41

H.—22a

Mr. McVeagh: Who produced the consultation-book at the consultations?—ln Dr Baldwin's time he produced it, but there was no written rule. When were the decisions signed?— Before we left the rooms. Do you attach importance to the consultation-book?—Y'es, I do. Mr. McVeagh then touched on the question of the operation performed on White, and, after describing the symptoms in the case, asked the witness his opinion as to what was done. Dr. Lewis: .1 don't consider it good surgery. Mr. McVeagh: Can you suggest why two incisions should be made? —No, I cannot. Assuming the necessity of the removal of gas from the intestines, what would be the proper surgical course to pursue?—To use a trocar and canula. The incision proposition was a very crude way to let out gas. The method you suggest would have a saving of time? — Undoubtedly ; and that is a matter of great importance. If there was great distension of the intestines one would be perfectly justified to expirate it, or remove it through the instrument I have mentioned. Can you say if it is possible for two pieces of faecal matter the sizi of walnuts to cause paralysis of the bowel?— Certainly not. Assuming there was paralysis, what would have been the condition of the patient's abdomen?—No doubt it would be considerably distended. Would it be difficult to find the appendix with the lower end of the incision 1J in. from the appendix?—No, I don't think so. The Chairman : Assuming you had access to the intestine to be able to make a careful puncture, could you find the appendix without making an incision?— There would be no necessity to make an incision to find the appendix. Mr. McVeagh: On rejoining the honorary staff last year you had a purpose in view?— Yes. I had heard there was a large amount of suppuration going on at the Hospital, and I determined to try and ascertain the cause. During that time did you have many cases of suppuration?— No. I had two or three cases of my own which suppurated, but I cannot speak of other cases. From your experience of hospital work, at what time, in your opinion, should the administrative work be carried out?— Between halfpast 8 and 9 o'clock Are you familiar with Rule 73 of the Hospital, dealing with fractures and dislocations?— Yes. Who should have charge of these cases?—l think they should be treated by the honorary staff. I may say that the rule is a new one. Do you happen to know w-hat classes of patients have been in No. 7 Ward?— Yes. Venereal, cancer, rectal cases, and all unfortunate cases generally. Do you approve of all these cases being kept together?— What cases ? Consumptives, and others you have mentioned?—l didn't know about the consumptives, but they should certainly be kept separate. Do you appi-ove of the porters passing catheters?— No. Who should undertake the duties?— The junior staff, undoubtedly. Do you approve of delirium-tremens cases being put in the typhoidfever ward?—No, certainly not. One of the essentials in the treatment of enteric or typhoid is quietness, and delirium-tremens cases are, as a rule, very noisy. That is one reason, and the most important one. Mr. McVeagh: You know the entrance to the Hospital. Take cases of fracture, abdominal complaints, Ac.: what is your opinion as to the effect of the entrance on these cases?—lt could not he worse. The patients have to be carried up steps, and a fatality might result. I have seen a fatality occur through such a condition of things, but not in this particular one It is a thing that could be very well remedied. The Chairman : To the ordinary layman such a practice is simply monstrous. Can you suggest a better method in regard to the entrance?— There is a lift in the Hospital I don't know if it has been abandoned, but it was in use many years ago when I was on the staff. Mr. Beetham: Is it near the entrance?—On a level with the ground. This is the invariable practice in all modern hospitals, and the lifts are of such a size that a wagon holding one patient can be wheeled on to the lift. Mr. McVeagh: What has been your experience of consultations held in recent years?—l don't think the cases were judiciously selected for consultation. Cases have been brought up for consultation sometimes which did not need consultation. One instance was a lip-com-plaint, and it was a waste of time to call three surgeons together to decide if the lip should he operated upon or not. T'm voicing the opinions of the profession when I -say that they are auite_ willing to go thoroughly into cases for consultation, but we don't think they have been iudiciouslv selected in the past. What has been the result of the injudicious selections made?— Well, the doctors would not turn up with the regularity they had always done, because the consultations were unnecessary and a waste of time. Consultations are one of the most interesting partsof the work, giving large experience and benefit to the surgeons participating, but when a consultation is not necessary a surgeon won't attend. Of the two consultation-books before you, which is the one properly k en t?—The one kept in Dr. Baldwin's time. The other one, the more '■ooent, is not properly kept,

6—H. 22a.