B. ALLEN

WHITE UNTO HARVEST

H. B. ALLEN

Our Fortnightly Meetings.

DR. SPRINGTHORPE'S LECTURE.

The first fortnightly meeting of the year took the form of a lecture by Dr. Springthorpe, entitled, " How to Work." The lecturer remarked at the outset that he ought to have something to say on such a subject, for he could certainly claim to be a Worker. He first dealt with study apart from lectures and Hos- pital work. Great stress was laid on the advantage of an hour's work in the morning, before breakfast, but not on a quite empty stomach. This, Dr. Springthorpe admitted, required a certain amount of energy and enthusiasm, but it paid. As a student, he himself did it religiously, but he was made to get up by an energetic father, for which he was now grateful. Two, or at the Most three, hours' work at night were sufficient, and bedtime should be not later than eleven o'clock. A certain amount of systematic exercise was demanded as a necessity. Saturday after noon and Sunday should be free from study. Various other points as to diet, regularity, meals, etc., were given. Dr. Spring- thorpe then passed on to Hospital work. Thorough and continu- ous individual work in the wards for at least five days of the week was urged. Working in pairs was sometimes of advantage.

Attention was drawn to the lecturer's " Guide to Medical Case- taking," in which direction is given for the complete detailed examination of a case. Further points were given in reply to questions. The lecture was listened to with keen appreciation throughout. Mr. Shelton moved a hearty vote of thanks to the lecturer, and took the opportunity of urging every one to obtain one of the Guide Books, pointing out Dr. Springthorpe's gener- osity in handing over the copyright to the M.S.S. Mr. Park seconded the motion. Mr. Crooke, our worthy chairman, in put- ting the motion, said that if we followed the advice we had been given on " How to Work," we would all doubtless be landed

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₃₆ THE SPECULUM. May, 1907.

where we wanted to be. Dr. Springthorpe, in replying, spoke aboitt examinations, and deplored the fact that students were conspicuous at the Hospital by their absence in the three weeks preceding the final examination. The meeting then terminated.

DR. STIRLING'S LECTURE.

The second fortnightly meeting of the M.S.S. took the form of a demonstration of instruments by Dr. R. A. Stirling. The latest instruments not included in the Hospital collection—which cer- tainly contains all the obsolete ones—were kindly lent for the occasion by Messrs. Mayer, Meltzer & Jackson. In consequence, a very interesting and thorough demonstration was given. Mem - bers asked questions at the conclusion, and Dr. Stirling gave

" points " as to where students failed in examination, the aspirat- ing apparatus being the greatest bugbear. Members were pleased to hear from an old examiner that it was not essential to learn the inventor's name of more than a very few of the most im - portant instruments. The meeting concluded with a hearty vote of thanks to Dr. Stirling for his excellent demonstration.

Annual Meeting.

The annual meeting of the M.S.S. was held at the University on Tuesday, 26th March. More than 120 members were present.

The large attendance was due in great measure to the efforts of Messrs. Potter and Nankivell, who canvassed the First Year and got over 60 new members. The President, Professor Allen, was in the chair. The annual report was read by Dr. Devine, and the balance-sheet by Dr. Opie. These were adopted.

Professor Allen then delivered his address. He dwelt on the increased prosperity of the Medical School. The pathological laboratory was one of the finest in the southern hemisphere, and we hoped to see shortly the anatomical department brought up to the condition desired by Professor Berry. He then referred in eulogistic terms to Dr. Berry, who had already done so much amongst us, and to Dr. Rothera in the bio-chemistry department- The medical library, too, was a splendid one, and far bigger than most imagined. He appealed to members not to borrow books without consulting the librarian, as several had been

" lost." The Professor then touched on various matters, includ - ing the increased number of hospitals for the Honour men, the new curriculum, and compulsory military training—the latter, he was sure, would be welcomed by members of the Medical School.

May, 1907.

The election of office-bearers was then proceeded with. Mr.

Bennett, after some discussion, gave notice of motion to consider the desirability of altering the rules of the society to permit of Preferential voting. The following office-bearers were elected :—

Hon. Secretary, Mr. W. L. Potter ; Hon. Asst. Secretary, Mr.

D. Bennett ; Hon. Treasurer, Mr. A. Y. Nankivell; Hon. Asst.

Treasurer, Mr. R. Morton ; Fifth Year Representatives, Messrs.

Crooke, Park and Shelton ; Fourth Year, Messrs. Florance and Robertson; Third Year, Messrs. Campbell and Jones ; Second Year, Messrs. Bird and Tymms

The President then awarded prizes won during the year. Dr.

Stawell's prize for best paper read before the Society was divided by Drs. Devine and Hutchings, and Dr. Boyd's, for next best, was awarded to Mr. Potter. Mr. F. Bird's prizes for contribu- tions to the Speculum were awarded to Messrs. Crooke and Nankivell.

Professor Berry was then called upon, and delivered a speech, Suggesting the formation of an Anatomical and Anthropological Society. The suggestion was energetically taken up, and a society

—to be run as a branch of the M.S.S.—was formed.

Mr. Bennett proposed that the Committee be instructed to act, with a view of securing a vote for students at the forthcoming Hospital election. Every man paid £10 10s., and was entitled to a vote, and there was no doubt students were in a position to know who were the best men. The motion, seconded by Mr.

Nankivell, received much support, and was carried unanimously.

Mr. Potter proposed that a hearty vote of thanks be accorded to Mr. Buchanan for the work he had done for the Society. He regretted exceedingly that Mr. Buchanan found himself unable to take up the secretarial duties, which Mr. Buchanan, members would agree, would have efficiently carried out. Mr. Hardie seconded the motion, which was carried enthusiastically. Mr.

Buchanan modestly responded, and characteristically offered to help the Committee in any way he could.

Dr. Devine was unanimously elected a life member of the M.S,S. The present prosperity of the Society is largely due to his efforts as Secretary during the past year.

The meeting terminated with a vote of thanks to the chairman for presiding.

Smoke Night.

The first of the two Annual Smoke Nights was held at the Port Philip Club Hotel on Saturday evening, May 11, and proved an unqualified success. The guests present included our three Professors, Dr. Rothera, and several members of the honorary staffs of the Melbourne and Women's Hospitals.

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THE SPECULUM. May,

1907.

The chair was occupied by our President, Professor Allen, who, to quote a recent graduate, " kept the ball rolling " in good style. The chairman having proposed " The King," Mr.

O'Sullivan sang an up-to-date version of the medical anthem, in which some good topical hits were made. One in particular struck us :—

" When the corpses go on strike The Meds. are far from merry ;

How can it be said, ' Go bury your dead,' When they give no dead to Berry ?"

Mr. Burns followed with a song, which was much appreciated.

Dr. Rothera then proposed the toast of " The Medical School and M.S.S.," and in doing so complimented us on the display at Prince's Court on 'Varsity Night.

Mr. Weston Pett followed with a " skit," in which he pointed out to us the dangers of investing (in years to come) in a motor car, after which Mr. Potter, in a humorous speech, replied to the toast of " The Medical School and M.S.S.," and incidentally to some other things as well.

The Zingari Orchestra next favoured us with another selec- tion, which was followed by two recitations from Mr. Will Elder, given in his own inimitable style.

Mr. Buchanan, in a clever and amusing speech, proposed the toast of " Our Visitors," after which Mr. Burns again favoured us with a song.

Mr. Crooke related to us the experiences of a French friend at a Queensland Summer Ball, and also some of his experiences at Ballarat.

Dr. McArthur then replied to the toast of " Our Visitors,"

and was supported in turn by all those present.

Mr. Weston Pett again charmed us with a song, and the Zingari Orchestra with a selection.

Mr. Bennett next proposed the toast, " Other Societies," which was responded to, after a recitation from Mr. Will Elder, by Mr. " Hopper " Brown.

Dr. Bowman then sang his old favourite, " Susianna."

Owing to the pernicious influence of Mr. Judkins in the com- munity, things were now somewhat hurried, and Mr. Buchanan came hastily before the footlights to sing " Back to Dissecting Again."

Mr. Lamble then briefly pronosed the toast of " The Chair- man," and Professor Allen having responded, the evening

ter- minated

with " Auld Lang ,Syne.'

Our heartiest thanks are due to the Zingari Orchestra, who

contributed so much to the enjoyment of the evening, and to

Mr. de Beer for kindly acting as accompanist.

'\14Y, 1907. THE SPECULUM. 59

A Country Medical Sketch from Life.

By " Ex-M.S.S."

He is my only medical companion in a country township where I bought a practice. I must look upon him as my sheet- anchor in time of professional tribulation, for his years number ' 13 , and we learn as students that the all-important " experi- ence " ripens as the years grow ripe.

As a student you are riding with me along a country road, and my medical confrere, on horseback, appears in the distance

I

I, ow awkwardly he rides—all " lobsided," and with one arm hanging somewhat loose and limp. You are naturally curious, and a closer " inspection " reveals the results of a past hemiplegia as the cause of his peculiar position in the saddle. But the real

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tiology ? Half a bottle of " Three Star " per day—perhaps More, perhaps less, according to circumstances—and the weather.

You are surprised to hear that he recovered from a severe Pneumonia. He swears that if he gets it again he'll commit suicide. The irony of it ! Or is it subtle humour ! My sheet- anchor in time of trouble !

But how does he display the qualifications ?

He meets a case of placentT prTvia, and allows hmmorrhage to progress for nine days, and then wires for a " specialist " from a neighbouring city. The specialist comes in a motor-car, and quickly, for he knows it is a desperate call. He also knows my medical brother, and calls me in to give the anaesthetic. " Good 'leavens !" you exclaim; " what about our medical ethics in-

s

truction, of which we were so proud ?" I answer that where stern necessity enters the surgery door " ethics " fly out of the

su

rgery window. You can't have two onmsthetic—the drunken and the drugged.

I become more confident, and even sarcastic, at the expense

cl

my " experienced " elder brother. But he makes more per

annum

than I do, being old established and of great cunning.

,„or instance, he completely upsets all midwifery statistics. Fully '1 " per cent. of his confinement cases are cross-births or similar

ab

normalities. He informs his patients that they would almost

c

ertainly have died but for his timely intervention, and having gained the confidence of the females in ills peculiar to themselves,

e is all serene. For what pleases Mrs. " So-and-So " better

t

han to relate very confidentially to Mrs. " Such-and-Such " :

You know, I was so bad with baby, but Dr. Bakkus pulled Lee through ' splendidly. He drinks, you know, but he is clever, ,,

Did you ever see an alcoholic medico who did not possess that mystic qualification in popular estimation ! If the foetus could

THE SPECULUM.

speak, he also might have something to say about being " pulled through."

My now despised confrere meets a case of " Ty." with haemor - rhage. He overcomes a tendency to alcoholic aphasia, and ex- claims, thickly : " I'll have him eatin' bananas in three days!"

The patient's friends think otherwise. I am called in, give 3 correct diagnosis, and by the help of Providence the patient re - covers—without the bananas. My first complete triumph ! MI patients increase in number, and my confidence grows accordingly.

Some tell me that my co-practitioner dispensed them drugs with the label jammed into the neck of the bottle by means of the cork. He scares a somewhat timid man to me by declaring,

—after two visits—" I've never (hic) sheen you before in ra life !"

My incompetent confrere (how the term changes !) even dis - plays hRmorrhage from a recent confinement on his frayed and buttonless shirt-cuff, and occasionally rides out with forceps dangling from his saddle a la John Gilpin !

I imagine I see the men in the students' room sitting on the name-hewn table, and exclaiming, " Nice lurid tale!" " What

a

yarn to tell ' Mary Anne ' ! "

I would have said precisely the same two years ago. But I've seen these 'things, and they are the truth, upon my " Osler."

So, when in a despondent mood about future prospects, take heart ! Perhaps there are other " experienced " men whose know- ledge is not equal to that of the bright, keen, up-to-date MS' who ever keeps before him a professional ideal, which the older man has oftentimes lost—perhaps years ago.

It iq with extreme regret that we have to record the death since our last issue of four old boys, Dr. A. H. Swindley, Dr. A. D.

Kearney, Dr. R. McLean and Dr. Colin Campbell. To their relatives we offer our sympathy.

1907 THE SPECULUM. 41

Our Commentary Column.

No. 1. OBSTETRICS.

Mrs. B., mt. 23. Admitted 27/4/07, 3.40 p.m.

Primpara. States she was last unwell November 25th, 1906, before which she had been quite regular. Has had some pain in the back and lower abdomen for the last seven days. Mother states that the swelling of abdomen has become much larger during the night before admission. Seen by a doctor outside, who gave morphia gr. by the mouth. Has not lost P.V. before admission.

Examination.—T. 99.6 ; P. 130. Good colour. Fundus of uterus about 4- in. below ensiform; uterine muscle very tense, likewise skin of abdomen, which was tight and glossy ; no striae.

Unable to feel fcetal parts or to hear F.H.

P.V.—Cervical canal still present. External os slightly patulous, but will not admit finger. Uterus feels very tense; no presenting part to be felt.

Comment on the above case, with special regard to diagnosis and treatment.

No. 2. GYN-eECOLOGY.

M.C., aet. 24. Housework. Admitted 12/5/07.

Menetrnal History.—First catamenia at 12 years, regular, in- terval four weeks; duration, 3 to 4 days ; no pain; quantity not large. Is now irregular, intervals 3 to 7 weeks, lasting 5 days ; no pain; quantity large. Has small amount of leu- corrlicea. Is now losing P.V. Married 3 years ago ; one child 4 years ago ; no miscarriages ; confinement normal; had an attack of " inflammation " afterwards.

Present Complaint.—Patient states that she was perfectly well until 22/4/07, when during the evening she fell down the stairs.

Shortly afterwards she was seized with sudden acute pain in right iliac region, and also in the lower part of the spine ; felt very hot and clammy, but did not shiver. Pain has continued more or less severe in lower abdomen up to time of admission. She was last unwell on 15/4/07, for 4 days ; then started losing again on the 24/4/07, 2 days after onset of symptoms, and has been losing ever since ; blood only : no clots. She states that she had a similar attack 4 years ago, shortly after her con- finement.

On Examination.—T. 100.2: P. 92. Patient is poorly nour- ished, rather an

ae

mic, cheeks flushed. Abdomen a little full ; very tender right across the hypogastric and in both iliac regions;

moves very little during respiration ; muscles on guard over area of tenderness ; no definite dulness on percussion.

THE SPECULUM. May, 1907.

P.V.—Vagina feels hot ; the os uteri is patulous, cervix lacer- ated; fundus in normal position, a little enlarged. There is a rounded mass in Douglas' pouch and in right fornex, which is very tender on palpation. Breasts—some fluid can be expressed from both. Bowels constipated ; slight frequency of micturition.

Comment on the above case, with a view to diagnosis, etiology, pathology and treatment.

No. 3.

Woman, mt. 29, single. Admitted at 11.30 p.m. on Thursday, the 9th. T. 102.8 ; P. 124 ; R. 24.

Was quite well till Monday (4 days ago), when she felt sick ; had pain in the abdomen and vomited ; vomiting continued off and on for 18 hours.

On Tuesday she was seen by a medical man, and was distended with very little rigidity.

On Wednesday the pulse was 112, T. 101. She was more dis- tended. Given an enema, with no result. Given i-gr. calomel half-hour for 5 doses.

On Thursday two more enemata were given, with no result.

Up to the time of admission has passed neither flatus nor f

ae

ces since the onset of illness. Menstrual history normal. No history of previous ill-health.

On Eramin(ttion.—Abdominal

respiratory movement dimin- ished in lower abdomen ; slight distension. Marked rigidity and tenderness, especially in left iliac forsa. No tenderness over MacBurney's point ; liver dulness normal ; no dulness in flanks.

No. 4.

M.C.. female ; married, and living with her husband. Ad- mitted to hospital on May 2.

She stated she was comparatively well up to the 26th of April, when she says she lost about half a pint of watery fluid, and a few hours later about the same quantity of blood. The following day a violent pain developed in her right lower ab- domen. The pain was very severe, and radiated to the right knee. A little later she vomited. Bowels are well open. She was last unwoll in January, and thinks she is about three months pregnant. .Her previous history is that three years ago for first time she noticed a small tumour in the right iliac fossa.

This was about the size of a walnut, and in about three years

it had increased gradually to the

size

of a foetal head. For the

last two years she had many attacks of pain and tenderness in

right iliac fossa. These generally lasted about half a day, and

were not accompanied by vomiting.

1907 THE SPECULUM. 43 On Examination.—T. 98; P. 114. Abdomen moves w311 on respiration, and is slightly distended, but not rigid. There is a very tender tumour the size of a foetal head in the right iliac fossa, extending as high as the umbilicus. This dull on per- cussion and movable.

P.V. Examination reveals a patulous os. and a tender tumour in right fornix; the fundus of uterus is not continuous with the tumour.

Comment on diagnosis and progress of symptoms.

No. 5.

Mrs. B., mt. 53. Admitted 2/5/07. Married ; no children.

Menopause at 45 ; became yellow jaundiced in December, '06, and has remained so ever since. There have been no variations in the intensity of the jaundice. Was perfectly well before she became yellow. She feels well, and has no pain. Has lost one stone in six months.

On Examination.—General condition good, except that she is Somewhat thin. Chest normal lower border of liver extends to within an inch of the anterior superior iliac spine, and from there passes up and to the left, crossing midline one inch below a point midway 'between xiphisternum and umbilicus. Surface of liver is smooth ; liver is not tender ; lower border is sharp ; on placing fingers beneath it and pressing liver inwards with other hand, the lower border rides over fingers. A rounded tumour is palpable in costal angle, smooth and hard. It is situated on anterior surface of liver. Gall bladder not palpable. The super-

.qcial veins on either side of abdomen are distended. Has had piles and slight bleeding from rectum before became jaundiced.

No vaginal discharge. No history of rigors or severe pain in liver region.

Compulsory Military Training at the University.

Contributed by Dr. J. W. Barrett.

There seems to have been a good deal of misunderstanding re- specting the exact nature of the proposals, and it may be as well, in the first instance, to state the facts.

The proposal, as finally adopted by the sub-committee of the Professorial Board, and by the minority of the Professorial board as a whole, was as follows : —That each full course student should devote three hours per week during the first two terms of the first two years of his course to the study of military science, Which included, of course, a certain amount of drill and other