At last the medical profession can congratulate itself on a measure of recognition being accorded to its claims for fuller representation on the governing board of the University. For the vacancy created by the death of Sir Redmond Barry, three gentlemen were nominated—Dr. Fetherston, Dr. Graham, and Sir Bryan O'Loghlen ; the two latter have withdrawn their names from the list of candidates, so at the next meeting of the Senate, Dr. Fetherston will be declared elected without opposition. Dr.
Graham's consent was, we believe, not obtained by his proposer and seconder before nomination, a practice to which grave exception can be taken. But we congratulate the retiring gentlemen on the good feeling which has at last secured the return of a medical candidate : the thanks of the profession are due in especial to Sir Bryan O'Loghlen for his courtesy in declining to oppose the medical representative.
38 Australian Medical Journal. JAN. 15, 1881
liftelhournt otialrientr 6mgre5s,
( Continued from VOL. II., page' 559.)
On the Comparative Immunity from Disease among the Jews.
By DR. LOUIS HENRY.
The author says that statistics show the Jews to have been but very slightly affected by epidemic diseases ; that they are not so liable to be infected by typhoid, cholera, consumption, inter- mittent fevers, syphilis, and puerperal fever as other races ; that their vitality and longevity are very high ; that suicides are rare ; that they marry early ; that a larger proportion of boys is born.
Explanation of these statistics is offered by a review, historical and critical, of the Sanitary Laws of Moses. These are-
1. Dietary laws : their origin and effect. (a) Clean and unclean animals. (b) Selection of parts of clean animals.
(c) Mode of slaughtering animals.
2. Hygiene of the body. (a) Baths, cleanliness of the person. (b) Puerperal fever.
3. General hygiene. (a) Moses the regenerator and reformer ; his objects. (b) The preventive treatment of diseases.
(c) Isolation and disinfection. (d) The terms leprosy, stroke, plague, in their different applications, are explained. (e) The germ theory of disease was known to Moses. (f) The conservancy of the soil, air, and water. (g) Mosaic ordinances and the present day.
(h) Prevention of filth diseases. (i) There was no overcrowding, even among the poorer classes, and there was an annual cleansing of homes. (j) The disposal of the dead.
On Infant Mortality. By DR. JAMIESON.
The author refers to the various modes of estimating infant mortality. A comparison between different localities is possible only when the number of deaths in infants under one year is calculated on the basis of the number of births in the same period.
The Victorian rate, though unnecessarily high, is lower than in
most countries, amounting to 123 deaths to 1000 births. The Melbourne rate is disproportionately high, viz., 168 per 1000, and greater than that of London. Climate, for the most part, acts only indirectly, high or low infantile death-rate being mainly a question of feeding The excess in the Melbourne rate depends mainly on diseases indicating mal-nutrition, the result of artificial feeding. Much of the milk sold in Melbourne is bad. Mal- nutrition is best prevented by rearing infants at the breast, but benefit would result from proper control of the milk supply. The example given in some German cities of producing a superior quality of milk for infants might be followed, cows being specially kept in town and carefully fed. Ice might be used for preserva- tive purposes.
On Contagious Diseases. By MR. H. K. RUSDEN.
The deaths from contagious diseases amongst us the author regards as disgraceful to our civilisation. Many people act, he says, as if they desired nothing so much as to spread them as widely as possible, though many hundreds die yearly of them ; and some other diseases are known to have been spread inten- tionally. Legislation is therefore demanded.
Heholds that such diseases as are contagious are therefore preventible, and should be extirpated. We exclude small-pox by quarantine, and we should exclude all other contagious diseases in the same way. While we have quarantine-vaccination, he thinks it useless and tyrannical. Those who like it are welcome to protect themselves by vaccination, and it is intolerant interference to make it compulsory on those who regard it as evil. Quarantine answers every purpose, and should be rigidly enforced among ourselves in the case of every contagious disease.
The Health Act here he regards as a dead letter, and it should remain so, being iniquitous and tyrannical. It oppresses one class to benefit another which does the most mischief. Experience, however, proves that all laws of this kind do more harm than good, and aggravate the very evils they were meant to lesson.
The principles which should form the basis of a Contagious Disease Act are :-
1. It should apply to all contagious diseases whatsoever.
2. Hospitals should be licensed to provide isolated wards or beds for those who do not want to be isolated privately, and at public cost for those who cannot pay. Those
might be treated privately who can afford the separate isolation, but a sub-officer of health or a constable should have entire charge and control of the isolated patient, and have power to make the isolation perfect. A con- spicuous flag, with " Contagious Disease " on it, without specifying what disease, should be displayed at the entrance to the isolated premises.
3. To find the diseased, confidential weekly returns of every case known indirectly or directly of any contagious disease should be exacted, under heavy penalties for evasion or neglect, from every medical man and chemist, and all attempts to evade isolation should be strictly penal. Names of persons or diseases should not be made public, unless in cases of obstruction or evasion of isolation. The confidential return should be made weekly in duplicate to the Chief Police Officer and Health Officer. The co-operation of the profession should be confidently anticipated, and to attempt obstruction or evasion should be regarded as socially disgraceful as well as criminal.
Such an act he thinks would abolish contagious diseases where- ever applied, and the successful example would be widely followed.
5000 more persons under 20 years of age would be saved here yearly, and 200,000 in England, and the saving in money, happiness, and health would be very great.
On the Forests and Timber Growths in Victoria in Relation to Health Conservation and Culture. By MR. BORST°, M.L.A.
The author refers to the timber condition of the colony at its foundation, and to the advance made since then in population, this increase levying heavily on our timber resources.' He points out the destructive use the people of any country will make if not prevented by stringent rules, of the indigenous products of the soil. For this reason many evils have arisen from free selection in timber districts. Therefore the forests are subjected to diminution, and even to annihilation under certain influences.
The destruction of timber goes on by selectors, and no provision is made for future wants, so that our timber resources are becoming greatly exhausted, notwithstanding that repeated warnings have been given to the state. The views, severally, of sanitists and politicians, of the value of our tree vegetation
40 Australian Medical Journal. JAN. 15, 1881
unfortunately conflict. Should this destruction continue, however, it is probable that serious climatic changes will ensue. Such changes have happened in the Mauritius. Forests are needed for a supply of water, and the system known as " ringing" leads to floods in winter and to scarcity of water in summer ; and the influx of floods over low-lying lands reacts seriously upon health.
He reviews the present forest area and its condition, and urges the need for further lands being set apart. A Forest Trust should be appointed, independent of Government control.
On Hospital Architecture. By DR. HENRY.
The author draws attention to the progress in medicine, and the nevertheless ignoring of the medical profession when hospitals are designed. The germ theory of disease requires to be recog- nised in such designs. He submits plans, showing that all the wards should be at least five feet from the ground to secure proper ventilation and prevent accumulations beneath the floors.
He thinks hospitals should provide for the accommodation of different classes of (paying) patients. He describes the closets, their draining and ventilation. He insists that the floors and walls should be smooth and easy to be washed ; that there should be a proper supply of gardens and outhouses ; that buildings for isolation and disinfecting purposes should be provided ; and that a proper amount of breathing space should be secured.
On the Prevention of the Spread of Infectious Diseases. By MR. T. R. WILSON.
Mr. Wilson is of opinion that much of the sanitary effort of the present day is in the wrong direction, in consequence of too much -attention being given to what is known as sanitary improvement rather than to isolation. He draws attention to the increasing recognition by legislators both here and in the old country of this necessity. The compulsory registration of disease he regards as an important ally of this principle of isolation.
Notes on Ventilation. By MR. LE CAPELAIN.
The paper gives an outline of the principal methods of venti- lation employed in Europe, and selects, as the most applicable to this country, that which is called " Natural Ventilation,"
described as a simple, cheap, and efficient method of providing
42 Australian Medical Journal. JAN. 15, 1881 ventilation for all kinds of buildings by a careful arrangement of inlet and outlet openings, disposed and distributed in the best manner to utilise the difference of temperature between the outer and inner air, so as to create a movement and change in the atmosphere of rooms. After showing substantial reasons for adopting this method in preference to any of the others, which are all artificial ones and expensive in their modes of application, the paper treats of various contrivances and means of putting the selected method into successful operation.
ertrarts from t4e Nome IJIrmrtrals.
The Lancets for November are to hand, and open with an address on the treatment of puerperal fever, by Matthews Duncan, who urges very strongly the local application of disinfectant, especially carbolic lotion, to the vagina or uterus, thus preventing putrefactive material from entering the system. He uses ergot as well. He makes a distinction between pyamia, septicaemia, and sapnumia, and it is to the last that his remarks mainly apply.
The question as to the infection of phthisis is exciting much interest, and Dr. Reginald Thompson affects to distinguish from the symptoms and course of phthisical cases such as are infective or not, but we do not think there is any marked distinction between the two classes.
From India Surgeon-Major McCann reports several successful internal urethrotomies by Teevan's instrument.
Chloroform is protested against by Dr. Jacob as a dangerous anesthetic, and Dr. Saundby carefully distinguishes the cases suitable for chloroform and ether. For young children, in operations about the face, in fractures, hernia, Svc., where muscular relaxation is required, chloroform is to be preferred.
Ether should be avoided where any lung mischief is present, or where the right heart is weak. Stertor is a good sign with ether, but bad with chloroform. The pulse gives no useful indications.
He prefers ether generally, and it appears to be the practice of the large hospitals now to use ether alone, or mixed with chloroform.
Nitrous oxide is recommended in operations for squint.
From Glasgow is reported the removal of an epitheliomatous L.
growth in the tonsil, while the patient was kept under chloroform, by a tube in the larynx.
Dr. Yeo relates the rapid cure of an asthma by the induced current applied to the throat over the great nerve trunks, and Althaus publishes a cure of tarsal tumours by electrolysis.
It is pointed out that the aspirator is useful in the diagnosis of bowel obstructions, inasmuch as the presence of faeces in the canula indicates that the obstruction is below the line of puncture.
Casca bark, in the form of tincture erythrophlcei, appears to act similarly to, if not better, than digitalis.
Mr. Grattan, of Cork, effectually secures Sayre's jacket by slipping in between the layers of the bandages a piece of telegraph wire on each side and stitching it in.
Buzzard, on tendon reflex as an aid in diagnosis, is worth reading, although it is doubtful whether there is any real reflex action at all.
From University College Hospital Mr. Heath publishes the particulars of a case of extensive epithelioma of lower jaw and mouth, which, at the end of two years after the operation, was found doing well.
At the Medico-Chirurgical Society, a long debate took place on the nature and treatment of genu valgum : a strong protest was made against the indiscriminate osteotomies now so fashionable.
Dr. Macewen, of Glasgow, has just published a book on this subject, the most noticeable feature in which is the record of the great immunity from after mischief from the operation.
At the Pathological Society, Dr. Hilton Fagge opened a discussion on Rickets, and in an article on the question, the Lancet is inclined to doubt whether Rickets is not due to a mere general debilitated condition rather than a specific malady. Its association with syphilis is doubtful.
At the Clinical, was read a paper on stretching the facial nerve for spasm of the facial muscles. The nerve was cut down upon just behind and below the ear, and a cure resulted.
At another meeting of the Medico-Chirurgical Society, an elaborate paper was read by Dr. Champneys, detailing the results of experiments upon the various methods of inducing artificial respiration in new born children. All those who took part in the debate, agreed with him in the superiority of Silvester's over the other eight methods which have been proposed.
44Australian Medical Journal. JAN. 15, 1881
The Guy's Hospital quarrel is still going on ; and the senior- physician, Habershon, and senior-surgeon, Cooper Forster, have resigned.
It appears from some recent experiments on snake-bite, that some varieties of the poison are barely absorbed if injected into the cellular tissue, but very rapidly if introduced into the blood.
A new section, devoted to pharmacology and therapeutics, makes its appearance ; and a new antiseptic, resorcin which is obtained from resins, especially from galbanum, is announced. It is valuable in wounds, ulcers, &c. ; it is also a diaphoretic and an antipyretic, as well as a specific in intermittent fever. Hydro- chinon is an ally of resorcin, but stronger ; neither cause in solution any irritation of the skin, and are thus suitable for spray. Aconitin, conia, hyoscyamin, pilocarpin, and jaborin are among the other drugs treated of.
A discussion, started by Jonathan Hutchinson, is going on about the possibility of leprosy being caused by fish-eating.
Dr. Manson, of Amoy, in his researches into the causation of Elephantiasis Arabum has been able to definitely associate it with filarite. They live and breed in the lymphatics, and have the curious habit of resting in some organ during the day and entering into the circulation at night, by which means they are taken up by the mosquito who passes them on to its next host.
In the correspondence, a curious letter deals with music as
The possibility of phthisical infection is now well-established, and a writer applying this principle to practice finds the use of a naso-oral respirator charged with creasote a curative.
Pasteur's researches on the cholera of fowls go to prove that the virus becomes greatly attenuated and often impotent after a few months.
A correspondent points out that the hair used for mixing with mortar often contains septic materials, and it appears that the Chinese are in the habit of substituting for hair clean white paper made from the bamboo.
Calomel dusting is recorded as curative of pterygium. P. M.
In the Glasgow Medical Journal for October, Dr. Munro recommends the inhalation of the steam of a solution of carbolic acid and water (3j. to a pint) in diseases of the respiratory organs
—especially in their suppurative stages. He gives notes of six cases, four of phthisis and two of chronic bronchitis, in which he
has obtained exceedingly satisfactory results. The inhalations should be used frequently to be of any benefit. He does not Vaunt it as a specific in pulmonary phthisis, but he states that he is certain it has helped to cure some cases that would have otherwise died. The application of the acid in the form recom- mended does not interfere with, nor is it intended to supersede the use of constitutional and internal remedies. J. W.
CONVICTION FOR MALPRACTICE IN NEW ZEALAND.
We have received from a medical correspondent the following account of a trial which took place recently at Invercargill, and which deserves the serious attention of the profession : the imperfect record of the evidence given at the trial contained in the Southland Times for December 22nd, agrees in the main with the statements of our correspondent. On the 22nd December last, at the Invercargill assizes, Dr. Moffatt was convicted of malpractice and sentenced to two years' imprisonment with hard labour.
The facts of the case were as follows :—A woman, named Cameron, the wife of a shepherd living near Winton, came into that township so as to be near assistance during her approaching confinement.
She was taken in labour on the morning of the 28th June last, and sent for Dr. Moffat whose residence was near. The doctor visited the patient in the forenoon, and left, promising to come back in the evening. On his return in the evening, he found an arm protruding from the vulva ; and he accordingly tried to turn the child. The attempt was made between nine and ten o'clock at night, caused a good deal of pain to the patient, and failed of its object. Labour went on, and at two o'clock the doctor advised the husband to send for additional medical assistance from Invercargill, eighteen miles distant ; and he said that as he could do nothing till another doctor arrived, and as he himself was exhausted he should go home and get a sleep. The friends and the patient begged Dr. Moffat to stop, but he replied that he was too tired and went away.
Dr. Hanan arrived from Invercargill at 8 o'clock next morning.
Patient had continued in labour till after 4 o'clock, when she
46 Australian Medical Journal. J. 15, 1881 showed signs of exhaustion, and had great pain in the abdomen.
Dr. Hanan found patient in a state of collapse—pulseless, the arm protruding, and the shoulder impacted in the pelvis. He immediately proceeded to turn, which he effected without difficulty, gave directions for the after-treatment, and went away. After that the patient seemed at first relieved, and expressed her thankful- ness for the relief. About 10 or 11 o'clock Dr. Moffat called, and was astonished at what he heard, and complained about not having been sent for. Patient gradually sank, and died next day, the 30th June, twenty-seven hours after delivery.
The husband of the deceased laid an information against Dr. Moffat for causing his wife's death through carelessness or unskilfulness ; a warrant was issued, and Dr. Moffat apprehended.
Post mortent examination of the body revealed a rupture of the anterior wall of the uterus, extending diagonally through all the coats about seven or eight inches, and this was stated to be the cause of death.
The coroner's jury, after hearing the evidence, returned a verdict unfavourable to Dr. Moffat, and the coroner committed him for trial, accepting bail for his appearance, which was immediately forthcoming.
The trial took place at Invercargill, as above stated. Counsel for the defence held that no evidence of unskilfulness had been shown. That even if the rupture had been caused by Dr. IVIoffat in attempting to turn, this was nothing more than had repeatedly happened in the hands of the most eminent obstetric practitioners ; and that if it occurred during Dr. Moffat's absence, while he was waiting for assistance, being unwilling to undertake such a serious operation as evisceration single-handed, he was not to blame.
That even if blameable for not possessing the highest obstetric skill, this was not a fault for which he should be criminally prosecuted. • Besides, he requested the jury to remember that there was no proof as to when the rupture was produced, and he expressed his belief that the rupture was produced by Dr. Hanan in the operation performed by him on the deceased. There were four medical witnesses ; two of them believed that the rupture had been caused by Dr. Moffat in attempting to turn ; the other two could form no valid opinion when it took place.
The judge summed up adversely to the prisoner, the jury returned a verdict of guilty, and the sentence was two years' imprisonment, with hard labor.