THERE is little fresh to report from the Students' Room. Already there is a marked tendency. to renounce the pomps. and vanities of the early part of the year, and settle down to work. The burning question of single subjects has been shelved so far as this year is concerned, and the wrangling that was once heard has settled down into a quiet talk
re
football, 4c.We have heard Dr. Chas. Ryan give us some delightful and spicy reminiscences of the Russo-Turkish war, but none more so than those of Thursday, 12th June. Charley has seen some stirring scenes of real life without doubt, and we could not but regret that we were not there on the occasion when he was introduced to the charming lady of Mr.— after not having seen a lady for so many years. We know it's bad enough not to see our best girl for a week, and to be without the sight of a charming lady for two years—well, we could not endure it.
Charley also said that dancing with ladies in Turkey was expensive ! In what way ?
We would like to point out to those gentlemen who are in the habit of doing the block on Saturday mornings that the mirror under the stairs is specially reserved for the lady students.
Once again are the nurses in arms. They have as many wrongs as Ireland to redress, but on this occasion we heartily sympathize with them. We also must regret the loss of Nurse Smith, who died from a tumour in the brain, and it does seem as if a screw were loose
somewhere, in that the case was not taken in hand earlier. The select committee, no doubt, will discover something, but what that something is will be hard to say.
We must congratulate the winner of the billiard tournament on his fine play, and we are glad to see that the Medicals keep up these little pleasures, which break the monotony of the work, and hope, when we get a billiard table of our own at the University, we will be able to produce an Evans.
During Dr. Molloy's absence in Sydney, Dr. Boyd has been taking his place. He has a beautiful auburn side appendage now to distinguish him from our Tom.
We have lost Dr. Clayton from the Women's Hospital. It is another Instance of the incompetency of women to legislate with regard to
a
nything where personal feelings are concerned, and the sooner such bias retires from the committee the more likely will justice and rightbe meted out. It does strike us as strange that the committee of the Women's Hospital cannot be made to see that a doctor should know more of the routine of a hospital than they themselves do. It was unfortunate for Dr. Clayton that he did not resign when he found that the committee were hostile to him, as evidently there was a want of candour on their part, and we tender him our heartiest sympathy on.
this occasion.
The residents at the Women's have always done their best for the students, and especially must we refer to the excellent clinical instruc- tion given by Dr. Fetherstone. He was a distinguished student of Dublin University, and spent some time at the Rotunda there. He has long
the M.D. of Melbourne, and students may rest assured that as
long as he has charge of the infirmary department of the hospital there Will be the same efficiency and high standard which it at present enjoys.
.We must congratulate Dr. Martell on his appointment, also our P
'end Dr. Peebles. No doubt when they leave there will be a high demand for their services.
Pathology Notes.
ALFRED HOSPITAL : POST-MORTEM BY DR. Al AUDSLEY. —Case of girl, tet• 19. History of severe anaemia ; died suddenly, before any further history could be obtained. P. M.—Body plump and well nourished, skin clear, but very anaemic, lips anaemic ; no wounds or bruises.
Internally organs all very anaemic. Small amount of fluid in the pericardium. Heart pale. Right ventricle distended, with dark fluid Wood. Left ventricle firmly contracted. No valvular lesions ; slight and patchy fatty degeneration of the walls. Lungs pale and anaemic.
barge ante mortem clot impacted in the pulmonary artery, completely plugging it. Liver normal. Kidneys normal Stomach—no ulcera- tion or congestion. No signs of poison. Intestines rather loaded with Ucces ; no ulceration or tumefaction. Spleen large, but normal.
tterus—no lacerations. Ovaries full of small cysts. Vagina—no sign of inflammation of the lining membranes, but venous plexuses filled
82 THE SPECULUM. June, 1890.
with dull grey clots. On opening the right iliac vein a large clot, several inches in length, and corresponding in appearance to that found in the pulmonary artery. The pelvic fascia, on the right side, was much thickened and indurated. No evidence of any bone or hip disease No clot found in left iliac vein. The lining membrane of larynx and trachea was found to be slightly injected in places, presenting a mottled appearance. Cause of death, asphyxia, through blocking of pulmonary artery, cutting off arterial supply of lungs.
MELBOURNE HOSPITAL.—An old man, on whom some weeks before a supra-pubic lithotomy was performed, was found to have in front of the bladder and beneath the peritoneum a sloughing mass, impregnated with calcareous matter. This was only prevented from bursting into the peritoneum by adhesions to the descending colon.
The left ureter, which was double for some short distance, was greatly dilated, and the left kidney showed pyelitis, which was then just beginning to give rise to surgical kidney. The right kidney showed 11 0 signs of suppurative mischief. There was no perinieal wound.
HYDATIDS.—(1 ). A woman, at. 64, had an emphysematous left lung, with several small hydatid cysts on the surface, also a suppurating hydatid and an old cicatrix. The right lung contained suppurating cysts and was bound down, and so accounted for the emphysema of the left. The liver contained one large mother cyst, and several small daughter cysts. These daughter cysts, instead of growing towards the inside of the mother cyst, as is usual, had grown outwards. This, though common in animals, is rare in man. Kidneys were undergoing atrophic changes, and were probably the cause of death. Gall bladder was
distended, and contained a number of small gall stones.
(2). A very large hydatid was seen in a middle-aged man It extended from the third rib down into the pelvis. It was confined to the right side. The task of counting the daughter cysts would have been so severe that no one would volunteer to do it.
The Toenia Echinococcus is a tape-worm, not a quarter of an inch in found in the intestines of dogs and other animals. It consists of four segments, the last of which produces the ova, and when fully developed, is equal in length to the other three. A mature tTnis contains hundreds of ova, which have hard shells and contain the six-hooked embryos. The ova, having escaped from the animal and found their way into the drinking water of man, are taken into his stomach. Their hard shells are dissolved, the six-hooked embryos are set free and bore their way into the veins, and are carried into the liver, where they remain and form the cysts, or else they pass to the right heart and are distributed through the lungs and settle there, or they may gain the general circulation and lodge in any part of the body'.
The embryo, having found a settlement, is soon surrounded by a zone of
condensed connective tissue, formed from the organ in which it is situated. This is called the adventitia. In a couple of months the embryo has undergone such changes as to produce a mother cyst containing delicate cells, which liquefy, so that now there is a central fluid contained in a cyst. This cyst consists of two layers, the outer ecto-cyst is laminated, but otherwise homogeneous, elastic and structure-
less, and the endo-cyst, which is more highly vitalised and is made up of small polygonal non-nucleated cells, and so called the cuticular layer.
"- is in this cuticular layer that the brood-capsules form, and in these
°rood- c aps ules there may develop scolices, numbering from one to twenty for each capsule. The daughter cysts arise either from dilatation of the capsules, or by the scolices themselves changing into cysts. The rule is in man for the daughter cysts to be found inside the parent cysts, but an example is given in case 1 of the exogenous formation. In a similar way to the formation of daughter cysts, grand-daughter cysts
1318,37 develop. These cysts may enlarge and burst, or may retrogress and be found to contain a putty-like substance. Bile in any considerable quantity proves fatal to the cyst, and may cause suppuration, however it need not do so, and suppuration, moreover, follows injury, and sometimes comes on without obvious cause. Hydatid fluid by transmitted light is opalescent, in reaction it is usually neutral. Sp. gr. is low. There Is. no albumen, but there are chlorides present. If there be a sediment It is chiefly scolices.
The University of Melbourne.
FINAL HONOUR EXAMINATION, FEBRUARY, 1890.
FIRST CLASS.
SECOND CLASS.—Thomas Cherry (Ormond College).
'TRIED CLASS.—Walter Thomas Harse, Walter Hansford Bracewell, William Isaac Boyes, George Owen Rigby, Walter Herbert Jermyn.
The Scholarship awarded to Thomas Cherry.
813RGERY AND OBSTETRIC MEDICINE AND DISEASES OF WOMEN AND CHILDREN.
FIRST CLASS.—Walter Herbert Jermyn.
u.,SDCOND CLASS --George Owen Rigby, William Isaac Boyes ; equal—George
" illiam Damman, Walter Hansford Bracewell.
otTanto CLAss.—James Ramsay Webb (Trinity College) ; equal—Thomas 'erY (Ormond College), Frank Montgomerie Peebles.
The Scholarship awarded to Walter Herbert Jermyn.
11th March, 1890.
HONOUR PAPERS.
THEORY AND PRACTICE OF MEDICINE.
CLASS LIST.
MEDICINE, FORENSIC MEDICINE AND PHYSIOLOGICAL MEDICINE.
1. Contrast the symptoms and course in cases of (1) Acute Myelitis, (2) Landry's Paralysis, (3) Haemorrhage into the spinal canal.
D2
Iq
84 THE SPEC UE TJ M. June, 1890.
2. What is Lardaceous Disease ? Describe its chief seats, its causes, symptoms, prognosis, and treatment.
3. Describe the attitude most frequently assumed by persons suffering from (1) Spasmodic Asthma, (2) Angina Pectoris, (3) Advanced Cardiac Dropsy, (4) Pericardial Effusion, (5) Pleurisy in its different stages.
CASES FOR COMMENTARY.
1. A child, aged 15 months, has been suffering from whooping cough, when, from some cause, she is affected with violent convulsions, which recur for 2 or 3 days. There is marked twitching of the muscles of the left side of the face, and during the whole time she is in a semi-comatose condi- tion. It is discovered that very complete paralysis of the right side has come on ; but, after consciousness returned, it was noticed that, though there was no power of voluntary movement, an occasional jerking move - ment of arm or leg accompanied a fit of coughing or some excitement.
What was the exact nature of the pathological condition present ; and by what additional symptoms would you be able to decide ? Discuss also the treatment and probable termination, on the view which you adopt as to the cause of the paralysis.
2. C. D., male, at. 25, had suffered with cough and expectoration for over two years before coming to the hospital. On admission he was weak and emaciated, cough was present, especially night and morning, with profuse expectoration. Physical examination of the front of the chest on the left side, over a space extending from the clavicle to near the nipple, revealed on inspection—retraction of chest wall, with impaired respiratory movements ; on percussion—dulness and well-marked" cracked pot " sound ; on ausculation—the heart sounds abnormally audible, the vesicular murmur replaced by cavernous breathing and gurgling.
Occasional sibilant and crepitant riles were heard elsewhere ; but the percussion note and breath sounds were fairly good over the rest of the pulmonary area. The heart sounds were normal, and the pulse equal at both wrists. Up to this time no lnemoptysis had occurred. Two days later, as patient was walking from the closet to his bed, profuse haamoptysis came on ; dark (venous) blood poured from his mouth and nostrils, and he died asphyxiated almost immediately.
Comment on above case, with a view to making a diagnosis of its different stages, and the post-mortem appearances.
FORENSIC MEDICINE.
1. Enumerate the indications of maturity in a new-born child, including the dimensions of the bones.
2. What are the signs of virginity ; and what are the appearances conclusive of rape having been completely effected ?
3. Mention all the acknowledged proofs of death, and say which of these in your opinion is the most conclusive.
4. Give the chronological order in which the phenomena of putrefaction occur.
State also what are the conditions which modify the appearance of these changes.
5. What is the procedure to be adopted, chemically and microscopically, in the examination of supposed blood stains ?
6. What various conclusions are to be drawn from the appearance of the mucous membrane of the stomach ?
7. What are the various procedures to be adopted in the examination of person presumedly insane, with the view to placing him in a lunatic asylum ?
8. What are the four recognised forms of insanity, and what are the indications characteristic of each form ?
9. Describe the symptoms and post-mortem appearances in poisoning by the several preparations of lead and antimony.
SURGERY.
1• Mention the various tumours found within the scrotum, and give the symptoms and diagnosis of each variety.
2. Give the symptoms, diagnosis, and treatment of a penetrating gunshot wound of the chest, in which the bullet has perforated the lung.
CASES FOR COMMENTARY.
1. A gentleman was riding at a gallop, his horse swerved and he fell heavily, striking the left side of his head on the ground ; he was immediately picked up, he was insensible, but in a short time he vomited. On examination, 20 hours after the accident, there was a severe bruise, about three inches in diameter, at the posterior part of the left parietal bone, also some contusions on the left hand, but no other external injury. He could not be roused, and had not recovered his senses since the accident ; his mouth was slightly drawn to the right side, he frequently raised his right hand to his head, and moved his right leg ; he would also wrinkle his brow on the same side. On the left side hemiplegia was nearly complete ; the pupils of both eyes acted indifferently, he could swallow a little, slowly ; the breathing was rather noisy, pulse 122, and the temperature 99 . 5. His urine was drawn off on the day of the accident ; he passed some in the bed during the night.
2• A man, at. 20, who has for the last two years been subject to occasional attacks of diarrhoea and vomiting, is seized with abdominal pain and loss of appetite, followed by vomiting ; the pain soon becomes severe, and there is absolute constipation. On the third day of the seizure his temperature was 102.4, there was intense abdominal pain and tenderness, with distension, some occasional bilious vomiting, and a small patch of slight redness, without any marked swelling, was observed in the right iliac foam.
a.
A boy is brought to a hospital, having received 18 hours previously a small punctured wound from a pair of scissors in the mid dorsal region, about an inch from the mesial line ; it can be traced by a probe to pass towards the spinal canal. A clear watery fluid is seen escaping from the puncture ; it has been escaping ever since the receipt of the injury, and has saturated his clothes.Give your diagnosis, prognosis, and treatment in each of these cases.
OBSTETRICS AND DISEASES OF WOMEN AND CHILDREN.
1. Give the chief pelvic deformities, with respective causes, mechanism of 2. delivery, and treatment.
Describe Rupture of the Uterus, the causes, site, symptoms, prognosis, and treatment, preventive and immediate.
13•Give the structure, progress and changes, diagnosis, prognosis, and treatment of Fibrous Tumours of the Uterus.
NOTES ON THE EXAMINATION PAPERS.
Of the papers comprising the School of Medicine and Forensic Medicine the 'commentaries are the only satisfactory ones. The Medicine paper is catchy,
-!-4,_endry's paralysis, for instance, being a disease interesting rather than '4ePortant ; and the Forensic paper, covering as it does almost the whole
4111bJect, was surely intended for three days instead of three hours. No
examination can be a proper test of a student's knowledge if the papers are .44? long that he is obliged to give the answers to a large extent in outline.
'Ile Surgery and Obstetric papers compare most favourably with those of the 'other school in every respect.
86 THE SPECULUM. June, 1890.
Social.
THE first social of the M.S.S. for the present year was held at Parer's Café on the evening of the 1st April. The usual custom of holding It at the end of the term was departed from in this case, in order not to clash with the socials of the other societies, which are also usually held at the end of term. Our old friend, Professor Halford, occupied the chair, and he was supported on his right by the Chancellor. That we should have two such fine old men at our social was very gratifying to all. Besides these, several others of our teachers were present, and many visitors who had accepted invitations. Mr. E. Strahan opened the ball by singing the 'Varsity Anthem, several new and original verses having been introduced for the occasion. Professor Halford proposed "Alma Mater," and the Chancellor replied in a very sympa- thetic speech. Dr. O'Hara, who was received with enthusiasm, sang in splendid form, and an encore was insisted upon by our chairman, to which Dr. O'Hara responded, and, by special request, obliged later on in the evening. Mr. Simons recited in his usual characteristic style.
Mr. Freyer proposed " Our Teachers," and Dr. Balls-Headley responded.
Messrs. Morris and Destree rendered an excellent pianoforte duet.
Mr. Francis related in musical style the story of a fine old Irish gentle - man, which seemed to go to the hearts of many present, and necessitated an encore, in which he told us about a very curious dinner-partY.
Mr Champion grew eloquent on the subject of " By Jabers," and several other vocalists rendered selections. The choruses were well responded to by all present, the chairman and Chancellor both joining heartily in. The toast of " Kindred Societies," proposed by Mr.
Godfrey and responded to by Mr. Groom, was followed by " Auld Lang Syne," which concluded a most enjoyable evening."
The Hare and Hounds' Meet.
THE annual meet of the Medical School Hare and Hounds, which had been eagerly looked forward to for some time previously, came off on Thursday, 17th April. Additional interest was lent to it on this occasion from the fact that Dr. Springthorpe had offered a gold medal to the first hound, provided that twenty should start. It was decided that the run should take place from Camberwell to Heidelberg Fortune favoured us in the matter of weather, the day being a perfect one for the sport.
On arriving at Camberwell it was seen that some forty had assembled, nearly every section of the University being represented, a number having decided to walk by the road. The hares for the occasion were Messrs. Champion, Davies, and Jackson, and they were allowed ten minutes start, each one carrying a large bag containing material for the trail. They were soon out of sight, and the hounds waited eagerly for the time to elapse till they were to start. On the word being given, about thirty started off, some of them at a great pace, which it was