AUSTRALIA.

1126 Government, who were unlikely to contribute, the charitable, who were unable to contribute on account of other claims, the patient when he was ill, patient when he was well. He thought that preferable to obtain the payment before

or the it was illness. Lord Cave’s Commission would only give money to the hospitals if the hospitals could find new money, and this was an attempt to find that new money. Dr. R. A. Bolam did not think that the promoters of the scheme had made the benefits very clear. It was not explained to the insured that he had the He thought it use of the hospital endowments. would be preferable that the medical profession should give their services free. He personally preferred to be an honorary officer of his hospital. Dr. J. F. Gordon Dill said that the scheme was the only one that gave hope of relieving the debt of the hospitals. It would help to prevent hospital abuse. As one of the promoters of the scheme he would be glad to have constructive criticism. Sir James Galloway said that the hospital with which he was associated had no debt, a state of affairs which was attributable to the excellent business capacity of their administrative staff. His main concern was whether the scheme, should it be successful, would be likely to interfere with their subscribers. He did not, however, think the scheme would be a permanent success, since, like all insurance schemes, it would need to be continuously boomed. Mr. F. R. Smyth, L.D.S., said that there was no progressive diminution of the annual premium where benefits had not been paid for the preceding year, and so no inducement to continue the premium, such as He would like was offered by insurance companies. to know whether the scheme had been submitted to an

actuary.

Mr. N. Bishop Harman said he was a supporter of the scheme. Times were different now from the days when the hospitals were founded. The State had no compunction about small payments from even their Poor-law patients. Why, therefore, should there be any compunction about accepting payments from the hospital patient ? Dr. A. Cox would rather see a straightforward insurance scheme, but he thought the present scheme worth a trial. Dr. F. J. Poynton said that above all things the staffs of hospitals must preserve their honorary status. If the hospitals must have assistance it should come from the State. Mr. Ernest Clarke thought the scheme was likely to appeal only to those who were sick. Dr. Gordon J. Lane thought the scheme had not been properly considered, and found it difficult to believe that 2 id. a week could provide all the services offered, and yet leave a surplus for the hospital. Dr. J. W’. Kynaston pointed out that -the scheme had been taken up at present by only three hospitals. Sir Charles Ryall said that this was not the first insurance scheme adopted by hospitals. In the eighteenth century the Westminster Hospital set the fashion of admission by subscribers’ letters which were distributed in proportion to the amount of the subscription. The real poor had thus been unable to gain admission, and it was the discovery of a poor woman in a dying condition, on whom all the hospitals of London shut their doors, since she had no subscriber’s letter, that led John Marsden to found the Royal Free Hospital. Other hospitals had been forced to abandon the subscriber’s letter. In reply Mr. Eccles said he had obtained the opinion of several people associated with insurance undertakings that his scheme was financially a sound one. At St. Bartholomew’s Hospital they now charged those of their in-patients, who could pay, £2 2s. a week, and he thought that the subscriber who found himself in hospital free, while his next-door neighbour was paying, would congratulate himself on his foresight in joining the scheme. On being put to the vote the resolution was defeated by a large majority.

AUSTRALIA. (FROM OUR OWN CORRESPONDENT.) Attslrulusiurz Medical Congress. THE next Congress will represent a departure from precedent and will be a meeting of the British Medical Association in Australasia, to some extent like the annual B.M.A. gathering in the United Kingdom. Mr. G. Adlington Syme has been elected President, and the meeting will probably be held in February 1923. at Melbourne. Presidents of sections and other officebearers have not yet been nominated.

Charge of Manslaughter. A death under anaesthesia occurred at the Adelaide General Hospital on July 21st, 1921. The patient was a young man who had sustained a severely cut hand. The resident surgeon on casualty duty administered ether with the assistance of a student and a nurse. The patient ceased breathing after having vomited. The medical superintendent was summoned and performed artificial respiration, and also cardiac massage through an incision. A second resident officer was directed to perform tracheotomy, which was done. Death was subsequently found to have been due to suffocation owing to the patient having vomited. At the coroner’s inquest the medical superintendent stated that the anaesthetic was not administered in accordance with the hospital rule, which required his own presence. A prominent barrister, for the relatives, demanded a verdict of manslaughter against all the medical men, but the coroner gave a verdict simply of death under anaesthesia, though he made unfavourable comment on the hospital management. Next day an information was laid charging the three doctors with manslaughter and they appeared before the policecourt. The case was postponed indefinitely owing to the procedure of prosecuting counsel, who, when the hearing was resumed on Sept. 5th, made no appearance, but wrote a letter to the magistrate intimating that he did not intend proceeding with the matter. The informations were thereupon dismissed. War JI emorial. The Victorian Branch, B. iAl.A., has decided to erect a memorial in the hall of the branch to the members who lost their lives during the war. A commission has been given to Mr. C. Web-Gilbert, the leading sculptor in Australia, to execute a design submitted by himself in bronze at an estimated cost of £600. Bubonic Plugue. Within the past three weeks a decidedly unpleasant situation has arisen in Queensland with respect to bubonic plague. It appears that a case occurred in Brisbane, which after death was recognised as plague. Nothing was allowed to transpire until some three weeks later when a second case occurred. Since that time a few further cases have been reported, together with one case from Townsville. Infected rats have been found from over a wide area of Brisbane, in Townsville, and as far north as Cairns. A steamer arrived at Sydney from Brisbane during the preliminary period before the declared case was announced; plague-infected rats have since been found in Sydney in the neighbourhood of the wharf at which this steamer discharged cargo. Dead rats have also been found in several coastal steamers. Vigorous measures have been taken for disinfection of steamers and cargo, and rat destruction has been actively undertaken. The Brisbane health authorities have been severely criticised for concealment of the first case and no explanation of their action has yet been offered. Up to the present the outbreak has not spread rapidly, but there is apparently a wide distribution of infection among the rat population in the coastal ports. Motor Fatality. On Sept. 23rd Dr. G. A. Paul, a well-known surgeon of the younger generation, lost his life in an accident near Sydney. Dr. Paul and Dr. Howard Bullock left Sydney in a motor-car in order to visit a country house:d

1127

-

Dr. Bullock was driving, and in attempting a sharp in the road the car overturned and both were it. Dr. Paul died shortly after being pinned beneath released and Dr. Bullock was severely injured.

rules

were

said to be adhered to.

In order to investi-

gate the matter the Government appointed a com-mittee under the chairmanship of the Famine Com-missioner. The committee is composed mainly of non-officials from districts commonly affected with. scarcity, but also includes two executive engineerswho have had experience of famine work, and theSanitary Commissioner. Medical opinion is required. as to the physical capacity of the people for work,the question of emaciation due to insufficiency of food, the sufficiency of the various diet scales laid down in the code, and the general questions of sanita--

curve

September, 1921.

NOTES FROM INDIA. (FROM OUR OWN CORRESPONDENT.) Indian

Voluntary Hospitals. In connexion with diet scales not, as a rule, supported by tion of camps, &c. voluntary contributions, but some hospitals, for the work of Colonel McCay, I.M.S., of Calcutta, is of , example those of the Dufferin Fund and the Walker interest, as his findings are somewhat antagonistic Hospital, Simla, are supported in this way. The to the opinions commonly held by the layman in this difficulty experienced by hospitals at home is being country. Ayurvedic Committee. fully shared by the Indian institutions, and great efforts are being made to collect funds. Ladies in Mention was made some time ago in these notes prominent official positions are taking an active part of a report on Ayurvedic drugs by Dr. Koman, who helping to raise money, and entertainments are carried out a prolonged investigation into the therabeing held in Simla and elsewhere for this purpose. peutic value of the most important of these indiAt a recent meeting of the Countess of Dufferin’s genous medicines. The Government have now gone Fund, Lady Reading made a strong appeal for the a stage further, and have recently decided to appoint support of the fund, which controls a very large a small committee consisting mainly of non-officials number of hospitals for women throughout the to report on the question of the recognition and Indian Empire. Commenting on the need for supof the indigenous systems of medicine encouragement port of the League for Maternity and Infant Welfare, in vogue in this Presidency. The object of the proLady Reading emphasised the importance of the posed inquiry is to afford the exponents of the Ayurprovision of trained nurses and midwives. She vedic and Unani systems an opportunity to state pointed out that except in the presidency towns such their case fully in writing for scientific criticism, and training involved hospitals under medical women. to justify State encouragement of these systems. In If the training was to be good and the work successful order that a preliminary programme of work should experienced medical women and equipment for these be drawn up, and that some indication might be hospitals were essential. The formation of the given of the lines on which the inquiry should proWomen’s Medical Service in India gave great impetus ceed, the - Government nominated Khan Bahadur to women’s hospitals by relieving the committees of Muhammad Usman Sahib Bahadur as chairman, and the difficult task of finding and paying the salaries of Dr. G. Srinivasamurti as the of the prosecretary medical women. The funds so set free were used to committee. Of the ten members three general posed provide the hospitals with other requisites. The practitioners from Madras City are included, Dr. number of labour cases has increased, and nearly all U. Rama Rao, Dr. A. Lakshmipathi Garu, and Dr. the hospitals under the Dufferin Fund were now in a 1VI. Subramania Ayyar ; whilst the Ayurvedic practiposition to give a good practical training to nurses tioners are represented by K. G. Natesa Sastri and midwives ; but nearly all of them were also in a I, Avergul, of the Venkatarama Dispensary, Madras, position of financial difficulty. and C. T. Arumugam Pillai, of the Ayurvedic DispenIndian Science Congress. sary, Georgetown, Madras. The ninth annual meeting of the Indian Science Congress will be held in Madras from Jan. 16th to the INDIAN

hospitals

are

in

,

21st, 1922.

The Medical Research Section of the

Congress will then meet for the fourth time. The ’, honorary local secretaries are Captain Clive Newcomb,

SCOTLAND. (FROM OUR OWN CORRESPONDENT.)

’, Azizullah Sahib Bahadur. It is hoped that a large I, number of delegates from the other provinces of India will attend the Congress. Health Officers in India. At a conference of health officers held recently at Calcutta, it was decided to form a public health association for Bengal, and to send a deputation to the Health Minister to represent the grievances of the officers. It was also decided to urge that the service should be provincialised, or, in the event of the officers being controlled by the local board, that their appointments or dismissals should be in the hands of a board of sanitary experts who would also possess power to transfer officers. The health officers also asked for first-class travelling allowances and immediate increase of salaries. Famine Coele Committee. Owing to the almost complete failureof the crops considerable areas in the ceded districts of the Madras Presidency havebeen declared to be in a state of famine, and a number of Government relief works have been instituted in order to carry the hard-hit ryots over the period until the next crop may be expected. Government relief works are controlled under rules laid down in the Famine Code, but a discussion recently held in the LegislativeCouncil made it evident that a certain amount of dissatisfaction existed regarding the rigid manner in which the

A Scientific Expedition to Peru. EDINBURGH University has a special interest in the expedition organised by the Royal Society which leaves England this week-end for Peru, owing to thefact that Dr. J. C. Meakins, professor of therapeutics, is acting as deputy director to the expedition. The main object of the expedition is the study of the circulatory and respiratory systems amongst those who live at the high altitudes of the Andes. There is a large mining population in the villages some 16,000 ft. above sea-level, and it is-reputed that these peopleare able to perform much heavier work than can be done by any other persons in so rare an atmosphere. Modern methods will be used in the investigation, and the results may prove of real value. Work of the llinistry of Pensions. The Rt. Hon. J. Ian Macpherson, M.P., at a meeting which he addressed at Oban recently, stated that shortly before he went to the Ministry of Pensions no less than 331 million pounds were required by the State for the provision of pensions-a sum six times the amount of the whole national expenditure at the time he entered political life. The Ministry of Pensions. was engaged at that time, he said, in the biggest work that any public department in the world had ever undertaken. Of all those who had served in the Forces, one in three had been the subject of a pension, or,stated in another way, 3! million persons were on

I.M.S., chemical examiner, Madras, and Dr.Mohammad