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MAY, 1 9 10 .

Sternlulu Pint-et, Justice.

The Speculum

THE JOURNAL OF THE

MELBOURNE MEDICAL STUDENTS' SOCIETY.

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CONTENTS.

Pag..

.. . Notes and Cori n 1,•ei . Patent Medieiri,-

A Wanderer's Song .. It)

Our Ladies' Letter .. .. 20

THE WEE ILIA' SHILE . 24

Epidemic infantile Paralysis and its Occurrence in the Bendigo District .. . .. ..

The Boarding House .. .. .. .. • 34

The Annual Meeting .. .. . 35

An Interview with Prof. MaSson ..

Progress .. . • • • • • • - THE AT ILLEXN11 - .11 Commentary Column .. ..

HOW TO CURETTE ..

Jests and Indigests .. .. ..

Sporting Notes ..

Spicula .. • • • • • • • - On Dit .. • •

Old Boys .. . • s2

fileibourne :

PUBLISHED BY THE MELBOURNE MEDICAL STUDENTS' SOCIETY.

PRINTED BY AUSTRAL PUBLISHING CO., ELIZABETH ST., MELBOURNE.

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Footballs!!

Jerseys, Hose, Knickers, Boots, All Requirements.

RUNNING SHOES,

SINGLETS,

PUNCHING BALLS

KNICKERS, h. I *7 i5

AND GLOVES.

BOXING GLOVES

A SPLENDID VARIETY

.

INDOOR AND OUTDOOR GAMES,

THE MELBOURNE

SPORTS DEPOT,

55 4, 57 Elizabeth St., Melbourne.

(3)

May, 191o. THE SPECULUM.

ALICE MILLS,

- PHOTOGRAPHER

82 ELIZABETH STREET.

*

New Velosse Carbon Process.

Cartes from 7/6 per dozen.

Cabinets from 12/6 per dozen.

Wedgewood Portraits on View at Studio.

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pgtl

2 THE SPECULUM. May Tt)10

GEORGE ROBERTSON & CO.,

Propy. Ltd....

UNIVERSITY MEDICAL BOOKS.

Schaefer—Histology . • • . if) 12 6 Beddard, Hill, &c.—Physiology .. • o 15 o Hawk--Physiological Chemistry .. 18 6 Haliburton—Physiology . • .. 0 18 o Tigerstedt—Physiology

Cunningham—Text Book, Anatomy .. 17 o 6 Cunningham—Practical Anatomy, 2 vols. each .. 0 12 6 McMurritch—Development of Human Body .. 0 15 o Spalteholz—Atlas of Anatomy, 3 vols. .. 2 Io 0 Berry—Regional Anatomy, 3 vols. each .. o 6 0 Morris—Treatise on Anatomy ..

10 o Berry—Surface Anatomy ..

0 8 6

Green—Pathology .. • • • • .. o

Keith—Embryology

o 15 o

• • ..

Walker—Inflammation . o 5 6

Adami—Inflammation .. • • .. o 6 o

Muir & Ritchie—Bacteriology.. o 12 6

Bolduan—Immune Sera .. 0 8 0

Hutchinson & Rainy—Clinical Methods .. o TO 6 Lazarus-Barlow—General Pathology . . 5 0 Lazarus - Barlow—Pathological Anatomy .. 8 o Mitchell-Bruce—Principles of Treatment .. o2 o i6 g Martindale & Westcott—Extra Pharmacopoeia

Friedenwald & Ruhrah—Diet

i o o

Whitelegge—Hygiene and Public Health .. o 7 6 Dakin—Midwifery

Eden—M' •f g oo

Eden—Mid

Dudley—Gynecology .. .. • • .. 7 6

Osler—Medicine . • • • • • ..

Allbutt—System of Medicine, 8 vols., each . 1 8 Guy & Ferrier—Forensic Medicine .. o 16 Taylor—Medical Jurisprudence, 2 vols. .. 2 2

Rose & Carless—Surgery .. •• • • .. 5

Spencer & Gask—Surgery 6

Waring—Operative Surgery .. 0 12

Treves—Surgical Applied Anatomy .. o 9•

Treves—System of Surgery, 2 viols. 2 8 Binnie—Operative Surgery, Vol. I. o 15 Swanzy—Diseases of the Eye .. . • .. 0 12

May & Worth—Diseases of the Eye .. 0 12 Holt—Infancy and Childhood .. .. • • .. 7

Walker—Dermatology 0 12

Crocker—Diseases of the Skin, 2 vols. . i 16

Clonston—Mental Diseases .. o 17

Craig—Psychological Medicine .. o 15 507-113 ELIZABETH STREET, MELBOURNE.

0

6

0 0 0 0

6

0 0 0

6 6 6

0 0 0

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May, 191n. THE SPECULUM. 3

Ii. R. SILBERRERG CO.

443 BOURKE STREET,

CORNER BOURKE AND QUEEN STREETS,

Telephone 1 377.

ME LBOURN E.

Large and up-to-date Stocks of Chemical Glassware

and Scientific Apparatus Assay and Chemical Balances & Weights.

Microscopes.

CoverGlasses & Slips Merck's Chemicals.

Crucibles. Furnaces,

&c., &., &c.

Students' Sets a Speciality.

Terms Moderate.

Indents Executed.

MICROSCOPES and ACCESSORIES.

T. GAUNT 4- CO.

Have the most complete stock of Micro- scopes, Histological Cabinets, Dissecting Instrupents, Glass Slips and Covers, and all other accessories used by Biological and Medical Students.

Being Agents for Leitz's Microscopes, are now able to supply every student's re- quirements at the very lowest prices. Price Lists on application. All instruments sold subject to the approval of the Professors.

Mathematical Instruments. A large and varied stock of Drawing Insts. in sets. Dividers, Pen and Pencil Bows, Protractors, T Squares, Scales and Offsets, Parallel Rulers, etc. All instruments sold subject to the approval of the Professors.

Repairs Department.—Our Repairs Department is complete in every detail. Watches, Clocks, Jewel- lery, Spectacles, Surgical, Optical, and all Scientific Instruments requiring repairs shall receive prompt and careful attention and executed by the most ex pert workmen in Australia.

EYESIGHT TESTED GRATIS.

T. GAUNT & CO.,

Watchmakers, Jewellers and Opticians.

337, 339 Micalnrizie, eltriecert, lherarkscamirzate.

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60 Highest Awards

OVER ALL COMPETITORS.

SEABU RY' S

Medicated & Surgical

PLASTERS

U RP' o

s..LABoR4,.

ct

4 THE SPECULUM. May, 1910

Absorbent Cottons,

Manufactured from selected staple, carefully carded, instantaneous absorbency, neutral and tissued.

" Standard" Gauzes,

Packed in folds, preserved in antiseptic lacquered air tight containers.

Ligatures, Lints, Drainage Tubes, Bandages (all kinds) Oiled Fabrics.

SURGEONS' AStPTIC TOWELS.

" Perfection " Formaldehyde" Fumigators, Sulphur Candles, etc., etc.

DESCRIPTIVE PRICE LIST ON APPLICATION•

Sole Representatives :—

FASSETT & JOHNSON,

LONDON & SYDNEY Stocked by all Leading Wholesale and Retail Chemists and

Surgical Instrument Makers.

When ordering please specify " SEABURY'S."

SEABURY & JOHNSON,

New York, London, Sydney, Montreal & Hamburg.

(7)

QUEEN'S ARMS HOTEL

CORNER SWANSTON ST. & FLINDERS LANE, MELBOURNE.

Proprietress, Mrs. E. Champion. Trams to all the principal Suburbs pass the door. Easy access to Princes Bridge and Spencer-st. Stations. Spacious up-to-date Billiard Room. Two Tables (Alcock's) under the management of J. P. (Son) Donahoo. Applications for Rooms, Special Tables, Dinners.

Luncheons, &c., to the Manager, Mr. W. Champion. Phone, No. 970.

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Phone No. 902

MEDICAL SUPPLY DEPOT. Phone No 9°g

DENVER BROTHERS

Surgical Instrument, Truss Makers, & Importers of 0 ANTISEPTIC DRESSINGS & HOSPITAL SUPPLIES .

By Attointment : --111elbourne, Alfred, Women's, Children's Hospitals.

Students' Ha lf Skeletons

in Cases.

Skeletons, Fine st selected Articulated.

Disarticulated Skulls.

SKULLS, it e One, Two, Th re e Five Section 5.

Pelvic Bone s with Ligaments' Hand, Feet. Avil.

Bones,

\\i , h and Witho ut

Ligaments.

" Sp cial "

DisseeStitnugdecna ses., _ _

All Metal Asert.- Handle Instrume n t , 2 containing -3 Scalpels 2

Is. Scissors (disjointing) nu

Forceps, 3 Needles 4 0 handles), / Set Chain Hooks, in Oak s e , price 15/- each- V

a lue Cheapest and Best V a

Note.Special Discount allowed to Students off Surgical Instrum ents.

the STETHOSCOPES, MICROSCOPES, THERMOMETERS, SCALPELS,

e hse. States

SCISSORS, MICROSCOPIC INSTRUMENTS, HISTOLOGICAL SETS, &C., 8CC•

Repairs of Every Description Neatly Executed. New Goods arriving

by Every

COIL SWANSTON & LONSDALE STS., MELBOURO'

and at 281 GEORGE STREET, SYDNEY.

t

ParleLaal Boas

& Nasal Boom

S

11/poerrtnower 111ft 11. I es•ll

4 g.::Iffr:

it tinr.A1 tad Laois, VG:WM&

1. I otwoolanta.

Macron..

U. Humana 111. Radio.

It Ma.

earpna ilelacargona 21 Ph...n[6dr Ram&

Pl DUI.

Eft

Mao n..na PW4npa of ft..

4

(9)

May, 191o.

E

THE SPECULUM. 7

Speculum.

THE JOURNAL OF THE MELBOURNE MEDICAL STUDENTS SOCIETY.

N°. 77. MAY, 1910. Single Copy, 2/-

PRICE Extra Copies,*

Editorial.

The London Medical Student has of late been keeping him- self prominent in the public eye by his treatment of the Anti-

1,rivisectionist monument, and this time perhaps his escapade

15 being sympathetically smiled upon.

We had long believed the Anti-vivisectionist Society to be moribund, but it would appear that the Society is making a desperate effort for a life whose object is to retard the pro- gress of the whole scientific world. The ideas of this Society are such as would have disgraced a Conservative of the Middle Ages, and yet such a brotherhood exists with its narrow- nlinded prejudices in the beginning of the loth century.

, This Society, this band of myopes, appears neither to possess

the power of looking forward nor of looking backward ; it pan no more foresee the benefits to be derived from experiment

5Y the generations to come, than it can appreciate that the luxuries it enjoys at present are the result of the researches of the world's masters of Animal Physiology.

Does the most ardent Anti-vivisectionist's child contract diphtheria it immediately receives a dose of anti-toxin and is saved, and this as the result of the very institution which this monomaniac is trying to suppress. Does not the man himself it "safe at home" in the knowledge that he cannot be attacked by the scourge small-pox, which vivisection has almost wiped

°ff the face of the earth?

, These are examples which serve to show that the gains of humanity are sufficient to contra-indicate the existence of such a society, and yet we can easily defeat the Anti-vivisectionist

131-1 his own ground by considering the case "for the dog."

The researches of one man, Louis Pasteur, have been the means of saving in 20 years more animals than vivisection has

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Jo THE SPECULUM. May, I9 1°'

in a Labour centre, i.e., with howls of indignation, though one meets isolated students who are apparently satisfied with th e change. The majority of men, however, feel the whole ar- rangement to be an indignity, and the air is rent with cries of If I had only known."

Personally, the Editor, worn to a shadow of his former self, in the vain search for a few men to write a few lines for the SPECULUM, warmly welcomes the idea in the hope that it perhaps may be a means not only of bringing out the late ril literary ability which some coeds. must possess, but also 0' training their delicate imaginations to think and of producing the power to write down the glib lie which springs unbidden to their only human brains.

Already has the Judgment Book become a source of amuse' ment, and we look forward to the time when we can run our Spicula column on the Ward-book alone.

Let the reader note the romance in the following entry in a flowing hand, " Talked for 15 minutes to nurse, re case, etc.' " Read the world of pathos in the following line, written in the semi-professional hand of a fifth year man :-

" Attended Dr. Nihill's clinic for two hours."

We have often wondered how much the chap, who made the following confession, won :—

(I) 9.4o a.m. Dressed case.

(2) 12.10 p.m. Took history of case.

Perhaps we may be forgiven for being cynical and for per- sisting in our declaration that the scheme won't work.

At any rate, is it time spent in the ward that is to count, or is it to be a matter of work done ? It would appear that the advocates of the day ledger will show in December that the labourer is not worthy of his hire.

Even thus early the new Clinical Schools are showing themselves to be "no small beer."

St. Vincent's, probably on account of its propinquity to the University, has received the greater share of patronage, but the more distant Alfred has not been wholly neglected.

The exodus of third year men to St. Vincent's was so grea t that the list was overfilled, and in consequence nearly a dozen disappointed hospital tyros were forced to resign their place s' It was not expected that many of the present fifth year would leave the Melbourne, but nearly a dozen have takel up their beds and walked to "fresh fields and pastures new , and it may be added, are loud in their praises of the endeav-

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tlu

flay 1910. THE SPECULUM. If

°nrs that are being made by the authorities in their new

Schools to make them comfortable. Certainly the arrange- Merits for the personal comfort of students—in comparison those at present existent at the Melbourne—bear out the 'rite old adage that "new brooms sweep clean."

The following are the office-bearers for the year I9I0 :—

k-"resident, Professor Allen. Vice-Presidents, Professors Os- _ borne and Berry ; Mr. Hamilton Russell, Drs. Beattie Smith,

S

rray Morton, Jamieson, Maudsley, Rothwell-Adam. Hon.

?e., Mr.

Hon. Treas.,

L. M. Tymms. Asst. Hon. Sec., Mr. R. 0. Doug- reas., Mr. P. A. Parer. Asst. Hon. Treas., Mr. D.

frowning. Committee : 5th year, Messrs. Lorimer, Henderson, Malcolm. 4th year, Messrs. Giblin, Wilson. 3rd year, Messrs.

1-an, Lind. 2nd year, Messrs. Birrell, Davis. 1st year, Mr.

1. Leahy. Auditor, Mr. F. H. Langlands.

Still another instance of the farsightedness and wisdom of the President of our Society is shown in the new Lending ,Library Scheme. By this the Library Committee undertakes

1.0 provide a number of copies of the various books put clown in the Calendar as Reference Books, and to lend these to The for the modest sum of half-a-crown per annum.

l'he Committee also proposes to appoint the custodian for these books, so that the only duties which devolve upon the Needless are to collect the money and to respect the books.

'Needless to relate, the M.S.S. Committee pounced upon the sheme with the alacrity of a parish loafer on a pint pot. And

the freshman need no longer wonder why the retiring Seec- retary eulogised "The Prof." at the Annual Meeting.

Still another medical student has received the Rhodes Schol- arship. This year it is Mr. Frank Apperley, who is carried

away with a fashionable crowd on a P. & 0. steamer to the country where one only sees the sky on holidays.

The SPECULUM heartily congratulates "Ap." on his appoint- Ment, and expresses its firm conviction that he will return covered with glory and Oxford Blue.

Conjecture is rife as to the procedure to be followed in the future choosing of residents at M.H.

The present rule reads

" The residents shall be not less than five, and they shall be chosen from the students of the hospital."

(12)

12 THE SPECULUM.

Aay,

Clearly this rule was made to suit conditions obtaining many years before the introduction of new Clinical Schools, and 0n the opinion of the great majority of medical students should be amended so that the best men may be eligible. In the mean - while the fifth year man busies himself with "if this rule is nog amended."

(I) Will men who are doing fifth year in other hospitals be considered M.H. students in virtue of their entrance fee?

(2) Will the other hospitals retaliate with a similarly pro - tective and equally absurd proposal to choose their residents from their own students ?

At present the note of interrogation throws its darksonle shadow over the whole matter.

The Annual Theatre Night of the 'Varsity Students will be held on 3rd June.

The Anatomical and Anthropological Society, of which A. Giblin is Secretary for 191o, announces that its first meet - ing will be held on loth June.

The event of the season, the first M.S.S. smoke night, wil l be held on uth June, and is to be complimentary to an old and esteemed member of this Society. It goes without saying that a "bumper house" is being prepared for in the mos t (sic.). sumptuous manner All meds. join with the SPECULUM in heartily congratulating our friend Mr. McArthur on his complete return to health after an attack of "itis" accompanied by a surgeon cum scalpel.

In the same breath also—to mix the metaphor—do we eN - tend the right hand of congratulation to Dr. G. Shelton who is, according to his younger brother Turner, "in grand con- . dition."

Before the Editor begins to develop his periodical attack of writer's cramp over the next issue of the SPE:CULUM, there will be gone from our shores the Dean of the Faculty of Medi - cine and our popular Lecturer in Surgery.

Needless to remark, we wish them bon voyage and a safe return, combined with all the success which their merits are sure to bring them.

* *

A word of praise to Charlie Mackey and a whole sentence of the same article to Sister Gray for their efforts at reduction of Hospital Expenditure. Charlie has shown himself to be

(13)

May, 1910. THE SPECULUM. 13

borrow on gauze, for nowadays the forgetful student cannot uerrow a yard of white gauze from F.C.R. as in the days of Yore; ; neither does the nurse wipe the . germs from the ward with that expensive commodity as she was wont to do In the pre-draw-in-your-horns days. The lady appears to have been extra careful with the household goods, else someone would have been howling for more eggs, etc.

Patent Medicines.

The modern patent medicine vendor would appear in the

t

eat majority of cases to have given up the idea of selling Wares as a cure-all. Nowadays it is quite common to see the naive confession that some notorious concoction "won't cure cancer or consumption"—a pharmaceutical parallel to the soap that "won't wash clothes."

However, it is of "paramount importance" to medicals, both Practising and stewing, that they should know something of the preparations which even in these enlightened days make

le cough curer a count or the pill preparer a peer.

With this end in view, the B.M.A. have recently issued at a Sinail cost a booklet containing a description of most of the Patent preps. on the market, and their cost to the purveyor and to purchaser. The present article quotes this book very largely, but not exclusively.

Osier in his delightful essay "Aequanimitas" advises you IT exhibit this virtue even when you find that your best patient

se

eps a bottle of Warner's Safe Cure stowed away in his

` °'Dtl-1. This guardian remedy is made up as follows :—

Pot: Nit : gr. v.

01: Gaulther : one-third of a drop.

Spirit : Rect : dr. v.

Lig: Ext : Tarax : dr. x.

Glycerin : dr. iv.

Aq: ad. oz. viii.

and costs the producer 5T/4.d.

The "best patient" pays 2/9, so that it is only fair to pro- .P.e'se that Osler's advice should rather be directed to the pa-

i-lent who finds this out.

Ayer's Sarsaparilla contains as its active ingredients Po-

"Phyllin and Pot. Iod.

, Mother Siegel's Syrup is made up with HC1. Tinct : Capsici,

"d aloes with treacle and water.

Clarke's Blood Mixture makes use of Pot. Tod. combined With Spirits of Chlo. and sal volatile.

(14)

14 THE SPECULUM. may, 191 • If a patient comes under your observation with a rash of an indeterminate character, it is always well to inquire if he has been taking patent medicines of this nature.

As showing in a by no means extreme case how the Pil l purveyor makes his pile, note Beecham's Pills, of the guinea a box fame. This guinea's worth is sacrificed at 072. W 11,Y the Y2d. ? asks the man in the street. This extra charge Is due to the fact that the British Government, interfering with the sacred rights of capital, etc., charges WA. on each shit - ling packet of patent goods, and the benevolent proprietors pass the tax on to the consumer. As shown below, the guinea's worth is produced for Ad.

Now, where the patent medicine really fails is in the fact that it treats in every case a symptom. The "every-picture - tells-a-story-ad." which stares at one in most nerve wracking fashion from every magazine cover, will inform you that that most excruciating pain in the back (which is generally due to constipation) is cured by Doan's Backache Pills. These must be rather good pills, as reference to Butler's Diagnostics of Internal Medicine informs us that the selfsame pain in the back may be due to any one or any combination of 35 cool' plaints, varying from influenza to amenorrhoea. Perhaps, how- ever, Butler is a perverter of the truth. Anyhow, to get back to Mr., or was it Mrs. Doan's 35 diseases curer :—These pill s are issued in two forms.

(a) Kidney Pills, which may be made up as follows :- 01: Juniper m. i.

Hemlock Pitch (used in skin plasters) gr. x.

Pot : Nit : (the active constituent) gr. v.

Pulv : Fenugreek (used in poultices in vet. practice) gr. xvij.

Wheat flour gr. iv.

Maize starch gr. ij.

Ft. Pil. xx.

(b) Dinner Pills.

Oil of Peppermint m. 7.

Podophyllin gr. 3.8.

Aloin gr. 6.9.

Resin. Jalap. gr. .8.

Cayenne Pepper gr. .5.

Powdered Liquorice gr. 6.

Maize starch gr. .5.

Acacia Gum gr. 1.5.

Ext. Henbane gr. 1.5.

Ft. Pil. xx.

(15)

14aY, rgio. THE SPECULUM.

Note the aloin and podophyllin. The latter is a drug which

°Ile would naturally hesitate to recklessly prescribe, but of aloin we have on the authority of Potter that "it may cause abortion in the female, priapism in the males and not unfre- quently it is said to have caused piles."

We have mentioned the classical Beecham's, which is made as follows :-

Aloes

Ginger aa. gr . y2.

Soap gr.

Ft. Pil.

How often as we have gazed at the lilting allurements of bile Beans for Biliousness have we wondered what was in them. The ad. says that the Bean is a kind of back-to-nature treatment, claiming as it does that Charles Porde, a distin- guished scientist, had while in Australia noted that the aborig- ines were markedly free from bodily ailments, and had, by much patient research, ascertained that this immunity from the ills which beset the civilised man was obtained by the use of a vegetable substance which was now presented to the world dirt cheap in convenient form. When we read that the Bean for Biliousness contains Cascara, Rhubarb, Liquorice, 011 of Peppermint, and a gelatin coating, can we wonder that four judges in London should call the ad. a "deliberate fraud."

Another remedy much in vogue amongst that class who won't see a doctor "at any price" or even "at no price," is the Paternoster Pill. The Paternostrum is alleged to alleviate

the pains incident upon gout, rheumatism, etc., and contains Colchicum and opium. We are not certain that the exhibition of opium along with colchicum would exactly gain a man a Pass in an examination, but it evidently gains one a living in a world wherein the species "mug" is by no means uncommon,.

The artistic alliteration of Pink Pills for Pale People asso- ciated with a weak Bland's pill still draws the half-crowns of a still pale people. 3o of the following are handed over the chemist's glass case or the grocer's deal board for 2/9.

Ferri: Sulph : Exsicc : 75 gr.

Pot : Carb :.66 gr.

Magnesia .09 gr.

Powdered Liquorice 1.4 gr.

Sacch : Alb : .2 gr.

And now to get on the track of that never ceasing heart- rending cough, which had carried the writer of the testimonial to the edge of the grave, whence he was carried triumphantly back by two bottles of someone's cough remedy.

(16)

16 THE SPECULUM. May 191 0.

Chemists bask in the sunlight of a local reputation earned by their Balsam of Horehound, which as a rule contains no horehound, and which if it did would probably be just as use- less. The man of the pestle and mortar flings in the flavor by such subtle fluids as 01. Anisi or treacle. Liquorice is also in great vogue to make it tasty. "The children love it," etc., etc., ad nauseam.

Act of Parliament in Australia has rendered "our" cough cures much less obnoxious. For example, Woods' Peppermint Cure of the "poetical" ( ?) advertisements, now contains no chloroform or morphine, which it once did until checked by the law. Hearne's Bronchitis Cure by analysis on Feb.

1904, contained chlo. and morph. No recent analysis is avail- able to the writer, but in all probability these offending sub- stances are absent from the cure, which has apparently lost none of its popularity.

Then there is the " Yankee"-made Ayer's Cherry Pectoral.

This consists of—

Morphine gr. 3.

Vin : Antimon : et Pot : Tart : dr. 3.

Vin : Ipecach : dr. iij.

Tr : Sanquinarii dr. ii.

Syr : Pruni : Virg : oz. iij.

According to the ad. it contains no narcotic or poison of any kind.

Mother Siegel's Cough Balsam, with its homely sounding nom-de-biz, contains the potent Pot. Brom. Owbridge's Lung Tonic, another British production, contains —

Vin : Ipecach : mxv.

Chloroform m.ij.

in each ounce. It certainly deserves its reputation for "pick- ing up" the lungs.

" The Wisdom of Ages" and a picture of Father Time, which we associate with Eno's Fruit Salts, help to boom the sale of our old friend the Seidlitz powder.

Obesity cures rile me. When I pick up my comic paper and read a dozen lines of conversation between a stout lady and a lean ditto, I naturally expect a semblance to a joke at the end of it. But no ; the last line is always in capitals. If

" her plumpness" will only use antilipo or something, she will in next to no time attain the scragginess of "her leanness," is all that rewards my quest.

To get to close quarters with a few of these ; take Trilene Tablets. Its composition is as follows :—

(17)

May, 1910. THE SPECULUM.

Fucus Vesiculosus (in pulp) 3 per cent.

Starch 7 per cent.

Sugar 87 per cent.

Water 3 per cent.

Yellow dye, a trace.

Antipon contains—

Citric Acid 39.3 grs.

Alcohol .4 per cent.

Practically whisky and soda with a dash of lemon.

Figuroids :—These are sold in large and small tablets. The Principal constituents in the large are—

Soda Bicarb : 62 per cent.

Tartaric Acid 22 per cent.

Salt 6.5 per cent.

Phenolphthalein 2 per cent.

The small tabs contained the same constituents in different Proportions.

Marmola is advertised in a most ingenious fashion. The Corpulent person finds a prescription at the bottom of a column of his morning paper which purports to be written by a grate- ful sufferer who has been cured by a wonderful remedy.

The "Scrip" reads :-

Fluid extract of Glycyrhiza (B.P.), one ounce.

Pure glycerine (B.P.), one ounce.

Marmola, one half-ounce.

Peppermint water, to make six ounces.

The fat laden sufferer evidently thinks that Marmola is a prep.—knowing it by the company it keeps as it were—

and pays the chemist the 4/6 which is demanded. This is What he gets from the " Marmola" share of it.

Thyroid gland 1.4 gr.

Phenolphthalein .4 gr.

Salt .7 gr.

Powdered Fucus Vesiculosus 5 grs.

Extractives 2.5 grs.

Oil of Peppermint, trace. In one dose.

Hair Restorers, with which may be considered those sub- stances subtly advertised "to make the moustache grow," as a rule are innocuous, and also as a rule useless. If the new Australian shilling is to be believed and the ad. as well, these are not used by "all the crowned heads."

17

(18)

18 THE SPECULUM.

May, 19 1 °•

Many of these restorers contain lead, which may b e ab- sorbed and give all the symptoms of lead poisoning. The compositions of the most popular are here given :—

Tatcho.—Kerosene, oil of lemon.

Harlene.—Glycerine, alcohol, ammonia, oil of cassia.

Koko.—Borax, glycerine, rosewater.

Allen's Hair Restorer.—Sulphur, lead acetate, glycerine water.

Ayer's Hair Vigor, and Mexican Hair Restorer, both con- tain the noxious acetate of lead.

Capsuloids, it may be noted, contain "hxmoglobin."

A word to my lady friends who might be advised to try the use of "a perfectly harmless application" for the removal of that unwelcome "mo" which "comes between" them and their friends.

Deep and painful ulceration may follow their incautious use, and if the skin be broken, arsenic poisoning is not an unlikely sequel, for the most popular of these contain arsenic trisulphide—(orpiment).

The transition from depilatories to Valaze is quite natural, and it must be remembered that this tasty little preparation contains mercury.

Zambuk, which screams aloud to be rubbed in contains eucalyptus oil and vaseline. The former I should think would be about the last thing any one would rub into a sore or cut.

Cuticura ointment is a mixture of soft and hard paraffins perfumed with rose and with no active ingredient.

Antexema contains a little boracic acid combined with soft paraffin.

TABLE OF COSTS.

Medicine Amount Retail

Price Estimated Cost Doan's i Kidney

i Dinner 40 pills 2/9 Ad.

Beecham's 50 „ 1/14 Id.

56 „ I/IA Ad.

Pink Pills 30 „ 2/9 Ad.

Antipon ai oz. 2/6 !Ad.

Trilene Figuroids Marmola

66 tabs.

24 2/6

2/9 T d . I id.

Warner's Safe Cure A oz. 8 „ 2/6 2/9 4d. Add.

Mother Seigel's Syrup 3 „ 2/6 Ad.

Clark's Blood Mixture Zam Buk

8A „ 2/9 1/-

10.0) Cuticura Ointment

Antexema 2/6 Id.

IA.. I/IA Ad.

(19)

4aY, 191o. THE SPECULUM.

A Wanderer's Song.

Drink long and free to the savour of sea, To the sway of the wind in the pines,

And the scent of the grass as we careless pass Between tall hedges' lines !

Sing loud and gay to the king's highway, For a wanderer's life, sing hey !

Then sing for the morning and sing for the noon, But what for the evening that comes down soon?

And what for the dying day?

New eyes look up with each stirrup-cup, So a sip and a kiss and good-bye !

No time to dread what may lie ahead—

And behind—or a laugh or a sigh.

For the wanderer goes where the old wind goes, And whither it leads—who knows?

To horse and away at the break of day And on till the fall of night,

When all desire is a tavern fire And a seat by its cheery light !

Drink deep and free to the things that be!

For the wanderer—what cares he ? ,

There is nought to care and nought to spare ; And the tale of the past is told.

Do we win or lose? There is little to choose, For we have, but we may not hold ;

And all we reap is a quiet sleep—

Here's a toast to it all—Drink deep !

Then sing for the morning and sing for the noon, And still for the evening that comes dozen soon;

For care is ill to keep!

Overheard in one of Springy's wards :

Student (taking history) : " What is your name?"

Patient : " Smith."

Student : "Age ?"

Patient : " Forty-two."

Student : " Business."

Patient : " Rotten."

19

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20 THE SPECULUM. May, OW'

Our Ladies' Letter.

Medical School, May, 191o.

Dear Ida,—

I am really sorry for not having answered your last epistle , but the examiners so flurried me that I could not find time in which to write, nor had I any news—you having previously expressed your strong disapproval of my medical "shop" talk.

Some of our girls are still talking of the lovely time they had during the long vacation ; one of them is reported to have had a perfectly idyllic time, but she is very quiet about it;

maybe she is intymidated, but of course one cannot believe everything one hears.

The new residents at the M.H. are said to be a decided success (it really beats me, Ida, how these nurses can be so forward) ; and really one hears weird stories of how four of them "put up" a fracture, and of how one 1-IKEly young man trochared an abdomen (I'm sure you'll excuse this rather shoppy reference). When a person walks into a ward and hears the patients singing old college choruses, she naturally wonders which of the new doctors is so musical, and her ii wonder is not diminished when she is asked "which of them is

it that plays the violin so nicely."

I am rather disappointed at not seeing you up at the opening of St. Vincent's Hospital as a clinical school. The Chan' cellor, of whom we see so little in these dark days of dignity , was in his best form, and really excelled himself when he came to talk about the boxing matches in the Cyclorama—for the moment I thought he was closing that place, not opening qh another. Professor Allen, who is looking as young as ever,

also spoke very nicely about everything.

While on the subject of St. Vincent's, I must lament the fact that it has taken from the Melbourne one of our hardest working bees. I would that it had captured another who also works hard, but is observed to Bit= harder.

By the way, Ida, have you heard of the new forms of amuse - ment for baby meds.? Nothing more nor less than the BoY Scouts. Last year, you remember, we had the Boy Spouts who wrote letters to the, paper about the fall of Snowballs and presided in the councils of the P.L.C.—not the Presby - terian Ladies' College, I would have you understand—; but this year it is worse. I really dream at nights of students walking into lectures with a broomstick and a knapsack, and carrying a volume of " The Complete Scout" instead of "Os - ier," who with all his faults is a much saner man than Bad'ilit Powell.

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ivlaY, 191o. THE SPECULUM. 21

I suppose you read in your study of psychology about such mental states as Automatism. One of the residents at a met- ropolitan hospital had a most exciting experience with an epileptic policeman in this state last month. The policeman after "canter"ing all round the hospital apparently vanished 1, 1to thin air, and the resident has since been wondering what he could have had for tea to make him see such things which he Can't or won't explain.

To the journalist you know, Ida, nowadays nothing is sa- cred. His latest profanity is the desecration of the abodes of

the early members of our profession in Melbourne.

It is just disgraceful of Sangrado and Co. to write to the Bulletin and rake up all those stories about the early doctors who gave up the profession and took to drink ; leastways, that Is of course to the hotelkeeping business.

And the manner in which they mention the names of our great ones without so much as a Dr. to serve as a handle.

Well, as I said a few lines back, it is just disgraceful. Some- ene ought to be appointed censor over these weekly papers.

Did you vote for Vida Goldstein for the Senate ? I did.

I would have liked to vote for her a dozen times, but

the man at the booth said that I could only vote once before lunch, and as I had lectures all the afternoon the result was that the horrid Labour party got in, and that next morning

the Argus said that I had put them there.

Of course you did not go to the Commencement. I 'believe that it was worse even than last year's ceremony. A friend Whispered to me that several of the portly old gentlemen who thronged the dais were hushed by the solemnity of the grand Occasion into their customary afternoon nap. The laud Mayor he had to be dug in the ribs like a recalcitrant horse before ne could be roused.

At all events, if a few students had been employed by the day, this could have been prevented, but as it is, the "glim" of -Commencement Day seems to have been "doused" for ever.

I was so sorry, dear, to receive an apology from you for non-attendance at our Annual Meeting. I am sure you would have come had you reflected for one moment on the subject and the lecturer. For myself, when I heard that Dr. Mac- Kenzie was to deliver himself on "A Day in Old Heidelberg,"

I must confess that a delicious thrill ran through my epicritic and hippocritic sensoria—for you know he makes such "de- lightfully" abstruse bon-mots—and only the esoterics can pick them out. He quite fulfilled my wildest expectations, and I could imagine he was once again a student in Old Heidelberg.

Professor Allen was an excellent heavy father, but his blushes

11 11

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22 THE SPECULUM. May, 1910.

were only partially concealed when the lecturer referred to the Professorial pastimes and showed some of them. Several Collins Street men were there. Sir James, Dr. Officer, Dr..

Shields, Dr. Wilson, and others of that ilk were present, and many of the "profesh" brought their wives and daughters. : Probably this latter circumstance explains why " Bricky coughed so often and cut so much out.

The lecturer began with a rhetorically enthusiastic appre - ciation of the most famous University city in all Germany.

Views of the castle (prepared very well indeed from rather poor material by Mr. (ahem) Preston), of the Necker, the city, bridges, terraces and students' quarters, took me back again to that long ago Wednesday afternoon when I cut lee - tures to see Nellie Stewart mash the prince at Her Majesty's.

By the way, it seemed rather horrid of the lecturer to sug - gest that we should have a University Prison here—" Where there are women students," he said—and still more horrid of the men to cheer the proposal.

Then after a number of caricatures of students and profs.

were shown, an all too short—as the dailies put it—lecture was brought to a close. Gertie then piped out a vote of thanks.

which Peggy sweetly seconded, and Margaret rose and thanked everybody who happened to be handy. while the col- 1 lective heart of the fourth year swelled with that pride which

anteceded the Fall.

Then coffee and very nice supper was served in the cor- i ridors, while some of the more venturesome spirits not afraid

of the cold. "etc."—as the ward book hath it—strolled round the lake; and I—well, I just called my taxi and drove home - wards, sighing for the days when Bricky and I idled on the terraces of our own New Heidelberg. And being at present in this retrospective (or is it introspective ?) mood, I will close with best wishes from ever your

SUSIANNAIL A gentleman thinking he possessed tubercular symptoms . went to a doctor to be overhauled. The doctor would give no opinion till he had inoculated a guinea pig. He then ex - plained to the gentleman that whatever happened the guinea, pig would be his own fate. The gentleman was asked to call again in three weeks, which he did, only to find the guinea pig healthy enough, but with the immediate prospect of a large family.

(23)
(24)

24 THE SPECULUM.

The

Wee Wan Smile.

"Mr. Syme was seen to smile."

Och, shure, Mr. Syme, —(Ancient History.) It's a terrible time-

(Begorra, begob !)

Since ye smiled, Mr. Syme.

It's a thunderin' time- Ye're poor at the job.

An' faith, ye'd be better for wearin' a grin As wide as the gap from yer nose to yer chin.

Ochone ! Do ye think That ye're dignity'd sink- (Bejabbers, bedad !)

By as much as a blink If ye're optic would wink Whin the bhoys behave bad ?

So a cheery "good marnin' " would niver do harm ; An' we're shiirc that yer smile has a wonderful charm.

Epidemic Infantile Paralysis and its Occur- rence in the Bendigo District.

By Robert Fowler.

Much of the recent outbreak of Infantile Paralysis in S.E.

Australia has been already placed on record. In this paper by the courtesy of my father, Dr. Walter Fowler, Medical Sup erintendent of the Bendigo Hospital, I am able to present to - you a resume of the 23 hitherto unpublished cases which came under our notice during the recent epidemic in the Ben- digo district.

As clinical assistant to the institution I had a great majority of these cases under my care and observation, subject to the supervision and advice of my father, together with the kind assistance of Drs. M. H. Box and T. E. Green.

Naturally enough, in a country hospital it is symptom- atology and treatment that engage most attention. It is, therefore, with symptomatology and treatment that this paper is mostly concerned ; and, although other aspects of the dis- ease are discussed it is mostly in these two sections that the paper supplements what is generally known concerning In-

fantile Paralysis.

May, 1910.

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May, 191o. THE SPECULUM. 25

The epidemic commenced late in November, 1908, and lasted until the beginning of March, 1909, being especially Prevalent during the months of December and January. It is the first epidemic known in Bendigo.

Perhaps the most noticeable features of the outbreak were (I) Its sudden appearance in the district, and equally sudden disappearance ; (2) The extremely widespread distribution and isolation of the cases ; (3) The occurrence of evanescent cases ; (4) The remarkably good results following the treat- ment adopted. Each of these points will be again referred to under the respective sections.

PATHOLOGY.

I. The Nature of the Disease.—The morbid change found in Ant. Poliomyelitis is an acute inflammation of localised areas of the anterior cornua of the spinal cord. The inflam- mation probably affects the vessels, giving rise to thrombosis and causing secondary degeneration of the actual nerve cells.

In a great majority of our cases the clinical picture was that of Ant. Poliomyelitis acuta. Both in Bendigo and in Mel- bourne, however, cases occurred which were complicated by symptoms of cerebral involvement. The morbid changes are Probably similar to those occurring in Poliomyelitis, so that the condition is called Polio-encepalitis. Besides these two conditions, I have included under the name Epidemic Infantile Paralysis two evanescent cases in which the palsy was prob- ably dependent upon a polyneuritis.

The simultaneous occurrence of Polio-myelitis, Polio-en- cephalitis, and Polyneuritis first in Melbourne and then in Bendigo, characterised as they are by the same age, incidence and such a similar onset, make it extremely probable that they are but different manifestations of the same disease. That the disease is an infective one has long been suspected. The occurrence of the disease in epidemics together with recent bacteriological research is strongly in favour of such a view.

Besides the focal degenerations upon circumscribed inflam- matory changes in the central nervous system, there is a toxaemia of variable intensity which causes well marked feb- ricular symptoms and probably in most cases a polyneuritis as well. Apparently certain evanescent cases ,may occur in which the febricular symptoms and the polyneuritis are the only manifestations present.

2. The 2Etiology of the Disease.—(a) The Exciting Cause.

As regards the exciting cause in this presumably infective disease, nothing definite is yet known. In none of the Bendigo cases was a lumbar puncture performed. Working in con-

(26)

26 THE SPECULUM. May, Nio.

junction with the Bacteriological Department, University o f Melbourne, Dr. H. D. Stephens isolated from the cerebro - spinal fluid in 7 cases out of the 26 examined, a poorly stain - ing diplococcus similar to that isolated by Gierswold in Nor wegian epidemics in 1905. Inoculation of the cerebro-spina l

sacs of rabbits and guinea-pigs, however, gave no result, and Dr. Stephens sums up : " We are unable to demonstrate any organism as the causal agent in this epidemic ; but there are, sufficient grounds for supposing that the organism isolated

—if not the cause—is at least in some way very closely asso - ciated with this disease, for it has not been demonstrated in any of the cultures made from cerebro-spinal fluids of other diseases examined at the bacteriological laboratory in recent years."

Nor is anything definite known concerning the route of infection. Judging from the distribution of our cases infec - tion would seem to be by air-borne virus as in Influenza. Dr' Stephens thinks that the disease is mildly contagious. Maybe, it is. That there are means of infection other than b y con- tact is shown by our experience in Bendigo. Quite half the cases came from isolated farms and country hamlets situate from 5 to 3o miles of Bendigo, and in many cases self-sup - porting and in practically no communication with the city.

More than one case occurring in one family does not prove contagion, although suggestive. In our series of hospital cases there was one instance of this, and I am aware of two cases occurring in one other Bendigo family.

Another of our cases suggestive of contagion was a child aged 12 months, who 7 weeks before the onset of her paral - ysis was in hospital for Summer Diarrhoea and in a ward with a case of polio-myelitis on either side of her. If such was a genuine case of contagion it would apparently place the incubation period somewhere about 7 weeks.

(b) Predisposing Causes.As regards predisposing causes age and season seem to be all important. The disease is es- sentially one of childhood, although a rare adult form is de- scribed. The average age in B.H. cases was about 33 years.

Only four out of the 23 were more than this, the eldest being 16. The summer prevalence of the disease seems well estab - lished, but, whereas Dr. Stephens describes an extremely dry season preceding the Melbourne epidemic, such was not the case in Bendigo.

In the Melbourne and other epidemics there has been a pre - ponderance of males affected. In our series 12 were males,

females.

[011111

1 [II

(27)

May, two. THE SPECULUM. 27 All our cases were apparently in perfect health at the time of onset. Previous infective disease has been advanced by several authors as an aetiological factor. In only four cases could we get any history of such-2 had Measles, i Summer Diarrhoea, and i Whooping Cough.

MORBID ANATOMY.

Unfortunately our experience throws no new light on this subject. One case died 23 days after the onset. The cord Was removed for examination, and Dr. Bull communicated With. Soon afterwards, however, our valuable specimen in- advertently came to an Untimely end at the•hands of a more tidy than scientific hospital authority.

The presence of atrophy and sclerosis in the ant. cornua of the cord in old-standing cases of polio-myelitis, together with degeneration and atrophy of the muscles and bones of the affected limb, is well established, but the early changes are even yet a matter of dispute ; and it is a matter for regret that our opportunities of examining a cord during the stage of acute inflammation should have been lost

SYMPTOMATOLOGY.

I have already indicated that the nature of the disease is a tox2emia accompanied by focal degenerations in the central nervous system. Consequently the symptoms may be grouped under two heads, viz., ( ) those clue to toxaemia, (2) those due to focal necroses.

Toxaemic Symptoms. The first manifestation of the dis- ease is the acute onset of constitutional disturbances. Slight Pyrexia was present in all the Bendigo cases. Of the other febricular symptoms we had numberless combinations. They Were, in order of frequency, constipation, restlessness and fretfulness, nausea or vomiting, difficulty in micturition or even retention, anorexia, headache and delirium. Convul- sions occurred in 2, unconsciousness in I. An unusual symp- tom was the occurrence in one case of albuminuria and haema- turia lasting several days, eventually clearing up with the administration of Calcium Lactate. In the great majority of • our cases besides vague general pains there was especial pain and tenderness in the affected muscles. In such young child- ren this pain does not permit of analysis, but the frequent occurrence in the disease of transient .palsies, which clear up with the disappearance of the febrile stage, make it extremely- tempting to assume a toxaemic neuritis as the basis of both the pain and the temporary muscular disability.

111

IPJp

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28 THE SPECULUM. May, WO'

(2) Symptoms Secondary to Focal Necroses.—Under this head will be described the various so-called residual paralyses.

In none of our cases was the paralysis the first indication of the disease. Comparatively rare cases are described, but a febricular prodromal period is the more general rule. In Bendigo this averaged 2 days (maximum, 5 days).

Although not "progressive" in the neurological sense, the paralyses take some time to attain their maximum. With us this averaged 36 hours (maximum, 4 clays).

Every case exhibited paralysis of the extremities in some degree. The lower motor neurone type greatly predominated but in three cases there was spasticity of the affected muscles The extent and distribution of these paralyses is shown in the

following table :-

Affection of i lower limb only .. • • • . 9 cases.

Affection of 2 lower limbs only .. cases.

Affection of 2 lower limbs and 9

upper limb .. 3 cases.

Affection of all extremities and more or less of trunk 2 cases.

The individual muscle groups were affected in the follow - ing order:

Dorsi-flexors of ankle and toes (Tibialis Anticus group

Quadriceps Extensor of Knee .. 12

Flexors of Hip (Ilio-Psoas) .

Int. Rotators of Hip ..

Extensors of Hip (Glutei) ..

Adductors of Hip

Abductors of Shoulder (Deltoid) .. 5

Flexors of Elbows (Biceps group) .. 5

Plantar flexors of ankle and toes .. 5

Flexors of Knee (Hamstrings, etc.) .. 4

Abductors of Hip .. . 3

This table agrees with most others published in assigning the premier position as regards frequency to the Tibialis An - ticus group and then to the Quadriceps Extensor of the Knee.

Twitching of the affected muscles was present at the onset in 5 of the series. Vaso-motor disturbance was more or less marked in all.

Besides the affection of the extremities 5 cases developed paralysis of the external rectus of one eye. Involvement of the diaphragm and intercostals was probably the cause of death in the fatal case. Dr. T. E. Green, of Bendigo, had a similar case in his private practice.

As regards the sphincters there was no instance of per - manent damage, but it was noticed that the younger children were particularly incontinent for a considerable time, and it

(29)

It

May, 1910. THE SPECULUM. 29

was inferred that this atonic condition was a manifestation of the disease.

The following case, the onset of which was observed in hospital, affords a good clinical picture of the disease and is fairly typical of the symptomatology of the series.

Case i.—M.B., Female, xt 9 years. Admitted 30/12/'09.

Quite well until 4 days before admission. She then woke up complaining of frontal headache and pains in knees, abdomen and back. Feverish and restless. Appetite good. No vomit- ing. Next day fever continued. Pains seemed worse. Com- plained of stiffness in both legs. Next day went to bed. Was restless and slept badly.

On admission, T.IO2, P.I04, R.24. Face flushed. Tongue coated with clean edges. Could walk well. No pains, tender- ness or swelling of legs.

3I/12/'09, complaining of pain shooting down R. lower limb. On examination R. hip extended and rotated outwards.

R. knee extended. R. foot drop present. Any movement of limb was extremely painful. L. lower limb tender, but could be moved in all directions. 12 hours later, L. lower limb ex- tremely tender, with flexion and outward rotation of hip, flexion of knee and left foot-drop. Absence of both knee- jerks. No plantar reflex. Retention of urine. Catheteri- zation. Bowels not open.

1/1/09. Complaining of pains over whole body. Lying with head thrown back. Constipation. Retention.

3/1/09. Rigidity of neck, but good movement. Complain- ing of pains in Rt. arm. Movements only fair. B.J.'s present.

More so on Rt. No retention. Bowels constipated.

4/I/'09. Flexors and Paralysis of Flexors Adductors and Abductors of hip on both sides.

5/1/09. Measured for Double Thomas.

8/iro9. Fitted with same.

II/1/09. Still complains of pain behind knees, otherwise Pain somewhat less.

17/I/'09. Good movement in arms and neck. Right lower limb absolutely flaccid, no power of movement whatever. Left low er limb—slight dorsi flexion and plantar flexion of toes and ankles. Otherwise no movement whatever. Absence of all reflexes in lower limbs.

25/0219. No change except of int. rotation of L. hip.

14/11/09. No change except for increased power of dorsi- flexion and plantar flexion of L. ankle and toes.

Soon afterwards the child came to Melbourne, and treat- ment has been continued at the Children's, with, I believe, slow but marked improvement.

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3o THE SPECULUM. May, 19 10'

I shall now detail the notes of an evanescent case, the whole course of which was observed in hospital. It illustrates the combination of transient paresis and neuritic pains without the occurrence of any residual paralysis.

Case 2.—F.T., Male, wt. 3/ years. Admitted 8/1/09. We ll nourished. No previous illness. Was quite well until on New Year's Day he became a little feverish. This quite cleared UP , and he was well until afternoon before admission, when whilst runninc, about he suddenly lost power in the L. knee. During the night was feverish, with some tenderness of the L. knee.

In the morning the mother noticed twitchings in L. leg.

On admission, T.99.4, P. 116, R.36. Able to stand and walk unsupported. All movements of lower limb good except some difficulty in extending the knee.

9/0)9. Fretful and restless during night. T.io3, R.28. Rigidity and tenderness of both lower limbs with some loss of power. K.J.'s both present. A.J. present only 011 left plantar reflexes normal.

12 hours later crying with pain in lower limbs. Also in left upper limb and hack of neck.

io/Ifo9. Very little sleep during night. T.98.2, P.1 16, R.36. Still crying with pain in limbs. P.U. in bed. 1/Ito9. Loss of power in left arm. Otherwise much the same.

12/I/'09. T.98.4, P.84, R.24. Tremendous improvement.

Able to move left arm and walk unsupported. No pain in neck or limbs. Slight tenderness on movement of lower limbs.

13/0)9. Improved.

14/1/09. Discharged. Cured.

29/5/09. Perfectly well. Perfect movement in all limbs.

No wasting.

TREATMENT.

It is to the consideration of this aspect of the subject that one finds oneself forced to attach most importance. A new, era in the treatment of Infantile Paralysis has begun, founded on the work of Dr. Jones, of Liverpool. Dr. W. Mackenzie and his colleagues of the Children's Hospital, Melbourne, have pioneered the work in Australia with admirable results. Dr.

Mackenzie has published in the Intercolonial Medical Journal

full details of the principle of treatment, together with nu- merous original modifications of method.

In Bendigo we followed the rules laid down by him, and are extremely happy to have had the opportunity of endorsing their efficiency, and of supplementing his results with results equally gratifying.

(31)

May, 1910. THE SPECULUM. 31 Although in the other sections of the paper I have drawn on notes of 23 cases, it is only 14 of theSe that were subjected

to systematic treatment at our hands. These were not picked cases, but are what remain of the series when one - deducts the case that died, and those which for sundry reasons would not stay in hospital or left prematurely.

Of the 14 cases treated, I I recovered ; in 2, although im- proving, the result is still imperfect ; whilst in I, the result is absolutely bad. In this latter case treatment was not com- menced until 2/ months after the onset, and even then was unsatisfactory, as the mother insisted upon having the child at home after 3 weeks in hospital. Of the imperfect cases, ne was a girl 6Y, years old, with almost complete paralysis in all four limbs. The legs improved well, and not long ago she walked 2 1/2 miles to see us, but the arms are only slowly in1Proving. The other case was a girl of 9, with complete Paralysis of both lower limbs. She is now being treated at the Children's, and is showing very fair improvement.

Of the II cases which recovered, 3 did so after 7-10 days in bed, and practically no other treatment. Of the . other 8, after 2-3 months of treatment, there has been a perfect result

4, and practically perfect in the rest, there being some slight impediment in walking, but no marked deformity.

So much for results.

The treatment may be considered under four heads.

(I) Treatment of the Constitutional Disturbance.

(2) Treatment of the Damaged Central Nervous System.

(3) Treatment of the Muscular Disability resulting from the Damage to the Central Nervous System.

(4) Operative Treatment of Resulting Deformities.

) Treatment of the Constitutional Disturbance.—This

simply requires rest in bed, attention to skin, bowels and bladder, and the symptomatic treatment of incidentals such as headache, general pains, anorexia, etc.

All our cases had Hst : Ammon : Acet : (M.H.P.) as a rou- tine, and Hst : Pot : Brom : et Chloral (M.H.P.) if the pains Were troublesome. In the evanescent cases constitutional

treatment is all that is required.

(2) Treatment of the Damaged Central Nervous System.—

0 quote Dr. F. G. Still, " It is conceivable that in the first few

days of the disease good may -be done by measures directed towards reducing the hyperxmia of the spinal cord, particu- larly by application of ice-bags over the affected portion or

1137 vigorous counter-irritation, e.g., with mustard plasters."

Such measures are of theoretical utility only, and it is hard to tell whether the paralysis is influenced by such applications.

,,d111[1

lvvv1.1

11111

Figure

TABLE OF COSTS.

References

Related documents

I recommend that you approve the amendment of the decision document for application APP203308 under section 67A of the HSNO Act, as the proposed amendment is to broaden the genetic