History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: November, 1939 Vancouver Medical Association Nov 30, 1939

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 Tihe BULLETIN
of the
VANCOUVER
MEDICAL ASSOCIATION
-Vol. XVI.
NOVEMBER, 1939.
No. 2
With Which Is Incorporated
Transactions of the
Victoria
cal Society
the
Vancouver General Hospital
und
St Paul's Hospital
In This Issue:
SOME OBSERVATIONS OF PEDIATRIC PRACTICE
J IN EUROPE
NEWS AND NOTES BULKEfTTS
(With Cascara and Bile Salts)
. . FOR . .
Chronic Habitual
Constipation
BULKETTS POSSESS ENORMOUS BULK
PRODUCING PROPERTIES AND BEING
PROCESSED WITH CASCARA AND
BILE SALTS PRODUCE! BULK WITH
MOTILITY.
WE WILL BE PLEASED TO PROVIDE
ORIGINAL CONTAINERS FOR TRIAL
ON REQUEST.
Western Wholesale Druglj
(1928) Limited
456 BROADWAY WEST
vancouver§§- British Columbia
(Or *t all Vancouver Drug Co. Stores) THE    VANCOUVER    MEDICAL    ASSOCIATION
BULLETIN
Published Monthly under the Auspices of the Vancouver Medical Association
in the interests of the Medical Profession.
. Offices: 203 Medical-Dental Building, Georgia Street, Vancouver, B. C.
EDITORIAL BOARD:
Dr. J. H. MacDebmot
Db. G. A. Davidson Db. D. E. H. Cleveland
All communications to be addressed to the Editor at the above address.
Vol. XVI.
NOVEMBER, 1939.
No. 2
OFFICERS,   1939-1940
Db. A. M. Agnew                  Db. D. F. Busteed Db. Lavell H. Leeson
President                            Vice-President Past President
Db. W. T. Lockhabt Db. W. M. Paton
Hon. Treasurer Hon. Secretary
Additional Members of Executive: Db. M. McC. Baibd, Db. H. A. DesBbisay.
Db. F. Bbodie
TRUSTEES
Db. J. A. Gillespie Db. F. W. Lees
Historian: Db. W. L. Pedlow
Auditors: Messes. Plommeb, Whiting & Co.
sections
Clinical Section Ip,
Db. F. Tubnbull Chairman Db. Kabl HaigL-1 Secretary
Eye, Ear, Nose and Throat
Db. W. M. Paton Chairman Db. G. C. Labge Secretary
Pcediatric Section
Db. J. R. Davies Chairman Db. E. S. James Secretary
STANDING COMMITTEES
Library:
Db. F. J. Bulleb, Db. D. E. H. Cleveland, Db. J. R. Davies,
Db. W. A. Bagnall, Db. T. H. Lennie, Db. J. E. Walker.
Publications:
Db. J. H. MacDebmot, Db. D. E. H. Cleveland, Db. G. A. Davidson.
Summer School:
Dr. T. H. Lennie, Db. A. Lowrie, Dr. H. H. Caple, Dr. Frank Turnbull,
Dr. W. W. Simpson, Dr. Karl Haig.
Credentials:
Dr. A. B. Schinbein, Dr. D. M. Meekison, Dr. F. J. Bulleb.
V. O. N. Advisory Board:
De. I. Day, Db. G. A. Lamont, Db. S. Hobbs.
Metropolitan Health Board Advisory Committee:
To be appointed by the Executive Committee.
Greater Vancouver Health League Representatives:
Db. W. W. Simpson, Db. W. M. Paton
Representative to B. C. Medical Association: Db. L. H. Leeson.
Sickness and Benevolent Fund: The Pbesident—The Tbustees.
*"4L NAVITOL  I
MALT COMPOUND
AN ECONOMICAL DIETARY SUPPLEMENT WHICH
PRESENTS IN A PALATABLE SYRUP AN ABUNDANCE
OF VITAMINS A, Bi, D AND G   (B2), IN NATURAL
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EXTRACT   IN   THERAPEU-
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IN 1-LB. AND 2-LB. WIDE-
MOUTH JARS.
For literature write
36 Caledonia Road, Toronto
ERiSqpibb & Sons of Canada. Ltd.
MANUFACTURING   CHEMISTS   TO   THE   MEDICAL   PROFESSION   SINCE    1858
WW Will VANCOUVER HEALTH DEPARTMENT
STATISTICS, SEPTEMBER, 1939.
Total population—estimated 263 974
Japanese  population—estimated _^_ 8391
Chinese population—estimated :„_ I      7 728
Hindu population—estimated         389
Number
Total deaths |    206
Japanese deaths \ 3
Chinese deaths      15
Deaths—residents only    177
BIRTH REGISTRATIONS
Male, 184; Female, 184.
368
INFANTILE MORTALITY: Sept., 1939
Deaths under one year of age.      12
Death rate—per 1,000 births      32.6
Stillbirths (not included in above) «        4
Rate per 1,000
Population
9.5
4.0
23.6
8.2
17.0
Sept., 1938
9
25.2
9
CASES OF COMMUNICABLE DISEASES REPORTED IN THE CITY
October 1st
August, 1939    September, 1939    to 15th, 1939
Cases    Deaths    Cases   Deaths   Cases   Deaths
Scarlet Fever  11 0'
Diphtheria     0 0
Chicken Pox  1 0
Measles    ; .  0 0
Rubella  0 0
Mumps ■  2 0
Whooping Cough * ....^ 10 0
Typhoid Fever _..!_ If 0
Undulant Fever \  0 0
Poliomyelitis '. ^--^- 0 0
Tuberculosis :_^- 36 16
Erysipelas :_l2 0 0
Ep. Cerebrospinal Meningitis _ 0 0
* Carriers,   f Outside case.
12
2*
7
3
1
17
7
0
0
0
32
2
0
0
0
0
0
0
0
0
0
0
0
14
0
0
19
0
22
1
0
5
11
0
0
0
14
2
0
V. D. CASES REPORTED TO PROVINCIAL BOARD OF HEALTH,
DIVISION OF VENEREAL DISEASE CONTROL.
West North
Burnaby   Vancr.   Richmond  Vancr.
Syphilis 0
Gonorrhoea :      1
0
0
0
0
0
0
0
0
0
0
0
0
Vancr.   Hospitals,
Clinic  Private Drs.   Totals
0
1
1
30
12
44
0
0
1
48
23
73
BIOGLAN
THE SCIENTIFIC HORMONE TREATMENT
Descriptive Literature on Request.
A Product of the Bioglan Laboratories, Hertford, England.
Represented by
STANLEY    N.   BAYNE
Phone: SEy. 4239
1432 Medical-Dental Bldg.
"Ask the doctor who is using it."
Vancouver, B. C.
Page 31 Autumn Diseases
— are mostly those of the Respiratory Tract.
In Tonsillitis, Acute Bronchitis, Influenza, Tracheitis, Laryngitis,
Pharyngitis, the use of the medicated cataplasm, Antiphlogistine,
stimulates the local capillary circulation and, through it, the circulation in the deeper structures. Decongestion of the affected tissues
is thereby aided and early resolution facilitated.
Sample on request
THE DENVER CHEMICAL MANUFACTURING COMPANY
153 LAGAUCHETIERE ST. W.     -     MONTREAL
Made in Canada VANCOUVER MEDICAL ASSOCIATION
Founded 1898    ::    Incorporated 1906
GENERAL MEETINGS will be held on the first Tuesday of ;the month at 8:00 p.m.
CLINICAL MEETINGS will be held on the third Tuesday of the month at 8:00 p.m.
Place of meeting will appear on the Agenda.
General meetings will conform to the following order:
8:00 p.m.—Business as per Agenda.
9:00 p.m.—Paper of the evening.
Programme of the 42 nd Annual Session (Fall Session)
1939.
October   3—General Meeting.
Dr. Howard Spohn: "Some observations on Pediatric practice in Europe.',
October 17—Clinical Meeting.
November   7—Gener al Meeting.
Dr. W. A. Dobson: "Diagnosis of early Schizophrenia."
Dr. J. M. Jackson: "Treatment of early Schizophrenia."
November 21—Clinical Meeting.
December   5—General Meeting.
Major H. A. DesBrisay: "Biliary Tract Diseases."
December 19—Clinical Meeting.
The New Synthetic Antispasmodic
Trasentin "Ciba"
(Diphenylacetyldiethylaminoethanolester-hydrochloride)
SUPPRESSES SPASMS OF THE GASTRO-INTESTINAL
TRACT, GENITO-URINARY SYSTEM AND
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Tablets—bottles of 20 and 100. Ampoules—boxes of 5 and 20.
1 tablet or 1 ampoule contains 0.075 grm.
of the active substance.
CIBA COMPANY LIMITED
MONTREAL
Page 32 Each fluid ounce contains
Heroin
Hydrochloride - 1-3 gr.
Ammonium
Chloride - - - 16 grs.
Chloroform • - - 2 min.
Acid Hydrocyanic
DiL B.P. - - - 4 min.
Syrup Scillae - - - 90 min.
Syrup Tolu    -   -    120 min.
Dose: One to two fluid
drachms repeated every four
hours until relieved.
An Efficient Expectorant,
Respiratory Sedative
and Anodyne
NOTE: Scilexol with Codeine
Phosphate 1 grain to the ounce
also supplied.
Each tablet contains:
Ebsal, E.B.S. -   -   -     3 grs.
(Acetysalicylic Acid)
Phenacetine -   - - 2 grs.
Caffeine Citrate - - 14 gr.
Codeine
Phosphate -   - - Va &?•
Dose: One to three tablets
as required.
Analgesic Febrifuge
Sedative
Each fluid ounce represents
Ammonium
Carbonate ...    8 grs.
Ammonium
Chloride    -   -   - 16 grs.
Prunus Serotina -   - 6 grs.
Senega ..... 8 grs.
Menthol   .... y4 gr.
Chloroform  -   -   - 2 min.
Glycyrrhiza   ... q.s.
Honey ..... q.s.
Dose:  One to  two fluid
drachms every three hours.
Non-Narcotic Stimulating
Expectorant
THE E. B. SHUTTLEWORTH CHEMICAL CO, LIMITED
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PRESCRIPTIONS THE   EDITOR'S   PAGE
Within the past few weeks a questionnaire was sent to every medical man in active
practice in British Columbia. This questionnaire was the first step toward a survey that
is being made of the entire Canadian medical profession. It was initiated! in Ottawa by
the Canadian Medical Association, which offered its services to the Minister of Defense,
the Hon. Norman L. Rogers, with a view to co-operation in ensuring not only that the
medical services of the country should be available when needed, but also that these services might be so arranged and guided that the maximum of efficiency bei secured at home
and abroad in military matters, with a minimum of dislocation and damage to civilian
interests.
The Minister gladly accepted this offer, and consulted with the military head of his
department, both combatant and medical, and as a result authorised the) Canadian Medical
Association, by a letter in the possession of Dr. Routley, to make! this survey. A central
committee, advisory in nature, and consultative, has been set up in Ottawa, and Provincial
Advisory Committees have been established for each Province.
This is merely detail—but something remains to be said. This whole affair is one of
great importance to organised medicine in Canada. It is, to begin with, a matter of great
satisfaction and even pride that as a body we have been recognized by the government of
our country as being a responsible organisation, with which it can negotiate. It is the
first time in our history that this has been done on anything like this scale.
It is, however, much more than this. It is a challenge to us as an organization, and to
each one of us individually. We are "on the spot." We have laid claim to be a responsible
organisation, able to speak for its members, and to represent their views and wishes. By the
manner in which we discharge this duty, and perform this task, will wej be judged by the
public at large and by future governments with whom we may want, or have to deal.
This questionnaire is not binding—no man is committed, who signs it, to any particular course of conduct. But it is a valuable document all the same. It gives information,
it classifies the man who signs it, it helps to protect him, to guide him, and to ensure that
his own interests, the interests of those amongst whom he works, and the interests of the
country at large, will be looked after. If the time comes when all! our power and skill are
needed, it will help to ensure that these will be used and allocated where this can best be
done, with a maximum of efficiency and a minimum of waste.
Steps are being taken by the central Provincial Committee, located in Vancouver, to
choose, in each district of the Province, key-men who will act asi centres of information
to all who feel that they want more knowledge of this whole matter.
There need be no feeling whatever that there is any attempt to regiment or control
anyone: but every man should give freely the information requested and assist in every way
the Cornmittee in its work. In Great Britain, the Central Committee for the nation has
and is using very drastic powers, conferred on it by the Government.
Great Britain is, of course, in a state of acute emergency. Conscription has been imposed. We here are fortunate in that the crisis is, as yet, not acute. But the significant
thing in Great Britain is that the Government has delegated to the British Medical Association very wide powers, the use of which in allocating men is contemplated both in
peace- and war-time. We suggest that our readers refer to the copies of the Supplement to
the British Medical Journal dealing with this question. It will help them to realise just
how far-reaching these powers are. Practitioners may be "earmarked" for almost any
service for which they are best suited. Age is taken into account; hospital needs are considered; local conditions are duly weighed; but the word of the Central Committee is final
—and it supplies men both to the fighting forces and the civilian population.
A very important feature is the Association's "model scheme for the protection of the
practices of general practitioners who under war conditions would be undertaking other
forms of service, whether abroad or at home, in a whole-time capacity." This is excellent, and we hope that the-Ganadian counterpart of this Committee will obtain and. study this
scheme.
As we said above, while this delegation by the Governments of these countries, of certain powers and privileges, to the controlling bodies of organised medicine, is to some
extent a tribute, and a cause for quiet pride, it is far more a challenge} and a demand that
we show ourselves worthy of the trust that has been placed in us. We know better than
anyone where and how we can best be used—and we must show it. If we succeed, we shall
in the first place have served our country well, and this is the primary consideration: we
shall have done ourselves great service: we shall have proved our right, and justified our
claim, to speak for medicine as a whole: we shall have demonstrated our good faith and
sincerity, and established ourselves for the future as a good citizen of Canada.
NEWS    AND    NOTES
Dr. J. F. Haszard has left Kimberley to assume command of the 8 th Field Ambulance
at Calgary. At a gathering of Kimberley citizens, who held a farewell, dance in honour of
Mrs. Haszard and himself on September 29th, he was the recipient of an engraved sterling
silver tray with the best wishes of his many friends.
Following the departure of Dr. Haszard, Dr. W. S. Hucbvale, who has been associated
as an assistant, has now joined Dr. D. W. Davis in the practice at Kimberley.
•C - *£ •{. jg.
Dr. L. Giovando of Nanaimo is on a two weeks' hunting trip in the Cariboo.
Dr. and Mrs. Alan Hall of Nanaimo have returned from a month's holiday in the East.
Dr. W. D. Higgs of Port Alberni has joined his former unit at Calgary.
*t sS. **• •?.
*r •*? *T ^T
Dr. G. A. B. Hall of Nanaimo has been touring the Province in his capacity as Grand
Master of the Free Masons.
Dr. A. C. Nash of West Vancouver returned from a trip to England. While there he
visited France and Italy.
* *      *      *
Dr. D. J. Millar's annual hunting trip took him as far as Kelowna and vicinity this year.
Dr. R. V. McCarley of North Vancouver is home after a trip to Kingston, Montreal
and way points.
* *      *      *
Dr. E. Therrien of West Vancouver is leaving for a visit to Ontario and will drop
down to Chicago.
iS» 3f> 2fr Sf»
Dr. W. K. Massey, formerly of Tranquille, has set up practice at Ashcroft.
•t jt *% **»
Dr. E. K. Hough, who has been in the practice at Woodfibre, is moving to New
Westminster.
* «•       *       *
Dr. J. A. Street, who has been away from the Province during several years, is taking
over at Woodfibre.
3p *E* *i* *r
Dr. R. H. Irish is leaving the practice at Fraser Lake and will be on the staff at Tranquille Sanatorium.
J?» **• ?£* 5f*
Dr. G. G. Ferguson of Smithers is moving to Moose Jaw, where he will take up practice.
Page 34 Dr. L. M. Greene of McBride is moving to Smithers to take over the practice of Dr.
G. G. Ferguson.
Jt *t «{. 5*
Dr. J. H. Carson of Prince Rupert is at present visiting in San Francisco.
3£ 55* •£• Sj»
We offer our congratulations to Dr. H. A. MacKechnie upon his marriage to Miss
Evelyn Simpson, in Vancouver, on October 19th. Dr. and Mrs. MacKechnie will make
their home in Vancouver, where Dr. MacKechnie is in practice.
*r »»* *E* 5j«
Dr. Reba E. Willits, formerly of Kelowna, is now at the University of Toronto taking
aD.P.H. course.
sfr S{» "^ *t
Dr. George R. F. Elliot, ormerly on the staff at Essondale, is at Toronto University
taking the course leading to the diploma of Public Health.
Dr. J. S. Henderson of Kelowna was in Vancouver recently and watched the Ward-
Black golf match.
*
Dr. W. Leonard of Trail travels far afield in search of pheasants. He reached Vernon
and had a successful shoot.
*^ *t *t A
Dr. R. W. Garner of Port Alberni returned from his vacation looking fit and well,
following a successful moose hunt.
Dr. J. C. Thomas, who has been relieving Dr. Garner in his former stamping ground,
has returned to Vancouver.
*      *      *      *•
The sympathy of the profession throughout the Province is extended to Dr. A. J.
MacLachlan, Registrar of the College of Physicians and Surgeons, in his recent bereavement in the passing of his wife.
LIBRARY NOTES
PUBLICATIONS OF MEMBERS.
Dr. E. S. James: Tuberculin Survey of Schlool Children.   Amer. Rev. of Tuberculosis,
Sept., 1939, p. 306.
Dr. F. Turnbull: Spinal Epidural Cyst. C.M.A.J., September, 1939, p. 250.
ARCHIVES OF SURGERY.
In the July, 1939, issue an editorial appeared, setting out the new editorial developV-
ments which were taking place with regard to the Archives of Surgery. For many years
this Journal has devoted most of the available space to experimental surgery, and the
highly technical character of much of the material that has appeared in the Archives has
diverted attention to other surgical journals, which dealt with clinical surgery to a larger
degree. Owing to the unfortunate illness of Dr. Dean Lewis, the Editor-in-Chief of the
Archives of Surgery since it was established, Dr. Waltman Walters has been made Chairman pro tern., and the Trustees have added four additional members to the Editorial
Board, viz., Dr. Arthur W. Allen, Boston; Dr. Alfred Blalock, Nashville; Dr. W. E.
Dandy, Baltimore, and Dr. L. R. Dragstedt, Chicago.
It has been decided to modify the nature of the contents, and in future the Archives
will publish papers dealing with clinical investigation on surgical problems, as well as
articles which concern developments in the various fields of general surgery. Collective
reviews will also appear from time to time. A review of Urologic Surgery appears in the
July and August numbers.
Page 35 RECENT ADDITIONS TO THE LIBRARY.
New and Non-Official Remedies; 1939.
Harvey Lectures, 1938-39.
Amer. L., R. & O. Society: Transactions, 193 8.
Vitamins: Published by the Council of Pharmacy and the Council of Foods of the A.M.A.;
1939.
Amer. Proctologic Society: Transactions; 1939.
Manual of Radiological Diagnosis: I. Tchaperoff; 1937.
Endocrinology in Modern Practice: W. Wolf; 2nd ed., 1939.
Surgical Clinics of Nortn America: June,  1939:  Contains a Symposium on Surgical
Technic from the Lahey Clinic.
Surgical Clinics of North America: August, 1939: Contains a Symposium on Diseases of
the Gall Bladder and Bile Ducts from the Mayo Clinic.
BENJAMIN BUTLER MARR, M.D.
On October 14th, 1939, at his home, a successful life was closed in the passing
of Dr. Marr of Langley Prairie.
All who knew this fine medical gentleman mingled memories of his work and
life with regret that he should have died at an early age. He was but 57, and yet
so many of our profession pass on in that decade. His quiet, unobtrusive personality endeared him to patients and colleagues. He had served widely and with
satisfaction in work well done. Those who had the privilege of serving with him
during the last war recognized his efficiency and fine qualities.
Dr. Marr was born in New Brunswick; graduated from Tafts Medical College
in 1907; during thirty years he practised first in Fort Langley and later in Langley Prairie. Two daughters and a son survive and to them the profession extends
sincere condolence in the loss of a good father.
DR. H. C. WRINCH
The rather sudden death of Dr. Wrinch on Oct. 19th deprives the profession of
British Columbia of one of its outstanding figures.
Dr. Wrinch was an excellent example of what the medical practitioner in a
rural area should be. An efficient and thoroughly well-trained doctor, trusted
and liked by all whom he served, he was also a leader in his community and
became a centre of authority and leadership to which all could look with assurance. Thus he became a political representative, and this in the best and most
worthy sense, and served his riding well and faithfully for many years.
Dr. Wrinch had the respect and adrniration of men of every political colour
and faith. His word in the House carried weight,, and he was always given an
attentive hearing. He did excellent work in all he touched, especially, as one
would expect, in all matters pertaining to the health of the citizenry, and his was
no partisan mind: but open to all shades of opinion; this was, of course, his
strength, that men could trust him to be free from prejudice or bias, and concerned only with the public welfare. He did honour to the profession of which
he was a member, and maintained its high standards and traditions, both in public
and private life.
Page 36 DR. H. E. YOUNG
Provincial Medical Officer of Health, British Columbia.
Although we had for some time recognised that Dr. Young was failing, living,
so to speak, "on borrowed time," and long overdue for a rest and retirement, yet
the news of his death came as quite a shock, even a surprise, so gallantly had he
for a long time refused to admit the least weakness or failing of his powers. We
saw him in Vancouver only a short time before his death, keen as ever, and right
on the job. He was a fortunate man. He was in harness, in full panoply of battle,
right up to the last; he had no horrid period of waiting, helplessly, for the
inevitable end. Death for him was just the close of another day.
Henry Esson Young had a long spell of service in this province—and it was
a notable service he gave. Not all of us realize what an outstandingly good
medical officer of health he was: and how much he accomplished and on how little.
How often, when talking to him of some much-needed service or reform which
we all felt was long overdue, one has heard him say, in tones of deepest regret,
even of humiliation, "But I haven't the money!" Yet in some way or other, sooner
or later, he would work out a plan by which it could be done. The department
of health in this province, as also, we suspect, in many others, has always been
starved for funds—though it is only fair to say, nay, we gladly say it, that under
the present administration by the present Minister of Health, tremendous strides
have been taken towards an adequate provision for preventive medicine: and
while we have not yet reached perfection, we have done much. But Dr. Young
for many years laboured with inadequate staff, scanty funds, poor public support,
and under many handicaps. But he never lost courage or faith—nor his temper
—and his patience, tact and ingenuity stretched his meagre resources to the
utmost, and accomplished wonders. Moreover, he always, in season and out of
season, was a missionary, and a most vocal and! ardent missionary, in health matters. He could talk well and. forcibly—yet courteously and understandingly—
and surprisingly often got his own way.
He was very loyal to all who worked with and for him: and would defend his
colleagues and subordinates through thick and thin. This support and confidence
was of great value to those in his department, and they gave of their best to him
—and this, too, made for good work. He was, too, a good friend of the general
medical profession, and we suspect that this loyalty and support given by him
were often very vitally important to our interests, and constitute a debt on our
part to his memory.
Gradually, through the years, he has built up an excellent and strong organisation, well-based and enduring, and such a monument to his memory as he would
most have valued: since to him all that mattered was the strengthening and
growth of preventive medicine and public health—and no personal consideration
of reputation or fame. His successor will have a high ideal at which to aim, a
noble tradition of service to maintain, and a fine example to follow. Many of us
will miss him personally for a long time—as we remember his courtesy and
graciousness, his warm friendliness and even affection. Others have spoken of
his public record, and it was a long and fine record, but we would merely pay a
personal tribute to one who, we feel, deserved well of his country and profession.
Page 37 VANCOUVER MEDICAL ASSOCIATION
The first meeting of the 42nd Session of the Vancouver Medical Association was held
in the Spanish Ballroom of the Hotel Georgia, on October 3rd, immediately following a
dinner.
The report of the Summer School Committee for 1938-39 was read, and showed a
balance of $851.68 remaining after all expenses of the School had been paid. The attendance at the school in June was 219—one of the largest in the history of the Summer School.
Drs. Andrew Lowrie and H. H. Caple were elected as new members of the Summer School
Committee to serve for three years.
It was announced that the Annual Dinner, usually held in November, had been postponed for the time being, until military arrangements are more settled.
The regular General Meeting of the Vancouver Medical Association will be held on
November 7th in the Auditorium of the Medical-Dental Building, when the speakers of
the evening will be Dr. W. A. Dobson and Dr. J. M. Jackson, who will speak on the
Diagnosis and Treatment of Early Schizophrenia, respectively.
SOME OBSERVATIONS ON PEDIATRIC PRACTICE
IN EUROPE
By Dr. Howard Spohn, Vancouver.
(Given before the Vancouver Medical Association, October 2nd, 1939.)
[This, the first regular meeting of the Vancouver Medical Association for the year
1939-40, was held in the Georgia Hotel, in the Aztec Room, and was well attended—it
was in the form of a dinner meeting. Dr. Spohn, who had just returned from Europe, was
given a hearty welcome. We all felt he had been rather lucky to return in one piece, and
as we listened to his moving tale of "perilous scapes" from the now war-torn lands of
Europe, told in a semi-humorous style, but none the less thrilling, we were even more sure
that he had been quite close to some rather unpleasant possibilities.
His talk, while nominally a discourse on pediatric practice in Europe, was really considerably more than this. It was partly a travelogue, partly a series of philosophical
reflections, such as would be apt to occur to a highly intelligent traveller under the circumstances of Dr. Spohn's tour. He could not help but be greatly impressed with the highly-
charged, even supercharged, atmosphere of Europe, the great emotional strain under which
its inhabitants are living, the reluctance and fear all normal and ordinary people felt at
the prospect of a new international struggle. He was fortunate in his contacts with representative people of every level of society, and gathered many impressions from many
conversations.
As we listened to him, we heard interesting and informative comments on travel to
and in Europe, and on the character and living conditions of various nationalities. Thus
Dr. Spohn was greatly taken, one could see, with the Scandinavian countries, their orderliness and love of cleanliness, their public spirit, their true sense of civic responsibility.
Swedish boats and trains, and Swedish streets, are clean and neat, with a high standard of
comfort; Swedish cities are modern and up-to-date, notably Stockholm, which the speaker
regards as the most modern, efficient, and up-to-date city in the world today. Denmark
is a pleasant farming country; Norway is B. C. Utopianized, a country where the policemen all speak excellent English, French and German as well as Norwegian, where educational standards are high. Finland is a hard-working nation of young people, with a
loathing of Communism.  Throughout Scandinavia, there is a strong co-operative spirit,
Page 3 8 wealth is evenly distributed. There are few if any millionaires: life is more simple and happier. He then spoke of Russia— and paid tribute to the medical profession of that country,
which has upheld, and often in difficult circumstances, the highest standards and traditions
of our calling. Dr. Spohn had friends in this country, and as one reads his paper reproduced later we find that he saw much of medical methods there.
In Germany, Dr. Spohn had some rather exciting moments, though he spent only 32
hours there, and saw little, most of it from train windows. But the usual courtesy and
kindness of the German were rather lacking, frequently replaced by rudeness and suspicion; few or no tourists were seen. Dr. Spohn got the impression that the tempo of the
whole country was set to the war motif, and everything else was ignored. Ordinary
rolling stock, passenger cars are unpainted, brass and copper are gone, stations are shabby,
rather dirty; the people are shabby, look ill-fed, the children anaemic. Happiness and cheerfulness are lacking. But huge areas are covered with aerodromes, thousands upon thousands
of troops are seen, and Mars' altar is heaped high with offerings and sacrifices.
It was a grim picture that Dr. Spohn drew, relieved by some touches of kindliness and
courtesy that he received, not from officials or those who should show these characteristics,
but from the "common folk" he met—a woman in a train, a traveller in a station, and so
on. who spoke in friendly style, expressed no hate, and hoped there would be no war.
At the end of his talk, Dr. Spohn showed moving-pictures taken by himself of his
travels.
The following sequence must be regarded more as a series of notes, and obiter dicta,
than a set paper in regular form. Dr. Spohn amplified much of what he has written down
here, and it was this informality and lack of ceremony that made the evening delightful.
It was as if we were with Dr. Spohn on his travels, his guest and companion, to whom he
was thinking out loud in casual conversation. The sections, however, on paediatrics, prenatal and postnatal care, and the general high ideals of preventive medicine, reflect an
attitude on the part of the people whose medical systems are described that must command
our respect, and is one which we might often do well to copy.—Ed.]
We are, on the whole, a complacent, trusting, easy-going lot of people—sometimes we
imagine that by vigorously damning a system or "ism" something can be accomplished
Unfortunately, the heads of certain systems that would prove absolutely destructive to
our democracies are often diabolically clever, and they are so used to abusing others that
nothing in that line matters except when they can attach suspicion through this on some
of their own people. We should recognize that the only effective way, besides actual fighting, to prevent the extensions of these various lines of thought is to govern ourselves in
such a manner that we shall be the envy of all autocracies, by showing not only that we can
administer justice fairly and with no regard to class or creed, but also that we can provide
for all our people liberty of religion and thought, possibilities for award for individual
endeavour, universal education, leisure time for rest and cultural development, and peace
and security throughout the various spans of life. With all our errors of omission, we can
still point with pride to the fact that the peoples of the British Empire have approached
this ideal better than any other racels, not excluding our friendly neighbour to the South.
But to continue under such conditions as we now have, and are going to have, will necessitate long-continued unselfish and high-purposed efforts on the part of the Government
and every individual Canadian.
Why is it necessary to stress this? For one reason, because of the cleverness of some
of the autocratic leaders. Always we should distinctly understand that since the beginning
of history all revolutions have been greatly alike. The reasons for such revolution may have
been quite jutifiable, but always there comes a series of events, both during and after the
fighting that disrupts, temporarily, all progress. There come occurrences which in their
drastic cruelty exceed all previous transgressions. Gradually, but often so slowly, a new
order is evolved and some sort of state or government is established. "Tojours la change,
tojour la menu chose." During reconstruction individual liberty is entirely subservient,
and what was originally a fight for freedom evolves with a new order which may be devoid
of freedom.  Such a course is familiar and usual, but the new orders that proceed as new
Page 39 forms of government must give to even a slave people something or some little bit of new
life that they did not possess before. Otherwise a new collapse would come.
It is, however, stupid to take the attitude that nothing good can transpire for the good
of the downtrodden in these lands. Such an attitude only makes us underestimate our
adversary, a thing Winston Churchill has never done. We should know something of both
sides of the picture, and we should also recognize the solemn truth that autocracy and
democracy cannot thrive in the same land. If there are, and thank God we know they are
few, but if there are people in Canada who imagine that they can flourish under autocracy,
then in peacetime these people should be deported to the land of their choice, and in wartime let us recognize that they are enemies within our gates.
From a pediatric and sociological point of view it is interesting to observe that under
autocratic orms of government it is recognized that it is essential to the continuation of
all races that women and children must be given increasing care. This is now so universally
apparent that even in countries where individual liberties are terrifically curtailed we
actually see that, during the last decade, quite remarkable advances have been made in the
social, medical and actual treatment of women and children. As the paediatrician is so
necessary to this work, it is found that this specialty is usually quite advanced. Obstetrics
and gynaecology are also often on a high plane, but in some of the Balkan states an obstetrician is seldom used among the peasantry.
Paediatric Observations in Russia.
I will take a short time to describe briefly some details I gleaned while inspecting some
centres engaged in rest and nutritional work. During a short stay of ten days I was allowed
to visit a region about seventy miles from Leningrad and about thirty-five miles from
Tzarselo, the old favorite palace of the last Tzar. It was in the centre of a beautiful forest,
the ormer estate of a Russian nobleman and cabinet minister of high rank during the reign
of the last Tzar. In this particular area were 150,000 people (50,000 children) enjoying
the so-called rest and culture period. There were four other similar areas in the vicinity, so
that 500,000 people from the Leningrad area were enjoying their particular rest period.
Each individual is, through a 1 % culture tax on both males and females, allowed for himself or herself and dependents a thirty-five-day rest period, which includes free transportation, lodging, food, recreation, medical care including hospital care in hospitals located
within their particular area. The instigation of this type of procedure was the result of the
clause in their constitution which says that every citizen has the inalienable right to labour,
education and rest.
From the following description you can see that it reads like an account of a well-
organized health unit, say from Boston, or Stockholm, etc. In this particular endeavour
one must admit that they1 have gone far, and that the children of Russia, at least in the
organized districts, are now being well fed, adequately clothed, protected scientifically
from infectious diseases, and are receiving proper rest and an education, which as far
as the rudiments of the three R's is of a good standard. Education for all ages is compulsory and universal, but of course in the higher education, as in Germany, the philosophies and other sciences which stimulate free individual thought and expression are not
encouraged.
The rest districts are assigned to those employed in different industries or occupations,
as rubber, steel, motor, etc. In each there are separate children's divisions which' include
residences, separate building, lodging from 40 to 50, hospitals with isolation admitting wards, infectious wards, small surgeries, medical wards and dental clinics. These all
in country districts. I will describe one children's unit for 500 children of the Kirov factory district of Leningrad. The buildings were in the heart of a pine forest about five
miles from a large collective farm, which had formerly been one of the estates of a progressive Kulick. This unit consisted of log buildings somewhat similar in construction say
to the Lodge on Grouse Mountain. There were about 20 separate buildings, school, hospital, sleeping lodges, a large bath house (Finnish baths and showers), several dining lodges,
buildings for the supervisors, physicians and other staff, and recreation rooms. There were
large playing fields for football, tennis, volley ball, etc., and these play fields were separated
by a long walk lined by shade trees and poster boards, which I will describe when I show
Page 40 the still picture. There was the usual platform for propaganda and speeches, and a semicircular area surrounded by pictures of Stalin and other high official figures. We were shown
about by a woman paediatrician and the chief of physical culture. I saw no evidence of
any skin diseases and was told there had been none so far that season. The children were
all comfortably dressed in shorts and shirt and all wore shoes which would have been
impossible three years ago. There were no tuberculous children in this unit. All pre-school
children are given physical examination and x-ray of chest, etc., and the families investigated as to the presence of infectious diseases. This represents similar units throughout
the country. Among the older children I saw camps with as many as 2500 children, varying in age from 14 to 18 years. There is a special division for the weaker children, and
they are given' special permanent supervision. These special groups of weaker children are
fed five times a day instead of four and have a special diet.
Abortion is forbidden and permitted now only on decision of medical men. Criminal
abortion is severely punished, both the doctor and others receiving drastic sentences. There
is no recognized term of illegitimacy and any mother can ask the state to take over her
child. With pregnancy (two months before and also after birth) holidays are given. The
mother can nurse the baby at the actory, and practically every child is breast-fed. Divorce
is easy but not frequent. Both parties must support the child,' especially the father, who
must pay money regularly into the State. Infant mortality has been lowered 30% in the
last twenty-year period. There is universal immunization against diphtheria. There is no
diphtheria.  Measles is also treated by prophylactic serum.
Each child must register for health purposes, that is, it belongs to a definite consultation clinic, with specialist, milk station, breast milk, x-ray. This applies up to 3 years.
After this age the children are watched by polyclinics. There are also many women's
clinics. Pregnant women register at a definite clinic and each is given a clinic booklet with
all data of pregnancy and child development. When an illness is serious the child may be
transferred to hospital.
I also visited rest homes for the adults (women and men). I found all the rooms neat,
with clean linen, and there was no knowledge that we would inspect. These home usually
contain recreation rooms, billiards, pianos, writing rooms, photographic rooms, etc. Children are under the special care of Stalin, and one sees many pictures depicting him with
children. Parents, except in cases of acute illness, visit only once a month.
Scandinavia.
In discussing social conditions in Scandinavian countries one must consider that one of
the chief points of interest is that they have been faced with financial, sociological and
political upheavals so adjacent to their! borders that they have been forced to devise within
their own borders methods calculated to meet the dangers of a spread of either Bolshevism
or Naziism within the Scandinavian group of Sweden, Norway, Denmark and Finland.
During the last fifteen years this group have expounded Democratic principles of self-
government which have been Conservative, and yet advanced, also Socialistic, yet Socialism
paying homage to the old traditions of religion and family tradition, and a high regard for
individual rights and initiative. One. should realize, then, that they have offered solutions
to problems which have not to date faced us with such directness or with such alarming
proximity. One need not compare their systems either favorably or unfavorably with our
own, but I would emphasize strongly that it is wise to give due consideration to their great
accomplishments. They have offered solutions to problems which in the very near future
(and especially on account of the war) will probably have to be faced and solved in this
country. Many problems are with us now and we have met them, on the whole, in the ways
best suited to our especial environment.
Always one must remember Scandinavian culture dates far back to around the year
800 and the first historical reference to the race was made by a Roman author 1200 years
ago. We are dealing with an old civilization which has for centuries gone through
numerous wars, on each other, and on adjacent countries as Russia, Germany, Estonia,
Latvia, Poland, etc. Wars and rumors of wars and conquest fill the pages of Scandinavian
history, but, unlike many of the other European countries, they have not become decadent
Page 41 but have emerged proud, self-disciplined and with a culture which is the envy of many
more powerful nations of the earth.
Three things have made changes perhaps easier than in other localities: (1) While differing somewhat in language they may all be said to embrace what is known as the Scandinavian race (the Finns have a somewhat different origin, but they all are racially
connected); (2) their religion is essentially the same and they have not been troubled
greatly during the last few centuries with a diversity of religions and accompanying
religious disputes; (3) their cultural qualities have not been reserved for any particular
brand of society but cultural aims and achievement and education have been much more
generally disseminated than in most European countries, and embraces the peasants, domestic and other classes.
The first hospital I visited was at Goteburg, and this institution is probably the best in
Sweden, and is presided over by Prof. Wallgren, well known internationally. The hospital,
of 175 beds, is situated in a very beautiful part of Goteburg, and is substantially built of
red brick. Their wards and operating rooms are about as one would expect in any good
American or Canadian children's hospital. Throughout Sweden and Finland there is
practically no diphtheria, nor has there been any for ages. On this account toxin antitoxin
is not used routinely.
Syphilis and Venereal Disease: There is very little syphilis in Sweden, and at this hospital there has been only one case of congenital syphilis in over three years. On this account
it is extremely difficult to find cases of syphilis in childhood to demonstrate to medical
students. Gonorrhceal infection in childhood is also extremely rare. In one district in
Sweden trial marriages have taken place for many years, but venereal disease is not prevalent in this area. The Swedes claim no saintly moral haloes, but have a very deep inherent
respect for their individual bodies and look with great repugnance on filth or infection
from any source. The greater part of the small amount of syphilis that is found is thought
to originate in the sailors visiting foreign waters.
Prophylactic toxoid for whooping cough and scarlet fever is generally used, and sul-
phanilamide is almost routine for treatment.
In this hospital a weekly sedimentation rate is done on every sick child.
Tuberculosis^ Since 1927 B.C.G. injections have been given shortly after birth to all
children with parents showing active T.B. at the child's birth. They claim excellent results
now. The Mantoux test becomes positive on the! 14th day after injection, and it is, of
course, necessary that the injections be started early, i.e., shortly after birth before the
child has become infected. It is, of course, useless to give B.C.G. injection after the child
shows a positive Mantoux test. The medical authorities are of the opinion that very few
cases in Sweden are of bovine origin, because cows' milk is generally pasteurized throughout
the country. The cows' milk for infants is invariably boiled. The B.C.G.-injected children are, if in good health, returned to their parents at 6 to 8 months of age. There were
previously quite marked reactions, but they claim this is not so now. By these means the
authorities think that tuberculosis in children can be very successfully attacked.
Rheumatism and allied infections are common both in Goteburg and throughout
Sweden. I saw six cases of inflammatory rheumatism in a small girls* ward of eight beds.
Rheumatic joint affections and chorea are apparently much more prevalent than with us,
and also rheumatoid arthritis in older children. I gathered that rheumatism in childhood is
in some localities a dreaded scourge. Five years is the average age for tonsillectomy, and
the doctors thought that teeth and other foci usually received average good care. Although
slums do not really exist, the rheumatic cases are predominantly from the poorer classes,
but the doctors thought the parents were not usually careless about parenteral infections
or neglected early treatment. Certainly the adult population employ a high protein diet,
but this is not looked upon as a contributory factor. I found that sulphanilamide preparations are used in nearly all infections, but with very doubtful effect in rheumatic affections.
In pyelitis sulphanilamide was regarded as by far the most efficient drug. I saw several
cases of encephalitis with unproven invading organism in young children of 8 to 18
months. The results with sulphanilamide were most successful. Poliomyelitis is a very
uncommon disease in Sweden.
Page 42 Erythema nodosum is found to be present three times more often in tubercular cases
than in rheumatic cases. On frequent occasions they have resected the tumescence in
erythema nodosum but have never isolated T.B. I heard of the case of an American nurse
developing T.B. after coming to Sweden, then for the first time in her life she developed
erythema nodosum.
Infant feeding: In the hospital only two kinds of milk feeding are used, i.e., breast milk
and citric acid milk, prepared by simply dumping a large citric acid tablet in each litre of
milk. They do not use evaporated milk for any feedings.
In eczema cases they continue to use orange or other fruit juice unless a definite allergy
against the particular fruit juice has been proved. In difficult eczema cases they use an
almond emulsion milk, i.e., a low-protein formula. They think this is often successful in
very difficult cases. The usual food for infant eczema cases is boiled citrated milk with
barley flour and some soluble carbohydrate.
Local application of tar preparations as usual are extensively used. Tumosal, a German
preparation, is apparently very popular. The fat is reduced in eczema formulae and in the
usual feeding cases 4% fat and 4% carbohydrates are used.
Pneumonia: Typed sera are apparently not now used, but Dagenan has had extensive
and satisfactory use.
Impetigo is extremely rare and when found is treated wth very rigid isolation precautions. They did not seem to know what I meant by impetigo in nurseries, as they had never
seen this infection in their nurseries.
Catarrhal jaundice, for some reason, seems much more common than in Canada, and
cases in hospitals are isolated. One doctor told me of an epidemic on the small island of
2000 inhabitants, and only a few individuals escaped. They consider isolation as necessary
as in influenza or impetigo. I saw an interesting case of puzzling anaemia in a child of 2
years. Thirty intraperitoneal injections of blood had been given over a long period. They
also use intraperitoneal salines. I was glad to find' in my old hospital, the Sick Children's
Hospital, Toronto, that intraperitoneal injections and injections into the longitudinal sinus
have now been discontinued. The technique of intravenous blood transfusions is not as
well understood in Sweden as with us. In the case referred to there was an extreme
secondary anaemia with almost an absence of reticulocytes, blood bleeding and clotting
time normal, Wasserman negative and no splenic enlargement. A splenectomy was being
considered.
Cod liver oil is routinely started at 4 or 5 months, or later in some country districts.
Rickets is most uncommon in the cities but fairly common in some isolated communities.
The use of x-ray of wrists is common in hospital practice.
Goitre is rare but is prevalent in a few districts.
Status lymphaticus: They have never seen this syndrome and could not discuss it, as
they have not come across cases.
Undulant fever was uncommon, but sporadic cases did occur.
Finland.
I visited the Children's Hospital at Helsingfors and talked with two of the doctors,
one a girl who had just graduated. I gathered) that after graduation it takes about seven
years, including hospital service, to get established in practice. There is an inclusive medical
service here. Hospital charges are about fifty cents per day. They regard the American attitude towards focal infection, operation in pyloric stenosis and early paracentesis in otitis
media as too radical. They have more, but not considerably more, syphilis than in Sweden.
The percentage rate is, however, steadily decreasing. They boil the milk feedings ^r infants but do not pasteurize milk. They consider their T.B. control of cattle satisf actcrv
and think they have very little bovine tuberculosis, although the incidence of tuberculosis
is high in some districts. I gathered they did not have much bone tuberculosis. The prevalence of undulant fever is extremely low.
The hospitals in Finland are not nearly as elaborate as ours, but I am sure they do excellent work. My one great surprise was their hesitation in operations for pyloric stenosis.
Dr. Yllpo's idea of resuscitation of the new-born with oxygen in the stomach seemed
Page 43 rational, sound and_safe, and is a method about which I hope to have the opportunity of
reporting more fully at a later date.
I have stated before, and repeat again, that impetigo is so rare in Finland that it is with
the greatest difficulty that cases can be secured for demonstration to mbdical students.
Itch, body lice and other such vermin come under the same category. Here cleanliness is
really next to godliness.
Social Medicine.
One almost hesitates to even mention this subject at such a time, as we must realize
that if the war is prolonged the social structure that we will have to face and become
adjusted to will demand methods which we need not at the present moment discuss.
As far as I could gather, in most of Scandinavia a large part of medical and surgical
practice is done under medical insurance schemes controlled by private insurance companies
but regulated by the different governments. The medical men do not appear to be suffering. I will not further complicate the evening of the Economic Committee by quoting
prices. But one must remember that in Scandinavia there is practically NO unemployment and therefore nearly the entire population can pay something for medical services.
C. H. Gundry, M.D.,
Director of Mental Hygiene Division of the Metropolitan Health Board.
In giving mental hygiene a place among the activities of the Metropolitan Health
Committee, we are trying to keep a few fundamental principles constantly in mind. The
purpose of the whole organization is prevention, not treatment. This distinction is definite when objectives are considered, though it may appear vague in some instances. The
tendency in modern public health work is to rely on education rather than regulation. In
the pre-school clinics, in the school health services, even in the examination of food
handlers, instruction in matters affecting health is the aim. Experience has shown that
patient insistence on a few definite points as they affect individuals is a more effective
method of public education than is a programme of popular lectures. In our Mental
hygiene Division our goal is not the establishment of a clinic for the treatment of a few
cases but a programme that will enable us to teach mental hygiene to a fairly large number
of individuals who are in key positions. We do not want a self-contained mental hygiene
clinic; we want the whole staff of sixty nurses and physicians to consider that they must
be just as interested in mental hygiene as they are in communicable diseases or nutrition.
A moment's consideration of what people are reading in these days shows that the
public is very much interested in topics that come within the field of mental hygiene.
Fictional studies of the neuroses, stories about mental hospitals and books purporting to
teach how one can improve one's personality axe best sellers, and lay societies take a keen
interest in child guidance. Undoubtedly, much of the popularity of irregular practitioners
is due to their having, whether inadvertently or by design, dime something to ease the
emotional stresses of their clients. If public health organizations are to give adequate,
education in matters affecting health they cannot neglect mental hygiene and they cannot
supply the needs by leaving the field to specialists. Mental hygiene must be grafted onto
the existing branches of public health departments.
A description of our mental hygiene programme would lose its meaning if it were not
presented against the background of those general ideas. The main lines of communication
between our staff and the general public are through the mothers who attend the well-baby
and pre-school clinics, the school teachers and school children, the students at the Vancouver Normal School and the University of British Columbia. Our most effective means
of giving our staff a more intimate familiarity with mental hygiene principles is by means
Page 44 of case studies in which they will all take part. Children referred by school teachers are
studied as individual problems. The school nurse and the teacher each prepares a short
history. The child and his parents are interviewed by the Director of the Division of
Mental Hygiene or by one of the other physicians of the Metropolitan Staff who acts as
the school doctor. They, the Director, the school doctor, the nurse and the school principal and teacher, meet at a conference and discuss the problem in all its aspects. If any
social agencies are concerned they send workers to the conference. We also try to get the
family doctor to come. In this way all the physicians and nurses of our staff partake in the
study of a fair number of cases, and with increasing experience they are steadily becoming
better equipped to utilize the principles of mental hygiene in their daily work.
At the well-baby clinics the discussion of problems of training and development will
fall on the nurses. We are not going to emphasize this work until thjby have had more
experience in the school clinics. It is also proposed that the Director ofj the Division of
Mental Hygiene shall give them a course of lectures designed to serve! as a guide in that
particular field.
At the Normal School the Director is to give a course of lectures in personality development and mental hygiene. It is also planned that he shall devote half a day a week to interviews with individual student teachers who present personality problems that interfere
with their teaching or who show symptoms of poor mental health. It should be pointed
out here that these students are accustomed to receiving general health advice from a
member of the Metropolitan Staff. It will not be a great departure to have them discuss
problems of mental health with another member of the same Staff.
The Metropolitan Health Committee looks after the Health Service at the U. B. C.
Last year it was noted in forty-four cases that psychiatric advice was indicated. It is hoped
that some of these cases will avail themselves of the chance to discuss their personality difficulties with our Mental Hygienist.
Throughout this programme our aim is to make mental hygiene an integral part of our
work. We hope in this way that in the course of time we can give the public a fairly correct conception of mental health, just as we have made some headway in teaching them
about tuberculosis, other infectious diseases, nutrition and chronic infections.
Victoria  Medical   Society
Officers, 1938-39.
President- Dr. W. A. Fraser
Vice-President Dr. A. B. Nash
Hon. Secretary Dr. E. H. W. Elkington
Hon. Treasurer Dr. C. A. Watson
ANNUAL GENERAL MEETING
The Annual General Meeting of the Victoria Medical Society was held in the Library
Rooms, St. Joseph's Hospital, on Monday, October 2, 1939. The President, Dr. Cousland,
was in the chair.
There was a very good attendance of members of the Society.
The time of the meeting was largely occupied by the submission of reports by the
chairmen of the various committees; namely, the Executive, Library, Indigent, Publications, Public Health, Clinics, and Cancer Committees; and their adoption. The members
of the committees were commended for their excellent work, that of the Indigent Committee receiving special mention.
Dr. Felton then introduced Dr. J. L. Gayton, Medical Health Officer for the district
of Saanich, who was welcomed by the Chairman.
Page 45 Wm Dr. M. W. Thomas, Executive Secretary of the B. C. Medical Association, and a Life
Member of this Society, was welcome^ by the Chairman, and later gave a short talk on
the organization of the Victoria Medical Society and the work of the B. C. Medical Association.
The Treasurer's report was then read by Dr. C. A. Watson, and showed the finances of
the Society to be on a very healthy basis.
The Representative of the Society to the B. C. Medical Association, Dr. W. A. Fraser,
reported on the activities of the Association and! suggested that it might be advisable to
train the younger men in the work of the provincial organization and to take them to
meetings.
Dr. G. Andrew Bird and Dr. E. T. Raynor were, by ballot, unanimously elected tc
ordinary membership in this Society.
The election of officers resulted in the appointment to office of the following: President, Dr. W. A. Fraser; Vice-President, Dr. A. B. Nash; Hon. Secretary, Dr. E. H. W.
Elkington; Hon. Treasurer, Dr. C. A. Watson.
Dr. W. A. Fraser was re-elected representative to the B. C. Medical Association, and
Mr. James H. Hill appointed Auditor for the coming year.
Dr. Cousland, as retiring President, gave a brief resume of the history of the Victoria
Medical Society, this being the 40th anniversary of the Society under its present name,
and in conclusion thanked his Executive Committee and the members of the Society for
their loyal support.
The meeting ended with the moving of a vote of thanks to the retiring officers.
ADDRESS BY DR. P. A. C. COUSLAND,
I   RETIRING PRESIDENT  |
Tonight marks the end of my tenure of office as President of this Society. As this
year marks the 40th Anniversary of the founding of the Victoria Medical Society, I think
it would not be amiss to glance back and give a brief review of the happenings of organized medicine in Victoria at the end of the nineteenth century and the beginning of the
twentieth. I have recently, with great interest, read the minutes of meetings, from the
initial meeting of the Victoria Me&co-Chirurgical Society to the present. The following
notes are brief extracts.
In May, 1895, at a meeting held in the Philharmonic Hall, the Victoria Medico-
Chirurgical Society was formed, with Dr. Hanington as President. The initiation fee to
the Society was placed at $5.00, with an annual fee of $2.00, payable in advance. The
only charter member of this original Society who is still living is Dr. W. A. Richardson of
Campbell River.
A few months after formation, the Society was approached by the local members of
the British Medical Association with a suggestion to amalgamate. The following motion
was passed at a meeting of the V.M.C.S.: "That, as the Victoria Medico-Chirurgical
Society has already absorbed most of the members of the local British Medical Association,
be it resolved that the remaining members of the B.M.A. be asked to surrender at discretion." I have been unable to find very much about the local B.M.A. Its members
apparently did not take kindly to the formation of a new Society, but must have come in
to a man when the Victoria Medical Society was formed.
The following year, a request was received from the City Council asking that the
local doctors wear badges. This request was ignored, and, as a counterblast, the Society
requested that the City Council allow physicians to drive over the city bridges at more
than a walk, on urgent cases!
Shortly after this, the Society apparently fell on evil days. Whether or not this was
due to the local members of the B.M.A., who, apparently, had not surrendered at discretion, I cannot say. Suffice it to say that no meetings were held for two and' ai half years.
A meeting was then held on the 6th of December, 1899, at the Driard Hotel—a meeting
called to revive the Society. Instead, a new society was founded—the Victoria Medical
Society—which remains to this day. Dr. Helmcken was the first President; Dr. Hermann
Page 46 Robertson, the first Secretary-Treasurer; and Dr. E. C. Hart was also among the first
members.
From this time on, meetings were held more or less regularly. At first they were held
in the various doctors' offices, then at the Alexandra Club, Balmoral Hotel, and the Victoria Club rooms in the Campbell Building. During the latter part of the last war, and
up to 1922, meetings were held at the Jubilee Hospital. The formation of a library was
first mentioned in 1911, but it was not until August, 1922, that the library was actually
founded, and the first meeting took place in the Library Room in the basement of the
Campbell Building.
Harking back to the meetings in the Balmoral Hotel in 1913—it is noted that the
manager offered the room free, provided the refreshments were paid for. Mention of
refreshments brings to mind the few times dinners and banquets were recorded. A banquet
was given on the 18th of January, 1900, to commemorate the birth of the Victoria
Medical Society, "the cost not to exceed $5.00 per capita"—quite a tidy sum in those days.
Several years later a banquet was held at the Boomerang Hotel, resulting in a deficit of
$40.00, while in 1913 a dinner was given that cost each individual member $5.30. As it
has been reliably reported that a bottle of good Scotch cost only $1.00, it would appear
that the gentlemen did themselves very well in those days.
It seems that the troubles in those days did not differ very much from those in ours.
They, too, must have had considerable difficulty in getting members to turn out to meetings, for one motion reads that "every member who is absent from the meetings be fined
25c." The minutes do not mention whether this motion was passed or not, but apparently
was never acted upon. Similarly, State Health Insurance is no new thing, for in July,
1919, Dr. Mcintosh gave an address on this subject, and advocated its adoption in British
Columbia.
Shortly after the outbreak of war, it is noted that "the members of the V.M.S. should
give medical care, free of charge, to the immediate members of the families of those men
who are on active service, or are mobilized for home duty." And again—"In the event of
any member of the V.M.S. being called away for military service, the members of the
Society will use their utmost endeavour to retain, intact, his practice until his return."
As time went on, these motions appear in minutes dated 1917: "Resolved that we, the
members of the V.M.S., are in favour of conscription of men and women and all natural
resources, and are ready to give our services where they will count most;.and that a copy
of this resolution be sent to the Prime Minister of Canada, and also to the Press of this
city"; and "Whereas we, the medical men, recognize that the abuse of alcohol has been
and still is such an enormous factor in causing inefficiency among our troops, therefore be
it resolved that, in the interest of national efficiency, we would strongly urge that national
prohibition be adopted until the end of the war."
And so it goes. The later history of the Society is too well known to need any recapitulation. Although incorporation only took place twenty-two years ago, yet, as an organized body under our present name, we are forty years old, and getting stronger in our
middle age. I would urge upon you all, particularly during these times, to give the Society
your utmost co-operation and support, so that we may go on from strength to strength.
Before retiring from the chair, I should like to give expression of my gratitude to the
members of the Executive Committee, who have helped me so immensely during the past
year, to all the committees who have worked so assiduously, and to each one of you who
has stood loyally behind the Society.
Page 47 ancouver
enera
Hospita
FRIEDMAN MODIFICATION  OF ASCHHEIM-ZONDEK
■|    TEST 9r^' I
H. H. Pitts, M.D.
The technique of the Friedman modification of the Aschheim-Zondek test is probably
generally well known, but it might be Well to tabulate the salient! poinjts in* the test, its
indication, etc.
As is probably well known, the test depends on the fact that anterior pituitary hormone
is elaborated in considerable quantity in the blood and urine of pregnant women.
The original biological test for pregnancy, as instituted by Aschheim and Zondek, used
three weeks' old female white mice, five of these being used in the test. 0.2! cc. of urine
were injected subcutaneously in mouse No. 1 on six occasions, at intervals over a 4 8-hour
period. The other four were injected at similar intervals with 0.25, 0.3, 0.35 and 0.4 cc.
respectively, and, at the end of the fifth day, were killed and the ovaries examined, both
macroscopically and microscopically, for the presence of corpora haemorrhagica. This
was rather a time-consuming procedure, especially where extra-uterine pregnancy was
suspected and immediate surgical intervention important. Consequently, Zondek devised
a more rapid method by concentrating the hormone with 10% acetic acid and ether
extraction. Even with this procedure a diagnosis could not be given for from 51 to 57
hours.
Friedman, later, elaborated the biological test which bears his name and which makes
use of virgin female rabbits of approximately 3 to 4 months of age and which is actually
a modification of the Aschheim-Zondek test.
The rabbits are isolated at least two weeks or more after purchase from a reliable
breeder, as, even with only does in the same hutch, some stimulation may produce false
reaction in the ovaries, which may be confusing. 10 to 12 cc. of the first morning specimen of urine are injected into the marginal vein of the rabbit's ear on two successive
mornings, after first making sure that the urine is not alkaline, and, if it is, acidifying it
with acetic acid. Alkaline urine, when injected into the rabbit, practically always kills
the animal. Twenty-four hours after the second injection the rabbit is anaesthetized and
the ovaries examined through a skin incision made along the'vertebral column in the lumbar
region, posteriorly, and reflecting the skin well down towards the flanks and then incising
the oblique muscles, when the ovaries can usually be easily delivered with a small hook.
With this type of incision no dressing is necessary as with the abdominal incision, as it is
not in contact with the bottom of the cage, and we have had practically no post-operative
wound infection.
In some institutions the animals are killed and autopsied, but we have been able to use
animals on the average 4 to 5 times and one evenl 0 times, allowing an interval of 4 to 6
weeks between their use.  This materially decreases the overhead.
While it is sometimes possible to obtain accurate results within 24 hours after injection
(using 2 injections 12 hours apart), one feels somewhat safer in using the 2 injections at
24 hours' interval and then exarnining the animal 24 hours after the last injection.
The Friedman test was introduced in the Laboratory of the Vancouver General Hospital in July, 1932, and since that time we have performed the test over 2200 times.
During the past year, an average of 40 to 50 tests per month have been done.
Dr. E. A. Gee and Miss Dorothy Wylie, M.A., our biochemist, are in charge of this
work, and in the follow-up for confirmation of the results have found that our figures
correspond fairly well with the percentage of error usually given of 1.5 to 2%. With this
small percentage of error, it is readily seen that it is an extremely useful test in differentiating any condition simulating pregnancy, notably the following, as tabulated by Wohl:
Page 48 1. Lactation and the onset of the menopause.
2. Endocrine dysfunction, such as ovarian, anterior! pituitary, thyroid and adrenal.
3. Metabolic disturbances frequently associated with obesity.
4. Ovarian cysts and uterine fibroids.
5. Primary and severe secondary anaemia.
6. Debilitating diseases, such as tuberculosis and acute infections.
7. Chronic intoxication, such as lead and alcohol.
8. Psychic amenorrhcea due to fear of pregnancy, especially in the unmarried, and the
anxiety to bear a child.
Positive reactions occur when embryonal tissue is in biological contact with the
maternal or host tissue. Also in chorionephithelioma (usually a very marked reaction),
hydatidiform mole, certain embryonal or disgerminoma types of malignant testicular
tumours, tubal pregnancy where, though the foetus may be dead, the placental tissue is
still viable. Similarly, in incomplete abortions, where viable placental tissue is still present,
a positive reaction may be obtained.
We have had two cases of extensive carcinoma of the ovary in which strongly positive
reactions were obtained.
It is generally stated that a negative test will result seven to ten days after delivery.
While positive tests have been obtained as early as 10 to 14 days after conception, it is felt
that the reliability of a negative test, ten to fourteen days' after trie last missed period, is
questionable and the test should be repeated probably one week later.
The fact that a positive biological test can be obtained so much earlier than the clinical
signs and symptoms are evident make it a most valuable one, especially in cases where therapeutic abortion may be indicated, as in tuberculosis, cardiac or nephritic cases. It is a useful
test in the follow-up of hydatidiform mole and chorionepithelioma and should be repeated
at intervals of 3 to 4 weeks in such cases.
Instructions for collecting specimens: The patient is asked to restrict fluids the evening
before, as this will aid the concentration of the specimen. The next morning, approximately 3 ounces of the first morning specimen of urine is placed in a clean receptacle and
sent to the Laboratory as soon as possible (a catheter specimen is not necessary), tt is
important that the first morning specimen be used, as the hormone is said to be in greater
concentration in this specimen.
When specimens are to be sent in from without the city, 1 drop of cresol or carbolic
should be added to each ounce of urine, as a preservative.
The two injections are made from the original specimen, which is kept in the refrigerator during the interval.
NORTHWEST PACIFIC DERMATOLOGICAL ASSN.
The semi-annual meeting of the Northwest Pacific Dermatological Association was
held in Vancouver on October 19th. A clinical meeting, at which a number of interesting
cases were presented, followed by discussion, took place at the Vancouver General Hospital
in the morning. After luncheon at Shaughnessy Heights Golf Club, it was decided at a
business meeting to hold the first meeting in 1940 in Portland, Oregon. Dr. Lyle B.
Kingery and Dr. John H. Labadie, both of Portland, were elected President and Secretary-
Treasurer respectively.
The meeting was attended by eleven dermatologists from Portland, Seattle, Spokane
and Tacoma, and all the doctors in Vancouver working in the field of dermato-syphilology.
The success of the meeting was contributed to in a large degree by the facilities put at its
disposal by the management of the Vancouver General Hospital, and the very active and
interested assistance of members of the resident staff, notably Dr. McLaren and Miss
Lightly. To these the Association wishes hereby to express its grateful thanks.
Page 49 THE INCREASED NUTRITIONAL REQUIREMENTS OF
PREGNANCY AND LACTATION
W. N. Kemp, M.D.
[The attached contribution by our old friend and colleague, Dr. Norman Kemp, will be not only
of interest, but of value to our readers.  The pregnant woman too often suffers from being taken for
granted in these regards, and both her immediate condition and future wellbeing would benefit
greatly from such extra care as is indicated here.—Editor.]
There is general agreement among nutritionists that a pregnant woman or a nursing
mother requires only those nutrients which she normally needs in' the non-pregnant state
but in greatly increased quantities. As McCollum1 puts it, "She needs more of everything,
particularly more energy, protein, calcium, phosphorus, iron and vitamins."
Provided no condition arises which interferes with the digestion and absorption of
carbohydrates and proteins, there is no special problem in pregnancy which arises in relation to these elements in the diet. Proteins of a high biological value are, of course, necessary, and these are readily obtained from such foods as milk, meat and eggs.
Of the mineral components of the diet, there are three which are essential to normal
nutrition and which may easily be present in inadequate amounts even when the food
intake appears to be varied and adequate.  These are calcium, iron and iodine.
The calcium content of the diet is of great importance, as is also the calcium phosphorus ratio (Ca:P). Judging from studies in experimental animals by Cox and Imboden2,
it would appear that a ratio of Ca:P of unity is near the optimum. On the basis of their
experimental studies they tentatively place the daily calcium requirement of the human
adult at 1370 mg. According to the estimate of Sherman3 and others the average daily
intake of calcium of North American women is about 63 0 mg. or about half the theoretical
requirement of pregnancy.
Idiopathic hypochromic anaemia—a simple secondary anaemia in which the reduction
in haemoglobin greatly exceeds that of the red cells—is frequently encountered during
pregnancy. Recently Labate4, after a study of 8 81 patients in the Bellevue Hospital, New
York, reported that 48 per cent of the patients in this series were anaemic when labour
commenced.
Straus5 6 has pointed out in his excellent discussions that gastric digestive defects, in
association with foetal demands for iron, may be the; cause of the hypochromic anaemia of
pregnancy. He has also pointed out that this type of anaemia can be prevented by the
administration of generous amounts of "ferrous" iron daily.
Until comparatively recent years it was thought that all the iron in ordinary iron-
containing foods was available for utilization by the body. However, the use of Hill's
new dipyridyl reagent, which differentiates between the so-called "haematin" iron and other
forms of iron, and the extensive studies of Elvehjem and associates have shown that only
about 50% of the" iron in such common foods as wheat, oats and meat isi available for
haemoglobin synthesis.
For years it has been assumed that the body's daily requirement for iron is about 15 mg.
for the normal adult and, for the pregnant woman, the figure has been at 20 mg. or above.
Now that it is known that the iron of foods is by no means all available, the actual requirement for iron becomes problematical.
As has been noted by McCollum1, "The excellent studies of Marine, Kimball, McClure
and Olin, in Michigan and Ohio, which are endemic goitre regions, have shown beyond
question the importance of keeping the thyroid glands of pregnant and lactating women
saturated with iodine." In this regard, W. R. Campbell7 of Toronto has recently stated,
"One of the most valuable uses to which a pre-natal clinic could be put would be the
training of the expectant mother to use sufficient iodine both for her own good health and
that of the child." REFERENCES:
1. McCollum, E. V.: Am. J. Obst. & Gynec, 36:586 (Oct.), 193 8.
2. Cox, W. M., and Imboden, M.: Jour, of Nutrition, 11:147, 1936.
3. Sherman, H. C, and Booher, L. E.: Jour. Biol. Chem., 93:93  (Sept.), 1931.
4. Labate, J. S.: Am. Jour. Obst. & Gynec, 38:48 (July), 193 9.
5. Strauss, M. B.: J.A.M.A., 102:281  (Jan. 27), 1934.
6. Strauss, M. B„ and Corrigan, J. C.: J.A.M.A., 106:1088 (Mar. 28), 1936.
7. Campbell, W~. R.: CM.A.J., 40:77 (Jan.), 1939.
Page 50 DAILY PRAYER
OF A PHYSICIAN
I begin once more my daily work. Be Thou -with me, Almighty Father
of Mercy, in all my efforts to heal the sick. For -without Thee, man is
but a helpless creature. Grant that I may be filled with love for my
art and for my fellow-men. May the thirst for gain and the desire
for fame be far from my heart. For these are the enemies of Pity and
the ministers of Hate. Grant that I may be able to devote myself,
body and soul, to Thy children who suffer from pain.
Preserve my strength, that I may be able to restore the strength of the
rich and the poor, the good and the bad, the friend and the foe. Let me
see in the sufferer the man alone. When -wiser men teach me, let me be
humble to learn; for the mind of man is so puny, and the art of healing
is so vast. But -when fools are ready to advise me or to find fault -with
me, let me not listen to their folly. Let me be intent upon one thing,
O Father of Mercy, to be always merciful to Thy suffering children.
May there never rise in me the notion that I know enough, but give
me strength and leisure and zeal to enlarge my knowledge. Our work
is great, and the mind of man presses forward forever. Thou hast
chosen me, in Thy grace, to -watch over the life and death of Thy
creatures. I am about to fulfill my duties. Guide me in this immense
work so that it may be of avail.
The author of this prayer. Moses ben Maimon, called Maimonides,
(1135-1204 A.D.), was a legislator, philosopher and one of the greatest
physicians of his time. He is referred to as the most celebrated
Jewish physician of the twelfth century. He lived and practiced in
Tafsat (Cairo), Egypt. First published in 1863, this bit of idealism
attracted wide attention. As private physician to the Sultan Almalie,
he attended, so he relates, "all sorts of patients, Jew and Gentile, rich
and poor, friend and foe, merchant and toiler—a mixed multitude."
Page 51
Prom a Reprint by Northwestern University Medical School, 1939 DR. J. W. McINTOSH
Died August 12, 1939.
Vancouver lost a devoted and wise medical health officer in Dr. Mcintosh,
and many of us have lost a close friend. The writer's first impression and memory
of "J. W." was as the Secretary of the Vancouver Medical Association, reading
voluminous minutes, in the Board Room of the old Molson's Bank Building, now
David Spencer's annex. This was typical of the man in many ways. Active and
energetic, possessed of a most restless and fertile mind, he was an integral moving
part of every organisation and group to which he belonged—and their name was
legion. It was not possible for him to be merely a member of anything—he must'
be on his feet, in committee work, leading in all the activities, and giving continually of his time and energy. Nor was it merely being busy for the sake of
being busy—his mind was of the constructive order, and usually packed full to
bursting of ideas and suggestions, which poured out in a never-ending stream.
J. W. Mcintosh was identified in one way or another with every worthwhile
public activity. He became a member of the Provincial Legislature, not, one felt,
because he had any love for political life, but because he had some causes to champion, some wrongs to right, and felt that he could do this best in some such
capacity. But he was not well suited for adherence to an ordinary political party.
He was rather too blunt and outspoken to be a comfortable bedfellow in the political nest, and he knew little of compromise, and was a nonconformist: so that he
soon became a rebel, and broke with the party to which he was so loosely attached.
But he did good work all the same while in office, and confirmed in men's minds
the reputation he had always had for honesty, sincerity and devotion to his Province and country.
It was natural that when war came in 1914, he was soon in the thick of it,
joining up for overseas service, and here again he did excellent work. Corning
back from overseas, he decided to leave the therapeutic side of medicine, which
for many years he had followed as an internist, and devote his energies to preventive medicine; he acquired a D.P.H. and became M.H.O. of New Westminster,
Burnaby, and last of all Greater Vancouver.
Here he found, one cannot but feel, his true metier. His enthusiasm grew
with the years. He was very keen on Health Insurance, and advocated this fearlessly. He had much to do with the establishment of the Metropolitan Health
Department now in existence, was its first head, and organised it to a high degree
of efficiency. He worked well and loyally with both superiors and subordinates,
was respected and liked by both—a severe test of any man. He had hosts of
friends and admirers, and no enemies.
"J. w\" has done what came to him to do, well and loyally. The recipient of
many talents, he allowed none of them to lie idle, or rust from disuse, but put
them all out to usury. A good and faithful servant, we feel that he has already
had much of his reward, in the coming to full fruition of so many of his plans
and ideas.
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Epinephrine in Oil (1:500) is supplied as a sterile mixture of
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*Finland, M., Spring, W. C, Lowell, F. C, and Brown, J. W.: Ann. Int. Med. 12:11, 1816 (May)  1939.
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e85 MONTREAL CANADA Army Medical Officer Puts
Ovaltine to the Test
One of the most striking of the thousands of testimonials
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officer of a scientific expedition into the high peaks of
the Himalayan Mountains—Major J.  R.  Foy.   Dated
from   Avondale,   Simla,   S.W.,   August   20,   1939,   he
writes:
"As Medical Officer of the Expedition I was very
frequently called upon to administer Ovaltine to
exhausted climbers upon their return to the base
camps at the feet of Nanda Devi East and the
Trisuli Peaks, respectively. I cannot speak too
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Vitamin A
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Canadian physicians prescribed and were responsible for the distribution
of 9,089,373 Wyeth Hematinic Plastules during the past twelve months.
No more striking proof of the merit of this modern iron therapy could
be advanced.
This growing acceptance is based entirely on the results obtained in the
treatment of hypochromic anemia. Hematinic Plastules are economical
—easily tolerated and extremely effective.
JOHN WYETH & BRO. INC.
WALKERVILLE, ONTARIO CLEAN COWS
CLEAN milk can come only from
clean cows. So the Carnation
Company's "field men" carefully
inspect the herds that supply its
numerous evaporating plants. And
"clean cows, clean barns, clean
hands, clean men" is the gospel
they preach ... It takes good milk
to make good milk. Protection at
the source definitely contributes to
the quality of Irradiated Carnation
Milk—and to the high reputation
it enjoys as a pure, nourishing, and
digestible milk for use in infant
feeding.
A BOOKLET FOR PHYSICIANS
—Write for "Simplified Infant
Feeding", an authoritative publication treating of the use of
Irradiated Carnation Milk in
normal and difficult feeding cases
. . . Carnation 'Company Ltd.,
Toronto, Ontario.
\a/maiwn
^0m>4   IRRADIATED
CI    IHRADIATED^X     JT ^|
arnation lVlilk
A CANADIAN PRODUCT- "from contented cows
KIMS STRAPPED FDR RICKETS
The swaddled infant pictured at
right is one of the famous works
in terra cotta exquisitely modeled
by the fifteenth century Italian
sculptor, Andrea della Robbia.
In that day infants were bandaged from birth to preserve the
symmetry of their bodies, but
still the gibbous spine and distorted limbs of severe rickets
often   made  their appearance.
^rSSSSSwi
%*»*
A bambino from the Foundling Hospital, Florence, Italy,—A. della Robbia
Qwaddling was practised down
^ through the centuries, from Biblical times to Glisson's day, in the
vain hope that it would prevent the
deformities of rickets. Even in sunny
Italy swaddling was a prevailing custom, recommended by that early pediatrician, Soranus of Ephesus, who
discoursed on "Why the Majority
of Roman Children are Distorted."
"This is observed to happen more
in the neighborhood of Rome than in other places," he wrote. "If no one oversees the
infant's movements, his limbs do in the generality of cases become twisted. ... Hence,
when he first begins to sit he must be propped by swathings of bandages " Hundreds
of years later swaddling was still prevalent in Italy, as attested by the sculptures of the della
Robbias and their contemporaries. For infants who were strong Glisson suggested placing
'Leaden Shooes" on their feet and suspending them with swaddling bands in mid-air.
How amazed the ancients would have been to know that bones can be helped to grow
straight simply by internal administration of a few drops of Oleum Percomorphum. What
to them would have been a miracle has become a commonplace of science. Because it can
be administered in drop dosage, Oleum Percomorphum is especially suitable for young and premature
infants, who are most susceptible to rickets. Its vitamins A and D derived from natural sources, this
product has 100 times the potency of cod liver oil. *
Important also to your patients, Oleum Percomorphum is an economical antiricketic.
Oleum Percomorphum offers
not less than 60,000 vitamin A
units and 8,500 vitamin D (International) units per gram.
Supplied in 10 and 50 cc. bottles, also in boxes of 25 and 100
ten-drop soluble gelatin capsules containing not less than
13,300 vitamin A units and
1,850 vitamin D units (equal to
more than 5 teaspoonfuls of
cod liver oil*).
♦U.S.P. Minimum Standard
MEAD JOHNSON & CO. OF CANADA, LTD.
BELLEVILLE, ONTARIO
Please enclose professional card when requesting samples of Mead, Johnson products to
co-operate in preventing their reaching unauthorized persons. Carefulness
The continuous vigil of accuracy
is the daily price we pay for
your patronage and satisfaction.
Day and Night
SEy. 2263
,*Cea£uL&.Jcle*ie&kao*i
GEORGIA PHARMACY
l_  1 M   I T E   O
eeoROiA
<£mtn & ijamut Sift.
Estmblitbtd 1M93
VANCOUVER, B. C.
North Vancouver, B. C.   Powell River, B. C. Ii
Hollywood Sanitarium
Limited
For the treatment of
Alcoholic, Nervous and Psychopathic Cases
Exclusively
Reference—B. C. Medical Aeeociation
For information apply to
Medical Superintendent, New Westminster, B. C.
or 515 Birks Building, Vancouver
Seymour 4183                                            Wsstminstbb 288
ROY WRIOUtY FRINTINO
• PUBUSHINO CO. LTD.

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