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valent perficere, et tamen ob senectutem prolem non obtinent,
sunt tantummodo steriles.

Sed quid dicendum de femina sine utero, vel sine ovariis? Ex
physiologia, ad quam solam quaestio de potentia generandi per-
tinet, scimus feminas carentes utero vel ovariis esse absolute et
necessario impotentes ad generandum, ob absentiam organorum
essentialium.

Quoad uterum obiiciunt nonnulli generationem seu preg^na-
tionem extra-uterinam aliquando evenisse. Sed hoc nullo modo
oflFicit sententiae nostrae ; nam illae praegnationes evenerunt qui-
dem, sed in] feminis, quae ovaria habebant, et uterum saltem par-
tialem ; nunquam vero in feminis carentibus totaliter vel ovariis
vel utero. Unde CI. Antonelli ita loquitur de hisce praegnationi-
bus {in op. cit) : " Haec praegnatio ut fiat supponit uterum, ad
minus unam tubam phalloppianam perviam et unum ovarium, aut
saltem huius partem omnino sanam. Deinde dicendum, praeg-



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IMPED IMENTUM DIRIMENS MA TRIMONIUM. 6 1 3

nationem naturalem et physiologicam esse illam, quae fit in utero,
quaeque ideo uterina dicitur; quaecumque vero alia praegnatio,
quae extra uterum accidit, et ideo extra-uterina appellatur, veram
anomaliam et derogationem legum physiologiae constituit, quae
propter hoc gravissimorum malorum et mortis matris et fetus fere
semper causa evadit" Evanescit igitur difficultas petita ex ano-
malia, quae dicitur praegnatio extra-uterina.

Quoad ovaria obiidunt nonnulli aliquando factum esse, ut
post operationem chirurgicam, qua ovaria feminae excisa fuerunt,
generatio eveniret. Ast reponimus ablationem ovariorum non
idem esse ac carentiam ovariorum. Saepe enim chirurgus aufert
ovaria, et tamen radix eorum, vel ovarium supplementare, adhuc
in femina invenitur, quae proinde valet post tempus iterum con-
dpere. Et ita praegnationes, quae post ovariotomiam secutae
sunt, nihil contra sententiam nostram agunt.

Stat igitur quod physiologi una voce proclamant, sdlicet ovaria
et ovulum esse in feminis, quod testiculi et semen sunt in homine.
Et sicut homines castrati utroque testiculo sunt impotentes ; ita
feminae carentes ovariis.

Neque dicas comparationem non valere, quia spadones seu
castrati actum coniugalem neque materiaiiter perficere possunt;
nam tum historia tum experientia contrarium docet. Et ex
Sixti V Constitutione superius dtata, sdmus tunc temporis
extitisse Eunuchos atque Spadones, qui et erectionem padebantur
virilis membri, et commiscebantur cum mulieribus, et humorem
quemdam similem semini emittebant. Et tamen Sixtus V diserte
ac emphatice eorum matrimonia invalida esse declarat, non quia
se copulare non possint, sed quia impotentes sunt ad generandum.

Igitur si, ex doctrina generali Ecclesiae, invalide contrahit
tnatrimonium qui impedimenta impotentiae laborat ; si, ex doctrina
certissima physiologiae, mulier careris ovariis laborat impedimento
impotentiae; patet midierem sine ovariis ^natrifnonium valide
contrahere non posse.

III.

Quae hactenus exposuimus sunt tam clara atque conspicua ut
nemo ea possit rationabiliter inficiari. Ast ob falsam quamdam
et erroneam citationem alicuius Responsionis S. Officii ; quae apud
aliquem S. Theologiae Moralis Scriptorem invenitur, nonnulli



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6l4 THE ECCLESIASTICAL REVIEW.

dedpiuntur atque contrarium tenent. Praestat banc specialem
Ecclesiae doctrinam pro re nostra consulere ac probe intelligere.

Hae sunt itaque duae responsiones Congr. S. Officii, quas
interrogatio relativa praecedit : i ®. Num mulier N. N. per utrius-
que ovarii excisi defectum sterilis effecta, ad matrimonium ineun-
dum permitti valeat et liceat, necne? — Resp. "Matrimonium
mulieris, de quo in casu, non esse impediendum." 3 Febr. 1887.

2°. Num mulier N. N., cui operatione chirurgica ablata sunt
duo ovaria et uterus, admitti possit ad matrimonium contrahen-
dum ? — Resp. *' Matrimonium non tsis& impediendum." 30
lulii 1890.

Antequam verum sensum harum responsionum determinemus,
notetur {d) illas responsiones non fuisse solemniter publicatas ; {S)
non fuisse publicatas in forma decreti, et cum clausula " ut ser-
ventur ; " (c) non se referri ad feminas carentes ovariis, sed ad
feminas, quarum ovaria exsecta fuerant, quod est plane diversum,
ut superius iam notavimus ; {d) non respicere nisi pardcularem
personam sub circumstantiis peculiaribus, quae nobis non inno-
tescunt ; {e) non continere uUam rationem, ob quam datae fuerunt
Hoc enim est proprium tribunalis Cardinalium, ut sententiae ibi
proferantur quin sententiarum motiva aflerantur.

Ex quibus omnibus iam patet quam inconsulto responsiones
praefatae adducantur, quasi legem pro omnibus constituant Nam,
ut ait Cardin. D'Annibale {Summ, TheoL Mor,, vol. I, n. 182,
not. 5) : " Authenticae sunt omnes interpretationes prodeuntes a
S. R. C. in forma decreti et cum clausula ut serventur ....
non item quae ab aliis SS. CC. prodeunt ; adeoque non habent
vim legis, nisi R. P. iussu publicatae (et non tantum editae) solem-
niter fuerint, nee tollunt probabilitatem sententiae contrariae ; nee
eis proinde necessario standum est." Et Genicot {TheoL Mor.
Inst, Edit. II, Lovanii 1878, vol. I, n. 137): "Illud certe diligenter
cavendum est ne sine magna circumspectione dedsiones pro uno
casu datae ad similes extendantur, vel responsa particularia tan-
quam norma generalis proponantur. Saepe enim ex ipso ver-
borum tenore patet decisionem restringi ad casum concrete S.
Congregationi propositum, ut cum quaesitum est : An constet de
valore matrimonii in casu, Neque allegantur in responsis rationes,
quae S. Congregationem moverunt ad huiusmodi sententiam feren-



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IMPED IMENTUM DIRIMENS MA TRIMONIUM. 6 1 5

dam .... Quare pronum est errare eos, qui huiusmodi
responsa specie tenus generalia vel dedsiones causarum tamquam
legem universalem proponant." Quae verba examussim rem
nostram tangunt.

Sed insuper S. Congregatio multoties declaravit, omnesque
theologi unanimiter tenent, matrimonium sub conditione evitandae
prolis contractum esse invalidum, ob exclusionem rei contractui
coniugali essentialis. Quomodo vero nunc matrimonium, ex S.
Congregationis decisione, validum esset, si mulier omnino careat
ovariis, quae tam essentialia sunt generationi ? Aliter igitur se
habet S. Congregationis decisio. Et ut hoc probemus, opere pre-
tium est alias hue S. Congregationis C. dedsiones afferre, quae
inexplicabiles forent, si duae praefatae responsiones S. Officii signi-
ficarent simplidter: mulierem sine ovariis posse matrimonium
valide contrahere.

I®. Agitur (in Salemitana 21 Martii 1863) de quadam nomine
C. N., carente utero et habente informem et vitiatam vaginam,
quae matrimonium contraxit cum C. N. 4 Februarii 1838. Post
multos annos cohabitationis ac reiterati conatus copulae, cum
coniuges illi non possent consummare matrimonium, causam
inierunt apud Curiam Archiepiscopalem Salemi, quae, praehabitis
voto cum iuramento quatuor peritorum in medicina et testibus
septimae manus, declaravit matrimonium esse irritandum ex capite
impotentiae. Ad banc sententiam defensor vinculi ex offido inter-
posuit appellationem ad S. Congreg. Concilii. Quae in comitiis
generalibus diei 9 Augusti 1862, ad dubium "An sententia Curiae
Archiepiscopalis Neapolitanae Salernitanae sit confirmanda vel
potius infirmanda in casu " Emi Cardinales respondere censue-
runt : " Dilata, et exquiratur votum Collegii Medico Chirurgici
Urbis, perpensis omnibus hinc inde hactenus deductis in Causa,
de qua agitur.'* Quare die 21 Martii 1863, ipsi Emi Cardinales
post votum Collegii Medico Chirurgici, quod sic conclusit examen :
" Collegium Medico Chirurgicum, 14 votis favorabilibus unoque
contrario, dedsit in casu veram impotentiam perpetuam, insana-
bilem atque antecedentem existere" ad dictum dubium responde-
runt: "affirmative ad i"* partem et negative ad 2*™, facta inhibi-
tione mulieri attentandi alias nuptias." Post hoc defensor vinculi
die 27 Junii eiusdem anni ipsam causam reproposuit cum dubio :



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6l6 THE ECCLESIASTICAL REVIEW.

" An sit standum vel recedendum a decisis : " responsum prodiit :
" In decisis."

2°. Eadem S. Congr. die 22 lunii 1871 (in Verulatui) inva-
lidum declaravit matrimonium, iam a 9 mensibus celebratum et
post 9 menses cohabitationis, ex eo quod mulier carebat utero, et
vaginam duos pollices longam habebat, et impotens a peritis
medicis iudicata fuit.

3°. Ob eamdem causam eodemque modo in Albiganen.j.S^i^
tembris 1875, aliud matrimonium invalidum fuit declaratum.

4°. Idem omnino accidit in Causa Monasterien 16 Decembris
1899.

Ergo S. Congregatio, quando feminae impotentia probata fuit,
semper invalidum declaravit matrimonium. Quomodo igitur hae
quatuor responsiones cum duabus praefatis S. Officii conciliantur ?
Facillime. Nam in duabus causis S. Officio propositis, et in quibus
responsiones pro validitate matrimonii prolatae fuerunt, quamvis
ovaria in una, ovaria ac uterus in altera exsecta fuissent, tamen de
carentia totali ovariorum vel uteri non constabat Et sic illae
responsiones nullo modo officiunt sententiae nostrae.

Et quod res ita se habeat, nunc cerdssimum est post ea quae,
duobus abhinc annis, public! iuris facta fuerunt a CI. P. Bucceroni,
qui ita loquitur : " Neque vero ullo modo obstant notae respon-
siones S. Poenitentiariae et S. Officii, matrimonium non esse im-
pediendiim, in casu excisionis ovarii et uteri. Nam, ut mihimetipsi
declaratum est ab ipso Emo Cardinali, S. Officii Secretario, Re-
sponsiones illae, ad particulares casus dumtaxat datae, supponebant
posse adhuc per se in illis casibus sequi generationem, scilicet
quatenus non fuisset perfecta et absoluta uteri et ovariorum excisio
et absentia" (Bucc. TheoL Mar., vol. II, Ed. 4a, Romae 1900,
n. 994.)

IV.

Ad haec adiungenda est illorum auctoritas, qui Romae sub
oculis Summi Pontificis plausu totius mundi Ecclesiasticas vel
Physiologicas scientias colunt ac docent Et sufficiat nomen
afferre clariss. Joseph Antonelli, olim Praeceptoris mei dilectissimi,
qui data opera duobus opusculis invicte ac triumphaliter sententiam
nostram propugnat ; clariss. Bucceroni, qui Antonellii sententiam



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IMPED IMENTUM DIRIMENS MA TRIMONIUM. 6 1 7

amplexus, earn, in ^ edit, suae TJieologiae Moralis, Roinae igoo,
strenue ac lucide demonstrat ; clariss. De Luca, consult S. C. C,
Professoris Textus Decretalium in Universitate Gregoriana, necnon
auctoris Praelect. Juris Canonici, qui plausu ac laudibus Antonel-
lium prosequitur, qui banc doctrinam docte ac solide exposuit ac
defendit; clariss. Lapponz, medici S. Pontif. Leonis XIII, ac in
Urbe Medicinae Legalis Professoris ; clariss. Topai^ qui tarn saepe
a SS. Congregationibus consulitur, propter eius eminentiam in
arte medicinae, qui duo postremi opusculis italice conscriptis rem
palmarie tuentur.

Omittimus deinde nomina plurimorum professorum, canonis-
tarum, ac theologorum, qui nunc, veritate victi. docent non amplius
de hac materia dubium adesse posse.



Quid tandem dicendum de moralitate oppositae sententiae?
Neminem latet ipsam onanismi crimini viam latissimam aperire ;
sacramentum enim niatrimonii ad prolem propagandam institutum,
et post peccatum in remedium etiam concupiscentiae concessum,
non amplius esset, nisi concupiscentiarum illecebra. Victas dare
manus cogeremur christianae moralis inimicis, qui prolis vitandae
consilio tam multum adlaborant, carnis voluptates tantummodo
quaerentes. Etenim mulieres corruptae, post castrationem, quae
operatione momentanea obtinetur, transactis decern circiter diebus,
iam valide matrimonium contrahere possent ad solam libidinem
explendam. Hoc larvatum matrimonium esset ruina Societatis,
homines bestiales redderet, ac ipsos contra naturam congressus
aliquo modo imitaretur. Faxit Deus ut tam horrendum crimen
ex christiani nominis societate exsulatum habeat, ac sacrosanctis
Ecclesiae Legibus strictissime adherentes, theologi omnes ac
Episcopi totius Orbis, iuxta decisiones authenticas RR. PP., ovari-
orum carentiam infeminis tanquam impedimentum dirimens matri-
monium iiabeant.

Hoc autem nos probasse censemus tum ex doctrina generali
ac particulari Ecclesiae, tum ex physiologiae ac iuris Canonici
auctoritate. Quomodo igitur se gerere debet Confessarius, vel
Parochus, quern mulier carens ovariis ad matrimonium contra-
hendum adit ? Quid practice agere debet sacerdos, cui talis casus
affertur ?



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6l8 THE ECCLESIASTICAL REVIEW.

VI.

Spedminis gratia et exemplo damus hie casum, qui in Italia
realiter accidit, et quern cl. Bucceroni in 4. edit, sui " Casus Con-
scientiae " refert :

" Fabia volens matrimonium contrahere cum Fabio, petit a suo
Confessario utrum possit: Ovarii enim exdsionem ex industria
passa est; sdllicet ne, inito deinde matrimonio, filios habeat
Nulla, inquit Confessarius, est difficultas. Ac ita respondet, quia
existimat matrimonium ad mutuum quoque vitae adiutorium per-
tinere et ad concupiscentiam coercendam. Difficultatem tamen
movet Parochus, qui chirurgi exigit attestationem, qua constet
physice impossibilem non esse generationem, attenta ratione, qua
ilia ovarii exdsio perfecta est At cum Fabia huic dedsioni non
acquiesceret, res est ad episcopum delata, qiy parochi decisionem
omnino approbavit" Quaer : Quid ad casum ?

Et Cl. Bucceroni, allatis rationibus, quibus ovariorum carentiam
totalem impedimentum dirimens constituere probat, tum Episcopi
turn Parochi decisionem approbat ac laudat.

Eodem modo sc gerant Confessarii, vel Parochi quibus tales
casus afferuntur ; non ipsi decisionem proferant, sed ad Ordinarium
omnes hos casus referant, qui, adhibita Curia, decemet ex deduc-
tis quid agendum ; sdlicet utrum, perspectis perspidendis, mulier
censenda sit sine ovariis, ac ideo impotens, vel non.

N. Casacca, O.S.A.

Villanova College, Pa.



PKIESTLT MINISTRATION IN VARIOUS DISEASES AGCOHPANIED

BY COMA.

" Infinnatur quis in vobis ? inducat presbyteros ecclesiae et orent
super eum unguentes eum oleo in nomine Domini."— Jacob, s : X4*

BETWEEN delirium and coma there are many points of differ-
ence. While both may be partial or total, temporary or
lasting, delirium is of less serious import than coma. In the former
we behold the result of a high state of fever ; in the latter we
witness a condition of unconsciousness, like to a deep sleep from
which a sufferer is with great difficulty aroused or at most only



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PRIESTL Y MINISTRA TION IN COMA PA TIENTS. 6 19

to partial consciousness, indqjendent of fever, the direct effect of
brain-affection. Again, while delirium is by no means a probable
forerunner of death, coma is usually a fatal omen. Hence the
advisability of a ipission-priest becoming acquainted with diseases
in which coma or insensibility reveals probable danger of death.

It is well to know that death may begin its work at the heart,
the lungs, or the brain. According to medical men death is at-
tributed to one of the following causes : {a) syncope, {b) collapse,
{c) asthenia, {d) asphyxia, {e) or coma. When the heart's action
is suspended suddenly and entirely, death is said to be due to
syncope; should, however, the failure of the heart's action be
more stealthy and accompanied by loss of vitality, death is ascribed
to asthenia. When, again, there precedes a notable depression
and general prostration, collapse is the term employed to describe
the cause of death. Should there be discovered an interference
with the respiratory functions we have, then, what is called
asphyxia or suffocation. Finally, death may result from coma,
which has its origin in the brain, and is evidenced by drowsiness,
stupor, and total loss of sensibility. Disorders of the brain must
be regarded, therefore, as of serious import — ^the direct and effi-
cient cause of insensibility. The medical term coma usually ex-
presses a morbid state of the brain, attended by loss of sensation
and consciousness. But it may be, as we have already pointed
out, partial or gradual, or complete and sudden, according to the
cause and consequent intensity. Not infrequently does one wit-
ness in a sick person a state of mental and physical torpor mani-
fested by intense drowsiness — such a condition is generally called
"lethargy;" but, again, the patient may have no distinct con-
sciousness, though able to be roused somewhat by pinching or
pricking. In such a case one sees what may be designated
" stupor." When, however, the insensibility is so profound that
the sick person reveals neither sensation nor feeling and docs not
respond to the touching of the eye-balls, we have, then, an illus-
tration of what is strictly termed " coma." This ^tate may be
induced by narcotic poisoning, pressure on the brain, injury to the
brain, alcoholism, or anaemia of the brain.

From what has been said, then, we gather that, just as in dis-
eases attended by delirium, there may or may not be probable



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620 THE ECCLESIASTICAL REVIEW,

danger of death ; so, too, with diseases accompanied by coma.
For probability of death must be judged by the cause which pro-
duces coma and also by its intensity, which varies according to
the brain-mischief.

It may be helpful to the younger readers of the Review, if we
set down certain specific diseases in which probable danger of
death or certain danger of death is to be apprehended, necessitating
the administration of the last rites of the Church. With sudden
deaths we are not at present concerned, since coma, as properly
understood, does not enter into such cases.

Some of the diseases that are of serious moment when fol-
lowed by coma may be enumerated as follows : Syncope ;
apoplexy ; uraemia ; anaemia ; heart disease ; senility ; acute bron-
chitis ; ague ; gastro-enteritis and congestion of the kidneys from
bacteria and ptomaine poisoning ; meningitis ; abscess on the
brain ; softening of the brain ; delirium tremens ; nephritis ;
haemorrhage on the brain ; concussion of the brain ; compression
of the brain ; skull-fracture ; diabetes ; drowning ; and excessive
heat or intense cold.

Our remarks will be confined to the cases above specified.

Some of the diseases we have mentioned may be grouped
together, viz.:

Apoplexy (haemorrhage).
Brain-fever.

Compression of the brain.
Concussion of the brain.
Lesions of the brain.
Skull-fractures and trephining.

As these are connected with the brain directly, suffice it to
remark here that brain-mischief is always of grave import, espe-
cially when as a result the sufferer is reduced to a comatose
state. Wherefore it may be laid down as a general rule, that any-
one who is rendered comatose from any of the above causes
should be anointed forthwith.

It is worthy of notice that often with the fracture of the ribs
there exists a fracture of the base of the skull, manifested by the
oozing of blood from the ears. Again, it is not superfluous to
direct attention to the fact that the operation known as " trephin-



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PRIESTL V MIMSTRA TION IN COMA PA TIENTS, 62 1

ing " is always a dangerous one, and performed only when some
internal affliction, in itself dangerous to life, exists, as for example
an abscess on the brain. Here we have a case, then, in which the
administration of the last rites would be justifiable before the per-
formance of this surgical operation. Let me add, also, by way of
caution, that in some instances, like railway accidents, in which
travellers receive violent shocks to the nervous system, though
there may appear no symptoms of immediate danger at the time,
yet later on, in the course of a few days, serious complications
may ensue in the form of epileptic seizures, faulty vision and deaf-
ness — the heralds in many cases of grave cerebral disease. The
diseases which call for special attention are, first

Apoplexy, — In apoplexy we behold not seldom the result of
cerebral haemorrhage, rendering the sufferer comatose. Generally,
the very usage of the term " apoplexy " denotes a loss of con-
sciousness and power. But as a rule this is not instantaneous,
though death does ensue in some instances after the lapse of five
or ten minutes. In the more severe cases persons are stricken
down suddenly and become quite helpless. In haemorrhagic coma
the patient is rendered completely insensible. The existing dan-
ger will be known to a priest by the pulse and also by the respira-
tion, usually of a stertorous character. As this disease, however,
has been dwelt upon at some length in a previous number of the
Review, I would merely say here, that in fetal cases the pulse
grows more and more feeble, the stertorous breathing becomes
less marked, and the temperature runs high. In all cases of this
kind, when coma is in evidence — as, indeed, in every instance of
apoplexy when the patient becomes unconscious — ^there should be
no hesitation in anointing.

What has been said of apoplexy applies equally to all cases of
brain-mischief, such as abscess on the brain, softening of the brain,
lesions of the brain, cerebral embolism, and thrombosis. The
former of the last-mentioned terms implies a floating clot of blood
which finally makes its way to the brain, an event liable to occur
at all times of life. The latter term means a coagulation of blood
in the cerebral vessels, which, though of rare occurrence in the
young, is often found in old people. To conclude, in cerebral
haemorrhage as the occasion of coma the pulse is observed to be,



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622 THE ECCLESIASTICAL REVIEW,

as a rule, slow and full, and the breathing not seldom of the
Cheyne-Stokes type. In such a case one has evidence of a fatal
augury in cerebral haemorrhage.

Syncope, — We will pass on now to the consideration of syn-
cope. Since syncope is induced by the weakness of the heart's
action, the state of coma, when it occurs, will be iound to be par-
tial or complete, according to the degree of heart-failure. Hence
in this case the danger of death may be proximate or remote.
The former is recognizable by the gradual cessation of respiration
and the feeble-growing pulse, to which may be added the impor-
tant symptoms of cyanosis and coldness and stiffiiess of the limbs.
The best indication of grave danger in syncopal seizures is the
weak pulsation, failing respiration, and conspicuous cyanotic
development.

Epilepsy, — A word now upon epilepsy. Here we must not
lose sight of the fact that seizures of this kind vary in intensity
and danger according to the subject ; for while one fit may end
fatally, there are common cases in which an epileptic may have
many fits without any imminent danger to life. It is with what is
known as the " status epilepticus " we are now concerned, since
coma strictly speaking is scarcely ever found to be more than
temporary in subjects not included under this head. Apart from
the coma, in cases of this kind, there will be noticed marked
cyanotic appearance, and a slow, feebly-beating pulse. In which
event the consolations of religion should be imparted at once.

Uramia, — Another common disease attended by coma is
ursemia or blood-poisoning arising from kidney trouble. As coma
only sets in, in this instance, at the fatal stage, it were needless to
dilate upon its serious import.

Ague, again, is a disorder that may be classed among those
diseases in which coma is found ; for though it is observed but
rarely in a grave form among young people, it is discovered among
the old. The symptoms of grave danger may be set down as,
bad headaches, dizziness or vertigo, drowsiness in what is known
as the cold stage and developing into total loss of consciousness
in the hot stage. In this condition one notices a slow stertorous
breathing, total collapse of the limbs, death-like pallor of face and
profuse perspiration.



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PRIESTL Y MINISTRA TION IN COAfA PA TIENTS. 623

Diabetes, — The next disease calling for comment is that known
as diabetes. In its grave stage the patient will give signs of pros-
tration and complain of severe abdominal pains. The pulse when
taken is found to be rapid yet feeble, and the breathing assumes
the character of a deep-drawn sigh known as " air-hunger." The
breath, too, has an odor like apples. The sufferer may continue
to lie in this condition for one to three days, after which lapse of
time he will become completely comatose and death will set in
alter about twenty-four hours. Coma in this case goes by the
name of diabetic coma.

Meningitis. — Let us treat now of meningitis. As we behold



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