John Griffith’s 1993 Letter to the Editor, “A Historical Oversight”
John Griffin’s Letter to the Editor, entitled “An Historical Oversight,” was published in Dialogue, the Journal of the Ontario Psychiatric Association on December 3, 1993, about 40 years after Ruth (Koeppe) Kajander presented her paper entitled “Largactil - Some Preliminary Clinical Observations” at a meeting of the Ontario Neuropsychiatric Association held at the Ontario Hospital, Whitby, on November 27, 1953. The document presented here is held in the Archives of the Centre for Addiction and Mental Health (CAMH) in Toronto. The source of this document may be cited as: CAMH (Toronto) Archives, Griffin–Greenland fonds, Biographical Files series, Dr. Ruth (Koeppe) Kajander. Received from John Court (Kajander Collection).
Letters to the Editor
An Historical Oversight
Forty years ago a young doctor, who had recently arrived from Germany via Finland, was completing her required rotation internship at the Oshawa General Hospital. Her name was Dr. Ruth Koepe (now Dr. Ruth Kajander, practising psychiatrist in Thunder Bay, Ontario and past president of the Ontario Psychiatric Association). Ever observant, she had noticed a staff anaesthetist, Dr. Elizabeth Martin, using a new drug in preparing patients for anaesthesia and surgery. It had not yet been federally approved but Poulenc Bros., the pharmaceutical firm producing the drug, had obtained permission to have it used for careful evaluation. It was Largactil (Chlorpromazine). In Europe it had been used chiefly to reduce anxiety and tension prior to anaesthesia.
Dr. Koepe, who had considerable psychiatric experience in Finland, felt this new drug might be useful in reducing tension and over activity in mentally ill patients. When her internship ended she moved to the Ontario Hospital London as a resident physician. Dr. Koepe approached Dr. D. M. Wickware, the acting superintendent, and with his approval administered the drug to some 25 patients over a period of several months in 1953. These patients were mostly over-active catatonic schizophrenics but Dr. Koepe recalls her first subject was a case of agitated depression of the involutional type. She was pleased with the results.
Recalling this work Dr. Koepe writes – "l was astonished at the remarkable effects of this drug. It calmed restless, excited or overactive patients without sedating them to the level where they could not function. Patients lost their agitation but not their consciousness. They could talk about themselves, and eat and sleep without difficulty.
Catatonic and other types of excitement were no longer life threatening. ECT and heavy sedation with their perils could be avoided."
Dr. Ruth Koepe presented a report on the drug with her preliminary analysis of its biochemical and neurophysiological action on November 27, 1953 before the regular meeting of the Ontario Neuropsychiatric Association which was held at the Ontario Hospital Whitby. A copy of her paper is in the Archives of the History of Canadian Psychiatry at the Queen Street Mental Health Centre, Toronto and a reference to her presentation at Whitby is contained in the minutes of the meeting in the files of the Ontario Psychiatric Association. This must have been one of the first, if not the first scientific report to a scientific body in North America on the use of chlorpromazine. Unfortunately it was not published. Dr. Koepe-Kajander received no formal recognition for this early work.
J. D. Griffin, M.D.
Archives on the History of Canadian Psychiatry
Queen Street Mental Health Centre,
May 21, 2020