H.—l

255

6412. Then C ? —That is an illustrative case, just to show how unfair it is to blame the Hospital. When he came in he had a strumous swelling of the knee-joint with open suppurating wounds. I treated him according to Thomas's method. He got considerably better, and so much so, indeed, I thought it would be best to let him go home where he would get better air than we can get in the Hospital. He went to his home, but some time afterwards he returned to the Hospital far worse than when he left it; in fact, he went utterly to the bad, and was in such a state—so extensive was the disease —that I deemed it advisable, after consultation with my colleagues, to amputate. 6413. Mr. Solomon.] Suppuration followed the amputation ?—Yes, the dressings had got displaced, but it was very little. 6414. The Chairman.] And what caused it ?—The air of the ward. 6415. Mr. Chapman.] Quite so ?—I may say you cannot go into the street but you get these micro-organisms. The air in the streets will cause it in some cases where the person is predisposed to it. The wound was saturated, and very extensively so, when he came back to the Hospital. I thank you, Mr. Chapman, for calling my attention to that fact. I now remember all about " Little George," as we used to call him. 6416. And you say it was saturated when he came back to the Hospital ?—Yes. 6417. There was no suppuration after the amputation?— Yes, there was a little in one corner of the wound. It did not heal altogether as first intended. 6418. Then C. M 's case ?—She came into the Hospital with an open abscess, in a septic condition, at the back of the knee. 6419. She came in in that condition ?—Yes ; and wherever you have suppuration there you have a certain amount of sepsis. 6420. The Chairman.] That is admitted by all surgeons ? —Yes. 6421. Mr. Chapman.] Now, D. V ?—That man was simply strumous from the top of his head to the soles of his feet. I have had to scrape abscesses, sometimes the size of a walnut, from his neck. Some time ago, outside the Hospital, I removed a series of glands from his neck and abscesses from various parts of his body, and th'en a diseased ankle-joint with open wounds set up to such an extent that I had to perform amputation there. Dr. Lamb will bear witness to what I say —that this man was in a septic condition long before admission. I performed an amputation and the man had suppuration. 6422. Mr. Solomon.] After the operation ?—Yes, but you had tuberculosis there, and there is where the unfairness comes in, because where you have a strumous constitution the least germ lights up much more quickly than elsewhere. 6423. Mr. Chapman.] M ■? —He came in septic after an injured nose. 6424. He came in in a septic condition ?—Yes; but the question in his case was this : He had a marked suppurative process going on on the bridge of his nose, and it went on to such an extent that I had to bring a large amount of the lateral skin-flaps forward. One did not want to destroy or disfigure the man more than one could help, and therefore I brought the flaps together and trusted to the epithelium flowing over the granulating area and joining. There was no attempt to thoroughly exclude the germs in that case. 6425. G ? —That is an interesting case. He broke his leg three years ago on the West Coast. He was treated in the Greymouth Hospital for a long time, and then went to the Hospital which has been called the panacea for all septic cases —the Wellington Hospital— and was there performed on for resection. He next came to the Dunedin Hospital with necrosis of the bone, with an open wound leading to it. I performed resection in January last. 6426. The Chairman.] How long ago is it since he was in the Wellington Hospital ?—I believe he was in Wellington also about January. Taking one hospital after another, I think that man has been inside the walls of these institutions for upwards of two or three years. After the operation I performed some suppuration occurred, but how it occurred it is impossible to say. The main point is that he required his leg to be amputated, because he had a marked thickening of the nerve, which produced, when placed in the splint, a jumping up and down. Under these circumstances no surgeon could expect to get a union, and at his own request I amputated. He is now better, and was in my house the other day thanking me for what I had done. He said he was going to work, and, as a non-unionist, worked with an improvised leg—and that was only nine weeks after the operation. 6427. You say that was in the man's constitution?— You must eradicate every other element first. 6428. Mr. Chapman.] M. F ?—That was a case that came in with suppurating hydatids— a pretty bad one to start with. Ido not know whether you can lay the blame of the disease getting into that poor person's body to the Dunedin Hospital, but I cannot see how you can have a consistent modern pathology without some septic infection with a case of that nature, and she was so on admission. 6429. Mr. Solomon.] There is the chart?— The chart is nothing. When the wound is opened up and the air gets fresh access again it assists the disease. The woman made a good recovery. 6430. Mr. Chapman.] Y. C ?—Yes ; he was a poor Chinaman with a cancerous mass. 6431. That was unconnected with septic symptoms?—l do not see how you can blame the Hospital for it. 6432. E. E ?—1 think you might possibly charge the Hospital air with that. I cannot explain, except that the dressing may have become displaced. 6433. The Chairman.] It is marked " Good result " ?—Yes, it is good in this way : She had a double rupture, and the last time she presented herself before me she was well and strong. 6434. Mr. Chapman.] M ? —That is a peculiar case. This man's system was debilitated by a temporary attack of diabetes, and where you* have got any diabetic mischief any wound has a