Full text of "Medical Journal of Australia"

THE

MEDICAL JOURNAL

OF AUSTRALIA

IN TWO VOLUMES ANNUALLY

DS/28

17.1

The following issue(s) is/are missing and
unobtainable

Date of collating . . . ./. . .&gt;. .&lt;:. .* .

-1946

) JUNE

(Sydney), F.R.A.C.P., F.R.A.C.S.

SYDNEY

AUSTRALASIAN MEDICAL PUBLISHING COMPANY- LIMITED
1946

THE

MEDICAL JOURNAL

OF AUSTRALIA

IN TWO VOLUMES ANNUALLY

Volume I- 1946

JANUARY TO JUNE

EDITOR:

MERVYN ARCHDALL, M.D., Ch.M. (Sydney), F.R.A.C.P., F.R.A.C.S.

SYDNEY

AUSTRALASIAN MEDICAL PUBLISHING COMPANY. LIMITED
1946

KEY TO DATES AND PAGE NUMBERS.

Number.

Date.

Pages.

January 5

1 to 32

January 12

33 to 64

January 19

65 to 96

January 26

97 to 132

February 2

133 to 168

February 9

169 to 204

February 16

205 to 240

February 23

241 to 276

March 2

277 to 312

March 9

313 to 348

March 16

349 to 384

March 23

385 to 420

March 30

421 to 456

April 6

457 to 492

April 13

4!&gt;3 to 536

April 20

537 to 572

April 27

573 to 608

May 4

609 to 644

May 11

645 to 680

May 18

681 to 716

May 25

717 to 752

June 1

753 to 7S8

June 8

789 to 824

June 15

825 to 860

June 22

861 to 896

June 29

897 to 932

VOL. I, 1946.

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

INDEX TO VOLUME I, 1946.

JANUARY TO JUNE

In this index (C.C.) indicates current comment : ((&gt;) indicates an original article; (R) indicates a report of case; (rev.), a review.

Page
A

Abbie, A. A. Anatomy in the Medical

Curriculum (O) 152

Abdomen, Gunshot Wounds of the,
Early Results in a Short Series
of Cases of, by T. F. Rose, A.
Newson and D. Watson (O) . . 180

Abnormalities, Congenital, in Infants
following Infectious Diseases
during Pregnancy, with Special
Reference to Rubella : A Third
Series of Cases, by C. Swan and
A. L. Tpstevin (O) 645

Aborigines in the Northern Terri
tory, A Sociological Study of the,
and their Eye Diseases, by M.
Schneider (O) 99

Abortion, Childbirth and, Infections
due to Streptococcus Hsemolyticus
Group A following, Stained
Smears for the Rapid Diagnosis
of, by H. M. Butler (O) .... 437

Abscess, Putrid Lung, by C. .T.

Officer Brown (O) 107

Abstracts from Medical Literature
Authors

Abrahamsen, D 343

Adams, M. L., Frobisher and

Kuhns 780

Allan, J. H 522

Allen, A. C., and Spitz 484

Altwie-Werber, E., Loewe and

Rosenblatt 161

Anderson, w. A. D., Pinkerton

and Smiley 88

Appleton, A. B 88!)

Armstrong, C. D., Bloomfield and

Kirby 376

Atkinson, J. D., and Wilson . . 376

Atkinson, W. B., and Elftman . . 89

Aynsley, T. R 305

Babudieri, B., and Bietti 304

Bacsich, P., and Wyburn 485

Bagby, J. W 812

Baker, R. D 888

Banerjee, S 121

Banner, E. A., arid Dockerty ti:!4, 888

Barach, A. L., ct alii 342

Barbara, D. A 343

Beikenstein, N., and Gold .... 343

Bennett, A. E 343

Bietti, G. B 304

Bigelow, R. R., Bruschwig and

Ricketts 194

Bishop, G. H 485

Blain, A. W., and De Matteis . . 596

Blair, H. A., and Wedd 924

Blair, J. E., and Buchman .... 597
Blank, I. H., Lane, Rockwood

and Sawyer 812

Bloch, K., and Rittenberg .. 121.925

Blomfield, L. B., and Clark 89

Bloomfield, A. L., Armstrong and

Kirby 376

Blum, G., and Wakeley 342

Bodian, D., and Howe 781

Bogen, E., and Margraves 413

Boisvert, I 1 ., Rantz and Spink . . 252

Borak, J., and Taylor 449

Blumgart, H. L 161

Boyd, R. W 377

Bridgman, C. S., and Smith . . 889

Britton, S. W., and Kline 924

Brown, J. B., and Orians 925

Brown, P. N., Salk, Pearson,

Smyth and Francis 781

Bruschwig, A., Ricketts and

Bigelow 194

Buchman, J., and Blair 597

Bugbee, H. G 25

Burke, G., and Canter 161

Burrows, A., Russell and May . . 24

Buschke, F., and Cantril 449

Camiel, M. R 852

Camp, J. D., and Moreton 57

Page

Abstracts from Medical Literature
Continued.

Authors Continued.

Candel, S., and Wheelock 556

Canter, M. M., and Burke 161

Cantril, S. T., and Buschke .... 449

Caro, M. R., and Stubenrauch . . 412

Castillo, J. C., and Stiff 523

Clark, W r . B. Le Gros, and Blom
field 89

Clarkson, J., and Lederman .... 853

Clayton, S. G 232

Cleveland, D., and Kindwall .... 343

Cohen, H. M., and Pfaff 412

Collom, S. A., and Ewing .... 596

Comfort, M. W., and Kelsey . . 88

Corber, A. A 233

Costello, M. J., and Landy 24

Counceller, V. S., and Pratt . . 25

Couper, E. C. Ross 672

Crimm, P. D., and Westra 556

Curtis, A. C., Teitelbaum and

Goldhamer 88

Custer, M. D., and Waugh 597

Cutting, W. C., and Dobson ... 744

Daland, E. M 597

Daly, D 745

Davalos, A 813

Davies, D. V 485

Davies, J. A. V., and Hutchings 672

Davison, C., and Demuth 889

Dawson, A. B 89

De Matteis, A., and Blain 596

Demuth, E. L., and Davison .... 889
Denny, E. R., Khallenberger and

Pyle 744

De^wiler, S. R 889

Dick, T. B. S 745

DiLeone, R., and Waterman . . 449

Dixon, G. J., and Dick 745

Dobes, W. L., Franke and

Romano 812

Dobson, L., and Cutting 744

Dockerty, B., and Banner 888

Dockerty, M. B.

And Banner 634

Hodgson and Muspey 634

Ducharme, P 448

Dudley, M. G., and Walton .... 781

Dyer, H. F 635

Eaton, R. M., et alii 597

Edlin, J. V., Johnson, HIetko and

Heilbrunn 744

Eggers, S. W. N 673

Eichwald, M., and Singletary . . 852

Elbel, E. R., and Green 924

Elftman, H., and Atkinson .... 89

Eller, G. H., and Frobisher 780

Elliott, H. W., and Norris .... 120

Elliott, S. D 376

Emmel, V. M 89

Enders, J. F 780

Epstein, B. S 448

Erickson, L., Taylor, Henschel

and Keys 522

Ewing, W. M. D., and Collom .. 596

Falk, A., and Nicholson 557

Farmer, C. J., Hagens and Karp 305

Feinberg, S. M., and Friedlaender 744
Feldman. W. H., Hinshaw and

Pfuetze 556

Field, J. B., ct alii 523

Fields, H 233

Fitzpatrick, F. K 780

Flippin, H. F.

Reinhold and Phillips 342

Zintel, Nichols. Wiley and

Rhoades 744

Florey, M. E., McFarlan and

Mann 304

Forbes. W. H., Sargent and

Roughton 120

Francis, T., junior. Salk, Pear
son. Brown and Smyth 781

Franke, A. G., Dobes and

Romano 812

Page

Abstracts from Medical Literature

Continued.
Authors Continued.

Freed, S. C 160

Freeman, W., and Watts 343

Friedlaender, S., and Feinberg . . 744
Friedman, A. P., and Merritt . . 342

Friedman, N. B 484

Frobisher, M., junior

Adams and Kuhns 780

And Eller 780

Frost, K., and Obermayer .... 412
Galindo, P., Hammon and Reeves 781

Gardner, J., et alii 925

Gates, O., and Warren 888

Gericke, O. L 744

Gibson, D. M 377

Gillan, R. U 304

Gold, L., and Beikenstein .... 343

Goldberg, L. C. . . 812

Golden, R., and Ducharme .... 448
Goldhamer, S. M., Teitelbaum

and Curtis 88

Goldstein, J 709

Goodall, J. R 233

Goodof, I. 1 88

Gordon, H. H 812

Gorro, A. P 813

Gortner, W. A 121

Goyanna, R., and Greene 813

Graham, M. P., and Small 597

Gralnick, A 745

Gratzek, F. R., and Stenstrom . . 57

Gray, D. J 89

Green, E. L., and Elbel 924

Green, M. J., and Hamburger 376, 780
Greene, L. F 413

And Goyanna 813

Groat, R. A., Rambach, junior,

and Windle 596

Grolnick, M., and Loewe 376

Hagens, E. W., Karp and Farmer 305
Hale, C. H., and Robbins . . 56, 448

Hall, A 70S

Hall, I. Simpson 709

Halperin, M. H., McFarland and

Niven 522

Hamburger, M., junior

Hamburger and Green . . 376, 780

I uck and Robertson 377

Puck, Robertson and Hurst . 377

Hamburger, V. C 376

Hammon, W. McD., Reeves and

Galindo 781

Hansson, C. J 57

Hauser, I. J., and Work 305

Heilbrunn, O., Edlin, Johnson

and HIetko 744

Helwig, F. C., and Read 160

Hemphill, J. E., and Reeves . . 57

Henderson, J 412

Hendry, A. M 253

Henschel, A., Taylor, Erickson

and Keys 522

Herrin, R. C., and Meek 522

Herzog, E. G 253

Hilding, A. C 708

Hinshaw, H. C., Feldman and

Pfuetze

Hirshfeld, J. W

HIetko, P., Edlin, Johnson and

Heilbrunn

Hodgson, J. E., Dockerty

Mussey

Hogan, G. F

Hone, E. L., et alii

Horn. R. C., Pendergrass and

Lafferty

Howe H. A., and Bodian

Howell. T. H

Hurst, V., Puck, Hamburger and

Robertson

Hutchings, G., and Davies

Hutter, A. M., and Parkes ....

Jackman, J., and Luhert

Jaffe, H. L

and

556
195

744

634
557

925

781
5 5 7

377

672

233

852

INDEX TO THE MEDICAL JOURNAL OP 1 AUSTRALIA.

VOL. I, 1946.

I age
Abstracts from Medical Literature

Continued.
Authors Continued.

Johnson, B. C., et alii 523

Johnson, H. K., and Larsener . . 343

Johnson, H. W 635

Johnson, R. H., Edlin, Hletko

and Heilbrunn 744

Kaplan. K. B 889

Karp. M., Hagens and Farmer . . 305

Kay, &lt;;. A., and Williams 120

Keeper, C. S 342

Keitzer, W. A., Nesbit and Lynn 813
Kelsey, M. P., and Comfort .... 88

Kennedy, C., and Palmer 121

Kerr, W. J., and Ralston 924

Keys, A., Taylor, Erickson and

Henschel 522

Kickham, C. J. E 413

Kindwall, J. A., and Cleveland . 343
Kirby, W. M., Bloomfield and

Armstrong 376

Klein, B. V., and Stettin 523

Kline, R. F., and Britton 924

Krieg, E. G 634

Kuhns, W. J., Frobisher and

Adams 780

KunMler, W. E 557

Kuyper, A. C 523

Laestar, C. H., and Phemister . 194
Lafferty, J. O., Pendergrass and

Horn 56

Lam, C. R 57

Landy, S., and Costello 24

Lane, C. G., Rockwoocl, Sawyer

and Blank 812

Larsener, R., and Johnson . . . 343
Lederman, M., and Clarkson . . 853

Lehr, D 813

Leslie, A., and Silverman 744

Leuceutia, T 853

Levinson, S. O., Milzer and Lewin 781
Lewin, P., Levinson and Milzer 781

Lewis, B. O., and Sodeman 744

Light. R. U., and Prentice 596

Limarzi, L. R., and Wolff 233

Loewe, L.

Altwie-Werber and Rosenblatt 161

And Grolnick 376

Lubert, M., and Jackman 56

Lucic, H 708

Luecke, R. W., and Pearson ... 121
Lynn, J. M., Nesbit and Keitzer 813
MacFarland, M. L., and McHenry 523

Maegraith, B. G., et alii 557

Magoun, H. W., and Wilson . . . 889
Mandeville, F. B., and Nelson . . 25
Mann, I., Florey and McFarlan 304

Manter, J. T 889

Margraves, R. D., and Bcgen . . . 413

Marks, M. B 252

Maroun, T., and Monnerot-

Dumaine 484

Martin, H., and Reese ! 304

Martinez, D., and Visscher . . 522

Mapsie, F. M 194

Mathe, C. P . . . . 25

May, H. B., Burrows and Russell 24

McAdam, I. W. J 597

McCarty, M 376

McClosrky, W. T., and Smith . . 377

McCulloch, C 708

McCutchan, G. R 160

McDonald, J. R., Moersch and

Tinney 888

McFarlan, A. M., Florey and

Mann 304

McFarland, R. A., Halperin and

Niven 522

McHenry. E. W., and Mac
Farland 523

McLoughlin, C. J., and Paulin . 342

McShan, W. H., et alii 925

Meek, W. J.. and Herrin 522

Meekison, D. M 673

Merritt, H. H., and Friedman 342

Mills, C. A., et alii 925

Milzer, A., Levinson and Lewin 781

Mitchell, H. H., et, alii 121

Moersch, F. P., and Stark 745

Moersch, H. J., Tinney and

McDonald 888

Moeys, E. J., and Tordoir .... . 673

Mohanty, J. K 161

Monnerot-Dumaine, M., and

Maroun 484

Moore, T 813

Morehead, R. P., and Woodruff . 888
Moreton, R. D., and Camp .... 57

Morrison, L. M 556

Morton, D. G., and Newgard .... 232

Morton, J 195

Munger, A 852

Page

Abstracts from Medical Literature

Continued.
Authors Continued.

Murphy, R. J., Romansky and

Rittmann 160

Murray, N. A 88

Mussey, R. D., Hodgson and

Dockerty 634

Nelson, C. M., and Mandeville . . 25
Nesbit, R. M., Keitzer and Lynn 813

Newgard, K., and Morton 232

Nichols, A. C., Zintel, Flippin,

Wiley and Rhoades 744

Nicholson, C S89

Nicholson, J. H., and Falk 557

Niven, J. I., McFarland and

Halperin 522

Norrie, E. R., and Elliott 120

Novak, E., and Stevenson 484

Noyes, R. W 634

Obermayer, M. E., and Frost . . 412

Olsen, A. M., and Tinney 5C7

Ordstrand, V., Thomas and

Tomlinson 557

Orians, B. M., and Brown 925

Osten, J. M., et alii 925

Ostow, M 745

Overholt. R. H 161

Page, I. H., and Taylor 161

Palmer, L., and Kennedy 121

1 arkes, J., and Hutter 233

Paterscn, M. T 745

Paul, H. E., et alii _.. 121

Paulin, J. E., and McLoughlin . 342

Peacher. W. G 744

Pearson, H. E., Salk, Brown,

Smyth and Francis 781

Pearson. P. B., and Luecke .. 121
Pendergrass, E. P., Lafferty and

Horn 56

Pendergrass, R. C 56

Perkins, J. F., junior 924

Perry, C. B 557

Peterkin, C. A. Grant 24

Peterson, L. W 195

Pfaff, R. O., and Cohen 412

Pfahler, G. E 853

Pfuetze, K. H., Hinshaw and

Feldman 556

Phemister, D. B., and Laestar . 194
Phillips, F., Reinhold and Flippin 342

Pick, J. F 195

Pinkerton, H., Smiley and

Anderson 88 i

Poth, E. J 194

Potter, E. L 635 |

Pratt, J. H., and Counceller . . 25
Prentice, H. R., and Light .... 596

Proom, H 376

Puck, T. T.

Hamburger and Robertson . . 377

And Hurst 377

Pugh, D. G 56

Pyle, H. D., Shallenbrger and

Denny 744

Ralston, H. J., and Kerr 924

Rambach, W. A., junior, Groat

and Windle 596

Ransohoff, N. S 342

Rantz, L. A., Spink and Boisvert 252

Read, J. T., and Helwig 160

Reese, A. B., and Martin 304

Reese, E. C 194

Reeves, R. J., and Hemphill . . 57
Reeves, W. C., Hammon and

Galindo 781

Reinhold, J. G., Phillips and

Flippin 342

Resenberg, R. . . . T 343

Resnick, L 233

Revens, W. S 160

Rhoades, J. E., Zintel, Flippin,

Nichols and Wiley 744

Rhoden, A. E 484

Rice, E. E., et alii 121

Ricketts, J. T., Bruschwig and

Bigelow 194

Rittenberg, D., and Bloch . . 121, 925
Rittmann, G. E., Romansky and

Murphy 160

Robbins, L. L., and Hale ... 56, 448
Robertson, O. H., Hamburger

and Puck 377

Robinson, S. S., and Tasker .... 812
Rockwood, E. M., Lane, Sawyer

and Blank 812

Rogers, H. M 88

Romano, D., Franke and Dobes . 812
Romansky, M. J., Murphy and

Rittmann 160

Rosenblatt, R., Loewe and

Altwie-Werber 161

Rosenwasser, H 305

Page
Abstracts from Medical Literature

Continued.
Authors Continued.

Ross, S. G 252

Rothbard, S 376

Roughton, F. J. W., Forbes and

Sargent 120

Ruben, J. A., and Tipson 925

Russell, B., Burrows and May . . 24
Russell, W. O., Stowell and

Sachs KS8

Sachs, E., Stowell and Russell 888
Salk, J. E., Pearson, Brown,

Smith and Francis 781

Sarett, H. P 523

Sargent, F., Forbes and Roughton 120
Sawyer, C. S., Lane, Rockwood

and Blank 812

Schachter, R. J 120

Scharrer, E 89

Senturia, B. H 709

Shallenberger, P. L., Denny and

Pyle 744

Phalom, E. S 556

Shorr, E 413

Silber, R. H 523

Silverman, D. N., and Leslie . . 744

Simpson, S. A., and Young 485

Singer, R 709

Singletary, W. V., and Eichwald 852

Small, J. M., and Graham .... 597
Smiley, W. L., Pinkerton and

Anderson 88

Smith, G. Harvey 232

Smith, K. U.. and Bridgman .... 889

Smith, M. I., and McClosky 377

Smyth. C. J., Salk, Pearson,

Brown and Francis 781

Snell, A. C 304

Snyder, J. C., and Wheeler .... 780

Sodeman, W. A., and Lewis . . . 744

Spealman, C. R 924

Speed, J. S 253

Spink, W. W., Rantz and

Boisvert 252

Spitz, S., and Allen 484

Stark, F. M., and Moersch ... 745

Stenstrom, K. W., and Gratzek . 57

Stetten, D 121

And Klein 523

Steven, R. A 161

Stevenson, R. R., and Novak . . 484

Stiff, H. A., and Castillo 523

Stocker, F. W 708

Stowell, R. E., Sachs and Russell 888

Stubenrauch, C. H., and Caro .. 412

Sunderland, S 89

Tasker, S., and Robinson 812

Taylor, H. K., and Borak ..... 449
Taylor. H. L., Erickson, Henschel

and Keys 522

Taylor, R. D., and Page 161

Teitelbaum, M., Curtis and Gold-

hamer 88

Tenennt, W 448, 673

Thomas, J. W., Ordstrand and

Tomlinson 557

Thome, F. C 745

Tinney, W. S.

And Olsen 557

Moersch and McDonald 888

Tipson, R. S., and Ruben 925

Tomlinson, C., Thomas and

Ordstrand 557

Tomnkins, P 634

Tordcir, B. M., and Moeys .... 673

Tuhy, J. E., and Welch 596

Turnbull, J. A 161

Van Buskirk. C 485

Van Harreveld. A 522

Vastine, J. H. and M. F 25

Vaughan, W. W 56

Visscher, M. B., and Martinez . 522

Wagman, O. H 70S

Wakeley, C. P. G., and Blum . . 342

Walker-Taylor, P. N 161

Walls, E. W 485

Walton, C. H. A., and Dudley . . 7 81

Warren, S., and Gates 888

Waterman, G. W., and DiLoone 449

Watts. .T. W., and Freeman . . 343

Waugh, J. M., and Custer .... 597

\Vedd, A. M., and Blair 924

Weinstein, L., and Wesselhoeft . 557

Welch, C. S., and Tuhy 596

Welch, P. B 556

Wesselhoeft, C., and Weinstein . 557

Westra, J. J., and Crimm .... 556

Wheeler, C. M., and Snyder . . 780

Wheelock, M. C., and Candel . . 556

Wiener, A. S 781

Williams, R. H., and Kay .... 120
Wiley, M. M., Zintel, Flippin,

Nichols and Rhoades 744

Vol.. 1, 1946.

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

Page
Abstracts from Medical Literature

Continued.
Authors Continued.

Wilson, A. K $52

Wilson, G. S., and Atkinson . . :!7(i
Wilson, W. C., and Magoun .. 889
W indie. W. F., Groat and

Rambach 59G

Wolf, A. V 120

Wolff, J., and Liniarzi 233

Woodruff, \V. JO., and Morehead S88

Woolley, D. W 121

Work, \V. P., and Hauser 305

Wyburn, G. M., and Bacsich .. 485
Voting-, J. Z., and Simpson .... 485

Xachary, K. B 590

Zintel, II. A., Flippjn, Nichols.

Wiley and Rhoades 744

Bacteriology and Immunology 370, 780
Body .Louse, Human, Experi
mental Infection of the, with

Typhus Strains 780

Carriers, Dangerous, of Haemo-

lytic Streptococci 780

Diphtheria in Baltimore 780

Endocarditis. Bacterial -

And Penicillin 37(j

Subacute, 1 m m u n o 1 o g i c a 1

Studies in :&gt;,7G

Mumps. Immunity in 780

Penicilllnase 376

I neumococcal Types, Transfor
mation of 370

1th Sensitization, Test for 781

Staphylococcus Aureus, Phage

Typing of 370

Streptococci

Group A, Bacteriostatic Effect
of Human Serum on . . 370

Group A, Proteolytic Enzyme

Ihemolytic, Dangerous Car
riers of

Typhus, Kickettsial Agglutina
tion in

Biochemistry 121, 523,

Acetic Acid

Alloxan ] 21,

Anoxia

Biotin 121,

Body Composition

Bone Formation

Calcium Pantothenatc

Cholinc

DDT

Endocrine Tissues

Fatty Acids

Fatty Liver

Folic Acid

(Jalacto.sc

&lt; ilycogenesis

Haematopoiesis

Human Milk Fat

Lipidea

Pantothenie Acid

Plasma Fibrinogen

Thiamin Requirements

Vitamin E

Vitamins in Muscle

Wound Healing

Dermatology &gt; (, U 2,

Dermatitis Exfoliativa following

Arsphenamine Therapy

Dermatoses of the Hands

Ihemangioendothelioma of ill 1

Skin

fehthyosis, Treatment of

Lupus Krythematosus

Penicillin

Allergic Reactions during the
Administration of

In Dermatological Therapy ..

In the Treatment of Cutaneous

Disease

Skin, Colloid Degeneration of the
Sulphonamides, Skin Eruptions

due to the Application of

Sycosis Barbae. The Treatment of,

with Penicillin Cream

Tropical Disease, A, Resembling

Lichen J Maims

Vitamin Therapy in Dermatology

( iymecology 232.

Chorionepithelioma, Extragenital

KMrophy of the Bladder with
1 rocidentia

Fallopian Tube, Surgical Ob
struction of the

Granulosa-Cell Tumour of the
Ovary

Haemorrhage, Vaginal, in Women
Aged Over Fort\ Years ....

370

925
121
925
925
925
121
523
523
121
523
925
925
523
523
121
523
925
925
121
523
523
925
121
121
121

S12

112
812
812

S12
812

24
24

812
412

634
233

232
034
634

034

Page
Abstracts from Medical Literature

Continued.
( lynaecoiogy Continued.

Ovulation. Basal Body Tempera
ture Graphs as an Index to .. 034
Theca-Cell Tumours of the Ovary 034
Tuberculosis and Cancer of the

Uterus, Coexisting 232

Uterine Polypi 232

Hygiene 377, 781

Encephalitis, An Epidemiological

Study of 781

Fungous Spores, Air-Borne, in

Manitoba 7S1

Influenza Vaccination, Effect of,

One Year Later 781

I oliomyelitis

Experimental, E f f e c t of
Fatigue, Chilling and Mech
anical Trauma on Resistance

to 781

Transmission of, The, to
Rhesus Monkeys by Acci
dental Laboratory Infection 781
Streptomycin and "Promin" in

Experimental Tuberculosis . . 377
Triethylene Glycol Vapour in

Hospital Wards 377

Tuberculosis. Prevention of .... 377
X-Ray Survey. An, of Healthy
Troops in Canada 377

Medicine 1 GO, 550

Allergy, Respiratory, and Un
resolved Pneumonia 101

Arterial Thickening 557

Bronchiectasis 557

Feeding Reflex, Gastric, Distur
bances (if the 55G

Gonorrhoea, The Treatment of,

with Penicillin in Oil 100

Haemorrhage, Impending Cerebral 101
Hypertension, Malignant, Cured

by Nephrectomy 557

Meningitis, Purulent, Hypertonfc
Solutions in the Treatment of 550

Mononucleosis, Infectious 100

Myocardial Infarction. Acute,
The Relation ot Effort to

Attacks of 101

Myocarditis, Acute 556

Night Cramps 557

Oleothorax in the Treatment of

Tuberculous Empyema 550

I aracentesis of the Chest 557

Penicillin, The Rectal Adminis
tration of 101

Peptic Ulcer 550

Pleural Effusion 557

Pneumonia, Non-Tuberculous,

Complicating Tuberculosis . . 557
Premenstrual Distress, The
Treatment of, and the Andro-

gens loo

Pruritus Ani 100

Scarlet Fever 557

Simmond s Disease, The Treat
ment of, with Male Sex Hor
mones 101

Sprue, Carbohydrate Absorption

in 557

Thiouraeil Therapy in Thyreo-

to.xicosis 100

Tuberculosis 550

Pulmonary, Lobectomy and

Pneumoneetomy for 161

Ulcer

Peptic, .Etiology of 101

Tropical 101

Whooping Cough, Maternal Blood
in 101

Morphology Nil, 485, 889

Anastomoses, Arterial, Efficiency

of Intramuscular 89

Argentattin Cells of the Stomach 89
Blood Vessels of Nervous Tissue SO
Carrying Angle of Human Arm 89
Cells, Absorbing, of the Small

Intestine $9

I i pus Callosum, Perception and

the Ns :&gt;

Extensor D gitorum Communis,

Insirt oiis of 889

Hamstring Muscles. Anomalous S9
Heart, Human. Conducting Sys
tem in 485

Light, Mechanical Ucsponses of

K .-tina to SS9

Lungs. Arteries and Veins of the 889
Meningeal Relations nf Hypo
physis v.i

Muscles, Intel-osseous, of the
Human Foot SS9

Page
Abstracts from Medical Literature

Continued.
Morphology Continued.

Nerve Regeneration, The Effect
of Interference with Blood

Supply on 485

Nerve. The Seventh Cranial

(Facial) 485

Nerves, Visceral and Somatic,

Regeneration of 485

Olivary Nucleus, The Inferior . 889
1 civic Brim, Female, Two Main

Diameters of 889

Skin, Regeneration of 485

Sleep Centres in the Cortex .... 889
Synovial Fluid, The Cell Con
tent of 485

Neurology and Psychiatry . . . 342,

Alcoholic Personality, Neurotic
Character Structure of the . .

Alcoholism, Chronic, The Con
ditioned Aversion Treatment
in

Criminal Behaviour, Psycho-
dynamics in

Cup, Physiological, of the Optic
Disk, The Depth of the, and
Mental Ability

Delirium Tremens, Psychogenesis
in

Electroshock Treatment. A
Fatality Incident to

Headache following Injuries to
the Head

Lobotomy, Prefrontal

Lupus Erythematosus, Acute
Disseminate, Central Nervous
System in

Organic Deterioration

Radiculitis, Acute Brachial ....

Sclerosis, Primary Lateral ....

Senile and Arteriosclerotic Men
tal Patient, Problems of the .

"Shock" Therapies, An Evalua
tion of the

Speech Disorders in the Second
World War

Torticollis, Spasmodic

"Tridione", The Anticonvulsant
Action of

Obstetrics 233,

Anaemia in Pregnancy

Infection, Uterine Defence
Mechanism against

Penicillin, The Transmission of,
through the Placenta

Placenta Praevia, The Conserva
tive Management of

"Prostigmin" as a Test for Early
Pregnancy

Stilboestrol, The Influence of, on
Lactation . . . ...

Toxaemia of Pregnancy, Late . . .

Vitamin K Administered during
Labcur, The Effect on Infant
Mortality of

Ophthalmology 304,

Blepharitis, Marginal

Blinking

Cataract Incisions, Closure of .

Corneal Ulcers, Insulin Treat
ment of . . . .

Disciform Degeneration of the
Macula

Eclipse Blindness

Glaucoma, Diathermy for

Hypotropia

Injuries, Perforating

Lysbzyme

Retinoblastoma, Bilateral

Strabismus Treated Orthopti
c-ally

Orthopaedic Surgery 253,

Air Arthrography in the Diag
nosis of Torn Semilunar Car
tilage

Colics Fractures, Treatment of

Ma limited

Dislocation, Chronic, of the Base
of the Metacarpal of the

Thumb

Fractures

Kunt seller Method, The, of

Treatment of

of Long Bones, The Treat
ment of Non-Union or De
layed Union of

Oateoarthritia as an Ortho
paedic Problem

Plasmocytoma of Bone

744
343

745
343
745
342

&gt; ,J *J

745
343
745
745

744
745

635
233

708
304

708
708

305

708

70S
7ns
708
304
304
304

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

VOL. I, 1946.

Page

Abstracts from Medical Literature -
Continued.

Oto-Rhino-Laryngology 305, 709

Acetylsalicylic Acid: A Probable
Cause for Secondary Post-
Tonsillectomy Haemorrhage . . 709
Aircraft Noise, Effect of, on

Hearing 709

Fenestration of the Labyrinth . . 709
Otitis, External, Treatment of . 709
Penicillin Therapy by Inhalation 305

Sinusitis arid Penicillin 305

Thrombophlebitis, Lateral Sinus 305

Paediatrics 252, G72

Neo-Natal Life, Sonic Problems

of 252

Penicillin in infections of Infancy 672
Penicillin Treatment

Of Oral Inflammations in

Childhood 252

Of Pneumococcus Meningitis

in Infants 672

Rheumatic Fever, The Treatment
of, with Penicillin 252

Pathology 88,484,888

Adenoma of the Bronchus 888

Burns, Internal Lesions in 888

Carcinoma of the Uterus, The

Vaginal Smear in Diagnosis of 888
Chorionepithelioma, Primary In-
tracranial, with Metastases to

the Lungs 888

Endarteritis, Subacute Bacterial
(Streptococcus Viridans) Pul
monary 484

Glomerulosclerosis, Intercapillary 88
Liver Function Tests, The Com
parative Value of Several .... 88
Lymphoma, Solitary Giant Fol-
licular, of the Vermiform

Appendix 888

Myasthenia Gravis, Tumours of

(he Thymus in 88

Neutropenia, Primary Splenic . . 88
Occlusion of the Hepatic Veins 88

Paraganglioma, Malignant 484

Pneumonia, Giant-Cell, with In
clusions 88

Scrub Typhus (Tsutsugamushi

Disease) and Other Riekett-

sial Diseases, A Comparative

Study of the Pathology of . . 484

Sweat Gland Tumours of the

Vulva 484

Theca-Cell Tumours of the

Ovary 888

Trench Foot, The Pathology of . 484

Physical Therapy 57,449,853

Anaesthesia, Refrigeration 57

Carcinoma

Cervical, Treated by Inter
stitial Radium Implanta
tion 44 J

Mammary, Survival after X-

Ray Therapy of 57

Of the Oesophagus, Radium

Treatment of 853

Hsemangioma, The Treatment of 853
Marie-Striimpell Disease, Ront-
gen irradiation in the Treat
ment of 57

Rontgen Therapy of Bladder

Carcinomata 449

Sarcoma, Kaposi s 57

Ureteral Obstruction, The Ques
tion of, by Irradiation 853

X-Ray Therapy in Advanced

Rheumatoid Arthritis 449

Physiology 120, 522, 924

Anoxia, Age, Sex, Carbohydrate,
Adrenal Cortex and Other

Factors in 924

Arsenic Trioxide, Tolerance to,

in the Albino Rat 120

Arsenite, The Effect of, on the

Respiration of Rat Tissues .. 120
Blood Flow in Hands, Effect of
Ambient Air Temperature and

of Hand Temperature on 924

Blood Volume of Normal Young
Men, The Effect of Bed Rest

on the 522

Calcification, Traumatic : A Pre
cipitating Factor in "Bends"

Pain 522

Carbon Monoxide Uptake, The

Rate of, by Man 120

Cholinesterase, Use of, in Shock 120
Dehydrating Effect, The, of Con
tinuously Administered Water 120
Muscle Fibres, Degenerated, Re-
innervation of, by Adjacent
Functioning Motor Units . . 522

Page

Abstracts from Medical Literature
Continued.

Physiology Continued.

Nerves, Afferent, Excited by In
testinal Distension ......... 522

Pulse Reaction to Step-Up Exer
cise on Benches of Different
Heights

924
924

Shivering, Role of Proprioceptors
in ........................

Skin Temperature Responses to
Local Heating, Observations
wn ........................

Ihiourea, Absorption, Distribu
tion and Excretion of .......

Vascular Responses of the Nasal
Mucosa to Thermal Stimuli . .

Venous Return, The Action of
Cardiac Ejection on ......... 924

Visual Thresholds as an Index
of the Modification of Anoxia
by Glucose ............... 522

522
120
924

Radiology .............. ,-&gt;(;, 44^

Amoeblasis, The Clinical Signifi
cance of Deformity of the
Caecum in .................

Calcification in the Ascending
Aorta ....... ..............

Carcinoma of the Prostate,

Treatment of, by Irradiation .
Collapse of the Lung, Lobar and

Segmental .................

Radiographic Appearance of
Fistula, Arterio-Venous, Cardiac

Changes in ................

Gastritis, Antral, Radiological

and Gastroscopic Findings in
Gaucher a Disease, The Early

Radiological Diagnosis of . .
Leontiasis Ossea, A Probable Ex

planation for : Fibrous Dys-

plasia of the Skull .......

Necrosis, Radiation, of the Cal-

varium .................

CEsophagea] Displacement, Atypi

cal, with Left Atrial Dilatation
Osteoma, Osteoid, of Bone .
Pulmonary Infiltrations, Tran

sient Successive (Loffler s Syn

drome) ................ \

Rontgen Examination in Con

genital Intestinal Obstructive

Defeats in Infants .......

Rontgenology of the Draining

Bronchi from Tuberculous

Cavltiea .................

Sarcoma and Chondrosarcoma,

Ostcogenic .................

, 852

448
50

852

56
448

448

448
852

852

N "-gery ................... 194,

Acrylic Resin for the Closure of

Skull Defects
Burns-

Local Treatment of .........

Metabolic Changes, after The
Cancer of the Breast .......

Concussion of the Spinal Cord
Dermoplasty of War Wounds of

the Lower Part of the Leg ..
Gelatin Sponge and Thrombin ..
Goitre, Substernal and Intra-

thoracic .........

Heparin, The Use of , In" the

Abdomen ...........

CErtema and Ecchymosis, Pul

monary. after Hemorrhage .
Pancreatitis, Acute ...........

Penicillin

In Acute Osteomyelitis ...

In the Treatment of Chronic
Osteomyelitis ............

Penicillin Therapy in Fracture

of the Femur ....
Removal, Total, of the Pancreas

.uid Other Organs and Tissues
Scgmental Resection, Primary in

the L -&gt;ft Side of the Colon
Shock, The Causation of ......

Su: cinylsulphathiaz o 1 e and

Phthalylsulphathiazole in Colmi

Surgery .............. j jM

Thenar Palsy ............. . . ] 59 fi

Wound Infection. Prophylaxis

of ................... ..... iy5

Wounds, Sucking, of the Chest 596

Theraneutics ............... ;!42. 744

Aetinomycosie ............... 744

Ainu lii Hepatitis ............ 744

"Diodoquin" ................. 744

Penicillin ................ ;&gt;4&lt;&gt;

Treatment, The. of Subacute
Bacterial Endocarditis with 342

596
597

194
195
597
596

195
596

596
194

597
195

."&gt; 9 7
597
590
191

597

191

Page

Abstracts from Medical Literature
Continued.

Therapeutics Continued.

Penicillin Aerosol, Inhalation of,
by Patients with Bronchial
Asthma, Chronic Bronchitis,
Bronchiectasis and Lung Ab
scess ............... 349

Poliomyelitis ............. . 342

Privine Hydrochloride ...... . . 744

Streptomycin, A Study of ... 744
Suicide by Ingestion of Amphet
amine Sulphate ............ 744

Sulphadiazine 42

U.F.I ............... :::::::::: 342

Vincent s Angina ............ 744

Urology ................ 25 413 813

Aluminium Hydroxide Gels in

Renal Calculus ............ 413

Anuria ..... ................. 25

Spinal Analgesia in Treatment
of .................... 4i3

Nephrolithotcmy for Recurrent

Branching Calculi ......... 25

Prostatic Adenomectomy, Perineal 813
Prostatic Resection, Trans-

urethral ............. 413

Pyuria, Abacxerial, True Infec

tive ...................... 813

Renal Pelvis and Ureter, Dupli

cation of .............. 813

Subcutaneous Urcgraphy ...... 25

Sulphacetamide in Urinary Tract

Infections .................. 813

Testicle, Rupture of the ...... . 25

Tuberculosis, Renal, 1 rognosis of 813
Ureteric Obstruction in Children 413
Uretero-Intestinal Anastomosis,

Bilateral .................. 813

Wilms Tumour of the Kidney . . 25

A }- A. F ......................... 884

Abt, I. A ......................... 884

Achalasia, CEsophageal ....... 816

Adams, D. Monk The Spelling of

\\ ords ....................... 34,-,

Addison s Suprarenal Syndrome of
Primary Pituitary Origin, A Case
of, by W. R. Lang (R) ...... 335

Address. An

By A. V. Meehan (O) ....... 133

By A. C. Thomas (O) .......... 573

Changing Face, The, of Medical
Practice in Tasmania, by G. M.
W. demons (O) ............ 609

Politics and the Medical Profes
sion, by J. Dale (O) ......... 65

Post -War Rehabilitation of Science
The, by J. G. Wagner (O) .... 97

Adenoids, Tonsils and, A Method for
the Removal of, under Local
Anaesthesia with the Patient in
the Recumbent Position, by R
H. Bettington (O) ............ 882

Adrenal Haemorrhage in Erythro-

blastosis ..................... 103

Advertisements for Permanent Posi-
. _ t. 0118 -. ..................... 566

Afibrinpgensemia, Congenital (C.C.) 375
Agglutinin, The Anti-O, in Human
Blood with the Report of a Case
of its Occurrence, bv N R
Henry (O) ..........

Aird, I ................

Akhurst, T. A. F .....

Albaugh, C. H .........

Albrect ......................... .

Allan, George, Death of ...... . . . . .

Allergy. Clinical, of the Upper
Respiratory Tract, The Botany of
Toowoomba and Environs and
its Relation to, by C. R Morton
(O) .......... * .............. 585

Amberson, J. Burns .............. 920

American Journal of Obstetrics and

Gynecology, The .............. 411

Amoebiasis, Occult, in Ex-Prisoners

of War. by C. E. M. Gunther . . 490

395
303
234
23
923
453

Amoebic Pericarditis (C.C.)

Amputation, Local, of Gangrenous
Toes in the Presence of Glyco-
suria and Senility, bv N. C. Joel

159

298
C69

Amsden, H. H ....................

Amyotonia Congenita (Oppenheim s

Disease) ..................... 854

Anaemia ......................... 814

Aplastie ....................... 814

Hypoplastic ................... 815

Anaesthesia

Hypnosis as a Substitute for. Some
Observations Concerning the Use
of, by R. L. H. Sampimon and
M. F. A. Woodruff (O) ....... 393

VOL. I, 1946.

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

Page
Anaesthesia Continued.

In Childbirth 198

Local, A Method for the Removal
of Tonsils and Adenoids under,
with the Patient in the Recum
bent Position, by K. H. Betting-
ton (O) 882

Spinal, and Chloroform : A Com
parison of Mortality

By C. E. Corlette (O) .. 545,892

By S. V. Marshall 750

By J. E. Thomas 750

Analgesia- -

In Labour 197

Spinal

By J. Oldham (O) 432

"Non-Take", by 1 . Gill 606

Anastomosis, Intestinal, The Preven-

vention of Leakage after (C.C.) 887
Anatomy

In the Medical Curriculum, by A.

A. Abbie (O) 152

Introduction to the Study of, An :
The Tissues of the Body, by W.

E. Le Gros Clark (rev.) 479

Anderson, A. J 157

Anderson, D. The Placing of X-Ray

Films in Envelopes 930

Anderson, G 638, 641, 712

North and Wilson

Resistance, The. of Hsemophilus
Influenzas to the Action of
Penicillin, with Special Refer
ence to Type B Strains (O) . . 626
Treatment, The, of Hsemophilus
Influenzse Meningitis with Sul-
phonamides in Conjunction
with Hsemophilus Influenzse,
Type B, Rabbit Antiserum (O) 215
Anderson, George Murray, Death of

608, 786

Anderson, G. W., ct alii (Global Epi-
diiniology: A Geography of
Disease and Sanitation) (rev.) 591

Anderson, J. Ringland 675

Anderson, P. M. A Note on the Use
of Penicillin in the Laboratory
Diagnosis of Whooping-Cough

(O) 244

Anderson, S. G. A Note on T\vo
Laboratory Infections with the
Virus of Newcastle Disease of

Fowls (R) 371

Aneurysm, Traumatic Arterio-Venous,
of the Femoral Blood Vessels,
by G. C. V. Thompson (O) .... 104

Angina

Ludwig s, A Case of, by V. Bulteau

(R) 514

Pectoris (C.C.) 632

Anniversary, A Twenty-Fifth (C.C.) 411

Anorexia Nervosa 310

Anoxia, Renal Failure and, by J.

Walker Tomb 63

Anti-Cancer Council of Victoria, The 571

Anus, Imperf orate 129

Appendicectomy, A Jungle, by N. M.

Kater (R) 443

Arachnoiditis, Basal 928

Araneidism (C.C.) 811

Archer, V. W. (The Osseous System :
A Handbook of Roentgen Diag
nosis) (rev.) _. 666

Arden, F. Rupture of the Liver in
the New-Born : Recovery after
Blood Transfusion and Lapar-

otomy (R) 187

Armstrong, W. D 86

Armytage, J. E., and Rountree Hos
pital Blankets as a Source of

Infection (O) 5U3

Arteriosclerosis, Hypertensive, with

Retinal Changes 378

Arthritis

Acute Suppurative, of the Hip . . 162
Rheumatoid, Muscular Lesions in
(C.C.) 670

Artificial Respiration Explained, by

F. C. Eye (note) 516

Ascorbic Acid in the Milk of Mel
bourne Women, by D. Winikoff
(O) 205

Aseptic Technique, Points in 201

Ashby, E 249

Aspinall, Andrew Eric and Archibald

John, Deaths of 238

Association professionellc inter-

natioiiale des metlecins 633

"Atebrin" and Dermatitis : An In
quiry

By "Inquirer" 60 ,

By N. Paul 715

Atelectasis, Congenital 854

Page

Atkinson, N. Preliminary Report mi
Strains of Salmonella Blegdam
Causing Infections in Humans in

New Guinea (O)

Atomic Energy in the Coming Era,

by D. Dietz (rev.)

Atlas of Surgical Approaches to
Bones and Joints, by T. Nicola

( rev. )

Aub, J. C

Australasian Medical Publishing
Company, Limited .... 127,558,
Australia and Science : The Univer
sity of Sydney and Scientists

By A. J. Canny

By N. E. Goldsworthy

By D. R. Moore

By F. W. Simpson
(Leading Article)

Australian and New Zealand Associa
tion for the Advancement of

Science

Australian Army Medical Curps,
Rates of Pay for Part-Time

Duties in the

Australian Broadcasting Commission
Australian Medical Board Proceed
ings

New South Wales .... 31,64,454,
490, (ill.

Queensland 64, 276, 384,

455. 491, 679,

Tasmania 455, 491,

Australian Pharmaceutical Formulary

Aviation NeurOrPsychiatry, by R. N.

Ironside and I. R. C. Batchelor

( rev. )

381
346

IIS
417
249

823

819
896
567

480

Bacille Calmette Gtierin, by J

Murphy

Bacillus Proteus OXK, The Use &lt;&gt;f
a Polysaccharide of, in the
Diagnosis of Scrub Typhus, by
1 . de Burgh (O)

Backache

In Soldiers, by D. Slurkey (&lt;&gt;)
Low

By A. E. Lee (O)

By E. Murphy (O)

Back Pain, Low, by A. V. Meehan
(O)

Bacteria in Relation to the Milk
Supply: A Practical Guide for
the Commercial Bacteriologist .
by C. H. Chalmers (rev.)

Bacterial Cell, The: In Its Relation
to Problems of Virulence. Im
munity and Chemotherapy, by R.
J. Dubos, with an addendum by
C. F. Robinow (rev.)

Bailey. H. (Demonstrations of Opera
tive Surgery for Nurses) (rev.)

Ball, L. Volkmaim s Ischsemic Con-
tracture of the Forearm (R)

Bancroft, Joseph, Memorial Lecture

Banks-Smith, R. G

Barach, A. L

Barber, A. Politics and the Medical
Profession

Barbour. J. R. Fractures of the Car
pal Scaphoid (O)

Basic Wage. The Shortage of Nurses
and Social Medicine

By M. C. DeGaris

By E. S. Meyers (O)

Balchelor, I. II. C., and Ironside
(Aviation Neuro-Psychiatry )
(rev.)

Battles, M. G

Bauer, L. H

Bayon, H. P

"Beach Foot", by E. Pockley

Bearham, G

Begg, J 00,62,130,163,

Bell, G

Bell, Hocking versus

Bell, W. J., junior

Benson, L. Blood Loss in Ctesarean
Section (O)

Bergman

Beriberi. Yaws and : A Warning, by
C. M. Deland

Berli ier, F

Bellinger, H. F., and Jacobs A Con-
tribulion to the Problem of Mas-
culinization (O)

Bettington, R. H.

And Vincent Report on a Series
of Cases of Sinusitis Treated by
Chemotherapy at an Australian
General Hospital (O)

838

I I

47!l

5 1 5
516

224
127
674
193

416
352

785
548

480
595
302
340
346
200
855
230
254
445

842

810

676

1 18

358

Page

Bettington, R. H. Continued.

Metl?cd, A, for the Removal of
Tonsils and Adenoids under Local
Ansesihesia wiih the Patient in
the Recumbent Position (O)

. 520,

882

i: \;in, Mr. A 520, 742

Beveridye, R. L 118

Beveridge, W. I. B., Campbell and
Lied Pleuropneumo n i a - L i k e
Organisms in Cases of Non-
Gonococcal Urethritis in Man and
in Normal Female Genitalia (O) 17H
Bickart, D. A Case of Intractable

Constipation 166

liiei.tiell, F., and Prescott (The Vita
mins in Medicine) (rev.) 552

Bicrring, W. L 740

Bicuspid Aortic Valve 163

Bisho,; Harman Prize, The Katherine 675

Bishci;, W. A 54

Black. D. A. K 373

Black, G. H. Barnaul 675

Black. R. H 234

Blackburn, C. R. Bickerton 234

Bladder, Urinary, Intraperitoneal

Rupture of the 380

Blanch, M 27, 28

Blankets, Hospital

As a Source of Infection, by 1 . M.
Rountree and J. E. Armytage

(O) 503

Treatment of, The, with Oil Emul
sions and the Bactericidal Action
of Fixanol C" (Cetyl 1 yri-
diiiium Bromide), by P. M.

Rountree (O)

Blashki, E. P

Legacy Club, The

"Blast" Injury of the Spinal Cord,
Report of a Fatal Case of, by

D. Leslie (R) 188

Blaubaum, P. E 130

Congenital Fibrocystic Disease of

the Pancreas (O)

"Blood", A Journal Devoted to

Hasmatology (C.C.)

Blood Group Frequencies

in Hollanders, by J. J. Graydon,
R. T. Simmons and E. F. Woods

(O) 576

In Papuans, Further Observations
on the Rh and Hr Factors and
the, by R. T. Simmons, J. J.
Graydcn and E. F. Woods (O) 537

Blood Groups

In Tasmania, by C. Duncan (O) . 475
In ihe Maori, by J. J. Graydon and

11. T. Simmons (O) ... 135

Blcod. Human, The Anti-O Agglu-
tinin in, with the Report of a
Ca.se cf its Occurrence, by N. R.
Henry (O) 395

Blood Loss

In Csesarean Section

By L. Benson (O) 812

By K. H. Broome 930

Some Efrects of, on Healthy Males,
by R. J. Walsh and A. K. Sewell

(O) 73

Boas. E. P 193

Bcile au-GiaiH, J. C., and Gates (A

Handbook for Dissectors) (rev.) 704

Bone as Human Food (C.C.) 595

Bone? and ..chits, Atlas of Surgical
Approaches to, by T. Nice a

(rev.) sos

Books Received 32, 64. 96,

168, 204, 240, 276, 312. 120.

456, 492, 536, 572. 008, 680,

716, 752, 787. 824, 860. 81Mi. 932

Botany, The, of Toowoomba and

Environs and ;ts Relation to

Clinical Allergy of the Upper

Respiratory Tract, by C. R.

Morton (O) ~&gt; s "&gt;

Bourne, A. W.

And Williams (Recent Advances in
Obstetrics and * -ynsecology )

(rev.) 2:1:

(Synopsis of Obstetrics and Gynae
cology) (rev.) 6GC

Bcurne, O. H 921

Bowden, K. M. Spontaneous Rupture
cf the Spleen, with Notes 1111 Two

Cases (O) 506

Bowel, Congenital Deformity of the s5i
I .oNvkcr. Cedrie Victor, Death of .. S23

r.nys. C. V sT

Braddon. P. D. Columnar-Celled
( areinoma of the Rectum
Treated by Radon : Preliminary
Report Sixteen Months after
Treatment (R) 477

Mil

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

VOL. I, 1946.

Page

Brain Disease, Organic : 1 ossibly

Cerebral Tumour ............. 309

Brain, W. R., and Strauss (Uecent
Advances in Neurology and
Neurppsychiatry) (rev.) ...... 371

Brait.hwaite, P. Treatment of Gun
shot Wounds of the Chest in the
Field by Penicillin Therapy .... 4 is

Bray, George AVilliam, Death of . . 489

Britain, Great -

Future Health Services in ...... 487

(C.C.) ...................... 482

National Health Service Bill of . . 524
By S. Siedlecky ............... 898

(Leading Article) ........... 517

Reporf, A, on a Comprehensive
Dental Service from (Leading
Article) . . , .................. 593

British Medical Agency of New South

Wales. Limited ............... 602

British Medical Agency of Queens
land, Proprietary, Limited.
Queensland Medical Finance,
Proprietary, Limited ......... 12(i

British Medical Association

Federal Council ............ 12G, 600

Advertisements for Permanent

Positions ................... 566

Appointment of Office Bearers . . 558
Australasian Medical Publishing

Company, Limited ......... 558

Australian Naval Medical Ser

vices ...................... 566

Australian Pharmaceutical For

mulary ................... 567

Brochure for Public Circulation 562
Commonwealth Employees Com
pensation Act ............... 505

Commonwealth Serum Labora

tories, Products from the .... 565
Compulsory Health Insurance . . 562
Conditions of Service Committee 568
Constitution of the Federal

Council and Autonomy of the

Branches in Australia ...... 559

Contract Practice ............ 561

Control of Medical Practitioners

of Recent Graduation ...... 570

Date and Place of Next Meeting 570
Deafness, Post-Rubella ........ 565

Decorations Received by Medical

Officers of the Australian

Armed Forces ............... 55S

Drugs, The Nomenclature of . . 567
Emergency Medical Service . . 569
Federal Common Form of Agree

ment ..................... 561

Federal Medical War Relief

Fund ..................... 559

Federal Organization Fund ..... 559

Fees for Medical Examinations 567
Fees for the Examination of

Recruits to the Army ...... 570

Finance ..................... 558

And the Western Australian
Branch ................. 560

High-Frequency Apparatus, Re

strictions on .............. 570

Hospital Services ............ 563

MacCallum. Dr. F., Illness of . 559
Medical Officers Relief Fund

(Federal) .................. 558

Medical Planning ............. 562

Medical Registration ......... 561

Meeting of the Federal Council

553,
National Health and Medical

Research Council .........

Xeti-e . 27, 59,162,236,273,310,

344, 380, 414, 450, 486, 530, 570,

603, 636, 675, 710, 782, 816, 855,

Ophthalmic Practitioners, Short

age of ....................

Opticians and ( (ptometrists, The

Teaching of, in any Branch of

Ophthalmology .............

organization of" the Profession .
Overseas Travelling Fellowships
Pharmaceutical Benefits Act

1944 ......................

Port-Graduate Facilities in the

United States ..............

1 rinciples-

Fundamental, of the Medical
Profession ....

Of Medical Ethics ........ .

Professional Rooms for Civilian

Medical Practitioners
Proprietary Medicines Investiga

tion Committee ............

Publicity Committee ........ 1

Quarantine Officers. Appointment

927
569

567
559
558

562
567

562

570

565
559

564

Page

British Medical Association Con-
tinned.
Federal ( ouncil Continued.

Rates of Pay for Part-Time
Dui c.s in the Australian Army
Medical Corps

569

ReestabliBhment and Reemploy-

ment Act, 1945 566

Refugee Medical Practitioners

i ro 1 1 Europe 558

Rehabilitation of Medical Officers

in Liie Armed Forces 568

Release "of Medical Officers from

the Services 570

Repatriation Commission .... 568

Representatives 558

Retirement, The -

Of Dr. T. A. Price and Dr.

H. C. Colville 558

Of Surgeon Captain W. J. Carr
and Air Vice-Marshal T. JO.

V. Hurley 558

Of the Chairman of the Medi
cal Equipment Control Com
mittee 570

Salaries of Commonwealth Medi
cal Officers 564

Special Groups 559

Specialist, Definition of a 565

Telephone Directories 567

Unemployment and Sickness

P.enefits Act, 1944 56f,

Votes of Thanks 570

War Emergency Organization . . 568
Katherine Bishop Harman Prize . . 675
New South Wales Branch-
Hooks Added to the Jjibrary .... 855
British Medical Agency of New

South Wales, Limited 602

Child Health. Chair of, at the

I niversity of Sydney 60J

Amendment of By-Laws 600

Annual Meeting 59S

Of Delegates 600

Annual Report &lt;;f the Council . . 598
Australasian Medical Publishing

Company, Limited 600

Chiropodists, Recognition of ... 601

Coal Inquiry 601

Congratulations 598

Constitution of ( ouncil 600

Contract Practice 601

( Y.uncil 599

lOlection of Office-Bearers 603

l-\(K ral Council of the British
Medical Association in Aus
tralia 600

Council Organization

Medical War Relief

600

600
602
601
603

603
599

599

Federal

Fund
Federal

Fund

Financial Statement

Hospital Policy

In.-(,ming President s Address ..

Induction of President

Library

Local Associations of Members,

Affiliated

Medical P.vnefhs Fund of New

South Wales 601

.Medical Finance Limited 602

Medical Sociology and Research,

Department of 601

Meet ings 598

Sckuiific 26, 58, 306,

378, 814, 854, 926

.M mbershin 598

Pathological Services, Compre
hensive, f. r New South Wales (in]
Pharmaceutical Benefits Act,

1944 601

Premises Revenue Account .... 602
Rehabilitation f Medical Officers

of tlh Arn-ed Forces 600

Representatives 598

Resident -Medical Officers

Salaries (HU

Roll of I lonour 5 US

Sandes, Francis Pereival 59S

Special Grotius for the Study of

Snecial P.ranches of Medical

Knowledge 600

X-Ray Set-vices in North Coast

Towns of X. \v South Wales 6(i|
Gphthalmological Society of Aus
tralia

Annual Meeting 674

i resident s Address 674

Qii HMis find Branch

Affiliated Local Associations .... 126

Annual Meeting 122

Annual Jtcport of Council 122

Australasian Medical Publishing

Company, Limited 127

Page

British Medical Association Con
tinued.

Queensland Branch Continued.
Bancroft, Joseph, Memorial Lec
ture 127

British Medical Agency of
Queensland. Prop r i e t a r y.
Jvimited. Queensland Medical
Finance, Proprietary, Limited 126
British Medieal Association
(Queensland Branch) Mem
orial Fund 125

Building Subcommittee 125

Election

Of Auditors 127

Of Office-Bearers 127

Ethics Committee 122,127

Federal Council 126

Federal Medical War Relief

Fund 123

Finance

Financial Statements

Hospital Matters

Induction of 1 resident

Jackson Lecture

Library 1 22

Licences under Alien Do; tors
(National Security) Regula
tions 121

Limbs, Artificial, Supply of 124

Linen for Doctors Surgeries .. 123

Liquid Fuel Supplies 123

Lodges 125

Medical Fees Tribunal 125

Meetings

Council 122

Scientific 122

Membership 122

Alt morial Roll 127

Motor-Car Tires and Accessories 123

Newsletter. Monthly 123

Obituary 122

Office-Bearers and Councillors . . 122
Organization Subcommittee .... 124
Pharmaceutical Benefits Act,

1944 126

President s Address i 29

Profession, The, and the Public 129
Queensland Medical Coordina
tion Committee 123

Queensland Medieal War Benefit

Fund 123

Rationing 123

Rehabilitation of Members of the

Armed Services 123

Repatriation Commission : Medi
eal Benefits for Dependants of

! ec eased Soldiers 123

Representation 123

Roll of Honour 122

Social 127

University of Queensland i - &gt;

Votes of Thanks 1 2!i

War Emergency Organization .. 123
Representative Meeting in London.

The Special 746

P.y II. Hunter 715

(Leading Article) 741

South Australian Branch: Sliort-
;ige tit Hospital Accommodation

in South Australia 344

Tasmanian Branch

Meeting. Annual 636

Victorian I! ranch

Annual Meeting 90

Annual Report of the Council . 90
Appointment of Subcommittees . 90
Attendances at Council Meetings 90

Business of Council 91

Election 90

Federal Council 92

Honours Conferred by His
Majesty the King for Services
Rendered during the Present

War 91

Installation of the President for

1946 92

Library of the Medieal Society of

Victoria 92

Meetings of the Branch 91

.Melbourne Permanent Post-
Graduate Committee 92

Mem.H rship Roll 90

Mollison, Dr. C. H.. Retirement
&gt; ! , from the Office of Honorary

Treasurer 92

Notice 344

President s Address 92

Roll of Honour 91

Votes of Thanks 92

Brody, J. A Case of Tick Typhus

in North Queensland (R) 511

Broncho-Pulmonpry Segments, The,

in Skiagrams.; of the Chest (C.C.) 670

VOL. I, 1946.

INDEX TO THK MEDICAL JOURNAL OF AUSTRALIA.

1 age
Broomc. K. I 1. -Blood Loss in

Cspsarean Section 1)30

Broster, L. K. (Endocrine Man : A
Study in the Surgery of Sex,
with a foreword by P. C.

-Mitchell) (rev.) 84

Broughton Hall Psychiatric Clinic . 306
Brown, A. E. Too Many Doctors? GOG

Brown, C. J. Officer 27, 29, 61

Putrid Lung Abscess (()) 107

Some Notes on the Treatment of

Pulmonary Tuberculosis (()) . . 825
Brown, D. A. Poliomyelitis: A

Question of Diagnosis 822

Brown, G. W., and Draper Staphy-
lococcal Enteritis in Children

(O) 4G9

Brown, J. Poverty, Housing and

Health 29

Browne, F. J 704

Bruce, James Whitson Kemp, Death

of . 132

Brues, A. M 707

Bryce, L 712

Buchanan, George Arthur, Death of 716

Bull, C 2?,

Bulteau, A.

Poverty, Housing and Health ... 29
[ leers in the Mouth: An Appeal

for Help 418

Bulteau, V. A Case of Ludwig s

Angina (R) 514

Burgess, J. N 4 8 G, 487

Burma and Siam ; Clinical Lessons
from Prisoner of War Hospitals
in the Par East, by A. E. Coates

(O) 753

Burnet, F. M 192

(Virus as Organism: Evolutionary

and Ecological Aspects of Some

Human Virus Diseases) (rev.) 372

Burnet, J. (Outlines of Industrial

Medicine, Legislation and

Hygiene) (rev.) 20

Burniston, G. G. Medical Rehabilita
tion: Its Organization in the
Royal Air Force and the Royal
Australian Air Force (O) .... 620

Burns, C. M 26

Burns Complicated by Haematemesis
and Melena. Report on a Case of.

by J. A. Marsden (R) 551

Burrett, A. F. Research at the

Kanematsu Institute 782

Burrows, H. (Biological Actions of

Sex Hormones) (rev.) 920

Burt, L. I. Treatment of Suppura-
tive Tenosynovitis in the Fingers

(O) 399

Butler, A. G. War and Humanism 165
Butler, H. M. Stained Smears for
the Rapid Diagnosis of Infec
tions due to Streptococcus Haemo-
lyticus Group A following Child
birth and Abortion (O) 437

Buzzard, 1 534

Byrne, K. Ma a -ia . 930

Caesarean Section, Blood Loss in

By L. Benson (O) 842

By K. H. Broome 930

Caffey, J. (Pediatric X-Ray Diag
nosis : A Textbook for Students
and Practitioners of Pediatrics.
Surgery and Rad ology) (rev.) 807
Calculus, Renal, Hydroncphrosis and

Hydroureter 163

Callagher, H. C. Placenta Praevia .. 571

Oallender. S. T 743

, Cameron, C,. R., Profe~r-or, is

Honoured (C.C.) 671

Campbell, A. D., Beveridge and
Lind Pleuropneumonia-Like Or
ganisms in Cases rf Non-Gono-
coccal Urethritis in Man and in
Normal Female Goim -lia (O) .. 179
Campbell, Alice Pritchaio. I&gt;i ; i:i of 311

Campbell, K 60.451.675.710.712

Clinical Aspects of Foetal Erythro-

blastosis (O) 68fi

Canada

And the United States. Recent
Experiences in, by H. M. .lames

(O) 827

Post-War Plans for Nutrition in . . 93

Canada Letter 236, 604, 929

i .nicer, Early Diagnosir and Early
Treatment of, The: A Publicity

Campaign 571

Canny, A. J 631

Australia and Science: The Uni
versity of Sydney and Scientists 381
Research at tbo K ancmatsu Insti
tute 642, 895

Page
Captivity. the Singapore, Medical

Aspects of, by C. Harvey (O) . . 769
Carbon Monoxide Metabolized in the

Body, Is? (C.C.) ". 483

Carcinoma

Adrenal, Causing Precocity 60

Columnar-Celled, of the Rectum
Treated by Radon: Preliminary
Report, Sixteen Months after
Treatment, by P. I). Braddon

(U) *. 477

Of the Bladder with Bilateral
Transplantation of Ureters . . . 379

ovarian in a Foetus (C.C.) 707

Cardiac Disease, Diagnostic Methods

in (C.C.) 886

Carr, Surgeon Captain W. .T.
And Air Vice-Marshal T. E. V.

Hurley, The Retirement of 558

Retiremtnt of, The (Leading

Article) 117

Castle, W. B 920

Casualties, Battle, Plasma Protein
Estimations in, by T. E. Wilson

(O) 153

Cataract Operation, Premedication

and Cooperation in 674

Cataract, Secondary, The Treatment

of 674

Gates, H. A., and Boileau-Grant (A

Handbook for Dissectors) (rev.) 704
Caughey, J. E., and Porteous An
Epidemic of Poliomyelitis Occur
ring among Troops in the Middle

East (O) 5

Cell, The Bacterial : In its Relation
to Problems of Virulence, Im
munity and Chemotherapy, by
R. J. Dubos, with an Addendum
by C. F. Robinow (rev.) .... 515
Centenaries of "Forty-Five", by H.

Stitton (O) 421

Central Hospital, Melbourne The

By C. H. Dickson 30

By C. L. McVilly 203

Cerebral Trauma and its Mechanisms

(Leading Article) 885

Chair of Child Health at the Uni
versity of Sydney 601

Chalmers, C. H. (Bacteria in Rela
tion to the Milk Supply : A Prac
tical Guide for the Commercial

Bacteriologist) (rev.) 479

Chambers, C. H., and Thompson
Chylangioma of the Mesentery,
with Report of a Case, and a
Brief Discussion of Mesenteric

Cysts (O) 210

Chest Examination : The Correlation
of Physical and X-Ray Findings
in Diseases of the Lung, by R.
R. Trail, with foreword by W.
L. Langdon-Brown (rev.) .... 703
Chest, Introduction to Diseases of

the, by J. Maxwell (rev.) 228

Chesterman, J. T. (The Treatment of
Acute Intestinal Obstruction)

(rev.) 156

Child, Pre-School, in Australia, The

Health of (C.C.) 374

Childbirth

And Abortion, Infections due to
Streptococcus Haeniplyticus Group
A following, Stained Smears for
the Rapid Diagnosis of, by H. M.

Butler (O) 437

Control of Pain in, by C. B. Lull
and R. A. Kingston, with an
introduction by N. W. Vaux

(rev.) 40S

Childhood, Nutrition and Chemical
Growth in, by I. G. Macy, with
a foreword by L. Reynolds and
a supplement by J. O. Holmes

(rev.) 884

Children s Hospital, Melbourne ..27,
59, 92,129,162,450,
486, 636, 675, 710, 890, 928
Survey from the, A : Coeliac
Disease, by G. E. M. Scott (O) 659

Chiropodists, Recognition of 601

Chiropody, The Essentials of, by C.

A. Pratt (rev.) 408

(Chloroform, Spinal Anaesthesia and :
A Comparison of Mortality

By C. E. Corlette (O) .. 545,892

By S. V. Marshall 750

By J. E. Thomas 750

Chloroma 163

Chondritis of the Patella, by N.

Little and C. Hudson (O) .... 398
Chorea

Chronic Progressive 30S

I luntington s 308

1 age
Chorioretinitis, Toxoplasmic En-

cephalomyelitis and 674

Christie, R.

And North Acquired Resistance of
Staphylococci to the Action of

Penicillin (O) 176

And Simmons Penicillin Sensi
tivity of Streptococci Mostly of
Groups A, B, C and G (O) .... 349
Chromoblastomycosis, with Reports of
Two Cases Occurring in Queens
land, by W. J. Saxton, F.
Hatcher and E. H. Derrick (O) 695
Chylangioma of the Mesentery, with
Report of a Case and a Brief
Discussion cf Mesenteric Cysts,
by G. C. V. Thompson and C, H.

Chambers (O) 210

Clark, F. J.

Recent Advances in the Surgical
Treatment of Lumbar Interver-
tebral Disk Disease (O) ... 49, 417

Trigeminal Neuralgia 895

Clark, W. E. Le Gros (The Tissues of
the Body : An Introduction to the
Study of Anatomy) (rev.) .... 479
Clayton, George Edward Burdekin,

Death of 716

Cleland, J. B 817

Acceptable Words : Quotations with

a Medical Bearing (O) 876

And Hamilton A Case of Ab
dominal Lymphangioendothelioma
or Peritoneal Mesothelioma (R) 477

Moulds in the Lungs (R) 247

Unknown Foreign Bodies in the

Lung (R) 225

Clements, F. W 374

demons, G. M. W 636

( hanging Face, The, cf Medical
Practice in Tasmania -An Ad
dress (O) 609

Climatic Factors and the Nutrition of

Herbage Plants 817

Cloward, R. B 118

Clune, F. Pacific Parade (note) . . 704

Coal Inquiry 601

Coates, A. E.- Clinical Lessons from
Prisoner of War Hospitals in the
Far East (Burma and Siam)

(O) 753

Cobb, S 300

Cobley, J. F. C. C 555

And Wilson Report of a Case of
Salmonella Blegdam Septicaemia
and Suppurative Pericarditis

with Recovery (R) 439

Cceliac Disease, A Survey from the
Children s Hospital, Melbourne,

by G. E. M. Scott (O) 659

Cceliac Syndrome 675

Cold Haemagglutinins, The Clinical

Significance of (C.C.) 743

Colquhoun, J 486, 890, 891

Colville, H. C 130

Commodore, The, by C. S. Forester

(note) H6

Commonwealth Employees Compen
sation Act 565

Commonwealth Serum Laboratories,

Products from the 565

Congresses, The Australian and New
Zealand Association for the Ad
vancement of Science 823

Constipation, Intractable, A Case of

By D. Bickart 166

By A. E. Lee 165

Contact Lenses 671

Contracture, Volkmann s Ischsemic,

of the Forearm, by L. Ball (R) 224
Control of Medical Practitioners of

Recent Graduation 570

Convalescence after Surgical Pro
cedures (C.C.) 594

Convulsive Therapy in Forward
Areas, Psychotic Casualties in
New Guinea, with Special Refer
ence to the Use of, by D. Ross

(O) 830

Conybeare, J. J 408, 776

Coordination Committee, Queensland

Medical 123

Cope, 779

Copeman, W. s. C 373

Corcoran, A. C., and Page (Arterial
Hypertension: Its Diagnosis and

Treatment) (rev.) 83

Corkill, A. B., Pollock and Smith
The Value of Biochemical Tests
in the Interpretation of Jaundice

(O) 617

Corlette, C. E. Spinal Anaesthesia
and Chloroform : A Comparison

of Mortality 892

(O) 545

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

VOL. I, 1946.

i age

( urn : pondi licf .

Ad&lt; inai .v. The, of Medical Train
ing-, by K. J. I!. Davis 275

Amierobic Pyuria, by J. Mo ik .... 7S5

.\u iiriii and Dermatitis: An In
quiry

By "Inquirer" 607

By N. Paul 715

Australia and Science: The Uni
versity of Sydney and Scientists --

My A. .1. Canny 381

My X. 10. Goldsworthy -".4(i

My !&gt;. K. Moore 41 S

By F. W. Simpson 417

Bacille Calmctte &lt; im-riii. by J. A.
K. Murphy 930

Basic Wage, The. Shortage of
Nurses and Social Medicine, by
M. C. DeGaris 7X5

"Beach Foot", by E. Pockley 346

Blood Loss in Csesarean Section,
by K. H. Broome 930

Can Epilepsy be Cured?, by R. S.
Ellery 30

Case, A, of Intractable Constipa
tion

By I). Bickart 165

By A. E. Lee 165

Central Hospital, Melbourne, The

By C. H. Dickson 30

By C. L. McVilly 203

Congenital Fibrocystic Disease of
the Pancreas, by L. Dods 929

Digestion, The, of Dogs and Chronic
Osteomyelitis, by "Curious" .... 275

Disclaimer, A, by A. W. Morrow 678

Epidemic Polyarthritis, by .7. R.
Nimmo 380

Federal Medical War Relief Fund,
The

By W. F. Simmons 418

By M. Thornton 41 S

Functional Disorders

By W. S. Dawson 21 5

By A. A. Pain Mil

Future, The, of Medical Practice,
by C. H. Jaede 823

Honorary Medical Staffs, by C. C.
McKellar 894

Inguinal Hernia and its Repair

By C. Craig 274, 678

By L S. Loewenthal 381

Intervertebral Disk, The

By W. H. Godby 237

By D. Miller 346

By M. A. Radcliffe-Taylor . 2: ,7, 454

Late Herbert Michael Moran, The,
by E. H. Molesworth 311

Legacy Club, The, by E. P. Blashki 63

Malaria

By K. Byrne 930

By M. R. Finlayson and .7. McF.
Rossell 784

National Health Service Bill of
Great Britain, The. by S.
Siedlecky 893

"Non-Take" Spinal Analgesia, by
P. Gill 606

Observations on Psychoses Occur
ring in Service Personnel in For
ward Areas, by F. W. Graham . . 785

Obstetric Bulletins, by B. T. Mayes 275

Occult Amoebiasis in Ex-Prisoners
of War, by C. E. M. Gunther .. 490

On the Prickly Heat

By J. P. O.Brien 164

By C. White 382

Organization of a Profession, by
E. S. Meyers 784

Pharmaceutical Benefits Act, The.
1944, by L. R. Jury 893

Placenta Prsevia

By H. C. Gallagher 571

By B. T. Mayes 715

By J. N. R. Stephen 490, 893

Placing, The, of X-Ray Films in
Envelopes, by D. Anderson .... 930

Poliomyelitis? : A Question of Diag
nosis, by D. A. Brown 822

Politics and the Medical Pro
fession

By A. Barber 416

By P. G. Dane 417,784

By E. P. Dark 534, 929

By C. O Day 273

By N. Pern 416, 677

Poverty, Housing and Health

By J. Brown 29

By A. Bulteau 29

Professor Ralph Stockman, by M.
Kelly 822

Psychiatric Programme for Peace,
A, by C. I. McLaren 677

Page
( nrrespondence- -Continued.

Psychotherapy, by A. A. Pain ... s.v.i
!;&gt;(, , Advances in the Diagnosis
and Treatment of Lumbar Inter-
vertebral Disk Disease

By F. Clark 417

By D. Miller 274

;:.v .7. H. Young 382

Renal Failure and Anoxia, by J.

Walker Tomb 63

Research -

At Sydney Hospital, by Is. Rose 75(i
At the Kanematsu Institute

By A. F. Burrett 782

By A. J. Canny 642, 895

By J. C. Eccles 641

By W. W. Ingram 783

By T. H. Vickers 642

Services Medical Officers" Associa
tion of New South Wales, by J.

M. Yeates 785

Special Representative Meeting in

London, The, by H. Hunter .... 715
Spelling of Words, The, by D. Monk

Adams 345

Spinal Anaesthesia and Chloroform :
A Comparison of Mortality

My ( . I-:. Corlette . . . 892

By S. V. Marshall 750

By J. E. Thomas 750

Spondylitis Ankylopoietica-

By K. Hasiett Frazor 453, 677

By "Froach Eilean" 535

Surgical and Applied Anatomy of
the Inguinal Region, by E. S.

Meyers 237

"Thio" Drugs in Thyreotoxicosis,
by H. R. (I. Poate and S. L.

Spencer 750

Too Many Doctors?, by A. E. Brown 606
Toothache and Folk-Lore, by P. G.

Dane : . 275

Treatment of Gunshot Wounds of
the Chest in the Field by Peni
cillin Therapy, by P. Braithwaite 418
Treatment of Scabies, The, by J.

G. Morris 380

Treatment, The. of Inguinal Hernia.

by C. Craig 345

Trigeminal Neuralgia

By F. .7. Clark 895

By A. Lyons 750

Tsutsugamushi Disease : A Warn
ing, by J. T. Gunther 419

Tuberculosis Patients and Hos
pitals

By A. H. Penington 237

By D. B. P tt 30

I leers in the Mouth. An Appeal
for Help

By A. Bulteau 418

By L. Hewitt 418

My B. Hiller 490

By "M.B. B.S." 274

By F. F. McMahon 715

By E. M. Murphy 5:1 I

By I. Roxon-Ropschitz : ,s2

Unusual Case of Malaria, An

By N. Cunningham 453

By R. F. Matthews 380

Use, The, and Misuse of Tetanus

Antitoxin, by S. Sheldon 131

War and Humanism, by A. G.

Butler 165

Wounds Caused by Small Fish

By H. Flecker 534

By K. F. D. Sweetman 345

Yaws and Beriberi : A Warning, by

C. M. Delar.d ". 676

Correspondence, Special

Canada Letter 236, 604, 929

London Letter 603

New Zealand Letter 344, 676

Corrigendum 348

Cosh, John Inglis Clark, Death of .. 311

Cottrell, J. D 669

Counseling, Personality Factors in,
by C. A. Curran, preface by M.
J. Ready, introduction by C. R.

Rogers (rev.) SO 7

Counsell. W. D 674

Craig, C.

Inguinal Hernia and its Repair

274,678
Treatment, The, of Inguinal Hernia 345

Cricket Match 491

Crooke, Robert Warren, Death of . . 895
Crosse, V. M. (The Premature Baby,
with a foreword by L. G. Par
sons) (rev.) 20

Crowther, W. E. L. H 7S6

Case, A. of So-Called Hydro
phobia : A Matter of Diagnosis
(O) 69

Page

&lt; i uxatto, H. and. K 810

Croydon Obstetric Service (C.C.) .. 554
Ciimmine, H. G., and Laidley The
Empirical Use of Penicillin for a
Sulphonamide-Resistant Patient

(R) 476

Cunningham, N. An Unusual Case

of Malaria 453

Curd, F. H. S 229

"Curious" The Digestion of Dogs

and Chronic Osteomyelitis .... 275
Curran, C. A. (Personality Factors
in Counseling, preface by M. J.
Ready, introduction by C. R.

Rogers) (rev.) 807

Curran, D., and Guttmann (Psycho
logical Medicine : A Short Intro
duction to Psychiatry, with an
Appendix on Psychiatry Associ
ated with War Conditions, with
a foreword by J. J. Conybeare)
(rev.) 776

Current Comment

Action of Iodine in Graves s Disease 779

Amoebic Pericarditis 159

Angina Pectoris 632

Annals of the Montevideo Faculty

of Medicine 158

Araneidism 811

Arterial Embolism and Thrombosis

in Infancy 87

Availability, The, of Vitamins in
Various Foods and Pharmaceuti
cal Products 410

"Blood", A Journal Devoted to

Hsematology 743

Bone as Human Food 595

Mrain, The, of Dr. Robert Ley ... 447
Broncho-Pulmonary Segments, The,
in Skiagrams of the Chest .... 670

Cerebral Hydatid Cyst 446

Clinical Significance, The, of Cold

Hsemagglutinins 743

Complete Obstetric Service, A .... 554

Congenital Afibrinogenaemia 375

Congenital Defects in Infants after
Maternal Rubella : Further Re
ports and Discussions 23

Convalescence after Surgical Pro
cedures 594

Diagnostic Methods in Cardiac

Disease 886

Dr. J. G. Hunter Flies to England 595
Droplet Spray Infection and Res
pirator y Activity 447

Effect of Emetine on the Heart, The 669

Epistaxis 669

Kxcretion of Iron 303

Kxperimental Study, An, on Pan
creatic Secretion and Division of

the Pancreas 4x:!

lOye Signs in Graves s Disease. The 521

Fat Embolism 671

Foams and Living Tissues Si;

Future Health Services in Great

Britain 482

Health, The, of the Pre-School

Child in Australia 373

Heart Sounds in Health 158

Hypertensin 810

Index to "The Medical Journal of

Australia" 447

International Medical Conference,

An 633

Is Carbon Monoxide Metabolized in

the Body? 483

Jean-Paul Marat : Visionarv or

Villain? " 340

Lesions of the Mouth and Iron

Deficiency &50

ht-ssons from Spinach 922

Medical Annual, The :!41

Medical Education and Medical
Practice in Germany during the

War 923

Medical History, The, of the War

of 1939-1945 633

Modern Treatment in Acute

Nephritis 742

Murmurs from Turbulent Flow . . 339
Muscular Lesions in Rheumatoid

Arthritis 670

New York Festschrift, A 193

Ovarian Carcinoma in a Foetus . . 707

Penicillin and the Skin 411

Placebo, The 887

Porphyria 250

Post -War Germany: A Psychiatric

Problem ] I n

Prevention, The

Of Influenza 192

Of Leakage after Intestinal

Anastomosis 887

Of Sunburn 375

Vol.. I, 1946.

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

Page
Current Comment Continued.

Problem, The, of Early Pulmonary

Tuberculosis ~7S

Professor G. it. Cameron is

Honoured 671

Prognosis, The, in Subarachnoid

Haemorrhage 22

Pulmonary Eosinophilosis 55

Results, The, of Prefrontal Leu-

cotomy 1 1 s

Retropubic and Extravesical Pros
tatectomy , 230

Sleep Paralysis 811

"Stevens-Johnson Syndrome, The" 193
Thoracic Complications of Typhoid

and Salmonella Infections 55."&gt;

Tick Paralysis 339

Toothache and" Folk-Lore 54

Toxic Factors in Experimental

Shock 707

Toxicity of Thiouracil, The 850

Transient Disturbances following

Head Wounds 706

Twenty-Fifth Anniversary, A .... 411
Two Causes of Pain in the Right

Iliac Fossa 303

Ulcer Problem, The 632

Unusual CKstrogen Reaction in a

Boy 595

Unusual Recto-Vesical Injury, An 743

Currie, J. R 630

Cyst, Hydatid, Cerebral (C.C.) .... 446
Cystic Disease, Congenital

Of the Kidneys 450

Of the Lung 450

Cysts, Mesenteric, Chylangioma of
the Mesentery, with Report of
a Case, and a Brief Discussion
of, by G. C. V. Thompson and
C. H . Chambers (O) 210

Daoryocystostomy, Endonasal, West s
Operation, Some Notes on, by

G. A. D. McArthur (O) 508

Dale, J 90, 92

An Address -Politics and the

Medical Profession (O) 05

Dameshek, W 743

Danber, D. V 193

Dandy, W. E 53

Dane, P. G.

Politics and the Medical Profession

417, 784

Toothache and Folk-Lore 275

Dangerous Drugs Regulations of

Victoria 382

Danielson, R W 23

Darby, W. J 850

Dark, E. P. Politics and the Medical

Profession 534, 929

Darling, H. C. R 823

Davey, D. G 229

Davies, Harold Whitridge, Death of 859

Da vies, J. H. Twiston 411.

Davis, K. J. B. The Adequacy of

Medical Training 275

Dawson, W. S. Functional Disorders 275

Day, A 93

"DDT" Poisoning in Man, by I. M.
Mackerras and R. F. K. West

(R) 400

Deafness. Post-Rubella 565

Death, Sudden, following Initial In-
t jection of a Mercurial Diuretic,

by A. Murphy (R) 589

de Burgh, P. M.

Notes on Field s Stain (O) 544

Use, The, of a Polysaccharide of
Bacillus Proteus OXK in the
Diagnosis of Scrub Typhus (O) 81
Defects, Congenital, in Infants, after
Maternal Rubella : Further Re
ports and Discussions (C.C.) . . 23
Deformities

Among Recruits, An Analysis of,
with Remarks on Sub-Standard
Types, by W. E. Roberts (O) . 360

Multiple Congenital 450

Deformity, Congenital, of the Bowel 854
DeOaris, M. C. The Basic Wage,
Shortage of Nurses and Social

Medicine 785

Deland, C. M. Yaws and Beriberi :

A Warning 676

Delohery, H. J., and Miller Staphy-
lococcal Meningitis and Ventric.u-
litis: Cure by Penicillin (R) .. 512
Dementia

Paralytica 306

Presenile 309

Denny-Brown, D 250

Page

Dental Service, a Comprehensive, A
Ucport from Great Britain on
( Leading Article)

Dental Students, Essentials of Sur
gery for, by J. C. Ross (rev.) ..

Derham, A. P 451, 452, 890,

Dermatitis, "Atebrin" and : An
Inquiry

By "Inquirer"

By X. Paul

Dermatology, An Introduction to,
with a Chapter on the Theory
and Technique of X-Ray and
Radium Therapy, by E. H.
Molesworth, with a Foreword to
the First Edition by J. Jadas-
sohn (rev.)

Derrick, E. H

Aiute Porphyria, with Reports of

Two Fatal Cases (O)

Saxton and Hatcher Chromo-
blastomycosis, with Reports of
Two Cases Occurring in Queens
land (O)

Deutpeh, H. (The Psychology of
Women : A Psychoanalytic Inter
pretation, with a foreword by S.
Cobb) (rev.)

Devine, J

Diabetes Mellitus with Hyperlipsemia
and Hypercholesterolaemia, by A.
M. Henderson (R)

Diarv for the Month 32, 64, 96, 132,
168, 204, 240, 276, 312, 348, 384,
420, 456, 492, 536, 572, 608, 644,
680, 716, 752, 788, 824, 860, 896,

Dick, B. M., and Illingworth (A
Text-Book of Surgical Path
ology) (rev.)

Dick, G. F

Dickson, C. H. The Central Hospital,
Melbourne

Dietary Deficiencies and Oral Struc
tures (Leading Article)

Dietetics, Tropical, Nutrition and, by
L. Nicholls (rev.)

Dietz, D. (Atomic Energy in the
Coming Era) (rev.)

Discipline, Clinical (Leading Article)

Disclaimer, A, by A. W. Morrow . .

Diseases

Infectious, During Pregnancy, Con
genital Abnormalities in Infants
following, with Special Refer
ence to Rubella : A Third Series
of Cases, by C. Swan and A. L.

Tostevin (O)

Of the Chest, Introduction to, by

J. Maxwell (rev. )

Of the Lung, The Correlation of
Physical and X-Ray Findings in :
Chest Examination, by R. R.
Trail, with foreword by W. L.

Langdon-Brown (rev.)

Virus, Some Human, Evolutionary
and Ecological Aspects of : Virus
as Organism, by F. M. Burnet

(rev.)

Disk Disease, Lumbar Intervertebral
Recent Advances in the Diagnosis
and Treatment cf

By F. Clark

By D. Miller

By J. H. Young

(O)

Recent Advances in the Surgical
Treatment of, by F. J. Clark

(O)

Disk, The Intervertebral

By W. H. Godby

By D. Miller

By M. A. Radeliffe-Taylor . . 237,

(Leading Article)

Dislocation, Congenital, of the Hip . .

Dissectors, A Handbook for, by J. C.

Boileau-Grant and H. A. Gates

(rev.)

Diuretic, Mercurial, Sudden Death
following Initial Injection of a,

by A. Murphy (R)

Dixon, K

Dixon, Mr. Justice

Doctors, Too Many?, by A. E. Brown

Dods, L

Congenital Fibrocystic Disease of

the Pancreas

Dogs, The Digestion of, and Chronic
Osteomyelitis, by Curious" ....
Doherty M. K., Sirl and Ring
(Modern Practical Nursing Pro
cedures ) ( rev. )

ITOmbrain, A. W

Donald, W. D

Donaldson, G. M. M

372

928

607
715

227
157

241

695

300

887

513

932

336

920

516

629

409
678

645

228

703

372

417

274

382

237

346

454

589
411
267
606
814

929

630
674
339
375

Page

Dowling. I . G. Epidemic Poly
arthritis (O) 245

Downes, H. R 849

Downing, H. F 703

Dowson-Weisskopf, A. B. (Industrial
Nursing : Its Aims and Practice,
with a foreword by E. Summer-
skill) (rev.) 84

Draper, F., and Brown -Staphylo-

coccal Enteritis in Children (O) 469
Drinker, C. K. (Pulmonary Edema
and Inflammation : An Analysis
of Processes Involved in the For
mation and Removal of Pul
monary Transudates and Ex-

udates) (rev.) 739

Droplet Spray Infection and Respira
tory Activity (C.C.) 447

Drugs, The Nomenclature of 567

Dubos, R. J. (The Bacterial Cell :
In its Relation to Problems of
Virulence, Immunity and Chemo
therapy, with an addendum by

C. F. Robinow) (rev.) 515

Dubos, R. T 707

Duguid, J. P 447

Duhig, J. V 157

Duncan, C. Blood Groups in Tas
mania (O) 475

Dunlop. E. E. Clinical Lessons from
Prisoner of War Hospitals in the

Far East (O) 761

Dunn, S. R 234

Uccles, J. C 631

Research at the Kanematsu Insti
tute 641

Ectodermal Dysplasia, Congenital . . 815

Eddy, C. E. The .Fiftieth Anniver
sary of the Discovery of X Rays
(O) 138

Edema, Pulmonary, and Inflamma
tion : An Analysis of Processes
Involved in the Formation and
Removal of Pulmonary Trans
udates and Exudates, by C. K.
Drinker (rev. ) 739

Editorial Notices . . 32, 64, 96, 132,
168, 204, 240, 276, 312, 348, 384,
420, 456, 492, 536, 572, 608, 644,
680, 716, 752, 788, 824, 860, 896, 932

Edman, P 810

Education, Medical, and Medical
Practice in Germany during the
War (C.C.) 923

Edwards, A. T 926

Some Remarks on Psychotic, Ex-
Servicemen (O) 738

Edwards, J. G 239

Electrocardiograms 378

Ellery, R. S.

Can Epilepsy be Cured? 30

(Psychiatric Aspects of Modern

Warfare) (rev.) 189

Psychiatric Programme for Peace,

A (O) 457

Embelton, D. M., and Jones -Volvulus
of the Small Bowel, with Report
of a Case Treated by Resection
with Recovery (O) 144

Embolism

Arterial, and Thrombosis in In
fancy (C.C.) 87

Fat (C.C.) 671

Emergency Medical Service, The . . 569
Emetine, The Effect of, on the Heart

(C.C.) 669

Encephalitis

Lethargica, A Syndrome Resem
bling Disseminated Sclerosis as a

Sequel to 308

Post-Varicellal. A Case of, showing
Bilateral Softening of the Neo-
striatum and Terminal "Tet-
anoid Chorea" (Gowers), by C.
Swan (R) 697

Endocrine Man : A Study in the Sur
gery of Sex, by L. R. Broster,
with a foreword by P. C. Mitchell
(rev.) 84

p:ndocrinology

Neurology, Psychiatry and, The
1945 Year Book of, edited by H.

H. Reese et alii (rev.) 919

Of Woman, by E. C. Hamblen
(rev.) 665

Entamoeba Histolytica, The Detection
of the Cysts of, in the Faeces by
Microscopic Examination, by A.
T. Marsden (O) 915

XII

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

VOL. I, 1946.

i "age

Enteric Fever clue to Bacterium
Enteritidis Var. Blegdam (Sal
monella Blegdam) : A Series of
Fifty Cases in Australian Soldiers
from New Guinea, by F. Fenner

and A. V. Jackson (O) 313

Enteritis, Staphylococcal, in Chil
dren, by F. Draper and (5. \V.

Brown (O) 469

Eosinophilosis, Pulmonary (C.C.) .. 55

Epidemiology, Global : A Geography

of Disease and Sanitation, by

J. S. Simmons, T. F. Whayne,

G. W. Anderson, H. M. Horack

and collaborators (rev.) 591

Epilepsy Can Epilepsy lie Cured?, by

R. S. Ellery 30

Epiphyses, 1 remature Union of ... 486
Episiotomy and Perineal Repair . . 200

Epistaxis (C.C.) 669

Ercole, Q. N 234

Erythroblastosis

Adrenal Haemorrhage in 163

Foetal 710

Clinical Aspects of, by K. Camp
bell (O) 686

Ethics, Medical, The Principles cf . . 570

Eusterman, G. B 920

Evans, C. Lovatt (Principles of
Human Physiology, with section
on the special senses by H.

Hartridge) (rev.) 704

Eve, F. C. (ArLJficial Respiration

Explained) (note) 516

Evidence at Inquests, Medical Prac
titioners and 345

Examinations, Rypins Medical Licen-
sure : Topical Summaries, Ques
tions and Answers, edited by W.

L. Bierring (rev.) 740

Exophthalmos, Unilateral Pulsating,
due to a Defect of the Orbital

Wall 674

Exposure, Extensile, Applied to Limb

Surgery, by A. K. Henry (rev.) 444
Ex-Servicemen, Psychotic, Some Re
marks on, by A. T. Edwards (O) 738
Eye Diseases A Sociological Study
cf the Aborigines in the Northern
Territory and their, by M.

Schneider (O) . 99

Eyes (Leading Article) 705

Fagan, K. J. Surgical Experiences

as a Prisoner of War (O) 775

Fairley, N. Hamilton 229, 234

Fantl, P. The Bleeding Tendency
in Obstructive Jaundice : Diag
nosis and Management (O) ... 547

Fass, E 809

Fat Embolism (C.C.) 671

Feddersen, A. S 533

Federal Medical War Relief Fund
123, 312, 419, 455, 492, 536,
559, 572, 600, G07, 644, 680,

716, 751, 788, 824, 859, 932

By W. F. Simmons 418

By M. Thornton 418

(Leading Article) 229

Fees for Medical Examinations .... 567
Fellowships, Overseas Travelling,

383, 558

Femur and Fibula, Congenital Ab
sence of 26

Fenn 483

Fenner, F., and Jackson Enteric
Fever, due to Bacterium Enteri-
tidis Var. Blegdam (Salmonella
Blegdam) : A Series cf Fifty
Cases in Australian Soldiers

from New Guinea (O) 313

Festschrift, A New York (C.C.) .. 193
Fetherston Memorial Lecture, The

R. H., by A. M. Wilson (O) . . . . 1
Fibrocystic Disease

Congenital, of the Pancreas

By P. E. Blaubaum (O) 833

By L. Dods 929

Pseldoarthrosis of the Tibia due to 26
Fibula, Femur and, Congenital

Absence of 26

Fielding, J. W.

Further Observations on Rat

Leprosy (O) 681

Observations on Human Lejrosy:
Infection of Rats with Human

Excretai Organisms (O) 578

Fieid s Stain, Notes on. by P. M. de

Burgh (O) 544

Fincke 922

Finlayson, M. R., and Rossell

.Malaria 784

Firor, \V. B

Fischer, A. E

Fish, Small, Wounds Caused by

By H. Flecker

By K. F. D. Sweetman

"Fixanol C" (Cetyl Pyridinium Bro
mide), Bactericidal Action of,
The Treatment of Hospital
Blankets with (Ml Emulsions and
the, by P. M. Rountree (()) ....

Flecker, H. -Wounds Caused by
Small Fish

Fluids, Intravenous Administration
of, A Trocar and Cannula for
the, by R. V. Pratt (O)

Fly nn. R. Congenital Stricture of
the Oesophagus (R)

Foams and Living Tissues (C.C.) ..

Foley, The Honourable T. A

Folk-Lore, Toothache and (C.C.) . .

Food Consumption in Australia
(Leading Article)

Food Shortage, The World (Leading
Article)

Food, The Relationship of, to Health,
by M. Hutchings (O)

Foot, Beach, by E. Pockley

Foreign Bodies. Unknown, in the
Lung, by J. B. Cleland (R) ....

Forester, C. S. (The Commodore)
(note)

Forster, W

Foster-Carter, A. F

Fracture of the Pelvis Complicated
by Intrapelvic Rupture of the
Urethra

Fractures

Compound, of the Extremities,
due to Gunshot Wounds : The
Early Results of Treatment in
the Field Aided by Penicillin
Therapy, by T. F. Rose and A.

Newscn (O)

Of the Carpal Scaphoid, by J. R.
Barbour (O)

Francis, T., junior

Frank, R. T

Frayne, Ernest John, Death of ....

Frazer, E. Haslett

Spondylitis Ankylopcietica . . 453,

Freedberg, A. S

Freund, H.

age

66t;

193

53 1

345

539
534

702
86

157
54

21
921

225

116
640
670

379

age

,ss:;

"Froach Eilean" Spondylitis Anky-

lopoietica

Fryberg, A

Fuller-ton, Alexander Young, Death

Functional Disorders

By W. S. Dawson

By A. A. Pain

Fungi, Exploring the Higher

Gabriel, W. B. (The Principles and
Practice of Rectal Surgery)
( rev. )

Gaha, T. R. Latent Primary Breast
Tumour (R)

Game, J. A Case of Periarteritis
(Pclyarteritis) Nodosa (R) ....

Gangrenous Toes, Local Amputation
of, in the Presence cf Glyco-
suria and Senility, by N. C. Joel
(R)

Gardner, B., Woodward et alii (Ob
stetric Management and Nursing)
( rev. )

Gardner, H

Gargoylism

Germany

Medical Education and Medical
Practice in, during the war

(C.C.)

Post-War: A Psychiatric Problem
(C.C.)

Gill, P. "Non-Take" Spinal Anal
gesia

Gillcspie, W. P

&lt; Jilmour, W

Glaister, .1. (Medical Jurisprudence
and Toxicology) (rev.)

Glaucoma, Traumatic, Monocular
Chronic

Godby, W. H. The Inrervertebral
Disk

Goddard, T. H

Goldswcrthy, N. E. Australia and
Science : The University of
Sydney and Scientists

Gonorrhoea, Penicillin Therapy in the
Treatment of, The Results of,
by S. Siedlecky (O)

Goodeli, H

352
192
193
895
58
677
632
670

535
157

490

275
131
817

228
590
295

298

923
119

606
703
670

480

671

237
636

346

Graham, E. A

Graham, F. W. Observation!) on

Psychoses Occurring in Service
Personnel in Forward Areas .. 785
Graham, Walter Robert, Death of . . 32
&lt; ira ves s Disease

Action of Iodine in, The (C.C.) .. 779

Eye Signs in, The (C.C.) 521

Gniydon, J. J.
And Simmons

Blood Groups in the Maori (O)
Rh Blood Types, The, and their

Reactions (O)

Simmons and Woods

Blood Group Frequencies in Hol
landers (O) 576

Further Observations on the Rh
and Hr Factor?, and the Blood
Group Frequencies in Papuans

(O) 537

Green Armour, by (). White (note) . 516

Green, J 202,711

Greene, J. A 303

Greenhill, J. P 884

Greenwood, Mr 741

Gregersen, M. 1 483

Gregg, N. McAlister 674

Gregory, T. S 234

Grier, R. C., junior ::::!

Grieve, J. W 60,61,93,675,890

Griffiths, G 488, 670

Grinker, R. R., and Spiegel- (War

Neuroses) (rev.) 630

Groat, R. E 87

Grove, J. L. Tetanus Treated with

Penicillin ; Recovery (R) 22i

Groves, H. (Synopsis of Surgery,
edited by C. P. G. Wakeley)

(rev.) * 190

Growth, Chemical, Nutrition and, in
Childhood, by I. G. Macy, with
a foreword by L. Reynolds and
a supplement by J. O. Holmes

(rev.) 884

Gunblast, Experimental Observations
on the Aural Effects of, by N. E. .

Murray and G. Reid (O) 611

Gunther, C. E. M.

New Conceptions of Malaria Con
trol (O) 510

Occult Amoebiasis in Ex-Prisoners

of War 490

Gunther, J. T. Tsutsugamushi

Disease : A Warning 419

Guthrie, D. (A History of Medicine)

(rev.) 1 ::

Guttmann, E., and Curran (Psycho
logical Medicine : A Short Intro
duction to Psychiatry, with an
Appendix on Psychiatry Associ
ated with War Conditions, with
a foreword by J. .]. Conybeare)

(rev.) 776

i Iwynne, F. J 670

Gymnastics, Medical, Massage and,
by M. V. L^ce, with a foreword

by J. MenneH (rev.) 24S

Gynaecological D&gt;crders, The Symp
tomatic Diagnosis and Treat
ment of, by M. M. White, with
a foreword by F. J. Browne

(rev.) 704

( lyna^cology

Obstetrics and, The 1945 Year Book
of, edited by J. P. Greenhill

(rev.) 884

Recent Advances in Obstetrics and,
by A. W. Bourne and L. H.

Williams (rev.) 299

Synopsis of Obstetrics and, by A.
W. Bourne (rev.) 666

Hsemagglutinins, Cold, The Clinical

Significance of (C.C.) 743

Hsemangiomata of the Lower Limb 26

Ifa?matology, "Blood", A Journal

Devoted to (C.C.) 743

Ilfemor.hiius Influenzse -

Ilesistaree of. The, to the Action
of Penicillin, with Special Refer
ence to Type B Strains, by E. A.
North, H. Wilson and G.

Anderson (O) L 626

Type B. Rabbit Antiserum, The
Treatment of Hremophilus In-
fluenzse Meningitis with Sul-
phonamides in Conjunction with,
by E. A. North, H. Wilson and
G. Anderson (O) 215

Hnemorrhage, Subarachnoid, The

Prognosis in (C.C.) 22

Vol.. I, 1946.

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

xin

llahn, P. F

Hair and Scalp, The. by A. Savill
(rev.)

llaidano. J. S

Hales, G. M. B

Hall, R. D. MeKeUar A Short Note
on the Changing Outlook in
Osteomyelitis brought about by
the Introduction of Penicillin (R)

Hallarr, K 28,451,480.

Hai ows, B. ... 28, 59, 00, 01,480.

Hajrblen, E. C. (Edocrlnology of
Wo.man) (rev.)

Hamilton, I.

And Cleland A Case of Abdominal
Lymphangioendothelloma or Peri
toneal Mosothelioma (R)

And Hardy Hernia through the
Foramen of Winslow Emerging
through the Castro-Hepatic
Omentum (R)

Hamilton. J. Bruce

Hardle, David, Death of

Hardy, J. K. S., and Hamilton
Hernia through the Foramen of
Winslow Emerging through the
Castro-Hepatic Omentum (R) ..

Hartr rtge, H

Harvey, C. Medical Aspects of The
Singapore Captivity (O)

Hatcher, P., Saxton and Derrick
Chromoblastomycosis, with Re
ports of Two Cases Occurring in
Queensland (O)

Hawker. R. W. Studies in Nicotinic
Acid (O)

I lay. Arthur, Death of

I layden, F

Hayes, W. Ivon i?6. 532,

Hay ward, G. W

Head Wounds. Transient Distur
bances following (C.C.)

Health

Of the Pre-School Child in Aus
tralia, The (C.C.)

Poverty, Housing and

By J. Brown

By A. Bulteau

Relationship of Food to. The, bv
M. Hutehings (O)

Health Education Council, Queens
land

Health Legislation in the United
States of America, Discussions
on (Leading Article)

Health Service Bill of Great Britain,

The National

(Leading Article)

Health Services, Future, in Great

Britain

(C.C.)

Heart Sounds in Health (C.O.)

Heath. C. W. (What People Are: A
Study of Normal Young Men)
(rev.)

Heliner

Hemivertebra, Spondylolisthesis and

Henderson, A. M. A Case of Dia
betes Mellitus with Hyper-
lipsemia and Hyperchclesterol-
aemia (R)

Henderson, J. L

Henry, A. K. (Extensile Exposure
Applied to Limb Surgery) (rev.)

Henry, N. R.

And Simmons Studies on Rh Iso-

Immunlzatlon (O)

Anti-O Agglutinin in Human Blood,
The, with the Report of a Case
of its Occurrence (O)

Herbage Plants, Climatic Factors and
the Nutrition of

TTerndon, R. F. (An Introduction to
Essential Hypertension) (rev.) .

Hernia

i Diaphragmatic

Inguinal

And its Repair

By C. Craig 274,

By L. S. Loewenthal

By H. Turnbull (O)

Treatment of. The

l ..\ ( . Craig

By F. V. Stonham (O)

Through the Foramen of Winslow
Emerging through the Gastro-
llenatic Omentum, by I. Hamilton
and J. E. S. Hardy (R)

HIS
483

854

401

-1ST
1ST

805

07-i

S05
704

872

533

53 I

009

374

2!)
29

TOO
124

524
517

487
482
158

444

Sit)
20

513
375

444

395
817
740

078
381
109

345

185

Hes^

Hewitt. L.- -Ulcers in the Mouth: An
Apopal for Help

Hewitt, \v. E

1 licks, .1. I &gt;. Lipomata o| the UteruHJ
with Report of n Case (O)

Page

1 1 igli-Freque.i&gt;ey Apparatus. The

Restrictions on 570

Hill, A 201

Hiller, B. I lcers in the Mouth: An

Appeal for Help 41)0

Hingston, II. A., and Lull (Control
i rain in Childbirth, with an
introduction by X. W. Vaux)
(rev.) 408

Hirschfeld, iOugen, Death of 931

Hirst, G. K 193

Historical Records 125

History, The Medical, of the War of

1!C;9-1SI45 (C.C.) 033

Hochberg, M 4 1 o, 11 1

Hocking versus Bell 254

Hollanders, Blood Group Frequencies
in., by .i. .1. Graydon, R. T. Sim
mons and 10. F. Woods (&lt;&gt;) .... 570

llelmes, J. O SSI

Honours, The Order of Saint John

of Jerusalem 1 li 1

Hookworm Disease in Australian
Soldiers, with Reports of Cases,
by C. B. Sangster (O) 3S5

Horark. H. M., ct alii (Global Epi
demiology: A Geography of
Disease and Sanitation) (rev.) . 591

Hormones, Sex, Biological Actions

of, by H. Burrows (rev.) 920

Horn, H. \Y 122

I lospital

Broughton Hall Psychiatric Clinic 300
Central Hospital, Melbourne, The

By C. II. Dickson 3o

By C. L. McVilly 20: 1 ,

Children s Hospital, Melbourne . 27.

59, 92, 129, 102, 450,

ISt;, 030. 075, 710, 890, 928

Survey from the, A: Coeliac

Disease, by G. E. M. Scott

(O) 059

Lewisham Hospital, Sydney 20

Royal Alexandra Hospital for

Children 814, 854

Sydney Hospital 378, 631

Research at, by N. Rose 750

Women s Hospital, Melbourne, Ob
stetrical Staff of the 190, 530

Hospital Accommodation. Shortage

of, in South Australia 344

Hospital Benefits Act, 1945 125

Hospital Blankets

As a Source of Infection, by P. M.
Rountree and J. JO. Armytage

(O) 503

Treatment of, The, with Oil Emul
sions and the Bactericidal Action
of "Fixanol C" (Cetyl I yri-
dinium Bromide), by I 1 . M.
Rountree (O) " 539

Hospital Color and Decoration, by R.

I . Sloan (note) 190

Hospitals

Slatting of. The: A Statement from

England (Leading Article) 777

Tuberculosis I atients and

By A. H. Penington

I .y D. B. I itt

Hospitals Act Amended

Housing

And Health, Poverty

By J. Brown 29

By A. Bulteau 29

Community, The Sociological As
pects of. by I. B. Scbirc (O) .. 327

Howard, R 451, 180. 040

Hoyle, C 070

Hudson, C., and Little Chondrit is of

the Patella (O) 398

Hudson. Catherine, and Hytten- The
Tuberculin 1 atch Test: A Com
parison with the Mantoux Test
(O)

Human Body after Death, The Study
of the, by K. Inglis (O)

Humanism. War and, by A. G. Butler

Hunter. H. The Special Representa
tive Meeting in London

Hunter, J. G- 553.

Dr.. Flies to England (C.C.) ....

Hunting-ton s Chorea

Hurley, Air Vice-Marshal T. 10. V.,
The Retirement of Surgeon
Captain W. J. Carr and 558

Hurst. A 53

Hurwitz, D 23

Hutehings. J 202

And Wheildon Post-Abort ional
Tetanus with Recovery (R) . . . 404

Hutehings, M. The Relationship of

Food to Health (O) 790

Huxlable, C .452

475

222
L65

715
741

595
308

Page

Huyck, ,|.H 339

Hydalid Cyst, Cerebral (C.C.) 440

Hydronephrosis and Hydroureier,

Renal Calculus 1(53

Hydrophobia, A Case of So-Called:
A Matter of Diagnosis, by W. E.

L. H. Crowther (O) 09

Hydrourcter, Renal Calculus, Hyclro-

nephrosis and 103

Hygiene, Industrial Medicine, Legis
lation and, Outlines of, by J.
Burnel (rev.) 20

I lyndman. O. R 53

I 1 yperchoieeterolaemia, Hyperlipsemia

and, A Case of Diabetes Mellitus
with, by A. M. Henderson (R) 513

Hypertensin (C.C.) 810

I lypertension

Arterial: Us Diagm:s ; s and Treat
ment, by I. H. Page and A. C.

Corcoran (rev.) 83

Essential. Ai 1 [htrodliction to, by
R. F. Herndon (rev.) 740

Hypnosis as a Substitute for Anses-
ihesia. Some observations Con
cerning the Use cf, by It. L. H.
Sampimon and M. F. A. Wo idruff
(O) 393

Hypotonia, Generalized: A Case fcr

Diagnosis 451

Hytten, F. E., and Hudson The
Tuberculin Patch Test : A Com
parison with the Mantoux Test
(O) 475

Illingworth, C. F. W., and Dick (A
Text-Book of Surgical Path
ology) (rev.)

Index to "The Medical Journal of
Australia" (C.C.)

Industrial Nursing: Its Aims and
I ractice. by A. B. Dovvson-
Weisskopf. with a foreword by
10. Summerskil] (rev.) 84

Infection, Droplet Spray, and Res
piratory Activity (C.C.) 447

Infections

Due to Streptococcus Hfemolyticus
Group A following Childbirth
and Abortion, Stained Smears for
the Rapid Diagnosis of, by H. M.

Butler (O) 437

Tendon Sheath, of the Hard, Peni
cillin Therapy for, by J. A.
Marsden (O)

Infectious Disease, Acute, Nursing in,
by F. V. G. Scholes (rev.) .....

Inflammation. Pulmonary Edema
and: An Analysis of Processes
Involved in the Formation and
Removal of Pulmonary Trans-
udates and Exudates, by C. K.
Drinker (rev. ) 739

Influenza, The Prevention of (C.C.) 192

Ingclfinger, F. J 067

Inglis, K 239

Study, The, of the Human Body
after Death (O) 222

Ingram. W. W. Research at the

Kaneinatsu Institute 7*3

Inguinal Region, The Surgical and
Applied Anatomy of the, by E.
S. Meyers 237

Injuries, Acute,, of the Head: Their
Diagnosis. Treat inent. Complica
tions and Sequels, by G. F.
Rowbotham (rev.) 20

Injury- -

"Blast", of the Spina! Cord, Report
of a Faial Case of, by D. Leslie

(R) * : ss

Recto- Vesical, An Unusual (C.C.) 713
Inoculations. Prophylactic, Some
Complications and Sequelae of the,

by M. Kelly (O)

"Inquirer" -- "Atebrin" and De
nial it is: An Inquiry

Intel-vertebral Disk Disease, Lumbar
Recent Advances in the Diagnosis
and Treatment of

By F. Clark 417

By D. Miller 274

By J. H. Young 382

(O) 45

Recent Advances in the Surgical
Treatment of, by F. J. Clark

(O) : 49

Intervertebral Disk, The

By W. H. Godby 237

By D. Miller 340

By M. A. Radcliffe-Taylor .. 237.454
(Leading Article) 53

XIV

INDEX TO TIIK MKDK. AL .JOl RNAL OF AUSTRALIA.

VOL. I, 1946.

Page

Intussusception, Bowel Resection for inn
Iodine in i Iraves s Disease, The

Action of (C.C.) 779

Iris Prolapse 674

Iron Deficiency, Lesions of the Mouth

and (C.C.) 850

Iron, Excretion of (O.C. ) 303

Ironside, R. N., and Batehelor

(Aviation Neuro-Psychia try)

(rev.) 480

Tso-Agglutinin, An Immune Anti-M,

in Human Serum, by R. J.

Walsh (II) H5

Jackson, A. V., and Fenner Enteric
Fever due to Bacterium Enteri-
tidis Var. Blegdam (Salmonella
Blegdam) : A Series of Fifty
Cases in Australian Soldiers
from New Guinea (O)

Jackson Lecture

Jacobs. H., and Bettinger A Con
tribution to the Problem of Mas-
culinization (O)

Jadassohn, J

Jaede. C. H. The Future of Medical
Practice

James, H. M. Recent Experiences in
Canada and the United States
(O)

Japan, Experiences as a Prisoner of
War in, by S. E. L. Stening (O)

313

127

227

823

827
773

547

617

487

298
193
531

SOS

141
3 Of.

117

ir,7

Jaundice

Obstructive, The Bleeding Ten
dency in : Diagnosis and Manage
ment, by P. Fantl (O)

Value, The, of Biochemical Tests
in the Interpretation of, by A.
B. Corkill, D. J. Pollock and Cr.
E. Smith (O)

Jens, J

Joel, N. C. Local Amputation of
Gangrenous Toes in the Presence
of Glycosuria and Senility (R) .

Johnson, F. C

Johnstone, J. W 196,

Joints. Atlas of Surgical Approaches
to Bones and, by T. Nicola (rev.)

Jones, P.. and Embelton Volvulus
of the Small Bowel, with Report
of a Case Treated by Resection
with Recovery (O)

Jones, S. Evan

Journal, The, and the Recent Indus
trial Unrest (Leading Article) .

Julius, S

Jurisprudence, Medical, and Toxi
cology, by J. Glaister (rev.) ....

Jury. L. R. The Pharmaceutical
Benefits Act. 1944

Kanematsu Institute

Research at the

By A. F. Burrett

By A. J. Canny 642,

By J. C. Eccles

By W. W. Ingram

By T. H. Vickers

Kaplan, I. L

Kater, N. M. A Jungle Appendicec-

tomy (R)

Katz, L,. N

Kelly, M.

Professor Ralph Stockman

Some Complications and Sequelae
of the Prophylactic Inoculations

(O)

Kennedy. F

Kennedy, R. T.

Remarkable "Dr." Spencer, The

(O) 149

Young Dr. Storch of Adelong (O) 362

Kepner. R. De M 11 S

Keratitis, Vitamin C (Ascorbic Acid)

in 675

Kern, F., junior 159

Kersley, G. D. (Outlines of Physical

Methods in Medicine) (rev.) . . 336

Kety. S. S 707

Kinsella, V. J 535

Kirk, N. T 808

Knox, O. M. (Principles of Pediatrics

and Pediatric Nursing) (rev.) . 703

Kohlstaedt 810

Kosmak, G. AV 411

Kruse, H. D 669

631

782
896

641

i S &gt;
642
666

S22

800
84

I age

Labour

Analgesia in 1 97

.Management of, The 1 9!i

Progress of, The, and Palpation . . 196

Symposium on 196

Third Stage of. Management of the 199

Uterine Pains in 196

Lace, M. V. (Massage and Medical
Gymnastics, with a foreword by

J. Mennell) (rev.) 24S

Laidley, J. W. S., and Cummine The
Empirical Use of Penicillin for a
Sulphonamide-Resistant Patient

(R) 476

Lang, W. R. A Case of Addison s
Suprarenal Syndrome of Primary

Pituitary Origin (R) 3

Langdon-Brown, W 703

Langley, Francis Ernest, Death of . . 490
Latham, Mr. Justice, Chief Justice . 254
Law, T. Boyd Penicillin in Pre-
Operative and Post-Operative

Ophthalmic Surgery (R) 442

Lawrence, J. H 483

Lawson, R. S. Report of a Case of

Ami Tobic Pyuria (R) 550

Leading Articles

Australia and Science: The Uni
versity of Sydney and Scientists 249
Cerebral Trauma and its Mechan-

o o ,~

isms Boo

Clinical Discipline 409

Dietary Deficiencies and Oral

Structures 85

Discussions on Health. Legislation
in the United States of America 301

Eyes 705

Federal Medical War Relief Fund,

The 229

Food Consumption in Australia . . 21
Heavy Blow, A, to Medical

Research ** :&gt;&gt; 1

Institute, An, of Medical Research

for Queensland 157

Intervertebral Disk, The 53

Journal, The, and the Recent Indus
trial Unrest 1 1 "

Meeting, The, of the Federal

Council 553

National Health Service Bill of

Great Britain, The 517

Overseas Travel for Australian

Students 191

Paludrine" 229

Parenteral I se of Vitamins, The . . 667

Peace and the Individual 481

Report, A

From Great Britain on a Com
prehensive Dental Service . . . 593
On the Remuneration of General

Practitioners 809

Research in Medical History .... 445
Retirement. The, of Surgeon Cap
tain W. J. Carr 117

Special Representative Meeting in

London. The 741

Staffing of Hospitals, The : A State
ment from England 777

"Story, The, of a Great Achieve
ment" :&gt; &gt; : &gt;7

Treatment, The, of Rheumatism by

Dehydration 373

Women in Medicine 849

World Food Shortage, The 921

Lead Poisoning 124, 816

Leakage after Intestinal Anastomosis,

The Prevention of (C.C.) 88 1 !

Lee, A. E.

Case, A, of Intractable Constipation 165

Low Backache (O) 42

Lee, D. H. K 157

Lee, R. 1 302

Legacy Club, The, by E. P. Blashki 63
Legislation and Hygiene. Outlines of
Industrial Medicine, by J. Burnet

(rev.) 20

Leichtentritt, B 670

Lemerle, T. H 234

Lemmon, W. M. . . 197

Leprosy

Human, Observations on : Infection
of Rats with Human Excretal
Organisms, by J. W. Fielding
(O) , 578

Rat, Further Observations on, by
J. W. Fielding (O) 681

Report. A. of Nine Cases among
Natives of the Mount Hagen
Area in New Guinea, by N.
Shlimovitz (R) 369

I age
Leslie, D. R.

Case, A, of Gunshot Wound of the

Large and Small Intestines (R) MM;
Report of a Fatal Case of "Blast"

Injury of the Soinal Cord (R) . . 188
L Estrange, Guy Stuart, Death of .. 204
Leucotomy, 1 refrontal, The Results

of (C.C.) 118

Lewis, F. T 86, 87

Lewis, N. D. C 919

Lewisham Hospital, Sydney 26

Ley, Dr. Robert, The Brain of (C.C.) 447

Limbs, Artificial, Supply of 124

Line!, I . E., Beveridge and Camp
bell Pleuropneumonia-Like Or
ganisms in Cases of Non-
Gonococcal Urethritis in Man and
in Normal Female Genitalia (O) 179

Linen for Doctors Surgeries 123

Lipomata of the Uterus, with Report

of a Case, by J. 1 &gt;. Hicks (O) 184

Liquid Fuel Supplies 123

Liquor Reform Society 124

Little, A. G., junior 303

Little, N 58, 59

And Hudson Chondritis of the

Patella (O) 398

Some Further Observations on

Sciatica (O) 33

Liver, Rupture of the, in the New-
Born : Recovery after Blood
Transfusion and Laparotomy, by

F. Arden (R) 187

Loewenthal, L. S. Inguinal Hernia

and its Repair 381

London Letter 603

Long, J. C 23

Lowsley, O. S. (The 1945 Year Book

of Uroloay) (rev.) 776

Lcwther, F. de L 849

Luckiesh, M 375

Ludwig s Angina, A Case of, by V.

Bulteau (R) 514

Lull. C. B., and Kingston (Control of
Pain in Childbirth, with an intro
duction by N. W. Vaux) (rev.) 408
Liii -.;. Diseases of the. The Correla
tion of Physical and X-Ray
Findings in : Chest Examination,
by R. R. Trail, with a foreword
by W. L. Langdon-Brown (rev.) 703
Lung Abscess, Putrid, by C. J.

Officer Brown (O) 107

Lymphangioendothelioma, Abdominal,
or Peritoneal Mesothelioma. A
Case of, by I. Hamilton and J.

B. Cleland (R) 477

Lyons, A. Trigeminal Neuralgia . . 750

Lyons, R 631

Lyttleton, O, The Right Honourable 337

MacCallum, P 92

Mace, L. M 483

Macindoe, N. M 674

Mackerras, I. M., and West "DDT"

Poisoning in Man (R) 400

Mackerras, M. J 234

Mackie, M. A 533

MacLaurin, C 340

Macnamara, J 640,641,712

Macpherson, M 374

Mary, I. G. (Nutrition and Chemical
Growth in Childhood, with a fore
word by L. Reynolds and a
supplement by J. O. Holmes)

(rev.) 884

Magee, C. G 23

Malaria

By K. Byrne 930

By M. R. Finlayson and J. McF.

Rossell 784

Unusual Case of, An

By X. Cunningham 453

By R. F. Matthews 380

Malaria Control, New Conceptions of,

by C. E. M. Gunther (O) .... 510
Malaya and Thailand, Observations
by a Pathologist during Three
and a Half Years as a Prisoner
of War in. by A. T. H. Marsden

(O) . 766

Malosetti, H. E 159

Mantoux Test, The The Tuberculin
Patch Test : A Comparison with
the by Catherine Hudson and

F. E. Hytten (O) 475

Maori, Blood Groups in the, by J. J.

Graydon and R. T. Simmons (O) 135
Marat Jean-Paul: Visionary or Vil
lain? (C.C.) 340

Marble, H. C 54

Marks, A 816

Marlev, H. W. H 157

VOL. I, 1946.

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

Page

Marrack, J. K., Panton and May

(Clinical Pathology) (rev.) .... 848

Marsden, A. T. H.

Detection, The, of the Cysts of
Entamceba Histolytica in the
Faeces by Microscopic Examina
tion (O) 915

Observations by a Pathologist
during Three and a Half Years
as a Prisoner of War in Malaya
and Thailand (()) 76U

Marsden, J. A.

Penicillin Therapy for Tendon
Sheath Infections of the Hand

(O) 435

Report on a Case of Burns Com
plicated by Haematemesis and

Melena (R) 551

Marshall, C. E. Chronic Vesiculitis
as a Factor in the Production of
Non-Gonococcal Urethral Dis
charges (O) 846

Marshall, S. V. -Spinal Anaesthesia
and Chloroform : A Comparison

of Mortality 750

Marvin 87

Masculinization, A Contribution to

the Problem of, by H. F.

Bettinger and H. Jacobs (O) .. 10

Massage and Medical Gymnastics, by

M. V. Lace, with a foreword by

J. Mennell (rev.) 248

Massler, M 85

Masten, M. G 919

Matthews, R. F. An Unusual Case

of Malaria 380

Matzke 87

Maun, M. E 670

Maxwell, J. (Introduction to Diseases

of the Chest) (rev.) 228

May, H. B., Panton and Marrack

(Clinical Pathology) (rev.) .. 848

Mayock, R. L 594

Mayer-Gross, W 118

Ma yes, B. T.

Obstetric Bulletins 275

Placenta Prsevia 715

"M.B., B.S." Ulcers in the Mouth :

An Appeal for Help 274

McArthur, G. A. D. Some Notes on
West s Operation (Endonasal

Dacryocystostomy ) (O) 508

McCance, R. A 303

McCarthy, C. M 92(5, 927

Rehabilitation, The, of War

Neurotics (O) 910

McCulloch. R. N. Studies in the

Control of Scrub Typhus (O) . . 717

McCutcheon, A 129

McDonald, C. G 674

McDonald, Edward, Death of 9f&gt;

McKellar, C. C. Honorary Medical

Staffs 894

McKillop, W. J 203

McLachlan, A. E. W. (Handbook of
Diagnosis and Treatment of

Venereal Disease) (rev.) 336

McLaren, C. I. A Psychiatric Pro
gramme for Peace 677

McLaren, W. W 450, 451

McLean, George, Death of 240

McLean, J 711

McLorinan, H 93, 638, 641

Report, A, on Sixteen Cases of

Supraglottic CEdema (O) 220

McMahon, F. F. Ulcers in the

Mouth : An Appeal for Help . . 715

McTiernan, Mr. Justice 271

McVilly. C. L. The Central Hospital.

Melbourne 203

Means, J. H 779

Medical Annual, The (C.C.) 341

Medical Appointments 96, 204,

276, 348, 384, 420, 456, 492, 536, 572,
608, 644, 680, 716, 752, 788, 860, 896, 932
Important Notice . 32, 64, 96, 132,
168, 204", 240, 276, 312, 348, 384,
420, 456, 492, 536, 572, 608, 644,
680, 716, 752, 788, 824, 860, 896, 932
Medical Benefits Fund of New South

Wales 601

Medical Conference, An International

(C.C.) 633

Medical Curriculum. Anatomy in the,

by A. A. Abbie (O) 152

Medical Defence Society of Queens
land 816

Medical Education and Medical Prac
tice in Germany during the War

(C.C.) 923

Medical Finance Limited 602

Medical History, Research in (Lead
ing Article) 445

Page

Medical Officers, Certain Service, The
Training Prior to Discharge of

30,
Medical Practice

Dangerous Drugs Regulations of

Victoria

Future of, The, by C. H. Jaede . .

In Tasmania, The Changing Face

of, An Address, by G. M. W.

demons (O)

Medical Practitioners and Evidence

at Inquests

Police Offences (Amendment) Act

of New South Wales

Supply, The, of Motor-Cars

Medical Prizes The Stawell Prize . .
Medical Profession, Politics and the

An Address, by J. Dale (O)

By A. Barber

By P. G. Dane 417,

By E. I . Dark 534,

By G. O Day

By N. Pern 416,

Medical Sciences Club of South Aus
tralia

Medical Societies

Medical Defence Society of Queens
land

Medical Sciences Club of South

Australia

Medico-Legal Society of Victoria,

The

Melbourne Psediatric Society . . 27,

59, 92,129,162,450,

486, 636, 675, 710, 890,

Obstetrical Society of the Women s

Hospital, Melbourne 196,

Public Medical Officers Association

of New South Wales, The

Medical Staffs, Honorary, by C. C.

McKellar

Medical Students, The Selection of,
in Relation to the Needs of a
Community and the Facilities
Available for Instruction, by

Lambert Rogers

Medical Training, The Adequacy of

By K. J. B. Davis

By B. Williams (O)

Medicine-

For Nurses, by W. G. Sears (rev.)
General, The 1945 Year Book of,
bv G. F. Dick et alii

240

382

823

609
345

of, A, by D. Guthrie

edited
(rev.)
History
(rev.)

Industrial, Legislation and Hygiene,

Outlines of. by J. Burnet (rev.)

Outlines of Physical Methods in,

by G. D. Kersley (rev.)

Psychological, A Short Introduction
to Psychiatry, with an Appendix
on Psychiatry Associated with
War Conditions, by D. Curran
and E. Guttmann, with a fore
word by J. J. Conybeare (rev.)
Social, The Basic Wage, Shortage
of Nurses and

By M. C. DeGaris

By E. S. Meyers (O)

Textbook of, by Various Authors,
edited by J. J. Conybeare (rev.)

Women in (Leading Article)

Medico-Legal Hooking versus Bell
Medico-Legal Society of Victoria, The
Meehan, A. V.

Address, An (O)

Low Back Pain (O)

Melbourne Paediatric Society . . 27,

59, 92, 129, 162, 450,

486, 636, 675, 710, 890,

Melbourne Permanent Post-Graduate

Committee (see Post-Oraduate

Work)

Mello-Leitao. C

Melnick, D 410,

Memorial, A, to the Late Professor

James Thomas Wilson

Men, Normal Young, A Study of:
What People Are, by C. W.

Heath (rev.)

Meningitis

And Ventriculitis, Staphylococcal :
Cure by Penicillin, by D. Miller

and H. J. Delohery (R)

Hsemophilus Influenzae, The Treat
ment of. with Sulphonamides in
Conjunction with Haemophilus
Influenzae, Type B, Rabbit Anti-
serum, by E. A. North, H. Wilson

and G. Anderson (O)

Purulent, of Infancy and Child
hood : A Twelve Months Survey
of the Results of Treatment by
Penicillin, by E. K. Turner (O)

65
416
784
929
273
677

817

816
817
273

928
530
414
894

162

275
147

920

443

336

408
849
254
273

133

928

811
411

348
444

512

215
14

Page

Mennell, J 248

Mennell, J. B. (Physical Treatment
by Movement, Manipulation and

Massage) (rev.) . . . 444

Meschan, I. A Radiographic Analysis

for Spondylolisthesis (O) 465

Mesothelioma, Peritoneal, Abdominal
Lymphangioendothelioma or, A
Case of, by I. Hamilton and J.

B. Cleland (R) 477

Meyers, E. S.

Basic Wage, The, Shortage of

Nurses and Social Medicine (O) 548
Organization of a Profession .... 784
Surgical and Applied Anatomy,

The, of the Inguinal Region .... 237
Michaelis, L. S. (Anatomical Atlas

of Orthopaedic Operations) (rev.) 848
Milk of Melbourne Women, Ascorbic

Acid in the, by D. Winikoff (O) 205
Milk Supply, Bacteria in Relation to
the : A Practical Guide for the
Commercial Bacteriologist, by C.

H. Chalmers (rev.) 479

Miller, D 58

And Delohery Staphylococ c a 1
.Meningitis and Ventriculitis:

Cure by Penicillin (R) 512

Intervertebral Disk, The 346

Recent Advances in the Diagnosis
and Treatment of Lumbar Inter-
vertebral Disk Disease 274

Miller, J. B 746

Millin, T 230

Minor, G. R 555

Minot, G. R 743, 920

Mitchell, 1 . C 84

Mitral Stenosis, Early 814

Molcsworth, E. H 415

(An Introduction to Dermatology,
with a Chapter on the Theory
and Technique of X-Ray and
Radium Therapy, with a Fore
word to the First Edition by J.

Jadassohn) (rev.) 227

Late Herbert Michael Moran, The 311
Mollison, Dr. C. H., Retirement of,
from the Office of Honorary

Treasurer 92

Moncrieff, A 479

Money, R. A 58, 59, 707

Sciatica (O) 37

Monk, I. Amicrobic Pyuria 785

Montevideo Faculty of Medicine,

Annals of the (C.C.) 158

Moore, D. R. Australia and Science :
The University of Sydney and

Scientists 418

Moore, F. D 779, 851

Moore, J. N. P 118

Moran, Herbert Michael

Death of 415, 535

The Late, by E. H. Molesworth . . 311
Morris, J. G. The Treatment of

Scabies 380

Morris, J. Newman Medical Aspects
of Red Cross in the Second
World War The Sir Richard

Stawell Oration (O) 169

Morrison, G 533

Morrow, A. W. A Disclaimer 678

Morton, C. R. The Botany of Too-
woomba and Environs and its
Relation to Clinical Allergy of
the Upper Respiratory Tract (O) 585

Moschowitz, E 193

Motor-Cars, The Supply of 95

Motor-Car Tires and Accessories .... 123
Moulds in the Lungs, by J. B.

Cleland (R) 247

Mouth, Lesions of the, and Iron

Deficiency (C.C.) 850

Muecke, Roy LePage, Death of .... 311
Murmurs from Turbulent Flow (C.C.) 339

Murphy, A 157

Sudden Death following Initial
Injection of a Mercurial Diuretic

(R) 589

Murphy, E. Low Backache (O) ... 44
Murphy, E. M. Ulcers in the Mouth :

An Appeal for Help

Murphy, J. A. R. Bacille Calmette

Gurin

Murray, N. E., and Reid Experi
mental Observations on the
Aural Effects of Gunblast (O) . 611

Murray, Senator 302

Muscular Atrophy, Peroneal 379

Nathanson, I. T 707

National Health and Medical Re
search Council, The 561

XVI

INDEX TO THK MKDICAL JOURNAL OF AUSTRALIA.

VOL. I, 1946.

Page

National Health Service Bill of Great

I .ritain, The 524, 740

By S. Siecllofky 891!

(Leading Ari cle) 517

Naval Medical Services, The Aus
tralian 566

Naval, Military and Air Force
Appointments . . . 3i, 132, 166, 203,
275, 311, 347, 453, 605, 643,
675, 712, 747. 782, 818, 857, 891

Casualties 31 , 64,168.419,

491, 606, 782, 891

Decorations 380, 419, 571

Training, The, Prior to Discharge
of Certain Service Medical

Officers 30, 240

Neil, J. Hardie 670

Nelson, T. Y 707

Nephritis, Acute, Modern Treatment

in (C.C.) 742

Nervous Diseases, The Diagnosis of,

by J. Purves-Stewart (rev.) .. 739

X( rvous System

Central, Early Diagnosis in
Tumours of the, by W. Lister
Reid (O)

Diseases ot the, by F. M. R. Walshe
(rev.) I

Neuralgia, Trigeminal

By F. J. Clark

By A. Lyons

865
52

895
750

Neurology

And Neuropsychiatry, Recent Ad
vances in, by W. R. Brain and

E. B. Strauss (rev.) 371

Psychiatry and Endocrinology,
The 1945 Year Book of, edited
by H. H. Reese et alii (rev.) .. 919
Neuropathology, Textbook of, by A.

Weil (rev.) 299

Neuro-Psychiatry, Aviation, by R. N.
Ironside and I. R. C. Batchelor

(rev.) 480

Neuroses, War, by R. R. Orinker and

J. P. Spiegel (rev.) 630

Neurosurgical Patient, The : His
Problems of Diagnosis and Care,

by C. W. Rand (rev.) 247

Neurosyphilis 306

Tabetic Form with Optic Atrophy 306

Tabo-Paretic Type 307

Neurotics, War, The Rehabilitation

of 926

By C. M. McCarthy (O) 910

By H, H. Willis (O) 912

Newcastle Disease of Fowl:-, Virus
of, A Note on Two Laboratory
Infections with the, by S. G.
Anderson (R) . 371

New Guinea- -

Enteric, Fever due to Bacterium
Enteritidis var. Blegdam (Sal
monella Blegdam) : A Series of
Fifty Cases in Australian
Soldiers from, by F. Fenner and
A. V. Jackson (O) 313

Leprosy : A Report of Nine Cases
among Natives of the Mount
Hagen Area in, by N. Shlimovltz
(R) . 369

Salmonella Blegdam Causing Infec
tions in Humans in, Preliminary
Report on Strains of, by N.

Atkinson (O) 326

New-land, H 558

Newson, A., and Rose -

Compound Fractures of the Ex
tremities due to Gunshot
Wounds : The Early Results of
Treatment in the Field Aided by

Penicillin Therapy (O) . . 330

Early Results of the Treatment of

Gunshot Wounds of Limb Joints

Aided by Penicillin Therapy (O) 75

Suture of Deep Soft Tissue War

Wounds Aided by Penicillin

Therapy (O) 364

Treatment of Gunshot Wounds of
the Chest in the Field Aided by

Penicillin Therapy (O) 290

And Watson Early Results in a
Short Series of Cases of Gun
shot Wounds of the Abdomen

(O) 180

Newton, A 570

New Zealand Letter 344, 676

Nicholls, L. (Tropical Nutrition and

Dietetics) (rev.) 51fi

Nicola, T. (Atlas of Surgical Ap
proaches to Bones and Joints)
(rev.) SOS

Page
Nicotinic Acid, Studies in. by It. W.

Hawker (O) 872

Nightingale, H. J 671

Nimmo, J. R. -Epidemic Polyarthritis 380
Nissen, R. (Duodenal and Jejunal
Peptic Ulcer : Technic of Resec
tion, with a Foreword by O. H.

Wangensteen) (rev.) 189

Noble, R. A 31

Nominations and Elections 32,

64, 168, 203, 240, 311. 347, 383,
420, 455, 492. 536, 571, 607, 644,
679, 716, 751, 787, 824, 859, 895, 931

North, E. A.

And Christie Acquired Resistance
of Staphylococci to the Action

of Penicillin (O) 176

Wilson and Anderson

Resistance, The, of Haempphilus
Influenzse to the Action of
Penicillin, with Special Refer
ence to Type B Strains (O) 626
Treatment, The, of Haemophilus
Influenzas Meningitis with Sul-
phonamides in Conjunction
with Hasmophilus Influenzas,
Type B, Rabbit Antiserum (O) 215
Northern Territory, A Sociological
Study of the Aborigines in the,
and their Eye Diseases, by M.

Schneider (O) 99

Notes on Books, Current Journals and

New Appliances
Artificial Respiration Explained,

by F. C. Eve 516

Commodore, The, by C. S. Forester 116
Green Armour, by O. White .... 516
Hospital Color and Decoration, by

R. P. Sloan 190

Pacific Parade, by F. Clune 704

Talk 552

Notice 204, 456, 572,

747, 752, 788, 896
Special Representative Meeting in

May 536

Nuffield Medical Endowment 895

Nurses

Demonstrations of Operative Sur
gery for, by H. Bailey (rev.) .. 516
Medicine for, by W. G. Sears (rev.) 20
Shortage of, and Social Medicine,
The Basic Wage

By M. C. DeGaris 785

By E. S". Meyers (O) 548

Nursing

In Acute Infectious Disease, by F.

V. G. Scholes (rev.) 300

Industrial : Its Aims and Prac
tice, by A. B. Dowson-Weisskopf,
with a, foreword by E. Summer-
skill (rev.) 84

Obstetric Management and, by H.
L. Woodward, B. Gardner et

alii (rev.) 703

Pediatric, Principles of Pediatrics

and, by C. M. Knox (rev.) .... 703
Nursing Procedures, Modern Prac
tical, by M. K. Doherty, M. B.
Sirl and O. I. Ring (rev.) .... 630

Nutrition

And Chemical Growth in Childhood,
by I. G. Macy, with a foreword
by L. Reynolds and a supplement

by J. O. Holmes (rev.) 884

And Dietetics, Tropical, by L.

Nicholls (rev.) 516

Post-W T ar Plans for, in Canada . . 93

Nutt, A. L 707

Nye, L. J. J. The Saliva Factor in

Peptic Ulceration (O) 114

Obituary

Allan, George 453

Anderson, George Murray . . 608, 786
Aspinall. Andrew Eric, and Archi
bald John 238

Bowker, Cedric Victor 823

Bray, George William 489

Bruce, James Whitson Kemp 132

Buchanan, George Arthur 716

Campbell, Alice Pritchard 311

Clayton, George Edward Burdekin 716

Cosh, John Inglis Clark 311

Crooke, Robert Warren 895

Davies, Harold Whitridge 859

Frayne, Ernest John 895

Fullerton, Alexander Young 490

Graham. Walter Robert 32

Hardie, David 95

Hay, Arthur 96

I -age
Obituary Continued.

1 I irschfeld, Eugen 931

Langley, Francis Ernest 490

L Estrange, Guy Stuart 204

McDonald, Edward 96

McLean, George 240

Moran, Herbert Michael .... 415, 535

Muecke, Roy LePage 311

I igdon, Douglas Clelland 451

l 61ya, Eugene 823

Retallack, Cyrus Bath 859

Rogerson, Edward 752

Hosebery, Sidney Solomon 204

Smith, Redford John Wright .... 716

Sutcliffe, Ernest Weston 859

Tennent. Joseph Thorn 536. 823

Van Someren, George Arbuthnot . . 716

Vickers, Wilfred 384

Wilkinson, William Camac . . 204, 488

Wilson, James Thomas 31

Wright-Smith, Redford John 931

O Brien, J. P. On the Prickly Heat 164
Obstetrical Society of the Women s

Hospital, Melbourne 196, 530

Obstetric Bulletins, by B. T. Mayes 275
Obstetric -Management and Nursing,
by H. L. Woodward, B. Gardner

et alii (rev.) 703

Obstetric Service, A Complete (C.C.) 554

( )l&gt;stetrics

And Gynaecology

Recent Advances in, by A. W.
Bourne and L. H. Williams

(rev.) 299

Synopsis of, by A. W. Bourne

(rev.) 666

And Gynecology, The 1945 Year
Book of, edited by J. P. Greenhill
(rev.) 884

Obstruction

Intestinal, Acute, The Treatment
of, by J. T. Chesterman (rev.) 156

Pyloric, without Tumour 59

Occipito-Posterior Positions, Some
Points in the .-Etiology and

Mechanism of 531

Occipito-Posterior Presentation, The

Management of the 532

Occiput, Posterior Position of the . . 530
Points in Statistics and /Etiology . 530

Ocular Syndrome, An 674

O Day, G.- Politics and the Medical

Profession ...._. 273

CEclema (see also Edema)

Supraglottic, A Report on Sixteen
Cases of, by H. McLorinan (O) 220

CBsophagus, Congenital Stricture of

the, by R. Flynn (R) 702

Oestrogen Reaction, Unusual, in a

Boy (C.C.) 595

Ohler, W. R 23

Oldham, J. Spinal Analgesia (O) .. 432

ophthalmic Practitioners, The Short
age of 569

ophthalmic Surgery, Penicillin in
Pre-Operative and Post-Opera
tive, by T. Boyd Law (R) ... 442

Ophthalmological Society of Aus
tralia (British Medical Associa
tion) 747

Oppenheim s Disease, Amyotonia

Congenita 854

Opticians and Optometrists, The
Teaching of, in any Branch of
Ophthalmology 567

Oral Structures, Dietary Deficiencies

and (Leading Article) S5

Organization of a Profession, by 1C.

S. Meyers 784

Orthopaedic Operations, Anatomical
Atlas of, by L. S. Michaelis
(rev.) . . . . 848

Oser, B. L 410, 411

i &gt;sseous System, The : A Handbook
of Roentgen Diagnosis, by V. W.
Archer (rev.) tit! 6

Osteomyelitis

Chronic, The Digestion of Dogs

and. by Curious" 275

Of the Acetabulum S54

Short Note, A, on the Changing

Outlook in, brought about by the

Introduction of Penicillin, by R.

D. McKellar Hall (R) 401

Pacific Parade, by F. Clune (note) 704

I age S10

Page, I. H., and Corcoran (Arterial
Hypertension : Its Diagnosis and
Treatment) (rev.) S3

VOL. I, 1946.

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

xvii

Page
1 ain, A. A.

Functional Disorders 131

I sychotherapy 859

Pain

Control of, in Childbirth, by C. B.
Lull and It. A. Kingston, with
an introduction by N. W. Vaux

(rev.) 408

In the Right Iliac Fossa, Two
Causes of (C.C.) 303

"Paludrine"

(Leading Article) 229

(M.488S) in Australia, Researches
on 234

Pancreas

Congenital Fibrocystic Disease of
the

By 1 . E. Blaubaum (O) 833

By L. Dods 929

Division of the, An Experimental
Study on Pancreatic Secretion

and (C.C.)

1 anton, P. N., Marrack and May

(Clinical Pathology) (rev.) ..

Papataci Fever, The Clinical Picture

of, especially in Palestine, by A.

Sandier (O) 789

Papuans, Further Observations on
the Rh and Hr Factors, and the
Blood Group Frequencies in, by
R. T. Simmons, J. J. Graydon and

E. F. Woods (O) 537

Paralysis

Sleep (C.C.) 811

Tick (C.C.) 339

Parr, L. J. A., and Shipton Spondy-

litis Ankylopoietica (O) 277

Parsons, L. G 20

Patella, Chondritis of the, by X.

Little and C. Hudson (O) ... 398

Pathological Exhibits 103

Pathological Services for New South

Wales, Comprehensive 601

Pathology

Clinical, by P. N. 1 anton, J. R.

Marrack and H. B. May (rev.) 848
Surgical, A Text-Book of. by C.

F. W. Illingvvorth and B M.
Dick (rev. ) 33G

Paul, X. "Atebrin" and Dermatitis :

An Inquiry 715

Paykoc. Z. V 743

Peace

And the Individual (Leading

Article) 481

Psychiatric Programme for, A

By R. S. Ellery (O) 457

By C. 1. McLaren 077

Peacock, W 779

Pediatric X-Ray Diagnosis: A Text
book for Students and Prac
titioners of Pediatrics, Surgery
and Radiology, by J. Caffey
(rev.) 807

Pediatrics

Principles of, and Pediatric Nurs
ing, by C. M. Knox (rev.) .... 703

Year Book of, The 1945, edited by
I. A. Abt, with the collaboration
of A. F. Abt (rev.) 884

I enicillin

Acquired Resistance of Staphylo-
cocci to the Action of, by E. A.
North and R. Christie (O) .... 170

And the Skin (C.C.) 411

Empirical Use of, The, for a Sul-
phonamide-Resistant Patient, by
H. G. Cummine and J. W. S.
Laidley (R) 476

In I re-Operative and Post-Opera
tive Ophthalmic Surgery, by T.
IJoyd Law (R) 442

In the Laboratory Diagnosis of
Whooping-cough, A Note on the
1 se of. by I 1 . M. Anderson (O) 244

Purulent Meningitis of Infancy and
Childhood: A Twelve Months
Survey of the Results of Treat
ment by, by E. K. Turner (O) 14

Resistance, The^ of Htemophilus
Influenza to the Action of Peni
cillin, with Special Reference to
Type B Strains, by E. A. Xorth,
H. Wilson and G. Anderson (O) 626

Septic Thrombosis of the Cavernous
Sinus Treated with Penicillin . . 674

Short Note, A, on the Changing
Outlook in Osteomyelitis brought
about by the Introduction of, by
R. D. McKellar Hall (R) 401

Page

Penicillin Continued.

Staphylpcoccal Meningitis and Ven-
triculitis : Cure by, by D. Miller

and H. J. Delohery (R)

Tetanus Treated with : Recovery,
by J. L. Grove (R)

Penicillin Sensitivity of Streptococci
Mostly of Groups A, B, (.. and
G, by R. T. Simmons and R.
Christie (O)

Penicillin Therapy

Compound Fractures of the Ex
tremities due to Gunshot
Wounds : The Early Results of
Treatment in the Field Aided by,
by T. F. Rose and A. Xevvson

(O)

Early Results of the Treatment
of Gunshot Wounds of Limb
Joints Aided by, by T. F. Rose

and A. Xewson (O)

For Tendon Sheath Infections of
the Hand, by J. A. Marsden

(O)

In the Treatment of Gonorrhoea,
The Results of, by S. Siedlecky

(O)

Suture of Deep Soft Tissues War
Wounds Aided by, by T. F. Rose

and A. Xewson (O)

Treatment of Gunshot Wounds of
the Chest in the Field by, by P.

Braithwaite

Treatment of Gunshot Wounds of
the Chest in the Field Aided by,
by T. F. Rose and A. Newson
(O)

Penington, A. H. Tuberculosis
Patients and Hospitals

Pepper, p. H. Perry

Periarteritis (Polyarteritis) Xodosa,
A Case of, by J. Game (R) ....

Pericarditis

Amojbic (C.C.)

Suppurative, with Recovery, Re
port of a Case of Salmonella
Blegdam Septicaemia and, by
J. F. C. C. Cobley and T. E.
Wilson (R)

Perineal Repair, Episiotomy and ....

Pern, X. Politics and the Medical
Profession 416,

Personality Factors in Counseling,
by C. A. Curran, preface by M.
J. Ready, introduction by C. R.
Rogers ( rev. )

Pett, L. B

Pharmaceutical Benefits Act, 1944,

The 91, 126, 562,

By L. R. Jury

Photographs, Clinical

Physical Methods in Medicine, Out
lines of, by G. D. Kersley (rev.)

Physical Treatment by Movement,
Manipulation and Massage, by
J. B. Mennell (rev.)

Physiology, Human, Principles of, by
C. Lovatt Evans ; with section
of the special senses by H. Hart-
ridge (rev.)

Pickering, E. W

1 igdon, Douglas Clelland, Death of .

Pink Disease

Pitt, D. B. Tuberculous Patients and
Hospitals ._

Placebo, The (C.C. )

Placenta Praevia

By H. C. Gallagher

By B. T. Mayes

By J. X. R. Stephen 490,

By R. H. Syred (O)

Plant, A

Plasma Protein Estimations in Battle
Casualties, by T. E. Wilson (O)

Pleuropneumonia-Like Organisms in
Cases of Xon-Gonococcal Ure-
thritis in Man and in X ormal
Female Genitalia, by W. I. B.
Beveridge, A. D. Campbell and
P. E. Lind (O)

Pneumothorax, Artificial, Pulmonary
Tuberculosis Treated by

Poate, II. R. G

And Spencer "Thio" Drugs in

Thyreotoxicosis

(O)

Pockley, E. "Beach Foot"

Poisoning

D.D.T., in Man, by I. M. Mackerras

and R. F. K. West (R)

Lead 124,

Police Offences (Amendment) Act of
New- South Wales

330

75
435
904
364
418

290

237

887

295
159

439
200

677

807
93

601

893

378

441

704
632
451
816

887

571
715
894
357
193

153

179

378

779

750
493
346

400
816

1 age

Poliomyelitis 636

Acute Anterior 124

Epidemic of, An, Occurring among

Troops in the Middle East, by

J. E. Caughey and W. M.

I orteous (O) 5

Paralysis, Mild, Early Detection of iin
Question of Diagnosis, A, by D. A.

Brown 822

Virus of, The j.. . . 638

Politics and the Medical Profession
Address, An, by J. Dale (O) .... 65

By A. Barbtr 416

By P. G. Dane 417,784

By E. 1 . Dark 534, 929

By G. O Day ". 273

By N. Pern 416, 677

Pollock, D. J., Corkill and Smith
The Value of Biochemical Tests
in the Interpretation of Jaun
dice (O) 617

Polya, Eugene, Death of 823

Polyarteritis Periarteritis Xodosa,

A Case or, by J. Game (R) .... 295

Polyarthritis, Epidemic

By P. G. Dowling (O) 245

By J. R. Ximmo 380

Pontine Degeneration, Progressive . 309

Pope, A 707

Pope, K. S 234

Porphyria

Acute, with Reports of Two Fatal
Cases, by E. H. Derrick (O) . . 241

(C.C.) 250

Porteus. S. D 118

Porteous, W. M., and Caughey An
Epidemic of Poliomyelitis Occur
ring among Troops in the Middle

East (O) 5

Post-Graduate Facilities in the

United States 567

Post-Graduate Medical Education
Committee of the University of
Queensland (see Post-Graduate
Work )

Post-Graduate Work

Melbourne Permanent Post-Gradu
ate Committee 92

Course at Geelong 535

Course on Anaesthesia in Mel
bourne 535

Courses at Melbourne during

1946 for Medical Graduates .. 62
Course at the Women s Hospital 751

Programme for March 203

Programme for April 383

Programme for June 643

Programme for July 821

Refresher Course for General

Practitioners in Melbourne ... 714
Xew South Wales Post-Graduate

Committee in Medicine 203

Annual General Course in Syd
ney: Programme for April .. 455

Course at Armidale 751

Course in Advanced Medicine at

Sydney 737

Course in Clinical Pathology at

Sydney . . 895

Course in Gynaecology and Ob
stetrics at Sydney 821

Courses in Sydney 311

Film Afternoon at Sydney . . 348,

679, 859
Film Programme at Sydney . . 535

Lectures at Sydney 859

Programme of Courses in Sydney

for 1946 " 607

Overseas Travelling Fellowships . 383
Post-Graduate Committee in Medi
cine of the University of Ade
laide
Course on Heart Disease at

Adelaide G79

Post -Graduate Study in England . 63
University of Queensland Post-
Graduate Medical Education
i Committee
Courses in Obstetrics and Gyna--

cology at Brisbane 931

Courses in Queensland in 1946 .. 131
General Revision Course at

Brisbane . 273

Lectures in the Principles of

Pathology 27;!

Post-Graduate Week in Brisbane

i!43, 678
Poverty, Housing and Health

P.y J. Urown 29

P.y A. Multeau 29

XV111

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

VOL. I, 1946.

Page

. 928
. 303

J o\vell, M. L

Power, M. H

Practitioners

General, Remuneration of, A

Report on the (Leading Article) 809
Medical, and Evidence at Inquests 345

I ratt, C. A. (The Essentials of

Chiropody) (rev.) 408

I ratt, R. V. A Trocar and Cannula
for the Intravenous Administra
tion of Fluids (O) 629

Pratt-Thomas, H. R 483

Precocity, Adrenal Carcinoma

Causing GO

Pregnancy, Infectious Diseases dur
ing, with Special Reference to
Rubella, Congenital Abnor
malities in Infants following: A
Third Series of Cases, by C.
Swan and A. L. Tostevln (O) . . 645

Premature Baby, The, by V. M.
Crosse, with a foreword by L. (J.
Parsons (rev.) 20

Prescott, F., and Bicknell (The

Vitamins in Medicine) (rev.) .. 552

Price, E 636, 641

Prickly Heat, On the

By J. P. O Brien 164

By C. White 382

Priestly, F. R 345

Prisoner of War

In Japan, Experiences as a, by

S. E. L. Stening (O) 773

In Malaya and Thailand, Observa
tions by a Pathologist during
Three and a Half Years as a, by

A. T. H. Marsden (O) 700

Sumo Medical Experiences as a. by

N. H. Rose (O) ..772

Surgical Experiences as a, by K.

J. Fagan (O) 775

Prisoner of War Hospitals in the Far
East

Clinical Lessons from (Burma
and Siam), by A. E. Coates

(O) 753

By E. E. Dunlop (O) 761

Proprietary Medicines Investigation

Committee . . : 565

Prostatectomy, Retropubic and Extra-

vesical (C.C.) 230

Pseudoarthrosis, Congenital, of the

Tibia due to Fibrocystic Disease 26
Psychiatric Aspects of Modern War
fare, by R. S. Ellery (rev.) 189

Psychiatric Programme for Peace, A

By R. S. Ellery (O) 457

By C. I. McLaren 677

Psychiatry

And Endocrinology. The 1945 Year
J5ook of Neurology, edited by H.
H. Reese et alii (rev.) 919

Short Introduction to, A, with an
Appendix on Psychiatry Associ
ated with War Conditions :
Psychological Medicine, by D.
Curran and E. Guttmann, with
a foreword by J. J. Conybeare
(rev.) 776

Psychology

In General Practice, edited by A.

Moncrieff (rev.) 479

Of Women, The: A Psychoanalytic
Interpretation, by H. Deutsch,
with a foreword by S. Cobb

(rev.) 300

Psychosis, Conf visional 310

1 syehoses Occurring in Service Per
sonnel in Forward Areas, Obser
vations on

By F. W. Graham 785

By H. J. B. Stephens (O) . . 145

Psychotherapy, by A. A. Pain 859

Psychotic Casualties in New Guinea,
with Special Reference to the
Use of Convulsive Therapy in
Forward Areas, by D. Ross (O) 830
Psychotic Ex-Servicemen, Some Re
marks on, by A. T. Edwards (O) 738

Public Health

Early Diagnosis and Early Treat
ment, The, of Cancer : A Pub
licity Campaign 571

Future Health Services in Great

Britain 487

National Health Service Bill of

Great Britain, The 524

Post-War Plans for Nutrition in

Canada 93

Public Medical Officers Association

of New South Wales, The 414

Page

Pugh, L. G. C 373

Pulmonary Edema and Inflammation :

An Analysis of Processes In
volved in the Formation and
Removal of Pulmonary Trans-
udates and Exudates, by C. K.
Drinker (rev.) 739

Purves-Stewart, J. The Diagnosis of

Nervous Diseases) (rev.) 739

Pyrexia, Prolonged 814

Pyuria, Amicrobic-

By I. Monk 785

Peocrt of a Case of, by R. S.
Lawson (R) 550

Queensland Health Education Council 124
Quarantine Officers, The Appointment

of 564

Queensland, An Institute of Medical

Research for (Leading Article) 157
Quotations wuh a Medical Bearing :

Acceptable Words, by J. B.

Cleland (O) 876

Radcliffe-Taylor, M. A. The Inter-
vertebral Disk 237, 454

Radiology, Year Book of, The 1945;
Diagnosis : edited by C. A.
Waters ; associate editor, W. B.
Firor ; Therapeutics : edited by I.

L. Kaplan (rev.) 666

Ralston 339

Ramfrez, F 446

Rand, C. W. (The Neurosurgical
Patient : His Problems of Diag
nosis and Care) (rev.) 247

Rapopcrt, M 742

Rationing 123

Rawlings, W. J 533

Rawson, R. W 779

Ready, M. J 807

Recto-Vesical Injury, An Unusual

(C.C.) 743

Rectum, Columnar-Celled Carcinoma
of the, Treated by Radon : Pre
liminary Report, Sixteen Months
after Treatment, by 1 . D.

Braddon (R) 477

Red Cross, Medical Aspects of, in
the Second World War, The Sir
Richard Stawell Oration, by J.

New : man Morris (O) 169

Reese, H. H 919

Reestablishment and Reemployment

Act, 1945, The 566

Reflexes, The Examination of : A
Simplification^ by R. Wartenberg,
foreword by F. Kennedy (rev.) 84
Refugee Medical Practitioners from

Europe 558

Registration, Medical 561

Rehabilitation

Medical : Its Organization in the
Royal Air Force and the Royal
Australian Air Force, by G. G.

Burniston (O) 620

Of Medical Officers of the Armed

Forces 568, 600

Of Members of the Armed Services 123

Of War Neurotics 926

By C. M. McCarthy 910

By H. H. Willis 912

Reid, G., and Murray Experimental
Observations on the Aural
Effects of Gunblast (O) 611

Reid, J. S. C 742

Reid, W. Lister Early Diagnosis in
Tumours of the Central Nervous
System (O) 865

Release, The, of Medical Officers from

the Services 570

Remuneration of General Prac
titioners, A Report on the (Lead
ing Article) 809

Renal Failure and Anoxia, by J.

Walker Tomb 63

Repatriation Commission 568

Medical Benefits for Dependants of
Deceased Soldiers 123

Representative Meeting, The Special,

in London (Leading Article) . . 741

Research

At Sydney Hospital, by N. Rose . . 750
At the Kanematsu Institute

By A. F. Burrett 782

By A. J. Canny 642, 894

By J. C. Eccles 641

By W. W. Ingram 783

By T. H. Vickers 642

Page

Research Continued.

In Medical History (Leading

445

631

Article)

Medical

Heavy Blow t&lt;., A (Leading

Article)

Institute of, An, for Queensland

(Leading Article) 157

Resident Medical Officers Salaries . 601
Respiration. Artificial, Explained, by

F. C. Eve (note) 516

Respiratory Activity, Droplet Spray

Infection and (C.C.) 447

Retallack, Cyrus Bath, Death of .... 859

Reviews

Acute Injuries of the Head : Their
Diagnosis, Treatment, Complica
tions and Sequels, by G. F.
Rowbotham 20

Anatomical Atlas of Orthopaedic
Operations, by L. S. Michaelis . 848

Arterial Hypertension : Its Diag
nosis and Treatment, by I. H.
Page and A. C. Corcoran 83

Atlas of Surgical Approaches to
Bones and Joints, by T. Nicola,
with a Foreword by N. T. Kirk 808

Atomic Energy in the Coining Era,
by p. Dietz . 629

Aviation Neuro-Psvchiatry, by R.
N. Ironside and I. R. C. Batchelor 480

Bacteria in Relation to the Milk
Supply : A Practical Guide for
The Commercial Bacteriologist,
by C. H. Chalmers 479

Bacterial Cell, The : In its Relation
to Problems of Virulence, Im
munity and Chemotherapy, by
R. J. Dubos, with an addendum
by C. F. Robinow 515

Biological Actions of Sex Hor
mones, by H. Burrows 920

Chest Examination : The Correla
tion of Physical and X-Ray Find
ings in Diseases of the Lung, by
R. R. Trail, with a foreword by
W. L. Langdon-Brown 703

Clinical Pathology, by P. N. Pan-
ton, J. R. Marrack and H. B.
May 84S

Control of Pain in Childbirth, by
C. Lull and R. A. Kingston, with
an introduction by N. W. Vaux 408

Demonstrations of Operative Sur
gery for Nurses, by H. Bailey . . 516

Diagnosis, The, of Nervous
Diseases, by J. Purves-Stewart . 739

Diseases of the Nervous System, by
F. M. H. Walshe 52

Duodenal and Jejunal Peptic
Ulceration ; Technic of Resection,
by R. Nissen, with a Foreword
by O. H. Wangensteen 189

Endocrine Man : A Study in the
Surgery of Sex, by L. R. Broster,
with a foreword by P. C. Mitchell 84

Endocrinology of Woman, by E.
C. Hamblen 665

Essentials

Of Chiropody, The, by C. A.

Pratt 408

Of Surgery for Dental Students,
by J. C. Ross 372

Examination of Reflexes, The : A
Simplification, by R. Wartenberg,
foreword by F. Kennedy 84

Extensile Exposure Applied to
Limb Surgery, by A. K. Henry 444

Global Epidemiology : A Geography
of Disease and Sanitation, by J.
S. Simmons, T. F. Whayne, G.
W. Anderson, H. M. Horack and
collaborators 591

Hair and Scalp, The, by A. Savill 408

Handbook

For Dissectors, A. by J. C.

Boileau-Grant and H. A. Cates 704
Of Diagnosis and Treatment of
Venereal Disease, by A. E. W.
McLachlan 336

History of Medicine, A, by D.
Guthrie 443

Industrial Nursing: Its Aims and
Practice, by A. P. Dowson-
Weisskopf, with a foreword by
E. Summerskill 84

Introduction

To Clinical Surgery. An : Sur
gical Wherefores and There-
fores, by C. F. M. Saint .... 848

Vol.. 1, 1946.

IXDKX TO THK MKDICAL JOURNAL OF AUSTRALIA.

XIX

Page

lie views Continued.

Jntnxlui-t ion- Continued.

Ti&gt; Dermatology. An, with a
Chapter on the Theory and
Technique of X-Kay and
Radium Therapy, by E. H.
Molesworth, with a foreword
to the First Edition by J.

Jadassohn 227

To Diseases of the Chest, by

J. Maxwell 228

To Essential Hypertension, An
by It. F. Hernclon 740

Manual, A, of Tuberculosis, Clinical
and Administrative, by 10. A.
I nderwood, with an introduction
by J. K. Currie 630

Massage and Medical Gymnastics,
by M. V. .Lace, with a foreword
by J. Mennell 248

Medical Jurisprudence and Toxi
cology, by J. Glaister ISO

Medicine for Nurses, by W. G.
Sears 20

Modern 1 ractical Nursing Pro
cedures, by M. K. Doherty, M.
B. Sirl and O. I. King 030

Neuroaiirgical Patient, The : His
i roblcnis of Diagnosis and Care,
by C. W. Kami :

.Nursing in Acute infectious
Disease, by F. V. G. Scholes . .

Nutrition and Chemical Growth in
Childhood, by 1. G. Macy. with
a foreword by L. Reynolds and
a supplement by J. O. Holmes . . 884

Obstetric Management and Nurs
ing, by H. L. \Vood\yard and B.
Gardner, with a section on home
deliveries l.y \V. i . Gillespie and
also a section on diseases of the
newly born by 11. F. Downing 703

&lt; isseous System, The : A Handbook
of Roentgen Diagnosis, by V. \V.
Archer 066

Outlines of industrial Medicine,
.Legislation and Hygiene, by .1.
Burnet

Cialmes of I hysical Methods in
Medicine, by (i. D. Kersley ....

Pcdiairie X-Ray Diagnosis: A
Textbook for Students and Prac
titioners of Pediatrics, Surgery
and Radiology, by J. Cafl ey .... 807

Personality Factors in Counseling,
by C. A. Curran, preface by M.
J. Ready, introduction by C. R.
Rogers _. 807

Physical Treatment by Movement,
Manipulation and Massage, by
J. B. Mennell 444

Premature Baby, The, by V. M.
Crosse, with a foreword by L. c&lt;.
Parsons 20

Principles

And Practice, The, of Rectal

Surgery, by W. B. Gabriel . . 228
Of Human Physiology (originally
"Starling s Princples of Human
Physiology ), by C. Lovatt
Evans, with section on the
special senses by H. Hartridge 704
Of Pediatrics and Pediatric
Nursing, by C. M. Knox 703

Psychiatric Aspects of Modern
Warfare, by R. S. Ellery 180

Psychological Medicine: A Short
Introduction to Psychiatry, with
an Appendix on Psychiatry Asso
ciated with War Conditions, by
D. Curran and E. Guttmann,
with a foreword by J. J. Cony-
beare 776

Psychology in General Practice,
edited by A. Moncrieff 471)

Psychology of Women, The: A
Psychoanalytic Interpretation, by
II. Deutsch. with a foreword by
S. Cobb 3 mi

Pulmonary Edema and Inflamma
tion: An Analysis of Processes
involved in the Formation and
Removal of Pulmonary Trans-
udates and Exudatos. by C. K.
Drinker 739

Recent Advances

In Neurology and Neuropsychi-
atry, by W. R. Brain and 10. B.

Strauss 371

In Obstetrics and Gynaecology,
by A. W. Bourne and L. H.
Williams 299

Page
Reviews Continued.

Rypins Medical Liicensure Exam
inations: Topical Summaries,
Questions and Answers, edited by

W. L. Bierring 740

Symptomatic Diagnosis and Treat
ment, The, of Gynaecological Dis
orders, by M. M. White, with a

foreword by F. J. Browne 704

Synopsis

Of Obstetrics and Gynaecology,

by A. W. Bourne 066

Of Surgery, by H. Groves, edited

by C. 1 . G. Wakeley 190

Text-Book. A, of Surgical Path
ology, by C. F. W. Illingwortn

and B. M. Dick ._. 336

Textbook

( f Medicine, by Various Authors,

edited by J. J. Conybeare .... 408
Of Neuropathology, by A. Weil 299
Tissues of the Body, The : An In
troduction to the Study of
Anatomy, by W. E. Le Gros

Clark 479

Treatment, The, of Acute Intes
tinal Obstruction, by J. T.

Chest erman 156

Tropical Nutrition and Dietetics, by

L. Nicholls 510

Virus as Organism : Evolutionary
and Ecological Aspects of Some
Human Virus Diseases, by F. M.

Kurnel 372

Vitamins in Medicine, The, by F.

Bicknell and F. Prescott 552

Wai- Neuroses, by R. R. Grinker

and J. P. Spiegel 630

What People Are : A Study of
Normal Young Men. by C. W.

Heath 444

Year Book, The 1945

of Genera) Medicine, edited by
G. F. Dick, J. Burns Amber-
son, G. R. Minot, W. B. Castle,
\V. D. Stroud and G. B. Eust er
man 920

Of General Surgery, edited by 10.

A. Graham 883

Of Neurology, Psychiatry and
Endocrinology ; Neurology
edited by H. H. Reese and M.
G. Masten ; Psychiatry- edited
by N. D. C. Lewis; Endocrin
ology edited by E. L. Sevring-

haus 919

Of Obstetrics and Gynecology,

edited by J. 1 . Greenhill .... SS4
Of Pediatrics, edited by I. A. Abt.
with the collaboration of A.

F. Abt 884

Of Radiology; Diagnosis: edited
l:y C. A. Waters, associate
(ditor W. B. Firor ; Thera
peutics : edited by I. L. Kaplan 666
Of Urology, by O. S. Lowsley . . 776

Reynolds 339

Reynolds. L 884

Rh and Hr Factors, Further Obser
vations on the, and the Blood
Group Frequencies in Papuans,
by R. T. Simmons, J. J. Graydon

a nd E. F. Woods (O) 537

Rh Blood Types, The, and their
Reactions, by J. J. Graydon and

R. T. SimiiK ns (O) 861

Rheumatism, The Treatment of, by

Dehydration (Leading Article) . 373
Rheumatoid Arthritis, Muscular

Lesions in (C.C.) 670

Rh Iso-Immunization, Studies on, by
N. R. Henry and R. T. Simmons

(O) 897

Rich, Mr. Justice 25-1

Uiddcll, C. B 779

Ring, O. I., Doherty and Sirl (Modern
Practical Nursing Procedures)

(rev.) 630

Riseman. J. E. F 032

Robert. A 86

Rol ei-ls, K. G 674

Roberts, \V. E. An Analysis of
Deformities among Recruits, with
Remarks on Sub-Standard Types

(O) 30o

Roller (sen. E. Graeme 674

"Robin May" Memorial Fund. The . . 7SS

Robinow, C. K 515

Rogers. C. R 807

Rogers. Lambert The Selection of
Medical Students in Relation to
the Nteds of a Community and
the Facilities Available for In
struction 162

Page

Rogerson, Edward, Death of 752

Rolleston, J. D 54

Rome, R. M 199

Rooms, Professional, for Civilian

Medical Practitioners 569

Root, W. S 483

Rose, N. H. Some Medical Experi
ences as a Prisoner of War (O) 772
Rose, N. Research at Sydney Hos
pital 750

Rose, T. F.
And Newson

Compound Fractures of the Ex
tremities due to Gunshot
Wounds : The Early Results of
Treatment in the Field Aided
by Penicillin Therapy (O) . . 330
Early Results of the Treatment
of Gunshot Wounds of Limb
Joints Aided by Penicillin

Therapy (O) 75

Suture of Deep Soft Tissue War
Wounds Aided by Penicillin

Therapy (O) 304

Treatment of Gunshot Wounds of
the Chest in the Field, Aided
by Penicillin Therapy (O) . . . 290
Bilateral Trigger Thumb in Infants

(R) 18

Newson and Watson

Early Results in a Short Series
of Cases of Gunshot Wounds

of the Abdomen (O) 180

Rosebery, Sidney Solomon, Death of 204
Ross, D. Psychotic Casualties in
New Guinea, with Special Refer
ence to the Use of Convulsive
Therapy in Forward Areas (O) 830

Ross, F. L 229

Ross, I. Clunies 340

Ross, J. C. (Essentials of Surgery
for Dental Students) (rev.)

372

784
250
483

Rossell, J. McF., and Finlayson

Malaria

Roth, N

Roughtor, F. J. W

Rountree. P. M.

And Armytage Hospital Blankets

as a Source of Infection (O) . . 503
Treatment, The, of Hospital Blan
kets with Oil Emulsions and the
Bactericidal Action of "Fixanol
C" (Cetvl Pyridinium Bromide)

(O) 539

Rowbotham, G. F. (Acute Injuries
of the Head : Their Diagnosis,
Treatment, Complications and

Sequels) (rev.) 20

Roxon-Ropschitz, I. Ulcers in the

Mouth : An Appeal for Help .... 382
Royal Alexandra Hospital for Chil
dren 814, 854

Royal Australasian College of Physi
cians

Annual Meeting 491, 820

Examination for Membership 29
Royal Australasian College of Sur
geons

Examination for Fellowship . . 94
George Adlington Syme Scholar
ship, 1946 786

Gordon Craig Scholarships 29,678
Meetings of the Courts of

Examiners 130

Post-Graduate Course in Sur
gery, A 130

Royal College of Obstetricians and
Gynaecologists Examination for

Membership 131, 678

Rubella

Congenital Abnormalities in Infants
following. Infectious Diseases
during Pregnancy, with Special
Reference to : A Third Series of
Cases, by C. Swan and A. L.

Tostevin (O) 645

Maternal, Congenital Defects in
Infants after : Further Reports

and Discussions (C.C.) 23

Rubin, M. 1 742

Rundle, F. F 521

Rupture

Intra pelvic, of the Urethra, Frac
ture of the Pelvis Complicated

by ;;79

Intraperitcneal, of the Urinary

Bladder 380

Of the Liver in the New-Born :
Recovery after Blood Transfusion
and Laparotomy, by F. Arclen

(R) 187

Six ntaneous, of the Spleen, with
Notes on Two Cases, by K. M.
Bowden (O) 506

INDEX TO THE MEDICAL JOUKN AL

AUSTRALIA,

VOL. 1, 1940.

Page

Russell, W. Ritchie TOG

Ryan, H &lt;&gt;74

Ryle, J. A 409

Rypins Medical Lie-ensure Examina-
lion.s : Topical Summaries, Ques-
tion.s and Answers, edited by \V.
L. Bierring (rev.) 740

Saint, C. F. M. (An Introduction to
Clinical Surgery : Surgical Where
fores and Therefores) (rev.) . . 848

Salaries-. The, of Commonwealth

Medical Orticers 564

Saliva Factor, The, in Peptic t" Itera
tion, by L. J. J. Nye (O) 1 14

Salmonella Blegdam

Causing Jn lections in Humans in
New Guinea, Preliminary Report
on Strains of, by X. Atkinson

(O) 326

Enteric Fever due to Bacterium
Enteriti lis Var. Blegdam : A
Series of Fifty Cases in Aus
tralian Soldiers from New
Guinea, by F. Fenner and A. V.

Jackson (O) &lt; I &gt;

Salmonella Blegdam Septicaemia and
Suppurative Pericarditis with
Recovery, Report of a Case of.
by J. F. .C. C. Cobley and T. 10.

Wilson (R) i:!!i

Salmonella Infections, Typhoid and,

Thoracic Complications of (&lt; .&lt; .) 555

Saltau, W. D 1 J! . 533

Sampimon, R. L. H., ar.d Woodruff
Some Observations Concerning
the Use of Hypnosis as a Sub
stitute for Anaesthesia (O) ... 393

Sanderson, 1 . H 632

Sandes, Francis Percival 598

Sandfly Fever (see Papataci Fever)
Sandier, A. The Clinical Picture 9f
Fapataci Fever, especially in

Palestine (O) 789

Sangster, C. B. Hookworm Disease
in Australian Soldiers, with

Reports of Cases (O) 385

Sarcoidosia 674

Savill. A. (The Hair and Scalp)

(rev.) 408

Saxton, W. J., Hatcher and Derrick
Chromoblastoniyeosis, with Re
ports of Two Cases Occurring in

Queensland (O) 695

Scabies, The Treatment of, by J. G.

Morris 380

Scalp. The Hair and, by A. Savill

(rev.) 408

Scaphoid. Carpal, Fractures of the,

by J. R. Barbour (O) 352

Scarborough, II 375

Schneider, M. A Sociological Study
of the Ab( rigines in the North
ern Territory and their Eye

Diseases (O) 99

Sclu.larships, Cordon Craig 29. 678

Schcles, F. V. G. (Nursing in Acute

Infectious Disease) (rev.) .... 300

Schour, 1 85

Schroeder 923

Srhrneder, A. 11 446

Schweit/.ei , A 481

Seiarra, D 250

Sciatica 58

By R. A. -Money (O) 37

Some Further Observations on. by
N. Little (O) . 33

Science

Australia t;nd : The University of
Sydney and Scientists

By A. J. Canny 3X1

By N. 10. Goldsworthy 316

I .y [;. R. Moore 418

By F. W. Simpson 417

(Leading Article) 249

Post-War Rehabilitation of. The
An Address, by J. G. Wagner

(O) 97

Scleroderma 92, 855

Sclerosis, Disseminated 26, 307

Syndrome Resembling, A. as a
Sequel to Encephalitis Lethargica 308

Scott, G . 487

Scott. G. 10. M 675

Cceliac Disease: A Survey from the
Children s Hospital. Melbourne

(O) 659

Scott, Kaye 890

Scrub Tvphus. Studies in the Control

of, by R. N. McCulloch (O) . . 717
Scurvy 816

Page

Sears, W. G. (Medicine for Nurses)

(rev.) 20

Sebire, 1. B. The Sociological As
pects of Community Housing
(O) 327

Sen, S 742

Septicaemia, Salmonella Blegdam, Re
port of a Cuse of, and Suppura-
tive Pericarditis with Recovery,
by . F. C. C. Cobley and T. E.
Wilson (R) 439

Serum, Hum:&gt;:i, An Immune Anti-M
Iso-Agglutinin in, by R. J. Walsh

Services Medical Officers Association

of New South Wales

By J. M. Veates

Sevringhaus, E. L

Sewell, A. K., and Walsh Some
Effects of Blood Loss on Healthy

Males (O)

Sex Hormones, Biological Action of,

by H. Burrows (rev.)

Sheldon, S. The Use and Misuse of

Tetanus Antitoxin

Sherman

Shipton, E., and Parr Spondylitis

Ankylopoietica (O)

Shlimovitz, N. Leprosy : A Report
of Nine Cases among Natives
of the Mount Hagen Area in New

Guinea (R)

Shock. Experimental, Toxic Factors

in (C.C.)

Short, A. 11

Siam, Burma and ; Clinical Lessons
from Prisoner of War Hospitals
in the Far East, by A. E. Coates

(O)

Siedlecky, S.

National Health Service Bill of

Great Britain, The

Results, The, of Penicillin Therapy
in the Treatment of Gonorrhoea

(O)

Simmons, J. S., et alii (Global Epi
demiology: A Geography of
Disease and Sanitation) (rev.) .
Simmons. R. T.

And Christie Penicillin Sensitivity
of Streptococci Mostly of Groups

A, B, C and G (O)

And Graydon

Blood Groups in the Maori (O)
Rh Blood Types, The, and their

Reactions (O)

And Henry Studies on Rh Iso-

Immunization (O)

Graydon and Woods

Blood Group Frequencies in

ll&lt; llanders (O)

Further Observations on the Rh
and Hr Factors, and the Blood
Group Frequencies in Papuans

(O)

Simmons, W. F

Federal Medical War Relief Fund,

The

Simpson, F. W. Australia and
Science: The University of Syd
ney and Scientists

Simpson, G 198,

Singapore Captivity, Medical Aspects

of the, bv C. Harvey (O)

Sinn, H 28, 450,

Sinuses, Tuberculous

Sinusitis Treated by Chemotherapy
at an Australian General Hos
pital, Report on a Series of Cases
of. by R. H. Bettington and G.

K. Vincent (O)

Sir], M. I ... Doherty and Ring (.Modern
Practical Nursing Procedures)

(rev.)

Skin, Penicillin and the (C.C.)

Sleep Paralysis (C.C.)

Sloan, R. I . (Hospital Color and

Decoration) (note)

Smith. E. Temple

Smith. G. E., Corkill and Pollock
The Value of Biochemical Tests
in the Interpretation of Jaundice

(O)

Smith, H

H. Fairfield

Redford John Wright, Death

1J5

788
785
919

920

131
922

707
341

753
890
904
591

Smith,
Smith.
Smith,

Smithy, H. G

Soldiers, Backache in. by 1 &gt;. Stuekey

(O)

Solis-Cohen. M

Sollmann, T

4L7
530

769
451

378

630
411
811

190
671

617
712
916
743

716
483

838
158
375

926

234

Page

Southby, R 28, 60, 129, 130,

533, 610, 710, 712, 890

Souttar, H. S

Spearman, H. L. 379

Special Article

Researches on 1 aludrinc (M.4888)

in Australia

.-^lection, The. of Medical Students
in Relation to the Needs of a
Community and the Facilities
Available lor Instruction, by

Lambert Rogers 162

S|v..-i;iiist, The De-&gt; .)ition of a 565

Spelling of Words. The, by D. Monk

Adams 345

Silencer , "Dr. ", The Remarkable, by

R. T. Kennedy (O) 149

Spencer, S. L 379, 779

Ai;d Pcate "Thio" Drugs in

Thyreotoxicosis 750

(O)

Speiis, W. ("The Spens Report") ..
Spiegel. J. P., and Grinker (War

Neuroses) (rev.)

Spinach, Lessons from (C.C.)

Spinal Anaesthesia and Chloroform:
A Comparison of Mortality

By C. E. Corlette 892

(O) 545

By S. V. Marshall 750

By J. E. Thomas 750

Spinal Analgesia

By J. Oldham (O)

"Nou- Take", by I . Gill

Spleen, Spontaneous Rupture of the,
with Notes on Two Cases, by K.

M. Bowden (O)

Spondylitis Ankylopoietica

By E. Hasleii Frazer 453,

By "Froacn Eilean"

By L. J. A. I arr and E. Shipton
(O)

Spondylolisthesis

And Hemivertebra

Radiographic Analysis ol, A, by

I. Mesehan (O)

Spriggs, E

Springthorpe, G

Stain, Fields. Notes on, by I . M.

de Burgh (O)

Sla-ibury, J. B

Staphylococcal Enteritis in Children,

by F. Draper and G. W. Brown

(b)

Staphylococcal Meningitis and Ven-
triculitis : Cure by Penicillin, by

D. Miller and H. J. Delohery

(R)

Staphylococci, Acquired Resistance
of, to the Action of Pei.icillin, by

E. A. North and R. Christie (O)

Stark, A. W. B

Starke, Mr. Justice

"Starling s Principles of Human

Physiology", ace Principles of
Human Physiology, by C. Lovait
10 vans (rev.)

Starr, I

Stats, D

Stawell Oratioi:, The Sir Richard
Medical Aspects of Red Cross
in the Second World War, by
J. Newman Morris (O)

Stawell Prize. The

Steindler, A

Steiner, G

Si ining, S. E. L. Experiences as a
Prisoner of War in Japan (O) . .

Stephen, J. N. R

Placenta Prtevia

Stephen, R. L

Stephens. II. H 27, 2S. 59, 92,

129. L30, 16?, 163, 450. ISii. 641,

Stephens. H. J. B.- -&lt; M.servalior.s on
Psychoses Occurring in Service
Personnel in Forward Areas (O)

493

809

630
922

432

6U6

677
535

277

465
779
640

544
339

469

176
SID
264

704
594
743

169
751

670

773
894
490

855

(175

St.

A. M.

Syndrome,
Ralph,

The"

bv M.

"Stevens-Johnson
(C.C.)

Stockman, Professor

Kelly

Stokes. E. H

Stokes, H. L

Stenham. F. V. The Treatment

Inguinal Hernia (O)

Storch, Young Dr., of Adeloiig, by

R. T. Kennedy (O)

"Story, The, of a Great Achieve
ment" (Leading Article)

Strauss, E. B., and Brain (Recent

Advances in Neurology and

Neuropsychiatry) (rev.)

145

1 . 3

193

822

378
451

185
162
137

VOL. I, 1946.

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

xxi

Page

Streptococci, Mostly of Groups A, B,
C and G, Penicillin Sensitivity of,
by R. T. Simmons and R.

Christie (O) 349

Stricture, Congenital, of the CEso-

phagus, by R. Flynn (R) 702

Stroud, W. D 920

Stuart-Harris, C. H 411

Stuckey, D. Backache in Soldiers

(O) 838

Sudeck s Post-Traumatic Bone Dys
trophy 480

Sulphonamides in Conjunction with
Haemophilus Influenzas, Type B,
Rabbit Antiserum, The Treat
ment of Hsemophilus Influenzas
Meningitis with, by E. A. North,
H. Wilson and G. Anderson (O) 215
Sulphonamide-Resistant Patient, The
Empirical Use of Penicillin for
a, by H. G. Cummine and J. W.

S. Laidley (R) 476

Summerskill, E 84

Sunburn, The Prevention of (C.C.) . . 375

Surgery

Clinical, An Introduction to : Sur
gical Wherefores and Therefores,
by C. F. M. Saint (rev.) 848

Essentials of, for Dental Students,
by J. C. Ross (rev.) 372

General, The 1945 Year Book of,
edited by E. A. Graham (rev.) . 883

Limb, Extensile Exposure Applied
to, by A. K. Henry (rev.) 444

Operative, Demonstrations of, for
Nurses, by H. Bailey (rev.) .... 516

Ophthalmic, Penicillin in Pre-
Operative and Post-Operative, by
T. Boyd Law (R) *. 442

Rectal, The Principles and Prac
tice of, by W. B. Gabriel (rev.) 228

Synopsis of, by H. GroveSj edited

by C. P. G. Wakeley (rev.) 190

Sutcliffe, Ernest Weston, Death of . . 859

Sutherland, B. M 202

Sutton, H. Centenaries of "Forty-
Five" (O) 421

Swan, C.

And Tosteyin Congenital Abnor
malities in Infants following In
fectious Diseases during Preg
nancy, with Special Reference to
Rubella : A Third Series of Cases

(O) 64f&gt;

Case, A, of Poet-Varicella! En
cephalitis showing Bilateral
Softening of the Neostriatum and
Terminal "Tetanoid Chorea"

(Gowers) (R) 697

Swan, M. S. A 234

Sweetman, K. F. D. Wounds Caused

by Small Fish 345

Sydney Hospital 378, 631

Research at, by N. Rose 750

Syme Scholarship, 1946, George

Adlington 78(5

Symonds, C. P 22

Syphilis, Gastric 378

Syred, R. H. Placenta Prsevia (O) 3.~&lt;2

Tait, L. G 816

Talk (note) 552

Taylor 339

Taylor, A. H 375

Taylor, G. C 157

Taylor, R. J 814

Tedeschi, C. D 885

Telephone Directories 567

Telfer, A. C 379

Tendon Sheath Infections of the
Hand, Penicillin Therapy for, by

J. A. Marsden (O) . 435

Tennent, Joseph Thorn, Death of 536, 823
Tenosynovitis, Suppurative, in the
Fingers, Treatment of, by L. I.

Burt (O) 399

"Tetanoid Chorea" (Gowers), A Case
of Post-Varicellal Encephalitis
showing Bilateral Softening of
the Neostriatum and, by C. Swan

(R) . 697

Tetanus

PoBt-Abortional, with Recovery, by
J. Hutchings and A. Wheildon

(R) 404

Treated with Penicillin ; Recovery,

by J. L. Grove (R) 22(i

Tetanus Antitoxin, The Use and Mis
use of, by S. Sheldon 131

Page

Thailand, Malaya and, Observations
by a Pathologist during Three
and a Half Years as a Prisoner
of War in, by A. T. H. Marsden

(O) 766

"Thio" Drugs in Thyreotoxicosis, by

H. R. G. Poate and S. L. Spencer 750
(O) 493

Thiouracil

Thyreotoxicosis Treated with 27

Toxicity of. The (C.C.) 850

Thomas, A. C 603, 926, 927

Address, An (O) 573

Thomas, J. E. Spinal Anaesthesia
and Chloroform : A Comparison

of Mortality 750

Thomas, R. C 554

Thompson, G. C. V.

And Chambers Chylangioma of
the Mesentery, with Report of a
Case, and a Brief Discussion of

Mesenteric Cysts (O) 210

Traumatic Arterio-Venous Aneu-
rysm of the Femoral Blood
Vessels (O) 104

Thornton, M. The Federal Medical

War Relief Fund 418

Thrombosis

In Infancy, Arterial Embolism and

(C.C.) 87

Septic, of the Cavernous Sinus
Treated with Penicillin 674

Thyreotoxicosis -
"Thio" Drugs in

By H. R. G. Poate and S. L.

Spencer

(O)

Treated with Thiouracil

Tibbetts, D. M

Tick Paralysis (C.C. )

Tick Typhus in North Queensland, A

Case of, by J. Brody (R)

Tidy, H. .

750
493
27
707
339

511
341
810
337

Tigerstedt

Times, The

Tissues of the Body, The : An Intro
duction to the Study of Anatomy,
by W. E. Le Gros Clark (rev.) 479

Tivey, E. A 58, 59, 59S

Tobias, C. A 483

Tomb, J. Walker Renal Failure and

Anoxia 63

Tonge, J. 1 234

Tonsils and Adenoids, A Method for
the Removal of, under Local
Anaesthesia with the Patient in
the Recumbent Position, by R.
H. Bettington (O) 882

Toothache and Folk-Lore

By I . G. Dane 275

(C.C.) 54

Toowoomba and Environs, The
Botany of, and its Relation to
Clinical Allergy of the Upper
Respiratory Tract, by C. R.
Atorton (O) 585

Torrents, E 446

Tostevin, A. L., and Swan Congenital
Abnormalities in Infants follow
ing Infectious Diseases during
Pregnancy, with Special Refer
ence to Rubella : A Third Series
of Cases (O) 645

Toxicology, Medical Jurisprudence

and, by J. Glaister (rev.) 480

Toxoplasmic Encephalomyelitis and

Chorioretinitis 674

Trail, R. R 778

(Chest Examination : The Correla
tion of Physical and X-Ray
Findings in Diseases of the Lung,
with a foreword by W. L.
Langdon-Brown) (rev.) 703

Training

Medical, The Adequacy of

By K. J. B. Davis 275

By B. "Williams (O) 147

Prior to Discharge, The. of Certain
Medical Officers 30, 240

Transposition of Viscera 129

Trauma, Cerebral, and its Mechan
isms (Leading Article) 885

Travel, Overseas, for Australian

Students (Leading Article) .... 191

Treatment, Physical, by Movement,
Manipulation and Massage, by
J. B. Mennell (rev.) 444

Trigeminal Neuralgia

Ry F. J. Clark 895

By A. Lyons 750

Page
Trigger Thumb, Bilateral, in Infants,

by T. F. Rose (R) 18

Trikojus, V 779

Trocar and Cannula, A, for the
Intravenous Administration of
Fluids, by R. V. Pratt (O) ... 629

True, E 196, 203

Truman, President 301

Trumble, H. C 817

Tsutsugamushi Disease, A W T arning,

by J. T. Gunther 419

Tuberculin Patch Test, The: A Com
parison with the Mantoux Test,
by Catherine Hudson and F. E.
Hytten (O) 475

Tuberculosis

Manual of, A, Clinical and Ad
ministrative, by E. A. Under
wood, with an introduction by
J. R. Currie (rev.) 630

Pulmonary

Early, The Problem of (C.C.) .. 778
Some Xotes on the Treatment of,

by C. J. Officer Brown (O) . . 825
Treated by Artificial Pneumo-

thorax 378

Tuberculosis Patients and Hospitals

By A. H. Penington ._ 237

By D. B. Pitt ". 30

Tuberculous Sinuses 378

Tumour

Breast, Latent Primary, by T. R.

Gaha (R) 590

Of Bone 890

Of the Axilla 854

Possibly Cerebral : Organic Brain

Disease 309

Wilms s 379

Tumours of the Central Nervous
System, Early Diagnosis in, by

W. Lister Reid (O) 865

Tunbridge, E. B 927

Turbulent Flow, Murmurs from

(C.C.) 339

Turnbull, H. Inguinal Hernia and

its Repair (O) 109

Turner, E. K. Purulent Meningitis
of Infancy and Childhood : A
Twelve Months Survey of the
Results of Treatment by Peni
cillin (O) 14

Typhoid and Salmonella Infections,

Thoracic Complications of (C.C.) 555

Typhus
Scrub

Studies in the Control of, by

R. N. McCulloch (O) 717

Use, The, of a Polysaccharide
of Bacillus Proteus OXK in
the Diagnosis of, by P. de

Burgh (O) 81

Tick, in North Queensland, A Case
of, by J. Brody (R) 511

U
Ulcer

Peptic, Duodenal and Jejunal :
Technic of Resection, by R.
Nissen, with a foreword by O.

H. Wangensteen (rev.) 189

Problem, The (C.C.) 632

Ulceration, Peptic

Duodenal and Jejunai: Technic of
Resection, by R. Nissen, with a
Foreword by O. H. Wangensteen

(rev.) 189

Saliva Factor in, The, by L. J. J.

Nye (O) 114

Ulcers in the Mouth : An Appeal for
Help-
By A. Bulteau 418

By L. Hewitt 418

By B. Hiller 490

By "M.B., B.S." 274

By F. F. McMahon 715

By E. M. Murphy 534

By I. Roxon-Ropschitz 382

Underwood, E. A. (A Manual of
Tuberculosis, Clinical and Ad
ministrative, with an introduc
tion by J. R. Currie) (rev.) .... 630
Unemployment and Sickness Benefits

Act, 1944, The 565

United States of America

Discussions on Health Legislation

in the (Leading Article) 301

Recent Experiences in Canada and

the. by H. M. James (O) 827

University Intelligence University of
Melbourne : Nuffleld Medical "En
dowment 895

XX11

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

VOL. I, 1946.

Page

University of Queensland 127

University of Queensland Post-
Graduate Medical Education
Committee (sec Post-Graduate
Work)
University of Sydney

And Scientists : Australia and
Science

By A. J. Canny 381

By N. E. Golds-worthy 346

By D. K. Moore 418

By P. W. Simpson 417

(Leading Article) 249

Chair of Child Health at the 601

Ureters, Bilateral Transplantation of
the, Carcinoma of the Bladder

with 379

Urethral Discharges. Non-Gonococcal,
Chronic Vesiculitis as a Factor
in the Production of, by C. E.

Marshall (O) 846

Urethritis, Non-Gonococcal

In Australian Troops Stationed in

Borneo, by S. Williams (O) . . 693
In Man, Pleuropneumonia-Like
Organisms in Cases of, and in
Normal Female Genitalia, by W.
I. B. Beveridge, A. D. Campbell

and P. E. Lind (O) 179

Urology, The 1945 Year Book of, by

O. S. Lowsley (rev.) 776

van der Heide, C 811

Van Someren, George Arbuthnot,

Death of 716

Vascular Diseases and their Relation
ship to the Eye 674

Vaux, N. W 408

Venereal Disease, Handbook of Diag
nosis and Treatment of, by A.

E. W. McLachlan (rev.) 336

Ventriculitis, Meningitis and, Staphy-
lococcal : Cure by Penicillin, by
D. Miller and H. J. Delohery (R) 512
Vesiculitis, Chronic, as a Factor in
the Production of Non-Gonococcal
Urethral Discharges, by C. E.

Marshall (O) 846

Vickers, T. H. Research at the

Kanematsu Institute 642

Vickers, Wilfred, Death of 384

Vickery, D. G. R 854

Vincent, G. K., and Bettington
Report on a Series of Cases of
Sinusitis Treated by Chemo
therapy at an Australian General

Hospital (O) 358

Virilism, Adrenal 379

Virus

As Organism : Evolutionary and
Ecological Aspects of Some
Human Virus Diseases, by F. M.

Burnet (rev.) 372

Of Newcastle Disease of Fowls.
The, A Note on Two Laboratory
Infections with, by S. G. Ander
son (R) 371

Viswanathan, R 55

Vitamin C (Ascorbic Acid) in Kera-

titis 675

Vitamins

Availability of, The, in Various
Foods and Pharmaceutical Pro
ducts (C.C.) 410

In Medicine, The, by F. Bicknell

and F. Prescott (rev.) 552

Parenteral Use of, The (Leading
Article) 667

Volkmann s Ischaemic Contracture of

the Forearm, by L. Ball (R) . . 224

Volvulus of the Small Bowel, with
Report of a Case Treated by
Resection with Recovery, by D.
M. Embelton and P. Jones " (O) 144

von Ries, J. . 595

Waddy, R. G 674

Wagner, J. G 127, 129

Address, An The Post- War Re
habilitation of Science (O) .... 97

Wagner, Senator 302

Wait, L 61, 92, 93, 451

Wakefield, E. G .303

Wakeley, C. P. O .190

Walch, J. H. B 9fi

Walsh, R. J.

And Sewell Some Effects of Blood

Loss on Healthy Males (O) .... 73
Immune Anti-M Iso-Agglutinin,
An, in Human Serum (R) 115

Page
Walshe, F. M. R. (Diseases of the

Nervous System) (rev.) 52

Recovery (R) 439

Waltz, A. D 742

Wangensteen, O. H 189, 633

War

And Humanism, by A. G. Butler . 165
Germany during the, Medical Edu
cation and Medical Practice in

(C.C.) 923

Madical Aspects of Red Cross in
the Second World The Sir
Richard Stawell Oration, by J.

Newman Morris (O) 169

Of 1039-1945, The Medical History

of the (C.C.) ~. 633

War Neuroses, by R. R. Grinker and

J. P. Spiegel (rev.) 630

War Neurotics, The Rehabilitation of 926

By C. M. McCarthy (O) 910

By H. H. Willis (O) 912

Warfare, Psychiatric Aspects of

Mod3rn, by R. S. Ellery (rev.) 189

Warren, S 671

\Vartenberg, R. (The Examination of
Reflexes : A Simplification, fore
word by F. Kennedy) (rev.) .. 84

Wasserman, L. R 743

Waters, C. A 666

Watson, D., Rose and Newson Early
Results in a Short Series of
Cases of Gunshot Wounds of the

Abdomen (O) 180

Watson, H. Preston 58

Webster, R 163,636,641,710

Weil, A. (Textbook of Neuropath-

ology) (rev.) . ... 299

Weinberg, J 811

Wenner, R 595

Wesley, C. H 854

West, R. F. K., and Mackerras,

D.D.T. Poisoning in Man (R) . . 400
West s Operation (Endonasal Dacryo-
cystostomy), Some Notes on, by
G. A. D. McArthur (O) .... . 508
Whayne, T. F., et alii (Global Epi
demiology : A Geography of
Disease and Sanitation) (rev.) 591
Wheildon, A., and Hutchings Post-
Abortional Tetanus with Re
covery (R) 404

Whitaker, J. G 129, 162, 163,

450, 487, 891, 929
White, C. On the Prickly Heat . . 382

White, M. L 555

White, M. M. (The Symptomatic
Diagnosis and Treatment of
Gynaecological Disorders, with a
foreword by F. J. Browne) (rev.) 704
White, O. (Green Armour) (note) . . 516
White Paper on Health Service in

Great Britain 524

Whooping-Cough, Penicillin in the
Laboratory Diagnosis of, A Note
on the Use of, by P. M. Ander
son (O) 244

Widdowson, E. W 303

Wilkinson, William Camac, Death of

204, 488

Willcocks, G. C 230

Williams, B 926

Adequacy of Medical Training. The

(O) 147

Williams, D 674

Williams, L. H., and Bourne (Recent
Advances in Obstetrics and

Gynaecology) (rev.) 299

Williams, S. Non-Gonococcal Ure
thritis in Australian Troops

Stationed in Borneo (O) 693

Willink, Mr 741

Willis, H. H 926,927

Rehabilitation, The, of War Neu
rotics (O) 912

Willius, F. A 886

Wilms s Tumour 379

Wilson, A. M 530, 533

The R. H. Fetherston Memorial

Lecture (O) : . 1

Wilson, C. W 521

Wilson, H., North and Anderson
Resistance, The, of Heemophilus
Influenzae to the Action of Peni
cillin, with Special Reference to

Type B Strains (O) 626

Treatment, The, of Haemophilus
Influenzae Meningitis with Sul-
phonamides in Conjunction with
Haemophilus Influenzae, Type B,
Rabbit Antiserum (O) 215

Wilson, James Thomas

Death of 31

Memorial, A, to the Late 348

Memorial, A, to the Late Professor 384

Page

Wilson, T. E 555

And Cobley Report of a Case of

Salmonella Blegdam Septicaemia

and Suppurative Pericarditis with

Plasma Protein Estimations in

Battle Casualties (O) 153

Winikoff, D 923

Ascorbic Acid in the Milk of Mel
bourne Women (O) 205

Winkle, W. J., et alii 851

Wittwer, S. H 922, 923

Wolf, G. A., junior 23

Wolff, H. G 23

Wolkin, J 53

Women

In Medicine (Leading Article) . 849
Psychology of, The : A Psycho
analytic Interpretation, by H.
Deutsch, with a foreword by S.

Cobb (rev.) 300

Women s Hospital, Melbourne, Obstet
rical Society of the 196, 530

Woodland, L. J 26

Woodruff, M. F. A., and Sampimon
Some Observations Concerning
the Use of Hypnosis as a Sub
stitute for Anaesthesia (O) ... 393
Woods, E. F., Graydon and Simmons
Blood Group Frequencies in Hol
landers (O) . . . ., 576

Further Observations on the Rh
and Hr Factors, and the Blood
Group Frequencies in Papuans

(O) 537

Woodward, H. L., Gardner et alii
(Obstetric Management and

Nurssing) (rev.) 703

Words, Acceptable : Quotations with
a Medical Bearing, by J. B.

Cleland (O) 876

Wound, Gunshot, of the Large and
Small Intestines, A Case of, by

D. R. Leslie (R) 406

Wounds

Caused by Small Fish, by H.

Flecker 534

Gunshot

Of the Abdomen, Early Results
in a Short Series of Cases of,
by T. F. Rose, A. Newson and

D. Watson (O) ISO

Of the Chest, Treatment of, in
the Field Aided by Penicillin
Therapy

By P. Braithwaite 418

By T. F. Rose and A.

Newson (O) 290

Compound Fractures of the Ex
tremities due to : The Early
Results of Treatment in the
Field Aided by Penicillin
Therapy, by T. F. Rose and

A. Newson (O) 330

Of Limb Joints, Early Results
of the Treatment of, Aided by
Penicillin Therapy, by T. F.
Rose and A. Newson (O) .... 75
Head, Transient Disturbances fol
lowing (C.C.) 706

War, Deep Soft Tissue, Suture of,
Aided by Penicillin Therapy, by
T. F. Rose and A. Newson (O) 364

Wright. L. E. A 631

Wright-Smith. Redford John, Death

of 931

Wynn, A 533

X-Ray Diagnosis, Pediatric : A Text
book for Students and Prac
titioners of Pediatrics, Surgery
and Radiology, by J. Caffey
(rev.) 807

X-Ray Films, The Placing of, in

Envelopes, by D. Anderson 930

X-Ray Services in North Coast

Towns of New South Wales .... 601

X Rays, The Fiftieth Anniversary of
the Discovery of, by C. E. Eddy
(O) " 138

Yaws and Beriberi : A Warning, by

C. M. Deland 676

Year Book, The 1945

Of General Medicine, edited by G.

F. Dick et alii (rev.) 920

Of General Surgery, edited by E.

A. Graham (rev.) 883

Of Neurology, Psychiatry and

Endocrinology, edited by H. H.

Reese et nlii (rev.) 919

VOL. I, 1946.

INDEX TO THE MEDICAL JOURNAL OF AUSTRALIA.

XXlll

Page
Year Book Continued.

Of Obstetrics and Gynecology,

edited by J. I . Greenhill (rev.) 884
Of Radiology ; Diagnosis : edited by
C. A. Waters, associate editor,
W B. Piror ; Therapeutics :
edited by I. L. Kaplan (rev.) . . GGG
Of Urology, by O. S. Lowsley (rev.) 770

Page

Yeates, J. M. Services Medical
Officers Association of New
South Wales 785

Young, J. H. Recent Advances in the
Diagnosis and Treatment of
Lumbar Intervertebral Disk

Disease 382

(O) 45

Page

743

Zamecnik, P. C

707

Ziegler E E

707

Kiillintrj r. R. M.

. 923

INDEX TO ILLUSTRATIONS.

Page

Ascorbic Acid in the Milk of Mel
bourne Women, by D. Winikpff . 203

Aspinall, Andrew Eric and Archibald

John 238

Blankets, Hospital, as a Source of
Infection, by 1 . M. Rountree and
J. E. Armytage 503

Cresarean Section, Blood Loss in, by

L. Benson 842

Chylangioma of the Mesentery, with
Report of a Case, and a Brief
Discussion of Mesenteric Cysts,
by G. C. V. Thompson and C. H.
Chambers 210

Coeliac Disease : A Survey from the
Children s Hospital, Melbourne,
by G. E. M. Scott 659

Deformities among Recruits, An
Analysis of, with Remarks on
Sub-Standard Types, by W. E.
Roberts 360

Diabetes Mellitus, A Case of, with
Hyperlipaemia and Hypercholes-
terolaemia, by A. M. Henderson 513

Disk Disease, Lumbar Intervertebral,
Recent Advances in the Diag
nosis and Treatment of, by J. H.
Young 45

Enteric Fever due to Bacterium
Enteritidis Var. Blegdam (Sal
monella Blegdam) : A Series of
Fifty Cases in Australian
Soldiers from New Guinea, by
F. Fenner and A. V. Jackson . . 313

Fibrocystic Disease, Congenital, of

the Pancreas, by P. E. Blaubaum 833

Foreign Bodies, Unknown, in the

Lung, by J. B. Cleland 225

Gunblast, Experimental Observations
on the Aural Effects of, by N. E.
Murray and G. Reid 611

Hardie, David 95

Hookworm Disease in Australian
Soldiers, with Reports of Cases,
by C. B. Sangster 385

Human Body after Death, The Study

of the, by K. Inglis 222

Page

Hydrophobia, A Case of So-Called :
A Matter of Diagnosis, by W. E.
L. H. Crowther 69

Leprosy, A Report of Nine Cases
among Natives of the Mount
Hagen Area in New Guinea, by
N. Shlimovitz 3G9

Lipomata of the Uterus, with Report

of a Case, by J. D. Hicks 184

Lymphangioendothelioma, Abdominal,
or Peritonea! Mesothelioma, A
Case of, by I. Hamilton and J.
B. Cleland 477

Masculinization, A Contribution to
the Problem of, by H. F.
Bettinger and H. Jacobs 10

Meningitis, Purulent, of Infancy and
Childhood : A Twelve Months
Survey of the Results of Treat
ment by Penicillin, by E. K.
Turner 14

Moran, Herbert Michael 415

Moulds in the Lungs, by J. B.

Cleland 247

Penicillin Therapy for Tendon Sheath
Infections of the Hand, by J. A.
Marsden 435

Periarteritis (Polyarteritis) Nodosa,

A Case of, by J. Game 295

I igdon, Douglas Clelland 452

Poliomyelitis, An Epidemic of, Occur
ring among Troops in the Middle
East, by J. E. Caughey and W.
M. Porteous 5

Prisoner of War Hospitals in the Far
East (Burma and Siam), Clinical
Lessons from, by A. E. Coates 753

Prisoner of War Hospitals in the Far
East, Clinical Lessons from, by
E. E. Dunlop 761

Prisoner of War in Malaya and Thai
land, Observations by a Path
ologist during Three and a Half
Years as a, by A. T. H. Marsden 76 G

Psychotic Ex-Servicemen, Some Re
marks on, by A. T. Edwards . . 738

Page

Salmonella Blegdam Septicaemia and
Suppurative Pericarditis with
Recovery, Report of a Case of,
by J. F. C. C. Cobley and T. E.
Wilson 439

Sciatica

By R. A. Money 37

Some Further Observations on, by
N. Little 33

Spondylitis Ankylopoietica, by L. J.

A. Parr and E. Shipton 277

Spondylolisthesis, A Radiographic

Analysis of, by I. Meschan .... 4G5

Stricture, Congenital, of the GBso-

phagus, by R. Flynn 702

"Thio" Drugs in Thyreotoxicosis, by

H. R. G. Poate and S. L. Spencer 493

Trocar and Cannula, A, for the Intra
venous Administration of Fluids,
by R. V. Pratt 629

Tumour, Latent Primary Breast, by

T. R. Gaha 590

Typhus, Scrub, Studies in the Control

of, by R. N. McCulloch 717

Volkmann s Ischsemic Contracture of

the Forearm, by L. Ball 224

Wilkinson, William Camac 488

X Rays, The Fiftieth Anniversary of

the Discovery of, by C. E. Eddy 138

SPECIAL PLATES.

Chromoblastomycosis, with Reports
of Two Cases Occurring in
Queensland, by W. J. Saxton,
F. Hatcher and E. H. Derrick

facing page 696

Encephalitis, Post-Varicellal, A Case
of, Showing Bilateral Softening
of the Neostriatum and Terminal
"Tetanoid Chorea" (Gowers), by
C. Swan facing page 697

Stricture, Congenital, of the CEso-

phagus, by R. Flynn, facing page 702

Reglttertd at the G.P.O., Sydney, for Transmission by Post as a Newspaper. Published Weekly. Price 1s.

THE

MEDICAL Km JOURNAL

OF AUSTRALIA

VOL. I. 33RD YEAR. SYDNEY, SATURDAY, JANUARY 26, 1946. No. 4.

COMMONWEALTH OF AUSTRALIA. DEPARTMENT OF HEALTH.

PENICILLIN

COMMONWEALTH

PENICILLIN "COMMONWEALTH" (THE CALCIUM SALT OF PENICILLIN)
IS AVAILABLE IN THE FOLLOWING SIZES AT THE PRICES SHOWN

1 ampoule containing 100,000 Oxford units 10/6

This quantity i sufficient for a series of parenteral doe.
(Available also in boxes holding 5 ampoules.)

1 ampoule containing 15,000 Oxford units 5/6

This quantity is intended for a single parenteral done.
(Available also in boxes holding 6 ampoules.)

1 ampoule containing 5,000 Oxford units 4/6

This quantity is intended primarily for dilution and local application, but may be used

for parenteral injection if desired.
(Available also in boxes holding 6 ampoules.)

The Medical Profession is notified that the Control of Penicillin Order, promulgated in the Commonwealth of
Australia Gazette, No. 85, of 3rd May, 1944, has been revoked.

The Penicillin Order published in Gaeotte No. 189 of 20th September, 1944, and in THB MBDICAL JOUKHAL ov
AUSTRALIA of 30th September, 1944, relaxes the conditions under which Penicillin may be supplied for the treatment
of members of the civilian population.

To obtain Penicillin a Medical Practitioner must apply in the form of certificate set out in the Order to the Senior
Commonwealth Medical Officer in the State concerned. The signature of a colleagrue is no longer required.

The addresses of the Senior Commonwealth Medical Officers are: NEW SOUTH WALES, Customs House,
Circular Quay, Sydney; VICTORIA, A.C.A. Building, 118 Queen Street, Melbourne; SOUTH AUSTRALIA,
C.M.L. Building, 41-47 King William Street, Adelaide; WESTERN AUSTRALIA, 4th Floor, G.P.O., Perth;
TASMANIA, Commonwealth Health Laboratory, Launceston; QUEENSLAND, Anzac Square, Adelaide Street.
Brisbane.

COMMONWEALTH SERUM LABORATORIES

PARKVILLE, N.2, VICTORIA, AUSTRALIA

THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER. JANUARY 26, 1946.

ANDREW S PHARMACEUTICAL PREPARATIONS

TUBERCULIN PATCH TEST

(Vollmer) L e d e r I e

ANDREW S LABORATORIES presents a simple and convenient
device to the Australian Medical Profession in introducing and
distributing the

TUBERCULIN PATCH TEST (Vollmer) Lederle

It represents a reliable, safe and painless test, in a stable form
which avoids the use of needles or any instrument, saves time,
as it may be applied by a nurse acting under the direction of
a physician. The VOLLMER PATCH TEST is a valuable
method for use in any public health campaign. It is of
particular value for testing

infants and pre-school age children

The test is made by the application of a strip of adhesive tape
(with tuberculin-treated squares) to the skin, showing a
reaction on removal of the tape after 48 hours.

Further instructions are given in the leaflet attached to each
packing distributed by our Laboratories.

ANDREW S LABORATORIES, SYDNEY

MANUFACTURERS OF DRUGS AND FINE CHEMICALS

LACTOGEN AND VI-LACTOGEN . . . and why they
are the most easily digested of all prepared foods for infants

When our research laboratories were developing the
new Spray Process Lactogen and Vi-Lactogen, they
thought and worked with the single purpose of making
them the best of all prepared foods for infants.
Specifically, the important advan
tages gained by adopting the exclu
sive Spray Process of manufacture

1. Forms a softer, finer curd, more
easily assimilated by baby s
delicate stomach.

2. The soft, finely divided Lactogen
and Vi-Lactogen curd is far more
readily digestible.

3. Fat separation is avoided during
feeding.

Photograph shows fine, uniform texture of Lactogen
curd.

Based on the scientific fact that all milk, in the process
of digestion, forms a curd, and that the ease or

difficulty of digestion is dependent upon the size and
toughness of the curd formed, the ultimate aim of our
laboratories was to produce a baby food that -would form
the softest and finest of curds, and at the same time,
retain the full nourishing qualities necessary to baby s
growth and development. Lactogen and Vi-Lactogen,
made by the new exclusive Spray Process, forms a
softer, finer curd of uniform texture, making them the
easiest of all prepared foods for infants to digest. In
addition, both foods are modified with added cream
and lactose so that baby can quickly assimilate all the
nutritive goodness. Whether used as supplementary
to, or wholly as a substitute for, breast milk, Lactogen
and Vi-Lactogen can be recommended as safe, alterna
tive foods of the highest quality. Vi-Lactogen . . .
modified more closely to breast milk composition, is
intended for the young baby. Lacto
gen, -with its higher protein content,
is the ideal food as baby grows older.

LACTOGEN

AND

VI-LACTOGEN

Nestle s Product

THE MEDICAL JOURNAL OF AUSTRALIA

VOL. I. 33itD YEAR.

SYDNEY, SATTKDAY, JANUARY 26, 1946.

No. 4.

Table of Contents.

[The Whole of the Literary Matter in THE MEDICAL JOURNAL OF AUSTRALIA is Copyright.]

ORIGINAL ARTICLES-

An Address The

Page.
Post-War Rehabilitation of

Science, by J. G. Wagner, B.Sc., M.B., Ch.M. . . 97
A Sociological Study of the Aborigines in the

Northern Territory and their Eye Diseases, by

Michael Schneider 99

Traumatic Arterio-Venous Aneurysm of the

Femoral Blood Vessels, by George C. V.

Thompson, F.R.C.S 104

Putrid Lung Abscess, by C. J. Officer Brown . . . . 107
Inguinal Hernia and its Repair, by Harley Turnbull 109
The Saliva Factor in Peptic Ulceration, by L,. J. J.

Nye 114

REPORTS OF CASES

An Immune Anti-M Iso-Agglutinin in Human

Serum, by R. J. Walsh 115

NOTES ON BOOKS, CURRENT JOURNALS AND NEW
APPLIANCES

The Commodore 116

LEADING ARTICLES

The Retirement of Surgeon Captain W. J. Carr
The Journal and the Recent Industrial Unrest

CURRENT COMMENT

The Results of Prefrontal Leuchotomy
Post-War Germany: A Psychiatric Problem . .

ABSTRACTS FROM MEDICAL LITERATURE

Physiology

Biochemistry

118

120
121

BRITISH MEDICAL ASSOCIATION NEWS Pago.
Annual Meeting 122

MEDICAL SOCIETIES

Melbourne Paediatric Society 129

THE ROYAL AUSTRALASIAN COLLEGE OF
SURGEONS

A Post-Graduate Course in Surgery . .
Meetings of the Courts of Examiners

130
130

THE ROYAL COLLEGE OF OBSTETRICIANS AND
GYNAECOLOGISTS

Examination for Membership 131

POST-GRADUATE "WORK

Courses in Queensland in 1946 131

CORRESPONDENCE

The Use and Misuse of Tetanus Antitoxin . .
Functional Disorders

. . 131
131

NAVAL, MILITARY AND AIR FORCE

Appointments 132

OBITUARY

James Whitson Keinp Bruce 132

\ DIARY FOR THE MONTH 132

I MEDICAL APPOINTMENTS: IMPORTANT NOTICE .. 132

EDITORIAL NOTICES . 132

THE POST-WAR REHABILITATION OF SCIENCE.

By J. G. WAGNER, B.Sc., M.B., Ch.M.,

President of the Queensland Branch of the British
Medical Association.

THE year 1945 will be entered in the annals of world
history as that which marked the fall of the tyranny of
the Axis, and the victory of the United Nations as
champions of democracy, over the evil powers of their
enemies. No one who witnessed the exuberant and spon
taneous joy of "V.P." day and compared it with the
restrained celebration of "V.E." day a few months earlier,
could doubt that the attainment of victory and the restora
tion ef peace had long been the earnest hope of all our
people. And though the present universal turmoil appears
to deny the world s aspirations towards freedom, yet in
itself it is an expression of the freedom that has been
restored, even though the celebrations savour too strongly
of the time-honoured folly of cutting off one s nose to spite
one s face. Even if at present the omens are unpropitious,
the building of a structure that will place war outside the
pale of civilization and allow mankind to devote its energies
to the proper pursuit of the arts of peace, must surely
be one of man s noblest aims, to be pursued equally by
all peoples. There still remain enemies to be conquered,
enemies whose conquest will require all man s skill and
knowledge and energy. These enemies are poverty and
ignorance, crime and disease.

Even more than its predecessor, World War II has been
remarkable for the use made by the belligerent nations

1 Read at the annual meeting of the Queensland Branch of
the British Medical Association on December 14, 1945.

of available scientific knowledge, and the development of
scientific research to provide new methods for the
prosecution of the war in all its aspects. The range of
this activity is so vast that oae person could hardly be
familiar with more than a .small portion of it. When we
think of such things as magnetic mines, "degaussing",
"radar", jet propulsion of aeroplanes, improvement of
fuels for internal combustion, synthetic rubber, tanks,
landing craft, bulldozers, camouflage, bombsights, "Fido",
"Pluto" and a thousand and one things culminating in the
development of the atomic bomb, we begin to realize how
far the application of science to war has proceeded in
these fields. In the domain of medicine we are more
familiar with the developments that have taken place.
The use of sulphonamides and of penicillin in the treatment
of wounds and illness, the modern treatment of shock, the
application of blood transfusion, the control of malaria,
to quote but a few these are stories whose romance is
well known to us.

That the application of science to war has been
reasonably effective is all the more remarkable when
it is remembered that we have not yet completely shaken
off the domination of ignorance amongst men in high
military and political command. There is cause for
thankfulness that the bad old days of the Crimean and
South African campaigns are almost entirely gone. How
otherwise could our troops have survived in New Guinea
and Borneo? No tribute can be too great to the efficiency
and devotion of the medical services in these areas, and to
the enlightened leadership which allowed them to function.
Nevertheless, it happens only too frequently that the
scientific expert who knows how to perform a particular
task is frustrated by a higher authority, fully charged
with ignorance and its concomitant inferiority complex.
For example, in World War I, although the importation
of fruit had been recommended as essential by the scientific
advisers to the British Board of Trade, the British Govern
ment showed clearly that it had not learnt the lessons in

THK MEDICAL JOURNAL OF AUSTRALIA.

.TANTAKY 26, 1946.

nutrition taught by Captain Cook in the eighteenth
century. In Germany at the same time the importance
of vitamins was not realized by government authorities,
and the population was stricken with deficiency diseases
and lowered morale on the home front, together with an
enormous increase in the incidence of tuberculosis. Such
instances could be multiplied a thousandfold.

But now the war is over. The time has come to beat
the swords of war into the ploughshares of peace. The
problems of rehabilitation are before us, involving the
reestablishment of men and women in useful civilian and
peace-time activity. No phase of this problem is more
important than the rehabilitation of science, by which I
mean the harnessing of all our scientific knowledge to
the problems of peace, and the enlargement of that
knowledge by intensive research. How, then, can we
achieve this objective? The answer is that it can be done
only by an intelligent appreciation by political leaders in
every country of the scope of science, in regard to both
the fullness of its knowledge and the shortcomings of its
ignorance which indicate the need for research. The
inevitable consequence of this state of mind would be
a determination to use science to the full for the better
ment of mankind without fear of political consequences.

In making this plea one must admit that already much
has been done; but in the field of medical science, and in
Australia, much remains to be done. For example, the
measures taken for the treatment of patients suffering
from tuberculosis on the one hand, and for the eradication
of tuberculosis from the community on the other, would
be no credit to a prehistoric civilization which could not
be expected to know any better. It is true that in
Brisbane a sanatorium will shortly be built, and this is
a step in the right direction. At present the compulsory
notification of tuberculosis as an infectious disease has
no value except from a statistical point of view. Surely
the role of a government in this matter is to obtain the
advice of its experts and to follow that advice to provide
facilities for a survey of the population, for accurate
diagnosis, for adequate treatment, and above all for main
tenance of the sufferer and his dependants as long as is
necessary. In the matter of prevention, why should the
infective patient not be isolated? How incongruous to
allow an infective patient to broadcast tubercle bacilli
throughout the community when the leprosy patient is
compelled to submit to strict isolation! Surely it is just
as culpable to allow tuberculous milk to be distributed,
when we know how to prevent this risk. The presence
of arsenic in fruit and vegetables rightly is a mutter for
strict and constant supervision; the danger of the tubercle
bacillus in milk demands equal vigilance.

In many parts of Australia, mosquitoes cause consider
able discomfort and ill-health. Filarial infection is more
widespread than is generally realized, dengue epidemics are
familiar to all of us, malaria is common in the north and
occurs in non-tropical areas. Some day we may have to
grapple with yellow fever. It is years now since the town
of Toowoomba was persuaded to undertake intensive
mosquito control and proved that such an idea was no more
than practical common sense; but progress in this respect
in other areas is still in its elementary stages. The amount
of money spent on mosquito nets, mosquito spirals and
sprays all more or less ineffective as far as the main
problem is concerned would go far towards the cost of a
thoroughly efficient mosquito control organization, and
increased industrial efficiency and decreased loss of work
and wages must also be regarded as an offset against the
cost. Here again we have failed to use our proved
knowledge to our immediate advantage.

Some day, perhaps soon, in this age of rapid transport,
smallpox will descend on Australian communities in whole
sale fashion. Outside that large number of discharged
service personnel who have had the boon of compulsory
vaccination, there is an enormous pool of susceptible popu
lation through which an epidemic of smallpox would rage
with devastating effect, and yet there is no public con
science in favour of compulsory vaccination for civilians.

The problem of venereal disease in the community is one
of major importance, and yet one in which a determined

effort in the application of known methods of prevention
and treatment would reduce the incidence to a minor
figure. It only requires public opinion and political leader
ship to decide firmly enough its policy in such a matter
to enable experts to carry out measures adequate for the
purpose.

In the matter of "quack" and patent medicine advertising,
untold harm is done to a long-suffering public by their
pathetic belief in the printed and spoken word. The impact
of the old familiar advertisement in the Press, and particu
larly of the newer blaring radio broadcast, is so powerful
that it is easy to understand its effect on gullible people.
But it is not so easy to understand why an intelligent
government, with skilled advisers to inform it, will allow
its citizens to be robbed in pocket and damaged in health
by the application of these confidence methods. In this
field there are signs of a movement towards better things.
I refer to the censorship established by the Australian
Press over medical advertising, and I have heard of the
banishment of worthless preparations from the Queensland
market by government activity. But much more remains
to be done before we can claim that we as a community are
using our knowledge for the public benefit.

Passing to the matter of research, we come to a field so
vast as to be intimidating; yet science need not be over
awed any more than General MacArthur was when faced
with the problem of the Pacific. Every giant has chinks in
his armour. The MacArthurs of science infallibly find them
and proceed to topple the monster. What is needed every
where is for governments to choose their MacArthurs and
Mountbattens, their Montgomery s and Eisenhowers, and
provide them with the means to carry out their campaigns.
This, of course, needs money, and as finance is alleged to
be the test of good government, criticism of apparently
wasteful expenditure will lead to the downfall of any
government, unless it can be shown that the money so
spent provides a direct benefit in hard cash for the
electors. The parliamentary candidate needs to be able to
show such concrete things as schools and bridges and
hospitals to say nothing of financial grants to this section
or that which have been provided by himself and his
party, and, moreover, he needs to be able to promise more
and bigger and better things for the future. And whilst
politicians and public give lip service to research in their
more expansive moments, she remains a Cinderella when
budgets are being framed.

I am aware that the British Government is making
extensive plans for research, that in Australia the National
Health and Medical Research Council and the Council for
Scientific and Industrial Research are well-grown strip
lings, and that the Queensland Medical Research Institute
is in its prenatal stage. All this is good; but in general,
ten times the amount of money proposed could be well
spent on scientific research and room would still be left
for more.

And while we are speaking about money, let us not forget
about men as the chief instruments of research. These are
no ordinary men. They conform to no regular pattern.
They are flowers of such rare blossom that it is wicked to
allow them to waste their sweetness. Yet here in Australia
we have examples of research men of proved merit con
demned to spend their days in useful routine work, when
all they need is the opportunity to go on with research
work already planned. Imagine Melba in the village choir!
Imagine Phar Lap in the plough!

Think of the research work to be done in medicine, and
do not forget the need for research in pure science, in
agriculture, in forestry, in engineering, and in almost every
sphere of human activity the gathering of knowledge and
its application for the benefit of mankind.

One field of research requiring development is that con
cerned with hours of work in industry. So far this has
always been a political matter; but the nation can no
longer afford it as a political plaything. For every human
activity there must be an optimum number of hours of
work per week, when regard is paid to the welfare of
the worker, the output of industry, the needs of the
public and every other pertinent factor. This is a question
that can and should be determined by scientific method.

JANUARY 26, 1946.

THE MEDICAL JOUttNAL OF AUSTRALIA.

In similar fashion the determination of the basic wage
lies within the province of the science of mathematics
rather than that of legal disputation. Basic needs in food,
clothing, housing et cetera are known factors, and together
make a total which, like a scientific law, is correct in all
circumstances and under all conditions.

There is a phrase that is frequently quoted to the effect
that the expert should be "on tap, but not on top". Such
a saying may be true when experts such as the water
diviner command high salaries in the departments by
which they are employed, and when their advice is pre
ferred to that of the trained and experienced geologist,
or in the medical field when addle-pated and psychopathic
pseudo-experts are placed in charge of important activities
for which they are utterly unfitted. Appointments such as
these arise because the true expert is on tap, but not on top.
If we have to wait until general public opinion is
sufficiently well informed in matters of this kind, many
generations will have lived and died before the community
gets the benefit of that scientific knowledge which is at
present available to us.

We have an example of this attitude in the persistent
refusal in Queensland to appoint as members of hospital
boards doctors and nurses who may well be regarded as
experts in hospital affairs and in matters relating to the
care of the sick. I do not hold that hospital boards
should be composed entirely of doctors and nurses
(although such a plan might well be an improvement on
the present set-up); in my opinion the composition of a
hospital board would be vastly improved, in the public
interest, by the appointment of doctors and nurses to it.
But these, being experts, are unfit to be on top, they must
merely be on tap. In these circumstances it is fortunate
that such expert advice as is on tap usually commands a
good hearing, though this is not always so. (I am
reminded of the story of the dominating husband, who pro
pounded to his wife an infallible formula for domestic
harmony; he agreed that she should have her way when
ever they were in agreement.)

In short, until such time as the conduct of human
activities with a scientific basis is placed in the hands of
men and women who by virtue of sound training and
experience fully understand the problems with which they
have to deal, we can expect nothing but retardation of
normal progress in the rehabilitation of science.

But to go further in this matter of direction of the
nation s activities, I submit that on the topmost rung of
national affairs, there is a lack of the necessary leaven of
science in the parliaments and cabinets of Commonwealth
and States. The absence of a scientific outlook at this
level is something that we can ill afford. We have little
enough to boast about in the general level of intelligence
quite apart from scientific training of those whom we
honour with the duty of representing us in our national
councils. The most that we appear to achieve is a group
of people who, by virtue of greater or less experience, and
by association with their subordinate technical advisers,
blossom forth as experts in their own right, and begin to
rush in with their own expert opinions where their sub
ordinates have feared to tread. So it happens that men
and women of science for all practical purposes are dis
franchised, since their influence as electors is nil, their
influence as technical advisers is minimal, and their
influence in parliaments and cabinets is infinitesimal.

The responsibility for this state of affairs lies heavily on
scientists themselves. It is their public duty to take an
active interest in politics, to make themselves available as
political candidates, however much they may shrink from
the hurly-burly and from other sacrifiices entailed.

Thirty-three years have elapsed since the University of
Queensland produced its first graduates, who now have j
attained some degree of maturity. How far have they been j
able to influence the public life of Queensland? On the
face of it, very little. Yet it would be saddening to think ;
that their unseen influence in the community had not been !
a source of great benefit. This, however, is not enough. |
We cannot expect intelligent government until a sufficient j
number of intelligent, well-trained men and women apply ,

their faculties to the problems of government. We cannot
expect a scientific outlook on scientific problems where
there is no scientific training, and without these conditions
no government can use science for the benefit of the
governed to its fullest capacity.

Democracy has triumphed; let it go forward hand in
hand with science towards a greater future for mankind.

A SOCIOLOGICAL STUDY OF THE ABORIGINES IN

THE NORTHERN TERRITORY AND THEIR

EYE DISEASES.

By MICHAEL SCHNEIDER,
Major, Australian Army Medical Corps.

The Sociological and Psychological Background.
DISTRIBUTED over an area of about 500.000 square miles,
comprising the Northern Territory, are some 15,000 full-
blooded aborigines. A number estimated at about 6,000
and classified nomadic have had very little contact with,
and live outside of, European influence. Approximately
50% of these are to be found in Arnhem Land. Approxi
mately a further 6,000 live in supervised camps, and the
remaining 3,000 or thereabouts are in regular employment.
The nomadic group live the way of their ancestors. Free
and fearless, they roam in their tribal country eking out
an existence on what can be gathered from the soil, the
plants and water, and by the chase. They have no know
ledge whatsoever of food production and conservation.
Those residing in supervised camps have become almost
entirely dependent on the white man for their existence.
At intervals a primitive urge to go "walkabout" compels
them to disappear into the trackless wastes and bush, and
to live the way of their ancestors. The third group,
classified as in regular employment, occupy a social position
somewhere between the nomadic and the supervised cainp
inhabitants. They are employed chiefly on cattle .stations
as cattle musterers, gardeners, goat herders, hewers of
wood and drawers of water. In return for their services
they are provided with a ration of flour, sugar, tea, tobacco,
a little beef, and a lot of offal. At times, which in the
northern areas correspond to the monsoonal wet season,
many station managers send them into the bush to live
in their primitive way, in country largely depleted of food
and game owing to the invasion of the white man s cattle.
Native habitations are never clean, and those connected
with cattle stations are extraordinarily filthy and squalid.
Some three or four feet high, constructed of any available
local material boughs, odd pieces of iron sheets, bags,
scraps of canvas, with the earth as a floor and the roof a
sloping extension of the walls they provide but slight pro
tection against the elements. Scraps of food lie on the
ground and adorn the forks of adjacent trees and shrubs or
the roof of the wurlie. Innumerable lean, flea-infested dogs
slink about uneasily. There is no pretence at sanitation,
and water may be in a distant stream or billabong. In
these surroundings the aborigines squat, or lie on dirty
blankets or canvas or on the ground. Clothing if worn
is never washed. In the dry areas flies are clustered
over scraps of food, refuse, dogs and human beings alike,
and add to the general misery.

In the nomadic state the natives move from one site
to another in their search for food, asd the elements
cleanse the vacated sites.

During the last six or seven decades, more and more
tribal hunting grounds have been alienated from the
aborigines and occupied by pastoralists. The consequent
competition between cattle and native animals has invari
ably led to a considerable reduction in the number of the
latter. Spearing of cattle is denied to the natives, and with
game becoming progressively more depleted, the erstwhile
possessors of the land have been compelled either to seek
help from the cattle station managers or to perish. This has
produced a gradual drift from the independent free nomadic

100

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY 26, 1946.

state to that of subservience to the white man. This drift
has been considerably accelerated during the war by the
army in its search for local labour.

As a nomad the aboriginal has a dignified bearing and
behaviour indicative of freedom and independence. Once
he has sold his birthright for a mess of potage by accepting
the white man s dole, his character changes completely.
His face betrays his servility and shame, and his eyes
reveal his fears and doubts. Some few aborigines can
adapt themselves to our world, but the vast majority
fail hopelessly. This failure cannot be entirely ascribed
to the white man s lack of interest, greed, intolerance
or fears. Many teachers have attempted to educate them
and missionaries to Christianize them, and at the present
time unionists wish to enlist them under the same wage
awards as white men.

It is the aboriginal himself who is unable to "make the
grade". Not only is he unable to adopt our mode of life,
but the mere attempt spells annihilation and extinction
for him. Separated from us by countless generations of
evolution, he has a simple, child-like mind which cannot
assimilate what we have to offer. His mind has developed
on an entirely different evolutionary scheme; it is a
scheme in which his environmental economy is all-
important. He has become a part of it. From his earliest
years all his activities, physical and mental, have been
related to it. The plants and trees, animals and birds,
the fish and streams and waterholes, the rocks and hills,
the clouds and rain, the wind, the stars, the sun and moon,
all are of the greatest significance to him, not only in his
sole practical avocation of food gathering, but still more
so in his totemic existence. Of much greater importance
to him than actual parents are his totemic forebears who
created these natural objects. These natural objects form
an integral part of his life and his conception of the
future world. They are the basis of his health and
happiness, his beliefs and his survival. He has struck a
balance with nature in the same manner as our unique
fauna and flora have done. When he is severed from this
association, his psychological make-up never recovers, his
joy and happiness disappear, his life becomes empty and
purposeless, and he declines and degenerates into a pitiable
outcast.

No matter how well-meant and willing our efforts, we
cannot obviate this decay. The native simply cannot bridge
the gulf separating his world from ours. This decay is not
obvious to him. He begins by adopting a passive attitude
to our world, and this is rapidly followed by indifference
to his personal welfare, to his survival, and to the survival
of his race. His lubra in consequence practises abortion
and infanticide, neither of which is countenanced in the
nomadic state, with perhaps the exception of multiple
births, in which case the environmental economy may exact
a relevant ruling. Furthermore, when he is in this stage
of decay he seeks the few small pleasures which he
associates with the white man flour, tea, tobacco, calico,
knives, hatchets and in some instances opium and alcohol.
He accepts the comparatively poor food doled out to him
and passively abandons the food, environment and social
structure more suited to his existence. Being incapable
of abstract thought, he cannot assess the comparative
advantages and defects of the two states.

The white man s attitude to his black employees can
be summed up by the statement that it is motivated by gain,
but is otherwise one of complete indifference. This applies
almost universally. Few cattle stations would be solvent
but for the cheap source of labour supplied by the natives.
All too frequently in return the native is not viewed as an
indispensable servant, but is despised and spurned, and
tolerated only if he is able-bodied and useful. This indict
ment must be modified in the case of many cattle owners
who support non-working dependants of their black
employees. Unfortunately, ill-advised legislation tends to
penalize employers who adopt this humane practice.

This, then, briefly outlines the sociological and psycho
logical background of the aboriginal in the Northern
Territory. The impressions thus penned were formed
during a sojourn of some twenty-one months in the area
with Australian general hospitals. It was during the

period when the Australian Army Medical Corps included
the aborigines in its care. Excursions were made to
various localities along the Stuart Highway (Alice Springs
to Darwin), to the large rivers Roper, Victoria, Daly,
Adelaide and Katherine. Natives were examined where
they were found, and in particular at the cattle, police and
mission stations, and at Army native camps; occasionally
also the roaming food-gatherer was examined.

Of the general diseases encountered very little will be
mentioned, apart from the enumeration of those most
commonly seen, with a note on their frequency rate. The
eye diseases were noted more carefully.

General Diseases.

Yaws.

Yaws or serologically allied disease (Cleland &lt;2) ), has
probably been with aborigines from time immemorial.
Its incidence is remarkably high.

In a series of 38 consecutive cases among adults examined
serologically in one month at an Australian general
hospital, the blood of 36 yielded the Kline reaction. Of
11 infants and children examined in the same series the
blood of two yielded the Kline reaction.

Leprosy.

Leprosy was introduced by Chinese indented labourers
towards the end of the last century (Cook &lt;3) ). There are
probably between 200 and 300 lepers amongst the northern
tribes distributed almost entirely in the coastal regions
(Kirkland&lt; 4) ).

Malaria.

Malaria may have been introduced to the Arnhem Land
coast by Macassars prior to its occupation by white men.
Matthew Flinders wrote of "ague" amongst the natives on
this coastline. Because of the absence of intertribal con
course it is highly improbable that the disease extended
inland. It was probably introduced into the area between
Darwin and Katherine by miners from New Guinea during
the mining boom at the latter end of last century and the
early part of the present century. Its incidence is not
high. Benign tertian malaria is endemic, and occasional
epidemics of malignant tertian malaria occur and are
associated with a high mortality rate.

Hookicorm.

In the higher rainfall areas north of the Roper River
it is assumed, owing to the frequency of eosinophilia, that
intestinal parasites must be common. Some 50% of subjects
with eosinophilia pass ova of hookworm in the faeces
(Andrews 09 ). The disease is highly endemic along the
coastline, around the northern coastal streams and in
adjoining islands. It leads to a greater degree of morbidity
and mortality than is generally realized. Apart from the
deaths more directly ascribed to the anaemic condition
itself, the profound secondary anaemia resulting from the
infection renders many subjects prone to certain inter-
current diseases, to which they succumb.

Tuberculosis.

Pulmonary tuberculosis is found in a moderate number
of cases fewer than one would expect in a people with
no knowledge of cleanliness and hygiene. Their outdoor
mode of life may be a modifying factor. Extvapulmonary
tuberculous infections are fairly common (Kirkland &lt;0) ).
This may be ascribed to the fact that bovine tuberculosis
is common amongst cattle in some parts of the Northern
Territory, and natives almost invariably eat their food
only partly cooked.

Eye Conditions.
The Conjunctiva.

One commonly finds collections of dark brown pigment in
the conjunctiva of the lids and bulbs of adults. They
tend to be localized into the larger accumulations in the
areas normally exposed when the eyes are open. The
caruncle and plica semilunaris sometimes share in this

.TAXI: Ait v L O, 194G.

THE MEDICAL JOURNAL OF AUSTRALIA.

lavish distribution of pigment. Because infants and
children are devoid of these collections of pigment, they
must be classified as acquired. Occasionally a complete
ring of pigment surrounds the cornea, usually but not
invariably separated by a space of about one millimetre
from the limbus. These rings are from 1-0 to 1-5 milli
metres in width.

The Iris.

The colour of the iris is always dark, varying between
chocolate-brown and almost black. Owing to lack of con
trast between iris and pupil, it is difficult to define the
pupillary edge in daylight.

The Fundus.

The fundi are almost invariably of a uniform slaty-
pink colour, and chorioidal vessels cannot be seen. By
contrast, the optic nerve head is apparently, but not
actually, paler than in Europeans. Rarely, the fundus
background is of a paler shade of pink or red resembling
the colour in European eyes.

Visual Acuity.

Tested with the Snellen illiterate chart, the visual acuity
as a whole approximates that of Europeans. Of a series
of 48 subjects taken at random, 33 had a visual acuity
of Ve in each eye, and four managed 6 /.v A further six
registered 8 / G in one eye, and the remaining five had a
visual acuity of less than % i n either eye. The impairment
of vision in these had resulted from trachomatous corneal
lesions. In the field, however, an aboriginal leaves us far
behind in perceptive powers. He recognizes objects at
many times the distance at which the white man can
recognize them, and his ability to recognize and follow
tracks and footprints leaves us bewildered. The extra
ordinary performances of black-trackers would be largely
discredited and classified as figments of fiction, but that
they are commonly accepted in legal practice. These feats
are not due to any advantage in visual acuity with which
the aboriginal is often credited, but are the result of
training and careful observation and of the accurate inter
pretation of natural phenomena so closely related to his
survival.

Refractive Errors.

Tests for errors of refraction were performed after
routine instillations of homatropine and cocaine (2%).
All eyes exempt from deep or extensive superficial corneal
disease were hypermetropic. The largest error discovered
was three diopters, and the majority varied between 0-25
and 1-5 diopters. Hypermetropic astigmatism varying
between 0-5 and 1-0 diopter was seen in about 30% of
subjects. In no instance was myopia found in an eye free
from corneal disease.

Lid Diseases.

Chalazion is not uncommon and chiefly affects young
adults. The incidence approximates that in whites.
Blepharitis and hordeolum, however, are rare.

Naso-lachrymal Duct.

Chronic dacryocystitis in association with old, active,
severe trachoma is not uncommon. In several instances
it had produced a diverticulum of the sac in the lower lid,
extending as far out as the external eanthus. In one
subject the distended sac readily held 2-5 cubic centimetres
of saline solution. No evidence of rupture through the
skin indicating acute dacrocystitis was found in any
subject.

Conjunctival Disease.

Pterygium is somewhat rare. In a series of 574 subjects
it was present in 17, and is therefore considerably less
common than in a similar number of whites residing in
the Northern Territory. It never encroaches more than
about two millimetres on the cornea.

Mucopurulent conjunctivitis is prevalent amongst
children, and is usually associated with profuse nasal

discharge and a tendency to bronchitis. The organisms
most commonly found on culture media were Koch-Weeks
bacilli and pneumococci.

No attempt at cleansing the conjunctival sacs is ever
made by the mother, and the discharge collects on the
lashes in hard, stiff pencils.

The Cornea.

Variations in diameter of the cornea are similar to
those in European eyes. Arcus senilis is not uncommon
in the elderly. Owing to their outdoor life in thick high
grass and bush, the natives in the northern areas occasion
ally present corneal abrasions.

The corneal lesions of trachoma will be dealt with under
a later heading.

Uveal Disease.

The aborigines appear to be remarkably free from dis
orders of the uveal tract. No frank case of acute iritis or
cyclitis was observed on external examination, nor was any
evidence of chorioiditis found in the fundi of 86 subjects
examined ophthalmoscopically. Iris atrophy with mydriatic-
resistant pupils was evident in several lepers. Popular
opinion among white people in the Northern Territory
maintains that the natives are largely infected with
gonorrhoea. In refutation of this common belief, it may
be stated that no evidence of gonococcal eye disease was
found, nor could gonococcal focal infection be suspected in
the absence of uveal inflammation.

Ocular Manifestation of Yaws.

If it is assumed that infection by Treponema pertenue
immunizes a people against infection by Treponema
pallidum m , then syphilis is not likely to be encountered in
the aborigines, and it is probable that the following cases
may be listed as presenting unusual manifestations of yaws.

CASE I. Aiden was aged about thirty years; he belonged
to the Djappada tribe, in the Wyndham area. He had optic
atrophy and central retinitis. He was admitted to hospital
with right-sided hemiplegia of recent origin. The blood
yielded both the Kline and the Wassermann reactions
("++"). An accompanying impairment of visual acuity (right
eye, 8 / 18 ; left eye Veo). also of recent origin, was due to optic
atrophy, and in the left eye it was also partly due to central
retinitis. The cerebro-spinal fluid was under normal pres
sure, contained globulin and ten cells per cubic millimetre, and
yielded a paretic type of gold curve and a "doubtful positive"
reaction to the Wassermann test. The patient intimated
that his lubra and two children were well. Rapid reduction
in the paralysis and some improvement in the visual acuity
followed initial treatment by potassium iodide and mercury,
later supplemented by "Novarsenobillon".

CASE II. Topsy, aged about twenty years, belonged to the
Rimburrunga tribe in lower Arnhem Land. She had bilateral
interstitial keratitis and keratoconus in the left eye. This
lubra had uniform grey opacities in the deeper layers of the
cornese associated with deep blood vessels. In the right
eye the grey area occupied approximately the upper half,
the lower margin being convex downwards. The lesion In
the left cornea resembled that In the right, but extended
further down and occupied all but a narrow zone about 1-5
millimetres wide inferiorly. A considerable degree of kerato
conus was superimposed in the left eye. The blood reacted
to the Kline test ("++").

CASE III. Blind Maggie, aged about twenty-five years,
belonged to the Nowla tribe in the Victoria River area. She
had optic atrophy. She stated that she had been blind "long
time" and that the blindness had "come slow". Her pupils
were 5-0 millimetres in diameter and Inactive. She was
completely blind without perception of light. The fundi
presented clearly denned, greyish-white disks, with no altera
tion in their level, the blood vessels appeared to be normal
and the fundus colour was a little paler than is usual in
aborigines. These conditions were combined with ataxla,
disturbance of balance, flaccid arms and legs, absent deep
reflexes and a positive ("+ + +") reaction of the blood to the
Kline test.

CASE IV. An infant, aged about two months, belonged to
the Ngullican tribe in the Roper River area. He had Inter
stitial keratitis. The blood of both parents and the infant
reacted to the Kline test. Both cornese of the child were
opaque and of a generalized pale-grey colour, amongst

102

THE MEDICAL JOURNAL OF AUSTRALIA.

JAXUAKY 26, 1940.

which numerous rounded, yellowish-grey plaques were dis
tributed. The subsequent history is not known, as the
family disappeared silently and suddenly into the bush soon
after treatment was initiated.

Cases III and IV have been described by Binns lsl .

Trachoma.

As may be expected in a people living in close personal
contact with each other, without the slightest notion of
personal cleanliness and hygiene, trachoma has a re
markably high incidence. Of a total of 574 subjects, 520
(91%) presented evidence of trachoma in one of its stages.

The most remarkable feature of the disease in the
Northern Territory is the extraordinary influence that
climate bears on its severity. In the southern areas of
the Northern Territory, rarely free from wind and dust,
the disease is severe. In the northern areas, comparatively
free from wind and dust, the disease is mild and complica
tions are rare. The incidence rate is practically identical
in the two areas thus subdivided climatologically.

The bush fly Musca vetustissima is so prevalent in the
interior dry areas that outdoor life is a most trying
experience. The flies have a predilection for one s eyes j
and are most persistent in their endeavours, and it becomes j
necessary to wipe them from one s lids times without
number. The aboriginal placidly ignores flies, and one
usually finds a group clustered about his eyelids. In
the northern areas these flies are practically absent a
few are seen in the winter months, but never in large
numbers.

The incidence rate of trachoma is practically identical
in the fly-ridden and the fly-free areas, and one may there- j
fore conclude that flies play a minor role, if any, in the !
dissemination of the disease.

The chief vehicle of transference of the organism of
trachoma in the aboriginal is almost certainly the human
finger. It is a common experience to observe a lubra j
wiping the secretion from her eyes with her fingers, and !
a moment later repeating the manipulation on her child s I
eyes, wiping any excess on to some part of her body or
thighs.

Corneal Conditions in Trachoma. In both severe and mild j
cases of trachoma in the aborigines, one frequently finds j
a crescent-shaped infiltration or degeneration of the cornea !
contiguous with the sclerotic. The lesions appear during |
the stage of healing and are apparently permanent. They
have a sharply defined border, are greyish-white to olive-
brown in colour, and may contain small collections of
dark brown pigment and both superficial and deep blood !
vessels. Their length varies from 7-0 to 12-0 millimetres,
they taper at each end, and the diameter in the middle
varies from 1-0 to 3-5 millimetres. They are most usually
situated on the upper border of the cornea, but may occur
on the upper and lower borders, or occupy the whole
circumference. Being contiguous with the sclerotic and
opaque, they distort the outline of the cornea to super
ficial examination, so that if they are present above and
below, the cornea appears to be horizontally oval. Irregular
mantles of pannus may coexist and extend beyond the
margins of these degenerated areas. The lesions were
found in 101 (22%) of 463 sufferers from trachoma. In
11 eyes the crescents contained Herbert s pits clear,
circular areas varying from one to two millimetres in
diameter, most of them discrete but others merging with
neighbouring pits. They varied in number from a solitary
pit to as many as nine, and if they were multiple they
described an arc in the area of crescentic degeneration.
In two subjects a narrow pigmented line described an arc
in the crescentic area.

Severe Trachoma. Severe trachoma is found in the dry,
dusty, windy interior country. It conforms to the classical
description of the disease, in that it begins in early child
hood and terminates with the grave, producing more
suffering than any other disease, and is accompanied by
progressive impairment of vision and not infrequently
blindness. Of a series of 140 consecutive subjects
examined, 11 were blind in both eyes, 13 were blind in one
eye, 41 presented cornea! opacities which considerably

impaired the visual acuity, and 31 had pronounced
entropion which in 25 instances had resulted in trichiasis.
Phthisis bulbi was found in five eyes. In nine cases there
was an associated chronic dacrocystitis with considerable
enlargement of the lachrymal sac, and symblepharon was
present in two subjects. Pannus, visible to the naked eye,
was present in all severe active cases of trachoma, and in
two cases the grey mantle extended over the whole cornea.
History taking, apart from its amusement value to a
bystanding colleague, is usually valueless. An aboriginal
cannot think in abstract terms, and time is of no sig
nificance to him. When he is questioned, his averted face
remains expressionless until he discovers whether one
wishes him to reply in the affirmative or negative, and then
his desire to please outweighs his respect (if any) for
scientific investigation.

The following will serve as illustrative cases of severe
trachoma.

Judy, aged about fifty-five years, belonged to the Wadamar
tribe. The conjunctives of her lids were red and considerably
swollen and speckled with areas of pigmentation. Scarring
in irregular patches coexisted with small collections of
follicles. Both lachrymal sacs contained a large quantity of
foul-smelling pus, which welled from the inferior puncta
on pressure over the enlarged sacs. Her right eye was
shrunken and the edge of its calcified lens projected some
two millimetres from an anterior perforation of the cornea.
(The lens was readily removed with a blunt curette.) Her
left eye presented early senile cataract and much pannus.

January, aged about twenty years, belonged to the
Ngeinman tribe. A series of well-defined scars on his throat
indicated an ineffectual attempt at suicide. Both his eyes
presented severe, active trachoma with many large follicles
on greatly swollen, hyperplastic and reddened conjunctiva.
Grey mantles of pannus with numerous blood vessels
extended downwards to cover half of his corneae. In the
upper area occupied by pannus in each eye was a greyish-
white crescent, tapering at both ends, about 7-0 millimetres
long and 3-5 millimetres wide in its middle. The crescent
in the left eye contained a solitary Herbert s pit.

Joe, aged about seventy years, belonged to the Billi-ngarra
tribe. His trachoma was characterized by a few follicles,
some scarring and much swelling and redness of the con
junctiva of the lids. He had entropion and trichiasis. His
left eye was quite blind from a dense white opacity of the
whole of the cornea. His right cornea presented a dense
central scar containing a horizontal pigmented line. The
visual acuity in this eye was poor. An optical iridectomy
would help Joe.

Charlie, aged about seventy-five years, belonged to the
Ngeinman tribe. He was completely blind from trachoma.
Both cornese presented dense opacities undergoing calcareous
degeneration, and blood vessels. His lids were distorted,
with the production of trichiasis, and follicles, areas of
epithelial hyperplasia partly pigmented, and irregular scars
on his tarsal conjunctivas were present.

Charlie was conducted by Joe (mentioned above) in the
manner invariably used by natives when leading their
blind. Joe s visual acuity was just sufficient for him to
avoid large obstacles and pitfalls, and he led Charlie at
the end of a stout cudgel some five feet long. They pro
ceeded in single file, one at each end of the stick held
loosely and horizontally by their sides.

Mary Anne, aged about forty-five years, belonged to the
Ngongalli tribe. Her trachoma had produced entropion,
distichiasis and trichiasis, and isolated scars on the cornese.
She was the only native examined who practised epilation
for the relief of trichiasis. She did this by pulling the lid
away from the eyeball, and then removing the offending
lashes between the index finger and thumb of the same
hand. Although performed without the aid of a mirror or
an instrument, the procedure was highly successful, in that
no lashes were rubbing on her cornese, although many were
projecting about half a millimetre from the lid.

Nellie, aged about sixty years, belonged to the Djamindjang
tribe. She was blind in both eyes from trachoma. The
right eye was affected by phthisis bulbi and the left by
keratectasia involving the whole of a densely opaque cornea.
Trichiasis involved both upper and lower lids, and had
produced spastic entropion of the lower lids.

Mild Trachoma. As has been previously mentioned
mild trachoma has a climatological distribution, and in
general belongs to the comparatively wind and dust free

JANUARY 26, 1940.

THE MEDICAL JOURNAL OF AUSTRALIA.

103

areas north of the Roper River. The incidence rate is
practically identical with that of severe trachoma about
90% of all persons. None of them complained even of dis
comfort, although this may be ascribed to the natural
stoicism of the natives. In no case was photophobia,
excessive lachrymation or active corneal ulceration present.
Slight ptosis was observed in a fair proportion of subjects
with pannus and follicles. Pannus was present in all
with follicles and epithelial hyperplasia. Most of the
children had early trachoma manifested by pannus, red
swollen conjunctiva of the lids containing follicles, and
a little hyperplasia. Fine cicatrices were found in those
who had attained the age of ten or twelve years, and adults
presented little evidence of preexisting trachoma apart
from fine scarring of the tarsal conjunctiva, and in a
large proportion of cases the areas of crescentic degenera
tion previously described.

The following will serve as illustrative cases.

Biblingi, aged about thirty years, belonged to the Ngandi
tribe. Fine scars were irregularly distributed over the |
tarsal conjunctiva of both eyes. Pannus could not be seen
with the naked eye, but with a x 10 loupe small blood vessel
loops could be followed on to the corneal epithelium. No
other abnormality was detected about his eyes.

Cobiyaryack, aged about twelve years, belonged to the
Nungabuya tribe. He presented slight ptosis, and a few
small follicles were present in a slightly reddened area over
the tarsal conjunctiva of each eye. Small areas of scar
tissue were distributed irregularly. A crescentic grey area
of corneal degeneration was present on the upper border
of each cornea; each was about 7-0 millimetres in length
and 2-5 millimetres wide in the centre, and tapered at the
ends.

Ironstone, aged about thirty years, belonged to the Rimbur-
runga tribe. Faint scarring, which produced a pale bluish
discoloration of the tarsal conjunctiva in each eye, and a
series of greyish-white crescents of degeneration in the j
peripheral area of the cornea, were the only remaining
evidence of previous trachoma.

Paddy, aged about twenty-five years, belonged to the
Melville Island tribe. His tarsal conjunctiva had become
scarred, with the production of an ivory-white, smooth,
glistening surface. There was no distortion of the lids or
entropion. His cornese presented a few fine invading blood
vessel loops above, and in the left eye he had an olive-green
crescent of corneal degeneration about nine millimetres long
and two millimetres wide in its middle.

Don, aged about twenty years, belonged to the Millingimbi
tribe. His lashes were unusually long. The conjunctiva of
his upper lids was reddened and contained small irregular
areas of cicatrization. The cornese appeared clear.

Treatment of the Diseases of the Aborigines.

As has previously been intimated, the natives of the
Northern Territory are readily divisible into three socio
logical groups: (a) the supervised camp group, (b) those
in regular employment, and (c) the nomadic group.

The inhabitants of supervised camps, largely treated
with contempt by their supervisors, with no hope of ever
being accepted in the white man s society, and with no
pride in their ancestry, are rapidly diminishing in numbers.
Their medical problem is a self-terminating one they are
doomed to early extinction. Medical care in the meantime
should be, and actually is, based on that provided for
white communities including treatment in hospitals. A
similar attitude is adopted to those employed on cattle
stations in the vicinity of towns.

As for the nomadic group, and those employed on out
lying cattle stations, we cannot approach these too
cautiously. On the outlying cattle stations a semblance
of the black man s primitive patriarchal family life is
still maintained, and for that reason these natives should
be treated in the same manner as the nomadic people.
It is for the latter, however the nomads that a special
plea is made. Previous experience shows us clearly that
there is no surer way of exterminating them, even if we
cure them individually of their physical ills, than by
collecting them in the vicinity of white people. They
cannot be separated from their highly adapted primitive
existence from the only world they know and survive.
There is no alternative. This factor must form the basis

of our approach to them, or better by far that we leave
them alone. Therefore as a general principle treatment
in hospital cannot be countenanced. These remarks do
not apply to the comparatively small numbers of lepers
and those suffering from tuberculosis, who must be segre
gated.

If the nomadic people in Arnhem Land, estimated at some
3,000 individuals, were left completely to themselves; if
we strictly excluded not only pearlers and beachcombers,
who under the pretext of seeking water land on its shores
to satisfy their lust, and the "poor whites" roaming in
the area, but also all manner of teachers and missionaries,
often well-intentioned but ill-informed; if these were
excluded, there is no reason why the aborigines should
not survive through hundreds of years. They have done
so through countless forgotten ages, and it is only when
we thrust ourselves upon them with our "civilization"
that they leave their virtuous primitive life, adopt our
vices, and end miserably.

All missionaries in the Northern Territory cannot be
included in this generalization. A few intelligent men
do exist teachers in the true sense, who do not allow
religious zeal to subjugate their respect for aboriginal
customs and habits. Fully cognizant of the havoc and
destruction created by fellow-missionaries, these few stand
preeminent in their helpful, unselfish and commonsense
attitude. They rate physical welfare as at least equal in
importance with spiritual welfare, and realize that the
uncontaminated black man is more virtuous than the
white.

The natives in Arnhem Land live in barren, inhospitable
country, which fortunately for them has not been inviting
enough for white men to occupy. How long this state of
affairs will continue is unpredictable. Even now certain
ignorant and misguided people maintain that lack of
development of Arnhem Land is one of the reasons why
the Northern Territory has failed economically in the past.
They have formulated the most extraordinary and fantastic
schemes for its so-called development. Let us call a halt to
these dreamers and at the same time preserve the aboriginal
in his last stronghold. Arnhem Land cannot be utilized
economically by the white man, so why destroy the black
man in it?

The problem confronting us, therefore, is primarily, the
prevention of their racial extinction, and secondarily, the
treatment of their diseases. The former is dependent on
wise and humane administration; the latter presents no
insuperable difficulties. The medical care of the aborigines
who live the primitive food-gathering, patriarchal family
existence could be maintained by mobile medical units.
A mobile medical unit would consist of a medical officer,
with special training in the treatment of trachoma and
aboriginal diseases, a guide-interpreter, with special know
ledge of native customs and habits, for each district, and
an orderly. The unit would have at its disposal two motor
vehicles, one of which would be fitted out with the neces
sary medical, surgical and laboratory equipment for the
diagnosis and treatment of the diseases commonly found.
It would visit suitable areas in the reserves in rotation.
The unit could control yaws, malaria, trachoma and
probably hookworm, determine the diagnosis of leprosy
and tuberculosis, act in an advisory capacity on matters
of personal hygiene and cleanliness in fixed native encamp
ments, and indicate the mode of procedure for treatment
of disease for the periods intervening between visits.
This approach would not "detribalize" the aboriginal or
interfere with his mode of life, and the medical officers
would receive the confidence of the natives, who would
readily submit to treatment. The white custodians of
aborigines would also welcome it, and their active coopera
tion would be assured.

Treatment in hospitals for natives other than those who
had been "detribalized" would, as has been previously
mentioned, spell death and destruction to them. Quite
apart from this aspect, there are other factors that would
render such a plan infeasible and ineffective. The large
number of sufferers from yaws and trachoma alone could
not be coped with by any transport unit over the trackless
areas involved, nor would air transport be adequate; and

THE MEDICAL JOURNAL OF AUSTRALIA.

JAM-AKY 26, 1916.

the aborigines, with their innate fear of any other than
their tribal grounds, even if successfully collected, would
quietly take to the bush and disappear.

A modification of the approach that a mobile medical unit
would employ, and more suited to the difficult terrain and
vast distances, was in force prior to the outbreak of the
war against Japan, through the medium of the Aerial
Medical Service. This service visited the cattle, mission
and police stations at regular intervals. The large number
of sufferers from the complications of trachoma alone
indicates that the service had insufficient medical officers
at its disposal. Its activities will be enlarged in the post
war period, more medical officers and more aircraft will
be engaged, and it is anticipated that this service will be
able to cope with the large number of sick natives in the
various stations under its supervision.

Summary.

1. The sociological and psychological background of the
aborigines in the Northern Territory is briefly outlined.

2. Their common diseases are enumerated.

3. A survey of their eye conditions and diseases is
presented.

4. The prevalence of trachoma is stressed.

5. The climatological influence on the severity of
trachoma is pointed out.

6. The frequent occurrence of a crescentic-shaped de
generation of the cornea in trachoma is mentioned, and
the macroscopic appearance is described.

7. A note on the mode of transfer of the infecting
organism of trachoma is tendered.

8. The theory that flies act as vectors of trachoma is
discredited.

9. Suggestions concerning a medical officer s approach to
the aborigines are outlined.

10. The formation of mobile medical units in the
Northern Territory is recommended.

11. A plea that Arnhem Land be maintained as an in
violate aboriginal reserve is added.

Acknowledgements.

I am indebted to the Director-General of Medical
Services of the Australian Military Forces for permission
to publish this paper. Appreciation is expressed for the
helpful criticism of Lieutenant-Colonel W. B. Kirkland and
Chaplain W. S. Chaseling. My thanks are due to many
kind and hospitable white residents on the cattle, mission
and police stations in the Northern Territory, who made
the investigation work both simple and pleasant.

References.

(1) "Official Year Book of the Commonwealth of Australia",
Number 34, 1941, page 307.

&lt;2 &gt; E. C. Black and J. B. Cleland : "Pathological Lesions in
Australian Aborigines, Central Australia (Granites), and
Flinders Range", The Journal of Tropical Medicine and Hygiene,
Volume XLJ, 1938, page 69.

&lt;a) C. Cook : "Epidemiology of Leprosy in Australia", Com
monwealth of Australia, Department of Health, Service Publica
tion Number 38, 1927, page 28.

&lt;4) W. B. Kirkland : Personal communication.

(5 &gt; J. Andrews : Personal communication.

&lt;"&gt; W. B. Kirkland : Personal communication.

&lt;7) "Hanson s Tropical Diseases", Eleventh Edition, 1942, page
634.

&lt;R) R. T. Binns : "A Study of Diseases of Australian Natives
in the Northern Territory", THE MEDICAL JOURNAL OF AUS
TRALIA, Volume I, 1945, page 421.

TRAUMATIC ARTERIO-VENOUS ANEURYSM OF THE
FEMORAL BLOOD VESSELS.

By GEORGE C. V. THOMPSON, F.R.C.S. (Edinburgh),

Surgical Registrar of a Royal Australian Air

Force Hospital.

TRAUMATIC arterio-venous communications most fre
quently result from wounds of an artery and an accom
panying vein by a penetrating projectile of the nature of
a rifle bullet or a bomb fragment, or as a result of stab

wounds. Thus it is to be expected that larger numbers
of arterio-venous aneurysms will occur in war-time and
that opportunities will be presented for the study of their
clinical features.

The common sites for arterio-venous communications of
traumatic origin are in exposed situations in which an
artery and vein are in contact over long distances. It is
not surprising that the most common vessels which sustain
injuries resulting in the development of arterio-venous
aneurysms are the femoral, axillary, brachial, popliteal,
carotid and subclavian vessels, the frequency being some
what in that order. The most commonly encountered
arterio-venous aneurysms are those of the femoral vessels.

The type of communication between the artery and the
vein depends upon the degree of wounding of the vessels,
the amount of perivascular hsematoma formation and the
relative positions of the arterial and venous wounds. A
small foreign body passing between an artery and its
accompanying vein may cause only a small puncture of
both artery and vein, with a minimal extravasation of
blood into the tissues, because the proximity of the
openings allows the blood extravasated from the artery to
follow a pathway of little resistance through the venous
puncture rather than to dissect tissue planes. A fistula is
thus established without the formation of an intervening
aneurysmal sac; either this may be a direct communication
between artery and vein or an arterio-venous fistula united
by a small channel may result. Such communications
constitute an aneurysmal varix. If the vascular damage is
greater than this, or if the wounding of the vessels is
such that the openings of the artery and vein are at the
same level although not contiguous, as may happen in
tangential wounds of blood vessels, blood is extruded into
the tissues and forms a hsematoma, which finally communi
cates with the venous opening. The organization of the
track thus formed gives rise to an arterio-venous com
munication in which an aneurysmal sac is an integral
part. This constitutes an arterio-venous aneurysm.

Reports of Cases.

In a recent case it was most instructive to watch the
formation of an arterio-venous aneurysm during the first
few days after injury to the femoral vessels. Such a
patient (Case I) was recently examined after he had
sustained a gunshot wound of the femoral region; a large
thigh hsematoma developed, which was rapidly reduced in
size, and at the same time the classical signs of an arterio-
venous communication became evident. The clinical con
dition and progress of this particular patient will be briefly
quoted.

CASE I. On November 9, 1944, B.N.M., an officer of the
Royal Australian Air Force, was injured by a rifle bullet
which penetrated his left thigh in the region of the apex of
the femoral triangle of Scarpa. He was examined almost
immediately; at this time his pulse rate was 60 per minute
and his blood pressure was 120 millimetres of mercury,
systolic, and 70 millimetres, diastolic. Three hours later, on
his admission to hospital, examination revealed that the
entry wound was a quarter of an inch in diameter and was
situated three and a half inches below Poupart s ligament,
just lateral to the femoral artery. A slightly larger exit
wound was situated in the gluteal region, two inches from
the mid-line of the body. The pulsations of the femoral and
popliteal arteries were readily palpable, but pulsations of
the posterior tibial and dorsalis pedis arteries were palpable
only with difficulty. There was a large hsematoma over the
thigh, which rapidly subsided during the next twenty-four
hours.

Two days after the accident a pulsation and thrill were
noticed for the first time over the femoral artery. These
features extended as far as Poupart s ligament and were
associated with an audible bruit; but no obvious localized
pulsating mass was recognizable as a distinct entity, apart
from the generalized effusion of blood into the thigh muscles
and tissues. Neither at this nor at any subsequent time did
venous engorgement or oedema of the leg appear.

During the next few days the thrill, pulsation and bruit
became more localized over the femoral region, and the
thrill now actually extended proximal to Poupart s ligament.
Proximal compression of the artery by digital pressure over
its course at Poupart s ligament controlled the thrill, but
unfortunately no record of the effect on pulse rate or blood

JA.MAKY L ii, 1940.

THE MEDICAL JOURNAL OF AUSTRALIA.

105

pressure was kept. No undue general symptoms or signs of
cardiac involvement were noted. About five weeks after
injury some deficiency of circulation in the foot occurred,
with transient colour changes.

On October 31 exploration of the area was carried out
under general anaesthesia, and a communication of the
aneurysmal type was found between the femoral artery and
vein immediately distal to the origin of the profunda femoris
artery. Ligation of the artery and vein proximal and distal
to the site of communication was carried out, followed by
excision of the aneurysm. After operation the foot became
cold, and cyanosis of the toes and forefoot was pronounced.
This condition lasted for a week, at the end of which time
the foot became warmer and pulsations reappeared in the
posterior tibial artery. Within a month of operation this
officer had begun walking and after another month s con
valescence he could play sport and walk moderate distances
without undue discomfort. Four months after injury a
medical board considered that he "had recovered all normal
usage of the leg and was fit for duties in the capacity of a
pilot".

The arterio-venous fistula having been established, there
gradually appear changes in the liinb circulation, in the
calibre of the vessels, and in the thickness of their walls,
and especially in the lower extremity, varicosity of the
superficial veins occurs. The pathological changes in the
vessels and in the blood flow have been described by
Horsley and Bigger. (1) There is considerable difference of
blood pressure between artery and vein, resulting in
rapid flow through the fistula and very little prospect of
spontaneous cure by clotting. The ease of blood flow
through the fistula allows a proportion of the blood in the
limb to be returned to the heart without taking part in
the limb nutrition, and eventually may cause cardiac
enlargement. Changes occur in the artery, which becomes
smaller distal to the fistula, owing to the reduced blood
flow, and dilated proximal to the fistula, so that it is able
to convey the blood needed to nourish the limb and to
accommodate the extra blood short-circuited back to the
heart. The veins become dilated distally as far as the first
valve, and proximally as far as the vena cava or even the
heart. If the venous valves become incompetent, vari
cosity of the veins ensues, the nutrition of the limb suffers,
and ulceration or eczema may supervene. As a result of
their dilatation the veins become thickened, so that it is
difficult from examination of their wall at operation to
distinguish artery from vein. These features are more
evident in long-standing cases. This was recently seen
in the case of a patient who had an arterio-venous
aneurysm of the femoral vessels of three years duration.
The clinical history of this patient (Case II) is also briefly
recorded.

CASE II. On July 22, 1942, W.G.M., a Royal Australian Air
Force corporal, was accidentally injured by a 0-22 rifle bullet,
which entered the medial aspect of his left thigh and was
recovered from the region of his left anterior superior iliac
spine at operation under local anaesthesia on the same day.
At this time he had a certain amount of extravasation of
blood in the medial aspect of his thigh, and during con
valescence a swelling was noted in the groin, which had an
"emphysematous" sensation to palpation. No record was
made of any damage to the main blood vessels, nor was
aneurysm suggested, although it appears probable that early
features were making themselves evident at this stage. The
patient did not report for medical examination for two years,
at which time he fainted on duty. The medical records
state that examination revealed no abnormality except for
varicose veins in his left leg.

On April 25, 1945, the patient reported at the unit sick
parade on account of swelling of his left ankle and dilated
veins in his left leg. He said that the veins of the leg had
gradually become more prominent since the date of his
accident and had been accompanied by the slow development
of o?dema. Clinical examination revealed dilatation of the
superficial veins below the knee, with considerable tor
tuosity accompanied by "pitting" oedema and a small ulcera
tion surrounded by low-grade cellulitis at an area of recent
bruising. In the upper half of the thigh a thrill and bruit
were present, localized over the femoral vessels, but no
aneurysm could be palpated. The thrill and bruit could
readily be followed to a point three inches proximal to
Poupart s ligament. The pulse rate was 80 per minute; the
systolic blood pressure was 170 millimetres of mercury and
the diastolic pressure 70 millimetres. The pulse was of the

typical "water-hammer" or Corrigan type. The apex beat
of the heart was displaced laterally, being palpable five
inches from the mid-line of the sternum. Control of the
blood flow through the arterio-venous communication by
pressure over the femoral artery resulted in a fall of pulse
rate to 70 per minute, and investigation of the blood pressure
revealed a less pronounced pulse pressure; the systolic blood
pressure was unchanged, but the diastolic pressure rose to
110 millimetres of mercury. An X-ray examination of the
heart showed slight enlargement in all cardiac diameters;
this confirmed the findings on clinical examination, as well
as revealing engorged pulmonary blood vessel markings
throughout the lung fields.

On June 7 operation on the femoral arterio-venous
aneurysm was performed by a consultant surgeon. After
control of the vessels, the aneurysmal communication
between the femoral vessels was found to be just distal to
the origin of the profunda femoris artery. Ligation of the
femoral artery and vein proximal and distal to the
aneurysmal area was followed by excision of the sac after
several small communicating vessels had been ligated and
divided. A small blood transfusion was given, as no evidence
of cardiac embarrassment had occurred as a result of
ligation. Immediately after operation the pulse rate was
76 per minute, and the systolic blood pressure was 130
millimetres of mercury and the diastolic pressure 84 milli
metres.

Since operation little variation has occurred in these
figures. There were no circulatory changes in the foot
after operation, the dorsalis pedis and posterior tibial arteries
being palpable at all times. The heart size rapidly decreased,
and one week after operation the apex beat was four and a
quarter inches from the mid-line. One month after opera
tion the heart was clinically normal, the apex beat being
in the normal situation. On July 10 X-ray examination of
the chest revealed a decrease in the size of the cardiac
shadow compared with the film taken prior to operation,
and considerable reduction in the congestive changes in the
lung fields. At this time the patient was considered fit for
discharge from hospital to have a short convalescence prior
to return to his normal duties.

Discussion.

It will be noted that the clinical signs and symptoms of
a femoral arterio-venous aneurysm, as exemplified by the
two cases quoted, differ according to the length of time
that has elapsed since the fistula was established. An
important feature to remember is that the signs of an
arterio-venous aneurysm may appear immediately after
the accident, or they may not become evident until after
the lapse of some days or weeks. In the first case quoted
the signs did not become manifest for a day or so. This
may be explained by the fact that absorption of the peri-
vascular hsematoma allows signs of the fistula to be found
or that the channels become more patent as swelling
subsides. To the signs of the local condition are added
general signs and symptoms in long-standing cases or in
cases in which the fistulous openings are very large. At
the same time nutritional changes in the limb may be
evident.

When a wound has occurred in the region of the femoral
vessels, a careful study of the exit and entry sites will
often lead one to suspect injury to those vessels. In all
such cases a careful examination should be made at that
time, and on several subsequent occasions, to exclude
vascular damage and the development of an arterio-venous
connexion. The formation of a large hasmatoma in the
soft tissues does not necessarily occur in those instances
in which a contiguous artery and vein are injured. The
venous opening permits rapid return to the circulation of
extravasated arterial blood, and so tissue distension is
prevented from occurring. According to the nature of
the fistulous communication, a swelling may or may not
be palpable. If the fistula communicates through a large
sac, a swelling may be palpable. Such a swelling, if
present, is usually pulsatile; but in the majority of femoral
arterio-venous aneurysms the sac is too small to be detected
on clinical examination.

The two most characteristic features of an arterio-venous
aneurysm are palpable thrill and an accompanying loud
characteristic bruit, which is probably most aptly described
as of a "machinery" type. The thrill is pronounced over
a considerable distance along the course of the vessels

10G

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY 26, 1046.

concerned in the fistulous communication. The nature of
the bruit is such that it is continuous throughout the whole
cardiac cycle but is accentuated in systole. In the cases
encountered the prominent feature noted was that the
thrill had its maximum intensity a considerable distance
proximal to the site of the vascular injury, and although
the femoral injury was below the origin of the projunda
femoris artery, the site of maximum thrill and
pulsation was proximal to Poupart s ligament along the
course of the external iliac vessels. It appeared as if
the most obvious thrill was on the venous efferent limb
from the fistulous opening. The distal transmission of
the thrill was less pronounced than its proximal
projection. The vascular bruit was heard most readily
over the vessels and was maximal over the area of
greatest thrill and at the fistulous site. The bruit had
extensive transmission in both directions, and could be
heard not only over the feet, but also along the vessels
proximally for long distances. The thrill and bruit are
continuous with systolic accentuation, but both can be
abolished by compression of the femoral artery proximal
to the site of the arterio-venous aneurysm.

At the same time, it will be noticed that as a result of
the compression there is a reduction in pulse rate, a
lowering of the systolic blood pressure (often after a
rise for a couple of beats, in experimental studies), or
a rise of the diastolic blood pressure. This has been
designated as Branham s sign; but Holman (21 credits
Nicholadoni with observing as early as 1875 the slowing
of the pulse rate on arterial compression proximal to the
vascular communication.

Other local features are signs of venous dilatation and
back pressure in the legs, with large dilated varicose
veins, oedema of the legs and trophic tissue changes,
giving rise to eczema and ulceration. It is rare for
pulsation to be noticed in the veins of the limb distal to
the fistula. The oedema of the legs rapidly disappears
when the part is elevated.

The deficient circulation of the leg accompanying some
arterio-venous aneurysms gives rise to symptoms of
fatigue after exercise, in addition to oedema and to trophic
changes. Actual gangrene or ischsemia are, however, rare
sequelae.

In long-standing femoral arterio-venous aneurysms, as
in other peripheral aneurysms of long duration, and
provided that the fistula is sufficiently large, there
develop various signs and symptoms of cardiac
embarrassment. Symptoms such as dyspnoea, tachycardia
on exertion, faintness and a sense of cardiac discomfort
are complained of, and ultimately, the condition
progresses until signs of cardiac enlargement appear or
even death may ensue. In occasional cases cardiac failure
rapidly supervenes, as was described by Mason, Graham
and Bush &lt;:l) and quoted by H. Bailey. (41 The rapidity of
the return of the heart to normal size and of the pulse
pressure to normal are striking cardio-vascular features
after operation for closure of the fistula. The cardio
vascular changes occurring after an arterio-venous fistula
have been tabulated by Tarnower, Lattin and Adie. (r&gt;) In
brief, the effects are: (i) acceleration of the pulse rate;
(ii) elevation of the systolic blood pressure and fall of
the diastolic pressure; this feature gives rise to the
water-hammer pulse, capillary pulsation and exaggerated
pulse pressure ; (iii) increased cardiac output with
decreased stroke output; (iv) engorged pulmonary vessels;
(v) increased circulating blood volume; (vi) cardiac
enlargement; (vii) changes in the electrocardiographic
tracings; (viii) increased venous pressure and circulation
time, when cardiac decompensation occurs.

The circulatory effects are dependent upon the size of
the fistula, the size of the blood vessels involved, the dis
tance of the fistula from the heart and the volume and
force within the artery which is short-circuited, as well as
upon the age of the patient and the presence or absence
of preexisting cardiac disease.

A careful consideration of the signs and symptoms makes
the diagnosis of arterio-venous aneurysm of Uie femoral
or other peripheral vessels moderately certain in nearly
all cases. The differential diagnosis from a simple

aneurysm, however, is extremely important from the point
of view of treatment. Ligation of the artery is all that is
required for the cure of a simple aneurysm; but this not
only fails to relieve the symptoms or produce a cure of
an arterio-venous aneurysm, but may actually precipitate
gangrene of the limb. The main difference between the
two conditions is, firstly, that the arterio-venous aneurysm
has a continuous thrill and bruit, with systolic intensifica
tion, while an aneurysm shows these features in systole
only; and, secondly, digital compression of the artery
proximally slows the pulse rate and affects the blood
pressure in the presence of an arterio-venous fistula, but
not in the case of a simple aneurysm.

Treatment.

The problem of treatment of arterio-venous aneurysms
involves a discussion of the nature of any operative pro
cedure and of the time at which operation should be
undertaken. It is generally agreed that, as only a small
number of arterio-venous fistulae close spontaneously,
operation is indicated, but that, except in a few cases in
which early repair may be attempted or in which cardiac
failure is developing, operative procedures should be
deferred until an efficient circulation has been established
by the collateral blood vessels of the limb.

Holman/ 8 who has extensively studied arterio-venous
fistula?, discusses the treatment of these conditions accord
ing to whether the fistula is recent or of long standing.
In a case in which an injury to a large artery is suspected,
bed rest is indicated. If an enlarging hsematoma of the
limb threatens the blood supply of the extremity, immediate
operation is indicated. The procedure adopted is the
temporary control of the affected vessels and evacuation
of the hsematoma; in the absence of infection the vein is
ligated, and after the edges of the arterial rent have been
trimmed, suture of the artery is the ideal procedure. It
is found that this is not possible in many cases, and
ligation of the artery has to be carried out. The collateral
circulation is encouraged by blood transfusion, and in
some cases sympathectomy has been recommended. The
use of blood transfusion needs careful consideration, how
ever, since closure of the fistula, in any but the most
recent cases, increases the circulating blood volume and
causes further cardiac embarrassment.

If diagnosis is delayed and primary treatment has not
been adopted, operation is postponed until an efficient col
lateral circulation has been established. This period of
delay should be six weeks at least, and perferably about
three or four months. At the end of this time, not only
has the circulation had time to establish an adequate
alternative route, but the local trauma has subsided, the
vessels have healed, and dissection is less difficult than
in the indurated tissues. The development of progressive
cardiac symptoms or any local complication may necessitate
operative interference at any time. In the event of
cardiac insufficiency, bed rest and frequent digital com
pression of the fistula are recommended before operation.
Adequate post-operative rest is also indicated in these
cases, to allow the heart to compensate for the increased
diastolic pressure which results from the closure of the
fistula, and which in some cases may cause some further
cardiac embarrassment, requiring venesection for its relief.
The normal effect of closing the fistula, however, is to open
up the capillaries of the collateral circulation in a manner
similar to that observed in limbs after ligation of a main
artery when a blood transfusion is given to the patient.
In this condition the closure of the fistula makes available
the blood previously short-circuited through the fistula for
use in the general circulation.

The operation performed on these arterio-venous fistulae
of the femoral vessels is usually proximal and distal liga
tion of the vein and artery involved in the anastomosis,
together with all the branches that may intervene between
the points of ligation. The further procedures adopted
depend on the circumstances, either excision of the sac or
its obliteration being carried out. These procedures can
be accomplished only with adequate exposure and complete
control of the main vessels above and below the field of
operation. In the case of the femoral vessels this involves

JA.M-AKY 26, 194(5.

THK MEDICAL JOURNAL OF AUSTRALIA.

107

control of the external iliac vessels and of the lower parts
of the femoral vessels as early stages of the operation.
The vessels can be controlled by special clamps or by
small pieces of rubber tubing encircling the vessels and
having a cord loosely tied in readiness should control
become necessary. It must be emphasized that proximal
ligation of the artery alone is inadequate to cure the
condition and is almost certain to precipitate gangrene of
the leg.

In special circumstances it may be possible to carry out
a more surgically sound procedure, aiming at reconstruc
tion of the arterial lumen, by such procedures as those of
Matas and Bickham, which have been described by H.
Bailey. &lt;4) The vein of the arterio-venous aneurysm or
aneurysmal varix is freely opened, after control of the
vessels, and the fistula is closed by sutures inserted from
within the lumen of the vein. The aneurysmal sac and
segment of the vein are then excised, no attempt being
made at reconstituting the venous lumen in any circum
stances. The ideal procedure is not readily applicable;
it needs special technique and atraumatic needles threaded
with fine silk impregnated with paraffin, and precautions
must be adopted to prevent vascular clotting by the use of
sodium citrate solution locally or of heparin. If this
procedure is successful, the limb receives its blood supply
through the reconstructed artery.

After operation careful nursing is necessary to aid the
limb to return to normal and to establish an efficient
circulation as quickly as possible. Rogers " briefly sum
marizes the essential features by advising that attention
be paid to the posture of the limb, so that its metabolism
is reduced and the peripheral vessels are relaxed. The
limb circulation should be aided by gravity and the limb
is therefore extended in a position approximating to heart
level. The leg is cooled; this lowers its metabolism and
its demand on a blood supply. Rogers recommends the
use of ice, but in the cases quoted, exposure of the leg to
ordinary room temperatures was all that was considered
necessary; warming of the legs by hot-water bottles or
other heat sources was avoided. The peripheral vessels
generally are relaxed by the application of warmth to the
body, with the exception of the injured leg, and thus the
establishment of collateral circulation to the limb is aided.
There is not, however, universal agreement about the
cooling of the leg, although present opinion is gradually
swinging towards cooling rather than heating of the limb
during the stage when the collateral circulation is being
established. Reichert &lt;8) found that, after ligation of an
artery of the previously amputated and resutured limb of
a laboratory animal, the limb would live if kept warm,
but became gangrenous if allowed to be chilled. The
experiment did not appear to be conclusive, and further
clinical experience on the subject of freezing or cooling of
a limb suffering from vascular damage or ligation is
necessary before a conclusion can be reached.

The immediate results of treatment by quadruple ligation
and excision of the fistulous area are excellent. The
return of the heart to normal size and the improvement
in the pulse rate and blood pressure are dramatic. The
collateral circulation is usually sufficient to supply the
needs of the limb, provided that operation has been delayed
for an adequate time after injury. However, Bigger 19
has further investigated some of these cases in which
ligations of main vessels of the extremities have been
carried out for arterio-venous aneurysms. He has found
that there is definite evidence that the circulation is
inadequate for sustained muscular activity, and stresses
the fact that this important observation has not received
the attention which is its due. As an example is quoted a
case in which a superficial femoral ligation was performed
for arterio-venous fistula, and in which the leg easily tires
and the foot is cold. In the series of cases quoted, after
ligation of a main vessel for arterio-venous fistula, there
was no instance of serious acute circulatory difficulty, but
all the patients had evidence of persistent circulatory
deficiency. Bigger concludes that, although a patient with
arterio-venous fistula has little chance of gangrene after
resection of a main artery, even the common femoral or
popliteal, yet "such a patient appears to be as prone to

chronic circulatory difficulty as one having ligation of the
corresponding vessel for arterial aneurysm". It is too
early yet to assess the terminal results of the cases quoted
in this paper, but a "follow-up" appears to be well worth
while at a later stage.

Summary.

1. Two cases of femoral arterio-venous aneurysm of the
superficial femoral vessels are reported, to demonstrate the
development of an arterio-venous fistula, and also to show
the late results in a long-standing case with classical local
and cardio-vascular signs.

2. The characters of the thrill and bruit present in
arterio-venous fistula are set out and their extensive
conduction is described. The cardio-vascular features
generally are discussed.

3. The importance of differential diagnosis from arterial
simple aneurysm is stressed.

4. The advantage of delay before operative treatment in
most cases is mentioned, and the operative procedures
adopted are briefly reviewed.

5. The rationale of post-operative treatment is described.

6. The prognosis of femoral arterio-venous aneurysm
treated by quadruple ligation and excision is good in
respect of immediate results, but signs of chronic circu
latory inadequacy are apt to develop, limiting return to
full activity in some cases.

Acknowledgement.

I wish to thank Air Vice-Marshal T. E. V. Hurley,
Director-General of Medical Services, Royal Australian Air
Force, for permission to publish this paper.

References.

&gt; J. S. Horsley and I. A. Bigger: "Operative Surgery", Fifth
Edition, Volume I, 1940, page 151.

&lt;2 &gt; E. Holman : "Arterio-Venous Aneurysm", 1937, page 48.

&lt; 3 &gt; J. M. Mason, G. S. Graham and J. D. Bush : "Early Cardiac
Decompensation in Traumatic Arterio-Venous Aneurysms",
Annals of Surgery, Volume CVII, June, 1938, page 1029.

&lt; 4) H. Bailey : "Surgery of Modern Warfare", Second Edition,
Volume 1, 1942, page 250.

(B &gt; H. Tarnower, B. Lattin and S. G. Adie : "The Successful
Closure of an Arterio-Venous Aneurysm Involving the Left
Innominate Vein and Left Common Carotid Artery", Annals
of Surgery, Volume CXVI, November, 1942, page 700.

&lt; 6) E. Holman : "The Immediate and Late Treatment of an
Arterio-Venous Fistula", The Australian and New Zealand
Journal of Surgery, Volume XIV, October, 1944, page 83.

&lt;7) L. Rogers : "Physiological Considerations in Vascular
Surgery : Ligation of Main Arteries of Limbs", THE MEDICAL
JOURNAL OF AUSTRALIA, May 19, 1945, page 517.

&lt;H &gt; F. L. Reichert : "The Importance of Circulatory Balance in
the Survival of Replanted Limbs", Biilletin of the Johns
Hopkins Hospital, Volume XLIX, August, 1931, page 86.

&lt;8&gt; I. A. Bigger : "Treatment of Traumatic Aneurysms and
Arterio-Venous Fistulas", Archives of Surgery, Volume XLIX,
September, 1944, page 170.

PUTRID LUNG ABCESS.

By C. J. OFFICER BROWN,
Melbourne.

PUTRID lung abscess is a serious and by no means
infrequent complication of surgical operations and par
turition. Since 1939 I have operated on 41 patients for
lung abscesses, 21 of which followed operation or par
turition (Table I).

The common factor in all these 21 cases was general
anaesthesia; in most cases the anaesthesia was "trouble
some", or post-operative vomiting occurred. Some patients
had recovered too soon from anaesthesia in a dental
operation, and anaesthesia was reinduced when the patient
had his mouth full of blood and saliva. In one case teeth
and tonsils, and in another tonsils and antra, were dealt
with at the same operation. In yet another case, although
the patient was not seen to vomit, some dried vomitus
was noticed on the pillow. Post-operative lung abscesses
1 result from the inhalation of blood, pns or debris, and it

108

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY 26, 1946.

can be shown by bronchoscopy that some blood always
enters the trachea during any operation on the nose or
mouth unless special measures are taken to prevent it.
Even in a conscious patient the laryngeal reflex is not
the complete protection it is often assumed to be. Lipiodol
introduced into the pharynx of a sleeping patient can be
demonstrated radiologically in the lungs next morning,
and heavy sedation is quite sufficient to put the laryngeal
reflex off its guard.

If the patient is lying on his back, inhaled material
tends to gravitate into the bronchus to the apex of a lower
lobe usually in the right lung and if he is lying on his
side it flows first into the upper lobe bronchus of the lower
lung. These facts can readily be demonstrated with lipiodol
under the X-ray screen. Post-operative abscesses are most
common in the apices of the lower lobes and in the upper
lobes.

After regional block anaesthesia inhalation may occur
while the patient is "sleeping it off", and heavy sedation
should be avoided in these cases.

TABLE I.

Number

.iEtiological Factor.

Abscesses.

Dental operations . .

Parturition

Abdominal operations

Ear, nose and throat oper

ations

Foreign bodies

Carcinoma of the lung

Unknown

"Pneumonia" et cetera

Total

It is recognized that some blood is aspirated into the
lungs in the majority of mouth and nose operations, but
in most cases this is coughed up and causes no trouble.
In some cases a small bronchus becomes blocked by the
inhaled material, and the corresponding segment of lung
becomes atelectatic; with infection added, a localized
pneumonitis develops, and this is the explanation of many
cases of post-operative pneumonia. When the infecting
organisms are necrotizing dental anaerobes or similar
types, a putrid lung abscess results.

The segment of atelectatic lung always abuts on the
visceral pleura, and infection excites an intense pleural
reaction and adhesions form over the area of reaction.
Since the greater part of the surface of the lung is in
contact with the chest wall, in most cases these adhesions
fix the site of the abscess to the chest wall. This does
not happen if the abscess reaches the pleura on the dia
phragmatic or mediastinal surfaces of the lung, or in a
fissure. In all other cases there is an area of adhesions
through which the abscess can be drained without
opening the free pleural space. This area is sealed
off early and the adhesions are firm within two or three
weeks of the onset of the abscess. The area of fusion may
be limited and is often not more than an inch or two in
any direction; but with accurate localization it Ls usually
adequate for approach to the abscess.

Cavitation always occurs in seven to ten days from the
onset, and in acute abscesses the cavity is found to average
about two inches in diameter, and is solitary, spherical and
unilocular. It contains pus, debris and sloughs, and after
a few days opens into a bronchus; this allows the exit
of the foul gases which cause the putrid smell and taste,
even before any pus is evacuated. As the bronchial opening
enlarges, pus and sloughs may be evacuated and spon
taneous cure may result.

In most cases bronchial drainage is inadequate and the
process tends to become subacute. Fibrosis develops in the
wall of the abscess and in the adjacent lung, local extensions
occur causing multiloculation, and "spillover" into adjacent
bronchi results in satellite abscesses and bronchiectasis. At
this stage drainage is useless, and the only hope of cure is

by extirpation of the diseased portion of the lung. At any
stage the abscess may perforate into the pleural cavity,
causing a localized or generalized pyopneumothorax. Cere
bral abscesses may result from blood spread, and amyloid
disease may develop from long-continued suppuration.
"Spillover" into other parts of the lung may cause
suppurative pneumonia or other abscesses.

Acute, subacute and chronic stages shade into one
another; but it is helpful to separate them arbitrarily.
For practical purposes a abscess less than six weeks old
is acute, from six weeks to three months it may be con
sidered subacute, and after three months it is considered
chronic.

Symptoms.

After operation there is usually an incubation period
of a few days, followed by the onset of illness with flushes,
chilliness and rigors. Pain in the chest indicates the site
of pleural involvement, and localized tenderness may be
elicited over this area. A cough develops, and although
at first it is dry and irritating and non-productive, in a
short time usually ten or twelve days from the onset
the patient begins to expectorate foul pus in increasing
amounts. Some days before expectoration commences a
foul odour may be noticed in the breath, and this is diag
nostic of the presence of a lung abscess. Haemoptysis
frequently occurs. The maximal interval between operation
and onset is probably fourteen days.

Prophylaxis.

Dentists and surgeons are usually held responsible for the
development of post-operative lung abscesses, but the real
blame in most cases lies with the anaesthetist. No operation
on the mouth or throat, involving general anaesthesia,
should be performed unless the patient is in a well-equipped
hospital. The operation should always be performed with
the patient in the prone position, and when it is likely
that aspiration will occur, the anaesthetic should be
administered through an endotracheal tube and the
pharynx should be packed or otherwise shut off. In any
operation, if aspiration does occur or is suspected, the
air passages should be cleared at the end of operation
by tracheal suction or bronchoscopy, and in the post
operative period, if atelectasis develops, active measures
should be taken to overcome it. First the patient should
be given morphine, laid on the sound side and vigorously
thumped and rolled about. This may start a fit of coughing
with the expulsion of a plug of mucus or blood clot, which
will be followed by reexpansion of the collapsed area. If
it fails, tracheal suction with a catheter may be tried or
bronchoscopy may be used. Bronchoscopy, although some
what terrifying to a sick patient, is undoubtedly the best
method, and should be looked on as an essential accomplish
ment for any specialist anaesthetist. I make it a routine
measure after all operations to insist that the patient takes
regular deep breaths and coughs, even if it hurts, because
sputum retention is the commonest cause of post-operative
chest complications.

No operation of election should be performed in the
presence of dental infection, and dental inspection should
be a routine measure before operation in all hospitals.

Management.

The majority of acute abscesses require surgical drainage,
just as surely as operation is required for the treatment
of acute appendicitis. Both conditions may resolve spon
taneously; but the decision whether to operate or not and
when to operate is entirely the province of the surgeon,
who should be called in as soon as a lung abscess is
suspected. It is obvious that complete resolution is much
more likely to occur if the infection can -be controlled in
the acute stage before secondary changes have developed
in the surrounding lung. If drainage has to be attempted,
it is much more likely to succeed in the acute unilocular
stage than when the cavity is multilocular and the
surrounding lung fibrotic and honeycombed. Once the
condition of chronic pulmonary suppuration has been
reached, although drainage may bring about some improve-

JANUARY 26, 1946. THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER.

iii

lamerazme

N I CH LAS

NICHOLAS PTY. LTD.
ETHICAL DIVISION

I I

ulph

amerazne

In each tablet

0.5 gramme (7.7 grains)
2 -Sulphanilamido-4- methyl
pyrimidine

In bottles of 25 100 and 500 tablets

A NICHOLAS ETHICAL PRODUCT

THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER. JANUARY 26, 1946.

WELLCOME -

CHLOROFORM

FOR ANESTHESIA

WELLCOME brand CHLOROFORM is particularly
free from irritating products of decomposition.
Contains a small definite amount of ethyl chloride
which has a marked beneficial influence on
induction of anaesthesia. It is manufactured by
processes which have been proved by extensive
research and experience to yield the most sat
isfactory results. Careful analytical control ensures
that it conforms not only to the pharmacopoeial
requirements but also to the stringent standards
laid down for all Wellcome Brand Chemicals.
Complete freedom from phosgene (a frequent
and dangerous impurity) is demonstrated by
micro-chemical tests of every batch.

^ WELLCOME -

CHLOROFORM

1 Ib. (454 gm. appro*-) -5

10? fl. oz.

^wUZr""* " * COOL :.*f"u 1 *"

WELLCOME CHLOROFORM

is issued in stoppered amber bottles of 2 ozs.,
% Ib., y 2 Ib. and 1 Ib.

BURROUGHS WELLCOME & CO.
(AUSTRALIA) LTD.

(Incorporated in England)

SYDNEY, N.S.W.

ASSOCIATED HOUSES : LONDON NEW YORK MONTREAL

CAPETOWN BOMBAY SHANGHAI BUENOS AIRES

JANUARY 26, 1946.

THE MEDICAL JOURNAL OF AUSTRALIA.

109

ment in selected cases in which large, poorly-drained pus-
containing cavities are present, cure is rarely possible
except by extirpation.

Probably about 30% of putrid abscesses resolve spon
taneously, and it is reasonable to be conservative for a
few weeks in cases in which abscesses are apparently
draining well into a bronchus, when the course is not
very acute and the cavity is only moderate in size.
Penicillin should be used for these patients and will help
if bronchial drainage is sufficient. Unless resolution is
progressing satisfactorily, drainage should never be
delayed beyond six weeks, and if symptoms recur after
apparent resolution the abscess should be drained without
further delay. Resolution must be assessed on the
disappearance of clinical symptoms (rise in temperature,
cough, sputum) and the clearing of X-ray signs. Until the
X-ray findings are normal relapse is likely, and the patient
should never be discharged from hospital. Good X-ray
films must be taken every week during the period of
observation, and if there is any evidence of deterioration
extra films should be taken at once. Clinical examination
is of little value, and the progress of the lesion can be
followed only by radiological methods. Films should be
taken in two planes, and various intensities and exposures
should be used in an attempt to demonstrate a cavity, if
one is not readily visible. Because cavities appear and
disappear in the films in accordance with their content of
pus or air, sufficient films should be taken for accurate
localization on the first occasion when a cavity is demon
strated. Accurate localization is the sine qua non for
successful drainage.

Non-operative treatment consists of "wait and see", with
supportive regime, drugs and postural drainage. Broncho-
scopy should generally be used once, to exclude the presence
of a foreign body or a carcinoma or other obstruction in a
bronchus. It is occasionally of value in improving drain
age, especially in the case of abscesses in the basal parts
of the lower lobes. Bronchoscopy should be carried out
by the surgeon, because the information obtained helps in
localizing the abscess and determining when and how to
operate; it should not be repeated unless it has obviously
improved drainage, or in an emergency, when a sudden
flooding of the bronchial tree has occurred and aspiration
is necessary to relieve respiratory distress.

Sulphonamides are useless for putrid infections. Penicillin
is efficient in controlling them, provided drainage is
adequate, but it is useless without effective drainage. It
should be used for twenty-four hours before operation and
for as long as seems necessary after operation. Penicillin
prevents the sloughing of the surfaces of the wound and
hastens the disappearance of the putrid odour after
operation, and it seems likely that it reduces the risk of
"spillover" suppurative pneumonia and possibly cerebral i
abscess in the immediate post-operative period, when \
coughing is painful and retention of secretions difficult to
prevent.

With accurate localization nearly every lung abscess can
be approached through the adherent area and drained in
one stage. If the pleura is inadvertently opened, a two-stage
operation may be necessary; but this has happened in
only a fe\v of my cases.

Drainage should be carried out at once in the case of
all hyperacute abscesses and all abscesses with excep
tionally large cavities, and in the case of an acute abscess
that has not responded satisfactorily to a few weeks
delay. It may be tried for subacute and chronic abscesses
with large, poorly-drained cavities associated with copious
sputum. Often in these cases lobectomy will be needed;
but the risk of the major operation may be reduced by
preliminary drainage, to reduce the volume of sputum and
improve the patient s condition.

Lobectomy is the only treatment for the patient who
has passed into the stage of chronic pulmonary suppuration
with multiple cavitation and bronchiectasis. Many of
these people are reasonably well, but have persistent cough
and sputum, and in my experience they have all been cured
by lobectomy. Contrasted to these is a small group of
patients whose infection is diffused through a lobe with
multiple small cavities and much fibrosis. They are febrile

and toxasmic and losing ground, but there is no cavity that
can be drained, and lobectomy seems to offer them their
best chance of recovery. Lobectomy was performed on
five of my patients suffering from this condition. The
first, in 1940, died on the operating table from suffocation
by the cheesy pus squeezed from the lobe as it was being
freed. Improved methods of anaesthesia and operation
that we now use would have prevented this, and recently
Dr. R. H. Orton piloted an even more troublesome patient
through a successful three-hour lobectomy by repeated
bronchial suction and bronchoscopy during the operation.
The next two patients survived the operation, but
succumbed to putrid infection a few weeks later. Penicillin
would probably have saved these two. The last two have
done well. One is cured and the other is convalescent.

Results.

The results have been as follows. From 1939 to 1941,
10 patients had lung abscesses drained; two patients were
cured and eight died. From 1942 onwards, 16 patients had
lung abscesses drained; 11 patients were cured, one died,
the condition of two was improved and they were later
cured by lobectomy, one contracted tuberculosis, and the
condition of one was not improved. Lobectomy for car
buncle of the lung was carried out in five cases; one
patient was cured, one is convalescent and three died.
Lobectomy for chronic suppuration after a lung abscess
was carried out in 13 cases; all the patients were cured.
Thus, of 18 patients submitted to lobectomy, three died.

In three of the cases in tbe 1942 and after group two
separate abscesses were drained. In one case recovery
followed drainage of a complicating localized pyopneumo-
thorax, and in another recovery followed a first-stage
operation in which rib resection was performed and the
cavity was not found, the wound being packed and closed
to allow further localization. Penicillin had been used
for some days before operation without response, and its
administration was continued after operation. The
patient s temperature became normal, and after an initial
increase, cough and sputum disappeared and he made a
complete recovery without further operation.

Acknowledgements.

I should like to express my indebtedness to the writings
of Neuhof and Touroff and their associates. From them
I obtained an understanding of the pathology and manage
ment of lung abscesses, and I have had opportunity to
confirm the accuracy of the principles they enunciate. At
the Mount Sinai Hospital in the last sixteen years these
men have operated on 172 patients suffering from acute
putrid lung abscess, with four deaths.

Bibliography.

Arthur S. W. Touroff and Harold Neuhof : "The Differentia
tion between Acute Putrid and Non-Putrid Pulmonarv
Abscess", The Journal of Thoracic Surgery, Volume X, August,
1941, page 618.

H. Neuhof : "Acute Putrid Abscess of the Lung", Surgery,
Gynecology and Obstetrics, Volume LXXX, April, 1945, page
351.

INGUINAL HERNIA AND ITS REPAIR.

By HARLEY TURNBULL,

Lieutenant-Colonel, Auslralain Army Medical Corps,
Australian Imperial Force.

THE Bassini operation is standing its trial. English
surgery in particular has been vehement in its condemna
tion, and unequivocably demands the death of the Bassini
technique. The operation was first described by Bassini
in 1889, and for fifty-five years it has been accepted. If it
is to be condemned, the evidence on which it is sentenced
must be irrefutable and irreproachable. Those who
wilfully destroy must of necessity rebuild, and the new
edifice must be finer and better.

110

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY 26, 1946.

The objections to the Bassini operation are based on
the statistics of recurrences, and a dogma which depends
on statistics must always be suspect. An article by
Edwards in The British Journal of Surgery of October, 1943,
is typical of this trend in the surgical treatment of hernia,
and is an example of the ever-increasing number of articles
over the last ten years damning the Bassini operation.
Edwards draws attention to the alarming recurrence rate,
and dogmatically states that it is due to a blind adherence
to the Bassini technique. He quotes figures which were
published by Max Page in 1943, and he bases his conclusions
largely on them. They are the results of 142 operations
performed in 1943. These figures are shown in Table I:

TABLK I.
After Edwards.

Number of

Recurrence

Operation.

Performances.

Recurrences.

Rate.

Bxcision of sac

9-3%

Fascial repair

15-4%

Other methods :

Bassini

Fowler

6 r

17-6%

McArthur

Bloodgood

The striking fact is the low number of Bassini operations
on which Edwards bases his opinion; the McArthur and
Bloodgood operations are only slight variations of the
Bassini operation and can be classed as a Bassini operation,
so that the total is 11 operations out of 142. The Fowler
operation can by no means be called a Bassini modification,
so that the given numbers included in "other methods"
should be 11 Bassini and six Fowler operations. The
recurrences were three a rate of 17-6%. There is no
mention of the type of operation the Bassini or the Fowler
in which the recurrences were observed. These figures
are thus unfair to the Bassini technique. As they stand in
the article by Edwards they are valueless, for there are
three fallacies, one of which has been mentioned. Other
important fallacies are as follows: (i) the operations were
performed by different men, who must vary in skill, tech
nique and judgement; (ii) much vital information is
omitted the age of the patient, his general physique, the
type of hernia, the suture material, the type of anaesthesia,
pulmonary complications, sepsis, the period of incapacity
(that is, the length of stay in bed), the length of con
valescence, and the period before hard work was resumed.
Without full information the figures are unintelligible, and
surgeons would be ill-advised to discard Bassini s operation
on a spurious deduction from such figures.

To illustrate how treacherous and misleading figures
without detail can be, the following two hypothetical cases
may be put forward. The first patient has a large scrotal
hernia of some years standing; the sac is thickened, fibrous
and adherent, and there is gross distortion of the
anatomical planes. The second patient is a young man,
whose tissues are firm and tonic; the hernia is small and
a bubonocele, the hernial ring, is small and there is no
distortion of the tissues. The first patient undergoes a
Bassini operation and the hernia recurs; the second has
the sac excised and the hernia does not recur. Is it
justifiable to state that the Bassini operation is no good
and should be discarded without considering the difference
in the two types of hernia and the relative difficulty of the
two operations? Excision of the sac can be performed
only in selected cases, and the recurrence rate should be
lowest in such a group. What is to be done with the other
cases? It is postulated that there are only two operations
that can be performed the Bassini operation or a fascial
repair. On the quoted figures, which by no means give
the true position, the recurrence rates were respectively
17% and 15%. The rate may well have been much lower
for the Bassini operation alone, for with it are included
six Fowler operations. Is it wise to state on these figures
that fascial repair should replace the Bassini operation,
as Edwards states? Edwards s final words are that early
hernia should be treated by excision of the sac with

tightening of the internal ring; all other herniae should be
treated by fascial repair; the Bassini operation and its
modifications must be abandoned.

There is no evidence here for a prima facie case against
the Bassini operation. Each surgeon must form his own
opinion, but that opinion must be impartial, and founded
on rock, not sand. The provocative opposition to the
Bassini operation has stimulated an interest which must
result in progress, for the treatment of hernia is not so
satisfactory as it should be. It is of great importance
now because the number of operations for hernia performed
on servicemen is large. The combined loss of man-hours
from these cases is enormous, and this loss is substantially
increased if the recurrence rate is high.

Ogilvie, of England, for a long time has been a bitter
opponent of the Bassini operation. His main arguments
against the operation are three: (i) suture of the conjoint
tendon to the inguinal ligament means a muscle working
out of place; (ii) the abdominal wall is weakened; (iii)
recurrence is favoured rather than prevented. These
statements must be considered in detail, and the answer
is found in the anatomy of the inguinal region.

The lowest fibres of the internal oblique arise from the
lateral two-thirds of the inguinal ligament, and with the
lower fibres of the transversus abdominis form the conjoint
tendon. The union results in a sickle-shaped fold, which
is inserted into the pubic crest and the medial three-
quarters of an inch of the ilio-pectineal line. The direction
of the fibres is downwards and medial. When the muscle
contracts, it must do so in the direction of its fibres
that is downwards and medially. This results in the lower
border s becoming straight, taut and approximated closer
to the inguinal ligament. The natural action of the con
joint tendon is thus to draw itself downwards on
contraction. In muscular people the conjoint tendon as
such exists only at its insertion, and the muscle of the
internal oblique and transversus is often so low that it
abuts against the inguinal ligament in its natural position.

When the conjoint tendon is sutured to the inguinal
ligament, as in the Bassini operation, the tendon is put in
a position that is a slight exaggeration of the normal, and
it is sutured in the direction of its pull. If unabsorbable
sutures are used, fibrous union does occur between the
two structures, despite statements to the contrary. Casti-
gators of Bassini state that this fibrous union is not
sound, will not withstand strain and has been achieved
by the destruction of the muscle fibres. It is asserted
that the insertion of sutures into the conjoint tendon to
anchor it to the inguinal ligament strangles the blood
supply, and causes a traumatic necrosis of the muscle
fibres and their replacement by fibrous tissue. Is this
strictly true? How often is it found that the lower inch
or so of the conjoint tendon is completely devoid of muscle,
and is a flat sheet of fibrous tissue of tendinous com
position? Tendon is practically avascular, so how can a
blood supply be strangled that does not exist? And how
can fibrous tissue be changed into fibrous tissue?

When the tendon is sutured to the medial two-fifths of
the inguinal ligament, its normal position is only slightly
changed, as is the direction of the pull of its fibres; should
not this union be considered an extension of the insertion
of the tendon? If this is so, then the abdommal wall should
be strengthened, for the tendon has a greater purchase.
If the conjoint tendon is firmly attached to the inguinal
ligament, and if the ilio-hypogastric and the ilio-inguinal
nerves are intact, when the internal oblique contracts
there can be no increased weakness of the abdominal wall.

If the Bassini operation weakens the abdominal wall,
then recurrence when it takes place should be through the
weakest spot, which is not at the internal ring but at
Hesselbach s triangle. Recurrences should accordingly be
direct rather than indirect. Experience shows that,
irrespective of the original type of hernia, 66% of the
recurrences are indirect; this proves that the wall cannot
be weakened by the operation.

Antagonists of Bassini point to the good results achieved
in children by simple ligation and excision of the sac,
using this fact as an argument against mechanical repair.

JANUARY 26, 1946.

THE MEDICAL JOURNAL OF AUSTRALIA.

Ill

They overlook the basic principles that in children the
tissues are firm and tonic, that there is no anatomical
distortion, that the sphincteric action of the internal ring
is unimpaired, and, what is more important, that the
older the child grows, the less is the chance of recurrence.
In the child the size of the internal ring compared to the
area of the abdominal wall is relatively much greater than
in the adult. As the child ages, the size of the internal
ring diminishes, owing to a "step-up" in the area and
bulk of the abdominal wall, until man s estate is reached.
Therefore the tendency to recurrence progressively
diminishes as the child develops. Heavy work, stress
and strain are potent factors in causing recurrence; but
the child s musculature is not subjected to the same degree
of strain as is the adult s, so that after operation the
passing of the years permits Nature to effect a permanent
cure.

These are the answers to the three statements by
Ogilvie: the muscle is not working out of place, the
abdominal wall is not weakened, and recurrence is not
made easier.

Those who would discard the Bassini operation must of
necessity put forward much weightier evidence than they
have done. The Bassini operation is not suitable for
every hernia, but it should be retained for those cases
in which it is suitable a decision for which the operating
surgeon alone must be responsible.

ANATOMY OF INGUINAL HERNIA.

The anatomy of the inguinal region reveals in part the
secret of success or recurrence. The inguinal canal is
1-5 inches long, and being cone-shaped, consists of an
apex, a base and anterior and posterior walls. It runs
obliquely from above downwards and medially. The apex
is a finger s breadth above the mid-point of the inguinal
ligament corresponding to the position of the internal
ring. The anterior wall is formed throughout by the
external oblique and the posterior wall throughout by the
transversalis fascia, and placed between these two are the
internal oblique and conjoint tendon, which encircle the
canal, taking part in the formation of both anterior and
posterior walls. The strength of the canal depends on
the internal oblique. Anteriorly this muscle covers the
lateral third of the canal including the internal ring and
thus forms a part of the anterior wall; it then curves round
as the conjoint tendon, and owing to the obliquity of the
canal, it forms a posterior relation of the medial third
of the canal. Where it forms the posterior wall the
internal oblique has joined with the transversus abdominis
to form the conjoint tendon. The floor is formed by the
grooved surface of the inguinal ligament and by the
lacunar ligament, which is the area of insertion of the
inguinal ligament on to the ilio-pectineal line. The external
ring is triangular in shape, admits the tip of the finger
and is formed by the pillars of the external oblique. The
floor of the canal is further strengthened by the trans-
vesalis fascia and by the insertion of the reflex inguinal
ligament from the opposite external oblique into the ilio-
pectineal line. Consideration must be given to the internal
oblique and to the conjoint tendon, for these constitute
the real strength of the canal.

Owing to the obliquity of the canal and the sickle shape
of the conjoint tendon, when the internal oblique contracts
it has a two-fold action, and the canal is compressed by
two opposing forces. The internal oblique compresses the
lateral third of the canal and internal ring backwards;
the conjoint tendon compresses the medial third of the
canal from behind forwards. The double action results in
the formation of the two potential sphincters one at the
internal ring and lateral portion of the canal, the other
at the external ring and medial portion of the canal. This
opposing action explains why a bubonocele is retained in
the canal for a variable period. It breaks through the
first sphincter and the internal ring, and is then delayed
by the second sphincter at the external ring.

In the construction of the canal are two points of weak
ness: one is of necessity the internal ring; the other is
the area just medial to the inferior epigastric vessels and

lateral to the pubic tubercle. It is at these two points
that hernia occurs. Therefore, any operation must be
designed to reinforce these two areas; otherwise it will
fail.

RELATIVE FREQUENCY OF HERNIA.

Of hernia? 75% are indirect, 25% direct. Recurrence
rates for both types of hernia are variously estimated
from 0% to 30%. The 0% figure can be discarded. The
average figure is probably about 15% and will vary with
the skill of the surgeon. Of the recurrences, 60% to 70%
are indirect. This fact requires careful thought. It means
that three-quarters of all herniae are indirect and three-
quarters of the recurrences are indirect that is that in
75% of the recurrences the original hernia is reproduced.
One most important fact is thus brought to light, for it is
obvious that at operation for both types of hernia the
surgeon has failed to deal adequately with the internal ring.
The explanation why most herniae recur as indirect hernia?
is simple and is indirectly wrapped up in the internal ring.
In my experience, fully 66% of the so-called direct herniae
have no claims whatever to be called direct herniae, for
the hernia is a combination hernia with both direct and
indirect sacs. This calls for a revision of the nomenclature
and of the relative frequency of the various types of hernia.
The figures should read: indirect hernia 75%, combination
hernia 15%, direct hernia 10%. In 66% of the direct
hernia?, if a search is made at the beginning of the
spermatic cord at the internal ring, a small indirect sac
will be found. This is never more than an inch long, is
very fragile, is non-adherent and has never been filled
with contents. If this fact is not recognized at operation
for direct hernia and the search is not made for the
indirect sac, then the seed is sown for the growth of an
indirect recurrent hernia, and the operation has been a
failure. This explains the frequent recurrence of so-called
direct hernise as indirect herniae. The funicular hernia
of Ogilvie is not a separate hernia, but a direct hernia
which has come through a small aperture in the posterior
wall of the inguinal canal just lateral to the pubic tubercle.

CAUSES OF RECURRENCES.

All indirect herniae are congenital, and Nature has fallen
down on her job. It is thus beyond our means to prevent
the occurrence of hernia; but by adequate operation
planned on physiological and anatomical grounds the
condition can usually be cured and recurrences largely
prevented. The causes of recurrence in general can be
labelled in most cases as bad surgery, due to ignorance of
the condition, and these causes can be grouped under
the following headings.

Poor Technique.

Poor technique covers a multitude of sins brutal
handling of the tissue, tearing instead of cutting and
stripping, faulty haemostasis, inadequate treatment of the
sac, missing of the sac, insertion of sutures under too great
a tension, faulty knots, injury of the ilio-hypogastric and
ilio-inguinal nerves, incomplete kowledge of the mechanics
of hernia, a lax aseptic technique, and lastly, tedious
surgery.

Ill-Advised Operation.

If the surgeon has a faulty conception of the mechanics
of hernia formation, he cannot perform the appropriate
operation required for each type. He fits the patient to a
standard operation and does not plan his operation to fit the
patient.

Faulty Pre-Operative Supervision.

The general physique of the patient is important. A
repair should not be performed during a period of ill-
health, and all general diseases should be eradicated. Tone
less, atrophic tissues must be rebuilt, muscles strengthened
and the patient s general condition improved. Complacency
in repair of hernia cannot be tolerated. The best time to
operate on a hernia is when it first occurs. Too often does
the medical man say: "Yes, you have a rupture, but it does
not matter much, you can have it fixed up if it troubles

112

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY 26, 1946.

you." Apart from subjecting the patient to the complica
tions of hernia, the medical man must remember that a
hernia is never stationary all the time it is increasing in
size and insidiously causing greater and greater anatomical
distortion, and the cure is gradually passing from a simple
to a more difficult operation with the greater chance of
recurrence. In the case of the large, irreducible, scrotal
hernia the patient should be put to bed for a period of
time in a moderate Trendelenburg position, and compres
sion spica bandages should be used; often the hernia will
be spontaneously reduced. If this occurs, the elastic tissues
will take up and a difficult operation will be made easier.

Faulty Suture Material.

In a mechanical repair operation the tissues are sutured
under slight tension, otherwise a firm repair will not result.
Therefore, as the tissues are sutured under some tension,
they must be firmly anchored until union occurs. In the
case of tissues that are relatively avascular (such as
fibrous and tendinous tissues), this apposition must be
maintained for a much longer period than in the case of
tissues with a good blood supply. Success in these cases
thus depends on the sutures, which must be non-irritating
and unabsorbable. Silk, thread or stainless steel wire are
the sutures to use, and the best of all is silk. This applies
also to chromicized gut. Silk is the ideal suture, and it
must be used for the whole operation ; bleeding points must
be tied with it and it must be used in each stage of the
repair. Catgut should not be used in combination with
silk. The dictum that Halstead gave to the world long ago
still holds good that if silk is used it must be used alone,
and not in conjunction with catgut.

In the use of silk there are three points that are to be
remembered. The knot must be a surgical knot that is,
a double twist in the first part completed as a reef knot
or else a triple knot. Silk thicker than necessary must
not be used, and lastly, if the knot is tied as advised, it
will not slip and the threads should be cut directly on the
knot, so that long ends are avoided.

Post-Operative Complications.

Despite every effort, post-operative complications will
occur. The aim should always be to prevent them and
thus minimize their occurrence.

Pulmonary Complications

Pulmonary complications are common, irrespective of the
type of anaesthesia used, and as such favour recurrence.
Careful pre-operative care should be given, particularly to
the heavy smoker. Nicotine before operation is a potent
cause of trouble after operation. Heavy smoking results in
rhinitis, sinusitis, pharyngitis and a "dirty" mouth. The
soil is thus present in which the seed may grow. Smoking
should be stopped, or at least reduced to a minimum, for
two weeks prior to operation. If this is done, upper
respiratory infection will largely subside, the "dirty"
mouth will become clean and the possibility of pulmonary
complications will be lessened.

The anaesthesia used is of no importance; complications
occur equally after any form. My own preference is for
spinal anaesthesia, for it gives perfect relaxation and avoids
post-operative vomiting.

Sepsis.

If sepsis occurs, recurrence is almost inevitable. Sepsis
causes redema, tension, inflammation, hyperaemia, cutting-
out of sutures and delayed healing. It can be avoided by
adequate skin preparation, the use of side towels, careful
surgical technique and perfect hsemostasis.

Complications Due to Faulty Post-Operative Care.

A common cause of recurrence is to allow the patient up
too soon. Bodily activity must be eliminated until healing
occurs. If this is not done, the whole strain of the
abdominal wall is taken by the sutures, in which case the
surgeon asks too much. Relatively avascular tissues, such
as fibrous tissues and tendon, require three times as long

for healing as vascular tissues, such as muscle. In respect
of a hernia operation, the period of stay in bed is thus
obvious. After the simple excision of the sac the only
fibrous tissue sutured is the external oblique; therefore
the stay in bed must be two weeks. When a mechanical
repair is performed, such as a Bassini operation, the stay
in bed must be longer a minimum period of three weeks.
For most patients with poor physique and large herniae, the
stay in bed must be four weeks. If a post-operative com
plication occurs particularly sepsis the rest period is
i proportionately longer. The time in bed can be profitably
i employed by the institution of gentle abdominal exercises
! starting not before the beginning of the third week. No
j lifting is to be done for a minimal period of two months
from the time the patient is allowed out of bed, and during
this period the patient takes gentle physical training. At
the end of three months from the time of operation the
patient makes a start on heavy work, and this is increased
over the next month. By the end of four months there are
no restrictions. Should the work be very heavy during
this fourth month, a light abdominal belt should be pre
scribed in order to take the general abdominal strain.

How is Hernia to be Treated f

There are only two hernia operations that should ever
be performed: (i) simple excision of the sac with tighten
ing of the transversalis fascia; (ii) a modified Bassini
repair, alone or combined with fascial graft. All other
operations are superfluous.

Simple Excision of the Sac.

Simple excision of the sac is the operation of choice for
early, small, indirect hernia. The cases must be carefully
selected. The patient is usually young and his abdominal
muscles are firm, tonic and well developed. No anatomical
distortion must be present, which means that the hernia
must be of short duration. The sac is ligated and excised
just above the neck, the spermatic cord is not dislocated
from its bed, the transversalis fascia is tightened and the
internal ring is narrowed until it fits snugly around the
cord.

Modified Bassini Repair.

The modified Bassini repair operation must be performed
in all cases that do not come into the above-mentioned
class namely, all direct herniae, all combined herniae and
all indirect herniae that are chronic, large and adherent.
In short, it must be performed in all cases in which there
is any distortion of the abdominal wall, however slight it
may be, and it must always be performed in the case of
recurrent hernia.

Technique of the Modified, Bassini Repair.
The original operation of Bassini is never strictly
followed by the writer. The broad principles are the same,
but the scope of the operation is enlarged in order to
strengthen the weak points on the canal.

The incision is made through the skin and fascia, and

skin towels are sutured on; a four-inch incision is made in

the external oblique in the direction of its fibres. This

incision must come well forward over the pubic tubercle,

which must be exposed, and free access must be given to

repair this weak point in the abdominal wall. This

incision goes through the external ring, and the edges of

the divided external oblique are picked up with haemostats

| and widely retracted. The upper portion is stripped up

| with the finger from the internal oblique to the point of

its union with that muscle. The lower portion with the

i inguinal ligament is carefully cleaned on its proximal and

; distal surfaces. The ilio-hypogastric and ilio-inguinal

! nerves are picked up and held out of the way. The

spermatic cord is then freed from the surrounding tissues

just above the pubic tubercle by passing the fingers from

i side to side underneath it, and a piece of gauze is then

| passed through so that the cord can be elevated when

I necessary. The bulk of the cord is not displaced. The

cremasteric fascia is incised longitudinally and the edges

| are retracted. The sac will then be found on the antero-

medial aspect of the cord.

JANUARY 26, 1946. THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER.

FOR PRE-NATAL AND POST-NATAL NUTRITION.

Ewtimi

The hospital-tested cereal
food rich in essential
Vitamin B Complex and
Minerals so vitally neces
sary in palatable and supple
mentary form for mother
and infant during Preg
nancy and Lactation.

ENERTONE is produced by the
makers of famous PRO VITA

WEATHARTS.

VITAMIN-ENRICHED PRE-DIGESTED PLEASANT TO THE PALATE

ENERTONE is obtainable from Chemists only 3/6.

PRO-VITA PRODUCTS, 422 COLLINS STREET, MELBOURNE, C.I

The Years Ahead

The Wise Man and his Will

"""THE Wise man recognises that economic conditions
* continue to change.

By the appointment of Perpetual Trustee Company as
his Executor he provides for the efficient management
of his Estate and thus saves his family from many
difficulties.

Write for a copy of the booklet "Your Executor and
Trustee", which explains the service that the Company
renders and what it costs.

PERPETUAL TRUSTEE

COMPANY LIMITED

DIRECTORS:

T. H. Kelly (Chairman); Hon. T. A. J. Playfair, M.L.C. ;
E. R. Knox; H. Norman Pope; Allen C. Lewis;

Hon. J. P. Abbott, M.H.R.
H. V. Douglass, Managing Director.

A. G. Armytage, Manager.

Executor and Trustee, Ajjeiit under Power of Attorney

for absentees and others, Administrator, etc.

TRl ST AND AGENCY FUNDS UNDKR

ADMINISTRATION EXCEED 64,OOO,OOO.

(The average estate being less than 10,OOO.)

33-39 HUNTER STREET, SYDNEY

Southern and Riverina District Representative: C. E.

Cowdery, Gurwood Street, Wagga Wagga.
Western District Representative: H. A. Shaw, 140

Lord s Place, Orange.
Northern District Representative: P. T. B. Thomas,

Fitzroy Street, Tamworth.

Ethyl Chloride

WOOLWICH or ELLIOTT BRAND

PROFESSIONALLY PREFERRED

Years of manufacturing experience.

Quality always provided.

Full conformation to B.P. requirements.

WOOLWICH-ELLIOTT CHEMICAL CO. PTY. LTD.
17 O Connell Street, Sydney. Tel. B 3877.

THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER. JANUARY 26, 194G.

ARGYROL

BRAND SILVER VITELLIN

TRADF MARK

REGISTERED

ADEQUATE STOCKS OF

ARGYROL

APE OBTAINABLE FROM PHARMACISTS EVERYWHERE

The specific uses of ARGYROL, its physico-chemical pro
perties, and the technique of its employment are indicated
in such conditions as : conjunctivitis, cystitis, prostatitis,
sinusitis, otitis media, head colds and pharyngitis. The facts
disclosed have been compiled from actual clinical data.

The fundamental characteristics of ARGYROL, as opposed
to othej- so-called mild silver proteins, are :

In respect to the concentration of its silver ions.
No other silver protein has so fine a colloidal dis
persion or so active a Brownian movement as
ARGYROL.

! Its pH and pAg are carefully adjusted to the
treatment of delicate mucosal surfaces.

Its bacteriostatic, detergent and inflammation
dispelling properties have never been duplicated.
ARGYROL is mild and non-irritating regardless
of the concentration in which it is employed ; it is
also non -toxic.

Sole Distributors:

FASSETT & JOHNSON LTD.

36/40 CHALMERS STREET, SYDNEY, N.S.W.

or LEVY BUILDING. MANNERS STREET, WELLINGTON. N.Z.

There is NO Chemical Equivalent for ARGYROL

JANUARY 26, 1946.

THE MEDICAL JOURNAL OF AUSTRALIA.

113

The fundus of the sac is picked up with a haemostat, and
the sac is freed by being stripped with gauze on the finger
and by occasional touches with the scalpel. When the sac
is freed as far as possible, it is opened at the fundus, and a
finger is inserted and used as a foundation on which to
strip with the finger of the other hand. The sac must be
freed until the area above the neck is clear, as indicated
by its collar of extraperitoneal fat. This area above the
neck is transfixed with two separate sutures of silk. These
sutures are passed from either side, and each pierces the
sac so that about three-quarters of the sac is enclosed in
each bite and the sutures are so placed that they inter
lock. These sutures are tied and a second single trans
fixion suture is tied just distal to the first. The redundant
portion of the sac is removed. On excision of the sac the
stump will retract deep down, and this is the first reason
why the sac must be tied high. The second reason is to
ensure that all the sac is removed.

The incised cremasteric fascia is now united with a few
interrupted silk sutures cut directly on the knot. In the
freeing of the sac up so high, there is one important fact
to remember: often the bladder is closely opposed to the
neck of the sac, particularly in the case of large hernise.
Unless this is remembered and care is displayed, trouble
some haemorrhage may occur from veins on the bladder
wall. If the bladder cannot be identified and abnormal
haemorrhage occurs, then it is certain that the bladder wall
is being traumatized. Do not expect to see rich red
muscle fibres; the fibres are pale and anaemic, and close
inspection must be made in order to identify them as
muscle. Should excess haemorrhage occur, then nothing
further is done until it has been absolutely controlled (this
control is sometimes difficult). If haemorrhage is not
controlled, a frequent result is the development of a large
extraperitoneal haematoma, which takes many weeks to
absorb and often suppurates. A scalpel should never be
used in this area, otherwise puncture of the bladder will
result. The danger of puncturing the bladder is not in
committing it, but in not recognizing that it has been done.
If the bladder is cut into, the opening is doubly sutured
and at the conclusion of the operation an in-dwelling
urethral catheter is inserted and left for seven days, fluids
are "pushed" and a sulphonamide is given.

The next step is completely to free the under-surface of
the conjoint tendon from the tratisversalis fascia until it
can be grasped as a separate entity. This freeing of the
conjoint tendon is important, for in most cases it permits
the tendon to be sutured to the inguinal ligament without
tension. The two points of weakness in this area are at
the internal ring and just lateral to the pubic tubercle;
the repair must aim at strengthening these two points.

The first step is to strengthen and tighten the trans-
versalis fascia. This is done either by a purse-string
suture or by interrupted silk sutures. The internal ring
is now narrowed by interrupted sutures placed on the
infero-medial surface until the ring is comfortably tight
and admits only the tip of the finger.

The next detail in technique is to suture the neigh
bouring lateral border of the rectus sheath, the area of the
linea semilunaris, to the periosteum of the pubic tubercle.
The needle must be felt to bite in and the suture grip
hard. This is the most important stitch in the whole
repair. It fixes the most medial point of the conjoint
tendon and relaxes the rest of the tendon, enabling it to
be sutured to the inguinal ligament without tension.
Rarely it will be found in placing this stitch that the
tension is too great; if so, the suture must be taken out,
and a semilunar fold of the anterior rectus sheath hinged
on the lateral border of the muscle must be brought down
and sutured in a similar way to the periosteum of the
pubic tubercle and the commencement of the inguinal
ligament. This effectively shuts off the weak point in
this area.

Vertical mattress sutures of silk are then used for the
repair. The fibres of the inguinal ligament run longi
tudinally. Thus sutures must not be inserted parallel to
the fibres, but across them; otherwise they will tear out,
split, mutilate and weaken the ligament, and so weaken

the repair. The second important point in the application
of these sutures is that they must be tied on the distal
surface of the inguinal ligament that is, on the femoral
triangle side. This permits the conjoint tendon to be
brought into the greatest possible contact with the inguinal
ligament, and the sutures can be tied more securely and a
sounder repair results. The conjoint tendon is stitched to
the inguinal ligament by interrupted sutures until it fits
snugly under the cord emerging from the internal ring.
One or two sutures are now inserted above the cord uniting
the internal oblique to the inguinal ligament. This is an
important step in strengthening the internal ring, for the
repair is now firm all round the emerging cord. In all,
about seven sutures are required.

The two nerves are now replaced and the external oblique
is repaired with interrupted "figure of eight" sutures. The
external oblique may be redundant; this is often the case
in big hernia. If this is so, it is overlapped after the
method of Mayo. If it is considered that the repair should
be further strengthened, fascial strips should be used from
the external oblique and plaited into the repair. This
method of using the external oblique fascia will be
described later.

This is the modified Bassini operation which the writer
considers should be performed in all cases in which the
operation is indicated.

Direct Hernia Repair.

Except for the method of dealing with the sac the opera
tion of repair for direct hernia is the same as the modified
Bassini operation described. An ever-present danger in
these hernise is the close proximity of the bladder; but
despite this close association the sac must be completely
freed until the surrounding peritoneum is taut. If haemor
rhage occurs (which it often does), nothing further is done
until it is controlled. If the sac is large, it must be treated
in the same way as an indirect sac, and the redundant
portion must be removed. Occasionally it is found that
when the sac is freed it is small. In these cases the sac
should be opened, surrounded by a purse-string suture
under direct vision and then invaginated.

It is of the utmost importance in dealing with a direct
sac to see whether there is an indirect extension into the
base of the cord. If so, the two sacs are converted into
one large direct sac by pulling the indirect out into the
direct sac. On no account are the inferior epigastric vessels
to be divided, as is advocated by some surgeons. They form
an important stanchion in the strength of the posterior
wall.

In the case of large scrotal herniae of the indirect type
(the sacs of which are adherent and thickened), after the
repair has been performed, the bottom of the scrotum must
be opened and a tube inserted to provide drainage, for
these herniae often ooze after operation. If drainage is not
provided, blood or serum tracks down into the scrotum, the
haemorrhage being concealed. A scrotal haematoma will
result, which may reach an alarming size, burying the
penis. If adequate drainage has not been provided and this
complication occurs, the blood must be rapidly aspirated.
But blood clots quickly, and usually by the time the
trouble is discovered aspiration is impossible because of
soft clot. The only thing to do then is to incise the
bottom of the scrotum, turn out all clot either mechanically
or by flushing with saline solution, and establish drainage.
In elderly men with large herniae it is justifiable to remove
the testis and cord in order to obtain a sounder repair.
The patient should always be warned of this possibility
before operation.

Gallic s Operation and Fascial Repair.

In the opinion of the writer there is no place in hernia
repair for the operation practised by Gallic. There are
several objections to the operation. The method of getting
the fascial strips is unnecessary and time-consuming, and
time is a factor in recurrence. The fasciotome Should
never be used, as it leaves a weakness in the thigh despite
assertions to the contrary by its advocates. It causes a
muscle hernia which is unsightly and constitutes a weak-

114

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY 26, 1946.

ness. Haemorrhage cannot be controlled, and a haematoma
sometimes occurs. A final objection is that some patients
for long afterwards complain of pain over this area. A
first axiom in surgery is never to replace one wrong by
another.

If the surgeon wants to take fascia from the thigh, he
should do it by the open approach. He should cut down
on the fascia, strip off the required amount, then suture
the gap in the muscle sheath so that no harm will result.
This method of obtaining fascia is seldom, if ever, needed.
In the case of large hernias of long standing, when the
tissues are stretched, attenuated and distorted, a fascial
repair should be used in addition to the modified Bassini
repair; but a fascial repair should not be used alone. In
these cases the external oblique is always redundant, and
this muscle will provide all the fascia that is required.
A long skin incision is used in the direction of the fibres
of the external oblique, the repair is performed as advo
cated, and strips of fascia are then obtained from both
upper and lower borders of the tendon. These strips must
be left anchored at one end. The beginning of the suture
is thus anchored, greater security being obtained with no
waste of fascia. The strips should be thin enough to be
threaded through a large non-cutting needle, and they
should be darned into the modified Bassini repair already
performed. Their insertion must be through the conjoint
tendon and inguinal ligament anterior to sutures used in
the Bassini repair. If this is done, the inguinal ligament
will not be mutilated, a double repair will be effected and
added security will be given. Fascial sutures must never
be inserted under tension. The Gallic needle should never
be used for introducing the fascial strips; it is cumber
some, it has a cutting point, it is far too big, and it irre
trievably damages the inguinal ligament and is one cause
of weakening the abdominal repair.

It is impossible in some cases to diagnose the type of
hernia, and operation alone will reveal whether the hernia
is indirect or direct. It is well to remember also that in
older people if bilateral hernia is present it is usually
direct. As a final injunction, the successful repair of a
hernia is a difficult operation. The patient with a hernia
is not a guinea-pig on whom the budding surgeon should
learn the first principles of surgical practice.

SURGICAL TREATMENT OF HERNIA IN AUSTRALIA.

Hernia is a common condition, and post-operatively
requires a prolonged period of rehabilitation. Loss in
wages, expenses incurred, compensation and loss of
effective working hours are considerable. The importance
of securing a permanent cure at the first operation is thus
evident. In Australia most general practitioners carry out
their own hernia operations, and this form of surgery is
not the sole prerogative of specialist surgeons. The opera
tion performed is invariably a Bassini modification, and
the results represent the individual efforts of many
surgeons good, bad and indifferent. The following figures
are offered for contemplation, in order that the importance
of this condition may be appreciated. The operations were
performed in only one of the many military hospitals in
Australia a hospital to which the writer was attached.

Seven hundred operations were performed, of which 52
were for recurrent herniae a percentage of 7-5. Whilst
not a strictly accurate assumption, it can be stated that
this figure of 7-5% approximately represents the recurrence

TABLE II.

Period.

Inguinal Hernia Operation?.

Primary
Hernia.

Recurrent
Hernia.

January 7 to December 31, 1943
January 7 to June 30, 1944

419

229

41
11

Total

648

rate in Australia, where the Bassini operation is univer
sally performed for all herniae except those not associated
with anatomical distortion of tissue planes. Further, the
recurrence rate in troops is probably higher than in
civilians, because of the increased severity of their work.
In this case the percentage recurrence rate in civilians is
probably lower. These figures are striking from another
viewpoint. Seven hundred hernia operations, performed
in one hospital over a period of eighteen months, meant
the complete immobilization of a full battalion of men for
a period of three months. If the whole Australian Imperial
Force is considered and, further, the whole Allied
services the loss of fighting personnel from this condition
alone is appalling.

In the Australian Imperial Force the approximate recur
rence rate is 7-5%. In the civilian populace it is probably
lower. How, then, can the opponents of Bassini fairly
insist that his operation be discarded?

SUMMARY.

1. The aim of this paper is an attempt to answer the
critics of Bassini.

2. The evidence given by the opponents in condemnation
of the operation has been considered in detail.

3. Reasons have been given for retention of the opera
tion reasons built on the sound foundation of anatomy,
physiology and results.

4. Herniae in general have been discussed and a form of
treatment has been recommended.

CONCLUSION.

The Bassini operation must not die. It must be retained
in surgery until such time as the ideal is found. To
abandon the operation would be a retrograde step in the
repair of hernias, and recurrences would inevitably
increase.

ACKNOWLEDGEMENT.

This paper is published by permission of Major-General
S. R. Burston, Director-General of Medical Services,
Australian Imperial Force.

THE SALIVA FACTOR IN PEPTIC ULCERATION.

By L. J. J. NYE,
Brisbane.

IN the aetiology and treatment of peptic ulcer many
theories have been advanced and have had enthusiastic
support for some years, but eventually have been dis
carded because they have failed to stand up to the
therapeutic test. It is, however, now believed with good
reason that ulcers are caused by peptic digestion of the
gastric mucosa by the hydrochloric acid of the gastric
juice. The question which must be asked is, why doee
the mucosa in certain subjects at certain times lose its
capacity to defend itself against this ever-present and
natural secretion? Is it due to some factor or factors in
the lives of these subjects which cause an increase in the
production of hydrochloric acid? Is it due to alteration in
the quantity and quality of the protective mucus which
is adherent to the mucosa? Is it some pathological process
or decreased resistance in the mucosa itself? Is it caused
by eating coarse food too rapidly, or do all the above-
mentioned factors play a part?

It is well known that many sufferers from duodenal
ulcer have been in the habit of "bolting" their food, and
it is of interest to speculate whether this may be one of
the setiological factors, for in addition to failure to pulp
the food, there is insufficient time for it to become mixed
with saliva. The pulping of the food with the teeth is
not the only purpose of chewing; the thorough mixing
with saliva plays a much more important part in digestion
than is usually believed. It is well known, for instance,

JANUARY 26, 1946.

THE MEDICAL JOURNAL OF AUSTRALIA.

115

that persons fed through a gastrostomy tube digest their
food better and gain in weight if the food is first chewed
in the mouth and mixed thoroughly with saliva before
being injected into the stomach. Moreover, many dys
peptics know that, if they eat mince meat, it is not well
tolerated unless it is well mixed with saliva before being
swallowed. Another interesting observation is that most
people can obtain relief from heartburn, flatulence and
hyperacidity merely by swallowing saliva.

This suggests that the saliva factor in dyspepsia is
worthy of more careful consideration than has been given
to it in the past. It has not been fully established how
saliva aids in digestion. It is believed that in the actual
process of digestion saliva plays an insignificant part.
There are no enzymes in saliva that could convert proteins
or fats into absorbable forms; but polysaccharides are
converted to disaccharides by the ptyalin.

Opinions have been put forward suggesting the presence
of some hormone in saliva which has some regulating
effect on carbohydrate metabolism as well as some influence
on gastric secretion; but the evidence presented in favour
of this hypothetical hormone is conflicting.

It is possible that mucus is an important factor. There
is a variable amount of mucin in saliva, and although
it is not known how it acts, mucin has been shown to be
an important aid in the treatment of peptic ulceration.
Possibly it has direct action on the secretory tubules as
well as a neutralizing effect.

It must be remembered also that the gastric mucosa is
covered by a protective layer of viscous tenacious mucus
with a pH between 4-0 and 7-0; this protects the mucosa
from the highly acid gastric juice, which has a pH of
perhaps less than 2-0. There is also a certain amount of
evidence to show that in peptic ulcer patients an inade
quate amount of mucus is secreted, both in the gastric
mucosa and in the saliva. Wolf and Wolff, (1) working on
their man with a permanent gastric fistula, showed the
importance of mucus in controlling gastric acidity and
preventing ulceration. They found that, when the mucus
secretion was continuously removed by suction from the
wall of the stomach, there soon appeared a tiny erosion
which rapidly developed into a typical peptic ulcer. If
mucus was allowed to flow again on this surface it would
soon heal.

The recent work on lysozyme, which is a powerful
bacteria-dissolving substance found in egg white and
saliva, suggests that it may serve the important purpose
of defending the gastric mucosa against bacterial invasion.
It is significant, too, that the amount of lysozyme in the
saliva varies not only in different subjects, but in the
same subject at different times.

The neutralizing effect of the salivary fluid is also
important. In a series of 22 patients with dyspeptic symp
toms it was found that the pH of fasting gastric juice
varied between 4-2 and 6-9, the average being 5-4. The
pH of the saliva taken at the same time varied between
6-1 and 6-9, the average being 6-5, and in all cases the
salivary pH was higher than that of the gastric juice.

The salivary glands have both sympathetic and para-
sympathetic innervation. The flow of saliva is not con
tinuous, but is regulated by the nervous system and
depends on certain food, chemical and emotional stimuli.
It is a matter of common experience for the mouth to
become moist at the smell of food or dry during certain
emotional states. Wolf and Wolff found the average
accumulation of saliva during the three hours of a
"control" morning was 40 millilitres; but one day, when
the subject was depressed, it was only 10 millilitres, and
later, during a day of intense resentment, it was 72
millilitres.

Babkin (a&gt; refers to Baxter s work in his laboratory;
Baxter, after section of the auriculo-temporal (secretory)
nerve root, found that the salivary glands were able to
secrete saliva nearly normal not only in quantity, but also
in chemical composition. Babkin then makes the following
statement:

It would be risky to suggest that the sympathetic
supply is alone responsible for such remarkable and
specific actions on the part of the glands to different
stimuli. It seems more likely there are other nerve
channels through which parasympathctic impulses may
reach the glands.

Babkin further states that in certain circumstances the
sympathetic and parasympathetic nerves act not antagon
istically but synergically.

In animals undoubtedly there are positive salivary con
ditioned reflexes (alimentary, sexual et cetera) which
increase or decrease the response of the glands to certain
stimuli. In dogs the ordinary phenomenon is the inhibition
of salivary secretion in case of fear and even at the sight
of anything unusual (the so-called "orienting" reaction).

However it acts, there is evidence to show that more
consideration should be given to the question of the
quantity, quality and effective utilization of saliva in the
dyspepsias. In order to take full advantage of certain
qualities inherent in saliva, it would appear that in the
treatment of all dyspepsias the thorough mixing of all
food with saliva is essential and alkaline lozenges should
be effective not only for their neutralizing effect, but
because they stimulate a flow of saliva which also has an
antidyspeptic effect, for it has been shown that the presence
of alkali in the mouth evokes a copious secretion of saliva
rich in mucin, and the act of sucking also increases the
flow.

I have experimented with satisfactory results with
lozenges made of calcium carbonate, magnesium carbonate,
sodium citrate and sugar. Not only do they give relief
in hyperacidity, heartburn and flatulence in most cases,
but the amount of alkali needed for this purpose is much
less than when the usual alkaline powder is used. Further
more, the lozenges are a much more convenient form of
medication, as they can be carried in the pocket or kept
in a box at the bedside.

Conclusion.

This article does not claim to have propounded any new
definite conclusions. It merely submits a theory which it
is believed may add something to the knowledge of treat
ment of dyspepsia and peptic ulceration and may serve
as a stimulus to further experimentation.

References.

&lt;u S. Wolf and H. G. Wolff : "Human Gastric Function".
&gt; A. Babkin : "Secretory Mechanism of Gastric Glands",
page 520.

Deports: of Cases,

AN IMMUNE ANTI-M ISO-AGGLUTININ IN
HUMAN SERUM.

By R. J. WALSH,

Major, Australian Army Medical Corps,
Australia.

THE agglutinogens M and N are of medico-legal interest,
but are not usually considered in blood transfusion work.
The anti-M and anti-N iso-agglutinins are only rarely found
in human serum. The anti-M agglutinin has been reported
on seven occasions and the anti-N agglutinin once. Wiener"
states that in four instances the anti-M agglutinins were
of natural occurrence and were not produced by iso-
immunization. The references to these reports are not
available to the writer. Wiener and Forer &lt;2) have recorded
the finding of a serum which contained an anti-M agglutinin
as well as an anti-Rh agglutinin. Clinical details of this
patient are not recorded, but Wiener (1) states that the
agglutinins were produced as a result of iso-immunization
from blood transfusion. Wiener* 3 reported a further patient,
a woman, in whose serum an anti-M agglutinin was found.
This patient had received a transfusion of blood one month
previously, and no abnormal agglutinin was detected at the

116

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY 26, 1946.

time. The patient described by Paterson, Race and Taylor w
had never received a transfusion of blood, and although she
had four children, none had suffered from haemolytic disease
of the newborn. The four children all possessed the
agglutinogen M. The serum in which the anti-M agglutinin
was detected was obtained from the mother four months
after the last child was born. It is impossible in this case
to determine whether the anti-M agglutinin was natural in
occurrence or whether it was produced by immunization of
the mother with the foetus s red blood cells during pregnancy.

Singer &lt;5) has reported the only serum in which an anti-N
agglutinin has been found; he considers that the agglutinin
was the result of iso-immunization following a transfusion
of MN blood seven days previously. As the agglutinin in
this case could not be detected by the usual methods of
cross-matching, there would appear to be little justification
for the assumption. The anti-N agglutinin could have been
of natural occurrence.

A further instance of a human serum containing an anti-M
agglutinin is now reported. Although there is no absolute
proof, it seems probable that the agglutinin resulted from
iso -immunization.

Clinical Record.

The patient, a female, aged sixty-two years, had suffered
since 1939 from a blood dyscrasia diagnosed as pernicious
anaemia. Since that time response to liver and iron therapy
had been unsatisfactory, and between 1939 and 1943 she
received at least seven blood transfusions. No details of
these transfusions are available; but the blood donors have
been compatible on all cross-matching tests. Difficulty of
administration has been frequently encountered, as the
patient s superficial veins are extremely small. Her elbows,
forearm and legs have numerous scars due to incisions over
the veins. In June, 1943, she received three transfusions of
blood. The first was discontinued after 200 mils had been
administered because of a rigor; 600 mils of blood were given
on the second and third occasions, the second transfusion
being without incident and the third associated with a slight
transient rigor. On February 15, 1944, she was again
admitted to hospital with a remission of anaemia, and was
given blood transfusions on two occasions. The second
transfusion was administered intrasternally, because no
suitable vein could be found. After 400 mils had been given
the transfusion was discontinued, because the patient became
cold, broke out into a sweat and complained of pain in the
chest. No jaundice was noted and no haemoglobinuria was
found. A further transfusion was contemplated on March 13,
1944, but a gross incompatibility was detected on cross-
matching tests with blood of a homologous group.

Investigation.

An investigation was carried out. Blood was obtained with
difficulty from a vein. A suspension of red blood cells in
2-6% sodium citrate solution was made and serum of icteric
tinge was separated. When the cells were tested, the
patient s blood was found to belong to group A, subgroup A 2 ,
and to group N, and the cells were Rh-positive. Her serum
agglutinated all group B cells and the majority of group A
cells, both subgroups A t and A 2 , and group O cells that were
available. The Rh factor could not have been involved,
because some Rh-negative as well as Rh-positive cells were
agglutinated. Agglutination was distinct to the naked eye,
and large clumps of agglutinated cells appeared within five
minutes of the mixing of the serum and cells on a slide at
room temperature. It was also obvious when the mixture
was made in test tubes and incubated at 37 C. The serum
wae then mixed on a slide with equal parts of a citrate
suspension of red blood cells of the following known
constitution:

OMN Rh + 4 samples, all positive (+)

OM Rh + 4 samples, all positive (+)

AM Rh + 1 sample, positive (+)

OM Rh - 1 sample, positive (+)

ON Rh + 5 samples, all negative (-)

By the application of Fisher s formula (quoted by Paterson,
a! 6!

Race and Taylor) , where a represents the number of

positive reactions and T&gt; the number of failures to react in
a total number n tested, it can be calculated that the odds
in favour of the antibody s being anti-M are 3,002 to one.

Complete absorption of the antibody was effected with an
equal volume of washed OM cells. This absorbed serum did
not agglutinate M or MN cells. The antibody was titrated
against OM and OMN cells by allowing a mixture of the
cells and serially diluted serum to remain in contact for one

hour at room temperature. Readings were made with the
naked eye after the cell-serum mixtures had been trans
ferred from tubes to a flashed opal glass slide. The titre
was found to be 1 in 32 in both instances.

Discussion.

It seems unlikely that the anti-M agglutinin could have
been of natural occurrence, since in that case it would
almost certainly have been detected earlier in cross-matching
tests. If, however, it was present in small amounts and
was overlooked, it must certainly have increased in titre as
a result of immunization. It appears much more probable
that the agglutinin was the direct result of iso-immunization
from previous transfusions, but the blood groups of previous
donors are not known. It is statistically improbable that all
belonged to group N. The possibility that the antigenic
stimulus was provided by a foetus the only two pregnancies
had occurred forty-six and thirty-two years earlier cannot
be overlooked; but it is not at all likely that an immune
antbody would have survived in the blood stream for thirty-
two years. There is no evidence that either child suffered
from hsemolytic disease of the newborn.

Acknowledgements.

The assistance of Dr. A. H. Tebbutt is gratefully
acknowledged. Facilities for the investigation were provided
by the New South Wales Red Cross Blood Transfusion
Service. The Director-General of Medical Services has
given permission for publication of the report.

References.

(1 &gt; A. S. Wiener : "Blood Groups and Transfusion", Third
Edition, 1943.

(2) A. S. Wiener and S. Forer : "A Human Serum Containing
Four Distinct Iso-Agglutinins", Proceedings of the Society of
Experimental Biology and Medicine, Volume XLVII, June, 1941,
page 215.

(:i &gt; A. S. Wiener : "Haemolytic Transfusion Reactions : Pre
vention, with Special Reference to the Rh and Cross Match
Tests", American Journal of Clinical Pathology, Volume XII,
June, 1942, page 302.

&lt; 4 &gt; J. L. Hamilton Paterson, R. R. Race and G. L. Taylor : "A
Case of Human Iso-Agglutinin Anti M", British Medical Journal,
Volume II, July 11, 1942, page 37.

(5) E. Singer: "Iso-immunization against Blood Factor N",
THE MEDICAL. JOURNAL, OF AUSTRALIA, Volume II, July 10, 1943,
page 29.

THE COMMODORE.

WE have at last been privileged to make the acquaintance
of that versatile sailor, Captain Sir Horatio Hornblower,
R.N., and we feel that the introduction has been too long
delayed. 1 In fact, it is almost impossible to believe that
the gallant captain is an apocryphal figure. In his book,
C. S. Forester has skilfully outlined a background of inter
national politics, life at sea and military operations, begin
ning a short time before Napoleon Buonaparte s fateful
attack on Russia. Hornblower is given a delicate mission in
and around the Baltic, and, as commodore in command of a
squadron of the Royal Navy, sets out to carry it out. It is
unnecessary to go into detail of how he does so; Captain
Sir Horatio Hornblower, we learn, is famous for ingenuity
and luck. The characters are living people and the tale is
exciting and well told; but obviously it is merely the vehicle
by which the reader is given a true appreciation of the very
human and lovable hero. To his comrades and subordinates
he appears a man of unswerving decision and iron will; we
are privileged to observe the mental and emotional processes
which go on behind the scenes to know how this outwardly
rock-like man conquers his genuine fear of the huge
responsibility that is laid upon him. At the close of the
book, Hornblower, his mission accomplished with something
more than the success expected of him, is left, obviously
about to suffer from a serious illness, which may be plague.
Let us hope that Mr. Forester will take pity on his readers
and not leave them in suspense for another six years the
period that elapsed between the previous "Hornblower" novel
and "The Commodore".

1 "The Commodore", by C. S. Forester; 1945. Sydney: Angus
and Robertson, Limited ; London : Michael Joseph, Limited.
1\" x 5", pp. 270. Price: 8s. 6d.

JANUARY 26, 1946. THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER.

vii

FOR IMPETIGO CONTAGIOSA

Two types of impetigo contagiosa of
Tilbury Fox can be differentiated, the
streptococcic and the staphylococcic. A
third mixed type has also been suggested,
caused by the combined action of strep
tococci and staphylococci.

While the streptococcic type of infection
responds to ointments containing ammoni-
ated mercury, those of the staphylococcic
type frequently fail to improve on these
ointments. For the latter type drying
lotions are superior.

Alulotion, Ammoniated Mercury with
Kaolin Wyeth, combines the bactericidal

action of ammoniated mercury with the
drying effect of aluminium hydroxide and
kaolin. It is a clean, effective treatment
for all types of impetigo contagiosa.
Clinical evidence has shown that Alulotion
cleans up impetigo contagiosa in less time
than older methods.

This unique water-miscible lotion can
also be prescribed effectively in the treat
ment of various other skin infections such
as ecthyma, folliculitis and the secondary
infections associated with eczema, seborr-
heic dermatitis and dermatitis due to
irritants.

Carries medication
into intimate con-
tact with lesion.

Contains no grease.
(Water mlscible-base

Helps to prevent
spread of infectio

AZULOTION

I NCORPOR ATED

NC. ID U.S.A.

44 Bridge Street, Sydney

AL5M

Vlll

THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER. JANUARY 26,

THREE IMPORTANT USES OF

I Ten drops daily of Adexolin Liquid
for the infant ensure normal dental
and skeletal development and build up
general resistance.

*J Twenty drops of Adexolin Liquid

daily during pregnancy safeguard the

mother against dental caries, the child

against rickets, and both against infection.

3 Up to twenty drops of Adexolin
hourly during the initial stages of
fever, increase resistance. At the later
stages, Adexolin in smaller doses supplies
the fat-soluble vitamins lacking in low-fat
diet.

ADEXOLIN

if- Each c.c. of Adexolin Liquid contains
12,000 i.u. of vitamin A and 2,000 i.u. of
vitamin D.

Available in 14 c.c. phials and 2 oz. bottles.

GLAXO LABORATORIES (AUST.) PTY.
LTD.

Melbourne Sydney

Well-tried and successful dried milk foods, graded to
suit bottle-feeding requirements from birth to weaning

I HE formula of Glaxo No.

approximates to that of human
breast milk. Both the fat and protein
content are diminished to suit the digestive capacity
of the infant during the first months of life.
It is also suitable for premature and weakly
babies.

Glaxo No. 2 contains a higher proportion of fat
and protein and is designed for the feeding of
infants whose dietetic requirements are no longer
satisfied by a fully humanised milk food.
The simple change from Glaxo No. I to Glaxo
No. 2 provides for the progressing needs of the

growing infant without causing any

digestive disturbance.

The declared content of vitamin D in
Glaxo is a warrant that proper regard is paid to
the importance of calcium metabolism. The incor
poration of both vitamin D and iron in measured
amounts provides factors -which build not only for
the present but for the future.

Constancy of composition and the greatest possible
freedom from bacteria are accepted features of
Glaxo.

Both forms of Glaxo are sold in sealed and dated
tins in I-lb. and 3-lb. sizes.

GLAXO LABORATORIES (AUST.) PTY. LTD., MELBOURNE AND SYDNEY

JANUARY 26, 1946.

THE MEDICAL JOURNAL OF AUSTRALIA.

117

SATURDAY, JANUARY 26, 1946.

All articles submitted for publication in this journal should
be typed with double or treble spacing. Carbon copies should
not be sent. Authors are requested to avoid the use of
abbreviations and not to underline either words or phrases.

References to articles and books should be carefully
checked. In a reference the following information should
be given without abbreviation: initials of author, surname
of author, full title of article, name of journal, volume, full
date (month, day and year), number of the first page of the
article. If a reference is made to an abstract of a paper, the
name of the original journal, together with that of the
journal in which the abstract has appeared, should be given
with full date in each instance.

Authors who are not accustomed to preparing drawings
or photographic prints for reproduction are invited to seek
the advice of the Editor.

THE RETIREMENT OF SURGEON CAPTAIN
W. J. CARR.

EVERYONE will agree that the head of a service, par
ticularly of a medical service, sets the standard of efficiency
and devotion to duty of its members. This has been shown
over and over again in the war to which we refer as having
just ended. Australian doctors have good reason to be
proud of the medical services of the sea, land and air
which they joined willingly and in such large numbers.
That they will acknowledge their own and the country s
indebtedness to the medical dii ectors there is no shadow
of doubt. Of the three services, that of the Navy is the
only one which before the war could be said to have a
staff of permanent medical officers. In 1933 the Royal
Australian Naval Medical Service had 28 medical officers;
of these, 15 were permanent officers, 11 belonged to the
Royal Australian Naval Reserve, one belonged to the Royal
Australian Naval Volunteer Reserve, and one was on loan
to the Royal Navy. It was this service which Surgeon
Captain W. J. Carr was called on to control at the out
break of war. On January 31, 1946, he is to retire from
the command. The occasion should not be allowed to pass
without comment; Captain Carr has served the Common
wealth and the Empire with the utmost devotion and in
the best tradition of the "Silent Service", and this should j
be acknowledged.

With the outbreak of war the Royal Australian Navy
increased its number of ships and the number of its
fighting personnel. The number of medical officers
increased with the number of ships and men. Security
reasons made it undesirable to refer to new ships as
they were commissioned, but it may be remarked that the
appointments to the navy were promulgated without inter
ruption in the Commonwealth of Australia Gazette. In
the year 1945 the Royal Australian Naval Medical Service

comprised 110 medical officers. Of these, 14 were per
manent medical officers; 83 belonged to the Royal
Australian Naval Reserve, and six to the Royal Australian
Naval Volunteer Reserve; seven were on loan to the Royal
Navy. In other words, the administrative duties of the
director of the service and his responsibilities had grown
enormously. The advent of the Royal Navy to Australian
waters threw extra work onto Captain Carr s shoulders.
To him was allotted the task of working out the plan
for the posting of the British Pacific Fleet s medical
establishment in Australia. He made all the hospital
arrangements and also those for the supply of medical
equipment. This was in August, 1944, and with the small-
ness of his staff (he has only one medical staff officer) the
extra work was no sinecure. Through the six years of
war Surgeon Captain Carr has thus carried a steadily
growing burden of work and responsibility. The medical
profession of Australia and those outside its ranks who
have given any thought to the subject cannot understand
why no promotion has come to him. By every standard
known to the non-naval observer promotion has been
earned. In any case it is ridiculous that so important a
service as the medical service of the Royal Australian
Navy should carry with it no rank higher than that of
captain. This rank is the equivalent of colonel in the
army. We maintain that Surgeon Captain Carr should
on his retirement be promoted to the rank of surgeon-
rear-admiral and that the promotion should be dated from
January, 1945, when the main body of the Pacific Fleet
came to Australia. But whether the parsimonious Royal
Australian Navy does what it should do in this matter or
not, it should be known in naval and non-naval circles
that the medical profession of the Commonwealth holds
Surgeon Captain Carr in high esteem, is grateful to him
for consistent first-class work, and wishes him peace and
contentment in his retirement.

THE JOURNAL AND THE RECENT INDUSTRIAL
UNREST.

THE last few months of the year 1945 and January of
1946 have been very difficult for those concerned in the
production of THE MEDICAL JOURNAL OF AUSTRALIA. Now
that the acuteness of the difficult period has passed, it
has been thought that a short statement should be made
for the information of readers. At the beginning of the
war the manager of the journal was faced with the demand
for economy in the use of paper. Certain restrictions were
imposed under National Security Regulations in regard to
the use of paper and other matters. These have been faith
fully observed. There is no need to quote details of the
amounts by which paper had to be reduced "or of the
difficulties in securing an adequate supply of paper. What
is important is that readers should appreciate how valuable
for them has been the reduction in the size of type which
was undertaken in August, 1940. An eight-point type was
substituted for what had previously been printed in ten-
point, and seven-point type for what had been eight-point.
The effect of the change in type was that the amount of
letterpress available to readers was practically unchanged.
As the war progressed and medical officers in the services
recorded their observations, an increasing number of con-

118

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY 26, 1946.

tributions were sent to this journal. These papers and
the reports on the use of new medicaments and new
methods of treatment had often the unfortunate result of
creating a long latent period before articles could be
published. The dispute in the printing industry which
began in September last accentuated all these troubles and
difficulties.

When publication was resumed on December 1, 1945, it
was quite impossible to make up the loss in the number
of issues of the journal, and the issue of December 1 was
designated "Numbers 12 to 22 inclusive". After two issues
had appeared the strike originating in the mining and
ironworkers industry occurred. At first, since THE
MEDICAL JOURNAL OF AUSTRALIA is registered as a weekly
newspaper, publication was not affected, but before long
the use of electricity and gas for all but daily newspapers
was prohibited and publication ceased for a second time.
Since work was resumed in the New Year the journals
held up by the second interruption of publication have been
published as quickly as possible and it is hoped that
normal running will continue.

In spite of the large hiatus in the latter months of 1945,
the volume for the second half of that year included 516
pages. When we remember that Volume II of 1943 con
tained 532 pages of reading matter with 25 pages of
supplement, the second volume for 1945, affected by the
large hiatus, does not appear so discreditable. Before the
break last September the intention was to return to the
use of ten-point and eight-point type in January, 1946.
This change-over has been postponed and in a week or
two some additional pages of reading matter will be
published in each issue. In this way some of the accumu
lated material will appear. The return to larger type will
be made as soon as conditions justify the change. In the
meantime it is hoped that readers will continue their
forbearance with the war-time type.

THE RESULTS OP PREFRONTAL LEUCHOTOMY.

IN May, 1944, a good deal of space was given in these
columns to the subject of psycho-surgery. The development
of the operation of prefrontal leuchotomy, or prefrontal
lobotomy, was traced and special reference was made to
work by W. Freeman and J. W. Watts. It was pointed out
that, though in certain circumstances the patient s con
dition was improved and he was able as a result of the
operation to lead a more or less equable life, the condition
produced was final "once one cuts, there is no return".
The general conclusion stated was that the place of the
method in the treatment of persons suffering from
abnormal mental states had not been determined and that
the greatest caution should be displayed in the selection
of patients to be subjected to it. For these reasons it
will be of interest to refer to two recent reports on the
results of the operation.

The first report is based on 100 cases and is by F.
Berliner, R. L. Beveridge, W. Mayer-Gross and J. N. P.
Moore, who write from the Department of Clinical
Research, Crichton, Dumfries. 1 At the time when these
authors wrote, the first fifty of their one hundred patients
had been operated on for at least fifteen months and it
was concluded that the outcome in these cases was more
or less settled. The second fifty had been operated on for

1 The Lancet, September 15, 1945.

less than fifteen months, some of them for less than two
months, and consequently the results could not be regarded
as final. The series included 49 male and 51 female
patients; the average age was 36 years and the range 19
to 53 years. The criterion for the selection of patients
for operation was the presence of a clinical picture of
"mental tension" a concept which, we are told, is hard
to define. "It may be thought of as a persistent emotional
change sustaining and to some extent determining the
clinical picture. Such a change is always of an unpleasant
quality, invariably distressing, and sometimes intolerable
to the patient. Its presence is shown by irritability, rage,
fear, or other forms of emotional excitation; insomnia,
and on the motor side, restlessness, aggressiveness, destruc-
tiveness, or impulsive behaviour." Of the 100 patients, 88
suffered from schizophrenia (54 were catatonics) ; the
remainder included four patients with melancholia, five
with severe obsessional states, two epileptics and a general
paretic, who, after fever treatment, developed chronic hal
lucinations. Judged by ordinary prognostic standards, all
the patients were hopeless chronic invalids. All of them
had failed to respond to treatment other than operation.
Of the patients with schizophrenia, 24 are described as
"recovered", 13 as "much improved", and 23 as "improved".
Of the four with melancholia, one fell into each of these
three groups, and the fourth died. Of five with obsessional
illness, four "recovered" and one was "much improved".
These workers point out that it is unwise to evaluate the
results of a new form of therapy without controls, but
they regard their results as encouraging and add that they
fully warrant the use of the operation in suitable cases.
With this most readers will agree.

The second report comes from S. D. Porteus and R. De M.
Kepner, of the Psychological Clinic of the University of
Hawaii. It deals with twenty patients who have been
treated at the Territorial Hospital for Mental Disorders,
Hawaii, where Porteus is the psychological consultant and
Kepner the clinical director. The operations were per
formed by R. B. Cloward, consultant neurosurgeon of the
institution. The report is a monograph of 115 pages. (It
has also been published in Genetic Psychology Monographs,
Volume XXIX, 1944, page 3.) The detailed histories of
the twenty cases are so full of interest that they will be
read, or should be read, by all psychiatrists interested in
the subject. Porteus and Kepner examined their subjects
by psychological tests; they used a modification of the
Binet test and also the Porteus maze test. In some
instances the results of the tests did not favour operation,
but since there were no established criteria for the selec
tion of patients, operation was carried out in spite of the
findings. Eleven of the twenty patients studied manifested
some degree of improvement; two improved to such an
extent that they were able to be released from hospital.
In nine of the eleven cases the psychological recommenda
tion "on the basis of present experience" would have been
favourable to operation. In seven of the nine cases in
which no improvement occurred, the recommendation
would have been adverse. This means that in 16 of the
20 cases the prognosis based on various psychological
considerations was justified. Porteus and Kepner think
that with more experience the percentage of accurate
prognoses would increase. They state the following guiding
principles in selection.

1. The elimination from the list of prospective
lobotomy patients of the mentally defective on the
ground that the operation cannot put into the brain what
was never there.

2. The elimination of the mentally deteriorated on
the grounds that the operation cannot restore what is
already lost.

3. A reasonably high maze test record is a favorable
sign, the reason being that, if planning capacity is
diminished, as it almost certainly will be after operation,
the individual will retain enough to enable him to
function satisfactorily in community life.

4. One conclusion, admittedly somewhat tentative, is
that hebephrenia should be considered a contraindication
for operation. This feature of behavior is probably to be

- interpreted as an emotional retrogression, similar in its
unfavorable implication to mental deterioration.

JANUARY 26, 1946.

THE MEDICAL JOURNAL OF AUSTRALIA.

ll J

5. Theoretically, certain catatonic types, because of
the strong tendency to stereotyped reactions in post-
lobotomy behavior, would also not be considered good
prospects.

6. Another presumption is that manic-depressives
exhibiting cyclical changes in mood are not good risks.
The operation cannot be expected to bring about
opposite results in the same patient.

7. One commonly dependable post-operative index of
the surgical adequacy of the operation is decline in
maze test ability. The results of several reoperations
will show whether this indication is completely reliable.

Porteus and Kepner have found that the general diag
nostic label is not of great assistance in the selection of
patients for operation. Their group of patients does not
represent fairly the types for whom lobotomy is recom
mended and they point out that success has been attained
in various types of psychosis. One point of considerable
interest is that among the criminal insane operated on
were three individuals whose collective convictions
included three killings and five stabbings. The condition
of all three was improved and one was discharged as
being no longer a menace to the community.

It would be possible to discuss both these reports in
much greater detail, but for our present purpose this is
not necessary. Two points should be mentioned. The first
is that apparently social adjustment after this operation
has been performed may take a considerable time. Freeman
and Watts, who are probably more entitled than any other
workers to express an opinion, have described the process
of adjustment as slow and as extending even into the
second year afer operation, or longer than that. The
second point is that sometimes a second operation may be
needed if the first has not done what is to be expected.
This is an aspect that will probably be discussed by future
workers. In the meantime all who are interested in the
subject will agree with Porteus and Kepner that the
application of the procedure should not become widespread
until careful and continued psychological and psychiatric
studies of its effects have been undertaken. There is some
thing to be said for their idea that a neuropsychological
institute should be established where such investigations
could be carried out, though others will hold that a special
institution is not required.

POST-WAR GERMANY: A PSYCHIATRIC PROBLEM.

IN April, May and June, 1944, there took place a
conference at the College of Physicians and Surgeons,
Columbia University, New York City, on "Germany After
the War". The participants in this discussion represented
a wide selection from experts in anthropology, sociology,
psychology, psychiatry, education, economic and political
science and other studies. The conclusions reached were
presented and individual sections discussed at the annual
meeting this year of the New York Regional Division of
the American Orthopsychiatric Association. An excellent
account of the deliberations has been published. 1 The
analyses given and the recommendations submitted make
rather grim reading, for the seriousness of the situation
in the Germany of today and the Germany of tomorrow
is disclosed with convincing realism of detail. There can
be no question that Americans have been profoundly
shocked at the change which Germany underwent between
the two world wars. For many years Germans had been
excellent colonists in the United States of America,
industrious and intelligent and soon imbibing the
American spirit; furthermore, American intellectuals
sought inspiration from German universities and many
looked upon Germany as their spiritual home. It is true
that Germany resorted to harsh measures in World War I,
but these were of military origin and purpose and had
what excuse military operations can claim. Then came the

American Journal of Orthopsychiatry , July, 1945.

promulgation of Nazi doctrine and the horrified Americans,
as well as the citizens of the British Empire, discovered
in the German people an insulting assumption of racial
superiority which did not hesitate at endeavouring to
exterminate a whole people, a contempt for democracy,
a proclamation of a new order to supersede all previous
orders, and the resort to a technique of lies, subterfuges
and world-wide spying and infiltration. The conference
emphasized strongly the fact that the measures to be
taken with post-war Germany must not be confined to the
military, political and economic spheres, for most impor
tant of all are a psychiatric analysis and based upon this
a treatment directed towards an abnormal and deeply
entrenched psychology. A whole generation of Germans
has been poisoned in moral fibre and in intellectual free
dom by cunning propaganda lavished on them during
their impressionable years. The boys of the Hitler
Youth Movement, who were fourteen to eighteen years of
age in 1933, when the toxicity had reached full potency,
are now twenty-six to thirty years of age, and it is with
these perverted adults that the Allies must deal. In
another article in the same journal, "Children under the
Nazi System", there is a cold, unbiased, but none the less
terrible description of the devilish devices used to win
over boys to the doctrine that the master race must be on
top and it mattered not by what methods this was
attained. Youngsters were encouraged to sneer at old-
fashioned parents and to regard the home as of no
account; girls were for pleasure and procreation, while
marriage was "not a biological necessity". In the main
report some concepts are given which Germans tenaciously
hold and which have been causative in the headlong rush
into degeneracy. Chief amongst these are the doctrine of
German superiority, the right of Germans to dominate all
other groups which must be regarded as enemies, the
apotheosis of the military cult and the application of
military methods to civil life, and particularly to educa
tion. Each of these must be destroyed beyond recovery
and the process may take a long time. We are warned
that the reaction of English-speaking democracies to any
particular form of treatment must not be taken as indicat
ing what the Germans will do in a similar position. The
British and Americans would, for example, accept a
remission of a penalty with gratitude; the Germans with
contempt, as it would in their view imply stupidity or
weakness in the victor. In fact, a strong plea is made
for "putting the boot in", to use a local expression, in
dealing with the conquered Teutons. An illustration
which might have been given in this discussion is that
after Versailles it was hoped to transform the German
army into something different and yet retain the former
corps of officers. What happened was that a new German
army arose more brutal than the old. 1 If democracy is to
be saved, then the German military system must be
destroyed to its minutest rootlet. Education must be
forcibly overhauled and reformed and freedom should be
restored to Press, radio, stage, film and Church. The
imposition of a superficial form of democratic govern
ment would be of little service so long as the poison
remains in the soul of the people. To rebuild German
character will be a long business; it may be impossible,
but it must be tried. If it fails, then the means of doing
harm must be taken away from the nation collectively
and individually. The report makes it clear that the
problem of post-war Germany is essentially a problem in
mental pathology; the country must be shielded from the
libido of desperate adolescents whose degenerate actions
should be kept under with a strong hand. The reading
of these measured analyses and recommendations gives
the feeling that there is little hope for betterment in
German manhood today, for the poison cannot be expelled
or neutralized by an arsenical or sulphonamide drug, nor
can the devils be exorcised by kindly treatment. It is to
be hoped that the report of these American deliberations
will be placed in the hands of the Allied statesmen in
whose responsibility the control of Germany now rests.

( The Times Literary Supplement, August 18, 1945, page 387.

120

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY 26, 1946.

from
Literature,

PHYSIOLOGY.

The Rate of Carbon Monoxide
Uptake by Man.

W. H. FORBES, F. SARGENT AND F. J. W.
ROUGHTON (The American Journal of
Physiology, April, 1945) present new
data for the rate of carbon monoxide
uptake by normal men at sea level,
when exposed to air containing various
percentages of carbon monoxide (0-01
to 2-0) for various times. The subjects
were at rest, engaged in light activity,
light work or hard work. A composite
chart is given for calculating the
average individual increase In per
centage of carboxyhaamoglobin in the
blood with time, at varying carbon
monoxide pressure and varying ventila
tion rate. Particular individuals may,
however, vary consistently by as much
as 20% from the data in the chart,
which may, therefore, in practical cases,
often be replaced by much simpler
approximate equations given in the text.
Variations in the ratio of tidal air to
dead space, and in the value of the
diffusion constant of the lungs, appear
to be responsible for the differences
between individuals in the rate of
carbon monoxide uptake. The observed
rates of carbon monoxide uptake are
lower than the average rates of most
previous observers: the difference is
attributed partly to more accurate
estimation of carboxyhsemoglobin (by
the Scholander-Roughton technique)
and partly to adequate allowance for
the blank carbon monoxide already
present in the blood before the exposure.
Lowering of the total barometric pres
sure (down to 140 millimetres of
mercury) is without effect on the rate
of carbon monoxide uptake, provided
the partial pressure of carbon monoxide
in the trachea is kept constant and cor
rection is made for any increase in
ventilation rate due to hypoxia. In
creasing the oxygen from 20% to 98%
at sea level decreases the rate of carbon
monoxide uptake: the effect is more
pronounced in hard work than at rest.
This decrease occurs because the rate
of reaction of carbon monoxide with
haemoglobin is inversely proportional to
the oxygen pressure.

The Dehydrating Effect of

Continuously Administered

Water.

A. V. WOLF (The American Journal of
Physiology, April, 1945) recalls that
other authors have shown that the
quantity of water lost in diuresis due
to water excess may be greater than
the quantity taken in. The author
studied this dehydrating effect in man.
Ten young subjects were taken and a
fixed amount of water varying from 20
to 200 millilitres was drunk every ten
minutes. The intake of water was con
tinued for periods up to seven hours.
A steady state of water intake under
the conditions of these experiments on
man results in a total output of fluid
larger than the intake, and if con
tinued, leads to the production of
negative water loads. The urinary out
put alone was 8% greater than the

intake rate. The ratio of rate of
chloride excretion to the rate of excess
water excretion is equal to the normal
plasma concentration in the steady
state, and the equation of steady state
is calculated. The threshold of appear
ance and the threshold of retention are
defined and are illustrated for chloride.
In renal excretion, the regulation of
concentration of plasma chloride takes
precedence over the regulation of body
volume, when water is drunk.

Use of Cholinesterase in Shock.

R. J. SCHACHTER (The American
Journal of Physiology, April, 1945)
reports that surgical shock was pro
duced in 66 anaesthetized dogs by exces
sive haemorrhage or manipulation of
the intestines. When permanent shock
levels of blood pressure were demon
strated to be present, treatment con
sisting of restoration of blood volume
or of injection of cholinesterase
was attempted. The dogs in haemor
rhage shock responded well to beef
plasma, administered in appropriate
volumes, by recovering from shock. The
dogs in traumatic shock were benefited
by plasma only temporarily. When
the dogs in traumatic shock were given
intravenous injections of cholinesterase,
the blood pressure nearly always (16
out of 18 dogs) returned to normal and
remained there for the duration of the
experiment.

Absorption, Distribution and
Excretion of Thiourea.

R. H. WILLIAMS AND G. A. KAY (The
American Journal of Physiology, May,
1945) state that in addition to the
recently demonstrated antithyreoidal
action of thiourea, the use of this sub
stance in the measurement of renal
function and in the estimation of the
total body water has been considered.
They have modified the methods to
allow determination of thiourea in any
of the fluids and tissues of the body.
They also state that thiourea is rapidly
absorbed from the gastro-intestinal
tract and is rapidly distributed through
out the tissues and fluids of the body;
its concentration in the tissues varies
widely. The distribution of thiourea
correlates poorly with the water content
of body fluids and tissues; the apparent
volume of distribution far exceeds the
actual content of body water. The sub
stance is broken down in the body in
a rapid and inconstant manner. No
thiourea is excreted in the stools, but
it appears in the urine within thirty
minutes of ingestion. None of the
substance is usually found in the urine
forty-eight hours after cessation of
therapy. In patients with nephritis
there is a distinct impairment in the
excretion of thiourea.

The Effect of Arsenite on the
Respiration of Rat Tissues.

H. W. ELLIOTT AND E. R. NORRIS (The
American Journal of Physiology, May,
1945) state that rats given 25 milli
grammes of arsenic trioxide as a solu
tion of sodium arsenite per kilogram
body weight may die in fifteen minutes
with the characteristic symptoms.
Animals on lower but still lethal doses
may develop the same syndrome in the
course of a twenty-four hour period.
Rats may be adapted to arsenic trioxide

by the injection of sublethal doses over
a long period of time. While normal
rats show a fall in temperature when
injected with solutions of sodium
arsenite, adapted rats show much less
or no drop in body temperature. The
hypothermia follows immediately after
the injection of arsenic and may be due
to a direct effect on the temperature-
regulating centre in the hypothalamus,
to some action on the vasodilator
centres, or to a lowering of the
basal metabolic rate which might con
ceivably be due to reduction of the
respiratory rate of the individual body
tissues. With the object of determining
the cause of the hypothermia, studies
were made of the effects of arsenic
trioxide on cerebral cortex, diaphragm,
kidney, cortex and liver. By tissue
respiration studies, action-concentration
curves of arsenic trioxide have been
prepared for cerebral cortex, diaphragm,
kidney cortex and liver in the albino
rat. Fatal doses of arsenic trioxide
administered subcutaneously in vivo
have no effect on cerebral cortex
respiration, cause reduction of dia
phragm and kidney respiration, and
induce stimulation of liver respiration.
Fatal doses of arsenic trioxide adminis
tered intraperitoneally in vivo have no
effect on cerebral cortex respiration, and
cause reduction of diaphragm, kidney
cortex and liver respiration. The
absence of effect on the cerebral cortex
respiration while the respiration of the
muscle tissue of the diaphragm is
reduced would suggest that the
hypothermia of arsenic poisoning is
influenced more by a decreased rate of
energy metabolism of the individual
tissues than by a direct effect on the
temperature-regulating centre in the
central nervous system.

Tolerance to Arsenic Trioxide in
the Albino Rat.

E. R. NORRIS AND H. W. ELLIOTT (The
American Journal of Physiology, May,
1945) discuss some of the work which
has been done concerning tolerance to
arsenic. There seems no doubt that
the arsenic eater may ingest quantities
of arsenic trioxide which would be
poisonous to the normal individual.
However, the ability of the individual
or laboratory animal to acquire a true
tolerance to arsenic trioxide either as
a solid or in solution as sodium arsenite
has been questioned by several investi
gators. The general belief was that no
tolerance could be developed to arsenic
in solution, but that with solid arsenic
the tolerance is due to diminished
absorption. In the course of studies
made by the authors on the detoxifica
tion of arsenic by rats it was desired to
administer the largest doses that could
be safely given. Solutions of sodium
arsenite were injected intraperitoneally.
When a group of rats had been injected
with sublethal doses for three weeks it
was found that the dose could be in
creased to a level which invariably
killed normal animals without pro
ducing toxic effects. Attention was
then given to this aspect of the
question, and the authors showed that
rats acquire a true systemic tolerance
to arsenic trioxide in solution, injected
intraperitoneally as sodium arsenite.
The toxicity of a dosage of arsenic
trioxide and the progress of adaptation
have been demonstrated by studying
the hypothermia after injection. The

JANUAKY 2(i, 1946. THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER.

ZERO HOUR

BLACK OF NIGHT. A ringing phone . . . another call to
arms. Instinctively, the doctor answers. For him it is the
zero hour. An accident at an industrial plant. A worker
seriously injured. Once again begins a battle in the war
that never ends . . . the crusade against disease . . . man s
untiring enemy.

And science marches by the doctor s side . . . helps fight
the foe with modern weapons. Take radiography ... a
good example. Radiographs may save the worker s life
. . . help chart a course that leads to successful treat
ment and a speedier recovery.

TODAY the satisfactory diagnostic radiograph is the rule
rather than the exception. One reason is that radiographers
recognize that a sharp, contrasty negative depends to a
large extent upon highly efficient intensifying screens.
Screen care and replacement are important. Screens that
are dirty, scratched or stained produce inferior results.

Examine screens regularly. Replace worn screens. Ample
stocks of Patterson Screens are available. Patterson Screen
Division of E. I. du Pont de Nemours & Co. (Inc.)

Patterson Screens

BETTER THINGS FOR BETTER LIVING

THROUGH CHF/MIST*r

Distributors for Australia and New Zealand:

WATSON VICTOR LIMITED

Watson House, Bligh Street, Sydney

Melbourne, C.I 117 Collins Street

Brisbane, B.10 . 105 Eagle Street

Adelaide 9 Gresham Street

Wellington, N.Z Kelvin Chambers, 16 The Terrace

Auckland, N.Z Lister Buildings, Victoria Street

Perth 205 St. George s Terrace

Why breathe

infected air?

Streptococci, pneumococci, bacilli and viruses are dis
seminated in the acts of sneezing, coughing and speaking.
They cause diseases which range from the common "cold"
to dangerous cross-infection and post-operative complica
tions. Vermin-borne and water-borne diseases have been
brought under sanitary control. Now it becomes feasible
to check the spread of air-borne diseases by continuous
elimination of bacteria from the air itself. The Hanovia
ultra-violet Air Sanitizer kills air-borne germs effectively,
automatically, at low-operating costs, and without any
detrimental effects on the air.

Physicians and surgeons, sanitary engineers, hospitals and
health officers, are invited to investigate air-sanitation by

The HANOVIA
AIR SANITIZER

Information, supply and service throughout Australia from

II IT E ]I&gt;

Branches at:

Sydney Bligh St.

Melbourne . . Collins St.

Brisbane Eagle St.

Adelaide . . . Gresham St.

Perth St. George s

Terrace
Newcastle . . Watt St.

The ultra-violet
Air Sanitizers are
another speciality
Of HANOVIA LTD.
Slough, England,
the specialists in
equipment for
actinotherapy.

COUPOX.
To Messrs. Watson Victor Ltd.

Branch.

Please send me the Hanovia book
let "Air-borne Infection and Air
Sanitation".

Name

Address. .

V.7/71.

THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER. JANTAKY 20, 1940.

TREATMENT

YEAR BOOK, 1945

Edited by Cecil P. G. Wakeley, C.B., D.Sc., F.R.C.S.,

F.R.S.E.

A year-book of modern diagnostic methods and treatment designed to
greet members of the medical services returning from the forces and to
enable the busy practitioner to keep abreast of current medical opinion.
IIIIIlllllllllIIHIIM

"A galaxy of brilliant contributors. . . . The subject matter has been
chosen with some care and there is not a single dull page in the volume."

Ulster Medical Journal.

iiiraiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii

SELECTION FROM CONTENTS

The Nature and Treatment of War-Time Malaria Relapses

"Sir Philip Manson-Bahr, C.M.G., D.S.O., M.D., F.R.C.P.
Hydatid Disease Mainly from the Clinical Standpoint.

Sir Louis Barnett, C.M.G., F.R.C.S., F.R.A.C.S.
The Treatment of Injuries to Peripheral Nerves.

H. W. S. Wright, M.S., F.R.C.S.

The Treatment of Karly Phthisis in the Young Soldier.

James Watt, M.A., M.D., D.P.H.

The Management of the Young; Diabetic in War Time.

G. M. Wauchope, B.Sc., M.D., M.R.C.P.

The Treatment of Peptic Ulcer in War Time.

A. Morton Gill, M.D., M.R.C.P.

THE MEDICAL PRESS AND CIRCULAR

8 Henrietta Street, London, W.C.2

BRITISH MEDICAL AGENCY OF QUEENSLAND PTY. LTD.

B.M.A. HOUSE, 225 WICKHAM TERRACE, BRISBANE, B 17

Doctors desiring Practices, Partnerships, Assistantships or Locums should apply now for advice and/or

particulars.

S. N. COBBOLD, Manager, B 9597. After hours F 9533. Telegrams: "Medicine", Brisbane.

jfiritwlf ^Hehtcal JVgmcg of ffitlvnx JJto.

COUNTRY PRACTICE. Cash takings 1,850. For sale, MEDICAL, PRACTITIONER required for country

1,400. House 1,100. practice. Guaranteed 800 per annum. House for

TASMANIAN CITY PRACTICE for sale, 3,000. House sale or rental.

for sale or rental. SUBURBAN AND COUNTRY assistants required.

PARTICULARS IN CONFIDENCE

340 Swanston Street, Melbourne. Telegrams: "Medagency", Melb. Phones: FJ 4123, 4124. After hours: LF 3110.

Srtttstj fiebtral

B.M.A. HOUSE, 135-137 MACQUARIE STREET, SYDNEY

CONSULT YOUR OWN AGENCY ON ALL MEDICAL AGENCY SERVICES
Sales and Purchases of , INSURANCES Financial Assistance

_ . Fire, Lire, Sickness and Acci-

rractices dent, Motor Car, Workers Com- available in approved

Advice and recommenda- cases to facilitate

J J M. COPYING, TYPING . , e r

tion rendered to enquirers. Duplicating, MSS.. Meeting transfers.

Notices, etc.

T . . (B41S9 C. R. STRANGE,

lelephonec j x ^ 2 644 (After Hours) Telegrams: "Locumten* Sydney". Manager and Secretary.

JANTAKY 20, IDlfi.

THE MEDICAL JOURNAL OF AUSTRALIA.

121

tolerance to injected arsenic trioxide
was shown not to be due to decreased
rate of absorption from the body cavity.

BIOCHEMISTRY.

Alloxan.

S. BANERJEE (The Journal of Bio
logical Chemistry. May, 1945) has
reported on the hypoglycsemic action of
alloxan. Hypoglycsemic convulsions
were not observed when alloxan (200
milligrammes per kilogram) was
injected intravenously into three
partially pancreatectomized rabbits. All
three animals survived and developed
hyperglycaemia and glycosuria on the
following day. Three normal rabbits
with the pancreas intact died of hypo-
glycffimic convulsions within varying
periods after the intravenous injection
of alloxan. The alloxan hypoglycsemia
is suggested to be due to the release
of preformed insulin from the necrosed
islets and not to stimulation of the
islet tissue.

Vitamin E.

D. W. WOOLLEY (The Journal of
Biological Chemistry, June, 1945) has
studied some biological effects produced
by the quinone of a-tocopherol.
Administration of dZ-a-tocopherol quinone
to pregnant mice causes haemorrhage
in the reproductive system and resorp-
tive termination of pregnancy during
the last week of gestation. Similar
amounts of the compound were without
detectable effect on non-pregnant mice.
No permanent damage was done to the
ability to reproduce. The action of
the quinone was not prevented by large
doses of a-tocopherol acetate, but was
negated by small amounts of 2-methyl-l,
4-naphthoquinone (vitamin K). The
quinone was viewed as a structural
analogue of both vitamin E and vitamin
K. 3, 3 -methylenebis (4-hydroxy-
coumarin), which caused signs (re
versible by vitamin K) similar to those
seen in vitamin K deficiency, did not
produce resorption or vaginal haemor
rhage in pregnant mice. The quinone
was much more effective when given
intraperitoneally than when given
orally.

Lipides.

\V. A. GRTNER (The Journal of Bio
logical Chemistry, June, 1945) has in
vestigated the lipide fractions of 438
foetuses, representing 66 litters and
covering 70% of the gestation period of
the pig. The water content of the pig
foetus exhibits two rapid falls during
growth, a phenomenon previously cor
related with changes in the foetal
kidneys. The total lipide and lipide to
protein ratio remain constant for a
large part of the embryonic growth
period. Evidence is presented that a
considerable portion of the non-
phospholipide fatty acids, often con
sidered "neutral fat", is actually present
in unesterified (free) form. On a dry
weight basis, the phospholipide content
is at a maximum in the very young
foetus, which has twice as much of this
lipide as does the foetus at term. The
phospholipide fatty acids, in common
with the other acid fractions, have an
average iodine number of 82. The
unsaponifiable lipides in the dry solids

progressively decrease in their per
centage content during embryonic
growth, the total and free cholesterol
fractions roughly paralleling this fall.
At no time is there any notable ten
dency for cholesterol to appear in ester
form. The foetal glycerides gradually
increase, beginning about the middle of
the gestation period, but even at term
they account for only a minor part of
the total lipide substance. Considerable
differences exist in the development of
the lipides in the foetal pig in com
parison with the foetal rabbit.

Galactose.

D. STETTEN (The Journal of Biological
Chemistry, June, 1945) has studied the
glycogen turnover in the liver and
carcass of rats fed with galactose.
When rats were fed with galactose
instead of glucose as the sole dietary
sugar, less glycogen was recovered from
their tissues, especially from their
livers. The rate at which deuterium
was incorporated into this glycogen
from deuterium oxide in the body fluid
was at least as rapid as when glucose
was fed. Prom the maximal isotope
concentrations in the glycogen it could
be shown that the animal can convert
galactose into glycogen without labiliza-
tion of all of the carbon-bound
hydrogen. The galactose excreted in the
urine when galactose is fed to male
rats receiving deuterium oxide is
essentially free of deuterium. This
finding provides a confirmation of the
non-exchangeable nature of the carbon-
bound hydrogen of hexose.

Choline.

R. W. LUECKE AND P. B. PEARSON

(The Journal of Biological Chemistry,
May, 1945) have studied the effect of
the ingestion of excessive quantities of
choline on the amount in tissues and
urine. The ingestion of forty grammes
of choline chloride daily for a period of
six days did not increase either the free
or total choline content of the liver,
kidney or plasma. The choline recovered
in the urine on any single day during
choline feeding ranged from 0-7% to
2-5% of the choline ingested by sheep.
The amount excreted in the urine of
dogs ingesting five grammes daily was
approximately 0-5% of the amount
ingested. The ingestion of choline is
accompanied by an increase in urinary
nitrogen. The increment in urinary
nitrogen is virtually equivalent to the
choline nitrogen ingested. Betaine
hydrochloride administered per os is
not excreted in urine as choline or
betaine.

Wound Healing.

H. E. PAUL et alii (Archives of Bio
chemistry, June, 1945) have found that
the thiamin content of repair tissue in
skin wounds at the stage of rapid
healing is approximately double that of
normal skin. The average thiamin con
tent of normal rat skin has been
determined to be 0-57 microgramme per
gramme in animals in the latter half
of life.

Biotin.

C. KENNEDY AND L. PALMER (Archives
of Biochemistry, June, 1945) have pro
duced evidence that biotin is one of
the factors needed for successful gesta
tion and the birth of viable young in

the rat and is probably a necessary
factor in lactation; however, as folic
acid was not included in the ration,
the effect of biotin on lactation is not
positively known.

Body Composition.

H. H. MITCHELL et alii (The Journal
of Biological Chemistry, May, 1945)
have studied the chemical composition
of the adult human body, thirty-five
years of age, with reference to moisture,
ether extract, protein (N x 6-25), total
ash, calcium, phosphorus and gross
energy. Individual analyses of the
skeleton, musculature, skin and many
visceral organs are reported. The data
from this material have been considered
in connexion with the requirements of
calcium for growth on the assumption
that the integration of calcium
accretions during the growing period
will equal the calcium content of the
adult organism.

Vitamins in Muscle.

E. E. RICE et alii (Archives of Bio
chemistry, June, 1945) have investigated
the distribution and comparative con
tent of certain B-complex vitamins in
pork muscular tissues. The thiamin,
riboflavin, niacin and pantothenic acid
contents of 24 pork muscles have been
determined for each of several animals.
It has been shown that the vitamin
content of the muscles in a single
animal vary as much as 200% to 300%.
Muscles which are high in a vitamin
in one pig tend to be high in other
animals of this species. Muscles con
taining relatively much thiamin usually
contain high levels of niacin, but
relatively low levels of riboflavin and
pantothenic acid. Although there are
indications that the activity or function
of the muscle may be responsible for
the variations in vitamin content, no
definite conclusions to this effect can
be drawn on the basis of the present
data.

Acetic Acid.

THE formation of acetic acid in the
rat has been studied quantitatively by
K. Bloch and D. Rittenberg (The
Journal of Biological Chemistry, June,
1945). The acetylation of foreign amines
by acetic acid was studied. By
employing acetate labelled with C 13 as
well as deuterium, it has been shown
that no loss of deuterium due to
exchange reactions occurs in the
acetylation of reaction. Acetic acid is
an effective acetylating agent for para-
aminobenzoic acid, d- and I-phenyl-
amino-butyric acids and sulphanilamide.
Evidence is presented to show that
acetic acid is the only acetlyating
agent for the aromatic amines,
sulphanilamide and para-aminobenzoic
acid. Acetic acid is the major source of
acetyl groups in the acetylation of
phenylamino-butyric acid, which, how
ever, can also be acetylated by a
mechanism probably involving pyruvic
acid. From the dilution of the acetate
fed it is calculated that 15 to 20 milli-
molls of acetic acid are formed daily
per 100 grammes of rat tissue. It is
suggested that the major part of this
acetate arises from the oxidation of
fatty acids. It is estimated that at
least half the carbon atoms of
cholesterol are derived from acetate.

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY !&gt;,

British Q^eDical association r^etos.

ANNUAL MEETING.

THE annual meeting of the Queensland Branch of the
British Medical Association was held at B.M.A. House,
Wickham Terrace, Brisbane, on December 14, 1945, DR. H. W.
HORN, the President, in the chair.

ANNUAL REPORT OK COUNCIL

The annual report of the Council, which had previously
been circulated among members, was taken as read on the
motion of Dr. C. C. Minty, seconded by Dr. D. Gifford Croll,
and adopted on the motion of Dr. C. C. Minty, seconded by
Dr. Alex Murphy. The annual report is as follows.

The Council has pleasure in presenting the following report
of the work of the Branch for the year ending November 15,
1945.

Membership.

The membership of the Branch is 641 and 3 complimentary
members, as against 623 last year, making a gain of 18.
Forty-five honorary associate members were elected during
the year.

The gains were: new members, 43; transferred from other
Branches, 2 ; members reinstated, 1.

The losses were: members transferred to other Branches,
13; deceased, 12; resignations, 3.

The following members of the Branch completed fifty
years of membership of the British Medical Association at
the end of the year 1944: Dr. W. Wallis Hoare, Dr. J. A.
Goldsmid.

There is a total of 146 members engaged on full-time duty
with His Majesty s Forces.

Honours have been conferred by His Majesty the King
on the following members for services rendered during the
war: O.B.E., Lieutenant-Colonel Arnold W. Robertson;
Military Cross, Captain H. Glynn Connolly. Mentioned in
Dispatches: Lieutenant-Colonel P. W. Hopkins, Lieutenant-
Colonel W. E. E. Langford, Lieutenant-Colonel L. McD.
Outridge, Lieutenant-Colonel J. H. Thorpe, Lieutenant-
Colonel L. G. Hill, Lieutenant-Colonel R. G. Quinn. A letter
of congratulation was sent to these members.

We are glad to extend a warm welcome to the following
members who have been prisoners of war: Major B. L. W.
Clarke, Major Clive Uhr, Captain C. R. R. Huxtable, M.C.,
Captain C. R. Boyce, prisoners of war in Japanese hands,
and Captain L. Pelham Sapsford, who was a prisoner of war
in Germany.

Obituary.

The Branch has sustained a loss by death of the following
members: Dr. Clive L. Paine, Dr. A. C. F. Halford, Dr.
R. Graham Brown, Dr. R. A. McWilliam Robinson, Dr. W. A.
Fraser, Dr. Alan R. East, Dr. J. E. Overstead, Dr. St. A. W. L.
McDowall, Dr. F. W. Harlin, Dr. Eric Meikle.

It is with regret that we record the death of Sir David
Hardie, M.D., which has just occurred. Sir David Hardie
had been a member of the Association for over fifty years
and he was a past president of the Branch.

Roll of Honour.

Captain Benjamin Hooper died on active service. Captain
D. G. Picone and Captain P. M. Davidson died whilst
prisoners of war in Japanese hands.

Meetings.

In addition to the annual meeting, twelve meetings of the
Branch were held, two of which were special meetings, one
being held to give members an opportunity of hearing the
views of the Federal Council on the Pharmaceutical Benefits
Act, given by the General Secretary, Dr. J. G. Hunter, and
the other an address by Dr. C. I. McLaren.

The average attendance was forty-one.

Council.

Twenty-one meetings were held. The record of attendances
of the Council is as follows:

Dr. H. W. Horn (President) 21

Dr. J. G. Wagner (President-Elect and Honorary

Treasurer) 20

Dr. L. P. Winterbotham (Past President) . . . . 14

Dr. Norman Sherwood (Honorary Secretary) . . 20

Dr. C. C. Minty (Chairman of Committees) . . 20
Dr. J. G. Avery (Honorary Secretary of Com
mittees) 16

Dr. Felix Arden (Councillor)

Dr. E. W. Casey (Councillor)

Dr. R. B. Charlton (Councillor)

Dr. D. Gifford Croll (Councillor)

Dr. Milton Geaney (Councillor)

Dr. L. T. Jobbins (Councillor)

Dr. Alan E. Lee (Councillor and Federal Council

representative)

Dr. F. W. R. Lukin (Councillor)

Dr. J. G. Morris (Councillor)

Dr. Mervyn S. Patterson (Councillor)

16
18
13
20
18
13

20
14
16
15

Dr. T. A. Price (Councillor and Federal Council
representative) 8

Dr. W. H. Steel (Councillor) 16

Scientific.

February. Clinical meeting in conjunction with the Mater
Misericordiee Public Hospital Clinical Society.

March. Dr. L. J. J. Nye: "The Management of Duodenal
Ulcer."

April. Dr. P. A. Earnshaw: "The Problem of the Under
weight Child."

May. Discussion of the profession s attitude to the
Pharmaceutical Benefits Act.

June. Brigadier N. Hamilton Fairley: "Tropical Medical
Research in the Australian Army" (Joseph Bancroft
Memorial Lecture).

July. Dr. Neville G. Button: "A Surgeon Visits the U.S.A."

July (Special). A talk by Dr. J. G. Hunter, General
Secretary of the Federal Council, on the Pharma
ceutical Benefits Act.

August. Symposium on backache. The opening speakers
were Dr. A. V. Meehan, Dr. Ellis Murphy and Dr.
Alan E. Lee.

August (Special). Dr. C. I. McLaren: "A Medical
Psychologist in the Far East."

September. Dr. S. Julius: "The History of Medicine in
Soviet Russia" (Jackson Lecture).

October. Major John F. Williams: "The Working of a
Child Guidance Clinic."

November. Clinical meeting in conjunction with the
Brisbane General Hospital Clinical Society.

Office-Bearers and Councillors.

Dr. J. G. Wagner was elected President-Elect for the
ensuing year and Dr. Norman Sherwood was elected
Honorary Secretary.

The following office-bearers were elected by the Council:

Honorary Treasurer: Dr. J. G. Wagner.

Chairman of Committees: Dr. C. C. Minty.

Honorary Secretary of Committees: Dr. J. G. Avery.

Honorary Librarian: Dr. Neville G. Button.

Assistant Honorary Librarian: Dr. Konrad Hirschfeld.

Dr. Mervyn Patterson, Dr. J. G. Avery, Dr. Robin Charlton
and Dr. L. T. Jobbins are not seeking reelection for 1946, and
the Council wishes to record its appreciation of the services
rendered by them.

Ethics Committee.

At the annual meeting of the Branch held on December 13,
1944, the following were elected members of the Ethics Com
mittee: Dr. Alex. Marks, C.B.E., D.S.O., V.D., Dr. G. P.
Dixon, C.B.E., V.D., Surgeon Commander Gavin Cameron,
Dr. M. Graham Button, Dr. L. J. J. Nye. The ex-offlcio
members of the Ethics Committee consist of the President,
President-Elect, the Honorary Treasurer and the Honorary
Secretary for the time being in office.

Two meetings of the committee were held to deal with a
complaint received regarding a member of the Branch.

Library.

During the year seventy-eight books were borrowed from
the library by thirty-three members.

Arrangements have been made to receive the reports of
the Medical Research Council of England as they are
published.

The only addition to the library this year is "Pre-School
Centres of Australia", by J. H. L. Cumpston and Christine
Heinig.

Leave of absence.

JANUARY 26, 1946.

THE MEDICAL JOURNAL OF AUSTRALIA.

123

Representation.

The Branch was represented as follows during the year:
Council of the British Medical Association: Professor

R. J. A. Berry.
Federal Council of the British Medical Association in

Australia: Dr. T. A. Price and Dr. Alan E. Lee.
Federal Council Contract Practice Committee: Dr. L. P.

Winterbotham.
Australasian Medical Publishing Company, Limited: Dr.

D. Gifford Croll, director; Dr. T. A. Price and Dr.

Alan E. Lee, members.

Medical Officers Relief Fund (Federal) : Queensland Com
mittee, Dr. D. Gifford Croll, Dr. G. P. Dixon, Dr. W. H.

Steel.

Medical Assessment Tribunal: Dr. A. H. Marks.
Queensland Medical Board: Dr. D. Gifford Croll, Dr. J. G.

Wagner, Dr. Felix Arden.
Queensland Post-Graduate Medical Education Committee:

Dr. S. F. McDonald and Dr. Alan E. Lee.
Queensland Medical Coordination Committee: Dr. F. W. R.

Lukin.

Queensland Radium Institute: Dr. Alan E. Lee.
Queensland Nutrition Council: Dr. P. A. Earnshaw, Dr.

Noel M. Gutteridge.
Queensland Bush Nursing Association: Dr. L. Bedford

Elwell.
Queensland Council of Social Agencies, Board of Studies:

Dr. C. C. Minty.

Flying Doctor Service of Australia: Dr. Harold Crawford.
Red Cross Blood Transfusion Service Committee: Dr.

Milton Geaney.

Red Cross Society Appeal Committee: Dr. L. J. J. Nye.
The Surf Life Saving Association of Australia, Queensland

State Centre: Dr. F. W. R. Lukin.
Physical Fitness Association of Queensland: Dr. E. S.

Meyers and Dr. Harold Crawford.

The Editor of THE MEDICAL JOURNAL OF AUSTRALIA was
represented by Dr. Felix Arden.

War Emergency Organization.
Rehabilitation of Members of the Armed Seri-ices.

The special subcommittee of the Branch appointed to deal
with this important matter consists of the following mem
bers: Dr. J. G. Wagner, Dr. F. W. R. Lukin, Dr. C. C. Minty,
Dr. Ellis Murphy, Dr. T. V. Stubbs Brown, and the ex-officio
members of the Council.

The Council has been watchful of the interests of members
returning from the services in regard to the provision of
facilities for post-graduate study and hospital experience, and
also in placement in civilian practice. Such members have
been urged to seek the advice of the Rehabilitation Sub
committee, and everything possible will be done to assist
them in all their problems.

Dr. Ellis Murphy has been appointed to act as the repre
sentative of the Queensland Post-Graduate Medical Education
Committee on the Rehabilitation Subcommittee of the
Branch, and Dr. Stubbs Brown is the nominee of the Society
of Returned Medical Officers of Queensland.

In June last the President attended a meeting of repre
sentatives of the Universities Commission with the local
Advisory Committee to that commission, at which details
regarding rehabilitation of medical officers were discussed,
and the general principles of medical education to be per
mitted and paid for by the Universities Commission were
defined.

The question of facilities for post-graduate work outside
Australia being made available to medical officers discharged
from the armed forces, on terms to be arranged, had been
under discussion by the Federal Council of the British
Medical Association. The Branch Council has expressed
itself in favour of the suggestion.

The Branch Council has also endorsed a recommendation
made to the Federal Council that there should be open com
petition between the medical agencies regarding ex-service
practitioners who are seeking avenues of practice.

Queensland Medical Coordination Committee.

Dr. F. W. R. Lukin was again reappointed representative
of the Branch on the Queensland Medical Coordination Com
mittee for the year 1945.

The Branch Council has endorsed the opinion of the
Federal Council that the present set-up of State Medical
Coordination Committees under Commonwealth control
should continue for the time being.

Repatriation Commission: Medical Benefits for Dependants
of Deceased Soldiers.

An agreement between the Repatriation Commission and
the Federal Council has now been reached, after having
been under discussion for several years. The terms of the
agreement should be satisfactory to the medical profession.

Payment for service to dependants of deceased soldiers
will be on a sliding scale determined by the nominal wage
index each year, with a differentiation for metropolitan and
extra-metropolitan areas. For the purposes of the agreement
the metropolitan area has been extended to include
Toowoomba, Maryborough, Rockhampton and Ipswich.

It is understood that beneficiaries may receive treatment
directly by agreement with the Repatriation Department
without the intermediary of a lodge. Also that benefits
must be taken up within six months without submitting to
medical examination. After the expiration of that time a
medical examination is necessary.

Queensland Medical War Benefit Fund.

The Queensland Medical War Benefit Fund was renewed
for a further period of twelve months, which expires on
April 30, 1946.

The future of the fund is undecided at present.

Federal Medical War Relief Fund.

It is proposed by the Federal Council to establish a Federal
Medical War Relief Fund to assist members of the medical
profession who have been disabled, and the dependants of
those who have died as a result of enemy action or of sickness
contracted whilst serving in the armed forces. Also to issue
loans, with or without interest, to medical men, who, as a
result of enemy action, may require temporary financial
assistance.

The fund is to be established by donations from members
of the profession in Australia, and an effort is to be made in
each State to secure as large initial donations as possible.

The control of the fund will be in the hands of trustees
appointed by the Federal Council, and a local committee of
management has been appointed in each State.

It was decided by the Branch Council to appoint the same
personnel as the trustees of the Queensland Medical War
Benefit Fund as the local committee of management for the
Federal Medical War Relief Fund in this State, namely, Dr.
J. G. Wagner, Dr. F. W. R. Lukin, Dr. J. G. Avery, Dr. Milton
Geaney and Dr. J. V. Duhig.

An appeal is to be launched shortly for donations to the
fund.

Rationing.

Although the war has ended, the supply of certain foods
necessary for special classes of the community is still a
matter for medical certification, but the position has eased
somewhat in this regard.

Liquid Fuel Supplies.

The subcommittee appointed to deal with petrol require
ments of metropolitan members has continued its useful
work with the able assistance of Mr. F. K. Davis. Dr. L. P.
Winterbotham is chairman, and the other members are Dr.
Alec Paterson, Dr. A. G. Anderson and Dr. J. G. Avery.

Motor-Car Tires and Accessories.

Members have also been assisted by Mr. F. K. Davis in
obtaining necessary new tires and retreads et cetera, in order
to maintain efficient transport to enable them to carry out
their professional duties.

Linen for Doctors Surgeries.

Through a subcommittee consisting of Dr. L. P. Winter
botham, Dr. J. G. Avery and Dr. Alec Paterson, members
are enabled to obtain adequate supplies and replenishments
of linen for their surgeries; returned service medical officers
particularly appreciate the assistance given in this matter.

Monthly Newsletter.

The monthly newsletter, which was originally sent only to
members in the forces to keep them in touch with current
events, is now circulated to all members of the Branch,
although it does not necessarily represent the views of the
Council.

The members of the Publicity Committee responsible for
the compilation of the newsletters are to be congratulated
upon their excellent work and variety of expression.

124

THE MEDICAL JOURNAL OF AUSTRALIA.

JAM-AKY 2&lt;J.

Supply of Artificial Limbs.

Attention was drawn to the serious position existing in
Queensland in connexion with the supply of artificial limbs.
It is almost impossible for a patient with an amputation to
obtain an artificial limb. The matter was referred to the
Chairman of the Medical Equipment Control Committee, who
promised that all possible steps would be taken to remedy
the position.

Licencees under Alien Doctors (National Security)
Regulations.

At the meeting of the Federal Council held in Melbourne
on October 15, 1945, it was decided to recommend to the
Branches that, unless their country of origin provides
registration of graduates of the State concerned upon con
ditions no less onerous than those existing in such State, the
registration of alien doctors whose licences will have expired
be opposed.

Organization Subcommittee.

Personnel: Dr. Alan E. Lee, Dr. W. H. Steel, Dr. Robin
Charlton. Dr. Felix Arden, Dr. E. W. Casey, Dr. J. G. Morris,
Dr. L. T. Jobbins and the ex-officio members of the Council.

This subcommittee is vested with power to act in matters
which came before it, provided they are not questions of
policy or of a controversial nature.

During the year 24 meetings were held, and recommenda
tions were made to the Council on matters which were not
dealt with directly by the subcommittee.

The following is a record of some of the important subjects
considered by the subcommittee.

Workers Compensation Schedule of Fees. A schedule of
medical fees for attendance on injured workers, as agreed
between the Council of the Branch and the Insurance Com
missioner, and endorsed by the State Treasurer, has been
published and circulated to the profession. This schedule
came into operation as from April 1, 1945, and appears to be
working satisfactorily.

The fees are applicable to treatment of injured workers in
their home, at the doctor s surgery or in a private hospital.
In ordinary cases of injury to workers the Insurance Com
missioner is responsible for payment of medical fees not
exceeding 25, but no responsibility is accepted by him for
private hospital fees, except in special circumstances where
no public hospital accommodation is available, or for injured
workers who are covered by a lodge agreement, or other con
tributory scheme. The sympathetic cooperation of the
Insurance Commissioner in all matters under dispute must
be fully acknowledged.

Unemployment and Sickness Benefits Act. Regarding the
question of medical certificates required under the provision
of this act, members have been advised, where information of
a confidential nature has to be disclosed, to give the
certificate to the patient concerned or obtain the written
consent of the patient to furnish the information to the
Social Service Department.

Medical Certificates. It is a matter of congratulation to
the profession that during the year there has been very little
need for the functioning of the subcommittee appointed to
deal with such matters.

The members of the subcommittee are Dr. H. W. Horn
and Dr. L. P. Winterbotham.

General Health Policy of the Branch. In view of the
importance of the health of the community which is receiving
the attention of the Government and other bodies, a special
subcommittee was appointed to draw up a general health
policy for the Branch, which was adopted by the Council in
August. Copies have been sent to the Federal Council, other
State Branches, and to local medical associations of the
Queensland Branch.

Queensland Institute of Medical Research. A letter was
sent to the Minister for Health and Home Affairs con
gratulating him upon the establishment of an Institute of
Medical Research, as outlined in the Press, and assuring him
of the full cooperation of the Association.

Queensland Health Education Council. The Queensland
Health Education Council, which was instituted by an Order
in Council of the Governor during the year, has superseded
the Queensland Cancer Trust, and its activities have been
extended to "educate the public in health matters generally".

The medical members appointed by the Government include
Dr. Alan E. Lee, Dr. L. M. McKillop, Dr. Konrad Hirschfeld,
Dr. E. H. Derrick and Dr. A. B. Fryberg.

A conference of interested bodies was held on August 7
to discuss the best avenues for the expenditure of public

money on health education of the general public, at which
the Branch was represented by Dr. Harold Crawford. Sub
sequently recommendations drawn up by a subcommittee
were submitted to the Health Education Council, and a copy
of the general health policy of the Branch was forwarded.

Operations Performed on a Minor. In response to an
inquiry for a statement as to the legal responsibility of the
profession in connexion with an operation performed on a
minor, a reply was received from the Minister for Health
and Home Affairs. It was stated that the Solicitor-General
advises that parents under Queensland law have full control
of infants within the meaning of our Children s Protection
Act, 1896, and an operation on such an infant would be an
I assault. On the other hand, if the parent s refusal of consent
were perverse, such parent might be guilty of an offence
under the act, or even of manslaughter.

Lead Poisoning. No improvement in the position with
regard to lead in paint has been achieved. It is contended
by the Master Painters Association that, while the Federal
Government permits paint to be manufactured with lead as
a pigment, the painters have no alternative but to use it.
Dr. L. J. J. Nye addressed the Master Painters Association
on the incidence of lead poisoning in Queensland. Sub
sequently at a joint conference between representatives of
, the Master Painters, Signwriters and Decorators Association
of Queensland and representatives of the Operative Painters
Union, it was decided to ask the British Medical Association
to join them in a deputation to the Minister for Health in an
endeavour to clarify the position with regard to the quantity
of lead being used in the manufacture of paint. A reply was
sent stating that we are only too pleased to cooperate, and
Dr. D. Gifford Croll and Dr. L. J. J. Nye will represent the
Branch at the deputation to the Minister.

Acute Anterior Poliomyelitis. At the suggestion of the
Minister for Health, a conference was held on March 9 to
make recommendations for the prevention of the spread of
this disease, at which the Association was represented by
the President, Dr. H. W. Horn. The recommendations were
as follows: That consultants should be made available and
that patients be isolated for fourteen days. If a case occurs
in a school child, all children in the class are to be isolated
at home. Contacts under fourteen years of age are to be
isolated at home for fourteen days. Power to control children
i at theatres, picture shows et cetera to be obtained. The
treatment will depend upon the medical practitioner in
charge of the case, and the wish of the parents.

Peters-Arctic Delicacy Company, Limited, Staff Super
annuation Scheme. A letter was received from the trustees
of the scheme, stating that they are desirous of instituting
a free medical examination for each member of the super-

. annuation scheme, in addition to the welfare benefits already
provided, and requesting advice on the matter. A conference

of representatives of both bodies was held, and subsequently
a medical officer was appointed to whom a fee of one guinea
is to be paid for each individual examination, and the scheme
will also meet the cost of any further examination by a

, specialist where necessary. All members of the scheme are

| invited to submit to free medical overhaul.

Liquor Reform Society. At a conference of organizations
interested in liquor reform which was held in July, a session
was organized by the Council to present the scientific angle
to the public. Dr. L. P. Winterbotham acted as chairman of
the session and the speakers were Professor John Bostock
and Dr. F. W. R. Lukin.

Health Inspectors Association : Annual Conference. The
President, Dr. H. W. Horn, accepted an invitation to attend
the annual conference of the Health Inspectors Association,
and delivered an address at the opening meeting on Tuesday,
August 21. These annual conferences have been in abeyance
for some yearg owing to the war.

Assistants in Doctors Surgeries. The question of salaries
paid to trained nurses in doctors surgeries was raised by
the Australasian Trained Nurses Association at the request
of their members concerned, with a view to having the
amount increased to 5 9s. per week as provided in the award
for registered nui-ses employed in industrial and commercial
establishments.

A reply was sent to the effect that the Council is in
favour of adequate salaries being paid, but it is not in a.
position to bind doctors in their individual contracts with
trained nurses.

An application is to be made to the Industrial Arbitration
Court by the Federated Clerks Union to have receptionists in
doctors surgeries brought under the conditions of the clerks
award. The claim will be opposed by the Association.

JANUARY 26, 1946.

THE MEDICAL JOURNAL OF AUSTRALIA.

125

Historical Records. With the object of collecting and pre
serving medical records of the early part of this century In
Queensland, a subcommittee has been appointed comprising
Dr. E. S. Meyers, Dr. Harold Love and Professor John
Bostock.

Queensland Surf Life Saving Association. It has come to
the notice of the Council that a member was acting as
honorary medical officer to a surf life saving club, and it
was pointed out to him that the holding of such an appoint
ment was an infringement of By-law 51, namely: "No mem
ber of the Association shall act as Honorary Medical Officer
of any athletic, sporting, racing or similar body." The
member subsequently resigned from the position.

Dr. F. W. R. Lukin holds appointment as honorary medical
officer to the Queensland State Centre of the Surf Life
Saving Association and liaison officer between the Queens
land Branch of the British Medical Association and that
organization, to which position he was nominated by the
Council. This does not involve giving free treatment to
members of the Surf Life Saving Association.

Hospital Matters.

The Hospital Subcommittee did not function this year,
and matters concerning hospitals have been dealt with by
the Organization Subcommittee.

Hospitals Act Amended. The Hospital Act Amendment
Act came into force during the year, and all efforts to have
medical representation on hospital boards have been
unsuccessful. The Part-Time Medical Officers Association
of the Brisbane and South Coast Hospitals Board has also
approached the Minister for Health and Home Affairs
regarding the matter.

The Brisbane and South Coast Hospitals Board, as
reconstituted, consists of eight members appointed by the
Government and one by the seventeen local authorities in
the board s area. The majority of the appointees are govern
ment departmental officers and union officials.

Hospital Policy of the Branch. During the year the
hospital policy of the Branch was revised to meet altered
conditions. The planning of hospitals in the past was largely
influenced by the fact that public hospitals were regarded as
places for treatment of the sick poor, but this function has
almost disappeared in Queensland, and public hospitals are
used to a great extent by the whole community. Only about
20% of hospital patients in Queensland use private hospitals.
It is considered, therefore, that hospitals should be divided
into three classes, (i) community hospitals, (ii) base hos
pitals, (iii) special hospitals, and the first requirement for
an improved hospital system in Queensland is decentraliza
tion. The amended hospital policy of the Branch is based on
these lines, and copies have been sent to interested bodies
and to members who had submitted comments on the draft
policy which was circularized to all members of the Branch.

Lack of Hospital Accommodation. A conference of
interested parties was arranged by the Council of the British
Medical Association to consider what steps could be taken
to improve the position of shortage of hospital accommoda
tion. Further private hospitals have had to close down
owing to lack of nursing and domestic staff. The only
solution appears to be to make more beds available and
provision of adequate staff.

Annual Leave for Hospital Medical Officers. This matter
has been taken up with the Department of Health and Home
Affairs, in view of the fact that some hospital boards include
a clause in their by-laws making it necessary for the medical
officer of the hospital to provide a locum tenens at his own
expense for four weeks annual holiday. It is considered that
the cost of a locum tenens for the period of four weeks
should be borne by the hospital board.

Hospital Benefits Act, 1945. The Federal Council met the
Acting Minister for Health, Senator Keane, and other
departmental officials on October 16 to discuss the Hospitals
Benefits Act, 1945, when the policy of the Federal Council
was placed before them.

The question of the retention of honorary medical service
to public hospitals in the event of the abolition of the means
test is under consideration by the Branches.

Lodges

The Joint Committee of representatives of the Friendly
Societies Medical and Hospital Council and lodge medical
officers met on three occasions. The representatives of the
Branch are: Dr. L. P. Winterbotham, Dr. H. W. Horn, Dr.
T. A. Price, Dr. F. W. R. Lukin.

Capitation Fee: Metropolitan Area. Approval was

i granted by the Prices Commissioner for payment of increased

capitation fees to medical officers in accordance with the

sliding scale laid down in the agreement between the

I Friendly Societies Medical and Hospital Council and the

1 British Medical Association. The capitation fee for the

year commencing July 1, 1945, was computed by the

Government Statistician as 33s. 6d. for adult male members.

Capitation Fee: Country Areas. The Council has expressed

the opinion that the rate for country areas should be a 25%

; increase on the metropolitan rate.

The Bundaberg Local Association suggested that the lodge

| rates should be compulsorily fixed by the Branch Council,

and not left to local associations or lodge medical officers, as

at present provided in the by-laws, which it is considered

i should be amended. This suggestion has been referred to

the local associations for their comment.

Federal Common Form of Agreement. At the last meeting
of the Federal Council it was decided that the time has
arrived for the implementation of the agreement, and a
communication is being forwarded to the Federal Council of
the Friendly Societies Association asking whether the
friendly societies throughout Australia are prepared to
accept the Common Form subject to agreement being reached
in regard to rates which will be on a sliding scale.

Building Subcommittee.

Personnel: Dr. D. Gifford Croll, Dr. M. Graham Sutton,
Dr. S. F. McDonald, and the ex-officio members of the
Council. The activities of the subcommittee have been
resuscitated with the object of considering the question of
j the erection of a new building on the Wickham Terrace
site.

Medical Fees Tribunal.

Personnel: Dr. G. P. Dixon (Chairman), Dr. Alan Lee
(Honorary Secretary), Dr. J. G. Wagner, Dr. D. Gifford Croll,
Dr. H. S. McLelland, Dr. S. F, McDonald.

Four cases were dealt with during the year, in two of
which the verdict given was: "That the fee charged was fair
and just." In the third case, in which a fee of 6 6s. had
been charged, the finding was: "That the fee charged was
higher than was warranted and that the just fee for such
service was 4 4s." In the fourth case a fee of 80 was
charged for an operation, including assistant and anaesthetic
fees and drugs. The finding of the tribunal was: "That the
! fee was considerably higher than was warranted and that a
just fee for such service was 38 17s.

British Medical Association (Queensland Branch)
Memorial Fund.

The indenture has been drawn by our solicitors, and the
I President, Honorary Treasurer and Honorary Secretary, for
i the time being in office, have been appointed trustees.

The purposes of the fund are as follows:

1. To provide prizes commemorating distinguished mem
bers of the Queensland Branch of the British Medical
Association for meritorious students in the University of

i Queensland in the Faculty of Medicine.

2. To provide volumes commemorating distinguished mem-
| bers of the Queensland Branch of the British Medical

Association to the library of the said Branch endorsed with
such commemoration on the fly leaf of such volume signed
by the President for the time being of the Branch.

3. To provide a British Medical Association Memorial Roll
to be kept in conjunction with such Memorial Fund. The
name of a deceased member shall be entered in such
Memorial Roll on the instructions of the Council of the said
Branch, so that such Memorial Roll may be read by the

j President for the time being of such Branch at every annual
meeting of the Branch.

4. To provide for any other kind of memorial to dis
tinguished members of the said Branch that the trustees
may detei-mine at the request of the Council of the said
Branch.

5. The name of a deceased member of the said Branch
shall not be inscribed on the Memorial Roll unless: (a) Not

j less than three friends of the deceased member make
application to the trustees that his name be inscribed. (&)
The Council of the said Branch certify the deceased member
to have been a distinguished and honourable member of the
Queensland Branch of the British Medical Association and of

i the medical profession, (c) The sum of not less than twenty-
five pounds to be paid into the Memorial Fund by the friends

1 of such deceased member at the time of such application.

126

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUAUY 26, 1946.

With the concurrence of its trustees, the Eustace Russell
Memorial Fund has been added to the Memorial Fund of the
Branch.

The following is a list of the foundation members to be
entered on the Memorial Roll: Joseph Bancroft, Kearsey
Cannan, Ernest Sandford Jackson, John Mowbray Thomson,
Charles Ferdinand Marks, William Nathaniel Robertson,
Donald Allan Cameron, Francis Washington Everard Hare,
William Frederick Taylor, Peter Bancroft, Joseph Espie
Dods, James O Neil Mayne, James Barr McLean, Hugh Bell,
Eustace Russell.

The Council has also approved of the following names
being entered on the Memorial Roll: John Lockhart Gibson,
Kenneth Joseph Gilmore Wilson.

, Affiliated Local Associations.

Rockhampton Local Medical Association.

The membership of the Association is as follows: President, !
Dr. F. C. Wooster; Honorary Secretary, Dr. R. Palmerston j
Rundle;; other members are Dr. E. R. Watkins, Dr. Paul E. !
Voss, Dr. D. B. Walker, Dr. C. N. Matheson, Dr. Adah Stuart,
Dr. W. E. Hasker, Dr. Doris Skyring, Dr. Vincent T. J. ;
Lynch, Dr. Bruce Gordon, Dr. N. C. Talbot, Dr. J. C. Ross,
Dr. B. R. V. Forbes.

Two meetings were held during the year. The first, which
was preceded by a dinner and followed by supper, consisted
of medical films and an address by the President of the ,
Queensland Branch, Dr. H. W. Horn. The second meeting
included an address by Dr. A. G. S. Cooper on "Indications
for Radium and X-Ray Therapy".

R. PALMERSTON RUNDLE,

Honorary Secretary-

Bundaberg Local Medical Association.

The membership of the Association is as follows: Dr. E.
Schmidt (President), Dr. I. C. Hains (Honorary Secretary-
Treasurer), Dr. Duncan Fowles, Dr. L. McKeon, Dr. A. W.
Graham.

We have to report for the year just past that the Associa- |
tion of members is developing along the direction of
strengthening the ties between the members. Regular
meetings are held and discussion is free, and careful records :
are kept of all proceedings, and there is general unanimity on
decisions made.

During this term we have had the pleasure of addresses j
by Dr. A. G. S. Cooper, of the Queensland Radium Institute,
Brisbane, who addressed us on radium and radio-
therapeutics. We greatly appreciated the detailed informa
tion given on this important subject, also by Professor J. V.
Duhig, of the Queensland University, who more recently, ;
at short notice, addressed us on various matters of patho
logical and biochemical interest. These lectures we feel are
very important inasmuch as the spoken word is a vast help
in augmenting what is learnt by experience, as also the
written word. We trust, therefore, that in the days to come
we may have more such addresses or lectures, particularly
as air travel is now so convenient and space has been greatly
diminished accordingly.

I. C. HAINS,

Honorary Secretary.

Maryborough Local Medical Association.

Several meetings have been held during the year to discuss I
lodge capitation fees, the annual meeting being held on
October 14, 1945.

Office-bearers elected are: President, Dr. A. J. Kennedy; !
Honorary Secretary, Dr. O. E. Nothling; other members are i
Dr. D. T. Rushton Smith, Dr. K. H. Hooper, Dr. Egmont
Theile, Dr. Alice M. Theile.

It was resolved at the annual meeting to draw up a j
constitution and submit a draft to the members in one |
month s time.

EGMONT THEILE,

For the Honorary Secretary.

Townaville Local Medical Association.

The annual meeting of this Association was held on
August 16, 1945.

Election of officers was as follows: President, Dr.
W. B. Chapman; Honorary Secretary-Treasurer, Dr. L.
Halberstater; the other members are Dr. H. A. Sundstrup, i
Dr. John Breinl, Dr. A. G. Bennett, Dr. V. F. A. O Neill, Dr.

F. R. Tod Stevens, Dr. G. H. Moore, Dr. Beatrice Nelson, Dr.
W. J. Chapman.

It was decided to undertake negotiations with the lodges
for variation of fees. Negotiations are proceeding.

L. HALBERSTATER,

Honorary Secretary.

Other Local Medical Associations.

The Cairns and Kingaroy Local Medical Associations
report that, owing to the war position, they are unable to
hold meetings.

British Medical Agency of Queensland, Proprietary,

Limited. Queensland Medical Finance, Proprietary,

Limited.

After five years service with the Royal Australian Navy,
Mr. S. N. Cobbold resumed the managership of the agency
and the secretaryship of the Queensland Medical Finance,
Proprietary, Limited, in September last. He subsequently
made a tour of south-eastern Queensland with a view to
assisting members released from the armed forces to
reestablish themselves in civilian practice.

Mr. F. K. Davis, who was acting manager and secretary
of the two companies respectively, is remaining on as
assistant to Mr. Cobbold, and will still carry on all services
to members hitherto attended to by him.

Whilst extending a welcome to Mr. Cobbold and wishing
him every success in the future, the Council desires to
place on record its appreciation and thanks to Mr. Davis
for the able manner in which he carried out his duties and
assistance to members during the difficult period of the war
years.

During the year a Ford sedan car has been purchased by
the agency and is available to members on a "Drive Your
self" basis. It is for use at such times as members own
cars are out of commission, and has proved a very useful
service.

Pharmaceutical Benefit s Act, 1944.

The implementation of the Pharmaceutical Benefits Act
by the Commonwealth Government is still a matter for
conjecture, as its validity has been tested in the Victorian
courts by the Attorney-General of that State. The verdict
is awaited with interest.

In October last an unsatisfactory conference took place
between the Federal Council of the British Medical Associa
tion and the Acting Minister for Health. At the conference
the Minister was asked whether the Government was pre
pared to meet the four objections of the Federal Council to
the act. Upon a negative reply being received, the Minister
was informed that the Federal Council s policy of non-
cooperation with the Government would continue.

Members of the Branch will be advised further on the
matter in the event of the implementation of the act being
proclaimed.

In July, Dr. J. G. Hunter, General Secretary of the Federal
Council, visited Queensland with the object of informing
members of the Branch of the latest developments in con
nexion with the Pharmaceutical Benefits Act. He addressed
members at an extraordinary general meeting of the Branch,
and, accompanied by Dr. Alan Lee, he made a tour of south
western Queensland, and contacted practically all the medical
practitioners in the various towns visited, either individually
or at meetings, and placed before them the views of the
Federal Council on the act. In addition, he addressed repre
sentatives of the Trades and Labour Council concerning the
views of the organized profession in relation to the Pharma
ceutical Benefits Act.

Federal Council.

During the year two meetings of the Federal Council were
held in Melbourne, at which the Branch was represented by
Dr. Alan Lee and Dr. Thos. A. Price at the first meeting, and
at the second meeting by Dr. Alan Lee and Dr. D. Gifford
Croll (replacing Dr. Price, who was unable to attend). A
record of the proceedings of the meetings is published in
THE MEDICAL JOURNAL OF AUSTRALIA.

We were pleased to have a visit from the General Secre
tary of the Federal Council, Dr. J. G. Hunter, in July last.

The Pharmaceutical Benefits Act, 1944, is referred to in
another part of this report, and the question of the general
medical services is still in statu quo. Both these subjects
are of major interest to the medical profession at present
and have occupied a great deal of time and thought by the
Federal Council.

JANUARY 26,

THE MEDICAL JOURNAL OF AUSTRALIA.

127

Many other matters of great importance were dealt with
by the Federal Council at its meetings.

A special contribution of 500 was forwarded to the Federal
Council by the Branch for organization expenses. This
amount was taken from the organization fund of the Branch.

Australasian Medical Publishing Company, Limited.

We are pleased to state that the directors of the company
have once again decided to continue the generous rebate to
the Branches of ten shillings for each member who has
totally relinquished civil practice as at December 31, 1945,
for continuous full-time service in His Majesty s Forces.

"The Medical Journal of Australia."

Owing to a printers strike in New South Wales, publica
tion of the journal has been temporarily suspended as from
September 15, and members have been deprived of their
copies for a period of nine weeks. This is the first time
that THE MEDICAL JOURNAL OK AUSTRALIA has ever failed to
put in its weekly appearance.

Lists of members of the Branches of the British Medical
Association in Australia, published by the Australasian
Medical Publishing Company, Limited, are now available at
the Branch office.

University of Queensland.

British Medical Association (Queensland Branch) : Queens
land Medical Students Loan Fund. The personnel of the
committee of administration is as follows: Dr. C. A.
Thelander (chairman), Professor H. J. Wilkinson, Dr. E. S.
Meyers, Dr. Alex Murphy, Dr. Arnold Robertson (a repre
sentative of the University of Queensland Medical Society,
nominated annually by the society) and the ex-officio mem
bers of the Council. The President attended a meeting of
medical students on May 8, when the objects of the loan
fund were put before them. The fund now stands at
346 Os. 4d., and during the year 15 Is. was donated by
medical students and 55 18s. 9d. by members of the Branch.

Faculty of Medicine. At meetings of the faculty of
medicine the Branch is represented by the President, upon
the nomination of the Senate. This provides a valuable
liaison between the Association and the faculty of medicine.
An, important matter under discussion during the year was
the revised medical curriculum, soon to be embarked upon
at this university.

Queensland Post-Graduate Medical Education Committee.
This committee is working in close relationship with the
British Medical Association in regard to the rehabilitation
of medical officers returned from the services, and is taking
an active part in the educational aspect of the matter.

University of Queensland Medical Society. Dr. W. H. Steel
has been appointed to act as liaison officer between the
Branch Council and the society. Assistance was rendered
in obtaining non-medical books for the society s library to
be established for the use of undergraduate members, and
several members of the Branch donated suitable books for
this purpose.

Harold Plant Memorial Prize, 1945. This prize was
awarded to Desmond Neville Bottcher, and was presented
to him by the President of the Branch at the Jackson Lecture
held on September 7.

Eustace Russell Memorial Prize, 1945. The winner of this
prize was Donald Nicholson O Reilly, and was presented by
the President of the Branch at the Jackson Lecture on
September 7.

William Nathaniel Robertson Medal, 1945. Advice was
received from the Registrar of the University of Queensland
that this medal was won by Desmond Neville Bottcher.

Joseph Bancroft Memorial Lecture.

Brigadier N. Hamilton Fairley, O.B.E., M.D., F.R.S.,
delivered the 1945 Joseph Bancroft Memorial Lecture on
Friday, June 1, in the Medical School Hall on the subject
of "Tropical Medical Research in the Australian Army".
There was an attendance of 51 members and visitors. A
vote of thanks to the lecturer was moved by Dr. Ellis
Murphy and seconded by Dr. C. C. Minty. At the conclusion
of the lecture the President presented the Bancroft Memorial
Medal to Brigadier Fairley.

Jackson Lecture.

On Friday, September 7, the Jackson Lecture, which is
given annually in memory of the late Ernest Sandford
Jackson, was delivered by Dr. S. Julius, his subject being
"The History of Medicine in Soviet Russia".

Social.

Council Dinner. Prior to the Bancroft Lecture, the Presi
dent and members of the Council entertained the lecturer,
Brigadier N. Hamilton Fairley, at dinner at the Belle Vue
Hotel on Friday, June 1. Other guests at the dinner were
Surgeon Captain Lambert Rogers, Commander in Chief,
British Pacific Headquarters; Surgeon Captain C. Keating,
Medical Officer in Charge, Royal Naval Hospital, Brisbane;
Surgeon Commander Gavin Cameron, Senior Medical Officer,
Royal Australian Navy, Brisbane; Colonel K. B. Fraser,
D.D.M.S., Headquarters, Queensland L. of C. Area; Wing
Commander Wicks, D.P.M.O., R.A.A.F., Brisbane; Dr. Ellis
Murphy, Chairman, Queensland State Committee, Royal
Australasian College of Physicians; Dr. J. J. Power, Chair
man, Queensland State Committee, Royal Australasian- Col
lege of Surgeons; Dr. S. F. McDonald.

Dinner to Returned Prisoners of War Members.- One of
the most enjoyable functions ever held by the Branch was"
a dinner party at Lennon s Hotel on November 15, to give
members an opportunity of extending a welcome to Major
B. L. W. Clarke, Major Clive Uhr, Captain C. R. Huxtable,
M.C., Captain Clive Boyce and Captain L. P. Sapsford.
Seventy-five members of the Branch were present.

Finance.

It will be noted from the balance sheet that the net surplus
for the year was 225 11s. 8d.

Conclusion.

It must be appreciated that this report to the members
mirrors only in part the enormous volume of business dealt
with by the Council in the year now past.

The document would be incomplete without reference to
the ready spirit of cooperation shown by all, whether at
council meetings, on committees, or in other matters where
personal sacrifice of time and energy has been called upon
in the interests of the public or the profession.

Nor would the efficient working of our organization have
been possible without the diligence and ability of the Secre
tary (Mrs. Spooner) and her staff, in which respect the
Queensland Branch is indeed fortunate.

In the presentation of the report I have no hesitation in
commending the work of your representatives at all times.

(Signed) H. W. HORN,

President.

BALANCE SHEET AND FINANCIAL STATEMENT.

The balance sheet and financial statement for the year
ended November 15, 1945, were taken as read and adopted
on the motion of Dr. J. G. Wagner, seconded by Dr. A. E.
Lee. The statements are published herewith.

ELECTION OF OFFICE-BEARERS.

The President announced the results of the election of
office-bearers and members of the Council.
President : Dr. J. G. Wagner.
President - Elect : Dr. Horace Johnson.
Past President: Dr. H. W. Horn.
Honorary Secretary: Dr. Norman Sherwood.
Councillors: Dr. H. W. Anderson, Dr. Felix Arden, Dr.

R. V. Adamson, Dr. T. V. Stubbs Brown, Dr. E. W.

Casey, Dr. D. Gifford Croll, Dr. Milton Geaney, Dr.

Alan E. Lee, Dr. F. W. R. Lukin, Dr. C. C. Minty, Dr.

J. G. Morris, Dr. T. A. Price, Dr. W. H. Steel, Dr. L. P.

Winterbotham.

ETHICS COMMITTEE.

Dr. M. Graham Button, Dr. L. J. J. Nye, Dr. S. F.
McDonald, Dr. J. J. Power, Dr. R. G. Quinn, Dr. J. G. Avery
and Dr. G. P. Dixon were elected members of the Ethics
Committee.

ELECTION OF AUDITORS.

Messrs. R. G. Groom and Company were reelected auditors
on the motion of Dr. J. G. Wagner, seconded by Dr. Robin
Charlton.

MEMORIAL ROLL.

The President read the Memorial Roll of the Branch and
gave a list of the foundation members as follows: Joseph
Bancroft, Kearsey Cannan, Ernest Sandford Jackson, John
Mowbray Thomson, Charles Ferdinand Marks, William
Nathaniel Robertson, Donald Allan Cameron, William
Frederick Taylor, Peter Bancroft. Joseph Espie Dods, James

ll S

THE MEDICAL JOURNAL OF AUSTRALIA.

JAM-AKY 20, 1946.

QUEENSLAND BRANCH OF THE BRITISH MEDICAL ASSOCIATION (INCORPORATED).
Balance Sheet as at November 15, 1945.

LIABILITIES.
s. d. s. d.
Fixed Liabilities
Loan from Queensland Medical Land
Investment Company, Limited . . 4,650
Current Liabilities-
Subscriptions for Remittance to :
British Medical Association,
London 28 16 ~&gt;
Australasian Medical Publishing
Company, Limited, Sydney . . 27

KC 1 C C

ASSETS.

Fixed Assets, at cost, less deprecia
tion
Land and Buildings B.M.A. House
Library

2,428
150

84
4

d. s.

o gg7 \i

Typewriters, Bookcases, Balopticon
and Furniture
Bancroft Medals and Collar

Queensland Medical Land Invest-

2,975

j 909 n

Association Funds
Accumulation Account .
Sinking Fund
Reserve for Dinners,
ments, etc.

. . . 5,116 14 5
388 5, :;
Entertain-
28 8

Shares of 1 each paid to 10s.
each at cost

British Medical Agency of Queens
land Proprietary, Limited 257
Shares of 1 each, fully paid-

257

- 5,533 7 8

Australian Consolidated Inscribed
Stock
31%, maturing 1959
3J%, maturing 1960

Australasian Medical Publishing
Company, Limited
5% Debentures at cost

Current Assets
English, Scottish and Australian
Bank, Limited Credit Balance,
Current Account
Sundry Debtors

1,500
300

1 800

1,478
608
6
4

2
8
3

Electric Light Deposit
Cash in Hand

Sinking Fund Investments
Australian Consolidated Inscribed
Stock
280: 33%, maturing 1951, at cost
90: 31%, maturing 1960 ..
Commonwealth Savings Bank, Bris
bane Credit Balance

O ||QC 7

278
90

388 5

10,239 4 1

10,239 4

We have compared the above Balance Sheet with the Books, Accounts and Vouchers of the Queensland Branch of the
British Medical Association (Incorporated), and have obtained all the information and explanations we have required. The
Register of Members and other records which the Company is required to keep by the Companies Acts of 1941-1942, or by
its Articles, have, in our opinion, been properly kept.

In our opinion, the Balance Sheet is properly drawn up to exhibit a true and correct view of the state of the Association s
affairs as at 15th November, 1945, according to the best of our information and the explanations given us. and as shown l&gt;v
the books of the Association.

R. G. GROOM & COMPANY.

Chartered Accountants (Aust. ),

Auditors.
Brisbane, 18th November, 1945.

(Sgd.) J. a. WAGNER, .

Honorary Treasurer.

QUEENSLAND BRANCH OF THE BRITISH MEDICAL ASSOCIATION (INCORPORATED).
Revenue Account for Twelve Months ended November 15, 1945.

EXPENDITURE.

REVENUE.

d. s. d.

s. d. s. d.

November 15, 1945.

Branch Expenses
Library Expenditure

947
60

By Branch and Organization Fund
Subscriptions

2,176 3

Depreciation of Office Equipment . .

,, Interest

1017 11

Federal Council

scribed Stock

.") S 1 2

Contribution to Expenses
Special Contribution to Council

464

Australasian Medical Publishing
Company, Limited, Debentures

2 15

Expenses

500

1 2

^&gt;

60 16

Q i; A i - (

Q. 1 f ~\* t -f- -n v,l

5 Cv

Expenses, B.M.A. House

, &gt; -t 11 O

,. oct ie or iNuintion I ampniets . .

t&gt; D

Rates, Land Tax, Insurance,

Repairs and Sundries

156

;;

Cleaning

Depreciation, Building

283

Less Rents Received

249

J 9 g I

Net Surplus for Year

Transferred to Accumulation

Account

225 11 8

2,242 2 10

2.242 2 10

JANUARY 20, 19&lt;&gt;.

THE MEDICAL JOURNAL OF AUSTRALIA.

129

QUEENSLAND BRANCH OF THE BRITISH MEDICAL ASSOCIATION (INCORPORATED).

GENERAL FUND.
Statement of Receipts and Payments for Twelve Months ended November 15, 1945.

RECEIPTS.

November 16, 1944.

To Funds at November lt&gt;, 1944
English, Scottish and Australian
Bank, Limited Current Ac
count

Cash in Hand

1,161
1

November 15, 1945
To Subscriptions

For Remittance to British Medi
cal Association, London . . 828 17 ;!
For Remittance to THE MEDICAL

JOURNAL OF AUSTRALIA, Sydney "95 12
Queensland Branch Subscriptions 1,091 it
Organization Fund. Queensland

Branch 1,084 11 :!

s. d.

4 8
14 11
1,162

General
Rent :

British Medical Agency of
Queensland Proprietary,

Limited, Part Payment Ar
rears . . . . 250

Basement, Garage

and Room . . 28

A.T.N.A 800

Medical Defence

Society . . . . 500

Sale of Nutrition Pamphlets . .

Interest on Commonwealth In
scribed Stock . . . . ....

Australasian Medical Publishing
Company, Limited Interest on
Debentures

291

2 15

s. d.

:&gt;,,600 9

5,120 11 8

PAYMENTS.

November 15, 1945.

By Amounts remitted on account of

Subscriptions Collected to
British Medical Association,

London

Australasian Medical Publishing
Company, Limited. Sydney . .

., Federal Council

Contribution to Expenses
Special Contribution to Council
Expenses

,, Branch Expenses

Salaries, Audit and Honoraria . .
Postages and Duty Stamps
Printing and Stationery
Bank Charges, Meeting Expenses

and Sundries

Telephone Rental and Calls

Travelling Expenses

Electric Light

,. B.M.A. House Expenses

Rates to December 31, 1945
Cleaners Wages, Insurance, Re
pairs and Maintenance
State Land Tax

s. d.

128 16 8

94 9 10
10 18 I)

Library Expenditure

Funds at November 15, 1945

English, Scottish and Australian

Bank, Limited, Brisbane . . 1,478 3 11

Cash in Hand 439

s. d.

831

599

464

500

706

100

1,430

234
60

17 7

1,482 7 8

5,120 11 8

O Neil Mayne, John Barr McLean, Hugh Bell, Eustace
Russell, Thomas Lane Bancroft.

The President announced that the following names had
been added to the roll during the year: Kenneth Joseph
Gilmore Wilson, John Lockhart Gibson.

INDUCTION OF PRESIDENT.

Dr. H. W. Horn then inducted Dr. J. G. Wagner to the
chair.

PRESIDENT S ADDRESS.
Dr. J. G. Wagner read his address (see page 97).

TIIK PROFESSION AND THE PUBLIC.

The following motion was carried at the instance of the
President :

That this annual meeting of the Queensland
Branch of the British Medical Association places on
record its sincere appreciation of the coopei ation
given to members of the profession by the civilian
public during the war years. Without that coopera
tion medical practice would have been chaotic.
It was decided that a copy of the resolution should be
sent to the Press.

VOTES OF THANKS.

Votes of thanks were passed to the retiring members of
Council, the Honorary Secretary and the office staff for
their work during the year.

C0eDical Societies.

MELBOURNE 1VEDIATRIC SOCIETY.

A MEETING of the Melbourne Pzediatric Society was held
on August 8, 1945, at the Children s Hospital, Carlton, DR.
H. DOUGLAS STEPHENS, the Acting President, in the chair.

Transposition of Viscera.

DR. ALAN MCCUTCHEON showed a male patient, aged five
years and eleven months. The child had first attended the

| out-patient department in July, 1943, with a distended
i abdomen and complaining of coldness and blueness of the
extremities. Consanguinity of his parents was established.
He next attended the hospital on April 14, 1945, when he was
noted to be mentally retarded, and a few rhonchi were
audible in the right lung. The heart appeared to be on
the right side and the liver on the left side. He had attended
at intervals with frequent colds, anorexia and nocturnal
enuresis. Dr. McCutcheon showed X-ray films taken at
these visits. A barium meal examination was carried out
on June 1, 1945; this revealed dexiocardia, congestion of the
base of the left lung and transposition of the gastro
intestinal tract. A cholecystogram was taken on July 11,
1945. The gall-bladder, which lay on the left side, was seen
to be of normal size and position. It filled with the dye,
concentrated it well and contracted after a fatty meal. In
none of the films were there any shadows of gall-stones,
and there was no evidence of abnormality of the gall-bladder.
Dr. McCutcheon said that he was hoping to have a broncho-
gram taken later, to determine whether transposition of the
lungs as well as of the other viscera was present. Dr.
McCutcheon wondered w r hether the consanguinity of the
parents might have been a factor in the anomaly in this
instance. He had observed, when dealing with such children
in institutions, that they were frequently retarded physically
or mentally or in both ways.

DR. ROBERT SOUTHBY said that Dr. McCutcheon had covered
the ground so fully that there remained little to add. In a
plain X-ray film, confusion between dexiocardia and trans
position of the viscera might arise, or even between these
conditions and a displaced heart. The electrocardiogram
w r as looked upon as revealing the most pathognomonic sign.
This showed inversion of all the deflections in Lead I. Dr.
Southby said that the patient should wear a disk disclosing
his anomaly in case an abdominal operation was contem
plated in later years. Dr. Southby asked whether Dr.
McCutcheon had observed dexiocardia or transposition of
the viscera in offspring of consanguineous parents.

Dr. McCutcheon, in reply, said that he had not previously
observed this anomaly in children of consanguineous
parents. He intended to study the electrocardiogram and
the bronchogram.

Imperforate Anus.

DR. J. G. WHITAKER showed a male child, aged four months,
who had an imperforate anus. The confinement had been

130

THE MEDICAL JOURNAL OF AUSTRALIA.

JANUARY 26, 1946.

normal, and after two days it was noted that the baby was
having no bowel actions and that the abdomen was becoming
increasingly distended. Rectal examination revealed an anal
canal only one inch in length, with what felt like a solid
block of tissue above. A sigmoid colostomy had been estab
lished, and when the baby recovered from this operation,
X-ray investigation of the defect with barium filling from
the colostomy revealed a probable atresia of the rectum
about one to one and a half inches in length. After some
difficulty in the feeding of the baby had been overcome, the
child was transferred to the Children s Hospital at the age
of eight weeks. Examination on his admission to the hos
pital revealed an infected colostomy wound with a pin-point
stoma in the left iliac fossa, and the anal canal was patent
for a distance of one to one and a half inches. The rest of
the examination revealed no abnormality, except that the
baby showed general signs of malnutrition. Soon after
wards, the colostomy opening was dilated with Spencer Wells
forceps and bowel irrigations were begun; also daily dilata
tion of the opening with Hegar s dilators was instituted. A
few days later the child was examined bimanually under
general anaesthesia by Dr. Whitaker. A finger in the anal
canal was separated from the finger above in the descending
loop of the colostomy by a deficiency in the lumen of the
rectum, the precise thickness of which was difficult to
estimate, but was adjudged to be about one inch in length.
The future treatment of the baby appeared to be one of
three possibilities: (a) the establishment of a permanent
palliative colostomy, probably in the transverse colon, owing
to inadequacy of left iliac colostomy; (b) laparotomy and
inspection of the bowel from above, to see whether any
reconstitution would be possible; (c) the insertion of a pair
of forceps up through the resisting tissue in the roof of the
anal canal, in the hope that this would recanalize the
deficiency. Dr. Whitaker said that the above-mentioned
propositions had been explained to the parents of the baby
and the risks made clear, and advice to allow laparotomy and
attempted reconstitution of the bowel if possible had been
given. Permission was obtained, and at laparotomy the
following features were noted and the lumen of the gut was
reconstituted. The distal loop of the sigmoid colon was
found to be hypertrophied and dilated to almost adult size,
and passed downwards to end suddenly where the rectum
became extraperitoneal. At this stage a pair of Spencer
Wells forceps was introduced per rectum and pushed
upwards, and guided by the operator s hand from above,
was pushed through the obstructing tissue till it was
palpated within the lumen of the lower sigmoid colon above.
The sigmoid colon was opened, and a length of rubber tubing
was grasped in the forceps, pulled through the opening and
made to issue through the anus. This end of the tube was
sutured to the skin around the anus. The opening in the
sigmoid colon was closed and oversewn, a drain tube was
placed in the pelvis and the abdominal wound was closed.
The child had made satisfactory progress after operation.
Liquid faeces were passed through the rectal tube on the
first day, while the iliac colostomy functioned normally and
continued to do so for three days, when the tube slipped
from the rectum as the restraining sutures sloughed from
the perineal skin. It was found that the tube could be
replaced easily, and so it was removed completely, and daily
dilatation of the reconstituted gut was commenced. From
that time the child had passed semi-solid, normal-sized
stools per rectum, and dilators up to Hegar s Number 13
could be passed with ease. The colostomy had not yet
closed. The abdominal wound was almost healed. The child
was apparently healthy and making progress. Dr. Whitaker
said that only time would determine the ultimate outlook.

DR. JOHN BEGG sought information on the treatment of
patients with imperforate anus. He had been injudicious
enough to operate on such a patient. The child was left
with a perineal anus, but no hope of a satisfactory sphincter
mechanism. The alternative of a permanent colostomy
offered little solace, though perhaps it was preferable to a
perineal anus. Dr. Begg wondered whether such patients
should be treated surgically or allowed to die.

DR. H. C. COLVILLE quoted a recent unusual experience of
his own. He said that five years earlier he had examined
a baby two hours after birth; the baby had an imperforate
anus, as well as a rudimentary tail. Dr. Colville observed
that there was a pronounced bulge in the perineum when
the baby cried. He punctured the bulging area, and was
rewarded by a free flow of cerebro-spinal fluid. He hastily
closed this opening and explored the perineum, until he
found the rectum and brought it down and sutured it to the
region of the anus. At the time of the meeting the child
was five years old, and presented the problem raised by
Dr. Begg. It could be said that this child was certainly not

the "write off" that Dr. Begg had visualized; he was a fine,
sturdy little boy, and needed dilatation only at intervals.
By careful training, in which the child was encouraged
to empty his bowels at a definite time each day, much had
been accomplished. During the remainder of the day there
was a slight fa?cal stain only. Some degree of sphincteric
control did develop, though anatomically no sphincter
existed. Dr. Colville said that he was wondering whether
greater sphincteric control developed in later life, and
whether anyone had attempted to construct a sphincter
from the adjacent muscles, such as the glutei.

DR. ROBERT SOUTHBY said that he was interested in a boy
who had had a colostomy established when he was a few
hours old. The boy went through school and later joined
his father in business. He died at the age of twenty years
from streptococcal septicaemia, after a full life of com
parative comfort.

DR. PETER BLAUBAUM asked whether the Injection of dye
to determine the size of the block of tissue constituting the
atresia was a safe procedure.

DR. H. DOUGLAS STEPHENS said that he was not nearly so
pessimistic as Dr. Begg about imperforate anus; the out
look was hopeful if a bulge could be visualized in the
perineum when the baby strained. It was Dr. Stephens s
belief that the operative treatment outlined by Ladd and
Gross was best. He had removed the coccyx and made an
artificial anus posterior to the usual site, but had not found
it satisfactory. In some cases it was better to establish a
colostomy and drainage. The ultimate result in these cases
was interesting. Dr. Stephens said that a few weeks earlier
a strong man had walked into his office and told him that
he (Dr. Stephens) had operated on him at the Children s
Hospital twenty years earlier for imperforate anus. Two
years later Dr. Stephens had again operated on him for an
inguinal hernia. Later he had found out that he had
congenital heart disease. The man was a butcher, and his
bowels were open every day. Dr. Stephens said that he
asked to see the patient s perineum, and succeeded in passing
a Number 22 Hegar s dilator without much difficulty.

(To be continued.)

CI)c

3u0ttaiasian College
of Burgeons*

A POST-GRADUATE COURSE IN SURGERY.

THE Royal Australasian College of Surgeons will conduct
| in Melbourne a post-graduate course. It will begin on
March 4 and conclude on May 31, 1946. The course is
I suitable for all graduates who wish to undertake post-
i graduate study in surgery, and is not designed solely for
j those desiring to present themselves for senior surgical
j qualifications.

Lectures will be delivered at Prince Henry s Hospital from
I 2 to 3.30 o clock p.m. on Mondays, Wednesdays and Fridays.
Lecture demonstrations will be held on Tuesdays and
Thursdays from 2 to 4 o clock p.m. From March 5 to April 2
inclusive the demonstrations will take place at the Alfred
Hospital; from April 4 to April 23 the venue will be Saint
Vincent s Hospital; on April 25 the Children s Hospital; from
April 3 to May 23 the Royal Melbourne Hospital.

Lectures and lecture demonstrations will be arranged in
the surgical specialities. These will be announced in detail
following the receipt of entries which close on January 31.
1946.

Twenty-four lectures and lecture demonstrations in
pathology will also be arranged.

MEETINGS OF THE COURTS OF EXAMINERS.

THE next meeting of the Courts of Examiners of the Royal
Australasian College of Surgeons for the Primary Examina
tion for Fellowship of the College will be held in Melbourne.
Australia, and in Dunedin, New Zealand, probably early in
June, 1946.

The next meeting of the Court of Examiners for the Final
Examination for Fellowship of the College will be held at the
College in Melbourne in the first week in June, 1946.

Candidates who desire to present themselves at either of
these meetings should apply to the Censor-in-Chief for

JANUARY -G, 194(5.

THE MEDICAL JOURNAL OF AUSTRALIA.

131

permission to do so on or before April 1, 1946. The
appropriate forms are available from the Secretary of the
Royal Australasian College of Surgeons, Spring Street,
Melbourne, C.I.

Hopal College of &gt;b$tetrician$ anD

EXAMINATION FOR MEMBERSHIP.

CANDIDATES who have not indicated their intention to sit
for the examination for membership of the Royal College of
Obstetricians and Gynaecologists are asked to do so as soon
as possible. All inquiries should be addressed to Professor
R. Marshall Allan at the University of Melbourne.

COURSES IN QUEENSLAND IN 194&lt;&gt;.

THE University of Queensland Post-Graduate Medical
Education Committee announces that the following courses
will be held in 1946.

General Revision Course.

The general revision course is of thirteen weeks duration
and will be repeated twice during the year, so that there
will be continuous clinical lecture demonstrations throughout
1946. In this way, any service medical officer granted three
months pre-discharge training, any ex-service medical officer
granted three months post-discharge rehabilitation training
or any post-graduate training to attend a general refresher
course, by joining the class at any time during the year and
attending the sessions set out in the time-table to be
circulated, will cover the five parts of the course.

Part I: Paediatrics, of three weeks duration, commencing
on Monday, February 4, 1946.

Part II: Medicine, of three weeks duration, commencing
on Monday, February 25, 1946.

Part III: Obstetrics and gynaecology, of two weeks dura
tion, commencing on Monday, March 18, 1946.

Part IV: Surgery, of three weeks duration, commencing
on Monday, April 1, 1946.

Part V: The specialities, of two weeks duration, com
mencing on Monday, April 22, 1946.

Three or four lecture demonstrations will be held each
week, in the afternoon or evening, during each part of the
course. The time and place of each lecture will be indicated
on a detailed programme shortly to be circulated.

Course II, a repetition of Course I, will commence on
Monday, May 6, 1946.

Senior Course in Medicine.

The senior course in medicine is suitable for candidates
preparing themselves for the M.R.A.C.P. and M.D. examina
tions. This will be run concurrently with Part II (medicine)
of the general revision course, which will be supplemented
by lecture demonstrations in pathology, clinical rounds in the
medical wards et cetera.

Anatomy and Principles of Pathology.

This course is suitable for candidates preparing themselves
for the M.S. (Part I). This is term III of the course, parts
I and II of which were held in 1945. Term III will com
mence sometime in March, on a date to be announced later.
Term III (anatomy) will cover the anatomy of the
extremities, in ten evening courses, each of which is of two
hours duration. The "Principles of Pathology" will also be
covered in ten lectures. The fees for this course will be
7 7s. per subject per term, providing nine members take
the full course.

Bancroft Oration and Post-Graduate Week.

The Bancroft Oration will bt&gt; delivered on June 7, 1946,
and will be followed by post-graduate week, June 7 to 14,

Week-End Courses in Country Centres.

Week-end courses to be held in country centres will be
announced later.

Post-graduate students are welcome at the medical school
library for study purposes. Books and journals may not be
removed from the library.

Service medical officers and ex-service medical officers
desiring further information on post-graduate study should
communicate with Dr. P. H. Macindoe, Medical School,
Herston Road, Brisbane (telephone: BO 534).

Correspondence.

THE USE AND MISUSE OF TETANUS ANTITOXIN.

SIR: A pamphlet, wrapped round each container of anti
toxin, is issued by the Commonwealth Serum Laboratories,
in which it is set out, under the heading, Directions for Use:
If the subcutaneous route is chosen the most favourable
position for injection is under the loose skin of the lower
abdomen." In Sydney and suburbs this direction seems to
me to be almost universally ignored. The upper arm is the
site selected, with the almost inevitable result that the
unfortunate patient experiences a more or less severe
reaction; the reaction frequently is so severe that he is
disabled and suffers much more from the treatment than
from the original injury. My experience is that such
reaction and incapacity do not eventuate if the proper
site is chosen for the injection.

While no one questions the expediency of administering
tetanus antitoxin in cases of penetrating wounds, such as
puncture by nails in the feet or puncture by cargo hooks
and in lacerated, contused or dirty wounds, it does, however,
seem to me unnecessary and overdoing it to follow the same
procedure in ordinary clean-cut quite superficial wounds.
Having in mind that the tetanus bacillus is anaerobic, it
would be more appropriate to administer antitetanic serum
to everybody who runs a rose thorn into their finger or
pricks it with a needle or pin. Like so many other useful
remedies, it is overdone.

Some years ago I had occasion to investigate the morbidity
and fatal cases from tetanus in New South Wales; the
statistics showed that the principal incidence was in children
under ten years of age who contracted it from penetrating
wounds in bare feet. In adults frequently the origin and
mode of infection were not discovered. It was also found
that it was as common in clerks as in fellmongers and there
were several cases after septic abortion. I have known more
than twenty sheep die from it after shearing in one shed,
and the infection was traced to a particular tar pot that was
used for dressing the wounds caused at shearing.

I have been prompted to write this note in the hope that
a little more discretion and horse-sense may be exercised
in administering the antitoxin, because I have seen such a
number of cases of suffering and disability from its misuse.

Yours, etc.,

STRATFORD SHELDON, M.B., Ch.M., B.Sc.
28, O Connell Street,
Sydney,

December 12, 1946.

FUNCTIONAL DISORDERS.

SIR: Half the patients seen in general practice have

nothing organically wrong with them. This opinion has

been frequently expressed and statistically confirmed by

I J. B. Barton. These patients are suffering from functional

! disorders of various kinds, including neurasthenia, anxiety

I states, functional dyspepsia, cardiac, gastric, ocular, bladder,

! genital and other neuroses, stammering, writer s cramp,

: behaviour disorders, globus, hysterical aphonia, conversion

I hysteria with backache or pains in the limbs, coccydynia,

I frigidity, epileptiform attacks and many other conditions.

| We have been accumstomed to prescribing "nerve tonics",

alkaline powders, bromide or phenobarbital, changing their

glasses, or ordering a holiday, with indifferent results.

Recently Evan Jones, of Sydney, Bostock, of Brisbane,
T. A. Ross in England, Kraines in America and others have
indicated that most of these illnesses respond dramatically

THE MEDICAL JOURNAL OF AUSTRALIA.

.JANUARY 1&gt;6, 1946.

to psychotherapy, and experience has shown that some can
be cured in an hour.

Although these cases comprise half the work of the
general practitioner, our medical periodicals are almost silent
on the subject, and this letter is an appeal for more articles
on the functional disorders in this journal.

142, Concord Road,
Concord,

New South Wales.
January 19, 1946.

Yours, etc.,

A. A. 1 AIN.

, S^ilitarp anD air jforce.

APPOINTMENTS.

THE undermentioned appointments, changes et cetera have
been promulgated in the Commonwealth of Australia Gazette,
Number 9, of January 17, 1946.

PERMANENT NAVAL FORCES OF THE COMMONWEALTH

( SEA-GOING FORCES).

To be Surgeon Captain. Surgeon Commander Denis
Adrian Pritchard.

AUSTRALIAN ARMY MEDICAL CORPS.

NX34968 Lieutenant-Colonel R. F. K. West relinquishes
command of 3rd/14th Australian Field Ambulance, 7th
November, 1945.

The following officers are placed upon the Regimental
Supernumerary List: SX1464 Lieutenant-Colonel R. G.
Champion de Crespigny, 7th November, 1945, and WX3416
Major (Temporary Lieutenant-Colonel) G. C. Moss, 8th
November, 1945.

WX3330 Colonel (Temporary Brigadier) A. L. Dawkins,
O.B.E., E.D., relinquishes the rank of Temporary Brigadier
and is transferred to the Reserve of Officers (Australian
Army Medical Corps) with the rank of Colonel and is
granted the rank of Honorary Brigadier, 14th November,
1945.

VB116930 Local Lieutenant-Colonel F. S. Gorrill ceases to
be seconded and relinquishes the rank of Local Lieutenant-
Colonel and ceases to be attached to the Australian Military
Forces, 24th October, 1945.

2nd/6th Australian General Hospital. VX65536 Captain
J. M. McCracken is placed upon the Regimental Super
numerary List, 27th August, 1945.

102nd Australian Casualty Clearing Station (Australian
Imperial Force). NX107907 Major R. C. Scobie is placed
upon the Regimental Supernumerary List, 16th November,
1945.

Q273987 Honorary Captain L. I. Burt is appointed from the
Reserve of Officers (Australian Army Medical Corps) and to
be Captain, 22nd October, 1945.

New South Wales Lines of Communication Area: To be
Honorary Captain, 16th November, 1945. James Lincoln
Kelly.

ROYAL AUSTRALIAN AIR FORCE.
Citizen Air Force: Medical Branch.

The probationary appointments of the following Flight
Lieutenants are confirmed with effect from the dates
indicated: C. F. Bellemore (267567), 13th March, 1944,
D. A. S. Morgan (287465), 19th September, 1945. (Ex. Min.
No. 5 Approved llth January, 1946.)

Ofcituarp,

JAMES WHITSON KEMP BRUCE.

WE regret to announce the death of Dr. James Whitson
Kemp Bruce, which occurred on January 22, 1946, at North
Sydney, New South Wales.

Diarp for tije

JAN. 31
FEB. 1
FEB. 5

FEB. 6

FEB. 7

FEB. 8

FEB. 12

FEB. 19

FEB. 21
FEB. 21
FEB. 22
FEB. 26
FEB. 27
FEB. 28
MARCH
MARCH
MARCH

.South Auptrnlian Branch, B.M.A. : Scientific Meeting.

Queensland Branch, B.M.A. : Branch Meeting.

New South Wales Branch, B.M.A. : Organization and

Science Committee.

Victorian Branch, B.M.A. : Branch Meeting.
Western Australian Branch, B.M.A. : Council Meeting.
South Australian Branch, B.M.A. : Council Meeting.
. Queensland Branch, B.M.A. : Council Meeting.
Tasmanian Branch, B.M.A. : Ordinary Meeting.
New South Wales Branch, B.M.A. : Executive and

Finance Committee.
. New South Wales Branch, B.M.A. : Medical Politics

Committee.

South Australian Branch, B.M.A. : Council Meeting.
Victorian Branch, B.M.A. : Executive Meeting.
-Queensland Branch, B.M.A. : Council Meeting.
New South Wales Branch, B.M.A. : Ethics Committee.
Victorian Branch, B.M.A. : Council Meeting.
South Australian Branch, B.M.A. : Scientific Meeting.
1. Queensland Branch, B.M.A. : Branch Meeting.
2. Tasmanian Branch, B.M.A. : Annual Meeting.
5. New South Wales Branch, B.M.A. : Organization

and Science Committee.

Qietiical appointments: important Notice*

MEDICAL PRACTITIONERS are requested not to apply for any
appointment mentioned below without having first communicated
with the Honorary Secretary of the Branch concerned, or with
the Medical Secretary of the British Medical Association,
Tavistock Square, London, W.C.I.

New South Wales Branch (Honorary Secretary, 135, Macquarie
Street, Sydney): Australian Natives Association; Ashlield
and District United Friendly Societies Dispensary ; Balmain
United Friendly Societies Dispensary ; Leichhardt and
Petersham United Friendly Societies Dispensary; Man
chester Unity Medical and Dispensing Institute, Oxford
Street, Sydney ; North Sydney Friendly Societies Dis
pensary Limited ; People s Prudential Assurance Company
Limited ; Phoenix Mutual Provident Society.

Victorian Branch (Honorary Secretary, Medical Society Hall,
East Melbourne): Associated Medical Services Limited;
all Institutes or Medical Dispensaries ; Australian Prudential
Association, Proprietary, Limited ; Federated Mutual
Medical Benefit Society ; Mutual National Provident Club ;
National Provident Association ; Hospital or other appoint
ments outside Victoria.

Queensland Branch (Honorary Secretary, B.M.A. House, 225,
Wickham Terrace, Brisbane, B.I 7) : Brisbane Associated
Friendly Societies Medical Institute ; Bundaberg Medical
Institute. Members accepting LODGE appointments and
those desiring to accept appointments to any COUNTRY
HOSPITAL or position outside Australia are advised, in
their own interests, to submit a copy of their Agreement
to the Counsil before signing.

South Australian Branch (Honorary Secretary, 178, North
Terrace, Adelaide) : All Lodge appointments in South
Australia ; all Contract Practice appointments in South
Australia.

Western Australian Branch (Honorary Secretary, 205, Saint
George s Terrace, Perth): Wiluna Hospital; all Contract
Practice appointments in Western Australia. All Public
Health Department appointments.

OBDitorial

MANUSCRIPTS forwarded to the office of this journal cannot
under any circumstances be returned. Original articles for
warded for publication are understood to be offered to THE
MEDICAL JOURNAL OF AUSTRALIA alone, unless the contrary be
stated.

All communications should be addressed to the Editor, THE
MEDICAL JOURNAL OF AUSTRALIA, The Printing House, Seamer
Street, Glebe, New South Wales. (Telephones: MW 2651-2).

Members and subscribers are requested to notify the Manager,
THE MEDICAL JOURNAL OF" AUSTRALIA, Seamer Street, Glebe,
New South Wales, without delay, of any irregularity in the
delivery of this journal. The management cannot accept any
responsibility or recognize any claim arising out of non-receipt
of journals unless such a notification is received within one
month.

SUBSCRIPTION RATES Medical students and others not
receiving THE MEDICAL JOURNAL OK AUSTRALIA in virtue of
membership of the Branches of the British Medical Association
in the Commonwealth can become subscribers to the journal by
applying to the Manager or through the usual agents and book
sellers. Subscriptions can commence at the beginning of any
quarter and are renewable on December 31. The rates are 2
for Australia and 2 5s. abroad per annum payable in advance.

JANUARY 26, 1946.

THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER.

Medical Practices, etc.

Medical.

1. Unopposed country practice,
excellent climate, south N.S.W.
Average cash take 1,200. Good
public hospital. Premium 1,000.

2. Unopposed subsidized practice,
northern N.S.W. Cash take 1,100.

Residence to rent. Price 600.

Wanted.

Ophthalmic assistantship wanted by
doctor keen to specialize.

All Enquiries Confidential.
GOYDER, SON & CO.,

Medical Agents,

Cutht-art House, lie Czistlereagh
Street, Sydney. BW 7149.

After Hours: JA 72OJJ.

The name of Goyder has been

associated with Medical Agency

since 1902.

Australian Physiotherapy
Association

(Australasian Massage

Association)
NEW SOUTH WALES

Massage, Remedial Exercises and

Medical Electricity.
Occupational Therapy.

Members are fully trained in
these subjects and work only under
the direction of a registered medical
practitioner.

Further information obtainable
from the General Secretary.

MISS E. P. EVANS,

Manchester Unity Building, 185

Elizabeth Street, Sydney.

(MA 2031.)

A PPLICATIONS are invited for
** the position of Medical Prac
titioner for Kimba District in South
Australia. Practice covers a radius
of approximately 35 miles.
Guarantee by District Council of
1,000 p.a. Well-equipped govern
ment subsidized hospital at Kimba.
Further particulars may be
obtained from the Secretary, Kimba
Hospital, Kimba, S.A.

RENWICK HOSPITAL, FOR
INFANTS, SUMMER HILL.

; Applications, on prescribed form.

j are invited for the position of
Resident Medical Officer. Salary at
the rate of 4 p.w. Vacancy March.
Particulars, Medical Superinten
dent. W. B. ROOD. Secretary,
Benevolent Society of N.S.W.,
General Offices, Thomas Street,
Sydney.

YTf ANTED TO PURCHASE,
&gt;T General Practice in or near
Sydney. Cash available. Particu
lars to Dr. A. B.C., this Office.

SPEECH THERAPY.

Remedial Treatment for
Reading, Writing, Speech

and Voice Disorders.

MISS WRAY, A.S.S.T., London.

Speech Therapist to R.A.H.C.,

Sydney.

1 Marqaarir Street, Sydney.
Phone &gt; B 4460.

Service for Doctors

Watson House, BJigh Street,

Sydney.
Telephone: BW4433.

No. 590. Radiological practice in
base hospital town. Goodwill and
X-ray plant for sale. Professional
rooms and private residence to
rent. Scope increase takings.
No. 591. Assistant required, view
partnership, large Sydney outer
suburban practice. Opportunity
young married ex-service surgeon,
Prot.

No. 586. Unopposed north-western
district, N.S.W., country practice,
taking 2,000. Excellent hospital.
Substantial appointments. Brick
house to rent. Goodwill for sale.
Pre-war takings over 3,000.
No. 574. N.S.W. country practice,
opposed, taking over 2,000.
Appointments worth 350. Mids.
70. Large district intermediate
hospital. Goodwill for sale.

Modern house to rent. Oppor
tunity young married ex-service
practitioner.

No. 5(J7. Base hospital town,
E.N.T. Practice taking 2,750 p.a.
Goodwill and modern residence for
sale.

Locum tenens available for short
term, suburban or country work,
from February 4.

Particulars in Confidence.

\VATSON VICTOR

LIMITED

LICENSED BUSINESS AGENTS

Watson Honoe, Rlich Street,

Sydney.

Branch** In all Capital Cltlea of
Australia and Nerr Zealand.

ROYAL HOBART HOSPITAL, :
RE-ORGANIZATION MEDICAL,
STAFF. Following the re-organiza
tion of medical staff, applications
are invited from fully qualified
and registered medical prac
titioners for the following posts.
Medical Registrar: Commencing
salary 750, rising to 800 per
annum in second year. Duties
include the supervision, investiga
tor and treatment of all
medical cases admitted to hospital,
also the work and case recording
of junior resident medical officers,
according to the wishes of the
Superintendent and honorary
physician in charge of the beds.
Applicants to have held the post
of a senior resident medical officer
in a hospital and interested in
medicine. The post is suitable for
one working for his M.R.A.C.P.
Senior Resident Medical Officer: At
least two years hospital experience
necessary. Duties include the
supervision, investigation and
treatment of obstetrical and
gynaecological Oases under the
honorary obstetricians and gynae
cologists to the hospital. Com
mencing salary 550 per annum
plus board and residence. Accom
modation for single men living out
allowance payable to married men.
Applications stating age, experience
and qualifications, together with
copies of recent testimonials, and
clearly stating position sought,
close with the undersigned on
February 20, 1946. Successful
applicants to commence duty March
15, 1946. H. M. WRIGHT. Secre
tary, Box 495, G.P.O., Hobart.

FOR SALE, Practice, North Shore
Line. Takings about 3,000.
Modern house for sale. Moderate
lodge list. No surgery undertaken.
Apply "P.B.", c.o. THE MEDICAL
JOURNAL OF AUSTRALIA, Seamer St.,
Glebe, Sydney, N.S.W.

/COMMONWEALTH DEPART-
VV MENT OF HEALTH : Vacancy
for Chief Medical Officer (Exempt),
Darwin, N.T. CONDITIONS OP
SERVICE. Salary Range: 1,202 to
1,352 (annual increments of 50).
The above salary is inclusive of
cost of living adjustment, which at
present is 40 per annum. In
addition, district allowance of 100
p.a. (married) or 80 p.a. (single)
is payable. Duties: He will be
responsible, under the Director-
General of Health, for all medical
services in the Northern Territory,
the control of hospitals, the leper
station, quarantine, aerial medical
services, and public health
generally. He should possess sound
professional knowledge, be a good
administrator, and possess a
diploma in public health or tropical
medicine. Hours of Duty: No fixed
hours. The Chief Medical Officer is
not regarded as eligible for special
monetary compensation for over
time, Sunday or holiday duty. No
right of private practice. No
superannuation. Motor-car trans
port provided ; or mileage allow
ance at Public Service rates, if
using own car. Housing and
furniture deductions from salary at
Public Service rates: (a) if
occupying departmental quarters in
Darwin, the deduction of rent to be
at the rate of 10% of the minimum
salary of the position. Furniture:
Rented on the basis of 10% of the
purchase price in all cases where
official furniture is provided. Fares:
Fares to the Northern Territory
will be paid by the department, but,
in the event of the appointee not
remaining in the service for at
least six months, he may be re
quired to refund the fare paid on
his behalf. Recreation Leave:
Thirty-six (36) days per annum
exclusive of Sundays and holidays,
which may be allowed to accumu
late for three consecutive years.
Recreation leave to be granted in
respect of each completed twelve
months continuous employment.
Travelling Time for Recreation
Leave: Seven (7) days each way.
This travelling time is the maxi
mum period which may be allowed,
irrespective of the locality in
which the employee spends recrea
tion leave or whether leave is
accumulated or enjoyed annually,
provided that where a lesser period
is occupied in travelling, the travel
ling time should be correspondingly
reduced. Sick Leave : In accor
dance with Public Service con
ditions. Engagements may be
terminated at any time without
notice by the Director-General of
Health on the grounds of mis
behaviour or inefficiency ; otherwise
it may be terminated by one
month s notice in writing by either
the Director-General of Health or
the appointee. Preference will be
accorded to persons with the neces
sary qualifications, in accordance
with the provisions of the Re-
establishment and Employment Act
(No. 11 of 1945). Applications
showing full name, date and place
of birth, war service (if any) and
full details of qualifications and
experience should be forwarded to
reach the Director-General of
Health, Canberra, A.C.T., on or
before 9th February, 1946.

FOR PRIVATE SALE, X-Ray
Practice in convenient country
centre. For further particulars
apply XYZ, c.o. THE MEDICAL.
JOURNAL OF AUSTRALIA. Seainer
Street, Glebe. Sydney, N.S.W.

EXPERIENCED PRAC

TITIONER wants to buy
suburban practice, preferably
partnership, in Adelaide. All in
formation confidential. Apply to
No. 94, c.o. THE MEDICAL JOURNAL
OP AUSTRALIA. Seamer Street,
Glebe, Sydney, N.S.W.

STORER-HARRISON
X-RAY COMPANY

FOR EVERYTHING

ELECTRICAL IN

MEDICINE

Ediswan Electric Convulsion
Therapy Apparatus.
Infra-Red Generators.
Ultra-Violet Lamps.
Short-Wave Diathermy.
Surgical Diathermy.
Faradic/Galvanic Apparatus.
X-Ray Apparatus.
X-Ray Accessories.
Equipment Hire Service.

Further Particulars:

STORER-HARRISON X-RAY

COMPANY

67 Hunter Street, Sydney
BW5122 BW 7277

A UCKLAND HOSPITAL

-tX BOARD, NEW ZEALAND.
Applications addressed to the
undersigned and closing on the 28th
day of February, 1946, are invited
from Registered Medical Prac
titioners of the British Empire of
at least ten years standing and
having wide clinical and adminis
trative experience, for appointment
as Superintendent-in-Chief of the
Board s institutions at a salary of
2,000 per annum, payable monthly,
rising by annual increments of 50
to a maximum of 2,250 living out
(New Zealand currency). The
Board s institutions include four
major hospitals accommodating
2,600 patients, with other hospitals
in course of planning. The position
will be wholly administrative. Con
ditions of appointment, accompany
ing explanatory memorandum and
official form of application may be
obtained on request to the Secre
tary, P.O. Box 2200, Auckland, New
Zealand. Applications should be
endorsed on envelope "Superinten
dent-in-Chief". R. F. GALBRAITH.
Secretary.

/COMMONWEALTH OF AUS-
^ TRALIA, DEPARTMENT OF
HEALTH : Vacancies for Position
of Medical Officer. Applications
are invited for appointment to the
positions of Medical Officer, Com
monwealth Department of Health.
Salary range is 720 to 864
(standard), subject to cost of
living adjustments, which raises the
salary at the present time to 760
to 904 (actual). The annual
ncrements are 36. The position
will be exempt from the provisions
of the Commonwealth Public
Service Act. A number of positions
are in the laboratory services of
the department, for which a course
of training is provided after
appointment. Applicants must be
medical graduates between 25 and
35 years of age, should produce
evidence of sound professional
knowledge, and be prepared to per
form duty anywhere in Australia.
Preference will be accorded to
persons with the necessary quali
fications in accordance with the
provisions of the Re-establishment
and Employment Act (No. 11 of
1945). Applications showing full
name, marital status, and date and
place of birth should be forwarded
to the Director-General of Health,
Canberra, A.C.T.

Xll

THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER. JANUARY 26, 1946.

FOR SYMPTOMATIC RELIEF

AND TREATMENT OF PEPTIC ULCER

Following the investigation of Mutch (B.M.J., October, 1937), the thera
peutic value of Hydrated Magnesium Trisilicate was established. Having a
ratio of MgO to SiO 2 of 1 to 2.24, Trinesium Stearns is in exactly the form
advocated by Mutch. Clinical tests have established the efficacy of Trinesium
in the management and treatment of peptic ulcer. It provides protection
against the corrosion of the ulcer bed, together with continuous control of
hyperacidity and sustained adsorbent action.

In combination with the gastric juices Trinesium forms a silica gel over the
ulcer, thus providing mechanical protection for the ulcer. By its neutralising
action and its potent adsorbing power, Trinesium can create a pepsin-free
and acid-free zone. This guards the raw ulcer area from further irritation and
corrosion due to digestive activities.

Mutch found that with Magnesium Irisilicate, a minimal amount of mineral
base controls hyperchlorhydria continuously.

Samples ana further literature on 1 rinesium will he
gladly sent to the medical profession on request to
Frederick Stearns & Company Division, Box 3286,
G.P.O., Sydney.

Trinesium

STEARNS

ANTACID Trinesium relieves
gastric Hyperacidity within a few
minutes. The single dose will
control excess acid for the entire
:.- period of gastric digestion.

ADSORPTIVE Mutch reports
that, as an adsorbent. Magnesium
Trisilicate "far transcends bis
muth salts, magnesia, aluminium
hydroxide or other medicaments
in common use. .

ANTIPEPTIC The silica gel
formed by Trinesium provides
mechanical protection for stomach
ulcers. It subdues pain and in
flammation and help? to achieve
healing

DOSAGE Trinesium
(Hydrated Magnesium Trisili
cate) is available in bottles con
taining l5 oz., and in tablet form.
Average dose is 21 grains (one
level teaspoonful).

rredi

reaenci

Stearns^

ompanu
1 &lt;7

ivision

SYDNEY, AUSTRALIA

Wholly set up, printed and published at the Printing House, Seamer Street, Glebe, Sydney, N.S.W., by ARTHUR FREDERICK ROOTS
SIMPSON, of B airholm Street, Strathfield, New South Wales, on behalf of the AUSTRALASIAN MEDICAL PUBLISHING COMPANY

LIMITED, Seamer Street, Glebe, Sydney, New South Wales.

Registered at the G.P.O., Sydney, for Transmission by Post as a Newspaper.

Published Weekly.

Price 1s.

THE

MEDICAL

JOURNAL

OF AUSTRALIA

VOL. I. 33RD YEAR.

SYDNEY, SATURDAY, FEBRUARY 9, 1946.

No. 6.

FOR SYMPTOMATIC RELIEF

AND TREATMENT OF PEPTIC ULCER

Following the investigation of Mutch (B.M.J., October, 1937), the thera
peutic value of Hydrated Magnesium Trisilicate was established Having a
ratio of MgO to SiO 2 of 1 to 2.24, Trinesium Stearns is in exactly the form
advocated by Mutch. Clinical tests have established the efficacy of Trinesium
in the management and treatment of peptic ulcer. It provides protection
against the corrosion of the ulcer bed, together with continuous control of
hyperacidity and sustained adsorbent action.

Mutch found that with Magnesium Trisilicate, a minimal amount of mineral
base controls hyperchlorhydria continuously.

Samples and further literature on Trinesium will be
gladly sent to the medical profession on request to
Frederick Stearns & Company Division, Box 3286,
G.P.O., Sydney.

Trinesium

STEARNS

L y T

7),

wision

SYDNEY. AUSTRALIA

FACTS ABOUT
TRINESIUM

ANTACID Trinesium relieves
gastric hyperacidity within a few
minutes. The single dose will
control excess acid for the entire
period of gastric digestion.

ADSORPTIVE Mutch reports
that, as an adsorbent. Magnesium
Trisilicate far transcends bis
muth salts, magnesia, aluminium
hydroxide or other medicaments
in common use.

ANTIPEPTIC The silica gel
formed by Trinesium provides
mechanical protection for stomach
ulcers. It subdues pain and in
flammation and helps to achieve
healing.

THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER. FEBRUARY 9, 1946.

For the local treatment of IMPETIGO

CONTAGIOSA and various
other skin infections

Efficiently distri
butes medication.

Carries medication
into intimate con
tact with lesion.

Contains no grease.
(Water miscible-base).

Helps to prevent
spread of infection.

Alulotion contains 5% ammoniated
mercury colloidally dispersed in a base
of aluminium hydroxide gel and kaolin.
It is a greaseless, water-miscible lotion
which is clean, convenient and effica
cious for local treatment of various
cutaneous infections. Clinical tests
have proved that the use of Alulotion
noticeably reduces healing time.

INDICATIONS: For local treatment of impe
tigo contagiosa, ecthyma, folliculitis and the
secondary infections associated with eczema,
seborrheic dermatitis and dermatitis due to
irritants.

ALULOTION

INCORPORATED

{S INC. N U.S.A.

44 Bridge Street, Sydney

AMMONIATED MERCURY with KAOLIN

FEBRUARY 9, 1946. THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER.

111

British Medical Insurance
Co. of Vic. Ltd.

Founded in the interests of the Medical Profession,

surplus profits are devoted to the Medical Society of

Victoria.

All Classes of Insurance Transacted:

FIRE Homes, Cars, Furniture, Equipment.
BURGLARY Contents of Homes, Instruments,

Cars, Jewellery, Furs.

WORKERS COMPENSATION. PERSONAL,

LUGGAGE, PERSONAL ACCIDENT. COM
PULSORY THIRD PARTY. WAR DAMAGE.

DIRECTORATE OF THE B.M.I.

Dr. C. H. Mollison (Chairman), Dr. L. Latham,

Dr. J. Newman Morris, Dr. F. Kingsley Norris,

Mr. T. E. V. Hurley.

THE BRITISH MEDICAL INSURANCE CO, OF VIC. LTD.

389-395 Little Flinders Street, Melbourne, C.I.
Phone: M 1871 (9 linen).

H. K. LEWIS & CO. LTD.

THE SYMPTOMATIC DIAGNOSIS AND TREAT
MENT OF GYNAECOLOGICAL DISORDERS

By M. MOORE WHITE, M.D.Lond., M.B., B.S.,
P.R.C.S.Eng., M.R.C.O.G., with a Foreword by
F. J. BROWNE, M.D.Aberd., D.Sc., F.R.C.P.Edin.,
F.R.C.O.G. Second Edition. Fully illustrated.
Demy 8vo. 16s. net, postage 2d. (Just published.)

THE SULPHONAMIDES IN THEORY AND
PRACTICE

By J. STEWART LAWRENCE, M.D.Ed., M.B.,
Ch.B., M.R.C.P., Demy 8vo. 9s. net, postage 7d.
(Just published.)

ANATOMY AND PHYSIOLOGY FOR NURSES

By J. L. HAMILTON PATERSON, M.D.Lond., M.B.,
B.S., M.R.C.P., M.R.C.S. With 93 Illustrations.
Demy 8vo. 9s. net, postage 7d. (Just published.)

A GUIDE TO HUMAN PARASITOLOGY

For Medical Practitioners

By D. B. BLACKLOCK, M.D.Edin., D.P.H.Lond.,

D.T.M.Liverp., and T. SOUTHWELL, D.Sc., Ph.D.

Fourth Edition. With 2 Coloured Plates and 122

Text Illustrations. Royal 8vo. 15s. net, postage 9d.

LONDON: 136 GOWER STREET, W.C.1
Cablegrams: Publicavit, Westcent, London

ANDREW S PHARMACEUTICAL PREPARATIONS

for therapy and in the pre^operative management of
thyrotoxicosis, for patients with exophthalmic or adenomatous
goitres, primary and secondary hyperthyroidism

Packed in bottles of 50 and 100 tablets of 0.05 grm.

, ,, 50 0.2

Dosage in pre-operative management . . .

from 0.2 to 0.6 grm. a day.
Maintenance dosage . . .

from 0.05 to 0.2 grm. a day.

THIOUREA

in bottles of 100 tablets
of 0.25 grm.

Literature and further information provided on request from the manufacturers

ANDREW S LABORATORIES, SYDNEY

MANUFACTURERS OF DRUGS AND FINE CHEMICALS:

Adrenalin Synthetic Hexoestrol Sulfaguanidine Analytical Reagents

Cholesterol Sodium Desoxycholate Thiouracil pH-Indicators

Dehydrocholic Acid Stibophen Thiourea Spot Test Reagents, etc.,

Stilboestrol Lecithin (Brain) D.D.T.

THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER. FEBRUARY 9, 1946.

SALINE THERAPY

in relation to
INEFFICIENT DEF/ECATION

Carefully controlled clinical tests conducted a
few years ago in England established the value
of a small regular dose of the simple mixture of
salts in Kruschen Salts, in the prophylaxis and
treatment of colon stasis and dyschezia. This
mixture comprises:

SODIUM SULPHATE
SODIUM CHLORIDE
MAGNESIUM SULPHATE
POTASSIUM SULPHATE
POTASSIUM CHLORIDE

Summary of conclusions:

Authorities recognize the widespread preva
lence of a condition known as dyschezia
inefficient defaecation, which may or may not
be associated with frank constipation.

2. This condition arises largely as a result of
present-day life low residue diets, paucity
of fluid intake, sedentary occupations and
lack of bodily exercise.

3. Experimental and clinical work demon
strates clearly the importance of controlling
the withdrawal of water from the faeces in
the intestine.

4. Carefully-controlled clinical tests proved
that a small daily dose (1-2 grammes as
much as will lie on a sixpence) of Kruschen
Salts, brought up the water content of the
faeces to normal and ensured regular, physio
logically satisfactory emptying of the bowel.

5. This effect is due to the indiffusible ions
released by Kruschen Salts in solution,
which attract and retain sufficient water in
the faeces by osmotic pressure.

6. In the treatment and prophylaxis of this
ubiquitous condition, the regular daily dose
of Kruschen Salts is the method of choice
its action accords with normal physiological
processes; it contains no "drugs" and is
neither injurious nor habit-forming.

KRUSCHEN SALTS

E. Griffiths Hughes Ltd.

Established 1156.

GOLD MEDAL, International Congress of Medicine,

191S.

Brand Ethooaln *

Hydrochloride.

3 HE ORIGINAL. PREPARATION.
Ellh Trade Mark If*. 37*477 (IMC).

COCAINE-FREE Local AMMthetle.

Despite the war, NOVOCAIN
preparations are, and will continue
to be, available in all forms, viz.:

Solutions In Ampoules, 1 or. and 2 ox. Bottles,
Stoppered or Rubber Capped. Tablets IB

various sizes, and Powder.

THE SAFEST AND MOST RELIABLE LOCAL

ANAESTHETIC.
Six to seven times less toxic than Cocaine.

Literature and Pall Technique ea Reejveat.

Sold Under Acreement.

THE SACCHARIN CORPORATION, Limited

M M ALFORD GROTE. SNARESBROOK. I O.1DOH. K.18
Telephones WAN8TKAD X3S7.

Australian Aeent: J. L. Brown eV Co.,
1SS William Street, Melbourne, C.I.

Made in Australia

simnniTE

INSUFFLATION POWDER

and

VAGINAL SUPPOSITORIES

provide an effective treatment for
vaginitis of any origin. SIMANITE
products are non-irritant and non-
toxic.

CARTER & CO. (AUST.) PTY. LTD.

267 Clarence Street, Sydney.

335 Flinders Lane, Melbourne.

Agents :

GRADWELL BROS., W. RAMSAY PTY. LTD.,

Brisbane. Adelaide.

S. VAN DAL & CO.,
Perth.

FEBRUARY 9, 1946. THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER.

ANAHMIN

The Active Haemopoietic Fraction of Liver.

The exceptionally high anti-anaemic potency of Anahaemin B.D.H. is sometimes not
realised by physicians who therefore tend to administer unnecessarily large doses or to
administer Anahaemin at unnecessarily short intervals. In consequence a proportion of
the material is wasted and the cost of treatment becomes excessive. Further, the patient
is subjected to the administration of larger or more frequent injections than are required for
effective treatment. It is important to realise, therefore, that even moderately severe cases
of pernicious anaemia usually require an initial dose of not more than 2 c.c. followed by
1 c.c. every seven to ten days until the blood count is normal. Doses of 1 c.c. to 2 c.c.
monthly provide adequate maintenance in most cases.

Thus, although the cost per ampoule of Anahaemin may seem to be high, the cost of
treatment over a period is low.

Stocks of Anahamin B.D.H. are held by leading pharmacists throughout
the Commonwealth, and full particulars are obtainable from

THE BRITISH DRUG HOUSES (Australia, Pty.) LTD.

250 Pitt Street Sydney

Anan/Aus/462

THE MEDICAL JOURNAL OF AUSTRALIA ADVERTISER. FEBRUARY 9, 1946.

Zephiran is a germicide of high bacteri
cidal and bacteriostatic potency. In proper
dilutions it is non-irritating and relatively
non-toxic to tissue cells.

Zephiran possesses detergent, keratolytic
and emulsifying properties, which favour
penetration of tissue surfaces, hence
removing dirt, skin fats and desquamating
skin.

INDICATIONS

Zephiran is widely employed for
skin and mucous membrane anti
sepsis for pre-operative disinfec
tion of skin, for vaginal instillation
and irrigation, etc., and for the dis
infection of hands and instruments.

HOW SUPPLIED

Zephiran is available as a stan
dardised 10% aqueous solution
called Zephiran Concentrate.

Bottles of 4 oz. and 40 oz. either

(A) aromatic and colourless
or

(B) blue-tinted and odourless

BRAND OF ALKYLDIMETHYLBENZYLAMMONIUM CHLORIDES

BAYER PHARMA PTY. LTD., SYDNEY

Distributors: FASSETT & JOHNSON LTD., 36-40 Chalmers Street, Sydney

THE MEDICAL JOURNAL OF AUSTRALIA

VOL. I. 33RD YEAR.

SYDNEY, SATURDAY, FEBRUARY 9, 1946.

No. 6.

Table of Contents.

[The Whole of the Literary Matter in THE MEDICAL JOURNAL OF AUSTRALIA i* Copyright.!

ORIGINAL, ARTICLES Page.

The Sir Richard Stawell Oration Medical Aspects

of Red Cross in the Second World War, by

J. Newman Morris . . ..-.. 169

Acquired Resistance of Staphylococci to the Action

of Penicillin, by E. A. North and R. Christie . . 176
Pleuropneumonia-like Organisms in Cases of Non-

gonococcal Urethritis in Man and in Normal

Female Genitalia, by W. I. B. Bereridge, A. D.

Campbell and Patricia E. Lind 179

Early Results in a Short Series of Cases of Gunshot

Wounds of the Abdomen, by Thomas F. Rose,

Arthur Newson and Donald Watson 180

Lipomata of the Uterus, with Report of a Case,

by J. D. Hicks 184

The Treatment of Ing-uinal Hernia, by Franklyn V.

Stonham 185

REPORTS OF CASES

Rupture of the Liver in the New-Born: Recovery
after Blood Transfusion and Laparotomy, by

Felix Arden, M.D., M.R.C.P 187

. Report of a Fatal Case of "Blast" Injury of the

Spinal Cord, by D. Leslie 188

REVIEWS

Psychiatry and Modern War 189

The Surgery of Peptic Ulceration 189

Synopsis of Surgery 190

NOTES ON BOOKS, CURRENT JOURNALS AND NEW
APPLIANCES

The Decoration of Hospitals- 190

LEADING ARTICLES

Overseas Travel for Australian Students 191

CURRENT COMMENT Page.

The Prevention of Influenza 192

"The Stevens-Johnson Syndrome" 193

A New York Festschrift 193

ABSTRACTS FROM MEDICAL LITERATURE

Surgery 194

MEDICAL SOCIETIES

Obstetrical Society of the Women s Hospital,

Melbourne 196

POST-GRADUATE WORK

The New South Wales Post-Oraduate Committee in

Medicine 203

The Melbourne Permanent Post-Graduate Com
mittee s Programme for March . . . ^ . . . . 203

CORRESPONDENCE

The Central Hospital, Melbourne 203

NOMINATIONS AND ELECTIONS 203

NAVAL, MILITARY AND AIR FORCE

Appointments 203

OBITUARY

Guy Stuart L Estrange 204

Sidney Solomon Rosebery 204

William Camac Wilkinson 204

NOTICE 204

MEDICAL APPOINTMENTS 204

BOOKS RECEIVED 204

DIARY FOR THE MONTH 204

MEDICAL APPOINTMENTS: IMPORTANT NOTICE .. 204
EDITORIAL NOTICES . 204

Cfte ^it iaictjatti ^tatoeli Station. 1

MEDICAL ASPECTS OF RED CROSS IN THE SECOND
WORLD WAR.

By J. NEWMAN MORRIS,
Melbourne.

THE Sir Richard Stawell Oration was established by its
founder to preserve the memory of one of the greatest of
Australian doctors, whose death occurred just ten years ago.
Six of those years have seen the greatest world war of all
time the aftermath of the war in which Sir Richard
Stawell rendered such distinguished service. In the war
just ended he has been represented by his only son, Dr.
John Stawell.

I was a student of Stawell s and that was a great
privilege. After more than forty years I still remember
the awed hush of expectancy and excitement when word
went round the hospital that "Dicky s here". Then would
follow a clinical demonstration, unequalled by any teacher
I have ever seen at work. After I graduated, Stawell
became to me the ideal physician, one to whom I could go
in confidence, in consultation or in great relief for help
in sickness in my own family. To those who had the
honour and privilege to know Stawell as leader, colleague,
doctor or friend, it is not necessary to stress the qualities
of the man. He has become a tradition of that generation.
For those who were denied that privilege, perhaps the

1 Delivered at a meeting of the Victorian Branch of the
British Medical Association on October 17, 1945. Received
for publication January 18. 1946.

picture of "the Chief" in "In Hospital", by William Ernest
Henley, will serve in some degree:

His brow spreads large and placid, and his eye

Is deep and bright with steady looks that still.

Soft lines of tranquil thought his face fulfil.

His face at once benign and proud and shy.

If envy scant, if ignorance deny

His faultless patience, his unyielding will.

Beautiful gentleness and splendid skill,

Innumerable gratitudes reply.

His wise, rare smile is sweet with certainties.

And seems in all his patients to compel

Such love and faith as failure cannot quell.

We hold him for another Heracles,

Battling with custom, prejudice, disease,

As once the son of Zeus with Death and Hell.

May his influence and example long pervade and glorify
the traditions of Victorian and Australian medicine!

When my fellow trustees did me the honour of asking me
to deliver the tenth Sir Richard Stawell Oration, it was
suggested that I should speak of the work of the Australian
Red Cross Society in the late war. Stawell found time to
take part in voluntary organizations related to the work
of the medical profession, and it is not inappropriate that
the war work of the largest voluntary organization in
Australia should be the theme of a Stawell oration.

The second world war, which ended with the surrender
of the Japanese forces on August 15, 1945, presented the
Red Cross movement with even greater opportunities for
service than the first world war. But its true functions
have not been generally appreciated. Because of the
manner of its origin eighty-one years ago, and of its close
association with the work of the medical services, the Red
Cross Society stands