An unpublished lecture by William Osler given in 1911 to young British administrators going to India gives glimpses of imperial history and travel medicine, and contains echoes of debates current at that time on a healthy tropical lifestyle and also the influence of race and climate on health.
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References
1.
Annual report of the curators of the Indian Institute (for the year 1911). Oxford University Gazette: 5 June 1912: p 839
2.
CushingH. The Life of Sir William Osler.Oxford: Clarendon Press, 1925: vol. II, p. 272
3.
FrancisWW, HillRH, MallochA. eds. Bibliotheca Osleriana. A Catalogue of Books Illustrating the History of Medicine and Science Collected, Arranged and Annotated by Sir William Osler, Bt.Oxford: Clarendon Press, 1929
4.
From an unpublished lecture by EvisonDr G, Indian Institute Librarian, Oxford
5.
Mowgli, the boy-hero of Kipling's Jungle Book stories (whom Osler mentions in his ‘The Master Word in Medicine’ address of 1903) was destined for a career in the Forest Service. Kim, another of his boy-heroes was taken into the prestigious Secret Service. (Wilson A.: The Strange Ride of Rudyard Kipling, His Life and Works. New York: The Viking Press, 1977: p. 128). For a touching incident involving Osler and the Jungle Books, see Cushing H (op. cit. ref. 2): p. 684
6.
Oxford University Gazette, 28 February 1912: p. 472 and 19 June 1912: p. 939
7.
OslerW, The Army surgeon (1894): In: Aequanimitas with Other Addresses to Medical Students, Nurses and Practitioners of Medicine, 3rd edn.London: HK Lewis & Co Ltd, 1948: pp. 97-113 (p. 101). The quotation is from: ‘Waring’ by the English poet Robert Browning (1812-1889). Vishnu is a major deity of the Hindu pantheon; an ‘avatar’ is an incarnation of God on Earth
8.
OslerW, British Medicine in Greater Britain (1897). In Aequanimitas (Ibid.: pp. 161-88: p. 185)
9.
OslerW. The Nation and the Tropics. Lancet1909; ii: 1401-6; see also Cook GC. William Osler's fascination with diseases of warm climates. Journal of Medical Biography 1995; 3: 20-9
10.
DateA, DateS. William Osler's letters from Egypt. Journal of Medical Biography2001; 9: 151-60
11.
OslerW, Physic and physicians as depicted in plato (1893). In Aequanimitas (op. cit. ref. 7): pp. 43-71. The dictum: ‘A sound mind in a sound body’ is attributed to Juvenal (AD c60-c130), the most powerful Roman satirist
12.
The writer could not be identified. It is not by Charles Darwin, though it is reminiscent of Darwinian natural selection. The frequent unreferenced quotations that appear in most of Osler's writings are a well-recognized hazard to annotators. (CS Bryan's review of Hinohara S, Niki H, eds: Osler's ‘A Way of Life’ and Other Addresses, with Commentary and Annotations in the Bulletin of the History of Medicine2002; 76:834-5)
13.
BlissM. New News from Norham Gardens. In: BarondessJA, RolandCG, eds. The Persisting Osler - III.Malabar, FL: Krieger Publishing Co, 2002: pp. 43-8
14.
This mechanistic approach apparently worked so well with the audience that Osler used it in an even more detailed fashion at a gathering of physicians, four months later. (OslerW. High blood pressure: its associations, advantages, and disadvantages. British Medical Journal1912: ii: 1173-7.) Osler also used this approach when communicating with patients. (Wrong O. Osler and my father. Journal of the Royal Society of Medicine 2003; 96: 462-4)
15.
The paragraph ending here, and beginning above with the words: ‘Take a dozen…’, is the only part of this lecture published earlier. (BlissM, William Osler. A Life in Medicine.Toronto: University of Toronto Press, 2000: pp. 372-3)
16.
From: ‘The Deacon's Masterpiece, or The Wonderful ‘One-Hoss Shay”. A poem by Oliver Wendell Holmes Jr (1809-94), Professor of Anatomy at Harvard and Osler's friend. The deacon's carriage was constructed with all its parts equally strong. A century later, all its parts broke up at the same moment: ‘You see, of course, if you're not a dunce,/How it went to pieces all at once, -/All at once, and nothing first, -/ Just as bubbles do when they burst’
17.
From Thomas Carlyle: Heroes and Hero Worship, the Hero as a Man of Letters (1841): ‘The suffering man ought really to consume his own smoke; there is no good in emitting smoke till you have made it into a fire’. One of Osler's favourite borrowed aphorisms used also in The Master-Word in Medicine (1903) In: Aequaninitas (op. cit. ref. 7): pp. 347-71 (p. 368). Hinohara and Niki (op. cit. ref. 12: p. 272) suggest it is from JR Lowell's: ‘learning how to burn your own smoke’
18.
Osler preferred this older usage and has corrected the typist's ‘protein’ in the manuscript, to ‘proteid’ - except in one place
19.
From: ‘Alma’ a poem by the English poet Matthew Prior (1664 -1721) who wrote: ‘Sallads and eggs and lighter fare/ Tune the Italian spark's guitar/And if I take Don Congreve right/Pudding and beef make Britons fight’
20.
Climatology - study of the influence of climate on health and healing, together with Balneology - the influence of spring water on treatment was, at the time, a section of the Royal Society of Medicine
21.
Cross-cultural interaction was frowned upon and actively discouraged in the later days of the British Raj. (DalrympleW. White Mughals.London: Harper Collins Publishers, 2000)
22.
Sir Joseph Fayrer (1824-1907) Bart, KCSI, MD (Edin.), FRCP (Lond.), FRCS (Eng. and Edin.), FRS (Lond. and Edin.) Physician Extraordinary to the King. Joined the Indian Medical Service, serving in various capacities in the Burmese War of 1852; Oudh after the annexation; in the Indian Mutiny with the besieged in Lucknow and at the death of Sir Henry Lawrence; as Professor of Surgery at the Medical College, Calcutta; President of the Asiatic Society; Surgeon to the Governor General Lord Mayo. After Lord Mayo's assassination in the Andaman Islands in 1873, he left India. Subsequently he accompanied the Prince of Wales on his 1875 tour of India. Wrote many papers and books including Thanatophidia of India, Tropical Diseases (Lettsomian lectures) and The Climate and Fevers of India (Croonian Lectures). He also wrote On The Natural History of Tigers, a great many of which he had killed while in India (Obituary. Lancet1907; i: 1530-4)
23.
Sir MorrisMalcolm A, ed. The Book of Health.London: Cassell & Co Ltd, 1884. Contains the chapter: Health in India by Sir Joseph Fayrer
24.
Lieutenant Colonel Charles Edward Woodruff (1860-1915), US Army Medical Corps, MD from Jefferson Medical College, Pa, 1886. Author of: The Effect of Tropical Light on White Men (1905), The Expansion of Races (1909) and Medical Ethnology (1915). A comment on his views appeared in the Lancet1911; i: 459, shortly before Osler's lecture
25.
CookJames. (1728-79), British Naval Captain, who led three scientific voyages of discovery to the Pacific
26.
GuyotArnold Henry (1807-1884), a Princeton University Professor who wrote a model series of Geography textbooks
27.
From Robert Browning's poem: Rabbi Ben Ezra (1864) and another Osler favourite used also in: On the Educational Value of the Medical Society (1903). In: Aequanimitas (op. cit. ref. 7): pp. 327-45 (pp. 333-4): ‘In his philosophy of life the young doctor will find Rabbi Ben Ezra a better guide… than Omar whose fatalism, so seductive in Fitzgerald's verses, leaves little scope for human effort’. (The Rubaiyat of Omar Khayyam, an 11th century Persian poet's verses translated and paraphrased by the English poet Edward FitzGerald in 1859)
28.
Surgeon-Major-General Sir A Frederick Bradshaw (1834-1923) KCB, CB, MA (Oxon), MRCP, MRCS (Lond) Worcester College, Oxford. St Bartholomew's Hospital, London. Army Medical Service. Served 35 years in India: Present at the siege of Lucknow, also served in the N W Frontier, Afghanistan, Baluchistan, Panjab. Hon Physician to Queen Victoria, King Edward VII and King George V
29.
Peers DimmockHenry. (b 1857) MD (Dur.) MRCS, LRCP, Lieutenant-Colonel Indian Medical Service. Principal and Professor of Midwifery Grant Medical College, and Senior Medical Officer and Obstetric Physician J J Hospital, Bombay. Retired April 1911. Author of: Health in India for Young Men
30.
Perhaps at this point, Osler may have had to mime the African's distended abdomen to make the meaning clearer. Such insensitive humour serves to remind devoted Oslerians who consider Osler to be ‘a man for all times and places’ that he was also, very much, ‘a man of his own time and place’. (Date & Date, op. cit. ref. 10: p. 151)
31.
ChittendenRussell H(1856-1943) was the first Professor of Physiological Chemistry in the USA, at the Sheffield Scientific School in Yale University. He challenged von Voit's generally accepted dietary standards and proved experimentally that a lower protein intake was more than adequate. Chittenden's views were not readily accepted by the medical establishment at the time of Osler's lecture, as seen in a review of G Carroll Smith's book (Lancet 1911; ii:687-8)
32.
McCayDavid (1873-1948) MBBS, MD (Queen's College Belfast), Lieutenant-Colonel Indian Medical Service. On entering the IMS took part in the Relief of Pekin 1900-1. Professor of Physiology, Medical College Calcutta 1908-18. His work on the chemistry and nutritive value of Indian foods and the metabolism and protein requirements of Indians is published in the Scientific Memoirs of the Government of India (New Series) 1906-10, and 1912-14
33.
Osler's admiration for the work of Professor Chittenden (op. cit. ref. 31) is clouded here by the then current ideologies of the Raj. Chittenden's experiments demonstrated athletes trained on a vegetarian diet performed as well as, if not better than, those eating meat. Of course athleticism is not the same as aggressiveness
34.
Osler did not drink ‘more than his glass of sherry or, at a large dinner, an occasional sip of wine in addition’. (ThayerWS. Reminiscences of Osler in the early Baltimore days. In: Osler and Other Papers, Baltimore: The Johns Hopkins Press, 1931: pp. 18-11 (36)
35.
Southern United States
36.
Source not identified
37.
‘How far he was able in later years to keep abreast of the march of science in the sphere of medicine is a matter on which I am incompetent to speak; but his activities were so many and various, and his exercise of hospitality so lavish and unceasing… that it is difficult to imagine that he can have found as much time for study as he could have desired’. The Rt Hon HAL Fisher quoted by Cushing H. (op. cit. ref. 2): p. 207
38.
BlissM. (op. cit. ref. 15): p. 286
39.
MetcalfTR. Ideologies of the Raj, (Volume III of The New Cambridge History of India).Cambridge: University Press, 1995
40.
The term ‘White-Man's burden’ was coined, at the time of the US annexation of Cuba and the Philippines. Kipling's poem ‘Take up the White Man's burden’, written in 1899, was a call to the Americans to assume their ‘imperial responsibilities’
