1 z a rule1 9 ! mid/ ( good heal?4 ,x is v trea*]\s1 & :5 ! pati5t is app>5tly b slightly ill1 a sudd5 turn = ! worse may ass]t itself1 & an int5sely pa9ful & pro/rat+ condition develop4 ,:]e symptoms ( app5dicitis are pres5t1 x is ! "p ( safety to h ! pati5t receive at lea/ ! ,sacram5ts ( ,p5ance & ! ,holy ,eu*>i/4 ,:5 p]itonitis develops1 vomit+ is ! rule4 ,h5ce ! advisability ( prompt adm9i/ration ( ,holy ,communion4 ,extreme ,unction c be giv5 ) "s satisfaction1 ev5 dur+ ! di/urb$ p]iod :i* foll[s a beg9n+ p]itonitis4 ,= ! p]itonitis t sometimes results f app5dicitis !re is no hope ( recov]y except by op]ation4 ,op]ation1 to be successful1 mu/ foll[ ! p]=ation ( ! app5dix n lat] ?an by a few h\rs4 #aed ,e>ly pregnancy1 t is1 ! fir/ eight to t5 weeks ( ge/ation1 is sometimes complicat$ by a set ( symptoms ! mo/ prom95t ( :i* are sudd5 v acute pa9s 9 ! l[] "p ( ! abdom51 foll[$ by int5se pro/ration1 & !n by ! symptoms ( int]nal ble$+1--namely1 a s(t pulse1 pallor ) cold extremities1 sigh+ respiration1 & m>k$ t5d5cy to fa9tness4 ,:5 symptoms l ^! occur dur+ ! fir/ ?ree mon?s ( pregnancy1 !y signify1 almo/ )\t exception1 rupture ( an extraut]9e ge/ation-sac4 ,except :]e op]ation c be p]=m$ at once1 ^! cases are almo/ inv>iably fatal4 ,extraut]9e pregnancy occurs ) greate/ frequ5cy 9 wom5 :o1 hav+ _h "o or m *ildr51 !n h a p]iod ( five or m ye>s )\t *ildr51 foll[$ by pregnancy4 ,und\bt$ly1 extraut]9e pregnancy1 ! k ( :i* is ! result ( m$ical advance 9 v rec5t ye>s1 & app5dicitis1 :i* is ! gr[? ( ! la/ twelve ye>s1 7 prom95t factors 9 ! production ( _m inexplicable dea?s 9 hi/ory4 ,^! 7 n infrequ5tly set d[n z due to poison4 ,acute indige/ion 9 eld]ly p is sometimes foll[$ by sudd5 dea?4 ,obs]vations 9 ?is matt] h someh[ become mu* m frequ5t ( late ye>s1 & _m ( ! s-call$ cases ( he>t failure belong to ?is gr\p4 ,! important n]ve trunk t c>ries n]v\s fibres to ! he>t be>s fibres to ! dige/ive tract1 ! oesophagus1 ! /oma*1 ! inte/9es1 ! liv] z well1 & also to ! l>ynx & lungs4 ,!re is a c]ta9 int]communication betwe5 ! impulses :i* pass along ^! v>i\s n]ve fibres4 ,int5se irritation ( ! n]ve end+s 9 any "o ( ^! organs may be reflect$ back ^u ! he>t4 ,curi\sly en\gh ! n]ve fibres to ! he>t t run 9 ?is trunk are _m ( !m inhibitory2 t is to say1 !y less5 ! function ( ! he>t or cause x to /op beat+ entirely4 ,if an int5se n]v\s irritation is set up 9 ! /oma*1 reflex n]v\s impulses may cause ! he>t to /op completely & nev] resume its "w4 ,typical cases ( ?is k9d (t5 occur dur+ ! fir/ cold days ( ! w9t] "t4 ,eld]ly p come to _! meals cold & *illy1 yet ) appetite increas$ by ! brac+ air4 ,!y sit d[n at once1 take a l>g] meal ?an usual1 & !n develop sev]e ga/ritis dur+ ! night4 ,?is is #aee reliev$ by purg+ & vomit+1 & ! pa9 yields to ! adm9i/ration ( morph9e4 ,_! condition improves & all dang] seems pa/1 :51 on sitt+ up sudd5ly ! next day1 or1 if left alone1 gett+ up to get some?+ = !mselves1 !y collapse & are dead be=e help c come to !m4 ,dea?s l ?is sometimes occur 9 dys5t]y also1 ! reason be+ ! int5se n]v\s reflex f ! irritat$ inte/9al n]ve end+s :i* ex]ts its influ5ce ^u ! he>t n]ves4 ,c]ta9 diseases practically always end 9 sudd5 dea? & mu/ be tak5 special c>e ( by ! prie/ = ?is reason4 ,aneurism1 = in/ance1 is "o ( ^!4 ,an aneurism is a wid5+ or dilatation at "s po9t ( an art]y4 ,! mo/ important aneurisms occur 9 ! ar* ( ! aorta1 t is1 9 ! l>ge curv$ art]y :i* comes directly f ! he>t itself & ( :i* all ! o!r art]ies are bran*es4 ,aneurisms develop1 accord+ to ! expression ( a di/+ui%$ ,am]ican physician1 9 ! special vot>ies ( ?ree hea!n div9ities1 ,vulcan1 ,bac*us1 & ,v5us1--t is1 9 ^? :o h work$ too h>d1 9 ^? :o h drunk too h>d1 & 9 ^? :o h devot$ !mselves too mu* to ! pleasures ( ! fle%4 ,! mo/ important factor ( all is1 h[ev]1 ! contraction ( v5]eal disease1 especially ( t =m kn[n z syphilis4 ,! t]m9ation ( aneurism cases is usually by rupture ) pr(use hemorrhage4 ,dea? takes place 9 a mom5t or two4 ,aneurisms (t5 cause int5se pa91 :i* is sometimes ?\ght to be rheumatic 9 orig94 ,if ! aneurism1 9 its enl>gem5t1 meets ) bony /ructure1 x produces absorption ( ! bone by pressure ^u x & s f9ds a way ev5 ?r\gh ! bone to ! ov]ly+ sk94 ,?is process is always int5sely pa9ful1 & %ortly aft] ! aneurism appe>s at ! surface ! pressure ^u ! sk9 causes x to become ?9 & ! aneurism may rupture ext]nally4 ,addison's ,disease always ends sudd5ly4 ,?is is a r>e affection1 describ$ by ,addison1 an ,engli% physician1 "s fifty ye>s ago1 :i* develops 9 individuals ^: supr>5al capsules are deg5]at$4 ,! supr>5al capsules are little bodies ( half-moon %ape :i* lie above ! kidneys4 #aef ,_! deg5]ation produces a great l[]+ ( blood pressure4 ,! pati5t becomes int5sely weak1 muscul> movem5t becomes impossible1 intellectual processes cause great fatigue1 & f9ally blood pressure becomes s l[ t fatal collapse ensues f lack ( blood 9 ! bra94 ,! ext]nal symptoms ( ^! cases is a pigm5tation1 t is1 a v d>k discol\ration ( ! sk91 :i* develops r e>ly 9 ! disease4 ,! tongue especially becomes a v d>k br[n4 ,areas ( pigm5tation also occur :]e ! sk9 is irritat$1--at ! wri/s f ! irritation ( ! coat sleeves1 at ! edge ( ! hair f ! irritation ( ! hat4 ,dr4 ,s4 ,weir ,mit*ell1 9 8 ,autobiography ( a ,quack1 has describ$ "o ( ^! cases v /rik+ly4 ,! h]o ( ! tale is f\nd dead "o morn+ by ! nurse 9 ! hospital1 aft] he has be5 feel+ q z well z usual = "s "t4 ,x mu/ n be =gott5 t pati5ts :o are burn$ ext5sively v frequ5tly die %ortly aft] ! accid5t4 ,a burn t involves m ?an "o-half ( ! body1 no matt] h[ sup]ficial ! burn+ may be1 w always h a fatal t]m9ation4 ,deep burns 9 "o "p1 unless x is "s v vital "p1 are n s s]i\s z ext5sive sup]ficial burns4 ,pati5ts ) ext5sive burns frequ5tly rema9 9 enc\rag+ly good condition = sev]al days1 & !n h a sudd5 *ange = ! worse4 ,sometimes dea? takes place 9 coma4 ,sometimes x takes place z ! result ( a p]=ation ( ! duod5um4 ,^! p]=ations ( duod5al ulc]s may take place z late z a week to t5 days aft] ! burn4 ,!y are always foll[$ by symptoms ( p]itonitis & ! condition ( int5se pro/ration :i* ?is br+s on4 ,su* cases ne$ to be prep>$ = ! wor/ aft] ! fir/ acute symptoms ( ! burn h subsid$1 :5 a c]ta9 am\nt ( peace ( m9d is re/or$4 ,cirrhosis ( ! liv] n infrequ5tly causes sudd5 dea?4 ,cirrhosis is an affection 9 :i* a l>ge "p ( ! liv] sub/ance prop] deg5]ates1 & its place is tak5 by connective tissue4 ,x is typically a disease ( p ( alcoholic habit4 ,x occurs 9 ^? :o are engag$ 9 ! sale ( spirits1 ?\gh ! alcoholic absorption does n take place #aeg ?r\gh ! sk91 b 9 a mu* m direct way4 ,x is mo/ frequ5t 9 p :o take /rong spirits on an empty /oma*4 ,^? :o are mu* expos$ to *anges ( temp]ature are especially liable to =m su* habits4 ,x is f\nd mo/ frequ5tly 9 ! driv]s ( wagons & c>s1 9 policem51 & 9 sea-capta9s1 sailors1 & ! l4 ,:5 cirrhosis causes sudd5 dea?1 x is ne>ly always by hemorrhage4 ,! hemorrhage takes place f ! oesophagus1 "s ( ! l>ge ve9s ( :i* h become dilat$ until ! ?9 walls are unable to reta9 ! blood4 ,! dilatation is due to int]f]5ce ) ! v5\s circulation 9 ! liv]4 ,( late ye>s pa?ologi/s & m$ical m51 especially ^? :o are int]e/$ 9 *ildr5's diseases1 h devot$ consid]able "t to ! /udy ( c]ta9 cases ( sudd5 dea?1 :i* h long be5 v my/]i\s4 ,infants (t5 die :ile 9 app>5t good heal? )\t any adequate reason t c be f\nd1 ev5 on ! mo/ c>eful autopsy4 ,*ildr5 ( an old] gr[? sometimes die sudd5ly z ! result ( "s slight %ock or fright1 or !y die aft] ! adm9i/ration ( a few :iffs ( *lor(orm1 giv5 to help 9 ! p]=mance ( "s simple surgical op]ation1 or !y die at ! beg9n+ ( "s infecti\s fev] :i* !y ought to be able to )/& )\t any difficulty4 ,a di/+ui%$ pa?ologi/ at ,vi5na1 ,pr(essor ,paltauf1 :o 0 ! coron]'s physician ( ! city & _h a l>ge numb] ( ^! sudd5 dea?s to inve/igate1 f\nd t 9 mo/ ( ! cases "o abnormal condition 0 con/antly pres5t4 ,?is consi/$ 9 an enl>gem5t ( ! lymph gl&s all ov] ! body4 ,! lymph gl&s 9 ! neck 7 involv$1 also ! tonsils & lymphoid tissue at ! back ( ! ?roat1 ! s]ies ( lymph gl&s 9 ! gro91 &1 f9ally1 !re 0 a hyp]trophy ( ! lymphoid tissue t occurs all along ! inte/9al tract4 ,?is condition ( hyp]trophy ( lymphoid tissue has come to be kn[n z ! lymphatic dia!sis or con/itution4 ,x is ne>ly always accompani$ by a di/9ct hyp]trophy ( ! ?ymus gl&4 ,! ?ymus gl& is an organ :i* occurs 9 ! upp] "p ( ! ?orax ( ! *ild1 b :i* atrophies & practically disappe>s aft] ! age ( two ye>s4 ,9 ^! cases x is f twice to ?ree #aeh times its normal size 9 ! infant1 & 9 old] *ildr5 x is p]si/5t--t is1 reta9s its prim>y size1 ?\gh 9 ! ord9>y c\rse ( nature x %\ld atrophy4 ,?is lymphatic dia!sis und\bt$ly has consid]able to d ) ! sudd5 dea?s :i* occur 9 ^! pati5ts4 ,:at ! exact connection is we d n z yet def9itely "k4 ,un=tunately1 moreov]1 ?is lymphatic con/itution gives no sure sign ( its exi/5ce be=e ! occurr5ce ( ! fatal t]m9ation4 ,enl>gem5t ( ! gl&s ( ! neck & ( ! gro91 ) "s enl>gem5t ( ! tonsils1 occurs 9 delicate *ildr5 )\t necess>ily be+ symptoms ( ! lymphatic dia!sis4 ,! enl>gem5t or p]si/5ce ( ! ?ymus c be bett] recognis$1 & doctors n[ seldom fail to notice x4 ,:]e any suspicion ( su* a condition exi/s 9 *ildr5 ( f eight to sixte5 or sev5te5 ye>s ( age1 prop] precautions mu/ be tak5 to prev5t sudd5 fatal t]m9ation ( any ev5 mild disease )\t due prep>ation4 ,und\bt$ly _m ( ! cases ( sudd5 dea? "u *lor(orm & e!r 9 *ildr5 & "y p]sons are due to ! exi/5ce ( ?is lymphatic dia!sis4 ,diseases1 l tub]culosis & canc]1 t run a long b assur$ly fatal c\rse1 usually t]m9ate unexpect$ly4 ,! tub]cul\s pati5t p>ticul>ly w almo/ surely be plann+ = next ye> ! day be=e he dies4 ,?is condition ( euphoria1 t is1 ( s5se ( well be+1 0 recognis$ z associat$ ) tub]culosis z f> back z we h any hi/ory ( ! disease4 ,hippocrates po9t$ out z "o ( ! symptoms ( consumption ! spes ph?isical or consumptive hope4 ,if ! pati5t has be5 v mu* run d[n1 dea? may take place f ?rombosis ( "s ( ! art]ies4 ,if ! ?rombosis takes place 9 ! bra91 consci\sness w be lo/1 & ! pati5t w (t5 die )\t recov]+ x4 ,pati5ts (t5 develop tub]cles 9 _! bra9 z ! result ( a spread ( ! disease beyond ! lungs1 & !n1 z a rule1 dea? w take place 9 ! mid/ ( a p>alysis1 :i* may be accompani$ by loss ( consci\sness t la/s = sev]al days or a week or m4 ,canc] pati5ts also die sudd5ly1 or at lea/ unexpect$ly1 at ! end4 ,v (t5 9 !m1 z 9 tub]culosis1 #aei ?rombosis plays an important role 9 ! fatal t]m9ation4 ,9 canc] ( ! /oma*1 p]itonitis f p]=ation ( ! /oma* may close ! sc5e4 ,! fatal t]m9ation 9 canc] ( ! ut]us is (t5 br\ght ab\t by ! developm5t ( uraemic symptoms4 ,! new gr[? 9 ! pelvis involves ! uret]s1 prev5ts ! free egress ( ur9e1 & s causes ! ret5tion 9 ! sy/em ( poison\s sub/ances t %\ld be excret$4 ,canc] 9 o!r p>ts ( ! body (t5 causes dea? by meta/atic canc]s1 t is1 (f%oots ( ! orig9al canc] :i* occur 9 o!r organs4 ,usually ^! are 9 ! liv]1 b sometimes !y are 9 ! bra91 & sometimes 9 ! bones t surr\nd ! sp9al cord4 ,9 ! c\rse ( _! gr[? !y cause pressure symptoms ^u ! n]v\s sy/em1 & ?is leads to dea?4 ,if pati5ts become v mu* weak5$1 z is n infrequ5tly ! case1 ?rombosis occurs1 & portions ( ! clots may be %ot into ! pulmon>y ve9s1 & cause dea? 9 ?is way4 ,two affections :i* are q common1 "o ( !m usually involv+ no dang] at all1 sometimes cause sudd5 dea?4 ,!y are v>icose ve9s & a dis*>g+ e>4 ,v>icose ve9s are ! enl>g$ ve9s :i* occur on ! limbs ( a great _m eld]ly p4 ,if ^! p become run d[n 9 heal? & !n exhau/ !mselves by ov]work1 ! circulation ?r\gh ^! enl>g$ ve9s is sometimes s imp$$ t clott+--?rombosis1 z x is call$--occurs4 ,if a portion ( ! clot becomes deta*$1 & is c>ri$ (f into ! circulation1 a s-call$ embolus1 ?is may cause sudd5 dea?1 ei!r by its effect ^u ! he>t1 or m usually ^u ! lungs4 ,middle-e> disease causes dea?1 ei!r by produc+ an abscess ( ! bra91 or by caus+ ?rombosis ( "s ( ! l>ge ve9s )9 ! skull4 ,! dang]s involv$ 9 a dis*>ge f ! e> are n[ well recognis$4 ,insurance companies refuse to take risks on ! lives ( p]sons affect$ by *ronic otitis m$ia1 z x is call$ sci5tifically4 ,su* p]sons may run along 9 p]fect good heal? = ye>s )\t accid5t1 b a sudd5 /oppage ( ! fl[ may be ! signal = ! =mation ( ! bra9 abscess1 ) almo/ inevitable dea?4 #afj ,c]ta9 sev]e =ms ( ! infecti\s fev]s are v (t5 fatal4 ,^! =ms are popul>ly kn[n z black fev]s1 t is1 black measles1 black sc>let fev]1 etc4 ,^! fulm9ant =ms occur especially 9 camps1 b>racks1 orphan asylums1 jails1 & ! l1 :]e ! hygi5ic conditions ( ! pati5ts h be5 v poor1 & :]e ! resi/ive vitality has1 z a consequ5ce1 become greatly l[]$4 ,! black spots t occur on su* pati5ts are really due to small hemorrhages into ! sk94 ,! hemorrhages are caus$ by a lack ( resi/ance 9 ! blood-vessels & by a *ange 9 ! con/itution ( ! blood t all[s x to escape easily f ! vessels4 ,:]e su* cases occur1 pati5ts %\ld be fully prep>$ = ! wor/ ,z a rule1 ! mortality is f #dj to #gj p] c5tum4 ,acute pancreatitis is a uni=mly fatal disease1 ?\gh =tunately x is r>e4 ,x occurs mu* m frequ5tly1 h[ev]1 ?an us$ to be ?\ght4 ,x occurs 9 p]sons ov] ?irty :o h be5 = "s ye>s addict$ to ! use ( alcohol4 ,! symptoms ( ! disease are sev]e pa9 9 ! upp] left zone ( ! abdom51 t is1 above & to ! left ( ! umbilicus4 ,?is is accompani$ by nausea & vomit+4 ,collapse ensues & dea? takes place on ! second to ! f\r? day ( ! affection4 ,?is disease may h important m$ico-legal be>+s4 ,"s slight injury 9 ! abdom51 z f a bl[ or a kick1 may precipitate an attack 9 pr$ispos$ individuals4 ,accusation ( murd] may result4 ,! m5tal attitude ( ! physician & ! cl]gyman ) reg>d to su* cases mu/ be v cons]vative4 ,no op9ion z to possible culpability %\ld be v5tur$4 ,*oleli?iasis1 t is1 /one 9 ! bile duct1 may n only cause sev]e pa91 b may lead to rupture ( ! duct & a rapidly fatal t]m9ation4 ,ow+ to ! practice ( we>+ corsets1 gall-/ones occur mu* m commonly 9 wom5 ?an 9 m54 ,tw5ty-five p] c5tum ( all wom5 ov] #fj ye>s ( age are f\nd to h gall-/ones4 ,:ile ^! cases suff] f int5se pa9 !y are v seldom fatal4 ,b x mu/ n be =gott5 t a fatal issue c take place ei!r f collapse & /oppage ( ! he>t1 because ( ! int5sity ( ! pa91 or f p]=ative p]itonitis4 #afa ,! p]=ation ( a ga/ric ulc] may cause symptoms :i* rapidly place ! pati5t 9 a condition 9 :i* ! adm9i/ration ( ! ,sacram5ts is v unsatisfactory4 ,ga/ric ulc]s occur especially 9 "y wom51 usually 9 ^? :o foll[ "s indoor occupation4 ,its fav\rite victims are cooks1 ?\gh laundresses1 seam/resses1 & ev5 cl]ks 9 /ores1 suff] f x mu* m ?an ^? engag$ 9 o!r occupations4 ,x occurs by pref]5ce 9 anaemic or *lorotic wom54 ,sometimes1 h[ev]1 z 9 ! case ( cooks1 ! pati5ts may seem to be 9 good heal?4 ,acute pa9 9 ! /oma* region1 foll[$ by symptoms ( collapse1 %\ld 9 su* p]sons be a signal = ! adm9i/ration ( all ! ,sacram5ts4 ,fatal p]itonitis soon br+s on a /ate ( pa9ful uneas9ess ill adapt$ to ! prop] dispositions = ! ,sacram5ts4 ,two diseases t are =tunately v r>e1 b :i* are almo/ uni=mly fatal1 des]ve to be m5tion$ "h4 ,9 bo? ( !m ! symptoms ( ! disease are manife/$ ?r\gh ! n]v\s sy/em4 ,!y are tetanus & hydrophobia4 ,tetanus occurs z a consequ5ce especially ( a w\nd :i* has be5 contam9at$ by ! /reet dirt ( a l>ge city1 or ! refuse ( a f>m4 ,x foll[s deep w\nds su* z are made by a hayrake or a pit*=k2 or se>$ w\nds1 su* z are made by a toy pi/ol4 ,a s]um = ! treatm5t ( ! disease has be5 discov]$1 b un=tunately ! fir/ symptom ( tetanus is n ! fir/ symptom ( ! disease1 b ! prelim9>y symptom ( ! t]m9al /age ( ! disease1 ! affection ( ! n]v\s sy/em4 ,practically all cases ( acute tetanus t]m9ate fatally4 ,z soon z a pati5t exhibits ! *>act]i/ic symptoms1 ! lockjaw1 ! /iff neck1 & ! rigid muscles1 all ! ,sacram5ts %\ld be adm9i/]$4 ,9 tetanus1 z a rule1 consci\sness is pres]v$ until v late 9 ! disease4 ,9 sev]e cases1 h[ev]1 a convulsive /ate ( int5se irritability develops 9 :i* ! slighte/ s\nd or ef=t br+s on a s]ies ( spasmodic seizures4 ,pati5ts mu/ be prep>$1 !n1 e>ly 9 ! disease1 if possible4 ,rabies or hydrophobia is a disease :i* claims a c]ta9 numb] ( victims e ye> 9 our l>ge cities4 #afb ,its symptoms are ! occurr5ce ( fev] & disquietude1 ) spasmodic convulsions ( ! muscles ( ! ?roat :5ev] an attempt is made to swall[4 ,^! symptoms come on f ?ree to fifte5 days aft] ! bite ( a mad dog4 ,unless ! ,pa/eur treatm5t has be5 tak5 %ortly aft] ! bite ( ! animal 0 inflict$1 no treatm5t t pres5t-day m$ic9e possesses is able to affect ! c\rse ( ! disease1 & pati5ts ne>ly always die4 ,_! prep>ation1 !n1 is a matt] ( necessity z soon z ! fir/ assur$ symptoms ( ! disease %[ !mselves4 ,footnote #d ,footnote #d3 ,"o _c help b add a ^w "h z to ! cause ( ! disease1 because cl]gym5 c by _! advice d some?+ to rem$y ! evil :i* lies at ! root ( ! infliction4 ,hydrophobia is due to /ray dogs4 ,9 practically e case ! fatal bite is inflict$ by "s animal t no "o 9 ! neighb\rhood claims4 ,bites by pet dogs are r>ely fatal4 ,if cl]gym5 w\ld use _! influ5ce to suppress ! dog nuisance we w\ld soon h an end ( hydrophobia4 ,alcoholic subjects are v liable to unexpect$ dea? f a good _m causes4 ,pati5ts suff]+ f delirium trem5s1 = in/ance1 may die sudd5ly 9 ! mid/ ( a p>oxysm ( excitem5t4 ,su* a t]m9ation is n frequ5t1 b x has occurr$ (t5 en\gh to make x ! cu/om1 at asylums = inebriates1 to w>n fri5ds :o br+ pati5ts ( ! liability ( su* an accid5t4 ,x is n s apt to happ5 dur+ a fir/ attack ( delirium trem5s z dur+ subsequ5t attacks4 ,x is mo/ frequ5t among ^? ^: addiction to alcohol = ye>s has caus$ repeat$ p>oxysms ( delirium trem5s4 ,! cause ( ! sudd5 dea? is usually he>t failure4 ,?is t]m means no?+ 9 itself1 b x expresses ! fact t a deg5]at$ he>t f9ally refuses to act4 ,alcoholic poison 9 ! circulation has l$ to fibroid deg5]ation ( ! muscul> elem5ts ( ! he>t & made !m incapable ( prop] function1 or at lea/ has greatly hamp]$ _! action1 & ! he>t ceases to beat4 ,x mu/ be borne 9 m9d t *ronic alcoholism makes a numb] ( s]i\s organic diseases run a lat5t c\rse4 ,! pati5t is apt to attribute 8 symptoms to ! aft] effects ( ! abuse ( alcohol4 ,unless ! doctor :o is call$ 9 makes a v c>eful exam9ation1 s]i\s kidney disease or ev5 advanc$ pneumonia may n be discov]$4 ,alcoholic subjects be> pneumonia v badly1 & ! prelim9>y #afc symptoms ( ! disease are (t5 completely conceal$ by ! symptoms due to ! pati5t's alcoholism4 ,o!r infecti\s diseases1 z typhoid fev]1 tub]culosis1 & ev5 v>i\s =ms ( m5+itis1 may run a v insidi\s c\rse & give b v slight w>n+ ( _! pres5ce4 ,! result is t ^! diseases are v frequ5tly fatal 9 alcoholic subjects4 ,old inebriates be> op]ations badly1 & ! mortality aft] any op]ation 9 su* subjects is di/9ctly high] ?an 9 normal individuals4 ,"o reason = ?is is t consid]ably m e!r or *lor(orm is requir$ to produce n>cosis 9 alcoholic subjects ?an 9 ord9>y individuals4 ,e!r & *lor(orm are v irritant to ! kidneys4 ,! kidneys are prone to be affect$ m or less 9 old alcoholic subjects4 ,dea? f o$ema ( ! lungs or f "s =m ( pneumonia is n infrequ5t 9 ^! po/-op]ative cases1 & gives z a rule b little w>n+ ( its approa*4 ,x is cle>1 !n1 t alcoholic subjects mu/ be prep>$ ) special c>e :5ev] disease is actually pres5t or an op]ation is to be p]=m$4 ,too great c>e c sc>cely be ex]cis$ 9 _! reg>d4 ,:at w\ld seem ov]caution w save _m a he>tburn to fri5ds & prie/1 = x is 9 alcoholic subjects especially t "s ( ! sadde/ cases ( unexpect$ dea? )\t prep>ation occur4 ,,james ,j4 ,,wal%4 #afd ,,xiii ,,! ,,mom5t ,,( ,,dea? ,x n infrequ5tly happ5s t a prie/ rea*es a pati5t :o has j di$4 ,conditional absolution1 baptism1 or o!r spiritual m9i/ration might h be5 (f]$ if !re 7 signs ( life1 b ! he>t & lungs are /ill1 ! pati5t is dead1 & ! prie/ leaves ! place )\t do+ any?+4 ,yet ! pati5t may n really be dead4 ,our k ( ! precise "t ! s\l leaves ! body is v imp]fect4 ,!re is1 we are aw>e1 a close connection betwe5 ! vital functions ( ! body1 tak5 toge!r or s+ly1 & cellul> activity4 ,if ! cells are n de/roy$1 a vital function sometimes may be re/or$ aft] its cessation1 b if ! cells are de/roy$ up to a c]ta9 ext5t1 ! vital function is n recov]able4 ,= example1 if ! v>i\s bodily cells ( a pati5t dead f diph!ria are exam9$ microscopically1 x w be f\nd t ! diph!ria tox9 has dis9tegrat$ ! nuclei ( ^! cells4 ,:at numb] ( cells proportionate to ! :ole 91 say1 ! he>t %\ld be de/roy$ be=e ! vitality ( t organ is lo/1 is n cle>ly kn[n4 ,:]e ! cells are intact1 or ne>ly s1 m]e abs5ce ( respiration1 or ( ev5 ! he>t movem5t1 are n absolute pro( ( dea?4 ,num]\s cases are f\nd 9 m$ical records ( p]sons t _h be5 ly+ "u wat] = _m m9utes1 up to ev5 an h\r1 b :o 7 re/or$ to life by pati5t & skilful ef=ts2 & ( late rem>kable re/orations aft] :at 0 practically dea?1 "u anae/hesia & o!rwise1 h be5 report$4 ,! te*nique consi/s *iefly 9 rhy?mical compression ( ! he>t1 commonly aft] surgical exposure ( t organ1 ) artificial respiration1 &1 9 ,crile's me?od1 p]iph]al resi/ance is #afe employ$ to raise ! blood pressure4 ,ludwig 9 #ahdb1 exp]im5t$ 9 c>diac massage1 & ,pr(essor ,s*iff at ,flor5ce 0 ! fir/ to apply ! me?od to human subjects4 ,kemp & ,g>dn]1 9 ! ,new ,york ,m$ical ,j\rnal1 ,may #g1 #aijd1 describ$ v>i\s me?ods us$ 9 attempt+ resuscitation4 ,pr(essor ,w4 ,w4 ,ke5 ( ,philadelphia has collect$ ! records ( ! *ief cases ( resuscitation aft] app>5t dea? 7see ,! ,!rapeutic ,gazette1 ,april1 #aijd71 & "s ( ^! are ! foll[+3 ,dr4 ,*ri/ian ,igel/rud ( ,tromsoe1 ,norway1 9 #aija1 0 op]at+ ^u a woman1 #dc ye>s ( age1 = canc]4 ,dur+ ! op]ation1 :i* 0 a coeliotomy1 %e collaps$ & h] he>t ceas$ beat+4 ,aft] ! usual means = resuscitation _h be5 ineffectively tri$1 h] he>t 0 laid b>e4 ,igel/rud took hold ( ! he>t ) 8 h& & made rhy?mic pressure ^u x4 ,9 ab\t "o m9ute ! he>t began to pulsate4 ,! pati5t 0 dis*>g$ f ! hospital five weeks aft]w>d4 ,tuffi] 7,bull1 et mem4 soc4 de *ir41 #ahih1 p4 #icg7 9 #ahih _h a pati5t ^: he>t /opp$ aft] an op]ation = app5dicitis4 ,! surgeon _h left ! op]at+ room1 b he return$1 laid b>e ! he>t1 press$ x rhy?mically1 & aft] two m9utes x began to move aga94 ,! pati5t brea!d regul>ly1 8 eyes op5$1 ! dilat$ pupils contract$1 & he turn$ 8 head4 ,aft] ! op5+ ov] ! he>t _h be5 clos$1 h[ev]1 he di$4 ,prus 7,wi5] kl94 ,wo*41 no4 #ba1 #aijj1 p4 #dhf7 by ! same me?od />t$ contractions ( ! he>t aft] #ae m9utes 9 a man t _h hang$ himself4 ,! ef=t at resuscitation 0 made two h\rs aft] ! suicide _h be5 discov]$1 b ! recov]y did n g beyond imp]fect movem5ts ( ! he>t1 :i* gradually ceas$4 ,maag 7,c5tralbl4 f4 ,*ir41 #aija1 p4 #bj7 reports ! case ( a man :o "u *lor(orm anae/hesia ceas$ brea?+ & ^: he>t /opp$4 ,aft] #aj m9utes ! pati5t 0 pulseless1 )\t respiration1 cyanotic1 & cold4 ,! he>t 0 expos$ & compress$ rhy?mically2 x 0 re/or$ to action1 & he began to brea!4 ,he rema9$ alive = #ab h\rs1 seem+ly asleep2 !n he di$4 #aff ,/>l+ & ,lane 7,lancet1 ,nov4 #bb1 #aijb1 p4 #acig7 7 op]at+ ^u a man #fe ye>s ( age4 ,! he>t & respiration ceas$4 ,lane put 8 h& into ! abdom9al incision & squeez$ ! he>t ?r\gh ! diaphragm4 ,aft] twelve m9utes ( artificial respiration ! lungs & he>t began to act4 ,! pati5t aft]w>d 0 dis*>g$ f ! hospital cur$4 ,sick 7,c5tralblatt f4 ,*irurgie1 ,sept4 #e1 #aijc1 p4 #iha7 reports a v rem>kable case4 ,a boy ( #ae ye>s ( age di$ ^u ! op]at+ table4 ,?ree qu>t]s ( an h\r aft] ! he>t _h ceas$ to beat x 0 laid b>e4 ,! flaps did n ble$1 ! p]ic>dium 0 bloodless1 ! he>t 0 motionless1 relax$1 & cold4 ,aft] a qu>t] ( an h\r1 dur+ :i* ! he>t 0 compress$1 & artificial respiration 0 kept up1 t is1 "o h\r aft] :at any physician w\ld call dea?1 ! he>t 0 beat+ & respiration 0 re/or$4 ,two h\rs lat] ! boy became consci\s & compla9$ ( great ?ir/ & dyspnoea4 ,he rema9$ 9 ?is condition = tw5ty-sev5 h\rs1 & dur+ t "t 8 spee* 0 indi/9ct b intelligible4 ,he !n di$4 ,dr4 ,george ,w4 ,crile1 ( ,clevel&1 ,ohio1 reports ! case ( a woman ^: he>t movem5t & respiration _h ceas$ = six m9utes4 ,%e 0 re/or$ completely1 ev5 )\t expos+ ! he>t4 ,dr4 ,crile uses an inflat$ rubb] suit on ! pati5t to raise ! blood pressure by p]iph]al resi/ance--he does n expose ! he>t4 ,he _h ano!r case1 a man #ch ye>s ( age1 :o di$ dur+ op]ation1 0 resuscitat$1 & di$ aga9 two h\rs lat]4 ,two ,hung>ian lab\r]s1 ^: skulls _h be5 cru%$ 9 ! same accid5t1 7 br\ght into ,dr4 ,crile's cl9ic 9 a dy+ condition4 ,! he>t ( "o ( ^! m5 ceas$ beat+ z he 0 br\ght into ! op]at+ room4 ,aft] n9e m9utes ! surgeons began to "w ^u him to resuscitate him4 ,!y succe$$1 b he liv$ = only #bh m9utes4 ,!y !n exam9$ ! o!r man & f\nd him dead4 ,j #de m9utes aft] ?is second pati5t _h be5 br\ght into ! op]at+ room ! ef=t to resuscitate him began4 ,z he _h n be5 obs]v$ :ile ! physicians _h be5 engag$ ) ! fir/ man1 !y d n "k :5 8 he>t #afg _h ceas$ to beat1 b he c]ta9ly 0 dead 9 ! op9ion ( skill$ obs]v]s4 ,!y resuscitat$ him s well t he mov$ 8 head away f ! op]ator :o 0 reliev+ ! depression ( ! skull1 b he di$ aga9 9 #cd m9utes4 ,^! cases are n :at is commonly call$ conditions ( susp5d$ animation4 ,all ! pati5ts w\ld h be5 pron\nc$ dead by any physician1 & if !y _h be5 left unt\*$1 !y surely nev] w\ld h be5 reviv$4 ,!re h be5 ab\t ?irty attempts made by surgeons to re/ore pati5ts :o 7 dead 9 ! full acceptance ( ! t]m z us$ at pres5t4 ,f\r ( ^! attempts result$ 9 complete success1 o!rs 9 a p>tial recov]y1 & _m 7 )\t positive result4 ,! numb] ( complete & p>tial resuscitations1 h[ev]1 are en\gh to ju/ify a prie/ 9 giv+ conditional absolution or baptism )9 an h\r1 or ev5 two h\rs1 aft] a pati5t has to all appe>ance di$1 especially 9 accid5t cases4 ,we d n "k :5 ! s\l ent]s ! body1 & !re is ! same d\bt z to ! mom5t :5 ! s\l leaves ! body4 ,9 ^! latt] cases we %\ld give ! pati5t ! b5efit ( ! d\bt4 ,,au/9 ,,omalley4 #afh ,,xiv ,,! ,,prie/ ,,9 ,,infecti\s ,,diseases ,! subject ( infection is complicat$1 & ! m$ical doctr9e conc]n+ x is f> f c]ta9ty despite ! multitude ( facts pres5t$ by bact]iologi/s1 *emi/s1 pa?ologi/s1 & cl9icians4 ,be=e ! days ( bact]iology ! t]m ,infecti\s commonly 0 appli$ to diseases produc$ by no kn[n or def9able influ5ce ( any p]son on ano!r1 b :]e9 common climatic or o!r widespread conditions 7 ?\ght to be *iefly in/rum5tal 9 ! diffusion4 ,! contagi\s disease 0 "o transmitt$ by contact ) ! pati5t1 ei!r directly by t\*1 or indirectly ?r\gh ! use ( ! same articles4 ,n[ we "k t _m diseases call$ infecti\s are caus$ by micro-organisms1 & we gr\p o!rs "u ?is class because we hold !oretically t !y h _! orig9 9 microbes n yet isolat$4 ,h5ce we def9e an infecti\s disease z "o :i* is caus$ by a liv+ pa?og5ic micro-organism1 :i* ent]s ! tissues f )\t1 & is capable ( multiply+ !re94 ,^! micro-organisms h a "t ( incubation dur+ :i* a poison is made 9 ! tissues1 & ?is br+s ab\t ! intoxication we call ! disease4 ,infection is a g5]al t]m t includes contagion2 & contagi\s diseases are infective diseases t may be transmitt$ directly or indirectly f pati5t to pati5t4 ,! pa?ological micro-organisms ) :i* we %all deal 9 ?is article are 7#a7 ! ,s*izomycetes or ,fission-,fungi1 :i* are microscopical organisms t multiply by fission1 & are commonly kn[n z ,bact]ia2 & 7#b7 a few ,protozoa1 :i* are animal micro-organisms4 ,! bact]ia are class$ ) plants because1 l plants1 #afi !y d]ive n\ri%m5t f bo? organic & inorganic mat]ial4 ,!y h no se$s or fl[]s1 b _m ( !m are reproduc$ by spores4 ,!y consi/ ( cells1 s+le or gr\p$1 :i* :5 sph]ical are call$ cocci1 :5 rod-%ap$1 bacilli1 :5 spiral1 spirilla4 ,!re are v>i\s subdivisions ( ^! gr\ps4 ,we d n "k :e!r bact]ial cells h nuclei or n4 ,a micro-organism is a p>asite :5 x c live 9 animal tissues4 ,x is a saphrophyte :5 x c exi/ outside animal tissues4 ,if a p>asite _c exi/ outside animal tissues1 x is an obligatory p>asite2 if x c1 x is a facultative saphrophyte4 ,simil>ly ! saphrophytes are class$ z obligatory saphrophytes & facultative p>asites4 ,pa?ological micro-organisms h v complicat$ products :i* are 9 l>ge "p poison\s4 ,bact]iologi/s require sev5 conditions to prove a micro-organism ! specific cause ( a giv5 disease1 & all ^! conditions h be5 fulfill$ = an?rax1 diph!ria1 & tetanus4 ,! specificity has be5 satisfactorily settl$ = gl&]s1 mal>ia1 tub]culosis1 act9omycosis1 gonorrhoea1 & malignant o$ema4 ,x has be5 practically settl$ = typhoid1 influ5za1 ! ,madura disease1 & ! bubonic plague2 & incompletely def9$ = leprosy1 relaps+ fev]1 & ,malta fev]4 ,!re are c]ta9 diseases :i* are n call$ specific1 because !y may be produc$ by v>i\s micro-organisms4 ,^! are pneumonia1 o/eomyelitis1 septicaemia1 pymaeia1 endoc>ditis1 m5+itis1 erysipelas1 ang9a ,ludovici1 bron*o-pneumonia1 & simil> maladies4 ,*ol]a & dys5t]y also might be gr\p$ ) ^!1 z *ol]a appe>s to be produc$ by v>i\s vibrios & dys5t]y by diff]5t amoebae4 ,!re are o!r infective diseases1 9 :i* we h n yet f\nd ! causative micro-organism1 b we presume its exi/5ce4 ,^! are3 rabies1 syphilis1 yell[ fev]1 d5gue1 typhus1 mumps1 :oop+-c\gh1 smallpox1 measles1 sc>let fev]1 & o!rs among ! exan!mata4 ,mal>ia & simil> diseases are caus$ by plasmodia1 :i* are protozoa & n bact]ia4 #agj ,! prie/ is almo/ z frequ5tly expos$ to ! dang] aris+ f contagion z ! physician is1 & a prie/ t (t5 m9i/]s to ! sick is liable to gr[ imprud5tly indiff]5t to dang]4 ,= "o prie/ t is too mu* afraid ( disease we f9d a hundr$ t h n suffici5t dread4 ,no matt] :at m$ical sci5ce may say to ! contr>y1 _m prie/s hold t !y h (t5 left smallpox cases1 = example1 )\t dis9fect+ !mselves1 & t !y h n spread ! disease4 ,?is is a v ra% ass]tion4 ,x is absolutely c]ta9 t smallpox has be5 communicat$ to susceptible p]sons by ^? com+ f pati5ts ill ) t disease m]ely pass+ ! susceptible man on ! /reet4 ,! numb] ( p]sons t w n take smallpox :5 expos$ to x is v l>ge4 ,9 ,wa%+ton 9 #ahie1 dur+ an epidemic ( smallpox1 #ahg p]sons1 to my p]sonal k1 7 expos$ to "o gr\p ( #ci smallpox pati5ts )\t tak+ ! disease4 ,! unh>m$ _h be5 pres5t 9 sick-rooms or _h ev5 nurs$ ! pati5ts1 n kn[+ t ! disease 0 smallpox4 ,9 ?is epidemic eight p]sons liv$ 9 ! same rooms )1 or visit$ frequ5tly1 two pati5ts t aft]w>d di$ ( virul5t smallpox1 & none ( ! eight took ! disease4 ,"o ( ^! eight1 h[ev]1 w5t into a dram%op1 _h "o glass ( be] & left imm$iately1 & 9 f\rte5 days aft]w>d 7! av]age "t ( incubation7 we took ! b>keep] to ! smallpox hospital4 ,?is b>keep] _h n be5 expos$ to smallpox except by contact ) ! man m5tion$ "h4 ,!re 7 ab\t #fj cases ( smallpox 9 t epidemic1 & we trac$ e "o to direct or indirect contact ) "o initial case4 ,if we 7 infect$ by e exposure to contagi\s disease ! _w w\ld be depopulat$4 ,x is true t y _c give "s p]sons diph!ria if y actually put ! ,klebs-,loeffl] bacillus into _! m\?s1 & nurses & physicians 9 consumptive w>ds h ! tub]cle bacillus 9 _! no/rils )\t ill effect4 ,s = _m diseases2 b x un=tunately rema9s true t !re are susceptible p]sons ev]y:]e :o w at once take a disease :5 !y are expos$ to x4 #aga ,immunity *anges 9 ! same p]son4 ,/>vation1 fatigue1 loss ( blood1 unsuitable diet1 exposure to heat1 cold1 & moi/ure1 & o!r influ5ces less5 ! p[] ( resi/ance to infection4 ,m5 v>y almo/ z d ! l[] animals z reg>ds infection4 ,! quantity ( tetanus tox9 t w kill #djj horses w n bo!r a h52 ,alg]ian %eep & ! :ite rat are n affect$ by an?rax1 b o!r %eep & ! br[n rat are v susceptible2 a hog w n take gl&]s1 man & a horse w2 m51 cattle1 & monkeys h tub]culosis1 dogs & goats d n2 :ite m5 ) few exceptions are susceptible to yell[ fev] & mal>ia1 negroes are practically immune2 negroes readily succumb to ! fatal sleep+ sickness1 :ite m5 are almo/ immune2 & simil> diff]5ces are obs]vable 9 ! same race or family4 ,! "q ( immunity to infecti\s disease is v difficult to make cle> because x is s te*nical1 & x is only a !ory at be/4 ,! poison ( an infecti\s disease kills by splitt+ & de/roy+ ! nuclei ( ! body's cells4 ,! toxic products ( ! micro-organisms seem to become *emically unit$ ) c]ta9 molecules ( ! body cells & to inhibit ! normal function ( ^! molecules4 ,accord+ to ,erli*'s !ory !re are o!r molecules 9 cells :i* neutralise toxic molecules1 & :5 ! neutralis+ molecules appe> 9 excess ! pati5t recov]s4 ,^! neutralis+ bodies are call$ antitox9s4 ,"s antitox9s are always pres5t 9 cells1 & :]e ! normal quantity ( ^! is us$ up 9 neutralis+ tox9s1 o!r antitoxic bodies are =m$1 until f9ally ! excess ( ^! is ?r[n (f into ! blood s]um4 ,aft] !y are call$ into be+ by ! excitation ( "s toxic products1 l ^? ( ! typhoid bacillus = example1 ! antitox9s rema9 9 ! blood = ye>s1 ready to neutralise at once any influx ( fre% infection4 ,9 o!r diseases1 l diph!ria & pneumonia1 !y are soon lo/1--h5ce ! recurr5ce ( su* diseases4 ,! acquir$ antitox9 la/s aft] smallpox1 vacc9ia1 yell[ fev]1 sc>let fev]1 measles1 typhoid1 mumps1 & :oop+-c\gh2 x is v transi5t aft] pneumonia1 influ5za1 diph!ria1 erysipelas1 & *ol]a4 #agb ,9 s]um !rapy antitox9s are artificially excit$ into be+ 9 ! blood ( bea/s4 ,?is artificially prep>$ antitox9 is inject$ into ! blood (1 say1 a diph!ria pati5t1 & ! poison is at once neutralis$1 in/ead ( leav+ ! pati5t to make 8 own antitox9 & lett+ him p]haps fail 9 ! ef=t4 ,! antitox9 produc$ 9 ! conte/ ( ! body cells aga9/ "s diseases w n only neutralise ! tox9 ( a p>ticul> disease1 b x w also neutralise ! tox9 ( a second disease4 ,by vacc9at+ a p]son we inoculate him ) vacc9ia or c[pox4 ,8 body cells make an antitox9 :i* neutralises ! tox9 or virus ( c[pox1 he recov]s f ?is light disease1 & ! antitox9 n[ rema9+ 9 8 body prev5ts = ye>s ano!r successful inoculation ) c[pox4 ,x does m3 9 #ij p] c5tum ( cases x w prev5t successful infection ) smallpox4 ,smallpox 7! pocks1 pokes or pockets ( matt]1--oppos$ to ! great pox or syphilis7 has be5 kn[n f v e>ly times--probably ev5 f #abjj ,b4,c4 ,! "n small pokkes 0 fir/ us$ 9 ,engl& 9 #aeah4 ,! disease 0 br\ght to ,am]ica 9 #aejg4 ,x may be communicat$ f ! sick to ! heal?y 7#a7 by p]sons suff]+ ) ! disease2 7#b7 by bodies ( p]sons t h di$ ( smallpox2 7#c7 by infect$ articles2 7#d7 by heal?y ?ird p]sons2 7#e7 by ! air1 to p]sons liv+ ev5 at "s di/ance2 7#f7 by inoculation4 ,! poison ent]s ! body by ! muc\s membrane ( ! nose1 m\?1 or respiratory tract1 & probably ?r\gh ! muc\s membrane ( ! /oma* & ?r\gh ! brok5 sk94 ,pati5ts c communicate ! disease probably dur+ ! p]iod ( incubation 7f #e to #bj days aft] exposure to ! disease--commonly ab\t #ad days72 & c]ta9ly f ! initial /age until no trace is left ( ! f9al sk9-desquamation4 ,! infection is mo/ active dur+ ! =mation & duration ( ! pocks4 ,! milde/ smallpox 9 "o p]son c cause malignant smallpox 9 ano!r1 & vice v]sa4 ,! mortality 9 ! unvacc9at$ is betwe5 #dj & #ej p] c5tum4 ,a typical case ( conflu5t smallpox at its height is ! #agc uglie/ disease 9 appe>ance & /5* & almo/ 9 sub/ance1 kn[n to m$ic9e4 ,anyone liable to infection by x1 or likely to c>ry x to o!rs1 :o says he is n afraid ( x1 has ei!r nev] se5 x & he is talk+ *ildi% nons5se1 or he has se5 x & he is a fool4 ,! face is a bloat$ mass ( corruption2 ! eyes are swoll5 %ut2 ! nose1 *eeks1 lips1 & neck are puff$ out enorm\sly2 ! m\? is a l>ge sore1 ulc]\s1 & spittle trickles f x ceaselessly4 ,! fev] is up to #ajc or #aje degrees2 !re is an unqu5*able ?ir/1 a vile /5*1 sleeplessness2 (t5 delirium is ! only relief1 & !re is "o *ance 9 two ( a disfigur$ recov]y4 ,tobacco1 alcoholic liquor & a walk 9 ! fre% air w n dis9fect ! visitor to su* a disease4 ,ye>s ago ,i inve/igat$ 9 ! laboratory ! popul> notion t tobacco is a dis9fectant4 ,i f\nd t bact]ia1 ! diph!ria bacillus & sw>ms ( o!rs m delicate1 w gr[ z well 9 ! pres5ce ( a l>ge piece ( ,navy ,plug1 z :5 tobacco is abs5t4 ,*ew+ tobacco1 :iskey1 a walk 9 ! fre% air z dis9fectants1 ! ,si\x m$ic9e-man's p[w[1 ! h9d leg ( a rabbit z a *>m1 are all 9 ! same category4 ,! fir/ & *ief protection aga9/ smallpox is vacc9ation4 ,vacc9ation does n always prev5t infection by smallpox1 b x does prev5t x 9 m ?an #ij p] c5tum ( exposures to ! disease4 ,wel* report$ 9 #ahid t ! dea?-rate 9 "o s]ies ( #e1jjj cases ( smallpox 0 #eh p] c5tum 9 ! unvacc9at$1 & #af p] c5tum 9 ! vacc9at$1 b ! vacc9at$ took ! disease 9 less ?an #aj p] c5tum ( ! exposures4 ,dur+ ! ,franco-,g]man ,w> 9 #ahgj-ahga1 ! ,g]mans :o _h a million vacc9at$ m5 lo/ #deh soldi]s f smallpox :ile a great epidemic ( smallpox 0 exi/+ 9 ,g]many2 ! ,fr5*1 :o 7 indiff]5t to vacc9ation1 dur+ ! same "t lo/ #bc1djj m5 f ?is disease alone4 ,9 ! ,unit$ ,/ates1 :]e !re is no compulsory vacc9ation except su* attempts z s*ool bo>ds make1 !re 7 betwe5 ,july & ,decemb]1 #aijc1 #ac1gci cases ( smallpox2 9 ,g]many1 :]e !re is a compulsory #agd vacc9ation law1 !re 0 no smallpox at all1 dur+ ! same "t1 except #ad cases 9 two seaports1 ,brem5 & ,kiel1 :i!r ! infection _h be5 br\ght f )\t4 ,be=e #ahgd !re _h be5 no compulsory vacc9ation law 9 ,g]many except = ! army4 ,9 #ahga1 #adc1jjj ,g]mans di$ ( smallpox4 ,s9ce ! law w5t into effect 9 #ahgd ! disease has be5 /amp$ out1 until !re 0 betwe5 ,july & ,decemb]1 #aijc1 only "o dea? f smallpox 9 ,g]many4 ,! *>t on page #age w %[ v graphically ! effect ( vacc9ation ^u smallpox4 ,9 ,octob]1 #ahih1 smallpox 0 endemic 9 ,pu]to ,rico2 9 ,decemb]1 #ahih1 x 0 epidemic2 9 ,janu>y1 #ahii1 x 0 all ov] ! isl& & spread+ rapidly4 ,9 ,febru>y1 #ahii1 compulsory vacc9ation 0 begun & c>ri$ out = only f\r mon?s1 :5 #hfj1jjj vacc9ations _h be5 made 9 a population ( ab\t #ifj1jjj p4 ,! dea?-rate f smallpox dropp$ f #fba a ye> to #b4 ,dur+ ! c5tury prec$+ ,j5n]'s discov]y ( vacc9ation1 accord+ to ,neimey]'s calculation #djj1jjj p di$ ( smallpox ea* ye> 9 ,europe4 ,b]n\illi1 a tru/wor?y /ati/ician1 says t dur+ t same c5tury1 ,fully two-?irds ( all *ildr5 born 9 ,europe 71 soon] or lat]1 attack$ by smallpox1 & on an av]age "o-twelf? ( all *ildr5 born succumb$ to ! disease4 ,e>ly 9 ! sixte5? c5tury #c1ejj1jjj p 9 ,mexico _h smallpox 7,prescott's ,conque/ ( ,mexico74 ,9 #agjg1 9 ,icel&1 #ah1jjj ( ! population ( #ej1jjj di$ ( smallpox2 & 9 #ahia1 #be1jjj p]sons 9 ,guatemala di$ ( ?is disease4 ,9 #ahge !re 7 anti-vacc9ation riots 9 ,montreal1 & z a consequ5ce mo/ ( ! y\ng] inhabitants ( t city 7 n vacc9at$4 ,9 #ahhe1 smallpox 0 br\ght 9 f ,*icago2 #c1afd p]sons di$ ( ! disease2 ( ^! #b1gag 7 *ildr5 "u t5 ye>s ( age1 & ?\s&s _h ! disease4 #age ,illu/ration3 ,,prussia4--,) compulsory vacc9ation & compulsory revacc9ation at ! age ( #ab4 ,,holl&--,) compulsory vacc9ation ( *ildr5 be=e ent]+ a s*ool4 ,,au/ria4--,)\t compulsory vacc9ation4 #agf ,vacc9ation may r5d] "o immune to smallpox = _m ye>s1 b if ! disease is epidemic x is well to r5ew ! vacc9ation aft] ab\t eight ye>s4 ,9 normal vacc9ation1 :]e ! lymph has be5 d]iv$ f a reliable s\rce1 on ! ?ird or f\r? day pale r$ papules develop at ! po9t ( inoculation1 & ab\t ! t5? day ^! h become pu/ules4 ,! vesicles dry gradually1 & betwe5 ! f\rte5? & tw5tie? days ! scab falls (f1 leav+ a pitt$ sc>4 ,ab\t ! fif? day an aureola ( inflammation =ms ar\nd ! pocks1 f a qu>t] ( an in* to two in*es 9 ext5t1 & ! inflam$ area may be some:at sore4 ,a %ield %\ld be kept ov] ! vacc9ation spot = two days1 & ?is is !n to be replac$ by a piece ( /]ile gauze held 9 place by n>r[ /rips ( /ick+-pla/] above & bel[ ! inflam$ area4 ,sometimes hives & o!r ra%es occur 9 vacc9ation1 b !y are unimportant4 ,:]e !re is a v sore arm or o!r tr\ble1 ! cause may be a pre-exi/+ unheal?y condition1 l scr(ula = example1 or ! pati5t has scrat*$ ! pocks1 or infect$ !m f 8 clo?+1 or ! vacc9e lymph 0 un/]ile4 ,a c>eless & dirty vacc9ator might infect an arm ) pus organisms4 ,if good glyc]9at$ lymph1 n too fre% or too old1 is us$1 !re is seldom any tr\ble2 b 9 any case all ! annoyance t may come f vacc9ation is inf9itesimal :5 comp>$ ) ! smallpox x av]ts4 ,we may take a smallpox case z a typical contagi\s disease 9 :i* ! prie/ is to give ! la/ ,sacram5ts2 & ! dis9fection & o!r precautions obs]v$ 9 su* a visit w s]ve = any o!r v contagi\s disease4 ,= only typhus & "o or two o!r maladies are ! precautions s elaborate z ^? ne$$ 9 smallpox4 ,!re is a dress1 call$ ,dr4 ,hawes' ,antiseptic ,suit1 & 9 "t ( epidemics a prie/ %\ld h "o ( ^! suits1 or "o made aft] x z a patt]n--!y c be obta9$ 9 ! %ops = two or ?ree doll>s4 ,!y cov] ! entire p]son1 ev5 ! %oes1 & !y make unnecess>y ! *ang+ ( clo?+ & ! dis9fection ( ! expos$ p>ts ( ! body4 ,! h&s ( ! prie/ may be left b>e aft] fa/5+ ! sleeves ( ! suit ab\t ! wri/s1 or he may we> surgeon's ?9 rubb] gloves4 ,9 visit+ a pati5t t has any ( ! contagi\s diseases m5tion$ 9 ?is *apt]1 ! prie/ %\ld nev] t\* #agg 8 own face ) 8 h&s aft] he has ent]$ ! sick-room until he has wa%$ !m 9 a bi*loride ( m]cury solution4 ,a ritual %\ld n be tak5 into a smallpox room1 because a book _c be dis9fect$ )\t r5d]+ x useless4 ,! prie/ %\ld memorise ! pray]s & c]emonial1 or write !m out on pap] :i* c be burn$ 9 ! hospital or ! pati5t's h\se4 ,! prie/ may be oblig$ to adm9i/] baptism1 to he> confession1 to give ! ,viaticum & ,extreme ,unction4 ,be=e go+ to visit a smallpox pati5t let him f9d out f ! physician 9 att5dance :e!r ! pati5t c receive ! ,viaticum1 :e!r he c swall[ x or n1 :e!r he c op5 8 m\? en\gh to take x4 ,ask also ab\t ! possibility ( vomit+4 ,only a v small p>ticle is to be br\ght 9 ! pyx4 ,! lea!r cov] = ! pyx %\ld n be tak5 into a smallpox room4 ,set ! pyx inside a corporal1 wrap ! corporal 9 pap]1 & put ?is package into ! pocket ( ! ,hawes suit be=e ent]+ ! room4 ,z to ! use ( a /ole1--! morali/s say gravit] peccatur ab eo qui s9e urg5te necessitate s9e ulla sacra ve/e unctionem adm9i/rat4 ,!re is a grave necessity "h = do+ away ) ! /ole because ( ! difficulty 9 dis9fect+ x1 unless y h "o made t c be put into boil+ wat] = t5 m9utes be=e y leave ! pati5t's h\se4 ,! oil-/ocks %\ld conta9 only z mu* oil z is necess>y = ! s+le occasion1 because :at rema9s1 ) ! cotton1 %\ld be burn$ 9 ! pati5t's h\se4 ,d n rema9 9 ! room long] ?an y mu/ unless y h _h smallpox4 ,if !re is any pray] or c]emonial t c be omitt$1 by all means leave x out4 ,lehmkuhl says t ! p5it5tial psalms & ! litanies may be omitt$4 ,baptise by ! %ort =m4 ,/4 ,alphonsus ,liguori 7,!ol4 ,mor41 lib4 #e1 tr4 #e1 n4 #gaj7 tells u !re is no obligation to ano9t bo? eyes & bo? e>s1 si adsit p]iculum infectionis1 b dang] ( infection is n mat]ially increas$ by ano9t+ bo? sides4 #agh ,lehmkuhl adds1 excepta disp5satione ,s$is ,apo/olicae addatur unctio p$um4 ,:5 ! feet are to be ano9t$ d n t\* ! b$-clo?+1--tell ! nurse to uncov] ! feet4 ,/4 ,alphonsus 7loc4 cit41 n4 #gbi7 speak+ ( extreme unction has ^! words3 ,pa/or ratione (ficii t5etur sub mortali d>e lis qui petunt1 nisi ju/a causa excuset3 etiam tempore pe/is1 modo possit absque p]iculo vitae2 cum eo non t5]i doc5t ,tann4 ,dian41 etc4 ,if y h n _h smallpox y c]ta9ly risk y\r life by go+ into ! room ( a smallpox pati5t1 & ! dang] ( infection is great] 9 typhus2 b suppose a pa/or 7 incl9$ to take advantage ( ! excuse1 he w\ld be oblig$ at any risk to g into su* a room to he> confession or to baptise1 & if he he>s confession he may z well /ay = ! ano9t+4 ,if y ano9t a pati5t t has conflu5t smallpox y probably c n wipe away ! oil1 because ! sk9 w be pu/ul>4 ,wipe ! oil-/ock c>efully2 !n all cotton us$ %\ld be wrapp$ 9 pap] & burn$ 9 ! pap] be=e y leave ! h\se4 ,aft] ano9t+1 y _h bett] wa% y\r h&s c>efully 9 wat] 9 :i* a bi*loride ( m]cury tablet has be5 dissolv$--d n use soap & d n put ! bi*loride 9 a metal vessel4 ,wa% y\r h&s ?us be=e y leave ! sick-room4 ,if ! pati5t c receive ! ,viaticum let him lie on 8 back1 & y %\ld drop ! ,ho/ into 8 m\? )\t t\*+ him ) y\r h&4 ,/4 ,alphonsus says3 non licet tempore pe/is porrig]e ,eu*>i/iam m$io aliquo in/rum5to 4 4 4 s$ manu d&a e/ ,!re is no ne$ ( an in/rum5t4 ,if !re are any crumbs left 9 ! pyx make ! pati5t take !m4 ,/4 ,alphonsus says ?is may be done1 & x w\ld be almo/ c]ta9 infection to take !m y\rself if y h n _h smallpox rec5tly4 ,let z little ablution wat] z possible be giv5 to ! pati5t4 ,:5 y leave ! room1 put ! pyx1 oil-/ocks1 corporal1 & /ole 9 a pan ( wat] & boil !m = t5 m9utes4 ,?is w dis9fect !m ?or\ghly & w n injure !m 9 any way4 ,!n take (f ! ,hawes suit z ne> ! /reet-door z possible & wet x ) bi*loride #agi solution4 ,wa% y\r h&s aga9 9 ! bi*loride solution & r9se (f ! bi*loride2 take ! pyx1 oil-/ocks1 corporal1 & /ole & leave imm$iately4 ,d n t\* ! door-knob :5 go+ out--let "s "o op5 ! door = y--& d n %ake h&s ) any "o4 ,typhus fev] is n[ r>e 9 ,am]ica1 b !re 0 an outbreak 9 ,new ,york ,city 9 #ahha4 ,?is 0 ! fev] t kill$ multitudes ( ,iri% emigrants ab\t ! middle ( ! n9ete5? c5tury4 ,x is call$ also spott$ fev]1 camp1 jail1 %ip1 & hospital fev]1 & x has _m o!r names4 ,! "n typhus is f ,greek text1 a smoke or fog1 & x indicates ! befogg$1 /upor\s condition ( ! pati5t4 ,typhoid fev] is s call$ because x has "s resemblance to typhus4 ,! specific cause ( typhus is unkn[n1 b ! contagion develops & reproduces itself 9 ! body ( ! pati5t4 ,x is ?\ght t ! contagion exi/s 9 ! secretions & excretions ( ! body & 9 ! exhalations f ! lungs & sk94 ,! infection c c]ta9ly be c>ri$ by clo?+1 du/1 furniture1 conveyances ( all k9ds1 & dead bodies1 & x rema9s active = mon?s4 ,x may be transmitt$ ?r\gh ! air = %ort di/ances1 n ne>ly s f> z ! air w c>ry ! contagion ( smallpox4 ,9 well-v5tilat$ rooms !re is less dang] ( infection1 & a typhus pati5t %\ld h at lea/ #a1ejj cubic feet ( air space4 ,! contagion may be transmitt$ 9 all /ages ( ! disease & dur+ convalesc5ce4 ,physical weakness1 anxiety & worry1 improp] food1 & pov]ty1 are dispos+ conditions = infection by typhus4 ,! mortality is ab\t #aj p] c5tum--mu* less ?an t ( smallpox4 ,9 giv+ ! la/ ,sacram5ts to a typhus pati5t exactly ! same me?od %\ld be foll[$ z t obs]v$ = a smallpox pati5t4 ,keep z f> f ! pati5t z possible4 ,aft] y t\* him 9 ano9t+ or 9 giv+ o!r ,sacram5ts /ep away f him to say ! necess>y words4 ,d n /& betwe5 him & an op5 fireplace1 w9d[1 door1 or v5tilator4 ,relaps+ fev]1 or fam9e fev]1 caus$ by ,ob]mei]'s #ahj spirillum1 is sometimes associat$ ) typhus4 ,x has a mortality t c g up to #ad p] c5tum 9 unfav\rable circum/ances1 b ! disease is n m contagi\s ?an typhoid "u hygi5ic surr\nd+s4 ,wa% ! h&s 9 bi*loride solution aft] visit+ a case1 & d n t\* ! door-knob or ?+s 9 ! room4 ,rabies 7call$ also hydrophobia 9 man7 is a r>e disease4 ,x is communicable by inoculation1 b x is v d\btful t ! disease has be5 communicat$ f man to man4 ,! saliva f a p]son suff]+ ) rabies if inject$ into a w>m-blood$ animal w cause rabies1 & on t acc\nt x is prud5t to use c>e 9 t\*+ su* a pati5t 9 adm9i/]+ ! la/ ,sacram5ts4 ,! virus might ent] ?r\gh an abrasion on ! prie/'s h&4 ,!re is a false hydrophobia obs]v$ 9 excitable p]sons t h be5 bitt5 by a dog ?\ght to be mad4 ,! dog t has g5u9e rabies gr[s sull51 x hides 9 com]s1 & x snaps at ev]y?+ pres5t$ to x ,a /icky1 fro?y mucus drivels f its m\? & its eyes become r$4 ,x w run /raight ahead1 snapp+ at any?+ x meets2 x swall[s small /ones1 *ips1 & simil> objects2 x does n avoid wat]4 ,x h[ls1 gr[s lean1 & its h9d legs & l[] jaw become p>alys$4 ,9 man !re is a premonitory /age2 a furi\s /age1 :i* la/s f ab\t a day to ?ree days2 !n a f9al p>alytic /age4 ,x is well to wait = ! p>alytic /age be=e ano9t+ ! pati5t1 because 9 ! o!r /ages ! slighte/ t\* causes viol5t spasms4 ,confessors %\ld note t ! virus ( rabies excites ! sexual c5tres4 ,sc>lat9a or sc>let fev] fir/ appe>$ 9 ,nor? ,am]ica 9 ,massa*usetts 9 #agce4 ,x is especially an ,april disease "h4 ,"o attack commonly makes ! p]son immune = life4 ,x is a disease ( *ildr51 b x attacks adults1 & x is fatal among *ildr5 old en\gh to receive ! la/ ,sacram5ts4 ,"s epidemics are v malignant2 & 9 su* times all ! precautions m5tion$ 9 speak+ ( ! visitation ( smallpox pati5ts %\ld be obs]v$4 ,! contagion is spread j z t ( smallpox is spread1 except t x is n c>ri$ ?r\gh ! air s f>4 #aha ,diph!ria is a disease ( *ildr51 b x also c be fatal to adults & to *ildr5 old en\gh to receive ! la/ ,sacram5ts4 ,x is caus$ by ! ,klebs-,loeffl] bacillus1 & x mo/ frequ5tly attacks ! ?roat & no/rils4 ,x c />t 9 a cut 9 ! sk91 or on any muc\s surface1 z ! inside ( ! eyelid4 ,! contagion is n 9 ! brea?1 b x c be c\gh$ out4 ,x is 9 ! saliva ( ! pati5t & x gets on 8 h&s & on :at he & ! nurse t\*4 ,x is n ne>ly s infecti\s z smallpox & sc>let fev]4 ,9 visit+ su* a pati5t ! prie/ %\ld be c>eful n to t\* any?+ 9 ! room1 & he %\ld wa% 8 h&s 9 ! bi*loride solution aft] a visit4 ,he mu/ also wet ! soles ( 8 %oes ) ! solution4 ,he %\ld be v c>eful le/ a *ild sudd5ly c\gh f9e sputum conta9+ ! bacillus into 8 eyes4 ,diph!ria 9 ! eyes w\ld de/roy sight1 & ,i h se5 a pair ( spectacles save a man 9 a case l t4 ,a detail$ description ( ! dis9fection 9 diph!ria is giv5 9 ! *apt] on ,infecti\s ,diseases 9 ,s*ools4 ,gl&]s is sometimes transmitt$ f bea/s to man1 & x is almo/ always fatal 9 ! human subject4 ,! disease is caus$ by ! gl&]s bacillus4 ,horses1 asses1 dogs1 cats1 goats1 & %eep are susceptible to ! disease2 pigs are some:at susceptible2 cattle & birds are immune4 ,! infection is 9 ! dis*>ge f ! nose ( ! pati5t & on ! sk9 eruptions4 ,! same precautions are to be tak5 z are ne$$ 9 a diph!ria case4 ,influ5za1 call$ popul>ly ! grippe1 is caus$ by ! bacillus influ5zae1 :i* 0 isolat$ by ,pfeiff] 9 #ahia4 ,! bacillus is f\nd 9 ! nasal secretions & 9 sputum2 x dies 9 f twelve to tw5ty-f\r h\rs :5 dri$4 ,! disease is contagi\s1 & x is (t5 fatal 9 alcoholics1 ! ov]work$ & h>ass$1 & 9 ^? t h *ronic diseases4 ,9 any case x is a s]i\s malady4 ,dis9fect ! h&s aft] visit+ a case4 ,d5gue becomes epidemic at times1 especially 9 ! ,s\!rn ,/ates4 ,! disease is v sev]e1 pa9ful1 & depressant1 b ! mortality is q l[ except 9 complication ) o!r maladies4 ,its cause is n kn[n4 ,x is #ahb v contagi\s & has symptoms :i* belong to ! class ( disease 9 :i* are sc>lat9a & measles4 ,! prie/ %\ld act z 9 a case ( sc>lat9a4 ,!re is a =m ( pneumonia :i* spreads s widely & rapidly t x is call$ epidemic pneumonia4 ,9 visit+ pati5ts afflict$ ) ?is disease ! prie/ %\ld act z 9 a diph!ria case4 ,epidemic c]ebrosp9al m5+itis is a v fatal disease at times 9 ,am]ica4 ,ev5 ^? pati5ts t survive are frequ5tly made bl9d or deaf1 or are left injur$ o!rwise4 ,! malignant type is ne>ly always fatal4 ,9 "s epidemics ! mortality is z high z #ge p] c5tum4 ,! visit+ prie/ %\ld act z 9 a case ( diph!ria1 al?\gh ! dang] ( direct infection is n great4 ,tub]culosis is a *ronic febrile disease1 caus$ by ! bacillus tub]culosis1 a p>asitic micro-organism discov]$ by ,ko* 9 #ahhb4 ,"o-sev5? ( mank9d die by ?is disease4 ,! bacillus rema9s virul5t a long "t aft] x leaves ! human body1 b x is soon kill$ by sunlight4 ,tub]culosis ( ! lungs is spread especially ?r\gh sputum4 ,9 ! room occupi$ by ! pati5t1 ! clo!s1 furniture1 walls1 doors1 & floor are infect$ by ! bacilli c\gh$ out1 ev5 :5 ! consumptive is c>eful to dis9fect ! sputum1 &1 by ! way1 he r>ely is c>eful4 ,:5 ! prie/ visits a consumptive's room he %\ld dis9fect 8 h&s ) bi*loride4 ,leprosy is caus$ by ! lepra bacillus1 discov]$ by ,hans5 9 #ahga4 ,x is pres5t 9 _m p>ts ( ! body1 especially 9 ! gl&s & n]v\s tissues1 & x is f\nd 9 ! mucosa ( ! m\? & 9 ! nasal secretions4 ,x is v pr(usely di/ribut$ 9 ! corium ( ! sk94 ,! "n comes f ,greek text1 scaly4 ,leprosy is pres5t "h & !re along ! ,mississippi valley f ,m9nesota & ,wiscons9 to ,l\isiana4 ,x is f\nd also 9 ,cali=nia1 ,florida1 & ! ,dakotas1 9 ! ,philipp9es1 ! ,we/ ,indies1 & ! wor/ infect$ "p ( ! _w is ! ,hawaiian ,isl&s4 ,! bacillus has n be5 f\nd 9 rooms us$ by lep]s1 nor 9 ! soil ( _! graves4 ,inoculation by lepr\s #ahc mat]ial has fail$ s f> und\bt$ly to cause leprosy4 ,!re is mu* dispute conc]n+ ! contagi\sness ( ?is disease4 ,! ,dom9ican ,si/]s nurs+ 9 ! ,tr9idad asylum h be5 9 con/ant contact ) ! lep]s = ab\t ?irty ye>s b none ( !m has yet contract$ ! disease4 ,zambaco ,pa%a tells ( a family :i* has liv$ 9 ! lep] asylum at ,con/ant9ople = ?ree g5]ations & no "o 9 ! family has be5 infect$4 ,fa!r ,dami51 h[ev]1 9 ,molokai1 & ,fa!r ,boglioli1 9 ,new ,orleans1 did contract ! disease4 ,!re h be5 cases ( infection f man to man1 b ord9>ily x seems t "s unkn[n factor mu/ be pres5t to insure infection4 ,a prie/ ne$ h no m fe> 9 visit+ a case ( leprosy ?an he %\ld h 9 visit+ a case ( tub]culosis--n s mu*4 ,he may wa% 8 h&s 9 bi*loride solution aft] ano9t+ a lep]1 b x is sc>cely necess>y to d ev5 t4 ,act9omycosis 7,greek text1 ray-fungus7 is a disease caus$ by act9omyces1 a micro-organism t p>tly resembles a bact]ium & p>tly a fungus4 ,! disease c be fatal4 ,x is v improbable t x ev] passes f man to man1 b z a matt] ( prud5ce ! prie/ %\ld wa% 8 h&s 9 bi*loride aft] ano9t+ su* a pati5t4 ,septicaemia1 or blood-poison+1 c be br\ght ab\t by diff]5t pyog5etic bact]ia1--! v>ieties ( ! /aphylococci 7irregul>ly gr\p$ cocci71 /reptococci 7*a9-cocci71 pneumococci1 & o!rs4 ,! dang] ( infection is s slight t x may be neglect$4 ,erysipelas c be fatal1 especially 9 alcoholics1 ! ag$1 & 9 *ronic diseases4 ,erysipelas is contagi\s1 especially if ! bact]ia get into an abrasion 9 ! sk94 ,pati5ts hav+ ?is disease sometimes gr[ deliri\s & viol5t1 & ! prie/ %\ld be c>eful h[ he h&les !m4 ,dis9fect ! h&s aft] ano9t+ su* a pati5t4 ,tetanus1 or lockjaw1 is n communicable except by inoculation4 ,! bacillus1 :i* 0 isolat$ by ,kitasato1 ! ,japanese bact]iologi/1 9 #ahhi1 is f\nd ev]y:]e 9 soil1 hay du/1 floors1 on old nails1 especially on ! floors ( old wood5 slaught]-h\ses4 ,x gr[s be/ 9 deep w\nds #ahd :]e x is %ut (f f ! oxyg5 ( ! air4 ,h5ce ! dang] ( tread+ ^u a nail t has be5 ly+ ne> ! gr\nd4 ,b]ib]i1 a disease obs]v$ especially among seam51 appe>s at times 9 our coa/ t[ns4 ,x is always a v s]i\s malady & sometimes x is rapidly fatal4 ,! infective ag5t1 :i* is n kn[n1 is n und\bt$ly communicable f man to man1 b x is c>ri$ f place to place1 & x cl+s to %ips & build+s2 x ?rives 9 hot1 moi/1 cr[d$ places4 ,! prie/ %\ld dis9fect 8 h&s aft] visit+ a case4 ,an?rax1 call$ also wool-sort]'s disease & spl5ic fev]1 is a v fatal disease1 & ! bacillus is communicable to any "o ?r\gh an abrasion ( ! sk91 ?r\gh ! inte/9es by swall[+ x1 or ?r\gh ! lungs by brea?+ x 9 9 du/4 ,dis9fect ! h&s & ! %oes aft] visit+ a pati5t4 ,be c>eful n to t\* any?+ 9 8 room4 ,! bact]ia t cause typhoid fev]1 ,asiatic *ol]a 7:i* has be5 epidemic 9 ,am]ica7 & epidemic dys5t]y mu/ get on ! h&s1 or on food1 or 9 wat]1 & ?us rea* ! m\? & be swall[$ be=e !y produce ^! diseases4 ,act 9 *ol]a z 9 an?rax1 & dis9fect ! h&s aft] visit+ a case ( typhoid4 ,! bubonic plague1 ! mo/ fatal ( all epidemic diseases1 has already appe>$ 9 ,cali=nia & ,mexico4 ,x is caus$ by a specific bacillus isolat$ by ,kitasato & ,y]s9 9 #ahid4 ,! disease is communicat$ by contact & x is seem+ly also miasmatic4 ,! t]rible plague ( ! ,black ,dea? t swept ov] ,europe f #acdg to #acej 0 a malignant =m ( ! bubonic plague4 ,ov] #a1bjj1jjj p di$ 9 ,g]many1 & ,italy suff]$ mu* m4 ,9 ,vi5na = "s "t ab\t #ajjj p a day di$ & 7 buri$ 9 great tr5*es4 ,v5ice lo/ #ajj1jjj inhabitants1 & ,london lo/ m ?an t4 ,9 bo? ,padua & ,flor5ce only "o-?ird ( ! inhabitants 7 left alive2 at ,avignon ! ,rhone 0 consecrat$ s t bodies might be ?r[n into x = burial2 & %ips drift$ ab\t ! coa/s ( ,europe #ahe ) dead crews4 ,heck]1 9 8 /udy ( ?is plague1 says t ne>ly "o-f\r? ( ! population ( ,europe di$ 9 t visitation4 ,civilisation 0 wellnigh ov]?r[n 9 ! panic4 ,9 ,g]many1 ,italy1 & ,france ! ,jews 7 accus$ ( poison+ ! wells & ?us caus+ ! plague1 & !y 7 slaught]$ by ?\s&s4 ,at ,/rasburg #bjjj ,jews 7 burn$ to dea? 9 "o holocau/2 at o!r places1 z at ,esl+51 9 despair ! ,jews set fire to _! synagogues & de/roy$ !mselves4 ,! ,great ,plague ( ,london 9 #affe1 9 :i* #gj1jjj p]sons di$1 0 also ! bubonic plague4 ,! mortality is ab\t #ij p] c5tum 9 "s epidemics4 ,! bacillus leaves ! body 9 ! faeces1 flies c>ry x to food1 x ?us gets to rats & mice1 & x is c>ri$ f place to place4 ,rats1 h[ev]1 are commonly infect$ z if by a miasm be=e ! disease appe>s 9 man4 ,!re is dispute z to ! communicability ( ! plague f man to man by contact ) fomites1 b x is practically c]ta9 ! disease c be ?us transmitt$4 ,kitasato once succe$$ 9 produc+ ! disease 9 animals by inoculation ) du/ tak5 9 an infect$ h\se4 ,m]ely t\*+ a pati5t does n app>5tly convey infection1 yet "s au?orities hold t 9 "t ( epidemic ! contagion is transmitt$ ev5 ?r\gh ! air1 especially on ! gr\nd floor ( h\ses4 ,p]haps mosquitoes are ! m$ium ( infection1 z !y are incl9$ to fly l[4 ,9 visit+ a case ( bubonic plague ! prie/ %\ld be z cauti\s z if he 7 att5d+ a smallpox pati5t4 ,aft] dea? by smallpox1 plague1 typhus1 *ol]a1 sc>lat9a1 diph!ria1 & measles ! fun]als %\ld be private & ! bodies %\ld n be tak5 to ! *ur*4 ,malta ,fev]1 or bili\s remitt5t fev]1 is f\nd 9 "s ( ! isl&s tak5 f ,spa94 ,x has a l[ mortality & is n contagi\s4 ,bruce 9 #ahhg isolat$ ! bact]ium t causes x4 ,we d n "k ! cause ( yell[ fev] despite ! claims ( ,san>elli t he has isolat$ ! specific micro-organism4 ,rec5tly ,am]ican physicians discov]$ t x is transmitt$ f man to man by mosquitoes t belong #ahf to ! g5us ,/egomyia1 ! ,/egomyia ,fasciata especially4 ,if a yell[ fev] pati5t is put into a room 9 :i* ! mosquitoes h be5 kill$ & ! doors & w9d[s are scre5$1 he is z h>mless1 z f> z contagion is conc]n$1 z a man ) a brok5 leg4 ,! disease is n spread by fomites4 ,mal>ia is caus$ by plasmodia1 :i* are protozoa1 n bact]ia1 & x is c>ri$ f case to case by mosquitoes ( ! g5us ,anopheles4 ,s c]ta9 are we t ?is is ! mode ( infection t ! expression no anopheles1 no mal>ia has almo/ become a m$ical axiom4 ,a bite f an anopheles mosquito does n cause mal>ia unless ! p>ticul> mosquito has previ\sly bitt5 a mal>ia pati5t4 ,! /egomyia flies & bites 9 ! e>ly aft]noon & aga9 at night1 ! anopheles flies & bites aft] sunset4 ,9 visit+ a case ( p]nici\s mal>ia or "o ( yell[ fev] avoid ! bites ( mosquitoes by gloves & a piece ( nett+1 & !re is no dang] :atev]4 ,! /egomyia mosquitoes are tropical & subtropical1 b !y c live z f> nor? z ,philadelphia & ev5 f>!r4 ,! anopheles is especially a nor!rn insect4 ,! ord9>y culex mosquito1 :5 x alights ^u a wall1 /&s ) its body p>allel to ! wall1 z a h\se-fly /&s2 ! anopheles mosquito /&s ) its tail rais$ f ! wall at an angle4 ,a mosquito lays its eggs 9 any pool ( /ill wat]1 & ! wriggl]s se5 9 an op5 ra9-b>rel are ! l>vae f ^! eggs4 ,! l>vae come to ! surface ( ! wat] to get air1 & !y may be smo!r$ ) petroleum2 b ! only effective way to get rid ( mal>ia & yell[ fev] is to dra9 or fill pools ( wat] & m>%es4 ,mosquitoes w bre$ also 9 ! small /ill bights along ! edges ( runn+ /reams2 9 old tomato cans t conta9 ra9 wat]2 9 any /ill wat]1 fre% or salt4 ,,au/9 ,,omalley4 #ahg ,,xv ,,infecti\s ,,diseases ,,9 ,,s*ools ,cases ( diph!ria1 sc>let fev]1 measles1 & ev5 smallpox are n seldom f\nd 9 s*oolrooms1 & mu* anxiety c be av]t$ & ! spread ( infection c be :olly or 9 great "p av]t$ by a k ( dis9fection4 ,! laity w (t5 foll[ ! advice ( a prie/ 9 matt]s ( hygi5e :5 !y are incl9$ to rebel aga9/ ! regulations ( heal? dep>tm5ts & ! sugge/ions ( physicians1 !re=e a prelim9>y explanation ( me?ods = ! prev5tion ( infection 9 ! family w be advantage\s2 prev5tion 9 ! family is also intimately connect$ ) prev5tion 9 ! s*ool4 ,me?ods useful 9 ! family are useful also 9 conv5ts & bo>d+-s*ools4 ,z reg>ds diph!ria1 ! *ief causes ( ! spread ( ?is disease are mi/ak5 diagnosis1 imp]fect isolation1 incomplete dis9fection1 &1 p>adoxical ?\gh x may seem1 a lack ( susceptibility to ! disease 9 a l>ge numb] ( *ildr54 ,_m physicians are /ill "u ! grave error t diph!ria c always be recognis$ )\t ! aid ( ! microscope1 & t membran\s cr\p commonly kills4 ,all sci5tific writ]s ^u diph!ria agree t x is caus$ by ! ,klebs-,loeffl] bacillus4 ,!y also hold t !re is a disease call$ membran\s cr\p1 z di/9ct f diph!ria z typhoid is1 b t membran\s cr\p is a comp>atively h>mless & non-contagi\s disease4 ,two p] c5tum is a lib]al mortality 9 membran\s cr\p1 yet a c]ta9 class ( physicians are con/antly report+ dea?s f ?is disease4 ,9 a s]ies ( #bhf cases 7n dea?s7 diagnos$ z membran\s cr\p by physicians ( ,new ,york #ahh ,city a few ye>s ago1 ,p>k f\nd ! diph!ria bacillus 9 #bbi1 or #hj p] c5tum4 ,i h nev] exam9$ ! ?roat ( a *ild dead f s-call$ membran\s cr\p 9 :i* ,i did n f9d ! diph!ria bacillus4 ,?is is ! exp]i5ce ( almo/ e bact]iologi/ :o has _h to d ) diph!ria4 ,"s m5 report dea?s f diph!ria z ?ru%6 ,^! dea?s might j z tru?fully be attribut$ to ! we>+ ( l95 coll>s4 ,on ! o!r h&1 accord+ to ,bag9sky ( ,b]l91 ,m>t9 ( ,p>is1 ,p>k ( ,new ,york1 & ,morse ( ,bo/on1 f #bj to #ej p] c5tum ( ! cases admitt$ ev5 to diph!ria hospitals h n diph!ria at all4 ,bact]iologi/s f9d t ab\t #ce p] c5tum ( ! cases report$ by physicians to be diph!ria are really no?+ b tonsilitis or ph>yngitis1 ) n[ & !n a case ( membran\s cr\p4 ,)\t a bact]iological diagnosis1 !re=e1 #ce families 9 ea* #ajj qu>ant9$ 7:]e qu>ant9e laws exi/7 are unju/ly qu>ant9$ & subject$ to ! tr\ble & exp5se ( useless dis9fection4 ,! suff]+ ?is c cause to a poor family1 ^: small bus9ess is (t5 ru9$ by qu>ant9e1 is a matt] = v s]i\s consid]ation4 ,aga91 no matt] :at exp]i5ce a physician may h _h1 he c n 9 _m cases diff]5tiate diph!ria 9 its e>ly /ages1 or 9 *ildr5 ( good resi/+ p[]1 f comp>atively h>mless ?roat affections4 ,! extraord9>y resi/+ p[] aga9/ diph!ria %[n by "s *ildr5 & adults has be5 describ$ by ,wass]mann 7,zeits*rift f4 ,hyg41 #ai ,b41 #c ,h474 ,he f\nd "o s]ies ( #ag *ildr51 f "o & a half to elev5 ye>s ( age1 & #cd adults1 9 :i* #aa *ildr5 & #bh adults 7 n only immune to diph!ria1 b "s ( !m _h en\gh antitox9 9 _! blood to neutralise a t5fold fatal dose ( diph!ria tox94 ,?is expla9s _m my/]i\s outbreaks ( diph!ria3 su* immune p]sons are infect$ & !y c>ry ab\t ! disease unconsci\sly because !y are n ill !mselves4 ,i h se5 a "m kiss a *ild dy+ ( malignant diph!ria & ! woman did n get ev5 a sore ?roat1 b ,i "k ( ano!r case exactly l ?is 9 :i* ! "m di$ f ! infection4 #ahi ,!re are bad cases ( diph!ria :i* ! exp]i5c$ physician c diagnose z soon z he ent]s ! pati5t's room )\t ev5 look+ at ! ?roat1 b ! light] cases t are dang]\s are n easily recognis$4 ,i h se5 two *ildr5 ( a family 9 ,wa%+ton attack$ ) a slight ?roat sor5ess aft] "o *ild _h di$ ( diph!ria 9 ! h\se4 ,! cases ( ^! two *ildr5 w\ld nev] ev5 sugge/ diph!ria if t fir/ *ild _h n _h ! disease4 ,bo? ^! pati5ts di$ )9 t5 days ( syncope )\t ! =mation ( any membrane1 b ! diph!ria bacillus 0 pres5t microscopically4 ,to ! mom5t ( dea? !re 0 no?+ 9 ! symptoms ( ^! two *ildr5 to %[ diph!ria to ! nak$ eye4 ,f a p]sonal exp]i5ce ) m ?an #hjj cases ( diph!ria 9 hospitals & z a m$ical inspector1 ,i feel c]ta9 t light attacks ( diph!ria c n be diagnos$ )\t ! aid ( ! microscope4 ,! immunity m5tion$ above expla9s ! fact t ! ,klebs-,loeffl] bacillus is sometimes f\nd 9 heal?y ?roats1 & ! p]son t has su* a ?roat is really m dang]\s ?an a pati5t t is ill ) diph!ria1 because we _c gu>d ourselves aga9/ him4 ,s*ool-*ildr5 at times h :at appe>s to be m]e sore ?roat b :i* is really diph!ria 9 ! naturally immune4 ,all cases ( sore ?roat 9 s*ool-*ildr5 %\ld be exam9$ bact]iologically1 b un=tunately ! bact]iological exam9ation = diph!ria is a complicat$ process :i* requires an exp]t bact]iologi/ & a laboratory4 ,! co/ ( a laboratory fitt$ = ?is diagnosis alone is n great1 b x is n easy to p]suade small city gov]nm5ts t !y ne$ su* plants4 ,! only res\rce1 !n1 is to treat e suspici\s case ( sore ?roat z if ! disease 7 really diph!ria1 until a diagnosis is e/abli%$ z ne> ! tru? z possible4 ,*ildr5 t are afflict$ ) ?roat inflammations %\ld be kept f s*ool4 ,! p %\ld be taught ! necessity ( isolation & dis9fection2 !y %\ld be w>n$ aga9/ pat5t dis9fectants1 & told to ask compet5t physicians to advise !m 9 dis9fection4 #aij ,diph!ria is n directly caus$ by unhygi5ic surr\nd+s4 ,a disreg>d = hygi5e disposes a *ild = infection if ! *ild is expos$ to ! bacillus4 ,! specific g]m mu/ be introduc$ into ! pati5t's m\? or no/rils4 ,:5 a *ild is infect$ ) diph!ria ! brea? is n a m$ium ( contagion4 ,! sputum1 spat out or c\gh$ out1 is a means :]eby ! disease is spread4 ,! bacillus is 9 ! pati5t's m\? & no/rils2 x gets ^u 8 h&s by contact1 ^u eat+ ut5sils1 ^u :atev] t\*es ! m\? ( ! sick p]son4 ,! bacillus does n float 9 ! air ( ev5 ! sick-room1 except 9 ^? cases :]e dri$ sputum is /irr$ up by sweep+ or attrition ( o!r k9ds4 ,9 a bo>d+-s*ool or family :5 a diph!ria pati5t is f\nd1 select a room set (f z f> z possible f ! rooms commonly us$1 & be=e putt+ ! pati5t into ?is room remove all curta9s1 uphol/]$ furniture & c>pets f x t are n s *eap or s worn t !y may be de/roy$ aft] ! pati5t's convalesc5ce1 or :i* are ( su* texture t !y w n be de/roy$ by wat] or dis9fection by heat4 ,9 any case ! less !re is 9 ! room ! easi] ! dis9fection w be4 ,use ! mattress ^u :i* ! pati5t _h slept be=e y discov]$ ! nature ( ! disease4 ,books %\ld be remov$1 because an infect$ book c n be dis9fect$ except ^u ! outside4 ,! room is n to be swept :ile ! pati5t is 9 x1--du/ may be wip$ up ) a damp clo?4 ,! clo? is to be dis9fect$ be=e x is s5t out ( ! room4 ,! popul> notions reg>d+ sulphur z a dis9fectant aft] diph!ria are errone\s4 ,sulphur fumes 9 c]ta9 def9ite quantities w dis9fect aft] smallpox1 sc>let fev]1 measles1 & "s o!r diseases2 ^! fumes w also kill ! diph!ria bacillus1 if ! bacillus is wet & expos$ directly2 b if x is buri$ 9 sputum or 9 clo?+ ! fumes w h no effect :atev] ^u x4 ,! dis9fectants to use are acid bi*loride ( m]cury & heat4 ,=maldehyde does n p5etrate well en\gh to be reliable 9 diph!ria4 #aia ,:5 ! pati5t is tak5 to ! room prep>$1 let a mixture ( "o ounce ( bi*loride ( m]cury 9 ! p[d]$ =m1 9 two ounces ( common hydro*loric acid 7n ! dilute hydro*loric acid us$ 9 m$ic9e71 be obta9$4 ,?is is a viol5t poison1 & x mu/ be kept out ( ! rea* ( *ildr5 & c>eless p]sons4 ,two teaspoonfuls ( ?is solution 9 an ord9>y wood5 bucket fill$ ) wat] to )9 two in*es ( ! rim makes ! dis9fect+ mixture4 ,a wood5 wa%tub ne>ly fill$ ) ?is dis9fectant1 mix$ 9 ! bucket z direct$1 %\ld be kept ne> ! door ( ! room1 & all t[els1 %eets1 & soil$ l95 mu/ be soak$ 9 ?is tub = tw5ty-f\r h\rs4 ,aft] t any "o may h&le ^! articles ) p]fect safety4 ,! articles t h be5 soak$ = tw5ty-f\r h\rs %\ld be r9s$ 9 ord9>y wat] to remove ! acid1 & !y may !n be wa%$4 ,! nurse %\ld n t\* ! outside ( ! tub ) infect$ articles :ile putt+ ^! 9 ! dis9fectant4 ,d n make ! dis9fectant /rong] ?an direct$ "h1 or x w de/roy ! articles soak$ 9 x1 & = ! same reason d n leave !m 9 x long] ?an tw5ty-f\r h\rs4 ,if ! att5dant c be kept isolat$ ) ! pati5t !re w be less liability ( c>ry+ ! infection ?r\gh ! h\se4 ,9 a majority ( cases 9 families1 h[ev]1 ! "m is oblig$ to c>e = ! pati5t & to att5d also to h] h\sehold duties4 ,9 ! la/ case1 let h] keep ne> ! door ( ! room a cotton wrapp] :i* c be put on ov] h] dress :5ev] %e ent]s ! room4 ,%e _h bett] tie a t[el ov] h] hair4 ,9 ! room a *9a-/one bas9 %\ld be kept1 conta9+ a gallon ( wat]1 9 :i* !re is a teaspoonful ( ! acid bi*loride4 ,e "t ! att5dant t\*es ! pati5t let h] wa% h] h&s 9 ?is mixture1 us+ no soap4 ,%e %\ld remove h] f+] r+s or !y w be black5$4 ,! pati5t %\ld n be h&l$ except :5 absolutely necess>y1 to avoid ne$less exposure to infection2 x is also injuri\s to a *ild ill ) diph!ria to lift x up4 ,! nurse's cov]+ wrapp] %\ld be soak$ 9 ! tub z (t5 z possible4 ,"s ignorant p]sons give z an excuse = a lack ( c>e 9 #aib h&l+ pati5ts hav+ contagi\s diseases l diph!ria1 t !y are n afraid ( ! infection4 ,fe> has no?+ to d ) ! matt]4 ,food is to be tak5 to ! door ( ! sick-room by "s "o o!r ?an ! att5dant4 ,! tray %\ld n be c>ri$ into ! room4 ,aft] ! meal1 take to ! door a pan conta9+ wat]1 & let ! att5dant set ! di%es1 knives & =ks1 & ! food h&l$ by ! *ild1 "u ! wat] )\t t\*+ ! rim or sides ( ! di%-pan4 ,!n any "o may c>ry ! pan to ! kit*51 :]e x is to be set ^u ! /ove1 & ! wat] hold+ ! di%es & ! reject$ food is boil$ = an h\r4 ,aft] t process ! cont5ts ( ! pan are safe1 & !y may be h&l$ = wa%+4 ,clo?s us$ 9 wip+ ! m\? ( ! pati5t are to be wrapp$ 9 pap] & burn$4 ,dejecta %\ld be cov]$ ) fre% *lor9at$ lime1 "o "p to two ( wat]4 ,aft] ! pati5t beg9s to convalesce ! dang] ( infection gr[s great]4 ,:5 ! membrane has disappe>$1 & ! *ild is able to run ab\t ! room1 ! att5dant ceases commonly to use ! ?roat-spray because ! process is tr\blesome4 ,9 su* cases ! diph!ria bacillus rema9s 9 ! pati5t's m\? = "s "t--f a few days to weeks4 ,dur+ ! mo/ ( ?is "t ! *ild is z dang]\s to o!rs z x 0 :ile x 0 ill4 ,9 "o case 9 my own exp]i5ce1 ! bacillus rema9$ pres5t = elev5 weeks f ! date ( diagnosis1 & ,i !n lo/ sight ( ! *ild4 ,9 ! t5? week ! bacillus pres5t :5 9 pure culture kill$ a gu9ea-pig 9 ?irty-six h\rs4 ,?is is1 ( c\rse1 an exceptional occurr5ce2 b ! r\t9e practice is to keep ! pati5t isolat$ = ?ree weeks aft] ! membrane has disappe>$1 unless a bact]iological exam9ation %[s t ! bacillus is abs5t4 ,! bacillus rema9s aft] ! use ( antitox9 j z if antitox9 _h n be5 us$4 ,:5 a *ild is to be releas$ f ! sick-room1 ba! x c>efully ) soap$ w>m wat]1 wa%+ out ! hair & "u ! f+]-nails c>efully4 ,!n wet a t[el ) ! dis9fectant 7! acid bi*loride ( m]cury1--a #aic teaspoonful to a gallon ( wat]7 & g ov] ! body ) x2 aft]w>d r9se ) ord9>y wat]4 ,d n let ! dis9fectant ent] ! *ild's m\? or eyes4 ,next1 )\t all[+ ! *ild to t\* any?+ 9 ! room1 especially avoid+ ! door-knob1 s5d x to ano!r room & dress x 9 clo?+ t has n be5 ne> ! sick-room4 ,if1 aft] ?is process1 o!r *ildr5 are infect$1 ! explanation is t ! *ild _h be5 releas$ too soon--be=e ! bacillus _h disappe>$4 ,x commonly happ5s t a *ild has be5 go+ ab\t ! h\se = "s days be=e a physician has be5 call$ 94 ,9 t ev5t y h ! h\se to dis9fect4 ,y mu/ !n wet ) bi*loride ev]y?+ ! *ild has t\*$1 & boil all eat+ ut5sils4 ,z to ! dis9fection ( ! room & its cont5ts3 ! irritation ( diph!ria causes a l>ge quantity ( saliva to fl[ f ! pati5t's m\?2 ?is infect$ saliva runs d[n ^u ! pill[s & soaks into !m4 ,x may also soak into ! mattress4 ,if a t[n has a /eam dis9fect+ plant1 !re is no tr\ble 9 deal+ ) b$d+ & c>pets aft] diph!ria & o!r contagi\s diseases2 su* a plant1 h[ev]1 co/s at ! lea/ #fjjj4 ,x is saf]1 9 ! abs5ce ( /eam dis9fection1 to de/roy pill[s by fire2 b if ^! are op5$ & ! fill+ put into tubs or b>rels conta9+ two teaspoonfuls ( ! acid bi*loride ( m]cury to ea* gallon ( wat] & soak$ = ab\t two days !y w be safe4 ,! tick+ 9 ?is case %\ld be boil$ 9 a wa%-boil]1 & ! fill+ is to be r9s$ be=e dry+4 ,! mattress is less liable to infection b x may be infect$4 ,if a piece ( oil-clo? or rubb] %eet+ is spread b5ea? ! b$-clo!s "u ! pati5t & ! mattress is kept well cov]$ dur+ ! c\rse ( ! disease1 ! fill+ ( ! tick w mo/ probably be n infect$4 ,! loss ( a good fea!r or hair mattress is consid]able 9 ! h\se ( a poor man1 & ^! (t5 may be sav$4 ,to dis9fect ! surface ( a mattress place x on *airs 9 a small room or 9 a closet & p\r ^u a clo? "u x #ejj cc4 ( =mal9 = ea* #ajjj cubic feet ( air-space 9 ! room or closet--multiply ! l5g? by ! height by #aid ! wid? ( ! room or closet to get ! cubic feet ( air-space4 ,leave ! room or closet %ut tightly = tw5ty-f\r h\rs4 ,! ,tr5n]-,lee =maldehyde dis9fector is a good app>atus = dis9fect+4 ,! small] size co/s tw5ty-five doll>s4 ,if any?+ is to be s5t out ( a room to be burn$1 spread a piece ( old c>pet1 bagg+1 or simil> useless clo? outside ! room door1 set on ?is ! articles to be de/roy$1 wrap !m c>efully 9 ! fabric1 ty+ all ) cords2 !n take ! bundle outside ! t[n 9 a cov]$ wagon1 p\r k]os5e oil on ! package )\t op5+ x1 & set x afire4 ,aft]w>d wa% ! wagon ) ! acid bi*loride4 ,wet ! furniture & floors ( ! room ) ! acid bi*loride4 ,d n m]ely spr9kle ! solution ab\t1 flood ev]y?+ ) x1 because ! g]m is kill$ only by direct contact2 & rememb] t a diph!ria bacillus magnifi$ #hjj times is n l>g] ?an ! eye ( a ne$le4 ,! bi*loride w spoil gilt picture-frames1 !re=e use a #aj p] c5tum solution ( pure c>bolic acid on ^! & all o!r metallic surfaces4 ,co9s %\ld be boil$1 & pap] money %\ld be dipp$ 9 ! #aj p] c5tum c>bolic acid solution & dri$ at a /ove4 ,money is frequ5tly f\nd 9 smallpox rooms "u ! pati5t's pill[4 ,=mal9 is ! be/ dis9fectant = wall-pap] unless ! *ild has spat ^u x--!n use ! bi*loride4 ,sometimes ! bi*loride w n injure ! wall-pap]1 b if !re are gilt figures ^u x ^! w be black5$4 ,sulphur fumes are no bett] ?an =mal9--n s good1 & !y injure & black5 t9t$ & gild$ wall-pap]1 silks1 sat9s1 & o!r fabrics4 ,if y det]m9e to h ! room repap]$1 wet x ) bi*loride be=e y br+ 9 ! workm54 ,x is difficult to dis9fect a c>pet except by /eam1 & on ?is acc\nt ! c>pet %\ld be remov$ f ! room be=e ! pati5t is br\ght into x4 ,if x has be5 kept 9 ! room1 wet x ?or\ghly ) ! bi*loride1 :5 y are dis9fect+1 if y c n h x dis9fect$ by hot /eam4 ,! wett+ commonly spoils ! c>pet1 consequ5tly x may be necess>y to bum x4 #aie ,keep cats1 dogs1 & especially kitt5s1 out ( a diph!ria room4 ,kitt5s w take ! disease easily1 & cats & dogs w c>ry ab\t ! contagion4 ,if a valuable dog %\ld get into ! room1 dis9fect its hair ?or\ghly ) ! acid bi*loride & !n r9se ! hair4 ,be c>eful to dis9fect its feet4 ,:ile us+ ! bi*loride d n =get ! w9d[-panes1 ! door-knobs1 & t "p ( ! *air-legs :i* t\*es ! floor4 ,aft] y h us$ ! bi*loride expose ! room to ! gas f =mal94 ,hang up %eets wet ) #ejj c4c4 ( =mal9 = ea* #ajjj cubic feet ( air-space1 & close all keyholes & cracks2 !n leave ! room %ut = tw5ty-f\r h\rs4 ,z to ! use ( antitox9 z a prev5tive & cure = diph!ria1 too mu* praise _c be giv5 to t wond]ful discov]y4 ,reliable diph!ria antitox91 us$ 9 prop] quantity & e>ly en\gh1 is almo/ an absolute cure4 ,:]e x fails x has be5 us$ too late or n 9 ! prop] dose4 ,9 any case its only evil effect may be an attack ( nettle-ra% or hives4 ,! few dea?s t h occurr$ 9 its use 7 caus$ by an ignorant use ( ! syr+e4 ,if y f9d a physician oppos$ to ! use ( antitox9 ?is simply means t he is a quack4 ,"o s]i\s disadvantage 9 ! use ( antitox9 is t x leaves ! dang]\s bacillus 9 ! ?roat ( ! pati5t ab\t z long z an unaid$ convalesc5ce w\ld leave x4 ,! membrane (t5 w disappe> 9 tw5ty-f\r h\rs :]e antitox9 has be5 us$1 & ! *ild w be play+ ab\t ! floor4 ,!n ! "m w say ! *ild nev] _h diph!ria2 %e w n dis9fect1 & %e w let ! *ild run ab\t ! h\se4 ,! free book sy/em t prevails 9 "s s*ools is a prolific s\rce ( infection4 ,books are infect$ at home or by *ildr5 f infect$ h\ses1 & mix$ ) o!r books 9 ! s*ool4 ,! diph!ria bacillus w cl+ to a book = at lea/ a ye>4 ,if books are giv5 to ! *ildr51 give !m outright2 d n let ! books be mix$ 9 ! s*oolroom4 ,dr9k+-cups us$ 9 common are ano!r s\rce ( #aif infection4 ,let ea* *ild h its own t9 cup4 ,! clo!s-rack 9 a s*ool also spreads infection4 ,room en\gh %\ld be giv5 to ea* hook to keep ! hat & coat ( "o *ild f t\*+ ^? ( ano!r1 & a wood5 p>tition /&+ out f ! wall ab\t eight in*es %\ld sep>ate hook f hook4 ,! janitor %\ld wa% ! clo!s-racks ) ! acid bi*loride solution e "t he sweeps4 ,suppose a *ild hav+ diph!ria is f\nd 9 s*ool1 or "o is discov]$ z com+ f a h\se :]e he 0 9 contact ) diph!ria4 ,! discov]y is made commonly aft] ! *ild has be5 spread+ infection = "s days4 ,d n fright5 ! y\ng/]1 b f9d out f him :at p>ts ( ! s*ool-build+ he has be5 visit+4 ,!n s5d him & ! o!r *ildr5 home4 ,rooms 9 :i* ! *ild has n be5 are n infect$1 & only t :i* he has t\*$ is infect$ 9 any case4 ,wet ev]y?+ 9 ! build+ & ou?\ses ) :i* he possibly c\ld h come 9 contact ) ! acid bi*loride4 ,burn 8 books & pap]s1 or1 if ?is action may cause difficulty ) p>5ts1 let him take 8 books home & in=m ! heal? (fic] ( t fact4 ,:5 he returns to s*ool be sure ( ! hi/ory ( 8 books4 ,use =mal9 or sulphur 9 ! infect$ rooms1 & classes may be begun aga9 ! next day4 ,if )9 ! week any *ild %[s signs ( sore ?roat s5d x home imm$iately4 ,sulphur mu/ be burn$ :5 us$ z a dis9fectant1 & to be effectual f\r p\nds %\ld be burn$ = e #ajjj cubic feet ( air-space 9 ! room4 ,a teaspoonful ( sulphur :5 burn$ w fill a h\se ) *ok+1 dang]\s fumes1 b two p\nds ( sulphur burn$ 9 an ord9>y b$room w h no effect :atev] on ! diph!ria bacillus & v little on any o!r disease4 ,spr9kl+ dis9fectants ab\t a h\se1 & sett+ sauc]s conta9+ dis9fectants 9 rooms is nons5se--! quantity mu/ be suffici5t & be 9 actual contact ) ! contagion4 ,a deodorant does n dis9fect because x removes a /5*4 ,to burn sulphur set a coal-hod or an old t9 pan on two bricks 9 ! middle ( ! room1 b see t !re are no #aig holes 9 ! bottom ( ! hod or pan ?r\gh :i* burn+ sulphur c\ld drip to ! floor4 ,= a l reason see t ! pan is n too n>r[ nor too %all[4 ,x is saf] to set ! bricks 9 a tub fill$ ) wat] up to ! top ( ! bricks4 ,use p[d]$ sulphur 9 pref]5ce to ! cakes sold by ! druggi/s1 & fire ?is sulphur ) a r$ coal4 ,! room %\ld be moi/ ) /eam :5 ! sulphur is set afire s t ! fumes w act effectually4 ,leave x %ut tightly = tw5ty-f\r h\rs4 ,9 ! ,nor!rn ,/ates diph!ria is mo/ preval5t 9 ,octob]1 ,novemb]1 & ,decemb]2 sc>let fev] is an ,april disease1 b x may occur at any "t4 ,x is easi] to spread ! infection ( sc>let fev] & measles ?an t ( diph!ria1 b x is n s difficult to dis9fect aft] sc>let fev] & measles z aft] diph!ria4 ,! contagion ( sc>let fev] does n resi/ ! fumes ( sulphur or =mal94 ,dis9fect a room aft] sc>let fev] z = diph!ria b be sure to use also ei!r sulphur or =mal9 because ! contagion c float ab\t a room4 ,eruptive contagi\s diseases l sc>let fev]1 smallpox1 & measles s affect ! sk9 t dur+ convalesc5ce ! cuticle scales (f4 ,9 sev]e cases ( smallpox & sc>let fev] ! entire out] sk9 ( ! h& may peel (f l a glove4 ,! contagion is always f\nd 9 ! scal+ sk94 ,z ! pati5t gr[s /rong] ! scales become f9]1 until at la/ !y lie z m]e mealy du/ 9 ! holl[s ( ! elb[s or o!r p>ts ( ! body4 ,d[n to ! v la/ ^! scales are infecti\s1 & !y w reta9 ! infection = mon?s1 probably = a ye> or m4 ,! scales float 9 ! air ( a sick-room1 fall on ! clo?+ ( visitors1 are c>ri$ away by ! %oes ( ^? t leave ! room4 ,! scal+ may cont9ue = ?ree weeks--x commonly does4 ,^! ?ree diseases are infecti\s be=e ! scal+ beg9s1 sometimes be=e ! ra% is well out4 ,a v light attack ( any ( ^! diseases 9 "o *ild may infect ano!r fatally4 ,insi/ ^u keep+ a sc>let fev] or measles pati5t out ( s*ool until all scal+ has ceas$4 ,*ick5pox is almo/ a h>mless disease1 b x is m infecti\s ?an ev5 measles4 ,be cauti\s ) x because #aih ne>ly e epidemic ( smallpox beg9s ?r\gh "s "o mi/ak+ smallpox = *ick5pox1 al?\gh !re is little or no simil>ity betwe5 ! diseases4 ,a *ild ) tub]culosis ( ! lungs or a *ild infect$ ) acute syphilis %\ld n be p]mitt$ to g to s*ool "u any circum/ance4 ,9 ! *apt] on ,! ,prie/ 9 ,infecti\s ,diseases w be f\nd an acc\nt ( ! necessity ( vacc9ation z a precaution aga9/ smallpox4 ,t9ea ,favosa1 or favus1 is a contagi\s & a v /ubborn disease ( ! sk91 caus$ by ! fungus ,a*orion ,s*o5le9ii4 ,x produces yell[i% cru/s ab\t ! hairs ( ! scalp & o!r p>ts ( ! body1 & x de/roys ! hair4 ,x attacks also ! f+]-nails & ! sk9 t is )\t hair4 ,9 ! lat] /ages ( ! disease !re is a f\l od\r4 ,x is "o ( ! mo/ difficult ( ! scalp-diseases to cure2 mon?s & sometimes ye>s are requir$ to get rid ( x4 ,a *ild ) t9ea %\ld be kept away f s*ool2 & 8 desk & :at he t\*es %\ld be wa%$ ) ! bi*loride ( m]cury solution4 ,burn 8 books & pap]s4 ,r+worm is a k9d ( t9ea1 & x is caus$ by v>i\s m\ld fungi4 ,t9ea ,tonsurans is r+worm ( ! scalp2 ,t9ea ,circ9ata is r+worm ( ! body2 ,b>b]'s ,it* is ano!r =m2 !re is also a r+worm ( ! f+]-nails2 & ,pityriasis ,v]sicolor is /ill ano!r =m4 ,all are contagi\s1 & "s are difficult to cure because ! p>asite gets d[n betwe5 ! sk9 & ! hair-follicles & an antiseptic c n rea* x4 ,*ildr5 affect$ ) ^! diseases %\ld be kept away f s*ool until !y h be5 cur$4 ,! pres5ce ( lice & ( ! ,ac>us ,scabiei c br+ ab\t acute & sev]e sk9 eruptions4 ,! ,ac>us ,scabiei causes it*1 b =tunately x is r>e 9 ,am]ica4 ,^! p>asites g f p]son to p]son1 h5ce a *ild hav+ ei!r %\ld be kept f s*ool until he is clean4 ,a ?or\gh wa%+ w remove lice if !y h n yet inflam$ ! sk91 b it* requires a m vigor\s #aii treatm5t4 ,! desks ( su* pati5ts %\ld be dis9fect$ & _! clo?+ %\ld be bak$4 ,!y w probably be re9fect$ at home if ! treatm5t is n appli$ to o!r memb]s ( ! family4 ,contagi\s ,impetigo1 or porrigo1 z x 0 =m]ly call$1 is a sk9 disease common among *ildr51 & x may affect adults4 ,x appe>s to be ( p>asitic orig91 b ! specific organism t causes x has n be5 isolat$4 ,! lesions 9 ?is disease are commonly discrete--sep>ate "o f ano!r--b !y may be cr[d$ toge!r4 ,!y are vesico-pu/ul> & !y are sunk5 at ! top 9 ! typical =m4 ,if !y are n brok5 by scrat*+1 !y dry into a yell[i% cru/4 ,! disease affects only ! sk91 b z x is contagi\s a *ild affect$ ) x %\ld be kept f s*ool until cur$4 ,! desk & articles us$ by ! *ild %\ld be dis9fect$1 & 8 books are to be burn$4 ,:oop+-c\gh is v infecti\s1 &1 contr>y to ! popul> op9ion1 x is frequ5tly a fatal disease4 ,!re is a p]iod ( incubation = f sev5 to t5 days1 !n a cat>rhal /age foll[s 9 :i* ! *ild has ! symptoms ( an ord9>y cold4 ,9 ab\t ano!r week ! dry c\gh becomes p>oxysmal ) ! *>act]i/ic :oop :5 ! air is drawn 9 aft] ! fit ( c\gh+4 ,:5 !re is an epidemic ( :oop+-c\gh1 *ildr5 ) colds %\ld be s5t home f s*ool4 ,! objects us$ by a *ild t has :oop+-c\gh %\ld be dis9fect$1 & its books & pap]s are to be burnt4 ,mumps c be a s]i\s & a v pa9ful disease & x is infecti\s to a m>k$ degree4 ,! specific organism is n kn[n4 ,boys are m liable to ?is disease ?an girls are1 & recurr5ce is r>e4 ,aft] a p]iod ( incubation1 :i* la/s f two to ?ree weeks1 !re is fev]1 pa9 "u "o e>1 & ! p>otid gl& swells4 ,! disease is commonly mild1 b x may affect a *ild s]i\sly4 ,! pati5t is to be qu>ant9$1 :at x has t\*$ %\ld be dis9fect$1 & its books are to be burnt4 ,!re are a numb] ( infecti\s eye diseases t occur among s*ool-*ildr54 ,acute ,contagi\s ,conjunctivitis1 #bjj or p9k eye1 is "o ( ! mo/ important4 ,"o =m ( acute ,contagi\s ,conjunctivitis is caus$ by ! ,ko*-,weeks ,bacillus2 x is p9k eye1 prop]ly s call$1 & x is v infecti\s4 ,objects h&l$ by ! pati5t c infect o!rs & spread ! disease4 ,! attack is sev]e1 b ! prognosis = full recov]y is good4 ,! *ild %\ld be /rictly qu>ant9$ until all secretion f ! eyes has ceas$1 & :atev] he has t\*$ is to be c>efully dis9fect$4 ,ano!r =m ( ,acute ,infecti\s ,conjunctivitis1 less contagi\s ?an t caus$ by ! ,ko*-,weeks bacillus1 is br\ght ab\t by ! introduction into ! eye ( ! bact]ia t give rise to pneumonia4 ,commonly ! pneumonia bact]ia d n cause conjunctivitis unless ! pati5t is susceptible 9 a special mann]4 ,z x is difficult to diff]5tiate ?is second =m f ! fir/1 ! same precaution %\ld be us$4 ,tra*oma1 call$ also granul> conjunctivitis1 ,egyptian oph?almia1 & milit>y oph?almia1 is a v s]i\s inflammatory disease ( ! ext]nal eye :i* has ( late ye>s become preval5t 9 ,am]ican cities1 :i!r x has be5 br\ght by immigrants f ea/]n & s\!a/]n ,europe4 ,p]sons t h ?is disease on l&+ 9 ! ,unit$ ,/ates are deport$1 b despite ?is precaution x has crept 9 & is n[ endemic4 ,x is contagi\s1 & :5 well e/abli%$ x is extremely difficult to cure4 ,if untreat$ x la/s = ye>s & x may de/roy ! cornea & consequ5tly ! sight4 ,a tra*omat\s *ild %\ld be kept f s*ool until x has be5 cur$1 & t cure w take a v long "t4 ,! ,gonococcus c be c>ri$ into ! eye by h&l+ objects l soap1 t[els1 wa%-bas9s1 :i* h be5 us$ by p]sons afflict$ ) gonorrhoea4 ,! infection ( ! eye is v sev]e & dang]\s1 & ! usual qu>ant9e is to be obs]v$4 ,! oph?almia ( ! new-born is gonorrhoeal4 ,! ,diph!ria ,bacillus also may get into ! eye1 & set up a prim>y infection !re4 ,a membran\s conjunctivitis1 too1 is at times induc$ by pus organisms4 #bja ,x]osis ,epi!lialis1 tub]culosis1 leprosy1 & syphilis may affect ! eye prim>ily1 & additional =ms ( eye-diseases are f\nd t are infecti\s4 ,! g5]al rule1 !n1 is t *ildr5 ) any inflammation ( ! eyes are to be kept out ( s*ool until a physician pron\nces !m h>mless4 ,,au/9 ,,omalley4 #bjb ,,xvi ,,s*ool ,,hygi5e ,prie/s h to put up build+s = p>o*ial s*ools1 colleges1 sem9>ies1 orphan asylums1 conv5ts1 & ! l1 b 9 su* "w sanitation is commonly giv5 only a pass+ ?\ght 9 connection ) sew]-traps & ^! are left to ! wisdom ( a plumb]4 ,! physical welf>e ( y\? is almo/ z important z its m5tal tra9+1 & !re are _m factors beside sew]-traps involv$ 9 ! ef=t to su/a9 x4 ,if !re is fre$om ( *oice z reg>ds ! site ( a s*oolh\se or simil> build+1 ! top ( a small elevation is to be select$4 ,su* a position af=ds ! be/ natural dra9age1 removes dampness1 avoids inundations1 gives full sunlight & ! pur] air4 ,! top ( a high hill may be too expos$ to ! w9d4 ,next to ! top ( a knoll1 ! s\!rly slope ( a hill is to be *os54 ,! build+ %\ld n be ov]%ad[$ by a hill1 especially on ! we/]n side4 ,trees are n to be plant$ close to a build+ 9 :i* *ildr5 live1 & ivy & simil> plants %\ld n be p]mitt$ to cov] ! walls4 ,if a build+ is set 9 a holl[ x w be surr\nd$ ) *ill air & mi/s 9 ! cold seasons1 ev5 if a co/ly dra9age sy/em keeps ! cell> & basem5t dry4 ,a gravelly or s&y soil b5ea? a build+ is ! be/1 provid$ ?is soil is n already saturat$ ) organic matt]1 or is n close above a d5se lay] ( clay or rock4 ,clay1 m>l1 peat1 & made soils %\ld be avoid$ if possible1 because !y are full ( organic matt]2 !y are cold1 & !y infect ! gr\nd air4 ,rock does n make a good build+ site--its seams c>ry wat]4 #bjc ,! subsoil %\ld be dra9$ f\r or six feet bel[ ! cell> floor1 & ?is floor is to be laid 9 concrete & cem5t4 ,at ! level ( ! gr\nd !re %\ld be a c\rse ( holl[ vitrifi$ brick to exclude dampness & to give v5tilation4 ,lime/one walls conduct m heat 9 & out ?an an equal ?ickness ( glass1 bricks1 pla/]+1 & wa9scot+4 ,! porosity ( ! build+ mat]ial det]m9es ! int]*ange ( ! air ?r\gh ! walls1 & x affects ! temp]ature ( ! rooms4 ,if !re is wat] 9 ! pores ( ! walls heat is conduct$ rapidly1 b air is n p]mitt$ to pass4 ,brick z a build+ mat]ial has _m disadvantages1 b on ! :ole x is be/ = s*ools1 & x resi/s fire bett] ?an mo/ /ones4 ,! h>d] ! brick ! bett] x is--vitrifi$ brick is ! be/4 ,h>d-press$ brick ( a light col\r makes an excell5t out] wall-surface4 ,x is v d\btful t sew] gas escap+ into a h\se w directly c>ry ! micro-organisms ( diseases l typhoid & diph!ria1 b su* gas is poison\s1 depressant1 & x r5d]s ! inmates ( a h\se liable to disease2 less5s _! p[] ( resi/ance4 ,! typhoid bacillus & o!r bact]ia c1 ( c\rse1 be c>ri$ into a cell> by ! seep+ 9 ( dra9age wat]4 ,infants kept 9 ! upp] /ory ( a h\se 9 hot wea!r are m liable to inte/9al diseases ?an are ^? t live on ! l[] floors1 b "h ! weak5+ ag5t is heat4 ,tub]culosis1 scr(ula1 rheumatism1 neuralgias1 bron*ial1 & kidney affections are made worse 9 damp h\ses4 ,! *ief defects 9 plumb+ & dra9age are ! foll[+3 7#a7 ,e>!n pipe dra9s become brok5 or _! jo9ts leak1 & !y saturate ! gr\nd "u a h\se ) sewage4 7#b7 ,tree roots break & clog dra9 pipes4 7#c7 ,! pipes sometimes h n fall en\gh4 7#d7 ,dra9s )\t runn+ traps admit sew] gas4 7#e7 ,rats burr[ along a dra9 pipe f ! sew] into ! h\se & admit sew] gas4 7#f7 ,:5 ! soil pipe f a wat]-closet is expos$ 9 cold wea!r x may freeze up or be clogg$ by ur9>y deposits4 7#g7 ,rats gnaw ?r\gh lead pipes & jo9ts4 7#h7 ,two or m closets or s9ks ) unv5tilat$ #bjd traps on ! same pipe w siphon back sewage4 7#i7 ,ov]fl[ pipes sometimes h no traps & !y let 9 gas4 7#aj7 ,a% pits ne> a h\se c>ry moi/ure to walls1 7#aa7 ,cesspools leak ?r\gh ! soil4 ,9 plann+ a s*ool-build+ ! classrooms & ! /udy-halls are ! fir/ ?+s to be consid]$4 ,! classrooms %\ld be oblong1 ) ! aisles runn+ l5g?wise4 ,ea* *ild %\ld h at ! lea/ #ae squ>e feet ( floor space & #bjj cubic feet ( air space4 ,a room #cj by #be feet ) a ceil+ #ac feet f ! floor w s]ve = #dh pupils & no m4 ,?is is ! be/ size = a room :5 blackbo>ds & maps are us$ 9 tea*+1 because a l>g] room sets ! *ildr5 9 ! back seats too f> away to see )\t eye-/ra94 ,dormitories %\ld h at ! lea/ #cjj cubic feet ( air space = ea* *ild1 & great c>e is to be tak5 9 ! v5tilation4 ,*ildr5 ab\t #aj ye>s ( age require #aa h\rs ( sleep2 "u #ac ye>s1 #aj-a_/b h\rs2 "u #ae ye>s1 #aj h\rs2 "u #ag ye>s1 #i-a_/b h\rs2 "u #ai ye>s1 #i h\rs4 ,d n make *ildr5 get out ( b$ be=e sev5 o'clock 9 ! morn+2 d n let !m /udy be=e breakfa/1 & d n =ce !m to "w aft] half-pa/ eight or n9e o'clock at night until !y are at ! lea/ #ag ye>s ( age4 ,! h\rs = "w %\ld be3 ,ages ,h\rs ( "w a week ,f #e to #f #f #f to #g #i #g to #h #ab #h to #aj #ae #aj to #ab #bj #ab to #ad #be #ad to #ae #cj #ae to #af #ce #af to #ag #dj #ag to #ah #de #ah to #ai #ej ,"w giv5 = puni%m5t mu/ be includ$ 9 ^! h\rs4 ,no "o1 ev5 an adult1 %\ld /udy = m ?an two h\rs at a "t )\t an int]mission = a few #bje m9utes4 ,9 a bo>d+-s*ool no "o "u any pretext1 ev5 on ra9y days1 %\ld be p]mitt$ to /udy dur+ recreation h\rs1 & ! deprivation ( recreation to make up lessons is a relic ( b>b>ism4 ,if a tea*] c n get class "w done except by %utt+ up *ildr5 dur+ recreation h\rs1 remove ! tea*] or expel ! pupil4 ,! am\nt ( glaz$ w9d[ surface admitt+ light to a classroom or /udy-hall %\ld be f "o-six? to "o-f\r? ! floor space ( ! room1 & ?is mu/ be increas$ if ! light is ob/ruct$ by neighb\r+ h\ses or trees4 ,! light is to be admitt$ on ! left side ( ! pupils1--all o!r w9d[s %\ld be c\nt$ z v5tilators only4 ,w9d[s fac+ ! *ildr5 or ! tea*] are to be avoid$4 ,9 rooms f\rte5 feet high a desk tw5ty-f\r feet f a w9d[ is insuffici5tly light$4 ,! l>g] ! panes ( glass ! bett]1 & ! ext]nal appe>ance ( w9d[s is to be sacrific$ to good light+4 ,if scre5s are us$ to protect ! glass f /one-?r[+1 all[ance is to be made = ! light ! scre5s cut (f4 ,if a room c n h en\gh light f ! left side alone1 put ! additional w9d[s on ! "r s t _! l[] sills w be eight feet f ! floor2 & be c>eful 9 ?is case t ! light f ! "r is n bright] ?an t f ! left4 ,w9d[s %\ld h z little space z possible betwe5 !m to avoid alt]nate b&s ( %ad[ & light4 ,set !m up z ne> ! ceil+ z possible1 s9ce ! high] !y are ! bett] ! illum9ation2 & !y %\ld n be ar*$ at ! top4 ,! l[] w9d[ sills may be ab\t f\r feet f ! floor4 ,:5 w9d[ %ades are us$ to cut (f direct sunlight1 !y %\ld be some:at d>k] 9 col\r ?an ! walls4 ,if artificial light is us$ 9 bo>d+-s*ools 9 ! /udy-halls1 ! be/ light is "o t is z ne> 9 col\r z possible to ! :ite light ( ! sun1 & ample1 b n gl>+4 ,x %\ld be /eady1 & x %\ld n give out great heat nor injuri\s products ( combu/ion4 ,h5ce ! electric light is ! be/2 aft] t1 gas ?r\gh ,welsba* #bjf or ,siem5s burn]s4 ,well ref9$ k]os5e oil gives a good light1 b x is always dang]\s4 ,acetyl5e gas is n[ us$ 9 a safe app>atus1 & x also is an excell5t light4 ,no col\r t absorbs light %\ld be us$ on ! walls4 ,pale gre5i% gray1 ne>ly :ite1 is ! mo/ satisfactory col\r4 ,!re %\ld be no wall pap]1 curta9s1 or hang+s ( any k9d 9 a s*ool or college build+4 ,! wall decorations %\ld be z pla9 z possible1 ) no r\gh5$ places to cat* du/4 ,/airways are to be well light$2 !y %\ld be at ! lea/ five feet wide1 & h l&+s half-way betwe5 ea* /ory4 ,diagonal or spiral /airways are dang]\s4 ,/eps ) six-in* ris]s & elev5-in* treads are ! easie/ = *ildr51 b six-&-a-half-in* ris]s may be us$ 9 high s*ools & colleges4 ,c>bonic acid 9 ! air ( a classroom is an index ( impurity4 ,ext]nal air has ab\t ?ree p>ts ( c>bonic acid 9 #aj1jjj p>ts ( air1 & above sev5 p>ts 9 #aj1jjj is injuri\s4 ,ea* p]son exhales ab\t f\rte5 cubic feet ( c>bonic acid gas 9 an h\r4 ,!re is no easy me?od ( det]m9+ ! quantity ( c>bonic acid gas pres5t 9 a room1 & we mu/ !re=e arrange ! v5tilation s t ab\t #cjjj cubic feet ( fre% air an h\r w be suppli$ to ea* p]son 9 ! h\se4 ,beside c>bonic acid !re are o!r impurities 9 h\se air1 z du/1 micro-organisms ( disease1 exhalations f bodies1 sew] gas1 & ! l1 :i* accumulate & d injury :5 ! v5tilation is defective4 ,if e p]son 9 a h\se has #ajjj cubic feet ( air space1 natural v5tilation w suffice ord9>ily1 b artificial v5tilation is ne$$ 9 s*oolrooms & dormitories4 ,! subject ( v5tilation c n be satisfactorily discuss$ 9 a %ort article1 & ^? t are int]e/$ 9 s*ool build+ %\ld leave ! matt] to a compet5t ar*itect1 or /udy books & articles l ,j4 ,s4 ,bill+s' ,v5tilation & ,heat+1 ,pett5k(]'s ,ueb] ,luft 9 d5 ,s*ul51 & ,kob]'s article on ,h\se ,sanitation 9 ! ,ref]5ce ,h&book ( ! ,m$ical ,sci5ces4 #bjg ,! prop] heat+ ( a s*oolroom is a matt] s g5]ally und]/ood t !re is no ne$ = special rem>k "h1 except ?is1 t provision = prop] humidity 9 ! heat$ air is commonly neglect$4 ,*eap wat]-closets d n save money--!y get out ( ord] too easily4 ,! pan1 valve1 & plung] hopp]s are n to be tol]at$4 ,! only k9d to use are %ort-hopp] closets ) a trap t op5s into ! soil-pipe above ! floor4 ,^! may h valve-lift]s atta*$ to ! seats1 because *ildr5 =get to flu% ! hopp]s4 ,! v5tilation ( ! wat]-closets %\ld be sep>ate f t ( ! ma9 build+4 ,9 c\ntry places :]e vaults are us$1 !re %\ld be a supply ( dry loam kept1 & en\gh ( ?is to cov] ! fre% cont5ts %\ld be ?r[n into ! vaults e ev5+4 ,*ildr5 are seem+ly always ?ir/y1 & !y %\ld be all[$ to h all ! dr9k+ wat] !y want if ! s\rce is free f typhoid g]ms & infection by organic matt]4 ,common cups are an abom9ation1 & a prolific cause ( contagi\s diseases4 ,ea* *ild %\ld h its own cup4 ,! rules = desks & seats = *ildr5 are ^!3 #a4 ,! height ( ! seat %\ld be ab\t two-sev5?s ( t ( ! body4 #b4 ,! wid? ( ! seat %\ld be ab\t "o-fif? ( ! l5g? ( ! body1 or ?ree-f\r?s ! l5g? ( ! ?igh4 ,d n keep un=tunate little *ildr5's feet dangl+ all ?r\gh _! s*ool ye>s to save a few p5nies on s*ool furniture4 #c4 ,! seat %\ld slope d[nw>d a little t[>d ! back1 be slightly concave1 & h r\nd$ edges 9 front4 #d4 ,!re mu/ be a back-re/4 #e4 ,! *ild1 :5 sitt+ erect1 %\ld be able to place bo? =e>ms on ! desk )\t rais+ or l[]+ ! %\ld]s4 ,?is is a v important rule4 #f4 ,! seat mu/ be correctly plac$ z reg>ds ! di/ance ( its front edge f ! correspond+ edge ( ! desk4 #g4 ,! desk slope %\ld be #ae degrees4 #bjh ,badly con/ruct$ desks cause eye-/ra9 & m>k$ di/ortions ( ! sp9e4 ,desks %\ld be adju/able 9 height1 especially = gr[+ *ildr54 ,s*ool-*ildr5 gr[ mo/ rapidly betwe5 ! ages ( twelve & sixte5 ye>s--ne>ly two in*es a ye>--& ! desks & seats %\ld be adju/$ twice a ye> at ! lea/4 ,if a *ild is mov$ to ano!r desk an adju/m5t is to be made at once4 ,to c\nt]act ! bad effect ( long sitt+1 ev5 at prop]ly adju/$ desks1 *ildr5 %\ld be frequ5tly s5t to blackbo>ds1 & at regul> int]vals a few m9utes are to be giv5 to sett+ up ex]cises4 ,great att5tion %\ld be paid to ! eyesight ( *ildr54 ,^? t compla9 ( heada*e %\ld h _! eyes exam9$4 ,! l9es 9 s*ool books %\ld be n m ?an f\r in*es 9 l5g?1 & !y are to be pr9t$ 9 cle>1 well-lead$ type4 ,slates are dirty & unsanit>y3 let ! *ildr5 write on pap] t has a dull f9i%4 ,tea*]s %\ld prev5t l\ng+ positions at desks1 especially /oop+4 ,!y are n1 h[ev]1 to try to make *ildr5 "u fifte5 ye>s ( age sit /ill4 ,! y\ng/]s c n rema9 immovable1 & ! ef=t to make !m d s is irritat+ to no purpose4 ,n]v\s *ildr5 ne$ outdoor ex]cise m ?an any?+ else4 ,:5 n]v\sness takes ! =m ( religi\s scrupulosity 9 s*ool-*ildr5 & novices d n imm$iately apply a moral !ology to !m--call 9 a physician t has common-s5se1 because !re is a n]v\s scrupulosity :i* is mu* m frequ5tly met ) ?an ! purely spiritual =m4 ,aridity 9 pray]1 a loss ( s5sible devotion1 & simil> tr\bles h to d ) advance 9 ! spiritual life1 b !y m commonly h to d ) ! liv] 9 p]sons t are n ne>ly s important spiritually z !y fancy !y are2 & 9 ^! cases ! cook is ! p>ticul> devil at fault1 if !y h ex]cise en\gh4 ,"o ( ! *ief sanit>y evils 9 our bo>d+-s*ools1 conv5ts1 & simil> in/itutions1 is ! /upid sam5ess 9 ! food :i* may be o!rwise unobjectionable4 ,! meat1 = example1 may be good1 b ! college & sem9>y cook s5ds x into ! refectory *ill$ & clammy1 or hot & ov]done4 ,9 any case x is ev]la/+ly ! #bji same4 ,*ildr5 c pr$ict a d9n]'s +r$i5ts a mon? 9 advance4 ,give *ildr5 meat twice a day2 :ite fl\r 9 _! bread1 because x is dige/$ bett] ?an :ole fl\r2 all ! sug> !y want at meals2 milk r ?an tea1 & tea r ?an c(fee2 b let x be tea1 n a dose ( tannic acid4 ,! physical education ( girls is neglect$4 ,_! g5]al education is effem9ate r ?an fem99e4 ,if a conv5t faculty gr[s bold & mod]n x hires a tea*] ( gymna/ics1 puts an extra on ! bill ( exp5se1 & t5 or twelve weal?y girls play at gymna/ics if !y are n too lazy4 ,ev5 if ! :ole s*ool is oblig$ to att5d ! club-sw++ & po/ur+ & ! o!r nons5se1 little good is done4 ,girls %\ld be kept out ( doors = _! ex]cise1 & fre% air is mu* *eap] ?an a gymna/ic tea*]4 ,if s*ool-girls 7 =c$ into ! op5 air m1 !y w\ld n h "t = mun*+ c>amels ov] ! erotic spasms ( ,aram9ta & ,reg9ald 9 ! popul> novel1 & !re w\ld be advantage 9 ! *ange4 ,! abs5ce ( daily1 regul>1 & suffici5t ex]cise r5d]s girls li/less1 anaemic1 sall[1 f\l-brea!d1 melan*oly1 /oop$1 irritable4 ,d n p]mit boys "u eighte5 ye>s ( age to g into regul> tra9+ = college track-teams4 ,_! he>ts are n /rong en\gh = ! /ra94 ,boys %\ld n use tobacco 9 any =m1 b x is useless to try to make !m believe ?is /atem5t4 ,tobacco /unts a boy1 causes dyspepsia1 & r5d]s 8 m9d dull4 ,! measurem5ts made = ye>s at ,yale1 ,amh]/1 & o!r colleges1 by physical directors1 %[ rem>kable r$uction 9 ! height & *e/ expansion 9 tobacco us]s z comp>$ ) boys t d n smoke4 ,cig>ette smok+ w\ld n be diff]5t f o!r smok+ if x did n s readily t5d to excess4 ,cig>ette smoke is inhal$ m ?an ! smoke f cig>s & pipes1 & ?us m ( ! injuri\s +r$i5ts ( tobacco are absorb$4 #baj ,if a boy w smoke let him use a good long-cut tobacco :i* has little or no ,p]ique tobacco 9 x1 9 a ,rem+ton1 ,edison1 or simil> wood5 pipe4 ,^! are pipes ) /ems ( l>ge calibre1 & 9 ! /em !re is a roll ( absorb5t pap] or pi? :i* keeps ! pipe clean4 ,cig>s1 no matt] h[ co/ly !y may be1 are too /rong = a boy & = mo/ m54 ,a poor cig> irritates ! ?roat aside f ! regul> effect ( ! tobacco1 especially if !re is mu* nitre 9 ! wrapp]4 ,me]s*aum pipes are dirty & too /rong4 ,! tongue is irritat$ by a pipe t has a small bore 9 ! m\?piece3 use a m\?piece t has z l>ge a bore z possible4 ,cig> smok]s %\ld1 aft] cutt+ (f ! end ( a cig>1 bl[ ! du/ out ( x f ! light+ end to avoid inhal+ ?is irritat+ du/4 ,,au/9 ,,omalley4 #baa ,,xvii ,,m5tal ,,diseases ,,& ,,spiritual ,,direction ,x is a well-recognis$ fact t p]sons suff]+ f _m =ms ( beg9n+ m5tal disease are likely to be affect$ by an exagg]ation ( religi\s s5tim5t4 ,an unacc\ntable increase 9 piety is sometimes ! fir/ w>n+ ( approa*+ m5tal det]ioration4 ,x is n h>d to und]/& :y ?is %\ld be1 s9ce religi\s feel+s occupy s prom95t a place 9 ! m9ds ( ! majority ( p1 & ! removal ( prop] control ov] m5tal op]ations ( all k9ds leads to an exagg]ation1 especially ( ^? t h meant mo/ = ! individual be=e4 ,suppos$ religi\s vocations1 especially :5 ( sudd5 developm5t1 are sometimes no m ?an an index ( di/urb$ m5tality4 ,e confessor ( l5g?y exp]i5ce has _h "s examples ( ?is4 ,?is makes x important t cl]gym5 %\ld h a k ( at lea/ ! fir/ pr9ciples on :i* ! diagnosis ( m5tal diseases is made4 ,sup]iors ( religi\s communities1 & especially ^? t h to decide z to ! suitability ( ^? apply+ = entrance to1 or already 9 probation =1 ! religi\s life1 ne$ ev5 m ?an o!rs a def9ite k ( ! beg9n+ symptoms ( ! v>i\s m5tal diseases1 & ( ! types ( individuals t are mo/ prone to suff] f !m4 ,besides1 confessors & religi\s fri5ds & advis]s (t5 ga9 ! confid5ce ( ! m5tally diseas$ mu* m fully ?an any "o else4 ,x is to !m especially t ! e>lie/ symptoms ( beg9n+ m5tal di/urbance are liable to be fir/ manife/$4 ,aft] all1 a pa/or's & a #bab confessor's duty is b\nd up ) ! welf>e ( 8 spiritual *ildr5 9 e s5se2 & x w\ld be supremely s]viceable to ! pati5ts !mselves & to _! fri5ds1 if ^! e>lie/ symptoms c\ld be recognis$ & prop]ly appreciat$1 & due w>n+ ?us giv5 ( ! approa* ( fur!r m5tal det]ioration4 ,! m5tal diseases t are ( special int]e/ 9 ?is respect are ! s-call$ idiopa?ic insanities4 ,idiopa?ic is a ^w we m$ical m5 use to conceal our ignorance ( ! cause ( disease4 ,idiopa?ic diseases are ^? t h come ( !mselves1 t is1 )\t asc]ta9able cause4 ,z a matt] ( fact1 ! mo/ important gr\p ( m5tal diseases develop )\t pres5t+ any alt]ation ( ! bra9 sub/ance1 s f> z c be detect$ by our pres5t-day me?ods ( exam9ation4 ,! initial symptoms ( ^! diseases1 !n1 are ( great importance1 & n readily recognisable unless look$ = especially4 ,!re is no physical *ange to attract att5tion1 & ! *ange ( disposition & m5tal condition is (t5 insidi\s & only to be recognis$ by "s "o :o is 9 ! confid5ce ( ! pati5t4 ,x is 9 ^! idiopa?ic insanities1 !n1 t ! c>eful obs]vation ( ! cl]gyman is ( special significance4 ,ne$less to say1 p[]s ( obs]vation to be ( s]vice mu/ be tra9$4 ,:ile !re are no kn[n *anges 9 ! bra9 tissues 9 ^! diseases1 x seems n improbable t ! developm5t ( our k ( bra9 anatomy1 :i* is especially active at ! pres5t "t1 w v soon demon/rate ! m9ute lesions t are ! basis ( ^! m5tal di/urbances4 ,x seems n unlikely t ! und]ly+ cause ( s-call$ idiopa?ic insanity is usually "s *ange )9 ! bra9 cells4 ,h9ts ( ! tru? ( ?is conjecture are already at h&4 ,meantime ! actual obs]vation ( ?is class ( pati5ts 9 asylums & in/itutions1 private & public1 & ! collation ( ! obs]vations ( au?orities 9 psy*iatry f all ov] ! _w1 h ?r[n a great deal ( light on ^! =ms ( m5tal disease4 ,we "k mu* m ( ! initial symptoms & ( incipi5t conditions t ?reat5 ! developm5t ( m5tal #bac disequilibration ?an we did tw5ty-five ye>s ago4 ,) reg>d to prognosis especially1 rec5t publications h add$ consid]ably to our k1 al?\gh x mu/ be confess$ t !y h r5d]$ our judgm5t ( su* cases mu* less hopeful4 ,! ord9>y =ms ( m5tal diseases h sometimes be5 consid]$ z pass+ incid5ts 9 ! lives ( pati5ts suff]+ f su* disord]s4 ,:ile x 0 g5]ally und]/ood t sev]e cases 7 apt to h recurr5ces1 & t aft] p]si/5ce ( m5tal symptoms = a c]ta9 l5g? ( "t ! outlook z reg>ds ev5tual absolute cure is r dubi\s1 yet ! g5]al prognosis ( su* simple /ates z melan*olia or simple mania 0 n consid]$ to be di/9ctly unfav\rable4 ,pati5ts might v well recov] _! m5tal s5sibility aft] ev5 a sev]e attack1 & nev] h a relapse4 ,x 0 some?+ ( an unpleasant surprise to ! m$ical _w1 a few ye>s ago1 :5 "o ( ! mo/ di/+ui%$ au?orities 9 ,europe on ! subject ( m5tal diseases1 ,pr(essor ,kraepel91 ( ! ,univ]sity ( ,heidelb]g1 /at$ 9 8 text-book ( psy*iatry1 t among a ?\s& cases ( acute mania he has obs]v$ only "o 9 :i* ! symptoms did n recur4 ,pr(essor ,b]kley1 ( ,johns ,hopk9s ,univ]sity1 ,baltimore1 a cons]vative ,am]ican au?ority1 9 discuss+ ?is subject ( relapses aft] s+le occurr5ces ( mania1 is evid5tly ( ! op9ion t ,pr(essor ,kraepel9's op9ion 9 ! matt] pres5ts ! inevitable conclusion t mu/ be drawn f rec5t advances 9 ! cl9ical k ( maniacal conditions4 ,simple mania1 he says1 is1 accord+ to ! /ati/ics n[ at h&1 an exce$+ly r>e =m ( m5tal disease1 & ! physician %\ld !re=e be cauti\s 9 mak+ a prognosis ( f9al recov]y4 ,relapses aft] a numb] ( ye>s1 :5 /ability is app>5tly assur$1 are frequ5t1 z e "o int]e/$ 9 m5tal m$ic9e kn[s only too well4 ,! m exp]i5ce ! speciali/ 9 m5tal diseases has1 ! less liable he is to give an op9ion t w assure fri5ds ( ! pati5t t relapses may n occur aft] any =m ( di/urb$ m5tality4 ,:ile ?is is true 9 mania1 #bad x is almo/ m g5]ally admitt$ ) reg>d to melan*olia4 ,mo/ pati5ts :o h "o attack ( sev]e depression ( spirits w surely h o!rs if !y are plac$ 9 circum/ances t enc\rage ! developm5t ( melan*olic ideas4 ,any sev]e emotional /ra9 w be foll[$ by at lea/ "s symptoms ( great] depression ?an w\ld be expect$ f ! normal p]son "u ! same conditions4 ,pr(essor ,kraepel9 has po9t$ out t 9 ab\t "o out ( six cases ! pati5ts :o came to him suppos$ly = ! treatm5t ( prim>y attacks ( melan*olia prov$ to be really suff]+ f a relapse ( sev]e m5tal depression4 ,! c>eful inve/igation ( ! hi/ory ( ^! cases %[$ t !y _h suff]$ f previ\s attacks ( depression1 ?\gh sometimes ^! 7 s slight z n to h attract$ any special att5tion f ! m$ical att5dant1--if inde$ "o _h be5 call$ 9 ! case--& at times ev5 fail$ to occasion m ?an a pass+ rem>k on ! "p ( fri5ds ) :om ! pati5t 0 liv+4 ,! mo/ frequ5t =m ( idiopa?ic insanity is melan*olia4 ,! disease is *>act]is$ by depression ( spirits4 ,pr(essor ,b]kley's def9ition1 besides be+ sci5tifically exact1 is popul>ly intelligible4 ,accord+ to him1 ,melan*olia is a simple1 affective insanity 9 p]sons n necess>ily burd5$ by neuropa?ic h]$ity1 *>act]is$ by m5tal pa9 :i* is excessive1 out ( all adequate proportion to its cause1 & accompani$ by a m or less well-def9$ inhibition ( ! m5tal faculties4 ,?is latt] "p ( ! def9ition is extremely important4 ,9 extreme cases pati5ts are able to accompli% no o!r m5tal acts beyond ^? :i* conc]n ! suppos$ cause ( _! depression4 ,_! lack ( att5tion to o!r ?+s is ! measure ( ! m5tal di/urbance4 ,_! m9ds con/antly revolve ab\t "o s\rce ( disc\ragem5t4 ,!y become absolutely introspective & _! surr\nd+s fail utt]ly1 9 pron\nc$ cases1 to produce any reaction 9 !m4 ,9 mild] cases ?is involves an increas+ neglect ( :atev] occupation ! pati5t may h1 solely = ! purpose ( giv+ up "t to ! contemplation ( ! cause ( 8 depression4 ,x is n easy always to recognise ! limits betwe5 a #bae depression ( spirits t is n entirely abnormal & a correspond+ /ate ( m9d t is manife/ly due to insanity4 ,:5 mis=tunes occur1 individuals w be m5tally depress$4 ,sorr[ has 9 x necess>ily no elem5t ( m5tal ali5ation4 ,x is only :5 x becomes excessive t obs]v]s realise t !re is di/urbance ( ! m5tal faculties1 caus+ ! undue p]si/5ce & ! exagg]ation ( ! grief4 ,= example1 a "m loses an only son 9 ! prime ( manhood & at ! height ( 8 c>e]4 ,x w n be surpris+ if1 = a consid]able p]iod1 %e is unable to take up once m ! ?read ( life :]e x 0 s rudely int]rupt$4 ,= weeks %e may react v little to h] surr\nd+s & may prove to be s moody z to ar\se suspicion ( h] m5tal condition4 ,aft] a "t1 h[ev]1 %e beg9s to h "s ( h] old int]e/ 9 affairs ar\nd h]4 ,h] depression ( spirits may n entirely disappe> = long ye>s1 p]haps nev]2 b h] affective /ate does n g beyond a simple sorr[4 ,on ! o!r h&1 "u ! same circum/ances1 a "m may give way to transports ( grief t aft] a :ile settle d[n into a p]si/5t /ate ( dejection4 ,e ?\ght1 e ^w1 e motive1 has a sorr[ful aspect to h]4 ,aft] a "t %e may beg9 to ?9k & ev5 to /ate t ! mis=tune ( ! loss ( h] son has come because ( h] own exce$+ wick$ness4 ,%e may consid] x a puni%m5t f on high & ?9k t %e has committ$ ! unp>donable s9 & absolutely refuse any consolation 9 ! matt]4 ,?is /ate ( m9d is di/9ctly abnormal1 & if x p]si/s = "s "t mu/ lead to ! pati5t's be+ kept "u c>eful surveillance4 ,! imm$iate cause ( ! developm5t ( su* a melan*olic /ate is always "s un=tunate ev5t 9 ! c\rse ( life4 ,worry & sorr[ are important causative factors4 ,mo/ly1 h[ev]1 ^! causes are only capable ( produc+ _! s]i\s effects ^u ! m5tal /ate ( pr$ispos$ individuals1 or at times :5 ! heal? ( ! subject is decid$ly bel[ ! normal4 ,emotional di/urbances are n liable to h su* s]i\s effects1 except :5 anaemia1 or cont9u$ dyspepsia1 or "s s]i\s nutritive dra9 ^u #baf ! sy/em1 l frequ5tly cont9u$ hemorrhages1 p]si/5t dys5t]ic conditions1 or too prolong$ lactation1 h br\ght ! sy/em into a condition ( l[]$ vital resi/ance4 ,un=tunately1 9 ord9>y life ^! run-d[n physical conditions are prone to be associat$ ) ! worry & ov]work t prec$e disa/]4 ,! effect ( grief z a cause ( melan*olia may be/ be realis$ f ! fact t 9 some?+ ov] "o-half ( all ! cases ( melan*olia ! dea? ( a ne> relative1 fa!r or "m1 or ev5 m frequ5tly husb& or wife1 or *ild1 is f\nd 9 ! cl9ical hi/ory ( ! pati5t %ortly be=e ! developm5t ( ! m5tal di/urbance4 ,s]i\s bus9ess tr\bles1 h[ev]1 loss ( prop]ty1 actual want ( prop] n\ri%m5t1 failure to succe$ 9 "s project on :i* ! m9d has be5 set1 & simil> conditions1 s common 9 our mod]n hurri$ life1 are also capable ( produc+ ! m5tal depression t assumes an insane "* 9 c]ta9 individuals4 ,= ! developm5t ( melan*olia a pr$isposition seems to be necess>y4 ,mo/ p c suff] ! rev]ses ( =tune1 ! accid5ts ( life1 & ! griefs ( loss ( fri5ds & relatives1 )\t m5tal disequilibration4 ,c]ta9 pr$ispos+ factors are well kn[n4 ,h]$ity1 = in/ance1 is extremely important4 ,melan*olic conditions are frequ5tly f\nd 9 successive g5]ations ( ! same family4 ,:ile h]$ity is n z prom95t a feature 9 melan*olia z 9 o!r =ms ( insanity1 ! direct desc5t ( a special =m ( melan*olic m5tal di/urbance f "o g5]ation to ano!r is not$ m frequ5tly ?an 9 any o!r =m ( insanity4 ,wom5 are m (t5 ! subjects ( melan*olia ?an are m54 ,?is is especially true 9 ! e>li] & 9 ! lat] p]iods ( life4 ,9 ! ye>s betwe5 tw5ty & ?irty-five ! proportion ( cases 9 ea* sex is m ne>ly equal4 ,! two conditions1 ! e/abli%m5t ( ! sexual functions1 t is1 ! important sy/emic *anges incid5t to pub]ty1 & ! oblit]ation ( ! sexual function at ! m5opause1 ) its consequ5t physical di/urbances1 are especially important 9 pr$ispos+ to ! occurr5ce ( #bag melan*olia 9 wom54 ,_! m5tal functions are less /able naturally1 & are subject to great] physical /ra9s & /resses4 ,*ildbir? & lactation are also important factors 9 ! causation ( ! condition4 ,long-cont9u$ lactation--t is1 beyond ! physiological limit ( ab\t n9e mon?s--is especially a frequ5t cause4 ,! developm5t ( ! m5tal di/urbance 9 ?is case is always prec$$ by a /ate ( int5se anaemia1 9 :i* ! sk9 assumes a pa/y pal5ess1 & o!r physical signs give w>n+ ( ! dang]4 ,lactation is sometimes prolong$ = no bett] reason ?an ! hope to avoid pregnancy4 ,usually we may say ?is me?od fails ( its purpose & pregnancy & lactation toge!r "w s]i\s h>m4 ,9 "y p p>ticul>ly1 homesickness is a n uncommon cause ( melan*olia4 ,x is especially liable to produce ! condition if "y p at a di/ance f home are subject$ to s]i\s m5tal & physical /ra9 at a "t :5 ! food provid$ = !m is ei!r insuffici5t or unsuitable1 or :5 di/urbances ( _! dige/ive sy/ems make x impossible = !m prop]ly to assimilate x4 ,a numb] ( in/ructive examples ( ?is condition h occurr$ 9 ! la/ few ye>s among our "y soldi]s 9 ! ,philipp9es4 ,to ! physical /ra9 necess>ily incid5t to campaign+1 especially 9 "y m5 unaccu/om$ to ! life ( ! soldi]1 !re 0 add$ ! s]i\s trial ( ! tropical climate & ! unusual & n ov]-abundant or v>i$ diet provid$ by ! army rations4 ,auto9toxication is said to play a prom95t role 9 ! causation ( melan*olia4 ,?is supposes t !re is a manufacture ( poison\s mat]ials )9 ! sy/em1 ^: transf]5ce to ! n]v\s tissues causes functional di/urbance ( ^! delicate organs4 ,su* poisons are especially liable to be manufactur$ :5 dige/ive di/urbances h exi/$ = long p]iods ( "t1 or :5 *ronic alcoholism is a feature ( ! case4 ,! ord9>y depress$ condition s famili> 9 our dyspeptic fri5ds & t develops s commonly z ! result ( indige/ion1 is an example ( ! depress+ effect ( toxic sub/ances ^u n]v\s tissues & m5tal /ates4 #bah ,melan*olia does n develop z a rule )\t "s w>n+ ( :at may be look$ =4 ,nutritive di/urbances are ne>ly always prom95t features 9 ! case = "s "t be=e any m5tal peculi>ities are notic$4 ,pr(essor ,b]kley rem>ks t a feel+ ( woe & ( uneas9ess seems to be ! way by :i* ! bra9 expresses its s5se ( ! lack ( prop] n\ri%m5t4 ,usually !re has be5 di/9ct dige/ive di/urbance = "s mon?s4 ,!re is apt to be loss ( appetite4 ,!re may be "s slight yell[ness 9 ! :ites ( ! eyes4 ,commonly !re has be5 an increas+ disreg>d = ! pati5t's usual habits1 especially 9 ! matt] ( ex]cise & fri5dly int]c\rse4 ,!re is a disposition to sit ap>t & brood by ! h\r1 & a well-m>k$ t5d5cy to avoid fri5ds & ev5 memb]s ( ! family1 ) an utt] dis9cl9ation to meet /rang]s4 ,"o ( ! m>k$ features ( ! disease 9 wom5 is a t5d5cy to untid9ess4 ,wom5 lose all reg>d = _! p]sonal appe>ance & fail to arrange _! clo!s prop]ly4 ,m5 :o h be5 specially neat 9 _! p]sonal appe>ance take on sl\*y1 c>eless habits1 all[ _! clo!s to become soil$ & dirty1 & h evid5tly =gott5 all _! old cu/oms 9 ?is matt]4 ,! symptoms are n always cont9u\s4 ,!re is (t5 a rhy?mic alt]ation ( int5sity ( symptoms t corresponds m or less to ! physiological rhy?m ( life4 ,9 ord9>y circum/ances human temp]ature is highe/ 9 ! aft]noon & vital processes are mo/ active at ?is "t4 ,! l[e/ temp]atures occur 9 ! morn+1 especially 9 ! e>ly h\rs2 & x is at ?is "t t vital processes are lea/ active & ! g5]al condition is mo/ depress$4 ,x is n surpris+1 !n1 to f9d t melan*olic pati5ts are liable to suff] f deep] m5tal depression dur+ ! morn+ h\rs4 ,9 suicidal cases x is especially 9 ! morn+ h\rs t pati5ts ne$ ! close/ surveillance4 ,9 a c]ta9 numb] ( cases ( melan*olia1 in/ead ( ! quiet1 (t5 absolute immobility ( ! pati5ts1 !re is a =m ( ! disease *>act]is$ by ! pres5ce ( incessant movem5t & an agitat$ /ate ( c\nt5ance1 #bai t disclose _! di/urb$ m5tal conditions4 ,9 melan*olia1 z a rule1 sleep is v mu* di/urb$1 & at times pati5ts d n sleep at all4 ,9 ! agitat$ =m ( melan*olia1 ! pati5t is (t5 quiet only :5 "u ! influ5ce ( a sleep+-potion4 ,pati5ts may te> _! hair1 dis>range _! clo?+1 /rike !mselves1 hit _! heads aga9/ ! wall1 sigh & sob1 & repeat "s phrase t indicates _! deep depression4 ,!y are apt to reit]ate su* expressions z ,i am lo/1 ,i am damn$4 ,?is is a mu* m s]i\s =m ( melan*olia ?an ! quiet k9d4 ,! m5tal faculties are mu* m completely unbalanc$1 & ! prognosis ( ! case is m unfav\rable4 ,!re may be recov]y )9 a v %ort "t1 & ?is recov]y may be m or less complete4 ,usually1 h[ev]1 ! condition becomes *ronic & runs = _m ye>s4 ,su* pati5ts may sometimes be di/ract$ suffici5tly f _! /ate ( depression to smile & manife/ pleasure 9 o!r ways4 ,usually1 h[ev]1 ?is div]sion is only tempor>y & !y recur to _! d>k] moods until "s new & specially /rik+ notion di/racts _! ?\ghts once m4 ,) reg>d to melan*olia ! mo/ important feature is ! t5d5cy to suicide4 ,?is is apt to be pres5t 9 any case1 h[ev] mild1 & may ass]t itself unexpect$ly at any mom5t4 ,:]e !re is suspicion ( ! exi/5ce ( melan*olia1 pati5ts mu/ be "u con/ant surveillance2 &1 z a rule1 !y %\ld be "u ! sup]vision ( "s "o accu/om$ to ! difficulties t su* cases may pres5t4 ,pati5ts are (t5 extremely +5i\s 9 ! me?ods by :i* !y obta9 ! opportunities necess>y = ! commission ( suicide4 ,= in/ance1 a man :o has be5 calm 9 8 depression & has %[n no special suicidal t5d5cies may make 8 prep>ations app>5tly to %ave & !n use 8 razor ) fatal success4 ,9 a rec5t case 9 ,new ,york ,city1 a woman "u ! surveillance ( a new1 ?\gh tra9$ nurse1 ask$ ! nurse to /ep f ! room = a mom5t4 ,:5 ! nurse came back ?ree m9utes lat]1 ! woman 0 cru%$ to dea? on ! sidewalk sev5 /ories bel[4 ,a male pati5t asks an att5dant #bbj to /ep f ! room = a mom5t = reasons ( delicacy1 & takes ! opportunity to possess himself ( "s %>p in/rum5t or ( "s poison4 ,at times1 dur+ ! night1 pati5ts rise up :ile att5dants doze = a few m9utes1 & f9d ! means to hang !mselves )\t ! production ( ! slighte/ noise4 ,^! un=tunate suicides are happ5+ e day4 ,!y are ! sadde/ possible bl[ to a family4 ,only ! mo/ c>eful wat*fulness w prev5t _! occurr5ce4 ,cl]gym5 %\ld add ! weight ( _! au?ority to t ( ! m$ical att5dant 9 insi/+1 :5 su* pati5ts are kept at home1 t !y %all be gu>d$ e mom5t4 ,z a rule melan*olic pati5ts %\ld be treat$ 9 an in/itution4 ,_! *ances ( ultimate complete recov]y1 &1 m important /ill1 ( spe$i] recov]y ?an at home are mu* bett] "u ! r\t9e ( in/itution life & ! c>e ( tra9$ att5dants4 ,ne>ly ?ree-f\r?s ( ! pati5ts :o suff] f melan*olia w recov] f a fir/ attack "u prop] c>e4 ,subsequ5t attacks make ! prognosis mu* m unfav\rable4 ,n m ?an "o-half w recov] f a second attack1 &1 al?\gh melan*olia is (t5 spok5 ( z a mild =m ( intellectual di/urbance1 recurr+ attacks give a proportionately worse & worse outlook = ! pati5t4 ,if ! g5]al condition ( ! pati5t1 t is1 ! physical heal?1 is v mu* run d[n :5 ! m5tal di/urbance comm5ces1 !n ! outlook is mu* bett] ?an if ! m5tal di/urbance %\ld occur :5 ! pati5t is enjoy+ ord9>ily good heal?4 ,?91 anaemic pati5ts1 contr>y to :at might be expect$1 usually recov] & (t5 _! recov]y is p]man5t4 ,! fir/ fav\rable sign 9 ! case is an improvem5t 9 physical heal?4 ,?is is v %ortly foll[$ by an almo/ correspond+ improvem5t 9 ! m5tal condition4 ,:5 ! pati5t has rea*$ ! normal physical condition1 ! m5tal di/urbance has usually disappe>$4 ,x is an extremely unfav\rable sign1 h[ev]1 to h run-d[n pati5ts gradually improve 9 physical heal? #bba )\t comm5surate improvem5t 9 _! m5tal condition4 ,?is is ne>ly always a positive index t ! m5tal di/urbance w cont9ue = a long :ile1 may n be recov]$ f completely1 or may deg5]ate into a condition ( dem5tia ) m or less complete loss ( m5tal faculties4 ,! sev]e =ms ( melan*olia are apt to be associat$ ) delusions4 ,fe> becomes a prom95t factor1 & ! pati5t is afraid ( e "o :o approa*es1 or conc5trates 8 timidity ) reg>d to c]ta9 p]sons or ?+s4 ,delusions ( p]secution are n unusual1 & ?is sometimes leads to homicidal t5d5cies4 ,aft] endur+ suppos$ p]secution = z long z he consid]s x possible1 ! melan*olic turns on 8 p]secutors & inflicts bodily h>m4 ,! simple/ actions1 ev5 ef=ts to b5efit ! pati5t by en=cem5t ( ! regulations ( ! physician1 may be miscon/ru$ into s]i\s attempts at p]sonal injury1 = :i* ! pati5t may execute summ>y v5geance4 ,at times ! halluc9ations take on ! "* ( ! supposition t attempts to poison !m are be+ made4 ,! pati5t may conceal 8 suppos$ k ( ^! attempts until a fav\rable opportunity pres5ts itself = rev5g+ !m4 ,on ! o!r h&1 x is n an unusual ?+ to h melan*olic pati5ts commit homicide ) ! idea ( putt+ fri5ds out ( a wick$ _w4 ,! /ories s common 9 ! newspap]s ( husb&s :o kill wives & *ildr51 ( mo!rs :o murd] _! *ildr51 are (t5 f\nd$ on "s su* delusion z ?is4 ,a "m argues ) h]self1 t h] own unwor?9ess is to be visit$ on h] *ildr51 & t !y are to be /ill m unhappy ?an %e is4 ,out ( mat]nal solicitude1 !n1 b 9 an acute excess ( melan*olia1 %e puts !m out ( exi/5ce & ends h] own life at ! same "t4 ,:5 ! melan*olia is f\nd$ on suppos$ incurable ills 9 ! body1 pati5ts are sometimes kn[n to mutilate !mselves1 or to h rec\rse to alcohol1 or "s n>cotic drug1 9 ord] to relieve !m ( _! pa91 :i* is mo/ly imag9>y1 & make life some:at m livable dur+ its cont9uance4 ,alcoholic excesses are especially common 9 #bbb cases ( recurr5t or p]iodical melan*olia4 ,_m ( ! cases ( s-call$ p]iodical dipsomania are really due to recurr+ attacks ( sev]e depression ( spirits1 9 :i* m5 take to alcohol z "s relief = _! int5se feel+s ( inw>d pa9 & disc\ragem5t4 ,"o ( ! mo/ *>act]i/ic symptoms ( melan*olia is ! refusal to take food4 ,sometimes ?is refusal is ! consequ5ce ( an express$ or conceal$ desire to commit suicide4 ,9 _m cases ! refusal ( food is associat$ ) ! pati5t's melan*olic delusions4 ,if ! pati5t is hypo*ondriac1 food is n tak5 because ! /oma* is suppos$ n to be able to dige/ x1 or because x w\ld nev] pass ?r\gh ! sy/em4 ,at times ! delusions are 9 ! moral sph]e & ! pati5t is too wick$ to eat1 or mu/ fa/ = a long p]iod or p]haps = ! re/ ( life1 ) ! idea ( do+ p5ance4 ,z a matt] ( fact ! refusal to eat is associat$ ) ! l[]$ /ate ( function all ?r\gh ! sy/em1 :i* is ! basis ( ! melan*olic condition4 ,?is causes loss ( appetite & l[]+ ( ! dige/ive function ) a c]ta9 am\nt ( nausea ev5 at ! ?\ght ( food1 s t x is sc>cely any wond] t pati5ts refuse to take food4 ,ne$less to say1 !y mu/ be made to eat4 ,?is (t5 requires ! ins]tion ( a /oma* tube & =c$ fe$+4 ,& z x mu/ be done regul>ly1 x is accompli%$ mu* m easily at an in/itution ?an at home4 ,! o!r mo/ common type ( functional m5tal disease is mania4 ,?is is a =m ( insanity *>act]is$ by exaltation ( spirits ) a rapid fl[ ( ideas & a di/9ct t5d5cy to muscul> agitation4 ,x is almo/ exactly ! opposite ( melan*olia 9 e symptom4 ,orig9ally1 ( c\rse1 mania meant any =m ( madness4 ,!n x became gradually limit$ to ^? =ms ( insanity :i* diff]$ f melan*olia4 ,n[ x has come to h a mean+ z an acute attack ( m5tal exaltation4 ,x is necess>y to rememb] ?is developm5t ( signification 9 read+ ! old] lit]ature on ! subject ( m5tal di/urbance4 ,pr(essor ,b]kley calls att5tion to ! fact t ,%akespe>e's /atem5t1 ,melan*oly is ! nurse ( fr5zy1 may h be5 f\nd$ ^u ! obs]vation t !re are #bbc few cases ( m5tal exaltation )\t a =]unn+ /age ( depression4 ,x is *>act]i/ic ( ! acuity ( obs]vation ( ! poet ^: works h creat$ s mu* discussion z to 8 e>ly tra9+1 t ?is association ( m5tal /ates1 :i* became an accept$ sci5tific tru? only dur+ ! la/ c5tury1 %\ld h be5 anticipat$ 9 a pass+ rem>k 9 ! developm5t ( a dramatic "*4 ,melan*olia prec$es mania s con/antly t x is n an unusual mi/ake 9 diagnosis to consid] a pati5t melan*olic :5 an outbreak ( mania is really prep>+4 ,mania is sometimes said to break out sudd5ly4 ,z a matt] ( fact !re are always prelim9>y symptoms2 ?\gh ^! are ( su* a g5]al nature t !y may h escap$ obs]vation4 ,! pati5t's hi/ory g5]ally %[s t !re has be5 loss ( appetite & consequ5t loss 9 weight1 commonly accompani$ by con/ipation & heada*e ) increas+ inability to sleep4 ,usually ^! symptoms h be5 pres5t at lea/ = "s weeks or a mon? or m4 ,!n ! pati5t bright5s up4 ,in/ead ( ! brood+ s common be=e1 !re is a t5d5cy to talkativ5ess2 ! eye is bright2 ! expression lively2 9 ! mid/ ( 8 loquacity ! pati5t becomes faceti\s & jocul>4 ,! backw>d be=e become ent]pris+4 ,und]tak+s are attempt$ t are evid5tly f> beyond ! p[]1 pecuni>y or m5tal1 ( ! individual4 ,active employm5t is s\ght1 &1 :]e ?is fails1 re/less to & fro movem5t becomes ! habit4 ,fri5ds notice ?is *ange 9 disposition1 & also note a c]ta9 lack ( connection 9 ! ideas4 ,!re is apt to be a di/9ct *ange ( disposition4 ,a man :o has be5 v loa? to make fri5ds be=e1 n[ becomes easy 9 8 mann] t[>d /rang]s & takes _m p into 8 confid5ce4 ,9 ! sev]] =ms motion becomes con/ant2 ! arms are ?r[n ar\nd2 to & fro movem5t at lea/ is kept up2 ! voice becomes l\d & is con/antly us$4 ,pati5ts c n be kept quiet1 &1 z a consequ5ce ( _! con/ant movem5t1 _! temp]ature rises & loss ( sleep makes !m weak] & weak] until p]haps physical exhau/ion ensues4 #bbd ,! causes ( mania are n always s di/9ctly traceable z ^? ( melan*olia4 ,h]$ity is an important factor4 ,?is is1 h[ev]1 n s mu* a "q ( actual direct inh]itance ( m5tal di/urbance f ! prec$+ g5]ation1 z a family trait ( m5tal weakness t c be trac$ ?r\gh _m g5]ations4 ,direct inh]itance ( acquir$ peculi>ities no sci5tific ?9k] n[ admits4 ,family peculi>ities1 h[ev]1 are traceable ?r\gh _m g5]ations4 ,s /rik+ a peculi>ity z ! possession ( six f+]s or six toes has be5 trac$ ?r\gh a majority ( ! memb]s ( z _m z five g5]ations 9 a s+le family4 ,& z has be5 said o!r family traits c be trac$ back 9 ! same way4 ,x w\ld n be entirely surpris+1 !n1 if m5tal peculi>ities & a pr$isposition to m5tal di/urbance %\ld be also a matt] ( inh]itance4 ,x is well kn[n n[ t ! physical condition ( ! bra9 sub/ance may h mu* to d ) ! intellectual functions4 ,injuries to c]ta9 p>ts ( ! bra9 may cause special *anges ev5 ( p]sonal disposition4 ,9 ! fam\s cr[b> case1 9 :i* an iron drill ov] f\r feet 9 l5g? 0 driv5 ?r\gh "o side ( ! head1 x 0 not$ t ! man1 :o _h be5 some:at morose be=e1 0 incl9$ to be m amiable aft]w>ds1 b also _h a t5d5cy to be bibul\s 9 8 habits4 ,g]man cl9icians h rec5tly po9t$ out t ! exi/5ce ( an excess ( pressure on ! frontal lobes ( ! bra91 su* z is produc$ by ! pres5ce ( a tum\r1 may cause a t5d5cy to make little jokes4 ,?is symptom is kn[n z ,witzelsu*t4 ,x is consid]$ ( di/9ct significance & value 9 localis+ tum\rs ( ! bra94 ,! "q ( ! type ( ! witticisms & p>ticul>ly a t5d5cy to obsc5ity are not$ z a special diagno/ic aid 9 ! recognition ( ! "* ( ^! tum\rs by at lea/ ?ree prom95t ,g]man m$ical obs]v]s4 ,if modifications ( ! bra9 sub/ance c produce *anges ( disposition & temp]am5t1 x is easy to und]/& h[ temp]am5t & disposition may be a matt] ( inh]itance4 ,if we inh]it a fa!r's nose & a "m's eyes1 #bbe ! m9ute/ con=mations ( bra9 sub/ance may also be inh]it$4 ,x is on ^!1 to a c]ta9 ext5t at lea/1 t ! g5]al outl9es ( ! disposition dep5d4 ,x w\ld n be surpris+ to f9d1 !n1 a disposition to m5tal un/ead9ess z ! result ( ! transmission ( bra9 peculi>ities4 ,"h1 z 9 ev]y?+ else1 !re is "q1 n m]ely ( p>5tal influ5ce1 b ( ! inh]itance ( ! family traits1 "s ( :i* are skipp$ 9 c]ta9 g5]ations4 ,:5 melan*olia & mania are said to be due to h]$ity z "o ( ! pr9cipal causes1 ! mean+ int5d$ is t 9 c]ta9 families ! bra9 tissues are liable to be transmitt$ 9 some:at impair$ condition1 & t ?r\gh ^! bra9 tissues ! m9d w ei!r n act prop]ly1 or "u ! /ress ( viol5t emotion1 ! loss ( fri5ds by dea?1 or ! loss ( =tune1 or s]i\s disappo9tm5ts 9 life1 or a love affair1 ! already tott]+ m5tal condition w be ov]turn$4 ,9 a ^w1 x is n ! direct transmission ( insanity1 b ( a pr$isposition to ! developm5t ( insanity "u /resses & /ra9s t is a matt] ( family inh]itance4 ,?is is consid]$ true n[ n only ( m5tal b ( all diseases4 ,n consumption1 b ! pr$isposition to x is inh]it$4 ,^! consid]ations make cle> h[ important ?is matt] ( h]$ity is4 ,physicians & /ud5ts ( an?ropology are s mu* conc]n$ ab\t ! increase ( insanity z ! result ( ! int]m>riage ( defectives t we are con/antly read+ 9 ! newspap]s ( attempts at ! legal regulations ( m>riage1 s z to prev5t fur!r racial deg5]ation4 ,"u pres5t circum/ances1 any su* legal regulation is probably impossible2 b x seems p]fectly cle> t cl]ical influ5ce %\ld be br\ght to be> to disc\rage1 z f> z possible1 int]m>riage among ^? ( ev5 slightly di/urb$ m5tal h]$ity4 ,especially mu/ any su* idea z ! possible b5eficial influ5ce ( matrimony 7= !re are popul> traditions to ?is effect7 be unhesitat+ly reject$ & x mu/ n be all[$ to tempt ^? int]e/$ to look on su* int]m>riage ) indiff]5ce4 #bbf ,ano!r & m s]i\s "q = ! cl]gyman is t ( ! vocation 9 life ( ^? :o are weak m5tally4 ,by vocation is meant n only religi\s call+1 b ! occupation 9 life g5]ally4 ,"y p ( un/able m5tality & especially ^? ( insane h]$ity %\ld be advis$ aga9/ tak+ up su* pr(essions z t ( actor or actress1 or brok]1 or o!r life duties t entail excitem5t & m5tal /ra94 ,z f> z possible !y %\ld be disc\rag$ f tak+ up city life1 & %\ld be advis$ to live quietly 9 ! c\ntry4 ,mania is apt to foll[ c]ta9 sev]e infecti\s diseases 9 delicate individuals4 ,pneumonia1 = in/ance1 or typhoid fev] or *orea1 & sometimes consumption or rheumatism1 may be foll[$ by a p]iod ( maniacal excitem5t4 ,sev]e injury to ! bra9 or ! pressure due to ! pres5ce ( a bra9 tum\r1 may also be a cause ( mania4 ,a c]ta9 numb] ( good au?orities 9 m5tal diseases h call$ att5tion to ! fact t mania is a little m liable to occur 9 pati5ts :o are suff]+ f he>t disease4 ,by ?is is meant 9 p]sons :o h "s organic lesion ( ! valvul> me*anism ( ! he>t4 ,?is leads to di/urbance ( ! circulation & int]f]es ) c]ebral nutrition1 ?us pr$ispos+ to functional bra9 di/urbance4 ,:ile melan*olia occurs v frequ5tly 9 old] p1 mania is almo/ ess5tially a m5tal disease ( ! "y4 ,! va/ majority ( cases occur betwe5 ! twelf? & ?irty-fif? ye>4 ,! subjects ( ! disease are usually ^? :o possess :at is call$ ! sangu9e temp]am5t1 t is1 hopeful1 en?usia/ic p1 easily excit$ & ar\s$1 easily ca/ d[n4 ,mania is mu* m common 9 females ?an 9 males4 ,"o ( ! important *>act]i/ics ( mania is ! sup]-excitation ( ! sexual faculty4 ,9 _m individuals ! fir/ sign ( _! m5tal disequilibration notic$ by fri5ds is a t5d5cy to sexual excess4 ,?is is true ( wom5 z well z ( m51 & ! ext5t to :i* ?is may manife/ itself is almo/ unlimit$4 ,at ! beg9n+ ( ! disease ?is symptom is (t5 a s\rce ( s]i\s misund]/&+1 & may be ! cause ( family disruption4 ,usually1 be=e #bbg !re are any op5 insane manife/ations1 !re are def9ite symptoms t w\ld po9t to a pa?ological excitem5t 9 ! sexual sph]e4 ,"o ( ! mo/ /rik+ *>act]i/ics ( maniacal pati5ts is ! anae/hesia t (t5 develops & is ma9ta9$ 9 spite ( ! mo/ s]i\s injury4 ,because ( ?is1 maniacal pati5ts %\ld be gu>d$ ) q z mu* c>e z ^? suff]+ f melan*olia4 ,i h se5 a pati5t :o1 dur+ an attack ( acute mania1 _h put h] h& ov] a light$ gas jet1 hold+ x !re until ! tissues 7 completely *>r$4 ,! burn] 0 beh9d an iron grat+1 b %e succe$$ 9 rea*+ x4 ,nei!r f ?is dreadful burn+ itself1 nor dur+ ! aft] dress+s1 did %e compla9 ( ! slighte/ pa94 ,because ( ?is anae/hetic condition & ! consequ5t lack ( compla9t1 maniacal pati5ts (t5 suff] f sev]e int]nal tr\ble )\t ! m$ical att5dant hav+ any suspicion ( its exi/5ce4 ,!re are few conditions t are m pa9ful1 = in/ance1 ?an p]itonitis1 yet maniacal pati5ts h be5 kn[n to suff] & die f p]itonitis1 due to inte/9al or ga/ric p]=ation1 )\t a s+le compla9t4 ,unexpect$ dea? frequ5tly occurs 9 mania because ( ! failure to recognise ! exi/5ce ( s]i\s pa?ological conditions4 ,pneumonia may develop1 = in/ance1 )\t ! slighte/ compla9t on ! "p ( ! pati5t & g rapidly on to a fatal t]m9ation dur+ ! exhau/ion incid5t to ! con/ant movem5t1 x be+ utt]ly impossible to conf9e ! pati5t to b$4 ,m5+itis may develop 9 ! same way & proce$ to a fatal issue )\t ! pati5t's mak+ any compla9t or any sign t w call att5tion to its exi/5ce4 ,9 ! meantime1 ! pati5t may be con/antly 9 ! wilde/ motion & s add to ! exhau/+ effect ( ! organic disease4 ,! prognosis ( acute mania is n unfav\rable4 ,pati5ts suff]+ f a fir/ attack w recov] completely 9 eight cases out ( t54 ,not)/&+ complete recov]y1 relapses are prone to occur :5ev] ! pati5t und]goes a sev]e emotional /ra94 ,z a rule n ne>ly s mu* m5tal di/urbance is requir$ to produce a second attack #bbh z ! fir/ "o1 s t pati5ts require great c>e4 ,9 a c]ta9 numb] ( cases recov]y is incomplete2 p]si/5t delusions rema91 & !re may ev5 be "s weakness ( intellig5ce4 ,p>anoia1 z x is call$1 mild delusional insanity1 may ass]t itself & !n may p]si/ = ! re/ ( life4 ,not)/&+ ?is1 pati5ts may get along 9 life reasonably well1 ?\gh _! m5tal condition is decid$ly bel[ ! normal4 ,9 a c]ta9 numb] ( cases1 aft] ! p]iod ( excitem5t disappe>s1 a c]ta9 am\nt ( dem5tia is notic$4 ,?is consi/s ( a di/9ct l[]+ ( ! intellig5ce1 ?\gh )\t ! pres5ce ( any special delusion4 ,?is dem5tia progresses until f9ally !re is a /ate ( almo/ complete oblit]ation ( ! m5tal faculties4 ,! prognosis z to life 9 cases ( mania is v good4 ,v few pati5ts die dur+ an attack ( acute mania4 ,at times !re is a developm5t ( tub]culosis t proves fatal1 because ( ! re/lessness ( ! individual4 ,pneumonia or typhoid fev] may also prove fatal4 ,besides mania or melan*olia1 !re is a ?ird =m ( functional m5tal disease1 :i* is a comb9ation ( ^! two =ms4 ,x is usually spok5 ( z circul> insanity4 ,! pati5t has usually fir/ an attack ( melan*olia1 !n an attack ( mania1 & !n aft] an int]val melan*olia & mania once m4 ,we h said t mo/ cases ( mania develop aft] a di/9ct /age ( depression ( spirits1 s t successive attacks ( mania take p>tly ! "* ( circul> insanity4 ,?is latt] disease1 h[ev]1 is an index ( a mu* m deg5]at$ m5tal /ate ( ! individual ?an is ei!r mania or melan*olia alone4 ,:5 x occurs1 ! prognosis z to future sanity = any l5g?y int]val is unfav\rable4 ,a s]ies ( attacks alt]nately ( depression & excitem5t f9ally make x necess>y to conf9e ! pati5t to an in/itution4 ,z might be expect$ 9 ?is sev]] =m ( m5tal di/urbance1 h]$ity plays an especially important "p 9 circul> insanity4 ,at lea/ #gj p] c5tum ( ! pati5ts affect$ %[ a family hi/ory ( insanity 9 "s =ms4 ,9 ?is disease direct inh]itance ( ?is p>ticul> =m ( #bbi m5tal di/urbance is noticeably frequ5t4 ,! pati5ts :o develop ?is =m ( insanity usually %[ m>k$ signs ( deg5]ation1 ev5 be=e any attack ( absolute m5tal di/urbance has occurr$4 ,w\nds ( ! head1 alcoholism1 & epilepsy are prom95t factors 9 ! production ( circul> insanity4 ,?is only means t ! pr$isposition to m5tal disequilibration is s /rong t b v little is requir$ to di/urb ! intellectual equilibrium4 ,=tunately1 circul> insanity is r>e4 ,9 #dj1jjj cases ( insanity 9 ,new ,york ,/ate1 only #if cases ( ?is =m 7 not$4 ,mild types ( ! disease are n1 h[ev]1 v r>e4 ,_m o!rwise sane p h alt]nat+ p]iods ( hopeful excitem5t & ( disc\rag+ depression1 n mom5t>y b endur+ = weeks at a "t1 :i* are really due to ! same functional di/urbances t 9 p ( less /able m5tality produce absolute insanity4 ,^! cases are ( special int]e/ to ! cl]gyman & to directors ( consci5ces4 ,,james ,j4 ,,wal%4 #bcj ,,xviii ,,neura/h5ia ,neura/h5ia1 or n]ve-weakness1 ! vap\rs ( ! old noveli/s & dramati/s1 is a v common malady1 & x gives ! cl]gyman tr\ble by ! turmoil x causes 9 families1 religi\s communities1 9 !mselves1 & else:]e4 ,:e!r ! condition is a di/9ct disease or n1 & t "q has be5 volum9\sly discuss$1 is n altoge!r an important matt]1 b t !re is su* a gr\p ( symptoms is un=tunately a weighty fact4 ,x takes s _m =ms t x is bewild]+1 & !re=e n readily r$uc$ to unity4 ,! c]ebral =m (t5 exi/s indep5d5tly4 ,!re is su* a ?+ z bra9 fag1 al?\gh _m compla9ants may h v little mat]ial = ! fag to "w on4 ,(t5 su* a pati5t is robu/1 ev5 an a?lete1 & 8 ass]tions meet ) ridicule or abuse in/ead ( treatm5t4 ,if ! pati5t is a woman %e is n seldom call$ hy/]ical4 ,%e is n hy/]ical4 ,hy/]ia1 by ! way1 is z di/9ct a tr\ble z a brok5 leg1 & f> m s]i\s1 & n a synonym = p]v]s5ess1 z ! t]m is popul>ly us$4 ,9 ! c]ebral =m1 bus9ess1 read+1 /udy g into "o e> & out ! o!r4 ,! pati5t's memory fails him tempor>ily j :5 he may ne$ x mo/1 say1 9 a spee* or s]mon2 a fly buzz+ on a pane is a calamity & a s\rce ( pr(anity2 a flat note 9 ! *oir-s++ is ample reason = d\bt+ ! div9e orig9 ( ! *ur*1 & e petty tr\ble t :isks its h>mless tail across 8 floor makes him seek ! table-top4 ,i h kn[n a :ole conv5t ( nuns1 :o 7 closely %ut 91 ) bad v5tilation & a worse cook1 until all 7 m or less neura/h5ic1 almo/ #bca dis9tegrat$ by ! pres5ce ( a lamb s5t 9 z a pet2 n because ( ! bleat+ or any ord9>y reason1 b solely because ( ! hide\s incongruity & indec5cy 9 ! fact t ! lamb 0 a male4 ,! c]ebral neura/h5ic makes ra%1 impetu\s *anges 9 8 mode ( life4 ,he leaves a religi\s ord] because ! c(fee is weak1 he resigns an important po/ 9 a bank because ! presid5t uses snuff1 he ab&ons m$ic9e = trade because ! curate m$dl$ 9 ! treatm5t ( two ( 8 pati5ts4 ,he takes on anxiety1 locks up ! h\se six times ov] ! same night2 meals are eat5 9 aw$ sil5ce by 8 trembl+ *ildr52 altoge!r he is an unmitigat$ nuisance4 ,he may get religi\s scruples4 ,if he is a prie/ he takes an h\r to an h\r & a half to say a l[ mass1 & mo/ ( t "t is sp5t 9 se>*+ ! corporal = imag9>y p>ticles or 9 dry+ ! dry *alice4 ,he r]eads 8 brevi>y until he is exhau/$4 ,because moral !ologians say t c]ta9 scruples are f ! devil1 he is conv9c$ t ! devil takes a p>ticul> int]e/ 9 8 case4 ,! devil did probably take a special int]e/ 9 8 fa!r's or gr&fa!r's lack ( scrupulosity1 = 8 condition is commonly a result ( alcoholism 9 an ance/or4 ,!re are ?ree *ief types ( neura/h5ics3 9 "o class is ! p]son t appe>s robu/1 & is really s except 9 8 n]v\s sy/em1 :i* lacks a gov]nor4 ,su* pati5ts h little m ?an a tr\bl$ appe>ance to draw ! att5tion ( a *ance obs]v] to _! condition4 ,a second class is made up ( eloqu5t n>rators ( _! tr\bles4 ,!y try all ! physicians 9 turn1 !n ! homoeopa?s & o/eopa?s & simil> quacks1 & !y add pat5t m$ic9es prescrib$ by !mselves4 ,!y are petulant1 caprici\s1 & despite _! app>5t en]gy !y accompli% no?+4 ,! ?ird class are sil5t1 limp1 clammy-h&$2 !y are br\ght aga9/ _! w to see ! physician2 !y are sulky2 bitt] & unreason+ hat]s2 incl9$ to melan*oly4 ,!y may h a t5d5cy ev5 to suicide1 b ?is is some:at r>e4 ,neura/h5ics are n s liable to insanity z is popul>ly suppos$1 b su* an outcome is possible 9 c]ta9 #bcb cases4 ,if _! vague fe>s g on into a m or less fix$ delusion !re is cause = anxiety le/ insanity result1 b c>e %\ld be tak5 "h to be sure ! delusion is really irremovable4 ,"s neura/h5ics are afraid to cross an op5 squ>e or a wide /reet1 o!rs dread any clos$ ap>tm5t4 ,v]tigo is common2 s is insomnia4 ,insomnia is almo/ a con/ant symptom4 ,! pati5t may h naps or he may h un9t]rupt$ vigils4 ,sometimes !re is a heavy b unrefre%+ sleep4 ,sleepless pati5ts are ?r[n into di/ract+ rage by ! b>k+ ( a neighb\r's dog1 ! h[l+ ( cats1 or ! cackl+ ( a successful h51 & !y haunt ! magi/rates' c\rts 9 ef=ts to suppress su* noises4 ,!y put cotton 9 _! e>s1 we> heavy nightcaps1 /op clocks1 bo>d up w9d[s 9 se>* ( sleep1 :i* is n f\nd4 ,^! pati5ts commonly h an endur+ feel+ ( weight or con/riction 9 ! head1 especially at ! occiput1--a heada*e t is n actual pa94 ,!y also h v]tigo1 :i* is indep5d5t ( any aural disease1 & ?is is transi5t1 %[+ itself on abrupt *anges ( position4 ,ano!r phase ( neura/h5ia is sp9al4 ,^! cases h pa9 9 ! back & _! legs give out4 ,! back-pa9 is a diffuse a*e1 or x manife/s itself on pressure at c]ta9 spots along ! sp9e4 ,!re may be sev]e pa9 at ! coccyx1 especially 9 wom54 ,! walk+ may simulate p>alytic =ms if hy/]ia is mix$ ) ! neura/h5ia4 ,c>diac symptoms are (t5 prom95t1 especially palpitation1 b !re is a n]v\s excitation ( ! he>t r ?an any def9ite lesion4 ,! ga/ro-inte/9al symptoms are (t5 important4 ,pa9 ref]r$ to ! /oma* & acidity are common1 ! tongue is coat$1 ! faeces scybal\s4 ,dige/ion is torpid4 ,sometimes !re is n]v\s di>rhoea4 ,a li/ ( ! belly symptoms describ$ by "s neura/h5ics is int]m9able4 ,we (t5 f9d a sexual =m1 :i* is ! wor/ ( all & ! h>de/ to cure4 ,x is commonly connect$ ) ma/urbation4 ,su* neura/h5ics are %ameless 9 ! description ( _! na/9ess4 ,x is bett] to keep !m f m>riage unless !y are cur$1 & !y are n to be foi/$ (f on #bcc any "o z husb& or wife to effect a cure4 ,allbutt says ( !m3 ,i fe> t "s ( our 'crim9al psy*ologi/s' are enc\rag+ _m sorts ( pruri5t debau*ees by dignify+ ! tales ( _! vice ) ! "n ( sci5ce1 a c\rse ( conduct :i* is 9 ! wor/ int]e/s bo? ( ^! p]sons !mselves & ( our own pr(ession4 ,x 7 a curi\s inquiry h[ x comes t sexual p]v]sions are s 'sci5tific' a /udy1 :ile ! brutalities ( ! ?ieves' kit*5 or ! wiles ( o!r pe/s ( society lie 9 comp>ative neglect4 ,physical1 intellectual1 or emotional /ra9 c cause neura/h5ia sudd5ly or gradually4 ,:]e x comes on )\t obvi\s cause !re is commonly a bad family hi/ory ( n]v\sness or alcoholism4 ,anaemia makes x worse2 eye-/ra91 too1 is a provok+ factor4 ,9 "s cases a r5al conge/ion is ! cause4 ,9 _m cases a lack ( re/ra9t1 bad education1 uncontroll$ passion1 are a m>k$ influ5ce 9 fix+ ! neura/h5ic habit4 ,a s$ul\s p>5t nags at a neura/h5ic *ild t is too weak = ex]tion until ! *ild's susceptibility to correction is blunt$4 ,in/ead ( treatm5t & help ! *ild receives cuffs & abuse1 & hell-fire is held up be=e him until he deems all religi\s talk du/ & a%es4 ,enc\ragem5t w sometimes d m good ?an all ! ?reats 9 ! via purgativa4 ,nagg+ nev] cur$ any?+ except a t5d5cy t[>d virtue1 & x always deep5s neura/h5ia4 ,be c>eful 9 ! selection ( a confessor = a neura/h5ic *ild4 ,get "o t does n believe 9 kick+ a s\l into p>adise4 ,! treatm5t ( neura/h5ia is difficult4 ,travel+ ab\t 9 se>* ( heal? is n advisable4 ,! ,weir ,mit*ell ,re/ ,cure is v effective 9 _m bad cases1 b x is co/ly1 & if n correctly appli$ x is useless4 ,x is ! only cure = "s pati5ts4 ,sea air helps a c]ta9 class ( neura/h5ics1 b x makes o!rs worse--x is bad = ! dyspeptic neura/h5ic4 ,a *ronic rh9itis1 a refractive error ( ! eyes1 a displacem5t ( ! ut]us1 a conge/$ kidney1 a float+ kidney1 a tight prepuce1 & simil> teas+ disord]s mu/ be cur$ be=e ! neura/h5ia c be remov$2 (t5 ! neura/h5ia disappe>s ) ?is cure4 ,traumatic neura/h5ia is l simple neura/h5ia 9 #bcd mo/ details4 ,x is call$ also n]ve %ock1 sp9al irritation1 railway sp9e4 ,!re is always a causative %ock or injury1 :i* is foll[$ at once or aft] an int]val by ! symptoms ( neura/h5ia4 ,9 acute traumatic neura/h5ia !re may be1 9 addition to ! symptoms obs]v$ 9 simple neura/h5ia1 high fev]1 & su* a fev] has be5 obs]v$ to g z high z #aac degrees ,fahr5heit4 ,,au/9 ,,omalley4 #bce ,,xix ,,hy/]ia ,! t]m ,hy/]ia 7,greek text ut]us7 has be5 h&$ d[n f ! days :5 physicians ?\ght !re 0 a connection betwe5 womb-disord]s & ! set ( n]v\s symptoms gr\p$ "u ! title hy/]ia4 ,x is n[ etymologically mean+less1--m5 also gr[ hy/]ical4 ,briquet f\nd #aa male to #bjd female hy/]ics1 & lat] /ati/ics increase ! numb] ( males4 ,! disease is n readily def9able4 ,! pati5t is usually a "y emotional woman1 (t5e/ betwe5 #ae & #bj ye>s ( age4 ,%e commonly has anae/hetic spots on h] body1 conc5tric limitations ( ! field ( vision1 & hy/]o-g5etic zones1 or t5d] po9ts1 :i*1 :5 press$1 appe> to inhibit ! hy/]ical fit4 ,! symptoms enum]at$ "h are n1 h[ev]1 f\nd 9 e case ( hy/]ia1 & x is difficult at times to diagnose ! disease4 ,! v>i\s manife/ations ( hy/]ia are 7#a7 apt to come & g sudd5ly4 ,a sev]e p>alysis t sudd5ly disappe>s = a "t is hy/]ical2 7#b7 ev5 if !y la/ = ye>s !y may be sudd5ly cur$2 7#c7 !y are dom9at$ m by m5tal & moral influ5ces ?an are ! symptoms ( any o!r disease2 7#d7 we f9d no organic lesion ) :i* we c connect ! symptoms4 ,! conditions t br+ ab\t hy/]ia are hy/]ia 9 a p>5t1 or insanity1 alcoholism1 or "s simil> neurotic ta9t 9 an ance/or4 ,!re is no direct connection betwe5 hy/]ia & ! disord]s ( ! sexual organs4 ,imm$iate causes are acute depressive emotions1 %ocks f dang]1 sudd5 grief1 sev]e revulsions ( feel+1 z f disappo9tm5t 9 love2 &1 secondly1 cumulative #bcf emotional di/urbance1 z f worry1 pov]ty1 ill treatm5t1 unhappy m>riage1 or religi\s revivals4 ,c]ta9 diseas$ conditions1 z anaemia1 *ronic intoxications1 pelvic tr\ble1 cause hy/]ia1 or1 m exactly1 />t x into activity :]e x is lat5t4 ,x is also communicat$ by imitation & x may become epidemic4 ,aft] ! great plague1 ! ,black ,dea?1 9 ! f\rte5? c5tury1 !re 7 v rem>kable epidemics ( imitative hy/]ia 9 ,g]many & else:]e4 ,9 #acgd1 at ,aix-la-,*apelle1 cr[ds ( m5 & wom5 danc$ toge!r 9 ! /reets until !y fell exhau/$ 9 a cataleptic /ate4 ,^! dances spread ov] ,holl& & ,belgium & w5t to ,cologne & ,metz4 ,x is said t 9 ,metz !re 7 #aajj ( ! danc]s se5 at ! same "t4 ,! ,danc+ ,plague broke out aga9 9 #adah at ,/rasburg1 9 ,belgium1 & along ! ,l[] ,rh9e4 ,viel hund]t f+5 zu ,/rassburg an ,zu tanz5 und spr+5 ,frau und ,mann1 ,am (fn5 ,m>kt1 ,gass5 und ,/rass52 ,tag und ,na*t ihr] viel ni*t ass51 ,bis ihn das ,wue!n wi$] gelag4 ,/4 ,vits ,tanz w>d g5annt die ,plag4 ,beckmann 7,hi/oria des ,fu]/5?ums ,anhalt4 ,z]b/4 #agaj7 tells ( a simil> outbreak 9 #abcg1 :]e9 ne>ly a hundr$ *ildr5 7 seiz$ by ! disease at ,erfurt1 & !y w5t along ! road to ,arn/adt1 danc+ & jump+ hy/]ically4 ,a numb] ( ^! *ildr5 di$ ( exhau/ion4 ,! same infection is (t5 at "w 9 ! fury ( a mob1 ! panic ( a beat5 army1 & x probably 0 an elem5t 9 ! ,*ildr5's ,crusade4 ,! ,t>antism s common 9 ,italy f ! fifte5? to ! eighte5? c5tury is ano!r example ( epidemic hy/]ia4 ,! ,bubonic ,plague ravag$ ,italy sixte5 times betwe5 #aaai & #acdj1 & smallpox 0 at "w :5 ! black dea? c\ld f9d no fre% victims4 ,z a consequ5ce ( economic di/urbance & fe> ! p 7 g5]ally neura/h5ic1 & a slight %ock 0 en\gh at times to set :ole villages into hy/]ical convulsions4 #bcg ,9 #aghg1 at ,hodd5 ,bridge 9 ,lanca%ire1 ,engl&1 a girl 9 a cotton mill ?rew a m\se ^u ano!r girl t _h a great dread ( ?is animal4 ,! fright5$ girl 0 ?r[n into a hy/]ical convulsion :i* la/$ = h\rs4 ,! next day ?ree girls t _h wat*$ h] 7 9 convulsions1 ! foll[+ day six m1 & two days lat] f\rte5 m girls & a man 7 9 fits4 ,am]ican :ite & negro camp-meet+s result 9 simil> outbreaks1 & ! ,fr5* ,convulsionnaires1 :o did outrage\s ?+s f #agca to #agij1 7 also afflict$ ) imitative hy/]ia4 ,! ,corni% ,jump]s1 f\nd$ 9 #agfj by ,h>ris ,r[l& & ,william ,williams1 & ! ,am]ican ,b>k]s 7 also hy/]ical4 ,! ,b>k]s 9 ! meet+s w\ld run ab\t on all f\rs gr[l+1 to %[ ! deg5]ation ( _! human nature1 & !y w\ld end 9 almo/ g5]al fits ( imitative hy/]ia4 ,!re 0 an epidemic ( hy/]ia 9 ,t5nessee1 ,k5tucky1 & a "p ( ,virg9ia1 :i* began 9 #ahjj & la/$ = a numb] ( ye>s4 ,x />t$ at revivals4 ,! majority ( ! cases 7 9 p]sons f #ae to #be ye>s ( age1 al?\gh x 0 obs]v$ 9 e age f #f ye>s to #fj4 ,! muscles affect$ 7 ^? ( ! neck1 trunk1 & arms4 ,! contractions 7 s viol5t t ! pati5ts 7 ?r[n to ! gr\nd1 & _! motions !re exactly resembl$ ^? ( a live fi% ?r[n out ( ! wat] ^u ! l&4 ,!re are num]\s !ories =mulat$ to expla9 hy/]ia2 "s are +5i\s1 especially t ( ,janet1 b none is conv9c+4 ,convulsions1 tremors1 p>alyses ( v>i\s =ms & degrees are common 9 hy/]ia4 ,9 major hy/]ia ! pati5t falls into a convulsion g5tly4 ,!re is *eck$ brea?+1 up to app>5t dang] ( suffocation4 ,!n foll[s a furi\s convulsion1 ev5 ) bloody fro? at ! m\?1 b !re is a trace ( wilfulness or purpose 9 ! movem5ts4 ,next may come a /age ( opi/hotonos1 :]e ! body is b5t back 9 a rigid ar* till ! pati5t re/s on h] heels & head only1 & ?is is foll[$ by relaxation & recurr5ce ( ! contortions4 ,an ec/atic phase succe$s ?is1 at times 9 ! s-call$ crucifix position1 ) outbur/s ( v>i\s emotions1 & a f9al rega9+ ( a #bch normal /ate4 ,any ( ^! /ages1 h[ev]1 may con/itute ! :ole fit4 ,9 m9or hy/]ia !re is commonly a s5sation ( a ris+ ball 9 ! ?roat 7! globus hy/]icus74 ,!re may be uncontrollable laught] or weep+4 ,muscul> rigidity is frequ5tly f\nd4 ,! pati5t1 especially if %e is a *ild1 may mimic dogs & o!r animals4 ,! sn>l+1 bit+1 & b>k+ ( false hydrophobia are hy/]ical2 ^! symptoms d n occur 9 real hydrophobia4 ,!re are almo/ innum]able physical symptoms ( ! disease1 :i* are *iefly ( m$ical int]e/1 b ! m5tal phases are su* z to involve que/ions ( morality4 ,! hy/]ical "* is m>k$ by an ov]ma/]+ desire to be an object ( g5]al sympa?y1 admiration1 or int]e/1 r ?an by a t5d5cy to bas] indulg5ce4 ,! w is weak1 ! emotions explosive1 ! pati5t is impulsive & lack+ 9 self-control4 ,%e is a giggl]1 :o goes f absurd laught] into floods ( te>s4 ,! desire = sympa?y & att5tion makes ! pati5t exagg]ate h] symptoms or simulate diseases & conditions t d n exi/ 9 h] case4 ,hy/]ics w swall[ p9s or /ick !m into _! fle% to =ce att5tion4 ,sometimes ! simulation ( disease is n will$4 ,if !re are a numb] ( hy/]ical girls 9 a hospital w>d & "o develops1 say1 a peculi> p>alysis1 )9 two or ?ree h\rs e hy/]ical woman 9 ! room w h ! same p>alysis1--n pret5d$1 b real1 al?\gh tempor>y4 ,x mu/ be rememb]$ t ! disease1 ) all its p]v]sity1 is z mu* a fact z pneumonia1 & ! elem5t ( %am is only "o ( its symptoms4 ,"s au?orities g s f> z to hold t a woman :o w n lie is n hy/]ical4 ,!y inv5t mo/ extraord9>y sl&]s aga9/ ev5 _! own imm$iate family1 & x is nev] prud5t to believe an accusation made by an hy/]ical pati5t1 no matt] h[ plausible ! /ory4 ,acquir$ hy/]ia 9 _m cases may be cur$1 b ! cong5ital condition is practically hopeless1 yet ! latt] k9d may be kept f viol5t outbreaks4 ,we c n prev5t drunk>ds1 epileptics1 & lunatics f propagat+ _! k9d1 & !re=e we %all /ill h ! #bci hy/]ic ) u4 ,! *ild t has a bad ance/ry & %[s hy/]ical t5d5cies %\ld be c>efully re>$4 ,if x has an hy/]ical fa!r or "m x %\ld1 if possible1 be remov$ f ?is evil influ5ce4 ,keep x f long h\rs ( me*anical "w t leaves opportunity = dream+4 ,%ut out novels & art = art's sake1 especially music4 ,give x a practical education4 ,tea* x ob$i5ce1 self-control1 & tru?fulness4 ,h>d5 its w by ex]cise at ?+s x does n l1 & d n coddle x4 ,d n m>ry (f an hy/]ical girl to cure h]4 ,d n inflict h] pres5ce ^u "s un=tunate "y man because he is a good citiz54 ,m>riage w n cure hy/]ia1--! wor/ cases are m>ri$ wom51 & !y beget o!r hy/]ics 9 spread+ succession4 ,:5 ! disease %[s itself (f] no sympa?y1--d n try to put out a fire ) oil4 ,:5 a good1 pi\s girl gr[s hy/]ical1 ! *ief ob/acles to h] cure are untactful & sympa!tic visits f fri5ds1 lay & cl]ical4 ,a visit f ! pa/or1 because ( 8 importance1 is always h>mful1 & if ! bi%op drives up 9 8 c>riage s t ! neighb\rs may see him1 all ! physicians 9 ! city c n help h]4 ,if y wi% to keep an hy/]ical girl 9 h] vap\rs1 get h] a physician t w gr[ excit$ ov] h]1 take ! de> *ild out ( s*ool & weep above h] c\*1 let ! family & its fri5ds assure ! un=tunate att5d+ physician 9 h] pres5ce t he is he>tless1 & %e w /ay hy/]ical to h] s\l's cont5t4 ,if y wi% to control ! attack1 or ev5 remove ! disease "u c]ta9 conditions1 call 9 an exp]i5c$ physician1 leave ! treatm5t to him1 & pay no att5tion to h]4 ,d n make light ( ! disease1 d n speak ( x at all4 ,!re are attacks t may be cur$ by ! razor-/rop or a bucket ( cold wat]1 b ^! are exceptional4 ,!y are new cases or old pr(essional (f5d]s4 ,r\gh treatm5t is n s good z pati5t tact1 b at times r\ghness is ! only cure4 ,,au/9 ,,omalley4 #bdj ,,xx ,,m5/rual ,,diseases ,m5/ruation is a p]iodic dis*>ge ( blood f ! ut]us & ! ,fallopian tubes4 ,x occurs e tw5ty-eight or ?irty days1 & x la/s f pub]ty to ! m5opause1 or ! cessation ( ! m5ses1--ab\t ! =ty-fif? ye> ( age4 ,!re is a connection betwe5 m5/ruation & ! production ( ! human ovum4 ,dur+ ! fir/ /age ( m5/ruation ! muc\s membrane l9+ ! ut]us swells to twice or ?rice its normal ?ickness1 & ?is gr[? is a prep>ation = ! reception ( ! ovum1 :i*1 z a rule1 is giv5 (f by "o ( ! ov>ies at ?is "t & passes out into ! ut]us4 ,m5/ruation & ovulation ord9>ily occur simultane\sly1 b !y may be indep5d5t & take place at diff]5t times4 ,if1 dur+ ?is /age1 ! ovum is impregnat$1 pregnancy beg9s1 & m5/ruation ceases until "s "t aft] *ildbir?4 ,9 m>ri$ wom5 conception is m likely to be effect$ dur+ ! fir/ /age ( m5/ruation ?an dur+ ! int]val ( quiesc5ce2 ! contr>y is almo/ ! exception4 ,impregnation1 h[ev]1 is likely to occur 9 ! spr+ m ?an at o!r seasons1 & ?is fact co9cides ) ! adv5t ( spr+ 9 v>i\s latitudes4 ,if ! ovum is n impregnat$1 ! mat]ial t made ! ut]9e muc\s membrane ?ick dur+ ! fir/ week ( m5/ruation deg5]ates & passes (f1 con/itut+ ! m5/rual fl[4 ,?is /age la/s ab\t five days4 ,a rep>ative p]iod ( ab\t f\r days foll[s1 & !n a p]iod ( quiesc5ce until ! next m5/ruation comm5ces4 ,m5/ruation is fir/ obs]v$ ab\t ! f\rte5? ye>1 b x may />t e>li] or lat]4 ,9 g5]al1 x comes on #bda e>li] 9 w>m climates1 & lat] 9 ! extreme nor?4 ,! m5/ruation1 too1 is likely to %[ soon] 9 ! lab\r+ classes ?an 9 girls :o d n "w4 ,ev5 9 normal m5/ruation !re is (t5 a m>k$ physiological excitation :i* affects ! entire p]son4 ,v commonly a n]v\s di/urbance & s5sitiv5ess are obs]v$1 & 9 wom5 t are n robu/ !re may be m5tal depression & irritability4 ,! temp]ature w rise a half degree1 & drop to ! normal height on ! day prec$+ ! fl[4 ,!re are d]angem5ts ( m5/ruation :i* are symptoms ( v>i\s diseases4 ,am5orrhoea is an abs5ce ( m5/ruation 9 conditions o!r ?an pregnancy or lactation4 ,absolute am5orrhoea is a complete abs5ce ( m5/ruation = sev]al mon?s2 relative am5orrhoea is delay$1 scant m5/ruation4 ,am5orrhoea is common dur+ convalesc5ce f acute diseases2 x is also a result ( *ronic diseases ( ! liv]1 /oma*1 inte/9es1 kidneys1 & especially ( ! lungs2 x complicates anaemia1 mal>ia1 rheumatism1 & o!r g5]al pa?ological conditions4 ,fright1 grief1 great anxiety1 m5tal %ock cause am5orrhoea2 s d homesickness & _m =ms ( insanity4 ,!re are also local causes ( ?is condition3 imp]fect developm5t ( ! ut]us or ! organs connect$ !re)1 & inflammations ( ^! organs or ( ! pelvic wall4 ,oppos$ to am5orrhoea is m5orrhagia1 or an excessive m5/rual fl[4 ,metrorrhagia1 or hemorrhage f ! ut]us at any "t1 is a t]m conf\nd$ ) m5orrhagia1 :i* is an inord9ate m5/rual loss ( ut]9e blood1 b ! di/9ction is n important4 ,m5orrhagia & metrorrhagia commonly h an id5tical cause & !y frequ5tly coexi/4 ,!y are f\nd 9 *ronic diseases ( ! he>t1 lungs1 liv]1 & o!r organs2 !y are an outcome ( prolong$ lactation1 & ( local affections ( ! ut]us & its app5dages4 ,any condition also t d]anges ! blood may cause m5orrhagia or metrorrhagia2 s d malignant tum\rs ( ! ut]us1 ut]9e displacem5ts1 lac]ations t #bdb occur 9 *ildbir?1 & psy*ical influ5ces1 z fright1 anxiety1 & o!r /rong emotions4 ,dysm5orrhoea1 difficult or ob/ruct$ m5/ruation1 is a t]m us$ = m5/ruation accompani$ by pa94 ,?is is a common m5/rual d]angem5t1 & x may be neuralgic or inflammatory 9 orig91 or x may be caus$ by ob/ruction to ! m5/rual fl[4 ,!re is ano!r v>iety ( dysm5orrhoea1 call$ membran\s1 9 :i* ! sup]ficial lay] ( ! ut]9e l9+ is ca/ (f p>tly or :olly4 ,9 ! neuralgic =m ! ut]us & its app5dages are normal 9 appe>ance1 b ! pa9 recurs mon?ly1 & x may h degrees f m]e discom=t to agony4 ,?is =m is *>act]is$ by reflex heada*e1 sympa!tic nausea or vomit+2 & ! pa9 may n be conf9$ to ! ut]us & its app5dages4 ,! irritation (t5 br+s out lat5t hy/]ical ph5om5a1 sp9al irritation1 & neura/h5ia4 ,rheumatism & g\t are pr$ispos+ causes1 s are indol5ce1 lack ( physical ex]cise1 light clo?+ 9 cold wea!r1 =c$ s*ool "w & simil> depress+ ag5ts4 ,9 ! neurotic v>iety ( dysm5orrhoea pa9 (t5 p]si/s aft] ! m5/rual fl[ has set 91 b 9 inflammatory dysm5orrhoea ! fl[ relieves ! pa9 or removes x4 ,m>riage commonly removes ! neurotic =m ( dism5orrhoea4 ,9 ob/ructive dysm5orrhoea ! m5/rual fluid is reta9$ by n>r[ or tortu\s outlets1 flexions ( ! ut]us1 & simil> causes4 ,! prognosis is good 9 all =ms ( dysm5orrhoea1 b frequ5tly long & skilful treatm5t is requir$ to cure su* conditions1 especially ! membran\s =m4 ,inflammatory1 ob/ructive1 & membran\s dysm5orrhoea are commonly made worse by m>riage4 ,at ! end ( ! *ildbe>+ p]iod m5/ruation gradually ceases4 ,9 temp]ate climates ?is m5opause occurs ab\t ! =ty-fif? ye>1 b x may come e>li] or consid]ably lat]4 ,"w t keeps a woman 9 a heat$ atmosph]e1 z cook+1 wa%+1 & bak+1 di/urbs m5/ruation & t5ds to advance ! m5opause4 ,work]s 9 *emical factories1 9 badly v5tilat$ rooms1 or wom5 t d heavy lab\r 9 ! op5 air1 are apt to age prematurely1 & h #bdc an e>ly m5opause or *ange ( life4 ,?is premature climact]ic is f\nd also 9 wom5 t be> _m *ildr5 9 rapid succession4 ,at ! m5opause !re may be v>i\s physical or m5tal di/urbances :i* are probably due m to ! some:at abrupt adv5t ( old age1 at ! cessation ( ! *ildbe>+ "p ( life1 r ?an to ! m5opause itself4 ,x is a fact1 h[ev]1 t (t5 pr(\nd di/urbances co9cide ) ! climact]ic1 & we "k no suffici5t cause = !m if ! m5opause itself may n be deem$ su*4 ,!re are num]\s disord]s ( ! n]v\s sy/em 9 wom5 :i* are dep5d5t directly or indirectly ^u a d]angem5t ( ! pelvic organs4 ,di/ant p>ts ( ! body are affect$ pa?ologically ?r\gh sympa!tic irritation :5 ! prim>y disease is 9 ! pelvic organs1 & direct treatm5t ( ! pelvic tr\ble alone cures ^! reflex conditions4 ,! v common disord]s ( pregnancy1 ! m>k$ physiological *anges 9 wom5 at ! beg9n+ ( m5/ruation ) pub]ty1 & its cessation ) ! m5opause1 are among ! fir/ pro(s ( ?is ass]tion t occur4 ,m5/ruation may aggravate goitre1 ut]9e fibroid tum\rs1 sk9 diseases1 & affections ( ! blood vessels4 ,disord]$ m5/ruation causes sleeplessness1 melan*oly1 dem5tia1 & mania1 by affect+ ! bra92 x may br+ on local p>alysis2 />t up lat5t epilepsy2 excite reflex c\gh & difficulty 9 brea?+2 make ! he>t irritable2 cause nausea1 vomit+1 dyspepsia1 flatul5ce1 di>rhoea1 sk9-inflammations1 pa9 9 ! jo9ts1 & _m o!r symptomatic ph5om5a4 ,*orea 7,/4 ,vitus's ,dance7 is caus$ by v>i\s irritatations1 & dysm5orrhoea c be su* a cause4 ,if a p]son is dispos$ to hy/]ia by neurotic inh]itance1 idl5ess1 s$5t>y habits1 vici\s practices1 excessive developm5t ( ! emotions1 any affection ( ! ut]us or its app5dages w greatly aggravate ! outbreaks4 ,! same is true 9 neura/h5ia2 & ut]9e disord]s c directly cause neura/h5ia1 a condition describ$ 9 ano!r *apt]4 ,migra9e is an extremely sev]e =m ( heada*e :i* arises f v>i\s excitations1 & ut]9e di/urbances are among ! causes4 #bdd ,insanity frequ5tly appe>s 9 wom5 at pub]ty1 soon aft] m>riage1 dur+ pregnancy or lactation1 & at ! m5opause2 at ^! p]iods dispos$ wom5 are especially prone to outbreaks ( insanity4 ,irritation & exhau/ion f diseases ( ! pelvic organs are pot5t factors 9 br++ on insanity1 al?\gh ^! conditions may coexi/ indep5d5tly ( ea* o!r4 ,symptoms %\ld n be mi/ak5 = causes1 b pelvic diseases at lea/ aggravate a t5d5cy t[>d m5tal unbalance4 ,9 an article l ?is x is n exp$i5t to speak ( treatm5t1 b ! conditions are describ$ 9 outl9e s t ! spiritual advis] may recognise ! ne$ ( m$ical aid & sugge/ its employm5t4 ,a woman suff]+ f pelvic disord]s %\ld be reliev$ f a lab\ri\s or responsible (fice until %e has be5 cur$ ( h] disease1 9 h] own int]e/ & especially 9 ! int]e/ ( ^? affect$ by h] condition4 ,,au/9 ,,omalley4 #bde ,,xxi ,,*ronic ,,disease ,,& ,,responsibility ,x is (t5 ( great practical importance to be> 9 m9d t a numb] ( affections1 commonly n s]i\s 9 !mselves at ! beg9n+1 & sometimes giv+ v few ext]nal symptoms1 may make ! m5tal condition ( ! individual suff]+ f !m utt]ly incapable ( meet+ grave responsibilities4 ,?is is especially true ) reg>d to su* positions z t occupi$ by ! ,sup]ior ( a religi\s community :o may1 dur+ ! c\rse ( an ailm5t t has a t5d5cy to affect ! m5tal condition1 d ?+s t involve ! community f9ancially1 or make life s uncom=table = _! subjects z to cause !m to ab&on ! religi\s life4 ,"s ( ^! ailm5ts are v insidi\s & may develop utt]ly ap>t f all anticipation 9 p]sons t 7 previ\sly heal?y4 ,! weight ( responsibility itself may1 by impair+ ! g5]al heal?1 br+ on an aggravation ( a previ\sly mild *ronic condition t w cause di/9ct m5tal det]ioration1 yet )\t ! absolute production ( su* di/urbance ( intellection z w be readily recognis$ by ^? t are n br\ght intimately 9 contact ) ! individual4 ,su* cases are n uncommon 9 hi/ory4 ,a di/+ui%$ speciali/ 9 m5tal diseases call$ att5tion1 9 ! ,london ,lancet n long ago1 to ! case ( ,nicias1 ! ,greek g5]al :o 0 9 *>ge ( ! ,a!nian exp$ition aga9/ ,syracuse4 ,nicias und\bt$ly _h a g5ius = w> & = politics :5 9 normal heal?4 ,"s ( ! mi/akes committ$ by him1 ?\gh1 are ( an ord] t indicate a lapse ( m5tal control at c]ta9 times4 ,details giv5 by a numb] ( ,greek hi/orians po9t to ! exi/5ce 9 ,nicias ( #bdf symptoms ( *ronic nephritis1 :i* at p]iods ( great responsibility became exac]bat$ ) consequ5t int]f]5ce ) normal intellection4 ,! same au?ority po9ts to c]ta9 o!rwise inexplicable political mi/akes 9 ! life ( ,napoleon ,,iii4 z due to ! exi/5ce 9 him ( a l[-grade nephritis1 consequ5t ^u ! pres5ce ( /one 9 ! kidney4 ,aft] 8 abdication1 dur+ 8 life 9 ,engl&1 he _h to be op]at$ ^u = ?is condition1 & ! calculi f\nd _h manife/ly be5 9 exi/5ce = _m ye>s4 ,ev5 m important = ! sake ( ! individual himself ?an = ^? he is 9 contact ) is ! recognition ( 8 pa?ological condition4 ,no?+ is m likely to cause kidney disease to gr[ rapidly worse ?an responsibilities heavi] ?an ! individual is accu/om$ to4 ,:51 !n1 !re are symptoms ( nephritis x is inadvisable = ! pati5t to be made ,sup]ior1 & if ! symptoms develop aft] 8 appo9tm5t or election he %\ld be reliev$ ( 8 responsibilities1 at lea/ to a consid]able degree4 ,!re are a numb] ( cases on record 9 :i* failure to realise ! necessity = ?is mode ( action has be5 a cause ( great unhapp9ess 9 religi\s communities1 & n infrequ5tly a %ort5+ ( a v preci\s life t might o!rwise h be5 sp>$ = long ye>s ( usefulness 9 "s less dem&+ position4 ,x is n impossible t p>esis %\ld develop 9 ! ,sup]ior ( a religi\s community4 ,! disease is extremely r>e among cl]gym5 g5]ally1 & ! /ati/ics ( asylums %[ t x is r>e/ ( all among ,ca?olic cl]gym54 ,%\ld x occur1 h[ev]1 x mu/ con/itute a q suffici5t reason ei!r = a *ange ( ,sup]iors1 or = ! in/itution ( su* o!r safegu>ds z may1 accord+ to ! special religi\s in/itute1 be provid$ 9 ord] to prev5t s]i\s evil4 ,9 ! religi\s communities ( wom51 p>ticul>ly1 x has seem$ to u t ! occurr5ce ( ,graves' disease 7! affection is ?ree times m frequ5t 9 wom5 ?an 9 m57 9 a ,sup]ior %\ld always be ! signal = reliev+ h] ( ! responsible duties ( h] position4 ,?is action is q z necess>y = ! pati5t's own heal? z = ! peace & happ9ess ( ! community4 ,! disease may exi/ 9 a #bdg lat5t =m & only develop /rik+ly aft] ! assumption ( ! s]i\s responsibilities ( ! position ( ,sup]ior4 ,:51 h[ev]1 ! eyes are prom95t1 ! pulse rapid1 & ! goitre1 or swell+ ( ! front ( ! ?roat1 *>act]i/ic ( ! disease1 is pres5t1 !re are practically always m5tal symptoms t make x extremely inadvisable = h] cont9uance 9 a position ( s]i\s responsibility4 ,pr(essor ,*ur* ( ,*icago 7,pr(essor ( ,n]v\s & ,m5tal ,diseases & ( ,m$ical ,jurisprud5ce1 9 ! ,nor?we/]n ,univ]sity ,m$ical ,s*ool71 9 ! la/ edition ( 8 book on ,n]v\s & ,m5tal ,diseases1 ,footnote #e has ?is to say ) reg>d to ! m5tal di/urbances ( ,graves' disease3 ,footnote #e3 ,n]v\s & ,m5tal ,diseases4 ,*ur* & ,pet]son1 #d? edition4 ,saund]s1 ,phila41 ,pa41 #aijc4 ,f ! beg9n+1 & (t5 = a long p]iod antec$5t to ! appe>ance ( c>diac symptoms1 ! subjects ( ,graves' disease pres5t a consid]able m5tal ere?ism4 ,!re is an indef9able & torm5t+ agitation1 m>k$ by m5tal & motor re/lessness & an imp]ative & impulsive t5d5cy to be do+4 ,_! emotions are too readily excit$1 & !y are unusually impressionable & irritable1 react+ 9 an exagg]at$ mann] to all ! incid5ts ( daily life4 ,9 m pron\nc$ cases !y become voluble & manife/ ! greate/ mobility ( ideas1 b h no p]si/5t conc5tration ( logical ord]4 ,_! affections are likely to und]go modifications1 & !y become irascible1 fault-f9d+1 inconsid]ate1 ungrateful1 & h>d to live )4 ,9 "s in/ances ?is di/urbance ( m5tation c>ries !m ov] ! bord] into active mania1 m>k$1 p]*ance1 by delusions ( fe>1 due to ! c>diac symptoms ( s5sations ( heat4 ,insomnia is (t5 add$ & ! fitful sleep is di/urb$ by horrify+ dreams t are likely to be project$ into ! wak+ mom5ts & wov5 into delusions :i* are usually unsy/ematis$1 & con/antly *ang+1 furni%+ ! analogue ( ! motor re/lessness4 ,halluc9ations ( sight & he>+ are n uncommon4 ,! m5tal p]turbance only r>ely rea*es ! degree ( actual mania1 & !n is1 p]haps1 equally dep5d5t ^u num]\s o!r causes act+ 9 a neurotic individual4 ,b #bdh a condition ( abnormal m5tal /imulation is *>act]i/ic ( ! malady1 & is z important an index z any ( ! c>d9al triad4 ,footnote #f ,footnote #f3 ,( physical symptoms1 namely1 ! rapid he>t1 ! prom95t eyes1 & ! enl>gem5t ( ! ?yroid gl& 9 ! neck4 ,dr4 ,*ur* consid]s1 !n1 t ! m5tal symptoms ( ! disease are z important a concomitant1 & z little likely to be abs5t 9 any giv5 case1 z are any ( ! ?ree or f\r well-kn[n physical symptoms *>act]i/ic ( ! disease4 ,"u ^! circum/ances ! necessity = ! ex]cise ( c>e 9 p]mitt+ su* a pati5t to cont9ue 9 ! (fice ( ,sup]ior mu/ be manife/4 ,x is a "q n = religi\s au?orities to decide b = physicians1 & !y are to be exp]ts 9 m5tal diseases4 ,!re are _m physicians :o h _h exp]i5ce ) cases 9 :i* ,graves' disease has be5 a s\rce ( un=tunate conditions 9 religi\s life1 ow+ to ! failure to und]/& ! relations ( ! physical affection to m5tal di/urbances4 ,at times un=tunate consequ5ces foll[ t are irretrievable 9 ! de/ruction ( vocations & ! impairm5t ( ! religi\s _s 9 communities4 ,z a rule x may be said t ! developm5t ( s]i\s disease is almo/ sure to incapacitate a ,sup]ior f fulfill+ ! functions ( (fice4 ,?is is true1 h[ev]1 n only = physical disease b = ! s-call$ neuroses4 ,^! are maladies :i* h _! basis 9 "s di/urbance ( ! physical con/itution1 ?\gh ?is is n always easy to f9d4 ,we pref] to speak ( !m z neuroses r ?an neura/h5ia1 because ?is latt] "n has someh[ come to h an unwelcome s\nd & to c>ry ) x ! idea ( imag9>y r ?an real ailm5ts4 ,a true neura/h5ic1 h[ev]1 is supremely to be piti$4 ,x has (t5 be5 notic$ t su* individuals1 :ile p]fectly capable ( judg+ prop]ly = o!rs1 are n able to =m "r judgm5ts ) reg>d to _! own conditions4 ,?is pr9ciple1 h[ev]1 %\ld n be tak5 z a rule1 & x mu/ n be =gott5 t neura/h5ics are (t5 ! subjects ( compulsory ideas--s-call$ obsessions1 9 :i* !y are n entirely responsible = actions p]=m$4 ,at su* #bdi times !y are prone to be irritat$ by v trivial faults1 & :at is worse1 to exagg]ate slight defects into s]i\s infractions ( rule or ( ob$i5ce4 ,) reg>d to su* p]sons1 !re=e1 con/ant c>e has to be ex]cis$ to control _! /atem5ts by ^? ( o!rs & n to take !m at _! full value )\t due sub/antiation4 ,9 ?is matt] ! subject is q z likely to suff] z ! ,sup]ior1 & in=mation obta9$ f !m %\ld n be act$ ^u )\t consultation ) o!rs :o "k ! details ( ! case4 ,z a rule neura/h5ic individuals become1 z is well kn[n1 worse z f> z ! m5tal condition is conc]n$ :5 !y are ask$ to assume new responsibilities4 ,?is physical side ( ! *oice ( ,sup]iors1 & ( ^? to be elect$ by memb]s ( ! community1 %\ld always receive due att5tion1 ?\gh sometimes x is entirely lo/ sight (4 ,n a few communities1 h[ev]1 h suff]$ 9 _! usefulness & 9 ! fulfilm5t ( ! design ( _! in/itute by ! selection ( ,sup]iors ^: neurotic conditions sometimes seem$ to proclaim a high degree ( piety1 :i* 01 h[ev]1 r emotional ?an practical4 ,! physician's view ( "s ( ^! cases w\ld add mat]ially to ! k ( ! "* ( su* individuals4 ,x %\ld 9 g5]al be v cle> t ! developm5t ( any s]i\s n]v\s disease1 :i* is n likely to be cur$ by ord9>y rem$ies or :i* requires fre$om f responsibility z ! fir/ requisite = improvem5t1 %\ld be ! signal = consid]ation z to a *ange ( ,sup]iors4 ,physicians see mu* m ( ! evil t may be work$ 9 ?is way1 & realise ! true significance ( :at is (t5 a sad /ate ( affairs1 mu* bett] ?an ^? :o h n ! secret ( ! cause ( ! un=tunate condition4 ,x is almo/ ne$less to say t ! "q ( ob$i5ce to "s "o ^: responsibility is n complete1 b is influ5c$ by neurotic di/urbance1 becomes an extremely difficult problem = ! subject1 & "o 9 :i* !re is apt to be ! feel+ t x 0 n ! orig9al int5tion ( 8 obligation ( ob$i5ce to b9d him "u su* circum/ances4 ,) reg>d to wom5 especially1 x mu/ be rememb]$ t !re is = !m a p]iod betwe5 ! ages ( =ty #bej & fifty1 dur+ :i* = sev]al ye>s !y are extremely unsuit$ = ! responsibilities & exact+ duties ( a ,sup]ior4 ,^! ye>s prove ev5 to mo!rs ( families1 surr\nd$ only by _! own *ildr5 & ! ord9>y circum/ances ( home life1 a "t ( worry & irritation t plays sad havoc ev5 ) ! be/ ( dispositions4 ,mo!rs con/antly compla9 to _! physicians ( an irritability ( temp] :i* !y c sc>cely acc\nt =1 & :i* makes !m d & say ?+s :i* !y are extremely sorry = aft]w>ds4 ,x is easy to und]/&1 !n1 t a ,sup]ior ) /ill m insi/5t duties :5 br\ght 9 contact ) a numb] ( p]sons1 "s ( :om are almo/ sure n to be entirely sympa!tic1 is likely to suff] f irritation t is n a sign ( abs5ce ( a fitt+ religi\s disposition1 b only a physical manife/ation ( ! physical /ra9 ?r\gh :i* %e has to pass at ?is "t ( life4 ,! ye>s ( ! m5opause1 to be v pla91 %\ld n be all[$ to make a ,sup]ior's life mis]able & to add to ! difficulties t a religi\s community always has to face 9 its relations to its ,sup]ior & to "o ano!r4 ,*>cot1 ! di/+ui%$ ,fr5* neurologi/1 us$ to say t wom5 %\ld nev] be ask$ to assume special responsibilities dur+ ! days ( _! mon?ly p]iod1 = _! judgm5ts are (t5 w>p$ by _! physical condition4 ,x is d\btful :e!r1 9 ! majority ( normal wom51 ?is is q true1 ?\gh ! expression des]ves to be rememb]$4 ,!re is no d\bt1 h[ev]1 t ! ye>s ( ! *ange ( life d br+ on v s]i\s modifications ( ! "* ( ! individual1 & occasionally ^! *anges are la/+4 ,,james ,j4 ,,wal%4 #bea ,,xxii ,,epilepsy ,,& ,,responsibility ,f ! v e>lie/ times epilepsy has be5 look$ ^u z a my/]i\s & 9 _m ways an inexplicable disease4 ,! ,romans spoke ( x z ! malum comitiale1 ! comitial disease1 because if an attack ( x occurr$ dur+ ! meet+ ( ! ,roman p kn[n z ! comitia1 9 :i* municipal (fic]s 7 elect$ & o!r city bus9ess transact$1 an adj\rnm5t 0 at once mov$1 & no fur!r proce$+s 7 consid]$ valid4 ,dur+ m mod]n times1 especially dur+ ! middle ages1 & almo/ d[n to our own "t1 ^? affect$ by ! disease frequ5tly came to be look$ ^u z ! subjects ( possession by ! devil4 ,hy/]ical manife/ations 7 ev5 m frequ5tly consid]$ signs ( possession 7diabolical manife/ations7 b ev5 9 our "t x is n always easy to make ! di/9ction betwe5 c]ta9 =ms ( hy/]ia & epilepsy4 ,_m ( ^! suff]]s 7 consid]$ z n responsible = _! actions4 ,9 ?is respect1 at lea/1 ! advance ( mod]n m$ical sci5ce has only s]v$ to confirm ! popul> impression ( less sophi/icat$ times1 & x has come to be recognis$ t q a l>ge numb] ( ! suff]]s f epilepsy mu/ be deem$ lack+ 9 responsibility4 ,!re are few n]v\s diseases t h be5 m /udi$ ?an epilepsy1 & yet1 because ! ailm5t involves s intimately ! relations ( ! n]v\s sy/em & ! bodily function1 !re are few diseases ( :i* less def9ite op9ions c be giv54 ,?is is especially true z reg>ds prognosis & ! "q ( m5tal det]ioration 9 any giv5 case4 ,z a matt] ( fact ! ext5sion ( our k ( epilepsy1 f> f mak+ ! "q ( ! responsibility ( ! #beb epileptic "u try+ circum/ances m easy ( solution1 has r s]v$ to %[ h[ difficult ?is problem mu/ ev] rema94 ,!re are _m =ms ( ! disease1--! frank epileptic convulsion 9 :i* pati5ts fall d[n1 are seiz$ ) c]ta9 convulsive movem5ts1 become pale & lose consci\sness = a "t & !n come to ) an int5se feel+ ( we>9ess :i* usually prompts !m to sleep = "s h\rs--too famili> to ne$ fur!r description4 ,!re are =ms ( epilepsy1 h[ev]1 q diff]5t f ^!4 ,9 "s cases1 ! attacks occur only at night1 & unless ! pati5t happ5s to be wat*$ = "s reason1 !re may be no trace ( _! occurr5ce1 except p]haps a sore tongue :]e x has be5 bitt51 or an int5se feel+ ( we>9ess & depression 9 ! morn+4 ,9 /ill o!r cases1 ! physical signs are lack+ almo/ entirely4 ,!re may be only a mom5t>y loss ( consci\sness4 ,a di/+ui%$ pr(essor ( m$ic9e 9 ?is c\ntry us$ to h a mom5t>y attack ( confusion1 dur+ :i* he lo/ ! ?read ( 8 disc\rse1 & always )9 a m9ute1 ) a some:at flu%$ face1 he 0 able to g on1 ?\gh he _h to beg9 ) ano!r idea4 ,! s-call$ psy*ic epilepsy1 9 :i* ! symptoms are entirely m5tal & consi/ ( "s m>k$ *ange ( disposition = a "t1 are n[ univ]sally conc$$ z con/itut+ well-m>k$ phases ( ! disease4 ,curi\sly en\gh x is ) reg>d to ^! obscure cases1 uncomplicat$ by s]i\s physical manife/ations1 t !re is mo/ my/]y2 & !y seem to affect ! m5tality & to di/urb volition & responsibility m ?an ! suppos$ly sev]] =ms :i* cause convulsive attacks & are s easy ( recognition4 ,c]ta9 =ms ( mask$ or psy*ic epilepsy con/itute ! mo/ puzzl+ problem t ! exp]t 9 n]v\s & m5tal disease has to deal ) :]e crim9al acts are p]=m$1 app>5tly )\t suffici5t motive1 & yet :]e ! limits ( responsibility mu/ if possible be det]m9$4 ,x is easy to dismiss ^! cases & to consid] t because a c]ta9 am\nt ( intellig5ce has be5 display$ 9 ! p]=mance ( ! act1 & because ! pati5t ord9>ily und]/&s p]fectly ! di/9ction betwe5 good & evil4 #bec t !re=e ! w mu/ h be5 entirely free 9 ! accompli%m5t ( ! crim9al action & ! intellect mu/ h und]/ood :at x 0 do+4 ,z yet ! g5]al public refuses to take ! /&po9t ( ! exp]t 9 m5tal diseases 9 _m ( ^! cases2 & only :5 cl]gym5 also %all come to a realisation ( ! pa?ological elem5ts und]m9+ free w 9 ^! cases1 t ju/ice w be prop]ly temp]$1 n by unwor?y or misplac$ *>ity1 b by ! m]cy :i*1 kn[+ all1 has le>n$ duly to appreciate :at is & :at is n crim9al4 ,epilepsy1 9 c]ta9 ( its obscur] =ms1 is responsible = _m conditions 9 :i* !re is a sudd5 access ( insane excitem5t ( a viol5t1 (t5 v impulsive1 "*1 ?\gh sometimes ( v %ort duration4 ,dur+ ?is /ate ! pati5t is practically irresponsible1 & yet he may h suffici5t control ov] 8 actions to enable him to "w s]i\s h>m4 ,su* a /age ( excitem5t may la/ n m ?an an h\r or two2 usually all trace ( x passes (f 9 a day or two2 be=e & aft] x ! pati5t may be 9 p]fectly s\nd s5se & 9 app>5tly good heal?4 ,"o ( our be/ au?orities "h 9 ,am]ica1 ,b]kley1 9 8 treatise on ,m5tal ,diseases1 gives ! foll[+ /rik+ op9ion on ?is subject4 ,! subject ( mask$ epilepsy & ! consequ5t mania is replete ) int]e/ to ! physician & ! juri/1 s9ce su* pati5ts are prone to impulsive acts ( viol5ce & automatic /ates 9 :i* ! mo/ complicat$1 b entirely unconsci\s1 actions & crimes may be c>ri$ out )\t prem$itation on ! "p ( ! suff]]1 be+ also out ( all accord ) 8 "* dur+ 8 int]vals ( m5tal heal?4 ,besides ! irritability1 impulsiv5ess is an equally *>act]i/ic feature4 ,no =m ( insanity m frequ5tly gives rise to assaults & murd] ?an epilepsy1 & 9 no =m ( ali5ation is ! physician s frequ5tly call$ to ! witness /& to det]m9e ! responsibility ( ! crim9al4 ,"o ( ! mo/ prom95t features ( all epilepsy is ! well kn[n t5d5cy to irritability t *>act]ises suff]]s f ! disease4 ,?is ( itself is an index ( ! fact t #bed _! responsibility is some:at less5$1 s9ce !y are unable to )/& ev5 ! petty annoyances ( life )\t exagg]at$ reaction4 ,fri5ds ( epileptics "k v well t x is a prelim9>y symptom ( ! com+ on ( an attack ( epilepsy = ! pati5ts to become ev5 m irritable ?an usual4 ,j aft] ! comatose condition :i* foll[s an attack ( epilepsy pati5ts are also prone to be v irritable4 ,an attack ( epilepsy is really an explosion ( n]ve =ce1 = no rational purpose1 along motor n]ves4 ,?is same t5d5cy to an unw>rant$ explosion ( en]gy is liable to occur along o!r n]ve tracts t rule ! pati5t's disposition4 ,! ma9 symptom ( importance 9 ! case1 & ! "o on :i* dep5ds ! recognition ( ! exi/5ce ( ! epileptic condition1 is ! actual occurr5ce ( typical epileptic seizures4 ,^! d n always occur4 ,sometimes ! p]iodic attacks take ! =m ( :at are call$ epileptic equival5ts1 t is1 c]ta9 anomal\s /ates ( consci\sness or disposition1 :i* c be acc\nt$ = only on ! supposition t !re is "s m or less lat5t explosion ( n]ve =ce 9 progress4 ,at times ev5 s simple a condition z migra9e s ne>ly simulates epilepsy ( ! psy*ical type1 because ( its complications & sequelae & ! regul>ity ) :i* x occurs1 t x has be5 spok5 ( z an epileptic equival5t4 ,!re is no d\bt t1 9 successive g5]ations1 epilepsy & migra9e may h a relation to "o ano!r t is some?+ m ?an m]ely a co9cid5ce4 ,a v int]e/+ feature ( epilepsy = confessors & spiritual directors is ! t5d5cy to religi\s emotionalism :i* s (t5 accompanies :at is call$ idiopa?ic epilepsy4 ,?is means epilepsy t develops )\t a direct cause1 & :i* is evid5tly dep5d5t on "s ess5tial defect ( ! n]v\s sy/em ( ! individual4 ,9 asylums epileptics t h become irrational are kn[n = _! religi\s manife/ations1 & v (t5 = p]v]sion ( _! religi\s t5d5cies4 ,z has be5 well said1 an epileptic may c>ry 8 ,bible "u 8 arm1 read passage aft] passage f ! ,scriptures1 s+ psalms cont9u\sly1 & yet be s #bee ungov]nable z to be a nuisance1 & s irritable t[>ds 8 fell[ pati5ts & att5dants z to be a con/ant s\rce ( worrim5t4 ,he may read j ^? passages :i* h ref]5ce to love & *>ity = "o's neighb\r & dwell on !m until !y become a bore by repetition1 & yet 9 a mom5t ( irritation implore to be all[$ to get hold ( "s deadly weapon 9 ord] to kill ! usually in(f5sive p]son :o has done him "s imag9>y injury4 ,?is la/ is a m>k$ feature ( ! disease1 = epileptics are prone to fo/] fanci$ grudges1 & to consid] )\t due reason t !y h be5 ill treat$4 ,?is is especially true ) reg>d to _! relatives or to ^? 9 att5dance on !m1 & mu/ be always borne 9 m9d :5 ! subjects ( epilepsy br+ tales ( woe & p]secution1 :i* !y p\r out to anyone :o w li/5 to !m1 & especially to anyone :om !y ?9k w set !m "r4 ,^! fanci$ wrongs are z real to ! pati5ts !mselves z if !y _h suff]$ f actual maltreatm5t4 ,! idea ( rev5ge may easily obtrude itself4 ,x c be kept "u control1 z a rule1 dur+ ord9>y heal?1 betwe5 attacks1 b j prec$+ or aft] an attack x may v well become ( ! imp]ative "* t sets an uncontrollable impulse at "w4 ,on ! o!r h&1 no class ( pati5ts is apt to exhibit ! l[ cunn+ ( ! insane 9 s m>k$ a degree z ! epileptic4 ,n only ?is1 b ev5 dur+ ord9>y heal? betwe5 attacks !y may1 ow+ to _! disposition1 plan cunn+ly to simulate "s ( ! symptoms ( an attack & !n accompli% a really malici\s purpose ) delib]ation4 ,9 a ^w1 ^! pati5ts pres5t to ! ali5i/ ! mo/ s]i\s problem 9 ! calculation ( responsibility t c possibly be imag9$4 ,z an exp]t has decl>$1 ,x is (ttimes impossible to decide :e!r an assault has be5 committ$ ) full consci\sness1 or 9 a transi5t b bl9d epileptic fury4 ,!re are a s]ies ( attacks t occur 9 :i* !re are "s almo/ typical convulsive movem5ts foll[$ by loss ( consci\sness t simulate epilepsy v closely1 yet are n true epilepsy4 ,^! attacks are usually due to "s #bef c]ebral affection or p]haps to "s injury ( ! bra94 ,*ronic intoxications1 t is1 ! long cont9u$ pres5ce 9 ! body 9 noxi\s quantities ( "s poison\s sub/ance1 are especially liable to cause ^! attacks1 :i* are call$ f _! "* epilepti=m4 ,*>act]i/ic epilepti=m convulsions occur z ! result ( lead poison+ or f alcohol or syphilis4 ,lead poison+1 = in/ance1 may v well occur 9 o!rs ?an ^? engag$ directly 9 ! manufacture or h&l+ ( lead4 ,c]ta9 p]sons are extremely susceptible to ! influ5ce ( lead4 ,9 !m su* small am\nts z are conta9$ 9 a hair-dye1 or ev5 9 wat] t is be+ us$ by o!rs )\t any bad effect1 may cause p>ticul>ly ! n]v\s symptoms ( lead poison+4 ,*ronic alcoholism is also a relative t]m 9 ?is reg>d4 ,"s p]sons are able to /& v l>ge am\nts ( alcohol )\t s]i\s consequ5ces1 ev5 ?\gh x is tak5 = long p]iods4 ,o!rs succumb to its influ5ce v rapidly2 "s especially susceptible p are liable to suff] f epilepti=m convulsions almo/ :5ev] !y take alcohol to excess4 ,?is mask$ epilepsy may take on an anomal\s =m4 ,! /ory is told ( a /ud5t ( a ,ca?olic college 9 ! ea/]n "p ( ?is c\ntry1 :o1 dur+ "o vacation1 0 giv5 z a joke by "s fri5ds a r /rong dose ( liquor 9 a glass ( g+] ale4 ,he 0 v ?ir/y at ! "t & did n notice ! pres5ce ( ! alcohol until he _h swall[$ ! :ole glass4 ,z he 0 well aw>e himself he 0 extremely susceptible to ! influ5ce ( alcohol4 ,dur+ ! c\rse ( half an h\r he became almo/ wildly drunk1 & go+ d[n ! /reet ) an op5 pocket-knife he murd]$ ! fir/ p]son :om he met1 :o happ5$ to be an entire /rang] to him4 ,! occurr5ce took place 9 ,new ,j]sey1 &1 9 spite ( e influ5ce t c\ld be br\ght to be>--! incid5t took place "s ?irty ye>s ago--,j]sey ju/ice w\ld h its way & ! "y fell[ ( less ?an tw5ty 0 hang$4 ,! epilepti=m attacks t occur 9 ! mid/ ( ^! intoxications are q z likely to be accompani$ by v>i\s =ms ( m5tal di/urbance z are attacks ( true #beg epilepsy4 ,only "o feature ) reg>d to !m is m fav\rable1 & t is t ! ultimate prognosis is n bad4 ,! neutralisation ( exi/+ poison 9 ! sy/em1 & ! prev5tion ( fur!r +e/ion ( ! toxic mat]ial1 puts an end to ! t5d5cy to epilepti=m convulsions1 z a rule1 & also to ! m5tal symptoms associat$ ) !m4 ,epilepsy rema9s1 not)/&+ all ! advance 9 mod]n n]v\s pa?ology1 q z my/]i\s a disease z x has ev] be54 ,x matt]s n :at its cause1 or h[ slight x may be1 soon] or lat] x is almo/ sure to be foll[$ by m5tal di/urbance & det]ioration ( intellectual & w p[]4 ,at times !re are p]iodic attacks ( m5tal p]turbation t may become true insanity4 ,ev5 ! mild =m ( epilepsy kn[n z ,jacksonian epilepsy1 & consi/+ n ( g5]al convulsive movem5ts1 b ( convulsive movem5ts 9 only "o memb] or "o side ( ! body1 are1 if all[$ to cont9ue1 foll[$ by "s m5tal di/urbance4 ,x w\ld seem z if ! explosion ( n]ve =ce 9 ! bra9 c5tres1--:i*1 physiologically speak+1 an attack ( epilepsy evid5tly is1--causes ev5tual det]ioration ( ! physical basis ( m9d & w1 s t m5tal op]ations c no long] be p]=m$ ) _! wont$ exp]tness or accuracy1 nor decisions made z rationally z be=e4 ,9 g5]al1 x is well und]/ood t ! m s]i\s ! epilepsy ! m liability !re is ( ! developm5t ( p]man5t m5tal di/urbance4 ,! e>li] 9 life ! epilepsy decl>es itself1 too1 ! m unfav\rable is ! prognosis z to ! endur+ ret5tion ( complete m5tal sanity4 ,9 p 9 :om ! epilepsy comm5ces late 9 life1 ! process ( m5tal det]ioration does n beg9 to be noticeable s soon z :5 x occurs 9 y\ng] ye>s1 & besides1 x practically nev] runs a rapid c\rse4 ,epilepsy1 h[ev]1 develop+ late 9 life1 unless = "s special cause1 z injury or ! developm5t ( syphilitic tum\rs 9 ! bra91 is an extremely r>e affection4 ,idiopa?ic epilepsy1 t is1 epilepsy = :i* no def9ite cause c be discov]$1 is usually dep5d5t on h]$it>y in/ability ( ! n]v\s sy/em & is typically a disease ( e>ly ye>s1 ( *ildhood #beh & adolesc5ce4 ,accord+ to ! be/ au?orities1 ab\t "o-f\r? ( ! cases ( epilepsy make _! appe>ance be=e ! age ( #g ye>s4 ,ov] #ej p] c5tum ( all cases develop be=e pub]ty4 ,ab\t "o-?ird ( all ! cases develop betwe5 #ad & #bj4 ,& ev5 ( ! rema9+1 less ?an #bj p] c5tum1 ov] #ab p] c5tum develop betwe5 #bj & #be1 leav+ sc>cely m ?an #e p] c5tum = all ! rema9+ ye>s ( life4 ,( c\rse1 ev5 9 sev]] =ms ( epilepsy1 m5tal di/urbances d n appe> at once4 ,x sometimes takes _m ye>s = ! con/antly recurr+ manife/ation ( explosive n]ve =ce to produce ! det]ioration t gives rise to l[]$ rationality4 ,di/9ct m5tal det]ioration is ev5tually inevitable1 ?\gh mod]n exp]i5ce ) epileptic colonies1 9 :i* pati5ts are enabl$ to live a quiet life1 mo/ ( x 9 ! op5 air & "u conditions ( nutrition & re/fulness especially fav\rable = _! physical well-be+1 %[s t ! developm5t ( insanity may be put (f almo/ indef9itely4 ,!re are _m adv]tis$ cures = epilepsy4 ,none ( !m is successful1 & all ( !m may d h>m4 ,! bromides h a di/9ct effect 9 less5+ ! numb] & frequ5cy ( seizures1 b if tak5 to excess !y h a s]i\s depress+ effect ^u ! pati5t4 ,!re h be5 m cases ( m5tal di/urbance among epileptics1 & intellectual deg5]ation sets 9 e>li]1 s9ce ! introduction ( ! bromides1 ?an be=e4 ,x is ! abuse ( ! drug1 h[ev]1 n its use1 t does h>m4 ,m important ?an any drug is ! c>e ( ! pati5t's g5]al heal?4 ,! dige/ion mu/ be kept )\t d]angem5t2 ! b[els made regul>2 all s\rces ( worry & emotional /ra9 mu/ be remov$4 ,pati5ts %\ld z f> z possible live 9 ! c\ntry1 & f>m life has be5 f\nd especially suitable4 ,relatives are (t5 a s\rce ( irritation r ?an consolation to ^! pati5ts1 & ! life 9 epileptic colonies has be5 f\nd em95tly helpful4 ,,james ,j4 ,,wal%4 #bei ,,xxiii ,,psy*ic ,,epilepsy ,,& ,,second>y ,,p]sonality ,"o ( ! mo/ int]e/+ phases ( epilepsy is ! type ( ! disease 9 :i*1 )\t any significant motor symptoms1 psy*ical manife/ations prevail v m>k$ly4 ,a special manife/ation 9 ?is affection is ! occurr5ce ( a m or less complete ass]tion ( :at is call$ a second>y p]sonality4 ,app>5tly ! individual becomes s divid$ 9 ! use ( ! m5tal faculties t !re are two /ates ( consci\sness4 ,9 "o ( ^! ! pati5t kn[s & rememb]s all ! ord9>y acts ( life1 ! o!r c>ries ! record ( only su* actions z are done 9 a peculi>ly morbid psy*ic or epileptic condition4 ,x is r easy to und]/& t ?is /range /ate ( affairs may readily give rise to ev5 s]i\s complications z reg>ds ! individual's relations to o!rs1 & may make ! problem ( responsibility = app>5tly crim9al acts t h be5 p]=m$ v difficult ( solution4 ,und\bt$ly1 h[ev]1 ?is set ( ph5om5a con/itutes a =m ( m5tal ali5ation t mu/ be reckon$ ) 9 _m m cases ?an might be ?\ght possible4 ,! difficulties t may h to be enc\nt]$ 9 ! prop] appreciation ( ! actions ( su* individuals is be/ illu/rat$ by "s cases4 ,at a rec5t meet+ ( ! ,new ,york ,/ate ,m$ical ,association a case 0 report$ t %[s h[ extremely difficult x may be to judge ( responsibility "u ^! pa?ological circum/ances4 ,! pati5t1 a "y man ( ab\t tw5ty-two1 0 ! son ( p>5ts !mselves ( m>k$ n]v\s h]$ity1 signs ( :i* appe>$ 9 o!r memb]s ( 8 g5]ation4 ,:ile 9 att5dance at a public academy he _h be5 q sev]ely maltreat$ dur+ ! #bfj c\rse ( an initiation into a secret society ( ! /ud5ts--! m or less famili> processes kn[n z haz+ be+ employ$4 ,z a result ( ?is he _h suff]$ f an attack ( unconsci\sness t la/$ = sev]al h\rs4 ,no o!r symptoms1 h[ev]1 or sequelae1 appe>$ = ne>ly a ye>4 ,!n1 :ile bo>d+ ) 8 si/]1 he became morose & difficult to get along )4 ,he qu>rell$ ) 8 si/] sev]al times & g5]ally _! relations 7 r /ra9$4 ,he came home "o ev5+ v late to supp]1 & because ?+s 7 n to suit him on ! table1 he grew viol5tly angry4 ,he w5t up/airs to 8 room 9 ?is morose /ate &1 procur+ a revolv]1 aft] a %ort "t came d[n & %ot at 8 si/]4 ,=tunately he miss$ h]4 ,he at once left ! h\se b 0 foll[$ by 8 bro!r-9-law1 &1 aft] he began to run away1 by o!rs ^: att5tion _h be5 attract$ by ! %ot4 ,he left ! c\ntry road & ran across ! fields4 ,he 0 f\nd at ! foot ( a r high /one wall 9 a /ate ( unconsci\sness4 ,f ?is unconsci\sness he did n recov] until ! next morn+4 ,9 ! meantime he _h be5 br\ght home & put to b$4 ,! next morn+ he claim$ t he _h absolutely no remembrance ( any?+ t happ5$ aft] he became angry at ! table because ( 8 supp]4 ,! family made no fur!r difficulty ab\t ! matt]1 &1 z no?+ s]i\s _h result$1 ! boy w5t home to live ) 8 fa!r on a f>m & seem$ to gr[ mu* m equable 9 temp]4 ,"o day1 :5 v tir$ & out ( sorts because ?+s _h n be5 go+ z he want$ !m to1 he 0 ask$ to cle> a potato pat* ( potato bugs by spread+ ,p>is gre5 ov] x4 ,"s h\rs lat] he 0 f\nd 9 ! field suff]+ f sev]e pa9s 9 ! /oma* & ) evid5t signs ( hav+ swall[$ "s ( ! poison4 ,a doctor 0 call$1 an emetic 0 giv5 & he purg$1 & aft] a "t he recov]$ f ! symptoms ( poison+4 ,he claim$ t he _h no recollection ( :at he _h done1 nor did he "k h[ he came to take ! poison4 ,aft] ?is he begg$ ! family to wat* ov] him c>efully & n to let him be alone at times :5 !y recognis$ t he 0 some:at #bfa morose 9 temp]4 ,he 0 n melan*olic 9 ! s5se t he want$ to commit suicide1 b some?+ seem$ to come ov] him 9 spells1 & :ile 9 a /ate ( m9d ( :i* he _h no recollection aft]w>ds1 he p]=m$ actions t seem$ volunt>y & yet 7 n4 ,he did n h v good heal? on ! f>m1 & s he 0 advis$ to try ! effect ( life at sea4 ,a position z assi/ant /ew>d 0 obta9$ = him on a coa/wise vessel4 ,9 ?is position he ga9$ rapidly 9 weight & seem$ to h excell5t heal?4 ,all t5d5cies to moros5ess ( disposition disappe>$4 ,aft] a "t he 0 promot$ to a /ew>d%ip & lat] became ! purs] ( a r important vessel4 ,he has giv5 excell5t satisfaction & feels 9 e way t he is 9 a mu* m balanc$ condition ?an ev] be=e4 ,he /ill insi/s t he rememb]s no?+ ( h[ ! two almo/ fatal incid5ts 9 8 life came ab\t4 ,all 8 family are conv9c$ t x 0 n a responsible /ate ( m9d t l$ him to attempt ei!r ( ! crimes4 ,x seems n improbable t ?is is "o ( ^? =tunately r>e cases 9 :i* an attack ( psy*ic epilepsy sometimes oblit]ates = a mom5t ! individuality ( a pati5t4 ,at times ^! attacks la/ mu* long]1 & ! *ange to a second>y p]sonality may repres5t a r long int]val4 ,a numb] ( cases ( :at are call$ ambulatory epilepsy h be5 br\ght to ! att5tion ( ! g5]al public ( late ye>s because ( c]ta9 int]e/+ features ( ! cases t h be5 exploit$ 9 ! daily press4 ,pati5ts suff]+ f ?is =m ( n]v\s disease may w&] f _! homes1 & :ile p]=m+ automatically a numb] ( actions1 su* z buy+ tickets1 travell+ on c>s & railroad tra9s1 or ev5 arrang+ ! details ( _! j\rney = a long di/ance1 may yet be 9 a /ate ( m9d t is n _! ord9>y consci\sness4 ,m5 may leave home "u ! circum/ances & f9d !mselves aft] mon?s 9 a /range t[n :]e !y h e/abli%$ !mselves 9 "s q diff]5t occupation f t to :i* !y 7 =m]ly accu/om$1 or = :i* _! e>ly tra9+ fitt$ !m4 ,!re seems to be an absolute division betwe5 ! #bfb /ates ( consci\sness t rule ! individual dur+ ! int]vals ( ord9>y & extraord9>y p]sonality4 ,!re are1 ( c\rse1 _m reasons = ?9k+ t at times su* a *ange ( p]sonality might be feign$2 b _m ( ! cases h be5 foll[$ ) too mu* c>e to all[ ?is ?\ght to s]ve z an explanation = all ( !m4 ,a case :i* s]ves to br+ home v cle>ly ! possibility ( su* a /ate ( m9d giv+ rise to s]i\s complications is ! foll[+3 ,! pati5t 0 a "y man 9 att5dance at ! m$ical s*ool ( a univ]sity 9 a =eign city4 ,he _h be5 v c>eless 9 money matt]s1 & _h ar\s$ family suspicion t ev5 ! money s5t him = tuition 0 be+ us$ extravagantly4 ,a fri5d ( ! family came to see him unexpect$ly 9 ord] to assure himself h[ ! boy 0 actually gett+ along4 ,! boy's acc\nts 7 9 a v disord]$ condition2 he _h n b\ght ! books = :i* he pret5d$ to want money2 he _h n paid 8 tuition4 ,he realis$ t all ?is w\ld come out z soon z ! univ]sity au?orities 7 consult$4 ,v naturally he 0 9 an extremely p]turb$ /ate ( m9d4 ,:ile on ! way to ! univ]sity ) ?is fri5d !y pass$ a corn] ph>macy1 & ! "y man ask$ to be all[$ to /ep 9 = a mom5t = a rem$y = heada*e4 ,! fri5d wait$ on ! sidewalk = him1 & :51 aft] "s m9utes1 ! "y man did n come out he w5t 9 to inquire = him1 & f\nd t aft] pur*as+ a heada*e p[d] ! "y man _h gone out by a side door4 ,= ?ree days no?+ 0 he>d f him4 ,!n a telegram ann\nc$ t he 0 9 a hospital 9 a di/ant city & t he _h be5 pick$ up on ! /reet unconsci\s4 ,:5 he came to 9 ! hospital he _h no idea :]e he 01 &1 accord+ to 8 own /ory1 no recollection ( h[ he got to ! di/ant city4 ,x might be v easy to ?9k1 "u su* circum/ances1 t ?is 0 all pret5ce4 ,a numb] ( ^! cases ( ambulatory epilepsy h be5 "u ! obs]vation ( di/+ui%$ neurologi/s1 h[ev]1 & !re seems no good reason to d\bt t "s ( !m1 at lea/1 7 entirely )\t any fictiti\s elem5t4 ,9 any giv5 case ! #bfc possibility ( ! occurr5ce ( an attack ( :at is really ! assumption ( a second>y p]sonality mu/ be judg$ f ! circum/ances1 f ! previ\s hi/ory ( ! individual1 f ! family traits1 & f c]ta9 /igmata z n>r[+ ( ! field ( vision & ! l1 :i* g to %[ ! exi/5ce ( a highly neurotic con/itution4 ,9 ?is case ! family hi/ory %[$ m>k$ neurotic t5d5cies on bo? sides1 & a bro!r _h display$ a t5d5cy to regul>ly spac$ attacks ( alcoholism ab\t e six weeks1 & f9ally became absolutely uncontrollable4 ,!re seem$ good reason to ?9k t ! case 0 a real example ( ambulatory epilepsy1 & t ! lapse ( memory claim$ by ! pati5t really exi/$4 ,9 ^! cases x is usual = ! s-call$ second>y p]sonality to ass]t itself at mom5ts ( int5se excitem5t1 especially if !y h be5 prec$$ by days ( worry & fatigue & nights ( di/urb$ re/4 ,! second>y p]sonality is n a complete p]sonality1 b is a manife/ation ( ! orig9al ego ) ! memory = pa/ ev5ts z a tabula rasa4 ,x is well kn[n t ! memory is "o ( ! intellectual faculties mo/ dep5d5t on physical conditions4 ,x is ! l[e/ 9 ! scale ( m5tal qualities & is %>$ to a v l>ge degree by ! animals4 ,injuries to ! head n infrequ5tly produce lacunae 9 ! memory4 ,^! lacunae (t5 h v /rik+ limitations4 ,x is n an unusual ?+ to f9d t old p rememb] ev5ts ( _! v e>ly *ildhood bett] ?an ?+s t h happ5$ )9 a few ye>s4 ,/ill m int]e/+ is ! fact t languages le>n$ 9 y\? may cont9ue to be easily us$1 :5 ^? t 7 le>n$ lat] 9 life1 ?\gh p]haps kn[n bett] ?an ! previ\sly /udi$ languages1 are =gott54 ,x has (t5 be5 not$ t p :o suff] f apoplexy may h peculi> affections ( _! memory4 ,?is may include su* /rik+ peculi>ities z ! =gett+ ( ! uses ( ?+s1 ?\gh _! names are reta9$1 or m commonly1 ! =gett+ ( names :ile ! k ( uses rema9s4 ,! "o =m ( memory di/urbance is call$ ,^w ,amnesia2 ! o!r is call$ ,apraxia4 ,x is on #bfd record t a p]son suff]+ f a hemorrhage 9 ! bra9 has lo/ completely ! use ( a language acquir$ lat] 9 life1 ?\gh ! memory ( ! native language1 long s9ce fall5 into disuse1 0 p]fectly reta9$4 ,"o apoplectic woman pati5t :o _h left ,g]many be=e %e 0 t5 ye>s ( age1 & :o _h liv$ 9 ,am]ica until %e 0 fifty1 =got absolutely ! ,engli% %e knew s well & _h to set h]self to "w to le>n x ov] aga91 ?\gh h] ,g]man came back to h] v naturally4 ,^! are wond]ful peculi>ities ( memory-pa?ology t %[ h[ mu* ?is faculty is dep5d5t on ! physical basis ( m9d & ^u ! cellul> con/itu5ts ( ! bra94 ,x is n surpris+1 !n1 to f9d t lapses ( memory may occur & t1 z a consequ5ce1 s _m ( ! facts t ord9>ily enable u to id5tify ourselves z p>ticul> p]sons may be 9 abeyance4 ,t app>5tly a second>y p]sonality ass]ts itself1--?\gh n 9 ! s5se t !re is ev] ano!r ego pres5t1 ano!r m9d or ano!r w1--practically all exp]ts 9 psy*ology & n]v\s diseases are n[ ready to conc$e4 ,!re are1 h[ev]1 involv$ 9 ?is "q a numb] ( important problems ( responsibility t h n z yet be5 entirely work$ out1 & ) reg>d to :i* prud5t p]sons are )hold+ _! judgm5t4 ,ea* case mu/ be /udi$ entirely on its own m]its1 ) a lean+ 9 fav\r ( ! crim9al or pati5t1 9 case !re are evid5ces 9 pa/ life ( s]i\s di/urbances ( m5tality1 ?\gh only ( v tempor>y nature1 or if !re is a /rong n]v\s or m5tal h]$ity4 ,! notion ( ! possibility ( a second>y p]sonality ass]t+ itself is a mu* old] idea ?an x is usually ?\ght to be4 ,:5 ,/ev5son wrote ,dr4 ,jekyll & ,mr4 ,hyde1 ! imm$iate widespread popul>ity ( ! book 0 n due to rec5t psy*ological /udies on dual p]sonality & popul> int]e/ 9 a r>e b /rik+ m5tal ph5om5on1 b r to ! traditional feel+1 long exi/5t1 ( ! possibility ( two p]sonalities 9 almo/ any individual4 ,! o!r law 9 8 memb]s1 ( :i* ,/4 ,paul speaks1 is an expression ( ?is feel+1 & its recognition 0 n orig9al ) him s9ce x is aft] all a ph5om5on at lea/ z old #bfe z ! exi/5ce ( consci5ce4 ,x is "o ( ! basic ideas 9 religi\s feel+4 ,ne>ly ev]yone has some?+ ( ! consci\sness t !re is 9 him possibilities = evil t someh[ he escapes1 & yet ! escape is n entirely due to 8 own w p[]4 ,!re is "h ! my/]y ( temptation1 ( free w & ( grace z ! drama ( consci5ce works itself out 9 e human be+4 ,at times ! evil incl9ation seems to get beyond ! p[] ( ! w & a p]iod ( irresponsibility sets 94 ,ne$less to say1 ! adjudication ( h[ mu* may be due to ! habitual neglect ( repression ( l[] in/9cts is extremely difficult1 & ?is con/itutes ! problem :i* ! ali5i/ mu/ try to solve4 ,9 ! meantime !re is ne$ 9 _m my/]i\s cases :]e second>y p]sonality may play a role1 ( ! ex]cise ( a l>g] ,*ri/ian *>ity ?an t hi!rto practis$4 ,pret5d]s may succe$ 9 deceiv+ only too (t51 b 9 ! pa/ n a few innoc5t individuals h be5 held to a responsibility = actions = :i* !y 7 n q acc\ntable4 ,,james ,j4 ,,wal%4 #bff ,,xxiv ,,impulse ,,& ,,responsibility ,n unlike t condition :i* develops z ! result ( s-call$ psy*ic epilepsy1 9 :i* pati5ts p]=m app>5tly volunt>y acts1 :ile ! m9d is really cl\d$ by an epileptic attack1 are ^? /ates 9 :i*1 z ! result ( a m or less bl9d impulse1 acts are p]=m$ = :i* ! responsibility ( ! individual is at lea/ dubi\s4 ,mod]n exp]ts 9 n]v\s & m5tal diseases h sometimes spok5 ( ^! /ates z obsessions4 ,?is t]m is adopt$ f ! old] writ]s on my/icism :o us$ x to designate /ates ( m9d 9 :i* an individual 0 "u ! influ5ce ( "s _s1 ?\gh 8 intellectual & volitional /ate 0 n z completely "u ! subjection ( ?is _s z 9 ! condition ( possession4 ,x seems cle> to ! mod]n /ud5t ( ^! obscure conditions t ! old my/ics & ! mod]n ali5i/s practically talk ab\t ! same /ate ( affairs :5 us+ ?is t]m4 ,z ! result ( obsession1 my/ical writ]s w\ld h conc$$ t responsibility is n q complete1 ?\gh x is n entirely done away )4 ,! mod]n ali5i/ is j z sure ( ! dim9ution ( responsibility1 ?\gh he consid]s x due to ! fact t = "s physical reason ! w is n able to act or prev5t action z x is "u normal conditions4 ,! w is sometimes spok5 ( by c]ta9 ( ^! mod]n psy*ologi/s z ma9ly an inhibitory faculty1 t is1 a faculty :i* prev5ts c]ta9 reflex acts f tak+ place1 ?\gh p]mitt+ "o set ( reflexes to h its way4 ,"u ! influ5ce ( an obsession or1 z ! ,fr5* call x1 une idee obs$ante1 ?is inhibition is n #bfg ex]cis$ & z a result an action is accompli%$ :i* ! ag5t may v %ortly aft]w>ds regret exce$+ly4 ,!re is no d\bt t impulsions or impulsive ideas may pu% an individual into ! p]=mance ( an action :i* 8 reason condemns4 ,uncontrollable ang] is a well recognis$ example ( ?is4 ,impulses ( o!r k9ds may ex]cise j z tyrannic a sway1 ?\gh x is h>d] to recognise ! elem5ts t make up ! m5tal condition 9 o!r cases4 ,( c\rse x may well be said t man mu/ control 8 impulses4 ,x is1 h[ev]1 j su* impulses z c n be controll$ t less5 responsibility & sometimes seem entirely to de/roy x4 ,x w\ld1 )\t d\bt1 be v easy to advance ! uncontrollable impulse z an excuse = _m crim9al actions4 ,9 fact1 ! discussion ( responsibility & its limitation by impulse w\ld seem to be op5 to s _m abuses z to make x advisable1 9 ! pres5t indef9ite /ate ( our k1 to put ! subject aside entirely4 ,! argum5t1 h[ev]1 f ! abuse ( ! ?+1 does n hold1 & an ef=t mu/ be made to get at ! tru? conc]n+ c]ta9 m5tal conditions :i* modify responsibility4 ,x is g5]ally conc$$ t no two m5 are free 9 q ! same way ) reg>d to ! actions :i* !y may or may n p]=m4 ,allurem5ts t are almo/ compell+ = "s individuals1 = o!rs h no influ5ce at all4 ,"s m5 are s "u ! influ5ce ( ang] t irritation may easily lead !m to ! commission ( acts = :i* !y w be subsequ5tly supremely sorry4 ,?is may ev5 be ! case to su* an ext5t z to endang] _! lives1 yet !y are n able to control !mselves4 ,_m m5 suff]+ f deg5]ation ( ! art]ies ( ! he>t h be5 w>n$1 l ,john ,hunt] m ?an a c5tury ago1 ( ! extreme dang] ( a fit ( ang]1 yet1 l ,john ,hunt]1 h succumb$ to bur/s ( ang]1 not)/&+ ! w>n+1 because someone irritat$ !m beyond _! r limit$ p[]s ( endurance4 ,x is extremely difficult ev] to come to any prop] appreciation ( ! responsibility ( a giv5 individual f a #bfh s+le act4 ,prec$+ acts1 h[ev]1 may v well give evid5ce ( ! /ate ( m9d & ! t5d5cies to disequilibrium :i* may make an app>5tly normal individual irresponsible "u try+ circum/ances4 ,! only way to r5d] ?is cle> is to illu/rate su* conditions by a concrete case4 ,n _m ye>s ago "o ( ! l>ge cities ( ?is c\ntry 0 %ock$1 = "o tw5ty-f\r h\rs at lea/1 by ! news t a bus9ess man _h %ot 8 p>tn]s & himself1 :ile at a consultation 9 :i* ! affairs ( ! p>tn]%ip 7 be+ settl$ up1 aft] legal dissolution _h tak5 place4 ,! man 9 "q _h paid "s debts ( ! firm ) 8 own p]sonal *ecks1 & )\t tak+ prop] legal recognisance = ! moneys paid4 ,:5 ! p>tn]%ip _h be5 dissolv$ 8 p>tn]s insi/$ t in/ead ( obta9+ cr$it = ^! paym5ts he %\ld1 on ! contr>y1 pay 8 %>e ( ^! debts once m z a p>tn]4 ,! /ate ( ! evid5ce 0 su* t 8 lawy]s told him x w\ld be useless to take ! case be=e ! c\rt at all2 !re 0 no?+ to d b pay ! unju/ dem&s4 ,he w5t to ! meet+ ( 8 p>tn]s ) a c]tifi$ *eck = ! am\nt ( _! claims 9 8 pocket4 ,z he took out 8 pocket-book to pass x ov] to !m he seems to h realis$ v poignantly ! fact t he 0 pay+ money t he knew he did n owe1 & t 8 p>tn]s knew he did n owe1 & t !y 7 evid5tly tak+ advantage ( a legal quibble 9 ord] to *eat him4 ,evid5tly x 0 an extremely try+ situation4 ,x 0 too mu* = 8 m5tal balance & he took a revolv] f 8 pocket1 %ot bo? 8 p>tn]s dead1 & !n %ot himself4 ,tak5 by itself x is extremely difficult to say any?+ ab\t ! responsibility ( a man :o commits an act l ?is4 ,9 ord9>y life he 0 kn[n z a clev] bus9ess man2 to 8 fri5ds he 0 kn[n to be r irascible & impati5t1 b a fairly good fell[4 ,he 0 kn[n to h :at is call$ an awful temp]2 he _h1 h[ev]1 nev] committ$ any viol5t act be=e4 ,x is possible1 ( c\rse1 t a man %\ld give way to a fit ( ang] = ! beg9n+ ( :i* he is responsible1 & !n d viol5ce #bfi mu* great] ?an he w\ld ju/ify himself = 9 calm] mom5ts4 ,!re 0 ano!r occurr5ce 9 ! man's life t seem$ to ?r[ in=m+ light on 8 m5tal condition4 ,:5 he fir/ came to live 9 ! l>ge city 9 :i* he di$ he began pay+ att5tion to a "y woman1 & ! "y woman 0 in=m$ by a fri5d t he probably _h a wife liv+4 ,! "y woman inve/igat$ ?is by putt+ ! "q directly to him4 ,he d5i$ x at once1 want$ to "k ! "n ( h] in=mant1 & f9ally laugh$ ! :ole matt] out ( h] m9d4 ,)9 a week aft] 8 m>riage to h]1 :ile on _! w$d+ t\r1 he 0 arre/$1 *>g$ ) bigamy at ! in/ance ( 8 fir/ wife1 & x became evid5t at once t ! *>ge 0 well sub/antiat$4 ,"h is a man1 !n1 :o twice at lea/ 9 life1 :5 put 9 ! pres5ce ( try+ conditions1 goes on to d ! irretrievable1 ?\gh ! act is em95tly irrational4 ,) reg>d to ! murd] & suicide x is said t he _h talk$ to fri5ds ( %oot+ ! sc\ndrels :o 7 *eat+ him1 b _h be5 p]suad$ ( ! utt] fooli%ness ( any su* idea4 ,he _h app>5tly giv5 x up entirely4 ,not)/&+ ?is1 he w5t to ! la/ conf]5ce ) 8 =m] p>tn]s ) a load$ revolv]1 z well z ! c]tifi$ *eck = ! am\nt ( _! claim4 ,9 ! case ( 8 bigam\s m>riage1 not)/&+ ! w>n+ t 8 second fiancee's que/ions mu/ h be51 he foll[$ out 8 preconceiv$ idea ( m>ry+ h]1 ?\gh he mu/ h realis$ 9 san] mom5ts t discov]y ( 8 d\ble deal+ 0 inevitable4 ,9 a ^w1 he 0 a man :o1 becom+ dom9at$ by an idea1 an obsession x may be call$1 to d some?+1 c\ld n get away f ! sph]e ( its influ5ce ev5 ?\gh x might be made v cle> to him x 0 em95tly irrational to foll[ out ! idea4 ,!re are _m su* individuals1 & only ! k ( _! previ\s c>e] enables u to desume ! responsibility = _! acts "u try+ conditions4 ,t !y are n responsible 9 ! ord9>y s5se 9 :i* ! logical1 timor\s mortal is :o is at once repell$ f su* modes #bgj ( action seems v cle>4 ,_! lack ( responsibility is manife/1 at lea/ to a degree t makes x easy = *>ity to f9d excuses = _! crimes because ( fatal flaws ( "*1 ! result ( physical defects & faulty tra9+1 :i* make !mselves felt especially at ! mom5ts t try m5's s\ls4 ,,james ,j4 ,,wal%4 #bga ,,xxv ,,crim9ology ,,& ,,! ,,habitual ,,crim9al ,9 rec5t ye>s no little att5tion has be5 devot$ to ! subject ( crim9ology1 & a suppos$ sci5ce ( ! crim9al has be5 evolv$4 ,x has be5 ! claim ( a v well kn[n ,italian s*ool ( m5tal diseases1 ^: lead] is ,pr(essor ,lombroso ( ,tur91 t !re is a crim9al type 9 humanity1 t is1 t !re is a g5]ic human organisation n difficult ( diff]5tiation1 at lea/ z a class1 ! memb]s ( :i* almo/ necess>ily develop crim9al proclivities4 ,ev5 :5 crim9ality has n actually occurr$1 ?is is ?\ght to be b an accid5t1 & crim9al acts may be look$ = at any "t f ^! individuals4 ,lombroso's claims 9 ?is matt] h met ) decid$ opposition 9 e c\ntry ( ,europe & also "h 9 ,am]ica4 ,?is opposition has come especially f s]i\s /ud5ts ( abnormal types :o h devot$ mu* "t to ! /udy ( crim9als & o!r suppos$ly deg5]ate individuals4 ,magnan1 ! v well & widely kn[n ,fr5* au?ority on insane peculi>ities1 especially ! s-call$ crim9al monomaniacs1 & ^: opportunities = c>eful inve/igation ( su* cases 9 ! ,asile ,/4 ,anne 9 ,p>is h be5 v ext5sive1 utt]ly rejects ! idea ( a special physical con=mation z *>act]i/ic ( ! crim9al4 ,he is n ! only "o ( ! di/+ui%$ au?orities 9 m5tal diseases :o is 9 opposition to ,lombroso 9 ?is matt]4 ,dr4 ,emile ,laur5t1 ! em95t crim9ologi/ ( ,p>is1 has %[n t ! same anomalies :i* are suppos$ to *>act]ise crim9als are to be f\nd among ^? :o h nev] committ$ any crim9al act1 & t ^! suppos$ signs ( deg5]acy are n suffici5t to indicate ev5 #bgb t !re are crim9al t5d5cies4 ,man\vri]1 ! di/+ui%$ an?ropological au?ority ( ! ,univ]sity ( ,p>is1 does n hesitate to advance ! op9ion t he c n f9d any di/9ctive diff]5ce betwe5 crim9als & normal m5 9 ! ext5sive /udies ( ! comp>ative anatomy ( ! two classes4 ,he admits1 h[ev]1 t environm5t sometimes leads to ! =mation ( habits :i* modify ! anatomy 9 c]ta9 ways1 & t ( c\rse traces ( h>d "w1 z well z ( poor liv+1 c be f\nd 9 ! anatomical con=mation ( _m habitual crim9als4 ,dr4 von ,hold]1 a di/+ui%$ ,g]man au?ority on ! subject1 says t x is impossible to draw any conclusion f cranial asymmetries z to psy*ical *>act]i/ics1 & t physical signs ( deg5]ation indicate no?+ fur!r ?an ! possible pres5ce ( a t5d5cy to psy*ic deg5]ation4 ,dr4 ,w9es1 quot$ by ,draehms 9 8 book on ,! ,crim9al1 a ,sci5tific ,/udy1 says t 9 a /rictly sci5tific s5se1 ! exi/5ce ( an an?ropological crim9al type has n be5 prov$1 & x is d\btful :e!r x ev] c be prov$4 ,dr4 ,ar?ur ,mc,donald1 ! well kn[n ,am]ican speciali/ 9 crim9ology & deg5]acy1 "s ( ^: "w 9 connection ) ! ,national ,bureau ( ,education at ,wa%+ton has attract$ widespread att5tion1 says1 9 8 ,abnormal ,man3 ,! /udy ( ! crim9al c also be ! /udy ( a normal man1 = mo/ crim9als are s by occasion or accid5t1 & diff] 9 no ess5tial respect f o!r m54 ,mo/ human be+s :o are abnormal or defective 9 any way are mu* m l ?an unlike normal individuals4 ,h[ mu* ! subject ( crim9ology has be5 ov]done because ( ! morbid popul>ity ( ! idea t _m p]sons are1 z x 71 =c$ by _! natures into ! commission ( crime1 c be/ be appreciat$ f "s rec5t publications ) reg>d to left-h&$ individuals4 ,a numb] ( suppos$ obs]v]s1 mu* m anxi\s1 evid5tly1 to make out a case = a pet preconceiv$ !ory1 ?an to make obs]vations t w\ld add to ! pres5t /ore ( tru?1 h ru%$ into pr9t4 ,z a result1 left-h&$ p]sons h be5 said to be crim9als mu* m commonly ?an #bgc ^? :o habitually use _! "r h&1 & h also be5 said to be defective 9 o!r ways4 ,!y 7 spok5 ( z weakl+s1 deg5]ates1 & ! l4 ,/ati/ics ev5 7 quot$ to %[ a mu* l>g] proportion ( crim9als ?an might be expect$1 accord+ to ! normal p]c5tage1 betwe5 "r-h&$ & left-h&$ p1 among ^? :o use _! left h& by pref]5ce4 ,z a matt] ( fact1 left-h&$ p are f> f be+ ! weakl+s or deg5]ates !y are ?us proclaim$2 b on ! contr>y are (t5 magnific5t a?letes & excell5t specim5s ( normal developm5t4 ,left-h&$ness is due to "r-bra9$ness & ?is is an accid5t dep5d5t on a div]sion ( blood supply 9 an increas$ am\nt to ?is side ( ! bra9 9 e>ly embryonic life4 ,?is "q ( ! crim9al & ! left-h&$ individual & _! mutual relations is only a good example1 !n1 ( h[ f> ov] zeal\s advocates ( a !ory h be5 l$ a/ray 9 _! attempts to bol/] x up4 ,draehms1 ^: op9ion on ! suppos$ born crim9al is wor? :ile quot+1 z x is f\nd$ on 8 p]sonal exp]i5ces & obs]vations :ile a resid5t *apla9 ( ! /ate prison at ,san ,qu5t91 ,cali=nia1 says3 ,crime is n1 z ,lombroso & 8 coadjutors w\ld h u believe1 :olly ei!r a disease or a neurosis 9 ! s5se ( a direct1 absolute1 physiological1 pa?ognomonic entity1 ?\gh d\btless n infrequ5tly closely associat$ ) physical1 anatomical1 & n]ve deg5]ation1 z above conc$$4 ,to presuppose absolute & necess>y bra9 lesion or diseas$ n]ve action1 or anomal\s1 physiognomonical1 or anatomical dia!sis1 z ! inevitable precursor ( any =m ( m5tal & moral deflection1 is an assumption :olly unw>rant$ & is n[h]e sub/antiat$ by facts1 ?\gh its advocates h s\ght to lay _! f\ndations deep & wide 9 ! mat]iali/ic hypo!sis4 ,mo/ crim9als pres5t unusually s\nd physiological conditions1 & !re is among !m no unusual dea? rate1 consid]+ _! habits & mode ( life1 z we %all h]eaft] see4 ,h5ce _! moral in/ability c n be associat$ ) physiological in/ability 9 ! absolute s5se4 ,! physical defect mu/ be ei!r rev]sion>y or incid5tal1 r ?an absolute4 #bgd ,! impetus 9 ! /udy ( crim9als1 :i* came z a result ( ! revolution>y tea*+ ( ! ,italian s*ool1 has n be5 )\t a good effect4 ,crim9als all ov] ! _w h be5 /udi$ m closely & m sympa!tically1 9 ord] to te/ ! new ideas1 until n[ x is possible to draw def9ite conclusions ) reg>d to c]ta9 features ( ! problem4 ,aft] a "t1 ,lombroso came to admit t ! s-call$ crim9al type occurr$ 9 some:at less ?an half ! crim9al cases4 ,crim9al an?ropologi/s1 h[ev]1 h %[n t ! physical con=mation call$ by ! "n crim9al1 is really only ! result ( a defective or deg5]ative physical con/itution4 ,x is easy to und]/& t p]sons born ) a defective n]v\s sy/em1 or ) s]i\s deg5]ative lesions 9 o!r p>ts ( ! body1 :i* prev5t ! prop] nutrition & functional developm5t ( ! n]v\s sy/em1 w\ld p]=m _m m mat]ially crim9al acts ?an ! re/ ( ! population4 ,! idiot & c]ta9 =ms ( ! deg5]ative insane %[ ?is4 ,any defective developm5t ( ! n]v\s sy/em1 moreov]1 may lead to in/ability ( moral "*1 because ! free action ( ! s\l may be hamp]$ by ! physical environm5t ) :i* x is associat$4 ,c]ta9 ( ! physical peculi>ities mo/ frequ5tly se5 9 crim9als h an influ5ce ( ?is k9d & m]it discussion4 ,a k ( !m w furni% cl]gym5 ) reasons = a l>g] *>ity to ^? un=tunates1 & a great] tol]ance = _! relapses1 )\t all[+ s5tim5t to play too important a role 9 deal+ ) !m4 ,!re are all grades ( defective human be+s1 f ! idiot up to ^? little less ?an normal4 ,anatomical peculi>ities prev5t ! prop] functions ( ! n]v\s sy/em1 z x is n h>d to und]/&4 ,! w is hamp]$ 9 its action by ! defect ( ! in/rum5t ?r\gh :i* x mu/ "w4 ,9 p]sons prop]ly to be consid]$ z deg5]ates usually ! head is small1 ?\gh ?is may n be v noticeable because ( ov]-developm5t ( ! jaws4 ,a heavy l[] jaw p>ticul>ly1 because ( ! pr9ciple ( bone-developm5t t size dep5ds on functional action & reaction1 may lead to ov]-?ickness ( ! skull at ! po9t ( articulation4 ,! #bge jaw articulates ) ! base ( ! skull1 & z a consequ5ce ! cranial capacity ( ^! individuals is di/9ctly less ?an normal4 ,besides ?is1 !re is commonly "s abnormality 9 ! %ape ( ! head1 or ! cranium is di/9ctly asymmetrical4 ,x has be5 not$ t crim9als h a l>ge orbital capacity1 t is to say1 ! bony framework surr\nd+ ! eye is s l>ge z to encroa* mu* m ?an usual ^u ! space left )9 ! cranium = n]v\s tissue4 ,! bones ( ! skull are likely to be ?ick] & heavi] ?an usual1 ?us also limit+ ! cranial capacity4 ,! sup]cili>y ridges (t5 project & give ! beetl+ br[ t is sometimes s rem>kable4 ,! jaws are heavy1 & especially ! l[] jaw is apt to be l>ge & progna?ic1 t is1 project+4 ,?is may ext5d ev5 to ! exi/5ce ( a s-call$ lemurian app5dix ( ! jaw4 ,! zygomatic process is apt to be prom95t1 9 keep+ ) ! heav9ess ( ! upp] jaw4 ,! nose is usually some:at flatt5$1 & may be crook$4 ,?is peculi> developm5t ( ! nose puts mo/ ( ! int]nal p>ts ( t important organ )9 ! skull itself4 ,?is fur!r encroa*es ^u ! cranial capacity4 ,! e>s are asymmetrical1 (t5 unev5ly plac$ at ! sides ( ! head1 sometimes adh]5t at ! lobule1 sometimes v prom95t4 ,! displacem5t ( ! s(t tissues is due to ! exi/5ce ( asymmetry ( ! skull4 ,z may be se51 all ( ! *>act]i/ics ( ! crim9al type1 po9t$ out by ,lombroso1 may practically be summ$ up 9 ! "o expression1 !re is dim9i%$ am\nt ( intracranial space4 ,) reg>d to _m cranial de=mities1 & especially v>i\s ?ick5+s ( ! cranial bones1 x mu/ n be =gott5 t !y are n ! expression ( physical h]$ity1 b are (t5 pa?ologically acquir$4 ,c]ta9 diseases ( *ildr5 are acc\ntable = _m ( !m4 ,v>i\s disord]s ( nutrition 9 ! e>ly ye>s ( life express !mselves 9 bony de=mities1 & ! skull is n sp>$4 ,rickets1 = in/ance1 is well recognis$ z a cause ( su* de=mities4 ,ow+ to a wrong etymology ( ?is ^w1 by :i* x is suppos$ to be d]iv$ f ! ,greek ^w ,greek text1 mean+ ! sp9e1 rickets is sometimes sci5tifically #bgf call$ ra*itis4 ,! connection1 !n1 betwe5 ! cranial de=mity & "s und]ly+ n]v\s di/urbance might be assum$4 ,x does n exi/1 h[ev]4 ,rickets is an ,engli% ^w1 ! d]ivation ( :i* is unkn[n1 b probably x is wrick51 twi/$1 de=m$1 & its use has crept 9 because ! disease 0 fir/ describ$ 9 ,engl&1 & is inde$ (t5 spok5 ( on ! cont95t ( ,europe z an ,engli% disease4 ,n t x is any m frequ5t 9 ,engl&1 h[ev]1 b 0 !re fir/ recognis$ z a di/9ct pa?ological entity4 ,z ! result ( ?is affection ! *ildr51 usually ( poor p>5ts1 suff] f ga/ro-inte/9al disord]s ( v>i\s k9ds1 & develop symptoms ( malnutrition1 affect+ especially bone tissue4 ,! ends ( ! long bones at ! wri/s & at ! ankles1 :]e ! effects ( ! disease c be notic$ p>ticul>ly1 become m ?ick5$ & nodul> ?an usual4 ,! ends ( ! ribs1 :]e ! bones jo9 ! c>tilages1 also become nodul>1 s t a s]ies ( beads c be se5 d[n ea* ( ! *ild's sides1 a condition describ$ z ! rickety ros>y4 ,9 a simil> way ! bones ( ! skull become ?ick5$1 especially at ! edges ( ! fontanels1 t is1 ! op5+s 9 ! *ild's head be=e complete ossification ( ! skull has tak5 place4 ,z a consequ5ce ( ?is ?ick5+ ^! op5+s d n close z !y %\ld1 & ! head becomes m>k$ly de=m$ 9 "s cases4 ,inde$1 z has be5 %[n by exp]ts 9 *ildr5's diseases1 _m ( ! peculi>ities t h be5 po9t$ out by ov] en?usia/ic craniologi/s z indicat+ crim9al deg5]ation1 are really ! results ( ! rickety process on ! skull4 ,ne$less to say1 h[ev]1 ?is does n *ange ! "* ( ! individual1 nor is !re any good reason :y su* de=mities %\ld h any special connection ) crim9ality4 ,x happ5s t _m ( ! crim9al classes suff] f malnutrition 9 _! e>ly *ildhood1 & z a consequ5ce !re is a faulty bony developm5t ( ! skull4 ,x is obs]vations ( ?is k9d1 p>ticul>ly1 t h s]v$ to discr$it craniology z an indep5d5t sci5ce4 ,) reg>d to habitual crim9als1 ! "q ( crim9ality mu/ be discuss$ f ! /&po9t1 n ( ^? :o !orise1 b ( ^? :o "k f actual #bgg obs]vation mo/ ab\t ! crim9al classes4 ,9 an article 9 ,! ,n9ete5? ,c5tury & ,aft] = ,decemb]1 #aija1 ,sir ,rob]t ,&]son discusses h[ to put an end to pr(essional crime4 ,sir ,rob]t has be5 ,*airman ( ! ,crim9al ,inve/igation ,committee ( ! ,engli% ,p>liam5t = _m ye>s4 ,8 op9ion1 !n1 is wor? weigh+ well & is v /rik+ly diff]5t f ^? ( ! crim9ologi/s :o w\ld f9d a v l>ge proportion ( crim9als among mank9d4 ,he says3 ,i am n turn+ phrases ab\t ?is matt]1 or deal+ 9 rhetorical fireworks4 ,i am speak+ s]i\sly & delib]ately1 & ,i appeal to all :o h any confid5ce 9 my judgm5t & k ( ! subject1 to accept my assurance t if n #gj1jjj b #gj kn[n crim9als 7 put out ( ! way1 ! :ole organisation ( crime aga9/ prop]ty 9 ,engl& w\ld be dislocat$1 & we %\ld1 n t5 ye>s h5ce b imm$iately1 enjoy an am\nt ( immunity f crimes ( ?is k9d t x might to-day seem ,utopian to expect4 ,! crim9al /ati/ics cult bl9ds its vot>ies4 ,x is ! crime committ$ by pr(essional crim9als t keeps ! community 9 a /ate ( siege4 ,! pr(essional crim9als are few & ,i may add !y are well kn[n to ! police4 ,! !ory t ^! m5 commit crimes "u ! ov]p[]+ pressure ( habit1 or ( impulse1 is altoge!r mi/ak54 ,!y pursue a c>e] ( crime because1 z ,sir ,alfr$ ,wills expresses x1 !y calculate & accept its risks4 ,& j 9 proportion z y increase ! risks y w dim9i% ! numb] ( ^? :o w face !m4 ,true x is t ! army ( crime includes a c]ta9 numb] ( wret*$ creatures :o h n suffici5t moral /am9a to resi/ ! crim9al impulse4 ,i believe !re are few] ( ?is class 9 ,engl& ?an abroad1 b ,i "k t ^! are n ! sort ( crim9als ^: crimes p]plex ! police4 ,! high-class crim9al is a diff]5t type ( p]son altoge!r4 ,sir ,rob]t gives an extract f "o ( ! morn+ pap]s ( ! day on :i* he wrote ^! l9es1 9 ord] to %[ h[ diff]5t is ! /atus ( e ord9>y habitual crim9al f t :i* ! en?usia/ic crim9ologi/ supposes x to be3 #bgh ,hewson ,pat*ett1 #dh1 0 s5t5c$ ye/]day = obta9+ sev5 p\nds & a gold wat* by false pret5ses4 ,he urg$ x 0 8 fir/ (f5ce1 b a ,london detective in=m$ ! c\rt t !re 7 ab\t two hundr$ cases aga9/ him = h\sebreak+4 ,sir ,rob]t adds3 ,if ,pat*ett is a cool-head$1 delib]ate crim9al1 ! :ole proce$+ is a f>ce4 ,& if he be "o ( ^? mis]able1 weak creatures :o c n ab/a9 f crime1 ! s5t5ce is b>b>\s4 ,su* exp]i5ces z ,sir ,rob]t h9ts at z occurr+ frequ5tly 9 ,engl&1 are c]ta9ly by no means uncommon 9 ?is c\ntry4 ,)9 ! pa/ ye> 9 at lea/ f\r cases 9 ,new ,york ,city1 9 :i* a burgl>1 besides committ+ robb]y1 w\nd$ or kill$ "s "o1 ei!r 9 ! commission ( ! crime itself or 9 endeav\r+ to avoid arre/ aft]w>ds1 !re 7 m ?an two convictions regi/]$ aga9/ ! crim9al 9 8 previ\s life4 ,!re c be no d\bt t crim9ality becomes = "s m5 a sort ( mania1 & t society mu/ protect itself aga9/ _! actions q z x does aga9/ ^? ( ! insane by conf9+ !m "u surveillance4 ,x seems v cle> t :ile a man may1 "u /ress ( circum/ances or because ( "s specially tempt+ opportunity1 be induc$ to commit burgl>y or "s o!r crime by viol5ce 9 ord] to obta9 money1 ?is w n happ5 a second "t1 except 9 ! case ( c]ta9 individuals ^: moral tone is s p]v]t$ t re=mation is practically hopeless4 ,if a second conviction = burgl>y1 !re=e1 is secur$1 a long] s5t5ce ?an is n[ ! cu/om %\ld be inflict$1 & ! individual %\ld n be all[$ to g f "u ! surveillance ( ! au?orities until he has demon/rat$1 = at lea/ five ye>s1 8 will+ness & capacity to e>n an hone/ liv+4 ,?is may seem a dra/ic me?od4 ,x may also appe> to "s t !re w\ld be consequ5t ^u ?is sy/em ( regulat+ crim9als a v undesirable increase ( our pres5t r ext5sive sy/em = ! c>e ( crim9als4 ,"h is :]e ,sir ,rob]t ,&]son's exp]i5ce is ( value4 ,! confirm$ crim9als are n ne> s _m 9 numb] z is usually suppos$1 or z is ev5 claim$ by c]ta9 he$less #bgi /ati/ical exp]ts 9 crim9ology4 ,!re is no d\bt1 h[ev]1 t ^! m5 succe$ 9 draw+ o!rs ar\nd !m & 9 organis+ mo/ ( ! crimes ( viol5ce t are committ$4 ,!re is a c]ta9 glam\r ab\t ! successful burgl> t allures ! "y man & />ts him 9 ! d[nw>d pa? ( crim9al t5d5cies f :i* he may n be able lat] easily to )draw4 ,if ^? :o are mo/ deeply int]e/$ 9 ! re=m ( ! crim9al classes w\ld unite 9 an ef=t to secure legislation to ! effect t ! habitual crim9al %\ld receive1 n a def9ite s5t5ce b an indet]m9ate s5t5ce2 t is to say1 t on 8 second conviction = burgl>y1 he %\ld be s5t to jail until su* a "t z1 9 ! op9ion ( (fic]s ( ! in/itution :]e he has be5 conf9$1 he %[s signs ( a disposition to become a wor?y memb] ( society1 & t !n he %\ld be all[$ to be at lib]ty only "u su* circum/ances z w\ld p]mit ( reports ) reg>d to 8 conduct = a "t equal at lea/ to ! ye>s sp5t 9 prison1 !n !re w\ld be mu* less ne$ ( ! !oretical consid]ations ) reg>d to ! h]$ity ( crim9al traits1 & ! suppos$ all p[]ful influ5ce ( environm5t 9 fo/]+ crim9al t5d5cies4 ,!re is 9 ?is matt] a v wor?y field = ! developm5t ( philan?ropic qualities1 & ! /ud5t ( ! abnormal man w f9d _m opportunities = ! ex]cise ( a l>ge-he>t$ *>ity1 r ?an ! facile condemnation :i* places all violations ( law "u ! head ( crim9ality4 ,^? :o h made special /udies ) reg>d to crim9als h1 z a rule1 come to ! conclusion t our mod]n me?od ( treat+ ^? convict$ ( crime is em95tly irrational4 ,x is a r>e ?+ to pick up a newspap] )\t f9d+ t a crime by viol5ce has be5 committ$ by "s "o :o has previ\sly be5 9 /ate's prison = a simil> crime4 ,mo/ ( ! burgl>s h a police record4 ,pickpockets & o!rs cont9ue to pursue _! avocations1 not)/&+ a s]ies ( convictions4 ,x is cle> t a s5t5ce ( a ye> or two1 or ev5 m ea* "t t a crime is committ$1 does n act z a det]r5t4 ,su* p are diff]5tly con/itut$ f ^? :o are influ5c$ by #bhj public conviction ( crime & re/ra9t ( lib]ty4 ,!re is some?+ radically wrong ) _! moral s5se4 ,x w\ld seem t ! prop] way to treat !m is aft] ! same fa%ion z ! me?od us$ ) ^? :o are m5tally impair$4 ,aft] a man has %[n1 by a second conviction ( a crime by viol5ce1 t he is "o ( ^? ^: moral s5se c n be re/or$ by puni%m5t to a realisation ( 8 action1 !n an indet]m9ate s5t5ce1 some:at z 9 ! case ( ! m5tally un/able1 :o are all[$ to leave ! asylum b are kept "u obs]vation1 is ! only prop] me?od4 ,m5 l ,sir ,rob]t ,&]son are sure t ?is proc$ure c\ld be adopt$ ) reg>d to q a lib]al numb] ( lead+ crim9als ^: influ5ce induces o!rs to crime4 ,!re w\ld be mu* less ne$ = all ma*9]y ( ! crim9al law ?an at ! pres5t "t1 & ! community w\ld be bett] protect$4 ,?is is c]ta9ly true z reg>ds ! l>ge cities1 :]e crimes aga9/ prop]ty are almo/ )\t exception committ$ by ^? :o h be5 previ\sly convict$ = su* crimes1 or :o at lea/ h be5 9 intimate association ) su* convict$ crim9als4 ,?is view ( ! crim9al1 z "o aga9/ :om society mu/ protect itself j z x does aga9/ ! insane1 is comp>atively mod]n4 ,x mu/ be borne 9 m9d1 h[ev]1 t insane asylums are by no means an old in/itution1 & t ! pres5t re/ra9t ( v l>ge numb]s ( ! insane is some?+ unkn[n be=e 9 hi/ory4 ,x seems n unlikely t if ?is new] aspect ( crim9ology c\ld be made popul> great b5efit w\ld foll[1 n only to ! peace ( ! community & ! fre$om ( its memb]s f fe> z to su* crimes1 b also a numb] ( ! weak] individuals1 :o are n[ influ5c$ & l$ a/ray by clev] crim9als1 w\ld be sav$ f commission ( crime & ! necessity ( puni%m5t1 ) ! degradation & lifelong /igma t ?is involves4 ,?is is an aspect ( crim9ology ) :i* ! ,*ri/ian cl]gyman c be 9 sympa?y1 & t does n smack ( ! utt] mat]ialism :i* 0 at ! f\ndation ( mu* ( ! discussion ( ! s-call$ crim9al type4 ,! #bha recognition ( moral p]v]sion z a =m ( insanity requir+ treatm5t & !n con/ant obs]vation = _m ye>s1 j z 9 ! case ( m5tal disequilibration w\ld be a di/9ct advance ov] our pres5t crude me?ods ( deal+ ) crim9als4 ,,james ,j4 ,,wal%4 #bhb ,,xxvi ,,p>anoia1 ,a ,,/udy ,,9 ,,cranks ,( late ye>s ! crank1 9 ! v>i\s =ms 9 :i* he or %e may occur1 has became a subject ( great popul> z well z sci5tific int]e/4 ,z a matt] ( fact1 ! que]nesses ( p are a m absorb+ /udy to ! neurologi/s & psy*ologi/s ?an are any =ms ( insanity4 ,x n infrequ5tly happ5s t individuals ( peculi> t5d5cies are prone to h special aff9ity = religi\s ideas1 & /range applications ( ,*ri/ian =mulae ( ?\ght4 ,ev5 :5 !y d n become absolutely insane 9 _! religiosity1 !y may (t5 g to extremes4 ,x mu/ be rememb]$1 too1 t "s cranks are m5tally affect$ 9 b mild =m1 & x may be difficult to det]m9e :e!r _! oddity is really ! result ( a c]ta9 am\nt ( m5tal torsion1 or m]ely intellectual t5sion4 ,su* p]sons are m likely to be br\ght 9 close contact ) _! pa/ors & o!r cl]gym5 & ) religi\s ,sup]iors ( v>i\s k9ds ?an ev5 normal individuals4 ,!y (t5 put _! confessors1 p>ticul>ly1 9 s]i\s qu&>ies 9 ! matt] ( spiritual advice4 ,a review1 !n1 ( ! accept$ ideas ( exp]ts ) reg>d to su* p is likely to be ( special s]vice to ^? :o w\ld und]/& ^! cases z well z possible1 ?\gh ! pres5t /ate ( m$ical k1 "h z else:]e1 leaves mu* to be desir$4 ,a di/+ui%$ au?ority 9 m5tal diseases once said1 half 9 je/ ?\gh he meant x to be tak5 at lea/ half 9 e>ne/1 t a great _m m ( u are crack$ ?an are usually ?\ght to be1 only t mo/ ( u succe$ 9 conceal+ ! crack q well4 ,! frequ5cy ( ! crank adds to ! #bhc int]e/ ( 8 /udy1 :i* is by no means a dep>tm5t ( m$ical sci5ce ( rec5t gr[?4 ,:ile int]e/ 9 ?is class ( p]sons has become mu* m int5se 9 rec5t ye>s1 ecc5tric individuals h be5 an object ( close obs]vation & ( s]i\s /udy almo/ z f> back z hi/ory goes4 ,:5 ,qu9tilian said t g5ius 0 n f> sep>at$ f insanity1 he meant to record ! conclusion ( 8 "t1 t m5 ( g5ius are apt to seem inexplicable 9 _! ways to ^? :o come closely 9 contact ) !m4 ,ecc5tric p]sons1 h[ev]1 are by no means always undesirable memb]s ( a g5]ation4 ,x has be5 not$ by hi/orians 9 all ages t to ! refusal ( ecc5tric individuals1--(t5 ?\ght at ! beg9n+1 p>ticul>ly1 to be little bett] ?an insane--to accept ! traditions ( ! pa/1 we owe _m ( ! privileges :i* we enjoy at ! pres5t "t4 ,_! refusal to ?9k along old l9es ( ?\ght (t5 makes !m valuable pione]s 9 progress4 ,def9ite k ) reg>d to ! pa?ological basis ( crankism1 or ecc5tricities1 has n yet be5 obta9$4 ,:at has be5 le>n$1 h[ev]1 has enabl$ ! neurologi/ to di/+ui% v>i\s =ms ( m5tal p]turbation1 to recognise ! probable influ5ce ( c]ta9 conditions & environm5ts on ! future action ( ecc5tric individuals1 & to =etell ! probable outcome ( ! cases4 ,all ( ?is in=mation is ( v practical importance to religi\s ,sup]iors & o!rs 9 positions ( religi\s confid5ce1 :o are sure to be br\ght1 ev5 m ?an ! re/ ( ! community1 9 contact ) ! ecc5tric class4 ,x has seem$ advisable1 !n1 to cond5se "s ( ! rec5t k on ?is subject into popul> =m = ! use ( confessors1 spiritual directors1 & ^? 9 religi\s au?ority4 ,h[ rec5tly m$ical k on ?is important subject has develop$ along /rictly sci5tific l9es may p]haps be/ be appreciat$ f ! fact t ,pr(essor ,m5del ( ,b]l91 to :om we owe ! t]m p>anoia1 ! recognis$ sci5tific designation = crankism1 is yet alive & cont9u+ 8 lectures on neurology at ! great ,g]man univ]sity4 ,! t]m1 f ! ,greek ^w ,greek text1 mean+ alongside (1 & #bhd ,greek text1 m9d1 expresses ! fact t ! m5tal faculties ( individuals designat$ by x are beside !mselves1 t is1 ! m5tal p[]s are n entirely "u ! control ( ! individual1 s t !y only come ne> volunt>y intellection 9 its highe/ s5se4 ,9 a ^w1 ! t]m conta9s a s]ies ( expressive innu5dos by its etymological d]ivation4 ,pr(essor ,b]kley ( ,johns ,hopk9s ,univ]sity says t ! ^w p>anoia 0 fir/ adapt$ by ,m5del f ! writ+s ( ,plato1 to indicate an especial =m ( m5tal disease occurr+ 9 individuals capable ( consid]able education1 at times ( brilliant acquirem5ts1 yet possess+ a m5tal twi/ t makes !m a class ap>t f ! great mass ( humanity4 ,pr(essor ,pet]son1 ! ,presid5t ( ! ,new ,york ,/ate ,commission ( ,lunacy1 gives a v good def9ition ( ! condition :i*1 ?\gh c\*$ 9 some:at te*nical t]ms1 furni%es ! mo/ def9ite idea ( ! ess5tial prop]ties ( p>anoia4 ,he says3 ,p>anoia may be def9$ z a progressive psy*osis f\nd$ on a h]$it>y basis1 *>act]is$ by an e>ly hypo*ondriacal /age1 foll[$ by a /age ( sy/ematisation ( delusions ( p]secution1 :i* are lat] trans=m$ into sy/ematis$ illusions ( gr&eur4 ,he cont9ues3 ,?\gh halluc9ations1 especially ( he>+1 are (t5 pres5t1 ! c>d9al symptom is ! elab\rate sy/em ( fix$ delusion4 ,9 a ^w1 ! p>anoiac is a crank usually desc5d$ f m or less cranky ance/ors1 ) an ov]we5+ int]e/ 9 8 heal? to beg9 )1 :o lat] develops ! idea t _m p are try+ to d him h>m1 or at lea/ to prev5t 8 rise 9 ! _w1 & :o f9ally becomes possess$ ( ! notion t he is somebody1 ev5 ?\gh ^? ar\nd him refuse to ackn[l$ge x & pay v little att5tion to ! claim4 ,su* p n infrequ5tly he> ?+s t are n said4 ,t is1 n only d !y he> ! voices ( ! dead1 ( spirits good & evil1 b also ! voices ( liv+ p]sons1 :o are at a di/ance f !m & sometimes ev5 :5 ^? liv+ p]sons are pres5t1 b h said absolutely no?+4 ,^! delusions ( he>+1 h[ev]1 are n s important z ! self-deception =c$ ^u !m by _! #bhe m5tal /ate ) reg>d to _! importance 9 ! _w & _! relations to o!r p4 ,! mo/ significant consid]ation ) reg>d to p>anoia is ! fact t x is practically always h]$it>y4 ,krafft-,eb+ said t he nev] saw a case ( true & reasonably well develop$ p>anoia )\t h]$it>y ta9t4 ,?is does n imply1 ( c\rse1 t ! same symptom ( delusions exi/s 9 sev]al g5]ations1 b "s s]i\s m5tal peculi>ity is always f\nd to exi/ 9 ! prec$+ g5]ation4 ,o!r au?orities are n q s sweep+ 9 _! ass]tion ( h]$ity = ^! cases1 ?\gh practically all are agre$ t 9 ov] #hj p] c5tum ( ! cases1 "s h]$it>y elem5t c be trac$ )\t ov]/ret*+ ! details ( family hi/ory t are giv54 ,p>anoia occurs a little m commonly 9 females ?an 9 males4 ,z x is ( h]$it>y orig91 x is n surpris+ to f9d t ! peculi>ities are notic$ v e>ly 9 life1 ?\gh !y may n be suffici5tly emphasis$ to attract ! att5tion ( any b acute obs]v]s1 :o are br\ght closely 9 contact ) ! pati5ts4 ,ev5 9 *ildhood1 pati5ts :o subsequ5tly develop s]i\s =ms ( p>anoia1 usually h be5 %y1 backw>d1 incl9$ n to play readily1 irritable1 peculi>1 precoci\s1 prone to sp5d mu* "t 9 /udy at an age :5 !y ought to be int]e/$ ma9ly 9 sports1 & !y are g5]ally old beyond _! ye>s4 ,a typical example ( ?is 0 ,fri$]i* ,nietzs*e1 ! ,g]man philosoph]1 :o di$ a few ye>s ago 9 an insane asylum4 ,olla ,hanss51 ,nietzs*e's biograph]1 :o c>efully collect$ ! family acc\nts ( ! philosoph]'s *ildhood1 said t he did n talk until mu* lat] 9 *ildhood ?an is usual4 ,z a boy he 0 retir+ & solit>y 9 8 habits4 ,dur+ 8 s*ool days he 0 always int]e/$ 9 books n 9 sports1 9 lonely walks n 9 "y companions4 ,a hi/ory ( ?is k9d w be f\nd 9 ! e>ly c>e] ( _m que] folk4 ,v (t5 ^! old-fa%ion$ traits are a s\rce ( pleasure to p>5ts & sometimes ev5 to tea*]s4 ,dur+ *ildhood1 h[ev]1 ! sports ( *ildhood %\ld satisfy ! *ild1 & abnormalities ( int]e/ 9 ?+s outside ( *ildhood's sph]e are always suspici\s4 ,! gr[+ #bhf organism ne$s1 fir/ ( all1 muscul> ex]cise1 & aft] t ! fre$om ( m9d t comes ) spontane\s play4 ,x may be said1 9 pass+1 t ! walk ( a city *ild ) its maid1 :5 ev5 ! *ild's *oice 9 ! matt] ( :]e x %all walk is n consult$ & ! maid's w is con/antly impos$1 is ! wor/ possible tra9+ = spontane\s action or volition 9 lat] life4 ,9 ! cases t develop e>ly 9 life x w practically always be f\nd t infantile c]ebral disord]s ( "s k9d are a prom95t feature ( ! hi/ory4 ,! "m's deliv]y 0 difficult p]haps1 & ! *ild 0 = "s "t aft] bir? unconsci\s1 or infantile convulsions occurr$4 ,x may be rem>k$ "h t a hi/ory ( convulsions 9 *ildhood is n[ consid]$ by physicians z ( s]i\s import = ! future n]v\s & m5tal life ( ! *ild4 ,x has rec5tly be5 ann\nc$1 = in/ance1 t s-call$ idiopa?ic epilepsy1--t is1 epilepsy )\t "s directly imm$iate cause1--v seldom develops lat] 9 life 9 p]sons :o h n _h 9 *ildhood convulsive seizures z ! result ( "s extreme irritation4 ,?is does n imply t e *ild t has convulsions w suff] f "s s]i\s n]v\s or m5tal condition lat]2 b e *ild ^: m5tal & n]v\s equilibrium is n /able1 because ( h]$it>y elem5ts ( weakness1 w almo/ c]ta9ly suff]4 ,injuries to ! head 9 *ildhood are ne>ly ( z great importance z ! actual occurr5ce ( convulsions4 ,!re are usually ?ree /ages ( p>anoia describ$ by au?orities 9 m5tal diseases4 ,^! h be5 call$ ! prodromal or initial p]iod1 :i* is also1 because ( ! set ( symptoms usually mo/ prom95t 9 x1 (t5 call$ ! hypo*ondriacal /age ( ! disease4 ,! pati5t occupies himself ) 8 feel+s & 8 s5sations4 ,he is conc]n$ v mu* ab\t ! /ate ( 8 heal? & is prone to ?9k himself affect$ by diseases t he reads ab\t or he>s describ$4 ,?is set ( symptoms1 by itself alone1 is n an index ( endur+ m5tal di/urbance1 b may be only a manife/ation ( a pass+ m5tal p]turbation 9 sympa?y ) "s slight physical ailm5t4 ,?is /ate may inde$ be no?+ m ?an ! result ( too p]si/5t introspection4 #bhg ,mo/ m$ical /ud5ts suff] f a c]ta9 am\nt ( hypo*ondria dur+ _! e>ly acquisition ( a k ( ! symptoms ( disease4 ,9 ! true hypo*ondriac1 h[ev]1 e bodily s5sation1 or z x is te*nically call$1 somae/hetic s5sation1 is translat$ to mean a significant symptom ( s]i\s disease4 ,a slight feel+ ( fatigue becomes to ! pati5t's m9d ! tir$ feel+ ( a dang]\s con/itutional disord]4 ,any peculi> feel+1 su* z t ( ! h& or foot go+ to sleep1 is set d[n at once z a symptom ( a s]i\s n]v\s disease1 or if ! pati5t has he>d t 9 old p numbness ( ! extremities is a =]unn] ( apoplexy1 he is sure to conclude t apoplexy is ?reat5+ 9 8 own case4 ,subjective s5sations ( heat & cold set him to tak+ 8 temp]ature & 8 pulse1 & ev5 slight v>iations 9 ^! are magnifi$ into important physical signs ( disease4 ,v (t5 su* slight symptoms z pass+ lapses ( memory are magnifi$ into approa*+ complete failure ( memory1 & lassitude becomes a p]man5t loss ( w p[]1 evid5tly due to disease 9 ! pati5t's m9d1 & !re beg9s ! p]suasion t no?+ c ov]come x4 ,morbid introspection becomes1 aft] a "t1 ! fav\rite occupation1 & e slighte/ s5sation or feel+ sets up tra9s ( ?\ght t lead to f>-rea*+ conclusions ) reg>d to physical weakness4 ,! pati5t is apt to be greatly preoccupi$ ) himself1 to neglect 8 duty t[>ds o!rs1 to be utt]ly selfi%1 to fail to realise h[ mu* sympa?y is be+ wa/$ on him4 ,"s p nev] pass beyond ?is prelim9>y /age ( ! m5tal disord]4 ,usually1 h[ev]1 aft] a "t ! pati5t mis9t]prets n only 8 own s5sations1 b ! actions ( o!r p 9 8 reg>d2 he becomes suspici\s & di/ru/ful ( ev]ybody ar\nd him1 sometimes ev5 ( 8 be/ fri5ds4 ,he is pass+ on to ! second /age ( ! disease1 9 :i* he is sure to feel t he is ! object ( p]secution4 ,j z he misund]/ood 8 physical symptoms1 s he miscon/rues ! actions ( 8 fri5ds4 ,he is sure t !y look at him curi\sly1 t !y smile #bhh ironically4 ,sometimes he ?9ks t !y w9k at "o ano!r ) reg>d to him1 or make signs beh9d 8 back t are meant to be d]isive4 ,ev5 h>mless pass+ obs]vations may be morbidly p]v]t$ into sev]e & inimical criticism ( himself & 8 actions4 ,! p>anoiac is n[ apt to ent] fully ^u ! second or p]secutory /age ( 8 m5tal disord]4 ,8 di/ress & discom=t he attributes to ^? ar\nd him & he is sure t he is ! subject ( p]secution4 ,at fir/ 8 p]secutors are n v def9itely recognis$4 ,no p>ticul> p]son is pick$ out & ev5 no p>ticul> set ( p]sons4 ,!re is j a vague s5se ( p]secution4 ,a di/+ui%$ neurologi/ once said t no sane p]son 9 ?is _w1 outside ( a novel or a play1 has "t to make x 8 bus9ess to p]secute anyone else4 ,:5 p come1 !n1 ) /ories ( p]secution1 ei!r !y !mselves are n 9 _! "r m9d & are delud$ z to ! s\rce ( ! p]secution1 or else _! p]secutor is n 9 8 "r m9d & ! case ne$s see+ to f ! o!r /&po9t4 ,aft] a "t1 long] or %ort] 9 individual cases1 ! p>anoiac beg9s to recognise def9itely :o 8 p]secutors are4 ,z a rule1 x is n "s s+le individual1 b a comb9ation ( individuals4 ,already !re is ! beg9n+ ( ! ?ird /ate ( ! disease--! gr&iose /age ( ! disease1 9 :i* ! pati5t feels an extreme s5se ( 8 own importance4 ,x w\ld be d]ogatory to 8 self conceit to consid] himself ! subject ( p]secution by an individual1 & s x is usually "s society1 or ! gov]nm5t1 or its (ficials1 or "s secret organisation t is p]secut+ him1 & p]haps also p]secut+ ^? :o are ne> & de> to him4 ,sometimes x is ! ,odd ,fell[s1 or p]haps ! ,masons1 :o are ! p]secutors4 ,if ! newspap]s h rec5tly _h "s acc\nt ( ! disappe>ance ( ,morgan ye>s ago1 & ?is subject crops up p]iodically 9 ! pap]s1 !n ! ,masons become a fav\rite subject = p>anoiacs' delusions ( p]secutions4 ,j aft] ! ,cron9 murd] 9 ,*icago1 ! ,clan-na-,gael became an extremely fe>some spectre = p>anoiacs :o ?\ght !mselves p]secut$4 ,x is ( "s #bhi importance to "k1 z a rule1 :at ! usual read+ matt] ( a pati5t is1 & :at ?+s are likely 9 8 pa/ hi/ory to h impress$ him1 9 ord] to realise :at ! real s\rce ( 8 delusions ( p]secutions are4 ,x is curi\s h[ rational ^! pati5ts may be on all o!r subjects except ! special topic ( _! delusion4 ,dur+ ! pa/ ye> a p>anoiac has be5 "u obs]vation1 :o is consid]$ a reasonably rational individual by ^? :o "k him well1 :o foll[s 8 daily occupation1 t ( cl]k1 )\t int]mission & ) bus9ess ability1 :o is a fai?ful att5dant at *ur*1 & :o is v k9d to 8 family1 b :o is sure t he is ! subject ( p]secution by ! ,clan-na-,gael4 ,he nev] belong$ to ! organisation4 ,he is n able to give any good reason :y he %\ld be p]secut$1 except p]haps ! fact t1 ?\gh an ,iri%man1 he nev] did belong to !m4 ,he is p]fectly sure1 h[ev]1 t !y are plann+ to poison him & 8 family4 ,he f9ds peculi> ta/es 9 ! tea & ! c(fee at times4 ,he ?r[s out ^! mat]ials & insi/s on 8 wife gett+ o!rs at ano!r groc]y /ore4 ,he sometimes br+s groc]ies home f a di/ance & yet f9ds t if he ev] buys mat]ials a second "t 9 ! same place1 !y are sure to h be5 tamp]$ ) 9 ! meantime by emiss>ies ( ?is secret organisation4 ,he feels sure t he has se5 ^! secret ag5ts1 b he is only able to give vague descriptions4 ,n a little ( ! prejudice aga9/ ^! organisations is really f\nd$ on su* morbid suspicions4 ,ano!r =m t ! idea ( p]secution sometimes takes1 9 ?is second /age1 is ! delusion t ! pati5t is neglect$ by ^? :o %\ld specially c>e = him or h]4 ,a woman insi/s t %e is neglect$ by h] husb&4 ,%e may become int5sely jeal\s ( him & make life extremely mis]able = him )\t !re be+ any good reason = h] jeal\sy4 ,^! cases are n ne>ly s r>e z might be ?\ght4 ,on ! o!r h&1 m5 suspect _! wives ( unfai?fulness4 ,?is suspicion may g to v s]i\s l5g?s 9 p]secution at home1 ?\gh ! man all ! "t keeps 8 suspicions to himself1 9 ord] n to make a laugh+ /ock ( himself outside ( ! h\se4 ,x is ?is curi\s mixture ( #bij rationality & delusion t is ! *>act]i/ic feature ( ! disease4 ,x is = ?is reason t ^! conditions 7 sometimes call$ monomanias1 z if pati5ts 7 really di/urb$ only on "o po9t4 ,z a matt] ( fact1 h[ev]1 pati5ts are m5tally wrong on a numb] ( po9ts1 ?\gh !re is "s "o m5tal ab]ration s mu* m prom95t ?an o!r peculi>ities t x ov]%ad[s ! o!rs4 ,x is n long aft] ! p]secutory /age sets 9 be=e pati5ts are apt to become !mselves p]secutors ( o!rs z a result ( _! belief t !y are be+ p]secut$4 ,! ,fr5* h a sugge/ive expression = ?is4 ,x is p]secutes p]secuteurs1 t is to say1 p]secut$ p]secutors1--pati5ts :o are try+ to repay suppos$ p]secutors by p]secution on _! own "p4 ,su* pati5ts1 ( c\rse1 v easily become dang]\s4 ,!y ne$ to be c>efully wat*$4 ,z a rule1 ! p]sons :om !y are prone to select z ! p]secutors ^u :om !y mu/ av5ge !mselves are absolutely innoc5t p>ties4 ,at times !y are ev5 de> & well mean+ fri5ds4 ,aft] ! p]secutory /age 9 p>anoia1 comes ! ?ird1 or s-call$ expansive p]iod ( ! disease4 ,x has be5 rem>k$ t sometimes ?is develops z a sort ( logical sequ5ce f ! pati5t's ideas ( p]secution4 ,if he has too _m enemies & if important secret organisations are try+ to be rid ( him1 he mu/ be a p]son ( "s importance4 ,z a consequ5ce he evolves = himself a royal or ari/ocratic desc5t1 or h9ts t he is ! unackn[l$g$ son ( great p]sonages4 ,9 a k+dom royalty is1 ( c\rse1 a dom9ant idea4 ,9 a republic l our own1 he may consid] himself to be ! ,presid5t or ! politician to :om ! ,presid5t owes 8 (fice4 ,p>anoia ,religiosa4--,n infrequ5tly ! fir/ h9t ( _! suppos$ greatness comes to su* pati5ts sudd5ly 9 a dream or 9 a vision2 :5 _! expansiv5ess takes a religi\s turn1 ?is is especially apt to be ! case4 ,!y may believe !mselves to be especially *os5 by ! ,almighty1 a new ,messiah or ev5 ,*ri/ ,himself1 come once m to e>?4 ,su* p may reta9 mu* ( _! rationality on mo/ ( ! po9ts relat+ to practical life1 & yet h ?is #bia halluc9ation z to _! close relation%ip ) ! div9ity4 ,n only may !y reta9 _! m5tal equilibrium on o!r po9ts1 b !y may ev5 give decid$ manife/ations ( great g5ius4 ,?is is1 ,i suppose1 "o ( ! mo/ int]e/+ features ( ?is =m ( m5tal disease1 b x is well illu/rat$ 9 ! lives ( _m mod]n f\nd]s ( religi\s sects1 ev5 9 our own g5]ation4 ,su* religi\s re=m]s z ,mahomet & ,sw$5borg seem und\bt$ly to h be5 afflict$ ) ?is ?ird /age ( expansive p>anoia4 ,9 our own day !re is no d\bt t _m ( ! f\nd]s ( new religi\s sects1 _m ( ! heav5-s5t apo/les or re9c>nations ( patri>*s & prophets1 ! miracul\s heal]s & ! l1 are afflict$ 9 ?is same way4 ,x is useless & entirely contr>y to ! kn[n facts to put su* p aside z m]e impo/]s4 ,impo/]s !y are1 b !y h impos$ on !mselves z well z on _! foll[]s4 ,!y are s9c]e z f> z !y g1 & ! m5tal twi/ t gives !m _! p[] has occurr$ 9 ! mid/ ( ! manife/ation ( ! intellectual faculties ( a highly practical "* & ( executive ability1 ) wond]ful capacity = ! direction ( complex affairs4 ,a prom95t neurologi/ said1 n long ago1 t ! mo/ int]e/+ feature ( ,*ri/ian ,sci5ce is to contemplate 9 ! /udy ( ! movem5t h[ ne> p may come to insanity & yet reta9 _! faculty to make & h&le money & ev5 accumulate =tunes4 ,p>anoia ,erotica4--,aft] ! p>anoia religiosa1 ! mo/ common =m ( ! disease is ! p>anoia erotica4 ,!re are au?orities 9 m5tal diseases :o d n hesitate to say t an excess ( religiosity & ( erotic s5tim5tality are m or less int]*angeable4 ,?is decl>ation repres5ts1 h[ev]1 ! unconsci\s exagg]ation ( a m9d unsympa!tic t[>ds religi\s ideas4 ,b x mu/ n be lo/ sight ( t ! two =ms ( excesses1 erotic & religi\s1 are m ne>ly relat$ ?an w\ld be ord9>ily suppos$1 & t erotic manife/ations may be confid5tly look$ = 9 pati5ts :o h be5 afflict$ by a too highly wr\ght religi\s s5tim5tality4 ,/4 ,!resa seems to h realis$ ?is v well & has t\*$ on ! subject 9 "o ( h] lett]s4 #bib ,ord9>ily erotic p>anoia manife/s itself by ! pati5t imag9+ himself or h]self to be belov$ by "s "o ( sup]ior /ation4 ,?is love is ( r a platonic "* & ! lov] cranks are prone to pick out z ! object ( _! att5tion & annoyance "s "y woman r prom95tly 9 ! public eye1 b ^: reputation is ( ! v highe/4 ,m>y ,&]son 0 ! subject ( a good deal ( ?is sort ( p]secution4 ,at ! pres5t mom5t ! well & fav\rably kn[n daught] ( a great millionaire is ! subject ( _m su* att5tions4 ,^! p>anoiacs are apt to become dang]\s if !y are prev5t$ f pay+ :at !y consid] suitable att5tion to ! object ( _! affection4 ,9 hospitals !y h to be c>efully wat*$1 & m ?an "o accid5t has tak5 place z ! result ( relaxation ( vigilance on ! "p ( _! att5dants4 ,if kept f ! object ( 8 affection1 delusions ( p]secution become prom95t 9 ! amor\s p>anoiac1 & he may become a p]secutor 9 turn & ?us a dang]\s lunatic4 ,he c n be made to und]/& t ! s5d+ ( fl[]s & photographs & lett]s is entirely di/a/eful to ! *os5 "o4 ,=tunately1 aft] a "t1 9 _m ( ^! cases1 a /ate ( dem5tia sets 91 & !n ! pati5ts become mild-mann]$ imbeciles :om x is n at all difficult to manage4 ,z a rule :]e ! pati5t has pass$ ?r\gh ! v>i\s /ages ( p>anoia1 dem5tia1 ) symptoms ( imbecility1 closes ! sc5e4 ,! p>anoia may n always foll[ ! c\rse mapp$ out = x4 ,/ages may be skipp$1 sev]al =ms ( delusions may become prom95t 9 ! life ( ! individual at ab\t ! same "t4 ,! ma9 feature ( ! disease is its progressive "*1 & its diagnosis dep5ds on ! que]ness exhibit$ all dur+ ! c\rse ( life1 z well z on ! pres5ce ( h]$it>y neurotic influ5ces4 ,special ,=ms ( ,p>anoia4--,!re are besides ! two types describ$ a numb] ( special =ms ( p>anoia1 "s ( :i* ar\s$ att5tion fir/ "u ! =m ( monomanias1 t seem to m]it brief treatm5t by !mselves4 ,9 _! extreme =ms !y are easy ( recognition4 ,mild] types1 h[ev]1 may easily escape classification "u ! #bic head ( p>anoia1 because !y are consid]$ to be individual oddities & n due to any physical or m5tal incapacity4 ,und\bt$ly1 h[ev]1 ! /udy ( ^! peculi> types1 z ! ,fr5* call !m1 f ! /&>d ( ! ali5i/ or exp]t 9 m5tal diseases1 w s]ve to make cle>] ! real significance ( _m o!rwise almo/ unacc\ntable actions4 ,!re is no d\bt1 t ! consid]ation ( ^! ecc5trics z p>anoiacs makes ! *>itable judgm5t ( _m ( _! acts mu* easi]1 & at ! same "t is ( s]vice 9 manag+ !m4 ,!y are likely to be ( mu* less h>m to ! community & to _! fri5ds1 :5 x is realis$ t !y are n to be tak5 too s]i\sly1 b t1 on ! contr>y1 !re is ample ju/ification = a b5evol5t comb9ation ( int]e/s to keep !m f injur+ !mselves & _! fri5ds4 ,p>anoia ,qu]ulans4--,"o ( ! mo/ important & famili> =ms ( ! special types ( p>anoia is :at is kn[n sci5tifically p>anoia qu]ulans1 t is1 ! peculi>ity ( ^? :o insi/ on go+ to law :5ev] !re is ! slighte/ pretext4 ,x is pretty g5]ally recognis$ t a goodly proportion ( ! civil suits t cr[d our law c\rts are due to ! peculi>ities ( ^! p :o insi/ on hav+ _! rights1 or :at !y ?9k _! rights1 v9dicat$ = !m by a c\rt ( ju/ice4 ,!re are v peculi> *>act]s 9 ?is l9e1 "s ( :om make !mselves v mu* fe>$ & dete/$ by _! neighb\rs4 ,!re are "s individuals to :om ! slighte/ injury or %[ ( injury means an imm$iate appeal to ! law4 ,n infrequ5tly ^! pati5ts1 = su* !y are 9 ! highe/ s5se ( t ^w1 wa/e _! own sub/ance & ev5 ! means ( support ( wife & *ildr51 on _! fooli% law s*emes4 ,:5 _! que]ness rea*es a c]ta9 excessive degree its pa?ological "* is readily recognis$4 ,9 a less degree p>anoia qu]ulans may be a s\rce ( v s]i\s discom=t to fri5ds & neighb\rs )\t excit+ a suspicion ( its basis 9 m5tal abnormality4 ,n infrequ5tly su* pati5ts become m irrational at times :5 _! physical condition is l[] ?an normal1 & a return to _! ord9>y heal? makes !m #bid m am5able to reason & less prone to appeal to exp5sive litigation4 ,x is evid5t t ! irrationality ( frequ5t appeals to exp5sive & bo!rsome litigation %\ld ar\se suspicion4 ,su* pati5ts ne$ to be c>$ = q z effectually z ^? :o h t5d5cies to gamble away _! sub/ance or to wa/e x 9 ! mid/ ( inebriety4 ,un=tunately x is extremely difficult to frame laws s z to meet su* conditions4 ,sev]] =ms ( ! affliction are readily recognis$ & ! suff]] is prop]ly re/ra9$4 ,i rememb] once see+ a pati5t 9 ,pr(essor ,fle*sig's cl9ic 9 ,leipzig1 :o _h be5 s5t to ! asylum because ( 8 t5d5cy to g to law on ! smalle/ possible pretext4 ,?is pati5t's inc>c]ation 9 ! asylum 0 due to a v /rik+ manife/ation ( 8 p>anoia qu]ulans4 ,he answ]$ an adv]tisem5t = a cl]k1 publi%$ by "o ( ! l>ge comm]cial h\ses4 ,he f\nd himself "o ( a r[ ( applicants = ! position1 & z ! memb] ( ! firm ^: duty x 0 to engage ! cl]k 0 at ! mom5t busy1 he _h to wait sev]al h\rs be=e 8 application 0 he>d & refus$4 ,he tri$ to secure a w>rant = ! firm 9 ord] to h !m indemnify him = ! "t he _h sp5t :ile wait+ = 8 application to be he>d1 at ! rate ( wages !y w\ld h be5 b\nd to pay him _h he obta9$ ! vacant cl]k%ip2 only z !y _h spoil$ a day he claim$ a full day's wages4 ,?is pati5t _h be5 9 ! asylum sev]al times be=e because ( 8 t5d5cy to g to law4 ,he always ga9$ 9 weight :ile 9 ! asylum1 became mu* m tractable & less qu]ul\s z 8 physical condition improv$1 & usually aft] "s mon?s c\ld be all[$ to leave ! in/itution4 ,he 01 h[ev]1 "o ( ! inept4 ,) ! help ( asylum influ5ce he usually obta9$ "s occupation m or less suitable1 b 0 n able to reta9 x = long4 ,:5 out ( a situation he worri$ ab\t himself1 usually did n take prop] food1 & !n soon 8 litigi\s peculi>ities began to manife/ !mselves once m 9 su* =m t if he c\ld get ! money to reta9 an attorney1 or if he c\ld p]suade "o to take 8 case on a cont+5t fee1 & he 0 v +5i\s at ?is1 he soon became a v]itable nuisance to #bie ^? ar\nd him4 ,:5 9 poor heal? he 0 nev] cont5t$ unless he _h at lea/ "o lawsuit on 8 h&s1 & only really happy :5 he _h sev]al4 ,! ,gambl] ,p>anoiac4--,a =m ( p>anoia t inflicts almo/ m ( human suff]+ on ! fri5ds ( ! pati5t ?an any o!r is t 9 :i* ! suff]] is possess$ ( ! idea t he c1 by luck or by +5i\s comb9ations1 succe$ 9 w9n+ money at gambl+4 ,mild] =ms ( ?is p>anoia are s common t x is ! cu/om n to ?9k ( ev5 ! sev]] =ms ( ! gambl+ mania z a manife/ation ( irrational m5tality4 ,:5 a man ?9ks1 h[ev]1 t he c beat a gambl] at 8 own game1 or :5 by long lucubration he comes to ! conclusion t he has inv5t$ a sy/em by :i* he c beat a r\lette :eel1 he is1 on ?is subject at lea/1 z little responsible z ! man :o ?9ks t he has discov]$ p]petual motion4 ,?is =m ( p>anoia inflicts suff]+ ma9ly on ! ne> relatives ( ! pati5t4 ,!re is no d\bt t :5 extreme manife/ation ( ! gambl+ mania becomes evid5t1 pati5ts %\ld be legally re/ra9$ f fur!r fooli%ness4 ,"o difficulty ) reg>d to ! prop] appreciation ( gambl+ has be5 an un=tunate t5d5cy to class gambl+ among ! malici\s actions4 ,!re are _m p = :om only two s9s seem to h any special importance1 drunk5ness & gambl+4 ,z a rule1 !re is n ! lea/ _s ( malice 9 ! ord9>y gambl]2 n mean+1 ( c\rse1 by ?is ! %>p]s1 :o try to make money at ! exp5se ( o!rs1 b ! man :o believes t1 someh[1 *ance & fate are go+ to conspire to enri* him at ! exp5se ( o!rs1 ?\gh x mu/ be confess$ t he does n usually ev5 ?9k ( ?is latt] "p ( ! proposition :i* he accepts s readily4 ,we h _h 9 rec5t times s _m manife/ations ( ! practical univ]sality ( ! gambl+ _s1 ! belief by p t brok]s & bank+ conc]ns are ready to make !m ri* quick1 t we h 9 x p]haps ! be/ illu/ration ( ! p>tial tru? ( ! proposition t half ! _w is (f1 & ! o!r half n q on4 ,! ,phobias4--,sometimes ! special =m ( que]ness #bif takes on a v h>mless aspect4 ,pati5ts are worri$ because ( ! fact t !y c n keep !mselves clean4 ,!y want to wa% _! h&s e "t !y t\* any object t has be5 h&l$ by o!rs1 :e!r t object seems to be specially dirty or n4 ,su* pati5ts may we> ! sk9 (f _! h&s wa%+ !m =ty or fifty times a day4 ,!y almo/ absolutely refuse to t\* a door-knob1 because x is h&l$ by s _m p4 ,!y w cons5t to take only p]fectly new bills4 ,x is almo/ amus+ to see ! ef=ts !y make to avoid %ak+ h&s ) p1 )\t giv+ direct (f5se4 ,:5 x comes to %ak+ h&s ) _! physician1 !y are apt c&idly to decl>e t he mu/ n ask !m to d s1 because !y c n ov]come _! feel+s z to ! possibility ( contam9ation f h&s t come 9 contact ) s _m pati5ts4 ,?is fe> ( dirt has receiv$ ! "n ,misophobia4 ,!re are a numb] ( o!r phobias1 & ! pati5t's fe>s are manife/$ at ! mo/ peculi> objects4 ,agoraphobia1 = in/ance1 is ! fe> ( cross+ an op5 place4 ,^! pati5ts beg9 to tremble z soon z !y get away f ! l9e ( build+s 9 a /reet1 9 _! way across ! squ>e4 ,?is trembl+ becomes actual /agg]+1 ) a s5se ( oppression ov] ! he>t t makes locomotion almo/ or q impossible4 ,clau/rophobia1 ! opposite ( ,agoraphobia1 is ! fe> ( n>r[ places1 & prev5ts "s p f go+ ?r\gh a n>r[ /reet ) high build+s4 ,_m ( ^! phobias h a physical basis 9 "s organic or n]v\s he>t affection4 ,! ,tramp4--,"o ( ! /rik+ manife/ations ( p>anoia 9 our mod]n life is ! tramp4 ,mo/ p are incl9$ to consid] t ! cause = ! w&]+ life ( ^! un=tunates is r :at a di/+ui%$ physician euphemi/ically call$ by ! sci5tific "n1 pigritia indurata1 t is1 *ronic laz9ess1 ?an any pa?ological condition ( m9d4 ,mo/ tramps1 h[ev]1 w be f\nd1 on t close acqua9tance%ip :i* alone w ju/ify judgm5t ( _! actions1 to h _m o!r peculi>ities ( m9d besides ! %iftlessness :i* prompts !m to w&] m or less aimlessly f place to place4 ,aft] all1 x w h>dly be d5i$ t ! calm #big acceptance ( ! notion t x is m satisfactory to indulge 9 laz9ess & w&] )\t home or fireside1 suff]+ ! _m privations & h>d%ips1 especially f ! wea!r :i* ^! creatures d1 r ?an "w & be respect$ & com=table among _! fell[s1 is ( itself irrational4 ,_m ( ^! tramps prove on close acqua9tance to be int]e/+ pa?ological *>act]s4 ,v>i\s /ages ( outspok5 p>anoia w be f\nd to exi/ among !m4 ,x is n unusual to f9d t c]ta9 among !m h acquir$ ! idea n s uncommon n[ among l>ge classes ( humanity1 t ! _w is s unju/ 9 its treatm5t ( ! lab\r+ man1 t "w seems to !m almo/ a p]secution t mu/ be und]gone = ! sake ( ! pittance d]iv$ f x4 ,sometimes !re is ! actual extr9sic idea ( p]sonal p]secution = "s fanci$ wrong done to a l>ge corporation dur+ a /rike1 or lab\r tr\bles1 :i* !y *]i% z ! reason = :i* !y h _h to give up a fix$ habitation1 & resign ! idea ( support+ !mselves hone/ly & respectably4 ,?is p]secution /age ( p>anoia easily turns to ! second phase ( ?is affection z already describ$1 t 9 :i* ! fanci$ victim ( p]secution becomes 9 turn ! p]secutor4 ,tramps ?us readily give way to ev5 organis$ attempts at rev5ge ^u social ord]1 & are l$ to believe !mselves ju/ifi$ 9 attempts to burn & o!rwise de/roy prop]ty because ( _! enmity t[>ds prop]ty hold]s & employ]s g5]ally4 ,n infrequ5tly ! ?ird /age ( p>anoia1 9 :i* !re are delusions ( gr&eur1 may be obs]v$4 ,p]sonally ,i h kn[n two tramps :o w&]$ ab\t ! c\ntry ) ^! gr&iose ideas4 ,"o ( !m ?\ght t he _h 9 8 possession imm5se weal? 9 ! %ape ( l>ge *ecks1 sign$ suppos$ly by v>i\s important capitali/s1 & ev5 =eign rul]s4 ,^! *ecks 7 actually sign$ 9 ! names ( ^! p]sonages1 at ! tramp's own reque/1 by any *ance pass]-by or acqua9tance4 ,?is pati5t di$ 9 a c\ntry insane asylum 9 ! dem5t$ /age ( p>anoia1 hav+ gone ?r\gh all ! usual phases ( ! disease4 ,ano!r tramp 0 confid5t t ea* recurr+ election he 0 to be elect$ to "o ( ! highe/ (fices 9 #bih ! /ate1 or ev5 to be made ,presid5t ( ! ,unit$ ,/ates4 ,n e "o 0 tak5 into 8 confid5ce 9 ?is matt]1 h[ev]4 ,! simple/ decl>ation aft] ! election f any *ance acqua9tance w\ld assure him ( 8 success at ! polls1 & on m ?an "o occasion he turn$ up at ! ,capitol to claim exalt$ (fice1 b 0 g5]ally in(f5sive 9 8 ways1 & 0 r readily p]suad$ t 8 t]m ( (fice did n beg9 = "s "t4 ,x is easy to und]/& t a p]son might come into ! possession ( ! idea t ! (ficial hold+ (fice 9 8 /ead %\ld be remov$2 ! result might v well be "o ( ! sad trag$ies suppos$ly due to an>*ism1 b really to p>anoia4 ,( c\rse z ) crim9als1 s ) tramps2 n a few ( !m take up ?is mann] ( life )\t any suffici5t ju/ification 9 _! m5tal /ate to less5 our wor/ op9ion ( !m4 ,i d n ?9k ,i %\ld hesitate to say1 h[ev]1 t ! majority ( ^! un=tunates pres5t di/9ct signs ( physical & m5tal deg5]ation & are r des]v+ ( pity & c>e ?an ( condemnation4 ,!y ne$1 z a rule1 v special environm5t to enable !m to lead ord9>y1 respectable lives1 because !y 7 n orig9ally end[$ ) suffici5t initiative & indep5d5ce ( _s to enable !m to c>ry on ! /ruggle = life 9 ! mid/ ( ! hurry & bu/le ( our mod]n civilisation4 ,z ! pressure ( ! "t becomes sev]]1 m ( ^! unfit come into evid5ce4 ,!y arc examples ( ! l[]$ m5tal /ates1 unable to /& ! rivalry ) fell[m51 & ready to give up ! /ruggle :5ev] ! example ( o!rs :o h already giv5 x up is br\ght prom95tly to _! notice4 ,x is n a little surpris+ h[ _m ( ^! tramps belong$ orig9ally to excell5t1 respectable families4 ,c>eful inve/igation ( _! p]sonal hi/ory1 h[ev]1 w %[ t !y h be51 z a rule1 backw>d *ildr5 at s*ool1 always a little awkw>d 9 ! way !y took hold ( ?+s e>ly 9 life1 unsuccessful 9 ! rivalries ( s*ool competitions1 & 9 _! fir/ ef=ts at lab\r aft] s*ool days 7 ov]4 ,!y always ne$$ ! enc\ragem5t ( ^? :om !y lov$ & respect$1 to keep !m at _! unsatisfactorily fulfill$ tasks4 ,!y 7 ! pr$e/9$ failures #bii 9 life1 & h f\nd out _! uselessness e>ly 9 _! c>e]s4 ,?is is ! view ( tramp life t is com+ to be realis$ z true by all ^? :o h /udi$ ! "q1 n f ! /&po9t ( !ory1 b ( practical exp]i5ce ) x4 ,s-call$ ,monomania4 ,! old t]m = p>anoia employ$ = a long "t 0 monomania1 a ^w co9$ by ,esquirol at ! beg9n+ ( ! n9ete5? c5tury4 ,?is ^w has dropp$ out ( ! t]m9ology ( m5tal diseases because !re is no su* ?+ z a pati5t suff]+ f a s+le symptom ( m5tal di/urbance1 t is1 be+ m5tally p]turb$ on b "o l9e ( ?\ght4 ,!re are always o!rs1 ?\gh !y may be hidd5 except f ! c>eful inve/igator4 ,:5 ,esquirol introduc$ ! t]m he appli$ x to ! mo/ prom95t symptom ( ! pati5t's m5tal ali5ation1 b did n int5d x to be tak5 z exclud+ o!r symptoms by :i* ! ess5tial nature ( ! pati5t's insanity c\ld be diagnos$4 ,c>eful /udy w always disclose ! fact t o!r symptoms are pres5t4 ,! ^w monomania has be5 an un=tunate "o = sci5tific psy*iatry1 because x has be5 abus$ to %ield crim9als4 ,! plea is (t5 he>d t a p]son "u *>ge ( crime is really subject to "s mania t br\ght ab\t ! commission ( ! crime4 ,we (t5 he> ( kleptomania z a def5ce = p]sons :o h fail$ to recognise ! di/9ction betwe5 meum & tuum1 & are hal$ be=e ! c\rt because ( ! detection ( infr+em5ts ( ?is di/9ction4 ,true kleptomaniacs !re are1 b !re are always o!r symptoms ( _! m5tal di/urbance besides ! t5d5cy to /eal4 ,_! que]ness 9 o!r ways has usually be5 recognis$ by _! fri5ds & by _! family physician be=e ! incid5t :i* calls att5tion to ?is special =m ( disequilibration occurs4 ,kleptomaniacs1 too1 are usually prone to take ?+s ( little value1 or n especially suit$ to _! wants & = :i* !y h practically no use4 ,x is true collectors1 t is1 ^? :o h a hobby = ga!r+ curiosities ( "o k9d or ano!r to make a collection1 may become s int]e/$ 9 additions to _! collection #cjj z to be tempt$ to appropriate to !mselves articles ( :i* !y c n o!rwise obta9 possession4 ,su* actions may easily g beyond ! b\nds ( reason4 ,x mu/ be rememb]$ h[ev]1 t ! collection mania itself is (t5 s pron\nc$ z to be a little beyond ! b\nds ( ord9>y rationality4 ,o!r s-call$ monomaniacs h ! same *>act]i/ic & are associat$ ) relat$ symptoms ( m5tal di/urbance4 ,pyromania is sometimes plead$ z a def5se = arson4 ,x is a legitimate def5se1 h[ev]1 only :5 ! c>eful trac+ ( ! pati5t's hi/ory be=eh& %[s ! exi/5ce ( o!r symptoms ( m5tal unbalance4 ,! homicidal mania is ( ! same ord]4 ,!re h be5 cases :]e m5 seem to h delight$ 9 inflict+ injuries or dea? ^u fell[ creatures f pure malice4 ,su* cases z t ( ,jack ! ,ripp]1 = in/ance1 are und\bt$ly due to a special t5d5cy to take life4 ,9 ^! cases1 h[ev]1 associat$ symptoms are nev] lack+4 ,x is n improbable t 9 ,jack ! ,ripp]'s case a sexual elem5t 0 pres5t1 because ! victims 7 always ( "o l[ class1 & t ! g5]al "* ( ! murd]] w\ld h reveal$ 8 irresponsibility4 ,!re are sev]al /ories ( *ildr5--^: mo!rs delight$ 9 see+ _! husb&s1 :o 7 but*]s1 slaught] animals--:o seem to h _h a v]itable mania = see+ blood fl[ & to h ex]cis$ x 9 ! murd] ( human be+s4 ,only ! mo/ c>eful exam9ations ( ! previ\s life ( ! pati5t1 ! inve/igation ( *ildi% t5d5cies & habits at s*ool1 & ! incid5ts ( boyhood & y\? w sometimes enable ! exp]t to recognise ! con/ant exi/5ce ( symptoms ( m5tal disequilibration1 ! decid$ manife/ation ( :i* leads to s]i\s ev5ts 9 aft] life4 ,monomania z a def5se = crime has br\ght exp]t evid5ce into great disrepute4 ,9 ?is matt] ! greate/ c>e is und\bt$ly ne$$1 h[ev]1 = x is easy to d great wrong & puni% ! irresponsible victim ( an impulse ov] :i* he has no prop] control4 ,on ! o!r h&1 x mu/ n be =gott5 t no su* ?+ is kn[n to exi/ z ! p]v]sion ( ! w on a s+le po9t4 ,moral insanity ) reg>d to "o special set ( actions is a delusion t ! #cja increase ( k ) reg>d to m5tal diseases has eras$ f ! text books on ?is subject4 ,responsibility ( ,p>anoiacs4--,f :at has be5 said x is easy to und]/& h[ difficult is ! det]m9ation ( ! responsibility ( p>anoiacs4 ,_m classes ( p]sons ord9>ily consid]$ to be q responsible = _! actions are yet s circum/anc$ t !y are l$ into ! p]=mance ( actions usually n consid]$ rational1 ?\gh n tempt$ !reto by any b5efit directly accru+ to !mselves4 ,on ! contr>y1 x n infrequ5tly happ5s t ! mode ( life adopt$ by ! p>anoiacs is ( su* a k9d z w\ld ( itself1 because ( ! h>d%ips involv$ or ! m5tal trials1 det] ord9>y p f foll[+ x4 ,p>anoia1 at lea/ 9 its sev]] =ms1 completely ju/ifies ! plea ( irresponsibility = actions committ$4 ,:5 x is rememb]$1 h[ev]1 t p>anoiacs are (t5 cunn+ en\gh to take advantage ( _! own suppos$ que]ness volunt>ily to commit crimes !y might o!rwise be det]r$ f by fe> ( puni%m5t1 "s idea ( ! difficulty ( ! decision 9 ^! cases may be appreciat$4 ,x is important1 ( c\rse1 t ! physician %\ld1 z f> z possible1 avoid fall+ into ! error ( judg+ su* p too h>%ly1 s9ce aft] all on him dep5ds ! attitude ( society t[>ds !m4 ,x w\ld seem to be q z important t ! cl]gyman %\ld occupy an advanc$ position 9 ?is matt]4 ,x might seem t *>ity c\ld easily be ov]done2 x mu/ nev] be =gott51 h[ev]1 t x is bett] t n9ety-n9e guilty %\ld escape r ?an t "o innoc5t p]son %\ld be puni%$4 ,z a matt] ( fact1 prejudice is mu* m likely to be aga9/ ! suppos$ crim9al ?an 9 8 fav\r4 ,:ile x is (t5 decl>$ t too _m p]sons1 :o h done at lea/ mat]ial wrong1 are all[$ to escape des]v$ puni%m5t1 z our k ( m5tal diseases increases !re is m & m ( a t5d5cy on ! "p ( exp]ts to recognise t = _m app>5tly volunt>y actions m5 h only a modicum ( responsibility4 ,responsibility is1 aft] all1 n ! same 9 all m51 b modifi$ v mu* by ! "* ( ! individual1 by 8 environm5t & by ! #cjb motives :i* h come to be ! well-spr+s ( 8 actions4 ,no two m5 are equal 9 _! responsibility :5 !re is "q ( c]ta9 temptations to d wrong4 ,"s m5 f9d x p]fectly easy to resi/ allurem5ts to di%one/y :i* o!rs c n resi/4 ,"s m5 are p]fectly free z reg>ds _! attitude t[>ds indulg5ce 9 spiritu\s liquors4 ,o!rs f9d x almo/ impossible to resi/ _! crav+s 9 ?is direction4 ,"o might g ?r\gh ! li/ ( passionate actions & f9d ?is true ) reg>d to e "o ( !m4 ,if ?is mu/ be admitt$ ) reg>d to m5 :o are consid]$ p]fectly sane & responsible1 h[ mu* m s does x become true ( ^? :o are already some:at m5tally unbalanc$8 ,un=tunately1 ! t5d5cy to judge h>%ly1 r ?an m]cifully1 /ill cont9ues to be "o ma9 reason = ! infliction ( puni%m5t :]e (t5 x is n des]v$4 ,above all ! cl]gyman mu/ be a lead] 9 ?is t5d5cy to m]cy1 & 8 influ5ce %\ld be felt 9 popul> education 9 ?is reg>d4 ,x only too (t5 happ5s t cl]gym5 are f\nd to be /r5u\s uphold]s ( ! op9ion t "r is simply "r & wrong1 wrong1 & t a man :o kn[s ! diff]5ce betwe5 "r & wrong mu/ be consid]$ z responsible = 8 actions1 no matt] :at modify+ circum/ances or m5tal conditions may ent] into ! problem ( ! decision z to 8 responsibility4 ,if ! cl]gyman w\ld b realise h[ difficult 9 any individual case mu/ be su* a decision1 & h[ mu* mu/ be kn[n ) reg>d to ! previ\s "* ( ! individual1 !n a great beg9n+ = ! modification ( ! pres5t ov]-sev]e modes ( ?\ght w h be5 made4 ,f a !oretic /&po9t1 x w\ld n be easy to /ate all t ! physician consid]s necess>y to enable him to make 8 decision z to individual responsibility4 ,p]haps1 h[ev]1 ! consid]ation ( a s]ies ( cases t h attract$ widespread att5tion1 & :i* h be5 mo/ c>efully inve/igat$ 9 all _! circum/ances1 may pres5t ! me?ods ( responsible det]m9ation bett] ?an any set ( rules4 ,?ree presid5ts ( ! ,unit$ ,/ates h be5 murd]$ )9 =ty ye>s4 ,! murd]]s 7 native-born #cjc ,am]icans4 ,9 none ( ! ?ree cases 0 !re any adequate motive = ! commission ( ! crime4 ,! assass9 9 ,presid5t ,l9coln's case might1 x is true1 be presum$ to h a suffici5t political motive1 b no entirely sane man c\ld h ?\ght = a mom5t t any good w\ld be accompli%$ at t "t = ! ,s\? by ! removal ( ,l9coln4 ,a man ( kn[n erratic t5d5cy1 ) ! crav+ = !atrical effects deeply +ra9$ 9 8 nature1 ) a p]sonal hi/ory n entirely free f ev5 m s]i\s manife/ations ( m5tal disequilibration1 & ) a family hi/ory ( m ?an suspici\s "* z reg>ds ! m5tal qualities ( 8 ance/ors1 committ$ ! crime4 ,he met 8 dea? at ! h&s ( pursu+ soldi]s4 ,su* 0 ! temp] ( ! "t1 t _h he be5 captur$ alive he w\ld surely h suff]$ ! =mal legal dea? p5alty4 ,ev5 z x 01 public s5tim5t clam\r$ = legal victims & un=tunately !y 7 f\nd4 ,x seems cle>1 beyond all d\bt1 t 9 ?is case complete responsibility = 8 action 0 n pres5t 9 ! assass9 himself4 ,! c\rts decid$ lat] t !re _h be5 a conspiracy1 b !re has always be5 ! feel+ t ju/ice 0 misl$ by ov]-zeal to f9d scapegoats = injur$ public s5tim5t4 ,!re is no d\bt t x is an extremely difficult matt] to say :at %all be done to ! assass9 9 su* a case4 ,! un=tunate result is z mu* an accid5t z ! fatal consequ5ces ( any o!r p]v]t$ natural =ce4 ,an e>?quake may kill its ?\s&s & ! inevitable mu/ simply be accept$4 ,society may protect itself f ! fur!r manife/ations ( su* p]v]se individuals by conf9+ ! un=tunate murd]] = life1 b capital puni%m5t1 9 ! s5se ( a sanction = brok5 law1 c sc>cely be consid]$ to h a place 9 ! giv5 conditions4 ,) reg>d to ! murd]] ( our second assass9at$ ,presid5t we _h ! f>ce ( a long-drawn-out public trial ( a man :o 0 evid5tly n 9 8 "r s5ses4 ,once m a victim _h to be f\nd to satisfy injur$ public feel+4 ,guiteau 0 condemn$ to dea? & suff]$ ! dea? p5alty4 ,any "o :o reads ! proce$+s ( ! trial & :o realises ! significance ( ! motive t ,guiteau #cjd himself gave = 8 act1 w appreciate t ! c\rt _h to d ) an irresponsible do] ( a mat]ial b n a moral wrong4 ,!re 7 _m signs ( m5tal disequilibration 9 ,guiteau's previ\s c>e]4 ,x is on ^! ev5tually t ! exp]t 9 m5tal diseases mu/ dep5d 9 ord] to enable him to obta9 a prop] e/imate ( ! ext5t ( ! m5tal di/urbance 9 any giv5 individual4 ,x may seem t _m real crim9als c be def5d$ on ?is same pr9ciple ( f9d+ an inadequate motive = _! crimes4 ,!re are1 h[ev]1 c]ta9 signs ( irrationality n difficult to detect if ! previ\s life ( ! individual be c>efully scrut9is$ & ^! mu/ =m ! ultimate crit]ion z to crim9al responsibility4 ,) reg>d to ! ?ird murd]] ( a ,presid5t ! case is cle>4 ,he 0 an ignorant1 some:at conceit$ individual1 b he pres5t$ none ( ! signs ( true m5tal disequilibration t c ord9>ily be dep5d$ on to indicate su* a di/urbance ( ! physical basis ( m9d z impairs responsibility4 ,he 0 n entirely )\t a motive1 :i* 9 ! m9d ( a brood+1 conceit$ individual1 might seem to be adequate = ! commission ( ! crime4 ,8 s5t5ce ( ! dea? p5alty 0 !n 9 accord ) ! judgm5t ( ! be/ m5tal exp]ts4 ,h[ society %all protect itself1 & especially its high (ficials1 aga9/ su* notoriety seek]s is h>d to say4 ,! consid]ation ( ^! cases gives a cle> idea ( h[ a physician endeav\rs to fill up gaps 9 8 k ( ! "* ( ! man1 8 h]$ity & environm5t1 z well z 8 previ\s actions at v>i\s times 9 life :5 "u ! /ress ( emotion4 ,x may be consid]$ t su* a weigh+ ( circum/ances w s]ve to excuse _m g5u9e crim9als :o em95tly des]ve to be puni%$4 ,?is is1 h[ev]1 ! assumption ( ! old] g5]ation :o consid]$ t if a man did a mat]ial wrong he mu/ be puni%$ = x4 ,x is a h]itage ( ! day1 :5 ev5 accid5tal kill+ 0 consid]$ to dem& "s puni%m5t4 ,at ! pres5t "t ! t5d5cy is r to consid] only ! moral wrong1 t is1 to calculate responsibility only = su* actions z are committ$ ) due #cje delib]ation1 int5tion1 & ! k ( "r & wrong z well z ! fre$om to p]=m ! action4 ,! old ,engli% legal op9ion :i* decl>$ a man responsible if he kn[s t :at he is do+ is wrong has n[ giv5 way 9 mo/ judicial proce$+s to ! pr9ciple t ! man mu/ n only "k t he is do+ wrong1 b t he mu/ also realise t he is free n to d t :i* he kn[s to be wrong4 ,t is to say1 if he feels himself compell$ to ! commission ( crime1 !re is surely an impairm5t ( responsibility4 ,su* impulses to d wrong )\t adequate motive occur n infrequ5tly among ^? ^: m5tal condition is n p]fectly normal1 & ?is mu/ always be tak5 into consid]ation 9 ! ultimate decision z to _! responsibility = _! action4 ,,james ,j4 ,,wal%4 #cjf ,,xxvii ,,suicides ,x is a v difficult problem at times to expla9 j h[ a suicide is due to m5tal ali5ation 9 a p]son ^: intellectual p[]s appe>$ previ\sly unimpair$1 yet 9 mo/ ( ! cases a k ( all ! circum/ances & ( ! individual himself w\ld lead inevitably to ?is m *>itable view4 ,mo/ suicides are p]sons t h be5 recognis$ z p>anoiacs & likely to d que] ?+s = a long "t be=eh&4 ,inde$1 "s ( ! melan*olic qualities on :i* ! un=tunate impulse to self-murd] dep5ds are likely to h exhibit$ !mselves 9 =m] g5]ations4 ,n long s9ce x 0 argu$ t ! regul> occurr5ce ( a c]ta9 numb] ( suicides e ye>--v>y+ 9 v>i\s places1 always on ! increase1 b evid5tly %[+ a def9ite relation%ip to c]ta9 local conditions --demon/rate t ! human w is n free1 s9ce f a set ( /ati/ics "o c =etell ab\t h[ _m cases ( suicide w\ld take place 9 a giv5 city dur+ ! next ye>4 ,z a matt] ( fact1 suicides are n 9 possession ( free w z a rule1 b are ! victims ( circum/ances & are unable to resi/ ext]nal influ5ces4 ,! mo/ important feature ( suicide 9 rec5t ye>s is ! con/ant increase 9 ! numb]1 ! increase affect+ disproportionately "y adults4 ,?is increase 9 ! numb] ( suicides is no illusion2 x is n due to m c>eful /ati/ics4 ,x is true t 9 rec5t ye>s1 t is to say dur+ ! la/ qu>t] ( a c5tury p>ticul>ly1 ! unsp>+ inve/igation by ! au?orities ( all cases ( suspici\s dea?1 & _! report by s5sational newspap]s1 has add$ some:at to ! app>5t numb] ( suicides4 #cjg ,families 7 accu/om$ to ann\nce accid5tal dea? & h _! /ory unque/ion$1 9 a c]ta9 numb] ( cases1 :]e n[ !re is no hope ( concealm5t because ( ! un=tunate publicity t has crept into life4 ,?is increase1 h[ev]1 w\ld acc\nt = only a small additional numb] ( suicides1 :ile ! actual figures h m ?an trebl$ 9 ! la/ ?irty ye>s4 ,?is increase has come especially 9 ! l>ge cities4 ,accord+ to ! report ( ! ,new ,york ,bo>d ( ,heal?1 !re 7 #a1cjh suicides 9 ,new ,york ,city dur+ ! decade f #ahgj to #ahhj4 ,dur+ ! decade f #ahij to #aijj !re 7 #c1idd suicides4 ,?is increase is mu* m ?an ! correspond+ increase 9 population4 ,dur+ ! fir/ decade m5tion$ !re 7 #abd suicides p] million ( population4 ,dur+ ! la/ decade ?is _h ris5 to #aif suicides p] million4 ,! increase is ne>ly #fj p] c5tum4 ,! increase is v>i\sly di/ribut$ ov] ! diff]5t ages4 ,:ile e five ye>s f tw5ty upw>ds %[s a p]c5tage ( increase 9 ! numb] ( suicides committ$1 some:at less ?an ! p]c5tage ( increase = all ages1 ! five ye>s betwe5 fifte5 & tw5ty %[s an increase ( #ajf p] c5tum4 ,9 a ^w ! dea?s ( adolesc5ts f suicide h m ?an d\bl$ 9 ! la/ ?irty ye>s4 ,t[>ds ! end ( ! la/ decade ( ! n9ete5? c5tury !re 0 = a "t a cessation ( ! cont9u\s increase4 ,?is occurr$ dur+ ! ye>s #ahih & #ahii4 ,app>5tly x 0 due to ! fact t ! occupation ( ! c\ntry ) o!r int]e/s1 ! w> & its problems1 & ! fact t an era ( prosp]ity made mat]ial conditions bett]1 & ?us gave less occasion = depression ( spirits4 ,dur+ ! ye>s s9ce #aijj1 h[ev]1 ! increase has n only reass]t$ itself1 b has m ?an made up = ! p]iod dur+ :i* suicides 7 less frequ5t4 ,! increase dur+ ! la/ f\r ye>s is m ?an 0 not$ dur+ ! six ye>s f #ahia to #ahig4 ,! same increase has be5 not$ 9 ,european cities4 ,! high] ! scale ( civilisation 9 a city1 or at lea/ ! great] ! mat]ial progress & ! m /r5u\s ! life1 #cjh ! high] ! dea? rate4 ,9 ,dresd51 = in/ance1 ! rate is #ea suicides p] #ajj1jjj e ye>4 ,9 ,p>is x is #db1 9 ,b]l9 x is #cf2 :ile 9 ,lisbon & ,madrid x is l[e/1 be+ only respectively two & ?ree p] #ajj1jjj p] ye>4 ,:ile suicides are m common among m5 ?an wom5 9 all c\ntries1 ?is is n true = c]ta9 ages4 ,betwe5 ! ages ( fifte5 & tw5ty-five ! suicides ( wom5 are m num]\s ?an ^? ( m54 ,! suicides ( wom5 are increas+ fa/] ?an ^? ( m54 ,fifty ye>s ago ! proportion 0 five to "o4 ,tw5ty ye>s ago x _h fall5 f ?ree to "o4 ,n[ x is less ?an two & a half to "o4 ,! sadde/ feature ( ! suicide situation is ! increas+ numb] ( ! *ildr5 :o commit suicide4 ,almo/ ne$less to say1 *ildr5's suicides are )\t any s]i\s motives & are usually due to an attack ( pique because ( a slight f a playmate1 a reprim& at home1 a rebuke f a tea*]1 envy ( ! success ( a companion1 disappo9tm5t ov] a pass+ love affair1 sometimes a peculi> atta*m5t 9 ! case ( weak & morbid individuals1 ! manife/ations ( :i* are res5t$ by its object1 or are =bidd5 by p>5ts & gu>dians4 ,^! un=tunate accid5ts h become s common n[ t special c>e mu/ be tak5 ) reg>d to *ildr5 ( neurotic h]$ity4 ,:5 9 previ\s g5]ations !re h be5 ! manife/ations ( lack ( m5tal equilibrium1 !n *ildr5's mutt]+s ) reg>d to possible rec\rse to suicide %\ld be ! signal = ! ex]cise ( close surveillance4 ,z f> z possible su* *ildr5 %\ld be kept f ! /r5u\s competition at s*ool 9 mod]n life4 ,z has be5 well po9t$ out !re is no d\bt t ! p[] ( sugge/ion & example has mu* to d ) ! increase ( suicide4 ,dymond1 an au?ority 9 ! matt]1 says1 ,! p[] ( ! example ( ! suicide is mu* great] ?an has be5 ?\ght4 ,e act ( suicide tacitly conveys ! sanction ( "o m judgm5t 9 its fav\r4 ,frequ5cy ( repetition dim9i%es ! s5sation ( abhorr5ce & makes succe$+ suff]]s1 ev5 ( less degree1 resort to x ) less reluctance4 #cji ,our mod]n newspap]s1 by supply+ all ! details ( e suicide t occurs1 especially if x pres5ts any crim9ally int]e/+ features or morbidly s5tim5tal accessories1 famili>ise ! m9d1 p>ticul>ly ( ! impressionable "y1 ) ! idea ( suicide4 ,:5 tr\bles come lack ( exp]i5ce 9 life makes ! y\?ful m9d =eca/ a future ( hopeless suff]+4 ,love episodes are responsible = mo/ ( ! suicides 9 ! "y1 :ile sickness & physical ills are ! causes 9 ! old4 ,9 a c]ta9 numb] ( cases1 h[ev]1 dome/ic qu>rels1 & especially ! infliction ( puni%m5t on ! "y at an age :5 !y are beg9n+ to feel _! indep5d5ce & _! "r to be deliv]$ f :at !y are prone to consid] re/riction1 are apt to be foll[$ 9 ! morbidly un/able by ?\ghts ( suicide4 ,! important practical "q is ! prev5tion ( ! fulfilm5t ( ! morbid impulse dur+ ^! impressionable ye>s4 ,_m a "y p]son has be5 sav$ f suicide at ?is "t to realise ! enormity ( ! act & to live )\t any fur!r temptation to its commission = a long lifetime4 ,z a rule ! motive = ! act is s trivial & (t5 s ins5sate t x is n difficult to make pati5ts 7because pati5ts !y truly are7 see ! folly ( _! irrational impulse4 ,9 ord] to =e/all ! putt+ into action ( _! impulse x is important t ^? :o are close to ! pati5t %\ld h "s realisation ( ! possibility ( its occurr5ce4 ,!re are usually "s signs be=eh& ( ! possibility ( ! crime4 ,_m ( ^! e>ly suicides h di/9ct t5d5cies to & /igmata ( hebephr5ic melan*olia4 ,! be/ kn[n symptoms ( ?is condition are ^? describ$ by ,dr4 ,pet]son1 ! pres5t presid5t ( ,/ate ,commission ( ,lunacy ( ,new ,york 9 8 book on m5tal diseases4 ,! symptoms not$ are extraord9>ily rapid & p>adoxical *anges ( disposition4 ,depress$ ideas intrude !mselves 9 ! mid/ ( boi/]\s gaiety1 & untimely jocul>ity 9 ! deepe/ depression1 or at solemn mom5ts4 ,!n !re is ! p>adoxical facial expression1 ! s-call$ p>amimia1 t is1 a look ( joy & pleasure :5 really m5tal depression is pres5t1 or a look ( depression :5 joyful s5tim5ts #caj are be+ express$4 ,! exi/5ce ( su* r noticeable peculi>ities may lead to ! suspicion ( m5tal disequilibration 9 "y p4 ,! mo/ important w>n+ may well be ! occurr5ce ( suicide 9 any o!r memb] ( ! family = sev]al g5]ations be=e4 ,! t5d5cy ( suicide to repeat itself 9 families is n[ well kn[n & recognis$4 ,dur+ ! ye> #aija 9 ,new ,york ,city1 9 "o case o!r memb]s ( ! imm$iate family _h committ$ suicide 9 six in/ances4 ,! subject has tak5 on additional int]e/ because ( ! suicide ( a well-kn[n gambl] :o 0 ! f\r? ( 8 family 9 two g5]ations to take 8 own life4 ,9 ano!r case1 report$ )9 ! la/ five ye>s1 ! suicide 0 ! la/ ( a family ( n9e *ildr51 e "o ( :om _h committ$ suicide4 ,!re is ! record 9 ! ,g]man army ( f\r g5]ations ( a noble family1 ! elde/ son ( :i* committ$ suicide dur+ ! #e ye>s f #ej to #ee4 ,9 ^! cases ! t5d5cy to suicide is n directly inh]it$1 b !re is a m5tal weakness t makes ! individual incapable ( )/&+ ! suff]+s life may entail4 ,9 ! lat] memb]s ( ! family !re is also a sugge/ibility t ! frequ5t contemplation ( ! idea ( suicide f9ally leads to ! putt+ (f ( ! natural abhorr5ce at ! ?\ght ( its commission4 ,9 su* families1 !re=e1 x is p>ticul>ly important to w>n m$ical att5dants & memb]s ( ! family ( ! possibilities ( un=tunate acts s z to prev5t if possible ! execution ( any impulse to self-murd]4 ,,james ,j4 ,,wal%4 #caa ,,xxviii ,,v5]eal ,,diseases ,,& ,,m>riage ,syphilis is a disease t is contagi\s1 inoculable1 & transmissible by h]$ity4 ,x may be acquir$ innoc5tly1 & x is s acquir$ 9 ab\t #d p] c5tum ( cases accord+ to good au?ority1 b ! o!r #if p] c5tum is v5]eal4 ,! disease attacks any "p ( ! body )9 & )\t f ! soles ( ! feet to ! hair & f+]-nails4 ,! fir/ evid5ce1 :]e ! case is n h]$it>y1 is a h>d5$ sore call$ a *ancre2 next ! lymphatic gl&s swell1 & _m =ms ( sk9-eruption occur2 !n foll[s a *ronic inflammation ( ! cellulo-vascul> tissues & ! bones1 & small tum\rs1 call$ gummata1 may develop 9 almo/ any "p ( ! body4 ,! disease may v>y f a light attack to malignancy4 ,!re are p]iods 9 ! c\rse ( ! disease4 #a4 ,! p]iod ( prim>y incubation1 or ! "t f infection to ! appe>ance ( ! *ancre4 ,?is is commonly ?ree weeks4 #b4 ,! prim>y /age3 ! *ancre =ms & ! neighb\r+ gl&s are affect$4 ,?is /age la/s f ?ree to t5 days4 #c4 ,! second>y incubation1 or ! "t betwe5 ! appe>ance ( ! *ancre & ! developm5t ( :at are call$ ! second>y symptoms1--usually ab\t six mon?s4 #d4 ,! second>y /age4 ,"h occur fev]1 anaemia1 neuralgic pa9s1 & ! eruptions on ! sk9 & ! muc\s membranes4 ,?is p]iod la/s f twelve to eighte5 mon?s 9 ! majority ( cases4 #e4 ,! int]m$iate p]iod4 ,dur+ ?is "t !re may be no symptom1 or slight] recurr5ce ( ! second>y #cab symptoms4 ,?is p]iod la/s f two to f\r ye>s4 ,x may end 9 recov]y ( heal? or be foll[$ by t]ti>y symptoms4 #f4 ,! t]ti>y /age4 ,9 ?is p]iod gummata =m1 or !re may be diffuse infiltration ( v>i\s p>ts ( ! body1 *ronic inflammation & ulc]ation ( ! bones1 sk9 & o!r tissues1 n]v\s diseases1 & s on4 ,! t]ti>y /age commonly beg9s f ?ree to f\r ye>s aft] ! prim>y infection4 ,! ?ree *ief divisions1 :i* are apt to bl5d "o into ! o!r1 are ! prim>y1 second>y1 & t]ti>y p]iods4 ,! affections ( ! second>y /age are (t5 sev]e4 ,!re may be fev] associat$ ) weakness1 heada*e1 g5]al malaise & pa91 & ?is may be m>k$ or r light4 ,9 ?is /age iritis is liable to occur1 & if x is n prop]ly diagnos$ & treat$ x w result 9 bl9dness4 ,! lesions ( ! t]ti>y /age may cause great de/ruction ( tissues & v grave consequ5ces4 ,c]ebral syphilis1 if un*eck$1 w inevitably cause p>alysis or p>esis4 ,!re may be loss ( spee*1 epilepsy1 coma1 p>alyses1 apoplectic hemiplegia1 & s on4 ,! pa9 is h>ass+ & (t5 x am\nts to great angui%4 ,:atev] "p ( ! bra9 sub/ance is de/roy$ w n be re/or$4 ,9 syphilitic affections ( ! sp9al cord1 if ! inflammation is acute dea? ensues 9 a few days or weeks4 ,tabes dorsalis1 or locomotor ataxia1 is caus$ 9 ab\t #ic p] c5tum ( cases ( ?is disease by syphilis1 & x is an incurable & dreadful malady4 ,if !re is neuritis f ! virus x becomes int5se & causes muscul> contractions1 p>esis1 & p>alysis4 ,! optic1 auditory1 & olfactory n]ves may be attack$ & de/roy$4 ,! nose also may be de/roy$ & x commonly caves 94 ,! bones ( ! face are frequ5tly attack$ 9 ! t]ti>y /age & !y rot away4 ,! tibia is diseas$ m frequ5tly ?an ! o!r long bones4 ,! he>t is r>ely injur$1 b :5 x is1 ! prognosis usually is bad4 ,9 a l>ge numb] ( cases dea? is sudd5 & unexpect$4 ,if ! art]ies are involv$ ! prognosis aga9 is bad1 because ! symptoms "h d n %[ until #cac too late = effective treatm5t ,:5 ! liv] is ! seat ( gummata ^! may be cur$ 9 ! e>ly /age1 b 9 ! lat] /age ! prognosis is unfav\rable4 ,"s =ms ( r5al syphilis are rem$iable1 b o!rs are n1 especially ! int]/itial k9d4 ,syphilis is transmitt$ to a *ild cong5itally1 n z a t5d5cy or pr$isposition1 b z an active contagion4 ,x may come f ! fa!r1 ! "m1 f bo? p>5ts1 or by direct infection4 ,! transmission f ! fa!r is ! mo/ frequ5t4 ,! sp]matozoa c>ry ! infection to ! mat]nal ovum4 ,d[n to ! end ( ! second>y /age1 & half ?r\gh ! int]m$iate p]iod betwe5 ! second>y & t]ti>y /ages ( syphilis1 a fa!r or "m may beget a *ild t w be infect$ ) h]$it>y syphilis1 a %iv]+1 bla/$1 rott5 little wret* = :om a quick dea? is ! greate/ imag9able bless+1 & x usually gets ?is bless+4 ,9 ! acute /age ( a virul5t syphilis ! disease is mo/ likely to be transmitt$2 b sometimes1 ?\gh r>ely1 a fa!r t has be5 free f all symptoms ( syphilis = _m ye>s may beget a *ild t is born ) a virul5t h]$it>y =m ( ! disease4 ,infection by ! "m is m c]ta9 & m h>mful ?an t f ! fa!r1 because ! intraut]9e life ( ! *ild is poison$ ?r\gh\t its c\rse4 ,two-?irds ( ! cases ( h]$it>y syphilis die ei!r by abortion1 or if !y live to t]m !y die %ortly aft] deliv]y4 ,if ! "m is infect$ dur+ ! fir/ eight mon?s ( pregnancy ! *ild w ne>ly always be syphilitic1 b if %e is infect$ aft] ! eigh? mon? ! *ild may escape4 ,if at ! mom5t ( conception bo? p>5ts h ! disease ! *ild w almo/ c]ta9ly take x1 & ?is infection w cause its dea?4 ,9 a s]ies obs]v$ by ,f\rni]1 #bh p] c5tum ( ! cases caus$ by pat]nal infections di$ & #cg p] c5tum %[$ ! luetic ta9t2 9 ! cases caus$ by mat]nal infection #fj p] c5tum di$1 & #hd p] c5tum _h syphilitic lesions2 9 ! mix$ h]$ity1 t is :5 bo? ! fa!r & "m 7 luetic1 #fh4e p] c5tum di$ & #ib p] c5tum 7 born syphilitic4 ,:5 a *ild #cad is fir/ infect$ at deliv]y ! case is n te*nically class$ z h]$it>y syphilis4 ,dur+ ! fir/ ye> aft] ! fa!r or "m has tak5 syphilis ! probability ( infect+ ! *ild is ! greate/4 ,9 ! ?ird ye> ! liability ( infect+ ! *ild is less5$1 b pres5t4 ,9 a s]ies ( #efb cases ( h]$it>y syphilis obs]v$ by ,f\rni]1 #fj *ildr51 ov] #aj p] c5tum1 7 infect$ m ?an six ye>s aft] ! prim>y p>5tal infection4 ,c>efully obs]v$ cases h be5 exceptionally f\nd :]e infection ( ! *ild has occurr$ 9 ! fifte5? & ev5 ! tw5tie? ye> aft] ! orig9al p>5tal lesion4 ,f\rni] reports ! case ( "o woman t _h n9ete5 consecutive /illbir?s f syphilis4 ,mild p>5tal syphilis may transmit h]$it>ily ! mo/ malignant type ( ! disease1 & v virul5t p>5tal infection may result 9 a comp>atively mild infection ( ! *ild1 if any infection by syphilis may be call$ mild4 ,t ! p>5t %[s no symptoms f an old infection is no pro( t he or %e is cur$1 or t ! *ild may n be infect$4 ,) prop] treatm5t ( ! "m ! infantile mortality 9 h]$it>y syphilis is r$uc$ f #ei p] c5tum to #c p] c5tum1 & ! *ildr5 t are born liv+ are n unfrequ5tly free f syphilis4 ,:5 a woman is infect$ at ! conception ( h] *ild misc>riage takes place be=e ! *ild is viable1 f ! fir/ to ! six? mon?2 lat] o!r misc>riages occur2 lat] /ill1 liv+ b syphilitic *ildr5 are born1 ( :om "o-f\r? die )9 ! fir/ six mon?s2 f9ally %e may h *ildr5 t are n infect$4 ,if a syphilitic man has be5 prop]ly treat$ he may1 aft] f\r ye>s1 beget heal?y *ildr51 & he commonly does1 b he may be ! fa!r ( syphilitic *ildr54 ,syphilitic wom5 prop]ly treat$ may1 aft] ab\t six ye>s f infection1 br+ =? heal?y *ildr51 & !y commonly d1 b n always4 ,!re is a wide div]sity ( op9ion among ! be/ au?orities conc]n+ ! curability ( syphilis4 ,g[]s 7,syphilis & ! ,n]v\s ,sy/em4 #ahib7 says3 ,!re is no evid5ce t ! disease ev] is or ev] has be5 cur$1 ! #cae ^w 'disease' be+ "h us$ to designate t :i* causes ! v>i\s manife/ations ( ! malady4 ,he means !re is no absolute pro( t a p]son :o has once be5 infect$ is ev] s fully cur$ t he may m>ry )\t dang] ( transmitt+ ! disease4 ,f\rni] requires1 z ! m9imum "t1 f\r ye>s ( me?odical treatm5t be=e he deems ! pati5t safe1 b ev5 ?is arbitr>y fix+ ( ! numb] ( ye>s is n w>rant$ by exp]i5ce4 ,_m physicians hold t 9 ! t]ti>y /age ! disease is n transmissible1 b t /atem5t is n true4 ,commonly x is1 sometimes x is n4 ,aft] all symptoms h disappe>$ ! disease has be5 transmitt$4 ,9 %ort1 a p]son t witt+ly m>ries any "o :o has _h syphilis at any "t is a fool2 & if "o ( ! contract+ p>ties has _h syphilis )9 ! f\r ye>s prec$+ ! m>riage ! m>riage is crim9al1 ev5 if ! syphilis has be5 c>efully & skilfully treat$ by a physician4 ,gonorrhoea is always a dang]\s disease4 ,9 ! male1 beside ! acute lesions1 x c cause *ronic or fatal inflammations along ! v>i\s p>ts ( ! g5ito-ur9>y tract or 9 diff]5t organs ( ! body4 ,:5 ! disease becomes *ronic x la/s indef9itely4 ,x may !n cause cy/itis1 or s affect ! kidneys z to br+ ab\t v grave results2 x may get into ! circulation & induce gonorrhoeal rheumatism ( ! jo9ts1 especially ( ! knee jo9t1 & result 9 a p>tly or completely /iff5$ jo9t4 ,! he>t may be affect$ & endoc>ditis ensue2 !re may be m5+itis or inflammation ( ! c]ebral membranes2 ! eye may be infect$1 & unless x is skilfully treat$ bl9dness w foll[4 ,/rictures ( ! male ure?ra f *ronic gonorrhoeal inflammation (t5 require major surgical op]ations = relief4 ,! disease 9 wom5 has mo/ ( ^! complications1 & o!r grave peculi> phases4 ,all pro/itutes h acute or *ronic gonorrhoea1 & #ab p] c5tum1 probably m1 ( reputable wom5 are infect$2 & ! suff]+ caus$ is v great4 ,! gonococcus rema9s virul5t = two or ?ree ye>s at ! lea/ 9 a man's *ronic gleet1 & if he m>ries he infects 8 wife4 ,%\ld h] womb be infect$ #caf %e is seldom completely cur$4 ,if ! ,fallopian tubes are involv$1 & ?is happ5s frequ5tly1 !y suppurate1 & (t5 !y mu/ be remov$ by coeliotomy4 ,! woman suff]s = a long "t :5 ! tubes are attack$ by ! disease1 & %e becomes /]ile ord9>ily4 ,:5 a *ild is born to a woman t has gonorrhoea its eyes are infect$ at deliv]y1 & if x is n v skilfully treat$ x w surely lose its sight4 ,because ( ?is dang]1 9 mat]nity hospitals ! eyes ( all babies are treat$ at deliv]y z a precaution1 & _m physicians obs]ve ! same precaution 9 private practice4 ,:51 !re=e1 a man has *ronic gonorrhoea he %\ld n m>ry until ab\t f\r ye>s aft] ! la/ infection1 & he %\ld be c>efully treat$ 9 ! meantime4 ,!re is a popul> op9ion t gonorrhoea is a trifl+ disease1 b ! contr>y is ! tru?3 x is a grave disease1 especially 9 wom52 & ! p]son t c>elessly infects ano!r is c]ta9ly guilty ( crime = :i* a long t]m 9 jail w\ld be a light puni%m5t4 ,,au/9 ,,omalley4 #cag ,,xxix ,,social ,,diseases ,!re are c]ta9 affections n at all uncommon & z a rule produc+ r s]i\s effects ^u ! social body1 ( :i*1 ?\gh _! exi/5ce is well kn[n to all1 v little is said4 ,x is c]ta9 t :at is consid]$ ! m sev]e ( ^! v5]eal diseases may be acquir$ q innoc5tly4 ,inde$1 _m ?\s&s ( cases ( ?is affection1 acquir$ innoc5tly1 h n[ be5 report$ by m$ical m5 9 ?is c\ntry alone4 ,if ! /ati/ics ( all ! _w 7 ga!r$ toge!r1 !re w\ld probably be a hundr$ ?\s& cases ( ?is dreadful affection1 :i* h be5 acquir$ )\t any blame on ! "p ( ! suff]]4 ,x has become ! cu/om1 especially 9 ,engli% speak+ c\ntries1 to ignore ! pres5ce ( ^! diseases1 & ?is has l$ to a multiplication ( opportunities = _! spread to su* a degree t n[ ! condition ( affairs1 = ^? :o "k x be/1 is r al>m+4 ,x is ) ! int5tion t a few def9ite ideas1 giv5 absolutely )\t exagg]ation & )\t any /riv+ aft] effect1 may enli/ cl]gym51 z well z physicians1 9 a crusade aga9/ ^! diseases1 t ! pres5t *apt] is writt54 ,x has be5 said ov] & ov] aga9 at m$ical society meet+s t x is a v un=tunate ?+ t univ]sities 9 ^! mod]n times are situat$ 9 l>ge cities4 ,! "y man j fre$ f ! re/ra9ts ( home life1 or ( ! seclusion ( a college1 is at once )\t any prelim9>y tra9+1 expos$ to all ! dang]s1 moral & physical1 ( l>ge city life4 ,n only is ?is true1 b he is ev5 n prop]ly w>n$ ( ! dang]s t lie s close to 8 pa?4 ,our prud]y has gone s f> t ! v names ( ^! #cah affections are taboo$ & above all mu/ n be m5tion$ be=e ! "y4 ,z to ! awful evils t su* diseases may cause1 z to ! lifelong suff]+1 ev5 to m5tal deg5]ation & e>ly dea?1 t !y may involve1 n ev5 a h9t is consid]$ to be prop]4 ,! consequ5ce is t "y m5 expose !mselves n infrequ5tly to dang]1 absolutely unkn[+ ! significance t su* diseases h 9 rec5t ye>s acquir$ 9 ! m9ds ( mod]n physicians1 & x is usually n until a s]i\s mi/ake has be5 made t ! "y man is br\ght 9 contact ) ! physician :o may be frank 9 po9t+ out evils utt]ly unkn[n be=e4 ,?is /ate ( affairs has come to be consid]$ z s irrational 9 _m =eign univ]sities t n[ a special c\rse ( lectures is giv5 e ye> on ! significance ( :at may be call$ ! social diseases4 ,! /ud5ts are told v frankly :at ! possibilities ( dang] = !m 9 c]ta9 excesses may be1 s t at lea/ ! "y man c n say ,i knew no?+ ab\t x1 :5 ! risk becomes an actual reality ( dang]4 ,at ! ,univ]sity ( ,b]l9 ! fir/ c\rse ( su* lectures 0 e/abli%$1 & ! int]e/ ar\s$ & ! results obta9$ 7 su* z to make o!r univ]sities consid] ! advisability ( su* lectures = _! /ud5ts4 ,ev5 "h 9 prim & prude ,am]ica1 "o or two ( ! great univ]sities h come to ! realisation t ! physical well be+ ( _! /ud5ts is committ$ to _! c>e1 z well z _! intellectual developm5t1 & at lea/ a beg9n+ ( t preci\s wisdom t comes f ! fe> ( ! physical evils ( s9 has be5 acquir$ because ( opportunities provid$ by ! faculty4 ,x is well admitt$ n[ by all t ignorance is n innoc5ce & t k ( ! consequ5ces ( social diseases is likely to be a v important factor 9 prev5t+ "y m5 f tak+ risks t w\ld o!rwise be consid]$ v slight1 p]haps4 ,z a matt] ( fact1 no?+ c be m helpful f ! e?ical /&po9t ?an ?is k ( h[ closely may foll[ ! wages ( s91 :i* is dea?4 ,x is = ?is reason t cl]gym5 w\ld seem to owe x1 z a duty to !mselves & _! position 9 social #cai life1 to acquire a c]ta9 k ( ^! affections4 ,a v great *ange has come ov] ! attitude ( ! m$ical pr(ession t[>ds ! s-call$ v5]eal diseases 9 rec5t ye>s4 ,a qu>t] ( a c5tury ago !y 7 consid]$ to be n v s]i\s aft] all1 & inde$ 9 "s cases to be no m s]i\s ?an a cold1 a m]e pass+ incid5t 9 life4 ,n[ x is well recognis$ t almo/ nev] d !y leave _! victim 9 ! /ate ( heal? 9 :i* he 0 be=e1 & t un=tunately ! det]ioration ( tissues :i* has tak5 place is likely to be endur+4 ,ev5 _m ye>s aft]w>ds !re may be s]i\s complications involv+ heal? or ev5 life4 ,= in/ance1 x is n[ v g5]ally conc$$ t p>esis1 or :at is sometimes call$ g5]al p>alysis ( ! insane1--a progressive m5tal & n]v\s disease1 :i* inv>iably ends fatally 9 f ?ree to sev5 ye>s1--is always due to "o ( ! s-call$ social or v5]eal diseases4 ,h[ important ?is affection has become 9 mod]n life c be be/ appreciat$ f ! fact t 9 ,europe ne>ly "o 9 f\r ( ^? :o die 9 ! insane asylums are suff]]s f p>esis4 ,9 ?is c\ntry ! disease is n s frequ5t1 ! proportion be+ less ?an "o 9 five or ev5 "o 9 six4 ,! disease is becom+ m & m common1 h[ev]1 z l>ge city life becomes m prom95t1 & z ! possibility ( infection ) social diseases is m widespread4 ,p>esis is :at is sometimes call$ s(t5+ ( ! bra91 & x attacks by pref]5ce m5 "u ?irty-five4 ,! fir/ symptoms ( x z a rule are n al>m+4 ,a "y man's disposition *anges1 s t an individual h]et(ore r /+y becomes extravagant1 :ile occasionally a prodigal becomes v sav+ & consid]s t he has already a l>ge sum ( money to 8 cr$it4 ,! mo/ prom95t feature ( ! e>ly /age ( ! disease is ! occurr5ce ( delusions ( gr&eur1 t is to say1 ! pati5ts get ! idea t !y are important p]sonages1 or t !y h fall5 heirs to a l>ge sum ( money1 or t !y h be5 appo9t$ to high sal>i$ positions4 ,z a consequ5ce ( ^! delusions1 !y may make exp5sive pres5ts to _! fri5ds4 ,occasionally !re are o!r *anges 9 disposition4 ,a "y #cbj man1 = in/ance1 :o has be5 ( g5ial "* becomes morose & h>d to live )4 ,! opposite *ange to great] livel9ess ( disposition is n unkn[n1 b is m infrequ5t4 ,sometimes !re are m>k$ excesses1 high liv+1 luxuri\s habits1 & ! l1 be=e ! exi/5ce ( disease is recognis$4 ,! m5tal /igmata ( ! disease at ! beg9n+ are n al>m+ at all4 ,!re are slight lapses ( memory4 ,a man :o has hi!rto be5 kn[n z an accurate ma!matician1 makes frequ5t mi/akes 9 add+ or multiply+4 ,! physical signs are ev5 slight]4 ,9 us+ long words1 syllables are omitt$ f !m4 ,a fav\rite me?od ( te/+ ! spee* ( a p]son suspect$ ( beg9n+ p>esis is to ask = ! pronunciation ( a ^w l ,con/ant9ople4 ,usually a syllable w be elid$1 & ! reply w be ,con/anople1 or some?+ simil>4 ,!re is a slight tremul\sness ( ! h&s & usually a r easily m>k$ tremor ( ! lips1 especially :5 ! tongue is protrud$4 ,(t5 9 ! v e>lie/ /age ( ! disease1 !re are *anges 9 ! pupils4 ,!y may be unequal1 or may fail entirely to react to light4 ,:5 ^! signs are positive1 t is1 :5 !re is a *ange 9 disposition & !n ! physical /igmata t we h gone ov] appe>1 ! diagnosis ( ! disease is almo/ c]ta94 ,! physician is able to say1 ) consid]able assurance1 t ! "y1 /rong1 heal?y-look+ pati5t1 :o has (t5 _h to be tempt$ to come to see ! doctor by "s speci\s reason1 because he does n consid] himself t he has any?+ wrong ) him1 w h to be conf9$ 9 an asylum )9 a ye>1 or at mo/1 two1 & w die 9 a /ate ( dem5tia )9 five ye>s4 ,?is1 ( c\rse1 is an awful picture4 ,?is is ! c\rse ( ! disease 9 ne>ly #bj p] c5tum ( ! inmates ( our asylums4 ,almo/ )\t exception !re is a hi/ory ( syphilis 9 ^! cases1 & ! m$ical _w is n[ p]suad$ t ?is is ! mo/ important factor 9 ! production ( p>esis4 ,ano!r n]v\s disease1 correspond+ 9 "s ( its features to p>esis & inde$ sometimes spok5 ( z a sp9al =m ( p>esis1 is locomotor ataxia4 ,?is affection #cba beg9s usually ) loss ( s5sation 9 ! soles ( ! feet s t ! pati5t ?9ks t he is walk+ on c>pet all ! "t4 ,be=e ?is !re may h be5 "s di/urbance ( vision4 ,! pupils may fail to react to light4 ,occasionally ! fir/ symptoms are motor1 t is1 ! man notices t he is n able to walk z readily z be=e4 ,he /agg]s easily4 ,if he tries to turn r\nd :ile walk+ he is apt to lose 8 balance4 ,if he tries to walk 9 ! d>k1 he is almo/ sure to h s great a s5se ( insecurity t he d>e n g f> f ! wall4 ,occasionally ! fir/ sign is a s9k+ ( ! limbs on ! way d[n /airs4 ,9 c]ta9 v sad cases1 ! fir/ & only symptom is a failure ( sight :i* goes on progressively1 until ! optic n]ve is completely de/roy$ & sight =ev] r5d]$ impossible4 ,all ^! symptoms are traceable directly to c]ta9 *anges :i* h be5 not$ 9 ! sp9al cord4 ,^! *anges are due to di/urbance ( ! blood & lymph supply ( ! n]v\s tissue4 ,once ! *anges h tak5 place1 !re is no hope ( ! pati5t ev] recov]+ ! normal use ( 8 limbs4 ,n infrequ5tly he becomes b$ridd5 & c n walk at all because he is n able to /eady himself4 ,he may n suff] 9 8 g5]al heal?1 h[ev]1 to any s]i\s ext5t1 & may live on = tw5ty ye>s1 ?\gh usually 8 resi/ive vitality is l[]$ & he is c>ri$ (f by "s int]curr5t disease4 ,at times locomotor ataxia beg9s ) v sev]e pa9 seizures1 kn[n z crises4 ,^! may occur 9 ! legs or arms or 9 ! /oma* or sometimes 9 o!r organs4 ,occasionally !y are ! fir/ symptoms ( ! disease t are notic$1 & !y may cont9ue = mon?s or ev5 ye>s be=e o!r symptoms manife/ !mselves4 ,?is sometimes makes x difficult to recognise ! disease = :at x really is4 ,! pa9s are usually mo/ excruciat+1 are te>+ or bor+ 9 "*1 & are sometimes describ$ by ! pati5t z be+ simil> to ! s5sation t w\ld be felt if a r$ hot iron 7 =c$ into !m1 or if a knife 7 ins]t$ & !n twi/$ r\nd4 ,h5ce ! descriptive "n :i* has be5 appli$ to !m ( lightn+ pa9s :i* describes ! sudd5ness ( _! onset & ! int5sity ( _! "*4 #cbb ,mo/ ( ! ord9>y anodyne or pa9-kill+ m$ic9es fall to influ5ce !m1 & ! pati5t is "o ( ! mo/ pitiable ( objects :ile !y la/4 ,x is n[ conc$$ on all sides t at lea/ #ge p] c5tum ( ! cases ( tabes are directly due to syphilis4 ,inde$ ?is affection & p>esis are sometimes spok5 ( z p>asyphilitic affections4 ,un=tunately ! ord9>y treatm5t = syphilitic manife/ations does n affect !m 9 ! lea/4 ,s f> z we "k at ! pres5t "t1 !re is no?+ t w h9d] ! c\rse or prev5t ! progress or alleviate ! symptoms or h any curative action on ei!r ( ^! dreadful diseases4 ,!y are mu* m common 9 ,europe ?an !y are 9 ?is c\ntry1 b h be5 se5 "h ) q suffici5t frequ5cy 9 rec5t ye>s to make physicians1 at lea/1 realise ! necessity = hav+ "y m5 appreciate ! dang]s !y invite 9 ?\ghtlessly yield+ to ! temptations ( great city life4 ,!re are o!r affections :i* c be trac$ directly to ! social diseases4 ,"o ( ! mo/ important ( ^! consi/s ( c]ta9 bra9 tum\rs :i* may ev5 cause dea? if n prop]ly treat$4 ,^! syphilitic bra9 tum\rs frequ5tly cause p>alysis & may lead to p]man5t *anges 9 ! n]v\s sy/em ) consequ5t loss ( motor p[]4 ,:5ev] ! symptoms ( bra9 tum\r occur1 c>eful inquiry is made z to ! previ\s exi/5ce ( syphilis 9 ! case1 9 ord] to det]m9e1 if possible1 if ?is is ! morbid ag5t at "w4 ,if !re is a hi/ory ( syphilis x is usually said to be =tunate1 = bra9 tum\rs due to syphilis may be made to disappe> by ! prop] use ( m]cury & ! iodides4 ,if ! treatm5t ( ! case is delay$1 h[ev]1 alt]ations 9 ! n]ve sub/ance take place :i* c n be improv$4 ,?is disease affects especially ! blood vessels &1 z a consequ5ce ( ! ?ick5+ ( ! coats ( ! art]ies1 blood may be %ut (f f c]ta9 portions ( ! bra9 entirely4 ,?is w1 ( c\rse1 produce symptoms ( p>alysis4 ,inde$1 :5ev] p>alytic symptoms manife/ !mselves "u =ty ye>s ( age1 ! physician's fir/ ?\ght is sure to be t !re is syphilis 9 ! case4 ,?is is n always #cbc true1 = by h]$ity & v h>d "w occasionally art]ies become s deg5]ate t !y rupture be=e a pati5t has rea*$ _m ye>s beyond =ty1 b ! case is always suspici\s4 ,9 ?is1 z 9 ! correspond+ in/ance ( bra9 tum\r1 treatm5t1 if appli$ suffici5tly e>ly1 may n only give relief ( all ! symptoms1 b produce a complete cure4 ,t is1 at lea/ ! symptoms are reliev$ = ! "t1 ?\gh !re may be relapses4 ,usually ^! relapses are q am5able to treatm5t1 b sometimes !y get beyond ! control ( ! physician & dea? ensues4 ,x is almo/ ! rule :]e !re h be5 s]i\s n]v\s symptoms once1 t recurr5ces ( !m mu/ be fe>$1 & !y w ev5tually %ort5 ! pati5t's life4 ,syphilitic manife/ations ( s]i\s "* develop1 h[ev]1 n only 9 ! n]v\s sy/em1 b also 9 c]ta9 ( ! important int]nal organs4 ,! liv] may become s mu* affect$ z to refuse to d its "w4 ,solid tum\rs may develop 9 ! /oma*1 or along ! c\rse ( ! inte/9es1 resembl+ canc] s mu* t occasionally op]ations are p]=m$ = _! removal4 ,z a rule1 h[ev]1 ^! yield q promptly to prop] antisyphilitic treatm5t4 ,:5ev] an obscure intraabdom9al tum\r is pres5t1 accord+ly1 x has become ! cu/om among physicians & surgeons n to make an absolute diagnosis nor to p]=m any s]i\s op]ation until antisyphilitic treatm5t has be5 tri$4 ,! surprises ( su* treatm5t con/itute a v int]e/+ *apt] 9 obscure diseases 9 m$ic9e4 ,z we said at ! beg9n+1 x is p]fectly possible to h contract$ ! disease innoc5tly1 & inde$1 ! fir/ manife/ations may be s mild z to fail to attract ! pati5t's att5tion4 ,9 ^! cases !re w be no hi/ory ( syphilis1 yet ! te/ ( antisyphilitic treatm5t w demon/rate t ! disease has be5 pres5t4 ,n a few physicians h di$ f ^! s]i\s manife/ations ( syphilis aft] hav+ contract$ ! disease ?r\gh a cut on ! f+] or ! prick ( an infect$ ne$le 9 ! ord9>y c\rse ( _! pr(essional "w4 ,"s ( ^! cases 9 "y m5 prove to be especially malignant & fail to react to treatm5t1 s t a fatal issue takes place )9 a few ye>s4 #cbd ,on ! o!r h&1 9 g5]al x may be said t ! disease is em95tly curable1 ?\gh x may require great c>e on ! "p ( ! pati5t & ! avoidance ( all excesses ei!r ( "w or indulg5ce = ! re/ ( life4 ,x has (t5 be5 not$ t p :o live 9 ! mid/ ( s]i\s emotional /ra9 are mo/ likely to suff] f manife/ations ( syphilis 9 _! n]v\s sy/em4 ,h5ce x is t p>esis & locomotor ataxia are comp>atively q common among actors1 brok]s1 & f9anci]s4 ,!y are also q common among sea capta9s & milit>y m5 :o are expos$ to sev]e h>d%ips & h to assume weighty responsibilities4 ,9 su* m5 ! previ\s attack ( syphilis has s weak5$ ! n]v\s sy/em t x deg5]ates "u ! /ra9 plac$ ^u x by ! subsequ5t responsibilities4 ,^! diseases are v uncommon among cl]gym5 & are less common 9 ,irel& ?an 9 any o!r c\ntry 9 ! _w1 :i* w\ld s]ve to confirm ! op9ion t ! v5]eal disease is a prom95t factor 9 _! causation4 ,we w\ld n h ! idea be assum$ t syphilis is an incurable disease & is b\nd to be foll[$ 9 all cases by ! awful manife/ations t we h describ$4 ,!re are _m ?\s&s ( cases ( syphilis t nev] h any ( ^! s]i\s manife/ations at all4 ,x is evid5t t "s cases are completely cur$ & t no delet]i\s influ5ce rema9s4 ,on ! o!r h&1 x mu/ n be =gott5 t ! pres5ce ( ?is disease 9 ! tissues ( ei!r p>5t dur+ ! fir/ five ye>s ( its c\rse are almo/ sure to affect (fspr+ born at ?is "t4 ,! *ildr5 may suff] f ! sk9 lesions ( syphilis 9 _! e>ly life1 may suff] f s]i\s eye diseases a little lat]1 & !n ev5tually succumb to n]v\s & m5tal diseases resembl+ p>esis & locomotor ataxia 9 e>ly adult life4 ,9 fact x is ?is transmission ( ! disease t con/itutes "o ( its sadde/ pictures1 & ! s9s ( ! p>5ts are inde$ visit$ on ! *ildr54 ,besides ?is sev]] type ( social disease1 !re is :at has be5 call$ sometimes a mild] =m4 ,x consi/s only ( a dis*>ge ) "s fev]1 :i* is consid]$ to la/ n m ?an a few weeks4 ,z a matt] ( fact1 h[ev]1 ! disease may cont9ue to exi/1 ?\gh ! symptoms become lat5t #cbe & ! pati5t may infect o!rs :5 he lea/ suspects x4 ,?is =m ( disease gives rise to _m sad complications 9 family life4 ,practically all ! sev]e eye diseases ( newly born *ildr51 ! oph?almia f :i* s _m eyes are lo/1 is due to ?is disease4 ,special m$ical c>e is n[ tak5 ( ^! cases1 & ! s]i\s consequ5ces are n s (t5 se5 z us$ to be ! case4 ,)9 a score ( ye>s1 h[ev]1 ab\t "o-half ( ! inmates ( bl9d asylums ow$ _! loss ( sight to ?is disease4 ,at ! pres5t "t !re /ill rema9s a v notable proportion ( p]sons bl9d f e>ly *ildhood ^: infirmity mu/ be attribut$ to ! sad consequ5ces ( ! social disease4 ,mo/ ( ! /]ility 9 families is due to ! same cause4 ,!re is an un=tunate impression t usually ! woman is responsible 9 ^! cases1 & n a little sympa?y is wa/$ on ! man1 because ( ! abs5ce ( *ildr5 9 ! family4 ,almo/ inv>iably1 h[ev]1 ! real cause ( ! family mis=tune is to be trac$ to an infecti\s disease 9 ! man contract$ p]haps _m ye>s be=e1 ( ^: pres5ce he may be m or less unconsci\s1 ! symptoms h become s slight1 b ?is has prov$ suffici5t to infect ! wife & br+ ab\t s]i\s *anges t preclude all possibility ( ! procreation ( *ildr54 ,^! /atem5ts may seem exagg]at$4 ,on ! contr>y1 !y are r und]/atem5ts ( actualities4 ,no "o :o kn[s ! real /ate ( ! case w fail to realise ?is4 ,physicians !mselves h only come prop]ly to appreciate ! true /ate ( affairs 9 ! la/ tw5ty ye>s4 ,we ne$ a coord9ation ( all ! =ces t make = social amelioration 9 mod]n life to correct pres5t false impressions4 ,,james ,j4 ,,wal%4 #cbf ,,xxx ,,de ,,imp$im5to ,,matrimonii ,,dirim5te ,,impot5tia ,hoc argum5tum praecipue ad juris consultos ecclesia/icos et civiles p]t9et2 et quamvis diff]5tia sit int] jurisdictionem judicis civilis et ecclesia/ici tam5 judicium utriusque quat5us necess>io p5det ab exi/5tia conditionum physicalium 9 m$ici consilio situm e/4 ,obscuritas doctr9ae et quidem gravis de hoc imp$im5to1 libris morali/>um1 m$icorum et juris consultorum p]lectis1 inv5itur2 et quamvis1 elapsis p]paucis annis1 f]e omnis lib] tractans de sci5tia m$ic9ali p>va fide dignus1 tam5 multa ex editis physiologorum vet]um tanquam v]a a morali/is praes]tim promulgantur4 ,hae difficultates p] ignorantiam anatomiae et physiologiae g5italium non m9uuntur4 ,ut auxilium1 si quid sit1 ad difficultates solv5das f]am1 species et gradus ,impot5tiae hie collegi tanquam m$icus1 eo modo ut conditio physica cl>ius cognoscatur4 ,9 unoquoque ,/atuum ,fo$]atorum ,am]icae ,sept5trionalis impot5tia ratio suffici5s divortium obt55di e/1 9 plurimis autem matrimonium irritum ab initio non r$dit4 ,impot5tia vel temporanea causa divortii esse pote/ si impot5s intra spatium temporis rationabile rem$ium m$ic9ale recuset4 ,sub lege civili ,am]icana contrah5s qui tempore matrimonii ineundi c]tior erat de impot5tia consortis jus divortii pet5di propt] abnormalitatem i/am amittit4 ,procra/9atio longa et inexplicabilis divortii pet5di1 et etiam inscitia culpabilis impot5tiae consortis divortium impossibile coram judice civili r$dunt4 ,conditio haec etiam imp$im5tum dirim5s matrimonii sub lege canonica ,ecclesiae e/4 ,si impot5tia contractum matrimonii anteat et p]petua sit1 matrimonii contractus #cbg solvitur ipso facto1 qu&ocumque detegitur4 ,procra/9atio aut ignorantia culpabilis non excusant4 ,jurgia oriuntur ex eo quod impot5tia cum /]ilitate saepius confunditur4 ,juris consulti civiles infrequ5t] hoc modo (f5dunt1 m$ici autem et morali/ae crebro 9 errore i/o v]santur4 ,juris consulti ,am]icani et m$ici de impot5tia doctr9am accipiunt librorum praes]tim ,on ,dome/ic ,relations1 auctore ,irv+ ,br[ne 7,bo/on4 #ahij71 ,a ,sy/em ( ,legal ,m$ic9e1 auctore ,all5 ,mac,lean ,hamilton 7,neo-,eboraci1 #ahig71 et ,a ,manual ( ,m$ical ,jurisprud5ce1 auctore ,a4 ,s4 ,taylor 7,neo-,eboraci1 #ahig74 ,irv+ ,br[ne 7op4 cit47 ait3 ,ubi ,impot5tia adsit nullum habetur matrimonium validum4 ,impot5tia autem incapacitatem prae se f]t physiciam1 non m]am frigitatem1 decl9ationem seu repugnantiam1 neque etiam recusationem absolutam coitus sexualis4 ,neque /]ilitas nec mal=matio quae copulam non imp$iant1 neque infirmatio quaecumque sanabilis incapacitatem gignunt4 ,impot5tiam tempore ineundi matrimonii ex/itisse necesse e/4 ,eadem e/ doctr9a ,s*\l]i et ,baldw9ii4 ,:ite et ,m>t91 m$ici1 7,g5ito-,ur9>y & ,v5]eal ,diseases4 ,philadelphiae4 #ahig47 impot5tiam ita def9iunt3 ,inabilitas actus sexualis p]fici5di4 ,non necess>io cum /]ilitate consociatur1 neque necesse e/ quod /]ilis impot5s sit4 ,et ita alii omnes4 ,significatio vocis ,impot5tiae sub lege canonica d$ucitur1 7#a71 ex dijudicationibus ,pontificum ,romanorum1 aut 7#b71 ex judiciis ,congregationis ,sancti ,(ficii1 tribunalis ad s5t5tias hujus g5]is pronunti&as in/ituti1 aut1 7#c71 ex legis int]pretatione a morali/is sci5tia pra$itis4 ,sixtus ,v1 ,pontifex ,romanus1 7,con/4 ,cum frequ5t]1 anno #aehg7 decrevit eunu*os impot5tes esse s5su legis canonicae de ,impot5tia1 nullum autem judicium papale totam que/ionem conficit4 ,congregatio etiam ,sancti ,(ficii 9 p]paucis casibus p>ticul>ibus dijudicavit s$ legem nullomodo di/9cte def9iebat4 ,norma igitur a nobis sequ5da ex int]pretatione morali/>um e/ deprom5da4 #cbh ,lex non e/ decretum m]e discipl9>e3 e natura ipsa contractus matrimonialis desumitur4 ,ball]9i 7,!ol4 ,mor41 vol4 #f1 p4 #feh7 scribit matrimonium consi/]e 9 mutua traditione pote/atis ad copulam conjugalem4 ,s4 ,?omas 7,supplem4 ,sum1 ,!ol41 q4 #eh1 a4 #c7 ait3 ,9 matrimonio e/ contractus quidam1 quo unus alt]i obligatur ad debitum c>nale solv5dum3 unde sicut 9 aliis contractibus non e/ conv5i5s obligatio si aliquis se obliget ad hoc quod non pote/ d>e vel fac]e1 ita non e/ conv5i5s matrimonii contractus1 si fiat ab aliquo qui debitum c>nale solv]e non possit2 et hoc imp$im5tum vocatur impot5tia coeundi4 ,antequam explicationem a morali/is pl5iorem vocum ,impot5tia coeundi dabamus1 att5d5dum accurate e/ ad def9itionem matrimonii f9um a ,s4 ,alphonso ,liguorio 7,!ol4 ,mor41 lib4 vi41 n4 #hhb7 datam4 ,f9es1 inquit1 intr9seci ess5tiales sc4 matrimonii sunt duo3 traditio mutua cum obligatione r$d5di debitum1 et v9culum indissolubile4 ,f9es intr9seci accid5tales p>it] sunt duo3 procreatio prolis et rem$ium concupisc5tiae4 ,f9es autem accid5tales extr9seci plurimi esse possunt1 ut pax concili&a1 voluptas capt&a1 etc4 ,8 positis1 c]tum e/ quod si quis exclud]et duos f9es intr9secos accid5tales1 non solum valide1 s$ etiam licite posset qu&oque contrah]e2 pr\t si esset s5ex et nub]et s9e spe procre&i prolem1 nec int5d]et rem$ium concupisc5tiae2 sufficit enim ut salv5tur f9es sub/antiales1 ut supra4 ,haec s5t5tia ,s4 ,alphonsi magni mom5ti e/1 et 9 ea solutio mult>um difficultatum inv5iri pote/4 ,dicit hic 7#a7 f9es intr9secos ess5tiales matrimonii esse traditionem mutuam cum obligatione r$d5di debitum1 et v9culum indissolubile1 atque illis demptis nullum matrimonium2 7#b7 procreationem autem prolis et rem$ium concupisc5tiae abesse posse1 et tam5 matrimonium esse validum si duo f9es ess5tiales ads9t4 ,sanctus hoc loco inf]t1 ut patet e contextu alibi 7e4 g41 lib4 vi41 n4 #ajie1 res4 #b71 traditionem mutuam pote/atis ad copulam c>nalem necess>io pot5tiam coeundi suppon]e1 pot5tiam autem g5]&i non esse necess>iam nec rem$ium concupisc5tiae4 ,9 libro vi41 n4 #ajif1 ait3 ,impot5tia e/ illa propt] quam conjuges non possunt copulam hab]e p] se aptam ad g5]ationem2 unde sicut validum e/ matrimonium #cbi int] eos qui possunt copul>i1 e/o p] accid5s nequeunt g5]>e1 puta quia /]iles aut s5es1 vel quia fem9a sem5 non ret9et1 ita nullum e/ matrimonium int] eos qui nequeunt consumm>e eo actu1 quo ex se esset possibilis g5]atio4 ,di/9ctio haec int] pot5tiam coeundi et pot5tiam g5]&i a morali/is omnibus datur2 illa autem data1 plurimi di/9ctionem obliviscuntur et /]ilitatem simplicem cum impot5tia confundunt4 ,a4 ,kon+s1 ,c4,,ss4,r41 7,!ol4 ,mor41 ed4 #g1 vol4 #b1 p4 #bgf7 haec habet3 ,impot5tia e/ incapacitas ad copulam c>nalem1 p] se aptam ad g5]ationem4 ,9 n4 #afai1 ,sec4 #e1 ait3 ,non e/ confund5da impot5tia coeundi cum impot5tia g5]&i4 ,h9c /]iles et s5es qui matrimonium consumm>e val5t1 valide contrahunt1 item muli]es quae possunt sem5 excip]e1 etsi illud non ret9eant4 ,hanc doctr9am ,s4 ,alphonso ref]t 7,!ol4 ,mor41 lib4 #d1 n4 #ajie1 ed4 ,me*4 #ahde71 et p>agraphum hoc modo complet3 ,non tam5 c>5tes ut]o vel vag9a4 ,hoc e/1 t5et muli]em ut]o et vag9a c>5tem impot5tem esse4 ,unusquisque c>5tiam vag9ae impot5tiam esse admittit2 muli] autem s9e ut]o sem5 excipi5di capax e/1 concupisc5tiam quoque m>is sati>e pote/4 ,/]ilis tantum e/4 ,pot5tiam etiam habet coeundi1 sem5 excip]e pote/ et ret9]e1 concupisc5tiam quoque sati>e pote/1 etiamsi ut]us1 ov>ia et tubi ,fallopiani abs9t4 ,praet]ea1 illi duo f9es intr9seci ess5tiales matrimonii exi/unt4 ,augu/9us ,lehmkuhl1 ,s4,j41 7,!ol4 ,mor471 alius illu/ris discipulus ,s4 ,alphonsi e/ ,impot5tiam def9it3 ,defectus propt] qu]n conjuges non possunt copulam hab]e p] se aptam ad g5]ationem4 ,alibi 7,am]ican ,ecclesia/ical ,review1 vol4 #bh1 n4 #c71 de impot5tia excisioneque ov>iorum scrib5s1 ait3 ,puto1 que/ionem propositam1 utrum excisio ov>iorum vel ut]i con/ituat imp$im5tum dirim5s necne1 !oretice nondum esse plane solutam4 ,exi/imat autem que/ionem practice solutam esse judiciis ,congregationis ,s4 ,(ficii1 d4 #c ,febru>ii1 #ahhg1 et d4 #cj ,julii1 #ahij1 editis1 matrimonium muli]is ov>iis c>5tis et muli]is ut]o et ov>iis c>5tis1 p]mitt5tibus4 ,etiamsi haec judicia non ed>5tur tanquam leges =malit] g5]ales1 ,lehmkuhl op9atur 9 #ccj casibus ejusdem g5]is apt>i posse4 ,re quidem v]a illa doctr9a sequi pote/ practice et !oretice2 nulla enim e/ quae/io s]ia de impot5tia 9 muli]e c>5te ov>iis4 ,joseph ,antonelli tam5 7,de ,conceptu ,impot5tiae et ,/]ilitatis relate ad ,matrimonium1 ,romae1 #aijj7 t5et c>5tiam ov>iorum esse impot5tiam sub lege2 et ,casacca 7,am]4 ,eccl4 ,rev41 vol4 xxvii1 n4 #f1 et alibi7 eamdem op9ionem sequitur4 ,e contra1 ,m>c 7,in/4 ,mor4 ,alphon47 docet c>5tiam ov>iorum ut]ique non esse impot5tiam4 ,joseph ,hild 7,am]4 ,ecc4 ,rev4 vol4 xxviii41 n4 #f7 optime v9dicat op9ionem1 nempe1 c>5tiam ov>iorum non esse impot5tiam1 et 9 corpore tractatus citat def9itiones impot5tiae a morali/is egregiis prolatas4 ,s*malzgrueb] 7,!ol4 ,mor41 lib4 iv41 tit #ae1 n4 #ca7 dicit3 ,sola impot5tia ad copulam dirimit matrimonium1 non v]o impot5tia ad g5]ationem4 ,con9ck 7,de ,sacr41 vol4 ii41 d4 #ca1 dub4 #g1 n4 #hf7 ita habet3 ,/]iles 444 si alit] pot5tes s9t ad usum matrimonii1 valide contrahunt2 quia nec g5]atio nec pote/as g5]&i e/ de ess5tia matrimonii4 ,ma/rius 7,dis4 de ,matr41 q4 v41 n4 #aad7 ait3 ,impot5tia e/ inhabilitas p]petua ad consumm&um matrimonium 4 4 4 non e/ ex eo praecise quod alt]ut] conjugum aut ut]que s9t /]iles1 quia impot5tia ad g5]&um seu ad prolific&um1 dummodo adsit pot5tia ad copulam c>nalem et sem9ationem1 non e/ imp$im5tum dirim5s1 ut omnes passim conc$unt cum ,scoto 4 4 4 et ubi e/ c]ta impossibilitas ad bonum prolis1 tunc matrimonium e/ ibi 9 rem$ium1 non 9 (ficium4 ,v9c5tius de ,ju/is 7,de ,disp5s4 ,matr4 lib4 ii1 c4 #ag1 nn4 #a1 #b1 #c7 scribit3 ,impot5tia ad matrimonium e/ duplex4 ,prima1 quae /]ilitas dicitur1 efficit ut proles g5]>i non possit1 ex se tam5 matrimonium nec imp$it nec dirimit1 ut doc5t ,san*ez1 ,gutti]1 ,con9ck4 4 4 4 ,ratio e/1 quia nec g5]atio1 nec g5]&i pote/as sunt de ess5tia matrimonii4 ,s4 ,?omas 7,supplem1 q4 #eh1 a4 #a7 9 articulo de ,impot5tia1 quam ,frigiditatem et ,impot5tiam ,coeundi nuncupat1 nihil de /]ilitate scribit1 nec de impot5tia g5]&i tanquam quid impot5tiae coeundi oppositum4 #cca ,9 omnibus hisce def9itionibus v]ba de se1 ex se1 p] se1 et alia similia1 adhib5tur de copula c>nali qua copula4 ,amort 7,de ,matr1 q4 #aja7 de 8 v]bis loqu5s ait3 ,impot5tia e/ inhabilitas corporalis ad copulam c>nalem de se ad g5]ationem prolis idoneam4--,dicitur3 de se2 pote/ enim cont+]e p] accid5s1 v4 g41 ob debilitatem spirituum sem9alium 9 viro aut fem9a1 vel ob indispositionem matricis 9 muli]e1 quod copula c>nalis1 etiam p]fecta1 hoc e/1 p] effusionem sem9is 9 vag9a muli]is completa1 non sit idonea ad g5]ationem prolis4 ,loquuntur morali/ae1 ut dixi1 de copula c>nali quat5us copula e/ s9e respectu ad possibilitatem g5]&i4 ,hisce omnibus positis1 rogamus3 7#a71 ,quid sit impot5tia sub lege 9 muli]e8 7#b71 ,e/ne muli] c>5s ov>iis1 ut]o vel tubis ,fallopianis impot5s8 7#c71 ,quid sit impot5tia sub hac lege 9 viro8 7#d71 ,e/ne vir asp]matosus impot5s1 et quid de viris sem5 /]ile hab5tibus8 ,i4 ,impot5tia ,muli]is4 ,muli]es /]iles frequ5tius quam viris1 viri autem impot5tes frequ5tius quam muli]es sunt4 ,impot5tia absoluta et p]petua r>o 9 muli]ibus1 9 viris crebro inv5itur4 ,9 fundo pelvis fem9eae septum e/ a lat]e 9 latus1 rectum int] et vesicam ur9>iam1 et 9 m$io hujus p>titionis ut]us1 qui pir(ormis e/1 quasi ad p]p5diculum jacet et c]vix sua 9 vag9am intrat4 ,a cornibus ut]i1 i4e41 ab angulis sup]ioribus1 tubi ,fallopiani proc$unt ad libellam1 et apud t]m9os tuborum ov>ium e/ 9 utroque lat]e4 ,tubi ap]ti sunt prope ov>ia1 et non sub/antiae ov>iorum cont9ui4 ,si unum ov>ium et tubus oppositi lat]is demantur1 vel si tubus i/e occludatur1 ovum ex ov>io man5te migr>e p] p>tem ext]iorem ut]i et foecund>i pote/4 ,g5italia ext]na muli]is e labiis majoribus praecipue con/ant2 intra et int] haec labia m9ora seu nymphae sunt4 ,intra labia m9ora ad summum v]sus clitoris e/2 infra hanc e/ meatus ur9>ius2 infra meatum1 orificium vag9ae4 ,p] imam p>tem orificii 9 virg9ibus ext5ditur pellicula t5uis quae hym5 vocatur4 ,haec communit] 9 coitu primo rumpitur4 #ccb ,tempore m5sium praes]tim ova egr$iuntur ex ov>iis 9 tubos ,fallopianos et inde 9 ut]um4 ,si ova non foecund5tur p] vag9am amittuntur4 ,foecundatio 9 tube ,fallopiano fit4 ,9 muli]e impot5tia temporanea aut p]petua oriri pote/ e causis sequ5tibus3 7#a71 propt] hym5em imp]=abilem aut cribri=mem1 aut septatum aut annul>em2 7#b71 propt] vag9am duplicem2 7#c71 propt] vag9ismum aut dolorem2 7#d71 propt] ut]um prolapsum aut productionem c]vicis ut]i2 7#e71 propt] atresiam vag9ae aut labia adha]5tia2 7#f71 propt] orificium vag9ae 9 loco abnormali2 7#g71 propt] arctationem vag9ae2 7#h71 propt] tumores aut increm5tum morbidum intra vel circa g5italia2 7#i71 propt] ,sadismum2 7#aj71 propt] ,maso*ismum2 7#aa71 propt] ,sodomiam gradus secundi seu defem9ationem2 ,sodomiam gradus t]tii2 ,sodomiam cum horrore2 ,urn+ismum2 ,&rogyniam4 #a4 ,aliqu&o vice hym5is normalis inv5itur membrana d5sa seu c>tilag9osa1 aut membrana cont9ua1 aut cribro similis1 aut tanquam septum1 aut annul>is1 quae imp$iat intromissionem4 ,op]atione simplici *irurgica conditio removetur4 #b4 ,r>o septum ade/ quod vag9am 9 duas p>tes dividit et impot5tiae causa e/4 ,*irurgus septum remov]e pote/4 #c4 ,vag9ismus contractio spasmodica musculorum ad orificium vag9ae e/1 et haec vag9am claudit4 ,frequ5t] int] neuroses ideopa?icas includitur1 scrut9ium autem dilig5s locum inflammationis detegit qui origo e/ spasmi reflexi4 ,insol5t] conditio ex hyp]ae/hesia murorum vag9alium inducitur4 ,m$icatio vag9ismi exam5 exp]tum supponit et qu&oque scrut9ium endoscopicum vesicae ur9>iae4 ,fissurae 9 ano1 endometritis *ronica1 ure?ritis granosa circa c]vicem vesicae ur9>iae1 causae pr9cipales sunt vag9ismi1 et i/ae #ccc causae sanabiles sunt4 ,inflammatio acuta vulvae1 vag9ae1 ut]i1 tuborum aut ov>iorum1 c>unculae ure?rales1 ure?ritis1 fissurae c]vicis vesicae ur9>iae1 haemorrhoides1 fissurae recti1 coccygod9ia1 ulc]a ut]i et amotio ut]i vel ov>iorum e loco debito1 possunt tantum dolorem 9 coitu inflig]e ut muli] practice impot5s fiat4 ,morbi autem i/i f]e omnes m$icabiles sunt1 s$ tam5 aliqui omn9o p]vicaces sunt4 ,9 vag9ismo hy/]ico et 9 aliis casibus insanabilibus intromissio fi]i pote/ ope *lor(ormi ad evit&um divortium4 #d4 ,qu&o ut]us prolabitur vel c]vix producitur ita ut copula impossibilis sit1 *irurgus m$]i pote/4 #e4 ,atresia vag9ae e/ occlusio vag9ae 9 longum p]fecta vel imp]fecta4 ,nullum orificium inv5itur4 ,cong5ita esse pote/1 et tunc pl]umque desunt omnia organa g5]ativa4 ,atresia etiam consequitur vuln]a et inflammationes morborum1 ut diph!ritis et sc>lat9a4 ,ubi atresia p] totam vag9am ext5ditur nullum datur m$icam5tum1 et impot5tia absoluta et p]petua ade/4 ,labia adha]5tia sep>>i possunt4 #f4 ,aliqu&o s$ p]r>o vag9a 9 rectum ap]it4 ,possibilitas remov5di impot5tiam e loco orificii vag9ae p5det4 #g4 ,arctatio vag9ae oritur ex causis atresiae1 et remotio conditionis quum impot5tia inducat impossibilis esse pote/4 #h4 ,tumores pud5di1 vag9ae et recti1 hyp]trophia labiorum et clitoridis1 et elephantiasis labiorum copulam imp$ire possunt4 ,alii tumores et hyp]trophiae remov]i possunt1 alii autem insanabiles sunt4 #i4 ,dantur p]v]sitates sexuales quae viros impot5tes r$dunt1 et haec aliqu&o 9 muli]ibus inv5iuntur4 ,tales sunt ,sadismus1 ,maso*ismus1 et gradus ,sodomiae praet] primum4 ,i/i morbi animi causae sunt impot5tiae 9 muli]e propt] av]sionem ejus virorum etiamsi physice pot5s sit4 ,vix 9 matrimonium iniit talis muli]1 et igitur p]v]sitates i/ae p>vi mom5ti relate ad muli]es1 relate autem ad viros magni mom5ti sunt4 ,de 8 quid infra dic5dum erit4 #aj4 ,s5ectus nunquam r$dit muli]em impot5tem1 virum autem r$dit4 ,etiamsi nihil ad impot5tiam p]t9eat1 hic #ccd juvat dic]e 9 locis temp]atis t]rae p>turitionem maxima ex p>te des9]e anno a natu quadragesimo-qu9to4 ,cess>e pote/ anno vicesimo-octavo1 et p]/>e po/ annum qu9quagesimum4 ,j4 ,:itridge ,williams 7,ob/etrics4 ,neo-,ebor4 #aijc71 casum citat muli]is quae anno sexagesimo-t]tio aetatis pu]um vicesimum-secundum pep]it et po/ea m5ses ad]ant4 ,p>turitio aliqu&o decem vel duodecim annos po/ ultimos m5ses ev5it4 ,nunc1 e/ne muli] ov>iis c>5s impot5s8 ,nullo modo3 /]ilis tantum e/4 ,nam 7#a7 ,congregatio ,s4 ,(ficii 9 matrimonium duas muli]es ov>iis orbatas inire p]misit4 7#b7 ,talis muli] capax e/ copulae c>nalis aeque ac muli] hab5s ov>ia1 et morali/ae omnes conc$unt nil amplius requir5dum ut matrimonium validum fiat4 7#c7 ,si talis muli] impot5s sit omnis muli] insanabilit] /]ilis impot5s esset1 et discrim5 a morali/is prolatum impot5tiam int] et /]ilitatem nugatorium esset et pu]ile4 ,muli] 9 qua tubi ,fallopiani occludantur /]ilis e/ p]petuo2 idem dic5dum de muli]e hab5te ut]um infantilem1 vel ov>ia rudim5t>ia1 vel ov>ia morbida1 et ita porro4 ,nemo autem tales tanquam impot5tes unquam t5et4 ,aliqu&o muli] ov>iis orbata s5sationem sexualem possidet1 vulgo autem non possidet4 ,9 utroque casu tam5 rem$ium idem concupisc5tiae m>i p]/at1 et hoc sufficit pro viro ut matrimonium validum sit4 ,huc acc$it1 relate tum ad muli]em tum ad virum1 quod duo f9es intr9seci ess5tiales matrimonii1 et f9es suffici5tes juxta ,s4 ,alphonsum1 ads9t1 scilicet1 traditio mutua cum obligatione et possibilitate r$d5di debitum1 et v9culum indissolubile4 ,si 9 tali muli]e exi/at s5satio sexualis1 pro ea rem$ium concupisc5tiae habetur1 s9 m9us1 dantur saltem duo f9es ess5tiales intr9seci matrimonii4 ,re quidem v]a muli] c>5s ov>iis et eodem tempore exp]s s5sationis sexualis diff]t a muli]e quae p>turit s$ s9e s5satione sexuali e/2 nihilom9us semp] man5t illi ov>iis c>5ti duo f9es ess5tiales intr9seci matrimonii4 ,vetula communit] nequit p>ire et exp]s s5sationis sexualis e/1 s$ licite matrimonium contrahit4 ,conditio vetulae e/ eadem ac conditio muli]is ov>iis orbatae4 ,lehmkuhl #cce 7,am]4 ,ecc4 ,rev4 vol4 #bh1 n4 #c71 9 hanc ass]tionem urget excisionem ov>iorum esse quid positive actum contra prim>ium matrimonii f9em1 quum s5ectus conditio naturalis sit ,*irurgus hone/us aut inhone/us nunquam removet ov>ia ut conceptio evitetur2 op]atio enim nimis p]iculosa e/4 ,remov5tur ov>ia prim>io ad morbum gravem m$5dum1 et /]ilitas consequ5s int5ditur tantum p] accid5s4 ,remotio ov>iorum igitur e/ quid p] accid5s actum contra prim>ium f9em matrimonii1 7et i/e non e/ f9is ess5tialis intr9secus7 seu g5]ationem prolis2 et nihil ref]t etiamsi positive actum esset si non sit 9 fraudem legis4 ,9 casu muli]is hab5tis ov>ia rudim5t>ia et nullam s5sationem sexualem 7casus enim qu&oque cont+it7 quid sit positive actum contra prim>ium f9em matrimonii8 ,e/ne una lex pro i/a a natura ca/rata et alia pro muli]e a *irurgo ca/rata et t]tia pro vetula s5ectute ca/rata8 ,int] ov>ia et te/iculos analogia e/1 etiamsi ob/et ,d4 ,bossu1 m$icus ,gallicus1 a ,pr(essore ,hild 7,am]4 ,ecc4 ,rev4 vol4 #bh1 n4 #a7 et ,es*ba* citatus4 ,demptis ov>iis s5satio sexualis de/ruitur haud secus ac quum te/iculi removeantur1 s$ analogia incompleta e/ et claudit4 ,eunu*us insup] incapax e/ communit] intromissionis1 et semp] insem9ationis4 ,morali/ae vulgo doc5t insem9ationem ess5tialem esse copulae c>nali4 ,utcumque de insem9ationis necessitate v]itas sit 7de qua infra7 eunu*us nequit satisfac]e primo matrimonii f9i ess5tiali intr9seco1 muli] exp]s ov>iis satisd>e pote/4 ,c>5tia aut occlusio tuborum ,fallopianorum /]ilitatem insanabilem efficit1 s$ usque adhuc nemo t5et illam c>5tiam vel occlusionem esse impot5tiam4 ,conditio quoad pot5tiam g5]&i eadem e/ ac 9 c>5tia ov>iorum1 s5sationem autem sexualem proprie c>5tia tuborum non efficit4 ,idem omn9o dic5dum e/ de c>5tia ut]i4 ,si vag9a remaneat capax talis muli] copulae c>nalis e/4 ,muli] igitur impot5s e/ sub lege ecclesia/ica tantum 9 qu9que casibus3 7#a71 ubi atresia vag9ae aut adhaesio labiorum insanabiles sunt3 haec atresia et adhaesio r>o inv5iuntur2 #ccf 7#b71 9 casu r>issimo 9 quo vag9a 9 rectum ap]it insanabilit]2 7#c71 ubi arctatio vag9ae imm$icabilis sit3 haec r>a e/2 7#d71 qu&o adsunt tumores maligni aut increm5ta morbida quae nequeant remov]i2 7#e71 9 casibus defem9ationis aut ,urn+ismi 7de quibus infra74 ,sadismus et ,maso*ismus et aliae p]v]sitates sexuales ita infrequ5t] obs]vantur1 9 gradu saltem 9 quo impot5tiam creant1 ut negligi poss9t4 ,,ii4 ,impot5tia ,m>is4 ,tractus g5italis viri1 a te/iculis ad meatum ur9>ium seu orificium p5is1 ad c5timetra #ha 7uncias f]e #cb7 ext5ditur4 ,ex te/iculis *orda sp]matica p] +u5 infra cutem transit1 murum abdom9alem p5etrat p] annulum +u9alem1 et sub vesica ur9>ia ure?ram juxta c]vicem vesicae intrat4 ,sem5 non ex uno fonte prov5it4 ,secretio i/a fluida e/ et c9]ea1 p>tim ex te/iculis qui 9 scroto sunt ori5s et p>tim ex vesiculis sem9alibus1 pro/ate1 gl&ulis ,c[p]i1 et folliculis cryptisque ure?rae1 quae omnia extra scrotum sunt4 ,elem5tum ess5tiale 9 sem9e cellulae sunt quae sp]matozoa vocantur1 et haec ex te/iculis prov5iunt4 ,locomotionis pot5tiam hab5t sp]matozoa et 9 foecundatione ovum p5etrant4 ,secretio gl&ul>um quae sp]matozoa f]t alkal9a e/ et removet aciditatem ur9ae2 acidus enim sp]matozoa de/ruit4 ,erectio p5is praec$it ejectionem sem9is1 et c5tra n]vosa erectionis et ejectionis 9 *orda sp9ale apud lumbos sunt4 ,erectio effectus e/ dilatationis art]i>um p5is et occlusionis v5>um quae conge/ionem sangu9is efficiunt2 po/ea musculi p]9eales aliique musculi erectionem p]ficiunt4 ,impot5tia m>is 9 tria g5]a dividi pote/2 videlicet3 ,impot5tia ,psy*ica1 ,impot5tia ,atonica1 ,impot5tia ,organica3 ,i4 ,impot5tia ,psy*ica4 ,species3 7#a71 ,impot5tia ,psy*ica absoluta aut relativa2 7#b71 ,sadismus2 7#c71 ,maso*ismus2 7#d71 ,feti*ismus2 #ccg 7#e71 ,eviratio2 7#f71 ,urn+ismus2 7#g71 ,sodomia cum horrore2 7#h71 ,gyn&ria2 7#i71 ,metamorphosis ,sexualis ,p>anoica2 7#aj71 ,anae/hesia ,sexualis2 ,,ii4 ,impot5tia ,atonica4 ,species3 7#a71 ,impot5tia ,p>alytica2 7#b71 ,impot5tia e v55is2 7#c71 ,impot5tia ex irritatione4 ,,iii4 ,impot5tia ,organica4 ,species3 7#a71 abs5tia p5is2 7#b71 p5is multiplex2 7#c71 hyp]trophia aut magnitudo p5is vel praeputii2 7#d71 p5is rudim5t>ius2 7#e71 adhaesio p5is scroto1 +u5i vel abdom9i2 7#f71 hypospadias et epispadias2 7#g71 di/ortiones p5is ex podagra1 lue1 rheumatismo1 gonorrhoea2 7#h71 aneurysma corporum cav]nosorum et v>ix v5ae dorsalis p5is2 7#i71 fr5um nimis curtum2 7#aj71 an*ylosis articulam5ti cox5dicis et abdom5 p]magnum2 7#aa71 tumores et increm5ta morbida circa g5italia1 sicut h]niae1 hydrocele1 haematocele1 elephantiasis1 lipoma1 c>c9oma1 s>coma1 cy/oma1 en*ondroma et fibroma2 7#ab71 ph?isis te/iculorum et v>icocele2 7#ac71 anor*ismus et ca/ratio2 7#ad71 pro/ratitis *ronica2 7#ae71 s5ectus2 7#af71 asp]mia4 ,i4 ,impot5tia ,psy*ica4 #a4 ,impot5tia psy*ica ea e/ quae ex co]citatione inhib5te c]ebri 9 c5trum g5ito-sp9ale ex]citata dev5it4 ,impot5tia ex maleficio vet]um morali/>um e/4 ,timor1 luctus1 gaudium magnum1 et av]sio hanc impot5tiam psy*icam efficiunt4 ,qu&oque #cch nup] m>itus propt] excitationem passionis ejectionem praecocem vel erectionem debilem vel nullam habet4 ,9 8 casibus impot5tia temporanea e/ si m$icus p]itus prud5sque sit4 ,haec impot5tia relativa esse pote/4 #b4 ,sadismus4 ,haec p>ae/hesia sexualis et aliae p]v]sitates ex excessu v5]eo dev5iunt et impot5tiam gignunt4 ,sadismus nom5 habet a quodem libid9oso ,gallico m>*ione de ,sade1 saeculo duodevicesimo vig5te4 ,datur libido magna erga alium sexum s$ cum crudelitate 9 objectum urig9is1 quae crudelitas usque ad homicidium cum mutilatione frequ5t] ext5dit1 vel saltem adesse debet humiliatio p]sonae amatae4 ,sadi/ae erant ,n]o et ,tib]ius2 et exemplum infame erat ,giles de ,laval1 qui ,a4,d4 #addj1 supplicium capitis affectus e/1 po/ trucidationem ,sadi/icam f]e #bjj lib]orum int] octo annos4 ,occisiones apud ,:ite ,*apel ,lond9i probabilit] ,sadi/icae fu]unt4 ,sadi/a impot5s e/ exceptis casibus 9 quibus crudelis vel saltem contumeliosus simul esse pote/4 ,haec crudelitas gradus habet a ,sadismo symbolico1 9 quo crudelitas simulatur1 vel m]e dramatica e/1 p] contumeliam v]am usque ad homicidium et an?ropophagiam4 ,=mae etiam be/iales et sodomiticae inv5iuntur4 ,sadi/a nullo modo tanquam semp] insanus consid]>i debet1 species autem suae pessimae p>anoicae sunt1 et deg5]atio neurotica frequ5s e/ 9 familiis ,sadi/>um4 ,sadismus m>is frequ5s e/1 s$ ,kraft-,eb+ 7,psycopa?ia ,sexualis1 ,philadelphiae1 #ahic7 tantum duos casus int] muli]es inv5it4 ,fictiones antiquae de ,lamiis et ,m>molycibus ex actibus muli]um ,sadi/ic>um ortae sunt4 ,necrophilia1 seu libido erga cadav]a cum prop5sione ad mutilationem1 species e/ ,sadismi quae vulgo p>anoica e/4 #c4 ,maso*ismus4 ,haec deg5]atio nom5 habet a fabul>um scriptore ,sa*]-,maso*4 ,conditio e/ ,sadismo contr>ia4 ,maso*i/a urig9em habet magnam uti ,sadi/a1 et nulla datur pot5tia sexualis s9e crudelitate vel humiliatione2 crudelitas autem vel humiliatio 9 ,maso*i/am ipsum v]t5da e/4 ,hic homicidium non intrat4 ,maso*ismus1 natura sua passiva1 vitium fem9>um esse debet1 s$ solummodo #cci casus unus 9 muli]e inv5tus e/ a ,kraft-,eb+4 ,valde communis e/ int] m>es4 ,maso*ismus ,l>vatus e/ species hujus deg5]ationis 9 qua sordes physicae sordibus adduntur moralibus4 #d4 ,maso*ismus ,symbolicus seu ,feti*ismus4 ,feti*i/a pot5s e/ tantum praes5te p>te ve/ium1 e4 g41 calccus muli]is1 vel aliud objectum seu ,feti*1 quodcumque sit4 ,aliqu&o m]a imag9atio sufficit4 ,tonsores furtivi capillorum puell>um qu&oque ,feti*i/ae sunt1 et 9 capillis longis virorum attractio sexualis qu&oque e/ muli]ibus4 ,virtus musicorum saepe 9 capillis ,samsoniis e/ plus quam arte4 ,we/]m>ck 7,hi/ory ( ,human ,m>riage4 ,neo-,eboraci4 #ahia7 describit s$itionem gravem muli]um 9 ,madagasc> quum ,rex ,radama capillos longos militum tond]i juss]it4 ,relatio etiam e/ odores int] et passionem sexualem4 ,si n]vi olfactorii catelli sc9dantur catellus nunquam canem fem9eam recognoscit4 ,m]etrices gaud5t odoram5tis pung5tibus1 e4g41 mos*o4 #e4 ,eviratio4 ,haec deg5]atio gradus e/ ,sodomiae4 ,9 gradu primo ,sodomiae impot5tia non necesse ade/1 9 gradu autem secundo semp] ade/4 ,9 hoc secundo gradu homo ,sodomiticus m]etrix mascul9a evadit cum m>ibus1 atque trans=matio pr(unda et /abilis animi sup]v5it1 ita ut mas se fem9am esse 9 actu sexuali s5tit4 ,hic e/ effem9atio usque ad /atum crim9alem pregr$i5s4 ,gradus initialis hujus /atus e/ amicitia inord9ata int] duos pu]os aut duas puellas4 ,9 casibus firmatis evirationis1 ,sodomi/a agit tanquam pellex mascul9a aliis ,sodomi/is1 aut 9 ve/ibus fem9eis ut uxor se g]it4 ,coloniae sunt ,sodomi/>um hujus g5]is 9 f]e omne urbe magna2 se invicem cognoscunt1 societates1 *oreas publicas1 et dialectum completam hab5t1 praes]tim ,b]ol9i1 ,lutetiae-,p>isiorum1 ,neapolis et ,wa%+tonii4 ,impot5tes sunt ad copulam c>nalem naturalem4 ,sodomia cum effem9atione seu virag9itate frequ5s e/ int] muli]es4 ,hie deg5]ata m>em m5te ev5it4 ,impot5s vix dici pote/1 nisi propt] av]sionem sexualem a m>ibus4 #f4 ,urn+ismus4 ,urn+ e/ vox ,g]manica ab ,ulri*s inv5ta4 ,urn+ismus idem e/ 9 re ac ,sodomia primi et #cdj secundi gradus1 s$ additur mollitia scriptionis poesis1 ambulationum imm95te luna1 et aliorum hujusmodi4 #g4 ,sodomia cum horrore e/ similis evirationi et defem9ationi1 s$ vice frigiditatis ade/ horror alt]ius sexus4 #h4 ,gyn&ria et ,&rogynia4 ,9 i/is deg5]ationibus trans=matio ita pr(unda e/ ut ,sodomi/a mascul9us circa pectus et 9 modo se g]5di fem9ae similis sit physice1 et virago virum evadat aspectu4 ,exempla sunt bote et muj]ado int] ,si\x et ,pueblos ,indos ,am]icanos4 #i4 ,metamorphosis ,sexualis ,p>anoica species insaniae e/ 9 qua pati5s imag9at sexum suum mutatum esse4 ,insanabilis e/4 ,deg5]ationes i/ae f]e omnes cum ma/urbatione incipiunt4 ,m$icatio moralis esse debet1 s$ ,kraft-,eb+ et von ,s*r5k-,notz+ sanationem obt9u]unt ope hypnosis4 #aj4 ,anae/hesia ,sexualis /atus e/ 9 quo vir aut muli] omn9o c>et s5satione sexuali4 ,illi secus hab5t corpora normalia4 ,conditio valde infrequ5s e/4 ,kraft-,eb+ enum]at decem casus cong5itos 9 m>ibus1 et duos 9 fem9is4 ,anae/hesia sexualis acquisita etiam inv5itur4 ,,ii4 ,impot5tia ,atonica4 #a4 ,impot5tia ,p>alytica4 ,c5tra n]vosa sexualia 9 *orda sp9ale apud lumbos atonica esse possunt propt] morbum g5]alem1 aut v55a1 aut p>alysem4 ,impot5tia atonica frequ5s e/ 9 anaemia1 diabete mellito1 uraemia1 *olaemia1 lepra1 rheumatismo1 ataxia lumbali1 lue *ordae sp9alis1 myelitide1 p>ese1 et haemorrhagia c]ebrali4 ,aliqui tumores c]ebrales impot5tiam gignunt1 p>alysis diph!ritica causa e/ impot5tiae temporaneae1 et conditio inv5itur 9 ca*exia alicujus morbi tabesc5tis4 ,ph?isicus autem saepe pot5s e/ usque ad f9em vitae4 ,utrum impot5tia p]petua sit necne ex natura morbi dep5det4 #b4 ,impot5tia ex v55is4 ,pot5tia sexualis m9uitur vel de/ruitur abusu v55orum vel absorb5do eadem1 uti opium1 morph9a1 *loral1 potassii bromidum et iodidum1 cannabis ,indica1 c>bonei sulphidum1 ars5ium1 antimonium1 plumbum et iodum4 ,fabri1 ut pictores 7h\se-pa9t]s7 et typographi1 qui plumbo utuntur hoc modo patiuntur4 ,alcohol frequ5t] origo e/ impot5tiae1 et qu&oque tabacum eumdem #cda affectum habet s9e alio indicio physico4 ,impot5tia p]vicax esse pote/ ex utraque causa4 #c4 ,impot5tia ex irritatione4 ,irritatio *ronica ure?rae pro/aticae e libid9e1 gonorrhoea1 ma/urbatione1 ur9a acida aut neurosibus g5ito-ur9>iis impot5tiam inducit4 ,neuroses c5trorum sexualium s5sibiles aut motoriae esse possunt1 et neuroses motoriae qu&oque impot5tiam creant4 ,prognosis hujusmodi impot5tiae fau/a e/ nisi ads9t sp]matorrhoea et g5italium atrophia4 ,pro/atorrhoea quoque impot5tiae causa esse pote/1 et hic prognosis melior quam 9 sp]matorrhoea e/4 ,a?letae1 ut pugil1 cursor1 et alii ejusdem classis temporalit] impot5tes esse possunt ,,iii4 ,impot5tia ,organica4 ,mas impot5s esse pote/ propt] mal=mationes cong5itas aut acquisitas1 morbos et defectus g5italium4 #a4 ,abs5tia cong5ita aut po/natalis p5is impot5tiam insanabilem creat4 #b4 ,p5is rudim5t>ius causa impot5tiae e/1 s$ casus amplificationis po/ matrimonium hab5tur4 #c4 ,p5is multiplex r>issime impot5tiam creat4 #d4 ,hyp]trophia p5is aut praeputii1 et magnitudo relativa p5is r>issime efficiunt hom9em impot5tem4 #e4 ,adhaesio p5is scroto1 +u5i vel abdom9i r$dit hom9em impot5tem2 sanabilis autem e/ conditio4 #f4 ,impot5tiam qu&oque creat hypospadias1 seu abs5tia p>tis inf]ioris ure?rae1 et epispadias1 seu abs5tia p>tis dorsalis ure?rae2 s$ conditiones a *irurgo san>i pl]umque possunt1 qu&oque autem nequeunt4 #g4 ,di/ortiones p5is e podagra1 lue1 rheuraatismo1 et gonorrhoea impot5tem faciunt virum qu&oque imm$icabilit]4 #h4 ,aneurysma corporum cav]nosorum et v>ix v5ae dorsalis p5is impot5tiae a *irurgo sanabilis causae sunt4 #i4 ,fr5um gl&ulae p5is curtum nimis incurvat p5em1 et ita vir impot5s e/4 ,conditio facile a *irurgo remov]i pote/4 #aj4 ,r>issime an*ylosis articulam5ti cox5dicis et v5t] p+u$9eus impot5tem virum r$dit4 ,an*ylosis insanabilis e/4 #aa4 ,tumores et increm5ta morbida circa g5italia1 ut #cdb h]niae1 hydrocele1 haematocele1 elephantiasis1 lipoma1 c>c9oma1 s>coma1 cy/oma1 en*ondroma1 et fibroma causae sunt impot5tiae4 ,h]niae1 lipoma1 hydrocele1 haematocele1 et qu&oque elephantiasis scroti san>i possunt2 tumores b5igni et maligni aliqu&o remov5tur s$ vulgo amputatione p5is aut te/iculorum4 #ab4 ,te/iculi m>cescunt 9 v>icocele et impot5tia sequitur4 ,v>icocele amov]i pote/1 et si mature op]etur *irurgus impot5tia evitatur4 ,lues te/iculorum de/rui pote/ sub/antiam te/iculorum nisi morbus mature sanetur1 et impot5tia pote/ esse absoluta4 ,tub]culosis te/iculorum de/ruit organum4 #ac4 ,anor*ismus seu abs5tia te/iculorum bilat]alis et cong5ita1 idem efficit ac ca/ratio4 ,conditio r>a e/ ,cryptor*ismus1 seu ret5tio te/iculorum 9 abdom9e1 pl]umque /]ilitatem gignit non necess>io impot5tiam4 ,ca/ratio completa1 morbo vel secus1 impot5tiae causa e/1 s$ non necess>io /atim po/ ca/rationem4 ,gross 7,a ,practical ,treatise on ,impot5ce1 ,philadelphiae4 #ahij7 citat quattuor casus 9 quibus erectio p]manebat1 9 uno hom9e usque ad dec5nium4 ,kruegel/e9 7,h5ke's ,zeits*rift4 #ahdb4 vol4 ,i1 p4 #cdh7 dicit virum quemdam po/ amissionem te/iculorum uxorem foecundavit4 ,si casus rev]a contig]it1 sp]matazoa 9 vesciculis sem9alibus p]mans]ant4 #ad4 ,pro/atitis *ronica causa e/ impot5tiae et pl]umque insanabilis e/4 #ae4 ,nulla regula firma d>i pote/ de impot5tia physiologica s5ectutis 9 m>ibus4 ,viri sexto et octogesimo anno non solum pot5tes inv5ti sunt s$ etiam lib]os g5]av]unt4 ,pot5tia g5]&i 9 m>ibus vulgo circa annum sexagesimum-secundum cessat1 exceptiones autem multae inv5iuntur4 ,pot5tia coeundi p]man]e pote/ longe po/ annum sexagesimum-secundum4 ,ecclesia igitur s5es cujuscumque aetatis ad matrimonium admittit2 et confess>ius nihil rogat de pot5tia nisi ab ipso s5e int]rogatur4 ,si confess>ius sciat s5em rev]a impot5tem esse1 non p]mitt]e debet matrimonium ejus4 #af4 ,op9io videtur esse morali/>um ad hab5dam copulam c>nalem necess>iam esse non solum erectionem et #cdc intromissionem s$ ettam insem9ationem plus m9usve p]fectam4 ,laymann 7,de ,imp$4 ,matr41 cap4 #aa7 ait3 ,impot5tia p]petua ad copulam p]fectam dirimit matrimonium subsequ5s4 ,et addit3 ,dixi p]fectam1 id e/1 quae fit cum effusione v]i sem9is 9 vas muliebre4 ,ma/rius 7loco jam citato7 t5et insem9ationem esse necess>iam4 ,lehmkuhl 7,!ol4 ,mor47 9 def9itione impot5tiae absolutae dicit talem esse impot5tiam quae aliquem ad quamlibet copulam consummatam inhabilem r$dit4 ,hic utitur vocibtis1 copula consummata1 9 qua ,ball]9i requirit insem9ationem quasi p]fectam 7op1 cit41 vol4 #f1 p4 #agh71 et ,san*ez 7,de ,matr41 lib4 #b1 disp4 #ba1 n4 #e7 insem9ationem imp]fectam4 ,petrus de ,l$esma quoque 7apud ,es*ba*4 ,disputationes ,physico-,!ologiae4 ,disp4 #bjj7 de s5ibus loqu5s ait3 ,si enim s5es ita s5io confecti et exhau/i1 quod nullo modo sem9e valeant1 quamvis poss9t erig]e membrum et p5etr>e vas1 non possunt contrah]e1 et si contrahunt1 matrimonium e/ invalidum4 ,qui /]iles sunt ita sunt ex tribus causis3 7#a7 ,asp]mia1 seu abs5tia absoluta sem9is2 7#b7 ,azoosp]mia1 seu abs5tia sp]matozoon 9 sem9e2 7#c7 ,oligosp]mia1 seu c>5tia alicujus p>tis sem9is4 ,asp]mia vulgo efficitur occlusione ure?rae vel oblit]atione p>tis ejusdem4 ,defectus i/i cong5iti esse possunt vel ex morbo aut vuln]e4 ,tumores tractus g5]ativi claud]e possunt aditum int] te/iculos meatumque ur9>ium et ita asp]mia efficitur4 ,spadones1 etiamsi r>o pot5tiam habeant intromissionis1 asp]mia afflictantur quoad p>tem sem9is ex te/iculis prov5i5tem 79 qua sp]matozoa sunt71 s$ humor ex p>te ant]iori tractus g5]ativi adesse aliquo modo pote/4 ,azoosp]mia f]e eodem modo oritur1 ob/ructio autem vel de/ructio prope te/iculos e/1 et ita secretio ali>um p>tium tractus g5]ativi exire pote/1 s$ s9e sp]matozois4 ,9 ,oligosp]mia sp]matozoa adesse possunt1 s$ quia aliud elem5tum sem9is dee/ sp]matozoa in]tia sunt4 ,casus inv5iuntur 9 quibus propt] mal=mationem sem5 p]fectum 9 vesicam ur9>iam ejactatur4 #cdd ,omnes i/ae conditiones insanabiles esse possunt1 r>o san>i possunt4 ,e/ne vir asp]matosus1 seu c>5s sem9e1 impot5s8 7#a74 ,affirmant multi morali/ae qui insem9ationem requirant talem impot5tem4 7#b74 ,ejectio sem9is confectio e/ actus sexualis viro1 et alia 9 actu ejectioni m]e conducunt4 ,9 ,azoosp]mia copula c>nalis qua copula eadem e/ ac 9 coitu normali3 microscopium solum aut /]ilitas abs5tiam sp]matozoon detegunt4 ,9 ,oligosp]mia coitus quoque normalis esse p>et4 ,op9or virum asp]matosum impot5tem sub lege esse quia nequit copulam sexualem p]fic]e2 e contra1 virum oligo-sp]matosum aut azoosp]matosum /]iles tantum esse4 ,impot5tia igitur def9iri pote/1 9 viro3 ,impot5s e/ quum 7#a7 vel absolute et p]petua1 vel relative et p]petua1 incapax sit intromissionis et quasi insem9ationis2 aut 7#b7 quum spado sit1 et ita sub decreto ,sixti ,v v5iat4 ,impot5tia 9 muli]e def9iri pote/3 quum nullam vag9am vel vag9am p]petuo imp5etrabilem habeat2 vel cum pa?ologice recuset m>em4 ,impot5tia coeundi pote/ esse 7#a7 aut antec$5s aut consequ5s2 pr\t matrimonii contractum anteit aut illi sup]v5it2 7#b7 p]petua seu insanabilis1 aut temporanea2 7#c7 absoluta aut relativa1 9 quantum aliquem ad quemlibet copulam consummatam inhabilem r$dit1 aut tantummodo usum matrimonii int] duas c]tas p]sonas impossibilem facit 7,lehmkuhl74 ,ut impot5tia tanquam imp$im5tum matrimonii dirim5s habeatur1 debet esse3 7#a7 impot5tia coeundi2 7#b7 insanabilis2 7#c7 antec$5s2 7#d7 aut absoluta aut relativa4 ,,augu/9us ,,omalley4 #cde ,,app5dix #cdf #cdg ,,app5dix ,,bloody ,,sweat ,! bloody sweat ( our ,"l m5tion$ 9 ,sa9t ,luke's ,gospel 7xxii41 #dd71 has giv5 rise to n a little discussion4 ,! ,greek text is3 ,greek text4 ,! ,vulgate has ?is text ?us3 ,et factus e/ sudor ejus sicut guttae sangu9is decurr5tis 9 t]ram4 ,! ,d\ay v]sion is3 ,& 8 sweat became z drops ( blood trickl+ d[n ^u ! gr\nd4 ,! ,k+ ,james translation has x3 ,& 8 sweat 0 z x 7 great drops ( blood fall+ d[n to ! gr\nd4 ,! ,greek text & ! ,vulgate & ,d\ay v]sions are ! same1 b 9 ! ,k+ ,james translation ! words1 z x 7 great diff] some:at f ! /atem5t 9 ,greek4 ,! belief 9 ! ,ca?olic ,*ur* is t our ,"l lit]ally sweat blood ?r\gh ,8 unbrok5 sk91 & ?is sweat is commonly deem$ miracul\s4 ,^? t d5y ! sweat 0 really blood h no gr\nd :atev] = _! ass]tion1 because ap>t f all miracle bloody sweat c be a purely natural occurr5ce4 ,dr4 ,j4 ,h4 ,pooley1 9 ,! ,popul> ,sci5ce ,mon?ly 7vol4 #bf1 p4 #ceg71 has an article on ?is subject 9 :i* he report$ #dg cases ( bloody sweat ?r\gh unbrok5 sk94 ,he1 h[ev]1 is ( ! op9ion t our ,"l's sweat _h no real blood 9 x4 ,:atev] 8 reason may be = ?is ass]tion he c>efully conceals x4 ,hemorrhage ?r\gh ! unbrok5 sk9 is a r>e occurr5ce2 b1 z has be5 said1 ,dr4 ,pooley f\nd #dg cases report$1 & !re are probably _m o!rs4 ,! dis*>ge may be pure blood :i* coagulates 9 cru/s1 or x may be blood mix$ ) sweat2 x may be pres5t ov] ! :ole surface ( ! body or only 9 ^? p>ts :]e ! #cdh sk9 is ?9 & delicate4 ,commonly1 bloody sweat is an ooz+1 b ,hebra1 is 8 ,diseases ( ! ,sk91 tells ( a "y man t he himself obs]v$1 f ^: legs & h& blood ran1 sometimes 9 m9ute jets "o-twelf? ( an in* 9 height4 ,! sk9 0 s\nd1 & ! bloody sweat 0 n caus$ by any emotion4 ,! fl[ may be int]mitt5t1 appe>+ at int]vals f a few h\rs to mon?s4 ,sometimes ! dis*>ge is connect$ ) sk9 diseases1 b (t5 ! sk9 is unaffect$4 ,examples h be5 f\nd at e age & 9 bo? sexes1 b ?is sweat is common] 9 wom54 ,du ,g>d reports an in/ance 9 a *ild only ?ree mon?s old1 & ,spol9us tells ( su* a sweat 9 a *ild twelve ye>s ( age4 ,bloody sweat may occur 9 mal>ia2 x may be connect$ ) neura/h5ic conditions1 & x has be5 caus$ frequ5tly by ov]:elm+ emotion1 z t]ror & angui%4 ,de ,?\ tells ( a ,fr5* (fic] :o 0 9 comm& at ,monte ,m>o 9 ,pi$mont 9 #aeeb1 :o sweat$ blood aft] he _h be5 ?reat5$ ) an ignom9i\s execution if he did n surr5d] ! t[n4 ,! same writ] m5tions a "y ,flor5t9e1 put to dea? 9 ,rome dur+ ! pontificate ( ,sixtus ,v1 :o sweat$ blood be=e execution4 ,! ,society ( ,arts at ,ha>lem report$ ! case ( a ,dani% sailor :o sweat$ blood ?r\gh t]ror 9 a /orm4 ,?is man 0 obs]v$ c>efully by a physician on ! %ip4 ,! physician at fir/ ?\ght ! man _h be5 w\nd$ by a fall1 b aft] wip+ away ! blood he discov]$ t ! ooz+ came ?r\gh un9jur$ sk94 ,:5 ! /orm _h ceas$ ! sailor at once rega9$ a heal?y condition4 ,9 ! ,fr5* ,transactions m$icales1 = ,novemb]1 #ahcj1 is n>rat$ ! case ( a "y woman :o _h turn$ f ,prote/antism to ,ca?olicism1 & aft] ?is conv]sion %e grew hy/]ical because ( p]secution by h] family4 ,dur+ ! hy/]ical attacks %e sweat blood f ! surface ( h] *eeks & belly4 ,be=e ! ,*ri/ian era bloody sweat 0 obs]v$ by ,ari/otle1 ,gal51 ,diodorus ,siculus1 & ,lucan also m5tion su* occurr5ces4 ,! /igmata ( "s sa9ts are au!nticat$ cases ( ble$+ ?r\gh ! s\nd sk9 ( ! h&s1 feet1 & side dur+ extraord9>y sympa?y ) our ,"l 9 ,8 ,passion1 & deep m5tal conc5tration ^u t ,passion1--! /igmata ( ,sa9t ,francis ( ,assisi1 = example4 ,su* ble$+ is reg>d$ 9 ! ,*ur* z miracul\s4 ,ap>t f any "q ( fai?1 !re is no reason :y !y may n be #cdi miracul\s1 especially if ! sup]natural quality is support$ by o!r facts2 b1 aga91 su* /igmata c be natural4 ,to prove1 9 g5]al1 t /igmata are miracul\s requires commonly h]oic sanctity z a backgr\nd1 & ev5 !n 9 all cases ! pro( is n necess>ily absolute4 ,foca*on1 a *emi/ at ,*>mes1 appli$ po/age /amps to ! left %\ld] ( a hypnotis$ subject1 & kept !m 9 place ) ord9>y /ick+ pla/] & a b&age4 ,he sugge/$ to ! pati5t t he _h appli$ a bli/]4 ,! subject 0 wat*$1 & aft] tw5ty-f\r h\rs ! b&age1 :i* _h be5 unt\*$1 0 remov$4 ,! sk9 "u ! po/age /amps 0 ?ick5$1 necrotic1 ( a yell[i%-:ite col\r1 puffy ) ! s]um ( ! blood & leucocytes1 & surr\nd$ by an int5sely r$ zone ( inflammation4 ,sev]al physicians1 includ+ ,beaunis1 confirm$ ?is obs]vation2 & ,beaunis made photographs ( ! bli/]1 :i* he %[$ to ! ,society ( ,physiological ,psy*ology1 ,june #bi1 #ahhe4 7,animal ,magnetism4 ,b9et & ,f]e4 ,new ,york1 #ahhi47 ,9 ,ric>d's ,j\rnal de magnetisme animal1 #b;d ye>1 #ahdj1 pp4 #ah1 #aea1 is a simil> case4 ,prejalm9i1 9 ,novemb]1 #ahdj1 rais$ a bli/] on ! heal?y sk9 ( a somnambuli/ by a piece ( ord9>y writ+ pap] on :i* he _h writt5 a prescription = a bli/]4 ,at ! meet+ ( ! ,societe de biologie1 on ,july #aa1 #ahhe1 ,b\rru & ,burot1 pr(essors ( ! ,ro*e=t s*ool1 publi%$ records ( epi/axis & ( bloody sweat1 produc$ by sugge/ion on a male hy/]ic4 ,on "o occasion1 aft] ! pati5t _h be5 hypnotis$1 8 "n 0 trac$ ) ! end ( a blunt probe on bo? ! pati5t's =e>ms4 ,!re 01 ( c\rse1 no m>k ( any k9d left on ! arms4 ,!n ! pati5t 0 told3 ,?is aft]noon1 at f\r o'clock1 y w g to sleep1 & blood w !n issue f y\r arms on ! l9es :i* ,i h n[ trac$4 ,! man 0 p>alytic & anae/hetic on ! left side4 ,he fell asleep at f\r o'clock1 & :ile he 0 asleep ! "n appe>$ on ! s\nd left arm1 rais$ 9 a r$ :eal1 & !re 7 m9ute drops ( complete blood 7s]um & corpuscles7 9 sev]al places4 ,!re 0 no *ange on ! p>alys$ "r =e>m4 ,lat] ! pati5t himself comm&$ ! arm to ble$ & x did s4 ,?is second occurr5ce 0 obs]v$ by ,mabille4 7,b9et & ,f]e4 ,op4 cit41 p4 #aii47 ,*>cot & 8 pupils at ! ,salpetri]e h (t5 produc$ by sugge/ion alone ! effects ( burns ^u ! sk9 ( hypnotis$ pati5ts4 ,! bli/]s 9 ^! cases did n appe> at once #cej b aft] "s h\rs _h elaps$4 ,! bli/]s1 ( c\rse1 conta9$ blood4 ,! weekly ble$+1 ?r\gh ! unbrok5 sk91 ( ! h&s & feet ( ,l\ise ,lateau is an example ( /igmata 9 our own day1 :i* may h be5 sup]natural or natural4 ,physicians w\ld call x natural1 an effect ( autohypnosis1 b !re is no reason :y x may n h be5 j z miracul\s z ! /igmata ( ! sa9ts4 ,pr(essor ,lefevre ( ! ,univ]sity ( ,l\va91 a physician1 said h] /igmata 7 miracul\s4 ,!odore ,s*wann1 ! discov]] ( ! cell doctr9e1 deem$ h] condition natural4 ,9 ! ,lett]s ( ! ,rt4 ,rev4 ,casp] ,borgess1 ,bi%op ( ,detroit1 ,mi*igan1 is an acc\nt ( a visit to ,l\ise ,lateau made 9 ,july1 #ahgg4 ,he says1 ,i fir/ seat$ myself on ! only *air 9 ! room1 :i* ,i _h plac$ at ! "r side1 ne> ! head ( ! b$4 ,l\ise's two h&s re/$ on sev]al ?icknesses ( fold$ l951 spread ov] ! b$-cov]1 & 7 cov]$ ) a fold$ l95 clo?4 ,?is ,i remov$4 ,! h&s 7 bo? heavily cov]$ ) blood2 9 "s places x _h congeal$1 & look$ v d>k2 b 9 ! c5tre1 betwe5 ! =e & little f+]s1 on ! upp] "p ( ! h&1 ! blood 0 q fre% & fl[$ freely4 ,n kn[+ at ! "t t ! wip+ ( ! h&s causes h] int5se pa91 ,i proce$$ to wipe (f ! h&s1 = a m p]fect inspection ( ! w\nd on ea* h&4 ,! w\nd1 or /igma1 on ! "r h& seem$ m ?an "o in* 9 l5g?1 ab\t half an in* at its greate/ wid?1 & 0 ( oval %ape4 ,turn+ ! h&1 ,i saw a w\nd ( ! same =m 9 ! palm ( ! h&1 & opposite ! w\nd on ! back ( ! same4 ,! blood seem$ to rise 9 bubbles1 =m+ 9 rapid succession1 fl[+ 9 a spread /ream d[n to ! wri/4 ,exam9+ ! w\nd itself1 ,i 0 well conv9c$ t ! sk9 ( ! h& 0 n brok5 nor 9 any way injur$2 & !re 0 no sign ( a w\nd made by any mat]ial in/rum5t1 %>p or dull4 ,&1 )al1 ! blood ooz+ out ( ! w\nd appe>$ a reality1 & complete 9 =m4 ,! bi%op evid5tly uses ! t]m w\nd 9 a figurative s5se1 because he draws att5tion to ! fact t ! sk9 0 intact1 cont9u\s4 ,%e bl$ f ! dorsal & palm> surfaces ( ! h&s 9 areas %ap$ l ! w\nds repres5t$ by pa9t]s on ! h&s ( our ,"l4 ,:ile ! bi%op 0 exam9+ h] h&s ,l\ise w5t into an ec/atic condition4 ,if ! ,*ur* def9es t a bloody sweat or ! /igmata ( a sa9t are sup]natural1 t def9ition1 ( c\rse1 ends ! matt] = ,ca?olics z f> z ! p>ticul> case is conc]n$2 #cea b until su* a decision has be5 made ^! conditions are all to be reg>d$ z effects ( natural causes work+ 9 a natural mann]4 ,9 _m conditions :]e ! n]v\s sy/em c h influ5ce a miracle is v difficult ( pro( f ! context4 ,!re c1 ( c\rse1 be evid5t miracles 9 ! cure ( "s n]v\s disord]s1 suppos+ ! diagnosis to be c]ta94 ,! sudd5 cure ( advanc$ p>esis w\ld be z mu* a miracle z ! sudd5 replac+ ( a lo/ femur4 ,commonly1 h[ev]1 9 neuroses if !re is an app>5tly miracul\s heal+ or simil> effect1 ! sup]natural quality c n be e/abli%$4 ,suppose ,b]nadette report$ t %e _h se5 ! ,bless$ ,virg9 at ,l\rdes3 ! only safe ?+ to d 9 su* a case is to d5y ! app>ition until x has be5 prov$4 ,suppose1 secondly1 t a pati5t :o has be5 conf9$ to b$ = ye>s by an hy/]ical p>alysis1 believ$ 9 ! reality ( ! vision1 _h himself c>ri$ to ,l\rdes1 & :ile at pray] !re he sudd5ly /ood up cur$4 ,t effect w\ld prove nei!r ! reality ( ! vision nor ! sup]natural quality ( ! cure2 nor w\ld x disprove ei!r4 ,we simply c n judge ! case1 because exactly ! same effect has happ5$ hundr$s ( times f purely natural impressions4 ,if t same p>alytic 7 ly+ 9 8 b$ at home & y set ! h\se afire he w\ld jump up & run4 ,if ! pati5t1 h[ev]1 _h be5 b$ridd5 ) a p>alysis caus$ by c]ta9 deg5]ation ( n]v\s tissue1 & he 7 cur$ 9 ! mann] describ$1 t effect w\ld be sup]natural1 miracul\s2 always provid$ !re is no error 9 ! m$ical diagnosis4 ,!re is a g5u9e diabetes & a pseudodiabetes4 ,! latt] condition may be diagnos$ z true diabetes by a numb] ( physicians1 b x is only a symptom ( hy/]ia4 ,if ! pseudodiabetes is sudd5ly cur$1 ?is cure may or may n be miracul\s1 b no "o c say :i* is ! tru?2 ! probability is a hundr$ to "o t ! cure is altoge!r natural4 ,!re 0 a fl\ri%+ ,*ri/ian ,sci5ce congregation e/abli%$ 9 ! we/ rec5tly ^u miracul\s cure ( a case ( pseudodiabetes1 :i* "s ignorant physicians _h call$ true diabetes1 not)/&+ ! fact t ,*ri/ian ,sci5ce does n believe 9 ei!r diabetes or false diabetes4 ,we mu/ n1 !n1 call e /range ev5t miracul\s2 nor1 :at is worse1 are we ra%ly to make ! sup]natural a matt] to be expla9$ away l(tily by ! impud5ce ( half sci5ce4 ,a ,belgian prie/ nam$ ,hahn wrote a monograph #ceb to ! effect t ! ec/atic conditions obs]v$ 9 ! life ( ,sa9t ,t]esa 7 autohypnotic1 & he succe$$ 9 draw+ ^u himself ! undivid$ att5tion ( ! ,congregation ( ! ,index & a s]i\s di/urbance ( 8 peace ( m9d4 ,he became a m>tyr to sci5ce4 ,we all l to be lib]al1 imp>tial2 b f ! religi\s ,mugwump lib]a nos1 ,dom9e6 ,autohypnosis is always a m>k ( deg5]acy 9 ! natural ord]1 & to call ! ec/acy ( a sa9t autohypnosis n only takes all wor? f ! manife/ation1 b ! ass]tion is also untrue4 ,!re is a va/ diff]5ce betwe5 ! int5se intellectual contemplation ( a great sa9t 9 ec/acy1 :i* leaves ! p]son unconsci\s ( ! body & its surr\nd+s1 & ! cataleptic trance ( a neurotic pati5t :o may mimic ! sa9t4 ,hypnotic or autohypnotic /igmata1 & by /igmata "h is meant ble$+ f ! h&s1 feet1 & side1 w\ld be deg5]acy ( ! m9d & body 9 ! natural ord]4 ,moreov]1 no cle>ly e/abli%$ cases are kn[n1 because conditions l ^? ( ,l\ise ,lateau are by no means c]ta9ly physical f all po9ts ( view1 z !y w\ld be if !y occurr$ 9 an ord9>y hy/]ic4 ,9 hypnosis or autohypnosis ! subject's m9d & body are deg5]ate2 9 sanctity1 :]e at times may be display$ c]ta9 effects t resemble autohypnosis1 !re is always a s\nd m9d4 ,a sa9t may h an uns\nd1 neurotic body1 b a crazy sa9t or an hy/]ical sa9t is no bett] ?an any o!r lunatic or hy/]ic1 & c]ta9ly any?+ b a sa9t4 ,if a sa9t has /igmata1 ^! ext]nal m>ks might come 7#a7 miracul\sly1 z a gratuit\s sign ( div9e fav\r2 7#b7 z an effect ( natural1 int5se contemplation ( ! ,passion ( our ,"l1 produc+ ^! ble$+s 9 a s\nd body2 or 7#c7 z an effect ( a rational1 int5se contemplation ( ! same ,passion1 act+1 m easily1 on a neurotic body4 ,sci5tific !oris+ on ?is matt] is necess>ily /]ile1 because su* an inve/igation is only half mat]ial = sci5ce1--physical sci5ce4 ,sci5ce is n a bad ?+ 9 itself1 especially :5 x m9ds its own bus9ess & keeps its place bel[ /airs2 b x nev] sympa?ises ) sanctity1 & !re is no deep k )\t sympa?y4 ,fact-gr9d+ made ,d>w9 nauseate ,%aksp]e4 ,sci5ce c n see 9 ! d>k z g5ius & sanctity see1 & if x does see 9 ! d>k x is no long] sci5ce b g5ius work+ on a sci5tific object4 ,z ,pr(essor ,william ,james said3 ,sci5ce tak5 9 its ess5ce %\ld /& only = a me?od1 & n = any special beliefs1 yet1 z habitually tak5 by its #cec vot>ies1 ,sci5ce has come to be id5tifi$ ) a c]ta9 fix$ g5]al belief1 ! belief t ! deep] ord] ( ,nature is me*anical exclusively1 & t non-me*anical categories are irrational ways ( conceiv+ & expla9+ ev5 su* a ?+ z human life4 ,sci5ce %\ld recognise its own limitations & n m$dle 9 attempt$ explanations ( ! inexplicable4 ,!re=e1 :at ( ! /igmata ( ! sa9ts f a sci5tific po9t ( view8 ,!re is no sci5tific po9t ( view4 ,,au/9 ,,omalley4 #ced #cee ,,index #cef #ceg ,,index ,a ,abdom9al pregnancy1 #e4 ,abortion1 #bb1 #dh2 causes (1 #dh1 #di1 #ea1 #eb1 #ec2 9 pu]p]al pneumonia1 #aea2 tubal1 #f4 ,abortus1 #ai1 #bj1 #di4 ,acephalus1 #ge4 ,act9omyces1 visits 91 #ahc4 ,acute indige/ion 9 ! ag$1 #aed4 ,addison's disease1 dea? 91 #aee2 symptoms (1 #aef4 ,adipoc]e1 #g4 ,a]tnys on ectopic ge/ation1 #bf1 #bg4 ,aggressor1 #ah1 #ai4 ,agoraphobia1 #bif4 ,air-space1 #bjd4 ,alcohol1 effects on ! m9d1 #aji2 9 propriet>y m$ic9es1 #ic2 9 snake-poison+1 #aah2 9 typhoid fev]1 #aah4 ,alcoholic amnesia1 #aaj2 climact]ic1 #ajh2 delusions1 #aji1 #aaj2 insanity1 #ajg1 #aje1 #aji2 liquors1 #ajh2 poison+1 #ajg1 #aji1 #aaj2 pseudo-p>anoia1 #aji4 ,alcoholism1 #aje2 & cirrhosis ( ! liv]1 #aef2 & coma1 #ach2 & conjugal infidelity1 #aji2 & epilepsy1 #bef2 & idiocy1 #aac2 & imbecility1 #aab1 #aad2 & m>riage1 #aaa1 #abf2 & pneumonia1 #aea2 & surgical op]ations1 #afc2 & ! w1 #aaa2 causes (1 #ajh2 *ildr5 91 #aab2 complicat+ disease1 #afb2 temp]ance societies1 #aab4 ,amateur m$ical advice1 #hi4 ,ambulatory epilepsy1 #bfa4 ,am5orrhoea1 #bda4 ,amnesia & epilepsy1 #bfc4 ,ampull> pregnancy1 #e4 ,amputations1 ut]9e1 #fe4 ,anae/hesia 9 mania1 #bbg4 ,anatomia g5italium muli]is1 #cca4 ,&rogynia1 #cdj4 ,aneurism1 causes (1 #aee2 dea? 91 #aee4 ,ang9a pectoris1 dea? 91 #adb4 ,ano9t+ 9 smallpox1 #agg4 ,anopheles mosquito1 #ahf4 ,an?rax1 visits 91 #ahd4 ,antitox91 #aga1 #aie4 ,aortic valvul> disease1 dea? 91 #adj4 ,apoplexy1 #adc2 & fa9t+1 #ade2 h>d art]ies &1 #add2 %ort neck &1 #adf2 symptoms (1 #add2 ! ?ird /roke 91 #adf2 treatm5t 91 #ade2 v]tigo &1 #add4 ,app5dicitis1 p]itonitis 91 #aec2 prognosis 91 #aec4 ,apraxia1 #bfc4 ,ari/otle1 8 det]m9ants ( morality1 #ad4 ,art]ies 9 apoplexy1 #adf4 ,art]ioscl]osis & apoplexy1 #add4 ,aspects ( intoxication1 #aje4 ,asp]mia1 #cdc4 ,asomata1 #ge4 ,assass9s ( presid5ts1 #cjb4 ,atresia vag9ae et impot5tia1 #ccc4 ,autohypnosis1 #acj4 ,autositic mon/]s1 #ge4 ,azoosp]mia1 #cdc4 ,b ,bact]ia1 #afh2 k9ds (1 #afi2 specific causes ( disease1 #afi4 ,baptism 9 ectopic ge/ation1 #hc2 ( mon/]s1 #hg4 ,b>b]'s it*1 contagi\sness1 #aih4 ,b>k]s1 #bcg4 ,be]1 p]c5tage ( alcohol 91 #ajh4 ,b]ib]i1 visits 91 #ahd4 ,bibliography ( hypnotism1 #aag4 ,bi*loride ( m]cury1 a dis9fectant1 #aia4 ,black dea?1 #ahd2 mortality (1 #ahd4 ,black fev]s1 #afj4 ,ble$]s1 #abd4 ,blood br\ght out by sugge/ion1 #cdi4 ,bloody sweat1 #cdg2 & hypnosis1 #cdi2 cases (1 #cdh4 ,books & infection1 #aie2 dis9fection (1 #aij4 ,borgess on ! ,lateau case1 #cej4 ,bra9 tum\rs1 #adh2 & syphilis1 #cbb2 symptoms (1 #adh4 ,bre$+ places ( mosquitoes1 #ahf4 ,breuss' ovum1 #gc4 #cef ,brick 9 build+s1 #bjc4 ,broad ligam5t1 #c4 ,broad-ligam5t pregnancy1 #e4 ,bromides & epilepsy1 #ih4 ,bubonic plague1 mortality 91 #ahe2 transmission (1 #ahe2 visits 91 #ahd4 ,build+ mat]ials1 #bjc4 ,build+ sites1 #bjb4 ,burns1 dea? 91 #aef4 ,c ,caes>ean section1 #da1 #db1 #ea1 #ee2 & sepsis1 #ef1 #eg2 indications =1 #ee2 /ati/ics (1 #ee4 ,canc] complicat+ pregnancy1 #dd2 dea? 91 #aeh4 ,canonical law on impot5ce1 #cbf4 ,c>bonic add 9 ! air1 #bjf4 ,c>diac massage1 #afe4 ,c>5tia ov>iorum1 #ccd4 ,c>pets1 dis9fection (1 #aid4 ,cases ( ectopic ge/ation1 #bb4 ,ca/ratio et impot5tia1 #cdb4 ,cat>rh & propriet>y drugs1 #ajj ,ca?>tics1 #ajj4 ,causae impot5tiae muli]is1 #ccb4 ,cats & diph!ria1 #aie4 ,cells1 #fi4 ,cellul> activity & dea?1 #afd4 ,c5trosome1 #gj4 ,c]ebrosp9al m5+itis1 #adh1 #ahb4 ,c]ebral neura/h5ia1 #bcj4 ,*ick5pox1 #aig4 ,*ildr5 ( drunk>ds1 #aab2 suicide (1 #cjh4 ,*orea1 #ea2 & m5/rual disord]s1 #bdc4 ,*romat91 #gj4 ,*romosomes1 #gj1 #ga4 ,circul> insanity1 #bbh4 ,circum/ances m morality1 #ab4 ,cirrhosis ( ! liv]1 causes (1 #aef2 dea? 91 #aef4 ,classrooms1 #bjd4 ,clau/rophobia1 #bif4 ,clo!s1 dis9fection (1 #aia4 ,coca9e1 insanity f1 #aaf2 intoxication1 #aae1 #aaf1 #aag4 ,coeliotomy1 #d4 ,coleli?iasis1 dea? 91 #afj4 ,coma & alcoholism1 #ach2 & kidney disease1 #ach4 ,composite mon/]s1 #gg4 ,compulsory vacc9ation1 #age4 ,conflu5t smallpox1 #agb4 ,cong5ital syphilis1 #cac2 /ati/ics (1 #cac4 ,conjugata v]a1 #ee1 #ef1 #eg4 ,conjunctivitis1 infecti\sness (1 #aii4 ,con9ck on impot5ce1 #ccj4 ,consangu9ity & mon/]s1 #gf4 ,consci5ce1 #ae4 ,con/ipation1 #ajj4 ,contagion1 #afh4 ,copula c>nalis1 #cca4 ,corni% jump]s1 #bcg4 ,c\gh1 physiology (1 #ia4 ,convulsionnaires1 #bcg4 ,cranial asymmetry & crime1 #bgb1 #bge4 ,craniopagus1 #hd4 ,craniotomy1 #bb1 #bh1 #db1 #ee1 #ef1 #eh1 #ei2 indications =1 #eh2 mortality 91 #ei4 ,cranks1 #bhb4 ,crile's me?od ( resuscitation1 #aff4 ,crime1 suppression (1 #bgh4 ,crim9al types n a sci5tific fact1 #bga4 ,crim9als1 indet]m9ate s5t5ce =1 #bgi4 ,crim9ology & ! habitual crim9al1 #bga4 ,cross immunisation1 #agb4 ,cyclops1 #ge4 ,cy/s complicat+ pregnancy1 #dj1 #da4 ,cytoplasm1 #gj4 ,d ,danc+ plague1 #bcf4 ,dea? f alcohol1 #afb2 f v>icose ve9s1 #aei2 9 acute indige/ion1 #aed2 9 ,addison's disease1 #aee2 9 aneurism1 #aee2 9 app5dicitis1 #aec2 9 burns1 #aef2 9 canc]1 #aeh2 9 cirrhosis ( ! liv]1 #aef2 9 coleli?iasis1 #afj2 9 delirium trem5s1 #afb2 9 dys5t]y1 #aee2 9 e> disease1 #aei2 9 ga/ric ulc]1 #afa2 9 hydrophobia1 #afa2 9 kidney diseases1 #acg2 9 ! lymphatic dia!sis1 #aeg2 9 mania1 #bbg2 9 pancreatitis1 #afj2 9 rheumatism1 #aec2 9 tetanus1 #afa2 9 tub]culosis1 #aeh2 mom5t (1 #afd2 prognosis (1 #acf2 resuscitation aft] app>5t1 #afd2 unexpect$1 #ace4 ,deg5]ation & crim9als1 #bga4 ,deg5]acy1 symptoms (1 #bgd4 ,de imp$im5to impot5tia1 #cbf4 ,dejecta1 dis9fection (1 #aib4 ,de ,lugo1 on homicide1 #ah4 ,delirium trem5s1 #aji2 dea? 91 #afb4 ,delusions 9 melan*olia1 #bba4 ,dem5tia1 #bbh4 ,d5gue1 visits 91 #aha4 ,d]moid cy/s1 #hf4 ,desks 9 s*ools1 #bjg4 ,desquamation aft] disease1 #aig4 ,de/ruction ( infect$ articles1 #aid4 ,dicephali1 examples (1 #hj1 #ha4 ,dicephalus1 species (1 #gi1 #hj4 #cei ,diph!ria & dome/ic animals1 #aie2 antitox91 #ajc1 #aie2 bacillus1 p]si/5ce (1 #aib2 cause (1 #ahg2 communication (1 #ahg1 #aij2 dis9fection 91 #aij1 #aic2 error 9 diagnosis (1 #ahg2 immunity aga9/1 #ahh2 9 a s*ool1 #aif2 precautions aga9/1 #aij2 visits 91 #aha4 ,diprosopi1 species (1 #gi4 ,dipsomania1 #aaj2 cur$ by hypnotism1 #aag4 ,dipygi1 #hc4 ,diseases caus$ by bact]ia1 #afi2 caus$ by plasmodia1 #afi4 ,dis9fection by =mal91 #aic2 by /eam1 #aic2 9 diph!ria1 #aij2 ( c>pets1 #aid2 ( clo?+1 #aia2 ( dejecta1 #aib2 ( eat+ ut5sils1 #aib2 ( money1 #aid2 ( rooms1 #aic2 ( ! body1 #aic4 ,divorce & impot5ce1 #cbf4 ,dome/ic animals & diph!ria1 #aie4 ,dormitories1 #bjd4 ,d\ble autositic mon/]s1 #gi4 ,draehms on ! crim9al1 #bgb4 ,dra9age1 defects (1 #bjc2 ( build+s1 #bjc4 ,dr9k+ cups & infection1 #aie4 ,drunk5ness1 acc\ntability 91 #ajf4 ,dysm5orrhoea1 #bdb2 v>ieties (1 #bdb4 ,dys5t]y1 dea? 91 #aee4 ,e ,e> disease & dea?1 #aei4 ,eclampsia1 #eb4 ,ec/acy ( sa9ts & hy/]ics1 #ceb4 ,ectod]m1 #gc4 ,ectopic ge/ation1 #a2 baptism 91 #aa2 *ildr5 sav$ 91 #cj2 difficult to diagnose1 #h2 location (1 #a2 m$ical treatm5t (1 #aj2 op9ions ( physicians1 #h1 #i2 /ati/ics (1 #cc1 #cd2 surgical op]ation =1 #bc4 ,effect ( actions1 #ad1 #ae4 ,embryo1 #d2 developm5t (1 #gc1 #gd4 ,embryotomy1 #eh4 ,emmet on ectopic ge/ation1 #h4 ,end 9 morality1 #ac4 ,endod]m1 #gc4 ,epibla/1 #gc4 ,epidemic hy/]ia1 #bcf1 #bcg4 ,epilepsy1 ambulatory =m (1 #bfa2 & alcoholism1 #bef2 & homicide1 #bec2 & insanity1 #bec2 & lapse ( memory1 #bfb2 & religiosity1 #bed2 & responsibility1 #bea2 age at developm5t1 #beh2 examples ( cases (1 #bei1 #bfb2 idiopa?ic =m (1 #beg2 irritability 91 #bec2 mask$ or psy*ic1 #beb2 notions ( p]secution 91 #bee2 prognosis 91 #beg2 symptoms (1 #beb2 treatm5t (1 #ii1 #beh4 ,epileptics & bromides1 #ih4 ,epilepti=m convulsions1 #bef4 ,erli*'s !ory ( immunity1 #aga4 ,erysipelas1 visits 91 #ahc4 ,eunu*s & impot5ce1 #cbg4 ,eviratio1 #cci4 ,evisc]ation1 #eh4 ,exoph?almic goitre1 #bdg4 ,extreme unction 9 smallpox1 #agg4 ,extraut]9e pregnancy1 #a1 #aed4 ,eye1 diph!ria 9 !1 #bjj2 gonococci 9 !1 #bjj2 infections ( !1 #aii4 ,eyesight & s*ools1 #bjh4 ,f ,fa9t+ & apoplexy1 #ade4 ,fallopian tubes1 #a1 #b2 rupture (1 #e4 ,false ang9a pectoris1 #adb4 ,favus1 contagi\sness (1 #aih4 ,fecundation1 #c4 ,fibroid tum\rs 9 pregnancy1 #da4 ,fimbria ov>ica1 #b4 ,fission fungi1 #afh4 ,fission !ory = composite mon/]s1 #gg1 #gh4 ,flat pelves1 #ef4 ,foetal blood1 #fg4 ,foetal dea?1 causes (1 #h2 9 ectopic ge/ation1 #f4 ,foetus1 #d2 anideus1 #ge2 9 ut]o1 #fg2 :5 viable1 #d4 ,food 9 s*ools1 #bjh4 ,=mal9 dis9fection1 #aij1 #aic4 ,fractures ( ! skull1 #adg4 ,frigidity1 #ccj4 ,fusion !ory = mon/]s1 #gg4 ,g ,gall /ones1 #afj4 ,gambl+ mania1 #bie4 ,gambl]'s p>anoia1 #bie4 ,g>field's assass9ation1 #cjc4 ,ga/ric ulc]1 dea? 91 #afa4 ,ga/ritis1 dea? 91 #aed4 ,ga/rula1 #gc4 ,g5icot on ectopic ge/ation1 #ba4 ,g5italia m>is1 #ccf4 ,g5italia muli]is1 #cca4 ,g]m9al vesicle1 #gb4 ,ge/ation1 duration (1 #c2 ectopic1 #a2 t]m (1 #d4 ,gl&]s1 visits 91 #aha4 ,glottis1 o$ema ( !1 #aci4 ,gonorrhoea1 #cbd2 & ectopic ge/ation1 #cf2 effects (1 #cae2 & m>riage1 #cae2 & /]ility1 #cbe4 ,goodell on ectopic ge/ation1 #i4 ,gr&eur1 delusions (1 #bij4 ,granul> eyelids1 #bjj4 ,graves' disease1 responsibility 91 #bdf4 ,grief & melan*olia1 #bae4 ,grippe1 visits 91 #aha4 ,guiteau's insanity1 #cjc4 ,gyn&ria1 #cdj4 #cfj ,h ,habitual crim9als1 #bga4 ,haematocele1 #f4 ,haematosalpynx1 #f4 ,h>elip1 #abc4 ,he>t disease & mania1 #bbf2 dea? 91 #adj2 9 pregnancy1 #di2 9 typhoid fev]1 #aeb2 pulse signification 91 #ada4 ,heat+ ( s*ools1 #bjf4 ,hebephr5ic melan*olia1 #cji4 ,hebra's case ( bloody sweat1 #cdh4 ,heck] on ! plague1 #ahe4 ,hemit]ata1 #gd4 ,hemophilia1 #abc4 ,h]$ity1 #abj2 & acquir$ *>act]i/ics1 #abb2 & melan*olia1 #baf2 circul> insanity &1 #bbh2 9 insanity1 #bbd1 #bbe2 mania &1 #bbd4 ,h]maphrodites1 #gd4 ,het]otaxic mon/]s1 #gd4 ,hir/ on ectopic ge/ation1 #h4 ,hola9d on ectopic ge/ation1 #h2 on self-def5ce1 #ah1 #ai4 ,holy ,(fice on abortion1 #bj1 #di1 #ej1 #ea4 ,homesickness1 melan*olia &1 #bag4 ,homicide1 #ag1 #ah2 direct1 #ag2 indirect1 #ah1 #dc2 morality (1 #ag1 #ah4 ,homicidal mania1 #cjj4 ,humoral pa?ology1 #hh4 ,hunt+don's *orea1 #abb4 ,hydramnios1 #ec4 ,hydrophobia1 dea? 91 #afa4 ,hygi5e 9 s*ools1 #bjb4 ,hym5 imp]=abilis1 #ccb4 ,hypnosis & bloody sweat1 #cde2 & crime1 #aca1 #acb2 & responsibility1 #aca2 dang] 91 #acj1 #aca2 utility (1 #acj4 ,hypnotism1 #abi2 bibliography (1 #aag2 9 dipsomania1 #aag2 9 morph9ism1 #aag4 ,hypobla/1 #gc4 ,hypo*ondriacs1 #bhg4 ,hy/]ectomy1 #db4 ,hy/]ia1 #bce2 & m>riage1 #bci2 causes (1 #bce2 imitative =m (1 #bcf2 9 males1 #bce2 major =m (1 #bcg2 manife/ations (1 #bce2 m9or =ms (1 #bch2 symptoms (1 #bch2 treatm5t (1 #bci4 ,i ,idee obs$ante1 #bff4 ,idiocy & alcoholism1 #aac2 & mat]nal impressions1 #fd4 ,idiopa?ic insanity1 #bab ,imbecility & alcoholism1 #aab1 #aad2 grades (1 #aad4 ,imitative hy/]ia1 #bcf1 #bcg4 ,immunity to disease1 #agj1 #aga4 ,impetigo1 contagi\sness1 #aii4 ,impot5ce1 ,am]ican au?orities on1 #cbg2 & ,am]ican law1 #cbf2 canon law on1 #cbf2 def9ition1 #cbg2 def9ition by morali/s1 #cbi1 #ccj2 ,/4 ,alphonsus's def9ition1 #cbh4 ,impot5tia atonica1 #cdj2 e morbis p5is1 #cda2 e vag9ismo1 #ccb2 e v55is1 #cdj2 et asp]mia1 #cdd2 et ca/ratio1 #cdb2 et insem9atio1 #cdc2 et prolapsus1 #ccc2 et s5ectus1 #ccc2 et v>icocele1 #cdb2 ex irritatione1 #cda2 ex maleficio1 #ccg2 m>is1 #ccf2 muli]is1 #cca2 organica1 #cda2 p>alytica1 #cdj2 propt] atresiam1 #ccc2 py*ica1 #ccf1 #ccg2 impot5tiae def9itio1 #cdd2 mult]is causae1 #ccb4 ,impregnation1 #bdj4 ,impulse & responsibility1 #bff4 ,indet]m9ate s5t5ce tor crim9als1 #bgi1 #bhj4 ,infect$ pati5t1 release (1 #aib4 ,infection1 #afh4 ,infecti\s diseases1 #afh2 & mania1 #bbf2 9 s*ools1 #ahg4 ,influ5za1 visits 91 #aha4 ,insanity1 #bab2 alcoholic1 #ajg2 & crime1 #bgd2 & epilepsy1 #bec2 & h]$ity1 #bbd2 & m5/rual diseases1 #bdc1 #bdd2 & religi\s vocations1 #bbf2 & sexuality1 #bbf2 diagnosis (1 #ajf2 f coca9e1 #aaf2 m>riage &1 #bbe2 recurr5ce (1 #bac4 ,insem9atio1 #cda4 ,int]/itial tubal pregnancy1 #e4 ,intoxicants1 #aje4 ,intraut]9e hemorrhage1 #ec4 ,iodide ( potassium & s>sap>illa1 #if4 ,is*iopagi1 #hb4 ,i/hmic ectopic pregnancy1 #e4 ,italian s*ool ( crim9ology1 #bga4 ,it*1 #aih4 ,j ,jacksonian epilepsy1 #beg4 ,jews & ! plague1 #ahe4 ,k ,kelly on ectopic ge/ation1 #e1 #h4 ,kidney diseases & o$ema1 #aci2 coma 91 #ach2 effect ( heat & cold 91 #ach2 fatality (1 #acg4 ,kleptomania1 #bii4 ,kon+s on impot5ce1 #cbi4 ,l ,laur5t on crim9als1 #bga4 ,law1 ,/4 ,?omas's def9ition (1 #af4 ,left-h&$ness & crime1 #bgb4 ,lehmkuhl on abortion1 #ai2 on ectopic ge/ation1 #be2 on impot5ce1 #cbi4 ,leprosy1 contagi\sness (1 #ahc2 visits 91 #ahb4 ,lice1 #aih4 ,light+ ( s*ools1 #bje4 ,l9coln's assass9ation1 #cjc4 ,life1 beg9n+ (1 #c4 #cfa ,li?opo$ion1 #g4 ,lockjaw1 #afa4 ,locomotor ataxia1 #cab1 #cbj2 symptoms (1 #cba4 ,lombroso's !ory on crim9als1 #bga4 ,l\ise ,lateau1 #cej4 ,lungs1 o$ema (1 #aci4 ,lusk on ectopic ge/ation1 #i4 ,lymphatic dia!sis1 #aeg4 ,m ,mac,donald on crim9als1 #bgb4 ,mc,kinley's assass9ation1 #cjd4 ,magnan on crim9al monomanias1 #bga4 ,mahomet a p>anoiac1 #bia4 ,major hy/]ia1 #bcg4 ,mal>ia1 #ahf4 ,malta fev]1 #ahe4 ,malum comitiale1 #bea4 ,mammalian ovum1 #fi4 ,mania1 #bbb2 anae/hesia 91 #bbg2 aft] infecti\s diseases1 #bbf2 a potu1 #aji2 causes (1 #bbd2 dea? 91 #bbg2 prognosis 91 #bbg2 symptoms (1 #bbc4 ,man\vri] on crim9als1 #bgb4 ,m>riage1 ends (1 #cbh2 & hy/]ia1 #bci2 & insanity1 #bbe2 & v5]eal diseases1 #caa2 ,liguorian def9ition1 #cbh4 ,m>is impot5tia1 #ccf4 ,mask$ epilepsy1 #beb4 ,massa*usetts report on alcoholic tonics1 #ic4 ,ma/rius on impot5ce1 #ccj4 ,maso*ismus1 #cch2 symbolicus1 #cci4 ,mat]nal impressions1 #fj2 & idiocy1 #fd4 ,mat]ially unju/ aggressor1 #ai1 #bf4 ,means 9 morality1 #ad4 ,measles1 dis9fection aft]1 #aig4 ,m$iaeval plagues1 #ahe ,melan*olia1 #bad2 & grief1 #bae2 auto9toxication 91 #bag2 causes (1 #bae2 *ildbe>+ &1 #bag2 delusions 91 #bba2 h]$ity &1 #baf2 9 wom51 #bag2 pr$isposition to1 #baf2 prognosis m1 #bbj2 recurr5ce (1 #bad2 />v+ 91 #bbb2 suicide 91 #bah1 #bai2 symptoms (1 #bah4 ,membran\s cr\p1 #ahg4 ,memory & alcoholism1 #aaj4 ,memory 9 epilepsy1 #bfc4 ,m5del & h]$ity1 #abj1 #abh4 ,m5+itis1 #adh4 ,m5opause1 #bdj1 #bdb2 & responsibility1 #bdi4 ,m5orrhagia1 #bda4 ,m5/rual diseases1 #bdj2 & insanity1 #bdc4 ,m5/ruation1 #c1 #bdj2 beg9n+ (1 #bdj2 d]angem5ts (1 #bda2 process (1 #bdj4 ,m5tal defects & pregnancy1 #fc4 ,m5tal diseases & spiritual direction1 #baa4 ,mesobla/1 #gc4 ,mesod]m1 #gc4 ,metamorphosis sexualis1 #cdj4 ,metrorrhagia1 #bda4 ,middle e> disease1 #aei4 ,m9or hy/]ia1 #bch4 ,miracles & ! n]v\s diseases1 #cea4 ,miracles1 physical pro( (1 #cea4 ,misc>riage1 #dh4 ,misophobia1 #bif4 ,mitotic division ( cells1 #gj4 ,mom5t ( dea?1 #afd4 ,money1 dis9fection (1 #aid4 ,monomanias1 #bib1 #bii4 ,mon/]s1 #fi2 aetiology (1 #gf2 composite1 #gg2 d\ble autositic1 #gi2 produc$ artificially1 #gf4 ,morality1 circum/ances 91 #ab2 det]m9ants (1 #ab1 #ac1 #aje2 end 91 #ac1 #ae2 g5]al laws 91 #ae2 means 91 #ad2 object 91 #ab1 #ae2 w 91 #ac4 ,morph9ism1 #aae2 causes (1 #aae2 effects (1 #aae4 ,morula1 #gc4 ,mosquitoes z disease-c>ri]s1 #ahf4 ,muli]is impot5tia1 #cca4 ,mumps1 #aii4 ,n ,n>r[ pelves1 #ee4 ,nephritis1 responsibility 91 #bdf4 ,n]v\s s*ool-*ildr51 #bjh4 ,n]v\s /ra9 & syphilis1 #cbd4 ,neuralgic dysm5orrhoea1 #bdb4 ,neura/h5ia1 #bcj2 causes (1 #bcc2 & responsibility1 #bdh2 sexual =m (1 #bcb2 sp9al =m (1 #bcb2 symptoms (1 #bcj2 traumatic =m (1 #bcc2 treatm5t (1 #bcc2 types (1 #bca4 ,neurotic dysm5orrhoea1 #bdb4 ,neurotic sup]iors1 #bdh4 ,newspap]s & suicide1 #acb1 #acc4 ,nietzs*e1 #bhe4 ,o ,object 9 morality1 #ab4 ,obsession1 #bff4 ,ob/ructive dysm5orrhoea1 #bdb4 ,o$ema 9 kidney diseases1 #aci2 ( ! glottis1 #aci4 ,oil-/ocks 9 smallpox visits1 #agg4 ,oligosp]mia1 #cdc4 ,omphalopagus1 #hd4 ,omphalositic mon/]s1 #ge4 ,omphalosites1 orig9 (1 #gf4 ,op]ation 9 ectopic ge/ation1 #bc4 ,oph?almia1 #bjj2 neonatorum1 #bjj4 ,opi/hotonos1 #bcg4 ,ov>ian pregnancy1 #e4 ,ov>iorum c>5tia1 #ccd4 #cfb ,ov>y1 anatomy (1 #b4 ,ovulation1 #c1 #bdj4 ,ovum1 #b1 #c1 #fi1 #gb2 arre/ (1 9 tube1 #d2 segm5tation-nucleus (1 #c4 ,p ,pancreatitis1 dea? 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91 #afa2 visits 91 #ahc4 ,?omas on ectopic ge/ation1 #i4 ,?oracopagus1 #hd4 ,t9ea favosa1 #aig4 ,tobacco1 n a dis9fectant1 #agc2 use ( by boys1 #bji4 ,tra*oma1 #bjj4 ,tramps1 #bif4 ,triple mon/]s1 #hf4 ,tubal abortion1 #f2 pregnancy1 #e4 ,tub]culosis1 #hi1 #ij2 & propriet>y drugs1 #ia2 curability (1 #ij2 dea? 91 #aeh2 9 s*ools1 #aih2 prophylaxis1 #ij2 visits 91 #ahb4 ,tubo-abdom9al pregnancy1 #e4 ,tubo-ov>ian pregnancy1 #e4 ,tum\rs ( ! bra91 #adh ,typhoid fev]1 #aeb2 p]itonitis 91 #aeb2 prognosis (1 #aeb2 walk+ cases (1 #aeb4 ,typhus1 #agi4 ,tw9s1 #gh4 ,u ,unexpect$ dea?1 #ace1 #aej4 ,unju/ aggressor1 #ah4 ,urn+ismus1 #cci4 ,ut]9e amputations1 #fe4 ,ut]us1 abnormal1 #g2 anatomy (1 #a4 ,v ,vacc9ation1 #agc2 compulsory1 #age2 symptoms (1 #agf4 ,vag9ismus et impot5tia1 #ccb4 ,v>icocele et impot5tia1 #cdb4 ,v>icose ve9s1 #aei4 ,v5]eal diseases & m>riage1 #caa4 ,v5tilation1 #bjf4 ,v]tigo & apoplexy1 #add4 ,v]wa*sung/heorie1 #gg ,viaticum 9 smallpox1 #agh4 ,v9c5tius de ,ju/is on impot5ce1 #ccj4 ,vital tripod1 #acf4 ,vitell9e membrane1 #gb4 ,vitellus1 #gb4 ,von ,hold] on crim9als1 #bgb4 ,w ,wall-pap]1 dis9fection (1 #aid4 ,walls ( build+s1 #bjc4 ,wat]-closets 9 s*ools1 #bjg4 ,:iskey1 p]c5tage ( alcohol 91 #ajh4 ,:oop+ c\gh1 dang] 91 #aii4 ,w 9 morality1 #ac4 ,w9d[s 9 s*ools1 #bje4 ,w9es1 p]c5tage ( alcohol 91 #ajh4 ,witzelsu*t1 #bbd4 ,work+ h\rs = *ildr51 #bjd4 ,y ,yell[ fev]1 aetiology (1 #ahe4 ,y\? & social diseases1 #cah4 ,z ,zona pellucida1 #gb4