PKESIDENt's address — SECTION I. 225 



been definitely classified, and can be made with proper organiza- 

 tion to serve larger populations. There are already sufficient trained 

 medical men to make a commencement, and there is nO' reason 

 why, laboratories to serve all public health purposes should not 

 forthwith be established at the principal country centres through- 

 cut Australia. There is, in fact, every reason why thesei labora- 

 tories should be established at once. 



There is proceeding now in Victoria an agitation for a more 

 satisfactory milk supply. It is not necessary to remind members 

 of this Congress that the only test of a milk supply is the labora- 

 tory test, either chemical or bactericlcgical. It is mere political 

 opportunism to talk of schemes for milk control when no provision 

 is made lor laboratory control of the purity of the milk supplied. 

 No brewery manager would dream of conducting his business 

 without a lai'ge staff of expert laboratory advisers, but for the 

 most important food supply of the people, there is in no State 

 adeqiiate provision of means for laboratory control. There is in 

 no State more than one small public health laboratory, and, in 

 some State«, the State Government has not provided the Public 

 Health Department with_ a laboratory at all. 



Under existing State laws, medical practitioners are required 

 to certify to the fact of a cure of venereal diseases — syphilis or 

 gonorrhoea. The curej in either case cannot be determined re- 

 liably M'ithout careful laboratory work in experienced hands. The 

 doctor at Thursday Island, at Broome, or at Queenstown, must 

 send his speciniens to Brisbane, *Perth or Hobart, and, in the 

 presence of a strike, he cannot send them at all. Preventive 

 medicine, obviously, cannot be effectively carried on under these 

 conditions. 



The control of typhoid fever, of diphtheria, of malaria, and of 

 bilharzia are impossible without laboratory exaininations. The 

 provision of one laboratory at the metropolitan centre of each State 

 was an inevitable first step, rendered inevitable by pressure of 

 circumstances, but this was merely a makeshift, and has for years 

 now been quite inadequate. It is true that all medical men can 

 send their specimens of various kinds to these laboratories for 

 examination, but there are narrow limits to the value of the in- 

 formation that a swab or a blocd sample is " positive" or " nega- 

 tive," particularly when, as sometimes happens, this result is 

 cpiite at variance with the doctor's conviction based on clinical 

 evidence . 



The desirable objective, the accessibility to each doctor of the 

 means for arriving at correct laboratory results, or at least of 

 seeing the processes in operation and discussing the results with 

 the laboratory expert, is not attained by these means, and pro- 

 gress is, under these conditions, exceedingly slow. 



