William Osler

Sir William Osler

Sir William Osler (1849 – 1919) was a British born, Canadian physician.

One of the four founding physicians of Johns Hopkins Hospital: William Henry Welch, William Stewart Halsted, Howard Kelly and William Osler.

A polypolymath described as a physician, teacher, clinician, naturalist, pathologist, bibliophile, parasitologist, physiologist, morbid anatomist, historian, comparative pathologist and even a veterinarian

Renowned for his educational ethos, pithy, memorable and defining quotations (Oslerisms); Osler nodules (nodes); and Osler signs…


Biography

  • Born 12 July 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
  • Died 29 December 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

Osler sign I, original description 1898

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


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

Controversies

William Osler had a mischievous alter ego – Egerton Yorick Davis (Penis captivus)

Other 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

Major Publications


LITFL Further Reading


References


**Foot note: Men and Books (1959)

Men and Books was collated as a 67 page tome in 1959. Articles were taken from the Journal of the Canadian Medical Association Journal between 1911-1914


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eponym

the person behind the name

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

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