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SPECULUM 1
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SPECULUM 3
SPECULUM
The Journal of the
MELBOURNE MEDICAL STUDENTS' SOCIETY
SI SPECULUM PLACET, INSPICE
EDITOR :
J. A. W. SMITH
SUB-EDITOR :
BUSINESS MANAGER :
G. SANTORO
J. WRIGHT-SMITH
First Published 1884
"Speculum" is published for private circulation among members of the M.S.S.
Copies are not supplied to non-members of the Society.

SPECULUMik
Contents
\NE ER ITy
0
LIBRARY
AIR VICE .MARSHAL SIR VICTOR HURLEY, K.B.E., C.B., C.M.G.
Page
EDITORIAL 9
PRESIDENT, M.S.S. 10
AN AFFAIR OF THE HEART M. L. Powell 12
E.C.G. DIAGNOSIS OF
CONGENITAL HEART DISEASE Dr. E. R. Trethewie 15
A SIMPLE TUBE Douglas Donald, F.R.C.S. 21
PRE-ANAESTHETIC MEDICATION W. H. J. Cole 25
MEDICAL EDUCATION K. S. Inglis 29
INFAMOUS CONDUCT IN A
PROFESSIONAL RESPECT Dr. C. H. Dickson 39
LIFE OF EUSTACE LOVELACE Fella Tor 43
SOME CONTRACEPTIVE TECHNIQUES Still Goblin 47
BOOK REVIEWS 53
A DOCTOR'S DUTY Matthew 57
DIAGNOSTIC QUIZ 61
M.S.S. CHRONICAL 69
MEDLEY'S '57 73
YEAR NOTES 77
SPICULA 89
TO BE OR NOT TO BE? 100

VICTOR HURLEY
Photo by the late Dr. Julian-Smith
By courtesy of Dr. J. V. Hurley.

Many medical men have given long and
valuable services to the public hospitals to
which they have been appointed in an
honorary capacity, but it is doubtful if any
one of them has been so closely associated
with his hospital in so many capacities as
was Victor Hurley with the Melbourne
Hospital. He went there as a student in
1907, became a resident medical officer in
1910, a registrar in 1911, medical superintendent
the following year, honorary surgeon
to out-patients in 1914, and in due
course surgeon to in-patients; and finally
consultant surgeon on his retirement from
the active work of an honorary surgeon.
His services to the hospital did not end
with his participation in its surgical work.
He had long been interested in hospital
management, so he became a member of the
committee of management and later its
president. For years he did most useful
work in this capacity, and retired only when
he found that his deteriorating health would
not allow him to carry out his duties as he
desired.
Apart from his long continued arduous
duties for many years as a surgeon, his most
concentrated activity at the hospital was
when he was, as a young man in his midtwenties,
its medical superintendent. During
his period of office the hospital was rebuilt
to form the group of buildings now
forming the greater part of the Queen Victoria
Hospital. The older hospital, where
he had started as a student, was a rambling
old structure, built at different periods, and
it was a tremendous task to keep the hospital
functioning while new parts were being
constructed. Physically as well as mentally
it was a great effort, for he used to climb up
six flights of steps in all the new pavilions
making his inspections at least twice a day,
before the lifts had been installed.
Yet during this busy and fatiguing period
he studied hard, and obtained his M.D. and
M.S. degrees. He was brought in contact
constantly with committeemen and honoraries
while this transition was taking place,
and his efficiency and unfailing good nature
in the presence of worrying problems made
a strong and lasting favourable impression
on them.
It was the same with whatever task he
was asked to perform. He gave to it his
best endeavour, did whatever he had to do
with a strong but unobtrusive sense of duty,
and above all, never failed to create a
friendly atmosphere among all those with
whom he had to work.
He did not "turn on charm". It came
natural to him to be pleasant to others, and
to arouse good feeling and friendliness towards
himself.
As a schoolboy, he was merry and lively,
with this unconscious natural capacity for
making people, young or old, feel well disposed
towards him.
This happy characteristic persisted
through life, and it undoubtedly contributed
to the successful outcome of the many difficult
tasks he was called upon to undertake
in peace and in war.
He was full of fun as a schoolboy and
undergraduate, and throughout life he never
lost the ability to see the funny side of
things. This must have helped him to cope
with many a difficult situation or troublesome
individual.
A pompous manner and a haughty or
superior air during a meeting or interview
did not apparently perturb him, but he
would quietly chuckle afterwards at the
ridiculous nature of the whole affair.
He was good naturedly tolerant of a lazy,
stupid, or inefficient man, but he would
never find anything funny or excusable in an
insincere one.
This combination of administrative efficiency
with good nature, made him a very
successful Dean of the Melbourne Medical
School. Students and young graduates always
felt he was so easily approachable and
they knew that they could rely on his
commonsense advice and fairness.
Rarely had he to reprove or reprimand
his juniors. If he did, it was done straightforwardly
without sting or insult and it left
no rancour or sense of resentment.
He, himself, never grumbled or grizzled.
He believed that if a man felt things were
wrong it was right to say so in good, honest,
temperate language and make every endeavour
to correct what was wrong; to finish the
argument and go on to the next business.
As a surgeon he was never dramatic or
spectacular. His surgery was based on
sound knowledge, acquired by continued
study, and on extensive clinical experience.

Above all, it was carried out with a humane
appreciation of what was the best and kindest
course in the interest of the patient.
His operative work was purposeful, unhurried,
calm and never accompanied by the
irritable actions and comments, such as
unhappily not infrequently, are the accompaniments'
of some surgeons' operations.
The greater part of his life was spent in
civil affairs, but he gained outstanding distinction
in two world wars. While he was
medical superintendent he joined the
A.A.M.C. and when war broke out he
volunteered for the A.I.F.
In the first world war he was first a medical
officer in a field ambulance, and as such
was at the landing at Gallipoli. Later, when
the A.I.F. went to France, General Howse,
V.C., took him as his right hand man at
headquarters in Horseferry Road. There
he was worked terribly hard but his good
personal relations with medical officers and
other ranks made him invaluable to his
chief. His health began to suffer and reluctantly
General Howse let him go back to
service in France as a surgeon. His administrative
work at Horseferry Road headquarters
was in every way most efficient,
and for it he received the C.M.G. decoration.
This experience stood him in good stead
in the second world war when he was called
upon to organise the medical services of the
new and rapidly expanding Royal Australian
Air Force.
The great success of this work has been
acclaimed on all sides. He was the ideal
man for this post. Not only did he know
what had to be done and how to do it, but
his personality and prestige made things
easy for its medical service in relation to
other parts of the Air Force. Furthermore,
in his relations with the naval and army
medical services, his friendly personality
and tact made real inter-service difficulties
impossible.
As a boy and student he took part in all
forms of sport, and was good at football,
tennis and cricket. Like all good cricketers
he never lost interest in the game. Later he
became a first rate golfer and took a leading
part in promoting competitions between the
metropolitan hospitals and in the British
Medical Association. He was always ready
to promote any action that would lead to
friendly relations between individuals and
sister institutions.
It was natural that he should be chosen
early in his professional life to be a member
of the council of the Victorian branch of the
British Medical Association. Throughout
the rest of his life he gave a great part of
his time to the affairs of the Association. He
• became President of the Victorian branch
and later became President of the Federal
Council of the Association.
He also took an active part in the affairs
of the Royal Australasian College of Surgeons,
and in due course became its President.
In all these activities his sane, practical,
well-balanced advice, and the atmosphere
of cordial co-operation, which
characterised any meeting over which he
presided, contributed tremendously to the
advancement of these bodies and the benefit
of their members.
He was a happy and fortunate man.
Happy in his amiable nature and fortunate
in the great mental ability which accompanied
his likeable character; happy and
fortunate in the choice of his profession and
in the great accomplishments which stemmed
from this choice; happy and fortunate
that his great gifts and benefits to his fellow
men and women were widely and warmly
recognised in his lifetime; happy and fortunate
in his close and affectionate relationship
with his surviving brother Leslie; and
most wonderfully happy and fortunate in his
marriage and in the comradeship and affection
of his remarkably brilliant sons and
daughters.
W.G.D.U.

SPECULUM 9
Editorial:—
Cancer : War for Peace
Throughout the history of mankind
wars have been fought, lost and won on
many fronts: on the battlefield, on the
sports ground and in the laboratory, to mention
but a few.
One definition given of war is "a state
of open hostility" and, as such, need not
be confined to nation-against-nation, managainst-man,
but may also include managainst-microbe
or the intangible. Intangible
might well describe cancer, although
research is, even now, on the brink of unfolding
its aetilogy.
This year an appeal was launched, to
which the response of the people shows
that they are ever ready to take up arms.
There is no doubt now that a magnificent
contribution will be made towards financing
the fight which medical science is waging
with the disease which, in this State, is
responsible for ten deaths a day.
It is a killer because science has not yet
learned the secret of its cause; no one can
be certain of escape and little, if anything,
can be done by the ordinary citizen to prevent
himself falling victim.
But the advance of medical science has
taught us not to be fatalistic about disease.
We can look back on the capitulation of
such scourges as diptheria, malaria, leprosy,
tuberculosis and poliomyelitis. Victories
are being won, year by year, in probing the
mystery of cancer, in recognition of the
symptoms and in cure. Society's determination
to succeed in controlling a killer which,
in spite of the progress made, is claiming
more victims each year is indisputably a
WAR FOR PEACE.

10
SPECULUM
PRESIDENT, M S S
Professor Ewing was educated at Daniel
Stewart's College, Edinburgh, being Dux of
the School in 1930.
He graduated from the University of
Edinburgh in 1935, obtaining the Cunningham
Medal in Anatomy, the Mouat Prize
for the Practice of Physic, the Leslie Gold
Medal and the Ettles Scholarship for the
first graduate of the year.
He held appointments successively with
the Royal Infirmary, Edinburgh, Leicester
Royal Infirmary and the University of Edinburgh.
He obtained his F.R.C.S. (Edinburgh)
in 1939. For the first year of the war he
was Clinical Tutor in the Royal Infirmary,
Edinburgh and then volunteered for the
Royal Navy in which he served from October
1940 till Dedember 1945, to the rank
of Surgeon Lieutenant Commander in Combined
Operations afloat and at the Royal
Naval Hospital in Malta.
In 1946 he obtained his F.R.C.S. (England)
and became Assistant Surgeon to the
Victoria Infirmary, Glasgow. In 1947 he
joined Professor Aird's unit as senior Lecturer
at the Postgraduate Medical School of
London.
In 1947 he was able to spend three
months visiting surgical units in the Scandinavian
countries under the Paterson
Travelling Scholarship award.
Again in 1950 for the period of one year
he was able to take up a British American
Exchange Fellowship and spent most of the
time working in the Head and Neck Service
of the Memorial Cancer Centre in New York.
During this year he was awarded a
Hunterian Professorship by the Royal College
of Surgeons of England.
In 1955 he was appointed the first Professor
of Surgery in Melbourne and this year
(1958) we have pleasure in welcoming him
as President of the Medical Students'
Society.
On the recreational side, since taking up
residence in his own home in Melbourne,
Professor Ewing has been able to give full
vent to his keenness for gardening and on
the rare occasions when he has been able
to get right away has found a very special
spot for fishing.

SPECULUM 11
Meet
PROFESSOR MAURICE EWING

12
SPECULUM
AN AFFAIR OF THE HEART
M. L. Powell
High upon the uppermost shelves of THE
LIBRARY there rests in placid content
Vol. XLVI of the Annals of Surgery which
was published in the year 1907. On page
335 is an article of rare prophecy. It is
titled "Ligation of the Ductus Arteriosus"
and is written by one John C. Munro M.D.,
of Boston, Massachussetts, U.S.A. Though
this paper was presented on May 6th, 1907,
the idea was. born 19 years before — exactly
55 years before Gross ligated the first ductus
in, perhaps not strangely, Munro's home
city of Boston.
In 1888, Munro, who appears to have
been surgically minded but with considerable
medical interest, saw a girl baby (note
that this first case was of the fair female sex
which later was to prove three times more
inept at closing that particular channel than
the male) "with symptoms of some cardiac
lesion. Ascultation at this time revealed
a cardiac murmur with pulmonary rales but
cyanosis was not• a marked feature. After
death, which took place without oedema or
marked cyanosis, examination showed an
open ductus arteriosus lying easily within
reach behind the sternum without any other
defect except a dilated right ventricle". This
in itself was a profound observation for it
is certain there have been many autopsies
since that time, done in well equipped post
mortem rooms in which the open ductus has
not been found or certainly its significance
missed as the cause of death.
Munro found "the simplicity of the
remedy so striking" that he made further
dissections and felt it should be possible to
ligate the duct during life if a diagnosis
could be made. But in this his hopes seem
to have been dimmed for his "paediatric
advisers were not reassuring", but he urged
"those skilled in the diagnosis of infantile
lesions to lend their aid".
Munro noted that cyanosis was wanting
(as we now appreciate befits a left to right
shunt) that an anaemia or waxy appearance
is shown which well describes the pallor
which is in fact often non-anaemic, but
rather due to poor peripheral flow due to
the shunt through the ductus, and that "a
loud systolic whir conducted into the cervical
vessels may be heard but, as a matter of fact
there are no definite auscultatory signs established
as yet". Here in this last observation,
is indicated for the first time that
wonderful diagnostic sign, the continuous
or machinery murmur heard high in the left
chest close to the sternum which actually
had been described by Gibson of Scotland
seven years earlier.
This is the murmur which when all its
facets are appreciated instruct the clinician
in terms of certitude unusual in the game of
chance which we call diagnosis, that the
Ductus Botalli is anachronistically open.
This small arteriovenous communication
usually about 15 m.m. long and 5 m.m. in
diameter is a useful channel during the
intrauterine sojourn when oxygen derived
from the placenta, short circuits the nonfunctioning
lungs, and is shunted to the
systemic circulation, a process which is
assisted by the hypertension of the foetal
pulmonary circuit. With expansion of the
lungs at birth the pulmonary arterial pressure
falls and after about two weeks the
ductus has closed.
No clear cut answer has been provided
to the question "Why does it close?". It
is not unreasonable to suggest that at some
time during the first two weeks of extra
uterine life the pulmonary and systemic
pressures are fairly well in balance and that
there is little flow either way through the
ductus for several days.
Such stasis must conduce to contraction
of the ductus, thrombus formation and
ultimate obliteration. But it is not easy to
suggest why on occasions it does not close
and is thus responsible for a new branch of

SPECULUM 13
thoracic surgery which is as demanding as
it is rewarding. Maternal rubella in the
early weeks of pregnancy appears to be a
factor but numerically a small one; very
occasionally two cases will appear in
siblings. Why should it be that females with
a patent ductus outnumber males by 3 : 1 ?
In cases like the Tetrad of Fallot it would
be highly advantageous for the ductus to
stay open but generally it closes, and the
infant's home made attempt to use the
Blalock principle has failed. Could it be
that in some cases the period during which
the pulmonary vascular tension equals the
systemic, and therefore the static period in
the ductus lumen is too short for constriction
of the ductus or thrombus formation to
occur or be permanent enough to withstand
the rising divergence of systemic and pulmonary
pressure? An unusually large ductus
would favour such a happening. It is indeed
very difficult to correlate such factors as the
effect of rubella or the sex incidence.
As in all illicit arteriovenous communications,
the effect of an open ductus of any
size is to grossly impair the cardiac efficiency.
The systemic circulation becomes akin
to a sprinkler system when, with one jet
dislodged, the volume of spray from the
remainder falls grossly whether proximal or
distal to the missing jet, at the site of which
a local useless flooding occurs so reminiscent
of the pulmonary plethora of the big left to
right shunts. The strain on the heart to
provide adequate systemic flow in the face
of a severe pulmonary circuit loss is severe
and unrelenting and produces ultimately
what is far and away the commonest complication
of the open ductus, slowly progressive
cardiac decomposition. For although
you will always mention subacute bacterial
endarteritis as a complication of the patent
ductus, as it is of all cardiac lesions associated
with a jet phenomenon, it is rare
indeed in infancy and childhood.
Pulmonary Hypertension
The effect of exposure of the pulmonary
circuit to the systemic pressure, which is
something like four times that of the
pulmonary, is to induce elastic tissue proliferation
in the subintimal layer of the
arterioles—a process which can be observed
in lung biopsy taken at operation, and which
can ultimately lead to equilibration of the
pulmonary and systemic pressures with
actual reversal of shunt and the result that
cyanosis appears and murmurs disappear.
This is the tragic stage; the golden opportunity
for cure has vanished and the
future is one of progressive cardiac failure.
Though this is usually seen in late childhood
or in adult life, it can occur in infants and
produces a clinical problem of great diagnostic
difficulty but one of importance in
that reversal of the pulmonary hypertension
is possible if the cause of it, i.e. the shunt
through the ductus, is eliminated.
So that to the very common question
"what is the optimum time for operation on
a patent ductus?", the answer is "as soon
as possible after diagnosis" — A reversing
ductus, i.e. with cyanosis will, in the future,
carry the stigma that its diagnosis was missed
clinically in its operable days.
Munro's suggested surgical approach
today sounds heroic. Hailing from Boston,
when the use of ether as an anaesthetic was
first demonstrated in the Etherdome of the
Massachussetts General Hospital (demonstrated
with pride to many Australian visitors
of recent years) one can understand his
preference of ether to chloroform! He then
describes a midline sternal split procedure
— an approach which has now become
accepted for pulmonary valvotomy, but not
in closure of the ductus.
He posed the question whether simple
crushing would not accomplish as much as
tying — he could not know the tendency
towards recanalization which still occurs in
some cases when the ductus is ligated. It
is fairly obvious that few cases would have
survived the operation in those distant days
— but the idea was abundantly right.
And so this article, written over half a
century ago gives on of the rarest of things—
a truly original concept and one which was
to produce a life saving surgical procedure
of immense importance. To the man in
busy general practice, who may not expect
to see many cases of patent ductus arteriosus
and therefore may feel uncertain as to
its diagnosis, it can be said that the great
majority of such cases are identified by
simple clinical means, especially careful
auscultation.
Munro's thoughts reclined on bookshelves
for many years. They have proved
supremely correct with the passage of years.
II

14
SPECULUM
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SPECULUM 15
E.C.G. DIAGNOSIS OF CONGENITAL
HEART DISEASE
Dr. E. R. Trethewie M.D., D.Sc., M.B., M.R.A.C.P.
Reader in Physiology, University of Melbourne
The lesion in congenital heart disease is
frequently able to be diagnosed by considering
the stethoscopic and electrocardiographic
findings alone. In many instances a bruit is
heard in the vicinity of the second left interspace
close to the sternum and it may be
heard over a wide area. The bruit of pulmonary
stenosis is harsh, superficial, and
occupies a considerable period of systole
(fig. 1). The bruit of interatrial defect has
a rumbling crescendo quality with rapid
diminuendo and occupies the early stage of
systole (fig. 4). The bruit of interventricular
defect may be harsh or soft and is
frequently best heard in the fourth left interspace
close to the sternum. The classical
bruit of patent ductus can never be mistaken;
it is a continuous machine-hum murmur;
but of course, it may not produce this
classical sound. It may even only be
systolic in time and sometimes we think we
are listening to an atypical patent ductus
murmur when in reality we hear the bruit of
aorto-pulmonary communication.
Having decided we have heard a basal
bruit, usually in a young person, often, btit
not necessarily, of inferior physique and one
who has never had rheumatic fever, an examination
of the electrocardiogram is
Pig. 1—Phonocardiogram of the bruit in pure
pulmonary stenosis. (i), (ii) timing of first
and second heart sounds. Note the prolonged,
well-sustained, late systolic bruit.
usually very illuminating. Interatrial and
interventricular septal defect become diagnosed
almost always. Pure pulmonary
stenosis can be confirmed. The combination
of pulmonary stenosis and interventricular
defect can commonly be recognised.
Patent ductus in a young person
produces only a slight degree of right axis
deviation with perhaps some strain pattern.
The pressure in the right ventricle can be
estimated approximately in all instances.
The lesion of coarctation of the aorta,
already largely diagnosed by the absence of
femoral pulses, can also be recognised.
However, to make a satisfactory electrocardiographic
diagnosis it is essential to
perform three dimensional electrocardiography.
The leads chosen here are the
ABC leads where lead A: manubrium sternum
(M) to xiphisternum (X); B: left axilla
(L) to xiphisternum (X); C: right chest at
base (R) to xiphisternum (X); such that
MXL = LXR = RXM = 1 rt. angle.
We shall consider the types of tracings
for the following defects:
1. Pulmonary Stenosis.
2. Interatrial Defect.
3. Interventricular Defect.
4. Patent Ductus Arteriosis.
5. Coarctation of the Aorta.
For comparison the normal electrocardiogram
is shown in fig. 2. Note the large
P(A) and the normal distribution of R to S
potentials. Large R- and small S-waves
occur in right axis deviation and large S-
and small R-waves in left axis deviation.
This applies to all leads. Another normal
electrocardiogram is shown in fig. 10, the
E.C.G. after tying a patent ductus, while the
prior tracing is shown in fig. 9; note the
inverted normal T(B), which is found in
more than half the subjects.

16 SPECULUM
Fig. 2—E.C.G. of normal subject. Details in text.
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Fig. 3—E.C.G. of pulmonary stenosis. Note the
large, sharp, clear-cut R-waves without
notching and the absent S-waves.
1. Pulmonary Stenosis.
In pure pulmonary stenosis, without associated
septal defect, the R-waves are large
and clear-cut in all leads (fig. 3). The S-
waves are practically absent. In mitral
Fig. 4—Phonocardicgram and E.C.G. in interatrial
defect. Note the early rapid crescendo,
rapid diminuendo systolic bruit.
Step on the R-wave it A and C made more
obvious in the lower C tracing by speeding
up the time base. Potential in millivolts,
time in 1/5th seconds.
stenosis the S-waves are not absent, though
there is right axis deviation, and the P(A) is
increased. Note that the T-waves are inverted
in all leads indicating right ventricular
strain; but there is no Q(B) so that the
pressure in the right ventricle is not very
high and Cor pulmonale is absent.
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SPECULUM 17
Fig. 5—E.C.G. and phonocardiogram of interatrial defect. Note the step on the R-wave
in A and C, the Q-wave in lead B indicating right ventricular hypertension and the
early systolic, rapid crescendo bruit.
2. Interatrial Defect.
The bruit is an early systolic bruit (fig. 4)
with rapid onset crescendo. Associated with
this there is a step on the R-wave in lead A
and frequently also in lead C (figs. 4, 5). If
the pressure in the right side is greatly elevated
a Q-wave appears in lead B which
may be 0.3-0.5 m.V. in severe cases, as
in figs. 2 and 5, indicating a right interventricular
pressure of 60-100 mm Hg. As
usual there is considerable right heart preponderance
with large R- and almost absent
S-waves, in interatrial defect. When the
defect has been repaired the step on the R-
wave is now seen in lead B instead of lead
A owing to axis change. (Fig. 6).
3. Interventricular Defect.
Keith, of Toronto, considers these cases
are probably often overlooked in adults,
because he sees the condition more frequently
in children than general physicians
recognise them in adults. Mild cases cause
little disturbance, especially for many years.
Severe cases may be associated with complete
block. Often there is an associated
pulmonary stenosis, and if overriding of the
aorta occurs also then Fallot's tetralogy is
present.
In lead B of the ABC display there is a
small "upright 0" wave of 0.25 m.V.,
though occasionally it is of much greater
potential in severe cases. This finding is
A
Fig. 6—E.C.G. in atrial septal defect after surgical
repair. Note the step on the R-wave
is now seen in lead B instead of lead A owing
to axis change. The atrial septal area
has moved through 90 deg. Auricular
fibrillation.
shown in fig. 7, where complete heart block
is present and the systolic bruit is shown. A
tracing from a patient with Fallot's tetralogy
is presented in fig. 8 and the severe pulmonary
stenosis is indicated by the large
R-waves and absent S-waves. Septal in-

18 SPECULUM
A
Fig. 8—E.C.G. in Fallot's tetralogy. Note the
upright Q-wave in lead B (0.05 m.V.—the
usual potential found) and large R-waves
and absent S-waves of pulmonary stenosis.
There is little evidence of right ventricular
strain as there is no Q(B).
C has disappeared and the inversion of T(B)
is of normal distribution.
Fig. 7—E.C.G. and phonocardiogram in ventricular
septal defect. Note the unusually
large upright Q(B) fused into the R-wave,
complete heart block and systolic bruit.
5. Coarctation of the Aorta.
In all instances of hypertension, especially
in young people, the femoral pulses
farcts with perforation also show this small
upright Q-wave, with a left or normal axis
pattern.
4. Patent Ductus.
The E.C.G. of patent ductus is not distinctive.
Some degree of right heart preponderance
with strain is seen depending on
the degree of overaction and strain imposed
on the right ventricle by the abnormal communication.
Such a tracing is shown in fig.
9, a tracing obtained from a healthy girl
aged 24 years with only slight symptoms.
There is slight right axis deviation and some
indication of right ventricular strain by the
inverted T(C). After tying the ductus the
E.C.G. became completely normal. The
tracing shown in fig. 10 was taken 8 days
after operation and the inverted T-wave in
,
Fig. 9—E.C.G. in patent ductus arteriosis prior
to operation. Note the slight right axis
deviation which would be normal in a
younger subject (this patient was aged 24
years), and also the inverted T(C) and deep
inverted T(B). Further details in text.

SPECULUM 19
Fig. 11—Tracing from patient with coarctation
of aorta. Details in text.
Fig. 10—F.C.G. of subject shown in Fig. 9, 8
days after operation. Tracing normal.
should be palpated. In an adult Buerger's
disease may account for absent pulses usually
associated with gangrene, but in most
instances coarctation of the aorta is present.
The E.C.G. (fig. 11) shows a left ventricular
strain pattern, segment elevation especially
in B, but also in C, with angulation and S-T
depression in lead A. In spite of this the
S-waves are of normal or even reduced
amplitude though the R-waves are practically
absent. With hypertensive strain of
such degree in the absence of coarctation
the S-wave in lead B is at least 1.5 m.V. in
potential and often much more.
Lest one should think the ABC leads are
only of value in the diagnosis of congenital
heart defects, the tracing in fig. 12 is shown
which clearly indicates myocardial infarction,
segment elevation in B being considerable,
and this is also present in C and A.
Fig. 13 showing the standard leads does not
rzyg
Fig: 12—Cardiac infarction shown by segment
elevation, especially in B, but also in C and
A.
Fig. 13—Standard leads tracing of same subject
as in Fig. 12, which does not indicate
unequivocal cardiac infarction.

-
20 SPECULUM
indicate unequivocal myocardial infarction.
This patient had a classical history of
cardiac infarction, with fall in B.P., later
leucocytosis, temperature rise and elevation
of sedimentation rate, and in fact, was being
treated for myocardial infarction in spite of
non-support electrocardiographically in the
standard leads. This situation arises in
approximately 15-20 per cent. of cases.
* *
A POEM
Tell me not, sweet, I am unkind,
That from the nunnery
Of thy chaste breast and quiet mind
To other arms I fly.
True, a new mistress now I chase,
The finest in the field,
And with a stronger faith embrace
—With a penicillin shield.
Yet this inconsistency is such,
Doubt not you I adore,
I could not love thee, dear, so much
Love I dishonour more.
J.M.
PATIENT'S LAMENT
•
I've just had an operation,
Squeaked the patient in Ward Four,
Last night they took them both away,
And left me feeling sore.
For many years they'd hung around,
Inseparable companions,
Like Jack and Jill or Pat and Mike,
Or even steak and onions!
But now these good old days have gone,
I cannot raise my head,
Than ever part with one of them
I might as well be dead.
They're pickled, look, in alcohol,
And stand upon a shelf.
Why did the Surgeon's knife remove
The best part of myself?
Why did that callous blade of steel
Ignoring all my moans,
Plunge swiftly to my very gall,
And take away my stones!
CAPRICADE.
a
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MEDICAL AGENTS
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FEDERAL SECRETARIAT PTY. LTD.
(B. A. CUSACK)
M.L.C. BUILDINGS, 303 COLLINS ST., MELBOURNE
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Managing 2:'irecior —
B. A. CUSACK

Demonstrator
The human body has been described as
a lump of flesh wrapped around a simple
tube; again, a baby has been described as
a simple tube with a sense of irresponsibility
at either end.
It is this simple tube which is the basis
for the expression "the rewards of Nature
are very great for the filling and emptying
of Her cavities", and it is the disturbances
of the filling and emptying of this simple
tube which demands so 'much study.
STRUCTURE
The intestine is lined by mucosa of function
varying inch by inch with that proximal
to it, according to the specialised function
of the part.
Typically, there are two muscle layers in
the wall.
The inner circular coat shows specialised
development at several sites. At the lower
end of the oesophagus it contributes to a
type of sphincter. In the stomach it provides
an inner oblique third layer of muscle,
and at the pylorus is accentuated to form
the sphincter. At the ileocaecal junction
the circular fibres play a part in the valve.
Whereas the fibres are not specially thickened
to form a sphincter the muscle plays
the part of a sphincter. At the anal canal
it forms the internal anal sphincter.
The longitudinal layer shows special development
in the stomach, being increased
velopment, in the stomach being increased
along the curvatures, in the small intestine
teric border, and in the large intestine as
taenia. The three taenia extend from the
base of the appendix along the colon to the
rectum over which they spread as a complete
layer passing distally to specialised
attachment at the anal canal.
SPECULUM 21
A SIMPLE TUBE
By Douglas Donald, F.R.C.S.
in Anatomy, University of Melbourne. Honorary In-Patient
Surgeon, Prince Henry's Hospital
•
The blood supply of the intestine is via
the three main unpaired branches of the
aorta. The Coeliac axis supplies from the
oesophagus to mid duodenum—the superior
mesenteric artery from this anastomosis to
the region of the left part of transverse
colon—the inferior mesenteric artery from
the anastomosis there to the rectum and
mucosa of upper anal canal.
Along the intestine there is a keen anastomosis,
except at certain sites where it is
inadequate; curiously enough these include
sites between areas supplied by the two
main terminal branches of the superior and
inferior mesenteric arteries. Firstly, in the
region of the oesophago gastric junction,
secondly within about six inches of the termination
of the small intestine; in the region
of the hepatic flexure; and between the area
of signoid colon supplied by the two
branches whose junction is known as
Sudeck's critical point.
INTESTINAL OBSTRUCTION
The disturbance results in a hold-up of
the onward flow of the contents—with many
side effects.
What happens may be referred to:
1. The tube in its function of supplying
nutrition.
2. The tube in its action of peristalsis.
3. The tube in its physiological secretions.
With obstruction no nourishment will
reach the body; peristalsis will produce
symptoms and signs; the outpouring of the
normal secretions of the mucosa of the
small intestine will upset the body fluids. and
electrolytes.
The action of the tube may be affected in
either of two ways: paralysis of the intestine

22 SPECULUM
called ileus, in which there is no peristalsis
to carry on the contents: or direct physical
blocking of the tube by an extimsic or intrinsic
factor.
The aetiology of ileus may be classified
A. Paralytic
reflex
anoxic
toxic
chemical
post operative
renal colic
torsion cyst
plaster to trunk
fractured pelvis
bruised abdominal wall
retro-peritoneal haemorrhage
effect of toxims on
Auerbach's plexus.
B. SpastiC
localised contractile phase
site of impaction of gall stone
post-operative from excess handling
acute appendicitis
renal colic
In contrast to this, with physical block
the bowel may go into hyper-peristalsis in
an attempt to overcome the obstruction.
This feature helps to explain some of the
clinical aspects, such as the silent abdomen
of ileus compared with the turbulent noises
in an abdomen with simple obstruction; the
lack of symptoms early in an ileus whilst the
severe colic of some obstructions is too real.
The clinical pictures which present from
obstruction vary considerably with the
level of the obstruction. It is probably
easiest to present the features in the form of
a geometric equation: the height of the obstruction
is proportional to the symptoms
and inversely proportionate to the signs.
That is, a high obstruction near the duodenum
will present with gross symptoms early
with almost no clinical signs, whereas one
distally will cause minor symptoms till the
condition is well established, but the clinical
signs will show early, including rising
pulse rate.
Among the many side effects of the obstruction
is that of distension, which is due
to the accumulation of the contents which
cannot pass on, increased by the normal
secretion of the intestine, and grossly aggravated
by gases which are the effects of the
condition—a form of "fermentation". Distension
causes sympathetic and parasympathetic
disturbances, as well as interfering
with the blood supply of the intestine, thus
causing anoxia.
Indirect effects such as vomiting and increased
peritoneal fluid, add to the disturbances
of body fluid and electrolytes, as
well as generally exhausting the patient.
AETIOLOGY
A simple obstruction of this tube in
which there is no damage of the wall can
result from congenital failures such as
septum of oesophagus, duodenum, or anus,
of ileus, tumours of small bowel, or adhesions.
Where' the cause of the obstruction results
in pressure upon the bowel, avascular
necrosis will occur if the condition is not
relieved, resulting in perforation of the
bowel. Such conditions include bands,
foreign bodies including masses of parasites
or more particularly because of its bad
clinical record: gall stone.
Another new feature added to the simple
hold-up of onward flow of contents can be
the interference with the blood supply of
the intestine. The outstanding example of
this is mesenteric thrombosis; other causes
include strangulated internal or external
hernia, volvulus, and intussusception. This
added phenomenon produces clinical features
further to those of fluid loss and electrolyte
disturbances: those of sympathetic
shock, toxic shock and secondary toxaemia.
This simple tube is functionally, embryologically,
and structurally of two distinct
parts—small intestine and large intestine.
Previous discussion has applied mainly
to the small intestine.
The difference in presentation of the large
intestine can be attributed to such as its
protected position extraperitoneally, its
much reduced activity, and by its structure
a capacity to adjust to increase of contents.
Thus there is a long warning latent period
of obstruction before it becomes dangerous,
and the clinical title of "acute-on-chronic"
is given. The only really acute obstruction

SPECULUM
2a
is that of volvulus which is the one condi-
Lion of the colon in which the blood supply
is in danger.
Other causes include:
neoplasm,
diverticulitis,
Hirschsprung's disease,
hypertrophic ileocaecal disease.
The clinical progress of acute-on-chronic
obstruction is influenced by the length of
intestine which can become distended before
the effects of the obstruction can be
noted. Vomiting occurs late. If the
ileocaecal valve is very efficient, distension
of the small bowel occurs very late, and
vomiting is a harbinger of death. In these
cases acute distension is limited to the large
intestine, presenting as a large swelling of
the distended caecum. The pattern as seen
in a neoplasm is:
I. Symptoms due to bowel ulceration including
blood and mucus in motion, spurious
diarrhoea, and toxaemia with anaemia.
2. Symptoms from local extension of the
process.
3. Symptoms from pericolitis.
4. Symptoms of subacute obstruction:
colicy pain,
gradually increasing constipation,
diarrhoea,
borborygmi with increasing flatus,
distension,
nausea and anorexia.
5. Acute obstruction.
Another approach in the aetiology may
be to consider directly the two factors:
Mechanical obstruction,
Interference with blood supply.
Pure mechanical obstruction is seen in
adhesions or stricture.
Pure vascular obstruction is illustrated
by mesenteric thrombosis.
Both mechanical and vascular charges
occur in strangulated hernia.
Neither factor is seen in paralytic ileus.
PATHOLOGY
The pathological changes which can occur
in intestinal obstruction are best illustrated
in strangulated niguinal hernia. Anatomical
areas of varying types of change
include
the loop and sac,
site of constriction,
bowel above,
bowel below,
peritoneum,
perforation,
general systems,
blood constituents.
MANAGEMENT
Diagnosis:
1. Age.
2. Sex.
3. Occupation; e.g., lead worker.
4. History.
pain,
shock,
vomiting,
borborygmi.
5. General examination:
T.P.R.
tongue,
gums,
vomitus,
urine,
heart,
spine,
C.N.S.
signs of uraemia.
6. Local abdominal examination:
Inspection
hernial orifices,
scars,
distension
central
caecum
peripheral.
peristalsis
visible
ladder pattern
palpation
lump
local tenderness
rigidity
percussion
auscultation
peristalsis
7. "Focal" examination
rectal—imperforate anus
red currant jelly
head of intussusception
rectal tumour
blood on finger
faecal impaction
ballooning
pelvic tumour.

24 SPECULUM
8. Special tests:
enemata—queried
radiograph of abdomen
fluid levels
bowel distension.
Differential diagnosis includes many
medical conditions, and surgical conditions
such as other abdominal colics, acute cholecystitis,
.and pancreatitis. To assist in
differential diagnosis the causes of intestinal
obstruction can be considered in age
groups.
1. Congenital—failed perforation of developmental
septum.
2. Two weeks—pyloric stenosis.
3. Nine months—intussusception.
4. Two to three years—Hirschsprung's.
5. 15-20 years—tuberculous adhesions.
6. 35 years—post-operative adhesions.
7. 45-50 years—strangulated hernia.
8. 50 years—carcinoma of colon.
9. Rarer
in the lumen,
in the wall,
outside the wall.
Treatment
can be summarised as:
1. of the cause,
2. of the peritonitis,
3. of the ileus.
Jenny kissed me where I sat,
Jumping from the chair she sat in,
Time, you thief, who love to put
Sweets in your list—put that in!
Say I'm feeble, say I'm old,
Say that health and wealth have missed me,
Add I've had a filthy cold
Since Jenny kissed me.
J.M.
Toll for the Brave,
The Brave that are no more!
All drunken and unshaved
As soon as they were ashore!
Eight hundred of the Brave,
No matter how they tried
Could not survive the little heel
Whom they had lain beside.
J.M.
JOUBERT & JOUBERT
575-9 Bourke Street, MELBOURNE MU 7277 (3 lines)
LTD
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COLCHIPIRINE
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PANBILINE PILLS
PANBILINE - METHIONINE
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LYXANTHINE
FLUSCORBIN

SPECULUM 25
PRE-ANAESTHETIC MEDICATION
By W. H. J. Cole
As all doctors have at some time or other
to give an anaesthetic, and, as the matter
of pre-anaesthetic medication arises in regard
to every anaesthetic administration, it
follows that this is a subject of universal
interest.
DEFINITION: — "Pre-anaesthetic
medication" is the name given to drugs
which are administered before an anaesthetic,
and, which are essentially a part of
the anaesthetic method. Pre-anaesthetic
medication is therefore to be distinguished
from Pre-Operative drug treatment of existing
disease (e.g. antibiotics in infections, or,
digitalis in auricular fibrillation).
AIMS :—
In general Pre-Anaesthetic
Medication (often called Pre-Operative
Medication) is given to facilitate the anaesthetic
administration. More specifically
the intention is to achieve one, or, more of
the following effects:
1. Sedation or sleep.
2. Relief of pain present pre-operatively
or the prevention of pain
which is expected post-operatively.
It is to be noted that unless the
operation is a very long one, drugs
given pre-operatively will continue
to act for some time post-operatively.
3. Reinforcement of the action of
general anaesthetic agents, especially
nitrous oxide.
4. To counteract certain undesirable
side effects of the general anaesthetic
agents. This effect is gained
mainly by anti-parasympathetic
drugs.
GENERAL PRINCIPLES:— There
are a number of basic considerations
in relation to pre-anaesthetic medication
which are essential if one is to achieve good
results.
1. Time of Administration:—Any drug
given pre-operatively must have reached the
peak of action before the general anaesthetic
is commenced. Undesirable results
could occur if, for example, a substantial
dose of morphia were given hypodermically,
followed immediately by the induction of
general anaesthesia. Later the increasing
activity of the morphia, added to the general
anaesthetic agent could depress or arrest
respiration.
The time before the induction of anaesthesia
at which the pre-medication is best
administered depends on the route of administration.
a. Intravenous Injection: —Immediately
pre-operatively.
b. Rectally:— Hypnotics are usually
instilled rectally 15-30 minutes preoperatively.
c. Hypodermic and Intramuscular Injection:-
1- 1 hr. pre-operatively.
d. Orally:—(Mainly used for children),
2 hrs. pre-operatively.
If the patient is shocked, the intravenous
route is best.
Where there is vomiting or diarrhoea, or
in accident cases where the stomach may be
full, oral administration is to be avoided.
2. Avoid "Routine" Pre -Medications:-
The only "routines" observed in anaesthetic
practice should be those associated
with safety. The responses of
different patients to drugs vary so greatly

26 SPECULUM
that pre-medication should always be considered
on an individual basis.
3. Dosage:— The dosages of drugs as
usually quoted are for healthy young adults.
These amounts must be reduced for patients
who are old or in a depressed state of
health.
Doses for children may be calculated on
an "Age" or a "Weight" basis. Young's
Formula which calculates the dose as
Age in years
X adult dose
Age plus 12
is satisfactory for children above the age of
3 years, but in general, is less accurate than
Clark's Formula (Weight in lbs./150 x
adult dose), which is applicable to children
of all ages, and is more related to physical
development.
4. Relation to Anaesthetic: —Pre-anaesthetic
medication must be related to the
type of anaesthetic which it is proposed
to give. If, for example, the anaesthetic
agent is one from which recovery may
be slow (eg., trichlorethylene), large doses
of hypnotics or narcotics should be avoided,
otherwise long periods of unconsciousness
may result. On the other hand, if the
The uses of
"NOVOCAIN"
TRADE
MARK
The original Local Anaesthetic
are constantly extending:
INTRAVENOUS APPLICATION
RECTAL DRIP APPLICATION
POST OPERATIVE PAIN
"NEURAL" . . . THERAPY
Samples and Literature on request to
J. L. BROWN & CO.
123 William Street, Melbourne
••■■••••■
anaesthetic agent to be used is one from
which recovery is usually rapid (eg., cyclopropane
or nitrous oxide) a sufficient dose
of analgesic or narcotic drug is required,
otherwise the patient may awake rapidly
with acute awareness of severe pain.
Vomiting after cyclopropane is fairly
common, but the incidence is reduced if
hyoscine is used pre-operatively instead of
atropine.
5. Loss of Heat Control:— Because
atropine and hyoscine upset body heat
regulation they should be used in minimal
doses in hot weather. (Excessive bedding
and clothing should be avoided.)
6. Chlorpromazine or Ganglion Blocking
Agents:— These drugs are undesirable
prior to the administration of the potent
inhalational agents as they upset the mechanisms
of circulatory homeostasis to such
an extent that circulatory depression may
ensue. If the patient is already taking
these drugs (Chlorpromazine, hexamethonium
bromide, etc.), it is probably best to
avoid the potent inhalational anaesthetic
agents.
7. Ideosyncrasy:— Abnormal reactions
to the drugs ordinarily used for preanaesthetic
medication are sufficiently common
for the possibility to be constantly remembered.
Drugs Used in Pre -Anaesthetic Medication
Drugs used for Pre-anaesthetic medication,
with a few exceptions, fall into one of
two groups:
a. Anti-parasympathetic drugs (also
called anti-parasympathomimetic,
parasympatholytic, or parasympathetic
antagonists).
COMPLAN
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A GLAXO PRODUCT
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SPECULUM 27
b. Central Nervous System Depressants
Let us consider these in more detail.
Anti-Parasympathetic Drugs.— Many
drugs have ' anti-parasympathetic activity,
but atropine and hyoscine are the most
satisfactory. The peripheral actions of
these two drugs are similar, but their central
actions differ in that while atropine is stimulant
to the central nervous system and to the
metabolism, hyoscine is depressant to both.
In general the desired actions of these
drugs are:
a. Diminished secretion of saliva and
mucous.
b. Lessening of vagal action on heart.
c. Lessening of tendency to vomit. In
this regard hyoscine (which during
the War was used as a preventative
of motion sickness), is the more
effective.
Both drugs may be injected hypodermically
or intravenously, or given orally.
Overdosage of atropine produces mental
stimulation, and a tendency to hyperthermia
in hot weather, while overdosage of hyoscine
produces central nervous system depression.
Central Nervous System Depressants:—
Apart from some drugs which have such a
complex pharmacology as to be difficult to
classify most of the central nervous system
depressants fall into one or other of the
following groups:
a. Hypnotics or sedatives which produce
sleep.
b. Analgesics which relieve pain.
c. Narcotics (opium derivatives) which
in addition to relieving pain, produce
sleep.
It must be remembered that this grouping
of drugs applies to therapeutic doses.
When given in overdose they are all capable
of producing unconsciousness, respiratory
depression, and in some cases, death.
a. Hypnotics: An enormous number
of hypnotic drugs have been made, and
new ones are being added continually.
When single, equivalent doses of any of the
accepted hypnotic drugs are given there
does not appear to be any great difference
in the quality of the sedation produced.
The group included barbiturates, chloral
hydrate, bromides, paraldehyde, chlorbutol
(Chloretone); "Avertin", Urea compounds,
methyl pentynol, and others. Most of the
hypnotic drugs may be administered orally
2 hours pre-operatively in appropriate
doses, when they produce drowsiness or
sleep.
Of particular interest is the rectal administration
of hypnotic drugs to young
children. Paraldehyde and "Avertin" (Tribrom
ethyl alcohol), which were formerly
popular, have now been supplanted by thiopentone
sodium. This drug, in a 10 per
cent. aqueous solution, is instilled rectally
on the basis of 1 gramme of thiopentone
per 50 lbs. body weight. In quiet surroundings
sleep comes in an average of six
minutes. If the rectal administration of thiopentone
is followed by an ether administration
recovery is apt to be protracted, so that
before dental and throat operations, where
prolonged unconsciousness is undesirable,
"rectal thiopentone" is to be avoided.
b. Analgesic Drugs: Pethidine is the
analgesic drug most commonly used for
pre-medication. It has the advantage of
producing less respiratory depression than
corresponding doses of morphine. (Adult
dose 100 mgms.)
c. Narcotic Drugs: The time-honoured
opium derivatives form this group. As preoperative
medicants Opium (gr. 1/3) and
Morphine (gr. I) are the members almost
exclusively used. (Omnopon is, if anything,
preferred to morphia.) While they are
magnificently effective in producing analgesia
and hypnosis they suffer the serious
disadvantage that in about 10 per cent. of
patients nausea, or vomiting, will follow
their use. One may at times be obliged to
avoid their use in people known to be susseptible,
or to combine them with an antiemetic
drug (eg., chlorpromazine).
Additional points: Finally, there are a
number of drugs which are hard to classify.
a. Chlorpromazine ("Largactil") This
potent drug has such a complex pharmacology
that one must use it carefully. It
produces sedation, intensifies the actions of
analgesic, and narcotic drugs, often causes
a drop in blood pressure, and diminishes the
tendency to coughing or vomiting.
b. Promethazine (Phenergan): This useful
drug will probably gain popularity
to a greater extent in the future. It
is a potent anti-histamine drug, which in
addition has hypnotic and antiparasympathetic
actions. (Dose, 50 mgms.)

28 SPECULUM
Operations to be Performed with Spinal,
Epidural, Regional or Local Analgesia
By producing drowsiness and lessened
appreciation of discomfort, hypnotic, analgesic
and narcotic drugs contribute greatly
to the success of such procedures. In the
past excessively heavy pre-medications were
sometimes used so that at times the patients
were actually unconscious. The present
attitude is that such heavy premedications
are undesirable, and that if such degrees of
mental depression are necessary for the
operation to be performed it is better to
gain the effect with a more controllable
agent such as nitrous oxide, which can be
administered in addition to the spinal,
epidural, regional, or local analgesia. Such
combinations are very satisfactory.
When large doses of local analgesic
drugs are to be injected the pre-operative
medication should include a barbiturate to
lessen the tendency which the injected
solution may have to cause convulsions.
Examples: It is obvious that a great
number of acceptable combinations are
possible. The following are only to be regarded
as illustrations.
Healthy young man for ether anaesthetic:
Atropine 0.6 mgms with, or without
Pethidine 50 mgms.
Middle aged man for gastrectomy: Omnopon
20 mgms, Hyoscine 0.4 mgms,
by H.I. 1 hour pre-op.
Old man for T.U.R. prostate (low spinal
analgesia): H.I. Omnopon 15 mgms.
1 hour pre-op.
7-year-old child for tonsillectomy: Chlorbutol
(Chloretone) gr.V, with atropine
1.2 mgms., both orally 2 hrs. pre-op.
2-year-old child weighing 30 lbs. for
plaster of dislocated hip: Atropine 1
mgm. 2 hrs. pre-op. orally, 0.6 gms.
thiopentone rectally 15 mins. preoperatively.
Finally, it must be mentioned that correct
pre-operative preparation of the patient,
from a mental point of view, must never be
forgotten.
Women are not uncommon victims of
himsomnia.
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•
SPECULUM 29
MEDICAL EDUCATION
K. S. Inglis
•
The University of Melbourne was founded
with fine prematurity in 1855, barely
twenty years after the first permanent settlement
of the colony. It had no medical
school. In July, 1857, The Australian
Medical Journal suggested that this gap be
filled. Already there were young men in
Victoria who wanted to become doctors,
and who were crossing the world to find
teachers. Not only was this expensive, but
according to the Journal it was morally dangerous;
innocent colonial youths would be
"easy victims for the seduction of a gay
metropolis". Since most Australian students
went to Edinburgh, this anxiety was
perhaps excessive; but the editor of the
Journal was not alone in his desire for a
medical school. A few months earlier Dr.
A. C. Brownless had tried to persuade the
university to begin medical education.
Brownless, who was a member of the
university council and an honorary physician
to the (Melbourne) hospital, put before
the council a plan for a faculty of medicine.
The council agreed to establish such a
faculty when finance and other circumstances
made it possible. The finances of
the university were strained by high capital
expenditure on building, and "other circumstances"
were just as formidable. The Act
of Incorporation allowed the university to
grant degrees in medicine but not to give
the instruction which would make degrees
possible. Among the medical profession
there were a few keen advocates, but others
believed that a medical school was not yet
needed. Moreover, the men who controlled
the affairs of the hospital were unsympathetic
to Brownless' plan, which presupposed
close co-operation between the
university and the hospital.
Five years passed while Brownless and
his supporters overcame each of these obstacles.
At last, in 1862, three young men
were admitted to the first medical school in
Australia. Brownless had been successful,
but not spectacularly so; not until 1876 did
he see medicine become a separate faculty.
Until a medical course at the university was
suggested, nobody at the hospital had given
a thought to the training of students. But
if the colony was to have a medical school
some members of the committee of management
wanted it to be under their own control.
They decided therefore to ask the
Royal College of Surgeons in England to
recognise a school at the hospital. But
when it became clear that the University
intended to pursue its plans for a degree
course in medicine, the hospital's own project
was abandoned.
In his inaugural lecture as Professor of
Anatomy, Physiology and Pathology,
George Britton Halford made no reference
to hospital work; but the syllabus, an ample
and severe one by the best European standards,
provided for surgical hospital practice
in the third year, medical hospital practice
in the fourth year, and several subjects requiring
work in wards during the fifth and
final year. When they received their degrees
in 1867, the first graduates in medicine
were presumed to have had adequate
practical experience and instruction at the
Melbourne Hospital, and at the Lying-in
(Women's) Hospital, where they were supposed
to learn the techniques of midwifery.
This presumption was doubtful. True, they
had been allowed into the wards of the hospital,
but the medical staff had taken little
notice of them. When the Australian

30 SPECULUM
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SPECULUM 31
Medical Journal accused the honorary
medical staff of neglecting students, only
one of its members, James Rudall, denied
the charge.
If only because the hospital was paid for
admitting students, the committee of
management was worried by 1870 at the
reluctance of its medical staff to become
teachers. All members of the medical
staff were therefore presented with a memorandum
requesting them to deliver clinical
lectures. The reply of the honorary physicians
and surgeons was cool. They were
prepared to give their time and skill without
charge for the care of the sick poor. It was
a different thing, however, for them to become
formal teachers of students whom
they had never sought. William Gillbee
spoke for his colleagues when he remarked
that medical gentlemen could not be expected
to give lectures which would take
considerable time and trouble to prepare,
and for which they would receive no money
and little thanks. Some honorary medical
officers gave academic lectures to students
in the university medical school itself; but
their case was different. Edward Barker,
Richard Eades and James Robertson had
applied for their lectureships, were paid for
them, and were recognised as members of
the university staff. The formal request for
clinical lectures, on the other hand, was
issued from the hospital and not from the
university. If the university made what
seemed to doctors at the hospital a proper
request, and offered proper terms, they
would consider it. Meanwhile they were
willing merely to give informal teaching to
any student who requested it. They refused
to be lecturers. The committee of management
could not circumvent the opposition
of the medical staff by appointing doctors
who were willing to be diligent clinical lecturers,
since the power to choose medical
officers was vested solely in subscribers to
the hospital. Lecturers in the university
medical school were unable to give clinical
examples from the wards unless they happened
also to be honorary medical officers
to the hospital, for only then were they permitted
to enter it. Teaching at the hospital
during the 1870's dissatisfied the committee
of management, the university council, the
faculty of medicine and, most of all, the
medical students. "No instruction is given,"
said one of them in 1874, "the student
merely trots around and picks up the
crumbs that fall from the table." This was
the system described by its authors as informal
teaching. Students complained at
the small return for their clinical fees, which
were higher than in many European hospitals.
If they went to Europe after graduating
they found themselves handicapped by
their lack of bedside experience and by the
consequently poor standing of Melbourne
degrees. It was not surprising that many
Victorians preferred to study medicine
somewhere in the United Kingdom where a
shorter course would give them a more
reputable degree. Nor was it remarkable
that students in Melbourne rarely bothered
to attend the hospital when their supposed
teachers were so truant. The university, as
if to condemn as useless what little instruction
was given, did not trouble to find out
whether medical students attended the hospital,
and gave them no examination in
clinical methods.
Delegates from the university and the
hospital met in 1875 to discuss a situation
which both parties agreed was intolerable.
They hoped to design a plan for affiliation
of the two institutions, but their conference
had only minor results. A European practice
was adopted by which the best students
became clinical clerks to physicians and
clinical dressers to surgeons. Resident
medical officers were to be appointed for a
year only, and preference was to be given
to the best local graduates of that year. In
this way some young doctors would acquire,
after graduation, the practical knowledge
which they had been denied during their
course. On paper, this conference achieved
more. A rule was adopted at the hospital
which required members of the medical staff
to give adequate bedside instruction and at
least once a month to deliver a clinical lecture.
Like the request that preceded it,
the order was ignored.
Significantly, the most diligent instruction
at the hospital by 1880 was given in the
out-patients' department; it was a Listerian
cell, where Girdlestone, Webb and Le
Fevre enthusiastically taught the techniques
of antisepsis to any student on whom they
could lay their carbolised hands. Their
seniors for the most part still refused to

32
SPECULUM
teach systematically unless the university
recognised them as official lecturers.
Brownless, the architect . of medical education,
was concerned at the poor state of
clinical teaching; it was all the more disturbing,
he said in 1882, because the medical
school of Melbourne was certain now to
supply the colony with most of its doctors.
Fewer British practitioners were arriving
than thirty years earlier, and 180 medical
students were now enrolled at the university.
He therefore advised the university
council to appoint clinical lecturers from the
hospital's medical staff. It was hard to see
any other solution unless .a crucial rule of
the hospital was amended. In medical
schools like those at the London hospitals,
the problem faced in Melbourne did not
arise; theoretical and clinical instruction
were under the same authority. At the
most distinguished university schools the
medical faculty had either its own hospital
or effective control over a neighboring one.
Since the university could not appoint its
own teachers to. the staff of the hospital,
Brownless' advice was accepted in 1884.
T. N. Fitzgerald and John Williams, honor-
ary medical officers to the hospital, were
appointed by the university council as Lecturers
in Clinical Surgery and Clinical Medicine
respectively, at an annual salary of
£250.
The medical faculty had often declared
that a thoroughly efficient course of training
in medicine was impossible so long as
the university had no voice in the appointment
of honorary medical officers at the
hospital, and therefore no guarantee of their
fitness as teachers. But members of the
faculty were pleased by the appointment of
these two men. Fitzgerald was the only
senior surgeon in the hospital who visited
the wards regularly for the benefit of the
students. Sir George Syme, who studied
under him in 1880, wrote later: "Mr. Fitzgerald
was the one surgeon for whom
everyone wished to dress, and whose visits
all attended. His great personality, his keenness
of observation, and his enthusiasm, not
less than his brilliance as a diagnostician
and operator, made him a most stimulating
influence." Students learned more from
watching Fitzgerald than from listening to
him; his oral instruction was informative,
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SPECULUM 33
MON
his practice inspiring. He was a successful
teacher primarily because he was an outstanding
surgeon. The qualities of John
Williams as an instructor, on the other
hand, were of a kind which could be transmitted
more directly by teaching, and which
could help to build a strong tradition of
clinical education at the hospital. Williams
was a graduate of Edinburgh, a university
which had inherited the spirit and the clinical
techniques of the best European teaching
centres. Students in his class did not
merely watch and listen; they examined and
spoke themselves. Each in his turn would
study a patient and deliver his opinions on
the nature, cause, symptoms, prognosis and
treatment of the disease. Finally their
teacher would state' his own views both on
the case and on the comments of his
students. This system of clinical instruction
became commonplace in the hospital
after Williams introduced it so successfully.
His clinics produced not only competent
physicians but skilful teachers.
But no two men could teach two hundred
students at different stages of training.
Senior students benefited from the appointment
of Fitzgerald and Williams, but paradoxically
the rest suffered. Other physicians
and surgeons, whose instruction had
been at best dilatory, interpreted the
appointment of special lecturers as relieving
them of all responsibility for teaching. Disappointed
that its reform should have had
such a reactionary effect, the university
council made a suggestion which pleased
nobody outside its own board-room; it proposed
that all honorary physicians and surgeons
to in-patients should be ex officio
clinical lecturers. The faculty of medicine
objected that, by putting appointments
wholly in the hands of an irresponsible constituency
of subscribers to the hospital, this
system would debase the status of university
lecturers. The young Medical Students'
Society asserted that unpaid clinical lecturers
who owed nothing to the university for
their position would be poor teachers. Most
of the medical officers themselves, when
they were asked to approve the plan, refused
to have any part of it unless each of
them was appointed personally by the
council, and given the status and remuneration
of a university lecturer.
The university council was now blamed
more generally than the hospital for the lack
of systematic clinical teaching. In London
the Lancet remarked, without taking sides:
"It is incredible that a University like that
of Melbourne should be without Professors
of Clinical Medicine and Surgery, not to
speak of the hardship inflicted upon the
students who, desiring to qualify in Great
Britain, find that their course of study has
been incomplete." Far from having professors,
the university was now without even
clinical lecturers. The appointments of
Fitzgerald and Williams had expired, and
for two terms of 1886 the council offered
no scheme to replace the one which everybody
had condemned. In August the
Medical Students' Society complained to the
Premier of Victoria, Duncas Gillies, about
the inertia of the council. Shortly after the
students' petition was presented, the council
reappointed Fitzgerald and Williams to the
offices they had held before, and gave clinical
lectureships to two more honorary medical
officers of the hospital. The council was
yielding to an immediate pressure rather
than planning a permanent clinical school:
all four appointments were for one term
only, and the academic year of 1887 began
without any official instruction at the hospital.
According to a caustic leading article
in the "Argus", the university was wholly
responsible for this situation:
"Were it not for the injustice done to
the medical students, the delay might be
regarded as a brilliant experiment in the
art of reducing the management of a
learned institution to an absurdity. A
hundred or more are attending the hospital,
and when the number is so large
there is obviously no need to increase it
by carrying out a thorough scheme of
education. Then the University collects
fees for clinical lectures, and leaves the
student to become his own 'lecturer,
which is no doubt excellent practice for
him. To crown all, it insists upon every
candidate for a degree receiving six
months' clinical instruction and playfully
gives him no opportunity of being instructed."
Faced with similarly outspoken criticism
from the faculty of medicine, the council
again appointed four clinical lecturers,
but again it was for one term only.
When these temporary lectureships expired,
the council did not renew them. Instead,
a plan was adopted which, although

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SPECULUM 35
it seemed to the medical faculty born of
despair, nevertheless improved clinical
teaching. The responsibility for clinical
lectures reverted to the hospital; medical
officers to in-patients were to be ex officio
lecturers, and officers to out-patients ex
officio tutors. This was not merely a return
to the chaos of earlier years, for it was
accompanied by a revision of the whole
medical curriculum which defined, more
clearly than ever before, the requirements of
hospital practice and the conditions on
which certificates of attendance at the hospital
would be awarded. The financial
terms suggested by the university, moreover,
were acceptable to the medical staff. In
June, 1888, E. M. James, physician to the
hospital, delivered the inaugural lecture of
a new clinical course which, it was hoped,
would raise the value of a Melbourne degree.
At the same time a clinical school was
opened officially at the Alfred Hospital.
Female medical students were allowed to
enter the university for the first time in
1887, and because their presence at the
Melbourne Hospital was not encouraged
the young ladies attended the new school.
Of the first seven students at the Alfred
Hospital, six were women. But they found
the teaching so poor that in the fourth year
of their course most of the ladies transferred
to the Melbourne Hospital.
There were many doctors who wanted
neither their profession nor their womenfolk
sullied by the admission of ladies into medical
courses. In 1865, when the demand for
female medical education was stirring in
Europe and America, the Australian Medical
Journal wrote: "A woman who dissects,
who makes post mortem examinations, who
tests urine, who perhaps carries diseased
specimens in her dress pockets . . . is not a
person in whom you would look for the
tender domestic qualities." But the Journal
had no fear that medical training for
women would be taken up in any British
community. Although female doctors
might be imported occasionally, and goggled
at like dancing dogs and bearded
ladies, the editor was certain that they
would never become a British institution.
By 1890, however, ladies were not only
admitted to the medical school, but had invaded
the Melbourne Hospital, to disconcert
the surgeon as he operated and to
interfere with the view of the young men
whose seats in the front row of the theatre
they had stolen. The ladies were not to
be intimidated by the frigidity and sarcasm
of their contemporaries or by the hostility
of their teachers. They were well equipped
to deal with opposition, for the struggle to
gain entry to the university in 1887 had
welded them into an efficient fighting force.
The committee of management might disapprove
of them, but no rule of the hospital
or the university excluded ladies so long as
they paid their clinical fees. "Is there no
indelicacy," one of them asked, "in male
students attending special operations on
women?"
Although the university and the clinical
school at the Hospital had been stormed by
ladies, one last line for the defence of male
rights remained. Female graduates could
be denied appointment to the hospital as
resident medical officers. It was customary
for these positions to be awarded to the
students who scored the highest marks in
their final examinations, but several members
of the committee of management, including
a vice-president, John Grice, were
quite ready to waive the custom in order to
keep women out. When Margaret Whyte
graduated with high honours in 1892 and
announced that she would be a candidate
for appointment to the hospital, Grice declared
that her presence would be a barrier
to that unconstrained consideration of
medical subjects which did so much to complete
the education of young graduates.
Before her application could be discussed,
however, Dr. Whyte accepted a resident
position at the Women's Hospital, and a
trial of strength was postponed.
In 1894 Clara Stone applied for appointment
to the Melbourne Hospital after getting
second place on the final honours list
in medicine. The committee of management
was nimble enough to get rid of her
without exposing themselves directly to a
charge of sex prejudice. Because she was
one of the few young ladies who had studied
at the Alfred Hospital clinical school
throughout her course, she was declared ineligible
for a resident position at the Melbourne
Hospital. But the men who ruled
the hospital could not put off much longer
the day when they must yield to women or
reveal themselves as enemies of female

36 SPECULUM
emancipation. That day came in 1896,
when Freda Gamble and Janet Greig, who
had attended the Melbourne Hospital
clinical school, finished their courses in
fourth and sixth places, and applied for resident
office at the hospital. The "Argus",
which opposed the appointment of the
ladies, alleged that patients in the hospital,
whether male or female, colonial born or
English, were seething, and threatening to
leave the wards to escape the touch of a
woman. In other newspapers the ladies
stated their case ably. Dr. Gamble said
that the hospital should never have accepted
their clinical fees if it did not intend to
admit them to office once their examination
results qualified them for appointment. The
only case against them, she said, rested on
prejudice and professional jealousy: "We
have beaten the men and they do not like
it." The committee of management could
not turn away these two applicants, graduates
in its own hospital, as easily as it had
rejected Dr. Stone. Some members of the
committee had approved the appointment of
lady doctors even in 1892, when Dr. Whyte
seemed likely to apply: "If ladies . . . suffered
a number of conveniences," said a
member who supported them, "then these
were for the consideration of the ladies
themselves." This attitude became more
common in the hospital by 1896, especially
as the two ladies had proved their competence.
Others on the committee of management
may have been intimidated by Dr.
Gamble's charge that she and Dr. Greig
could be refused only if it were true that
the male rulers of the hospital resented their
success. With varying degress of enthusiasm,
the men of the hospital agreed to admit
its first female medical officers.
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Teaching at the hospital remained
neither wholly incompetent nor wholly satisfactory.
If they were attached to Williams
or Fitzgerald, students could not help being
instructed and inspired. In 1891, however,
the city coroner, Dr. Richard Youl,
who seldom criticised irresponsibility, was
still able to remark that students at the hospital
had to pick up knowledge as best they
could. The cause was well known. Despite
an improvement in its relations with
the hospital, the university still had to
choose its clinical lecturers from a body of
doctors whose election lay in the hands of
charitable subscribers. This obstacle was
finally overcome in 1910, when the right to
elect honorary medical officers passed from
subscribers to the committee of management.
The university council and the
faculty of medicine were both represented
after 1910 on an advisory board which was
established to recommend candidates for
election. The hospital and the university
could at last work closely together in the
training of doctors, for students could now
be given clinical instruction by honorary
medical officers appointed for their skill as
teachers. An official channel joined theory
and practice in the medical course.
Yet, despite the caprice of the old electoral
system, teaching at the hospital improved
remarkably between 1900 and
1910, owing to the ability and devotion of
particular teachers. Williams was no longer
very active, but there were now more men
at the hospital who shared his mastery of
two sets of techniques—who were able
practitioners and successful teachers.
Among the surgeons, G. A. Syme, G. C.
Rennie, F. D. Bird and R. A. Stirling had
replaced the men who fought out the
Listerian controversy; each of them taught
his students as capably as he tended his
patients. But it was a physician, Dr. R. R.
Stawell, who made the greatest impact on
the hospital clinical school. Like his contemporary,
Henry Maudsley, Stawell owed
much of his skill as a teaching physician to
post-graduate training at University College,
London, which had the only medical
school in England comparable with those in
Scottish and European universities. Sir
Alan Newton spoke thus of Stawell's English
training during his Stawell Oration in
1947: "He returned from England in the
'nineties of the last century, deeply

SPECULUM 37
pressed by the methods of clinical teaching
adopted in London, particularly in the
Socratic method of question and answer
ruthlessly pursued until the student had
arranged his facts with due regard to the
relationship of each to the others". John
Williams had introduced to Melbourne the
practice of teaching by dialogue; in Stawell's
time it became a standard practice. Students
were taught the crucial importance of accurate
clinical observation, and were given
no mercy when they made mistakes.
According to Newton, who became himself
a brilliant teacher at the hospital, Stawell's
pitiless cross-examination made students
rapidly competent in clinical diagnosis. The
hospital and its students were fortunate that
subscribers had elected teachers like these,
who established a tradition of sound clinical
education. The electoral reform of 1910
made it certain that the tradition would
survive. The disposition of honorary medical
staff could now be planned more carefully,
to the benefit of both patients and
students. Four medical officers — a physician
and surgeon to in-patients and their
corresponding out-patient officers — acted
now as a team both for day to day work
and for teaching.
In the agitation for a new hospital after
1 900, clinical lecturers took a leading part.
Teaching, like every other activity in the
hospital, was handicapped by the decrepit
and crowded condition of the buildings, and
in particular by the lack of special departments.
One of the strongest items in the
case for a new hospital was that in the old
one, medical students could not be kept
abreast of medical advance. Stawell believed
firmly that the new hospital should
be at Parkville, and in this view he was
supported by each of the clinical teachers
mentioned above, with the single exception
of F. D. Bird. They preferred the Parkville
site not merely because it was larger, but
also because it was closer to the university.
In the short run their hope was defeated,
but teachers at the hospital did not give up
their efforts to achieve closer union between
the two institutions. When Edward Wilson's
trustees made it certain that the hospital
could not move to the university, the Professor
of Anatomy, R. J. A. Berry, suggested
that the faculty of medicine should move
to the hospital. In 1914 he proposed that
the State Government should acquire a large
block to the east of the hospital for a medical
school. The plan was endorsed by the
university council and the hospital committee
of management, but not by the
Premier, Sir Alexander Peacock, who asked
a deputation in 1915 to see him again when
the war and the drought were over. Since
the project depended on the financial support
of parliament, it was abandoned.
For half a century the benefit to medical
education had been one of the reasons given
for removing the hospital to Parkville, but
in 1935 it became decisive. In the last
stages of negotiation it was concern for the
training of students rather than for the care
of patients which persuaded the Dunstan
government to approve the new site. If its
problem had been merely one of accommodating
beds, the hospital might have had
to accept haphazard additions to the old
buildings. For a time, plans to remove the
hospital awaited only an agreement with
other teaching hospitals. Although the
Alfred and St. Vincent's Hospitals had
clinical schools, most students attended the
Melbourne Hospital. If a new Melbourne
Hospital were built close to the university,
the others would be unlikely to attract any
students at all. Their interests were therefore
safeguarded by a decision to allot an

38 SPECULUM
agreed proportion of students to each of
the teaching hospitals.
The new Royal Melbourne Hospital provided
admirably for the comfort and convenience
of students and lecturers. The
members of its clinical school carried on
the tradition of patient and exacting instruction
begun by men like Williams and
Stawell and continued by the remarkable
group of practitioners and teachers which
included Sir George Syme, Sir Alan Newton,
Sir Victor Hurley, Sir Sidney Sewell, Dr.
Leslie Hurley, Dr. H. H. Turnbull and Dr.
S. 0. Cowen.
In 1936 the university council agreed that
departments of medicine and surgery would
be created if the new Royal Melbourne
Hospital provided clinical wards for their
use. Negotiations for the departments
began in 1949 between the university and
the teaching hospitals. In 1950 the hospital's
committee of management and the
governing bodies of other teaching hospitals
agreed to provide beds and accommodation
for professors of medicine and surgery when
the university required them. All differences
over the best way of beginning the
departments were settled by 1952, and the
university council approved the appointments
of professors if money could be found
to pay for them. By the end of 1953 the
money was being raised by public appeal,
and in 1955 Melbourne gained the first
professors whose absence the Lancet had
found incredible in 1886.
The above extracts, taken from Chapter
5 of HOSPITAL AND COMMUNITY —
A History of the Royal Melbourne Hospital,
prepared and written by Dr. K. S. Inglis,
and recently published by Melbourne University
Press, are reproduced by courtesy of
the publishers.
The hospital (R.M.H.) has never lacked
enough trainees. Its position as Victoria's
leading hospital, the reputation of its nursing
school, and perhaps the presence of a body
of unmarried students, have kept the hospital's
waiting list of potential nurses a long
one.
—"Nursing": Hospital and Community.
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Microdissectors
Dissecting sets
Haemacvtometers
Haemaglobinometers
Prepared slides
etc.
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SYDNEY, BRISBANE, PERTH, ADELAIDE, HOBART.
FJ.3661.

SPECULUM 39
INFAMOUS CONDUCT
IN A PROFESSIONAL RESPECT
Dr. C. H. Dickson
Although the Royal Colleges of Physicians
and Surgeons had long been in existence,
it was not until 1858 that the State
as such evinced an interest in the registration
and control of medical practitioners
and in that year the first Medical Act was
passed. Under it was established "The
General Council of Medical Education and
Registration of the United Kingdom" (commonly
known as the G.M.C.), which was
charged with the duty of establishing and
maintaining a Register of Medical Practitioners,
as it was stated in the preamble to
the Act, "it is expedient that persons requiring
medical aid should be enabled to
distinguish qualified from unqualified practitioners."
In addition the Council was
made responsible for the maintenance of
standards of medical education and for the
publication of the British Pharmacopoeia.
The Council was also given disciplinary
powers including the power to de-register
doctors convicted of felonies or misdemeanours,
or who were guilty of "infamous
conduct in a professional respect." Infamous
conduct was not defined, but as the years
passed the Council considered charges
against doctors and some were de-registered
on the ground that they had been guilty of
infamous conduct.
Until recent years there was no appeal
from a decision of the General Medical
Council, but doctors who had been deregistered
found their way into the Courts
by seeking injunctions restraining the Council
from removing their names from the
Register and so judicial pronouncements
resulted. In 1894 in Allison v. the
General Medical Council, Lord Justice
Lopes said: "If a medical man in the pursuit
of his profession has done something with
regard to it which will be reasonably regarded
as disgraceful or dishonourable by
his professional brethren of good repute
and competency, then it is open to the
General Medical Council, if that be shown,
to say that he has been guilty of infamous
conduct in a professional respect"; and in
a later case in 1930 Lord Justice Scrutton
said that the phrase "means no more than
serious misconduct judged according to the
rules, written or unwritten, governing the
profession."
Over the years as cases were dealt with
and precedents established, the Council
published a series of "warning notices"
listing for the guidance of the profession
some of the offences which had led to disciplinary
action; and at the One Hundred
and Ninety-Sixth Session of the Council
(June 1958) it was decided to issue a revised
edition of this notice indicating to the
medical profession those things which
might lead to a charge of infamous conduct,
namely:
(a) adultery or improper conduct or association
with a patient;
(b) advertising and canvassing for
patients;
(c) the writing of certificates containing
untrue or misleading statements;
(d) association with unqualified or unregistered
persons practising medicine;

40 SPECULUM
(e) other grounds not particularised, but
including-
(i) treating or attending patients
while under the influence of
drink,
(ii) abuse of dangerous drugs or
abuse of privileges conferred on
medical practitioners by the
legislation covering dangerous
drugs,
(iii) commercialisation of a secret
remedy,
(iv)) gross and/or prolonged neglect
of duties and disregard of personal
responsibilities to patients,
and
(v) improperly obtaining or attempting
to obtain payments from the
National Health Service without
entitlement.
In Australia (outside Commonwealth
territories) the control of medical practice
is a function of the States and each State
appoints a Medical Board in the terms of
its Medical Acts which, basically, follow
the pattern of the British Acts.
His name
became
a
byword
In the term "pasteurisation" the name
LOUIS PASTEUR, founder of microbiology,
has become a household word.
Pasteur's studies revealed the function
of micro-organisms in such processes as
organic decay and fermentation.
Today, with the modern bacteriological
processes employed in the KRAFT
laboratories and kitchens, the work
started by Pasteur lives on in a great
Australian enterprise.
40 KRAFT FOODS LIMITED
KR43
Under the Medical Acts of Victoria the
Governor-in-Council appoints a Medical
Board of not more than nine medical practitioners.
The duties of the Board are to
register persons holding recognised qualifications
and to maintain a Medical Register.
The Medical Act of 1928 (the principal
Act) empowered the Board to remove
from the Register the name of any
person convicted of felony or misdemeanour,
but in 1933 its powers were extended
to include the power to erase or remove
from the Register the name of any registered
person (a) convicted of a felony or
misdemeanour, (b) guilty of infamous conduct
in a professional respect, or (c) who is
an inebriate within the meaning of the
Inebriates Act 1928.
The term "infamous conduct in a professional
respect", however, as stated in the
Act "does not include any conduct which
either from its trivial nature or from the
surrounding circumstances does not in the
public interest disqualify a person from
practising his profession."
Further, in Victoria an appeal may be
made to the Supreme Court against a decision
of the Board.
It will be seen, therefore, that following
the passage of the 1933 Act, the Medical
Board of Victoria was given powers equivalent
to those possessed by the General
Medical Council, but the only disciplinary
power it possessed was the power of deregistration.
Subsequently, in 1950 the legislature saw
fit to amend further the Medical Acts providing
that the Board, after finding a medical
practitioner guilty of infamous conduct
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SPECULUM 41
in a professional respect could, if that conduct
was not of sufficient gravity to warrant
removal from the Register, (a) reprimand
that person, or (b) suspend his registration
for such period as the Board thinks
proper.
What then is the nature of the charges on
which doctors appear before the Disciplinary
Committee of the G.M.C.? In descending
order of frequency they are:
drunkenness, advertising and/or canvassing,
fraud, misuse of drugs, and adultery or improper
conduct with a patient. In many
cases the alleged misconduct is of a minor
nature and does not lead to erasure, but
between 1901 and 1955 two hundred and
seventy-seven doctors were erased-26%
for adultery or improper conduct with a
patient, 19% following convictions for abortion,
15% concerned with drink or drugs,
10% for advertising or canvassing and
30f7( from other causes. In our own State
in the last 20 years some half dozen doctors
have been de-registered, but none in relation
to improper conduct with a patient. Perhaps
it is realised here more than in Great
Britain that you can make your mistress
your patient but not your patient your mistress.
In one Victorian case erasure followed
a charge of covering an unqualified person;
in another a charge of obtaining money
from a patient on the false representation
that the fee of a consulting surgeon was
considerably higher than that actually
charged; and, in a third case, the name of a
registered practitioner was erased following
proof that he had left his practice in the
care of an unregistered person and supplied
that person with death certificates signed in
blank, together with signed blank prescriptions
for "free medicine" under the National
Health Act.
It should be realised that bodies such as
the G.M.C. and the Medical Boards of the
Australian States have been set up not for
the protection of doctors, but for the protection
of the public and, quite properly,
the community, through the legislature, insists
that every medical practitioner, while
given certain privileges by virtue of his
registration under the Medical Acts, has
obligations to the community and must
maintain a high standard of conduct.
SPINX-
King Farouk had been ousted as titular
head of Egypt by the powers that be. We
can only assume that this did not please him
very much. Nevertheless, while in exile, he
summoned his legal aides and instructed
them as follows: To show the people that I
carry no grudge and bear no malice, I wish
to donate a million dollars to a University
in Egypt. There is but one condition—it
must be named after me. I want it called . .
FAROUK U!
*
A Stride
Girls who eat their vegetables have legs
like this:
! !
Girls who ride horses have legs like this:
)
Girls who get drunk have legs like this:
) (
Girls who use good judgment have legs
like this:
X
* *
Upon seeing a little girl leading a cow
along a country road, the Parish Minister
asked:
"Little girl, where are you taking the
cow?"
"To the bull," was the reply.
"Can't your father do it?" questioned the
Minister, somewhat taken aback.
"Nope," said the girl. "Only the bull."
* * *
Proud father, after twenty years of marnotice
of the fact. On his return it was disriage,
went to the local paper to insert
covered that the advertisement had cost him
£40.
"What did you tell them?" asked his
astonished wife.
"Well," he replied, "I told them the name
of the father and mother, the name of the
Hospital, and the name we are giving the
child. And when they wanted to know how
many insertions, I told them three times a
week for twenty years."
—S.U.M.J.
* * *
Then there was the man who divorced
his wife because he thought all his friends
had it in for him.

42 SPECULUM
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SPECULUM 43
LIFE OF EUSTACE LOVELACE
By Fella Tor
Medical Shoot o/ "Shangri - cEa ff
To even the most literate of medical men
the name of Eustace Lovelace is little more
than that. This is unfortunate, and it is the
purpose of this article to raise Lovelace to
that pinnacle of honour hitherto reserved
for Hunter, Lister and Florey.
Lovelace was born in 1718, some ten
years before John Hunter. Unlike Hunter,
he was not a Scot. So much for his family
history.
At the age of ten, Lovelace was articled
to a Rocking-Horse manufacturer. It is
understood that he painted on the spots. He
suffered from spots before the eyes, so he
became a cook. The sight of food revolted
him, so he became a seaman.
He tired of the sea life.
The Captain swore at him.
The food was awful.
The hard work, the long hours, the lack
of sleep, the monotony, the heat, the cold,
were too much for him. The constant exposure
to the sun and the moon told on him.
He decided to leave the ship. He had stuck
it out for nearly ten hours; he crept off the
ship on to the wharf.
In the next two years Lovelace was a
thief, gypsy, burglar, murderer and poacher.
We have not reason to believe that he even
failed to give of his best in these jobs.
In 1736 Lovelace decided to study medicine.
He enrolled at St. George's Hospital
(Hunter's Alma Mater). He tells us in this
diary, begun about this time, that he was
first drawn to study medicine by the incidence
of fallen arches in flat feet.
The rest of Lovelace's life is traceable in
his diary, this is not always easily legible,
for wine, porridge, beer, spirits and gin
have been spilt on its pages over the years.
Lovelace's playful habit of mis-spelling
words, and his rather spidery scrawl, render
the historian's task still more laborious.
We have some other documents of Lovelace's.
We have many I.O.U.'s signed by him,
apparently treasured for years by their recipients.
We have a cheque, which is for one
hundred pounds, written in Lovelace's hand.
There is, unfortunately, no signature to the
cheque.
Most of the documents are addressed to
well-known Bookmakers and Madams.
Lovelace already was well known in society.
Some of the notes he left are illegible or
indecipherable.
e.g.—Anny the Fanny.
Rm 16. Cvt. Garden Place.
"Joe sent Me."
We don't know what this may mean. It
may be a pneumonic.
Lovelace, a poor student, was always
short of money. On one occasion he had to
sell his books, noting that they were "As
new, hardly used", but even this loss appeared
to make no difference to his studies.
A friend is reported to have said of him
that he knew more about a certain subject
than anyone else in the world.
Soon' after, Lovelace set up in practice
for himself. This brilliant young man did
not wait to graduate. He refused to be
bound down by the foolish know-alls of his
time.
He had to earn money. He was in love!
His beloved was Angela Stephenson.
There was something about her, her father's

44
SPECULUM
position as a member of the East India
Company, her father's title, the several
country homes, and his influence with the
Court, that thrilled Eustace.
But it was not Angela's money that attracted
Eustace. When told that she had an
income of eight thousand pounds a year, he
replied that he thought it was only six
thousand, and the extra two thousand
pounds made no difference at all to his feelings.
Angela must have been a beauty. We
have a portrait which shows her in a blueblack
farthingale, with a scarlet porringer
wrapped around a slashed doublet. A belt
encircles her waist in a single sweep.
She is beautiful.
(Some authorities believe the portrait is
of Mrs. Siddons, others, Nell Gwynn. The
painter may have been Hilliard or Turner,
or possibly someone else.)
Eustace (according to the diary) got a
thrill when he thought of Angela.
One night he held her hand—he got a
bigger thrill.
Next week he put his hand around her
waist—he got a thrill much bigger than
ever before. He then had to go home.
Next month he kissed her—he got the
biggest thrill imaginable.
It was obvious they would have to get
married.
Lovelase reports that on the ocasion of
the Kiss his pulse was 102/min, full, good
(Our illustration is an old etching. Lovelace is in the foreground. His assistants
and instruments are well shown. In the next room an assistant reassures an
anxious patient.)

SPECULUM 45
volume, vessel impalpable, etc., B.P. was
not recorded. It is not known if the results
are reproducible.
Angela and Eustace came to an agreement.
Eustace would do all the work.
Angela would be merely required to
wash, cook, keep the house, garden, chase
away hawkers, usher in patients, shop, and
keep the accounts. Eustace was to be her
slave.
At this time the great impetus given to
human thought by the reformation and the
renaissance had reached its peak. People
refused to be bound down by such mundane
considerations as ethics and morals.
It was the age of Rationalism, of Nothing
to Excess.
Men, and women too, enjoyed the Good
Life.
Usually they enjoyed it together.
At the same time, the birth rate was elevated.
Lovelace had read Malthus, and knew
what that meant, or at least he thought he
knew what it sounded as if it might mean.
Chaos!
The solution: (a) Birth Control—Objections—inconvenient—unreliable.
(b) Abortion—Objections—Not
Cricket.
Fearlessly ignoring the objections to (b),
Lovelace decided on his life's work.
He would cater for the rich as well as the
poor.
He didn't care how poor they were, as
long as they paid his fee in full.
His technique was crude but effective.
The patient was clubbed into unconsciousness.
The uterus was curetted, soaked in turpentine,
set on fire, inverted, trampled on,
and then the patient went to the recovery
room.
Complaints were very few.
The hardier customers returned year after
year.
It was a great saving in woman-hours.
Lovelace kept the Stately Houses of England
on their feet. Everyone came to him.
Nobody raised any moral stricture
against him. The children, after all, were
merely cannon fodder. If the statesmen of
the world showed so little respect for life
after birth, why should he respect it before
birth?
If the Church objected, why, it was their
job to exercise better prophylaxis.
At the height of his powers Eustace was
struck a body-blow. Angela refused to
marry him.
Lovelace accused her of kissing someone
else.
He didn't know who, he couldn't see
through the telescope.
She eventually married and had four
children.
Lovelace gave her away as a bad job.
He went back to his life's work. He
battled for the ladies
"to the end
to save from shame and thrall".
Many an unsmirched reputation owes itself
to Lovelace.
He made many experiments with animals.
He resembled John Hunter in ever so
many ways.
He even acquired syphilis.
This was apparently done in an exploratory
vein, but details are lost to us.
He became interested in astronomy.
One night he attended a lecture on
Halley's Comet.
On returning home he entertained a
dozen friends to dinner. He disappeared at
midnight. Some time later he appeared on
the roof, yelling "I'm a comet! I'm a comet!"
His trousers were on fire.
He dived past the window and exploded
on the cobblestone below, like a fallen star.
His friends were overcome by grief and
were unable to bring themselves to view his
remains until the morning.
He was buried in an unmarked grave.
Nothing marks it, save only a marble
mausoleum capped by a floodlit tower, with
the simple motto, "Cave Canem" carved on
it.
Lovelace was modest in death, as in life.
His greatness is unrecognised.
His profession has fallen into disrepute.
But his soul goes marching on!
The Author wishes this article to be
taken in all seriousness as he is considering
entering it for the essay competition on
some aspect of Medical History—conducted
annually (as from this year) by the Victorian
Section of the B.M.A.

46 SPECULUM
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SPECULUM 47
SOME CONTRACEPTIVE TECHNIQUES
By Still Goblin
. a book on birth-control with well-worn pages,
A contraceptive that's been used for ages . .
— Student Song.
This article is one of a series on various
aspects of family planning. In our last issue
"Goblin" covered briefly the history of con-.
traceptive methods, and we hope to include
in our next issue a discussion on recent advances
in birth-control, especially the muchpublicised
oral contraceptives.—Sub-Editor.
This article deals solely with a few of the
more common mechanical and chemical
contraceptive devices locally available to
the public. It is often said that the medical
profession knows of a 100 per cent. perfect
contraceptive method which it will not
divulge. This, of course, is quite incorrect,
and statements of this nature stem from the
fact that manufacturers and distributors of
these products are legally not allowed to
advertise to any extent. A few advertisements
are seen in pharmaceutical and medical
literature, but these do not reach the
general public. Contraceptive literature
comes under the Obscene Literature Act, and
except when addressed to a doctor or chemist,
it can not be posted. When the manufacturing
drug houses obtain overseas apparatus
or literature the parcel must be
addressed to a medical practitioner, as a
"front", from whom it is collected by the
distributors. There are some mail-order
chemists who do a very good trade by posting
contraceptives every few weeks, under
a plain wrapper, to families using them,
but even this is illegal. Chemists who stock
these goods, and about 95 per cent. of
chemists do, must keep them out of sight of
the public in a drawer, and they are not
even allowed to leave them on a shelf
which is visible to the customer. About two
years ago a Melbourne chemist was fined
twenty-five pounds for placing a few unopened
packets of contraceptive jelly in a
window display.
The best known contraceptive device is
the condom or French letter, and is a rubber
sheath which is placed on the penis. On
ejaculation, the semen collects in a small
bulb on the distal end. It is often recommend
by medical practitioners especially
when used in conjunction with a spermicidal
jelly, as it has a high percentage of success.
To quote Norman Haire, ". . . when used by
intelligent people it is very efficacious . . ."
These days, condoms are manufactured
very scientifically and are pre-tested either
by air pressure or by automatic electronic
means. (Two electrodes are inserted into
an electrolyte bath, one electrode is covered
with the insulating condom, if no current
passes, it is presumed to be safe, if a current
passes the condom is automatically rejected.)
Aesthetically, condoms are not very good
as much of the tactile sensation is lost, and
for this reason, even when pregnancy is
contra-indicated, many husbands are not
keen on using them for any length of time.
Also, many couples complain of difficulty
in reaching an orgasm because of the interplaced
latex membrane.

48 SPECULUM
ReJearch . . .
". . . . to merit and preserve the
confidence of the best element
in the medical and pharmaceutical
professions . . . . to build
well, to last."
It was in these words that, over 90 years ago, the
founders of the House of Parke-Davis expressed their
policy for the future.
To meet these self-imposed and exacting demands,
research has been a constant feature of the Company's
activities. Over the years many contributions to Medicine
have resulted: vegetable drugs such as Cascara
Sagrada; glandular products, including Adrenalin, Pituitrin,
Pitocin, Pitressin, Antuitrin "S" and Eschatin; vitamin
preparations; and many synthetic chemicals such
as Dilantin. Recent achievements include the antihistamines,
Benadryl and Ambodryl, and the first synthetic
antibiotic, Chloromycetin.
Today, backed by a research programme more extensive
than ever before, Parke-Davis offer the medical profession
products worthy of their symbol, "Medicamenta
Vera"—truth in medicine.
PARKE, DAVIS & CO., LTD.
(Lnc.
BOX 4198, SYDNEY

SPECULUM 49
Post-coital douching has often been suggested,
but as douching only washes out the
sperm in the vagina, it is not very effective
against the motile sperm already within the
cervix and uterus. Some authorities believe
that at the moment when the female reaches
her orgasm there is a movement of the
uterine muscle wall which, by suction, facilitates
the entry of the sperm into the uterus.
If this theory is correct, then post-coital
douching is akin to closing the stable door
after the horse has vanished.
This theory also casts grave doubt on the
usefulness of the intra-cervical stem, or
"collar stud", which is supposed to plug up
the canal against sperm entry, not that these
were ever considered useful because the
dilation of the cervix can vary greatly.
Because of this constant variation in the
muscular cervix, cervical caps, which are
also supposed to prevent sperm entry, are
of little use.
Intra-uterine rings have found widespread
usage. These were accidently developed
by Dr. Grafenberg when he was
carrying out experiments in an attempt to
increase fertility. They should be inserted
only by an experienced medical practitioner.
The cervix is dilated and the ring is inserted
into the uterine cavity. Not much is known
about the theory of their action but it is
probably mechanical, or, perhaps a response
of the uterus to the foreign object, because
it is equally effective no matter from what
material it is made. Although pregnancy
has occurred in some cases when a Grafenberg
ring was present in the uterus, it is
considered to attain a high percentage of
reliability. Certain authorities do not
approve of them on the grounds that the
intra-uterine presence of a foreign body may
enhance the possibility of local cancer.
Whilst this may be so, I have yet to hear
of a case of oral cancer which is blamed on
the presence of false teeth. Smith-Petersen
metallic pins in the neck of the femur
and medullary pins in the same bone do not
bring about an increase in chances of obtaining
cancer. Neurosurgeons sometimes
insert plates of metal in the bones of the
skull without expecting cancer to occur. I
am not defending this contraceptive device,
but only suggesting a few obvious
analogies. On the other hand, the inserting
of these rings often results in a temporary
upset in the menstrual cycle. It has
been suggested that the presence of these
rings in the uterus does not interfere with
fertilisation, but with the actual implantation
of the fertilised ovum in the uterine
wall. Local surgical suppliers sell thousands
of these rings annually. As they must
be inserted by a medical practitioner, and
replaced within a specified time, which
varies greatly, practitioners who specialise
in this are never paupers. It is quite understandable
that they appeal to the public, for
once they are inserted they can be forgotten
for at least 8-12 months, and there is absolutely
no interference with intercourse.
There is no laborious pre-coital preparation,
either, which always has a tendency to inhibit
orgasm.
Another mechanical device which finds
great usage is the occlusive pessary. This
consists of a loose circular latex diaphragm
attached by its circumference to a circular
spring. The latex entirely encloses the
spring. It is inserted into the vagina and
covers the opening of the cervix. When of
the correct diameter it extends from the
posterior fornix and rests on the back of
the pubic bone. As the spring resists
distortion, it is continually in close relation
to the walls of the vagina all around
its circumference, and hence, to an extent,
stops the passage of sperm between it and
the vaginal wall reaching the cervix.
One firm markets diaphragms in sizes
from 55 mm to 90 mm. in gradations of
5 mm. The particular size is decided by
the physician using a set of fitting rings.
The appropriate sized diaphragm is obtained
and the patient then attempts to fit it
herself, with the doctor's assistance. She
inserts it by compressing the ring with the
fingers and positioning it whilst in a reclining
position. She pushes it well back until
it is felt to cover the cervix, and then the
anterior part is forced upwards behind the
pubic bone. The manufacturer states that if
the patient or her husband is conscious of
its presence, then it is of incorrect size.
When the patient is unable to insert it in this
manner, perhaps because of short fingers or
a long vagina, a plastic introducer can be
obtained. The diaphragm is placed on the
introducer which extends it along one diameter
and hence decreases its width. It is

50 SPECULUM
The Wisest Choice
. . . is Nitrous Oxide Analgesia combined with relaxation therapy. Nitrous
Oxide-Oxygen or Nitrous Oxide-Air offers the ideal analgesic and, where
necessary, the ideal anaesthetic. Its application with modern relaxation therapy
has overcome most of the difficulties and dangers associated with obstetric
anesthesia.
Pleasant to inhale, simple to administer, Nitrous Oxide is safe for selfadministration.
Pain is eliminated without loss of consciousness or the patient's
co-operation, thus preserving natural childbirth conditions. Recovery is
particularly rapid, elimination is speedy, vomiting is minimised and cough
reflexes are maintained—marked advantages in prolonged deliveries.
Fully descriptive literature is available from your
nearest C.I.G. Company.
GM.2.FP
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138 BOURKE ROAD, ALEXANDRIA, NEW SOUTH WALES
OXYGEN • NITROUS OXIDE • CARBOGEN • CYCLOPROPANE • CARBON DIOXIDE
41,

SPECULUM 51
inserted as far as possible. The introducer
is given a slight twist to dislodge it
from the diaphragm, and taken out of
the vagina leaving the diaphragm within.
The anterior portion of the diaphragm is
then pushed up into position. The patient
should practice this a few times in the doctor's
presence until she is capable of using it
herself, correctly. She inserts it prior to
intercourse and with experience has no more
trouble in inserting it than she has in taking
false teeth out of a cup and placing them in
her mouth. The patient should return to
the doctor every year for re-measurement
with fitting rings. As well as this annual
check she should be re-measured about six
weeks after childbirth.
It has been suggested that once inserted
in the vagina, instead of pressing against the
walls, half the spring may rotate, forming a
figure eight. The locally marketed article
would not do so as it is a very firm solid
spring. When these were first produced
they were supplied, not with a spring
around the circumference, but a piece of
metal of the type used in clock mainsprings,
and hence the name, watch spring pessary.
This resisted distortive forces and would
never form a figure eight. The local product's
spring is firmly soldered together and
is made of cadmium-plated wire. There
are, apparently, no recorded cases of this
spring breaking. The latex diaphragm is
loose and can be obtained with a high or
shallow dome. The diaphragm is, of course,
rendered useless if the latex is torn or broken
in any way, but with normal usage this
is unlikely as it is of good quality and has
been tested for weak points. The most
popular size is about 70 mm , but if the
diaphragm is to be at all effective, its size
must be determined by a physician.
The occlusive diaphragms are economical,
costing a little over one pound, and
when the manufacturer's instructions are
adhered to, a diaphragm can last for more
than two years.
The difficulty is that not many physicians
can fit it properly, yet they must be quite
popular for more than fifteen hundred are
sold monthly by local distributors. Their
reliability is greatly enhanced by using them
in conjunction with an effective, non-oily
base spermicidal. (Oil would quickly "rot"
the latex). This is placed on both sides of
the diaphragm prior to insertion. Its lubricating
effect also assists insertion of the diaphragm.
When used in conjunction with
spermicidal cream or jelly, the diaphragm
should not be removed until 6-8 hours
after intercourse.
On an economical basis the cost of using
the diaphragm in conjunction with a spermicidal
jelly is not great. For example, a 3
oz. tube of spermicidal, non-oil jelly costs
ten shillings and lasts for more than a dozen
acts of coitus, which is about ninepence
per time, and so it can be considered a
cheap form of insurance.
It a douche is wanted when the diaphragm
is removed, half of it should be before
the removal and the douche should.
then be completed after removal. This
double contraceptive technique, mechanical
and chemical, is claimed to be 98 per cent.
effective in preventing conception.
In the range of chemical contraceptives
there is a wide variation in types and successfulness.
Cocoa butter suppositories
containing quinine and/or lactic acid have
been used for some time. These melt at
body temperature, but the difficulty is in
obtaining an adequate concentration at the
end of the cervix. Effective spermicidal
action is difficult to obtain when it is realised
that a single ejaculate contains very
many millions of sperm. The melted cocoa
butter itself is useful in increasing the viscosity
of the semen, so lessening sperm.
motility.
Various forms of foaming tablets can also
be obtained, containing mercury salts. Again
the difficulty arises in obtaining sufficient
concentration between the ends of the penis
and cervix. In some cases the foam and
gas so formed can give vaginal pain and
irritation.
Another chemical contraceptive is
the gel. This is inserted in to the vagina
with a syringe-type applicator. As a large
amount of this is inserted (about 5cc) it is
also a mechanical barrier which prevents
sperm entering the cervix, but it is doubtful
if the mechanical barrier it provides is as
good as that provided by the occulsive diaphragm.
Nevertheless, by its quantity alone,
it is somewhat successful in preventing
sperm motility.
The spermicidal agents in this gel are
p-Di-iso-butyl-phenoxy-poly-ethoxy-ethanol
and ricinoleic acid.

52 SPECULUM
The difficulties in obtaining a good
chemical contraceptive are that in vitro
conditions are far removed . from clinical
conditions, and a substance which is an excellent
spermicidal on a microscope slide is
often quite useless in the vagina, and substances
which are not impressive in the
laboratory may actually be of great value
as contraceptives.
When a large group of married couples
are organised for actual testing of a contraceptive,
it is difficult to ascertain whether
the instructions for its usage are adhered
to, or indeed, used at all.
Finally, the greatest difficulty with the
contraceptive devices discussed (with
perhaps the exception of the Grafenberg
ring) , is the psychological factor. Having
to take "time off" to adjust a contraceptive
device very often leads to frustration and
inhibition of orgasm. With the diaphragm
it is better if the wife makes a habit of
inserting it in position EVERY night
before going to bed, as a part of the normal
toilet whether coitus is expected or not. By
this method its insertion is a normal procedure,
just as cleaning the teeth, and so the
psychological factor is greatly lessened.
References
1. Normal Haire, Ch. M. M.B. "Birth Control
Methods".
2. The works of Dr. Marie Stopes.
I would also like to take this opportunity
to thank the Victorian representative of the
Ortho Pharmaceutical Company for the
great amount of assistance and advice he
provided on locally available contraceptive
devices.
CIO
Dr. Freud,
Rather enjeud,
Examining the region above the necks,
For secks.
Nietzsche
Is peachy,
But Freud
Is enjoyed.
Person who thought that Little Red
Riding Hood was a Russian contraceptive.
POPULATE or PERISH!
A CRY FROM THE HEART...
Australia desperately needs to hear the pitter patter
of tiny feet. We must head directly to propagation
and a better standard of loving. A sure fire method
to succeed in this direction is to acquire a platinum
diamond-studded engagement ring. All types catered
for—no appointments necessary .. .
PAUL BRAM
Your Gemacologirt
FIRST FLOOR, 288 LT. COLLINS ST,
•

SPECULUM
53
BOOK REVIEWS
RADIOLOGICAL PHYSICS
Author: M. E. J. Young, M.Sc.
Pages: 365.
Illustrations: 184.
Publication Date: October, 1957.
H. K. LEWIS & COY. LTD., LONDON
Reviewed by Mr. Donald Stephens, Director
of the Commonwealth X-Ray and Radium
Laboratory.
M. E. J. Young in this book presents the
basic physics of diagnostic and therapeutic
radiology. The author states in a preface
that the book is written as a text for students
preparing for specific diplomas in
radiology and for radiographers-in-training
preparing for qualifying examinations. In
addition, the author hopes that it will be
useful to physicists who are entering the
specialty of hospital physics. The book
should fulfil these aims admirably.
The text is developed in a logical fashion
and important points are emphasised by
well-chosen and well-produced diagrams,
tables and graphs. Most of the important
sections of a rapidly expanding subject are
covered in some detail. In dealing with
such an extensive subject in a comparatively
small volume, the author has been forced to
limit his elaboration of topics which one
might have expected to be dealt with in
greater detail. For example, it is somewhat
surprising to find that only 30 pages of text
are devoted to nuclear structure and production
and medical use of artificial radioactive
isotopes. Perhaps a more notable
limitation of discussion is found in a section
devoted to the dose received by patients
during diagnostic radiology. This subject
which, in recent years, has come into such
prominence is covered in two pages of
which almost one complete page is devoted
to tables. It is surprising, too, to find in
this section that attention is devoted, in the
main, to the dose to the skin, no mention
being made of the gonad dose to the patient
during diagnostic radiology.
These criticisms are to a very large degree
compensated for by the well chosen
references in the text to journal articles
which should be reasonably accessible to
students, and by supplementary general
references to other books and review
articles. The author, who was formerly
Lecturer in Physics, Royal Free Hospital
School of Medicine (University of London),
has a commendable objective of encouraging
students to read beyond the test, and he
has, as he states in his preface, provided
"points of entry to the current literature".
In two chapters dealing with measurement
of ionising radiations, the author
presents the subject in a manner which
should enable the student to consolidate
further knowledge on a sound foundation.
Similarly, chapters on the interaction of
radiation with matter and some chemical
and biological effects of ionizing radiation,
will equip the student to handle his future
problems with satisfactory basic knowledge.
Students preparing for examination will
welcome the typical examination questions
which are set out at the end of each chapter.
The book should prove a useful text to
students in Australia preparing for the Certificates
of Competence of the Conjoint
Board of the College of Radiologists of
Australasia and the Australasian Institute
of Radiography or for University Diplomas
of Radiology or Diplomas of the College
of Radiologists of Australasia. Its clear
presentation and excellent references will
enhance its value to students preparing for
these examinations without the aid of formal
lecture courses.
Price: £2/2/- st.
IDEALS IN MEDICINE
A Christian Approach to Medical Practice.
Editors: Vincent Edmunds, M.D., M.R.C.P.,
and C. Gordon Scorer, M.B.E., M.D.,
F.R.C.S.
Pages: 192.
Publication Date: February, 1958.
THE TYNDALE PRESS, LONDON.
An excellent book, stimulating thoughts
in the mind of every medical practitioner

54 SPECULUM
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INVITED
We welcome requests from medical students for literature and information about
any of our pharmaceutical preparations. The Medical Information Department
Library of our head office in England contains a comprehensive collection of reprints
and abstracts from the medical literature of the world that have a bearing on the use
available to students and medical prac-
of our products; its resources are always
titioners throughout the world who
require bibliographies and references,
or assistance in the solution of problems
relating to our preparations.
When writing to us please give your student
year.
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Words in quotation marks are trade marks. Those marked * are the property of
Smith Kline & French International Co.

SPECULUM 55
who tries to conduct his life on the foundation
of, "Do unto others as you would that
they should do to you"!
It is a basic fact that man possesses a
spirit as well as a body, and it is this "whole
man" that every doctor is called upon to
treat. And so every practitioner would do
well to cultivate this aspect of medicine
very early in his professional life and try
to build on this foundation.
The role of faith, spiritual comfort and
a philosophy of life is very important in
helping one's own patients to "cope" with
their own illnesses, in which, indeed, the
mind plays so large a part. The practice of
medicine is incomplete if spiritual and
moral factors are ignored.
I have enjoyed each section of this admirable
little book, especially Chapter 111,
which deals with "The satisfactions of a
Family Doctor"!
I thoroughly recommend its inclusion in
any medical library.
B.G. (Medical Practitioner).
Price•. 12/6 st.
ANOTHER SPECULUM!
The Editor has received copies of another
medical students' magazine called Speculum
—the magazine of College of Medicine at
Syracuse, New York State.
It appears three times a year in editions
of twenty pages or so printed by a zinc plate
process. (This is a process by which the
whole page is typewritten first and then
photographed and etched onto a zinc plate
—it has the advantage of cheapness and the
well-known Lange Medical Publications are
set up by this process). The editors are to
be congratulated on the very high artistic
standards of the magazine—cover, layout
and illustrations—a standard which our
magazine has never reached.
The subject matter is more serious and
staid than ours—perhaps reflecting the
higher average age of the U.S. medical
student. The levity and irreverence of
Spicula in particular is lacking, and what
humour there is is more gentle.
Melbourne can claim priority to the name
by some sixty-five years or more as the
origins of the New York Speculum are a bit
uncertain, though it seems to have been
irregularly in print for the last five or six
years.
THE REFLEX
Speculum is glad to receive the first issue
of The Reflex, a brother magazine from the
new West Australian Medical School. It
says much for the hopeful and spirited start
of the school that in its first year, when it
consists only of a final year and a first year,
these two can collaborate to produce a
magazine of great readability.
The articles are by staff and students on
technical and non-technical subjects, and it
also contains reports of the year's activities
of their Medical Students' Society.
This magazine follows the Australian
tradition of humour.
*
Marriage — a pipe dream ?
The bad man wants his women to be like
cigarettes — slender and trim, to be selected
without much thought, set aflame, and discarded
when burnt out.
The fastidious man wants his woman to
be like a cigar — more expensive, have a
better appearance, and last longer. If the
brand is good, they are seldom discarded.
The good man wants his woman like his
pipe — something he becomes attached to,
knocks gently but lovingly, fondles when in
dreamy and sentimental mood, and looks
after with great care.
A man gives you a cigarette, offers you
a cigar, but he never shares his pipe.
* * *
A man is known by the company he
thinks nobody knows he is keeping.

56 SPECULUM
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SPECULUM
57
kavg:61,4 &iv
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NOT
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SUITABLE FOR
AWCNE. EN.4 FT
CHILDREN
Wh;ch Was Its Duty ?
To MS PrOrC.SSion
TO
H es Wife I or to tile
Ti
S ir! e Loved ? •
"(ruck"
can
n
EXCATEMara!
VOREDom
0 16(164 itv
14!
01, 14eY fi
Zowie
6-usegiuse 1 fi
c).--
JOCK NV SON • MARY MOtJuZO g •
,v. As 5ifue,..: covkirs,t,
boft16 KARLOFF • siR BERNARD DOCKER • PRINce RAMER
ft..9Y0 PATTERSotv C As +he SHoST 4 Sig wit.LoAri eSt.ER) ,
6v9 AG(SoTT •, t-Ov co4reu1-0 • RofiteRT HuLeMANN.
1014A, FOSTER pui_Lci•• LVInvti VAN teSE.ET+1 09E.W • 6EOR6e- DERNAIRO SHAW
mAiC04.t4 mviieRt vie • auul a- ‘ a / 1- 01Cr n, 4 N/C) " 5
Arecked by Lavta. Tu. n er • ProditcciA by Nt'clAccel Bald.

58 SPECULUM
IN THE FILM:
"What a fool a man is to be a doctor! The
continual suffering, the pain, the death! How
little we know! I can't stand it, I tell you—
I can't stand it much longer."
IN REAL LIFE:
"Then the old B--d asked me the course of
the lesser Superficial Petrosal Nerve. 'Course
I hadn't even heard of the bloody thing.
Blast him!"
FILM:
"While I know that clinical work is your
first love, Jones, I feel that a brain such as
yours can be of untold value in research, and
I think you should therefore accept this
scholarship."
LIFE:
Jones: "Yes, Sir, I suppose you're right."
"The porter of the Nurses' Home witnessed
the entire incident, and I feel that we have
no longer a place for you here."
Jones: "Yes, Sir, I suppose you're right."
FILM:
"See if you can get some more curved forceps
like these, will you, Sister, please."
LIFE:
"FOR GOD'S SAKE, CAN'T YOU TELL
CURVED FROM STRAIGHT ARTERY
FORCEPS!!"

SPECULUM
59
FILM:
"People who aren't skin specialists can have
great fun with us: patients never die, or get
well, and so on; but skin diseases are a definite
physical and mental disturbance, which it
is highly important to realise if we are to
treat such diseases successfully."
LIFE:
"Seen the moth-eaten old b—r in the end
cubicle?"
IN THE FILM:
"We're too late, Roberts. We can't save the
limb. I'll never forgive myself for the delay."
IN REAL LIFE:
"Well, well, can you beat that. According
to the X-ray, you've put that T.K.N. and P.
on the wrong side!"
THE ONLY TIME WHERE FILM EQUALS
REAL LIFE
(We hope, we hope)
"Gee, you certainly don't procrastinate, do
you?"
"Whatever else may be my faults, I doubt
if I'd ever do that."

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• "Paludrine" Proguanil Hydrochloride B.P.
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• Penicillin with "Sulphamezathine"— for
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• Pethidine — possesses analgesic, antispasmodic
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• Phemitone — antiepileptic and antispasmodic.
• Phenobarbitone B.P. — sedative and hypnotic.
• 'Siopel' Cream — skin protective for prevention
of contact dermatoses and related
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SPECULUM
6t
SURGERY
Professor Ewing
DIAGNOSTIC QM
1. A young man of 30 received a head
injury in a motor car accident. He was
believed to have a fracture of the base of the
skull but regained consciousness after a
short interval. A few days later, however,
he began to complain of an unremitting
swishing noise in the head, which made
sleep impossible. At the same time his
right eye became prominent and he developed
diplopia.
What was the pathological basis for his
symptoms?
2. She was a stout woman and her
hysterectomy was a difficult and blood one.
A blood transfusion was given in the theatre
in somewhat of a hurry in the left arm.
When she recovered from the anaesthetic
she found that she could neither bend the
elbow nor dorsiflex the wrist on that side.
What had happened?
3. The veins at the bend of the elbow
seemed obvious enough but the patient
complained unduly when the needle was
introduced and inordinately as the pentothal
was injected. He did, however, fall asleep.
Might there be some later troubles?
4. The goitre was a big one and the dissection
correspondingly difficult. After the
operation the airway did not appear too
good and later there was manifest cyanosis
and increasing respiratory distress. What
possibilities must be borne in mind?
5. A young man of 30 sustained a simple
fracture of the shaft of the femur on each
side. Following resuscitation he made very
good progress until the third day, when he
lapsed into unconsciousness and later developed
convulsions. A petechial eruption
was noticed on the skin over the front of
the chest. What was the diagnosis?
6. On the third day after an operation for
the repair of a hernia a robust old gentleman
of 60 developed a high fever and
severe pain in the foot. What have we here?
7. Her husband, who was actively engaged
in establishing a milk bar, died sud-
denly from a coronary infraction about a
month before. She was very much upset
and could not sleep until her doctor gave
her some tablets. She was admitted to
hospital ten days later with anorexia and
jaundice which the biochemical tests
showed to be obstructive in type. Would
you hazard a diagnosis?
8. We first came to know him when we
operated for what was believed to be acute
appendicitis. In the immediate post-operative
period the diagnosis was amended to
enteric fever and we did not see him again
until two months later when he reported
back complaining of pain and acute tenderness
over the body of the sacrum. Is this
a rare bird?
9. A truck driver, aged 50, came complaining
of a painful swelling of his index
finger. It seemed to be a bony swelling,
originating in the proximal phalanx and an
X-ray showed destruction of bone. The
finger was otherwise normal save for
nicotine staining. He was apparently in
good health although he admitted that he
had been unable to shake off a cough since
an attack of influenza a few weeks previously.
Guess what?
10. His cough never left him at peace
and he was bringing up mouthfuls of bitter
greenish material, with things in it that
looked for all the world like grape-skins.
He was 55 and had been a radiographer in
a metropolitan hospital for over 30 years.
Sixpence on it?
11. She was a front seat passenger in a
Holden which ran off the road and hit a tree.
Her face came into violent contact with the
windscreen and when she consulted her
doctor next day the eye was closed and her
face greatly swollen. When we first saw
her a week later she was complaining of
numbness of the right upper lip and the
diagnosis was obvious enough. What was
it?
12. She was a very old lady, stout and
very deaf. She had been up all night with
severe generalised colicky abdominal pain
and repeated urgent vomiting. There had
Answers on Page 67

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SPECULUM 63
been a small bowel action soon after the
onset. As far as we could ascertain she had
always enjoyed good health apart from
vague discomfort in the upper abdomen
and flatulence. There was a little distension,
no tenderness and occasional noisy bowel
sounds. A straight X-ray showed the presence
of a large stone in the gall bladder
area. What had we here?
13. A bright young man came into
Casualty with a clean cut on the dorsum of
his left hand about 2 cm. long. His jacket
was bloodstained. He spoke with an accent
which was unmistakably Scottish and he
was loud in the praises of the Demons. His
wound was sutured and he was given an
injection of tetanus toxoid. As he left, the
pretty nurse on duty said: "Goodnight
Officer". How did she know he was a
policeman?
MEDICINE
Dr. Doyle
1. A man aged 40 had a pleural effusion
10 years ago. He now complains of moderate
dyspnoea on exertion but has no
dyspnoea at rest. His jugular venous pressure
is 10 cms. above the sternal angle, his
heart is normal in size and he has an enlarged
liver and ascites. Diagnosis?
2. A woman aged 33 complains of being
awakened at night by palpitation; she has
noticed that on these occasions her pulse
rate is slow. At the same time she trembles
and sweats profusely and feels that her neck
is swelling. Her B.P. is 155/100 and she
has glycosuria. Diagnosis?
3. A man of 43 has chronic osteomyelitis
of his right leg. He now complains of
oedema of both legs, but no dyspnoea.
Clinically he has gross oedema of both legs,
a palpable spleen and his urine contains 8
G. of protein per litre. Diagnosis?
4. A woman aged 28 has been treated for
5 months for pulmonary tuberculosis. She
now complains of numbness and tingling of
both hands and feet. On examination she
has absent knee and ankle jerks and tender
calves. What is the diagnosis and what is
it due to?
5. A girl aged 13 complains of dyspnoea
on exertion. On examination she has an
enlarged right ventricle, a systolic murmur
in the 2 left space and cyanosis and clubbing
of the toes of both feet, but has none in the
fingers. Diagnosis?
6. A woman aged 36 states that for 17
years she has had recurrent episodes of
frequency of micturition and that she frequently
has haematuria. On examination
she is pale and hyperpnoeic, and both kidneys
are enlarged and readily palpable. Her
B.P. is 250/150. Diagnosis?
7. What changes would you expect to
find in the patient's plasma in (6) in
i. Urea.
ii. Na+
iii. K+
iv. HCO 3-
v. C1.-
8. A single girl aged 31 consulted doctor
complaining of difficulty in swallowing,
trembles and feelings of anxiety since she
was jilted seven years ago. Her doctor prescribed
some white tablets, which she took.
Three days later her skin began to itch, and
on the following day she became jaundiced.
What were the tablets?
9. A male medical student who claimed
to be a teetotaller became nauseated and
lost his appetite a week ago. Three days
later he became jaundiced and noticed that
his stools were pale and his urine dark. On
examination his liver is easily palpable and
his spleen can just be felt. What is the
likely diagnosis?
10. A man aged 53 complains of diplopia
for 3 days. He admits to a cough for 3
months and has lost a little weight. On
examination he has clubbing of the fingers,
a dull percussion note at the apex of the
left lung, a left Homer's syndrome and a
right external rectus palsy. Diagnosis?
11. A widower aged 66, who lives alone,
presents with red spots on the arms and
legs, and says that he has been bleeding
from the mouth for one month. On examination
his gums are swollen and bleed
readily. Diagnosis?
12. A market gardener aged 37 is admitted
with peripheral neuritis. He says that
for three weeks he has had intermittent
diarrhoea and vomiting. On examination
he appears to have lost weight, has hyperkeratosis
of the palms and soles and has
peripheral neuritis. Diagnosis?

64 SPECULUM
13. A 19-year-old girl complains of
swelling of the abdomen, oedema of the
legs and amenorrhoea for 7 months. The
blood pressure is 100/110 and the urine
contains protein. What is the most likely
diagnosis?
14. A 43-year-old woman has 3 children
aged 19, 17 and 12 respectively. All her
pregnancies were uneventful except for a
post partum haemmorrhage in the last. She
now has amenorrhoea and complains of
lassitude, intolerance of cold, and occasional
episodes of confusion in which she
sometimes loses consciousness. On examination
she is a thin, pale woman with no
axillary or pubic hair.
a. What is the diagnosis?
b. Why does she become confused or
unconscious?
15. A 50-year-old man complains of
weakness in both hands and the left forearm.
On examination there is wasting of
the muscles in both hands and in the left
forearm, and there is fibrillation of these
muscles. All tendon jerks in both arms and
legs are very brisk, and there is patella and
ankle clonus. The plantar responses are
entensor. Diagnosis?
16. A boy of 16 experienced a sudden
severe headache and became confused. On
admission he had marked neck stiffness and
a port wine stain on his face. Lumbar
puncture revealed evenly blood stained
C.S.F. What is the cause of this, and what
is the underlying lesion?
X Patient c/o biting the buttons off railway
seats. Diagnosis?
You can bank on . . .
I NTRADEX
(6% dextran in normal saline)
The reliable plasma volume extender.
Another Product of the Glaxo
Laboratories.
Dr. E. E. G. R-b-r-s-n
DOING FINALS ?
Then arrange to receive
SPECULUM
in future years and keep
in touch !
See your Year Representative

SPECULUM 65
MI-1,DICAL Alf,DLI -;rYS
1958
THANKS
for the
MAMMARY"
THURSDAY, 11th DECEMBER

66 SPECULUM
THE
AUSTRALIAN PHARMACEUTICAL FORMULARY, 1955
A.P.F. 1955
ENLARGED AND COMPLETELY
REVISED EDITION
INCORPORATING
THE FOLLOWING SPECIAL FEATURES:
General Notices (which includes a concise guide to
prescribing practice and prescribing conventions.)
Monograph Section
General Therapeutic Formulae
Infants Section
Poisons and Antidotes Section
Table of B.P. Doses
Therapeutic Index
AN INDISPENSABLE STANDARD REFERENCE
BOOK FOR STUDENTS AND PRACTITIONERS
per 15'- copy
AVAILABLE FROM LEADING MEDICAL BOOKSELLERS
AND WHOLESALE DRUG HOUSES
PHARMACEUTICAL SOCIETY OF VICTORIA
College of Pharmacy
360 Swanston Street, Melbourne, C.1. Phones: FJ 5161, 5162,

SPECULUM 67
ANSWERS TO DIAGNOSTIC QUIZ
SURGERY
1. He had sustained a fracture of the
middle fossa and a fistulous communication
between the carotid artery and the cavernous
sinus.
2. She had sustained a brachial plexus
injury when the arm was brought out at
right angles to the table on an arm board,
the patient being in the Trendelenberg position
and with shoulder rests to restrict
scapular rotation.
3. The pentothal had been injected inadvertently
into the brachial artery. This
is surprisingly easy to do, especially in old
people. Gangrene of the hand is a not uncommon
sequel.
4. Mediastinal emphysema and tension
pneumothorax are infrequent sequelae of
thyroidectomy. The latter may cause very
urgent symptoms.
5. He had fat embolism from which he
fortunately made a spontaneous recovery.
6. He had gout, which had plagued him
in the past. It is not very uncommon as a
post-operative complication.
7. The tablets were, of course, chloropromazine.
She was, however, still jaundiced
six weeks later and at this stage we felt
constrained to operate. Although there
had been no pain, a stone was firmly impacted
in the common duct.
8. He had periostitis, which is one of the
less frequent sequelae of . typhoid fever
during the convalescent period. It usually
resolves without suppuration.
9. The story is only too familiar these
days. He had an inoperable carcinoma of
the left lower lobe bronchus with an area of
collapsed lung.
10. He had a liver hydatid, which had
become infected and broken through the
diaphragm to communicate with the bronchial
tree. The grapeskins were daughter
cysts. The occupation was totally irrelevant:
he spent his boyhood on a farm in the Western
District.
11. She had a depressed fracture of the
malar bone with damage to the infra-orbital
nerve. The diagnosis was masked in the
first instance by the swelling.
12. We were far too clever! We plumped
for gallstone ileus. It was only when we
were preparing the skin on the table that
the resident spotted a swelling in the right
groin. It was a strangulated femoral hernia
all right!
13 He was wearing police uniform.
MEDICINE
1. Constrictive pericarditis.
2. Phaeochromocytoma.
3. Nephrotic syndrome due to amyloid
disease.
4. Peripheral neuritis due to isoniazid.
5. Patent ductus arteriosus with a reversed
shunt due to pulmonary hypertension.
6. Polycystic kidneys.
7. Raised.
Reduced or normal.
Raised or normal.
Reduced.
Reduced or normal.
8. Chlorpromazine.
9. Infective hepatitis.
10. Bronchial carcinoma with secondary
cerebral deposits and involvement
of the cervical sympathetic ganglia.
11. Scurvy.
12. Arsenic poisoning.
13. Pre-eclamptic toxaemia of pregnancy
14. (a) Post partum necrosis of the pituitary.
(b) She has spontaneous hypoglycaemia.
15. Amyotrophic lateral sclerosis.
16. Sub Arachnoid Haemorrhage due to
Cerebral Vascular Anomaly.
X Sacro-coccygeal teratoma.
At a meeting of the Loddon Region
Medical Advisory Committee at Bendigo,
Country Practitioners were discussing Reserve
Equipment to be held at the Base for
emergency and replacement use for hospi- .
tals in that area. The advisability of having,
a sigmoidoscope on the list was debated.
Dr. N.T. suggested that the sigmoidoscope
be retained!

68 SPECULUM
Xbe eat of epenbabititp )
of
(etbicat robuctii
• B.C.M.
• CODIPHEN
• MULTI - B
• POLYHAEMEN
reconstructive TONIC for VITAMIN B-COMPLEX
and MINERAL deficiencies.
tablets: Safe, effective, quick acting
ANALGESIC, ANTIPYRETIC and mild Hypnotic.
tablets: presenting the essential members
of the Vitamin B-COMPLEX in balanced amounts.
tablets: for MICROCYTIC and
HYPOCHROMIC ANAEMIAS.
G • P.
PTY. LTO.
Manufacturers of Standardircd
Pharmaceutical Products
Laboratories and 1-lead Office:
SYDNEY, AUSTRALIA
Telephone: MX 1164
Telegraphic and Cable Address: Glandular, Sydney

SPECULUM 69
Int.BYtant
M. S. S. CHRON1CAL
1957
76th ANNUAL GENERAL MEETING
Secretary's Report
Another year passed, and the apathy of
the students towards the M.S.S. reached
greater heights. It would appear the only
time the society means anything is when
Speculum is published, or tickets for the
Medleys are on sale. Unless this trend is
corrected, the privileges afforded by the
Society will be curtailed, a position in which
the committe does not wish to be placed.
It is only with your assistance and interest
that this can be averted.
Nevertheless we can record an eventful
year. In the Sporting World we made our
presence felt, winning two football matches
—the only times we had more than fourteen
players. The anual rowing contest against
the Engineers is still doubtful—when the
judges and umpires have a remission from
their cirrhosis and the truth may be told.
We were outright winners in table tennis,
and gave a good account of ourselves on the
tennis court.
The Annual Dinner was held on the 3rd
of July, and Dr. Don Lawson, amidst some
good stories, emphasised the importance of
the family, particularly the mother, in
society. The small number at the dinnersixty-five—was
accredited to simultaneous
College functions, etc. (Apathy!)
Graham Martin again turned out a terrific
edition of Speculum—we are sorry to learn
that this is his last year as editor.
Eric Cooper and Sid. Kosky turned on
one of the best Medleys yet. Our warm
thanks go to them, and to their gallant crew
of typists, musicians, stage hands, decor
artists, etc. The floor show was the most
polished seen for many a year.
Last year founded a new function within
the Society—the Wednesday afternoon
sherry party given by the Div. 1A Students
to all their lecturers and tutors. It proved
a great success, and we hope will turn into
an annual event. Our thanks go to the
Physiology Department for allowing the
students the use of their main lab. as the
scene of festivities.
The committee would like to express its
appreciation of the great work done by
Geoff Conron—the retiring Treasurer. He
has done a colossal job for the Society over
the past four years as Business Manager of
Speculum and Medleys, and as Treasurer.
Also our sincerest thanks to Professor
Hayden, our retiring President. He has
been a tower of strength to the committee,
and the sparing of his valuable time is
greatly appreciated. We hope he enjoyed
his sojourn with us, and that we shall see
him at future M.S.S. functions.
N. SUTHERLAND,
(Hon. Sec.)

-
•
70 SPECULUM
O
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MEDICAL STUDENTS '
Statement of Receipts and Expenditure for period April 4, 1957, to April 9, 1958
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SPECULUM 71
ANNUAL DINNER
JUNE 13th, 1958
Friday, June 13, saw ninety ladies and
gentlemen of varying sobriety gathered in
the Buff. for the Annual Dinner. Sherry
was served before the dinner, giving the
diners a chance to become familiar. During
the Tomato Soup, to the accompaniment of
thunderous applause, our President, Prof.
Ewing, proposed the Royal Toast. This
was followed by Schnapper Mornay, and
with it, Abdul Sutherland—the M.S.S. Secretary—proposed
the toast to the staff. In
Pansy's unfortunate absence, Prof. Rubbo
did a quick-thinking act and replied on behalf
of the staff.—Pedro and the Town Hall
clock will go down in the annals of dinner
jokes. After the Roast Pork, Prof. Gray
proposed the toast to the students, and gave
an insight into the activities of students
studying abroad. In the middle of the
Fruit Salad, the whole thing became too
much for Treth., and completely overwhelmed,
he gave a stimulated rendition of
Abdul the Bul Bul Amin
Our Treasurer, Pixie Wright-Smith, then
replied for the students and libelled the
whole of the Bugs staff at the same time!
Amongst the cheese and coffee our President
introduced Doug. Donald—the guest
speaker—and under the subterfuge of "The
Anatomy and Physiology of the Artist's
Model", told new and fresh stories,—Lott's
wife—I still don't get it.
This year saw white and red wine on the
table during the meal—of course we had
beer—after the coffee! Treth. and Doug.
(in lieu of Pansy), then got together and
gave out the famous duet; after which the
Editor of Speculum gave a hiccup and
launched into thanking Doug. for his presence
and address. Well done, Jim!
This dinner was also a send-off for Dr.
Rogers, who is concluding lecturing at the
end of the year after 35 years of it (got it
right this time). Luckily, he is not leaving
our midst completely. We wish him the
very best in the years to come. At 10 p.m.
the President closed what has surely been
one of the best dinners yet.

72 SPECULUM

SPECULUM
73
MEDLLY'S '57
Dear S. & M.'s,
Six weeks to go and the producers had no
show, but plenty of Piles. However, some
solid thinking by members of the cast and
the producers resulted in a stack of scripts
and songs which were torn apart, censored,
re-written and finally put together as the
'57 'Medleys revue: "Piles of Fun".
This year's final curtain was also a farewell
performance for one of the greatest
stalwarts of Med. revues, Ken Shankly, our
stage manager. We would like to sincerely
thank Ken for his inestimable help both in
producing the show and managing it on
stage, not only for '57 but the many years
before. We're sure gonna miss you, Ken!
While we are on the topic of thanks, we
would like to extend it to the host of helpers
which made Piles of Fun a success; especially
Strahan Sutherland, to whom we owe
the hall decor and stage scenery. Also
thanks to the Union office, Nina Harrison
and Margot Featherston for typing the
scripts and songs.
One thing the show couldn't do without
is the "orchestra", which was again ably led
by Dr. Trethewie. (Thanks, Treth.)
As usual, the producers made mistakes,
but this time due to the keenness and expert
acting ability of the cast few were noticed.
We must apologise to the audience for
our main gremlin—hearing that which is
said—but just bear with us fellas and at the
'58 show you might be able to understand
all the dialogue.
Live and learn is a good policy with
Medleys, provided that the learning doesn't
interfere too much with the living. So
here's to Med. Medley's '58 (title to be revealed
later in the year—yes, we've got
one). May it be brighter, bigger and better
than ever.
Yours sincerely,
ERIC COOPER.
Opening Song:
Sit Down For Piles Of Fun
Tune: "Sit Down, You're Rockin'
the Boat"
As I stepped out upon the stage this evening
I saw no one to act or sing a song,
Then from that thing
A voice in anguish holler'd,
We've come from space to send the show
along.
Then the people they all stepped out,
stepped out to start the show,
Yes, the people they all stepped out, and
shouted, "Man, let's go,"
For we've come to do some acting,
To sing some songs and quip some puns,
Sit down, sit down, sit down, sit down, and
you'll have piles of fun.
As I sat down not believing what had
happened,
I thought in time my seeing would be right,
But then I sensed
Something queer right behind me,
And a voice cried out, "My Dear, Tonight's
the Night."
Yes, tonight's our night of fun, let's really
go to town,
Yes, tonight our race we'll run and let our
hair right down,
And we hope you will agree that
There's laughs galore for everyone,
Sit down, sit down, sit down, sit down, sit
down for piles of fun.
Sit down for piles of fun,
(Repeat)
SIT DOWN FOR PILES OF FUN.

74 SPECULUM
Of Dames And Things
Tune: "Guys and Dolls"
What's happening at the Uni.?
I'll tell ya what's happening at the Uni.
Guy who used to be sane and single is
Now behavin' like a perfect luni.
That's what's happin' at the Uni.
What's happin' at the Med. School?
I'll tell ya what's happin' at the Med.
School.
Guy who used to be lively and bright,
Is now behavin' like a dead fool.
That's what's happin' at the Med. School.
What's happin' all over?
I'll tell ya what's happin' all over.
Stude sittin' down with a text book
Who used to be somethin' of a rover.
That's what's happin' all over.
Dames is the thing that has licked 'em.
And it looks as if we're jest three other
victims.
When you see a stude,
And his hair is all chewed,
You might think that he's taking the benzedrine.
When a Res. comes in with an audible
moan,
You can bet that the elf
Is dosin' himself
With testosterone.
When a lazy jerk settles down to some work
And he swots in a tramcar or a train;
Call him queer or a moron,
Ah, but you can get six to four on
That the mug's only doin' it for some Jane.
When a student sighs,
With that look in his eyes,
You might think that he's takin' a bromide
fizz.
When a solo king calls misere at it's best,
On four aces and nought,
It's sure that the sport
Has feathered his nest.
When a drinking mug gives up taking a jug,
And he drinks nuttin' but water like a drain,
Call him brave, call him stupid,
Ah, but you can get odds from Cupid
That the creep's only doin' it for some Jane.
When you see a lair
Puttin' pins in his hair,
You might think that he's swallowed some
mist. mag. co .
When a Cas. stude moans that no sleep can
he catch,
You can tell by his voice
That without any choice
He could doze in a snatch.
When a certified wet makes a ten to one bet
That from henceforth he'll not be a pill or
a pain,
Call him mad, call him clever,
Ah, but you can get odds for ever,
That the lad's only doin' it for some Jane.
Some Jane.
Some Jane.
The lad's only doin' it for some Jane.

SPECULUM 75
The Stately Homes of Carlton
Tune: Stately Homes of England.
The Stately Homes of Carlton
Have blue lights at the gate.
The public's always welcome,
You never have to wait.
As long as your money is in your hand,
You'll find that an evening can soon be
planned
With a tasty little dish.
You can choose between brunette, redhead
or blonde,
Any sort you wish.
The Stately Homes of Carlton
Have every kind on hand.
From passionate to frigid,
The best in all the land.
As long as the Medical Faculty boasts
A dozen virile men,
We'll fight for the Stately Homes of Carlton.
The Stately Homes of Carlton
Supply the students' needs.
And if you pay us promptly,
We'll give you back your tweeds.
For only a little extra,
You can see what the other patrons do
Through a peep-hole in the wall.
You would be surprised at who you'll see
in there;
Lecturers and all!
The Stately Homes of Carlton
Have lots of girls on tap,
And if you stick to us, sir,
You'll never get the clap.
The spirochaete just isn't see here,
Which is one more reason why
We'll fight for the Stately Homes of
Carlton.
The Stately Homes of Carlton
Are in the public eye,
As long as there are men, sir,
The sport will never die.
Though ministers may denounce us,
And policemen may pursue us,
We shall be sure to have our way.
While our girls remain as lovely as they are,
The customers will pay.
The Stately Homes of Carlton
Are vital to the land,
For if they were not with us
Just think of the demand.
With knot holes and post-holes and keyholes
We should occupy our time,
So we're proud of the Stately Homes of
Carlton.
The Stately Homes of Carlton
Are never at a loss;
For if our girls don't please you,
We'll let you have the boss.
Although it's not customary,
We could probably fix you up
If you would prefer to have a male.
Or if you require a little boy, or dog,
We shall never fail.
The Stately Homes of Carlton
Have always been discreet,
You'll find us close and handy
Up every little street.
Except for a murder once in a while,
Your safety is assured,
So we'll fight for the Stately Homes of
Carlton.
—Ron Quirk.
All This And A Degree Too
Tune: "Whoopee"
Another year
You're in the ward,
The teaching's started
Don't look so bored;
You're in the clinics
Amongst the cynics,
Some call you Doctor.
You palpate hearts
And auscultate,
You heard the murmurs?
By George you're great;
But then a voice said
That patient's long dead,
Send for a doctor.
The setting's bright and airy
Between the long white walls,
Be careful that the fairies
Don't souvenir your .. .
Seeing patients
Alive and dead,
They're stuffing seaweed
Into your head;
But just remember
When you're an ember,
They called you Doctor.

76 SPECULUM
At last you reach
The final year,
You sober up,
Won't have a beer,
But constipation
And dissipation
Makes you a doctor.
Finale:
There's No Medleys
Like Med. Medleys
Tune: "There's No Business Like Show
Business"
There's no business like med. business,
Like no shambles we know,
Everything about it is revealing
All the clues that Siddy can instil,
Nowhere can you get that happy feeling
When you are stealing that extra thrill.
There's no people like med. people
Like no boozes we've done,
All the boys are ready when you say you'll
shout,
You'll soon find out, they like their stout,
But when it comes to paying up they all
hang out,
But let's have piles of fun.
A BRITISH RESEARCH
ACHIEVEMENT
Working in conjunction with the
Medical Research Council, chemists
of the Glaxo Laboratories developed
a synthesis of cortisone from hecogenin,
which is obtained from the
juice of sisal leaves.
All Glaxo Cortelan (cortisone),
Efcortelan (hydrocortisone,) Delta-
Cortelan (prednisone), and Delta-
Efcortelan (prednisolone) preparations
are manufactured from materials produced
by this new British synthesis.
The pan-rooms, the theatres, the patients,
the smell,
The cigarettes you always seem to lend,
The ward rounds, the students, the orderlies
—ah, well.
Who's caring, for the year is at an end.
The nurses who will give the studes a bit,
Ah, bless their souls—tonight they'll make
a hit.
There're no subjects like Med. subjects,
Like no subjects we know,
None of them are worth the trouble learning,
Think of Physiol. and Biochem.
All the notes are only fit for burning,
What of the lecturers? We've finished them.
There's no fooling or no drooling that our
Profs. ever shun,
Never was there such a mouldy lot,
They're always ready to drink a pot,
And what's more they'll take you down for
all you've got.
We're having Piles of Fun.
The doctors, the sisters, the nurses, the lot,
Will keep you on the run from morn till
night.
The lectures, the clinics, the P.M.s, so what,
Tonight's the night we'll give the fright a
bite.
We're fit and well and rearing for the
chance,
The booze is waiting, let's get down and
dance.
There's no medleys like Med. Medleys,
Like no medleys we know.
Never has there been a show so daring,
Never has there been a grander cast.
You orta guess by all the bloomin' swearing
That we have finished the show at last.
We hope you have had fun, too, and still
vote us number one,
Thanks to all who helped us to this final
night
It's sad that some should have died of
fright,
As for all the rest of us, well boy we're
tight,
We've had Piles of Fun.

SPECULUM
77
PRE-MEDICINE
This year will be notable in the history
of the Pre-Med. as it is the last year that
Dr. J. S. Rogers will lecture in Physics. As
he has lectured for 35 years, we might
almost say an era has passed.
This year, as a result of representations
made to the Chem. School, and by 3/6
collected from eager students tutorials have
been started. Dr. Brown has passed on to
the greater intricacies of Chem. 1 A, and so
Dr. O'Donnell (the other half of The
Manual) is burdened with the Pre-Meds.
and vice-versa.
Meds were much more prominent in interfaculty
football this year, and could be a
force in years to come. Pre-Med. players
SIC ITIIR AD NAUSEAM
YEAR NOTES
were Curry, Dinley, Swann, Rush, Keogh,
Cravan "A", and Heffernan. With the very
small number of repeats, and migrants from
other faculties (10 in all), the P.M.R.S. —
Pre-Medical Repeats' Society — could well
become an exclusive if not entirely nonexistent
body in future years. This year we
have Jock (Unkempt) Cravan "A" (again),
Uncle Bill Darvall, J.C.H's answer to Panzee
— Elizabeth Blakewell, Ian Larding,
Ken (who do we hate?) Hamer, Ted (sex is
here to stay) Heffernan, and Ray (Daddio)
Hinks in the exclusive band.
There are two chemistry prac. classes
now, and those on Thursday are familiar
with the words pie-pet, Man-gan-ous ions,
Bury-em salts and Cupper which "ridooces"
many things. One of our number (acknowledgements
to Mr. Bordmann) under

78 SPECULUM
the spell of hypnotist Lee Saxon was heard
to say some rude things about one of our
lecturers. Congratulations to Peter Rush
who played inter-varsity football during the
carnival. •
Wishing physics students in future years
the best of luck (you'll need it!), we'll see
you in Div. 1A.
FIRST YEAR
Who are we? What are we? (Don't
answer that!).
Well, there are 186 of us — now that
Jan has whizzed off in search of pure science
— or scientists?
Twenty six of us are of the long-haired
(XX) variety.
The remaining 160 are of the short haired
(XY) variety (from Bob's Brynner-like crewcut
to Peter's regularly recurring long bob).
How old are we? To be exact, our
average age is 21.1 years.
The range is from 18 years to 40 years
and here is the breakdown —
i.:•■■■■•••••■■••■■■••• ■■•■■ ■•■•
_
ANGUS & ROBERTSON
LTD.
have a
very large range of
MEDICAL AND DENTAL BOOKS
in their
Medical Book Department
on the First Floor
at
66-68 ELIZABETH STREET,
MELBOURNE
Phone: MF 6466
Age 18 5 Age 27 3
19 . 46 28 2
20 64 29 1
21 30 30 3
22 15 32 . 1
23 5 34 1
24 3 35 ... 1
25 3 36 . 1
26 . 1 40 .... 1
Where are we from? Most of us are
Victorians (173) and 10 are from Malaya,
2 from Tasmania and one from Hong Kong.
Some of us have already jousted and won
in the battle for academic spurs. We have
three B.D.Sc's, two B.Sc's, two Dip.Pharm.'s
an M.Ag.Sc., a B.A., Dip.Ed., a B.Com .,
Dip.Ed., a B.A., a B.Arch., and two 2nd
year B.Sc.'s who will qualify when they
complete Div. 1. In addition, three of us
are ex-servicemen.
In fact, just to complete the picture, this
is what we are —
154 who passed Pre-Med. last year.
16 who are repeating the year.
2 who passed 2nd year Science last year
in the combined Science-Medicine
course.
6 graduates in some branch of Science.
8 who were not admitted to Pre-Med.
quota last year but who successfully
completed first year B. Sc.
Strictly entre-nous, a high official source
remarked of us: "a very select group".
What have. we been up to, apart from
preparing for November?
The Med. Monsters, trying their hands
(and feet, claws, teeth and hair too) at
Carlton rules footer cleaned up the Fizzios
nicely, though the official result gave a misleading
impression to the contrary. In
announcing her XX variety side, Mary
(veteran Van Diemen's Land full-back) had
said supporters were very much needed.
(Very sensible idea.)
Brian ("The Hair-cut") Roet, your
favorite sports commentator, reports: "This
year Med. bettered last year's performance
greatly (only because no team was
fielded last year).
"The team selection was made by placing
a list in the dissecting room with NAME
and POSITION of footballer to be filled
in by volunteers. A noted volunteer was
FOO and his position was SIDEWAYS.
"Most of the faculty people refused to

SPECULUM 79
play as they had to swot (which shows
what a corrupt faculty this is).
"On the field, captain DANNY
CZARNY used the rugby tackles he
learned at school and brilliant marking
by ANDY BURGESS and determined
ruck work by GEOFF VAUGHAN were
highlights of the games.
"Credit must be given to the plucky efforts
of back pocket CARROL MAJOR who
came through 'like a tank' every time.
"We won three out of four games, losing
narrowly to Ag. Sc. (through lack of
supporters, we claim) but defeated Architecture
and Dentistry soundly and simply
walked all over Engineering."
Thirty three of us (including six of the
long-haired variety) got indoctrinated into
Med. Dinners . . . Phewhh! The brave types
were Lois, Keay (the gal who oralled her
demo that a femur was a humerus), Marlene
(who throws good parties), Renee, Elizabeth
and (clued-up) Sylvia. And, incidentally,
for those who didn't attend the Dinner, get
Bob (who attended very strongly) to tell you
the one about the wallaby.
To add to our tribulations, Ian got us all
shot (Salk-wise) but we evened the score by
nominating him as guinea-pig when mad,
electric-needle-bearing scientist wanted a
feature player for his T.V. show "The Biceps
Blips Ballet".
This year's Pansyism (for the benefit of
other readers):
PANSY: What else is a criterion for living,
as against non-living?
DARRYL: The ability to reproduce.
PANSY: Yeah? Well what about the mule?
(Apparently mule seeds aren't any
good).
DARRYL: Yes, but the mule does reproduce
at the cellular level.
PANSY (disgustedly): Yeah, but there isn't
much fun in that.
A small boy was asked by his father what
he would like for his birthday.
"A baby sister," he replied.
"But it's only two weeks to your birthday,
and that doesn't leave much time."
"I know. But can't you put more men on
the job?"
SECOND YEAR
The year started off quite well, when Prof.
Trikojus informed us all that "This is NOT
a penal institution!". Suitably assured we
forged our way ahead, forging biochem.
results, physiology experiments and anything
else which needed slight assistance in obtaining
a correct result. Early decease in
Mammalian was always treated with glee,
as the experimenters had the rest of the day
off. In respiration prac. one student faithfully
recorded in his prac. book that he
"became so anoxic that during the resultant
mental derangement he mislaid his kymograph
tracing".
In clinical biochemistry, after a term of
collecting urine samples, two students have
set up conditioned reflexes and are unable
to even walk past a flask without stopping
to micturate in it.
Saturday morning lectures are enough to
make us all throw the Course in and start
Law, but somehow we all manage it by 9
a.m. — even if Dick S. is still in pyjamas.
Sammy R. often doesn't manage it on time
— probably because he is suffering from
"Testicula Amorosa".
Darrel, Drippin and Put missed out at
Marysville but the last two are making up
for it. Clive took over Darrel's job as year
rep. Jacky W. hasn't been able to put on
another display because Clive refuses to
organise sherry parties.
Shaw R. and Rex B. can both vote now.
The occasions were celebrated in the usual
way. Although it is difficult to get anyone
to divulge information to their press representative,
rumour has it that Jerry G. is
married, and that both Buck and Shagger
are engaged. Our biochem. graduate is also
engaged (be careful of him Margaret!). No
one admits that they are expecting, although
so far this year two gentlemen have been
looking rather worried.
Roger B. did a good job with the S.R.C.
Review. Here. still plays billiards (both
types). Mal D. tells us that judo is good
for you. Ted F. and Beppo don't room
together in college any more, but Ted insists
that he did not break it off (unlike the Eskimo's
girl friend). Warwick G. spent a few
weeks in hospital, but he is now quite well

80 SPECULUM
and has returned to his old habits. Bill tells
us that if we want to get our fair share
Queensland is the place.
The parking situation is worse, but "Nohole"
T. came up with a good suggestion,
even if it was anatomically impossible.
Robin H's. old man gave the year an Anatomy
lecture, Robin walked in the door, took
one look at the lecturer and said "I've seen
THAT bloke somewhere before!" George
S., when seen critically examining the
Anatomy School lavatories for data for his
article in next issue stated "What me? I'm
not a perv.!"
We hear that General Motors have offered
both Wally K. and Roger K. jobs in
their styling department — as if we couldn't
guess who they were rooting at the boatraces
("Rooting" means "Barracking", you nasty
minded, illiterate people, e.g. "Let's root
for the home team" or, as in the definition of
the vegetarian sailor who "eats roots, shoots
and leaves").
Toni C. helped Lee Saxon put on a good
show in the Union Theatre. First term
vac. saw most of the female members of our
year down at a house party at Sorrento.
Eve kept them all on the straight and narrow.
Rosemary, Joan and Terry formed their
unual trio. More of "No-hole": In drunken
stupor and making amorous advances to an
engaged air-hostess he was asked what he
was going to do when he graduated. "I'm
going to be a gynaecologist, because that's
the only way I'd get any sex!" K. M.
reckons work is pretty heavy this year and
leaving Div. 1A is almost a case of "out
with the fat and into the fyre(?)!" "Wophole"
M. is just crazy on an interstate Florence
Nightingale.
Although we hope everyone is successful
in September, we mainly wish a lot of luck
to those among us who are drunkards, pornographers,
perverts, sadists, vagrants, jailbirds,
homosexuals, arsonists, maniac
speedsters, bludgers and all other immoral
unsavory characters — best of luck boys!
* *
This Actually Happened: The following
records were heard over the National Radio
Station one evening in the following order
exactly:
Don't look at me that way.
You do something to me.
Let's do it.
Don't tell a soul.
Please, do it again.
Don't blame me.
M S S COMMITTEE, 1958
President
M.B., Ch.B. (Edin.), M.Sc.,
Secretary
Treasurer
Editor of Speculum
Medical Medleys' Production
Sports Representative
Pre-Clinical Women's Representative
Clinical Women's Representative
Year Representatives:
Pre-Medical
Div. IA
Div. I
Hospital Representatives:
R.M.H.
A.H.
St. V.H.
P.H.H.
S.R.C. Medical Representative
PROF. M. R. EWING
F.R.C.S. (Edin.), F.R.C.S., F.R.A.C.S.
N. SUTHERLAND
J. WRIGHT-SMITH
J. W. SMITH
E. COOPER, R. BUCKLE
C. CZARNY
JANICE PEELER
CYNTHIA MOORE
E. HEFFERNAN
W. WHITE
C. MORRIS
G. TREVAKS
G. CONRON
A. MacLEOD
P. RUBENSTEIN
I. SIGGINS

SPECULUM
81
ROYAL MELBOURNE HOSPITAL
THIRD YEAR
In November we arrived at RMH
60 eager bods, complete with brand new
guessing tubes and horrible hangovers after
Alan's party.
Seen in viscerectomy ward: Don puts on
white gown before assisting at P.M. Can't
find the sleeves; then recognises the shroud,
still cold from the bod — shroud hastily
discarded.
Pixie managed to get a sore back under
very suspicious circumstances. The RMH
orthopoedic surgeons discovered a 13th rib
to account for his symptoms — but we
suggest they didn't take a very careful
history!
After Christmas, we returned full of
happiness, only to be confronted by the
Pharmacy exam and the arrival of Ross
Winton. However, we battled on gamely.
At a certain ding at Brighton, Jim Wearing
Smooth demonstrated what a REAL
alcohol tolerance is like — "the trouble
with this party is there's not enough serious
drinking" — HURK (I never did —Ed.)
We still haven't found out who was responsible
for pushing Abdul over the cliff while
he was having a leak.
Pete Guy, the noted cloacologist and originator
of the joke about the elephant's fart,
woke up at RMH the morning after the
Med. Dinner, to find a blonde in the bed
beside him. Luckily, he realised before he
attacked that it was Ron Q. (4th year) —
also recovering.
"Mack", carrying on a dirty affair with
"Stinky", looks none the worse for wear.
We can't say the same for Stru, ("Whenever
I get drunk something awful happens") —
better get home quick, Wendy.
Naturally, the activity most popular
(besides the other one) is solo—practiced
every day to the strains of Alf's "haw haw"
and Ross' acromegalic antics.
Sandy must take the prize for pursuing
the greatest number of females. At the time
of going to press he is chasing one of the
pathological girls — which goes to show,
he does have a morbid interest in the subject.
"There can be no happiness within this
circle of flesh."—Sir Thomas Browne.
Either Don, John and Henry haven't read
these lines before, or are claiming workers'
compensation. Anyway, they are engaged
— congratulations, fellers.
So with only a few more glorious weeks
before the exams, its extract digitalis and
back to Payling Wright and Jawetz.
FOURTH YEAR
A, is for anderson a female she-masher;
B, is for bennetts a well-known spine basher;
and also for baird whom on since being wed
has removed his address to a large double
bed.
brown, burke and burr a trio so regal
congrats to you ian, now make it all legal,
mister bleakley, sweet denny, and boyum
miss c.
are the last (thank harry) of the packet
of b(s).
C, is for chan miss m, m, and 1
who dresses to kill and does very well,
and also for cocks that boy who plays rugger
and also for cooper (who mentioned that
b . . .r).
D's for de voogd who's become supercharged
he's spent all the year on becoming delarged.
F's for fitzpatrick miss j. d. i fear,
who certainly is miss take it from here.
G. is for goldstein whose thoughts of hard
yacka
are a bed, a bottle and a blonde for our
jacka.
H is for ham mister r. p. i wonder
if there's a car in this world that dick ain:t
been under,
and also for howell, a second don juan
at least he is learning, our versatile euan;
and jonathan also, that's our mister hurst
has read ovid and kinsey and now is quite
versed.
K (don't be filthy) can be only klug
an exponent indeed of the bed and the mug,
and also there's frank whose surname is
(wot the heck)
ah yes i remember, his surname is kopeck.
L is for leow and lipton and loh,
as quiet as they come not as quiet will
they go.
M is for madill miss b. j. and mathew

22 SPECULUM
and miss m. c., and melville (who looks like
a stathew)
also there's morley, mister a. a. — looks
ominous
we're certain it means alcoholics anonymous.
P is for pead and pohl and miss pickle
good old george has at last found out where
to tickle.
Q, have we got one? yes ronald the quirk,
a man who has worked out a good solid lurk.
R is for rogers old percy the stan,
marvellous what marriage can do for a man,
and also for rose mister p. n., it seems
got an oral infection from a rather damp
dream.
miss rubinstein too her name starts with R,
now that's enough chum we can't go too far.
S stands for scott, shen and st. john
they're willing and ready when anything's on,
and also there's sutherland, his riding's
improving,
when he turns the pedals those three wheels
are moving.
and syme too, there's talent in our little
rodney,
his feats of skill are quite extra-odney.
T stands for tung mister kenneth s. k.
W for wong, two beers and he'll pay.
Y is for yeung, I'm sure that he will bend,
and Z is for zoo where we'll all probably
end.
FIFTH YEAR
Once again the time for slander has
arrived.
We salute those who became engaged or
married, or who added to their progeny.
We also congratulate anyone who feels
that he (or she) deserves congratulation.
Unfortunately the exams are nearly upon
us, the lines are beginning to show beneath
our make-up, the solo "schools" are closing
down, but only a few are turning to Russian
roulette.
W.C., who has always been noted for the
fact that whenever duty or otherwise
keeps you back at the hospital after hours
he is there, too, now carries Cecil and Loeb
on his nocturnal rounds. For purposes of
identification for those who don't know
them, Cecil is the one in the middle.
G. M. startled us all when he asked the
Professor regarding complications of ganglion
blockers, whether "impotence was a
problem in females"!
Has anyone done a series? Only statistically
significant numberS will be accepted.
One of the older students reports that he
was having some trouble doing a pelvic in
G.O.P. The keen nurse who was standing
by came to his rescue by telling the patient,
"Just relax and take some deep breaths,
dear; imagine you are at the pictures."
Undoubtedly she had some continental film
in mind!
By the way, the latest thing in arterial
grafts acording to a usually unreliable
source is nylon underpants. We recommend
them for replacing the aortic bifurcation
in elephants, taking care to insert them
the right way up!
If certain students continue their idiosyncracies
one can expect on the first day of
"finals" that Alf. will be half an hour late,
Ken will insist he read that they were to be
held on top of the I.C.I. building, Gad. will
fall asleep, Oscar will ask at least one question,
Big Jim will compose a ditty, Boydie
& Co. will bring a pack of cards, and Les.
will bring a woman.
It is the writer's duty to share some tips
he has received. In medicine, there is
bound to be a question on one of the -oses,
or -itides, or possibly the -opathies.
In surgery, remember that tumours of the
left testicle are very much in the public eye.
A good obstetrical question is: Write an
essay on labour and the liberal obstetrician,
or vice versa, or just vice.
To bring up a cheerful point, contact with
the nursing staff has been maintained at the
traditional low level—one foot below the
umbilicus.
However, complaints have been made
that some chaps have been doing all the
work, so we extend a plea for a more even
distribution of weight on everyone's shoulders.
Finally, chaps, if you remember nothing
else, remember that passing flatus, if artful,
is always more rewarding than passing
exams!
*
There was a young lady of Trent,
Who said she knew what it meant
When men asked her to dine,
Gave her cocktails and wine,
She knew what it meant, but she went.

SPECULUM
83
ALFRED HOSPITAL
THIRD YEAR
FOURTH YEAR
After having survived the vicissitudes of
the pre-clinical years and escaped the
clutches of Sid, Pansy and Trik, eleven
students—the cream of the year—descend -
ed on this noble establishment like a fresh
epidemic of the plague.
After a very short stay (six weeks) we
bade farewell to "Our Lou" who has joined
the ranks of the pleasure-seekers by tripping
off to England.
However, the New Year saw another face
in our midst, when we welcomed Clive after
his sojourn in a far country wasting his substance
in riotous living among the scientists.
As though we are not already lacking in
females, Misses H. and H. have joined the
ranks of the "temporary Australians" by
procuring scooter bikes, "crash hats", and
all. There's been one "prang" already; a
ditch got in the way.
Hear our Bob has been bitten by the love
bug. His mates say he is really in a bad
way. Rumours have it he'll be making that
"first slip" very shortly.
Bert, on the other hand, is somewhat
frustrated; he can't remember a certain
nurse's name
Paul still holds the lead in the P.R. race,
having notched up seven unfortunate victims.
Understand Bob is close on his heels.
Peter distinguished himself by making
the trip to Perth with that select group of
men, the University Rifle Team. Shooting
was only an incidental, we hear.
You should have seen Bill's face when
the eye he had been carefully examining for
five minutes turned out to be glass.
Notable Quote:
C.R. at P.M. presentation, reading the
history: "On admission the patient was
SOB."
Dr. T.: "He was what? Sure you don't
mean short of breath?"
C.R.: "No, Sir; he was a bit neurotic
and was crying."
* *
It takes two to make a marriage—a single
daughter and an anxious mother.
Since passing the last big hurdle before
finals there has not been much of note to
report.
On the more serious side, the year seems
to be working at least as hard as Fourth '
Years in the past. On the lighter side, there
was a social at the end of last year which
was enjoyed by all, some more than others.
This was followed by the Alfred Hospital
float in the Caulfield Centenary procession
—all there is to comment on this is the fact
that both the spectators and participants
enjoyed themselves to the full.
As regards the matrimonial aspects of
our Year, our only event was the marriage
of Gabriell Medley to Mr. Stern—we offer
our sincere congratulations to them both.
There have been no engagements to report,
but perhaps by this time next year a few
more may have bid farewell to freedom.
FIFTH YEAR
After the discovery that these notes are
more widely read than we ever suspected,
it might be a good idea to tone them down
a bit this year. Actually, that shouldn't be
too hard, as a more righteous, hard-working
mob can hardly be imagined. However,
there always seem to be a few bright sparks
who can be relied upon to provide a little
entertainment.
"Never-a-dull-moment" Don has continued
on his merry way and invariably en--
livened proceedings at R.W.H. mealtimes
by disturbing someone and eventually
dirtying the tablecloth. Pity he's a light
sleeper; he would have looked a real dasher
with his moustache decorated with Bonney,'s
blue.
As always, the Tuesday clinico-path. sessions
provide us with lively comment. At
one of these the well-beloved Brian H.
leered at Doreen and said, "What do you
thing about that, DEAR"? Reply by male
voice on left, "Well, I don't . . . ." (drowned
by laughter). Just goes to show what married
life does to a bloke. The owner of the

84 SPECULUM
aforesaid voice, by the way, brought his wife
along to a certain out-patient physician's
clinic for investigation and treatment. It
looked as if she may have had a serious
disease and she was admitted for a fortnight.
Investigations threw no light on her
condition. Things looked grim. Four
weeks after discharge (from hospital, that is)
it was discovered that she was pregnant ,
George "won friends for himself" when
quizzed at The Kids'.
Dr. "Bunny" Neal: "What is the prognosis
in cases of Wilm's tumour?"
George: "If they're treated at this hospital
the mortality is 100 per cent."
Highlight of the lectures at the Women's
was "Bung's" classic: • "Remember, chaps,
always be on the ball; in fact, be on both if
you can." Rather appropriate after his
previous. effort in telling of climbing over
his wire grille at night and the possibilities
if one slipped.
While on the subject of The Women's, we
should mention Fred's faux pas. His habit
of hesitating when half way through a
NIALL 8eCOGHLAN
PTY.
Medical Agents
Practices Transferred
Partnerships Arranged
Locum Tenens Provided
127 COLLINS STREET
MELBOURNE
*
Phone MF 1983
DIREcTORS
M. D. COGHLAN R. H. VAN ASSCHE
word had rather uproarious repercussions
at a tute one night. The word was "routinely",
and then he couldn't stop laughing for
five minutes after he'd realised the magnitude
of his question. Ever find out, Fred?
These notes wouldn't he complete unless
we mentioned that without doubt
"Ronny" Barassi must be the greatest
player ever to pull on a football boot.
Heaven help us all if the "Demons" win the
flag!
Now a word or two of congratulations.
To Don and Dave, who cleaned up the
rest of the field to take first and second prize
money respectively in the "Edgar Rouse
Prize in Industrial Medicine 1957";
To Jack (our boy from the "Home of
Science") and wife—a bouncing male Australian
citizen;
To Stew, on prospective fatherhood;
To Brian, for taking the plunge into
matrimony;
To Meggs on his engagement to a physio.
To Man (God help him), on his engagement
to a labour ward Sister;
To "Simmo" for his ability to dodge
any of the above catastrophes;
and finally,
To the whole lot of us for being so dumb
as to have the "Harry Hindlip Green
Scholarship" declared a "no contest".
Let's hope we can improve sufficiently
over the next few weeks to pull the wool
over the examiners' eyes and all wind up
with the glorious, long-awaited M.B. B.S.
A fellow we know got a broken arm fighting
for a woman' honor.
It would seem she wanted to keep it.
RESEARCH
AND THE MEDICAL PROFESSION
The original British isolation of
vitamin B12 was achieved in 1948 by
E. Lester Smith working in the
Glaxo Research Laboratories. Since
that date it has been available to the
medical profession as Cytamen for
parenteral use and Cytacon for oral
administration.
CYTAMEN INJECTIONS
in five potencies.
CYTACON
Liquid and Tablets

SPECULUM 85
THIRD YEAR
ST. VINCENT'S HOSPITAL
1. 26 hand-picked students and George
arrived stary-eyed at St. V.'s, and obeying
the injunction of one far more senior than
they that "This is the last . . . holiday you
will ever have," quickly settled down to a
varied programme of solo, picnic races and
the Carlton Club Hotel.
2. At this stage George was already investigating
the raptures of astrocytomata,
Raynaud's disease and disseminated lupus.
3. It was about this time, too, that we
noticed amongst our number from time to
time two errant characters named, it is believed,
"Dave and Sandy" (or is it Mabel?).
However, we have on good authority that
their meanderings are not entirely confined
to St. V.'s.
4. Congrats to Vip on his engagement.
As Sprog said on the beloved one's departure
for Thailand, "He's a better man
than I if he can stay away from it for three
years."
5. On this same distasteful subject we
noted that there was a rush by our more
advanced mating couples to see "April
Love". We also noted that Val kept herself
strictly dissociated with this manoeuvre.
6. As the year progressed several "swivel
heads" made their presence felt in clinics
and elsewhere, and one nurse (dear girl)
was heard to mutter, "They just about drive
me up the wall."
7. C.W. (the boy from the Apple Isle),
developed a rare skill for emitting a continuous
stream of, to say the least, doubtful
comments just out of earshot of the clinician
though, let it be placed on record, one was
heard to say as the said gentleman sprawled
disgustedly at the foot of the bed, "Mr. G.
seems to have lost all of his faculties except
speech."
8. T.J. (Skinny alias Grumpy), perhaps
our keenest student, nevertheless managed
to hide all beneath a scowling bleak
exterior.
9. And now for some gems heard around
and about.
Zealous student, to dear old lady: "And
what was the nature of your previous
lesion?"
Again, to another D.O.L. (in extremus):
"Have you had a heart attack lately?"
10. Finally, as the exams draw near we
note that L.J. has at last managed to draw
himself away from the magic cards to deliver
his maiden case history! !—Congrats
on a truly mighty performance.
FOURTH YEAR
Despite dire prognostications and examination
obstacles, our Year remains intact
and flourishing in exam-free Div. III. These
notes are not intended to libel, but rather
entertain and inform the future medical
student historian perusing through "Speculum"
of the dubious activities of his predecessors.
Who will believe when Tom is a revered
practitioner that he did not enter a "boozer"
for the first six months of his married life,
or in his youth, that "MOOF" won the
Intervarsity Golf Title of Australia? In his
age will Denis be remembered as an agile
footballer with more retirements than
Melba? Will Kevin be recognised as doing
pioneer work in placing the MANIA A
POTU syndrome on a firm clinical footing?
As we become fat and , bald, will the
members of our Year be remembered or,
in fact, discredited, if they claim, like
Hodge, that they once compered Medleys,
attended Med. dinners and other frivolous
activities?
Enough of pandering to posterity, and
back to the present. Eric and Frank have
placed rings on the most important finger
of a girl's left hand—congratulations. Stan
and Barry are proud fathers (we admit only
of baby cars) and some of our number even
include diagnostic sets amongst their possessions.
Commiserations with Paul—he contracted
rubella at Bulla, dysentery at Lorne,
and a sub-arachnoid from Intervarsity
Rugby—going to give the game up, too, we
hear. Jack maintains that he did pronounce
cupola without getting mixed up, and Norm
does not disclose what his specific illness
was (oops! sorry, he has not specifically said
what his illness was in spite of Denis'
theories.) Sympathy also to Anne, the most
popular girl (ref., "Speculum" 1957). The

Aillr"°44
86 SPECULUM
old perineals, Kevin and Marro, are maintaining
the average rate of beer consumption
and themselves in penury, whilst if you
want a quiet game of solo contact Adrian
and Peter any time; Dennis would also play
if you knew where he was.
Any time now, and off to The Kids' and
The Women's, and with tutorials, a forensic
exam, and lots to be yet done in extracurricular
activities, we will soon be finishing
the only year in the medical course
worth repeating, but the only one which is
impossible to repeat. Harking forward to
posterity again, we can categorically say
that the lads not mentioned in these notes
either did irreputable deeds, or were so
quiet about them that none was informed
of their enormity.
Not tonight, Josephine?
DOING FINALS ?
Then arrange to receive
SPECULUM
in future years and keep
in touch!
See your Year Representative
FIFTH YEAR
All members of this Year's group have
their hearts set on great achievements, like
those of their predecessors. Congratulations
to Tony Capes on getting into the Australian
Amateur Football team, and also to
"Tennis Player" Jack Fraser on reaching
the final of the Victorian hardcourts title.
In other fields of sport we would like to congratulate
Jim Cummins and Graham Oliver
on their engagements. Also time must be
running out fast for Bernie "Caruso"
Clarke and Dave Lunn, unless they, too,
run out. Paul McKenna and Eugene
Spangaro should also rate a mention for
achievements in this particular field.
Congratulations to Julian Heinze for his
champion crop of boils. That big one
under the right arm must have been a
handicap when at the Balls. A pat on the
back for Helene Wood has already been
administered with a rubber stamp, but we
must frown on Lorraine Briggs' use of the
men's shower at The Women's. Wendy
Donohue and her friends Kathy Hayes and
Betty Lenaghan, are reported to have been
weaving something or other.
In the academic field some of our members
have used themselves as guinea pigs
for the sake of science. Consequently Bob
Molmar produced a prize-winning Psychiatry
Essay, and Don McDonal and Don
Brodie contributed the "P-O-P Syndrome".
Mario "Misere" Marchesani is setting a hot
pace for the attendance prize, and Alan Ng
is the man to ask if you want to known
where the library is. Aubrey Moss is being
pursued by the post-grads, who wish to
know more about Osler's Disease.
We all appreciate Joe Xipell's benevolent
presence, particularly when extolling the
virtues of our more noteworthy teachers.
Frank Spillane deserves an Oscar for the
masterful job he did with the fire extinguisher
at The Women's. Mok and Yeung have
no opposition now as our table tennis
champions, and Eric Doenau still mystifies
us with his strange eating habits. For the
most sociable member of our group, the
prize must go to the man with the M.G. and
the famous blue cardigan. In view of possible
repercussions, the author of this great
literary work will remain annonymous.
t
z

SPECULUM 87
PRINCE HENRY'S HOSPITAL
THIRD YEAR
"And the gates were thrown open and
the hordes entered through the portals and
stared in bewilderment at what lay before
them."—"Revelations."
Twenty-five wary and apprehensive students
finally threw off the yoke of Anatomy
and Physiology, and entered into a realm of
X-rays, sigmoidoscopes, solo and plessors.
(I've got the big one.) Our congrats. to Sol.
Levine, who took the whole thing to heart
and rushed off and got married.
We would be the quietest, most conscientious
group of students ever to give clinicians
grey hair. At lunch time, in our penthouse
on the eleventh floor (you'll be in
your new quarters by December), the only
sounds heard are the shrieks from the
Trainee demons playing their lunch-time
games in the police barracks, and the patter
of little feet as the prostatic liftmen trot
back and forth between the lifts and the
Men's! There's no solo, no grog, no
nuthin!—they've even pinched the pick-up
head from our new radiogram.
Our thanks must go to Starch and Cynth,
for organising the first term dance—it exceeded
all expectations (you'll be in your
new quarters by May). Starchy's mates
from the bush churned out the music, composed
from two dozen of the oldest and the
best.
Some of the boys have exploited the Bulk
store in Wells Street. Col. Abery (Root!)
has established himself a nice charming
morsel. Arthur (Bugle) Steele ("A" Company,
that is) gave it a slight nudge, but he
didn't push quite hard enough. (Hark! —
I hear Rockets on the range). Starchy,
between being an actor (mind my tiara,
darling) and supporting the bookmakers,
has been slipping in and out of the tunnel
at odd and interesting hours. (You'll be
in your new quarters in July.)
Clinician, handing Starchy an X-ray of
an I.V.P.-
"What do you see there?"
Starchy, after much consideration and a
thoughtful look "There's something wrong
with the oesophogus!" (It was upside down,
anyway).
Hap. (I got the Humber last night)
Webster has all the clinical signs and
symptoms of the chronic Burwood Syndrome.
Shag Phillips has been moving
among the local Florence Nightingmares
with some notable successes. (And Russian
Balls to you, too). We might move into
our new quarters by 1959.
Someone:— "What's ergometrine meleate
used for?"
Beryl:—"Oh, that causes babies, doesn't
it?" — Beryl, you're in for a big fright one
of these days. Cynthia is preoccupied with
— he's at the same hospital, and Jenny,
— well, — no one's quite sure. Tom and
Nick are getting more playful (-?), and
Rachael does not use her white coat for
catching tadpoles on Sundays! (You'll be
in your new quarters by 2000 A.D.)
Something should be said for our clinicians
— trouble is, no one's game enough
to say it. (They could have their fundi
checked, though.)
One last question. If a liftman goes 284
times a day, and Col. has beaten Hap 1248
times at table tennis, and Arthur cleaned his
car once a week, and Rachael arrived early
for o P.M., and Dave stopped smoking
horse and the chauffered lifts came as far as
the eleventh floor, and Johnny Wolstenholme
smoked something others could take when
he handed it around, and they stopped scrubbing
our passage at Thursday lunchtime,
when are we going into our new quarters??
FOURTH YEAR
At the beginning of this year, we departed
in two halves, to the Women's and Children's.
At the Women's, Joe spent his time
making cats pregnant, Fergie, as usual,
played the role of the invisible man, Hymie
was his usual schitzophrenic self, Maude
knew the lot, and Don was the strong silent
type.
Meanwhile, at the Children's, the four
solo players, played on and found little in
the place to their satisfaction. Lloyd was
even quoted as saying "they can't teach me
a thing, I knew as much before I came here

88 SPECULUM
as I do now" (nothing). Two of our members
had to see the Dean after "wrecking
Frankston Orthopoedic". (It's just as well we
didn't really let our hair down).
After three months, we reversed positions,
and each respective group was happier
with the change.
At the Women's the four solo players
changed to all night pontoon schools punctuated
by odd sorties into the labour wards
to satisfy either S.L.T. or the labour ward
sister (who were often given satisfaction
elsewhere, perhaps more expertly by our
friends from the Alfred).
One of the highlights was, perhaps, S.L.T's
embarrassment on jumping out of a lift full
of students to abuse two white clad figures
only to find out they were male physios. The
prof. apparently thought that he had found
two of the gang who had successfully eluded
him for five weeks.
At the closing party , things got a little
rough and one of the four solo players
became the first male adult patient treated
in Emergency at the Women's Hospital.
Now back at Prince Henry's we are settling
down to some solid work. In conclusion,
we would like to offer congratulations to
Lloyd and Maurie on getting engaged.
A young man on his first date with a
rather flat chested maiden, started to get
fresh.
"Here, here," she said
"Where, where?" he said.
* * *
Boy, was he mad at his wife. He turned
her across his lap, raised her dress, lifted his
spanking hand . . . and forgot what he was
mad about.
Radiological Media
by G laxo
DIONOSIL
MYODIL
PHENIODOL
PYELOSIL
PYELECTAN
bronchography
myelography
cholecystography
Inj. diodone B.P.
Inj. idodoxyl B.P.
FIFTH YEAR
The class notes every year to scribble
A willing soul one has to find,
In 'final year' who's got the time
To write these flamin' things in rhyme.
Well here goes, just once again
To speak a little of mice and men,
A little bit of that and this
If you don't read the rest you'll nothing
miss.
Now some words about the work
To say the least it could drive you berserk.
Gynae. and Surg., 'Stets and Med.
How will I ever get it all into my head?
Forsenic Med. we have mastered.
What to do with alcoholics, plastered.
Arson, vice, crime and sin
Who was that who said that he enjoyed
Gin?
We've been to the "Women's" and we've
been to the "Kid's"
And we've also been out in G.P.,
But glad were we all when we did return
To see the new Radiogram at Prince
Henry.
Presentation of cases, has become second
nature
Adept we have been at this game.
Inspection, palpitation, percussion and listen
All over the world its the same.
Tradition has it, that in year notes we write
Every name in the group of distinction,
But they are nine staunch and true, and I
can't separate them for you,
So the lot I will forthwith now mention.
Y. L. LEE and LEON C.,
And PHIL. and PETER and TONY.
Then there's MAX and there's KEN, and
two more mighty men,
By the names of DAVID and BARRY.
In closing we'll say "Good Luck" to Prince
Henry's,
Some solo and beer for St. V's,
Hurrah, for Lorraine and her lolly-legs too
And a wish to you all that these exams
we get through!

SPECULUM 89
spicula
Surgeon, to patient with fistula in ano:
"How did you get this, my man?"
Patient: "I think it must have been affection,
Doc."
* * *
". . . the U.S.S.R. is (next to the U.S.)
incomparably the greatest suppository in the
world."—"The Herald."
* * *
THIS ACTUALLY HAPPENED—
Last year's "SPECULUM" carried an
article on the OS PENIS.
Young med. girl saw the name, wondered,
and then commented: "I didn't know
that they came in sizes!"
* * *
"THE SUN," 21/6/58—
Mr. Gary Cooper, a lively 57, complains
that he is not getting enough.
*
Recent Schoolteachers' Conference: Adolescents
shouldn't date before they are 16.
Sweet young Physio to Med. 1 Male:
"You are your great long coccyx!"
*
There was a young lady called Fozzet,
Who paid 2d. to go to a closet,
When she got there,
She only passed air,
It wasn't worth it—was it?
* * *
Thomas A'Beckett must have led a very
dissipatld life—three nights killed him.
* * *
"SUN," 21/7/58:
JAI' SEAMEN RADIOACTIVE?
Up as atom!
* * *
"GET THE THUMBS UP AGAIN"
—Adelaide daily.
* *
Young med. bloke to female member of
clergy: "May I kiss you?"
"Yes, so long as you don't get into the
habit".
* * *
Pathology practical class:
R. W.: "I didn't think surgeons ever
masqueraded as pathologists"
Mr. K. Br--ly : "We prostitute ourselves
sometimes, old man!"
* * *
Pansy : "For one who never knows what
she wants, my wife's surprisingly adept at
getting it."

90 SPECULUM
From Dr. Alan F. Guttmacher's book
"Having a Baby" —
"Injections are begun when labour is well
established and are continued until after
delivery. Caudal anaesthesia sounds like
the answer to a maiden's prayer ... "
* * *
She was only a fisherman's daughter,
that's why she kept saying fillet.
* * *
PATIENT : "That's not P.R. Doctor."
DOCTOR : "No madam This isn't a
thermometer."
She was only a woodcutter's daughter,
that's why she gave all the boys circular
saws.
• *
When taking a young nurse out one
should always enquire:
B4iVu 18 ?
ru
* * *
PANSY : "When a police siren is heard
down in Alexandra avenue in the early hours
of the morning, biological material parts
company"
* * *
PANSY AGAIN : " . . . and that's why
Australian girls like American sailors —
can get blood but not tissue".
* * *
Person who thought that intercourse was
a ticket to the races.
Two eggs boiling in a saucepan:
1st: In three minutes I'll be done.
2nd: Don't be silly—it takes me four
minutes to get hard.
"Have you heard what happened to
Harry? Wasn't he engaged to a contortionist?"
"Yes, poor chap; she broke it off."
• * *
Did you hear about the cannibal who
passed his friend in the desert?
* * *
Conversation piece in Labour Ward:
"At your Cervix, ma'am."
"I am dilated to meet you."
* * *
He was only an endocrinologist's assistant,
but he could make a hormone.
* * *
CONFUCIUS :
A cow give milk, a cow give whey,
Woman give way, give milk, too.
Woman give no way—she cow.
* * *
The perverted swan.—He spend his time
looking on the river for cygnet rings.
* * *
Two little rabbits hopping down lane—
one of them stopped and the other hopped
on.
* * *
Modern Dancing:
without casualties.
Naval engagement
A
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SPECULUM 91
Gallup pole clerk visiting Mexican housewife,
with dozens of children with a high
percentage of duplicates:
"Do you always have triplets and twins,
Signora?"
She gravely replied that, many times she
had nothing at all.
* * *
Pity the elephant who has a miscarriage
after 23 months.
*
Tutor, demonstrating a scrotal swelling:
"Right, who's to set the ball rolling by
examining this first?"
* * *
A Fourth Year thought the causative
organism of gonorrhoea was Koch's bacillus.
* * *
Lecturer on Hypospadius: "There's no
need to do a plastic operation when the
urethral opening is near the base of the
glans; after all, you don't have to gild the
lily."
As a physio. staggered out of her examination
a nearby Med. Student remarked:
"Looks as though she satisfied her examiner!"
* * *
And then there was the bright young
thing who wouldn't travel underground because
she was afraid of tubal pregnancies.
* * *
Abortion: From Papua and New Guinea
Medical Journal.
The practice of abortion is not uncommon,
the instrument used is the stalk of a
small plant, stripped of bark, the tip being
rubbed with a species of onion or ginger
plant. The same plant is believed by the
Natives* to be efficacious as an oral abortifacient.
The death of six women over the last
thirty years is attributed the complications
arising out of this practice.
*NATIVES—the inhabitants of Omu, a
Papuan Highland Village.
* * *
Woman at Gynaecology: "My husband
always wants to be on top."
Did you hear of the dear old soul who
denied ever having a pelvic examination,
but who confessed that her doctor performed
a digitalis examination on her? No doubt
he used a foxglove.
* * *
The Bishop said that in most circumstances
adultery should be condomed.
—Newspaper report.
* * *
At a Gynae Clinic—
Stud: "Sir, is it true that in every packet
of twelve quondongs, one is a dud?"
Tutor: "Good heavens, boy—that's a
fruit."
FRUITS OF LOVE, NO DOUBT.
* * *
Then there was the W.R.A.A.C. who
was given a medical discharge because she
was hit by a guided muscle.
* * *
An Eccentric Architect: A gentleman who
has his house made upside down.
* * *
Heard during a conversation on contraception:
"We'll get on all right—my wife's got it all
sewn up!"
* * *
Kept Woman: One who wears mink all
day and fox all night.
* * *
There was general assent when the immunology
lecturer suggested we should use
prophylactic covers more often.
* * *
Wally had a little mump,
His neck was large and tender,
He did not think so small a lump
Would rob him of his gender.
* * *
He was chewing on a splinter of wood
and watching the moon come up lazily out
of the cemetery in which nine of his daughters
were lying, only two of whom were
dead.
—From "Let Your Mind Alone,"
by James Thurber.

92 SPECULUM
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Telephones: JA2197, JA2198

SPECULUM
93
After a man finds out that a woman is
no angel, he tries to find out to what extent
she isn't.
* *
Lost and Found:
Lost: One letter from a French Pen-
Friend.
* * *
"What color are violets?"
"She doesn't wear any."
* * *
Many a tight nut has been loosened by
a small wench.
* * *
Overcome by gas while in her bath, she
owed her life to the watchfulness of the
Janitor.
* * *
She knows what Reggie did,
But not where Reggie went,
She isn't even sure
In fact, what Regiment.
* * *
Some girls like a man with a future,
other girls prefer a man with a past, but
there never was a girl who could resist a
man with a present.
* * *
Heard about the Nudist?
She was reprimanded because she was
getting a bit over the fence.
* * *
Heard about the Monk who was excommunicated
because he had a dirty habit?
* * *
THE MAN HIMSELF (P. R. Guy) at
Medleys: "I have my eye on a strapless
gown that can't possibly last another
Samba."
* * *
And then there was the bloke who played
the Fallopian Tube in the Gubernacular
Band.
* * *
Dr. Hicks: One must look at vital statistics
from a face value of what MAY be
present and not what is present.
—It's all in the mind.
Ad. in Daily: If it's long and slim, it's the
fashion, Sir. * *
Prof. H.: Spontaneous pneumothorax
may come about by sexual intercourse or
cranking a car.
* * *
Mr. H.: A differential diagnosis of
chronic appendicitis is coitus interruptus.
* * *
Shampoo—pile of sawdust behind a rocking
horse.
* * *
Good mornings begin with curette.
* * *
Dr. Wh-t-, on Adenovirus group tissue
cultures:
"In 1952, a girl called Helen Lane had
a cervix biopsy. These cells were found to
be carcinomatous, and no doubt today
Helen would have been rather embarrased
to learn that her cervix is represented in
practically every diagnostic laboratory
throughout the world."
* * *
Prof. R-bb- : "There is no means of birth
control among the rat population."
CURATTE?
* * *
Clinician: "What is the cause of vaginal
obstruction?"
J.S.: "Fat embolism, Sir."
* * *
Telephone rang in the mortuary at
R.M.H.; S.S. answered.
Voice: "I want a vagina and uterus, but
no ovaries."
S.S.: "WHO DOESN'T!"
* * *
Dr. Nestel: "Mr. McKenzie, how would
you feel for a thrill?"
Mac.: Oh, you need a nurse for that, Sir."
* * *
Dr. G-b-l: "I get a distinct thrill in the
pulmonary area of this lass."
* * *
"SUN":
"1, 2, 3 . . . then Prince got it!!!"

94 SPECULUM
I know women who're thin,
I know women who're stout,
But oh, what women would I know,
If I left the apostrophe out!
The V.I.P. rose to make the key speech
of the evening.
"I came near to not being here tonight.
I got out of a sick bed to' be with you. My
secretary, poor girl, hasn't been feeling, well
for some time."
*
Feminine Voice (from a parked car):
"What were you drinking tonight—rubbing
alcohol?"
* * *
Mama, Mama, don't wait for the shrimp
boats,
Sister is coming home with the crabs.
* * *
NEWS FLASH: A girl tried to commit
suicide last night—she jumped under a fast
mail.
* * *
Sonny: Pop, what's an optimist?
Father: An optimist is a man who thinks
his wife has quit smoking cigarettes when
he finds cigar butts in the house.
She was only the Sergeant's daughter, but
she knew when to call a halt.
* * *
Harry: "Say, what's the idea of that man
committing suicide?
Bob: "He just heard Bing Crosby singing
'There'll never be another you'."
CORLAN
(hydrocortisone hemisuccinate)
PELLETS
A NAME TO REMEMBER FOR
THE TREATMENT OF
APHTHOUS ULCERS
Another product of the
GLAXO LABORATORIES
A patrol car came up and flashed a light
into the parked car.
"No parking; you can't loaf along here,"
he said.
"Do I look as if I'm loafing?" came the
reply.
* * *
Voice on the 'phone: "How do you feel
this morning?"
Lady: "Fine, thanks."
Voice: "Must have the wrong number."
* * *
Old Time Mosquito: "And to think when
I was young, I could only bite girls on the
hands and face."
* * *
She was just a second-hand dealer's
daughter, and that's why she wouldn't allow
much on the old sofa.
*
Garters, brassieres and highwaymen are
all in the same business—but at different
places.
* * *
A woman finally found that she could get
a divorce from her husband because of flat
feet—his feet were in the wrong flat.
* * *
They sat side by side in the moonlight.
She murmured as she smoothed his brow,
"Darling, I know my life's been fast, but I'm
on my last lap now."
* * *
He: "Please."
She: "No."
He: "Just this once."
She: "No, I said."
He: "Aw, hell, Mum—all the rest of the
kids go barefoot."
* * *
When does a pullet become a hen?
When she loses her first foot race.
* * *
Mrs. H. was granted a divorce when she
testified that since she and her husband
were married, he had spoken to her but
three times. She was awarded the custody
of their three children. A BLOKE LIKE
THAT SHOULD GET A MEDAL!

SPECULUM 95
e
y
Girl's voice heard during a blackout:
"Take your hand off my leg! No, not you
. . . YOU."
She: "Do you want to see where I was
operated on?"
He (eagerly): "Yes!"
She: "Well, we're just two streets from
the Hospital."
* * *
For Sale, Two Alsatian Puppies, Prize
winning parents—BOTH MALES.
J. S.: "What actually is a venereal disease,
sir?"
Dr. T.: "A disease contracted pursuing
the avocations of Venus."
* * *
Dr. T. on the pathology of the female
reproductive system: "I'm not at all familiar
with this field"— and the man's married!
* * *
Pathology Notes : Penis: Early circumcision
is a good prophylactic.
???
* * * * * *
A girl doesn't need a speedometer to
know what her boyfriend is driving at.
The girl who knows all the answers learnt
them from going around with the fellows
who ask all the questions.
* * *
FROM A DIARY.—Up at 8. Felt a
little seasick, so took two pills. Passed an
iceberg at 10.
THESE MODERN PURGES!
* * *
Old Lady: "I suppose you and your husband
worry a lot because you don't have
any children after having been married three
years."
Young Lady: "Oh, yes. We've spent
many a sleepless night because of it."
* * *
A married couple were sleeping peacefully
when the wife suddenly shouted out
in her sleep. "Good heavens! My husband!"
The husband, waking suddenly, jumped
out of the window.
* * *
Heard in a blackout: "These zippers save
a lot of time."
* * *
She was only a butcher's daughter, but
oh, what calves!
* * *
Parked outside the Women's Hospital:
van with sign on top announcing "Speedy
Delivery".
Prof. R. on epidemiology:
"Anti-natal care is an application of prevention."
* * *
A medical survey made several years ago
in Melbourne set out to determine why men
get up in the middle of the night.
ONLY 2.4 per cent. had an evacuation
problem.
A MERE 1.6 per cent. prowled the refrigerator
for the midnight snack,
BUT THE OTHER 96 PER CENT.
GOT UP TO GO HOME.
* * *
Little nips of whisky,
Little nips of gin,
Make the ladies wonder,
WHERE THE HELL THEY'VE BIN.
* * *
She was only a telegraphist's daughters,
but how she DIDIT, DIDIT, DIDIT.
* * *
I'm going to have a little one,
Said the nurse so gay and frisky,
But the med-stude upped and fainted,
BEFORE HE KNEW THAT SHE
MEANT WHISKY.
* * *
I like blondes platinum,
With fatinum,
For patinum.
* *
A formal old girl called Wisteria,
Once fell in a fit of hysteria,
When a man in besottage,
Got into her cottage,
And stained her Victorian Interior.

96 SPECULUM
Phthirus pubis infestation: "Crabs", or
the patter of little feet over the private
parts.
*
• *
Then there was the disillusioned nurse
at The Women's who decided to do midwifery
the practical way—find a man and
wait nine months.
* *
*
The poor nurse wasn't very bright. She
always got things back to front. Sister gave
out her orders and returned later to find the
patient writhing in agony.
"Please, Nurse, I said to prick the
patient's boil."
* * *
Newly wed honeymooning in Katoomba
wired his boss: "Please grant extension on
holiday. It is wonderful here."
Boss wired back: "Return at once. It's
wonderful anywhere."
Confucius he say:
(1) Boy and girl go camping together
sure to have naughty intent.
(2) Girl sit on jockey's knee and get hot
tip.
(3) Girl runs faster with pants up than
man with pants down.
* *
*
Some men are bachelors because they
failed to clutch their opportunity.
* * *
Overheard at Royal Park:
"I feel so bad I often think of killing myself."
"Now, now, you leave that to us."
* * *
Patient: "I'm thirsty."
Nurse: "I'll bring you a glass of water."
Patient: "I said thirsty—not dirty."
*
"Changing a tyre?"
"No, I just get out every few miles and
jack up the car to give it a rest."
* * *
Nurse: "Do you know what they're saying
about me?"
R.Q.: "Yeah, that's why I came over."
Visitor: "Where are the monkeys?"
Zoo Keeper: "In the back making love."
Visitor: "Would they come out for peanuts?"
Zoo Keeper: "Would you?"
* * *
The father of a student in Casualty paid
his son a surprise visit at 1 a.m. He banged
on the Students' Quarters' door. A voice
from the window above yelled: "What d'ya
want?"
"Does Will Carter live here?"
A tired voice answered: "Yeah, dump
him on the porch."
* *
*
Mark Antony: "I want to see Cleopatra."
Servant: "She's in bed with laryngitis."
Mark Antony: "Damn those Greeks."
* * *
Jack be nimble,
Jack be quick,
Jack jumped over the .. .
Jack walks differently now.
* * *
"But that's not our baby."
"Shut up; it's a better pram, isn't it?"
* * *
"What do you do all day?"
"Hunt and drink."
"What do you hunt?"
"Drink."
* *
*
Doc.: "Do you dribble at all?"
Patient: "Half and half."
Doc.: "Oh! Half on one shoe and half on
the other."
From a Case History at The Women's:
"Not particularly bright—quite likes it."
* * *
In the days of good Queen Bess 'tis said
some of the ladies liked to curl up with a
good book, whereas others used to prefer
to curl up with one of the pages.
* * *
Parked car, moonlight night, AND
ABDUL.
"Goodness, it's three o'clock. I should
have been in hours ago!"
"So should I," he said disgustedly.

SPECULUM
97
Is it true that storks bring babies, or is
it just poppycock?
* * *
The weatherman's wife says he's not
hitting it as often as he used to!
* * *
Petting Polly says it's fun to fight about a
kiss—but it's much more fun to take it
lying down.
* * *
The newlywed wanted to fly UNITED,
but the hostess objected.
* * *
There once was a man from France,
Who waited ten years for the chance,
HE MUFFED IT.
Sign in Nudist Colony: Gentlemen playing
leapfrog—please complete your leaps.
* *
Prof. R.: Then you get someone that's
not sterile—like a nurse
* *
*
Mr. Newlywed: "How are we going to
kiss goodbye over the telephone?"
Mrs. Newlywed: "You kiss your end and
I'll kiss mine."
* * *
Dr. P-t-r: "Old fellows that work a lot
get hyperkeratotic lesions."
* * *
Highball: An undescended testis.
* * *
In a discussion on Sex: I'll tell you when
I've got a bit more nymphomation.
* * *
46 . • .and you find that if you go through
a bunch of women . . . in an ante-natal
clinic . . ."—Lance.
*
D. Mac.: "Periods can be very erratic.
They may be anything from 20 to 40 days
—or more."
Bill Morcom: "I know—I haven't had
one for 22 years!"
*
Falsies: The bust that money can buy.
Prof. W.: "I'm not feeling like contraception
right now."
* * *
Prof. T.: "After the end of each menstrual
cycle, we begin again with a clean
sheet."
* * *
"What is a lingula copula?"
"The root of the tongue, I suppose."
• * *
A girl can be very sweet when she wants.
* * *
Girls with hiccoughs,
Seldom are piccoughs.
* * *
He took his girl out into the night air
and mist.
* * *
Have you heard of the lawyer who sat up
all night trying to break the widow's will?
* * *
"Swell party tonight."
"Yeah, I'd ask you for the next dance,
but all the cars are taken."
*
She got her fur coat on time, and boy,
what a time.
*
Then there was the sculptor who put his
model to bed and chiselled on his wife.
* * *
"I bet that man was embarrased when
you caught him looking over the trousseau."
"Gosh, yes. I thought he'd never get
over it."
* * *
Hotel Manager: "Did you find any of our
towels in that man's suitcase?"
Hotel Detective: "No, but I found a
chambermaid in his grip!"
* * *
SUGGESTIVE:
A clever hotel manager had the bridal
suite done in wallpaper with an interlocking
design.

98 SPECULUM
TOUGHE!
A young medical student about town approached
a news stall counter, behind which
stood a cute young thing, and said: "Do you
keep stationery?"
Replied the cute young thing: "Yes, up to
a certain point—then I go all to pieces."
* * *
Some men believe,
That Eve
Didn't need such a big leaf
As a fig leaf.
* * *
There is some co-operation between wild
creatures; the stork and the wolf usually
work in the same neighborhood.
*
Familiarity may breed contempt, but as
the old maid said, a certain amount of
familiarity is necessary to breed anything.
A. Wall: "In one man I had two fingers
in his ring."
Mr. Webb: "That would have been an exceptional
experience for both of you, I
should imagine."
Nads: "Did she blush when her shoulder
strap broke?"
Trey.: "I didn't notice."
* * *
One psychoanalyst to another: "You feel
fine; how do I feel?"
You hesitate if you should take a wife,
Do as your father did, stay single.
* * *
An old maid is a YES girl who never had
chance to talk.
* * * Birth control—something you wish for on
a ship when you are seasick.
* * *
Mary had a little drink,
It looked as pure as water,
But Oh, the things that Mary did,
She shouldn't really oughter!
Then there was the golfer who used to
keep golf tees in his glovebox to rest
his balls on whilst driving.
* * * * * *
I smoked my first cigarette and kissed my
first woman on the same day. I have never
had time for tobacco since.
—Toscanini.
* * *
National News:
. . . In the Legislative Assembly today,
the leader of the State Opposition, Mr. S.,
moved a motion. The Premier, Mr. B.,
said he was amazed at Mr. S's. action!
There was a young man named McLeod,
Was caressing his girl in a crowd,
When a man up in front
Said, "Take your hand off the fence,"
Just like that—right out loud.
Heard about the girl who preferred men
to liquor?
* * *
Jack Legge in biochem lecture:
"People with diabetes are unable to
handle their fats in the manner to
which they are accustomed."
*
Tony Sahhar, Div. II, claims:
"The striate arteries are the most common
site of cerebral haemorrhoids!"
Undoubtedly he also thinks the perineal
body is his third eye.
• Frustrated husband — his wife had
gonorrhoea, diarrhoea and pyorrhoea.

SPECULUM 99
What would you do if a girl came up and
kissed you?
Kiss her back.
What if she was a tall girl?
Mirandy: "Silas, tomorrow is our 50th
wedding anniversary. What shall we do?"
Silas: "Let's celibate."
*
What is the difference between egg and
beetroot?
You can beat an egg.
1st Physio: I was out with a member of
the football team last night.
2nd Physio: In what position does he
play?
1st Physio: Think I'd tell?
* * *
Her will was strong—but her won't was
weak.
* * *
Meteorologist: Someone who can look
into a girl's eyes and tell weather.
* * *
"What does your husband think of
UNO?"
"He thinks of nothing else."
Patient c/o pain on passing a motion
down the back of his legs.
*
She's descended from 'a long line her
mother listened to.
* * *
PASSION: A feeling you feel when you
are about to feel a feeling you have never
felt before.
*
*
SPINSTER: A woman who remains
single for the same reason that most men
remain single.
Women's desires in every age and country
are an eternal struggle between admitted
desire to dress and the unadmitted desire to
undress.
—Chinese Proverb.
*
Once upon a girl I had a time-
*
Anatomy Tutor: "What do you know
about the fillet?"
Student: "It commences in the medulla.
and runs up to the third ventricle, where it
defaecates."
If all the students who go to sleep in lectures
were put end to end, they would be so
much more comfortable.
* * *
Treatment for a peptic ulcer:
Sack boss, double salary, divorce wife,
drown kids.
Pathology Report on a completely tapped
pleural effusion: Specimen inadvertently
dropped—please repeat.
* * *
House Detective: He who strikes when
the eye'ins hot.
* *
One of the reasons for the decreasing
severity of syphilis these days is that the
world's population is becoming more
syphilised.

100
U1,1
mmalf
MEDICINE
CU M
TO BE OR NOT TO BE ?
Well gentlemen, you have just read
"Speculum", 1958. Just like every other
year, from well before you were born, at
the end of some lecture someone came in
with copies of "Speculum" and started distributing
them.
Perhaps you think that they just arrive
out of nowhere? They do not. Months of
writing, discussions with printers, hundreds
of phone calls, hours of potential study time
go into this magazine. And do you give a
damn? It doesn't look like it.
Each magazine costs at least twice as
much to produce as you pay for it, and remember
the staff (three in all) are honorary.
Thanks to the work and organisation of Mr.
Wright-Smith our business manager, the
advertisements pay the other five shillings
for each copy. Hundreds of circulars and
hours of interviews must be organised
before we can get our advertisements. The
least you can do is to support your magazine.
"Speculum", on exchange goes to medical
student groups all over the world; we also
obtain their magazines. You can examine
some of these if you wish. The front page
is quite impressive, it usually lists the names
of about a dozen staff members — not three!
Actually only two people produced this
magazine, for I gave no assistance after July,
because of a sudden illness in my family.
To make a comparison it is interesting
to note that most assistance came from nonmembers
of the M.S.S. Graduates who were
asked for articles and assistance, were
only too willing to help. Others such as
typistes gave up their spare time to type out
illegible mis-spelt articles, and Mr. Foo,
(M.S.S.) gave up valuable time for photography.
Medical students had a different attitude.
Obtaining year notes from year-reps. was
one of the most formidable tasks we had.
Glance at the year notes — on the whole
they are not impressive are they? Admittedly
some are good, others were written
almost at gun-point. After all, your rep.
doesen't have much to do, the least he can
manage is to spend one night writing
reasonable year notes, and getting them
typed. Is this asking too much? I do not
think so, but you be the judge for it is your
magazine.
"Team Spirit" is not only a sportsman's
approach, it is necessary in all walks of life
but the present day medical student lacks it.
There are no excuses for the other nine
hundred odd members of the M.S.S. — the
editorial staff have to pass exams just like
the rest of you.
The greatest thing that ever happened in
my life was that I was given the chance to
study medicine. I appreciate this. I respect
those who gave of their time to teach me for
most of them could obtain twice the financial
gain for half their trouble in other walks
of medicine, yet they lecture and teach year
after year to a dumb pack of lethargic
students. It is our teaching staff who remember
their Hippocratic Oath —
"To consider dear to me as my parents
him who taught me this art; . . . to look upon
his children as my own brothers, to teach
them this art; . . . to impart to my sons and
the sons of the master who taught me and
the disciples who have enrolled themselves
and have agreed to the rules of the profession,
but to these alone, the precepts and
the instruction . . ."
Someday, we too must make this oath.
Are any of us unselfish enough to carry it
out? I wonder?
All that is asked is a very small display of
unselfishness on your part towards your
fellow students. It is not often in the present
day world that people do "something for
nothing", yet, in our hearts we know that
all our teachers do far more than they
should for us. I do not think it is too much
to ask the student to do a little extra work
for his fellows in assisting to present an
annual magazine.
No return is offered for this small sacrifice,
except personal satisfaction, so most
of you will not understand.
— George Santoro
It has been interesting to note, that in both
the above article and the secretary's report
which were received from entirely separate
sources, the lack of interest shown by the
members of the M.S.S. for their faculty
should not go unnoticed.
I heartily endorse their views.
— Editor

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