History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: March, 1927 Vancouver Medical Association Mar 31, 1927

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Published monthly at Vancovr
Subscription $1.50 per.rfearO
23. H Laboratories bulletin
Summer School Qlirdcs
MARCH, 1927
Published by
'M.c^Beatk Spedding Limited, 'Vancouver, ^B. Q.
Founded 1898. Incorporated 1906.
GENERAL MEETINGS will be held on the first Tuesday of the
month at 8 p.m.
CLINICAL MEETINGS will be held on the third Tuesday of the
month at 8 p.m.
Place of meeting will appear on Agenda.
General Meetings will conform to the following order:—
8:00 p.m.—Business as per Agenda.
9:00 p.m.—Paper of Evening.
March   1st—General Meeting:
Paper —       Dr. George Seldon, The OSLER Lecture.
Mar.   15th—Clinical Meeting.
April    5th—General Meeting:
Paper —       Symposium, "The Treatment of the Poor Risk
Patient," Drs.  C.  E.  Brown, A. B. Schinbein,
D. D. Freeze and R. E. Coleman.
April 19th—Annual Meeting.
Total Population   (estimated)      137,197
Asiatic Population  (estimated)     10,576
Rate per  1000
of population
Jan.,  1927
Cases Deaths
15th,  1927
Cases Deaths
Total Deaths  .       209
Asiatic   Deaths           17
Deaths   (Residents only)        159
Total Births .__..    308
Male,       164 Female,  144
Stillbirths—not included in above         19
Deaths under one year of age         21
Death rate per 1000 births         68.2
Feb.  1st, to
Dec,  1926
Cases Deaths
Scarlet Fever 	
Diphtheria            1
Whooping Cough 	
Tuberculosis   ,...
Typhoid Fever 	
Cases from outside city included in abov
Diphtheria     4 0 4 0
Scarlet Fever         6 0 10
Typhoid Fever .... 2 0 0 0
Page 172 yst-.ic ultraviolet
rac ion with Air*
'oot QuartzLamp,
n t nutrition.
'iai rmy for pain,
Hig fracture of
These photographs are used through the courtesy of Northwestern
University Medical School, Chicago. Above is a view of one section
of Physical Therapy Clinic, showing three of the treatment cubicles.
Physical Therapy Apparatus
Designed to Medical Ideals
IN the Dec. nth issue of the Journal of A. M. A. were printed the
Official Rules of the Council of Physical Therapy of the American
Medical Association. These official rules "have been adopted primarily
with the view to protecting the medical profession and the public
against fraud, undesirable secrecy and objectionable advertising in con'
nection with manufacture and sale of apparatus and methods for physi'
cal therapeutic treatment."
Quoting further from the A. M. A. Bulletin of the House of Del'
egates: "It is hoped that the medical profession will give consistent
support to this effort for sound therapy. Physicians may well follow in
their choice of apparatus and in their work the opinions of the Council
on Physical Therapy as to what is reliable."
For over thirty years the Victor X'Ray Corporation has specialized
in the design and manufacture of electro'medical apparatus, and its
policies have always been dictated by the ideals sought by
the medical profession itself. The Victor line of Quartz;
*1    ^* Lamps, Diathermy Apparatus, Galvanic and
Phototherapy Lamps will bear investigation
by the discriminating  physician who  seeks
quality first.
Write for Clinical Reprints indicating uses of any of these physical
therapeutic agents, together with descriptive literature on apparatus
Physical Therapy Division
2012 Jackson Blvd., Chicago
33 Direct Branches Throughout U. S. and Canada
Vancouver Branch
570 Dunsmuir Street
Page 173 Latest Refinements in
Diphtheria Antitoxin
Purity, Concentration, Limpid
EESEARCH—long,   patient,   painstaking   research—has   en-
I abled us to make progressive improvement in the methods
of refining Diphtheria Antitoxin.
And now Parke, Davis & Company's Diphtheria Antitoxin
represents, in the light of our present knowledge, the acme of
desirability from the standpoints of purity and concentration.
Compare it with others. You will be impressed with its
smaller bulk, its crystal clearness, its water-like fluidity.
It contains a minimum of protein matter and other solids,
thus reducing the risk of serum reactions. And its low viscosity
insures rapid absorption.
There is no question about it—this Diphtheria Antitoxin is
outstanding in its excellence. That's why many physicians
specify, and insist on getting, the Parke, Davis & Company
The syringe containers in which this Antitoxin is supplied are of very satisfactory design and are easily manipulated even under the trying conditions which
which frequently attend the injection of Antitoxin in children.
Diphtheria Antitoxin, P. D. & Co., is supplied in syringe containers—1000 units
for prophylaxis and 3000, 5000,10,000 and 20,000 for curative purposes.
Our   22-page   booklet,    "Diphtheria   Prophylaxis   and
Treatment,"   is available  to physicians  upon  request.
Parke, Davis & Company
fUnited States License No. 1 for the Manufacture of Biological Products\
Through the kindness of Dr. Hill, Director of Laboratories at the
Vancouver General Hospital, we are in receipt of a copy of a letter sent
to Dr. Young of the Provincial Board of Health by Dr. J. J. Heagerty
of the Federal Division for control of venereal diseases.
Dr. Heagerty calls attention to an interesting statement in Report
No. 107 of the Medical Research Council on the "Effect of treatment on
the Wassermann Reactions of Syphilitic Patients." On page 90 under
the head of conclusions the authors Glynn, Roberts and Bigland, state
that "mercury tablet courses certainly do not diminish the relapse incidence, as expected; they very probably increase it. Grey oil courses
definitely increase the relapse incidence." (The italics are those in the
original text.)
Commenting on this Dr. Heagerty says "one is left to infer that
one should not use mercury between salvarsan treatments (presumably in
latent cases) and that it (mercury) is only of use when the spirochaetes
are circulating in the blood."
Despite Schaudinn, and Wassermann and Ehrlich, this question of
the proper and efficient method of treating syphilis is still with us evidently. The lines of development of syphilo-therapy are interesting. For
years clinicians worried along with mercury as the chief agent and with
iodides as supplementary in the immediate background, a position which
they still occupy. With these "cures" undoubtedly resulted, or so it appeared in the absence of the Wassermann test. This indeed, must have
been so, for not all those patients who survived the other mischances of
life, developed later visceral manifestations or even tabes or G.P.I., nor on
the other hand did they always beget or bear clinically infected offspring.
Ehrlich's great discovery nevertheless, was enthusiastically and universally adopted with the brightest hopes of a speedy and lasting cure.
Speedy relief in many, perhaps in most cases, was indeed evident, but its
permanancy left much to be desired. Somewhat disheartened we have
since tried to combine the new with the old, trusting that by this means
our aims would be more adequately realized: the new to produce rapid
control, making the patient presentable to and safe for society; the old to
finish the lethal work on the already moribund Treponema.
In this mode, which in one or other form is probably the practice of
most clinics, we have continued, feeling that with the means at our disposal all possible will be accomplished. Now we have the Medical Research Council and Dr. Heagerty's letter referred to above.
We recommend careful consideration of the original report by
those interested in this particular work, the results of which closely affect all clinicians. Apparently it throws the whole matter of the treatment of syphilis once more into the melting pot and that which will ultimately come out of this process no man can foresee.
(Note)    Report mentioned above is in the Library for perusal.
Page 175 The Programme of the Seventh Annual Summer School of the Vancouver Medical Association is now almost completed and will be published
in full in our next issue. Meantime notices are being sent to every medical man in the Province giving the names of the speakers, etc., and
monthly notices will be issued till the month of June. The Committee
sees no reason why this year's meeting should not be a big success, and it
will be a big success if it is properly supported by the profession throughout the Province.   The speakers will be:
Dr. B. P. Watson, Professor of Gynaecology and Obstretrics, Sloane
Hospital for Women, New York.
Dr. Herbert C. Moffitt, Professor of Medicine, University of California.
Dr. Wm.. Boyd, Professor of Pathology, University of Manitoba.
Dr. J. G. Fitzgerald, Director of the Connaught Laboratories, Toronto.
Dr. Clarence L. Starr, Professor of Surgery, University of Toronto.
Dr. John Oille, Asst. Professor of Medicine, University of Toronto.
On February 14th, Vancouver lost one of her pioneer medical men;
Dr. Thos. H. Wilson passed away at his residence after a very brief illness.
Dr. Wilson graduated from Manitoba Medical College in 1897 and came
to Vancouver the following year. Settling in an office on Main Street,
he gradually built up an extensive practice.
Although of a quiet and almost retiring disposition, he made many
friends and only those who knew him best realized the kindliness of heart
which lay beneath the quiet exterior.
Never taking an active part in medical organizations, he yet maintained his interest in all matters touching the profession, and was a consistent upholder of the ideals of that profession. As a member of the
community, he stood for the best influences and good citizenship.
He leaves a wife and two children—one, Lloyd, is attending the
University of British Columbia, while Marjorie is at present at Whitley
The monthly General Meeting of the Association was held on February 1st. Fifty members were present, with Dr. A. W. Hunter, President, in the Chair. An important discussion took place in regard to the
application of the Vancouver Graduate Nurses' Association for consideration of the question of shorter hours for special nurses.    Communica-
Page 176
J tions on this subject have been received from the hospitals in Montreal
and Toronto and from various societies and individuals, the general opinion being that in places where shorter hours have been instituted, satisfactory working arrangements have been arrived at. In view of this it
was moved by Dr. Wallace Wilson, seconded by Dr. D. D. Freeze, that
the Association go on record as being in favour of an eleven-hour duty
for special nurses in selected cases. It is understood from the original
communication received from the nurses that in cases of seriously ill patients the full twelve-hour day will be given. After further discussion
the motion was passed unanimously.
Dr. Hunter notified the meeting that Dr. F. W. Brydone-Jack, the
Secretary of the Association, was leaving for a prolonged course of study
and it would be necessary to appoint a substitute for the remainder of his
Dr. J. M. Pearson was then called on for a paper on the "Treatment
of Hypertension." He made the working classification of cases of hypertension into those showing kidney lesions and those without. This question, he thought, was one of the most important which had to be made in
approaching the treatment of any case. He noted the considerable difficulty there was in connection with the estimation of blood pressure, such
as the variations occurring in the same individual at different times, the
influence of excitement and rapidity of the heart rate, the difficulty in
arriving at a conclusive point for the reading of the diastolic pressure
and the relative importance to be attached to the systolic and diastolic
pressures. He considered that it was never possible to say that in a general way the patient's pressure was higher or lower than the considerable
limitation within which we regarded it as normal. Speaking more directly of the treatment of hypertension Dr. Pearson said he felt that we
might be guided in our general principles of treatment by a consideration
of the ways in which a fatal termination might occur in these cases. A
fatal ending might be the result of cerebral accidents, it might occur
from cardiac failure, it might occur on account of kidney disability or
by way of terminal, more or less accidental, infections. The lecturer considered that cerebral lesions and kidney disability were by far the most
common causes of fatality, but Dr. Christian, speaking lately on essential
hypertension only, had said that no less than 32 per cent, would find a
fatal ending in some form of cardiac disability. Examining, then, into
these causes of death, we find that we have to protect the heart so far as
possible, the blood vessels, the kidneys and to provide against intercurrent
infections. In other words we must reduce the stress and strain of life.
This means that in so far as it is possible to do so an accurate adjustment
of the individual to his altered capacity must be made, either by means
of the reduction of excessive intake of food and drink, or by elimination
of physical exercise and mental anxiety.
Dr. Pearson then discussed the specific means we have at our disposal for the treatment of these cases. The question of diet was taken
up. An ordinary mixed diet was advised eliminating obviously indigestible foods. A sufficient intake was insisted upon. The use of a salt-free
diet,  originally   suggested  by  Dr.   F.   M.   Allen,   was   recommended   as
fage  17: worthy of a trial being in some cases of considerable use in the reduction
of pressure.     The  administration  of  digitalis  in  cases  of  suspected  or
actual cardiac disability was discussed and its use was recommended in
suitable cases, any effect the digitalis might have in the direct raising of
the blood pressure being considered to be negligible.    As direct methods
of possible means of reducing the blood pressure he mentioned the recent
work on liver extracts which was a promising but by no means proven
method.     Luminol  had  also  its  advocates.     In   the   speaker's   hands  it
had been without result, but it might be worthy of a trial.    Nitrites,
which are among the oldest remedies we possess, were considered in some
detail. Among these erythrol-tetranitrate was, the speaker thought, of some
value as its effects were more prolonged than some of the other forms.
Potassium iodide was a time honoured drug and always worth a trial.    At
times it appeared to act in a highly satisfactory manner, but it was impossible  to  tell  beforehand  which  cases  were likely  to  benefit.     Other
drugs such as diuretin, benzylbenzoate, were briefly discussed.    Bleeding
the speaker thought, was an unsatisfactory procedure and very temporary
in its effects, and also very likely to leave the patient in the long run
somewhat worse than we found him.    Electricity, usually given in the
form of auto-condensation as a means of producing presumably arteriolar
or capillary relaxation, had had a greater vogue than at present, but some
patients seemed to be considerably benefitted thereby.
The speaker in conclusion said that he considered it was more important to fit the patient to his altered blood pressure than to exhaust our
efforts in futile attempts to adjust the increased blood pressure to the
Following the conclusion of this paper Dr. C. S. McKee gave a preliminary report on some investigations he is conducting into the blood
chemistry of patients suffering from various forms of nephritis. This
work is being carried on chiefly at the Shaughnessy Military Hospital in
conjunction with the physicians in charge, the patients being returned
men who have been under observation for several years. Dr. McKee said
he was collecting a large mass of statistics on the subject which he hoped
to publish in detail at a later date, following this original communication
by subsequent bulletins concerning the progress of all or selected cases.
In this way he hoped to make this body of observations, which now numbered several hundreds, a valuable means of prognosis.
An important question was what amount of nitrogen retention constituted a danger signal in these cases and whether by arriving at a definite figure for this we could assume what a patient's future progress was
likely to be. Dr. McKee said he had been struck with the very considerable range of variability in the so-called constants of the body which
was compatible with life, and even health. The extent of this range was
an indication of the power of adaptability of which the body is capable
and this adaptability, the amount of energy available and the capacity to
utilize this energy, he considered as the response of the human economy
to its environment, which is life itself.
Dr. McKee took the amount of non protein nitrogen present in the
blood as an indication of the functional capacity of the damaged kidney.
Page 178 By this he considered, as a result of his observations, that 40 mgm per
100 cc. of blood might be regarded as the commencement of retention,
the important question being as to what height this retention might attain to before it begins to be dangerous. He had taken 247 cases which
had been seen personally by him between 1921 and 1927. On these he
had made some 800 different observations on blood and urine. He found
that there were peaks of ill health during which retention would rise, to
be followed by a diminution and a return to a sense of well-being. The
number of examinations made ran from 2 to 15 per individual. His
opinion thus far was that if the non protein nitrogen was over 55 and
persisted at that, while the patient might go on for some years, the downward tendency was inevitable. At 65 mgm or over the danger was greatly increased and a fatal termination was probable within a year or two.
Dr. McKee cited a number of cases giving the various readings in
different years and using these variations in readings as an index of prognosis.
At the close of Dr. McKee's paper considerable discussion took
place and the meeting adjourned at 10:30.
The February Clinical Meeting of the Association was held at St.
Paul's Hospital on the 15 th of the month. Dr. John Christie presented
a series of skin diseases. (1) A case of erythema induratum in a young
woman with many healed lesions below the knees on the anterior as well
as on the more usual posterior surfaces of the calves. This condition is
most common in young women between 15-25 with poor circulation.
(2) A case of xanthelasma with typical yellow plaques under the epidermis of the upper eyelids near the inner canthus. The condition is frequently associated with migraine. (3) A case of sycosis of the beard
and eyebrows of a coccygenic type which had been severe but was now
practically healed. (4) Another case showing a mixed skin condition
in a man of 62 apparently enjoying poor hygenie surroundings with an
old pediculosis, many small boils and two large indurated tumours of the
back, possibly gummata, with an old history of syphilis.
Dr. Keith showed a young man who suffered a bullet wound of the
chest in October. The bullet passed near the apex of the heart through
the lung and was lodged by the first lumbar vertebra just under the skin.
Twelve days after the injury 22 ozs. of. bloody fluid were removed from
the right chest. Patient developed a pneumonia which has cleared up.
There may have been an injury to the kidney for the urine early showed
red and white blood cells. The bullet apparently also wounded the diaphragm. Now breath sounds are absent below the third rib on left side,
no expansion of the chest, the lung is probably collapsed, the heart is
not displaced, no evidence of pericarditis, pulse runs constantly about 96.
The patient is up and apparently doing well.
Discussion brought out the possibility of the dullness being due to a
thickened pleura which frequently follows pleural effusion. The prognosis as to improvement is considered not good.
Continued on Page 190
Page 179 The
British Columbia Laboratory Bulletin
Published  monthly  September  to  April  inclusive  in   co-operation  with  the  Vancouver
Medical Association Bulletin, in the interests of the Hospital, Clinical and
Public Health Laboratories of B. C.
Edited by
Donna E. Kerr, m.a., of The Vancouver General Hospital Laboratories
Financed by
The British Columbia Provincial Board of Health
COLLABORATORS: The Laboratories of the Jubilee Hospital and St. Joseph's Hospital,
Victoria; St. Paul's Hospital, Vancouver; Royal Columbia Hospital, New Westminster;
Royal  Inland Hospital,  Kamloops;   Tranquille  Sanatorium;  Kelowna  General  Hospital;
and Vancouver General Hospital.
All communications should be addressed to the Editor as above.   Material for publication
should reach the Editor not later than the seventh day of the month of publication.
Volume 1
MARCH, 1927
No. 3
An Analysis of 223 Consecutive Glucose Curves Coleman and Kerr
A Summary of Red Cell Counts for 1925 Pottinger
The Digestibility of Fried Carbohydrate Foods Kerr
Material for Vincent's Angina R.E.C.
Abscess Material for Laboratory Examination , ...R.E.C.
Serial Sectioning of the Eyes. Garner
Editor's Note.
Despite our anticipation expressed in last month's bulletin we again
go to press with material only from the V.G.H. Laboratories. Of course,
we realize that without the constant reminder (the Editor) always on
hand in the above Laboratory the time slips by before one is aware of it.
However, we are of a cheerful and hopeful disposition and are reserving
most, if not all, of next month's bulletin for the other collaborators,
especially as it will be the last issue until next September.
By R. E. Coleman, M.B., and Donna E. Kerr, M.A., V.G.H. Laboratories.
The varying concentration of sugar in the blood following the oral
administration of glucose is commonly spoken of as a Glucose Curve.
Originally designed for the study of diabetes mellitus, this test has led to a
considerable volume of literature clearly indicating that abnormal values
are common in the complete absence of clinical diabetes. The following
is a summary of 223 glucose curves done at the request of practitioners
attending Vancouver General Hospital, of over 900 beds, during the years
1922-1926 inclusive. During the first year of the period, the examinations were made exclusively as an aid to the diagnosis of clinical diabetes
mellitus. By 1926, the last year of the period, a number of the examinations were a part of the attempt to elucidate obscure clinical conditions.
A difference in the character of the selection at both extremes of the
Page ISO
wm period was noted in tables of the first and last years.    In the accompany
ing table is a summary for the entire period.
DURING 1922-1926
• 13
. 1
• 4
Totals 223      197        26      173        48        89       46        88
Range for group in mg. glucose per 100 cc. blood.
Total number in group.
Hypoglycaemia absent (i.e., not below 70 mg.)
Hypoglycaemia present (i.e., falling below 70 mg.)
Attaining maximum in a single period.
Attaining maximum in 2 or more periods.
Falling from maximum to 110 mg. in single period.
Falling from maximum to 110 mg. in two periods.
Failing to return to 110 mg. by end of test.
Rising to maximum in single period and returning in single
subsequent period.
TECHNIQUE.—In the earlier curves 1.75 gms. of commercial glucose per kilogram of body weight was administered per os. This was
usually taken in 25 per cent, solution flavoured with coffee or lemon
juice. Later this dose was reduced so that it was roughly proportional
to 100 gms. of glucose for a man of 150 lbs.
Before the administration of the glucose and after an all night fast
a sample of the "fasting" blood was obtained. Three-quarters of an hour
after the subject commenced to eat the sugar a second sample of blood
was taken.    This specimen was designed to indicate the maximum in-
Page 181 crease in the blood sugar. Then two hours after the ingestion of the
glucose a third sample of blood was taken. This sample was designed to
differentiate those which failed to return to the normal fasting level in
two hours. Finally, three hours after the ingestion of the glucose, a
sample of blood was taken to serve as a check on the previous sample and
to aid in the interpretation of special cases.
The analysis of the blood was made by the Folin and Wu technique,
later modified as improvements were noted in the literature.
GENERAL INTERPRETATION.—It is customary to interpret
glucose curves according to the following main features:
1. The first or "fasting" sample should not be over 110 mg. of
glucose per 100 cc. of blood . (The upper fasting limit was earlier set
at 120 mg. but with most of the modern methods 110 mg. is probably
more nearly correct.)
2. The second sample taken three-quarters of an hour after the
ingestion of the glucose closely approximates the time of the maximum
rise in the normal individual. This should not exceed 170 mg. of glucose per 100 cc. of blood.
3. The third sample taken two hours after the ingestion of the
glucose should be below the upper limits for the normal "fasting" blood,
i.e., below 110 mg.
In chacteristically diabetic curves the "fasting" blood sugar exceeds 110 rag. per 100 cc. of blood; the sample taken three-quarters of
an hour after the ingestion of the glucose is usually higher than 170 mg.
(200 mg. or more); the sample taken two hours after the ingestion of
the glucose is still above 110 mg. of glucose per 100 cc. of blood (usually
over 160 mg.) and is frequently even higher than the preceding one.
DETAILED INTERPRETATION.—-Though the previous outline
is adequate for the interpretation of the majority of cases showing clinical symptoms of diabetes mellitus, yet in obscure clinical conditions a
number of curves are met with in which the various factors may appear
in almost every possible combination. Since every clinical case is at the
moment a very pressing problem urgently demanding a definite interpretation and consequent action on the part of the practitioner, it can be
seen that it is imperative that the significance of each individual factor
be estimated. It is of no satisfaction to the patient or physician to be
told that the curve is atypical and therefore valueless. As one physician
said, "Statistical averages are of no interest to the patient unless they
apply to the particular case."
1. A patient showing a normal "fasting" blood sugar may yet
be a diabetic with clinical symptoms, and these symptoms may disappear
following diabetic treatment. On the other hand if the fasting blood
sugar is 140 mg. or more a diagnosis of diabetes can usually be made.
2. With a "fasting" blood below 110 mg. the second sample taken
three-quarters of an hour after the ingestion of the glucose may be well
over 170 mg. (usually considered to be the normal maximum), and yet a
Page 182 diagnosis of diabetes be at the very least questionable. A glance at the
Table will show 16 curves in which, while the fasting blood was normal,
the blood sugar rose over 170 mg. and yet the third sample had returned
to 110 mg. Just what interpretation can be put on such curves is uncertain but we think that they indicate a definite error in the carbohydrate metabolism. We also think that, if the exciting cause continues to
act, these cases will later develop typical diabetic curves.
3. One feature is unfailingly diagnostic of diabetes, when it occurs. If the third sample of blood is higher than the second and over
170 mg. the patient is always a clinical case of diabetes. In our opinion
this is a feature toward which different types of curves trend and is
probably similar in type to the fixation of specific gravity found in certain types of chronic nephritis. We think it indicates a chronic state of
fatigue of the carbohydrate metabolism.
DISCUSSION OF DATA.—The persistence with which atypical
glucose curves present themselves for interpretation has led us to summarize our data. We wished particularly to determine the frequency of
the following features.
1. There were 21 curves in which the blood sugar failed to rise
above the fasting level of 110 mg., or 9.5% of the entire series.
2. There were 34 curves in which the blood sugar failed to rise
above 120 mg. which is the upper limit for the normal fasting level set
by some authors.    This was 15% of the entire series.
3. There were 111 curves in which the blood sugar rose above 170
mg. Of these high curves 20 or 19% had returned to 110 mg. or lower
by the end of the second period. The frequency with which this occurred
was a surprise to us, for late in diabetes the height of the curve tends to
be related to the degree of recovery. As already noted one curve rose
from a fasting level to between 270 mg. and 281 mg. in the first three-
quarters of an hour. Yet by the end of the second hour it was below
111 mg.
4. It was anticipated that the capacity to return to the normal
fasting level would have been found to be closely proportional to the
maximum height of the curve. Such relationship can be seen in the Table,
and was not found to be as close as might have been anticipated. The
group of 15 which show a maximum between 120 and 131 mg. (just
emerging from the fasting level) show 5 or 30% failing to return below 111 mg. This same per cent, holds for the entire group of 77 curves
whose maximum rose between 120 mg. and 171 mg. for 23 (30%) of
these also failed to return below 111 mg. Even when values up to 200
mg. are included the same 30% relation holds. On the other hand when
those rising to between 200 mg. and 301 mg. are considered as a group
there are still 10 or 20% found to be below 111 mg. at the end of the
second hour. In fact not till the maximum reaches over 401 mg. do we
find 100% remaining above 111 mg. three hours after the ingestion of
the glucose. Clearly the height of the maximum rise alone does not in
itself determine the ability to return to the normal fasting level within
two or three hours.
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Page 185 5. One feature has been of special interest to us partly because of
the lack of comment in the literature and partly because of the type of
cases in which it has appeared. If we accept 70 mg. as the lower normal
limit and call all values below this hypoglycaemia, there were 26 or 12%
of the curves which showed this feature. It is true that this feature is%
far more common in the curves with maximum below 161 mg., still 7
are found above this. In fact 2 curves rising to between 250 mg. and 261
mg. fell below 70 mg. before the end of the test.
6. From data already in hand we hope at a later date to be able to
indicate the process by which the normal curve passes into the late diabetic curve. . Our observations both in known and obscure clinical conditions indicate that tests of the glucose metabolism including the glucose
curves reflect earlier changes than any other test of a metabolite. This is
probably because except for the ionized gases and inorganic radicles no
other metabolite commonly measured is capable of such rapid fluctuations.
SUMMARY.—1. An analysis is made of 223 consecutive glucose
curves done for clinical reasons as indicated in a large (900-bed) general
2. The analysis indicated that the fully developed curve as found
in late diabetes mellitus does not develop from the normal by a gradual
increase in the height of the curve with a corresponding decrease in the
ability to return to the normal "fasting" or even a hypoglycaemic level.
3. Investigations are being carried on which already indicate the route
by which the earlier changes from the normal are effected.
Walter Pottinger, V.G.H. Laboratories.
The following data summarizes the 857 red cell counts made in this
hospital during the year 1925.
Of this number:
74 or    8.6% were over 5% millions.
480 or  56.0% were between 4 and 5l/z millions.
303 or 35.4% were less than 4 millions.
63 or    7.3% were over 110% haemoglobin.
439 or 51.6% were 80% to 110% haemoglobin.
351 or 41.0% were under 80% haemoglobin.
1 or    0.1%  was under 15% haemoglobin.
The highest red cell count was 9,800,000.
The highest haemoglobin was 188%.
The lowest red cell count was 856,000.
The lowest haemoglobin was 10%.
There were eight cases in which the blood picture indicated per-,
nicious anaemia, all of these cases were men.
Page 186 Three cases of polycythaemia were found, all being women.
Out of the 857 red cell counts examined 480 or 56% were wi
the normal range.    This per cent, would be higher if some of the cases
showing anaemia had not been repeatedly examined.
The high proportion falling within the normal range is of special
interest since all examinations were selected for clinical reasons, there
being no tendency in this hospital to call for routine red cell counts.
Donna E. Kerr, M.A'., V.G.H. Laboratories.
We have frequently heard the opinion expressed that the frying of
starchy foods in grease materially interferes with the digestion of the
starch. The fat, it is maintained, surrounds the starch cells and thus protects it from the action of the ferment diastase. In an attempt to test
this out in vitro a quantity of particularly greasy, thin and dry French
fried potatoes was obtained and these were cut up into small pieces approximately the size they would be broken up into in mastication. Two
aliquot portions of the mixture were accurately weighed out and from
one the fat was completely removed by ether extraction (Soxhlet extraction) . These two samples were placed in volumetric flasks, made up to
volume with a solution of diastase and kept in a water bath at 37° C
over night. The solutions were filtered and the filtrate used to determine
the amount of reducing sugar produced by the action of diastase. This
was done both by Folin's blood sugar method and Benedict's method for
sugar in the urine, the results of both methods being almost the same.
It was found that the fat-free sample of potato yielded 53.5% of reducing substance calculated as glucose and the fatty sample 51% of reducing substance calculated as glucose. Considering the nature of the
specimen, no importance could be attached to this small difference. The
emulsification and splitting of the fat which normally occurs in digestion
in vivo, were naturally absent in the experiment and the efficiency of the
diastase might be expected to be less. This experiment would indicate
that carbohydrates fried in deep fat are net markedly indigestible.
For Vincent's Angina the bacteriologist reports on the examination
of the direct smear only. This organism has been cultured but only with
considerable difficulty and not on ordinary media. It is necessary, therefore, that the clinician make smears (two) at the time. Swabs sent to
the laboratory are apt to be too dry to permit of smears being made from
them. The bacteriological diagnosis is from the direct smear and is
usually quite definitely positive or negative.
Though the organism of Vincent's angina is most often associated
with infection of the mouth and throat it is not an uncommon infecting
agent in other parts of the body, specially as a secondary invader. Besides in the mouth it may  be found as  the etiological factor in lung
Page 187 lesions, as a secondary invader in chronic mastoiditis, following industrial
wounds, and about the genitalia. R.E.C., V.G.H. Laboratories.
The clinician sends abscess material to the laboratory for the purpose
of determining the causative organism. If the laboratory is to be in a
position to give him a maximum of information it is necessary that the
material be received in a suitable condition.
The first thing that the bacteriologist does, with such material, is
to examine smears and, therefore, the clinician should procure two smears
on microscopic slides at the time the' abscess is incised. If the clinician
does not secure this material then, it often occurs that the material sent
to the laboratory is too dry to make a satisfactory smear.
If the bacteriologist finds that the direct smear indicates an organism which will not grow on the ordinary media, special media may be
prepared or other precautions may be taken. If staphylococci, streptococci,
etc., are indicated then the material is inoculated on plain agar, Loe-
fler's media and broth. Most of the common organisms will yield a growth
the following day and will be so reported. It may be necessary, however, for the bacteriologist to make a provisional diagnosis at this time
because of the morphological similarity of some groups of organisms.
Bacillus coli and Bacillus pyocyaneus can not be distinguished in the direct smear nor from the appearance of a twenty-four-hour-old culture.
It may be necessary for the bacteriologist to make special tests. This will
take three to six days more. A much better way to identify pneumococci
is by means of specifically immune sera. This not only distinguishes
streptococci from pneumococci but also identifies the type of pneumococci (types I, II, III, and IV). The type sera are not kept in this
laboratory because the laboratory is not kept supplied with sufficient material to keep the sera fresh on hand. Other less common bacteriological
differentiations should always lead to direct consultation with the bacteriologist. Some organisms will either not grow on any of the known media
or their cultivation is not practically advisable. Such for example is
the B. tuberculosis. For this organism the direct smear obtained by the
clinician is the most satisfactory when it is positive. If the direct smear
is negative and it is desirable to exclude the organism in so far as that is
possible, a guinea pig should be inoculated. At the end of two weeks in
most cases that are positive a positive diagnosis can be made but if that
is negative it will be necessary to wait another four weeks (six weeks in
all) before a definite negative report can be made from an autopsy on
the animal.
If the clinician is unable to obtain fresh material when the abscess
is first opened and as a result secondary invaders are found it may be
impossible for the bacteriologist to determine which was the primary invader or, in any case, the isolation and identification will require a longer
time, varying from one to six weeks. For this reason it is most desirable
that the clinician decide whether or not to take a culture before the first
incision is made.
Page 188 From the direct smear the bacteriologist may be able to report positively as follows:
Gram negative bacilli=including chiefly the colon group.
the typhoid group.
B. pyocyaneus.
staphylococcus aureus,
ram positive cocci   =including chiefly staphylococcus albus.
streptococcus group,
=This is of some value when tuberculosis is
suspected and is further supported if a sterile culture results.      — R.E.C., V.G.H. Lab.
No organism found
Joseph Garner, V.G.H. Laboratories.
One of the most delicate operations, from a pathological technician's
standpoint, is the serial sectioning of the eyes.
After experimenting with several methods, I find the following
method best:
Put the eye into a wide-mouth bottle, on a piece of cotton wool, fill
with a solution, composed of 5% formalin and 0.8% saline; after 24
hours, with a sharp scalpel, cut a small nick into each side of the sclera;
return to the formal-saline solution, and leave for one week more;
then increase to 10% formal-saline, and leave eye in this for approximately one month; get a sharp needle, and run it into the vitreous of the
eye; if any adheres it is not yet ready.   The needle must come out clean.
When hardened, with a long sharp knife, carefully sever eye with
one clean long stroke; hacking must be carefully avoided. Put. section
into 20% alcohol, then, every 24 hours increase the strength of the alcohol until 80% is reached.
During this process, note carefully that the vitreous does not shrink,
if so, reduce the time in alcohol. When the vitreous is clear, indicated
by the absence of a cloudy whitish blur, wrap the eye in a thin piece of
gauze, and put into absolute alcohol, for approximately two hours, using
two changes; then place in two changes of chloroform for two hours,
then into mixture of aa paraffin and chloroform for four hours, using
two changes, and keeping just warm enough to keep the paraffin melted.
Finally place in melted paraffin for from one to two hours and embed.
During the whole dehydration and embedding process watch carefully for shrinkage.
Reasons for this procedure:
Saline has a tendency to keep the eye swollen whilst hardening. The
vitreous must be hardened sufficiently to resist the alcohol treatment.
If the alcohol is too strong, shrivelling results, therefore dehydrate
quickly from 70% up.
From this on celloidin can be used in place of paraffin embedding,
but celloidin sections are thicker and have a tendency to curl and break.
If any calcified deposits are present, decalcify before putting into the
second series of formal saline.
Page 189 Continued from Page 179
Dr. Hunter showed specimens of papillomata of the bladder from a
case whose history goes back to 1921 when patient was about 28 years
of age. The first evidence of trouble was pus in the urine which may
have been due to g.c. infection. There was difficulty in urination and
retention followed, with catheterization, then intermittent haematuria.
Cystoscopy in 1922 showed papillomata of bladder, one at the neck apparently the cause of retention. Four fulgurations were of no help and
patient was operated and masses removed. In 1923 he was again operated and the masses removed and the stumps fulgurated. Patient was
well until May, 1926, when he was operated for the third time, extensive papillomata being removed. Cystoscopy in December, 1926, showed
no recurrence. Dr. Hunter emphasized the necessity for an immediate
diagnosis in a case of haematuria without symptoms.
Dr. Vrooman presented a series of X-Rays showing cases in which he
had injected lipiodol in a diagnosis of lung cavities. His injections were
made through the crico-thyroid membrane led by the bronchoscope or by
the supra glottic method. 20 cc. of a warm mixture of cottonseed oil
and iodine were injected and patient turned to allow drainage to the part
suspected. The first films showed only chronic bronchitis with possibly
a slight bronchiectasis. The second case was a Japanese boy who had had
repeated pulmonary haemorrhages and a condition in the right base with
thickened pleura. The bronchi were outlined as sharply as lead pencils
and considerably enlarged. The third case was one of aspiration pneumonia which was still raising large amounts of purulent sputum, and is
suspected of being tubercular. The films showed an area in the right
upper chest probably tubercular with a partial pneumothorax. Diagnosis
not satisfactory. Discussion on the uses of lipiodol brought out the facts
of its successful use in the diagnosis of bronchiectasis, lung abscess and
its use also in working out sinuses in general. The injection gives no discomfort and no trouble. It is not in any sense a curative measure. Dr.
Prowd mentioned it as of use in determining the patency of the Fallopian
tubes and stated that it is better than bismuth.
While in Vancouver in connection with the recent Customs enquiry Mr. R. L. Calder, K.C., gave an interesting address at a joint luncheon meeting of the local and provincial associations. Under the title
"Murder and Medicine" Mr. Calder discussed the medical aspects of
various celebrated murder trials in which he had been engaged as counsel. The speaker said it would be a good thing for both professions if
lawyers and doctors met together socially a little oftener. They could
get together from many viewpoints. Lawyers very frequently had to
deal with medical problems, and he thought if lawyers studied medicine
and medical men studied the law their mutual co-operation might bring
about something which they now often failed to accomplish, namely,
Speaking of confessions obtained under duress Mr. Calder showed
how, in certain recent cases, these had operated to work injustice and
speaking personally he believed them to lie at the root of the crime wave
in the United States. One case to which the speaker referred was eminently one for the medico-legal expert, and owing to the crime waves in
Page 190 the United States and their reflection in Canada he hoped there would
shortly grow up in the ranks of the medical profession a body of men
who would become experts in criminal investigation. In all the major
crimes life was involved. In France, Mr. Calder said, there has grown
up a body of men whose keenness of investigation is almost miraculous.
Any man who adopts this specialty would have to go to the French school
of "expertise criminelle" and learn from them how to detect stains on
clothing, finger marks, etc. The man who will become a trained and
competent observer and who will add to that a complete absence of
passion and who will take a pride in proving what is a mystery to other
people, that man will become the surest guardian of our Commonwealth
against crime. The criminal fears nothing so much as the trained observer. The need for trained scientific observation is great, and when
we have properly organized our forces for combatting crime, the only
thing the ordinary policeman will do will be to establish a cordon. The
first man on the scene in any great crime should be a trained prosecutor,
with a trained photographer and additional members of a staff each
trained in some particular branch of scientific observation. More can
be observed in the first ten minutes than in the next twenty years.
The meeting was attended by over one hundred medical men who
thoroughly enjoyed Mr. Calder's refreshing and stimulating address. At
the close of his talk Mr. Calder paid an eloquent tribute to Dr. D. J.
McTaggart, of Montreal, the well-known jurisprudent. He commented
on his possession to a high degree of the qualities of impartiality and
keenness referred to above.
Ethel C. Pipes
Dietitian, Vancouver General Hospital
The orders now written for the dietitian clearly show that the
physician of today finds definite indications for the therapeutic use of
carbohydrates, chiefly to counteract acidosis and ketosis. When these indications are urgent the carbohydrates may be given intravenously, in-
terstitially or per rectum and under these conditions the dietitian receives
no orders. When, however, the urgency is less acute the dietitian receives orders for orange juice or other carbohydrate food.
In actual practice we find that the very patients for whom orange
juice and other sweet drinks are ordered, belong to a class to which sweet
foods do not appeal. Although these patients will frequently take one or
two doses of sweet mixtures they tend to object more and more to each
succeeding dose. After twenty-four hours, the orange has become a real
trial and then a change to some other form of carbohydrate seems to produce just as good clinical results, with the added approval of the patient.
A discussion of this feature with clinicians would seem to indicate
that after the first or second dose of orange juice or other sweet drink,
Page 191 some insoluble form of carbohydrate serves equally well. The juice of one
medium orange contains 6.5 grams of carbohydrate. If a level teaspoon-
ful of cane sugar be added, the total carbohydrate becomes 11.5 grams.
Both of these doses may be nauseatingly sweet to the sick patient while
16 grams of starch in the form of six ounces of a tomato soup may be
well tolerated. This same dose of insoluble carbohydrate, having no
sweet taste, really supplies 1.4 times the antiketogenic value of the former
nauseating dose.
Whether carbohydrate in the form of an insoluble starch is clinically
as efficient as the soluble sugars can not be definitely stated at present,
but there does not seem to be a serious failure of starch digestion in these
cases. When it is considered, therefore, that the orange juice is not repeated under an hour there would apparently be ample time for the complete conversion of starch into sugar. So that probably over a period of
twelve hours, more carbohydrate is made available by means of starch
than of sugar.
Dietetically then, when ketosis or acidosis is to be combatted, the
carbohydrate equivalent of one medium orange can be given in any one
of the following forms:
1. A slice of zweibach or a rusk.
2. Two ounces of plain blanc mange.
3. Four ounces of puree vegetable soup.
1 oz. pureed 20% vegetable.
1 oz. pureed  10%  vegetable.
1 l/z oz. pureed    5■ '<   vegetable.
3 oz. vegetable water.
2 oz. whole milk seasonings.
Each oz. contains 3 grams carbohydrate.
4. Two heaping tablespoons of cooked Cream of Wheat or Farina
may be taken plain or in gruel.
The Library is situated in 529-531 Birks Building, Granville Street,
Vancouver, B.C.
Librarian: Miss Ftrmin
Hours: 10 to 1, 2 to 6
Common Procedures in Pediatrics, by Alan Brown and Fredk. F. Tis-
dall.    McLelland & Stewart, Toronto, 1926.    $4.00.
The early chapters of this book are devoted to history taking and
methods of physical examination. The section on Infant Feeding is written in a very concise manner presenting the modern ideas on the subject
Page 191 as similarly described by Hess in his book "Principles and Practice of Infant Feeding." It is interesting to note that the authors recommend milk
containing 2 per cent, fat acidified either by commercial lactic acid or
by the cultural method as being preferable to whole milk acidified. An
important chapter is that devoted to the pre-school and adolescent child
and this, in the reviewer's opinion, is by far the most excellent portion
of the book. Diagnostic and therapeutic procedures in hospital work are
well covered, the methods of dealing with the parenteral administration
of various fluids being discussed in considerable detail. Exsanguination
transfusion, which the authors regard as truly "a life-saving procedure,"
is also brought to our attention and the method of use is described in a
very clear and simple manner. The dietetic treatment of nephritis is
discussed fully and is apparently regarded as the method of choice.
Most recent developments in regard to the prevention and treatment
of scarlet fever are noted, as well as the production of active immunity
against diphtheria, but here the authors say that it is too early to determine the duration of the immunity but it probably lasts for years.
In dealing with thymus enlargement it is stated that care must be
taken in arriving at the diagnosis of enlarged thymus as there is a tendency to consider many unexplained symptoms as due to this condition.
In pyloric stenosis the authors consider immediate operation to be the
method of choice, and probably to the class of cases usually coming to
hospital this treatment may be almost necessarily applicable. Little or
no consideration is given to the medical treatment of this condition.
The chapter on drugs and therapy shows the present day tendency
to use therapeutic measures other than drugs. Useful tables are appended
concerning height and weight for various ages, daily caloric requirements,
caloric values, composition of food stuffs, etc. This book should be extremely useful to the practitioner as giving details of procedures actually
in use. —E.C.
International Clinics. Series 36, Vol. 11. J. B. Lippincott Company, Philadelphia and London.    $3.00.
This number contains some good articles, among which may be
mentioned that by Antony Feiling on retinal changes in hyperpiesia, with
plate. Bronchial dilation is dealt with by Sargent in an exhaustive article
and a consideration of the X-Ray and Lipiodol method of examination.
The chronic gall bladder is discussed by Forman and this dubious condition explained fully. A series of cases from the Surgical Clinic of the
Broad St. Hospital is reported. Other articles are given on such subjects
as spirochaetal pulmonary gangrene, summer diarrhoea of infants, hypertrophy of the prostate and one on cranial and intercranial injuries by
Johnson. This last article calls attention to the necessary care which
must be taken in diagnosing or excluding these injuries in case of accident and gives in detail some of the many methods employed.
The volume maintains in a satisfactory manner the level attained
by its many predecessors. —F.N.R.
Abstract of an article on "Colitis as a Common Disorder of Digestion," by John L. Kantor, M.D., and Zachary Segal, M.D., in the American Journal of the Medical Sciences for November, 1926.
The authors have long been impressed with the frequency with
which simple colitis is encountered in the general run of cases and
with the relative infrequency with which it is recognized by the profession at large. 50% or more of all patients complaining of digestive disorders show evidence of colitis. Under etiology the injudicious use of
cathartics and the recent fad of colonic irrigations is considered to be a
very common cause as well as improper diet both qualitative and quantitative. Intestinal dyspepsia, whether of the fermentative or putrefactive
type, is always accompanied by a colitis. When the cecocolic tract is affected the spasm will cause overdistension of the cecum and pain in the
right iliac fossa suggestive of appendicitis. Excessive accumulation of
gas in the hepatic flexure and irritation of the transverse colon may often
be mistaken for affections of the gall bladder, stomach or duodenum.
Diagnosis.—The usual tenderness over various parts of the colon,
localized tenderness in the right iliac fossa and right hypochondrium.
Proctosigmoidoscopic examination is very useful. In early and mild functional cases merely congestion of the mucosa is found. In the more severe
cases the pathology ranges from small punctate petechiae and ulcerations
to atrophy of the mucous membrane.
Test Meal.-—Achylia or marked hypochlorhydria is generally associated with the colitis. Stool examination is of great importance. Given
a stool mushy in appearance, with an excess of mucous, the presence of
several small gas bubbles, and strongly acid in reaction with a sour penetrating odour, the rest of the examination is superfluous or merely confirmatory. The outstanding feature in colitis is the presence of mucous
mixed with the stool.
Roentgen Diagnosis.—Normally the caecum begins to fill four hours
after the standard opaque meal. At six hours the head of the barium
column reaches the region of the hepatic flexure, and the tail is still in the
ileum. At nine hours the head reaches the splenic flexure and the tail
has cleared the terminal small intestine. At 24 hours the bowels have
moved once and the left sided shift has occurred. By 48 hours the bowels
have moved twice and the colon is clear except for traces of barium.
The authors claim that any departure from this schedule is abnormal.
If the change is in the direction of stasis a diagnosis of constipation is in
order. If on the other hand colonic transit is hastened, there exists a
state of irritability, which is the essential motor expression of colitis.
Colitis may therefore be diagnosed from the following roentgen findings:
(1) at the six-hour observation the head of the barium is beyond the
splenic flexure. (2) at nine hours the head of the column is in the pelvic
colon or rectum with or without the passage of a stool containing barium.
(3) at 24 hours the colon is empty. In colitis there is either irregularity
or complete absence of the haustrations lending an atypical beaded, mot-
Page 194 tied or smooth appearance to the fecal colon as the case may be. Increased
gas content of the large intestine is also suggestive of colitis. Stasis in the
terminal ileum is a strikingly constant finding in colitis. This is suggested if (1) at the 6-hour observation no barium has passed the ileocecal
junction (2) at the 9-hour observation barium is still present in the terminal ileum.
Therapy.—The first step is absolute withdrawal of all forms of colonic abuse, cathartics, irrigations, ennemata, etc. The next step is a
bland well balanced diet, such as the standard Schmidt diet, which may be
concentrated as regards the number of feedings in the following manner:
Breakfast.—One pint of milk or tea or cocoa prepared with milk,
one soft-boiled egg, one buttered roll, one large roll, one large plate thick
oatmeal gruel.
Dinner.—One large plate thick potato soup, y4 lb. chopped or scraped
beef slightly browned in the pan.
Supper.—Same as breakfast with one or two additional rolls, also one
additional egg.
In very irritable cases it may be well to reduce the milk intake or
eliminate it altogether. Also it may be necessary to split up the feedings
into five meals a day. All cold foods and drinks are to be avoided. Mineral oil or agar in addition if above diet proves too constipating.
As the condition improves other articles may be added one by one—
cooked chicken, rice, fish and finely pureed starchy vegetables. Fermented
milk is well borne by some patients. Medication may be useful—barium
sulphate or kaolin. The authors give a tablespoonful of each stirred up
in a cup of cocoa twice daily. Sedatives, such as bromides, or if much
pain, codein is helpful. For overcoming spasm belladonna in increasin
doses is very helpful. 10-15 drops of the tincture to begin with,
increasing the dose by one drop daily until symptoms disappear. Where
gastric anacidity exists dilute hydrochloric acid is indicated. Heliotherapy
seems helpful, also warm moist compresses about the abdomen.
Summary.—Simple colitis is a common disorder of digestion. It is
often overlooked by both patient and physician. The diagnosis can be
made (a) clinically (b) by stool examination (c) by Roentgen ray.
Prognosis is guarded but improves in proportion to precision of diagnosis
and persistence of treatment. Therapy is outlined. It is primarily dietetic,
but general hygenic measures, certain medicaments, hydrotherapy and
possibly actimotherapy are often of value. —C.E.B.
Recent visitors to Vancouver include Dr. H. H. Murphy, of Kamloops, Dr. M. W. Thomas, Victoria, and Dr. W. A. Coghlin, of Trail.
Dr. W. C. G. Bissett has relinquished his practice at Cassidy, B.C.,
and is now at Trail.
Page 19? Dr.A. E. Trites, who has been assisting Dr. H. B. Maxwell, of Lady-
smith for some months, has been appointed medical officer at Cassidy,
vice Dr. Bissett.
Dr. Geo. More, late of Nanaimo, is now assisting Dr. Maxwell of
A meeting of the full Executive Committee of the B.C. Medical Association was held in Vancouver on January 30th. Many important matters of an economic nature were dealt with, and seventeen new members
elected to the Association.
We would again call our readers' attention to the forthcoming Summer School of the Vancouver Medical Association to be held in June
next. This is more than merely a local effort on the part of the Vancouver Medical Association. It affords to the whole of British Columbia
a ready method of attending clinics and lectures which cannot in a
province like ours be secured in any other way than the one adopted, and
the contention of Vancouver has always been that this should be open to
men fro mevery part of the province equally with those practising in
Vancouver. The Executive Secretary of the B.C. Medical Association in
his trip shortly to be made round the province will carry tickets for this
meeting and it will be of the greatest possible service to the committee
in charge if those who intend to come will get their tickets as early as
We are pleased to report that Dr. A. W. Montague, of Victoria, has
recovered from an operation for appendicitis.
The Victoria Medical Society was delighted by Dr. E. L. Garner, of
Duncan, when he presented a paper on "Fractures and their Treatment."
The lecture was illustrated with lantern slides and Dr. Garner was able to
show a number of patients with results of special treatment and demonstrated a large collection of splints and appliances which he used in this
work. Those present will long remember the instruction given and their
gratitude to Dr. Garner was evidenced in an enthusiastic vote of thanks
and long continued applause.
The November clinical meeting at the Royal Jubilee Hospital, Victoria, was well attended and interesting cases and other clinical material
comprised an instructive evening.
Dr. W. Allan Fraser, of Victoria, son of the late Dr. R. L. Fraser,
was married on December 18 th, in San Francisco, to Miss Laura Margaret
Eng, of Victoria. After honeymooning at Del Monte Dr. and Mrs. Fraser
have returned to Victoria and taken up residence at 800 St. Charles
Dr. Stuart G. Kenning, of Victoria, has recently returned from
Eastern centres where he spent some time doing post-graduate work.
Page 196 Dr. A. S. Underhill, of Vancouver, left on January 17th to relieve
Dr. J. H. Carson at the Premier Gold Mine, for three or four months.
Dr. H. C. Wrinch, M.L.A., of Hazelton, B.C., was detained in the
Vancouver General Hospital for a few days with an infected leg, whilst
on his way to attend Parliament in Victoria.
Our congratulations to Dr. and Mrs. S. G. Baldwin, of Vernon,
on the birth of a son on January 13 th.
Dr. C. H. Hankinson, of Smithers, was a recent visitor to Vancouver, where he spent some time in the business office of the B.C. Medical
Association, and lots of money in the Vancouver stores. B. C. Pharmacol Co. Ltd.
329 Railway Street,
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For information apply to
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or 515 Birks Building, Vancouver
Seymour 4183
Westminster 288
Page 200


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