that Napoleon I's death the preceding day was due to extensive cancerous lesions of the stoma.ch. The view that Napoleon died of 'cancer' was not accepted by Francesco Antomrnarohi, the man who actually performed the autopsy, who had been Napoleon's household physician for the last twenty months, and was the only physician on St. Helena with a pathologist's training. He maintained that the hepatitis the Emperor had suffered from for a long time was the cause of death. Furthermore, the Emperor's enlarged, tender liver, jaundiced complexion and yellow conjunctivoo had also been diagnosed as signs of severe hepatitis by Barry O'Meara, Napoleon's household physician during his first three years in exile, and John Stokoe, who had attended Napoleon for a week in January 1819. Consequently, apart from Dr. Arnott, who assisted Antommarchi during the last few weeks when the morbid picture was especially baffling, those medical men who personally had attended Napoleon during his illness refused to admit that he had died from cancer. Many medical writers with doubts about the cancer diagnosis have attempted to identify Napoleon's disease on St. Helena by analysing compilations of his signs and symptoms. This has produced surprisingly disparate results. Thus, when exiled on St. Helena, Napoleon is alleged to have had, or suffered from the sequels of, the following diseases: peptic ulcer, intestinal ulceration, various liver inflammations, undulant fever, malaria, dysentery, rheumatoid arthritis, heart failure, congenital extremely slow blood circulation, epilepsy, tuberculosis, pleurisy, severe hormonal imbalance leading to obesity and impotence (dystrophia adiposogenitalis), syphilis, gonorrhrna, intoxication from defective teeth (socalled focal infection), gout, piles, and a constitutional predisposition to severe constipation which, it is SS1id, wa.s fatal owing to auto-intoxication and poisoning by laxatives. If a suitable selection is made from the variety of signs and symptoms manifested by Napoleon on St. Helena, it is a simple matter to make out a convincing case for every one of these diagnoses in turn. But if what, after all, was a fairly unchanging disease pattern on St. Helena is taken as an entity, and allowance is made for all the signs and symptoms and their interrelations, then one cannot escape the impression that all the pieces form an orderly picture of two highly characteristic syndromes, namely, the chronic and acute types of arsenic poisoning.
BLOMBERG, L.-H. and A. WASS~N. The effect of small doses of alcohol on the "optokinetic fusion limit". Acta physiol. scand. 1962. 54. 193-199. -Optokinetic nystagmus was examined and registered electronystagmographically in the cases of 2 1 healthy subjects where the angular speed of optical stimulation was successively increased until the eyes could no longer follow the black and white bands on the optokinetic screen (the "optokinetic fusion limit", OFL). This limit was also examined under the effect of a small dose of alcohol intravenously 0.8-1.6 g (concentration in serum of up to 5 mg/100 ml). The results showed a statistically significant decrease in OFL (P < 0.01). I t is pointed out that the effect of small doses of alcohol on the eye movements is similar in certain respects to that of the barbiturates. No information concerning the exact site of action of alcohol on the central nervous system may be implied from those data.The effect of alcohol on the position and movements of the eyes has earlier been studied only to a comparatively limited extent. POWELL (1 938) and COL- SON (1940) found that moderate amounts of alcohol taken orally (about 40 ml of whisky caused a tendency to esophoria, i. e. the ocular axes converged in the fusion-free position. Alcohol can also produce positional and deviational nystagmus if relatively small amounts are taken orally (see ASCHAN et al. 1956).The object of our investigation was to study the effect of alcohol on the involuntary following movements of the eyes elicited by optokinetic stimulation. One must then, to the greatest possible extent, attempt to eliminate the effect upon the nystagmus response of such factors as a lowered degree of attention, Present address:
Hospital records of all women operated on for ectopic pregnancy (EP) in four Swedish towns during 1970-72 and 1980-82 were elaborated. The gynecological and obstetrical background was noted and the clinical picture and management was recorded and analysed. The incidence of EP more than doubled between the two periods. There was no major change in classical background factors between the periods, but the proportion of IUCD users rose from 4 to 16 percent. The use of hCG assays, curettage and ultrasound in establishing the diagnosis increased markedly and the proportion of women with ruptured tubes and heavy intra-abdominal bleeding decreased. Moreover there was a clear tendency towards a more conservative surgical approach in the latter period.
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