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Maltese Epidemiological Information

Dr. James Barry: an enigmatic Army Medical Doctor

C. Savona-Ventura

Maltese Med J, 1996; 8(1):41-47


On April Fools Day 1851, The Malta Times reported the departure of Dr. James Barry MD Inspector General of Military Hospitals from Malta [1]. Dr. Barry had served as a Principal Medical Officer with the British Military in Malta for about four and a half years. An eccentric but very professionally able person, Dr. Barry joined the Army Medical Department as a hospital assistant on 5 July 1813 and subsequently practiced for the benefit of soldiers in Plymouth, South Africa, Jamaica, St. Helena and Barbados before being posted to Malta on 2 November 1846 [2].

In spite of the marked eccentricity, Dr. Barry became notorious only after dying on 25 July 1865. The Irish newspaper Saunders's News Letter on 14 August 1865 reported Dr. Barry death and revealed that the doctor was in fact a female who had masqueraded as a male throughout her life [3]. The story was taken up by a number of British newspapers, including the Manchester Guardian [4]. In Malta, it was reported in The Malta Times of the 5 October 1865. ' MISCELLANEOUS: A strange story is just now going the round of the clubs, and is being discussed in military circles, of the truth of which there appears to be no doubt. An army medical-officer of very high standing, whose death was recently announced, was a female. The correspondent of an Irish paper furnished the subjoined details of the incident:-"Our officers quartered at the Cape between 15 and 20 years ago may remember a certain Mr Barry attached to the medical staff there, and enjoying a reputation for considerable skill in his profession, especially for firmness, decision and rapidity in difficult operations. This gentleman had entered the army in 1813, had passed, of course, through the grades of assistant-surgeon and surgeon in various regiments, and had served as such in the various quarters of the globe. His professional acquirements had procured for him promotion to the staff at the Cape. He was clever and agreeable, save for the drawback of a most quarrelsome temper, and an inordinate addiction to argument, which perpetually brought the former peculiarity into play. He was excessively plain, of feeble proportions, and laboured under the imperfection of a ludicrously squeaking voice. Any natural "chaffing" with regard to these, however, especially roused his ire, but was at length discontinued on his "calling out" a persevering offender, and shooting him through the lungs. About 1840 he was promoted to be medical inspector, and was transferred to Malta. There he was equally distinguished by his skill and by his pugnacious propensities, the latter becoming so inconveniently developed upon the slightest difference of opinion with him, that at last no notice was allowed to be taken of his fits of temper. He proceeded from Malta to Corfu, where he was quartered for many years, still conspicuous for the same peculiarities. When our Government ceded the Ionian Islands to Greece, and our troops, of course, quitted the territory, Dr. Barry elected to leave the army, and take up residence for the rest of his days at Corfu. He there died about a month ago, and upon his death was discovered to be a woman! Very probably this discovery was elicited during the natural preparations for internment, but there seems to be an idea prevalent that either verbally, during the last illness, or by some writing perused immediately after his (for I must still use the 'masculine') death, he had begged to be buried without any post-mortem examination of any sort. This, most likely, only aroused the curiosity of the two nurses who attended him, for it was to them, it appears, that the disclosure of this mystery is owing. Under the circumstances, the fact was deemed so important that medical testimony was called in to report upon and record its truth. By this investigation not only was the assertion placed beyond a doubt, but it was equally beyond a doubt brought to light that the individual in question had, at sometime or another, been a mother! This is all that is yet known of this extraordinary story. The motives that occasioned, and the time when commenced this singular deception are both shrouded in mystery. But thus it stands as an indubitable fact, that a woman was for 40 years an officer in the British service, and fought one duel and had sought many more, had pursued a legitimate medical education, and received a regular diploma, and had acquired almost a celebrity for skill as a surgical operator! There is no doubt whatever about the "fact", but I doubt whether even Miss Braddon herself would have ventured to make use of it in fiction" [5].

Little in known about the early years and parentage of James Barry. She was born in London around 1795 and joined the Edinburgh University as a 'literary and medical student' in the autumn of 1809, qualifying with a Medical Doctorate in 1812. Throughout her medical studies, Barry maintained her male masquerade. She appears to have made but one friend at the University, a fellow-student named John Jobson, who in after years declared that he had never suspected her of being a woman. Having gained her MD, she was successful in the Army Medical Board examination in June 1813 and was commissioned as a Hospital Assistant with the British Army on 5 July 1813. She was initially posted to Plymouth until she was gazetted as Assistant Surgeon to the Forces and ordered to the Cape of Good Hope arriving there in August 1816. After a successful though nefarious career at the Cape, she was re-posted as Staff-Surgeon to the Mauritius on 8 October 1828 and subsequently to Jamaica in 19 April 1831. The Jamaican sojourn increased vastly Dr. Barry's experience in tropical and infectious disease, an experience that was to serve her well in her subsequent career. Early in 1835, she sailed for England on a well-deserved year's leave, after which she received orders to go the St. Helena as Principal Medical Officer. Here she became involved in the intrigues of Civil and Military administration of the Island. This resulted in her eventually being brought before a Court of Inquiry which resulted in her being sent back home, under arrest, in March 1838. She was demoted to Staff Surgeon and eventually posted to the West Indies in November 1838. The adverse medical conditions in the West Indies allowed Dr. Barry to exert all her efforts towards medical management and in attempting to improve the conditions of the troops. The men had few complaints and Dr. Barry had time to concentrate solely on medicine. After four years in this Command, she was promoted to P.M.O. After falling victim to yellow fever, she left for England on sick leave on 14 October 1845 [2].

It took Dr. Barry almost a year to recover from the yellow fever from which she had so nearly died in Trinidad; the War Office records show that she was "At Home - sick" from 27 December 1845 until 2 November 1846, on which date she was posted to Malta as Principal Medical Officer. This was the beginning of more than a decade of service on the Mediterranean station, four-and-a-half years at Malta, then a year at Corfu, a year's leave at home, and then back to Corfu for four years until she finally left that island on 23 June 1857. She had in her previous thirty-three years of service as a Army Medical Officer prior to her arrival to Malta survived enmities, a court-martial, intrigues, disease and discovery of her sex on at least one occasion [2]. She arrived in Malta from Southampton and Gibraltar probably on the 17 November 1846 on the Achilles to take up duties as Army P.M.O [6]. She apparently arranged a tour of the military hospitals in Malta jointly with other medical officers on the 1st December [7]. She resided at Sliema, though in the earlier part of her sojourn in Malta, she may have taken up rooms at Claredon Hotel at Valletta. The Malta garrison was a small and relatively health one, though its situation in the center of the Mediterranean trade routes exposed the Island to the introduction of epidemic infectious disease [8,9]. Within a month of her arrival to Malta, Dr. Barry featured in the local news when she took a seat in the Collegiate Church of St. Paul in one of the stalls reserved for the clergy. Dr. Barry was severely reprimanded by the Lieut. General Sir P. Stuart who issued a garrison order declaring Dr. Barry's act something more than disrespectful. Dr. Barry was cautioned not to repeat the act and threatened with severe penalties. A Roman Catholic by upbringing, Barry was compelled to conform to the established church for the sake of her career [10,11].

Within a fortnight of taking charge, Barry became involved in the court-marshal proceedings against Paymaster Lt. D. Cahill who was charged "for writing an intemperate and insulting letter to Surgeon McGregor of the 42d Regt and of having accused that gentleman of propagating a falsehood without having previously asked for an explanation, and afterwards refusing to make a proper apology to Surgeon McGregor, such conduct being unbecoming an officer and a gentleman". Lt. Cahill had twice applied for invalidation to a medical board presided by Dr. James McGregor who turned down his application because at the time Cahill was not under regular medical treatment but under the care of a civilian doctor Dr. Waugh who practiced unconventional cold water therapy. Cahill was planning to appeal the decision and appear before a new board presided by Dr. Barry. Cahill's medical condition was discussed by the medical personnel when Barry visited of the military hospitals. It appears from the evidence of the court-martial that Lt. Cahill was informed by two of the medical officers (Drs. James G. Moore and G.D. Dods) that Dr. McGregor had stated to Barry "that Mr. Cahill had never been under military medical treatment in Malta". McGregor claimed that he never used made that statement to Dr. Barry, and in fact had confirmed that he had been familiar with Lt. Cahill's case and was aware that his case had been the subject of advice and treatment by several medical officers of the regiment and others. Dr. Barry, in her testimony, confirmed McGregor's version. Dr. Barry testified that she was surprised that a confidential discussion between medical men was passed on to the patient, stating under oath "Here's a professional conversation between medical men which should be sacred and secret - told to a patient, a poor unfortunate sick man, and even the truth not told - .......I did not wish to know who these two gentlemen were, as I should feel contempt for them and it would not be possible for me to have any confidence in them....". Barry had further tried to intervene in the dispute by attempting to reassure Cahill through Dr. Moore as intermediate, who apparently failed to pass the assurance. It was Dr. Barry who advised McGregor to forward the issue to the commanding officer for further action since "no gentleman should write such a letter, and no gentleman should receive it....... I have only to add that I deeply regret being subjected to hold intercourse with tattling, gossiping individuals, who appear to me to have no regard for simple verity; but by their garbled statements endeavour to excite strife and discontent in the Garrison". Lt Cahill was found not guilty of the charge and was acquitted, though the style and tenor of his letter was considered improper and reprehensible. It appeared that the whole problem appears to have resulted from the rivalry between the medical practitioners. Dr. Barry's aversion to the court-martial case was obviously based on the fact that a professional discussion was divulged to the patient. This resulted in her advising action against the patient, an action quite in line to her previous encounters with the established protocol regarding matters of principle [7,12,13].

The controversial and difficult character of Dr. Barry contrasted with her generosity to her patients and those in need. Following a request to set a famine relief subscription for Ireland and Scotland in 1847, Dr. Barry contributed the sum of five pounds to the fund. The significance of this contribution is reflected by the fact that the same sum was forwarded by the Bishop of Gibraltar, while the Maltese Archbishop forwarded the sum of twelve pounds. The Governor's contribution amounted to twenty pounds [14].

Dr. Barry's significant contribution to the health of the Malta garrison and that of the population was however her expertise in the management of infectious disease. The Mediterranean littoral throughout the first half of the nineteenth century saw a number of outbreaks of cholera in various Mediterranean ports. A cholera epidemic which affected a total of 8785 persons of whom 4253 lost their lives had previously occurred in Malta in 1837-38. Dr. Barry had had active experience with cholera in Mauritius during the 1819-1820 epidemic. The awful visitation of cholera again menaced Malta in 1847 when new outbreaks were reported from a few Mediterranean ports. The infection did not apparently reach the Island, but in 1848 a mysterious illness having similar manifestations as cholera broke out among the population and the soldiers quartered at St. Elmo, though only twenty-two cases were severely affected. The true cause for the infection was disputed with some medical practitioners maintaining that it was cholera, while others were of the opinion that the malady was an "influenza or epidemic constitution". A Medical Board was set by the Governor to assess the epidemic and identify its aetiology. The Board included among its members Dr. Barry in her capacity of P.M.O. for the garrison. In mid-September 1848, accompanied by police physician Dr. Collings, and two other military medical officers, Barry visited a number of affected individuals at the Casal (?Paola). The doctors examined the first patient, a woman, and concluded that she was not suffering from the disease, but from "Sporadic Cholera", which Barry defined as a severe affection of the stomach and bowels and prevalent in all countries at certain seasons. The local doctor conformed to the view that the case was one of typhus fever. This patient perished in spite of efforts to restore her. The second patient was "a poor man with a large family", who after examination was unanimously declared not to be suffering from cholera. He recovered after adequate sustenance was made available. The other two cases, a boy of twelve years and an old woman, were declared to be suffering from typhus fever and a malignant form of typhoid fever respectively. The deliberations of the Board concluded that the infection was not cholera and that quarantine restrictions with the attendant disruption to trade and loss of revenue were not necessary. Dr. Barry was adamant in her opinion that the disease was not cholera, even when she found herself at odds with another medical officer Dr. Richardson. To dispel panic and confirm her views, she performed on the 6th October a post-mortem on a soldier who had allegedly died from cholera at St. Elmo. At postmortem, the soldier's death was attributed to a quantity of fruit in a marked state of fermentation from bad wine and brandy. The contribution of Dr. Barry to the Board's deliberations must have been substantial, since The Malta Times further reported that "a penny subscription is talked of to be got up in the island to purchase a suitable piece of Plate to be presented to Dr. Barry for his having in his unremitted exertions and perseverance saved us from a calamity which by false assertions of some of the faculty might have tended to ruin many families". The disagreement about the aetiology of the prevalent disease, particularly between medical officers, displeased the Governor who wished his officers to present a united front. The Governor wished his doctors to sink their disagreements in order to present a show of unity, an action that the honest open-minded intellectual Dr. Barry could not accept. She commented that " It is proverbial that all professions, whether legal, ecclesiastical or medical differ and seldom arrive at the same conclusion as to the cause and effect of things; in fact the world in general disagrees.... I even presume to contend that such equality of opinion would in no wise add to the credit of the Profession or ensure the safety of the Public." She did however deplore the military medical officers' indiscretion in allowing the troops to get wind of the fact that cholera was suspected since " Giving publicity to anything that might excite panic among the troops.... could only drive them to despair, drunkenness and death: every Soldier looking on a case of Cholera as a Forlorn Hope" [2,11,15,16,17,18,19].

Like the rest of the medical profession, Barry was ignorant about the true cause of cholera. She believed it to be caused by the "miasma" or foul vapors from matter polluted by excrement or refuse of any kind. During her visit to the Casal, she commented that she had been informed that the villagers suffered from remittent and typhus fever every year, owing to the marshy, badly drained land, as well as "Their being miserably poor and crowded ". She showed concern about the open sewers around Valletta which polluted the atmosphere, particularly near the pig stys. She considered that these brought on disease "equally destructive, if not more so, than the so much dreaded Cholera ." While her medical experiences should have hardened her to individual suffering, she still reacted indignantly to unnecessary suffering. She described the sick she visited as " wretched beings.... in the most deplorable plight, surrounded by filth and stench intolerable, without sustenance or support ". She finished her report to the Assistant Military Secretary Major Pipson dated October 1848 with a religious sentiment "However, should it please almighty God to inflict this awful scourge on us, we have only to commit ourselves to the never failing mercies of Our Heavenly Father and with deep humility and resignation, bowing down to say 'O Lord, Thy will be done' " [11].

A serious cholera epidemic eventually broke out in Malta in June 1850 and lasted until October. The number of cholera cases reported to the authorities was 4029 with 1736 deaths. Again Dr. Barry's contribution to the care of the affected troops was substantial and merited the thanks of the Duke of Wellington. Barry records in a memorandum that she had received "the thanks of the Duke of Wellington for my services during the period that Island (Malta) was visited by the cholera"[11,15,20,21].

Throughout her career, Dr. Barry had striven to improve the living conditions of the common soldier and thus improve his health. In spite of being a vegetarian herself she concentrated on maintaining an adequate diet for the troops in all the stations she had served. Her interest in ensuring the maintenance of an adequate diet to the troops resulted on one occasion in the arrest of a Maltese servant. On this occasion, Dr. Barry observed a Maltese servant exiting from the guard-room with a large dish of beef and potatoes, which had been illicitly purchased from a soldier. The dish, which contained the rations of four men, was sold for four pence to enable the soldiers to procure liquor. The Maltese servant was arrested and imprisoned for 24 days for subverting military discipline. Dr. Barry felt strongly about the evils of drink, believing that liquor was the direct or indirect cause of many disease, ailments and injuries, causing organic damage and predisposing the system to chills and fevers. Furthermore many a drunken soldier had died from exposure through sleeping off his stupor in bitter weather, or injured himself in falling or fighting. Drunkenness was a common problem among the services. In Malta at the postmortem of five soldiers no trace of food residue could be identified, these preferring to exchange their rations with money to buy liquor [2,22]. Barry also attempted to improve the sanitary conditions in the barracks and military hospitals. These were overcrowded, dark and stuffy. The latrines were foul, the water supply from the open tanks polluted. She evidently had endless interviews with the Governor on the subject, who "not infrequently condescended to approve of measures suggested by me" [11].

Her efforts in the troops' health during the cholera epidemic was recognized and soon afterwards, on 16 April 1851, she had the satisfaction of receiving promotion to the rank of Deputy Inspector-General of Hospitals and was posted to Corfu. She was apparently not pleased with her new assignment, preferring to be posted to the East Indies. Her request was apparently turned down [ 23,24,25]. She left Malta on the Triton for the Ionian Islands on the 1 April 1851 [1]. On Corfu she successfully contributed to the care of sick and wounded soldiers evacuated from the Crimea. Her interest in the situation on Malta did not decrease with the passage of time. Colonel Lockyear of the 97th Regiment wrote to her from Malta, where nearly 100 men were suffering from cholera, that he had neither medicines nor medical comforts for his troops who had just been ordered to Piraeus and no means of obtaining them. Barry "within two hours of getting the letter..... had embarked a supply of comforts and medicines for the use of the Regiment and Hospital." She continued to send supplies once a week since there was no other way of getting them through. She left Corfu in June 1857 when she was attached with local rank of Inspector-General of Hospitals to the Canada Command. In Canada, she again campaigned for a balanced diet for soldiers such as "the cheering change of a roast instead of eternal boiled beef and soup". She also tackled the living circumstances of the troops at this station. She was promoted to the rank of Inspector-General, with rank equivalent to major-general, on 7 December 1858. Following a severe bout of influenza in Canada she was pronounced unfit for service in July 1859, at the probable age of sixty-five after forty-six years of army service. She died in London on 26 July 1865 (not Corfu as reported by the Saunders's News Letter) during an epidemic of diarrhoea [2,11].

How had an active female army medical officer managed to conceal her sex in a predominately male environment throughout her career? There can be no doubt that in early Victorian era, as warriors grew more hirsute, Dr. Barry's smooth face must have become more conspicuous. Her physical appearance was distinctly feminine. She was small and delicately built being only five feet tall, her face was pale and smooth with high cheek bones and sandy curls (dyed reddish in later life), a long nose and blue eyes. Her hands were small and delicate. Many of her acquaintances subsequently reported that they had had suspicions about her true sex, some believing her to be a hermaphrodite. She was a teetotaler and vegetarian, the latter habit gaining her the nickname Haxxixu from her Maltese acquaintances. Even in Malta, correspondence after her death suggested that her landlord at Sliema used to swear he (Dr. Barry) was a woman having the obstinate manner of females and is alleged to have stated that " Dan ix-xitan ghandu icun Mara". In spite of her eccentricity, her activities were well appreciated by the troops and by her social acquaintances. Before her departure, The Malta Times reported that "the soldiers and the poor particularly, as well as a numerous acquaintance amongst the first circles in the island will regret their loss". Her medical expertise was also duly appreciated by the non-military personnel. It is recorded that Dr. Barry had saved the life of a sea captain's daughter in Malta by adopting different measures from the doctors previously employed on the case[8,11,24,26].

Her sex had been discovered at least once during her severe illness from yellow fever while in Trinidad. During the course of her illness, she was obliged to summon her assistant-surgeon Dr. O'Connor. After giving her the necessary assistance, she directed him not to call again unless he was summoned. Worried about her condition, although strictly against orders, Dr. O'Connor felt it was his duty to call taking a companion with him, who after Dr. Barry's death told his story. "I was quartered as a subaltern in Trinidad while Dr. Barry was serving there in the capacity of principal medical officer. One day a fried of mine, the assistant-surgeon, asked me to walk with him into Port of Spain. 'The P.M.O.,' said he, 'is down with fever at the house of a lady-fried, but has given strict injunctions to us not to visit him. Nevertheless I feel bound to call and see how he is, will you come with me?' On arrival my friend entered Barry's bed-room, while I remained in the verandah. In a few minutes he called me excitedly into the room, exclaiming as he flung back the bed-clothes, 'See, Barry is a woman!' At that moment the P.M.O. awoke to consciousness and gazed at us bewilderingly. But she quickly recovered presence of mind, and asked us in low tones to swear solemnly not to disclose her secret as long as she lived"[2]. And so the masquerade could go on until her death.

Through her subfertige, Dr. James Barry had made history by being the first woman in Britain to graduate as a medical doctor and to fulfill an active army career dedicated to Medicine and the amelioration of human suffering. The reasons for her masquerade during her medical training can easily be explained by the fact that a medical career for a female in the United Kingdom in the early decades of the nineteenth century was unthinkable. In 1856 the official medical opinion on the issue of women's entry into medicine came to the fore. A Jessie Meriton White had applied to the Royal College of Surgeons and to the University of London to know if they would be willing to admit a woman to their examinations. Both had refused to the amusement of the British Medical Journal which considered the whole question a great joke. The first woman medical graduate in the UK was Elizabeth Garret who in 1865 passed the examination of the Society of Apothecaries. Denied access to recognized medical schools, she had been forced to pay high fees for private tuition and was only allowed to sit the examination after threatening a law suit [27]. The subsequent entry of Dr. Barry into the Army Medical Department was possibly based on career opportunities and the reality that a female medical doctor was unlikely to be accepted by the community. Perhaps her quarrelsomeness and hectoring manner was due to an inferiority complex which made her adopt an aggressive and uncompromising attitude. Whatever the reasons for the subfertige, Barry, during her forty-six years service showed herself to be a successful doctor and administrator.



REFERENCES
  • 1. Anon. Ship News: Passengers left. The Malta Times, 1 April 1951, p.4
  • 2. Rae I. The strange story of Dr James Barry. Longmans: London, 1958, p.1-114
  • 3. Anon. Saunders's News Letter, 14 August 1865
  • 4. Anon. A Strange Story. Manchester Guardian, 21 August 1865
  • 5. Anon. Miscellaneous. The Malta Times and United Service Gazette, 7 September 1865
  • 6. Anon. Ship News: Passengers arriving. The Malta Times, 17 November 1846, p.3: this news item reports the arrival of a 'Dr. J. Bavey' possibly a misprinting of Barry.
  • 7. Anon. The Court Martial. The Malta Mail and United Service Journal, 31 December 1846, p.2-5
  • 8. Anon. The Late Dr. Barry. The Malta Times and United Service Gazette, 5 October 1865, p.3
  • 9. Anon. The Malta Mail and United Service Journal, 25 June 1847, p.2: a person named 'Barry' is registered as arriving at the hotel during the previous week.
  • 10. Anon. Dr. Barry P.M.O. The Malta Mail and United Service Journal, 24 December 1846, p.2
  • 11. Rose J. The Perfect Gentleman. Hutchinson: London, 1977, p.127-132, 141-142
  • 12. Anon. Court Martial on Lieut. Cahill, Paymaster 88th Regiment. The Malta Times, 22 December 1846, p.3
  • 13. Anon. The Late Court Martial. The Malta Times, 5 January 1847, p.2-3. Lt Cahill had 15 months previous to the court-martial suffered a severe attack of "rheumatism" depriving him sight and the use the legs. The illness terminated in blindness of the right eye, total paralysis of the left leg, and partial paralysis of the right hand and arm. He had suffered a number of relapses.
  • 14. Anon. Subscription for the relief for the distress in Ireland and Scotland. The Malta Mail and United Service Journal, 26 February 1847, p.2
  • 15. Cassar P. Medical History of Malta. Wellcome Hist Med Libr: London, 1964, p.192-201
  • 16. Anon. Cholera in Malta. The Malta Mail and United Service Journal, 29 September 1848, p.2
  • 17. Anon. Cholera and the Soldiery. The Malta Mail and United Service Journal, 6 October 1848, p.1
  • 18. Anon. The Malta Times, 3 October 1848, p.3
  • 19. Anon. The Malta Mail and United Service Journal, 13 October 1848, p.3
  • 20. Lafferi J. Surgeons in the Field. Dent & Sons: London, 1970, p.97
  • 21. Barry J. The humble memorial of Dr. James Barry, inspector general of hospitals to the Rt. Hon. Secretary of State for War . c.1858-59. London: Wellcome Tropical Institute Archives. RAMC collection, catalogue no.373. In: Hurwithz B, Richardson R. Inspector General James Barry MD - putting the woman in her place. BMJ, 4 February 1989, 298:299-305
  • 22. Anon. The Malta Times, 8 July 1850, p.3
  • 23. Peterkin A, Jonston W. Commissioned Officers in the Medical Services of the British Army 1660-1960. Wellcome Hist Med Libr: London, 1968, vol.1, p.242
  • 24. Anon. The Malta Times, 18 March 1851, p.3
  • 25. Anon. The Malta Mail and United Service Journal, 14 March 1857, p.4
  • 26. Cantlie N. A history of the Army Medical Department. Churchill Livingstone: Edinburgh, 1974, vol.2: p.413-418
  • 27. Donnison J. Midwives and Medical Men. Hieneman: London, 1977, p.71-73


   
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