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November 19, 1887

LETTER FROM NEW YORK.-Reply

JAMA. 1887;IX(21):670-671. doi:10.1001/jama.1887.02400200030010

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Abstract

REPLY TO DR. H. C. MARKHAM, OF INDEPENDENCE, IOWA. 

Dear Sir:  —The facts reported concerning Dr. Chandler's disease are too meagre to warrant a positive expression of opinion as to the cause of his death. There are, however, certain considerations which may serve to throw light upon the abrupt termination of his malady. Aside from sunstroke, lightning and other forms of traumatism, the causes of instantaneous dissolution may be put down as hæmorrhage into the medulla and paralysis of the heart or, in other words, arrest of the heart in diastole. Bulbar hæmorrhage, sufficient to promptly destroy life, must be so copious as to involve the respiratory or cardiac centres, or both; and such a hæmorrhage is extremely rare in the young, and even in the aged is not common. Disease of the blood-vessels of the part is for the most part essential to its occurrence, and degenerative weakness of

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