.e4 ustralian Medical yournal
JANUARY 15, 1882.
riginal Articles.
DEATH OF FETUS IN UTERO.
By CHARLES SMITH, M. D., Casterton.
The sudden death of the foetus in utero as a result of shock to the mother has been often noticed, but so far as I am aware no attempt has been made to show the manner in which this occurs.
As the case which I am about to narrate, although incomplete, failing as it does in one important particular, yet appears to point to failure of the heart's action as the immediate cause of such sudden death, I have thought it worth while sending it to you, more for the purpose of drawing attention to the matter than as an attempt to decide it.
An unmarried girl, respectably connected, consulted me some months ago for amenorrhoea ; not suspecting the presence of pregnancy, I treated her with iron and aloes, but without success.
After discontinuing her visits for some time she again called, when
I
noticed a decided alteration of figure ; without any remark, therefore, I proceeded to examine her breasts and afterwards to listen for the foetal heart ; she was extremely excited, and anxious to hear my diagnosis, hoping doubtless to find that there had been a suspension of the laws of nature in her favor. The foetal heart-beat was distinctly audible, and while listening to it I noticed it become irregular and even intermit a beat occasionally ; unfortunately I had not my finger upon the patient's pulse at the time, so that I cannot say whether the foetal intermission corresponded with a similar condition in the pulse of the mother. I listened for a considerable time afterwards, with the mother's pulse also under observation, but there was no further irregularity in either.Whether, therefore, the irregularity was the result of a nervous impulse conveyed directly from the mother to the child, or whether it was secondary to a diminished and irregular supply of blood to the maternal portion of the placenta in consequence of the mental condition of the parent, I cannot say, but am inclined to think it was the latter, as the mother was, and continued for some minutes afterwards, very pale. Further investigation may throw more
VOL. IV.
No. 1.
—NEW SERIES.A
2 Australian Medical Journal. JAN. 15, 1882 light upon the subject, the importance of which from a medical and medico-legal point of view may be much greater than appears upon the surface.
Dec. 14th.—The child has since been born prematurely, I believe, as the result of the irritation to the mother following marriage. The cord was twice round its neck, it survived a few hours only, and was not examined.
A CASE OF DEATH BY LIGHTNING.
By D. JERMYN, L.R.C.S.I., BALLARAT.
On Monday, the 5th inst., about 2 p.m., I was sent for to see a man who had been just struck with lightning at the Ballarat Orphan Asylum. I saw him within a quarter of an hour from the time of the accident. I found him on my arrival lying on a bed in one of the dormitories; he was still alive, but breathing very feebly and without stertor; his face livid; his pulse was about 70, and weak; the eyes were extremely dull, as if death had taken place some hours previously ; the pupil of the right eye was much dilated and insensible to light, the left was about the natural size. On the upper and back part of the skull, a little to the right side, at the junction of the occipital and right parietal bone, there was a small punctured and slightly lacerated wound, which had ceased bleeding I could not detect fracture. He died in about seven minutes, without a struggle. There were no marks of the electric fluid on any part of his body, nor was the hair singed at the site of the wound, although he had thick black hair. Corresponding to the site of the wound I found a small hole burned through his soft felt hat.
There was no inquest or inquiry.
On the following forenoon I went to see the body ; cadaveric rigidity had set in slightly, the dilated pupil had assumed its proper size ; the body had been placed in the coffin. I then visited the outhouse where the accident occurred, it contained some potatoes and lumber, there was a small quantity of blood where deceased had fallen, but I could not find anything that could have caused the wound. Deceased when struck was in the erect position. About a foot above his head, and under the flooring of the loft, was a hay-fork, the prongs of which projected a little between the boards ; immediately under the fork was a wooden rake with iron prongs pointing downwards. One portion
a
of the electric fluid which broke through the shingle roof passed downwards through the hay-fork and rake, splitting the wooden portion of the latter; it was evidently this which struck deceased.
The gardener, who was sitting close to the deceased, was struck in the loins, but was not injured, and one of the boys who was sitting on the potatoes was struck on the left shoulder; his arm
was paralyzed for a short time. The fluid, without in the slighest degree injuring the boy's clothes, passed down the chest, abdomen and thighs, leaving a bright red, irregular track, which had nearly disappeared by the following day ; it was not a burn, nor at all painful, and must have been very superficial.
A young man who had also been in the outhouse for shelter, had at that moment gone outside to unharness his horse, and was also knocked insensible. He complained mostly of much pain in the soles of his feet, and stated next day that he had perspired all night most profusely.
A small quantity of chaff which lay on the floor of the loft, Immediately above the hay-fork prongs, was charred quite black.
The lightning after entering the loft took three different directions—
one directly downwards, one tore the loft door off the hinges, and one portion could be traced in the opposite direction, quite outside the building, to a paling fence which it perforated.
I think it is not usual that a person killed by lightning should live for nearly twenty minutes, as occurred in this case; death is generally instantaneous, or a recovery takes place.
PARTICULARS OF, AND EXTERNAL POST-MORTEM APPEARANCES IN, A CASE OF DEATH BY LIGHTNING.
By CHARLES HENRY SCOTT, M.B. et Ch. B.
A comparatively large number of deaths by lightning having occurred during the last few weeks in Ballarat and surrounding districts, the report of a case which recently came under my notice may prove interesting.
On the 10th December last, I was summoned to attend at the residence of Mr. R. L. B., under the following circumstances :
The gentleman named, accompanied by his wife, had just returned home from Ballarat, and had reached within a few yards of his homestead, when, during the height of a violent
A2
4 Australian Medical Journal. JAN. 15, 1882•
thunderstorm then raging, he was struck with the electric discharge and killed instantaneously. Mrs. B., who was sitting beside her husband in the buggy, was, although untouched by the electric bolt, confused and almost blinded for the moment. She, however, recovered herself almost immediately, to find that the horse had been thrown down and the shafts of the buggy broken.
On arrival at the station I made an examination of the body of deceased. Externally the post-mortem appearances were as follow :
Clothing.—Beginning at the right iliac region and extending thence to the centre of the thigh, were four circular patches (the largest of the size of an orange, the smallest the size of a bagatelle ball) where the electric discharge had torn the clothing, burnt out the cloth, and marked the integuments beneath. The edges of these patches were burned, and the room in which deceased had been placed had a distinct odour of burned material.
A strong abdominal belt was perforated and burned at the edges, and the leg of the right trouser torn below the knee.
During examination, I found that deceased's watch and chain were missing, but were subsequently found about fifteen yards from where deceased met his death. The case of the watch (a gold one) was forced in at one point—in appearance, giving one the idea of its having been struck in with a punch. The gold around and in the hollow thus formed, looked as if it had been recently melted. Likewise the accompanying chain had all its links roughened and out of shape.
External Surface of the Body.—A dark red discoloration, commencing at the right ala nasi, extended down the whole right side of the body, as far as the lower of the thigh. There were also some small patches of discoloration on the left side of the abdomen.
In conclusion I may add that the body retained its warmth for a considerable length of time.
Buninyong, 12th January, 1882.
HYDATID DISEASE IN QUEENSLAND HOSPITALS.
By J. DAVIES THOMAS, M.D. Lond., F.R.C.S. Eng.
One of the Honorary Medical Officers to the Adelaide Hospital.
Returns have been received from Bowen, Charters Towers, Georgetown, Ipswich, Maryborough, Springsure, Stanthorpe, and Toowoomba. None have yet reached me from Brisbane, Cook- town and Edward's Town.
THE BOWEN HOSPITAL.
No record Of any case of hydatid disease up to the end of 1879.
THE CHARTERS TOWERS HOSPITAL.
In existence about 6 years; number of beds, 19; daily average 'of in-patients — males, 14; females — " occasionally admitted."
Total number of in-patients received during the year, 148.
There are no cases of the treatment of Hydatids occurring in the hospital books for the last three years" (1879).
THE GEORGETOWN HOSPITAL.
Established about 6 years. Number of beds, 10. Total num- ber of in-patients received during the year, 26. No authenticated case of hydatid recorded.
THE IPSWICH HOSPITAL.
In existence about 18 years. Number of beds, 62. Daily average of in-patients : males-23 ; females-10. Total number of patients received during the year, 207. The hydatid returns over the period 1860-79 inclusive, are as follows: Liver—male, 1;
female, 1 ; total, 2.
Cured, 1; uncured (and proceeded to Sydney), 1.
THE MARYBOROUGH HOSPITAL.
In existence 20 years. Number of beds, 71.
in-patients—males, 25; females, 6. No return in the hospital books from 1873 to 1879 inclusi
THE SPRINGSURE HOSPITAL.
In existence about 11 years. Number of number of in-patients received during the year, the books of any case of hydatids.
THE STANTHORPE HOSPITAL.
In existence about 5 years. Number of beds, 20. Average number of in-patients daily—males,
4i ;
females, Total num- ber of in-patients received during the year, 46. The hydatid returns include the period 1875 to 1879 inclusive: Liver—males, 2. Total, 2. Died, 2.% Uterus, female, 1. Total, 1. Cured, 1.t There is also mentioned one case of hydatid of the ovary which proved fatal. It was not a hospital case.THE TOOWOOMBA HOSPITAL.
In existence 13 years. Number of beds, 36. Daily average of
• in-patients—males, 27; females, 8. Total number of in-patients
* One of these was relieved, but died subsequently to leaving the hospital. 1- Probably hydatid male (J.D.T.).
Daily average of of hydatid disease ye.
beds, 25. Total 43. No record in
6
Australian Medical Journal. JAN. 15, 1882received during the year, 386. The only case of hydatid returned was in a man—situation, right lobe of liver; operated upon and cured.
RUPTURES OF THE UTERUS.
By W. V. JAKINS, L.R.C.P., L.M. Enur. Fell. Obst. Soc. Lond.
(Continued.)
In the following case also death seemed to have followed from shock. It was her fifth pregnancy. Her last child was five years old—a case of difficult labour, and instruments were used. This was all the former history I could gather from her friends.
I saw her late in the evening of a very warm day ; she had been dead an hour ; she was on her back in bed, pale and cold ; there were signs of moderate haemorrhage, but not sufficient to cause death ; there were no marks of violence on the body.
About sixteen hours afterwards I made a post mortem examina- tion. She was a middle-aged woman, and well nourished ; her skin very pale ; a little dark blood was oozing from the vagina, and the anus was stained by the passing of a small quantity of pale yellow semi-fluid faeces. On opening the abdomen in the middle line, directly under the peritoneum was a full-grown male fcetus, whose meconium had tinged what seemed to be the amniotic waters with which the belly was distended. The child lay on its right side across the abdomen, its head in the right lumbar region. Below the child, and reaching from the lower third of the distance between pubes and umbilicus, right across the pelvis, lay the uterus, its long axis being transverse and measuring about nine inches ; from above downwards it measured about five inches ; it was covered with peritoneum, and looked normal ; the funis disappeared under its anterior middle part ; on lifting the uterus its anterior portion was seen to be separated from the vagina ; this rent began on the right side of the sacrum, extended forwards and across to the left side ; its edges were thin but not ragged, deeply injected with dark blood, and of firm consistence ; the body of the uterus was pale, in places almost white, of normal thickness and density ; there was no softening ; I could find no trace of the os ; the placenta was attached completely to the posterior upper part
of
the uterus, from which I removed it with ordinary facility.The bladder contained about a quarter of a pint of normal looking
urine.
After dividing the lateral ligaments and the posteriorpart of the uterus still attached to the vagina, I saw a sub-peritoneal extravasation of dark semi-coagulated blood, reaching from the sacrosciatic joint of the right side up to the diaphragm, and about one third of the way across the upper part of the mesentery; this extravasation varied from three to four inches in width, and its upper part gave a port wine colour to some of the small intestines. There were a few black currant jelly looking flat clots in the abdomen. These were all the appearances of note.
The history of the case is as follows :—She had been in labour a fortnight previously, it passed off after a few hours and came on again the day she died ; the pains began at 2 p.m., but not with severity till half-past seven ; about a quarter past nine, as in her previous confinement, she complained of cramps, for which she was seated on the edge of the bed ; in a quarter of an hour a gush of about half a pint of blood came through the vagina; she fainted, was laid down, and in a few minutes breathed her last. There was no sudden onset of severe pain, neither was there any increase of the jactitation she had exhibited all the evening The midwife said she could not feel the head, and that she could barely get the tip of her fingers into the mouth of the womb. Probably a case of tranverse presentation.
Ballarat, 30th November, 1881.
Nospxtal geports.
MELBOURNE
HOSPITAL.Intra-capsular Fracture of
Femur, occurring in a Patient, aged 23, while sickening with Typhoid Fever.
Under the care of Mr. JAMES.
Reported by J. B. BACKHOUSE, M.B., Ch.B.
A. D., 'et. 23, married, was admitted into the hospital on September, the 27th. She was complaining of pain in her right hip and she limped very much when she walked.
On examination, the right foot was found to be slightly everted and there was shortening of the right leg to the extent of one and a half inches. Crepitus could be distinctly made out over the joint when the limb was rotated. There was some slight
flattening of the hip.
8 Australian Medical Journal. JAN. 15, 1882 She stated that about eighteen months previous to admission she fell down a flight of fifteen stairs, striking her hip with considerable violence. She was able to rise and walk to her room, a distance of several yards. She felt considerable pain in her hip. At the time of the accident she had been for several days sickening with typhoid fever. On her arrival at a sister hospital she was already delirious, and no attention was drawn to the hip. She remained there for fifteen weeks, and sometimes complained of pain in the joint, but this was considered to be one of nondescript pains of typhoid, and she was never examined for any injury to the hip.
On admission to this Hospital she was somewhat weak, but was able to walk with the aid of a parasol. Whilst an in-patient she walked up and down stairs to the garden without any aid whatever.
She was discharged at her own request about five weeks after admission.
Fracture of the Pelvis—Rupture of the Small Intestine.
Under care of MR. JAMES.
Reported by J. B. BACKHOUSE, KB., Ch. B.
Resident Medical Officer.
J. D., wt. 40, was admitted into the hospital on the afternoon of October 10th, 1881. On admission he was quite sensible, but in a state of intense collapse, the surface of the body cold, the lips blanched, and the pulse almost imperceptible. He stated that while attempting to get off the back of one of several trucks which were in motion, he slipped, and the lower portion of the right side of the abdomen and pelvis was jammed between the buffers of two trucks.
On examination, there was very great eversion of the right foot, and some bruising of the abdomen in the right iliac region, where there was most exquisite tenderness on the slightest pressure. No pulsation was to be detected in either the femoral or posterior tibial arteries on the right side. On passing a catheter only a few drops of bloody urine and mucus were drawn off. Hot bottles, brandy, ammonia, and ether were ordered to try and rally patient, but he sank, and died about two-and-a-half hours after admission.
I am indebted to Dr. Allen for the following notes of the autopsy :—Body well nourished and muscular ; superficial abrasions over and below the anterior superior spine of the right ilium, and over the lower and front part of the right side of the
chest. The soft tissues in the right groin and scrotum, including the right testicle, were severely crushed, and full of extravasated blood. The right psoas muscle was crushed almost to a pulp, the great nerves of the lumbar plexus being completely dissected out, but not torn. The iliac vessels were intact, excepting a minute rupture of the right external iliac vein close to Poupart's ligament.
Pelvis.—The right os innominatum was completely torn away from the sacrum, and broken across in a vertical direction ; the line of fracture commenced at the brim of the true pelvis at the junction of the ilium and pubes, and ran downward through the acetabulum into the obturator foramen, the ascending ramus of the ischium being fractured transversely below.
Chest.—The
seventh, eighth, ninth, and tenth ribs on the right side were fractured opposite the midline of the axilla, the costal pleura being slightly lacerated. The lungs were uninjured, but on the right side there was a huge rent in the diaphragm extending along its posterior attachment from the convexity of the ribs nearly to the midline of the body. The right pleural cavity contained a small quantity of extravasated blood.
There was slight superficial laceration of the liver immediately in front of the right triangular ligament. Above fourteen feet above the ileocaecal valve a piece of small intestine fifteen inches long, with the corresponding portion of the mesentery, was completely torn from its attachment s and lay loose in the cavity of the abdomen.
The connective tissues around the right kidney and behind the mesentery were full of extravasated blood.
NOTE.—This case shows how extensive and severe internal injuries may be present, with very slight lesion of the surface of the body.
Cbtrapeutir autr Surgical Ulemarauba.
Cotton wool saturated with a mixture of equal parts of chloral and carbolic acid and allowed to dry, makes a good pledget for toothache.
For dissolving gall stones the hydrated succinate of peroxide of iron, gr. x ter in die in aqua menth. pip., is reported as successful.
Five parts of carbolic acid dissolved in an equal quantity of alcohol, to which six parts of liq. ammon. and ten of water are afterwards added, makes a good inhalation in chronic bronchial
catarrh.
10 A ustralian Medical Journal. JAN. 15, 1883 For profuse diarrhoea Fothergill recommends am. carb., gr. v, Tin3t. opii m x, Inf. htematox j. every three hours.
Equal parts by weight of sulphur, glycerine, sp. vin., pot. carb.
and ether sulph. applied externally is recommended for comedo.
Nitrate of silver, hypodermically 5 drops of a 1 to 4 solution, has cured sciatica ; great pain follows, and a small abscess forms.
Professor Nussbaum advocates the passing of an act rendering the omission of antiseptic precautions in surgery criminal.
Dr. Bell, of Glasgow, uses in uterine displacements only tampons of wool placed before or behind uterus, with a larger plug below, saturated with a solution of glycerine (80 oz.), alum (10 oz.), and carbolic acid (1/ oz). Removal is necessary only every third day.
Professor Keith has given up the use of the antiseptic treatment.
From using the carbolic acid so much he got renal haemorrhage himself. Lister himself has lately expressed his doubts as to its efficacy.
From America we learn that a bent wire or a couple of quill toothpicks fixed together will, in the absence of a catheter, effect a passage of urine from the female bladder.
MacEwen, of Glasgow, uses for ligature a gut steeped in a watery solution of chromic acid (1 to 5), one part of which is added to 20 of glycerine.
Professor Hueter recommends in scrofulous inflammation a direct injection into the joint of 3 to 5 per cent. solution of carbolic acid.
Esmarch advises the total abandonment of tourniquets in the battle-field.
The ripe tomato is said to be curative of sore mouth, when eaten in the ordinary way.
Tincture of dogwood (Piscidia Erythrina) in 3ss. to 3 j. doses is useful in shock with pain and for neuralgia.
Cascara sagrada is a favourite American remedy for costiveness.
The eucalyptus tincture, m. xx every three hours, is valuable in chronic cystitis with hmmaturia.
Tincture of Actinomeris Heliamthoides (gravel weed) in doses of 3 j to 3 ii every hour is useful in acute gravel.
Benjamin Bell, in the Edinburgh Medical Journal, speaks highly of the eucalyptus in typhoid as lessening diarrhoea and preventing ulceration.
Ice to the breast is said to prevent mammary abscess.
From India Dr. Saunders reports the successful use of amyl nitrite in ague. The drug is mixed with equal parts of oil of coriander to make it less volatile, and four drops are inhaled from lint till the patient gets flushed and warm ; perspiration follows and the attack is checked.
Pilocarpin used hypodermically in eclampsia is very dangerous, as the patient may be suffocated by his or her own saliva.
Quebracho ext. fluid, m. xx to lx every hour or two, is reported by Ringer as useful in dyspncea.
Nerve stretching has been suggested as a curative of tetanus.
Cinchonidia (gr. 5) and tinct. ferri. mur. (m. xx) in water every three hours is a good prescription for glossitis.
Picrotoxine has been found to produce an artificial epilepsy.
Borate of quinoidine is a new substitute for quinine in malaria.
An induced electrical current is valuable in the chronic rheumatism of infants.
Arsenic is often almost a specific in angina pectoris. Balfour, Edinburgh, in these cases gives one granule of Nativelle's digitaline night and morning with a pill of arsenic, iron, and strychnia twice daily.
Amyl nitrite inhalation is a good antidote in opium poisoning.
Aspiration of the gall-bladder has been done successfully.
dhloro-phosphide of arsenic (m. 10 of Routh's solution) is useful in hay fever.
For diphtheria the following is recommended: pilocarpin gr. i7 pepsin gr. j. acid hydroch. m. 3, aq. dest. s ij.ss ; a teaspoonful
hourly.
Da Costa speaks highly of quebracho in emphysema and dilatation of the heart with dyspncea. The dose is m. x of the ext. fluid, every six hours.
Chloral has been found beneficial in asthma.
The epistaxis of children is often caused by ulcers low down in the nasal membrane which should be touched with caustic.
For constant inhalation small tubes containing small pieces of flannel or blotting paper, saturated with the inhalant, may be concealed within the nose.
Acid boracic pt. i, warm water pts. xx, hot glycerine pts. v, is given by Rosenthal in teaspoonful doses, largely diluted, once or twice a day for catarrh of the bladder.
12 Australian Medical Journal. JAIL 15, 188 A poultice of two parts of linseed meal and one of jaborandi leaves will be found very effective in mastitis.
Citrate of caffein in three grain doses thrice daily is a valuable diuretic.
Benzoate of calcium (gr. x in water) every three hours is an efficient drug in the albuminuria of pregnancy.
Parsley leaves applied locally several times a day will suppress the secretion of milk
Lead-poisoning is reported as occurring from the use of a face powder.
A new French treatment for suppurating buboes is by aspiration.
Naphthol, 10 to 15 per cent. in ointment, is beneficial and cleanly in skin diseases.
Iodoform externally and internally is reported as useful in goitre.
The American Journal of Obstetrics reports two cases of hydrocele in the female.
Phosphate and hypo-phosphate of calcium is recommended in pregnancy, to prevent the decay of the teeth.
Injections of pure carbolic acid or tinct. iodi. into their substance will cause nasal polypi to shrivel and disappear.
Cocoa is credited with being a cure for morphinism.
An ointment of salicylic acid and vaseline will cure carbolic eczema.
Maclagan obtains the best results in gonorrhoeal rheumatism by administering chlorate of potass. gr . x, and liquor ferri perchloridi m. xx every three hours.
Grindelia Robusta, an excellent remedy in some cases of asthma The ethereal extract of male fern is efficacious in removing the ankylostomum duodenale.
Dr. H. B. Stehman has never seen jaborandi fail in mastitis, if used before suppuration had began.
Coto-bark, very good in the night sweats of phthisis.
Sulphurous acid, 1 to 15 parts of water, always cured gonorrhoea (Mr. W. D. Wilson.)
Carbolic acid (m j for a child of two years) is often efficacious in whooping cough.
We have a new galactagogue inAitana digitifolia, a native of Brazil.
A good application for lupus vulgaris—iodoform.
tbitai Sandy pi Vittoria.
ANNUAL MEETING.
WEDNESDAY, JANUARY 11TH, 1882.
(Hall of the Society, 8 p.m.)
Present : Mr. Rowan, Dr. Allen, Mr. W. A'Beckett, Dr.
Graham, Mr. Bowen, Mr. Hewlett, Mr. Webb, Dr. James Robertson, Dr. Haig, Mr. J. P. Ryan, Mr. Griffith, Dr. Neild, Dr. Jamieson, Dr. Walsh, Mr. J. D. Thomas, Dr. Jonasson, Mr. Armstrong, Mr. P. Moloney, Dr. Balls-Headley, Mr. Dowling, Mr. Gray, Mr. Gillbee, Mr. Phillips, Mr. LeFevre, Mr. Girdlestone, Baron von Mueller, Dr. Cutts, and eight others.
The president, Dr. James Robertson, occupied the chair.
MINUTES.
The minutes of the preceding meeting were read. Dr. Robertson took exception to the record of the discussion concerning the case of Smith v. Iffia ; he did not interfere with the remarks of members or rule them out of order until Dr. Allen was proceeding to comment on the merits of the case and refer to the opinions of the judges. The minutes were confirmed subject to this addition.
NEW MEMBERS.
Mr. Cowper Johnston M.B. Ch. M. Edin., of St. Kilda was unanimously elected a member of the Society.
The
Hon. Secretary then read the report of the Committee for
the past year.
REPORT OP THE COMMITTEE.
At the close of another year we can congratulate the Society
on its uninterrupted progress. The
roll of members is larger than ever; the various meetings have been fairly attended; the Papers submitted have been of great value, and have evoked lively dis- cussion and not a little difference of opinion. The exhibition of pathological specimens continues to be one of most notable and most interesting features of our work, and the almost complete absence of ethical troubles is another sign of the healthy condi- tion of the Society, and of the pleasant relations established between its members.
During the year, nineteen members have been added to the Society, eighteen ordinary and one corresponding ; there have
14 Australian Medical Journal. JAN. 15, 1882
been four deaths and one resignation. The total number at present on the roll is 181, of whom 166 are ordinary members, 8 corresponding, and 7 honorary.
There have been twelve ordinary meetings of the Society, at the close of one of which a special meeting was held.
Papers have been read as follows :-
By Mr. T. N. Fitzgerald, "Notes of a Case of Extra-Uterine Fcetation."
Dr. Bird, on "Two Cases of Intra-Thoracic Suppurating Hydatid, treated by Incision and Extraction of the Cyst."
Mr. J. P. Ryan, on "A Case of Foreign Body in the Orbit."
Dr. Williams, " Notes of a Case of Fibropigmentary Consolidation of the Lung, pressing upon the right Pulmonary Artery and simulating Thoracic Aneurism."
Dr. James Robertson, "Notes of Two Cases of Hemiplegia."
Dr. Williams, "An Account of a Case of Sudden Death from lamoptysis, in consequence of the Rupture of an Aneurism of a Branch of the Pulmonary Artery, with remarks on similar formations."
Dr. Balls-Headley, on "A Case of Epithelioma of the Rectum —Removal—Recovery."
Dr. Bird, on "A Case of Hystero-Epilepsy, with Tetanised Diaphragm."
Mr. Snowball, on " The Jury-Mast in Spinal Disease."
Mr. S. Zichy Woinarski, "Notes of a Case of Hydatid Tumour of the Bladder—Peritonitis—Death."
Mr. Thomas Elmes, on "Rupture of the Bladder within the Peritoneal Cavity."
Mr. Jermyn, on "The Medico-Legal Aspect of the Recent Shooting Case at Jung Jung."
EXHIBITS have been submitted by Dr. Allen, Dr. Balls-Headley, Mr. Bowen, Mr. FitzGerald, Mr. Jermyn, Mr. J. P.
Ryan, Mr. Snowball, Dr. Walsh and Dr. Williams.
At the instance of our valued friend Baron von Mueller, a letter was sent to Dr. Rudolf von Virchow, congratulating him on the attainment of his sixtieth birthday, and on the completion of the twenty-fifth year of his Professorship in Berlin.
A Sub-Committee was appointed to consider the provisions at present existing for the treatment of inveterate drunkards. Its
report has been received and remitted to the General Committee, that further action may be taken by the Society at an opportune time.
Attention has also been given to the Amending Medical Act, the introduction of which into Parliament has so long been deferred. The wish hitherto has been to postpone action until the Imperial Act shall assume its final form, but there has been already quite enough delay, and we would recommend that the Society take an early opportunity of laying its views before the Government.
We are unable to point out any great advance in the furnishing of the Hall. The ordinary expenditure of the Society is being curtailed as much as possible so as to permit the gradual re- demption of the debentures, the interest on which is a severe strain upon our finances. Hence we have not felt warranted in devoting any part of the common funds to the improvement of the Hall, and the Special Furnishing Fund requires many fresh contributions before much progress can be made in this direction.
There have been twelve meetings of the Committee during the year: the attendance of the members has been as follows :—Dr.
Robertson 6, Mr. Hewlett 6, Mr. James 4, Mr. Girdlestone 11, Dr. Allen 11, Mr. Snowball 4, Mr. Moloney 8, Mr. Fitzgerald 0, Dr. Bird 0, Dr. Williams 4, Mr. Gray 2, Mr. Webb 11, Dr.
Cutts 0, Mr. Bowen (sometime absent from colony) 0, Dr. Graham 4.
The Hon. Secretary stated that at the last meeting of the committee letters had been received from the Council of the Victorian Branch of the British Medical Association, requesting a conference concerning the Amending Medical Act and the inadequate fees paid to medical men in court cases, lunacy proceedings, &c. The committee intended bringing these matters before the Society at as early a date as possible, and arrangements for a conference would then be made. A little delay would not be of great consequence as Parliament was out of session, and a conference would be useless until opinions were matured.
The Report of the Committee was then adopted on the motion of Dr. Neild, seconded by Mr. Bowen.
16 Australian Medical Journal. JAN. 15, 1882 The Hon. Treasurer then submitted the following report :
TREASURER'S ACCOUNT.
The TREASURER in account with the MEDICAL SOCIETY OF VICTORIA,
for the year ending December 81st., 1881 .
DR.
To Balance from 1880 .. .. £22 15 1
90 Annual Subscription, 1881 (£1 Is.) .. 94 10 0 23 Arrears of Subscription .. .. 24 3 0
13 Entrance Fees .. .. 13 13 0
Country Cheques for Collection 0 3 0
£155 4 1 CR.
By Interest on Debentures .. .. £27 0 0 Purchase of Debentures (W. Molloy) 10 0 0 Cackett, Caretaker .. .. .. 10 0 0 Stillwell & Co., Printing .. .. 27 14 6 Geo. Robertson, Books .. .. 10 4 3 Rates—Town, Lighting and Water .. 5 0 0
Gas, Hall .. .. .. 2 14 9
Postage .. .. 1 19 0
Collection on Country Cheques .. .. 0 10 6 Sydenham Society, Subscriptions Three Years 3 18 0
Furniture, Hall .. .. .. 0 5 6
Balance .. 55 17 7
£155 4 1 Audited and found correct,
WILLIAM HAIG
Auditors.
JAMES P. RYAN FURNISHING FUND.
Balance from 1880 £8 12 0
Dr. J. Robertson .. 5 5 0
Burke .. 1 0 0
James .. 1 1 0
fFletcher 0 10 0
Webb .. 0 9 0
Alexander Morrison 1 0 0
£17 17 0 January 5th, 1882. T. M. GIRDLESTONE, Hon. Treasurer.
The Hon Treasurer proceeded to remark that he could congratulate the Society on the soundness of its finances, though great economy had necessarily been practised. Considerable inconvenience arose from debenture-holders not applying for the interest due to them ; he would be glad if they would either call or send some one with a written order for it. In fact, members
were so dilatory in coming for their interest that they evidently did not want it much. He might hint that perhaps the best thing would be to give up the interest altogether. The Furnishing Fund was in a rather low state ; any subscription hitherto had always fallen on a few ; further donations would be very acceptable : and there was a standing promise from two members of £5 each, if twenty others would give £1.
Mr. BOWEN said the trustees had been discussing the whole question of debentures, and would shortly call a meeting of the debenture-holders to come to some decision about it.
Mr. GIRDLESTONE subsequently announced that Mr. Rowan and Mr. Ralph had presented their debentures to the Society, A vote of thanks was accorded to these gentlemen on the motion of Dr. Allen, seconded by Mr. Girdlestone.
Dr. CUTTS
enquired at what rate the debentures belonging to the late Mr. Molloy had been purchased. Being informed that it was at par, he remarked that those of Mr. Morton had been deposited in one of the banks as security for an advance, and he had been able to buy twenty-five pounds worth for fifteen pounds and interest. It would doubtless be easy to buy up all the debentures in this way.
The Report of the Hon. Treasurer was then adopted on the motion of Dr. Haig, seconded by Mr. Hewlett.
The HON. SECRETARY then read for Mr. Snowball, who was unavoidably absent, the following report :-
LIBRARIAN'S REPORT.
I regret that much positive progress in the formation of the library cannot be reported. In connection with the re-organization of the finances of the Society, the committee reduced the expenditure on books and periodicals as much as possible, and even for those at present in our possession the accommodation is inadequate. Although many plans have been suggested, any one of which would have met the case, the furnishing fund has always been too low for the execution of any of them. At present there is a standing offer from two members to subscribe £5 each, if twenty £1 subscriptions were secured. As usual the committee were ready to help, but as yet only half the required amount has been promised. It remains now for the Society to determine whether they will allow the library to remain in its present state or provide the money necessary to put it on a satisfactory basis.
Donations have been received from the Government of
18 Australian Medical Journal. JAN. 15, 1882 New South Wales, the Linnfflan Society (N.S.W.), Baron Von Mueller, the Surgeon-General of the 'United States Army, Dr. Wilkie, Mr. Ellery. Large donations are at present under offer, notably a complete set of the Lancet from Mr. Webb, which we have been unable to accept from want of accommodation.
W. SNOWBALL,
M.B.
&C.Dr. ALLEN proceeded to say that many months ago Mr. Gray and Mr. Webb had offered £5 each to the Furnishing Fund if twenty members would subscribe £1. Promises had been received from Mr. Girdlestone, Mr. Hewlett, Dr. Williams, Dr. Allen, Dr. Graham, Dr. Willmott, Mr. Fyffe, Mr. C. S. Ryan, Mr. D. Turner, Dr. J. Robertson, and Mr. P. Moloney ; and Mr. Morrison had paid his subscription. Eight more donations were required, and surely they would be forthcoming.
MR. GRAY said that though his offer was such a small one, he did not wish it to be hanging on for an indefinite time. The money too ought to be paid in, and then the library could be extended and proper provision made for the books and papers.
Mr. MOLONEY proposed, and Mr. J. P. Ryan seconded the adoption of the Librarian's Report. The motion was carried unanimously.
Mr. MOLONEY remarked that the Society ought to be thankful to Mr. Gray and Mr. Webb for their offered donations, and he moved that it be an instruction to the new Librarian to send a circular to each of the members informing them of the offer, and asking for subscriptions within a month.
After further discussion, in which Mr. Le Fevre, Mr. Gillbee, Dr. Balls-Headley, and Dr. Jonasson took part, the resolution proposed by Mr. Moloney was carried. Baron von Mueller promised a subscription of one guinea, and similar amounts were received from Mr. Bowen and Mr. Le Fevre.
SENIORITY OF VICE-PRESIDENTS.
A question having arisen as to the seniority of Vice-Presidents, the Hon. Secretary stated that usually seniority went by time—
the junior Vice-President of one year becoming the senior in the next; but in 1880 both the Vice-Presidents had resigned, and hence last year two gentlemen were elected at the same time to this position.
DR. NEILD
said there was no rule as to seniority; it had been a custom to elect the Vice-Presidents who had held office longest to be President, but it was open to the meeting to elect any member who had been nominated.
ELECTION OF OFFICE-BEARERS FOR 1882.
A ballot was then held for the election of the Office-Bearers of the Society, and the Editors of the
Australian Medical Journal for 1882. Mr. Armstrong and Mr. J. D. Thomas acted as Bcrutineers.
The following were the results of the election :
President, Mr. Hewlett; Vice-Presidents, Mr. James and Mr.
Burke ; Hon. Treasurer, Mr.
Secretar Girdlestone (unopposed); Hon.
y, Dr. Allen (unopposed); Hon. Librarian, Mr. LeFevre.
CoJ. mmittee : Mr. Gray, Dr. James Robertson, Mr. P. Moloney, Mr. P. Ryan, Dr. Williams, Dr. Bird. Auditors : Dr Haig and Mr. W. Barker. Editors of the
Australian Medical Journal:
Dr. Allen, Mr. P. Moloney, and Dr. Williams.
INDUCTION OF PRESIDENT.
DR. JAMES ROBERTSON
in vacating the chair briefly returned thanks to the members for the support and kindness accorded to him during his year of office. The unvarying cordiality prevailing at all the meetings had rendered his duties very pleasant ; at no time had there been any disagreeable feeling or friction to mar the harmony of the meetings. One pleasant duty remained, and that was introduce Mr. Hewlett to them as his successor. Mr. HEWLETT
then took the chair, and thanked the meeting for the honour it had conferred upon him. He trusted to be able to discharge the
duties of President to the satisfaction of the Society during his term of office. He would endeavour to uphold the dignity of his position, and the honour of the profession.
The retiring President, Dr. James Robertson, then delivered the following address :
PRESIDENT'S ADDRESS.
GENTLEMEN,—In
accordance with established custom, it is now my duty, on vacating this chair, to deliver a valedictory address.
I have first to congratulate you on the continued prosperity of the Victorian Medical Society, as evidenced by the Report of your Committee which has just been read. Judged by the
accession of new members, the Society continues to prosper, but its
success B 2
20 Australian Medical Journal. JAN. 15, 1882
has been more particularly displayed by the steady attention to clinical and pathological work. Its meetings have not been always numerously attended, but during the year very interesting and instructive papers have been read, and animated discussions have followed, eliciting the opinions and views of members.
Where all the communications have been highly creditable, it would be invidious to particularise them, but I may be permitted to refer more particularly to the large amount of pathological work done by the Society. We have had numerous exhibits and frequent opportunities of observing the morbid and altered conditions of organs and tissues brought about by disease, while in many cases we have had detailed the symptoms present during life. The instruction derived from such observations cannot be too highly estimated. We have thus been enabled to refer symptoms to their causes, to connect them with the morbid changes observed. But not only have we had morbid specimens submitted by numerous members of the Society to ocular inspection, we have also in many instances had the microscopical appearances described by the Hospital Pathologist. We are indebted to Dr. Allen for his zealous labours in the domain of pathology, perhaps I should rather say morbid anatomy, which at all events forms the basis of pathology. I cannot but think that the interest attaching to that department will tend to its further development by the members of the Society, for medical knowledge is best promoted by clinical and pathological work being combined.
The use of the microscope would be most desirable in the examination of the exhibits at the society's meetings, did time permit ; arrangements might also be made for the exhibition of new instruments and medical and surgical appliances as they are introduced into the colony.
I am happy in being able to state that no grave ethical question has cropped up during my year of office.
I regret to notice that three members of the Society have been removed by death since last annual meeting. All were in the prime of life, and engaged in the active practice of their profession. Obituary notices of two of them have already appeared in the pages of the Journal. Of the third, who had very recently joined the Society, I can speak from personal
knowledge.
Dr. John Lindsay Miller was a lover of his profession, and continued a zealous student of it until struck down by fatal
disease. After many years of successful practice in Launceston, Tasmania, he went to Europe to enjoy a holiday. He was not however idle. He contributed several papers on medical subjects to the Glasgow Medical Journal, and passed the examination for the degree of M.D. of the University of Glasgow. He also obtained the diploma of F.R.C.S. Edinburgh. On his return to the colonies he commenced practice in Melbourne, where he was well and favourably known. He was suddenly seized with symptoms of cerebral disease on the 7th November, and died on the 19th December, 1881, at the comparatively early age of 50 years. He has been removed at an age when it might have been expected that a career of active practice was before him.
He was respected and esteemed by all who had the plea,sure of his acquaintance, on account of his kind and genial disposition, and highly honourable and gentlemanly character.
During the past year the health of the community has been fairly good, no dire epidemic has occurred in the colony. We are, however, threatened with small-pox, which, introduced into the neighbouring colony of New South Wales in May 1881, has carried off not a few victims, and is still extending. The disease appears to have hitherto baffled all attempts to stamp it out, but now that the hot season of the year has arrived, there is more hope of the success of sanitary measures when aided by a dry hot wind. While small-pox and scarlatina extend during the cold season of the year, they are liable to be arrested in the hot season. The potency of the contagium is diminished if not entirely destroyed by heat. Vaccine lymph is with difficulty preserved in the warm season ; it is liable to be desiccated and rendered inert. It is high time for Victorians to set their houses in order, for should small-pox survive the summer heat in the neighbouring colony it will most assuredly penetrate to Victoria. From the constant communication by railway between Sydney and Melbourne, the risk of contagion being
•conveyed is not only extreme, but amounts, in my opinion, to a certainty.
Although we are now threatened with small-pox from the sea-board the risk from that source is not so great as from the interior, on account of the quarantine regulations being enforced.
Certainly the precaution has been taken to appoint a health officer at Albury to examine passengers going by railway to Victoria.
This is simply a farce, although it may serve to allay the public
22 Australian Medical Journal. JAN. 15, 1882
dread of the disease. The subjects of small-pox are not likely to.
travel when the eruption has appeared, or even during the period of invasion or primary fever. Small-pox contracted in Sydney may not become developed until the lapse of ten or twelve days after the arrival of the subject of it in Melbourne, the period of incubation extending from twelve to fourteen days after exposure.
The only reliable precautions against the invasion of the disease would be to ascertain that all travellers had been recently vaccinated. Many going from Melbourne to Sydney, I am aware, have adopted this precaution.
When vaccination and re-vaccination are strictly enforced, and diligently and efficiently carried out, almost absolute security may be predicted. Statistics furnish the strongest possible evidence of the power of vaccination to influence the issue of small-pox favourably. If it do not prove prophylactic, it so modifies the disease as to deprive it of its sting or danger. Yet vaccination is not carried out with sufficient care. Some are careless and indifferent, and some are prejudiced against it by reason of ignorance, or from unfounded notions regarding the communica- bility of other diseases. They therefore object to vaccination ; but confronted with the more immediate danger of contracting small- pox, few I apprehend will remain obstinate.
As to whether animal or humanised lymph is employed appears to be of small consequence. There is no valid reason for preferring calf-lymph, and it is difficult to obtain, while human- ised lymph is found to be more uniform in its action, and can be readily transmitted from arm to arm.
The event of the past year of the deepest interest to the profession was the meeting of the International Medical Congress at London. Whether viewed as regards the number and eminence of the members (of the profession) attending it, gathered from all the centres of learning, it may be almost said, of the civilized world, or whether as regards the importance of the subjects brought under discussion, or the facts revealed, it was a remarkable event.
" Every fact in science," remarks Sir Jas. Paget, " is a living and germinal power of which none can guess the issue," and certainly this holds true in relation to the evidence adduced in proof of the germ theory.
While some physicians have been searching for antidotes or new remedies for the various " ills that flesh is heir to," others have been no less zealous in investigating the causes of diseases,
with a view to prophylaxis, and it is in this direction that great advances are making at the present day, and that the greatest triumphs of medicine are likely to be achieved in the future.
Our profession may justly claim to be regarded as being influenced by no sordid motives, but by the most unselfish and benevolent feelings, in their endeavours to discover and arrest the causes
of
disease. True, a cry of cruelty to animals has been raised against members of our profession, and an act has been passed and has been in operation in England for several years, which, by imposing barriers, obstructed the scientific investigation of disease.It is only by experiments on animals that numerous sources of relief to suffering humanity have been discovered. Not only so, many experiments, having for their object the discovery of the causes and prevention of contagious diseases, tend to the direct benefit of animals themselves, inasmuch as the diseases of the lower animals very closely resemble those of man, and in some instances disease is common to animals and man. The value of experimental pathology has been demonstrated in relation to contagious diseases as they affect the lower animals more particularly in inoculation for pleuro-pneumonia.
The progress recently made in the discovery of the causes of contagious diseases gives earnest of the still greater advances of scientific medicine—I should say prophylactic medicine—in the more immediate future. For a long time the germ theory with regard to the mode of transmission of contagious diseases has held sway ; yet these germs eluded the most careful microscopic research.
Our knowledge of epidemics led to the belief that the virus or contagium must be very subtile, very minute, and capable of being conveyed to a distance through the medium of the atmosphere.
Different epidemics were found to vary greatly as regards the virulency or danger; some were comparatively mild, and some assumed a malignant form, and were very fatal. The virulency of a contagious disease may be due to the intensity or virulence of the contagium, which may be cultivated to an increased degree under favouring conditions, or it may be due to the bodily con- dition or state of health of the recipient. It is known as a rule that " like begets like "—that a severe form of contagious disease transmits or begets a severe form, and a mild form a mild form, yet it must be allowed that a mild form of disease in one person may beget or propagate a most severe form in another.
All
epidemics become milder towards their termination, and gradually24 Australian Medical Journal. JAL 15, 1882' die out. Of course different theories were adopted in explanation of these phenomena. It was supposed that epidemics terminated when all those susceptible of contagion had passed through the disease, and that they returned when the number of individuals susceptible of contagion in any community became increased.
With a knowledge of the facts that have been gradually accumulating from the experiments of different observers, we occupy a higher vantage ground, and are enabled to approach nearer to the truth. Instead of surmise wehave now the most positive proof that contagious diseases are transmitted by germs, that the virus is in reality a contagium vivum, or microbe, as
Pasteur terms it.
Professor Pasteur has shown that certain organisms are always present in the blood of chickens suffering from cholera ; that these organisms can be cultivated outside the body in certain prepared media ; that again they may be introduced into the body of another chicken by inoculation, and become increased in it, giving rise to fatal results, the chickens dying presenting the specific organisms in the blood and tissues. We have thus positive evidence that these organisms are the causes of the disease. The experi- ments of Professor Pasteur are so interesting, and the inferences to be drawn from them so instructive, that I offer no apology for giving a brief resume of them.
He takes a minute drop of blood from a fowl dying from chicken cholera, places it in a vase of very clear bouillon de poule, rendered sterile by exposure to a high temperature, 115° Cent., (239° Fah.), care being taken to exclude all germs or impurities from the outer air. The liquid medium kept at a temperature of 25° to 35° Cent. (77° to 95° Fah.), soon becomes turbid by the generation of innumerable germs or microbes, that are exceedingly minute, and shaped like the figure 8. A minute drop from this vase is placed in a second similarly charged to the first, when the same phenomena result; and again from a second to a third, from a third to a fourth, and so on to a hundred or even a thousand, or ad infinitum; for here we are dealing with a living germ, capable of reproduction in a suitable medium, and not with the infinitesimal subdivisions of homoeopathy. At the end of two to three days' exposure to a temperature of 30° Cent. (86° Fah.), the development of the minute organisms ceases, and they subside or fall to the bottom in the form of a sediment, but they retain their vitality for months while the atmospheric germs are
excluded. Inoculation the sediment is shaken of blood from a fowl organisms are found inoculation.
with a drop of the cultured liquid, when up, is as virulent and fatal as with a drop dying from cholera, while similar minute in the blood of the fowl subjected to And now we have presented to us a remarkable fact, the result of observation and experiment. When longer intervals than two or three days were allowed to elapse between the impregnation of the successive culture preparations, say from weeks to months, the virulency of the successive cultures became diminished, or gradually attenuated, so that the effect of inoculation was confined to the muscle or part inoculated, or rendered altogether nugatory.
Fowls inoculated with the attenuated virus (with the culture liquid, in which the development of the organisms was arrested)
suffered no bad effects, but were rendered exempt from chicken- cholera even after inoculation with virulent virus. The modifying cause of the attenuation of virulency, according to Professor Pasteur, was exposure to the oxygen of the air in the prolonged intervals between the successive impregnations. Here we have reason to conclude that oxygen is a valuable disinfectant, and that a free supply of fresh air, the frequent renewal of air in the sick chamber, is a powerful means of favourably modifying contagious diseases.
From the discoveries now being made in regard to contagion, we may hope to be able to ward off, or render abortive, all contagious diseases by the adoption of inoculation. The contagion of anthrax
or splenic fever can be so mitigated or rendered innocent that inoculation can be performed without inducing danger, and with such effect as to prove protective against that disease. In the same way the infection of pycemia or septicemia can, it is said, be modified by inoculation ; not only so, there is the most indubitable evidence that antiseptic treatment is prophylactic of pycemia, erysipelas, et hoc genus omne,
known by the term Hospitalism.
The experiments of Professor Lister, and the success of his practice, show that septic poisoning is due to the presence of bacteria,
or other organisms. Listerism is to be regarded as the strongest evidence of the successful development of preventive medicine, inasmuch as recovery from dangerous wounds, and from serious operations, has been rendered much more safe and certain through its adoption.
26 Australian Medical Journal. JAN. 15, 1882
Attention has just now been directed to the prevalence of erysipelas in the Melbourne Hospital by some sensational state- ments. The old part of the building has been described as being
" saturated with erysipelas and pymia," and it is recommended that it should be pulled down. From the report of the super- intendent, based on statistics, it appears that the cases of erysipelas originating within the hospital are few compared with those admitted from without, erysipelas being unusually prevalent at the present time. It is also found that of the cases occurring in hospital, the majority originated in a ward in one of the pavilions—in the more recently built, and not in the old part of the buildings. Is it therefore to be pulled down ? An investiga- tion should rather be made into the sanitary conditions of the ward and its surroundings, with a view to the discovery and removal of unhealthy conditions. When the pavilions were being built I drew attention to the ceilings, which were formed of pine boards, the grooves and chinks between each board being eminently fitted to afford a lodgment for germs, &c., and more particularly the large chasms formed between the boards and the wooden cornice. However it was regarded at the time by the authorities in power as being very superior to the common plaster roof. Instead of seeking for the cause of the unhealthy conditions in the waxed and dry polished floors let attention be directed to the ceilings, and to the communication between the lavatories and water closets and the wards. Has due attention been paid to antiseptic precautions in the treatment of patients I It is now asserted that erysipelas and pycemia may be banished from hospitals by the careful observance of antiseptic measures.
Indeed, so strongly impressed with the importance and value of antiseptic treatment are some German authorities, that Nussbaum has even proposed that the neglect of antiseptic precautions should be made a criminal offence. Certainly the neglect of them is to be regarded as little less than criminal, in view of the satisfactory results that have been so generally obtained wherever the system has been faithfully carried out.
Now that the proposition has been made to pull down part of the hospital, with a view of re-building it, a fitting opportunity occurs for considering the question of a change of site. The area now occupied by the hospital is too small, and too closely surrounded by other buildings. A detached building is required for the isolation of contagious diseases, and no space is available
for it. Provided a larger area of ground, say about ten or twelve acres, could be obtained in an easily accessible and elevated position in the neighbourhood of the University, the present buildings and valuable block of land might be disposed of, at a sum sufficient to pay for the erection of a new hospital with all the latest sanitary improvements.
But I am digressing from the subject I had in view, viz. to show that all contagious diseases were due to the presence of organisms hi the blood and tissues, which could be so modified by culture as to permit of inoculation as a means of prophylaxis.
Evidence is accumulating to show that that scourge of the human race, phthisis, is an infectious disease, and may be propagated by inoculation. The presence of the tubercle- micrococcus or organism in the blood and tissues of the body can, it is said, be demonstrated by microscopical examination and by experimental inoculation.
It may be anticipated that contagious diseases will be so modified by inoculation as to deprive them of their danger.
But
when the germs of the different contagious diseases have been discovered, and so attenuated by culture that inoculation can be practised with safety, when the so-called vaccine of Prof.
Pasteur of all the virulent contagious diseases has been introduced into practice, childhood will not be a period of happiness or freedom from pain. Consider the number of contagious diseases.
Imagine children being subjected to inoculation with the specific virus of each—when just recovering from the effects of one, being subjected to another. The effect of the numerous inocula- tions on the health, whether for good or for evil, would be rather problematical.
Should the
nidus, habitat, or culture-bed (medium) of each specific germ external to the human body be discovered, then means might be adopted for their destruction or annihilation, but this idea is exceedingly chimerical. It is by no means pleasant to reflect that chicken broth is found to be a suitable medium for the culture of germs : it is suggestive that on some occasions we may swallow myriads of these organisms in a basin of soup.
Were it possible to stamp out all contagious diseases, and even were prophylactic measures against other diseases well known, there is no reason to dread that our occupation would be gone.
28 Australian Medical Journal. JAN. 15, 1882
The preventible diseases due to intemperance constitute a large class.
" The gods are just, and of our pleasant vices Make instruments to plague us."
This is abundantly evidenced by hospital experience, and more particularly on holiday occasions. A large number of cases admitted are sufferers from the more immediate effects of drunkenness, but a still larger number from organic disease of important organs induced by habits of intemperance. None are so able to estimate the prevalence of the vice of drunkeness, or its detrimental effects on health, as medical men. The vice prevails extensively among those that avail themselves of hospital attendance—among females as wellas males. Constant tippling habits are far more destructive to health than an occasional excess.
They tend to induce organic disease of the most vital organs—the brain, heart, liver, and kidneys. The stomach is a very tolerant organ, but it nevertheless frequently resents the treatment it experiences. Evidence of the truth of these statements is abundantly afforded in the medical wards of the hospital, and I have no doubt in the surgical also, for numerous accidents are the result of intemperance.
The question of restraint in the case of drunkards has been noticed by the Society ; this is a difficult one to solve, the law is so jealous of the liberty of the subject. Unless a man agrees to be put under restraint, and remains a sufficient length of time to benefit by it—till the morbid craving for stimulants has passed away, and the whole bodily system has in a measure become renovated—there is little hope of his being reclaimed. Indeed, the man who has given way to habits of intemperance is seldom if ever reclaimed. He may appear when sober very rational and reasonable, but is strangely oblivious of his failing; he either cannot or will not speak the truth. When under the influence of drink he is reckless of wife and children, of everything; he is " lost to all sense of shame in the hurried chase of indulgence." He has no power of self-restraint ; he destroys his own self, body and mind ; he wastes his substance, beggars his wife and family, and embitters the lives of all those dependent on, or in any way connected with him. He seems to be a fit subject for admission to a lunatic asylum, for he is suffering from a species of insanity
—dipsomania. What preventive measures can be adopted in
such a case, which is by no means a solitary one? He objects to his being sent to a retreat for inebriates, and if summoned to appear before a County Court Judge, in accordance with the law, there is little chance of his being committed to an asylum or retreat if it cannot be said that he is " dangerous to himself and others."
The only danger to be apprehended is as regards his own health, mental and bodily. His mind becomes obfuscated, fatuous, and his bodily health suffers, but there is no risk of his proving dangerous to others. Such an alteration of the law is required as to provide that an habitual drunkard shall, on conviction thereof, be committed to an Asylum or Retreat for Inebriates, for at least twelve months, so that the habit con- tracted may be completely broken off. As it at present stands the law is practically inoperative for the reclamation of drunkards.
DR. ROBERTSON concluded by again thanking the members for their kindness and attention, and for the unvarying support they had given him during his tenure of the Presidential chair.
It was proposed by Dr. Haig, seconded by Dr. Jonasson, and carried unanimously, " That a vote of thanks be accorded the retiring President, Dr. James Robertson, for the most able manner in which he had performed the duties pertaining to that office."
ROLL OF MEMBERS.
The following is the roll of members up to the present date.
The names distinguished by an asterisk are those who have been Presidents.
A'Beckett, William Goldsmid, M.R.C.S. Eng., L.S.A. Lond.
Adam, George Rothwell Wilson, M.B. et Ch. M. Ed.
Allen, Harry Brookes, M.D. et Ch. B. Melb.
Alsop, Thomas Osmond Fabian, M.B. et Ch. M. et L.M. Ed., M.R.C.S. Eng.
Annand, George, M.D. et Ch. B. Melb., M.R.C.S. Eng., L. et L.M.R.C.P. et S. Ed.
Armstrong, William, M.B. et Ch. B. Melb.
Atkinson, William Joseph, L. et L.M.R.C.P. et S. Ed.
Baird, John, M.R.C.S. Eng.
Balls-Headley, Walter, M.D. et Ch. M. Cant., M.R.C.P. Loud.
*
Barker, Edward, M.D. Melb., F.R.C.S. Eng.Barker, William, M.R.C.S. Eng.
30 Australian Medical Journal. J.ks. 15, 1882 Barrett, James, M.D. Syd., M.R.C.S. Eng., L.S.A. Lond.
Barton, Frederick, M.R.C.S. Eng., L.S.A. Lora.
Bennie, Peter Bruce, MA., M.B., et Ch. B. Melb.
Bernays, Sidney Adolphus, M.R.C.S. Eng., L.S.A, Lond.
*Bird, Samuel Dougan, M.D. St. A. et Melb., L.R.C.P. Lond., M.R.C.S. Eng., L.S.A. Lond.
Black, Archibald Grant, M.B. et Ch. M. Glas.
*Bowen, Thomas Aubrey, L.K. et Q.C.P.I., M.R.C.S. Eng.
Browning, John Henry, M.D. et Ch. B. Melb.
Burke, Stephen John, M.R.C.S. Eng., L.K. et Q.C.P.I.
Campbell, James, M.D. et Ch. M. McGill. Univ. Montreal.
Cooke, John, M.R.C.S. Eng., L.S.A. Lond.
Colquhoun, Archibald, L.R.C.S. Ed., M.B. Glas.
Cox, James, M.D. Melb.
*Cutts, William Henry, M.D. Ed. et Melb., L.S.A. Lond.
Dempster, John James Colquhoun, L.R.C.S. Ed., M.D. Ed.
Deshon, Frederick Peter, M.R.C.S. Eng., L.S.A. Lond.
Dickinson, George Dixon, M.R.C.S. Eng., M.B. et Ch. M. Ed.
Dobbyn, William, M.R.C.S. Eng., L.A.H.D.
Dowling, Francis Joseph, M.R.C.S. Eng., L.S.A. Lond., M.B.
Lond.
Duigan, Charles B., L.R.C.P. et S. Ed.
Duncan, James Campbell, M.B. Glas.
Duncan, Robert Byron, L. et L.M. F.P.S.G., L.S.A. Lond.
Dunn, Robert Henry, M.R.C.S. Eng.
Elmes, Thomas, M.R.C.S. Eng., L.K.Q.C.P.I.
Embling, William Henry, L.F.P.S.G., L.R.C.P. Lond.
*Fetherston, Gerald Henry, M.D. Melb., L.R.C.P.Ed.,L.F.P.S.G., L.A.H.D.
Fishbourne, John William Yorke, M.B. et Ch. M. Dub.
Fisher, Alexander, L.R.C.S. Ed.
Fitzgerald, John Patrick, M.B. et Ch. B. Melb.
*Fitzgerald, Thomas Naghten, L.R.C.S.I.
Fleetwood, Thomas Falkner, M.A. Dub. et Melb., M.B. Dub., L.R.C.S.I.
Fletcher, Edward, M.R.C.S. Eng.
*Ford, Frederick Thomas West, M.R.0 S Eng.
Foster, Thomas, M.R.C.S. Eng.
Fulton, John, M.D. Glas. et Melb., L.F.P.S.G., Ch. M. Glas.
Fyffe, Benjamin, M.R.C.S. Eng., L.R.C.P. Lond.
Garlick, Thomas, M.B. Melb.
