Inuit

The Inuit's cold-adapted culture did not reach a state of near- perfection until the arrival of the Thule-culture people, who moved eastward from Alaska about A.D. 800, and within less than 200 years spread across most of the North American Arctic, displacing or absorbing the Dorset people. 

Superb sea-mammal hunters, Thule-culture Inuit pursued and killed everything, from the small ringed seal to the giant bowhead whale, and, according to archaeologist Robert McGhee of the Canadian Museum of Civilization, they had evolved "a technology more complex than that of any other preindustrial society, which allowed not only an economically efficient but also comfortable way of life throughout arctic North America."

 The Thule Inuit invented, perfected, and passed on to Inuit of historic times such a plethora of specialized tools and hunting equipment that the late James A. Ford of the American Museum of Natural History described them as "gadget burdened. 

The tool kit, for instance, used by Inuit not long ago to hunt seals at their agloos, the snow-covered breathing holes through the ice, consisted of about forty items, from the thin, slightly curved bone probe to determine the shape of the agloo, to tutereark, the piece of thick caribou winter fur on which the hunter stood so that no sound would warn the seal of his presence. 

The Inuit achieved this broad-ranging yet highly specialized Arctic material culture against what seem insuperable odds. Not only was their land exceedingly cold, hostile, and barren, it was also poor in those raw materials most societies have found essential. Metal was rare: meteoric iron, brittle and hard to work, was found in the Cape York region of northwest Greenland, and native copper in a few areas of the central Canadian Arctic. Driftwood was abundant along Alaska's coast and east past the Mackenzie River delta; it was rare in the eastern Arctic and virtually nonexistent in the central Arctic. That left stone, ice, snow, and sod as the most readily available and most widely used materials that the land and the sea provided. Infinitely more important were the materials they obtained from the animals they killed: bone, horn, baleen, antlers, teeth, ivory, furs, skins, sinews, and intestinal tissues.

After two hours, I had run out of poetry and patience. After three hours, I felt stiff, cold, and exhausted. The total lack of movement, the absence of any stimuli, grated on my nerves. After six hours, I gave up. I was cold, creaky, cranky, and intensely annoyed with myself, but that was about as much as I could take. Yet the Inuit did this nearly every day for ten to fifteen hours, and sometimes they got a seal and often they did not. Their concentration was total, their patience endless, for to Inuit (and polar bears) the seal was everything. I once asked Inuterssuaq of the Polar Inuit, "What is the most important thing in life?" He reflected for a while, then smiled and said: "Seals, for without them we could not live." 

George Best, captain and chronicler of Martin Frobisher's 1578 expedition to Baffin Island, said of the Inuit: "These people hunte for their dinners... even as the Beare." Inuit and polar bear do, in fact, use similar seal-hunting methods. Both wait with infinite patience at agloos, hoping for seals to surface. 

In late spring and early summer, seals bask upon the ice, and Inuit and polar bears synchronize their patient stalk with the sleep- wake rhythm of the seals. Typically, a seal sleeps for a minute or so, wakes, looks carefully all around to make certain no enemy is near, and then, satisfied that all is safe, falls asleep for another minute or two. The moment the seal slumps in sleep, the bear advances. The instant the seal looks up, the bear freezes into immobility, camouflaged by its yellowish-white fur. At 20 yards (18 m) the bear pounces, a deadly blur across the ice, and grabs and kills the seal. 

In the eastern Arctic, Inuit stalk a seal on the ice hidden behind a portable hunting screen, now of white cloth, formerly of bleached seal or caribou skin. In the central Arctic, Inuit do not use the screen. Instead they employ a method known to Inuit from Siberia to Greenland: they approach the seal by pretending to be a seal. They slither across the snow while the seal sleeps. When it wakes, the hunter stops and makes seal-like movements. To successfully impersonate a seal, a hunter told me, "you have to think like a seal." It is a hunt that requires great skill and endurance. They hunted seals at their agloos, they stalked them with screens on the ice. They waited for them at the floe edge and they harpooned them from kayaks. 

They hunted seals in fall on ice so thin it bent beneath the hunter's weight. They hunted them in the bluish darkness of the winter night, and they invented and perfected an entire arsenal of ingenious weapons and devices to hunt the seal. For, to Inuit, the seal was life, and their greatest goddess was Sedna, mother of seals and whales. 

A few inland groups lived nearly exclusively on caribou. The Mackenzie Delta Inuit are beluga hunters. Many Inuit of the Bering Sea and Bering Strait region live primarily on walrus. In Greenland and Labrador, Inuit hunted harp seals and hooded seals (the Polar Inuit drum Masautsiaq made for me as a farewell present is covered with the throat membrane of a hooded seal). But, for most Inuit, two seal species were of truly vital importance: the large bearded seal that weighs up to 600 pounds (270 kg), and the smaller - up to 180 pounds (81 kg) - but numerous ringed seal. These two seals were the basis of human life in the Arctic. 

I spent the spring of 1975 with the walrus hunters of Little Diomede Island in Bering Strait, between Alaska and Siberia. Among our crew was Tom, Jr., or Junior as everyone called him, the eleven-year-old son of Tom Menadelook, captain of the large walrus-skin-covered umiak, the traditional hunting boat of the Diomeders. On one of our trips into the pack ice, Junior shot his first seal. His father was typically gruff and curt, but we could see that he was pleased and proud. The crew made much of the boy and he glowed in their praise. That night, his mother, Mary Menadelook, cut the seal into many pieces, and following ancient custom, the boy took meat to all the households in the village, including to my shack, thus symbolically feeding us all. He was a man now, a provider, who shared in traditional Inuit fashion. 

Seal meat and fat, raw or cooked, was the main food of most Inuit and their sled dogs. The high-calorie blubber gave strength, warmth, and endurance to the people; it heated them from within. Rendered into seal oil, it burned in their semicircular soapstone lamps, cooked their meals, heated their homes, and, most importantly, melted fresh-water ice or snow into drinking water. Lack of blubber meant hunger, icy, dark homes, and excruciating thirst. Although Inuit were hardy and inured to cold, and dressed in superb fur clothing, their high-calorie, high-protein meat-fat diet also helped them to withstand the rigors of winter, for it raised their basal metabolic rate by 20 to 40 percent. Fortunately for the Inuit, blubber is a beneficial fat. Scientists were fascinated that Inuit who, a recent study says, "traditionally obtained about 40 percent of their calories from fat," had, in the past, no heart disease because their diet "although high in fat, is low in saturated fat.. and that presumably explains their freedom from disease." 

Seal oil, in the past, was stored in sealskin pokes and kept in stone caches, safe from arctic foxes, for spring and summer use. At Bathurst Inlet, Ekalun once showed me a great, solitary stone pillar, too sheer and high for bears or foxes to climb, upon which, in the past, Inuit had stored pokes of oil (they used a sled as a ladder to climb to the top). Even now, after decades of disuse, the distinctive, cloying smell of ancient seal oil clung to the pillar. 

The Inuit of Little Diomede eat seal oil with nearly all their meals. When they have to go to hospital in Nome or Anchorage, they take a bottle of seal oil along, because without it, they say, "food just doesn't taste right." Seal oil is their main preservative: they store in it the thousands of murre eggs they collect in summer, and bags of greens - and both keep reasonably fresh for about a year. They even had a type of chewing gum made of solidified seal oil and willow catkins, and a mixture of whipped blubber and cloudberries is known in Alaska as "Eskimo ice cream."

Yet, on reading their reports, one cannot fail to be struck by the explorers’ relatively unprejudiced tone as they describe the natives’ mutual solicitude or even their fundamental honesty. It is true that Davis sometimes seems to contradict himself: commenting on the Inuit’s apparent passion for iron – which caused them to steal the ship’s anchor – Davis felt bound to denounce their ‘vile nature’. But both Davis and Janes display a genuine interest in the Arctic people they interacted with. Failing to find a new maritime route to China, Davis appears to have turned part of his attention to the Inuit instead. The Inuit often take pride of place and it looks as if the description of their mores had been substituted for the traditional list of profitable ‘commodities’ that can be found in so many travel narratives. This is all the more remarkable as the quest for a Northwest or Northeast maritime route to China partly originated in the English merchants’ desire to remedy their financial woes after the cloth trade with Antwerp and the Low Countries had become less profitable.  What is more, Davis did not content himself with listing their drinking and eating habits, or ‘the many little images’ and diverse cultural artefacts they produced. Our main contention is that Davis also approached their language with linguistic acuity. 

Encountering 'very tractable people': Arctic pre-ethnography 

Davis set sail in June 1585 with a total crew of forty-two. He was the captain of a ship called the Sunshine while the other ship, the Moonshine, was under the command of one William Bruton. John Janes was Davis’s supercargo and a member of the Sunshine’s crew. Davis and his men sighted Greenland for the first time on 20 July. He seems to have been far from favourably impressed if one is to judge by the name he chose to give it: 

The 20. as we sayled along the coast the fogge brake up, and we discovered the land, which was the most deformed rockie and montainous land that ever we saw ... the shoare beset with yce a league off into the sea, making such yrksome noyse as that it seemed to be the true patterne of desolation, and after the same our Captain named it, The Land of Desolation.

 Davis and his men then turned Cape Farewell (Uummannarsuaq) without trying to explore the coast and entered what is now the fjord of Nuuk (Nuup Kangerlua, previously Godthaab Fjord), which Davis named ‘Gilbert Sound’, at latitude 64°11’. It was there that they first encountered a group of Inuit. If the very first contact proved a little baffling and rather disconcerting, Janes tells us that surprise and diffidence rapidly gave way to ‘many signs of friendship’: 

The Captain, the Master and I, being got up to the top of an high rock, the people of the countrey having espied us, made a lamentable noise, as we thought, with great outcries and skreechings: we hearing them, thought it had been the howling of wolves ... Whereupon M. Bruton and the Master of his shippe, with others of their company, made great haste towards us, and brought our Musicians with them from our shippe, purposing either by force to rescue us, if need should so require, or with courtesie to allure the people. When they came unto us, we caused our Musicians to play, ourselves dancing, and making many signs of friendship.

 It is perhaps significant that the first interaction between the two parties should have taken such a musical form as this scene may be said to set the tone for Davis’s subsequent encounters with the different groups of Inuit he met. On the whole, it seems that concord prevailed over disharmony, though it is important not to oversimplify the necessarily complex and ambivalent feelings that both sides mutually experienced towards the other party. It should also be noted that, from the start, the Inuit’s ‘speech’ and their ‘pronunciation’ aroused Janes’s linguistic curiosity: ‘their pronunciation was very hollow thorow the throat, and their speech such as we could not understand’. If Frobisher’s first contact with the natives gave rise to a display of gymnastic virtuosity on the part of the Inuit, in Davis’s case the first encounter between the explorers and the natives concluded with music, dancing and a scene of rejoicing: ‘one of them came on shoare, to whom we threw our cappes, stockings and gloves, and such other things as then we had about us, playing with our musicke, and making signes of joy, and dauncing’.

In the rest of his narrative, Janes often insists on the feelings of ‘trust’ and ‘familiarity’ that gradually developed between the two groups. On the second day, the English gained the trust of the Inuit by mimicking their attitudes and ‘swearing by the sun after their fashion’: ‘so I shook hands with one of them, and he kissed my hand, and we were very familiar with them. We were in so great credit with them upon this single aquaintance, that we could have anything they had.’ Much like Thomas Harriot who also admired the ingenuity of the native Algonkians, Janes marvelled at the skill of the Inuit. In particular, he showed deep interest in their fine – and warm – sealskin buskins, gloves and hoses, for which he willingly exchanged his much less comfortable clothes, ‘all being commonly sowed and well dressed: so that we were fully perswaded they have divers artificers among them.’ In fact, except for their religion – or lack thereof – Janes did not find anything wrong with them, as can be seen from the following description of the first group he came into contact with: ‘they tooke great care one of another ... They are very tractable people, void of craft or double dealing, and easie to be brought to any civility or good order: but we judge them to be idolaters and to worship the Sunne.’

In 1967, I lived some months at Coral Harbour on Southampton Island in northern Hudson Bay and often traveled with Tommy Nakoolak, then, at sixty-two, patriarch of the island's sizable Nakoolak clan. Of Knud Rasmussen, the great Danish ethnologist, it was said that he was the only man known who collected old women. They, of course, were the repositories of the ancient tales he loved and recorded. Similarly, whenever possible, I lived and traveled with older Inuit who told and taught me many things the lore, the legends, the skills of their people. 

Tommy Nakoolak was small and wiry, kind and considerate, and he owned a Peterhead boat, the Tereglu (the word for a baby bearded seal), which he handled as if it were a racing yawl. One day along Coats Island, south of Southampton Island, he spotted a herd of walruses on a rocky promontory. "You want pictures?" he asked, and when I said yes, he swung the boat around and headed full speed for the rocks. He sheered past them so closely, I tensed instinctively for the coming crash, but Tommy only smiled. Like many old-time Inuit, he had an astounding geographical memory and knew every rock and ridge along hundreds of miles of coast. 

One day while his sons were hunting caribou on Coats Island, Tommy said: "Come, I'll show you something." He took the Tereglu to a secluded bay near Cape Pembroke. Ashore were ancient stone houses, man-high cairns, box-like graves built of large flat stones, and everywhere masses of bleached bones of caribou, walrus, bowhead whale, and seal. "This is where the Sadlermiut lived," said Tommy. A mysterious, long-isolated Stone Age people, the Sadlermiut were briefly known to the outside world and then all were killed by a whaler-brought disease in the winter of 1902. They may even have been Tunit, the powerful Dorset-culture people. Extinct everywhere else for 800 years, they had found a final refuge on these isolated islands. (The people who now live on Southampton Island are descendants of mainland Inuit brought by whalers and traders to the island to replace the extinct Sadlermiut.) 

The Sadlermiut were "discovered" in the summer of 1824 by the explorer Captain G.F. Lyon of the Royal Navy. He anchored his ship, HMS Griper, off Cape Pembroke. From the camp which Tommy Nakoolak was showing me, a man approached the Griper, riding on a most peculiar craft. It consisted of "three inflated seal- skins, connected most ingeniously by blown intestines, so that his vessel was extremely buoyant." The man's legs dangled in the water while he propelled this strange float toward the ship with a narrow- bladed paddle made of whale bone. The poor man had never seen other humans before and he was afraid: "his teeth chattered and himself and seal-skins trembled in unison. 

Lyon went ashore. The people were shy but friendly, of "mild manners, quiet speech, and as grateful for kindness, as they were anxious to return it." The men wore pants of polar-bear fur; their mittens were the skins of murres, feathers inside. The women were slightly tattooed, and "their hair was twisted into a short club, which hung over each temple." The men's topknots were even more impressive: "Each man had an immense mass of hair as large as the head of a child, rolled into the form of a ball, and projecting from the rise of the forehead." 

Once the Sadlermiut had been numerous. At Native Point on Southampton Island, the archaeologist Henry B. Collins of the Smithsonian Institution found, in 1954, "the largest aggregation of old Eskimo house ruins in the Canadian Arctic." But whalers began to stop at the islands and contact with another world was fatal to the long-isolated people. When the whaling captain George Comer visited Southampton Island in 1896, only seventy Sadlermiut were left. Comer admired the strength and courage of these "fearless people" who had only stone-tipped harpoons and spears: "For an Eskimo in his frail kayak to attempt to capture a [50-ton/ 45-tonne] whale with the primitive implements which they manufactured meant great courage. 

In the fall of 1902, the whaler Active stopped at Southampton Island. One sailor was sick; he may have had typhus or typhoid. Sadlermiut visited the ship and took the disease back to their village. That winter the last Sadlermiut died in lonely agony upon their island. Collins studied their house ruins and graves in 1954 and 1955 and "found evidence that the Sadlermiut descended from the Dorsets - that they were in fact the last survivors of the Dorset culture."

This is, perhaps, too rosy a view of early Inuit life. It was hard, precarious, and in some regions haunted by recurring famines. But it did have that saving grace of contentment known only when a people are secure within their society and in harmony with their natural environment. That ancient balance was broken when Europeans came to the Arctic - the whalers who took from the North much of its wildlife, the basis of the Inuit's existence, and who brought to the North diseases to which the long-isolated Natives had no immunity. 

Between 1850 and 1885, the Inuit population of coastal arctic Alaska declined by 50 percent. In two generations, the Mackenzie Delta Inuit were reduced from about 1,000, to fewer than 100. Labrador's Inuit numbered about 3,000 in 1750. In 1946, 750 were left. With the whales nearly exterminated, the whalers departed, leaving a people wracked by disease and accustomed to, and dependent upon, many southern goods. Into the vacuum created by the whalers' departure stepped the fur traders, and to pay for the southern goods they had come to regard as essential, the Inuit became trappers. Where once they had been poor but independent, they were now dependent and still poor, their ancient autarky destroyed beyond redemption.

Page 26:

"McClure and his men noted that these Inuit made extensive use of copper for making hunting implements and other tools: 

this knives, arrows, needles, and other cutting and piercing instruments were all made of copper--several speciments which were obtained--fashioned into shape entirely by hammering. No igneous power being had recourse to, it was surprising to see the admirable nature of the work, considering the means by which it was effected, and the form reflected great credit on their ingenuity and excellence in the adaptation of design. (Armstrong 1857:339-340).

The British and Eskimos then traded. One of the expedition members later noted:

They were all quite devoid of that mercenary spirit, and those strong thieving and other propensities so universal amongst the Esquimaux on the American coast[i.e. North Alaska]--the result of their contact with civilized man--being a few of the evils which invariably follow his footsteps over the world...They were quite ignorant that there existed any other people differing from themselves in manners and customs; and asked our party where they came from, and where their hunting ground was situated. Their entire occupation consisted of hunting and fishing, migrating to and from along this coast, fixing their temporary abode wherever success was most likely to attend their efforts; and appeared to be influenced by no other feeling than the acquistion of what was essential to their sustenance from one season to another, to afford them sufficient food and raiment for sustaining life and protecting them from the cold (Armstrong 1857:340)

The meeting--the first European contact and communication with this northernmost group of Copper Inuit--was brief. But from their written observations, it is clear that these explorers were extremely impressed with the Inuit's remarkable ability to survive in such a harsh climate, using ingenious tools and hunting implements made from the limited resources at their disposal. Since no trade items of southern manufacture had yet reached this isolated region of the Arctic, these people were totally independent and self-reliant. 

The First Case of Diabetic Retinopathy 

(Eduard von Jaeger, Vienna 1853) by FRANZ FISCHER 

We have before us the plates and documentation of a case of retinitis (retinopathy) in diabetes mellitus, the first of its kind. It derives from the Beitrage zur Pathologie des Auges by Eduard von Jaeger for the year 1855. That it was the first such case we have the best guarantor, Theodor Leber. In 1875, he collected the cases from the literature - there were 19 in all, of which Jaeger's case was the first - and coined the term retinitis diabetica. So characterized, Jaeger's case wanders through the literature. After Leber he found no-one more appreciative. We thought it stimulating as well as conducive to the continuity of research to exhibit this case. 

It is no accident that the observation was made in Vienna, and made by Eduard von Jaeger. In the second half of the 18th century and subsequently, Vienna was very fruitful medical soil, a place where the new seed of ophthalmology could flourish. We see Joseph Barth, the gifted individualist, Georg Joseph Beer (first professor, 1818), the first teacher and founder of scientific ophthalmology, Friedrich Jaeger, Ritter von Jaxtthal (Eduard's father), Professor at the military medical Joseph's Academy (Josephinum), the most sought-out eye-surgeon in Europe. In the so-called II Vienna Medical School, Eduard von Jaeger with Ferdinand von Arlt and K. Stellwag von Carion was an outstanding champion of the specialty. As the son of Friedrich von Jaeger and grandson of the great Joseph Beer, Eduard von Jaeger had glittering prospects. 

Nevertheless, and with all his personal accomplishment, he was denied what he felt to be his heart's desire: only at the age of 65 did he become Professor at the II Ophthalmic Clinic, Vienna, not long before his death (5 July, 1884). His main creative work lay in ophthalmoscopy. The best witnesses on his account are two competent ophthalmologists: Ludwig Mauthner (in the obituary): "Eduard von Jaeger's career is inextricably bound up with the history of the ophthalmoscope. He was one of the first who turned Helmholtz's discovery to practical use. He also produced an improved form of Helmholtz's instrument very soon for everyday practice. Eduard von Jaeger was the greatest ophthalmologist the world had yet seen." Then Maximilian Salzmann (in the preface to the reworked Atlas of 1890): "The time has its expectations, which Eduard von Jaeger, linked with the appearance of his Atlas has satisfied in full measure. His work is recognized as the most important in the field of ophthalmoscopy and has become a foundation on the basis of which numerous young doctors have been introduced into this important oculists' discipline." So much for the environment and personality of our author. 

And now for the case. The description begins as follows: "The gardener Wilhelm W., then 22 years old, of slender physique and medium height, had always been healthy and strong in childhood and adolescence. However, 4 years previously, through catching cold, he developed a disorder which repeatedly kept him in bed with slight fever and swelling of the right foot, loss of strength and appearance. As this continued, the phenomenon of a diabetes emerged, coupled with marked anorexia, dry throat, frequent vomiting after eating and feelings of great decline and weakness. For a short time the patient had also complained of frequent cough with much sputum and feelings of oppression and pressure in the chest. " 

We now shorten this account. 5 weeks before he had experienced a disturbance of vision: transient seeing of flashes and "slight clouding of the outer half of the visual field in the left eye". The clouding had spread to the other eye and was increasing. The sight in the left eye had temporarily improved. The disorder had steadily increased. It is stated: "The patient presently appears very ill and low, is thin and has a sallow complexion." Then a "disturbance of the visual field in the middle" with reduction of visual acuity is described. Passing to the ophthalmoscopic findings: The media had appeared quite transparent and normal. The peripheral parts of the fundus were free from lesions. 

On the other hand, the site and vicinity of the transverse section of the optic nerve (in the extent of the extravasate illustrated in the picture) is dull in color, less translucent, more blood-red, and the optic nerve cross-section is so completely covered by the aforesaid color change as to be no longer perceived and can only be recognized by the union of the retinal vessels. 

"Anomalous redness of the optic fundus" and "radiate spreading of the optic fibers in the vicinity of the optic nerve" were reported. Then it states: "In the region of this anomalous coloring of the optic fundus there are to be perceived a considerable number of apparently uniformly distributed blood-red flecks, some punctate, some striate or otherwise shaped, of the most various size, which seem to lie in the plane of the retinal vessels, i.e., deep to the retina, are predominantly elongated, and whose arrangement and orientation correspond partly to the optic expansion and partly to the paths of the retinal vessels, particularly the veins. Between the flecks, at some distance from the optic disc, there also appear numerous irregular, rounded, light-yellow spots whose brightness makes them very obvious." 

It then states that the retinal vessels in the region of the optic disc were hazy. The arteries showed an especially brilliant media. The diameters of the arteries and veins were significantly increased above normal. The description ends as follows: "The left eye exhibits objectively and subjectively exactly the same appearances, though to a lesser degree and the patient is still capable with its aid of getting about in the street and even doing some work as a gardener." 

We note that plate and text are quite consistent. The text, based on the author's principle, is descriptive, not explanatory. The illustration is quite true to life and free from any exaggeration. The lithography and color printing, carried out by the Imperial and Royal Court and State Press in Vienna is an amazing technical achievement for a hundred years ago. 

What was Eduard von Jaeger describing? At the fundus: an edema of the optic disc and adjacent retina, streaked and radially arranged hemorrhages at some distance from the disc, light-yellow spots, to be explained later, as essential features. The question whether this complied with the concept of diabetic retinitis (retinopathy), then and now, may be answered as follows. Th. Leber (1875) remarked of Jaeger's case that it resembled the retinitis occurring in albuminuria. Later, the edema (with the star figure in the macula) were counted as characteristics of albuminuric (nephritic, angiospastic) retinitis as against diabetic retinitis. What can we say today? Diabetic retinopathy embraces a whole range of retinal lesions: "blood-spots (anatomically: capillary aneurysms) at the outset, hemorrhages and white degenerative foci subsequently, and finally vascular and connective tissue proliferation, vitreous hemorrhage, retinal shrinkage, etc. (retinitis proliferans), though these stages are not always observed. As always with retinopathy, the edema is not part of the fundus picture. It is the view of not a few workers today that, when an edema appears, the case is one of nephritic and not diabetic retinopathy. We believe, however, that diabetic retinopathy can, exceptionally, imitate nephritic retinopathy. Edema formation is shown especially by young diabetics, as confirmed by R. Thiels and our own observations. Frankly, we cannot share Thiels' view (1956) that this depends on the special nephropathic forms of diabetes, the KimmelstielWilson glomeruloscleroses. The fact that most Kimmelstiel-Wilson cases are heralded by retinopathy without edema formation is an argument against. Therefore nothing prevents us from acknowledging Jaeger's case as one of true diabetic retinopathy, despite any similarity with albuminuric retinitis. Jaeger's case admits of another interpretation. The indistinct disc, the numerous radially arranged hemorrhages, the markedly reduced visual acuity - all are very suggestive of a thrombosis of the central vein of the retina. This is not at all an uncommon event in older diabetics (with advanced arteriosclerosis), in any case commoner than in non-diabetics; in young diabetics it was unknown. Now, J. Dietzel and P. White have recently observed a central vein thrombosis in a young diabetic, followed by a retinitis proliferans in the other eye. This demonstrates that the angiopathy specific to diabetes (and not just the usual arteriosclerosis) is capable of producing such a picture. Jaeger's case in a 22-year-old diabetic could be interpreted in this sense; but, frankly, the fundus picture is not at all consistent and the appearance in both eyes arouses doubts. The possibility exists. Now for the "rounded light-yellow spots" in our fundus picture. That this referred to the usual retinal degenerative foci we believe can be dismissed without more ado. K. vom Hofe was the first (1938) to point out the frequency of such a finding in diabetic retinopathy, and we confirm this from our own experience. It only surprises us how little awareness of this there was until now. Vom Hofe interpreted the picture as lipid infiltration of the deep retinal layers or choroid and proved correct. For the picture certainly is not related to "choroiditis in diabetic retinopathy" as we have recently described it. How accurate, then, were Jaeger's observations!

 If we leave the fundus picture: the patient's age of 22 years leads to the following remarks. Until some 10 years ago, diabetic retinopathy below 40 years of age was an absolute rarity. Thus we find in a world-famous textbook of ophthalmology of 1935 that only a single case is quoted from the literature. A marked change has occurred here. The number of young diabetics is large and steadily increasing, due to insulin and other modern treatment. The young diabetic is becoming older and now experiences its vascular complications, notably nephropathy and retinopathYi at the age of 30 or 40, he is confronted with a gloomy fate. For us, this is the main problem of diabetes mellitus today. On the other hand, the practicality of oral treatment of diabetes is fading. 

And now back to Jaeger's case. At that time, and for one of his age, he was certainly a rarity. And it should be considered that in the pre-insulin era young diabetics died off very quickly without exception from comai young diabetics did not live to experience vascular complications. As for the duration of the diabetes - in our case barely longer than 5 years - the following may be noted. As far back as 1858, Albrecht von Graefe was struck by the fact that the ocular disorders in diabetes mellitus belonged to "an advanced stage of the general disease". It required intensive research up to our own time to reveal the role of the duration of the diabetes in the development of retinopathy. 

Today, many workers, notably Dolger (USA) adopt the standpoint that every diabetic will experience the "vascular complications" of nephropathy, retinopathy, etc., if he lives long enough, for 20 years or more. On the other hand, Joslin's school in the USA advances the view that the vascular complications can be prevented or at least postponed by precise management of the diabetes from the outset without interruption, with proper treatment and surveillance. The advocates of the "free diet" (which actually is not a free diet) for diabetic children and adolescents rather incline to Dolger's view. We ourselves acknowledged Joslin's requirements in various articles though, like other authors, we were well aware that in by no means a few cases, and despite the best monitoring of the diabetes, a retinopathy (and nephropathy) develops after quite a short duration of the diabetes, while others remain unaffected despite continuously poor monitoring and overlong duration of the disease (30 or more years). We sought to explain the "bad" cases by a special penetrating power of the diabetes on an unherited basis. 

We are further of the opinion that, not only the diabetes as such, but also the associated vascular constition are inherited, and in a decisive manner. On this, the findings have yet to be made known. Jaeger's case, with its relatively short duration of diabetes, therefore also falls outside the rule in this respect and requires a special explanation, as given above. What does the case tell us otherwise? We may pass over the classical diabetes symptoms. Nothing is said relating to albuminuria or nephritis. Th. Leber felt this as a defect in the completion of his task. Thanks to the exact illustration, we can say with fair certainty that a nephropathy did exist, indeed in the uremic end-stage. This is not surprising, since we know how much alike are diabetic retinopathy and nephropathy, both clinically and pathologically; and it is just in young diabetics that nephropathy, as Kimmelstiel-Wilson's glomerulosclerosis, runs a deleterious course. 

That the report contains nothing about the blood-pressure only evokes the late development of blood-pressure measurement. A hypertension would not be surprising; according to our findings, it is associated just like the nephropathy with the retinopathy of young diabetics. The disease was ushered in by an infection, as we know well today. We amplify: the course of the diabetes was also unfavorably influenced by infection. Unfortunately, the eradication of focal sepsis has been pushed into the background in modern diabetes treatment. The description even suggests pulmonary tuberculosis. Over and again, this disease plays a noteworthy yet too little noted role in juvenile diabetes, being the second cause of death after uremia. 

We may conclude: The case reported by Eduard von Jaeger in 1855 is unusual as regards age, duration of diabetes and fundus findings. It withstands any check by current standards. We are right to see in it the first observation of diabetic retinopathy. The strictly scientific approach of the author has saved the case from oblivion. Yet it is quite remarkable that our acquaintance with diabetic retinopathy should have begun in such an unusual way. And what is even stranger is that in Jaeger's case we encounter the problem case of diabetes mellitus today. Eduard von Jaeger published this case in his Beitriigen zur Pathologie des Auges (1855-1856). 

Just listen, in conclusion, to what our historian, J. Hirschberg, writes on this: "No sacrifice for science was too heavy for him. For his wonderful Contributions to the Pathology of the Eye he plunged into a debt of 20,000 gulden, which he gradually paid off from his earnings." Such was Eduard von Jaeger. May he be a model to all young ophthalmologists!

 Summary 

The priority of the case is certified by Th. Leber (1875). That the observation was made in Vienna and by Eduard von Jaeger (1855) is not a matter of chance. Though this case of diabetic retinopathy is unusual in many respects, the diagnosis is beyond doubt and satisfies any check. The author's comprehensive and very factual approach gives us cause, even today, for valuable inferences and reflections, and not only as regars the fundus appearances. The spirit of a true natural scientist reveals itself. 

References 

F. Fischer: Probleme der diabetischen Retinopathie. Klin. Mbl. f. Augenheilkunde 125 (1954): 666 - Einst und jetzt. Die historische Entwicklung der Retinopathia diabetica. Miinchner med. Wschr. 44 (1954)1287. - Die Retinopathie des jungen Diabetikers (unter 40 Jahren). Graefes Arch. 1957. - J. Hirschberg: Geschichte der Augenheilkunde. In Handbuch Graefe-Saemisch, Bd. XV, 1916. - Eduard von Jaeger: Beitrage zur Pathologie des Auges. 2. Lieferung, S. 33, Tafel XII. K. K. Hof- und Staatsdruckerei, Wien 1855. - Th. Leber: Uber die Erkrankungen des Auges bei Diabetes mellitus. Arch. f. Ophthalm. 21, 3 Abtlg. (1875): 206 - Die Krankheiten der Netzhaut. In Handbuch Graefe-Saemisch, Bd. VII12 (1914): 969. -1. Mauthner: Eduard von Jaeger. Wiener Med. Wschr. 28 (1884): 878 - Th. Puschmann: Die Medizin in Wien wahrend der letzten 100 Jahre. M. Pedes, 1884. - M. Salzmann: Ophthalmoskopischer Handatlas von Eduard von Jaeger, neubearbeitet und vergr6Bert. F. Deutike, Leipzig und Wien 1890. - L. Schonbauer: Das Medizinische Wien. Geschichte, Werden, Wiirdigung. Urban & Schwarzenberg Berlin und Wien 1944. in: Wiener Medizinische Wochenschrift 107 (1957) 969-972.

By February 1, 1879, the few Inuits at Camp Daly had moved over to Depot island, it being more available for walrus hunting in the ice-flow, which season was then just commencing. For the first time among these savage sons of old Boreas I was brought in contact with one of their superstitions that caused me no little annoyance. When the reindeer hunting season is over the walrus and seal come into the Esquimaux market, completely excluding the reindeer, which from that date becomes forbidden fruit. The Inuit who has relinquished reindeer meat tears down his old igloo and builds a new one, as he must not hunt or eat walrus or seal or work on sealskin clothing in an igloo where the now discarded deer has been eaten or clothing made from his hide. 

Now I found it impossible to procure any reindeer meat for self or for dog-feed while I lived in my present igloo. If I would only build another, which they beseeched me to do, even on the site of the present one, they would bring me plenty. Natives came over daily but brought no meat and we finally had to take the dogs over to Depot Island, where the natives allowed them to be fed. 

This superstition is founded on the belief that there exists two Gods antagonistic to each other, one ruling the seas and all in them, and the other the land with all its beasts and birds, and they must appease their respective divine jealousies by holding true allegiance to only one at a time. 

CHAPTER V 

THE LONG SLEDGE JOURNEY BEGINS 

As everything was ready for the start quite a number of days before the day set- April 1, 1879 - we waited with a strange, lonesome anxiety for that date. All the stulf that was to remain had been boxed up carefully and Ahmow, its custodian, was removing it to his igloo on Depot Island. Life in a half deserted house is enough to set one half crazy, but living in a half deserted igloo is amply sufficient to fill an insane asylum. 

Let us take a hurried look at the party before it starts. The officers were: Lieutenant Frederick Schwatka (myself) and Colonel William H. Gilder, second in command. Frank Klutshak, our scientist and Frank Melms, the only one of us white men who had previously lived in the Arctic, completed the white members in our party. The Esquimaux included Joseph Ebierbing ("Esquimaux Joe") who, as has been stated, had been with Captain Hall and Captain Hayes on their Arctic journeys, and his wife Nipschank or Hannah; Toolooah, hunter and chief sledge driver, and his wife Tooloohalek or Susie, and their two-vear-old boy Iyow- kawank, or Jack; Ikqueesik, our chief guide; (Nachilluk Joe) and his wife, Lizzee and three-year-old daughter Koodleuk; Ishoowark (Jerry) and his wife, and two Innuit boys, brothers of Ikqueesik, aged eighteen and fourteen, named Milkolilluk and Awanak respectively. An Iwilli boy, aged twelve, named Koomunah, completed the party of eighteen souls. 

We had three large sledges, well shod with the bone from the jaw of a whale, and forty-four very good dogs. Our arms consisted of 

• two Remington breech-loading muskets, 

• two repeating Winchester carbines, 

• one breech-loading Sharp's sporting rifle, 

• one heavy breech-loading Sharp's sporting rifle, 

• one heavy breech-loading Whitney (Greedmoor pattern) rifle, 

• one 26-shot repeating sporting rifle, 

• (Evans patent), 

• two Smith & Wesson revolvers, 

• and some muzzle-loading muskets. The latter were to be used for trading purposes, if necessary, among the natives whom we expected to encounter. 

Our ammunition supplies were far beyond the greatest ever taken before upon an Arctic sledge journey. But our provisions were extremely limited for so large a party over the nine or ten months we would be absent, so that our caisson was none too large. Dependent as we would soon become upon the game of the country, we had fair reasons to believe such existed in sufficient quantities to support us and our dogs if our hunters were only vigilant. 

Our ammunition boxes showed [turned to bulleted list for readability and unintended pun]

• 700 rounds of Remington cartridges, of 50 calibre and 70 grains powder; 

• 700 rounds Winchester cartridges, cal. 45., 75 grs. powder: 

• 300 rounds Sharp's cartridges, cal. 40., 70 gr, powder; 

• 450 rounds Evans cartridges, cal. 44., 55 grs. powder;

• 220 rounds Whitney cartridges, cal. 44, 95 grs. powder. 

• besides 200 rounds for the Smith & Wesson's revolvers 

• and 100  bullets, 2000 caps and 25 lbs. of powder for the Springfield muskets. 

• I must not forget to mention a breech-loading Remington shotgun, with 100 rounds of filled cartridges,

•  a muzzle loading shotgun with a box of (25 lbs.), duck power and 25 lbs. shot. 

• A sum total shows fifteen guns and about 4000 rounds of ammunition. 

Our only anxiety now was to be able to transport such a heavy load and to find sufficient game upon which to throw it away. 

Without giving an uninteresting list of the provisions with which we burdened ourselves, suffice it to say, counting as a day's ration, three pounds a day for an adult and proportionally less for the others, we had a trifle less than a month's supply. But it was not the intention to depend upon this until it was eaten up and then live upon the country, but to stretch it out as far as possible by the assistance of reindeer meat, as soon as we entered the hunting country. Two thousand pounds of Kow (walrus hide) and our bedding gave our sleds quite a heavy and formidable looking appear ance, as we started, but most of the load was of a nature that stead- ily decreased as the time advanced. 

As the world turned round it brought our appointed date, April 1, 1879, and found us already to start, but like all other first-day starts it was a late one. It was nearly noon as we pulled out on the salt water ice near Camp Daly and, shaking hands, bid our trusty Inuit friends good-bye. We stopped a second to take a last look on that dreary cheerless mass of snow domes that had so long been our home, and seemed doubly like a home now that we were parting with it for a still less cheerless and dreary journey. 

There is something peculiarly depressing in starting upon a long unknown venture, especially if a person has upon his mind all the cares and duties of a commander to warn him that, in case of misfortune, he alone does not suffer. And this was to be an expedition where misfortune might easily befall us. With less than one month's provisions, we were separating ourselves by an icy desert of eight and nine leauges from all chance of rescue, with eighteen human and forty-four brute mouths to be fed in a country reported destitute of game. And in this forbidding land we were to spend possibly a year - under the most favorable cireumstances not less than nine months - to make an extended and laboriously thorough search to determine the sad fate of those that had died here. it brought up the most solemn thoughts to one responsible for the lives and comfort of those who thus willingly joined in this unselfish effort to accomplish such a task. 

My triangulation cairns around Depot Island had not yet faded completely from sight as we stopped for our first camp, about ten miles north of Camp Daly, on the eastern shore of the Winchester Inlet. The weather had been exceedingly fine during the day and the oft-repeated injunctions of our Innuits, that the weather about this time of year was nearly always like this, was cheering news. 

We built two large double igloos, the four white men and Toolooah's family occupying one, and the remainder of the Innuits the other. The next night, however, this latter igloo was again divided. Joe and Jerry, with their respective families, occupying one and Ikqueesik the other. Thereafter this arrangement was continued until we reached King William Land.

THE BELUGA HUNTERS IN PREHISTORIC TIMES - A MERE 200 YEARS AGO - THE MACKENZIE River delta and adjacent coasts were the richest, most populous region in what is now the Canadian Arctic. About 30,000 bowhead whales summered in the shallow Beaufort Sea, 50-ton (45-tonne) feasts for hunters skillful and daring enough to kill them. There were Dall's sheep in the mountains, moose in the valleys, musk-oxen on the tundra, and in summer vast herds of caribou on the wind-swept coastal plains. 

Seals were common. Great polar bears patrolled the ice, and fat Barren Ground grizzlies patrolled the land. Here were the breeding grounds of much of North America's waterfowl: the myriad tundra lakes were speckled with ducks and geese, loons and swans. Rivers and lakes were rich in fish: char and inconnu, and immense shoals of herring and fat whitefish. 

Most important to the Inuit of this region were the milky-white beluga whales that arrived each year in large pods in late June at the edge of the Mackenzie estuary and remained for six to seven weeks in its shallow, sun-warmed bays and inlets, where they were relatively easy to hunt. The people were the Mackenzie Inuit, the "Beluga Hunters," as archaeologist Robert McGhee of the Canadian Museum of Civilization has called them. When he dug trenches through the thick refuse layers at Kittigazuit, the main village of the Mackenzie Inuit, "87 percent [of all bones] were of beluga." These Inuit took all that a bounteous nature offered, but the beluga large, easily killed, and abundant - was their favorite prey. 

While in other parts of the Canadian North the average population density was one person to every 250 square miles (648 km2), 2,500 to 4,000 Mackenzie Inuit lived in settlements near the river mouth. Inuit camps, specks of humanity scattered across the vastness of the Arctic, were usually home to a few families, perhaps 50 people. Kittigazuit, the main village of the Beluga Hunters, had a summer population of 800 to 1,000 people. 

Among the Inuit at Kittigazuit at the turn of this century was an orphan boy named Nuligak who lived with his crippled grandmother. "Because I was an orphan and a poor one at that, my mind was always alert to the happenings around me. Once my eyes had seen something, it was never forgotten." He became a famous hunter and, in old age, wrote I, Nuligak, the story of his life, wonderfully vivid glimpses of a long-vanished world. 

"The Inuit of those days [about 1900, when Nuligak was five years old lived on game and fish only, and fished and hunted on a grand scale." The 200-yard (823-m)-long Kittigazuit beach was hardly large enough for all the kayaks drawn up there," and the moment belugas were spotted "a swarm of kayaks was launched. At the great whale hunts I remember there was such a large number of kayaks that when the first had long disappeared from view, more and more were just setting out... Clever hunters killed five, seven belugas, and after the hunt the shore was covered with whale carcasses... Once I heard elders say that three hundred whales had been taken. 

The great driftwood racks and stages were packed with drying meat, sealskin pokes were filled with fat, ample food for "kaivitivik, the time of dancing and rejoicing which began with the departure of the sun and ended with its return," Nuligak recalled. "In those days the Inuit could make marvelous things": puppets and toy animals, activated by baleen strings and springs, that hopped and danced across the floor of their great winter meeting hall, while Nuligak and the other children watched in wonder. "There was such an abundance of meals, games, and things to admire that these sunless weeks sped by as if they had been only a few days. 

Until 1888, the Mackenzie Inuit had little contact with the outside world. That year the southern whalers came and the ancient, unchanging world of the Beluga Hunters collapsed in agony, despair, disease, and death. "Aboriginal Mackenzie Eskimo culture could probably be considered to have become extinct between 1900 and 1910," Robert McGhee noted with scientific detachment. 

In 1888, whalers reached the Beaufort Sea, last sanctuary of the rapidly declining bowhead whales. Six years later, 2,000 people wintered at Herschel Island, west of the Delta, soon known as the "Sodom of the North." It was the largest "town' in northwestern Canada, inhabited, according to a Nome, Alaska, newspaper report, "by demons of debauchery and cruelty," the scene, according to horrified missionaries, of "bacchanalian orgies."

Nuligak's memories are less lurid. He remembered the whalers more as friends than as fiends. "White men and Inuit played games together, as well as hunting side by side. We played baseball and wrestled. We danced in the Eskimo fashion to the sound of many drums. 

Unintentionally, though, the whalers brought death to the long-isolated Inuit. They needed great amounts of fresh meat. Musk-oxen vanished from the land. Few bowhead whales remained. In 1914, the Royal North-West Mounted Police reported that caribou were virtually extinct in the Mackenzie region. By then, the Beluga Hunters, too, were nearing extinction. 

As the plague had ravaged medieval Europe, measles and smallpox epidemics wiped out the Beluga Hunters, who lacked immunity to southern diseases. Of 3,000 people, fewer than 100 survived. In 1900, nearly 1,000 Inuit camped at Kittigazuit. In 1906, a single family remained in this village of death and decay. 

Into the vacuum created by the demise of the Mackenzie people flowed Inuit from as far west as Alaska's Seward Peninsula, and even Yuit and Chukchi from Siberia. Traders and trappers came from the south. And whalers from all over the world and from every social stratum - the dregs of San Francisco's slums and a Count Bülow, a remote cousin of the chancellor of the German Reich; Spanish- speaking Africans; Chinese coolies; and people from the Polynesian Islands - - settled in the region and "went native." One day in the town of Inuvik an Inuk girl, a sociology student, asked me: "Where are you from originally?" I told her I was Baltic German, born in Riga, Latvia. "Well, for heaven's sake!" she exclaimed. "My grandfather came from Riga. 

These people, then, part Inuit, part everyone, became the new Beluga Hunters, following, to some extent, the millennial customs and traditions of the nearly extinct Mackenzie Inuit. The changes wrought through the coming of the whalers were enormous, but some things had not changed: the coming of the belugas, the need for food, the ancient rhythm of camp life through the seasons. 

Even the remnants of this ancient whaling culture seemed fated to fade away. Professor Vagn Flyger of the University of Maryland, who studied the Beluga Hunters in 1961 and 1962, predicted confidently that "Eskimo whale camps will soon be no more," and Nuligak wrote in the 1950s that "the Inuit eat white man's food nowadays." In the late 1970s, the oil companies came, their made- in-Japan module headquarters, with gleaming offices and dining rooms, with swimming pools and cinemas, squatting on the tundra, with their spacecraft-like drilling rigs far out in the Beaufort Sea, all backed by multibillion-dollar exploration budgets. Yet, "the old way of life" persisted. When I went to join the Beluga Hunters in the summer of 1985, twenty-five families from the towns of Tuktoyaktuk, Inuvik, and Aklavik had "returned to the land," to ancient camps along the coast where Inuit had lived and hunted belugas for thousands of years. "From time immemorial this has been our life," said Nuligak. 

"In 1893, he sailed on the Emily Schroeder, which traveled through the Bering Strait to the Inupiat(North Alaskan) community of Point Hope(Tikigaq). The purpose of the expedition was to trade with the Inupiat along the North Alaskan coast. Members of the expedition built a small trading post near the community of Point Hope and settled down for the long arctic winter. It was Klengenberg's first exposure to the Arctic and it is apparent in his autobiography that he relished the northern life. During the winter of 1893/1894, Klengenberg spent most of his time with the young Inupiat men from the village, whose company he preferred "over the dull adults for whom I cooked at the trading post"(Klengenberg 1932:90). Klengenberg also courted and eventually married a young Inupiat woman, Gremnia(Qimniq), with whom he had eight children.

"In summertime, the boats plied the Beaufort sea hunting bowheads. Klengenberg had planned to return immediately to Point Hope, but he could not resist the temptation of signing on as a whaler aboard the Mary D. Hume. He thus spent the summer whaling in the Beaufort Sea. At one point, the ship anchored off Banks Island to take on fresh meat and Klengenberg was among those who disembarked. While walking on the tundra, he spotted footprints and concluded they had been made the same summer. Klengengberg was excited at the possibility that there were unknown bands of Inuit on Banks Island. 

Page 47:

Several years after Klengenberg's visit with the Inuit of Prince Albert Sound, whaling captain William Mogg spent the winter in a small bay on the northern side of Minto Inlet. On contemporary maps, this small bay is called Fish Bay, a little to the west of Omingmagiuk (known on maps as Boot Inlet). Mogg had more than twenty years of experience in arctic whaling, and like many captains in the western Arctic he turned to trading with the collapse of commercial whaling at the turn of the century. Mogg loaded a ship with trade goods and spent the winter of 1907/1908 in Minto Inlet. Mogg's ship was the Olga, the same ship captained by Klengenberg two years earlier. 

Mogg was interested in exploring the Kuujjuak River for evidence of native copper, which Klengenberg had reported to be in great abundance on Victoria Island. According to Holman elder Uluariuk, Mogg, or one of his men, accompanied an Inuk named Tuptualuk up the river, but found no evidence of copper. Upon their return, Taptualuk was given some rifles, ammunition, and a bag of flour. Since the Copper Inuit had no use, or taste, for southern food, the flour was dumped on the ground so that the bag could be used as a container (Uluariuk interview, Jun 8, 1989).