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The William Osler Papers

Sir William Osler--First Impressions pdf (2,910,049 Bytes) transcript of pdf
Sir William Osler--First Impressions
Account of Osler's activities at the Radcliffe Infirmary.
[Description courtesy of McGill University.]
Soon after Osler's death in 1919, Lady Osler asked their good friend Dr. Harvey Cushing to write a biography. For this project, Cushing gathered a wide variety of material, including a substantial amount of Osler correspondence and other memorabilia borrowed from Osler's family, friends, and colleagues. He employed three secretaries to transcribe these documents, and later donated the transcripts (along with his other working materials) to the Osler Library. Many of the original documents were returned to the owners. The originals that were retained, together with the Cushing transcripts, constitute the largest and most accessible collection of Osler's correspondence.
Harvey Cushing's "Life of Sir William Osler" was published by Oxford University Press in 1925, and was awarded a Pulitzer Prize in 1926.
Item is handwritten.
Number of Image Pages:
5 (2,910,049 Bytes)
1916-06 (June 1916)
Viets, Henry
Original Repository: Osler Library of the History of Medicine, McGill University. Osler Library Archive Collections, P417: Harvey Cushing Fonds
This item is in the public domain. It may be used without permission.
Exhibit Category:
Sir William: Regius Professor at Oxford, 1905-1919
Unique Identifier:
Document Type:
Physical Condition:
Oxford. June 1916
Sir William Osler - (first impressions) -
This morning (Sunday) I went to the Radcliffe Infirmary on Dr. Osler's invitation. It is only a short walk from my rooms and at 1030 I was waiting in front of a rather modern looking O. P. D. However, I soon found that behind this new building was a hundred-and-fifty-years-old moss covered hospital with a picturesque small chapel beside it in a find enclosed garden in front of it surrounded by lawns such as one only finds in England. Two or three students were waiting outside the door; they seem to be young but looked like good workers. Prof. O. came down the street, a little late, apologetic and very friendly, taking me by the arm at once and proceeding down long underground corridors to the wards. Although I had dined at his home the night before, he appeared in quite a new light. He is short, rather pale, with an overlong mustache and eye glasses. He steps briskly and his small hands are very active. A cut away code the standup collar and Bow tie gives him a very gentile air. A pair of yellow gloves hang partly out of his right trousers pocket and he carries his stethoscope hanging in the armhole of his vest and in one of the upper pockets, the bell dangling down at his waist while in the wards, but carefully tucked in beneath his trousers and belt when he left the hospital. The stethoscope looked as if it might have belonged to Laennee, with an ivory bell as yellow as an old tooth.
He steps quickly into the Ward and, with a curt nod to his assistant (who has joined us by this time) goes to the bed of the first patient. It is
a case of chronic nephritis with cardiac complications, and after a brief visit in which he carefully, but apparently casually, inspects the patient, inquires about the laboratory work and has the assistant take blood pressure, finally getting down on his knees he also put the stethoscope to the arm; he passes on. He's very active and quick, but talks little, as this is evidently an old case which is seen before.
He passes along from bed to bed making a few inquiries of each. At last a new case is reached, a boy of twenty. By this time three or four students have, and with the nurse, or sister as they are called here, we make a party of seven. Osler first asks a few questions of the boy in regard to his past troubles it receives a history of two attacks of rheumatism. The boy lies quietly in bed and Osler stands at the head for a minute, then has the bed turned so as a better light falls on the patient, and turning to the nearest student and poking him in the ribs speaks of the possibilities of cardiac complications following rheumatism. He says, he has not seen a patient die of rheumatism for years and turning quickly to the sister asks her how many cases they have had in the hospital which died of rheumatism. She knows of none, and turning to the students Osler remarks on the value of asking information from sisters, as they always know much and their opinion is worth having. He then looks carefully at the ears and eyes, turning the head with a peculiar shove of the patient's chin, like a barber ready to shave the other side of your face. He finds
a phlyctenular conjunctivitis in one eye and he immediately calls for a dictionary which the nurse runs to get. She brings him back a very old 'Dorland', which causes Osler to remark on its age and usefulness; and then, as he read the definition of phlyctenular, he comments on the benefits of knowing the etymology of words.
This taking of the pulse is interesting free carefully inspect the fingers, hand, and Arvind same time, running his hand up and down the harm from wrist to elbow much as a cellist uses his left hand on the strings. In this case there is a very definite Corrigan pulse and Sir William talks of the possibility of a trutation (?) diagnosis from the pulsating carotids or from just shaking hands with a man who was a victim of aortic insufficiency. The chest is then layed bare and he goes through the ordinary routine of inspection, palpation, percussion and auscultation, talking quietly most of the time to students. The case is fairly well compensated and Sir William talks of prognosis and the pathology of this romantic edition. The whole examination takes 15 to 20 minutes, three takes a good deal of time in inspection and the possibilities of diagnosis by that alone.
In one colony of a female ward is a woman of 50 with a very red nose, cyanotic ears and a ruddy face. Sir William stops in his rounds at once, and going over to the bed has it moved to the best possible light. He shows extraordinary interest, making a careful inspection of the tongue, mottled[?] [ . . . ] and finally palpating a very large spleen. He then quietly tells of his researches in this disease to which he first
called the attention of physicians, as an entity (Osler's disease). The case is very typical one (symbol?) a r.b.c. of over 12 million. He explains in a most delightful manner just what goes on in capillaries and bone marrow. The case has another aspect, also, for a small lump (hardly more than pea-sized) has been found in the left breast and a new growth has appeared in the choroid of one eye. Although the growth in the breasts is very small and is not changed for over two years, he thinks that the eye condition is surely systastatic. Hearing a noise of a shutting door at the other end of the ward, Osler at once straightens up and calls and waves with his stethoscope to a colonel in uniform, who proves to be Mr. Bernot, a surgeon, and they go over the case together; Bernot being a little doubtful as to the breast growth being carcinomatous and Osler very sure of it.
Thus we pass from case to case, Osler stepping quickly ahead with a kind word for each patient and a hasty but searching look at patient or chart or both as the case may present itself to him. We reach the end of the ward and pass out through the door held by the sister who hands Osler postcard, in which he writes to the publishers for new dictionary and requests the sister to burn the old one. Taking me by the arm we pass out to the street, he talking of how red in the face the English are anyway, and how easily it is to overlook cases of polycythemia, also speaking of the work of Cabot, and how many cases are reported as it is one clearly defines an entity.
With an invitation to tea, he leaves me at the entrance and I see him briskly walking up the street, the tails of his coat flying and his yellow gloves flopping out of his pocket with each step.
He leaves behind an impression of alertness, sincerity and friendliness which I have never seen surpassed in any way; a careful observer, a deep delving fact-hunter, an ideal compiler of knowledge already acquired, a teacher of great forcefulness and interest, and a man of the most lovable type as a host.
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