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.

Sir Thomas George Roddick (July 31, 1846 – February 20, 1923)

Sir Roddick was a surgeon who graduated from McGill Medical School in 1868 with the highest honour of winning the Holmes Gold Medal and Final Prize. For the next decade, he held various positions including assistant house surgeon at the Montreal General Hospital and Lecturer in Hygiene in 1872 and professor of clinical surgery at McGill in 1875.

Roddick travelled to Edinburgh in 1877 and observed Lord Joseph Lister’s findings. He brought Listerian antiseptis back with him (in the form of carbolic spray). This radically changed Montreal hospitals’ practice of surgery. In 1894, Roddick secured the position as the first chief surgeon at the Royal Victoria Hospital.

In 1901, as if by a cruel twist of fate, Roddick found out that he was allergic to the new antiseptic, iodoform, and thus could no longer continue surgical practice. He was Dean of Medicine from 1901-1908. He helped form the Medical Council of Canada and established a system of common Canada-wide examinations that would test aspiring medical students desiring a license to practise. Lastly in 1914 he was knighted for all his tireless work, including work as an MP.

In 1925, Mrs. Roddick erected a memorial at McGill – the iconic Roddick Gates at the south entrance. These gates include a clock because Roddick was a stickler for punctuality.

Baron Guillaume Dupuytren (5 October 1777 – 8 February 1835)

 

 

 

 

 

 

 

 

 

Baron Dupuytren was a French anatomist, pathologist and military surgeon. He obtained his medical degree from École de Médecine in Paris. At 18 he received his first post as prosector at the Hôtel-Dieu in Paris. In 1803 he was appointed assistant surgeon and in 1811, became professor of operative surgery. In 1816, he became Read Chair of clinical surgery and head surgeon. Dupuytren served as a surgeon to Louis XVIII, who named him baron

As an anatomical pathologist, Dupuytren made several discoveries and developed techniques including:
1812, the first excision of the lower jaw
1818, compression treatment of aneurysms
1822, he pioneered surgical treatment for wry neck
1826, a new burn classification and the first clear pathological description of congenital dislocation of the hip
1828, surgery for cancer of the uterine cervix and creation of an artificial anus, the theory of which was taken from John Hunter
1812 and 1829, ligations of the subclavian artery.

He was one of the first to use trepanation to drain brain abscesses and to treat seizures. However, by far his best-known description and discovery was the 1832 surgical procedures, detailed in the Lancet, to alleviate Dupuytren’s Contracture.

Jacques Lisfranc named him “The Brigand of Hôtel-Dieu” and Pierre-François Perry said he was “First among surgeons, least among men”.

Dupuytren is famous (or infamous) enough to have been included in many famous stories, including “The Atheist’s Mass” by Balzac, Flaubert’s “Madame Bovary”, Hugo’s “Les Miserables” and more recently Gabaldon’s “The Fiery Cross”.

Musée Dupuytren -Université Pierre et Marie CURIE

Anatomy Department Reading Room c1918.

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

 

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