History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: September, 1942 Vancouver Medical Association Sep 30, 1942

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Full Text

 The BULLEiriN
of the
■I § VANCOUVER
MEDICAL ASSOCIATION
■Vol. XVIII
SEPTEMBER, 1942
No. 12
With Which Is Incorporated
Transactions of the
Victoria Medical Society
the
Vancouver General Hospital
and
StiPaul's Hospital
In This Issue:
Page
NEWS AND JNTOTES^^^^^^B ,----J^^^^^p/; .|gf■ jj||p 59
TAXATION-RATES AND DEDUCIlONS^^^^^R —^^^^^^369
CORRESPONDENCE—WORKMEN'S COMPENSATION fl v^.-^j|373
IDIOSYNCRASY TO MORPHIA"^^^^^^^^^^' .. -Jyjjg |f376
METABOLISM OF CALCIUM-^^ '^^^^^^ llll?77
CASE FOR DIAGNOSIS- -''PS^^S^^I^^fef'"—^fc ^^^^fe380
VANCOUVER MEDICAL ASSOCIATION
ill    H      SUMMER SCHOOL
SEPTEMBER 15ll8 Inc. B.
W
i%
WITH
MINEROVITE
E.Mm 5 a
1879
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m
• Adequate supplies of both minerals and
vitamins are prerequisites of normal nutrition.
Deficiency states resulting from lack of adequate
vitamins in the diet are frequently accompanied by
a lack of certain minerals. For this reason, combined therapy with both vitamins and minerals is
indicated. CCT. Minerovite E.B.S. provides both
vitamins and minerals and is thereby a dependable source of supply when either a vitamin or a
mineral deficiency is the obstacle in the path
of recovery.
Frequently, the physician sees a patient in whom he recognizes a number of distinct deficiency diseases. There may be
partial deprivation of vitamin A, vitamin D, nicotinic acid,
thiamine, riboflavin and ascorbic acid, accompanied by a
deficiency of certain rare but vital mineral elements. As a
result, of this combined deficiency, the skin, alimentary tract
and the nervous, hemopoietic and cardiovascular systems
may be involved.
Supplements of several vitamins and minerals may be necessary in such situations as: reducing diets for obesity, restricted
diets in allergy cases, during convalescence from severe
infections and special diets for the treatment of peptic ulcer.
Minerovite E.B.S. is offered to supply the deficiency of
vitamins and minerals in such conditions. The formula has
been balanced to provide, in the daily dose, at least, the
ynin)TP"Tr> requirements of vitamins A.D.C. Bl and nicotinic
acid, and half the requirements of riboflavin. In addition, the
other purified members of the B complex are present, in
proportionate amounts, and vitamin K because of its essential
quality for the maintenance of a normal concentration of prothrombin in the blood Minerovite E.B.S. also contains suitable amounts of salts of iron, manganese, copper and calcium.
WHEN PRESCRIBING
Specify E.B.S. Preparations
Available in
bottles of 100,
500 and 1,000.
CCT  N
o   466
Minerovite
E _ s
D°*e: Three or four tablets
daily.
Control
C'_"«SCH(M,<
Formula of CCT. #466 MINEROVITE
Each tablet contains:
Vitamin A   .   «::'$^SjS  .  2500 Int. Unit*
Vitamin D   . -„i"s.   ,   .ijik&gi 400 Int. Units
Vitamin C   .'&-JL7.5 mgms. (350 Int. Units)
Vitamin K .   . .008 mgms. (200 Dam Units)
Vitamin Bl (Thiamin Chloride)
jragl      »||:.  .375 mgms. (125 Int. Units)
Vitamin Be (Riboflavin .  %S'£*ii:~J25 mgms.
Vitamin Be (pyridoxine
sags; Hydrochloride) .125 mgms.
Pantothenic Acid  ^V4'f^I>^p^i-5 mgms.
Nicotinic Acid    ..|£.J'_^.»v^j'.'-v> 5.0 mgms.
Combined with Salts of the following mineral
elements:  Iron,   Manganese,   Copper   and
Calcium.
DOSE: One tablet four time daily.
THE E. B. SHUTTLEWORTH CHEMICAL CO. LIMITED
TORONTO
MANUFACTURING   CHEMISTS
CANADA THE    VANCOUVER    MEDICAL    A SSOCIA j<* fOiN
BULLETIN
Published Monthly under the Auspices of the Vancouver Medical Association
in the interests of the Medical Profession.
Offices: 203 Medical- Dental Building, Georgia Street, Vancouver, B. C.
EDITORIAL BOARD:
Db. J. H. MaoDebmot
Db. O. A. Davidson Db. D. E. H. Cleveland
All communications to be addressed to the Editor at the above address.
Vol. XVIII
SEPTEMBER, 1942
No. 12
OFFICERS, 1941-1942
Db. J. R. Neilson Db. H. H. Pitts Db. C. McDiabmid
President Vice-President Past President
Db. Oobdon Bubke Db. A. E. Tbites
Hon. Treasurer Hon. Secretary
Additional Members of Executive: Db. J. R. Davidson, Db, J. A. McLean
TRUSTEE^
Db. F. Bbodie Db. J. A. Gillespie Db, W. T. Lockhart
Auditors: Messrs. Plommeb, Whiting & Co.
SECTIONS
Clinical Section
Db. Ross Davidson Chairman Db. D. A. Steele: Secretary
Eye, Ear, Nose and Throat
Db. A. R. Anthony Chairman Db. C. E. Davies Secretary
Pediatric Section
Db. G. O. Matthews Chairman Db. J. H. B. Gbant. Secretary
STANDING COMMITTEES
Library:
Db, F. J. Bulleb, Db. D. E. H. Cleveland, Db. J. R. Davies,
Db. A. Bagnall, Db. A. B. Manson, Db. B. J. Habbison
Publications:
Dr. J. H. MaoDebmot, Db. D. E. H. Cleveland, Db. G. A. Davidson.
Summer School:
Db. H. H. Caple, Db, J. E. Habbison, Db. H. H. Hatfield,
Db. Howabd Spohn, Db, W. L. Gbaham, Db. J. C. Thomas
Credentials:
Db. A. W. Hunter, Db. W. L. Pedlow, Db, A. T. Henby
F. O. N. Advisory Board:
Db. L. W. McNutt,~Db. G. E. Seldon, Db. Isabel Day.
Metropolitan Health Board Advisory Committee:
Db. W. D. Patton, Db. W. D. Kennedy, Db. G. A. Lamont.
Greater Vancouver Health League Representatives:
Db. R. A. Wilson, Db. Wallace Cobubn.
Representative to B. C. Medical Association: Db. C. McDiabmid.
Sickness and Benevolent Fund: The Pbesident—The Tbustees.
I <W'L
,m\ I
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|||§
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_M
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A PRODUCT
OF CHOICE
SQUIBB Cod Liver Oil was given to
babies long before anyone knew what
was in i t that made it so beneficial. First
introduced in 1875, it is today the largest
selling brand of medicinal cod liver oil in
the world.
Only carefully selected fresh livers are
used in the preparation of Squibb Cod
Liver Oil, and the rendering and refining is
conducted under conditions which avoid
excessive heating of the livers and exposure
to air. The final oil is carbonated and
bottled under carbon dioxide to avoid
oxidation of vitamin A.
Make sure that your patients' babies get
a dependable source of vitamins A and D.
Squibb Cod Liver Oil helps babiesdevelop
a straight back, strong legs, fine full chest,
well-shaped head and sound even teeth.
Squibb Cod Liver Oil provides twice as
many vitamin A and vitamin D units as a
cod liver oil which meets the minimum
U. S. P. requirements. Each gram supplies
1800 units of vitamin A and 175 units of
vitamin D, U. S. P. XI.
For Rapidly Growing Infants
Premature or rapidly growing infants need
extra vitamin D.   Squibb Cod Liver Oil
with Viosterol
10D has the
same vitamin A
content    as
Squibb Cod
Liver Oil and is
enriched with i r-
radiated ergos-
terol to a vitamin
D content of 400
U. S.P. XI units
per gram.
For literature write 36 Caledonia Road, Toronto, Canada.
E R:Sqjjibb _ Sons of Canada, Ltd.
MANUFACTURING   CHEMISTS   TO   THE    MEDICAL    PROFESSION    SINCE    1858 VANCOUVER     HEALTH     DEPARTMENT
STATISTICS—JULY, 1942
Total Population—estimated _   272.352
Japanese Population—estimated , "     g769
Chinese Population—estimated  8558
Hindu Population—estimated B  360
Rate per 1,000
Number        Population
Total deaths  ^  272 11 8
Japanese deaths       " £ ~ 4 5*2
Chinese deaths  „ ______      11 14^8
Deaths—residents only .    233 lo!l
BIRTH REGISTRATIONS:
Male, 295; Female, 272    567 24.6
INFANTILE MORTALITY: July, 1942 July, 1941
Deaths under one year of age 10 10
Death rate—per 1,000 births      17.6 19.2
Stillbirths (not included in above)      11 11
CASES OF COMMUNICABLE DISEASES REPORTED IN THE CITY
June, 1942 July, 1942 Aug. 1-16,1942
Cases   Deaths Cases Deaths Cases   Deaths
Scarlet  Fever    13           0 18           0 4 0
Diphtheria      10 0           0 0 0
Diphtheria Carrier 0           0 0           0 10
Chicken Pox 63           0 126           0 50 0
Measles 11           0 7           0 10
Rubella 27           0 0           0 0 0
Mumps 590           0 251           0 87 0
Whooping Cough    65           0 10           0 7 0
Typhoid Fever      0           0 0           0 0 0
Undulant Fever Jf,   10 0           0 0 0
Poliomyelitis 0           0 0           0 0 0
Tuberculosis    41         16 35         10 28
Erysipelas         4           0 0           0 10
Meningococcus Meningitis      2           0 0           0 11
Varicellaform Dermatitis      0           0 0           0 0 0
V. D. CASES REPORTED TO PROVINCIAL BOARD OF HEALTH,
DIVISION OF VENEREAL DISEASE CONTROL
West North      Vane.   Hospitals &
Burnaby   Vancr. Richmond   Vancr.     Clinic  Private Drs.  Totals
Syphilis  Figures not yet received.
Gonorrhoea	
%m
if',' i
A DYNAMIC MENTAL AND PHYSICAL TONIC
INDICATED IN THESE DAYS OF STRESS
<< A "
BIOGLAN "A
Another Product of the Bioglan Laboratories, Hertford, England
an*
Phone MA. 4027
Stanley N* Bayne, Representative
1432 MEDICAL-DENTAL BUILDING
Descriptive Literature on Request
THE SCIENTIFIC HORMONE TREATMENT
Vancouver, B. C.
Page 355 _*
HULTIVITE
(Vitamins A Bx C and D)
fc
Hi
■ 11'
1 ''!*'
Multivite pellets are a convenient form in which the four vitamins, A Bi C and D, can be administered in order to make good
the deficiencies of modern diets and some of the restricted diets
of ill and convalescent patients.
Of the particular indications for the individual vitamins, the
following are of special importance:—
Vitamin  A
Vitamin Bi
is specific in the treatment of night blindness of dietary
origin
is of value in patients with paraesthesiae, nervousness, loss of
memory, depression, anorexia and atony of intestinal muscles
as well as neuritis (Journ. Amer. Med. Assoc, November  1,
1941, p. 1493).
Vitamin C — 's n°t only a factor in the normal development of bones, cartilages, teeth and gums but is also necessary for the rapid
and efficient healing of fractures and wounds (Journ. Amer.
Med. Assoc, February 22, 1941, pp. 663 and 669).
is essential for the prevention of rickets and for the normal
development of bones and teeth.
Vitamin   D
Children readily take Multivite pellets which provide the necessary vitamins for the normal functioning of the body for aiding
growth; they may help also to maintain appetite.
One or two pellets provide a considerable proportion of the daily
requirement of these four vitamins, and thus are a suitabTe dose
for the prevention of deficiencies. Two to four pellets' daily are
sufficient to correct many of the minor deficiencies commonly
encountered.
Stocks of Multivite are held by leading druggists throughout the Dominion,
and full particulars are obtainable from: "
THE BRITISH DRUG HOUSES (CANADA) LTD.
Toronto Canada
Mlvt/Can/429 VANCOUVER MEDICAL ASSOCIATION
FOUNDED   1898     ::    INCORPORATED  1906
Programme of the Forty-fifth Annual Session
(Winter Session)
GENERAL MEETINGS will be held on the first Tuesday of the month at 8:00 p.m.
CLINICAL MEETINGS will be held on the third Tuesday of the month at 8:00 p.m.
These meetings are to be amalgamated with the clinical staff meetings of the
various hospitals for the coming year.    Place of meeting will appear on the agenda.
General meetings will conform to the following order:
8:00 p.m.—Business as per Agenda.
9:00 p.m.—Paper of the evening.
. 1942
October    6—GENERAL MEETING.
Dr. D. H. Williams: "Historical Drama of Syphilis."
October 20—COMBINED CLINICAL MEETING and CLINICAL STAFF MEETING at VANCOUVER GENERAL HOSPITAL.
The remainder of the programme for the Winter Session will be announced in the
October Bulletin.
mi
a
Brisk, racy GUINNESS STOUT has long
been prescribed as a tonic by leading
doctors in Great Britain. Literally thousands of them, from their own clinical
experience, have vouched for its therapeutic attributes.
Its restorative value during convalescence is famous. In cases of insomnia
Guinness promotes sound, restful sleep,
obviating the depressing after-effects of
most hypnotics, Guinness is a stimulating and appetizing food for older people.
Guinness has been brewed in Dublin
since 1759, and is the largest selling
malt beverage in the world. It is brewed
from only four ingredients, barley malt,
hops, Guinness yeast and spring water.
It is matured over a year in oak vats
and bottle.
S316
HEARTY
recommendation
— as thousands in Britain have testified
Unlike other stouts and porters, Guinness is unfiltered and
unpasteurized, and thus contains all its natural goodness including useful minerals and active yeast, a source of Vitamins B
and G. foreign Extra Guinness is obtainable through all legal
outlets. Write for convenient 3" x 5" file card giving complete
analysis and indications to Representative, A. Guinness, Son &
Co., Limited, $01  5th Avenue, N.Y.C.
AN ANALYSIS OF GUINNESS STOUT 100 cc.
Total solids 5.87 gm.
Ethyl alcohol (7.9% by volume) !      6.25 gm.
Total carbohydrates 3.86 gm.
Reducing sugars as glucose 0.66 gm.
Protein None
Total nitrogen —     0.10 gm.
Ash . \  0.2S gm.
Phosphorus ]  38.50 mg.
Calcium 7.00 mg.
Iron 0.072  mg.
Copper 0.049  mg.
Fuel value 61 cat.
Vitamin Bi :— 6 Int. Units
Vitamin G 33 Sherman Bourquin Units
A. GUINNESS, SON & CO., LIMITED
DUBLIN and LONDON
Page 3 56 M1
n ■
In these days of stress and strain, it is probable that few would have time to read
the long editorials which we in our turn have no time to write. But? we should like to
make a brief comment or two on the contents of this issue.
The open letter from the Chief Medical Officer of the Workmen's Compensation
Board appears this month—and the Bulletin is very glad indeed to be of service to the
Board in this regard. We suggest very careful reading of this by medical men. The
points brought out are all of importance: the! letter is concise and to the point, and we
shall be helping ourselves as well as the Board by attention to this letter.
Under Correspondence we publish a very welcome letter from our old friend Major
Roy Huggard. It is, we think, as good a tonic as he ever prescribed in his life, bless
him. Cheery and optimistic, it makes us feel that if he and the men; with him, in the
middle of the thick of it, can talk that way, and act that way, there can be nothing
very much wrong. You will remember the cartoon of the two French soldiers in a heavy
barrage, one saying to the other "Pourvu que les civils tiennent." We need have no
doubt or fear of the morale of our men at the front, of all services—we can only do
our level best to back them up here.
We hope to print another letter from Dr. Norman Kemp "Somewhere in England,"
in our next issue.
5^ -if 5$> *?
Finally, we would issue the last call to everyone to roll up to the Vancouver Summer
School beginning Sept. 18 th. The programme is excellent, and it is being held in the
Hotel Vancouver. It is very hard this year to take much time out, but we believe it
will be time very well spent.
CORRESPONDENCE
July 31, 1942.
Dear Jack:
Your welcome letter arrived some time ago and it would be superfluous to add, it
was most welcome.
I should like to thank the Bulletin through you for their kindness; and generosity
in forwarding the publication each month. It is most acceptable and such literature is
greatly appreciated.
The group from B. C. duly arrived and needless to say one was most happy to see
them. They are of good spirit and enthusiastic, and I am certain will make a valuable
contribution to the cause here. I might say that seeing them made one feel most "at
home."
The budget we have read of here saddles all Canadians with a very great burden.
However, I am certain all will accept it with tolerable co-operation under the circumstances. We are also quite aware of the developing rationing policy as well as the necessary curtailment in divers other matters of internal economy. While a few perchance
will suffer some difficulties, I am sure most will soon adapt themselves to the new standards of living.    If one could adequately describe the conditions that have been related,
Page 357
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in the European countries under Nazidom, I am certain we should all feel our restrictions were as nothing. We may all rest assured that in due course, as victory comes,
we shall have those happier days to anticipate.
We are also aware of the most efficient manner in which you of Vancouver and Victoria, B.C., have become organized should the worst ensue. If air attack should come, I
have the utmost confidence that you wilt give a good account of yourselves.
At this time we anxiously cast our eyes to the Black Sea region. There can be no
denying that anxious days are ahead. The might of German forces is being applied in
all its fury and might I say, most efficiently. However, to miss by a hair is as good as
a thousand miles. This southern operation suggests encircling movement of the Middle
East. There are nevertheless many factors in our favor. I am most confident that our
fortunes in Egypt are sound. I believe that shortly, perhaps before you read this, the
German operation in Southern Russia will have been halted. Should this be sustained,
and there is every reason to feel it will be, our enemies will not be in an enviable position.
Staggering losses of men and equipment with little dividend; the winter to face in conjunction with the formidable growth of Anglo-American forces. It reminds one of a
picnic party starting out for somewhere, getting on a fast train, having forgotten their
tickets, being put off and forgetting their lunch. Hence I feel there is every good
reason to face the future with courage and confidence.
I somjetimes feel that occasionally our patience is frayed and we feel our leaders
could do more. It is a sobering thought to realize that our leaders in their efforts can
only do up to that degree which represents the total of our individual works. One feels
without hesitation, that great accomplishments have been carried through and greater
ones are to come. There is no slackening here and I believe that the records of the
Royal Navy and Royal Air Force are a fitting indication of that statement, not to mention Egypt.
Might I say in all sober reflection that I bejie^ve beyond all doubt that sooner or
later, perhaps sooner, good news will be forthcoming.
The several B. C. Medical Officers seen upon occasion all appear well and getting on
with the job.
Those who know England know what Summer is here and for obvious reasons I
can elaborate no further.
Nightly and daily, the great birds of the air are heard and seen as they pass overhead
to deal Jerry a hand. The Lords of the Air are making it hot for Hans and Gretchen and
we can anticipate it is going to be much hotter. The degree of attack is now much
greater than anything; that has yet been delivered against this kingdom. These things,
of course you read of from day to day in your local press.
For awhile cheerio—greetings to all—chins up and put on a smile—all is well—
Victory is sure.
As ever,
Roy.
L. H. A. R. Huggard, Major, R.C.A.M.C.,
Group H.Q., C.R.U.,
Canadian Army Overseas.
Page 358 NEWS    AND    NOTES
net.
■K_W
Dr. and Mrs. R. H. B. Reed of Vancouver are receiving congratulations on the birth
on August 14th of a son.
When Major L. G. Wood, R.C.A.M.C, now stationed at Debert, last visited the
coast, he returned accompanied by his wife and children.
We are glad to learn from newspaper reports that Dr. Jack A. G. Reid, who served
with the R.C.A.M.C. as Medical Officer with the troops in Hongkong, is safe. He will
be remembered as an interne at the General Hospital, later associated with Dr. Lyall
Hodgins.
The best wishes of the profession go to Dr. C. E. Davies on the occasion of his marriage to Miss Beth M. Wright.
Dr. E. Lewison, until recently practising at Zeballos, has been relieving Dr. L. Giovando at Nanaimo while the latter has been away.
Dr. and Mrs. W. F. Drysdale of Nanaimo have been on a short holiday.
Dr. M. R. Basted of Trail had a well-earned holiday at his summer home aC Syringa
Creek.
Dr. and Mrs. E. S. Hoare of Trail and their daughter Francis spent a vacation at
Calgary.
«*
«!'■
Dr. F. M. Auld of Nelson, Dr. J. S. Daly of Trail and Dr. Arnold Francis of New
Denver travelled to Vancouver to attend the last meeting of the Board of Directors of
the British Columbia Medical Association.
M«l
Dr. M. E. Krause of Trail has been on vacation.
Dr. L. B. Wrinch of Rossland spent his vacation at the coast, and called at the office.
Dr. D. M. Black of Kelowna visited the coast and dropped in at the office.
Dr. G. R. Barrett of Nelson and Mrs. Barrett spent a vacation at the coast.
Barrett visited the office.
Dr.
Dr. L. F. Brogden of Penticton visited the coast.
Dr. H. McGregor of Penticton and Dr. H. L. Burris of Kamloops travelled to Vancouver to attend the meeting of the Board of Directors of the Provincial Association.
Page 3 59 I   r
1 .1
g;>i
Capt. W. R. Walker, formerly of Penticton, now with the R.C.A.M.C. stationed at
Vernon, visited his home in Penticton.
Capt. W. H. White, R.C.A.M.C, visited Penticton recently.
We are relieved to learn that Dr. R. B. White, who has been ill, has made a rapid
recovery.
Dr. and Mrs. Frank Turnbull of Vancouver spent a short holiday at Kelowna.
Dr. and Mrs. H. J. Alexander of Vernon are visiting in Eastern Canada.
Congratulations to Dr. and Mrs. J. M. Hershey of Kelowna on the birth of a daughter.
Dr. H. H. Milburn left by plane to attend the meeting of the Medical Council of
Canada in Ottawa on September 2nd. Dr. P. A. McLennan of Vancouver and Dr.
Thomas McPherson of Victoria also attended the annual meeting of the Medical Council
of Canada.
BRITISH COLUMBIA MEDICAL ASSOCIATION
Canadian Medical Association, British Columbia Division
By courtesy of the Summer School Committee a LUNCHEON will be held
by the British Columbia Division, at which DR. A. E. ARCHER, President of
the Canadian Medical Association, will be the guest speaker.
The Luncheon will be held on the ficstXday of the SUMMER SCHOOL,
TUESDAY, SEPTEMBER  15th, at  12$0 noon in the MAYFAIR ROOM,
MAIN FLOOR, HOTEL VANCOUVER^
All doctors welcome.   Luncheon tickets $1.00.
Please notify office: 203 Medical-Dental Building.
Drs. G. F. Amyot, F. M. Bryant, P. A. C Cousland, Thomas McPherson of Victoria,
A. H. Meneely of Nanaimo, R. W. Garner of Port Alberni, Ewart Henderson of Chilliwack, G. S. Purvis of New Westminster, W. G. Saunders of North Vancouver, were
all in attendance at the meeting of the Board of Directors on August 19th.
Dr. E. W. Boak, President of the Victoria Medical Society, visited Vancouver and
attended a meeting of the Advisory Committee of the B. C. Security Commission.
wil
Dr.  U. P.  Byrne,  formerly on the  staff  at  Essondale,  is  now  serving with  the
R.CA.M.C
Capt. C C Covernton, who proceeded overseas as Medical Officer with the Artillery,
has arrived in Great Britain.
Capt. J. Ross Davidson is now stationed in Victoria, serving with the R.C.A.M.C.
It is our information that Dr. J. W. Arbuckle, Jr., is serving with the rank of
Surgeon-Lieutenant with the Naval Medical Services.
Page 360 LIBRARY NOTES
RECENT ACCESSIONS TO LIBRARY:
The Medical Annual, 1942.
Vaginal Hysterectomy, 1942, by James W. Kennedy and Archibald D. Campbell—
Gift of F. A. Davis Company.
Medical Clinics of North America, Symposium on Industrial Medicine, July, 1942.
Renewal sheets for Nelson's Loose Leaf Medicine have been received, and members
will be interested to learn that a complete new article by Dr. Perrin FL Long is included,
the title being "The Clinical Use of Sulphonamide Compounds."
Another new article is "Hypertensive Heart Disease" by Dr. Thomas J. Dry of the
Mayo Clinic. There is also a review of this subject by Doctors Harry Goldblatt, Harvey
A. Lewis and Joseph R. Kahn, entitled "The Pathogenesis and Treatment of Hypertension: Experimental Observations."
There is a new chapter by Robert W. Clarke on "Diseases Due to Variations in
Atmospheric Pressure."
The Oxford Loose Leaf Medicine has also issued revisions of several chapters as well
as the two following new articles:
"Sujbacute Bacterial Endocarditis" by Dr. Emanuel Libman and Dr. Charles K.
Friedberg, and
"Gastroscopy" by Dr. Edward B. Benedict.
Two articles which have been completely revised are:
"Climate in Relation to Health and Disease," by Dr. Clarence A. Mills, and "Physical
Medicine," by Dr. Frank H. Krusen.
STATE JOURNALS
A sample index of the New York State Journal of Medicine has been chosen for this
month. It is published semi-monthly, and following is the Table of Contents for the
August 15th, 1942, issue:
Scientific Articles'.
Protective Methods for the Prevention of Industrial Dermatoses, Louis Schwartz,
M.D.
Skin Irritants, Earl D. Osborne, M.D., and Joseph J. Hallett, M.D.
Sensitization, Rudolf L. Baer, M.D.
' Commercially Available Newer Endocrine Products, William A. Schonfeld, M.D.
Abscess of Brain—Medical Diagnostic Aspects, Gilbert M. Beck, M.D., and Irving
Hyman, M.D.
Psychopathologic Reactions and Electric-Shock Therapy, Bernard C Glueck, Jr.,
M.D.
Employment of Diabetics, Herman O. Mosenthal, M.D.
Stuttering: A Psychosomatic Disorder, James S. Greene, M.D.
Water Balance, L. Corsan Reid, M.D.
The Yellow Fever Epidemic in New York City, 1795-1805, Louis Faugeres Bishop,
Jr., M.D., and Ruth V. Bennett.
Diagnosis (Fourth Medical Division of Bellevue Hospital).
Special Article:
Report of "Medical and Surgical Care Inc.," Frederick Munger Miller, Jr., M.D.
Case Reports:
Hydatid Cyst of Pelvis with Intracapsular Haemorrhage and Anaphylactic Shock
with Recovery, Vincent D. Leone, M.D.
An Unusual Case of Pulmonary Embolism, Foster Hampton, M.D., and Floyd S.
Winslow, M.D.
Eventration of  the Right Diaphragm,  O. S.  Whitmore, M.D.,  and S.  C  Kahl-
strom, M.D.
Page 361 -"
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Vancouver Medical Association
SUMMER SCHOOL, 1942
Hotel Vancouver
September 15th to 18th Inclusive
SPEAKERS:
Dr. Walter C. Alvarez, Professor of Medicine, The Mayo Clinic, Rochester, Minn.
Dr. W. Fulton Gillespie, Professor of Surgery, University of Alberta, Edmontn, Alta..
Dr. John W. Scott, Assistant Professor of Clinical Medicine, University of Alberta,
Edmonton, Alta.
Dr. Edwin G. Bannick, Seattle, Wash.
Dr. Donald H. Williams,   Vancouver, B. C.
|    PROGILAJvIME:
Tuesday, September 15 th—
-Registration and Film: "Regional Anaesthesia."
-Dr. Alvarez: "Hints in the Diagnosis of Indigestion."
-Dr. Gillespie: "Treatment of Varicose Veins and Ulcers."
-LUNCHEON—Guest Speaker:  Dr.  A. E.  Archer, President, Canadian
Medical Association.
-Films: "Eclampsia" and "Radium Treatment of Carcinoma of Cervix."
-Dr. Bannick: "Pneumonia and Virus (Influenzal) Pneumonitis."
-Dr. Scott: "The Haemorrhagic Blood Diseases."
Wednesday, September 16th—
-Dr. Bannick: "Present Status of Sulphonamide Compounds."
-Dr. Gillespie: "Modern Principles in Wound Treatment."
-Dr. Alvarez: "Puzzling Types of Abdominal Pain."
-Film: "Vitamin Deficiency Diseases"  (colour).
-Medical Clinic—Vancouver General Hospital.
Round Table Discussion on Gastro-Duodenal Lesions.
Chairman: Dr. W. L. Graham.
9:00 a.m-
10:00 a.m-
11:00 a.m.-
12:30 p.m-
2:00 p.m.-
8:00 p.m.-
9:00 p.m.-
9:00 a.m.-
10:00 a.m.-
11:00 a.m.-
12:00 noon-
2:30 p.m-
8:00 p.m. \
9:00 p.m.]
9:00 a.m.-
10:00 a.m-
11:00 a.m-
Afternoon \
2» Evening \
Thursday, September 17th—
-Dr. Gillespie: "Diagnosis and Treatment of Intestinal Obstruction."
-Dr. Scott: "The Diagnosis and Treatment of Chronic Arthritis."
-Dr. Alvarez: "What is the Matter with the Patient who is Always Sickly?"
GOLF TOURNAMENT and DINNER.—CapUano Golf & Country Club.
The Golf Tournament will be held jointly with the Annual Tournament of
the Vancouver Doctors.
9:00
10:00
11:00
2:00
2:30
8:00
9:00
Friday, September 18 th—
m.—Film: "Sulphonamide Therapy."
m.—Dr. Scott: "The Iron Deficiency Anaemias."
m.—Dr. Gillespie: "The Surgery of Empyema Thoracis."
,m.—Film: "Cardiac Oedema."
m.—Surgical Clinic—St. Paul's Hospital,
.m.—Dr. Alvarez: "The Handling of the Nervous Patient."
m.—Dr. Williams: "Common Skin Lesions of the Trunk—Their Diagnosis and
Treatment."
Page 362 • I
~m
Vancouver Hotel,
where Summer School,
Vancouver Medical
Association, will be held
September 15-18 inclusive.
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SUMMER SCHOOL DATE
The Surnmer School was postponed to September this year so as not to conflict with
the Annual Meetings of the Canadian Medical Association and the British Columbia
Medical Association, which were held at Jasper in June.
CHANGES IN PROGRAMME
Although there have been numerous alterations in the programme, necessitated by
prior claims of National Service, the Q>mmittee is confident nevertheless that the programme outlined above will be of interest to the medical profession and that it will
receive their usual enthusiastic support.
It is regretted that Lt. Colonel Warner, whose name appeared on the original announcement as one of the speakers, has found it impossible to be present. Dr. Simeon
Cantril has also had to cancel his engagement to speak at the .Summer School because of
a National assignment forj the duration, and Dr. Trueblood, who had promised to take
his place on the programme, has since entered the United States Army.
We are very fortunate in having obtained Dr. Edwin G. Bannick of Seattle to
address the Summer School. The subjects of his two lectures appear in the preceding
schedule.
FEE—CORRECTION
We wish to direct attention to the fact that the fee has been maintained at $5.00
this year, in place of $6.00 as previously announced.
GUEST SPEAKER AT LUNCHEON
The Committee is happy to announce that Dr. A. E. Archer, President of the Canadian Medical Association, will be Guest Speaker at the luncheon to be held on the first
day of the Summer School. This luncheon is being held under the auspices of the British
Columbia Division of the Canadian Medical Association.
Page 363 m
:W
ROUND TABLE DISCUSSION
A Round Table Discussion will be held on Wednesday evening, September 16 th.
The subject chosen this year is "Gastro-Duodenal Lesions." The Chairman is Dr. W. L.
Graham, who will welcome any questions the members wish to put before the meeting.
GOLF
This year we are holding the Summer School Golf Tournament with the Annual
Tournament of the Vancouver Doctors at Capilano Golf & Country Club. A feature
of the latter tournament is the Rams Horn Golf Trophy, presented by Dr. Daniel
McLellan, for the Aggregate Low Net Score of any two out of three scheduled games
each year. Members of the College of Physicians and Surgeons resident on the Main-
land^crf British Columbia, south of Powell River and west of Hope, both towns included,
are eligible to compete. Other prizes will be open for competition to all who attend the
Summer School.    A dinner will conclude the tournaments.
FILMS
A number of interesting motion picture films will be presented during the Sessions.
Their titles are given below:
1. Radium Treatment of Carcinoma of Cervix.—Dr. Max Cutler, Michael Reese
Hospital, Chicago.
2. Eclampsia.—Dr. DeLee.
3. Regional Anaesthesia.
4. Cardiac Oedema.
5. Vitamin Deficiency Diseases (Colour).
6. Sulphonamide Therapy.
The time of presentation of these films will be posted at the Information Desk of the
Summer School.
TELEPHONE SERVICE
Private telephone service to the Summer School suite in the Hotel will be available
as usual .
MEDICAL MEN ON ACTIVE SERVICE
The Committee wishes to extend to all members of the medical profession on active
service a cordial invitation to attend the Summer School Session. Complimentary tickets
will be issued on registration.
BOOK REVIEW
VAGINAL HYSTERECTOMY, James William Kennedy, Surgeon-in-Chief to the
Joseph Price Hospital, Philadelphia, and Archibald Donald Campbell, Assistant Professor of Obstetrics and Gynaecology, McGill University, Montreal. 495 pp. illus.
F. A. Davis Company, Philadelphia, 1942.
This new* monograph has been written in an effort to renew the interest of the profession in a valuable gynaecological procedure. It also fulfills many requests received by
the authors for a detailed and illustrated description of vaginal hysterectomy as practiced
by them. Both authors have had a wide experience with the operation, and two distinct
techniques are well illustrated. J. W. Kennedy describes vaginal hysterectomy by the
clamp method, as performed at the Joseph Price Hospital, and A. D. Campbell discusses
the operation by the suture method. It would appear that most of the chapters in the
volume have been written independently by one or other of the authors.
The book commences with an interesting history of vaginal hysterectomy, with
special mention of the late Dr. Joseph Price of Philadelphia, who undoubtedly did more
to popularize the operation than anyone on this continent. Dr. Kennedy, as his successor, makes a strong appeal for the broadening of the field of indications, based upon
his experience.   Emphasis is placed upon the low mortality and excellent post-operative
Page 364 results which have been obtained. Since vaginal hysterectomy is a total hysterectomy,
its results should be compared with abdominal pan-hystectomy as regards mortality and
morbidity. Attention is called to the fact that in the obese patient, or one who is a
poor surgical risk, the vaginal route of approach for hysterectomy is much superior
because of its shorter operation time, and freedom from shock. The authors also emphasize the fact that a wider adoption of! vaginal hysterectomy would prove a real advance
in the prophylaxis of malignancy of the uterus.
Among the various pathological condition^ of the uterus, which are listed as indications for the operation are fibroid tumours, chronic cervicitis ("the abused cervix")
procidentia, menopausal uterine haemorrhage, fibrosis uteri, hyperplasia of the endometrium, and malignancy. The indications, in general, are much broader than one finds in
the average textbook of gynaecology, but a strong argument is presented to substantiate
this apparent radicalism, provided of course that the operator is f amiliar with the technique of vaginal hysterectomy. Attention is also properly called to the ease with which
vaginal plastic work such as the repair of a cystocele or rectocele may be combined with
removal of the uterus through the vagina.
Dr. Campbell discusses the important points in the anatomy of the uterus and pelvic
floor necessary for a proper understanding of the operation. For this he is very well
qualified, and his description of the anatomical features, while brief, is clear and practical. He also adds an interesting and original section on the pre-operative care of
vaginal hysterectomy patients, especially those with prolapsus uteri. Stress is laid on
the need for an adequate pre-operative study of the general condition of the patient,
particularly as regards investigation of the urinary tract and carbohydrate metabolism.
We feel that these principles might well be applied to gynaecological patients in general
who are about to undergo operation.
This monograph should prove of real value to all who do pelvic surgery, and will
undoubtedly renew interest in a valuable operation, which is probably not as popular
as it should be.
A. E. T.
FIVE THOUSAND GLASS EYES
Came From Unique English Factory Last Year
German prisoners are among the thousands who have been given glass eyes by a
unique Government factory in the north of England.
It issued 5,000 eyes last year, and close upon 600 of them went to civilians who had
lost an eye in the air raids. The factory supplies the Navy, the Army and the R.A.F.;
the Allied Forces including the Poles, the Fighting French, the Norwegians and the
Czechs; the A.T.S., the W.A.A.F.'s and other Women's Services. They have even sent
eyes out to the troops in the Middle East.
The factory was working in a small way in peace time for men who had lost an eye
in the last war.   They used to get their glass from Germany.   It is made in Britain today.
The glass comes to the factory in long tubes and rods. A glass tube is heated over
a gas burner; the worker blows througH it and makes a bulb in the middle; one end is
snapped off, and work on the eye begins.
The bulb is again heated as are rods of coloured glass which are pressed upon the bulb
to form the pupil and iris. Crystal glass is worked in for the cornea and little red veins
are marked out with tiny strands of red glass.
It is often a difficult job to match up the colouring for there is no standardisation.
Each eye depends upon the patient himself.
Glass eyes are coming in for renewal at the rate of 250 a week.
Page 365 i
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British  Columbia  Medical  Association
(Canadian Medical Association, British Columbia Division)
President, ■. Dr. A. H Spohn, Vancouver
First Vice-President Dr. PA. C Cousland, Victoria
Second Vice-President Dr. H. McGregor, Penticton
Honorary Secretary-Treasurer Dr. G. O. Matthews, Vancouver
Immediate Past President Dr. C. H. Hankinson, Prince Rupert
Executive Secretary Dr. M. w". Thomas, Vancouver
MEETING OF BOARD OF DIRECTORS
The Board of Directors of the British Columbia Medical Association met on August
8 th, following dinner in the York Room, Hotel Georgia.
Those present included: Drs. A. H. Spohn, President; A„ M. Agnew, G. F. Amyot,
Victoria, F. M. Auld, Nelson, Murray Blair, F. M. Bryant, Victoria, FL L. Burris, Kamloops, D. F. Busteed, D. E. H. Cleveland, P. A. C. Cousland, Victoria, J. S. Daly, Trail,
H. A. Desbrisay, Arnold Francis, New Denver, R. W. Garner, Port Alberni, W. Ewart
Henderson, Chilliwack, T. H. Lennie, H. McGregor, Penticton, A. Y. McNair, Thomas
McPherson, Victoria, H. H. Milburn, A. H. Meneely, Nanaimo, K. D. Panton, G. S.
Purvis, New Westminster, W. G. Saunders, North Vancouver, Ethlyn Trapp, C. H.
Vrooman, D. H. Williams, G. O. Matthews, Honorary Secretary-Treasurer, and M. W.
Thomas, Executive Secretary.
The Executive Committee was appointed as follows: Dr. A. H. Spohn, Chairman;
Dr. G. O. Matthews, Honorary Secretary-Treasurer; Drs. Murray Blair, A. Y. McNair,
H. H. Milburn, G. S. Purvis, G. S. Strong, and M. W. Thomas, Executive Secretary.
The following Chairmen of Committees were appointed:
Constitution and By-laws . ! Dr. D. F. Busteed
Programme and Finance Dr. A. Y. McNair
Legislation Dr. Thomas McPherson
Medical Education Dr. K. D. Panton
Archives -Dr. D. E. H. Cleveland
Maternal Welfare Dr. J. W. Arbuckle
Public Health : Dr. D. H. Williams
Ethics and Credentials Dr. P. L. Straith
Economics I J>r. G. F. Strong
Pharmacy Dr. C. H. Vrooman
Hospital Service Dr. .R. A. Seymour
Cancer f Dr. Ethlyn Trapp
Nutrition | Dr. H. A. DesBrisay
Membership * Dr. A. M. Agnew
Industrial Medicine Dr. A. W. Bagnall
Divisional Advisory Dr. Murray Blair
Editorial Board Dr. J. H. MacDermot
A Provinciaf Conimittee on Emergent Epidemic Diseases has been formed under the
Chairmanship of Dr. G. O. Matthews, who will be a member of the National Conimittee
under the aegis of the Canadian Medical Association.   Representatives from various organizations have been appointed as follows:—
Department of Pensions and National Health—Dr. F. C. Bell.
B. C. Hospitals Association—Dr. R. A. Seymour.
Registered Nurses Association of B. C.—Miss Heather Kilpatrick.
Canadian Red Cross Society—Dr. G. A. Lamont.
St. John Ambulance Association—Dr. Isabel Day.
Page 366 Provincial Health Department—Dr. C. E. Dolman, Dr. J. M. Hershey, Dr. J. S. Kitching.
Indian Affairs Branch—Dr. A. L. McQuarrie.
Dr. Murray Blair, representative from British Columbia on the Executive of the
Canadian Medical Association, reported to the Board of Directors on the highlights of
the work done by that body.
Committee on Industrial Medicine
The Committee on Industrial Medicine, of which Dr. A. W. Bagnall is Chairman,
other members being: Drs. D. F. Busteed, D. E. H. Cleveland, G. A. Davidson, R. H.
Fraser, G. L. Hodgins, A. Lowrie, S. C. MacEwen, J. A. MacLean, A. M. Menzies, H. H.
Milburn, D. J. Millar, S. S. Murray, W. G. Saunders, C. H. Vrooman, A. H Spohn and
M. W. Thomas, has been very active and is studying ways and means of assisting in the
introduction and maintenance of Industrial Medical Services to wartime industry.
A Sub-Committee on Literature has been appointed consisting of: Dr. H. H. Mil-
burn, Chairman; Drs. D. F. Busteed, A. M. Menzies, G. A. Davidson, J. A. MacLean,
D. E. H. Cleveland, A. W. Bagnall, A. H. Spohn.   The study of the subject of Industrial Medicine has been divided into th efollowing groups:
1   Public Health Aspect of Industrial Medicine.
3.   Dermatoses in Industry.
Occupational Diseases.
Ophthalmic Phase of Industrial Medicine.
Industrial Surgery, including Burns, First Aid Supervision and Protective Measures.
Psychiatry in Industry.
Child Labour in Industry.
Organization, to include Inter-relationship of Medical Personnel and Management
and Employees—Records—Examinations—Pre-employment—Routine—Special.
■
2.
4.
5.
6.
7.
8.
BOARD OF DIRECTORS—1942-1943
President and Chairman Dr. A. H. Spohn, Vancouver
First Vice-President Dr. P. A. C Cousland, Victoria
Second Vice-President Dr. H. McGregor, Penticton
Honorary Secretary-Treasurer Dr. G. O. Matthews, Vancouver
Immediate Past President Dr. C H. Hankinson, Prince Rupert
Representatives from Council: Dr. F. M. Auld, Nelson; Dr. H. H. Milburn, Vancouver
Directors at Large   (Elected at Annual Meeting)—Dr.  G. F. Amyot, Victoria; Dr.
Murray Blair, Vancouver; Dr. J. Stuart Daly, Trail; Dr. W. Ewart Henderson,
Chilliwack; Dr. A. H. Meneely, Nanaimo.
Representatives from District Associations:
Vancouver Medical _ Dr. Colin McDiarmid, Vancouver
Victoria MedicaL Dr. F. M. Bryant, Victoria
Fraser Valley Dr. G. S. Purvis, New Westminster
Upper Island Dr. R. W. Garner, Port Alberni
West Kootenay- Dr. N. E. Morrison, Nelson
East Kootenay Dr. W. O. Green, Cranbrook
District No. 4 Dr. H. L. Burris, Kamloops
North Shore Dr. C M. Onhauser, West Vancouver
Central Interior Dr. E. J. Lyon, Prince George
Prince Rupert -Dr. L. W. Kergin, Prince Rupert
Chairmen of Committees:
Constitution and By-laws Dr. D. F. Busteed, Vancouver
Programme and Finance Dr. A. Y. McNair, Vancouver
Legislation Dr. Thomas McPherson, Victoria
Medical Education § E -Dr. K. D. Panton, Vancouver
Archives J^r- D. E. H. Cleveland, Vancouver
Maternal Welfare Dr. J. W. Arbuckle, Vancouver
Page 367
:"«'
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Pubhc Health Dr. D. H. Williams,
Ethics and Credentials JDr. P. L. Straith,
Economics Dr. G. F. Strong,
Pharmacy _Z Dr. C. H. Vrooman,
Hospital Service Dr. R. A. Seymour,
Cancer Dr. Ethlyn Trapp,
Editorial Board . Dr. J. H. MacDermot,
Nutrition Dr. H. A. DesBrisay,
Membership Dr. A. M. Agnew,
Industrial Medicine Dr. A. W. Bagnall,
Divisional Advisory Dr. Murray Blair,
Emergent Epidemics— _Dr. G. O. Matthews,
Representative from the Board of Management of the
British Columbia Cancer Instituted Dr. T. H. Lennie,
Executive Secretary __-_' I Dr. M. W. Thomas,
Vancouver
Courtenay
Vancouver
Vancouver
Vancouver
Vancouver
Vancouver
Vancouver
Vancouver
Vancouver
Vancouver
Vancouver
Vancouver
Vancouver
WEST KOOTENAY MEDICAL ASSOCIATION
ANNUAL MEETING
The West Kootenay Medical Association held its Annual Meeting in New Denver,
where the President, Dr. Arnold Francis, resides.
Dr. Francis had gone "all out" to make a success of the meeting and assure a pleasant
visit for the members. He had enlisted the support of the Board of Trade, who had done
everything to put New Denver on the map as a convention city.
The] Legion Hall provided an excellent room for the lectures, which were given by
four speakers from Spokane, Washington: Dr. J. W. Lynch—"Ruptured Nucleus Poly-
posus," Dr. J. W. Mounsey—"Common Anal-Rectal Pathology," Dr. D. A. Palmer—
"Peptic Ulcer," Dr. R. D. Reekie—"The Water Balance in Pregnancy."
The group then joined the ladies in the gardens at the home of Dr. and Mrs. Francis
before dinner. The ladies had dinner with Mrs. Francis, and the men's dinner was held
at the Newmarket Hotel.
The members attending were: Dr. Francis presiding, Drs. M. R. Basted, W. A.
Coghlin, J. S. Daly, W. J. Endicott, W. Leonard, F. L. Wilson of Trail; Drs. F. M. Auld,
G. R. Barrett, R. B. Brummitt, W. Laishley, N. E. Morrison of Nelson; H F. Tyerman
of Nakusp. Dr. W. O. Green, President of the East Kootenay Medical Association, was
visiting. Other members included the four speakers, and Dr. M. W. Thomas, Executive
Secretary of the College of Physicians and Surgeons.
Dr. Arnold Francis was an able toastmaster and overlooked none of the amenities.
Drs. Lynch, Mounsey, Palmer and Reekie of Spokane spoke briefly and were cordially
thanked by the President for their excellent contribution to the success of the meeting.
This was recorded in the minutes by a vote of thanks. Dr. Green of Cranbrook brought
greetings from the East Kootenay and expressed himself as much impressed by the whole
atmosphere of this gathering of his West Kootenay colleagues.
The election of officers resulted as follows: Dr. W. A. Coghlin of Trail, Honorary
President; Dr. N. E. Morrison of Nelson, President; Dr. G. R. Barrett of Nelson, Vice-
President; Dr. W. Laishley of Nelson, Honorary Secretary-Treasurer.
Dr. N. E. Morrison, as President, will represent the West Kootenay Medical Association on the Board of Directors of the British Columbia Medical Association.
Dr. Francis introduced Dr. M. W. Thomas to the meeting. In opening the discussion on the many matters which affected the profession at this time, he referred to the
contribution which had been made by the Kootenays to the cause of Medicine in British
Columbia. Dr. J. Bain Thom, Councillor from No. 5 District, had passed away since the
last meeting in West Kootenay. Dr. Thomas paid a well-deserved tribute to the work
of Dr. Thom. Not only Trail, but the Kootenays and the whole of British Columbia,
had lost a valued councillor and friend.
Page 368 College of Physicians and Surgeons
President Dr. W. A. Clarke, New 'Westminster
Vice-President  Dr. F. M. Bryant, Victoria
Treasurer Dr. H. H. Milburn, Vancouver
Members of Council—Dr. F. M. Auld, Nelson (District No. 5); Dr. F. M. Bryant, Victoria
(District No. 1); Dr. W*. A. Clarke, New Westminster (District No. 2); Dr. Thomas
McPberson, Victoria (District No. 1); Dr. H. H. Milburn, Vancouver (District No. 3);
Dr. Osborne Morris, Vernon (District No. 4); Dr. Wallace Wilson, Vancouver (District
No. 3).
Registrar Dr. A. J. McLachlan, Vancouver
Executive Secretary Dr. M. W. Thomas, Vancouver
TAXATION RATES ON 1942 INCOME
These taxes must not reduce the income of a Single Person below $660.00 or a married person below $1200.00.
NORMAL TAX
Single Class, if income not over $1800.00, rate is 7%.
If income over $1800.00 and not over $3,000.00, rate is 8%.
3,000.00    I    "  9%.
Married Class 7%.
Note: Single Class Rates apply to both if wife's income, other than from being employed, exceeds $660.00.
DEPENDENTS
A taxpayer may deduct from normal tax $28.00 for each dependent allowable under
the Act. Children allowed if dependent and under 18, or if over 18 but under 21
years of age attending School or University, also dependent children over 21 physically
incapacitated. ||||
*«
GRADUATED TAX
Single or married, deduct from income the basic exemption of $660.00, and compute
tax on the balance as follows:
On first $500.00, or any portion thereof, 30%, or
$     150.00 on first      $   500. and 33% on next      $ 500. or portion thereof, or
315.00 "
CC
1,000.
|    37%   I
1,000. "
685.00 "
cc
2,000.
"   41%0   "
1,500. "
1,300.00 "
cc
3,500.
"   45%   I
1,500. "
1,975.00 |
cc
5,000.
I    50%   1
3,000. "
3,475.00 "
cc
8,000.
"    55%   "
5,000. "
6,225.00 "
cc
13,000.
"    60%   c
7,000. "
10,425.00 "
cc
20,000.
"    65%   '
j      10,000. "
16,925.00 "
cc
30,000.
"   70%   '
*     20,000. "
30,925.00 |
cc
50,000.
"   75%   ;
'     20,000. "
45,925.00 "
cc
70,000.
j    80%   "      •
j     30,000. "
69,925.00 "
cc
100,000.
"    85% or
i ami
)unt in excess
SURTAX on Investment Income, Exemption $1500.00, 4% on balance.
Page 369 DEDUCTIONS FROM GRADUATED TAX
For wife $150.00. No allowance if Husband's Income over $660.00 and wife's
income, other than from being employed, exceeds $660.00. For each dependent child
$80.00. (See note re dependent children above.) For each dependent allowable under
the Act, 20% of the amount contributed, with maximum allowance of $80.00.
SAVINGS PORTION
of tax is the lesser amount of—One-half of Total Tax, or
Single Class    8% of income with maximum $  800.00
Married   "    10% "        | " " 1000.00
plus 1% of income with maximum of $100. for each dependent.
MEDICAL EXPENSES AND CHARITABLE DONATIONS
Are only taken into consideration when you file your Income Tax Return.
/ \
FILING RETURNS
Taxpayers on a salary or wage basis file Income Tax Returns reporting income for
calendar year 1942, on or before SEPTEMBER 30th, 1943.
Taxpayers with salary and investment income—Employer makes deduction from
salary, taxpayer estimates tax payable on investment income and must pay tax on the
investment income by quarterly instalments commencing October 15 th, 1942; if salary
income equals or is in excess of three-yuarters (%) of total income, taxpayer files Income
Tax Return on or before SEPTEMBER 30 th, 1943, but if investment income exceeds
one-quarter (%) °f total income, taxpayer files Return on APRIL 30th, 1943.
TAXPAYERS WITH INVESTMENT AND PROFESSIONAL INCOME
AND PROPRIETORS AND PARTNERS IN BUSINESS
(Other than Incorporated Companies) must pay tax by quarterly instalments commencing October 15th, 1942, figuring the tax on the 1941 income (or
estimated income for 1942) calculated at 1942 Rates.
m
EMPLOYERS' INCOME TAX TROUBLES
While September is viewed with misgiving by many hundreds of thousands of taxpayers who will have tax deducted from their pay, comparatively few appreciate the
position of the employer who, by law, is compelled to make any deduction due. In
connection with Income Tax deductions by employers, Mr. Norman Lee, Inspector of
Income Tax at Vancouver, wishes to issue a warning to those who may unwittingly not
be prepared to obey the law, and points out that where the employee is paid at a rate'
which calls for deductions, the Act applies to all wages and salaries paid, and that if
there is any doubt, inquiries should be made at his office for further information.
Casual and Seasonal Help, Domestic Employees, Farm Labor, any and all other persons paid wages or Salary must have deductions made if paid at a rate as set out in the
Table of Deductions and each Employer is held liable for the deduction and remittance
of the Tax.
Value of Room and Board and Cost of Living Bonus, where received, must be added
to the amount paid to establish the rate of pay.
Even should the Employer estimate his Employee's Income for the year will be less
than $660.00 single or $1200.00 married this does not permit the Employer to forego
any deduction if the Employee is paid at a rate of pay during the pay roll period that,
in accordance with the Table, calls for a deduction.
The Employer has no option, and the employee at the end of the year has a
right of reclaim from the Government if deductions made exceed any tax due.
Instructions and the Table of Deductions setting definite Rates have been mailed to
the Employers and any Employer paying Salary or Wages at any time must have a copy
Page 370 of this Table and make deductions accordingly. Instruction Brochure and Tables may
be obtained from the Inspector of Income Tax, Winch Building, Vancouver, B. C.
The tables show tax must be deducted from a single person without dependents if
paid at} a rate in excess of $2.15 daily, $13.00 weekly or $56.00 monthly, and in die
case of a married person without dependents if paid at a rate in excess of $3.90 daily,
$23.00 weekly or $100.00 monthly.
The Daily Table must be used when casual labor is paid by the hour or day.
"EJmployer" means any person liable to pay any Salary or Wages, and under the
term "Salary or Wages" is included any remuneration, compensation, hire, perquisite or
similar payment, including Director's Fees, paid for any services or duties performed in
Canada.
Monies deducted must be remitted to the Government "within seven days,
and are held in trust for the Crown, and take precedence over any secured or
unsecured creditors.
The penalties for failure to deduct or remit on time are severe and on conviction the
penalty is only limited to an amount not exceeding ten thousand dollars or to six months
imprisonment or to both such fine and imprisonment.
A special staff of auditors has been engaged and it is intended to check up the
employers' records in all districts of B. C.
MONTHLY DEDUCTIONS
Basis—12 Months per Year
Single
Si-
igle
Married
Married
1
No Dependents
One Dependent
No Dependents
One Dependent
Total
Savings
Total
Savings
Total
Savings
Total
Savings
Income Monthly
Tax
Portion
Tax
Portion
Tax
Portion
Tax
Portion
66.00
66.99
4.93
3.56
.97
.97
67.00
67.99
5.23
3.73
1.00
1.00
68.00
68.99
5.53
3.90
1.03
1.03
69.00
69.99
5.83
4.06
1.06
1.06
70.00
72.49
6.13
4.23
1.09
1.09
72.50
74.99
6.88
4.65
1.16
1.16
75.00
77.49
7.63
5.06
1.24
1.24
77.50
79.99
8.38
5.48
1.39
1.39
80.00
82.40
9.12
5.76
2.13
1.85
82.50
84.99
9.87
5.94
2.88
2.26
85.00
87.49
10.62
6.12
3.63
2.68
87.50
89.99
11.37
6.30
4.38
3.09
90.00
92.49
12.12
6.48
5.13
3.51      1
92.50
94.99
12.87
6.66
5.88
3.93
95.00
97.49
13.62
6.84
6.63
4.34
97.50
99.99
14.39
7.02
7.40
4.77
100.00
102.49
15.21
7.20
8.22
5.22
.60
.60
.60
.60
102.50
104.99
14.66
7.38
7.67
5.67
.58
.58
.58
.58
105.00
107.49
15.44
7.56
8.45
6.12
1.00
1.00
2.11
2.11
107.50
109.99
16.22
7.74
9.23
6.57
3.17
3.17
2.20
2.20
110.00
112.49
17.01
7.92
10.02
7.02
5.33
4.50
2.28
2.28
112.50
114.99
17.79
8.10
10.80
7.47
8.04
5.90
2.3 5
2.35
115.00
117.49
18.57
8.28
11.58
7.92
8.86
6.3 5
2.42
2.42
117.50
119.99
19.36
8.46
12.37
8.37
9.67
6.80
2.68
2.68
120.00
122.49
20.14
8.64
13.15
8.82
10.50
7.25
3.50
3.20
122.50
124.99
20.92
8.82
13.93
9.27
11.31
7.70
4.32
3.65
125.00
127.49
21.71
9.00
14.72
9.72
12.13
8.15
5.13
4.09
127.50
129.99
22.49
9.18..
15.50
10.17
12.94
8.60
5.95
4.55
130.00
132.49
23.27
9.36
16.28
10.53
13.76
9.05
6.77
4.99
132.50
134.99
24.06
9.54
17.07
10.73
14.57
9.50
7.58
5.45
135.00
137.49
24.84
9.72
17.85
10.94
15.40
9.95
8.40
5.90
137.50
139.99
25.62
9.90
18.63
11.14
16.21
10.40
9.22
6.35
140.00
142.49
26.47
10.08
19.48
11.34
17.09
10.88
10.09
6.82
142.50
144.99
27.34
10.26
20.3 5
11.54
17.99
11.37
11.00
7.32
145.00
147.49
28.21
10.44
21.22
11.75
18.90
11.87
11.91
7.81
*».s
Page 371 A. STEWART, Manager
North 70
STEWART SHEET METAL WORKS
115   ESPLANADE  WEST     ::    NORTE  VANCOUVER,  B.  C.
"ANYTHING IN SHEET METAL"
•:.;f:
TO OUR EMPLOYEES:
We are pleased an announce that we have made arrangements with the Travelers
Insurance Company and the Medical Services Association to provide a very complete
plan of insurance protection on a basis which cannot be bought by an individual.
Because we realize that taxes will leav_- little surplus to make provision for the cost
of sickness and feel that every employee should have the benefit of the protection offered
by this plan, the Company will pay a large part of the total cost. Your share of the
cost will be deducted from the payroll.
This plan includes Life Insurance, Accidental Death, loss of sight or limbs, at work
or away from work; a weekly income for disability caused by sickness or caused by
accidents away from work; hospital benefits and doctors' bills. The benefits (fully
described in the following pages) and the monthly cost are as follows:
™
Life
Insurance
Accidental
Death
Loss of sight
or limbs
Daily
Weekly    Hospital
Income     Benefits
$1000
$1000
$15.00
$3.00
Medical
and
Surgical
Care
In home, office,
or hospital
Employee's
Monthly
Contribution
$1.85
M-S-A
The Company, in addition to its monthly contribution, will pay the initial registration fee of $1.50 per employee.
We appreciate the loyalty of our employees, and are glad to be able to express our
appreciation in this practical way. This plan cannot be placed in effect until 75% of
those eligible have completed the attached application cards. We would suggest that
you complete and return the cards to the office promptly.
STEWART SHEET METAL WORKS.
Page 372 THE WORKMEN'S COMPENSATION BOARD
VANCOUVER
Dear Doctor:
Through the courtesy of the Editorial Board we are addressing you through the
columns of the Bulletin. We have found that some of the Doctors have not read
our circular letters and have thereby caused unnecessary inconvenience to themselves and
this Department. Whenever it has become necessary to send out a circular letter we
have endeavored to make it as clear as possible on whatever matters are of importance
to those treating industrial cases.
Owing to the very great increase in the amount of our work, we have had to rearrange our examination routine. The hours of examination at the Board offices are in
the forenoon, with the exception of cases which come from long distances out of town.
These cases will be accommodated, but we would ask that any cases you do refer for
examination should be sent in during the forenoon.
We would call your attention also to the Schedule of Fees, with particular reference
to Section 8 on the front page, and would ask you to delete therefrom the words "Chief
Medical Officer of the Board" and substitute "a Medical Officer of the Board." This
change has been brought about because it is impossible for the Chief Medical Officer to
attend to the taxation of medical fees in all cases that might come for consideration.
May we direct your attention again to the necessity for prompt and complete medical
reports and the avoidance of indefinite terms. We so frequently find such indefinite
terms as "cannot yet say," "don't know," and "impossible to estimate," that it is frequently impossible in many claims where such terms are used to form any clear conception of the probable length of disability. We would ask also that your final reports
(form 11a) be rendered promptly because it has been found that frequently an estimate
is given of a week or ten days on a progress report, to be followed in some weeks: by a
form 11a indicating a much longer period of time. Failure to send in reports promptly
delays payment of compensation to the workman.
In the matter of X-ray films, we again ask that you should see that all films are properly labelled with the workman's name, the date and if possible the workman's claim
number, whenever it becomes necessary to send these films to the Board. This will make
for an easy identification of the workman's file and will insure the prompt return of the
films when we are finished with them. Further, in the event of a workman being transferred to Vancouver for treatment, any X-rays' which you may have taken before he is
sent, should accompany the workman or be forwarded promptly by mail.
In the matter of hospitalization, we would direct your attentionn to the clause in the
Act which only permits us to pay for necessary hospital care. As you are probably
aware, the hospital rates beginning with 1941 were raised thrughout the whole Province,
and in consequence of this raise, we would ask your still closer attention in the discharge
of patients immediately the point has been reached where the necessity for hospital care
is no longer present. In» addition to the increase in hospital rates, the hospitals charge
for emergency department treatment in cases which could equally well be treated in
the doctor's office but are sent to the emergency because the doctor is not readily avail-
ble. This charge is contingent upon the hospital immediately furnishing the Board with
a report of the nature and extent of disability and the treatment given. In such cases
the amount charged by the hospital will be deleted from the Doctor's account.
In workmen who have sustained permanent disabilities there are several factors which
should be borne in mind as follows:
(1) In a workmen who has lost the vision in one eye or had it enucleated, it is
essential that the vision in the remaining eye should always be given.
!-. PaPge 373
, ■'." I
(2) Where amputation has occurred of fingers or toes, we ask that the chart on
the reverse of form 8 or 11a be marked at the exact level of amputation. If no amputation has occurred, but stiffness in the small joints of the fingers or toes has resulted
then the degree of stiffness should be accurately indicated.
We would again direct your attention to a previous request that when the attending doctor wishes to discuss any cases under his medical office, he should telephone the
Medical Department rather than any one particular medical officer. If you will then
give the claim number to the Medical Department the claim will be located and passed
to thej Medical Officer most conversant with the case who will in turn telephone you.
The foregoing applies chiefly to Vancouver surgeons.
It has been a matter of frequent-comment from many doctors that the desired
results from physiotherapy are not being achieved, so that to bring about improvements
the Board is centralizing this treatment \inder the direction of Dr. E. E. Shepley, who
has had considerable experience in this work. Premises at the moment are beong prepared ancjf you will be advised later as to the location and the date of opening the Department.
We appreciate your past co-operation and would ask for its continuance.
Yours truly,
John Ray, Chief Medical Offcer.
m
FLOODLIT WOUNDS
New Surgical Instruments in Desert Battles
New surgical instruments which "floodlight" the interior of the body are being
used by some Army surgeons in the Middle East.   Equipped with a set of these unbreakable luminous instruments, medicos can perform field operations under a tree or a lean-,
to shelter, without worrying about aircraft overhead and with better lighting in the
wound than in an operating theatre.
Made of a transparent plastic material like glass which transmits light round corners,
does not conduct heat and can be thrown on the ground without breaking, these instruments are made in about thirty different shapes, to suit any kind of wound or operation.
Even where there are two right-angled bends in the transparent instrument, the light
rays travel down to the frosted tip and flood the wound with a cold, shadowless light,
however inaccessible the place may be. Blood does not easily congeal on the instrument,
as it does with ordinary lighting apparauts.
About thirty different instruments are available, but there are three or four dual-
purpose models which are quite sufficient for ordinary diagnostic and surgical work in
the field. A set of these, together with a small electric commutator, costs about £12,
and many surgeons in the fighting services have bought them out of their own pockets,
so useful have they proved in action. Some of Britain's greatest surgeons are now using
thesd instruments for wounds which cannot be seen into by ordinary operating theatre
lighting.
Similar instruments have been made in other countries for some years past, but they
had the disadvantage of losing their shape in sterilising. The new instruments however
are made of a methyl methocrylate plastic specially developed by British chemists, which
will stand any amount of boiling without losing shape.
"Curvlite" surgical instruments are patented by Vann Bros. Ltd., London, the "Per-
spex" material being made by Imperial Chemical Industries, Ltd., London.
Page 374 Department of Dietetics
REDUCING DIET
Eileen M. Dunn, B.A., B.Sc.
Breakfast:   Orange—1,  or   Grapefruit—
*/_, or Apple—1, or Prunes—3; or
unsweetened fruit juice—J/_ cup.
Egg—1 poached or cooked in shell.
Dry wholewheat toast—1 thin slice.
Sl-imcmed milk—J4 glass.
Clear tea or coffee—if desired.
11   a.m.—Skimnaed milk—l/z  glass   (see
note 6").
Lunch:   Clear   fat   free   beef,   mutton,
chicken or vegetable broth.
Lean  meat,   chicken  or   whitefish—1
large serving (size of palm of your
hand) from list allowed.
Vegetables—2 or 3 servings, from list
allowed, raw or cooked.
Clear tea or coffee—if desired.
4 p.m.—Skimmed milk—1 glass.
Supper: Soup—as at lunch, if desired.
Lean meat, chicken or whitefish—as at
lunch, or cottage cheese—2/3 cup.
Vegetables—as at lunch.
Unsweetened fruit—raw or cooked, ap-
'  proximately x/z cup, or custard made
with saccharine, or D'Zerta.
Clear tea or coffee—if desired.
Notes:
1. Saccharine may be used instead of
sugar if desired. % grain = 1 teaspoon sugar.
2. Spices, unsweetened pickles, ketchups,
pepper, vinegar, relishes, vanilla, and
mineral oil salad dressings may be used
if desired.
3. Include canned tomatoes, or tomato
juice, or grapefruit or orange daily in
the diet.
4. Four Brewers' Yeast Tablets, plus cod
liver oil, one teaspoon or one capsule,
should be taken daily with the diet.
5. Water as desired.
6. Skimmed milk—J/_ glass may be taken
before retiring instead of at 11 a.m.,
if desired.
Meats and Fish Allowed
(Serve baked, boiled, roasted, broiled or
steamed.) Avoid gravies and sauces.
Lean Beef
Cod
Veal
Halibut
Steak
Shrimp
Chicken
Crab
Liver
Lobster
Lamb
Trout
Fruits
Allowed
(Use raw or cooked without sugar)
Apples
Strawberries
Apricots
Raspberries
Blackberries
Watermelon
Canteloupe
Pears
Casaba melon
Prunes
Oranges
Loganberries
Gooseberries
Cherries
Grapefruit
Red Currants
Grapes
Black Currants
Peaches
Vegetables Allowed
(Use raw, steamed, boiled or baked)
Cucumbers
Mushrooms
Radishes
Unsweetened
Asparagus
pickles
String beans
Sauerkraut
Cabbage
Sorrel
Brussels sprouts
Spinach
Cauliflower
Swiss chard
Celery
Tomatoes
Eggplant
Turnip
Endive
Cress
Kohlrabi
Beets and Greens
Leeks
Carrots
Lettuce
Peppers
Marrow
Onions
•"is
Page 375
*»; Foods to
Avoid
Bread—brown and
white
Butter
Corn
Dried Beans
Macaroni, spaghet
Cream
Bacon
Fried foods
ti, etc.
Rice, barley, sago,
etc.
Sauces and gravies
Salad dressings
Parsnips
Rusks, Rye-Vita
Sugar
Bananas
Olives and nuts
Cereals
Honey, jams and
jellies
Potatoes
All foods not mentioned in the d
Recipes
Broth: Use one pound of lean beef, mutton, meal or chicken to one quart of
water. Allow to simmer gently 3 to
4 hours. Strain, cool overnight, then
remove all fat before using.
Jelly Salads: Chop 1/3 cup) of cooked or
raw vegetable. Allow ]/2 tablespoon of
gelatin to one (Yz cup) mould. Add a
pnch of salt and 1 teaspoon of vinegar
to chopper vegetables and place in
mould. Dissolve the gelatin in one
tablespoon of cold water, add as much
boiling water as there is room for in
the mould, pour over vegetable and
chill. Unmould on lettuce leaf when
set. This may be used as a vegetable
in the diet.
Mayonnaise Dressing:
Yolk of 1 egg l/z teaspoon vinegar
1J4 cups mineral oil salt, petter
juice of 1 lemon
Beat yolk well, then add oil drop by
drop, beating continually until mixture
is thick. Continue adding oil in increasing amounts, adding vinegar and lemon
juice when mixture becomes too thick.
Add seasoning. This may be served on
vegetables if desired.
Custard:
Skimmed milk Yz cup
Yolk of 1 egg
Vanilla Ya teaspoon
Saccharine Ya grain
Heat milk in double boiler. Dissolve
saccharine in 1 tablespoon cold water.
Beat egg yolk, then stir in the scalded
milk gradually, mixing well. Add the
dissolved saccharine and vanilla. Pour
into custard cup and bake in a pan of
hot water in a moderate oven until set.
IDIOSYNCRASY TO MORPHIA
Report of a Case
Geo. F. Strong, M.D., and
Fl./Lt. J. Parnell, M.B., R.C.A.F.
From the Department of Medicine, The Vancouver General Hospital.
Male, age 49, was admitted to The Vancouver General Hospital on May- 26, 1941,
for tonsillectomy. As only local analgesia was to be used the customary pre-operative
exarnination was omitted.    On the night before operation he was given Nembutal gr.
iss., and slept well.
At 8 o'clock the following morning he was given gr, iss of Nembutal and at 8:30,
morphia gr. Ya and atropine gr. 1/150. He was given) about 15 c.c. of 54% novocain
around each tonsil after the throat was pointed with 10% solution of cocaine.
The tonsillectomy began at 9:15 and finished at 9:45 and was uneventful. He left
the Operating Room in good condition, but on his return to the ward the nurse's notes
stated that his colour was poor.   However, the patient himself had no complaints.
A routine post-operative order for morphia gr. Ya was given and, when the patient
complained of pain in his throat at 1:30 p.m. he was given an injection of morphia gr. Ya-
At 2:45 p.m. the patient was found unconscious, deeply cyanosed, and with infrequent gasping respirations. Coramine was given at once, a metal airway inserted, oxygen
Page 376 with carbon dioxide given by mask, and the trachea aspirated. Then artificial respiration was done for half an hour when he began to breathe spontaneously at a rate of eight
per minute. Oxygen with carbon dioxide was given continuously for several hours
but the patient remained unconscious.
We saw him. first at 5:15 p.m. He was in a deep coma. The pulse rate was 100 per
minute, regular, and of good quality. Cardiac sounds were normal. The apex beat was
not displaced. The chest was resonant on percussion, and breath sounds came through
equally on both sides. The pupils were small and did not react to light. All the reflexes
were lost and the extremities were flaccid. Respirations were infrequent, hollow and
came as short inspiratory gasps.
Thus, he had an almost complete respiratory paralysis, and, as some means of maintaining respiration was essential, the patient was placed inside the "Iron Lung" as soon
as possible. He was given stimulants, atropine, and oxygen. His colour improved considerably but there were no other1 signs of recovery until about 11:30 p.m., when there
was a slight response of his pupils to light. At midnight he moved his legs, his pupils
became dilated and! he asked for a drink of water. The respirator was shut off and it
was found that he could breathe without assistance. It was thought advisable to leave
him in the machine over night. He had a brief relapse into unconsciousness an hour
later, but after that his condition was fairly good and he was able to be removed, from
the respirator early the next morning.    Subsequent recovery was uneventful and rapid.
In considering the differential diagnosis in this case we may eliminate intracranial
accident by the absence of localizing signs, the rapid recovery, and the absence of
sequelae. Massive collapse of the lung was also ruled out by finding the apex beat in its
normal position and by hearing normal breath sounds on both sides. The fixed pin point
pupils, lost reflexes, flaccid limbs and respiratory paresis with a relatively normal pulse
all pointed to morphia poisoning.
This diagnosis was substantiated by the patient's own statement that he had "passed
out for twenty-four hours" many years ago when he had been given an injection of
morphia.
It is interesting to note that the effects of the first dose of morphia were modified
by the simultaneous injection of a small dose of atropine.
THE METABOLISM OF CALCIUM
H. G. Weaver, M.D.
From The Department of Medicine, The Vancouver General Hospital. ■
The Metabolism of Calcium has long been recognized to be important, but in recent
years it has been found to be even more important than early workers thought. I propose to outline the more common physiological, pathological and clinical considerations
of this subject.
Calcium is found chiefly in milk, cheese, green vegetables and butter. The minimal
amount of calcium required to be absorbed by the average adult is one half gram per
day. The optimum amount is one gram per day. Due consideration should be taken
of the fact that absorption of calcium is always incomplete, usually about 25% being
absorbed through the intestinal wall. This obsorption varies according to a number of
factors which determine whether the calcium salt formed in the small intestine will be
relatively soluble or relatively insoluble. When the acidity (pH) of the small intestine
is increased, acid calcium phosphate is formed, which is quite soluble and therefore is
absorbed well. Conversely in an alkaline gut there are formed relatively insoluble
alkaline phosphates and carbonates which are not absorbed well. Another factor concerned has to do with the combination of calcium with the products of incompletely
digested fats to form insoluble soaps which are not absorbed.   Also there are two other
Page 377 M
'
1.
2.
4.
5.
factors which must be considered, namely Vitamin D and Phosphorus. If the phosphorous intake is too high insoluble calcium phosphate tends to be formed in excess.
Vitamin D, m itself, is necessary for the normal absorption of calcium through the
intestinal wall.
When calcium is absorbed it has several important functions:
It is necessary for normal ossification of bone.
It is necessary for adequate contraction of the heart muscle.
It is one of the essential factors necessary for the formation of thrombin in the
blood.
Calcium dinainishes the permeability of the capillary endothelial layer.
Last, but by no means least inprmportance, the blood level of calcium regulates
neuromuscular excitability.
It is this last function in which we are most interested, insofar as the parathyroid
glands are concerned. The normal level of calcium in the blood is 9-11 mgm. per 100
c.c. It is divided into un-ionized and ionized fractions. The un-ionized fraction usually
makes up 3-5 mgm. It is loosely combined with the plasma proteins, is not diffusible,
and is not believed to be physiologically active. The ionized fraction is made up of 2
mgm., which are in simple physical solution in an active form, and 3-5 mgm., which are
kept dissolved in some way not definitely determined, but probably by the action of the
hormone of the parathyroid gland, parathormone. This last fraction is physiologically
active and diffusible.
Parathormone, the active principle of the parathyroid glands, can be prepared by
acid extraction of fresh parathyroid gland. The active principle is freely soluble in
water and can be given subcutaneously or intravenously. This parathormone determines the rate of movement of calcium from the great calcium depots, the bones, into *
the blood stream and the tissues, and from there into the urine. It has the disadvantage
of losing its effect on the calcium level in the blood after several months of use so
should be kept for emergencies.
The other important factor in controlling calcium metabolism is vitamin D. This
vitamin can be given as irradiated ergosterol in large amounts. By this means calcium
absorption from the intestines is improved and calcium is also liberated from the bones.
Highly irradiated ergosterol, such as dihydrotachysterol (commonly called "A T-10")
increases absorption of calcium from the intestines and niimics the action of the parathyroid hormone in raising the blood': calcium level. As no tolerance to it develops, it
is of great value in tetany due to hypoparathyroidism. Vitamin D and dihydrotachysterol have the same fundamental actions, but vitamin D acts more slowly and longer
than dihydrotachysterol.
High blood calcium is usually associated with hyperactivity of the parathyroid
glands, whether it be due to a parathyroid adenoma or general parathyroid hyperplasia.
In hyperparathyroidism we get the condition known as generalized osteitis fibrosa. The
increased parathyroid hormone causes mobilization of calcium from the bones to the
blood, the bones become rarefied, the blood calcium rises, andj there is marked excretion
of phosphorous and calcium in the urine. The decalcified areas in the bone become
fibrosed. The tissues become flooded with calcium and the neuromuscular irritability is
greatly decreased. The level of calcium in the blood at which symptoms begin is
between 12 and 13 mgm. percent. When the blood level reaches 15 mgm. percent
symptoms become very severe. The patient presents a picture of pre-coma, somewhat
resembling uraemia. There is: 1. Loss of appetite and wasting. 2. Diarrhoea. 3. Drowsiness. 4. General muscular flaccidity. 5. Nausea, vomiting and abdominal cramps. 6.
Excessive thirst in 15% of cases. 7. Renal calculi in 30% of cases. 8. Pain and tenderness in bones or joints, often restricted to the hands. 9. Tender lumps on the bones.
10. Spontaneous fractures.
Page 378 As the condition becomes mare acute the blood becomes more viscid, loses its volume,
and the\ circulation begins to fail. Renal failure sets in, the blood NPN rises, and the
patient dies in coma.   Only surgical treatment of hyperparathyroidism is of avail.
In cases with a high blood calcium some calcium tends to be deposited in the kidney
pelves, causing renal calculi, and sometimes it is deposited in the renal tubules causing
renal impairment. As a matter of clinical interest, there have been a few cases reported
where the presence of renal calciuli led to a diagnosis of parathyroid adenoma. The
adenomata were subsequently removed with good results.
In hypoparathyroidism there is a decrease in the production of parathormone, excessive amounts of calcium are left in the bones and as a result of the low blood calcium, a
low calcium concentration in the tissues occurs and the neuromuscular irritability is
increased. When the blood calcium is lowered to 7-9 mgm. percent the condition is
known as latent tetany. The patient! only has tetanic symptoms after external stimuli
such as in Trousseau's sign, where the blood pressure cuff is tightened on the patient's
arm causing carpopedal spasm or in Chvostek's sign of facial nerve irritability produced
by tapping over the facial nerve causing muscular twitching, or occasionally laryngismus
stridulus may be noted. When the blood calcium goes below 7 mgm. percent the condition of clinical tetany develops, manifested, by spasms without external stimuli, intense hyperpncea develops which causes the loss of carbon dioxide and is followed by
alkalosis, which further aggravates the condition.
The treatment of hypoparathyroidism depends upon the severity. If there are severe
tetanic spasms, the treatment must be given with a view to obtaining immediate relief
and calcium salts are given intravenously. This quickly relieves the spasm but the
relief is only brief. The calcium is repeated in an hour if necessary, but parathyroid
hormone must be given because of its quick action in mobilizing calcium from the
bones. Later, the best treatment is A T-10, which assumes the physiological actions of
vitamin D and parathyroid hormone combined.
Fuller Albright of Boston has written that laboratory facuities are not necessary for
the successful treatment of hypoparathyroidism. He compares the evolution of treatment of hypoparathyroidism with diabetes mellitus. In both conditions a great deal of
scientific knowledge and laboratory equipment was required for treatment which even
then was not very satisfactory. Just as in diabetes we have insulin plus a simple
urinalysis, so for hypoparathyroidism, we have A1 T-10 plus an even more simple urine
test. He states it is no longer necessary that a blood calcium determination be done
and that:
"All the symptoms of tetany in hypoparathyroidism are due to the low level of
calcium in the blood. .The goal to be sought is to raise the level of calcuim to normal
without overdoing the process and obtaining hypercalcemia. Thus, all that is needed
is an agent to raise the blood calcium level readily to any desired degree and a simple
method of gauging this level. Dihydrotachysterol or A T-10 fills the first need and
the Sulkowitch test for calcium in the urine the second." The normal renal threshold
(for excretion of calcium in the urine) is 7.5-9 mgm. Above 11.5 mgm. large amounts
of calciumi are excreted in the urine. At levels of about 16 mgm. of serum calcium
the danger of sudden death due to hypercalcemia is present. With these points in mind
and with the help of a very simple test for differentiating urine specimens with no calcium, with a small amount of calcium, and with a large amount of calcium, the regulation of dosage of A T-10 becomes very easy.
Thus, a person with the tetany of hypoparathyroidism will have no calcium in his
urine. In the tetany of alkalosis due to hyperventilation there is calcium present in the
urine. Once a diagnosis of parathyroid tetany is made A T-10 is given until the urine
tests show moderate amounts of calcium' present. If large amounts of calcium start to
show in the urine the dose of A T-10 is reduced, and the danger of hypercalcemia is
avoided.
Page 379 The Sulkowich reagent is a solvent containing oxalate radicals buffered at such a pH
that when equal amounts of this reagent are added to urine the calcium will almost
immediately come down as a fine white precipitate of calcium oxalate.
Sulkowich Reagent:
2.5 grams Oxalic Acid 1 Dissolve in distilled
2.5  grams ammonium oxalate [-water and make up to
5     c.c. glacial acetic acid      J 150 c.c.
1. No precipitate—no calcium—therefore serum calcium is 5-7.5 mgm.
2. Fine white cloud—moderate serum calcium, therefore normal.
3.   Milky precipitate—hypercalcemia.
The patient can do his own tests and modify the dose according to the results.
Sulkowich suggests 3 c.c. of dihydrofac^prerol daily until calcium appears in the urine
then drop dosage to maintenance level of \ c.c. taken three to five times a week.
There are just a few variations here which should be noted:
1. Occasionally a normal person on a low calcium diet will show a single urine
specirojen with practically no calcium.
2. After drinking a large amount of milk a normal person will show an excess of
calcium in the urine.
Thus a patient with hypoparathyroidism on a high calcium diet tends to show larger
amounts of calcium in the urine when blood calcium is nrmal, so a smaller dose of
A T-10 can be given. This patient will have a slightly subnormal serum calcium, which
does not hurt him, and he is surely protected from hypercalcemia.
Conclusion: The metabolism of calcium in hyperparathyroidism and hypoparathyroidism is discussed.   The treatments of both conditions are outlined.
CASE FOR DIAGNOSIS
Earle R. Hall, M.D.
The original site of the lesion in this case, proven to be one of carcinoma, remains
obscure. I think the symptoms presented together with the findings make this an
extremely interesting case.
Case: A. B., male, age 62, first seen by me on February 26, 1941, with the following
history:
Previous Illnesses: Thirty-three years ago, while playing football, he sustained a blow
in the region of the right testis—there was no swelling and it did not lay him up for
more than a few minutes at the time of the accident. Ever since, this portion of the
scrotum has been slightly tender, and he has worn, a suspensory for support.
Three months ago he developed pain at the right lumbar area, corning on with his
usual activity, and when present, radiating anteriorly to the upper right quadrant, the
pain being somewhat colicky in type and resembling renal colic. He was examined on
several occasions by bis physician, who reported a palpable right kidney with negative
urines. Excretory urography at that time showed a kinking of the upper right ureter.
He has since worn a support, and reports no more pain.
Family History: Mother died, age 75; father, age 65—cause in both instances
unknown to him.
One sister died, age 32—ulceration of stomach.
One brother died, age 43—cause unknown to him, other than that it was a sudden
death.
Page 380 Blood Count: Hgb.: 78%.    R.B.C.: 3,629,000—morphology within normal limits.
W.B.C:  3,600.    Polymorphs: 76; Lymphocytes: 24.
N.P.N.: 38 mgs.
March 14, 1941—He was advised to have a barium enema. The X-ray report of
this was negative. A diagnosis of retro-peritoneal tumour was made and he was advised
to have operation—if only for exploration.
March 15, 1941: St. Paul's Hospital—Avertin and ether anesthesia—Incision was
made through the right lateral lumbar area exposing the right kidney, right ureter and
surrounding regions. The kidney itself appeared perfectly normal—it was rotated, very
freely movable, and pulled down by adhesions attached to the lower pole. These were
completely removed. The renal pelvis and ureter were normal. It was now quite
evident that the abdominal tumour previously palpated was the right kidney which
assumed a lower and more anterior position, presumably from the pull of the adhesions
attached to its lower pole. There was absolutely no evidence of a retro-peritoneal
tumour. During a careful search for such, a large number of enlarged glands were
found in the renal area—posterior to the renal pelvis and also extending along the course
of the ureter, but slightly posterior and more medial to it. These glands were hard and
varied in size from a very small pea to about three times that size. A number were
removed for biopsy.
Pathological Report: "These glands are composed of solid, proliferating masses of
cells, epithelial in type, densely packed together, forming many pseudo glands or tubules.
Cells are somewhat polyhedral in shape, with markedly hyperchromatic nuclei. They
vary greatly in size and in staining. Many mitotic figures are seen. This has the
appearance of a rapidly growing, highly malignant tumour, carcinoma in type, and is
probably secondary to testicle (?)"—Dr. A. Y. McNair.
These slides were also sent to Chicago, where Dr. C. Apfelbach, pathologist at Presbyterian Hospital, examined them without a history of the case. H_ stated "they were
consistent with metastases of a tumour of the testis; the cells were undifferentiated and
appeared! very malignant."
Following these two reports it was decided to remove the right scrotal contents for
exarnination. The post-operative course of the patient had been uneventful and as a
matter of fact he appeared generally improved. The edema disappeared entirely from
the external genitalia (the first time I had ever seen a total absence of swelling), and
re-examination did not disclose any difference from previous appearance.
May 1, 1941: St. Paul's Hospital—Spinal anesthesia—right orchidectomy. At
operation the previously-observed firm, localized swelling at the upper pole did not
appear neoplastic. It was a slight thickening of the epididymis and appeared as an old
inflammatory lesion.
Pathological Report: Pathological report of right scrotal contents was entirely negative.—Dr. A. Y. McNair.
The patient received deep X-ray therapy under direction of Drs. Prowd and Campbell, and was discharged from hospital on May 14, 1941.
July 7, 1941: Patient returned to the city. At that time his chief complaint was
pain through the abdomen, also involving the left chest and mediastinum. He had slight
edema of the lower limbs and of the external genitalia. He was weak, and showing
emaciation. He presented a typical picture of one approaching the terminal stage of
carcinoma with its rapid cUssemination throughout. He returned home, becoming slowly
weaker and experiencing more severe pain, requiring morphia for relief. He expired
approximately ten months after my first contact with the case. Unfortunately a necropsy
was not obtainable, and to me the original site of this malignancy appears uncertain.
Page 381 Mi
One brother died, age 55—carcinoma of the urinary bladder.
Previous VenereabJDemes.
Marital: Widower—four children alive and well—oldest, 38—youngest, 28.
Sexual—Sexual desire is not great—hast occasional erections.    He has had occasional
nocturnal emissions, the last one being six months ago.
Present Complaints:   1. Swelling of penis and scrotum.
2. Frequency.
3. Slight burning.
Onset and Course: About three weeks ago he had onset of swelling involving the
penis and scrotum. It has been gradual, coming on for no apparent reason, and involving all parts simultaneously. The swelling reduces if he is in recumbent posture for
several days, but never goes down completely.
About five years ago he commenced^ to) have nocturia. At first this was one to two
times each night, but during the past year it has increased to two to three times.
During the past year he thinks that he has had to pass urine oftener during the day.
During the past two weeks there has been at times a slight burning- during micturition.    This is most noticeable with the increase in swelling of the genitalia.
There has been no loss in weight, no hematuria, and no difficulty in passing the urine.
Examination
External Genitalia: There was edema of the penis, the whole organ being about three
times larger than normal. Swelling involved the prepuce which could be rolled back,
exposing the glans, which was negative. There was edema of the scrotum—being the
size of an average grapefruit. Both testes could be palpated—they were negative except
for a very small area at the upper pole of the right, which was firmer than usual, but
not to real hardness. It was difficult to say whether this localized area involved the
testis proper, the upper pole of the epididymis, or the cord itself. It was not tender.
The scrotal swelling transmitted light.
Urine examination was completely negative.
Rectal examination showed the prostate to be enlarged about two times—broad, firm,
with no part suggesting malignancy.    It appeared as a benign enlargement.
Prostatic fluid showed a sprinkling of W.B.C.'s and some non-motile spermatozoa.
Abdomen: -The right lumbar region! appeared fuller with bi-manual palpation, and a
mass was present in the upper abdominal quadrant. This was slightly tender on pressure,
and somewhat movable. It was smooth and firm, but not to hardness. It was difficult
to say whether it was the right kidney, retro-peritoneal, or intra-abdominal in location.
The remainder of the abdomen was negative.
Bloos Pressure: 140:80.
Blood Kahn: Negative.
He was admitted to St. Paul's Hospital.
Cystoscopy and Pyelography: Cystoscope entered without difficulty. There was no
cystitis. There were a number of thick interlacing trabeculations involving the bladder
walls with a tremendous amount of edema of the trigone. Both ureteral orifices were
elevated and surrounded by considerable edema, more marked on the right. The edema
at the bladder base involved the vesical orifice which was very irregular and swollen.
Catheters engaged both ureteral openings easily, but could not be passed more than a few
cms. in each.
Pyelography: Excretory urography was obtained by the intravenous route. This
indicated bi-laterally functioning kidneys which were symmetrical with slight clubbing
of the terminal calices. Size, position, and filling of both were within normal limits,
except for1 slight anterior rotation of both, possibly greater on the right. Both ureters
from the fourth lumbar vertebra upward took a more lateral course, as if there was a
pressure between each, pushing both outward.
Page 382 ':'?; IN COMBATING A COMMON
AND STUBBORN CAUSE OF
LEUKORRHEA—
TRICHOMONAS VAGINALIS
• In the treatment of trichomonas leukorrhea consideration should be given
not only to the extermination of the parasites, but to the restoration of the
normal vaginal flora.
Such a dual action is achieved through treatment with Devegan. Marked
improvement is frequently observed within three or four days. The subsidence of the profuse, malodorous discharge is accompanied by a corresponding decrease of the intense local burning, itching and other discomfort. Even
in chronic cases a cure may result in two or three weeks.
Devegan is applied in two forms: in powder and in tablets. The powder is
insufflated into the vagina several times a week by the physician, while the
patient is instructed to use the tablets at home. Later, when the discharge has
been greatly reduced, the tablets alone are usually sufficient to complete
the cure.
Pamphlet giving detailed information
sent on request
Devegan Tablets are supplied in boxes
of 25 and 250, each containing 0.25 Gm.
of acetylaminohydroxyphenylarsonic
acid.
Devegan Powder, bottles of 1 oz. and
8oz.
DEVEGAN
Trademark Reg. U. S. Pat. Off. and Canada
WINTHROP
WINTHROP  CHEMICAL  COMPANY,  INC.
Pharmaceuticals of merit tor the physician
General offices: WINDSOR, ONT.
Professional service office: Dominion Square Building, Montreal, Que. MEASLES
m
Modification
»«
Prevention
In 1939 there were 197 deaths from measles in Canada.
More than 95 per cent of these were in the age-group 0-5
years.
Human serum prepared from the blood of healthy adults
so as to involve a pooling from a large number of persons
may be used effectively either for modification or prevention
of measles. Modification is often preferable in that it reduces
to a minimum the illness and hazards associated with measles,
but does not interfere with the acquiring of the active and
lasting immunity which is conferred by an attack of the
disease. On the other hand, complete prevention of an attack
of measles is frequently desirable, and can be accomplished
provided that an ample quantity of serum is administered
within five days of exposure to the disease.
For use in modification or prevention of measles, pooled
human serum is available from the Connaught Laboratories in
a concentrated form. While the recommended dose of this
pooled and concentrated human serum for purposes of prevention is ordinarily 10 cc, the most usual dose is for
purposes of modification and amounts to 5 cc. The serum is
therefore supplied in 5-cc. vials. Prices and information
relating to it will be supplied gladly upon request.
m
CONNAUGHT LABORATORIES
UNIVERSITY   OF   TORONTO
Toronto
Canada
DEPOT FOR BRITISH COLUMBIA
MACDONALD'S PRESCRIPTIONS LIMITED
MEDICAL-DENTAL BUILDING, VANCOUVER, B.C. Hcluskcd
wmmwtj
HOW SUPPLIED
Pink Compressed Tablets for oral use
—in containers of 20, 100, 500 and
1000 tablets.
Suppositories for rectal administration
—boxes of 10 suppositories.
SONERYL..
IS EFFECTIVE IN ALL FORMS OF
INSOMNIA, in sleeplessness of nervous
origin accompanying worry and overwork or associated with neuroses, as well
as in pyrexial conditions where restlessness and discomfort so often interfere
with sleep. The hypnotic dose is from one
to three tablets, or one suppository, half
an hour before retiring.
jLa^vxatoru I ouJuuijc -j%£/i£A
OF      CANADA       LIMITED   —  AfOJV7"A-,4_ I
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VICTOR X-RAY CORPORATION of CANADA, Ltd.
DISTRIBUTORS FOR GENERAL @ ELECTRIC X-RAY CORPORATION
TORONTO: 30 Bloor St., W.-VANCOUVER: Motor Trans. Bldg., 570 Ounsmuir St.
MONTREAL: 600 Medical Arts Building • WINNIPEG: Medical Arts Building  iUw
All too frequently, the man with a tendency to gastric upsets is
addicted to unwise eating habits. Reforming these individuals
takes time and patience. In the meantime, palliative treatment
can be provided by the prescription of a dependable gastric antacid such as Cal-Bis-Ma. It is surprising what a teaspoonful of
Cal-Bis-Ma can do by way of prompt and prolonged relief from
the distress of gastric hyperacidity.
May we send you a trial supply? Please
write your request on your letterhead. Cal-Bis-Ma powder is supplied
in tins of 1% and 4 ounces. A palatable preparation, Cal-Bis-Ma is very
easy to take.
William R.Warner & Co.,Ltd. • 727 King Street,W, Toronto,Out.  :
«n
■ 5
u
f   Breaks the vicious circle of perverted    »
menstrual function in cases of amenorrhea,   I
tardy periods (non-physiological) and dys-    '
menorrhea. Affords remarkable symptomatic
relief by stimulating the innervation of the
uterus and stabilizing the tone of its    j
musculature. Controls the utero-ovarian    J
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Hk    normal menstrual cycle. Jf*
• MARTIN H. SMITH COMPANY
W ISO l»f»TITTI  STREEI.   NEW YOMC N. T.
Full formula and descriptive
literature on request
Dosage: 1 to 2 capsules
3 or 4 times daily. Supplied
in packages of 20.
Ethical protective mark MHS
embossed on inside of each
capsule, visible only when cap*
sule  is cut in half at seam.
14
Jlecd GoUi GUecked
US       WITH 3 DROPS IN EACH NOSTRIL . . .
PRIVINE"Ciba"
(1:1000 solution of 2— (naphthyl—1—methyl)-imidazoline hydrochloride)
I  NASAL   DROPS
Clinical investigations on Privine Nasal Drops have proved that
they are excellently suited for the treatment of all forms of nasopharyngeal affections. In head colds, a few moments after the
instillation of 3 drops of Privine in each nostril, the headache and
sensation of heaviness in the head disappear, while the nasal respiration becomes easier, the watering of the eyes stops, the voice regains
its normal tone and the sense of smell is restored.
ISSUED:
In bottles of V_ ounce with dropper, and bottles of 4 ounces.
CIBA COMPANY LTD.
Montreal
I A molt evident and. economicat
FOOD SUPPLEMENT FOR SCHOOL-TIME HEALTH
IftooSt
NEO-CHEMICAL FOOD
During the indoor school days to come, food supplements rich
in vitamins and minerals will be required by many children.
"Neo-Chemical" Food is the most complete and economical preparation available to supply this need. It provides adequate
amounts of Vitamin Bx, Vit_min A, Vitamin D, Iron, Copper,
Calcium, Phosphorus, chemical and bio-chemical factors which
tend to be deficient in unsupplemented diets.
MODES OF ISSUE:
In liquid form, 7% oz. bottles (24 day size), 2314 oz. (72 day size), A6*A oz.
(economy size, 144 days)—recommended for children. In Capsule form, Boxes
of 50 (25 days supply), Boxes of 100 (50 days supply) and Boxes of 250
(125 days supply) recommended for adults.
Principal Ingredients
IRON (as ferrous salt)
COPPER (as salt)
VITAMIN A
VITAMIN D (Ostogen)
PHOSPHORUS (as salt)
CALCrtTM (as salt)
VITAMIN B|
(Thiamin chloride)
IODINE (as salt)
MALT EXTRACT
Protein 3.5%; fat
ounce.
In dally dose
Mgr.        1 Aids in the prevention of nutritional
1/50 gr.        f    ANAEMIA
2000 Int. units ' Helps keep the EPITHELXAL TISSUE healthy;
specific to prevent and treat NIGHT BLIND-
.     NESS of dietary origin
t Promotes normal development of BONES and
C    TEETH, and prevents and cures RICKETS
Protects against and aids in the treatment of
symptoms of Bi deficiency including NEURITIS of Bi deficiency
Aids in prevention of IODINE D___CIENCY
2000 Int. units
H gr.
fgr.
200 Int. units
1/192 gr.
0.6%; carbohydrate 54% by weight; 85.4 calories per fluid
Biologically standardized in our own laboratories.
_^s^ii___i_l__iss*
Iftoddt
The Canadian Mark of Quality Pharmaceuticals Since 1899
etuude6&.¥/io^6ceo.
MONTREAL   -   CANADA
WHERE QUALITY AND PRICE ARE EQUAL OR BETTER, PRESCRIBE CANADIAN PRODUCTS vMsn
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KINGSWAY at 11th AVE. Telephone FAirmont 0058 VANCOUVER, B. C.
R. F. HARRISON W. E. REYNOLDS
13 th Ave. and Heather St.
Exclusive  Ambulance  Service
FAirmont 0080
PRIVATE AMBULANCES AND INVALID COACHES
WE  SPECIALIZE  IN AMBULANCE SERVICE   ONLY
J.  H. CREKLIN
W.  Ii.  BERTRAND MEMBERS OF
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OF PRESCRIPTION OPTICIANS
OF AMERICA
Always maintain the
ethical principles of
the medical profession.
Guildcraft Opticians
430  Birks  Building Phone SEymour   9000
Vancouver,  Canada
ARTHRITIS and ECZEMA
of endogenous origin
claimed to be allergic, may be
favored or induced by calcium
and sulphur deficiency, impaired
cell action, and imperfect elimination of toxic waste.
lyxanthinFastier
administered per os, brings about
improved cell nutrition and activity, increased elimination, resulting symptom relief, and general functional improvement.
Since the best evidence is clinical
evidence, write for literature and
sample.
L-1
Canadian Distributors
ROUGIER FRERES
350  Le Moyne   Street,  Montreal
COLONIC AND PHYSIOTHERAPY CENTRE
Up-to-date Scientific Treatments
COLONIC  IRRIGATIONS, SHORTWAVE  DIATHERMY,  SINNEWAVE GALVINISM,
IONIZATION, ULTRA VIOLET RAY, STEAM BATHS AND SHOWERS
Medical and Swedish Massage
Physical Culture Exercises
STAFF OF GRADUATE NURSES
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Post Graduate Mayo Bros.
MArine 3723
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Ntttttt  Sc ®tjmtt00tt
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2559 Cambie Street
anc ouver
, B. C. For Healthy Bodies . .
iiiiiy
The medical profession today unhesitatingly recommends pure whole milk as the complete food for all ages.
From a midmorning snack to a midnight bite, it's "Just
what the Doctor ordered." Keep an ample supply on
hand at all times and laugh at Father Time's futile effort
to mark you. Be sure your milk and cream is from carefully selected, tested herds, and reaches you with a minimum of delay—pasteurized, of course.
LIMITED
//cy J€RS€Y QUALITY
MILK   CREAM   BUTTERMILK INDEX TO VOLUME XVIII, V.M.A. BULLETIN, 1941-42
ANAEMIA,   PATHOGENESIS  OF—William  Magner  129
ANEURYSMS, ARTERIOVENOUS—L. H. Appleby and L. H. Patterson  212
APPENDICITIS, ACUTE, IN THE VANCOUVER GENERAL, HOSPITAL IN 1940—
L.   B.   Harville  278
APPLEBY, Li. H.—The use of snake venom in medicine  245
and PATTERSON,   L.  H.—Arteriovenous  aneurysms  212
ARTHRITIS, DESTRUCTIVE, FOLLOWING RENAL INFECTION—Earle R. Hall  314
AUKLAND, N.  L.—Neuronitis   : ,  182
BAILLIE, D. M.—Medicine in Soviet Russia 1  316
BLOOD DONOR  CLINICS   (CANADIAN  RED  CROSS)     19
BODY WATER IN HEALTH AND DISEASE—B.  L.  Newton   283
BRITISH COLUMBIA CANCER INSTITUTE ANNUAL MEETING HONORARY
ATTENDING   STAFF      204
BRITISH COLUMBIA MEDICAL ASSOCIATION 32,   72,   201,  366
Annual Meetings   7,  175,  238, 263, 298
Annual  Reports  268
COMMITTEE   ON   INDUSTRIAL   MEDICINE.: -   337
COMMITTEE  ON  MATERNAL "WELFARE  12,  36,  73,  139
COMMITTEE ON  STUDY  OF CANCER 13,  35,  73,  112,  177,  256,   273,  300,  338
BRONCHOSCOPY—W.  E.  Harrison  214
BUELL, LOUIS A.—^-Spontaneous haematoma of abdominal wall     89
BULLETIN  WAR  RELIEF FUND    11,   34,  75,  113,   178,  262,  299
BURNS AND THEIR TREATMENT—W. A.  Farmer  333
C
CALCIUM,  METABOLISM  OF—H.  G.  Weaver  377
CANADIAN RED  CROSS  BLOOD  DONOR  CLINICS  19
CANCER,  SIMPLE TEST  FOR—F.  N.  Robertson _.  156
CHOLECYSTOGRAPHPY—PRACTICAL   AND   THEORETICAL   CONSIDERATIONS—
G.   E.   Trueman  46
CHORIONEPITHELIOMA,   RELATIONSHIP   BETWEEN   HYDATIDIFORM  MOLE
AND—H.   H.   Pitts  217
COLLEGE OF PHYSICIANS AND  SURGEONS   19,  37,  200, 296
Health  Insurance  Plans _  76
COMMITTEE   ON   ECONOMICS   116, 239
MEDICAL  ADVISORY   COMMITTEE  39
COMMON BILE DUCT, STENOSIS—Douglas Telford _  209
COMMUNICABLE DISEASE CONTROL, CURRENT TRENDS—J.  S. Kitching  304
CURTIS,   E.  J.—Meningococcus  mseningitis  93
_>
DAVIDSON,  GEORGE A.—Neurocirculatory asthenia  344
DEATH,   SUDDEN—H.   H.   Pitts   220
E
EMBOLISM,  FAT—R.  L.  Whitman     23
EPP, H. W.—Some observations of conditions caused by the prostate gland  254
FAIRLEY, GRACE M.—Hospital problems—Nursing service (Notes of a brief address).. 274
FARMER, W. A.—Burns and their treatment  333
FLUOROSCOPY OF THE LUNGS,  STUDY OF ACCURACY—Lieut.  R. A.  Palmer,
R.C.A.M.C   153
FRASER VALLEY MEDICAL SOCIETY—Annual elections  339
Gr
GALL-BLADDER  DISEASE—J.   R.   Neilson..  80
GENITO-URINARY CONDITIONS IN GENERAL PRACTICE—Lee  Smith  86
GORDON-TAYLOR,  Surg. Rear Admiral, R.N.—Report of address at luncheon  Ill
GORSSLINE,  BRIGADIER R. M.—Luncheon addresses   74, 195
GOULD, C. E., and TURVEY, S. E. C.—An unusual case of chronic subdural haematoma 21
GRANT,  J. H.  B.,  and  SMITH,  J.  A.—Laurence-Moon-Biedl  syndrome—  252
X
HAEMATOMA  SPONTANEOUS,  OF ABDOMINAL WALL—Louis A.  Buell   89
HAEMATOMA, CHRONIC SUBDURAL—UNUSUAL CASE—C. E. Gould and S. E. C.
Turvey     21
HAEMORRHAGE, INTRACRANIAL,  IN THE NEWBORN—AN ANALYSIS OF SOME
CAUSATIVE FACTORS—Reginald Wilson    180
HAEMORRHAGE, MASSIVE, INTO ADRENALS—A clinical-pathological case report—
W. J. Holley  276 •_PW
Mai
if ii'"'
"r.
>_
Hfal
ill
INDEX TO VOLUME XVIII—Continued
H—Continued
HAEMORRHAGIC  DISEASE OF NEWBORN,  PREVENTION WITH VITAMIN K—
G.   O.  Matthews • 1  342
HALL, EARLE R.—Case   for  diagnosis...  380
Case  of  ureteral   (bi-lateral)   obstruction with  complications  following   sulfadiazine     243
Destructive arthritis  following renal  infection  314
Granular   (non-purulent)   urethritis  in women...  150
HARRISON,   W.   E.—Bronchoscopy  214
HARVILLE, L. B.—Acute appendicitis in the V.G.H. in 1940  278
HOLLEY. W. J.—Massive haemorrhage into adrenals—A clinical-pathological case report 276
HOSPITAL PROBLEMS—NURSING SERVICE—Notes of a brief address by
Miss Grace M. Fairley, R.N _ _ I _  274
HYDATIDIFORM MOLE AND CHORIONEPITHELIOMA, RELATIONSHIPS^ H. Pitts  217
HYPOSPADIAS—L.   R.   Williams |  348
I
INCOME   TAX,   DOMINION—INFORMATION    207,  369
INTERVERTEBRAL DISC, EXTRUSION—THE COMMONEST CAUSE OF SCIATICA—
Frank Turnbull    125
INTESTINAL OBSTRUCTION—AN UNUSUAL CASE—R.  G. D.  McNeeley   281
J
JAUNDICE,   PATHOGENESIS   OF—William   Magner _.    57
JOHNSON, A. M.—Case   history   report     92
and STRONG,  G.  F.—Case  history report  127
K
KEITH, W. D.—Safety in the operation for toxic thyroid     40
KELLER OPERATION—Donald  E.   Starr 1 _   301
KITCHING, J. S.—Current trends in communicable disease control   304
I.
LANGE, CARL—Methods for the protection of spinal fluid  (Abstracted by
S.  E.  C.  Turvey)  143
LAURENCE-MOON-BIEDL SYNDROME)—J. H. B. Grant and J. A. Smith _  252
LUPUS ERYTHEMATOSUS, LOCALIZED AND DISSEMINATED—R. D. G. McNeeley.... 145
M
MAGNER, WILLIAM—Pathogenesis   of   anaemia  129
Pathogenesis  of  jaundice  57
MATTHEWS, G. O.—The prevention of haemorrhagic disease of the newborn with
vitamin  K   '.  342
MEDICAL ECONOMICS—S.  Cameron  MacEwen  14
MEDICINE IN SOVIET RUSSIA—D. M. Baillie  316
MENINGITIS, MENINGOCOCCUS—E.   J.   Curtis     93
MENINGITIS, MENINGOCOCCIC—CLEAR SPINAL FLUID IN—Case report—
R. A Palmer, Capt., R.C.AM.C, and F. D.  Sinclair  240
METABOLISM, CELLULAR, ROLE OF VITAMINS IN—R. Y. Stanier     51
MICROFILM   SERVICE   170
MORPHIA IDIOSYNCRASY TO—Report of a case—George F. Strong and Fl. Lt.
J.   Parnell,   R.C.A.F .'  376
He
MacDERMOT,  J. H.—Sacro-iliac lipomata  185
MacEWEN,  S. CAMERON—Medical Economics     14
McNEELEY, R. G. D.—An unusual case of intestinal obstruction  281
Lupus  erythematosus,  localized and  disseminated  145
_T
NEILSON,  J.  R.—Gall-bladder  disease  .. 80
NEUROCIRCULATORY ASTHENIA—George A.  Davidson   344
NEURONITIS—N.   L.   Aukland  182
NEWTON, B. L.—The body water in health and disease  283
NURSING SERVICE—HOSPITAL PROBLEMS—Notes of address by Miss Grace
M.   Fairley,   R.N  274
NUTRITIONAL DEFICIENCIES,  METHODS FOR DIAGNOSIS—A. E. C. Riggs....   309
O
OBITUARIES—
Bell,   D.   J     31
BOLTON,   ELMER   ......_   169
KNIPE,   G.   W. :   169
McTAVISH,   W.   A :  140
SUTHERLAND,   A   A   140
THOM,   J.  B     31 INDEX TO VOLUME XVIII—Continued
PALMER, R. A, Capt., R.C.A.M.C.—A study of the accuracy of fluoroscopy of the lungs 153
and SINCLAIR, F. D.—Clear spinal fluid in
meningococcic   meningitis—Case   report  240
PARNELL, J., Fl. Lt., R.C.A.F., and STRONG, G. F.—Idiosyncrasy to morphia  376
PATTERSON, L. A., and APPLEBY, L. H.—Arteriovenous aneurysms  212
PITTS, H. H.—Relationship between hydatidiform  mole and  chorionepithelioma  217
—Sudden   death  220
PROSTATE GLAND—SOME  OBSERVATIONS  OF CONDITIONS  CAUSED  BY—
H. W.  Epp   254
RADIO  INTERFERENCE  FROM  ELECTRO-MEDICAL  EQUIPMENT   113
RIGGS, A. E. C.—Methods for the diagnosis of nutritional deficiencies  309
ROBERTSON, F. N.—A simple test for cancer  156
S
SACRO-ILIAC  LIPOMATA—J.   H.   MacDermot  185
ST. PAUL'S HOSPITAL—Case reports        212,  243,  314,  380
SAUNDERS, F. S.—Sterility in the female  119
SCIATICA  COMMONEST CAUSE OF—EXTRUSION  OF INTERVERTEBRAL DISC—
Frank Turnbull    125
SINCLAIR F. D., and PALMER R. A., Capt., R.C.A.M.C.—Clear spinal fluid in
meningococcic meningitis _  .. 240
SMITH, J. A, and GRANT, J. H. B.—Laurence-Moon-Biedl syndrome  252
SMITH, LEE—Genito-urinary conditions in general practice     86
SNAKE VENOM, USE IN MEDICINE—L. H. Appleby   245
SPINAL FLUID, CLEAR, IN MENINGOCOCCIC MENINGITIS—Capt. R. A. Palmer,
R.C.A.M.C, and F.  D.  Sinclair  240
SPINAL FLUID, METHODS FOR PROTECTION—Carl Lange  (Abstracted by
S. E.  C. Turvey _  143
STANIER R. Y.—The role of vitamins in cellular metabolism     51
STARR,  DONALD  E.—The Keller  operation  301
STERILITY IN THE FEMALE—F.  E.  Saunders  119
STRONG, GEORGE F. and FL. LT.  J. PARNELL,  R.C.A.F.—Idiosyncrasy to  morphia.. 376
and A. M. JOHNSON—Case history report  127
TELFORD, DOUGLAS—Stenosis of the common bile duct  209
THYROID, TOXIC, SAFETY IN OPERATION FOR—W. D. Keith  40
TRUEMAN,  G.   E.—Cholecystography—Practical  and   theoretical   considerations  46
TURNBULL, FRANK—Extrusion of intervertebral disc—the commonest cause
of sciatica    125
TURVEY,  S. E. C.—Abstract of "Methods for the protection of spinal fluid"
by  Carl   Lange  143
and GOULD, C. E.—An unusual case of chronic subdural haematoma 21
TJ
UPPER ISLAND MEDICAL ASSOCIATION—Annual   Meeting     35
Spring Meeting  301
URETERAL   (BILATERAL)   OBSTRUCTION  WITH   COMPLICATIONS   FOLLOWING
SULFADIAZINE—Earle   R.   Hall  243
URETHRITIS, GRANULAR, NON-PURULENT, IN WOMEN—Earle R. Hall  150
VANCOUVER GENERAL HOSPITAL—Case Reports.... 21, 89, 92, 127, 240, 252, 276, 281,  376
Review of the work at the Heart Station  313
Department   of  Dietetics..    340, 375
VANCOUVER   MEDICAL   ASSOCIATION J*   171
Annual Dinner        71
Annual Meeting    227
Annual Reports    -  232
A.  R.  P.  Committee -  109
Summer School  - |    330,  362
VITAMIN K—PREVENTION OF HAEMORRHAGIC  DISEASE  OF THE NEWBORN
WITH—G.  O. Matthews   342
VITAMINS—RODE IN CELLULAR METABOLISM—R. Y.  Stanier     51
W
WEAVER, H. G.—The metabolism of calcium  377
WEST KOOTENAY MEDICAL ASSOCIATION—Annual meeting  75, 368
WHITMAN, R. L.—Fat embolism _     23
WILLIAMS,   L.   R.—Hypospadias     348
WILSON, REGINALD—An analysis of some causative factors in intracranial
haemorrhage in the newborn  180 !ii
Regulations   Governing
Prescriptions   (or
CODEINE
Druggists must have in their possession the actual signed and dated doctor's prescription or order for Codeine and Codeine preparations, or any other narcotic drug,
before releasing the prescrption to the purchaser.
It is unlawful for a physician to give, and a druggist to release a Codeine prescription
by telephone, both parties being equally responsible. It is also illegal for a druggist
to telephone another druggist who is more conveniently located for delivery of the
prescription.
ft
We bring this matter to the attention of the Medical Profession in order to avoid
confusion or misunderstanding with regard to the filling of codeine prescriptions.
This ruling is made by the Narcotics Division, Department of Pensions and National
Health, and the Medical profession will appreciate the fact that we must adhere
strictly to this ruling.
You may rest assured that we will co-operate in every way in the prompt filling and
delivery of all prescriptions.
CUNNINGHAM      DRUG     STORES    LTD.
WITH WHICH ARE MERGED THE STORES
OF THE   VANCOUVER   DRUG   CO.   LTD.
• The Unusual Prescription
-one which calls for rare or un
usual png red ients-^'can be dispensed from our largelltock. We
endeavor to keep a complete supply
on hand at allllimes.
Phone
MArine 4161
[jC§aujl ^.JaendriAon
GEORGIA PHARMACY
LIMITED
tniiT w.
(&tx\tn $c ifattnaHtb
ESTABLISHED IMS
VANCOUVER, B. C.
North Vancouver, B. C.
Powell River, B. C. ■_:i
m
:..[
Ifri
..■J
V* i 1        B
£^ ____^__w^ ^_#*
New Westminster, B. C.
For f J&e treatment of
NEUROPSYCHIATRY
DISORDERS
Reference—B. C. Medical Association
For information apply to
Medical Superintendent, Nev Westminster, B. C.
or 721 Medical-Dental Building, Vancouver, B. C.
PAcific 7823
Westminster 288
27
,i.s=fT,r   -> P , .,  ■ ■a.T^?*^ _~—Tv*-S_*» ^f^,'W.^^; V*?.*    University of British Columbia Library
DUE DATE
SERIALS	
APR 2 8 W8
(Vlrs i    «*
f    5 19781
___
FORM  310S toWggW.
V. /J-if.
woodward
library
<r
T7
~3
t2„__,aiv of
WOODWARD LIBRARY
UNIVERSITY Or BRITISH COLUMBIA
VANCOUVER 8, CANADA 

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