Before the Epidemic

Canadian Medical Practice

    The first Canadian schools of medicine opened in the 1820s. Medical students were educated in therapeutics, the origin and application of medicines, anatomy, physiology, surgery, midwifery, and medical law. They were taught to dissect corpses and, from the 1870s onward, to use microscopes and other laboratory equipment.

Figure 1. McGill University’s first medical building. Adapted from “Brief History of Medicine at McGill,” by R. Cruess, (2019), McGill, retrieved from https://www.mcgill.ca/medicine/about/glance/history. Copyright 2019 by McGill University. Reprinted without permission.

The 1800s saw considerable tension within the Canadian medical practice as various doctors debated how the profession should be defined and regulated and whether or not a medical license should be mandatory for a doctor to practice. The medical community wanted some sort of regulations to get rid of quacks, who were frequently quite successful due to the fact that the general public did not have the scientific education required to recognize them as charlatans, but many professionals disagreed as to what these regulations should be. Much of the tension was caused by differences between French-speaking and English-speaking doctors and between doctors who had been trained in Canada and doctors who had been trained in other countries. (Roland & Marshall, 2015). Multiple regulations and policies were passed in both Upper and Lower Canada throughout the 19th century before the formation of the Canadian Medical Association (CMA) in 1867, which continues to oversee the profession to this day (Geekie, 2013). Within Ontario, the 1869 Ontario Medical Act outlined a clear examination process for people who wished to enter practice. Both the Act and the CMA helped to strengthen the structure of the medical profession in Canada, but they did not fully succeed in getting rid of charlatans, who were still operating at the time that the Spanish flu broke out. Also, although the CMA was important, there was still no government organization that oversaw national health at the time of the outbreak. Local boards of health were created to enact rules for the protection of public health (Roland & Marshall, 2015).

Medical Advancements

Throughout the 19th century, there were a number of important medical advancements. First of all, the first vaccine was developed for the disease smallpox by Edward Jenner, who published his treatise “On the Origin of the Vaccine Inoculation” in 1801 (Centre for Disease Control & Prevention, 2019). Shortly afterwards, the vaccine was introduced to Canada by a Nova Scotian doctor. However, the Canadian public was extremely wary of vaccines and only really grasped the importance of them at the beginning of the 1900s, shortly before the outbreak of the Spanish flu.

Figure 2. Edward Jenner, inventor of the first vaccine. Adapted from “Edward Jenner (1749-1823)” by the BBC, (2014), BBC, retrieved from http://www.bbc.co.uk/history/historic_figures/jenner_edward.shtml. Copyright 2014 by the BBC. Reprinted without permission.

Vaccines were far from the only medical concept that the public was unwilling to accept, as they also were resistant towards various measures that had been enacted that governed the sale of food, immigration, and other things in the interest of maintaining sanitation. The discovery of anesthetics around 1840 was also important, as well as the introduction of antisepsis into surgery practice in the mid-1900s; prior to this, surgeons held their knives in their mouths when they were not in use and did not take great pains to clean their equipment thoroughly. So, although a number of important medical discoveries were made prior to the outbreak of the Spanish flu, there were still many medical concepts and practices that were not known or that were only recently discovered. Some important drugs, like insulin and synthetic antibiotics, were not discovered until many years later (Roland & Marshall, 2015).