THE AUSTRALIAN
MEDICAL JOURI\AL.
MARCH, 1868.
ORIGINAL COMMUNICATIONS.
ON *THE ESSENCE OR NATURE OF DISEASE IN VICTORIA.
By J. B. CLUTTERBUCK, M.D. and L.S.A.
There are few countries which present features of greater import- ance, in relation to practical medicine, than those observable in this portion of the southern hemisphere, which, notwithstanding the comparative dryness of its atmosphere, and perhaps its generally reputed healthy climacteric influence, forces the conviction that its more formidable diseases—those of the cranial and abdominal cavi- ties—assume a violence of form, and a rapidity of termination, unknown in England. This being so, a large field of inquiry may be usefully traversed, having for its object (so far as this be attainable) the investigation of, firstly, the nature of disease, and, secondly, the general principles of treatment. On venturing how- ever on a discussion of such subjects, I do so with much diffidence, because I am aware the views entertained are at variance with the prevailing doctrines of the day • these implying a distinctiveness of character in diseases of this colony, totally different in their nature from those occurring at home, and to such an extent as almost to exclude what is called an antiAlogistic practice ; by general blood- letting more especially.
The ars nzedendi is, and ever will be, essentially one of conjecture ; its zenith of perfection will never probably be reached, notwith- standing the most close and attentive analysis of its phenonema ; long and extensive experience perhaps on many occasions, is the most reliable basis or guide to help us onward in the exploration of the mysteries of the science of medicine. It is assumed however that a specific agent—unquestionably, if there be such, indefinable and not cognizable by the senses—is in operation in Victoria, predisposing or giving rise to new forms of disease ; this however is, I conceive, supposition merely, unsupported by proof. On occasions we are prone to adopt a rugged, barbarous nomenclature, because the right one does not at the moment present itself ; hence the terms Bilious Fever, Low Fever, Putrid Fever, Nervous Fever, the Fever of Debi- lity, Dyspepsia, Torpor of the Liver, Blood Disease, Pulmonary
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66 DR. CLuTTERBucli on Disease in Victoria. [March, Apoplexy, * cum multis aliis—terms, for the most part, expressive only of a symptomatic state ; proving how frequently words are exalted to greater importance than things. The tyrannous power of fashion, too, has a good deal to do in the matter of physic ; appeals to the intellect being frequently subordinate to it. The efficacy of blood-letting, for example, is now-a-days ridiculed ; and by not a few the lancet is considered so formidable in its effects as to induce them to consign it to oblivion, as one of the remedies of the past, on the plea, amongst others, of more efficient substitutes having been found—but like every other herculean remedy, the danger lies in its abuse. On this subject Dr. Forbes says, " One of the besetting sins of English practitioners at present, is the habitual employment of powerful medicines in a multitude of cases that do not require their use. Mercury, Iodine, Colchicum, Antimony, drastic purgatives, and excessive blood-letting, are frightfully misused in this manner."
This eminent physician inculcates points of doctrine in accordance with those taught many years ago by a no less great authority, the late Dr. George Fordyce, in his lectures delivered in Guy's Hospital.
The acquisition of real knowledge, they both intimate, is a slow pro- cess. To learn what diseases are curable by art, and what not ; to simplify the treatment of diseases ; to learn to prevent, rather than to cure, and, where the indication is obscure or doubtful, to refrain and wait. But however difficult it may be to emancipate oneself from the shackles of some, even of the modern schools, yet how difficult to believe our predecessors' practice and theory were utterly at variance with recognised physiological principles. The poisoned blood theory has been peihaps more generally embraced by a larger section of the community than any other. If, as has been assumed, the fluids of the body are contaminated by an unknown virus, and this the fons et origo of a certain set of symptoms, the practical question arises : What remedial measures have we to counteract or to purify the contaminated mass ? Blood-letting would be useless, and for obvious reasons ; the same may be said of mercurial pfepa- rations, arsenic, and the like ; nor wouldthe use of purgatives, nor of diaphoretics, accomplish the object aimed at, that of driving out the peccant impurities, supposed by humoral pathologists to exist, because the tests are so incomplete as to induce scepticism of their presence, and if so, rendering our ideas so disconnected as to become valueless to any really useful and practical end. Doubt- less the theory itself is an attractive one, but its incompleteness seems to lie in a want of symmetry, of simplicity, and of reality or fact. I am not now alluding to that altered condition of the mass of blood induced by any of the morbid poisons when introduced into the system, including that contained in the sacs of some species of snakes which, when emitted from the reptile and absorbed, causes rapid dissolution ; experiments on which latter subject are being prosecuted with much zeal by Professor Halford.
* Another of the fashionable names of modern invention, devoid of meaning
—the apoplectic state implying a suspension of sensorial functions as residing in the brain.
1868.] DR. CLUTTERBUOK on Disease in Victoria. 67 Climate simply predisposes to certain forms of disease, but does not alter its nature; " majus et minus non variant specient ;" the difference is one of degree. With us Fever (strictly so-called), Sun-stroke Apoplexy, Palsy, Insanity, all brain affections, and con- sisting probably in, or being the consequences of, inflammation ; also diseases of the alimentary canal, whether Diarrhoea, Dysentery, or Cholera, and Hepatitis, are the endemic and special maladies of this country, commencing usually with violence, and apt to termi- nate rapidly. This is easily understood when the intense heat of our summer months is remembered, a cause than which per- haps there is none more powerful amongst the class of stimuli in the production of the above-named diseases—none whose action is so immediate—and as speedy and fatal terminations often ensue, we are prone to picture new varieties of morbid action. Hydrocephalus, too, may be enumerated amongst the class of diseases occurring at this season, ascribable very generally to intense solar heat, a disease essentially of inflammation of the meninges of the brain. The importance therefore of a change of climate, from a hot to a cold meridian, (as by a residence in New Zealand, or even in Tasmania, during the summer months), would seem to be a means of avoiding one of the chief predisposing causes of disease. But I am digressing.
If the various solids of the body, after death, be subjected to minute and fine injection, nearly the whole structure will present a net-work of vessels which, during life, are presumedly filled with blood ; in short, its component parts are principally made up of blood vessels and nerves connected together by cellular membrane. Organic structure therefore seems simple enough ; but the important question,
" what constitutes the real nature of the morbid action to which it is liable 'I" is one admittedly of great difficulty of solution, whatever methods may be adopted in the attempt to unravel the obscurity in which it is shrouded. Disease perhaps, like human nature, is the same everywhere, unchangeable in its essence, but modified by accidental circumstances. Now, if the admittedly usual tests be applied to aid our investigations, namely, an appeal to symptoms, there will be presumptive grounds for believing that the principal diseases of Victoria are founded in inflammation, a doctrine by no means novel, and inculcated by men of the highest authority in rela- tion to diseases occurring elsewhere, and in northern latitudes. The subject altogether, therefore, is one of paramount importance, espe- cially as regards remedial measures, " indications of cure," as they are commonly termed, its teaching enjoining simplicity of prescrip- tion, with a less bias for, or a reliance upon, powerful agents whose modus operandi is for the most part conjectural, ambiguous, and at times no doubt positively prejudicial ; for we have now-a-days in the category, Prussic Acid, Corrosive Sublimate, Arsenic, and a host of other poisonous substances, whose administration in a multitude of diseases often serves to embarrass diagnosis, and to interfere with those spontaneous efforts which nature herself makes in ridding her- self of the effects of disease, truths which must be admitted, whether we are willing or not to receive them, inasmuch as all diseases
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68 DR. CLUTTERBUCK on Disease in Victoria, [March, have a natural tendency to subside, and frequently in health, unaided by drugs of any kind.
Professor Pirrie, in his " Principles and Practice of Surgery," ob- serves,--" That a perfect acquaintance with the doctrines of inflamma- tion is of the utmost importance, both to the surgeon and the physician, must be allowed, when it is considered that in most of the maladies to which the human frame is liable, inflammation presents itself at one period or another." Other testimony, equally credible, recites, " Inflammation is a disease of the most frequent occurrence, and from which no part of the living body is altogether and at all times exempt. It is peculiar to no clime nor country, and it affects indiscriminately all ages and constitutions. It arises under the greatest possible variety of circumstances, and is produced by a number of causes, many of which are in constant operation, or to which the body is habitually exposed. When to all this we add that it is often the occasion of the greatest suffering to the patient, and is, at the same time, of all diseases infinitely the most fatal in its results, the extreme importance of the subject will not be questioned." Again, admitting the general principles contended for, we shall no longer be prescribing for names but for things. We shall not find it necessary to exhibit a different " remedy " in every different disease that comes before us, merely because it goes by a different appellation. The treatment of inflammation, altogether, is reducible to a few leading principles, with corresponding indications of cure which may all be fulfilled by few and simple means, requir- ing only to be properly adjusted to the peculiar circumstances of the case. Instead of proposing new remedies, we have already by far too many to allow of our attaining a full or accurate knowledge of their properties. " Each school of medicine," says a popular writer,
" has its favourite dogma on the nature of inflammation and of other diseases, and which prevails to a greater or less extent, and for a longer or shorter period, in proportion to the popularity and influence of the teacher, till it happens to be superseded by some- thing more attractive, because more new than the preceding. Thus there seems to be nothing like stability, either in doctrine or in practice, amongst us." Innumerable authorities might be quoted in illustration of the vital importance of this subject, but this would ' be superfluous ; my chief purpose is to direct attention to that phase of colonial disease, with its apparently corresponding yet simple treatment, which, as it seeems to me, has been but very partially recognised in this portion of the southern hemisphere ; not dogmatically, nor with a view of teaching,* but with the hope of inducing others to weigh unprejudicedly a hypothesis, and give a trial to a treatment or practice, which latter a tolerably long ex-
* The opinions and doctrines of authors entitled to respectful atttenion I shall freely make use of, as from professional engagements and other causes, it is probable that some of our members may not have had the leisure of critically testing their own theory and practice with those whose views may not acccord with their own.
1868.] DR. CLUTTERBUCK on Discose in Victoria. 69
perience has served to convince me is not fruitful in those direful results which I know many of my professional brethren no doubt consistently believe to be the case. Should scepticism be still in- dulged in, a useful purpose will have been achieved, namely, an inducement to others, far better qualified than myself, to prosecute the matter further, and so stimulate to a discussion on the nature and treatment of our prevailing diseases.
The four general features or characters of a part externally attacked by inflammation are too well known" tomerit more than a passing notice. The case of a common whitlow will serve to designate what these are, namely : attendant pain, heat, redness, swelling. The physiological condition of the parts implicated is thus, as it were, brought into view, and few would hesitate to question the intrinsic nature of the affection as consisting in inflammation, although we may be unable to account satisfactorily, even by the aid of the microscope, for the precise manner in which the arteries, veins, nerves, and cellular tissue are changed from their normal state. No one of these single signs however is to be relied upon as indicative of the inflammatory process. Over-distension by pressure on the nerve may produce pain, irrespective of inflammation. In- crease of animal heat may be produced by 'exercise. Friction, mental emotion, as in the act of blushing, will be followed by redness. Swelling is produced by many causes, mechanical and others. Increased sensibility is another of the symptoms of inflam- mation seated externally—tenderness to the touch as we call it.
Reasoning from analogy therefore, the same train of symptoms may be presumed to follow when internal organs or parts are the seat of the disease, but with this difference, that according to the texture of the part involved and the duration of the complaint, so wid be the degree of pain, the sensibility heightened or otherwise, and the tumefaction. The liver, when inflamed, gives little pain unless on pressure made externally. The lungs also may be extensively diseased, yet with little accompanying pain ; and so with the brain also, although the seat of sensation, and as a consequence of the transfer of its nervous power to other parts. Hence, as the most dangerous forms of disease take place irrespectively of this symptom, we are careful in our diagnosis not to rely upon it. In the case of serous membranes, however, and of the tendinous aponeuroses the pain is sometimes distressing, so much so as in a measure to make us set aside established rules, and to treat this symptom instead of the actual disease which gave rise to it : an empirical mode, doubt- less, but which we are occasionally constrained to adopt. Pain, too, may be of a continued kind, or otherwise (spasmodic), and erratic, and may show itself in a part remotely distant from the seat of mischief. Redness cannot so easily be determined. In addition to the above signs, no one of which, as before stated, is to be exclusively relied upon, others less equivocal are to be found.
Supposing the brain be the locale of mischief in the form of acute encephalitis : in this case the nature of the affection is to be judged of by the disturbance of function of the brain ; and secondly, by
70 Du. CLUTTERBUOK on Disease in Victoria. [March, the symptomatic fever (the Pyrexia of authors) ; as preternatural heat in and about the head, extreme sensibility to impressions of light and sound, the restlessness, throbbing of temples, flushing of the cheeks, and usually redness of the conjunctiv, depression of muscular power, quick pulse, thirst, and above all furred tongue.
As the disease advances (presupposing no early energetic means have been adopted, and with the effect of arresting its course) it becomes aggravated, not in essence nor in nature, but in degree ; the tongue becomes drier and assumes a brown shade, ultimately perhaps black ; greater prostration of strength, pulse more irregu- lar, the functions of the brain more disordered, as shown by intellect or mind becoming more impaired, delirium, coma—death being too often the sequel. This, the latter stage of the disease, has by some been termed typhoid fever ; by others, the low fever, or fever of debility ; and by not a few, the putrid fever, and bilious fever—
terms which seem to imply not only a difference in essence, but also as regards the seat of mischief. Yet it does not seem improbable that the latter assemblage of symptoms may be a prolongation, an aggravation of the incipient ones, although the order of their occurrence is by no means uniform ; all however originating from a local disease—inflammation of the brain ; which, first commencing with functional disorder of this organ is succeeded by the process alluded to. The variety of symptoms is such as might naturally be expected to arise in connexion with an organ, so complicated in its physical structure : at once the focus of sensation, voluntary motion, and mind ; the principal source and centre of feeling ; the principal controlling power of the sanguiferous system ; the organ that wills, if the expression be allowable, or materially influences even the healthy action of the digestive apparatus—as evidenced by the loathing of food on the occurrence of sudden mental emotion, as by unexpected bad news, the death of a near relative, &c. No wonder then that the sensorium commune should be so uniformly affected, ab initio, in fever ; and less wonder that secondary de- rangement follows, namely : the furred tongue, disturbed circulation both of the heart's action and of the secreting vessels, and other deviations from the healthy standard. During the course of this affection some other organ or portion of the body usually becomes involved in inflammatory action, mutually influencing the topical or local one. We then have to deal with what is called complicated fever, and if under these circumstances a fatal termination ensue, death is attributable not so much perhaps to the primary as to the secondary disorder. It has been assumed from this, the occurrence of other diseases during the course of fever and their attendant and multi- farious symptoms, that it is a general disease. In answer it might be stated that we do not call pulmonic inflammation enteritis, and similar affections, universal diseases, simply because pyrexia, or symptomatic fever, attends them. We call the one simple inflammation of the lungs ; the other of the substance of the intestines—in other words, local diseases ; the furred tongue, heat of skin, quick pulse, Arc., springing from or caused by the inflamma-
18681 DR. CLUTTERRUCK on Disease in Victoria.
tory condition of the affected organ. It seems not therefore un- reasonable to include in one general name or appellation, fever included, almost all diseases under that of inflammation and its effects, as taught for so many years by those more especially qualified to instruct in such matters. Thus, Bright, Addison, Henry Clutterbuck, and others, have drawn conclusions almost coincident as regards both the seat and nature of fever more especially ; as also of inflammation being the most constant and general of all maladies. The two former observe—" In every case of fever the causes producing it inflict a morbid impression upon the nervous system (the brain is here obviously meant), by which the functions of that system, intellectual and bodily, are deranged, that derange- ment differing in degree in different cases, and in consequence of their derangement every organ, and every function of the body, appears to be more or less disordered. Either primarily or second- arily we know the brain to be more or less affected, the affection being scarcely less manifest in the mild than in the severe ; in the early than in the latter periods of the disorder." As regards the nature of morbid action, it is further stated, " we are altogether unacquainted with the actual condition of the brain in the earlier stages of fever; that inflammation of the organ or its membranes does frequently occur, is proved alike both by the symptoms during life And by dissection after death ;" but this, the inflammatory condition, is supposed by those gentlemen to arise some days after the accession of the cerebral disturbance, and which, " if it be not actual inflam- mation, is one which is closely allied to it, both in its nature and consequences." On commenting on the above passage, Dr. Clutter- buck says, " Now, if this state of things, as occurring in the severer cases of fever, is so unhesitatingly admitted to be characteristic of inflammation of the brain, I do not see how the existence of inflam- mation an be questioned in the earlier and milder stages of the di'sease, for the symptoms are similar in nature in both cases and differ only in degree. The mildest cases of fever at first are often seen to degenerate into the most severe, and that by gradual and almost imperceptible changes. There is no visible line of demarca- tion by which the early and mild is separated from the latter and severer stage of the disease, so as to enable us to mark precisely the actual accession of inflammation. In short, the real and essential difference between the mildest and the most malignant form of fever appears to consist merely in the degree and extent to which the brain and its functions are suffering," views in which the late Sir Astley Cooper fully coincided. In the account of the epidemic fever in 1818, and published by one of the most distinguished men of that day, Dr. Thomas Batemen, the following weighty observa- tions occur, "In all the instances of the more severe forms of fever, in which considerable confusion and delirium occurred, the brain must undoubtedly be considered as the seat, at least of much over- action and over-distension, if not of some degree of inflammation."
Dr. Batemen's practice was based upon the theory here given, the antiphlogistic ; bleeding, amongst the rest, being practised to a
72 DR. CLUTTERBUCK on Disease in Victoria. [March, moderate extent, even when the fever had somewhat advanced, and generally with good effect. Mr. John Bell, too, thus expresses himself in equally energetic and forcible language. " Nothing but the most violent inflammation of the brain can possibly account for the symptoms of malignant fever."
Perhaps no single symptom, as showing the nature of inflamma- tion, is less equivocal than the altered condition of the lingual mem- brane. If the brain be the organ implicated, the lungs, the intestinal canal, or the liver ; or the serous membranes lining any M the great cavities, as in cases of pleurisy, ascites, hydrocephalus, hydrothorax ; or of the ligamentous structure, as in gout and rheumatic fever ; or of the mucous membrane of the alimentary canal, as in diarrhoea, dysentery, and cholera, a coated tongue is uniformly present, the crust or fur covering it being partial or universal, and variable as to colour, according to the violence and duration of the local affection. For example, in the majority of inflammations, and at their commencement, the upper surface of the tongue is covered with a thin moist coat of white fur, the edges being clean and healthy. If the disease pursue an uninterrupted course, the crust will usually become thicker and drier, gradually changing to a brown colour, eventually perhaps to a perfectly black ; the continuous membrane presenting a similar appearance—sordes, the result of this, collecting about the teeth—in the last stage of fever and of pneumonia we notice these appearances more dis- tinctly. The common opinion is, that foulness of the tongue is in general the result of derangement of, or of some impurities in, the stomach, or primce vice, to use an antiquated term, some supposed peccant humor being lodged there. If this were so, the evacuation of its contents, as by emetics, ought to be followed by a return to its healthy aspect; but such is not found to be the case. As before stated, the appearance of a coated state of the tongue is characteristiet and one of the ordinary signs of inflammation, wherever seated. On this point the remarks of an eminent writer are worth transcribing : " This organ—the stomach—appears to be considered by many as the great store-house of disease in the human body, and particularly with regard to affections of the brain. Nothing is more common than to hear of headaches, vertigos, and even apoplexies and palsies being referred to the stomach, as if this were the actual seat of • morbid affection in these cases. It is not to be questioned that a very close and reciprocal connexion subsists between the brain and the stomach, so that the condition of the one is liable to be much influenced by that of the other. Admitting this, however, it is not warrantable to consider the stomach as the actual seat of disease in such cases. No affection of the stomach, per se, could occasion such symptoms as headache or vertigo, nor constitute the immediate cause of apoplexy or palsy ; all these are manifestly affections of the brain and its functions, or its vessels. The frequent affection of the stomach in fever, as well as in the other cases mentioned, it is not difficult to understand upon physiological principles. The stomach .
not only receives nerves from the great intercostal for the support
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1868.] DR. CLUTTERBUCIC on Disease in Victoria. 73 of its simple or organic life, but also communicates directly with the brain by means of the par vagum ; from this it probably derives its peculiar sensation and appetites ; thus becoming, in some measure, an organ of sense as well as of motion and secretion ; and therefore, like the other senses, depending more immediately on the brain, and obeying its different impulses. The dependence of the func- tions of the stomach on the nervous power, as derived from the brain, is shown in the experiment of tying the eighth part of nerves in dogs, in consequence of which, they become affected with indiges- tion and flatulency (Whytt's works) ; also by the effect of large doses of opium in these animals, which suspend almost entirely the • peristaltic motion of the stomach and intestines, whilst the action of the heart suffers comparatively little change. It has been, and indeed still is, a prevailing opinion that the tongue is, as it were, an index to the stomach, and that Its appearance is but a counter- part or type of that which exists in the latter organ. The tongue, in short, is an index to the sanguiferous system, the excited and disordered state of which it clearly serves to mark—a point of some importance, practically considered. Many are the cases in which a slow inflammation in organs of great importance in the animal economy, without being attended either with much pain or disturb- anc* of function, yet sufficient to undermine and gradually to
destroy the structure of the part, and ultimately life itself, but which nevertheless may be detected through this medium—a foul
or coated state of the tongue." In the case of infants and young children, who are naturally incapable of aiding us in defining their symptoms and feelings, a febrile state of system, furred tongue, &c., will serve to elucidate with tolerable certainty the nature of the existing complaint, if they do not determine its precise seat.
This is a point of Moment therefore when, for the most part, parents refer all the disorders incidental to childhood to the fever of teething, to the presence of worms, or to disorder of the stomach, and treat such cases with paregoric, febrifuge, anthelmintic, or other nostrums when, as now and then happens, art comes too late to be of any avail, and convulsions, cr other formidable disease, supervene and prove fatal. Enough perhaps has been stated to justify the assumption that where febrile action (pyrexia) exists, a coated tongue, better than any other isolated symptom, will serve to denote this state, and of course of the disease, inflammation that produced it. A surer test of the gradual subsidence of acute as well as chronic inflammatory action cannot be found than in a return to its natural state of the lingual membrane ; and vice versa, according to the extent and shade of its incrustation, so will usually be our prognosis.
To give even a short outline of all the theories which have pre- vailed upon the actual condition of the blood-vessels when roused into disordered action by inflammation would be a profitless task, even were I acquainted with them—debility of the capillary vessels, a con- gested state ( ,f the vessels, paralysis of vessels, and other hypotheses, are for the most part exploded in the present day, or but partially
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74 DR. CLUTTERBUCK on Disease in Victoria. [March, acquiesced in. John Bunter, that unrivalled pathologist, maintained
" inflammation to consist in an increased vascular action of the part, chiefly of the smaller vessels, the capillaries, the larger arteries doing little more than supplying the part with the additional quantity of blood required ; and as the natural result of such increased action, not only is more blood sent to the part, but circulated through it with increased force and velocity." This is, I believe, the most generally received doctrine of the present day, and certainly the attendant phenomena seem to warrant the conclusion that it is the most sound one. Now, the condition of the blood itself, in inflam- mation of organs important to life, is more readily demonstrated.
'Instead of the character exhibited in health, if blood be drawn rapidly from the system—the part is immaterial—from a vein or artery, and received into a narrow-mouthed vessel, the surface of the crassamentum may be flat or it may be incurvated (cupped, as we call it), and present either a huffy (chamois leather appearance), sizy, or a gelatinous aspect. The serum may be diminished, or in excess.
Either of these conditions will be noticeable in such a disease as that we are considering ; but the organ affected will determine the particular features of each. If foulness of the tongue be, as I take it, one of the surest indications of inflammation—wherever seated—
its twin-sister is to be recognised by a buffy, or sizy, or inverted edges of the crassamentum, or solid portion of the blood when drawn.
Hence, if we are in doubt concerning the nature of the complaint under which a patient labours, a more simple experiment and one that will rarely disappoint, does not offer than that of opening a vein or an artery, and drawing off, by a large orifice so as to allow the blood to flow freely, two or three ounces of blood and examine it after coagulation has taken place ; when, if inflammation be present, one or other of the appearances referred to will be present. As a' means of diagnosis therefore simple blood-letting may be resorted to with perfect safety, as I know from repeated experiments ; and as a means of establishing general principles of treatment, not necessarily including blood-letting as one of such means. Knowing the disease we have to treat we shall not be so much puzzled to find suitable remedies, because the consequences or terminations of inflammation being so well known we shall be better enabled to arrest or modify them, points which will be more fully gone into when alluding to the treatment of the principal or more prominent diseases of the colony.
There are other features which serve to mark the existence of this affection and entitled to attention, but on which less reliance can be placed—these are : changes in the state of the secretions ; the urinary discharge varying in quantity and colour according to the duration of the disease, and its seat ; so also the salivary glands, thirst being a never-failing symptom ; wasting of the flesh in long- continued inflammatory action shows that the absorbent vessels have been in a particularly excited state.
( To be continued.)
1868.] DR. DAY'S New Blood Test. 75 DR. DAY'S NEW BLOOD TEST.
The following letter from Professor Taylor to Dr. Day, in reply to a communication forwarding an account of the guaiacum test for blood, has been kindly placed at our disposal. It will be seen that whatever disposition there may be in the colony to underrate the value of Dr. Day's interesting researches on the subject of ozone, his labours are properly understood and correctly estimated by the highest authorities at home :-
15, St. James' Terrace, Regent's Park, Sept. 2nd, 1867.
Dear Sir,—Your letter of December 22nd, 1866, with the small bottles of ozonized liquids, &c., reached me in the course of the spring. I have delayed replying to it, as I wished not only to make some extended experiments with the guaiacum test for blood, but also, if possible, to apply it practically to cases involving criminal charges in this country.
I have been able so to apply it during the last six months, and the result is, with proper precautions, most satisfactory. I have detected by means of it the colouring matter of blood in urine when • the new and delicate process of spectroscopic examination failed to give satisfactory results.
Van Deen and Schonbein appear to have used and recommended this process for detecting blood, employing for this purpose ozonized oil of turpentine as it is called. You will find a very full account of this process, with the results of numerous experiments, in a paper by Dr. Liman, published in " Casper's Vierteljahrschrift fur gerichtliche Medicin" for 1863, 24th Band, p. 193. The writer never seems to have gone beyond the use of oil of turpentine, which I find very inconvenient for use. This led me to speak depreciat- ingly of the process in my large volume published in 1865 (" Principles and Practice of Medical Jurisprudence," p. 461). Your letter, with the report of the curious case of the Chinaman, a por- tion of whose trousers you sent to me, induced me to go more deeply into the matter.
I have employed all the liquors which you have sent to me in experiments on animal and human blood, old and fresh, and on blood-stained articles of dress which had been washed, and with very satisfactory results, where neither corpuscles nor a red-coloured watery solution could be obtained. Among these liquids the com- pound sulphuric ether ozonized answered the best. It was in a fiat bottle, marked as having been more than nine years in the colony—
then the methylated ether, eau de cologne, and oil of lavender. I tried some old spirit of lavender which I had had by me for many years, and found it very efficacious. Some of these liquids act more rapidly than others and bring out a brighter cerulean blue.
I agree with you in your statement that the ether contains not ozone but peroxide of hydrogen or antozone, and that this is the efficient agent. The production of blue perchromic acid as chromate
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76 DR. DAY'S New Blood Test. [March,
of potash, is a proof of it. As therefore peroxide of hydrogen (the antozone of Schonbein) was the agent, I thought it best to employ this at once, discarding ether, alcohol, turpentine, and all other liquids. Garden and Robbins, of Oxford-street, supply good peroxide of hydrogen in eight ounce bottles, which keeps well for months. It is slightly acid (from H. Cl.), but this does not affect the chemical pro- perties. It is wonderfully delicate—add a few drops to a very attenuated solution of the colouring matter of blood—then a few drops of guaiacum in alcohol (tincture made from bits of resin not exposed to the air), and the blue colour comes out either immedi- ately or in a few minutes. None of the red colouring matters of fruits or flowers of roots, of cochineal, magenta, &c., produce a similar effect. For blood, the peroxide and tincture are both required, one will not act without the other, and it matters not which is added first. As there are many substances which turn the tincture of the resin blue without peroxide, it is better to add the tincture first in order to avoid a fallacy. The salts of iron, a solu- tion of chloride of sodium, and all salts containing traces of iron, the pulp of potato-bread, and all substances containing gluten, some pre- pared farinaceous foods, render the-tincture alone blue without peroxide.
Manganates, pertnanganates, and oxidizing agents—chlorine, bromine, chloride of lime, &c , also blue the guaiacum ; but for the blueing by blood peroxide of hydrogen in some form is absolutely necessary.
Such are the general results of my experiments. This test acted in detecting the colouring matter of blood in partially cooked meat which had been kept in a tin case since 1826 (forty-one years) ! I ! Its application to washed blood on clothing is very interesting-- taking care to apply the guaiacum first, and to apply both solutions to an unstained as well as to a stained portion of dress.
Your suggestion of the method of detecting blood in dark cloth is excellent ; i.e., moistening the cloth with wnter—then adding guaiacum—getting no result by pressure on white blotting paper—
then adding the peroxide and at once obtaining a blue colour. To avoid fallacies from iron-dyes, potato-pulp, flour, ac., guaiacum must be used first without peroxide.
In reference to the disinfecting powers of the ozonized ether, I have not found them so great as I expected. My expe4iments were performed on small per centages of sulphuretted hydrogen in closed jars of air. Lead papers showed at long intervals that the sulphu-
retted hydrogen was not completely removed. Nevertheless it has oxidizing properties and pro tanto must be a useful agent. There is a peculiar pungency about the vapours of ozonized ether.
With regard to the Chinaman's trousers, I was able to obtain a small blue stain on paper by the process, although no other method, microscopic or otherwise, showed blood.
I gave a portion of the trousers to Mr. Sorhy, of Leeds, the dis- coverer of the spectroscopic process for detecting blood, but have not heard the result. I suspect the spectroscope would show nothing.
There are some difficulties about the theory of this action of blood on guaiacum in contact with peroxide of hydrogen. I per-
1868.] DR. DAY'S New Blood Test. 77 ceive from your letter that you are aware of the existence of these.
Bodies containing or imparting ozone, immediately give a blue colour to guaiacum. Thus, permanganate of potash in the smallest quantity gives a beautiful blue. The red colouring matter of blood does not give a blue colour to guaiacum, hence it cannot contain ozone either in a free state or in a combined state to be imparted to other bodies which are disposed to receive it. I find, as you do, that ozonized oil of lavender, eau de Cologne, essence of lavender, &c., produce no change of colour in guaiacum—the same with ozonized ether. Until the red colouring matter of blood is added there is no blue produced. My in- ference from this is, that the oil of lavender and eau de Cologne, &c., do not contain ozone but entozone, or peroxide of hydrogen. This is the inference you have drawn respecting ether. If these liquors were really ozonized, they would produce on guaiacum the change of colour which ozonized compounds produce. Ergo, I infer they are not ozonized but antozonized, and therefore requires the interme- diate action of the colouring matter of blood before blueing the guaiacum. How the blood operates to give them the property of ozonizing agents when the blood itself does not act on guaiacum like an ozonized substance, is not very clear.
The blueing of the guaiacum is a process of oxidation. I find that light alone has no action upon it. Precipitated guaiacum resin (white and fresh), sealed hermetically in a glass vessel nearly full to exclude air, exposed to day light and sunlight for six months, has undergone no change of colour. Exposed to air it is slowly blued, although no oxidizing agent is added. Thus, stains on articles of dress should have the changes of colour speedily produced to justify the inference of blood. A spot of tincture of guaiacum precipitated by water, is slowly blued in air.
I advise you to procure and read Liman's paper in " Casper's Journal," as above mentioned. I will write to your brother to send it out to you. The next edition of my work on Medical Jurispru- dence will contain a much fuller account of the guaiacum test than the last, and I owe it to you to have directed my attention to its full value.
The work on Chemistry, by Professor Braude and myself, is now undergoing a second edition in the United States. (H. C. Lea, Philadelphia.) In rewriting the tests for blood, I have given an account of your experiments, and of the great utility of the guaiacum process. The book will be published at Philadelphia, in a month or two. I shall be glad to hear from you when you can find time to send me any scientific information.
Believe me, yours very truly,
ALFRED S. TAYLOR.
Dr. JOHN DAY.
ik
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78 Medical Society of Victoria. [March,
MEDICAL SOCIETY OF VICTORIA.
The following is the paper read by the Rev. Dr. Bleasdale, at the • meeting of the Society on the 5th ult :-
ON THE ESSENCE OF MEAT AND OTHER METHODS OF PRESERVING FLESHMEAT.
By the Rev. J. J. BLEA SDALE, D.D., Honorary Member.
Among the many useful researches successfully conducted by scientific chemists during the last thirty years, and notably so by the illustrious Baron Von Liebig, not the least important are those which have had for their object the improvement of human food, especi- ally that food destined to be consumed on long voyages, by all but the few first class passengers, and by people situated as our miners frequently are, before the comforts and appliances of civilisation have reached the last new scene of their labours ; by armies on the march or during campaign, and by residents in the remote bush.
In the course of their researches, many new and improved forms of utilizing substances commonly used for food and nourishment have been discovered. Scarcely twenty years ago, but little, if any, fleshmeat other than salted, was considered safe for ships' stores ; for the soup and bouilli hardly deserved the name of fresh provisions. It is true that fresh pork was brought over in a frozen state in some of the North American ships, but that was of no general application, for if it once became thawed, it immediately perished.
Since, however, the modern discoveries have been found satisfac- tory in their results, and confidence in them is now quite estab- lished, the very high price of meat in Great Britain, and the very slender chance there is of its becoming more abundant, have caused merchants to turn their attention towards obtaining a supply from Australia and those parts of South America where a superabundance of horned cattle and sheep is. known to exist.
That there is a vast superabundance of such meat is rendered evident by the prices obtained for fat stock in South America and the north-east of Australia, and in Victoria at the present day, and also by the active preparations in progress for boiling down sheep for the mere value of their fat. It is said by persons well informed, that a million and a-half will be thus boiled down in Victoria during the next twelve months, if the summer threatens to be dry.
There is then no wonder, with meat at its present price in Eng- ]and, ls. 2d. per pound for sirloin of beef, and from 5d. to 7d. per pound for our Australian preserved fresh meat, that attention should be anxiously turned towards utilizing the vast amount of the best of- lean meat represented by this wholesale slaughter for the sake of the tallow. It is, however, for those interested in a mercantile way a.
1868.] DR. BLEASDALE on Preserved Meats. 79 to consider how far the preservation of all this lean meat will be remunerative. My purpose is not to deal with it from that point of view alone, any further than to state that, if even a smaller sum per head were added to the sheep's value than that recently stated at a public meeting by Mr. Gideon Lang, one of our best informed public men on these matters, there would be no fear of the under- taking of preserving it by any of the approved processes not yield- ing very large returns in the shape of profits.
At a very low estimate indeed, more than £300,000 ought to be • saved to the flockowners out of the one million and a-half said to
be destined to the melting-pot.
To such a state of perfection have the processes of preserving meat been now brought, that it has become a subject of secondary consideration, so far as concerns merely the keeping, which particular one is adopted. Those of course which leave the meat free from salt and smoking will be preferred. The following seem to be the best and to have yielded the most favourable results, and to them I would at present direct attention :
1. Salting.—Salt meat, the most ancient and universal of all, seems in these dry countries to be prepared with far too much salt- petre. Experiments made by myself, and my observations extend over many years in Victoria, leave little doubt on my mind that saltpetre might be in all cases beneficially omitted, if a small pro- portion of sugar were added instead ; and this has reference especi- ally to meat intended at some time to be hung, dried, or smoked.
2. As cooked meat put up in tins or otherwise sealed from the air.
Abundance of experiments have proved that meat properly cooked and packed in air-tight vessels, may be kept for any period of time without a particle of salt.
At a recent dinner of the Connoisseurs' Club in this city, some most excellent preserved ready cooked meat, both beef and mutton, prepared by Smith and Son, of Hotham, was placed on the table, as was also a 71b. tin of beef prepared by a meat-preserving com- pany at Grafton. These meats were eaten both cold and after having been heated in the usual way, and met with the highest approval. I remember that I and most of the gentlemen who sat . near me, almost wholly dined off them. Such food might be placed before anyone when time or other difficulty prevented fresh meat from being cooked. It might be called " a relish."
I have mentioned the name of one Melbourne firm as being ex- dellent preservers, only because theirs. happened to be the only sample on the table on the occasion to which I refer. But it is not my intention either to signalise them or to put them in comparison with others, for more than one preserver of meats exhibited excel- lent articles at the late lntercolonial Exhibition.
Regarding thekeeping properties of well cookedfood, I maymention in this place that on several occasions during the last ten years, I and many others have tasted preserved meat put up more than twenty years ago by Mr. Sizar Elliott, of Brighton. It was perfectly sweet, wholesome, and appetizing ; in fact excellent human food.
80 Medical Society of Victoria. [March, Wherever meat has not kept well, the fault will be found to have arisen either out of the badness of the tins, the want of perfect cookery, or closing of the tins. The simple contrivance adopted by the preparers of the Grafton meat recommends itself as replete with common sense. It consists in inserting in the meat when being packed in the tins in a raw state, or before being quite cooked, a tin tube, open at both ends, about one inch in diameter, well per- forated throughout its length with holes about one-eighth of an inch
• in diameter, and of just such length as will suit the depth of the tin.
The use of this seems to be mainly to aid the circulation of the fluids during the process of cooking. Water, and such mixtures of it as constitute the natural juices of meat, are the best carriers of heat ; and this simple means helps much to insure the uniform and more rapid conducting of the cookery. I have eaten meat prepared in this way quite without salt, and willingly bear the highest testi- mony in my power to its goodness. I know of nothing short of freshly-cooked meat equal to it.
3. Prepared soup.—There was in the late Intercolonial Exhibition a fine sample of this kind of food, prepared by Mr. H. M. Whitehead, of Mossman's Bay, Sydney, N.S.W., and I devoted some time to the study of it during the time the Exhibition was open, and gave a partial report upon it. It occurred to me then, as indeed it does now, that this form of preserved meat, namely, for soup and beef- tea, is of especial interest.
There are, however, two forms of it known favourably to me :- 1st. This of Mr. Whitehead's—the only one of the kind I have met with which came up to my idea of prepared soup—and, 2nd, Liebig's Extractum Carnis—" Essence of Meat."
There is very considerable difference, however, between these two preparations. In Mr. Whitehead's many animal matters, not unwholesome in themselves, such as gelatine, &c., are left ; while in Liebig's " Essence of Meat " all such are removed, as nearly as possible.
Criticising, as I now must, these two prominent forms of preserved meat—and which, as of the soup type, I consider to be the very best
—I trust I shall be pardoned by this honourable and learned society for being a little diffuse.
Liebig's Extractum Carnis is what he describes it, and an account of all its best uses will be found in a subsequent paragraph. Without any doubt they are very great where sickness suddenly occurs, because no time need be lost in preparing the finest and purest of all beef-tea or soup, to which a glass of our noble colonial wine will add not only a relish, but all the health-giving properties of that most wonderful of all prescriptions, the one elaborated by the natural laws governing the universe, in accordance with the design of our Almighty Maker and Ruler, who wills his children should rationally enjoy health, and the intensification of the sweets of existence in their present condition ; one suited to the health of the healthy and the strong, and equally so to the convalescent from severe disease ; a gift of the Eternal God, rejected, I regret to say, equally by the
1868.] DR. BLEASDALE on Preserved Meats. 81 blind follower of Mahomet, and the miserable teetotaller of the present day, bigots, in their several ways, each of them. But our business just now is not with wines, but meats. Of the pure kind, so to speak, there is nothing better than Liebig's ; of the composite kind, I have neither read of, seen, nor tasted anything better than Whitehead's Concentrated Essence of Soup, if he will allow me to help him to a name.
As I must criticise both of these forms of essences of meat, I will begin with Liebig's account of his process—one I have laboured at for some months, not without success– and then I will say what I think I am warranted in saying of the other.
Liebig's own Statement of his " Extractum Carnis."
" When finely-chopped muscular flesh is lixiviated with cold water, and pressed out, there is left a white fibrous residue, consist- ing of the true muscular fibres, cellular tissue, vessels and nerves.
" When the lixiviation is complete, the water dissolves from 16 to 24 per cent. of the weight of the dry flesh. The fibrine of flesh, the chief constituent of the muscular fibre, constitutes three-fourths of the weight of the lixiviated residue. If this residue be heated to between 158° and 177° F., the fibres contract together, shrink, and become horny and hard ; a change—a kind of coagulation—takes place, in consequence of which the fibres of the flesh lose the power of sucking up water like a sponge, and retaining it. Water flows out, for without the addition of water the pressed residue, when heated, soon swims in water. The lixiviated flesh, when boiled with water is, like the water in which it has been boiled, tasteless, or has a slight nauseating taste. It cannot be masticated, and even dogs reject it.
" All the savoury constituents of the flesh are contained in the juice, and may be entirely removed by lixiviation with cold water.
"When the watery infusion of flesh thus obtained, which is com- monly tinged red by some of the colouring matter of blood, is gradually heated to boiling, the albumen of flesh separates, when the temperature has risen to 133° F., in nearly colourless cheesy floculi.
The colouring matter of the blood is not coagulated till the tempera- ture rises to 158°. The liquid is now pale yellowish, clear, and it reddens litmus paper, proving the presence of a free acid.
" The proportion of the albumen of flesh separated as a coagulum by heat is very various, according to the age of the animal. The flesh of old animals often yields no more than 1 or 2 per cent. ; that of young animals as much as 14 per cent.
" The infusion, or eatract of flesh, after being freed by boiling from albumen and the colouring matter of blood, has the aromatic taste and all the properties of the soup made by boiling the flesh. When evaporated, even at a gentle heat, it becomes darker coloured, finally brown, and acquires the flavour of roast meat. When dried up there is obtained a brown, somewhat soft mass, amounting to 12 or 13 per cent. of the weight of the original flesh (supposed to be dried). This extract is easily soluble in cold water, and, when
ua
82 Medical Society of Victoria. [March, dissolved in about 3.2 parts of hot water, with the addition of some salt, gives to the water the taste and all the peculiar properties of an excellent soup. The intensity of the flavour of the dry extract of flesh is very great ; none of the means employed in the kitchen is comparable to it in point of flavouring power."*
I have quoted these details partly because they are of a common- sense kind, and partly because they may at any time be of use to apothecaries and others, desirous of either preparing Liebig's Extra,ctum Carnis, or testing the purity of samples offered in com- merce. As an adulterant, the principal thing to be guarded against is gelatine. There are always present other matters of a character somewhat analogous to gelatine, but gelatine itself has no business there.
The following is a minute record of a detailed examination of the Essence of Meat, as prepared by one of the New South Wales Com- panies, for whom Mr. Sloper is Agent. (Samples forwarded through the Hon. J. H. Plunkett.)
This Sample of Essence of Meat was delivered to me in a well- stoppered, wide-necked, glass bottle ; the quantity being about five ounces.
1. When first opened it was of the consistency of rather solid honey.
2. Colour : a deep dark brown.
3. Odour : a powerful one of roast meat.
4. It was opened, and let stand for a day, and then a small quan- tity taken out, about as much as would fill the mouth of an ordinary salt-spoon ; closed again, and after a few days the same was repeated, and again repeated, and any change in its appearance carefully attended to. A slight darkening on the exposed surface was all that could be noted, and this was of no material consequence.
5. The small quantities mentioned in the last paragraph were dissolved in an ordinary breakfast-cup full of boiling water, and with the addition of a little salt, and once or twice a little dripping, sub- mitted to that last but not least of human referees in matters of food, the human palate, and found to be perfectly good.
6. After the lapse of a fortnight, the surface, occasionally exposed to the air, had acquired a decidedly darker appearance to a depth of about an eighth of an inch. This, however, proved to be no indica- tion of an injurious change.
T. 100 grains were placed in proof spirit in a glass vesseL After the lapse of three weeks, during which time it was repeatedly agitated, it was shown not to be perfectly soluble in the spirit. This undissolved portion was then boiled in proof spirit for a considerable time, and found to be entirely insoluble in that menstruum. This portion not soluble in spirit dissolved readily and °completely in hot water. It was carefully evaporated to dryness at 160° (the same
it
J,,
* Liebig's Familiar Letters, pp. 134, 135, 136. Dr. Blyth's Translation.
1868.0 DR. BLEASDALE on Preserved Meats. 83
•
heat as had been previously applied to the 100 grains), and weighed to test its per centage of substance, insoluble in proof spirit.
8. 50 grains, previously dried as above, were dissolved in hot water, and when cold a solution of tannic acid added. A precipitate was soon formed, indicating the presence of matters of the nature of gelatine.
9. 50 grains, as above, were dissolved in ten ounces of boiling water, in which they dissolved perfectly, the colour being clear and about the depth of ordinary brown sherry wine. This solution was covered with paper so as to keep out dust, but otherwise open to the air. It remained clear and sweet for four days. On the fifth day signs of the formation of flocculent matter were visible, and on the seventh a precipitate had been formed, leaving the supernatant fluid
turbid. •
10. On comparison, the amount of matter insoluble in proof spirit and the per centage of that, thrown down by tannic acid in one case, and by exposure to atmospheric air in the other, proved to be very nearly alike. I conclude that the substance insoluble in alco- hol was gelatine.
11. The bottle was then purposely broken—an accident quite likely to happen in families ; or, what comes to the same thing, in case of the loss of the top-cover if tins be used ; or again, the neglect of servants and nurses to close the vessel in which it is con- tained, and then covered with paper, in a rough way, as a careless servant might do it, and left to stand for a fortnight on the table.
Beyond the absorption of a little moisture, and a slight blackening of the outer exposed surface, no change could be observed. The absorption of moisture in no way affected the wholesomeness of the article.
12. It was again dried in an air stove, at a temperature of 120 °, for two days, when it became much firmer, the dark colour of the outer surface changed to a much lighter brown, and the smell of roast meat was much intensified.
13. Uses.—There can be no doubt concerning the vast value of the essence of meat uncle?' innumerable circumstances of life. The above investigations, all of a common-sense kind, and such as any druggist can easily repeat for himself, leave no question about the keeping properties of the essence of meat prepared in the way in which this sample has been turned out ; and when we take into account its price, from 16s. to 23s per pound, these are serious con- siderations, especially for the poor, and those who may take it with them on long voyages.
Now it is under such like circumstances as those just alluded to that this article is of the most importance. Thousands of fami- , lies have to undertake long voyages by sea in the " second-class "
and " steerage " of ships, to whom this preparation especially—but one or two others also—would be a positive blessing. A child falls ill, and the chances are that neither love nor money can procure a cup of broth or " beef-tea." But with the quarter of a teaspoonful
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84 Medical Society of Victoria. [March
of this essence, a little hot water, and a pinch of salt, the difficulty is met. I put this case as one of daily occurrence.
Again, as a nourishing food.—When arrowroot or, still better, sago, is cooked in the usual way with water, and then the same . quantity of the essence as would be used for making it into broth or beef-tea is added, a soup is at once produced of the most palat- able nature, suitable alike for the sick chamber or the dinner-table.
Its great recommendations are, the small space it occupies ; its durability under hard treatment ; its consisting, when properly pre- pared, of all the essentially nutritive elements of the best of flesh meat ; and the perfect facility with which it can be placed as soup or beef-tea in the hands of the invalid. Neither is the price—say, average retail, Ms.—at all excessive, for one ounce of it will make several quarts of soup. I look upon it as a perfect godsend to the poor who have to undertake long voyages, as an element of health and comfort to the thousands who in future will have to come to Australia ; and almost as much so to those whose avocations take them away from the regular conveniences of a settled home.
Danger of adulteration arises mainly from gelatine being added, this being about 4s. 6d. per pound, while the other is 18s.
The particular sample I have examined could be found fault with really only from one point of consideration ; it had not the distinc- tive character of any one particular kind of flesh-meat, though it seemed to approach nearest to that of beef. In view of this circum- stance, the want of distinctness of taste as to the peculiar kind of flesh from which the essence had been obtained, I instituted a series of direct experiments to satisfy myself of the accuracy of Liebig's statement, that " each kind of flesh retained its own distinctive properties of taste and relish, when prepared by lixivia- tion in cold water, and evaporation at a temperature not exceeding that of boiling water."
With this view I got 64 ozs. of ordinary beef-steak, and 64 ozs.
of lean mutton, and had them both well chopped.
They were then well lixiviated in cold water.
The water was raised to 200°, and maintained at that temperature for about one hour, but not allowed to boil, and well scummed ; then allowed to cool, and afterwards it was filtered through fine muslin, and then through the finest Swedish filtering paper to remove any remaining impurities. This liquid was then evaporated till it began to show signs of thickening at 160°, after which it was removed to an air store, and the drying continued at 130° till it acquired the consistency of the commercial article.
Exactly the same was done in the instance of both kinds of meat, with the aim of discovering whether beef could be distin- guished from mutton when so prepared.
Work it howsoever one will, it always assumes the character of roasted meat.
Reverting again for a moment to Mr. Whitehead's prepared essence of soup, I would add that I have most carefully studied it
1868.] DR. BLEASDALE on Preserved Heats. 85 and can recommend it as a most excellent preparation, and equally useful to the cook of a private family as to that of a restaurant ; and invaluable to travellers in the bush, to persons on a voyage, and to all, either as soup, beef-tea, or stock for the foundation of gravies.
Everything depends on the proportion used. It needs the addition, in some cases, of a little fat. It is moreover cheaper, when time and fire are considered, than ordinary made soup. Where however a little weak broth has been prepared from fresh meat, or meat bones, and this preparation is then added to it, it is not possible for such palates as I have submitted it to to distinguish it from freshly prepared soup.
Having said thus much on the two articles on which I originally began to study these preserved meats, I will now give you some account of the systems of meat curing, on the large scale, for expor- tation, in actual working among us, I mean in or near the city. I begin with Mr. McCracken's establishment.
Mr. McCracken is now manager of one of our largest meat pre- serving companies, known as " The Victorian Meat Preserving Company." A few days ago I paid that establishment a visit, and was courteously shown over its various departments. Meat is pre- served in several different ways, but so far as I could observe there was nothing absolutely new in the methods adopted. The distinguish- ing, or, at any rate, the remarkable points were extreme cleanliness and attention to the minutiae of the various operations. The most interesting portions to myself were those in which what are called
Glasgow hams are prepared frim beef, and the curing of the whole sheep. This latter operation needs a little description :—The whole sheep is carefully boned, and the entire flesh left in one piece. One would think this scarcely could be done ; but 1 saw it done. The meat is then washed in one or two brines, not made very salt, spiced slightly, rolled up tightly, and tied like a roll of bacon—smoked a little sometimes—and then packed in ship's tanks in perfectly new and sweet tallow. Of course it is plain that this meat, so cured and packed, will keep any reasonable length of time. I should have said, however, that the inner fat, the " leaf fat " of the sheep, as well as any other fat available from other processes of preserving mutton, is rendered down and yields the tallow.
In this place I should make mention of Mr. McCracken and his works :—Mr. McCracken, formerly of Hobart Town, was one of those fifty exhibitors at the late Intercolonial Exhibition who obtained one of the Commissioner's special medals for rare and extraordinary zeal, skill, and labour, exhibited in domiciliating among us a new industry, and had there been a greater number of those peculiar distinctions to be awarded, Mr. Sizar Elliott, of Brighton, ought to have shared the honour, as a successful preserver of meat long ere Mr. McCracken was known in Victoria. But. Mr.
McCracken was in the field and at work in 1867, while Mr. Elliott had long ago given up all idea of looking to meat curing as an industry, and personally as a source of emolument. I hardly can, without being considered invidious, go into the details of Mr.
86 Medical Society of Victoria. [March, Elliott's work, since he has published them long ago in the Transac- tions of the Royal Society.*
WEDNESDAY, FEBRUARY 12, 1868.
ADJOURNED MEETING.
The President, Dr. Neild, in the chair.
Present :—Dr. Neild, Dr. Bleasdale, Dr. Martin, Dr. Jonasson, Mr. Fletcher, Mr. Gray, and Dr. McCarthy, with several visitors.
The President stated that the previous meeting of the Society had been adjourned for the purpose of obtaining the report of a Sub- Committee on the various samples of preserved meats which had been forwarded to the Society. The Sub-Committee had met three times and had examined fourteen specimens, a detailed account of which had been drawn up.
Dr. BLEASDALE then read the report, which was adopted, and which a press of matter compels us to hold over for the present.
WEDNESDAY, MARCH 4, 1868.
ORDINARY MONTFILY MEETING.
Present .—Mr. Girdlestone, Mr. Blair, Dr. Neild, Mr. Gillbee, Dr. Martin, Dr. Black, Mr. Grey, Dr. Cutts, and Mr. Fletcher.
The President, Dr. Neild, in the chair.
ELECTION OF NEW MEMBERS.
J. Fulton, M.B., Glas , and L.F.P.S.G., and Nicholas Avent, M.R.C.S. and L.S.A., were elected members of the Society.
CASE OF LITE OTRITY.
The President read for the author, Mr. MacGillivray, of Sand- hurst, a paper with the above title, the publication of which is unavoidably postponed. On the motion of Mr. Gillbee, seconded by Mr. Girdlestone, the thanks of the Society were accorded to Mr.
MacGillivray.
PATHOLOGICAL PREPARATIONS.
The President exhibited the following pathological specimens :—
Scirrhus of the sigmoid flexure, causing intestinal obstruction, for the relief of which Amussat's operation had been performed. For- warded by Mr. MacGillivray.
Uterine tumour, expelled after the administration of Ergot and Tincture of Opium: Forwarded by Mr. Ford.
ASPHYXIA FROM THE INHALATION OF CARBURETTED HYDROGEN.
Mr. GILLBEE drew the attention of members to a case he had that day been called to, of a woman-servant who had nearly been suffo- cated by the inhalation of carburetted hydrogen gas. She had been sleeping in an ill-ventilated apartment, beneath the floor of which there was an escape of gas, and when found in the morning she was
• Through want of space the rest of this paper and the judgments of the Meat Jury of the Medical society are held over for our next number.
1868.] The Value of Health Officers. 87 comatose. A peculiar feature in the case was the circumstance of her master being a person of disreputable antecedents, so that in the event of the girl's death, there might have attached to him some suspicion of foul play. Mr. Gillbee therefore had thought it well to place the case on record, as possessing some interest of a medico- legal character.
g\ustralian Okra Agana',
MARCH, 1868.
•
THE VALUE OF HEALTH OFFICERS.
In the report of the meeting of the Borough Council of St. Kilda, of February 24, the following paragraph occurs under the head of " Correspondence ":—
" From Dr. W. A'Beckett accepting the office of health officer, at a salary of J.:20 per annum."
This is, unfortunately, one of the too many examples in which members of our profession damage the general interests of the body to which they belong by contracting to undertake the performance of important services for alto- gether insufficient remuneration, solely, as it would seem, in order to gain some temporary advantage over their fellow- practitioners. The borough of St. Kilda is a wide district, requiring close and careful sanitary supervision. It is inha- bited, for the most part, by a wealthy, well-to-do class, to whom sanitary precautions should be important, and who should be willing to pay adequately for the services that a Health-Officer is able to render them. If the medical profession were not unlike every other profession, in the singular disposition of its members to injure themselves by trying to gain very small advantages over each other, no public body would venture to offer such an insult as to fix twenty pounds for the salary of its Health-Officer; but the Borough Council of St. Kilda were, no doubt, shrewd enough to know that they would be quite safe in making such an offer, and that somebody would be sure to accept it. In the adjoining borough of Prahran, where some time ago a protest was entered and a stand made, against the attempt of the municipal body to obtain an honorary Health-Officer, they were obliged to give a salary of £100, and the present incumbent of the office is now in the receipt of that sum.
They would have given £20, or less, or even nothing at all, if they had not known that an agreement had been entered into by the medical men in that neighbourhood, not to accept
