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Erik R. Seeman’s Speaking with the Dead in Early America (2019)

By at least the 1830s, evangelical Protestants in the United States considered relic collection and distribution to be an essential part of an individual’s ‘good death’ experience. Protestant relics took form as bodily and contact relics. Bodily relics included locks of hair, pictures of bodies that once lived, post-mortem images, and, in rare cases, blood and bones. Contact relics included Bibles, clothes, burial shrouds, letters, and other objects associated with the dead. Evangelical publishers employed the memoir genre to teach children and adults how to distribute these relics on their deathbeds to family and friends. Some evangelical children even modeled handwritten memoirs of their friends after these published accounts. By the mid-nineteenth century, most Anglo-American Protestants regarded relic collection and distribution around the deathbed as a defining feature of evangelicalism. This held true for evangelical women, children, and men. In fact, evangelical men took these deathbed practices with them to war. Civil War soldiers who died away from home insisted on writing deathbed letters to families as part of their good death experiences. These letters usually carried soldiers’ most treasured possessions back home as Protestant relics, including locks of hair, Bibles, and rings.

A 28-year old man presented with decreased vision and a bitemporal hemianopia. Magnetic resonance (MR) imaging demonstrated what appeared to be an enlarged optic chiasm and, on T2-weighted images, hypersignal extending along the optic tracts. This was felt to represent an intrinsic chiasmal mass, most likely a chiasmal glioma. Biopsy specimens from the first craniotomy were nondiagnostic. With continued visual failure, the patient underwent a second operation, and the correct diagnosis of craniopharyngioma was established. This article emphasizes the difficulties encountered with neuroradiologic evaluation and histopathologic study of craniopharyngioma.

Treatment of washed erythrocytes with tert -butyl hydroperoxide (0.5 m m , 10 min) inhibited basal Ca 2+ + Mg 2+ -ATPase activity by 40% and calmodulin-stimulated activity by 54%. The inhibition was accompanied by the formation of methemoglobin and the aggregation of some membrane proteins into a high-molecular-weight polymer. Membranes, isolated from washed erythrocytes, showed a similar pattern of inhibition. Basal Ca 2+ + Mg 2+ -ATPase activity was inhibited 50% at 10 min and 70% at 30 min while calmodulin-stimulated activity was inhibited 70% at 10 min and 84% at 30 min. Thiobarbituric acid-reactive products formed slowly during the first 10 min and then increased sharply between 10 and 30 min. The polymerization of membrane proteins was also observed during the tert -butyl hydroperoxide exposure. Inhibition of erythrocyte membrane enzymes was selective. The Na + + K + -stimulated Mg 2+ ATPase, like the Ca 2+ + Mg 2+ -ATPase, was sensitive to membrane oxidation but the activities of Mg 2+ -ATPase and acetylcholinesterase were less inhibited by tert -butyl hydroperoxide. Acetylcholinterase was found to be very resistant to hydroperoxide treatment with less than 10% loss of activity. The effects of two other hyproperoxides on enzyme inhibition were studied also. Cumene hydroperoxide (0.5 m m ) was found to be as potent as tert -butyl hydroperoxide but hydrogen peroxide at 10 m m did not produce thiobarbituric acid-reactive products or inhibit Ca 2+ + Mg 2+ -ATPase activity until after 20 min. The selective effects of peroxides on these enzyme activities are discussed.

Since the recent introduction of a drug regimen containing 2 mg of the antiandrogen cyproterone acetate and 50 micrograms ethinyl-oestradiol (Diane; oestrogen-cyproterone acetate) several uncontrolled reports have extolled the benefits of this drug. Double blind studies, however, are lacking. Sixty two patients with moderate or moderately severe acne were therefore included in a double blind trial of treatment for six months comparing tetracycline alone, oestrogen-cyproterone acetate alone, and a combination of these agents. Sebum excretion rates and bacterial counts were measured before, during, and after treatment, at the same time as a clinical assessment was made. At six months the acne (as assessed by overall grade) had improved by 68% in the antibiotic treated group and by 74% in the oestrogen-cyproterone treated group. The group given a combination of both agents improved by 82%, which was significantly better (p less than 0.025) than the improvement in the tetracycline treated patients. No significant difference was found between the groups given oestrogen-cyproterone alone and the combined treatment. The sebum excretion rate was suppressed by 25% in the patients in both groups receiving oestrogen-cyproterone but not in the group given antibiotics alone. Oestrogen-cyproterone acetate is as effective as antibiotics in treating acne in women, and adding antibiotics offers no advantage over using oestrogen-cyproterone on its own, although in this study the combination was more effective than tetracycline alone at six months.

In 1966 Neumann and Elger1 first showed that the anti-androgen cyproterone acetate (CPA) reduced the output of the sebaceous glands of mice. This interested those involved in the treatment of acne. The first regime to be used in women was the ‘reverse sequential’ regime of Hammerstein2 who gave 100mg of CPA from day 5 to day 15 of the cycle and 50μg of oestrogen from day 5 to day 26. This regime was used to ensure that withdrawal bleeding occurred on completion of the cycle, because of the strong progestrogenic effect, and depot storing of this high dose of CPA. This method of treatment was found to be successful, with rates of response of 70 per cent improvement after 3 months of treatment being claimed. However, because of the potent unphysiological effect of this dose of CPA, a lower dose combination preparation was developed as an oral contraceptive with 2mg of CPA and 50μg of ethinyloestradiol (Diane, Schering).