History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: November, 1929 Vancouver Medical Association Nov 30, 1929

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 VOL. VI.
NOVEMBER,
No. 2
'VX
The BuMmri^j
KJ
ofthe^
Vancouver Medical Association
^Boo^s and ^he ^Professional c^lflan
23. Q. cAnnual (^fleeting
Laboratory bulletin
Tublished monthly at "Vancouver, 'JB. Q., by
McBEATH-CAMPBELL LIMITED
"N»cPrice-> $1.50 per year-'' Patient Types:
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907 Elliott St., "Windsor, Ont. Address   	
Dept. V.M.  10. 	 THE  VANCOUVER  MEDICAL  ASSOCIATION
BULLETIN
fubhihtd Monthly undtr the Auspices of the Vancouver Medical Association m  the
Interests of the Medical Profession.
Offices:
203 Medical and Dental Building, Georgia Street, Vancouver, B. C.
Editorial Board:
Dr. J. M. Pearson
Dr. J. H. MacDermot Dr. D. E. H. Cleveland
All communications to be addressed to the Editor at the above address.
VOL. VI.
NOVEMBER, 1929
No. 2
OFFICERS 1929-30
Dr. T. H. Lennie Dr. G. F. Strong Dr. W. S. Turnbull
President Vice-President Past President
Dr. E. M. Blair Dr. W. T. Lockhart
Hon.-Secretary Hon. Treasurer
Additional Members of Executive:—Dr. W. A. Dobson; Dr. A. C. Frost.
Trustees
Dr. W. F. Coy Dr. W..B. Burnett Dr. J. M. Pearson
Auditors:    Messrs. Price, Waterhouse 8c Co.
SECTIONS
Clinical Section
Dr. J. R. Davies Chairman
Dr.  S.  H.  Sbevenpiper Secretary
Physiological and Pathological Section
Dr.  A.  M.   Menzies Chairman
Dr.  R. E. Coleman Secretary
Eye, Ear, Nose and Throat
Dr.  F. W.  Brydone-Jack. Chairman
Dr. N. E. McDougall Secretary
Physiotherapy Section
Dr. H. R. Ross Chairman
Dr. J. W. Welch _, Secretary
Pediatric Section
Dr. C. F.  Covernton Chairman
Dr.  G. O.  Matthews Secretary
STANDING COMMITTEES
Library Orchestra Summer School
Dr. C. H. Bastin Dr. J. R. Davies rj>R. w. T. Ewing
Dr. Wallace Wilson Dr. J. H. MacDermot £>r   r   p< KiNSman
Dr. S. Paulin Dr. F. N. Robertson Dr. w. L. Graham
Dr. D. F. Busteed Dr. J. A. Smith j)R_ j   Christie
Dr. W. H. Hatfield Publications j)R. c. E. Brown
Dr. D. M. Meekison Dr. J. M. Pearson qr# t. L. Buttars
Dinner Dr. J. H. MacDermot
Dr. W. T. Ewing Dr. D. E. H. Cleveland Hospitals
Dr. W. A. Gunn Credentials Dr. J. W. Arbuckle
Dr. L. Leeson Dr. A. W. Bagnall Dr. F. Brodie
Rep. to B. C. Med. Assn.   Dr. W. L. Graham Dr. A. S. Monro
Dr. A. Y. McNair Dr. A. J. MacLachlan Dr. F. P. Patterson
Sickness and Benevolent Fund — The President — The Trustees VANCOUVER MEDICAL ASSOCIATION
Founded 1898
Incorporated 1906
PROGRAMME OF THE 32nd ANNUAL SESSION
GENERAL MEETINGS will be held on the first Tuesday and
CLINICAL MEETINGS on the third Tuesday of the month at 8 p.m.
Place of meeting will appear on the Agenda.
1929
October
October     15 th-
November   5 th-
November 19 th-
November 23rd-
lst—General Meeting:
Paper—Mr. John Ridington; "Books and the Professional Man."
-Clinical Meeting.
-General Meeting:
Paper—Dr. T. Homer Coffen, of Portland, Oregon;
"Progress in Cardio-Vascular disease."
-Clinical Meeting.
-ANNUAL DINNER.
December    3rd—General Meeting:
Papers—Dr. J. P. Bilodeau; "Practical Views on late
Toxaemias of Pregnancy."
Dr. W. L. Graham; "Post Operative Intestinal Obstruction."
December 17th—Clinical Meeting.
1930
January       7th-
January   -21st-
February     4 th-
February 18 th-
March 4 th-
March 18 th-
April 1st-
April
April
15 th-
22nd-
-General Meeting:
Papers—Dr. C. H. Bastin; "Traumatic Neuroses."
Dr. C. E. Brown; "Chronic Cholecystitis."
-Clinical Meeting.
-General Meeting.
Paper—Dr.  W.  E.  Scott-Moncrieff,  Victoria;   "The
Importance   of   the   Early   Recognition   of
Glaucoma by the General Practitioner."
-Clinical Meeting.
-OSLER LECTURE—Dr. J. J. Mason.
-Clinical Meeting.
-General Meeting:
Papers—Dr. L. H. Appleby;  "Surgery of the Sympathetic Nervous System."
Dr. G. O. Matthews; "Common Practices in
Infant Feeding—their Use and Misuse."
-Clinical Meeting.
-ANNUAL MEETING.
Page 2't I—.-
Olfhy the Qrowing Preference for
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DURING the past yearwehave published a series of
advertisements in which are quoted abstracts from
writings of recognized international authorities, pertain'
ing to the use of the Quart? Lamp in ultraviolet therapy.
Believing that this method of presenting facts is pre'
ferred by the profession to a mere statement of claims
by ourselves as manufacturers, we continue this series
herewith.
The Victor line of Mercury Arc Quartz; Lamps, air'
cooled and water-cooled types, includes all models re
quired in modern practice, for general office use and
for the specialized practice.
As with all other Victor equipment, these Quartz;
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and experimental engineering, and collaboration with
specialists to the end that the most exacting require'
ments of present-day ultraviolet therapeutics are met.
Let us advise with you in the selection of an
outfit best suited to your individual practice.
"In tuberculosis therapy, as well as in
all other phototherapeutic indications.
I use Quartz Light exclusively. For two
reasons: First, because I agree with Ros r.
one of our most experienced light therapists, that the light reaction I endeavour
to obtain cannot be procured as simply,
rapidly, conveniently and cheaply with
anything but the Quartz Light. Second'
ly, because at that time, I could not convince myself, either from personal experiments or from the works of others,
that the biological effect of other types
of light surpassed that of Quartz Light.
Without laying stress on this statement,
I should be more inclined to assert the
contrary. This would be in complete accord with the assertion of Rost, Pee-
moller, Huldschin'ky and others, that
the Quartz Light has the advantage
over other types of light, not only in the
Ultraviolet domain, but also in other
erythema-forming groups of rays."
—A. J. CEMACH, M. D. An extract
/rotnnis'arricle,' Ultraviolet Therapy
in Oto - RKino - Laryngology," read
be/ore the Second International Conference on Light and Heat in Medicine and Surgery, University of London, 1928.
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ROUGIER FRERES    -    MONTREAL EDITOR'S PAGE
Recent paragraphs in the daily press seem to indicate that another of
our colleagues (this time British) has been voicing his opinion of the
profession in no uncertain and no complimentary manner. Our limitations, instability, conservatism, imitativeness and impulsiveness are discussed in the manner of the "candid friend." This sort of effusion is
familiar enough and is usually the prerogative of old age and presidential
addresses. Such explosions, confined to a medical audience, are doubtless
quite harmless and are good humouredly condoned. The average layman,
also, who comes across such extracts in his daily paper, may probably be
trusted to take them at something less than their face value.
As a source of ammunition for the "antis" for later use in pamphlets, articles or speeches, they are useful. In this respect, such hasty
over-emphatic statements are doubtless harmful. There is no special
need for any one to supply his opponent gratuitously with ready-made
arguments which are mostly less than half true.
Generally, in these addresses there is a strong strain of laudation of
times past which, in its fully developed form, may probably be classed
among the early symptoms of a generalized arteriosclerosis.
The profession of medicine is deteriorating. Where are now the
equals of the giants of old? We venture to say (as showing our freedom from present sclerotic tendencies) that the profession is as well
equipped now as ever it was and probably, on the whole, a great deal
better.
We are often told too that by the development and multiplication
of laboratory and mechanical aids to diagnosis, doctors are losing or are
in danger of losing their clinical ability. If that should prove to be the
case, we doubt if the substitution entails any great hardship. After
all, why should a doctor laboriously perfect himself, so that by prolonged experience and when he has reached a ripe age, he may be able
to detect the presence of an early pulmonary tuberculosis, which any
competent X-ray man could find more certainly and probably sooner?
That many doctors will in practice be so situated as not to be able
to avail themselves of such appliances, is no argument, the answer being
that convenient centres will be established so that all but the most
remote pioneers will be able to obtain such assistance. The medical
student of today will, when he gets into practice, no longer be satisfied
with the limited armamentarium which has hitherto been available.
And, in any event, and always, there will still be plenty of room
for the cultivated observation, the logical ratiocination, the orderly
judgment, the wide experience which is clinical ability—the application
to medical problems of what is the true aim of all real education.
NEWS AND NOTES
The first meeting of the thirty-second session of the Vancouver
Medical Association was held in the Auditorium of the Medical-Dental
Building on Tuesday, October 1st, with the President, Dr. T. H. Lennie,
in the Chair. As this meeting marked the opening of the new Library
quarters  the  Library  Committee  acted  as host  to  the  members,   the speaker of the evening being Mr. John Ridington, Librarian of the
University of B. O, whose paper, "Books and the Professional Man"
appears in this issue of the Bulletin. At the close of the evening the
Library Committee served refreshments and the new Reading, Committee and Stack Rooms were thrown open for inspection.
A short business meeting was called to order at 8 p.m. A letter
was read from the Associated Drug Clerks regarding their organization and a letter from the Fraser Valley Medical Society inviting the
members to attend on Tuesday, October 8 th to hear an address by Dr.
Tate Mason on "Sodium Amytal."
The Summer School Committee reported the results of the 1929
Summer School which showed a credit balance of over three hundred
dollars. Drs. C. E. Brown and T. L. Buttars were duly elected to the
Committee in place of Drs. Appleby and B. D. Gillies whose term had
expired.
Dr. William E. Harrison was elected to membership in the Association and Drs. W. J. Dorrance and Geo. A. Sutherland were nominated
for election at a later date.
The Hospitals Committee, in view of the approaching hospital
survey, moved a resolution, which was duly carried, urging the civic
authorities to make the proposed survey as complete and thorough as
possible and asked that copy of the resolution be sent to the Mayor and
Council and to the Provincial Secretary. This resolution was duly
carried.
In view of the heavy expense incurred by the Association in furnishing the new quarters authority was given to the Trustees to sell bonds
to the required amount.
The Committee re the use of Iodine in the Schools reported favourably on the suggestion contained in Dr. White's letter. The Committee's report, which is on file, was adopted and a copy ordered to be sent
.to Dr. White.
Dr. Lennie, Chairman, voiced the thanks of the Association to the
Council of the College of Physicians and Surgeons for equipping the
Committee Room and to the Library Committee for their work in
superintending the furnishing of the Offices and Library.
The annual meeting of the B. C. Medical Association was held in
Vancouver in the last week of September, and both the business and
social programmes were of exceptional interest.
The papers presented by eminent authorities in their respective subjects from three eastern Canadian Universities will be published in due
course.
The entertainment of the large number of medical men from various parts of the province who attended, and of the wives who accompanied them, was capably dealt with by special committees.    Luncheons
Page 24 were held at the Hotel Georgia on the 25th and 26th of September, at
which Drs. Bazin of McGill, Ross Miller of the Dominion Department
of Health, and G. Harvey Agnew of the Department of Hospital Service
of the C. M. A., spoke to appreciative gatherings. Following a golf
tournament at Shaughnessy Golf Club links on the afternoon of September 26th, the annual B. C. M. A. dinner was held at the Hotel Georgia.
The president's address by Dr. Wallace Wilson was followed by an
address on Medical Organization by Dr. T. C. Routley, the efficient General Secretary of the C. M. A. This subject was dealt with comprehensively and was received as a very timely contribution. This was succeeded by the Secretary-Treasurer's report, the reports of the chairmen
of standing committees, and election of officers for the coming year.
The visiting ladies were cordially welcomed and entertained by a
committee formed from the wives of Vancouver doctors. On the first
afternoon a tea was given by Mrs. Wallace Wilson at Jericho Country
Club, and on the next afternoon a tea was given at Whytecliffe Park.
Cars for transportation to Jericho and Whytecliffe and the drives preceding the teas were furnished in plenty. Following the tea at Whytecliffe a dinner, followed by bridge, was held at the Hotel Georgia.
We deeply regret to report the presumed death on September 22nd,
of Mr. George S. McKee, second son of our well-known colleague, Dr.
C. S. McKee. Mr. McKee met his end while doing his duty on a humane
mission. With two companions he flew north in search of a lost party
of explorers. In spite of warnings of the danger he was running on account of poor visability, he pursued his quest until he himself lost his
bearings and flew into the surface of a- lake. The bodies of his com-
panions were found, but no hope is held out that Mr. McKee survived.
The members of the Vancouver Medical Association extend to Dr. McKee
their sincere sympathy in his bereavement.
Dr. Hugh McKechnie, son of the late Dr. L. N. McKechnie, has
been seriously ill in the Vancouver General Hospital. While in Japan
recently, acting as ship's surgeon on the "Empress of Asia," he contracted dysentery, and for a time on the return voyage to Vancouver,
his condition was regarded as critical.   He is now progressing favourably.
Dr. Lyall Hodgins has recently returned after a month spent in
visiting Rochester, Minn., Chicago, and Toronto.
Dr. D. D. Freeze has been enjoying—as you were, this is not the
Tonics and Sedatives department—enduring, we should have said, enforced leave of absence, at Okanagan Mission, for a fortnight, Olecranon
bursitis was the predisposing condition. This would have been alright,
we understood Dr. Freeze to have stated, had the surgeons not seen it
and taken it seriously.
Dr. A. B. Schinbein enjoyed two weeks' holiday at Jasper and
Kelowna recently, golfing and/or resting.
Page 25 Dr. A. S. Monro has left for Chicago to attend the annual meeting
of the American College of Surgeons.
As evidence of the wide recognition the work of a member of the
Vancouver Medical Association is receiving, requests have been received
recently, among others, from the Government of the Australian Commonwealth for Dr. C. S. MpKee's paper on red-water in cattle. This
paper, embodying the products of prolonged study and research, and
advancing towards conclusions of great economic importance, was published in the Bulletin last year.
It is noted that the description of the Canti film of the growth of
the cancer cell, published in the Washington State Medical Bulletin
after its exhibition recently in Seattle, is a faithful transcription of the
article which appeared in the Vancouver Medical Association Bulletin
reporting its exhibition in Vancouver last year.
Attention is drawn to the presentation, simultaneously with this
issue of the Bulletin, of drafts upon those members of the Vancouver
Medical Association whose dues are in arrears. It is requested that they
will be honoured with no delay.
While the Vancouver Medical Association may congratulate itself
upon the inviting appearance and comfortable furnishings of the Reading Room adjoining the Library, it appears necessary to point out emphatically that this room was not so arranged in order to encourage social
gatherings. It is intended solely for purposes of study, and not as a
lounge or common-room. The golden tones pervading its decorations
should be regarded as intentionally suggestive.
1                 rill!
MJII
LEADERS IN BRITISH MEDICINE
Lord Dawson of Venn
Naturally the meeting of the British Medical Association at Winnipeg in August, 1930 wil lbring to the city, men who are not only
known internationally as men of science but whose names are household
words in the old land. Chief among these notable figures is the King's
physician, Lord Dawson of Penn, who will be President of the Section
of Medicine.
The son of a prominent architect, Bertrand Dawson was educated
at University College and the London Hospital where Sir Frederick Treves
was one of his teachers; he received the M.D. degree in 1893, and became
Assistant Physician to the London Hospital 1896, and Physician in
1906. He is also Consulting Physician to King Edward Seventh Sanatorium, and Royal National Hospital for Consumption at Ventnor,
member of the Senate of the University of London, and President of
the Royal Society of Medicine. The Universities of Pennsylvania,
Oxford, and Edinburgh have granted him honorary degrees.
Page 26 It is, however, as the King's Physician that he is best known. His
Majesty's recent and serious illness with so happy a recovery served to
focus attention on his medical advisers. At first Physician Extraordinary
to King Edward Seventh and to His present Majesty, he was created
Physician-in-ordinary to H. M. the King in 1907, and to the Prince of
Wales in 1923.    In 1920 he was created First Baron of Penn.
In 1890 he married the youngest daughter of Sir Alfred Yarrow,
head of the great Clyde shipbuilding firm. There are three daughters in
the family.    Lady Dawson has received the Order of the British Empire.
The list of his medical publications is long and varied. His professional qualifications added to a charming personality make him an outstanding figure in British Medicine.
NEW BOOKS IN THE LIBRARY
Old Masterpieces in Surgery By Dr. Alfred Brown
Mayo Clinic volume XX	
Proctology  F.  C.  Yeomans,
Urological Roentgenology Young & Walters
Vols. 3, 10, 12 and 15 of the American Medical History of the War	
Dean Lewis' Surgery Vols. 1, 2, 6, 8, 9, 10 and 12
• International Abstracts of Surgery ;	
Surgical Clinics of North America Vol. 9, Nos. 3 and 4
William Harvey  By  Archibald Malloch
Introduction to the Study of Physic William Heberden
Diseases and Deformities of Spine and Thorax Steindler
Arthritis and Rheumatoid Conditions Ralph Pemberton
Diseases of the Skin _•- Sutton, 7th Edition
Nutrition  Graham Lusk
Thrombo-angeitis Obliterans    Brown & Allen
Dictionary Modern English Usage  Fowler
Roget's Thesaurus  	
Crabb's English Synonyms	
Dictionary of Foreign Phrases jBIJones
Traumatic  Surgery         Forester
Diseases of the Liver and Gall Ducts Rolleston
Complications of Pregnancy Davis
Symptoms in Gynecology  Rubin
Pelvic   Surgery   CulbeTtson
Diseases of the Vulva. Taussig
Non-operative Gynecology  Gellhorn
Cum.: Supp.: and Composite Index to Gyn. and Obst. Monographs	
B. C. MEDICAL ASSOCIATION NEWS
The Annual Meeting of the B. C. M. A. for 1929, held in Vancouver at the Hotel Georgia, was an extremely successful one and
showed definite and gratifying progress in every department of its activity. The Association goes from strength to strength and the reports of
the various committees, showing the really immense amount of work
that has been done, give ample evidence of the benefit that organization
gives to the medical profession in B. C.
Page  27 It was an outstanding meeting, reminding one of the Victoria meeting by its smoothness of organization and the interest and enthusiasm
shown by all who attended—some 200 in number. It is particularly
gratifying that so many out of town men were able to come and
bring their wives and families. In this regard, the gratitude of the Executive is especially owed to those ladies who did so much hard work,
with such admirable results, in organizing entertainment for visitors.
Where so many helped so loyally it is perhaps invidious to mention names
but Mrs. Wallace Wilson, wife of our President, Mrs. Lyall Hodgins
and Mrs. Monro were particularly untiring and devoted.
Nor were the men neglected—a Golfing Tournament held at
Shaughnessy drew its quota—and in these days, when golf is so deservedly popular with doctors, that represents the great majority. Winners
in the event were presented with prizes at the Dinner which closed the
Meeting—Dr. T. R. B. Nelles being the first prize winner.
The scientific side of the meeting was extremely good. We were
fortunate in the fact that the Post-graduate Tour of the C. M. A.
(again thanks to the Sun Life Assurance Co. of Canada) coincided with
the date of our Meeting. The team was an excellent one and we must
congratulate them most sincerely on their choice of subjects, as well as
on the manner of their presentation. Every address, without any exception, was good—and the packed meetings must have shown the
speakers how much we appreciated their work. The personnel of the
team was as follows:
Dr. Geo. H. Murphy, Assoc. Prof, of Surgery, Dalhousie University,
Halifax.
Dr. K. A. MacKechnie, Assoc. Prof, of Medicine, Dalhousie University, Halifax.
Dr. Gordon E. Richards, Prof, of Radiology, University of Toronto.
Dr.  H.  B.   Van  Wyck,   Senior  Demonstrator  in   Obstetrics   and
Gynaecology, University of Toronto.
Dr.. Geo. S. Young, Assoc. Prof, of Medicine, University of Toronto.
Fortunately, too, Dr. A. T. Bazin, President of the C. M. A., Dr.
T. C. Routley, General Secretary and Dr. G. Harvey Agnew, of the
Dept. of Hospital Service, Canadian Medical Assn., accompanied the
team and it was delightful to have them. They brought the latest news
of medical progress and their visit was a stimulant and encouragement
to further effort on our own part.
Another visitor from the East was Dr. Ross Millar of the Federal
Health Department, who met the Association's Committee on Marine
Hospital and Medical Service. Much has been done along this line to
improve conditions of medical work in the Marine Service. Dr. Millar
explained the Act under which this is administered and the difficulties
his Department has had to overcome and it was very gratifying to find
that gradually the exploitation of medical men, that was formerly indulged in by hospitals concerned in this work, is being stopped by the
Federal Health Department, so that doctors doing this work are being
paid a fair fee for it.
Page 28 Following the Annual Dinner, the business programme of the
Association was carried through. The General Executive Meeting had
been held the previous day to expedite proceedings, and the reports of
the various Chairmen of Committees were presented at the dinner.
Dr. Wallace Wilson opened the proceedings by the delivery of his
presidential address.
He first sketched the history of the Association briefly, and showed
how steady its progress had been, owing mainly to the excellent work of
those who reorganized it in 1921. He paid tribute to the original
Executive who built such a solid foundation for the late S. Michue.
Today we have a membership of 405 medical men. This membership
is divided into those living in Vancouver and those from other parts of
the Province. The second group represents nearly 100% of the men
practicing outside of Vancouver and the first less than 50% of those
in Vancouver. This he considered a situation which should be remedied,
but he did not feel that it was due to lack of interest or enthusiasm,
but mainly due to the fact that Vancouver has a strong medical association of its own which largely satisfies the needs of its members.
In connection with this, however, he emphasized the necessity of a
strong provincial association which is necessary to do work that no local
association, however strong, can efficiently accomplish. He told how
friendlier and more intimate relations were being established between
the three medical organizations, namely, the College of Physicians and
Surgeons of B. C, the B. C. Medical Association and the Vancouver
Medical Association, by the taking of joint offices in the new Medical-
Dental Building. This, which is not in any sense an amalgamation,
would, he hoped, lead to the elimination of overlapping and the reduction
of costs, and, more important, to a greater possibility of discharging to
both the profession and the public the duties which they owed them.
He reminded the audience of the Winnipeg meeting of the British
Medical Association to be held in 1930 and strongly urged as great an
attendance from B. C. as was possible.
Dr. T. C. Routley then spoke upon "More Medical Organization,"
in a very concise and complete manner. He gave a summary of the work
of the C. M. A., showing what a really great amount of work is being
done by this body, to the advantage of the profession primarily, but also
very greatly to that of the public of Canada. He described the formation of the Royal College of Physicians and Surgeons of Canada,
which is one of the greatest advances which has been made in medical
matters of recent years. It is a matter for some pride that Canada is no
longer to be tied to the leading strings of other countries in the matter,
of having her own hallmarks for medical qualifications.
Perhaps the most important item in Dr. Routley's speech was his
explanation of the arrangement that had been entered into between the
C. M. A. and the leading insurance companies in Canada. This will be
put into force in January, 1930. Dr. Routley described very fully the
arrangement which is briefly as follows: The clientele of these insurance companies will, in blocks of so
many at a time, be offered, free, a complete medical examination. It
will be made clear that this is in no sense for the insurance companies'
benefit, either as a check on the health of the client or to obtain knowledge of his insurability. The examination will be made by any doctor
that the client selects, and pains will be taken to have him choose his
family doctor. This examination will be made on a form provided by
the C. M. A. or on any form that the doctor chooses. It will be entirely
confidential between the doctor and his patient and no account will be
given either the Canadian Medical Association or the Insurance Company,
except that, at the end of a year or some such period, the doctor will be
asked to render a summary (with no names) giving the number of
conditions that he finds present in the patients he has examined. This
is for statistical purposes only, and the promise that no capital will be
made of these examinations will be honourably observed by all parties
concerned.
At the conclusion of this address, Dr. Routley asked for an expression of opinion from the Meeting as to endorsement of this plan.
On due motion, unanimous endorsation was given to the proposed plan of
periodic health examination.
Dr. G. L. Hodgins read his report as Secretary-Treasurer and presented the Auditor's Report. Copies of these can be seen on file at the
office, but Dr. Hodgins also was able to report steady and continuous
progress. He paid a tribute to the post-graduate tours of the C.M.A.
and pointed out that the attendance in B. C. was the highest in any
Province.
The report of the Legislative Committee by Dr. M. W. Thomas
was one of great interest and reviewed the activities of the Association
during the last session of the Legislature, when various measures were
brought before the House, some of them more or less pernicious in character. The Committee working with the College of Physicians and
Surgeons of B. C. was able to do good work in influencing the treatment
accorded to this suggested legislation.
As a result of interviews with the Attorney General and the Police
in Victoria, consent has been given to the issue of a block of motor
licenses for Doctors' use only. The numbers from 20,000 to 20,999
will be reserved for this purpose and all numbers will be procured direct
from Victoria.
Dr. Routley said that this custom was observed in Toronto, Ont.
and was being found of very great value to the medical profession.
The Meeting passed a resolution, asking the Legislative Committee to
carry this to a conclusion so that plates may be obtained for the coming
year.
The report of the Constitutional and Credentials Committee was
presented by Dr. W. T. Ewing, together with the names of 36 new
members.
The next report, that of Dr. J. W. Arbuckle, Chairman of the
Ethics and Discipline Committee, gave rise to a good deal of discussion
when he referred to the question of consultation between medical men
and duly licensed osteopaths.    The College of Physicians and Surgeons
Page 30 had ruled in a given case that such consultation was within the rights
of the medical men but it was apparent that the meeting did not agree
that it was ethical to do so. The matter will be further considered by
the Ethics and Discipline Committee.
The report of the Industrial Service Committee was read by Dr.
J. H. MacDermot and showed that a great deal of good work had been
done during the year in the way of improving the condition of medical
practice throughout the province and a survey had been made of all contracts and brought up to date, showing that in most cases conditions
had been greatly improved. Many of the big industrial companies
make a habit of referring to the B. C. Medical Association when require-
ing medical aid and this enables us to secure equitable arrangements for
medical men. Dr. MacDermot quoted many cases and he also referred
to the question of locum-tenens work which keeps the office of the B. C.
Medical Association constantly busy.
He then discussed fully the subject of Health Insurance with the
conclusion arrived at by the Executive in considering what principles
should form the basis of any discussion that we may have with the
Commission of the House appointed to investigate this matter. He
appealed for unanimity of action by the profession and asked that individuals refrain from delivering suggestions to the Commission if such
opportunity should arise during the sittings of the latter, since all expressions of opinion should come from one Committee appointed to speak
for the Association. Each Branch Organization had been circularized
to this effect and if any medical man is anxious to be informed further
as to the conclusions of the Health Insurance Committee, such information can be obtained from the secretary of the local branch.
The report of the Publicity and Educational Committee was also
read, outlining the work of the year.
Dr. Munro, Chairman of the Historical Section, gave a most interesting report of the work of his section and Dr. Bazin, President of
the C. M. A., asked that copies of any work prepared by this Committee, be furnished to the Journal.
The  following  gentlemen  were  elected  to  office   for  the  ensuing
year:
Dr. W. A. Clarke, President.
Dr. G. L. Hodgins, President Elect.
Dr. W. J. Knox, Vice-President.
Dr. W. T. Ewing, Secretary-Treasurer.
Dr. F. W. Green
Dr. Alan Beech       ^Members of the Executive
Dr. W. C. Bissctt
BOOKS AND THE PROFESSIONAL MAN
An address delivered before the October Meeting of the Vancotiver
Medical Association by John Ridington, Librarian,
University of British Columbia.
Books, like so many things we accept casually as part of the ordinary
and expected equipment of life, are in reality wonderful, indeed, well
nigh.miraculous things.    They abolish time, they annihilate space.    They
are the supreme symbol of civilization.    The world, as we of this genera-
Page 31 tion know it, would be impossible without the printed page. If, by
some unthinkable calamity, the world of print were to be swept away,
there would be at one stroke destroyed the foundations of human progress. For civilization is a many-storied structure, to which each successive generation adds something of height and stability to the work of
its predecessors. Mankind has a deep-seated, universal urge to perpetuate
his aspirations, his accomplishments. In older days, they were carved on
monoliths or entablatures of temples, written on papyrus or skin, hewn
into totems, cast into enduring bronze, or transcribed on vellum. But
when, some 450 years ago, Gutenberg superseded the old block book
(itself a notable advance) by the invention of moveable type, civilization commenced to leap forward. It was not necessary to travel to Paris
or to Padua, to Seville or to Oxford, to personally hear famous teachers
expound the lore of the past, the life of the present, the hope of the
future. The printed page brought the thought of the distant and of the
past to one's own fireside. Just as the invention of gunpowder abolished
the age of chivalry, by making the owner of a flint lock musket more
than equal in combat to the armoured knight, so Gutenberg's invention
democratized knowledge, making it no longer the prerogative of the
few, but the privilege, the right, of all.
This is an age of marvels. In the world of mechanics what amazing
things we see—and hardly note. We are so accustomed to them—we
accept them as matters of course, without wonder, without surprise,
almost without interest.
The indomitable, unconquerable spirit of man has subdued Nature
to his will. He has probed to the heart many of her secrets and her
mysteries. He has made countless practical applications of his discoveries, inventing amazing mechanical and electrical devices that enlarge his
life, multiply his effectiveness and minister to his comfort. Much of this
has been accomplished within the lifetime of men now living. In science
and invention marvels crowd on us so fast, and so thick, that we are in
danger of losing all sense of wonder—and with it much of delight.
How were these miracles accomplished? Largely by reason of the
fact that all the resources of the human mind and spirit, from the very
beginning until this latest day of time, are open store-houses and treasuries to whoever desires to utilize them for purposes of further progress.
Knowledge is specialized, organized, modified, co-ordinated, and, more
important still, it is available to every seeker. The rich records of the
past are very various in their forms, but of all these records none can
vie with the printed page in importance and universality. The photograph and phonograph and the radio amuse and amaze us with their
wonderfully ingenious modern modifications, but none of these promise
to supersede the printed page as the supreme record of mankind, alike
for permanence of preservation and widespread diffusion of knowledge.
If it were conceivable, all the splendid trophies of man's civilization
might be destroyed, but all could be recreated, if only the records, the
printed page, were preserved. Every man's present is built on his past;
take away his memory, he is adrift without compass or chart on a shoreless sea.    As with the man, so with the race.    We are what we are be-
Page 32 cause of what our ancestors have thought, and felt, and done. The more
widespread, the more universal mankind's knowledge of the past, the
greater assurance we have of the certainty, the direction of his future
progress.
So, ever since the accumulations of human effort and accomplishment became apparent and notable, there have been some who conserved
the capital stock of the race by preserving its records. Ever since books
became the principal record and repository of the race's labours and
triumphs, collections of such records—libraries—became part of every
centre of learning and culture. Some of these collections are stupendous
in their volume and scope. Think of the magnificent collections of the
British Museum or the Bibliotheque Nationale—the later has nearly
5,000,000 books. Its catalogue is a library in itself—over 200 volumes.
Think of the Library of Congress, with over 3,000,000, and the really
amazing service it gives, not alone to American, but to scholars everywhere. When I compare the national library of the Republic, and what
it is doing, with that of our own Dominion at Ottawa, and its complacent futility, as a Canadian I am ashamed, and as a librarian I am enraged. Think, too, of the splendid and growing collections of books
owned by many of the American universities, headed by Harvard and
Yale, each with over 2,000,000 volumes. The 72,000 books owned by
our own University does not seem so very important by comparison. Yet
it should be remembered that Harvard's magnificent library was started
by the bequest of the personal library of its founder, Rev. John Harvard,
190 years ago, and that it amounted to only 300 volumes. Perhaps,
after another such period of time has elapsed, our own resources of
knowledge, as represented by books, may be as great, or even greater.
They certainly will, if British Columbians of this and succeeding generations realize, as did and do the citizens of Massachusetts, that knowledge
is power, and that he who makes possible the enlargement and diffusion
of knowledge is the best of benefactors.
It was this realization that founded the great libraries of the world,
from that of Alexandria, over the portal of which was carved the
legend, "Medicine for the Soul," and the destruction of which by Julius
Caesar in the great fire that consumed the Egyptian city, nigh two thousand years ago, caused gaps in our knowledge of the world's history that
probably can never be filled, to the last and least of the modern libraries
supported by municipal taxation. And when, in the long evolution of
social progress, political power was taken by the people to themselves,
when privilege and aristocracy were dethroned, and democracy rose ascendant, it did not take long for its leaders to realize its dangers, as well
as its opportunities. Power of any sort is to the wise a responsibility
as well as a privilege, but in the hands of prejudiced, passionate ignorance,
it frequently becomes a menace. When the first Reform Bill was passed
in England, the old Duke of Wellington, conqueror of Waterloo, said:
"My lords, we must now educate our masters!" So the common school
was founded, as the best means by which the State could insure its
safety under democratic conditions.
Every created appetite seeks means of gratification. It became obvious that a child taught to read would demand books.    The most econ-
(Continued on page 38)
Page 3 3 YOU.. .
as a physician . . . would not prescribe proprietary medicines of unknown formulae.
WE . . .
as pharmacists . . . fully co-operating with the
medical profession ... do not even stock
these items.
This  policy  was  introduced  threi
years  ago  by Canada's  First  Exclusive Prescription Pharmacy . .
namely . . .
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Scarlet Fever Toxin
Tetanus Antitoxin
Anti-Meningitis Serum
Anti-Pneumococcic Serum (Type 1)
Anti-Anthrax Serum
Normal Horse Serum
Smallpox Vaccine
Typhoid Vaccine
Typhoid-Paratyphoid Vaccine
Pertussis Vaccine
Rabies Vaccine (Semple Method)
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GONNAUGHT LABORATORIES
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MACDONALD'S PRESCRIPTIONS LIMITED
Medical-Dental Building Vancouver
<M"I British Columbia Laboratory Bulletin
Published irregularly in co-operation with the Vancouver Medical Association Bulletin,
in the interests of the Hospital, Clinical and Public Health Laboratories of B. C.
Edited by
Donna E. Kerr, m.a., of The Vancouver General Hospital Laboratories
Financed by
The British Columbia Provincial Board of Health
COLLABORATORS: The Laboratories of the Jubilee Hospital and St. Joseph's Hospital,
Victoria; St. Paul's Hospital, Vancouver; Royal Columbian Hospital, New Westminster;
Royal Inland Hospital, Kamloops; Tranquille Sanatorium; Kelowna  General Hospital;
and Vancouver General Hospital.
All communications should be addressed to the Editor as above.   Material for publication
should reach the Editor not later than the seventh day of the month of publication.
Vol. III.
NOVEMBER,  1929
No. 7
CONTENTS
A New Procedure for Syphilis Test Malcolm
"Kidney Function Tests," Direct and Indirect Matheson
A NEW PROCEDURE FOR SYPHILIS TESTS
Mabel M. Malcolm, Head, Bacteriology Division, V. G. H. Laboratories
The Vancouver General Hospital Laboratories propose certain
changes regarding laboratory examinations for Syphilis which are believed to be in the interests of better and more satisfactory results and
reports to the physicians of British Columbia. The reasons for these
changes are discussed below.
The Laboratories will be glad to hear from any member of the profession in B. C. who may have constructive suggestions for further improvements. The Kahn Precipitation test for Syphilis (discussed later)
has apparently so demonstrated its general superiority over the Wassermann that we have in mind the two following propositions, to go into
effect December 1, 1929.
Proposition 1. That the routine test for-Syphilis will be the
Kahn test. (Wassermann tests will still be available, but only by special
arrangement in each case).
Proposition 2. That routine reports on Kahn tests will take the
form only of Negative, when there is no precipitation; Doubtful, when
the reading is -j- * or -j-2, and Positive, when the reading is -\-3 or -4-4, as
the case may be. That is to say, all -j-1) H~2j etc, signs will be omitted in routine reports, and the plain statement made of the result, as in
other diagnostic reports. Physicians who wish details in any given case
may have them from the Laboratory on request. Wassermann tests will
be regarded in the established manner, i.e. —|—a, —f-2, etc., for each antigen.
The Kahn Precipitation test is a modification of several flocculation
reactions and is claimed, by its authors and many others, to be more
accurate, as well as more sensitive, than the Wassermann test. In the
complement fixation test (Wassermann) there are many reagents required, each one producing a possible source of error; these sources are
practically eliminated in the Kahn test, as the latter reaction requires
only one reagent (a beef-heart antigen).
Page 34 During the past five months we have made 5,300 Wassermann and
4,460 Kahn examinations, a total of 8,115 tests. Insufficient amounts of
blood and spinal fluid being received, in some cases, and three weeks during the summer holidays, when we were unable to run both tests,
account for the discrepancy in the numbers of Wassermann and Kahn
tests done.
We obtained the following results:
Number of Kahn tests    4,460
Number of Kahn and Wassermann agreements  3,655
Number of Kahn and Wassermann disagreements  805
This shows an agreement of approximately 82%. Of the 18%
showing disagreement all showed the Kahn test to be positive and the
Wassermann negative. We have not had an instance where a positive
Wassermann has given a negative reaction with a Kahn. In only three
cases out of the 4,460 tests, as far as we have been able to ascertain,
has there been a questionable result.
"KIDNEY FUNCTION TESTS"—DIRECT AND INDIRECT
J. E. Matheson, V. G. H. Laboratories
This is the second article on laboratory tests and their interpretation,
the series having commenced in the Laboratory Bulletin of August,
1929, with an article on Blood Sugar Determinations.
"JSidney Function Tests" is a name for those examinations that are
more or less direct tests of kidney function. The other tests are indirect
in that they only reveal the results of decreased kidney function.
Many tests have been devised to determine the functional abilities
of the kidney. Dye stuffs, first used, were criticised in that they were
abnormal constituents of the blood and that the kidney, even though
healthy, might not be able to handle such material.
So for the dye stuff was substituted urea, a normal excretory product of the kidney and the urea concentration test found wide favour.
This urea test, however, is only a measure of one of the many functions of the kidney. One function is to concentrate the urine. To
determine the ability of a kidney to concentrate the urine, Mosenthal
(1914) devised a plan for collecting the specimens under controlled conditions and over a period of time. He was able, thus, to ascertain the
amount of variation in many of its characteristic properties. The various constituents, normal or abnormal, in presence or amount, were
also determined. The variations in specific gravity were also noted.
The range between the night and day specimen was found to be between
10—20 in normal healthy people. In those with failing kidney function this range gradually narrowed, until the urine was very dilute and
and of a low fixed specific gravity.
Indirect. On the other hand we can determine whether or not
the kidney is functioning properly by examining the blood. It is
obvious that if the kidney is not functioning satisfactorily those waste
substances which it is supposed to excrete will gradually "pile up" in
Page 3 5 the body, more particularly in the blood which is the vehicle for these
waste products. The rate of production of the waste products and the
ease of their excretion both play a part in the rate of accumulation in
the blood stream. Creatinine, produced relatively slowly, rises slowly
with impaired kidney function, while urea, produced rapidly, rises relatively rapidly. The former is produced during body cell breakdown
or endogenous metabolism, the latter from the food ingested.
The following paragraphs give the main details of procedure for
these various tests.
The Two-Hourly Test. This test is a modification of the original Mosenthal in that less rigid restrictions as to diet are applied and
fewer examinations are made on the samples. The patient is on a more
or less ordinary diet. The urine is collected, one 12-hour overnight
specimen from 8 p.m. to 8 a.m. and thereafter every two hours till
8 p.m. the same day. The urine specimens are examined for volume,
specific gravity, albumin, sugar, and microscopic contents. No solid
food nor fluid is to be taken between meals or at night.
This test gives apparently earlier indications of kidney inefficiency
than other tests. The specific gravities should vary at least 10 points
and the volume of the night urine should be 750 cc. or less. The night
specimen usually shows the first change, specific gravity falling and
quantity rising.
The P.S.P. Test. The dye stuff is injected intramuscularly, 1 cc.
(only) containing 6 mgs. of phenolsulphonephthalein (the ampules
contain about 1.5 cc.) one-half hour after the patient has received 300
—400 cc. of water. The time of the injection is noted. At this time
also the patient voids. One hour and ten minutes after this injection
the patient again voids, and also at two hours and ten minutes later.
On these two samples the determinations are made to ascertain how
much dye has been excreted. The normal range is 40%—60% in the
first hour, and 60%—85% by the end of the second hour. The amount
of dye excreted is independent of the quantity of urine. If one desires
to test the function of each kidney separately, ureter catheters are used,
the examination being otherwise as for the bladder specimens, namely,
to the samples of urine one adds 25% NaOH till a maximum intensity
of color appears and the sample is then diluted to 1,000 cc. with water.
This dilution is then compared with a standard containing 3 mgs. of
P.S.P. per 1,000 cc.
The Urea Concentration Test. This test consists in giving
the patient a known quantity of urea (15 gms., dissolved in 100 cc. of
water) immediately after emptying the bladder. The bladder is again
emptied at the end of an hour. Two hours after the patient received
the urea the bladder is again emptied and the urine examined for urea
content. (In routine work the sample taken at the end of one hour is
discarded as it is usually greatly diluted, the urea having had a diuretic
effect on the kidneys). The higher the concentration of urea the more
efficient the kidney—above 2% being considered a good result.
The tests mentioned so far are those of a positive or direct nature,
but there are also the indirect tests of kidney function. These are those
examinations of the blood which give evidence of kidney failure.    The
Page 3 6 increase above normal of certain waste products in the blood, as determined by the laboratory examinations, is a rough measure of the
degree of kidney dysfunction.
Among these are the N.P.N., Blood urea and Blood creatinine. I
mention these as they are the routine examinations done at the V. G. H.
Laboratory. The N. P. N. of the blood is roughly double the blood urea
nitrogen and ranges around 35 mgs. per 100 cc. of blood.
As mentioned before, creatinine, being more readily handled by the
kidney and occurring in much smaller quantities than urea, shows no
rise in the blood till there is relatively marked kidney damage. So a
creatinine blood determination is not indicated in a case showing an
average two hourly examination or an N.P.N, under 60. The normal
creatinine blood content ranges between one and two mgly. per 100 cc.
of blood. Over five mgly. indicate a grave prognosis not far hence in
chronic cases. An acute rise in blood creatinine may be found in acute
cases where it has not the same grave significance. N. P. N. blood
values may go as high as 400 mgs. in severe nephritis with uremia.
The urea nitrogen of blood normally varies between 10—15 mgs. per
100 cc. High values (30—40 mgs.) are found in early nephritis but
extreme urea retention may occur in acute and chronic nephritis as well
as in other conditions associated with renal damage,—intestinal obstruction, prostatic obstruction, bichloride poisoning, etc.
Summary. The two hourly examination gives a fair comparative
result of the kidney function, and is the first examination that should
be done. If any deviation from normal is found, then further examinations are necessary.
Using P.S.P. one can then determine, to a further degree, the efficiency of the kidney. This test can be adapted for the appraisal of one
or both kidneys. If any deviation from normal is found in either of
these two tests, a more definite idea of the degree of kidney dysfunction
can be obtained from an N.P.N, determination of the blood.
A blood creatinine determination is not indicated in cases with
normal two hourly results or in those cases showing an N.P.N. under 60
mgs. per 100 cc. of blood. If done, and found to be over 5 mgs. prognosis is extremely grave, in chronic cases indicating complete kidney
failure not far hence, and in acute cases indicating the severity of the
lesion.
In these examinations as with all other clinical laboratory examinations the results are only comparative. Certain results have been
found in a large group of normals and other figures obtained in various
pathological conditions. So we have come to recognize the relation between diseases and changes as demonstrated by laboratory tests. This
holds true also in nephritis. The non-protein nitrogen figures, for example, are not absolute and are only of value in that they indicate, when
raised, the degree of kidney damage. This is because the identifiable
"non-protein nitrogenous compounds" of the blood which can be determined at the present time constitute only about one-half the total
non-protein nitrogen of the blood. This fact does not detract in any
way from the clinical significance of the relative results obtained.
Page 3?
■F** {Continued from page 33)
omic way to meet that demand was by a public co-operative service, the
cost of which should be equitably distributed among all whom the service
is designed to serve. In the early days of a community each citizen dug
his own well in his own backyard, but considerations alike of health and
convenience soon necessitated a public water system. Our property is
better protected by municipal fire brigades and police systems than by
our own vigilance. So with books, co-operation means extension, efficiency and economy. Few citizens could buy for themselves all the
books they wanted, whereas, by the levy of a very small tax, any community could acquire, maintain and administer a book collection that,
for information and for recreation, would serve the needs of all. It
began to be recognized that the public library was an integral part of
any system of public education, and that, in developed intelligence, in
industrial efficiency, in professional proficiency, as well as in those higher
pleasures of imagination and inspiration, it paid excellent dividends on
the investment. A reading community is a more intelligent, and, other
things being equal, a happier and more progressive community than one
which does not appreciate the use and value of books. I am not sure
that the patronage of its libraries is not a surer and safer index by which
to judge a city than are its bank clearings, its shipping tonnage, or its
lumber cut.
Two things grew out of the movement to establish libraries. One
was a backwash, so to speak, of reform into the schools. It started at
the beginning of the century in American cities, but here in Canada it is
only now receiving its initial impulses. Sometimes I am inclined to
think that teaching is the most reactionary of professions. Whether this
is so, or whether it is not, it would appear to be natural and logical, seeing that ninety per cent, of our future Canadians do not pursue their
formal education beyond the age of 15, that teachers, and superintendents
and inspectors, and school boards, and education departments, should
realize the value of early training in the use of books, and install suitable
reference libraries in all schools. But teachers and scholars alike were,
until recently, slaves of the text book; and, even today, speaking broadly,
only a few, even of our city schools, are properly equipped in the matter of school libraries. It cannot, I think, be denied that the man who
quickly and with certainty can secure desired information from a collection of books has a distinct advantage over one who cannot so acquire
the knowledge he needs. In American city schools, the library is as much
a part of the educational plant as the desks and the blackboards. A study
hall and reading room would no more be left out of the architect's
plans for a city high school than would a locker room. There are
12,000 high school librarians in the United States. How many are there
in British Columbia—in Vancouver? The enormously increased patronage of American public libraries is largely due to the fact that in his
school days the American youngster develops the reading habit, establishes contacts with libraries, and uses them, to his combined profit and pleasure, not alone during school days, but throughout life.
The second development in the library field was inevitable as the
advantages—the necessity—of the new educational services became appreciated.   Development, in an institution as in an organism, means spec-
Page 3 8 ialization. Your own profession affords proof of this. The backbone of
medicine is still, of course, the general practitioner, but almost as soon
as the science emerged from the empirical stage, and surgery became dissociated from the noble craft of barbering. its personnel began to divide
according to interests and aptitudes. So dentistry became a special profession, and oculists and aurists and diagnosticians, dermatologists, neurologists and pediatrists,—and doctors alone know how many other kinds
of specialists in how many obscure forms of disease. And then there
are whole armies of people, sternly frowned on by you gentlemen, and
occasionally prosecuted by medical societies (in the public interest, of
course), who also claim the right to practise the healing arts for fee
and financial reward—osteopaths and chiropractors and a host of others
—all accepted as specialists by some other practitioners, or making
claims as such on a public they hope will give them their income.
The specializing process entered the library in good earnest about a
half century ago. Prior to that time, the librarian took for his motto
the saying of old John Wesley "The world is my parish!" He collected
books irrespective of their subject. All was fish that came to his net.
Today librarians are—have to be—much more discriminating. None
but those of the largest income, or possessing, as do Oxford, Cambridge,
and the Library of Congress, the privilege of copyright, can hope to
sally into the markets, and triumphantly bring back all the spoils of
knowledge as represented in books. The field is too vast, the tide of print
too strong, too swift. Germany, for instance, published over 31,000
books last year. Britain has for many years run a good second, but last
year she had to give way to Japan, which published 20,000 volumes.
Last year she printed 13,810 volumes. After Britain comes France,
with almost 12,000 new books, and a little further down the list the
United States, which printed 10,153 titles. It may surprise you, however, as it did me, to find that the world's premier publishing honors go
to—Russia. A year ago, the land of the Soviets printed 36,680 books,
four for every one published in the United States, almost treble the titles
issued in England!
Solomon, in his day, complained that "of the making of books there
is no end." What, I wonder, would the poor king say to the flood of
print that today inundates and overwhelms us? The year before last,
160,000 new books were issued in 17 of the countries of the world. The
total publications—which of course do not include periodicals—must
amount to over a quarter of a million a year.
Apart from the unbearable expense involved in any successful effort
to keep abreast of the ever-increasing and ever-onrushing tide of print,
there is another reason to account for the rapid development of special
libraries. Their field being smaller, it can be cultivated the more intensively. Having a clearly defined area of operation, it can rely on
financial support from those it directly benefits. Its members realize
they get full value for whatever it costs them—indeed, such a library is
in truth a very real economy, for otherwise its subscribers would have
to personally pay many times the library's annual assessment, and then
get but a fraction of the necessary professional information it gives.
The lawyers were among the first profession to establish special
libraries of their own.    The example set in Europe where the gentlemen
Page 39
5*S5S of the long robe put a legal reference library into every Court of Justice
—they usually got its cost from out the taxes—was followed in every
state in America and province in Canada. Most of you, I expect, have
seen the excellent law library in the Vancouver Court House, and the
equally excellent one at Victoria. The court houses at the various
judicial centres of British Columbia have similar, but of course much
smaller collections, for judicial and legal consultation.
Theology, of course, had its libraries ever since—and before—books
were printed. Implicit faith in the printed word seems to be a characteristic of some of the divines in ancient seats of learning—at least one of
the librarians at Cambridge assured me that Saturdays were rather busy
days—the parsons came in to borrow books of sermons for their Sunday
services!
But it is only since the beginning of this century that specialization in the library field has assumed astonishing proportions. Several great
special libraries are of course of older date—the Surgeon General's great
library of medicine at Washington, the John Crerar library of science
and medicine at Chicago, the Newbery library of history and literature
in the same city, the libraries of historical and other societies, and of
governments, such as our own fine collection of North West Americana
at Victoria, or the John Ross Robertson collection in the Toronto Public
Library. But, abut 1900, all sorts of people—some of them the most
unexpected—seemed suddenly and simultaneously to realize that properly
organized and administered collections of printed material, arranged for
speedy and accurate reference, might take much of the guessing out of
business, and pay substantial dividends,—in time, in money, in certainty
and satisfaction—on their cost. The railways were among the first—
the Bureau of Railway Economics has 140,000 volumes in its own building at Washington—and this does not touch technical or engineering
problems, or problems of law, which are cared for by the libraries of the
Inter-State Commerce Commission and the Engineering Society. Banks
and insurance companies, telephone, gas, electric railway and oil companies, automobile manufacturers, makers of zinc, iron, steel, aluminum
and other. metal wares—makers of everything from aeroplanes to ice
cream, from rubber goods to roller bearings, from duco to cantilever
bridges—every conceivable activity and industry and branch of research
has come to rely on the printed record, collected and arranged in referable form—the library—as a time-saving, money-saving, essential department. There are some 12,000 such libraries in the United States
alone. Some of them have as many as 400,000 items in their collection.
The librarians of these have formed a special professional association,
quite distinct from, though in complete co-operation with, the American
Library Association, and a glance at the programmes of their annual,
regional or local conferences would be an eye-opener to most people as
to the range of their work, and the importance of its proved results.
This association publishes a professional periodical, wholly devoted to
the interests of its work. It is called "Special Libraries," and is now in
its twentieth volume. I have a file of it before me as I write, and I
am sure Dr. Bastin and Miss Firmin, as well as myself, will feel envious
at some of the reports. The first I glanced at stated, "Our book allowance is almost unlimited, and we purchase all the important books and
Page 40 periodicals related to the various research work being actively carried
on.
"Regardless of a very crowded condition at present," says another
report, "we aim to purchase all important literature in the special fields
of chemistry, chemical technology and related subjects." "The Library
is regarded," the same report says elsewhere, "as one of the most important departments, and is accorded all the privileges that pertain to such
a recognition." There is no doubt whatever about it—the special library
is an active force, not alone in the academic and professional, but in the
industrial and economic life of our times.
I would like, before closing, to say somewhat in regard to the professional library, as related to the various branches of medicine. Fundamentally, a medical library has the same economic basis as the public
library. It exists because a hundred men, let us say, who each contribute
$10.00 a year, can buy $1,000.00 worth of books and periodicals that
will keep them abreast of the developments in the different branches of
their profession. Each saves money by this co-operation, at the same
time that a much wider range of information is made available to all at
a mere fraction of the cost. Professional skill and professional standing
are thus both advanced, professional inertia overcome, professional esprit
de corps stimulated, and—as important as any of these considerations—
the public welfare served.
In medicine, as in life generally, books take a doctor into a larger
world. If a doctor had to rely on his student and hospital training, and
such subsequent experience as came to him through the practice of his
profession, he would be baffled and bothered, alike in diagnosis and
treatment, by every new case presenting to him new, puzzling and ap-
parendy contradictory symptoms. Few sciences or arts have made more
rapid progress in recent years than have medicine and surgery. Discoveries, almost as epochal as those of Harvey and Pasteur, are from
time to time reported from the great centres of research, where the
endowed foundations are constantly warring against disease and suffering.
We all acknowledge that every man is a debtor to his own profession. Since by it he lives, he owes to it the obligation to be as well informed, as skilful, as time and circumstances permit, and to keep himself
abreast, so far as is possible, of its improvements and developments. I
do not know whether or not such an obligation is included in your Hip-
pocratic oath, but I am sure that you will agree that this understanding,
this undertaking, is part of the ethics of every worthwhile profession.
It is part of the unwritten contract that every doctor makes with his
patients,—it is the reasonable and proper expectation of the general public, which has given to your profession a legal monopoly to practice the
arts of healing.
It is almost a quarter of a century since the medical men of Vancouver united to organize a medical library. It is a personal pleasure
to me to know that there is a living link btween your library here, and
that of the University. One of the prime movers in the establishment
of your medical library was my good friend, Dr. Pearson, and he, for
two years, was chairman of the Library committee of the Senate of the
University. In that capacity, he presided over the joint meetings of
the Senate and Faculty Library committees, so long as they were held.
Page 41
as I congratulate him, and his early associates, on the splendid developments from the small beginnings of 1905. I congratulate your Association on the fine and roomy quarters the Library now occupies in its new
home. I congratulate myself, as one who may at some future time—may
it be very distant!—be a patient of one of you, that you have available
here such a body of proven, accurate data to guide you in your treatment of my own case, shortening the duration of illness, and reducing
what, in any event, will probably be, for a poverty stricken librarian, a
formidable fee. Wasn't it Rochefoucauld who cynically defined a doctor
as "a person who poured medicine, of which he knew little, into a body
of which he knew less?" The reproach is no longer deserved or just.
It is true that there are still great problems to be solved, vast stretches
of undiscovered country in the realm of medicine to be explored. The
significant and traceable reactions that are the bases of laboratory diagnosis are not yet fully understood, though what has been learned has
been of widespread benefit to the race. There is a good deal yet to be
known about the functions of the ductless glands. We have hardly
started to make progress in our fight against cancer. The significance
of the obscure chemical reactions involved in metabolism, in their relation to health and disease, is only beginning to be appreciated or understood. In these and other directions, there is still much to learn—
more than enough to justify the endowment of great medical research
foundations, to stimulate every medical man who appreciates the value
of research. But much-has been accomplished, much gained, and medicine and surgery were never on so sure a basis of proven knowledge.
In all but the rarest cases, the causes of physical ailments are positively
identifiable, and the percentage of their removal and cure is increasing
with the passing of the years. The span of life is lengthening with each
decade. Public education as to sanitation and infection is removing
risks that every day threatened the health and lives of our grandfathers.
All along the line, progress can be reported. The future is brighter even
than the present, for there is no finality to human;progress, or to that
of science. Every discovery that has conquered disease, mitigated pain,
and lengthened life in the past is an assurance, ^a guarantee, of newer
conquests in days to come. No profession dedicates itself more wholeheartedly to the service of its high aims than does medicine; none numbers in its ranks students more brilliant or more devoted. Their discoveries are not for their own profit, but for the relief of suffering
mankind. The honourable esteem of their colleagues, te gratitude of the
recovered sick, are often their only rewards.
As I have said, the necessity of keeping abreast of the discoveries of
medical science is regarded by most doctors as part of the obligation
they owe to their profession. The younger men—indeed, many with
successful and established practices—regularly plan to take at intervals
special courses at some famous clinic or centre of medical education, in
that particular department of work in which they are professionally interested. The popularity of the clinics organized annually by this
Association, at which distinguished visiting doctors and surgeons lecture and demonstrate, the interest taken, the attendance, are proof that
the medical men of Vancouver are keen to seize opportunities to gain
additional professional knowledge and skill.
Page 42 But not all doctors can spare the time, or the money, to take special
courses in Vienna, Paris or Edinburgh, or even New York or Chicago.
The names of famous doctors and surgeons rarely appear in the columns
of the "Province" as visitors to Vancouver—they are too much in demand in their own cities and countries. Nevertheless, it is possible to
keep abreast of the general advance in medicine and surgery, and of the
progress in any particular department therein, without leaving this
city, and sacrificing time that can ill be spared from income-producing
purposes. The means by which this can be done are just around the
corner from this hall in which we are meeting—your Association's library.
Medicine has a tremendous literature. Colonel Fielding Garrison,
that most indefatigable of medical bibliographers, said: "The ctirse of
recent medicine is the gigantic, senseless proliferation and prolixity of
of its periodical literature. It has been the despair of librarians, the
enslaver of indexers, the bugbear of editors." So vast are the volumes
dealing with various aspects of medical science, and so numerous are the
periodicals devoted to the generalities and specialties of medicine, that
another great medical bibliographer, Dr. Fletcher, once wrote in despair,
"The whole world is in a conspiracy against medical bibliographers."
Do you know that there are more than 2,000 medical journals today
being published? Only three of the medical libraries in America, such
as the great Surgeon General's Library, receive more than 1,000. There
are eight receiving more than 500, and 20 subscribers to more than 3 00.
Miss Firmin tells me that your own library subscribes to 65 medical and
surgical periodicals, that this Association spends each year about $800.00
for these, and between $400 and $500" for books. These annual investments in professional knowledge will in time give to your library characteristics of distinction, and in the meantime these expenditures are
doing valuable—indeed, invaluable—service; in keeping the medical men
of the Lower Mainland in the main streams of modern medical progress,
and preventing their being stranded by eddies and backwashes.
And, even if your funds cannot afford to subscribe to more than
one in thirty of the journals presumably published in the interests of
surgical and medical progress, the seeker after knowledge, however, eager
and thirsty, can find means of gratification in these monumental works,
the Index Medicus and Quarterly Medical Index. Every doctor—indeed,
every one of his patients—owes a debt of gratitude to Dr. John S.
Billings and Dr. Robert Fletcher, who just 50 years ago started the publication of this great catalogue. It has bankrupted two successive publishers, but its present and future are now assured, for the Carnegie
Institute of Washington has underwritten the enterprise. I regard such
financial guarantees, given in order that the benefits of research may be
world-wide, as the most enlightened philanthropy. It makes available
at every medical library subscribing thereto not only the results of researches by the Rockefeller, and other great medical endowments, but
of laboratory research, wherever undertaken, of the great clinics, and of
hosts of specially interesting cases arising in private practice. In conjunction with another monumental medical bibliographical work, "The
Catalogue of the Surgeon General's Library"—which I am glad to see
Page 43 you possess complete—you already own the basic material for medical
book enquirers, while your book collection, though by no means the
largest of the nine medical libraries in Canada, is of respectable proportions, is growing (though slowly), and appears to be already of sufficient
size and authority to competently answer many of the questions you
gentlemen of the stethoscope and the probe may address to it.
Various matters have prevented my completing this paper on the
day I started to write it. Necessarily, there is much different to that
which is here set down that I might have said. Necessarily too, much of
what is here set down might have been said better. The whole paper is
perhaps open to the criticism that it is an elaboration of the obvious.
But isn't it a fact that sometimes the obvious things are those we are
slow to see, and of which we need to be occasionally reminded? At any
rate, one to whom books have been lifelong companions and friends,
inspirers and advisors, may be pardoned for again emphasizing the fact
that they can be of invaluable assistance to men in their professional
work, much as they of course contribute to the personal pleasure of
every intelligent man and Woman.
I consented to write this paper for a number of reasons—not the
least of which was my lifelong conviction that it was my pleasure and
duty, as well as my business, to do all in my power to encourage the
reading of books, and the use of libraries. If I have reminded any of
you of the importance of supporting your Library Committee in enlarging, and thus extending the usefulness of, your own Library, I
shall feel amply repaid.
In pneumonia |
1  I Optochin Base
For the specific treatment of pneumonia give
2 tablets of Optochm Base every 5 hours,
day and night for 3 days. Give milk with
every dose but no other food or drink.
Start treatment early
MERCK & CO. Limited
412 St. Sulpice St.
Montreal
Page 44 INDOLENT ULCERS
when not due  to  specific  pathogenic  organisms become
largely a question of impediment of circulation
and faulty nutrition.
Antiphlogistine, applied hot, dilates the capillaries,
brings more blood to the area, stimulating thereby local
circulation, resulting in better tissue nutrition as well as
hastening the absorption of assimilable exudate. The
continuous moist heat generated and maintained by this
plastic, analgesic dressing is non-irritating and may therefore be applied over a long period of time with complete
absence of toxic action.
Antiphlogistine, containing 45% c.p. glycerin, can be
relied upon as a safe antiseptic agent, exerting a sedative
action upon the cutaneous nerves, promoting local metabolism, a marked phagocytosis, increasing the number
of red cells and stimulating granulation.
The observations of leading practitioners confirm the
fact that this procedure does much to shorten the chron-
icity and suffering in these cases, and that coupled with
"rest and elevation
serves   to   complete   the   cycle  of   the
successful treatment of indolent ulcers.
: The Denver Chemical Mfg.
Company
153 W. Lagauchetiere St., Montreal VANCOUVER HEALTH DEPARTMENT
STATISTICS, SEPTEMBER,  1929
Total  Population   (estimated)    228,193
Asiatic  Population   (estimated)    .. 12,300
Rate per 1,000 of Population
Total   Deaths     '.	
Asiatic   Deaths    '.	
Deaths—Residents   only   	
Male       187
Female    151
INFANTILE MORTALITY—
Deaths under one year of age . i       12
Death  rate per   1,000  births . I 35.50
Stillbirths   (not included  in  above) ; '.       7
Cases of Contagions Diseases Reported in City
182
9.70
10
9.89
338
18.02
August, 1929
;                                                     Cases Deaths
Smallpox          1 . 0
Scarlet   Fever         5 1
Diphtheria     22 1
Chicken-pox         1 0
Measles        4 0
Mumps         3 0
Whooping-cough          5 1
Tuberculosis      19 23
Erysipelas      _    5 0
Typhoid   Fever         0 0
Poliomyelitis           0 0
Meningococcus   Meningitis    ..0 0
September, 1929
Cases    Deaths
October, 1st
to 15th, 1929
Cases    Deaths
4
11
52
12
6
16
1
18
8*
2
2
2
0
0
3
0
0
0
0
14
0
0
0
0
0
5
33
6
0
5
3
11
2
1
0
0
0
0
0
0
0
0
0
1
0
0
0
THE INTERNATIONAL MEDICAL CLUB
A Society under this name has been formed in New York. It is a
tribute to the cosmopolitan character of the United States that the chief
objects of the Club are concerned with the establishment of contacts
between foreigners practising in that country and their foreign language
societies, with the native practitioners and native societies of the land.
Incidentally it will welcome foreign visitors, give introductions to
Americans about to travel abroad and promote relations with similar
societies in other countries.
The president is Dr. J. W. Maliniak. Among other officers we notice
the names of Dr. Einhorn and Dr. Albee. Dr. Richard Kovacs, 223
East 68 th St., New York, is the Secretary, to whom communications
may be addressed.
NOTICE
Doctors' books and records kept up-to-date.
Statements rendered regularly to patients.
For this service leave message at
Seymour 1896 or Douglas 578-R
J. C. DUNSTERVILLE
Suite 5, 884 Bute Street
Vancouver, B. C.
Page 45 Doug. 3406
1436 Harwood Street
PRIVATE HOSPITAL
Vancouver     -     B. C.
Overlooking English Bay
Specializing in
THERAPY WORK and DIETORY
(Visited by Qualified Physicians)
Patients can be visited in their own homes.
Non-resident patients treated.
Miss R. Backett, R.N.
Try It at Our Expense...
v "Return Coupon for Sample    /
Iearn for yourself how promptly out the irritation of inhalants
4 and effectively Swan-Myers containing menthol, thymol,
Ephedrine Inhalant, 1%, No. 66, eucalyptus, or other aromatics...
relieves the nasal congestion of Stocked by dealers in  1-ounce
colds, coryzas and hay-fever with- and 1-pint bottles.
THE WINGATE CHEMICAL CO., Ltd., 468 St. Paul St., West, Montreal
Send physician's sample Swan-Myers Ephedrine Inhalant, No. 66, to
Ac/dress. Say it with Flowers
Cut Flowers, Potted Plants, Bulbs, Trees, Shrubs,
Roots, Wedding Bouquets.
Florists' Supplies and Funeral Designs a Specialty
tMMU
Three Stores to Serve You:
48 Hastings St. £.
66$ Granville St.
151 Hastings St. W.
One Phone:
Seymour 8033
Connecting all three stores.
Brown Bros. & Co. Ltd.
VANCOUVER, B. C.
McKEE-COLEMAN
CLINICAL LABORATORIES
Vancouver, B. C.
1030 Medical Dental Building
Telephone Sey. 2996
C. S. McKee, M.B., Res. Bay. 268.
R. E. Coleman, M.B., Res. Bay 5194
Mary M. McKee, B.A.  —♦->£©«!
31<33f-4~-
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B^^^^^^^^*
lilt
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!gj-l A'       .
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£^^i>jfj^«|
Hollywood Sanitarium
LIMITED
'tfor the treatment of
Alcoholic, Nervous and Psychopathic Cases
Exclusively
Reference ~ ^B. £. oMedical ^Association
For information apply to
Medical Superintendent, New Westminster, B. C.
or 515 Birks Building, Vancouver
Seymour 4183
Westminster 288
5K5V

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