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ALABAMA. Dr. J. W. Pearce of Oxford a prom. inent physician and president of the Calhoun Medical Society, died May 26, at the age of 62.-Dr R. N. Hawkins of Elyton, has been appointed physician to the county convict camp.-The cornerstone of the Hale Seminary at Montgomery, notable as the first infirmary given by a colored man to his own race in the South, was laid with appropriate ceremonies May 21. The building is to be 77x120 feet, two stories and basement, and is to be under the management of Dr. C. N. Dorsette, a son-in law of the founder -Dr. J. V. White of Cooperstown, is so seriously ill that his recovery cannot be hoped for.-Drs. J. C. Jones and Armstrong have been elected physicians at Blue Creek mines-Drs. Drennen and Parke assumed charge of the Birmingham Charity Hospital, in place of Drs. Whelan and Wyman, whose term of office has expired.

ARIZONA. "Come over into Apache county and help us" is the cry. Several thousand inhabitants

and yet no doctor How long?

ARKANSAS-Dr O Tydings of Conway has gone to Baltimore to recuperate. He has for some time been in rather delicate healih.-Dr. C. S. Gray has removed from Fayetteville to St. Louis -The too common practice among physicians of writing cipher prescriptions has been condemned by many of the physicians of Hot Springs, who have expressed their strong approval of an ordinance making it a violation of law for a physician to write a cipher prescription: Dr. L. B. Baker of Beeber, entered the precarious paths of matrimony, June 18, at Newport.

CALIFORNIA.-Independence has a lady physician who recently rode fifty-six miles over a lonely desert to reach a patient.-Dr. Stephen Bowers of Ventura, is out on a prospecting tour in the San Jacinto mountains and the Colorado desert. Dr Barton Dozien, late resident physician of the Los Angeles county hospital, has located in Fresno.- Dr John B. Smith of Petaluma, has had a stroke of apoplexy and is not expected to live.-The disputed membership in the State Board of Health is to be decided by the courts Dr. J. R. Laine has brought suit against Dr. G. G. Tyrrell, who, the plaintiff says, usurps the office and the functions thereof to the exclusion of the plaintiff.-Dr. G P. Thomas has resigned his position as superintendent of the county infirmary and will resume practice in Alameda. Dr. A. Shirk of the same city, has been elected to fill the vacancy. We are glad to hear that Dr. J J. Choate of Los Angeles, who has been ill for several days, is now on the high road to health.-$5,000 has already been subscribed for the founding of a hospital for British subjects in San Francisco, and it is hoped that the Victoria Hospital may soon be built and in operation. Germans and Frenchmen

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already have hospitals in the city. Why should England wait?-Gold Run, Placer county, has an epidemic of diphtheria.-Dr James H. Foulkes, one of the most prominent among the medical men of Oakland, died May 23, of diabetes, at the age of 60. Dr. Foulkes was a North Carolinian, a graduate of Jefferson Medical College, and practiced medicine in Fayetteville, N C., until 1875, when he came to California and built up a large practice in Oakland -At the meeting of the San Francisco Board of Health June 14 the present water supply and sewer system were criticized and sweeping improvements suggested. The bond of Dr Xavier Dodel. charged with the murder of Annie Dorries by criminal malpractice, has been reduced from $20,000 to $10,000. -The contract for the construction of the Veterans' Hospital at Yountsville, has been awarded to John Morton of Calistoga, whose bid was $4,700. -Dr. D. P. Albee of Blocksburg, has located in Eureka -Dr. Stoerk of Coronado, has been arrested for practicing medicine without a license and has been bound over to the Superior Court

COLORADO.-Dr. W G. Schussler of Orland, Ill., died at Pueblo May 22 -Dr. C. C. Lathrop, son of Rev. C. C. Lathrop, of Decker, N Y., committed suicide May 28, at Denver, by taking morphine. He was a graduate of the Sheffield Scientific school of Yale, and was graduated in madicine from Heidelberg University, Germany. - Judge J. M North, lecturer on medical jurisprudence at the Boulder University, has been appointed delegate to the International Congress of Medical Jurisprudence in New York. Dr. H. J Smith, formerly of Leadville, has removed to Aspen.

CONNECTICUT.-Dr. John E Kelly, a promising young physician of Bridgeport, died May 31.

DAKOTA -Dr. A. H. Webster. formerly of Grand Forks, died at Benguela, on the west coast of Africa, where he had gone as a missionary. - A Yankton paper announces that Dr. Craven, late superintendent of the insane asylum at that place, is an applicant for the superintendency of the Chicago Insane Asylum.-Dr. Etter of Yankton, who has been under medical treatment in Chicago, is slowly improving -Dr. Joseph McIntyre of Madison, charged by Johanna Johnson with attempted criminal assault, has been found guilty of simple assault, and sentenced to a year in the county jail.-Dr. Frank Campbell of Fargo, has been appointed resident surgeon of Mercy Hospital, Chicago

FLORIDA. Dr. James L. Powell of Cottondale, was married to Miss Virginia T. Shaver of Lexington, Va., at Smithville, Ala., June 18.-The Senate passed the bill providing for a board of medical examiners, and regulating the practice of medicine, May 22.-Dr. A J. French, who has resided in

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STATE ITEMS

Fort Meade for several years, has removed with his family to Sanford.-Dr. G. S. Brown and wife of Madison, have sailed for Europe. They expect to be on the continent about six months.

GEORGIA.-Dr. Tho nas W. Battle one of the most prominent and successful physicians of Columbus, died June 17, at the age of 73.-Dr. William Clements of Big Creek, died June 5 of consumption. -Dr. W. L. Davis of Albany, was married to Miss Annie Smith of the same place, June 6-The colored people of Atlanta are agitating for a colored city physician and have recommended Dr. Asbury The city has at present six city physicians, one for each ward. It is rumored that the number will be reduced to five. Whether the city council consider one colored man as good as two white men we can't say, but mathematically it looks so.

ILLINOIS.-We regret that we have to announce the death of Dr. H. W. Alexander of Joliet, which occurred May 28, at the age of 51. Dr Alexander has been an invalid for many years on account of injuries received while in the army, and these caused his death Dr. French Moore was married to Miss Jessie H. Carrier of Lake View, June 25.-The vigilance of Dr. Marcus Whiting, the efficient president of the Peoria Board of Health, is attested by the excellent sanitary condition of the city-What will Rockford do this summer? Dr. T. N. Clark has left for Wisconsin, Drs. Thomas Kerr and Boyd have left for Europe, and Dr. E C. Huse intends to shake the dust of Montreal and other eastern cities from his feet, and has started eastward in that endeavor Dr. L. T Pease of Cisco, who has been rusticating in a dark room for six weeks past on account of his eyes, is much better.-Dr. Pritchard of Bushnell, will soon move to Chicago. -Dr. PE. Chapman has been re-appointed postmaster at Sigel, Shelby county. He held the office under Garfield and Arthur, and his re-appointment is an evidence of the good taste of the present administration.-It is reported that measles are getting thicker at Leroy. -The funeral of the late Dr. George H. Hosmer was conducted by Bartleson Post, G A. R., Joliet, in accordance with the wish of the deceased. Chaplain Laing officiated.-Dr L. C. Taylor of Auburn, has sailed for France, where he expects to spend a year in hospital practice. We suppose that he will take in the sights in his spare moments. They all do. Dr. John A. Rawlins of Warren, has removed to Lanark and gone into partnership with Dr. J. Haller. Dr. J. E. Kaiser, after an experience of Missouri, has decided to settle down to the practice of medicine in Earlville.-The legislature has passed the appropriation bill for an additional building for the incurable insane, to cost about $100 000. This addition will make the Illinois Southern Hospital for the Insane one of the largest in the country.Dr. Abell of Coal City, is thinking of moving to Joliet.-Dr. Marshall has been appointed physician to the McLean county poor farm and jail at a salary of $250 a year.-Mrs. Le Grand, the wife of Dr.

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G. W. Le Grand, of Springfield, died recently.Dr. P L. Markley of Shirland, was married to Miss Hannah McHoes of Leaf River, May 21.-Dr. and Mrs. W. E. Guthrie have returned to Bloomington after a year's absence in Germany.— Dr. W. S. Gates of Lake View, has moved to Wilmette. Wilmette is to be congratulated.— Dr. Staley of Browntown, Wis., has moved to Freeport, where he will associated with Dr. W. S. Caldwell. Dr. Laman, Dr. Caldwell's assistant for several years, is going west to look up a location.-Cairo has erected a handsome monument to the memory of Dr. Roswell Waldo, at Mound City, in recognition of his services in the yellow fever epidemic in 1878 --Dr. J. L Polk of Arcola, has returned from his visit to Chicago.-Dr. Harry Bailey has returned from his European trip and intends to locate in Pekin-Dr. Kruse of Peoria, is spending the summer in Europe -The following are the recent appointees on the Board of Examining Surgeons for the Pension Bureau: Dr. George S. Rainey, Salem; Dr. R. P. Hazzard, Odin; Dr. J. G. Munselle, Centralia; Dr J. F. McKinney, vice Dr. J. M. McKown, Arcola; Dr. Cyrus Rutherford, Newman, vice Dr McKinney, Camargo; Dr. F. S. Dodds, Jonesboro, vice Dr. Hale; Dr. L F. Morse, Cobden, vice Dr. Lence, Jonesboro; Drs W. L. Athon and O. Mitchell, Marshall; Dr. S. A. Burner, Martinsville: Dr. C. S. Hollingsworth, Aledo; Dr. C Barnhardt, Rock Island; Dr. I. M. Martin, La Harpe; Dr. J. A. Harvey, Rushville; Dr. H D. Noyes, Carthage; Dr. C. B. Horrell, Colchester; Dr. D. M Creel, Bushnell; Drs J. T. Willis and J H. Norris, Metropolis; Dr Jno. D. Young, Brooklyn; Drs. Z T Baum, Jas. P. English and J. S Slaughter, Paris; Drs. F O. Harrison and C. C. Kelley, Benton; Dr R. O. Lacey, Elizabethtown; Dr. E. B. Emerson, Carmi; Drs. H. L Rodgers and L. W. Gordon, Shawneetown; Drs J. N. Matthews, J Alsop and T. J. Dunn, Effingham.-Chicago.-Dr. Chr. Fenger and family sailed from New York June 19 for Bremen. They expect to return early in September.-We are glad to learn that Dr. Frederick C. Schaefer, who has been SO dangerously ill with rheumatic fever for sev eral weeks past, is considerably better and probably out of danger.-Dr. G. E. Brinckerhoff was married to Miss Sadie Broadie, by Rev. J W. Caldwell, June 12.-The new building for the Woman's Medical College will be ready for occupancy in September. The new structure will cost $20,000, will be of brick and stone, and will accommodate about two hundred and fifty students. It will adjoin the present building, corner of Lincoln and Harrison streets.

INDIANA.-Mrs. Emma Ford of Wabash, a wellconnected widow, has brought sensational charges of breach of promise, seduction, etc., against Dr. Andrew J. Smith, a prominent physician of Wabash. Damages are laid at $5,000.-Dr. A. J. Kimmel of Hudson, is able to be about again.-The Elkhart

Board of Health organized May 25 by electing E. H. Keene, president; D, Harmon, vice-president, and Dr. Barney, secretary.-Dr. Daniel Dayton, one of South Bend's most widely known and most highly respected physicians, died May 27 of uræmic poison.-The physicians of Jeffersonville have resurrected the aged scheme of blacklisting delinquent debtors. History repeats itself.-Dr. David P. Bourie, one of the best known citizens of Northern Indiana, died at Ligonier a few days ago, aged 76.-On June 15 Dr Thomas C Austin of Anderson, and Miss Christian E. Moffett, were married at Crawfordsville. - Measles at the Indianapolis Orphan Asylum have deferred the anniversary exercises. Dr. W. F. Stone of Ullin, committed suicide June 9 by the shotgun method.-Measles environ Hoosierville, Clay county.-Dr E. A. Wehrman of Indianapolis, has gone to Europe for a year's study Dr. John H. Talbott of Logansport, has been appointed one of the medical examiners of the Pennsylvania Company's Employes' Relief Association - Dr. T. N. Watson, the wellknown Indianapolis colored physician, died May 29. -Dr. S. B. Hartman of Fort Wayne, and Miss Maggie Ketcham of Goshen, were married at Elkhart June 19.-Dr. J. Ellis Lyons has taken out a license to practice in Wayne county. He is a graduate of Rush Medical College.-Drs. W. W. Blair and G. C. Kendle of Princeton, Dr. J. C. Patten of Francisco, Drs. T. C. Donnell, L. E. Ott and R. S. Byers of Franklin, are recent appointees on the board of pension examiners --Dr. Charles E. Wright, the new superintendent of the Central Hospital for the Insane, took charge of the institution June 6.

IOWA. The medical board of Mercy Hospital, Davenport, held its annual meeting May 30. Dr. Thompson was re-elected president and Dr. Allen secretary. Dr. Parker was appointed to fill the place of Dr. Grant on the visiting staff. Dr. Henry Krogstad of St. Paul, Minn., was married to Miss Margaret Bacon at Trinity Church, Iowa City, June 13. The newly married couple will reside in Washington, D. C.--Dr Issac W. Martin died at Des Moines, Iowa, June 20, at the age of 51. Dr. Martin was born in Indiana, but for the past fourteen years was a resident of this county, practicing his profession, holding meantime the position of county physician and pension medical examiner, and a chair in the medical department of Drake Uni. versity.-Dr. F. M. Brady died at Osceola, June 12.-Dr. A. Weismann of Keokuk, has been elected State medical examiner at the annual session of the Grand Grove of Druids at Muscatine.-At the meeting of the Board of Regents of the State University at Iowa City, June 19, Dr. J. F. Kennedy wrote in favor of a Chair of Sanitary Instruction. The Medical Committee's chief report was the acceptance of the resignations of Drs. Hill and Hobby, and these physicians were highly complimented. Dr. Jesse Wasson died at La Porte City

May 15. He was the founder of the town where he lived and practiced medicine. He formerly lived at La Porte, Ind Scarlet fever has broken out at Plymouth, Grafton and Mason City.-The board of health of Des Moines has commenced the publication of monthly health reports -One hundred and fifty or more cases of measles at Ida Grove.-Drs. Hutchinson and Hanawalt of Des Moines, have gone into partnership -Dr Edward Robinson and Miss Mamie Conzett of Dubuque, were married June 12.-Dr D, W. Dickenson of Des Moines, and Miss Lena K. Sherman, daughter of Ex-Gov. Sherman, were married June 12 at the residence of the bride's father at Waterloo -Dr G. H. Mott has located in Springdale, Cedar Co -Scarlet fever is prevalent at Dixon -Drs. M. H Staples, J. S, Lewis and G. A. Staples of Dubuque, Drs. O. L. Wilson and John O. Montgomery of Charleston, and Drs. C H. Pinney an1 J. F. White of Council Bluffs, are among the recent appointees as Medical Examiners for the Pension Department.

KANSAS Dr. H P. Merriman and bride of Chicago, have been visiting in Iola.-Dr Millard of Louisville, has removed to Wamego.-Dr. J. P. Stewart of Clay Center, shot and mortally wounded J. P. Wellington of Wichita, June 11, on account of Wellington's seduction of Mrs. Head, Dr. Stewart's daughter. The coroner's jury returned a verdict to the effect that the killing was justifiable, having been done in defense of his own life and of his family.-Dr. J. W. Redden and family of Topeka, have gone to Europe for the summer. Dr. James B. Lawrence of Wichita, dropped dead of heart disease while conferring the third degree in a Masonic lodge:-Atchison doctors, as a forlorn hope, are going to black-list patients in arrears.— Dr A. O Foster of Ellsworth, has removed to Sylvan Grove, Lincoln Co, where he intends jointly to run a farm and practice medicine.-Dr. L. A. Ryder of Topeka, and Miss Minnie Wolcott of Atchison, were married at Trinity Church, Atchison, June 12. Dr. T. H. Miller of Hutchinson, was found in a box car at Pittsburg, June 11, in a dazed condition and with indications of concussion of the brain. Dr. Seacat of Kinsley, intends to move to Pittsburg.

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KENTUCKY.-The Louisville Board of Public Charities met at the City Hospital May 29 and elected the following gentlemen as the hospital medical staff: Consulting Surgeons: David W. Yandell, George W. Griffith, Holloway, J. M. Matthews, C. Godshaw. Consulting Physicians: J. Ouchterlony, C. W. Kelly, J. B. Marvin, F. C. Wilson, C. R. Henderson. Visiting Staff. Surgeons: J. M. Cartledge, W. D Rodman, Fusch Samuels, E. H. Stuckey, H. H. Grant, Ap M. Vance, J. Cecil, C. Skinner. Visiting Physicians: H. M. Goodman, F. L. Jenkins, A Griswold, Carl Weitner, R. T. Yoe, J. M. Crann, J. B. Enright, B. Guntermann. Consulting Gynecologists B. Morton, W. B. Morton, W. H. Wathen, M. Thumb.

THE MEDICAL STANDARD.

VOLUME VI.
NUMBER 2.

AUGUST, 1889.

CHICAGO:

G. P. ENGELHARD & CO.

NEUROSES FROM OVARIAN DISEASES.1
BY C. L. DANA, M. D., NEW YORK.

The symptoms properly falling within this. description embrace those which are produced at points remote from the ovaries by reflex influence, and not in the ovary. The term "irritating ovary" expresses to me this relation. Such an ovarian condition might exist without anatomical change, and the general neuroses might be produced by it. But most commonly chronic hyperæmia or oophoritis is present. Parenchymatous and cystic degenerations, or ovarian tumors, do not cause these symptoms, and might be excluded. The mechanism by which reflex effects are obtained may be of two sorts-trophic and vascular. An irritation traveling through the vaso-motor nerves causes congestion of the pelvic organs which might become chronic; but if the trophic connections felt the irritation, various remote symptoms may be produced, and of these a large number are on record. Among those recorded are vasomotor disturbances, cardiac irritability, hysteria, mania, melancholia, neuralgias in the hands or feet, spinal irritation, sciatica, migraine, dyspepsia, insomnia and vesical and rectal pains. It is an open question how large a part of these are direct effects of, and really due to conditions in the ovary, and especially as the removal of the ovaries do not, to any great extent, relieve the severer constitutional nervous diseases, such as chorea; and, on the other hand, melancholia, epilepsy, bad neuralgias, etc., often occur in persons having perfectly healthy ovaries, and severely diseased ovaries are often unaccompanied by any such disorders. Ovarian epilepsy was not mentioned by Gowers, and, although Battey had recorded ten cases, eight of which he had cured, one of these patients had had hysteria and catalepsy, another had afterward died of a brain disorder and another in convulsions, and a fourth had probably had convulsive hysteria rather than epilepsy.

Patients having the hysterical affections simulating epilepsy are often cured by small things which make an impression on the mind, such as one dose of a nauseous drug, or the snipping of the conjunctiva. As for ovarian insanity and amenorrhoeal insanity, similar obIN. Y. Academy of Med. Trans. Condensed.

servations can usually be made as to the real nature of the malady present in the recorded cases sufficient to show that it lies outside the ovary to a very large extent. In women the thoughts tend to dwell on the organs of the pelvis. If the ovaries of a hysterical patient are removed, she might fancy herself cured. The ovarian function occupies a subordinate place among the things which determine the chronic neuroses. Sickness could be produced by ovarian irritation doubtless, but not in the specific ways which have been supposed by some to be usual, leading directly to epilepsy, chorea, insanity, etc. The brain, the

stomach and the pelvic organs constitute in all organisms what might be called the tripod of life; but as in man the brain tends to predominate over the two others in comparative development, so the functions of the stomach and pelvic organs tend to become automatic and of subordinate influence on the whole organism.

Dr. W. G. Wylie thought the influence of the ovary in producing nervous symptoms had been overrated, as much depended really on the inherited nervous organization. A delicately organized woman might be made an invalid by the existence of ovarian hyperæmia or disease which in a strong and robust woman would have no secondary effects discoverable. The sexually undeveloped women from whom so large a proportion of gynæcological practice was derived were very apt to have also poorly developed nervous systems, at the same time that they were more likely to have ovarian disease. The rectum and colon had an intimate connection with the nervous system. Anal fissures, ulcerative patches in the lower bowel, collections of scybala, etc., were frequently the cause of nervous symptoms, for the relief of which the generative organs had been needlessly operated on. lessly operated on. A common condition present, where he had found nervous disturbances really resulting from ovarian disorder, was the thickening and hardening of the ovarian tissue by increased fibroid elements. This caused intense pain locally, and general excitability and irritability before menstruation. Before oophorectomizing he made it a rule to get the opinion of an alienist, and to keep the patient for weeks

under his observation; to examine under ether and see if the ovary was enlarged or confined by adhesions, to try treatment locally and attention to the general health, and to determine that the patient's subjective symptoms were such as to warrant the operation. No well-established ovarian disease could be cured during menstrual life; attempts at ovulation must go on, and this of itself would interfere with any attempted reparative process. From this point of view the necessity of ovariotomy in certain cases was evident. If imperfect sexual development had been more generally recognized as a very common thing and more conscientious attempts made to improve the circulation, digestion and muscular systems of these patients, better results would have been obtained than had followed castration in hundreds of instances. He had found also that the uterus had much to do with the reflex disturbances under consideration as well as the ovaries, although he had, after years of menstrual hysteria that had resisted all uterine and other treatment, cured it by removing the ovaries. In brain diseases he had not seen good results from oophorectomy. He had done the operation five times for epilepsy. In three of these patients it had returned, and in the case of the two who had been cured he had not been convinced that epilepsy had been present at all.

Dr. B. Sachs instanced two cases in which epilepsy had returned after oophorectomy. Where cures were effected by it, hystero-epilepsy had been present and not epilepsy. The question then arose as to what effect the removal of the ovaries might be expected to have on hysteria of a bad sort, its progress, and its continuance. If in hysteria the ovary was found to be much enlarged or inflamed, its removal was justified. In the majority of cases it was healthy, and the removal of such an Ovary was to be decided on as of value or not. He belleved that a hyperæsthetic ovary represented only a portion of a general hyperæsthetic organization, and that there was no better reason for removing such an ovary than for excising an over-sensitive stomach. The varieties in neuralgic disturbances were not easily numbered. If a painful ovary was removed this might prove merely the excision of one of several foci,and compelling the disorder to crop out in other directions. He had seen instances where symptoms were much ameliorated, but in time these symptoms had always returned, sometimes in six months or after a year.

Dr.Mary P. Jacobi agreed that larger statistics, based on more precise diagnosis, were needed before the actual influence of oophorectomy

over hysteria could be determined. In every case it was necessary to distinguish between pain really seated in the ovary and a hallucination of pain generated in a hysteric brain. The grave forms of constitutional hysteria were quite noticeably free from utero-ovarian disease. She had had occasion to observe several such cases of serious psychic deterioration, where the symptoms had developed spontaneously early in life, and where, in spite of the asseverations of the patient, there had been no objective sign of pelvic disease in either uterus, ovaries

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Dr. H. T. Hanks said that cases existed where neuroses were relieved by removal of ovarian irritation.

Dr. H. J. Boldt had observed the tendency of well-established neuroses to return in time after oophorectomy was performed for their relief.

Dr. A. H. Goelet said that prolapsed inflamed ovaries often caused only intense pain and backache, and no neuroses. It had been proved that the treatment of uterine conditions might cure nervous diseases. He had himself cured epilepsy by dilating the cervix, and a case of spinal irritation that eminent neurologists had pronounced a meningitis, by the treatment of an endometritis complicated by salpingitis.

Dr. M. D. Field said there were a large number of female patients in lunatic asylums who had lost their ovaries. Five such had come to the Blackwell's Island asylum in the past year, directly from Bellevue Hospital (where they had been operated on). However, they belonged to a class of persons who needed only a straw to carry them past the line of sanity, and the shock of the operation or the ether itself might have furnished this. Altogether, thirty or forty cases of insanity following gynæcological operations had come under his care at the asylum named.

Dr. L. C. Gray said that when epilepsy was relieved by some operation on the genital organs, it was needful to remember that epilepsy might be relieved by any treatment whatsoever, or no treatment at all. All cases relapsed in alternation with periods of relative freedom from the disease. He had seen a case of wellmarked tubercular meningitis so improved for a little time by amputation of the prepuce as to cause him to doubt the correctness of his diagnosis until the autopsy was held. Disorders of

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