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DEPARTMENT OF PROVINCIAL SECRETARY NINTH ANNUAL REPORT OF THE TRANQUILLE SANATORIUM OF THE PROVINCE OF… British Columbia. Legislative Assembly 1931

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 DEPARTMENT OF PROVINCIAL SECRETARY
NINTH ANNUAL REPORT
OF
THE TRANQUILLE SANATORIUM
OF  THE   PROVINCE   OF
BRITISH COLUMBIA
FOR  THE
FISCAL TEAR ENDED MARCH 31ST, 1930
PRINTED BY
AUTHORITY  OF THE LEGISLATIVE  ASSEMBLY.
VICTORIA,  B.C. :
Printed by Chahles F. Banfield, Printer to the King's Most Excellent Majesty.
1931.    To His Honour Robert Randolph Bruce,
Lieutenant-Governor of tlie Province of British Columbia.
May it please Your Honour :
The undersigned respectfully submits herewith the Annual Report of the Medical Superintendent of Tranquille Sanatorium for the fiscal year ended March 31st, 1930.
S. L. HOWE,
Provincial Secretary.
Provincial Secretary's Office. DEPARTMENT OF THE PROVINCIAL SECRETARY.
HON. S. L. HOWE, Provincial Secretary.
P. WALKER, Deputy Provincial Secretary.
TRANQUILLE SANATORIUM HEADQUARTERS STAFF.
A. D. Lapp, M.B., Medical Superintendent. H. Jefferis, Bursar.
H. G. Chisholm, M.D., Assistant Medical Superintendent.
M. McQuitty, M.B., Assistant Physician. H. A. Jones, M.D., Assistant Physician.
A. Hakstian, M.B., Assistant Physician.
W. G. Lothian, Radiologist. G. Darling, Laboratory Technician.
G. J. Cameron, D.D.S., Dentist.
Miss B. Bibby, Matron. Miss L. Wright, Dietitian.
J. G. Simmonds, Clerk. Miss M. L. Haycroft, Stenographer.
AV. Jackson, Farm. Manager.
A. N. Low, Steward. T. G. Kingscote, Book-keeper.
J. Trevors, Laundry Manager. J. L. Stephenson, Chief Engineer.
Rev. Dr. E. D. McLaren, Chaplain.
DEPARTMENT OF PUBLIC WORKS.
J. R. Mathieson, Clerk of Works. TRANQUILLE SANATORIUM.
REPORT OF THE MEDICAL SUPERINTENDENT.
Tranquille, B.C., March 31st, 1930.
The Honourable S. L. Howe,
Provincial Secretary, Victoria, B.C.
Sir,—I have the honour to submit herewith the Ninth Annual Report of Tranquille
Sanatorium, covering the fiscal year April 1st, 1929, to March 31st, 1930.
The year just finished has surpassed any previous year in the amount of work done and
the number of patients treated at the Sanatorium. This was due to the occupation of the new
100-bed infirmary. In spite of this extra accommodation we find ourselves unable to keep pace
Avith the applications for admission. It would appear that either a great many more beds are
required in the Province or we will have to make a radical change in our methods of combating
tuberculosis.
During the coming year I intend to submit for your consideration a plan which would result
in a much shorter period of Sanatorium education and treatment for each patient, delay considerably the necessity for more beds, reduce the cost of treating each case, and greatly increase
the educational value of the anti-tuberculosis Avork. This plan would centralize all Government
anti-tuberculosis work at the Sanatorium and would take the form of a combined field service
department and extension clinics. The idea behind the plan is to make the Sanatorium more of
an educational centre, where all cases could have a period of training and only patients
requiring special treatments would be kept for more than four to six months. The Sanatorium
would be kept in close touch with the home and preparations made to receive the patient back
into the home when the period of Sanatorium education was finished. In this way many more
people would accept their responsibilities toAvards the sick members of their families and the
Sanatorium Avould be better able to fulfil its proper functions of education and treatment, and
would not, as is happening in most sanatoria, gradually become a home for incurable cases of
tuberculosis. The extension clinics would work in conjunction Avith the family doctor and keep
in touch with patients both before and after their stay in the Sanatorium.
With your consent, at the British Columbia Hospitals Convention at Nanaimo in August,
1929, I submitted a plan for an affiliation with the nursing-schools of the Province. This affiliation Avould provide for a two-months' course at the Sanatorium for nurses-in-training. The
plan was favourably received and I feel confident of having it in operation some time during
the coming year.
Another educational plan which I intend to submit for your approval during the next few
months is for the establishment of an annual medical school at the Sanatorium. This would be
for general practitioners and invitations should be issued through the Medical Association. It
Avould enable medical men to get acquainted with the Sanatorium and the work it is doing, give
them an opportunity of reviewing diagnostic methods, and of familiarizing themselves with
special treatments such as pneumothorax, which they could carry out in private cases. At
present many patients have to prolong their stay at the Sanatorium because they cannot receive
these special treatments near home. This class would be limited to about ten men and would
be held in May for about ten days. A definite intensive course of lectures and demonstrations
would be given.
Although instruction is given to medical students in some of the Canadian sanatoria, I do
not know of any where a definite course of instruction is given to practising physicians. It
should be infinitely more valuable to the latter than to the former, and if this plan is approved
next year, Tranquille Avill lead all the Canadian institutions in this line of educational work.
The cost of such a plan would be very small and the value of the returns Avould be very great.
With the above plans in operation I consider the people of this Province will be receiving
the returns they are entitled to expect from the considerable amount expended annually on the
maintenance and operation of the Sanatorium. V 6 BRITISH COLUMBIA.
FINANCIAL.
As predicted in last year's report, tliere has been a marked decrease in the per capita cost
and a further marked decrease is expected during the next year. This is very satisfactory and
is due partly to the increase in the number of beds and partly to improved business methods
which were made possible by the appointment of a Bursar with good training and experience,
and I would like to commend him for the good work he is doing. The financial operations are
discussed in detail in the Bursar's report.
SURGICAL AND MEDICAL.
The Sanatorium has been kept abreast of the times by the adoption of surgical measures as
an aid to securing localized rest and collapsing open caA'ities, as they are practised generally.
The major operation of thoracoplasty is usually resorted to in suitable cases when all other
measures have failed. For this reason the results may sometimes be disappointing to the
surgeons, but, judged on the whole, they are very gratifying, as by this operation many patients
have been literally snatched from the brink of the grave and several of this class are now not
only supporting themselves but their families as well.
A total of forty-one patients has now had the operation of thoracoplasty. There were nine
during the last year, with recovery and good results in five. Tavo of the operations were for
chronic lung-abscess. Phrenic evulsion is done as a preliminary operation in all cases for
thoracoplasty and also as a separate measure in many cases for various reasons and with
good results.
Pneumothorax treatment Avas being given to forty-seven patients at the beginning of the
year and was attempted in fifty-one new cases. In nineteen of these no free space could be
found and the treatment was successfully instituted in the remaining thirty-tAvo. There were
five patients admitted with pneumothorax already established. The total number of refills
was 1,593.
The services of the consulting surgeons AA'ere required for various reasons in several other
cases.
The eye, ear, nose, and throat specialist has spent half a day at the Sanatorium once a
month during the last year, making examinations and doing refractions. Many operations, such
as tonsilectomys, submucous resections, and one radical antrum, as well as numerous minor
operations, were performed by him at other times.
Nothing spectacular has developed during the past year in the way of medical treatment,
but our resident physicians have been kept busy with their daily visits, examinations, and
pneumothorax treatments. The medical staff and the Medical Superintendent meet together for
one afternoon each week to discuss diagnosis and the possibilities of special treatment for
various cases.
There were 100 people X-rayed and examined who were either referred to us by their attending physicians or asked for an examination when on a visit to their friends in the Sanatorium.
X-RAY.
This department has shared Avitb others in the increased Avork. The accommodation and
equipment are both becoming unsuitable to our needs, but we do not wish to go to the expense
of making any changes at this time if the new administrative block is to be constructed in the
next year or two. There were 1,069 pairs of chest films, 3,138 dental films, and 119 miscellaneous
films taken during the year. Several treatments jyere also given for glandular and skin conditions. The fluroscope is a great aid in our pneumothorax-work and with the increased number
of cases the calls on it are becoming heavy.
Our seven quartz lamps are in almost constant use during the day. We do not group them
as is done in many institutions, but have one on each floor.
LABORATORY AND DENTAL SERVICES.
For full information regarding these services you are referred to the reports of those in
charge of them. The laboratory-work has been greatly increased Avithout adding to the staff
and the Chief Technician and his assistant are to be congratulated on the amount and quality TRANQUILLE SANATORIUM, 1929-30. V 7
of the work they have accomplished. As pointed out in my last report, the one small room is
quite inadequate to do the variety of work we attempt and is so crowded that accuracy in
bacteriological work is very difficult.
The Dental Clinic has been able to keep up Avith the additional work and the correction of
bad mouth conditions has been of great assistance in the medical work.
Both these services will be incorporated in the contemplated administrative block and Avill
be given better accommodation.
LAUNDRY.
We now have a well-laid-out and splendidly equipped plant which is turning out work of a
very high quality. A new flat-work ironer and a battery of six air-driven presses were added
to the equipment. The manager is to be complimented on the manner in which he has dealt
with the large volume of Avork.
SANATORIUM FARM.
A new Farm Manager was appointed during the year, but it was too late in the season for
any opinion of his Avork to be formed from the results of the farming operations. With the
change in management the farm has been brought more directly under the control of the Medical
Superintendent, and the Bursar is able to be of more assistance with the business part of it.
At the same time the Farm Manager has a free hand in the practical working of the farm and
the arrangement promises to work out very satisfactorily.
A heavy operating loss is shoAvn, but is largely accounted for by the revaluation of
inventories. We found the inventory value of all live stock and machinery to be greatly inflated,
and decided to correct this condition with the change in management, so that in future we will
be better able to judge results. As will be seen by the appended table, there was a loss of
nearly $11,000 in the revaluation of machinery and horses alone. A good deal of the loss not
accounted for by inventories was due to re-establishing the herd of hogs, which had to be
butchered following an epidemic. As a result there were no material returns from what is
usually the best-paying branch of the farm. Next year we anticipate a much better financial
showing, with a still better one the following year, as we are bringing 15 additional acres under
production. The fences, both around the farm and on the range, are in a deplorable state and
the rebuilding of these will be an expenditure during the coining year Avhich Avill not bring any
cash return. New records Avere made by the dairy herd and average production was much
higher.    The bacterial count Avas very Ioav, averaging below 10,000.
BUILDING OPERATIONS.
No buildings of any size were erected during the year, an addition being made to the
residence for the male employees. A second greenhouse was built by our own staff and the
additional tomatoes, etc., which we Avere able to produce through the AVinter were a great help
with our patients' menus.
RECOMMENDATIONS.
I would very strongly recommend that an administative block of some size, sufficient to
accommodate, on the main floor, auditorium, canteen, barber-shop, and post-office, in addition
to all offices, be erected for completion not later than the autumn of 1931. The need for such
a building has been recognized for some time and our Avork will be seriously hampered until it
is finished.
The new power-house will be completed about the same time and a steam-line should be run
over to the farm, so that the dairy can be made more up-to-date. The sterilizing plant is very
unsatisfactory and should be improved. A cool-room should be added. I would also recommend that the milk be bottled, as the present method of handling results in uneven distribution
of cream and also permits contamination of the milk.
In order to make the farm pay I would recommend the acquiring of more land suitable for
growing alfalfa. In this way we Avould be able to increase our beef herd and make full use of
our range lands, which used to support three times our present herd. Unfortunately our range
lands are not suitable for grazing the Avhole year and it takes a good deal of hay to Avinter a
large herd. V 8 BRITISH COLUMBIA.
I would also recommend the extension of hard surface around buildings and on the roadway
as a means of keeping down dust, which is very troublesome here in the dry climate. It Avould
also make it much easier to keep the grounds looking neat and clean.
ACKNOWLEDGMENTS.
The visiting clergymen, the Red Cross, the I.O.D.E., and organizations which provided entertainments have all helped materially in the work of the community and their efforts have been
greatly appreciated.
I wish to thank members of the staff and the consulting staff for the splendid way in which
they have co-operated.
In conclusion, allow me, Sir, to express my appreciation of the support and assistance Avhich
I have had from the members of your Department.
I have the honour to be,
Sir,
Your obedient servant,
A. D. LAPP,
Medical Superintendent. : ■_.. - !>^----^r"'*"* *•-* _.'•'•'
INFIRMARY.  TRANQUILLE SANATORIUM, 1929-30.
V 9
STATISTICAL TABLES.
TABLE No. 1.—GENERAL STATISTICS FOR YEAR 1929-30.
Movement of Population.
Male.
Military.
Female.
Total.
Number of patients in Sanatorium, March 31st, 1929
Number of patients admitted, 1929-30	
Number of patients discharged, 1929-30	
Number of patients treated, 1929-30	
Number of patients in Sanatorium, March 31st, 1930
148
162
122
310
184
15
106
17
102
25
78
32
208
11
130
269
281
225
550
325
TABLE No. 2.—CLASSIFICATION OF 281 CASES ADMITTED TO SANATORIUM
DURING YEAR 1929-30.
Classification.
Male.
Military.
Female.
Total.
Percentage.
9
37
107
9
5
11
1
13
26
60
3
22
68
178
13
7.8
24.2
63.4
4.6
Totals	
162
17
102
281
100.0
TABLE No. 2a—CLASSIFICATION OF 13 CASES ADMITTED AS MISCELLANEOUS.
Classification.
Male.
Female.
Total.
3
1
1
1
1
1
2
1
2
1
Debility                     . ..                   	
2
3
1
1
1
1
1
2
Totals	
10
3
13
TABLE No. 3.—SHOWING CIVIL STATE OF PATIENTS ADMITTED FROM
APRIL 1st, 1929, TO MARCH 31st, 1930.
Civil State.
Male.
Female.
Total.
77
99
3
37
63
2
114
162
5
Totals	
179
102
281 V 10
BRITISH COLUMBIA.
TABLE No. 4.—SHOWING RELIGIOUS DENOMINATIONS OF PATIENTS ADMITTED
FROM APRIL 1st, 1929, TO MARCH 31st, 1930.
Religious Denominations.
Male.
Female.
Total.
Protestant	
127
24
14
3
1
4
1
1
1
1
2
74
16
6
1
1
2
1
1
201
Roman  Catholic _	
40
20
4
Seventh Day Adventist	
1
2
Bible Student	
1
4
2
1
1
1
1
9
Totals	
179
102
281
TABLE No. 5.—SHOWING THE NATIONALITY OF PATIENTS ADMITTED FROM
APRIL 1st, 1929, TO MARCH 31st, 1930.
Nationality.
Male.
Female.
Total.
10
4
69
1
1
31
1
1
1
5
2
1
3
3
1
29
1
10
2
3
8
64
17
1
1
1
1
6
3
18
4
133
1
1
English    	
48
2
0
1
e
2
l
8
Polish      	
3
2
35
1
13
2
Welsh                           	
3
Totals      -	
179
102
281
TABLE No. 6.—SHOWING WHAT DISTRICTS CONTRIBUTED PATIENTS FROM
APRIL 1st, 1929, TO MARCH 31st, 1930.
Place of Residence.
Male.
Female.
Total.
1
2
1
1
1
1
1
3
1
1
1
2
1
1
1
3
5
6
11 TRANQUILLE SANATORIUM, 1929-30.
V 11
TABLE No. 6.—SHOWING WHAT DISTRICTS CONTRIBUTED PATIENTS—Continued.
Place of Residence.
Male.
Female.
Total.
Brought forward	
5
1
1
1
1
. 2
1
2
1
2
1
1
5
2
2
1
1
2
1
1
1
1
1
1
5
1
1
1
1
1
2
3
3
2
1
2
2
1
1
1
1
1
1
1
5
4
94
6
1
1
2
1
1
1
1
1
1
1
2
3
1
1
10
1
2
1
1
1
1
1
1
3
1
1
1
1
46
11
1
1
1
1
1
2
1
1
2
1
2
1
1
1
2
1
2
1
1
1
2
1
1
1
2
1
1
1
1
1
1
Natal	
1
15
1
1
1
1
3
2
3
1
3
3
2
1
9
3
1
1
4
2
1
1
1
Toha Inlet	
1
1
1
Trail	
6
5
140
173
96
269 V 12
BRITISH COLUMBIA.
TABLE No. 6.—SHOWING WHAT DISTRICTS CONTRIBUTED PATIENTS—Continued.
Place of Residence.
Male.
Female.
Total.
173
2
2
1
1
1
96
2
3
269
4
Victoria	
5
1
Yahk	
1
1
Totals..
180
101
281
TABLE No. 7.—SHOWING THE OCCUPATIONS OF THOSE ADMITTED FROM
APRIL 1st, 1929, TO MARCH 31st, 1930.
Occupation.
Male.
Female.
Total.
3
1
1
1
2
1
2
1
1
1
2
1
2
1
1
4
1
2
1
14
3
1
1
1
1
1
1
7
7
3
1
1
1
1
1
1
1
1
1
20
1
1
11
2
4
2
1
6
36
5
1
3
1
1
Baker              	
2
1
2
1
1
1
2
1
9
1
1
4
1
2
1
Clerk	
16
3
Cook	
1
1
1
1
1
1
7
3
1
1
1
1
1
1
1
6
1
1
36
1
20
1
1
1
11
2
113
55
1«8   TRANQUILLE SANATORIUM, 1929-30.
V 13
AGE-GROUPS OF PATIENTS ADMITTED, APRIL 1st, 1929, TO MARCH 31st, 1930.
Nil
ADMITTED
.70
65
no
55
50
45
40
35
30
25
20
15
10       IINI)-I<
1IV
OyeaiiS
^      __
21t„25
YEARS   *
15t..20
YEAIIS
2(.T,..{0
YCAIIS
c'tG TO 40
YCAIIS
.Ji.,,35
YEAIIS
41 to 45
YEAIIS
46™ 511
YEAIIS
YEAHS ,*f.       ,.,
YEAIIS
I
blroGS
; YEAIIS      YEAIIS
OCCUPATION OF MALE PATIENTS ADMITTED, APRIL 1st, 1929, TO MARCH 31st, 1930.
Lahoiiiurs
13 &%
Lllfi.KEHS
&2%
MlNEIIS
74%,
Fahmeiis
(iLEIIKS
■ti"/       Seamen
*    av7
*   "/*'     Mechanics     Students
5
4JK       4^
I  I
ieiimen        Salesmen      WVITEns       r ,.
«>  -Cl0/ O'Cl'/ ' «/        EnIJINEEHS   IkAKPENTERS <  OliDEIILIES    -fAlll-ElIS   OtiIEII   HIT
A,,)/,     Adfi    z-z/„      L.fl      {1yo      tl£      17^        ^
I I
I V 14
BRITISH COLUMBIA.
OCCUPATIONS OF FEMALE PATIENTS ADMITTED, APRIL 1st, 1929,
TO MARCH 31st, 1930.
Housewives
NllllSES
13 i\%
II
OIISEWOliK
"£-&%*
TENIIUHAITIEIl
ILEitKS      g , . . .   ,
■w .4 «>/  «A1HI>HESSEIIS   TeAi:HEIIS
II
%
TI'lllSPITAL   ..
E" NE lll>_IIAT<IIIS> OfHEll   OCCUPATIONS
M   •-_>"/ «J   -Sj'!/ llASHIEHS. HooKKEEPHtS. -.AUNIIUYWOHKEHS MAIIJS i.\,.„   I
I7 ■ 14>        1 4>       1 4/» 14/i        0.7% TRANQUILLE SANATORIUM, 1929-30.
V 15
TABLE No. 7.—SHOWING THE OCCUPATIONS OF THOSE ADMITTED—Continued.
Occupation.
Male.
Female.
Total.
113
1
6
1
2
9
1
1
6
1
1
1
1
1
1
1
1
1
1
7
4
1
1
1
1
1
5
1
1
1
1
1
1
1
1
55
1
2
14
7
1
3
6
7
1
3
2
168
1
6
1
1
2
9
1
1
8
14
7
1
1
1
1
1
1
1
1
1
1
1
7
3
4
1
1
1
Smelterman	
1
6
1
Student	
12
1
2
3
1
1
1
3
1
1
Totals '. -	
179
102
281
TABLE No. 8.—SHOWING THE AGES OF THOSE ADMITTED FROM APRIL 1st,
1929, TO MARCH 31st, 1930.
Age.
Male.
Female.
Total.
1
16
33
28
13
26
28
17
7
5
4
1
4
15
38
13
12
10
1
5
3
1
15 to 20 years    	
31
21   „  25     „    	
71
26  „   30     „    .	
41
31  „  35      „     - 	
36  ,,  40     ,,          	
36
41 „  45     „    	
29
46  „   50     „                  	
99
51 .,  55     „    	
10
56  „   60     ,,                 	
6
4
66  „   70     „    	
1
Totals	
179
102
281 V 16
BRITISH COLUMBIA.
TABLE No. 9.—SHOWING ADMISSIONS, DISCHARGES, AND DEATHS FROM
APRIL 1st, 1929, TO MARCH 31st, 1930.
Month.
Admissions.
DlSCHAEGES.
Deaths.
Male.
Female.
Total.
Male.
Female.
Total.
Male.
Female.
Total.
1929.
16
20
12
16
11
31
19
5
11
13
14
11
8
12
8
8
5
23
3
6
2
7
7
13
24
32
20
24
16
54
22
11
13
20
21
24
16
15
18
8
'7
6
3
9
11
5
6
5
6
9
9
5
4
5
4
2
6
1
4
5
22
24
27
13
11
11
7
11
17
6
10
10
3
3
1
4
6
1
2
2
5
5
3
3
3
1
1
1
2
2
6
2
6
May	
3
1
July	
5
7
2
October	
2
4
December	
1930.
January	
7
5
9
5
Totals	
179
102
281
109
60
169
38
18
56
TABLE No. 10.—SHOWING CLASSIFICATION OF 225 DISCHARGES DURING 1929-30.
Results.
Classification on Admission.
Apparently
arrested.
Quiescent.
Improved.
Unimproved.
Died.
Total.
0
1
2
10
38
31
1
4
22
17
1
6
25
5
2
52
2
18
51
132
24
Totals    	
9
79
44           1           37
56
225
TABLE No. 10a.—AVERAGE LENGTH OF RESIDENCE OF 115 DISCHARGED PATIENTS.
Condition.
Male.
Female.
Apparently arrested
Quiescent	
Improved	
Days.
Days.
255.0
371.7
552.2
504.4
311.2
503.4
TABLE No. 10b.—SHOWING LONGEST AND SHORTEST PERIODS OF RESIDENCE
IN 115 DISCHARGES.
Condition.
Longest Period.
Shortest Period.
Apparently arrested
Quiescent	
Improved	
Days.
646
5,684
1,089
Days.
143
57
15 TRANQUILLE SANATORIUM, 1929-30.
V 17
CLASSIFICATION OF PATIENTS ON ADMISSION, APRIL 1st, 1929, TO MARCH 31st, 1930.
Fau advanced I/O
66 4%
MllDEIlATELY ADVANCED (III
%V> '4%
Im;b_».ent#£<^ V 18
BRITISH COLUMBIA.
CLASSIFICATION OF PATIENTS DISCHARGED, APRIL 1st, 1929, TO MARCH 31st, 1930.
OlIIESIKNT   /<,)
' 38 11%
/XlWAHENTLY ARRESTED (I
4 (i%
I
Died & f)
?A\'k\%
Unimproved k\A»
Improved <a / 13* cJ/o
i.J *4^ TABLE No. 11.—SHOWING CLASSIFICATION OF 24 CASES  (MISCELLANEOUS)
DISCHARGED.
Classification.
Male.
Female.
Total.
Debility            	
2
1
3
7
1
1
1
1
1
3
1
1
1
3
2
1
3
7
2
1
1
1
1
1
1
Totals	
18
6
24
TABLE No. 12.—SHOWING CAUSES OF 56 DEATHS.
Cause of Death.'
Male.
Female.
Total.
33
2
1
1
1
15
1
1
1
48
3
2
1
1
1
Totals	
38
18
56
TABLE No. 13.
Daily average population         293
Per cent, of discharges on admission (not including deaths)         75.1
Per cent, of deaths on whole number under treatment        10.1
Total number of patient-days  107,174
TABLE No. 14.—SHOWING AVORK COMPLETED BY PATIENTS IN OCCUPATIONAL
THERAPY CLASSES DURING THE YEAR ENDED MARCH 31st, 1930.
Reed-work—
Trays, size 14 by 20   103
Trays, size 12 by 18   86
Trays, size 10 by 18   24
Trays, size 12 by 12   48
Fruit-dishes, 9 by 9  26
Doll-cradles     22
Flower-baskets    :.  53
Pin-trays, small  50
SeAving-baskets  22
Table-lamps    4
Dresser-lamps, small  :  6
Flower-vases     68
Pine-needle Avork—
SeAving-baskets    ,.  12
Trays, 10 by 18   7
Fruit-dishes  14
Sandwich-trays    9 V 20 BRITISH COLUMBIA.
Woodwork—
Picture-frames   68
Cribbage-boards  14
Flower-stands, small  4
Parrots, pine-cone   18
Storks, pine-cone  96
Bead-work—
Bead-bags   42
Necklaces     34
Beaded garters   64
Watch-fobs   18
Bead butterflies   56
Bead flowers  24
Embroidery—
Tray-cloths   8
Table-centres    4
Table-runners   7
Shopping-bags    6
Hand-painted handkerchiefs   400
Hand-painted scarfs  47
Hand-painted flower-vases  '.  29
Passe-partout work—Pictures framed   109
Note.—About 130 patients have taken part in the above work. The show-case has proved
a great boon and many articles haA'e been sold from it. A sale of work was held in December
which netted $120 for the patients. This work is invaluable in several ways, giving patients
instruction in useful work, which keeps their minds as well as hands occupied. WEST PAVILION, TRANQUILT,E.
•_A*)__- >•••..Ifc.
SCHOOL-HOUSE AND GARDENS.  TRANQUILLE SANATORIUM, 1929-30. V 21
DENTAL EEPORT.
Tranquille, B.C., March 31st, 1930.
The Medical Superintendent,
Tranquille Sanatorium, Tranquille, B.C.
Sie,—I have the honour to submit the following report and statement of work completed in
the Dental Clinic of the institution during the year ended March 31st, 1930:—
The principal aims of the Clinic have remained the same as in preceding years—namely, to
remove all foci of infection, to restore the mouth to a healthy condition, and to maintain it as
such as long as the patient is in the institution.
Working on the principle that the nature of all dental Avork must be governed by the health
of the patient at all times, the objective is fixed at placing the mouth of the patient in such a
condition that, while being free from infection, Avould ensure his freedom from any dental work
of any great extent for some time after his discharge from the institution. Very often the
commencement of this work must be delayed on account of the condition of the patient on
admission. But, acting on the advice of the physician in charge, the work is started as soon as
possible either in the Clinic or in the patient's room.
I would also dnuv attention to the great benefits and help derived from constant co-operation
with the X-ray department. On admission, the patient receives a full-mouth roentgenologic
examination, regardless of the condition of the mouth. This brings to light many concealed
areas of infection and enables the Clinic to examine and diagnose more fully. In case of
prolonged treatment these films are valuable for comparison with post-operative ones.
Of the 270 patients in the Clinic during the last fiscal year, one, a Ukranian, was found to
have a perfect mouth—all teeth in correct position with no fillings—and three were found to
require no dental treatment. This indicates the very large percentage of mouths requiring dental
attention.
I wish to thank the staff of the institution for the considerate assistance I received from
them throughout the year.
Following is a statement of work completed in the Clinic:—
Fillings     661
Extractions  251
Dentures    44
-   Denture repairs  9
Inlays  45
Bridges  14
Treatments   274
Root fillings   16
Prophylaxis  76
Special cases   4
I have, etc.,
G. J. Cameron, D.D.S.
LABORATORY REPORT.
The Medical Superintendent,
Tranquille Sanatorium, Tranquille, B.C.
Sie,—I append herewith the annual report for the fiscal year ended March 31st, 1930. There
has been an increase of over 100 patients consequent upon the opening of the Greaves Building.
It is gratifying to report that the present staff has been able to take care of the extra Avork
entailed without adding to operating expenses. The routine adopted for every patient on admission requires sputum examinations, urinalysis, complete blood-counts, Kahn test, blood-sedimentation, and any other test suggested by abnormalities in the above findings. V 22 BRITISH COLUMBIA.
Within the past few years the ancient phenomenon observed in the variations of blood-
sedimentation has been revised, and applied particularly to the prognosis of tuberculosis cases.
This subject has been the basis of a scientific study in the Laboratory. There is no standard
technique for the test, and after reviewing the available literature a modification of Fahreau's
original method advocated by Forman Avas adopted, whereby we hoped to pursue an exhaustive
investigation. After several months certain discrepancies were apparent and the above technique
was discontinued. AVe tabulated data in fifty cases and these were discussed before a staff
meeting in July. A presentation of this paper was published in the British Columbia Laboratory
Bulletin in September. In the American Review of Tuberculosis, May, 1929, Dr. Jacob A. Cutler
proposed a technique which he advocated as a standard method for the sedimentation rate of
erythrocytes. Our line of investigation has proceeded from this point and, with the collaboration of Dr. H. A. Jones, we have been observing sedimentation curves on a number of patients
taken at stated intervals, and correlated Avith physical, X-ray, and other laboratory data. This
research is now Avell established, and the results, whether positive or negative, will be of
indisputable value. .
In September an exhibit was planned for the British Columbia Hospitals Association Conven-
tion at Nanaimo. This was the first occasion Tranquille Avas represented. Laboratory tests, X-rays
of artificial and surgical pneumathorax, incipient, moderately, and far advanced tuberculosis,
and photographs of the institution were displayed. BetAveen sessions the exhibit was well
patronized, and was commented upon publicly by both the Honourable the Piwincial Secretary
and the chairman of the convention. Your attendant Avas plied with many inquiries and much
A'aluable publicity was gained for the Sanatorium. It is recommended that a more elaborate
exhibit be planned for this year at the amalgamated convention of the British Columbia Hospitals
Association, AVestern Hospital Association, and North-Western Hospital Association to be held
in Vancouver.
The patients and staff at various times express curiosity regarding the work of the
Laboratory. In March a lecture on the tubercle bacillus with microscopic demonstrations,
and an exhibit of living and dead cultures, was given in the recreation-room. The response
was immediate. It is estimated that 400 listeners heard the lecture direct, or over the radio,
and many requests were received asking that such talks be repeated frequently.
As a convenient comparison of the work done this year, a total of the tests for 1928 has
been shown in the statistical table. The greatest increase has been in sputum, urinalysis, and
blood. There were 325 patients in residence on March 31st. The records show that 73.2 per cent.
haA'e had tubercle bacilli demonstrated in sputum; 48.7 per cent, became negative during treatment ; and of the eighty-seven cases with persistently negative sputum, eleven were diagnosed
as non-tuberculous and four as doubtful. Apart from the clinical work, weekly bacteriological
and chemical analyses are done on the milk-supply, and a monthly test is performed on the water.
These are constantly maintained at a high leA'el of purity.
A commodious Kelvinator Avas installed during the year, the advantages of which are
manifold. Culture media which has a tendency to dry is kept indefinitely. The life of chemical
reagents can be prolonged by maintaining a cold temperature not otherwise obtained. Auto-
toxins and vaccines require a frigid atmosphere for storage, which the Kelvinator supplies.
Stock cultures Avhich must be kept alive are best sustained by a temperature of 4° C. Electric
. refrigeration meets all of these requirements, and also serves to preserve rubber goods, which
perish readily in Tranquille's dry climate.
A perusal of former reports reveals the present year as being the most satisfactory in the
history of this department. There is, however, much that the Laboratory can still do under
favourable and adequate working conditions, and it is anticipated that the future will see an
even greater development.
In conclusion, I wish to express my appreciation of your interest and encouragement, and
to thank the Assistant Laboratory Technician for his efficient co-operation throughout the year.
All of which is respectfully submitted.
George Darling,
Laboratory Technician. TRANQUILLE SANATORIUM, 1929-30.
V 23
GENERAL WORK DONE IN LABORATORY.
Material examined.
tj
fo
a
Sputum	
Positive	
Negative	
Urinalysis	
T.B. in urine	
Positive	
Negative	
Albuminuria	
Renal functional tests..
Blood—
Erythrocytes	
Haemoglobin	
Leukocytes	
Differential	
Kahn precipitin	
AVassermann	
Sedimentation rate...
Blood-sugars	
Non-protein nitrogen
Blood coagulation	
Cerebrospinal fluid	
Autopsies	
Guinea-pig inoculation..
Guinea-pig autopsies	
Cultures	
Bacteriological smears..
Autogenous vaccine	
Gastric analysis	
Pleural fluid	
T.B. positive	
T.B. negative	
F feces	
Agglutinations	
Tissue sections	
Milk bacteriology	
Milk chemistry	
Water analysis	
148
54
94
38
3
3
6
1
30
30
33
33
42
34
48
26
63
34
165
78
87
299
15
4
11
28
36
36
36
23
16
40
10
30
17
2
119
43
76
20
2
2
4
32
32
32
32
35
2
44
1
1
14
205
75
130
27
2
1
1
23
23
25
25
84
40
2
2
1
1
12
13
1
1
1
4
5
12
1
145
73
72
288
25
12
13
26
9
16
16
17
17
22
39
3
1
3
36
78
155
66
89
59
1
1
1
1
26
26
29
29
44
55
2
2
5
12
17
4
3
2
1
149
63
86
32
5
1
4
1
2
55
55
53
53
39
55
1
1
17
17
1
7
1
5
10
1
141
61
80
336
15
3
12
28
2
11
11
11
11
14
72
51
30
111
52
59
19
2
1
13
13
13
13
10
18
177
74
103
33
1
1
4
1
25
25
24
24
29
30
1
1
1
2
26
10
1
1
1
179
177
69
63
110
114
347
34
20
1
9
11
1
30
3
2
2
17
27
17
27
19
24
19
24
27
32
43
81
4
4
. 1
1
3
14
21
27
40
4
1
4
3
2
2
2
1
1
2
4
4
8
10
1
1
1,871
771
1,100
1,532
90
34
56
139
23
311
311
316
316
401
52
565
40
2
7
12
17
306
305
4
18
29
15
14
9
9
12
52
100
10
1,416
602
814
1,226
69
23
46
104
7
290
290
294
299
245
220
117
142
4
3
7
9
14
13
408
256
5
16
3
4
21
48
101
87
BURSAR'S REPORT.
Tranquille, B.C., March 31st, 1930.
The Medical Superintendent,
Tranquille Sanatorium, Tranquille, B.C.
Sir,—I have the honour to submit herewith the Balance-sheet and the Profit and Loss
Accounts covering the fiscal year ended March 31st, 1930.
The tAvelve months covered by this report has been a period of unusual expansion. During
this time the Grieves Building, which was opened just before the beginning of. the fiscal year,
has been put into full operation and the patient population has been greatly added to. The
changes necessitated thereby have brought additions to every department of the staff, and the
general increase in the number of residents has been reflected in the gross operating costs.
Both the operating costs and the number of hospital days show considerable increases, while
there has also been an increase of over §20,000 in the revenue.
It is satisfactory to note that the increase in the operating costs has been held within limits
which, taken in conjunction with the increase in the revenue, has effected a reduction in the V 24 BRITISH COLUMBIA.
per capita cost per patient-day from $3.11 in the previous year to $2.49 in the present year.
By this means the net cost to the Government of maintaining a patient for one year in the
Sanatorium has been lowered from $1,133.86 in 1928-29 to $909.36 in 1929-30, a reduction of
$224.50, or almost one-fifth of the previous year's figures.
The task of bringing down the estimates for the iiast year, with these changes in contemplation, contained a greater element of uncertainty than is usually the case, and it is a matter for
congratulation that the end of the fiscal year found us with an unexpended surplus of over
$42,000.
My thanks are due to you for the unvarying support that you have given me in the performance of my duties, and to my assistants and the heads of departments I must express my
appreciation of their cordial co-operation.
I have, etc.,
H. Jefferis,
Bursar.
TRANQUILLE SANATORIUM.
Balance-sheet, March 31st, 1930.
Assets.
Land    $6,922.94
Buildings     647,496.90
Plant and equipment   138,873.55
Furniture and fixtures  51,026.87
Inventories .".  17,451.75
Petty cash   1,000.00
Accounts receivable  2,253.55
$865,025.56
Deficit (cost of operations, 1929-30)....  309,689.54
$1,174,715.10
Liabilities.
Government of British Columbia  $1,174,715.10
Profit and Loss Account, March 31st, 1930.
Depreciation—
Buildings     $34,037.32
Plant and equipment          6,690.90
Furniture and fixtures         2,517.15
Salaries      159,576.74
Office supplies         2,990.38
TraA'elling and transportation         2,572.81
Fuel, light, and water       46,278.46
Maintenance and Janitors' supplies       18,235.77
Furniture and fixtures   268.57
Provisions       99,273.19
Medical and surgical        14,749.34
Incidentals           3,994.32
By Revenue  -      $79,995.41
Donation, J. Greaves Estate   1,500.00
Balance       309,689.54
$391,184.95    $391,184.95   TRANQUILLE SANATORIUM, 1929-30.
V 25
Summary of Profit and Loss Account, 1929-30. Yearly
Per Capita.
Salaries   $159,576.74 $544.63
Office supplies   2,990.38 10.21
Travelling and transportation  2,572.81 8.78
Fuel, Avater, and light   46,278.46 157.94
Maintenance and Janitors' supplies   18,235.77 62.23
Furniture and fixtures   268.57 .92
Provisions  99,273.19 338.82
Medical and surgical   14,749.34 50.34
Incidentals  ,  3,994.32 13.64
$347,939.58       $1,187.51
Less revenue      81,495.41 278.14
Net cost of operating  $266,444.17 $909.37
Depreciation (plant, buildings, and fixtures)       43,245.37 147.53
$309,689.54        $1,056.90
Remarks. __=_______ :
Number of days' treatment given during year 1929-30  107,174
Number of patients in residence, March 31st, 1930  325
Daily average population for year ended March 31st, 1930  293
Gross maintenance per capita cost, 1 year   $1,187.51
Gross maintenance per capita cost, 1 day   3.25
Net maintenance per capita, cost, 1 year   909.36
Net maintenance per capita cost, 1 day   2.49
FINANCIAL TABLES.
Table A.—Showing the Average Number of Patients in Residence each Year, the ToTj_x
Amounts spent for Maintenance, and the Gross Per Capita Cost.
Year.
Average Number
in Residence.
Maintenance
Expenses.
Per Capita
Cost.
1921-22	
190.04
194.46
207.15
221.21
224.00
223.00
216.00
214.31
293.00
$271,730.08
284,019.31
312,065.72
300,350.00
293,980.72
308,194.82
294,674.82
299,621.79
347,939.58
$1,429.85
1,460.55
1,506.46
1,357.75
1,312.44
1,382.04
1,364.24
1 400 10
1922-23 ,	
1923-24	
1924-25	
1925-26	
1926-27	
1927-28	
1928-29	
1929-30	
1,187.51
Table B.—Showing Analysis of Gross Per Capita Cost.
Year.
^§
Cii
a rt
£"?
w
w
03
M§
a ct
~ Qj
i-l ,-•_:
at at
rt
«1
at Ut
> a
•rt U
-a) tt>
__!!
■KM
SI
rD CS
T/l
QW
HB
fefe
SlcS
ssjg
r-iaiO-
1921-22.
1922-23.
1923-24.
1924-25.
1925-26.
1926-27.
1927-28.
1928-29.
1929-30.
$439.59
$9.01
$20.56
$225.14
$138.43
482.22
8.09
11.32
232.81
133.03
479.85
7.46
9.42
243.48
85.77
407.52
6.01
11.93
211.11
70.55
479.75
8.97
8.09
189.92
68.62
501.57
9.51
14.81
173.22
65.85
554.98
10.32
11.89
169.48
64.20
603.51
9.67
12.60
190.78
82.77
544.63110.21
8.78
157.94
62.23
$57.79
66.89
13.70
25.78
6.62
33.96
34.93
24.66
.92
$421.96
472.17
441.26
288.86
392.98
426.23
448.96
421.89
338.182
$28.37
13.07
39.95
26.17
34.68
39.32
53.82
42.95
50.34
I
$72.06
28.46
65.76
33.05
19.31
12.36
15.65
11.27
13.64
$1,429.85
1,460.55
1,506.46
1,357.75
1,312.44
1,382.04
1,364.24
1,400.10
1,187.51 V 26
BRITISH COLUMBIA.
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©CS©CSCSC-CSC-CS   TRANQUILLE SANATORIUM, 1929-30.
V 27
Table E.—Summary of Laundry-work, App.ii. 1st, 1929, to March 31st, 1930.
Month.
Fiat-work.
Personal.
Total.
Value of Work
done.
April	
May	
June	
July	
August	
September	
October	
November	
December	
January	
February	
March	
Totals
33,
35,
33
36,
36,
36,
42
39,
38,
41,
37
4'0
318
420
85S
934
868
382
296
551
820
658
,666
748
453,519
17,145
14,589
12,830
14,595
13,026
14,003
15,450
13,742
15,225
15,278
14,235
15,563
175,6S1
50,463
50.009
46,688
51,529
49,894
50,385
57,746
53,293
54,045
56,936
51,901
56,331
629,200
$2,553.61
2,829.61
2,650.79
2,975.94
2,737.18
2,856.00
3,225.96
2,875.14
3,018.37
3,057.40
2,834.60
3,101.89
$34,716.80
Flat-work, 453,519 ;   personal, 175,681 ;   total, 629,200.
Average per month : Flat-work 37,793 ; personal, 14,640 ;
Average monthly increase :  12,354.
Value, $34,716.80.
total, 52,433.     Value, $2,893.06.
SANATORIUM FARM REPORT.
TRANQUILLE SANATORIUM FARM.
Balance-sheet, March 31 st, 1930.
Assets.
Buildings and improvements   $90,822.61
Equipment   .  2,948.45
Land Account  70,405.88
Automobile  643.53
Accounts receivable  2,115.21
Dam Account   421.72
Petty cash   500.00
$167,657.43
Inventory—
Live stock   $43,188.00
Machinery        1,562.19
Tools  167.57
Unissued stores  '.       3,289.50
Harness   166.25
      48,373.51
Gross operating loss       34,270.93
$250,301.87
Liabilities.
Petty Cash Account
Capital 	
$500.00
249,801.87
$250,301.87 V 28 BRITISH COLUMBIA.
The heavy operating loss is partly accounted for by the revaluation ol inventory, namely
Dairy herd, old stock reduced     $2,025.00
Dairy cows butchered, book value  $1,865.00
Amount realized        669.80
$1,195.20
One casualty          50.00
      1,245.20
Horse inventory, 1928-29   $6,540.00
Horse inventory revalued, 1929-30     1,325.00
       5,215.00
Machinery inventory, 1928-29   $7,436.40
Machinery inventory revalued, 1929-30      1,896.01
      5,540.39
$14,025.59
Dairy Herd—Profit and Loss Account, March 31st, 1930.
Expenditure.
Milk for calves   $3,017.35
Inventory, live stock, 1928-29   20,275.00
Inventory, feed, 1928-29   5,823.57
Wages     5,713.09
Board of employees   2,520.00
Equipment     446.79
Sundries  118.56
Electricity   369.45
Hay  3,500.00
Mangels   400.00
Beet-pulp  287.75
Ground corn   159.50
Coarse salt   49.83
Bran   885.38
Oilcake  1,371.08
Potatoes  173.59
Oats    1,352.00
Medicine, etc  39.91
Laundry  150.39
Bone-meal   7.80
Cotton-seed meal  31.20
Barley  2,010.75
Soya bean   30.00
Dairy feed, 20 per cent.  460.00
Distillers' grains   75.00
Straw   594.17
Fish-meal  53.60
Green feed   1,725.00
Silage  2,250.00
Horse-labour  511.00
Tractor-labour   40.00
■  $54,441.76
Carried forward   $54,441.76 TRANQUILLE SANATORIUM, 1929-30. V 29
Dairy Herd—Profit and Loss Account—Continued.
Brought forward  $54,441.76
Receipts.
Milk supplied to Sanatorium  $21,896.00
Milk supplied to boarding-house  536.20
Milk supplied to Provincial Home   662.40
Milk supplied to calves  3,017.35
Milk supplied  (sundry)  14.00
Skim-milk supplied to pigs  115.30
Veal calves sold  140.00
Beef sold   1,330.40
Manure produced   652.50
Inventory, live stock, 1929-30   18,885.00
Inventory, feed, 1929-30   2,105.60
Hides   35.50
    49,390.25
Loss, 1929-30     $5,051.51
Dairy Herd—Production and Cost Account, March 31st, 1930.
Salaries   $5,823.57
Board of employees      2,520.00
Feed   11,441.65
Sundry expenses         912.06
Equipment    c       446.79
Silage      2,250.00
Straw       594.17
Horse-labour '.       511.00
Tractor-labour   40.00
Inventory, feed, 1928-29      5,823.57
  $30,362.81
Less allowance for manure          652.50
$29,700.31
Less cost of feed and care of young growing non-producing dairy stock      4,900.00
$24,800.31
Less inventory, feed, 1929-30       2,105.60
$22,694.71
Milk production for year, 744,045 lb., or 74,404 gallons.    Average cost of production, 30.50
cents per gallon.
Milk Production, March 31st, 1930.
1929.                                                        Milk, Lb. 1929.                                                        Milk, Lb.
April  58,214.3 December    60,593.9
May  64,663.9 1930.
June   66,087.8 January  59,453.4
July    68,219.6 February  53,809.0
August   65,982.7 March     62,052.6
September  62,977.8 ■	
October    64,387.3 744,045.0
November   57,602.7 ____=__= V 30 BRITISH COLUMBIA.
List of Record of Performances produced by the Tranquille Sanatorium Farm Herd
for the Year 1929-30.
Wor__ Milk Production. Butter.
iName-                                                                      Lb. Lb.
Excellency Hengerveld Echo (100835)  29,788 1,123.75
Mina Posch Pontiac (86568)  25,898 1,061.25
Alexandra Birdie May (51192)   20,345 941.25
Alexandra Verona May (77144)   23,910 937.50
Fairy Sylvia Echo (100836)   20,151 920.00
Lady Vancouver Burke (111995)   20,530 885.00
Johanna Butter Girl Pontiac (81162)   20,141 866.25
Alexandra Tranquille Korndyke (45807)   18,133 852.50
Alexandra Dorothy Kelly Pontiac (105894)   15,787 848.75
Colebrook Ormsby Colantha (152512)   18,679 817.50
Hengerveld Pontiac Countess  (86567)   17,464 786.25
Lucy DeKol Pontiac (81160)   16,785 755.00
Lady DeKol Clinker (31393)  _  15,068 735.00
Alexandra Lady Ormsby  (120109)    16,060 716.25
Alexandra Ormsby Birdie  (101010)    14,827 671.25
Alexandra Birdie Canary (150633)   16,050 067.50
Alexandra Princess DeKol (135857)   14,687 666.25
Alexandra Forbes DeKol (143103)   12,761 666.25
Johanna DeKol Princess (99510)    13,979 626.25
Alexandra Korndyke DeKol (115096)    13,997 626.25
Alexandra Excellency Ormsby (119394)   13,894 605.00
Aaggie Lady Posch  (156331)    13,091 601.25
Uneeda Peach DeKol (42717)   14,486 577.50
VICTORIA,   B.C. :
Printed by Charles P. Banfield, Printer to the King's Most Excellent Majesty.
525-131-3642

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