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is no part of the skeleton. This bone does not articulate with any other bone, and on this ac- count its mobility is only limited by the soft structures through which it runs. This bone is a ridge acting as a center for a large' number of muscles. When compression is applied over this bone by means of a sheet, which is to some ex- tent yielding, the pressure will bear more upon the muscles above and the musculo-membranous space between the hyoid bone and thyroid cart- ilage. The direct pressure capable of breaking the bone, must be such as will firmly grasp it, and compress it more from side to side than from before backward. Still, compression over and about the hyoid bone is not without serious results to the bone itself, but the effect is not due to direct force. The result of the pressure is to interfere with the free entrance of air, and this interference with respiration Zantac Relief Tablets causes spas- modic contraction of the muscles which act upon the hyoid bone. The muscles acting upon the bone from below are four, and those acting from above are ten. The hyoid bone is subjected to violent and irregular contraction of the muscles inserted into it, with the effect of the bone break- ing, as a result of this muscular contraction. Fracture of the hyoid bone caused by muscular action is recognized in all surgical works which treat of this subject. The attention of the ex- perts having been directed to the direct force of the compressing sheet, it was fairly open to doubt whether the injury could follow directly from this violence. Even the defendant's experts would have admitted the possibility of the bone break- ing from muscular action. It is too much to ex- pect of the expert witness that he should take into consideration every possibility, indirect as well as direct. That is impossible, as the mind, how- ever honest, decides on facts placed before it. It is counsel's duty to marshal the facts and Zantac Chewable Tablets submit them fully. Medical expert testimony is not a race among liars. Medical expert testimony, as this case demonstrates, is more often defective from the manner of its presentation than an assumed yielding of the expert witness to whatever opin- ion is desired of him. Medical expert evidence has the indifferent witness who makes the possi- bilities of medical science his excuse for almost any opinion demanded of him. That medical witness exists, and it behooves the medical pro- fession to brand him as a canker eating into their body professional. They alone can do it, as they are the only ones capable of weighing an opinion made possible by the possession of a medical diploma. But this last class of medical expert evidence is not found in a trial of great public interest, and where the medical witnesses are the foremost members of the medical profession. Appointment of Dr. Christian. — Dr. Frank L. Christian, formerly a house physician at Bellevue Hospital and more lately medical of- ficer of the Eastern District Reformatory, has been appointed Medical Superintendent of El- mira Reformatory. 980 TAYLOR: OBSTIPATION. [Medical News OBSTIPATION. 1 BY STERLING B. TAYLOR, M.D., or COLUMBUS. rROCTOLOCISTTO GRANT HOSriTAL, ETC., COLUHaUS.OBtO. Obstipation, as its name would indicate, is an obstructive costiveness and is to be differen- tiated from functional costiveness, intentional, habitual delay of bowel movement, and consti- pation. It is a far more common disease than the profession is prepared to admit. That type of costiveness which deserves and has received the name of obstipation is dependent upon some mechanical or foreign interference situated in the rectum or Zantac 200 Mg sigmoid flexure. Func- tional costiveness is that condition which may exist as the result of errors in diet or neuroses, exhibiting itself by small daily movements, leav- ing a residue to accumulate in the intestine. Wirthington^ says "There is no sharp line sep- arating constipation from health." We claim there is a very clear line separating obsti- pation from the two lesser evils, constipation and functional costiveness, hence sharp demarcation between health and obstipation. In constipation there is a sluggishness of per- istalsis which consequently delays bowel move- ment, but eventually there is an eflFective and satisfactory effort at defecation. Just the re- verse of the latter proposition Zantac 300 Mg Twice Daily is true in the con- dition under discussion, as there is a constant un- requited desire which is only partially relieved by using such adjuncts as physic and enemata, producing a stool which is either liquid, semi- solid or tape-like in form, and which leaves still that uncontrollable desire for further and com- plete defecation. The name obstipation is derived from two Latin words, ob meaning "against" and Zantac 100 Mg stipo to "stuff or cram." We therefore have in obsti-
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