History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: May, 1926 Vancouver Medical Association May 31, 1926

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Published monthly at Vancouver, B. C.
Subscription $1.50 per year
cfAnnual Greeting
cUancouDer oTKtedical ^Association^
Qanadian (fMedical ^Association (Lectures
MAY, 1926
Tublished by
c^Ktc^eath Spedding Limited, ^Vancouver, <23. Q.
>K ~5Is©e
A few distinctive features of
PETROLAGAR (Deshell) is a corrective, not a cathartic. It
forms no habit, permitting decreasing instead of increasing
dosage and may be discontinued when regularity is established.
Its oil content is the greatest—65% mineral oil of the highest quality,
means maximum lubricating power and is of paramount importance.
The oil being emulsified, leakage is practically eliminated.
Agar is the sole emulsifying agent used—no fermentative  gums or soaps.
Petrolagar   (Deshell)   is particularly palatable, more like ice cream thus making
the  physician's  task  easier;   both  children  and  adults find  it pleasant  to   take.
Three   years   of   satisfactory   results   in   clinical   usage   solely   under  physicians'
prescriptions, prove conclusively the therapeutic value of Petrolagar   (Deshell).
No 1 Blue Label
The palatable emulsion of pure mineral
oil and agaragar is
indicated in the ordinary cases of constipation and as a follow
up in severe cases
when Petrolagar Phe-
nolphthalein has been
previously used.
No.   2  Red  Label
Phenolpbthalein % gr.
to the tablespoonful,
is indicated in severely constipated individuals who have used
drastic purgatives. We
recommend reducing to
Plain after one or two
No.   3   Green  Label
Contains magnesia calcined and is indicated in hyperacidity
and acidosis, and is
extremely useful in
gastric ulcer where
constipation is present.
Useful in Pyorrhea
and  acid-mouth.
No. 4 Brown Label
Indicated for those
who do not like
sweets and may be
prescribed safely for
Diabetic patients. It
is bland like the
other numbers and
while unsweetened, is
unusually   palatable.
The principle of lubrication and bulk calls for the usage of Petrolagar Plain
in all cases unless special considerations indicate one of the other forms.
Deshell Laboratories of Canada, Limited, Dept. V.,
245 Carlaw Avenue, Toronto, Canada.
Please send without obligation, copy of Habit Time and samples of Petrolagar.
Published Monthly under the Auspices of the Vancouver Medical Association
in the Interests of the Medical Profession.
529-30-31 Birks Building, 718 Granville St., Vancouver, B. C.
Editorial Board:
Dr. J. M. Pearson
Dr. J. H. MacDermot Dr. Stanley Paulin
All communications to be addressed to the Editor at the above address.
VOL. 2.
MAY 1st, 1926
Physiological and Pathological Section
DR.   C.   H.   BASTIN - - - -
Dr.  C. E.  Brown  -
Eye, Ear, Nose and Throat Section
Dr. Colin Graham	
Dr. E. H. Saunders	
Genito-Urinary Section
Dr. G. S. Gordon	
E>r. J. A. E. Campbell -
Physiotherapy Section
Dr. H. A. Barrett      ------
Dr. H. R. Ross	
Library Committee
Dr. W. D. Keith
Dr. W. F. McKay
Dr. C. H. Bastin
Orchestra  Committee
Dr. F. N. Robertson
Dr. J. A. Smith
Dr. L. Macmillan
Dr. W. L. Pedlow
Dinner Committee
Dr. C. F. Covernton
Dr. A. C. Frost
Dr. G. B. Murphy
OFFICERS, 1926-27
Dr. A. W. Hunter
DR. A. B.  SCHINBEIN Past President
Vice-President DR.   J.   A.   GILLESPIE
Secretary Treasurer
Dr. F. W. Brydone-Jack Dr. W. S. Turnbull
Dr. w. F. Coy Dr. W. B. Burnett
Representative to B. C. Medical Association
Dr. A. C. Frost
Clinical Section
Founded 1898. Incorporated 1906.
The 29th Annual Session
GENERAL MEETINGS will be held on the first Tuesday of the month
at 8 p.m.
CLINICAL MEETINGS will be held on the third Tuesday of the month
at 8 p.m.
Place of Meeting will appear on Agenda.
General Meetings will conform to the following order:—
8.00 p.m.—Business as per Agenda.
9.00 p.m.—Paper of Evening.
Vancouver, B. C.
Total Population   (estimated)   128,3 66
Asiatic Population   (estimated)         10,100
Rate Per 1000 of
Total   Deaths    -     	
per Annum
Asiatic   Deaths         '■-
Deaths   (Residents only)   „ .
Total Births—Male, '172
Female,   148   _
Stillbirths—not  included  in
Deaths under one year
of age    	
Death Rate per  1000 Births     40.6
Cases Deaths
0          0
5          0
March, 1926           15 th,
Cases Deaths         Cases
0          0                   0
9          0                   5
25         2                12
73         0                25
32         0                30
342         0                68
4         1                   1
16       14                  7
29         1                 17
4         0                  0
4         0                  2
3         0                  0
Medical  Health  Officei
1st to
Scarlet Fever 	
9          1
Chicken Pox       	
30         0
4         0
Measles  .    _. 	
Mumps ,    	
167         0
3         0
6         2
Whooping Cough 	
6         0
0         0
ty—included in
3          0
2          0
Typhoid Fever        	
Cases from Outside Ci
Diphtheria   ._  .
Scarlet   Fever   	
Page Four
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S'Toum State- EDITOR'S PAGE.
Amid the enthusiastic applause of the large audience assembled
the retiring President, Dr. J. A. Gillespie, introduced the new incumbent of that office, Dr. A. W. Hunter, and the Twenty-eighth
Annual Session of the Vancouver Medical Association came to an
official end.
We must congratulate the retiring President and his officers
upon the successful conclusion of their labours. It is indeed an
arduous task to administer the affairs and to guide the destinies
of a Society so large and having so many contingent interests. Yet
though the offices may be insistent in their requirements, we have
wondered at times whether the policy of the Association in changing its officers for the most part yearly, is altogether wise. It is
true that within the last few years the services of the retiring President have been retained on the Executive for the succeeding year,
which gives a degree of continuity, and it not infrequently
occurs that other members of that body are also retained.
It might, however, be wise at times to break through what has
become through lapse of years the considered policy of the Society
and re-elect a President for a second term.
Surveying the crowded agenda paper filled with its notices
of reports of committees of various sorts and of allied interests and
undertakings, we realize how a Society grows and acquires a place
of value in the community.
We welcome the new officers and members of the Standing
Committees. Our readers are referred to an earlier page in this
issue for full particulars. We feel sure that they will worthily
represent the best interests of the Association and carry on its honourable traditions. They will find their own special problems to
solve, and will doubtless introduce innovations and developments
which are necessary if stagnation is to be guarded against.
We call the attention of our readers to the advertisement
which appears in this issue of the meeting of the Canadian Medical Association, in Victoria, on June 21st to 25th. There is no
need to extol to residents of British Columbia the advantages of
Victoria as a Convention City. Its climate, the beauty of its
setting and surroundings, and the adequate accommodation, are
known to all. We believe that when the programme is issued
an intellectual treat of no mean order will be discovered. Headquarters for the Convention will be at the Empress Hotel.
The April Regular Meeting of the Vancouver Medical Association was held in the Auditorium, Tenth and Willow, on Tuesday, the 6th, when 37 members attended.
After the minutes of the previous meeting had been read and
adopted, the Secretary read a letter from the Victorian Order of
Nurses relative to its Annual Campaign for Funds, and announced that the President had appointed Drs. Sievenpiper and
Craig to collect funds for the Order on behalf of the Association.
Dr. A. B. Schinbein moved an extraordinary resolution in
terms of the notice of motion given by Dr. Pedlow at the last
regular meeting, to rescind the extraordinary resolution carried
at the meeting on December 10th, thus restoring Section "C"
of By-Law No. 1 to its original reading. This was carried unanimously.
The Chairman explained the aims and purpose of the proposed Solarium for Crippled Children on Vancouver Island, and
on motion of Dr. Vrooman, seconded by Dr. C. F. Covernton,
the undertaking was endorsed by the Association.
Drs. B. H. Champion and A. W. Hunter presented the paper
of the evening on genito-urinary work. Dr. B. H. Champion
spoke on "Diagnosis and Treatment of Lesions of the Bladder
and Lower Urinary Tract," while Dr. A. W. Hunter spoke on
"Diagnosis and Treatment of Lesions of the Kidneys and Ureters." Films were shown, and the papers were followed by a
good discussion, in which Drs. C. E. Brown, A. B. Schinbein and
H. C. L. Lindsay participated.
We are pleased to report that Dr. Neil MacDougall, who
was confined to St. Paul's Hospital for about four weeks suffering from a cellulitis of the scalp and face, is now convalescing
satisfactorily and it is hoped after a short holiday he will be fit
to resume practice.
Dr. T. F. Saunders was recently a patient in the Vancouver
General Hospital, following an appendectomy and gastroenterostomy for gastric ulcer. A few days subsequent to operation
Dr. Saunders had some obstructive symptoms which caused
anxiety, but we are happy to say he is now back home and reported to be getting along satisfactorily.
The Vancouver Medical Association golf tournament is now
being played on the various links and it is expected will be completed early in May. We are informed there are four prizes this
year: First prize, one for the runner up, one for the gross medal
score, and one for the net medal score.
A group of Vancouver and Victoria medical men went to
Seattle for the annual inter-city golf match on April 29th. The
results will be reported in our next issue.
In connection with the recent appointment of Drs. Bonnell
and Petrie by the C.P.R. Medical Association, we wish to make
the following statement: The names of those applying for this
position were referred by Dr. Procter, Chief Surgeon of the
C.P.R., to the Executive of the B. C. Medical Association, and
only those names which represented members in good standing
were considered for the positions. Drs. Bonnell and Petrie are
members in good standing of the B. C. Medical Association. It
may also be well to point out, in view of certain comment, that
the choice was made, not by Dr. Procter, but by the C.P.R.
Medical Association.
Dr. H. N. Watson, of Duncan, Vancouver Island, has been
confined to bed for a few days with influenza, and is at present
recuperating in Vancouver, meeting many old friends. His practice is being cared for by Dr. G. A. Petrie.
A meeting of the Executive Committee of the B. C. Medical
Association was held on March 24th, 1926, when the following
were present in addition to local members: Dr. M. J. Keys, Victoria; Dr. T. J. McPhee, Nanaimo; Dr. H. H. Murphy (President), Kamloops; Dr. M. G. Archibald, Kamloops; Dr. F. W.
Andrew, Summerland; Dr. E. J. Rothwell and Dr. W. A. Clarke,
New Westminster. Nineteen doctors were elected to membership. Reports from the various committees were made, and the
date of the Annual Meeting arranged for June 22nd, in Victoria,
B. C, at the Empress Hotel.
The following letter, dated March 29th, 1926, has been re-
recived from the Vice-President of the Canadian National Railways, Montreal:—
"On behalf of the Radio Department of the Canadian National Railways (over which I have jurisdiction) , I beg to express appreciation of the address delivered by you from our radio station 'CNRV on the
16th instant, as also your undertaking to give from
that station a series of health talks. It is, I can assure
you, a great encouragement to the Department in its
efforts to maintain a high standard of such entertainments to have the co-operation of men of your attainments."
Such comment is very gratifying, as it shows that we are on
the right path in our efforts at publicity. The Vancouver Daily
Star has been added to the list of daily newspapers publishing
these articles, and we must again take this opportunity of thanking the New York State Health Department for its courtesy in
allowing us to use its articles. They are carefully prepared for
broadcasting, arid in addition to being readable, are accurate and
The details of "Canadian Medical Night" were given in
the last number of the BULLETIN.    Drs.  Boyd and Galloway
Page Eight spoke in Victoria to a large and enthusiastic audience, which included members from points on lower Vancouver Island, in addition to Victoria doctors. It is felt that this move of the C. M. A.
is an exceedingly good one, and we take this opportunity of expressing our appreciation of the generosity of the Sun Life Insurance Company which made these courses possible.
Our Executive Secretary, Mr. Fletcher, has just returned
from his annual tour through the Okanagan and Kootenays, where
he met practically every physician practising in this area. He was
received cordially by every man visited, and was able to discuss medical matters fully with them, as these affect the province. He also made a trip up the coast as far north as Anyox
and Stewart.
A well attended luncheon meeting of the B. C. Medical
Association was held on March 25 th, when Dr. Forrest Leeder,
in a witty and humorous address, gave some interesting facts relative to the value of efficient organization in medicine. We had
with us as guests Dr. Wm. Boyd and Dr. H. P. H. Galloway, of
Under the auspices of the Canadian Medical Association, an
Extra Mural Postgraduate tour throughout British Columbia is
being arranged for next September. Tentative programme has
been submitted to Dr. T. C. Routley, and it is hoped the itinerary
will, in addition to the Vancouver Summer School, include Victoria, Nanaimo, Prince Rupert, Prince George, Kamloops, Pen-
ticton, Nelson and Cranbrook.
The Twenty-eighth Annual Meeting of the Vancouver
Medical Association was held in the Auditorium of the old University buildings, Vancouver, on April 29th, 1926, the retiring
President, Dr. J. A. Gillespie, in the chair.
After the minutes of the last general meeting had been read
and adopted; the Secretary read a letter from the Vancouver General Hospital calling for nominations for the appointment of
Proctologist to the Hospital. On motion, duly put and seconded,
Dr. J. A. Sutherland and Dr. A. J. MacLachlan were elected
nominees of the Association.
Reports of the Hon. Officers of the Association were then
Dr. G. H. Clement, Secretary, said that during 1925-26
eight special and seven regular meetings had been held. Some of
the leading authorities in medicine had addressed the Association,
notably Dr. L. F. Barker, Dr. Lundy, Dr. William Boyd, and
Page Nine Dr. H. P. H. Galloway. The general meetings had been addressed by Drs. J. Tate Mason and L. J. Palmer, of Seattle, and
Drs. Gillespie, Hill, Wallace, Wilson, Hodgins, Hunter and Champion had read papers which proved of general interest to the members.    Dr. E. D. Carder delivered the Osier Lecture for 1925-26.
The Treasurer, Dr. A. B. Schinbein, presented the financial
statement, showing a credit balance of $1,758.06, of which
$1,575.33 was earmarked for Summer School purposes. Expenditures for the year amounted to $3,540.54, $2,348.62 being for
working expenses, $1,034.92 for Library expenses, and $157
donations, etc. The amount collected in fees was $3,610. Dr.
Schinbein explained the origin and present state of the two special funds (Ultra Scientific and Dr. Stephen's Memorial Fund),
both of which showed creditable balances. The total membership at date is 193, nineteen of which are not paid up for the
past year.
The Auditor's report was presented by Dr. A. C. Frost,
and the Trustees presented a statement of the securities held by
them belonging to the Association.
The Editor of the BULLETIN, Dr. J. M. Pearson, reported
as follows—
Nineteen numbers of the paper have been issued and the
total net profits to date are $411.32, an average of $21.65 per
issue. According to our present arrangements with the publishers, after paying the cost of printing, the balance is divided between them and the Association equally. Our share in therefore
$205.66, or about $11 per issue. The cost of printing each number is $85. For the April issue the advertisements brought in
$116, leaving for that month a net profit of $31. From our
share of this has to be deducted the cost of distribution, which
amounts to about $3.50. It is gratifying to the Committee to
feel that even this small profit has been shown from the beginning,
and with different arrangements there is no reason why it should
not be materially increased.
The reports of the various Sections of the Association were
then received.
Dr. F. N. Robertson, Secretary of the Clinical Section, stated
that six meetings were held during the year. Four of these were
held at the General Hospital, one was given by the doctors of the
Workmen's Compensation Board and aroused particular interest,
one was held at St. Paul's Hospital, and one at Shaughnessy Hospital. The Committee felt these meetings might be more useful
and would stimulate greater interest if the cases shown were of
common interest along the line of. the daily work. The large attendance and interest in the discussions justified this opinion. The
Committee thanked the staff of the different hospitals, and also
the members who had shown cases and spent much time in their
preparation, and also the Editorial Board for reporting the meetings in the BULLETIN.
The work of the Section of Physiology and Pathology was
Page Ten outlined by Dr. C. H. Bastin, Secretary, who reported a very satisfactory season's work. Ten meetings had been held, with good
attendance. At the last meeting plans for next season's work were
agreed upon and the Chairman and Secretary elected. Dr. Bastin
is the new Chairman and Dr. C. E. Brown was chosen as Secretary.
Dr. H. A. Barrett, speaking on behalf of the newly formed
Physiotherapy Section, said that fortnightly meetings had been
held during the session. The membership at present was small,
but with increasing interest in this branch of medicine he hoped
the Section would be much larger next year. He wished to emphasize the fact that physiotherapy was not a specialty, but rather
a mode of therapy applicable to all branches of medicine and therefore of general interest. The American Medical Association has
recently appointed a committee consisting of pathologists, physicists, clinicians and others, to thoroughly investigate physiotherapy and standardize apparatus and technique.
The Eye, Ear, Nose and Throat Section, through the Secretary, Dr. E. H. Saunders, reported.
Dr. G. F. Strong gave an interim report on the proposed
arrangements for the 1926 Session of the Summer School. The
meetings this year are to be held in the week of September 13th.
The tentative programme includes: Dr. A. S. Warthin, Pathologist, University of Michigan; Dr. George Gellhorn, Obstetrician, University of St. Louis; Sir Henry Gauvain, the noted
Orthopaedist, from England; and others. The full programme
will not be published until after the close of the Canadian Medical Association annual meeting in Victoria in June.
On behalf of the Library Committee the Secretary, Dr. W.
F. McKay, reported an expenditure of $1,034.92, of which
$811.70 was for books and journals. This exceeded the previous year's expenditure by $137. Dr. McKay stated that 59
journals are now on file in the Library. During the year 53% of
the membership availed themselves of Library privileges, a total
of 661 books and 817 journals being borrowed. He expressed
the thanks of the Committee to the various members who had
donated books and journals, and also to those gentlemen who
had been kind enough to contribute reviews of books and abstracts of journal articles for inclusion in the Library pages of the
BULLETIN. Fuller details of the Committee's activities are on
file in the Library and can be consulted by anyone interested.
Dr. Lachlan Macmillan, speaking for the Orchestra Committee, said that owing to the change in the personnel of the Dinner Committee just before the Annual Dinner, the Orchestra had
not functioned to its usual limit. The more work it was given to
do the better it did it. This year he hoped its work would be
mapped out in good time and better results achieved.
The Credentials Committee reported that ten applications
for membership had been received.    All applicants had been fa-
Page Eleven vourably reported on and seven had been elected to membership,
the remaining three would be voted upon at the October meeting.
The year's work of the Credit Bureau was reviewed by Dr.
Lachlan Macmillan, Chairman. In presenting his report Dr.
Macmillan reminded the Association that the Bureau had now
been in operation for eleven years. Very little had been done to
advertise its merits, but much routine work had been accomplished. He wished to thank his Committee for their loyal support
and the Manager, Mr. Welch, for his untiring efforts to produce
the maximum of results with a minimum of expense. The Bureau
had increased its membership from 10 to 114, and the annual
turnover is now $25,000. The financial statement was appended
to Dr. Macmillan's report.
Dr. Pearson made a short interim report of the work done
by the Committee appointed to consider the question of closer
co-operation with the B. C. Medical Association. After several
meetings the Committee had drafted a series of definite suggestions as a basis for future discussion. These were submitted to
the committee of the B. C. Medical Association, and in reply a
similar series of suggestions from them was handed to Dr. Pearson recently. There was considerable variation in opinion, but at
least the ground was cleared and the proposals are in writing. It
remained for the Committee, or some other committee, to extract
some concrete proposition out of them.
Coupling this interim report with his remarks as Editor of
the BULLETIN, Dr. Pearson asked permission of the Chair to
make a short statement as to the possibilities of the BULLETIN
as a money producer for the Association. He thought an increase
in the staff of the Association was now warranted, and made
various suggestions whereby he thought the membership in the
Association could be materially increased.
Dr. A. J. MacLachlan, representative of the Vancouver
Medical Association on the Executive of the B. C. Medical Association, reported in part as follows:
"The past year has been mostly one of routine work as regards the B. C. Medical Association. I am simply mentioning
some of the points which I think will be of interest to the members of the Vancouver Medical Association. In conjunction with
the Summer School Committee of the V. M. A. a scheme is being
worked out for post-graduate work in this province under the
Canadian Medical Association.
"At the first Executive meeting it was decided that the Industrial Service Committee of the BV C. Medical Association
should offer its services to the Workmen's Compensation Board
as an arbitration committee. This was taken advantage of by the
W. C. Board, but it was felt that as the Committee was not a true
arbitration committee this service should be discontinued. I might
say no disagreement with the W. C. Board was met with;   in
Page Twelve fact, the utmost courtesy was shown,  but all the recommendations of the Committee were not carried out.
"The C.P.R. situation remains more or less in an unsettled
state. Dr. S. Bonnell and Dr. Petrie have been appointed to succeed Dr. de Muth and Dr. Lyons, whose services have been dispensed with. It is unfortunate that Vancouver men were not
appointed to these positions, as to my mind it was understood
that men from Vancouver would be appointed. A letter was sent
out to the profession from the Executive of the B. C. Medical Association which was interpreted by many to mean that the B. C.
Medical Association was responsible for the supposed settlement,
but this was not the case; the negotiations were carried out by
Dr. Procter, acting on reports by men who were not even members of the B. O Medical Association, and the B. C. Medical Association really had no direct hand in the settlement which has
been made, except that the members of the Executive met Dr.
Procter on three or four occasions and were assured by him that
only members of the B. C. Medical Association would be considered for the positions. In fact I now think it was unfortunate
that the Executive of the B. C. Medical Association sent out letters asking men to apply for this contract.
"A number of articles are being published under the direction of the Publicity Committee of the B. C. Medical Association.
They- are appearing in various papers throughout the province,
and to date none but favourable comment has been heard."
The work of the Staff of the Vancouver General Hospital
was reviewed in a very comprehensive manner by Dr. J. W.
Thomson. Extracts from this review will be published in later
numbers of the BULLETIN.
Dr. E. J. Gray, on behalf of the Staff of St. Paul's Hospital,
said that ten meetings were held, the average attendance being
80%. Papers were read on Caesarian Section, Diseases of the
Thyroid, Fractures, Thymus Gland, and Recent Work in Blood
Chemistry. These papers included detailed reports of cases occurring in the hospital during the past three years. At each Staff
meeting a complete report of cases treated in the hospital during
the preceding month is read and discussed, after which clinical
cases are presented.
Before proceeding to the Election of Officers and members of
Standing Committees, Dr. J. A. Gillespie, retiring President, addressed the members present on the work of the past year. After
thanking the members generally for the loyal support accorded
him during his year of office, he particularly thanked the Dinner
Committee for taking hold at the last moment and achieving such
satisfactory results.
Dr. Gillespie said he concurred in the view expressed by the
past President, Dr. H. H. Milburn, that the Association should
liave a President-elect as a member of the Executive, who would
Page Thirteen thus have a year in which to become conversant with the work
before taking office. He commended this idea to the incoming
Executive. He thought progress had been made during the past
year. The standard of papers given had been a high one; the
meeting place was an improvement on former years, thanks to
the goodwill of Dr. F. C. Bell and the Hospital authorities. The
attendance at meetings still left much to be desired, though the
average had been fair. With regard to a permanent home for the
Association, he had been approached personally and the Executive
had been interviewed many times by .various promoters regarding
the erection of a Medical Building, but nothing definite had yet
been decided. He hoped the Association would soon have a home
of its own.
Touching on the suggestion which had emanated from some
quarters as to the possibility of students taking two years of their
medical course at the University of B. C, Dr. Gillespie said he
thoroughly approved of the suggestion. While the time was not
yet ripe for the establishment of a Medical Faculty, he thought it
would be a great boon and saving if two years of the medical
course could be obtained in British Columbia.
With regard to membership in the Association, Dr. Gillespie
said there were over 240 names in the telephone directory, which
meant that only about 55% of the medical men in the city were
members of the V. M. A. This situation should not continue.
He agreed with Dr. Pearson's suggestion that if they had someone whose business it was to look after the financial end of the
Association the membership fees could be increased by about
$1000 per annum. He did not think $20 could be spent to better advantage than by membership in the Association. He recommended the new Executive to carefully consider Dr. Pearson's
remarks as to co-operation with the B. C. Medical Association.
At present there was an undercurrent of discontent among the
members, who felt that $20 was too much for Vancouver men
to pay to the Provincial Association.
As regards the C.P.R. situation, he felt that the contract
system was a bad one. The man doing contract work could not
give the same service as the man who got paid regular fees. The
Association should consider the possibility of getting that work
thrown open to all the men in the city.
Under new business, Dr. Vrooman explained the proposed
Preventorium for Children to be established under Rotary and
the I.O.D.E. A committee was in process of formation, and a representative was desired from the Medical Association. He moved,
seconded by Dr. Carder, and carried unanimously, that a representative be appointed and that such representative be Dr. Lyall
The meeting- then proceeded to the Election of Officers and
members of Standing Committees, the following appointments
being made:    President, Dr. A. W. Hunter; Vice-President, Dr.
Page Fourteen A. B. Schinbein; Secretary, Dr. F. W. Brydone-Jack; Treasurer,
Dr. W. S. Turnbull; Auditor, Dr. F. W. Lees; Editor, Dr. J. M.
Pearson; Representative to B. C. Medical Association, Dr. A. C.
Frost. Clinical Section: Chairman, Dr. F. N. Robertson; Secretary, Dr. Wallace Wilson; Library Committee, Dr. Wallace Wilson and Dr. C. H. Bastin; Dinner Committee, Dr. C. F. Covern-
ton, Dr. A. C. Frost and Dr. G. B. Murphy; Orchestra Committee, Drs. F. N. Robertson, L. Macmillan, J. A. Smith, W. L.
Pedlow; Credentials Committee, Drs. E. H. Saunders, B. H.
Champion and T. R. B. Nelles; Credit Bureau Committee, Dr.
D. McLellan.
By invitation Dr. H. W. Hill, Director, Vancouver General
Hospital Laboratories, and Professor of Public Health, University of B. O, presented "The Non-Relation of Malnutrition to
Infection," before the Oregon State Health Officers' Convention
in Portland, on March 31st, 1926, and before the Oregon State
Medical Society on April 1st.
Being invited to describe and demonstrate the Canadian
(puncture) method of anti-smallpox vaccination, Dr. Hill had
the unexpected pleasure, on March 31st, of vaccinating the President and Secretary of the State Board of Health, full time and
part time health officers and some nurses, to the total number of
thirty; and on April 1st of performing a like service for 20 members of the State Medical Society.
The American method of vaccination (two parallel scratches)
leaves two scars; the British vaccination leaves four; the Canadian custom seems to be three. Dr. Hill pointed out to his victims that any takes they secured would label them permanently
as "Canadian three scars." This did not dampen the enthusiasm
of our good Oregonian friends, who in medical affairs seem to regard but lightly the well known 49th parallel.
The Women's Auxiliary to the State Medical Society, composed largely of the wives of members, held a banquet of their
own at the same time and hotel as the banquet of the State Medical Society, but in a different room. Dr. Hill was invited to address them and also a luncheon nearby of the Portland Social
Service Society; six addresses and 50 vaccinations in all in 36
Toxin-antitoxin is no longer supplied by the Connaught
Laboratories, its place as a producer of active immunity to dipth-
theria having been taken by "diphtheria toxoid."    Dr. J. G. Fitz-
Page Fifteen gerald, Director of the Connaught Labortories, has been good
enough to forward a sample outfit to us; and Dr. F. C. Bell, Superintendent of the Vancouver General Hospitals, has ordered it
stocked in the hospital pharmacy, for local use. This diphtheria
toxoid is the "anatoxin" of Ramon—a diphtheria toxin, treated
with formaldehyde in such a way that the diphtheria toxicity is
destroyed, while the ability to elicit diphtheria-immunity is retained. The dose is small, the reaction in children almost or quite
nil, and the immunity develops in about six weeks. The absence
of serum from this toxin-formaldehyde mixture does away with
any fear of anaphylactic sensitization, which is a definite drawback of the toxin-antitoxin mixture. "Full directions with each
Despite the housecleaning and painting which has upset the
Laboratories so badly of late, the routine laboratory work done
has broken all records for similar periods. During March we averaged 200 urines per day, reaching over 260 in one day on several occasions. This corresponds somewhat with the unusually
high congestion of the Hospital, where March yielded almost
26,000 "hospital days," as against the usual figure of about
The University of Toronto Medical Bulletin of February,
1926, contained so excellent and concise an article on "Blood
Grouping and the Selection of Donors for Transfusion," by I. H.
Erls, that we have applied for 100 reprints, intending to distribute them to interested physicians attending the Hospital.,
We are expecting, also, 100 copies of a recent symposium
on the Kahn and Wassermann tests for syphilis, issued by the
Michigan State Board of Health.
On receipt of such literature for distribution, it will be placed,
by consent of the Superintendent of the Hospital, in the Physicians' Room, with an invitation that each physician "Take one
only, but take one" so long as they last). We hope to secure
other material from time to time for similar distribution—not
necessarily "new," but we hope, usually good.
"Disappearing Diseases."
B. M. J., Feb. 20,  1926.
Table showing the decline in the death rates (per 1,000
population) from certain infectious diseases in the period 1871
to 1924.
Great   Britain
Death Rate 	
Infant   Mortality    (1891)
Diphtheria    (1891-1900)
Enteric   Fever   	
Scarlet   Fever   	
Tuberculosis   (Respiratory)
The following abstracts are from addresses delivered before
the Vancouver Medical Association on March 25th, by Dr. William Boyd and Dr. H. P. H. Galloway, of the University of
Some Aspects of Heart Disease.
Dr. Boyd took as his subject "Infections of the Heart" as
represented by acute rheumatic infection, acute bacterial endocarditis, or ulcerative endocarditis, subacute bacterial endocarditis and
syphilitic infection.
He emphasized the necessity of regarding these infections as
affecting the entire "cardium," including the endocardium, the
pericardium and the myocardium. Referring to the effects of
rheumatism on the heart, Dr. Boyd said that in many of these
cases the joint lesions were of decidedly minor importance, the
brunt of the disease being borne by some portion of the heart
structure. By means of an excellent series of lantern slides Dr.
Boyd demonstrated the lesions which may result from rheumatic
Taking, first, the myocardium, Dr. Boyd showed illustrations of the Aschoff bodies as found lying in the muscle wall of
the heart. These bodies are giant cells, irregular in shape, having
one or more nuclei, and are regarded as definite evidence of rheumatic infection. The infiltration of small round cells accompanying these bodies is evident more in the neighbourhood of the vessels, producing a cuff-like appearance in many instances.
The later effect of this inflammation is, of course, the onset
of fibrosis in which scar tissue obliterates and replaces the musculature. As a cause of scarring of the heart wall rheumatic infection is common. If the infection occurs in the neighbourhood of the Bundle of His interference with the conduction system of the heart might become evident and heart block of a more
or less permanent nature would occur.
The pericardium was also frequently involved in the rheumatic process and two varieties of lesion might occur. One, in
which the two layers of the pericardium were affected and became
ultimately more or less adherent to one another, was characterized
as not being of very great significance or interfering with the action of the heart. But when, in addition, a mediastinitis occurred
and adhesions of the parietal pericardium to the surrounding
structures or to the chest wall became evident, then a serious impediment was offered to the action of the heart, leading to dilatation and cardiac failure.
Slides were shown exhibiting the effect of the rheumatic processes on the endocardium, which chiefly affected the free edge of
Page Seventeen the valves, generally the mitral.    A thin layer of vegetation could
easily be demonstrated and was of frequent occurrence.
Dr. Boyd said that it had always been somewhat incomprehensible to him how the subsequent deformity which was found
in these cases of rheumatic endocarditis could occur from the simple involvement of the endocardium overlying the valve. However, on section of the valves themselves the explanation is abundantly clear, in that the substance of the valve is affected in precisely the same manner as the general musculature of the wall, and
it was the subsequent fibrosis and contraction following this inflammation which produced the great deformity not uncommonly
seen in these cases.
Illustrations of the funnel shape and buttonhole form of
mitral valve lesions were shown. An interesting point was
brought out by Dr. Boyd when he explained the manner in which
the rheumatic infection might involve the wall of the aorta, and
slides were exhibited showing the presence of the Aschoff bodies
lying in the wall of that vessel. The late effect of this implication of the arterial wall appears to be that of a weakening or dilatation rather than a contraction such as occurred in the valves.
This dilatation doubtless expresses itself in the enlargement of
the aortic ring leading to the presence of regurgitation. Whether
or not the rheumatic process was concerned in the actual production of aneurysm, Dr. Boyd was not at present prepared to state.
Turning to the question of bacterial endocarditis, in the acute
or ulcerative variety the offending organism might be the strep-
tococcus-haemolyticus, the staphylococcus, pneumococcus or occasionally the gonococcus. It was, in most instances, an incident in
a generalized septicaemic infection, a focus in some more or less
distant portion of the body having become generalized and the
endocardium being secondarily affected in the form of large ulcerative vegetations. From these, septic emboli were readily distributed and the condition proved rapidly fatal.
In the sub-acute infective variety, on the contrary, the chief
organism found was the streptococcus viridans, an organism of
low virulence originating doubtless in some focus, the presence of
which could rarely be demonstrated, so that the heart lesion assumed a prominent place in the picture. The duration of life in
these cases was very variable, ranging from a few weeks or months
to two to three years.
The character of the lesion as found upon the valve differed
considerably from that of rheumatism, especially in its tendency
to involve the wall of the adjacent auricle or ventricle. In specially stained slides, pictures of some of which were exhibited,
large masses of bacteria can be demonstrated and it is easy to see
how in such a condition small embolic foci can be detached and
carried into the general circulation. In this way, doubtless, the
blood infection found at times occurred. It is important to remember that the infective organism is not pyogenic in character in
Page Eighteen contradistinction to the organism of ulcerative endocarditis, consequently embolic foci of suppuration were not found in this disease. As a later manifestation these vegetations and their surmounting organisms became covered over with a layer of mucoid
material, thus sealing the lesion, and this might account for the
fact that in later stages the blood stream, which had before yielded
cultures of the streptococcus, might now be found free.
It is probable, the lecturer said, that all or most of us, at one
time or another, became infected with this organism, and why,
he asked, was it that only in certain circumstances it found a lodging in the valves of the heart? He thought the explanation—or
one explanation—might be found in the work of Gross on the
circulation of the heart. If the infection is a blood-borne one,
how is it that the valves become involved when the actual cusps
themselves are generally regarded as being devoid of vessels? In
the adult this is certainly the case for the most part, but in early
life, as Gross has demonstrated, the valves are very fully supplied
with a system of blood vessels and in some instances, even in
adult life, as he has shown, the system of blood vessels persists,
and it is doubtless in these individuals who maintain definite
circulation in the valves to adult life, that infections of this nature may occur.
The lecturer here showed one of Gross' preparations which
demonstrated the point at issue. The injected blood vessels were
clearly to be seen ramifying throughout the substance of the valve
and it was perfectly comprehensible how infection might occur in
this instance.
Finally, Dr. Boyd referred to conditions of exacerbation of
old syphilitic myocarditis producing symptoms of infection and
cardiac failure. His attention was drawn to this interesting subject by a paper published by Dr. Warthin, of Ann Arbor, which
appeared in the first number of the American Heart Journal, and
subsequently in looking through his old material he had come
across a case which appears to confirm Dr. Warthin's views. Sections being taken from this heart revealed the presence of spiro-
chaetes in considerable numbers. Slides from this case were shown
and also one taken from Dr. Warthin's paper. He desired to
draw attention to this new syndrome as a possible explanation
of otherwise inexplicable occurrences of sudden death of apparent
cardiac origin.
Fractures of Elbow and Hip Joints, Common Fractures.
Dr. Galloway took as the subject of his address "Details in
the Management of Some Common Fractures." The lecturer desired to emphasize the word "details" in the title, as in his opinion good or bad results very often turned upon the careful management of fractures. Dr. Galloway said he had originally intended to speak on four different varieties of fractures, viz., those
in connection with the elbow joint, fractures of the neck of the
femur, Colles' fracture and Potts' fracture, but he found that as
Page Nineteen he developed his theme time would not permit him to speak on
all four. He had, therefore, decided to confine his remarks firstly
to fractures involving the elbow joint, and, secondly, to fractures
of the neck of the femur.
Fractures of the elbow joint were of rather common occurrence, especially in the young, and were often the cause of a good
deal of deformity and disability in after life. He thought the
most important single contribution which had been made to the
treatment of this difficult class of fracture was that enunciated by
Sir Robert Jones, of Liverpool. Sir Robert Jones, if he did not
actually discover the method of treating these cases in acute flexion,
had certainly popularized and standardized the method. The idea
underlying this method of treatment was his famous saying of
"right of way."
As to the diagnosis of this condition, it was not thought of
prime necessity that the exact direction of the line of fracture
should be ascertained. Prolonged and undue examination, especially under an anaesthetic, should be avoided. The X-rays unfortunately, as so many of these cases occurred in children, did
not give us the assistance that we require. Only too often an examination of the skiagram showed that considerable portions of
the ends of the bones involved in the fracture were still in a
cartilaginous condition, and consequently did not show clearly
in the/picture. However, the exact diagnosis was not absolutely
necessary in the condition, as the treatment for all these classes of
cases was much the same. Sir Robert Jones' directions in regard
to this fracture were:
First: extend the arm gradually to its fullest possible extent, supinate the forearm completely. Having done this, manipulation of the fragments might be attempted. Then, maintaining the traction in extension, the arm is slowly brought up into
complete flexion; if complete flexion was found to be impossible,
the manoeuvre must be repeated, and in cases where complete reduction had been effcted acute flexion could be readily established.
There are occasions where the traumatism has been very great and
consequent swelling extreme, in which it would not be advisable,
to maintain the extreme acutely flexed position for a few days.
In fact it must always be remembered that the circulation should
be carefully watched. The nurse, or parents, should be instructed
to examine the finger nails, and by pressing upon them from time
to time be sure that no impediment exists. As a final dressing
Dr. Galloway uses plaster of paris, and by means of a picture
thrown upon the screen he showed the method in actual use. The
dressing is usually left on from three to four weeks, but upon this
point opinions differ, some advocating a shorter time.
Following the removal of the dressing the forearm is lowered. Day by day the child is encouraged to flex the arm. Meanwhile the wrist rests in an ordinary sling fastened round the neck.
If the flexion can be painlessly accomplished, all is well. The
lecturer deprecated the endeavour to carry out passive movements
Page Twenty especially in those fractures in which there is joint injury. Indeed
the endeavour to carry out such movements may produce pain,
and with the pain comes increased inflammation and limitation
of movement.
Fractures of the Neck of the Femur.
If the method of Jones is of value and importance in connection with fractures round the elbow joint, the work of Royal
Whitman, of New York, is of equal value in connection with
fractures of the neck of the femur. It has too long been the general impression of the medical profession that fractures of this
nature carry a very bad prognosis. Occurring as they are supposed
to do chiefly in elderly people, treatment has been perfunctory. In
this connection Royal Whitman has said that treatment of these
fractures is inefficient because the prognosis has always been regarded as bad, whereas the prognosis is bad largely because the
treatment is inefficient.
Contrary to the generally accepted opinion, many of these
cases occur comparatively early in life. Hamilton quoted 241
cases occurring in three consecutive years, and he found that of
these 241 patients only 37 were past-the age of 60, while 40 per
cent, were 50 years of age or under, and, in addition^ he found
that only three of these cases terminated fatally.
Dr. G. A. Moore, of Boston, reporting on 48 cases occurring
in private practice, found that on the contrary most of the patients
were round 65 years of age, and it is interesting to note the difference in age onset as shown in these two sets of cases.
We have further been taught that in cases of impaction it
was very unwise to disentangle these impactions, as it greatly increased the possibilities of non-union. Whitman describes his
method of treating these cases as follows: The patient is placed on
some variety of fracture table. If a Hawley or similar table is
available, as it is in most large centres, this is, of course, the best.
If not, other methods may be used, and Dr. Galloway illustrated
by means of lantern slides a home-made table which he had constructed and which was most useful as a substitute for the more
complicated apparatus when such was not available. With the
patient on some such table, traction is made by two assistants, one
on either limb, it being, of course, understood that unless the uninjured member is properly controlled the manipulation of the
injured limb is apt to result in tilting of the pelvis.
Having produced this traction, both limbs are placed in an
abducted position, the injured side being pulled outwards to its
physiological limit. With this traction and abduction goes an
internal rotation on the injured side.
By means of diagrams the lecturer showed how muscular
contraction is by this means relaxed, and use is made of the fulcrum offered by the ring of the acetabulum and the iliac bone.
With the limb in this position the lower part of the trunk, pelvis, entire injured limb and part of the sound limb are placed
in a plaster spica. Special attention is paid to the groin, where the
plaster is very apt to crack, and re-enforcement with a strip of
iron is often used to strengthen the cast at this point.
A modification of this method has been introduced whereby,
while abduction is maintained, the thigh is flexed upon the abdomen and the knee upon the thigh, thus allowing the patient to be
nursed in a sitting posture, avoiding the tendency to any passive
congestion of the lungs as a complicating factor. If this method
of treatment is properly carried out, the results are often surprisingly good, and are by no means so bad as we have been led
to suppose.
It will be found that when the plaster is removed the knee
joint is apt to show considerable stiffness, but this can gradually
be overcome by massage and movement.
Dr. Galloway concluded his interesting address by again emphasizing the importance of the most careful attention to details
in following out these well-thought out principles of treatment.
Fractures and Dislocations.
Wilson and Cochrane.   1925.   J. B. Lippincott Co., Philadelphia
and London.   $11.00.)
It would seem that the number of books on fractures at present was amply sufficient to meet the demands of the medical profession. However, this new volume is a most welcome addition
to the already large library on this subject. The views expressed
therein are not original with the authors, but are the results of the
practice of the fracture staffs of the Massachusetts General Hospital at Boston and the Edinburgh Royal Infirmary. Consequently the book is much more authoritative than if it contained
the expression of opinion of merely two specialists in fracture
The volume is written primarily for the general practitioner
and the non-operative treatment of fractures has been emphasized.
The indications for surgical interference are, however, pointed out
and in a general way the nature of the operation. Stress has been
laid upon anatomy, and the matter of after-treatment very carefully gone into.
The first three chapters cover the general principles of treatment, the emergency splinting and compound fractures. The remainder of the book is divided, as is general, into chapters on
regional fractures. All the modern apparatus that has been found
worth while is fully described and illustrated by photographs: in
fact the illustrations, including Roentgenograms, clinical photographs and anatomical diagrams, are very numerous and of an unusually high type of excellence.
Taken all in all, the book is a most welcome addition to
the Library. H. R. S.
Report on Cystoscopies done in the Vancouver General Hospital,
in 1924, by Dr. A. W. Hunter.
In the study of 140 case reports for 1924, in the Vancouver
General Hospital, 70 were examined and deductions drawn from
those examined. This shortening of the examination was done
on account of the lack of material evidence in the reports submitted. It was considered that the deductions drawn from 70
cases would apply to the 140.
The examination shows that clinical histories were written
in 40% of the cases, while in 60% of them no histories were
available. The histories that were most valuable were those written by the attending surgeons. These histories were generally
a short synopsis of the case, dictated to the operating room stenographer. The histories written by the internes were generally
incomplete and no diagnosis was available. It would appear
that the interne started his history, left it and never returned to
complete it.
The ratio of sex in the cystoscopic examinations shows that
47% were on males and 53% on females.
The cystoscopic findings were generally very complete, giving details of the lesions, such that usually a correct diagnosis
could be made from the findings recorded, but it is regrettable
that some doctors are loath to make a written diagnosis. The
lack of summarizing the cystoscopic findings, discounts their report: you have to make your own conclusions, and these may
be incorrect, as your perspective of the case is biassed by the findings given and not by those omitted.
Cystoscopic reports were available in 47% of the cases. In
16% of the cases the cystoscopic report had been dictated, and
these reports were lost or misplaced. In 10% no reports were
The comparison between the cystoscopic findings and those
of the X-ray department show that there is a very high percentage of concurrence in diagnosis. In 90% of the cases cystoscopic
examination and X-ray examination agreed, and only in 10%
would they disagree. This report is limited, as only cases cysto-
scoped and X-rayed without operation were examined. The disagreement was due in one case to the cystoscopist being wrong
in his inference, and in the other the increased capacity of the kidney pelvis was due to distortion produced by a former operation
on the case: but both agreed that operation was not indicated.
The cystoscopic diagnosis was confirmed by X-ray and by
operation in 87'/ of the cases. The prinary findings show a
very high incidence of red blood corpuscles in both diseased and
healthy sides, demonstrating that red blood corpuscles in themselves are most frequently of traumatic origin, and here it brings
out the importance of the surgeon making the deduction from
the urine analysis, and not the laboratory.
Page  iwenig-three Canadian Medical
Annual Meeting, Victoria, B* C*
JUNE 21-25
An excellent programme has been arranged, and will be published  in full in an early issue of the BULLETIN.
Come prepared for a week of delightful recreation. Golf, Fishing, Tennis, Motor Drives are all arranged for, and a Banquet and
Dance are part of the week's programme of entertainment.
Headquarters   of   Convention - - Empress   Hotel.
For information regarding hotel accommodation,
write at once to
Victoria, B. C.
Miss R. Backett, R.N.
l436Harwood St.,Vancouver, B.C., Phone Sey.3l47
Overlooking English Bay
SWEDISH and MEDICAL GYMNASTICS, London, England, Certificate
Patients attended in own homes.    Special Dietary.   Graduate  Nurses  in
Attendance.    Visited by Qualified Physicians
Page Twenty-four «<©('"
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of Clinical Results
UNIFORM methods cannot be employed for the extraction
and desiccation of different glands. The best method
of handling each gland must be determined by experiment,
the processes of manufacture in each instance being designed
with reference to the peculiarities of the particular gland in
question to yield a satisfactory finished preparation.
The identity of the gland is of first importance, and this is
particularly true of parathyroids. It is very easy to confuse
other glands with the true parathyroid glands.
All glands employed by us must be normal. They are all
examined for evidence of disease. Before desiccation, all non-
glandular matter is removed; this procedure reduces the
weight of the glands as they reach us, often to a large extent.
> The greatest care is also exercised to select and dissect only
that part of the gland which is required in the manufacture of
the product, such as the corpus luteum, from ovaries, the
anterior lobe from the pituitary body, ovarian residue from
ovaries and the posterior lobe of the pituitary. Some glands,
such as the thyroid, thymus, pineal, etc., are utilized in entirety.
Where fatty tissue is present in excessive quantity it is removed by solvents in a way to prevent injury to the active
gland substance.
To still further increase the activity of our gland products
we pass the desiccated material, after it has been finely
powdered, through sieves to get rid of the remnants of inactive
fibrous and connective tissue.
Our gland products therefore represent only the useful
parts of the raw material we receive, and for this among other
reasons contain a maximum amount of the therapeutically
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Only by specifying our gland products—by adding to his
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We will gladly send literature on the gland products in
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Page Tweniy-fioe H. A. BARRETT, M.D.
Practice limited to Physiotherapy.
Quartz   Lamps,   water   and   air-cooled;   High   Frequency,
Galvanic Static and Wave Currents; Massage, etc.
Special   facilities   for   surgical   diathermy   (electro-coagulation) .
Hydrosine bath  for  weight  reduction—by  artificial  exercise of muscular tissue—not a dehydrating process.
Electrolysis for hyertrichosis, e'tc.
Ionization for otorrhoea.    A. R. Friel's method.
Authorized   by   the   Workmen's   Compensation   Board   to
treat their cases.
Trained assistants only.
Hours  9  a.m.  to  6  p.m.,   including Saturday.     Evenings
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Private Clinical Laboratory
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We are prepared to undertake all the work usually
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C. S. McKEE, M. B.
Page Twenty-six The Basis of all Artificial
Infant Feeding
The basis of infant feeding is human milk, and
the principle involved in the artificial feeding of normal infants is the imitation of human milk.
Cows' milk is the basic material used in practically all artificial feedings. It is modified one way
or another to make it better suited to the infant's
digestion, and to have more or less the same proportions of food elements as human milk.
Pediatrists say that fresh cow's milk is, therefore, a logical diet for normal infants, provided that
it is diluted with water to reduce its fat and protein
contents and that a suitable sugar is added to the
mixture to give it approximately the same percentage
of carbohydrate as in human milk.
Mead's Dextri-Maltose
is a special sugar to be added to diluted milk, which
has been found to be more easily assimilated by infants and less likely to produce diarrhoea than cane
sugar or milk sugar.
DEXTRI-MALTOSE is advertised only to
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formula to suit the needs of the individual baby.
On request, a Mead's Feeding Calculator, showing usual formulas for normal infants suggested by
the results of pediatrists, will be supplied to physicians, together with samples of Dextri-Maltose.
Mead, Johnson & Company
Page Twenty-seven B. C. Pharmacol Co. Ltd.
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Arsenious Acid 1/50 gr.
Ext. Nux Vomica, J gr.
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Page Thirty-one sgiee
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"Reference ~ GB. Q. c&YCedical Association
For information apply to
Medical Superintendent, New Westminster, B. C.
or 515 Birks Building, Vancouver
Seymour 4183 Westminster 288
Page Thirty-two


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