hospital were placed there. But the opposition to the scheme, on the ground of its being a menace to the health of the inhabitants and a source of danger of infection by the tubercle bacilli, is based on an entire misconception of the modes of infection in pulmonary tuberculosis, so far as we are acquainted with them at present. To refer again to the Brompton Hospital for Consumption in London. This hospital is situate in a crowded neighbourhood of good-class houses and residences, and every week hundreds of phthisical patients travel by rail and 'bus to the hospital; yet statistics prove that the death rate from pulmonary tuberculosis in the district of Brompton is lower than in almost any other part of London. The same holds good in the case of the Victoria Park Hospital for Diseases of the Chest in the East End of London.

These facts show that a consumption hospital conducted on proper lines is not in any wise a source of danger to the district, and the fears of the inhabitants of Hornsby and district on this score are groundless.

While, however, it would be manifestly wrong in the face of our present theoretical and practical knowledge of the pathology of pulmonary tuberculosis to deny the danger of contagion, it is equally wrong to promulgate false theories and statements, the only effect of which must be to hinder the progress of preventive measures, and to render the lot of the poor consumptive much harder than it need be.

THE MEDICAL PROFESSION AND THE AUSTRALIAN NATIVES' ASSOCIATION.

SOME recent tactics of the Australian Natives' Association in Victoria prove, what has already. been urged in these colums, that this "patriotic" association is primarily a political organisation which secures for its officials and members special political and municipal privileges; and, secondarily, is in reality a medical sweating

institution under the guise of a friendly society. The latest proposal emanating from this high class patriotic society is to establish a medical institute, to be called the Carlton, Collingwood, and Fitzroy Medical Institute. The medical officers are to be precluded from private practice, and are to be paid at the munificent rate of £300 per annum for 500 members, and £6 per annum for every 10 additional members; the total number, however, on any one medical officer's list not to exceed 1,000.

This proposal has arisen in consequence of the recent action of some members of the Victorian Medical Defence Association in refusing to accept a reduction in their rate of remuneration for attendance on the members of a Foresters' Lodge in Carlton from 15s to 13s per annum. In the eyes of the A.N.A. this looked too much like organised resistance by the medical men, hence they felt that it was time to put on the screw and crush any attempt on the part of the profession to throw off the yoke. We hope that this incident will be an object lesson to the profession in Victoria, and that instead of calmly submitting to this proposal they will at once organise and take a determined stand in this matter. We hope that the profession in New South Wales will also take note of these tactics, and observe what they are likely to experience at the hands of the A.N.A. in this State if once they yield in the smallest degree to their arrogant assumptions and submit to become their slaves.

It is deplorable that over 70 medical men in the metropolis of Melbourne should be content to accept 12s 6d or even 13s for attendance on lodge members. Nothing less than 16s, which is the minimum recognised in New South Wales, should be accepted, and a determined effort should be made to secure it. This must be done sooner or later if the profession is not to be sold body and soul to the A.N.A. There never was a time when medical defence organisation was more necessary, and we trust that the Medical Defence Association of Victoria will adopt a bold policy, not only of defence,

but also of offence, and carry the battle directly against the strongholds of these politicomedical-sweating institutions. In this battle every individual practitioner in the State is interested more or less, and though one may think that it is a matter of indifference to him, he will yet find that the welfare of the whole profession is of vital interest to every member of it.

MEDICAL PRACTITIONERS' BILL.

A BILL to further amend the law relating to the registration of medical practitioners has been introduced in the N.S.W. Legislative Assembly. It provides that it shall be lawful for the Medical Board to place upon the separate register referred to in section 3 of the Medical Practitioners Acts Further Amendment Act of 1900 the name of any person who proves that he has studied at a recognised school of medicine, surgery, or obstetrics, although he had not completed the full course at any school; and (b) proves that he had practised in a reputable manner in New South Wales as a medical practitioner during 10 years prior to the passing of the bill; and (e) produces a certificate signed by two legally qualified medical practitioners of his ability and good repute in the practise of his profession. Such person when so registered shall have the rights of a legally qualified medical practitioner registered under the Medical Practitioners Act of 1898. It is hardly necessary to point out that under this bill, if it be passed in its present form,* anyone who has had no medical education whatever can have all the rights of a legally qualified practitioner. For if he has spent only one day inside a medical school, he can comply with the requirements of the first clause. We sincerely hope that this bill, which has obviously been introduced in the interests of some unqualified practitioners, will not become law, and that the State Legislature will decline in future to impair the utility of

The bill was thrown out on the second reading, on July 15th.

the Medical Practitioners Acts Further Amendment Act of 1900. Any act which will facilitate the acquirement of a full status as a legally qualified practitioner by an imperfectly educated person must only result in jeopardising the maintenance of the health of the general public. As we urged in our last issue, the question of medical registration should be dealt with by the Federal Government, and we hope that a comprehensive Medical Bill will be introduced into the Federal Parliament at an early date.

THE MONTH.

British Medical Association Conversazione. A very successful conversazione was given by the president and committee of the New South Wales Branch of the British Medical Association in the great hall of the University of Sydney on the evening of June 24th. Some 900 invitations were issued to members of the profession throughout the State, as well as to prominent officials and citizens. His Excellency Sir Harry Rawson, K.C.B., Lady Rawson, Miss Rawson and suite, His Excellency the Admiral and Lady Beaumont, Lady See, His Worship the Mayor of Sydney and Mrs. Hughes, the Chancellor of the University (Sir H. Normand MacLaurin, M.D.), and many others were present. Exhibits were shown by Drs. Ashburton Thompson and F. Tidswell from the Department of Public Health; by Mr. H. C. L. Anderson from the Public Library; by Mr. H. C. Russell, Government Astronomer; by Dr. F. H. Quaife, Dr. Hankins, Dr. G. L. O'Neill, Dr. Houison, Prof. J. T. Wilson, Dr. Sydney Jamieson, and others. Dr. C. A. Edwards gave an excellent exhibition of X-ray apparatus and vacuum tubes. The function was in every way most enjoyable.

The Governor's Levee.

At the levée held by His Excellency the New South Wales State Governor (Sir Harry Rawson, K.C.B.) on June 17th last, the New South Wales Branch of the British Medical Association was for the first time recognised as a public body. Some 50 members of the Branch attended and were presented to His Excellency by the President, Dr. G. E. Rennie. The Branch was also well represented at the farewell levée held by His Excellency the Governor-General on July 7th.

Proposed Maternity Hospital in Hobart.

It is proposed to establish a Maternity Hospital in Hobart as a memorial of the King's Coronation. At a meeting of members of the Medical section of the Royal Society the following lines were unanimously agreed upon as those upon which the profession would strongly support the proposed Maternity Hospital:1. That a Maternity Hospital is desirablesay, six to eight beds. 2. Patients unable to pay should be admitted free of charge; such patients to have a claim to one-third of the beds, and that an honorary medical staff should be appointed to attend such patients. 3. All paying patients must produce a recommendation from a medical practitioner before admission, and shall be allowed to engage their own medical attendant. These views were subsequently communicated to the finance committee of the King's Coronation Celebration Committee at a conference with members of the profession in Hobart, and a vote of thanks was accorded to the doctors for their valuable advice and promised co-operation.

Australasian Trained Nurses' Association.

The annual meeting of the Australasian Trained Nurses' Association was held in Sydney on July 11th. The President (Dr. F. Norton Manning) took the chair, and there was a large gathering of members of the Association. The report presented by the council gave a lengthy resumé of the large amount of work done during and records steady progress. the year, The total number of ordinary members on the register is now 513, and the midwifery branch now number 111 members. There are 62 medical members and 12 honorary members. The general funds of the Association are in a satisfactory condition, but the benevolent fund has not received the amount of support necessary to place it on a good foundation. It is gratifying to note that the question of the training of nurses has been carefully considered, and no nurse is registered who cannot produce certificates of having received systematic education and careful training.

there are Government vaccinators no vaccinations have been reported. It is therefore presumed that none have been performed. The number of births registered in the State during 1901 was 37,826, and the vaccinations thus give a percentage of 5.5. We have previously drawn attention to the very small percentage of vaccinated children in this State; and the fact of there being 97 districts in which no public vaccinations have been performed shows great laxity on the part of the profession in advocating what has been proved to be an important prophylactic against smallpox.

The Friendly Societies' Association of New South Wales and the A.N.A.

At a general meeting of the Friendly Societies' Association of New South Wales, held on June 27th last, the main business brought under consideration was the following motion, notice of which had been given by Bro. O. C. Pennington, G.M. of the National Independent Order of Oddfellows :-"That the Australian Natives' Association be requested to retire from the Friendly Societies' Association, as its aims and objects are inimical to the interests of this Association." This question formed the basis of a long discussion, but eventually it was decided in the affirmative by 20 votes to 11.

We are glad to notice that the Friendly Societies have taken the same view of the A.N.A. as that adopted by the New South Wales Branch of the British Medical Association, and have refused to be drawn by the A.N.A. into an attitude of hostility to the medical profession in New South Wales.

Honours to Medical Men.

Some members of the medical profession have been honoured by His Majesty the King on the occasion of his Coronation.

Sir Henry Normand MacLaurin, Kt., M.L.C., M.D., LL.D., the Chancellor of Sydney University, graduated M.D. at Edinburgh University in 1857, and in the same year was admitted L.R.C.S. and L.M.R.C.S. of Edinburgh. He is an LL.D. of Sydney University, and was nominated to the Legislative Council of New South Wales in 1889.

Sir John Logan Campbell, Kt., M.D., M.R.C.S., was born in 1817, and educated at He has been associated with Edinburgh. political and mercantile life in New Zealand, and has also published a book on early life in New Zealand.

Lieutenant-Colonel Robert Vandeleur Kelly, C.B., of Sydney, originally went to the front with the second detachment of the A.M.C. He

acted as regimental surgeon to the composite cavalry brigade, and assisted the 1st and 2nd Life Guards and the "Blues." He is the chairman of the New South Wales centre of St. John Ambulance Association, and also holds the position of Knight of Justice in the Order of St. John.

THE FIGHT AGAINST TUBERCULOSIS IN AUSTRALASIA.

VII.

Tasmania.

Ir is most probable that prior to the colonisation of Tasmania the island was free from the scourge of tuberculosis, and that this disease was an importation from Europe, as the early French savants who visited the island found no traces of phthisis or other tubercular disease amongst the aborigines. Be that as it may, soon after European settlement phthisis commenced its ravages amongst the natives, and finally acquiring almost an epidemic form helped to exterminate the aboriginal tribes.

In the long years which have elapsed since then tuberculosis has taken its annual toll of the white population, though never to the alarming extent of the old world's death-rate, thanks to our mild climate, our sparse population, our pure air, our outdoor life; and this despite the fact that we were continually importing tubercular subjects in all stages of their malady, who, in their search after health, doubtless often served as centres for the propagation of disease.

Taking the statistics of deaths from phthisis in Tasmania for the last 30 years, we find that in the first decade, 1871-80, the mean deaths per 10,000 people living was 10; in the decade 1881-90, 105; and in the 11 years 1891-1901, 7-5, showing an appreciable diminution. Since the year 1887, when the death-rate was almost at its highest, viz., 11.5 per 10,000 living, there has been a gradual diminution until, in 1901, the death-rate from phthisis has fallen to its lowest figure, viz., 57 per 10,000 people living.

If we consider the statistics of the last 11 years which show the figures of deaths from all forms of tubercular disease the decrease is still apparent, the death-rate being in 1893 at its highest, viz., 12:03 per 10,000 living, and gradually falling to 8-06 in 1901, figures which compare favourably with those of the other States.

As regards legislative and administrative action, there is no legislation in Tasmania directly dealing with tuberculosis; but the

Public Health Act of 1885, and its amendments of 1887, 1889, and 1896, and the establishment under these Acts of Local Boards of Health, have been indirectly of no little value. Unfortunately it is only in the larger towns of Hobart and Launceston that the powers conferred by these Acts have been made much use of. Under these Acts the inspection and registration of dairies, &c., is carried on; and any dairy or store supplying milk or butter within the district of a Local Board of Health, even if itself outside the radius of that Board is, nevertheless under its jurisdiction.

may

At the abattoirs of the two cities there is regular inspection of carcases, tubercular ones being destroyed in whole or in part, as the G.O.H. direct. At the Launceston abattoirs about 25% of the carcases are found to show signs of tuberculosis. As for bovine tuberculosis no active steps have so far been taken to deal with this phase of the question, although the attention of the Government has been repeatedly drawn to it.

Both in Hobart and Launceston by-laws have been adopted prohibiting expectoration on pavements, &c., and it is to the credit of the Hobart local board and its G.O.H. that it was the first in Australia to pass such a by-law in 1896.

A great want in the public health system of Tasmania is the establishment of a public bacteriological laboratory in the north and south of the island for the examination of sputum. Not only is such necessary for suspected cases of tubercle, but also for diphtheria, typhoid, plague, &c. ; and it is to be hoped that the public health authorities will ere long take steps to ensure the opening of such laboratories, the equipments for which already exist, although a somewhat "dog-in-the-manger' policy has hitherto prevented their proper utilisation. There is no notification of tubercular disease, and although such a measure would be of no little value should it ever become law, great care will have to be exercised to guard the social and pecuniary interests of the patient and his family, and much judgment will be demanded in its administration lest a tubercular scare" be created and the unfortunate sufferers from this disease be stamped as social outcasts.

Were notification in force, the inspection and disinfection of the patient's habitat might be carried out, and much useful information imparted to himself and his friends; at present there is no system of advice by circulars and placards, and in some cases absolutely no care is taken as regards the destruction of sputum, proper ventilation, &c.; the medical attendant

is the only agent in educating the public in this respect, and his endeavours should be reinforced by the provision of such literature.

In 1901 Dr. Walch, of Hobart, was sent to represent the Tasmanian Government at the Tuberculosis Congress, on the work of which he has written an interim report. Dr. Walch is now preparing a detailed report, in which he is dealing at length with the Nordrach cure, with special reference to the establishment by the State of such a sanatorium.

At a general meeting of the Science Congress held in Hobart at the beginning of the year, a resolution was passed recommending in every State (1) the notification of phthisis; (2) the establishment of at least one sanatorium for tuberculosis in each State. This resolution was referred by the Central Board of Health to the Medical Society of Hobart, which body endorsed the resolution of the Science Congress.

A word as regards the climate of Tasmania in relation to the treatment of tubercular disease. Some cases of phthisis and other forms of tubercle do well in our higher altitudes in the lake district, while the mild dry climate of the East Coast is beneficial to some of the early cases, but great care will have to be taken in the examination of the climatic conditions of different localities before a site or sites are chosen for the establishment of sanatoria.

Tuberculosis.-Professor Behring, the inventor of diphtheria antitoxin, in a book he has recently published, gives some valuable information concerning the relation between the tubercle bacilli from men and those from animals. In co-operation with Dr. Ruppel and Dr. Roemer, he has succeeded in elaborating a practical preventive inoculating process against the tuberculosis of cattle. The experience gained in the laboratory is to be carried out on a large scale for agriculture. The book contains a brief review of all the researches in connection with tuberculosis made in Professor Behring's Marburg Institutes in the last six years. The introduction gives a summary of the results of experiments detailed in the first part with the help of numerous interesting protocols, tables, &c. Important information is given concerning the successful attempts to make young cattle immune from tuberculosis. Behring, by treating young cattle with living slightly virulent tubercle bacilli, has given them such power of resistance to tubercular injections that they are unharmed by very virulent tubercular bacilli, which certainly would prove fatal to cattle not thus treated. This success is of such great importance for agriculture that already immunising vaccination is being carried out on a large scale.

Dr. Frank Tidswell, micro-biologist to the Sydney Board of Health, delivered the first popular science lecture at the rooms of the Royal Society, on June 30th, on "Bacteria and Disease." Professor Warren, President of the Royal Society, presided over a large audience, and Dr. Tidswell received a hearty vote of thanks for his interesting address.

BRITISH MEDICAL ASSOCIATION NEWS.

PROCEEDINGS OF AUSTRALASIAN BRANCHES.

New South Wales.

THE regular monthly meeting of the Branch was held at the Royal Society's Room on Friday, 27th June, 1902, at 8.15; Dr. G. E. Rennie (president) in the chair. Present Drs. Crago, Nolan, McDonagh, Scot Skirving, Hinder, Angel Money, Maitland, Newmarch, Palmer, J. Morton, Roth, Herschell Harris, Fiaschi, McPherson, Jones, Taylor Young, W. Chisholm, Ellen Wood, Harriett Biffin, Agnes Bennett, Kate Hogg, J. C. Windeyer, Maher, Pockley, Bennet, McMurray, Flynn, Brady, Wilkinson, McKay, Doak, Dixson, Murray Will, Gill, Kirkland, Sinclair Gillies, Chas. MacLaurin, Arthur, Gledden, Stratford Sheldon, W. E. Warren, Corlette, Sandes, Worrall, Ludlow, Binney, Sawkins, Martin, H. Marshall, Kenna, Megginson, Shand, Leahy (New Zealand), and others.

The minutes of the previous meeting were read and confirmed.

The PRESIDENT announced the election of the following members :-Drs. S. S. Shirlow (Balmain), G. H. Smith Hozier (Lismore), F. W. Kane (Nowra), R. B. Stoney (Nowra), A. E. Barcroft (Bowral), F. S. Stuckey (Burwood), F. W. Langton (Redfern), C. J. Kearney (South Grafton), E. R. Roseby (Marrickville), J. L. B. Dixon (Bulli), S. Monti (New Italy, Richmond River), J. S. Milne (North Sydney), M. A. Schalit (Sydney), J. C. Windeyer (Sydney), Stratford Sheldon (Sydney), Johannes Carl Hein (Walla Walla), J. A. Caldwell (Maclean), W. J. Olivey (Millthorpe), W. H. Read (Sydney), E. W. Fairfax (Woollahra), C. Hardcastle (Hillgrove), W. R. Clay (Hornsby).

Members Nominated for Election.-Drs. E. W. Buckley (Wallsend), Harrie Cox (Warren), Harry Oswin Johnson (Parkes), A. S. Marr (Blayney).

Dr. F. A. BENNET exhibited a strong and otherwise healthy man who for the past three months had suffered from a skin disease, covering the whole of his body with the exception of head and face. The eruption was more marked on the lower part of the body. It was scaly and tended to run in lines. He diagnosed the case as one of lichen planus.

Dr. HANKINS exhibited a patient suffering from keloid in a scar behind the ear, the result of a mastoid operation.

Dr. ANGEL MONEY said he had nothing to find fault with in the diagnosis of Dr. Bennet's case. He thought it was of neurotic origin.

Drs. RENNIE and CRAGO exhibited a boy. Dr. Rennie said they had produced this boy for the second time, he having been operated on two years previously for hydatid cyst of the brain. When the patient had been exhibited there two years ago, after operation, they had been challenged to produce him again that progress in the case might be noted. Fuller notes of the case would be read later. Briefly, about 12 months ago they had considered a second operation necessary, and they trephined, but on this occasion found no cyst wall but merely fluid from a cystic cavity. The patient now suffered from right hemi-anæsthesia. Dr. ARTHUR read a paper on "The Choice of an Anaesthetic in the Adenoid Operation" (see page 369).