Who’s Reading over Your Shoulder?

 

 

 

 

 

 

 

 

Do you hate the feeling of someone reading over your shoulder? Does it affect how you respond to the text? Do you feel judged based on the book in your hand? The student sitting next to you isn’t a big deal, but the thought of someone like William Osler peering over your shoulder definitely could put an edge on things. The Anatomy Reading Room, just before the entrance to the Maude Abbott Medical Museum on the second floor of the Strathcona Anatomy and Dentistry Building, houses a number of busts and portraits of eminent men that peer over the shoulders of the students sitting at the long oak tables. Who are these men?

Blog written by Sean Goldfarb, November 2017.

Sir William Osler, Baronet (July 12, 1849-December 29, 1919)

Osler was born in 1849 and obtained his medical degree at McGill. He was a world-renowned physician and professor who taught in Canada, Great Britain and the United States. Osler was among those who founded John Hopkins University’s medical school. At John Hopkins and elsewhere, he revolutionised medical education with the championing of patient-centered teaching. Believe it or not, he was a famous practical joker, writing bogus medical articles for respected journals under the pseudonym Egerton Yorrick Davis. Throughout his career, he wrote several books, including The Principles and Practice of Medicine, which became the gold-standard medical textbook of its day. Additionally, several of his lectures were published, such as Aequanimitas. Osler’s name has been immortalised in medical terminology: Osler’s nodes, Osler-Vaquez disease and Osler-Rendu-Weber disease. Osler was also a bibliophile, owning a large collection of books on various subjects. Upon his death in 1919, he conferred his library to McGill, where to this day it remains intact, named the Osler Library History of Medicine. There are many of his works and published lectures in the Osler Library, such as Aequanimitas and several editions of The Principles and Practice of Medicine, even including a microfilm of the first edition. You may even find some works of the infamous “Dr. Egerton Yorrick Davis”.

Hippocrates (c. 460 – c. 375 BCE)

 

 

 

 

 

 

 

 

 

Hippocrates was a Greek physician who lived during the Classical period of Greece’s history; he was thought to be a descendant of the demi-god Asclepius. Little is known about Hippocrates, since most things related to him are intermingled in myth and legends. He is usually considered to be the father of (modern, western) medicine and he is one of, if not the best well-known figures in medical history. He made an indelible mark on medical practice and is accredited with writing various texts known as the Hippocratic Corpus. His most famous writing is the Hippocratic Oath, which details medical ethics. Even if many of the tenets of the Oath are no longer followed, graduating medical-school students still swear to some form of the Oath (incidentally, at the turn of the twentieth century, few medical schools recited the Oath).

The Hippocratic Corpus outlines his philosophies of medical practice. Hippocrates separated mysticism from medicine and was more in favour of observation than a priori arguments, and preferred to observe and ask his patients many questions to elucidate the disease. His method would eventually come to dominate modern clinical practice. Hippocrates was a strong proponent of using dietetics to treat disease (restoring balance to the body). His teaching became the basis for the humoral theory of disease which would inform medicine for the next 2000 years until scientific inquiry would come to dominate medicine.

Asclepius

 

 

 

 

 

 

 

 

 

In ancient Greek and Roman mythology Asclepius was a demi-god of medicine. According to the legend, he was the son of Apollo and a human princess named Koronis. He was taught the healing arts by Chiron, a centaur. Zeus ultimately executed Asclepius by lightning, fearful that he may have made humans immortal. However, Homer in the Iliad merely refers to him as a physician that sired two children. He is often considered to be a direct ancestor of Hippocrates, although some believe he was merely Hippocrates’ mentor.

He was worshipped by the ancient Greeks as a healer. In sanctuaries which bore his name, events were held in his name and worshippers prayed to him so that he may present cures for their ills.

Asclepius is perhaps most well-known for the art depicting him with the staff of Asclepius, around which the serpent of eternal life coils. This staff is the symbol for medicine. However, it is often confused with the caduceus. The caduceus is also a staff but it is often winged and has two snakes coiling around it. This staff belongs to Hermes, god of messengers, merchants, thieves, etc. It is believed that Asclepius’ rod originates from the removal of dermal parasitic worms by incising the skin and winding the worm around a rod or stick. This treatment was so common that the healers of that day and age would even advertise their practice with the rod and worm, hence its association with medicine.

No apology needed, Dr. Johnston!

McGill Libraries offers access to more than 70 digital projects covering a wide array of subjects. The perusal of the old journals and newspapers that have been made available online can lead to some serendipitous findings. For example, on page 14 of the McGill University GAZETTE Monday, December 1, 1885 there is the following report:

Dr. W. G. Johnston, we are surprised to see, has neither been made to apologise for anything or send in his resignation for nothing, though he has been House-Surgeon in the M. G. H. [Montreal General Hospital] since May last.

Johnston succeeded William Osler as Pathologist at the Montreal General Hospital after the latter left for Philadelphia. Johnston had an important influence in the development of the McGill Medical Museum. For more information on Johnston see Physicans.



Guest post by Dr. Chantal Atallah, Pathologist, Hôpital Régional de Saint-Jerôme



Wyatt Galt Johnston and the Montreal General Hospital Autopsy

At the Montreal General Hospital (MGH), an imposing brass plaque dedicated to Dr. Wyatt Galt Johnston flanks the door of the pathology grossing room leading on to the autopsy suite. Following his appointment as a pathologist at the MGH in 1884, Johnston performed over a thousand autopsies during his short career – he died at thirty-nine years of age from the complications of a cut sustained while performing an autopsy.1

Johnston shared with Maude Abbott an interest in the Museum. He suggested a classification scheme based on the Dewey Decimal System which Abbott developed and used for the McGill Museum and which was exported to other centers. He also suggested that she should organize a society with other curators to share museum specimens and knowledge, leading to the establishment of the International Association of Medical Museums in 1907 (later to become the International Academy of Pathology).2

Although the total number of specimens he donated to the Medical Museum is unknown, a review of the museum log books, produced after the 1907 fire which destroyed most of the original Medical Museum, yielded 48 specimens attributed to Johnston. Forty-two of these were accessioned between 1890 and 1903, while the remaining six were not dated. Roughly half of those specimens originated from the gastro-intestinal or respiratory tract and a wide variety of disease was illustrated, including the spleen in malaria and echinococcosis. Only three of Johnston’s specimens remain today: “atrial ball thrombus” (1890), “bulging fossa ovalis“(1896) and “scirrhous carcinoma of the stomach” (1895).

 

 

 

 

 

 

 

 

 

Atrial ball thrombus (1890)

This specimen shows a smooth surfaced thrombus occupying most of the left atrium. It originates from the autopsy of a 42 year-old female who suffered from rheumatic fever. Sir William Osler published articles on “ball thrombi” in 1891 and 1897. Both include mention of a specimen at the “Museum of the Medical Faculty of McGill University”. This specimen was lost and replaced by Johnston’s, likely by Maud Abbott to illustrate this cardiac pathology described by Osler. 3,4

 

 

 

 

 

 

 

 

Scirrhous carcinoma of the stomach (1895?)

This specimen shows marked thickening of the pylorus and loss of the rugal folds. Although definite confirmation is lacking, it likely originates from the autopsy of a 35 year-old male conducted in 1895. Johnston performed nineteen autopsies between 1886 and 1900 in which “carcinoma of the stomach” was a main diagnosis. Of these, three were “scirrhous carcinoma of the pylorus”; two in 1886 and one in 1895. Given the state of preservation, the latter case is the most likely candidate.

 

 

 

 

 

 

 

 

 

Bulging fossa ovalis
This specimen shows a fossa ovalis with multiple fenestrations bulging into the right atrium. It originates from the autopsy of a 47 year-old male who presented a dilated heart showing stigmata of rheumatic heart disease (mitral and aortic stenosis) along with pulmonary embolus and deep vein thrombosis. The latter were probably related to a hypercoagulable state secondary to a “fungating polypoid and necrotic” lesion of the stomach, likely an adenocarcinoma.  3

References:

  1. Report of the Committee on Resolutions on the Death of Dr. Wyatt Johnston Public Health Pap Rep 29, 416-418. 1903.
  2. https://www.mcgill.ca/medicalmuseum/introduction/history/physicians/johnston
  3. “Pathological Reports (Montreal General Hospital) no. IV” published in 1904.
  4. https://www.mcgill.ca/medicalmuseum/exhibits/maude-abbott-medical-museum-osler-collection/specimens/miscellaneous-cardiac-disease/27-heart-ball-thrombosis

 

Sparks and Waves: the Uses of Electricity, Light and Sound in Physiotherapy

You are invited to visit the exhibit Sparks and Waves at the entrance of the Maude Abbott Medical Museum. The exhibit displays machines housed in the McGill School of Physical and Occupational Therapy during the mid 20th century.
Sarah Marshall speaks of the exhibit:
Sparks and Waves: the Uses of Electricity, Light and Sound in Physiotherapy

 

The Heart in Science and in Fiction / Le cœur humain: science et fiction

Saturday, May 13 2017
10:00 to 3:00
Maude Abbott Medical Museum

The event will explore the heart as a medical/anatomical organ and as a subject of literature. Museum specimens illustrating cardiac muscle death, infection and aging will be displayed and some current treatments will be shown.

Anatomic dissections by a pathologist illustrating normal animal heart anatomy will be performed at:
11:00 and 13:00 (English)
12:00 (noon) and 14:00 (French).

The contrasting concept of the heart as a spiritual/vital organ in literature – including poetry, novels and biography – will also be illustrated.

 

Hic Est Locus

Nobbs proposed watercolour drawing of the Pathological Institute.

The inscription, Hic est locus ubi mors resurgens rediviva est, carved over the gated archway of the Pathological Institute (today known as the Duff Medical Building), is easily missed. Translated, the words read: “Here is the place where death comes forth again in life.” The quote is attributed to the 18th century physician Giovanni Morgagni, and is a motto used in many morgues and departments of anatomical pathology. The Duff Medical Building housed McGill’s Department of Pathology from 1924 to 2015. The McGill pathology museum was moved to the building when it was built in 1924. Many of its specimens were accessioned from the morgue housed in its basement.

Two other Latin inscriptions in the main lobby off University Street give reference to the usage of the building as well. “Hic est locus ubi mors gaudet succerrere vitae” (Here is the place where death rejoices to be of service to life) and “Nihil sic revocat a pecato quam frequens mortis meditatio” (Nothing prevents error or sin so much as frequent contemplation of death). The architect of the building was Percy Nobbs. His choice of ornamentation reflected his belief that is was an essential carrier of meaning in architecture.

 

Detail of one of the plaster letters in lobby of the Pathological Institute

Lobby of the Pathological Institute, 3775 University Street, Montreal.

 

 

 

 

 

 

 

 

References

Wagg, Susan W. Percy Erskine Nobbs: Architecte, Artiste, Artisan. Percy Erskine Nobbs: Architect, Artist, Craftsman. Kingston: McGill – Queen’s University Press, 1982.

Illustrated Lecture: The Maude Abbott Medical Museum: 1822-2017

With objects dating from 1822, the Maude Abbott Medical Museum has collected thousands of specimens over the years.

The talk reviews the history of the museum, key individuals associated with it, and important changes introduced in recent years.

All are welcome.

Part of the solution, not part of the problem

Papier-mâché model: Head details. Fabrication: Louis Thomas Jerome Auzoux. Date: early 1900s. Maude Abbott Medical Museum

All kinds of materials have been used to create medical models, including wax, wood, ivory, cardboard, bronze, fabric, plaster, rubber, and plastic. Some of the most intricate models were produced by Louis Thomas Jerome Auzoux (1797-1880), a preeminent producer of papier-mâché models in France during the 1800s.

Auzoux’s use of papier-mâché as a modelling material, as well as his system of labelling, was a radical change from earlier techniques.

In his “Catalogue. Preparations of Artificial Anatomy By Dr Auzoux, 1841”, the models were promoted as being “ …instrumental to the student whose repugnance to the dissecting room is difficult to overcome… ”. The models could be taken apart piece by piece and responded to the shortage of cadavers available for human dissection.

Since the Licensing Act of 1788, which stipulated “cadaver surgery”, dissection was an integral part of the medical student’s training in Canada. At the time the Act was passed, no guidance was given for the procurement of cadavers. In 1843 the legislative assembly of the Province of Canada passed “An Act to regulate and Facilitate the Study of Anatomy”. The Act stipulated that “the bodies of persons found dead publically exposed, or who immediately before their death shall have been supported in and by any Public Institution receiving pecuniary aid from the provincial Government… ” (with the exception of bodies claimed by relatives) be delivered to medical schools. However, because a cadaver could only be used once, and because of religious customs and the lack of means of preservation, shortage of cadavers remained a problem. In 1871, the Editors of the Canada Medical Journal blamed the shortage partly on “ …maudlin notions about the desecration of the dead”.

The number of medical students enrolled in medical faculties also put pressure on the need for cadavers. By the fall of 1871, Montreal alone had three medical schools. Dr. Shepherd, demonstrator of anatomy at McGill in 1875, freely admitted that he had to accept cadavers from “Resurrectionists” (usually medical students) who charged thirty to fifty dollars per body.

Montreal newspapers at the time reported on grave-robbing incidents that horrified the relatives and citizens. The practice of using resurrected bodies for dissection more or less ended after the passage of an amendment to the Anatomy Act in 1883.

Today, Auzoux’s papier-mâché models are relegated to museum collections and admired for their beauty and intricate detail. Most models are surprisingly robust and have numbered pieces. A caveat: it is easier to “dissect” them than to put them back together. Something that students do not have to do after dissection: reassemble the body.

References

  • Catalogue of preparations of artifical anatomy: https://archive.org/details/101170613.nlm.nih.gov
  • Hallam, E. (2016). Anatomy museum: Death and the body displayed.
  • G. Lawrence. Resurrection and Legislation, or Body-Snatching in Relation to the Anatomy Act in the Province of Quebec. Bulletin of the History of Medicine 32, 1958, p. 408
  • Francis J. Shepherd, Reminiscences of Student Days and Dissecting Room (Montreal: Privately Printed, 1917), p. 24-25
  • Resurrecting the History of Body-Snatching at McGill:
    http://blogs.library.mcgill.ca/osler-library/history-of-bodysnatching/
  • W.J. Goob. The Anatomical Models of Dr Louis Auzoux: A Descriptive Catalogue (Leiden: Museum Boerhaave Communication 305, 2004)

 

 

 

 

 

 

 

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