THE PLAGUE.

New Zealand Herald, Volume XXXVII, Issue 11366, 8 May 1900, Page 6

THE PLAGUE.

' By Telegraph.— Association.—Copyright Sydney, May 7.;; The hospital report shows that there havr been so far 196 cases of ; plague and & deaths, Last week furnished 37 cases, thi highest yet for one week. The deaths in quarantine of Sprott anc McClemon are reported. Later. The following cases of plague have beer reported :—A child named McKinnon, Red fern ;' and Margaret Lawrence, Camperdown. Both are dead. Edmunds has died in quarantine. Brisbane, May 7. The second patient on the Cintra has died, is is stated, of typhoid. The steward of the Cintra died of plague. THE CASE OF THE BOY PAUL. DISCUSSION BY THE HOSPITAL BOARD. DR. BALDWIN'S EXPLANATION. RECOMMENDATIONS BY THF. HON. MEDICAL STAFF. At yesterday's meeting of the Auckland Hospital and Charitable Aid Board, Mr. A. Bruce, chairman, presiding, the reports of Dr. Lloyd-Smith and the members of the honorary staff of the Auckland District Hospital, on the case of the boy Augustus Paul, suffering from the effects of a rat bite, were read, and, as indicated in the copies already published in the Herald, expressed the opinion, after careful investigation, that the lad was not suffering from plague. Mr. R. Salmon said it was very gratifying to find, chat after all, no case of plague existed in Auckland, and that the honorary staff and Dr. Smith had acted wisely in immediately intimating the fact to the public, through the columns of the press, as the scare had already done sufficient harm to the city, and particularly the merchants and shippers. Business people had suffered very seriously, more particularly those trading to the Islands, through the announcement having gone forth to the outer world that the plague had got into Auckland, and he would, therefore, under the circumstances, suggest that the Board should forward a resolution to the Harbour Board, through the Chamber of Commerce, respectfully inviting the authorities in question to remove the barricades at the wharf. Such a.resolution would strengthen the hands of the Chamber, which had already convened a meeting of merchants and shippers in connection with the restrictions on the port. The Rev. W. Finlay Wilson suggested that before they went further in the discussion, a letter received from Dr. Baldwin in connection with the case of the boy Paul should be read, as it would throw light on the matter, and afford an explanation of the medical superintendent's (Dr. Baldwin's) action with regard to the precautions taken, etc. The letter referred to was then read by tho secretary (Mr. Garland), as under: — The Secretary Hospital and Charitable Aid Board. Dear Sir,— tho case of Augustus Paul. This boy was sent to hospital on April 24 as a .case of typhoid fever or acute rheumatism. The usual Widal test being made, negatived typhoid fever. The history of the case showed that the illness commenced suddenly, within throe days of being bitten by a rat. On April 26 I received a message from the bacteriologist that an examination of pus showed a bacillus which she would like Mr. Gilruth to see. In response to a message from me, the Plague Commissioners came to the hospital on the 27th. when Dr. Mason saw the case, and Mr. Gilruth the specimen, which ho pronounced to be like plague bacillus. I am prepared to admit that I did wrong in not first speaking to the honorary physician in charge ot the ease before sending word to Dr. Mason, and I have privately expressed to him my regret. The chairman of the honorary staff had a look at the case with Dr. Mason, and ordered it to be isolated at once. This was done, and the case was seen by mo on the 27th, 28th, and 29th, when, as it was not considered advisable for mo to be attending a case requiring isolation, as I had to perform duties which brought me into contact with many others, Dr. WoodWard was appointed to take entire charge, and I have not seen tho case since. On the night of the 30th I was asked to go to the isolation ward, whoro I was shown a very suspicious-looking bacillus from tho boy's blood. I asked for other microscopical examinnli.us to bo made next morning, May 1. Tiiese specimens showed a bacillus apparently identical with a specimen of plague bacillus which had been left with me for comparison. I then wired to tho Colonial Secretary, saying: "Further examinations showed plague bacillus." On May 3 a further exj amination of blood was reported to me, but I no bacillus, such as was seen before, was , found. On May 4- a consultation was held ! by tho staff with Dr. Lloyd-Smith, of tho ».s. Wakanui. when, T am informed, it was decided the caso was not one of plague. I I was not invited to bo present at this consul- ! tation as health commissioner, nor was I in- ! structed to be present as medical superintenI dent of the hospital. I knew nothing of (lie ; affair till afterwards. This is not tho time to comment on the diagnosis, and a3 regards the treatment I was subjected to by the honorary staff, I can only say that, even if my mind had not previously been mado up to resign my position at the hospital, this action of theirs would havo compelled me to dn so. I have been found fault with for n-aking a diagnosis on microscopical evidence ! alone, and for not having cultures made. The action of some members of the staff prevented mo doing that. Cultures were being made in the laboratory at the hospital from rats found on the wharf. I may say that according to the literature on the subject these were typical. Theso members objected to any such work being done in the hospital precincts, and the cultures wero destroyed by mo under Dr. Mason's supervision, as there was no other incubator available to complete tho investigation. As regards the Plague Commissioners, I only feel called upon to say that although they appear to he unknown in Auckland, they aro both known in the scientific and professional world outside this city. As regards my position and action in the matter, I can only say that I havo been actuated by a desire to do what I behoved to be in tho interests of the public health. If tho caso had been loft in the goneral wards, and it had afterwards been proved to bo plague, I should have been taken to task for not diagnosing it. even though I had never seen a case. On the other hand, I am blamed for my presumption in attempting to diagnose a disease which I have hod no opportunity of practically studying. Tho importance ot tho matter to mo personally must be my apology, for the length of this letter, copies of which I am sending to the press.—l am. yours truly, G. Pearce Baldwin, lato Medical Superintendent Auckland Hospital. Mr. Wilson then proceeded to comment on the action of the city authorities and Dr. Baldwin's action. He said that some 12 months ago he had drawn attention to the filthy slate of the citv, but no steps had been taken to improve its sanitary condition until tho outbreak of plague occurred in Sydney, and caused the Auckland civic authorities to fear that it might get a hold here unless some action was taken to remove the accumulations oi filth that were known | to exist in various parts of Auckland City. Then there was a rush to improve matters, a scare was create!, and the boy Paul was sent to the hospital, where Dr. Baldwin had, after consultation with the Commissionersthe outcome of a message from the bacteriologist, to the effect that an examination of pus had led to the discovery of a bacillus, which was pronounced by Mr. Gilruth as like plague bacillus—pronounced the case suspicious, and caused the lad to be isolated for further observation and developments. Now, however, other expert opinion indicated that the case was not one of plague, and Dr. Baldwin was being ; blamed for what he had done, even though, in the first instance, it had been impossible to satisfactorily diagnose the case, and there was room for grave doubt. He (the speaker) considered that Dr. Baldwin had acted wisely in taking all necessary precautions in the case in question, and was deserving of every credit, rather than the contumely that was being heaped upon him. What would these same gentlemen have said of Dr. Baldwin had the case proved one of plague, and he had not taken proper precautions? Mr, Friend said it was clear that the isolation of the case was done under the orders of the chairman ot the lion, medical staff. The circumstances were exceptional, and there was great justification for what Dr. Baldwin hail done. Dr. Baldwin bad been indirectly censured by the press, and tho Board ought to support him. Mr. Bollard said he had no desire to censure Dr. Baldwin, but ho. had no hesitation

in Baying that Dr. Baldwin simply; lost his ;'";• head,' and had done incalculable injury, to the city and port of Auckland by pronouncing t; the case a case of plague, '.-which lie did in '. the presence of the members of the Board. V When Dr. Baldwin thought.he found plague , e in the blood of that boy why.did he not con--12 suit the honorary staff and let the hon. staff • communicate .with, Mr. Ward Dr. Bald--16 win simply ignored the honorary staff,'and wired to Mr. Ward, and the wire had been d sent all round that there * was a case of plague in, Auckland. It would take six months to 'undo the injury to the'city and n port done through the action of Dr. Baldwin . and of the Premier, Notwithstanding all Mr. Wilson and Mr. Friend had said Dr. " Baldwin was condemned by his' own letter. d Had any man in the colony confidence in the two men who had been set up as bacteriologists '! Had, any man, after what had [ transpired, any confidence in Dr. Baldwin's statement that there was a case of plague in Auckland ? The only man here competent as a bacteriologist was Professor Thomas, and he had never been consulted. The idea of bringing a country practitioner and a veterinary surgeon to say whether' or not there was plague in the city, was an insult to the medical profession of the country. The leading members of the medical profession in Auckland admitted that there was not a medical man in the colony fit to say by bacteriological tests whether there was plague in Auckland or hot. They wanted a man imported from Britain who had high honours as a bacteriologist, in whom the 1 people would have confidence, and not a pet man of the Premier's. The hon. medical { staff had objected to their laboratory being used for examination of dead rats and portions of a cow, It was time the Board put a stop to that. p Mr, Salmon's motion was then put to the meeting and declared unanimously carried. " e Mr. Taylor moved : " That as this Board 0 has been made responsible for the unnecessary expenditure of such a large amount of „ the ratepayers' money during the last week e or ten days, in consequence of a report that r the bubonic plague had almost certainly . broken out in Auckland, and that it was therefore necessary to build a new plague e hospital immediately, also a crematory and 0 destructor, and that a supposed plague 1 patient should be isolated in the present <f scarlet fever hospital, and that a doctor and a two nurses should be engaged to isolate them- - selves with this plague patient, and that as a such report is now stated by the hon. medi- , cal staff and Dr. Smith to have been a false t report, and that there was never any ground i for it, and as it is now generally believed r that there was never a single case of bubonic • plague in Auckland, this Board will now set s up a committee, consisting of the chairman ' (Mr. Bruce), Mr. Bollard, Mr. Warren, Mr. 1 Jamieson, and the mover, to ascertain who " are responsible for such false report, and the 8 consequent unnecessary expenditure of the ratepayers' money by this Board ; that this ' committee will furnish a full statement of the result of its inquiries to the Board at its next meeting, such statement to show the probable cost to the Board, and that the secretary be requested to furnish a copy of 1 it to the newspapers for the information of the ratepayers." Mr. Wilson asked the chairman's ruling , if notice would have to be given of this, and the Chairman ruled that Mr. Taylor's motion could only be discussed after notice. The previous matter, lie said, was put to s the meeting and declared closed. , Mr. Taylor gave notice of motion for next '-, meeting. p- The following letter from the hon. medical 1 staff was read : — At a meeting of the hon. hospital staff, hold on tho 261h inst., the question of a pos--1 siblo outbreak of plague was discussed, and tho following resolutions were carried: (1) 8 "That tho hospital staff, in view of tho prox--3 imity of the plaguo to Auckland, feel it 1 their duty, in tho interests of patients under ' their charge, to represent to the Board that ' it would bo injurious for any of the resident medical or surgical staff to come into contact f with the plague, and that any experiments of a bacteriological nature ought not to bo f carried out within the hospital precincts. ' We may state that at present all bacterio- : logical work of the hospital is carried out in ' a portion of the main building, a circum--8 stance which incurs great risk, especially ' with so virulent a disease as tho plague." 3 (2) " That in the interests of our hospital ' patients wo feel that a sufficiently-equipped c hospital should bo constructed without delay, for the reception of plague patients, so that ' the danger of contamination to the district 8 hospital might bo minimised." (3) "That ' the present system of dressing out-patients 7 in tho operating-room of the main build--3 ing bo at once put a stop to, and that no in or out-patients be allowed in tho operating--7 room, except when brought in for operation. That a room bo provided in tho base--0 mont, where all minor operations and dressings of out-patients shall be performed." 1 Mr. Bollard moved : Th.it all the matters . referred to in the letter be discussed with t the hon. medical staff at a conference to be a held in connection with the filling up of tho ' vacancy caused by Dr. Baldwin's resigna- • tion." j This motion was agreed to. the chairman and secretary being instructed to arrange . for the conference on as early a date as possible. e Mr. Salmon moved : " That the hon. staff a be respectfully asked to exercise supervision 9 over the hospital until the appointment of a ' superintendent." } A letter was read from the hospital nurses 8 expressing regret at the resignation of Dr. , Baldwin, and asking the Board to endear vour, if possible', to induce Dr. Baldwin to e reconsider his determination to leave. a ~,, . . ] THE LOCAL BOARD OP HEALTH. s At a meeting of the local Board of Health, • held on Friday last, the following reso'.u- ---' tions were carried "1. That this Board I would respectfully suggest, as there is no j proved case of plague in Auckland, that 3 fullest consideration be given before passing 5 restrictive measure. further than those that a are used with reference to other ports in i New Zealand." "2. That the preceding re- - solution be telegraphed to the Hon, J, G. 1 Ward." j In reply the following telegram was yestert day received by the Board from the Hon. t J. G. Ward :—"I thank your Board for re--3 solution. It is particularly gratifying to 3 me to know that there lias been no proved i case of plague in Auckland. Your Board 1 may depend that no difference will be made in J the treatment of Auckland and that of the J other large centres of the colony. Procau- [ tions are essential, however, throughout the . colony to minimise, and if possible prevent i the introduction of the plague into any Dart i of it, and I feel quite sure that your Board. C as well as the citizens of Auckland, will still '• co-operate in every direction possible towards attaining this object." \ BATS. ! The destruction of rats in the crematorium s at the Ponsonby reservoir is still being I steadilv pursued. The dailv average is close i on 100, although the daily tale varies i from 55 to 100. Yesterday, up to two ■ o'clock, 3070 had been cremated at the I pumping station, which is a satisfactory num.- ! her to have got rid of. The rats have been i brought from all parts of the city. ; DR. BALDWIN'S TELEGRAM TO , COLONIAL SECRETARY. [m TELKORAPir.-fRESS ASSOCIATION.] ! Wellington, Monday. ' Dr. Baldwin, Sanitary Commissioner at Auckland, now wires to'the Colonial Secre--3 tary :—"With regard to the boy bitten by , a rat I am glad to bo able to say that the ; suspected case has been decided not to be t plague. The honorary staff of the hospital , called in Dr. Lloyd-Smith, as an expert. I , was not asked to be present at the consulta- ' tion, but Dr. Woodward says he admitted j the bacillus to be like plague, though not > plague. I feel that the precautions taken ) were in the public interest, so that if further , examination had shown the case to be true . plague everything possible to be done to ,- conserve tho public health would have been i done. I may say that the staff have left (ho i case in the isolated ward, though not in l quarantine, and that one member thought it 1 necessary to leave his coat to be burned. It should be noted that the case has been under - treatment in tho hospital since April 24, and s was ordered into isolation by members of . the staff.-(Signed) G. Pkarc'k Baldwin." 1 • PRECAUTIONS IN THE SOUTH. 3 [BY TELEGRAM;.— ASSOCIATION.] Wellington, Monday. The time allowed for pulling down the l first batch of condemned buildings has ex-

i pired) and a number are still standing.;• Tho i Council-intends to prosecute the owners at [ once.;;'-' '.' -.- ■':.'':''■■': i •& The Wellington City Council has paid for over 2000 rats. . : ' : CHRiSTOHUBCn, Monday. . *: The City- Council to-day decided to fall in ■ with the Appeal, Court's decision, and issue '. a lease- of the site on which tho plague hospital stands, to the town clerk, as trustee ' for the Board of Health. At the instance of ; the Health Commissioner the Mayor has pro- ■ mised to add a crematorium to the hospital. v At » meeting of the City Council to-night The Mayor reported that the work of sanitary inspection had been going on satisfactorily 'during the past week. He regretted it would be necessary to take proceedings against a number of people who had not complied with the instructions of the inspectors, but probably the first batch of cases would act as a deterrent. A letter was ; received from a ratepayer, protesting against being ordered to remove poultry from his 1 premises. He considered that 'such action was a hardship upon persons who kept good 1 birds in clean quarters. He suggested that tho Council should issue annual licenses to persons to keep fowls. Such license fees would cover the cost of inspection of premises. The Sanitary and By-laws Committees were instructed to frame regulations for the control of fowl yards and stables in the city.