History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: May, 1944 Vancouver Medical Association May 31, 1944

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Vol. XX.
With Which Is Incorporated
Transactions of the
Victoria Medical Society
Vancouver General Hospital
St Paul's HospitaM
In This Issue:
SUMMER SCHOOL PROGRAMME ^^tf * ■-- - Jl|ll' —Jjy; ^IKfe - 202
JUNE 20-23
Aluminum hydroxide
and zinc oxide,
both mildly astringent.
Phenol and mercurous
chloride, both
strongly antiseptic.
ggacffigps      • ss^igs^fi2S£'if^^^^^SjS^aL^^i
Benzocaine, for its
analgesic effect*
Hemroydine E.B.S. is designed far the relief of non-surgical haemorrhoidal
conditions and such other irritations of the mucous membrane as pruritis
ani and vulvae, in which conditions it affords rapid relief from itching and
pain. Hemroydine EJB.S. is also useful for symptoms of eczema, impetigo,
favus, acne and psoriasis.
In prescribing Hemroydine, follow the
name Hemroydine with the letters E.B.S.,
to identify  this  Shuttleworth product.
Rx   Hemroydine E.B.S.—one tube
Sig x As directed.
Hemroydine is available
in collapsible tubes, with
a convenient applicator
nozzle, and in 16 oz.jars.
SiHim   tmmmm ■>&m.-.
116 1944
Pulished Monthly under the Auspices of the Vancouver Medical Association
in the interests of the Medical Profession.
Offices: 203 Medical-Dental Building, Georgia Street, Vancouver, B.C.
Dr. J. H. MacDermot
Dr. G. A. Davidson Dr. D. E. H. Cleveland
All communications to be addressed to the Editor at the above address.
Vol. XX
MAY, 1944
No. 8
OFFICERS, 1944 - 1945
Dr. H. H. Pitts
Dr. Frank Turnbull
Dr. A. E. Trites
Past President
Dr. Gordon Burke
Hon. Treasurer
Dr. J. A. McLean
Hon. Secretary
Additional Members of Executive: Dr. G. A. Davidson, Dr. J. R. Davies
Dr. P. Brodte Dr. J. A. Gillespie Dr. W. T. Lockhart
Auditors: Messrs. Plommer, Whiting & Co.
Clinical Section
Dr. E. R. Hall_, Chairman Dr. S. E. Turvey Secretary
Eye, Ear, Nose and Throat
Dr. Letth Webster Chairman Dr. Grant Lawrence Secretary
Pediatric Section
Dr. J. H. B. Grant Chairman Dr. John Piters Secretary
Dr. A. Bagnall, Chairman; Dr. F. J. Buller, Dr. D. E. H. Cleveland,
Dr. W. J. Dorrance, Dr. J. R. Neilson, Dr. S. E. C. Turvey
Db. J. H. MacDermot, Chairman; Dr. D. E. H. Cleveland,
Dr. G. A. Davidson
Summer School:
Dr. W. L Graham, Chairman; Dr. J. C. Thomas, Dr. G. A. Davidson,
Dr. R. A. Gilchrist, Dr. A. M. Agnew, Dr. G. O. Matthews
Credentials: LjP
Dr. D. E. H. Cleveland, Chairman; Dr. E. A. Campbell, Dr. D. D. Freeze
V. O. N. Advisory Board:
Dr. Isabel Day, Dr. J. H. B. Grant, Dr. G. F. Strong
Metropolitan Health Board Advisory Committee:
Dr. W. D. Patton, Dr. W. D. Kennedy, Dr. G. A. Lamont
Representative to B. C. Medical Association: Dr. A. E. Trites
Sickness and Benevolent Fund: The President?—The Trustees Whether rationing is more or less liberal,
the pediatrician as always has the problem of
supplying sufficient vitamins A and D to his young
patients. Vitamin D in particular must be supplied
abundantly to insure adequate structural development and calcium-phosphorus metabolism.
For this purpose Navitol* with Viosterol offers
these features:
1. It has an unusually high vitamin A and D
content per gram—65,000 units of A—
13,000 units of D.
2. An average daily dose of THREE DROPS
supplies 5000 units of A—1000 units of D.
3. Cost per daily dose about one-half cent.
4. Highly palatable.
Navitol with Viosterol thus affords a convenient
and economical means of supplying the fat-soluble
vitamins A and D which every infant needs every
day. Specify it for expectant mothers, infants,
children, and patients requiring a vitamin A and D
Navitol with Viosterol conforms to the maximum vitamin A and D potencies of U. S. P. XII
Concentrated Oleovitamin A and D.
•Navitol is « trade-mark of K. R. Squibb fit Sons.
For literature write
36 Caledonia Road
Toronto, Ont.
ER: Squibb &Sons
Uanu/octurint Chemists to Ike Medical PrejessUm
Total  Population—Estimated   _
Japanese  Population	
Chinese   Population—Estimated
Hindu  Population	
Total deaths 	
Japanese   deaths   	
Chinese  deaths 	
Deaths—residents only 	
Male,  338;  Female, 317
Rate per 1,000
Number Population
  302                    11.9
      Population Evacuated
  16                    33.0
  263                     10.4
March, 1944
Deaths under one year of age 22
Death rate—per 1,000 births 33.6
Stillbirths  (not included above)       14
March, 1943
February, 1944
Cases      Deaths
March, 1944
Cases      Deaths
April 1-15,1944
Cases      Deaths
Scarlet Fever 	
Diphtheria    1
Diphtheria Carrier
Chicken  Pox  	
Whooping   Cough  	
Typhoid   Fever	
Undulant Fever	
Meningococcus  Meningitis
Paratyphoid Fever 	
Infectious   Jaundice   	
Gonorrhoea .
West North       Vane.   Hospitals &
Burnaby    Vane.  Richmond   Vane.      Clinic   Private Drs.   Totals
Figures not yet available. <
The most effective therapy for waning mental and physical energy,
deficient concentration and memory, reduced resistance to infection,
muscular weakness and debility, neurasthenia and premature senility.
The efficacy of this very potent endocrine tonic has been confirmed by
the clinical evidence of many thousands of cases treated during
Stanley N. Bayne, Representative
Phone MA. 4027 1432 MEDICAL-DENTAL BUILDING Vancouver, B. C
Descriptive Literature on Request
Page One Hundred and Ninety-eight This homely analogy could describe the physician's lot today. With heavier rounds
of hospitals and homes, more office appointments and important wartime activities,
time conservation has become a real problem.
In treating menopausal patients, it has been the experience of many clinicians
that "Premarin" and "Emmenin" help to solve this problem. These naturally-
occurring oestrogens provide effective oral therapy for all menopausal patients.
conjugated oestrogens   (equine)—for alleviation of
even the 'most severe menopausal symptoms.
TABLETS (No. 866)—bottles of 20 and 100'
conjugated oestrogens (placental)—for treatment of
the milder menopausal symptoms and for maintenance;
TABLETS (No. 701)—bottles of 42      LIQUID (No. 927)—bottles of 4 oz.
Supplied with the approval of the Research Institute of Endocrinology,
McGill University, under the direction of Dr. J. B. Collip.
Biological and Pharmaceutical Chemists       •       Montreal,  Canada
FOUNDED 1898    ::    INCORPORATED 1906
*        *        *        *
GENERAL MEETINGS will be held on the first Tuesday of the month at 8:00 p.m.
CLINICAL MEETINGS will be held on the third Tuesday of the month at 8:00 p.m.
These meetings are to be amalgamated with the clinical staff meetings of the various
hospitals for the coming year.   Place of meeting will appear on the agenda.
General meetings will conform to the following order:
8:00 p.m.    Business as per Agenda.
9:00 p.m.    Paper of the evening.
Nttntt & 5J!jmtt0im
2559 Cambie Street
1B. C.
13 th Ave. and Heather St.
Exclusive Ambulance  Service
FAirmont 0080
Page One Hundred and Ninety-nine PERTUSSIS   VACCINE
WHOOPING COUGH is one of the most common communicable diseases
and it may be followed by death, particularly in the case of children under
two years of age. Among older pre-school children serious complications
may follow an attack of the disease. It is desirable, therefore, to administer
pertussis vaccine to infants and young children as a routine procedure,
preferably in the first six months of life or as soon thereafter as possible.
PERTUSSIS VACCINE is prepared by the Connaught
Laboratories from recently isolated strains (in Phase
I) of H. pertussis. The vaccine contains approximately
15,000 million hilled bacilli per cc.
Research studies relating to the bacteriology and immunology of H. pertussis
have been conducted for many years in the Connaught Laboratories.
Further advances in the method of preparation of PERTUSSIS VACCINE
have made possible reductions in the price of this product. For convenience
in use and as an added economy, it is supplied in packages for the inoculation of a group of six children as well as in packages for the inoculation of
one child. The following packages of PERTUSSIS VACCINE are distributed:—
Three 2-cc. ampoules — For the inoculation of one child.
Six 6-cc. ampoules — For the inoculation of a group of six children.
Also for the convenience of physicians who wish to inoculate children
against both diphtheria and whooping cough, the following packages of
Three 2-cc. ampoules — For the inoculation of one child. .
Six 6-cc. ampoules — For the inoculation of a group of six children.
University of Toronto    Toronto, Canada
MEDICAL-DENTAL BUILDING, VANCOUVER, B.C. In this number we are publishing the verbatim report of the Special Meeting held by
the B. C. Medical Association in April.    Our comment on this is attached.
We should like here to call attention to the immense amount of work that went to
the preparation of the brief which was discussed. Under the chairmanship of Dr. G. F.
Strong, committees were formed to deal with various aspects of the matter, and these
committees worked hard and earnestly. The result, we think, is a credit to British
Columbia, and will be distinctly helpful to the general Canadian profession, as it very
greatly clarifies our position on many points, where it was rather difficult before for the
general public to find just what our position was. We congratulate the committee especially in that it has greatly strengthened our hand in our dealing with the authorities,
by its suggestions along such lines as the removal of the income limit and the insistence
on gradual introduction, step by step, of health insurance, as opposed to what we should
regard as a tragic error, the adoption, holttsi bolus, of some scheme called health insurance, which could only be a makeshift and an experiment, and might, by the trouble and
misunderstandings it would undoubtedly cause, hold back a truly beneficial and constructive scheme for many years. Repeatedly, in these columns, we have urged that medical
care, and especially hospital care, are simply not obtainable in sufficient amounts to
implement the immediate establishment of a complete scheme, and we rejoice that the
medical profession as a whole is coming to realize this and to insist on its recognition
by the public.
Again, the insistence on certain safeguards, as regards men overseas, is very right and
necessary. Too, the insistence on general principles—the necessity for improved and
increased facilities for medical training; the necessity for post-graduate work; the urgency of provision of facilities for research. This is all excellent—not alone from our
standpoint, important as this is, too. But as we see it, the original reason for wanting
health insurance at all is not to improve our lot, but because of an urgent public need.
That being so, we must first ascertain what that need really is. The public only knows
it has a pain. The politicians assure it that they have the remedy: immediate application
of "health insurance." We are the only ones who can really diagnose the nature and
extent and cause of the pain, and apply the real remedy. Yet for years we have had to
fight off the politicians, who really mean well and want to be generous (at our expense,
chiefly), while we can work out a truly adequate scheme.
In England, in Germany and other places the politicians had their way and put in a
scheme. Now they are spending their time (in Britain at least) trying to revise then-
way out of it, and having a hard time in doing so. We are anxious to avoid these
mistakes. Not theoretical mistakes that we think might result—but actual mistakes
which have resulted, and which have retarded true medical and health progress in England for the past thirty-five years. This may seem an unfair statement—but we believe
firmly that if Britain had had an adequate scheme, omitting benevolent societies, and
cash benefits, taking in everyone, giving complete service, and allowing her doctors to
give the service of which they are really capable, she would by now have had such amazing results that every other country would have followed her lead as a matter of course.
As it is, what progress has been made, has been mainly due to the excellent Health and
Preventive Medicine work of the Ministry of Health. In this country, we should start
on our own lines—duly noting the good points of these and other schemes, and avoiding,
like grim death, the errors into which they fell.
It may not be amiss, at this juncture, while we are congratulating the committee,
to pay a special tribute of thanks to our very able leader in this province, Dr. G. F.
Page Two Hundred Strong, Chairman of the Committee. He has been invaluable and indefatigable and has
provided inspiration and leadership, not only in B. C, but throughout the Dominion,
as a member of Council of the C.M.A., and of the Committee of Seven, and in dealing
with the government as our representative, he has done us a great service. How on
earth he manages to do all this so well, and remain in practice, is a mystery to us.
The Bulletin would like to extend its heartiest congratulations to St. Paul's Hospital, which has just celebrated its jubilee of existence in Vancouver, having been first
established here in May, 1894. This magnificent hospital, which is an ornament to
Vancouver, and would be a credit to any city, has now given fifty years of the best
kind of hospital service to the people of Vancouver, and for the matter of that, to the
province at large, since one finds among its patients, people from all over B. C.
St. Paul's has a singularly warm spot in our hearts, here in Vancouver." The writer
remembers well the first hospital that was built here, and which he first saw in 1906.
It was a small hospital then, but very busy. Its sisters were well-known visitors in the
logging and mining camps of the Coast, and the men working in these places used to
buy hospital tickets for ten dollars a year, which entitled them to care when they were
sick.    They got excellent care, and were very fond of the Hospital.
The old hospital was very different to its grown-up daughter: a homely, comfortable,
but unpretentious old lady she was. As one went up the stairway from the front hall, a
rather alarming note was struck by a large illuminated "Nearer, My God to Thee," which
confronted one on the wall. It hardly seemed to be a happy omen to anyone entering
the hospital as a patient, and one was relieved when modern progress made it seem a
less necessary reminder. In those days, they had an infectious diseases department, and
took in alcoholics, and even mental cases; these have all found their fitting place elsewhere. The operating room would seem very rudimentary to us today, but Boyle and
McPhilhps and McKechnie and many others did good surgery there, though they wore
no gloves, and no canvas shoes. It was as much as they would do, to scrub their hands
thoroughly. We remember one eminent surgeon, proudly starting to put on his first
pair of rubber gloves, and then declaring loudly that they would have to be sent back.
"But why, Doctor?" asked the Sister in the O.R. "They're both left hand," was the
But St. Paul's was always, as it is now, a real hospital—where patients received something rather more than scientific medical care and nursing, though they got. these too,
the best available. But they( felt a kindly, personal note in the care they received, which
in some way, St. Paul's has always been able to give, to a very unique degree. Perhaps
it is the Sisters, single-hearted, devoted only to their duty imposed upon them by their
Order and their sacrificial lives, on the job from early morning till late at night, making
a little personal visit to the sick man or woman who senses in their coming a warmth
and friendship above and beyond the necessary, service of the hospital. Or it may be
their admirable system of nursing, where each nurse has her own patients to look after
and do everything for; so that there is a personal relation between patient and nurse
which makes for greater comfort of mind as well as body. .Whatever the reason, we see
constantly that St. Paul's has won not only the respect, but the affection, of the citizens
of Vancouver, among whom its work lies.
So we congratulate St. Paul's Hospital with all our hearts, and wish it all good luck
and prosperity. It is today a thoroughly modern, up-to-date hospital; filled to the
doors, as are all hospitals, fitted for any kind of work, a working hospital, where the
doctor can find help in all his needs, and the very best of service; while the patient finds
friends, and care, and a warm-hearted devotion to his or her interests and well-being.
I ft* Hi
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- . £**w »- «*?s*sw  . -Sis
:■■..*..:*>... * .
June 20th to 23rd Inclusive, 1944
Surgeon Captain C. H. Best, Director, R.C.N. Medical Research Unit.
Lieut.-Colonel R. I. Harris, R.CLA.M.C, Consultant in Surgery for Eastern Canada.
Squadron Leader L. G. Bell, R.C.A.F., Medical Consultant to Command Medical
Boardy No. 2 Training Command.
Dr. W. A. Scott, Professor of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto.
Dr. Clifford Sweet, Chief of Medical Service and Chairman of the Executive Committee of the Children's Hospital of the East Bay, Oakland, Calif.
Page Two Hundred and Two £A
Tuesday, June 20th
9:00 a.m.—Dr. Sweet: "The Child in the Family."
10:00 a.m.—Lt.-Col. Harris: "Foot Problems in the Army and Out of It."
11:00 a.m.—Surg. Capt. Best: "Naval Medical Research."
12:30 p.m.—LUNCHEON—Guest Speaker: Capt. C. H. Best, R.CN.V.R.
2:30 p.m.—Surgical Clinic—Shaughnessy Hospitals-Conducted by Lt.-Col. Harris.
8:00 p.m.—S/Leader Bell: "Rheumatic Fever."
9:00 p.m.—Dr. Scott: "Heart Disease in Pregnancy."
Wednesday, June 21st
9:00 a.m.—S/Leader Bell: "Some Psychosomatic Aspcets of Gastro-intsetinal Disease."
10:00 a.m.—Dr. Sweet: "The Child as a Patient."
11:00 a.m.—Dr. Scott: "Diagnosis of Ectopic Gestation."*
2:00 p.m.—Paediatric Clinic—St. Paul's Hospital—Conducted by Dr. Sweet.
8:00 p.m.—Surg. Capt. Best: "Penicillin—Non-clinical Aspects."
9:00 p.m.—Lt.-Col. Harris: "The Use of Penicillin in the Management of Infected
Thursday, June 22 nd
9:00 a.m
10:00 a.m
Dr. Scott: "Antepartum Haemorrhage."
■Lt.-Col. Harris: "The Management of Amputations and the Use of Satisfactory Prosthesis."
11:00 a.m.—S/Leader Bell: "The Management of Acute Coronary Occlusion."
1:00 p.m.—GOLF TOURNAMENT—Capilano Golf and Country Club.
8:00 p.m.—Dr. Sweet: "The Diagnosis and Treatment of Upper Respiratory Tract
Infections in Infants and Children with special reference to Sinusitis.**
9:00 p.m.—Surg. Capt. Best: "Recent Work on Shock and Burns."
Friday, June 23 rd
9:00 a.m.—Lt.-Col. Harris: "Fractures of the Os Calcis: Improved Methods of Treatment." '
10:00 a.m.—Dr. Sweet: "The Role of Body Mechanics in the Health Examination and
Care of Growing Children.'*
11:00 a.m.—Surg. Capt. Best: "The Canadian Blood Serum Projcet."
2:00 p.m.—Medical Clinic—Vancouver General Hospital—Conducted by S/Leader Bell.
8:00 p.m.—S/Leader Bell: "The Diagnosis and Treatment of Headache."
9:00 p.m.—Dr. Scott: "Treatment of Genital Prolapse."
The Summer School Committee feels that once more it has an interesting slate of
speakers to present. Each branch of the Armed Services is supplying a lecturer. Surgeon
Captain C. H. Best, R.CN.V.R., formerly Professor of Physiology of the University of
Toronto and Director of the Banting Institute, will represent the Naval Service.   Sur-
Page Two Hundred and Three geon Captain Best is Director of the R.C.N. Medical Research Unit, and some of his
papers will be concerned with this work. Lieut.-Colonel R. I. Harris, R.C.A.M.C.,
Consultant in Surgery for Eastern Canada, will be sent by the Army, and will be the
surgical lecturer. He will also conduct a surgical clinic at Shaughnessy Hospital on the
first day of the Summer School. Squadron Leader L. G. Bell, R.C.A.F., Medical Consultant to Command Medical Board, No. 2 Training Command, will be the Air Force
representative. He is well known in Vancouver, having lectured here in previous years,
and his subjects will deal with problems of internal medicine. In addition to the above,
the Committee has been fortunate in securing Dr. W. A. Scott, Professor of Obstetrics
and Gynaecology, Faculty of Medicine, University of Toronto, and Dr. Clifford Sweet, a
well-known pediatrician, from Oakland, Calif. Dr. Sweet will present a pediatric clinic
at St. Paul's Hospital on the second day of the School.
The fee this year will revert to the original amount ($7.50) in order to cover-
Invitations have been issued to the Medical Officers of the Navy, Army and Air Force
to attend the Summer School. There will be no fee for doctors in the Services. It is
hoped that there will be a large enrolment again this year.
In order to provide adequate space for the lectures, the Ballroom of the Vancouver
Hotel has been reserved for the four days of the School Session. This will ensure ample
seating accommodation.
Surgeon Captain CT H. Best, R.C.N.V.R., will give the luncheon address on the
opening day of the School, June 20th. The luncheon will be held in the Mayfair Room
at 12.30 o'clock.
Doctors from out of town who are planning to attend the Summer School should
make their hotel reservations without delay. Anything the Committee can do to help
in this direction, will be gladly, undertaken.
A private telephone will be installed, as usual, for the convenience of doctors attending the Summer School.
It is hoped that all those who can will buy their tickets before the School commences.
The registration desk outside the Ballroom in the Hotel will be open at 8:30 a.m. on
the morning of June 20th for those who have been unable to register previously. Medical
Officers in the Services who wish to attend are requested to register at this time, when
they will be provided with tickets. Holders of tickets will be requested to show them at
each Session.
The Golf Tournament will be held on the afternoon of Thursday, June 22nd, at the
Capilano Golf and Country Club. The usual worthwhile prizes will be offered. We
are fortunate in being able to obtain this scenic course for our tournament.
This was held on May 22 nd in the Medical-Dental Auditorium. The main business,
of course, was the Election of Officers for the coming year and the submission of reports
by the Chairmen of various Committees.
The following are the officers for the 1944-45 session:
President, Dr. H. H. Pitts; Past President, Dr. A. E. Trites; Vice-President, Dr.
Frank Turnbull; Honorary Treasurer, Dr. Gordon Burke; Honorary Secretary, Dr. J. A.
McLean. Additional Members of Executive: Dr. G. A. Davidson, Dr. J. R. Davies.
Trustees: Dr. F. Brodie (re-elected for a term of three years).
The reports showed a very healthy condition of the Association's affairs; financially
we seem to be very prosperous. For the first time in recorded history the Library Committee was not able to spend all of its appropriation, and even the Bulletin shows a
"nominal" profit of $568. But since w ehad a "nominal" deficit last year of about the
same amount this is not really very significant. As an actual matter of fact since the
fiscal year of the Association does not as a rule coincide with the date at which most of
,the advertising accounts are paid, the auditors can only show the condition at a given
moment—and actually from year to year, the balance may appear on one side or another.
But in reality, the profit on operation k shown in the report of the Publications Committee.
One rather depressing feature is the attendance at meetings. This is bound to be
poorer than it should be—most men are so busy that it is almost a physical hnpossibihty
to fit in a meeting, and many of our'members are away. The membership, by the way,
reached a new high record of 321, and this is a very encouraging feature indeed.
The Clinical Section meetings were well attended, and their programmes were excellent.
Mr. President and Members:
During the past year eight general meetings were held. The March meeting took
the form of the Osier Dinner, after which Dr. T. H. Lennie delivered the Osier Lecture.
The P.G.F. Degree was conferred at this time on E*r. A. W. Bagnall.
One special meeting for mscussion of the arrangement with the Provincial Government and the City of Vancouver for medical care of Old Age Pensioners, Mothers' Allowance and City Relief cases, was held.
The average attendance at all meetings was 45, which was lower by ten than the
preceding year.
The total membership of the Association, including applications for membership
which are pending, is 321, a gain of nine over last year.    This number is made up as
Life members «-    _ _
Active members :—	
Associate members —	
Privileged members	
Thirteen new members were elected during the year.    Seven more of our members
entered the Armed Services, but this loss was offset by the return to practice of seven
members who were formerly in the Services.
The Association lost two members by the death of Col. F. W. Lees and Dr. J. A.
Montgomery, a Life member.
Page Two Hundred and Five The Executive Committee held twelve meetings during the year, one of these being
a joint meeting with the Publications Committee.
Respectfully submitted,
JOHN A. McLEAN, Honorary Secretary.
Mr. President and Members:
I herewith submit the following financial report of your Association for the year
1943-44, which has been duly audited by Piommer, Whiting & Co., Chartered Accountants, under date of March 31st, 1944:
Income from members' annual dues $3,852.50
Interest on invested funds 344.79
Relief Administration Management allowance 600.00
Profit on Association Bulletin $568.24
Profit on Osier Dinner 18.99
Salaries - : $3,251.12
Rent 3 1,377.00
Total ; $4,628.12
Received from C. P. & S. and B.CM.A.—their share___$2,035.80
Other running expenses 749.14
Total expenditures apart from library maintenance.- _  3,341.46
The Association has aso expended on the library___ 1,176.88
Excess of Income over Expenditure $2,043.06
Library j $1,148.66
Furniture and equipment- !      121.46
—  1,470.12
Net Transfer to General Surplus Account. .1 $   572.94
Present value $11,287.91
1—$1,000 Dominion of Canada Bond was purchased during
the year from the General Account.
Historical and Ultra-Scientific Fund Savings . $   203.82
Stephen Memorial Fund "Savings 13.20
Sickness and Benevolent Fund Savings 1,130.23
Benevolent Endowment Fund 700.00
John Mawer Pearson Lecture Fund Savings !      545.55
John Mawer Pearson Lecture Fund Principal 3,018.75
All of which is respectfully submitted,
GORDON BURKE, Honorary Treasurer.
Mr. President, Ladies and Gentlemen:
The Publications Committee has held regular meetings during the past year: the
purpose was to held these monthly, but on one or two occasions, owing to the incidence
of the holiday season, or the press of work, it was impossible for us to get together.
At the first meeting of the year, it was decided to add to our regular Committee of
three members some other names, to augment the size and widen the representation of
the membership of the ■ Vancouver Medical Association. Accordingly, we asked the
Chairmen of the Clinical Section, the Eye, Ear, Nose and Throat, and the Paediatric
Section, to join our Committee. Doctors J. W. Millar, C. E. Davies and J. H. B. Grant
were thus added to our number. We had hoped that the transactions of each of these
Sections might be made a regular feature of the Bulletin, but it appears difficult to
achieve this with any regularity. However, we are in hopes that this field of medical
work may be further explored, and that in' time we shall be able to arrange for the
publication of the more significant parts of the work done by the Sections. We think
that this practice of attaching these officers of the Association to our number, and making them permanent members of the Committee, should be continued.
During the year we introduced, partly by way of experiment but very hopefully,
an innovation in the form of a symposium on the subject of the Thymus Gland.   This
" met with considerable success, we felt, and we propose, from time to time, to endeavour
to repeat this process in regard to other matters of general interest.-,
The Bulletin has continued during the year to receive valuable contributions from
the Staff of the Vancouver General Hospital. The limitations imposed by the conditions
of war have greatly curtailed this most important work, and we are all the more grateful
for the excellent papers received.
We regret that the Victoria Medical Society, whose transactions we should so much
like to publish, as we formerly did, has not seen its way to furnish us with any material
during the past year. We can quite appreciate that they may have difficulties of their
own in this regard, but we hope that at an early date in the future we shall be able to
resume our connection with them.
We have received several new exchanges, and the Bulletin now travels very far
afield. ' /
We have considerably increased our total of copies published, as will be seen from
the report of our publisher, Mr. W. G. Macdonald, appended hereto. It is with sincere
appreciation that we record the fact that Mr. Macdonald has always co-operated most
fully with us in every way—especially in keeping down the expenses of publication,
which, as will be seen from the detailed cost and income returns, have not increased as
much as one might have expected from the increase in copies printed.
Financially, it will be seen that we are solvent, and in fact, show a profit. As regards
the surplus shown in operating, we propose to use some of this to "secure a competent
reporter for the Vancouver Medical Association's Summer School, to be held in June.
The Bulletin again tenders its sincere, thanks to Dr. M. W. Thomas, Executive
Secretary of the B. C. Medical Association, for his very friendly interest and most valuable help in so many ways, and especially as regards news and notes from all over British
Columbia. We are constantly hearing of how greatly these are valued by our readers,
especially those British Columbia members on Overseas Service. These latter are nearly
all in receipt of the Bulletin.
To Mrs. Craig, our Librarian, we extend our heartfelt thanks for her efficient and
most readily given help.
In conclusion, I extend my personal thanks to my colleagues on the Conunittee,
with whom it has always been a delight to work.
Page Two Hundred and Seven REPORT OF TRUSTEES
The President, Vancouver Medical Association:
The Board.of Trustees begs leave herewith to submit the Annual Report.
Already in the Treasurers and Auditors' report have been statements of the amounts
in the various funds over which the Trustees have control. There have been no disbursements from the Sick and Benevolent Fund in the past twelve months.
During the year there has been a refunding of the North Vancouver bond issue and
the bonds of that Municipality now held are paying a small dividend. Since Burnaby
began paying on their bonds last year there are now no investments in the Association
of funds which are not bringing in a return. During the year One Thousand Dollars
($1,000.00) have been invested in Victory Bonds.
All of which is respectfully submitted.
Mr. President and Members:
I wish to submit herewith the report of your Library Committee fjr the year ending March 31st, 1944:
General Collection:
47 new books at a cost of $   246.44
42 gifts
4 Nicholson Collection, at a cost of        14.64
Total 93 books added at a cost of '. ! $   261.08
Nicholson Fund:
4 books purchased at a cost of \ $  14.64
Leaving a balance of $  56.66
Additional donation by Dr. Nicholson 250.00
Total 1 $306.66
62 Journals subscribed to at a cost of ; _•_
47 Journals received as gifts.
109 Journals received in Library.
79 volumes bound at a cost of z       179.30
Dues to Medical Library Association $ 16.83
Sundries - 26.3 8
Total 1 - $ 1,176.8 8
Seven meetings were held during the year.
Expenditures were slightly under the budget allowance. This is largely due to the
fact that long delays have been encountered in getting journals bound, and at the end
of the year there was an accumulation of books waiting to go to the bindery, which
ordinarily would have been completed and included in the year's expenses.
Six journals were discontinued during the year. Of these two ceased publication,
one donation was cancelled, and three others announced that they would be unable to
continue on an exchange basis for the duration.   Three journals were added, one being
Page Two Hundred and Fight a new subscription to the American Review of Soviet Medicine, and the other two were
new exchanges—an Indian journal, The Antiseptic, and The Canadian Journal of Medical
Your Committee wishes to remind all members of the micro-film service which is
available in the Library. The Librarian will obtain free of charge, any article not in
the journals of our Library.
Dr. F. J. Nicholson donated the sum of $250.00 to the Fund which he instituted in
193 5. All of the original amount, with the exception of $56.66 has been expended on
books for the Collection. The additional contribution, which was duly acknowledged,
will ensure the continuation of accessions to the Nicholson Collection.
Another much appreciated gift was that of ten books by the late Dr. George W.
Crile of Cleveland, which were sent to the Library by Mrs. Crile. Appropriate acknowledgement was made.
Your Committee also wishes to acknowledge gifts of journal subscriptions and books
from Dr. Gordon Burke, G. A. Davidson, H. H. Milburn, S. E. Turvey, W. A. White-
law and others.
All of which is respectfully submitted.
A. W. BAGNALL, Chairman.
Progress has been made in the gathering of material relating to the History of the
Vancouver Medical Association. Much remains to be done. The thanks of the Committee are tendered to Dr. W. D. Keith for his assistance; and also to Major Matthews,
the City Archivist, for putting at our disposal any material which he had on hand
relating to early members of the Society.
G. E. KIDD, Chairman of the Historical Committee.
During the year 1943-44 the City of Vancouver and the Provincial Government
have, in addition to Social Assistance cases, made provision for medical care for Old Age
Pension and Mothers' Allowance groups. Several conferences were held with representatives of the City of Vancouver and Doctors.G. F. Strong and W. C. Walsh were
appointed by the Vancouver Medical Association to join the Relief Administration Committee in the discussions.
It was agreed that the City of Vancouver should make a monthly contribution of
$4,000.00 to provide for house and office calls and minor operations for Old Age Pension, Mothers' Allowance and Social Assistance cases. This arrangement has proved
satisfactory and the Committee has been able to pay 75 per cent on doctors' accounts for
five months of the year and 100 per cent on the balance with the maximum of $75.00
paid to any man for one month's work.
Owing to the increase in the numbers receiving medical care, as is to be expected,
there has been an increase in the amount of accounts. In 1943 the gross accounts were
$37,116.96 and the amount paid to doctors $12,853.63. In 1944 the gross amount of
acounts was $57,636.80 and the amount paid to doctors $39,989.20.
All of which is respectfully submitted.
J. A. SUTHERLAND, Secretary, Relief Administration Committee.
Six joint meetings of the Clinical Section of the Association and staff meetings of
the various hospitals were held during the Fall and Winter Session. Three of these
meetings were held at St. Paul's Hospital, one at Shaughnessy and two at the Vancouver
Page Two Hundred and Nine General Hospital. One'of the regular meetings at the General had to be cancelled be-
caus of the impossibility of obtaining sufficient clinical material for presentation. This
remains a major problem as far as the Clinical Section is concerned.
Respectfully submitted,
J. W. MILLAR, Chairman.
The President, Vancouver Medical Association:
I herewith report on the activities of the Eye, Ear, Nose and Throat Section.
We welcome the return of Drs. E. E. Day and L. H. Leeson from military duties.
We regret the departure of Dr. Colin Graham to Victoria, B. C.
Regular meetings of the section were held throughout the year.
Our section has kept going during the past year. Although our numbers are greatly
reduced we have held several meetings with a full attendance.
Matters relating to Health Insurance are very much to the fore in our group.
Our meetings have tended more to the social and economic sides than to the scientific
During the year another of our members, Dr. Wilson, was called into the Army.
Respectfully submitted,
J. H. B. GRANT, Chairman.
Your representative to the B. C. Medical Association attended all the regularly
scheduled meetings of that Association. Routine business was chiefly the order of the
day, with the exception of course, that considerable time was spent on Health Insurance
Two special meetings were held in Vancouver, one to hear Colonel Montgomery and
Colonel Warner, speak on Army Medical problems, the other to hear and discuss the
revised Principles of Health Insurance as recommended by the Executive of the B. C.
Mdeical Association. The former meeting was well attended, while the latter had a
very discouraging attendance representing the Vancouver Medical Association.
Mr. President and Members:
This Committee was only called together on one occasion during the past year to
enter into discussion with a representative of the Metropolitan Health Staff on a matter
which was dealt with later by the Association.
It is to be greatly regretted that this Committee ,the liaison group between the
practicing profession and the public health group is not called in for discussion more
often. Matters in a public health activity programme are developed and brought into
operation which may affect the profession as a whole and the lives of our patients, and
surely much could be contributed in these matters by the members of the profession
engaged in actual practice.
It is recommended that steps be taken to make the work of this Committee more
active, as was intended in the original set-up of the Metropolitan Health Committee,
Page Two Hundred and Ten upon whose request this Committee of the Vancouver Medical Association originally
came into being.
Respectfully submitted, »
Secretary of Vancouver Medical Association:
No meetings were held througout the year and there does not seem to be any good
reason for the existence of this Conunittee.
I would recommend disbandment.
So far as I am aware there has been no question for discussion for the V.O.N,
through the past three years.
L. W. MacNUTT.
At the Annual Meeting of the Vancouver Medical Association, an address was given
by Major A. H. Jukes, D.S.O., O.B.E., in which he ended his remarks in the following
"Let me now gather up the points I have tried to make, and embody them in a
resolution. This you might study and champion (italics ours) without waiting any
longer for others to forestall you with their plans, possibly inimical to your interests.
Resolution—National Health
(Advocated by the Vancouver Medical Association and now brought to the attention
of the people of Canada . . .)
WHEREAS a healthy, vigorous people and a prosperous countryside are the true foundations of
national greatness; and
WHEREAS poverty and the threat of economic insecurity -with its consequent loss of freedom
sap the national morale by lowering living standards below the minimum subsistence level;
WHEREAS the highest standard of medical and hospitalization services should be made available
to every citizen; and
WHEREAS all compulsory contributory state sickness insurance schemes are based on compulsion
rather than inducement, exact penalties and compel regimentation thereby adding to the
worries of the citizen; and
WHEREAS such schemes depend upon continuous payment of taxation thereby increasing prices
and bureaucrats, lessening the economic freedom of the individual and consequently undermining his health; and
WHEREAS we have emerged from an era of scarcity and now live in an  age  of increasing
THEREFORE BE IT RESOLVED that the following Health policy be adopted and made effective
in our National Social System:
1. To make such adjustments in our distributing mechanism, i.e., the money system, as
will ensure the total abolition of poverty by enabling every citizen, man, woman and child, to
share in the increase of real wealth, thus granting everyone economic security with freedom
from fear and want as expressed in unemployment, sickness, disability and old age.
2. To institute a non-contributory system of health insurance whereby everyone will be
assured the benefit of preventative, curative and perfective medical attention, free from bureaucratic interference with either patient, doctor or hospital authorities.
3. To authorize such supplementary schemes of voluntary sickness insurance as may be
desired by groups or localities.
4. To provide for hospitals and other medical facilities to be built and operated by local
5. To grant allowances for medical research in accordance with the recommendations of
a duly representative medical council.
Page Two Hundred and Eleven 6. To give every encouragement to games, sports and outdoor exercise and in addition to
provide for the upkeep of playing fields, parks, beaches, etc.
7. To recognize leisure as a valuable adjunct to health and to reduce hours of labour and
lengthen holidays.
8. To ensure that only the best and most nutritious food be available for human consumption and to assist agriculture to provide this.
9. To introduce systematically supplementary incomes for medical officers and others responsible for maintaining the good health of the people in whose community they serve to the
end that the medical profession may progressively be freed from its present unenviable position
of benefitting only when the people suffer from disease.
Further, be it resolved, that we detest the present tendency in proposed legislation to ignore
the fundamental principle of freedom of the individual in association and to substitute, in- its
place domination by the state in compelling him to submit to bureaucratic measures and schemes
of compulsory sickness insurance which latter we consider an ineffectual means of rectifying
conditions directly attributable to flaws in the existing distributing, or money, mechanism.
Major Jukes had reprints made of this article and sent all over Canada. At the
Annual Meeting of the Canadian Medical Association many members spoke to delegates
from B.C., drawing attention to this "resolution" and asking whether this represented
the views of the Vancouver Medical Association.
The Bulletin would like to emphasize the following facts: and has been asked to
do so by the President of the V.M.A., and by Dr. G. F. Strong, Chairman of the Committee on Economics of the B. C. Medical Association:
1. The context shews that this was merely a suggestion made by Major Jukes to
the Vancouver Medical Association. The wording and suggestions are entirely his own.
In fairness to him it should be pointed out that he stated at the outset that this was a
resolution for our study—and, he hoped, our advocacy.
2. The Vancouver Medical Association did not endorse nor accept this resolution.
A committee was appointed to study the resolution, and has not reported.
3. The Vancouver Medical Association has never advocated, nor will it advocate,
any policy which, is not in uniformity with the decisions and majority opinions of (a)
the B. C. Medical Association, which represents the whole profession of B. C. in medical
matters, economic and political, and (b) the Canadian Medical Association, which similarly represents the Canadian profession as a whole.
In this matter the prime consideration is that the medical profession of Canada should
work and express its views as a whole, and through a single voice, that of the Canadian
Medical Association. The Vancouver Medical Association is heartily in accord with
this principle and policy, and will not deviate from it.
A Bio-Biblography of Andreas Vesalius, 1943, by Harvey Cushing. (Nicholson
The Role of Nutritional Deficiency in Nervous and Mental Diseases, 1943, by
Various Authors.
Surgical Clinics of North America, Symposium on Reparative Surgery, April, 1944.
Medical Research Council, Special Report. A Provisional Classification of Diseases
and Injuries for use in Compiling Morbidity Statistics.
Medical Research Council War Memorandum No. 11. The Control of Cross Infection in Hospitals.
Medical Research Council War Memorandum No. 12. The Use of Penicillin in
Treating War Wounds.
Annual Reports of the United States Public Health Service, 1941-42 and 1942-43.
Page Two Hundred and Twelve British  Columbia  Medical  Association
(Canadian Medical Association, British Columbia Division)
President . Dr. P. A. C Cousland, Victoria
First Vice-President ! ■. Dr. A. Y. McNair, Vancouver
Second Vice-President '. Dr. A. H. Meneely, Nanaimo
Honorary Secretary-Treasurer Dr. G. O. Matthews, Vancouver
Immediate Past President: \ Dr. A. H. Spohn, Vancouver
Executive Secretary a, Dr. M. W. Thomas, Vancouver
Attached is a report of the Special Meetig of the B. C. Medical Association, held on
April 19th to consider a brief containing Twenty Principles which had been drawn up
by the Committee on Economics of the B. C. Medical Association, and which this
Committee and the Board of Directors of the Association had endorsed and felt should
underlie any scheme of Health Insurance which we could accept as a medical profession.
.• The Committee has put in many hours, many days in fact and weeks, of work over
this matter. Their brief represents the result of this work, and is a series of amendments to the original "Twenty Principles of Health Insurance" adopted in 1942 by the
Council of the Canadian Medical Association. In some cases, the new points constitute
amendments and even changes, necessitated, in the Committee's opinion,, by changing
conditions of society-—in most cases, they are clarifications and definitions of some of
the clauses of the original document.
In any case, the Committee on Economics, and the Directors of the B.C.M.A., felt
that this brief should be submitted for discussion and explanation to the profession at
large, and so called this Special Meeting. Whilst conditions of medical practice at
present made the attendance much smaller than it would otherwise have been, there was
a very lively and keen discussion—and the results of the meeting fully justified, it was
felt, the action of the Executive in calling it. i
The brief will be presented to the Council of the Canadian Medical Association at
a meeting to be held in Toronto very shortly, and will undoubtedly come before the
Annual Meeting as well.
We urge all our readers to go carefully through this Discussion. The Principles are
each dealt with very fully—and the whole thing is quite easy and simple to follow.
Discussion Held at Special Meeting of B. C. Medical Association,
April 19th, 1944
Chairman—Dr. P. A. C. Cousland, President.
President's Opening Remarks:
The Committee on Economics has asked each division to study the twenty Principles
of Health Insurance adopted by the Council of the Canadian Medical Association in
Jasper in 1942 with the idea of bringing these principles up-to-date and suggesting any
desirable changes. We have given the subject of these principles a great deal of study
and, as a result, we have suggested a revision of them. These amendments have been
adopted by the Committee on Economics and by the Board of Directors of the B. ,C.
Medical Association on February 9th, 1944, and it is now recommended that they be
put to the members of the B. C. Medical Association in order that we may ascertain
the views of the members of British Columbia pripr to the meeting in Toronto in May.
Dr. Strong will present the twenty points that this Committee has drawn up.
Page Two Hundred and Thirteen Dr. G. F. Strong:
It has been suggested that it would be best to consider these principles, then consider certain of the details of the latest revision of the Health Insurance Act, and lastly
make any comments, suggestions, or recommendations which may result from this
As the President has said, the request to make this revision came from the Executive
Committee of the Canadian Medical Association. It reached us here just after Christmas and we spent a good deal of time on the process of the revision and then we presented these twenty principles with additional comments to the Board of Dirctors of
the B. C. Medical Association and they adopted them on the 9th of February.
I might say that there was some disagreement in one or two instances. One man
asked particularly that a vote be registered I think that applied to three of the articles.
The others were adopted and the whole group was adopted by the Board of Directors.
In the adoption of this group of principles, we went on record as favouring the
removal of the income limit. The present draft of the Act, which appeared one month
later, carries with it, for the first time, a suggestion that there should be no income
limit.    The timing of those things is important.
As a means of giving our consideration to these twenty principles, I am offering
this plan:
After February 9 th, when your Board of Directors had adopted them, we sent these
principles east for the consideration of the Executive Committee of the C.M.A. They in
turn sent them to each one of the other eight divisions in Canada, asking that they go
over the principles and make comments. In addition to that, the Executive Committee
of the C.M.A., the Health Insurance Commission and the Nucleus of the Committee
on Economics reviewed these principles and made certain comments. It seems to me
that, as an introduction to our discussion tonight, it might be well to consider the comments made by these three Commitees, thus giving us the views of other parts of Canada.
The health of the people depends to a great extent upon environmental conditions under which they live and work, upon security aganist fear and want,
upon nutritional standards, upon educational facilities, and upon the opportunities for exercise and leisure. The improvement and extension of measures to
satisfy these needs should precede or accompany any future organization of
medical service. Failure to provide these measures will seriously jeopardize the
success of any Health Insurance Scheme.
2. We approve the adoption of the principle of contributory Health Insurance,
and favor a plan which will secure the development and provision of the highest standards of health services, preventive and curative, if such plan be fair
both to the insured and to all those rendering the services.
The Committees were in agreement with these first two principles. As a matter of
fact, in our original draft we had reversed the order, but they suggested, and your
Committee agreed with them, that the order should be as you find it on your printed
You will recognize, in Principle No. 2, the resolution that was passed by the special
meeting of the General Council of the C.M.A. in Ottawa in January, 1943.
3. In our opinion it is impractical to introduce at once a nation-wide scheme of
complete Helath Insurance. Any such scheme should be developed in successive
stages in each Province that accepts the Federal Enabling Act.
Note: The term "successive stages" comprises:
1. Hospitalization;
2. Diagnostic aids, including X-ray and Laboratory facilities for ambulatory patients and those not hospitalized;
3. Medical, surgical and obstetrical care.
Page Two Hundred and Fourteen Their comment was as follows: "This might be either omitted or recast. The second
sentence was interpreted as meaning that in the province the plan would provide hospital, surgical and medical care in progressive stages of development." As a matter of
fact, that is exactly what we had in mind. The Executive Committee of the C;M.A.
had not been sitting in with us when this was discussed and I think their comment has
to be taken with reservation.
To my mind the most important thing for us tonight "is the consideration of this
Principle No. 3 and the corrollaries which you .find in the additional comments.
I believe that the medical profession has a duty to the public as well as to the government and to itself. I think that as practising physicians we know certain implications of this scheme which may not be apparent to men in government positions and
which may not be apparent to certain of our own Executive. One of these is that the
introduction of a comprehensive scheme of health insurance would cause a terrific
impact on our way of life, on the way that doctors do their work and the way that
medical services are distributed. I don't think that the physical facilities exist to make
the scheme a successful one. Therefore, your Committee on Economics became convinced that the scheme would be better introduced by successive stages.
The first thing would be to introduce a widespread hospital insurance—an extension
of the present plan—to ensure that anyone could go to hospital when the need for hospitalization occurred. I think most of you will agree that if that were the case, much
of the difficulty in the cost of medical care would be overcome. The point is that if
we had a scheme of hospital insurance in successful operation, we could then move on
to the next step, whichever that might be, applying each when facilities were available.
Therefore, we will go back to No. 3 later but I think that it is an extremely important
4. Each Province should be served by an adequate Department of Public Health,
organized on the basis of the provision of individual health supervision by the
medical practitioner.
Their comment was that it should be recast to emphasize the position of the general
practitioner. I will leave that to you. We felt No. 4 carried the idea that we had in
mind and that was, that there should be increased emphasis on the preventive services
secured through the medical practitioner.
5. The Association believes that it is not in the public interest in Canada that the
state should convert the whole medical profession into a salaried branch of any
government service.
This, also, was approved with the suggestion that we had originally made in the last
but one line. They suggested that the present wording was best. The implication of
this prniciple should be entirely clear to all—what we are saying is that we are opposed
to state medicine.
6. It is not in the public interest that the state should invade the patient-doctor
relationship. This relationship includes free choice of doctor by patient, free
choice of patient by doctor, and maintenance of the confidential nature of medical practice.
Their comment was that this principle was satisfactory. (And, by the way, I said
that these comments were from the Executive Committee. They were also from the
Nucleus of the Committee on Economics and from the Health Insurance Commission.
The three Committees individually considered our principles and what I am reading is
the combined comments of those three Committees.)
7. In any form of Health Insurance there should be no income limit.
Here, again, is a very important principle and, again, it is a principle about which
there was unanimity. The Nucleus and the Health Insurance Committees were inclined
to omit this one. A month after we adopted these things the government came out with
a plan which removes the income limit.
Page Two Hundred and Fifteen I think that you gentlemen tonight should have some explanation as to why your
Committee on Economics adopted this principle and, as Chairman of that Committee,
my answer is that we adopted it in the firm belief that in the long run it was the
simplest and wisest method to follow. Regardless of what income level is considered,
there would be always a number of people close to that level, some just under it and
some just over it. When we discovered from the Income Tax Department that something like 94% of the people of Canada have incomes less than $2400, and since $2400
had been considered as a possible income level, we realized that the thing we were
arguing about before only affected about 6% of our population. This 6% would pay
their preiniums and, as they do now, they would quite likely seek private medical services. This would be a charge levied for improved national health services and I think
it should be paid by everyone in the community, even though that suggestion was not
well received in the East. I don't know how they have reacted to the government's suggestion of a plan that has removed the limit of income. Personally, I am glad that we
went on record as favoring this before the government came out with it. We felt that
this Principle No. 7 should stand.
8. Medical care for indigents and transient indigents should be provided under the
plan, the Government to pay the premiums of the indigents who then receive
medical care under exactly the same conditions as other insured persons.
The comments here were that this was satisfactory but the Executive Committee
would recast the last line—just a matter of wording as to how these people should receive
medical care. In other words, they approve of the principle with slight modification in
the wording.
9. The dependents of insured persons shall be included in the medical benefits.
This principle was approved, of course, as it has always stood as an approved principle.
10. We favour the principle of insured persons being required to contribute to the
insurance fund.
The comment is that the Nucleus and the Health Committees would omit this. The
Executive Committee would retain the principle for emphasis, recasting the wording.
We adopted their wording of that principle. The Executive Committee suggested that
the wording that you see before you, and, again, it is a good thing that it was re-worded,
so that this more or less fits in with the present legislation. In any case, the change
was one of wording rather than meaning.
11. Any Health Insurance plan should be studied and approved actuarially before
being adopted, and actuarially approved at periodic intervals.
They accepted this with only slight change in the wording, and I am sure that this
will find general agreement.
12. In the Province where Health Insurance is established it shall be administered
by a small, independent Health Insurance Commission, the Chairman of which
shall be a Doctor of Medicine, regularly qualified, duly licensed, and in good
standing in the Province, who has practised Medicine for at least ten years.
There should be a Central Advisory Committee composed of representatives
from various lay and professional groups to discuss matters of policy and
administration with the Health Insurance Commission.
The Province should be divided for purposes of administration of Health Insurance, each Region with a Regional Medical Officer, Regional Public Health
Officer, and Regional Advisory Committee.
15. The professional side of Health Insurance medical service should be the responsibility of the medical practitioner providing the services under the Act through
the appointment of a C:ntral Medical Services Committee and Regional Medical
Page Two Hundred and Sixteen
14. Services Committees, to consider and advise on all questions affecting the ad-
ministration of the medical benefit and preventive and public health service.
16. Under Health Insurance the Chief Medical Officer and the Regional Medical
Officers should be appointed by the Health Insurance Commission from a list
submitted by the organized medical profession of the Province.
The general opinion seemed to be that these five principles should be reconsidered
and compared with the earlier wording. Their commentwas one more of wording than
of meaning. The writing of Nos. 13, 14, 15 and 16 might be subject to certain change.
We felt that they should be reaffirmed.
17. Cash benefits should not be included in any Health Insurance Act. Should cash
benefits be considered desirable from the viewpoint of social welfare, such should
be provided from funds other than the Health Insurance Fund.
The inclusion of this principle was approved but it was considered that the wording
might be modified to indicate that should cash benefits be considered desirable from the
viewpoint of social welfare, they should be provided from funds other than health insurance funds.    (Originally, that principle consisted only of the first sentence.)
18. Medical Benefits to be organized as follows:
(a) Every qualified licensed medical practitioner to be eligible to practise
under the plan.
(b) The medical service to be based upon making available to all a general
practitioner service supplying preventive medicine and L public health
measures as well as the treatment of disease.
(c) Additional services to be secured ordinarily through the medical practitioner:
1. (a)   Specialist medical service.
(b)  Consultant medical service.
2. Special private duty nursing service.
3. Hospital care.
4. Auxiliary services, usually in hospital.
5. Pharmaceutical service.
(d) Dental service.
The comments were that these benefits could hardly be called medical benefits as
thye also include nursing care, etc.   The term "health benefits" was suggested.
In (b), the phrase "to all" should be reconsidered. The Committees objected to the
"to all" because they still had in mind that question of income limit. However, if you
remove the income limit then there is nothing wrong with the wording, including "to
Regarding those words, "medical benefits"—this was used in the Jasper draft to
cover those same things that they have now objected to—in addition to doctors' services, hospital care, nursing benefits and drugs.
19. The medical practitioners of each Province should be remunerated according
to the method or methods of payment agreed upon by the medical profession
and the Commission.
Their comment was that they approved but that it might be recast to avoid the
ambiguity which allowed of much criticism of the old principle, so we rewrote it as
you see it on your paper.
You remember that Labour and the Canadian Federation of Agriculture objected to
the original wording of that Principle No. 19. They took it to mean that we were
going to be paid as much as we wanted. The point that we wanted clear was that the
method and the amount of remuneration would be a matter to be dealt with between
the Commission and the medical practitioners.
Page Two Hundred and Seventeen 20.   Under Health Insurance, provision must be made for:
(a) Adequate clinical teaching in medical schools and hospitals.
(b) Facilities for research work.
(c) Periodic post-graduate training of all medical practitioners.
We had originally drawn *up 19 Principles and 9 Comments. Our third important
comment that we had considered originally was thought to be so important, according
to the comments of these three Committees, that it should be added to the list of
Principles, so we made it Principle No. 20 instead of keeping it as a Comment. We
know it is important, for there has been a tendency on the part of legislators to overlook the provision of material for the teaching in medical schools.
As far as these comments are concerned, all have been adopted.
1. It is sometimes suggested that the introduction of Health Insurance will practically eliminate the need for curative medicine, but it should be emphasized
that in spite of the great importance of Preventive Medicine, even the full application of our present-day knowledge of preventive measures will not abolish
all disease or eliminate the need for curative medicine.
The Committees question the value of this Comment No. 1, but I believe that it
should be retained; even though it serves no other purpose, I think it is well that we
should put ourselves on record.
Health insurance is not going to bring about a Utopia. We are not going to be able
to inoculate them all or vaccinate them all or send them all in for periodic examinations.
The point is that there is a tendency to talk as if health insurance will bring about a
complete change and there will be practically no need for curative medicine. I know,
for instance, that there is no guaranteed way of preventing arteriosclerosis, and yet they
say that there will be a great reduction in this disease. I don't know on what they base
this statement. People are still going to die. They are not going to live forever just
because we introduce health insurance. It is not square dealing; it constitutes a false
promise. They can't reduce the incidence of diabetes, nor of arteriosclerosis, nor of
cancer. There are still going to be silent cancers developing. And so I think that
Comment No. 1 should be retained. |
2. We are opposed to the inclusion of any and all irregular practitioners in any
scheme of Health Insurance.
Our No. 2 they thought should be omitted. We certainly do not want any irregulars included in this scheme of health insurance.
3. The introduction of Health Insurance should not be undertaken until the medical personnel that is now engaged with the Armed Forces is again available for
civilian duty.
I am sure there will be no disagreement about this comment. The Committees in
the east thought that this should be put first in our comments. It is of great importance, and the arrangement of these comments has no bearing on their relative merits.-
4. The introduction of any system of Health Insurance into Canada should be
preceded by ah increase in the facilities for under-graduate and post-graduate
medical training. ^|#;
The Committees all agreed with this comment.
5. Some plan should be devised for the provision of pensions for medical practitioners.
Regarding the pension scheme, the question is whether it should be included here.
It probably should not be included as part of the Act, but we felt that if the doctors
are to be asked to decrease their incomes considerably, then there should be some sort of
compensation for that, and one of the compensations should be some sort of a pension
Page Two Hundred and Eighteen 6. A survey of existing hospital facilities and future requirements is an urgent
7. Preceding any Health Insurance programme there should be initiated a vast plan
of new hospital construction.
8. In accordance with our recommendation that Health Insurance be introduced
in successive stages, we believe that a compulsory "contributory hospital insurance scheme would be the logical first stage.
These last, three comments are dovetailed in with Principle No. 3, which had to do
.with hospital facilities. I am convinced that there are not, at the present time, enough
hospital facilities to undertake the plan which is under consideration. Dr. Heagerty
does not agree. He has said many times that there are plenty of hospital beds. I feel
that the man in practice will agree that you cannot offer unlimited hospitalization to
the whole population without any stipulation as to the time limit that they can stay
in hospital. You all know how indefinite that can be in the case of chronic illnesses.
I think there will be a need for many more hospital beds. However, we think that
there should be, first, a survey of existing hospital facilities and, before proceeding with
any insurance scheme, there should be initiated a vast plan of new hospital construction.
3^ 3fr sfr afr
Dr. Strong: The object of this meeting is to consider these principles and comments and, if you agree with them, to adopt them. The President has suggested that
I read each one, but since you have them in front of you, I need not.
Dr. D. J. Millar: Mr. President, would it not be better to have a general discussion
of all the principles and the accompanying comments before that takes place?
Answer:    Yes, I think that is a good idea.
Dr. C. H. Vrooman: Mr. President, the general discussion would take up the
whole evening and nothing would be adopted. I think we should take it, principle by
principle, and get something done.   I make a motion that we consider these by number.
Motion seconded and carried.
1. Moved, seconded and carried.
Dr. D. J. Millar: Mr. President, one of the reasons I suggested that we have a
general discussion preceding the adoption of these principles was because there may be
individuals in our professoin who, if they were acquainted with all the things, might not
favour health insurance. For instance, my feeling towards health insurance—and I am
going to be mercenary—would largely depend on the Act itself—how am I going to be
paid? My feeling towards whether or not I want health insurance would depend on
facts which do not enter into this particular article.
Dr. S. Murray: The additional clause at the end of that principle covers such an
objection as Dr. Millar brings forth.
Dr. Strong: It is impossible to settle every detail before you adopt the general
principles. It follows the line of the resolution which was unanimously passed at a
general meeting of the Council of the CM.A. in January, 1943.
Dr. D. A. Dunbar: I think we should know what we are doing. The danger I
see is this—are we going to set up a bureaucracy among ourselves to run this thing and,
say, 75 % of the general practitioners abide by that group? I think that's a thing that
we should be very careful about, in forming your plan as to how your group should be
set up. The individual should have the say. I am not in favour of setting up a group
that will just tell us how we have got to practise and under what conditions we should
practise. Even our Chairman admits that we can't get a group in which the majority
would be doctors. We are going to have laymen telling us what to do. I am not
against the thing, but we have got to be very careful in setting up a group that is
going to dictate to the whole medical profession.
Page Two Hundred and Nineteen Dr. Strongs   No. 2 is the adoption of the principle of contributory health insurance.   There are many details which will have to be worked out later on, of course.
No. 2 moved, seconded and carried.
Col. R. L. Miller: Here is where I disagree. The whole thing is entirely inconsistent with what the government is trying to do. We are all in favour of the principle
of health insurance and then we are going to start in tearing the thing to pieces. You
put hospitalization first and then you turn around and state that until we get more
hospitals we cannot introduce hospitalization; that there must be a survey of hospitals.
I don't believe the general public thinks that is more important than diagnostic aid. As
a matter of fact, diagnostic aid is the most important thing. I think you are trying to
throw in a monkey wrench. There has got to be a full health care, including preventive
care, or we might as well forget health insurance.
I feel that Dr. Archer has covered all the important points. We don't want in any
way to become servants of the state. Some of us will be. I have never,heard of anyone
that was a servant that was independent. I think the whole thing is entirely inconsistent. You will never build hospitals until you have people to put into them, and the
poor men can't have hospitals until health insurance comes in.
Question: May I suggest that the period after the words "Health Insurance" be
taken out and the word "but" put in there?   I think that would be much better.
Dr. L. MacMillan: It seems to me there is an ambiguity in the words "at once."
"At once" means now. It would not make any difference if it were introduced a year
from now.   I suggest that you make it read "at one and the same time."
Dr. Strong: It seems to me that you can endorse a principle and then you can
proceed to point out that the immediate application of that principle is impossible. I
think Dr. MacMillan has given us a very good point and our wording "at once" should
be revised.
Further to Col. Miller, I don't know what his experience is but it is not the experience of us here in Vancouver. We have hospitals that are full and have a long waiting
list of patients. We know that the waiting list will increase tenfold with the adoption
of health insurance. You can't give them hospital insurance unless there are hospital
beds empty to put them in. It is fantastic to say that there will not be more demand
for hospital services. There are no exclusions under this Act—everything will be
eligible for treatment. We think that the Government should be warned that it is out
of the question to attempt the whole thing in one move and we think that a successive
stage plan should be followed. We recognize that it cannot be successful until more
hospitals are built. Under the Act there is no provision for the building of hospitals.
The government is going to sell a scheme to the public without any provision for the
facilities to give these people service.
Col. Miller: I realize that we shall not have hospitals until we stir the people up
to the necessity for them. When they pass this Act they will realize that they will need
more hospitals and they will be built.
Another thing, you don't want this scheme to come into effect until all the medical
men come back from the war. How long do you think this war is going to last? You
are denying the citizen the right to get these benefits, of which the Dominion Government intends to give the major share out of the revenue from income tax, enabling the
poor person to pay a little and get a lot in health insurance. The hospitals will have to
come in order to implement the scheme.
Dr. Schilder: In Austria the hospitals increased five times up to 1914 until the
war started. In 1919 that scheme was widened for the middle classes. Hospitalization
increased twenty times of the normal, and later on, in 1928 or 1929, the general scheme
was introduced which excluded only the larger incomes, incomes which are not available for any working man, and the hospital scheme increased fourteen times.
Pate Two Hundred and Twenty Col. Miller: I think that is the very argument I am making. They didn't wait
until they got their hospitals. We are doing nothing for our poor people in our country
in the matter of health. The first thing is to have a health insurance act and then you
will increase yoru hospitals.    Russia has done the same thing.
Dr. L. MacMillan: I move that an amendment be made to delete the words "at
once" in Principle No. 3 and the words "at one and the same time" be substituted.
Amendment as above seconded and carried.
Dr. C. H. Vrooman: I don't think we shall get through this paper until four or
five tomorrow morning if the discussion is not confined to one person speaking once on
each clause, at least not more than twice.
A member remarked that he did not understand this one.
Dr. Strong: The doctor has had this before him for as long as ten years and has
never raised any objection to it before.
No. 4 moved, seconded and carried.
No. 5.
Col. Miller: Was there any reason for putting "whole medical profession" in
Dr. Strong: Yes. At first we put that principle in there without the word
"whole." Then we realized that there was a part of the medical profession that is an
essential salaried branch employed by the government, so we put that word "whole" in.
We had no objection to the salaried systems as they now exist. We do think the salaries
might, be greater, but we have no objection to the public health men and others that
are serving on a salary basis.
No. 5 moved, seconded and carried.
No. 6 moved, seconded and carried.
No. 7.
Dr. Schilder: I would like to ask Dr. Strong, where there is no income limit
what about private practice?
Dr. Strong: We think everyone in the community should be required to assist in
paying these premiums. Our suggestion is that everyone pays the levy for health insurance. A man that can afford it is permitted to seek private medical service and we
feel that there will be a certain number in the community who will do this. Therefore,
the private practice will come from that source. As you know, there will be other
sources of income. There will be the W.C.B. cases; there will be certain private insurance examinations; there will be all the transient tourist work that comes in—visitors
from provinces that have not adopted the scheme will be available and subject to a
private medical fee.
Dr. E. E. Day: In regard to this wealthy 6% of the population—they are going
to demand service. They are the people who have got the money and they are going
to demand the service.
Dr. Strong: If you want btter accommodation than public ward accommodation,
then you will have to pay for it—you'll have to pay the difference. My feeling is that
these people will use the insurance practitioner for certain illnesses, but that they will
want, and demand, private medical attention for the more serious things that develop,
and that is where the doctor will have to charge them.
Dr. L. MacMillan: It is quite a common practice in Los Angeles for the doctors
to charge a different fee for the patients who take the public, semi-private and private
A Doctor: For the average general practitioner there will not be any other practice.   My practice will be health insurance practice practically 100%.
Page Two Hundred and Twenty-one Dr. Funk: If all specialists are going to be included in the scheme, why will you
pay more to these men? Ot are all the specialists going to De kept out of it and be paid
A Doctor: The specialists are in the scheme but their method of payment has not
yet been settled.    Oh yes, the specialist will be definitely in the scheme.
Dr. Strong: You are overlooking the fact that there are a lot of details to be
settled. The matter of remuneration has not been settled. The plan calls for some
registration of patients with doctors. Regardless of whether they are paid on a fee for
service basis or on capitation, the Health Insurance Commission will have to know how
many people intend to call, say, Dr. Funk during the year. It is a question of allocating
certain people to certain doctors. None of the specialists will be included because access
to specialists will be through the general practitioner, with the exception of E.E.N. &
T. men, for instance, where the public generally go to them direct. The whole thing
requires a terrific amount of thinking out.
What are you going to do with the man who goes to the general practitioner as a
rule but goes to a so-called surgical specialist if he requires a major surgical operation?
Dr. Vrooman: The government in their bill have said that it is going to apply
to everybody. Why should we now agree with them. I think it is a good plan to leave
it out and not agree with them at the present time.
No. 7 moved, seconded and carried. »
No. 8.
Dr. Boak:    Why should that clause say that the government should pay for the
Dr. Strong: We want to make it clear that the indigents are included and we
want the government to pay their premiums so that there will be no difference in the
care they will get.
Dr. MacEwen: I think the government is already arranging for that. They take
the total number of the provinces, and any that don't pay, then the government must
make up the difference, according to the draft bill.
No. 8 moved, seconded and carried.
No. 9 moved, seconded and carried.
No. 10 moved, seconded and carried.
No. 11 moved, seconded and carried.
No. 12.
Dr. L. MacMillan:   The Commission appointed by whom?
Answer:   The Lieutenant-Governor-in-Council appoints it.
Capt. Glasgow: I understand that that Chairman was not necessarily to be a Doctor
of Medicine.
Answers Your understanding is incorrect.
No. 12 moved, seconded and carried.
Nos. 13, 14, 15 and 16.
Dr. S. Murray: The doctors cannot have the major number of appointees. I have
in mind tlhe nursing profession, the pharmaceutical profession, etc.
Dr. Strong: There is provision in the Act for Committees of medical men; nurses,
dentists, druggists, etc We are only concerned with the fact that the medical men
should have a Committee.
Dr. S. Murray: As it stands now, supposing that the Main Committee is set up
with doctors in the minority. That could be overcome by encouraging the nurses and
other allied professions to have ample representation and in that way it woud it would
be dominated by professionaly trained people.    I am referring to Principle No. 13.
Page Two Hundred and Twenty-two Dr. Strong: In the consideration of No. 13, the Conunittee suggests a majority of
professional people.
Dr. Dunbar: This No. 13 Committee is only advisory. The oHier is the one that
administers the Act.
Nos. 13, 14, 15 and 16 moved, seconded and carried.
No. 17 moved, seconded and carried.
No. 18.
Dr. L. MacMillan: I am sure that that particular section must have involved an
enormous amount of work. I would suggest that the word "limited practitioner" has a
rightful place in that section, and under "limited practitioner" I would class the E. E.
N. and T. specialist to whom the public go directly, and also under "limited practitioner"
I would suggest a general practitioner who has limited his work for 10, 20 or 30 years
but who is as useful in any other part of the other branches. I think there has been
an omission when they do not mention a "limited practitioner."
Dr. Strong: The wording of this clause has been practically unchanged for the last
ten years. It is a clause about which there has been more discussion than any one of the
other principles. We recognize, as Doctor MacMillan has pointed out, that there are
certain specialists that the general public almost demands ready access to; for instance,
the E. E. N. and T. men. I don't like the introduction of the word "limited." I think
the writing here contains the usual understanding that we have of these things. I
know that there are men who limit their practice to one part of the whole medical service and yet are not specialists. Consultants, of course, is a broad term. A consultant
can be anyone in a rural community; he is the nearest available medical practitioner. I
don't think that the addition of limited service will add anything to the meaning of that
whole principle.   I think it is fairly clear.
I tihnk we must try to visualize this: that you cannot introduce any plan of socialized medicine without realizing that there are going to be certain disruptions which will
be entirely foreign to our present concept. I think our idea should be to make them
in the interests, not only of the doctor but of the patient, and I think that this principle
regarding medical benefits attempts to set out what should be provided under this scheme.
Dr. Millar: Why bother about general practitioners until we start this scheme?
No. 18 moved, seconded and carried.
No. 19.
Dr. Boak: Should we add the words "of that province" to that sentence?
Dr. D. J. Millar: It think it would still be state medicine if the province introduced
No. 19 moved, seconded and carried.
No. 20 moved, seconded and carried.
Chairman: I think it would be well to go through the additional comments as well.
Comment No. 1 moved, seconded and carried.
Comment No. 2 moved, seconded and carried.
No, 3.
Question: Why not six months after the cessation of hostilities? Or why not two
years after the cessation of hostilities—the majority will be out by then?
Dr. Strong: The reason that it is included is because there have been a number of
requests, particularly from men overseas, that those of us in Canada use every effort to
this end and it seems the government has recognized that nothing should be undertaken
against the advantage of the men in uniform. Whether you leave it in this phrasing or
not, you might add "or until six months after the cessation of hostilities." It is obvious
that there cannot be an immediate mobilization.   We know that.   The idea was to leave
Page Two Hund.ed and Twenty-three it in a more or less general phrase to show that there must be consideration for the men
in uniform.
A Doctor: We are going to have a panel system of medical service. If we have a
panel system and all the entire population has signified which doctor they are going to
have, how can a man get into the scheme after he comes back? I think it is a perfectly
proper comment.
A Doctor: How would it be to put in there—"is rehabilitated"?
A Doctor: There is no reason why we should not include that clause. It is our duty
to protect the man overseas or in uniform.
Comment No. 3 moved, seconded and carried.
Comment No. 4 moved, seconded and carried.
Comment No. 5 moved, seconded and carried.
Comments Nos. 6, 7 and 8 moved, seconded and carried.
Dr. D. J. Millar: Mr. President, I think that this meeting should move a vote of
thanks to show the appreciation they feel for the very excellent work that has been done
by Dr. Strong and his Committee in the matter of health insurance. While I don't
always agree with the findings, I know that this Committee has worked very excellently
along these lines.
Motion seconded and carried.
Dr. Lorne Wood: What difficulties does the health insurance scheme expect from
these other groups or cults, including the chiropractors and religious organizations? Are
they going to force them to conform to this thing?   How are you going to handle them?
Dr. Strong: The answer that has been given is that everyone will have to contribute. No one has to take the benefits. They point out that these levies are partly for
the sake of public health. They say that the state has a perfect right to demand contribution to the welfare of the whole. There as yet has been no word as to how the
situation is going to be handled; for instance, whether they will let children go to
school who are not vaccinated or inoculated, etc.   That is still to be settled.
This plan will do away with the contract schemes now in existence. It will do away
with our voluntary services that have been established.
Dr. H. H. Milburn: I have been going over these principles and additional comments. Principle No. 3 and Additional Comments Nos. 6, 7 and 8 stand out prominently as far as I am concerned. I would like to move a resolution that this body especially should endorse these particular ideas, and that we forward this resolution to the
annual meeting of the C.M.A. in Toronto in May.
Dr. G. A. McLaughlin: I think these are the basis of our whole health insurance
discussion and I second the motion.
Motion carried.
The Seventy-fifth Annual Meeting of the Canadian Medical Association was held in
Toronto with headquarters at the Royal York Hotel on May 22nd, 23rd,. 24th, 25th
and 26th.
The attendance was large and ideal weather made this successful meeting very enjoyable. The total registration of doctors was 1508,—a new high for an annual meeting in
The Sessions of General Council were well attended,—British Columbia being represented by ten members: Dr. P. A. C. Cousland of Victoria, President of the British
Columbia Division; Dr. F. M. Auld of Nelson; Dr. Murray Blair of Vancouver; Dr. F.
M. Bryant of Victoria; Dr. H. A. DesBrisay of Vancouver; Dr. A. H. Meneely of
Nanaimo; Dr. A. H. Spohn of Vancouver, representative from B. C. on Executive Committee of the Canadian Medical Association; Dr. G. F. Strong of Vancouver of the Corn-
Page Two Hundred and Twenty-four mittee on Health Insurance, C.M.A.; Dr. Ethlyn Trapp of Vancouver, and Dr. M. W.
Thomas, Executive Secretary.
Dr. A. E. Archer of Lamont, Alta., was re-elected Chairman of General Council.
Dr. D. Sclater Lewis of Montreal, President, passed the insignia of office to Dr. Harris
McPhedran of Toronto, who is the new President of the Association. The Presidentelect is Dr. Leon Geriri-Lajoie of Montreal, and Dr. Frank S. Patch was re-elected Honorary Treasurer.
The Annual General Meeting was largely attended and the colourful ceremony and
addresses were very impressive. Senior memberships were conferred upon eight members,
Dr. M. G. Archibald of Kamloops being elected from British Columbia. The election of
Dr. Charles F. Martin of Montreal to Senior Membership was very popular.
Dr. P. A. C. Cousland of Victoria was elected to represent British Columbia on the
Executive Committee of the C.M.A., and Dr. A. Y. McNair of Vancouver is the alternate representative.
Those in attendance from British Columbia were: Dr. P. A. C. Cousland, President
of the British Columbia Medical Association, Dr. F. M. Auld of Nelson, Dr. L. F. Brog-
den of Penticton, Dr. A. O. Rose of Langley Prairie, Dr. A. H Meneely of Nanaimo,
Doctors F. M. Bryant, E. W. Boak and A. B. Nash of Victoria, Dr. J. G. Robertson of
New Westminster, and from Vancouver: Doctors A. M. Agnew, L. H. Appleby, Murray
Blair, Aristide Blais, W. Harold Brown, Otto DeMuth, H. A. DesBrisay, E. H. Funk,
W. L. Graham, E. R. Hall, G. L. Hodgins, T. H. Lennie, Josephine Mallek, G. E. Mc-
Kenzie, Murray Meekison, G. E. Seldon, Howard Spohn, G. F. Strong, Ethlyn Trapp and
M. W. Thomas.
The thirty members listed above were joined by a number of British Columbians,
who are now serving with the Forces. Those in uniform included: Surgeon Captain A.
G. Laroche; Surgeon Commander H S. Morton; Lieut.-Col. Walter Bapty, formerly of
Victoria; Lieut.-Col. G. H. Clement and Lieut.-Col. D. H. Williams, formerly in Vancouver; Major S. G. Kenning, formerly in practice in Victoria; Major S. L. Williams,
formerly Nanaimo; Majors A. N. Beattie and I. Tchaperoff of Vancouver; Surgeon-
Lieut. R. M. Jameson; Capt. S. Janowsky and Flight-Lieut. H. V. Hughes of Victoria.
Papers were presented by Doctors L. H. Appleby, E. R. Hall, Murray Meekison and
Howard Spohn of Vancouver, Dr. A. B. Nash of Victoria and Surgeon Commander H.
S. Morton of Esquimalt.
The British Columbia members were very shocked to learn of the passing of Dr.
R. E. McKechnie. Many expressions of sympathy to his family were heard. The whispered news was passed with a tribute to a great medical gentleman. At the General
Session on the day that word was received the President, Dr. Harris McPhedran, called
upon the large assembly in the Concert Hall to stand while he reviewed the life of a
former President of the Association.
Dr. H. A. DesBrisay, who is a member of the sub-committee of the Committee on
Medical Education of which Doctors C. E. Dolman, convener, and F. A. Turnbull are
the other members, upon receipt of a telegram from Dr. K. D. Panton, Chairman of the
Committee on Medical Education, arranged a conference with prominent members of
the Faculty of Medical Schools in Canada, and on the following day a luncheon was held
which was attended by representatives from the Universities of Toronto, Alberta, Dal-
housie, Manitoba and McGill. The following from British Columbia were present: Doctors P. A. C. Cousland and F. M. Bryant of Victoria, H. A. DesBrisay, T. H Lennie, G,
E. Seldon, G. F. Strong and M. W. Thomas. Much useful information was gathered in
the informal discussion of the needs to be met in the pre-clinical and clinical years of the
medical course. While much impressed by the task which confronts the profession in
British Columbia those present were encouraged and supported in their effort by the
conference. Dr. A. T. Mathers, Dean of Medicine of the University of Manitoba, and
Dean Grant of Dalhousie University, gave much information. Doctors Scott and Gillespie of the University of Alberta, discussed the difficulties encountered in the establishment of the Faculty at Edmonton. Dr. Duncan Graham, Dean of Medicine of the
Page Two Hundred and Twenty-five University of Toronto, and Dr. D. Sclater Lewis of McGill, joined the others in giving
strong support and encouragement to British Columbia. Surgeon Captain Best of
Toronto was very interested and contributed freely to the discussion regarding the needs
during the whole course in impressing the opportunity which British Columbia has to
build a Medical School on proper lines. British Columbia students are finding it increasingly difficult to secure entry to other medical schools and this together with the need
to use the abundance of clinical material in our hospitals and discharge a responsibility
by B. C. in support of Canada's needs, makes it imperative that immediate steps be taken
to establish a Medical School in British Columbia.
Advantage was taken of the presence of Dr. G. M. Weir in Toronto to confer with
him regarding the need of a Medical School in the re-training programme. Dr. Weir is
Director in this department at Ottawa.
It was unfortunate that the meetings interfered with the attendance of Doctors
Appleby, Funk, Spohn and others at the Woodbine racing meet.
Doctor Appleby is now a patient in Toronto General Hospital where Dr. Roscoe
Graham operated upon him on May 29th.   We hope he makes satisfactory progress.
May 10th, 1944
In the death of Dr. F. J. Nicholson, the Vancouver Medical Assocation lost
a loyal friend and member of many years' standing: -and Vancouver lost a man
who was in his day a very distinguished physician and surgeon, though for
many years he had given up medical practice—partly on account of his health,
which has been none too good for a long time, and partly because he wished to
devote himself to other interests.
But the F. J. Nicholson fund of the Association will endure as a memorial
to him—he established it some few years ago, and donated many valuable books,
in addition to a sum of money earmarked for Library purposes. All his active
medical life he was a faithful member of our Association, and took a close
interest in its -affairs.
Dr. Nicholson was one of the old-timers in Vancouver medicine. He came
to Vancouver at the beginning of the century, or at the end of the last one, and
quickly attained a high place in the ranks of the profession. His academic record
was a very high one at McGill and he had in addition a great deal of practical
ability.   He was a good surgeon and an excellent clinician.
During the first World War Dr. Nicholson volunteered for service with
the No. 5 General Hospital that saw service in the Mediterranean as well as in
France, and contained so many of our men—Proctor, Monro, McTavish, Patterson, Wallace Wilson, Schinbein, C. S. McKee, W. B. McKechnie, Harrington,
W. A. Clarke, and 'many others. Not long after his return, he became deeply
interested in mining and became a director of the.Pioneer Gold Mines, which
had such a meteoric rise into active operation. He suffered from poor health—
and found medical practice too demanding—so gave it up for this other work.
But he never lost interest in medicine, as our history of him shows. He took
an interest, too, in the University of British Columbia, which was also a recipient of his benefactions. i
"Nick", as he was familiarly, called, was personally very well liked by all
who knew him: he was always friendly and genial, and retained his friendships.
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With all its pleasures, "the good old summertime" leads all the seasons in gastrointestinal upsets and diarrheas.
Vacations, outings and picnics with their
dietary indiscretions, changes from accustomed food and water supplies, bacterial
contamination, all may be responsible lor
severe diarrhea during summer months.
Whatever the cause, prompt control of
diarrhea is ensured with Kaomagma.
At the Onset . . 1 administer
two tablespoonfuls of Kaomagma Plain, in a tittle
water —
And follow this -with one
tablespoonful of Kaomagma
Plain, after every bowel
movement —
Then . . . when stools become consolidated, one table-
spoonful of Kaomagma with
Mineral Oil may be indicated
three times daily.
Many physicians prescribe Kaomagma to
be included as an important unit in the
vacation kits of patients bound for isolated
vacation spots. Giving directions for its
use at the first indication of diarrhea, these
doctors provide immediate protection which
their patients need until they are able to
return for proper follow-up and specific
rf^-j/l       ^ Trademark Reg'd in Canada
" A Wyethical
Prevention of rickets is part of the
daily routine in the care of infants
and young children. Hence there is
a big advantage in simplifying the
administration of vitamin D.
Two drops of Drisdol in Propylene
Glycol in the daily ration of milk is
the prophylactic dose.
Drisdol in Propylene Glycol disperses uniformly in milk and does
not affect its palatability.
Brat^0^^mA^ii^Vlt9mi0 th
uiidthrop CHcmiciiL compflnv, inc.
Pharmaceuticals of merit for the physician
Quebec Professional Service Office:
Dominion Square Building, Montreal, Quebec HI TO—Age 43
Patient appears to be sufering from mental reactions
following rabies.
The illness was indirectly caused by his partnership
in the Greater East-Asia Co-Prosperity Sphere, Inc.
The patient was alloted a territory in China. While
in Shanghai in 1937 he was bitten by a rabid dragon.
The patient has not completly recovered from the
shock; hydrophobia and other mental symptoms remain.    The dragon is doing well.
Mental reactions simulate those of delirium tremens
and he imagines attacks at various times by eagles
(U.S.) and  lions (Br.).
There is a definite mistrust of all those around him.
The patient has a feeling of insecurity and apprehension. He feels that his partners in business have
failed him. He is less inclined to travel, feeling that
when he is away from home he is liable to be suddenly attacked. Sea voyages, he believes, are definitely dangerous.
To date treatment has been purely symptomatic, the
patient is being persuaded to wind up his partnership
and withdraw from the Greater East-Asia Co-Prosperity
Sphere, Inc. He is to lead a quiet life of retirement;
frequent purges (Tojo) are recommended. The taking
of oil and .quinine is to cease and rubber to which an
allergy exists is to be avoided.
URASAL is a tart effervescent saline containing Hexamine, piparazine
and Lithium compounds.
It is safe for long term treatment of rheumatic pains and
mild infections of the urinary
URASAL is entirely safe.
It  can  produce  no  cumulative
URASAL is a solvent.
Therefore it aids the effective
elimination of waste materials
and toxins.
URASAL is a urinary antiseptic.
Hexamine breaks down to formaldehyde which is a bactericide.
Prescribe: One dessertspoonful in 4 ounces
of water three times daily.
Package: In bottles of 4 ozs. and 10 ozs.
CANADA It is well to bear in mind that dried brewers yeast,
weight for weight, is the richest food source of the Vita-
min B Complex. For example, as little as 1 level teaspoonful (2.5 Gm.) Mead's Brewers Yeast Powder supplies:
45% of the average adult daily thiamine allowance
8% f    %     ■   i "       "   riboflavin allowance
10% n     " n "       n        niacin  allowance
— in addition to the other factors that occur naturally in
yeast such as pyridoxine, pantothenic acid, etc. Following
are suggestions for palatably
mixing 1 level teaspoonful
Mead's Brewers Yeast Powder:
(1) Shake in cocktail shaker with
4 ounces of milk (with or without 1
level teaspoonful sugar and cocoa).
(2) Stir with fork into 3A ounce of
ketchup or chili sauce. Optional, add
a few drops of lemon juice.
(3) Stir with fork into 3 ounces of
soup (preferably thick soups such
as bean, pea, oxtail, beef, etc.).
(4) Spread on bread with 2 to 3
times the amount of peanut butter.
(5) Add 1 level tablespoonful (and
a little extra salt) to 2 cups of meat
stock gravy. *^^,
Mead's Brewers Yeast is supplied in 6-oz.
bottles, economically. At the rate of even
2 level teaspoonfuls per day, per adult, a
battle should last over a month. Also supplied in 6-grain tablets. 100 and 250 tablets
per bottle. All Mead Products are advertised
only to the medical profession.
706% *tot #up tfat nectfoe at Aome? *)t *h*6c& $o*d
$>uutyr%Jfaate   *tt€€it£0i.   Send  fan,   tested xvanttoitc
MEAD JOHNSON & CO. OF CANADA, LTD., Belleville, Ontario How Does ^m^U^imi Become Inherent?
HETHER you buy medical equipment for private practice or for a hospital, always it is with the hope that time and experience will prove
that you correctly judged its value.
| Your investigation of variously offered products is, of course, primarily
in view of determining which offers most toward helping to render a
better service to patients; price alone is not your determining factor, as with ordinary
If you haven't had. experience with G-E x-ray or electromedical equipment, you'll not
#take for granted that it is of the fine quality you are looking for. But to countless
thousands of other physicians, hospitals, and clinics, the world over, equipment bearing
the flggfl trademark is accepted without question, because they have learned from experience that in all G-E equipment this desired fine quality is inherent.
This reputation for inherent fine quality has been earned the hard way—by strict
adherance to definitely established policies and ideals throughout a half-century of
service to the profession. And it perhaps best explains why a G-E apparatus, wherever
it may be used—in physicians' offices, or in civilian or military hospitals, in any and
all climes—always can be relied upon to give the eminently satisfactory service that
characterizes all G-E products.
Though your plans for buying an x-ray or electromedical apparatus may be yet rather
indefinite, may we suggest that in the meantime you obtain further information through
our local representative, whose branch office address we will be glad to send you.
Address Dept. K65.
Tutors 73eit 7?mt
£fe» SavingGitifietm
TORONTO - 30 Bloor St., W. - VANCOUVER: MotorTrans. Bldg., 570 Dunsmuir St.
MONTREAL: 600 Medical Arts Building • WINNIPEG: Medical Arts Building
luL Wartime Spastic Gut —
The assault and trauma of disturbing psychic influences
may reflect themselves in a hyperexcitability of the autonomic nervous system. The resulting spastic disorders of
the gastro-intestinal tract are now being effectively managed with the well-known antispasmodic and sedative
NEUO-TRASENTIN* . . . supplemented by additional
dosage of Trasentin* when increased spasmolytic effect
is desired.
*Trade Mark Reg'd.
Literature and samples    N E U R O -T R AS E N TI N
on request.
CM Bill
* & MONTR 1
flftount pleasant Tllnbertalnno Co. %tb.
KINGSWAY at 11th AVE. Telephone FAirmont 00 51 ,  VANCOUVER, B. C
Physiotherapy Centre
Up-to-date Scientific Treatments
Medical and Swedish Massage
Physical Culture Exercises
Post Graduate Mayo. Bros.
1119 Vancouver Block
MArine 3723      Vancouver, B.C.
effective treatment suggests the use of
agents te correct mineral deficiency,
increase cellular activity, and secure
adequate elimination  ef toxic waste.
orally given, supplies calcium, sulphur,
iodine, and lysidln bitartrate — an
effective solvent. Amelioration of
symptoms and general functional improvement  may  be  expected.
Write for Information.
Canadian Distributors
350  Le Moyne   Street,   Montreal
Jf    Breaks the vicious circle of perverted^l
menstrual function in cases of amenorrhea,
tardy periods (non-physiological) and dysmenorrhea. Affords remarkable symptomatic
relief by stimulating the innervation of the
uterus and stabilizing the tone of its
i   musculature. Controls the utero-ovarian
Ik    circulation and thereby encourages a    A
Ifik i ii '•'' *
Ik   normal menstrual cycle.
Full formula and descriptive
literature on request
Dosage:   \ to 2 capsules
3 or 4 times daily.   Supplied
in packages of 20.
Ethical protective mark MHS
embossed on inside of each
capsule, visible only when capsule is cut in half at seam. 6iin£!B$
High dosage B vitamins of stable potency plus Vitamin _
providing a daily therapeutic dose of the B complex and D
in   a   pleasant  tasting   liquid   preparation   which   is
economical to your patient.
BeForte LIQUID is compatible with syrupy solutions, like simple syrup
which will carry any of the well-known drugs such as bromides. It may
also be mixed in any proportions with Syrup Ferro-Catalytic. A one-to-
one mixture of BeForte LIQUID and Syrup Ferro-Catalytic makes an
extremely palatable 'preparation exhibiting" Iron and the B complex
RetyoJite. liquid
Vitamin B, (Thiamin hyd.)  1100 Int. units (3.3 mg.)
Vitamin B2 (Riboflavin)  800 S.-B. unite (2 mgs.)
Nicotinic (add amide)    -------- 20 mgs.
Calcium pantothenate  500 micrograms
Pyridoxme  250 micrograms
Vitamin D  500 bit units.
A concentrate containing all B complex factors
natura I to brewers' yeast in Hie ratio of 160 S.-B.
units of B2 per G -  200 mgs
Stabilized in a base of Malt Extract:
DOSE: One teaspoonful once or twice daily.
MODES OF ISSUE: 4, 8 and 80 fluid ounce botflesi
Clinical data indicates that beneficial effects are obtained following Intensive therapy
with vitamin B complex in a large number of clinical conditions.
The basic "BereTta** formula has been improved, at no extra cost to your patients, by
increases in the riboflavin and nicotinic add content.
BeForte BeForte with C BeForte with D
CT. No. 360 "§mf CT. No. 361 "Snf CT. No. 362 'm**
DOSAGE: One to three tablets daily.
MODES OF ISSUE: In bottles of 30, 100 and 500 tablets.
Chante* &.S^Met&cb. _
MONTREAL CANADA The Canadian Mark of Quality
Pharmaceuticals  Since   1899
'm*. Supplied   in:   PINK COMPRESSED
TABLETS Containers of 20, 100 and
500 tablets. Also in suppository form
for rectal use.
Physicians are cordially invited
to request clinical samples.
r  followed by
Soneryl is a medium acting barbiturate,
which is relatively free from undesirable
after-effects. Sleep is induced within thirty
minutes and continues restfully for six to
eight hours.
JjaJuv*vatjrruj / oicLejtc j*£/i£A
OF      CANADA       LIMITED   —  MONTREAL ■'■m
Qcuuda'l Vital
Milk is accepted as the most valuable protective
food because it surpasses all others in supplying
vitamins, minerals, and high quality proteins that
build and maintain sound physical fitness. No
wonder our fighting forces are among the best fed
in the world—their milk consumption is exceptionally high—and no wonder Canada's home front,
too, is by far the best fed!
A quart of milk (4 glasses) gives the following
percentages of your DAILY FOOR NEEDS.
Iron 16%
Vitamin C*'% 16%
Energy 22%
Vitamin B 28%
Vitamin A 37%
Protein —49%
Vitamin G 79%
Phosphorus    69%
Calcium 100%
* Values Variable. BUSylDOCTORSil
Find that the Georgia prescription service allows them to save time and worry.
Our several registered pharmacists
check and double-check for your protection and ours.
MArine 4161
jhAjL ~&. JhtduAAen
L. t M I ■ T t'O
North Vancouver, B. C.
Powell River, B. C.


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