History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: January, 1951 Vancouver Medical Association Jan 31, 1951

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The Vancouver Medical Association
Publisher and Advertising Manager
OFFICERS  1950-51
Dr. Henry Scott Dr. J. C. Grimson Dr. W. J. Dorrance
President Vice-President Past President
Dr. Gordon Burke Dr. E. C. McCoy
Hon. Treasurer Hon. Secretary
Additional Members of Executive:
Dr. J. H. Black Dr. D. S. Munroe
Dr. G. H. Clement Dr. A. C. Frost Dr. Murray Blair
Auditors: Messrs. Plommeb, Whiting & Co.
Eye, Ear, Nose and Throat
Dr. N. J. Blair jj Chairman Dr. B. W. Tanton Secretary
Dr. C. J. Trefry Chairman Dr. Peter Spohn Secretary
Orthopaedic and Traumatic Surgery
Dr. D. E. Starr Chairman Dr. A. S. McConkey Secretary
|lpNeurology and Psychiatry
Dr. F. E. McNair ] Chairman Dr. R. Whitman Secretary
Dr. Andrew TuRNBULL—Chairman Dr. W. L. Sloan Secretary
Dr. E. France Word, Chairman; Dr. A. F. Hardyment, Secretary;
Dr. F. S. Hobbs, Dr. J. L. Parnell, Dr. S. E. C. Turvey, Dr. J. E. Walker
Co-ordination of Medical Meetings Committee:
Dr. R. A. Stanley Chairman Dr. W. E. Austin Secretary
Summer School:
Dr. E. A. Campbell, Chairman; Dr. Gordon C. Large, Secretary;
Dr. A. C. Gardner Frost; Dr. Peter Lehmann; Dr. J. H. Black;
Dr. B. T. H. Marteinsson.
Medical Economics:
Dr. F. L. Skinner, Chairman; Dr. E. C. McCoy, Dr. T. R. Sarjeant,
Dr. W. L. Sloan, Dr. J. A. Ganshorn, Dr. E. A. Jones, Dr. G. Clement.
Dr. G. A. Davidson, Dr. Gordon C. Johnston, Dr. W. J. Dorrance
Special Committee—Public Relations:
Dr. Gordon C. Johnston, Chairman; Dr. J. L. Parnell, Dr. F. L. Skinner
Representative to B. C. Medical Association: Dr. W. J. Dorrance
Representative to V.O.N. Advisory Board: Dr. Isabel Day
Representative to Greater Vancouver Health League: Dr. I>. A. Patterson VANCOUVER MEDICAL ASSOCIATION
Founded 1898; Incorporated 1906.
(Spring Session)
FEBRUARY 6th—GENERAL MEETING—Devoted to Medical Economics.
MARCH 6th—OSLER DINNER—Dr. H. A. DesBrisay, Osier Lecturer.
APRIL 3rd—GENERAL MEETING   (Speaker to be announced).
MAY 28th to JUNE 1st (inclusive)—ANNUAL SUMMER SCHOOL.
FIRST TUESDAY—GENERAL MEETING—Vancouver Medical Association—T. B.
Clinical Meetings, which members of the Vancouver Medical Association are invited
to attend, will be held each month as follows:
Notice and programme of all meetings will be circularized by the Executive Office
of the Vancouver Medical Association.
Refresher Courses for the General Practitioner
SURGERY—February 12th, 13 th, 14th, 1951.
EYE, EAR, NOSE and THROAT-^March 5th, 6th, 7th, 1951.
OBSTETRICS and GYNAECOLOGY—April 9th, 10th, 11th, 1951.
Regular Weekly Fixtures in the Lecture Hall
Monday, 12:15 p.m.—Surgical Clinic.
Tuesday—9:00 a.m.—Obstetrics and Gynaecology Conference.
Wednesday, 9:00 a.m.—Clinicopathological Conference.
Thursday, 9:00 a.m.—Medical Clinic.
12:00 noon—Clinicopathological Conference on Newborns.
Friday, 9:00 a.m.—Paediatric Clinic.
Saturday, 9:00 a.m.—Neurosurgery Clinic,
edition, 1950.
Regular Weekly Fixtures
Tuesday, 9:15 a.m.—Paediatric Ward Rounds.
Wednesday, 9:00 a.m.—Medical Ward Rounds.
Second and Fourth Wednesday's in month—Obstetrical Clinics.
Friday, 8:00 a.m.—Surgical Clinic  (and alternate weeks)  Clinical Pathological Conference.
Regular Weekly Fixtures
Tuesday, 8:30 a.m.—Dermatology.
Wednesday, 10:45 a.m.—General Medicine.
Wednesday, 12:30 p.m.—Pataology.
Thursday, 10:30 a.m.—Psychiatry.
Friday, 8:30 a.m.—Chest Conference*
Friday, 1:15 p.m.—Surgery.
Tuesday, 9:00 a.m. to 10:00 a.m. (weekly)—Clinical Meeting.
B. C. Surgical Society Meeting Dates:
Spring Meeting,  March  30th-31st—Vancouver Hotel   (open  to  all members  of  the
Publishing and Business Office — 17 - 675 Davie Street, Vancouver, B.C.
Editorial Office — 203 Medical-Dental Building, Vancouver, B.C.
The Bulletin of the Vancouver Medical Association is published on the first of
each month.
Closing Date for articles is the 10th of the month preceding date of issue.
Manuscripts must be typewritten, double spaced and the original copy.
Reprints must be ordered within 15 days after the appearance of the article in question, direct from the Publisher. Quotations on request.
Closing Date for advertisements is the  10th of the month preceding date of issue.
Advertising Rates on Request.
Page 78 Return
At the time of life when so
many women are distraught by
menopausal symptoms, oral
Conestron therapy restores joy of
living and brings a feeling of
well-being that is a comfort
to all concerned.
.625 mg. and 1.25 mg. tablets
Bottles of 100 and 500
Total population — estimated 3 85,500
Chinese population — estimated—       6,877
Hindu   population  —   estimated  133
Total deaths   (by occurrence) 394
Chinese  deaths     17
Deaths,   residents  only 373
November, 1950
Rate per
1000 Pop.
(Includes  late  registrations)
November,  1950
Male    47 8
Female - 472
November,  1950
Deaths under 1 year of age \     13
Death rate per  1000 live births     19.3
Stillbirths   (not included in above item)       2
November, 1950
Cases Deaths
Scarlet Fever j  32
Diphtheria : ililsl
Diphtheria Carriers  —
Chicken Pox  3 8
Measles   9
Rubella |   12
Mumps  54
Whooping Cough  14
Typhoid  Fever -— —
Typhoid Fever Carriers -_  —
Undulant Fever  —
-Poliomyelitis ■        2
Tuberculosis  49
Erysipelas - :—k  2
Meningitis  3
Infectious  Jaundice  —
Salmonellosis  1
Salmonellosis Carriers  —
Dysentery j  15
Dysentery Carriers  —
Tetanus \  —
, Syphilis  -  20
Gonorrhoea  157
Cancer   (reportable)—Resident  121
November, 1949
Cases Deaths
19 —
Following an extended period of clinical trial there is now
generally available a modified Insulin preparation known as NPH
Insulin. The product is distributed as a buffered aqueous suspension
of  a  crystalline preparation  of Insulin,  protamine,  and  zinc.   It  is
supplied in 10-cc vials containing
either 40 or 80 units per cc.
NPH Insulin exerts a blood-
sugar-lowering effect extending for
slightly more than a 24-hour period.
In most instances this new preparation has been found to act more
quickly than Protamine Zinc Insulin
but for a shorter period. Probably
because of the fact that NPH
Insulin is a suspension of crystals,
its use has been found advantageous
in cases where it is desired to administer Insulin and a modified form of Insulin in a single injection without
appreciable alteration of the effect of either of the two preparations.
□ .  .if   ■ '
University of Toronto Toronto 4, Canada
Established in 1914 for Public Service through Medical Research and
the development of Products for Prevention or Treatment of Disease.
Crystals   formed   of  Insulin,   protamine   and   zinc
in  NPH  Insulin
Recently, as most of us know, the M. S. A. has altered its plan of payment of
accounts, and is paying 90 % of the account, instead of from 75 to 80 % as formerly.
The various approved medical plans, B. C. Telephone, C. U. & C. Vancouver
and B. C. Schoolteachers' Association and others, have been asked to do the same thing,
and the whole matter was discussed at a meeting with members of Council and of the
Economics Committee of the Council.
A great deal of frank discussion took place. The representatives of the various
plans, with one accord, stated that while they were anxious to do all they could to
meet the demands of the medical profession, they could not, at present at any rate,
see their way to do so without very grave risk of losing their membership. One or two
of the plans stated bluntly that any attempt on their part to increase fees to meet
this extra call would mean that they would have to suspend operations.
We feel that these approved plans fill a very important part in our medical economy,
and that if possible we must help them to survive and prosper. These are some of
our reasons:
We, as a profession, have been declaring for years that we want to see voluntary
prepaid plans of medical care grow and increase. We have been seeking ways to enlarge
the application of M. S. A.
These plans, apart from the M.S.A., serve some 32,000 people throughout the
province—not merely in Vancouver or Victoria but in every small town and rural area.
They include in their membership people of small income—telephone operators,
school teachers, many with families, employees of the government, C. U. & C. members
and so on.
They give to them, not as complete a coverage as does the M. S. A., but nevertheless a very good coverage. They provide in addition to medical and surgical care,
specialists' care, X-rays, laboratory tests, etc. These are all things that these people
should have, but are also things that most of them could never afford, and would
not pay for. Operations of major nature, to these people, are catastrophic. They put
them off and avoid them as long as they can.
These plans encourage people to go early to their doctor. Thus they are doing
valuable preventive work, helping people to avoid the consequences of delay.
They are the cause of very many people going to see a doctor, who would otherwise
not go—we all know that. If they did have to go, they would be incurring bills which
they know they cannot afford. Being honest working people they would in many
cases rather not go. ||pt
These plans, it has been proved again and again, increase our volume of work
in this wage-level tremendously. We could not hope to apply any but the minimum
scale to at least 90-95% of them.
These plans pay promptly, and with hardly any question. The people who run
them do so with no remuneration of any kind, and give largely and generously of their
own time to make them a success.
They charge a discount, which does two things. It pays them operating expenses,
provides a small margin, very small, for emergencies, and it enables them to fix a fee
which their membership can afford. That the discount does not provide much of a
backlog, if any, is shown by the fact that many of these plans have a provision for
levies in case of emergency. Most of them, we understand, are living almost entirely
up to their income.
They are non-profit making, have practically no reserve, and their membership depends upon the ability of members to meet the fee charged. The discount they pay
must be regarded not as a discount at all, but as an operating charge.
Page 80 All of us, every day, have to pay a collection charge on the money we collect,
after we have earned it. We must send bills, often a great many times. We often have
to reduce charges to settle the bill. We often have to send a bill for collection, the
charges for which amount to from 3 3 ^3 to 50%. This does not improve our relations
with our patients, and frequently means friction and unpleasantness.
Those of us who have been in practice for twenty to thirty years or more, will,
we think, agree that a 20% to 25% cost of collection is not unreasonable, and we
doubt if the average medical man can do it for much less even now.
Under the operation of these plans, we have received, over the years, many
hundreds of thousands of dollars—promptly, with little or no bookkeeping—no bad
debts, no delay. We have had work which we should not have had otherwise. We
have avoided friction, bad feeling, resentment on the part of patients who cannot pay.
We believe that to the great majority of medical practitioners, these plans have
been a godsend and most welcome. We believe that they have meant a lot of actual
cash to us.
They are a very good piece of public relations and we should consider this aspect
of the question very carefully. There should be something more than a mere cash
relationship for work done between ourselves and the public we work for. We need to
show them our sincere desire to do all that we can, in fairness to ourselves, to mitigate
their burdens and to resolve some of their difficulties. If we support these plans, and
give them our whole-hearted backing, we thereby create good feeling and a kindly
relationship between them and ourselves.
For us to allow these plans to collapse would be. a very bad piece of public relations.
We must not put ourselves in a position where it could be said that rather than relinquish our pound of flesh, we are willing to lose all that has been gained in the way
of tremendous unselfish effort through the years—that all we are considering is our
own pocket, not the good and the friendship of those whom we claim to serve.
For us to allow these plans to collapse would be giving the lie to our own arguments and pretensions in favour of voluntary prepaid plans. It would be forcing
people back into the arms of those who advocate compulsory, state-controlled health
insurance.  Let us make no mistake, this would be the result.
On the other hand, if we will do all we can to help these plans to operate, will
cooperate with them, make necessary adjustments, help them to institute economies,
and the like, we may perhaps not get all that we should like, but we shall be doing
good public service, aiding the cause of early and complete medical care. We believe
that those responsible for the administration of these plans, will, if "they are shown
the justice of any request, do all that they can to meet it—they have always shown
their willingness to do so.
These plans, too, are of especial value as guides in our negotiations with government in the matter of the care of the indigent. They give us figures of cost which
can be of great help to us. If they succeed, we have a standard on which we may
rely. If they fail, then even the scale on which they are asked to pay is evidently more
than a large section of the working population can afford to pay. How then could
we expect the indigent and pensioner's scheme to pay as much?
Medical practice, like all other human enterprise, tends to have elevations and
depressions. For some years we have been riding on the wave of general prosperity
and rising incomes; collections have been good, and we, being human, would like them
to be even better. But we cannot count on this being always the way—and the time
may come, as it has come in the past, when we should be very glad of all these prepaid plans from the M. S. A. down. So let us take good care of our various geese who,
month by month, lay us golden eggs—even if they are not quite as large as we should
And let us never forget the immortal words of David Harum: "Mebbe it ain't a
bad idee to let the other feller make a dollar oncet in a while."
Page 81 ®; I
Monday, Wednesday and Friday 9:00 a.m.-9:30 p.m.
Tuesday and Thursday 9:00 a.m.-5:00 p.m.
Saturday   - 9:00 a.m.-l:00 p.m.
The following is a letter of thanks and appreciation sent to the C. S. Williams
Clinic of Trail, B.C., for their recent donation to the Library:
October 30th, 1950.
Dr. M. R. Basted,
C. S. Williams Clinic,
901 Helena Street,
Trail, B.C.
Dear Doctor Basted:
On behalf of the Library Committee and members of the Association, I would
like you to convey to members of the C. S. Williams Clinic, their sincere thanks for
the recent gift to the Library of $100.00.
At the recent meeting of the Library Committee we agreed to assign the money
to the Historical and Ultra-Scientific Fund, which as the name implies is for the purchase
of books of historical value and on the history of medicine.
We are glad to know of the interest shown in the Library by members of the Clinic.
Sincerely yours,
(sgd) A. F. Hardyment, M.D.,
Secretary, Library. Committee.
VARICOSE VEINS, by R.  Rowden Foote, Buterworth,   1949, pp.  226, illustrated.
Mr. Rowden Foote of London has written a rather remarkable book on a disease
which afflicts 10 % of our population, thrives on our orthograde position and is enhanced
by a defect in the genes. His historical account of this ugly and disabling condition is
a saga of the failures of great historical figures to find a therapeutic solution for this
disorder. Because varicose veins and their complications are not lethal and because their
treatment is unspectacular, tedius and unrewarding success has long been delayed.
This concise book contains all the current information on varicose veins and their
complications. It includes the pathogenesis, classification, abnormal anatomy and physiology and a detailed account of the investigation and treatment of this condition.
Although the study is thorough and exhaustive one has the impression that the
book is brief. This is due, no doubt, to the unusually lucid and pleasing presentation,
the generous number of excellent illustrations, the frequent quotations and to some
extent at least to the brightly handsome binding.
It is difficult not to be genuinely enthusiastic about this addition to our library.
Re:   NEW Physician's Notice of Birth Form
Dear Doctor:
Effective February 1st, 1951, this province is bringing into use a revised
"Physician's Notice of a Live Birth or Stillbirth", a copy of which is attached. This
revision has been made to enable the compilation and analysis of certain facts relative
to Births in British Columbia. The new report form has been drawn up with the
help and advice of a special committee of medical men headed by Dr. Donald Paterson,
and each item has been carefully studied for its utility and availability before being
included in the form. As a clarification of the new points that have been added to the
form an explanatory letter written by Dr. Paterson is enclosed. To assist in completing
the form a check-off system has been used wherever possible, the typewriter spacing
has been maintained throughout.
The revised notification forms are available upon request from the local District
Registrar of Births, Deaths and Marriages. Supplies are also being forwarded to all
.We trust that you will find the new form entirely satisfactory, and that the
data which will become available through its use will prove valuable to the medical
Yours very truly,
J. H. Doughty,
What brought about the alterations in the Physician's Notice of a Live Birth
or Stillbirth Card?
The infant mortality of British Columbia during the last quarter century has
been the most favourable of any of the Provinces of Canada and during the same
period our infant mortality rate has been reduced by over fifty percent. In 1922, 68
of every 1,000 children born alive failed to survive the first year of life, whereas in
1949, fewer than 30 of every 1,000 born alive died before reaching the age of one year.
Proud as we may justifiably be of this record, the loss in infancy of 30 of every
1,000 children born and the crippling of many more still represents a shocking
wastage and impairment of lives which calls for renewed effort on the part of the
medical profession. The recent Survey of Crippling Diseases of Children has brought
forcibly to our attention the fact that some of the crippling diseases which occurred at
birth were not brought to the attention of the medical profession for some months
or even years. The great improvement noted above has resulted mainly from our attack
on the more glaring and tangible causative factors, but in order to effect further
gains it now becomes imperative that we discover the additional underlying factors
which continue to take their toll. This can only be done by painstaking study and
analysis of the conditions associated with the pre-natal, natal, and post-natal experience
of all children currently being born in this Province.
The Division of Vital Statistics of the Provincial Department of Health and Welfare has agreed to undertake the massive statistical job that is required in this next
phase of our attack on infant mortality and crippling conditions. To this end the
Physician's Notice of Birth Card has been modified to obtain the important data needed,
while still serving its statutory function under the Vital Statistics Act.
Composition of Advisory Body
Requests for statistics of the type now proposed have been frequently received
by the Division of Vital statistics in recent years,  and hence in July,   1949, I was
Page 83  asked as chairman of the Sub-committee on Crippling Diseases of Children to call
representatives of those Doctors mainly concerned with newborn babies and seek their
advice on the nature of the information to be sought.
The group consulted consisted of Obstetricians, Pediatricians and representatives
of Public Health, and were as follows: Dr. Alec Agnew and Dr. Reginald Wilson,
Vancouver General Hospital; Dr. F. S. Hobbs and Dr. A. F. Hardyment, Grace
Hospital: Dr. E. B. Trowbridge and Dr. Peter Spohn, St. Paul's Hospital; Dr. Stewart
Murray and Dr. A. M. Menzies, Metropolitan Health Committee.
The Card and its Description
You will note the card which was evolved as a result of long and careful discussion.
Going into details, many of the questions asked are self-explanatory but some
of them may require further elucidation. It was felt that the question "Was resuscitation necessary" would give us much information as to the correlation of difficult
resuscitation with birth injury and with both the anaesthetic and sedation used. The
question "Name of anaesthetic agent and sedation used" refers to regional anaesthesia,
general anaesthesia, as well as sedation such as morphine, hyoscine and barbiturates.
Under the heading "Describe complications of pregnancy or labour" is meant such
complications as pernicious vomiting of pregnancy, toxemia of pregnancy or acute
haemorrhage. Complications particularly of labour would be the use of forceps, version
or Caesarean Section. Under "Describe birth injury" one would note an external
injury such as bruising or trauma to any part of the body or fractures or nerve injury.
Where internal injury such as cerebral oedema or cerebral haemorrhage was suspected,
this would also be noted. Finally, under the description of ''Congenital malformations"
would be noted hare lip, cleft palate, spina bifida, club feet, mongolism and all the
many slight or gross malformations detectable at birth.
Statistical Advance
It is anticipated the Medical Profession will realize immediately the value of the
statistics compiled and will welcome this step forward. This will place at the disposal
of the profession in this Province desirable information which cannot now be obtained
anywhere in Canada.
Available for  Locums  until  July
2950 Philips, R.R. No. 8
New Westminster, B. C.
Phone GLenburn 0184-L
10 Y2 acres, 7l/z miles from Medical Dental Building, atop high
bench where privacy can't be spoiled. Ideal for estate. One
third almost clear with only light brush, balance large cedar,
fir hemlock. On road with light, water. Sell all or half. Buyer
could subdivide profitably if desired.
Owner, Don Tyrell, ALma 3061-L.
The Lister Oration—Victoria Medical Society, May Sth, 1950
Given by DR. H. H. MURPHY, Victoria
In any medical community the establishment of a memorial lecture marks a very
definite advanced plateau in professional thought and development. It signifies, as I
see it, a quickened tempo in appreciation of what has been handed on to us through
the life and work of the great masters of medicine. Our primary interest is of course
the application of scientific medicine to the needs of mankind—to the relief and cure
of disease—disease which has been defined as "the shadow of death that clouds the life
of man." When we establish an annual address of this type we are saying at the same
time that we are interested in how this knowledge came to us—what manner of men
these were who made possible our daily work, and that we have paused in the busy
round of everyday tasks to pay homage to them.
This forward step was taken by the Victoria Medical Society last year and the
Lister Oration was established. When I was invited to address you this year the title
was still the same although I was advised that I might choose my own subject. Although
the address last year was on Lord Lister I thought that, in the language of the book
of Ruth, I might still glean some corn after the reapers—and decided to speak to you
again this year on the times and on the work of this great man. As you know the title
has been broadened and in the current year is simply a memorial address.
You will recall how fortunate was the choice of the first speaker, Dr. H. E. Ride-
wood—the Dean of the profession of Medicine in Victoria. You will readily remember
how Dr. Ridewood linked up the life and the work of Lord Lister with the problem
of education today and with the need of hobbies in the life and training of thoughtful
men. Our attention was directed to the careful, painstaking and accurate research that
characterized the active life of Lord Lister and Dr. Ridewood reminded us that money
cannot purchase successful research unless the mind of the worker has been trained
and developed by thoughtful study and the power of reflection developed during the
formative years of childhood. To be invited to give the second of these addresses—to
be given the privilege of following Dr. Ridewood—is an honour which I deeply appreciate. I very humbly thank you for the confidence you have shown in me and for the
opportunity you have placed before me. I am very happy to be one of those who will
try to build a superstructure worthy of the foundation laid last year for us by our
first essayist.
In her recent delightful biography of Dr. Thomas Cullen of Baltimore, Judith
Robinson quotes from the second book of Maccabees the 15th chapter and the 38 th
verse: "And if I have done well and as is fitting the story, it is that which I have
desired: but if slenderly and meanly, it is that which I could attain unto."
As I speak to you this evening I hope you may remember that verse.
If we are to properly appraise a great man we must have some unit of measurement—some yardstick with which we can estimate his worth as against that of mankind in general. It is not easy to find or to formulate such a standard, but for this
evening I shall go back to the prophet Isaiah—Chapter 32, verse 2—'believed today
to have been written about 400 B.C. "And a man shall be as an hiding place from the
wind, and a covert from the tempest; as rivers of water in a dry place and as the
shadow of a great rock in a weary land." It is all of course cast in the imagery of the
desert and each simile used signifies that a man is great as his life is lived in relationship to his people and to his time. Man is here compared with those fundamental
necessities which made life in the desert possible—shelter from the storm; water for
the irrigation of crops and for the maintenance of life in man and beast and protection
from the desert sun. I would ask you this evening to combine this with the dictum
of Lord Brougham, "The true test of a great man—that at least which must secure
his place among the highest order of great men—is his having been in  advance of
Page 86 his age." In terms of these two definitions we shall consider this evening very briefly
the life, the times and the work of that great English surgeon, Lord Lister. I would
further remind you that in the sense in which we shall speak of "great" men the old
adage is incorrect—men are not born great—they become great through devotion to
an ideal and hard unremitting work—largely forgetting self in their work for mankind.
That we may have a1 definite sequence of thought in mind this evening I shall
summarize very briefly the important dates in the story. Lord Lister was born on
April 5th, 1827, at Upton in the county of Essex, England. This merits emphasis as'
there is a current fallacy that he was a Scotchman because as we shall see later he came
to London from Edinburgh. His father, as Dr. Ridewood told us last year, was a^wine
merchant but throughout his life was a student of science, an expert microscopist
whose studies won him membership in the Royal Society in 1834 when Joseph was
seven years old. The special subjects which interested Joseph Jackson Lister were the
blood and animal tissues—research work which had a very definite bearing on medicine.
This is worthy of note because from time to time there has been a tendency for us to
believe that a degree in medicine is a necessity if the worker's findings are to be applied
to medical problems. Fortunately, today the work of physicists, physiologists and chemists
is steadily disproving this narrow and false conception. That broadening influence was
seen in our own society quite recently when the Executive very wisely arranged for
Dr. Newton of the Experimental farm at Sidney to speak to us on plant hormones.
It was, I think, quite an important fact, that the Lister family belonged to the Society
of Friends. The Quaker faith, to use the term more commonly heard today—has been
a very powerful influence for good in the world since its birth in 1647 and perhaps
more than any other philosophy in the Western world sets an indelible stamp on its
followers. The Quaker faith is a branch of Christianity differing in many ways from
the prevailing type. Adherence to a definite creed is not demanded—there is no. liturgy,
priesthood or outward sacrament, and women have an equal place with men in the
church organization. It is a way of life rather than a philosophical doctrine. The
Quakers have always been opposed to war and have refused to take an oath in the
courts of law as they believe it creates a double standard of Truth. John Morley in
his life of Oliver Cromwell writes as follows: ^Mm
"When the Quakers entered history it was indeed high time, for the worst of
Puritanism was that in so many of its phases it dropped out the Sermon on the Mount.
Quakerism has undergone many, developments, but in all of them it has been the most
devout of all endeavours to turn Christianity into the religion of Christ."
As you know Friends refused, as a matter of conscience, to accept the thirty-nine
articles. This debarred them from the older universities and it militated against their
taking up law or medicine. They were naturally disqualified from taking orders, and as
they had what they termed their "Christian testimony against war" they were unable
to join the army or navy. They protested against what they called "vain sports and
places of diversion" so they did not attend theatres, did not dance, did not hunt, had
no music in their homes and so naturally they studied, very often some branch of
science, and combined this quite successfully with business. During the boyhood of
Joseph Lister the restrictions against Quakers were gradually being relaxed and by
the time he had finished private school, University College in London—the Godless
college as it was known for many years—had been opened. It was non-denominational
and so open to Friends. Lister secured his Bachelor of Arts degree in 1847 and five years
later in 1852 graduated in medicine and became a member of the Royal College of
Surgeons at the age of 25.
About this time James Syme (1799-1870)—his name is current today in association with a special amputation and an operation for external urethrotomy—was at
the height of his fame as Professor of Surgery in Edinburgh. Following the death of
Robert Liston (1794-1847), another Scottish professor at University' Hospital in
London, Syme, had gone there for a few months, but disliking conditions, had returned
to Edinburgh.  During his undergraduate course in medicine, Lister had been influenced
Page 87 by Graham, professor of chemistry, and Sharpey, professor of physiology, and now
these two men advised him to go to Syme's Clinic for six weeks. He went for six weeks
and remained in Scotland twenty-three years. He went to Edinburgh known as a good
student; he returned a famous man, and he returned with Syme's eldest daughter as
his wife—an exceptionally fortunate choice resulting in an unusually happy married
life. The years 1854-1860 were the junior years leading to his appointment as Professor
of Surgery at Glasgow. This post he filled with great distinction until 1869 when he
returned to Edinburgh as Professor of Surgery. He continued successful and happy in
Edinburgh until appointed Professor of Surgery in King's College, London, in 1877.
This position he filled until 1893 when he retired from the professorship as Emeritus
Professor of Clinical Surgery and consulting surgeon to the hospital. He was made a
baronet in 1883 and was elevated to the peerage in 1897. On this occasion, Dr. Weir
Mitchell, of Philadelphia, author, poet and physician, wrote in part as follows:
"Surely in all the great story of surgical progress, there has been no one man who
has given to his fellows a gift so great as that which came from your hand. It is a little
thing, a title, but if it represents to you the gratitude of the world, it acquires a larger
meaning than if it had been given even for service, however great, to your own country
alone. It—that which you did—was a thing so past comparison great and far reaching,
that, except as to our own gift of anaesthesia, there is nothing in medical annals with
which to compare it."
Lady Lister had died in 1893 and he survived, a lonely man, until 1912.
From this brief summary of outstanding dates in his career you will at once notice
that Lord Lister's life span covered a very interesting historical period. At his birth
the Napoleonic wars had ended with Waterloo only a few years before, and Britain
was entering upon her great period of Empire development—the industrial age was
dawning and changes as great as we are witnessing today were in the making, but
Lister's work for surgery and for mankind was still to be done. His lifetime was to see
great wars—the Crimean, the Franco-Prussian, the American Civil War, the South
African War, besides many minor ones—and his work was destined to save more lives
than were ever sacrificed in territorial conflicts. To bring his period more clearly home
to us here in. Canada it was to see the Union of Upper and Lower Canada and in 1867
Confederation was to bring British Columbia into the union. I might mention that
1867 was a very important year in Lister's life, and we can easily remember it not only
on account of Confederation but also because in this year our national organization
—The Canadian Medical Association—was founded.
Lister graduated in medicine, as mentioned before, in 1852. Ten years earlier, in
1842, ether had been first used as an anaesthetic—the microscope was in use but not
'much employed directly in medicine as yet. The Atlantic cable was not to be laid down
by the Great Eastern for many years. In 1843 Dr. Oliver Wendell Holmes published
his famous paper on the contagiousness of puerperal fever in the New England Quarterly
Journal of Medicine, and we might pause a moment to survey the state of obstetrics at
this time. In proving his point Dr. Holmes refers to a Dr. Gordon, of Aberdeen, who,
in 1795, published a treatise in which he stated: "This disease seized such women only
as were visited or delivered by a practitioner, or taken care of by a nurse who had
previously attended patients afflicted with the disease, -|ff . I had evident proofs that
every person who had been with a patient in the puerperal fever became charged with
an atmosphere of infection which was communicated to every pregnant woman who
happened to come within its sphere." And remember Pasteur and his founding of what
we know as Bacteriology was still fifty odd years in the future. Holmes then quotes
from some clinical" histories which seem pertinent in illustrating certain aspects of
medical and surgical practice of the period.
"Dr. Campbell, of Edinburgh"—Holmes writes—"states that in October, 1821,
he assisted at the post-mortem of a patient who had died of puerperal fever. He carried
the pelvic viscera in his -pocket to the classroom.. The Same evening he attended a
woman in labour without previously changing his clothes—the patient died.   The next
Page 88 morning he delivered a woman with forceps—she died also, and of many others who
were seized with the same disease within a few weeks, three shared the same fate in
succession." mm
When you have finished his paper—about 30 pages—you feel that further proof
should not have been required in any country. I think you will find his conclusions
pertinent even today.
1. A physician holding himself in readiness to attend cases of midwifery should never
take any active part in the post-mortem examination of cases of puerperal fever.
2. If a physician is present at such autopsies he should use thorough ablution, change
in every article of dress, and allow twenty-four hours or more to elapse before
attending to any case of midwifery. It may be well to extend the same caution
to cases of simple peritonitis.
3. Similar precautions should be taken after the autopsy or surgical treatment of
^P^erysipelas^if^the.physician is obliged to unite such offices with his obstetrical duties,
S^|fcwiiicli:-is»in? the highest degree inexpedient.
4. On the occurrence of a single case of puerperal fever in his practice the physician
is bound to consider the next female he attends in labour, unless some weeks have
elapsed, as in danger of being infected by him, and it is his duty to take every
precaution to diminish her risk.
5. If within a short period two cases of puerperal fever happen close to each other,
in the practice of the same physician, the disease not existing or prevailing in the
neighbourhood, he would do well to relinquish his obstetrical practice for at least
a month, and endeavour to free himself by every available means from any noxious
influence he may carry about him.
6. The occurrence of  three or more closely connected cases in the practice of one1
individual, no others existing in the neighbourhood, and no other cause being alleged
for the coincidence, is prima facie evidence that he is the vehicle of contagion.
7. It is the duty of the physician to take every precaution that the disease shall not be
introduced by nurses or other assistants, by making proper inquiries concerning them,
giving timely warning of every suspected source of danger.
8. Whatever indulgence may be granted to those who have hitherto been the ignorant
cause of so much misery, the time has come when a private pestilence in the sphere
of a single physician should be looked upon, not as a misfortune, but as a crime;
and in the knowledge of such occurrences the duty of the practitioner to his profession should give way to his paramount obligation to society.
And yet so little was known at that time in one country of what happened in
another that Ignaz Phillip Semmelweiss (1818-1865) a Hungarian physician practicing
in the great maternity hospital in Vienna where 7,000 women were delivered annually—
was struggling in the dark about puerperal fever. Some thought it was a fever like
smallpox—some that it was associated with erysipelas—some attributed it to undue
modesty on the part of patients associated with their examination by students. This
question of students brings up another interesting point. In the institution there were
two divisions—one in which the cases were attended by midwives where the mortality
from puerperal fever was 3.8%. The other division was designed for teaching purposes.
The labour room adjoined the autopsy room so that if students were engaged in a
post-mortem they could at once hurry into the case room—should occasion demand.
Here the mortality was 9.92% and at times as high as 25-30%. Today the conclusion,
even without bacteriology would seem obvious. However, Sammelweiss wrote at this
time:     /
i|i "All this reduced me to such an unhappy frame of mind as to make life unenviable.
Everywhere questions arose: everything remained without explanation. All was doubt
and difficulty.   Only the great number of the dead was an undoubted reality."
Page 89 When his friend, Kolletscha, died from a wound received in the course of an
autopsy on a case of puerperal fever, he recognized that the symptoms were the same
as those of puerperal fever. His theory was that infection came from some material in
the dead body and he reduced the mortality in the students' section by insisting on
disinfection of their hands in chlorine water—or chlorinated lime. In spite of the very
obvious results from his innovations all his ideas were bitterly opposed by the medical
profession of Vienna. He had some supporters, however, and their names have come
down to us today—Rokitanski (1804-1878), the pathologist, Skoda, the physician
(1805-1881); Hebra, the dermatologist (1816-1880). Semmelweiss was not the
prudent, cautious, self-controlled man that Lister was—he had solved the problem
and knew he had done so, but when his results were not accepted readily he became
discouraged and returned to Budapest where he became insane. He died in Vienna in 1865.
And yet when Lister visited Vienna in 1856 he did not even hear of Semmelweiss or
of his work. Remember also that in 1861 Semmelweiss published his great book and
closed it with these words.
"When I, with my present convictions, look back upon the past, I can only dispel
the sadness which falls upon me by gazing at the same time into that happy future,
when within the lying-in hospitals, and also outside of them throughout the world,
only cases of self-infection will occur. . . . But if it is not vouchsafed to me to look
upon that happy time with my own eyes, from which misfortune may God preserve
me—the conviction that such a time must inevitably arrive sooner or later after I
have passed away will cheer my dying hour."
In 1904 a teacher from Budapest stated that Lord Lister had said "Without Semmelweiss my labour would have been in vain—modern surgery owes much to this
son of Hungary." Later when questioned on this point Lord Lister made the following
statement: "Although it is extremely distasteful to me to speak of the question of my
priority, I cannot but answer the question you ask in your most kind letter. When in
1865 I first applied the antiseptic principle to wounds, I had not heard the name of
Semmelweiss, and knew nothing of his work. Even twenty years later when I visited
Buda Pesth, where I was received with extraordinary kindness by the medical profession
and by the students, Semmelweiss' name was never mentioned, having been as it seems,
entirely forgotten in his native city as in the world at large. It was some time after this
that my attention was drawn to Semmelweiss and his work by Dr. Duka, a Hungarian
physician practicing in London. I need hardly add that I never pronounced the sentence
you quote. But while Semmelweiss had no influence on my work, I greatly admire his
labours and rejoice that his memory will at length be duly honoured."
How this qpuld be forgotten is explained by Sir Watson Cheyne in the following
words: ". . . it must be attributed to . . . that self-satisfied inertia of mind which
makes men cling to routine, think their own opinions final, and distrust what is novel."
The well known longevity of error and its perpetuation by restatement is my reason
for mentioning this incident this evening. In a fictional biography of Semmelweiss
—written by Morton Thompson under the title of "The Cry and the Covenant" in
1949—this story is given a new lease of life on the dust cover.
Now let us pass on briefly to see how Surgery was practiced at the" time Mr. Lister
qualified. Some present here this evening may recall the painting of Sir William
Ferguson (who was described as "the leading operator in London for many years")
which hung for many years in the Royal College of Surgeons and may still be in existence.
The artist was Lehmann and engravings of it hung in the consulting room of many a
London practitioner. Sir William was Professor of Surgery at King's College until
his death in 1877 and was succeeded by Lord Lister. In the painting he is depicted
standing by a table dressed in a frock coat, the cuffs of which are rolled up, and on the
table covered with a glass bowl is a scapula which he had removed—the scapula was a
tribute to his skill and the turned-back cuffs on the coat showed that he was ready
to begin operating—no other preparation would be necessary—he would wash his hands
after the operation was over. It was, of course, unnecessary before, as surgery was a
Page 90 dirty business. This type of operative garb was confirmed for me many years ago by my
chief in surgery in Philadelphia, Dr. Neilson. As a novice in surgery he recalled the
pre-Listerian days and often spoke of the great names, such as Gross and Agnew, of
Philadelphia and Sayre of New York. He told me, and I found it difficult to accept
it all at its face value then, that the surgeon wore the same frock coat at all operations,
and the greater and more famous the surgeon the more the coat was caked with dried
pus and blood from many surgical baptisms. By the time the surgeon had really arrived
his coat bore witness to his prowess—he did not have to hang it up—he stood it in the
corner—which at once distinguished it from the coats of younger surgical aspirants. Of,
course, Philadelphia had been the seat of English government and many English customs
still prevail there—but all authorities assure us that conditions were much worse on the
continent. Incidentally the assistant also wore a frock coat of more recent vintage and
from a button hole hung the wax whipcord which would be used for ligatures to tie
the arteries—James Syme would never tie a vein.
In all countries the table and instruments used for an autopsy today on a case
of puerperal fever or erysipelas would serve equally well tomorrow for an amputation.
Sea sponges were used to mop up pus and were held in a pewter basin which would later
hold the dressings for use at the completion of the operation. The sponges were rinsed
out of cold water—perhaps soaked in water for a couple of hours and were ready for use
again. Curiously enough we are told that the cataract operations were often successful
and escaped infection. This is now attributed to the fact that the instrument maker
was always present at such operations with a freshly ground knife.
Before leaving this aspect of the subject a little story of the time may interest you.
Sir Astley Cooper—the greatest English surgeon of his day (1768-1841) was called
to remove a wen from the scalp of George Fourth. He was, of course, anxious that
infection would not develop, and when suddenly called to see the royal patient the
next day he went in fear of what he would find. He thought the king viewed him
with disfavour and on his return home he asked his nephew if there was anything
wrong with his appearance. The nephew replied that he would have put on a clean
shirt and washed his hands before waiting on the king. Sir Astley looked at his hands
and shirt all spotted with blood and replied: ""God bless me I ought, but I was not
aware of it: and the king is so very particular."
When I say as others have said so often before me that septic diseases were "rife"
in all hospitals I must give you some definite idea of what this short word means in
this connection. What was known as a "good old surgical stink" prevailed • in all
surgical wards. From time to time surgical wards were closed entirely in the hope that
the pestilence might die out. Many in England, Germany and Austria advocated that
general hospitals should be burned and rebuilt as a means of controlling sepsis. Sir James
Young Simpson, of Edinburgh, the great Scottish obstetrician (1811-1870), advocated
small iron huts which would house two surgical cases to be built in the country
as it was known that infections of this type were much more uncommon there than
in the large city hospitals. Indeed, it was Sir James who first used the term "hospital
diseases" to cover the prevalent septic type. Is it to be wondered at that von Helmont
(1577-1644) ptayed:
"O' merciful God, how long wilt Thou be angry with men, that Thou hast not
revealed one truth to Thy students in healing? Is this Moloch sacrifice pleasing to
Thee, and wilt Thou that the lives of the poor, of widows and of children, be continually
offered up unto Thee, in miserable torments of incurable diseases or through the
carelessness and ignorance of physicians."
Many believed that the pestilence spread up from one floor of a hospital to that
above and hence came the pavilion type of hospital as we still see today in the older
parts of the Royal Jubilee Hospital. In this connection the following story was told
to me many years ago and I like to think that it is true. When this idea of a pavilion
type of hospital as the preventative of sepsis was accepted the Widal Clinic was built
in Paris on this plan. Many years later—long after Pasteur and Lister had demonstrated
Page 91 the fallacy of this theory a new hospital was to be built in San Francisco and the Paris
pavilion type was copied and again from San Francisco the newest idea in hospital
construction was brought to Victoria. So does error continue to influence the world
long after its falsity has been known to those who are capable of judgment in the matter.
To return to our thesis it is natural when you consider the prevailing conditions
that everywhere in Europe physicians and surgeons were groping blindly for an explanation and drifting into a state of depressed fatalism as described by Sir Hector Cameron
—the surgeon who had done his work well felt when his patients died of sepsis that he
was a man "beset by misfortune" so that Velpeau (French surgeon, 1795-1867) could
write "a pin prick is a door open unto death. That door widened before the smallest
operation; the lancing of an abscess or whitloe had such serious consequences that
surgeons hesitated before the slightest use of the bistoury." Von Volkman (1830-1839)
said when he closed a wound that he was "like a husbandman who, having sown his
field, waits with resignation for what the harvest may bring, and reaps it, fully conscious
of his own impotence against the elemental powers which may pour down upon him
rain, hurricane and hailstorm."
When Lister went to Glasgow he found sepsis in control there as elsewhere—even
in the new surgical hospital. You will be interested in the fact that four feet from
Lister's accident ward in the basement were the cholera pits where those who had died
in the cholera epidemic of 1849 had been buried. "The uppermost tier of the multitude
of coffins reached within a few inches of the surface of the ground and adjoining tne
grounds of that Infirmary were the pits where the paupers were buried.
Statistics available to this day confirm all this. Mr. Erichsen (1816-1896) reported
mortality in the University Hospital—London—was 25%; in the Edinburgh Infirmary
43%; Glasgow Infirmary 39.1%; Pennsylvania Hospital, Philadelphia, 24.3%; Massachusetts General, Boston, 26%; Parisian hospitals, 60%; Bilroth, Zurich, 46% (1829-
1894), and in military practice, 75-90%.
Spencer Wells (English gynaecologist, 1818-1897) and Keith had been performing
ovariotomies with a mortality of 30% at King's College when Lister went there in
1869—four years after Lister had announced the antiseptic treatment of wounds and
had made this type of operation in Edinburgh in his hands practically comparable
to our results today. The governors at King's had prohibited the operation being done
by any surgeon on account of the mortality, a degree of outside control of the medical
profession which I am sure would gladden the hearts of some of those who would like
to make over the world more nearly to. their own specifications. That 60% mortality
figure which I just mentioned for Parisian hospitals explains the remark of an ancient
French author to the effect that "A young surgeon who is bred in the Hotel Dieu
may learn the various forms of incision, operations, too, and the manner of dressing
wounds; but the way of curing wounds he cannot learn. Every patient he takes in
hand—do what you will—must die of gangrene."
Erysipelas of a sporadic type we still see from time to time and the occasional case
of septicaemia is also still an occasional problem, but pyaemia is practically never seen,
and hospital gangrene is non-existent—at least I have never seen a case. You will be
interested in Lister's own description of it, as he knew it and as he banished it from
the hospitals of the world:
"One variety is where the disease advances with frightful rapidity; hence the
affected part becomes brown and black but the blackness is not the same as ordinary
gangrene but brownish black. It may be that the inflammation in the vicinity is so
great as to cause ordinary gangrene when the blackness will be of a purplish color. But
-hospital gangrene may be extremely languid and then the color instead of being brownish
black is pale gray—such a color as is produced by caustics on granulation tissue or as
is seen in a 'weak' ulcer. There may be no pain and nothing characteristic of hospital
gangrene except that as you watch it, you find the gray surface steadily increasing in
size, and if it be scraped away it is found to consist of a layer of slough one-eighth of
an inch or more in thickness.   Between these two extremes—the weak form with pus
Page 92 formation but no pain or inflammatory blush and the worst form with pain, redness
and constitutional disturbances—there are all sorts of degrees. The constitutional
disturbance consists of elevation of pulse, loss of appetite and generally the symptoms
of depression."
In one of his articles, Sir Hector Cameron recalls Lister's distress over the state of
surgery and his inability to accept it with the resignation of contemporary surgeons.
Quite clearly Lister had that gift which Cicero referred to when he wrote "Instead
of striving, as we ought, to render ourselves strange to the familiar, we strive, on the
contrary, to render ourselves familiar to the strange."
At the meeting of The British Medical Association in Dublin in 1867 Lister spoke
in part as follows:
"In the course of an extended investigation into the nature of inflammation and
the healthy and morbid conditions of the blood in relation to it, I arrived several years
ago at the conclusion that the essential cause of suppuration in wounds is decomposition
brought about by the atmosphere upon blood or serum retained within them; and in
the case of contused wounds upon portions of tissue destroyed by the violence of the
injury. To prevent the occurrence of suppuration, with all its attendant risks, was an
object manifestly desirable but till lately, apparently unattainable, since it seemed
hopeless to exclude the oxygen which was universally regarded as the agent by which
putrefaction was affected. But when it had been shown by the researches of Pasteur
that the septic properties of the atmosphere depended not on oxygen or any gaseous
constituent but on minute organisms suspended in it, which owed their energy to their
vitality, it occurred to me that decomposition in the injured part might be avoided
without excluding the air by applying as a dressing some material capable of destroying
the life of the floating particles."
Antiseptics actually date back to the Egyptians, but in that civilization they
served the dead rather than the living. In the preparation of the important dead
cassia, frankincense and myrrh were used. The word as we know it dates back to about
1750 and- the drugs used were compound tincture of benzoin, alcohol—oiland wine as
in Biblical times—glycerin, chlorine and its compounds, chloride of zinc and tincture
of iodine after its discovery in 1811. Lister had watched superficial wounds in the
human heal under a scab and he knew that in animals large wounds may heal in this
manner, so in all his earliest efforts he was very conscious of attempting to secure
a satisfactory scab. He turned to one of the newly discovered products of coal tar—
oarbolic acid—first prepared in 1834. Now Pasteur had taught Lister that putrefactive
change is similar to fermentation and is due to microscopical organisms. Lister at once
realized that to be effective, antiseptics should be applied as a preventative of putrefactive change and not reserved until infection had developed. Lister learned
of carbolic from his colleague, Dr. Anderson, Professor of Chemistry in Glasgow, and
he began his work with a very crude preparation known as German creosote, which had
come into use about 1840 as a preservative of wood. Lister had heard of its use in the
purification of sewerage in Carlisle—that its use there had destroyed the odour from
the effluent and that cattle feeding on the pastures treated with this effluent no longer
developed infection with entozoa. He had tried simple cleanliness and in all his work
he continually stressed it—he had seen to proper ventilation of his wards and had tried
to prevent overcrowding, but still sepsis continued. He knew that simple fractures
healed without sepsis, but not so compound fractures. At this time Syme had reached
the conclusion that it might be better to amputate all cases having compound fracture
rather than try to save the leg or arm. Lister also knew (John Hunter knew it, 1728-
1793) that penetrating wounds of the lung did not necessarily suppurate, so he was
sceptical of the theory that suppuration was due to the oxygen in the air.
In 1865 Lister treated his first successful compound fracture of the femur with
carbolic acid and he dressed it in this manner: The wound was swabbed out with
undiluted crude carbolic acid with a piece of lint held in forceps and a piece of lint
large enough to lap the wound for a least half an inch in every direction was soaked
Page 93 in undiluted acid and applied. This was covered with a piece of block tin or lead to
prevent the evaporation of the carbolic. The dressing was held in place with plaster and
the whole covered with another dressing to absorb the discharges. From day to day
further coatings were made under the metallic shield. The disadvantages of this
dressing were soon evident—the inevitable sloughing from the acid. Lister was, however,
encouraged by his first success and soon secured a purer form of carbolic—soluble 1-20
in water and to almost any extent in oil, and he found that the acid evaporated more
slowly from the oily solution. The next development was the carbolic paste or putty
which consisted of ordinary whitening (carbonate of lime) and a solution of carbolic
one-quarter or one-sixth. This putty was spread about one-quarter of an inch thick
on block tin and Sir Rickman Godlee, Lister's nephew, says in the official biography that
it looked like a poultice. This putty dressing could be as large as desired so that the
discharge could be made to travel quite a distance without allowing air to enter and
contaminate the wound. From the time of Ambrose Pare (1509-1590) ligatures had
been left long enough to hang out of the wound. They were supposed to provide
drainage and later would slough off with, of course, all the attending danger of secondary
haemorrhage. To quote further from Lister's address at the Dublin meeting:
"If the severest forms of contused and lacerated wounds heal thus kindly under
the antiseptic system, it is obvious that its application to simple incised wounds must
be merely a matter of detail. I have devoted a great deal of attention to this class, but
I have not, as yet, pleased myself altogether with any of the methods I have employed.
I am, however, prepared to go so far as to say that a solution of carbolic acid—one
part in twenty parts of water—while a mild and cleanly application, may be relied upon
for destroying any septic germs that may fall upon the wound during the performance
of an operation; and also that for preventing the subsequent introduction of others, the
paste above described, applied as for compound fractures, gives excellent results. . . .
Further, I have found that when the antiseptic treatment is efficiently conducted,
ligatures may safely be cut short and left to be disposed of by absorption or otherwise."
The full details of the fascinating work he did experimentally on animals in
developing his carbolized silk ligature and later his absorbable catgut ligature you will
find in detail in Godlee's life. In 1871 he introduced his carbolic spray—first a hand
spray, then a complicated spray worked by a lever, and then a steam spray. It was
then that the surgeon, as well as the patient, began to show evidence of carbolic acid
poisoning. After a long operation, the surgeon's fingers would be quite white (rubber
gloves were not to come until Halstead, of Baltimore, 1852, added his quota to our
glorious inheritance) and the patients showed carboluria and vomiting from inhalation
of the spray. From now on, other workers began to contribute. In 1883, Metchnikoff
(1845-1916), the Russian physiologist, announced his work on phagocytosis. This was
at once accepted by Lister, and in 1887 Lister abandoned the spray as he was convinced
of the defensive powers of the body and of the comparative absence of pathogenic
germs in the atmosphere. ||||
I have just referred to the readiness with which Lister accepted new ideas which
were adequately documented. Perhaps we might now turn to see how his new system
of operative surgery was received—for it was a new conception of the cause and prevention of sepsis—it was not just a new type of surgical dressing. The younger men, trained
under Lister, were at once impressed with his accuracy, knowledge, sincerity, love of
truth, devotion to his work and by the results he obtained. Not so the older men.
In Edinburgh, Sir James Young Simpson was his bitter opponent. Sir William Osier
(1849-1919), in his delightful essay on Captain Thomas Dover, gives a vivid picture
of this man of the Elizabethan period who combined the roles of physician and
buccaneer. As a physician he gave us the powder that bears his name to this day—
Dover's powder—and as a pirate, he discovered Robinson Crusoe on the Island of Juan
Fernandez. Sir William closes his essay with these words: "A good fighter, a good hater,
as also so many physicians have been."  And Lister was to learn the truth of this dictum.
rfr:| Page 94 Sir James had throughout most of his life carried on a vendetta with James Syme
and it would seem as if he welcomed the opportunity to carry the war into the second
generation by attacking Lister's antiseptic method. Simpson began by making disparaging remarks at the Dublin meeting and soon an anonymous letter was circulated about
Edinburgh stating that Lemaire and others on the Continent had used carbolic before
Lister. Of course, Lister never claimed priority in the.use of carbolic as an antiseptic,
but nevertheless this anonymous letter was reprinted in the Lancet. This, of course,
was not during the active period of the founder of the Lancet, Thomas Wakley (1795-
1862). His son was now the editor, but certainly something of the founder's editorial
policy and principles still influence this journal. Before the appointment to King's
was confirmed, the Lancet pontificated as follows:
"In many quarters Mr. Lister has acquired a reputation of a thoughtful, painstaking
surgeon and has done some service to surgery by insisting on the importance of cleanliness
in the treatment of wounds, although this has been done by the glorification of an idea
which is neither original nor universally accepted."
Later, however, the Lancet, too, became Lister's enthusiastic supporter. Lister's
ideas and results were attacked by prominent surgeons in medical meetings and in the
journals, and as we read these effusions today we realize that these men had never really
grasped the fundamental basis of Lister's work nor had they perfected themselves in his
technique. Not so, however, on the Continent. In Germany, Richard Volkmann (1830-
1899) was probably the outstanding surgeon and in the year that Lister announced his
work, Volkmann succeeded Blastius (1802-1876) in the chair of surgery at Halle.
The hospital there was old and unsanitary; even the minor operative cases died, and
for three months in each year the surgical wards were closed in a vain attempt to stay
the pestilence. Volkman had served in the Prussian-Austrian War in 1868 and had
improved his results with what was known as the open method. Under this technique
—if you may apply such exact terminology to such a hit-and-miss procedure—the
wound was left widely open, a piece of lint was placed a little distance off to keep
away the flies and a pillow beneath to catch the discharge. When Volkmann returned
home he found conditions exceptionally bad and considered closing the hospital completely, but before doing so, decided to try the Listerian method. In the winter of
1871-1872 he went to Edinburgh and personally mastered the details of the treatment
and then sent one of his assistants to do likewise. He said that his basis for doing so was
"with the settled opinion that it was a question of a few weeks only of fruitless experiment and he did it from the point of view of a laborious but unavoidable duty." The
results seemed like magic—it was as if an evil spirit had been exorcised. Lister had no
more enthusiastic follower and disciple, and in 1874 at the Third Congress of German
Surgeons he said: "There is no luck in surgery, as Pirogoff (1810-1881) says there is.
There are no privileged surgeons, who always hold good cards. Knowledge and ability
are the only factors that command success. For every case of pyaemia; for every case
of erysipelas; for every death from diffuse suppuration, the surgeon himself is
The next convert was Johann von Nussbaum (1829-1890) who had said of hospital
gangrene that "it gnawed at every wound like a wild beast." He became one of the
champions of the new method, and when deaths due to other causes were blamed on
Lister's method, he made this wise remark: "Naturally antiseptics do not confer
immortality." ||||
Ernst von Bergmann (1836-1907) soon accepted Lister's teaching and in addition,
noted a suggestion that Lister had made, to the effect that.the antiseptic system might
be superseded by the aseptic—as proved to be true. This was the same Professor
Bergmann who was to cross swords with Sir Morell Mackenzie over the malignancy
of the larnyx of the Crown Prince of Germany in 1886—probably the most internationally discussed medical case in history and one which probably altered the whole
course of European history from that date onwards.
Page 95 Soon many famous names were added to the growing list—Esmarch, of Kiel
(1823-1908; Konig of Gottingen (1832-1910); Trendelenburg, of Bonn (1844-1925),
and then surgeons of St. Petersburg, Copenhagen and Amsterdam. When Kocher
(1841-1917) was called to Berne he wrote to Lister asking for a full account of the
antiseptic system, gave it a fair trial and, like other Continental surgeons, soon passed
on to the aseptic method. The irony of the situation was that Lister's methods were
quickly accepted in England when they came back with a "made in Germany" tag
.attached. Then came the long and unhappy struggle in England between the antiseptic
system and the aseptic—the latter championed by Lawson Tait (1845-1899). As
you read the story of that controversy you realize that Sir William was correct—
"Physicians have been good fighters."
With the firm foundation of antiseptic surgery behind him, Lister went on to
perfect other aspects of the same problem leading to forty years of continuous experimentation and research on antiseptic dressings. When he began, one. of the commonest
and most acceptable gifts to any hospital was a bundle of old linen, and in Lister's
writings in the earlier period, this accounts for his reference to "clotjhs". This work
on dressings deserves much more attention than it has ever received and in this hurried
review of the work of a great man I can only mention it. He began with an oakum
dressing; then a carbolic gauze; then a gauze soaked in blood serum obtained from
abbatoirs and combined with sublimate of mercury—the so-called sero-sublimate gauze
—and this was used as far away as Spain and Poland. Today we find it difficult to
understand the Russian point of view—or perhaps I should say when we understand it
only too well—it is of interest to find that the idea of an antiseptic dressing was readily
grasped by the Russian surgeons of Lister's day. The antiseptic dressing was put in a
sterile packet by women workers, and while they were not allowed to undertake this
work during the menstrual period their pay for this time was not deducted. Then came
his sal-alembroth gauze—a double salt of bichloride of mercury and chloride of
ammonium. During this long period of experimental work, Lister drew on his deep
knowledge of chemistry, physics, biology and physiology, and please remember that no
paid corps of workers were engaged—the work was all done by Lister himself, always
looking for a dressing less irritating to the skin, cheap to manufacture and efficient as
an antiseptic.
In its final form the antiseptic system worked out about as follows for any
operation. Two basins were filled with solutions of carbolic 1/20 and 1/40. The
instruments which had been thoroughly washed after the last operation but not sterilized by heat, were placed in a carbolic solution 1/20 for half an hour and this solution was slightly weakened before the operation commenced. The sponges were placed
in 1/40 carbolic and his own words may interest you here: "I put the sponges after
an operation into a tank of water and let them purify there. The fibrine which clings
among the pores of the sponges becomes liquified by putrefaction. They can then be
washed thoroughly clean of their fibrine and the washing is continued until they no
longer give a red colour to the water. They are then put in 1/20 carbolic and kept
there." The site of the operation was not washed with soap and water but was cleaned
with 1/20 carbolic while the chloroform (never ether) was being given. Lister would
then take off his coat, roll up his shirt sleeves and fasten an ordinary clean, unsterilized
towel across his waistcoat. (He never wore the flowing classical white robe in which
he is depicted in the tympanum of the Polyclinico Umberto I in Rome.) He then
washed his hands in 1/20 carbolic and towels wrung out of the same kind of solution
were placed in position on the patient. He never wore mask or gloves—his hands and
those of his assistants were frequently dipped in 1/20 carbolic, sponges wrung out
of 1/40 and the wound washed with 1/40 before suturing. Vessels were tied with his
own sulpho-chromic gut brought dry to the house and sterilized in carbolic solution
and occasionally he used silver wire, catgut or fine silk all sterilized in carbolic 1/20.
The dressing was of cyanide gauze covered with salicylic wool. The part of the gauze
next to the wound was moistened in the carbolic solution.   And lest you might think
Page 96 this too simple a procedure, remember that this method, with its cruder predecessors,
when properly used, banished sepsis from the hospitals and surgeries of the world.
Lister never abandoned the antiseptic system. He always felt that with great
care, expense and many assistants, the aseptic system could be made safe but if there
should be one weak link, the patient might suffer. In the antiseptic system, all was
under control of the surgeon—nothing was delegated and his method could be used
in a hospital, a castle or in a cottage. The chemical antiseptic would ever be on the
alert. What a joy it would have been to Lister could he have lived to see the work
done in the first great war with Carrel-Dakin solution, a chemical antiseptic constantly
applied, and if he came into the operating room of today he would feel quite at home
when he would see the surgeons' hands carefully sterilized with a chemical antiseptic,
some chemical antiseptic applied to the operative field and at the conclusion of the
operation, should occasion call for it, an anti-biotic distributed in the wound.
"Who dreams shall live . . . say nevermore
That dreams  are fragile things.   What else endures
Of all this broken world, save dreams alone."
Dana Burnet
I shall not detain you long with an account of the honours which were showered
upon Lister not only by his own country but by the whole civilized world. I shall
mention only a few—Oxford and Cambridge gave him degrees as did Toronto. He
succeeded Syme as Surgeon-in-ordinary to the Queen. Foreign decorations of every
kind came before his baronetcy was bestowed in 1883. He was given the French Boudet
prize of 6,000 francs for his "application of M. Pasteur's researches in the art of
healing" to quote the citation. He was awarded the Prussian Ordre pour le Merite
in 1885 and at that time this was limited to thirty Germans and thirty foreigners and
up to that time had never been given to a physician or surgeon engaged in actual
When Lister entered the surgical stage, Benjamin Bell's leaden drainage tubes had
been forgotten. Cassaignac had introduced rubber drainage tubes but it was Lister
who first used them in England or rather, I should say, in Scotland as his first use of
such a drainage was when he operated upon Queen Victoria while at Balmoral for
an axillary abscess. I might here mention his careful attention to small details—the
tube was always cut off obliquely and flush with the skin so that the pressure of the
dressing would not buckle the tube and so prevent proper function—a point not always
remembered today.
Lest you might think that Lister added to surgical technique in only one way,
let me remind you that he developed a new amputation through the femoral condyles
in 1858; a new plan for excision of the wrist—the whole so-called bloodless system
of operating; a new amputation of the hip joint; and perhaps most outstanding, the
first operation for removal of the breast for malignancy which could be called radical
and comparable to the operation of today. He left his mark on the surgery of the
bladder and urethra; of bones and joints, and did not hesitate to remove a cataract.
What manner of man was this? What were the mainsprings of his being? How
far can we, in a few minutes, sum up those qualities of mind and conscience which
enabled him to mark out for all time his own part in the gradual process of the civilization of mankind.
As mentioned earlier, he was born into the Quaker faith and although he "married
out" of the Friends and became a member of the Episcopalian Church, he never lost
the Quaker imprint. In a letter to his family even in the later years, he used the simple
language of thee and thou and as was expressed in the Epistle of the Society of Friends
the year before his marriage, he knew that "True religion stands neither in forms nor
in the formal absence of forms." He was modest without in any way lacking confidence
in himself. In a letter written to his father in the early days in Edinburgh we find
the following: "It is true it must depend entirely upon myself (under the blessing,
if I may humbly say so, of Almighty God in Christ Jesus)  whether I succeed or not;
Page 97 but I am encouraged to hope that though I must not expect to be a Liston or Syme,
still I shall get on. Certain it is I love surgery more and more and this is one great
point; and I believe my judgment is pretty sound, which is another most important
point. Also I trust that I am honest and a lover of truth, which is perhaps as important as anything. As to brilliant talent, I know I do not possess it but I must try to make
up as far as I can by perseverance." A little later, Syme wrote of his son-in-law as
follows: "He has a strict regard for accuracy, extremely correct powers of observation and a remarkably sound judgment united to uncommon manual dexterity and a
practical turn of mind."
In his opening address to the students, in Glasgow, Lister closed with these words
as descriptive of the two great requisites of the medical profession: "First a warm,
loving heart, and secondly, truth in an earnest spirit." When he went to Glasgow he
was given a complimentary dinner and in his address, the following interesting sentence
merits repetition, perhaps even more today than when the words were spoken:
"Scientific truth, as bearing directly on the well being of our fellow creatures
will always be a becoming object of our pursuit; and while there is probably no calling
in which there is greater opportunity for deception than ours, yet when we consider
the sacred interests which are committed blindfold by the public to our trust, we
must allow that there is no calling in which falsehood is more unbecoming or despicable."
The following account of an incident associated with Lister's move to London
tells you much of the character of this great man. I shall give it to you in the worlds of
Mr. Grasset of Toronto, one of Lister's favourite house surgeons:
"When Lister left Edinburgh in 1877 there were eight cases in his wards of psoas
abscess—seven men and one woman. Lister thought they would remain in the hospital
until they got well. Dr. John Stewart tells me that shortly after Lister went to London
it was decided to turn these patients out. Caird wrote to Stewart and asked if the girl,
a lady's maid from the South of England, would be taken in at King's. *I shall never
forget,' he says, 'the pained look of surprise in Lister's face when he heard his patients
were turned out.' I wired Caird "yes" and that night she left for London under the
care of a nurse, transported in< one of those long baskets, which in Edinburgh were
used to carry patients to the operating theatre, manned by dressers of the surgeon.
She ultimately got well and the "Chief" writing a year or two later said that he had
seen her walking and looking bright and well. Lister had the men and boys taken from
the Infirmary to a Nursing Home where he used to operate in Edinburgh. He put
them under the care of his old assistant, John Bishop, and paid all the expenses therewith
including attendance and dressing.  In the end, all of them got perfectly well."
Many such stories could be told. I shall mention only one more. A friend of
Lister's told him of a young medical student who, on account of lack of funds, could
not finish his course. Lister at once gave the friend a check for fifty pounds to be
given to the student with his best wishes. His gentleness and kindness were proverbial
and in all things he showed his consciousness of the higher character of his work. He
often said: ". . . to intrude an unskilled hand to such a piece of divine mechanism as
the human body is indeed a fearful responsibility." His courtesy was unfailing but he
could give a deserved rebuke in no uncertain manner. Once a pompous practitioner
introduced himself to Lister as an old college associate some time after the antiseptic
system had been generally accepted. Commenting on the ups and downs of life, the
visitor said: ". . . here we are, Sir Joseph—I am unknown and you are famous everywhere for this antiseptic system. Not that there is anything in it. I would not let
any of my patients have any of these new fangled methods. I would not even try them
on anyone." Lister answered, "Sir, if your patients know what I know they would
not let you enjoy the honoured name of physician."
Addresses made on the occasion of complimentary dinners given to distinguished
people or comments made in connection with the confering of honourary degrees never
lack superlatives but even allowing for this, we can read again some of those made
111 Page 98 regarding Sir Joseph on such occasions—two or three samples suffice this evening.
In his essay entitled "Pasteur and Lister", Mr. Stephen Paget writes: "There never
was, there never will be, a surgeon more careful over each case, more open-minded
in his criticism of his own method." In 1900 a dinner was given in Paris to Lord
Lister. Dr. Lucas Champonniere closed with these words: "We can remember the
miserable condition of surgery and how great was the mortality. Nelaton said that
a statue of gold should be raised to the person who was able to prevent what we know
as sepsis. You, Sir, have deserved that statue." At the same banquet, Dr. Pinard said
in part: "Lord Lister when we are asked why you are illustrious we reply—because you
have driven back death itself; because in all you have done you have caused only tears
of gratitude." In 1902, the Royal Society gave Lord Lister a banquet and Mr. Bayard,
the American Ambassador, said: "My Lord, it is not a profession, it is not a nation,
it is humanity itself which with uncovered head salutes you."
At a time when physicians and surgeons seldom, if ever, took holidays, a common
remark during the hunting season was "My moors are in Harley Street" or wherever
the office of the individual might be located. John Abernethy spoke of chasing the
"damned guinea" but Lister took regular vacations. Before his lectures he always tried
to find time to sit down and quietly think over the subjects he intended to present.
In Glasgow, Edinburgh and in London, his choice of a home was largely dictated by the
close proximity of a park where he could walk quietly as he thought out his problems.
It is always interesting and perhaps profitable, if too much time is not spent on it,
to try to fit a great man from one period into the problems of a later one. When we
pause to consider the very rapid progress our profession is making along so many fronts,
it is not surprising that many problems beset us. Perhaps two stand out over and
above all others—the problem of specialization—and I am a specialist—and that of the,
economic relationship of our profession to the population as a whole.
Amongst his many firsts, Lister was the first to practise surgery as a specialist
in the strictest modern sense of the word in Glasgow—that is his practice was entirely
referred. When we use the term specialist or think of the problem of specialization
we are apt to think of it in terms of our own work or our own profession. Dr. Richard
Asher in a recent article in the Lancet (August 27—1949 page 358) says in part: "I
have known an eye surgeon after seeing a case of Retinitis Pigmentosa write in the notes
'This might be part of the Lawrence-Moon-Biedl syndrome; is there any evidence of
Polydactyly?' For an opthalmologist to feel himself incapable of counting fingers is
surely the limit of over specialization." However, the whole problem has a much
greater significance than to our profession alone. It is one of the outstanding earmarks s
of our civilization today. Pioneer specialist that he was, I think Lord Lister would have
recognized the dangers inherent in it today. I know of no better analysis than is given
by A. G. Gardiner in his essay on Professor Geddes:
"You remember the man at the Breakfast Table whom Holmes called Scarabee?
He sat absorbed and silent over his meals. Nothing that was said reached the remote
fastness of his being until one day somebody mentioned beetles. To the amazement
of everybody, he awoke to the world around him. The key had been found that unlocked his prison and he came out into the daylight only to return to his solitude and
abstraction when the subject that was his one contact with life ceased to hold the
table. In that quaint figure Holmes satirizes the specialist—the men who, in pursuit
of one microscopic phase of being, becomes divorced from the splendid pageant of life.
In some degree, most of us are victims of this myopy of the mind. It is one of the
diseases of civilization. It is the price we pay for that wonderful subdivision of labour,
that intricacy of relationship which moves each of us farther and farther from the
centre of the wheeling universe of things. As the artificial structure we create becomes^
more vast, more complex, a more cunning contrivance of machinery, the individual
man diminishes in stature and authority. The primitive shepherd shearing his sheep,
spinning his wool, weaving his cloth to make his crude coat was nearer to the heart of
things than the multitude of clever mechanics, salesmen, labourers and clerks who each
Page 99 carry out some detail of modern industry. We are like Frankenstein in his laboratory—
we have constructed a monster who makes us his slaves; a monster so enormous, so
amorphous that we can neither measure nor control him. All that we know is that
we are caught in his intangible toils.
The remedy for this tragedy of civilization, which exalts the machine and belittles
the man is in education. Since we cannot have the joy of creation, which the old craftsmen had, we must learn to let the mind expand outside the scope of our daily work.
And alas, when we come to education, we find the Scarabee. The same principle of
specialization which reduces the artisan and the clerk to a tiny function in a structure
he does not see or understand, reduces scholarship to water-tight compartments, mechanics
'divorced from art, economics from ethics, medicine from education. Yet all are only
phases of one theme that is universal—the art and practice of life. It is the full light
of the sun we want; not the broken fragments of the spectroscope. We should use
pigeons, not live in them."
The relationship of economics to the practice of medicine would undoubtedly have
served as a challenge to Lord Lister just as the problem of sepsis did. Like the problem
of sepsis, this concerns mankind first and the profession of medicine in the second place
—So it would have appealed to him on both counts. He did not look towards the Government to solve the problem of sepsis nor did he try, as so many of his associates did,
to make himself believe that no such problem existed. He believed that the problem
of sepsis was one for the medical profession to solve and as far as my study of the man
and his work goes, I believe he would have felt the same way about our economic problem
today.  We cannot act as if the problem does not exist—it is ours to solve.
Lord Lister's marriage was an exceptionally happy one and the years of his life
following Lady Lister's death, while filled with honours and distinctions, found him
a very lonely man. She died from pneumonia in 1893 while they were on a visit to the
continent, the year he gave up his appointment at King's when he was sixty-six. A
serious illness in 1903 seriously impaired his health and the end came nine years later—
also from pneumonia. He was buried beside his wife in Hampstead Cemetery but there
was a memorial service for him in Westminster Abbey attended by the King and Queen
and the representatives from every civilized country. The anthem used at that service
was Handel's and the. juxtaposition of texts from the Old Testament and the New
seemed to have been composed especially for that occasion:
"When the ear heard him, then it blessed him; when the eye saw him, it gave witness to him; he delivered the poor that cried, the fatherless and of him that had none
to help him. Kindness, meekness and comfort were his tongue. If there was any virtue
and if there was any praise, he thought on those things. His body is buried in peace
but his name liveth for evermore."
1—Lord Lister, by Sir Rickman Godlee.   MacMillan & o. Ltd., London, 1917.
2—Lord Lister, by G. T. Wrench, M.D.  (London).   T. Fisher Unwin, London, 1913.
3—Joseph Lister, by Rhoda Truax.   The Bobbs-Merrill Co., New York, 1944.
4—Pasteur and After Pasteur, by Stephen Paget, F.R.C.S.   Adam 6h Cjharles Black, London, 1914.
5—Reminisciences of a Specialist, by Greville Macdonald, M.D.   George Allen & Unwin, Ltd., London,
6—Surgical Memoirs, by James G. Mumford, M.D., 1908.   Moffat, Yard & Co., New York.
7—Fifty Years of Medicine Surgery, by Dr. Franklin H. Martin.   The Surgical Publishing Co., Chicago,
8—The Lancet, Richard Asher, M.D., London M.R.C.P., August 27, 1949, Page 358.
9—An Alabama Student & Other Essays, by Sir William Osier.   Oxford University Press, 1908.
10—Articles by Lord Lister—The Lancet, September 19th, 1896.   Page 797.
11—Never Dies The Dream, by Margaret Landon.  Doubleday & Co., Garden ity, N.Y., 1949.
12—British Medical Journal, 1893—Pages 161, 272 and 337.
13—British Medical Journal, Dec. 13th, 1902.   Articles by John Chiene; B. W. Watson Cheyne, F.R.C.S.-
F.R.S.; Dr. Lucas Championiere; Alexander Ogston, M.D., Aberdeen; D. Berry Hart; Thomas Annan-
daye, F.R.C.S.; Sir Hector C. Cameron.
14—The Encyclopaedia Brittanica.
Page 100 J. C. McPhee, J. S. Madill and H. H. Brooke, in radiology; Drs. David Mowatt, C. J.
Reich, Henry Scott, C. G. Campbell, B. F. Paige and W. Simpson, in medicine; Drs.
Lloyd W. Warcup, R. D. Coddington, H. A. Chisholm and Frank Paulson, in surgery;
Dr. Ben Schuman in pediatrics; Dr. H. O. Cooper in urology; Dr. William P. Fisher in
Two Vancouver orthopedic surgeons have returned from the U.K. with degrees in
Dr. R. J. Paine, Dr. H. S. Hamilton and Dr. R. S. Crimmett in Ophthalmology; Drs.
neurology; Dr. Malcolm Allan in thoracic surgery and Dr. Frank McNair in psychiatry.
Among B. C. doctors who have gained additional degrees in their special fields are:
their field.  They are Dr. Palmer McLean and Dr. Hector Gillespie.
Dr. Anthony Larsen, of Nanaimo, is spending a short time at the Vancouver
Venereal Disease Control Unit preparatory to entering Public Health Work in the
Fraser Valley.
Dr. G. Marion, former pediatrics resident at the Vancouver General, is doing
locums in B.C. with a view to eventual practice here.   |
Dr. D. Tompsett, of Vancouver, is on a five-week vacation in California.
To Dr. and Mrs. R. W. Boyd, a son.
To Dr. and Mrs. Hal Spiro, a son.
To Dr. and Mrs. B. F. Paige, a daughter.
To Dr. and Mrs. J. D. F. Alexander, a son.
To Dr. and Mrs. C. A. Cawker, a daughter.
During the meeting of the B. C. Medical Association to be held next
October in Vancouver, there will again be a Hobby Show.
All exhibits -will be insured and there will at all times be a man
to care for the exhibits.
Let's make this a bigger and better show and begin now to prepare
your exhibits.
Dr. A. C. G. Frost,
Chairman, Hobby Show",
B. C. Medical Association.
Available  at  once,  attractive office,   1645   Marine Drive,  North
Vancouver, near Norgate Park.   New, modern building.   Apply:
629 Hornby Street Telephone: MArine 2431
Page 101


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