Sir William Osler, 1st Baronet,FRSFRCP (/ˈɒzlər/; July 12, 1849 – December 29, 1919) was a Canadian physician and one of the "Big Four" founding professors ofJohns Hopkins Hospital. Osler created the firstresidency program for specialty training of physicians.[1] He has frequently been described as theFather of Modern Medicine and one of the "greatest diagnosticians ever to wield a stethoscope".[2][3] In addition to being a physician he was abibliophile, historian, author, and renowned practical joker. He was passionate about medical libraries and medical history, having founded theHistory of Medicine Society (formally "section"), at theRoyal Society of Medicine, London.[4] He was also instrumental in founding theMedical Library Association of Great Britain and Ireland, and the (North American) Association of Medical Librarians (later theMedical Library Association) along with three other people, includingMargaret Charlton, the medical librarian of his alma mater,McGill University. He left his own large history of medicine library to McGill, where it became theOsler Library.
William Osler's great-grandfather, Edward Osler, was variously described as either amerchant seaman or apirate.[5] One of William's uncles,Edward Osler (1798–1863), a medical officer in theRoyal Navy, wrote theLife of Lord Exmouth and the poemThe Voyage.[6]
William Osler's father, the Reverend Featherstone Lake Osler (1805–1895), the son of a shipowner atFalmouth, Cornwall, was a former lieutenant in the Royal Navy who served onHMS Victory. In 1831, Featherstone Osler was invited to serve onHMS Beagle as the science officer forCharles Darwin's historic voyage to theGalápagos Islands, but he turned it down because his father was dying. In 1833, Featherstone Osler announced that he wanted to become a minister of theChurch of England.[7]
As a teenager, Featherstone Osler was aboardHMS Sappho when it was nearly destroyed by Atlantic storms and remained adrift for weeks. Serving in the Navy, he was shipwrecked offBarbados. In 1837, Featherstone Osler retired from the Navy and emigrated to Canada, becoming a "saddle-bag minister" in ruralUpper Canada. When Featherstone and his bride, Ellen Free Picton, arrived in Canada, they were nearly shipwrecked again on Egg Island in theGulf of Saint Lawrence. Their children included William,Britton Bath Osler andSir Edmund Boyd Osler.
In 1867, Osler announced that he would follow his father's footsteps into the ministry and enteredTrinity College of theUniversity of Toronto, in the autumn. However, he became increasingly interested in medical science under the influence ofJames Bovell and the Rev.William Arthur Johnson, encouraging him to switch his career.[9][10][11]
In 1868, Osler enrolled in the Toronto School of Medicine,[12] a privately owned institution that was not part of the Medical Faculty of the University of Toronto. Osler lived with James Bovell for a time, and through Johnson, he was introduced to the writings ofSir Thomas Browne; hisReligio Medici caused a deep impression on him.[13]
While studying at McGill, Osler lived on lowerSaint Urbain Street, at a time when the medical school was on nearby Côté Street.[14] While in Montreal, Osler, who was a practicingAnglican regularly attended the "free seat"Chapel of St. John the Evangelist which at the time was located on Dorchester Street (nowRené Lévesque Boulevard).[14] Osler held the chapel's rector, Fr. Edmund Wood in high regard due to his care for the less fortunate. Osler had personal copies of the1662 Book of Common Prayer andHymns Ancient and Modern, both of which are kept in theOsler Library of the History of Medicine at McGill.[14] Osler and Fr. Wood would later on contribute to the installation of a memorialstained glass window in honour ofRev. Dr. William Wright, a professor ofMateria medica at the McGill Faculty of Medicine and also a long time associate priest at the Church of St. John the Evangelist, which had since built a new church building onOntario Street (now President Kennedy Avenue) and Saint Urbain, a few blocks north of the chapel's former location.[14]
Following post-graduate training underRudolf Virchow in Germany, Osler returned to theMcGill University Faculty of Medicine as a professor in 1874. There he created the first formaljournal club, showed interest in comparative pathology, and is considered the first to have taughtveterinary pathology in North America as part of a broad understanding of disease pathogenesis. In 1884, he was appointed Chair of Clinical Medicine at theUniversity of Pennsylvania inPhiladelphia and in 1885, was one of the seven founding members of theAssociation of American Physicians, a society dedicated to "the advancement of scientific and practical medicine." When he left Philadelphia in 1889, his farewell address, "Aequanimitas",[15] was about the imperturbability (calm amid storm) andequanimity (moderated emotion, tolerance) necessary for physicians.[16]
In 1889, he became the first Physician-in-Chief of the newJohns Hopkins Hospital inBaltimore, Maryland. In 1893, Osler was instrumental in creating theJohns Hopkins School of Medicine and became one of the school's first professors of medicine. Osler quickly enhanced his reputation as a clinician, humanitarian, and teacher. He presided over the rapidly expanding hospital's first year of operation, when it had 220 beds and 788 patients were seen for a total of over 15,000 days of treatment. Sixteen years later, when Osler left for Oxford, over 4,200 patients were seen for a total of nearly 110,000 days of treatment.[17]
In the UK, he initiated the founding in 1907 of the Association of Physicians[18] and was founding Senior Editor of its publication theQuarterly Journal of Medicine until his death.[19]
In 1911, he founded the Postgraduate Medical Association and was its first President.[21] The same year, Osler was named abaronet in the Coronation Honours List for his contributions to the field of medicine.[22]
In January 1919 he was appointed President of the Fellowship of Medicine[23] and was in October appointed founding President of the merged Fellowship of Medicine and Postgraduate Medical Association,[24] which became theFellowship of Postgraduate Medicine.
Perhaps Osler's greatest influence on medicine was to insist that students learn from seeing and talking to patients and the establishment of themedical residency. The latter idea spread across the English-speaking world and remains in place today in most teaching hospitals. Through this system, physicians in training make up much of a teaching hospital's medical staff. The success of his residency system depended, in large part, on its pyramidal structure with many interns, fewer assistant residents and a single chief resident, who originally occupied that position for years. While at Hopkins, Osler established the full-time, sleep-in residency system whereby staff physicians lived in the administration building of the hospital. As established, the residency was open-ended, and long tenure was the rule. Physicians spent as long as seven or eight years as residents, during which time they led a restricted, almostmonastic life.
He wrote in an essay, "Books and Men", that "He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all."[27] His best-known saying was "Listen to your patient—he is telling you the diagnosis", which emphasises the importance of taking a good history.[2]
The contribution to medical education of which he was proudest was his idea of clinical clerkship – having third- and fourth-year students work with patients on the wards. He pioneered the practice of bedside teaching, making rounds with a handful of students, demonstrating what one student referred to as his method of "incomparably thorough physical examination." Soon after arriving in Baltimore, Osler insisted that his medical students attend at bedside early in their training. By their third year they were taking patient histories, performing physicals and doing lab tests examining secretions, blood and excreta.
He reduced the role ofdidactic lectures and once said he hoped his tombstone would say only, "He brought medical students into the wards for bedside teaching." He also said, "I desire no other epitaph ... than the statement that I taught medical students in the wards, as I regard this as by far the most useful and important work I have been called upon to do." Osler fundamentally changed medical teaching in North America, and this influence, helped by a few such as the DutchinternistP. K. Pel, spread to medical schools across the globe.
Osler was a prolific author and a great collector of books and other material relevant to thehistory of medicine. He willed his library to the Faculty of Medicine ofMcGill University where it now forms the nucleus of McGill University'sOsler Library of the History of Medicine.[28] Osler was a strong supporter of libraries and served on the library committees at most of the universities at which he taught and was a member of the Board of Curators of theBodleian Library in Oxford. He was instrumental in founding theMedical Library Association in North America, alongside employee and menteeMarcia Croker Noyes,[29] and served as its second president from 1901 to 1904. In Britain he was the first (and only) president of the Medical Library Association of Great Britain and Ireland[30] and also a president of theThe Bibliographical Society (1913-1919).[31]
Osler was a prolific author and public speaker and his public speaking and writing were both done in a clear, lucid style. His most famous work,The Principles and Practice of Medicine quickly became a key text to students and clinicians alike. It continued to be published in many editions until 2001 and was translated into many languages.[32][33] It is notable in part for supporting the use ofbloodletting as recently as 1923.[34] Though his own textbook was a major influence in medicine for many years, Osler describedAvicenna as the "author of the most famous medical textbook ever written". He noted that Avicenna'sCanon of Medicine remained "a medical bible for a longer time than any other work".[35] Osler's essays were important guides to physicians. The title of his most famous essay, "Aequanimitas", espousing the importance of imperturbability, is the motto on the Osler family crest and is used on the Osler housestaff tie and scarf at Hopkins.
Osler said Canada should be a "white man's country" in a 1914 speech given around the time of theKomagata Maru incident involving immigration from India.[36][37]Osler wrote "I hate Latin Americans" in a letter to Henry Vining Ogden.[38][39]Under the pseudonym "Egerton Yorrick Davis", Osler mocked Indigenous people: "Every primitive tribe retains some vile animal habit not yet eliminated in the upward march of the race."[40]Uncovering this historical context, the journalists David Bruser and Markus Grill and the archivistNils Seethaler reconstruct the shipment of several indigenous skulls by Osler from Canada to Germany, which were (previously unknown) in the custody of the State Museums of Berlin.[41]
Osler is well known in the field ofgerontology for the speech he gave when leaving Hopkins to become the Regius Professor of Medicine at Oxford. "The Fixed Period", given on February 22, 1905, included some controversial words about old age. Osler, who had a well-developed humorous side to his character, was in his mid-fifties when he gave the speech and in it he mentionedAnthony Trollope'sThe Fixed Period (1882), which envisaged a college where men retired at 67 and after being given a year to settle their affairs, would be "peacefully extinguished by chloroform". He claimed that, "the effective, moving, vitalizing work of the world is done between the ages of twenty-five and forty" and it was downhill from then on.[42] Osler's speech was covered by the popular press which headlined their reports with "Osler recommends chloroform at sixty".[43] The concept of mandatory euthanasia for humans after a "fixed period" (often 60 years) became a recurring theme in 20th centuryscience fiction—for example,Isaac Asimov's 1950 novelPebble in the Sky andHalf a Life (Star Trek: The Next Generation). In the 3rd edition of his Textbook, he also coined the description ofpneumonia as "the friend of the aged" since it allowed elderly individuals a quick, comparatively painless death: "Taken off by it in an acute, short, not often painful illness, the old man escapes those 'cold gradations of decay' so distressing to himself and his friends."[44] Coincidentally, Osler himself died of pneumonia.
Grace Revere Osler13 Norham Gardens: Sir William Osler's residence in Oxford
An inveterate prankster, he wrote several humorous pieces under the pseudonym "Egerton Yorrick Davis", even fooling the editors of thePhiladelphia Medical News into publishing a report on the extremely rare phenomenon ofpenis captivus, on December 13, 1884.[45] The letter was apparently a response to a report on the phenomenon ofvaginismus reported three weeks previously in thePhiladelphia Medical News by Osler's colleague Theophilus Parvin.[46] Davis, a prolific writer of letters to medical societies, purported to be a retired U.S. Army surgeon living in Caughnawaga,Quebec (nowKahnawake), author of a fake paper on theobstetrical habits ofNative American tribes that was intended as a joke on his rival, Dr. William A. Molson. The piece was never published in Osler's lifetime, nor was it intended to be published; Osler knew the content was outrageous, but he wanted to make a fool of Molson by getting the piece to the brink of publication in theMontreal Medical Journal, of which Molson was the editor. Osler would enhance Davis's myth by signing Davis's name tohotel registers andmedical conference attendance lists; Davis was eventually reported drowned in theLachine Rapids in 1884.[46]
Throughout his life, Osler was a great admirer of the 17th century physician and philosopher SirThomas Browne.
He died at the age of 70, on December 29, 1919, inOxford, during theSpanish flu epidemic, most likely of complications from undiagnosedbronchiectasis.[47] His wife,Grace, lived another nine years but succumbed to a series of strokes. Sir William and Lady Osler's ashes now rest in a niche in theOsler Library atMcGill University. They had two sons, one of whom died shortly after birth. The other, Edward Revere Osler, was mortally wounded in combat inWorld War I at the age of 21, during the 3rd battle ofYpres (also known as thebattle of Passchendaele). At the time of his death in August 1917, he was asecond lieutenant in the (British) Royal FieldArtillery;[48] Lt. Osler's grave is in the Dozinghem Military Cemetery in WestFlanders, Belgium.[49] According to one biographer, Osler was emotionally crushed by the loss; he was particularly anguished by the fact that his influence had been used to procure a military commission for his son, who had mediocre eyesight.[50] Lady Osler (Grace Revere) was born in Boston in 1854; her paternal great-grandfather wasPaul Revere.[51] In 1876, she married Samuel W. Gross, chairman of surgery at Jefferson Medical College in Philadelphia and son of Dr.Samuel D. Gross. Gross died in 1889 and in 1892 she married William Osler who was then professor of medicine at Johns Hopkins University.
Osler was a founding donor of theAmerican Anthropometric Society, a group of academics who pledged to donate their brains for scientific study.[52] His brain was donated to the American Anthropometric Society after his death and is currently stored at theWistar Institute in Philadelphia. A study of his brain, conducted in 1927, concluded that there were differences between the brains of the highly intelligent and normal brains.[53] In April 1987 it was taken to theMütter Museum, on 22nd Street near Chestnut inPhiladelphia where it was displayed during the annual meeting of the American Osler Society.[54][55] He was elected as a member to theAmerican Philosophical Society in 1885.[56]
Osler's nodes are raised tender nodules on the pulps of fingertips or toes, suggestive ofsubacute bacterial endocarditis. Osler described them as "ephemeral spots of a painful nodular erythema, chiefly in the skin of the hands and feet." Osler nodes are usually painful, as opposed toJaneway lesions which are due to emboli and are painless.
Osler's manoeuvre: inpseudohypertension, the blood pressure as measured by thesphygmomanometer is artificially high because of arterial wall calcification. Osler's manoeuvre takes a patient who has a palpable, although pulseless,radial artery while the blood pressure cuff is inflated abovesystolic pressure; thus they are considered to have "Osler's sign".[citation needed]
Osler's rule: States that a neurological defect has to be related to a specific lesion, in contrast toHickam's dictum, which states that the neurological defect can be due to several lesions.[citation needed]
Osler's syndrome is a syndrome of recurrent episodes of colic pain, with typical radiation to back, cold shiverings and fever; due to the presence inVater's diverticulum of a free-movinggallstone which is larger than the orifice.[citation needed]
Oslerus osleri is ametastrongyloid nematode lungworm parasite of wild and domestic canids. Osler discovered the parasite while teaching comparative pathology at McGill.[citation needed]
A quote by Sir William Osler engraved in the stone wall within the Peace Chapel of theInternational Peace Garden (in Manitoba Canada and North Dakota, US)
Osler Building at TheJohns Hopkins Hospital currently The Johns Hopkins Hospital Human Resources. Until 2012 the Medical Intensive Care Unit (MICU) was located on the 7th floor
Osler Library of the History of Medicine,McGill University, Montreal. Osler left his 8000 volume collection of books on the history of medicine to hisalma mater. The library now holds over 100,000 volumes and is Canada'sde facto 'national library of the history of medicine'
Osler House is one of the two undergraduate hostels of theJIPMER medical school inPuducherry, India
Osler Textbook Room 1999 atJohns Hopkins Hospital[66] in the room in the Billings Building where Osler wrote "Principles and Practice of Medicine". It houses a collection of Osler memorabilia
Osler Center for Clinical Excellence 2002[67] devoted to teaching "the basic elements of a sound doctor patient relationship"
^Osler, Edward (1798–1863).The Voyage: a poem, written at sea, and in the West Indies, and illustrated by papers on natural history. London: Longman, 1830.
^Bliss, Michael (1999).William Osler: a life in medicine. Oxford, New York: Oxford University Press. p. 37ISBN978-0-19-512346-3.OCLC41439631.
^Joseph Hanaway, '(1996).McGill Medicine: The First Half Century, 1829–1885. McGill-Queen's Press. p. 179
^Bliss, Michael (1999).William Osler: a life in medicine. Oxford, New York: Oxford University Press. p. 44ISBN978-0-19-512346-3.OCLC41439631.
^Sir William Osler.The Quotable Osler. ACP Press. p.283ISBN9781934465004
^Osler, William (2008). edited by Mark E. Silverman,T. J. Murray, Charles S. Bryan.The Quotable Osler. ACP Press. p. 284
^Bliss, Michael (1999).William Osler: a life in medicine. Oxford, New York: Oxford University Press. pp. 45–46ISBN978-0-19-512346-3.OCLC41439631.
^abcde"Sir William Osler. 5.Two World-Renowned Lay Figures. PART 1. ANNALS".Centenary Book of the Parish of St. John the Evangelist Montreal 1861-1961. Gardenvale, P.Q.: Harpell's Press Co-Operative. 1961. pp. 33–34.
^AEQUANIMITAS. Medicalarchives.jhmi.edu. Retrieved on May 30, 2014.
^"Our History". Association of Physicians of Great Britain and Ireland. Archived fromthe original on August 8, 2022. RetrievedJuly 7, 2021.
^Anon (1936). "Early history of the Association of Physicians of Great Britain and Ireland and of the Quarterly Journal of Medicine".Quarterly Journal of Medicine.5:536–40.
^"Honours to Medical Men: Coronation Honours".Lancet.178 (4609):1874–1876. 1911.doi:10.1016/s0140-6736(01)58188-x.Sir William Osler, Regius professor of medicine in the University of Oxford, who is famous throughout two continents, has enriched the literature of medicine with many works of high scientific and literary value.
^Osler appointed President of the Inter-Allied Fellowship of Medicine. The Times. 14th January 1919.
^Cook G. John McAlister's other vision. Abingdon, Oxon: Radcliffe Publishing Limited; 2005ISBN1-85775-789-0
^Journal of Perinatology (September 6, 2007). "Access : Avicenna (AD 980 to 1037) and the care of the newborn infant and breastfeeding".Journal of Perinatology.28 (1).Nature:3–6.doi:10.1038/sj.jp.7211832.PMID17805338.S2CID41337692.
^Golden, Richard (1999).The works of Egerton Yorrick Davis, MD: Sir William Osler's alter ego. Montreal: McGill University.ISBN9780771705489.
^David Bruser/Markus Grill: The untold story of four Indigenous skulls given away by one of Canada’s most famous doctors, and the quest to bring them home. Toronto Star, 17.12.20.
^Hirshbein, Laura Davidow (September 24, 2001). "William Osler and The Fixed Period: Conflicting Medical and Popular Ideas About Old Age".Archives of Internal Medicine.161 (17):2074–8.doi:10.1001/archinte.161.17.2074.PMID11570935.
^For details, see Charles G. Roland: "What Did Trollope Actually Write?The Fixed Period and 'The Fixed Period'" (1995)[1].
^Osler, William (1899).The principles and practice of medicine: designed for the use of practitioners and students of medicine. New York: Appleton and Company. p. 109.
^Davis, Egerton Yorrick (1999). Golden, Richard L (ed.).The Works of Egerton Yorrick Davis, MD: Sir William Osler's Alter Ego. Osler Library studies in the history of medicine, no. 3. Montreal: Osler Library, McGill University.ISBN978-0-7717-0548-9.OCLC48551127. A collection of writings by the fictitious surgical character created by Osler, E. Y. Davis
^ab"Egerton Y. Davis", Chris Nickson,Life in the Fastlane, November 16, 2008
Borghi, Luca.Osler and Italy. An intermittent love story, Amazon KDP, 2019, pp. 190, ISBN 9781701243002
Bryan, Charles S, ed. (2020).Sir William Osler: an encyclopedia (First ed.). Novato: Norman Publishing HistoryofScience.com in association with the American Osler Society.ISBN9780930405915.
Kingsbury, Mary. “Book Collector, Bibliographer, and Benefactor of Libraries: Sir William Osler.”The Journal of Library History. 16 no. 1 (1981): 187–98.
Lyons, C. (2015). “The Touch Divine of Noble Natures Gone”: Sir William Osler as a Book Collector.Papers of the Bibliographical Society of Canada/Cahiers de La Société Bibliographique Du Canada, 53(2), 209–232.
Osler, William (1969) [1929]. Francis, William W; Hill, Reginald H; Malloch, Archibald (eds.).Bibliotheca Osleriana: A Catalogue of Books Illustrating the History of Medicine and Science (Revised ed.). Montreal:McGill-Queen's University Press.ISBN978-0-7735-9050-2.OCLC75916. The Introduction and other editorial matter is freely availableon-line.
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