Sir William Osler, Baronet

Sir William Osler, Baronet (born July 12, 1849, Bond Head, Canada West [now Ontario], Can.—died Dec. 29, 1919, Oxford, Eng.) was a Canadian physician and professor of medicine who practiced and taught in Canada, the United States, and Great Britain and whose book The Principles and Practice of Medicine (1892) was a leading textbook. Osler played a key role in transforming the organization and curriculum of medical education, emphasizing the importance of clinical experience. He was created a baronet in 1911.

William Osler was the youngest of the nine children of the Reverend Featherstone Osler, who had gone to Canada as an Anglican missionary, and his wife, Ellen. William, like his father, was intended for the church. But while at school he became fascinated by natural history. He began to study at Trinity College, Toronto, but decided that the church was not for him and entered the Toronto Medical School in 1868. He subsequently transferred to McGill University in Montreal, Que., where he took his medical degree in 1872. During the following two years he visited medical centres in Europe, spending the longest period at University College, London, in the physiology laboratory of John Burdon-Sanderson, who was making experimental physiology preeminent in medical education.

In 1873 Osler demonstrated that hitherto unidentified bodies in the blood were in fact the third kind of blood corpuscles, which were later named the blood platelets. These corpuscles had been observed before, but no one before Osler had studied them so thoroughly. Thus began what he called his periods of “brain dusting”—travel and studies that made him almost as much a part of Europe as of America.

Osler returned to Canada and began general practice in Dundas but was soon appointed lecturer in the institutes of medicine at McGill University. He became professor there in 1875. A year later he became pathologist to the Montreal General Hospital and in 1878 physician to that hospital. At McGill he taught physiology, pathology, and medicine. His research was conducted largely in the postmortem room. In 1884 he was invited to occupy the chair of clinical medicine at the University of Pennsylvania in Philadelphia. He decided to do so on the toss of a coin. While in Philadelphia he became a founding member of the Association of American Physicians.

In 1888 Osler became the first professor of medicine in the new Johns Hopkins University Medical School in Baltimore. There he joined William H. Welch, chief of pathology, Howard A. Kelly, chief of gynecology and obstetrics, and William S. Halsted, chief of surgery. Together, the four transformed the organization and curriculum of clinical teaching and made Johns Hopkins the most famous medical school in the world. Students studied their patients in the wards and presented the results to the “Chief.” They were also encouraged to take their problems to the laboratory. Finally, the experts pooled their knowledge for the benefit of the patient and the student in public teaching sessions. Thus was born the pattern of clinical teaching that spread throughout the United States. Osler was not only professor of medicine but physician in chief to the hospital, an office first devised by the president of the university on the basis of his experience of running a large department store and later to spread to most of the medical centres of the United States. For the first four years there were no students at Johns Hopkins, and Osler used the time to write The Principles and Practice of Medicine, first published in 1892. In the same year, he married Grace Gross, widow of a surgical colleague at Philadelphia and great-granddaughter of Paul Revere.

Osler’s textbook was lucid, comprehensive, interesting, and scholarly. It quickly became the most popular medical textbook of its day and has continued to be published since under a succession of editors, though never regaining the quality with which Osler endowed it. The textbook had an unexpected sequel. In 1897 it was read by F.T. Gates, who had been engaged by John D. Rockefeller to advise him in his philanthropic endeavours. As a result of his reading, Gates inspired Rockefeller to direct his foundation toward medical research and to establish the Rockefeller Institute of Medical Research in New York.

In 1904, while visiting in England, Osler was invited to succeed Sir John Burdon-Sanderson in the Regius chair of medicine at the University of Oxford. Osler’s practice and teaching had for many years imposed enormous demands on his time and energy. His forceful wife telegraphed him from America: “Do not procrastinate. Accept at once.” Osler did. The Regius chair at Oxford is a crown appointment for which only citizens of the crown are eligible, but Osler had kept his Canadian nationality. He took up his chair in the autumn of 1905. In Oxford he taught only once a week, did a small amount of practice, and spent most of his time on his books. His library became one of the best of its kind, and after his death it passed intact to McGill, where it is specially housed. His scholarship was recognized by his election as president of the Classical Association. He was also active in medical affairs and inspired the formation of the Association of Physicians of Great Britain and Ireland and the establishment of the Quarterly Journal of Medicine. He was elected a fellow of the Royal College of Physicians of London in 1884 and a fellow of the Royal Society of London in 1898. He and his wife were immensely hospitable, especially to visiting Americans, among whom their house was known as the “Open Arms.”

Osler gave many lectures on medicine, some of which were collected and published. Aequanimitas, which he regarded as the most desirable quality for doctors, was the title of the most famous of these. Osler had a puckish wit and wrote some admirable medical nonsense under the pseudonym of Egerton Yorrick Davis, whom he presented as a retired surgeon captain of the U.S. Army.

In medical terminology, Osler is immortalized in Osler’s nodes (red, tender swellings of the hand characteristic of certain cardiac infections), a blood disorder known as Osler-Vaquez disease, and Osler-Rendu-Weber disease (a hereditary disorder marked by recurring nose bleeds with vascular involvement of the skin and mucous membranes).

The Oslers had one son, Revere, named after his great-great-grandfather, Paul Revere. His death in action during World War I took the spirit out of his father, who died of pneumonia in 1919.