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Pursuant to a resolution of the Council, passed on selecting Miss Clark in face of their unanimous disapthe 28th January, the London County Council have proval, left the staff no choice but to resign office, both issued the following order :

in fairness to themselves and to the best interests of "The London County Council do hereby resolve and the infirmary. Fortunately this consummation, which order that Section 55 of the Public Health (London) would have been a very disastrous one for all the Act, 1891, with respect to the notification of infectious interests concerned, was at the last moment averted by diseases, shall apply in the administrative county of

the resignation of the lady whom the Governors had London, for a period of three calendar months, to the

chosen. disease known as chicken-pox, and the Council do It is very obvious that the domestic circumstances of hereby declare that the case is one of urgency, owing

a small hospital are such as to make it highly undesirto the prevalence of small-pox in London, and the fact able to have the two resident medical officers of that the failure in many cases to distinguish between opposite sex, and it is equally apparent that, in every chicken-pox and small-pox has led, and is leading, to general hospital, however small, there must always be the spread of the latter disease."

a certain number cases unsuitable for the ministra. It has been decided by the Medical Councils of Cape

tions of a woman. It is all very well to argue that Colony and of the Transvaal that foreign subjects will

because men doctors treat indiscriminately all the disnot be allowed to practise medicine in those colonies,

orders of women, therefore there is no valid reason unless they belong to a country in which the holders of

why women doctors should not similarly be allowed to

deal with all the ailments of men. The cases are not British medical diplomas are accorded similar privileges. This is a wise and reasonable provision, which will

parallel, and nothing is more certain than that were not only sare South Africa from an inrush of foreign

such an argument to be put to the test of experience, practitioners, but will also standardise the value of the

patients would seriously object, and in most instances qualifications to practise up to the level of the mother

refuse to have many of their ailments enquired into country.

and managed by a lady doctor. The inevitable result It is only a few months since Professor Virchow

would be constant friction, and consequent inefficiency celebrated, with great éclat, his eightieth birthday, the

in the service of the hospital towards the patients under occasion being taken advantage of to pay the veteran

its roof. If such unseemly wrangles as this at Macclesscientist all the honour he so well deserved, and to con

field are to be avoided in future, the medical staff of gratulate him on having reached such a hale and hearty every hospital must be granted - as it ought to haveold age. The echoes of these rejoicings in Berlin have

a prominent voice in the selection of the resident fcarcely died away when the news comes that Professor

officers. Virchow, when alighting the other day from an electric car, fell on the asphalt roadwar, and fractured bis

Victoria femur. This unfortunate occurrence has evoked the greatest sympathy among all classes of the German

(FROM OUR OWN CORRESPONDENT.) population, as well as among scientific workers all over the world, and it is earnestly to be hoped that the

The Women's Hospital Dispute-The Melbourne Hose serious consequences which at his advanced age are apt

pital Williamstown Lodge Matters Infant to follow such an accident, may he averted, and that

Mortality-Bubonic Plague in Melbourne-Comthe favourable progress so far recorded may be unin

monwealth Army Medical Service The A.N.A.terruptedly continued. According to the Berliner

Lodge Abuses. Klinische Wochenschrift, the subcutaneous hæmorrhage The Women's Hospital Committee are now advertising is rapidly beiug absorbed, and callus has begun to for a Resident Medical Officer, with a salary of £250, develop. The organs of circulation and respiration are to take charge of the midwifery department. So far also said to be normal, but the patient's rest at night is they have had no response, and Dr. Shields, sen., has not so good as is desirable.

been filling the breach in the meantime. There is a The difficulties with which female practitioners of great disinclination evinced by any medical men to medicine and surgery have to contend are considerable. engage themselves under existing circumstances to the In the practice of their profession among women and Women's Hospital Committee, and no doubt the junior children there is probably little doubt that ultimately medical men feel that Drs. Yule and Lewis bave a prior they may find an extensive and appropriate sphere of claim to any positions that may be vacant, and that usefulness ; but public opinion in this country is not they have been badly treated. The general opinion, so yet ripe for their acceptance as suitable exponents of far as I can gather from medical men, is that the whole the medical art in all cases indiscriminately. No one Committee should resign, and a new Committee com• denies the right of women to practise. Having worked | posed of business men and members of the honorary for and earned her degree or qualification, she is as staff should be appointed, and ladies be left out of the much entitled to seek the suffrages of the sick as any management altogether. mere man; but it will probably be long before public There is a good deal of dissatisfaction amongst the confidence establishes her on anything like the sure students at the Melbourne Hospital at the high fees basis of ber brother practitioner, and circumstances they have to pay for clinical instruction, and it is to be must constantly arise where the question of sex becomes hoped that a fair reduction will be soon made. There a matter of awkward importance, from the point of is also a growing feeling that better accommodation view both of convenience and of propriety.

should be provided for the Resident Medical Officers at This has been strikingly illustrated quite recently at the Hospital, and that they should be paid for their the Macclesfield Infirmary, where the Governors, no services. doubt because they considered her the best candidate, Payment for medical services is a question that is appointed a lady as junior house surgeon. Toe medical being discussed in many quarters, and it is felt that staff strongly and unanimously objected to this selection, our Defence Association might interest itself in bring. and when they found that their expression of disap- ing to a finality so many honorary positions that should proval was resisted by the governing body, they quite not be honorary. By this I mean appointments to racing properly threatened to resign en bloc. As they had clubs, football clubs, bicycle associations, etc., etc. All from the beginning declined to countenance the ap- these amusements should be paid for, and medical pointment of a lady, the action of the Governors in attendance should not be gratuitous.

The Williamstown medical men held a meeting on

ANISOMETROPIA. the 12th March, at which it was agreed that the ladies' lodges should be notified that at the end of Warch their ( To the Editor of the Australusian Medical Gazette.) medical fees would be on the same basis as all the other

SIR, --I have to thank teriscopist for his courteous lodges. Dr. Honman intimated that he considered 10s.

note to my letter. To begin with, I should like to would be a fair fee to charge the Rechabite lodges for single members, but the proposition was not accepted others, he seems to have proved me partly wrong.

freely acknowledge that on one point, the practice of by the other members, and it was agreed that the rates

When one has recognised what he believes to be a of pay should remain as they were until complete principle, and has put it in practise with success for unanimity was obtained amongst all the medical men.

years, one is apt to assume, as I did without reference, Dr. J. l'homson brought forward the following motion

that such names as Periscopist overwhelms me with -" That the medical officers of the Williamstown

have recognised and practised it also. I must ask to Friendly Societies bring under the notice of the

be acquitted of knowingly suggesting that such men Medical Defence Association the paragraphs in

are capable of slipshod work. In this matter, how. the Australasian Medical Gazette of February last,

ever, I would venture to disagree with part of their stating that the A.N.A. Board, Sydney, had de practice, and to even prophesy that they will come to cided to fix the wage limit for benefit members at

change their opinions. The sweeping character of my £200 per annum, that in their opinion the abuse

assertion however, is modified when it is remembered of medical benefits is most deplorable, and that the

that I referred to anisometropia and not merely to high Medical Defence Association be requested to take degrees of anisometropia. Upon his use of this term I action at once in this matter of wage limit in benefit

hope Periscopist will forgive me for again joining issue societies." This was seconded by Dr. Bryant, and carried unanimously.

with him. Before writing my note I did consult one

authority, owing doubtless to a like puzzling thought The infant mortality during the summer months has lo that which assailed Periscopist, viz., can my conbeen very great, and it has been suggested by Coronerception, translation or definition of anisometropia be Dickson that there should be some public place where correct? On referring to Landoit (Refraction and Acinfants could be treated in a uniform manner. This commodation of the Eye) I found the following defiis a very wise suggestion, and would be found to

nition of anisometropia : “ The state in which the answer its purpose admirably, and would be highly refraction of the two eyes is unequal. Slight differappreciated by medical men.

ences between the eyes in the same person are freThe bubonic plague has at last made its appearance quently found, and are certainly commoner than in cur midst, in the person of a man living at Fitzroy. absolute equality of the two. But it is not of such He was removed to Coode Island, and every precaution | trifling inequalities which deserve no special name that taken to prevent the spread of the disease. Another we are about to speak. For our purposes anisometropia supposed case was reported from Yarraville, but did begins when the aifference of refraction between the not prove to be plague.

two eyes exceeds the value of the minimum intercal The Easter camp has been partially postponed, prescribed by our notation for the different degrees of owing to heavy rains ; but if the weather clears refraction. In other words anisometropia exists whenup part of the programme is to b gone through. ever the two eyes demand in order that each shall Colonel Williams, the P.M.O., met the medical possess its maximum of visual acuteness, or in order to officers of the Victorian military forces at the Victoria present to the observer the same clearness in their Barracks on the 10th March, and gave a

ophthalmoscopic images two different numbers of of the duties of the medical officers under the spectacle glasses.” The italics are mine. Commonwealth regime, and it was felt by all present periscopic note given any indication that it referred that in Colonel Williams they had a man who knew only to high degrees of anisometropia or to exceptional his work himself, and would see that everyone else cases my letter had not been witten. But it talked of should at least have the opportunity of bringing anisometropia, and I am content to abide by Landolt's himself up to a proper standard. It was hoped that in definition of this. There can be little doubt that it will future more consideration would be given to the also be the definition which would naturally occur to medical department of the forces, which is woefully those not engaged in special eye work, and that to such behind the times in many ways. Colonel Ryan voiced members of the profession the suggestion that the the opinion of all his officers when he stated that incorrection of each eye in ordinary cases of anisometropia Colonel Williams we had the most suitable officer to was unusual would come as a species of shock. Dr. occupy the position of head of the medical department Duane, though using anisometropia somewhat ambiguof our Commonwealth.

ously, and including in his table “ for the most part Dr. Worrall's remarks anent the A.N.A. at the only such cases as showed a difference of refraction of Hobart Congress have caused a great amount of dis- at least 2 D. between the two eyes," evidently does not cussion in this State, both amongst medical men and restrict the word to high degrees of inequality. In the various branches of the A.N.A., and many motions fact his table includes one case in which the following have been passed by the A.N.A. branches, expressing correction was given, viz. :their indignation at the remarks, and their denial of the

R. E.-75 D. qt. charges brought by Dr. Worrall against them.

L, E.-1.75 D. oph. A lodge abuse that has been quite common lately is In justice to Periscopist, however, I must acknowledge as follows :- A young man passes the lodge doctor, and that some of the text books contain some justification w.thin a week the doctor is called in to attend an for the restricted use of the term claimed to be usual invalid mother, and by the lodge laws he must attend by him, this chronic case perhaps for months. It is quite time The practice of ordering spectacles for constant wear that lodge matters were brought to a better condition ! exact for one eye, and knowingly inexact for another for the general practitioner, whose life at present in eye, capable of sight, seems to me difficult of justifica. most unenviable, what with heavy expenses, small fees. tion. I find, however, as Periscopist says, that most of and petty annoyances of all sorts from exacting lodge the text-books recommend it for high degrees of anisopatients.

metropia, though not always for the same reason,


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My numerous cases, of all of which I have notes, piece which will last as long as the apparatus itself, it include amongst them, as Periscopist surmises, high will not get out of shape, and what is more important degrees of inequality, and my rule has been for the past it can be thoroughly cleansed after each time it is used, sixteen years to endeavour to give each eye its correc- with soap and hot water, or some disinfectant as thought tion. I have been so satisfied with the course, which desirable. If you think this suggestion may prove of seemed obvious, and with the result, that it would use, 1.erhaps you will kindly find room for it in the appear to have made me unconscious of the practice columns of the Garette. being unusual in cases of high degree.

I am, Sir, etc., I should, of course, have referred to the different

JOHN I. SANGSTER (Senr.) text-books, etc., before speaking so strongly for others, Kooringa, S. Australia, March 19th, 1902. for I admit that my assertion included all but exceptional cases of high as well as those of low degrees of anisometropia. It has occurred to me that my satis

SANATORIA FOR CONSUMPTIVES. factory results with these cases have been largely due to the fact that I practically never look for immediate (To the Editor of the Australasian Medical Gazette.) comfort, or immediatc good distant vision with the

SIR.-I think the Medical Congress is to be con. glasses 1 order ; expecting sometimes a considerable gratulated on its rejection of the resolation proposed amount of discomfort and of reduced discant vision (in with regard to the establishment of sanatoria for hypermetropis) until after a few weeks of constant rear.

consumptive patients at distances from all towns and In younger hypermetropis, indeed, immediate comfort villages with at least an area of 200 acres to each. with the spectacles ordered means, almost invariably This well-meant resolution if passed would, I am in my experience, under correction of the spherical convinced, have proved most mischievous in retarding

the provision of suitable accommodation for phthisical I am gratified to learn that Periscopist's practice in patients. I do not deny that the isolation of these general agrees with mine. I have the hope and had

cases on 200-acre blocks at distances from towns and the belief that it is not an unusual one amungst my villages would be effectual in the prevention of interstate colleagues. I hope that you will not con

phthisie, so also would their deportation to an island in sider the space occupied by this subject has been

the Pacific. a proposal which is scarcely more impracgreater than it deserved.

ticable. It shouldbe hardly necessary in writing to a Yours faithfully,

medical journal to repeat such truisms as :That the J. LOCKHARDT GIBSON. consumptive is not necessarily a source of infection, or [Dr. Gibson's honourable withdrawal from his un

that the danger of infection in or from an institution tenuble position leaves me nothing to say beyond that

in which proper regulations for the disposal of sputum, it is a gratifying proof of my estimate of his fair- etc., are carried out is practically nil. I could, if mindedness. I should possibly have made it clearer necessary, having recently atteniled the International that Duane's paper referred to cases of considerable Congress for the prevention of Tuberculosis, cite overdifference between the two eyes, but it must be re

whelming authority for these propositions, were it membered that in the limited space allowed one for justifiable to fill your space with what must surely be these notes one has to eliminate every unnecessary

familiar to the majority of your readers. The comword, and seeing that Dr. Gibson had read Dr. Duane's munication of phthisis from the sick to the healthy in original paper, I naturally supposed be understood that private houses, work-shops, hotels, boarding houses, Duane referred almost entirely to cases of considerable travelling conveyances, etc., is at present owing to the difference in refraction. I should like to know Dr.

almost universal want of proper precautions in dealing Gibson's practice in one class of case, viz., in aphakia with the sputum, a most serious danger In dealing of one eye, the other eye being healthy. Does he give with it by the provision of sanatoria and hospitals we in these full correction of each eye ?-PERISCOPIST.]

are hampered mainly-apart from ignorance as to the existence of infection, an ignorance which is gradnally

disappearing-in the first place by the fear of the A SUGGESTED IMPROVEMENT IN CLOVER'S expenditure which might be entailed, and secondly by ETHER INHALER.

the popular prejudice against sanatoria and hospitals for consumption as possible centres of infection. The

effect of passing this resolution would have been to (To the Editor of the Australasian Medical Gazette.)

have strengthened both these obstacles Proposals for BIR.—I suppose that most practitioners who have the prevention of tuberculosis on a wide scale to be much use for Clover's inhaler, find that after a time the of use must (1) be of a practical character, utilising as face piece becomes almost unusable, it gets soft, out of far as possible existing institutions by the addition of shape, and on its inner surface lined with cracks which suitable accommodation, and (2) must, while pointing become receptacles for execretions, often offensive, out real dangers carefully refrain from encouraging an from the mouth. On application at wholesale houses, ignorant fear of sanatoria, for which there is no real I have not been able to get the face piece replaced, so foundation, To develop such proposals in detail that meant the purchase of a new inhaler. It occurred would, sir, be to trespass too much upon your space. I to me that a metal face piece, capped with the rubber could hardly do my argument justice within a small cap, which can always be procured, would answer very compass, and indeed I have already discussed the well. The local tinsmith having the old face piece for whole subject recently in an official report, of which I a pattern made me an excellent substitute, and fixed it

forward you a copy: to the tubular portion of the inhaler, the edge of the

I have the honour to be, Sir, tiu face piece needs to be made thicker, by having a

Your obedient servant, rim of wire soldered around it, this prevents the rubber

A, JEFFERIS TURNER, M.D. Lond., cap from slipping, two bits of adhesive plaster make

D.P.H. Camb. that doubly sure. The metal tin answers the purpose Late Representative of the Queensland Government at quite well, perba ps nickel or aluminium woulit look the International Congress for the Prevention of more finished. Tbe repaired Clover now has a face

Tuberculosis held in London in 1901.


Victorian societies will do the same, for there is nothing

whatever to justify the continuation of the practice. (To the Editor of the Australasian Medical Gazette.) report of the recently formed Queensland Medical

In this connection, however, one is sorry to see in the SIR, -Although there may be a considerable difference Defence Association that an honorary solicitor had of opinion as to the advisability of establishing an been appointed and had drafted out the rules and conAustralasian Medical Association yet, I believe, those stitution of the association. May one, in a kindly who are interested in medical politics will readily agree spirit, suggest to the Queenslanders that their action is that the federation of all the rarious State Medical somewhat inconsistent with the South Australian Defence Associations is desirable, and that the sooner resolution, and that they should pay their lawyer and it can be accomplished the better. For any great not accept his services gratuitously. good to result from such a federation it would be We all hope our Queensland brethren will be able to necessary, however, to alter the constitution of at least successfully boycott the Brisbane Medical Institute. one of the Medical Defence Unions, and that the oldest, In this connection, may one draw attention to the viz., the New South Wales. Comparing this union recent decision of the General Medical Council of Great with the younger association of Victoria, we find that Britain, as reported in the British Medical Journal of the latter is becoming much more vigorous and increas. | December 7th, 1901, in the case of Dr. Randell. The ing each year, wbile the former is doing little else than action of the Council is surely the most hopeful sign that accumulating funds, though, of course, one must admit the general practitioner has be able to see amidst the that the mere establishment of such a union is enough gloom cast round him by lodge work, and should in many cases to deter people from entering on legal cucourage all medical reformers not to be faint-hearted. action. If we ask for the reason why the younger society There is no doubt whatever that Friendly Societies is outrunning the older, we shall find it in the fact

canvass, but it is done so irdirectly that it is difficult that the Victorian society combines with its medical

to prove.

If newly qualified medicoes can be kept defence work the consideration of any matter affecting from accepting these lodge appointments, only half the welfare of profession in general. Hence it is able and the applications would be received. Years ago I does deal with such matters as lodge abuses, insufficient suggested the method advocated in your leading remuneration of medical men at inquests, notification article, viz., special lectures on medical politics to of infectious diseases, etc., whereas the New South fifth-year students, to bring matters prominently under Wales Medical Union is by its constitution confined to the notice of recent Melbourne graduates. I, at the the legal defence of its members only, and is thus request of one of the Melbourne Hospital staff, wrote purely provincial since nothing it does can have any an arti•le dealing with the subject for the Melbourne effect upon nen outside New South Wales. The medical students' journal, The Speculum. Cannot entrance fee, £1 1s. and annual subscription £1 ls. is more of our men do likewise ? also double that of the Victorian Association and seeing

Yours, etc., that it has now a balance of £1,560 to its credit there

ABOU BEN ADHEM. is surely no need to keep its subscription at the higher figure. A striking illustration of the difference in the

(To the Editor of the Australasian Medical Gazette.) working of the two associations is afforded by a recent instance. It will be within the recollection of your practitioner in New South Wales after two years'

SIR, - Contemplating the position of the contract readers that last year certain Friendly Societies in

absence from the State, and having carefully read the Broken Hill combined and advertised for a doctor. The only man in New South Wales who accepted the correspondence, notes, etc., in your issues during that

interval, I beg to draw your readers' attention to page position was a member of the New South Wales

53 of the report of the Brisbane Intercolonial Med. Medical Union, and still is a member. Such a

ical Conference, held in September, 1899. It will be thing would never have occurred in the Victorian Medical Defence Association,

seen that on September 20th, 1899, I suggested that it would have

the members of our profession “should form an at once notified, not only its members, but the association to supervise all contracts between medical whole of the profession in Victoria, of the con. ditinn of matters, and any member so applying ditions under which such practitioners laboured. He

men and friendly societies, and to improve the conwould have been summarily dealt with. Fortun

moved that they should recommend the formation of ately the Broken Mill men by standing together such a Society, because he believed its disciplinary have been able to prevent the continuance of the

powers would be of benefit, and its advisory powers institute, but the New South Wales Medical Union did little to help it. This instance as well as the fact that equally great.”. I believe that in formulating that

motion I used the word " contract" medicoes of one of the largest New South Wales

very markedly, as

I wished to bring insurance companies and hospitals towns were not aware till lately that the Australian

into the scope of the resolution. A later speaker made Natives' Association had been declared a society pre

a demur at this word, and I, with permission, altered judicial to the best interests of the profession, afford

my proposal, naming an “ Australian Medical Pracproof enough that there is nced in New Sonth Wales of an organisation working on the Victorian lines. Is it and controlling the practice with regard to benefit

litioners Asssociation for the purpose of supervising too much to hope that the members of the New South

societies and similar institutione." Dr. Worrall mored Wales Medical Union will so alter its constitution as to

as an amendment that the defence associations should become a more active body, and worthily representa. tive of the unity with which the Sydney men

take up the matter, and proposed the names of six have held together, as shown by their opposition to the gentlemen “ to press forward the desire of the Congress

in this important matter.” I withdrew my motion, Australian Natives' Association, the Clerk and Ware

an 1 seconded Dr. Worrall's. His motion was unani. housemen's Association, etc.

mously carried. The last entry in the report of the The South Australian Medical Defence Association is meeting is “ The proceedings then terminated.” Can 10 be congratulated upon passing a resolution disapproving you inform me if, at the Hobart Conference or else. of its members giving their services to racing clubs in where, a report has been made by the six'gentlemen au honorary capacity, and it is to be hoped that the referred to ?



I can see so slight a difference in our position after 3. The chances of the discharge continuing even two and a half years lapse of time that I again venture after the operation. to suggest the formation of a new and special organi. I would say to No. 1. The dangers of the operation, zation. The chief difficulty under which we when skilfully performed, are small; of the anæsthetic, labour is lack of mutual aid. If Dr. A. ‘resigns a not more than in other operations-less probably than Lodge day, to-morrow Dr. B. offers himself. If Drs. that for tooth extraction. A. and B. will join such an association, A's articles To No. 2. In sixteen years experience of mastoid would prevent Dr. B.'s action when opportunity arose operations in private and hospital practice, during six from Dr. A.'s action. The essence of mutuality in of which I have, when necessary, done the radical such cases is some common bond other than that which operation, I have not had one case of permanent is now regarded as nominal-a professional kinship. I paralysis of the facial nerve. The hearing power is am more than ever convinced that not only union, more likely to be improved than injured when a middle but the discipline of volunteers, is required. A rule ear, filled with granulations and pus, is converted into that none should offer their services except with the & clean cavity. consent of the Council, or to bodies already approved To No. 3 I would say that I have many cases of of by the Council, would make such a society real. complete success by the radical operation, which could Items of detail I am prepared to add, but not to this be attained by no other means. letter, which is already too long. As Dr. Syme said at I agree with Dr. Arthur that operative measures are the meeting to which I referred above, the other only exceptionally required, but not with his pessimis. Societies have their special work. Therefore I think tic statement that "a chronic otitis will exhaust all something new is required. The British Medical our remedies and patience." I find that cases which Association has its scientific work, Defence Unions have existed for years will generally yield to local their special work, and so on.

treatment-particularly when diseased granulation and Some practices have made an improvement—but only polypoid tissues are removed. The exceptional cases a small number -after many years. Let our profession may include some which require radical operative try to get all into line that individuals will have the treatment. In fact, I regard the treatment of middle advice and support of a centre. By such means only ear suppuration-acute and chronic-as the most will, I believe, we all be freed in this connexion from brilliant field of the aural surgeon, if we except the and away from distrust of the profession or any fine results which follow the removal of a piug of individual member thereof.

impacted cerumen. I am, etc.,

I do not hold with the view thac operations on the GERALD S. SAMUELSON. mastoid should be postponed till dangerous symptoms Armidale, March 1912, 1902.

supervene. This means that a mastoid suppuration may have extended to a sinus thrombosis, a cerebral,

or cerebellar abscess. Like Dr. Arthur, I do not THE TREATMENT OF MIDDLE EAR

operate because there is pus in the middle ear, which it SUPPURATION,

may be impossible to stop by local treatment, that is,

so long as the condition is quiescent. I operate wben ! (To the Editor of the Australasian Medical Gazette.)

believe the patient's life is endangered by delay, but I SIR,—I desire to offer a few remarks on Dr. Arthur's

go further, and comply with the wish of many, and paper on “ The Treatment of Middle Ear Suppuration,"

endeavour to cure a condition, which makes life a misery, which appears in your issue of March 20th. With by operative measures, when other treatment, after most of his conclusions I agree, but some I think, sufficient trial, has failed. cannot be allowed to pass without criticism. Where he

Against the method mentioned by Dr. Arthur of makes Macewen, of Glasgow, say that “ he would

some American surgeons of filling the auditory canal rather have a charge of dynamite in his ear than a drop with carbolic acid, I would warn the profession. I of pus,” I would point out that Professor Macewen, whom

bave no experience of it, nor am I likely to have. The I may venture to call my friend, having been so kindly result would be a probable necrosis of the epidermis of received by him when I, six years ago, had the privi. the auditory canal, and of what remained of the lege of attending his Clinic in Glasgow, does not

memb. tympani. If I have thought it necessary to express any personal preference of this sort. Macewen,

make these remarks on the able and thoughtful paper in his classic work, “Pyogenic Diseases of the Brain, of my colleague, Dr. Arthur, it does not follow that I etc.,” says : “ Where the tympanic cavity has become do not agree in the main with most of his conclusions. the seat of chronic suppuration, with ulceration of the

I am, Sir, mucous membrane extending into the antrum and

Yours obediently, mastoid cells, it becomes a standing menace to the

A. J. BRADY. safety of the patient. A person might as well have a charge of dynamite in the mastoid antrum and cells, as

Hon. Surgeon, Department for Diseases of the Ear, one cannot know the moment when accidental circum

Nose, and Throat, Sydney Hospital. stances may arise, which may cause the infectious 3 Lyons' Terrace, Sydney, matter to become widely disseminated all over the

March 24th, 1902. cerebro-spinal system.” The italics in the passage quoted are mine. They emphasise the cases in which surgical treatment of the mastoid, according to According to a recent consular report, Dr. Macewen, becomes necessary. The indications for Ekenberg, of Gothenberg, has worked out a method of opening the mastoid antrum' are clearly stated later reducing milk to the form of powder, which will be on in his work. Regarding the radical operation, Dr. of far-reaching importance to the business of dairy Arthur says before he would allow it to be performed farming. It is said that the product pussesses all the on himself he would like to know

qualities of milk in concentrated form, except that 1. The dangers of the operation and the anæsthetic. moisture is absent, and that it will not get suur or

2. The danger to my facial nerve and what hearing ferment. The milk flour is completely soluble in water, power I had left.

and can easily be transported in tins, barrels, or bags.

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