History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: May, 1952 Vancouver Medical Association May 31, 1952

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 BULLETIN
OF ;|§
The Vancouver Medical Association
EDITOR:
dr. j. h. macdermot
EDITORIAL BOARD
DR. D. E. H. CLEVELAND DR. J. H. B. GRANT
DR. H. A. DesBRTSAY DR. j. L. McMILLAN
Publisher and Advertising Manager
W. E. G. MACDONALD
rOLUME XXVIII
MAY,  1952
NUMBER 8
OFFICERS 1951-52
Db. J. C. Grimson Db. E. C. McCoy Db. Henby Scott
President Vice-President Past President
Db. Gobdon Bubke Db. D. S. Munboe
Hon. Treasurer Hon. Secretary
Additional Members of Executive'.
Db. J. H. Black Db. Geobge Langley
TRUSTEES
Db. G. H. Clement Db. A. C. Fbost Db. Mubbay Blaik
Auditors: Messrs. Plommeb, Whiting & Co.
SECTIONS
Eye, Ear, Nose and Throat
Db. B. W. Tanton Chairman Db. John A. Ieving Secretary
Paediatric
Db. Peteb Spohn. Chairman Db. John W. WHrrELAW-Secretary
Orthopaedic and Traumatic Surgery
Db. A. S. McConkey. Chairman Db. W. H. Fahbni Secretary
Neurology and Psychiatry
Db. R. Whitman Chairman Db. B. Bbyson Secretary
Radiology
Db. R. G. Moffat Chairman Dr. H. Brooke  Secretary
STANDING COMMITTEES
Library:
Dr. A. F. Habdyment, Chairman; Db. J. L. Parnell, Secretary;
Dr. F. S. Hobbs, Dr. J. B. Walker, Db. E. Fbance Wobd, Db. D. W. Moffatt
Go-ordination of Medical Meetings Committee:
Db. J. W. Fbost Chairman Db. W. M. G. Wilson Secretary
Summer School:
Db. J. H. Black, Chairman; Dr. J. A. Irving, Secretary; Dr. B. T. H.
Marteinsson; Dr. Peter Spohn; Dr. S. L. Williams; Dr. J. A. Elliott.
Medical Economics:
Db. F. L. Skinneb, Chairman; Db. W. E. Sloan, Db. G. H. Clement,
Db. E. A. Jones, Db. Robert Stanley, Db. F. B. Thomson, Db. R. Langston
Credentials:
Db. Gobdon C. Johnston, Db. W. J. Doebance, Db. Henby Scott
V.O.N. Advisory Committee
Db. Isabel Day, De. D. M. Whitelaw, Db. R. Whitman
Representative to the B.C. Medical Association: Db. Henby Scott
~ Representative'to the Vancouver Board of Trade: Db. E. C. McCoy
Representative to Greater Vancouver Health League: Db. J. A. Ganshobn
Published  monthly  at  Vancouver,  Canada.     Authorized   as  second   class   mail,  Post  Office  Department,
Ottawa, Ont.
Page 241 for EXTRA SAFETY
"Sulfadine" is one of the most effective
sulfonamides for use in systemic
infections . . . yet it appears to be one
of the least toxic of all. Its extreme
solubility reduces the need for
alkalinization or high fluid intake
and practically eliminates the risk
of renal complications. With
"Sulfadine", a high blood level
is quickly reached and can be
sustained by repeating the
maintenance dose only every
six hours.
Availability:
"SULFADINE" Tablets, No. 3551
Each tablet contains 0.5 Gm.
Sulphadimidine B.P.C.
In bottles of 100 and 500.
"SULFADINE" Suspension, No.3855
Each 5 cc. (teaspoonful) contains 0.5 Gm.
Sulphadimidine B.P.C.  in an unusually
palatable raspberry-flavored base.
In 4 &nd 16 ounce bottles.
Ayerst, McKenna & Harrison Limited
MONTREAL
Canadian Manufacturers and Distributors for:
IMPERIAL CHEMICAL (PHARMACEUTICALS) LIMITED
Page 242 VANCOUVER MEDICAL ASSOCIATION
PROGRAMME FOR THE FIFTY-THIRD ANNUAL SESSION
Founded 1898; Incorporated 1906
REGULAR MONTHLY MEDICAL MEETINGS
First Tuesday—General Meeting—Vancouver Medical Association—T.B. Auditorium.
Clinical Meetings, which members of the Vancouver Medical Association are invited
to attend, will be held each month as follows:
Second Tuesday—Shaughnessy Hospital Staff Meeting.
Third Tuesday—St. Paul's Hospital Staff Meeting.
Fourth Tuesday—Vancouver General Hospital Staff Meeting.
Fifth Tuesday—(when one occurs)—Children's Hospital Staff Meeting.
Programme of General meetings will be circularized monthly by the Executive
Office of the Vancouver Medical Association Programme of Clinical meetings will be
displayed weekly on bulletin boards prepared for that purpose and placed in the Vancouver General, St. Paul's and Shaughnessy Hospitals.
VANCOUVER GENERAL HOSPITAL
Regular Weekly Fixtures in the Lecture Hall
Monday, 8:00 a.m.—Orthopaedic Clinic.
Monday, 12:15 p.m.—Surgical Clinic.
Tuesday—9:00 a.m.—Obstetrics and Gynaecology Conference.
Wednesday, 9:00 a.m.—Clinicopathological Conference.
Thursday, 9:00 a.m.—Medical Clinic.
12:00 noon—Clinicopathological Conference on Newborns.
Friday, 9:00 a.m.—Paediatric Clinic.
Saturday,  9:00  a.m.—Neurosurgery Clinic.
.     ST. PAUL'S HOSPITAL
Regular Weekly Fixtures
2nd Monday of each month—2 p.m J| JH ..Tumour Clinic
Tuesday—9-10 a.m j  \        ...Paediatric Conference
Wednesday—9-10 a.m.-.--,-- §| ,  ...,-Medical Clinic
Wednesday—11-12 a.m.i Obstetrics and Gynaecology Clinic
Alternate Wednesdays—12 noon . Orthopaedic Clinic
Alernate Thursdays—11 a.m Pathological Conference (Specimens and Discussion)
Ytv&zy 8  a.m.— Clinico-Pathological Conference
(Alternating with Surgery)
Alternate Fridays—8 a.m Surgical Conference
Friday—9 a.m Dr- Appleby's Surgery Clinic
Friday—11 a.m Interesting Films Shown in X-ray Department
Page 243 '■^F&tf^
it would take
a troop of trailers
• • • To house all of the patients who represent each of the many
conditions for which short-acting NEMBUTAL is effective,
Iou'd count at least 44 people, if you could see them
all at once. For over 44 uses is the clinical record for
short-acting Nembutal since it was introduced in 1930.
Case after case from the 570 published reports shows that
adjusted doses of short-acting Nembutal can achieve any
desired degree of cerebral depression—from mild sedation
to deep hypnosis. And this is accomplished with only about
half the dosage required by many other barbiturates.
The dosage is small, the margin of safety is wide. Note,
too, the shorter duration of effect, the virtual freedom
from cumulative effect and "hangover," the definite
economy for your patient.
For your copy of the new booklet, "44 Clinical Uses
for Nembutal," write Abbott Laboratories Limited,
Montreal. Perhaps it will suggest to you additional
effective uses for short-acting Nembutal
in your practice.
Remember:
In equal oral doses, no
other barbiturate combines
QUICKER,   BRIEFER,
MORE   PROFOUND
EFFECT than . . .
fVUM)
Nembuta
TRADE MARK REG'D
(PENTOBARBITAL,  ABBOTT)
FOR INSOMNIA AND
SIMPLE SEDATION
fry  the   50-mg.   (%-gr.)
NEMBUTAL Sodium Capsule
Page 244 SHAUGHNESSY HOSPITAL
Regular Weekly Fixtures
Tuesday, 8:30 a.m.—Dermatology.
Wednesday, 10:45 a.m.—General Medicine.
Wednesday, 12:30 p.m.—Pathology.
Thursday, 10:30 a.m.—Psychiatry. |p
Friday, 8:30 a.m.—Chest Conference.
Friday, 1:15 p.m.—Surgery.
BRITISH COLUMBIA CANCER INSTITUTE
685 West Eleventh Avenue,
Vancouver 9, B.C.
SCHEDULE OF WEEKLY  CLINICAL MEETINGS
Monday—9 a.m. - 10 a.m Ear, Nose and Throat Clinic
Tuesday—9 a.m. - 10 a.m Weekly Clinical Meeting of Attending Medical Staff
Tuesday—10:30 a.m. -  11:30 a.m . . Lymphoma Clinic
Daily—11:45 a.m. -  12:15 p.m. i Therapy Conference
B.C. SURGICAL SOCIETV
Spring meeting—April 25 th, 26th, 1952.
EXCLUSIVE AMBULANCE
LIMITED
EM. 2266
NW. 60
Wimm
i.
WM
wmmm
OXYGEN THERAPY SUPPLIED ON YOUR ORDER
|24 HR. SERVICE fig    !
J. H. CRELLIN W. L. BERTRAND
Page 245 antibiotic
decongestive
111
treatment of sinusitis
Neo-SynephmnttPenicillin
Since most of the organisms
responsible for sinusitis belong to
the penicillin-sensitive group,1
this antibiotic is well suited for
topical therapy in this condition.2
For penicillin to be effective,
however, it should be applied
frequently and in adequate
concentration to the diseased area.
Application of Neo-Synephrine
aids in accomplishing penetration
of the antibiotic by reducing
nasal congestion 3
NeO-Synephrine® Penicillin is supplied in combination package
(with diluent) to make 15 cc. of 0.25% Neo-Synephrine HCI solution
containing 10,000 units of penicillin in 1 cc. ^-. — —•  *""■*' """
1. Putney, J. F.: Sinus Infection,
in Conn, H. J.: Current Therapy
1951. Philadelphia,
W.B.Saunders Co., 1951, p. 71.
2. Craig, S. L: New York State Jour.
Med., 49:181, Jan. 15,1949.
3. Woodward, F. D., and Holt,T.:
Local Use of Penicillin in Infections of
the Ear, Nose and Throat. J.A.M A.,
129:589, Oct. 27,1945.
i
I
f
Of  CANADA, LTD
For Dual Control of the Common Cold,
Allergic Rhinitis, Vasomotor Rhinitis
and Sinusitis...
Neo-Synephrine Thenfadil*
Decongestant Antihistaminic Nasal Solution
Botdes of 1 fl. oz. containing
Neo-Synephrine hydrochloride 0.25%
and Thenfadil hydrochloride 0.1%.
Neo-Synephrine,trademark reg. U.S. & Canada,
brand of phenylephrine
Thenfadil, trademark reg. U. S. & Canada, brand of
N,N-dimethyl-N'-(3-thenyl)-N'-(2-pyridyl)
ethylenediamine hydrochloride
443 SANDWICH STREET WEST, WINDSOR, ONTARIO
Page 246 VANCOUVER HEALTH DEPARTMENT
^STATISTICS—MARCH,  1952        }
Total population—census figures 340,272
Chinese  population—census   figure :       7,117
Other—census   figure    1 1  788
March,  1952
Rate per
Number        100 pop.
Total    deaths    (by   occurrence) I 408 14.4
Chinese  deaths '. 1     24 40.5
Deaths, residents only _:  / 348 12.3
\ - 118
Birth Registrations—residents and non-residents
(includes late registrations)
Ipl March,  1952
Number
Male    . . - 406
Female j i 432
838 29.5
Infant Mortality—residents only
Deaths under   1   year  of  age	
Death  rate per   1000  live births	
Stillbirths   (not  included   in   above  item).
CASES OF COMMUNICABLE DISEASES REPORTED  IN  THE CITY
March,
Cases
j Scarlet Fever 5 | 128
Diphtheria , — 1 —
Diphtheria   Carriers Jl —
Chicken Pox I 100
i Meales  2 44
Rubella 13
|» Mumps     80
Whooping Cough -  2
Typhoid Fever 1  —
Typhoid Fever Carriers — —
I Undulant   Fever   —
'<  Poliomyelitis 1 j 1
Tuberculosis | ! -  51
Erysipelas I I :  1
Meningitis  ;——-  1
Infectious   Jaundice   —
Salmonellosis j  :  1
Salmonellosis Carriers | 1	
Dysentery  1
Dysentery Carriers  —
Tetanus —
Syphilis :     13
Gonorrhoea  \ 13 6
Cancer   (Reportable   Resident) 123
1952
March,
1951
Deaths
Cases
Deaths
—
94
—
—
145
—
—
58
—
—•
21
—
—
72
—
—
6
—1
11
56
54
3
•   1
3
8
1
13
1
157
—
76
74
Page
249 { CONNAUGHT>
ACTH
Adrenocorticotrophic Hormone
In December 1949, at the invitation and with the financial support of thej
Federal and Provincial Governments, the Laboratories undertook to produce ACTHl
in Canada.
Specially collected pituitary glands were obtained across Canada through thej
helpful co-operation of the Canadian meat-packing industry. The facilities and
staff of the Laboratories were applied to the development of methods of production
and testing of ACTH, with the result that a product was prepared which met with
favourable acceptance. Under the arrangements in effect during the initial period,
supplies of ACTH were delivered to the National Research Council of Canada for
distribution for research purposes by its Advisory Committee on ACTH and Cortisone.
Since August 1950, supplies of ACTH sufficient to meet the requirements of this
Committee have been maintained.
It is now possible for the Laboratories to commence Hmited distribution of
ACTH  directly  to  Canadian  hospitals,  physicians,   and  research  workers.
The Connaught Medical Research Laboratories supply ACTH as a stable,
sterile powder, protein in nature and readily soluble in water or saline. It is free
from other pituitary hormones or harmful impurities in clinically significant amounts.
One Provisional U.S.P. Unit is equal in activity to one milligram of the ACTH supplied
through the National Research Council.
HOW SUPPLIED
10 Provisional U.S.P. Units per vial.
25 Provisional U.S.P. Units per vial.
CONNAUGHT   MEDICAL   RESEARCH    LABORATORIES
University of Toronto Toronto, Canada
Established in  1914 for Public Service through Medical Research  and the development
of Products for Prevention or Treatment of Disease.
DEPOT FDR BRITISH COLUMBIA
MACDONALD'SfPRESCRIPTIONS   limited
MEDICAL-DENTAL BUILDING, VANCOUVER, B.C.
Page 250 There is great virtue in a good phrase. It is of ten the sugar-coating which makes
the pill palatable and conceals the fact from the patient that he is really swallowing a
bitter drug, which may later make him feel very much upset. The phrase "Social
Security" which has come into such common use of late, is one which comes into this
category. It makes us swallow the three per cent tax without more than a slight
shudder—we see old-age pensions given to everyone over 70, rich or poor, and because,
someone whispers "Social Security" we are comforted, until we receive our Income
Tax statement. In Great Britain, under the guise again of Social Security, the citizen
receives, as apparently free gifts, everything from false teeth to wigs, with medical
and hospital care thrown in: but we know it is anything but free.
And the process is only in its early stages as yet. There is much more to come.
Labour, by which we mean the part of the community whose income is in the lower
brackets, has grasped very fully the fact that this phrase, this attitude of general
appropriation of wealth to cover up and hide the real cost of social benefits can be
turned to very great advantage and that there are all sorts of ways in which to make
it work.
We were shown recently by Dr. Gunn the Registrar of the B.C. College of
Physicians and Surgeons, a most illuminating document. It is a summary of the programme of International Labour (the International Labour Conference) for the next
few years. They are working quite openly for a compulsory Welfare State. In the
U.S.A. they propose to work through Congress. As an organization of the U.N. they
propose to try and induce member nations to ratify the "Social Security" package plan
which they have worked out. Canada will no doubt be approached on similar lines.
The package, which is to be obtained by legislation, and will,be compulsory, and under
control of government, will cover the entire population, rich and poor, ultimately,
although at first there will be an upper income level.
It will provide: t*^
1. Medical benefits in every condition requiring medical care.
2. Sickness allowances—maternity allowances and benefits.
3. Invalidity pensions.
4. Survivors' pensions. mm
Two-thirds of the cost is to be borne by employers or the government, one-third
I by the beneficiaries—but in the case of maternity, employment injury, or such diseases
as tuberculosis, the beneficiary pays nothing.
Ultimately, all medical benefits, hospital care, appliances, are to be "free" for
everyone.
And'this is to be worked internationally.    A Universal Welfare State, in fact.
What answer shall we, as medical men, have to give to such a proposal, or have
we any alternative to offer? Or are we to sit still and say nothing until the storm breaks
over us?   We had best give very careful thought to this matter.
The fact, of course, and we know it, is that some Way must be found to make
medical care, the best medical care, available to every citizen. Preferably, he should
be able to pay for it himself—actually, the great majority of the population cannot
afford to pay the cost of the medical care they need, of the type that they demand,
and to which they are entitled, the type we want to give them. That is an ineluctable
fact. So we cannot blame Labour, if it demands that something be done—either by
the State or by ourselve's, or a combination of the two.
Page 251 Our only answer, as far as we can see, is prepaid medical plans. We have here a
good, almost a completely satisfactory, answer, as far as it goes. But there are two
things to be said. First, prepaid medical plans do not go far enough—and we must
find some way, perhaps as in Australia, in cooperation with the Government, to make
them cover a much wider field, if not the whole field below a certain income level.
We in B.C. have gone a long way on this road already.
The other point is, that we as medical men must play fair with prepaid plans. We
must give them a really square deal, and accept the minor disadvantages of the scheme
in consideration of the greater advantages that it presents.
And as organised medicine we must make all our members conform—and not
allow a small, highly vocal minority to endanger the scheme by their actions. If they
do not wish to work under it, this is a free country (until the Welfare State takes over)
and they do not have to. But if they do work under it, they must play ifhe game
with their fellows, and with the prepaid schemes.
For let us make no mistake, this is the only answer we have—at least we can see
no other. And if it fails, then we shall have a compulsory welfare state plan, and we
must do all we can to prevent that, which we believe to be bad, not only for ourselves,
but, for our patients and the community in general.
To all HOBBYISTS:
The Committee on the Hobby Show would again appreciate t}ie active participation
of B.C. Hobbyists at this year's Convention in September.
Those members who have participated, would you please signify your intentions
for this year's Convention, by writing to the Chairman of the Committee. The others
who have hitherto not participated, would you please let us know if you mean to send
an entry.
This serves as an announcement that the Committe is active, and is a request for
the possible number of proposed entries.
S. Janowsky, M.D.,
c/o Victoria Medical Society Library,
Chairman, COMMITTEE ON EXHIBITS,
Royal Jubilee Hospital,
Victoria, B.C.
WANTED
A medical officer is required (preferably with radio-therapy
experience) for the months of June, July, August, and September at
the British Columbia Cancer Institute.
Application should be made to the Director of the British Columbia Cancer Institute, 685 West Eleventh Avenue, Vancouver 9, B.C.
Page 252 t:
I
iff;
library Hours (until the end of May):
Monday to Friday 1  9:00 a.m. - 9:30 p.m.
Saturday j 9:00 a.m. -  1:00 p.m.
Library Hours during the Summer months:
Monday to Friday -  9:00 a.m. - 5:00 p.m.
Saturday '. - - - 9:00 a.m. - 1:00 p.m.
Recent Accessions:
Aird, I., A Companion in Surgical Studies, 1949.
Beckman, H. (editor), Year Book of Drug Therapy, 1951.
Brain, W. R., Diseases of the Nervous System, 4th edition, 1951.
Bronowski, J., The Common Sense of Science, 1951 (Hist, and Ultra-Scientific
Fund).
DePalma, A. F., Surgery of the Shoulder, 1950.
Essays in Surgery presented to Dr. W. E. Gallie on the occasion of his retirement
from the Chair of Surgery, University of Toronto, 1950 (Hist, and Ultra-
Scientific Fund).
Medical Clinics of North America—Symposium on Symptoms, Tulane—Toronto
number, March, 1952.
Potter, E. L., Pathology of the Fetus and the Newborn, 1952.
Smith, C. A., Physiology of the Newborn Infant, 2nd edition, 1951.
Surgical Clinics of North America—Symposium on Recent Advances in Surgery,
Chicago number, February, 1952.
Wintrobe, M. M., Clinical Hematology, 3rd edition, 1952.
Medical Research Council Special Reports:
No. 273—Infective Hepatitis—Studies in East Anglia during the period 1943-1947
by MacCallum, F. Ov McFarlan, A. M., et al.
No.  277—Observations on the General Effects of Injury in Man with  special
reference to Wound Shock by Grant, R. T. and Reeve, E. B., 1951.
Medical Research Council Memorandum No. 27 (revision of Memorandum No. 19) —
The Rh Blood Groups and their Clinical Effects by Mollison, P. L., Mourant, A. E.
and Race, R. R., 1952.
Journal Subscriptions
There have been some changes in the journals subscribed to by the Library, some
have been discontinued, while others have been added.    The following is the list of
new journals being received in the Library as from January, 1952:
Diabetes (bi-monthly)
Gastroenterology  (monthly)
Great Ormond Street Hospital Journal  (irregularly)
Page 253 Nature (gift of Dr. E. Trapp)
Postgraduate Medicine
The following are the journals that have been discontinued:
American Journal of Digestive Diseases
American Journal of Public Health
Antibiotics
Journal of Biological Chemistry
Mental Hygiene
BOOK REVIEW.
CANCER OF THE RECTUM AND COLON by F. W. Rankin and A. S. Graham.
2nd edition, 1950, pp. 427 illus.
This work is rather short, but in most ways a complete presentation of the subject.
It can in most ways be classified as a reference book, but in concise terms covers the
subject.
The sections devoted to anatomy, physiology, pathology and etiology, whilst
necessary to such av contribution, present very few new features.
The authors are quite definite in their opinion as to the type of surgery they
believe that they would advise in any particular case, and quite naturally favor their
own method.   This they justify by extensive, excellent statistical reviews.
The contributions made on this subject by such outstanding proctologists as Bacon,
Babcock and others are given only casual mention. A description of their work would
appear to me to be a necessity in any work on this subject.
The reviewer believes the whole subject would have been better balanced if more
expression had been given to other procedures.
The sections devoted to pre-operative and post-operative management are clear
and concise, and are in accordance with present-day concepts.
The operative section is short, and as previously stated, is devoted purely to the
surgical procedures which the authors believe to be the most suitable, and favors
decidedly only one school of thought, but the pictorial description of the presented
operative procedures is excellent and easily followed.
A larger bibliography would be-of service to anyone wishing to delve further into
some of the subject material.
H.L.J.
FOR SALE
Improved Hugh Young Urological table with Victor (G.E.) 100 MA.
generator and Victor (G.E.) shock proof X-ray tube.
Phone: New Westminster 399 or 2180
Page 254 Vancouver Medicalf Association
President—,,  Dr. E. C. McCoy
Vice-President Dr. D. S. Munroe
Honorary Treasurer j Dr. G. E. Langley
Honorary Secretary.  Dr. J. H. Black
Editor & Dr. J. H MacDermot
VANCOUVER MEDICAL ASSOCIATION REPORTS
\ .   1951-T952 1 sSK:    'i
PRESIDENT'S REPORT
Ladies and Gentlemen:
The year just past has been one in which the efforts and plans of many years have
been brought to a successful termination and in this respect our year has been one of
conclusion rather than initiation of projects.
The New Academy of Medicine initiated, during the year when Dr. Dorrance was
President, was continued during Dr. Scott's term of office and was completed during
the past year. It has given our Association a magnificent building in which to house
our library and offices. It has given us a pleasant meeting place for committee and
sectional meetings and it is to be hoped that it will in the years to come become the
rendezvous of the growing family of medicine in Vancouver.
The scientific programme was varied,  well attended  and well received.    There
were five general meetings, eleven executive meetings as well as the Osier Dinner and
the Annual Dinner.    The Annual Dinner was held at the Commodore and was highly
successful.   To. Dr. Webb, Dr. Langley, Dr. Storey and many others on the committee
j I wish to express my very sincere thanks.
Our Osier Dinner was very well attended and all present enjoyed the delightful
| address given by Dr. Ethlyn Trapp on the subject of "Modern Alchemy."   The P.G.F.
degrees were conferred on Dr. Archie Hunter and Dr. George Seldon.
It is with sincere regret that we record the passing of five of our members during
the past year. These were Drs. M. R. Basted, J. A. Smith, E. H. Saunders, Wm. Paton
and W. C. McKechnie.
It was with considerable foreboding that I commenced my term of office a year
ago   I felt that one could not carry out the affairs of your Association without a very
I great amount of work, and still feel that I could not have done so without the loyal
| and unfailing support of all my confreres to whom I turned to for assistance.   To
them all, to our executive, to the members of our committees, to the staff of our^
library and office I wish to express my very sincere gratitude for their assistance.
J. C. Grimson.
REPORT OF THE HONORARY TREASURER—1952-53
I have the honour to present the financial report of your Association for the
Fiscal Year of 1951-52. The books have been duly audited by Messrs. Plommer,
Whiting & Co., Chartered Accountants, under the date of March 31st, 1951, (the end.
of our fiscal year) and I feel that although owing to continually rising costs, expenses
for the year have been heavier than usual, the Association is still in a sound financial
position. Added expenses are also due in large part to the increase in salaries and
increase in rent which we are paying for the new quarters in the Academy of Medicine.
The latter is understandable as the Association offices and library now occupy around
four or five times more space than in former years. This has led to the higher dues
for 1952-53.
Page 255 RECEIPTS
Income from members' annual dues   $  13,899.00
Interest received:
Bond savings account $ 5.18
Bond interest  |  408.68
 $       413.86
Revenue from Association Bulletin   1.175.00
TOTAL RECEIPTS I  $ 15,487.86
EXPENDITURES ,    .
Salaries       6,003.53
Rent    I . .    , 3,725.00
Other expenses  \       2,207.08
TOTAL EXPENSES  .  J§$  11,935.61
Excess of Income over Expenditure   (which does not include
amount spent  on Library—books,  journals  and  binding 3,552.25
Depreciation:
Library   \ $    1,580.71
Equipment i «^      ;|J|99.78
 $    1,680.49
Excess of Revenue over Expenditure $     1,871.76
NOTE: The Association this year spent $2,354.02 on the purchase of books, journals
and bindings for the Library. This does not come under expense items as only
depreciation of the library is charged to expense.
The charge to income and expenditure for depreciation amounting to $1,680.49
has been calculated in accordance with the practice established by the Association
in prior years—namely five per cent on the net book value in the case of furniture,
seven and one-half per cent in the case of library and fifteen per cent in the case of the
projectorscope. No depreciation has been charged for furniture, etc., purchased for
the new offices and library.
ASSETS
General:
Bonds at cost  $    5,490.33
Cash on hand and balances at bank   1,701.77
Library, less depreciation  19,495.40
Furniture and equipment, less depreciation  1,843.00
Purchases of furnishings for new offices and library .___ 11,362.80
Total General   $ 39,893.30
Investments (Special Funds):
Historical and Ultra Scientific Fund:
Bank savings account : $        667.60
Bonds at cost       2,479.38
Owing by general funds M  .16
 $    3,147.14
Stephen Memorial Fund:
Bank savings account : $ 15.18
Bonds at cost 11  100.00
 $        115.18
Page 256 John Mawer Pearson Lecture Fund:
Bank savings account i $    1,268.29
Bonds at cost 1      3,553.75
 $    4,822.04
TOTAL ASSETS $ 47,977.66
Out of the sum of $12,500.00 which was voted from the General Savings for the
purpose of furnishing and moving to the Academy of Medicine, you will note that the
sum of $11,362.80 was used. Your Trustees will report further regarding the sale of
bonds from this account.
There has-been very little change this year in the number of members as deaths,
resignations, etc., have just about evenly balanced with the number of new members
elected. The membership now stands at 622—including active, associate, life, privileged and honorary members—as compared with 620 at this time last year.
All of which is respectfully submitted.
Gordon Burke, M.D.,
Honorary Treasurer.
ANNUAL REPORT OF THE BOARD OF TRUSTEES
Mr. President and Members:
This has indeed been a year of expense for the Vancouver Medical Association,
and as a result our savings have been markedly depleted.
You will note in the Treasurer's report that the sum of $11,362.80 was spent for
the purchase of furnishings for, and moving charges to, the new offices and library in
the Academy of Medicine. On December 5th, 1950, the sum of $7,500.00 was voted
by the members for this purpose and on November 6th, 1951, a further sum of $5,000.00
was voted—making a total of $12,500.00 in all to meet these obligations. Your
Trustees have cashed securities amounting to $10,824.32 and a balance of $600.00 was
transferred from the General savings account. As a result, your Association finds itself
financially solvent, but capital has in great part disappeared.
On April 15th, 1952, your Trustees met with Mr. Whiting—a member of the
Audit firm of Plommer and Whiting—and checked the bonds in the safety deposit
box held in the Royal Bank of Canada. It was found that the following securities still
remain to the credit of this Association:
General Savings Fund $ 5,500.00
Historical and Ultra Scientific Fund  2,500.00
Stephen Memorial Fund   100.00
"John Mawer Pearson Lecture Fund   3,550.00
TOTAL    $  11,650.00
For some time now the Association has found it necessary to spend for maintenance
all of the income derived from dues. As a result the only annual savings have been
those derived from interest on our securities. These securities, as I have shown, are
markedly depleted.
Your Trustees, together with your Finance Committee feel strongly that with the
increase in dues, some part of our annual income should be put aside each year in an
attempt  to recover our  depleted finances.
Respectfully submitted,
E. Murray Blair, M.D.,
Trustee.
Page 257 LIBRARY COMMITTEE—ANNUAL REPORT,  1951-1952
I have the honour to present the report of your Library Committee for the past
year.
In August, 1951, the Library moved to its new quarters. The move, the erection
of new stacks, the packing and unpacking of 11,000 volumes and the setting up in
new surroundings, were all accomplished without major incident. This is due, in large
part, to the tireless efforts of the ladies of the Association staff, Mrs. DeWest, Mrs.
Briscoe and Mrs. Holmgren—to whom the Committee here publicly tenders its very
sincere thanks and appreciation.
For the first time, it is believed, a statement has been prepared showing the
estimated total expense involved in running the Vancouver Medical Association Library.
You will note that approximately $10,600 was required. Of this, $2,400.00 was spent
on books, journals and binding, and the balance, about $8,200.00 was spent as follows—
$3,500.00 for rent, $3,800.00 for salaries, $1,000.00 for office expenses. Your Committee stresses these figures for one reason only. The members of this Association should
realize that their excellent library of good standard, now well housed, is a "big
business", and is costing each individual member a sizeable annual sum of money.
\ It is only fair to state at this juncture that your Committe has recommended to the
Executive Committee an increase in budget for Library spending for the year 1952-53
of approximately 25 per cent. This will take care of known and anticipated increase^
in costs.
As a result of the policy of regularly scrutinizing the usefulness of journals subscribed to, four journals have been discontinued. You will note that your Library
received 167 journals. One of the discontinued journals—the Journal of Biological
Chemistry—was on our shelves in an almost complete set. The set was offered for sale,
because of its value, to many booksellers and to the University of British Columbia.
We are pleased to report that this set has been purchased by Walter J. Johnson, Inc.,
of New York, for $1,900.00 (Canadian). This sum will be a welcome addition to the
Association funds.
Gifts are at all times welcome in the Library and during the year two very
interesting ones have been presented. These were a reproduction of the "Edwin Smith
Surgical Papyrus" together with Prof. J. H. Breasted's translation of it, given by Dr.
W. C. Gibson, while Dr. I. Steiman has given two volumes of the works of Hippocrates
in Greek and Latin, published in Geneva in 1657. Our appreciation of these gifts has
already been shown in the Bulletin, but we should like to express our thanks once again
to these members for their generosity. Dr. D. E. H. Cleveland has, during another
year, been most kind in presenting to the Library numerous duplicate journals for
which we are very grateful and Dr. Morton E. Hall presented a set of the Annals of
the Royal College of Surgeons which is proving very useful. Dr. E. Trapp has started
to present copies of Nature, a valuable scientific publication, while Dr. A. Turnbull,
Dr. H. H. Milburn and the Section of Neurology and Psychiatry again presented gift
subscriptions; to all these members and to the following who have also presented gifts,
we should like to extend our sincere thanks: Doctors R. A. Hunter of Victoria, D. F.
Busteed, A. F. Hardyment, I. Kennedy-Jackson, R. J. Macdonald, H. A. McKechnie
and E. A. McAmmond.
On the recommendation of your Committee, the Executive Committee has this
year paid tribute to each deceased member by purchasing a suitable book and placing it
in the Library. Each book is inscribed to the memory of the deceased member, and is
selected as a book dealing with the member's special interest. This custom has replaced
the sending of floral tributes to the funeral. The bereaved family receives a letter informing them of the placement of the book.
Library hours have been increased so that now the Library is open every evening
until 9:30 p.m., except on week-ends and during the summer months.
A study of the statistics attached to this report reveals that the volume of work
done by the Library during this past year has remained about the same as during the
Page 258 year 1950-51, if one remembers that the Library was closed for five weeks during the
move. Messenger service has been used less, probably because of the new location.
Inter-library loans continue to increase. Medical students and individuals studying
for examinations have made more and more use of our new increased seating space/and
of our study rooms.
As a public relations gesture, in January of this year, the Committee held an!
Open House and Tea, for the Librarians of the City, which we felt was a success.
Three members of the Committe are now retiring—Dr. Hobbs, Dr. Walker and
Dr. Word. We would like to say a very special "thank you" to Dr. Walker, who was
on the Committee before the war, and has been on it for six years since the war—he has
been a valuable member at all times and we are sorry to see him retire from the
Committee.
Towards the end of the year, Mrs. L. Briscoe, the assistant librarian, who gave us
j six years of untiring service, resigned and we were sorry to see her leave us.    In her
place we welcome Miss A. Reaps who we hope will be happy in her new surroundings/
Mrs. Holmgren, our chief librarian, continues to provide the members with skilful
and pleasant service. Your Committee feels that the Association is fortunate in having
Mrs. Holmgren in charge of the Library.
All of which is respectfully submitted.
A. F. Hardyment, M.D.,
Chairman, Library Committee.
LIBRARY EXPENDITURE
BOOKS ADDED TO LIBRARY
General Collection
54    new books added at a cost of $   566.57
20    Gifts
4    books  purchased   from  Nicholson  Collection  at  a   cost  of   $20.75,
leaving a balance in this Collection of $165.11.
6    books purchased from the Historical and Ultra-Scientific Fund at a
cost of $44.73.
MEDICAL JOURNALS
83    journals subscribed to at a cost of 1 $   897.38
2    journals subscribed to from the Historical and Ultra-Scientific Fund
at a cost of $15.50.
36    journals received as gifts
46    journals received in exchange for Bulletin
167
BINDING
178    volumes bound at a cost of  $   785.20
4    volumes bound at a cost of  $22.75  from the Historical and Ultra-
Scientific Fund.
182
Supplements to Loose-Leaf systems $     99.11
Dues to Library Associations  $     40.00
Rent    - Ppl $3,445.00
Salaries _A   3,821.46
Stationery         391.80
Laundry    | - M -      11{U)0
Telephone   -      l26A1
Page 259 Insurance
.
37.00
75.00
Audit Fee
Miscellaneous
(messenger  service,   petty  cash,   typewriter  inspection,
boxes for unbound periodicals, office expenses, etc.)   -—     231.23
BOOKS AND JOURNALS LOANED J|
j Borrowed direct from Library  2660
Borrowed by mail  |  201
Borrowed by messenger -, *     64
2925
Books returned by messenger  112
Interlibrary loans
VISITS TO LIBRARY
Members 2040
Others  ___ 1001
During Evening Hours  (8 months)
Members   '. j  237
Others       110
Bibliographies  prepared   jj .  309
Requests for information |p  742
Microfilms requested     70
Photostats requested      10
REPORT OF THE PUBLICATIONS COMMITTEE OF THE VANCOUVER
MEDICAL ASSOCIATION—1952-1953
The history of the past year has been one of some growth and a sound financial
condition—as you have heard from the Auditors in their report. I would like however,
to go into a little detail about one or two significant happenings during the past twelve
months.
The first point is the circulation of the Journal. Over 2,000 copies are printed
monthly. Every medical man in practice in British Columbia receives a copy. The
members of the Council of the Canadian Medical Association each receive a copy
and this amounts to about 125 more. We have 46 regular exchanges with Libraries,
Universities, etc. Most of these of course are in Canada and the United States, but we
have exchanges with South America, India, France, Belgium and Great Britain. This
is a large circulation for a small Journal, and it ensures us a good deal of very good
advertising. Since the cost of such advertising is based on the size of the circulation,
we get a very fair price for the advertising we receive.
The next point is the allotment to the C.M.A.—B.C. Division of a definite amount
of space. This is useful to them, and we are delighted that they should have it, as it
greatly enhances the value of the journal to our readers.
The Public Health Department of the Province is also contributing a regular
monthly article—and this we consider a great advance—again, it is of value to them,
but probably of much greater value to our readers, and so to the Bulletin. Through
the efforts of Dr. D. E. H. Cleveland, we hope to have a similar contribution at regular
intervals from the B.C. Cancer Society.
Speaking personally, I regard this regular allotment of space in this way as a most
important improvement, as it provides regular information and knowledge about things
with which we all need to keep closely in touch—information which we can obtain and
disseminate in no other way.    I should like to draw attention too, to the Library pages
Page 260 in the Bulletin.    Our Librarian, Mrs. Holmgren, is, I think, greatly to be congratulated
on the excellent way in which she utilizes her space, and it gives our members a much
better idea of what the Library has, as well as of what it is doing and can do to help us
jail.
During the past year we were approached by the Editorial Board of Northwest
I Medicine, who asked us to consider the possibility of some type of amalgamation or
j union with their Journal, as the British Columbia section of that Journal which has
Washington, Oregon, Idaho and Montana sections now.
No definite offer could, of course, be made by them until the matter was very
j carefully and thoroughly considered. Their idea, and it was in some ways an excellent
i one, was that we should thus have an international journal—the first of its kind—and
all economic and similar problems of the profession on both sides of the border could
be attacked by us working together—similarly with other problems. The idea had a
good deal of attractiveness, but after considerable discussion, it was felt that it would
not be practicable—we should lose our identity completely, and could not expect to
cut a very important figure in any such merger. The offer was made in a very generous
spirit by our friends to the South, and they were willing to lean over backwards to give
us the fairest deal possible: we felt grateful to them, and rather gratified by the fact
that they wished to have us with them, but we felt that we could not recommend
such a step to the Association.
The Publication Committee has held regular monthly meetings and every attempt
is made to get the journal out on some kind of regular schedule. It is not always
easy, though—but we are still trying.
Financially we are in, we think, good shape. Our Publisher, Mr. W. E. G.
Macdonald, has worked hard and loyally for us. He secures all the advertising, does
the publishing, and is very generous in the matter of extra pages, extra copies to those
who want them and so on. He has paid us $500 according to his contract, and assumes
all the expenses in connection with the publication. One issue, containing the symposium on epilepsy, which had several excellent papers, went quite a bit over the usual
size, and this entailed of course, an extra charge, not to us, but on the Publisher. He
absorbed it however, without a murmur and we appreciate it. We owe him a very real
debt for all he has done for us.
In this connection I would again remind authors of articles who want reprints
that these must be applied for early, whilst the type is still set up.
The past year or eighteen months has been a transition period—we are crossing
one or two streams, and we have felt it would not be quite wise or safe to do any
changing of horses during this time. So we have refrained from suggesting any
changes, but the time is coming when we have to contemplate some of these. The
medical profession in British Columbia is rapidly increasing—we have a University with
a medical faculty. The Bulletin can, we think, be more useful in many ways even
than it is now, and it is our duty to see that opportunities are not only not missed,
but that they are anticipated.
The Bulletin should, perhaps be more of a definitely Provincial Journal. The
question must be faced of a subscription rate, of a better organized editorial set up with
a business manager as well as an editor. All these things come to our minds, and need
investigation.
I should like again, most sincerely to thank those men who have been associated
with me during the past year, for their support, their keen interest, and their advice
and help. This is no mere formal expression—I mean it most sincerely. It is not always
easy for them to attend meetings, but it is very rarely that we do not have a full
meeting of the Committee.
Mrs. DeWest, who has been a most loyal secretary to the Bulletin, is another to
whom I would pay grateful tribute.    She collects material, arranges meetings, takes
Page 261 letters   and   gets   out   mailing   envelopes   with   unfailing   cheerfulness   and   complete
efficiency.
All of which is respectfully submitted.
J.  H.  MacDermot, M.D.,
Editor.
ANNUAL REPORT MEDICAL ECONOMICS COMMITTEE VANCOUVER
MEDICAL ASSOCIATION
Your committee had several meetings during the year at which time all medical
economic subjects affecting the Vancouver Medical Association were considered and
discussed. These included Workmen's Compensation Board, prepaid medical plans,
S.A.M.S., the fee schedule, the cost of living, as well as other less.well defined subjects.
The highlight of the year was the regular monthly meeting of the V.M.A. on
February 6th, 1952, when your committee was responsible for the programme. Several
members spoke along the lines mentioned above, with the object of disseminating information and encouraging discussion. Wm
DrrElmer Jones has been elected chairman for the year 1952-53. wm
F. L. Skinner, M.D.,
Chairman.
V.O.N. ADVISORY COMMITTEE
Mr. President:
This Committee was called on once this past year.
In September, Miss Creasor, the Superintendent of the V.O.N., asked for approval
of a plan to hold classes for pre-natal patients. These classes to be held weekly and to
consist of discussion of pre-natal care, and relaxation exercises. It was to be understood
that no patient would be admitted without the written consent of her physician.
This Committee felt that this plan would meet with the approval of the members of the
Vancouver Medical Association.
Miss Creasor reports that at present there is a class of 40 women attending, and
another class of 30 is being enrolled. The women coming to the classes seem
enthusiastic. W&
It may seem that this V.O.N. Advisory Committee is not called upon very often
and there have been suggestions that it be done away with. However the Superintendent
of the V.O.N, is most anxious that there should be some Committee to whom she
may apply for advice from time to time.
The V.O.N. Nurses do excellent work, and I think it would be a pity to lose our
contact with them, especially as they are eager to accept any guidance which the
profession will give.
In view of the fact that this Committee is not called upon very often, I would
like to move that the V.O.N. Advisory Committee be appointed for a term of three
years instead of one as at present.
Respectfully submitted,
Mabel Thomas Day
REPORT OF THE RADIOLOGICAL SECTION
During the year regular monthly meetings have been held in addition to ans special
meeting. These were held at the various hospitals in rotation and also one meeting at
the Academy of jMedicine.
Instructive discussions on films of unusual interest occupied several of the scientific
sessions.   We were very grateful to Dr. J. Cluff fbr a most profitable evening on skull
Page 262 radiography and later for a combined session with the medical staff of T.B. Contral on
chest radiographic problems. Dr. Felsted brought us up to date on the technique and
limitations of isotopic work and undoubtedly our greatest privilege was to have a talk
from Dean Weaver on the Place of the Specialty of Radiology in Medical Teaching—
Undergraduate and Postgraduate.
Formulation of the terms of service for various forms of contract practice in our
specialty has preoccupied us for several months and has now been submitted to the
Economics Committee for comment and approvaljljln this connection we have continued
to emphasize our status as a medical service and definitely not a hospital service. We feel
the principles we have evolved also apply to other specialties who have not been fortunate
to avoid contract practice. Secondly we have undertaken a more explicit constitution
for our organisation.
There has been a very gratifying high level of interest, including the participation
of several out of town members.
All of which is respectfully submitted.
R. G. Moffat, M.D.,
President.
3
REPORT ON ACTIVITIES OF THE HEALTH BUREAU OF THE
BOARD OF TRADE—1951-1952
Monthly luncheon meetings of this bureau have been held throughout the year
and many matters have been discussed at considerable length. Without attempting
to go into the various details of these problems I will attempt to outline the problems
discussed and the action advocated with regard to each problem.
1. There was considerable discussion about the formation of an Alcoholic Foundation
in Vancouver and it was finally decided that the Health Bureau was in favour of
the establishment of such a foundation but felt that this should not be initiated by
the Board of Trade.
2. There was considerable discussion also with regard to a Metropolitan Hospital Advisory Committee.    With the cooperation of the Health Bureau Mayor Hume formed
a committee which had one meeting; no further action has been taken with regard to
this.
The Health Bureau also studied the City Charter particularly the new section pertaining to Health and made some recommendations.
A brief was presented to the Hospital Insurance inquiry board by the Board of Trade.
This was undertaken at the instigation of the Health Bureau and several recommendations were made.
A detailed study was made with regard to employment of older workers. As a result
of this a resolution was sent to the Canadian Chamber of Commerce pointing out
the sociological problems arising through the increasing proportion of older people
not being gainfully employed and recommending that ways should be found to
employ these people.
There was considerable discussion with regard to fluoridation of communal water.
The Health Bureau passed a recommendation favouring this but as yet council have
not endorsed it.
A study was made of the medical uses of living animals and a report was made to
council that no mistreatment of these animals was going on.
Numerous other smaller problems were discussed but the above constitute the
major discussions and recommendations made during the past year.
E. C. McCoy, M.D., CM.,
Representative on the Health Bureau
of the Board of Trade.
Page 263
7. ANNUAL   REPORT—REPRESENTATIVES   TO   GREATER   VANCOUVER
HEALTH LEAGUE
Dear Sir:
Your representatives to the Greater Vancouver Health League have been unable
to attend every meeting, but are pleased to report that the general activity level of this
organization continues as in former years.
Major interest has been shown, again, in alcoholism, mental hygiene, industrial
hygiene, nutrition and in many other fields. The activities of this organization are
a tribute to the effectiveness of our Community Chest.
It is recommended that representation on this organization by the Vancouver
Medical Association continue.
Yours truly, ||p
L. A. Patterson, M.D.,
Chairman.
ANNUAL REPORT OF THE CO-ORDINATION OF MEDICAL MEETINGS
COMMITTEE
\The Committee this year has little to report.
It has been very difficult to improve on the organization that had taken place the
previous year under the chairmanship of Dr. R. A. Stanley, and the plan to co-ordinate
all medical functions pertaining to the Vancouver Medical Association has followed
along the lines laid down at that time.
I would move a vote of thanks to the recording secretary, Mrs. DeWest, who saw
to it that the programmes from the various hospitals were received and publicized on
time, and to the individual programme chairmen for their co-operation.
John W. Frost, M.D.,
Chairman.
REPORT OF CHAIRMAN OF BLOOD TRANSFUSION COMMITTEE
Your Chairman, during the past year, attended 11 out of 15 meetings held by
the Vancouver Blood Transfusion Branch of the Red Cross Society at Red Cross
House.
A Pilot scheme is being carried out at St. Paul's Hospital whereby the nurses
administering the blood obtain the addresses and telephone numbers of the recipients
relatives and friends, and this is mailed to the Red Cross daily, who then in turn, phone
or write these persons asking them to replace this blood. If this plan works satisfactorily, an attempt will be made to have it included in all the hospitals.
It is still the opinion of your Chairman that medical men could and should be
more co-operative in sending the relatives and friends down to Red Cross House as
donors.
It is moved that this report be adopted.
A. C. Gardner Frost, M.D.,
Chairman,
Blood Transfusion Committee,
Vancouver Medical Association.
REPORT OF THE EYE, EAR, NOSE AND THROAT SECTION
There are 33 paid up members, and the average attendance of our meetings for
the past year has been 26. To date, there have been 8 dinner meetings with guest
speakers. Our final meeting of the year is on May 22nd, which is a golf tournament
followed by a dinner.
I respectively submit this as the annual report for the years 1951-1952.
Yours sincerely,
B. W. Tanton, M.D.,
Chairman.
Page 264 ORTHOPAEDIC SECTION
There have been four dinner meetings of this section during the year. At the
second the present officers were appointed for a one year term of office. The meetings
were largely business.   One meeting was addressed by invitation by Doctor Fred Preston.
The present membership is 13.
One new member, Dr. W. J. Thompson, was elected during the year.
Dr. A. S. McConkey, M.D.,
Chairman.
REPORT OF THE PAEDIATRIC SECTION
Since all.members of the Paediatric Section of the Vancouver Medical Association
are also members of the Paediatric Section of the Canadian Medical Association—B.C.
Division, the necessity for meetings of this Section has become much less, and this
year there was only one meeting to welcome Dr. J. F. McCreary, Professor of Paediatrics,
University of British Columbia.
In the near future, a business meeting is to be held to determine whether or not
this Section should continue to function.
Respectfully submitted,
Peter H. Spohn,
Chairman.
REPORT ON THE ACTIVITIES OF THE PSYCHIATRIC SECTION
Regular monthly meetings of the Section have been held throughout the fall and
winter, on the fourth Monday of the month.
On June 1st an informal luncheon was held to honor Dr. Ronald Ross of the
University of Cincinnati who was a lecturer at the Summer School at that time. On
October 22nd a dinner meeting was held at which Dr. Janness, Professor of Anthropology, spoke on "The Arctic" and discussed the social, personal, and anthropological
problems of the Eskimos. Dr. Kinnard, of the Crease Clinic Research Unit, spoke at
the meeting of November 26th at the Vancouver General Hospital and discussed "The
Significance of Abnormal E.E.G.'s in Mental Disorder." On January 28th at the
Vancouver General Hospital Dr. Gundry related his recent experiences in Thailand and
illustrated his remarks with colored slides. A clinical meeting was held at Shaughnessy
Hospital on February 25th. On March 24th we were guests of Hollywood Sanatarium
and heard a paper by Dr. A. E. Campbell on "The Use of Adreno-Cortical Extract in
Alcoholism."
The annual meeting for the Section will be held at the Crease Clinic on April
20th and will take the form of a dinner followed by clinical presentations.
The Section has again voted to continue its donation of the Journal of Nervous
and Mental Diseases to the Vancouver Medical Library.
R. Whitman, M.D.,
Chairman,
Section of Neurology and Psychiatry.
Page 265 CANADIAN MEDICAL ASSOCIATION—B. C. DIVISION
October,   1951   —  September,   1952
OFFICERS
President Dr. H. A. L. Mooney, Courtenay, B.C
President-Elect Dr. J. A. Ganshorn, Vancouver, B.C
Vice-President Dr. R. G. Large, Prince Rupert, B.C.
Honorary Secretary-Treasurer Dr. W. R. Brewster, New Westminster, B.C.
Chairman, General Assembly ; Dr.  F. A. Turnbull, Vancouver, B.C
STANDING COMMITTEES
CHAIRMEN
Constitution and By-Laws Dr. R. A. Stanley, Vancouver, B.C
Finance Dr. W. R. Brewster, New "Westminster, B.C.
Legislation ! Dr.  J.. C  Thomas, Vancouver, B.C
Medical Economics _ . Dr. R. A. Palmer, Vancouver, B.C.
Medical Education : Dr.  G.  O. Matthews, Vancouver, B.C.
Nominations Dr. H. A. L. Mooney, Courtenay, B.C
Programme and Arrangements Dr. R. C Newby, Victoria, B.C.
Public Health Dr.  G. F. Kincade, Vancouver, B.C.
SPECIAL COMMITTEES
Arthritis and Rheumatism.
Cancer	
Civil Defence	
Emergent Epidemics	
Hospital Service _j	
Industrial Medicine	
Maternal Welfare	
Membership	
Pharmacy	
CHAIRMEN
— Dr. A. W. Bagnall, Vancouver, B.C.
 Dr. A. M. Evans, Vancouver, B.C.
—Dr. L. H. A. R. Huggard, Vancouver, B.C
—Dr. G. F. Amyot, Victoria, B.C.
—Dr. J.  C  Moscovich, Vancouver, B.C.
._Dr. E. W. Boak, Victoria, B.C
—Dr. A. M. Agnew, Vancouver, B.C
— Dr. L. H. Leeson, Vancouver, B.C.
__Dr. D. M. Whitelaw, Vancouver, B.C.
CANADIAN MEDICAL ASSOCIATION—B.C. DIVISION
ANNUAL MEDICAL CONVENTION—EMPRESS HOTEL, VICTORIA, B.C.
SEPTEMBER  15,  16,  17,  18,  1952
MEMBERSHIP   IN   CANADIAN   MEDICAL   ASSOCIATION
The campaign for total membership in Canadian Medical Association —• B.C.
Division, has now been going on for over three months. To date there are over 800
members which is quite good—so far. However it is felt that every doctor in British
Columbia should belong to this Association, as it is the organization whidh looks after
the business and scientific interests of the profession. During the past three months,
the Canadian Medical Association—B.C. Division, has been successful in concluding
arrangements for a much more realistic monetary return for our services in three
different fields of medical practice:
(1) The new Workmen's Compensation Board fee schedule is now out and is
much fairer than was the schedule under which we were working.
(2) S.A.M.S. cases are now being paid at a per capita rate of $18.50 instead of
$14.50 as previously. Although this is still not adequate, it is much fairer than
previously.
Page 266 (3) A new nainimum fee schedule is now out after much work—weekly meetings
by Tariff Committee, etc., and at considerable cost. It is estimated that the copies of
these fee schedules cost nearly $2 each to get out. Hence the decision to send them
only to members of the Canadian Medical Association—B.C. Division, as we did not
feel that it was fair to have the members paying for those who did not see fit to become
members.
The above points out only a few of the things that are being done by the Canadian
Medical Association—B.C. Division on your behalf. In return you are asked to pay
dues of $30 per year to help support this work. We see no reason why every doctor
should not belong, as all stand to benefit from what is being done.
Another $ 10 makes you a member of Canadian Medical Association and includes
your subscription to the C.M.A. Journal. In previous years this was collected with
College of Physicians and Surgeons' dues, but starting this year is not—as you must be
a member of Canadian Medical Association—B.C. Division, before being a member of
the Canadian Medical Association.
"FOUNDER'S DRIVE"
For this year only, it is requested that all who possibly can contribute an extra
$60—a so-called "Founders Fee." This money is being put aside into a special reserve
fund to be used at any time that might be necessary. This fund may be there for
years or it might be needed shortly. The fee of $30 is actual estimated operating
expenses and will leave nothing for emergencies. We hope to have at least 500 Founders
and to date have over 200. If you have already become a member, you may still
become a Founder by paying $60 more or dropping us a line and promising to pay $60
sometime later this year. It is expected that within the near future the list of Founders
and of promises will appear in the Bulletin.
If you have not paid any of these dues, a cheque for $100 payable to the Canadian
Medical Association—B.C. Division and sent to 1807 West Tenth Avenue, will pay
them all—a cheque for $30 will pay dues to C.M.A.—B.C. Division and show your
interest in and supjfbrt of your own organization.
E. C. McCoy, M.D.,
Director of Organization.
THE SECRETARY'S NOTES
A medical association is an absolute necessity for the full professional development
of any physician. The day to day task of making a living is never satisfying to the
professional mind, for he or she is always inquiring into methods of improving the
service, of assisting patients to a better life and of improving the health affairs of the
county, province or county in which he lives and works.
Some physicians exercise their energies toward mastering certain diseases or disorders, such as tuberculosis or cancer. Others make their contribution to ways and
means of distributing medical care and its costs. Still others bend their energies to the
education of the young physician and some to the problem of maintaining the standard
of practice and behaviour so the honour, dignity and effectiveness of the profession in
caring for the health of the nation is always assured. All these individual efforts will
add up to very little if there is not a common meeting ground to debate and define
a group policy for the effective implementation of responsible thinking.
All this adds up to the need of the association by and for every physician. The
financial support keeps the body alive, the active participation of workers in professional
affairs will develop the spirit.
These pages in the Bulletin that are devoted to the C.M.A.B.C. Division will be
used for comment, debate and instruction on professional matters.
Page 267 UNSUPERVISED LABORATORIES
The quality of medical care is a subject which at all times must be foremost in
the mind of the practising physician. Methods of maintaining good quality and of
improving it will always be carried out in the day to day physician's work. The
responsibility for medical care is also one properly belonging to the Association and
particularly in the general relation to the health and welfare of the population being
served. In bringing a medical service, the physician is more and more being supported
by what are called 'ancillary services'. It is a responsibility of the profession not only
to be interested in these ancillary services but to assist them and if necessary, insist
upon their doing a high quality of work. Recently, the Association has had under
review a policy in respect to laboratory services.
The Association believes that diagnostic procedures should be performed by or
directly under the supervision of a qualified practitioner and if possible, a practitioner
specially trained in laboratory work. It is the opinion of the Association that where
laboratory and diagnostic procedures are performed without this supervision that the
quality of medical care is jeopardized. The following resolution then, has been prepared
as the considered opinion of the Association and this resolution has been directed to
the Prepaid Medical Care Plans:
"THAT the Executive of the Board of Directors recommends to the Approved
Prepaid Plans that only laboratories supervised by a member of the College of
Pnysicians and Surgeons of B.C. shall be paid for diagnostic services."
This is the first step in helping to maintain a quality of service and the next and
most important step is for every physician to be fully aware of the quality of service
he recommends or requests in the care of his patient. It is suggested to you by the
Executive of the Association that where you do not do the laboratory services or
diagnostic procedures in your own office or at a recognized hospital, that you make
certain that the laboratory used for your service on behalf of your patients is one which
is properly supervised.
LA91HMW
LETS     ALL    Pull    TOGETHER/
Page 268 UNITY OF THE PROFESSION
It was in 1936 that the Medical profession of B.C. learned what a power unity
was. The Health Insurance Act of B.C. had been passed in the legislature but this
act has never been brought into force because the medical profession by an almost
unanimous vote indicated they would not work under the scheme.
There has not been a second crisis such as that of 1936 and it seems unlikely
that such a major crisis will occur again. The forces tending towards the socialization
of medicine were manifest. The profession recognized this and in October, 1940,
brought M.S.A. into existence. This was an attempt by the profession so well united
against the government's Health Insurance Act to lead and to direct the changes which
they foresaw as inevitable in the practice of medicine. M.S.A. which during the war
was only beginning has now grown in its 14 years to cover 1 in 6 of the population
of B.C. Health Insurance is still our major problem—our own plan, the M.S.A. now in
its adolescence presents problems, problems which the profession needs to face as a
united profession. The Federal government has indicated that it is renewing its interest
in Health Insurance. Times of stress are with us and lie in the path ahead. Our
strength will be measured by our unity.
What are the factors affecting our unity? Is there a change in the profession in
these 14 years since it acted so effectively in opposing the government? There has
been a change in the composition of the profession. Specialists have increased and the
general practitioners have decreased. In 1939 seventeen per cent of practising doctors
in British Columbia were on the specialists' list. In 1951 specialists make up forty-
three per cent of the practising doctors. The tremendous advances made in medicine
require an increase in the proportion of specialists, but not to this extent. The tendency
to over-specialization is evident here in B.C. the same as it is everywhere on this
continent. The trend to the setting up of specialist or group organizations or sections
has paralleled this over-specialization. The purpose or motivation of such organizations
should always have as its prime purpose as far as doctors are concerned the promotion
of the entire medical profession, not of just one section of the profession. In this
regard one points to the plight of the Great British Medical Association, unable to
protect the British people from the effects of their own folly: lack of unity was most
evident and I do here suggest that it is a strong possibility that the estrangement of
many specialist groups from the National body of England reduced the B.M.A. as an
effective unit, so that in time of stress they found the truth of "Divided we fall."
Nothing is "more important to the profession of B.C. than unity. We must do our
thinking, be we general practitioner, surgeon, orthopaedist, obstetrician, paediatrician
or what, as members not of a section, but as members of the profession practising
medicine here in B.C. It is desirable that groups should organize and promote scientific advancement and deal with problems which they are most informed in, but their
outlook must never be "provincial."
We are fortunate indeed to have re-organized the B.C. Medical Association so that
a united profession is more attainable. A parliament, the general assembly has been set
up with wide representation including all sections and with a majority of representatives
elected by secret ballot to allow each and every one of us to consider well those who
shall make our policies. Having set up such a democratic organization to represent
the profession as a whole it must follow that authority must lie with this parent body
and not with the sections. Negotiations done on behalf of the profession or any one
part of it should be done by the parent organization. Actions taken following decisions
by the profession or any of the sections must have the authority of the parent body,
which represents the whole profession.
Times of stress lie ahead; let us stand as a body.    It is the pfrime requisite for
success.
J.A.G
Page 269 IMMUNIZATIONS FOR TRAVELLERS
DR. STEWART MURRAY,
Metropolitan Health Committee, Vancouver, B.C.
Many physicians are being faced with the problem of providing immunization
procedures and information regarding the requirements for travel to various countries.
The increased speed at which persons can now travel from country to country
makes the danger of disease transmission much more real than in former years. To
^minimize this danger the World Health Organization has suggested minimum requirements for international use, with the proviso that further restrictions may be imposed
by or in respect to any country as the need may arise from time to time.
A recent supplement to the Weekly Epidemiological Record of the World Health
Organization has listed the requirements for travel to or from 157 countries or places.
It is impossible to reproduce those 'here but the following remarks based on this Report
and on the 1944 International Sanitary Convention should be of assistance.
Smallpox Vaccination:
Required by nearly all countries for travellers entering. There are a few exceptions
such as the United States and Canada which has no such restrictions between the two.
Great Britain also does not require vaccination for entry unless coming from an infected
country or ship. However, the traveller finds that he requires a vaccination certificate
for re-entry into Canada or the United States from the Britis'h Isles so it is a good idea
to have this completed before starting on his journey.
The International Certificate of Vaccination has been accepted by nearly all
countries and is the one that should be used. It has been issued in the form of a little
yellow-covered booklet by the Department of National Health and Welfare, Canada.
This booklet may be obtained direct from (a) The Department at Ottawa, or (b) from
the Provincial Health Department or (c) in the Vancouver Metropolitan Area, from
the following:
1. Quarantine Dept., Vancouver City Hall.
2. Health Unit No. 1, 306 Abbott St.
3. I        I     No. 2, 5851 W. Boulevard.
4. I        I     No. 3, Vancouver City Hall.
5. No. 4, 41st Ave. and Fraser St.
6. Burnaby Health Unit, Burnaby Municipal Hall.
7. North Shore Health Unit, 251 E. 14th St., North Vancouver.
Some official travel agencies also have supplies of these certificates for their clients.
The first part of the certificate should be filled in by the vaccinator at the time
of vaccination. In cases of re-vaccination, inspection should be made on the second
or third day to check on the reaction of immunity which may fade completely if a
longer period is allowed. If there is no reaction by the 5 th or 6th day the vaccination
should be repeated until a suitable reaction is obtained. Every physician should read
carefully the directions on the lower part of the certificate regarding interpretation of
results.
Since all these International Certificates must be stamped by a recognized Health
Department, Dominion, Provincial or Municipal, the applicants can usually be referred
for both reading and stamping at the one time if this is suitable to the physician.
Yellow Fever Inoculation:
This is required for entry into only a few countries and is administered solely by
the Federal Immigration Department .
Typhoid-Paratyphoid Inoculation;,
This is advised before entry into most oriental countries or into any other place
where the sanitation is of questionable standard. Two weeks are required to complete
the usual course of three doses, a week apart.
Page 270 If the combined product with tetanus is used, an interval of four weeks between
doses is suggested, thus requiring twelve weeks to complete the course of four doses.
Further information regarding immunization procedures can be obtained from your
local Health Officer. In the Vancouver Metropolitan area, immunization clinics are held
regularly each week at the Health Units mentioned above—Fridays, 3 to 4:30 excepting
Unit 1, at which the clinics are on Wednesday afternoons. Immunizations, inspections
and stamping of certificates may be done at any of these clinics or at other times by
special arrangements through the respective Health Unit offices, or the main office at die
City Hall.
Our readers should find this very succinct summary very useful. Every week it
seems to us, someone wishes to go travelling overseas, and we can save our patients
themselves much wasted time, if we follow the above directions carefully, especially
with regard to vaccination.        i —ED.
RAM'S HORN GOLF TROPHY
The winners of The Ram's Horn Golf Trophy from 1930 to 1951 inclusive, with
the exception of years 1941 and 1945, are as follows:
1930—Dr. Gordon C. Draeseke.
1931—Dr. George E. Seldom
1932—Dr. William T. Ewing.
1933—Dr. George E. Seldon.
1934—Dr. James A. Sutherland.
1935—Dr. Leith H. Webster.
1936—Dr. W. LeRoy Pedlow.
1937—Dr. George A. Davidson.
1938—Dr. Harry H. Pitts.
1939—Dr. David B. Collison.
1940—Dr. Jack E. Harrison.
1941—
1942—Dr. George L. Langley.
1943—Dr. S. C. Peterson.
1944—Dr. S. C. Peterson. §p
1945—
1946—Dr. George H. Clement.
1947—Dr. E. H. McEwen.
1948—Dr. W. A. Morton.
1949—Dr. Wilford G. Evans.
1950—Dr. Boyd Story.
1951—Dr. Donald E. Starr.
As I am most anxious to have the Ram's Horn plaque brought up-to-date and
returned to the Medical Library, I would be grateful if anyone who can fill in one
of both of the missing names would let me know. If you cannot remember off-hand,
please read the list, and you may recall someone that you know did win The Horn,
whose name is not here.   Then he must be 1941 or 1945.   Thanks.
Daniel McLellan, M.D.
We hope that Dr. Dan McLellan's request will be satisfactorily answered. This
has been a matter dear to Dan's heart, and we owe him a big debt of gratitude for his
generosity in providing this Ram's Horn Trophy in the first place. —Ed.
Page 271 LEGAL ASPECTS  OF  SEDATION  IN  CHRONIC ILLNESS
DR. J. C. THOMAS if
Vancouver, B.C.
The use of sedatives in chronic illness divides into two main groups, namely
narcotics to control pain and hypnotics to quieten disturbed patients and to induce
sleep. Both narcotics and hypnotics are under control by certain statutes and regulations.   The purpose of this paper is to present some information about these controls.
Since misuse of narcotics strikes directly at the health and welfare of our people
and because of the scope and magnitude of the problem, control of potent drugs is
accepted as a Federal responsibility. It is directed by the Narcotics Control Division of
the Department of National Health and Welfare, which works with the R.C.M.P. in
enforcement of the Act designed to keep drugs in legitimate channels. Much technical
work is done by the scientists of the Food and Drug Laboratories of the Department.
The present chief of the Narcotics Control Division is Mr. K. C. Hossick. Under his
direction there is a systematic inspection of importing', manufacture, wholesale and
retail sales, and prescribing of all narcotics. In order to control these transactions the
Act makes certain provisions.
Under the Act "physician" means a person registered as a medical practitioner, and
in good standing under the Medical Act governing the practice of medicine and surgery
within the province wherein is tendered any prescription or order for any drug bearing
his signature. The Act defines persons to whom drugs may be sold by properly licensed
druggists. It states that drugs may be supplied only with a written order therefor, signed
and dated by a physician, as defined above, whose signature is known to the said
druggist, or if unknown duly verified before such order is filled. It also provides that
tlhis order or prescription may not be used to sell any drug on more than one occasion.
It also states that it is unlawful for a physician to prescribe, administer, give, sell or
furnish any drug to any person or to sign any prescription or order for the filling of
which any drug is required, -unless such drug is required for medicinal purposes, or is
prescribed for the medical treatment of a person who is under professional treatment
by such physician. The Act defines "drug" as any substance mentioned in the schedule
of the Act whether or not the same be produced in whole or in part by a synthetic
process. Physicians are not required to keep records with respect to drugs received,
dispensed, prescribed, given away or distributed by them.
If any person charged with unlawful prescribing of drugs pleads that the drug
was for medicinal purposes or was prescribed for the medical treatment of a patient
under professional treatment, the burden of proof is upon the person charged. It shall
be no defence to a physician charged, that he did give, sell, furnish or prescribe any
drug to an habitual user for self-administration, unless such habitual user is suffering
from a diseased condition caused otherwise than by excessive use of any drug.
The schedule of drugs under the Act lists 14 groups of drugs and includes opium
or its preparations, cocaine, morphine, heroin, dilaudid, paramorfan, genomorphine,
demerol, codein, methadone, physeptone, morphinane, being the more widely known.
The Division recognizes that narcotics have an important legitimate function in
contributing to human well-being, and that it is essential that narcotics and other drugs
be made available when and where they are required and that they be kept out of the
hands of those who would do mischief with them. Where one is dealing with a chronic
case requiring increasing amounts of drugs, it may save embarrassment by noting on
the prescription the reason for prescribing larger amounts such as "inoperable carcinoma"
or by writing a note to the Division head stating that such a condition exists.
The Act provides that any person, who, in the course of treatment, is supplied
witlh drugs or a prescription therefor by the treating physician and who, without
disclosing the fact to such physician, is supplied during such treatment with drugs or a
prescription therefor by another physician, shall be guilty of an offence. In order to
avoid implying that a patient may appear to be guilty of such an offence, it is advisable
Page 272 to put the attending doctor's name on a prescription as well as one's own when
ordering for his patient during his absence, thus showing that you are issuing sudh a
prescription for him.
The Division of Narcotic Control is faced with great responsibility and it is
making every effort to cooperate with the medical profession and its officials have not
the slightest desire to interfere in any way with the legitimate use of narcotic drugs.
In hospitals they have found some cases where narcotic medication has been made
available rather freely on P.R.N, orders, resulting in cases of medical addicts. Arthritic
and asthmatic patients form a large group of medical addicts if they were unfortunate
enough to be supplied with narcotic drugs in the early stages of treatment. When a
patient shows withdrawal symptoms when a drug is discontinued, great care should be
taken to supervise the patient to avoid development of addiction.
The use of hypnotics is also subject to certain control by statutes and regulations.
The sale of barbiturates is restricted by the Pharmacy Act of this province which is
being constantly changed to conform to the Food and Drug Act of the Federal
Government. The latter is administered like the Narcotic Act by the Department of
National Health and Welfare.
Under this act provision is also made for control of other drugs such as benzedrine,
methedrine, penicillin, cortisone and A.C.T.H. and insulin, where their uncontrolled
sale might be dangerous to the health of an individual.
A written order is required for barbiturates, signed by a physician.    If sucjh an
order is made p.r.n. there must be a limit placed on such an order by stating either the,
number of times it may be refilled or the duration of time for which the order may be
refilled.
If the order is filled by telephone request there must be a written order supplied
to the druggist within 72 hours. The druggist who fills prescriptions for your patient in
response to telephone requests is \held responsible and in fairness to him our profession
should see that he is adequately covered by the properly signed written order when such
is required.
While no physician can be expected to know when a patient is likely to use an
overdose of barbiturate with suicidal intent, it is important to order limited amounts
unless there is supervision in cases where sedation is being ordered for patients who are
emotionally disturbed. Granted that it is not the legal responsibility of a physician
to make sure that his patient takes no more than the prescribed dose, from our experience
relaives and coroner's juries do not always share this view.
Some years ago, Dr. John Amyot, when he was Deputy Minister of Health at
Ottawa, stated, "Practise legitimate medicine and you need not think of the law."
These words are just as true today.
In this brief paper an attempt has been made to draw attention to the legal aspects
of sedation in chronic illness. It is hoped that this information will help to remove
some of the misunderstandings which have resulted in annoyance to many physicians by
clarrifying the purposes of existing laws and regulations to control the legitimate use of
narcotic and hypnotic drugs. It is strongly recommended that anyone, who has any
problem regarding the proper procedure to follow in any case, write to the director
of the Division where he will receive prompt and courteous cooperation.
We would underline especially the parts of this paper dealing with our relations
with pharmacists. We owe it to the pharmaceutical profession to protect them in every
way possible while they are endeavoring to carry out our wishes., No medical men, no
matter what the circumstances, has any 'right to ask any pharmacist to violate the
Narcotics Act in any particular. Remember, the pharmacist is the one that is punished
if he does this out of goodwill or to oblige a medical man. —Ed.
Page 273 PUBLIC HEALTH AND MENTAL HEALTH NEWS
G. F. AMYOT, M.D., D.P.H.,
Deputy Minister of Health; Province of British Columbia
A. M. GEE, M.D.,
Director, Mental Health Services, Province of British Columbia
COMMENTS   ON   SALMONELLA-SHIGELLA   INFECTIONS
Some physicians wonder why the terms "salmonellosis" and "shigellosis" are displacing e.g. typhoid and paratyphoid fever, acute infectious gastro-enteritis and bacillary
dysentery. The older terminology had at least some clinical connotations, whereas these
substitutes perhaps seem meaningless. Actually, the derivation of salmonellosis is from
the American veterinary pathologist D. E. Salmon, who in 1886 isolated the "hog
cholera bacillus," now known as Salmonella cholerae suis, the prototype of the Salmonella
group of micro-organisms. Shigellosis similarly derives from the Japanese bacteriologist
K. Shiga, who reported in 1898 that a bacterium (currently designated Shigella shigae)
was^the cause of one of the severest forms of dysentery.
Most bacteriologists and epidemiologists consider that infections due to organisms
of the Salmonella and Shigella groups should be designated salmonellosis and shigellosis,
respectively, for the following main reasons:
i The cause of an intestinal syndrome of infective origin cannot be determined on
clinical evidence alone. Apart from certain viral, protozoal and helminthic agents,
and from food poisoning due to preformed staphylococcal enterotoxin, any one of
many scores of different types of Gram-negative, non-lactose-fermenting bacilli in
the Salmonella-Shigella groups may be responsible for a given symptomatology.
The actual aetiological agent can only be identified in a properly equipped laboratory
by a well-trained staff.
ii Conversely, although certain types of Salmonellae and Shigellae tend to provoke
characteristic syndromes, any given type may be associated with a wide range of
clinical effects. One host may thus die from an infection which leaves others
apparently unharmed. Only the laboratory can determine the presence and identity
of the agents common to both fatal case and healthy carrier.
iii The two most important species of intestinal pathogens, the Salmonellae and
Shigellae, are closely related to each other, and somewhat most distantly to the
cqliforms normally inhabiting the intestinal tract of man and lower animals. So
far about 2X)0 types of Salmonellae have been distinguished, and over 30 types
and sub-types of Shigellae. (The greater complexity of the Salmonellae is due
to their being motile and flagellated, so that type identification must reckon with
many permutations of flagellar as well as of somatic agglutinogens.) These totals
are steadily increasing, and their limits cannot be foretold. Yet each type within
these species is a distinct entity, which customarily breeds true. Tne more
recently discovered Salmonella types have generally been named after the places
where first isolated, which range alphabetically from Aberdeen to Zanzibar. The
Salmonella department in a public health laboratory is thus liable to come across
such more or less easily recognized place names as Salmonella Cambridge, S. derby,
S. Kentucky, S. manhattan, S. montevideo, S. london, S. oranienburg, S. saint paul,
S. urbana, and S. Vancouver. Shigella types on the other hand, have so far been
named after bacteriologists especially associated with them, e.g. Shigella boydii, Sh.
flexneri and Sh. sonnei.
iv. By continually improving the selectivity of culture media, and by applying precise
techniques of agglutinOgenic analysis to any Salmonella-Shigella organism isolated,
the laboratory may be able therefore both to identify an intestinal pathogen, and
Page 274 to indicate the source and route of infection.    Hence the epidemiologist, no less
than the clinician, is dependent upon the laboratory.
In British Columbia, over the 8 rear period 1944-51 inclusive, the Provincial
Laboratories isolated 1107 Salmonella and 765 Shigella cultures from different persons.
Before the summer of 1952 is over, the 2000-person total will have been reached. A
detailed tabulation of the annual findings will be published elsewhere, but a few highlights may be mentioned here.
First, the variety of Salmonella strains encountered in this Province has tended to
increase over the years. In the years up to and including 1944, only the four types
S. typhi, S. paratyphi B, S. typhi murium and S. new port, had been isolated; but thereafter, new types were added each year to the endemic bacterial flora, so that some 31
Salmonella types have now been isolated from residents of British Columbia, including
one type so far peculiar to ourselves, (S. Vancouver) identified in 1949. Incidentally,
there have been several instances of multiple Salmonella infections, i.e. of a single stool
specimen yielding two Salmonella types.
Secondly, although the numbers of cases and farriers of Salmonella-Shigella
organisms identified each year have fluctuated quite widely, the general trend is upwards. The smallest number of different Salmonellae isolated was 65 in 1944, and the
largest number was 259 in 1946. The coresponding range for the Shigellae over the
same period had a low of 31 in 1947, and again in 1948, against a high of 328 in 1951.
The large Salmonella total in 1946 was mainly due to several outbreaks traced to
restaurants, whose food-handling employees were shown to include a few carriers, either
convalescent or healthy. The ten-fold range between the extremes of the annual Shigella
totals is particularly noteworthy. Its explanation lies in an outbreak of shigellosis in
a children's camp in the Howe Sound area in the late summer of 1950. The camp was
disbanded, and mild cases or carriers were dispersed to many parts of the Province.
Consequently, whereas Shigella sonnei was isolated in 1948 from only one person in
British Columbia, and in 1949 from 13 persons, the totals in 1950 and 1951 jumped to
180 and 297, respectively.
Thirdly, apart from one or two outbreaks apparently due to an endogenous
Salmonella infections of turkeys, there has been little or no conclusive local evidence
of other than man-to-man conveyance. This does not eliminate the possibility that
rodent excreta, and the flesh or eggs of certain domestic animals, might have been
occasionally the vehicle for human salmonellosis. (The Shigellae seldom infect animals,
so that human shigellosis is usually acquired from food polluted by dirty fingers or
flies.) Many of the types of Salmonellae isolated to date in British Columbia have been
associated in other parts of the world with such sources as powdered eggs, the carcasses
of turkeys and hogs, or the excreta of rodents, dogs and cats. For instance, over the
past three years, strains of S. typhi murium have accounted for almost one-half the
total isolations of Salmonellae in British Columbia; and S. typhi murium is particularly
catholic in its host-relationships, having been isolated from an extraordinary variety of
♦ animals, from mouse to moose, from camel and elephant to chipmunk, lizard, and turtle.
So we should be on the look-out for alternatives to man-to-man epidemiology.
Finally, early laboratory diagnosis of the Salmonella-Shigella infections is obviously
important from every standpoint. The patient's own welfare, the protection of the
immediate family and other contacts, and the determination of the route and mode of
infection, all demand prompt submission of one or more stool speciments to tfhe
laboratory, along with appropriate clinical data, before beginning treatment with
sulpha-drugs or antibiotics. But far too often nowadays we secure negative cultures
from specimens in which the presence of pathogens is masked by the action of some
orally administered bacteriostatic agent. Here is plainly a situation in which such
treatment of the individual, prior to securing appropriate specimens for the laboratory,
becomes unscientific and against the public interest—an easily avoided conflict of
objectives. c  E  Dolman.
Page 275 n
ewd  an
d   rioted
Dr. L. K. Poyntz, formerly of Vancouver is now practising in the Peace River
District.
Dr. Josephine Mallek of Vancouver has received a certification in Internal Medicine
for Endocrinology.
m& Dr. T. D. Stout is now practising at Shawinigan Lake.
Dr. N. Wolochow of Vancouver has been certified in General Surgery.
"Dr. George Lee of Vancouver ihas re-opened offices in Vancouver after a brief
illness.
Dr. K. Fish of the Vancouver General Hospital administration staff is retiring this
summer after a career of service well-remembered by Vancouver practitioners. Dr. Fish
was largely responsible for the organization of the Medical Records of the hospital.
Dr. J. E. Hill, formerly of the Vancouver General Hospital, is now practising
in pathology in Spokane.
Forty Queens' Graduates entertained Dr. E. K. Robertson of the University on a
recent visit to Vancouver this month at the home of Dr. David Claman.
Dr. Norman Cook of Victoria has returned from the Pacific Coast Opthalmological
Society Conference in Salt Lake City.
Dr. J. D. Devlin, formerly of Victoria, is now practising in Port Alice.
BIRTHS
To Dr. and Mrs. Harold Krivel of Vancouver, a daughter.
To Dr. and Mrs. Ross McLean of Vancouver, a son.
To Dr. and Mrs. J. R. Flint of Burnaby, a daughter.
To Dr. and Mrs. Horace Graves of Vancouver, a daughter.
To Dr. and Mrs. Peter Lehman of Vancouver, a son.
To Dr .and Mrs. A. F. McGill of Victoria, a daughter.
Page 276 DR. A. H. HAYWOOD
Obit. May, 1952
. The passing of Dr. A. H. Haywood will be sincerely mourned by a great
many of us who knew this kindly and courteous man as Medical Superintendent
of the Vancouver General Hospital for a good many years. He was the last
of a long line of medical men who/filled this office, but by no means the least.
All of us who had occasion to meet him in his office, knew how sincere his
interest was in the welfare of medicine, and how constantly he tried to help
us all in our work.
Alf Haywood, as everyone called him naturally, came to Vancouver with
a great record as hospital administrator from the Montreal General Hospital.
He had done a magnificent job in Montreal of bringing the various hospital
administrations into closer touch with each other, eliminating friction and
jealousies and increasing hospital efficiency generally., Soon after his arrival here
the Vancouver General improved its Medical Staff standards and a complete
reorganization was effected.
Personally, Dr. Haywood was one of the most charming men we have
known. Always friendly and courteous, he made many fast friends in the
profession, and outside it—everyone liked him, since he liked people himself.
To his wife and family we offer our deepest sympathy in their bereavement.
CAMPBELL & SMITH LTD.
820 Richards Street
Vancouver 2, B.C.
TAtlow 7364
cZffzativE iJ^intina
Page 277 We are happy to announce the Canadian manufacturing of
suBTOsnn
(P.V.P. 3.5yo)
\
an ideal fluid replacement therapy
FOR ALL  EMERGENCIES  AND   PARTICULARLY
WHERE  BLOOD   IS   IN   SHORT  SUPPLY
has proved safe and effective in clinical practice/'
". . v keeps perfectly well and requires no special conditions for storage ..."
THROWER, W. R. and CAMPBELL, H:
The Lancet* May 19, 1951, p. 1096.
available in sterilized and pyrogen-free bottles of 500 cc.
easily adaptable to any apparatus for intravenous drip
*SUBTOSAN  is   sold  in   England  under   the  name  of
PLASMOSAN
POULEIK
monTREAi
Page 278

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