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Charles Francis DeCoursey
(1874 - 1938)
| STATE OF KANSAS
State Board of Health � Division Vital Statistics |
STANDARD
CERTIFICATE OF DEATH |
252 7685 | |
Township___________ Registered No. 218
or
City Leavenworth No. St John's Hospital St., ______Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2. FULL NAME: Charles F. DeCoursey
(a) Residence (Usual place of abode). No. National Hotel, Leavenworth Kansas St. _____Ward.
Length of residence in city or town where death occurred __yrs. __mos. __ds.
How long in U.S. if of foreign birth? __yrs. __mos. __ds.
Was deceased ever a member of the Army, Navy, or Marine Corps of the United States? ___
PERSONAL AND STATISTICAL PARTICULARS
3. SEX Male
4. COLOR OR RACE White
5. Single, Married, Widowed, or Divorced (write the word) Single
5a. If married, widowed, or divorced HUSBAND of (or) WIFE of _________
6. DATE OF BIRTH (month, day, and year) Sept.
7. AGE 63 Years 8 Months
OCCUPATION
8. Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. Partner,
9. Industry or business in which work was done, as silk mill, saw mill, bank, etc. DeCoursey Creamery Company
10. Date deceased last worked at this occupation (month and year) _________
11. Total time (years) spent in this occupation _________
12. BIRTHPLACE (city or town) Leavenworth Co (State or country) Kansas
FATHER
13. NAME James DeCoursey
14. BIRTHPLACE (city or town) _________ (State or country) Nova Scotia
MOTHER
15. MAIDEN NAME Mary Ann Murphy
16. BIRTHPLACE (city or town) St Thomas (State or country) Canada
17. Informant James DeCoursey 1
(Address) Kansas City, Kansas
18. BURIAL, CREMATION, OR REMOVAL
Place Mt Calvary Cem Date May 26 , 19 38
19. UNDERTAKER J. J. O'Donnell Und Co
(Address) Leavenworth, Kansas
20. Filed 5/25/38 EA Schaaf Registrar.
MEDICAL CERTIFICATE OF DEATH
21. DATE OF DEATH (month, day, and year) May 24th , 19 38 ,
22. I HEREBY CERTIFY, That I attended deceased from 4-25 , 19 38 , to 5-24 , 19 38 . I last saw h im alive on 5-23 , 19 38 , death is said to have occurred on the date stated above at 1:10 A-M .
The principal cause of death and related causes of importance in order of onset were as follows:
Carcinoma at head of Pancreas. 2 Date of onset Last 6 mo.
Chronic Myocarditis 3 Date of onset ?
Contributory causes of importance not related to principal cause:
Cachexia 4 Date of onset Last 2 mo.
Arteriosclerosis Date of onset ?
Name of operation none Date of ____
What test confirmed diagnosis Clinical Was there an autopsy? No
23. If death was due to external causes (violence) fill in also the following: [...]
24. Was disease or injury in any way related to occupation of deceased? No
If so, specify ____
(Signed) Albert A. Gansz , M.D.
(Address) Leavenworth, Kansas
1 This is most likely James H., son of Charles' brother Edwin. The only other James DeCoursey living at the time was James W. III, who lived in Leavenworth.
2 Cancer of the pancreas is the fifth leading cause of cancer death in the United States today. The disease is extremely difficult to treat. Surgical removal of the cancer is currently the only chance for a cure.
3 Myocarditis is an inflammation or degeneration of the heart muscle. It causes symptoms of heart failure, which may mimic a heart attack. It is an uncommon disorder most often caused by viral infection, but may also appear as a primary disease in adults or as a degenerative disease of old age.
4 Cachexia is a weight loss condition occurring in people with advanced illness who have shown poor response to treatment. It often accompanies malignancies of the pancreas, stomach, esophagus, lung, and intestines. The condition is now regarded as part of the body's reaction to the presence of cancer, which causes the body's metabolism to change. Recent research also indicates that, in some cases, tumors themselves produce substances that induce cachexia.
