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Advising the parents : child rearing in British Columbia during the inter-war years Lewis, Norah Lillian 1980

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ADVISING THE PARENTS; CHILD REARING IN BRITISH COLUMBIA DURING THE INTER-WAR YEARS  NORAH LILLIAN LEWIS B.Ed. University of Saskatchewan, 19°5 M.Ed. University of B r i t i s h Columbia, 1975 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF EDUCATION in THE FACULTY OF GRADUATE STUDIES Department of Elementary Education We accept t h i s thesis as conforming to the required standard  THE UNIVERSITY OF BRTISIH COLUMBIA September, 1980  Norah L i l l i a n Lewis  In p r e s e n t i n g  this  an a d v a n c e d  degree  the  shall  I  Library  further  for  agree  scholarly  thesis at  the U n i v e r s i t y  make  that  freely  of  this  for  of  British  available  p u r p o s e s may be g r a n t e d  his representatives.  written  it  fulfilment  It  financial  the  shall  requirements  Columbia,  copying o f  by t h e Head o f  is understood gain  of  I  agree  f o r r e f e r e n c e and  permission for extensive  by  thesis  in p a r t i a l  that  n o t be a l l o w e d  or  that  study.  this  thesis  my D e p a r t m e n t  copying  for  or  publication  without  my  permission.  ( Mrs) Norah L i l l i a n LEWIS  Department of The  Elementary Education Faculty o f Education  U n i v e r s i t y of B r i t i s h  2075 Wesbrook Place Vancouver, Canada V6T 1W5  Date  1 7 September, 1 9 8 0 ,  Columbia  Abstract During the inter-war years, health professionals and c h i l d care advisors i n the i n d u s t r i a l i z e d world urged parents t o r e j e c t t r a d i t i o n a l c h i l d rearing practices and t o apply a s c i e n t i f i c approach to c h i l d rearing.  Basing some o f t h e i r advice on research i n medical science and  studies i n c h i l d development, these advisors assured parents that, i f they adopted the s c i e n t i f i c approach to c h i l d rearing, t h e i r c h i l d r e n would have a greater p o s s i b i l i t y of growing into  h e a l t h i e r , happier,  more morally/upright, productive members.cf society than had children of any previous generation.  In B r i t i s h Columbia, many voices joined  together t o advise parents.  These advisors included p r o f e s s i o n a l and  non-professional i n d i v i d u a l s , members of government boards and departments, employees of public and private agencies, members of community and women's organizations and service clubs, and public r e l a t i o n s personn e l f o r food production and l i f e insurance companies.  In t h e i r e f f o r t s t o reach parents i n a l l areas of B r i t i s h Columbia, advisors u t i l i z e d a v a r i e t y of approaches» they published and d i s t r i b u t e d pamphlets, newsletters, and c h i l d care manuals; they showed f i l m s i n l o c a l movie theatres and schools; they prepared broadcasts f o r l o c a l radio s t a t ions.  This study examines the i n d i v i d u a l s and the agencies that provided  c h i l d rearing advice t o B r i t i s h Columbia's parents, and the methods and media used t o disseminate t h i s advice.  Advice t o parents centred on four age groups, the prenatal stage, the i n f a n t , the preschool c h i l d , and the school c h i l d .  Because expectant  mothers tended t o be secretive about t h e i r pregnancies, advisors found i t d i f f i c u l t t o reach them with the message that through proper care, c h i l d -  ii  iii bed deaths were preventable and that healthy mothers produced healthy babies.  Advisors found, however, that women reluctant t o seek advice f o r  themselves were often w i l l i n g t o accept assistance and advice on the care and rearing of t h e i r i n f a n t s .  Determined t o lower the province's mort-  a l i t y r a t e , advisors urged parents t o adopt a systematic,  regimented,  s c i e n t i f i c approach t o the feeding, caring, and t r a i n i n g of t h e i r i n f a n t s . When children passed from infancy t o the preschool stage, both parents and advisors believed they no longer required the intensive care they had received as i n f a n t s .  Thus, less advice was available t o parents on rear-  ing preschool children than f o r rearing i n f a n t s .  Once children moved into  the p r o v i n c i a l school system, t h e i r health was monitored through  annual  medical inspections by a medical health o f f i c e r and by regular examinations by a school nurse.  At t h i s stage, advisors were concerned with the health  of school children, although they a l s o viewed such children as instruments and the school as an agency through which to educate parents t o the scienti f i c approach to c h i l d rearing. Advisors believed the way t o produce a strong, healthy c i t i z e n f o r the future was by expanding existing and developing a d i t i o n a l health care and c h i l d care programs f o r the c h i l d , and by changing the c h i l d rearing practices of the B r i t i s h Columbia parent.  Although advisors proposed to educate a l l parents i n new modes of c h i l d rearing, the nature, content, and amount of advice directed towards each age group varied considerably.  This study i d e n t i f i e s the sources  of c h i l d care and c h i l d rearing advice f o r each age group.  I t shows,  furthermore, that as advisors' knowledge of c h i l d development increased, t h e i r perceptions of c h i l d care changed, and the nature and content of c h i l d rearing advice a l s o changed.  This study i d e n t i f i e s changes i n  the focus of advice t o parents during the 1920's and 1930*s.  Addition-  a l l y , i t shows that during the inter-war years, the amount of advice to  iv parents increased both i n quantity available and i n the number of sources through which information was disseminated to parents.  Many B r i t i s h Columbia health professionals and c h i l d care  advisors  were committed to changing c h i l d rearing techniques used by parents, and they j u s t i f i e d t h e i r claims by pointing to a s t e a d i l y d e c l i n i n g c h i l d mortality and morbidity r a t e . for children  Not only d i d they desire these changes  growing during the 1 9 2 0 ' s and the 1 9 3 0 ' s , but a l s o they  believed t h e i r influence would be manifest i n the c h i l d rearing practices of the next generation.  Motivated by p o l i t i c a l , economic, and human-  i t a r i a n considerations, advisors worked to provide conditions that would produce children that were an asset to the r a p i d l y developing province  of B r i t i s h Columbia.  TABLE OF CONTENTS  Abstract  i i  Tables  vi  Acknowledgements  vii  Chapter 1  Advice to the Parents:  Chapter 2  Motherhood:  Chapter 3  Rearing the Infant:  The L i t t l e Machine  59  Chapter 4  The Preschool C h i l d :  The Neglected Age  97  Chapter 5  The School C h i l d :  U t i l i z i n g the Media  In the Service of the Nation  37  Physical Perfection f o r 123  S p i r i t u a l Welfare Chapter 6  1  Advising the Parents:  A Preventive Measure  l66  Note on Sources  186  Selected Bibliography  189  vi  TABLES  Table 1.1 Table 2.1  Infant Health Care - D i v i s i o n of C h i l d Hygiene C l i n i c s and Home V i s i t s , 1920-1939  10  Maternal Mortality - Province of B r i t i s h Columbia, 1919-1939  ^9  Table 2.2  Maternal Mortality - C i t y of Vancouver, 1919-1939. •  50  Table 3.1  Infant M o r t a l i t y - Province of B r i t i s h Columbia, Analysis of Causes of Death, 1923-1939 Infant Mortality - Province of B r i t i s h Columbia,  ?8  1920-1939  85  Table 3.2 Table 3.3  Infant Mortality - C i t y of Vancouver, 1914-1939  Table 5.1  School Medical Health Inspections - Province of B r i t i s h Columbia, 1911-1939  Table 5.2  Table 5.3  Reported Cases and Reported Deaths from Specified Diseases of Children Under Twenty Years of Age,  • •  86  125  1918-1957  133  C h i l d Mortality - Province of B r i t i s h Columbia, Ages B i r t h to Nineteen Years, 1923-1939  15^  vii  Acknowledgements I wish to express my gratitude  to my supervisor N e i l Sutherland  f o r h i s encouragement, d i r e c t i o n and h e l p f u l c r i t i c i s m at every stage of t h i s d i s s e r t a t i o n .  My appreciation  also to Professors John Galam,  Glen Dixon and Naomi Hersom f o r t h e i r careful reading, comments and thought provoking questions.  constructive  I am also grateful to Suzanne  Dobson, Head Government Publications D i v i s i o n , Anne L e i t h , Biomedical Librarian and my t y p i s t Velma Hrehorka.  Special thanks to my husband  Rolland, who provided constant support through a l l the stresses and s t r a i n s of t h i s project.  Chapter  1  Advice To The Parents:  U t i l i z i n g The Media  During the inter-war years, health professionals and c h i l d care advisors expended considerable time and energy persuading B r i t i s h Columbia parents to change t h e i r c h i l d rearing techniques.  Advisors believed that  i f they could change c h i l d rearing practices of the 1920's and 1930's, the generation growing up would be healthier, happier and more productive than t h e i r parents had been."*" To e f f e c t these changes, advisors t o l d parents they could no longer r e l y on t h e i r t r a d i t i o n a l practices or t h e i r natural parenting i n s t i n c t s ; rather, parents must adopt the new s c i e n t i f i c approach to c h i l d care and c h i l d rearing.  Advisors believed that once the new meth-  ods were demonstrated, t h e i r value was so r a t i o n a l and so obvious that parents would immediately  adopt the new techniques and procedures.  With  great enthusiasm, health professionals and c h i l d care advisors set out to change c h i l d rearing practices.  2  Advising parents i s not a phenomenon of the twentieth century.  Indeed  there have always been advisors w i l l i n g to t e l l parents how to rear their child.  Over the centuries, however, the changing concept of c h i l d nature  and development has effected changes i n both the focus and the content of 3 advice given parents.  For example, f o r much of the nineteenth century,  advice focused on the development of the c h i l d ' s moral character.  For  most children, l i f e was tenuous, i f not short, and parents were urged to prepare t h e i r c h i l d f o r the next l i f e .  Developments i n disease c o n t r o l  and prevention between the 1880*s and the 1920's shifted attention to the c h i l d ' s feeding and physical care.^  Whereas advisors of the early nine-  teenth century were clergymen, educators, and upper c l a s s women, advisors of the period 1880  to 1920  were physicians, educators, and s o c i a l workers.  During the 1920's and 1930's, the concept of c h i l d nature and c h i l d develop-  1  2 ment continued to change as c h i l d psychologists and nursery school educati o n a l i s t s studied the s o c i a l and the emotional development of the c h i l d . ^ In response to t h i s new focus, parents of the 1930*s were urged to consider t h e i r c h i l d ' s care and rearing i n quite a d i f f e r e n t way than had t h e i r mothers or grandmothers.  Indeed, by 1930.  the c h i l d was not only perceived  as having a soul but also a body, an i n t e l l e c t , and a s o c i a l and  emotional  nature.  B r i t i s h Columbians d i d not suddenly become aware of c h i l d r e n and t h e i r needs a f t e r World War I.  N e i l Sutherland has examined i n d e t a i l the  e f f o r t s of Canadian reformers to provide better health care, better educati o n a l programs, and more rights before the law f o r Canadian children f o r the period 1880 to 1920/  Why,  then, i n the years immediately a f t e r the  war was there so much stress on educating parents to new c h i l d rearing practices and i n providing health care services f o r children?  The "war to end a l l wars" was over, and Canadians f i l l e d with s e l f confidence and optimism, saw Canada as a vigorous and growing nation. P o l i t i c i a n s , academics, and s o c i a l reformers talked and wrote of a developing Canada i n a new age, where s o c i a l i l l s could at l e a s t be ameliorated i f not eradicated.  Governments were urged to assume more r e s p o n s i b i l i t y Q  f o r the care and welfare of a l l t h e i r c i t i z e n s .  Government administrations  a t a l l levels began to organize and maintain services designed to provide health care, education, and welfare programs f o r children and c h i l d rearing education f o r parents.  Voluntary organizations such as the Red Cross,  V i c t o r i a n Order of Nurses, and the Women's I n s t i t u t e , channelled t h e i r  3 energies toward peacetime work and sought to coordinate t h e i r work with o the governmental agencies.  As the nation's future c i t i z e n , the c h i l d  was the r e c i p i e n t of t h e i r e f f o r t s . Nationalism was not the only influence i n post-war Canada.  Inter-  national developments i n s c i e n t i f i c and medical research during the period 1870 t o 1920 had given science and s c i e n t i f i c management a p o s i t i o n of r e s p e c t a b i l i t y and a place of preminence.  By 1920, both the knowledge  and the tools existed t o improve health care and reduce the incidence of disease among children.  Advisors set about organizing c h i l d care services  and parents' education through the a p p l i c a t i o n of the p r i n c i p l e s of s c i e n t i f i c management.  Although the p r i n c i p l e s of s c i e n t i f i c management were designed  by American Frederick W. Taylor t o achieve maximum i n d u s t r i a l productivity, Taylor believed the same p r i n c i p l e s could be applied with equal success to the operation of governmental agencies, educational programs, home management or family l i f e . ^  The use of s c i e n t i f i c management was considered  not only pragmatic but a l s o p a t r i o t i c , intended t o provide the panacea for  a l l society's i l l s . ^  For health professionals, use of s c i e n t i f i c  management meant educating parents to new methods of disease prevention and c o n t r o l , and the s c i e n t i f i c methods of feeding, t r a i n i n g , and caring for  the c h i l d .  I t a l s o meant establishing public health services and educat-  ing  the public t o good health habits.  For educators, the use of s c i e n t i f i c  management meant the process of shaping the minds of the public a t large,  12 a task that could be effected as s c i e n t i f i c a l l y as shaping s t e e l r a i l s . The prospganda techniques which had proved so e f f i c i e n t i n moulding public opinion during World War I were q u i c k l y adopted to teach parents new principles^ of c h i l d care and c h i l d rearing. -^ The immediate post-war period 1  i n Canada was not only a time of r i s i n g nationalism, but a l s o a time when 14  science and s c i e n t i f i c management pereated every aspect of l i f e .  4 The p r a c t i c e of advising B r i t i s h Columbia parents of t h e i r duties was not new, but changes i n post-war B r i t i s h Columbia society changed the focus of advice.  For instance, i n 1911» A l i c e Ravenhill, advisor to the Women's  I n s t i t u t e , believed a good family f u l f i l l e d four e s s e n t i a l functions: i t provided shelter and support f o r both young and old; i t educated the young i n useful' habits and l i f e s k i l l s ; i t provided both physical and s p i r i t u a l care and nourishment f o r the young; i t provided t r a i n i n g i n mutual love, s e l f - c o n t r o l and service f o r others.' ''' 1  In the post F i r s t World War years,  the family was increasingly under attack f o r i t s f a i l u r e to provide good physical care f o r the c h i l d .  In a 1916 address to the members o f the  Summerland Women's I n s t i t u t e , Dr. F. W. Andrew, a Summerland physician, defended the p r a c t i c e of medical inspection of school children on the grounds that some parents were either ignorant or unable to detect physical defects i n t h e i r c h i l d .  This f a i l u r e , Andrew stated,  led the State to step i n , c a l l attention to the c h i l d ' s condition, and emphasize the Importance of treatment so that ignorance should no longer be the parent's excuse f o r not r a i s i n g as sound children as possible.1° During the f i r s t World War,  Andrew argued, the m i l i t a r y discovered "that  one t h i r d o f the men presenting themselves f o r service overseas were phys i c a l l y u n f i t , that eighty percent of that number owed t h e i r condition to 17  defects which could have been remedied i n childhood."  Armed with t h i s  information, advisors of the early 1920's focused t h e i r attention on teaching parents how to provide f o r t h e i r c h i l d ' s physical needs. By the end of the 1920's as the focus s h i f t e d from the c h i l d ' s phys i c a l care to h i s s o c i a l and emotional development, advisors believed parents had to be educated to understand these other facets o f t h e i r c h i l d ' s development, and educational programs were developed to help parents meet t h i s change.  In 1928, Frances Lucy Johnson, Director of Parent Education, St.  5  George's C h i l d Study Centre, Toronto, noted that a s c i e n t i f i c a l l y based parent education program was a v a i l a b l e t o teach parents how to study t h i e r children so they could guide t h e i r development. ^ 1  As researchers became more aware of the importance  of the e a r l y years  i n a c h i l d ' s o v e r a l l development, they considered parents to be increasi n g l y less competent as c h i l d rearers, and they were quick t o blame parents 20 f o r any d i f f i c u l t i e s the c h i l d might encounter.  In 1927,  f o r example,  the Public Health Journal asked ten prominent Canadian j u r i s t s , educators, and clergymen to respond to s i x questions r e l a t i n g to the proper home t r a i n ing of c h i l d r e n , and to explore the need f o r parent education. ponses were evenly divided as t o whether parents of 1927 or unfavourably with parents of past generations.  Their r e s -  compared favourably  Seven of those responding  believed parents could be held responsible f o r t h e i r children becoming juvenile delinquents, and an equal number believed parents could mould the character of t h e i r children by c o n t r o l l i n g the environment i n which they l i v e d , and by selecting the companions with whom they played.  A l l ten  responded that they agreed with the p r i n c i p l e of parent education, a l l believed i t should begin long before the infant a r r i v e d , and some even 2" suggested that t r a i n i n g f o r parenthood should begin as early as age twelve. Responses of t h i s nature d i d l i t t l e t o enhance the image of or b u i l d confidence i n parents i n the 1920's and 1930's. II Health professionals and c h i l d care advisors saw t h e i r duty as twof o l d : establishing health care services f o r children and educating parents to new methods of c h i l d rearing.  What i n s t i t u t i o n s and servies were  developed t o provide health care to the c h i l d and c h i l d rearing advice to the parents?  6 U n t i l the creation of the P r o v i n c i a l Board of Health and l o c a l boards of health i n urban areas of the province i n  1893»  no permanent agency e x i s t -  ed i n B r i t i s h Columbia to d i r e c t health care services.  22  Once established,  the Board issued and enforced modern health regulations f o r the control 23  and prevention o f contagious and i n f e c t i o u s diseases.  J  In  Br.  1899•  C. J . Fagan was appointed P r o v i n c i a l Health O f f i c e r , a p o s i t i o n he held u n t i l 1 9 1 4 . He recommended amendments to the Health Act which included a ban on the use and sale of milk from tubercular cows, the reporting and treatment of a l l cases of tuberculosis, and the n o t i f i c a t i o n of any cases of i n f e c t i o u s or contagious diseases.  24  Dr. Fagan's supervisor and successor, Dr. Henry Esson Young, was major a r c h i t e c t who the foundation  the  developed B r i t i s h Columbia's public health service on  l a i d by Dr. Fagan.  From the time of Dr. Young's appointment  as P r o v i n c i a l Secretary and Minister of Education i n 1907, as P r o v i n c i a l Health O f f i c e r i n 1916,  and h i s death i n 1939,  h i s appointment the basic  2 framework of B r i t i s h Columbia's public health services grew and developed. Young, a physician by profession, saw public health as preventive work covering four broad areas:  school work; c h i l d welfare c l i n i c s ; public  26 education; health c l i n i c s f o r the general public. Although Young and the board had not been i d l e during the war i t was i n the immediate post-war period that he set out to organize  years, an  expanded and e f f i c i e n t public health system throughout B r i t i s h Columbia. To accomplish t h i s goal he required a trained s t a f f and money. of trained s t a f f was p a r t i a l l y solved i n 1919  The problem  when Dr. Young, supported by  Dr. Malcolm T. MacEachern, Medical Superintendent of Vancouver General Hospital, and Dr. R. E. McKechnie, Chancellor of the University of B r i t i s h  7  Columbia, encouraged and f i n a n c i a l l y assisted by the B r i t i s h Columbia Branch of the Canadian Red Cross, established a Department of Nursing at the 27  University of B r i t i s h Columbia.  The nursing program, organized by Ethel  Johns, was a f i v e year program leading to a Baccalaureate i n Nursing.  It  offered s p e c i a l i z a t i o n i n either public health work or nursing education. At the request of the B r i t i s h Columbia Hospital Association, Ethel Johns also organized a four month post-graduate program i n public health  nursing  28  f o r registered nurses.  The course was popular, and by 1 9 2 3 Young reported  that f i f t y - s i x graduates from the post-graduate program were working i n the province's more nurses.  schools and health u n i t s , and there was  s t i l l a need f o r  In addition to nurses employed by the V i c t o r i a n Order and  the Red Cross, by 1 9 3 7 ninety public health nurses were working i n the 29  province. In an e f f o r t to strengthen the work of the developing health units, the P r o v i n c i a l Board of Health appointed f u l l - t i m e medical o f f i c e r s to smaller urban areas to i n i t i a t e and coordinate health services and educ30 a t i o n a l programs. was  The Tuberculosis Control D i v i s i o n , established i n 1 9 2 3 ,  extended to a province w i d e - d i s t r i c t based control and  program i n  educational  1 9 2 8 . ^  By 1 9 3 0 public health services were well established i n the  province.  In addition to s i x f u l l - t i m e r u r a l health u n i t s , the r u r a l areas of the province were served e i t h e r by the public health nursing service, the V i c t o r i a n Order of Nurses, the Red Cross Outpost Hospitals, or by medical 32 services provided by r e l i g i o u s organizations. depression  Unfortunately,  the great  placed serious constraints on the growth of public health services.  L i k e a l l p r o v i n c i a l departments, between 1931  and 193^  the Board's budget  was reduced i n s p i t e of i t s increased requirements caused by a s i g n i f i c a n t  8 i n f l u x of unemployed people.  In 1932,  the actual amount spent by the Board  amounted to f i f t e e n cents f o r each resident of the province - "barely s u f f i c i e n t to maintain our work.  33 ^  Not u n t i l 1935  was Dr. Young able to  announce any material progress i n the Board's work, yet, i n s p i t e of the depression, B r i t i s h Columbia d i d not suffer a major outbreak of i n f e c t i o u s 34 or contagious disease, nor the consequences of widespread malnutrition. From 1936 In 1937  u n t i l the end of the decade, three more health units were opened.  the Vancouver Metropolitan Health Unit, an amalgamation of Greater  Vancouver health units, was organized, and additional plans were underway 35 to open health units i n several other areas of the province. In the urban areas of the province, the c i t y administration assumed the i n i t i a t i v e i n developing health care services and c h i l d care f a c i l i t ies.  Although the Vancouver D i v i s i o n of C h i l d Hygiene was not organized  u n t i l 1919,  as early as 1910  Dr. F. T. Underhill, the c i t y ' s medical health  o f f i c e r , reported h i s concern f o r the health of the c i t y ' s children.  He  believed the high infant mortality rate was caused by the great number of f l i e s , the open manure boxes about the c i t y , and the deplorable tenement 37 housing i n which many families were forced to l i v e .  In 1912,  the c i t y  opened a creche, or day nursery, designed to provide care f o r children of 38 working mothers,  but, u n t i l 1919.  there were no c l i n i c s designed s p e c i f i c -  a l l y f o r c h i l d r e n , although sick children were treated at either the Infant's Hospital on Haro Street or at the Vancouver General Hospital.*^ The D i v i s i o n of C h i l d Hygiene of the Vancouver Board of Health, formed i n 1919,  provided a well-baby c l i n i c at the Infant's Hospital, an infant's  c l i n i c at Community House, and a p e d i a t r i c s c l i n i c at Vancouver General Hospital.  The newly formed d i v i s i o n c a r e f u l l y analyzed the causes of  i n f a n t and c h i l d deaths, and then focused i t s e f f o r t s toward eliminating  9 or a l l e v i a t i n g the causes  (Table l . l ) . The D i v i s i o n was able to report  success f o r i t s e f f o r t s , as the rate f o r i n f a n t deaths i n Vancouver under one year of age caused by gastro e n t e r i t i s and acute chronic indigestion dropped from 13.4?S of infant deaths i n 1920 to k.%  i n 1938i and deaths  caused by acute i n f e c t i o u s diseases declined from 9.1$ i n 1920 to 1.7%  41 i n 1939.  The D i v i s i o n also c a r r i e d on an extensive home v i s i t a t i o n program. The Division's nurses believed the most e f f e c t i v e way to work with mothers was on a one-to-one basis i n the home.  In 1920, the nurses made 2,847  house c a l l s and i n 1932 they made t h e i r maximum number of c a l l s - a t o t a l of 16,112.  The steady decline i n the i n f a n t mortality rate from 55.76  per 1000 l i v e b i r t h s i n 1920 t o 26.84 i n 1939 must have been intensely en^-  42 couraging to D i v i s i o n nurses.  Also, the nurses inspected c h i l d care  i n s t i t u t i o n s where children were sheltered, and the registered homes where dependent or neglected children were housed.  Not only were the nurses  concerned f o r the quality of care, but also they worked to eliminate the  43  disastrous practice of baby farming.  Not u n t i l the formation of the Vancouver Metropolitan Health Unit i n 1936 were Vancouver's school nurses and D i v i s i o n of C h i l d Welfare nurses  44 brought under the same administration.  In 1920, the medical health  o f f i c e r had concentrated the e f f o r t s of h i s s t a f f on improving the physical health of the c i t y ' s children; by 1939» a f a r wider range of services was  45  available f o r c h i l d r e n , including the addition of a mental hygienist.  While p r o v i n c i a l and municipal health workers were developing health care services, they were also disseminating information  to parents.  health care and c h i l d r e a r i n g  They devoted attention and care both i n the choice  Table 1 . 1  INFANT HEALTH CARE - DIVISION OF CHILD HYGIENE VANCOUVER CITY 1919-39 - METROPOLITAN HEALTH UNIT 1937-39  No. of C l i n i c s Sites Sick Well Baby Baby  Year  Total Births  1919  2706  2  1  1920 1921  3366 3623  2  2  2  4  2192  2  4  3165 3303 3578  1  4  3458  1  3563  1  3346  1922 1923  1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 *1936 -** **1937 •1938  4354 4539  SOURCE:  New Admissions  Preschool Age Attending Clinics  Home Visits  2194 3425  171  2847  231  6604  4344  249  6664  Total Attendance  133 179 254  629 682  256  640  4367  698 983  5147  5605  847  4617  546  6458 6569 5678 6378  785  4608  387  5025  1  253 257 205 203 197  161 203 706  747  5463  408  5632  1  3  152  6226  1  5  243  547 874  1 1  247  4241  3597 3232 3407 3587 3577  3951 4226  •)H(-  *1939  Total Number of Clinics  2 closed  251  763 1311 1365  10412  1363  11977 8060  14884  8118  13694 14878  4  199  6  272  1261 938 1066  5 12  299  1121  508  5  614  2057: 2452  202  13  583  21  801  25  601 894  4359  11070  8823 9884 14891 16234  6227  13435 14459 16112  15878 13717  19591 22818  1908 2367  20906 24906  2584 4084  8733 10051  Vancouver Board of Health,Report, 1 9 1 9 - 1 9 3 9 • Where no numbers are available the spaces are l e f t blank. * Vancouver C i t y ** Metropolitan Health  46  of information imparted and the type of media u t i l i z e d .  1 1  As early as  1912-13, the B r i t i s h Columbia Board of Health pamphlet "Instructions to Parents regarding the Care of Teeth" was issued to school children at the time of t h e i r annual school medical inspections. 1920*8  Throughout the  and 1930's, the Board distributed printed materials, some of which  were prepared and produced by the Board, other materials were reprinted from publications produced i n other provinces, other countries, or by other 48 agencies.  The Board's main concern was t o get the information t o parents  regardless of who produced i t .  By 1920, the Board had produced a set of  ten advisory letters and f i v e diet folders f o r distribution to expectant mothers.  These materials were mailed at monthly intervals, one prenatal  l e t t e r at a time, i n plain brown envelopes, to mothers-to-be. After the release of the Child Welfare Division's The Canadian Mother's Book, i n 1921,  i t was also included i n the information mailed to prospective 49 mothers. The one major problem faced by the Board was to obtain names 50 7  and addresses of pregnant women so materials could be mailed to them. In 1920, the Women's Institute assumed responsibility f o r submitting names of expectant mothers, but they too encountered the same d i f f i c u l t y as the Board.^  Printed materials were also distributed during the nurse's home  v i s i t s , a t baby, dental and T. B. C l i n i c s , at demonstrations and exhibits, and at f a l l f a i r s . ^  2  As Dr. Lamb noted i n the 1927-29 Annual Report of  the Provincial Board of Health, "We average a distribution of 30,000 pamphlets a month and t h i s i s growing each month.^  In 1929-30, Dr. Young  noted that i n addition to numerous t a l k s , lectures, and demonstrations given during the year by public health workers, 240,000 bulletins and 54 pamphlets had been distributed, an average of 20,000 each m o n t h . O n l y at the height of the depression did the Board reduce i t s quantity of pamphlets and bulletins printed and d i s t r i b u t e d . ^  With improved economic  conditions, the distribution of literature again increased and by 1939#  12 1,705  sets of prenatal l e t t e r s , 3,6hZ sets of postnatal l e t t e r s ,  1,108  sets of preschool l e t t e r s and 604 sets of school c h i l d l e t t e r s were mailed to people i n the province.-^  These numbers d i d not include the  thousands of pamphlets, b u l l e t i n s and other printed materials d i s t r i b u t e d through l o c a l health units, other health care and welfare agencies, by community workers.  Between 1919  or  and 1939» hundreds of thousands of  pamphlets and b u l l e t i n s that covered a wide range of topics were d i s t r i b 57  uted throughout the  province.  Health workers also u t i l i z e d other forms of media.  In 1914,  Dr.  Fagan indicated h i s i n t e n t i o n to purchase a set of moving picture f i l m s 58  dealing with health subjects.  As early as 1925» Mrs. C. A. Lucas,  nurse-in-charge of the Saanich Health Unit, used a V i c t o r i a radio station to speak to l i s t e n e r s i n the Saanich Municipality about the Saanich public 59  health program. '  "The Health O f f i c e r Suggests..." was  twenty-four part s e r i e s of radio t a l k s , given i n 1939 ionals over V i c t o r i a radio s t a t i o n CFCT.  the t i t l e of a  by health profess-  The t a l k s touched on a l l aspects  of the public health program, and included separate broadcasts to discuss each age group of c h i l d r e n :  i n f a n t s ; preschoolers; school c h i l d r e n . ^  0  Owners and operators of p r i v a t e l y owned radio stations frequently donated airtime f o r the broadcast of health b u l l e t i n s and t a l k s and health workers were quick to accept the o p p o r t u n i t y . ^  In response to  l o c a l needs, public health workers developed s p e c i f i c programs.  In 1933t  during Chilliwack's "Health Week" p u b l i c i t y campaign, two public nurses organized f i v e , f i f t e e n minute t a l k s on c h i l d and health care to be c a r r i e d on the l o c a l Ghilliwack radio s t a t i o n at the supper hour; the nurses believed a radio broadcast at that hour would reach an immediate audience  62 of ten thousand l i s t e n e r s .  In f a c t , l o c a l health workers used public  t a l k s , demonstrations, classes and group studies, dramas and window displays i n their efforts to reach the p u b l i c . ^  They not only d i s t r i b -  uted materials produced by other agencies, but also materials they produced themselves.  The Vancouver Metropolitan Health Unit's booklet on  c h i l d care was given to each new mother at the time of the nurse's f i r s t 64  visit.  In 1939» Peace River Health workers, concerned about a recurring  outbreak of acute e n t e r i t i s , prepared and distributed detailed instructions for home water chlorination and r u r a l home s a n i t a t i o n . ^  Materials  prepared by l o c a l units were designed to meet l o c a l needs and to supplement the materials produced by other agencies. Ill But not a l l health care and c h i l d care problems were of a l o c a l nature; many of the same problems affected a l l areas of Canada.  In res-  ponse to demands f o r a central agency to coordinate and i n i t i a t e Canada wide health programs and services, the Federal Department of Health was created by Act of Parliament on June 6, 1919.^ Among the duties assigned the new department was that of coordinating provincial and t e r r i t o r i a l health services to preserve and improve public health, conserve c h i l d l i f e , and promote c h i l d w e l f a r e . ^ In direct response to the concern f o r c h i l d health, the Child Welfare Division, with Dr. Helen MacMurchy as director, was formed i n May, 1920.  MacMurchy immediately  i n i t i a t e d a program designed to educate the public to better c h i l d care68  c h i l d rearing practices through the dissemination of relevant information. The f i r s t publication produced, The Canadian Mother's Book, was released March 3» 1921.  This book was an immediate success and by March 31,  1921,  69  a t o t a l of 12,000 copies had been dispensed.  7  By 1923, 220,000 copies  in both French and English were distributed to Canadian mothers through the Child Welfare Division, provincial and l o c a l boards of health, municipal  o f f i c i a l s , r e g i s t r a r s of b i r t h , members of the clergy, women's organ70  i z a t i o n s , policemen and private c i t i z e n s .  The Canadian Mother's Book  was soon translated into several other languages f o r use with immigrant 71  women i n Canada and i n other countries. (not  Newspapers i n Newfoundland  y e t a Canadian province), Great B r i t a i n , the United States, and  India quoted from the book and reproduced sections i n s e r i a l form f o r 72  t h e i r own national readers.  Helen MacMurchy pointed out that, "No one  w i l l ever convince the Canadian Department of Health that mothers do not want to learn.  Thousands of mother's l e t t e r s are on the department  files  73  to(prove the contrary.'"^ In 1 9 2 4 , the C h i l d Welfare D i v i s i o n prepared A Supplement to The Canadian Mother's Book f o r use by health workers i n 74  Outpost Hospitals and i n other i s o l a t e d areas of Canada.  Only one run  7*5  of one thousand copies was made of the Supplement.  J  Encouraged by the success of The Canadian Mother's Book, the C h i l d Welfare Division produced a series of booklets c a l l e d "The L i t t l e Blue 76 Books".  The f i r s t series of fourteen t i t l e s was, published i n October,  when  1921,  10,000  copies were d i s t r i b u t e d i n the f i r s t few weeks; by 1 9 2 3 , 77  the series was i n t o i t s fourth edition.  The series was continually  revamped and expanded to meet the changing needs and i n t e r e s t s of both health workers and parents.  For example, i n 1 9 2 6 , booklets were added  which were especially suitable f o r adolescents, f o r use i n schools, f o r benefit of children needing s p e c i a l care, and f o r parents of children who are brought before the Juvenile Courts or are dealt with by probation o f f i c e r s . ' Two publications released i n 1 9 3 0 "Be Prepared to Prevent I n f a n t i l e P a r a l y s i s " and "Maternal Care" were addressed to s p e c i f i c concerns of the 79  time. (1923)  Two other publications, A Handbook of C h i l d Welfare Work i n Canada, and An Enquiry into Maternal Mortality i n Canada,  (1927).  were  15 80  published i n response to specific conditions.  The f i r s t reviewed the  state of c h i l d welfare work across Canada. The second investigated the causes of death among Canadian mothers between July 1, 1925 and July 1, 1926,  and recommended measures that should be taken to reduce the mater-  nal death rate.  Other types of materials produced by the Division includ-  ed lithographed posters prepared for displays at f a i r s and baby health demonstrations.  Each poster provided health information, a l i s t of free  publications available from the Federal Department of Health, and a set of post cards addressed to the Department of Health.  By simply mailing  the card to the Department of Health, a woman would receive her own free copy of the Division's publications.  In the f i r s t month of the  poster program, 1,400 posters and 40,000 cards were sent out and 7,315 81 post cards were returned with requests for free l i t e r a t u r e . MacMurchy reported that during the f i s c a l year 1922-23, the Child Welfare Division had distributed 3^5»503 publications to Canadian parents.  82  The Child Welfare Division recognized the potential of other forms of media. Only fifteen months after the release of The Canadian Mother's Book, the Canadian Government Film Service (Canadian Government Motion Picture Bureau (forerunner of the National Film Board) released Film No. 98.  This f i l m , showing some of the pictures and pages from The Canadian  Mother's Book, was distributed for viewing i n movie theatres across Canada.^ MacMurchy and her s t a f f also used radio to reach Canadian mothers. In 1932t MacMurchy met with the director of the newly formed Canadian Radio  Commission to arrange with him theibroadcast of health information on the new network; Less than a year l a t e r , February 7  t  1933» the f i r s t broadcast 84  presenting the work of the Child Welfare Division was aired.  In 193^i  the Child Welfare Division was disbanded and many of i t s a c t i v i t i e s , including the dissemination of information, was assumed by the Canadian Council  on C h i l d Welfare.  The Federal Department of Health, however, continued  to d i s t r i b u t e The Canadian Mother's Book.  D  In response to pressure from various voluntary organizations concerned with c h i l d welfare, i n October, 1920, Helen MacMurchy convened an Ottawa conference of health professionals, s o c i a l workers,  educators,  r e l i g i o u s s p e c i a l i s t s , j u r i s t s , labour leaders, representatives of women's organizations, s o c i a l agencies, and service clubs.  Out of that meeting  86 was  formed the Canadian Council on C h i l d Welfare.  The Council was  not  a government agency, although i t functioned under the wing of the C h i l d Welfare D i v i s i o n u n t i l 1924, when the Council established a national o f f i c e with Miss Charlotte E. Whltton as Executive  Secretary.  Social h i s t o r i a n Taanara Haraven described the Council as the most  88 important Canadian welfare agency of the 1920's and 1930's.  As a  national organization, i t coordinated the work of public and private c h i l d care agencies, i t provided leadership i n organizing c h i l d care programs, and worked as a pressure group to effect changes i n f i v e areas; c h i l d health; c h i l d labour; education and recreation; the c h i l d with  89 special needs; the e t h i c a l and s p i r i t u a l development of the c h i l d .  It  published and d i s t r i b u t e d a wide range of informational materials that r e f l e c t e d i t s diverse i n t e r e s t .  In 1935 t  f o r instance, the l i s t of free  materials a v a i l a b l e from the Canadian Welfare Council t o t a l l e d eighty-one publications, sixteen wall charts, seven posters, prenatal, postnatal and preschool l e t t e r s , a series of s i x pamphlets i n habit formation  and  t r a i n i n g , patterns of layettes, abdominal and hose supports, s i x d i e t pamphlets, health record forms, three forms for use by c h i l d care agencies or c h i l d care i n s t i t u t i o n s , the proceedings of the Annual Meetings and  17 conferences of the C h i l d Welfare Council and The C h i l d and Family Wel90 fare, and the bimonthly news publication of the Council.  The Council  appears to have been indefatigable i n i t s e f f o r t s to get materials to the public through press notices and advertisements i n newspapers and 91 magazines.  The May, 193 *, issue of The C h i l d and Family Welfare News 2  noted that "The regular press notices c a r r i e d i n the Chatelaine, the Canadian Home Journal, La Revue Moderne, The Free Press P r a i r i e Farmer, 92 continue to prove a source of requests." How successful was the Council i n d i s t r i b u t i n g i t s materials t o the public? 1926  Between the inception of the prenatal l e t t e r service i n A p r i l ,  and May,  1931, 58,000 sets of prenatal l e t t e r s were d i s t r i b u t e d to  Canadian mothers and another 50,000 were on order.  Between the i n i t i a t i o n  of the postnatal l e t t e r service i n August, 1930, and May,  1931, 7,810 sets  of the postnatal l e t t e r s and 25,000 sets of the d i e t folders had been 93 d i s t r i b u t e d across Canada.  No one i s able to determine what percentage  of these publications reached B r i t i s h Columbia, but by 1937 the B r i t i s h Columbia Board of Health was d i s t r i b u t i n g the prenatal and postnatal l e t t e r s prepared by the Council with i t s own introduction attached to the letters. IV Voluntary organizations played a v i t a l r o l e i n the development of c h i l d care programs i n B r i t i s h Columbia.  Three leading organizations  i n t h i s process were the Women's I n s t i t u t e , the B r i t i s h Columbia D i v i s i o n of the Red Cross, and the V i c t o r i a n Order of Nurses (VON).  The Women's  I n s t i t u t e was formed i n Ontario i n 1897 and by 1909 had established several other i n s t i t u t e s i n B r i t i s h Columbia.  The Women's I n s t i t u t e  believed a woman's r e s p o n s i b i l i t i e s were to her family, her home, and her  18  community, and i t s purpose was to improve l i v i n g conditions f o r r u r a l 95  families.  Both I n s t i t u t e members andppollticians recognized the In-  s t i t u t e ' s potential f o r providing community leadership and f o r moulding 96  public opinion. For example, i n 1 9 1 6 , the I n s t i t u t e recommended the i n c l u s i o n of household science t r a i n i n g i n the public school curriculum and urged the general enforcement of the "Medical Inspection of Schools 97  Act".  I t supported the appointment of a d i s t r i c t nurse to Saanich i n  1917, and the establishment o f Saanich Rural Health Centre i n 1921. I t continued to provide l o c a l leadership i n the development of r u r a l health 98  programs throughout the province during the  1920's  and 1930's.  In  1924,  99  i t urged women to seek election to l o c a l School Boards.  Throughout the  two decades i t demanded health care f o r children o f a l l ages and f o r t h e i r m o t h e r s . I t worked through the 1920's and 1930 's to improve sanitary conditions and water supplies f o r r u r a l schools, and purchased equipment for hot lunches, f i r s t a i d supplies, and playground apparatus. I t provided l i b r a r y books, p r i n t s by the great masters, gramaphones, weighing scales f o r schools, and encouraged beautifying school grounds.  I t also  demanded domestic science and manual t r a i n i n g i n both elementary and high schools, ^"and organized well-baby c l i n i c s and health crusades i n schools 10  102  and communities. children.  I t frequently provided funds f o r dental treatment f o r  In 1 9 3 5 , f o r example, the Women's I n s t i t u t e i n the Hazelmere  D i s t r i c t paid the t o t a l cost of dental treatment f o r 1 2 7 children, paid h a l f the cost of dental care f o r 1 , 6 0 8 Surrey children, and made subs t a n t i a l contributions toward dental care i n Kaslo, Gibsons, and several other areas o f the province.  I t also assisted children i n need of correct103  i v e treatment of ears, eyes, and t o n s i l defects.  The Queen Alexandra  Solarium, opened i n 1 9 2 7 , another Women's I n s t i t u t e project, provided essential treatment f o r children s u f f e r i n g from d i s a b i l i t i e s and deformiti e s caused by tuberculosis, bone i n f e c t i o n s , i n f a n t i l e p a r a l y s i s , and  anterior p o l i o m y e l i t i s .  There i s ample evidence to indicate that the  Women's I n s t i t u t e played an important r o l e i n supporting the development of health care and health services f o r the province's c h i l d r e n .  The second organization to provide leadership i n health care i n B r i t i s h Columbia was the Red Cross.  Following the lead o f the Internat-  i o n a l Committee of Red Cross S o c i e t i e s , the B r i t i s h  Columbia D i v i s i o n  agreed to assume a peacetime program aimed a t health improvement, disease prevention, and mitigation of s u f f e r i n g throughout the  world.The  B r i t i s h Columbia D i v i s i o n saw i t s duties as providing a i d to veterans, continuation o f r u r a l nursing service and Red Cross Health  Centers,  the organization of the Junior Red Cross, the extension of health work i n schools, and the establishment  of d i s a s t e r r e l i e f depots throughout the  107 province.  Public health work immediately became an important component  of the peacetime program of the Red Cross.  Drawing from i t s supply of  nursing s i s t e r s returned from overseas i n 1918, the Red Cross placed ten -I A Q  nurses i n public health work i n r u r a l B r i t i s h Columbia i n 1920.  Their  duties included the regular examination of school children, the i n s t r u c t i o n of L i t t l e Mother's League classes, bedside v i s i t s , and prenatal and maternity v i s i t s .  With the development o f the P r o v i n c i a l Public Health Service,  the Red Cross re-evaluated i t s r o l e and, i n 1922, decided that the society's activities  would take the form of educational work rather than an exten109  sion of nursing service.  '  From 1923 to 1939, i n s t r u c t i o n i n f i r s t aid  and home nursing became the major thrust of the society, although i t continued to operate well-baby c l i n i c s , d i s t r i b u t e cod l i v e r o i l and/or milk where needed, and performed emergency c r i s i s r e l i e f . T h e Red Cross also sponsored the Junior Red Cross, a children's organization designed to promote good health, humanitarian i d e a l s , good c i t i z e n s h i p , and i n t e r n a t i o n a l friendliness.'''' '''" 1  The contributions by the Red Cross,  20  f i r s t , through the establishment of a Chair of Public Health, and secondly, through educational programs f o r both adults and c h i l d r e n , were very important i n the development of B r i t i s h Columbia's health care and 112  health services.  Another national organization a c t i v e i n B r i t i s h Columbia was the V i c t o r i a n Order of Nurses.  Established i n 1 8 9 7 to help improve the  q u a l i t y of maternal and c h i l d care, the VON quickly developed a nursing service composed of nurses trained i n public health work.  These nurses 113  worked as d i s t r i c t nurses and manned cottage hospitals i n r u r a l areas. With the development of the province's public health services and t r a i n i n g programs f o r public health nurses, the VON's d i s t r i c t nursing service and cottage h o s p i t a l s were no longer required.  In 1 9 2 1 ,  the VON turned i t s  energies to maternal and c h i l d care5 i t provided prenatal Instruction, postnatal care, maternity nursing i n homes, and general home nursing.  In  some areas of the province, the VON handled most of the maternity care 114  as iwell as prenatal and postnatal care.  Additionally, the VON cond-  ucted an extensive educational program designed to advise and inform parents about c h i l d care and c h i l d rearing techniques through well-baby c l i n i c s , group t a l k s , mothercraft classes, and home nursing c l a s s e s . " ' 11  V Health care agencies were not the only source of c h i l d care-child rearing information f o r parents o f the 1 9 2 0 * s and 1 9 3 0 ' s .  On the contrary,  publications and information services were a v a i l a b l e from a variety o f sources: l i f e insurance companies; drug manufacturers; magazines; church organizations.  newspapers and  For example, i n 1 9 2 5 the Metropolitan  L i f e Insurance Company had "forty d i f f e r e n t health and disease subjects available f o r d i s t r i b u t i o n on r e q u e s t " . ^ 11  These included pamphlets on  21 c h i l d care, the prevention and care of colds, the preparation and  use  117 of milk, and the establishment of good health habits.  In another  example, during the f i s c a l year 1930-31 the Canadian L i f e Insurance O f f i c e r s Association contributed $7,097.49 to a s s i s t f i n a n c i a l l y the 118 National Council on C h i l d Welfare produce the prenatal l e t t e r s e r i e s . Undoubtedly, the motives of the insurance companies were highly mercenary, but t h e i r materials were f r e e and parents and other agencies  utilized  them.^^ Drug companies also provided both free information and materials.  120  Throughout the 1920's and 1930's Steedmans, producers of teething powders  121  for babies, offered a f r e e booklet t i t l e d Hints to Mothers.  During the  d i f f i c u l t days of the depression, drug firms frequently provided f r e e samples of cod l i v e r o i l and public health nurses d i s t r i b u t e d these samples to homes where they saw the need to encourage mothers to use cod  122 liver oil.  c  A feature of many pharmacies during the 1930's was a Baby Department where not only those items required or desired f o r infant care were sold, but also where a set of scales was^  a v a i l a b l e to weigh i n f a n t s .  In some  pharmacies the scales could be borrowed or rented by the mother, and i n others a weekly weighing day was announced and the mother brought her i n f a n t to be weighed.  The weight was either recorded on cards kept  i n the dispensary, or by the mother h e r s e l f .  This service was not only  useful f o r keeping a record of the infant's weight gain, but also f o r the nursing mother to weigh her i n f a n t before and a f t e r feeding to determine how much milk the i n f a n t consumed.  Although baby departments were organ-  ized with merchandising baby care materials i n mind, they provided an 123 essential and well-used service to mothers.  22 124 The press also joined the campaign to "bring Information  to parents.  Mrs. V. MacLachlan, Secretary t o the Women's I n s t i t u t e s o f B r i t i s h Columbia believed the press to be a potent force, as she reported to the 1 9 2 5 Conference on C h i l d Welfare that "Day a f t e r day the press i s a t work i n the mind and character of vast masses of t h i s country and no other i n fluence i s to be compared with t h e i r s i n shaping the moral destinies of our nation."  1 2 5  Seven publications were examined as part o f t h i s study.  These i n c -  luded two Vancouver d a i l y newspapers, The Dally Province (The Province), The Vancouver Sun (The Sun), one small urban weekly newspaper^The Vernon News, three weekly magazines, the Family Herald and Weekly Star (a farm paper), the Star Weekly, and the Canadian Churchman (the o f f i c a l organ of the Church of England i n Canada) and one monthly women's magazine, 126 Chatelaine.  This small sample indicated that publications as diverse  as these seven c a r r i e d either a regular column addressed to parents, or pertinent items on c h i l d rearing and c h i l d care.  The Vancouver Sun and  Star Weekly, f o r example, c a r r i e d a Hearst syndicated column written by Mrs. Myrtle Meyer Eldred.  In addition to o f f e r i n g f r e e advice through  her column, "Your Baby and Mine", Mrs. Eldred offered free pamphlets on a v a r i e t y of topics that included thumb-sucking, t o i l e t t r a i n i n g , bed127 wetting and d i e t s . The Vancouver Sun and the Family Herald and Weekly 123 Star c a r r i e d the B e l l syndicated column edited by Angelo P a t r i .  Why  these papers c a r r i e d syndicated American columnists i s not c l e a r , but i t may  have been more convenient or cheaper to u t i l i z e a syndicated outlet  than a l o c a l consultant.  The Family Herald and Weekly Star weekly  "Mother and Baby" column which appeared i n every issue was written by 129 an u n i d e n t i f i e d Montreal physician.  7  From i t s inception i n 1928,  Chatelaine consistently c a r r i e d a v a r i e t y of items and a r t i c l e s written  From 1933  by Canadian c h i l d care advisors and health professionals. 1939  "to  "The Baby C l i n i c " edited by Dr. J . S. W. McCullough, Inspector of  Health f o r Ontario was c a r r i e d as a regular monthly feature. '* 1  0  The  Star Weekly also c a r r i e d regular weekly items and a r t i c l e s of i n t e r e s t to parents, but the writers of the information changed several times over 131 the two decades. ^  B r i t i s h Columbia's l a r g e s t d a i l y newspaper, The Vancouver Province, and Vernon's weekly, Vernon News, d i d not feature a regular column to parents, but they frequently c a r r i e d pertinent news items and a r t i c l e s 132 dealing with c h i l d rearing and c h i l d care.  For example, the October  1, 1924 issue of The Vancouver Province reported the r e s u l t s of the vaccination program i n Vancouver schools.  Amongst the l o c a l items from  the Vernon area were reports of developing health services, dates of 133 well baby c l i n i c s , and the appointment of VON  and school nurses.  The  encouraging and optimistic tone of these l o c a l news items must have encouraged community members to u t i l i z e the f a c i l i t i e s and services a v a i l able, or to request s i m i l a r services f o r t h e i r own  areas.  Church organizations not only prepared and published, but a c t i v e l y d i s t r i b u t e d information and materials to t h e i r members.  The  materials  prepared frequently r e f l e c t e d the problems and concerns of the time.  For  example, three b u l l e t i n s a v a i l a b l e from the General Board of Religious Education of the Church of England i n Canada were t i t l e d , "The Problem of the Moving Picture Theatre",  "Eugenics", and "The Family". -^ 1  In  1920,  "Infant M o r t a l i t y " , "Juvenile Courts", and "Women and C h i l d Labour" were 135 added to the l i s t . 1923  J J  A more d i r e c t approach was the d i s t r i b u t i o n i n  of seventy thousand copies of a Lenten l e t t e r "Commandments to  Parents" to the churches' 162,000 f a m i l i e s . ^ In 1927, 1  another Lenten  l e t t e r "Look to Your Children" was also d i s t r i b u t e d Canada-wide to Church 137 of England f a m i l i e s . '  A d d i t i o n a l l y , the Church's Council of Social  Service operated a lending l i b r a r y mail service from Toronto.  Among  the t i t l e s a v a i l a b l e f o r loan were C i t y Planning f o r G i r l s by Henrietta Additson, S t e r i l i z a t i o n ?  B i r t h Control? by Helen MacMurchy, Teaching  of Temperance and S e l f Control by E. C. Urwin, Psychology and Religion i n Early Childhood by J . W. D. Smith, Parents and the Preschool C h i l d by W. E. Blatz and Helen Bott, The Retarded C h i l d and How to Help Him by Arnold G e s e l l , and The Unmarried Mother and Her C h i l d by M. H. 138 Notingly.  Certainly the choice of t i t l e s r e f l e c t e d the concerns of  the era as well as the concerns of i n d i v i d u a l churchmen and women involved i n c h i l d care and c h i l d welfare.  These i n d i v i d u a l s included  Charlotte Whitton, Secretary to the Canadian Council on C h i l d Welfare and a member o f the Church of England's Council f o r S o c i a l Service, and Dr. Helen MacMurchy, Director of the C h i l d Welfare D i v i s i o n and an active member of the board of the Missionary and Deaconess Training School f o r 139 the Presbyterian Church i n Canada. Health professionals also recommended a substantial number of books 140 and manuals on c h i l d rearing to parents. Natal Letters" recommended eight books.  The 1 9 3 7 issue of the "PostIncluded i n the l i s t were L.  Emmett Holt's The Care and Feeding of Children, Alan Brown's The Normal C h i l d , Jessie Fenton's The P r a c t i c a l Psychology of Babyhood, and Thorn 141 Small's Habit Training f o r Children. Although many books were recom14; mended to parents, there i s l i t t l e evidence they were extensively used. Although the books may have been overly expensive for many parents, i t i s more l i k e l y that parents were looking for a more pragmatic type of manual on c h i l d care.  The publications provided by the various health agencies  were not only free, but also better suited to parents' needs.  The p u b l i c i t y surrounding the b i r t h and childhood of the Dionne quintuplets provided another source of c h i l d rearing and c h i l d care information.  Born i n May,  193^»  the"Quints*'immediately  became newsworthy,  and every d e t a i l of t h e i r feeding, care, and development was broadcast to the world.  Dr. A. R. Dafoe, the midwives, and the nurses associated with  the Dionnes, were touted as experts, and several individuals associated with the early care and r e a r i n g of the Quints gave interviews in^which they outlined the s c i e n t i f i c method used to rear the f i v e babies.  In  a series of a r t i c l e s i n Chatelaine, Madam De K i r i l i n e revealed i n minute d e t a i l the feeding, care, and treatment given the Quints during t h e i r 143 f i r s t two years.  As a guest on the Rudy Vallee radio show, Dr.  Alan Dafoe outlined the minute-by-minute r i g i d d a i l y schedule followed with the Quints, including the regular doses of orange j u i c e , cod l i v e r 144 o i l and d a i l y naps i n fresh a i r .  Any news about the Quints had a large  l i s t e n i n g , reading, or viewing audience on radio, i n the press, or i n newsreel films i n the l o c a l movie theatres. The Quints' endorsement of food and health care products such as milk, soap, toothpaste, cereal and cod l i v e r o i l c e r t a i n l y p r o f i t e d the sponsoring companies, but perhaps some Infants were better fed or better cared f o r because they were fed Pablum, Carnation milk, or Puretest Cod-liver O i l as t h e i r parents imitated the feeding practices of the 145 Quints.  -  /  In h i s book The Dionne Years, Pierre Berton points out what  he believes to be the e f f e c t of the p u b l i c i t y surrounding the l i f e of the Quints. adoption.  "They influenced attitudes towards c h i l d rearing, inoculation, and They boosted the sales of condensed milk, toothpaste, d i s i n f e c t -  ant, and dozens of other p r o d u c t s . " ^ 1  In 1936,  the year the Quints were  photographed receiving t h e i r diphtheria shots, the Toronto immunization 147 c l i n i c s had the heaviest attendance i n t h e i r history. Whether the  26 published Quints' p i c t u r e created the same effect i n B r i t i s h Columbia i s not c l e a r , but Dr. Young notes i n h i s 1936  Report f o r the P r o v i n c i a l Board  of Health that "The d i s t r i b u t i o n of vaccines and serums by the P r o v i n c i a l Board of Health shows an increase f o r those required f o r preventative work 148  and a decrease i n the curative branch..."  Young attributed the gain to  the cumulative work of public health workers; he probably never considered the p o s s i b i l i t y of the Quints having an influence on immunization  numbers  i n B r i t i s h Columbia. VI The inter-war years saw the development of health care and c h i l d care services as government departments, voluntary agencies and organizations consolidated and coordinated t h e i r services f o r children.  With the  recognition by p o l i t i c i a n s and c i v i l servants that the State had a r e s p o n s i b i l i t y f o r the growth and development of i t s future c i t i z e n s came the development of public health services and health information programs organized and financed by a l l l e v e l s of government.  Voluntary agencies,  women's organizations, church groups, i n d i v i d u a l health professionals, j u r i s t s and s o c i a l workers coordinated t h e i r e f f o r t s under one large, active and i n f l u e n t i a l organization, the Canadian Council on C h i l d Welfare. The concerns of the Council extended beyond health care to education and recreation, labour, e t h i c a l and s p i r i t u a l development, and children with s p e c i a l needs.  Voluntary agencies, such as the VON,  Red Cross and Women's  I n s t i t u t e , continued to work at the community l e v e l where they  observed  and attempted to meet community needs by providing either s p e c i f i c types of services themselves, or by rendering f i n a n c i a l assistance to other organizations to provide services.  Health professionals and c h i l d care advisors firmly believed parents  27 could be educated to the new rearing.  child  To accomplish t h i s end, they u t i l i z e d every form of communication  media available to them: displays.  s c i e n t i f i c approach to health care and  printed materials} radio; f i l m s ; exhibits  and  Throughout the 1920*s and 1930's, hundreds of thousands of  pieces of free l i t e r a t u r e were d i s t r i b u t e d through the public school system, public health units, voluntary  agencies, insurance companies and food and  drug companies.  Was  the use of the media i n f l u e n t i a l i n a l t e r i n g c h i l d rearing pract-  i c e s of B r i t i s h Columbia's parents? answer i s "yes".  There seems l i t t l e doubt that  the  Educator Urie Bronfenbrenner points out, "the f a c t  remains that changes i n values and practices advocated by p r e s t i g e f u l professionals can be substantially accelerated by rapid and widespread dissemination through the press, mass media of communication and  public  149 discussion."  7  There i s ample evidence that the media played a r o l e  i n e f f e c t i n g change i n the c h i l d rearing practices of B r i t i s h Columbian parents.  28 Footnotes 1 BCBH)r  B r i t i s h Columbia Board of Health, Report, 1921, p. A7, (hereafter  2 Robert Sears, Eleanor Maccoby, Harry Levin, Patterns of C h i l d Rearing (Evanston: Row, Peterson and Co., 1957). pp. 5 7» Raymond E. Callahan, Education and the Cult of E f f i c i e n c y (Chicago: University of Chicago Press, 1962), p.23. -  3 Bernard Wishy, The C h i l d and the Republic (Philadelphia: University of Pennsylvania Press, 1968), p. VI; see also William Kessen, "Research i n the Psychological Development of Infants: An Overview," Merrill-Palmer Quarterly, 9 (1963), 83-94. 4 A Tract on Twigs (Edinburgh: Thomas Constable, I 8 6 7 ) ; A. Hoare, Hints f o r the Improvement of E a r l y Education and Nursery D i s c i p l i n e (New York: C o l l i n s and Co., 1820); Richard Henry Smith, Twigs f o r Nests or Notes on Nursery Nurture (London: James Nisbet and Co. 1 8 6 6 ) . 5 L. Emmett Holt, The Care and Feeding of Children, 1921 ed. (London: D. Appleton and Co., 1894); F. Truby King, Feeding and Care of the Baby, 1920 ed. (Toronto: Macmillan, 1913); E r i c Pritchard, Infant Education (London: Henry Kimpton, 1907). 6 John B. Watson, Psychological Care of Infant and C h i l d (New York: W. W. Norton, 1928); W. E. Blatz and Helen Bott, Parents and the Preschool C h i l d (Toronto: J . M. Dent, 1928). 7 N e l l Sutherland, Children i n English-Canadian Society: Framing The Twentieth-Century Consensus (Toronto: University of Toronto Press, 197")t see also Rebecca Coulter, "The Dear L i t t l e Ones," The ATA Magazine, 59 (Jan. 1979). 6-8. 8 Robert Craig Brown, Ramsay Cook, Canada, I896 - 1921: A Nation Transformed (Toronto: McClelland and Stewart, 1974), pp. 294-309, 336338; see also Kenneth McNaught, The Pelican History of Canada 1976 ed. (Markham: Penguin Books, 1969). p.219? Richard A l l e n , The S o c i a l Passion: Religion and S o c i a l Reform i n Canada, 1914-29 (Toronto: University of Toronto Press, 1973). PP. ^-17; BCBH, ReportT 1920, p.A5; Jessie Forshaw, "How C h i l d Welfare Work Can Be Assisted i n the Rural D i s t r i c t s of B r i t i s h Columbia," Canadian Public Health Journal, XII (June 1921), 283-288, (hereafter CPHJ). 9 Margaret Kerr, "The Public Health Nurse and C h i l d Study Groups," Public Health Nurses?Bulletin, 1 (Mar. 1932), 10, (hereafter PHNB); Vancouver Board of Health, Report, 1919, p.18, (hereafter VBHJT 10  Callahan, Education and the Cult of E f f i c i e n c y , pp. 23-25.  11  I b i d . , pp. 20, 91.  12  I b i d . , p. 81.  13  I b i d . , p.  233  14 John Newson and Elizabeth Newson, "Cultural Aspects of Child Rearing i n the English-Speaking World," i n Rethinking Childhood: Perspectives  29 Footnotes on Development and Society, by Arlene Skolnick ed., (Berheiey:Little, Brown and Co., 1976), p. 343. 15 A l i c e Ravenhill, The Place and Purpose of Family L i f e ( B r i t i s h Columbia Department of Agriculture, • 1911), p. 5J "Report of the Third Annual Conference of the Women's I n s t i t u t e s , " Women's I n s t i t u t e Quarterly,  11 (Oct. 1916), 30. 16  F. W. Andrews, "Medical Inspection of School Children," i b i d . , p. 9  17  I b i d . , pp.  9-13.  18 V. S. MacLachlan, "Child Health Program i n B r i t i s h Columbia," CPHJ, XIV (Jan. 1923), 119. 19 Frances Lucy Johnson, "What of Your Child?" Chatelaine, Apr. 1928, p. 28; "Mental Needs of Child Needs Study By Parents," Star Weekly, Oct. 1, 1932, p. 3. 20 Angelo P a t r i , "The Other Mothers," Family Herald and Weekly Star, Dec. 26, 1928, p. 36, (hereafter FHWS) see also "The Baby C l i n i c , " Chatelaine, Oct. 1936, p. 59; Glenn Frank, "Peter Pantheism," The Vancouver Sun, Oct. 4, 1926, p. 6; "Ex-Convict Says Child's Future i s With Parent," The Vernon News, Oct. 2, 1931» P« 4; E i l e e n Carruthers, "Discussion Groups f o r Mothers," PHNB, 2(Apr. 1935)»P« 10; "Mother and Baby - Successful Parenthood," FHWS, Sept. 21, 1927, p. 41. 21  "The S i x Questions," CPHJ. XVIII (July 1927), 312-317; i b i d . , (Aug.  1927), 372-375.  22 B r i t i s h Columbia, Statutes, 1893. "An Act Respecting Public Health," Sec. 3, Sec. 28, Sec. 135; J . T. Marshall, "The Development of Public Health i n B r i t i s h Columbia," CPHJ, XXV (Aug. 1934), 359. 23  B r i t i s h Columbia, Statutes, 1893,  sec. 9.  24 Marshall, "The Development of Public Health i n B r i t i s h Columbia," p. 361; B r i t i s h Columbia, Statutes, 1899, "An Act to Amieridthe Health Act," Sec. 1, Sec. 3, Sec. 11, ibid,,May 10, 1909; i b i d . , Feb. 10, 1904; i b i d . , Mar. 12, 1906. 25 BCBH, Report, 1939. p. 1; " E d i t o r i a l , " The Vancouver Sun, June 2, 1916; "Henry Esson Young, B.A., M.D., CM., L.L.D." CPHJ, XXX (Nov. 1939), 564; Marshall, "The Development of Public Health i n B r i t i s h Columbia," p.363. 26 BCBH, Report, 1928-29, pp. U23-26; i b i d . , 1930-31. P. 34; i b i d . , 1936, pp. M29-34; MacLachlan, "Child Health Program i n B r i t i s h Columbia," pp. 119-120; " C h i l d Health Programme In B r i t i s h Columbia," C h i l d Welfare News, 1 (Jan.-Apr. 1924), 2-3. 27 Margaret Street, Watch F i r e s on the Mountain} The L i f e and Writings of Ethel Johns, (Toronto: University of Toronto Press, 1973). p. 116; History of t h e ~ B r i t i s h Columbia D i v i s i o n , The Canadian Red Cross Society, 1919 - 1957, p. 2; Canadian Red Cross Society, B r i t i s h Columbia D i v i s i o n , Annual Report, 1920, pp. 9-10.  30  Footnotes 28  Street, Watch F i r e s On The Mountain, pp. 1 1 6 , 1 2 6 , 128.  29  BCBH, Report, 1 9 2 3 , p. E6; i b i d . , 1 9 3 7 , P. P3-  30  I b i d . , 1 9 2 8 , p. W5.  31 I b i d . , 1 9 2 3 , p. E6; i b i d . , 1 9 2 8 , p. W 5 ; Marshall, "The Development of Public Health i n B r i t i s h Columbia," pp. 3 6 6 - 3 6 7 . 32 John Murray Gibbon and Mary S. Matheson, Three Centuries of Canadian Nursing (Toronto: Macmillan, 1 9 4 - 7 ) , p. 3 3 2 J There were, f o r example, United Church h o s p i t a l s a t B e l l a B e l l a , B e l l a Coola, Queen Charlotte C i t y , Port Simpson, and Hazelton. 33 BCBH, Report, 1 9 3 2 , p. Y3; Myrtle Harvey, "The Effects of the Depression on Public Health," PHNB, 1 (Mar. 1 9 3 2 ) , 41-42; , "Depression and Community Health," i b i d . , 2 (May 1 9 3 3 ) , Z-W. 34  BCBH, Report, 1 9 3 5 , p. FF3«  35  Ibid., 1 9 3 7 , P. M3; i b i d . , 1 9 3 8 , p. Q 4 .  36  VBH, Report, 1 9 1 0 , p. 3i i b i d . , 1 9 1 2 , p. 3 .  37  Ibid., 1 9 1 0 , p. 3 .  38  Ibid., 1 9 1 2 , p. 3 .  39  Ibid.  40 Ibid., 1 9 1 9 , P. 2 1 1 Minutes of the February 2 , 1 9 2 0 , Health Committee Meeting, Vancouver, C i t y Council. 41 "Analysis of Causes of Death of Children Under One Year," VBH, Report, 1 9 3 8 , p. 8 ; i b i d . , 1 9 3 9 , p. 7 1 . 42  Ibid., 1 9 2 0 , p. 1 8 ; i b i d . , 1 9 3 2 , p. 4 ; i b i d . , 1 9 3 9 , p. 7 .  43  Ibid., 1 9 2 2 , p. 18.  44  Ibid., 1 9 3 6 , p. 1 9 . ;  45  Ibid., 1 9 3 9 , PP. 1 - 4 5 .  46 Anne E. Wells, " P r i n c i p l e s and Methods o f P u b l i c i t y i n Health Education," CPHJ, XXIII (Sept. 1 9 3 2 ) , 4 4 2 - 4 4 7 ; see also Olive M. Garood, "Public Health i n Kamloops," PHNB 1 (May 1 9 3 0 ) , 2 6 - 2 9 ; Anne Yates, "ChildWelfare Work i n Cowichan D i s t r i c t , " i b i d . , 2 (May 1 9 3 0 ) , 2 9 - 3 2 ; "May Day C h i l d Health Day," B u l l e t i n o f the B r i t i s h Columbia Board of Health, 4 (May 1 9 3 3 ) ^ 3 ^ , (hereafter BBCBH); "Educational P u b l i c i t y , " i b i d . , 3 (Mar. 1 9 3 3 ) , 3 4 ; Geraldine Homfray, Marian Campbell, " P u b l i c i t y Campaign," PHNB, 2 (May 1 9 3 3 ) , 1 0 - 1 2 ; "Perfect Baby a t P r o v i n c i a l F a i r , " The Vancouver Province, Oct. 6 , 1 9 1 9 . 47  BCBH, Report, 1 9 1 2 - 1 3 , p. P 5 .  31  Footnotes 48 "Facts About Vaccination," BCBH, (1925); "The Health Guards," Canadian Dental Association, (n.d.); "The Treasure House," 'Canadian Dental Hygiene Council, (1937)? The Runabout, American Child Health Association, (1923); "Guide to A r t i f i c i a l Feeding," New Zealand Health B u l l e t i n , n.dv 49 MacLachlan, "Child Health Program i n B r i t i s h Columbia," p. 120; Canadian Child Welfare News, 1 (Jan.-Apr. 1924). 50 "The Prenatal and Postnatal Letter Service - The Experience of a Women's Institute Member," BBCBH. 7 (Aug. 1937), 138. 51  "Child Health Program i n B r i t i s h Columbia," p. 120.  52 "Educational Publicity," BBCBH, 3 (Mar. 1933), P- 34; W. H. Hatf i e l d , "Public Health Education - A Tuberculosis Exhibit i n Vancouver, B.C.," CPHJ, XXVII ( A p r i l 1936), 195. 53  BCBH, Report, 1928, p. W6.  54  Ibid., 1930, p. R8.  55  Ibid., 1934, p. Z5.  56  I b i d . , 1939. p. CC9.  57  Ibid.  58  I b i d . , 1913-14, p. P 5 .  :  59 V. S. MacLachlan, "Progress 1920 to 1925 and Recommendations 1925 to 1930 in:Child Health," Proceedings and Papers of the Canadian Conference on Child Welfare, 1925, pp. 29-3360  "The Health Officer Suggests," BBCBH, 9 (July 1939), 144-228.  61  MacLachlan, "Progress 1920 to 1 9 2 5 . . . . " p. 31.  62  Homfray and Campbell, "Publicity Campaign," p. 12.  63 M. R. Upshall, "Rain or Shine," PHNB, 2 (Apr. 1935). 34-35; see also Alive Garrood, "Public Health i n Kamloops," i b i d 1, (May~1930), 26-29; Margaret E. Kerr, "The Public Health Nurse and Child Study Group," i b i d . , 1 (Mar. 1932), 10-11; Elizabeth Martin, "Vernon," PHNB, 2 (Apr. 1935), 24; History of the B r i t i s h Columbia Division, The Red Cross Society 19191927, pp. 2-3; Canadian Red Cross Society, B r i t i s h Columbia Division, Report, 1922, pp. 13, 14, 19, 21, 22. 64  VBH, Report, 1937, P- 6.  65 J . M. Hershey, "The B r i t i s h Columbia Peace River Health Unit," CPHJ, 30 (Sept. 1939), 450. 66 Canada, Statutes, 1919, "An Act Representing the Department of Health."  32  Footnotes 67  Ibid., Sec. 4(a).  68 Handbook of Child Welfare Work i n Canada, (Department of Health: King's Printer, 1923), pp. 7-8. 69  Child Welfare Division, Report, 1921-22, p. 23.  70  Handbook of Child Welfare Work i n Canada, 1923,. p. 9.  71 Child Welfare Division, Report, 1923-24, p. 43; i b i d . , 1924-25, p. 29; i b i d . , 1930-31, P. 1^5; Hildur Hermanson, R.N., Medical Missionary to Taiwan, 1930-1965, Presbyterian Church i n Canada. 72 Child Welfare Division, Report, 1923-24, p. 43; i b i d . , 1924-25, p. 29; i b i d . , 1930-31. P. 45. 73  Handbook of Child Welfare Work i n Canada, p. 9.  74  Child Welfare Division, Report, 1923-24, p. 29.  75  Ibid., 1924-25, p. 39.  76  Handbook of Child Welfare Work i n Canada, p. 9.  77  Ibid.  78  Child Welfare Division, Report, 1926-27, p. 67.  79  Ibid., 1932-33, PP. 133-13^.  80 Handbook of Child Welfare Work i n Canada, 1923; An Enquiry into Maternal Mortality i n Canada, (Department of Health: King's Printer, 1921). 81  Child Welfare Division, Report, 1923-24, pp. 37-38.  82  Ibid., 1922-23, p. 37.  83 Ibid., 1932-33. P. HO; see also "Radio Talks on Health," CPHJ, XVI (Feb. 1925). 31; MacLachlan, "Progress 1920 - 1 9 2 5 . . . , " p. 31; "Coast to Coast Talks on F i r s t Aid," Canadian Pharmaceutical Journal, LXIV (Mar. 15, 1931), 153. 84  Child Welfare Division, Report, 1932-33, p. 110.  85  Child Welfare Division, Report, 1933-3^, p. 1^.  86 Child Welfare Division, Report, 1933-34, p. 14; for further details see Tamara K. Hareven, "An Ambiguous Alliance: Some Aspects of American Influences on Canadian Social History," Histoire Sociale/Social History (Apr. 31, 1969), 91. 87 Ibid., p. 93; "The Canadian Council on Child Welfare," The Canadian Churchman, Nov. 26, 1925, p. 776; Sutherland, Children In EnglishCanadian Society, pp. 229-231.  33 Footnotes 88  Hareven, "An Ambiguous A l l i a n c e , " p. 93.  89 Ibid.; Sutherland, Children i n English-Canadian Society, p. 230; "Proceedings and Papers," 1924, p. 1?. 90 C h i l d and Family Welfare, IX (May 1935), Back cover; Jean E. Browne, "News of Voluntary Health Agencies," CPHJ, (Mar. 1928), 144; 91 Advertisements appeared i n Chatelaine, July 1932, Feb. 1932, Nov. 1932, July 1934, Oct. 1935; Family Herald and Weekly Star, Sept. 30, 1930, Oct. 30, 1930, Nov. 3, 1932, Oct. 10, 1934, Oct. 4, 1936, Nov. 4, 1936; The Canadian Churchman, Nov. 19, 1925, Sept. 10, 1939; The Vancouver Province, Oct. 3, 1929. 92  C h i l d and Family Welfare, IX (May 1934), 15.  93 Ibid., VII (May 1931). 20; Arleen M. Roider, "Prenatal and Postnatal Letter Service," CPHJ, (Jan. 1931), 46-47. 94 Handbook of Women's I n s t i t u t e s With Report of Advisory Board, 1913t P« 11; S t e l l a Gummow ed., Handbook, B r i t i s h Columbia Women's Ins t i t u t e s , (1942), p. 2. 95 (Mrs.) F. B. Atkinson, "Motherhood - I t s Relation t o Our Country and Empire," i b i d . , 1912, p. 104; Women's I n s t i t u t e Third Annual Conference, Women's I n s t i t u t e Quarterly, 11 (Oct. 1916), 30-31; Mrs. Malcolm Macmillan, "Women's Responsibility to the Empire," i b i d . , ( A p r i l 1916), 104-107. 96 "How To Organize Hot Lunches In The Schools," i b i d . , 1 (Oct. 1916), 109; Handbook, B r i t i s h Columbia Women's I n s t i t u t e s , (1913), p. 10. 97 "Report of the Annual Meeting of the Advisory Board of the Women's I n s t i t u t e , " Women's I n s t i t u t e Quarterly, 1 (Apr. 1916), p. 77. 98  MacLachlan, "Progress 1920 - 1925...," p. 30.  99 "Report of the Secretary, B r i t i s h Columbia Women's I n s t i t u t e s , " Women's I n s t i t u t e Yearbook, 1923-24, p. 18. 100  MacLachlan, "Child Health Program i n B r i t i s h Columbia, " p. 119.  101  Women's I n s t i t u t e Yearbook, 1923-24, p. 35.  102  Handbook of C h i l d Welfare Work i n Canada, pp. 36-37.  103  BCBH, Report, 1936, pp. J 6 - 7 .  104  Ibid., 1927, pp. K17-18; i b i d . , 1926, p. M20.  Women's I n s t i t u t e Yearbook, 1923-24, pp. 20-22, 30-31, 35; 105 "Child Welfare Programme i n B r i t i s h Columbia," pp. 2-3; "Report of Health Work, Women's I n s t i t u t e s , " BCBH, Report, 1936, p. M36.  34  Footnotes 106 Jean Browne, "Address to the New Brunswick Branch of the Canadian Red Cross," i n Three Centuries of Nursing, p. 3^3; "Peacetime Programme of the Red Cross Society," CPHJ, XI (Apr. 1920), 1 4 9 - 1 5 3 . 107 History of the B r i t i s h Columbia D i v i s i o n , The Canadian Red Cross Society, n.d., p. 1; "Vancouver Branch Red Cross Annual Meeting," The Vancouver Province, Oct. 4, 1919» p. 2. 108 Gibbon and Matheson, Three Centuries of Canadian Nursing, p. 352; Canadian Red Cross, B r i t i s h Columbia D i v i s i o n , Report, 1920, pp. 8, 11. 109  I b i d . , 1922,  110  I b i d . , pp. 13,  p.  13. 22.  111 "Recommendations and Resolutions - Committee of Red Cross Societ-i e s - Cannes Conference, 1919," CPHJ, XI (Apr. 1920), 154} Jean Browne, "The Programme of the Junior Red Cross," Proceeding and Papers, 1923,  pp. 72-77. 112  BCBH, Report, 1921,  113  John Murray Gibbon, The V i c t o r i a n Order of Nurses f o r Canada: (Montreal: Southam Press, 19^7), p. 69.  1897-1947  p. B6; i b i d . , 1925,  p. N6.  114 Gibbon, The V i c t o r i a n Order, pp. 3, 8 2 ; Elizabeth L. Smellie, "The Responsibility of the Voluntary Agency with Regard to the Mother and C h i l d , " Papers and Proceedings, 1925, pp. 94-99; "Funds Needed to Support D i s t r i c t Nurse," Vernon News, Oct. 1 7 , 1929, p. 7; "Board of Management of Peachland - Westbank Branch of VON," i b i d . , Oct. 20, 1932, p. 5; "VON Dance at Westbank," i b i d . , Oct. 31, 1935, p. 1. 115 Bertha H a l l , "Provision f o r Infant Care i n a Small Community," Proceeding and Papers, 1927, pp. 27-31; BCBH, Report, 1937, P« ?37; VBH, Report, 1938, p. 12; "Victorian Order Encourages Help For Body and Mind," The Vancouver-Province, Oct. 3, 1935; Gibbon, The V i c t o r i a n Order, pp.  82-84.  116 Metropolitan L i f e Insurance Company offered free publication as i n Chatelaine, Jan. 1938 and Mar. 1939. Other free materials included pamphlets printed by the Metropolitan L i f e Insurance Company, but d i s t ributed by the B r i t i s h Columbia Board of Health. 117 The C h i l d (1924); A l l About Milk (1927); F i r s t A i d i n the Home (1914); The Baby (n.d.); Baby Book Record (n.d.); Good Habits f o r Children (n.d.). 118  C h i l d and Family Welfare, VII (May 1931),  17.  119 The B r i t i s h Columbia Board of Health d i s t r i b u t e d Metropolitan L i f e Insurance Company health information such as "Measles." and "My Health Habits." 120 "Some Sources of Materials - Health Education f o r Schools," C h i l d and Family Welfare, VIII (May 1932), 36-52; Kerr, "The Public Health  35 Footnotes Nurse and Child Groups," p.  11.  121  Steedman's Powders Advertisement, FHWS. Sept. 25, 1929,  p. 34.  122  Kerr, "The Public Health Nurse and Child Study Groups," p.  11.  123 George Fisher, Pharmacist-Owner, Fisher's Drugs, 4355 Dunbar Street, Vancouver; "Why Not a Baby Department i n Drug Stores?" The Druggists C i r c u l a r . LXXVI (Sept. 1932), 35; "A Section f o r Baby's Needs," Canadian Pharmaceutical Journal. LXXX (Jan. 1937), 22. 124  MacLachlan, T r o g r e s s 1920 - 1925," p. 31.  125  Ibid.  126  1935 1939 The Vancouver Sun. 1935 1939 Chatelaine (B. C. only), 1930 1939 Star Weekly (National), 1919 1939  127  The Vancouver Sun. 1926 - 1939;  The Vancouver Province.  -  128 The Vancouver Sun. 1929 - 1939; 1926 - 1938; Star Weekly. 1930.  85,000 c i r c u l a t i o n 88,000 c i r c u l a t i o n 66,000 c i r c u l a t i o n 70,000 c i r c u l a t i o n 12,270 c i r c u l a t i o n 22,285 c i r c u l a t i o n 80,613 c i r c u l a t i o n 361,159 c i r c u l a t i o n Star Weekly. 1930 -  1932.  The Family Herald and Weekly Star.  129  Family Herald and Weekly Star. 1919  130  Chatelaine. 1934 -  131  Star Weekly. 1919 1924 1926 1927 1930 1930 1932 1934 care  -  1939.  1939. - 1923 - Child Welfare Bureau, Toronto - 1925 - Star Weekly Health Bureau - 1927 - Dr. W. A. Evans, "How to Keep Well." - 1933 - Canadian Medical Association - 1932 - Mrs. M. E. Eldred - Angelo P a t r i - Mother Cract Association - 1939 - No regular columnist or column but c h i l d items and a r t i c l e s c a r r i e d .  132 "Returns from Vaccination at Various Schools," The Vancouver Province. Oct. 1, 1921; Dr. Royal S. Copeland, "Overfeeding Your Baby," i b i d . , Oct. 2, 1924; "Diet and Suggestions Recommended f o r Mothers," (rpt. from the Children's Bureau, United States Department of Labour), i b i d . , Oct. 3 , 1926. 133 "Child Welfare Convention," The Vernon News. Sept. 23, 1920, p. 11} "School Nurse f o r Armstrong," i b i d . , Oct. 23, 1924, p. 8 ; "What W i l l Happen When the Boy i s Father to the Man," i b i d . , Oct. 14, 1925, p. 11; "Build Character By Reading Only Best L i t e r a t u r e , " i b i d . , Oct. 27, 1932, p. 1? "Why Waste Time of Eager Students," i b i d . , Oct. 5 , 1933. PP. H - 12.  36 Footnotes 134 Church of England i n the Dominion o f Canada, Yearbook, 1919. p. 180, (hereafter C of E ) . 135  C of E, Yearbook, 1920, p. 197.  136  Proceedings of the General Synod of the C of E, 1923, p. 233.  137  Ibid., 1927, p. 285.  138 "Report of the Council f o r S o c i a l Services, C of E," Yearbook, 1937; i b i d . , 1939. 139 "The Canadian Council on C h i l d Welfare," The Canadian Churchman, Nov. 26, 1925, p. 776; Hildur Hermanson, Medical Missionary To Taiwan. 140 Alan Brown, The Normal C h i l d , I t s Care and I t s Feeding, (1923); W. E. Blatz, Helen Bott, Parents and the Preschool C h i l d , (1929); G. E. Reaman, C h i l d Guidance f o r Parents and Teachers, (1933); see also Geoffrey H. Steere, "Freudianism and C h i l d Rearing i n the Twenties," American Quarterly, 10 (1968), 759 - 767, Steere l i s t s forty-two c h i l d rearing manuals published between 1925 and 1929. 141 "Mother and Baby - Post Natal Letters," Canadian Council on C h i l d Welfare, 1939. 142 Kerr, "The Public Health Nurse and C h i l d Study Groups," p. 11; The Canadian Churchman, Oct. 11, 1923, p. 645; The Vancouver Sun, Oct. 17, 1930, p. 17; Chatelaine, June 1929, p. 42. 143 Madam Louise DeKeriline, "I Nursed The Quintuplets," Chatelaine, May 19, 1936 to Jan. 1937; "Quint's Progress," FHWS, Nov. 10, 1937, p. 32; Pierre Berton, The Dionne Years: A T h i r t i e s Melodrama (Toronto: McClelland and Stewart, 1977). pp. 81-82, 88-92, 95; E l z i r e Dionne, "My L i f e and Motherhood," The Vancouver Sun, Oct. 5 . 1935. 144  "Sounds of the Past," CBC Vancouver Radio, Aug. 12, 1979.  145 For example advertisements f o r Quaker Oats - FHWS, Oct. 28, 1936, p. 28; The Vancouver Sun, Oct. 4 , 1935; The Vancouver Province, Oct. 3 ,  1935. 146 Berton, The Dionne Years, p. 12; see also Stuart Ewen, Captains of Consciousness (Toronto: McGraw-Hill, 1976), pp. 33, 35, 48; Christopher Lasch, Haven i n a Heartless World: The Family Beseiged (New York: Basic Books, 1979). PP. 12-21. 147  Berton, The Dionne Years, p. 18.  148  BCBH, Report, 1936, p. M3.  149 Urie Bsonfenbrenner, "The Changing American C h i l d - A Speculative Analysis," i n Children Reading i n Behaviour and Development by E l l i s E. Evans ed., (Toronto: Holt, Rinehart, Winston, 1968), p. 94.  Chapter 2  Motherhood!  By 1920,  In the Service of the Nation  health professionals and c h i l d care advisors recognized that  i f they were to change c h i l d rearing practices of B r i t i s h Columbia parents, they must begin working with expectant parents before p a r t u r i t i o n . Developments i n medical research and health care not only ensured a greater chance of s u r v i v a l f o r the infant, but also a h e a l t h i e r pregnancy, a l e s s dangerous delivery, and a greater chance of survival f o r the mother than had previously been the case.  1  Advisors were aware that the f o e t a l  stage was an extremely important period i n the child's t o t a l development, and that the mother's health was the most important factor i n determining the chances of s u r v i v a l f o r both the infant and the mother.  Furthermore,  health professionals knew puerperal septicaemia (child-bed fever), the greatest k i l l e r of new mothers, was preventable through good personal health care and cleanliness by the mother and proper hygienic precautions by the attending physician or midwife.  Deaths caused by abortion (induced or  natural), haemorrhage, bleeding during pregnancy or labour, uncontrolled vomiting, eclampsia, and n e p h r i t i s , were at least controllable i f not preventable.  A d i f f i c u l t labour could be anticipated, and b i r t h complic-  ations could be sometimes predicted before the woman actually went into  2 labour.  Throughout the 1920's and 1930's, B r i t i s h Columbia mothers were  urged to seek prenatal care not only as a way of reducing the number of physical defects and deaths among t h e i r infants, but also as a means of 3 ensuring t h e i r own s u r v i v a l . I During the e a r l i e r part of the twentieth-century, B r i t i s h Columbia's health professionals had expressed concern with the high rates of maternal and infant deaths.  For example, i n 1912,  37  Dr. F. T. Underhill, Vancouver's  38 medical health o f f i c e r , drew attention to the c i t y ' s high mortality rates. He argued that deaths of both infants and mothers were d i r e c t l y related to the quality of l i f e i n the c i t y ' s tenements, which he believed  lacked  fresh a i r , natural l i g h t , proper sanitation, and s u f f i c i e n t l i v i n g space.  Underhill argued that these conditions created "within the expectant  mother a dread and abhorrence of children, very often ending i n disastrous r e s u l t s f o r both h e r s e l f and the c h i l d . "  4  But Vancouver's health professionals were not the only groups aware of the problem, and i n November, 1919,  the B r i t i s h Columbia Government  appointed a Commission on Health Insurance to investigate, among other things, the subject of maternity insurance. Maternity  The Report of the Committee on  Insurance and Public Nursing (1921)revealed a province-wide concern  by women's organizations, r e l i g i o u s s p e c i a l i s t s , and other members of B r i t i s h Columbia's society at the lack of medical f a c i l i t i e s and f i n a n c i a l a s s i s t ance f o r expectant mothers.  5  At the national l e v e l , a s t a t i s t i c a l analysis  of b i r t h s , i n f a n t deaths, and maternal deaths i n the 1921  Dominion Census  brought i n t o sharp focus the magnitude of the problem.^  As Helen MacMurchy  pointed out, "On  the l i s t seventeen c i v i l i z e d nations averaged i n order  as regards maternal mortality, Canada and the United States were at the foot of the l i s t . "  7  Switzerland, Norway, and the Netherlands, countries which  provided compulsory maternity benefits f o r t h e i r mothers, had the lowest g maternal mortality rates.  S t a t i s t i c a l l y , B r i t i s h Columbia's  maternal mortality rate of 4.78  per 1000  higher than the national rate of 4.70, of 56.5  1921  l i v e births was only s l i g h t l y  although the infant mortality rate  was considerably lower than the national rate of 102.0  per 1000  live  9 births.  But these s t a t i s t i c s must not be accepted without reservations;  H. B. French, P r o v i n c i a l Deputy Minister of B i r t h s , Deaths, and Marriages, pointed out that, because of the widely spread - spaifeely s e t t l e d populat-  39 ion i n some areas, and the migratory nature of the population i n other areas, accurate v i t a l s t a t i s t i c s were not only delayed but also d i f f i c u l t to c o l l e c t .  1 0  Nevertheless, the s t a t i s t i c s derived from the 1921 Dominion  Census d i d a l e r t health professionals, public health workers, p o l i t i c i a n s , and concerned l a y m e n t o the extent of infant and maternal deaths.  Once  aware of the magnitude of the maternal mortality problem, the 1924 Conference on Medical Services i n Canada passed a r e s o l u t i o n requesting the Federal Department of Health make a comprehensive enquiry into the causes of maternal m o r t a l i t y .  1 1  Dr. Helen MacMurchy and the s t a f f o f the C h i l d Welfare D i v i s i o n began the requested enquiry i n Janury, 1925* of data:  They examined two types  the death c e r t i f i c a t e s of a l l Canadian women aged f i f t e e n to  f i f t y years who died between July 1, 1925 and July 1, 1926; the responses of s i x hundred forty-one Canadian physicians to a questionnaire sent out  12 by the D i v i s i o n i n May, 1925.  The enquiry found that of the approximat-  ely 11,000 deaths of Canadian women of child-bearing age, 1532 deaths could be d i r e c t l y attributed to complications of pregnancy, labour, or post-parturition i n f e c t i o n s .  There were an a d d i t i o n a l 2,800 deaths which  might or might not be attributed to complications a r i s i n g from pregnancy. Of the 1532 deaths, only 230 (twelve percent) of the women involved had 13  sought prenatal care.  The enquiry also disclosed that complications  a r i s i n g during pregnancy or c h i l d b i r t h were the second greatest cause 14  of death among Canadian women, tuberculosis being the most common cause. Although concerned for a l l mothers, health professionals were parti c u l a r l y anxious to reach those women who neglected to consult a physician during pregnancy, could not a f f o r d medical care, or l i v e d i n i s o l a t e d areas where medical assistance was not available. "^ 1  But, as the research shows,  40  not a l l women neglected to seek prenatal care.  In a study of medical  attendance i n Vancouver between 1 8 8 6 and 1 9 2 0 , s o c i a l h i s t o r i a n Margaret Andrews focused on the medical .practice of Vancouver physician Henri Evariste Langis.  Among other d e t a i l s of Langis' practice, Andrews found  that f o r the time periods 1 8 9 3 to 1 8 9 4 and 1 9 0 3 to 1 9 0 4 , seventy percent of the women whom Langis attended at c h i l d - b i r t h had seen him before the onset of labour.  Andrews concluded these women "had the advantage of  some prenatal care."''"^ She also noted that i t was neither ethnic background, economic position, nor occupation, that determined which women sought Langis* services before t h e i r confinement, but rather a high proportion were women who either experienced or anticipated d i f f i c u l t i e s 17  during pregnancy or labour.  Although Andrews found that seventy percent  of Langis' o b s t e t r i c a l cases sought prenatal advice, this was not the case for most of the province's expectant mothers, therefore, among other recommendations the Report on Maternity Insurance and Public Nursing  (1921)  c a l l e d f o r the i n i t i a t i o n of a vigorous educational c h i l d - b i r t h program by the Board of Health.  The report also recommended provision be made  for medical, s u r g i c a l , and o b s t e t r i c a l services and materials wherever necessary to ensure a safe pregnancy and delivery f o r every B r i t i s h Columbia 18  mother.  The Report of the Enquiry i n t o Maternal Mortality confirmed that  a large number of women did not seek prenatal care, and i t c l e a r l y demonstrated that most maternal deaths (eighty-eight percent) occurred 19 among women who had no prenatal care.  Although mothers were urged t o  v i s i t t h e i r family physician early i n t h e i r pregnancies and to continue regular v i s i t s throughout t h e i r nine month gestation period, the v e i l of secrecy and embarassment that surrounded pregnancy made mothers reluctant to do so.  Health workers were constantly appalled by the large number of 20  maternal deaths that need not have occurred.  Because health workers believed most maternal deaths, and frequently the deaths of infants, could be prevented through prenatal care, they saw t h e i r primary task as one of convincing B r i t i s h Columbia women that the number of deaths of both mothers and infants could be greatly reduced  21 through proper prenatal care.  They saw t h e i r second task as that of  teaching women that a healthy mother produced a healthy i n f a n t .  Their  t h i r d task was that of persuading expectant mothers (and fathers) t o seek medical advice long before women went i n t o labour, and c e r t a i n l y long  22 before complications developed during labour.  Health professionals  attempted t o provide prenatal care and advice t o expectant mothers by three d i f f e r e n t methodst  having women attend prenatal c l i n i c s ; through  home v i s i t s made by nurses; through the d i s t r i b u t i o n of relevant l i t e r a t u r e . Throughout the 1920's and 1930*s, public health, VON, and Bed Cross nurses attempted t o e s t a b l i s h prenatal c l i n i c s throughout the province, but they found i t a slow and d i f f i c u l t process.  For example,  the Saanich Health Centre made plans t o e s t a b l i s h a prenatal c l i n i c as early as 1922, but i t s organization took two years t o complete, and then attendance was ensured only i f the nursing s t a f f drove women t o and from 23 the c l i n i c s .  Saanich*s medical health o f f i c e r reported that nurses  found t h i s practice time consuming i n proportion t o the number of expectant mothers delivered t o the c l i n i c , therefore, i n 1927t the nurses began t o 24 make home v i s i t s t o expectant mothers.  In h i s 1925 report t o the  Child Hygiene Section of the Canadian Conference on C h i l d Welfare, Hon. W. F. Roberts, Minister of Health f o r New Brunswick, expressed the opinion that prenatal c l i n i c s were d i f f i c u l t t o e s t a b l i s h because i t was not 25 easy t o convince women t o attend. ^ Roberts observed that mothers were w i l l i n g t o bring t h e i r infants t o well-baby c l i n i c s , but unwilling  26 to attend prenatal c l i n i c s .  Two years l a t e r , Miss A. G. Wells of the  hz Manitoba Board of Health, reported to the Canadian Council on Child Welfare that prenatal c l i n i c s were s t i l l lacking i n r u r a l areas of the western provinces, although r u r a l mothers c e r t a i n l y needed access to 27 In 1930. Olive Garrood, the i n d e f a t i g -  prenatal information and advice.  able public health nurse i n Kamloops, attempted to establish a prenatal c l i n i c , but she also encountered d i f f i c u l t y convincing mothers to attend. She reported that pregnant mothers s t i l l did not seem to understand the 28 importance of prenatal care. Attempts to establish prenatal c l i n i c s i n urban areas met with l i t t l e more success than i n r u r a l areas.  The 1920 organizational plan f o r the  Vancouver D i v i s i o n of Child Hygiene included a weekly prenatal c l i n i c at Vancouver General Hospital, and the Vancouver Board of Health annual report o p t i m i s t i c a l l y stated, "The Department commences with the expectant mother 29 ..."  7  The 1921 report and a l l subsequent reports up to 1939 do not  mention a prenatal c l i n i c .  Furthermore, as l a t e as 1937, Br. Stewart  Murray, Director of C h i l d Hygiene f o r Vancouver, reported that Vancouver public health unit s t i l l had no d e f i n i t e prenatal care program, and wherever maternity cases were found they were referred either to the 30 woman's personal physician or were directed to VON c l i n i c s . In p o s t - F i r s t World War B r i t i s h Columbia, the V i c t o r i a n Order of Nurses s h i f t e d i t s focus from d i s t r i c t work to home nursing. Elizabeth L. Smellie, Superintendent  By 1924,  of the V i c t o r i a n Order, reported that 31  s i x t y percent of the Order's work was i n o b s t e t r i c s .  U n t i l the mid-  1930' s, a l l prenatal work-by the.VON was on a one-to-one basis through house c a l l s made to.expectant mothers, but during the mid-1930's the VON 32 organized i t s f i r s t regular prenatal c l i n i c i n Vancouver.  Although the  Vancouver branch of the Junior League assumed operational r e s p o n s i b i l i t y  43 for the prenatal c l i n i c , i n 1935, a V i c t o r i a n Order Nurse was always i n attendance to give prenatal i n s t r u c t i o n and advice to prospective mothers. VON Superintendent  Margaret D u f f i e l d stated, " i t has become one of (our)  33 most active and best attended classes..."  The c l i n i c ' s program consisted  of a l e c t u r e on prenatal care, i n s t r u c t i o n s and d i s t r i b u t i o n of materials 34 for making layettes, and a s o c i a l time over a cup of tea.  Yet t h i s one  c l i n i c appears to have been the only regular prenatal c l i n i c  operating  i n the C i t y of Vancouver.  In s p i t e of the repeated attempts by B r i t i s h  Columbia's health professionals and public health workers to establish care f o r the expectant mother i n various areas of the province, prenatal c l i n i c s appear to have been the most d i f f i c u l t type t o i n i t i a t e and to maintain. The second method used by health workers to reach expectant mothers was through home v i s i t s , but the reluctance of expectant mothers to contact 35 the nurse made i t d i f f i c u l t f o r the nurse to contact them.  In 1921,  Dr. Young noted that (unnamed) voluntary organizations were t r y i n g to introduce the p r a c t i c e of voluntary r e g i s t r a t i o n of pregnancies, however, the p r a c t i c e was never implemented and health workers had no sure method of l o c a t i n g mothers-to-be.  They frequently r e l i e d on the less-than-  e f f e c t i v e method of word-of-mouth communications f o r r e l a t i n g prenatal services to expectant mothers and f o r supplying the names of known pregnant women to health professionals.  For example, i n 1927-28, nurses i n the  Kelowna Rural D i s t r i c t recorded four prenatal cases t o whom they made 21 home v i s i t s .  In 1929-30, the nurses recorded four prenatal cases to whom  they made 11 home v i s i t s .  In 1930-31* they reported no prenatal v i s i t s ,  although 289 infants were brought t o the well-baby c l i n i c s during t h i s  37 time.  Obviously, nurses were not reaching even a small portion of the  expectant mothers i n the area, as the Reports of the Department of V i t a l  44 S t a t i s t i c s indicates that 137 b i r t h s were registered i n the Kelowna area i n 1927, 153 b i r t h s i n 1928, 156 b i r t h s i n 1929, 144 b i r t h s i n 1930, and 166  b i r t h s i n 1931•  Although these numbers include b i r t h s i n both r u r a l  and urban areas of the Kelowna D i s t r i c t , they also indicate public health nurses were making scant inroads i n t o prenatal work.  Public health workers i n the Peace River area used records of the l o c a l r e l i e f o f f i c e r to locate names of expectant mothers that should be visited.^  This method proved quite successful f o r i n 193&, nurses made  40 325 prenatal c a l l s , and i n 1937 they made 220 prenatal c a l l s .  In other  areas of the province where r e l i e f work was one of the public health nurses' many r e s p o n s i b i l i t i e s , nurses frequently contacted pregnant c l i e n t s through  41 routine s o c i a l service c a l l s .  In terms of reaching prenatal cases,  home v i s i t s were probably more e f f e c t i v e than prenatal c l i n i c s , but nurses c e r t a i n l y d i d not locate a l l pregnant women.  This was p a r t l y because of  the f a i l u r e of women to seek prenatal a i d from public health workers, and the growing tendency during the 1920's and 1930's f o r women to go to hospitals for deliveries.  In 1931, Audrey Payne, Saanich Public Health nurse,  noted that even i n r u r a l d i s t r i c t s of the province the majority of women seemed to think two or three v i s i t s to t h e i r physician was a l l the prenatal  42 care necessary during t h e i r pregnancies.  These women often did not  bother to contact the public health nurse u n t i l a f t e r t h e i r babies were born.^ The t h i r d method used to advise expectant mothers was through the d i s t r i b u t i o n of printed materials.  The f i r s t prenatal advice issued by  the B r i t i s h Columbia Board of Health was a set of ten prenatal l e t t e r s  44 prepared i n 1920.  Throughout the 1920's and 1930's, the P r o v i n c i a l Board  of Health, the Vancouver Board of Health, and the V i c t o r i a n Order of Nurses  45 d i s t r i b u t e d materials either prepared by t h e i r own from materials prepared by New  agencies or reprinted  Zealand, B r i t i s h , or American health  45  agencies.  These materials were d i s t r i b u t e d free to B r i t i s h Columbia  mothers through health care agencies or by health care workers. prenatal materials were a v a i l a b l e through health care agencies,  Although only  occasionally did newspapers and magazines provide prenatal advice or urge mothers to seek medical advice early i n t h e i r pregnancies. For example, i n ninety-eight issues of Chatelaine magazine examined f o r t h i s study, 46  only s i x a r t i c l e s dealt with some aspect of prenatal care. s p e c i f i c products recommended to expectant mothers.  Nor were  Among the materials  examined, only one advertisement (by the Ovaltine Company) recommended mothers begin drinking i t s product about two months before the b i r t h of their child.  Drinking Ovaltine, the advertisement stated, would ensure an 47  abundant milk supply and a f a s t e r recovery a f t e r p a r t u r i t i o n .  Not only  was prenatal advice minimal i n amount as compared to that a v a i l a b l e on infant care, but also most prenatal advice came either through d i r e c t contact with health workers or through the d i s t r i b u t i o n of pamphlets, l e t t e r s , or materials prepared by health  agencies.  Ill The advice f o r mothers-to-be c a r r i e d both an i d e a l i s t i c and a p r a c t i c a l message.  The i d e a l i s t i c message was that mothers were the back-  bone of the nation and c h i l d rearing was part of a woman's national service.' 49  As Helen MacMurchy stated, "No baby - no nation." '  Motherhood was not only  a desirable state but also a sacred right,-^and a woman's s p e c i a l mission 51  i n l i f e was to protect the home, the family, and the c h i l d .  In f u l -  f i l l i n g t h i s r o l e , MacMurchy wrote,the mother " . . . i s the one important 52  f a c t o r i n the future health of the nation, morally and p h y s i c a l l y . "  In  46 her address to the 1918 convention of the C h i l d Welfare Association of B r i t i s h Columbia, Mrs. Mary E l l e n Smith, M.L.A. f o r Vancouver, stated that she believed a l l g i r l s should be looked upon as p o t e n t i a l mothers t o be 53  educated t o f u l f i l l t h e i r duties as the future mothers of the race.  At  the same convention, Dr. Ernest H a l l , of V i c t o r i a , recommended the immediate passage of the Mother's Pension B i l l i n B r i t i s h Columbia "as a recognition of the divine r i g h t of motherhood to be recognized as the highest service to the state." The p r a c t i c a l message to women wasihat c h i l d bearing was a normal, natural process that need not be hazardous to either mother or infant. Yet, t o reduce the hazards of c h i l d b i r t h s , public health personnel recognized the need to provide both prenatal and postnatal services i n 55  a l l areas of the province.  In an address to the 1917 meeting of B r i t i s h  Columbia Medical Health O f f i c e r s , Dr. Isabel Arthur, Nelson's Medical Health O f f i c e r , stated "In order to have the healthy c h i l d we must have healthy parents so that the care of the c h i l d i s p r e n a t a l . T h e Report on Maternity Insurance and Public Health Nursing (1921) argued that the provision of prenatal care by public health agencies was a p a t r i o t i c duty, and the committee's investigations demonstrated "...that c h i l d b i r t h under favorable conditions i s vastly more important to the nation than i s c h i l d 57 b i r t h under adverse conditions." Rather than seek professional advice, young women accepted the h a l f truths and misinformation passed on by other women. This advice was r a r e l y based on medical knowledge or research, therefore, health workers t r i e d to educate women about medical facts about pregnancy, t o make them aware of normal bodily changes that occurred during pregnancy, and to recognize which changes were abnormal and required medical treatment.  47  While working with expectant mothers, health workers discussed the need for  regular medical supervision, expected changes i n weight and general  appearance, changes i n temperature, pulse rate and r e s p i r a t i o n with expectant mothers.  Women were warned t o keep t h e i r bowels regular, and to  seek medical assistance a t the f i r s t signs of oedema, disturbed v i s i o n , vaginal discharge, protracted nausea or vomiting, persistent headaches,  cp excessive f l a t u l e n c e or disponea, or varicose veins.  Women were taught  to care f o r t h e i r breasts so they could breast feed t h e i r i n f a n t s .  They  were t o l d to get s u f f i c i e n t fresh a i r and exercise, eat a n u t r i t i o u s d i e t , and to get adequate r e s t .  Health workers described the development  of f o e t a l l i f e so mothers would be better prepared both p h y s i c a l l y and 59  mentally f o r motherhood. Frequently, health workers taught mothers how to prepare f o r delivery a t home, and how to sew and gather a l a y e t t e f o r 60  t h e i r expected infants."  IV How successful were health workers i n educating and i n decreasing the mortality rate?  expectant mothers  In s p i t e o f the health worker's  e f f o r t s , the o f f i c i a l maternal mortality rate f o r B r i t i s h Columbia showed no s i g n i f i c a n t decline u n t i l 1 9 3 6 . 1000  The maternal mortality rate o f 5 . 0 per  l i v e b i r t h s i n 1 9 2 0 rose to a maximum rate o f 6 . 8 per 1 0 0 0 l i v e b i r t h s  i n 1 9 2 4 , and then declined to 5 . 1 i n 1 9 3 5 .  6 l  U n t i l 1 9 3 6 , the only s i g -  n i f i c a n t deviation i n the maternal death rate was i n 1 9 3 3 » when the maternal death rate declined to 4 . 7 per 1 0 0 0 l i v e b i r t h s , however, the decline i n the b i r t h rate from 1 0 , 8 6 7 l i v e b i r t h s i n 1 9 3 0  to 9 , 5 8 3 l i v e b i r t h s i n  62 1933  could account f o r the decline.  the'province's  From 1 9 3 4 t o the end o f the decade,  b i r t h rate s t e a d i l y increased to a high of 1 2 , 3 7 3 l i v e b i r t h s  i n 1 9 3 9 , yet the maternal death rate continued new  low of 3 . 8 per 1 0 0 0 l i v e b i r t h s i n 1 9 3 9 . ^  to s t e a d i l y decline to a B r i t i s h Columbia's maternal  48 mortality rate showed improvement two years before the national rate, and the province's 1938 rate of 3.8 per 1000 l i v e births was encouragingly  64 lower than the 4.2 national rate.  Even more encouraging was the cont-  inued downward trend, and by 1943 the province's maternal mortality rate dropped to 2.5 per 1000 l i v e births-  J  (Table 2.1) .  Although the mortality rate f o r the C i t y of Vancouver declined s i g n i f i c a n t l y from a high of 5-5 i n 1922 to a low of 2.3 per 1000 l i v e births i n 1939» the decline was not continuous because of the low numbers involved.  Small variations i n the number of deaths made dramatic changes  i n the death rates.  For example, the deaths of four non-resident women  i n 1930 sent the Vancouver maternal mortality rate up from 4.1 to 4 . 3 per 1000  l i v e births.  The following year the rate dropped to 2 . 9 . ^  Again,  i n 1932 the actual b i r t h s dropped by 3^5 b i r t h s from the previous year, yet the maternal mortality rate rose from 1.1  to 3«5 per 1000 l i v e b i r t h s . '  What was the reason f o r the increased maternal mortality i n 1933? A l though no health workers, either p r o v i n c i a l or municipal, point to the depression  as the d i r e c t cause, they consistently point to the lack of  68 proper d i e t s and health care among both adults and children  (Table 2.2) .  Why was there no s i g n i f i c a n t decline i n maternal death rates p r i o r to 1936?  Part of the explanation may be that s t a t i s t i c s c o l l e c t e d a f t e r  1926 r e f l e c t e d a more accurate and complete r e g i s t r a t i o n and c l a s s i f i c a t i o n of the causes of deaths.  Helen MacMurchy pointed out i n 1931 that i n  s p i t e of the apparent increase i n the maternal death rate, she believed the rate to be decreasing.  MacMurchy asserted that greater accuracy and  completeness i n reporting and r e g i s t e r i n g maternal deaths accounted f o r the apparent increase i n maternal mortality rates between 1926 and 1929*  During  that time period, the Dominion Bureau of S t a t i s t i c s made further enquiries  49 Table  2.1  MATERNAL MORTALITY - PROVINCE OF BRITISH COLUMBIA 1920 -  1939 Percentage of Maternal Deaths  Total Live Births  Death Rate Per 1000 Live Births  Year  Total Deaths  Maternal Deaths  1920  4888  47  .96  9308  5.0  1921  4489  63  1.40  10687  5.9  1922  4748  63  1.32  11197  5.6  1923  4906  63  1.26  10001  6.3  1924  5004  69  1.87  10119  6.8  1925  4945  60  1.21  10342  5.9  1926  5474  65  1.18  IOO63  6.4  1927  5750  68  1.18  10084  6.7  1928  5910  61  1.15  IO385  5.8  1929  6397  58  .90  10378  5.6  1930  6400  63  .98  10867  5.8  1931  6114  66  1.07  10404  6.3  1932  6150  54  .87  10214  5.2  1933  6221  45  .72  9583  4.7  1934  6400  50  .78  9813  5.0  1935  6857  52  .75  10013  5.1  1936  7222  50  .69  10171  4.7  1937  7973  51  .63  11279  4.5  1938  7450  48  .64  12476  3.8  1939  7515  38  .50  12373  • 3.8  1940  8315  43  .51  13830  3.1  1941  8505  31  .36  15038  2.7  1942  8869  ^5  .50  16808  2.7  1943  10012  47  .46  18802  2.5  SOURCES:  B r i t i s h Columbia Board of Health, Reports, 1920 to. 1939; B r i t i s h Columbia Department of V i t a l S t a t i s t i c s , Reports, 1927 to 1943.  50 Table 2.2 MATERNAL MORTALITY - CITY OF VANCOUVER 1919  Year  Total Deaths  -  No. of Births  1939  Death Ral 1000 Live  1919  9  2776  3.3  1920  15  3366  4.5  1921  20*  3623  5.5  1922  10  3192  3-1  1923  14  3165  4.4  1924  16  3303  4.8  1925  11  3578  3.1  1926  14  3458  4.0  1927  13  3563  3.6  1928  11  3346  3.3  1929  18  4354  4.1  1930  20  4539  4.3  1931  13  4241  2.9  1932  4  3597  1.1  1933  14  3232  3.5  1934  12  3407  3-5  1935  12  3587  3.3  1936  18  3577  5.0  193?  11  3951  2.8  1938  11  4226  6.2  1939  10  4359  2.3  * Four of these deaths were non-residents of Vancouver C i t y . SOURCES:  B r i t i s h Columbia Board of Health, Reports, 1919 to 1939; B r i t i s h Columbia Department of V i t a l S t a t i s t i c s , Reports, 1926 to 1939; Vancouver Board of Health, Reports, 1919 to 1939.  51  into the recorded death of every woman of child-bearing age where puerpe r a l causes might be involved, even though puerperal causes might not be stated on the death c e r t i f i c a t e .  I n i t i a l l y , as a r e s u l t of t h i s intensive 69  enquiry, the number o f reported maternal deaths increased.  In 1 9 3 6 ,  the maternal mortality rate f o r B r i t i s h Columbia, as well as f o r the three other western provinces, began to decline steadily, and i n 1 9 3 8 the rate f o r Canada as a whole began a decline that continued throughout the 1 9 4 0 * s and 1 9 5 0 * s .  In July, 1 9 4 0 , the editor of the Canadian Public  Health Journal pointed out that the decrease i n maternal deaths resulted from a f o r t y percent reduction i n deaths caused by puerperal sepsis, the d i r e c t r e s u l t of greater e f f o r t s to prevent i n f e c t i o n a t the time of 70 delivery and the use of sulphanilamide.  A few months e a r l i e r , Dr. A.  Hardlsty S e l l e r s , S t a t i s t i c i a n f o r the Ontario Department of Health, also noted a t h i r t y - f i v e percent reduction i n the number o f maternal deaths caused by puerperal haemorrhage, and a t h i r t y - s i x percent reduction i n 71 the number of deaths caused by puerperal toxemia. But, as the editor of the Canadian Public Health Journal pointed out, most of the maternal deaths between 1 9 3 6 and 1 9 3 9 were caused by puerperal haemorrhage, puerperal sepsis and toxemia, and that p r a c t i c a l l y none o f these women had received 72 any prenatal care before t h e i r confinement. Dr. S e l l e r s also stated that no province i n Canada could point to any s p e c i f i c changes i n either p o l i c y or practice that accounted f o r the steady decline i n maternal mort73 ality.  What Dr. S e l l e r s f a i l e d to note was that between 1 9 2 0 and 1 9 3 9 ,  p a r t u r i t i o n was treated as a medical problem, and more and more B r i t i s h Columbia women went to a maternity home or hospital f o r d e l i v e r y .  No  s t a t i s t i c s are available f o r the early 1 9 2 0 ' s , however, by 1 9 2 7 , s i x t y percent of b i r t h s occurred i n an i n s t i t u t i o n that provided medical care. This number increased to eighty-two percent by 1 9 3 7 , and to ninety-two percent of a l l b i r t h s i n 1 9 3 9 . ' ^ '  (Hospital b i r t h s i n Canada f o r 1 9 2 7  52 was 1 9 . 3 percent of b i r t h s , f o r 1937  was 36.4  percent, and f o r 1939  only 76  4 1 . 7 percent of b i r t h s - rates f a r below that f o r B r i t i s h Saanich nurse Audrey Payne reported i n 1931  Columbia).  that even i n r u r a l d i s t r i c t s  of the province the majority of maternity cases were sent to hospitals. L i t t l e doubt exists that better care and more*, hygienic conditions at the time of delivery saved the l i v e s of many mothers and infants.  7r>  V Between 1920  and 1939* B r i t i s h Columbia women were urged by health  professionals and c h i l d care advisors to provide proper care both f o r themselves and t h e i r unborn infants.  Mothers were assured that a healthy  woman d i d not r i s k her own l i f e to produce a healthy baby, and by maintaining a n u t r i t i o u s d i e t she d i d not have to s a c r i f i c e a tooth f o r every child.  Although public health workers, the VON,  and Red Cross nurses urged  mothers to seek prenatal care f o r themselves and t h e i r unborn c h i l d , l e s s progress was made i n t h i s area than i n any other stage of c h i l d development. Whether from embarassment or from f i n a n c i a l constraints, many women were reluctant to attend prenatal c l i n i c s or seek prenatal care.  I f women  sought prenatal care, i t was more l i k e l y to be from t h e i r family physician than through a prenatal c l i n i c , and they were more l i k e l y to seek prenatal care i f they either anticipated or experienced d i f f i c u l t i e s during pregnancy or i f they planned to give b i r t h i n a h o s p i t a l or a maternity home. Obstetrical cases i n maternity homes or hospitals were treated as medical cases, and there the mother received medical care.  This kind of treatment  greatly reduced the number of deaths caused by childbed fever, toxemia, or haemorrhage.  Although health professionals were not able to convince a l l  mothers of the e f f i c a c y of prenatal care, one change was evident: mothers of 1939  expectant  had prenatal medical services and health care available  that enabled them to face c h i l d b i r t h with l e s s fear and trembling than had  mothers a generation before.  5 4  Footnotes 1 B r i t i s h Columbia Board of Health, Report, 1920, p. A 5 ; p. N 9 , (hereafter BCBH).  i b i d . , 1925,  2 J . W. Ballantyne, Expectant Motherhood: I t s Supervision and Hygiene (Toronto: C a s s e l l and Co., 1914); Adam H. Wright, A Textbook o f Obstetrics (London: D. Appleton Co., 1908), pp. 192-403, 433-476; Mothercraft (London: The National League f o r Health, Maternity and C h i l d Welfare, 1925), pp. 1-44. 3 B r i t i s h Columbia Commission on Health Insurance, Report on Maternity Insurance and Public Health Nursing, 1921; BCBH, Report, 1925, p. N 9 ; ibid,., 1926-27, p. K 2 ; J . T. Marshall, "The Development of Public Health i n B r i t i s h Columbia," Canadian Public Health Journal, XXV (Aug. 1934), 359-368, (hereafter CPHJ); Margaret E. Kerr, "The Refresher Course f o r Public Health Nurses," Public Health Nurses"'Bulletin, 1 (May 1930), 3 - 5 , (hereafter PHNB). 4  Vancouver Board of Health, Report, 1912, p. 3 , (hereafter  5  Report of the Committee on Maternity Insurance, pp. 1, 7 , 10-11.  VBH).  6 Handbook of Child Welfare Work i n Canada (Department of Health, Ottawa: King's Printer, 1923), pp. 2, 54. 7 Ibid., p. 10; M. C. Urquart and K. A. H. Buckley, H i s t o r i c a l S t a t i s t i c s of Canada (Toronto: Macmillan, 1965), p. 4 0 . 8 The Enquiry into Maternal Mortality i n Canada, July 1, 1925 to July 1, 1926 (Department of Health, Ottawa: King's P r i n t e r , 1927), p. 4 1 ; Report of the Committee on Maternity Insurance, pp. 3-4. 9  Handbook of C h i l d Welfare Work, p. 2.  10 Herbert B. French, "The Low Birth-Rate of B r i t i s h Columbia - Some Causes and a Remedy," CPHJ, XVIII (June 1927), 263; f o r a discussion of the accuracy o f the 1921 Dominion Census see Enid Charles, 'The Changing Size o f the Family i n Canada," Eighth Census of Canada, Census Monograph Ho. 1 (Ottawa: King's P r i n t e r , 194l), p. 2 6 l ; Urquart and Buckley, H i s t o r i c a l S t a t i s t i c s of Canada, Series B l - 1 4 , B51-58. 11  Maternal Mortality i n Canada, p. 7.  12  I b i d . , pp. 9-10.  13  Ibid., pp. 11-12.  14  Ibid.  15 The Canadian Mother's Book (Department of Health, Ottawa: King's Printer, 1923), pp. 11-12; Mother, Department of Health, 1928, pp. 1 3 - 1 4 . 16 Margaret W. Andrews, "Medical Attendance i n Vancouver, 1 8 8 6 - 1920," B. C. Studies, 4 0 (Winter 1978-79), 49-52. 17  I b i d . , p. 50.  55  Footnotes 18  Report of the Committee on Maternity Insurance, pp. 7 - 1 0 , 1 1 , 14.  19  Maternal Mortality i n Canada, pp.  10-11.  20 Advisory Letters for Expectant Mothers, British Columbia Board of Health, 1 9 2 0 ; "Prenatal Letters," Canadian Council on Child Welfare, 1 9 3 1 ! "Ante-natal Series - Suggestions to Expectant Mothers," British Columbia Board of Health, 1 9 3 1 ? Advice to Expectant Mothers, Victorian Order of Nurses, n.d.; Mother, pp. 8 - 1 3 ; Maternal C are (Department of Health, Ottawa: King's Printer, 1 9 3 1 ) , pp. 7 - 9 . 21  Maternal Mortality i n Canada, pp.  22  Ibid.  23  BCBH, Report, 1 9 2 2 , p. B7; ibid., 1 9 2 3 , p. E7.  11-12.  24 David Berman, "First Full-Time Health Unit at Saanich i n British Columbia," Bulletin of the British Columbia Board of Health, 6 (June 1 9 3 6 ) , 142, (hereafter BBCBH). 25 W. F. Roberts, "Child Welfare Report," Papers and Proceedings of the Canadian Council on Child Welfare, 1 9 2 5 , p. 2 7 ; see also Miss Elizabeth Smellie, "The Responsibility of the Voluntary Agency with Regards to the Mother and Child," ibid, pp. 9 ^ - 9 9 ; Bertha E. Hall, "Provision For Infant Care In a Small Community," ibid, 1 9 2 7 , pp. 2 7 - 3 1 . 26  Roberts, "Child Welfare Report," p. 2 7 .  27 A. E. Wells, "Provincial Programs for Infant Care," Papers and Proceedings of the Canadian Conference on Child Welfare, 1 9 2 7 , pp. 1 6 - 2 7 . 28 Garrood, "Public Health i n KamloopsV'! p. 2 9 ; see also Norah E. Armstrong, "The North Vancouver Health Unit," PHNB, 1 (Mar. 1 9 3 2 ) , 5 0 . 29  VBH, Report, 1 9 2 0 , p. 1 7 .  30  VBH, Report, 1 9 3 7 , p. 5 ; ibid., 1 9 3 6 , p. 5 .  31 Elizabeth L. Smellie, "The Responsibility of the Voluntary Agency with Regard to the Mother and Child," Papers and Proceedings of the Canadian Conference on Child Welfare, 1 9 2 5 , pp. 9 ^ - 9 9 . 32 "Victorian Order Encourages Self-Help For Body and Mind," The Vancouver Province, Oct. 5 , 1 9 3 5 , P» 1 2 . 33  Ibid.  34  Ibid.  Olive M. Garrood, "Public Health In Kamloops," PHNB, 1 (May 1 9 3 0 ) , Helen Kelly, "Saanich," ibid., 1 (Oct. 1 9 2 4 ) , 1 0 ; A. J. Lee and M. J. Woods, "Nanaimo," ibid., 1 (Apr. 1 9 2 6 ) , 9 - 1 0 ; Hilda Barton, "Summary of Year's Work," ibid., 1 (Mar. 1 9 3 2 ) , 1 0 - 1 1 ; Armstrong, "The North Vancouver Health Unit, ibid., pp. 4 9 - 5 1 . 35  29;  56 Footnotes 36 BCBH, Report, 1921, p. B6; see also Handbook of C h i l d Welfare Work i n Canada, p. 36. 37 BCBH, Report, 1927-28, p. W23; i b i d . , 1928-29, p. U29, i b i d . , 1929-30, p. P39? i b i d . , 1930-31. 38 B r i t i s h Columbia, Department of V i t a l S t a t i s t i c s , Report, 1927, "Births by D i s t r i c t " ; i b i d . , 1928; i b i d . , 1929; i b i d . , 1930; i b i d . , 1931. 39  BCBH, Report, 1936, p. M33.  40  I b i d . ; i b i d . , 1937, p. M32.  41 Myrtle Harvey, "The E f f e c t s of the Depression on Public Health," PHNB, 1 (Mar. 1932), 4 l . 42 Audrey B. Payne, "Public Health Nursing i n Montreal and Saanich," i b i d . , 1 (Mar. 1931), 15-17. 43  Ibid.  44 V. S. MacLachlan, "Child Health Programme i n B r i t i s h CPHJ, XIV (Jan. 1923), 119-126.  Columbia,"  45 V. S. MacLachlan, "The Prenatal and Postnatal Letter Service The Experience of a Women's I n s t i t u t e Member," BBCBH, 7 (Aug. 1937), 138. 46 Bertha E. H a l l , "Must Mother Die?" Chatelaine, July 1928, pp. 6-7; Anne E. Wilson, "Teaching Men to Legislate For Women: A Remedy For The Loss of Canadian Motherhood," i b i d . , p. 85 Charlotte Whitton, "For The Children Of The World," i b i d . , Aug. 1928, pp. 6^7; S t e l l a E. Pines, "We Want Perfect Parents," i b i d . , Sept. 1928, pp. 12-13; J . W. S. McCullough, "Should Canada Have Midwives?" i b i d . , Oct. 1931, p. 12; "The Baby C l i n i c - The Baby's Mother," i b i d . , Aug. 1935, p. 46. 47  "Ovaltine For Mothers," The Vancouver Province, Oct. 3, 1924.  48  The Canadian Mother's Book, p. 5.  49  Ibid., p. 8; BCBH, Report, 1920, p. A 5 .  50  The Canadian Mother's Book, p. 8.  51 Gwen Matheson, Women i n the Canadian Mosaic, (Toronto: Peter Martin Ass., 1976), p. IX; Barbara Weller, "The C u l t of True Womanhood: 1820-1860," The American Family S o c i a l - H i s t o r i c a l Perspective by Michael Gordon, ed. (New York: St. Martin's Press, 1978), pp. 313-333; The Canadian Mother's Book, p. 8; BCBH, Report, 1920, p. A 5 . 52 p. 2.  Maternity and C h i l d Welfare, June 1920, c i t e d i n Maternal Care,  53 Report of the F i r s t Annual Convention of the C h i l d Welfare Association of B r i t i s h Columbia, 1918, p. 3.  57  Footnotes 54 I b i d . , p. 5, Commission on Health Insurance, Report on Mother's Pensions, 1 9 2 0 , p. T3. 55 The Canadian Mother's Book, p. 8 ; How To Take Care of the Baby, Department of Health, 1 9 2 3 , pp. 8 - 1 0 ; Prenatal Letters, B r i t i s h Columbia Board of Health, 1 9 2 0 . 56  BCBH, Report, 1 9 1 8 , p. G 1 3 9 .  57  Report on Maternity Insurance, p. 7 -  58  M. McGuaig, "The Rural Prenatal Programme," CPHJ, XXIII (June  1932), 273.  59 E. D. Carder, "Neonatal Mortality and Antenatal Care," Papers and Proceedings of the Canadian Council on C h i l d Welfare, 1 9 2 7 , p. 5 » "Maternal Welfare," BBCBH, 4 (May 193*0, 1 0 1 - 1 0 2 ; Mother, p p . ~ l l - 1 3 ; "Mother's Health Important f o r Baby," Star Weekly, Oct. 1 1 , 1 9 3 1 , p. 8 ; "The Baby C l i n i c , " Chatelaine, May, 1 9 3 9 , p. 7 6 ; "Your Baby and Mine," The Vancouver Sun, Oct. 4 , 1 9 2 6 ; "Mother and Baby," Family Herald and Weekly Star, Oct. 4 , 1 9 3 9 , P. 3 6 . 60 6 0  Carder, "Neonatal Mortality and Antenatal Care," p. 5 «  61 BCBH, Report, 1 9 2 0 , p. A 4 8 ; i b i d . , 1 9 2 4 , p. Q 6 0 ; B r i t i s h V i t a l S t a t i s t i c s , Report, 1 9 3 5 . 62  Ibid., 1 9 3 3 , i b i d . , 1 9 3 0 .  63  I b i d . , 1 9 3 5 to 1 9 3 9 .  Columbia  64 "Signs of Improved Maternal M o r t a l i t y , " CPHJ, XXXI (July 1940), 3 4 ; see also P. Hardisty S e l l e r s , "Recent Improvements i n Maternal Morta l i t y i n Canada," i b i d . , (Jan. 1 9 4 0 ) , 9 3 . 65  BCBH, Report, 1 9 4 3 , p. V21.  66  VBH, Report, 1 9 3 3 , p.  67  Ibid., 1 9 3 2 , p. 4 .  68  I b i d . ; i b i d . , 1 9 3 6 , p. 3 .  69  Helen MacMurchy, " C l a s s i f i c a t i o n of Maternal Deaths," CPHJ, XXII  i b i d . , 1 9 3 9 , p. 3 .  (Aug. 1 9 3 1 ) , 4 9 2 .  70  "Signs  of Improved Maternal Mortality," pp. 339-340.  71  S e l l e r s , "Recent Improvements i n Maternal Mortality i n Canada,"  P. 3 9 . 72  "Signs of Improved Maternal M o r t a l i t y , " pp.  73  Sellers,"Recent Improvement i n Maternity Mortality i n Canada,"  P. 3 9 -  339-340.  Footnotes 74 B r i t i s h .Columbia, V i t a l S t a t i s t i c s Report, 1 9 2 7 , P. AA13; i b i d . , 1 9 3 7 , P. S 1 3 ; i b i d . , 1 9 3 9 , P. C 5 6 . ' Y3  Urquhart, Historical S t a t i s t i c s Of Canada, p. 3 8 .  76  Payne, "Public Health Nursing i n Montreal and Saanich?" p. 16.  Chapter 3  Rearing the Infant: The Little Machine  The 1920*8 and 1930*s witnessed many new and dramatic changes in child rearing practices i n both british Columbia and elsewhere i n the English-speaking world.  Two major factors accounted for these  changes: shifts in health professionals understanding of the fundamental nature of childhood; attempts by health advisors to have parents rear their children by principles of scientific management rather than by former traditional methods.  1  For the f i r s t time i n history,  infants had a good chance of surviving to become  healthy, happy, indiv-  iduals i f their parents adopted the new scientific methods of child rearing.  Mothers were counselled to no longer rely on maternal instinct  or on traditional child rearing techniques for, in the words of one advisor, "Maternal instinct i s erratic, irregular, and altogether untrustworthy."^  Rather, parents were urged to seek solutions to child care  problems by rational means instead of relying on "traditional, personal experience and self-abrogated wisdom.,.  Historian Lynn Bloom characterized the change i n child rearing techniques during the f i r s t three decades of this century as a shift from a religious to a secular orientation where science and not Providence determined the chances of the child's survival.  Indeed, the  appeal to parents by child care advisors to adopt the new scientific methods was so successful that many rejected their traditional practices i n favour of the systematic, regimented approach that, according to c r i t i c s , seemed to turn the infant into a " l i t t l e machine."^  59  60 By 1 9 2 0 , developments i n medical research, advances i n c h i l d care, and studies i n c h i l d psychology convinced advisors they must educate the public to new ways of feeding, caring, and t r a i n i n g the c h i l d . '  For  example, Mrs. V. S. MacLachlan, Secretary to B r i t i s h Columbia Women's I n s t i t u t e s , t o l d the November , 1 9 1 9 t Okanagan Convention that "every woman i n B r i t i s h Columbia had the r i g h t to know the f a c t s which science Q  has made c e r t a i n f o r the protection of c h i l d l i f e , "  and that each woman,  out of p a t r i o t i c duty, should demand to know any information that would make her a better informed and more i n t e l l i g e n t mother.  This chapter  w i l l examine the sources of changes i n c h i l d rearing practices as they r e l a t e to the i n f a n t during the 1 9 2 0 ' s and 1 9 3 0 * s , i d e n t i f y the changes that were advocated, and examine the nature and content of advice  on  feeding and d i e t s , t o i l e t t r a i n i n g and elimination, and habit t r a i n i n g .  I The work and research of three physicians, L. Emmett Holt of York, F. Truby King of New  New  Zealand and E r i c Pritchard of the Marylebone  D i s t r i c t of London, and the research of psychologist John B. Watson, formed the nucleus of the t h e o r e t i c a l advice given to parents of the 1 9 2 0 ' s and 1 9 3 0 ' s on the feeding and care of infants by B r i t i s h Columbia's o public health workers and c h i l d care a d v i s o r s .  7  Probably more than any  other i n d i v i d u a l , Dr. Holt was responsible f o r e s t a b l i s h i n g the systematic s c i e n t i f i c method of c h i l d care and c h i l d r e a r i n g .  new While  serving as a professor on children's diseases at Columbia University and as an attending physician at both the New  York Babies and Found-  l i n g s Hospitals, Holt wrote h i s systematic approach to c h i l d caxe i n a simple manual, Catechism f o r Nurses.  O r i g i n a l l y prepared i n 1 8 8 9 f o r  61  use i n t r a i n i n g nursery maids, i n 1 8 9 4 Holt expanded the catechism i n t o a book c a l l e d The Care and Feeding of Children.  Holt emphasized the  physical aspects of c h i l d care because he believed the high infant mortality rate was caused e i t h e r by ignorance or the carelessness of mothers.  Holt l a i d out i n meticulous d e t a i l how he believed infants  should be fed, rested, clothed, exercised, bathed, and taught how to eliminate.  10  Holt's work i n i t i a t e d the t i g h t l y scheduled, systematic approach to infant care that was to dominate the 1 9 2 0 ' s and 1 9 3 0 ' s .  1 1  But i t  was King and Pritchard who developed community based health care-health education programs designed to provide care f o r both infants and mothers. As a r e s u l t of the e f f o r t s of King, the Royal New  Zealand Society f o r the  Health of Women and Children (Plunket Society) was formed i n Dunedin, 12  New  Zealand, i n 1 9 0 7 .  governor general of New  The Plunket Society (named a f t e r the then Zealand) was an organization devoted to reducing  both infant and maternal mortality rates. of King and the Plunket Society, the New was reduced to the lowest i n the world.  J  By 1 9 1 1 , through the e f f o r t s Zealand infant mortality rate Because of the success of h i s  work i n New Zealand, i n 1 9 1 7 , King was i n v i t e d to England to e s t a b l i s h an infants* h o s p i t a l and mothers' t r a i n i n g centre a t E a r l s Court.  Subsequ-  ently, Plunket centres were established i n South A f r i c a , A u s t r a l i a , 14  B r a z i l , and Canada.  Among other aspects of c h i l d care, King's book focused on the feeding of i n f a n t s .  1 5  His research during the period 1 9 0 0 to 1 9 1 0 provided  information i n two a r e a s J techniques and procedures used by mothers t o i n i t i a t e and maintain t h e i r a b i l i t y to breast feed; the development of a r t i f i c i a l formulas, which King c a l l e d modified milk, f o r use with  62 infants who were not breast f e d . ^ 1  King outlined not only the components  f o r f o u r •'humanized milk" formulas, but a l s o provided instructions f o r the preparation and handling of each component of the formula such as lime 17  water, whey, dextri-glucose, and emulsion.  The work and research of  King and the Plunket Society was u t i l i z e d by B r i t i s h Columbia's public health nurses i n t h e i r work with mothers and infants, and the p u b l i c a t ions of the Plunket Society./were d i s t r i b u t e d throughout the province 1 ft by the P r o v i n c i a l Board of Health. The St. Marylebone Health Society of England, i n i t i a t e d i n focused on two aspects of health care: tuberculosis;  1906,  the prevention of the spread of  the reduction of infant mortality among the poor within  the Marylebone D i s t r i c t of London.  The infant program, under the d i r e c t -  ion of E r i c Pritchard, a prominent London p e d i a t r i c i a n , i n s t i t u t e d an active campaign to educate and i n s t r u c t mothers i n the feeding and care 19  of t h e i r children.  Pritchard demonstrated that a successful parent  education - c h i l d care program required three e s s e n t i a l elements: trained and competent s t a f f ; and materials;  uniformity and continuity of methods  advice that dealt with both the care and management  20 of the infant and the mother's general health.  B r i t i s h Columbia's  public health workers u t i l i z e d both the research methods employed and the materials produced by these three physicians and they i n s i s t e d mothers put t h e i r infants on r i g i d schedules, maintain scrupulous cleanliness i n t h e i r care and feeding, and breast feed t h e i r infants f o r at least the f i r s t nine months of the baby's l i f e .  21  Although the major concern during the 1920's was physical care of infants, there was a gradual but growing concern f o r t h e i r psycho-  63 logical development. In 1928, John B. Watson, professor of psychology at Johns Hopkins University, published Psychological Care of the Infant and Child, a book Watson described as a complementary volume to Holt's 22 book The Care and Feeding of Children.  Watson believed the "psychol-  ogical care of the child to be as necessary as the physical care."  J  He saw parents as the shapers of their child's personality and character; once a child's character had been spoiled by bad handling, i t 24 was possible the damage could never be repaired. According to Watson, 25  "No one today knows enough to raise a child." ^ The purpose of his book was to help mothers rear a happy, independent, non-demonstrative child 26 whose manners and actions were acceptable to adults. Canada i s not without i t s own medical authority on child care. In his book, articles, and speeches, internationally known pediatrician Alan Brown, physician-in-charge at Toronto's Hospital for Sick Children, head of the Department of Pediatrics of the University of Toronto Medical School, and one of the inventors of Pablum, preached child 27  rearing techniques to Canadian Parents. Although Brown's book, The Normal Child: Its Care and Its Feeding, focused on the physical aspects of child care, he also dealt with the topics of discipline and 28 habit training.  The Normal Child was enthusiastically reviewed by  The Canadian Churchman as the only book of i t s kind written by a Canadian containing "just what every mother should know, from the birth of the child - the care and feeding during infancy, etc., and a thousand .29 and one other suggestions."^ Dr. John W. S. McCullough, a contemporary of Brown's and chief inspector of health for the Ontario Board of Health from 1910 to  64 1 9 3 5 , edited Chatelaine's monthly  "The Baby C l i n i c " from 1 9 3 3 to 1 9 3 9 .  McCullough a l s o focused on the physical aspects of c h i l d caret feeding; •an  immunization;  habit t r a i n i n g .  McCullough's assertive and d i d a c t i c tone  showed l i t t l e patience with maternal ignorance or l a z i n e s s , and i n h i s monthly column, he castigated mothers who f a i l e d to e s t a b l i s h good habits through a r i g i d l y scheduled systematic approach to feeding, r e s t , t o i l e t t r a i n i n g , and habit t r a i n i n g . ^  1  The work of these theorists must be examined i n the context of the broader s o c i a l concerns of the inter-war years.  The high infant mort-  a l i t y rate i n both r u r a l and urban areas, and the lack of coordinated c h i l d welfare programs f o r Canadian children was of concern to govern32 mental a u t h o r i t i e s .  In 1 9 2 0 , i n response to these concerns and other  related problems i n c h i l d health, the newly organized Federal Department of Health created the Child Welfare D i v i s i o n with Ontario physician Helen MacMurchy as D i v i s i o n C h i e f M a c M u r c h y had previously prepared three comprehensive reports f o r the Ontario government i n which she outl i n e d the various causes of infant deaths and summarized attempts being made to reduce the infant death rate.^  At i t s May,  1 9 2 0 , meeting, the  Dominion Council of Health, a body composed of both p r o v i n c i a l and f e d e r a l representatives, requested the newly formed C h i l d Welfare D i v i s i o n 35  produce o r i g i n a l publications on c h i l d welfare f o r use i n Canada.  J  MacMurchy and the Child Welfare D i v i s i o n s t a f f set to work a t once and provided Canadian mothers with pragmatic advice through The Canadian Mother's Book, a publication which focused on the c h i l d ' s physical care and development.  I t was an immediate success, and has remained  a popular publication unto the present time.^  6  Dr. MacMurchy d i d not  i n i t i a t e any new or innovative c h i l d care practices, but rather worked to disseminate p r a c t i c a l advice and information that could be u t i l i z e d  by parents and health professionals i n both rural and urban areas.  65  II  The nature and content of advice  available to parents was firmly  rooted i n the advisor's concept of the infant.  Alan Brown reflected the  tabula rasa point of view accepted by most child care advisors of the time when he described the newborn as having l i t t l e more intelligence than a vegetable, with l i t t l e or no control over bodily motions or facial expressions, unable to hold his head upright, unable to distinguish light and darkness, unable to hear, but equipped with a slight sense of smell and a well developed sense of taste.  The newborn, he said, was "not directly  37 conscious of anything.  ' In fact, the infant's mind was regarded as a  clean sheet :of paper awaiting sensory experience from the world around him.-^ As a consequence, Brown, as well as other advisors of the 1 9 2 0 * s , 39 placed a strong emphasis on systematic child training.  Beginning  immediately after birth, parents were charged with the responsibility of training the child i n those basic habits which would produce an 40 obedient, self-reliant, self-controlled, unselfish adult.  Parents  were warned that i f they took the wrong action, their child would be permanently impaired.  Parenthood, and especially motherhood, was  considered an awesome responsibility. Other child care advisors of the late 1920»s and the 1 9 3 0 ' s , such as W. E. Blatz, Helen Bott, and Myrtle Meyer Eldred, were influenced by the work of G. Stanley Hall and the Child Study Movement. They saw the child as an active individual who learned through the interplay of innate characteristics and environmental influences.  Although concerned for the  physical development, these advisors saw the child as also having emotional  and s o c i a l needs.  66 Parents were urged to study t h e i r infants and to guide  42  t h e i r development i n a manner best suited to t h e i r needs and p e r s o n a l i t i e s . Whereas Brown urged parents of the 1920's to t r a i n t h e i r children i n good habits, Blatz, who i s discussed i n greater d e t a i l i n a subsequent chapter, emphasized the need f o r parents to guide t h e i r children into good habits at an e a r l y age i n order to prove the basis f o r t h e i r emotional, i n t e l l e c t u a l , and moral development.  J  Child care advisors throughout the 1920's and 1930's continued to emphasize the permanent and unalterable influence parents had upon t h e i r infants.  The writer of the introduction to the "Post Natal L e t t e r s "  published by the Canadian Council on Child Welfare (1938) stated that The care and t r a i n i n g of the child f o r the f i r s t few years lays the foundation upon which i s b u i l t the physical and mental conditions that w i l l govern the l i f e of the c h i l d and determine i t s success i n l i f e . 44 Syndicated columnist Angelo P a t r i a l s o pointed to the v u l n e r a b i l i t y of children during t h e i r early years. on the part of the parent. i s a l a s t i n g wrong.  The neglect to t r a i n children was wrong  And, P a t r i stated, "Any wrong done an infant  There i s no excuse and no pardon f o r o f f e n d e r s . *  nj  A sobering thought indeed f o r young parents who desired the best f o r t h e i r children.  Confronted by such advice and threatened with the r u i n of  t h e i r children i f they f a i l e d , many parents turned to advisors f o r help*,  III What advice did health professionals and c h i l d care advisors give parents?  Did advice change over the time period under study?  A review  of information available to parents from various sources indicates that advice centered on three general topics:  feeding and d i e t ; elimination  67 and t o i l e t t r a i n i n g ; habit t r a i n i n g .  What to feed, how much to feed, and when to feed were questions that concerned mothers.  In the early 1920*s, health professionals,  c h i l d care advisors, and newspaper columnists advocated breast feeding  46 as the best method of feeding i n f a n t s .  Not only was human milk  considered more n u t r i t i o u s , but also i t was believed to contain speqifel components which provided the infant with protection against childhood  47 diseases. '  Advisors argued that "Nursing by a mother i s safer, easier,  48 wiser, and more s u c c e s s f u l . "  They a l s o believed breast feeding  was  49 a natural, normal function, and the best way to feed the i n f a n t . Health workers claimed, but could not substantiate, that a r t i f i c i a l l y fed babies ran an eight or nine times greater r i s k of dying i n infancy than d i d babies nursed by mothers.-'  0  There i s , i n f a c t , evidence that  the a v a i l a b i l i t y of animal milk rather than breast feeding played a major r o l e i n reducing infant m o r t a l i t y . ^  1  B r i t i s h Columbia's health  nurses based t h e i r appeal f o r breast feeding on the success of Truby King's New  Zealand program, and they attempted t o teach B r i t i s h Columbia 52 women the same techniques. By the s i x t h or seventh month of her pregnancy, f o r example, the expectant mother was encouraged to begin 53 to prepare her breasts f o r feeding. Once the c h i l d was born, the  mother was urged to begin her breast feeding routine, and the public  54 health nurse made regular home v i s i t s to insure the mother d i d so.-^ When mothers f a i l e d to e s t a b l i s h a breast feeding routine or discontinued breast feeding, the public health nurse i n s i s t e d they begin again. Nurses G r i f f i n and Garrood followed a procedure c a l l e d "re-establishing breast feeding by technique of e x p r e s s i o n . " ^  F i r s t , they assured  68  the mother she was capable of breast feeding her i n f a n t , then they taught her how  to r e - e s t a b l i s h her milk supply.  This was accomplished  by the simple method of bathing the breasts with hot and cold water a l t e r n a t e l y , massaging d a i l y , and s t r i p p i n g them a f t e r each feeding, and regular three hourly to four hourly feedings; no feed between 1 0 p. m. and 6 a. m. 5 6 Mothers were a l s o advised to improve t h e i r own d i e t s and thereby increase 157 the quantity and q u a l i t y of t h e i r milk.-"  Advisors were so adamant that  mothers breast feed t h e i r i n f a n t s , the Canadian Mothers Book.  The C h i l d .  and T o s t Natal L e t t e r s " simply gave no advice on a r t i f i c i a l feeding. Helen MacMurchy assumed every mother could and would breast feed her 58  infant u n t i l he reached about nine months of age.  Yet, health workers  were forced to acknowledge that a l l women could not or would not breast feed t h e i r i n f a n t s . Infants were to be weaned a t about nine months of age,  although  advisors agreed they should not be weaned during hot summer weather, CO  when they were teething, or when they were unwell.-^  In the best of  circumstances, weaning a t any time frequently l e d to c o l i c , rashes, diarrhoea, and sometimes to more serious or even f a t a l  dysentry.^  0  Some advisors counselled mothers not to breast feed t h e i r infants longer than one year, as they believed the composition of milk changed a f t e r that time.^  1  Other advisors believed that breast feeding past 62  one year increased an infant's s u s c e p t i b i l i t y to r i c k e t s .  There was general agreement among advisors that weaning should be effected over a two to s i x week period by gradually s u b s t i t u t i n g bottle feeding f o r breast feeding.  Alan Brown, hlowever, believed sudden  and complete weaning t o be less detrimental i n the long run because the infant accepted the substitute bottle from sheer hunger.  69  In practice,  J  most Canadian mothers adopted the gradual approach as they believed i t to be l e s s t r y i n g f o r both infant and mother.  The problems associated with a r t i f i c i a l feeding of babies caused the greatest concern t o both advisors and parents, and an examination of requests from mothers and responses by advisors indicates t h e i r concern 64 was j u s t i f i e d .  Some infants were f e d strange mixtures of cream and  water, milk, cornstarch and water, or one part milk t o two parts water. As a r e s u l t , a r t i f i c i a l l y fed babies were more susceptible to c o l i c , diarrhoea, constipation, skin rashes, and colds.  Mothers sought advice  on popular formulas by w r i t i n g to newspaper columnists and by consulting t h e i r family physicians.  Cow's milk, raw, pasturized, or condensed, was  the most common substitute f o r mother's milk, although cow's milk had to be modified Or humanized t o make i t suitable f o r babies.  Although  both Holt and Pritchard discussed the preparation of a r t i f i c i a l milk, King developed four modified milk formulas based on the use of top milk, 65 fresh milk, sweetened condensed milk, and dried milk. •  J  When r e f e r r i n g  to these formulas, Nurse Garrood pointed out "The mixture f o r t h i s humanized milk has been worked out s c i e n t i f i c a l l y t o be exactly the same as mother's m i l k . " ^  In some circumstances, the use of modified  milk provided a more n u t r i t i o u s , safer, and more p r a c t i c a l method than breast f e e d i n g . ^ Between 1920 and 1939, a r t i f i c i a l feeding became more and more acceptable to B r i t i s h Columbia nurses as i t became evident many infants thrived on bottle feeding.  Health professionals set about teaching mothers  70  how  68  to make s u i t a b l e formulas f o r t h e i r i n f a n t s .  Mothers wrote to news-  papers and magazine columnists to request formulas and d i e t s based on an infant's age and weight, and advisors provided formulas.  In f a c t , formulas  became so standardized that i n the March, 1 9 3 9 , issue of Chatelaine. Dr. McCullough outlined d i e t s f o r infants between one day and one year of age. The outline included changes i n the proportions of ingredients and s p e c i f i e d supplements to be added to the infant's d i e t on a bi-weekly or monthly basis.^  To convince mothers to use pasteurized milk, to pasteurize raw cow's milk, and to b o i l water fed infants was a recurring theme i n information 70 provided to parents.'  Many B r i t i s h Columbian households d i d not have  access to pasteurized milk, but used the raw milk from t h e i r own or t h e i r 71 neighbour's cows. Impure or raw milk was not only the occasional cause of i n d i g e s t i o n and diarrhoea, but a l s o the possible cause of 72 diseases such as tuberculosis and tubercular meningitis.  Convincing  mothers to feed b o i l e d cooled water was almost as d i f f i c u l t as convinc73 ing them to b o i l milk.  But there i s evidence that at l e a s t one pure  milk - pure water educational program was e f f e c t i v e , f o r i n 1 9 3 7 » Br. J . M. Hershey, d i r e c t o r of the Peace River Health Unit i n the north eastern area of the province, reported that i n spite of the  prevalence  of diarrhoea and dysentry among older age groups, the incidence was among younger c h i l d r e n .  low  He stated that "This i s a t t r i b u t e d to the f a c t  most mothers are b o i l i n g the milk and water used i n feeding t h e i r c h i l d ren." ^ 7  Scrupulous cleanliness of the infant's u t e n s i l s , bottles and nipples was another recurring theme of the 1 9 2 0 ' s and 1 9 3 0 ' s .  In 1 9 1 9 ,  one  unnamed advisor advocated bottles be boiled f o r several minutes and 75 nipples be washed or stored i n a solution of boric acid.'-^ The need f o r cleanliness d i d not change over the two decades, but the techniques d i d . In 1 9 3 9 , Dr. McGullough recommended bottles and nipples be s t e r i l i z e d i n b o i l i n g water, but he made no mention of boric a c i d .  During the period  between 1 9 2 0 and 1939» B r i t i s h Columbia's public health nurses became less adamant i n t h e i r demands that a l l mothers breast feed. Safer milk, purer water, s c i e n t i f i c a l l y developed formulas and d i e t s made 77 a r t i f i c i a l feeding a suitable and safe substitute f o r breast feeding. In the l i g h t of today's knowledge, the most s t a r t l i n g feature of infant's d i e t s was the amount of sugar used.  Before foods other than  milk were given t o the infant, sugar or some other sweetener was added to modify cow's milk.  Nurse Margaret Laine gave the formula f o r a new-  born as one ounce of cow's milk (boiled), one ounce of water (boiled), one teaspoon of sugar, and one teaspoon of cream.  The writer of  the Family Herald and Weekly Star's "Mother and Baby" column recommended a s i x week o l d , eight and one-half pound baby be fed a d a i l y formula consisting of fourteen ounces of whole milk, fourteen ounces of water, and four l e v e l tablespoons of sugar.  Mrs. Eldred, the writer of "Your  Baby and Mine" column t o l d parents to remember sugar was used as a food 79 and not as a flavouring.  One voice of warning raised was that of Dr.  John W. S. McCullough, who not only warned parents against the excessive use of sugar, but also against the use of sugar as a substitute f o r 80  e s s e n t i a l foods.  Was McCullough's warning j u s t i f i e d ?  School records  of the 1 9 2 0 ' s and 1 9 3 0 ' s indicated a high incidence of tooth decay, caused, perhaps, by the high sugar content of infant's formulas.  72 What other foods were advocated f o r an infant's d i e t ? Except f o r small regular doses of orange or prune j u i c e , milk was the only food  8l young babies received f o r the f i r s t s i x to nine months.  F r u i t juices  were given as a constipation preventative, rather than as a n u t r i e n t . Even though s c i e n t i s t s were aware of the need f o r vitamins i n the c h i l d ' s d i e t , i t was not u n t i l the l a t e 1920's advisors urged parents t o give t h e i r infants a d a i l y dose of f r u i t juice f o r i t s vitamin content and  82 n u t r i t i v e value.  Advisors were frequently unaware of the n u t r i t i o n a l  value of some food supplements f o r the prevention of some disorders. They f a i l e d , f o r example, to recognize the -alue of c o d - l i v e r o i l i n the prevention of r i c k e t s .  Canadian physician and columnist Dr. Royal S.  Copeland pointed out that babies born during the summer months had fewer cases of r i c k e t s , therefore, infants should be exposed to sunshine and fresh a i r .  He noted that cod-liver o i l was a simple cure f o r r i c k e t s ,  but i t was not u n t i l the l a t t e r part of the 1920's or early 1930's that  84 c o d - l i v e r o i l became a recommended component of the infant's d a i l y d i e t . The amount recommended varied from one advisor to another, by the season of the year, the age of the c h i l d , and whether the c h i l d was breast 6r bottle fed, but by 1939, c o d - l i v e r o i l was a f i r m l y established component of the infant's d i e t . Because infants could not l i v e on milk i n d e f i n i t e l y , s o l i d foods were incorporated into t h e i r d i e t s , however, the types of food i n t r o d uced and the age a t which they were introduced changed over the two decades.  In 1920, f o r example, infants received no s o l i d food u n t i l  they were weaned a t nine or ten months of age.  They were then given barley,  r i c e , or oatmeal j e l l y and pureed green vegetables.  At eleven months,  they were f e d oatmeal or cream of wheat c e r e a l that had been cooked f o r three to four hours, and c r i s p buttered toast.  Baked apples, baked  73  potatoes, and a t i n y b i t of raw apple were added a t twelve months, and coddled eggs, scraped beef or chicken were added a t 1 5 months of age.  D  By two years of age, the d i e t of 1 9 2 0 consisted of h a l f milk and h a l f 86 s o l i d food.  D u l l fare indeed!  Obviously the advisors recognized the  dullness of the d i e t , f o r Alan Brown suggested the young c h i l r e n dine away from t h e i r parents u n t i l they were able t o eat the same food as the a d u l t s . I t i s a species of c r u e l t y to expect a hungry c h i l d of tender age t o s i t a t a table, see and smell fragrant dishes, and be forced to content g himself with r e s t r i c t e d fare without complaining. 7  Children were t o be r e s t r i c t e d t o their,own d i e t .  The "Mother and Baby"  columnist noted that i f children have never been given anything else "they do not t i r e of t h e i r simple d i e t , anymore than a dog t i r e s of h i s meat or 88 bones, or the horse of h i s hay."  Infants of the m i d - 1 9 2 0 * s fared better than t h e i r older s i b l i n g s i n that they were fed a greater variety of s o l i d foods a t a younger age.  At  age seven months, they were given a green vegetable d a i l y and spinach three times a week.  Peas, carrots, and asparagus were included, but they were  cooked f o r t h i r t y minutes i n l i g h t l y salted water, thereby destroying both the n u t r i t i v e value and the f l a v o u r . and well cooked whole wheat or f a r i n a .  Infants were a l s o fed egg yolks  Their d i e t was supplemented with  one teaspoon of c o d - l i v e r o i l and one tablespoon of orange juice or two 89 of tomato j u i c e .  Mrs. Eldred described such fare as well-cooked,  d e l i c a t e l y seasoned, palatable, and a t t r a c t i v e .  Infants, however, 90  probably d i d not share Mrs. Eldred's opinion of t h e i r food.  By 1 9 3 9 , further changes had been made i n the infant's d i e t .  Cooked  cereals and zweiback rusks were fed a t s i x months, boiled eggs by the ninth month, c l e a r meat broth by the tenth month, and vegetable soup by  74  the eleventh month.  The d i e t recommended i n 1 9 3 9 contained considerably-  less milk and more s o l i d s than d i d the d i e t s recommended i n the 1 9 2 0 ' s . In f a c t , infants of 1 9 3 9 were much better fed than t h e i r 1 9 2 0 counter91 parts.  The introduction of s o l i d food into i n f a n t s ' d i e t s created three recurring problems: reluctance t o change from milk to s o l i d foods; 92 chronic constipation; the serious disorder of d i a r r h o e a .  7  Parents  sought advice about the easiest and surest way to convince t h e i r infants to accept s o l i d foods, but the advice offered varied.  The Canadian Mother's  Book and the Canadian Mother Craft Society suggested that i f infants were taught early to drink from a cup they would not r e j e c t s o l i d foods. Furthermore, hunger during the f i r s t week of weaning would force babies 93 to accept s o l i d f o o d s . ^  The Family Herald and Weekly Star columnist sug-  gested that mothers feed t h e i r infants t h e i r s o l i d foods f i r s t and then 94 reward them with milk.  Mrs. Eldred suggested the parent subtly incorp-  orate new food i n t o the c h i l d ' s d i e t without drawing attention to i t , or creating a fuss about i t . ^  5  The e d i t o r of "Post Natal Letter '?'" took  a more pragmatic approach to the problem of fussy eaters by s t a t i n g Firmly, but gently, teach your c h i l d to eat what i s given him as a matter of course and you w i l l prevent malnutrition and under nourishment that often r e s u l t s from bad eating h a b i t s . 9 6 The problem of getting babies to accept foods other than milk was  prev-  alent enough not only to be of concern to mothers but also to health professionals.  Alan Brown noted that most underfed children over one year of  age that he saw were those who had been breast fed too long or "those 97 who were kept too long on an exclusive milk d i e t . " ' Although feeding and d i e t s seems to have been the subject of greatest  concern, a second problem was constipation.  Child care advisors of  the early 1920's insisted that bowels must be kept open and the infant 98  must have one or more movements each day.  F. Truby King admonished  mothers, "Don't l e t 1 0 o'clock i n the morning pass without getting the bowels to move i f there has not been a motion i n the previous 24 hours." King shared the opinion of other health professionals that open bowels was the key to good health.  " I f we could keep the motions always normal  we should have few or no delicate c h i l d r e n . " 1920's  1 0 0  Infants of the early  were subjected to many different treatments f o r constipation.  Commonly, laxatives such as paragoric suppositors or enemas were used. Foods such as l i q u i d paraffin, fresh cream, olive o i l , orange juice, or milk of magnesia were also u s e d .  101  Although Dr. McCullough warned  against i t s excessive use, castor o i l was the most frequently recom102  mended laxative.  Fortunately,for children, by the early  1930's  advisors realized that a d a i l y bowel movement was not normal f o r every child.  Mrs. Eldred, f o r example, advised mothers to pay more attention  to t h e i r infant's diet than to t h e i r bowels. -* Dr. McCullough pointed 104out that only f i v e or s i x defecations a week was quite normal. Concern over constipation progressively diminished throughout the 1 9 3 0 * s as infants were fed more s o l i d foods at an e a r l i e r age. 10  Closely a l l i e d to the question of defecation was the advice furn- • ished to mothers regarding changes i n t h e i r infant's stools.  Health  professionals pointed out that any change i n colour, odour, or texture was to be noted as t h i s indicated the state of an infant's health, the source and causes of some illnesses, and the s u i t a b i l i t y of the infant's diet. ^ 1 0  More serious than constipation was the sometimes f a t a l dysentry (cholera infantum," summer complaint).  Breast fed babies were not  susceptible to g a s t r i c upsets caused by impure or t a i n t e d milk, but a l l babies were affected by impure water, teething, colds, extremely hot weather, or b a c t e r i a l infections of the i n t e s t i n a l t r a c t .  Health  professionals t r i e d to impress on mothers that dysentry was highly infectious and could be e a s i l y communicated to other infants, and unless mothers were scrupulously clean the same infant could be r e infected from h i s mother's hands or from bottles and diapers. bottles, and diapers were to be b o i l e d to ensure  Nipples,  r e i n f e c t i o n d i d not  occur, and an i n f e c t e d infant must be i s o l a t e d from a l l other c h i l d -  106 ren.  The suggested treatment f o r dysentry changed r a d i c a l l y over the two decades.  During the 1920's, health professionals agreed that once  an infant had developed dysentry the family physician should be called immediately,  but while waiting f o r the doctor to a r r i v e , the infant  should be given one to two teaspoons of castor o i l and fed only cooled,  107 boiled water.  The rationale f o r t h i s treatment was that castor o i l  would clean the b a c t e r i a l i n f e c t i o n or the cause of the dysentry from the i n t e s t i n e .  Such treatment sounds as serious as the disorder, and  must surely have led to the death of some infants from dehydration. With new medical discoveries and developments during the 1920's and 1930's, the advice to parents changed.  In 1938,  Dr. McCullough advoc-  ated feeding an infant f r e s h scraped, d r i e d , or powdered apples to stop severe diarrhoea.  For two or three days the infant was to be  iod given only cooled b o i l e d water and the apple mixture.  McCullough  claimed t h i s treatment was an e f f e c t i v e method to check diarrhoea. Perhaps the most interesting aspect of the constipation-diar-  77 rhoea problem was the great concern expressed by parents i n l e t t e r a f t e r l e t t e r to columnists on the problem of constipation. Rare indeed were l e t t e r s requesting information or advice on the more serious problem of diarrhoea.  Was t h i s because constipation was a recurring disorder  with which mothers f e l t they could cope, whereas dysentry was a d i s order so serious they must seek the advice of a physician?  Did mother  f e e l that once an infant had contracted dysentry there was l i t t l e  she  could do and that the infant's l i f e was i n the "lap of the gods?" Or d i d the number of l e t t e r s concerning constipation simply indicate columnists chose to respond to questions about constipation and d i d not p r i n t queries about the treatment of dysentry?  A review of inform-  a t i o n a v a i l a b l e to parents throughout the 1 9 2 0 ' s and 1 9 3 0 ' s f a i l s to provide an answer to these questions.  What i s evident, however, i s  that infant deaths i n B r i t i s h Columbia caused by dysentry s t e a d i l y declined over the two decades.  Pure milk, clean water, improved care,  and cleanliness i n handling the c h i l d brought the deaths by dysentry from 5 . 4 percent of infant deaths i n 1 9 2 3 to 2 . 3 percent of infant deaths i n 1 9 3 9  1 0 9  (Table  3.1).  In the 1 9 2 0 ' s and 1 9 3 0 ' s , before the invention of disposable paper diapers and the widespread use of automatic washers and dryers, mothers were anxious to t o i l e t t r a i n t h e i r infants as soon as p o s s i b l e . For hygienic reasons, health professionals and c h i l d care advisors urged parents to begin t o i l e t t r a i n i n g as early as p o s s i b l e . As Holt pointed out, not only was r e g u l a r i t y important to the c h i l d , but a l s o " I t also saves the nurse much  trouble and l a b o u r . "  i n i t i a t e d by mothers, who  1 1 0  Toilet training  was  observed t h e i r children to determine the time  of bowel movements, and when they were s i x weeks to two months old i t was time they were put on a chamber pot once or{twice a day.  I f mothers  Table  3.1  INFANT MORTALITY - PROVINCE OF BRITISH COLUMBIA ANALYSIS OF CAUSES OF DEATH  Premature  1923  1924  1925  1926 1927  28.4  27.5  27.8  32.8  25.8  1928 29.0  1923 - 1939  1929 1930 1931 1932 1933 1934 26.2 28.6 32.1 22.3 27.9  26.7  8.2  4.5  3.9  5.2  10.3  8.9  9.8  10.1  28.1  6.4  5.9  10.7  6.1  9.8  4.3  4.0  5.7  6.9  7.2  5.7  4.1  6.6  3-9  6.5  5.9  4.6  6.3  6.0  7.0  5.2  4.8  8.2  5.6  3.6  3.1  5.5  3.8  5.2  6.0  5.7  8.0  3.5  5.7  6.5  6.5  6.4  6.8  3.7  4.2  4.7  4.1  4.3  1.3  1.2  3.6  3-3  2.5  1.9  Conginital Debility  7.8  6.7  8.6  6.6  Malformation  9.3  9.1  8.8  14.9  Diahorrea  5.4  6.6  6.9  4.7  Bronchal Pneumonia  6.7  3-0  6.5  4.8  7.3 8.7  6.7  Injury at Birth  10.2  Pneumonia  3.9  Whooping Cough  3-4  5.9 5.9  Influenza  1.9  2.1  1.8  2.7  3.7  2.3  3.7  Convulsions  1.5  1.2  2.5  1.4  1.8  1.1  1.0  T. B.  1.2  2.3  2.1  2.0  1.3  2.3  1.7  6.8  10.6  16.3  Total Deaths Total l i v i n g Births Death Rate Lxve^Sirths SOURCES:  668 10001 66.8  27.2  574 10119  56.7  21.3  569 10342  55.0  20.4  24.8  26.0  558  606  524  10063  10084  58.4  60.9  29.4  10.8  13.6  5.2  4.4  5.2  2.3  8.5  7.7  6.8  9.2  6.8  7.5  7.6  6.5  4.6  6.7  8.1  5.0  5-4  4.8  4.9  4.0  5.2  5.4  2.1  1.5  5.0  1.5  1.9  2.5  3.6  2.3  3.8  1.1  3.8  4.3  2.8  4.9  .71  3.3  1.5  1.3  2.8  3.7  3.6  2.2  1.9  4.3 14.0  3.1  22.2  20.8  21.2  20.7  630  556  483  1.9  1.9  575  562  IO385 10378 IO867 50.4  58.4  51.7  22.4  3.3  1938 1939 27.5  29.1  10.0  11.1  1.7  22.2  1937 25.2  3.9  .53 1.9 2.7  24.5  4.1  6.1  .91 2.1  Measles Other Causes  1935 1936  26.4  .5  21.9  22.3  22.6  455  .79  .35 3.4  .80 2.1  477 10404 10214  439  426  460  9583  9813  10013  10171  11279  12476  12373  46.7  45.8  42.3  45.9  43.9  55.8  44.6  39.0  517  49.4  Decline 6 6 . 8 to 3 9 . 0 per 1 0 0 0 l i v e b i r t h s . B r i t i s h Columbia Board of Health Report. 1 9 2 3 - 1 9 3 9 ; B r i t i s h Columbia Department of V i t a l S t a t i s t i c s Report. 1 9 2 7 ~ 1 9 3 9 . Where no numbers are available the spaces are l e f t blank.  79  were good observers and i f children had any sense of r e g u l a r i t y , t h e i r  needs could be anticipated by t h e i r f r e t t i n g and -grunting, and thereby reduce the number of diapers mothers had t o wash.  Advisors believed  r e g u l a r i t y of bowel movements could be established within the f i r s t few weeks, but complete bladder control probably could not be achieved u n t i l the infants were a t l e a s t fourteen t o twenty-four months of age.  By  putting infants on a chamber pot when they f i r s t awoke and before and a f t e r each meal, mothers could help e s t a b l i s h the "dxy h a b i t . " The success of t o i l e t t r a i n i n g was watchfulness and p a t i e n c e .  1 1 1  Parents  were t o praise t h e i r c h i l d r e n f o r successful r e s u l t s , but they were not to punish them f o r f a i l u r e s .  "Post Natal Letter #2" pointed out "expect-112  ancy of success helps g r e a t l y . . , iate the approval of others.  because children want and apprec-  Infants who were not completelyytrained  by eighteen to twenty-four months of age were a r e f l e c t i o n of t h e i r mother's f a i l u r e t o establish good h a b i t s . 113 Another aspect of children's d a i l y schedules was exercise. ^  Just  before t h e i r morning bath or a t diaper changing time, the infants were s t r i p ped of t h e i r cumbersome clothing and l e f t free to arm-wave, leg-kick, wiggle and squirm.  Mothers were admonished t o remember that babies t i r e d e a s i l y ,  therefore they should be permitted only ten minutes of unhampered k i c k i n g several times a day f o r the f i r s t few months of t h e i r l i v e s , but as i lit  infants grew older, t h e i r play time could be extended.  Mothers play-  time with t h e i r babies was i n the morning before bath time and the father's time was i n the evening before the babies went t o bed, but fathers were remonstrated not t o get babies:so excited they could not sleep.  Above a l l , babies must learn t o play alone and amuse themselves;  t h i s was one step along the road to independence.  115  Undoubtedly, many  busy mothers had no alternative but t o leave babies t o t h e i r own  80 amusement!  A l l babies were to cry f o r a few minutes each day i n order to expand t h e i r chests and lung capacities, and to exercise t h e i r arms and legs.  "They (babies) set the rhythm of the exercise with a couple  of l u s t y howls and then begin with the arms and l e g s . " ^ 1 1  I f the cry  was not one of hunger, pain, or i l l n e s s , the parents were to leave the children alone, as they would soon learn that crying a v a i l e d nothing and therefore they would cry only f o r a purpose.  Giving i n to crying infants  117 would q u i c k l y create a behaviour problem.  Once children were put to  bed, parents were advised to ignore t h e i r crys and they would soon learn  118 to go to sleep.  But i t was not always that simple.  Canadian newspaper  columnist Gregory Clark d e t a i l e d the trauma he and h i s wife endured while 119 withstanding t h e i r f i r s t baby's c r i e s .  7  Anxious to apply new c h i l d rear-  ing methods, Clark and h i s wife managed to hold out f o r twelve minutes before they resorted to the t r a d i t i o n a l , time proven practice of rocking 120 baby and singing l u l l a b i e s to put him to sleep. Clarks?  How  t y p i c a l were the  Were many parents able to withstand t h e i r infant's c r i e s , or was  t h i s one area where s c i e n t i f i c c h i l d r e a r i n g methods gave way to t r a d i t i o n a l practices? Although parents made many changes i n t h e i r c h i l d rearing practices, the most s t a r t l i n g change was the willingness of mothers to give up t h e i r natural desire to cuddle, handle, and pamper t h e i r infants. Advisors advocated parents play with t h e i r infants as well as show them love and a f f e c t i o n , but they opposed overt demonstrations  of a f f e c t i o n .  As an example, mothers and other adults were advised not to k i s s t h e i r infants, nor to allow infants to be kissed by others.  Advisors  81  warned that disease germs, including tuberculosis, were transmitted i n 121  t h i s manner.  In 1923* Alan Brown argued that infants should not be  handled frequently as t h e i r bones and ligaments were s o f t , and frequent 122  handling could cause s p i n a l curvature and other bone deformities. 1934,  By  McCullough s t i l l believed infants under s i x months should not be  p h y s i c a l l y played with as such play made infants nervous and i r r i t a b l e , spoiled t h e i r sleeping habits, and caused indigestion which resulted i n weight l o s s . - * 12  Chatelaine columnist  Emma (Jary Wallace a l s o believed  constant handling and playing with the babies used up t h e i r strength and retarded t h e i r growth. Wallace stated: about a l l the handling a c h i l d should have f o r the f i r s t year i s that which i s necessary to make i t p h y s i c a l l y comfortable - to bathe, feed, change and take i t out to a i r , and to give i t as time goes on some opportunity f o r physical exercise. 124 I f the babies were bottle fed, mothers were advised to hold the bottle and not t h e i r babies.  Infants of the 1 9 2 0 * s and 1 9 3 0 ' s were c e r t a i n l y  not to be indulged, pampered, or petted.  As the Family Herald and Weekly  Star columnist pointed out, too much petting was just as bad f o r babies as i t was f o r pets. -^ 12  Many;; mothers accepted the advice of c h i l d care  advisors and permitted medical hygiene to supersede natural demonstrations of love and a t t e n t i o n . As Newson and Newson point out, only women with courage, and those who  ignored a l l advice i n the f i r s t place,  rejected the advice of the authorities and gave way to t h e i r natural desires to cuddle t h e i r infant.  126  V Although the c h i l d care advisors of the 1 9 2 0 ' s and 1 9 3 0 ' s focused on physical care, throughout the period there was a growing awareness of the  infant's psychological development.  Temperance, s e l f - c o n t r o l ,  82 s e l f - d i s c i p l i n e , obedience, and s i n c e r i t y were the a t t r i b u t e s t o be developed.  These a t t r i b u t e s would be developed through t r a i n i n g the  infant i n good habits and by eradicating bad habits.  As one advisor  stated, " i t i s i n the home that the foundation of character and the 127 art  of l i v i n g must be l a i d . "  The columnists of the Family  Herald  and Weekly Star likened the development of a c h i l d ' s character t o growing a plant; sometimes i t needs t o be pruned, sometimes i t needs to be supported, but i t always had t o be trained i n the d i r e c t i o n the parent wants him t o go.  Good habits must be taught and bad habits  must be e r a d i c a t e d . ^ 12  Among the bad habits that must be eradicated were thumbsucking, the use of p a c i f i e r s , ear p u l l i n g , and temper tantrums. attitudes toward these habits gradually changed. sucking was a habit that must be stopped.  Advisor's  In the 1920*s, thumb-  I t was a source of d i r t and  disease; i t could misshape the thumb or the jaw, create thick and soggy l i p s , receding teeth, and bulging jaws.  Parents were advised t o bandage  t h e i r children's hands and t o moisten the bandages with a s o l u t i o n of quinine, make them wear a f i n g e r s t a l l , or mitts, or p u l l the sleeves of 129 t h e i r nightgowns over t h e i r hands and p i n the sleeves.  7  The "Mother and  Baby" columnist of the Family Herald and Weekly Star wrote "In obstinate cases, i t i s often necessary t o confine the elbow by small cardboard s p l i n t s to prevent c h i l d r e n from bending" t h e i r arms so as t o get t h e i r hands t o t h e i r mouths.""^ views. ing  By the mid 1930's, however, advisors had modified t h e i r  Mrs. Eldred believed thumbsucking could be cured without attack-  the problem d i r e c t l y ; she suggested thumbsucking be ignored and 131  infants be offered other amusements to occupy t h e i r time. -'  The Canadian  Mothercraft Society suggested the mother f i r s t check whether the cause of thumbsucking was hunger.  I f hunger was not the cause, mothers  were t o place mobiles over t h e i r infant's c r i b s t o provide a d i v e r s i o n .  Only as a l a s t desperate resort was the mother t o resort t o bandages or s p l i n t s , but under no condition was the mother to scold her c h i l d or to withhold love. -* 1  2  By 1 9 3 8 , Dr. McCullough demonstrated a modified view  and agreed that thumbsucking indicated the baby had not been kept amused and occupied.  He advised mothers pay no attention to t h e i r children's  thumbsucking, as the more attention paid the habit the more the children  133 would p e r s i s t .  Although the attitude of advisors toward thumbsucking modified considerably, t h e i r attitude towards p a c i f i e r s d i d not.  Both health  professionals and columnists waxed eloquent on t h i s t o p i c . described the p a c i f i e r habit as "an inexcusable  piece of f o l l y f o r which  134  the mother or nurse i s d i r e c t l y responsible.''  Alan Brown  bed McCullough described 134  a p a c i f i e r as "the l a s t resort of the lazy and i l l - t r a i n e d mother."  P a c i f i e r s transmitted diseases such as tuberculosis, diphtheria, and s y p h i l l i s , i r r i t a t e d the throat glands, and caused enlarged adenoids. McCullough r e f l e c t e d the attitude of a l l other advisors when he f l a t l y 135  stated that burning was the only suitable fate f o r p a c i f i e r s .  Ear p u l l i n g was another habit McCullough deplored.  He sug-  gested putting mitts on the babys' hands so they could not reach t h e i r ears.  For children who made a habit of putting things i n t h e i r ears,  McCullough suggested an even s t i f f e r penalty.  "At the f i r s t sign of 13r>  such a habit a vigorous spanking may cut i t short."  VI Health professionals and c h i l d care advisors of the inter-war years adopted an extremely authoritative attitude towards parents as  they demanded that parents - e s p e c i a l l y mothers - adopt the s c i e n t i f i c method.  The new  new  s c i e n t i f i c method advocated by advisors  i s best summarized i n the introduction prepared by the B r i t i s h Columbia Board of Health to the "Post Natal Letters"  (1937)  Canadian Council of Child and Family Welfare.  published by the  The introduction stated:  Breast feeding i s the baby's b i r t h r i g h t . Do not deprive him of i t . A r t i f i c i a l feeding should be given only on your physician's orders. See that the baby has regular medical supervision. Have your baby protected against smallpox and diphtheria. Regularity on your part w i l l develop regular habits i n the baby. A clean baby i s l i k e l y to be a healthy and happy baby. A baby needs sleep, sunshine and fresh a i r . The baby's bowel c o n t r o l depends on your e f f o r t s . You are moulding the baby's character and habits whether you plan to do so or not: The Baby t r u s t s and depends on you; Do not f a i l him. 1 3 7 Was  the new  s c i e n t i f i c method of c h i l d rearing successful?  Certainly, advisors were able to support t h e i r appeal with s t a t i s t i c a l data that showed a s t e a d i l y d e c l i n i n g infant mortality rate, the d i r e c t r e s u l t of fewer cases of g a s t r o - e n t e r i t i s , acute chronic indigestion, and acute i n f e c t i o u s diseases  (Table 3 * 2 and 3 . 3 ) • Although other  f a c t o r s , such as better s a n i t a t i o n , purer milk and water supplies, and better medical care, combined with the s c i e n t i f i c method of c h i l d rearing to reduce the infant mortality rate, advisors put f o r t h such convincing arguments that most parents adopted, at l e a s t to some degree, the very r i g i d , systematic approach t o c h i l d rearing  (Table 3 . 3 ) .  There were, however, a few health professionals who deplored the regimentation of i n f a n t s .  Dr. Grover F. Rowens, Yale University Medical  School, i n a syndicated a r t i c l e t i t l e d "Modem Babies i n Rebellion: Regimentalism Creeping Into Nursery?" stated that he believed many problems were caused by an u t t e r disregard f o r baby's needs and desires, and by parents and pediatricians who schedule.  wanted to f i t each baby into a  " I t would be wise f o r the physician to worship the baby  more and the measuring s t i c k , the scales, the graduate and the clock  85 Table 3.2 INFANT MORTALITY - PROVINCE OF BRITISH COLUMBIA 1920 - 1939 Total Deaths f o r B. C.  Total Deaths Under 1 Year  Percentage of Total Deaths  Total Births (Live)  Death Rate Per 1000 Live ]  1920  4888  685  14.0  9308  73.6  1921  4489  617  13.7  10687  57.7  1922  4748  627  13.2  11197  56.0  1923  4997  668  13.4  10001  66.8  1924  5004  574  11.5  10119  56.7  1925  4945  569  11.5  10342  55.0  1926  5474  588  10.7  10063  58.4  1927  5750  606  10.5  10084  60.9  1928  5910  524  8.9  10385  50.4  1929  6347  575  9.1  10378  55.4  1930  6400  562  8.8  10867  51.7  1931  6114  518  8.5  10424  49.7  1932  6150  477  7.8  10214  46.7  1933  6221  439  7.1  9583  45.8  1934  6400  426  6.7  9813  42.3  1935  6857  460  6.7  10013  45.9  1936  7222  465  6.4  10517  43.9  1937  7973  630  7.9  11279  55.8  1938  7450  556  7.5  12476  44.6  1939  7517  483  6.4  12373  39.0  SOURCES:  B r i t i s h Columbia Board of Health, Reports. 1919 t o 1939; B r i t i s h Columbia Department of V i t a l S t a t i s t i c s , Reports. 1927 t o 1939.  86  INFANT MORTALITY - CITY OF VANCOUVER  Table 3 . 3  1914 - 1939 Year  Total Deaths  Death of Children Under 1 Year  Percentage of Total Deaths  Total Live Births  Death Rate per 1 0 0 0 Live Births  Stillborn  1914  1013  198  19.5  2774  71.3  150  1915  972  142  14.6  2794  50.8  140  1916  1097  166  15.1  2688  61.8  119  1917  1190  154  12.9  2676  57.5  115  1918  1846  I85  10.0  2776  66.6  99  1919  1530  153  10.0  2700  56.7  145  1920  1622  186  11.5  3366  55.3  154  1921  1331  164  12.3  3623  45.3  161  1922  1436  176  12.2  3192  55.1  125  1923  1366  153  11.2  3165  48.0  137  1924  1433  133  9.3  3303  40.3  1925  1427  130  9.1  3578  36.3  120  1926  1588  153  9.6  3458  44.3  139  1927  1677  142  8.5  3563  39.9  154  1928  1739  141  8.1  3346  42.1  117  1929  2210  146  6.6  4354  35.5  135  1930  2225  148  6.7  4539  32.6  112  1931  2237  140  6.2  4241  33.0  131  1932  2240  139  6.2  3599  38:. 6  92  1933  2230  108  4.8  3232  33.4  91  1934  2194  80  3.6  3409  23.5  88  1935  2479  99  4.0  3587  27.6  79  1936  2697  119  4.4  3577  33.3  77  1937  2792  125  4.5  3921  31.6  86  1938  2768  134  4.8  4226  31.8  74  1939  2816  117  4.2  4359  26.5  95  SOURCE:  .  Vancouver Board of Health, Reports, 1 9 1 4 - 1 9 3 9 .  131  less. . . " 1 3 9  87 Syndicated columnist Angelo P a t r i expressed the same  view i n a s l i g h t l y d i f f e r e n t way when he suggested that a d i f f i c u l t boy d i d not need d i s c i p l i n e , but rather that, "Maybe he needs a r e s t JL4O from the schedule.  Such contradictory advice must have raised  uneasy f e e l i n g s i n the minds of young parents anxious to adopt correct c h i l d rearing p r a c t i c e s . Advisors stated that modern, responsible mothers d i d not play with t h e i r infants a t unscheduled times, cuddle t h e i r infants when they c r i e d , rock them when they could not sleep, nor feed them when they were hungry.  Parents must not indulge t h e i r infants nor allow them to  develop bad habits, f o r the r e s p o n s i b i l i t y of moulding i n f a n t s ' habits and p e r s o n a l i t i e s rested with t h e i r parents.  This r e s p o n s i b i l i t y must  have created tensions within parents as they sought t o reconcile t h e i r desire to comfort and cuddle t h e i r c h i l d r e n with the s c i e n t i f i c method which condemned such indulgences.  Poetess Mona Gould expressed these  f e e l i n g s i n a poem e n t i t l e d "Modern Mother." I have t r i e d philosophy And applied psychology And when John bumps h i s knee I forget and k i s s i t . 141  In reviewing the advice available t o parents, there i s evidence that the new s c i e n t i f i c method, designed to ensure both good physical care f o r c h i l d r e n and convenience f o r parents, turned infants i n t o a " l i t t l e machine."  The schedule and not the infant became the more  important f a c t o r .  There i s also evidence that by the 1 9 3 0 ' s ,  parents were confused by contradictory advice from health professionals and c h i l d care advisors.  Parenting during the 1 9 2 0 ' s and 1 9 3 0 ' s  was both an exacting and demanding task as parents attempted to reconc i l e t h e i r t r a d i t i o n a l c h i l d rearing practices and natural parenting instincts with the s c i e n t i f i c approach demanded by advisors.  Footnotes  89  1 Bernard Wishy, The Child and the Republic (Philadelphia: University of Pennsylvania Press, I 9 6 8 ) , p. VI; - Raymond E. Callahan, Education and the Cult of E f f i c i e n c y , (Chicago: University of Chicago Press, 1 9 6 2 ) , p. 2 3 ; Robert R. Sears, Eleanor Maccoby, Harry Levin, Patterns of Child Rearing (Evanston: Row, Peterson and Co., 1 9 5 7 ) , P« 5 « 2 John Newson and Elizabeth Newson, "Cultural Aspects of C h i l d Rearing i n the English-Speaking World," i n Rethinking Childhood: Perspectives on Development and Society by Arlene Skolnick, ed., (Berkeley: L i t t l e Brown' and Co., 1 9 7 6 ) , p. 3 4 3 ; See also N e i l Sutherland, Children i n English Canadian Society: Framing the Twentieth Century Consensus (Toronto: University of Toronto Press, 1 9 7 6 ) p. 2 8 8 ; Helen K e l l y , "Colwood," Public Health Nurses' B u l l e t i n . 1 (Oct., 1 9 2 4 ) , 1 - 2 . (Hereafter PHNB). 3 A. Wynler Blyth, "Preface," Infant Education, by E r i c Prtichard, (London: Henry Kimpton, 1 9 0 7 ) , p. VI. 4,  Sears, Patterns of Child Rearing, p. 5 «  5. Lynn Z. Bloom, " I t ' s A l l f o r Your Own Good," Journal of Popular Culture. 1 0 ( 1 9 7 6 ) , 1 9 3 ; see also Newson, "Cultural Aspects of Child Rearing," p. 3 4 3 . 6 Alan Brown, The Normal C h i l d : I t s Care and"Its Feeding. (London: The Century Co., 1 9 2 3 ) , p. 2 - 5; "The Baby C l i n i c , " Chatelaine. Nov., 1 9 3 4 , p. 4 4 . 7., Alan Brown, "The Relation of the P e d i a t r i c i a n to the Community," Public Health Journal. X (Feb., 1 9 1 9 ) , 4 5 - 5 5 (Hereafter CPHJ); B r i t i s h Columbia Board of Health, Report. 1 9 2 1 ; p. A 6 (Hereafter BCBH). 8, 1 9 1 9 ,  "Women's Institutes Holds Convention," P. 1 1 .  Vernon News, Nov. 6,  9, L. Emmett Holt, The Care and Feeding of Children, ninth e d i t i o n , (London: D. Appleton and Co., 1 9 2 3 ) ? F. Truby King. Feeding and Care of Baby (London: Macmillan, 1 9 1 3 ) ; E r i c Pritchard, Infant Education (London: Henry Kingston, 1 9 0 7 ) ; John B. Watson, Psychological Care of Infant and Child (New York: W. W. Norton and Co., 1 9 2 8 ) . 10  Holt, The Care and Feeding of Children.  11, Mrs. Dr. Patten, "The Care and Feeding of Children," Women's Institute Handbook, 1 9 1 4 , p. 1 6 8 . 12, 1938),  Nov.,  Olive M. Garrood, " S i r F. Truby King - A T r i b u t e , " PHNB, 2 (Mar., 10 - 11; "A Lowered Death Rate," Family Herald and Weekly Star, 2 2 , 1 9 2 2 , p. 2 9 . (Hereafter FHWS).  1 3 B r i t i s h Columbia Commission on Health Insurance, Report on Maternity Insurance and Public Health Nursing, 1 9 2 1 , p. 5 1 9 . 14  Garrood,  15  King, Feeding and Care of Baby, pp. 9 - 4 3 .  " S i r Truby King,"  p. 1 1 ; "A Lower Death Rate," p; 2 9  Footnotes Lactation," i n Mothercraft (London: The National League for Health, Maternity and Child Welfare, 1 9 2 5 ) , pp. 8 0 - 8 5 . 17 - King, Feeding and Care of Baby, pp. 1 9 - 2 6 . 18  Olive M. Garrood, "Public Health i n Kamloops," PHNB. 1 (Apr. - 23; Margaret E. Kerr, "The Refresher Course For Public Health Nurses," ibid., 1 (May, 1 9 3 0 ) , 3 0 5 ; Pamphlets included "Guide to the A r t i f i c i a l Feeding of Babies After Nine Months," adapted from a New Zealand Bulletin, distributed by the British Columbia Board of Health, 1928),  21  1932.  19  Pritchard, Infant Education,  20  Ibid.  pp. VI - XIII, 1 7 0 - 1 9 0 .  21 Olive M. Garrood, "Teaching Public Health i n Kamloops," PHNB. (May 1 9 3 0 ) , 2 1 - 3 3 ; M. M. G r i f f i n , "Breast Feeding For Infants In Saanich, ibid., 1 1 (Apr. 1 9 2 7 ) 2 4 - 2 7 ; "Education and Public Health," Bulletin of the British Columbia Board of Health. 4 (Sept. 1 9 3 4 ) , 1 5 6 . (Hereafter BBCBH)\ The Canadian Mothers Book, p. 3 2 . 7  22  Watson, Psychological Care of Infant and Child, p. 3 *  23,  Ibid.  24,,  Ibid., pp. 3 - 4 .  25  Ibid., p. 1 2 .  26  Ibid., p. 1 0 .  27 Brown, The Normal Child. Title page; Pierre Berton, The Dionne Years (Toronto: McClelland and Stewart, 1 9 7 7 ) , P. 7 3 . 2 8 , Brown, The Normal Child. "Discipline and Education," 214, "Habits of Infants and Children," pp. 2 1 5 - 2 2 0 .  pp. 2 0 5 -  29,  The Canadian Churchman. Oct. 1 1 , 1 9 2 3 , P.  30,  "The Baby;;Clinic," Chatelaine. Nov. 1 9 3 4 , p. 4 4 ; There were i n British Columbia i n 1 9 3 0  645.  1 2 , 2 7 0 copies of Chatelaine distributed and 2 3 , 0 0 9 copies distributed i n 1 9 3 9 .  31, "The Baby Clinic," 1935. P. 24.  Chatelaine.  Nov. 1 9 3 4 , p. 4 4 ; Ibid., Jan.  32, Handbook of Child Welfare Work in Canada. (Ottawa: King's Printer, 1 9 2 3 ) , p. 3 . In 1 9 1 9 , child welfare work in Canada came under six federal departments: Health; Immigration; Indian Affairs; Soldier Settlement Board; Soldier's C i v i l Re-establishment; Agriculture. 3 3 , Child Welfare Division,  Report. 1 9 2 2 , p. 2 2 .  Footnotes  9  1  34 Helen MacMurchy, "The D i v i s i o n of C h i l d Welfare Department of Pensions and National Health," CPHJ. XIX (Nov. see also Sutherland, Children i n English Canadian Society, p. 6 2 . 1 9 2 8 ) ,  35  Handbook of Child Welfare Work,  5  1  4  -  5 2 1 ?  p. 9 .  The Canadian Mother's Book was released March copies were d i s t r i b u t e d i n the f i r s t t h i r t y days. By 1 9 2 3 , the book was i n i t s s i x t h e d i t i o n , available i n both French and English and copies had been d i s t r i b u t e d . 3 6  3  ,  1 9 2 1 ,  1 2 , 0 0 0  2 2 0 , 0 0 0  37 Brown, The Care and Feeding of Children, p. 5 3 ; a l s o King, Feeding and Care of Baby, pp. 9 3 - 9 5 ; "Your Infant's Sight," FHWS, Oct. 1 7 , 1 9 2 3 , P. 3 9 ; "How Much A Baby Sees," i b i d . , Oct. 24, T9Z5. s  J  Brown, The Normal Child, and Care of Baby, pp. 9 3 - 9 5 . 3 8 r  pp.  5  2  -  5  5  e  e  see also King, Feeding  ;  39, "Post Natal Letter, # 2 , " Canadian Council on C h i l d and Family Welfare, n. d.; Pritchard, pp. 8 8 - 1 2 9 . 40 "Post Natal Letter, # 1 , " Canadian Council on Child and Family Welfare, 1 9 3 7 ; see a l s o S t e l l a E. Pines, "The Baby's Routine and Management," Chatelaine, Jan. 1 9 2 9 , P. 1 9 . 43 "Ex-Convict Says Child's Future i s With Parent," Vernon News. Oct. 2 , 1 9 3 1 , P« 4 ; see also Frances Lucy Johnson, "The Making and Breaking of Habits," Chatelaine. June 1 9 2 8 , p. 3 8 ; Watson, Psychological Care of Infant and Child, p. 3 . 42 W. E. Blatz and Helen Bott, Parents and the Preschool c h i l d . (New York: William Morrow and Co., PP. H I - IV; p. Hurlock, Modern Ways With Babies. (Montreal: Lippincott, PP« - H . 1 9 2 9 ) ,  2  1 9 3 7 ) ,  7  ;  1  W. E. Blatz and Helen Bott, The Management of Young Children. (New York: William Morrow and Co., p. 1 9 3 0 ) ,  2  5  1  .  44 "Post Natal Letters," Canadian Council on Child and Family Welfare, 1 9 3 8 . Introduction by the B r i t i s h Columbia Board of Health. 45  Angelo P a t r i , "Defenceless Children,"  FHWS. Nov. 6 , 1 9 3 5 ,  P. 3 4 .  46. P. Charlton, "Armstrong," PHNB. (Apr. see also "The Care and Preparation of the BreastsT" Ante-Natel C l i n i c , "PreNatal Letter # 6 , " Canadian Council on C h i l d and Family Welfare, n. d.; The Canadian Mother's Book, pp. 3 0 - 3 3 ; "Your Baby and Mine," The Vancouver Sun. Oct. 5 , 1 9 2 6 ; "Mother and Baby," FHWS. Sept. 9 , 1 9 3 1 , P. 1  1 9 2 9 ) ,  8 ;  1 9 3 5 ;  3  0  .  47 The Child. 1 9 1 6 , p. 1 2 ; Dr. Harvey W. Wiley, FHWS. Oct. 2 7 , 1 9 2 0 , p. y7~. Wiley noted children deprived of mother's milk had poor teeth and d i f f i c u l t y during teething; M. A. Twiddy, "Physical Welfare of Children," BBCBH. (Dec. 4  1 9 3 4 ) ,  1  9  2  .  Footnotes 48.  The Canadian Mother's Book, p. 3 7 .  49 Charlton, "Armstrong," pp. 7 - 8 ; Twiddy, "Physical Welfare of Children," p. 1 8 2 . 50  The Canadian Mother's Book, p. 7 5 ; The C h i l d . 1 9 2 4 , p. 14;  "Ten b o t t l e - f e d babies die t o one that i s breast fed." 51. M. W. Beaver, "Population, Infant Mortality and Milk," Population Studies. XXVII ( 1 9 7 3 ) , 2 4 3 - 2 5 9 . 52. The Royal New Zealand Society f o r the Health of Women and Children. Annual Report of the Central Council and Dunedin Branch. 1 9 2 4 , c i t e d i n Maternal Mortality i n Canada, p. 5 , Report on Maternity insurance and Public Health Nursing. 1 9 2 1 , pp. 5 » 9 ; Garrood, "Teaching Public Health i n Kamloops," p. 2 1 . 53. The Canadian Mother's Book, p. 3 0 ; "Prenatal Letter # 6 , " Canadian Council on Child and Family Welfare, n. d.; "Expectant Mother Needs Extra Sleep," Star Weekly. Oct. 1 6 , 1 9 2 0 , p. 2 0 . 54  G r i f f i n , "Breast Feeding For Infants,"  55  I b i d . , p. 2 5 .  56  Garrood, "Teaching Public Health In Kamloops,"  p. 24.  p. 2 2 .  57 "Flavouring Milk f o r Beverage," FHWS. Oct. 4 , 1 9 2 2 , p. 2 9 ; also see "Mother and Baby," i b i d . , Nov. 2 9 , 1 9 2 2 , p. 2 9 ; i b i d . , Nov. 7 , 1 9 3 4 , p. 3 4 ; Florence F u l l e r t o n , "Saanich," PHNB. 1 (Apr. 1 9 2 5 ) , 4 58 The Canadian Mother's Book, p. 1 0 7 ; p. 1 9 ; "Post Natal Letters."  .  see also The C h i l d . 1 9 2 4 ,  5 9 . A l l About Milk. Metropolitan L i f e Insurance Co., 1924, p. 24; Wean as early as s i x months and as late as ten; "Mother and Baby," FHWS. Sept. 2 3 , 1 9 2 1 , p. 3 9 ? Wean a t nine or ten months; i b i d . , Nov. 8 , 1 9 2 2 , p. 2 9 , Wean at twenty-two pounds; "Our Baby's Health," Star Weekly. Oct. 1 , 1 9 3 2 , p. 1 3 . wean a t nine months. 60 "Mother and C h i l d , " FHWS. Sept*, 6 , 1 9 2 2 , p. 2 9 ; Frederick F. T i s d a l l , "Care of the Infant and Child Care During the Summer Months," CPHJ. XX (July, 1 9 2 9 ) , 3 5 7 - 3 6 0 ; "Wean Child a t F i r s t Sign of Teeth," Star Weekly, Oct., 2 2 , 1 9 2 2 , p. 3 6 . 61 62 63 102  -  The C h i l d . 1 9 2 4 , pp. 18 - 1 9 . "Mother and Baby,"  FHWS. Nov. 1 5 , 1 9 2 2 , p. 2 9 .  The Canadian Mother's Book, p. 1 0 7 ;  Brown, The Normal C h i l d , pp.  1037~~  64 "Mother and Baby," FHWS. Oct. 2 9 , 1 9 1 9 , p. 5 3 - Diet f o r s i x month old consisted of two tablespoons of cornstarch to one cup each of  93  Footnotes  milk or water; i b i d . , Nov. 7 , 1 9 2 2 , p. 2 9 . S i x week o l d fed one part milk t o two parts water; i b i d . , Sept. 2 , 1 9 3 1 » P« 3 0 • S i x week infant fed cream and water; i b i d . , Oct. 6 , 1 9 2 0 , p. 3 7 . Mother used catnip tea to r e l i e v e infant's c o l i c . 65  King, Feeding and Care of Baby, pp. 1 9 - 2 6 .  66  Garrood, "Teaching Public Health i n Kamloops,"  67  Beaver, "Population, Infant Mortality and Milk,"  p. 2 2 . pp. 2 5 3 - 2 5 4 .  68 Elizabeth E. Martin, "Vernon," PHNB. 2 (Apr. 1 9 3 5 ) , Garrood, "Teaching Public Health i n Kamloops," p. 2 1 .  69  "The Baby C l i n i c , "  70  "Your Baby and Mine,"  Chatelaine.  P. 24;  Mar. 1 9 3 9 , p. 42.  The Vancouver Sun. Oct. 3 , 1 9 2 7 .  71 "Halt Wastage of Child L i f e , " Vernon News. Nov. 1 0 , 1 9 2 1 , p. 4 ; B r i t i s h Columbia, Statutes. "An Act To Amend the Health Act, May 1 1 , 1 9 0 9 , " prohibited the sale and use of milk from tuberculosis infected cows. 72 "The Baby C l i n i c , " Chatelaine. July, 1 9 3 4 , p. 4 4 ; see also i b i d . , May, 1 9 3 9 , p. 7 6 ; "Mother and Baby," FHWS. Sept. 2 5 , 1 9 2 9 , p. 34. " I t i s not necessary t o b o i l milk when the cows are free from tuberculosis by t e s t i n g . " 73 The Canadian Mother's Book, pp. 7 0 , 1 0 8 - 1 0 9 ; The Child. 1 9 2 4 , pp. 1 8 - 1 9 ; "Child Welfare Bureau," Star Weekly. Oct. 4 , 1 9 1 9 , no page; "A Thirsty Baby," FHWS. Oct. 1 0 , 1 9 2 8 , p. 3 7 . 74  BCBH, Report. 1 9 3 7 , P. 3 2 .  75  "Mother and Baby,"  FHWS. Oct. 1 , 1 9 1 9 , P. 3 8 .  76  "The Baby C l i n i c , "  Chatelaine. July, 1 9 3 9 , p. 46.  77 Garrood, "Teaching Public Health i n Kamloops," p. 2 2 ; "Diet Series # 2 - A r t i f i c i a l Feeding," Canadian Public Health Association, n. d.; "Keeping Babies A l i v e , " The Vancouver Province. Dec. 2 0 , 1 9 3 4 . 78  Margaret Laine, "Weaning the Baby,"  79  "Your Baby and Mine,"  80  "The Baby C l i n i c , "  Chatelaine. May, 1 9 3 2 , p. 40.  The Vancouver Sun. Oct. 3 , 1 9 2 7 .  Chatelaine. June, 1 9 3 4 , p. 4 4 .  81. "How To Take Care of the Baby," C h i l d Welfare D i v i s i o n , 1 9 2 3 , p. 2 1 ; see also "Mother and Baby," FHWS, Nov, 1 5 , 1 9 2 2 , p. 2 9 ; The Canadian Mother's Book, p. 1 0 5 . 82 "What are Vitamines?" Star Weekly. Oct. 1 , 1 9 2 1 , p. 1 3 (reprinted from the S c i e n t i f i c American); "Your Baby and Mine," The Vancouver Sun. Oct. 1 , 1 9 3 4 .  94 Footnotes 83  FHWS. Nov. 2 9 , 1 9 2 2 , p. 2 9 .  "Prevention and Cure of Rickets,"  84 "Mother and Baby," Oct. 1 6 , 1 9 2 9 , p. 3 9 } "Diet Suggestions Recommended f o r Mothers," The Vancouver Province. Oct. 3 , 1 9 2 6 , p. 1 8 (reprinted from the Children's Bureau, Department of Labour, U. S. A.); also see "Necessary Vitamines," FHWS. Sept. 1 6 , 1 9 3 1 , P. 3 0 ; "The Baby C l i n i c , " Chatelaine. Mar. 1 9 3 9 , p. 4 2 ; "Sunshine and Health - The Health O f f i c e r Suggests," BBCBH. ( (July, 1 9 3 9 ) , pp. 2 2 8 - 2 3 0 .  Oct.  85  "Mother and C h i l d , "  FHWS. Oct. 6 , 1 9 2 0 , p. 2 9 .  86  The Canadian Mother's Book, pp. 1 1 0 - 1 1 1 .  87,  Brown, The Normal Child, pp. 1 5 0 , 141.  88  "Simple Routine Diet Best," FHWS. Oct. 1 9 , 1 9 2 3 , P« 3 9 ; i b i d . , P. 2 9 .  10, 1923,  89  "Diet Suggestions Recommended f o r Mother,"  90  "Your Baby and Mine,"  91.  "The Baby C l i n i c , "  p. 1 8 .  The Vancouver Sun. Oct. 3 , 1 9 2 7 .  Chatelaine.  Mar. 1 9 3 9 , p. 4 2 .  92 Brown, pp. 1 3 9 - 140; Donald Paterson and J . Forest Smith, Modern Methods of Feeding i n Infancy and Childhood (London: Constable and Co., 1 9 2 6 ) ,  pp. 7 9 - 8 9 .  93. Canadian Mother's Book, p. 1 0 5 ; "Our Babies' Health - Canadian Mothercraft Society," Star Weekly. Oct. 8 , 1 9 3 2 , p. 7 ; i b i d . , Oct. 2 9 , 1 9 3 2 , p. 1 3 . 9 4 , "Mother and Baby," FHWS. Oct. 1 0 , 1 9 3 2 , p. 3 9 . 9 5 .. "Your Baby and Mine,"  The Vancouver Sun. Oct. 4 , 1 9 3 6 .  96.  "Post-Natal Letter # 7 " n. d.  97  Brown, The Normal Child, p. 140.  98 "Mother and Baby," FHWS. Oct. 1 , 1 9 1 9 , p. 3 8 ; The Canadian Mother's Book, p. 1 0 0 ; The Child. 1 9 1 6 , p. 2 5 ; Holt, The Care and Feeding of Children, p. 1 1 6 . 99  King, Feeding and Care of Baby, p. 6 2 .  100. given.  Ibid., p. 6 3 , c i t e s physician Dr. Harry Campbell, no source  101 "Mother and Baby," FHWS, Oct. 1 , 1 9 1 9 , p. 2 9 ; i b i d . , Sept. 9 , 1 9 3 1 , P. 3 0 ; The Canadian Mother's Book, p. 1 0 0 . ;  Footnotes  95  102  "The Baby Clinic,"  103  "Your Baby and Mine," The Vancouver Sun. Oct. 6 , 1 9 3 2 .  104  "The Baby Clinic,"  1 0 5  Book, 106  Chatelaine. Mar., 1 9 3 9 , p. 42.  Chatelaine.  Brown, The Normal Childy p. 1 0 0 . "The Baby Clinic,"  pp.  1  Chatelaine.  Mar., 1 9 3 9 , p. 42. 2  6  -  I3I5  The Canadian Mother's  May, 1 9 3 8 , P. 5 8 .  10? The Child. 1 9 2 4 , p. 2 7 ; Brown, The normal Child, p. 2 ^ 3 ; Advertisement, The Canadian Churchman. Aug. 2 6 , 1 9 2 6 , p. 5 6 3 . Baby's Own Tablets were recommended as a cure for cholera infantum. 108  "The Baby Clinic," Chatelaine.  May, 1 9 3 8 , p. 5 8 .  109 British Columbia Department of Vital Statistics, Report. 1 9 2 3 ; ibid., 1 9 3 9 . 110  Holt, The Care and Feeding of Children, p. 1 1 8 .  111  "Post Natal Letters # 2 , "  112  Ibid.  113  The Canadian Mother's Book, p. 9 7 .  114  "Freedom for Baby," FHWS, Nov. 2 , 1 9 2 9 , p. 3 9 .  115  "The Runabout," p. 4 3 .  116  Angelo Patri, "The Crying Baby," FHWS. Oct. 1 9 , 1 9 3 2 , p. 2 6 .  no date.  117 Brown, The Normal Child, p. 4 3 ; Children, p. 2 3 . 118  Holt, The Care and Feeding of  "Your Baby and Mine," The Vancouver Sun. Oct. 1 , 1 9 3 0 .  119 Gregory Clark, "Don't Spoil the Baby by Picking Him Up," Weekly. Oct. 1 5 , 1 9 2 1 , no page. 120  Ibid.  121  "The Baby Clinic,"  Star  Chatelaine. Nov., 1 9 3 4 , p. 4 4 .  122 Brown, The Normal Child, p. 3 9 ; "Holding The Baby," FHWS. Sept. 2 3 , 1 9 3 1 , p. 3 0 . 123  "The Baby Clinic,"  Chatelaine. Nov., 1 9 3 4 , p. 4 4 .  124 Emma Gary Wallace, "Quiet for the Infant," FHWS. Nov 2 , 1929, p. 3 9 ; see also "Holding the Infant," ibid., Sept. 2 3 , 1 9 3 4 , p. 3 4 ;  96  Footnotes  Flora Westercott, "The Baby's Daily Play Time," Chatelaine, July, 1 9 3 0 , P. 24 125, "Mother and Baby," P. 3 8 .  FHWS. Oct. 2 , 1 9 2 0 , p. 3 7 ; ibid., Oct. 1 5 ,  1919,  126  Newsom,"Cultural Aspects of Child Rearing,"  127  Ethel N. Shook, "Play Time f o r Children," Chatelaine. May,  1936,  p. 6 9 .  128 P.  p. 3 3 1 .  "Character Like a Plant Needs Pruning,"  FHWS. Oct. 2 6 , 1 9 2 1 ,  27.  9. The Child. 1 9 2 4 , p. 2 3 $ Brown, The Normal Child, p. 2 1 6 ; "Your Baby and Mine," The Vancouver Sun. Oct. 5 , 1 9 3 0 ; ibid., Oct. 1 , 1 2  1935.  130  "Mother and Baby,"  FHWS. Nov. 14, 1 9 2 8 , p. 3 7 .  131  "Your Baby and Mine," The Vancouver Sun. Oct. 5 , 1 9 3 7 .  132 "Thumbsucking - Canadian Mothercraft Society," Star weekly. Oct. 2 2 , 1 9 3 2 , p. 1 2 . 133. "The Baby Clinic," Chatelaine. March, 1 9 3 6 , p. 6 1 ; ibid., Nov. P. 5 0 . v  1938,  134  Ibid., Nov. 1 9 3 4 , p. 3 4 .  135  Ibid.  136  Ibid.  137 "Introduction" by the British Columbia Board of Health to the "Post Natal Letters," 1 9 3 7 . 138 Ernest"Couture, "Some Aspects of Child Health Program i n Canada," CPHJ. XXX (Nov., 1 9 4 0 ) » 5 3 1 - 5 3 8 ; "Diseases of Early Infancy, 1 9 2 1 1930," BBCBH. 1 (Aug. 1 9 3 3 ) . P. 2 9 ; "British Columbia's Infant Mortality Rate Lowest i n Canada, 1 9 2 1 - 1 9 3 0 , " ibid., 1 (Nov., 1 9 3 1 ) , P. 1 8 . 139 "Modem Babies i n Rebellion: Regimentation Creeping into Nursery," The Vancouver Sun. Oct. 7 , 1 9 3 5 . 140  Angelo Patri, "A Bad Day," The Vancouver Sun. Oct. 7 , 1 9 3 6 .  141  Mona Gould, "Modem Mother," Chatelaine. Nov. 1 , 1 9 3 2 , p. 2 6 .  142.  Angelo Patri, "Too Many Voices,"  1931.  The Vancouver Sun. Oct. 1 0 ,  97  Chapter 4  The Preschool Child - The Neglected Age  During the inter-war years, British Columbia's health professionals and child care advisors focused their energies and attention on two groups of children - infants and school children.  As the^public health service  developed and expanded throughout the 1 9 2 0 ' s and 1 9 3 0 ' s , health workers were charged with?the task of reducing the infant mortality rate through the application of new developments i n child care and disease prevention and by educating parents to new scientific methods of child rearing.  1  Through the school medical inspection program, initiated i n 1 9 1 0 and expanded during the inter-war years, health care was provided for most of the province's school children.  But what of preschool aged children? They  had survived the hazards of infancy and they no longer required the intensive care they received during the f i r s t two years of l i f e .  Their place as  babies of the family had probably been usurped by a new sibling and they were no longer the centre of their mother's attention.  They were too old  for the well-baby c l i n i c and too young for the school medical inspection program. What help was available for parents of preschool aged children?  During the early decades of the twentieth century, American and Eastern Canadian educators focused attention on preschool children through organizations such as the Kindergarten-Nursery Association and the Child Study Association, yet neither of these associations gained a large membership i n Western Canada, nor did these institutions develop extensively throughout this province during the 1 9 2 0 ' s and 1 9 3 0 ' s . ^  Only a few i s o l -  ated health or educational programs were organized to meet the needs of preschool children, however, throughout the two decades, British Columbia's public health personnel were quick to acknowledge that the province's preschool aged children constituted a neglected age group. Even though Dr.  98  H. E. Young, Provincial Health Officer, pointed out i n 1 9 2 6 that "This period of a child's l i f e has always been neglected . . ,  the Board of  In 1931» Saanich Nurse  Health failed to come to grips with the problem.  C. Rose argued that the perschool years were the time to detect and correct physical defects such as defective teeth, infected tonsils, enlarged adenoids, poor eyesight, curvature of the spine, weak lungs, and the time to immunize and vaccinate children against contagious and infectious diseases.  5  Furthermore, Rose pointed out that many health problems  which developed i n adult l i f e could have been prevented i f they had been treated during the preschool years.  Nevertheless, as late as 1 9 3 9 , " r .  J. L. M. Anderson, School Medical Inspector for Victoria, confirmed that the preschool child s t i l l "suffered from his place between the infant and the school child."^  This chapter w i l l investigate the sources of advice  available to parents of the preschool aged child, examine the nature and content of advice to parents, and identify changes i n the focus of the advice throughout the 1 9 2 0 ' s and 1 9 3 0 ' s .  In short, i t w i l l answer the  question as to whether preschoolers were the neglected age group.  In 1 9 2 3 , Helen MacMurchy described three kinds of children: l i t t l e children; big children.  infants}  Infants became l i t t l d children when they  were weaned, and l i t t l e children became big children when they went to 7  school.  A l l children, MacMurchy stated, were composed of body, mind, and Q  soul, a l l three of which needed care and feeding.  MacMurchy made no attempt  to describe children at various stages of development, but, rather grouped a l l children from just weaned to school age in one "preschool" group. Because of this view of the preschool child, British Columbia parents had great d i f f i c u l t y locating specific advice to help them rear their preschool children.  99 During the mid-1920's North American and European researchers such as Arnold Gesell , Susan Isaacs and Jean Piaget focused t h e i r research on the 9  preschool age c h i l d .  But f o r B r i t i s h Columbian parents, most of the  advice originated from three sources:  the research and work of W. E.  Blatz and h i s associates at the St. George's School f o r C h i l d Study, Toronto; two syndicated American columnists, Angelo P a t r i and Mrs. Myrtle Meyer Eldred; publications issued by health care agencies such as Federal C h i l d Welfare D i v i s i o n , the B r i t i s h Columbia Board of Health, the Canadian Council on C h i l d and Family Welfare.  In addition to these sources, occ-  asional a r t i c l e s on the c h i l d aged two to s i x years appeared i n newspapers and magazines.  However, the advice directed to the parents of the pre-  school aged c h i l d was f a r l e s s i n quantity than that available on the care of infants.  Whereas the o r i g i n s of trends i n i n f a n t rearing advice  are readily i d e n t i f i a b l e (Holt, King and Watson), the origins of trends f o r the rearing of the preschool c h i l d are l e s s easy to i d e n t i f y .  However,  one source of influence that can be r e a d i l y i d e n t i f i e d i s the research and work of W. E. Blatz and h i s associates.  In January, 1926,  the St. George's C h i l d Study Centre opened at  the University of Toronto under the d i r e c t i o n of W. E. Blatz, a young and enthusiastic Canadian p s y c h o l o g i s t . of Toronto i n 191?  10  B l a t z graduated from the University  with a Master's degree i n physiology, and i n 1924  the University of Chicago with a Ph.D.  i n psychology.  from  His area of graduate  study focused on psychological changes produced by lemotions.  11  At the  urging of Dr. Clarence M. Hincks, a founder of the Canadian Committee on Mental Hygiene, and Dr. E. H. Bott, head of the Department of Psychology, University of Toronto, B l a t z was appointed as director of the newly organ-  12 ized C h i l d Study Centre.  The Centre was designed to provide nursery  school education f o r preschool children and c h i l d study t r a i n i n g f o r the  1 0 0  parents. -* 1  The Centre i t s e l f did not directly affect British Columbia  parents, but the writings and research of Blatz, his co-worker Helen Bott, and his associates at the child study centre, had Canada-wide coverage. W. E. Blatz and Helen Bott co-authored two books, Parents and the Preschool Child.  ( 1 9 2 8 ) ,  and The Management of Young Children.  ( 1 9 3 0 ) ,  both of  which received wide publicity in newspapers and magazines and were recom14  mended for use by British Columbia's public health nurses.  Blatz believed  children's emotional and social growth were as essential to their development as was their physical growth. Blatz's books were designed to teach parents the principles of child study so that through the application of these principles they would not only be more efficient parents, but also they would enjoy the task of parenting.  15  Blatz and Bott clearly outlined  the underlying principles and steps for parents to follow in applying the "child study method" in the rearing of their preschool aged children.  "First,  the need for training i n basic physical habits; secondly, the importance of emotional control; thirdly, the significance of the child-parent relationship." ^ 1  Parents were advised to observe and closely study their growing  children, for by doing so they would be more aware of their needs and better 17  able to direct their development. '  Blatz believed that through training  and education the potentialities for a happy, f u l f i l l i n g and effective l i f e could be developed. As he pointed out, "There are three things that every member of your family has to learn i f your home i s to be a good place 1 8  to live i n . Co-operation, Compromise and Tolerance." Blatz believed his role was one of educating parents to manage their children rather than to 19  give specific advice on specific topics.  Frances Lucy Johnson, another  St. George's staff member, was a regular monthly contributor to Chatelaine from the magazine's f i r s t issue in March, 1 9 2 8 , until January, 1 9 3 1 . Additionally, Chatelaine carried occasional articles by members of the Toronto Child Study Centre staff throughout the  1 9 3 0 ' s ,  but Blatz and his co-workers  101 became even better known to Canadians through their work i n the late 1930's 20 with the Dionne quintuplets.  Two syndicated columnists, both American and contemporaries of Blatz, discussed problems of the preschool child as well as those of infants and school aged children.  Angelo Patri wrote a daily column which was  carried i n a large number of Canadian newspapers, including three the writer examined for this studys The Vancouver Sun; the Family Herald and Weekly Star; the Star Weekly.  Patri, who may be described as an educator  by profession a humanist by philosophy, and a realist by experience, offered sage advice to his readers on a wide range of problems including discipline, inter personal relationships, intellectual development, mental 21 health, and school progress.  Patri focused on methods to develop the  child's character i n order to produce honesty, sincerity, self-control and industry.  Patri believed this could be accomplished through a happy adult-  child relationship, one in which adults showed love, patience, and confid22 ence towards children. Unlike Blatz, Patri did not see child study as an exact science, rather, he urged both parents and teachers to be sensitive 23 to children and their needs, and to use good sense i n dealing with them. J  Myrtle Meyer Eldred based her expertise on her personal experience as a mother and a grandmother, but she kept informed of new developments in child psychology and child development and reflected these developments in the advice she gave i n her book Your Baby and Mine and her column of 24 the same name.  For example, Eldred was cognizant of the work of Arnold  Gesell of Yale University, and his influence was reflected i n Eldred*s 25 description of the age-stage development of preschool children.  J  She  described the two year old as being active, bottle weaned, toilet trained,  102  walking well, running unsteadily, and using a vocabulary composed of names 26  of familiar things and questions about unfamiliar things.  In contrast,  she described the five year olds as being better coordinated, having a longer attention span and perfect bladder and bowel control, and well on their way to becoming as independent and self-reliant as their mothers would permit. '' 2  Rather than initiate new trends i n childrearing practices,  Mrs. Eldred gave pragmatic and specific advice which reflected changing 28  concepts of child nurture and child development.  The "Your Baby and  Mine" column, which Eldred wrote, was carried i n a number of Canadian newspapers including a daily feature i n The Vancouver Sun, beginning i n 1 9 2 6 , and a weekly feature i n the Star Weekly, beginning i n 1 9 3 0 .  Eldred did  not focus a l l her advice on the preschool aged child, but offered advice on physical care, mental development, habit training, and sex education as i t related to infants through to adolescents. The Child Welfare Division, Federal Department of Health, the Provincial Board of Health, and the Canadian Council on Child and Family Welfare, produced and distributed a limited number of publications which dealt  29 with preschool aged children and their particular needs.  7  These included  How To Take Care Of The Children, published by the c h i l d Welfare Division, Diet Folder #3. produced by the Provincial Board of Health, and "The Runabout," prepared by the American Child Health Division but distributed by the Provincial Board of Health.  But specific information on preschool  children from these sources appears to be almost as scarce as specific programs designed to meet their needs through health care or education. The concept of the preschool child continued to change throughout the 1 9 3 0 ' s , and i n a 1 9 3 9 radio broadcast to Victoria parents, Dr. J. L. M. Anderson, Victoria Public School Medical Inspector, described the pre-  103 school child as being an active, .energetic, insatiably curious, exploratory individual anxious to investigate the world around him.  But Anderson  also recognized each child to be a distinct entity with a unique personality created by the combination of five distinct elements:  physical make-up;  inherited instincts; learned habits; intellectual ability; emotional make30 up.  During the 1920's and 1930's, the advisors' view of the preschool  child definitely changed from that of just a " l i t t l e child" to that of a distinct and unique individual, with specific s k i l l s , a b i l i t i e s , and needs at each age and stage development. Although health professionals and child care advisors focused their attentions and energies on infants and school children, enquiries to newspaper and magazine columnists during the early 1920's indicate the concern of parents about the care of their preschool aged child.  A review of  advice to parents from these two sources shows a small but gradually increasing amount of advice available each year.  As the concept of the  child changed over the two decades, the nature and content of advice to parents reflected those changes.  II  Throughout the 1920s, and 1930's parents continued to be concerned about the physical development of the preschool child, but certainly not to the same degree as during the child's f i r s t year of l i f e .  Parents were  advised to continue the regular routine of feeding, resting, exercising, and eliminating that had been established in infancy, but, during the preschool years, the child was to be given definite instructions in personal hygiene and health care.  These lessons formed the basis of the child's  future health habits and included training in proper dietary habits, personal cleanliness, and good manners.  31  104 In addition there was concern for the dietary problems of preschool children.  Malnutrition was a common problem caused by their  reluctance to eat a variety of foods, the lack of access to a variety of foods, or the ignorance of mothers concerning what constituted a wellbalanced diet.  As late as 1 9 3 1 , Emma Gary Wallace, i n an article i n  Chatelaine. stated, but offered no s t a t i s t i c a l evidence, that one-third of Canada's children between two and six years of age suffered from malnutrition. She pointed out that preschoolers did not require a special diet i n the same sense as infants, but they did require a good diet that provided for adaquate growth.  Considerable variation existed among advisors as  to what constituted a good diet.  In 1 9 2 3 , for example, Helen MacMurchy  advocated that a preschooler's diet include a variety of vegetables, meats, raw fruits, coddled eggs, baked custard, milk toast, creamed toast 33 and wafered toast. ^  In the same year the unnamed columnist of the  Family Herald and Weekly Star, however, claimed that Children should not have meat or vegetables for the evening meal until they are at least six years old. Broths and eggs should be given occasionally. Milk, cereal, bread or crackers i n some form, and cooked f r u i t , are amply sufficient for them. 34 If parents fed the heavy carbohydrate diet advocated byythis advisor, preschool children certainly would be malnourished.  They would, in fact,  have been better nourished had they eaten the same diet as the adult members of the faimly.  During the early 1920's, milk was considered the nearly perfect food, and children (up to fourteen years) were to drink a quart of milk a day to ensure they ingested the amount of lime necessary for bone development. Although a diet consisting of a pint of milk, carrots, spinach and other vegetables had the potential to provide the necessary amounts of lime, iron and phosphorus needed for building bones and teeth, Dr. H. C. Sherman  1 0 5  and Miss Edith Hawley, of Columbia University, insisted that only by drinking a quart of milk a day could children ensure they were receiving 35 sufficient nutrients.  Furthermore, vegetables were to be well-cooked  (to a state of mushiness) i n lightly salted water, a process that certainly destroyed their nutritive value as well as their flavour.  The deficiencies  of such a diet were reflected i n the child's poor teeth, bone structure, rough skin, and lack of resistance to disease. The recommended quart of milk was needed to supply minerals and vitamins destroyed i n the overcooked vegetables.  Porridge, such as rolled oats, farina, or cream of wheat,  covered with milk was considered the almost perfect food.. Although advisors advocated porridge, milk, and a number of other foods as good for children, the problem was to get them to eat those nutritious foods. Advisors advocated a range of techniques for dealing with fussy eaters. Suggestions included making the meals more attractive, withholding dessert, force feeding children, or simply ignoring them i n the hope that hunger would eventually force them to eat.  The writer of the Star Weekly's  "Kitchen Column" took a firmer stand; i f children refused to eat meat, 37 vegetables, and f r u i t , mother should starve them into submission. '  Parents  must be firm, for bad training or over-indulgence created fussy eaters. Furthermore, mealtimes must be observed with scrupulous regularity, with 39 children seated at their own child sized tables and not with adults. Whether absenting children from the dinner table was designed for the comfort of the children or the adults i s never clearly stated, but until children could eat the same food as adults and had developed s k i l l s and manners acceptable i n adult company, they were to be excluded from the 40 family dinner table. Although t o i l e t training was an area of major concern in infant  106 rearing, i t received far less attention and advice for the preschool aged child.  Advisors assumed that toilet training began early in infancy and  must be well established by age two.  Advisors warned parents of pre-  school aged children not to punish for accidents, lest they repeat the accident as an attention getting device.  Language training and language development was, however, a major area of concern.  As children learned to talk, parents were admonished to  provide a flawless example by using traditional grammar, neither using nor permitting the use of baby talk, avoiding workiness, concentrating on teaching a simple vocabulary, and providing a listening ear for child-  kz ren as they learned to talk.  Children were to be trained to hear speech  sounds, to see and feel how each sound was formed, and parents were to "correct l i t t l e slips of the tongue before they became habits of speech.  J  Such stress was placed on children speaking clearly that stuttering may have resulted, a subject that received considerable attention by child care advisors.  Stuttering, child care advisors believed, was caused by a  fright, shock, illness, or nervous strain, and the stammering children were subjected to various techniques and exercises designed to cure this disorder.  Two of these techniques included training children to speak  rhythmically/ and.stopping them to have them think what they are going /(A  to say before speaking. within  1  These kinds of procedures surely created tension  children and increased their inclination to stutter. Ill  Although health professionals and child care advisors were concerned with children's physical development, the main thrust of their advice 45  was towards the development of character and social s k i l l s .  The  preschool  years were the time for moral training and for shaping ideals - a respons-  i b i l i t y shared equally by both parents  The Family Herald and Weekly  Star quoting an unnamed source wrote: It has been said that a person who has the care of a child for the f i r s t seven years of i t s l i f e has formed that child's character and disposition for good or i l l . And to this we might add that the foundations of good or indifferent health are also l a i d . 47 Parents were admonished to guide, direct, and discipline the growing and 48 developing child.  The stress by advisors on the responsibility of  parents for the total development of the child must surely have been frightening to concerned and conscientious parents. Parents were also responsible for disciplining the preschool child but controversy existed among advisors concerning the best methods to use. The whole issue of discipline depended on what kind of obedience was expected from children and what kind of action parents should use to produce this behaviour.  For example, many advisors i n the early 1920's  demanded instant, unquestioning obedience.  The f i r s t law of the home  and the cornerstone of character development i s respect for law and authority.  In 1921, the Family Herald and Weekly Star asserted i t was the  parent's right and duty to enforce obedience by children, and the children's duty to learn obedience i n the home.  50  The same advisor, reflecting the  then current view of preschool children, stated that, "theoretic reasoning . . . " with a four year old was a waste of time, as the child's mind had not developed sufficiently to enable them to understand the reasoning process. Furthermore, wrote the columnist, "There i s no need to give a tiny child (age four years) reasons for demanding obedience from him, 'Because mother says so' i s reason enough for the l i t t l e one."  51  Chatelaine columnist  Dr. J. W. S. McCullough reflected this same attitude as late as 1935.  When  a mother wrote him that her l i t t l e g i r l "will go and bring me things when I ask her, but my friends say that i s the way to train a dog but i s a l l  108 wrong for a child7" McCullough responded, "I can find no fault with your training, i t speaks well of your baby's temper that she i s so obedient.  52  But, McCullough appears to have been the exception rather than the rule, for during the 1930's a different attitude emerged. Maud Newcombe, Family Herald and Weekly Star columnist, believed children could be so managed and trained during their early years they would not want to disobey their parents.  She stated, "One need not be exacting to the point of un-  53 reasonableness to have obedient children.  ^ Angelo Patri also believed  parents should reason with their children as a means to achieve obedience,  54 for "Reason stays longer, reaches further, wins i n the end.**^ Blatz and his associates attempted to teach parents to study their children and to adopt a T l e x i b l e attitude" towards dealing with them. Blatz pointed out that instant obedience was not the goal, for, "The accept of the parent's thinking w i l l not be on his ascendency over the child but on the learning process by which the child i s coming to rule h i m s e l f . S e l f control and self-reliance would develop as children were guided and directed by their parents. Did the changing concept of obedience produce a change i n the form of discipline used with preschool children? The editor of "The Runabout" stated that discipline was designed, "to teach a child to want to do right and to think before he acts.""^  Most advisors accepted this definition;  the controversy centered on how children should be disciplined and who should do the disciplining.  There was generally agreement among advisors  against harsh or severe discipline; even spanking was generally frowned upon by the advisors. Rather, parents were admonished to spare the rod  57 and to use some alternative form of punishment.  Blatz and Bott believed  discipline was achieved through setting reasonable, clear and consistent  58 rules for children to observe.-^  If the rules were simple and consistent,  109 children would readily obey them, but i f children failed to obey the rules, i t was not punitive discipline but a simplification of the rules CO  that was required.  The editor of "The Bunabout" went so far as to state  that "Situations that c a l l for severe punishment, especially during the f i r s t five years, are usually thfe-fault of the parent."^  0  Most advisors  agreed that well-nourished, healthy children, provided with activities suitable to their interests and level, and functioning in an established routine and well-ordered environment, would create few disciplinary problems.^  1  Nevertheless, parents were warned against taking the path of  least resistance i n disciplining their children, and they were also warned not to seek unnecessary confrontations.  Furthermore, advisors warned that  discipline must not be evasive or indifferent, for such discipline would 62 f a i l to give the child constructive guidance.  Most child care advisors  agreed that discipline must be applied by a loving parent who considered not only the results of their children's deeds but also their motives, For discipline to be effective, advisors stated i t must be immediate, inevit63  able, invariable, and in proportion to the offense. ^  Child care advisors  of the inter-war years believed that through careful training and d i s c i p l ine children would develop the desirable attributes of self-reliance, independence, and self-control.  Researchers of this period suggested a  child be permitted to make choices when alternatives were available, and to learn from the mistakes they would most certainly make. They must also learn to accept responsibility for their decisions.  In 1935» Angelo Patri  pointed out that "Every child should learn the consequences and be per64 mitted to suffer from the effects of his own erros of judgement." Children were encouraged to become independent, but assertive aggression or dominance was discouraged.  Parents were to discourage  and excessive displays of aggression by children and to suppress  110 attempts  to dominate  either adults or other c h i l d r e n . ^  c h i l d must l e a r n to play, amicably  and  cooperate  with  The  preschool  others.  IV Play, essential  indoors  or outside, alone  to a c h i l d ' s p h y s i c a l development  M a c M u r c h y p o i n t e d o u t i n 1923, in  the  or with  open a i r and  nized as a normal associates,  sun  o t h e r s , was  considered  as food and  rest.  As  as Helen  "Play i s the very l i f e of the child,  i s t h e m a k i n g o f t h e c h i l d . "^  part of every  c h i l d ' s development,  and members of the Canadian  made parents more aware of the  P l a y was and  W.  E.  C o u n c i l of C h i l d and  tremendous importance  play-  recog-  Blatz,  Family  of play both  his Welfare  for  67 emotional relief  and  from  s o c i a l development.  the constraints of a rigidly  ed motor c o n t r o l and concentration and powers and  They argued  manipulative  t a l e n t s , and  i t taught  scheduled  skills,  the resourceful use  that play  provided  routine, that i t  i t encouraged  self-reliance,  of l e i s u r e time,  co-operation with  develop-  i t developed  latent  other children  and  68 the care and use of m a t e r i a l s . As H a r r i e t t M i t c h e l l o f the Canadian C o u n c i l on C h i l d and F a m i l y W e l f a r e e x p r e s s e d i t : "To the c h i l d , p l a y i s  69 not amusement, i t i s h i s work. factor  too important  were urged carefully  not  Playthings are his tools."  i n the c h i l d ' s l i f e t o be  left  P l a y was  to chance.  only to provide a s u i t a b l e play environment,  s e l e c t the toys and  equipment  to  a  Parents  but  also  to  "provide planfully for the  most  70 desirable s t i m u l a t o r s and Increasingly, and  over  t h e two  exercises at each decades,  parents  stage  were urged  play materials suitable to the c h i l d ' s mental  toys that stimulated sensory  development,  of the c h i l d ' s  and  to select physical  self-activity  and  growth..." toys development,  imagination,  71 toys that were durable, P l a y was  washable,  serious business  that play, f o r the child,  simple,  f o r the child. was  workable, Frances  and Lucy  well-designed. Johnson  a means of gaining f a c i l i t y  pointed  i n the  out  management  Ill of the tools of l i f e .  Another function of play was to provide social training for children whereby they learned to co-operate and associate with other children.^  The Family Herald and Weekly Star advocated children learn to  associate with children of other economic, ethnic, and racial groups provided, of course, their play was out i n the open and under the watchful 74 eye of parents.  An examination of the subject of play throughout the late  1920's and 1930's indicates a growing trend by child care advisors towards having children learn designated s k i l l s or attitudes by placing them in a carefully prepared environment, equipped with carefully selected toys suited to their ages and stages of development, with companions acceptable to their parents.  Spontaneous play became a carefully engineered event!  Although advisors recommended the organization of children's play, i t i s d i f f i c u l t to determine to what extent most parents actually followed their advice.  It seems more likely most children outside the preschool setting  played as they had always played;  when, where, with whom they liked, and  with what toys and materials were immediately available to them. If play was considered an essential element i n children's development, then so was work. Mrs. Eldred reflected the traditional work ethic when she pointed out that the "joys of doing these (helpful) things far out75  weigh the purely 'play' things a child can do."'-' She believed a two year old could help with bed-making, putting the cutlery away, setting the table, wiping the dishes, and straightening clothes. Angelo Patri believed children should do some useful work every day so the habit of work would become firmly established.  Blatz and Bott noted that as  preschool children frequently wanted to help their parents, they should take 77 advantage of this interest and direct them into simple household tasks."  112 When children helped about the house, or obeyed their parents, theyyshould be praised, but not overly praised.  Rather, they should be intermittently  praised, "We can easily overdo our flattery and praise until i t acts not as an inspiration to more effort, but an actual throttle on i t . "  As  Dr. Anderson pointed out, "Let us remember how sensitive the young child i s to any form of suggestion, and not dull the response by excesses of 79 either praise or punishment."  While parents were training their children to develop good work habits, they were to be on guard against them developing undersirable habits. If habits such as thumbsucking, nail biting, nose picking, bed wetting, temper tantrums and masturbation developed, parents must extinguish them 80 immediately.  As the writer of "The Runabout" pointed out, "Most bad  habits w i l l give way before intelligent home training, a few may require the help of a specialist."^  1  What techniques were parents to use to  extinguish undesirable habits i n their preschoolers? First, they were to look for the cause of the habit — and then try to remedy i t or to replace i t with another activity.  For example, although thumbsucking and nail  biting were undesirable habits, elbow splints or s t i f f cuffs were not recommended treatments; rather, mothers should begin teaching their pre82 school children to be well-groomed and to have neat hands and nails.  The  writer of "The Runabout" suggested parents not use severe punishment to stop n a i l biting and thumbsucking, "but instead get the child's co-operation i n overcoming the habit. Health professionals and child care advisors suggested that several undesirable habits stemmed from physical causes. such habit.  Nose picking was one  Children's tonsils and adenoids were to be checked for i n -  1 1 3  fection or enlargement, and parents were to ensure that children received proper nourishment, fresh air, exercise, rest, play activities and, 84  f i n a l l y , provide materials and activities to keep them occupied.  The  editor of "The Runabout'' considered bed-wetting to have a physical cause that could be easily remedied by stopping children's intake of liquids by four in the afternoon and taking children to the toilet before their parents retired for the night.  Although Mrs. Eldred agreed that bed-  wetting might have a physical cause, she also believed chronic bed-wetting to be a sign of an emotional proMeja, and the bed-wetter, like the hypochondriac, was using this ploy to get parental attention. "One must look below the surface in such cases to determine what misguided but natural 86  motive i s actuating unusual behaviour, other than real i l l n e s s . "  Of a l l the habits of early childhood which must be prevented or extinguished, masturbation  (or self-abuse) was the major one.  Blatz and  Bott pointed out that masturbation i n one form or another was quite i*  common among children and, " i t should not be regarded with alarm as a 87 s&x perversion."  Nevertheless, common or not, parents were warned to  investigate f i r s t for possible physical causess tight clothing, lack of cleanliness or need of circumcision. No mechanical device was to be used 88  to prevent masturbation except on the physician's recommendation.  The  writer of "The Runabout" suggested that when children were put to bed, their hands be put outside the covers (even i f he sucked his thumb), they be given 89  a toy to hold, and they be encouraged to go to sleep at once. "Try to keep his mind off himself and keep his thoughts and hands always absorbed i n 90 7  other occupations."  Where masturbation was a recurring problem, Blatz and  Bott advised mothers to keep a record of episodes, noting the time and circumstances i n which i t occurred.  This information would help mothers to determ-  ine the cause and to apply treatment to extinguish the habit.  Persistent  114 masturbation i n older (preschool)children required c l i n i c a l investigation and guidance because i t indicated internal conflicts and emotional problems too serious for parents to treat. to seek professional  In these circumstances, parents were urged  91 assistance.  The writer of "The Runabout" had one  further word df caution for parents; "avoid leaving your child with servants 92 with morals you question."  They may wittingly or unwittingly introduce  the child to unacceptable sexual habits. Although temper tantrums were not considered acceptable behaviour i n preschool children, advisors took a pragmatic view concerning them. Most advisors considered tantrums to be growing pains that most children went through between two and four years of age.  If the tantrums were ignored,  they would probably go away. Furthermore, advisors argued, i t was unlikely 93 children would do themselves any serious harm during a temper tantrum.  If  the tantrums persisted, Blatz and Bott urged parents to look for under94 lying causes and, i f possible, remove or alleviate the source.  Parents  were admonished always to provide young children with a consistent model of self-control and to encourage them to follow their parents* example. Parents were also to provide models of self-control, truthfulness, honesty, sincerity, unselfishness, service, and respect and consideration for others. Advisors believed these qualities were best learned from parents in a home environment.  Parents were also to provide good models  in their relationships with other adults as well as with their own children. They were to give their children the same respect and consideration they 96 expected from their children.  Angelo Patri firmly believed i t was through  the parents* teaching and modelling that children acquired a desire for 97 personal integrity.  Children's lack of truthfulness and their use of  exaggeration, or imagination, were of concern to both teachers and advisors.  1 1 5  Parents were urged to teach children to distinguish between the real and the imaginary.  Allowances were made for very young children; day-  dreams were acknowledged as a normal part of children's lives, but advisors insisted that as soon as possible children learn that daydreams were no substitute for real action, and imagination had i t s place only i n a play 9 8  world.  As with a l l aspects of their children's lives, parents were resp-  onsible to ensure that their children developed characteristics, attitudes, and habits that were acceptable to British Columbia society. An awesome task indeed! VI The "neglected child" i s the best description of the preschool child of the  1 9 2 0 ' s  and  1 9 3 0 ' s .  Preschoolers had survived the rigours of infancy,  were mobile, articulate, and no longer i n need of the special attention required by infants.  Probably they were no longer the youngest member of  the family, and their new siblings, received the intensive care and attention they had previously received. Although health professionals recognized the desirability of treating physical defects during these early years, there were few scientific programs designed to detect and correct their bad teeth, diseased tonsils, or malnutrition. Lack of early treatment of some defects l e f t permanent effects upon growing children.  Preschool  children were neglected i n that there were very few health or educational programs designed to meet their needs.  Throughout the inter-war years, however, an increasing amount of advice became available about rearing preschool aged children.  Whereas  the major portion of advice for rearing infants came from health professionals and focused on the scientific methods of child rearing, advice for the rearing of preschool children became eclectic as research  116 was developed among psychologists, educators, and physicians. Parents were urged to "study" their children and from their study determine how best to meet their needs.  Based on children's individual rates of development,  special interests, and specific needs, parents provided for the physical, emotional, social, and intellectual growth of children.  Although the traditional values of truthfulness, honesty, sincerity and industry were s t i l l held by advisors, the traditional means of achieving those ends changed. No longer could parents rely on traditional child rearing techniques for, by inference of the advisors, those techniques were no longer applicable. to preschoolers.  In fact, they were believed to be detrimental  Did parents who appeared to have readily accepted the  "scientific method" of rearing their infants readily accept the "science of child study"?' From the information available, one has d i f f i c u l t y deter1  mining the reaction of British Columbian parents to the "science of child study," for there i s less information available about preschool aged children than about either infants or school aged children.  Footnotes  117  1 B r i t i s h Columbia Board of Health, Report, 1921, p. B6 (hereafter BCBH); see also Olive M. Garrood, "Teaching Public Health i n Kamloops," Public Health Nurses'Bulletin, 1 (May 1 9 3 0 ) , 2 1 - 2 3 , (hereafter PHNB). 2 B r i t i s h Columbia, Statutes, "An Act Providing For the Medical Inspection of Schools," 1 9 1 0 ; BCBH, Report, 1 9 3 9 , p. Al6. Eighty-nine percent of B r i t i s h Columbia's school children were examined i n 1 9 3 9 3 Mary Northway, "Child Study i n Canada: A Causal History," i n C h i l d Development: Selected Readings by Lois Brockman, John Whiteley, John Zubeck, (Toronto: McClelland and Stewart, 1 9 7 3 ) . PP. 41-42; B r i t i s h Columbia, Survey Of The School System, ( V i c t o r i a : King's P r i n t e r , 1 9 2 5 ) , p. 2 0 0 . 4  BCBH, Report, 1 9 2 4 , p. Ml?.  5  C. Rose, "The Pre School V i s i t , " PHNB, 1 (Mar. 1 9 3 1 ) ,  39-40.  6 "Your Health O f f i c e r Suggests," B u l l e t i n of the B r i t i s h Columbia Board of Health, 9 (July 1 9 3 9 ) , 184, (hereafter BBCBH). 7 How To Take Care of the Children, (Ottawa: King's P r i n t e r , 1 9 2 3 ) , p. 7 » see also F. W. Brydon-Jack, "Medical Inspection of Schools," Address to the Medical Health O f f i c e r s of B r i t i s h Columbia, BCBH, Report, 1 9 1 8 , p. G 1 6 2 .  8  How To Take Care of the Children, p. 8 .  9 ¥. E. Blatz, Human Security: Some Reflections (Toronto: University of Toronto Press, 1 9 6 6 ) , pp. 4 - 5 ; Arnold Gesell., The Mental Growth of the PreSchool C h i l d (New York: Macmillan, 1 9 2 5 ) . Susan Isaacs, The Nursery Years (London: Kegan Paul, 1 9 2 9 ) ; Herbert Ginsburg and S y l v i a Opper, Piaget's Theory of I n t e l l e c t u a l Development (Englewood C l i f f s : Prentice H a l l , 1 9 6 9 ) , PP. 1 - 2 5 . 10 Karl S. Bernhardt, "A Prophet Not Without Honour" i n Twenty-five Years Of C h i l d Study, University of Toronto, 1 9 2 6 ^ 1 9 5 1 , by Karl S. Bernhardt, et a l , (Toronto: University of Toronto Press, 1 9 5 1 ) , PP« 3 9 ; Northway, "Child Study i n Canada," pp. 13-18. _  11  Blatz, Human Security, pp. 4 - 5 .  12  Northway, "Child Study i n Canada," pp. 1 3 - 1 8 .  13  Ibid.  14 M. A. Twiddy, "A C h i l d Study Group," PHNB, 2 (Mar. 1 9 2 8 ) , 4 9 ; . Margaret Kerr, "The Public Health Nurse and the C h i l d Study Group," i b i d . , 1 (Mar. 1 9 3 2 ) , 1 2 ; see also Church of England i n Canada, Yearbook 1 9 3 9 , Lending Library Service recommends Parents and the Preschool Child; Chatelaine, June 1 9 2 9 , P. 5 4 ; The Vancouver Sun, Oct. 1 7 , 1 9 2 9 ; i b i d . , Oct. 17,  1930.  15  W. E. Blatz, The Management of Young Children (New York: William  Morrow, 1 9 3 0 ) , p. V.  Footnotes 16 Morrow, 2  17 (Apr.  118  ¥. E. Blatz, Parents and the Preschool C h i l d (New York: William 1 9 2 9 ) , p. 1 2 . Eileen M. Carruthers, "Discussion Groups f o r Mothers," PHNB, 1 0 - 1 1 ; Twiddy, "A C h i l d Study Group," pp. 4 9 - 5 0 .  1935),  18 W. E. Blatz, Hostages to Peace: (New York: William Morrow, 1 9 4 0 ) , p. 1 0 . 19  Parents and Children of Democracy  , Parents and the Preschool Child, pp. III-IV.  20 , Five S i s t e r s : A Study i n C h i l d Psychology McClelland and Stewart, 1 9 3 8 ) .  (Toronto:  21 Angelo P a t r i , How To Help Your C h i l d Grow-Up, (New York: Rand McNally, 1 9 4 8 ) , pp. 1 - 4 ; "Our Children" a B e l l Syndicate Column written by Angelo P a t r i ; other books by P a t r i : C h i l d Training, n.d.; Talks to Mothers, n.d.; School and Home, n.d.; The Problems of Child.Training ( 1 9 2 2 ) ; The Questioning C h i l d ( 1 9 3 1 ) . 22  P a t r i , How To Help Your Child, pp. 1 - 4 .  23  Ibid.  24 Myrtle Meyer Eldred, Your Baby and Mine, (New York: John Day Company, 1 9 5 1 ) » introduction, p. IX; i b i d . , 1 9 3 1 ed.; Syndicated Hurst column "Your Baby and Mine." 25 Ibid., 1 9 5 1 ed., p. Ix, other influences and sources include Charles A l d r i c h , James Maloney and Milton Senn. , Your Baby and Mine (New York: G. Howard Watt,  26 pp.  1931).  113-114. 27  Ibid., pp.  115-116.  28 "Your Baby and Mine," The Vancouver Sun, Oct. 3 , 1 9 3 0 , no thumbsucking permitted; i b i d . , Oct. 5 . 1 9 3 7 . ignore thumbsucking. 29 How To Take Care of the Children (Department of Health, 1 9 2 3 ) ; "The Runabout" (Children from 2 to 6 years), i n The House of Health, American C h i l d Health Association, 1 9 2 3 ? Diet Folder # 3 , C h i l d Hygiene Section, Canadian Public Health Association, n.a.  "The Health O f f i c e r Suggests," pp. 1 8 2 - 1 8 3 ; Angelo P a t r i , " A l l of a Suddeni?" Family Herald and Weekly Star, Dec. 5 , 1 9 2 8 , p. 3 6 , (hereafter FHWS). 30  31 Marjorie Blandford, "Nine Diet Essentials," Chatelaine, May 1 9 3 7 . P« 6 4 ; "Canadian Medical Association Health Service," Star Weekly, Nov. 3 , 1 9 2 8 , (no page given)5 Gary Emma Wallace, "During The No Man's Land Of Childhood," Chatelaine, Feb. 1 9 3 1 , p. 2 1 ; M. A. Twiddy, "Physical Welfare of Children," BBCBH, 4 (Dec. 1 9 3 4 ) 1 9 2 . 32 Wallace, "During No Man's Land," p. 2 1 ; Twiddy, "Physical Welfare of Children," p. 1 9 2 ; "Do You Know How To Feed Your Child?" The Canadian  119  Footnotes  Churchman, Nov. 1 9 , 1 9 2 5 , p. 7 5 3 ; "Mother and Baby," FHWS, Oct. 1 1 , 1 9 3 9 , P. 3 4 . 33 How To Take Care Of The Children, pp. FHWS, Oct. 1 7 , 1 9 2 3 , p. 2 9 .  pp.  29-35;  "Mother and Baby,"  34  Ibid., Oct. 3 , 1 9 2 3 , p. 2 9 .  35  Ibid., Nov. 7 , 1 9 2 3 , p. 3 9 ; How To Take Care Of The Children,  30-31.  36 "Porridge For Breakfast," FHWS, Oct. 9 . 1 9 2 8 , p. 3 7 ; "Appetizers for Child's Diet," The Vancouver Province, Oct. 1 , 1 9 3 2 . 37  "The Kitchen Column," Star Weekly, Oct. 3 1 , 1 9 3 1 , p. 14.  38  "Mother and Baby," FHWS, Oct. 6 , 1 9 2 0 , p. 3 7 .  39 Blatz, Parents and the Preschool Child, p. 9 7 ; MacMurchy disagreed with general trend, see How To Take Care Of The Children, p. 28. 40  Blatz, Parents and the Preschool Child, p. 9 7 .  41  "Your Baby and Mine," The Vancouver Sun, Oct. 3 , 1 9 3 3 .  42 Gertrude Rotenberg, "Has Your Child A Speech Difficulty?" Chatelaine, May 1 9 3 3 , p. 2 2 ; "Your Baby and Mine," Star Weekly, Oct. 24, 1 9 3 1 , no page given; Angelo Patri, "Clear Language," The Vancouver Sun, Oct. 6 , 1 9 3 0 ; "Simple Language and Clear Enunciation are Necessary in the Teaching of Children," The Canadian Churchman, Sept. 2 3 , 1 9 2 0 , p. 6 3 . 43 "Make Children Speak Correctly," FHWS, Oct. 14, 1 9 2 2 , p. 2 9 ; Rotenberg, "Has Your Child A Speech Difficulty?" p. 2 2 . 44 Ibid.; Dr. A. Fishbein, "When Children Begin To Talk," Star Weekly, Nov. 8 , 1 9 2 4 , p. 2 7 ; "Children Who Stammer," FHWS, Oct. 2 5 , 1 9 2 2 , p. 2 9 ; Angelo Patri, "Learning To Talk," ibid., Oct. 3 , 1 9 3 4 , p. 24. 45 Blatz, The Management of Young Children, p. V; Frances Lucy Johnson, "Training i n Responsibility," Chatelaine, May 1 9 2 9 , P« 3 1 . 46 "The Runabout," p. 3 8 ; "Mental Care For Your Child," The Canadian Churchman, Nov. 5 , 1 9 2 5 , p. 7 2 1 . 47  "As The Twig Is Bent," FHWS, Nov. 7 , 1 9 2 8 , p. 3 7 .  48 How To Take Care Of The Children, pp. 8 , 2 6 ; "Patterns on Which to Raise Children," Star Weekly. Oct. 18, 1 9 3 0 , no page given; Angelo Patri, "Encourage hot Discourage," The Vancouver Sun, Oct. 5 , 1 9 3 1 ; Blatz, The Management of Young Children, p. V. 49  "Mother and Baby," FHWS, Oct. 1 2 , 1 9 2 1 , p. 3 9 .  50  Ibid.  51  Ibid., Nov. 2 , 1 9 2 1 , p. 3 9 .  1 2 0  Footnotes 52  "The Baby C l i n i c , " Chatelaine, Jan. 1 9 3 5 ,  p. 3 4 .  Maud Newcombe, " F i r s t Dangerous Words," F H W S , Nov. 1 4 , p. Frances Lucy Johnsin, "When Children Say, 'I Won't'," Chatelaine, July P. 5 3  1 9 3 4 ,  1 9 2 9 ,  5  54  4  3  4  ;  .  Angelo P a t r i , "Force and Strategy," The Vancouver Sun, Oct. 5 ,  1 9 3 2 .  55 Blatz, The Management of Young Children, p. 3 8 ; Mrs. Nestor Noel, "Meeting the S p i r i t o f Contradiction," FHWS, Oct. 1 7 , 1 9 2 3 , p. 2 9 ; How To Take Care of the Children, p. 3 8 . "The Runabout," p. 4 1 .  56  57 Ibid.; "Mother and Baby," FHWS, Oct. 2 0 , 1 9 2 0 , p. 2 9 ; i b i d . , Oct. 5 , 1 9 2 1 , p. 3 9 ; "Your Baby and Mine," The Vancouver Sun, Oct. 1 4 , 1 9 2 8 ; i b i d . , Oct. 5 , 1 9 2 9 . 58  Blatz, Parents and the Preschool C h i l d , p. 2 8 .  59  Ibid.; John Martin, " D i s c i p l i n e - How Much Or L i t t l e ? " p.  Nov.  1 9 3 2 ,  2  6  Chatelaine,  .  "The Runabout," p. 4 2 .  60  61 Angelo P a t r i , "Indirect Training," FHWS, Oct. 1 0 , 1 9 3 4 , p. 3 4 ; " C r i t i c a l Children," i b i d . , Sept. 2 5 , 1 9 3 7 ; p. 3 6 ; Eleanor Brett, "Never Say 'Don't'," Chatelaine, Aug. 1 9 3 1 , P. 1 9 . 62 Blatz, Parents and the Preschool C h i l d , p. 2 9 ; The Management of Young Children, pp. 2 0 2 - 2 0 4 ; Angelo P a t r i , "Thwarting Children," FHWS, Nov. 7 , 1 9 3 4 , p. 3 4 ; "Mother and Baby," i b i d . , Oct. 2 0 , 1 9 2 6 , p. 3 7 . 63 "The Runabout," p. 4 2 ; Blatz, The Management of Young Children, pp. 2 1 5 - 2 1 8 , Angelo P a t r i , "Maintaining the Balance," FHWS, Oct. p. 3 4 ; "Some Don't," i b i d . , Oct. 3 0 , 1 9 3 5 , P« 3 4 ; Frances Lucy Johnson, " S h a l l We Punish Our Children?" Chatelaine, Jan. 1 9 3 0 , p. 5 1 . 1  7  ,  1  9  3  64 Angelo P a t r i , "Offering a Choice," FHWS, Oct. 2 7 , 1 9 3 5 , p. 3 2 ; "Self-Reliance Important f o r C h i l d Welfare," The Vancouver Province, Oct. 2 , 1 9 2 9 ; "Standing Alone," FHWS, Oct. 7 , 1 9 3 1 , p. 3 0 . 65 p.  1 9 3 4 ,  66  Elmore Reaman, "When Your C h i l d I s Aggressive," Chatelaine, May B l a t z , The Management of Young Children, pp. 4  4  ;  1 0 2 - 1 0 3 .  How To Take Care Of The Children, p. 8 .  67 Blatz, Parents and the Preschool C h i l d , p. 1 7 6 ; Frances Lucy Johnson, "Constructive Toys For Children," Chatelaine, May 1 9 2 8 , p. 3 0 ; H a r r i e t M i t c h e l l , "Play, An Important Factor i n the Child's L i f e Development," The Vancouver Province, Oct. 3 , 1 9 2 9 , p. 1 3 . 68 ( 1 9 3 1 ) ,  Johnson, "Constructive Toys," p. 2 8 ; Eldred, Your Baby and Mine pp. 1 3 8 - 1 4 2 ; M i t c h e l l , "Play,An Important Factor," p. 1  3  .  4  ,  Footnotes 69 Harriet M i t c h e l l , "What Shall We Give the Children?" Chatelaine, Dec. 1931. P. 28. 70 Ibid.; Mrs. C e c i l Newcombe, "Annusing the Wee Ones," FHWS, Nov. 2 0 , 1 9 2 5 , p. 37; Blatz, The Management of Young Children, pp. 9 1 - 9 7 71 Johnson, "Constructive Toys," p. 28; Eldred, Your Baby and Mine ( 1 9 3 1 ) , PP. 138-142. 72  Frances Lucy Johnson, "The Play of Children," Chatelaine, Mar.  73  Blatz, Parents and the Preschool C h i l d , pp. I 6 8 - I 6 9 .  74  "Needed Playmates," FHWS, Dec. 2 6 , 1 9 2 8 , p. 3 6 .  75  "Your Baby and Mine," The Vancouver Sun, Oct. 3, 1 9 3 0 .  76  Angelo P a t r i , "Home Chores," The Vancouver Sun, Oct. 4, 1 9 3 3 .  77  Blatz, The Management of Young Children, p. 1 2 0 .  1929, P.  25.  78 "Your Baby and Mine," The Vancouver Sun, Oct. 1 , 1 9 3 8 ; Angelo P a t r i , "Encourage not Discourage," i b i d . , Oct. 5 , 1 9 3 1 ; "Comparisons are are Bad f o r Children," FHWS, Oct. 8,1939, p. 40. 79  "Your Health O f f i c e r Suggests," p. I 8 3 .  80  "The Runabout," p. 46.  81  Ibid.  4 82 Antoinette Donnelly, "To Make Your Daughter Beautiful," Star Weekly, Oct. 1 5 , 1 9 2 7 , p. 34; i b i d . , Oct. 2 2 , 1 9 2 7 , p. 48; A l i c e Hart, "Young C h i l d Can Be An A t t r a c t i v e Grown-Up," The Vancouver Sun, Oct. 1 , 1938.  83 "The Runabout," p. 47; "Thumbsucking - Prevented the New Way," FHWS, Oct. 2 1 , 1 9 3 7 , P. 3 2 .  84  "The Runabout," p. 4 7 .  85  Ibid., p. 48.  86  "Your C h i l d and Mine," The Vancouver Sun, Oct. 5 , 1 9 2 7 .  87  Blatz, Parents and the Preschool Child, p. 1 9 9 .  88  "The Runabout," p. 4 9 .  89  Ibid.  90  Ibid.  91  Blatz, Parents and the Preschool C h i l d , pp. 2 0 0 - 2 0 1 .  122  Footnotes 92  "The Runabout," p. 4 9 .  93 "Mother and Baby," FHWS, Nov. 1 , 1 9 3 6 , p. 3 6 ; "Play Problems i n a Small House," i b i d . , Nov. 1 , 1 9 3 9 , p. 3 6 ; How To Take Care Of The Children,  pp. 1 5 - 1 6 .  Blatz, Parents and the Preschool C h i l d , pp. 2 6 9 - 2 7 0 ; Johnson, "Training i n Responsibility," p. 28. 94  95 Frances Lucy Johnson, "Why Does A Child Lie?" Chatelaine, May 1 9 3 0 , p. 4 4 ; John Martin, " D i s c i p l i n e - How Much or How L i t t l e ? " i b i d . , Nov. 1 9 3 2 , p. 2 6 ; "The Runabout," p. 4 5 ; "Mental Care For Your Child," p. 7 2 1 . 96  P h y l l i s Blanchard, "Your C h i l d and You," The Vancouver Sun, Oct. p. 1 2 ; Blatz, The Management of Young Children, pp. 1 7 2 - 1 7 3 ; "Lack of Home L i f e i s a Serious Menace to Recent Age," The Canadian Churchman, Oct. 14, 1 9 2 9 , p. 6 7 4 . 17,  1924,  97  Angelo P a t r i , "An Old Lesson," The Vancouver Sun, Oct. 1 , 1 9 3 3 -  98 S t e l l a E . Pines, "From Babyhood On," Oha.+.Plaing. Jan. 1 9 2 9 , P. 1 9 ; Donna Matthews, "We Teach Them," i b i d . , June 1 9 3 4 , p. 2 0 ; Johnson, "Why Does A C h i l d Lie?" i b i d . , p. 4 4 ; Angelo P a t r i , "Imagination Run Wild," FHWS, Oct. 2 1 , 1 9 3 6 , p. 28.  123  Chapter 5  The School Child: Physical Perfection for Spiritual Welfare  Health professionals and educators of the 1920's and 1930's viewed the school child as the instrument and the school as the agency through which to educate British Columbia parents.  Through the child, the parents  would be educated to practise better hygiene and nutrition, better home management, and a 'higher' moral standard.  1  Public health nurse Eileen  Carruthers described the process as adult education by a second-hand 2 method.  Statements made by many of British Columbia's health care prof-  essionals and educators implied that they generally regarded parents as incompetent, and thus Incapable of providing nourishment proper for the child's body or mind without instructions and advice from advisors, and 3  they were quite willing to give both instructions and advice to parents. An examination of available materials for the inter-war years indicates that health professionals and educators executed a persistent and wellplanned program designed to provide health care for the school children, to make parents aware of their parental responsibilities and duties, and to advise parents how to rear their children. I By 1920, British Columbia health care programs had moved into a new stage, one which Dr. Young, Provincial Health Officer, described as a period of disease prevention and health education.  Public health care  expanded through the organization of the provincial public health services and the coordination of existing health services provided by the Victorian Order of Nurses and the Red Cross Outpost Service.  5  But health services  for the school child had originated thirteen years earlier when the Vancouver School Board initiated the practice of medical inspections for each student in Vancouver schools.^  In 1910, the Provincial Board of Health  124 followed the Vancouver example by passing the "School Health Inspection Act."  This act required each school board appoint a physician to examine  annually every c h i l d i n the public school system, members of school s t a f f s , g and the state of sanitation and s u i t a b i l i t y o f each school building. I n i t i a l l y , the policy met with opposition from a few educators, health professionals and parents, but two years a f t e r i t s inception Dr. Walter Bapty, Acting P r o v i n c i a l Health O f f i c e r , reported that most people concerned 9  had accepted the practice.  But Dr. Bapty was overly o p t i m i s t i c , f o r as  l a t e as 1 9 3 7 a few parents continued to oppose the medical inspection of t h e i r school age children, especially of older g i r l s .  1 0  In s p i t e of some  opposition, however, the practice was quickly adopted i n urban areas of the province.  In 1 9 1 1 , the f i r s t year of the medical inspection program,  2 4 , 3 7 6 children i n 145 schools ( f i f t y - f o u r percent of the school population) were inspected.  During the post-war period, health care f o r school children  expanded rapidly, and i n 1 9 2 0 , 5 2 , 4 0 7 children i n 5 0 4 schools (sixty percent of the school population) were examined.  By 1 9 3 9 , 1 0 7 , 8 3 0  stud-  ents i n 1 , 1 1 9 schools (eighty-nine percent of the school population) were inspected. (Table 5«l). An additional 1 3 , 2 7 4 children (eleven percent of the school population) l i v i n g i n r u r a l and i s o l a t e d areas of the province were reported as not r e c e i v i n g an annual medical i n s p e c t i o n .  1 1  Why d i d health professionals and educators focus so much attention on the school child? reasons.  In retrospect, one can see that there were f i v e main  F i r s t , Henry Esson Young, a physician by profession, was Prov-  i n c i a l Secretary and Minister of Education from 1 9 0 7 to 1 9 1 5 , and P r o v i n c i a l Health O f f i c e r from 1 9 1 6 to 1939; he undoubtedly influenced the order of p r i o r i t i e s f o r the development o f the province's health programs.  As  minister of education, he was able to i n i t i a t e a health program i n the school system, an action he probably could not have effected through any  Table 5 . 1 SCHOOL MEDICAL HEALTH INSPECTIONS - PROVINCE OF BRITISH COLUMBIA 1911  # Year  Medical Inspectors  #  Schools Inspected  # H.S. Students Inspected  1911 1912-13  145 224  1913-14  302  1914-15 1915-16 1916-17 1917-18  309  1,734  331  1,915 1,999 2,155 2,013 2,020  1918-19 1919-20 1920-21 1921-22 1922-23  1923-24  1924-25 1925-26 1926-27  1927-28 1928-29 1929-30 1930-31 1931-32 1932-33 1933-34 1934-35 1935-36 1936-37 1937-38 1938-39  SOURCE:  28  328  142 154  504 514  151  581  153 157 155 156 160 164  613 638 671  740 765 778  163 163 160  790 764  151 152 154 154  841  156  823 803 1,055 1,068  -  1939  #  #  #  Graded City  Rural Municipal  Rural and Assisted  Total pupils inspected 24,376 786 9,804 22,412 966  3,049 3,908 4,783  26,606  11,212 11,562  500  24,019  10,946  29,366  11,869  8,396  27,278  13,154  32,392  18,159  9,955 11,231  21,617  13,395  30,218 32,181  10,469 9,012  21,103  Cost Per Pupil  4,589 7,498 8,079 7,945 3,518 7,384  25,523 25,254 22,564  Percentage of Defects  14,080  90.13 91.52 93.98 94.01  1/30  73 71 60  1/60 1/20  76 69  1/30 1/20  710 850  840  110.35 107.56 100.81  870 860  5,551 7,419 7,861 9,368  32,475 34,036  24,856  35,653  26,547  16,748  100.65  840  39,882  28,130  17,661  860  11,783 12,790  39,387  29,696  18,140  101.97 105.47  48,898 48,860 48,585  16,030  18,318  103.31  18,391  104.24  830 85.60  19,655 20,728 20,451  101.29  85.30  107.37 112.15 111.29  84.70 750  105.41  710 670 680  15,327 16,955  26,163  17,785 18,256 16,192  47,834  16,925 17,705 16,196  46,046  16,267  44,800  18,732  40,197 41,235 38,466  15,075 17,054  157  1,138 1,116  20,655 22,010  163 163  1,096  27,219  1,119  28,609  39,273 38,025  14,687 15,331  21,217 21,205 21,011  17,783 17,956 19,366  21,114 22,182  18,542  22,663  116.75 112.31 108.7 100.6  850  870  710  64.90 68.10  B r i t i s h Columbia Board of Health, Report, 1 9 1 1 to 1939.Where no numbers are available the spaces are l e f t blank.  H  126 other governmental department. Subsequently, as provincial health officer, he was able to co-ordinate public health and school health services into 12 an effective program.  But a second and more important reason for focus-  ing on school children was expressed by Dr. F. W. Andrew, a Summerland physician, i n a 1916 address to the Okanagan Women's Institute. Andrew reflected the attitude of many health professionals i n industrialized countries when he pointed out that the regular systematic inspection of 13 school children was a branch of preventive medicine.  J  For example,  through a regular medical inspection, physical defects that were noted early might be corrected before permanent damage resulted.  Furthermore,  by 1920, recent discoveries i n bacteriology indicated that through vaccination, immunization, and quarantine procedures, both infectious and contagious diseases could be controlled. Schools were the obvious point of contact for many victims of communicable diseases, therefore, a third reason for focusing on school children was to locate infected children and diagnose their diseases early so they could be quarantined before their disease spread.  Children, of course, were  captives i n an environment  where they were readily accessible for treatment.  15  Andrew also expressed a fourth reason, one that was supported by a large number of reformers of the era.  From the standpoint of eugenics  (a popular theory of the time) and the desire to establish a superior race, those individuals constituting 'the race* should be kept under medical observation and educated along 'right lines.'"^  Finally, Andrew argued  (other health advisors agreed) that some parents were too ignorant or too apathetic to detect defects i n their children, therefore the state was obligated to c a l l attention to their condition and to emphasize the importance of 17 early treatment.  II  127  Health professionals were quick to recognize that i f the school health program was to succeed, they required the cooperation of classroom teachers and school administrators.  In 1908,  two years before the i n i t i a t i o n  of the school medical inspection program i n the province, Dr. C. J . Fagan, P r o v i n c i a l Health O f f i c e r , argued that the classroom teacher the best person to impart health knowledge to the school c h i l d .  was  Fagan  recommended to Dr. H. E. Young, then Minister of Education, that teachers 18 be q u a l i f i e d to "impart i n s t r u c t i o n s i n sanitary sciences."  In the  1908-  09 Annual Report of the Public Schools of B r i t i s h Columbia, Dr. Young urged teachers to assume leadership i n educating the school c h i l d to better health care and i n encouraging school o f f i c i a l s to provide sanitary and suitable school f a c i l i t i e s .  1 9  In 1912, Dr. E. C. Hart, V i c t o r i a ' s School  Medical O f f i c e r , suggested "that at l e a s t two lectures as to the needs of school inspection and methods and duties of teachers be made part of 20 normal school t r a i n i n g . . . " But the annual reports of both the Vancouver and the V i c t o r i a Normal Schools indicated health education was not included 21 as a regular part of the teachers t r a i n i n g program u n t i l the mid-1920's. Only with the cooperation of educational administrators and classroom teachers was the medical inspection program able to become as extensive and 22 successful as i t was. By 1911,  Vancouver school health workers had established an  examination procedure f o r the medical inspection of school children; t h i s same general procedure was subsequently adopted by school health workers across the province.  The school medical officers inspected each c h i l d at  l e a s t once a year f o r cleanliness, communicable diseases, skin disorders, and pediculosis.  Weight and height were measured, hearing and sight  tested, t o n s i l s , adenoids, teeth and respiratory system checked, and any physical defects such as f l a t feet or curvature of the spine were noted.  128 School medical officers recommended modifications to be made in the school program for any child with defects.  They also recommended that parents  take defective children to their family physicians or dentists for 23 necessary treatment.  School nurses or the public health nurses assigned to school work 24 considered themselves 'teachers of health' rather than 'angels of mercy.' They assisted the school medical officers with their examination of children.  They sent notices of physical defects to parents and instructed  them to have defects treated by their family physicians or dentists. As their time and energy permitted, they examined a l l school children on a regular schedule for cleanliness, communicable diseases, pediculosis, skin infections, sight, and hearing. They kept accurate, cumulative, up-to-date records of the weight, height, growth gain, and defects of a l l children. In goitre prone areas of the province, they distributed iodine p i l l s on a regular b a s i s .  25  Home visits were a routine part of a l l school nurses' duties. Not only did they use home v i s i t s as a means to encourage parents to have their childrens' physical defects corrected, but also as an opportunity to instruct parents on home ventilation, selection of suitable clothing, 26 infant care, childrens' sleeping habits, nutrition, and hygiene.  In 1912,  Vancouver's head school nurse, Elizabeth Breeze, considered home visits the most important feature of her work, but she also pointed out the nurse's 27 v i s i t was not always warmly welcomed.  Twenty-five years later, Lyle  Creelamn, public health nurse i n Revelstoke, s t i l l stressed the value of follow-up home v i s i t s as the best way to enlist the co-operation of parents in providing treatment for children and educating parents i n child care . ... 28 principles.  129  As each medical inspection was conducted, an exact record was kept of the numbers of defects found (e.g. carious teeth, skin disorders, curvature of the spine) and the score computed against the number of children examined.  Of the 52,407 school children inspected i n 1920,  the  school medical officers found 91.52 percent of defects, or less than one defect for each child.  In 1923• however, the 72,147 children insp-  ected showed a rate of 110.32 percent of defects, or more than one defect for each child.  Probably the expansion of the school medical services to  include new areas, and more careful examinations accounted for the increased number of reported defects and justified the further expansion of 29 school health services.  By 1939> health workers were s t i l l reporting  an average of one defect for each child inspected. School medical personnel reported that the most common defects among school children were poor nutrition, diseased tonsils, enlarged goitres, skin infections, and other health conditions caused by improper hygiene, poverty, and ignorance.  For example, a survey conducted in 1920 by Dr.  Robert Wightman, Vancouver's School Medical Officer, showed a high rate of malnutrition among the city's school children.  Judged against the  standards of physical development established by Thos. D. Wood, Professor of Education at Columbia University (1910-1931), 14,282 or seventy-nine percent of Vancouver's school children were recommended for further 30 examination because of possible malnutrition.  Of that number, 3,584  (25.1 percent) were found to be more than ten percent below normal physical 31  weight and size as indicated by Wood's standards.  Because Wood's stand-  ards made no allowance for differences relating to racial origin or body types, the 25.1 percent figure may have been inaccurate, but malnutrition among Vancouver school children, Wightman noted, was manifest i n their lack of resistance to infectious and communicable diseases, the frequency of  skin disorders, and their general apathy toward school. 32 of malnutrition were not limited to the urban areas.  130  But the effects  The November 4,  1 9 2 0 , issue of the Vernon News carried an article by Ethel Todd, of Columbia Agricultural College, in which she cited Dr. Wood as pointing out that rural children suffered an even higher percentage of defects 33 than did their urban counterparts.  J  Wood asserted that the major causes  for poor health among rural children were poor housing, poor sanitation, and parental ignorance of modern scientific methods of child rearing.  This 34 opinion was shared by several of British Columbia's public health nurses. The most serious health problem found among school children was dental defects.  In  1923»  Dr. Young reported that ninety percent of child-  ren inspected suffered from some form of dental defect, and that some of 35 those defects were of an irreparable nature.  Young attributed the large  number of carious teeth to ignorance, apathy, poverty, lack of available dental f a c i l i t i e s , and failure by children to care for their teeth. In an effort to reduce the number of dental defects, school nurses began conductor ing tooth brush d r i l l s with school children. The need for dental care was so serious that, in 1913» the Vancouver School Board established a free dental clinic for children whose parents could not afford the services of a regular dentist. In 1 9 2 0 , the clinic requested parents who were financially able pay a small fee to cover the cost of materials.  The clinic continued to operate throughout the two 37  decades covered by this study.  In several rural areas of the province, the Women's Institute provided either free or subsidized dental care for large numbers of children, and in other areas, the Provincial Board of Health provided subsidized dental  care. '"  During i t s f i r s t year of operation the Peace River Health Unit  -  provided a temporary dental clinic for 1000  1,300  of i t s approximately  39 school children. '  In his 1937  annual report, Dr. Young reported that  5,000 children in the province had received subsidized dental treatment 40 during that year.  Health professionals saw dental treatment as the  f i r s t step in a dental care program.  Once the defects were treated,  parents were expected to maintain the work and to take their child to a dentist regularly.  Dr. R. L. Pallan, Chief Dental Officer for the Vancou-  ver School Board, reported in 1920  that, among other duties, the school  nurse checked whether children brushed their teeth, and whether parents In  maintained the dental work that had been completed at the c l i n i c .  Yet,  in spite of their efforts to promote better dental care among school children dental defects were of continuing concern to the province's health professionals. Ill Epidemics of infectious and communicable diseases, including the common cold, were of constant concern to health workers and to educators. Outbreaks of smallpox, diphtheria, scarlet fever, whooping cough, measles and mumps could and did reach epidemic proportions in both urban and rural areas.  During 1924,  for example, there were 2,964 school children  (l4.6  percent of the Vancouver school population) infected with some type of 42 communicable disease.  J. S. Gordon, Inspector of Vancouver schools,  reported that for the same school year (1924-25), school time just lost by smallpox cases and their contacts totalled 1,310  school days, or an average  4? of sixty children for each school day. Dr. Young noted that during 192425 epidemics of chicken pox, diphtheria, influenza, measles, scarlet fever, J  smallpox and whooping cough were reported in various areas throughout the  44 province.  132  Each time an outbreak of smallpox occurred, health workers used i t to j u s t i f y extensive vaccination programs.  J  During smallpox scares i n  1921 and 1925, the Vancouver Board of Health attempted to have a l l school children vaccinated.  To e f f e c t t h i s process, free vaccination c l i n i c s  were opened at some of the c i t y ' s schools and a t the Vancouver School Board offices,and c i t y medical workers urged parents to have t h e i r children vaccinated by t h e i r family physician or at one of the free c l i n i c s . the  Of  18,590 children enrolled i n Vancouver schools i n 1921, 10,553 were  vaccinated, 1,403 d i d not comply with the order to be vaccinated, 789 were considered unsusceptible to the disease, and 5»8l4 were registered  46 conscientious objectors.  During the 1925 smallpox epidemic, health  workers were armed with the March 19, 1925 "Order i n Council" which made obligatory the vaccination of a l l i n d i v i d u a l s not registered as conscientious objectors.  In s p i t e of the Order and the smallpox scare, only  4,511  47 school children were vaccinated.  Yet, a subsequent outbreak of a v i r u l -  ent type of smallpox i n 1932, which resulted i n sixteen deaths among f i f t y - s i x cases, resulted i n 8,000 children being vaccinated within a four  48 day period.  Between 1929 and 1939, the number of cases o f smallpox  i n Vancouver steadily declined from seventy-five reported cases i n 1929 to no reported cases i n 1939-^ (Table 5.2), Vaccination was an extremely emotional issue f o r some members of the Vancouver and V i c t o r i a communities.  They believed no disease was prevented  by loading the body with what they c a l l e d p u t r i d f i l t h from a s i c k cow. During the 1925 debate surrounding the Issue of obligatory vaccination, the editor of The Vancouver Sun raged, "Vaccination i s d i s c r e d i t e d . I t i s illogical.  I t i s dirty.  I t I s one of the most damnable i n j u r i e s one person  ever t r i e d to i n f l i c t upon another."  50  Health professionals attempted to  educate the public to the values o f vaccination and to reassure them about  Table 5 . 2 ! 3 3 REPORTED CASES AND REPORTED DEATHS FROM SPECIFIED DISEASES OF CHILDREN UNDER TWENTY YEARS OF AGE 1918  Diphtheria Cases Deaths 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948  1949 1950 1951 1952 1953 1954  369 267 289 682 601  985 667 286  342 721  137 232  191 430 261  833  243  98  257 278  257 368  36  738 157 37 57 8  17  83 33  40 27 31 26 17 9 10  3 5 5 8 4 1 4  7 13 3 2  14 1 2 1  23 60 28 17 36  5 1 8  63 34  5  35 12  3 3  5  63 5 11 8  SOURCES:  429  35 576  20 368  14  Tuberculosis Deaths Cases  22  1014  375 477 578  1957  Smallpox Cases Deaths 60  143 70 306  1955 1956  - 1957  1 1  6 1 2 1  235 377 260  167  376 586 876 1063 898 728  177  853  141  861  45 169  748 1209 1610 1351 1345  1408 1991 2051 2536 2544  1  5  161 153 172 162 167 165  148 153 135  124 99 129 136 96 122  2178 2202 1828  49  1662  48  1411 1494 1434 1414  7 8  180  1331 1355  99 47  25 13 8 1 1  B r i t i s h Columbia Board of Health, Report, 1 9 1 8 - 1 9 5 7 ; B r i t i s h Columbia Department o f V i t a l S t a t i s t i c s , Report, 1 9 2 7 - 1 9 5 7 . The Reports of the Board of Health and the Reports o f Department of V i t a l S t a t i s t i c s cover only approximately the same time periods, not exactly same time period. Blank spaces indicate, no„recorded deaths.in the above reports.  134  the controlled conditions under which vaccine was produced and tested, but letters to the editor of The Vancouver Sun clearly indicate that not a l l members of the public were convenced.  51  Vaccination appears to have met with considerably less opposition i n other areas of the province.  Dr. Young reported i n 1 9 2 1 that eighty  percent of the province's school children had been vaccinated during the 52 previous six months. In the face of opposition i n Vancouver and Victoria in 1 9 2 5 , Dr. Young reported that sixty percent of the province's unvaccin53 ated school children had been vaccinated during the year.  In spite of  the articulate opposition of the anti-vaccinationists, vaccination became an acceptable and standard practice throughout the province. Health workers i n rural areas used various tactics to effect vaccination of children. In the Peace River area, children were immunized and vaccinated by public health personnel during their regular school medical inspections.  If children were absent from school on health inspection day,  health workers found the most efficient method was to v i s i t the children's 54 homes and vaccinate them.  In this way, health workers were certain to  treat a l l children. Dr. White noted i n his f i r s t report of the Metropolitan Board of Health i n 1 9 3 7 that a l l school children within the health unit area (Burnaby, Richmond, North Vancouver, Vancouver, West Vancouver) were checked for their vaccination requirements. excluded  Children not vaccinated were  from the school system until they were treated unless their parents  were registered conscientious objectors.  White reported that vaccination  and immunization clincis were held weekly i n each school and <a$ each public 55 health unit. This procedure was effective, for by 1 9 3 9 , White reported that eighty-four percent of Richmond school children were vaccinated and 56 sixty-eight percent immunized. J  135  Between 1920  How effective was vaccination?  and 1926,  the number of  57 reported cases of smallpox dropped from 576 to 98 cases.  Although the  number of reported cases increased sharply to 738 cases i n 1928-29» the cumulative effect  of vaccination was demonstrated by the rapid and steady 58  decline to no reported cases in 1940."^ pox in 1932,  In spite of an outbreak of small-  only fifty-seven cases and sixteen deaths were reported.  Six of those deaths were children  (Table  5 9  5.2).  Diphtheria was another recurring contagious disease that responded to immunization.  The development in 1923  of a diphtheria toxoid provided  health workers with another tool i n their fight to reduce the diphtheria incidence.^  0  In 1926 Vancouver's Medical Officer recommended an extensive  toxoid Immunization program. But the immunization program did not bring an immediate decrease i n the number of cases of diphtheria, rather, the number of reported cases increased from seventy-four cases in 1926, one hundred seventy-eight cases in 1929 two cases in 1930.^  1  Between 1929  were immunized, and by 1938  to  before dropping sharply to sixty-  and 1934,  30,000 Vancouver children  there were no reported cases of diphtheria  62 among Vancouver's school children,  (Table  5.2)  The toxoid immunization program against diphtheria also met with opposition, but not so vigorous as that directed against smallpox vaccination.  As late as 1938,  Dr. J. W. Macintosh, Vancouver's Medical Officer,  stated in a report carried i n the Vancouver Province that "Young children do not feel the slightest effects of toxoid immunization under the age of 12."  Three Vancouver physicians took Dr. Macintosh to task and  publicly declared in a letter to the editor that any poison introduced into the body through the use of toxoid certainly had detrimental effects on a child's body and led; to increased cases of heart disorders among  children under ten years of age. 6k  136  They did not substantiate their claim  with research or statistical evidence.  Was toxoid immunization effective? The diphtheria rate dropped from a high of 985 reported cases in 1928  to eighty-three in 1931  ^  5.2).  (Table  Dr. Young reported a startling f i f t y percent reduction in the diphtheria mortality rate between 1930  and 1933«^  In 1939» only nine cases were 67  reported for the entire province, eight less than for the previous year. Health professionals believed their program of immunization, vaccination, quarantine procedures and sanitation to be effective, and the decrease in the number of cases of communicable diseases appeared to substantiate their beliefs.  Another opinion, however, was expressed by George Rosen,  Professor of Public Health Education at Columbia University. that from about 18?0  Rosen argued  onward a number of infectious diseases including small-  pox, diphtheria and tuberculosis, began to wane both in v i r i l i t y and  68 frequency. I f this i s true, the total effect of immunization cannot be accurately evaluated, but what can be clearly demonstrated i s that there were fewer cases and fewer deaths caused by these diseases.  69  IV Smallpox and diphtheria, both highly visible diseases, were preventable through vaccination and immunization at the cost of a few cents a person, but tuberculosis was a less visible and far more insidious disease. Robert Koch, a German physician, discovered the tubercule baccile in  Dr. 1882,  and the subsequent research established the highly infectious nature of 70 the disease.  Nevertheless, health workers had great difficulty convinc-  ing some members of the British Columbia medical profession and the general public that tuberculosis was both contagious and preventable.  The reluct-_  ance of physicians to commit tuberculosis victims to the sanatorium for  137  treatment during the incipient period of the disease was based on the physicians' refusal to accept sthe highly contagious nature of the disease, and economic considerations for patients, their families, and the state. The cost of maintaining patients i n long term care, or the loss of family breadwinners made physicians pause before committing patients to treatment.  At the 1914 meeting of the British Columbia Medical Officers,  Dr. J. J. Thompson of North Vancouver argued that the eradication of tuberculosis could be accomplished only by curing those with the*disease and by preventing the spread of infection through systematic inspections 71 but he did not recommend a l l cases be isolated for treatment.  In 1 9 1 6 ,  Dr. H. E. Young, reflecting the view of the time, argued that only advanced cases of pulmonary tuberculosis were sources of infection and only those cases should be institutionalized.  He believed that incipient cases could  continue their work uninterrupted and receive treatment at a locally 72 operated dispensary similar to the one established i n Vancouver in 1 9 1 4 . Through this method, patients would receive necessary treatment and their families would not lose their breadwinner or family members. By 1 9 1 8 , Young modified his opinion for he recognized tuberculosis as a highly infectious 73 disease, especially among children.  In his 1 9 1 8 report, Young announced  that plans were underway to appoint a full-time travelling health officer to supervise and advise local health officers in locating both active and 74 incipient tuberculosis.' In an address to the 1 9 1 8 meeting of Medical Health Officers, Dr. C. H. Vrooman, Medical Superintendent of Tranquille Sanatorium, outlined in detail the highly contagious nature of tuberculosis and the need for early 75 detection i n order to contain the disease.'^  Basing his address on the work  of researchers such as American physician M. P. Revenal, a pioneer in sanatorium treatment, Dr. H. M. Briggs, State Commissioner of Health for  138  New York, and his own experience at Tranquille, Vrooman alerted his listeners to the magnitude of the tuberculosis problem. He stated that about fifteen percent of the province's children contracted tuberculosis during their f i r s t year, about f i f t y percent during their f i r s t five years, 76 and about eighty percent during the f i r s t fourteen years.  Vrooman  reported that the mortality rate for children under two years of age was high, but dropped for those aged two to fifteen.  After fifteen, the rate 77  rose sharply until age forty, and then again declined.  He noted that  the requirement that a l l milk cows be tested for tuberculosis and that no milk be sold from infected cows kept the numbers of tuberculosis cases originating from that source very low.  He recommended that the Provinc-  i a l Board of Health launch a well organized anti-tuberculosis program designed to locate and assign for treatment a l l active cases, and he also recommended an extensive educational program for both physicians and the general public.  In 1923, the Division of Tuberculosis Control was formed  with Dr. A. S. Lamb as travelling diagnostician.  Lamb was directed to  seek out and commit for treatment active cases, check their contacts, do follow-up work on ex-patients, and educate members of the medical profession and the general public to the causes, treatment, and prevention of tuber79 culosis.  In 1928, the program was extended to a provincial wide-district  based tuberculosis prevention and education program. By 1936, there were permanent clinics i n Vancouver, Victoria and Tranquille, and three travelling clinics covering the remainder of the province.  In 1939, a fourth  80  travelling c l i n i c was added. Prior to Lamb's appointment i n 1923, the family physicians either treated tuberculosis cases at home or referred them to Tranquille for treatment. As Lamb travelled about the province, local physicians, health workers and school nurses began to refer suspected tuberculosis cases to  139 him.  Lamb examined each case, and requested X-rays be taken of doubtful  cases.  The X-ray was used to provide d e f i n i t i v e evidence f o r the presence  81 or absence of tuberculosis.  In 1 9 3 5 , the tuberculin t e s t i n g was adopted as a way of detecting active cases among school children.  Each c h i l d with a p o s i t i v e reaction  to the test was X-rayed and a trace made to determine from whom the c h i l d  72 might have contracted the disease.  This procedure made t e s t i n g f o r tuber-  c u l o s i s both more e f f i c i e n t and more e f f e c t i v e .  In 1 9 3 & , tuberculin  tests were administered to 6 , 0 5 4 school c h i l d r e n l i v i n g i n Vancouver, V i c t o r i a , Kamloops, Kelowna, Steveston and Prince Rupert but only 5 2 cases were found. Even with the convenience of tuberculin t e s t i n g , procedures varied from d i s t r i c t to d i s t r i c t .  Health workers and school administrators i n  the Peace River area required routine tuberculin t e s t i n g include not only suspected a c t i v e cases and t h e i r contacts, but also as many preschool and  84 school aged c h i l d r e n as l o g i s t i c a l l y possible.  The Eraser Valley Health O f  Unit tested only suspected cases and t h e i r contacts.  Beginning i n 1 9 3 5 ,  each c h i l d entering the Vancouver school system and each Vancouver high school student was given a tuberculin t e s t and, when deemed necessary,  86 a follow-up X-ray.  In 1 9 3 7 , each teacher i n the Vancouver school system  was given a chest X-ray.  The same p o l i c y was adopted i n areas covered by  the Metropolitan Health Unit formed i n 1 9 3 7 .  8 7  By 1 9 3 9 , Dr. White report-  ed the annual tuberculin t e s t i n g program had located no advanced cases of tuberculosis i n the Metropolitan Health Unit area, and only four minimally  88 advanced cases.  Beginning i n 1 9 3 8 , the Vancouver Metropolitan Health  Unit administered a tuberculin t e s t to a l l c h i l d r e n entering the Greater Vancouver school system f o r the f i r s t time, a l l high school students, and  i4o a l l teaching s t a f f s .  The intensive tuberculosis prevent!onal  and educat-  i o n a l program helped reduce the tuberculosis mortality rate and  the  oq  number of advanced cases among both adults and childrenDr. A. S. Lamb noted i n h i s 1925  (Table  5«2).  report that as he t r a v e l l e d about the  province an increasing number of school aged children were referred to him by school doctors or nurses, although he found many of.the c h i l d r e n were non-tubercular.  This procedure, however, provided an opportunity  to  locate p o t e n t i a l cases and to recommend treatment before tuberculosis  90 developed. Between 1924 and 1928, the tuberculosis mortality rate among the province's general population declined from 95^1 f o r 100,000  91 population to 74.0. dropped to 49.2  By 1939,  the tuberculosis mortality rate had 92  f o r 100,000 population.  Yet the tuberculosis mortality  rate f o r children did not drop s i g n i f i c a n t l y u n t i l 1948,  but, as Dr. Hat-  f i e l d pointed out, the high incidence of tuberculosis among Indian children accounted f o r the high rate among the province's c h i l d r e n . ^ (Table  5*2).  V Another feature of the school medical program was  the introduction of  s p e c i a l d r i l l s , exercises, and treatment f o r children who physical defects.  In 1923,  suffered from  a s p e c i a l exercise program designed to correct  deformities caused by poor posture, poor seating, and poor footwear introduced.  was  Although Dr. White reported on the success of these classes  i n both h i s 1924  and 1930  reports, he d i d not d i s c l o s e either the number  94 of participants or the number of successes achieved By 1932,  the program was redesigned  through exercises.  to provide exercises to correct spine  deformities, chest deformities, p a r a l y s i s of the extremities, and feet.  flat  The appropriate remedial exercises were prescribed by the school  physician and supervised by the school nurse.  Parents were i n v i t e d to be  present f o r the f i r s t treatment, and they were expected to carry on the  141 same exercises at home. '' Although Elizabeth Breeze reported encouraging 9  r e s u l t s from s p e c i a l exercises, i n her 1937  report she did not indicate  96 the number of children p a r t i c i p a t i n g nor the number completing.  Such  classes were not l i m i t e d to the Vancouver school system, but were also held  97 i n other areas of the province.  Although these exercises probably  a l l e v i a t e d physical defects to some degree, some c h i l d r e n appeared to regard exercise time as a pleasant way  to escape the classroom routine.  Endemic goitre was another health problem among children l i v i n g i n goitre prone belts of the province such as the Peace River, Okanagan,  98 L i l l o o e t , Prince George, Vanderhoof, and Lower Mainland areas.  Dr.  H.  B. Maxwell i n s t i t u t e d the regular administration of iodine to Ladysmith  99 school children as a g o i t r e preventive measure.  Vancouver commenced a  s i m i l a r program the same year; with the parent's permission  and payment of  ten cents a year, each c h i l d received one iodine p i l l a week. ing the 1932  100  Follow-  report of 5400 cases of goitre among B r i t i s h Columbia's  school children, the P r o v i n c i a l Board of Health urged iodine be r e g u l a r l y administered,  either i n l i q u i d or chocolate-coated  p i l l form, to those  school children l i v i n g i n the g o i t r e belts of the p r o v i n c e . exists concerning 1937  1 0 1  No record  the number of p i l l s issued, but Dr. White noted i n his  report that 7.349 ten mg.  iodine tables were d i s t r i b u t e d weekly to  102 Vancouver school children.  Was  the treatment effective?  Menzies, P r o v i n c i a l Epidemiologist, stated i n 1933  Dr. A.  M.  that some school  medical inspectors reported excellent r e s u l t s i n reducing the number of 103 cases i n t h e i r areas. Between 1930 and 1936, the percentage of cases of endemic g o i t r e among Vancouver school children decreased from 3»9 104 1.1  percent.  The d i s t r i b u t i o n of iodine p i l l s continued  1940's, when iodine became a standard  u n t i l the  additive to table s a l t .  to  142 VI Although health professionals during the  1920*s  and  1930's  focused  considerable time and energy on improving the physical health of school children, they also worked to improve their knowledge of hygiene and health care.  As Mrs. C. H. Lucas, Nurse Superintendent for .the Saanich  Health Centre pointed out i n Public Health Education i n the Schools (1926), a booklet distributed by the British Columbia Board of Health, teaching 105 health education was a patriotic duty.  ^  Health education, she argued,  would prepare school children, the citizens of the future, to demand proper health care for themselves and their communities. ^ 10  students began high school i n the  1920*s  Because few  and fewer completed high school,  Mrs. Lucas contended that the seventh or eighth grade children should have a good working knowledge of the fundamentals of good health habits and disease prevention. ^ 10  As early as 1 8 9 4 , anatomy, physiology, and hygiene were included among the twenty subjects a teacher candidate must pass to receive a second-class teaching certificate.  Until the Vancouver Normal School  opened in 1 9 0 1 , preparatory classes for a teaching certificate were offered 108  at some high schools.  A review of high school entrance requirements and  high school examinations indicates that lessons focused on anatomy and 109 physiology and not on health care.  '  But from i t s inception in 1 9 0 1 ,  the Vancouver Normal School included lessons in physiology and hygiene in i t s nature study courses.  110  In 1908-09, then Minister of Education  Dr. H. E. Young requested teachers to post a set of health rules in their classrooms f o r the children to see, to teach a series of short lessons on each of the health rules, and to encourage children to observe health rules.  1 1 1  In the same year the Council for Public Instruction provided  free copies of Stowe11's Essentials i n Health for use in high school  classrooms. 112  143 In 1913-14, How To Be Healthy was also recommended and 113  supplied as a reference book f o r use with senior high school students. Although health education was being accomplished d i r e c t l y through classes, the appointment of school nurses and public health nurses brought a d i r e c t approach to health education.  As these nurses made t h e i r regular v i s i t s  to the schools they gave l i t t l e health talks to children after every directed classroom dramas, conducted toothbrush and handkerchief  visit,  drills,  organized essay contests, organized school f a i r s , health pageants and poster contests, a l l designed to educate children i n proper n u t r i t i o n , personal hygiene, and body c a r e . ^ 1 1  In 1925-26, health education became a pre115  scribed course i n public schools.  J  To equip teachers to i n s t r u c t health  education classes, the 1925 p r o v i n c i a l summer school offered a course titled  "Hygiene and C h i l d Health" taught by Vancouver's Head School Nurse,  Elizabeth B r e e z e . ^  Not u n t i l 1927-28 did health education classes 117 become a regular feature of the normal school t r a i n i n g program. 11  The 1925-26 health program focused on each student establishing basic health habits, on developing a p o s i t i v e a t t i t u d e toward personal hygiene and health care, and on developing a sense of r e s p o n s i b i l i t y f o r the health care of others.  N u t r i t i o n , cleanliness of s e l f and  surroundings,  and control of i n f e c t i o u s and contagious diseases were recurring themes throughout the f i r s t eight grades.  Pupils i n grades one to s i x were  taught the need f o r proper r e s t , sleep, fresh a i r , and exercise.  Child-  ren from grades s i x to eight were expected to apply t h e i r knowledge of health p r i n c i p l e s and health care to remedy conditions i n t h e i r homes and 118 communities.  With the curriculum r e v i s i o n of 1928-29, the health program  was redesigned not only to i n s t r u c t children i n health care and  personal  safety, but also: To lead parents and other adults through the health education  144 programme for children to better habits and attitudes, so that the school may become an effective agency for the social aspects of health education i n the family, school and community. 119 Ideally, curriculum editors believed improvement of individual children and adults would promote national health improvement and race betterment.  Although the curriculum guide for  1928-29  continued to stress nutrit-  ion, hygiene, rest, exercise, and disease prevention, i t also included accident prevention and safety education*  Traffic safety received special  attention, probably because of the increase i n the number of automobiles. In addition, classroom teachers of grades one to five were expected to conduct a daily health inspection of their classes, and to focus their health lessons on those habits neglected by their children.  The  1928-29  curriculum guide of health education f o r grade one outlined i n graphic detail the proper way to unfold, blow into, and refold a handkerchief, and 121  By 1 9 2 9 ,  the most efficient way to teach children to use a toothbrush.  the classroom teacher and not the school nurse taught health education classes, conducted handkerchief and toothbrush d r i l l s , and made the daily cleanliness inspections. Following the major revision of the public school curriculum i n  1935i  health education took on a new focus. At that time, a mental health 122  component was added to the existing physical health component.  Health  educationwas no longer concerned onlyrwith children's physical health and safety, but also with their mental, moral, emotional, and social state. To the health workers and educators, the development of a healthy personal123 ity was as important as the development of a healthy body. Ten years before, teachers were teaching children the basic rules for good physical J  healths by 1 9 3 6 , they were exhorted to teach the rules for good mental 124  health.  Included i n the instruction was the concept of personal adjust-  145  ment, which meant \children conformed to the highest social standards, modified by behaviour to meet new situations, cooperated with others,  respected the rights of others, and disciplined themselves at a l l times. Health educators firmly believed mental health care could be taught in the classroom just as physical health had been taught during the previous decade.  The classroom was not the only place children received health education.  During the 1920's and early 1930's, L i t t l e Mother's League classes  constituted a regular part of the school health program for girls between 125  ten and fourteen years of age.  J  The twelve week course, taught by pub-  l i c health, VON, Red Cross, or school nurses, trained adolescent and preadolescent g i r l s how to feed, clothe, bathe, and train a baby. As Nurse Lucas pointed out: The general care of the baby i t s e l f was included, not only his physical care as we ordinarily understand i t , but instruction as . to how to avoid the formation of bad habits, and particularly concerning the necessity of protecting the baby from communicable diseases.126 Upon completing classes and passing a written examination, each g i r l was 127  issued a badge and certificate from the Provincial Board of Health.  '  During the late 1920's and 1930's as Junior Red Cross branches became more numerous in classrooms, and domestic science classes were redesigned to include a child '•care component, responsibility for health education shifted from nurses to classroom teachers.  Consequently during the late  128 1920*s and the 1930's L i t t l e Mother's League classes were discontinued. The Junior Red Cross movement commenced in 1914 as a means for children to participate in the war-time humanitarian work of the Red Cross 129 Society.  At the October 1919,  Cannes Conference of International Red  Cross Societies, the conference resolved to retain the Junior Red Cross as  146 a children's peacetime organization devoted to the promotion of good health and humanitarian ideals, good citizenship, and international friendship.^  0  The Junior Red Gross program was endorsed for school children by  the British Columbia Department of Education in 1922. -* 1  1  This made i t  possible for the classroom teacher to use school time and school f a c i l i t ies in which to operate the program.  Junior Red Cross clubs were classroom based groups operating under the direction of classroom teachers.  For a ten cent membership fee, each  child received a Junior Red Cross membership badge, a membership care on which was printed ten health rules, and a copy of the Junior Red Cross magazine. The health rules taught the .child the need for a nutritious diet, fresh a i r , sleep, exercise, posture, elimination, cleanliness of teeth, body, hands and fingernails, and the way to prevent the spread of diseases through coughing, sneezing, and spitting.  Club activities  encouraged members to develop a wholesome interest i n personal physical development by following specific health rules and hygienic practices. The Junior Red Cross Magazine, colourful posters, playlets and classroom 132 dramas reinforced the club's health teachings.  J  Although the clubs  operated under the direction of classroom teachers, the public health nurse often addressed them on health topics and awarded achievement badges. Was the Junior Red Cross an effective organization?  The essential  element to the success or the failure of the organization was the classroom teacher.  When the teacher was interested, voluntary participation by ;  children seemed to engender an 'esprit de corps'.  Jean Browne, the Nation  a l secretary of the Junior Red Cross, believed the clubs stimulated child134 ren to practice better health habits. ^ in the Fraser Valley noted that*  A public health nurse working  147 With a l l the schools now a f f i l i a t e d with the Junior Red Cross and the new (health) curriculum s t r e s s i n g Health, the children are now r a p i d l y becoming health-conscious and looking back, one can see marked improvement i n the personal hygiene.135  The Junior Red Cross grew and flourished between 1922 and 1 9 3 9 . There were 112 branches with 2280 members by 1928. increased to 202 branches with 4656 members i n 1 9 3 5 .  The organization By 1939-40, the  p r o v i n c i a l membership reached 3 0 , 9 9 9 students representing 2 5 * 7 percent of the province's school population, and forty-four of those branches 137 operated i n high schools.  VII One other area where c h i l d care advisors believed school c h i l d r e n needed education was i n s o c i a l hygiene.  S o c i a l hygiene, or race hygiene,  referred to those "Social-health problems which d i r e c t l y or i n d i r e c t l y 138 have grown out of sex i n s t i n c t . "  Although children were considered  a legitimate instrument to educate parents to better physical health, they c e r t a i n l y were not considered a s u i t a b l e messenger to enlighten parents about s o c i a l or r a c i a l hygiene.  In f a c t , controversy centered  about who should teach sex education, or whether children should be given 139 sex education at a l l .  J . H. Putman and G. M. Weir recognized the need  f o r sex education i n the schools, but acknowledged "that the present state of public opinion makes i t impossible to study t h i s subject i n the 140 public schools."  The membership of the Canadian S o c i a l Hygiene Council  (and many other members o f the community) believed sex education to be the sole r e s p o n s i b i l i t y of parents, which the school should merely supplement by the teaching of nature study and 'kindred subjects' i n the 141 classroom.  Parents who  f e l t unequal to the task could seek information  through pamphlets or books, or encourage the organization of "programmes  1 4 8  of enlightenment..." through organizations such as the Parent-Teacher 142 Association.  Laura Jamieson, Judge of the Juvenile Court of Burnaby  and a member of the Canadian Social Hygiene Council, suggested that for their own edification parents read those authors "who place sex on a high plane - Maude Royden, Edward Carpenter, and the greatest of a l l , 143 Havelock E l l i s . "  v  To help parents achieve this 'higher plane,' the  B r i t i s h Columbia Board of Health re-issued five l e a f l e t s prepared by the National League f o r Health, Maternity and Child Welfare, London, England, entitled, "Some Thoughts f o r Wives and Mothers and Some Teachings to be given to Children by Parents who find i t d i f f i c u l t to put their Thoughts 144 into words."  This material was intended to teach children to 'think  r i g h t l y ' about their wonderful bodies. The five l e a f l e t s included i n the package were, "God Saw That I t Was Good," "The G i f t of L i f e , " "The Temple of L i f e (boys)," "The Temple of L i f e ( g i r l s ) , " and "The Meaning of Love."  These pamphlets certainly informed children about the birds 145  and the bees, but contained l i t t l e information about human sexuality. Unfortunately, the annual Reports of the Board of Health do not indicate how many copies of these pamphlets were distributed nor to whom they were distributed. In the l i t e r a t u r e examined, no reference was made or recommendations given for use of the eight volume "Self and Sex Series."  Published i n  Philadelphia but distributed i n Canada through the o f f i c i a l publisher for the Methodist Church i n Canada, the "Self and Sex Series" was probably the most popular set of sex manuals for sale i n Canada between 1900 and 1915. Canadian historian Michael B l i s s described the series as "A compendium of orthodox sexual knowledge and precept i n late-Victorian and Edwardian Canada." Rather than place sex on a 'higher plane' as suggested by Judge  149 Jaraieson, t h i s series stated that sexuality created d i f f i c u l t i e s f o r  146 a l l ages from childhood to old age.  I f the school was to teach sex, who should do the teaching?  In  1 9 2 6 , Mrs. Lucas stated that sex education must be taught by some s p e c i a l -  147 l y trained person, but c e r t a i n l y not by classroom teachers.  Dr. Harold  White took a very pragmatic approach to health care and sex education; he and the school nurses taught the subject.  Although Dr. White does  not mention h i s annual talk on hygiene and sex to each group of high school boys u n t i l h i s 1 9 2 6 Report, former K i t s i l a n o High School students Ruth Sutton and Frank Hardwick remember Dr. White's t a l k to the boys and Nurse M. Campbell's t a l k to the g i r l s i n 1 9 2 3 and 1 9 2 4 .  The t a l k s ,  they r e c a l l , centered on personal hygiene and physical development; any reference to sex or human sexuality was couched i n extremely oblique 148 terms indeed.  White established a pattern that continued long a f t e r  h i s retirement i n 1 9 4 2 . Health professionals and c h i l d care advisors c e r t a i n l y believed that pre-adolescent students should be taught about human reproduction, sexual development, parenthood, and the sanctity of family l i f e .  Furthermore,  i n 1 9 2 7 Laura Jamieson argued that adolescence was the time i n s t r u c t i o n was to be given "regarding the darker side o f sex, i n order that young  149 people may be safeguarded from sexual disease."  7  Throughout the two  decades, advisors attempted to impress upon youth the permanently d e b i l i t -  15( ating e f f e c t of venereal diseases upon both victims and t h e i r  offspring.  But the major problem with sex education i n schools during the 1 1 9 3 0 ' s  9 2 0 ' s  and  was that discussions about human reproduction, venereal disease,  and b i r t h control were wrapped i n such vague and oblique terms that c h i l d ren probably learned more on the streets or behind barns than they ever d i d  150  in sex education classes.  VIII During the immediate pre-First World War and post-war years, the school assumed more and more responsibility for the moral and ethical education of the school c h i l d .  Some B r i t i s h Columbia advisors maintained  that only the school could provide moral education for the c h i l d who did not attend church or Sunday school, or whose parents were derelict i n their  parental duty.  In a 1918 address to the f i r s t annual meeting of  the Vancouver Child Welfare Association, Wm. Burns, Principal of the Vancouver Normal School, contended that the ultimate end of education (and the duty of the school) was character formation and the development of correct h a b i t s . ^ 1  1  A year l a t e r , V i c t o r i a physician Dr. Ernest Hall  told the second annual convention that the school must assume those res152 p o s s i b i l i t i e s which the home neglects to f u l f i l l .  Not a l l B r i t i s h  Columbians shared that view, for at the same conference Mrs. J . Muir, President of the Parent-Teachers Federation of B r i t i s h Columbia, noted and deplored the tendency for the school to assume the duties of parents for the child's physical, mental and s p i r i t u a l well-being without consulting 153 parents.  The Canadian Churchman, o f f i c i a l organ for the Church of  England i n Canada, declared that i t was the duty of the church to inculcate standards of personal honesty and honour i n children, and to support the family by being certain "never to cast reflections on a child's parents, 154 his b e l i e f s , or his moral sense."  Nevertheless, some educators and  other citizens believed the school should be involved i n developing the child's moral character. The movement to teach moral and ethical values 155 i n the school gained momentum throughout the 1920's. ^  In the December,  1929, issue of The B. C. Teacher, John Ewing, of the Vancouver Normal School, stated that he believed morals should be taught, and that the child's moral  151  character could be developed by both d i r e c t and i n d i r e c t teaching i n the classroom. ^ 15  Mr. T. R. H a l l , Inspector of Schools f o r the Kelowna Dist-  r i c t , t o l d the October, 1 9 3 0 , convention of the Qkanagan Valley teachers that "Modern education was more than the three R's.  The teacher had a  157 very important part to play i n the teaching of ethics and morals."  In  1 9 3 5 , Charles C. Watson, teacher at Point Grey Junior High School, stated i n an a r t i c l e i n The B. C. Teacher that (unnamed) authorities agreed that a strong moral character could be b u i l t within the schools' specialized -j  and controlled environment.  cp  Watson discussed i n d e t a i l the aims and  methods used to achieve character development. Although momentum increased among some educators during the 1 9 2 0 ' s and 1 9 3 0 ' s to have schools assume more r e s p o n s i b i l i t y f o r moral t r a i n i n g , other educators declined to accept t h i s r e s p o n s i b i l i t y .  Miss  M. Harwood, a Summerland teacher, speaking to a 1 9 3 1 meeting of the Women's I n s t i t u t e , deplored the attempt to pass the major task of character b u i l d ing on to the schools and other i n s t i t u t i o n s .  I n s t i t u t i o n s , Miss Harwood  159 declared, could never replace good parenthood.  Another type o f concern  was voiced by Premier T. D. P a t t u l l o i n an A p r i l , 1 9 3 5 , address to the B r i t i s h Columbia Teachers' convention.  P a t t u l l o claimed there was  a  "considerable tendency upon the part of parents to expect the schools to do many of the things that should be done a t h o m e . . . A n d he deplored the f a c t parents were unwilling to accept t h e i r parental r e s p o n s i b i l i t y . As schools assumed more r e s p o n s i b i l i t y f o r the c h i l d ' s moral development throughout the 1 9 3 0 ' s , opposition from parents and the church appears to have declined.  In a 1 9 3 3 address to a Prince Rupert Parent  Teachers  meeting, Rev. Dr. W. D. Grant Hollingworth pointed out there were two i n s t i t u t i o n s which dealt with the c h i l d - the home and the school.  The  152 home and the church were responsible f o r " i n c u l c a t i n g i n t o the mind of the c h i l d those high i d e a l s of C h r i s t i a n l i v i n g which can and motivate a l l ^ehaviour...  should  But, Dr. Hollingworth conceded, as c h i l d r e n  spent more l i v i n g time i n school than i n church, i t was  "In the school  162 they r e a l l y learn to l i v e by l i v i n g . "  Reflecting the philosophy of  American educator John Dewey, Hollingworth stated that i t was the duty of the school to give the c h i l d "what i t needs to know i n order to develop -I  i n t o a well-rounded, happy, e f f i c i e n t c i t i z e n . " By  1 9 3 8 *  go  ^  educators had assumed some r e s p o n s i b i l i t y f o r the moral  education of B r i t i s h Columbia school c h i l d r e n . The curriculum guide f o r junior high schools i n 1 9 3 6  stated that the ultimate goal of education  was character, and the school and the curriculum should be organized to  16b achieve t h i s end.  Moral education ensured development of a good moral  character, and a good moral character manifest i t s e l f i n 'right l i v i n g * based on the a p p l i c a t i o n of high moral p r i n c i p l e s , r i g h t a t t i t u d e s , proper values, and highest i d e a l s .  The concept of 'right l i v i n g ' d i d not develop  during the  Helen MacMurchy, Director of the C h i l d Wel-  1 9 3 0 ' s .  In  1 9 2 3 ,  fare D i v i s i o n , defined 'right l i v i n g * as: To love truth and follow the r i g h t , to do j u s t l y and love mercy, to l i s t e n to conscience, to be u n s e l f i s h , kind and a f f e c t i o n a t e , to fear God and honour the king, to respect and reverence and remember high standards,noble thoughts, and great t r a d i t i o n s of home and service and s a c r i f i c e - these are learned at Mother's knee and from Father's way and world. 1 6 5 In 1 9 2 5 ,  The Canadian Churchman placed a C h r i s t i a n emphasis on i t s def-  i n i t i o n of 'right l i v i n g . '  In addition to the p o s i t i v e q u a l i t i e s l i s t e d  by MacMurchy, the editor emphasized acceptance of f a i l u r e s , the need to bear i l l s with cheerfulness, to replace doubt with hope, to accept sorrows s i l e n t l y , to t r u s t , to pray, and to keep i n mind that r i g h t l i v i n g pleasing i n God's s i g h t . T h e ( 1 9 3 6 )  was  writers of the Programme of Studies  d i d not give the C h r i s t i a n emphasis to 'right l i v i n g ' stated by  153  MacMurchy or by The Canadian Churchman, nevertheless they believed " r i g h t attitudes and i d e a l s furnish the motive f o r r i g h t action and the centre around which the habits of l i f e are i n t e g r a t e d . " ^ 1  I n s t i l l i n g r i g h t attitudes and i d e a l s i n school children  through  textbooks, story books, and organizations f o r children and youths was not i n i t i a t e d during the inter-war years.  Historian Ruth Elson, i n her  book Guardians of Tradition d e t a i l s the process by which p o l i t i c a l , economic, s o c i a l , c u l t u r a l , and moral concepts were presented to nineteenth-century American children through t h e i r school books, a process 168  Elson maintains both created and s o l i d i f i e d American t r a d i t i o n s . B r i t i s h Columbia educators and c h i l d care advisors followed the same approach.  The children were bombarded with s t o r i e s , poems, and a c t i v i t i e s l69 which focused on r i g h t l i v i n g , bravery, honour, and service. Even the graded basal readers were f i l l e d with s t o r i e s and poems of valour, 170 patriotism, truth, and kindness, lauding the Nation and the Empire. Youth organizations such as G i r l Guides, Boy Scouts, and the Canadian G i r l s 171 i n Training embodied r i g h t l i v i n g i n t h e i r creed and programs.  Health  professionals and c h i l d care advisors believed the world would become a better place i f children of the 1920's and 1930's were educated to take care of t h e i r bodies, develop t h e i r minds, and to form a good upright moral 172 character.  As Dr. Young pointed out i n 1 9 2 0 and again i n 1 9 3 5 ,  "Phy173 s i c a l perfection must and does go hand i n hand with s p i r i t u a l welfare." l J  IX Were health professionals and educators successful i n improving the school c h i l d ' s health and i n educating h i s parents  (Table  5»3)?  In  1937,  while gathering information f o r the Royal Commission on Dominion P r o v i n c i a l Relations, the B r i t i s h Columbia Board of Health used the opportunity to  Table 5 . 3 CHILD MORTALITY - PROVINCE OF BRITISH COLUMBIA AGES BIRTH TO 1 9 YEARS.  4  1923 - 1939 T o t a l Deaths of Children  Total Deaths  245  1291  4997  25.83  137  247  1220  5004  24.38  39  117  215  1151  4945  23.27  42  47  119  238  1290  5474  23.56  91  59  45  136  321  1342  5750  23.33  83  70  40  163  293  1212  5910  20.50  575  118  52  44  39 48  157  311  1305  6397  20.40  1930  562  :83  44  48  30  146  279  1192  6400  18.62  1931  514  89  37  44  37  125  280  1126  . 6114  18.41  1932  477  67  44  27  32  127  254  1030  6150  16.74  1933  439  70  38  35  89  261  —  —  6221  —  1934  562  83  44  48  40  146  279  1202  6400  18.78  1935  460  82  48  33  31  98  242  994  6857  14.49  1936  465  71  30  38  26  110  258  998  7222  13.81  1937  630  136  62  32  32  148  280  1320  7973  16.55  1938  556  61  56  38  27  112  253  1108  7450  14.80  1939  483  47  41  27  22  92  256  ,968  7517  12.87  1  2  Year  Years  Years  110  68  36  547  104  61  1925  569  110  1926  688  1927  Year  Under 1 Year  1923  668  1924  3  5-9  10-19  Years  Years  28  136  50  46  62  39  106  50  561  129  1928  524  1929  SOURCE!  Years  B r i t i s h Columbia Board of Health, Report, 1 9 1 9 - 1 9 3 9 ; B r i t i s h Columbia Department of V i t a l S t a t i s t i c s , Report, 1 9 2 7 - 1 9 3 9 .  Percentage of Deaths  155 send questionnaires r e l a t i n g to the school health program to every board of school trustees i n the province.  Dr. Young reported "We  asked them  to give us t h e i r opinion of the work i n general and the r e s u l t s obtained, Young then incorporated responses i n t o h i s own inspections i n schools.  m  annual report of medical  The trustees unanimously agreed that the  province  school children were generally healthier than before the provision of health services as evidenced by fewer epidemics of contagious diseases and l e s s absenteeism.  Physical defects were corrected e a r l i e r and  ions treated before they spread.  infect-  Trustees also believed school c h i l d r e n  were more health conscious than t h e i r predecessors had been.  One  board  stated "the betterment of health conditions i n the school i s r e f l e c t e d i n 175 the general well-being of the community." children were healthier now  J  The trustees believed  than formerly; one board stated that "Mothers  176 are educated i n the better care of c h i l d r e n . "  Young concluded that  responses to h i s questionnaire indicated "that the public are e n t i r e l y s a t i s f i e d with these r e s u l t s which w i l l bring about, of course, further 177 extension of the work," As l a t e as 1 9 3 7 » he continued to see schools as the agency through which to educate parents. We have centered our public-health teaching-work on the populace, using the schools as a basis. I t i s the best approach to the home, and the counsel given the parents i s i l l u s t r a t e d by the children of the family as examples of what can be done when the rules and regulations of the improvement of the d a i l y l i f e of the p u p i l i s shown.178  By 1939» health and health education focused not only on the physical care of the i n d i v i d u a l c h i l d , but also on b u i l d i n g wholesome attitudes and a s o c i a l conscience that advisors believed would lead to the betterment of l i f e i n both home and community.  156  Footnotes 1 "Women's I n s t i t u t e Hold Convention," Vernon News, Nov. 6, 1 9 1 9 » p. 11; M. A. Twiddy, "A C h i l d Study Group," Public Health Nurses B u l l e t i n , 2 (Mar. 1 9 3 8 ) , 4 9 , (hereafter PHNB); Elizabeth Breeze, "School Nursing," i b i d . , 1 (Oct. 1924), 5 ; Olive Garrood, "Public Health Nurses and Education," i b i d . , 2 (Mar. 1 9 3 7 ) , 17; B r i t i s h Columbia, Public School Report, 1920-21, p. F42. 2  E i l e e n Carruthers, "Discussion Groups f o r Mothers," PHNB, 2 (Apr. 10; see also Jessie Foreshaw, "How C h i l d Welfare Work Can Be Assisted i n B r i t i s h Columbia," Canadian Public Health Journal, XII (June 1 9 2 1 ) , 285, (hereafter CPHJ); Vancouver Board of Health, Report, 1 9 2 5 , p. 24, (hereafter VBH). 1935),  3 "How To Take Care of the Children," (Department of Health, Ottawa: King's P r i n t e r , , 1 9 2 3 ) , p. 3 6 ; Olive Garrood, "Education and Public Health," B u l l e t i n of the B r i t i s h Columbia Board of Health, 4 (Sept. 1 9 3 4 ) , 158, (hereafter BBCBH); Foreshaw, "How C h i l d Welfare Work Can Be Assisted i n B r i t i s h Columbia ;"pp. 283-288; "Better School Health Program," BBCBH, 1  3(Aug. 1 9 3 3 ) , 1 0 5 .  4 BCBH).  B r i t i s h Columbia Board of Health, Report, 1920, p. A5, (hereafter  5  I b i d . , p. A7.  6  I b i d . , 1911, p. M7; VBH, Report, 1928, p. 24.  7  B r i t i s h Columbia, Statutes, 1 9 1 0 , "School Health Inspection Act."  8 Ibid.;"Guide f o r the Use of Teachers and Medical Inspectors of Rural and Assisted Schools," BCBH, 1 9 1 3 . 9  BCBH, Report, 1921, p. M3; I b i d . , 1 9 1 3 , p. P5.  10  I b i d . , 1 9 3 7 , p. H3.  11  I b i d . , 1 9 1 1 , p. M3; i b i d . , 1920, p. Al6; i b i d . , 1 9 3 9 , p. A l 6 .  12 "The Death of Henry Esson Young," BCBH, Report, 1 9 3 9 , pp. CC7-8; "Guide f o r the Use of Teachers and Medical Inspectors o f Rural and Assisted Schools," BCBH, 1913. 13 F. W. Andrew, "Medical Inspection o f School Children," Women's I n s t i t u t e Quarterly, 11 (Oct. 1 9 1 6 ) , 9 - 1 3 . 14  Ibid., p. 9 .  15 I b i d . , p. 10; see also N e i l Sutherland, Children i n English Canadian Society; Framing the Twentieth Century Consensus (Toronto: University of Toronto Press, 1 9 7 6 ) , pp. 4 2 - 5 1 ; George Rosen, "A Healthier World," i n The Nation's Children: The Family and S o c i a l Change by E l i Ginzberg, ed., (New York: Columbia University Press, I 9 6 0 ) , pp. 9-10. 16 Andrew, "Medical Inspection of School Children, p. 11; "Congress of Farm Women, 1912," Report of the Advisory Board of the Women's I n s t i t u t e ,  Footnotes (Vict eugen Oct. the E  157  o r i a : K i n g ' s P r i n t e r , 1913)» P « 43. A r e p o r t o n t h e n e w s c i e n c e o f i c s was made t o t h e I n t e r n a t i o n a l C o n f e r e n c e o f F a r m Women, L e t h b r i d g e , 1912; C a r o l B a c c h i , " R a c e R e g e n e r a t i o n a n d S o c i a l P u r i t y : A S t u d y o f n g l i s h - S p e a k i n g S u f f r a g i s t s , " Hi#i^^SociaIe7social H i s t o r y , X I  ( N o v . 1978), 460-474.  17 A n d r e w , " M e d i c a l I n s p e c t i o n o f S c h o o l C h i l d r e n , " p . 9; B C B H , 1921, p . B7; C a r r u t h e r s , " D i s c u s s i o n G r o u p s F o r M o t h e r s , " p p . 10-11. 18  BCBH, Report,  1908, p .  19  British Columbia,  Report,  G5.  Public Schools Report,  1908-09, p p . A66-6?.  20 B C B H , R e p o r t . 1913, p . S5; s e e a l s o " C h i l d H e a l t h , " C h i l d W e l f a r e N e w s , 1 ( A u g . - O c t . 1924), 5-6. 21 B r i t i s h C o l u m b i a , P u b l i c S c h o o l s R e p o r t . 1902-03, p p . V 4 0 - 4 1 ; i b i d . , 1911-12, p . A 5 2 ; i b i d . , 1927-28, p . V49; H e l e n G r i e r a n d F r a n k Hardwick, former students and former i n s t r u c t o r sa t t h e Vancouver Normal School. 22  British Columbia,  23  BCBH, Report,  24 BCBH, Report. 1928, p . 24.  Public Schools Report,  1924-25, p p . M 6 9 - 7 0 .  1911, p p . M7-10; V B H , R e p o r t , 1927, p . K T ? ; i b i d . ,  1928, p . 24.  1911, p p . M ? - 1 0 | V B H ,  Report.  25 E l i z a b e t h B r e e z e , " S c h o o l N u r s i n g , " P H N B , 1 ( O c t . 1924), 4; C o l u m b i a , S u r v e y o f t h e S c h o o l S y s t e m b y J . H. P u t m a n a n d G. M .W e i r t o r i a : K i n g ' s P r i n t e r , 1925), p . 48.  British (Vic-  " S c h o o l N u r s i n g , " p p . 4-5.  26  Breeze,  27  BCBH, Report,  28  L y l e Creelman,  29  BCBH, Report,  1911, p . Ml4; V B H , R e p o r t ,  1924, p . 24.  " R v e l s t o k e R e f l e c t i o n s , " P H N B , 2 ( M a r . 1937), 13. e  1920, p . Al6; i b i d . ,  1923, p . E 1 3 .  30 V B H , R e p o r t , 1920, p . 23; f o r d e t a i l s h o w W o o d ' s t a b l e s w e r e a p p l i e d s e e S . J o s e p h i n e B a k e r , C h i l d H y g i e n e ( N e w Y o r k : H a r p e r , 1925), p p . 418-421. 31 V B H , R e p o r t , 1920, p . 23; T h o s . D . W o o d , " W e i g h t - H e i g h t - A g e Tables for Boys (Girls) School Age," P r i n t e d by the Iowa C h i l d Welfare Research S t a t i o n , S t a t e U n i v e r s i t y , I o w a C i t y , I o w a , n . d . ( c i r c a 1918), d i s t r i b u t e d by t h e N a t i o n a l E d u c a t i o n a l A s s o c i a t i o n , The C h i l d Health O r g a n i z a t i o n and the Bureau o f Education o f t h e United States Department o f t h e Interior; see a l s o G e o r g e R o s e n , A H i s t o r y o f P u b l i c H e a l t h (New Y o r k : M.P. P u b l i c a t i o n s , 1958), p . 369; D r . W . A . E v a n s , " H o w T o K e e p W e l l , " T h e V a n c o u v e r P r o v i n c e , O c t . 1, 1921, f o r s c a l e o f N a t i o n a l C h i l d O r g a n i z a t i o n b a s e d o n a g e , r a c i a l stock, and family peculiarities. 32 V B H , R e p o r t , 1920, p . 23; s e e a l s o " D o Y o u K n o w H o w T o F e e d Y o u r C h i l d ? " T h e C a n a d i a n C h u r c h m a n , N o v . 19, 1925, p . 753; " M o t h e r a n d B a b y , "  Footnotes 158  The Family Herald and Weekly Star, Nov. 7, 1923. p. 29; "Milk f o r the School Child," i b i d . , Oct. 9, 1928, p. 37. 33 "Rural School Children Not So Healthy As Believed," Vernon News, Nov. 4, 1920, p. 11, c i t i n g the work of Dr. Thos. D. Wood, Health Problems i n American Public Schools, National Educational Association Proceedings, 1914,  pp. 294-301.  34 "Rural School Children Net So Healthy As Believed," p. 11; BCBH, Report, 19l6, p. 122; see also Jean Dunbar, "School Nursing i n a Mining Town," PHNB, 1 (Apr. 1926), 17-18. 35  BCBH, Report, 1923, p. E12; VBH, Report, 1922, p. 21.  36 Helen Hartley, "Toothbrush D r i l l and Handkerchief D r i l l , " Public Health Nurse, 1918; BCBH, Report, 1923, p. Q17s i b i d . , 1925, p. N10. 37 "School Dental C l i n i c s Doing Good Work but More Urgently Needed," The Vancouver Sun, Oct. 3, 1921, p. 13; VBH, Report, 1939, p. 17. 38 Women's Institute of B r i t i s h Columbia, Yearbook, 1923-24, pp. 22, 30, 35; BCBH, Report, 1938, p. 3; "Rural Dental C l i n i c s , " Child Welfare News,  2 (May-July 1924), 5-8. 39  BCBH, Report, 1936", p. K54.  40  Ibid., 1937, PP. H8, M36-37.  41  "School Dental C l i n i c Doing Good Work," p. 13.  42  VBH, Report, 1924, p. 24.  43  B r i t i s h Columbia, Public Schools Report, 1924-25, p. M44.  44  BCBH, Report, 1924, p. Ql?.  45  VBH, Report, 1921, p. 24; i b i d . , 1924, p. 24; i b i d . , 192?, p. 24.  46  VBH, Report, 1921, p. 21.  47 Ibid., 1925, p. „24; B r i t i s h Columbia, Public Schools Report, 1924-25, p. M24. 48 BCBH, Report, 1932, p. Y4; J . W. Macintosh, "Smallpox i n Vancouver, Preliminary Report," CPHJ, XIII (Mar. 1932), 144-145. 49  VBH, Report, 1929, p. 24; i b i d . , 1930, p. 24; i b i d . , 1939, p. 19.  50 "The Curse of Vaccination," The Vancouver Sun, Sept. 13, 1926; BCBH, Report, 1925, p. N8; see also H. Dyer, "The Troubles and Risks from Modern Attempts to Check the Spread of Infectious Diseases i n Schools," BCBH, Report, 1914, pp. 656-5?. 51 "Letters To The Editor," The Vancouver Sun, Oct. 1, 1926; i b i d . , Oct. 6, 1926.  Footnotes  159  52  BCBH, Report, 1921, p. A8.  53  Ibid., 1925, p. M2.  54  Ibid., p. M33.  55  Ibid., 1937, P. H5.  56  VBH, Report, 1939, P. 19.  57  BCBH, Report, 1920, p. A l l ; i b i d . , 1926, p. M i l .  58  Ibid., Reports, 1940 to 1957.  59  Ibid., 1932, p. Y14.  60  Rosen, A History of Public Health, p. 337.  61  VBH, Report, 1926, p. 24; BCBH, Report, 1928 29, P.  62  VBH, Report, 1926, p. 24; i b i d . , 1939, P. 23; i b i d . , 1934, p. 28.  T  U23.  "Toxoid Treatment For Young Babies," The Vancouver Province, Jan. 63 8, 1938, e d i t o r i a l page. 64 "Case Against Toxoid," i b i d . , Jan. 15, 1938. Letter to the Editor signed by Vancouver physicians E. F. Fridlefson, N.F. McConnell, A. S. Murphy. 65  BCBH, Report, 1 9 3 0 - 3 1 , P- B7.  66  Ibid., 1933, p. Z4.  67  Ibid., 1939, P. GC8.  68  Rosen, A History of Public Health, pp. 38-39.  69 Ibid., pp. 384-390; see also Arthur Newsholm, Evolution of Preventive Medicine (Baltimore: Williams and Wilkins, 1 9 2 7 ) , p. 217. 70  BCBH, Report, 1914, p.  71  Ibid., 1917, PP. H8-9; i b i d . , 1914, pp. UlO-11.  72  Ibid., 1917, P. H-8-9.  73  Ibid., 1 9 1 8 , p. G17.  74  Ibid.  75  Ibid.,  76  Ibid., p. G188.  77  Ibid.,  1918,  .1924,  pp.  U10-11.  G179-197.  pp. ,Q15-16.  1 6 0  Footnotes 78  B r i t i s h Columbia, Statutes, 1 9 1 1 , "An Act to Amend the Health Act."  79 J . T. Marshall, "The Development of Public Health i n B r i t i s h Columbia," CPHJ, XXV (Aug. 1 9 3 4 ) , 366-36?; BCBH, Report, 1 9 2 4 , pp. Q 1 4 - 1 5 , Q24.  80  BCBH, Report, 1936, pp. M9-10; i b i d . , 1939, p. E31.  81  Ibid. , 1924, pp. Q15-16.  82  Ibid. ,  83  Ibid. , 1936, pp. M9.  84  Ibid. , p. M35? i b i d . , 1937, P. H5.  85  Ibid. , 1938, p.  1935,  P.  86 Ibid. , 1935, P. i b i d . , 1937, p. 15.  FF25.  HH4. FF25?  VBH, Report, 1937, p. 22; i b i d . , 1937, p. 16;  87 "T.B. Test i n City Schools," The Vancouver Province, Sept. 12, 1938? VBH, Report, 1938, p. 16? i b i d . , p. 15.  88  Ibid.  89 "Public Health Services i n B. C," The Colonist, Oct. 4, 1934? "The Baby C l i n i c , " Chatelaine, Nov. 1937, p. 53? i b i d . , Sept. 1938, p. 4 6 ; i b i d . , May 1939, p. 76.  90  BCBH, Division of TB Control Report, 1925, p. Nl6.  91  BCBH, Report, 1925, p. Nl6; i b i d . , p. N58.  92  BCBH, Division of TB Control Report, 1939, P- CC28 .  93  Ibid., 1943, p. C96.  94  VBH, Report, 1923, p. 24; i b i d . , 1930, p. 23.  95 Ibid., 1923, p. 21; Ruby Simpson and G. Hanna, "Corrective Physical Education," CPHJ, XXIII (Mar. 1932), 141. 96  VBH, Report, 1937, p. 15»  97 BCBH, Report, 1921, p. B?; i b i d . , 1929, p. U26; Olive Garrood, "Annual Report of Public Health Nurse," BBCBH, 7 (Sept. 1937), 205; M. A. Twiddy, "Physical Welfare of Children," i b i d . , 4 (Dec. 1934), 192. 98  BCBH, Report, 1934, p. Z l l .  99  Ibid., 1926, p. M18.  100  VBH, Report, 1926, p. 24.  161 Footnotes 101 "Endemic Goitre," BBCBH, 2 (June 1932), 73; see also "Endemic Goitre Prophylosis," i b i d . , (Sept. 1932), 107; "The Baby C l i n i c , " Chatelaine, Sept. 1926, p. 52. 102  VBH, Report, 1939, p. 22.  103  BCBH, Report, 1933, P. Z4.  104 B r i t i s h Columbia, Public Schools Report, 1936-37, P» 156; VBH, Report, 1937, p. 22. 105 C. A. Lucas, Public Health Education i n the Schools, BCBH, 1926, PP. 3-13. 106  Ibid.  10? B r i t i s h Columbia, Public Schools Report, 1919-20, 6,636 of 57,104 students; i b i d . , 1923-24, 9,562 of 92,204 students. 108 "A H i s t o r i c a l Resume of Teacher-Training i n B r i t i s h Columbia," B r i t i s h Columbia, Public Schools Report, 1927, pp. V40-41. 109 Acxxx.  B r i t i s h Columbia, Public Schools Report, 1901-02, pp. Acv, A c x i i ,  110  Ibid., pp. V40-41; i b i d . , 1911-12, p. A52.  111  Ibid., 1908-09, pp. A64-71.  112  Ibid., p. A77.  113  Ibid., 1913-14, p. A15.  114 I . M. Jefferles, "School Health Fairs," PHNB, 1 (Oct. 1929), 6; see also Amy A. Lee, "Revelstoke - A New Service," i b i d . , 1 (Mar. 1932), 48; BCBH, Report, 1930, p. R43; i b i d . , 1922, p. 137; VBH, Report, 1926, p. 24; see also "Convention Notes," PHNB, 1 (Oct. 1924), p. 7, Child Welfare Section of the National Organization of Public Health Nursing recommended much of the health-training be given to teachers. 115 Programme of Studies f o r Elementary Schools, 1925-26, pp. 16, 24, 32, 39, 52-53, 64-65, 74-75, 86. 116  B r i t i s h Columbia, Public Schools Report, 1924-25, pp. M69-70.  117  Ibid., 1927-28, p. V49.  118 Programme of Studies f o r Elementary Schools, 1925-26, pp. l 6 , 24, 32, 39, 52-53, 64-65, 74-75, 86. 119 Ibid., 1928-29, pp. 103-109; Programme of Studies Junior High Schools, 1927-28, p. 35. 120  Ibid.  162  Footnotes 121  Programme of Studies f o r Elementary Grades, 1928-29, pp. 18-19.  122  Ibid., 1936, pp. 4-41.  123  I b i d . , pp. 16-17.  124  Ibid.  125 C. A. Lucas, " L i t t l e Mother's League Glasses as Conducted i n Saanich area Period Five Years," PHNB, 1 (Apr. 1927), 8-10. Classes were held i n V i c t o r i a , Ladysmith, Qualicum, Nanaimo, Fernie, Vancouver and Kamloops} Olive M. Garrood, "Public Health i n Kamloops," i b i d . , 1 (May 1930), 26-29; VBH, Report, 1919, p. 19 notes l l 6 meetings of the L i t t l e Mother's League; Canadian Red Cross, B r i t i s h Columbia Division, Report, 1922, p. 13. 126  Lucas, " L i t t l e Mother's League...," p. 9.  127  BCBH, Report, 1922, p. B7 .  128 E l s i e Groves Benedict, "The Contribution of the Junior Red Cross to Public Health," CPHJ, XVII (July 1927), 322-330; Lucas, Public Health Education, p. 4; "Junior Red Cross," The B. C. Teacher, XII (Feb. 1933), 21-22. 129 Jean Browne, Papers and Proceeding., of the Conference on C h i l d Welfare, 1923, p. 71. 130 "Recommendations and Resolutions. Committee of Red Cross S o c i e t i e s , Cannes Conference, 1919," CPHJ. XI (Apr. 1920), 154. 131 P. 73.  Browne, Papers and Proceeding of the Conference on C h i l d Welfare,  132 Jeane Browne, "News of National Voluntary Agencies," CPHJ, XIX (Mar. 1928), 145; "Contributions of Junior Red Cross to Health," i b i d . , XIX (Feb. 1931), 99; "The Junior Red Cross: An Idea Whose Time Has Come," i b i d . , XXX (Jan. 1939), 20-23; Ruth Witbeck, " P r a c t i c a l Citizenship as Taught at Tecumseh School," The B. C. Teacher, XVI (June 1936), pp. 17-19. 133  Garrood, "Public Health Nurses and Education," p. 17.  134  Benedict, "The Contribution of the Junior Red Cross to Public Health,  135  J . M. Arnold, "Matsqui-Sumas-Abbotsford Demonstration Area," BBCBH,  136  Canadian Red Cross Society, Report, 1928; i b i d . , 1934-35.  137  B r i t i s h Columbia, Public Schools Report, 1939-40, p. B29.  PP. 323-324.  2 (Mar. 1937), 7.  138 Lucas, Public Health Education i n the Schools, p. 7s see also Dr. Ernest H a l l , "Social Disease and the Need f o r Education," C h i l d Welfare Association of Vancouver, Report, 1919, pp. 52-53.  163  Footnotes  139 Laura E. Jaraieson, Sex Education In the Child Welfare Program, BCBH, 1936, (A paper read before the Vancouver Conference on Child Welfare, 1927); Survey of the School System, pp. 51-52; "For Parents - When and How to T e l l the Children," BCBH, 1922. 140  Survey of the School System, p. 531.  141 Jamieson, Sex Education i n the Child Welfare Program, pp. 3-7S Child Welfare Association of B r i t i s h Columbia, Report, 1918, p. 4. Dr. Ernest H a l l , V i c t o r i a , advocated children be instructed i n sexual matters by the parents and the school program supplement the teaching of the home. 142 Lucas, Public Health Education i n the Schools, p. 7; How To Take Care Of The Children, (Department of Health, Ottawa, King's Printer, 1923), p. 40.  143  Jamieson, Sex Education In the Child Welfare Program, p. 5«  144 "Some thoughts for Wives and Mothers and some Teachings to be given to Children by Parents who f i n d i t d i f f i c u l t to put their own Thoughts into Words," BCBH, 1936 (by permission of the National League f o r Health, Maternity, and Child Welfare, London, England). 145  Ibid.  146 Michael B l i s s , "'Pure Books on Avoided Subjects': Pre-Freudian Sexual Ideas i n Canada," i n Studies i n Canadian Social History, by Michael Horn and Ronald Sabourin, eds. (Toronto: McClelland and Stewart, 1974), pp. 326-346. 147 Lucas, Public Health Education i n the Schools, p. 7, Survey of the School System, p. 52. 148 VBH, Report, 1926, p. 24; former Kitsilano High School students Ruth Sutton and Frank Hardwick. 149  Jamieson, "Sex Education i n the Child Welfare Program," p. 6.  150 BCBH, Report, 1920, p. A7; i b i d . , 1926-2?, p. K3; Child Welfare Association of B r i t i s h Columbia, Report, 1918, p. 4. 151  Child Welfare Assocation of B r i t i s h Columbia, Report, p. 4.  152 Dr. Ernest H a l l , "Social Disease and the Need for Education," i b i d . , 1919, p. 5. 153 Mrs. J . Muir, "Parents Responsibility," B r i t i s h Columbia Child Welfare Assocation, Report, 1919, p. 41. 154 "Mental Care For Your Child," The Canadian Churchman, Nov. 5. 1925, pp. 721, 730. 155 David Purpel and Kevin Ryan, Moral Education....It Comes With The Territory (Berkley: McCutchon, 1976), pp. 3-10; see also Wilson R i l e s , "Role of the School i n Moral Development," Proceedings of the 1974 Educational  164 Footnotes Service Conference, pp. 69-79» Proceedings, The National Conference on Character Education i n Relation to Canadian Citizenship, (Winnipeg, 1919)• 156 John M. Ewing, "Can Morals Be Taught?" The B. C. Teacher, IX (Dec. 1929), 7-11; "The Highest Morality Shall Be Inculcated," i b i d . , XII (Feb. 1933), 19-21; Angelo P a t r i , "School Service," Family Herald and Weekly Star, Sept. 2, 1931, P. 30. 157 "Splendid Addresses Feature Valley Teacher's Convention," Vernon News, Oct. 23, 1930, p. 3; see also Harry McKown, Character Education (New York: McGraw-Hill Co., 1935). 158 Chas. C. Watson, "The Development of Character: I t s relation to Education," The B. C. Teacher, XIV (June 1935), 10-15; T.D. Pattullo, "Education as a Public Service," i b i d . , XIV (May 1935), 4. 159  Miss M. Harwood, How Parents Can Help Teachers, BCBH, 1931, P. 5«  160  Pattullo, "Education as a Public Service," p. 4.  161 "Strong Plea on Behalf of Youth, at Prince Rupert Parent-Teacher Meeting," Evening Empire, Sept. 21, 1933, PP« 1-2; "Sees Real Emergency," The Prince Rupert Daily News, Sept. 21, 1933, PP» 1, 4. 162  Ibid.  163  "Strong Plea on Behalf of Youth," p. 2.  164  Programme of Studies, 1936, p. 8 .  165  How To Take Care of The Children, p. 39.  166  "Right Living," The Canadian Churchman, Nov. 19, 1925, cover.  16?  Programme of Studies f o r Junior High Schools, 1936, p. 253.  168 Ruth M i l l e r Elson, Guardians of Tradition (Lincoln: University of Nebraska, 1964). 169 K. E. Barlow, "Teaching Courage," The B. C. Teacher, VIII (May 1929), 37-38; "The L i t t l e Boy Who Didn't Like To Work," Star Weekly, Oct. 4, 1919, p. 10; Carolyn Cornell, "Canada's V i c t o r i a Cross Heroes," Star Weekly, Oct. 4, 1919, (weekly series); "The Maple Leaf Club," Family Herald and Weekly Star, (a weekly feature page). 170 High Roads to Reading (Toronto: W. G. Gage); "Build Character By Reading Only Best Literature," Vernon News, Oct. 27, 1932, p. 1. 171 "'Development of Character - Keystone of Guide Work,' Lady Baden Powell," The Vancouver Sun, Oct. 6, 1922, p. 22; "Canadian G i r l Guides," Canadian Child Welfare News, 1 (Jan.-Apr. 1926), 26; The Handbook of Child Welfare Work i n Canada, p. 8. 172 "What W i l l Happen When the Boy I s Father To The Man?" Vernon News, Oct. 14, 1925, p. 11. (Address by Dean Coleman, U.B.C. to the Okanagan  Footnotes teachers' convention). 173  BCBH, Report. 1 9 2 0 , p. A 1 5 ; ibid., 1 9 3 5 . P.  174  Ibid., 1 9 3 7 , P. H4.  1 7 5  I^ii.  176  Ibid.  177  Ibid.  178  Ibid.  H5.  166  Chapter 6  Advising the Parents:  A Preventive Measure  I The c h i l d i s the asset of the State, and a l l conditions should be arranged as far as possible to get the best results from that c h i l d . I t (child welfare) i s a business transaction, and results are what we are looking for i n a l l business transactions. We do not want i n f e r i o r products turned out that may or may not answer the purpose, but as perfect a thing as can be produced - something to be proud of; something with s t a b i l i t y and quality, that can be used for the purpose of development and advancement and f j r protection, i f need be, of the State to which i t belongs. This statement by Dr. Isabel Arthur of Nelson i n an address to the 1917 meeting of the B r i t i s h Columbia health officers expressed the attitude that many social reformers i n industrialized countries have expressed for the past century.  These reformers, motivated by p o l i t i c a l , economic,  and humanitarian considerations, and armed with developments i n both social and health sciences, devoted considerable time and energy to improving the care and rearing of children.  Research i n medical science  and studies i n c h i l d development provided health professionals and c h i l d care advisors with better techniques for health care, more effective methods of disease prevention, and a greater understanding of the developmental processes and specific needs of the c h i l d .  Armed with this know-  ledge, a concerted effort was made to produce a child who was an asset to the state.  B r i t i s h Columbia social reformers during the post-First World  War period worked to provide an appropriate environment i n which the c h i l d could grow and develop.  Advisors used two approaches to accomplish their goals.  F i r s t , they  i n i t i a t e d health care and c h i l d care programs and coordinated the efforts of existing social agencies into more effective services. Second, they disseminated health care and child rearing information to parents. In an effort to provide appropriate health care services i n the immediate post-First World War period, the B r i t i s h Columbia Board of Health, assisted  167 by the B r i t i s h Columbia Division of the Red Cross and the Women's Insti t u t e , organized and expanded public health services throughout the province.  Although the province's public health service provided diverse types  of care and treatment designed to reach a l l age groups and a l l segments of B r i t i s h Columbia society, specific programs such as well baby c l i n i c s and school medical inspection programs were directed towards children.  Addit-  ionally, programs of numerous small philanthropic agencies were reorganized and coordinated into larger and more effective associations such as the B r i t i s h Columbia Child Welfare Association, because such associations were able to provide help and care to a wider segment of the province's children than they had been able to offer individually.  Simultaneously,  at the community l e v e l , women's organizations, service clubs, and community associations coordinated their efforts to provide needed and effective l o c a l health and c h i l d care programs.  In short, i n response to their  vision of B r i t i s h Columbia as a growing and thriving province and the c h i l d as i t s future c i t i z e n , B r i t i s h Columbia's p o l i t i c a l leaders, health professionals, and other concerned c i t i z e n s worked to provide health and child care services they believed essential to produce strong c i t i z e n s for the future.  But the provision of health care and c h i l d care services was only part of the process; advisors also directed their energies towards disseminating child care and c h i l d rearing advice to B r i t i s h Columbia's parents.  Advisors believed the key to producing a healthy, happy, productive  c i t i z e n lay i n convincing parents to abandon traditional c h i l d rearing practices and to adopt the new systematic, highly regimented, s c i e n t i f i c approach to c h i l d care.  Science, they argued, had provided  greater  efficiency and effectiveness i n both industry and the school system, and medical science had effected the control and prevention of some diseases,  168  therefore, the s c i e n t i f i c method should also be u t i l i z e d to improve c h i l d 2 care and c h i l d rearing practices. Parents were assured that i f they adopted the new s c i e n t i f i c methods of feeding, caring, and t r a i n i n g their c h i l d , they would prevent or at least reduce the major causes of infant and c h i l d mortality. Health professionals were so diligent i n their efforts and so convincing with their message that, by 1939,  most advisors  and many parents no longer assumed a child's survival rested i n the providence of God, but rather depended on secular science.  Advisors  claimed the steadily declining infant and c h i l d mortality rates were prodf of the effectiveness of the new health care and c h i l d rearing techniques. Between 1920  and 1939,  the mortality rate i n B r i t i s h Columbia for infants  under one year of age declined from 73«6 to 39*0 per thousand l i v e births; from 14.0 percent of 6.4 percent of t o t a l deaths.  Furthermore, the  mortality rate for children under twenty years of age declined just as dramatically from 25.8 percent of t o t a l deaths i n 1923  to 12.8  1939.  in  To strengthen their argument for the effectiveness of the s c i e n t i f i c approach, public health workers pointed to the steady decline i n the number of reported cases of infectious and communicable diseases such as diphtheria and smallpox, and school o f f i c i a l s pointed to the increased percentages of pupil attendance i n the province's schools as the d i r e c t result of less i l l n e s s among school children. Although advisors attributed the decline i n both mortality and morbidity rates to parents adopting  new  approaches to c h i l d care, credit must also be given to improved sanitation, purer milk, cleaner water, immunization, vaccination, and the a v a i l a b i l i t y of health services.  Advisors devoted considerable time and energy to improving the physical health of the c h i l d , for they believed there was a close relationship between a healthy body, a good mind, and an upright moral character,  169 therefore, by extrapolation, improving the health of the province's children would improve British Columbia society i n general.  If diseases  such as smallpox, diphtheria, and typhoid could be prevented or at least controlled through education and the application of scientific principles, then social diseases such as poverty, indolence, apathy, and sexual immorality could also be prevented or at least controlled by the same 3  methods.-' Health education, through the public school system, health care programs, the distribution of printed materails, and the use of mass public media was deemed to be the most effective way to "arouse the Jx  apathetic and enlighten the ignorant and prejudiced."^  With the expanding  body of knowledge available through medical research and the child study movement, with the growing number of helping professionals ready to assist children and advise parents, and with the increasing reliance on education as the panacea for society's problems, the school system increasingly assumed more and more responsibility for health education, moral training, and character education.  Training i n these areas, which had once been  the prime responsibility of the home and the church, became a prescribed area i n the public school curriculum.  Additionally, character training  and moral education i n the school was supplemented by programs of associations such as the Junior Red Cross, Canadian Girls i n Training, and the Boy Scouts. The tendency of public health services to focus on providing health care for the child, coupled with the proliferation of studies i n child growth and development by the Child Study Movement i n both the United States and Eastern Canada during the inter-war years brought a rapid i n crease i n the number of helping professionals associated with child health and child care services.  Amateur child care advisors, such as religious  specialists and untrained but concerned social workers, were replaced  170 by child psychologists and trained social workers wh6?>provided specialized care for the child.  Paramount among these professionals was the  medical advisor, a position achieved because, for the f i r s t time i n history, medical science could provide the kind of care that greatly enhanced the child's chances for survival.  The aura of the medical expert, either by  inference or by image, was utilized by both health professionals and commercial outlets to advise parents on such diverse topics as selecting proper food, clothing, soap, and laxatives.  Furthermore, reports of many  health professionals of the 1920's and 1930's indicate that they were f u l l y convinced they were more knowledgeable about children and child rearing than were parents.  Because they believed they possessed superior  knowledge, many advisors approached parents i n an authoritarian and dictatorial manner, insisting parents adopt the child care and child rearing practices and methods advisors considered to be correct.  Parents  were made increasingly aware that many advisors believed the family was no longer capable of providing for the total development of the child without advice and assistance from helping professionals.  As early as  1919, Mrs. J. Muir, president of the British Columbia Parent-Teacher Federation, deplored the tendency of schools and other child care agencies to assume duties and responsibilities which had once been those of the parents.^ Yet, i n spite of the concerns of people like Mrs. Muir, advisors increasingly assumed more responsibility for the care and training of the province's children.  II Advisors considered the task of disseminating child care and child rearing information to parents to be of paramount importance, and to accomplish this process they utilized a l l the methods and media available to them. As health care and child care services grew and expanded, more  171 outlets  became a v a i l a b l e  through which  With on-going medical research d a t a , more c h i l d dissemination  w h i c h 2,194 no  provided  infant visits  same y e a r ,  division  V a n c o u v e r i n 1920  1921 of  numbers o f m o t h e r s a n d i n f a n t s .  w e r e made.  fails  to indicate  who a t t e n d e d that  18.6  o f C h i l d Hygiene.  R e p o r t s by h e a l t h  cate a steadily increasing  baby c l i n i c s  born i n Vancouver i n  baby c l i n i c  operated  20,906  visits  by t h e  8,733  such as school  immunization  clinics,  t o a d v i s e p a r e n t s on b e t t e r  health  indi-  m e d i c a l work,  b y some  with  there  parents.  vaccination,  classes  care and c h i l d  Yet,  information.  o f contact  a n d home n u r s i n g  also  physician,  adequate i n f a n t care  point  home  baby c l i n i c s .  t o a pediatrician or family  were n o t t h e o n l y  and t u b e r c u l o s i s  a t well  percent  made b y  d i v i s i o n n u r s e s made  H e a l t h workers used occasions  unities  f o r the  baby c l i n e s and t h e p r a c t i c e  m o t h e r s who d i d n o t r e c e i v e  well  born i n  fifty-four  a t t e n d a n c e by i n f a n t s  mothers t o take t h e i r i n f a n t s  But  Unfortunately, the  w o r k e r s i n o t h e r a r e a s o f the; p r o v i n c e  o f the success o f the well  were s t i l l  involved.  B y 1939,  t o the  baby c l i n i c s ,  clinics to  number o f i n f a n t s  percent o f infants  In addition  to well  133  The d i v i s i o n r e p o r t  a well  1920,  During  the percentage o f i n f a n t s  a clinic.  health  b y a n i n f a n t was c o u n t e d ,  home c a l l s .  one o f t h e d i v i s i o n ' s c l i n i c s .  mothers and i n f a n t s  spite  As each v i s i t  2,847  babies born i n Vancouver attended  calls.  opportunity for  t o determine t h e actual  year indicates  attended  Division  in  an e x c e l l e n t  d i v i s i o n n u r s e s made  report  following  a d v i c e was a v a i l a b l e f o r  t h e Vancouver D i v i s i o n o f C h i l d Hygiene h e l d  method i s a v a i l a b l e  The  rearing  more  t o parents.  w o r k e r s t o work w i t h l a r g e example,  t o parents.  a n d t h e C h i l d S t u d y Movement p r o v i d i n g  care and c h i l d  W e l l baby c l i n i c s  for  to d i s t r i b u t e advice  as opport-  rearing  tech-  172  niques.  Undoubtedly, parents l i v i n g i n some isolated areas of the prov-  ince lacked the services and advice of health professionals, yet by  1939»  through the combined efforts of the B r i t i s h Columbia Public Health Service, private agencies such as the Red Cross and the Victorian Order of Nurses, and church organizations, most residents of the province, both rural and urban, had access to advice from health workers or general medical practitioners.  But only i n the large urban areas such as Vancouver or  V i c t o r i a were the services of c h i l d care specialists such as c h i l d psychologists and mental hygienists available through the school system.  Parents unable or unwilling to seek help or advice from health professionals had access to a large supply of free printed materials.  Govern-  mental boards and departments, voluntary agencies, and commercial firms printed and distributed thousands of pamphlets, booklets and c h i l d care manuals throughout the province through health workers, women's groups, and booths at f a l l f a i r s and exhibitions.  Newspapers and magazines aimed  at both rural and urban readers carried regular child care information columns and feature a r t i c l e s written or edited by health professionals and c h i l d care specialists.  These same publications advertised free  pamphlets and bulletins available to parents from agencies such as the B r i t i s h Columbia Board of Health, the Canadian Council on Child Welfare, and the Child Welfare Division of the Dominion Department of Health. Furthermore, newspaper and magazines reviewed and recommended several c h i l d care manuals and books prepared and written by Canadian health professionals and child care specialists.  Indeed, every parent i n the  province could obtain a large number of informational pamphlets and bulletins directly from health care workers, through commercial outlets, or by writing for materials from various boards or agencies.  1 73 British Columbia's health care workers quickly recognized the educational potential of radio and film as a means to disseminate information to parents.  As early as 1922, health workers prepared and broadcast talks  on their local radio stations on a variety of health topics.  Although  advisors continued to use radio throughout the inter-war years, the mountainous terrain and the distances involved prevented radio braodcasts from reaching a l l areas of the province.  The use of films as a media  of health education was initiated before the use of radio, but the need for electricity to run projectors limited the distribution of films to schools, community centers, and local movie theatres. Although radio broadcasts and films were not available i n every area of the province, sufficient sources of child care and child rearing advice existed to provide information to any parent who requested either advice or assistance. By 1939, f a c i l i t i e s and services existed to enable every British Columbia parent to be well informed.  Ill How had l i f e changed for children of 1939 as compared to their 1920 counterparts?  Although the mother of 1939 did not attend a prenatal clinic  or class, she probably visited her physician at least once or twice before her delivery date, and, i n a l l likelihood, the birth occurred i n a hospital or nursing home. No statistics are available for the number of births i n hospitals i n 1920, but by 1927, sixty percent of births registered i n British Columbia occurred i n either a hospital or nursing home, and by 1939, eighty-two percent occurred i n a medical institution.  A delivery within a  hospital setting was treated as a medical case and, as a result of better medical care, mothers were less likely/to develop puerperal septicaemia or other birth complications, and infants were more likely to survive their f i r s t year of l i f e .  Because of better care, between 1920 and 1939 the  174 maternal mortality rate for British Columbia dropped from 6.8 to 3«5 V  eT  thousand l i v e births.  During the same period the infant mortality rate  declined from 73.6 to 39*0 per thousand live births.  Following her return from hospital, the mother of 1939 who was living within a health unit area was more likely than her predecessor  of 1920 to  be visited by a public health nurse or a member of the Victorian Order of Nurses.  The visiting nurse instructed the mother i n the proper feeding and  care of her infant.  As she had i n 1920, the nurse insisted the infant be  placed on an extremely rigid schedule of feeding, sleeping, exercising, and toileting.  The nurse also encouraged the mother to take her infant  to a bi-weekly or a monthly well baby c l i n i c which monitored the infant's weight and general health, and administered immunization shots.  As was the mother of 1920, the mother of 1939 was encouraged to breast feed her infant.  If she could not or would not breast feed, health prof-  essionals recommended a carefully balanced diet consisting of pasturized whole or canned milk, water, and sugar, supplemented with citrus f r u i t juice and cod-liver o i l .  Unfortunately, the diet advisors believed to be a  proper substitute for mother's milk included a high sugar content that not only taught infants  to regard sweets as food, but also created  dental problems during their.growing . years.  On the positive side,  advisors recognized that rickets was preventable, and they urged the mother to expose her child to fresh air and sunlight and to feed cod-liver o i l on a regular basis. For the infant born i n 1939, better sanitation, pure water, pasturized milk, and scrupulous cleanliness and care i n preparing formulas reduced by f i f t y percent the chance of the child dying from gastro enteritis or dysentry.  175  Advisors justifiedfichanges in infant feeding procedures and diet ingredients on the basis of a scientifically determined formula, and their claims for the success of new feeding methods were supported by the reduction in both infant mortality and morbidity rates.  But there was  no  scientific justification for placing the infant on the highly regimented sleeping, eating, and exercising schedule which discouraged the mother from handling and cuddling her infant.  In attempting to ensure the infant's  survival, advisors failed to recognize the emotional and  psychological  needs of both mother and infant to express and receive love through physical contact.  Because vaccination and immunization programs were increasingly extended during the 1920*s and the 1930's, children born in 1939 were less likely to contact smallpox or diphtheria than their 1920 counterpart. Even though sulfa drugs were available for the treatment of bacterial infactions, no effective drugs existed to combat virus infections, and by 1939 infants were s t i l l vulnerable to respiratory diseases, including tuberculosis. Although infants born i n 1939 were s t i l l susceptible to some diseases, no doubt exists they had a greater chance of surviving to adulthood than had infants born twenty years earlier.  The greatest change i n child rearing advice over the two decades related to the preschool child.  In 1920, most advisors made l i t t l e dist-  inction between two year olds and five year olds in terms of physical, i n t electual, and social development. The work of researchers such as Arnold Gesell and W. E. Blatz, however, made advisors more cognizant of the specific and sequential ages and stages of child development.  During the  late 1920's and the 1930's, the Child Study Movement in both Canada and the  176  United States worked to disseminate a growing pool of information on child development to the parent, and the movement's leaders popularized the idea that parents not only apply the new scientific principles to child rearing, but also study their own children so they would know best how to guide, teach, and train them during their preschool years.  Although many advisors claimed to apply the scientific approach to child study and child care, as late as 1939 they were not f u l l y aware of the a b i l i t i e s and the capabilities of preschool children.  They expected  them, for example, to speak clearly and distinctly from the time they learned to talk, even though they were physically incapable of doing so. In a l l probability, the pressure exerted by adults on the preschool child to enunciate clearly and distinctly produced stuttering i n many young children.  Additionally, advisors agreed that play was a natural and  desirable learning activity, but from two years of age onward advisors insisted children be trained to work at the same time they learned to play.  As soon as they were able, preschool children were expected to be  working members of tthe family and to assume responsibility for a portion of the household chores. Undoubtedly, the scientific approach to child rearing brought many positive changes i n the lives of preschool children of the 1920's and the 1930's, but a l l changes were not for their benefit. Until the 1920's, for example, most preschool children ate essentially the same food as their parents, but the scientifically determined diet recommended by advisors during the inter-war years was high i n carbohydrates, low in proteins, and included pureed vegetables that had lost both flavour and nutrition through over cooking.  Preschool children of 1939 who shared their parent's diet of meat,  vegetables, cheese and eggs, were probably better nourished than children who were fed the diet prescribed by advisors.  177 While the preschool c h i l d tended to be a member of a neglected age group, from 1910 on the B r i t i s h Columbia school c h i l d received considerable attention from health professionals and c h i l d care advisors over the whole of the inter-war years.  By 1 9 3 9 , f o r example, eighty-nine percent of the  province's school c h i l d r e n came i n touch with the school medical program immediately system.  before or soon a f t e r entering the B r i t i s h Columbia school  An annual medical inspection by the school medical o f f i c e r and  regular examinations by a school nurse ensured the systematic monitoring of the school c h i l d ' s health.  In addition, health professionals and  educators taught c h i l d r e n habits of personal hygiene, r u l e s of safety and accident prevention, and p r i n c i p l e s of community health with the expectation  that the c h i l d would carry t h i s information home to t h e i r parents.  Not  only d i d advisors of the 1920's and the 1930's provide health care and health education f o r the school c h i l d , but also some advisors advocated the school assume r e s p o n s i b i l i t y f o r the c h i l d ' s moral t r a i n i n g and character education.  As a consequence, the B r i t i s h Columbia school c h i l d of the  1930's was taught from a prescribed Course of Study designed to i n c u l c a t e those values, attitudes, and high i d e a l s advisors deemed to be correct, proper, acceptable, and to r e f l e c t the B r i t i s h point of view.  Supplementing the school program were club a c t i v i t i e s f o r both boys and g i r l s .  These a c t i v i t i e s included such associations as the L i t t l e  Mother's League classes f o r g i r l s aged ten to fourteen years.  No records  exist reporting how many g i r l s were involved, but during the 1920*s, Mother's League classes were held across the .province.  Little  In these classes,  g i r l s were taught procedures touted by nurses as the s c i e n t i f i c approach to feeding, bathing, and t r a i n i n g an infant - a message nurses hoped the g i r l s would take home to t h e i r mothers and would apply when they had t h e i r own children.  During the 1 9 3 0 ' s , membership i n the L i t t l e Mother's League  178 classes declined, and the Junior Red Gross, an association f o r both boys and g i r l s , r a p i d l y expanded.  The Junior Red Gross stressed, among other  goals, the development of habits of personal hygiene and health care, both individually  and within one's own home.  Columbia Department of Education i n 1922,  F i r s t endorsed by the B r i t i s h by 1940  30,999 school children,  or approximately thirty-two percent of the province's school children were involved i n Junior Red Cross a c t i v i t i e s .  The parent of 1920 c h i l d rearing advice.  had few resources from which to seek c h i l d care and The parent of 1939  could turn to c h i l d care  special-  i s t s , helping professionals, and a vast amount of printed material.  Yet,  with the increase i n c h i l d care and c h i l d rearing information, most advisors implied that many parents f a i l e d to provide properly f o r t h e i r c h i l d ' s physical, i n t e l l e c t u a l , moral, and e t h i c a l development. t h e i r own c a p a b i l i t i e s , certainly  I f parents doubted  the c r i t i c i s m of health professionals and advisors  was not reassuring.  Furthermore,  attempts by advisors to use the  school c h i l d as a means to educate parents d i d l i t t l e to enhance the parents* f e e l i n g s about t h e i r parenting " a b i l i t y , and probably served to create tension between parent and c h i l d .  Because advisors were c r i t i c a l of parents,  they were ready and w i l l i n g to advise parents on a l l aspects of c h i l d rearing and c h i l d care.  This study has focused on the nature and content of c h i l d care and c h i l d rearing advice available to B r i t i s h Columbia parents during the i n t e r war years, but the reader w i l l notice that several questions remain f o r further study.  Despite the a v a i l a b i l i t y of advice, what proportion of  parents of the 1920's and the 1930's a c t u a l l y sought and heeded the advice? To which sources d i d parents turn f o r advice and which advisors d i d they f i n d most acceptable?  Were parents more l i k e l y to seek advice on the care  179 and rearing from one group of advisors i n preference to that of another?  A second area f o r research involves an i n v e s t i g a t i o n of f a c t o r s that led  to the steady decline i n i n f a n t and c h i l d morbidity and mortality  rates during the inter-war years.  Was  t h i s decline the r e s u l t of parents  adopting the s c i e n t i f i c approach to c h i l d care and c h i l d rearing, or  was  i t simply the e f f e c t of better s a n i t a t i o n , pure milk, clean water, and better methods to prevent and control i n f e c t i o u s and contagious  diseases?  No doubt e x i s t s that the c h i l d born i n 1939 had the p o t e n t i a l f o r a healthier,  happier, more productive l i f e than had those of previous  generations.  The question i s , how much of t h i s p o t e n t i a l can be attributed to changes i n c h i l d rearing practices?  IV What does t h i s study contribute to the historiography of  childhood  7  i n Canada? Columbia.  I t i s the f i r s t study to investigate c h i l d rearing i n B r i t i s h By focusing on the content of c h i l d care and c h i l d rearing advice  disseminated to parents rather than on the development of health care programs and c h i l d care agencies, t h i s study provides a new on the h i s t o r y of Canadian childhood.  perspective  Not only does i t demonstrate  advisors' changing concepts of both the nature of the c h i l d and the state of childhood,  but also i t shows that advisors believed c h i l d rearing  meant more than feeding and caring f o r the c h i l d .  C h i l d rearing involved  i n s t i l l i n g i n children  the a t t i t u d e s , values, and mores of the society  i n which they l i v e d ,  a process American h i s t o r i a n Lawrence Cremin desg  cribes as education.  But c h i l d rearing during the 1920's and the 1 9 3 0 ' s  was  an educational>process i n v o l v i n g both c h i l d and parent, and the l a t t e r  was  supported i n the c h i l d rearing through c h i l d care services and  rearing information provided by public health workers, c h i l d care  child advisors,  180  educators, and s o c i a l workers.  These same educational agents urged the  parent to abandon t r a d i t i o n a l c h i l d rearing techniques f o r the new scienti f i c approach to c h i l d care.  Although t h i s study does not investigate how  many parents adopted the highly r i g i d , systematic approach to feeding, caring, and t r a i n i n g the c h i l d , i t does demonstrate that advisors were persistent and consistent i n t h e i r attempts to change c h i l d rearing practi c e s and to improve the l i f e p o t e n t i a l of the c h i l d .  What were the advisors' motives f o r demanding parents change t h e i r c h i l d rearing techniques?  Radical r e v i s i o n i s t h i s t o r i a n Michael Katz  contends that, during the nineteenth and early twentieth centuries, education was used as a means to e f f e c t s o c i a l control of the working c l a s s and to i n s t i l l i n them the attitudes, values, and i d e a l s acceptable 9  to the middle c l a s s .  Even though c h i l d rearing was an educational process  designed to produce a healthy, happy, productive c i t i z e n , an examination of advice disseminated by health professionals and c h i l d care advisors during the inter-war years does not indicate that i t was aimed at any one c l a s s of B r i t i s h Columbia society.  Advisors believed i t was essential a l l  parents adopt the new approach to c h i l d rearing, f o r a l l children were susceptible to i l l n e s s and disease, and these problems could be prevented, or at l e a s t ameliorated, i f the parent followed the advisor's advice. Individuals such as Alan Brown and W. E. Blatz d i d not d i r e c t t h e i r advice s p e c i f i c a l l y towards the poor, and the province's public health nurses worked to reduce the i n f a n t and maternal mortality rate of a l l classes of B r i t i s h Columbia society.  Although The Canadian Mother's Book was written i n a  s i m p l i s t i c , almost condescending manner, the editor, Helen MacMurchy directed her p r a c t i c a l advice to a l l Canadian mothers i n both r u r a l and urban areas of the province.  Rather, t h i s study supports the view of moderate  r e v i s i o n i s t s that the advisors' motives were based on humanitarian and  181  compassionate considerations." " 1  0  The advisor's stated purpose was to lower  the infant and maternal mortality rates, and they diligently worked to that end during the 1 9 2 0 ' s and 1 9 3 0 ' s .  In his examination of the development of health care services and child care agencies in English Canada, social historian Neil Sutherland contends that by 1 9 2 0 social reformers had formed a consensus of how the generation of young, growing Canadians should be reared. land's contention.  This study supports Suther-  Whether through the provision of care for children  or through advice to parents, advisors never wavered in their efforts to provide better child care i n both the home and the community, and to lower the child and maternal mortality rates. Sutherland also suggests that reformers believed the way to reform society was by establishing better public health care programs, a more efficient educational system, and better child and family services, and advisors saw these changes as the methods to improve l i f e for children.  But, this study makes abundantly clear,  advisors believed the way to change society was to change child rearing practices, and the way to change child rearing practices was by educating parents to the new scientific approach to child care and child rearing. As important as health care and child care agencies were, advisors viewed them as an avenue through which to teach parents.  This study also supports  the notion that while reformers and advisors expected the scientific approach i n child care to provide a better l i f e for children, better care did not always result.  In some cases, pseudo-science rather than real  science provided the rationale for changes i n child rearing techniques, and the method advisors considered as scientific was not always best for children.  Infants' lives, for example, were determined by the clock and  not by their individual needs.  182 Educational h i s t o r i a n Alison Prentice contends that the t r a d i t i o n a l educational system created stereotypical roles f o r women,''' This study 1  bears out Prentice's findings.  Although c h i l d rearing advice was general-  l y addressed to 'parents,' the mother was viewed as homemaker, c h i l d rearer, and implementor of advice being disseminated.  But father fared no better  than mother as he was portrayed i n the equally stereotypical r o l e of bread winner, ultimate authority i n the family, and supporter of mother. Although encouraged to show i n t e r e s t i n h i s c h i l d ' s welfare, advisors d i d not encourage the father to become involved i n the c h i l d rearing process; that was the mother's r o l e .  So narrow was the advisors' perception ..... 1  of the parents' r o l e and c h i l d rearing a b i l i t y , they frequently overlooked the competent and capable manner i n which many B r i t i s h Columbia parents reared t h e i r c h i l d .  Throughout the inter-war years, advisors continued to  view both mother and father i n the same stereotypical roles.  As a consequ-  ence, even though research i n c h i l d care and studies i n c h i l d development changed the advisors' concept o f the c h i l d and the nature of childhood, 1  t h e i r view of the parent remained r e l a t i v e l y constant.  In summary, t h i s study places c h i l d rearing during the inter-war years within the broad spectrum of education.  Not only was c h i l d rearing  the deliberate and systematic education of the c h i l d to the attitudes, values and mores of B r i t i s h Columbia society, but also i t was the deliberate and systematic education of parents to a new s c i e n t i f i c a l l y based approach. This study c l e a r l y demonstrates that advisors of the 1920's and the 1930's believed t h e i r r e s p o n s i b i l i t y was to ensure a better l i f e f o r the province's children by providing c h i l d care services and by educating parents to new techniques.  By these methods, advisors believed they provided the pot-  e n t i a l f o r a h e a l t h i e r c h i l d of the present, and a healthier, happier, more productive c i t i z e n of the future than was possible before 1920.  An examin-  183 ation of advice to parents identifies many of the sources of child rearing advice the media used to disseminate information and demonstrates changes in advice as concepts of the child's needs and the nature of childhood underwent continuous change. Finally, this study provides a perspective of advisors' perceptions of the role and the duty of parents, and indicates why advisors believed parents required their advice and guidance.  The practice of advising the parent i n child care and child rearing techniques was not, of course, limited to the inter-war years.  Today,  parents have access to a vast body of advice from pediatricians, health workers, child psychologists, nutritionists, early childhood educators, family counsellors, and social workers. Health workers continue to distribute free copies of the 1979 edition of The Canadian Mother and Child (formerly The Canadian Mother's Book) as well as a wide range of materials on topics such as thumb sucking, bed wetting, and shyness.  Through news-  paper columns, feature magazine articles, and radio and television programs, parents have access to information on a l l aspects of child growth and development from the time of conception through to adolescence.  Interest-  ingly^ many concerns of advisors of the inter-war years are reiterated by advisors today.  Television advertisements prepared by the British Columbia  Ministry of Health urge expectant mothers to seek prenatal care early i n their pregnancies.  Mothers are encouraged to breast feed their infants for  the f i r s t six months, and to give them no solid foods during that time. Furthermore, advisors suggest mothers make their babys' food at home and supplement their diet with vitamin D. Parents are admonished to ensure their infants are immunized against polio, measles, diphtheria, and other diseases as many parents are negligent i n this responsibility, and public health workers fear outbreaks of contagious and infectious diseases once considered eradicated. Nutrition i s s t i l l of great concern, and parents are  184 urged to make certain their children eat a well balanced diet and do not exist on junk food.  The availability of modern drugs and commerc-  i a l l y prepared milk diets means gastro-enteritis and respiratory infections are no longer the scourge they once were, but advisors are now concerned that milk and water may be contaminated with chemica l agents more insidious and dangerous than those of sixty years ago. The high incidence of teen age pregnancies and the onset of puberty at a younger age has led some parents and advisors to advocate family l i f e education classes be included as a required course i n the public school program. Family counsellors also recommend both male and female high -school students be given training i n child care and child rearing. In spite of the optimism of advisors of the 1920's and 1930's, the scientific approach to child rearing has not solved a l l the problems associated with child care and child rearing.  Indeed, advice to the  parent has changed significantly less i n the past sixty years than a cursory examination would lead one to expect.  185  Footnotes 1 Isabel Arthur, "Child Welfare," British Columbia Board of Health, Report, 1918, p. G139. 2 Steven L. Schlossman, "Philanthropy and the Gospel of Child Development," i n Proceedings of the Rockefeller Archive Center. June 8. 1979. Gerald Benjamin, ed., pp. 15 - 1 6 , 22. Schlossman discusses the development and role of the Child Study Parent Education Movement i n the United States. One of the goals of the Movement was the immediate application of scientific research information to the child rearing process. 3 Sol Cohen, "The Mental Hygienist Movement, The Commonwealth Fund, and Public Education, 1920 - 1 9 3 3 , " ibid., pp. 33 - 46. Cohen points to the confidence American advisors placed on science and the school system to detect, correct, and prevent mental illness. 4 C. A. Lucas, Public Health Education i n the Schools. British Columbia Board of Health, 1926, p. 3. 5 Christopher Lasch, Haven i n a Heartless World: The Family Beseigedl (New York: Basic Books, 1 9 7 8 ) , pp. 12 - 24. Lasch gives the period 1900 to 1930 as the time of the development of the helping professionals. 6 J. Muir, "Parental Responsibility," Report of the Child Welfare Association of British Columbia, 1919, P. 41. 7 For a discussion of the historiography of childhood, family l i f e , and education, see Neil Sutherland, "Introduction Towards a History of English Canadian Youngsters," i n Education and Social Change by Michael Katz and Paul Mattingly (New York: New York University Press, 1 9 7 5 ) , PP. x i xxxij see also Marvin Lazerson, "Revisionism and American Educational History," Harvard Educational Review. 4 3 (May, 1 9 7 3 ) , 2 6 9 - 2 8 3 . 8 Lawrence A. Cremin, American Educationt The Colonial Experience. 1607 - 1783 (New York: Harper and Row, 1 9 7 0 ) , p. XII. 9 Michael Katz, Class. Bureaucracy and Schools. (New York: Praeger Publications, 1 9 7 1 ) , PP. xv - xxiv. 10 Neil Sutherland, Children in English Canadian Society: Framing the Twentieth Century Consensus (Toronto: University of Toronto Press. 1976). pp. 228 - 241. 11 Alison Prentice, "The Feminization of Teaching," i n The Neglected Majority, by Susan Trofimenkoff and Alison Prentice, (Toronto: McClelland and Steward, 1 9 7 7 ) , pp. 49 - 6 5 .  186 Note on Sources In disseminating c h i l d care and c h i l d rearing advice to parents during the inter-war years, health professionals and c h i l d care advisors provided a wide variety of information through government departments, p r i v a t e and voluntary agencies, popular press, and commercial outlets.  A complete  bibliography i s contained i n the footnotes of t h i s study, and a selected bibliography i s provided at the end of the study.  In searching out the  materials f o r the study, the B r i t i s h Columbia Board of Health Reports  (1900-1957) contained a wealth of d e t a i l e d information t r e a t i n g the development of public health services, the organization of well-baby  clinics  and dental c l i n i c s , and the effects of disease prevention and disease control programs.  The Reports also contained some annual reports of the  i n d i v i d u a l health units where s p e c i f i c l o c a l health care programs are deta i l e d and the contributions of voluntary organizations noted.  The l e g i s -  l a t i v e l i b r a r y contains copies of pamphlets and other printed materials d i s t r i b u t e d through the Board of Health to B r i t i s h Columbia parents.  The  public schools Reports (1894-1941) provided information on the development of health t r a i n i n g f o r both teachers-in-training and children i n the public school system.  The Programme of Studies f o r the public school system  (1920-1939) outlined the focus and the content of the health curriculum used throughout the two decades.  The province's Statutes supplied informat-  ion on regulations governing sanitation, pure water, safe food, and the immunization,  reporting, and t r e a t i n g of contagious and i n f e c t i o u s diseases.  At the federal l e v e l , the C h i l d Welfare D i v i s i o n of the Department of Health Reports (1920-1932) provided information on the d i v i s i o n ' s work i n developing and supplying information to parents.  Also available were copies  of The Canadian Mother's Book (1923), the " L i t t l e Blue Book Series," and The Enquiry i n t o Maternal Mortality i n Canada, July 1, 1925  to July 1,  1926  187  (1927), produced by the Child Welfare Division.  The Vancouver Board of Health Reports (1910-1937) and the Vancouver Metropolitan Health Unit Reports (1937-1939) furnished information on health care and c h i l d care i n both Vancouver and the Greater Vancouver area. The major source of c h i l d care-child rearing information to parents was contained i n regular columns or frequent a r t i c l e s i n Vancouver's largest daily newspaper, The Vancouver Province (1919-1939), the daily Vancouver Sun (1919-1939), the weekly Vernon News (1919-1939), the weekly national magazine the Star Weekly, a weekly farm magazine The Family Herald and Weekly Star (1919-1939), and the woman's monthly magazine Chatelaine (1928-1939).  Seven  to ten issues of each publication were examined f o r each year covered by this study. The Canadian Churchman, o f f i c i a l organ of the Church of England i n the Dominion of Canada (1919-1933), provided another valuable source of information.  The Church of England's Yearbook (1919-1939), available i n  the archives of the Anglican Church In Canada at the Vancouver School of Theology, provided information on the types of materials recommended and distributed to parishioners of a major Protestant church.  The B r i t i s h Columbia Division of the Canadian Red Cross Reports (1919-1939), located at Red Cross Headquarters, Vancouver, provided information on the role of the Red Cross i n training public health workers, establishing c l i n i c s , and sponsoring specific programs such as the Junior Red Cross.  Periodicals that were extremely useful included the Public Health Nurses which not only reported work a c t i v i t i e s of nurses, but also frequently i n c l uded their c h i l d care-child rearing messages to parents. The B. C. Teacher,  188 o f f i c i a l organ of the B r i t i s h Columbia Teachers' Federation, which c a r r i e d a r t i c l e s by educational administrators and classroom teachers who commented on the r o l e of the teacher and the school system i n providing health education and moral t r a i n i n g of the province's school children, and the Canadian Public Health Journal (1919-1939)» which gave background information on the development of c h i l d welfare and health care programs across Canada.  The Papers and Proceedings  of the Canadian Council on C h i l d and Family  Welfare, 1 9 2 3 . 1 9 2 5 , and 1 9 2 7 , detailed the coordinated a c t i v i t i e s and e f f o r t s of various health care and c h i l d care organizations throughout Canada.  The Proceedings  of the B r i t i s h Columbia Conference on C h i l d Wel-  fare ( 1 9 1 8 and 1919) supplied information on developments i n c h i l d care i n B r i t i s h Columbia.  The Metropolitan L i f e Insurance Company provided copies of pamphlets and b u l l e t i n s d i s t r i b u t e d to t h e i r p o l i c y holders by public health workers.  189 SELECTED BIBLIOGRAPHY I  Primary  A  Government Documents  1  Federal Canada  Census of Canada, 1921,  1931,  1941.  Annual Reports of the Child Welfare Division. 1920 - 1932. 2  Provincial B r i t i s h Columbia  Annual Reports of the Board of Health. 1900 - 1957. Annual Reports of the Public Schools. 1894 - 1941. Commission on Health Insurance, Report on Mother's Pensions. 1920. Commission on Health Insurance, Report on Maternity Insurance and Public Health. 1921. Department of Education. Programmes of Study. 1925 - 1939. Survey of the School System by J. H. Putman. and G. M. Weir, 1925.  3  Municipal Vancouver  Annual Reports of the Vancouver Board of Health. 1910 - 1937. Annual Reports of the Vancouver Metropolitan Board of Health. 1937 - 1939.  B  Pamphlets and Booklets  1  Federal Canada  The Canadian Mother's Book, 1921. An Enquiry Into Maternal Mortality i n Canada. July 1, 1925 to July 1, 1936, 1927.  190 Handbook of Child Welfare Work i n Canada,  1923.  "Little Blue Book Series." 2  Provincial British Columbia  "Ante-Natal Clinic - Diet for Expectant Mother's," 1935. Child Hygiene - Diet Series, n. d. "Consumption," 1918. Guide f o r the Use of Teachers and Medical Inspectors of Rural Schools. 1913. Harwood, M. Teachers,"  "How Parents Can Help 1931.  Jamieson, Laura, E. "Sex Education i n the Child Welfare Programme," 1927. "Letter to Medical Officers and Others in Charge of the Management of Outbreaks of Smallpox," 1911. Lucus, C. "Public Health Education i n the Schools," 1931. "School Posters," n. d. Other Sources American Child Health Association  "The Runabout," 1923. "March in our Line - Keep Health," n. d,  Canadian Dental Hygiene Association  "The Treasure House," 1937.  Canadian Council on Child Welfare  "Post Natal Letter." "Pre Natal Letters."  Metropolitan Life Insurance Company  A l l About Milk. 1927. The Child. 1916. The Child. 1924. Measles, n. d.  Books The Management of Young Children. Blatz, W. E. and Helen Bott. New York: William Morrow , 1930.  191  l Helen Bott. Parents and the Pre School Child. New York: William Morrow/1929. 1  a n c  Brown, Alan. The Normal Child; Its Care and Its Feeding. New York: Century Co., 1923. Eldred, Myrtle Meyer. T. Your Baby and Mine. Toronto: Longmans Green, !  1923.  Holt, Emmett, L. The Care and Feeding of Children. 9th ed., I 8 9 8 ; rpt. London: D. Appleton and Co.. 1921. Patri, Angelo.  Child Training.New York:D. Appleton and Company,1922.  Pritchard, Eric. Infant Education. London: Henry Kimpton, 1907. Watson, John B. Psychological Care of Infant and Child. 1928; rpt. New "York: W.W. Norton, 1928. D,  Articles  Bates, D.A. " Character, Good Citizenship and the Good L i f e . " The B.C. Teacher. XV (Jan.1936). 16 -18. Breeze, Elizabeth. "School Nursing." Public Health Nurses'Bulletin. 1 (Apr. 1929), 4- 5.  Carruthers, Eileen. "Discussion Groups For Mothers." Public Health. Nurses' Bulletin. 2 (Apr. 1935), 10 -11. CreelmanjiLyle. "Revelstoke Reflections." Public Health Nurse' Bulletin. 2 (Mar. 1931), 11 -14. Cunningham, Norah. "Baby Welfare- Fort St.John." Public Health Nurses' Bulletin , 2 (June 1936), 10 -11. Ewing. John M. " Can Morals Be Taught?"  The B.C.  Teacher.  IX (Dec. 1929), 7 -11.  Fullerton ,Florence. "Saanich." Public Health Nurses' Bulletin. 1 (Apr. 1925), 2- 4.  Garrood, Olive M. "Public Health in Kamloops." Public Health Nurses' Bulletin. 1 (May 1930), 26 - 29. . "Public Health Nurse and Education? Public Health Nurses' Bulletin. 2 (Mar. 1937), 17 - 18. f  G r i f f i n , M; M. "Breast Feeding for Infants in Saanich."Public Health Nurses' Bulletin. 1 (Apr. 1927), 24 -27. " The Health Officer Suggets." Ths Bulletin of the British Columbia Board of Health. 9 (July 1939), 144 - 158.  192 Higgs, N. "Child Welfare Work i n Saanich." Public Health Nurses' Bulletin. 1 (Apr. 1928), 14 -15. , "The Value of Pre School Work." Public Health Nurses' Bulletin. 1 (Apr. 1929), 23 - 24. "The Highest Morality Xll. (Feb.1933), 19 -21.  Shall Be Inculcated." The B.C. Teacher.  Kerr, Margaret E. "The Public Health Nurse and Child Study Groups." Public Health Nurses' Bulletin. 1 (Mar. 1932), 10 -11. Lee, A.J. and J.M. Woods. "Nanaimo." Public Health Nurses' Bulletin. 1 (Apr. 1926), 9 - 1 0 . Lucas, C.A. "Little Mother's League Classes as Conducted i n Saanich over a Five Year Period." Public Health Nurses' Bulletin. 1 (Apr.1927),  8 - 10.  Martin, Elizabeth. "Vernon." Public Health Nurses' Bulletin.  2 (Apr. 1935), 24.  Rose, C. "The Pre School Visit." The Public Health Nurses' Bulletin.  1 (Mar. 1931), 39 -40. Tisdall, Frederick F. "Care of the Infant, and Child During the Summer Months." Canadian Public Health Journal. XX (July 1929), 357 "360. Twiddy, Mi A. " A Child Study Group." Public Health Nurses Bulletin. r  2 (Mar. 1938), 49 - 50. , ^Physical Welfare of Children." The Bulletin of the British Columbia Board of Health. 4 (Dec. 1934), 191 - 193. Upshall. M.R. "Rain or Shine?" Public  2 (Apr. 1935), 34 -35.  Health Nurses' Bulletin.  Watson, Chas. C. "The Development of Character: Its Relation to Education." The B.C. Teacher. XIV (June 1935), 10 - 14. E  Periodicals The B.C. Teacher.1921 - 1939. The Canadian Churchman. 1919 - 1933. Canadian Public Health Journal. 1919 -1940. Chatelaine . 1928 - 1939. Public Health Nurses' Bulletin. 1924 - 1939. Women's Institute Quarterly. 1912 - 1924.  193  Newspapers Family Herald and Weekly Star. 1919 - 1939. Star Weekly. 1919 - 1939. The Vancouver Province. 1919 - 1939. The Vancouver Sun. 1919 - 1939. The Vernon News. 1919 - 1939. G.  Reports British Columbia Child Welfare Association, Convention Reports, 1919,  1920.  Canadian Council on Child Welfare, Proceedings and Papers, 1923, 1925, 1927.  Canadian Red Cross, British Columbia Division, Annual Reports. 1919 - 1939.  II Secondary A. Books Bernhardt, Karl S. et a l . Twenty-five Years of Child Study; University of Toronto - 1926 - 1951. Toronto* University of Toronto Press, 1951. Berton, Pierre. The Dionne Years: A Thirties Melodrama. Toronto: McClelland and Stewart, 1977. Brown, Robert C. and Ramsay Cook. Canada 1896 - 1921: A Nation Transformed. Toronto: McClelland and Stewart, 1974. Callahan, Raymond E. Education and the Cult of Efficiency. University of Chicago Press, 1962.  Chicago:  Charles, Enid. The Changing Size of the Family. Eighth census of Canada, Census Monograph no. 1. Ottawa: King's Printer, 1941. Cremin, Lawrence A. The Transformation of the School. New York: Vintage Books, 1961. Defries, R. D. ed. The Development of Public Health: Canadian Public Health Association. Toronto:University of Toronto Press, 1940. Eldred, Myrtle Meyer. Your Babv and Mine. New York: Ewen, Stuart.  Captains of Consciousness.  Toronto:  John Day, 1951. McGraw-Hill, 1976.  lftQ7 ?^ S yIhe Victorian Order of Nurses i n Canada AP97 ~ 1947. Montreal: Southam Press, 1947. ibb  Joh  M u r r a  1 9 4  Kessen, William.  The Child,. Mew York: John Wiley and Sons,  I965.  Lasch, Christopher. Haven i n a Heartless World: The Family Beseiged. New York: Basic Books, 1977. Patri, Angelo.  The Questioning Child.  New York: D. Appleton and Co.,  1931. Sutherland, Neil. Children i n English Canadian Society: Framing the Twentieth Century Consensus. Toronto: University of Toronto Press, 1976. Rosen, George. A History of Public Health. ations, 1958.  New York: M. D. Public-  Sears, Robert, Eleanor Maccoby, and Harry Levin. Rearing. Evanston: Row, Peterson and Co., 1957.  Patterns of Child  Street, Margaret M. Watch-Fires on the Mountains: The Life and Writings of Ethel Johns. Toronto: University of Toronto.Press, 1973. Study of the Distribution of Medical Care and Public Health Services in Canada. Toronto: National Council for Mental Hygiene, 1939. Wishy, Bernard. The Child and the Republic. ersity of Pennsylvania Press, 1968.  Philadelphia: Univ-  B  Articles Andrew, F. W. "Medical Inspection of School Children." Women's Institute Quarterly. I l l , (Oct., 1916), 9 - 13.  Andrews, Margaret W. "Medical Attendance i n Vancouver, 1886 - 1920." B. C. Studies. 40 (Winter, 1978 - 79), 32 - 56. Arnould, J. Maryon. "Matsqui - Sumas - Abbotsford Demonstration Area." Public Health Nurses Bulletin. 2 (Mar., 1937), 5 - 7. Barlow, K. E. "Teaching Courage." The B., C. Teacher. VII (May, 1929)  37 - 38. Beaver, M. W.  "Population, Infant Mortality."  XXVII (1973), 243 - 259.  Population Studies.  Beck, Rochelle. "The White House Conferences on Children: An Historical Perspective." Harvard Education Review. 43 (Nov., 1937), 653 - 668. Benedict, Elsie Graves. 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