fourth year.

WE

physiology. But there is much to be said society which boasts of its accumulated in favour of attendance in the surgical millions finds a difficulty in keeping up its department of the hospital, with tutorial bonuses at an inflated figure. Instead of

, instruction in surgery in the third year, and the attempting to reduce its expenses in other commencement of the study of medicine in the directions, the General Manager hopes to

At present, this appears to us to squeeze needy practitioners of medicine, and be the best adjustment of the work of the compel them to accept just one half what the curriculum.

universal custom of Australia has declared a The able paper by Professor Wilson of the just and fair remuneration. It seems by this Sydney University, which we publish in process of squeezing or sweating, the Australian another column, on the Medical Curriculum, is Mutual Provident Society hopes to make a the result of much thought and practical profit of between a thousand and fifteen

a acquaintance with this subject, and his hundred pounds a year. It is certainly a suggestions on the principle of specialising by confession of weakness that this society so long the student in the course of his career are well supposed to be great and flourishing should be worth serious consideration.

compelled in order to keep up its rate of profit

to scrape together £1,500 by taking toll of the THE FEE FOR MEDICAL EXAMINA

modest earnings of the profession of medicine. TION FOR LIFE INSURANCE

But the author of this proposal has reckoned without his host. We can assure him that he

will not find the profession of medicine that understand the Australian Mutual Provident Society desire to reduce the fee for cohesionless body which he imagines us to be.

We shall resist his unworthy attempt to sweat medical examination for life insurance in all cases under £250 to half a guinea. It is said us, and the public will be greatly edified by the that this Society has now to pay such large spectacle of a great and wealthy society sums by way of commission to induce the

endeavouring to obtain skilled services for half

their real value. assuring public to enter its doors that it can only make a reasonable profit by cutting down

THE MONTH. the doctors' fees. Whether the profits which this Society has been declaring of late in the

The A.N.A. and the British Medical

Association. shape of bonus can be fairly described as reason

• The Australian Natives' Association Board has able is a question ; from the flourish of trumpets decided to agree to the terms of the British Medical

Association fixing the wage limit for benefit members which usually accompanies the annual report of

at £200 per annum. This will solve the difficulty in the Australian Mutual Provident Society, a dis regard to the appointment of a medical officer for the

branch which has been experienced since iis establish. passionate observer would probably characterise ment.” the profits as very large, but whether they be The above appeared in the Sydney Evening very large or only reasonable, we feel quite News of the 7th instant. We wish to point out sure that not a single person who is assured that the last portion of the paragraph is, to say

, in the Australian Mutual Provident Society the least, premature and possibly misleading. would desire that his bonus should be kept up The fact is that the whole question as to to an unjust figure by sweating the profession whether, under any circumstances, relations of medicine. That this proposal is neither more with the Australian Natives' Association would nor less than sweating in the worst form is be deemed desirable, is referred to a general

An extremely wealthy meeting of the New South Wales Branch of

obvious to everyone.

the British Medical Association, to be held on interesting in the light of the present crisis at March 7th In the meantime, the position as

the infirmary at Macclesfield in England, where

a lady house surgeon was appointed contrary to between the Australian Natives' Association

the expressed wishes of the honorary visiting and the British Medical Association remains staff, and the latter have consequently resigned unaltered; and we would warn members of the in a body. Some interesting correspondence on British Medical Association against allowing would appear that there is some personal

the subject has appeared in the Lancet, and it themselves to be appointed Medical Oflicers of feeling against the lady in question. Still the Association without their consent, as has there can be no doubt of the truth of some of already been done in some instances. Such

the statements made in this correspondence, and

that it is hardly decent to compel a respectunwarranted appointments should be at once able man to submit to catheterisation by a lady

a repudiated.

house-surgeon; and on the other hand, the

constant direct contact with cases of disease In this issue we have endeavoured as far as our and injury of the genital organs must tend to space would allow, to give a concise account of deaden that sense of refinement and delicacy, the medical curricula at the different Austral- which is essential to a woman's character. The asian medical schools. We have tried to secure

directors of the large metropolitan hospitals in the latest information on this subject, but Sydney have, in the past, consistently refused owing to some changes in the curriculum to elect lady graduates to the posts of resident pending at some of the schools, the statements medical officer,

and we believe that the given must be understood as being at present authorities of the Sydney Children's Hospital approximately accurate. The comparisons thus are also averse to such appointments. Howafforded between the different medical schools ever, at the Coast Hospital, the senior resident will furnish information to students about to medical officer is a lady, and she has been in enter on the study of medicine, and will also be residence at this hospital for three years, and of some interest to those who are concerned in has given every satisfaction to all in the the question of medical education in these lands. discharge of her duties. The Adelaide University Medical School. Reception House for the Insane, Mel. It must be a source of considerable satisfac

bourne. tion to the authorities of the Adelaide The necessity for the establishment of a University, and also to the students of the reception house in connection with the hospitals faculty of medicine, that after the past few for the insane in Melbourne has been impressed years of trouble at the Adelaide Hospital, peace upon the authorities, and a site at the Royal has been restored, and medical students are Park reserve has been suggested for this again able to complete their full course in institution. It is elevated, picturesque, and Adelaide. For some years past students have healthy, not too near any residences, and has only been able to obtain their first three years been inspected and approved by the Chief instruction in Adelaide, and have been obliged Secretary and Dr. McCreery. It has also been to migrate to Melbourne or Sydney to complete suggested that some provision should be made their course. The revival of the medical for paying patients, either in a special asylum, school was playfully represented by the students or in special wards. during their part of the proceedings preliminary to the official function at the annual com

The Fear of Tuberculosis. memoration at the University in December The large amount of attention which has last.

been directed to the dangers of infection from

tuberculosis in the public newspapers, while The Resident Appointments at the having a beneficial effect on the spread of the Adelaide Hospital.

disease, has unfortunately brought disabilities The Board of Management at the Adelaide on the heads of the poor consumptives. Boarding Hospital have recently elected four lady medical houses object to take in persons suffering from graduates and one gentleman to fill the posts pulmonary phthisis. This fear of taking of resident medical officers. We believe this infection from phthisical patients has, we proportion of ladies to gentlemen on the understand, extended to the trained nurses, and resident staff of a large general hospital to be the Committee of the Queen Victoria Home for unprecedented. The position of affairs is Consumptives at Thirlmere are at present

a

experiencing great difficulty in securing the THE FIGHT AGAINST TUBERCULOSIS services of trained nurses for this institution.

IN AUSTRALASIA. The reason for this is, we are informed, the fear of taking the infection. This is a matter to be

IV. regretted, and by way of re-assurance, we may

Victoria. remind the trained nurses that amongst the large number of nurses and resident medical In the war waged against tuberculosis in officers at Brompton Hospital for Consumption Victoria a strong frontal attack against an in London, no case of infection has ever

enemy, entrenched behind barriers of ignorance occurred. In the present day with our know- and so strongly supported by prejudice, has ledge of the risk and of the proper precautions hitherto been deemed inexpedient by those to be taken, there is not the slightest danger of charged with the care of the public health, it a nurse who understands her duties contracting being realised that a heavy and long-continued the disease, and we hope that this re-assurance

educational bombardment must precede any will have the effect of removing the difficulty successful general advance. Still, there have which now besets the authorities at Thirlmere been affairs of outposts and flank attacks in securing a satisfactory nursing staff for their whereby advantages have been gained, and the institution which is, ať the present time the enemy's position weakened, and the appearances only public institution of its kind in this state. promise that the psychological moment will

arrive in the near future when a vigorous, Abolition of Compulsory Vaccination aggressive movement may be looked for against in South Australia.

this most deadly, but yet, if met with all

available weapons after proper reconnaissance, The Act to abolish compulsory vaccination

most vulnerable of foes to human life. The was passed by Parliament last session and is recorded death rate from the disease in all its now in force. Clause 1 of the statute provides forms had not till recent years shown any that no parent or other person shall be liable to a penalty if within six months from the birth of marked improvement, but a downward tendency the child he makes a declaration before a justice ultimate decade, and it has now reached a

was noticeable about the middle of the penof the peace that he conscientiously believes

lower level than before recorded. The that vaccination would be prejudicial to the health of the child, and within seven days date from a valuable report on tuberculosis by

accompanying chart, copied with revision to thereafter delivers to the vaccination officer Dr. Gresswell, Medical Inspector, and now also such declaration. It is to be regretted that Permanent Head of the Publie Health Departsuch an Act should have been passed, in view

ment of this State, shows clearly the gradual of the serious outbreak of smallpox in London.

fall since 1887. The most marked decrease Victorian Association for the Preven

has been in the metropolitan area, and this was

to be expected if sanitary activity might be tion and Cure of Tuberculosis.

credited with being a contributing cause to the The committee of the Victorian Association for the Prevention and Cure of Tuberculosis verbially slower in more sparsely populated

improvement; for sanitary progress is proheld its first meeting at the Town Hall, areas, and the tendency is for the increased Melbourne, on January 27th last. Dr. Jamieson sanitary vigilance exercised in large centres of ,

population to approximate the death rate to the Association and the work of its committee.

that of corresponding country districts. The An executive committee of 20 members was then appointed. Mr. F. R. Godfrey, president mortality* is what might be reasonably antici

specially marked decrease in the phthisis of the Melbourne Hospital, was appointed pated if the modern outlook on the disease is treasurer, and Dr. Daish agreed to continue to rational, and the efforts of the Public Health act as hon. secretary: It was decided to make authorities chiefly extend in the direction of the member's subscriptions 5s. per annum, with providing an environment in which pure air, the view of obtaining a large enrolment, and clean soil

, freely sunlighted streets and buildproportionate increase of personal interest.

ings, and wholesome meat and milk supplies are The next Annua! Meeting of the subscribers to the leading factors. Apart from efforts directed to Children's Hospital, Sydney, is to be held in the Town

of those concerned in local government, it has of the disease and of the deaths therefrom from been on these lines that the energies of the Public ratepayers and district registrars, and to Health authorities in this State, have mainly undertake the disinfection of infected premises. been expended.

In 1900, the city of Melbourne, as became the To deal now with some of the individual premier municipality of the State, took action measures employed in this combat, and con- somewhat on the lines suggested by the Board. sidering first the powers arising from existing law, Local registrars now report all deaths from it may be noted that the only direct references phthisis to the Council

, whereupon the sanitary to tuberculosis in the Health Act, 1890, concern inspector visits the premises and supervises a the sale of the milk or meat of tuberculous thorough cleansing and disinfection. The animals. In the attempt to safeguard milk homes of phthisical persons attending the outsupply, inspections of dairy premises have been patient department of metropolitan hospitals and are still being carried out, and extensive are also visited, and householders advised as to applications of the tuberculin test have been the necessity of adopting precautionary nade by Mr. Cameron, the Veterinary Inspec- measures against infection. It has not been tor of the Board of Health, with a view to the found practicable to exercise direct control elimination of diseased stock from dairy herds. over private premises except to a very limited Tuberculous cattle have also been destroyed in extent, and constant activity on the part of considerable numbers for many years past by health officers and sanitary inspectors is inspectors under the Stock Act. Circulars of required if those conditions in the home which advice, and more recently a pamphlet prepared favour the incidence of tuberculosis are to be by Mr. Cameron, have been issued by the Board overcome. More, however, has been done by to dairymen, still the industry cannot be said the central health authorities with regard to to be conducted in anything approaching a public buildings, and great improvements have satisfactory manner, owing to the very im- been and are still being effected in these in the perfect control frequently exercised by municipal direction of ventilation, sunlighting, and the councils, which constitute the local sanitary prevention of over-crowding. The operations authority under the Health Act, and very few of the Factory Act also tend to improvement councils have, up to the present, appointed along somewhat similar lines. veterinary inspectors, dairy inspection being In the matter of direct attack against the often but one of the duties of an officer, whose disease, the powers conferred by the Health functions are as multifarious as those of Pooh Act, except in the directions already indicated, Bah, of operatic fame.

are limited

Thus an amendment of the Act is Legislation, with the object of further necessary before the nuisance arising from safeguarding the production and storage of indiscriminate expectoration in public places milk, may be expected shortly, and will can be effectively dealt with. It may be probably be along the lines of the recently mentioned that for some years past the introduced Meat Supervision Act,

, which gratuitous examination of suspected sputum requires that all meat intended for human has been undertaken for medical practitioners consumption shall be inspected and adjudged by the Board of Health. The great sign of a free from tubercle other communicable new departure in the campaign was the disease, and otherwise sound by a municipal definition of pulmonary tuberculosis as officer, whose qualifications have been approved “ dangerous infectious or contagious disease of by the Board of Health. This Act at which appeared in the Government Gazette of present applies only to the metropolis, but its August, 1901. Such a definition opens the door extension to other large centres can only be a to the compulsory notification of this form of matter of a short time.

the disease, a step which, while calling for due In 1893, the report on tuberculosis, prepared circumspection, will yet, if carried out with by Dr. Gresswell and already referred to, was judicious discrimination, prove a most valuable published by the Board, and has since passed weapon of defence. But the effect of this through six editions, and has been widely definition reaches still further, as it renders distributed throughout the State. This report many sections of the Health Act of 1890, which deals succinctly with the nature of the disease have reference to preventive measures in cases and its incidence

, and detailed directions are of infectious diseases potentially operative; given of the lines along which preventive some of these sections it will probably be found

should proceed. In addition, inexpedient, and indeed, unnecessary to enforce, municipal councils have been urged by the but others, it may be expected, will be brought Board to invite information of the occurrence ' into active operation in the near future. Thus,

or

a area

90

92

93

98

99

persons affected with phthisis may be removed Incurables a detached wing has been set apart from a common lodging-house, or indeed from for cases of advanced phthisis. There is any premises compulsorily to a hospital if such accommodation for 40 patients, and during the removal is legally certified to as necessary in past year about 80 patients have been admitted. the interests of the public health. Again, the Dr. Zwar, the resident physician, enforces the letting of rooms or premises previously ten- open-air treatment as far as possible, and the anted by phthisical patients may now be placed work is carried on reciprocally with that of the under safe-guarding restrictions, and the ap- sanatorium (next to be referred to), cases plication of this provision to hotels in which improve sufficiently being transferred to consumptive resorts, such as the northern the latter, while other cases are received from the towns of this State, will lessen a distinct sanatorium. This sanatorium for consumptives danger to the health of the travelling public. is a public charity, which has been established

about 12 years, patients are

received on Deathe rales per 10000 population medical recommendation, and payment only

required

warrant it. in Victoria (a from all tubercular disease During the winter season patients are accomļ from Philisis) and in Melbourue and modated, to the number of 40, at Echuca,

where the institution is in reality a consumptive Suburbs (e formall tubercular disease d from Phthions

home, as the premises are not self-contained, occupying an of only one acre, and patients during the day wander about the public park and town; during the summer

season patients reside at Macedon, where the 26

premises are much more commodious, and the

site elevated. Funds are at present being 15

solicited for the purpose of extending the 24

operations of this charity, and it is to be hoped

that a more suitable and adequate site for the 23

purpose than the existing premises at Echuca 22

will be obtained.

In the education of the public to a true con216

ception of the importance and nature of tuberculosis the efforts of the Press must not be

forgotten, nor the untiring efforts of the Aus19

tralian Health Society in a similar direction, 18 C

and it may safely be said that the bulk of the

community are now alive as never before to the 'Y

dangers that may arise from want of care in 16

dealing with this disease.

The medical profession has, through its 15

members, done its share, and has organised two a

public meetings in the metropolis, the first in

1899, and the second quite recently, with a 13

view to the formation of a l'ubercle Prevention

Society, and the bringing of the matter weightily 12

before the public mind. The potential usefulIl

ness of such a society none can deny, working as it must by exercising steady and public

pressure against prejudice, and by supporting Travellers by train or ship-board affected those measures which are the logical outcome with the disease may also be required to give of the recognition of tuberculosis as an infecnotice of the fact. With regard to provision tious disease, favoured, if not in part conditioned for the treatment of those afflicted with by debilitating environment and hereditytuberculosis, in addition to the many cases of how often indeed by an inherited evil all forms of the disease which are received at / vironment. the general hospitals throughout the State, The amelioration of the conditions under special provision has been made in two which Labor lives and works, the raising of the directions. At the Austin Hospital for standard of living and other kindred social

20

en