H.—l

254

twelve cases out of your forty-three being accompanied by septic symptoms after operation is consistent with an absolutely healthy condition of the atmosphere ?—Would you put that again please. 6393. I see I must put these other cases to you, and I will do so shortly. "E. A ; puncture of one of the knee-joints ; in hospital about four months ; suppuration recurring; left at length healed." Then there is the case of S. X . Do you think that the fact that all these cases I have referred to —such a large proportion of cases as 30 per cent, of your cases —having been, accompanied by septic symptoms, is consistent with an absolutely healthy condition of the atmosphere ? — I do not think that the condition of the atmosphere in some of these cases had anything to do with it. 6394. That is not an answer to my question. I ask you again, is not the fact of these cases having been accompanied by septic symptoms inconsistent with a healthy condition of the atmosphere? —You are asking me a question which almost implies the answer you wish me to give to it. 6395. I must press for an answer to my question ?—Well, I will answer your question in this way : I say, in regard to the class of cases that you have referred to, the air outside might just as easily have caused them as the air inside. 6396. But when you find that 30 per cent, of your operations in the Dunedin Hospital within twelve months have been accompanied by septic symptoms, does not that fact make you suspicious as to the condition of the air?—No, for the simple reason that I knew the condition of the cases when they came into my hands. 6397. All of them?— Most of them. 6398. All of them ?—I know the condition of most of them, and that weighs in my mind. 6399. Just one more general question. Do you think that the imperfections in the Dunedin Hospital which you have mentioned could remain for any length of time without doing injury, although that injury could not be directly traceable absolutely to that cause ?—No, but I can add to that by saying that the evils of those imperfections may be minimised and mitigated by strict supervision and management; and I should further add that in the steward of the Hospital, Mr. Burns, we have a man who exercises great thought and a great deal of care in his management, a man who takes a much more active -and living interest in the institution than the majority of stewards I have seen elsewhere. Mr. Solomon : And will you allow me to add a word. I am very much obliged to you for the assistance that you have given to the Commission, instead of trying to baffle us as some of the other witnesses have done. 6400. Mr. Chapman.] Following up the last question, I will take the latter part of your crossexamination first. If the imperfections that have been spoken of, or have been suggested, had been allowed to remain, do you think they must have been detected long ago ? —I think so. 6401. That the alleged results would have been connected with the alleged causes long ago, you think?—l would conceive that if it were so they would have been found out. 6402. We have been told that there wrere twenty-one deaths in the Dunedin Hospital during a given period as against one in the Ghristchurch Hospital as the result of a similar class of operations. Should not a startling result as that have come out long ago? —Yes. 6403. And become apparent to the practitioners practising in the Dunedin Hospital—to surgeons and physicians alike ?—Yes. 6404. And should have become apparent to the Inspector-General, whose duty it is to know something about these matters ?—Yes, if the Inspector-General did his duty. 6405. And there have been two or three of them in succession, have there not?—l think that is one of the things an Inspector-General should inquire into. 6406. I will take your cases, and, at the risk of delaying these gentlemen, will ask you to make your own explanation regarding them. First, as to M. H ? —That was a case of a girl with a tumour in the upper jaw. I called a consultation of the staff —I wished to remove the whole of the upper jaw for that tumour, but the advice of my colleagues was against that course being adopted, and lam bound to defer to the views of the majority. Much against my will I performed the operation, scraping out the parts that were get-at-able from below. What occurred in this case was that there was a rise in temperature, and the erythema were distinctly due to tension. Ido not blame my colleagues for differing from me, because the very object of a consultation is to get the various opinions. At the same time, if I had been allowed my full liberty of action Ido not think the tension would have come about. 6407. The case is one of tension ?—lt is impossible to explain it as septic, except that it was the temperature deliberately rose from tension which retained discharge. It was not a septic case purely. This reminds me of something more. [Witness read from the consultation-book of the Hospital a remark he had there written on this case, in which he stated he "regretted he had not been permitted to follow his own opinion in dealing with this case."] I did not know I had written that; I had almost forgotten about it. 6408. The second case is that of C ? —He had been living in a vitiated condition, and was indeed an extremely desperate case. He was in a septic condition before he came in. The nonunion of the fracture occurred before he came to the Hospital or under my care. 6409. I suppose if he had gone to the Christchurch Hospital you would have had him septic there ? —Yes. 6410. Mr. Solomon.] Here is the chart ? —I do not take the chart as anything. I, as a modern surgeon, simply say " that is septic." There is no quibbling on my part, yet he left with union of the fracture. 6411. Mr. Chapman.] Then the case of H ?—The explanation of that is that he was a boy suffering from acute tuberculosis, which was latent, and suppuration of knee-joint, and after I had performed the operation for erosion of a joint general tuberculosis set up. The reason I sent him out of the Hospital was so that he might go to the country for the air.