It had a somewhat peculiar appearance due to the character of the blood, but, except for its increased size, it appeared healthy. However, it should be remembered that enlargement of the spleen does not always mean leukocythemia. The next day the throat was better, some of it was gone, but there was some roughness of breathing.
I was hurried away in the afternoon of the same day, and found the child suffering from diphtheritic croup. After the final removal of the tracheal tube, some paralysis of the glottis remained. There was reddish serous fluid and considerable congestion of the membranes in the spinal canal.
Sir Ranald Martin, in illustration of the good effects of blood-letting, even in Asiatic cholera in the Bombay Presidency, says,. The condition of the system in the suppressed stage of fever is such as to render their effects exceedingly obscure. During the hottest summer days I have never seen such a display of blood when taken.
When both occur, a modification of the primary disease is observable, but the same general principles of treatment—the antiphlogistics—apply. The use of the common saline mixture serves well enough to fill a vacuum in fever. Taking this as a given, I proposed in the year 1863 to destroy the Echinococci' of the human body, and especially of the liver, by tincture of.
HOSPITAL REPORTS
The matter was considered somewhat perplexing, for although the bladder was apparently greatly distended, only a few ounces of urine were drawn when a catheter was passed; however, the complication was compounded by his sudden attack and death from illness of the respiratory organs, which were apparently healthy at the time of his admission to the hospital. The autopsy was very instructive and amply explained all the symptoms of the case. The sudden right thoracic pleuritic effusion had been caused by the rupture of a large hydatid cyst with expulsion of its contents into the pleural cavity.
On opening the chest, the right side was found full of a sero-puriform fluid, in which floated the ruptured hydatid cyst. The right costal pleura was thickened by coagulable lymph deposits and was easily detached from the ribs. When the abdomen was opened, the cause of the apparent enlargement of the bladder became apparent, for a large hydatid cyst was found filling the true pelvis and most of the false pelvis as well.
They were firmly attached to the walls of the cyst and passed through the layers of its outer coat. A third hydatid cyst, as large as a good-sized cocoa nut, was found on the underside of the right lobe of the liver.
MEDICAL SOCIETY OF VICTORIA
The Committee of the Melbourne Hospital made themselves amusingly conspicuous some time ago by the dictatorial attitude they took towards the honorary staff of that charity, and were much and deservedly humiliated in the meeting which then took place a few weeks ago. , for lack of better employment, turned their attention to the resident staff; with a view to subjecting them to a course of judicious discipline. They worried about the impeccability of the resident staff, whose duties they practically insisted on being non-stop, and whose pleasures seemed to be limited to a limited amount of pedestrian exercise in the hospital grounds. June, The Committee, in fact, asked the gentlemen performing the duties of house surgeons and physicians to give circumstantial particulars of the manner in which they spent their time whenever they passed the bounds of the Hospital enclosure.
But the members of this body hold no position at all of professorial or parental authority, and their only claim to interfere with the comings and goings of resident staff arose from the relationship that existed between them as employers and employees. A few months ago this eccentric body severely reprimanded one of the resident surgeons for following the rule to the letter, and was informed that he had committed a grave error in not perceiving that the circumstances warranted a violation of the rule. Rees, assistant surgeon at the Adelaide Hospital, may have awakened some remnant of common sense by which they could perceive that they were dealing with educated gentlemen, and not, as they at first seemed to imagine, with day labourers. , and that therefore the immediate re-employment of dr.
Moloney still remains in force, it may not be out of place to inquire into the particular theory held by this remarkable organization of the obligations due to the charity of the resident staff. It is to be understood that paid medical services must be provided continuously, without interruption or interruption, except as absolutely necessary to preserve life. At least that is obviously the Hospital Committee's theory; only since the resident staff have fortunately read the rules backwards themselves, the theory has so far never been put into practice.
PROFESSIONAL AMENITIES AT GEELONG
June, The Committee not wishing to become contemptible chroniclers, will proceed at once to revise the regulations, so as to conform both to the demands of health and respect to educated gentlemen. Sibley, it seems, could not be immediately found, and the man, instead of getting another at once, delayed doing so for several hours, and meanwhile the hemorrhage recurred with such violence that, later in the evening, two more physicians were brought to the patient, she was exhausted beyond the power of healing. Now, however, comes the special interest of the matter, so far as it relates to the ethics of the profession.
On the day at midnight when the woman died, the police were contacted and the statements made by an unfriendly doctor to Dr. Day was then presented as a witness, the coroner considerably hinted that he did not consider him in the light of a witness, and throughout the first day his treatment of him was quite consistent with this statement. But the jury, as might be expected, returned the verdict to which we have alluded, and indeed it would have been nothing surprising, considering the aspect which the case would have taken, if they had returned a verdict of manslaughter against Dr.
Day could have avoided any subsequent embarrassment simply by refusing to have anything to do with the case, and a less humane and more selfish man would have done so. However, he went along with the urgent wishes of the patient's husband; he found himself obliged to leave for the reason given in his testimony, but he gave a letter to take to a friend, who never thought it would not be immediately postable, and to get all this ordeal he underwent the pain and despair of being practically charged in a court of law with the crime of manslaughter.
MEDICO-ETHICAL SOCIETY
It is cases like these that help to make some members of our profession deaf to all pleas or requests from those who are in the extreme; for in a certain class of cases there is always a great deal of responsibility and risk involved, and it is not unreasonable that most men should endeavor to escape it if they can. The establishment, as far as possible, of a fair scale of fees, both as a guideline in private practice and in the case of medical witnesses. Resistance to the system of club practice, as it now exists, and the substitution of some preferred mode of attendance for those persons whose circumstances do not enable them to pay the usual cost of medical attendance.
The establishment of a Medical Court, to which disputes between members of the profession may be submitted for arbitration. Neild, be appointed to draw up rules to be submitted to a general meeting of the profession. The committee is now engaged in the preparation of a draft of Rules in accordance with the above decision, and the profession will be reconvened with as little delay as possible.
LOCAL TOPICS
Browniess has been re-elected, for the eleventh year, Vice-Chancellor of the University of Melbourne. A week or two ago all the rats left the Geelong Hospital in a body and marched to the residence of the Superintendent of Police. When the rats leave a ship, it is generally considered to portend the impending sinking of the vessel.
Thomas, of Collins Street, was appointed an Official Visitor under the Lunatic Statute, of the Melbourne Lunatic Asylums, and coincident with this appointment he is Gazetted as a Justice of the Peace for the Colony. Lloyd, L.R.C.S.I., has just been elected Chairman of the Hotham Bench of Magistrates for the third time. Cusack, who had recently removed from Nelson to Wellington, New Zealand, was duly inscribed on leaving the former city with a highly complimentary address, signed by the principal inhabitants of the place, and a massive silver salver.
Cusack's resignation as Provincial Health Officer recognized in very flattering terms the valuable services rendered to the district during his five years' residence in Nelson. Considerable sensation and some disgust was recently caused in Geelong by a doctor who performed an autopsy in the open air, in view of the upper windows of the surrounding houses, and in the presence of a crowd of boys who stood around watching the proceedings with great interest.
