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severe pain in the region of the right nipple, oppression in base of right lung and pleuritic pains in the right thoracic region as sequels. Temperature 104 when first seen, respiration 36. No cough thruout attack. Fever fluctuating daily, ranging from 101° to 1021⁄2°. Respiration, pulse and facial expression characteristic of ordinary pneumonia. Slight invasion of base of left lung noted on fourth day, but not progressiv or in the right lung, and on same date left cheek became a well-defined area as if painted a reddish-brown color, but this disappeared within a day and the end of nose assumed an erysipeloid appearance; anyway, erysipelas or erythema, it invaded the forehead, and some parts under chin; no swelling around eyes; in fact, there was no pruritus.

As evidence of its mildness, ichthyol effected much relief; not forgetting to name zn. oxid unguentum first used. Patient never delirious, no typhoid symptoms, no epistaxis. Evidences well markt of rapid resolution on ninth day, respiration and fever lowered, appetite and sleep nearly normal; and the erysipelas or erythema disappearing. Was this a "bastard" pneumonia (better classified pneumonitis), or what was it?

Was not the facial inflammation erythema, or was it a form of herpes or eczema, even if there was only a slight exudation? If pneumonia, why not the cough? Even if Flint said such a condition can exist-we cannot so consider it unless conditionally. Canada.

VERITAS.

[We see no reason whatever to doubt your diagnosis. While we have never seen a pneumonia without accompanying cough, we do not question the experiences reported by such observers as Flint, for he is not alone in such statements. The consensus of opinion is rapidly crystallizing into the belief that pneumonia is always a microbic infection. It is quite possible that you had a mixt infection, with autoinoculation of the parts seeming to be infected with erysipelas.

There is no way, now, of settling the questions you raise. We can only make the hypothesis and theorize on the solution.-ED.]

Candler's "Diseases of Children."

EDITOR MEDICAL WORLD:-Looking over the book reviews in January issue I was imprest with your opinion on Candler's book of "Diseases of Children," and sent for it; but was greatly disappointed when I examined it, as I found the author uses the alkaloidal method of therapy, which you did not mention. Such treatment is of no use to the general practician who after many years of practise is used to the general international therapy, as he cannot start anew a different mode of drug therapy peculiar to a certain class of physicians. I think you should have mentioned it. S. SEILIKOVITCH, M.D.

935 S. 3d St., Philadelphia, [We agree with you that we should have stated in our review that the author uses the alkaloidal therapy in his methods. We endeavor to mention such things in our reviews. However, there is not an absolute difference between alkaloidal therapy and the commoner forms of plant drugs. The ordinary extracts of the same plants as the alkaloids are derived from contain a portion of the alkaloid, and the only difficulty present is to gauge the dose of the cruder extract to that given for the separated alkaloid. Being familiar with the older remedies by many years' experience, you

should have little difficulty in using the drugs in place of the alkaloids. It must not be forgotten, however, that there may be several alkaloids in a plant which may be synergistic or antagonistic; in which event the crude extract does not produce the effect of the single alkaloid, as it contains all the alkaloids. It is really not a different mode; it is prescribing the alkaloids, the activ principles, in place of the crude extracts.-ED.]

Cataract.

EDITOR MEDICAL WORLD:-Will you kindly inform me whether or not there is a serum or collyrum or eyewash for removing cataract cf the crystalline lens? I am under the impression that I read of such recently in some journal. I concluded if there was such you would know of it and where I could find it.

Zelienople, Pa. A. V. CUNNINGHAM, M.D.

[The fresh juice of Senecio cineraria (Cineraria maritima, L.), the common "dusty miller" of our mother's garden, has the reputed virtue of "absorbing cataract," when instilled into the eye. A proprietary medicin of the alleged juice of the cineraria maritima is offered for sale, and can be procured thru any druggist.

Our best oculists deny that any medication is of any avail in cases of cataract. Phosforus, in oil, has likewise been reputed to have curativ power. It is rubbed on the forehead, and instilled into the eye. We have no personal experience with either the juice of the dusty miller nor with the phosforus, and above information is merely given on your request and neither is recommended.-ED.]

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Removal of Powder Stains.

DEAR DR. TAYLOR-I have a case in which I am very much interested and want your help and advice: What will remove (if anything) gunpowder stains from skin except mechanical means? Is there any drug or medicin that I can apply, and if so, what is it, and how use it? Will give brief history of case. Boy, 12 years old (only child of well-to-do parents, highly respectable) tried to celebrate Christmas morning by filling one end of a gas pipe 11⁄2 inches in diameter and 12 inches long with paper wad to keep powder from running thru pipe when poured in. He then stuck the end with paper in it in the snow, poured in about half pound powder (did not tamp it), then proceeded to drop lighted match upon loose powder in the pipe, and caught the full flash of powder in face, burning both ears, both eyes, nose, mouth, tongue and neck. I have

succeeded to my satisfaction and to satisfaction of all in treating the burns. He will see to read with one eye and can see fairly well with other; will possibly see to read some with it. Have got excellent results so far as burns and scarification are concerned, but there are hundreds, possibly thousand, powder stains. Some grains of powder look to be almost whole, but rather deeply buried beneath epidermis. I commenced trying to help his appearance just as soon as possible. I have and am yet using glycerin and peroxid. Hope you will see fit to help me. FRED. R. GOBBEL.

English, Ind.

[We fear you will never be able to get satisfactory results where the imbedded grains are so numerous and so deeply bedded in the skin.

Variot's plan of treatment follows: A concentrated solution of tannin is tattooed into the skin over the stain; then a silver nitrate pencil is vigorously rubbed over the tattooing. Within a few days a closely adherent dark crust forms. After fourteen to sixteen days the crust separates spontaneously, the corium and epidermis underneath having been repaired, and the site of operation presents a faint pinkish scar, which gradually fades to the normal color of the skin. The operation may be repeated over the same site, if necessary.

Brault uses 30 grams of chlorid of zinc to 40 grams of water, and tattoos in the same manner. Not over two square inches of skin should be treated by either method at one séance.

Ohmann-Dumesnil attempts removal of marks by digesting the encapsulating connectiv tissue so it can be carried away by the lymphatics. He uses glycerole of papoid or caroid, well tattooed in, followed by a dressing of the same, and covering with gauze, which is removed after three days. It is of doubtful superiority to the other methods.

Some of the larger and deeper marks will be best removed by electrolysis or by the epidermal punch, under local anesthesia. It will be readily appreciated that extreme patience will be required, both on the part of the patient and the operator, whatever method be selected, and you should be a little chary of promising much by any method, as results are frequently discouraging, even after repeated efforts.-ED.]

Numbness.

EDITOR MEDICAL WORLD:-I would like to know what will relieve numbness in a railroad section hand 70 years old. Has always been hearty, but for last year the numbness has gotten so bad he had to quit work, and now can hardly get around, at times. The numbness is in hands, ankles and feet largely, but some in forearms and from hips down. Sometimes pricking-like sensations, like needles sticking him. Have had him on the iodids, also strychnia 1/60th, and given some salol. All to no avail. He eats and sleeps moderately well. Conover, Ohio. L. R. EMERICK, M.D.

[You must first ascertain the cause of the "numbness." It is not rare to have rheumatism manifested in this form. Examin the heart and kidneys thoroly. You did not give enuf strychnin to test it. It is often necessary to give as high as 1/20 grain, every four hours, to produce an effect. If you have a sphygmomanometer, test his blood pressure. If you determin the cause of the sensation, we will be glad to suggest remedial measures, if the therapy is not then clear to you. This is

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DEAR DR. TAYLOR:-On a visit to the country this week I saw a case I will report and ask the fraternity to give some light on how to treat such a patient. A young lady of 16 years has sweating of both hands and feet all the year around. summer time she leaves a track going barefoot on ground and over the floor. I felt both hands and they were sweating just up to wrist, palms moister than you would be in a hot day in July or August. Feet sweat same as hands so that stockings are wet all the time. In sewing the garment is so moist that she can hardly do a decent job of work on it. Her general health is good as anybody's. other trouble. This has been of long-standingover ten years. I have never treated her for it. The trouble is unique and hence I am reporting it for advice as to what sort of a course to adopt for

a cure.

No

Lives on a farm and does lots of work and has no other complaint. This greatly annoys her all the time.

Any advice or suggestion as to a remedy or remedies will be very thankfully received. Lamar, Mo. DR. W. L. GRIFFIN.

[We think if you will have the hands and feet soakt in a solution of potassium permanganate for ten minutes twice daily you will be able to produce Half a teaspoonful of the crystals to a

a cure.

large basin of water will be strong enuf. She should have two or more pairs of shoes, and wear them in alternation. Fresh stockings should be worn each day. A dusting powder made up of a dram of salicylic acid to 2 or 3 ounces of impalpably powdered boric acid should be used after the potassium permanganate bath, and it might be well to wear stockings thru the night, and to dust their inner surfaces freely with this powder. A dram of formaldehyde solution to a pint of water makes another very serviceable bath, but must not be used in the presence of any excoriation.

Agaricin may be given internally, 1/10 grain tablets being employed. Give one tablet every hour in the morning till three or four are taken.ED.]

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sled on which was seated a buxom madam of great proportions. The legend quoted above explained the young man's predicament. It also very appropriately applies to efforts to find a scientific basis for fraud medicins, because they have none.

The action of many diabetes remedies is simply diuretic. The diluted urin is of lower specific gravity than that passed previously by the patient, and thus a fallacious condition is produced which the unobserving will consider an improvement, and he may be induced to write a testimonial on the strength of it.

The Fulton remedies have been referred to in June, 1914, WORLD, page 255, and August, 1912, page 358.-ED.]

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[The following is a reproduction in small type of the circular.-ED.]

When all other doctors fail call on Miss Hattie Jackson, the world's renown doctor. Years in the medium business. 4 William St., Natchez, Miss. LADIES AND GENTLEMEN:

Take notice that I have the best Lucky Pieces and Lucky Powder that will cause Speedy Marriages and bring Lovers together without fail. The only importers in America of White and Black Lode Stone that bring luck to the owner. My St. Denies Powder and Candles are the very best articles for all kinds of Family troubles, Court affairs and against your enemies. Use the home Powders which keep peace and happiness all around. It prevent all kinds of Conjuration or Hoodoo trouble.

Do not let yourself get fooled by imitators, but get the right goods for your money. Write for circulars of proof, and inclose two-cent stamp for answer. Consultation letters must be accompanied by $1 to be attended to, or no answer will be returned.

I have all kinds of instruments for locating Hidden Treasures and lost Property, also Indian Root, Herbs, Barks, etc. Also the best Indian Oils, Salves and Rubbing Liniments to cure all kinds of Blood Poisoning, Rheumatism, Pains, Swellings, Sores and all kinds of Conjured Sickness of many years past. goods are all first-class quality and will give satisfaċtion if used according to direction.

My

Goods delivered true and safe in or out of the city. Orders and correspondence letters promptly attended to as will be directed.

My Medicine is $5, $10, $15 and $20 a treatment, depending on how long you have been sick. My Luck Pieces are $7.50, $10, $20 and $25. The more you pay for one the stronger it is and the longer it lasts you. My Love Powders are all $1.10 a package. Lode Stone, $1.10 a package. Give me a trial and be convinced. Respectfully,

MISS HATTIE JACKSON.

[This "renown doctor" must be a rival to Capt. Rand, mentioned in February WORLD, page 77. She calls herself a "doctor" in the circular, and may be amenable to the medical practise act of her state. -ED.]

Mitchella Compound.

EDITOR MEDICAL WORLD:-I would be obliged to you if you could tell me the formula for the herbs employed in the "painless motherhood" remedy of Dr. J. H. Dye Medical Institute, Lewis Block, Buffalo, N. Y. It has been on the market for the last thirty years. I am curious to ascertain if the

claims made for this herbal tea can be substantiated by any person. Only recently have I had inquiries about it. ROBERT DENNEY.

Melbourne, Australia.

[We quote the following from "Nostrums and Quackery," second edition, pages 236 and 237:

A sample of "Dye's mitchella compound" was examined botanically for us by Prof. Wm. Baker Day, of the University of Illinois. Professor Day writes as follows:

I have examined botanically a sample of "mitchella compound." The sample consists apparently of a mixture of vegetable material, chiefly fragments of leaves, roots and bark, among which I have been able to identify the following: Mitchella repens-herb-commonly known as partridge berry or squaw-vine.

Chamalirium luteum-rhizome and roots (Helonias dioica), commonly known as starwort or false unicorn root.

Cornus florida--bark of the root-commonly known as flowering dogwood.

Cypripedium pubescens or Cypripedium parviflorum, commonly known as ladies' slipper.

All of these drugs have been used at some time as medicinal agents, but, with the exception of ladies' slipper, have long been practically discarded as useless. Cypripedium, while official, is so little employed as a remedy that few text-books even mention it. Mitchella compound is, in short, but one more of the innumerable cure-alls on the market in which discarded, unrecognized or useless drugs are prest into service and invested with miraculous virtues.

Dye sells this mitchella compound at $1 per box. ED.]

Viavi.

EDITOR MEDICAL WORLD:-I would like to ask you what you know about the "Viavi" treatment sent out by The Viavi Co., of New York. Are they regular practicians or frauds? Corning, N. Y.

A. F. SMITH. [Viavi was discust in THE WORLD for October, 1912, pages 452-454.-ED.]

CURRENT MEDICAL THOUGHT.

Gleanings from Current Literature. Woolens held over from last winter should be washt before wearing. They may induce a herpetic affection otherwise. This has been called herpes tonsurans, herpes tonsurans maculosus, herpes squamosus, and pityriasis rosea. It is easily cured by ointments of sulfur or pyrogallol.-ISAAC, Berlin klin. Woch.

Salvarsan is retained in the body longer than atoxyl, arsazetin or neosalvarsan. The amido group may be demonstrated in the muscle after ten weeks, and traces of arsenic appear in the urin for months.-Riebes.

Iodism is most intense when 0.25 gram of potassium iodid is administered every four hours, and disappears if this dose is doubled.-Brunton.

The simultaneous administration of iodid and chlorin increases the free iodin in the blood, by oxidizing the potash salt.-Curle.

The trend of professional opinion is toward the staphylococcus origin of pruritus ani; and, in accordance with universal custom, all other causes are ignored.

Try scarlet red ointment for anal pruritusbut don't get the ointment too strong.

Bloch treats gonorrheal arthritis by intramuscular injections of antityphoid vaccine, believing that the intense reaction is the curativ agency.

Eggers treated five cases of lupus with copper salts, getting fine results. Of course, he did not use anything so common as the pharmaceutic salts, but new ones made in Germany-the cinnamicacid copper-lecithin, zykloform and copper chlorid-lecithin.-Derm. Woch., No. 42.

Acne-McCoy says the causes must be removed; galvanism is useful in uterin disorders; vaccine is sometimes essential; and the use of the x-ray is based on a misconception.-Urol. and Cutan. Review.

The glamour attaching to study under the great Professor Heisseluft has blinded the American public to the fact that much of the special training in Europe is a joke. Vienna has been aptly described as the medical lunch counter. -Urol. and Cutan. Review.

Phenol is a dangerous dressing for the penis. A navy surgeon once reported a case of complete erosion of the organ following such applications.

Infection is no longer regarded as a punishment for sin, but as due to natural causes that may be controlled by man.-ROSENAU, Medical Herald.

Eberth's bacillus typhosus will kill in 1914 in the United States more than will German shrapnel and bullets in France and Russia.-Osler.

Goiter. The only drug that is of advantage in hyperthyroidism is atropin.-HAGGARD, Southern Practitioner.

Tetanus.-French journals speak of tetanus as one of the principal dangers to be met in military surgery. Knowing the part too often played by prejudice in testing new methods, we would suggest that Baccelli's method, the injection of phenol subcutaneously, receive further trials. The fact that some adverse reports were made on it should not influence us unduly, in view of the paucity of success in treating developt cases. However, the antitoxin serum treatment is preferable.

Traumatic aneurisms are excised and the vessels sewn together, quite successfully in the present war.-OREDSON, Journal-Lancet.

So long as true grain alcohol is known as Cologne spirits and wood alcohol as Colonial spirits it is little wonder that mistakes occur. Both names are unnecessary and inexcusable. Fourteen deaths in Vermont were caused by the addition of wood alcohol to whiskey by a druggist.

Leprosy increases in Texas and Louisiana, and affects more than half the States of the Union.DYER, Texas State Journal.

Evans and Middleton call attention to the frequency of arthritis deformans complicating endamebic pyorrhea. They applied emetin subcutaneously in the latter with distinguisht success, the daily doses being % to 4 grain.—J. A. M. A.

In transfusing blood Weil advises the addition of sodium citrate to prevent clotting.-J. A. M. A. The stomach and intestins are frequently affected reflexly, the symptoms masking the original affection.-WATERMAN, Medical Herald.

Tuberculosis will kill ten times as many this year in Great Britain as will die abroad for their country.-Osler.

Thornton reports decided improvement of the

hearing following the application of cantharidal collodion to the drum and external meatus.Ellingwood's Therap.

Nephritic Diet.

This diet is low in most extractivs, since these substances are high in purin bodies, which are eliminated poorly by the kidneys. It is also properly low in salt, since salt is eliminated poorly by the kidneys and the edema of nephritis is largely dependent on this condition. The fruit acids, being also undesirable to inflamed kidneys, are either left out if they contain high amounts of the acids, or the fruit is cookt, which, in a measure, overcomes that undesirable feature:

Milk in any form, and foods made from milkin limited quantity; buttermilk; kumyss; whey; junket; peptonized milk; cream;

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Saratoga and Its Mineral Waters.

Dr. A. W. Ferris, in Albany Medical Annals, says that the plateau on which Saratoga stands, between the foothills of the Adirondack Mountains on the west and the Hudson River on the east, was the Kayaderosseras, the hunting ground of the Iroquois Indians, and the present county of Saratoga was probably the special resort of the Mohawk tribe. The word Saraghtoghie is said to signify "place of salt," and it is supposed that deer-licks, existing at certain points where the mineral waters reached the surface, attracted the game animals in the olden time.

It was probably densely wooded with a growth of white pines, and the Kayaderosseras River as well as Fish Creek and the lake undoubtedly teemed with fish.

In 1684 Peter Philip Schuyler and other Albany citizens purchast from the Indians their "Hillside Country of the Great River," finally deeded to the white man over the signatures of the sachems of several tribes, in 1704. This transfer was ratified in 1708 by Queen Anne, who granted a patent of land to the white purchasers. 1772 the patents of Saraghtoga and Kayaderosseras were united into one district to which the name Saratoga was given.

In

The first white man to visit a Saratoga spring was Sir William Johnson, Baronet, who bore a commission from his Majesty, George II, of England, and who inflicted a severe defeat upon the French army under Baron Dieskau, at the battle of Lake George, in 1755.

Ill and disabled by an old gunshot wound. Sir William was conveyed in 1767 by friendly Indians, partly by boat, partly on a litter placed on Indian shoulders, from Johnstown to Schenectady, thence

to Ballston, and thence thru the forest to the Kayaderosseras River, and finally to the High Rock spring, the "Medicin Waters of the Great Spirit." Obeisance was made to the Manitou of the spring, and then "Warraghiyaghy," the White Brother of the Mohawks, partook of the water of the healing stream as it spouted thru the orifice of the High Rock cone, and bathed in its waters. The old cone stands to-day where Sir William saw it, now in the little High Rock Park, protected by a pavilion, and against the background of the limestone scarp of the geologic "fault." Military duty called him away before his recovery, but he was so much benefited as to be able to walk part of the way thru the forest_to Schenectady, after taking the Saratoga Cure. Sir William shortly wrote to General Philip Schuyler concerning the healing waters of the High Rock Spring, and this report is supposed to have actuated General Schuyler to cut a roadway to the spring thru twelve miles of forest in 1783, and to erect a shelter for himself and his family while for several weeks they used the water. Ten years earlier a clearing had been made and a cabin built by a hardy adventurer, whose camp had long since been destroyed. But from the time of General Schuyler's trip thither the locality was visited by many celebrated people, including George Washington, Alexander Hamilton, George Clinton, Colonel Humphrey, Colonel Fish and others. From that day to this Saratoga has been a resort more or less popular, reaching the position of perhaps the best known and most fashionable spot in America, about a hundred years after Sir William set the fashion.

No resort in this country has entertained so many distinguisht literary, scientific, military or diplomatic celebrities or statesmen. Of the presidents, Harrison, Madison, Tyler, Van Buren, Fillmore, Buchanan may be mentioned of the ante bellum guests, while Daniel Webster, Stephen A. Douglas, Gen. Winfield Scott, Daniel D. Tompkins, DeWitt Clinton, Silas Wright, Wm. L. Marcy, Chancellor Kent, Washington Irving, Fenimore Cooper, Gerritt Smith, Gottschalk, Joseph Bonaparte (ex-king of Spain), and many other illustrious people were among the guests at the spa a generation ago, when its tide of gayety reached the high-water mark.

The history of its gayety, its gambling and its racing is well known. The desultory and unscientific use of the waters led to nothing further, and a level of mediocrity was reacht, judging the matter from a physician's standpoint. During the years the springs were most visited, their waters were employed more because of certain establisht fashions than with an intelligent idea of the proper use of specially selected waters to meet definit diseases or conditions.

Action of the Saratogians resulted in an act of legislature in 1909 which provided for the purchase by the state of lands, mineral rights and mineral springs. Thus began the state control, comparable with the method of conservation of mineral waters in European countries for generations, our old-world cousins having developt similar properties years ago, by invoking governmental ownership, for the enlargement of public health.

While the underlying aim and incentiv of the development of this health resort are the prevertion of disease and the relief of the sick and suffering, it is an undoubted fact that a properly

constructed bathhouse and drink hall well equipt and conducted' will result in a large and constant income to the state.

Our Saratoga waters resemble in many respects the fewer springs at Kissingen, and the range of application of these mineral agencies is very similar in the two resorts.

The amount of spring water available may be appreciated from a consideration of the fact that the Champion Spring No. 3 spouted 142 gallons a minute, or 202,480 gallons a day, when its neighbor, Champion No. 2, was sealed. The gas (carbonic oxid) has always been present in very large quantities. From the Adams Spring alone a total of about 1,200 pounds a day was extracted by the General Gas Company and sold for $5,000 a year. The Island Spring produced a revenue of $3,000 a year for a long period. All the waters are supersaturated with carbonic oxid.

The mineral waters may be classified as follows: Saline-laxativ, alkaline-saline and ferruginous or chalybeate. Others are also mildly chalybeate, and many waters fall into two of these classes. Of special value are the table waters, Geyser and Minno-nebe. The latter resembles the Grande Grille of Vichy, and since it contains about one-half as many bicarbonates, it is suitable for free use during meals.

Prescribed as chosen for individual cases the waters are variously indicated for use in gastrointestinal disorders, gout, rheumatism, arthritis and anemia. Some are admirably adapted for use in incipient kidney disorders, in neurasthenia, general fermentation from increase of acidity in the digestiv tract, certain skin diseases, and in the elimination of various poisons from the body and the removal of certain exudations due to dis

ease.

Saratoga has also a spring which resembles the Spring No. 12 at Nauheim, Germany, since it contains the same calcic and magnesic salts. It is, therefore, suitable for use in giving the Nauheim system of baths for incipient arteriosclerosis, certain other circulatory disorders and especially for some forms of heart disease. The chief field of activity, however, will be in the domain of disorders of the digestiv tract and in diseases producing tissue change, and in the reduction of obesity.

All Saratoga springs are radio-activ. The radio-activity is due to dissolved radium salts, and not merely to absorbed radium emanations. Therefore they contain a permanent agent which will produce activ emanations indefinitly.

The reservation commission obtained the presence of Dr. Paul Haertl, the director of the chemical and balneologic laboratory at BadKissingen, Germany, who studied the Saratoga Springs situation thoroly, and said that the springs at Saratoga are unexcelled in the world.

EXAMINATION QUESTIONS.

Kentucky, December 11-13, 1913.

OBSTETRICS AND GYNECOLOGY.

1. What is the hygiene of pregnancy, and what advice would you give a pregnant woman from a hygienic standpoint? 2. How would you differentiate between pregnancy and ovarian tumor?

3. (a) Describe an eclamptic attack, (b) give premonitory symptoms.

4. (a) How would you manage inevitable abortion? (b) Give some of the dangers of an abortion.

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