Why was JB killed?

Mama2JML · Jan 19, 2014

MeanDonnaJean said:
FYI: the above link requires a log-in.

I make that same mistake quite often myself. Please log out then re-post link.

Just saw this. Will do! Thank you...

Mama2JML · Jan 19, 2014

Mama2JML said:
The description of the hymen, provided by Dr. Meyer in the AR, does not indicate JonBenet "had very little of a hymen left." The configuration of the hymen, as described by Dr. Meyer, is known as 'crescentic', and it's one of a few normal hymenal configurations observed in pre-pubescent females.

Source: *Warning Graphic Images*
http://www.medscape.com/viewarticle/723678_3

(^^^Link requires free registration/log-in.)

An excerpt from Hymen: Facts & Conceptions, also highlights variations of hymenal morphology. As well, the hymenal configuration observed @ autopsy, in this case, is most common:

"Variations of Hymenal Morphology

The hymen is a thin fold of mucous membrane situated just within the vaginal orifice.16 It is perforated to allow the egress of the menses. The aperture of the hymen ranges in diameter from pinpoint to one that admits the tip of one or even two fingers.17 The configuration of hymen differs dramatically from one female to another one.18 At birth, it is commonly annular in shape, while the crescentic configuration is most prevalent in children over age 3 years."

Source: http://www.thehealthj.com/december_2012/hymen_facts_and_conceptions.pdf

UKGuy · Jan 19, 2014

Mama2JML said:
The description of the hymen, provided by Dr. Meyer in the AR, does not indicate JonBenet "had very little of a hymen left." The configuration of the hymen, as described by Dr. Meyer, is known as 'crescentic', and it's one of a few normal hymenal configurations observed in pre-pubescent females.

Source: *Warning Graphic Images*
http://www.medscape.com/viewarticle/723678_3

I agree, and I'm open to consider other ideas. This is simply my research-based interpretation of the observations noted by Dr. Meyer.

Mama2JML,
BBM. Presumably Coroner Meyer was describing a normal hymen then? Without viewing the autopsy photographs, on what basis do you arrive at JonBenet's hymen being normal?

How do you know that JonBenet's hymen was not originally crescentic, but had degraded to this shape due to repeated chronic abuse?

Have you cross-referenced Coroner Myer's autopsy investigations to confirm if he has previously mistaken the genitals of any prepubertal girls?

When Coroner Myer tells you in his AR that JonBenet's hymenal orifice is 1x1 cm, and that verbatim Digital Penetration had taken place along with Sexual Contact, then in most people's estimation that is prima facie: a sexual assault or molestation has taken place, this is only the acute assault.

JonBenet's injuries suggest an ongoing chronic molestation since the various descriptions in the AR are all at different stages of healing.

6-year old girls, simply should not exhibit such a history, coupled with her death, which IMO was deliberate and intended to silence her, along with the basement staging, her body being cleaned up and redressed all allow the obvious conclusion that JonBenet was killed in an attempt to prevent her chronic and acute abuse being attributed to a member of the Ramsey family!

Mama2JML · Jan 19, 2014

UKGuy said:
Mama2JML,
BBM. Presumably Coroner Meyer was describing a normal hymen then? Without viewing the autopsy photographs, on what basis do you arrive at JonBenet's hymen being normal?

How do you know that JonBenet's hymen was not originally crescentic, but had degraded to this shape due to repeated chronic abuse?

Have you cross-referenced Coroner Myer's autopsy investigations to confirm if he has previously mistaken the genitals of any prepubertal girls?

When Coroner Myer tells you in his AR that JonBenet's hymenal orifice is 1x1 cm, and that verbatim Digital Penetration had taken place along with Sexual Contact, then in most people's estimation that is prima facie: a sexual assault or molestation has taken place, this is only the acute assault.

JonBenet's injuries suggest an ongoing chronic molestation since the various descriptions in the AR are all at different stages of healing.

6-year old girls, simply should not exhibit such a history, coupled with her death, which IMO was deliberate and intended to silence her, along with the basement staging, her body being cleaned up and redressed all allow the obvious conclusion that JonBenet was killed in an attempt to prevent her chronic and acute abuse being attributed to a member of the Ramsey family!

1. See my previous post in this thread. "Most prevalent" indicates normalcy with regard to the frequency of an observed configuration.

2. I do not know this.

3. No.

4. Right.

5. Not exactly.

6. I understand your position, but your proposal doesn't satisfy me. It leaves me with so many unanswered questions.

UKGuy · Jan 20, 2014

Mama2JML said:
1. See my previous post in this thread. "Most prevalent" indicates normalcy with regard to the frequency of an observed configuration.

2. I do not know this.

3. No.

4. Right.

5. Not exactly.

6. I understand your position, but your proposal doesn't satisfy me. It leaves me with so many unanswered questions.

Mama2JML,

1. See my previous post in this thread. "Most prevalent" indicates normalcy with regard to the frequency of an observed configuration.

So without the benifit of an observation you have decided on the basis of bell curve statistics that JonBenet's hymeneal configuration must fall into the central bands, completely ignoring the possibility of any outliers?

Bear in mind Wall Street used bell curve methods to measure financial risk, wilfully ignoring any possibility of outliers, since they were to big to fail, e.g. AIG bailout.

5. Not exactly.

So are you suggesting JonBenet had no prior internal injuries, and that the acute assault was a one off?

6. I understand your position, but your proposal doesn't satisfy me. It leaves me with so many unanswered questions.

Unless a Ramsey steps forward there will always be unanswered questions. On this forum we are largely dealing with probable fact, i.e. what reasonable people assume took place after they review the evidence.

On the balance of probabilities most of us assume JonBenet had been chronically molested and that her death and staging directly relate to this ongoing molestation.

Even allowing the assumption that there was no chronic abuse still does not invalidate the conclusion that JonBenet was killed to prevent her talking about her acute assault.

And if you wish to interpret her acute assault as staging and not of a sexual nature then you still have someone killing JonBenet yet staging her death to appear as that of a sexually motivated psychopath?

Why so?

.

Mama2JML · Jan 20, 2014

UKGuy said:
Mama2JML,

So without the benifit of an observation you have decided on the basis of bell curve statistics that JonBenet's hymeneal configuration must fall into the central bands, completely ignoring the possibility of any outliers?

No. I don't ignore the possibility.

Bear in mind Wall Street used bell curve methods to measure financial risk, wilfully ignoring any possibility of outliers, since they were to big to fail, e.g. AIG bailout.

So are you suggesting JonBenet had no prior internal injuries, and that the acute assault was a one off?

Could be. I'm not trying to "suggest" that exactly. I've tried to be very clear. I don't wish to imply anything.

Unless a Ramsey steps forward there will always be unanswered questions.

This doesn't satisfy me, and I don't agree.

On this forum we are largely dealing with probable fact, i.e. what reasonable people assume took place after they review the evidence.

I would like to think so.

On the balance of probabilities most of us assume JonBenet had been chronically molested and that her death and staging directly relate to this ongoing molestation.

I am unsure to which probabilities you refer, but it's evident we weigh the evidence differently.

Even allowing the assumption that there was no chronic abuse still does not invalidate the conclusion that JonBenet was killed to prevent her talking about her acute assault.

It is a possibility.

And if you wish to interpret her acute assault as staging and not of a sexual nature then you still have someone killing JonBenet yet staging her death to appear as that of a sexually motivated psychopath?

Why so?

I'm not sure why you're asking me. This doesn't describe my thoughts.

BBB167893 · Jan 20, 2014

UKGuy said:
JonBenet's injuries suggest an ongoing chronic molestation since the various descriptions in the AR are all at different stages of healing.

UKGuy's right. That's just what the other doctors told the police and DA. Also, let's not forget: during the BPD's presentation, they showed a side-by-side photo comparison of JB's vagina with that of an unmolested 6-y/o girl. The difference was said to be striking.

otg · Jan 21, 2014

(Mama2JML, I apologize for taking so long to reply to your excellent posts. You linked a lot of information I had to read and try to absorb in my little brain, and I had to do a bit of research in order to give you an equally intelligent response. All that, and this is only my part-time job . Ive combined everything into one post to try and keep all the information together.)

Mama2JML said:
Okay...

First, we must understand that the term 'chronic', used to describe the inflammation observed by Dr. Meyer, indicates a stage of healing, and is not intended to diagnose an ongoing/recurrent state of the vaginal wall. It simply indicates the membrane was observed to be healing. Next, we must consider why. It seems logical to surmise JonBenet's recent round of antibiotics caused a shift in fungal & bacterial levels present in a healthy child's vagina. Vaginal inflammation is a normal side effect & an expected result of a round of antibiotics.

I'll move on to the hymen next...

We agree about the term "chronic" as Dr. Meyer used it (and I'm glad someone understands it). I'm not certain about this recent round of antibiotics that you refer to (which I'll get to later). But if she had taken them, I agree that it could cause a change in the normal pH balance and kill off the "friendly" bacteria of a healthy vaginal environment which will ordinarily fight off fungal, bacterial, and viral infections. Vaginal inflammation is sometimes a result of this imbalance, but I don't think I would go so far as to call it an expected result. But so far, we don't completely disagree with one another.

This whole discussion would be unnecessary had testing been done to check for other possible causes of the inflammation. But it wasnt, probably because presented in total, Dr. Meyer saw the inflammation as related to the rest of the indications of sexual assault. But your position is that since the vaginal inflammation is one of the indications of prior abuse, it is possible that it might not be related to any prior abuse. Instead, you say, it might be coincidental from some other source. Ill agree with you that, however unlikely, it is possible. However, since we dont have anything to confirm or refute either of our positions, we have to look at likelihoods and probabilities, which probably isnt going to sway either of us from our positions. But youve made a very good case, Mama, and I have given it a great deal of thought. Ive also gone through my bookmarks looking for any information related to the subject, and Ive read the articles in the links you provided. Ill respond with my thoughts to make my case. This has taken me a while to gather the information, as we both know my simply writing my opinion counts for nothing. So Ill post references at the end so you (or anyone else) can verify my quotes and even look for more information than I thought relevant.

Mama2JML said:
otg said:

1. His findings were that the entire inside surface of JonBenets vagina (all sections of the vaginal mucosa) had vascular congestion (engorgement of blood at that level) 2. and the type of inflammation which indicated prior injury/injuries that had begun to heal (focal interstitial chronic inflammation).

Click to expand...

1. Agreed. This is not indicative of previous sexual abuse. Or, do you feel differently?

2. Inflammation of the vaginal mucousa, vaginitis or vulvovaginitis, is most often attributed to infection:

1. I agree that vaginal inflammation alone could be from something other than sexual abuse, as well as being from sexual abuse. So actually, taken by itself, it could be indicative of either. I think we can both agree on that.

2. Most often attributed to infection would depend on the group being compared. If it is all instances of vaginal inflammation, it would be comparing it to adults as well as premenarchal girls. If so, any inflammation experienced by most adult women would certainly not likely be from sexual abuse (as in the case with a child), and would therefore skew any implied statistics about its frequency as the cause.

OTOH, if you are only comparing prepubertal girls, I would imagine the likelihood of infection versus abuse as the cause of inflammation to be much more in line with one another. But thats just a guess; I have no statistics to support that supposition. It most likely would depend on how frequently child abuse is reported or found, and how common some type of infection is (within JonBenets age group).

So how common is vaginal infection in girls around JonBenets age, and what are the causes?

"Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection."
Source: http://www.mayoclinic.org/diseases-conditions/vaginitis/basics/definition/con-20022645

The entire quote from your Mayo Clinic link says the following (note the bbm):

Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection. Vaginitis can also result from reduced estrogen levels after menopause.

The most common types of vaginitis are:

Bacterial vaginosis, which results from overgrowth of one of several organisms normally present in your vagina
Yeast infections, which are usually caused by a naturally occurring fungus called Candida albicans
Trichomoniasis, which is caused by a parasite and is commonly transmitted by sexual intercourse
Vaginal atrophy (atrophic vaginitis), which results from reduced estrogen levels after menopause

Treatment depends on the type of vaginitis you have.

So indeed we are looking here at all women -- not children (or else we wouldnt be considering postmenopausal women in the group). So if we eliminate the last type (vaginal atrophy) because of age group, and the one above it (Trichomoniasis) because we are (for the time being) excluding sexual intercourse as a cause, that leaves us with either bacterial or yeast infection as the possible most likely types of vaginitis (assuming for the time being that the inflammation is from systemic vaginitis and not due to sexual abuse).

&

"Bacteria, yeast, viruses, chemicals in creams or sprays, or even clothing can cause vaginitis. Sometimes, vaginitis occurs from organisms that are passed between sexual partners. In addition, the vaginal environment is influenced by a number of different factors including a womans health, her personal hygiene, medications, hormones (particularly estrogen), and the health of her sexual partner. A disturbance in any of these factors can trigger vaginitis."
Source: http://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID=85&ContentID=P00595

Again, most of this quote is relevant to adult women. In looking for information on this, we have to be careful not to include information which is not applicable to someone in JonBenets age group. From Sexually Transmitted Diseases: Vaccines, Prevention, and Control:

The normal anatomy, physiology, and microbial etiology of the vagina are age-dependent (Cruickshank and Sharman, 1934). There are also obvious age-dependent differences in the source of vaginal infections. These factors account for different etiologies of vaginitis in neonates, infants, prepubertal girls, and premenopausal and postmenopausal adults (Farage and Maibach, 2006) (Table 2.1).

Also from the same book (bbm):

As the neonate grows into infancy the cuboidal vaginal epithelium becomes susceptible to bacterial STIs of N. gonorrhoeae and C. trachomatis, but becomes resistant to candidiasis. Vaginal infection by N. gonorrhoeae among infants is thought to represent postnatal acquisition, usually from abusive situations.

In older premanarchal girls the etiology of vaginal symptoms is correlated with the status of puberty and the presence or absence of signs of abnormal vaginal discharge. In one study of premenarchal patients with suspected vaginitis and age-matched controls (Hammerschlag, et al., 1978), a microbial pathogen was isolated from 53% of patients with abnormal vaginal discharge, none with only suspected vaginitis without discharge, and one of the control subjects. N. gonorrhoeae was isolated from one-third of abnormal vaginal discharges in prepubertal girls, whereas Candida albicans was isolated only from those premenarchal girls who were considered to be pubertal based on breast growth (Tanner stages II, III, or IV). C. trachomatis has not been implicated as a common cause of prepubertal vaginitis, but its occurrence in prepubertal sexually abused girls has been documented in several studies (Fuster and Neinstein, 1987; Shapiro et al., 1993).

I think you and I, Mama, as well as others reading this, can agree to exclude STIs (mentioned in the preceding passage) as a factor. For one thing, the responses to an STI would not be present if it was contracted during the last sexual assault, so that would mean it would have to have been contracted earlier enough to confirm the prior abuse which you are taking the position of trying to disprove (at least for the sake of argument as Devils advocate). So discounting this, that leaves the two other possible causes: bacterial or yeast (Candida). In the above referenced study, Candida was only found in girls who were at puberty (JonBenet would be at stage I in the Tanner scale, and therefore would be excluded). Continuing:

About 75% of women get candida vaginitis at some time in their lives. Vaginal candida does not generally occur without estrogen, so premenarchal girls and postmenopausal women not on estrogen replacement almost never develop vaginal yeast.

I know what you might be thinking. Saying almost never does not completely exclude the possibility. And on that, I have to agree. But here again we are down to the likelihood of something as opposed to the possibility, and we will probably never get beyond that point.

From Synopsis of Pediatric Emergency Medicine:

The term nonspecific vaginitis, referring to a disorder of prepubertal girls, encompasses a variety of genitourinary symptoms and signs that are sometimes caused by poor perineal hygiene but that in other cases have no readily identifiable cause. Genital discomfort, discharge, itchiness, and dysuria are relatively common childhood complaints. When a girl with such symptoms has either a normal vulva and vagina or only mild vulvar inflammation on physical examination, a specific vaginal infection is unlikely, and other possible explanations for the complaint -- smegma, pinworms, urinary tract infection, a local chemical irritant, or sexual abuse, for example -- should be sought with appropriate questions and laboratory tests. (It should be noted that commercially available bubble bath is not often the culprit.) If, on the other hand, a vaginal discharge is present on physical examination, the specific vaginal infections discussed in this chapter are diagnostic possibilities, and cultures should therefore be obtained. In reported series of premenarchal girls with vaginitis who have been systematically evaluated, between 25% and 75% ultimately are categorized as having nonspecific vaginitis. The diagnosis should not be made until other entities have been excluded.

From Pediatric Emergency Medicine:

Pathologic vaginal discharge and inflammation (vaginitis) is much more common in postmenarchal adolescents and adults than in the pediatric age range.

Reduced levels of estrogen and the more alkaline pH of the vagina in premenarchal girls are two important reasons why the prevalence, etiology, and presentation of vaginitis is different in premenarcheal girls than postmenarchal adolescents and adults.

The majority of cases of premenarchal vulvovaginitis are not caused by an infection, yet when the patient has a visible vaginal discharge, there is a higher likelihood of a specific infectious cause.

So for vaginitis to occur from something other than physical means (regardless of its cause), it needs two things: an upset to the natural balance of the vagina (which could certainly be from antibiotics), and an environment that would allow it to thrive (the higher level of estrogen produced with the onset of puberty).

As noted above, it would help to know whether or not she had any vaginal discharge in order to confirm the possibility of a bacterial infection. But the last time Dr. Beuf had seen her (according to him in an interview with Diane Sawyer) was in August of the same year for a routine physical which included (according to him) a vaginal exam. There is nothing (to my knowledge) to indicate he found anything out of the ordinary at that time to suggest any vaginal concerns; so we can surmise she had no unusual discharges found by, or reported to, him. Had something serious come up after that, I have no doubt that Patsy would have consulted him. The other things that people remember come from much earlier (September 1993 -- a call about vaginal redness, possibly associated with recent diarrhea. April 1994 -- a visit about a problem perhaps related to the use of bubble bath, which can be an irritant.) I think these dates were probably (and I believe most will agree) before any sexual abuse had begun. So I think we can assume that no one was aware anyway of any unusual vaginal discharge which would be an indication of a bacterial infection (or yeast). And as for the bubble bath irritant, that had been noted and taken care of back in April of 1994, and Patsy should have discontinued them after that if that was a concern (even though other sources will dispute this as a problem because commercial bubble baths are formulated so they should not cause irritation in children, as noted in the previous quote above).

Ill point out here that I cant help but be at least just a little suspicious of information given by Dr. Beuf. One reason is the ridiculous answer he gave to Diane Sawyer in response to her question about his routine vaginal exam:

DIANE SAWYER:If there had been an abrasion involving the hymen, you would have seen it?

Dr. FRANCESCO BEUF: Probably. I can't say absolutely for sure because you don't do a speculum exam on a child that young at least unless it's under anesthesia.

:what:

What?!!! Does he not know where the hymen is located, or does he not know what a speculum is for? Or, does he just think were too stupid to think about what he said?

&

"Respiratory pathogens are the bacteria isolated most often. Group A beta-hemolytic Streptococcus is the pathogen identified most commonly in all cases of vulvovaginitis and may cause, in addition to a nonspecific discharge, a dramatic scarlet, well-demarcated dermatitis of the vulva or perianal tissues. (7) Haemophilus influenzae (nonen- capsulated) is another common pathogen. These bacte- rial infections are likely to be caused by self-inoculation as a child carries bacteria from her nose and mouth via her hand to her vulva."
Source: http://depts.washington.edu/hcsats/...lems in Prepubertal Gyn Sugar Graham 2006.pdf

I have to admit that I wasnt aware that respiratory pathogens might cause vaginal infection if carelessly transferred by the person. I would have thought the nature of the pathogen would make it unique to its environment and therefore not viable in some other area of the body. I hadnt read about this anywhere else until I read your post. Ive since looked into it and I agree that apparently it is not that rare for this to happen. However, we have to be careful to distinguish between bacterial and viral pathogens. Antibiotics are useless against viruses, and most respiratory illnesses are viral -- not bacterial. Strep throat (from the streptococcus bacteria) is one that would be treated with antibiotics, but a doctor shouldnt try to diagnose and treat that without visually examining the patient. To learn more about this, here are some links:

http://www.nlm.nih.gov/medlineplus/ency/article/000678.htm
http://www.health.com/health/condition-article/0,,20251853,00.html
http://www.webmd.com/cold-and-flu/cold-guide/antibiotics-colds
http://www.webmd.com/oral-health/tc/strep-throat-topic-overview
http://www.cdc.gov/features/getsmart/

According to JonBenet's pediatrician, Dr. Francesco Beuf, she was last evaluated five weeks before her death during a follow-up visit as she had recently been diagnosed with, and treated for, a sinus infection. The "chronic inflammation" noted in the autopsy report is likely attributable to antibiotic treatment (reduced levels of healthy bacteria & increased levels of yeast) &/or to the respiratory bacteria itself.

Im not sure about the timing of the sinus infection, the follow-up visit, or the use of an antibiotic five weeks before her death. The only information I know of to go by is the interview he did with Diane Sawyer where he stated she was last seen as part of a routine physical in August, and notes that were alleged to have been related to Detective Harmer (which I cannot verify or substantiate) where the following dates were given (from FFJ post [ame="http://www.forumsforjustice.org/forums/showpost.php?p=11609&postcount=39"]here[/ame]). Ill repost all of the dates and notations so well have it here:

8/6/90: JBR born.

12/6/91: First visit with Beuf. Treated for fever, cough, and wheezing.

Over next 10 months, she had the usual colds and coughs of a toddler.

1/93: Diagnosed with ear infection (her first). Amoxicillin prescribed.

By age 2 1/2, she had a history of coughs accompanied by low grade fever.

3/93: First serious illness, fever 102, difficulty breathing. Coughed up yellow mucus and looked droopey.

7/93: (Patsy diagnosed with cancer; JBR under Nedra's care). Regressed in toilet training and eating habits.

8/31/93: Responding to Beuf's questions, Patsy says JBR doesn't have any phobias and no aspect of JBR's sexual education needed to be discussed.

9/6/93: Buttocks and vaginal area chafed red from diarrhea.

11/93: Cough and stuffed nose. Sleeping poorly, grouchy from fatigue, bad breath. Chronic sinusitis.

12/31/93: Still drinking from bottle; parents having trouble weaning her.

1/94: Bad breath, cough and congestion.

2/4/94: Nedra suggests Fifth Disease. (Childhood viral illness, often accompanied by rash. Fifth in line of common childhood diseases, i.e., chickenpox, measles). No medication prescribed.

4/94: Breath still bad, runny nose, little appetite, slept poorly, bladder infection and vaginal discharge. Diagnosed with vaginitis. Amoxicillin prescribed and warned against bubble baths.

4/94: (3 weeks later) Still coughing, stuffy nose, congestion. Ear hurt, cranky. Diagnosed with allergic rhinitis, Benedryl prescribed.

4/94: (1 week later). Still coughing, Suprax prescribed.

10/5/94: Came in for checkup, doctor notices scar on left cheek. She'd been hit accidentally by a golf club when the family was in Charlevoix. A week after the accident, a plastic surgeon was consulted. No injury to cheekbone. Beuf is told (at this visit) that she's getting along with brothers and older sister. Wearing pullups at night because she's wetting bed. Patsy completes developmental questionnaire, and says there are no aspects of JonBenet's behavior or sex education she needed to discuss, and also notes JBR has no fears or phobias.

11/1/94: Had diarrhea five times and was lethargic. One bowel movement appeared bloody.

11/4/94: Badly congested, deep cough, bad breath. Diarrhea gone.

1/1/95: Chickenpox. Rash even appears in vaginal area. Recommended Avino, Benadryl and Lanocaine.

1/31/95: Still has bad cough and not sleeping well. Robitussin not helping.

Mid-Feb/95: Cough. Temp 99.3.

3/95: Complained of stomachache but sleeping well.

4/95: JR calls in, says JBR has another cough, but he doesn't think daughter needs to be examined.

5/8/95: JBR falls in Alfalfa's food market, lands on nose, not broken.

12/95: Trips and hits head above left eye. Stuffy nose, bad breath, coughing.

3/96: Coughing a lot.

5/96: Bent nail back on fourth finger, left hand, in another fall. Swollen and painful, but no bruising. Ibuprofen recommended.

8/27/96: Patsy reports JBR's a good sleeper, wasn't hard to get to bed, and was easily awakened in the morning. Not interested in opposit sex, behaved modestly in public, and didn't engage in sex play with her friends. She was, however, asking about sex roles and reproduction. She was not rude or afraid of either parent. Didn't seem to be bossy with brother, didn't react with trantrums, and was active. Loved fruit and some vegetables. Patsy said she was delightful and doing very well. Burke had his annual checkup same day.

9/96: Cough back, Robitussin recommended.

10/96: Stuffy nose, bad breath. Diagnosed with allergic rhinitis.

11/12/96: Runny nose and cold sore, sneezing.

12/3/96: Sees eye doctor.

12/96: Misses pageant due to illness.

[Note: In the above list, it seems like (my speculation here) that the specific dates are for actual office visits, and the approximate dates (mo/yr only) are phone consultations or simple notations.] Notice in this list that it notes what was prescribed, what over-the-counter medications were recommended, and even in one case (2/4/94) he mentions No medication prescribed.

In the Diane Sawyer interview, he lists the following:

DIANE SAWYER: (voice-over) We asked him to specifically review all notes that might pertain. He agreed, citing the frenzy of uninformed speculation. Be warned, these are a doctor's clinical notes about a young patient.

September 1993 -- a call about vaginal redness, possibly associated with recent diarrhea.

April 1994 -- a visit about a problem perhaps related to the use of bubble bath, which can be an irritant.

October 1994 -- a routine physical. No problems noted, though some indication of occasional bedwetting. Dr. Beuf says 20 percent to 25 percent of children that age wet the bed.

March 1995 -- abdominal pain and fever. Tests and exam showed no problem.

August 1996 -- another routine physical with a vaginal exam. The doctor said everything checked out as normal.

But later from the phone interview Sawyer states the following:

DIANE SAWYER: (on camera) And some other notes. Dr. Beuf says he last saw JonBenet Ramsey in November 1996, and that was a checkup for a sinus infection.

This November 1996 checkup for a sinus infection would coincide with the 11/12/96 date from the earlier transcription where no mention is made of any prescribed or recommended medications. Neither does he mention to Sawyer that he had prescribed any medications. Symptoms listed for 11/12/96 are, Runny nose and cold sore, sneezing. Those are not symptoms that would warrant a diagnosis of a bacterial infection, and therefore antibiotics would have been useless (from links above). [A cold sore, BTW for anyone who doesnt know, is from a virus -- herpes simplex I (usually), or sometimes HSV-II.]

Im not a doctor, but Beuf was. I have to add that if he was able to diagnose allergic rhinitis over the phone (10/96), hes pretty damn good (or... not so much :giggle: ). But being that good of a doctor, I cant imagine that he would prescribe an antibiotic for an allergy, much less not make note of the prescribed medication.

With all things considered from above, I dont believe we can assume that JonBenet was taking antibiotics shortly before her death. And since there is no direct evidence of it (to my knowledge), I dont believe that it can be considered as a possible cause for the vaginal inflammation that was found in her autopsy.

Mama2JML said:
otg said:

There was an area of hymenal tissue that had a 1 cm red-purple area of abrasion (the abrasion would be acute) from which he removed a sample for microscopic examination.

Click to expand...

Agreed.

otg said:

His finding from it was that it contained epithelial erosion with underlying capillary congestion.

Click to expand...

I am not surprised by these findings, nor do I believe these observations indicate prior sexual abuse.

otg said:

3. IOW, it had an eroded surface (resulting from repeated exposure)

Click to expand...

Exposure to?

...something physical -- not systemic or pathogenic, and not part of a natural process of shedding dead cells.

Mama2JML said:
The hymen erodes naturally over time, and medical conditions, (i.e. vaginitis) contribute to epithelial erosion. 'Everyday activities' contribute as well. Children grow, hormone levels vary (drastically) from birth to age 6, and skin sheds. This is not atypical.

Erosion (from a medical definition): Superficial destruction of a surface by friction, pressure, ulceration, or trauma.

Epithelial erosion is the loss of the thin layer of cells formed on the surface of (in this case) the hymenal tissue. From The microscopic anatomy of the hymen:

The main bulk of the hymen is formed of fibrous connective tissue, partly elastic and partly collagenous fibers. Both surfaces are covered by stratified squamous epithelium which lacks any evidence of cornification. The epithelium is thicker at the attached edge.

The microscopic examination done by Dr. Meyer should give him the information he needed to determine what he stated. He would see the loss of the layer of stratified squamous epithelium exposing the vascular sub-layer of the hymenal tissue. This is how he determined that the mucosal layer of the hymen was eroded. In the natural process of shedding cells, older cells are replaced with new ones of the same microscopic structure before the dead cells fall off. If this thin layer of cells on the surface is missing, it exposes the underlying cellular structure called the lamina propria. From Wikipedia:

The lamina propria (more correctly lamina propria mucosæ) is a thin layer of loose connective tissue, or dense irregular connective tissue, which lies beneath the epithelium and together with the epithelium constitutes the mucosa. As its Latin name indicates it is a characteristic component of the mucosa, "the mucosa's own special layer". Thus the term mucosa or mucous membrane always refers to the combination of the epithelium plus the lamina propria.

The loss of the layer of epithelium (whether it is on the hymen or in the vagina) is not natural. It is obvious microscopically. It is evidence of something having physically removed it.

Mama2JML said:
otg said:

4. with increased capillary activity (the bodys response indicating a healing injury).

Click to expand...

...a healing injury, like a bruise?

Depending on the type of injury and where it is, there are different grossly visible, as well as microscopic, indications. The color of a bruise is a visible indication of how far along in the healing process it is. In the mucosal tissue of the hymen addressed in the AR, the underlying capillary congestion (underneath the eroded epithelium) is determined microscopically. It would probably be (depending on the extent) grossly visible as being unusually redder in color than surrounding tissue. This could be due to the bodys reaction by angiogenesis (depending on the amount of time since injury), or it could be from reactive hyperemia.

Mama2JML said:
I DO know that 'capillary congestion', in the female sex organs, is a result of sexual arousal. EA, perhaps? Regardless of one's RDI/IDI leanings, this is plausible.
Source: http://books.google.com/books?id=Pi...a=X&ei=qI_YUoeYNcr22QXe_oCgDg&ved=0CCgQ6AEwAA

This is not plausible. In fact, this one really stretches the boundaries of credulity. Even mentioning it seems to me a desperate attempt at straw grasping, but Ill address it nonetheless.

First of all, the capillary congestion that occurs in the adult female sex organs during arousal (as well as other responses) is transient. We all wish it could last longer, but its just doesnt. Even in speaking about adults where sexual arousal can occur, it does not extend beyond death. This heightened peak of arousal is supported not only by the physical stimuli causing it, but by the mental excitement as well. This only happens in living persons.

Secondly (and this probably should have been firstly), I dont think a child is even capable of sexual arousal. If you care to dispute this, Ill have to take your word for it. Im not about to start researching the subject on my computer and risk someone, someday, for some reason, seeing that I had been searching the subject.

Lastly, it looks like well never be able to totally dismiss the EA BS. This has been addressed so many times by so many people, it doesnt deserve consideration. As much respect as I have for him, I blame this on Dr. Wecht for bringing it up in trying to account for injuries he misinterpreted (IMO). But since you bring it up in a different context (as a possible stimulus for sexual arousal, in a child, that lasts beyond death and into the second day afterwards when it would show up in the autopsy as a source of vascular congestion in her genitalia), Ill tell you why it doesnt apply here. The auto-erotic practice of depriving the brain of oxygenated blood (cerebral hypoxia) is done to heighten the persons orgasm. The only stimulation it might provide beyond the climax itself is in the mind of a person who has practiced it in the past and has had a pleasurable experience from it. This mental stimulation is not something that would be experienced by a person having it forced on them. Wecht implied it was for the visual stimulation of the person he believed was forcing it on JonBenet. I can assure you, it would not be pleasurable for her, and it would not have caused a sexual response in her.

Mama2JML said:
otg said:

5. So when he tells us that her uterus measures 3 x 1 x 0.8cm, and that the hymenal orifice is 1x1 cm, and that the hymen itself is represented by a rim of mucosal tissue extending clockwise between the 2 and 10:00 positions, we are supposed to understand that she has very little left of a hymen (which is something Nancy Grace doesnt seem to understand). In fact, it is completely missing in the upper one-third of its circumference (clockwise from 10 to 2). What is there in the lower two-thirds (clockwise from 2 to 10) is an eroded and retracted rim of tissue, meaning that it has been exposed repeatedly enough to cause this reaction. A single forceful entry will usually cause tears (none of which were noted in the AR) and bleeding in the membrane. (This is despite the misconceptions of pubescent boys about a mysterious organ called a cherry that gets popped during first intercourse.) After repeated exposure, the hymen erodes and retracts until it is no longer present.

Click to expand...

The description of the hymen, provided by Dr. Meyer in the AR, does not indicate JonBenet "had very little of a hymen left." The configuration of the hymen, as described by Dr. Meyer, is known as 'crescentic', and it's one of a few normal hymenal configurations observed in pre-pubescent females.

Source: *Warning Graphic Images*
http://www.medscape.com/viewarticle/723678_3

I agree with you that the shape of the hymen itself is not enough to conclude sexual abuse. The crescent shape (according to your link) is equally common with the annular hymen. Ive read different approximations, but it doesnt matter which is most common because it is certainly not rare according to any source. Even the wider absence of hymen written in the AR over this articles estimation of an 11 to 1 oclock absence is not in itself cause for a conclusion by itself. But if you consider this along with the remaining small, retracted and eroded rim of hymen described by Dr. Meyer, I believe it all adds up (along with all the other vaginal evidence) to more than can be ignored as evidence of continuing sexual abuse leading up to JonBenets death.

BTW, the link you provided here is to one of the best articles Ive read online describing what a medical professional should be looking for in screening patients for possible sexual abuse. (And in case anyone was unable to understand my earlier point about Dr. Beufs use of a speculum for hymen examination, there are certainly enough pictures to provide explanation.) Page 6 of the article has a good explanation of the healing process of genital injuries (more specific than any Ive ever read) and is useful in considering the period of time in which the injuries could have occurred. In fact, its so good, Im going to copy it here for the benefit of anyone who wants to read it:

Superficial genital injuries, such as abrasions, bruises, and transections, usually progress through a process of regeneration that involves four stages (Finkel, 1989, McCann et al., 1992). These stages include thrombosis and inflammation, regeneration of epithelium over the denuded surface, multiplication of new cells, and differentiation of the new epithelium. Wound healing may be complete in 48 to 72 hours, while further differentiation of new epithelium may take 5 to 7 days (McCann et al., 1992). Complete restoration of normal tissue may take up to 6 weeks. The injuries heal without scar formation.

Mama2JML said:
otg said:

This is all stuff that shouldnt matter whether you or I are IDI or RDI. This is all information found in the AR. We can disagree politely with one another on who we think is responsible, but there really shouldnt be any disagreement on the injuries and what they mean. Again, Medicalese is not my native language (I'm still learning it), so if I wasnt clear in explaining what I was trying to say, or if you (or anyone) has any questions about what I meant, just let me know and Ill be glad to discuss it more with you.

Click to expand...

I agree, and I'm open to consider other ideas. This is simply my research-based interpretation of the observations noted by Dr. Meyer.

Mama, I know you are sincere in your beliefs, and I think you are open to changing your opinion if you are convinced. Thats the only reason I would have considered spending as much time as I have gathering the information I believe is important in answering your posts. Ive seen others who I know cannot be swayed from their expressed beliefs for reasons I dont expect to know. Its not that I think Im capable of convincing you otherwise, but I dont mind telling you what I read into the evidence and discussing it with you so we might both be able to learn something. I did, and I appreciate the opportunity.

(Now I have a lot of catching up to do on all the rest of the posts made since I started this.)

Sources (and Resources):

http://www.mayoclinic.org/diseases-conditions/vaginitis/basics/definition/con-20022645
http://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID=85&ContentID=P00595
Sexually Transmitted Diseases: Vaccines, Prevention, and Control, edited by Lawrence R. Stanberry, Susan L Rosenthal
http://umm.edu/health/medical/altmed/condition/vaginitis
Synopsis of Pediatric Emergency Medicine, edited by Gary Robert Fleisher, Stephen Ludwig, Benjamin K. Silverman
Pediatric Emergency Medicine,Steven G. Rothrock, John A. Brennan
http://depts.washington.edu/hcsats/...lems in Prepubertal Gyn Sugar Graham 2006.pdf

The microscopic anatomy of the hymen, by Maher Mahran and A. M. Saleh (Abstract)
http://medical-dictionary.thefreedictionary.com/cell
http://en.wikipedia(dot)org/wiki/Epithelium
http://www.merriam-webster.com/medical/lamina propria
https://www.inkling.com/read/histology-cell-biology-kierszenbaum-tres-3rd/chapter-22/vagina
http://en.wikipedia(dot)org/wiki/Angiogenesis
http://en.wikipedia(dot)org/wiki/Wound_healing
http://en.wikipedia(dot)org/wiki/Hyperaemia
http://www.nlm.nih.gov/medlineplus/ency/article/001435.htm
http://www.corpus-delicti.com/auto.html

http://www.medscape.com/viewarticle/723678_6

Tawny · Jan 21, 2014

I always picture otg dropping a mic after these posts.

questfortrue · Jan 21, 2014

Tawny said:
I always picture otg dropping a mic after these posts.

I know how much time and thought OTG put into his reply and I'm really appreciative of the knowledge he provided.

Your video clip though :floorlaugh: Now I picture him that way too, a dropped mic moment.

Mama2JML · Jan 21, 2014

Tawny said:
I always picture otg dropping a mic after these posts.

No way. otg is a gentleman. Ego doesn't drive him. He's my favorite RDI by far.
:loveyou:

Tawny · Jan 21, 2014

Mama2JML said:
No way. otg is a gentleman. Ego doesn't drive him. He's my favorite RDI by far.
:loveyou:

I definitely agree! It's just a funny visual :floorlaugh:

Mama2JML · Jan 21, 2014

otg said:
(Mama2JML, I apologize for taking so long to reply to your excellent posts. You linked a lot of information I had to read and try to absorb in my little brain, and I had to do a bit of research in order to give you an equally intelligent response. All that, and this is only my part-time job . I’ve combined everything into one post to try and keep all the information together.)

We agree about the term "chronic" as Dr. Meyer used it (and I'm glad someone understands it). I'm not certain about this recent round of antibiotics that you refer to (which I'll get to later). But if she had taken them, I agree that it could cause a change in the normal pH balance and kill off the "friendly" bacteria of a healthy vaginal environment which will ordinarily fight off fungal, bacterial, and viral infections. Vaginal inflammation is sometimes a result of this imbalance, but I don't think I would go so far as to call it an expected result. But so far, we don't completely disagree with one another.

This whole discussion would be unnecessary had testing been done to check for other possible causes of the inflammation. But it wasn’t, probably because presented in total, Dr. Meyer saw the inflammation as related to the rest of the indications of sexual assault. But your position is that since the vaginal inflammation is one of the indications of prior abuse, it is possible that it might not be related to any prior abuse. Instead, you say, it might be coincidental from some other source. I’ll agree with you that, however unlikely, it is possible. However, since we don’t have anything to confirm or refute either of our positions, we have to look at likelihoods and probabilities, which probably isn’t going to sway either of us from our positions. But you’ve made a very good case, Mama, and I have given it a great deal of thought. I’ve also gone through my bookmarks looking for any information related to the subject, and I’ve read the articles in the links you provided. I’ll respond with my thoughts to make my case. This has taken me a while to gather the information, as we both know my simply writing my opinion counts for nothing. So I’ll post references at the end so you (or anyone else) can verify my quotes and even look for more information than I thought relevant.

1. I agree that vaginal inflammation alone could be from something other than sexual abuse, as well as being from sexual abuse. So actually, taken by itself, it could be indicative of either. I think we can both agree on that.

2. “Most often attributed to infection” would depend on the group being compared. If it is all instances of vaginal inflammation, it would be comparing it to adults as well as premenarchal girls. If so, any inflammation experienced by most adult women would certainly not likely be from sexual abuse (as in the case with a child), and would therefore skew any implied statistics about its frequency as the cause.

OTOH, if you are only comparing prepubertal girls, I would imagine the likelihood of infection versus abuse as the cause of inflammation to be much more in line with one another. But that’s just a guess; I have no statistics to support that supposition. It most likely would depend on how frequently child abuse is reported or found, and how common some type of infection is (within JonBenet’s age group).

So how common is vaginal infection in girls around JonBenet’s age, and what are the causes?

The entire quote from your Mayo Clinic link says the following (note the bbm):
Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection. Vaginitis can also result from reduced estrogen levels after menopause.

The most common types of vaginitis are:

Bacterial vaginosis, which results from overgrowth of one of several organisms normally present in your vagina

Yeast infections, which are usually caused by a naturally occurring fungus called Candida albicans

Trichomoniasis, which is caused by a parasite and is commonly transmitted by sexual intercourse

Vaginal atrophy (atrophic vaginitis), which results from reduced estrogen levels after menopause

Treatment depends on the type of vaginitis you have.

So indeed we are looking here at all women -- not children (or else we wouldn’t be considering postmenopausal women in the group). So if we eliminate the last type (vaginal atrophy) because of age group, and the one above it (Trichomoniasis) because we are (for the time being) excluding sexual intercourse as a cause, that leaves us with either bacterial or yeast infection as the possible most likely types of vaginitis (assuming for the time being that the inflammation is from systemic vaginitis and not due to sexual abuse).

Again, most of this quote is relevant to adult women. In looking for information on this, we have to be careful not to include information which is not applicable to someone in JonBenet’s age group. From Sexually Transmitted Diseases: Vaccines, Prevention, and Control:
The normal anatomy, physiology, and microbial etiology of the vagina are age-dependent (Cruickshank and Sharman, 1934). There are also obvious age-dependent differences in the source of vaginal infections. These factors account for different etiologies of vaginitis in neonates, infants, prepubertal girls, and premenopausal and postmenopausal adults (Farage and Maibach, 2006) (Table 2.1).

Also from the same book (bbm):
As the neonate grows into infancy the cuboidal vaginal epithelium becomes susceptible to bacterial STIs of N. gonorrhoeae and C. trachomatis, but becomes resistant to candidiasis. Vaginal infection by N. gonorrhoeae among infants is thought to represent postnatal acquisition, usually from abusive situations.

In older premanarchal girls the etiology of vaginal symptoms is correlated with the status of puberty and the presence or absence of signs of abnormal vaginal discharge. In one study of premenarchal patients with suspected vaginitis and age-matched controls (Hammerschlag, et al., 1978), a microbial pathogen was isolated from 53% of patients with abnormal vaginal discharge, none with only suspected vaginitis without discharge, and one of the control subjects. N. gonorrhoeae was isolated from one-third of abnormal vaginal discharges in prepubertal girls, whereas Candida albicans was isolated only from those premenarchal girls who were considered to be pubertal based on breast growth (Tanner stages II, III, or IV). C. trachomatis has not been implicated as a common cause of prepubertal vaginitis, but its occurrence in prepubertal sexually abused girls has been documented in several studies (Fuster and Neinstein, 1987; Shapiro et al., 1993).

I think you and I, Mama, as well as others reading this, can agree to exclude STIs (mentioned in the preceding passage) as a factor. For one thing, the responses to an STI would not be present if it was contracted during the last sexual assault, so that would mean it would have to have been contracted earlier enough to confirm the prior abuse which you are taking the position of trying to disprove (at least for the sake of argument as Devil’s advocate). So discounting this, that leaves the two other possible causes: bacterial or yeast (Candida). In the above referenced study, Candida was only found in girls who were at puberty (JonBenet would be at stage I in the Tanner scale, and therefore would be excluded). Continuing:
About 75% of women get candida vaginitis at some time in their lives. Vaginal candida does not generally occur without estrogen, so premenarchal girls and postmenopausal women not on estrogen replacement almost never develop vaginal yeast.

I know what you might be thinking. Saying “almost never” does not completely exclude the possibility. And on that, I have to agree. But here again we are down to the likelihood of something as opposed to the possibility, and we will probably never get beyond that point.

From Synopsis of Pediatric Emergency Medicine:
The term nonspecific vaginitis, referring to a disorder of prepubertal girls, encompasses a variety of genitourinary symptoms and signs that are sometimes caused by poor perineal hygiene but that in other cases have no readily identifiable cause. Genital discomfort, discharge, itchiness, and dysuria are relatively common childhood complaints. When a girl with such symptoms has either a normal vulva and vagina or only mild vulvar inflammation on physical examination, a specific vaginal infection is unlikely, and other possible explanations for the complaint -- smegma, pinworms, urinary tract infection, a local chemical irritant, or sexual abuse, for example -- should be sought with appropriate questions and laboratory tests. (It should be noted that commercially available bubble bath is not often the culprit.) If, on the other hand, a vaginal discharge is present on physical examination, the specific vaginal infections discussed in this chapter are diagnostic possibilities, and cultures should therefore be obtained. In reported series of premenarchal girls with vaginitis who have been systematically evaluated, between 25% and 75% ultimately are categorized as having nonspecific vaginitis. The diagnosis should not be made until other entities have been excluded.

From Pediatric Emergency Medicine:
Pathologic vaginal discharge and inflammation (vaginitis) is much more common in postmenarchal adolescents and adults than in the pediatric age range.

Reduced levels of estrogen and the more alkaline pH of the vagina in premenarchal girls are two important reasons why the prevalence, etiology, and presentation of vaginitis is different in premenarcheal girls than postmenarchal adolescents and adults.

The majority of cases of premenarchal vulvovaginitis are not caused by an infection, yet when the patient has a visible vaginal discharge, there is a higher likelihood of a specific infectious cause.

So for vaginitis to occur from something other than physical means (regardless of its cause), it needs two things: an upset to the natural balance of the vagina (which could certainly be from antibiotics), and an environment that would allow it to thrive (the higher level of estrogen produced with the onset of puberty).

As noted above, it would help to know whether or not she had any vaginal discharge in order to confirm the possibility of a bacterial infection. But the last time Dr. Beuf had seen her (according to him in an interview with Diane Sawyer) was in August of the same year for a routine physical which included (according to him) a “vaginal exam”. There is nothing (to my knowledge) to indicate he found anything out of the ordinary at that time to suggest any vaginal concerns; so we can surmise she had no unusual discharges found by, or reported to, him. Had something serious come up after that, I have no doubt that Patsy would have consulted him. The other things that people remember come from much earlier (“September 1993 -- a call about vaginal redness, possibly associated with recent diarrhea. April 1994 -- a visit about a problem perhaps related to the use of bubble bath, which can be an irritant.&#8221 I think these dates were probably (and I believe most will agree) before any sexual abuse had begun. So I think we can assume that no one was aware anyway of any unusual vaginal discharge which would be an indication of a bacterial infection (or yeast). And as for the “bubble bath irritant”, that had been noted and taken care of back in April of 1994, and Patsy should have discontinued them after that if that was a concern (even though other sources will dispute this as a problem because commercial bubble baths are formulated so they should not cause irritation in children, as noted in the previous quote above).

I’ll point out here that I can’t help but be at least just a little suspicious of information given by Dr. Beuf. One reason is the ridiculous answer he gave to Diane Sawyer in response to her question about his “routine vaginal exam”:
DIANE SAWYER:If there had been an abrasion involving the hymen, you would have seen it?

Dr. FRANCESCO BEUF: Probably. I can't say absolutely for sure because you don't do a speculum exam on a child that young at least unless it's under anesthesia.

:what:

What?!!! Does he not know where the hymen is located, or does he not know what a speculum is for? Or, does he just think we’re too stupid to think about what he said?

I have to admit that I wasn’t aware that respiratory pathogens might cause vaginal infection if carelessly transferred by the person. I would have thought the nature of the pathogen would make it unique to its environment and therefore not viable in some other area of the body. I hadn’t read about this anywhere else until I read your post. I’ve since looked into it and I agree that apparently it is not that rare for this to happen. However, we have to be careful to distinguish between bacterial and viral pathogens. Antibiotics are useless against viruses, and most respiratory illnesses are viral -- not bacterial. Strep throat (from the streptococcus bacteria) is one that would be treated with antibiotics, but a doctor shouldn’t try to diagnose and treat that without visually examining the patient. To learn more about this, here are some links:

http://www.nlm.nih.gov/medlineplus/ency/article/000678.htm
http://www.health.com/health/condition-article/0,,20251853,00.html
http://www.webmd.com/cold-and-flu/cold-guide/antibiotics-colds
http://www.webmd.com/oral-health/tc/strep-throat-topic-overview
http://www.cdc.gov/features/getsmart/

I’m not sure about the timing of the “sinus infection”, the “follow-up visit”, or the use of an antibiotic five weeks before her death. The only information I know of to go by is the interview he did with Diane Sawyer where he stated she was last seen as part of a routine physical in August, and notes that were alleged to have been related to Detective Harmer (which I cannot verify or substantiate) where the following dates were given (from FFJ post here). I’ll repost all of the dates and notations so we’ll have it here:
8/6/90: JBR born.

12/6/91: First visit with Beuf. Treated for fever, cough, and wheezing.

Over next 10 months, she had the usual colds and coughs of a toddler.

1/93: Diagnosed with ear infection (her first). Amoxicillin prescribed.

By age 2 1/2, she had a history of coughs accompanied by low grade fever.

3/93: First serious illness, fever 102, difficulty breathing. Coughed up yellow mucus and looked droopey.

7/93: (Patsy diagnosed with cancer; JBR under Nedra's care). Regressed in toilet training and eating habits.

8/31/93: Responding to Beuf's questions, Patsy says JBR doesn't have any phobias and no aspect of JBR's sexual education needed to be discussed.

9/6/93: Buttocks and vaginal area chafed red from diarrhea.

11/93: Cough and stuffed nose. Sleeping poorly, grouchy from fatigue, bad breath. Chronic sinusitis.

12/31/93: Still drinking from bottle; parents having trouble weaning her.

1/94: Bad breath, cough and congestion.

2/4/94: Nedra suggests Fifth Disease. (Childhood viral illness, often accompanied by rash. Fifth in line of common childhood diseases, i.e., chickenpox, measles). No medication prescribed.

4/94: Breath still bad, runny nose, little appetite, slept poorly, bladder infection and vaginal discharge. Diagnosed with vaginitis. Amoxicillin prescribed and warned against bubble baths.

4/94: (3 weeks later) Still coughing, stuffy nose, congestion. Ear hurt, cranky. Diagnosed with allergic rhinitis, Benedryl prescribed.

4/94: (1 week later). Still coughing, Suprax prescribed.

10/5/94: Came in for checkup, doctor notices scar on left cheek. She'd been hit accidentally by a golf club when the family was in Charlevoix. A week after the accident, a plastic surgeon was consulted. No injury to cheekbone. Beuf is told (at this visit) that she's getting along with brothers and older sister. Wearing pullups at night because she's wetting bed. Patsy completes developmental questionnaire, and says there are no aspects of JonBenet's behavior or sex education she needed to discuss, and also notes JBR has no fears or phobias.

11/1/94: Had diarrhea five times and was lethargic. One bowel movement appeared bloody.

11/4/94: Badly congested, deep cough, bad breath. Diarrhea gone.

1/1/95: Chickenpox. Rash even appears in vaginal area. Recommended Avino, Benadryl and Lanocaine.

1/31/95: Still has bad cough and not sleeping well. Robitussin not helping.

Mid-Feb/95: Cough. Temp 99.3.

3/95: Complained of stomachache but sleeping well.

4/95: JR calls in, says JBR has another cough, but he doesn't think daughter needs to be examined.

5/8/95: JBR falls in Alfalfa's food market, lands on nose, not broken.

12/95: Trips and hits head above left eye. Stuffy nose, bad breath, coughing.

3/96: Coughing a lot.

5/96: Bent nail back on fourth finger, left hand, in another fall. Swollen and painful, but no bruising. Ibuprofen recommended.

8/27/96: Patsy reports JBR's a good sleeper, wasn't hard to get to bed, and was easily awakened in the morning. Not interested in opposit sex, behaved modestly in public, and didn't engage in sex play with her friends. She was, however, asking about sex roles and reproduction. She was not rude or afraid of either parent. Didn't seem to be bossy with brother, didn't react with trantrums, and was active. Loved fruit and some vegetables. Patsy said she was delightful and doing very well. Burke had his annual checkup same day.

9/96: Cough back, Robitussin recommended.

10/96: Stuffy nose, bad breath. Diagnosed with allergic rhinitis.

11/12/96: Runny nose and cold sore, sneezing.

12/3/96: Sees eye doctor.

12/96: Misses pageant due to illness.

[Note: In the above list, it seems like (my speculation here) that the specific dates are for actual office visits, and the approximate dates (mo/yr only) are phone consultations or simple notations.] Notice in this list that it notes what was prescribed, what over-the-counter medications were recommended, and even in one case (2/4/94) he mentions “No medication prescribed.”

In the Diane Sawyer interview, he lists the following:
DIANE SAWYER: (voice-over) We asked him to specifically review all notes that might pertain. He agreed, citing the frenzy of uninformed speculation. Be warned, these are a doctor's clinical notes about a young patient.

September 1993 -- a call about vaginal redness, possibly associated with recent diarrhea.

April 1994 -- a visit about a problem perhaps related to the use of bubble bath, which can be an irritant.

October 1994 -- a routine physical. No problems noted, though some indication of occasional bedwetting. Dr. Beuf says 20 percent to 25 percent of children that age wet the bed.

March 1995 -- abdominal pain and fever. Tests and exam showed no problem.

August 1996 -- another routine physical with a vaginal exam. The doctor said everything checked out as normal.

But later from the phone interview Sawyer states the following:
DIANE SAWYER: (on camera) And some other notes. Dr. Beuf says he last saw JonBenet Ramsey in November 1996, and that was a checkup for a sinus infection.

This November 1996 “checkup for a sinus infection” would coincide with the 11/12/96 date from the earlier transcription where no mention is made of any prescribed or recommended medications. Neither does he mention to Sawyer that he had prescribed any medications. Symptoms listed for 11/12/96 are, “Runny nose and cold sore, sneezing.” Those are not symptoms that would warrant a diagnosis of a bacterial infection, and therefore antibiotics would have been useless (from links above). [A cold sore, BTW for anyone who doesn’t know, is from a virus -- herpes simplex I (usually), or sometimes HSV-II.]

I’m not a doctor, but Beuf was. I have to add that if he was able to diagnose “allergic rhinitis” over the phone (10/96), he’s pretty damn good (or... not so much :giggle: ). But being that good of a doctor, I can’t imagine that he would prescribe an antibiotic for an allergy, much less not make note of the prescribed medication.

With all things considered from above, I don’t believe we can assume that JonBenet was taking antibiotics shortly before her death. And since there is no direct evidence of it (to my knowledge), I don’t believe that it can be considered as a possible cause for the vaginal inflammation that was found in her autopsy.

...something physical -- not systemic or pathogenic, and not part of a natural process of shedding dead cells.

“Erosion (from a medical definition): Superficial destruction of a surface by friction, pressure, ulceration, or trauma.”

“Epithelial erosion” is the loss of the thin layer of cells formed on the surface of (in this case) the hymenal tissue. From “The microscopic anatomy of the hymen”:
The main bulk of the hymen is formed of fibrous connective tissue, partly elastic and partly collagenous fibers. Both surfaces are covered by stratified squamous epithelium which lacks any evidence of cornification. The epithelium is thicker at the attached edge.

The microscopic examination done by Dr. Meyer should give him the information he needed to determine what he stated. He would see the loss of the layer of “stratified squamous epithelium” exposing the vascular sub-layer of the hymenal tissue. This is how he determined that the mucosal layer of the hymen was eroded. In the natural process of shedding cells, older cells are replaced with new ones of the same microscopic structure before the dead cells fall off. If this thin layer of cells on the surface is missing, it exposes the underlying cellular structure called the “lamina propria”. From Wikipedia:
The lamina propria (more correctly lamina propria mucosæ) is a thin layer of loose connective tissue, or dense irregular connective tissue, which lies beneath the epithelium and together with the epithelium constitutes the mucosa. As its Latin name indicates it is a characteristic component of the mucosa, "the mucosa's own special layer". Thus the term mucosa or mucous membrane always refers to the combination of the epithelium plus the lamina propria.

The loss of the layer of epithelium (whether it is on the hymen or in the vagina) is not natural. It is obvious microscopically. It is evidence of something having physically removed it.

Depending on the type of injury and where it is, there are different grossly visible, as well as microscopic, indications. The color of a bruise is a visible indication of how far along in the healing process it is. In the mucosal tissue of the hymen addressed in the AR, the “underlying capillary congestion” (underneath the eroded epithelium) is determined microscopically. It would probably be (depending on the extent) grossly visible as being unusually redder in color than surrounding tissue. This could be due to the body’s reaction by angiogenesis (depending on the amount of time since injury), or it could be from “reactive hyperemia”.

This is not plausible. In fact, this one really stretches the boundaries of credulity. Even mentioning it seems to me a desperate attempt at straw grasping, but I’ll address it nonetheless.

First of all, the capillary congestion that occurs in the adult female sex organs during arousal (as well as other responses) is transient. We all wish it could last longer, but it’s just doesn’t. Even in speaking about adults where sexual arousal can occur, it does not extend beyond death. This heightened peak of arousal is supported not only by the physical stimuli causing it, but by the mental excitement as well. This only happens in living persons.

Secondly (and this probably should have been firstly), I don’t think a child is even capable of sexual arousal. If you care to dispute this, I’ll have to take your word for it. I’m not about to start researching the subject on my computer and risk someone, someday, for some reason, seeing that I had been searching the subject.

Lastly, it looks like we’ll never be able to totally dismiss the EA BS. This has been addressed so many times by so many people, it doesn’t deserve consideration. As much respect as I have for him, I blame this on Dr. Wecht for bringing it up in trying to account for injuries he misinterpreted (IMO). But since you bring it up in a different context (as a possible stimulus for sexual arousal, in a child, that lasts beyond death and into the second day afterwards when it would show up in the autopsy as a source of vascular congestion in her genitalia), I’ll tell you why it doesn’t apply here. The auto-erotic practice of depriving the brain of oxygenated blood (cerebral hypoxia) is done to heighten the person’s orgasm. The only stimulation it might provide beyond the climax itself is in the mind of a person who has practiced it in the past and has had a pleasurable experience from it. This mental stimulation is not something that would be experienced by a person having it forced on them. Wecht implied it was for the visual stimulation of the person he believed was forcing it on JonBenet. I can assure you, it would not be pleasurable for her, and it would not have caused a sexual response in her.

I agree with you that the shape of the hymen itself is not enough to conclude sexual abuse. The crescent shape (according to your link) is equally common with the annular hymen. I’ve read different approximations, but it doesn’t matter which is most common because it is certainly not rare according to any source. Even the wider absence of hymen written in the AR over this article’s estimation of an 11 to 1 o’clock absence is not in itself cause for a conclusion by itself. But if you consider this along with the remaining small, retracted and eroded rim of hymen described by Dr. Meyer, I believe it all adds up (along with all the other vaginal evidence) to more than can be ignored as evidence of continuing sexual abuse leading up to JonBenet’s death.

BTW, the link you provided here is to one of the best articles I’ve read online describing what a medical professional should be looking for in screening patients for possible sexual abuse. (And in case anyone was unable to understand my earlier point about Dr. Beuf’s use of a speculum for hymen examination, there are certainly enough pictures to provide explanation.) Page 6 of the article has a good explanation of the healing process of genital injuries (more specific than any I’ve ever read) and is useful in considering the period of time in which the injuries could have occurred. In fact, it’s so good, I’m going to copy it here for the benefit of anyone who wants to read it:
Superficial genital injuries, such as abrasions, bruises, and transections, usually progress through a process of regeneration that involves four stages (Finkel, 1989, McCann et al., 1992). These stages include thrombosis and inflammation, regeneration of epithelium over the denuded surface, multiplication of new cells, and differentiation of the new epithelium. Wound healing may be complete in 48 to 72 hours, while further differentiation of new epithelium may take 5 to 7 days (McCann et al., 1992). Complete restoration of normal tissue may take up to 6 weeks. The injuries heal without scar formation.

Mama, I know you are sincere in your beliefs, and I think you are open to changing your opinion if you are convinced. That’s the only reason I would have considered spending as much time as I have gathering the information I believe is important in answering your posts. I’ve seen others who I know cannot be swayed from their expressed beliefs for reasons I don’t expect to know. It’s not that I think I’m capable of convincing you otherwise, but I don’t mind telling you what I read into the evidence and discussing it with you so we might both be able to learn something. I did, and I appreciate the opportunity.

(Now I have a lot of catching up to do on all the rest of the posts made since I started this.)

Sources (and Resources):

http://www.mayoclinic.org/diseases-conditions/vaginitis/basics/definition/con-20022645
http://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID=85&ContentID=P00595
Sexually Transmitted Diseases: Vaccines, Prevention, and Control, edited by Lawrence R. Stanberry, Susan L Rosenthal
http://umm.edu/health/medical/altmed/condition/vaginitis
Synopsis of Pediatric Emergency Medicine, edited by Gary Robert Fleisher, Stephen Ludwig, Benjamin K. Silverman
Pediatric Emergency Medicine,Steven G. Rothrock, John A. Brennan
http://depts.washington.edu/hcsats/...lems in Prepubertal Gyn Sugar Graham 2006.pdf

“The microscopic anatomy of the hymen”, by Maher Mahran and A. M. Saleh (Abstract)
http://medical-dictionary.thefreedictionary.com/cell
http://en.wikipedia(dot)org/wiki/Epithelium
http://www.merriam-webster.com/medical/lamina propria
https://www.inkling.com/read/histology-cell-biology-kierszenbaum-tres-3rd/chapter-22/vagina
http://en.wikipedia(dot)org/wiki/Angiogenesis
http://en.wikipedia(dot)org/wiki/Wound_healing
http://en.wikipedia(dot)org/wiki/Hyperaemia
http://www.nlm.nih.gov/medlineplus/ency/article/001435.htm
http://www.corpus-delicti.com/auto.html

http://www.medscape.com/viewarticle/723678_6

I appreciate the time & energy you put into researching this topic, and composing this post, VERY MUCH, otg. I want to dig deeper into one element of the autopsy report that you've addressed...

Of all the observations Dr. Meyer noted, I find "epithelial erosion" involving the hymen, most curious/thought provoking. Alarming? Not yet.

I have been unsuccessful in finding recent research evaluating this specific ?phenomenon?. Erosion of the epithelium does not require a physical/mechanical irritant. Vulvovaginitis, in severe or recurrent cases, causes epithelial erosion: http://emedicine.medscape.com/article/2188931-clinical

BUT, is this ?phenomenon? more often indicative of sexual abuse? Could be, I just don't know. I'd certainly like to find out. Have you come across any sources that discuss hymenal/vaginal epithelial erosion, specifically, in the prepubertal child?

Venom · Jan 21, 2014

Mama2JML said:
I appreciate the time & energy you put into researching this topic, and composing this post, VERY MUCH, otg. I want to dig deeper into one element of the autopsy report that you've addressed...

Of all the observations Dr. Meyer noted, I find "epithelial erosion" involving the hymen, most curious/thought provoking. Alarming? Not yet.

I have been unsuccessful in finding recent research evaluating this specific ?phenomenon?. Erosion of the epithelium does not require a physical/mechanical irritant. Vulvovaginitis, in severe or recurrent cases, causes epithelial erosion: http://emedicine.medscape.com/article/2188931-clinical

BUT, is this ?phenomenon? more often indicative of sexual abuse? Could be, I just don't know. I'd certainly like to find out. Have you come across any sources that discuss hymenal/vaginal epithelial erosion, specifically, in the prepubertal child?

Mama, I hope you don't mind, I went searching for an answer.
I did find this:
Dr. Wecht, who is a medical doctor, a lawyer, and a coroner, told the Daily Camera in 1997, "Chronic inflammation and epithelial erosion of the vagina indicates sexual abuse more than two days old."
from http://websleuths.com/forums/archive/index.php/t-22887

Nom de plume · Jan 21, 2014

Well if there's a way out there, totally improbable, against all odds, never gonna happen in REAL life scenario to explain this crime, or any aspect of it, by all means let's find it, latch onto it, and run with it to exonerate the guilty party(ies). Just SMH...

Anybody else around her have a headache from :banghead:???

Venom · Jan 21, 2014

Nom de plume said:
Well if there's a way out there, totally improbable, against all odds, never gonna happen in REAL life scenario to explain this crime, or any aspect of it, by all means let's find it, latch onto it, and run with it to exonerate the guilty party(ies). Just SMH...

Anybody else around her have a headache from :banghead:???

You bet I do.

gramcracker · Jan 21, 2014

like, hitting yourself in the head with a hammer 'cause it feels so good when you stop?

STANDREID · Jan 21, 2014

How seriously Munchhausen's looked at? Perhaps she was a sickly child but that looks like a lot of doctor visits.

BBB167893 · Jan 21, 2014

Mama2JML said:
No way. otg is a gentleman. Ego doesn't drive him. He's my favorite RDI by far.
:loveyou:

I suddenly feel like the Wicked Queen when the Magic Mirror broke the bad news!

BBB167893 · Jan 21, 2014

Nom de plume said:
Well if there's a way out there, totally improbable, against all odds, never gonna happen in REAL life scenario to explain this crime, or any aspect of it, by all means let's find it, latch onto it, and run with it to exonerate the guilty party(ies). Just SMH...

Anybody else around her have a headache from :banghead:???

At this point, I got a head like iron anyway.

Why was JB killed?

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