History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: November, 1924. Vancouver Medical Association Nov 30, 1924

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 )K
THE VANCOUVER MEDICAL
f      ASSOCIATION   I    H
BULLETIN
Published monthly at Vancouver, B. C.
c5Abstract of Presidential ^Address
«
Of
a
a
^oo\ <rRevie<ws
'•(She Infectious 'Diseases hospital
NOVEMBER, 1924
X(
^Published by
(fM.d&eath Spudding Limited, Vancouver, 6B. Q.
i  THE   VANCOUVER   MEDICAL  ASSOCIATION
BULLETIN
Published Monthly under the Auspices of the Vancouver Medical Association
in the Interests of the Medical Profession.
Offices:
529-30-31 Birks Building, 718 Granville St., Vancouver, B. C.
Editorial Board:
Dr. J. M. Pearson
Dr. J. H. MacDermot Dr. Stanley Paulin
All communications to be addressed to the Editor at the above address.
VOL. I.
NOVEMBER 1st, 1924
No. 2
OFFICERS,  1924-25
President
DR. H. H. Milburn
Secretary
Dr. O. S. Large
Vice-President
Dr. Stanley Paulin
Treasurer
Dr. A. J. MacLachlan
Dr. W. F. Coy
Past President
DR. F. J. BULLER
TRUSTEES
Dr. W. B. Burnett Dr. J. M. Pearson
Delegate to B. C. Medical Association
Dr. J. A. Gillespie
SECTIONS
Clinical Section
Dr. Lyall Hodgins	
Dr. W. L. Pfdlow ------
Physiological and Pathological Section
DR.             -
Dr. R. E. Coleman
Eye, Ear, Nose and Throat
DR. G. C. Draeseke	
Dr. Colin Graham - -
Genit o-Urinary
Dr. G. S. Gordon -	
Dr. J. A. E. Campbell -----
COMMITTEES
Chairman
Secretary
Chairman
Secretary
Chairman
Secretary
Chairman
Secretary
Library   Committee
Dr. Wallace Wilson
Dr. r. E. Coleman
Dr. W. A. Bagnall
Dr. W. F. MacKay
Orchestra Committee
Dr. L. Macmillan
Dr. F. N. Robertson
Dr. J. H. MacDermot
Dr. W. D. Patton
Credit Bureau Committee
DR.   L.   MA.CMILLAN
Dr. J. W. Welch
Dr. g. A. Lamont .
Dinner   Committee
Dr. N. E. MacDougall
Dr. A. W. Hunter
Dr. f. N. Robertson
Credentials  Committee
DR.   G.  E.   SELDON
Dr. D. McLellan
Dr. Neil McNeill
Summer  School  Clinics
Dr. J. M. Pearson
Dr. Alison Cumming
Dr. Howard Spohn
Dr. g. S. Gordon
Dr. R. A. Simpson
Page  Three VANCOUVER MEDICAL ASSOCIATION
Founded 1898. Incorporated 1906.
Programme of the 27th Annual Session
GENERAL MEETINGS will be held on the first Tuesday of the month
at 8 p.m.
CLINICAL MEETINGS will be held on the third Tuesday of the month
at 8 p.m.
Place of meeting will appear on Agenda.
GENERAL MEETINGS will conform to the following order:
8 p.m.—Business as per Agenda.
9 p.m.—Paper of Evening.
1924.
OCTOBER   7th— General Meeting.
Presidential Address:    DR. H. H. MlLBURN.
OCTOBER 21st—
OCTOBER 28 th—
NOVEMBER 4th —
NOVEMBER 18 th—
DECEMBER 2nd—
DECEMBER  16th—
1925
JANUARY 6 th—
JANUARY 20 th—
FEBRUARY 3rd^
FEBRUARY 17th—
FEBRUARY 25 th—
MARCH 3rd—
MARCH  17th—I
APRIL 7th—
APRIL 21st—
Clinical Meeting.
Special Clinical Meeting.
DR. R. C. COFFEY   (of Portland, Ore.)
Subject:     "The Quarantine Pack in Abdominal Surgery."
General Meeting.
Paper:    DR. J. J. MASON, "Abdominal Hysterotomy."
Clinical Meeting.
General Meeting.
Paper:     Dr.   G.   A.   LAMONT,   "The  Early  Weaned
Baby."
Clinical Meeting.
General Meeting.
The OSLER LECTURE by Dr. FREDERIC BRODIE,
"Aphasia."
Clinical Meeting.
General Meeting.
Paper:    DR. W. A. DOBSON, "Neuroses in Everyday
Practice."
Clinical Meeting.
Special Clinical Meeting.
DR. C. E. HAGYARD  (Seattle).
Subject:     "Colitis."
General Meeting.
Paper:    DR. R. B. BOUCHER, "Inflammatory Diseases
of  the Ear."
Clinical Meeting.
General Meeting.
Paper:    DR. J. L. TURNBULL. "Differential Diagnosis
of Acute Abdominal Conditions."
ANNUAL MEETING.
Page Four fj^<6^<S^<S^e^<^<?$&><&£?><?SS>^>
Luer 5,;v
Hypodermic Syringes
l%cc       25 M.
50 CENTS
<\,
<:iKospital) <rPhysiciansy and J\[urses
Supplies
Canadian Surgical Supplies Limited
Cor. Robson and Burrard Streets
Phone Seymour 4802
Vancouver, B. C.
;i®i*>
Page  Five EDITOR'S PAGE.
Our readers will have noticed in the last issue of this Bulletin
a short communication from Dr. F. C. Bell, Superintendent of the
Vancouver General Hospital, on a constantly increasing demand
for hospital accommodation. This is a problem not confined to
Vancouver. Every section of the community is having similar
difficulty. The immediately pressing need of this city is that of
room for the commoner "infectious diseases"—Scarlet Fever, Diphtheria, Measles, Chicken-pox—which in spite of the unceasing
vigilance of the Health Department and the School authorities,
recur in season with distressing regularity. The hospitalization of
these cases has long been urged by those engaged in public health
work, .and is becoming gradually recognized by the laity as necessary. Not only can, in most instances, better treatment and better
care be afforded,, but economically great relief is offered to the immediate family of the patient by an earlier release of quarantine
restrictions. In any event, such a large part of our population is
housed in hotels, rooming houses and apartments that the incidence of cases in these quarters unavoidably entails removal to a
hospital. We are of the opinion that this tendency, as regards
infectious diseases at any rate, is one to be encouraged. This year
our always inadequate and antique accommodation has been convincingly demonstrated to be both insufficient and out of date. In
the recent epidemic overflow quarters were hastily requisitioned
and shift made by a long-suffering Hospital staff to meet the
demand. A new Infectious Hospital is inevitable. Opinion will
be divided on details only. Apart from a certain natural fear that,
in view of the ratepayers' thrifty attitude of late regarding money
by-laws, the funds may not be forthcoming, the chief points under
discussion will be those of site and management.
On the one hand there are those who believe that the best
interests of the community will be served by the choice of a site
adjacent to the General Hospital, and by retaining the management as at present under that institution. This would provide us
with better and larger quarters mainly for city use. On the other
hand there are those, taking shall we say, a wider view, who would
choose a site, it may be remote from the; present situation, but one
designed to accommodate not only the needs of Vancouver but
also those of surrounding municipalities.
Exponents of this scheme again differ as to whether the management of an institution so placed should be retained in the
present hands, the Directorate of the General Hospital, or should
be directly under the charge of the city authorities.
We have no hesitation in proclaiming ourselves to be of a
"Metropolitan" cast of mind. To us it seems futile and impossible to draw the line of Vancouver's influences at any of the city
boundaries. For the present the City of Vancouver, Hastings
Townsite, Burnaby, South Vancouver, and Point Grey, should in
our opinion all be considered, and a site selected which will serve
the best interests of the district.
Page Six As to management, there is much to be said for the administration of the Infectious Hospital by the civic and municipal
health authorities as an open hospital.
Infectious diseases are distinctly a community problem, and
the various health bodies concerned must necessarily require to be
closely in touch with all that concerns such diseases. Admission,
discharge, quarantine, entailing as they do penalizable obligations
on the public, are the affair of those with plenary powers. Methods of infection, locality of outbreak, results in the mass, are
health problems. The nursing of infections remains almost a special branch of that profession, including as it does a knowledge of
the natural history of the disease in question, in order that its complications may be readily and easily recognized. Probably the
most common argument in favour of centralized control is that of
economy. We think that in the purchase of supplies this economy
is more often desired than attained. What is even more necessary
than purchase in quantity is ability to pay promptly and receive
every discount the trade allows for such methods of payment.
We trust that the amount of the by-law which the City
Council must submit to the ratepayers in the event of the erection
of an Infectious Diseases Hospital, will receive the most careful
consideration of all concerned.
The belated sense of economy recently awakened in those
who are to be asked to provide the money, is commendable if it is
not allowed to become extreme. It is certain that the demands of
the by-law will be scrutinized with care and an excessive size in
the amount asked will only defeat its own object. The ratepayer has no opportunity of bargaining about the size of a bylaw. He must accept it or reject it as it stands. Publicity will
be required, and though the public memory is proverbially short,
we trust that the experiences of the present year will not be forgotten.
NEWS AND NOTES.
The first regular meeting of the Session, 1924-25, of the
Vancouver Medical Association, was held in the Physics Building,
University of B. C on Tuesday, October 7th.
The President, Dr. Milburn, was in the chair, and some
forty-six members were present. In the absence of Dr. O. S.
Large, General Secretary, who is at present visiting the Orient,
Dr. Hodgins acted as Secretary of the meeting.
A request was received from the Secretary of the Shipping
Federation of B. C, asking the members of the Association to
notify them of all accidents to longshoremen, and enclosing a suggested form for that purpose. After consideration, it was decided
to recommend that where possible this be done.
Page Seven Dr. H. A. Barrett was elected to membership.
Dr. Milburn referred to the extensive programme of the Association for the session now beginning, calling special attention to
the visit of Dr. Coffey, of Portland, on October 28th, and of Dr.
Hagyard, of Seattle, on February 25 th. He urged that members
should endeavour to attend all meetings and take an active part in
the work of the Association.
Dr. Pearson reviewed the work which had led up to the
establishment of the Bulletin, and gave an account of the arrangements under which it is published.
The President, Dr. H. H. Milburn, then delivered his annual
address, an extensive abstract of which will be found on another
page, after which the meeting adjourned.
5JC ^ 3{C 9^
It is to be hoped that all our members will be out on the
evening of November 7th for our Annual Medical Dinner, to be
held at the Ambassador Cafe. We are promised by the Dinner
Committee that the programme will be up to all previous standards, and that the evening will be replete with "snappy songs,
snappier music, and peerless vaudeville."
* *     *     *
Staff lectures and clinics for the internes of the Vancouver
General Hospital were resumed on October 2nd. It is intended to
have a lecture every Thursday evening and a bedside clinic every
Friday morning, given by a member of the Staff.
H5        H6        ^        H*
Dr. Charles S. McKee has recently been placed in charge of
the Department of Bacteriology at the University of British
Columbia.
T T *P T
Miss H. Bennett, Supervisor of the Operating Rooms at the
Vancouver General Hospital, who has recently recovered from an
attack of scarlet fever, has gone for a trip East. She attended the
meeting of the Hospitals Association at Buffalo, and is also visiting
various other centres to acquaint herself with their operating room
technique.
* *     *     *
Dr. W. S. Turnbull has completely recovered from his indisposition of the past summer.    He is now in Toronto taking special work in Obstetrics and Gynaecology.    He expects later to pro-,
ceed to New York for further work along these lines.
^ ^c i|c ^
Dr. W. T. Lockhart left on the Blue Funnel liner "Achilles"
on October 23rd for Kobe, Hong Kong, and Manila. He expects
to return about the end of January, 1925.
* *     *     *
The discussion on Dr. J. J. Mason's paper, "Abdominal
Hysterotomy," to be given on November 4th, will be opened-by
Dr. W. C. McKechnie and Dr. W. B. Burnett.
Page Eight ©bituaqj
Again must we record the death of one of our profession in the person of Dr. Charles Woollard, who died after
a short final illness on September 29th, 1924.
Dr. Woollard was born in London, England, 52 years
ago. He came to Canada when a young man of nineteen,
and for a time worked on a prairie farm. He decided to go
in for Medicine and entered the Manitoba Medical College
in 1897. In 1900, when the South African War broke out,
he volunteered and went overseas with the Canadian Artillery. He was wounded in the arm and returned to Winnipeg, finished his medical course, and was an interne in the
Winnipeg General Hospital. He started practice in Winnipeg, but owing to ill health took a position as ship's surgeon on a boat sailing between Vancouver and Australia.
After two years of life at sea he went home to London, England, and in nine months was able to take the London qualifications of M.R.C.S. and L.R.C.P. He returned to Canada
and started to practice in Vancouver in 1911, shortly afterward affiliating with the 18th Field Ambulance, the local
unit of the C.A.M.C. In the spring of 1915 he proceeded
overseas with a draft from the 18th Field Ambulance. Later
he was selected for the Headquarters military medical staff in
London, and was highly thought of as a dependable officer.
He attained the rank of lieutenant-colonel in the C.A.M.C.
When the "Vancouver Military Hospital was organized, he
became the first Commanding Officer, being asked to return
from the scene of conflict to take up this important post. Dr.
Woollard relinquished the command of the hospital when it
came under the direction of the S.C.R., and subsequently was
appointed one of the local medical officers of the Board of
Pension Commissioners. Of a retiring nature, he was highly
respected by his confreres, and also by hundreds of ex-
soldiers with whom he came into contact in the work of his
profession.
In spite of many rebuffs of ill health, he maintained a
cheerful courage and philosophy which made him beloved by
all. As one of his friends, who knew him long and well,
said of him: "He was one of the most straightforward men
I ever knew." Dr. Woollard leaves a wife and two little
girls, besides a large circle of close friends.
Page   Nine THE CREDIT BUREAU.
Before you glance over these few lines, STOP. Turn to
Page 23. Cut out the advertisement inserted by the Credit Bureau
of the Vancouver Medical Association, paste it carefully in a conspicuous place on your desk or on a firm piece of card for frequent
reference.
Now for a story.
Fifteen years ago, a book agent of thirty-three years' experience (let me say "God bless him!") made this remark to a young
physician just starting practice in Vancouver:
"Young man, if you will collect carefully your bills
before they become bad debts, you will make more friends
than enemies, and be able in ten years to build and pay for a
fine residence for yourself; have a first-class library, medical
and general; and in twenty^years, to pay for enough life
insurance to properly protect your wife and family in case
you die—as a basis of a good practice—all of these out of
collections, you will certainly lose by bad business methods."
It was this rather serious remark that indirectly led to the
formation of the Credit Bureau.
Established in 1914 with ten members, it now serves one
hundred and sixty members, and is still growing.
During the past ten years numerous collecting agencies have
been born in hope, lived on the monies due their clients, and died
because doctors had good reason to distrust them.
You should know that the Bureau is associated with the
American Collection Service, whose members are bonded up to an
amount not exceeding One Thousand Dollars on any claim, so
that when a debtor moves to another city in any part of America,
every cent collected is safe. In this way the Bureau prevents any
of its claims falling into the hands of the many fraudulent agencies
operating in every city.
The Manager of the Credit Bureau, Mr. J. C. Welch, is a
member of the American Collection Service, and also of the Pacific
Coast Collectors' Association, and is regarded by them as a very
efficient and capable collector. At their request, he has given
addresses before both the Washington and Oregon Associations as
to the most successful methods of collection, and his ability in this
line is duly recognized.
Page Ten LIBRARY NOTES.
When good old Omar went singing into the wilderness with
a book of verses, a loaf of bread, a jug of wine, and "thou beside
me," he confined himself strictly to the essentials and carried no
superfluous baggage.
He was wise.
In the bygone days before the war Vienna was known as
the medical lunch counter of Europe. When a man's time was
limited and he wanted a particular course, he stepped up, ordered,
and received it unaccompanied by an array of unnecessary side
dishes.    The counter did a big business.
The purpose of the Library is to cater to the reading wants
of the members of the Association, but at the present time there is
so much medical literature coming off the presses that it is impossible (and because of the varied quality entirely undesirable) to
purchase or read all that is published or even one narrow specialty.
So the Library stocks representative journals and, from time to
time as they are issued, new books that appear to be valuable contributions to the subjects discussed. It is important that the members should know of these and at the same time not be forced to
search through them, when a special article and reference, or
definite information on a certain subject is required. Call up the
Librarian, who knows what is on the shelves, tell her your wants
and the available literature will be sifted out. Thus will worry
be avoided, time saved, and you will not take home a book only
to discover later that it does not contain just the exact thing you
were after.
Following its policy, the Committee appends a list of books
received by the editors for review, and short reviews of some of
them. These books are recommended to the attention Of the
readers of the Bulletin. Further reviews will appear in the next
issue.
BOOKS RECEIVED.
The Treatment of the Common Disorders of Digestion—A
Handbook for Physicians and Students. By John L. Kantor,
Ph.D., M.D. 1924. 245 pages with sixty-four illustrations, all
original. C. V. Mosby Co., St. Louis. $4.75. (Canadian
Agents: McAinsh & Co., Toronto.)
Edema—By Leo Loeb, Professor of Comparative Pathology,
Washington University. 1924. Cloth, 178 pages. Williams &
Wilkins Company, Baltimore.    $3.00.
Race Hygiene and Heredity—By Hermann W. Siemens, M.D.
Translated and edited by Lewellys F. Barker, M.D. 1924. Cloth,
178 pages.   D. Appleton & Co., New York and London.    $2.00.
Cosmetic Surgery—The Correction of Featural Imperfections.    By Charles Conrad Miller, M.D.    With one hundred and
Page Eleven forty illustrations.    1924.    263 pages.    F. A. Davis Company,
Philadelphia.    $4.00.
International Clinics—A Quarterly of Illustrated Clinical
Lectures and Especially Prepared Original Articles. Edited by
Henry W. Cattell, A.M., M.D., with the collaboration of Chas.
H. Mayo, M.D. Volumes I. and II. Thirty-fourth Series. 1924.
J. B. Lippincott Company, Philadelphia and London. $2.00 a
volume.
Basal Metabolism—Determination of the Metabolic Rate in
the Practice of Medicine. By John T. King, Jr., M.D. 1924.
112 pages.    Williams & Wilkins Company, Baltimore.    $2.50.
Calorimetry in Medicine—An Analytical Review and Summary of the Entire Field of Determination of Basal Metabolism.
By William S. McCann, M.D. 1924. 98 pages. 304 references. Illustrated. Willia^ns & Wilkins Company, Baltimore.
$2.25.
Blood Pressure, Cause, Effect and Remedy—By Lewellys F.
Barker and Norman B. Cole. 1924. 154 pages. D. Appleton
&> Company, New York and London.    $1.25.
NOTES ON NEW BOOKS.
Modern Methods of Treatment—By Logan Clendinning,
M.D. With Chapters on Special Subjects by H. C. Anderson,
M.D.; J. B. Cowherd, M.D.; Carl O. Rickter, M.G.; F. C. Neff,
M.D.; E. H. Skinner, M.D.; and E. R. deWeese, M.D. 1924.
Pages 692. Illustrated. The C. V. Mosby Company, St. Louis.
$9.00.     (Canadian Agents:   McAinsh & Co., Toronto.)
The author introduces this work by a pungent preface in
which he takes exception to previous books on Treatment, their
scheme and method, the language and style in which they are
written. Inferentially improvement in the present case is suggested. Such a beginning naturally sharpens the critical eye of the
reviewer, especially if he also happens to be an author in esse or in
posse. We, not being either, are of opinion, after a perusal of this
work, that the writer has endeavoured to justify his position and
has partly succeeded. The book is divided into two parts, the
first dealing with the materials, appliances and methods used in
treatment; the second, with their application to disease. It is
doubtless true that exception will probably be taken to some of
the procedures recommended by Dr. Clendinning by those who
practise medicine as a branch of the higher mathematics, but to the
practitioner, urged by the condition of his patient no less than by
the clamour of the patient's friends, who feels that something must
be done, this book will be welcome. The author has detailed,
dogmatically maybe, but definitely, certain methods of treatment.
As he remarks, no doubt with an eye on the "atrocious English"
of which he complains in his preface, "a method is better than any
old method."    Some sections receive more attention than others.
Page Twelve The thyroid seems to us to get less than its due. The articles on
the heart and on digitalis are excellent. We are intrigued by the
graphic methods of enforcing systems of treatment such as that for
congenital universal asthenia on page 638. Such a method of
presentation is modern, but not necessarily unsuited to a medical
textbook. There are occasional errors. We note on page 631,
"calcined carbonate" is printed for what is evidently intended to
be "calcium carbonate," and on page 104 the author has grains
VI. to grains VII. of Digitalis leaves as the apparent equivalent to
one to two drams of the tincture. The format is admirable, making allowance for the heavy paper which seems inseparable from
the reproduction of good illustrations, but which renders the work
less a handbook than a desk-book.
—J. M. P.
A Manual of Gynaecology and Pelvic Surgery—For Students
and Practitioners. By Roland E. Skeel, M.D., A.M., M.S. Second edition, 1924. With 281 illustrations. Pages 674. P.
Blakiston's Son & Co., Philadelphia.
A Manual of Gynaecology and Pelvic Surgery, by Roland E.
Skeel, of Los Angeles, formerly of Cleveland, has many commendable features. The inclusion in textbooks of gynaecology of a chapter on appendicitis, haemorrhoids, etc., is, to the reviewer, unwise.
The first chapter on anatomy of the pelvic organs is quite orthodox, with possibly too little emphasis given to the important supportive tissues of the pelvis. The chapter on physiology is lacking in many essentials (eight pages given to physiology in a book
of 649 pages). The chapter on symptomatology and diagnosis is
one of the best and will be read with profit by practitioners. The
use of the Harris Segregator in this day, when in any centre men
can be found proficient in the use of the ureteral catheter, is unnecessary. The author takes up in rotation, from the vulva upwards,
diseases of the different organs. The symptoms, diagnosis and
pathologic descriptions, leave little to be desired. The description
of plastic vaginal surgery is not as well done, and many ancient
operations and descriptions could be supplanted with more modern work. The chapter on prolapse of the uterus is decidedly
mediocre. The description and drawings of hysterectomy fail to
show the round ligaments sutured into the cervical or vaginal
stump. The chapter on extra-uterine pregnancy is well written,
although the majority of gynaecologists will not look with favour
upon double salpingectomy, so that the remaining tube may
not become ectopic later. Indeed, the majority of gynaecologists
to-day do not sacrifice the whole of the affected tube, and in some
instances even not a part in operating for ectopic pregnancy. In
the chapter on ovarian tumours nothing is written of Sampson's
or Bell's recent work on ovarian haematomata. The article on
sterility is incomplete. Gynaecological therapeutics is quite to the
point. In the article on cystitis the modern urologist will question the remark that practically all cases of cystitis which one sees
are the result of infection which ascends through the urethra, or
Page Thirteen is introduced into the bladder by means of instruments.    The subchapter on asepsis and antisepsis is of high standard.
Taken as a- whole, the book is well written, devoid of hobbies, and covers the field. It will be more useful to the student
than to the specialist.
—J. J. M.
^ ^ ^c ^
Physical Diagnosis—By W. D. Rose, M.D. Fourth Edition.
1924. 755 pages. Three hundred and nineteen illustrations.
The C. V. Mosby Company, St. Louis. $8.50. (Canadian
Agents: McAinsh & Co., Toronto.)
While there is little new material to be put into a textbook
of this kind, there is always need for a concise, orderly statement
of the known^pr-inciples of physical diagnosis and the physical
findings in the commoner diseases, and such a statement is to be
found in Dr. Rose's Physical Diagnosis (fourth edition) . The
book is especially well adapted for the student who wants a complete discussion of the subject in a rather elementary way. The
greater part of the book is devoted to the study of the lungs and
heart, and probably rightly so. These subjects are treated first
by reviewing the anatomy, then considering the various deviations
from the normal, and finally by enumerating the physical findings
as they occur in the commoner disease. The attempt has been
made throughout to adhere strictly to objective signs of disease, a
factor that has made for simplicity and clearness. It is doubtful if
the chapter on Radiographic Diagnosis has a place in such a text,
for while this section is well written and illustrated, it is impossible to cover the subject of radiography adequately in twenty-
eight pages. The section on Sphygmomanometry seems unnecessarily short, especially since no further mention of blood pressure
is made in the discussion of the various types of cardiac and vascular disease. The chapter on diagnosis of abnormalities of the
heart beat, by Dr. Drew Luten, of St. Louis, is admirable, emphasizing the correlation of the electrocardiographic and clinical findings in"the study of these conditions. It is from such an attempt
as this that the graphic method of the study of cardiac irregularities will achieve its greatest usefulness, which must be the training
of the observer for correct diagnosis at the bedside.
—G. F. S.
PERIARTERIAL  SYMPATHECTOMY.
Every artery of the body may be regarded as a scaffolding
for the support of a leash of sympathetic nerve fibres, which fibres
are responsible for the maintenance of, and variations in, arterial
tone. Physiologically there are no vaso-dilator fibres, the dilation
occurring as a result of inhibition of the constrictor fibres.
Leriche, of Lyons, showed that if the sheath of an artery be
opened and the adventitious coat dissected therefrom, for an inch
Page  Fourteen or so, the interruption of the sympathetic vaso-constrictor impulses
throughout the distribution of the vessel, results in a marked dilation of the arterioles, with increased local temperature and a more
efficient nourishment of the parts. He has utilized this physiological finding by stripping off the adventitious coat of the main
artery to a limb in a great variety of conditions, and reports very
marked improvement in such conditions as intractable varicose
ulcers, trophic ulcers of tabes and syringomyelia, threatened diabetic gangrene, frost bite, ischaemia, Raynaud's disease, and many
other ischaemic or under-nourished conditions. Although reported
results are not wholly uniform, the operation is sound physiologically, and practically has given sufficiently good results to warrant a thorough trial in these otherwise intractable cases.
The following literature on this subject is available in the
Medical Library:
B. M. J.—165-66.    Aug. 2, 1924.
J. A. M. A.—Vol. 180:  173-175.    Jan. 20, 1923.
Ann. Surg.—Vol. 77
Ann. Surg.—Vol. 78
Ann. Surg.—Vol. 74
30-37. Jan., 1923.
323-325. Sept., 1923.
385. Oct., 1921.
Med. Jnl. 8 Rec—553-54. June 4, 1924.
S. G. 8 O.— Vol. 38: 81-82. Jan., 1924.
-L. H. A.
B. C. MEDICAL ASSOCIATION.
Dr. D. P. Hanington, of Kimberley, B. C who is enjoying
a six weeks' vacation, will return on November 1st. His practice
was cared for by Dr. Wm. Rose, who has had considerable experience this year doing locum tenens work throughout the province.
An interesting ceremony took place in Vancouver on the 6th
of September, when Dr. Jas. W. Lang, of Hutton, B. C, was
married to Miss Florence Lott, R.N., of Pictou, N. S. Dr. Lang
is a McGill graduate,   1923.
Dr. W. Laishley, of Giscome, and Dr. J. W. Lang, of Hut-
ton, have recently been appointed Medical Officers of Health for
their respective districts.
Dr. Walter Bapty has been appointed to the Executive of
•the B. C. Medical Association as representative of the Victoria
Medical Society.
The semi-annual meeting of No. 4 District Medical Society
(Okanagan) was held at Tranquille Sanatorium on Sept. 16th.
Delegates from the B. C. Medical Association to this meeting
included Dr. C. H. Vrooman and Dr. J. H. MacDermot, of Vancouver. Mr. Fletcher, Executive Secretary, also attended the meeting. A paper on "Diagnosis of Some Lung Conditions" (abstracted in the last number of the Bulletin), was read by Dr.
Vrooman. Dr. MacDermot, Secretary of the Association, spoke
on "Medical Organization"; and Mr. Fletcher on the activities of
the B. C. Medical Association in particular.    The members were
Page   Fifteen entertained at dinner by Dr. Lapp, of the Tranquille Sanatorium,
and the whole day was enjoyed greatly, the weather being at its
best, even for Tranquille. The following officers were elected for
the ensuing year:—
President—Dr. J. J. Gillis, Merrit, B. C.
Vice-President—Dr. J. H. Hamilton, Revelstoke.
Secretary-Treasurer—Dr. Lee Smith, Princeton.
Representative on Executive of B. C. Medical Association—
Dr. J. E. Affleck, Penticton.
The first luncheon of the session was held at the Ambassador
Cafe, Vancouver, on the 3rd October. Many members from other
districts were present, including Dr. H. E. Young, Provincial
Medical Health Officer; Dr. E. J. Roth well, New Westminster;
Drs. Archibald and Murphy, of j Kamloops, and others. The
Honourable A. M. Manson, Attorney-General of B. C, gave a
forcible and interesting address on the duty of the medical man to
take his part in the political life of his country. The address was
a surprise to many men who had expected the speaker to deal with
some matter more closely affecting the medical profession, but was
probably none the less timely and valuable, because it touched on
matters which receive, perhaps, too little attention from the busy
medical man. The members of the Provincial Parliament were
invited to attend the luncheon. Unfortunately Mr. Walkem and
Mr. A. McC. Creery were unable to attend, but we had the
pleasure of the company of members of both the Liberal and the
Labour parties, and received expressions of regret from those members who were unable to be present. Dr. H. H. Murphy, of Kamloops, moved a vote of thanks to Mr. Manson in a very delightful
speech, full of wit and good sense.
An executive meeting of the B. C. Medical Association was
held on Friday, Oct. 3rd. Reports of committees were adopted
and the work for the session outlined. A committee has been
appointed to go into the matter of the establishment of a Benevolent Fund for the Association, and a report will be made at a
later date.
We record with very great regret the death of Dr. Charles
Woollard, one of our members. An obituary notice appears in
another column of the Bulletin. We offer our respectful sympathy
to his wife and two little daughters.
The Health Bureau of the Board of Trade held its first meeting on Wednesday, October 1st, and the question of the "Mentally Deficient Child" was taken up, and a very able address given
by Miss Dauphinee, of the Vancouver School Board. A committee has been appointed to go into this question and prepare a
report for the Council of the Board of Trade, in order that some
steps may be taken towards providing proper institutional treatment for children of low mental grades, and a proper classification
of children in general for educational purposes. This Bureau
offers great opportunities to the medical profession,  to perform
Page Sixteen more fully its duty to the community, by giving us an outlet for
the expression of our knowledge to a section of the public that is
particularly interested in promoting the welfare, and increasing the
business efficiency of all classes, which realizes, too, that health is
one of the chief assets, from a business point of view, that a city
can possess. The preventive side of our art can be dwelt on with
especial emphasis, and the recommendations of this Bureau receive
the closest attention and the warmest support from the Board as a
whole. We may note here that at least one other Board of Trade,
that of Kamloops, has an active Health Bureau. We would again
urge on all medical men that they join the Board of Trade in their
community, and work for the formation of Health Bureaux,
where these are not already in existence. We are often accused,
and not altogether without reason, of being dilatory in taking
the public into our confidence, and indeed, there is much that we
could give to the public, in ways like this, which would help to
build up and safeguard its interests, which are also ours.
PRESIDENT'S ADDRESS.
Vancouver Medical Association, Oct. 7th, 1924.
. After expressing his sincere gratitude for the high honour conferred on him this year, Dr. H. H. Milburn stated that it had
occurred to him many times that an Association of this size should
devote at least one evening a year to the History of Medicine. He
thought it "fitting that we should pay tribute from time to time
to the great master minds of medicine whose efforts and character
have added such lustre to our calling." Hoping that his effort
would be repeated each year, he had selected as his particular topic
"Thomas Sydenham, the Practical Physician."
After alluding briefly to what little was known of this great
master's early life up to the time he entered Oxford a second time
(1646), his course having been interrupted by four years of war
between Charles I. and Parliament, in which "The Fighting Syd-
enhams," as they were called, served with great distinction on the
latter side, the speaker referred to Sydenham's brief medical training in the university. He had been induced by the learned and
honourable Dr. Thomas Coxe to study medicine. Sydenham's
own biographical statement of this event was read. He was created M.B. on April 14th, 1648, by command of the Earl of Pembroke, then the Chancellor, barely a year after he began his studies.
During the succeeding eight years he remained at Oxford, first as
a Fellow of All Souls' College and later as Senior Bursar. Oxford
at this time offered little facility for medical study; there was no
hospital for clinical work. There was some regular teaching in
Anatomy, Chemistry and Botany. Sir Thomas Clayton, Regius
Professor of Medicine, gave bi-weekly lectures on the doctrines of
Hippocrates and Galen. We imagine Sydenham here developing
a good acquaintance with the writings and doctrines of Hippocrates, whose methods he so greatly respected.
Page Seventeen After his marriage in 1656 he moved to London, where he
took up practice in the Westminster quarter.
To explain the remarks of Dr. John Brown, who stated of
Sydenham, "in the midst of what a mass of errors and prejudices,
of theories actively mischievous, he was placed, at a time when the
mania of hypothesis was at its height and when the practical part
of his art was overrun and stultified by silly nostrums," the
spea'ker dealt briefly with the different sects then existant in medicine, viz.; the Galenist, the Chemical sect and the followers of
Sylvius. . He also read a letter of Dr. George Wharton, ari eminent
physician and anatomist, portraying the invidious position of a
physician of that day, which he wrote to dissaude a young man
from embracing physic for a livelihood. This was a humorous
sketch and quite ipplicable in some respects to present conditions.
Payne states that "it may be divined that Sydenham found
his scanty stock of professional knowledge hardly sufficient for
practising medicine with the thoroughness which his conscientious
nature must have felt to be necessary. It was not in him to carry
off imperfect knowledge by plausible manner or dogmatic assumption." So that one is not at all surprised to learn that his next
step of importance was to go. to the continent to improve himself.
It is now an almost undisputed fact that Sydenham studied
at Montpelier under the celebrated physician and clinical teacher
Barbeyrac, where he must have acquired a great deal of knowledge
of an intensely practical nature. London, a fever ridden community on account of the great open marshes situated in the city,
and the bad hygienic conditions of the streets and houses, was a
fertile field for his newly-acquired knowledge. Sydenham's first
recorded observations on the fevers of London began in 1661,
presumably the year he returned from the continent. He obtained
his licence from the Royal College of Physicians in 1663, but
never obtained the coveted Fellowship. "From all we know of
Sydenham," writes Payne, "we should conclude that he cared little
about academic distinction, and doubtless bore this privation with
equanimity."
Sydenham in the first place studied fevers, and after long and
painstaking researches he discovered such a happy treatment that he
obtained most remarkable success. His friends were desirous that
he should make public the treatment, and finally he published a
work which appeared in London in 1666, having for title
"Thomas- Sydenham Methodus Curandi Febres Propriis Observa-
tionibus Superstructa" (Thomas Sydenham's method of treating
fevers based on his own observation). This is a small octavo
volume of 156 pages, containing about 17,000 wordsr The
treatise was written in Dorsetshire, where he had taken his family
to protect them from the ravages of the Great Plague.
Dr. Milburn dwelt at some length on the contents of the
"Methodus," noting the prominence of fevers in those old days
Page  Eighteen (Sydenham estimated that they made up two-thirds of medicine,
as against the present percentage of one-tenth), and many of his
unique observations and principles of treatment. There were four
sections of the book: (1) continued fevers; (2) on certain symptoms that accompany continued fevers; (3) intermittent fevers;
(4) smallpox, under which he includes measles. Sydenham was
the first to distinguish the two types of smallpox, discrete and confluent. Sydenham's prefix to this work has often been referred to
as his "Religio Medici," it reveals his lofty purpose and the high
regard he had for his calling. "Whoever applies himself to medicine ought seriously to weigh the following considerations: First,
that he will one day have to render an account to the Supreme
Judge of the lives of sick persons committed to his care. Next,
whatever knowledge he may, by the Divine favour, become possessed of, should be devoted above all things to the glory of God
and the welfare of the human race. Moreover, let him remember
that it is not any base or despicable creature of which he has undertaken the cure. For the only begotten Son of God, by becoming
man, recognized the value of the human race, and ennobled by
His own dignity, the nature He assumed. Finally, the physician
should bear in mind that he himself is not exempt from the common lot, but subject to the same laws of mortality and disease as
others; and he will care for the sick with more diligence and
tenderness if he remembers that he himself is their fellow sufferer."
Four editions were published of this work, the last in 1685.
"With all deductions," writes Payne, "this work will always
remain one of the greatest of medical classics. The descriptions
of many diseases and symptoms are so admirable and complete that
ihey have never been surpassed, nor are they likely to be. Many
flashes of insight and pregnant hints might be collected, which
contemporaries did not understand, and to which later knowledge
only is able to do justice. Above all, the resolute endeavour to
study natural facts by pure observation, putting aside theories,
facts and fictions collected out of books, which, he says, have as
much to do with treating sick men as the painting of pictures has
to do with sailing ships—this endeavour, successful or not, will
always be the best example of method to all students of medicine."
Sydenham published many shorter writings. Epistolae Re-
sponsoriae Duae (further observations on the fevers of London,
with a treatise on Venereal Disease) was published in 1680. Dis-
sertatio Epistolaris appeared in 1682, and treated of confluent
smallpox and hysteria, which he recognized as a distinct form of
disease. The pictures of hysteria in women, which are often
quoted, are vivid and true. In 1683 he brought out a short treatise on Gout and Dropsy. His work on Gout is the more important; so vivid and accurate is his description of the attacks that it
has never been surpassed and remains to this day absolutely classical.    He was himself a frequent sufferer from gout.
In 1686 Sydenham published his last work, "A Sketch by
Way of Warning of the Approach of a New Fever."    There is a
Page Nineteen chapter on calculus, giving his own habits of life, as he was for
many years a victim of this painful affection. There is a final
chapter on Chorea—a masterpiece of description. Chorea in children described by him is often referred to as "Sydenham's chorea."
At the end of the book, Sept. 29, 1686, he states "that he has
now delivered nearly all that he knows respecting the cure of diseases." This was his last work. Three-years later—Dec. 29th,
1689—the great innovator of practical medicine passed away in
his 65th year.
After reading Payne's brief description of Sydenham, which
pictures a manly and simple personality, gaining the most complete confidence of his patients by plain honesty and benevolence,
and the ascendancy of a strong character, rather than by pleasing
and flattery, and mentioning his regrettable indifference to the
anatomical and physiological school of Harvey, the speaker closed
by referring to the noble purpose expressed in Sydenham's own
works: "As long as Almighty God shall give me life, I shall press
forward to my avowed end of doing all the good in my calling."
"There is no end to the sufficiency of character. It can afford
to wait; it can do without what is called success. To a well-
principled man existence is victory. He defends himself against
failure in his main design by making every inch of the road to it
right. He feels the immensity of the chain whose last link he
holds in his hand, and is led by it. Having nothing, the spirit
hath all. It makes no stipulations for earthly felicity, does not
ask, in the absoluteness of its trust, even for the assurance of continued life."
PRESCRIPTIONS
filled exactly as written
Phones! Seymour 1050 * 1051
Day and Night Service
H Qeorgia Pharmacy Ltd.
Qeorgia and Qranville Sts. Vancouver, B. C.
Page Twenty The Medical Profession is United
in recognition 'of the fact that the MOST IMPORTANT
FACTOR IN THE LIFE OF A CHILD is the Milk supply.
MILK is the first and only food the new-born child receives, and when—as is frequently the case—cow's milk has
to be substituted for the natural mother's milk, too much care
cannot be taken to secure the best and purest milk obtainable.
THE BEST AND PUREST MILK can come only from
the MOST SANITARY AND EFFICIENT DAIRY. Therefore, when recommending a supply of Milk, for either BABY,
INVALID, or HEALTHY PERSON,  REMEMBER that the
VALLEY DAIRY
holds the record score for SANITARY, MODERN, and EFFICIENT DAIRY EQUIPMENT, and PURITY OF PRODUCTS.
VALLEY DAIRY LIMITED
"The Children's Friend"
15 69 Sixth Avenue West.
Bayview 553.
Burns Drug. Company
limited
DISPENSARY    PHONE
SEYMOUR   606
The Dispensing Department is an entirely separate
unit of our business.
We stock all the  leading   manufacturers'   lines.
Don't forget —- Dispensary  Phone,   Seymour   606
Page Twenty-one  Collecting Money Made Easy
1. Educate your patients to appraise your time, care, skill and
attention at their full value.
2. Be sure your patients know definitely the cost of your services, and when you expect payment.
3. Be   able   to   identify   your  patients   when   your  services   are
completed, by recording the following facts in your books:—
Surname   (Mr., Mrs., Miss).
Christian Name  (Jr. or Sr.).
Nationality,  Age,  Married,  Widow,  or Single.
Addresses, present and previous.
Phone Number.
Occupation,  Employer   (Name,  Address,  Phone).
Years in the City   (if  recent arrival,  where from).
Voter, Tenant or Owner.
Relative  or Friend   (Name,   Address,  Phone).
Hospital Number,  or Workman's Compensation  Number.
Remarks   (ability  to  pay;   number and  date of accounts rendered;   special letters sent;   replies  received).
4. Render all bills monthly.
5. Register, by A. R. letter, a bill or special letter, to all slow
pay immediately, and also to all returned bills.
6. Once  each  month   consult   the   Credit   Bureau  of  the Vancouver Medical Association,  615  Pender Street West;  Seymour 2033.
Doctors'—'
Your stationery is
always neat and
attractive when
entrusted to
McBeath Spedding
Limited
569 Howe St.     Seymour 2487
A New Service
We desire to announce to the
Medical Profession that a twenty-
four hour phone service is now
available,
The patronage of all practicing
licensed physicians and surgeons
is respectfully solicited.
For further information apply
to
Medical Phone Service
Seymour 2062
Page Twenty-three Rest Haven Sanitarium
Medical and Surgical
No Tubercular cur Mental Cases
Strictly Ethical
■^Sfe
«£<:.
C~7'    ^E cordially  invite  the  medical  profession  to  visit  Rest
yVJ Haven.    Here, beautiful surroundings, kind and cheerful
attendants, with liberal but carefully prepared diet, furnish an environment favorable to recovery.
Hydrotherapy, massage and other physio-therapy treatments
are provided under careful medical supervision.
Your own program for patient carried out, including special
diet for diabetics, etc. Reports and laboratory tests sent to physicians referring patients to.us.
Don't miss an opportunity, Doctor, to see our place, and if
possible enjoy a day or two here with your family as our guest.
O. S. PARRETT, M.D.,
Medical Superintendent.
SIDNEY, B.C., near Victoria
Phone 95-0
Page  Twenty-four

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