Dr. Ian Carr
Professor Emeritus, Faculty of Medicine, University of Manitoba
The history of medicine in Canada and in Manitoba is a subject too large to be discussed except by selection. A complete account would include a discussion of pre-conquest health, sickness and medicine of aboriginal peoples, and a comparison with contemporaneous European medicine, which was at a similar stage of development, a consideration of health sickness and medicine in the Canadian colonies before Confederation, an account of epidemic disease , a history of institutions -- hospitals, medical schools, and licensing bodies, and an account of famous names and discoveries. Only some of these topics will be covered.
It is difficult to obtain accurate accounts of the health and sickness of pre-conquest peoples, largely because the observers were either untrained in medicine, or did not have the chance to make accurate medical observations. It is likely that before European contact health and nutrition were as good as in other aboriginal peoples.
Hans Egede in 1757 noted on the Greenland coast, that there was no epidemic infectious disease till 1734. Few of the population exceeded 50-60 years of age and there were many children. They that dwell in the most northerly parts are often miserably plagued by dysenteries or bloody fluxes, breast diseases, boils and epilepsy or falling sickness.
Other observers noted snow blindness, chronic respiratory disease, nose-bleeds, and on occasion scurvy. From 1734 on, there was sufficient contact with European explorers to generate devastating epidemics of small pox, measles influenza, diphtheria, and more recently poliomyelitis.
Similarly preconquest Indian peoples were fairly healthy, and were devastated by epidemics introduced by Europeans -- influenza, scarlet fever, measles, smallpox. The epidemic spread of disease was dictated by the movement of people.
This has been well studied in Western Canada for the period 1830-1850. At that time large numbers of natives followed seasonal migration patterns, passing the winters in sheltered river valleys, and forested parklands, and summers in the open grasslands hunting bison. The non native population was as highly mobile, by boat and canoe, in highly organized brigades, whose movements can be traced in detail the records. The traffic was heaviest to York Factory, the major entrepot.
In 1837, a smallpox epidemic spread because there was one infected person on the American Fur Company's boat from St. Louis. At Fort Union, just south of the Canadian border, a party of 1000 natives were warned off but still came for the trade goods; 150 survived. A long boat was sent on to Fort Mackenzie, and a party of 5000 Blackfoot and Piegans who were waiting for goods, carried the infection north, ultimately throughout the interior of the North West. It was ultimately stopped by a vaccination campaign organized by the HBC.
An epidemic of measles in 1846 spread from the Red River with the canoe brigades, reaching Norway House and then York Factory, and spreading to the more distant north western trading stations. It had a high morbidity and mortality, among native people largely due to respiratory complications. The Hudson's Bay Company noted that transport was severely disrupted because of shortage of healthy crews.
From the records of medicine in Quebec, before and after the English Conquest come several memorable stories The first autopsy on what was to be Canadian soil is recorded as follows. Jacques Cartier was ice-bound in 1535, and his sailors sickened with scurvy. After many deaths Cartier ordered the barber surgeon to cut open the body of Phillipe Rougemont from Amboise.
He was found to have his heart white but rotten, and more than a quart of water about it; his liver was indifferent faire, but his lunges black and mortified, his blood was altogether shrunke about the heart so that when he was opened, great quantities of rotten blood issued out from his heart; his milt towards his back was somewhat perished, rough, as if it had been rubbed against a stone.
The first record of a physician in Canada is that of Robert Giffard who arrived in Quebec in 1627 and practised in the Hotel Dieu in Quebec, founded by the Ursulines in 1639. In 1685 Michel Sarrazin, aged twenty-six came to Quebec, returning to France for further experience for three years in 16994, and spending the rest of his life in Quebec. He was appointed physician by the King of France at a salary of 300 livres a year, rising to 2000, probably a good income. He was physician to the Hotel Dieu and the Hopital General in Quebec. In 1700, he performed a mastectomy on a nun who had developed cancer after wearing several self mortifying devices next to the skin. She survived for 19 years.
Sarrazin also dissected animals and plants in a laboratory in his house and corresponded with European scientific writers of his day. He dissected the beaver but gave up on the skunk.
Most of the hospitals in Quebec, and many in the rest of Canada were founded by religious orders, who had a great and largely beneficial influence.
The social conditions in 18th and 19th Century Lower Canada are well illustrated by the record of admissions and mortality related to a foundling hospital in Montreal -- similar to others at the time.
|Admissions to and Mortality in the Grey Nuns' Foundling Hospital, 1754-1884|
Social and medical conditions in rural Lower Canada after the English Conquest are well illustrated by the story of the St. Paul's Bay Disease. (Mal de la Baie St Paul, Mal de Mal Baie).
Notes on the measures adopted by Government between 1775 and 1786 to check the St. Paul's Bay Disease (Mal de la Baie St. Paul), which was read by the Hon. A.W. Cochran, D.C.L., before the Quebec Historical Society in March 1841.
About the year 1773, the attention of the Government of Lower Canada was drawn to the increasing ravages of a peculiar disease which, originating at Mal Baie (Baie St. Paul), had spread to other parts of the province. A tradition exists that it was imported into Mal Baie by a detachment of Scotch troops who were either sent there on service or were thrown there by some accident of navigation some years before; but there will appear much reason in the sequel to doubt the correctness of the supposition.
The characteristics of the disease were as follows:
The first manifestations of this fatal disease consist of little ulcers on the lips, the tongue, the interior of the mouth, etc. These are little pustules filled with a whitish and purulent matter which encloses a poison so subtle that its smallest portion is capable of conveying the infection; to drink out of a glass, to smoke a pipe infected with this poison is enough to give rise on the lips to a little bleb filled with this same matter which in breaking spreads the sore, corrodes the neighbouring flesh and forms a large ulcer. The linen, the sheets, the blankets, the clothes, may contain enough of this matter to communicate the infection. There are some constitutions which absorb the poison and the ulcers appear cured, but they soon reappear and then the disease is at its second period. The largest ulcers form in the mouth, on the throat at the sides and base. The glands of the gullet, the armpits, the groin, are inflamed and sometimes discharge pus; often they (the glands) become hard and insensible tumours which change place in touching them. Soon pains are felt in the head, in the shoulders, arms, hands, thighs, legs and feet. During this time the sick person believes that it is his bones that are affected. These pains increase, sometimes by exercise in wet weather, in bed when one begins to be warm and diminish towards morning when perspiration appears.
The third stage of the disease can be recognized by the scabby crusts on the skin which appear and disappear by turn. Soon the bones of the nose rot, as well as the palate, teeth and gums; lumps appear on the head, clavicles, on the bones of the legs, on the arms, and on the fingers. One sees ulcers all over the body which after having disappeared recur.
Finally, pains in the side, and in the chest, difficulty in breathing, cough, loss of appetite, falling of the hair, loss of sight, of hearing, of smell, are the precursors of death. In addition, one must not make a mistake, because sometimes the first appearances of the disease are shown by symptoms of the second or third stage.
Shortly after the disease first attracted the attention of the Government, General Carleton, the Governor, sent a surgeon's mate, Mr. Dan, of the 7th Regiment, to Baie St. Paul to investigate. He reported:
...the means of communication differs essentially from the pox given by coition.
The Canadians make use of the same cups and drink from the same bucket; they frequently borrow each others pipe to smoak with; they chew the food for their infants and spit it in their mouths.
I insist on the strongest dose of corrosive sublimate and with greatest success possible, for the sick of all ages and all stages of the disease. Those upon whom I was able to keep an eye and a hand were all cured, as well as those who followed under supervision of intelligent persons the simple directions.
The disease was recorded widely across Lower Canada. One physicians account of his cases went as follows:
Cases Treated by Dr. Selby
|September 12, 1785|
|Patient Name||Age||Symptoms||Time for Cure (Weeks)|
|G.H.||24||Soft palate ulcerated, pain in the bones||4|
|M.H.||26||Ulcers on her legs, nose affected||8|
|G.H.||5||Lips and tongue ulcerated||3|
|R.H.||3 mths.||Lips ulcerated||2|
|J.Bte.S||26||Lips cancerous, palate affected. Cancer extirpated||6|
|Marie S.||23||Ulcers on her legs. Tonsils and mouth ulcerated||4|
|Marie S.||5||Lips and mouth ulcerated||3|
|Jean S.||3||Similar symptoms||3|
|Michelle S.||4 mths.||" "||4|
|Louis C.||32||Severe pains, ulcerated lips, tongue, tonsils||4|
|Cath C.||32||Similar complaint||4|
|Francoise C.||9||Lips ulcerated||3|
|M. Francoise C.||7||" "||3|
|September 18, 1785|
|Patient Name||Age||Symptoms||Time for Cure (Weeks)|
|Mr. Sicard||74||Lips and palate affected||6|
|Josete Sicard||65||Palate ulcerated||7|
|N. Archambault||63||Tongue, tonsils, etc||6|
|Marie||63||Pain in legs and palate||9|
|Five children||-||Mouth and palate affected||-|