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When you specify more than one term to appear anywhere in the article, the method is similar, but the search engine looks at how many of those terms appear, and how close together they appear, how close to the beginning of the document, and can even take into account the relative rarity of the search terms and their density in the retrieved file, where infrequent terms count more heavily than common terms.
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Look at the density of matches in each document on the first page of the hits. Then go to the last page of matched documents, and observe the density of matches within the documents.
A more complex search illustrates this nicely with a single page and only 15 matches:
counter*tr* w/25 “liv* out” w/25 enact*
There are a lot of word forms and variants of the words (due to the * wildcards) above that can match, but the proximity (w/25) clause limits the potential for matching. What’s interesting here though is how easily you can see the match density decrease as you view down the short list.
The end result of selecting order by rank is that the search engine’s best “guess” as to which articles are more relevant appear higher on the list than less relevant articles.
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B., D. (1924). Sexuality: John F. W. Meagher. Quackery de Luxe. A Form of Medical Charlatanism known as Orificial or Constructive Surgery. New York Medical Journal and Medical Record, February 21, 1923, p. 224.. Int. J. Psycho-Anal., 5:96-98.
Psychoanalytic Electronic Publishing: Sexuality: John F. W. Meagher. Quackery de Luxe. A Form of Medical Charlatanism known as Orificial or Constructive Surgery. New York Medical Journal and Medical Record, February 21, 1923, p. 224.
(1924). International Journal of Psycho-Analysis, 5:96-98
In this article Dr. Meagher gives an account of the cult of orificial or constructive surgery. It is carried out by a certain number of people who call themselves orificial surgeons. Many of these people hold medical degrees. The number of 'orificialists' is increasing, and they conduct sanataria; in Chicago they publish a medical journal. Dr. Meagher
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says these people are especially dangerous to the health of women patients. Apparently one can become a proficient orificialist by taking out their correspondence course of instruction, as is shown by this quotation from their journal:
Many of our students have become very proficient orificialists merely through their mastery of the correspondence course, and have not even attended an orificial clinic. We have no dissatisfied students. Join us. Sign the blank. You pay $125 for the course; only $100, if cash is paid at once.
Dr. Meagher adds, 'This payment is the only important requirement to take the course'.
The orificialists only concern themselves with the orifices of the body, and of these the anus and vagina only appear to be of any importance to them. It is true they have had a nose and throat specialist, but he does not seem to be particularly interested in this part of the body. Dr. Meagher quotes from their 'Journal' (Vol. VIII, p. 75):
His specific work for some time has been troubles of the upper orifices and cavities, but unlike the usual nose and throat specialist, a large part of his treatment for these troubles is pelvic attention … the true spirit of the orificialist.
This nose and throat specialist tells how to examine the female external genitalia.
Examine the tissue texture as in the male, with the same conclusions in the same existing conditions. If the tissues are full in both labia majora and labia minora, we will have a full-blooded person who accomplishes things, provided the tissues in the rectum are in good condition. … If the labia majora are flabby or flat, then the round ligaments are relaxed, and we may look for trouble in all the rest of the ligaments.
The chief methods of the orificial surgeons seem to be examination and dilatation of the anus, rectum, and vagina, and removal of the clitoris. They also circumcise boys. They have what they call a 'tension' table upon which they stretch their unfortunate patients.
Dr. Meagher mentions the following case that came under his observation:—
This case I saw was a nineteen-year-old girl, feeble-minded and epileptic, who had already been in the Johns Hopkins Hospital. She was stretched on a table—for what reason it would be hard to say; had autohemic treatment, some of her own blood serum being reinjected into her, and was mutilated by having her clitoris and nymphæ amputated. Her credulous father told me she had been "circumcised". Immediately following this operation, she went violently insane. And yet the "operator" had the audacity and indecency, weeks later, while she was under my care, to leave a pseudo-religious card for her, writing to the little girl, now insane … 'whose inner self is noble, sweet, and large … freed from the earth-time temple … no longer bound by the material fetters".
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Dr. Meagher mentions that,
One of their number who was handy with the knife reports this "interesting" case. The patient was a demented woman of fifty-six, who became perfectly well and rational the day after the operation, which evidently was a sort of field-day affair. This is what she had done to her: "Cæcal readjustment; a subperitoneal fibroid removed; a ventral fixation; circumcised; remnants of hymen and urethral caruncle removed; urethra dilated; the uterus dilated and packed; pockets and papillæ and a hemorrhoid were removed after complete divulsion of the anal sphincters; and to give a new floor to the pelvis, a perineorrhaphy completed the work. … This was all done at one sitting."
The rest of Dr. Meagher's article is taken up with quotations from their 'literature', which are given to show their gross ignorance of anatomy and physiology. A study of their 'literature' from a psycho-analytical point of view would certainly be interesting.
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B., D. (1924). Sexuality. Int. J. Psycho-Anal., 5:96-98