H.—3lb.

C. LUDWIG.

57

Some of the nurses do not keep the charts tidy. If the charts are untidy and the nurses have time I make them make fresh copies. If they have no time I do them myself. The two charts [produced] are not exactly the same. That that went to the Hospital has a little more explanation in it, I produce the chart relating to Mrs. Stevenson. [Exhibit No. 4.] It is the original. To Mr. Mays.] It is the practice in hospitals I have been in to destroy untidy charts after making copies. I have seen that done at the General Hospital at Nottingham, also at St. Helens at Christchurch. I went over the chart of Mrs. Porch that I sent to the Auckland Hospital with the original. To Mrs. Nicol.] I knew nothing about you asking a question in the House, which came out somewhere about the time the chart was destroyed. I knew 7 nothing about you at all. I destroyed the chart on my own authority. I did not know you had anything to do with Mrs. Chamberlain or that the case was coming up. I do not know who gave the information to Dr. Valintine that w-as conveyed by him in answer to a question you say you got Mr. Bradney to ask in the House. I know 7 nothing on the subject. I do not know to what you refer. I put a fuller explanatory note on the chart that went to the Hospital for their information there. We had the information in the case-book. The fuller notes were not taken from the temperature-chart. I cannot say that I took the two copies from the original at the same time. To Mr. Skelton.] Mrs. Chamberlain's chart is the original one. Copies have been made from this. Mr. Mays has two and Mr. Skelton one. They were made for use in this case. To the Commissioner.] When the trouble was made about Mrs. Chamberlain's case no special report was made by me to Dr. Valintine on the case. Dr. Valintine went over the Hospital some time in November. During the progress of the case I wrote from time to time to Miss Maclean about it. To Mrs. Nicol.] Dr. Valintine was through the Hospital in September. It was not an official visit. I remember Dr. Makgill being there with him. To the Commissioner.] I have not seen before this the report of Dr. Valintine now put into my hand. I do not know absolutely where Dr. Valintine got the information that enabled him to make this report. It may have been from my letters to Miss Maclean. Adjourned to 4th February proximo.

Tuesday, 4th February, 1913. [Medical certificate of cause of death put in at Mr. Skelton's request (Mrs. Chamberlain's case). (Exhibit No. 59.).] Herbert Myer Goldstein, recalled, saith. Cross-examined by Mrs. Nicol continued.] [Mrs. Nicol refers witness to page 35 of his evidence.] I have a fairly wide practice, wdiich extends over a fairly large area. I make no difference as to what patients I take first —whether those nearest or furthest. I have no general hour for starting out in the morning and none for coming home in the evening. I visited St. Helens twice a day during this time. Ido not know if I was rung up or not. I was at the home when I was told that Mrs. Porch definitely needed attention. It was about 4 p.m. I did not see her before the end of the first stage of labour. I do not remember at what case I had been before coming in to the home and attending to Mrs. Porch. I should say I was about an hour in the home before the birth of the child. The patient was on the delivery-bed. Four hours for the second stage of labour is not normal, but it is very usual. A labour of sixtyfive hours is not a normal labour. If a case is a simple straightforward one the child might be born in from eighteen to twenty-four hours. The time in Mrs. Porch's case is not unusual, though it is abnormal. One expects it in such a case as Mrs. Porch's. The time from the end of the second stage to the end of the third is not abnormal. The total of sixty-five hours is abnormal, but not unusual. When I first saw the patient the second stage was just starting. There is no sharp line between the various stages. When I first saw Mrs. Porch she was ready for surgical interference. I attended to her then. She had not been ready for surgical interference for any length of time—absolutely not. There was nothing in her condition when I first saw her that suggested to me that I should have been called in earlier. I had no reason to suspect that anything had been delayed or overlooked in her treatment. Sometimes one takes the risk of injuring the patient by hastening delivery. There was not equal danger to the mother and child by the protracted labour. I gave the patient chloroform, but not immediately on going into the room. I saw after I examined the patient that she was ready for immediate delivery. The perinaeum was ruptured. I put in two stitches. I saw the rupture. My attention was not called to it that I know of. I knew the patient was ruptured when I delivered her. When I am there I always put in the stitches. Mrs. Porch was put into ward No. 2. I did not see Mrs. Porch shiver violently. I visited Mrs. Porch the next day. Her temperature had risen. I visited her the next clay. I could not say whether it was with or without Dr. Inglis. It is usual to examine the uterus. I did so on this occasion. On the third day the temperature went up to fever height. I was suspicious of something being wrong from the first day. That was because the temperature was up. Temperatures always go up and down. I was suspicious of all sorts of things. The second time I saw the patient she was peculiar. I pressed the patient over the uterus to see if it was tender or enlarged. I have frequently allowed my patients to go to forty-eight, fifty, or sixty hours. Puerperal insanity alone could cause the temperature of 103. I concluded that the patient was becoming septic. I passed the case over to Dr. Inglis on the fourth day. I gave Mrs. Porch bromide medicine and vaginal douching. The douching was a precautionary measure. The temperature was still rising. It is generally done to give the douche when the temperature is rising. The case was one of puerperal insanity. The patient was removed to a room by herself on the third day. I saw her in No. 6. Dr. Inglis

31b.