Physicians as explorers: The contribution of John Rae to Canada's development
Again this year, Associated Medical Services, Inc. and the Hannah Institute f.r the History of Medical and Related Sciences present a series of articles on physicians, this time those that have been notable explorers. The series, written by Dr. W.E. Swinton, distinguished paleontologist, historian, author and retired academic, was stimulated by AMS, the CMA committee on archives and other organizations. Reprints of the eight articles, after publication, will be. available from the Hannah Institute, 59 Prince Arthur Ave., Toronto M5R IRS, as may reprints of the previons Swinton series on contribnlions by physicians to literatut.e and nonmedical science. The illustration on page 532 Is by permission of the archivist, Hudson's Ray Company, Winnipeg, and that on page 534 by per. mission of the Royal Geographical Society, London.
John Rae's expeditions cover vast areas of Canadian North Passage, thus shortening Arctic exploration by many years. As it was, hard conditions and shortages of food compelled him and his men to make stupendous efforts, which covered new shorelines for 1040 km around the east and west sides of Committee Bay, which separates the mainland from Melville Peninsula. The party saw no Inuit - but an Inuit saw them! Before leaving for England, Rae met the party of sappers and miners who had come out from England for the Franklin search expedition of Sir John Richardson. Rae arrived in London in October 1847, made his report to the company and wrote an account for The Times. With Parry, Ross and Franklin himself, Rae was now established, at least in England, as an Arctic traveller. His London stay was not prolonged, for he was soon asked by the Admiralty, with the approval of the company, to join the expedition to search for Franklin. The expedition would be led by Sir John Richardson (another Scottish MD) who duly appointed Rae as his second-in-command. It is perhaps unique in the annals of exploration that an important expedition had two practising physicians as leaders. The fate of Franklin was unknown. His expedition had left England May 19, 1845, and no word had been heard from him for
some time. But the sight of Rae by an Inuit led to a belief that some of the party still lived. Using boats in coastal waters and by the most strenuous marches, the considerable party, which included the sappers and miners Rae had met earlier, spent the permissive months of 1848 and 1849 examining the entire coast between MacKenzie River (which, it was thought, might have been used by Franklin to escape the Arctic) and Coppermine, but without result. During the winter, at quarters at Fort Confidence, Great Bear Lake. the weary months were spent in meteorological and magnetic observations. Glad to see him go Richardson left Fort Confidence for England May 7, 1849, and Rae, 26 years younger than his leader, was glad to see him and the English members of the party go. They were "the most awkward, lazy and careless set I ever had anything to do with." Rae now carried on, descending the Coppermine River with a single boat and attempting to cross Coronation Gulf to Wollaston Land (SW peninsula of Victoria Island), but his way was blocked by ice in Dolphin and Union Strait. Rae then returned to the MacKenzie River and
532 CMA JOURNAL/SEPTEMBER 3, 1977/VOL. 117
was put in charge of that territory from Fort Simpson. There he contented himself with the company's affairs, believing that he had no more duty in the search for Franklin. However, in June 1850 the British government again asked him to lead a search party. The remaining months of that year and winter were spent in the necessary planning, but in April 1851 he was at Fort Confidence on the northern edge of Great Bear Lake with two men building two boats, which with sleds were to be part of a fantastic tour of the coast and Wollaston Land in which the sledding part covered 1760 km at the record speed of 38 km/d. Returning to base June 10, the boat expedition took off, via the Kendall River to Coronation Gulf, and then surveyed the whole south and east coast of Victoria Island, much of which had never been explored. The west side of the channel between Victoria Island and King William Island was named Victoria Strait by Rae; in all, some 1920 km were sailed before the party returned up the Coppermine River and overland to Great Bear Lake. This would have been expedition enough for most hardened travellers but not for Rae and his indomitable party. Rae had asked permission to return to Britain, so on they went by water and over snow to the MacKenzie River and down by Fort
Garry (now Winnipeg) over the border into Minnesota Territory and St. Paul. On the way back to the mainland, Rae had found two pieces of wood, obviously from a British naval vessel. They were found Aug. 21, 1851 at Parker Bay on the southeast of Victoria Land. Almost certainly they came from one of Franklin's ships but their investigation was not very seriously undertaken. Highest award Rae took the tacks, line and bits of the wood to the Admiralty in London. For the whole of this expedition he was given the highest award - The Founder's Medal - of the Royal Geographical Society, and the highest praise was given to him for his achievements. Oddly enough, Rae was not at the presentation; he had gone to his native Stromness for a visit. When he left London again in the spring of 1853 he had the company's blessing for a new expedition to conclude the survey of Boothia. This he nearly did, and he was able to prove that King William's Land was an island. But on this journey, on Apr. 21, 1854, in Pelly Bay, southeast of Boothia, he met some Inuit, one being In-nook-poo-zhee-jook, an intelligent man, who told him of the bodies of about 35 to 40 people who had starved to death, a long way off by a big river. The Inuit was wearing a gold band on his head; Rae purchased this and asked the man to send any other Inuit with knowledge of the dead men to him at Repulse Bay. He later learned that the river was the Great Fish River to which he could not go that season. Rae determined now to report his news - that Franklin and his men had died 4 years before - and to attempt to divert Sir Edward Belcher's expedition from its now-useless course. Toward the end of September 1854, he embarked on a second Prince of Wales for England. After a stormy voyage Rae reached England at 3 pm on Sunday Oct. 22, 1854. He learned that Sir Edward Belcher and his men had returned home and he at once went to the Admiralty to present his report and his list of the relics and their crests and markings he had received from the Inuit. This brief report, so final as to Franklin, is in the Admiralty records, Public Record Office (Chancery Lane, London) dated July 29, 1854. On the day of hjs arrival he also prepared a letter to the Hudson's Bay Company. All this was accomplished at a speed unthinkable now. The company sent his letter to the Admiralty on Oct. 23. On that day also, Rae's July letter to the Admiralty appeared in The Times together
John Rae
with details that Rae had written on Oct. 20 while at sea in the Prince of Wales. The reports were widely copied in newspapers and the crests were pictured in the Illustrated London News Oct. 28. The letter to the company states "that a portion if not the whole of the then survivors of Sir John Franklin's long-lost party died of starvation in spring 1850 at no great distance to the northwest of the mouth of Beck's Fish River." Named objects included silver forks and spoons with initials of "the Surgeons and Assistant Surgeons Goodsir, Peddie and McDonald" among other officers. All this news, received in England (and Europe) in October, had earlier been sent from Rae to Sir George Simpson on Sept. 4 and was published in the Montreal Herald on Oct. 21. Controversy broke out at once. Rae was accused of continuing his exploration when he might have gone to seek for more precise news. However, in brief, the Franklin relics were displayed publicly in London and are now in the National Maritime Museum at Greenwich. Rae was allowed to keep a few as souvenirs (a spoon and fork belonging to Franklin) and lesser objects that are now in the Royal Scottish Museum, Edinburgh. The controversy over Rae's statement was not its news, for the Admiralty had long given up hope of Franklin, and his death had been publicly pro534 CMA JOURNAL/SEPTEMBER 3, 1977/VOL. 117
claimed as of "March 31, 1854" (London Gazette of same date), but Rae had written that the Inuit had told him that some of the party had been driven by starvation to cannibalism. This horrified the British public and resulted in two strongly worded repudiations of the idea (but not of Rae's integrity or honesty in reporting it) in Household Words. These were under the title of "The lost Arctic Voyagers" and appeared in Household Words for Dec. 2, 1854 and Dec. 9, 1854. The editor, Charles Dickens, cast doubt not on Dr. Rae, but on the ability of his Inuit interpreter and on the Inuit culture generally ("a babble of savages") and cited some examples of misfortune in which men in desperate conditions had turned their minds to cannibalism. Integrity and discipline, so entrenched in the English character (Dickens said. "we can be proud of Dr. Rae as an Englishman") would prevent this, and after all if Inuit did not disturb the dead or dying, what about animals? Dr. Rae replied, also in Household Words, under the same title on Dec. 23, 1854, with what was, in fact, a stout and factual defence of the interpreter and of the Inuit that he had met in these and earlier travels. None the less, Dickens's last words on this are "Therefore, teach no one to shudder without reason, at the history of their end. Therefore, confide with their own firmness, in their fortitude, their lofty sense of duty, their courage and their religion." To a great extent Rae's active days were now different, if not over. He learned he was entitled to the government's long-advertised reward of £10000 for solving the Franklin mystery, although that was not really solved until the "Voyage of the Fox", (under Sir Francis McLintock) was published in 1859. Rae had £8000 of the sum; the remainder was divided amongst his few companions, but the doctor wanted to use the sum for exploration and spent £2000 on having a small schooner built in Canada. Unfortunately the late delivery of the ship defeated his purpose; it was lost in a storm on the Great Lakes and so the Arctic project was dropped. Tour of United States Late in 1858 Rae made a tour of the United States with Edward Ellice, a director of the company. In the following year he, with others, crossed the prairies to Saskatchewan; later on this visit to Canada he walked on snow shoes from Hamilton to Toronto, about 65 kin, in 7 hours and dined out that evening "without any signs of fatigue." He was then about 46 years old. In 1860, he did the land part of a survey
for a projected telegraph line from England to America by way of the Faroes, Iceland and Greenland. In 1861 he made a journey to the Red River and Saskatchewan accompanied by Henry Chaplin (later Viscount Chaplin) and Sir Frederic Johnstone, Bart. With a guide (James McKay) they were on the prairies and into the buffalo plains of western Canada. Rae characteristically analysed all the problems; those of climate, ecology and the Indians and Red River settlers. His paper on this expedition seems to have been rediscovered only recently (Irene M. Spry, of the University of Ottawa, refers to it in an article in the Geographical Journal of February 1974) and it is interesting to see that he thought "no Englishman or Canadian would dream of adopting the policy of getting rid of the Indians, even to promote so great an object as the Colonization of the Saskatchewan Valley." His final field trip was in 1864 from Winnipeg across the Rockies (and 800 km in a small boat down the Fraser River) to the Pacific coast. In 1860 Rae had married Catherine Jane Alicia Thompson, third daughter of Major Thompson of Ardkill, County Londonderry. They had no children and Mrs. Rae, surviving her husband by many years, died at Chiselhurst, in Kent, England, in 1919. Retirement After his travels, Rae lived in London and spent summers in Orkney. He does not seem to have had much interest in medicine in retirement. He was prominent in the Royal Colonial Institute and was an Ontario representative on the Imperial Institute (now the Commonwealth Institute), and he served as director of several commercial enterprises in Manitoba and British Columbia. He was a keen volunteer and was a private in the London Scottish and competed at Wimbledon, with the Orkney Artillery Volunteers, in rifle shooting. His expeditions were accomplished through his remarkable health and physical energy, and they were more than explorations. He made observations on animals, plants, climate and geology. He recorded some of these in his 30 scientific papers. He was highly regarded by his peers, receiving an honorary MD from McGill in 1853 and an LLD at Edinburgh in 1856, an honour he greatly valued. He had long been a fellow and correspondent of the Royal Geographical Society and was made a fellow of the Royal Society in 1880 and often attended the meetings of both societies. Dr. John Rae died July 22, 1893 continued on page 541
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536 CMA JOURNAL/SEPTEMBER 3, 1977/VOL. 117
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jouer, a 6t6 heureux de notre collaboration. D'autres m.decins verront dans nos services une concurrence possible, tel ce m6decin sp6cialis6 en madecine familiale qui concluait que nous voulions faire la m.me chose que lui". Le personnel infirmier de l'Atelier s'efforce de r.pondre aux besoins mdividuels exprim6s par les usagers mais si un probl.me est commun on essaiera de regrouper les gens pour qu'ils puissent travailler ensemble, encadr6s par le personnel infirmier, pour trouver des moyens d'action et des solutions. Les groupes d.j. constitu6s autour d'un centre d'int6r& sont aussi sp6cialement bienvenus: les locaux de l'Atelier leur sont grand ouverts et s'ils veulent se joindre un aviseur sur les questions de sante, le personnel se d6clare disponiPHYSICIAN EXPLORERS continued from page 536 at his house in Addison Gardens, Kensington. He was almost 80 years old and was laid low by influenza and congestion of the lungs. He was buried in the churchyard of the medieval cathedral of St. Magnus, Kirkwall, Orkney. In 1895 a fund was raised in Orkney for a suitable memorial, which was erected in the cathedral in that year. Although there is one curious omission, Rae has been generously documented. He has a paragraph in Chamber's "Biographical Dictionary.. (1962), 2½ pages in "The Dictionary of National Biography" (1959-60 edition) and a whole volume of the Hudson's Bay Record Society, "Rae's Arctic Correspondence 1844-55" (1953), a splendid biography by Sir James Wordie, who had been with Shackleton in the Antarctic and who was a colleague of mine on the Scottish Spitsbergen expedition in 1920. Some of Rae's journeys are marked on "A Historical Atlas of Canada" (1959) by D.G.G. Keer, and the abovementioned article by Ms Spry is a full account of Rae's visit to the Red River and Saskatchewan in 1861. The omission appears to be in the "Dictionary of Canadian Biography". This excellent work is now being published by the University of Toronto, and entries are in the order of date of death of the subjects. The most recent addition, Volume X, has not yet reached 1893 but the volume does contain an interesting short summary of Canadian Arctic exploration. Many of the great figures are mentioned, but John Rae is not among them. A distinguished explorer who admired the man and the memorial at St. Magnus was Edward Wilson (of whom more will be written in these
Mais la clientele qui donne la meilleure id.e du "genre de Ia maison" c'est certainement celle des jeunes de 7 .i 12 ans qui sont venus voir ce qui se passait dans ce nouveau local. Entr.s en curicux, les jeunes n'ont pas .t6 refou1.s comme us le sont d'ordinaire des Ijeux de travail des grands. us ont au contraire . accuejilis avec beaucoup d'int.r& et se sont tout naturellement mis . l'oeuvre pour s'informer . l'aide des livres traitant d'anatomie, de biologie etc. Comme on pouvait le pr6voir les questions ont
vite fus6 et les jeunes ont d6veIopp. l'habitude de venir faire un tour en passant . l'Atelier pour jaser, lire un peu ou tout simplement jouer. Maintenant, pour eux, ii est normal de venir parler des questions de sante et Ia fr& quentation de sp.cialistes n'est plus associ6e . un bobo qui fait mal. Voil. en somme . quoi voudraient en arriver les infirmi.res avec tous les gens qui veulent acqu6rir une nouvelle mentalit6 face . leur sante: leur faire d.couvrir que c'est en eux que reside la r.ponse . leurs questions et . leurs inqui&udes. La meilleure m6decine, c'est celle qu'on se prescrit soi-m.me quand elle est faite de recherche de connaissances par Ia frequentation des ouvrages sp&ialis6s et par des discussions avec les personnes capables de nous 6clairer. U
pages). Wilson wrote in his diary: "A full-length figure. of John Rae, MD, LLD, FRS, FRGS, Arctic Explorer, Intrepid Discoverer of the fate of Sir John Franklin's last expedition. Born 1813, Died 1893. Expeditions 1846-47; 1848-49; 185 1-52; 1853-4. Erected by public subscription 1895". That is the whole inscription - and the man is a life-size figure lying asleep wrapped in a buffalo sleeping bag, with moccasins on and a gun and a book
open by his side. He "sleeps soundly in this little out-of-the-way beautiful Cathedral at Kirkwall - honoured by his own people and caring nothing about the rest. This is what the monument suggested to me in the darkening nave of Kirkwall Cathedral at about 10 pm that evening just before the verger turned me out" (June 1, 1910). A noble tribute from a great man who himself now lies asleep in a little tent under the snows in the Antarctic.E
ble. L'Atelier a ainsi d.j. r6pondu . Ia demande de groupes de b.n6vo1es, . des classes pour adultes, . un groupe de travail du YMCA Ct aux guides de la region.
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Again this year, Associated Medical Services, Inc. and the Hannah Institute f.r the History of Medical and Related Sciences present a series of articles on physicians, this time those that have been notable explorers. The series, written by Dr. W.E. Swinton, distinguished paleontologist, historian, author and retired academic, was stimulated by AMS, the CMA committee on archives and other organizations. Reprints of the eight articles, after publication, will be. available from the Hannah Institute, 59 Prince Arthur Ave., Toronto M5R IRS, as may reprints of the previons Swinton series on contribnlions by physicians to literatut.e and nonmedical science. The illustration on page 532 Is by permission of the archivist, Hudson's Ray Company, Winnipeg, and that on page 534 by per. mission of the Royal Geographical Society, London.
John Rae's expeditions cover vast areas of Canadian North Passage, thus shortening Arctic exploration by many years. As it was, hard conditions and shortages of food compelled him and his men to make stupendous efforts, which covered new shorelines for 1040 km around the east and west sides of Committee Bay, which separates the mainland from Melville Peninsula. The party saw no Inuit - but an Inuit saw them! Before leaving for England, Rae met the party of sappers and miners who had come out from England for the Franklin search expedition of Sir John Richardson. Rae arrived in London in October 1847, made his report to the company and wrote an account for The Times. With Parry, Ross and Franklin himself, Rae was now established, at least in England, as an Arctic traveller. His London stay was not prolonged, for he was soon asked by the Admiralty, with the approval of the company, to join the expedition to search for Franklin. The expedition would be led by Sir John Richardson (another Scottish MD) who duly appointed Rae as his second-in-command. It is perhaps unique in the annals of exploration that an important expedition had two practising physicians as leaders. The fate of Franklin was unknown. His expedition had left England May 19, 1845, and no word had been heard from him for
some time. But the sight of Rae by an Inuit led to a belief that some of the party still lived. Using boats in coastal waters and by the most strenuous marches, the considerable party, which included the sappers and miners Rae had met earlier, spent the permissive months of 1848 and 1849 examining the entire coast between MacKenzie River (which, it was thought, might have been used by Franklin to escape the Arctic) and Coppermine, but without result. During the winter, at quarters at Fort Confidence, Great Bear Lake. the weary months were spent in meteorological and magnetic observations. Glad to see him go Richardson left Fort Confidence for England May 7, 1849, and Rae, 26 years younger than his leader, was glad to see him and the English members of the party go. They were "the most awkward, lazy and careless set I ever had anything to do with." Rae now carried on, descending the Coppermine River with a single boat and attempting to cross Coronation Gulf to Wollaston Land (SW peninsula of Victoria Island), but his way was blocked by ice in Dolphin and Union Strait. Rae then returned to the MacKenzie River and
532 CMA JOURNAL/SEPTEMBER 3, 1977/VOL. 117
was put in charge of that territory from Fort Simpson. There he contented himself with the company's affairs, believing that he had no more duty in the search for Franklin. However, in June 1850 the British government again asked him to lead a search party. The remaining months of that year and winter were spent in the necessary planning, but in April 1851 he was at Fort Confidence on the northern edge of Great Bear Lake with two men building two boats, which with sleds were to be part of a fantastic tour of the coast and Wollaston Land in which the sledding part covered 1760 km at the record speed of 38 km/d. Returning to base June 10, the boat expedition took off, via the Kendall River to Coronation Gulf, and then surveyed the whole south and east coast of Victoria Island, much of which had never been explored. The west side of the channel between Victoria Island and King William Island was named Victoria Strait by Rae; in all, some 1920 km were sailed before the party returned up the Coppermine River and overland to Great Bear Lake. This would have been expedition enough for most hardened travellers but not for Rae and his indomitable party. Rae had asked permission to return to Britain, so on they went by water and over snow to the MacKenzie River and down by Fort
Garry (now Winnipeg) over the border into Minnesota Territory and St. Paul. On the way back to the mainland, Rae had found two pieces of wood, obviously from a British naval vessel. They were found Aug. 21, 1851 at Parker Bay on the southeast of Victoria Land. Almost certainly they came from one of Franklin's ships but their investigation was not very seriously undertaken. Highest award Rae took the tacks, line and bits of the wood to the Admiralty in London. For the whole of this expedition he was given the highest award - The Founder's Medal - of the Royal Geographical Society, and the highest praise was given to him for his achievements. Oddly enough, Rae was not at the presentation; he had gone to his native Stromness for a visit. When he left London again in the spring of 1853 he had the company's blessing for a new expedition to conclude the survey of Boothia. This he nearly did, and he was able to prove that King William's Land was an island. But on this journey, on Apr. 21, 1854, in Pelly Bay, southeast of Boothia, he met some Inuit, one being In-nook-poo-zhee-jook, an intelligent man, who told him of the bodies of about 35 to 40 people who had starved to death, a long way off by a big river. The Inuit was wearing a gold band on his head; Rae purchased this and asked the man to send any other Inuit with knowledge of the dead men to him at Repulse Bay. He later learned that the river was the Great Fish River to which he could not go that season. Rae determined now to report his news - that Franklin and his men had died 4 years before - and to attempt to divert Sir Edward Belcher's expedition from its now-useless course. Toward the end of September 1854, he embarked on a second Prince of Wales for England. After a stormy voyage Rae reached England at 3 pm on Sunday Oct. 22, 1854. He learned that Sir Edward Belcher and his men had returned home and he at once went to the Admiralty to present his report and his list of the relics and their crests and markings he had received from the Inuit. This brief report, so final as to Franklin, is in the Admiralty records, Public Record Office (Chancery Lane, London) dated July 29, 1854. On the day of hjs arrival he also prepared a letter to the Hudson's Bay Company. All this was accomplished at a speed unthinkable now. The company sent his letter to the Admiralty on Oct. 23. On that day also, Rae's July letter to the Admiralty appeared in The Times together
John Rae
with details that Rae had written on Oct. 20 while at sea in the Prince of Wales. The reports were widely copied in newspapers and the crests were pictured in the Illustrated London News Oct. 28. The letter to the company states "that a portion if not the whole of the then survivors of Sir John Franklin's long-lost party died of starvation in spring 1850 at no great distance to the northwest of the mouth of Beck's Fish River." Named objects included silver forks and spoons with initials of "the Surgeons and Assistant Surgeons Goodsir, Peddie and McDonald" among other officers. All this news, received in England (and Europe) in October, had earlier been sent from Rae to Sir George Simpson on Sept. 4 and was published in the Montreal Herald on Oct. 21. Controversy broke out at once. Rae was accused of continuing his exploration when he might have gone to seek for more precise news. However, in brief, the Franklin relics were displayed publicly in London and are now in the National Maritime Museum at Greenwich. Rae was allowed to keep a few as souvenirs (a spoon and fork belonging to Franklin) and lesser objects that are now in the Royal Scottish Museum, Edinburgh. The controversy over Rae's statement was not its news, for the Admiralty had long given up hope of Franklin, and his death had been publicly pro534 CMA JOURNAL/SEPTEMBER 3, 1977/VOL. 117
claimed as of "March 31, 1854" (London Gazette of same date), but Rae had written that the Inuit had told him that some of the party had been driven by starvation to cannibalism. This horrified the British public and resulted in two strongly worded repudiations of the idea (but not of Rae's integrity or honesty in reporting it) in Household Words. These were under the title of "The lost Arctic Voyagers" and appeared in Household Words for Dec. 2, 1854 and Dec. 9, 1854. The editor, Charles Dickens, cast doubt not on Dr. Rae, but on the ability of his Inuit interpreter and on the Inuit culture generally ("a babble of savages") and cited some examples of misfortune in which men in desperate conditions had turned their minds to cannibalism. Integrity and discipline, so entrenched in the English character (Dickens said. "we can be proud of Dr. Rae as an Englishman") would prevent this, and after all if Inuit did not disturb the dead or dying, what about animals? Dr. Rae replied, also in Household Words, under the same title on Dec. 23, 1854, with what was, in fact, a stout and factual defence of the interpreter and of the Inuit that he had met in these and earlier travels. None the less, Dickens's last words on this are "Therefore, teach no one to shudder without reason, at the history of their end. Therefore, confide with their own firmness, in their fortitude, their lofty sense of duty, their courage and their religion." To a great extent Rae's active days were now different, if not over. He learned he was entitled to the government's long-advertised reward of £10000 for solving the Franklin mystery, although that was not really solved until the "Voyage of the Fox", (under Sir Francis McLintock) was published in 1859. Rae had £8000 of the sum; the remainder was divided amongst his few companions, but the doctor wanted to use the sum for exploration and spent £2000 on having a small schooner built in Canada. Unfortunately the late delivery of the ship defeated his purpose; it was lost in a storm on the Great Lakes and so the Arctic project was dropped. Tour of United States Late in 1858 Rae made a tour of the United States with Edward Ellice, a director of the company. In the following year he, with others, crossed the prairies to Saskatchewan; later on this visit to Canada he walked on snow shoes from Hamilton to Toronto, about 65 kin, in 7 hours and dined out that evening "without any signs of fatigue." He was then about 46 years old. In 1860, he did the land part of a survey
for a projected telegraph line from England to America by way of the Faroes, Iceland and Greenland. In 1861 he made a journey to the Red River and Saskatchewan accompanied by Henry Chaplin (later Viscount Chaplin) and Sir Frederic Johnstone, Bart. With a guide (James McKay) they were on the prairies and into the buffalo plains of western Canada. Rae characteristically analysed all the problems; those of climate, ecology and the Indians and Red River settlers. His paper on this expedition seems to have been rediscovered only recently (Irene M. Spry, of the University of Ottawa, refers to it in an article in the Geographical Journal of February 1974) and it is interesting to see that he thought "no Englishman or Canadian would dream of adopting the policy of getting rid of the Indians, even to promote so great an object as the Colonization of the Saskatchewan Valley." His final field trip was in 1864 from Winnipeg across the Rockies (and 800 km in a small boat down the Fraser River) to the Pacific coast. In 1860 Rae had married Catherine Jane Alicia Thompson, third daughter of Major Thompson of Ardkill, County Londonderry. They had no children and Mrs. Rae, surviving her husband by many years, died at Chiselhurst, in Kent, England, in 1919. Retirement After his travels, Rae lived in London and spent summers in Orkney. He does not seem to have had much interest in medicine in retirement. He was prominent in the Royal Colonial Institute and was an Ontario representative on the Imperial Institute (now the Commonwealth Institute), and he served as director of several commercial enterprises in Manitoba and British Columbia. He was a keen volunteer and was a private in the London Scottish and competed at Wimbledon, with the Orkney Artillery Volunteers, in rifle shooting. His expeditions were accomplished through his remarkable health and physical energy, and they were more than explorations. He made observations on animals, plants, climate and geology. He recorded some of these in his 30 scientific papers. He was highly regarded by his peers, receiving an honorary MD from McGill in 1853 and an LLD at Edinburgh in 1856, an honour he greatly valued. He had long been a fellow and correspondent of the Royal Geographical Society and was made a fellow of the Royal Society in 1880 and often attended the meetings of both societies. Dr. John Rae died July 22, 1893 continued on page 541
(levodopa and carbidopa combination) INDICATIONS Treatment of Parkinson's syndrome with exception of drug induced parkinsonism. CONTRAINDICATIONS When a sympathomimetic amine is contraindicated; with monoamine oxidase inhibitors, which should be discontinued two weeks prior to starting SINEMET*; in uncompensated cardiovascular, endocrine, hematologic, hepatic, pulmonary or renal disease; in narrowangle glaucoma; in patients with suspicious, undiagnosed skin lesions or a history or melanoma. WARNINGS When given to patients receiving levodopa alone, discontinue levodopa at least 12 hours before initiating SINEMET* at a dosage that provides approximately 20% of previous levodopa. Not recommended in drug-induced extrapyramidal reactions; contraindicated in management of intention tremor and Huntington's chorea. Levodopa related central effects such as involuntary movements may occur at lower dosages and sooner, and the 'on and off' phenomenon may appear earlier with combination therapy. Monitor carefully all patients for the development of mental changes, depression with suicidal tendencies, or other serious antisocial behaviour. Cardiac function should be monitored conti nuously during period of initial dosage adjustment in patients with arrhythmias. Safety of SINEMET* in patients under 18 years of age not established. Pregnancy and lactation: In women of childbearing potential, weigh benefits against risks. Should not be given to nursing mothers. Effects on human pregnancy and lactation unknown. PRECAUTIONS General: Periodic evaluations of hepatic, hematopoietic, cardiovascular and renal function recommended in extended therapy. Treat patients with history of convulsions cautiously. Physical Activity: Advise patients improved on SINEMET* to increase physical activities gradually, with caution consistent with other medical considerations. In Glaucoma: May be given cautiously to patients with wide angle glaucoma, provided intraocular pressure is well controlled and can be carefully monitored during therapy. With Antihypertensive Therapy:Assymptomatic postural hypotension has been reported occasionally, give cautiously to patients on antihypertensive drugs, checking carefully for changes in pulse rate and blood pressure. Dosage adjustment of antihypertensive drug may be required. With Psychoactive Drugs: If concomitant administration is necessary, administer psychoactive drugs with great caution and obeerve patients for unusual adverse reactions. With Anesthetics: Discontinue SINEMET* the night before general anesthesia and reinstitute as soon as patient can take medication orally. ADVERSE REACTIONS Mest Cemmon: Abnormal Involuntary Movements-usually diminished by dosage reduction-choreiform, dystonic and other involuntary movements. Muscle twitching and blepharospasm may be early signs of excessive dosage. Othr Serious Reactions: Oscillations in performance: diurnal variations, independent oscillations in akinesia with stereotyped dyskinesias, sudden akinetic crises related to dyskinesias, akinesia paradoxica (hypotonic freezing) and 'on and off' phenomenon. Psychiatric: paranoid ideation, psychotic episodes, depression with or without development of suicidal tendencies and dementia. Rarely convulsions (causal relationship not established). Cardiac irregularities and/or palpitations, orthostatic hypotensive episodes, anorexia, nausea, vomiting and dizziness.
536 CMA JOURNAL/SEPTEMBER 3, 1977/VOL. 117
Other adverse reactions that may occur: Psychiatric: increased libido with serious antisocial behavior, euphoria, lethargy, sedation, stimulation, fatigue and malaise, confusion, insomnia, nightmares, hallucinations and delusions, agitation and anxiety. Neurologic: ataxia, faintness, impairment of gait, headache, increased hand tremor, akinetic episodes, 'akinesia paradoxica', increase in the frequency and duration of the oscillations in performance, torticollis, trismus, tightness of the mouth, lips or tongue, oculogyric crisis, weakness, numbness, bruxism, priapism. Gastrointestinal: constipation, diarrhea, epigastric and abdominal distress and pain, flatulence; eructation, hiccups, sialorrhea; difficulty in swallowing, bitter taste, dry mouth; duodenal ulcer; gastrointestinal bleeding; burning sensation of the tongue. Cardiovascular: arrhythmias, hypotension, nonspecific ECG changes, flushing, phlebitis. Hematologic: hemolytic anemia, leukopenia, agranulocytosis. Dermatologic: sweating, edema, hair loss, pallor, rash, bad odor, dark sweat. Musculoskeletal: low back pain, muscle spasm and twitching, musculoskeletal pain. Respiratory: feeling of pressure in the chest, cough, hoarseness, bizarre breathing pattern, postnasal drip. Urogenital: urinary frequency, retention, incontinence, hematuria, dark urine, nocturia, and one report of interstitial nephritis. SpecialSenses: blurred vision, diplopia, dilated pupils, activation of latent Homers syndrome. Miscellaneous: hot flashes, weight gain or loss. Abnormalities in laboratory tests reported with levodopa alone, which may occur with SINEMET*: Elevations of blood urea nitrogen, SGOT, SGPT, LDH, bilirubin, alkaline phosphatase or protein bound iodine. Occasional reduction in WBC, hemoglobin and hematocrit. Elevations of uric acid with colorimetric method. Positive Coombs tests reported both with SINEMET* and with levodopa alone, but hemolytic anemia extremely rare. DOSAGE SUMMARY In order to reduce the incidence of adverse reactions and achieve maximal benefit, therapy with SINEMET* must be individualized and drug administration continuously matched to the needs and tolerance of the patient. Combined therapy with SINEMET* has a narrower therapeutic range than with levodopa alone because of its greater milligram potency. Therefore, titration and adjustment of dosage should be made in small steps and recommended dosage ranges not be exceeded. Appearance of involuntary movements should be regarded as a sign of levodope toxicity and an indication of overdosage, requiring dose reduction. Treatment should, therefore, aim at maximal benefit without dyskinesias. Therapy in Patients not receiving Levodopa: Initially 'A tablet once or twice a day, increase by 1/2 tablet every three days if desirable. An optimum dose of 3 to 5 tablets a day divided into 4 to 6 doses. Therapy in Patients receiving Levodopa: Discontinue levodopa tor at least 12 hours, then give approximately 20% of the previous levodopa dose in 4 to 6 divided doses. FOR COMPLETE PRESCRIBING INFORMATION, PARTICULARLY DETAILS OF DOSAGE AND ADMINISTRATION, PLEASE CONSULT PRODUCT MONOGRAPH WHICH IS AVAILABLE ON REQUEST. HOW SUPPLIED Ca 8804-Tablets SIN EMET* ?5Q, dapple-blue, oval. biconvex, scored, compressed tablets coded MSD 654, each containing 25 mg of carbidopa and 250 mg of levodopa. Available in bottles of 100. CERCK .Trademark
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jouer, a 6t6 heureux de notre collaboration. D'autres m.decins verront dans nos services une concurrence possible, tel ce m6decin sp6cialis6 en madecine familiale qui concluait que nous voulions faire la m.me chose que lui". Le personnel infirmier de l'Atelier s'efforce de r.pondre aux besoins mdividuels exprim6s par les usagers mais si un probl.me est commun on essaiera de regrouper les gens pour qu'ils puissent travailler ensemble, encadr6s par le personnel infirmier, pour trouver des moyens d'action et des solutions. Les groupes d.j. constitu6s autour d'un centre d'int6r& sont aussi sp6cialement bienvenus: les locaux de l'Atelier leur sont grand ouverts et s'ils veulent se joindre un aviseur sur les questions de sante, le personnel se d6clare disponiPHYSICIAN EXPLORERS continued from page 536 at his house in Addison Gardens, Kensington. He was almost 80 years old and was laid low by influenza and congestion of the lungs. He was buried in the churchyard of the medieval cathedral of St. Magnus, Kirkwall, Orkney. In 1895 a fund was raised in Orkney for a suitable memorial, which was erected in the cathedral in that year. Although there is one curious omission, Rae has been generously documented. He has a paragraph in Chamber's "Biographical Dictionary.. (1962), 2½ pages in "The Dictionary of National Biography" (1959-60 edition) and a whole volume of the Hudson's Bay Record Society, "Rae's Arctic Correspondence 1844-55" (1953), a splendid biography by Sir James Wordie, who had been with Shackleton in the Antarctic and who was a colleague of mine on the Scottish Spitsbergen expedition in 1920. Some of Rae's journeys are marked on "A Historical Atlas of Canada" (1959) by D.G.G. Keer, and the abovementioned article by Ms Spry is a full account of Rae's visit to the Red River and Saskatchewan in 1861. The omission appears to be in the "Dictionary of Canadian Biography". This excellent work is now being published by the University of Toronto, and entries are in the order of date of death of the subjects. The most recent addition, Volume X, has not yet reached 1893 but the volume does contain an interesting short summary of Canadian Arctic exploration. Many of the great figures are mentioned, but John Rae is not among them. A distinguished explorer who admired the man and the memorial at St. Magnus was Edward Wilson (of whom more will be written in these
Mais la clientele qui donne la meilleure id.e du "genre de Ia maison" c'est certainement celle des jeunes de 7 .i 12 ans qui sont venus voir ce qui se passait dans ce nouveau local. Entr.s en curicux, les jeunes n'ont pas .t6 refou1.s comme us le sont d'ordinaire des Ijeux de travail des grands. us ont au contraire . accuejilis avec beaucoup d'int.r& et se sont tout naturellement mis . l'oeuvre pour s'informer . l'aide des livres traitant d'anatomie, de biologie etc. Comme on pouvait le pr6voir les questions ont
vite fus6 et les jeunes ont d6veIopp. l'habitude de venir faire un tour en passant . l'Atelier pour jaser, lire un peu ou tout simplement jouer. Maintenant, pour eux, ii est normal de venir parler des questions de sante et Ia fr& quentation de sp.cialistes n'est plus associ6e . un bobo qui fait mal. Voil. en somme . quoi voudraient en arriver les infirmi.res avec tous les gens qui veulent acqu6rir une nouvelle mentalit6 face . leur sante: leur faire d.couvrir que c'est en eux que reside la r.ponse . leurs questions et . leurs inqui&udes. La meilleure m6decine, c'est celle qu'on se prescrit soi-m.me quand elle est faite de recherche de connaissances par Ia frequentation des ouvrages sp&ialis6s et par des discussions avec les personnes capables de nous 6clairer. U
pages). Wilson wrote in his diary: "A full-length figure. of John Rae, MD, LLD, FRS, FRGS, Arctic Explorer, Intrepid Discoverer of the fate of Sir John Franklin's last expedition. Born 1813, Died 1893. Expeditions 1846-47; 1848-49; 185 1-52; 1853-4. Erected by public subscription 1895". That is the whole inscription - and the man is a life-size figure lying asleep wrapped in a buffalo sleeping bag, with moccasins on and a gun and a book
open by his side. He "sleeps soundly in this little out-of-the-way beautiful Cathedral at Kirkwall - honoured by his own people and caring nothing about the rest. This is what the monument suggested to me in the darkening nave of Kirkwall Cathedral at about 10 pm that evening just before the verger turned me out" (June 1, 1910). A noble tribute from a great man who himself now lies asleep in a little tent under the snows in the Antarctic.E
ble. L'Atelier a ainsi d.j. r6pondu . Ia demande de groupes de b.n6vo1es, . des classes pour adultes, . un groupe de travail du YMCA Ct aux guides de la region.
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