37

H.—3lb.

C. LUDWIG.j

saw no sign of the patient having taken a chill. Miss Broadley (the sub-matron) and Miss Brawn were present during labour. A slight shivering fit very often occurs at the end of the third stage of labour, due to the reaction. A. patient during her first confinement might easily take that for a chill. Dr. Goldstein told me he could do nothing till it reached the end of the first stage. I cannot say if he mentioned that it was no use his coming till the head was well down in the pelvis. I think he came about an hour before the end of the second stage. Before the doctor arrived I administered two doses of hyoscine. The object of that is to hasten the dilatation. I usually give this at night. I cannot say that it hastened the dilatation in this case, but it induced sleep on each occasion. Patient slept for Several hoiirs after each dose. The allegation that the patient had no sleep during this protracted labour is quite incorrect. There was no reason whatever during the first forty-eight hours after her admission for calling in a doctor. Dr. Inglis was ill at this time, and his work was being performed by Dr. Goldstein. Dr. Goldstein was present in the morning, and I told him of Mrs. Porch's case. He then told me what to do as regards getting him. Dr. Inglis told me to call Dr. Goldstein when I wanted a doctor. Ido not remember Mrs. Porch having a cough at all. She could not have had a bad one, or I would know of it. If she had a severe cough, it would be recorded in the report-book. After Mrs. Chamberlain's death on the 9th September I communicated with Dr. Inglis as to disinfecting the ward where she had been, and as to what was to be done with Mrs. Porch. Dr. Inglis told nic what to do. His instructions were verbal. He said it would be sufficient if the walls, ceiling, and floor were washed with disinfectant, bedding burnt, and all clothes soaked in disinfectant before going to the laundry. By clothes are meant sheets, pillowslips, blankets, and everything which had been used by Mrs. Chamberlain, except the blankets and mattress. The nurse was to have a disinfectant bath, her hair done, and all her clothes disinfected in the usual way. These instructions were carried out to the letter. Jeyes fluid was used. The room was not fumigated. This was an urgent case, and we could not wait for the Health Department Inspectors, who come sometimes three days after they are wanted. I reported to Dr. Inglis by telephone what Bad been done. He said that would be sufficient. Mrs. Porch was then removed to this ward. From that time onwards I had nothing personally to do with the patient further than making necessary inquiries. Mrs. Porch was taken to the General Hospital on the 18th September. Mrs. Chamberlain died on the 9th September. Her body was removed about 8.30 a.m. on the 10th September, and I believe Mrs. Porch was put into the isolation ward the same evening. I recollect Mrs. Allen's two confinements ; at least, I think I can. So far as I recollect, they were both normal. I remember Mrs. Allen calling at the home about her baby. I could not swear as to what advice I gave her. I never told anybody to take a child to a chemist. To the Commissioner.] The patients usually bring up the subject of their discharge. As a rule, an indication is given them that they must move on a certain day. Mrs. Allen left on the 14th or 15th November with her child. She was quite fit to go. There was nothing to cause any anxiety about the child. It was apparently quite healthy. There was nothing at all to suggest to me that I should keep the child under Rule 13. Examination-in-chief continued.] We could not keep every child that was a little raw or had diarrhoea. If there was any doubt as to the safety of letting a child go out of the home, we would keep it. I never advise separating a mother and child when the mother is able to nurse it. I remember Mrs. Allen coming back with the child. I cannot say the date. She told me that its buttocks were raw, and it had diarrhoea. I think she said it was vomiting. lam under the impression that I told the woman to take the child to Dr. Sweet, in view of the fact that she had lost her first baby. I did not consider the child to be in a dangerous state. I have never advised any mother to take her child to a chemist for advice. My usual practice is either to advise them to go to a Plunket nurse or to a doctor at once. When discharged the condition of the child was satisfactory. It had had an attack of diarrhcea in the Hospital, but I cannot say that this had quite ceased when they left. The buttocks were red,,but not raw when they left. I generally give advice to the women leaving, especially when I know they are ignorant of the subject of babies. When Mrs. Allen left I told her not to wean the child till she had seen a doctor. I told her to feed the child regularly at the breast. She had been a sleepy patient, and did not feed the child regularly. The child took the breast very greedily, and I told her to prevent it from doing so, as it brought the food up afterwards ; drinking too quickly brought on indigestion. [Blrs. Nicol states that she makes no complaint in connection with Mrs. Allen other than those in writing.] I know of nothing in connection with Mrs. Allen's case, either done or left undone, that indicated any neglect of her case. I put in two stitches in Mrs. Allen. That is a customary thing. I might have been put in one or two. They were not deep stitches. Cross-examined by Mrs. Nicol.] I did not pass my degree in Germany. I was not trained in Germany. I was registeied under the Central Midwives Board. I believe it is the rule under that Board that midwives have to call in a doctor for any rupture of the perinaeum. I quite believed that Mrs. Allen's baby was in a proper state when it came out. Green motions is not a proper thing in a baby. Ido not think the baby had green motions when it left the home. It had them before, but it had recovered before leaving. When Mrs. Allen came back to the Hospital she had a witness with her. I did not tell her to go to any chemist for advice. I state that I have never told any person to go to a chemist for advice, though there was a witness present. I consider the baby was in a proper state to be discharged when it was discharged. When Mrs. Allen took the child back to the Hospital I did not at all think the child should have been taken back into the Hospital. I have no record of the time Mrs. Porch was admitted to the Hospital. The time might have been 3.30 a.m. I expect labour had begun before she came in. It generally does. She might have come in twelve hours later than the beginning of labour. Mrs. Porch might have been put in the nursery and left in a chair there till 5.30. That is not an improper thing. The time of admission might have been 3-30 a.m. I was probably in bed when the patient was received. She would be received by the night nurse. I cannot say without my duty-book who that would be. Ido not know the date of the notification of Mrs. Chamberlain's sepsis or Mrs. Porch's sepsis. The nurses disinfected Mrs. Chamberlain's room