The writings of Sir Bernard Spilsbury: Part I

This is a two-part historical feature, highlighting the rare writings of Sir Bernard Spilsbury, the recognized leader of British forensic medicine in the first half of the 20th century. Parts I and II were compiled from the publications of the Medicolegal Society of Great Britain, where Sir Bernard Spilsbury served as President in 1933. Although his profile was presented previously in this Journal (vol. 2, no. 2, 179-182, 1981), it is felt that much of Sir Bernard Spilsbury's personality comes out in his writings and recordings of his speeches in the Medicolegal Society publications. Part I includes his lecture on "The Medico-Legal Significance of Bruises," presented before the Medicolegal Society in 1938; and a short case report read before the Medicolegal Society in 1924. The subject of the case report was sudden death from inhibition. Part II will contain two papers from the Medicolegal Society publications.     

Medicare program; refinements to geographic adjustment factor values, revisions to payment policies, adjustments to the relative value units (RVUs) under the physician fee schedule for calendar year 1995, and the 5-year refinement of RVUs; correction--HCFA. Correction of final rule with comment period

This document is a second correction to technical errors that appeared in the final rule with comment period entitled "Medicare Program; Refinements to Geographic Adjustment Factor Values, Revisions to Payment Policies, Adjustments to the Relative Value Units (RVUs) Under the Physician Fee Schedule for Calendar Year 1995, and the 5-Year Refinement of RVUs" published in the Federal Register on December 8, 1994. The first correction notice was published in the Federal Register on January 3, 1995 (60 FR 46).     

Paolo Zacchia--the spiritual father of forensic medicine

Paolo Zacchia (1584-1659) was the personal physician of the popes Innocent X and Alexander VII, legal advisor to the Rota Romana and head of the health system in the Papal States. His most important work, written in Latin, is entitled "Quaestiones Medico-Legales" and was published in 9 volumes between 1621 and 1651. Even after Zacchia's death comprehensive reprints were published at several places up to the late 18th century. Zacchia covered all the medicolegal issues of his time including the problem of "malpractice" and medical ethics. He is rightly considered an outstanding representative of his profession, whose "Quaestiones Medico-Legales" gave legal medicine its name.     

The Argumentative Value of ��gamic Quotations in the Spho?asiddhi by Bharata Mi?ra

In a rare book published in Trivandrum (1927), entitled Spho?asiddhi? Bharatami?rapran??t??, we find an interesting argument in defense of spho?a-theory, based on ??gamic quotations, especially RV X, 71, 4 (the stanza where the poet describes his own activity in perceiving the essence of Speech as like a beloved woman naked). The main idea is that the numerous word spho?as, as an atemporal multiplicity, free from any sensuous quality, were the objects of the ??is?? primordial intuition. So the internal diversity of the Veda is not a mere subjective convention in order to adapt the highest truth to limited human minds. The absolute brahman has an objective cosmogonical power of which the temporal mutiplicity is only the very last result. There is also an intermediate ideal multiplicity, which the Veda, as eternal and transcending the guru-?i?ya transmission, consists in.     

Medicare program; Medicare secondary payer for individuals entitled to Medicare and also covered under group health plans; correction--HCFA. Final rule with comment period; correcting amendments

This document makes corrections to the final rule with comment period entitled "medicare program; medicare secondary payer for individuals entitled to medicare and also covered under group health plans" that was published in the Federal Register on Thursday, August 31, 1995 (60 FR 45344).     

Bio-nanoscience and bio-nanotechnology: social and ethical aspects]

This article is an abstract of a conference with the same title presented at the XIII Jornadas sobre Derecho y Genoma Humano and is basically centred in a report for the Royal Society and the Royal Academy of Engineering entitled Nanoscience and Nanotechnology made publicly available July 2004.     

Medicare, Medicaid and CLIA programs; CLIA program fee collection; correction--HCFA. Correcting amendments

This rule corrects a technical error in a rule entitled, "Regulations Implementing the Clinical Laboratory Improvement Amendments of 1988 (CLIA)" which inadvertently deleted some content of another rule entitled, "CLIA Program Fee Collection." Both rules were published in the Federal Register on February 28, 1992. We are restoring, without change, the content of sections 493.602 through 493.634, which was incorrectly removed effective September 1, 1992.     

Quality mammography standards; correcting amendment--FDA. Final rule; correcting amendment

The Food and Drug Administration (FDA) is correcting its regulations governing mammography, published in a document entitled "Quality Mammography Standards" that appeared in the Federal Register of October 28, 1997. The regulations are effective April 28, 1999; except section 900.12(b)(8)(i), (e)(4)(iii)(B), and (e)(5)(i)(B), which become effective October 28, 2002. The October 28, 1997, document was published with some inadvertent typographical errors. Some of those errors were corrected in a document entitled "Quality Mammography Standards; Correction" that appeared in the Federal Register of November 10, 1997, but additional typographical errors occurred in the publication of this document. In addition, since November 10, 1997, certain other problems with the text of the regulations have been identified that, if uncorrected, would lead to unforeseen and undesirable consequences. This document corrects those errors.     

International Conference on Harmonisation; evaluation of stability data; availability. Notice

The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q1E Evaluation of Stability Data." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). This guidance is a supplement to an ICH guidance entitled "Q1A(R2) Stability Testing of New Drug Substances and Products," which was revised from Q1A(R) and published in the Federal Register of November 21, 2003 (68 FR 65717). It is intended to provide guidance on how to use stability data, generated in accordance with the principles outlined in Q1A(R2), to propose a retest period for the drug substance and a shelf life for the drug product.     

Reconciling dualism and non-dualism: three arguments in Vijñānabhikṣu’s Bhedābheda Vedānta

The late 16th century Indian philosopher Vijñānabhik?u is most well known today for his commentaries on Sā?khya and Yoga texts. However, the majority of his extant corpus belongs to the tradition of Bhedābheda (Difference and Non-Difference) Vedānta. This article elucidates three Vedāntic arguments from Vijñānabhik?u’s voluminous commentary on the Brahma Sūtra, entitled Vijñānām?tabhā?ya (Commentary on the Nectar of Knowledge). The first section of the article explores the meaning of bhedābheda, showing that in Vijñānabhik?u’s understanding, “difference and non-difference” does not entail a denial of the principle of contradiction. The second shows how the relation between the individual soul (jīva) and Brahman can be understood as a relation of part and whole. The third section discusses Brahman as cause of the world, and Vijñānabhik?u’s particular formulation of Brahman as “locus cause” (adhi??hānakāra?a). Understanding these arguments enables us to appreciate how Vijñānabhik?u’s Difference and Non-Difference Vedānta is a credible alternative to the Advaita Vedānta schools prevalent in northern India in the late medieval period, and how in his later works Vijñānabhik?u built upon this Difference and Non-Difference metaphysical framework to argue for the unity of Vedānta, Yoga, and Sā?-khya philosophies.     

Medicare program; Essential Access Community Hospitals (EACHs) and Rural Primary Care Hospitals (RPCHs)--HCFA. Correction of final rule

This notice corrects two technical errors in the regulations text we published on May 26, 1993 in a document entitled, "Essential Access Community Hospitals (EACHs) and Rural Primary Care Hospitals (RPCHs)."     

Signs of death as considered by Dr. B.M. Vance in a lecture fifty years ago

This work is based on the lecture given by Dr. Bernard M. Vance, then Assistant Chief Medical Examiner of New York, to the Homicide Squad Detectives of New York City on November 2, 1933, at the New York Police Academy. He entitled his presentation "Death, simulation of death and suspicion of death." Dr. Vance was an outstanding member of the New York Office's Forensic Pathology Group and was known for his colorful renditions of the scene and autopsy findings in medicolegal cases.     

Quality mammography standards; correction--FDA. Final rule; correction

The Food and Drug Administration (FDA) is correcting a document entitled "Quality Mammography Standards" that appeared in the Federal Register of October 28, 1997. The document was published with some inadvertent typographical errors and incorrect dates in the regulatory text. This document corrects those errors. FDA is also identifying with greater specificity those sections of the quality standards that will become effective October 28, 2002. For the convenience of the reader, FDA is republishing 21 CFR part 900 in its entirety with corrections.     

Medicare program; home health agencies: conditions of participation--HHS. Correction of final rule

This document corrects technical errors that appeared in the final rule published in the Federal Register on July 18, 1991 [56 FR 32967] entitled "Medicare Program; Home Health Agencies: Conditions of Participation."     

International Conference on Harmonisation; revised guidance on Q3B(R) Impurities in New Drug Products; Availability. Notice

The Food and Drug Administration (FDA) is announcing the availability of a revised guidance entitled "Q3B(R) Impurities in New Drug Products.' The revised guidance, which updates a guidance on the same topic published in the Federal Register of May 19, 1997 (the 1997 guidance), was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The revised guidance is intended to provide guidance to applicants for drug marketing registration on the content and qualification of impurities in new drug products produced by chemically synthesized new drug substances not previously registered in a country, region, or member State. The revised guidance clarifies the 1997 guidance, adds information, and provides consistency with more recently published ICH guidances. The revised guidance complements the ICH guidance entitled "Q3A(R) Impurities in New Drug Substances.'     

Medicare program; prospective payment system and consolidated billing for skilled nursing facilities; correction--HCFA. Correction of interim final rule with comment period

This document corrects technical errors that appeared in the interim final rule with comment period published in the Federal Register on May 12, 1998 entitled "Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities."     

Medicare program; revisions to payment policies under the physician fee schedule for calendar year 1999; correction--HCFA. Correction of proposed rule

This document corrects technical errors that appeared in the proposed rule published in the Federal Register on June 5, 1998, entitled "Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 1999."     

Patterns in drug use in the United Kingdom as revealed through analysis of hair in a large population sample

This paper presents an overview of the most common sectioning patterns utilised in the analysis of hair for drug use; report on the major user groups (sectors) that currently make use of hair analysis in the United Kingdom (UK); present the results for the different drug groups analysed in samples of hair samples analysed at TrichoTech between 2001 and 2005.A total of 186,084 tests on 34,626 hair samples were performed for the commonly requested drug groups. There were 145,799 enzyme-linked Immunosorbent positive screening tests (ELISA), which were subsequently confirmed by gas chromatography equipped with mass spectrometry detection (GC–MS). The two major sectors were the Medico-Legal sector (65%) and Workplace (20%). Police (Forensics), Clinical Monitoring, Schools, Research and Insurance accounted together for the remaining 15% of the samples. Combinations of several sections patterns were requested covering periods from the most recent month up to 24 months. The most common sectioning pattern was one single section measuring 3 cm, to cover the most recent 3 months (44%), which in some cases was complemented by a further 3 cm to cover together 6 months (13%). The second most common sectioning pattern was the analysis of three sections of 1 cm each to cover the most recent 3 months (28%), when a more detailed evaluation of drug use pattern was relevant. Samples collected from other areas of the body such as axilla, pubic, chest, beard and leg, constituted 6% of the samples. The analysis of monthly sections plays an important role in the evaluation and interpretation of drug use, particularly in certain Medico-Legal cases. The sectors with the highest rates of positive results were Police (Forensics) (78%), Medico-Legal (62%) and Clinical (54%). The common drugs in each group were cannabinol (27%), cocaine (25%), morphine (17%), amphetamine (13%) and diazepam (15%). The positive rate for the Workplace sector was 10%. The most common drugs detected in the Workplace samples in each group were: THC (4%), codeine (2%), cocaine (2%), MDMA (0.5%) and diazepam (0.1%). The concentration levels of drugs found in samples from the workplace were lower than in the other sectors (95% of cases). The exceptions were for dihydrocodeine and MDMA, where levels were 170 and 143% higher, respectively. However, the maximum levels detected in the Workplace samples were lower. The Medico-Legal sector is the most prevalent sector using hair analysis in the UK but the rate of Workplace sector use of hair testing is increasing. One in 10 workplace hair tests detected the presence of at least one drug, which is twice the rate of detection using urine, which is a 1 in 20 urine sample. This means that the chances of identifying people on drugs in the workplace by testing hair samples are twice as likely than urine samples.     

Eugen Bleuler and forensic psychiatry

The list of Eugen Bleuler's writings shows that he grappled with forensic issues quite early, even before he became a full professor in 1898. Bleuler regularly prepared forensic criminal expert's reports himself until emeritus status was conferred on him in 1927. Analysis of his writings indicates that his position remained explicitly deterministic. In Bleuler's later work, that position was integrated into the natural philosophy vitalistic theory of mnemism, itself part of a more comprehensive theory, without any corrections to its content. Eugen Bleuler always remained a critic of criminal law, although it can be seen from later expert's reports that he for the most part accepted the existing system for the administration of justice for practical reasons. However, Bleuler always defended the idea that punishment should not be based on the moral guilt of the perpetrator but rather on the prospect of curing him.