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)
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.
Sir William: Regius Professor at Oxford, 1905-1919
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
[END PAGE ONE]
[BEGIN PAGE TWO]
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
[END PAGE TWO]
[BEGIN PAGE THREE]
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
[END PAGE THREE]
[BEGIN PAGE FOUR]
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.
[END PAGE FOUR]
[BEGIN PAGE FIVE]
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.