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For the purpose of Table 8 medicine versed purchase 5mg oxytrol fast delivery, a confusion matrix is shown symptoms bipolar disorder order oxytrol 2.5mg mastercard, which classi es heart sounds extensive testing 5 medications generic 2.5 mg oxytrol with visa, these parameters were varied with all possible as normal or abnormal symptoms dengue fever buy oxytrol 2.5 mg line. Frame size of a signal (number of samples used in one frame): heart sound as normal is very low. Software design of heart sound application tions of parameters is shown in Table 6. The heart sounds software (App) is smartphone software to record and analyze heart sounds. Using the App requires an external customized microphone and a smart phone with an Android 5. Using this application, the users can (i) record, (ii) localize, (iii) view, (iv) listen to, (v) classify, (vi) detect split in, (vii) generate electronic records of heart sounds, and (viii) share electronic medical records. Once the Start button is pressed, the heart sound starts appear ing on the screen. When the Record button is pressed, the microphone starts recording the heart sounds from the stetho scope. Therecordingautomaticallystopsafter10sandtherecorded signal is made available for analysis on the results screen. The blue signal represents the live audio signal being recorded while the green dots represent the potential S1 or S2 peaks. The App selects the best S1–S2 pairs from the whole record ing based on the peak selection method (discussed in Algorithm 1) for further analysis. The signals are simultaneously used for split calculation and ltering as explained in earlier sections. The displayed signal is segmented into two parts—S1 will produce an electronic record of the heart sound that can be in pink and S2 in red. Blue indicates other signals that were not shared with medical practitioners via e-mail, while the Play button selected for analysis. The x-axis is time in milliseconds while the replays a ltered and ampli ed audio signal for the user. The lower section shows the A video demonstrating the presented system is available at initial diagnosis of the signal with details such as patient’s name, youtu. This video shows the use of the modi ed anddateandtimeoftherecording,alongwiththeauscultationarea stethoscope to record heart sounds and the user-interface of the soft selected by the user. Next, the screen’s table shows all the selected wareinasmartphonetoprocessandclassifytherecordedheartsounds. Performance analysis split(s) is/are more than 30ms, the App will indicate the presence of a split in the rst and/or second heart sound. Finally, the result of To analyze the App performance, heart sounds are collected the classi cation is displayed. The classi cation of normal and abnormal Available: atlanticpediatricdeviceconsortium. Hurst, Clinical Methods: the History, Physical, and Laboratory Examinations, Butterworths, 1990. Bassam, Phonocardiography signal processing, in: Synthesis Lectures on Biomedical Engineering, Morgan and Claypool Publishers, 2009. Bereksi-Reguig, Computerized heart sounds analysis, cess, and identify 16 types of heart sounds. Hall, Textbook of Medical Physiology, Guyton Physiology reliable in the detection of abnormal murmurs in heart sounds. Barlow, the atrial sound and the atrial component of the two systems built on the smartphone platform, making it more rst heart sound, Br. Kelly, Diagnostic value of phonocardiography in mitral stenosis: mode of ing is one of the highest, making our presented data more reliable. Wood, Atrial septal defect: with special reference tures not available in all products. Furthermore, our system can to the electrocardiogram, the pulmonary artery pressure and the second heart provide instant and accurate classi cation of heart sound that is sound, Br. Harvey, Mechanisms of xed splitting of the second heart not available with most other available products. Bereksi-Reguig, Automatic measure of the split in the second to detect more body sounds such as from lungs and bruits. Choi, A cardiac sound characteristic waveform method for in-home heart disorder monitoring with electric stethoscope, Expert Syst. Krishnan, Neural network [31] Advanced Physical Diagnosis, University of Washington, Department of classi cation of homomorphic segmented heart sounds, Appl. Stein, Arti cial [32] Heart Sound and Murmur Library, University of Michigan [Online] Available: neural networks in computer-assisted classi cation of heart sounds in. Wu, Research on the method of characteristic Sounds [Online] Available. Xiao, Heart murmur recognition based on of the rst heart sound in normal man, Med. Models and application to objective speech quality and isolated-word speech [41] C. Hartimo, Heart sound segmentation algorithm Industrial and Applied Mathematics, 2008. Jonnada, Cuf ess Blood Pressure Measurement Using a Smart Phone, and Murmurs, Davis, 2000. Wu, S1 and S2 heart sound recognition using deep neural heart-mobile interface, in: A Dissertation, Univ. Shenoi, Introduction to Digital Signal Processing and Filter Design, Wiley, sounds using rule-based classi cation tree, J. Hoer, Computer analysis of and secured transmission and retrieval of vital signs from remote devices, phonocardiograms, Prog. Summary of review: Echocardiography is a rapidly evolving field which is relatively new to intensivists. In intensive care practice echocardiograpy is used to evaluate clinical syndromes such as unexplained hypotension, search for source of sepsis or source of emboli, as well as haemodynamic assessment and monitoring. Conclusions: Echocardiography often provides useful information in critically ill patients. Intensivists should familiarise themselves with this new technology and if possible become skilled practitioners of this exciting technique. Some common syndromes in which echo 1) diagnosis of specific cardiac/aortic pathology cardiography is especially useful are listed in table 2. As a general rule, unless 3) others such as evaluation of patients with atrial there is gross haemodynamic instability or some other fibrillation for the presence of left atrial clot prior to overriding reason, the echocardiographic examination cardioversion. For ‘comprehensive’ echocardiographic examination is example, hypotension in a patient with acute myocardial impractical in most critically ill patients. Indeed, once infarction suggests severe left ventricular dysfunction the echocardiographic diagnosis has been made, the associated with a major regional wall motion patient’s condition may be so grave that immediate abnormality. Nevertheless, the echocardiographic exam treatment takes precedence over any further examin Correspondence to: Dr. Indications for Echocardiography Diagnosis Valvular heart disease (native or prosthetic valves) • Stenosis/regurgitation • Infective endocarditis Left ventricular (and/or right ventricular) function • Systolic Regional wall motion abnormality (myocardial infarction/stunning) Global (cardiomyopathy/stunning) • Diastolic function • Cardiomyopathy dilated hypertrophic restrictive Pericardial disease • Pericardial effusion • Cardiac tamponade • Constriction • Tumour (rare) Cardiac masses (thrombus, tumours and vegetations) • Clot atrial (left > right) ventricular (usually left) • Tumours. There may be no ‘echo • Cardiac tamponade free’ space due to clot compressing the heart. For example if cardiac tamponade is diagnosed in Valvular stenosis a patient with severe hypotension then pericardio Narrowing or stenosis of any heart valve obstructs centesis should be given absolute priority. Various mobility of the valve cusps, Doppler techniques allow accurate haemo-dynamic 2) some quantification of the degree of stenosis, and, evaluation of the valves. Transvalvular pressure occasionally contribute to haemodynamic instability in gradients (P) can however be estimated by Doppler critically ill patients. Using the simplified Bernouilli equation (P for many years so the diagnosis has usually been made 2 prior to admission to intensive care. Mitral stenosis = 4V, where V is the velocity of blood flow) accurate and reproducible estimations of maximum and mean produces typical 2-D images of thickened and fused pressure gradients can be obtained. Note that in mitral valve leaflets with diastolic doming resulting in a conditions of low cardiac output pressure gradients will ‘hockey stick’ appearance of the anterior leaflet together be low, thereby underestimating the severity of stenosis. Aortic stenosis should be excluded ‘fish mouth’ orifice the area of which can be in critically ill patients presenting with sudden collapse, planimetered to estimate the mitral valve area. Mitral cardiogenic shock, or pulmonary oedema of uncertain stenosis severity can be assessed by Doppler techniques: aetiology. The most common cause of valvular aortic stenosis is degeneration and calcification of the valve 1) the peak velocity across the mitral valve is usually apparatus.

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If the processus vaginalis fuses proximally and distally but remains open in between treatment trends buy 5mg oxytrol with visa, the isolated fluid collection is referred to symptoms 5dpiui generic 5 mg oxytrol free shipping as a hydrocele of the cord symptoms bladder cancer oxytrol 2.5 mg with mastercard. This type of hydrocele treatment uveitis effective oxytrol 5mg, although not in communication with the peritoneal cavity or the scrotum, is often associated with a hernia and/or a scrotal hydrocele (6). In some older boys, a scrotal hydrocele may result from inflammation within the scrotum caused by various conditions including testicular torsion, torsion of the appendages, epididymitis, and testicular cancer (1,4). When the processus vaginalis fuses distally but remains patent proximally, abdominal contents can enter the inguinal canal resulting in an inguinal hernia. However, if the processus vaginalis fails to fuse completely, there will be communication between the scrotum and the peritoneal cavity through the patent processus vaginalis resulting in an inguinal-scrotal hydrocele, or communicating hydrocele. Of note, there is a rare but important type of communicating hydrocele called an abdominal-scrotal hydrocele. With this type of hydrocele, the communication is between the scrotum and a cystic loculation of fluid within the lower abdomen. This may result in recurrent communicating hydroceles or unusually large hydroceles. If a communicating hydrocele is large enough, abdominal contents may extend through the patent processus vaginalis to the scrotum resulting in an inguinal-scrotal hernia (complete inguinal hernia). The hernia sac in males and females may contain intestine or omentum, with the ileum being the most common intestinal component. Of note, it is possible for a testis to be found in the hernia sac of a female infant if testicular feminization (complete androgen insensitivity) is present. More than half of patients with testicular feminization have an inguinal hernia (4). In differentiating a hydrocele from a hernia, history and physical examination can be diagnostic. The most important information elicited from parents is a history of fluctuation in the volume of the mass that would be consistent with a hernia or communicating hydrocele. Parents may report an increase in size that is particularly noticeable at times of increased intra-abdominal pressure (activity, crying or straining). Parents may also report previous reduction of the mass by either themselves or another physician. A history of fussiness, obvious discomfort, poor feeding, vomiting, and abdominal distention would suggest incarceration. This usually results in crying, thereby causing an increase in intra-abdominal pressure. The mass is palpated and evaluated for tenderness, tenseness, and associated skin discoloration that, if present, would suggest incarceration and possible strangulation. If the mass is non-tender, smooth, firm and located in the scrotum, a hydrocele is likely to be present. A scrotal hydrocele should be moved away from the inguinal canal and palpation of normal cord structures superiorly should be performed to exclude the presence of a hernia. If a patient presents with a large hydrocele or a history of recurrent communicating hydroceles with or without a palpable ipsilateral lower abdominal mass, an abdominal-scrotal hydrocele should be suspected. If compression of the fluid-filled mass completely reduces the size of the hydrocele, a communicating hydrocele or hernia is the likely diagnosis. An inguinal hernia is non-tender, soft, reducible and can be located in the inguinal canal or may extend into the scrotum (inguinal-scrotal hernia). Of note, retractile testes, a common finding in infants and young children, can resemble an inguinal hernia. To avoid misdiagnosis, palpation of the testes should be done prior to palpation of an inguinal mass. An increase in size of the mass would be consistent with a hernia or communicating hydrocele. However, in children, inguinal-scrotal hernias and incarcerated bowel may also brilliantly transilluminate. The internal ring of the uninvolved side should be examined before proceeding to the internal ring of the affected side. If an inguinal hernia is present, abdominal contents may be palpated extending through the internal ring (2,3,6). If there is a history suspicious for a hernia but no mass can be demonstrated on examination, it may be helpful to empty the bladder which, when full, can block the internal inguinal ring and mask an inguinal hernia. Otherwise, a classic history of intermittent inguinal, scrotal or labial swelling that spontaneously reduces may be all that is necessary for diagnosis. However, another physical examination finding that can be present with inguinal hernias is a thickened spermatic cord with an associated "silk" sign. The spermatic cord is palpated over the pubic tubercle and a "silky sensation" is appreciated when the two layers of peritoneum are rubbed together. This finding, along with a history of a hernia, is highly suggestive of an inguinal hernia (2). A scrotal hydrocele that is sufficiently large and tense may cause ischemic injury to the testis. A communicating hydrocele may enlarge and lead to development of an inguinal-scrotal hernia (6). Nine to twenty percent of inguinal hernias in children become incarcerated with more than half of those cases occurring in children less than 12 months of age. The incidence of incarceration increases in premature infants and in term female infants (2,5). Strangulation of the hernia can occur and ischemic injury to intestine and testis/ovary may result (3,6). Intestinal obstruction, intestinal gangrene, and gonadal infarction occur more commonly in the first 6 months of life (4). Thus, because the risk of incarceration is high, particularly in infants, with a risk of strangulation, prompt surgical intervention is recommended as soon as the diagnosis is made. The differential diagnosis of inguinal-scrotal swelling in children (6,7) can be classified based on acuteness of presentation, tenderness, location (intratesticular versus extratesticular), and transillumination. They are extratesticular, but scrotal hydroceles may be difficult to distinguish from an enlarged testicle on palpation. Communicating hydroceles are compressible (that is, they decrease in size with pressure), while non-communicating hydroceles will not change in size. Non-communicating hydroceles are frequently mistaken for incarcerated hernias, because they do not change in size with compression (seemingly non-reducible). However, scrotal hydroceles are spherical or oval in shape, while an incarcerated inguinal hernia is usually tubular in shape (often shaped like a small banana with a slightly tapered point at the end). Additionally, hydroceles are usually softer in consistency, while incarcerated hernias are the consistency of a refrigerated hot dog and sometimes harder than this. Other diagnoses in the differential include lymph nodes, undescended or retracted testis (smaller in size), varicocele (soft spaghetti or bag of worms consistency), and spermatocele. Other considerations include epididymal cyst, testicular cancer, peritesticular rhabdomyosarcoma, benign soft tissue tumors, meconium sequestration, testicular torsion (tender), torsion of appendages, epididymitis, trauma, idiopathic scrotal edema, and Henoch-Schonlein purpura. If there is uncertainty in the diagnosis, an ultrasound examination may aid in differentiating a hydrocele from a hernia, may confirm the presence of an abdominal-scrotal hydrocele, or may rule out other causes of inguinal-scrotal swelling. In a female, ultrasound examination can be used as part of the evaluation for testicular feminization (4). It can also be used to examine both ovaries when an incarcerated ovary is suspected (6). Abdominal x-rays are unnecessary for diagnosis of an incarcerated hernia, although they may be helpful in confirming an intestinal obstruction. If an incarcerated or strangulated hernia is associated with bowel obstruction or shock, laboratory studies and vascular access are indicated (5). Treatment is usually not required for uncomplicated, simple hydroceles (non-communicating) because they tend to decrease in size with complete resolution in the first 2 years of life. Significant hydroceles persisting beyond 12-24 months are likely to be communicating and are generally surgically corrected at that time (1). However, early surgical repair is recommended for large, tense hydroceles because they rarely disappear spontaneously, they can cause ischemic injury to the testis, and they may be difficult to distinguish from hernias. Communicating hydroceles also require early surgical repair due to the fact that they may progress to symptomatic inguinal-scrotal hernias (6). In fact, inguinal hernia repair is the most common surgical procedure in children (4). In an outpatient setting, if a child presents with an inguinal hernia but is otherwise well (no obstruction or shock), manual reduction should be attempted. About 95% of inguinal hernias can be reduced by applying gentle but steady upward pressure on the hernia sac.

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Travel writers medicine ball exercises buy cheap oxytrol 5 mg online, if at all possible medications on airplanes generic oxytrol 5 mg visa, wanted to treatment of schizophrenia generic oxytrol 5mg amex write of areas for which guide-books could not be purchased – Wharton achieved that medications ocd oxytrol 2.5 mg online, or so she thought, with her 1920 book In Morocco21 – and preferably to which Thomas Cook did not run tours. Wharton’s Italian Backgrounds contrasts tellingly with Henry James’s 1884 travel book, A Little Tour in France, an account of a journey around provincial French cities; James covers all their major sights, and quite happily describes him self as a tourist. Although James also published collections of essays about Italy and England, mainly written in his rst years in Europe, his nest travel writ ing is not about Europe, but came out of his visit, in 1904–5, to the United States, after twenty ve years’ absence. The American Scene (1907) describes a journey from New England to Florida, covering explorations around city streets and views from behind the plate glass of Pullman cars. All travel writ ing is a form of autobiography, and this book is sometimes considered as the rst in the series of James’s late autobiographical writings. It has all the 79 helen carr complexity of response of his novels; James describes how his visit brings back his childhood, and yet offers him a country disturbingly changed, so that interpreting it is ‘like the spelling out of foreign sentences of which one knows but half the words’. The book was criticised for what was seen as James’s snobbish distaste for American modernity, and more recently for his ambivalent responses to the numbers of immigrants that had entered the States since his departure. Yet his reactions are never simple, and he is fascinated with the cultural changes that a new environment brings – not that he thinks them necessarily for the best, particularly in the case of the Italians. The international theme is as present in this travel memoir as in any of his novels. Pound, who described the American Scene as the ‘triumph of the author’s long practice’,23 also wrote an account of his own return visit, after a mere two years, to the States. Like James, Pound has ambivalent feelings about American modernity, though unlike James, who describes New York as a ‘huge jagged city’ with a skyline like a ‘broken hair-comb turned up’ (p. Ironically, just three months after the last instalment of Patria Mia appeared in the New Age, the Armory Show, the famous exhibition of modernist art that marked the beginning of a new era, took place in New York, and American modernist art and writing exploded. One traveller who went beyond Europe in those years – apart that is from the bold Polar explorers – was Gertrude Bell, one of a number of travel writers in the Middle East, including T. Lawrence and Freya Stark, who became intimately involved with the British political interests in the area. She came to know the region rst through family connections in the diplomatic services, and her works are, like the earlier travelogues, detailed and informative. Although she admits she is not travelling on ‘ground virgin to the traveller’, she wants to expand and correct previous accounts. The gates of the enclosed garden are thrown open, the chain at the entrance to the sanctuary is lowered, with a wary glance to right and left you step forth and behold!. Lawrence’s rst travel book, Twilight in Italy (1916), appeared during the war, though it recorded his pre-war visit, whilst the other Lawrence (T. Ironically, one of the most pervasive moods in travel writing of the inter-war years is a certain world-weariness, springing from disillusionment with European civilisation and dismay at its impact on the rest of the world. Eliot – for whom journeying and displacement are constant motifs, although he was not a travel writer himself – encapsulates many of the themes of inter-war travel writing in the Waste Land: sordid metropolis, fragmentation, tawdry present, jumbled cultures, the otsam and jetsam of a decayed civilisation, nostalgia for an earlier, lovelier world, fear of past and future horrors. The word ‘seedy’ that Graham Greene uses to sum up Liberia in Journey Without Maps (1936) could apply to many of the depictions of travellers’ destinations – and departure points – at this time. This sense of an older, more aesthetic world in the throes of decay was not entirely new. Mary Louise Pratt has argued that travel writing in the eighteenth and nineteenth centuries ‘produced “the rest of the world” for Europeans’ (Imperial Eyes,p. Most travel writers now wrote of areas whose repertoire of char acteristics had been well established; what becomes increasingly evident is that the repertoire is no longer what it was. Rod Edmond has pointed out that travellers to the South Paci c in the nineteenth century already found it hard to avoid acknowledging the destruction of a world earlier depicted as an innocent paradise; indeed, as he says, the ‘legible evidence of Western diseases on blemished native bodies haunted Western writing about the Paci c from the early moments of contact’. Stevenson makes clear in his melancholy account of the region, In the South Seas (1896). Travel writers became increasingly aware that they were describing fragmented, hybridised cultures, the shabby remnants of the tapestry of otherness their predecessors had woven. If this was the era of ‘sal vage anthropology’ for ethnographers who felt their subjects were rapidly disappearing from the globe, it was also, for some, the era of ‘salvage travel writing’. For others, modernity, in the shape of tourists if not colonialists, is about to sweep away the picturesque customs they have come to seek. Edith Wharton, a warm admirer of French colonialism, writes regretfully in In Morocco: ‘In spite of the incessant efforts of the present French administration to pre serve the old monuments of Morocco from injury, and her native arts and industries from the corruption of European bad taste, the impression of mys tery and remoteness which the country now produces must inevitably vanish with the approach of the “Circular Ticket”’. The native arts are superior to Western vulgarity, even if the best of the West is superior to both. Change came more slowly to the Middle East, which, thanks largely to the power of the Ottoman Empire, while it lasted, and to its Islamic beliefs, re mained amenable for longer to familiar and reassuring exoticisation, perhaps one reason for its popularity as subject matter. Freya Stark begins her 1932 Baghdad Sketches, the rst of some twenty travel books she wrote about the region: In a very short time a railway will link Baghdad with Europe. Even now the crossing of the desert is an every day affair, and although the Nairn Motor Transport do what they can, and cook your breakfast-sausage romantically for you in the open desert over a re of camelthorn, with an paraf n box ready to help in case of need, they do not quite succeed, one must admit, in giving the true nomadic feeling to any except most innocent travellers. Yet if travel writing had become deliber ately anti-romantic, it was in addition anti-heroic. Peter Fleming – the brother of Ian – says insouciantly in his ‘Foreword’ to Brazilian Adventure, that al though ‘in treating of the Great Unknown one has a free hand, and my few predecessors in this particular eld had made great play with the Terrors of the Jungle’, he himself had found that ‘the hardships and privations were of a very minor order, the dangers which we ran were considerably less 82 Modernism and travel (1880–1940) than those to be encountered on any arterial road during a heat wave’. He refuses to emulate the professional travel writer who nds ‘a pe culiar relish in discomfort. Bed bugs, frightful food, inef cient ships and trains, hostile customs, police and passport of cers, consuls who will not cash cheques, excesses of heat and cold, night club champagne and even im prisonment are his peculiar delights’. Nor however, does he wish to be like ‘those pitiable droves of Middle West schoolteachers whom one encounters suddenly at street corners and in public buildings, baf ed, breathless, their heads singing with unfamiliar names. How their eyes haunt us long after they have passed on to the next phase of their itinerary – haggard and un comprehending eyes, mildly resentful, like those of animals in pain, eloquent of that world-weariness we all feel at the dead weight of European culture’ (p. Animal imagery, used by earlier travellers to describe savage others, is now applied to the hapless American tourists. Refusal of a heroic posture does not make Waugh’s judgments any less con dent; Waugh’s travel writing is ruthless satire, like his novels, and is as much about his fellow-travellers as about indigenous inhabitants. European culture, middle-class tourists, and foreign lands have neither worth nor glamour. Yet if Waugh implies his own superiority, it is not a superiority that he feels his compatriots or even his class necessarily share. Tellingly, one of the few groups that he admires are the Kenyan colonials, with ‘their wish to transplant and perpetuate a habit of life traditional to them, which England has ceased to accommodate – the traditional life of the English squirearchy’. Paul Fussell suggests in his study of travel writers of this period that travel in the inter-war years often appeared to be more about escaping from England than anything else. Yet some travellers still went in hope: Lawrence, for all his bitterness against post-war England, was not just es caping. His travels were energised by a passionate quasi-primitivist quest; he longed for a truer, simpler, more intense way of being, and was endlessly disappointed. Lawrence loathed modern hybridity; he wanted to seek out the pure essence of the people he visited. Rebecca West describes how he 83 helen carr would go ‘straight from the railway station to his hotel and immediately sit down and hammer out articles about the place, vehemently and exhaus tively describing the temperament of the people’. Ironically, there is often more description and evocation of place in his ction than his travel writing, in which it is the nature of these others that he obsessively pursues. In Mornings in Mex ico (1927) he creates his own intoxicated version of the Indian soul. He despises the Indians with whom he has contact, his servant and the local vil lagers, who live a mongrel half-European, half-Indian existence, but when he comes to describe their dances he insists that ‘so long as he is pure’ the Indian is in touch with the vital universe, unlike the modern European or American, trapped in their mechanical existence. They have their limitations, as does the modern world, and neither can satisfy him. Only in his loving reconstruction of the long lost Etruscan civilisation did he nd solace, and even then Etruscan Places (1932) ends with Lawrence’s raging against the Florentine museum’s attempt to systemise Etruscan culture. Orwell wrote some essays about his experiences in colonial Burma, but as a travel writer he is most famous for books like Down and Out in Paris and London (1933) and the Road to Wigan Pier (1937), written in the long tradition of the middle-class ethnographer – Mayhew, Booth or London – uncovering the dark underside of civilisation, in which the lower classes are discovered to be, metaphorically speaking, a race apart. Graham Greene wrote a couple of bleak and troubled travel books, which were spiritual as well as geo graphical journeys, expeditions into an inner ‘heart of darkness’, as he says of his visit to Liberia. Like Fleming and Orwell, he was an old Etonian – Fleming, when he applied to join the expedition to Brazil, mentioned his school, know ing the selectors would consider that ‘an Old Boy is worth two young men’ (Brazilian Adventure,p.

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Johnson vetoed the Civil Rights Act treatment conjunctivitis buy oxytrol 5 mg low price, but his veto was overridden medicine escitalopram generic oxytrol 5mg online, a sign of the solidarity of opinion that was beginning to medicine 6 year program buy generic oxytrol 2.5 mg line become apparent in Congress shinee symptoms discount oxytrol 2.5 mg mastercard. Meanwhile, the Joint Committee drafted and sent the Fourteenth Amendment to the states for ratifcation. This Amendment echoes the intent and language of the Civil Rights Act by proclaiming that “all persons born or naturalized in the United States are citizens of the United States and of the states wherein they reside. And lastly, the Amendment disqualifed from any state or national offce anyone who had been involved in an “insurrection or rebellion against the [United States]. In Memphis, trouble broke out in May 1866 when carriages driven by a white man and a black man collided. What began as a fght between the two men evolved into violence when a group of whites stormed the black quarter and began burning houses and killing their inhabitants. A more serious riot occurred in New Orleans when a peaceful procession of blacks was fred upon. When the smoke cleared, 119 blacks and seventeen of their supporters had been injured, and thirty-seven blacks and three white friends were killed. It was in the context of this unrest that the Congressional campaigns of 1866 began. Northern opinion shaped the Congressional elections of 1866, as Johnson and the Radicals squared off before the American public. Johnson made what he called a “Swing around the Circle,” an eighteen-day tour in which he went from Washington to New York to Chicago, south to St. While he did not declare a party allegiance, his rhetoric was decidedly pro Democratic. Despite his efforts, the Republicans won by a landslide, taking thirty-seven additional seats in the House, which gave them a total of 173 seats in that body; the Democrats were left with forty-seven. Radical Reconstruction the Radicals now had a frm base of support in both the House and Senate, and they moved to adopt the plans outlined by the Joint Committee, including the First Reconstruction Act of March 1867. Historian Samuel Eliot Morison calls this act “the most important legislation of the entire period. When a convention was elected by all citizens of a state (with the exception of those disenfranchised because of participating in “the rebellion” or those who had been convicted of a felony), a constitution created in keeping with the language and intent of the Constitution of the United States, and the Fourteenth Amendment ratifed, then the states could apply for reentry into the union. An addendum to this act was passed in July; it stated, “no district commander shall be bound in his action by any opinion of any civil offcer of the United States. In South Carolina, for example, property qualifcations for voting were removed, thus allowing universal manhood suffrage; the Bill of Rights was expanded; all reference to “distinctions on account of color” were removed; women’s rights were expanded; and imprisonment for debt ended. The remainder of the states were reconstructed in 1870, at which time they had to ratify the Fifteenth Amendment as well as the Fourteenth; the former specifed that “the right of citizens of the United States to vote shall not be denied or abridged by the United States or by any State on account of race color or previous condition of servitude. The Reconstruction Act began this process when it included the provision that “no district commandershall be bound in his action by any opinion of any civil offcer of the United States. The immediate goal of this legislation was to keep President Johnson from removing the Secretary of War, Edwin Stanton, who was the last remaining Figure 17. The next goal Andrew Johnson was impeached by the House of was to remove Johnson through Representatives in 1867 for disobeying the Tenure of Offce Act, itself clearly unconstitutional. Davis impeached and convicted, then his Source: Library of Congress replacement would be the president pro-tempore of the Senate, the Radical Benjamin Wade. Falling in line with the Radical plan, Johnson did in fact dismiss Stanton and appointed to his place in the War Department General Lorenzo Thomas. On February 24, 1867, the House voted to impeach Johnson for “high crimes and misdemeanors. Had one more Senator voted to convict, Wade would have become the President of the United States. Johnson’s Amnesty Proclamation, delivered shortly after he came to offce, was mild, and, within eight months of the death of Lincoln, all but one of the previous Confederate states had been brought back into the Union. When white Southerners displayed attitudes and political policies reminiscent of those in place before the beginning of the War, the Radicals in Congress seized the reins of reconstructing the South and created a series of Reconstruction Acts designed to punish as well as reconstruct the South. Congress also attempted to secure Congressional supremacy over the executive branch by passing the Tenure of Offce Act and then bringing articles of impeachment against Johnson. The last of the southern states fulflled the dictates of the Page | 803 Page | 803 Chapter Seventeen: reConStruCtion Congressional reconstruction acts, including the acceptance of the Thirteenth, Fourteenth, and Fifteenth amendments, and were returned to the union in 1870. According to the First Reconstruction Act passed in 1867, the South was divided into military districts. Click here to see answers Page | 804 Page | 804 Chapter Seventeen: reConStruCtion 17. Anywhere the armies had clashed, terrible destruction ensued, and where the armies had not advanced, there was still suffering from deprivation due to the shortages during and after the war. Almost everyone in the South, no matter their race, gender, social standing, or political views, suffered during and immediately after the war. The war had been physically and emotionally diffcult; for many, Reconstruction would also prove to be a painful, even traumatic, experience. President Lincoln had not laid out concrete plans for reconstruction before his assassination. After his assassination, anger in the North became a key component of the reconstruction equation. Was the South to be accepted back and the nation healed, or was the South to be punished and brought to heel. Differing opinions among the public and the politicians held sway at various times as the Union decided what to do with the defeated Confederacy. President Jefferson Davis’s experience was atypical, but it does illustrate on a very personal scale the impact of the wrangling in the North following Lincoln’s assassination. Davis had been captured in Georgia in 1865 as he tried to make his way to Texas in hopes of joining with Confederates still in the feld. Davis was taken to Fort Monroe, Virginia while the investigation into Lincoln’s assassination was conducted. Many believed that the Confederate government, and thereby Davis, had been behind, or at least connected to, the assassination. The investigation proved otherwise, but with feelings running high, Davis could not be released. Magazines and papers such as Harper’s Weekly called for Davis to be charged with treason, tried, and, if convicted, executed. Lee and his army; however, Davis was not a part of the military, so he received no such parole. He was kept in a small cell and, at one point, shackled, not due to any order for such from Washington or fear of his escape, since his health was failing. Rather, the offcer in charge of Davis’s care, General Nelson Miles, who was given full authority and discretion to do as he thought best, chose to do so. Eventually he was moved into offcer’s quarters, and his wife and children were allowed to live at the fort with him. Davis was released on bond after two years, having never been brought to trial, and the charges were dropped. New charges of treason were brought in Richmond in 1868, and Davis was fnally brought Page | 805 Page | 805 Chapter Seventeen: reConStruCtion to trial, a proceeding that soon became entangled in constitutional issues. The trial simply ceased to continue, and the prosecution eventually dropped the case. For many in the South before, during, and after the war, life was not a case of simple segregation. Lax, of Halifax County, Virginia, was a white, slave owning tobacco farmer with personal property valued at over $4,000 in 1860. By the time they learned of his death, his body had long been buried in a mass grave. Along with such uncertainties as the Lax family faced, came the uncertainty regarding the treatment of former slaves. At the end of the war, slaves were freed; however, entities responsible for their rights were unidentifed. Although set free by law, many had nothing and were given nothing except their freedom. They almost certainly had been slaves previously but were listed in 1865 as servants.

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