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COLUMBIA LIBRARIES OFFSITE

HEALTH SCIENCES STANDARD



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Sir William Osier, b



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SIR WILLIAM OSLER, Bart.



Digitized by the Internet Archive

in 2010 with funding from

Open Knowledge Commons



http://www.archive.org/details/sirwilliamoslerbOOblog




William Osler in 1906. ""'"''''^ '^ ''^^^^"'-



SIR WILLIAM OSLER, Bart.



tat



Brief Tributes to His Personality,
Influence and Public Service

Written by His Friends, Associates and Former Pupils,

In Honor of His Seventieth Birthday and First Published in the

Bulletin of The Johns Hopkins Hospital for July, 1919



THE JOHNS HOPKINS PRESS
BALTIMORE, MD.

1920



Copyright, 1920, by
The Johns Hopkins Press



S<1



BALTIMORE, MD., U. 8. A.



CONTENTS

PAGE

Some Memories of the Development of the Medical School

and of Osier's Advent. By Henry M. Thomas 7

Osier as Chief of a Medical Clinic. By Lewellys P. Barker. . 19
Some of the Early Medical Work of Sir William Osier. By

W. T. Councilman 33

Osier as a Pathologist. By William G. MacCallum 45

Osier, the Teacher. By W. S. Thayer 51

Osier and the Student. By Thomas R. Brown 55

Osier and Patient. By Thomas McCrae 59

Osier and the Tuberculosis Work of the Hospital, By Louis

Hamman 65

Influence on the Relation of Medicine in Canada and the

United States. By Thomas B. Futcher 69

Osier as a Citizen and His Relation to the Tuberculosis Cru-
sade in Maryland. By Henry Barton Jacobs 75

Osier's Influence on Other Medical Schools in Baltimore. His

Relation to the Medical Profession. By Edward N. Brush. 83
Influence in Building up the Medical and Chirurgical Faculty.

By Hiram Woods 89

Osier and the Book and Journal Club. By J. A. Chatard 95

Osier's Influence on the Library of the Medical and Chirurgi-
cal Faculty of the State of Maryland. By Marcia C.

No yes, Librarian 97

Some Early Reminiscences of William Osier. By Henry M.

Hurd 101

Osier as I Knew Him in Philadelphia and in the Hopkins. By

Howard A. Kelly 107

Osier as a Bibliophile. By Thomas R. Boggs Ill

Osier's Literary Style. By Edward N. Brush 115

Bibliography. By Minnie Wright Blogg 121



SIR WILLIAM OSLER, Bart.



SOME MEMORIES OF THE DEVELOPMENT OF THE
MEDICAL SCHOOL AND OF OSLEE'S ADVENT

By Henry M. Thomas

In thinking of the early days of The Johns Hopkins Uni-
versity and Hospital and the development of the medical
school, my memories begin with the founder — Johns Hopkins.
As a small boy between 10 and 12 I sat on the same bench with
Johns Hopkins many Sunday mornings at the Friends' Meet-
ing on Eutaw and Monument streets. I cannot remember that
he ever spoke to me, and I remember him merely as a rather
unkempt old gentleman. At that time he had announced his
intentions for his double bequest, had, in 1867, incorporated
the two institutions that were to bear his name, had appointed
his trustees, and had bought the site for the hospital. Gallo-
way Cheston, the president of the university board ; Francis T.
King, president of the hospital board ; Francis White, James
Carey Thomas, James Carey, and other trustees, were also
constant attendants at the meeting, and it is pleasant now to
think that in the congregation there were represented the
founder, his trustees, and the rising generation which was to
be benefited by the bequests.

Johns Hopkins believed that his wealth had been given to
him for a purpose, and, to use a Friendly form of speech, that
he would be " given to see '' how to dispose of it. He had asked
advice freely and much had been volunteered, and many of his
advisers have claimed that they suggested the objects of his
bequests and the forms which they should take, but I like to^
think that the wise instructions that he gave to his trustees
were finally determined in meeting. The most important of



8 Sir William Oslek, Bart.

these for the development of the medical school was his direc-
tion in a letter to the hospital board, dated March 10, 1873,
that " in all your arrangements in relation to this hospital you
will bear constantly in mind that it is my wish and purpose
that the institution shall ultimately form a part of the medical
school of that university for which I have made ample provi-
sion by my will,^^ so uniting forever the two bequests for the.
furtherance of medical education.

Johns Hopkins died on December 24, 1873, and in the early
part of 1875 the trustees received the bequests and entered into
active administration of the trusts. The first important de-
cision of the university board was the wise and fortunate choice
of Daniel C. Oilman as president of the university. He came
to Baltimore May 1, 1875, and I can remember well the expec-
tation and interest his coming aroused. He and his twoi
daughters took apartments at the old Mt. Yernon Hotel, and
for me a delightful friendship began.

Johns Hopkins chose his trustees well and left them un-
trammeled, and they in their turn gave President Gilman a
free hand. They had already determined upon the establish-
ment of a real university, which, as Gilman once said, was to
supplement and not supplant existing institutions. In speak-
ing of his first instructions which he received from the trustees,
he says :

Often in private conversations and in official interviews, I was
charged to hold up the highest standards, to think of nothing but
the best which was possible under the limitations of the new
establishment in a country where the idea of a university had not
been generally understood.

In furtherance of these objects. President Gilman, in the
summer of 1875, went abroad to visit the various universities
and to consult with the leaders in education. Medical educa-
tion was much in his mind, particularly the establishment of
the laboratories and courses of instruction in the fundamental
sciences which would be best fitted for the preliminary training
of medical students. The field was almost entirely unbroken,
and young men not yet 30 were selected for its cultivation —



The Medical School and Osler's Advent 9

Rowland in physics, Martin in biology, and Eemsen in chem-
istry. Rowland, although not then appointed to the chair of
physics, had accompanied Oilman to Europe to aid him in the
selection of physical apparatus and books. While on this
journey he found time to publish some articles in the Philo-
sophical Magazine which Oilman, with characteristic prompt-
ness and prophetic vision, dated from The Johns Hopkins
University — the first university publications.

Oilman was inaugurated on February 22, 187G, and the
university received students and began instruction in the fall
of that year. Professor Huxley, who had taken much interest
in the proposed biological department, and who had recom-
mended a favorite pupil of his — H. Newell Martin — as its
director, was in America and was asked to give an opening
lecture. In this lecture he spoke of the importance of bio-
logical studies, and particularly their relation to a properly
organized medical course. My father, who had selected me as
the son most available upon whom to experiment with this new
method of medical education, saw to it that I attended Oil-
man's inauguration and Huxley's opening lecture. I have no
recollection of the inaugural exercises, but I do remember
hearing Huxley at the Academy of Music, principally, I think,
on account of the storm of protest that followed. This protest
was directed against the emphasis which the new university
appeared to be giving to scientific research^ especially in
biology, even the study of which was thought at that time to be
little less than impious, and was focused on the fact that
Huxley, the great champion of science, had been asked to
speak and that the lecture had not been ushered in by prayer*
I believe that Mr. King and my father, both devoted religious
workers, were responsible for this last circumstance. They
certainly were astounded by the public reaction to this entirely
consistent Quaker procedure.

Following the advice of Huxley and others the chemical-
biological course was designed, and was recommended to those
students who intended to take up the study of medicine; in-
deed, it was also called the preliminary medical course. It was



10 Sir William Osler, Bart.

from the first the design of the "university to establish the full
medical course as soon as the hospital should be completed,
and much thought was given to it. Martin and Eemsen were
recognized as forming the nucleus of the medical faculty.

At the opening of the fourth academic year, September,
1879, Professor Acland, then Eegius Professor of Medicine at
Oxford, was expected to give a lecture embodying his advice
as to the proper co-ordination between the university and
hospital in the organization of an advanced medical school.
Unfortunately, on account of illness, he was unable to deliver
the address. His views, however, have been preserved in a
letter to the university and hospital authorities. How sur-
prised he would have been had he been told that it was from
this unborn medical school that his successor at Oxford was to
be chosen!

In the early days the university was a small, compact body,
made up, for the most part, of a young, active faculty, sur-
rounded by a group of advanced workers, called fellows, and
other post-graduate students, and a few rather over-powered
undergraduates. Every encouragement and opportunity was
given to research and to prompt publication of work accom-
plished. There was the closest sympathy among all the depart-
ments, and everyone knew and sympathized with the work of
the others. It was naturally around Martin that the idea of
the medical school germinated, and a more inspiring teacher
it would be hard to imagine. Besides the regular biological
courses, he gave lectures to medical students and practitioners
of the city, and graduates in medicine entered his laboratory
for special work.

The emphasis which the university had put upon men in
contrast to buildings had permitted it to function at once, and
to strike a remarkable pace in a very short time. With the
hospital it was different; buildings were absolutely essential,
and even though Johns Hopkins before his death had in-
structed his hospital trustees to begin work, time was neces-
sarily consumed in the formation of plans, so that it was not



The Medical School and Osler's Advent 11

until June of 1877 that these were adopted and the excavations
were begun.

The choice by the hospital board, in 1876, of Dr. John S.
Billings, surgeon of the United States Army, and librarian
of the surgeon-generaFs office, as their medical adviser was
most fortunate, both as to the construction of the hospital
buildings and as to the future of the medical school. Dr. Bill-
ings was much in Baltimore, and his encyclopaedic knowledge
of things medical was always at the service of the university
as well as the hospital. He supplemented Oilman, and made
with him a remarkable team. He was attached to the uni-
versity academic staff as a lecturer on the history of medicine
and municipal hygiene, although I do not think he gave many
lectures until after the opening of the hospital.

Among the physicians who were attracted to Martinis labora-
tory was Wm. T. Councilman, who began work in 1878, just
after having received his medical degree from the University
of Maryland, and who, after his return from Europe in 1882,
was made a fellow by courtesy, and was appointed associate in
pathology in 1884. He busied himself about medical problems,
gave some courses in special subjects, and lectured at the
University of Maryland on pathology.

In 1879, Wm. H. Howell came from the Baltimore City
College and entered the chemical-biological course and began
a career which was to mean much to the university and medical
school. He soon became a favorite pupil of Martin's, and after
receiving his bachelor's degree, he was made in quick succes-
sion a fellow, an assistant, and then, in 1885, an associate in
biology, having received his Ph. D. the year before. He
resigned from the university in 1889, to return again as pro-
fessor of physiology at the opening of the medical school.

I, in my capacity as experimental animal, was entered in
the university the same year, and I can well remember Howell
as the model student and also on the football field where he
made up for his light weight by the accuracy and neatness of
his tackling.



12 Sir William Osler, Babt.

I look back upon my course at the university with the
greatest pleasure. To have been under such men as Martin,
Eemsen, and Hastings in physics, to have read Shakespeare
with Sydney Lanier, and to have heard the lectures from the
noted men who were constantly coming to the university, could
not help being stimulating to a youth even though over-
occupied with many athletic pursuits. It had been hoped by
those of us who took the preliminary medical course that at
its completion the university would have started its medical
school, but this was not to be. The buildings of the hospital
were going up very slowly, and as there seemed no immediate
prospect of the completion, we were forced to go elsewhere for
our medical instruction.

While at the University of Maryland, I attended Dr. Council-
man's first lectures on pathology, and also took a course with
him in the biological laboratory in the histology of the nervous
system. We had excellent professors at the University of
Maryland, but it was the old lecture system, the only labora-
tories being the dissecting room and a newly established
chemical laboratory. The students had practically no chance
of getting close to patients, and I was graduated without ever
having been instructed in physical diagnosis, and I received
the prize in obstetrics without ever having seen a woman in
labor ! I took my medical degree in 1885. By this time the
university was on the point of establishing its medical depart-
ment. In the register for 1883-1884 it is announced that " The
medical department of the university is soon to be organized.
Its plan is receiving the constant attention of the trustees, and
it will be made known before the completion of The Johns
Hopkins Hospital. The nucleus of a medical faculty has been
instituted as follows: The president of the university; J. S.
Billings, M. D., lecturer on hygiene; W. H. Welch, M. D.,
professor of pathology; Ira Eemsen, M. D., professor of chem-
istry; H. Newell Martin, M. D., professor of physiology.^'

In this somewhat casual way, the university announced the
epoch-making facts that it had recognized pathology as a full
university subject, and had appointed Dr. Welch to fill the



The Medical School and Osler's Advent 13

chair. The first was the natural development of the university
idea in medicine, and the credit of the second has been claimed,
in a friendly rivalry between the university and the hospital,
both by Oilman and by Billings. However that may be, no
other choice now seems conceivable.

Dr. Welch's appointment was the first one that had to do
with practical medicine, and I remember my father's en-
thusiasm over it, for with it he felt that the university had
made a wonderful beginning in medical teaching. What a
wonderful beginning it was he was to learn later !

Welch gave his first course of lectures in Hopkins Hall in
February and March, 1886, on microorganisms in disease.
The hospital trustees allowed the university to furnish the
autopsy house as a pathological laboratory, and so the first of
the hospital buildings to be used was dedicated to the common
purpose of the two trusts. Dr. Councilman had been appointed
an associate in pathology, and courses of instruction were
started on N'ovember 1, 1886. Halsted came from New York
to work in the laboratory and Mall was appointed the first
fellow. Other students gathered, most of them graduates in
medicine, and when I returned from Europe at the end of the
year I joined the group. Those early days have often been
described, and it was, indeed, a rare privilege to have taken
part in them. As the hospital was not yet opened, the institu-
tion had to depend upon other sources for its autopsy material.
This was obtained for the most part from the City Hospital
at Bay View. In the reorganization of this charity. The Johns
Hopkins University had assumed the care of the insane, and
my father. Dr. Councilman and I were appointed visiting
physicians. Dr. Councilman was also pathologist.

At this time everything seemed to point to the early opening
of the full medical school. The buildings of the hospital were
practically finished, and there seemed to be no reason why they
should not be shortly opened. The university authorities were
completing their plans and Welch was on the spot. It was just
at this time that financial calamity overtook the university.
The Baltimore and Ohio common stock, of which the uni-



14 Sir William Osler^ Bart.

versity had nearly 15,000 shares, dropped its dividend from
10 to 8 per cent in 1886, to 4 per cent in 1887, and ceased
paying the next year; the university was struggling for life
and could not take on new obligations, so that the plans of the
medical school were indefinitely suspended. The hospital
income had not been affected as it was derived almost entirely
from real estate, and there had been no inroads on the capital
by the erection of the hospital buildings. It had, indeed,
increased, and the hospital had now become the rich member
of these organically joined twin bequests.

The time had come for the hospital to take up the work, but
for it to begin to function, men had to be found to organize
the various clinical departments. Above all, a physician-in-
ehief had to be appointed and everything depended upon the
choice. The question was anxiously discussed by the two
boards of trustees and their advisers, and the little band of
students in the pathological laboratory discussed the question
with critical, impotent anxiety. Now that adversity had fallen
on the university, what hope was there that the unbroken
series of phenomenal appointments could continue? Where
could a clinician be found to match Gilman, Billings, Martin^;
Eemsen, and Welch, and if found, would such a man come now
that the opening of the medical school in the near future was
less than probable ? We doubted, but we did not at that time
know Dr. Osier and how impossible it would have been for
him to have refused to add his strength to the endeavor to
bring to fruition the long-nourished idea of a real university
medical school. He has given an account of his reaction to
the proposal. In speaking of Billings' visit to him in Phila-
delphia, he says: "Without sitting down, he asked me
abruptly, ^Will you take charge of the medical department
of The Johns Hopkins Hospital ? ' Without a moment's hesi-
tation I answered, ^ Yes.' ^ See Welch about the details ; we
are to open very soon. I am very busy to-day ; good morning,'
and he was off, having been in my room not more than a couple
of minutes."



The Medical School and Osler's Advent 15

The appointment was made in the fall of 1888, and he was to
begin his service at the opening of the hospital, which was
announced for May, 1889. It soon became evident that
although it was easy to announce the opening day, it was quite
another thing to get the complicated mechanism of the hospital
organized and ready to function. In this emergency the hos-
pital appealed to the university and induced Gilman to assume
the task. The work was colossal and the time was short, and it
speaks volumes for the estimation in which Oilman's organ-
izing ability was held that no one doubted the result.

The formal opening occurred on May 7, 1889, and Osier,
with his satellites, took his place as our guiding star. He
brought Lafleur from Montreal, Scott and Toulmin from
Philadelphia, and those of us who were able to do so joined the
ever-increasing group.

The hospital annexed Welch with his already organized
department of pathology. Halsted was given charge of the
surgical department and the organization of the dispensary,
Kelly was brought in June from Philadelphia to take charge
of gynaecology, and in August Dr. Hurd, as superintendent
took over from President Gilman the direction of the hospital.

The opening of the hospital was for the trustees, the faculty,
and above all for us expectant, impatient medical novices, the
beginning of the fulfillment of long-suppressed desires. For
me the reality far surpassed the fantasy of my dreams. In the
association that was to follow, which for my part was as close
as I could make it. Osier as a physician, teacher and friend,
constantly raised my preconceived ideal. Memories of this
time overwhelm me.

The dispensary was opened first and patients were admitted
to the wards from it, and Osier, surrounded by a few of us,
himself wrote the first dispensary history. Until the wards
were full he was constantly in the dispensary, organizing the
various sub departments of medicine, for it was an unique
feature of the system that the services were continuous, and
that the various special departments were grouped under
either medicine or surgery. As it was in the early days of the



16 Sir William Osler, Baet.

■amversit}^ so it was with the hospital at the beginning.
Workers formed a closely united body. All that happened was
of interest to each of ns. On the medical side Osier radiated
by his example and personality constant stimuli to careful
clinical work and investigation along all sorts of lines. He
23ointed out problems, encouraged everyone in what he desired
to do, and was more than liberal in his commendation of work
done. His absolute generosity threw open his whole clinical
material to the use of anyone who had a problem. He urged
and assisted in the publication of the results, and saw to it that
the young men got the whole credit of the work when often it
should have gone to himself. Is it to be wondered at that such
a chief has such devoted followers ?

The Medical Society, the Journal Club, the Historical Club,
and other associations, were organized in quick succession.
Post-graduate courses were given, but the medical school of
the university seemed as far from beginning as ever. The
university trustees were not unmindful of the question, and
some of them in spite of the depleted income, were constantly
urging the establishment of the school. I have found among
my father's papers the notes of an earnest appeal on the subject
which he appears to have made to the Board of Trustees in
May, 1890. Certain women, several of whom were daughters
of trustees, who had from the first unsuccessfully sought admis-
sion for themselves and other women to the university, and
who had been told that it was planned to admit women to the
medical school when it should be established, collected money
and offered $100,000 to the trustees on condition that it should
be used to help the establishment of a medical school to which
women should be admitted on the same terms as men. On
October 29, 1890, the trustees made a minute accepting the
gift, with the proviso, however, that the university should not
establish its medical school until an endowment of $500,000
had been secured, and that women who desired to enter should
receive their preliminary education somewhere else. Miss
Mary E. Garrett, who had contributed most of the original
Women's Medical Fund, completed the endowment on Decern-



The Medical School and Osler's Advent 17

ber 22, 1892, by a gift of $306,977. Leading up to this gift
there was a protracted three-sided discussion between Miss
Garrett and her friends, the Medical Faculty and the Board of
Trustees. The outlook for an agreement was often gloomy,
and only one who was in a position to know, as I was, some-
thing of the ideas of all three parties to the negotiation, can
realize on how many occasions the scheme came close to being
abandoned. In this discussion, together with Welch and
Martin, Osier was deeply concerned. He had become very
restive under the delay of the opening of the medical school,
complained to me on one occasion of what he called the dry
bones of post-graduate teaching, and even intimated that
unless something were done he might be forced to go where
there were some real medical students.

The decision as insisted upon by Miss Garrett, to fix per-
manently by the terms of the gift the conditions for admission
to the medical school at an unprecedented standard, required


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Online LibraryMinnie Wright BloggSir William Osler, bart. Brief tributes to his personality, influence and public service → online text (page 1 of 14)