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THE Annual Meeting was held at 121 Bathurst Street, Sydney, on 26th March, 1902. Present: Mr. G. T. Hankins (in the chair), Drs. W. H. Crago, T. M. Martin, J. M. Gill, G. A. Marshall, W. A. West, Gordon M'Leod, J. M Pherson, A. J. Brady, Gledden, and Sinclair Gillies. Apologies for non-attendance were received from Drs. Walter Spencer, Coutie, and A. J. Hood.

As only sufficient members to fill the vacancies were nominated, the late office-bearers, having been duly nominated, were re-elected.

Some of the members present complained that they had had no opportunity ot nominating members for the different offices. It was explained by the Secretary that, although it had been the custom to invite nominations from all the members by circular, no such proceeding was required by the rules; but, in accordance with the general wish, such a notification would be sent out in future.



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Dr. J. M. Gill, joint Hon. Secretary read the annual report :

"Sydney, March 26th, 1902.

"The Council congratulates the members on the close of another successful year in the history of the Union. Two hundred and seventy-five (275) members paid the annual subscription, as against two hundred and seventy-four (274) in the previous year. Thirteen new members have been elected. The Council has to record with regret the deaths of Drs. C. Dagnall Clark, Elsner, Stapleton, and Clifton Sturt. The Local Hon. Secs. have continued to perform their duties in a satisfactory manner. The Council fortunately has not had to assist any member this year. The sum of £34 10s. 8d. was paid to a member, in accordance with a resolution of the Council during the preceding year. (This sum was paid to reimburse him for legal expenses incurred, which he was unable to recover from the plaintiff.) Several other members have sought the advice of the Council in various matters. The following alterations were made in the Rules at the instance of the Hon. Treasurer, viz. :-Rule 8 to read as follows: The Treasurer shall on or before the 1st day in March in each year, notify all members that their subscriptions fall due on that date.' To add the following words to Rule 9 Provided always that the Council shall have power, under special circumstances, to suspend the subscription of any member who may be absent from the State.' These rules were submitted to and fully discussed at a special meeting in the month of September. The occasion for these alterations has arisen from the absence of several of our members at the seat of war in South Africa, some of them being absent for a year and more, and it was felt that it would be well if the Council had the power of remitting their subscriptions.

W. H. CRAGO, Hon. Treasurer.

which power it did not possess under the previons rules. The Treasurer's statement shows the funds in hand to be £1,848, an increase of £288 on the previous year. Mr. Grigson has continued to perform the duties of Assistant Secretary in a satisfactory manner."

The Hon. Treasurer, Dr. CRAGO, made his financial statement, and moved its adoption. Seconded by Dr.

G. A. MARSHALL. Carried.

An informal discussion was introduced by Dr. CRAGO, in order to test the opinions of those present on the question of the reduction of the annual subscription, and Dr. Crago therefore informally suggested the following resolution: "The annual subscription shall be one guinea, due and payable in advance, on 1st March. After the payment of ten annual subscriptions, a member shall be exempt from further payments, unless the funds of the Union become greatly reduced by any unexpected call, in which event the Council may again demand the annual subscription from every member for as long as may be necessary to place the finances in a sound condition." After some discussion, members present were unanimously of opinion that it would be inexpedient to adopt the suggestion at present.

Sydney and Suburban Provident Medical Association.-At the last quarterly meeting, the Hon. Secretary announced that the Association was making steady progress.

The Hon. Treasurer stated that £1,140 5s. 7d. had been collected during the quarter, which, after deducting expenses, enabled the usual dividend at the rate of 17s. per annum to be declared, and a small surplus to be carried to the accumulated fund.


Dr. MAITLAND read the statement of accounts for the past year. The adoption of report was carried.

The following Committee were elected for the ensuing year-Hon. Secretary, Dr. H. L. Maitland; Hon. Treasurer, Dr. R. L. Faithful. Members of Committee: Drs. Fiaschi, F. W. Hall, and Macdonald Gill.





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By Money disbursed to various deserving cases as decided by the Committee from 31st March, 1901, to 31st March,

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A well-known Melbourne practitioner writes as follows:-"If the society is a national association, what business has it with cheap medicine, any more than cheap weddings or funerals, or cheap civil servants? If it is a medical benefit society, why should it-because its members secure a doctor's services for 3d. a week-be allowed to pose as an exponent of the national and patriotic aspirations of the rising generation? There is no doubt whatever (in the minds of the A.N.A.) of their immense superiority over the M.U., I.O.O. F., etc., etc.; but though they exact extra attentions, they pay no more than the modest fees paid by the horny-handed section of the community. If they exercise no political influence, how is it that civil servants-when presidents of the A.N.A.-seem to be able to get leave at all times to go about the country opening new lodges?"


Another Victorian correspondent writes "A more serious innovation is the establishment of the Long Distance Club. To instance a case, the town of X is some miles from Y; the district of Z lies less than half way-there was no medical man there. Two medical men in Y took clubs, also two in X, of which I was one. A branch of the A.N.A. was started at Z, and made overtures to the medical men, the two doctors in one town being played off against those in the other. It was arranged that we should all join on equal terms, and have lists, The terms were 24s. per annum to supply medicine (actually 16s. pcr member),

R. L. FAITHFULL, Hon. Treasurer. H. L. MAITLAND, Hon. Secretary.

and a reduced mileage of 5s. per mile from X (the ordinary being 7s. 6d. per mile). When a few months had elapsed, the secretary said they could not afford 53., and we must reduce to 2s. 6d. I declined and resigned. In consequence, I have completely lost any practice in that district, which is a community of wealthy farmers. They all send for my opponent,

who is an Australian native!"

Drs. Bardsley, of Waverley, Barber, of Penrith, and Cocks, of Wentworth, have severed their

connection with the A.N. A,

Mr. H. J. Cannington, who was elected vicepresident of the Newcastle branch of the A. N.A. at the inaugural meeting a week or so ago, stated, says the Newcastle Morning Herald of March 18th: "That if there was to be any wrangling he would retire from the position. He quite disagreed with the attempt by the A.N.A. to fight the British Medical Association. If the Newcastle branch could not get over the threatened boycott by the local doctors, he thought the lodge would not achieve success, for he could not see that it established practice, to take on the lodge. would pay any other medical man, who had not an

The Melbourne Herald of March 22nd in a leading article speaks in contemptuous terms of the A. N.A. in New South Wales deigning to accept a wage limit, and says that, "Meanwhile, perhaps, a missionary might be spared from Victoria to help the authorities of the A.N.A. in New South Wales back to the region of commonsense!"





and yet how hard to secure in private practice. One of the requirements of a sanatorium was a good cook. No special diet was required, but it must be liberal and nutritious, and include plenty of meat, milk and butter. Rest was so important that they were apt to forget the value of exercise, but it was the due proportioning of these that was one of the main features of the Nordrach treatment. Rest was necessary for active disease, high temperature and losing weight, but to restore health, strengthen the circulation, develop the healthy part of the lungs, exercise was required. He thought he had said enough to prove the vast superiority of the sanatorium over the private open-air treatment of consumption, but it must be admitted a great deal depended on the medical superin. tendent. A young, inexperienced man, with a small salary, who only intended to hold the position for a short time, was not likely to make it a success. A man must have a special training, and be willing to devote his whole time and energy to the work.

The PRESIDENT said there was one sanatorium near Melbourne, but it had not grown to a large size, and was simply a charity.

Dr. CAMAC WILKINSON (Sydney) said he would like to have facts and results in support of the sana. torium treatment. He agreed with most of what Dr. Gault had said, but the physician who trusted in sanatorium treatment in a hard and fast way was lost. It was absolutely impracticable as a means of dealing with tuberculosis in the poor classes, among whom the disease was chiefly found. One could not expect the poor to go to a sanatorium when they were able to work. Sanatorium treatment was valuable if money and time were of no account. But was it not better to cure a patient in the climate in which he had to spend his life? Climate, per se, was not the important factor that it was at one time considered.

SANATORIUM TREATMENT OF CONSUMPTION. Dr. A. H. GAULT (Adelaide), read a paper, entitled "A plea for the sanatorium treatment of consumption." He said there were at least 10,000 persons at the present time in Australia suffering from pulmonary tuberculosis in an active form, and we had sanatorium accommodation for only 150 of the poorer classes. The only provision throughout the whole continent for paying patients was one small home with seven beds. It was possible that the value of the open-air method had been over-estimated, but there could be no question of its great superiority over any previously tried. Most of their patients previously died, after many ups and downs, in the course of a few years-the death-rate must have been 90 per cent. Of the cases brought under sanatorium treatment, with only one lobe of one lung affected, he thought that they might safely say one-half were cured, but even this would mean the saving of over 1,000 lives annually in Australia alone. On the part of the public, there was a rooted objection to all kinds of institutions, which nothing would overcome but the firm attitude of the profession, backed up by actual results. The disadvantages of leaving home would be more than counter-balanced by a speedy restoration to health. There was no doubt that this form of treatment would embrace other kinds of disease. A sanatorium afforded a choice of climate and situation; a building thoroughly adapted for the purpose; strict medical supervision, careful nursing, regularity, and discipline. The things desired were climate and situation, plenty of sunshine, pure air, absence of strong winds. He was told that the site selected at Wentworth Falls, New South Wales, for the proposed sanatorium in New South Wales was subject to such strong winds that trees would not grow without proper protection. Other conditions required were avoidance of extremes of temperature, a bracing atmosphere, a dry, well-drained sub-soil. Excessive rainfall, or the prevalence of fogs, was a decided drawback, and must be avoided. It had been tried in Victoria to have one sanatorium suitable for summer and another for winter, but this was quite unnecessary, and a great waste of money. A properly constructed building would cost at least £200 per bed. A sanatorium erected with due regard to proper conditions would possess advantages most difficult to find in a private home. In a private house it was almost impossible to find a room suitable for a consumptive. Fresh air could be best secured by erecting a substantial stone building on the Nordrach plan-a single row of rooms with a passage behind. The front of the building Dr. G. H. HOGG (Launceston) read a paper on "The should face the north, be sheltered by a verandah, not Medicines of the Aboriginals of Tasmania." He said: too wide, having glass over the windows of the rooms Backhouse mentions an old man or doctor who had for to admit sunlight in winter. All windows must be of his instrument supply a stock of broken glass, which he the casement pattern, much larger than ordinary ones, used as lancets for superficial and deep scarification. and having a large fanlight over them, as well as over This old gentleman suffered from some form of "fits," each door. At Nordrach the windows and doors took which were attributed to a devil, and made use of to up about one-quarter of the wall space. It was only in impose upon his fellows-the first recorded example, the sanatorium that one could get strict medical super- doubtless, of a Tasmanian "quack." As to nursing, vision, careful nursing and feeding, combined with the that was left to the women of the tribe; confinement regularity and discipline of an institution. The three cases were left in charge of one or more women; and cardinal principles of the open-air treatment were the sick also were, if attended to at all, nursed by fresh air, good food and rest. How simple it seemed, them, although frequently the sick person was left

Dr. VERCO said that the open-air method of treatment was recognised as an advance in the treatment of tuberculosis. Personally he felt certain that the method was the best they had ever had, and the further they extended it the better for the phthisical patient. If they could impress its value upon the charitably disposed they might do much. In South Australia they had a sanatorium, which was a partial charity. But the sanatorium treatment was simply an accessory to other treatment.

Dr. HOVEY said he went to South Africa some years ago with lung trouble, and settled in the climate of a highland plateau. Subsequently, when he got to Sydney and was examined for life assurance they could not find in which lung there had been a cavity.

Dr. JARVIE HOOD suggested that the North Shore railway line was the best place for a sanatorium in New South Wales.

The PRESIDENT did not like to say anything about the management of the congress by the executive, but thought that the subject of sanatoria might have been given prominence to instead of cancer.

behind by the tribe to take his chance, a stock of food and a supply of the leaves of the mesembryanthemum, a native purgative, being given to him before his desertion. With regard to. the surgery of the Tasmanian aboriginals, it was, as might be expected, of a most primitive character. Bleeding was stopped by the application of clay and leaves. Incisions and scarifications were held in much favour in the treatment of various diseases; thus Truganini treated the swollen thigh of her husband by six incisions, which produced sloughing, and cured him in nine days; and Robinson relates how a woman, suffering from sick head, breast and belly was incised in each of these parts, the idea in this and similar cases being that the pain was a distinct entity and must be put out. Billandiere, the naturalist of the D'Entrecasteaux expedition, was of the opinion that they used the actual cautery in some diseases; snake bites certainly were treated by a kind of cauterisation, a hole being bored in the flesh near the wound and stuffed with fur, which was then singed. Massage seems to have been occasionally employed, and applications of cold by means of compresses were used for the relief of headache and other pains. As to the diseases which prevailed amongst the aboriginals our knowledge is of the slightest, the early medical men having interested themselves very little in the matter. Before European colonisation they seemed to have been a healthy race. The scientists of D'Entrecasteaux's expedition found but little trace of disease, although there existed among the aboriginals themselves a tradition that their race-at one time much more numerous-was decimated by an epidemic which swept through the island prior to Europern discovery. After the English colonisation, however, various diseases spread amongst them, syphilis, phthisis, and pneumonia becoming frequent and fatal. Various skin diseases became very prevalent, and were particularly noticed by the early colonists. Thus there are described by various writers:-1. "Scabby sores, affecting the whole body." 2. "Loathsome ulcerated sores, attended sometimes by fatal results." 3. " Leprosy," so offensive as to cause isolation of the sufferer. 4. "Scurvy." 5. " Eruptive disorders, attended by fever." Doubtless, some of these skin diseases were syphilitic, some parasitic. The usual treatment for all skin diseases was the application of ashes, the patient wallowing in them if necessary. Rheumatism was common, and was treated by scarification and incision, sometimes by mutton bird oil. Headaches were treated sometimes by cold compresses, sometimes by scarification, sometimes by charms made of human bones. Thus Backhouse relates how one man had a charm of three bones fixed as a triangle on his head as a cure for headache. The use of such charms, made of the bones of the dead, often of a dead relative or friend, was common, not only as a cure, but also as a preventive against sickness or death. Lung diseases became very common among the Tasmanian natives, and were the chief cause of the final extinction of the race. Inflammation of the lungs was often very rapid and fatal; and phthisis was prevalent, partly because of the alteration of the habits of the rece, partly, no doubt, because of the introduction of that disease by Europeans. Some lung troubles were apparently treated by incisions in the chest walls. With regard to nervous diseases, madness and convulsions were known by the aborigines, and were believed by them to be due to an evil spirit; while that peculiar form of melancholia known as nostalgia became a marked feature amongst the survivors of the race interned in Flinders Island, many of whom became the sad victims of that strange disease.


A special meeting of this section was held on Thursday evening, February 20th, to discuss X-Ray work. In the absence of the President (Hon. Dr. Butler, M.L.C.), Dr. Drake called on Dr. Crowther to read Dr. Fox's paper.

Dr. E. L. CROWTHER, M. D., M.H.A. (Hobart), said he was pleased to read the paper, and, in doing so, desired to express the thanks of the Hobart Hospital Committee to Drs. Fox and Clendinnen, of Melbourne, for the assistance given by those gentlemen to the committee in the selection of an X-Rays apparatus, the result of which was that the hospital would, in a very short time, be equipped with one of the best X-Ray apparatus in the Southern Hemisphere. He then proceeded to read the paper,-" On Recent Developments in X-Rays Apparatus, and in the Use of Rays," prepared by Dr. W. R. Fox, L.R. C. P., L.R.C.S. (Melbourne). The writer stated that the tremendous impetus given to this branch of physical research by Röntgen's discovery continued to make itself felt. One of the results had been a very great improvement in induction apparatus generally. The different systems of interruption were dealt with, and the comparative advantages of electrolytic interruptors and photography were discussed. It would be readily seen that there were many cases in which the interruptor method possessed advantages over photography. For instance, where much time and trouble had been expended over setting a limb, and where it was impera. tive that the splints should not be removed, unless good reason were shown-examination by the interruptor method would permit of the bones being seen from every point of view; also, in examination of the heart and lungs. Originally introduced into surgery with the object of locating foreign bodies and the position of fractured bones, X-Rays had extended their usefulness in a very wide manner. At the recent British Congress on Tuberculosis, it was shown that the rays would give evidence of the existence of tubercular disease as soon as, or perhaps before, it manifested itself in other ways. The results of the experiments of Wolfenden and Forbes-Ross on the effects by the rays on micro-organisms were explained, it being proved that the cultures of some microorganisms exposed to the rays grew luxuriantly. Other tests proved that milk X-Rayed for an hour showed a greater degree of acidation than milk not so treated; cress seed X-Rayed for an hour, and then sown, started germination, and grew much more vigorously than seed not so treated. The experiments on the tubercle bacillus, however, were not satisfactory, the scientists stating their belief that it was impossible to kill growths of bacilli in the lungs, or cocci, by X-Rays. The effects of the rays on the skin were then discussed, the writer expressing the opinion that the destruction of tissues, etc., was due, not strictly to the X-Rays, but to the radiation of some other nature, proceeding from an excited Crookes' tube. Experiments to test the curative value of the rays were detailed. It was hoped that it would exercise some beneficial influence over cancer, but the only effect so far produced was to ease the pain-which it certainly did. The only case of cancer improved by the rays so far was one of carcinoma of the breast, reported by Dr. Andrew Clark in the British Medical Journal, Vol. I., 1901, p. 1,368. In this the improvement was most remarkable, and if the beneficial effect continued, it certainly looked as if it should have ended in a cure. In the treatment of rodent ulcer, the rays had proved singu larly successful. In all probability the local character

of this disease, as distinguished from other forms of cancer, contributed to this result. In lupus, certain forms of eczema, sycosis, and in one case leprosy of the skin, the treatment of the rays has been successful. In the large suppurating surfaces, left after extensive burns and scalds, the rays would promote rapid heal ing, and resulted in much less cicatricial deformity. It was possible that they were not aware of the nature of all the radiation emanating from an excited Crookes' tube, but they knew it included :-(1) Anode Rays. which include X-Rays, properly so-called; (2) Cathode Rays, about which not much seemed to be known; (3) Heat Rays, which were more manifest in small tubes than in those of six or seven inches in diameter; (4) Light Rays; (5) Electric Rays, or waves, which mani. fested their presence in a similar manner to the waves given out by other apparatus generating electricity of extremely high tension. When one, said the writer, considered the above constituents of X-Ray radiation, it ceased to be surprising that its effects were so many and so varied. With regard to rodent ulcer and lupus, he was strongly inclined to think it would be found later that the curative agent in this form of radiation, and in that from the Finsen light, were one and the same thing. Photographs taken by the X-Rays were show of an injured elbow joint; a diseased neck (atlanto-axoid) of a foetus born dead; of the bullet in Dr. Fraser's head; a compound comminuted fracture of both bones of the fore arm.


Dr. L. II. HARRIS (Sydney Hospital) read a paper on the "Rontgen Rays, with Special Reference to Renal Radiography." (lo appear in a future issue.)


Dr. F. J. CLENDINNEN (Melbourne Hospital) gave an interesting exhibition of Rontgen Ray work. The views exhibited showed the effects of broken and deformed bones, the presence of foreign substances in different parts of the body, and the result of several bullet wounds received by soldiers during the war, concluding with slides showing adulterations of various articles of food, such as flour with chalk, sugar with sand, tea with various substances, etc.




Dr. B. BURNETT HAM, Commissioner of Public Health for Queensland, read a paper on "The spirit of hygiene in Australia." After a brief introduction, Dr. Ham referred to hygiene as it was practised by the ancients, and said that plague, leprosy, cholera, and small-pox, the pestilences of the middle ages, were, like the poor, still with us, but the modern science of bacteriology had invested them with the dignity of the order of germs." Modern dwellings were still illventilated and overcrowded, public and domestic water supplies were still polluted, food was still adulterated, drains and sewers were still badly constructed, Governments were still apathetic, local authorities indifferent, individuals still careless or ignorant of those simple laws of health and purifying observances practised in the days of Moses. The spirit of sanitation decreed that men should no longer herd in caves; that the individual should no longer pollute the water he drank, contaminate the air he breathed, adulterate the food he ate, or be insensible to the insanitary arrangements of the house in which he dwelt. Selfishness and the struggle for existence had forced the individual, formerly solicitious

only of his own individual health, to recognise in his neighbour a possible source of danger to himself, and and he, therefore, looked to a paternal Government for that protection, which he imagined legislation was able to afford. There was no sanitary reformer like an epidemic of some dread disease, such as plague or small. pox. The recent visitation of plague to the Australian States brought about a great sanitary awakening, both of the authorities and of the more intelligent citizens. Legislation on matters pertaining to the public health must necessarily be progressive, and, therefore, of a piecemeal character. In enacting our statutes sight must never be lost of the fact that the conditions of life, and the environment of the people in Australia were somewhat different to what existed in the old country. However good and wise legislation might be, it was of little service unless it could be backed by equally effective administration. In fact, it was administration rather than legislation which was at default. Since the establishment of the Commonwealth there was a tendency on the part of the State Governments to reserve to themselves many departments which were formerly under, the control of the local authorities. To some extent municipal authorities had only themselves to blame if Parliament was unwilling to delegate its powers to them. Until there was a keener interest in municipal affairs no solid advance in sanitation was possible. The Health Act of 1900, of Queensland, cast upon each local authority the responsibility of protecting the public health of its own district. It further provided for hospital accom modation and isolation of infectious diseases, and indicated to local authorities, more especially to those of districts of small or moderate size, the means by which they might advantageously make such provision. Some 20 local authorities within a radius of 12 miles of Brisbane had combined to form what was known as the Metropolitan Joint Board for the Prevention of Infectious Diseases. The board was subsidised by the State to the extent of £1 for £1 on the amount raised by precepts levied on the local authorities represented on the board. It was the duty of the board to deal with all diseases of an infectious and epidemic character. Sanitary administration by local selfgoverning bodies, as well as administration by a central authority, was nowhere in the Commonwealth better illustrated than in the State of Queensland. In New South Wales there was, practically, no local selfgovernment, the central authority being the administrative and controlling power. It was true that sanitary reform was much more easily carried out, and work requiring skill and money might be better done by the Parliament; but direct taxation of the people without central authority, acting through, or on behalf of, adequate representation, was never likely to become popular with the masses; nor was it a system conducive to that voluntary action of the people which sanitary education should always have in view. Municipal authorities were slow enough to move even when seemingly convinced, but apathy appeared to increase with the square of the distance from the controlling or compelling authority. With the dawn of the Commonwealth the time had arrived when the appointment of a Federal Minister of Public Health might be seriously considered, and the splendid work accomplished by the Sanitary Institute of Great Britain was an incentive to the establishment of a similar institution in the future federal capital. Dr. Ham then detailed what he considered ought to be the objects of such an institution in Australia, and said it was difficult to estimate the influence for good upon the community at large such an institution might ultimately exercise in Australia.

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