History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: October, 1933 Vancouver Medical Association Oct 31, 1933

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 VOL. X.
No.  1
»f    th<
Vancouver Medical Association
Test for Syphilis
Association Activities
Anaemia (Conclusion)
Winter Programme
made from
the finest quality Acetylsalicylic Acid so compressed
as to insure immediate disintegration in the
We commend VANASPRA to the profession as
of the highest standard at less than half the price
of other makes.
Western Wholesale Drug
456 Broadway West
Published   Monthly  under  the  Auspices  of  the  Vancouver  Medical  Association  in   the
Interests of the Medical Profession.
203 Medical Dental Building, Georgia Street, Vancouver, B. C.
Editorial  Board:
Dr. J. H. MacDermot
Dr. M. McC. Baird Dr. D. E. H. Cleveland
All communications to be addressed to the Editor at the above address.
Vol. X.
OCTOBER,  1933.
No.   1
OFFICERS 1933-1934
Dr. W. L. Pedlow Dr. A. C. Frost Dr. Murray Blair
President Vice-President Past President
Dr. W. T. Ewing Dr. W. T. Lockhart
Hon. Secretary Hon. Treasurer
Additional Members of Executive:—Dr. C. H. Vrooman; Dr. H. H. McIntosh
Dr. W. D. Brydone-Jack Dr. J. A. Gillespie Dr. F. Brodie
Auditors:   Messrs.  Skaw, Salter  & Plommer
Clinical Section
W. H. Hatfield : Chairman
W. L. Graham Secretary
Eye, Ear, Nose and Throat
R.   Grant   Lawrence    Chairman
E.   E.   Day : . . Secretary
Pacdialric Section
E.  D.  Carder Chairman
R.  P.  Kinsman-. — Secretary
Cancer Section
A.   Y.  McNair     Chairman
A. B. Schinbein   Secretary
Library Summer School
H.   A.   DesBbisay 8 1   f Thomson
G   E   Kidd ^"    • Brown
T   E   Harrison Publications                Dr. C H. Vrooman
\V7   n   Trr,Tt_ t^     t   ti   -k,    t-. Dr. J- W. Arbuckle
W. D. Keith Dr. J. H. MacDermot _. „    .    c
r  m  r.ctiv .->     w t. Dr. H. A. Spohn
(^. Jti. JBastin Or, Murray Baird -. „   „    ,,
a   w  B.rvin t-_     t->   i-   ht  /- Dr. H. R. Mustard
A.   W.  BAGNALL JJ>r.   D.  E.  H.  CLEVELAND
Dinner Dr.  W. C  Walsh
T   r   m_-Kav Credentials Dr. s- b- Peele
J. G. McKay Dr  t  h  Lennie
N. E. MacDougall Dr.  F.  p.  Patterson Dr. C F. Covernton
G. E. Gillies Dr. S. Paulin
Dr. F. W. Brydone-Jack V.O.N. Advisory Board
~   „ j    , Dr. I. Day
I i0 B- C- Med- Assn- . Dr. J.  W. Sh.er
G. F. Strong Dr. H. H. Boucher
Sickness and Benevolent Putid — The President — The Trustees VANCOUVER HEALTH DEPARTMENT
Total   Population    (Estimated)             247,2 51
Japanese   Population   (Estimated)     8,429
Chinese   Population    (Estimated)      7,759
Rate per 1,000
Number     Population
Total    Deaths        .  172 8.2
Japanese   Deaths     11 15.4
Chinese Deaths   6 9.1
Deaths—Residents only   148 7.0
Birth   Registrations   ..  297 14.1
Male      163
Female  134
Deaths under one year of age   ■ 5
Death   rate—Per   1,000   births     16.8
Stillbirths   (not  included  in  above)     10
September 1st
July,  1933 August,  1933 to 15th, 1933
Cases     Deaths Cases    Deaths Cases    Deaths
Smallpox           0              0 0              0 0              0
Scarlet    Fever              6             0 11              0 8              0
Diphtheria                2              1 0              0 0              0
Diphtheria   Carrier             0              0 0              0 0              0
Chicken-pox           41              0 10              0 4              0
Measles             0             0 0             0 0             0
Rubella              0              0 0              0 0              0
Mumps             7              0 10 3              0
Whooping-cough             10 3              0 3              0
Typhoid   Fever    (Carrier) .._        2             0 10 10
Paratyphoid               0              0 0             0 0              0
Poliomyelitis              0              0 10 0              0
Tuberculosis             57            14 69            11 29
Meningitis    (Epidemic)              0              0 0              0 0              0
Erysipelas             4             0 2              0 10
Encephalitis   Lethargica            0             0 0             0 0             0
is a handy, convenient, clean commodity for the bag or the
office. Supplied in one yard, five yards and twenty-five
yard packages.
Phone Seymour 698 730 Richards St., Vancouver, B. C.
The issue of "Health News" for July 17, 1933, contains
a report regarding epidemics of septic sore throat at two
adjoining villages in New York State, Luzerne and Hadley.
The State Department of Health reports 137 cases of sore
throat occurring in the two villages between March 13 th
and June 14th.
The evidence regarding relation to milk is given as
"It was found that 77% of the 137 cases were among
customers of Milk Dealer A who furnished 310, or 55%
of the 562 quarts of milk sold in the two villages daily.
Moreover, 91% of the 78 persons attacked while the epidemic was at its height, (May 14 to 27 inclusive) were
among users of Dealer A's milk. Only raw milk was sold
by Dealer A; none was pasteurized.
"His supply came from two dairy farms, on one of
which a cow was found suffering from mastitis with
greenish yellow pus dripping from the affected teat. A
hemolytic streptococcus was isolated from specimens of
pus from this cow. No history was obtained of a human
septic sore throat case on the farm in question.
"Although many details of the situation are lacking, the
conclusion seems warranted that the septic sore throat
outbreak at Luzerne and Hadley was probably due to
the consumption of Dealer A's milk, and that this milk
may have been infected by the cow from which the
hemolytic streptococcus was isolated."
Later, 19 additional cases occurred. Apparently the milk
of this cow was again used, causing the second outbreak.
Then the cow was slaughtered and all of the milk from
this dairy was required to be pasteurized. This put an
effective end to the infection.
Associated Dairies Limited
Fairmont 1000—North 122—New Westminster 1445 To Doctors:
The high standard of the ingredients used in the
filling of prescriptions at The Georgia Pharmacy,
and the careful, intelligent manner in which they
are filled, has been recognized by hundreds of
Vancouver Physicians for the past 26 years. We
appreciate the responsibility placed in our hands.
Call upon us any hour of the Day or Night
For the Failing Heart ||
(theobromine'calcium salicylate)
Give Theocalcin to increase the efficiency of the
heart action, diminish dyspnea and to reduce edema.
Theocalcin is a potent diuretic and cardiac stimulant in doses of 1 to 3 tablets, three times a day
with or after meals.
In 7l/2 grain Tablets and as a Powder.
Literature and samples upon request
MERCK & Co. Ltd., 412 St. Sulpice St., Montreal
Selling Agents
Manufacturers: Bilhuber-Knoll Corp., Jersey City, N.J. VANCOUVER MEDICAL ASSOCIATION
Founded- 1898
Incorporated 1906
GENERAL MEETINGS will be held on the first Tuesday of the
month at 8 p.m.
CLINICAL MEETINGS will be held on the third Tuesday of the
month at 8 p.m.
Place of meeting will appear on Agenda.
General Meetings will conform to the following order:
8:00 p.m.—Business as per Agenda.
9:00 p.m.—Paper of Evening.
Dr. E. L. Garner: "Fractures."
Dr. F. Brodie: "Brain Injuries."
Dr. C. E. Brown: "Disturbances of Gastric Secretion."
Dr. Lyon Appleby "Some Points in Surgery of the Spleen."
Dr. B. D. Gillies: (subject to be announced later.)
The OSLER Lecture.
Dr. Murray Baird: "Erythema Nodosum in Relation to Tuberculosis."
Dr. D. E. H. Cleveland: "Drug Eruptions."
With this number, the Bulletin enters upon its tenth volume: the
row of green-bound books with its name is growing on the Library shelf.
As we grow old, it is Said, we tend to reminisce, to dive into the waters
of antiquity for treasures left there in years gone past, or perhaps, like
a dog, to go back and dig up old bones that we have buried some time
before—not that ten years is a great age, but ten of such years as the
Bulletin has just passed through have contained so much, have been
packed so full with variety, as to constitute almost a lifetime. Perhaps
that would be true of any ten years, if we had the vision to see all that
they contained, but we think that the past decade has been especially
eventful, perhaps mainly because the last three or four years mark, as we
think, the end of an old order, and the introduction to a new one.
It is a good plan to take stock occasionally—and the beginning of
a New Year is traditionally the time for that sort of thing. As a young
journal, full of ambition and an earnest desire to be of value and service
to the medical profession of British Columbia, we ask ourselves "Have
we fulfilled this purpose"? What part do we really play in the life of
the medical man of B. C? because while we are nominally the Bulletin
of the Vancouver Medical Association, we reach every part of the province.
Well, we will tell you what we want to do, what our ambition is,
what we have been trying to accomplish.
In the first place we want to be the medium whereby all activities
of the medical profession can be recorded and coordinated. We should
like to be the unofficial organ of the medical profession of the province,
so that members of that profession could use our columns to make suggestions, even occasionally make complaints, if they ever have any, and
cleanse their bosom of any perilous stuff which may weigh upon their
heart. [This is not our own language, but an adaptation of Shakespeare.
Next, we want to be the medium whereby original work or research
done by any man in B. C. can be published. We have, we feel, been rather
successful in this regard. Quite a lot of excellent work is done every
year, some of it by men in the cities, some by men in outlying districts,
and the Bulletin is always eager to secure this and publish it. And no
man need feel that in sending his work to us, he is sending it to an
obscure little paper which nobody reads. Our readers would be surprised
if they knew the extent to which recognition has been accorded the
Bulletin. We send the paper to many centres, and very often our articles
are quoted or abstracted by other journals, some of national scope.
Then we would like to be a sort of corner-store club, where all the
news and gossip may be set forth, even a little mild scandal occasionally
—but "nought set down in malice." To this end we would welcome
all news and notes of doings in the lives of our readers, births, deaths,
marriages, golf triumphs, tours—whatever is of interest to you is of interest to all of us.
And lastly, and we feel this to be most important, the Bulletin has
consistently taken a stand for more thorough and complete organization
Page 3 of our profession, into a strong fighting unit, armed to protect all its
members against injustice or exploitation. This armour can only be
forged out of unselfish cooperation—out of loyalty of each to the good
of all, out of generosity and a sincere willingness to play the game. The
last few years have been stern ones, but they are not without their
brighter side. For we see dawning on our horizon, a better, more genuine
feeling of solidarity and unity amongst our members than we have ever
seen before. These things are of slow growth and perhaps it is well
they should be. But the stern press of circumstance is teaching us surely
and relentlessly that we must work together, if we are to continue to
prosper, and that there is no room for greed and selfishness, if we are
to become what we should be, a strong and united profession, not only
for our own profit, but for the ultimate good of the community we live
in and serve.
So we bespeak for the Bulletin, for another year, your support and
forbearance. Read the Bulletin, read the ads, patronize our advertisers,
and all things shall be added unto you.
The postgraduate tour of the Canadian Medical Association is proceeding at the time of writing. The team comprises Drs. Jonathan
Meakins, Roscoe Graham and Grant Fleming, with Dr. T. C. Routley,
General Secretary of the Canadian Medical Association, accompanying
They have given lectures and clinics in most of the large cities between here and Montreal and if the lectures they gave here are a sample
of their usual work, we can only say that it must have been a most
profitable and educative tour from the point of view of the audiences—
for everyone here agreed that they were exceptionally good.
It is in no spirit of criticism, but rather as a constructive suggestion
to say that we think that in other tours, more attention should
be paid to seeing that the smaller and outlying places receive visits from
these teams. Medically they are every bit as important as Vancouver or
Victoria, and their opportunities are far fewer. In saying this, it must
be stated emphatically that this omission was not the fault of the Execu-
ive of the B. C. Medical Association, which had been asked to make the
arrangements. This body had mapped out an itinerary for visits elsewhere, but the visiting team could not see its way to giving the
necessary time. But we suggest that if someone has to suffer from this,
it would better be the larger centres. The Executive is at present contemplating the sending of local teams to the outlying districts of the
A dinner was held at the Hotel Vancouver at which these gentlemen were guests of honour. About a hundred men were present. Dr.
Routley spoke at some length regarding these tours, and his especial
duties in this one. He reminded us that for seven years the Sun Life
Assurance Company of Canada had donated $30,000 yearly for postgrad-
Page 4 uate work. In this time some two thousand lectures have been given
with an average attendance of thirty—at a total cost of $210,000.
Depression has temporarily compelled our benefactor to suspend this
donation, but Dr. Routley is very hopeful that there may be a resumption
of it at a not too distant date. Meantime we must all feel and express
a most sincere gratitude to the Sun Life.
He spoke about the Journal too, and points out that some 501
doctors are in arrears—most of them, especially on the prairies, are being
carried, at a cost to the Journal of $5.00 a year each.
He then referred to the problem of the care of the indigent in Canada. At this time Dr. Routley is very busy attempting to co-ordinate the
efforts of the profesison in the various provinces, and has spent much
of his time during the tour interviewing both medical and political leaders.
He met the Vancouver Medical Association Committee on Medical
Care recently, and there and at the dinner he gave an account of the
work he has been doing in this regard. He finds, as we have found here,
that the great difficulty is to pin any responsible governmental body,
provincial, federal or municipal, down to a definite promise. They are
all "letting I dare not wait upon I would" or rather letting their "would"
wait upon someone else's "will not." Each one would gladly pay its share
if the others would pay theirs. Meantime, while they pass the pea from
one shell to the other, we, like the gullible hick from Reubensville, try
to pick out the right shell, but true to form, we never can. But from
what Dr. Routley told us, we think that definite progress has been made,
especially in Ontario: a very gratifying note was struck by him when
he told us how fairly and honourably the medical profession had played
the game in this regard, where, the government had trusted them. We
know, of course, that the vast majority of them would do just that, but
here is a definite proof.
Dr. Grant Fleming also spoke on Preventive Medicine.
We record with very sincere regret the death of Dr.
V. E. D. Casselman, which occurred on September 16th,
at the termination of a long and painful illness. Dr.
Casselman will be greatly missed by all of us—he has
been long in Vancouver, and was an outstanding figure
in his profession. Always competent, calm and friendly,
he commanded the affection as well as the respect of his
fellows, and the esteem in which he was held was shewn
by his election to the Presidency of the Vancouver Medical
Association in 1919. He was also a well-known figure in
certain fraternal orders. "Cassie," as he was affectionately
known to us all, was a good citizen, and a most likable
fellow to boot. He was in uniform during the war, and
went overseas with the C. E. F. To his wife and family,
we extend our sincerest sympathy.
Page ^
The one hundred and forty-eight active and eleven associate members
who are in arrears of dues are reminded that no drafts will be issued this
year at the commencement of the winter session.
It is urged that where payment in full is difficult at this time, one-
fourth or a half might be paid now, and the remainder later on in the
The political pot is coming to a boil, and we note that Dr. Dan.
McLellan made a very close fight of it, in the nominations for one of
the Vancouver divisions. As to the result, we do not know quite whether
to condole with Dan, or congratulate him—on the whole, perhaps, we
think the latter. The witches' cauldron, as he will remember, brought
forth the remark from one of the attendant crones "Bubble, bubble, toil
and trouble", and we are inclined to think that may be especially true of
this brew.
We all rejoice to see Dr. J. L. Turnbull walking round the hospital,
apparently none the worse for his recent adventures; except for a slight
increase in absent-mindedness, as evidenced by his wearing rims without
any glasses in them.   And you should see the lamp-post!
Our old friend and companion, J. R. Naden, appeared recently in
the General with one arm in a sling, due to the dislocation of a shoulder
in a motor accident. Later, we understand, he dislocated the other in
another accident. This is a remarkable, and we should imagine, a rather
painful coincidence, but at any rate, we congratulate the doctor on the
fact that he has only two shoulders.
Some of our readers may have noticed that the Canadian Medical
Journal, our elder brother, abstracted, almost in full, Dr. F. E. Coy's
article on the danger of Carriers in Postnatal Care, especially as regards
nurses in attendance. We hope Dr. Coy will follow up this important
Dr. W. F. Ewing has returned to town after a trip of several days
around Puget Sound. We hope some day to publish a photograph of him
with the 32% lb.  (note the l/z ) salmon that he caught.
Page 6 Inspecting gold-mining properties in which they are interested, is
becoming a regular side-line amongst medical men. Drs. Prowd and
Worthington are away, we understand, inspecting one mine, while Dr.
A. C. Frost is neglecting his golf, to go watching a "clean-up", whatever that may mean, at another. Playing with him lately, we seemed to
notice a lack of concentration, when it came to approaching.
Our hearty congratulations are extended to Dr. C. H. C. Bell and
Mrs. Bell, whose wedding took place at St. Paul's church on September
2nd. Mrs. Bell was formerly Miss Elspeth Kilpatrick, a popular graduate
in nursing of the U. B. C. and at one time in the Operating Room of the
General, but more recently engaged in Public Health work with the
Children's Aid Society.
It is understood that Dr. and Mrs. Lavell Leeson, whose recent
marriage was reported in a late Bulletin, are both suffering from whooping-cough. Further, that the doctor has broken a rib. Having in mind
Genesis 2: 21-23, we are in doubt as to whether this should be reported
as a major or a minor accident.
Dr. A. B. Schinbein has been appointed Honorary Consulting Surgeon to the Vancouver Public Health Institute for Diseases of the Chest.
It is rumoured that the Board of Aldermen has been struck with consternation on learning from the daily press that this is an instance of a
doctor working for the City without pay.
The marriage of Dr. S. Graham Elliot and Dr. Ellen Stark took
place quietly on August 26th. The Bulletin offers its congratulations
to these two popular members of the sister professions of Medicine and
Dentistry respectively. Two more people testifying to the opinion that
the Chief End of Man is the head end.
Bralorne stock is still going up. Dr. D. McK. King, of Bralorne,
a nephew of Dr. W. A. Whitelaw, has shown his confidence by bringing
home a bride. His marriage to Miss M. D. Munn took place on September
20th. We congratulate them.
Page 7
___■__■■ Talking of golf, our genial friend, Dr. J. P. Bilodeau, has been unaccountably absent from the links of late. We were wondering if the
trimming administered by Dr. J. A. (Okey) Smith, still rankled, but
are sorry to find that it is due to a bad knee, at least Joe says it is. We
are inclined to think that this is rather a lame excuse.
We note the return to active golfing life of Dr. George Clement,
who, with Dr. Lyon Appleby and others, recently graced the Totem Pole
Tournament, at Jasper. George did not, we understand, actually win
the cup, but rather put the wind up the other contestants. George is
still young, however, and will have another chance next year.
Dr. F. P. Patterson has been away from the City, visiting Eastern
Dr. J. A. McLachlan is recovering from a tonsillectomy.    We, who
have suffered likewise, extend to him the hand of sympathy.
The arrangement made with the City with regard to maternity
cases amongst those on city relief, appears to be working out well. Between August 22 and September 15th, some 20 cases have been notified,
of whom 4 have been delivered, and the bills sent as per agreement to
the General Hospital. We believe that there have been no troubles, and
the arrangement is working smoothly.
How many of our readers know that the forthcoming session of the
Vancouver Medical Association is the 36th Annual Session? The boy is
growing up. He owes his present lusty good health, as does every healthy
adult, to the excellent care he received in his early childhood. Some of
those who nursed him in his tender years are still with us, and active as
ever. Of course, in this connection, we think first of Dr. J. M. Pearson,
and congratulate him again on the strength and vigour of his protege.
Long may he live to watch its progress.
Calamus Scriptorius notes: (Vide Province, August 25th) That a
lady "would work for board with doctor, or intellectual person"—and
she doesn't care which.
Page  8 That Smoky Snyder, of Kimberly, B. C, was tossed by a steer at
the World's Fair, (vide News Herald, September 4th) and suffered a
broken collar bone and clavicle. It should be added that his sufferings
were not increased by the fact that both his key bone and clavicula were
also broken.
That Dr. Molesworth of Sydney (vide Med. Jnl. Aust. 2, 1932, 197)
has "seen multiple rodents in a youth of twenty with red hair and freckled
skin" and doubts if this is preferable to seeing single pink ones in the
back of the bar.
Principles and Practice of Rectal Surgery,  by William  Gabriel,  M.S.,
F.R.C.S., 1933.
This manual is rather a disappointment. It is concise and in
parts very interesting, but some of the views expressed are rather unusual.
The author's method of handling ischio-rectal abscesses is very good. He
advises immediate drainage, and free drainage with the least amount of
interference. His idea of a two stage operation for ordinary anal or
ano-rectal fistula appears rather extreme. These fistulae usually take
from four to six weeks to heal from a single operation, without waiting
two to three weeks for a second stage operation. The time and expense
for the patient is more than can be justified. On page 100 a very interesting point is made in the statement that ten per cent, of fistulae are
tuberculous. This percentage is sufficiently high, but it was believed,
and very recently too, that seventy-five per cent of all fistulae" were
tuberculous. In the chapter on pruritus ani some new ideas might have
been expected, but no new light appears on this subject. The most
interesting point in the whole book is to be found on page 130 in the
last two paragraphs, the last one in particular: "After dilating the sphincter, a sub-acute synovitis occurred in a knee-joint." This is very important, as any joint in the body can be similarly attacked. The surgeon
is blamed for introducing infection, whereas some old latent condition is
at fault ,and many a malpractice claim has thus arisen.
T. R. Whaley.
Colon, Rectum and Anus.
Rankin, Bargen & Buie.    W. B. Saunders,
This is an excellent and comprehensive treatise on the subject. It
would be a useful addition to any professional library. Anatomy and
physiology of the parts dealt with are well presented and the plates are
Page 9 a valuable aid. The chapter on megacolon is very good, as are also those
on diverticulosis and diverticulitis in which the authors point out that
these conditions are more frequent than they were formerly believed to
be, and how the use of the sigmoidoscope renders the diagnosis more certain. Tuberculosis of the large intestine is fully discussed and attention
is drawn to pages 171 and 172 in which the significance of blood in the
stool is emphasized and tuberculous ulcer is described. The reference to
pain in a tuberculous ulcer is worthy of note—it is the most constant
symptom, particularly after meals. An important statement appears on
page 178—"Chronic ulcerative colitis begins in the rectum and progresses proximally. Amoebic ulcerative colitis and tuberculous ulcerative
colitis have their lesions in the caecum and progress distally." The
chapter on chronic ulcerative colitis provides a full description of this
prevalent condition including the role of Bargen's Diplococcus. The
diet described on page 273 is far more extensive than the old bland diet
of the past. Attention must also be drawn to the chapters on benign
and rare tumours and polyposis in which latter condition the sigmoidoscope is an aid to diagnosis which should be used more often. The interesting subject of Pruritus Ani is fully described and Buie's alcohol injection is recommended. According to Buie this is very satisfactory but
few others get as good results with it as the originator claims. An
unusual amount of space is given to the subject of carcinoma of the
rectum and anus. This is worth reading many times especially page 551
which describes the clinical appearance of a carcinoma. The work concludes with an outline of operative procedures.
T. R. Whaley.
Acute Poliomyelitis as a Primary Disease of the Central Nervous System.
(A reconsideration of the Pathology, Symptomatology and Treatment, based on the hypothesis of Axonal Propagation of the infective agent.) Harold K. Faber. Medicine, vol. xii., May, 1933,
No. 2, Pg. 53-186.
This is a very excellent review of the whole question of Acute
Poliomyelitis. As the title infers, the subject has been treated exhaustively. Probably the most outstanding feature of this discussion is the
author's hypothesis of Axonal Propagation of the virus in humans.
With regard to the portal of entry, the author states "We may
accept without much hesitation, the olfactory mucous membrane as the
most probable route of penetration of the virus of poliomyelitis from
the surface into the central nervous system, and it should be noted that
it is quite unnecessary to assume in explanation of this penetration any
preliminary local irritation or inflammation . . . ." There is a full description of the pathology produced by the presence of the virus. Symptomatology is fully discussed under the heading of the four phases: (i)
symptoms at the beginning; (ii.) symptoms subsequent to the onset but
preceding the appearance of paralysis; (iii.) symptoms present at the
onset of paralysis; and (iv.) period of recovery.
The use of diathermy for the alleviation of pain
is one of the most successful measures in modern
treatment. Its effect is enhanced and prolonged by
the application of Antiphlogistine.
By its glycerine content it produces a relaxant
effect, by its osmosis it absorbs the exudates and
by its plasticity, which promotes rest and comfort,
Antiphlogistine is the ideal adjuvant in the diathermic treatment of the various forms of neuritis,
traumatism, sciatica and all other rheumatic conditions.
Antiphlogistine does not supplant diathermic treatment, but, rather, should
be co-ordinated with it.
Sample and literature will be sent upon request.
The Denver Chemical Mfg. Co.
153  Lagauchetiere  St. W.
Diphtheria Antitoxin
Diphtheria Toxin for Schick Test
Diphtheria Toxoid (Anatoxine-Ramon)
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Scarlet Fever Toxin for Dick Test
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)
Price List   Upon Request
University of Toronto
Depot fir British Columbia
Medical-Dental Building Vancouver The discussion of "the Route of Propagation of the Virus"—leads
up to the various phenomena seen in the course of the disease: (a) halting; (b) abortive cases; (c) Dromedary cases; (d) cases with advancing-
paralysis; (e) subclinical poliomyelitis; and (f) relapses and second
attacks. This is followed by a discussion of the "Conditions Favoring
In treatment, the need for "supplying the maximum concentration
of antibodies in the blood at the earliest possible moment, and maintaining this concentration as long as is necessary," is stressed. In this connection the author concludes, "Intravenous injection of whole blood or serum
in large amounts from donors tested for immunity appears to be the best
method at present generally available. Foreign serum of high antibody
titer, when this can be supplied, may be still better."
An excellent bibliography is appended.
C. A. Ryan.
By F. Smith
Assistant, Provincial Board of Health Laboratory, Kelowna, B. C.
Four years ago, the Director of this Laboratory placed at my disposal, literature regarding the Micro-Meinicke Test.
He instructed me to try this test parallel with the Kahn and Macro-
Meinicke. Unfortunately we could not depend on securing a regular
supply of guinea-pigs to enable us to do the Wassermann as well.
After comparing the results of our first 100 trial tests, there was
such a high percentage of agreement of the micro-method with the
others, and where routine tests on all patients might become a rule the
small quantity of blood required would prove such a convenience, that
it seemed worth while to adopt this test to control our routine tests and
at the same time give us data re the Micro method.
What further strengthened this view was that in 2 cases the micro-
method showed a weak delayed reaction (now called a -\- while the
macro-methods were negative. One of these was found to be from a
patient who had been given a course of neosalvrsan treatment. In "control
of treatment" tests, the immense importance of this observation is apparent.
Page 11 The percentage results of our first 100 cases:
Micro Macro-Meinicke
On the strength of these results we decided to continue work on
the micro-method.
After further comparative tests we endeavoured to find a method
more suited to our small laboratory. With this object in view we prepared:
(1) A slide of such a width that it would fit into a broad test
tube.   The slide was ruled in squares by means of a glass cutter.
(2) Two platinum loops: 2 mm. diameter and 4 mm. diameter respectively.
(3) A watchmaker's glass or other magnifier which might be used
without the use of the hands.
(4) If possible, control sera: —, -f, -)—|-, -j—|—|-, -|--|—|—\-,
In order to get an accurate idea fixed in the mind it is probably
essential at first to work with the four positive control sera.
The antigen as used in the Kahn test was also tried and results are
narrated later herein.
The test now used and called the Macro-Micro Flocculation Test for
The blood may be taken in an ordinary capillary pipette, centri-
fuged, the pipette cut at the top of the blood and the serum taken off
on the loop, or, when larger quantities of blood are sent in, the serum
may be taken from above the clot.
The antigen is prepared as for the Meinicke Test.
The ruled plate is placed in the incubator to warm.
2 mm. loopfuls of sera are placed on the ruled squares, each square
being marked with the symbol for the sera placed on it, taking first the
known negative serum, then the unknown sera, and lastly the positive
control beginning with the single -j-. It is a safe precaution to heat the
loop to redness after the delivering of each drop of serum but when the
weather  is  very hot,  one may,  to prevent  the sera  drying out,  omit
Page  12 heating between the minus control and the first unknown serum and
also between the positive controls, provided these are arrranged -f-> H—K
-|—j—f-, —J—[—j—[-, in sequence.
One must be very careful to allow the loop to cool before taking a
fresh drop of serum.
Next a 4 mm. loopful of antigen, which must still be warm, is
added to each serum starting with the negative control and continuing
as with the sera, heating and cooling between the unknown sera.
The ruled plate is then placed, with its mixed sera and antigen, in
the large test tube to prevent drying out. The cap is placed securely
over the open end and the apparatus is shaken vigorously and continuously for 8 minutes.
The test is best read in daylight.
Stand in front or to one side of a window, not in direct sunlight.
Hold the apparatus above and in front of the eyes so that one may see,
by tilting the slide, the underside of the droplets. It is best to be in
front of a window next to the corner of the room. One faces then half
towards the corner giving a dark background, the light from the window
striking the droplets obliquely.
Observe flocculation first with the naked eye, then with the magni-
The  appearance of  the  positive  may  vary  somewhat  in  different
tests, but the following may give some slight guidance:
— show a homogeneous milky fluid—granules may be
seen evenly distributed throughout,
shows fine granulations in muddy suspensory fluid.
-)—\- shows coarser granulations in milky suspensory fluid.
! shows coarse and fine granulations in only slightly
turbid fluid.
-\--\—|—\-  shows coarse granulations in clear suspensory fluid.
The following shows the percentage obtained by our three methods
during the past 4 years:
++ +
++ + 4
+     1%
84 %
Page 13 Notes on Technique: Technique must be carried out carefully.
Warming of the ruled slide is essential. Steel loops are not very satisfactory. It is best to use platinum loops. Quantities of antigen of less
than 5.5 cc. have not given good results in my experience.
A slight clumping may occur in negatives, especially those which
have been stored in refrigerator. Practice will enable one to distinguish
this from a positive flocculation.
The Macro-Micro method was used also, employing the antigen used
for the Kahn test.
The apparatus used was the same as for the previous test, but the
loops used were 2 mm. diameter and 3 mm. diameter respectively.
Method: Take one 2 mm. loopful of negative control serum. Place
twice on the first square so that there are two droplets side by side in the
lower third of the square.
Take Kahn antigen, mixed and developed according to directions
for Kahn test, on 2 mm. loop. Place twice on the same square making
two droplets about the middle third of the square on a line parallel with
the first droplets.
Take normal saline on 3 mm. loop. Deposit once on square with
the serum and antien but on the upper third of the square. Mix and
Read as in previous test. The appearance of positives in this case
does not correspond with those in the first method.
Advantages over previous test:
(a) flocculations clearer and easier to see.
(b) stored sera do not give a trace of flocculation as in previous
Disadvantages over first method:
Slight single -f- may give negative.
These methods are probably open to further improvement, but in
our small laboratory, amid a mass of routine, we have little time for
experiment. We therefore hand on the results for anyone, who has the
facilities, to use or improve as they wish.
The great value of the Macro-Micro test appears to lie in the facts
Page  14 (1) A small quantity of blood is required and may be obtained by
pricking the finger. This it is hoped may lead to a test for
syphilis being done as a routine on all patients entering hospitals.
(2) No inactivation of sera is required, which adds to the rapidity
and simplicity of the tests.
(3) The cost of the apparatus required is small, it is simple and
easily cleaned.
ANAEMIA (Conclusion)
John Eden Walker, M.B.
Having discussed at some length the subject of pernicious anaemia
as an example of anaemia with anhaemopoietic megaloblastic marrow,
we would like to show how this condition is linked up with anaemias
showing anhaemopoietic normoblastic type of marrow. First, there is a
great deal of evidence to show that all these types of anhaemopoietic
anaemias either with megaloblastic or normablastic bone marrow are all
gastro-intestinal in their origin.
In looking over the list of conditions given earlier in this paper
it is observed that they are all gastro-intestinal conditions or conditions
due to vitamine or other dietary deficiency. It will also be noticed, that
in some cases the type of anaemia may be either macrocytic or microcytic. In other conditions it is always of one type.
The second point is the presence of achlorhydria. The most important
causes of achlorhydria may be classified as follows:
(A) Achylia gastica—complete absence of all stomach secretions.
1. Constitutional or familial.
2. Atrophic gastritis—end stage of chronic gastritis.
3. Total gastrectomy.
(B) Achlorhydria without achylia.
1. Chronic  (non-atrophic)  gastritis.
2. Gastro-enterostomy.
3. Partial gastrectomy.
It is found that in practically all cases of pernicious anaemia as well
as in most of the other anaemias of the anhaemopioetic megaloblastic type,
achlorhydria is present. This is found not only after the ordinary test
meal, but also after histamine injection. In true pernicious anaemia,
where post mortems have been made, all degrees of chronic gastritis have
been found, even down to atrophic gastritis where all the secreting glands
are absent. In the exceptional cases of pernicious anaemia where free
HCL is found, and we believe these cases do occur, it is probable that
Page 15 the secretion of intrinsic factor has been affected while that of free
HCL has been spared. The victim of pernicious anaemia is either born
into the world with a defective gastric mucosa, or has a deficient gastric
mucosa thrust upon him later. When we take simple achlorhydric
anaemia as the example of the anhaemopoietic normoblastic type, the study
of the stomach contents is interesting. Practically all these cases show
the absence of free HCL after a simple test meal, but in contrast to
pernicious anaemia, in most of these cases histamine injection is followed
by some secretion of free HCL, that is, the lesion of the gastric mucosa
is apparently not so severe as in pernicious anaemia.
The third point is the presence of changes in the tongue mucosa.
All degrees of glossitis may be found present in pernicious anaemia and
simple achlorhydric anaemia. Very marked changes may be found in the
mucosa of the tongue and in some cases these changes may extend into
the pharynx and oesophagus. The fact that both these types of anaemia
show this type of change is of great interest, The fourth point is
brought out by a consideration of the family history. There have been
found in the same family, either in one or several generations, cases of
simple achlorhydria with no clinical symptoms; cases of simple achlorhydric anaemia; and cases of true pericious anaemia. Moreover, the same
individual has been followed, showing, first, a microcytic anaemia, which
later changed to a macrocytic type and which finally has progressed into
the aplastic or final exhausted stage of the bone marrow. These cases
cannot be dimissed lightly. It would appear that the factors governing
the successive stages of maturation of red blood cells in the bone marrow
have been disturbed. The site of the disease is probably in the stomach
mucosa. Processes governing maturation of red blood cells must have
closely related physiological bases.
We wish to show two cases which are quite typical of simple achlorhydric anaemia.
(a) Mrs. W.S. Age 34. Was seen Feb. 1st, 193 3. Was in her
usual good health until birth of the last baby two years previously. She
did not feel well during the latter period of that pregnancy and following
her confinement states that she "went to pieces." At that time she was
suffering from headaches, dizziness, shortness of breath and weakness.
During the past two years she has never felt well, her symptoms varying
in intensity during this period. She consulted two or three doctors and
was told that she was anaemic. During this time she had received iron
therapy at various times, but had never felt well in spite of treatment.
On examination her colour was sallow; examination otherwise negative. X-ray of chest negative; heart showed no enlargement; urine negative. Barium series negative. RBC 4,600,000; haemoglobin 66%; colour
index .7; stomach contents show no free HCL; staining of cells pale,
size and shape irregular; microcytes plus 1; WBC 7,500 Poly. 62; lymph.
34. At this time she was put on Frosst's ferro-catalytic capsule, two
t.i.d. She rapidly began to feel better and the count on May 10th, two
months later, showed RBC 4,450,000 haemoglobin 90%; colour index
1.02. She states that she feels as well now as at any time in the past.
Page 16 This case illustrates the frequency of this type of anaemia as associated
with pregnancy, and the rapid improvement on adequate therapy.
(b) This woman's sister, Mrs. F. J., age 43 years, also consulted us
some time after her sister had first started treatment. Her symptoms
dated back over a year, including throbbing in the head, shortness of
breath, intolerance to cold and poor appetite. Physical examination was
negative, except that she was very pale. RBC 3,700,000; haemoglobin
40% colour index .55; staining pale and size and shape of cells irregular;
microcytes plus 2; stomach contents show no free HCL. Barium series
negative. This woman was started on iron and ammonium citrate, grains
130 per day. She has been on this dosage for ten days and states that
she already feels much improvement. These two cases illustrate the frequency with which this condition may occur in one family.
Simple achlorhydric anaemia seems to be comparatively common, and
is much more prevalent in women than men. Usually the age is from 3 0 to
65 years. The symptoms are those due to anaemia, and those due to gastrointestinal disturbance. In these cases it is usually found that meat causes
more distress than other food and not uncommonly the diet degenerates
into small frequent carbohydrate meals. On examination one finds a peculiar sallow skin, not unlike pernicious anaemia, and quite unlike that of the
ordinary secondary anaemia. There are changes in the tongue and the
nails. The spleen is often palpable and there is usually loss of weight.
The condition is aggravated during pregnancy. The blood changes are
reduction in haemoglobin out of all proportion to the reduction in the
number of cells. These cases usually show no free HCL following a test
meal, but on histamine injection some free HCL is usually found. This
is in contra-distinction to pernicious anaemia. When in addition to the
above picture there is also present dysphagia, the name of Plummer-
Vinson syndrome has been applied. The dysphagia is due to atrophy of
the mucosa of the tongue, pharynx, and oesophagus, which is probably,
in many of these cases, nutritional in origin. Many of these cases clear
up spontaneously after the menopause, and in some cases an artificial
menopause has been produced, followed by cure. On the other hand many
cases continue indefinitely and will relapse if iron therapy is discontinued.
As long as iron therapy is continued the disease is held in check. Iron
has exactly the same relationship to this desease as liver extract has to
pernicious anaemia.
I would like to say a few words on iron therapy. Iron is indicated
in anaemias where the colour index is below 1; that is, in the microcytic type. It seems to be the most helpful in the anhaemopoietic group,
which, as I have pointed out, is probably gastro-intestinal in origin. Iron
may or may not be effective in anaemia showing hypoplastic bone marrow.
There are a few rules one must observe in prescribing iron. (1) Inorganic
iron is better than organic iron. When given in the form of haemoglobin or haematin, iron has to be broken down from its organic compound before it becomes available. (2) Iron acts best in the ferrous state.
(3) Give sufficient iron. In a given case 3 0 grains of iron compound may
produce  no  effect,   whereas   120   grains  may   have  remarkable  results.
Page 17 There are literally dozens of preparations containing iron in the various
pharmacopoeias; two of the most satisfactory are Blaud's pill and iron
and ammonium citrate; 60 grains of either of these, per day, is considered a rninirnurn dose; even double or quadruple this dose must often
be given to obtain results. (4) Do not stop treatment as soon as the blood
has returned to normal. Give it for several weeks longer. In some forms
of anhaemopioetic anaemia it may need to be given indefinitely. (5) The
action of iron may be inhibited by the presence of infection
or arterio-sclerosis, or of cardio-renal conditions, just as is liver extract.
6. Copper may enhance the blood regenerating power of iron.
Copper is accepted by most authorities as necessary for blood formation. The role of copper is apparently to help convert iron into haemoglobin. There is probably enough copper in a balanced diet to allow
this process to take place, and it is doubtful if copper medication is
necessary in most cases of anaemia.
7. Whole liver is effective in microcytic anaemias, but is not nearly
so effective as is iron.
8. Liver extract has no place in the treatment of microcytic
9. In most cases of anaemias the so-called anaemic diet is not
necessary so long as a balanced diet is being taken.
We have attempted, to clarify the question of treatment of some
of the various types of anaemia. The presentation of the question has been
taken up under the following headings.
I. Physiology of the normal maturation of red blood cells.
II. Classification of anaemias based on disturbances of normal
III. Pernicious anaemia as an example of anaemia shewing an
haemopoietic megaloblastic marrow.
(a) Etiology,  (b) Principles of treatment (c) Presentation of cases.
IV. Relationship between anhaemopoietic anaemias shewing megaloblastic and normoblastic bone marrow.
V. Simple achlorhydric anaemia as an example of anaemia shewing
anhaemopoietic normoblastic bone marrow.
VI.    General principles of iron therapy.
The Antiquity of Cancer
The antiquity of cancer was proven long before medical history
was written. Pathological lesions including tumors in the fossil bones
of extinct animals were first recognized among the pleistocene mammals,
especially the cave mammals of Europe. These remains were the first
to attract the attention of early paleontologists and the relics found in
them were for a long time supposed to be evidences of the universal flood,
which, according to Hebrew tradition, had destroyed all animal life. In
the Mesozoic era, or age of reptiles (6,000,000 to 12,000,000 years ago),
the bones of the monosaurs, dinosaurs, pleisosaurs, phytosaurs and other
reptiles show lesions resembling the modern forms of osteoma, osteosarcoma and hemangioma of bone. The evidences of bone cancer increase
with each succeeding geological period through the Cenozoic and Holo-
zoic ears until, in the Egyptian, benign and malignant tumors of the
soft parts are discovered. Thus we possess definite proof that cancer as
a disease is older than man, older than prehistoric man, even older than
the age of mammals.
The Evolution of Cancer Knowledge
The earliest medical document yet discovered, the Evers Papyrus
(circa B. C. 1500), contains a reference to tumors which is disclosed
in the classical translation of Edwin Smith. Cancer of the breast is
described with some detail in an inscription from Ninevah (B. C. 800).
As we follow the development of medicine through the succeeding centuries, we find the problem of cancer compelling the attention of the
leaders of medical thought. Democedes (B. C. 250) describes the cure
of Atossa, the daughter of Darius Hystaspes, of breast cancer. This
accomplished Greek surgeon was employed as a city physician in Athens
at a salary of $2,000 a year. It is significant that even at this early
period a public health official in the world's largest city was actively
interested in the treatment of cancer.
Hippocrates (B. C. 460-375), the father of medicine, employed the
terms cancer and carcinoma, described cancer of the skin, breast,
stomach, uterus and rectum, and gave a description of recurrent cancer
of the neck treated by cautery. Celsus, a contemporary of Christ, devised a plastic operation for carcinoma of the lip and practiced excision
of cancer of the breast, advising against removal of the underlying pectoral muscles. Galen (A.D. 131-203) believed that the body was composed of four fluids; blood, mucus, yellow and black bile. He held that
the concentration of black bile at any part of the body would cause
cancer. In spite of this bizarre theory, wise surgical instinct led him
to advise and practice wide surgical removal of cancer. Moreover, he
proposed a classification of tumors which endured for 1500 years. Leon-
ides, who lived in Alexandria in the latter part of the second century,
was apparently the first surgeon to carry out a dissection for cancer of
the breast approaching modern technique.
Page 19 Then came a long sterile period, lasting for almost a thousand years
when little was added to our knowledge of cancer. Sporadic efforts were
made to amplify the descriptive anatomy of tumors. The operative
treatment of cancer was not improved, as the practice of surgery was
held in disrepute and was consigned to itinerant practitioners of the lowest
social order. The Council of Tours (1162) even placed the ban of the
Church on the practice of surgery. The communes of Northern France,
early in the thirteenth century, admitted to membership no man suffering from an incurable disease. Under these circumstances, the unfortunate cancer patient lost, first, his right of franchise, then his life, due
to the legal prohibitions of his day. The one bright light of this period
was Guy de Chauliac (1300-1368), the author of the classical treatise,
"Chirurgia Magna," who employed caustic pastes and excision in the
palliation of cancer.
The Renaissance, with the invention of the printing press by Cax-
ton, the development of the microscope (1592), and the recognition of
cellular structure by Schleiden and Schwann, gave the first impulses to
the dissemination of medical knowledge and the intelligent study of the
histology of tumors. Ambroise Pare (1510-1590), the great French
army surgeon, was hopelessly ineffective in his treatment of cancer,
employing diet and purgation as routine measures and occasional surgical
excision for small early cancers. He allocated only a few brief chapters
to cancer in the many volumes of his large system of medicine. Fabri-
cius Hildamus (1560-1634), the father of German surgery, was the
first to practice a complete axillary dissection in the treatment of mammary cancer. Severinus (1580-1676) was the first surgeon to distinguish
between cancer and benign tumors of the breast.
With the advent of the nineteenth century, came the beginning
of effective histological study of tumors. Johannes Muller (1801-1858),
who has been called the founder of cellular pathology, made the first
comprehensive study of the histology of tumors. His work was made
possible by the development of the achromatic microscope by Silligues
in Paris in 1824.
Rudolph Ludwig Karl Virchow (1821-1902), the pupil of Muller,
is perhaps the greatest figure in the history of pathology. His famous
book, "Die Cellular Pathologie" and the unfinished "Die Krankhaften
Geschwulste," have contributed more to our theoretical and histological
knowledge of cancer than any other source. The study of tumors was
his chief interest. The theory he taught, that "Omnis Cellula e Cellula"
and later, "Omnis Cellula e Ejusdem Cellula," furnished the most important conception known of the histogenesis of tumors.
In the succeeding years, we find that the majority of the master
minds in medicine were intrigued by the problem of cancer. To name
these men and to recite their achievements would read like a veritable
history of medicine. Pathologists, surgeons, biologists, bacteriologists,
physicians, and more recently radiologists, have devoted their lives to
this important and interesting subject and have enriched our knowledge
by many valuable discoveries.    Research in the general fields of medicine,
Page 20 biology and physics have contributed directly and indirectly to methods
of cancer control. The science of surgery made rapid progress after the
discovery of bacteria by Pasteur, the establishment of principles of antisepsis by Lister, and the introduction of general anesthesia by Morton and
Long with ether and by Simpson with chloroform. In this connection
it may be pertinent to recall that the first known operation on a patient
who was under ether anesthesia was performed by Crawford Long, of
Georgia, on James Venable, on March 30th, 1842, for a tumor of the
neck. Moreover, the dramatic operation performed by Dr. John Warren,
on October 16th, 1846, on Gilbert Abbott, at the Massachusetts General Hospital, in which Dr. Warren confirmed the value of ether anesthesia, was an excision of a tumor of the jaw. It is significant that these
two operations of great historic import were done for neoplastic diseases. The percentage of cancer cures has increased in direct ratio, to
the improvement in surgery during the last three-quarters of a century.
Among the many who might be mentioned as important contributors to the modern conception of cancer and its treatment, the following names should be mentioned: Billroth, Halsted and Willy Meyer in
the surgical treatment of cancer; Volkmann, who first observed occupational cancer induced by tar compounds; Krompecher, who defined
the basal cell epithelioma; von Recklinghausen and multiple neurofibromas; Thomas Hodgkins and Sternberg, who established the entity of
malignant lympho-granuloma; and Hansemann, who propounded the
theory of anaplasia and first prepared an histological index of malignancy.
The Advent of Physical Agents in the Treatment of Cancer
But a wholly new field of research and therapeutic attack upon
cancer was opened through the discovery of the x-rays and radium.
Wilhelm Canrad Roentgen, in December, 1895, published his account of
the discovery of x-rays. Marie Curie, in December, 1898, announced
her discovery of radium, the substance which showed an astonishing
degree of radioactivity. These two discoveries inaugurated a new era
in cancer therapy and emphasized anew the inadequacy of surgery in
the treatment of many varieties of malignant tumors. The roentgen
rays have furnished a new and important method of diagnosis in the
field of cancer, particularly in primary tumors of bone and the metastases
to bone from primary tumors of various parts of the body. They have
also given us a trustworthy method of diagnosis in metastasis to the
pleura and lung. Radiology has become one of the important special
fields in medicine, and throughout the civilized world, many men of
outstanding talent have devoted themselves to this field, and Philadelphia
contains its quota of distinguished radiologists. No hospital today is
considered fully equipped to study and treat cancer without modern high
voltage x-ray machines and an adequate supply of radium. An even
more mportant requisite for such an institution is that it must have upon
its staff competent radiologists who may safely employ these agents.
The twentieth century has seen the field of cancer research open
still more widely and effectively. The three outstanding figures of the
present  generation in  cancer research are,  Regaud of Paris,  Forsell of
Page 21 York. In the work of this last man, the acme of the descriptive pathology of tumors has been reached in his work, "Neoplastic Diseases,"
the present Bible on the subject of cancer. Ewing, with his profound
knowledge of the gross and histological pathology of tumors, has contributed more in the present century, than any one man to an intelligent
approach to the whole subject of the diagnosis and treatment of cancer.
Moreover, he has elaborated in his concept of the histology of tumors,
the well known principle of radiosensitivity, which has furnished a unique
and entirely new approach to the study of neoplastic diseases. Ewing
was quick to grasp the importance of these newer physical agents in the
treatment of cancer. His aroused interest has led him along lines of
cancer research which no other pathologist of the last three decades has
had the courage or the vision to follow ,and his inspiring leadership is
recognized today throughout the world.—Burton J. Lee, M.D., in the
Bulletin of the American Society for Control of Cancer, August, 1933.
18 Years'
For further particulars call
Margaret Leslie
Seymour 7258
Office: 445 Granville St.
Vancouver, B. C.
Page 22
< I
If this tired, worried, over-worked mother were using Pablum for her babies' cereal feedings, she could have
slept that extra much-needed hour instead of losing her temper while her children clamor for breakfast
For she can prepare Pablum in an instant, directly in the cereal bowl, simply by adding water or milk of
any temperature—salt, cream and sugar for the older child and herself.
Getting up an hour earlier in the morning is an inconvenience for most persons,
but for the mother of young babies it is
a hardship, sometimes almost tragic,
frequently nullifying the best-planned
pediatric advice.
This is especially true in the case of
the nursing mother whose supply and
quality of breast milk are affected by
emotional shocks resulting often in agalactia and sometimes giving rise in the
baby to diarrhea, colic, and even convulsions. Furthermore, the mother's
emotional stress brings about a train of
behavior on her part which is reflected in
the child's psychologic reactions so that
a vicious circle of bad habit formation is
set up.
From this angle, the recent introduction of the pre-cooked form of Mead's
Cereal, known as Pablum, assumes new
importance in the doctor's psychologica
handling of both mother and child
quite aside from its nutritional value.!
Because Pablum can be prepared in i
minute, the mother can sleep the extrs
hour she would otherwise be compelled
to spend in a hot kitchen cooking cereal
Added rest means better poise, so tha'
petty annoyances do not bring jadeif
nerves. Prompt feedings prevent manj
childhood tantrums, and a satisfied bahj
usually eats better and enjoys bettef
digestion and growth.
*Like Mead's Cereal, Pablum represents a gre^
advance among cereals in that it is richer in
wider variety of minerals (chiefly calcium, phoa
phorus, iron, and copper), contains vitamins fl
B, E, and G, is base-forming and is non-irn
tating. Added to these special features, it i
adequate in protein, fat, carbohydrates, an
calories. Pablum consists of wheatmeal, oal
meal, cornmeal, wheat embryo, yeast, alfalfl
leaf, and beef bone.
Mead Johnson & Co. of Canada, Ltd., Belleville, Onl
Please enclose professional card when requesting samples of Mead Johnson products to cooperate in preventing their reaching unauthorised per»* 536 13th Avenue West Fairmont 80
Exclusive Ambulance Service
"St. John's Ambulance Association"
R. J. Campbell J. H.  Crellin W. L.  Bertrand
(&mttx & $|arara, JUtb
Established 1893
North Vancouver, B. C
Powell River, B. C ^^f~~$&^^
Hollywood Sanitarium
For the treatment of
Alcoholic, Nervous and Psychopathic Cases
Reference—B. C. Medical Association
For information  apply  to
Medical Superintendent, New Westminster, B. C.
or 515 Birks Building, Vancouver
Seymour 4183
Westminster 288


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