William Osler

Biography

• Born on July 12, 1849 Bond Head, Canada West
• 1864 – Expelled from grammar school in Dundas, Ontario
• 1866-1868 Trinity College, Toronto, in preparation for career as a minister.
• 1868– Toronto School of Medicine.
• Honorary Professor of Medicine, Johns Hopkins University, Baltimore
• 1905-1919 Regius Professor of Medicine, Oxford
• Additional titles: Fellow of the Royal Microscopical Society, London; President of the Montreal Veterinary Medical Association; Professor of Physiology in McGill University; Fellow of the Veterinary College, Montreal; Professor of medicine successively at McGill University; the University of Pennsylvania; Johns Hopkins University; and Oxford University
• Died December 29, 1919 Oxford, England

Medical Eponyms

Osler nodules (presented 1908, published 1909)

Painful, red, raised lesions usually found on the hands and feet. They are caused by immune complex deposition and the resulting inflammatory response. Associated with a number of conditions, including infective endocarditis, SLE, and disseminated gonococcal infection. To be differentiated from painless Janeway lesions

One of the most interesting features of the disease (chronic endocarditis) and one to which very little attention has been paid is the occurrence of ephemeral spots of a painful nodular erythema, chiefly in the skin of the hands and feet, des nodosités cutanées éphémères of the French. The blood-cultures and the presence of the painful erythematous nodules and the occurrence of embolism furnish the most important aids.

Osler. Quarterly Journal of Medicine. 1909

Osler Sign I (1898)

Pretibial myxedema of Graves disease

The legs present a very remarkable appearance. [The patient] says that two years ago, shortly after the onset of the exophthalmus, he began to notice a change in the color of the skin of the legs. This has gradually increased and the skin has become swollen, infiltrated, and very hard. With the onset of this condition there was no special redness, no itching, nor any disturbance of sensation. Anteriorly it extends close to the tuberosities of the tibiae; on the sides of the legs it does not reach so high, only to within about three inches of the head of the fibula on the right side, and a little higher on the left side.

The form of distribution is quite symmetrical. Behind, it extends in an uneven border a little above the most prominent part of the calves. It shades insensibly into the normal skin. The color is a peculiar tan-brown. It is everywhere smooth, though there are in places little whitish elevations, particularly on the outer surfaces of the legs. One or two of these look like small fibroid nodules. They are very closely set over the skin, but only a few of them project beyond the surface.

On palpation the affected areas feel leathery, firm and hard. The skin can nowhere be picked up. The line of demarcation between the normal and infiltrated skin is marked by a distinct ridge. A slight discoloration of the normal skin extends beyond the prominent part of this ridge. Below, the affection is limited accurately by a line corresponding to the tops of the boots. There is no coldness, and it does not pit on the deepest pressure

Osler 1898

• Osler W: On diffuse scleroderma; with special reference to diagnosis, and to the use of the thyroid-gland extract. Journal of cutaneous and genito-urinary diseases. 1898; 16: 60
• Graner JL. “Osler’s sign”: pretibial myxedema of Graves’ disease. Can Med Assoc J. 1985; 132(7): 745–746.

Other eponyms…

Oslerus osleri (1877) [aka Filaria osleri, Filaroides osleri ] is the canine lungworm, a Metastrongyloidea nematode living in the pulmonary tract, usually in the bifurcation of the trachea and the bronchi.

Osler triad (1881) association of pneumonia, endocarditis, and meningitis.

Erythraemia (1903) [aka Vaquez-Osler disease, Polycythemia vera, Polycythaemia rubra vera] acquired myeloproliferative disorder characterized by an elevated absolute red blood cell mass caused by uncontrolled red blood cell production, frequently associated with uncontrolled white blood cell and platelet production.

Oslerisms A collection of anecdotes, pithy, memorable and defining quotations

Major Publications

• Osler W. Christmas and the microscope. Hardwicke’s Science-Gossip 1869; 50: 44. [First publication]
• Osler W. Verminous bronchitis in dogs. The Veterinarian 1877; 50: 387-397 [Oslerus osleri]
• Osler W. Two cases of striated myo-sarcoma of the kidney. Journal of Anatomy and Physiology 1880;14(2):229-233 [Wilms Tumour]
• Osler W. Infectious (so-called ulcerative) endocarditis. Archives of Medicine, New York, 1881;5:44-68. [Osler triad]
• Osler W. On dilatation of the colon in young children. 1893 [Hirschsprung disease]
• Osler W: On diffuse scleroderma; with special reference to diagnosis, and to the use of the thyroid-gland extract. Journal of cutaneous and genito-urinary diseases.1898;16: 49-67, 127-134 [Osler sign I]
• Osler W. Chronic cyanosis, with polycythaemia and enlarged spleen: a new clinical entity. American Journal of the Medical Sciences 1903; 126: 187-201. [Vaquez-Osler disease]
• Osler W. Aequanimitas, with other addresses to medical students, nurses and practitioners of medicine. 1906
• Osler W. Modern Medicine: its theory and practice. 1907. [Vol I, Vol II, Vol III, Vol IV, Vol V, Vol VI, Vol VII]
• Osler W. A Clinical Lecture on ERYTHRÆMIA. Lancet 1908;171(4403):143-146 [Vaquez-Osler disease]
• Osler W. Chronic infectious endocarditis. Quarterly Journal of Medicine. 1909;2(6):219–230. [Osler nodules]
• Osler W. An Alabama student and other biographical essays. 1908
• Osler W. Man’s redemption of man. 1910
• Osler W. The old humanities and the new science. 1919
• Osler W. Bibliotheca Osleriana. 1929. A Catalogue of Books Illustrating the History of Medicine and Science
• **Osler W. Men and Books. Collated writing from CMAJ. 1959
  

LITFL Further Reading

• Lessons from Osler 001 – Work, the Master Word in medicine
• Lessons from Osler 002 – Fun and a sense of humor
• Lessons from Osler 003 – the art of observation
• Lessons from Osler 004 – treat the patient, not the disease
• Lessons from Osler 005 – Why examinations are necessary
• Sir William Osler (1849-1919) 

References

• William Osler: Original Papers 1881-1897. Digital Commons@TMC
• William Osler: Original Papers 1898-1906. Digital Commons@TMC
• William Osler: Original Papers 1907-1919. Digital Commons@TMC
• Osler Special edition: Bulletin of the Johns Hopkins Hospital. 1919:XXX(34):183-220
• Osler Memorial edition. Canadian Medial Association Journal. 1920;10:1-123
• Cushing HW. William Osler, the man. New York, Hoeber. 1920
• Farrior JB, Silverman ME. A consideration of the differences between a Janeway’s lesion and an Osler’s node in infectious endocarditis. Chest. 1976 Aug;70(2):239-43.
• Graner JL. “Osler’s sign”: pretibial myxedema of Graves’ disease. Can Med Assoc J. 1985; 132(7): 745–746.
• Christian HA. Sir William Osler (1849-1919). Proceedings of the American Academy of Arts and Sciences, Volume 57.
• Burrow GN. The trial and tribulation of Egerton Yorrick Davis. West J Med. 1991;155(1): 80–82
• Nation EF. Osler’s alter ego. Dis Chest 1969; 56:531-537
• Tiggert WD. An annotated life of Egerton Yorrick Davis, MD, an intimate of Sir William Osler. Journal of the History of Medicine and Allied Sciences, 1983;38;3:259–297
• Jarcho S. Some Hoaxes in the Medical Literature. Bulletin of the History of Medicine. Vol. 33. 1959. p.342-347.

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