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MELBOURNE MEETING OF THE B.M.A.
493
diaphragm and a more satisfactory pulmonary collapse. Pneumoperitoneum is also suggested in support of artificial pneumothorax when basal adhesions are preventing an adequate collapse elevation of the
a lower lobe. The graver complications of pulmonary tuberculosis that no method of treatment, are so distressing however strange, should be lightly dismissed as worthless, but though operations of this nature may bring a measure of relief to some incurable consumptives, euthanasia might be more surely and more comfortably attained by simpler means. Though in skilled hands a pneumoperitoneum may be induced without serious danger in selected cases, its general employment would entail risks and might add to
of
the bulk of the men had over 1 in 1000. The incidence was greatest on Saturdays, but nearly as large The bulk of the accion Wednesdays and Fridays. dents were made up of collisions between motor-cars and pedestrians and of motor-cycle accidents. Half the lorry drivers and pedestrians injured, but only a third of the motorists and motor-cyclists, had alcohol in their blood. These figures bear out what many observers have suspected-that the pedestrian is by no means always a blameless victim of the motorist. The law of this country does not yet allow to a defendant motorist "discovery" of the blood alcohol of a plaintiff pedestrian at the time of the accident ; but, if it did, less might be heard of the
wrongs of
injured foot-passengers.
-
sufferings already sufficiently great. MELBOURNE MEETING OF THE B.M.A. GAIN IN WEIGHT ASSOCIATED WITH MENSTRUATION
IT is
announced that Sir Richard Stawell, to the Melbourne Hospital and 1 the Melbourne Children’s enters so into WATER Hospital, will preside over intimately every activity of the cell that alteration of almost any physiologicalthe annual meeting of the British Medical Association variable is accompanied by either gain or loss of bodywhich commenes on Sept. 9h, 1935. Thect presidents fluid. It appears from a paper by J. S. Sweeney 1of sections are : medicine, Lord Horder ; surgery that menstruation offers no exception to this general (including urology), Sir Thomas Dunhill; obstetrics rule. He noticed that an obese patient who was and gynaecology, Dr. J. S. Fairbaim ; radiology and losing weight steadily on a reducing diet suddenly radiotherapeutics, Dr. A. E. Barclay; diseases of gained 7 lb. in 48 hours shortly before the onset children, Dr. ’Robert Hutchison ; neurology and of menstruation. As soon as the menstrual flow psychological medicine, Prof. Edwin Bramwell; appeared the extra weight was equally quickly lost. orthopaedics. Prof. E. W. Hey Groves ; oto-rhinoSweeney proceeded to make observations on the laryngology, Mr. Francis Muecke ; pathology and body-weight in 42 normal adult girls and found that bacteriology, Prof. A. Murray Drennan ; dermatology, Dr. J. M. H. Macleod ; medical sociology, Dr. E. K. some 30 per cent. gained 3 lb. or more in weight Le Fleming ; ophthalmology, Dr. A. J. Ballantyne ; before or during menstruation. The gain in weight was in some cases associated with thirst and with pharmacology, therapeutics, and anaesthesia. Sir perceptible diminution in the output of urine, and William Willcox ; public medicine, Sir Henry there is little doubt that water retention was responGauvain, who will also preside over the section which sible. This phenomenon apparently accounts for the concerns itself with the development of medicine feeling of tightness in the extremities which often in Australia-an interesting history. accompanies menstruation, and in a few cases pitting oedema has actually been demonstrated. The cause THE CHINESE PLAN OF PAYING THE DOCTOR of these interesting fluctuations in water balance IT is often said that the Chinese method of paying is at present unknown. The problem may be related the doctor is to remunerate him beforehand, when in some way to the obscure oedema which appears he works to preserve the health of the subject, while, in otherwise healthy adolescent girls, and possibly if he fails to preserve it, he deals with events gratuialso to the pre-eclamptic toxaemias of pregnancy. he tously, i.e., regards the consequent treatment as the work for which he has already been paid. This THE BLOOD ALCOHOL IN ACCIDENT VICTIMS statement is frequently made, and happens to have LEGISLATION has been passed enabling courts to been made prominently this week ; it is sometimes deal severely with motorists who over-indulge in endorsed and sometimes contradicted, while latterly, alcohol, but the possibility of an accident being with fuller comprehension of what contract service caused by the drunkenness of the injured party is implies, it has been asked whether such a plan does rarely mentioned. Nevertheless, anyone who has not constitute a form of insurance. When the matter had charge of a casualty department knows that was last being discussed we turned for information it is not uncommon for accident victims to be suf- to Dr. Wu Lien Teh, part author of a recent and fering from alcoholic excess, and it seems fair that voluminous history of Chinese medicine and the this cause of accident should be given proper weight. well-known director of the National Quarantine Inquiry has been made into this subject in Sweden Service of China. His reply shows that a categorical on all points is not quite easy. He writes : especially, and Drs. James Hindmarsh and Paul answer " Linde have lately given an account2 of an investigaI have tried to obtain something definite from tion of all the accident cases admitted to the surgical ancient books likeChou-li.’ The only certain division of the Maria Hospital in Stockholm over a thing I find is that during the Chou-li dynasty state year. They used Widmark’s method of estimating examinations were held regularly for medical practithe alcohol content of the blood-one which has tioners and that grades were given to four classes shown itself to be accurate within limits of ±0-03 according to the percentage of cures effected by them. Since then medical practice in China has per 1000-and they tested only cases brought to hospital within five hours of the accident. The varied in many directions, but although, different numbers were 283 men and 103 women ; of these, conditions prevail it may be said with fair accuracy 41 per cent. of the men and 10 per cent. of the women that many families pay their doctors regular sums gave positive reactions. Most of the women had annually for their services ; and this may be taken very small percentages of alcohol in the blood, but to mean that the doctors are paid to keep the families well, for no extra payment is made for attendance 1 Jour. Amer. Med. Assoc., July 28th, 1934, p. 234. 2 Acta Chir. Scand., 1934, lxxv., 198. upon the sick. In some cases the practitioners are now
consulting physician
diaphragm and a more satisfactory pulmonary collapse. Pneumoperitoneum is also suggested in support of artificial pneumothorax when basal adhesions are preventing an adequate collapse elevation of the
a lower lobe. The graver complications of pulmonary tuberculosis that no method of treatment, are so distressing however strange, should be lightly dismissed as worthless, but though operations of this nature may bring a measure of relief to some incurable consumptives, euthanasia might be more surely and more comfortably attained by simpler means. Though in skilled hands a pneumoperitoneum may be induced without serious danger in selected cases, its general employment would entail risks and might add to
of
the bulk of the men had over 1 in 1000. The incidence was greatest on Saturdays, but nearly as large The bulk of the accion Wednesdays and Fridays. dents were made up of collisions between motor-cars and pedestrians and of motor-cycle accidents. Half the lorry drivers and pedestrians injured, but only a third of the motorists and motor-cyclists, had alcohol in their blood. These figures bear out what many observers have suspected-that the pedestrian is by no means always a blameless victim of the motorist. The law of this country does not yet allow to a defendant motorist "discovery" of the blood alcohol of a plaintiff pedestrian at the time of the accident ; but, if it did, less might be heard of the
wrongs of
injured foot-passengers.
-
sufferings already sufficiently great. MELBOURNE MEETING OF THE B.M.A. GAIN IN WEIGHT ASSOCIATED WITH MENSTRUATION
IT is
announced that Sir Richard Stawell, to the Melbourne Hospital and 1 the Melbourne Children’s enters so into WATER Hospital, will preside over intimately every activity of the cell that alteration of almost any physiologicalthe annual meeting of the British Medical Association variable is accompanied by either gain or loss of bodywhich commenes on Sept. 9h, 1935. Thect presidents fluid. It appears from a paper by J. S. Sweeney 1of sections are : medicine, Lord Horder ; surgery that menstruation offers no exception to this general (including urology), Sir Thomas Dunhill; obstetrics rule. He noticed that an obese patient who was and gynaecology, Dr. J. S. Fairbaim ; radiology and losing weight steadily on a reducing diet suddenly radiotherapeutics, Dr. A. E. Barclay; diseases of gained 7 lb. in 48 hours shortly before the onset children, Dr. ’Robert Hutchison ; neurology and of menstruation. As soon as the menstrual flow psychological medicine, Prof. Edwin Bramwell; appeared the extra weight was equally quickly lost. orthopaedics. Prof. E. W. Hey Groves ; oto-rhinoSweeney proceeded to make observations on the laryngology, Mr. Francis Muecke ; pathology and body-weight in 42 normal adult girls and found that bacteriology, Prof. A. Murray Drennan ; dermatology, Dr. J. M. H. Macleod ; medical sociology, Dr. E. K. some 30 per cent. gained 3 lb. or more in weight Le Fleming ; ophthalmology, Dr. A. J. Ballantyne ; before or during menstruation. The gain in weight was in some cases associated with thirst and with pharmacology, therapeutics, and anaesthesia. Sir perceptible diminution in the output of urine, and William Willcox ; public medicine, Sir Henry there is little doubt that water retention was responGauvain, who will also preside over the section which sible. This phenomenon apparently accounts for the concerns itself with the development of medicine feeling of tightness in the extremities which often in Australia-an interesting history. accompanies menstruation, and in a few cases pitting oedema has actually been demonstrated. The cause THE CHINESE PLAN OF PAYING THE DOCTOR of these interesting fluctuations in water balance IT is often said that the Chinese method of paying is at present unknown. The problem may be related the doctor is to remunerate him beforehand, when in some way to the obscure oedema which appears he works to preserve the health of the subject, while, in otherwise healthy adolescent girls, and possibly if he fails to preserve it, he deals with events gratuialso to the pre-eclamptic toxaemias of pregnancy. he tously, i.e., regards the consequent treatment as the work for which he has already been paid. This THE BLOOD ALCOHOL IN ACCIDENT VICTIMS statement is frequently made, and happens to have LEGISLATION has been passed enabling courts to been made prominently this week ; it is sometimes deal severely with motorists who over-indulge in endorsed and sometimes contradicted, while latterly, alcohol, but the possibility of an accident being with fuller comprehension of what contract service caused by the drunkenness of the injured party is implies, it has been asked whether such a plan does rarely mentioned. Nevertheless, anyone who has not constitute a form of insurance. When the matter had charge of a casualty department knows that was last being discussed we turned for information it is not uncommon for accident victims to be suf- to Dr. Wu Lien Teh, part author of a recent and fering from alcoholic excess, and it seems fair that voluminous history of Chinese medicine and the this cause of accident should be given proper weight. well-known director of the National Quarantine Inquiry has been made into this subject in Sweden Service of China. His reply shows that a categorical on all points is not quite easy. He writes : especially, and Drs. James Hindmarsh and Paul answer " Linde have lately given an account2 of an investigaI have tried to obtain something definite from tion of all the accident cases admitted to the surgical ancient books likeChou-li.’ The only certain division of the Maria Hospital in Stockholm over a thing I find is that during the Chou-li dynasty state year. They used Widmark’s method of estimating examinations were held regularly for medical practithe alcohol content of the blood-one which has tioners and that grades were given to four classes shown itself to be accurate within limits of ±0-03 according to the percentage of cures effected by them. Since then medical practice in China has per 1000-and they tested only cases brought to hospital within five hours of the accident. The varied in many directions, but although, different numbers were 283 men and 103 women ; of these, conditions prevail it may be said with fair accuracy 41 per cent. of the men and 10 per cent. of the women that many families pay their doctors regular sums gave positive reactions. Most of the women had annually for their services ; and this may be taken very small percentages of alcohol in the blood, but to mean that the doctors are paid to keep the families well, for no extra payment is made for attendance 1 Jour. Amer. Med. Assoc., July 28th, 1934, p. 234. 2 Acta Chir. Scand., 1934, lxxv., 198. upon the sick. In some cases the practitioners are now
consulting physician