I wish here to summarise the findings in the more important diseases.

PNEUMONIA. Of 17 cases examined pneumococci were found in seven, and in three only of these before death. In the other four the blood was not examined during life; possibly, if it had been, the organisms would have been found. Of the three cases in which it was found during life, six hours was the longest period before death ensued. Its presence is thus inconsistent with very many hours of life. The blood was examined in several very bad cases which eventually recovered, no organisms being found, so that their presence or absence is of some prognostic value; but, all the same, a great many cases of pneumonia die without becoming septicæmic. In one fatal case recorded in the table pneumococci were present in the blood and in the pus of the sphenoidal sinus, but there was no evidence of pneumonia.

..

Recovered.

Remarks.

Blood examined 4 hours after a rigor, of which she had many. Died 2 days later. Curetted 2 weeks previous to blood examination for septic endometritis after miscarriage. Some swelling of the knee-joint, probably due to pus.

Blood examined several days before death. Had been ill several weeks. Blood showed a most intense anæmia. Blood examined a few hours after death. P.M. showed abscesses in several of the joints, as well as pus in the iliac vein; the latter showed in film diplococci and streptococci. In culture on agar, staphylococcus albus. Blood examined about 9 days before death, and about a fortnight after the onset of the illness.

Blood examined 3 days before death (about the 3rd week of the illness). Blood examined again after death showed no organisms. P.M. disclosed septic infarets of the lungs and spleen, purulent peritonitis, and pus in the temporo-maxillary joint. The pus contained numerous bacilli, also some diplococci and streptococci ; no cultures of the pus made.

the staphylococcus aureus; in one, streptococcus; in one, staphylococcus albus (? streptococcus; see introductory remarks); and in the other one, the staphylococcus aureus during life, but when examined after death streptococcus and staphylococcus albus. All were fatal, the staphylococcus aureus killing quite as rapidly as the streptococcus.

DIPHTHERIA.-In the fatal case examined there was a mixed infection of the throat, viz:-Klebs-Loeffler and staphylococcus, but the blood was devoid of organisms.

EPIDEMIC CEREBRO-SPINAL MENINGITIS.-Only one case examined; no organisms were present.

ENTERIC FEVER.-Two cases examined and in both typhoid bacilli were present. In one case the patient died, seven days after they were found, of septic peritonitis following perforation. The other case (at time of writing, 22 days after) is still alive and thought to be recovering; so that their presence in the blood does not necessarily mean a fatal issue.

PUERPERAL SEPTICEMIA.-Of the three cases recorded only one was purely septicæmic, the other two developing abscesses in other parts of the body, thus being pyæmic as well. In one the streptococcus was found. In the other two, staphylococcus albus (? streptococcus; see introductory notes). The patients lived on an average several weeks after becoming infected; they invariably became intensely anæmic.

and about 1890. As to the architectural style of this building, that of the already existing University building was fortunately followed, and for this we owe much to Mr. James Barnett, at that time Colonial Architect. As a young man Mr. Barnett worked at the building of the Great Hall, and it is to him that I am indebted for pointing out Dr. Douglass' coat of arms on the Great Hall.

As to the internal arrangements, I had already served a sort of apprenticeship, for it was while I was Assistant to Professor Rutherford that we "flitted" from the old Edinburgh University building in Nicholson-street to the new Medical School on the Meadows, and I had taken a good hand with the Professor in planning the fittings of our department in the new school. I may add that I was also at the

but the intention was to occupy these rooms only until they should be required for other purposes, when the University might be enabled in some way to build a separate and properly adapted Museum building in the space reserved for it, between the Medical School and the main University building. This period is undoubtedly within measurable distance, for, on the one hand, the collection very nearly fills the available space, and will one of these days overflow, and, on the other hand, the demands for increased accommodation can be satisfied only when the museum has found another home.

At first one often heard remarks as to the folly of building so great and costly a mansion, and Sir Arthur Renwick, who was Minister of Public Instruction at the time, informs me that

"flitting" from the old to the new Edinburgh Royal Infirmary.

In regard to the size of the building, it was not the small number of students at that time in attendance for which we provided, but for our future greatness. Nor was it only the number of students we had to think of; we had also to consider the possible development of subjects of instruction. And has not the University's foresight already been amply justified?

The preliminary scientific subjects are each. housed in its own building, so that this building accommodates only the purely medical subjects. The clinical subjects are provided for at the Prince Alfred Hospital.

The Museum of Anatomy now possesses 24,000 specimens, and is well worthy of a visit. It is housed in this building, several rooms having been thrown together for that purpose,

there was much opposition to the vote in Parliament, the first cost being about £80,000; but was it not a good investment for the State? Let us see what is the money value to the State of the Medical School. Suppose, for instance, that there were no Medical School here. The community would still need medical advisers, and it is fair to assume that at least one-half, say 100, of the students would go to Europe for their medical education. The average expenditure of each would not be less than £200 per annum, and the average time would not be less than six years, for the curriculum is five years, to which must be added the time of travelling to and fro, and the time inevitably lost in various ways. This would be in all at least £1200 per student, or at the rate of £20,000 a year, actually taken out of the State and spent elsewhere. This is now kept in the State, and, since what is paid in salaries is

THE PRESENT MEDICAL SCHOOL (LOOKING FROM THE SOUTH).

spent in the State, 25 per cent. is a fair return, is it not?

To this magnificent building as it stands we undoubtedly owe much of the success of the Medical School as an Institution. Student and graduate and teacher alike feel proud to belong to it, and its influence in creating an esprit de corps and good traditions cannot be overestimated. The pride we all take in the Great Hall is paralleled by the pride which the medical takes in the Medical School building, and it all makes for good.

ON THE CONNECTION OF THE PRINCE ALFRED HOSPITAL WITH THE UNIVERSITY: ITS ADVANTAGES.

As we have seen, there have been three successive schemes for the permanent location of the Medical School. 1st. That it should be connected with the Sydney Hospital. 2nd. That it should be at the Prince Alfred Hospital, but connected with the University. 3rd. At the University, but connected with Prince Alfred Hospital and recognising certain other hospitals as places where study may be carried on. last, the existing scheme, is undoubtedly far and away the best; so that if the Medical School did take so many years to incubate, when it was hatched it came forth under most favourable conditions.

This

This intimate connection of the Prince Alfred Hospital with the University is an advantage to both institutions. The University has a hospital convenient of access for the clinical instruction of students; the Hospital gains in various ways. For instance, we may fairly

assume that upon the whole the best men of the Medical Profession will always desire to be connected with the University, and, therefore, also with the Hospital. Further, the senior students do a considerable amount of work in the Hospital, and in time the pick of the students when graduates become the Resident Medical Officers at a salary which is practically nominal, for the real remuneration is the experience they gain.

It is so arranged that each Resident in his 12 months' term of office takes charge in turn of the different departments of the Hospital. He is attached to the Hospital, and his experience is general and as complete as the time allows. He is not merely attached to the ward of some particular Physician or Surgeon by whom he has been selected and practically appointed, and whose practice alone he sees, as is so commonly the case elsewhere.

It is, indeed, simply astounding what the 12 months' service does for the Resident. His association with the visiting Medical Men, with his fellow Resident Medical Officers, with the Nurses, and with the Patients has brought him.

experience beyond price, and has made a man of him. When he leaves he is

A wise physician, skill'd our wounds to heal. I find that out of the 218 graduates no less than 184 have held office as Resident Medical Officers, and this extraordinary proportion must have very largely contributed to that success of the graduates in practice to which I shall presently refer. When the extensions of the Hospital now in course of erection are completed, the number of beds will be raised from 236 to 456, and the number of Resident Officers required will be correspondingly increased.

Again, a body such as the Conjoint Board, composed of the University Senate and of the Hospital Board sitting together, should succeed in selecting the most competent Medical Officers to begin with, and then we may rely a good deal on the students for stimulating them to do their best. The students, who follow the work of the hospital Physicians and Surgeons in the wards or operation theatres, are valuable critics, and though their criticism is that of young men, nevertheless, in the multitude of them there is safety. As a matter of fact, it is admitted that the best and most intelligent work is, as a rule, done in Hospitals which are attached to Medical Schools, so that it is the patients who gain most by all these arrangements, the tendency of which is to secure and maintain efficiency on the part of the Medical Officers.

RECOGNISED HOSPITALS.

Certain other Hospitals have been recognised as places where study may be carried on, viz., Sydney Hospital, St. Vincent's Hospital, Benevolent Asylum, Women's Hospital, Hospital for Sick Children, Gladesville and Callan Park Hospitals for the Insane. At some of these places a considerable amount of work is done; and, doubtless, more will be done as the advantages of the University connection are more and more fully appreciated.

APPARATUS DOCENDI.

The two most important changes in the teaching arrangements since the School began have been the creation of two new ChairsAnatomy and Pathology. Midwifery and Gynecology have been separated as independent Lectureships, and five new Courses have been established, namely, Medical Ethics; Diseases of Children; Diseases of the Ear, Nose, and Throat; Diseases of the Skin; and Demonstrations on Psychological Medicine and Neurology. A new and important class, suitable for graduates and advanced students, is about to be established, namely, special Bacteriology. The special object of this class will be to enable the members to acquire a practical knowledge of