Henry Ray, M.B., Ch.M., Mel- 98 Pregnancy in Double Uterus (illus- 233 414 Stereoscopic Photography in Medical 422 Too Bad 423 Medical Men and the Lay Press... 468 British Medical Association at The Conduct of Medical Meetings 468 468, 577 530 North Sydney.. 280 "At Home" at the Sydney Hos- R. H. K. Bennett, L.R.C.S., Irel.; Proposed Reduction of Hospital 530 C. J. H. Wray, L.R.C.S., L.R.C.P., 280 Proceedings of Australasian Medical 118 235 439 Poisons Act 531 Braidwood, N.S.W. 392 Parliamentary Notes. Paton, D. M., L.R.C.P., The Solution Obscure Case, an, by Angel Money, N.S.W. Medical Benevolent Fund 203 272 256 Obstetrics and Gynecology, Inter- colonial Medical Congress, by R. Reviews: Index of Symptoms, a Clue 112 Esophagus, Removal of Foreign M.D. 25 371 eases, by H. de Meric, M.R.C.S. 25 gology and Otologists, by R. 26 Golden Rules for Diseases of 429 6355 67 Children, by G. Carpenter, M.D. 26 26 Cliniques Medicales Iconographi- ques, par M. M. Haushalter, 75 Etienne, Spillmann 26 397 445 Pathologie Generale et Experi- 26 77 77 Pocket Formulary Treatment of Four Epochs of Woman's Life, by 465 Skirving, R. Scot, M.B., Diagnosis 225 465 Skirving, R. Scot, M.B., Aims and 351 Snake-Bite, Serum-Therapy of, by F. Tidswell, M.B., Ch.M. 177 465 Souter, C. H., M.B., Sudden Death 411 Specialism in Medical Work, by G. A. 55 465 128 Healing of Nerves, by C. A. Ball- 527 Springthorpe, J. W., M.D., The 343 Acute Dilatation of the Stomach, 321 821 Rhinology, Laryngology and Ot- Atlas and Epitome of Operative 373 873 378 416 American Edition of Nothnagel's Thyne, J. A., M.B., C.M., Abdominal 628 Todd, C. E., M.D., Placenta Prævia, Trichina Spiralis, by E. A. Johnson, 120 Trichinosis, Additional Notes on, by 415 625 417 Tuberculosis and the Public Health, 287 554 181 623 Typhoid Fever, Epidemic of, in 255 413 55 MEDICAL MATTERS IN VICTORIA. As a scientific body a wide field is open to us FEB 3 fo1908 exercise of our legitimate functions, and by99 THE ANNUAL ADDRESS LIBR By J. E Neild, M.D., Ch. B., Melbourne, I can bu Hope that for the future we shall confine ourselves to what is truly beneficial to humanity and advantageous to ourselves as a brotherhood, having the health of the com Retiring President Victorian Branch B.M.A.|munity in our collective keeping. Looking back upon the past year, and limit Read at the Annual Meeting of the Victorian Branching our reflections principally to local matters, of the British Medical Association. We have had a quiet year, but then there have been few of us to quarrel, even if we had been so inclined. We have met in Council and we have met in monthly meeting, and the unity of our gatherings has been maintained, consequently there has been an agreement in discussion, which I can only describe as beautiful. We thus close the year at peace with all men for the present, and, our minds being undisturbed by pyrexial influences, we can the more calmly apply ourselves to the work of passing, in brief review, some of the matters which have occupied the attention of the profession during the year now nearing its close. But before doing so I would ask you to pardon me if I parenthetically digress by saying a few words about myself. When, some eighteen months ago, I was asked to take the position of President of the Victorian Branch of the British Medical Association I was indisposed to do so, not because I felt no interest in the success of the Branch, in the planting of which, I may say, I took a prominent part twenty years ago, and of which I had been Honorary Secretary and President, but because I had virtually for some time ceased to occupy any official position in its organisation. I was reminded that there had recently occurred a sort of cataclysm in the Branch, and that the integrity of the Association was imperilled, and that I, as one of the founders, might be able to restore its cohesion and strength. I therefore acceded to the request made to me, and I can but say that I have done my best. The charming courtesy of those who have attended the meetings during the year has been beyond reproach, and to them I offer my very grateful thanks, and I can only regret that the Branch should have been concerned in a matter which, regarded from any point of view, added nothing to its dignity, its reputation, or its usefulness. although, nevertheless possessing an interest common to all scientific workers, we find ourselves embarrassed by the multitude of subjects which claim our retrospective attention. It is hardly too much to say that the question of sanitation stands foremost in the list. Those who, like myself, have a considerable burden of years upon their shoulders, can remember very well the time when, practically, no attention was given to the observance of conditions neces sary to the prevention of disease and the preservation of health. The physician was regarded by most people as a man to look wise, feel pulses, and give large quantities of medicine; and he himself, with rare exceptions, limited himself to the exercise of these simple duties. Hygiene, as we now know it, possessed no meaning to the average mind. Boards of health had no substantive existence, and those members of the profession who busied themselves about water supply, the regular removal of filth, the purification of streams, the construction of dwellings in which light and pure air were provided for, and in which houserefuse was regularly removed, were looked upon as doctrinaires or as eccentric faddists. also with reference to the wholesomeness of food and drink. Adulteration was openly practised, and only nominally punished, and the public, who suffered both in health and pocket, were slow to believe that any harm came to them from these frauds. Even at this day, among educated and otherwise intelligent people, there is still an incomprehensible disregard of the danger incurred by the consumption of poisonous food, although the risks they run are pointed out by the profession. So In respect of diet as an adjunct to strictly medical treatment, there has come about a great change. There was a time, and that not so long ago, when patients were allowed to eat what they pleased, both as to quality and quantity, and though some measure of reform has been accomplished in this matter, the reform is not complete either in adults or children. Young people are allowed to stuff themselves to their heart's content and to their stomach's discomfort, and especially in the case of infants the practice of overfeeding, and wrong feeding, continues to exist. The number of artificial foods that are crammed into the alimentary canals of these unfortunate creatures add greatly to the infantile mortality, as I have reason to know from the number of necropsies I have performed since the Infant Life Protection Act came into force. In strictly medical, or, as it would be more correct to term it, drug treatment there has been a great change of late years. Many of the old preparations have been swept away and new ones substituted, not always, as I think, with advantage. And here I may remark that the enormous number of pills, tabloids, ovoids, and other forms in which nearly every drug is now manufactured by the wholesale druggists, has unquestionably extended the consumption of medicine in these forms, more especially by the general public, who, knowing both the nature and the quantity of the drug they are swallowing, are enabled to treat themselves without the interposition either of the doctor or the pharmacist. Nevertheless, the quack still thrives; and he thrives because of his mystery. He demonstrates practically the truth of the very old adage, Omne ignotum pro mirifico. The treatment of certain diseases by what is comprehensively known as the serum method, appears to maintain the favour with which it was at first received. Its efficacy has been enthusiastically proclaimed, but, at the risk of being pronounced unreasonably sceptical, I am obliged to declare that I cannot but regard this treatment as still only on its trial. If it is found to maintain the specific virtues with which it is credited so much the better. Up to the present I cannot but regard it as requiring confirmatory evidence in many cases. gical antisepsis as propounded by its apostle, Lord Lister, there is no need to speak with hesitation. Its success has been established without question, and it has changed completely both the method and the results of operative surgery. With anæsthesia and asepsis in operative surgery, chirurgical procedure has been made possible in cases which, little more than half a century ago, were past the limits of recovery, and which it was regarded as criminal to treat with the knife. Conservative surgery has thus been made possible where it was formerly not attempted by the most experienced surgeons. The Röntgen light, moreover, has lent a valuable aid in diagnosing conditions of an obscure kind, which could not be made clear save by much suffering and mutilation. Of sur It would be superfluous at this day to speak of the microscope as an adjunct in diagnosis. It is so indispensable in certain bacteriological enquiries that the wonder is certain forms of disease could formerly be treated otherwise than empirically. And here it is only right to speak of the progress which has recently been made with the pathology of tuberculosis, and more especially to express satisfaction at the consequent results of this enquiry in the treatment of that disease which I need hardly say is now, or at least should be, conducted on principles wholly different from those formerly regarded as indispensable. I am not sure, however, that the inclusion of non-medical persons in the committees appointed to manage the proposed consumptive sanatoria is an unmixed advantage; for while their intentions might be beyond cavil, their amateur efforts might work mischief. The special instruction of nurses, however, beth in these and cognate institutions, might possibly act as valuable counteracting influences. com Touching the subject of our hospitals, there is not much new to be said save that the Contagious Diseases Hospital is not pleted, and apparently is not likely to be completed. Such portion of it as is finished stands in the grounds of the Yarra Bend Asylum, a mournful memento of the scriptural warning of what happens to persons who commence to build houses without first sitting down and counting the cost thereof. The Government will tell us it is no affair of theirs to provide the money for its completion, and the public will say we contributed twenty thousand pounds, and that should have been sufficient to complete it, and everybody will write or want to write to the newspapers to say what should be done. Meantime the feverstricken people are dying, and we shall wish we were ruled by an autocrat who could order things on the sic volo sic jubeo principle; and we shall also wish we had a new general hospital in place of the patchwork institution which should have been razed twenty years ago. From hospitals we may speak of medical schools, and our own Medical School of the University necessarily claims chiefest attention. It has recently undergone some changes, some of them not for the better, but at any rate it is nevertheless still the most flourishing department of our principal seat of learning. It will probably suffer in common with the other sections as the result of the financial cloud which has shadowed the chest; and by the time this has passed away we shall perhaps have learnt wisdom sufficient to look more |