time being. This seemed to him pretty conclusive evidence that the pain was not merely due to inflammation on which morphia would have no curative, but merely an anodyne effect; but was really due to muscular spasm, which the morphia would relax. Pain in biliary colic strongly resembled other pain found in hollow viscera; as for instance, the heat in certain aortic lesions, the uterus in parturition, etc. He saw no reason to postulate an inflammatory cause when a purely mechanical one seemed to suffice.

Dr. HINDER, in reply to Dr. Gillies, stated that it was the stone that caused the patient severe biliary colic. He advocated operation on the gall bladder whether there was stone there or not, to relieve any abnormal condition of that organ. As for the enemata of water, distilled or otherwise, he had not much faith in such treatment, owing to the time it would entail to get any effect. Dr. McKay's case had been treated in the best way under the circumstances. The speaker believed when there was stone in the gall bladder of duct to remove it at once. Dr. Bowker's was an extremely good case, admirably conducted.

Dr. BOWKER, in reply to Dr. Gillies, as to whether gall stones were the result of cholecystitis or occasioned cholecystitis. He had not stated that gall stones caused colic, or that cholecystitis caused colic; he said obstruction caused colic. The speaker did not think enemata of water would cause the gall bladder to contract. He considered that Dr. Hinder and he were both working from the same stand-point. A gall stone might be present in the bladder without causing much trouble.

Dr. SINCLAIR GILLIES read "Notes on a Case of Diaphragmatic Hernia." (See p. 11.)

Dr. SAWKINS referred to a case where rupture of the diaphragm, and consequent diaphragmatic hernia ensued as a result of external injuries, but without any fracture of the ribs.

Dr. BOWKER considered that Drs. Clubbe and

Gillies were to be congratulated on the diagnosis of the case, seeing that according to statistics, only about five per cent. of cases of diaphragmatic hernia were diagnosed during life.

Dr. MILLS congratulated the authors on the diagnosis of their case. He remembered when he was House Surgeon at Prince Alfred Hospital admitting a man who had been crushed between a cart and a gate. He was collapsed and presented obscure symptoms, which were only explained at post-mortem examination as being due to diaphragmatic hernia.

Dr. SINCLAIR GILLIES considered Dr. Sawkins' case of great interest as showing the possibility of rupture of the diaphragm without injury to the ribs. He greatly regretted the enforced absence of Dr. Clubbe, to whom was due the greater part of whatever credit there was in the case.

A SPECIAL general meeting of the Branch was held at the Branch Offices, 121 Bathurst-street, Sydney, on Monday, 10th January, 1902. Present: Dr. G. E. Rennie (Vice-President) in the chair; Drs. W. G. Armstrong, Sinclair Gillies, Macpherson, Sydney Jones, Hankins, Arthur. J. M. Gill, Crago, West, Nolan, G. Hall, Pockley, Kirkland, Todd, Hinder, Mills, Abbott, G. A. Marshall, Read, Dixson, Worrall, Gledden, Bennet, Fiaschi, Shand, J. A. Dick, Flynn, Kate Hogg. The minutes of the previous meeting were read and confirmed.

The CHAIRMAN announced the election of Dr. Kate Hogg and Dr. W. J. Durack.

Dr. RENNIE said the meeting had been called at the suggestion of their late President (Dr. Coutie), who had written from Victoria directing attention to the proposed Australian Medical Association, and suggesting that the New South Wales Branch should hold a meeting and institute a full discussion on the matter for the instruction of those members of the Branch who would attend the meeting of the Medical Congress at Hobart, so that the views of the members on the matter might be expressed at the Congress. Accordingly the Council had decided to call the meeting that night. He (the speaker) would move a resolution, and they would then have an opportunity of discussing it.

The General Secretary (Dr. Gregory Sprott) had communicated with the speaker, and stated that the time fixed for the discussion of this question was the last evening of the Congress. The discussion on cancer was to be held on the Tuesday and Friday evenings, then would be taken the proposed Australian Medical Association at the close of the discussion on cancer if time would allow, but it was quite possible that the question might not come on at all. The proposal, it had been intimated, had not received as much support as was expected, and it was not likely to be carried by a sufficient majority to make the scheme a success. The question had emanated from the Victorian Medical Society, the oldest society of the kind in Victoria. The Victorian Branch of the British Medical Association had never been so influential in that State as the older body, and there had always been a certain amount of antagonism between the two, and during the last year or two a great breach had occurred in the ranks of the Victorian Branch of the British Medical Associa

tion, which had tended to increase the influence of the Victorian Medical Society. It was this Society that had proposed instituting this Australian Medical Association, which was to be established on the same lines as the British Medical Association-to hold annual

meetings, the Association to take charge of these Congresses instead of a shifting committee. In that connection, even in England, the annual meetings of the British Medical Association were controlled by local committees. He thought that most of them would agree that the suggestion to hold annual meetings instead of triennial ones would be a mistake, the latter being much more likely to be successful. Such a proposal would necessarily destroy the existing branches of the British Medical Association in all the different States. Personally, he could not see what advantage was to be gained by this proposal, rather a loss all round by such a procedure. It would be far better to work on with the existing Branches of British Medical Association in the different States, carrying on the work as in the past. He moved the resolution, "That the New South Wales Branch of the British Medical Association, after discussion, is of opinion that the proposal to form an Australian Medical Association is premature."

Dr. POCKLEY inquired how the matter came before the memters.

Adelaide, who was a strong advocate of it, and had also talked it over with some members of the profession in Melbourne three years ago, but found it was not practicable then. He had also written to Dr. Rennie when he was in England, to ascertain what steps would be necessary to form an Australasian Branch, He (the speaker) was decidedly opposed to the starting of an Australasian Medical Association as opposed to the British Medical Association, and, if attending the Congress at Hobart, should do all in his power to prevent it. He (Mr. Crago) said that the Secretary of the Congress had definitely asked for an expression of opinion on the subject.

Dr. WEST wished to point out that the proposal emanated from the Victorian Medical Society, which was on unfriendly relations with the Victorian Branch of the British Medical Association; and the attempt appeared to be one to undermine the usefulness of the Branches.

Dr. ARTHUR said it seemed to him that the present discussion was premature. Nothing that the Congress could do would be binding on the Branches. It could only bring forward an abstract resolution, and postpone the matter for three years before anything could be done. He thought it useless to discuss the question before the meeting of Congress.

Dr. TODD was sorry to hear Dr. Arthur express the views he had. As a Branch of the British Medical Association they were bound loyally to oppose the movement.

Dr. POCKLEY proposed making the resolution firmer by striking out the word "premature," and substituting the word "undesirable.'

Dr. T. STORIE DIXSON, as one of the founders of their Branch, would strongly oppose any proposal to start such an Association. They owed their strength to their connection with the parent Association in the old world, and in severing that connection they could but risk loss of strength. He regretted the paucity of members present, for it was needful that a vigorous expression of opinion against the proposal should be voiced in Hobart, and they must fight there and fight successfully rather than bring forward an abstract resolution to be transmitted to the Congress.

Dr. SYDNEY JONES considered that it was not quite fair to say that the proposed Association was a rival to the British Medical Association, He thought the proposal was to form an Australasian Medical Association, with Branches in the different States, as was now the case with the British Medical Association. He did not know that such was the fact, but considered it highly probable. He did not rise to support this proposal, for he regarded such a step as calamitous, and one that could but weaken the British Medical Association. He would do his best to oppose the proposal tooth and nail.

Dr. WEST said that as a great many of their members would not be able to go to Hobart it might be as well to get a document drawn up for signature by members, protesting against the proposal.

Dr. FIASCHI suggested obtaining the same end by a somewhat different method. He would have a vote taken of the whole of the profession before any steps were taken in the direction indicated by the Congress. Dr. ARTHUR proposed as an amendment, "That the discussion be postponed for six months."

Dr. WORRALL hoped Dr. Arthur would withdraw his amendment. It was highly desirable that the original resolution should be carried at the meeting unanimously.

Dr. ARTHUR saw no reason for withdrawing his amendment. Nothing that the Congress could do

would be binding on them. As the amendment was not seconded it lapsed.

The resolution, as amended, was put to the meeting by the Chairman, and carried with one dissentient. Mr. CRAGO proposed, "That it be a request to the members of the New South Wales Branch attending the Medical Congress to oppose the resolution for the establishment of the Australian Medical Association." Seconded by Dr. WEST. Carried. Dr. WORRALL proposed, 64 That the resolution be transmitted to the General Secretary of the Congress." Seconded by Dr. MILLS, and carried unanimously.

COUNCIL MEETING.

THE Council met at the Editor's room on Friday evening, December 13th, at 8.30 o'clock. Present:Drs. Foreman, Hankins, Crago, Rennie, Jamieson, Fiaschi, Brady, Newmarch, and Todd.

The minutes of the previous meeting were read and confirmed. Members elected-Dr. H. Clatworthy and Dr. Tilley.

A letter was read from Dr. Coutie with regard to the proposed Australian Medical Association. Resolved that a special general meeting of the branch be held on the January 10th for the purpose of discussing the question of the proposed Australian Medical Association before the congress in Hobart.

Letter from a member with reference to the employment of an unqualified assistant. To be informed that the General Medical Council considers such employment as infamous conduct in a professional respect.

Read letter from the Superintendent of the Australian Ambulance Association requesting to be furnished with names of members of the British Medical Association who would be willing to act on the staff of their hospital at Miller's Point. The reply of the Secretary, that he did not know of any members of the Branch who would be willing to accept the positions, was endorsed.

Credit balances :-General Account, £232 8s. 1d; and Gazette Account, £73 7s. 11d.

Accounts passed for payment :-Stamps, £2 18s. 1d. ; refreshments, £2; stamps for Hon. Secretary, £1.

Dr. Rennie proposed that a hearty vote of thanks be accorded to Dr. Crago for having carried on the Gazette while the editorship was vacant. Carried unanimously.

REPORTS OF SOCIETIES.

SECOND ANNUAL MEETING OF SOUTH AUSTRALIAN MEDICAL DEFENCE ASSOCIATION.

THE second annual meeting of the South Australian Medical Defence Association was held at the Adelaide University on Thursday, December 5th, at 8.30 p.m.

Present Dr. Swift (president) in the chair; Drs. Hayward, A. E. Wigg, Harrold, Cudmore, Benham, Jay, J. A. G. Hamilton, Todd, W. Anstey Giles, Marten, and Cavenagh Mainwaring.

Dr. TODD proposed, and Dr. MARTEN seconded, that the annual report be taken as read. (Carried.)

SECOND ANNUAL REPORT. "GENTLEMEN,-The Council of the South Australian Medical Defence Association have much pleasure in presenting to you to-night their second annual report.

"They are glad to be able to say that the interest shown in the association during its first year of

existence has been very fairly maintained; for though, unfortunately, the number of our members has sunk from seventy-six to sixty-six, of which three are new members, still, death or absence from the colony accounts for seven of the deficiency, and of the remaining six they hope that some, at all events, will continue to be members.

"The death of the late Dr. Way is too recent and fresh in the memories of all of us to need any reminder of it, except to say that, great as was the loss to the profession and to society at large, still more does this Council miss one whose long experience of professional work, and whose sound judgment rendered his opinion on all matters concerning the welfare of the profession invaluable. Dr. Machlachlen, too, has gone from among us, and though perhaps not so well known to the city members of the association, his loss will be very much felt by his fellow-practitioners in the district in which he has been so long practising.

"The finances of the Association, of which you will receive a detailed account from the hon. treasurer, are in a sound position, and no great call has been made upon them during the year.

"Nine meetings of the Council have been held during the year, and many important questions have been considered at these meetings. An effort has been made

under the circumstances the Police Department should be responsible, and that in many other cases the services of a medical man are obtained by the police gratis, when a fee is justly due to them.

"The Council also wish to enter a protest against the avoidance of inquests in cases where the circumstances of the case seem to demand an enquiry, more especially in the country districts, but also occasionally in the city of Adelaide itself.

"The question of the appointment of unqualified medical men to be lodge surgeons, where qualified men are willing to give their services, is at present under the consideration of the Council.

"On several occasions the question of fees for examinations for life insurance has come before the Council, and they deem it wise to publicly announce that in their opinion the minimum fee for such examination should be £1 1s.

"In conclusion, the Council would like to see the members of the association take a more active interest in the proceedings by nominating candidates for office, and not allowing the work to be done by the same gentlemen year after year.'

Dr. SWIFT moved the adoption of the report. Dr. TODD seconded, and, after some discussion, the motion was carried.

to see if something could not be done to check the objectionable advertisements of Messrs. Freeman and Wallace that disfigure the city. An appeal to sydney, their headquarters, was of no avail, and at present we are awaiting the results of a communication with Scotland, where Mr. Wallace received his diploma.

"An attempt has been made to assist Messrs. Sands and McDougall to compile a more accurate Medical Directory, but that firm did not consider the matter of sufficient interest to demand a reply to our communication, so at present things remain as before.

"The question whether members of the medical profession in actual practice should take shares in companies where their professional advice might make a considerable difference to the profits of such companies, was considered, and referred by the Council to the General Medical Council of England, who, however, in their reply threw the onus of deciding such questions on the individual practitioners themselves.

A

"A complaint has reached us that after, at the request of the local police office, a written report on a case had been sent to the coroner, a fee was refused. reference to the Coroner's Acts shows that no communication is valid from that office unless signed by the coroner as coroner. The Council thinks, however, that

T. W. CORBIN.

Dr. HAYWARD apologised for not notifying to the members that their subscriptions were due on January 1st, 1902. He then presented the treasurer's statement, which was adopted.

The following officers for the year 1902 were elected unopposed-President, Dr. Swift; Hon. Treasurer, Dr. W. T. Hayward; Hon. Secretary, Dr. Cavenagh Mainwaring; Committee, Dr. A. E. Wigg, Dr. J. A. G. Hamilton, Dr. E. W. Morris, Dr. Henderson; Auditor, Dr. T. W. Corbin.

Dr. HAYWARD gave notice of proposal to alter rule regarding election of members to the Council at the next general meeting, viz., "That in future, three weeks notice of the annual meeting be given to members instead of one as at present, and that two weeks notice instead of three weeks be necessary for nominators of office-bearers; also, that two members of the Council should retire annually, and not be eligible for re-election, the first retirement to take place by ballot, and subsequently in rotation, each member serving two years in succession.

Dr. TODD proposed that in the opinion of this Association it was not desirable that its members should hold the position of honorary surgeon to racing and

other clubs that could afford to pay its officers a reasonable fee for their services.

After a lengthy discussion, in which most of the members took part, the following amendments were proposed :

(I) Proposed by Dr. MARTEN, and seconded by Dr.
LENDON, "That the question be adjourned till
a fuller meeting, and that the subject be
placed on the agenda of that meeting."
(2) Proposed by Dr. J. A. G. HAMILTON, seconded
by Dr. W. ANSTEY GILES, "That the South
Australian Medical Defence Association
strongly disapproves of its members giving
their services to racing clubs in an honorary
capacity. The Association holds the opinion
that such work should command proper pay-
ment."

First amendment put and negatived. Second amendment put and carried.

Dr. J. A. G. HAMILTON proposed, and Dr. HAYWARD seconded, "That notices of this motion be sent to the secretaries of the following clubs ;-S. A. Jockey Club, Port Adelaide Racing Club, Adelaide Racing Club, Tattersall's Racing Club, Onkaparinga Racing Club, Hunt Club, and the S. A. League of Wheelmen." Carried.

Dr. JAY proposed, and Dr. HARROLD seconded : That the notice be also sent to the secretaries of the other Medical Defence Associations of Australia. (Carried.)

Dr. BENHAM brought forward the question whether Dr. Jürs had qualified himself according to the Medical Act to prefix the title of Dr. to his name. The subject was referred to the Council for consideration.

Dr. HARROLD raised the question of formulating a scale of fees, and the meeting requested the Council to consider the question.

Point and Lambton.

While a lad he was noted as a student, sure of success in work he attempted. His two ambitions were as a medical practitioner to accomplish all the good that a sound professional knowledge would make him capable of; as a man of letters to have a full knowledge of Shakespeare's works.

During the year 1899 he travelled though the United States, and studied in New York and London. All his spare time was given to the study of Shakespeare's works in the library of the British Museum. In 1900 he returned to Wallsend, and succeeded Dr. J. B. Nash. He died suddenly on December 12th, 1901.

MICHAEL JOSEPH CLUNE, F. ET L. MID., K.C.P., L.R.C.S. IREL., M.D. BRUX., SYDNEY.

at St. Mary's College, Lyndhurst, and later at St. John's College. At the Sydney University he took his B.A. degree in 1863. Thence he went to the Dublin University, where he had a brilliant medical career. He returned to Sydney in 1872, and practised for many years in College Street. He was senior physician to St. Vincent's Hospital, with which institution he was closely associated for 20 years. Dr. Clune was also chief medical officer to the Citizen's Life Assurance Company, which position he held until about two years ago, when owing to failing health he was compelled to relinquish his post. It was about that period that he gave up practice. His name was prominently before the public in connection with the first outbreak of small-pox in Sydney. He attended and reported to the authorities the first case, and with his patient was transferred to the Quarantine Station at North Head, where he spent an enforced period of isolation. As a medical man, his advice was frequently sought by young practitioners, and it was readily given. Dr. Clune paid a visit to Europe after his release from quarantine, but soon after his return he was attacked with typhoid fever, which left behind it a disease of the spinal cord, and this eventually resulted in his death. He leaves a widow and one daughter.

D. L. Macdonald, M. B., C.M. et L.M. Edin., died at Rockhampton, Q., on December 22nd, 1901.

Geo, Harward Brown, M. B. Ch. B. Melb., late of Derby, W.A., died at Melbourne last November

The death is announced of Alexander Stewart Paterson, M.D. Edin., of Carrington Street, Adelaide, on January 6th, at the age of 65 years. We shall publish an obituary notice in a future issue.

Charles Ferdinand Eichler, M. D., M.R.C.S., L.R.C.P., L.S.A.L., late of Bridge Street, Sydney. Died on January 10, 1902, aged 81 years.

Poisoning by Charcoal Fumes.-A dressmaker who resided by herself in Annandale, and had occupied the house for the past four years, died from poisoning by charcoal fumes. On entering the room a constable found the remains of deceased lying on the bed in a decomposed state. Her feet were resting on the floor, while her head was hanging over the other side of the bed. Beneath her head were two kerosene tins filled and a small pair of tongs and a fire shovel were also with half-burnt charcoal. A bag containing charcoal lying beside them.

An examination of the room showed that all the cracks in the windows and doors had been sealed up with pieces of rag, making the room almost airtight. In the room were found several letters which deceased had written, and one referred to some money and concluded with the words, "Goodbye; good-bye, eternally." The City Coroner conducted an inquest, when a finding of suicide was returned.

TRAINED MALE NURSE seeks engagement in mental or ordinary medical cases. Has had considerable experience in mental nursing, massage, etc., and is accustomed to travelling with patients to Europe and in the Australasian States. Unexceptional testimonials. References kindly permitted to Drs. F. N. Manning, Jarvie Hood, W. E. Warren, T. S. Dixson. Address: R. T. O'NEILL,

68 Crown Street, Nr. William St. (Late 17 Leicester St., Sydney.)

REVIEW OF CURRENT MEDICAL

LITERATURE.

GYNECOLOGY AND OBSTETRICS.

caseous pus, and the inner surface is shaggy from ulceration of the mucous membrane. There is very

little thickening of the wall of the tube anywhere, and in some parts it is much thinned by distention and ulceration. Microscopic sections of the undilated uterine end of the tube exhibit general thickening of the mucous membrane and infiltration with miliary

Some

This was the chief subject discussed at the Ninth Congress of the German Gynecological Society at Giessen, May 29th to 31st, 1901, more especially with regard to the ultimate results. Freund, Winter, Küstner, Leopold, Mackenrodt, Olshausen, Wertheim, and many others took part in the debate. favoured the abdominal, others the vaginal method of operation, and in this connection the conversion of Wertheim from the vaginal to the abdominal route is worthy of note. Three years ago there was no greater advocate for vaginal hysterectomy. Winter summarises the discussion by urging instruction of physicians and midwives as the best means of securing early operations by prompt diagnosis of uterine cancer. None of the present methods absolutely exclude the possibility of recurrence from implantation of cancer cells. It cannot yet be decided whether the abdominal or the vaginal operation is preferable. Until this has been done Winter would prefer the vaginal route for cases in which the growth is confined to the uterus, the abdominal if the parametrium is involved.

Inoculation of Carcinoma.

At

R. Schaeffer (Zeit. für Geb. u. Gyn., Bd. xlv., H.3) records what is apparently an instance of this Occurrence. The patient had had both ovaries removed four and a half years before for adenocarcinoma of those organs. For one and a half years the woman had observed a gradually but constantly increasing hard lump in the abdominal scar. operation this growth was found to be entirely extraperitoneal, in the anterior abdominal wall. No evidences of new growths were found in the peritoneum or in the region of the former operation. Microscopic examination showed the tumour in the scar to be an adeno-carcinoma, apparently the result of inoculation of the abdominal wound with a fragment of the ovarian tumour during the first operation.

Primary Tuberculous Pyosalpinx.

Macnaughton-Jones (The Medical Press, October 30th, 1901) reports a case of this nature, in a young woman otherwise in perfect health and without any hereditary history of tuberculous disease. The patient, aged 22, had been married for two and a half years, at the time of operation, and had completed her first pregnancy at the end of the first year of her married life. She complained of considerable and constant pain in the left side, with inability to walk, and dyspareunia. Catamenia regular and normal. On examination the left adnexa were found much enlarged, softened, and very sensitive. On operation the fallopian tube was found distended with pus forming a long crescentic swelling an inch and a half in diameter at its widest part, the surface of the tube being adherent. The right ovary, though fixed by some adhesions was healthy. Mr. Targett examined the specimen and gave the following report :-" The external surface of the specimen is covered with thin fibrous adhesions in which many miliary tubercles are embedded. The lumen of the tube is filled with thick

intact."

Operative Treatment of Purulent Collections in the Appendages.

L. Mandl and O. Bürger (Arch. für Gyn., Bd. lxiv., H1., contribute a very exhaustive paper on this subject, basing their conclusions on the results obtained in Professor Schauta's clinic, Vienna. They are of opinion that the vaginal route is preferable in most cases. Double salpingo-oophorectomy (abdominal route) for bilateral disease has been discarded as giving unsatisfactory results, while exposing to the dangers of laparotomy. Unilateral abdominal extirpation is permissible only where it is certain that the appendages of the other side are in normal condition. Abdominal radical operation is suitable only in case the vaginal route cannot be employed. Radical operation through the vagina is the method of choice for bilateral suppuration, or for unilateral suppurative disease with chronic inflammatory changes in the adnexa of the other side. It gives the best immediate and permanent results. Vaginal extirpation of suppurating appendages of one side is confined to cases in which puncture has shown that the pus is not virulent, and in which the other tube and ovary are normal. Vaginal incision is rarely used, as its permanent results are unsatisfactory. Abdominal incision is applicable to certain cases in which the purulent collection is easily evacuated by opening the abdominal wall.

Retroversion of the Uterus.

I. Clarence Webster (Jour. Am. Med. Assoc., October 5, 1901), when operating for this condition, opens the abdomen, frees and brings forward the uterus. A small hole is then made through the broad ligament on one side under the utero-ovarian ligament near the uterus. Through it a pair of forceps is passed from behind, in order to grasp the round ligament about an inch from its uterine end. It is pulled through the broad ligament in a double fold. It is carried across the posterior surface of the uterus a short distance above the uterosacral ligaments, and is stitched in this position with chromic catgut. A similar procedure is done on the opposite side. Each ligament is stitched to the hole in the broad ligament. He claims there is no possibility of any interference with pregnancy and labour, and that the normal range of uterine movements is not materially altered.

The Prevention of Post-operative Adhesions

G. Gray Ward, junior (American Journal Obstetrics, June, 1901) says the formation of adhesions after operation is directly proportionate to the amount of sepsis, traumatism, dry air contact, loss of heat and raw surface there is present. The mass ligature should be abandoned, the vessels in the pedicle tied individually, and the raw surface covered by suturing the peritoneum over it. The time element is of the utmost importance. Everything that will shorten the time of exposure of the peritoneal cavity to air contact should be employed. Moist and not dry asepsis must be used. One of the most important measures for the prevention of intestinal obstruction from adhesions is the replace