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73-422: Contrary to popular misconception and misuse, mucus and phlegm are not always the same. Mucus is a normal protective layering around the airway, eye, nasal turbinate , and urogenital tract . Mucus is an adhesive viscoelastic gel produced in the airway by submucosal glands and goblet cells and is principally water. It also contains high-molecular weight mucous glycoproteins that form linear polymers. Phlegm

146-410: A nasal turbinate or turbinal , is a long, narrow, curled shelf of bone that protrudes into the breathing passage of the nose in humans and various other animals. The conchae are shaped like an elongated seashell , which gave them their name (Latin concha from Greek κόγχη ). A concha is any of the scrolled spongy bones of the nasal passages in vertebrates . In humans, the conchae divide

219-455: A faster metabolism. For example, when the emu exhales, its nasal turbinates condense moisture from the air and absorbs it for reuse. Dogs and other canids possess well-developed nasal turbinates. These turbinates allow for heat exchange between small arteries and veins on their maxilloturbinate (turbinates positioned on maxilla bone) surfaces in a counter-current heat-exchange system. Dogs are capable of prolonged chases, in contrast to

292-586: A few such as the Dutch internist P. K. Pel , spread to medical schools across the globe. Osler was a prolific author and a great collector of books and other material relevant to the history of medicine . He willed his library to the Faculty of Medicine of McGill University where it now forms the nucleus of McGill University's Osler Library of the History of Medicine . Osler was a strong supporter of libraries and served on

365-631: A persistent inflammation within the sinuses can lead to turbinate swelling. Deformity of the nasal septum can also result in enlarged turbinates. Treatment of the underlying allergy or irritant may reduce turbinate swelling. In cases that do not resolve, or for treatment of deviated septum , turbinate surgery may be required. Turbinate reduction is a surgery to reduce the size of the turbinates (typically inferior turbinates ). There are different techniques, including bipolar radiofrequency ablation (also known as somnoplasty ), electrocautery , and use of cold steel instruments (e.g. microdebrider). In

438-481: A president of the Bibliographical Society of London (1913). Osler was a prolific author and public speaker and his public speaking and writing were both done in a clear, lucid style. His most famous work, The Principles and Practice of Medicine quickly became a key text to students and clinicians alike. It continued to be published in many editions until 2001 and was translated into many languages. It

511-502: A prolific writer of letters to medical societies, purported to be a retired U.S. Army surgeon living in Caughnawaga, Quebec (now Kahnawake ), author of a fake paper on the obstetrical habits of Native American tribes that was intended as a joke on his rival, Dr. William A. Molson. The piece was never published in Osler's lifetime, nor was it intended to be published; Osler knew the content

584-442: A sharp increase in the pressure within, in response to acute cooling of the body core. The pain from this pressure is often referred to as " brain freeze ", and is frequently associated with the rapid consumption of ice cream . The shallowness of the venous blood supply of the mucosa contributes to the ease with which nosebleed can occur. Conchae are composed of pseudostratified columnar , ciliated respiratory epithelium with

657-636: A single chief resident, who originally occupied that position for years. While at Hopkins, Osler established the full-time, sleep-in residency system whereby staff physicians lived in the administration building of the hospital. As established, the residency was open-ended, and long tenure was the rule. Physicians spent as long as seven or eight years as residents, during which time they led a restricted, almost monastic life. He wrote in an essay "Books and Men" that "He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all." His best-known saying

730-448: A thick, vascular , and erectile glandular tissue layer. The conchae are located laterally in the nasal cavities, curling medially and downward into the nasal airway. Each pair is composed of one concha in either side of the nasal cavity, divided by the septum . The superior conchae are smaller structures, connected to the middle conchae by nerve-endings, and serve to protect the olfactory bulb . The superior conchae attach to

803-504: A total of over 15,000 days of treatment. Sixteen years later, when Osler left for Oxford, over 4,200 patients were seen for a total of nearly 110,000 days of treatment. In 1905, he was appointed to the Regius Professor of Medicine at Oxford , which he held until his death. He was also a Student ( fellow ) of Christ Church, Oxford . In the UK, he initiated the founding in 1907 of

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876-438: Is considered a social taboo , being described as disgusting or unhygienic. One Igbo adage , for example, uses the swallowing of phlegm as a metaphor for wrongdoing . Also, due to the social image of spitting (the alternative of swallowing) in some communities, females were shown to be more likely to swallow phlegm and less likely to report experiencing it. The alternative to swallowing would be throat-clearing. To do this,

949-426: Is more related to disease than mucus, and can be troublesome for the individual to excrete from the body. Phlegm is a thick secretion in the airway during disease and inflammation. Phlegm usually contains mucus with virus, bacteria, other debris, and sloughed-off inflammatory cells. Once phlegm has been expectorated by a cough, it becomes sputum . There are multiple factors that can contribute to an excess of phlegm in

1022-478: Is notable in part for supporting the use of bloodletting as recently as 1923. Though his own textbook was a major influence in medicine for many years, Osler described Avicenna as the "author of the most famous medical textbook ever written". He noted that Avicenna's Canon of Medicine remained "a medical bible for a longer time than any other work". Osler's essays were important guides to physicians. The title of his most famous essay, " Aequanimitas ", espousing

1095-427: Is partially composed of mucus -producing goblet cells . This secreted mucus covers the nasal cavities, and serves as a filter, by trapping air-borne particles larger than 2 to 3 micrometers . The respiratory epithelium also serves as a means of access for the lymphatic system , which protects the body from being infected by viruses or bacteria. The conchae provide, first and foremost, the humidity needed to preserve

1168-499: Is sometimes a pair of supreme conchae superior to the superior conchae. When present, these usually take the form of a small crest. The conchae comprise most of the mucosal tissue of the nose and are required for functional respiration . They are enriched with airflow pressure and temperature-sensing nerve receptors (linked to the trigeminal nerve route, the fifth cranial nerve ), allowing for tremendous erectile capabilities of nasal congestion and decongestion, in response to

1241-415: Is the cause of tumours, of chlorosis, of rheumatism, and cacochymia - where is it? Who will ever see it? Who has ever seen it? What can we say of this fanciful classification of humours into four groups, of which two are absolutely imaginary?" Nasal turbinate In anatomy , a nasal concha ( / ˈ k ɒ n k ə / ; pl. : conchae ; / ˈ k ɒ n k iː / ; Latin for 'shell'), also called

1314-577: The Father of Modern Medicine and one of the "greatest diagnosticians ever to wield a stethoscope". In addition to being a physician he was a bibliophile , historian, author, and renowned practical joker. He was passionate about medical libraries and medical history, having founded the History of Medicine Society (formally "section"), at the Royal Society of Medicine , London. He was also instrumental in founding

1387-650: The McGill University Faculty of Medicine as a professor in 1874. There he created the first formal journal club , showed interest in comparative pathology, and is considered the first to have taught veterinary pathology in North America as part of a broad understanding of disease pathogenesis. In 1884, he was appointed Chair of Clinical Medicine at the University of Pennsylvania in Philadelphia and in 1885,

1460-561: The Medical Library Association of Great Britain and Ireland , and the (North American) Association of Medical Librarians (later the Medical Library Association ) along with three other people, including Margaret Charlton , the medical librarian of his alma mater, McGill University . He left his own large history of medicine library to McGill, where it became the Osler Library . William Osler's great-grandfather, Edward Osler,

1533-408: The ankylosaurid dinosaur Saichania . William Osler Sir William Osler, 1st Baronet , FRS FRCP ( / ˈ ɒ z l ər / ; July 12, 1849 – December 29, 1919) was a Canadian physician and one of the "Big Four" founding professors of Johns Hopkins Hospital . Osler created the first residency program for specialty training of physicians. He has frequently been described as

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1606-406: The ethmoid bone . The openings to the posterior ethmoidal sinuses exist under the superior meatus. The sphenoid sinus ostium exists medial to the superior turbinate. The middle conchae are smaller but have the most complex anatomy of the nasal turbinates. They originate from the lateral edge of the cribriform plate of the ethmoid bone . They insert anteriorly into the frontal process of

1679-444: The four humours , which are held in balance when a person is healthy. It is closely related to the ancient theory of the four elements and states that all diseases and disabilities result from an excess or deficit in black bile, yellow bile, phlegm, and blood. Hippocrates , an ancient Greek medical doctor, is credited for this theory, about 400 BC. It influenced medical thinking for more than 2,000 years, until finally discredited in

1752-449: The maxilla and posteriorly into the perpendicular plate of the palatine bone . There are three mutually perpendicular segments of the middle turbinate: from proximal to distal, there is the horizontal segment ( axial plane ), the basal lamella ( coronal plane ), and the vertical segment ( sagittal plane ). They project downwards over the openings of the maxillary and anterior and middle ethmoid sinuses, and act as buffers to protect

1825-421: The weather conditions and changing needs of the body. In addition, the erectile tissue undergoes an often unnoticed cycle of partial congestion and decongestion called the nasal cycle . The flow of blood to the nasal mucosa in particular the venous plexus of the conchae is regulated by the pterygopalatine ganglion and heats or cools the air in the nose. The nasopulmonary and nasothoracic reflexes regulate

1898-601: The 17th century physician and philosopher Sir Thomas Browne . He died at the age of 70, on December 29, 1919, in Oxford , during the Spanish influenza epidemic , most likely of complications from undiagnosed bronchiectasis . His wife, Grace, lived another nine years but succumbed to a series of strokes. Sir William and Lady Osler's ashes now rest in a niche in the Osler Library at McGill University . They had two sons, one of whom died shortly after birth. The other, Edward Revere Osler,

1971-455: The 1800s. Phlegm was thought to be associated with apathetic behaviour; this old belief is preserved in the word " phlegmatic ". This adjective always refers to behaviour, and is pronounced differently, giving full weight to the "g": not /ˈflɛmatɪk/ but /flɛgˈmatɪk/. To have "phlegm" traditionally meant to have stamina and to be unswayed by emotion. In his 1889 farewell speech at the University of Pennsylvania , Sir William Osler discussed

2044-734: The Association of Physicians and was founding Senior Editor of its publication the Quarterly Journal of Medicine until his death. In 1911, he founded the Postgraduate Medical Association and was its first President. The same year, Osler was named a baronet in the Coronation Honours List for his contributions to the field of medicine. In January 1919 he was appointed President of the Fellowship of Medicine and

2117-571: The Navy, he was shipwrecked off Barbados . In 1837, Featherstone Osler retired from the Navy and emigrated to Canada, becoming a "saddle-bag minister" in rural Upper Canada . When Featherstone and his bride, Ellen Free Picton, arrived in Canada, they were nearly shipwrecked again on Egg Island in the Gulf of Saint Lawrence . Their children included William, Britton Bath Osler and Sir Edmund Boyd Osler . William Osler

2190-599: The Regius Professor of Medicine at Oxford. "The Fixed Period", given on February 22, 1905, included some controversial words about old age. Osler, who had a well-developed humorous side to his character, was in his mid-fifties when he gave the speech and in it he mentioned Anthony Trollope 's The Fixed Period (1882), which envisaged a college where men retired at 67 and after being given a year to settle their affairs, would be "peacefully extinguished by chloroform". He claimed that, "the effective, moving, vitalizing work of

2263-570: The Sky and Half a Life (Star Trek: The Next Generation) . In the 3rd edition of his Textbook, he also coined the description of pneumonia as "the friend of the aged" since it allowed elderly individuals a quick, comparatively painless death: "Taken off by it in an acute, short, not often painful illness, the old man escapes those 'cold gradations of decay' so distressing to himself and his friends." Coincidentally, Osler himself died of pneumonia. An inveterate prankster, he wrote several humorous pieces under

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2336-748: The University of Toronto. Osler lived with James Bovell for a time, and through Johnson, he was introduced to the writings of Sir Thomas Browne ; his Religio Medici caused a deep impression on him. Osler left the Toronto School of Medicine after being accepted into the MDCM program at the McGill University Faculty of Medicine in Montreal , and he received his medical degree (MDCM) in 1872. Following post-graduate training under Rudolf Virchow in Germany, Osler returned to

2409-505: The ambush predation of cats, and these complex turbinates play an important role in enabling this (cats only possess a much smaller and less-developed set of nasal turbinates). This same complex turbinate structure help conserve water in arid environments. The water conservation and thermoregulatory capabilities of these well-developed turbinates in dogs may have been crucial adaptations that allowed dogs (including both domestic dogs and their wild prehistoric gray wolf ancestors) to survive in

2482-592: The brains of the highly intelligent and normal brains. In April 1987 it was taken to the Mütter Museum , on 22nd Street near Chestnut in Philadelphia where it was displayed during the annual meeting of the American Osler Society. He was elected as a member to the American Philosophical Society in 1885. In 1925, a biography of William Osler was written by Harvey Cushing , who received

2555-490: The case of turbinate reduction, only small amounts of turbinate tissue are removed because the turbinates are essential for respiration. Turbinectomy is usually reserved for patients who have persistent symptoms despite previous turbinate reduction surgery. Risks of reduction of the inferior or middle turbinates include empty nose syndrome . As Steven M. Houser suggested, "this is especially true in cases of anterior inferior turbinate (IT) resection because of its important role in

2628-424: The delicate olfactory epithelium , which in turn is needed to keep the olfactory receptors healthy and alert. If the epithelial layer gets dry or irritated, it may cease to function. This is usually a temporary condition but, over time, may lead to chronic anosmia . The turbinates also increase the surface area of the inside of the nose, and, by directing and deflecting airflow across the maximum mucosal surface of

2701-732: The dinosaurs they examined had nasal passages that they claimed were too narrow and too short to accommodate nasal turbinates, so dinosaurs could not have sustained the breathing rate required for a mammal-like or bird-like metabolic rate while at rest, because their lungs would have dried out. However, objections have been raised against this argument. Nasal turbinates are absent or very small in some birds, such as ratites , Procellariiformes and Falconiformes . They are also absent or very small in some mammals, such as anteaters, bats, elephants, whales and most primates, although these animals are fully endothermic and in some cases very active. Furthermore, ossified turbinate bones have been identified in

2774-454: The harsh Arctic environment and other cold areas of northern Eurasia and North America, which are both very dry and very cold. Reptiles and more primitive synapsids have olfactory turbinates that are involved in sensing smell rather than preventing desiccation. While the maxilloturbinates of mammals are located in the path of airflow to collect moisture, sensory turbinates in both mammals and reptiles are positioned farther back and above

2847-510: The imperturbability required of physicians. "'Imperturbability means coolness and presence of mind under all circumstances, calmness amid storm, clearness of judgment in moments of grave peril, immobility, impassiveness, or, to use an old and expressive word, phlegm." The phlegm of Humourism is far from the same thing as phlegm as it is defined today. Nobel laureate Charles Richet MD, when describing humorism's "phlegm or pituitary secretion" in 1910 asked rhetorically, "this strange liquid, which

2920-631: The importance of imperturbability, is the motto on the Osler family crest and is used on the Osler housestaff tie and scarf at Hopkins. Osler said Canada should be a "white man's country" in a 1914 speech given around the time of the Komagata Maru incident involving immigration from India. Osler wrote "I hate Latin Americans" in a letter to Henry Vining Ogden. Under the pseudonym "Egerton Yorrick Davis", Osler mocked Indigenous people: "Every primitive tribe retains some vile animal habit not yet eliminated in

2993-421: The inner nose, they are able to propel the inspired air. This, coupled with the humidity and filtration provided by the conchae, helps to carry more scent molecules towards the higher, and very narrow regions of the nasal airways, where olfaction nerve receptors are located. The superior conchae completely cover and protect the nerve axons piercing through the cribriform plate (a porous bone plate that separates

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3066-505: The internal nasal valve." Concha bullosa is an abnormal pneumatization of the middle turbinate, which may interfere with normal ventilation of the sinus ostia and can result in recurrent sinusitis . In some cases, the concha bullosa may be resected to help resolve persistent symptoms. Generally, in animals, nasal conchae are convoluted structures of thin bone or cartilage located in the nasal cavity . These are lined with mucous membranes that can perform two functions. They can improve

3139-434: The latter case, the sputum is normally lightly streaked with blood. Coughing up any significant quantity of blood is always a serious medical condition, and any person who experiences this should seek medical attention. Apophlegmatisms , in pre-modern medicine, were medications chewed in order to draw away phlegm and humours. Humourism is an ancient theory that the human body is filled with four basic substances, called

3212-688: The library committees at most of the universities at which he taught and was a member of the Board of Curators of the Bodleian Library in Oxford. He was instrumental in founding the Medical Library Association in North America, alongside employee and mentee Marcia Croker Noyes , and served as its second president from 1901 to 1904. In Britain he was the first (and only) president of the Medical Library Association of Great Britain and Ireland and also

3285-565: The loss; he was particularly anguished by the fact that his influence had been used to procure a military commission for his son, who had mediocre eyesight. Lady Osler (Grace Revere) was born in Boston in 1854; her paternal great-grandfather was Paul Revere . In 1876, she married Samuel W. Gross, chairman of surgery at Jefferson Medical College in Philadelphia and son of Dr. Samuel D. Gross . Gross died in 1889 and in 1892 she married William Osler who

3358-488: The mechanism of breathing through deepening of inhalation. Triggered by the flow of the air, the pressure of the air in the nose, and the quality of the air, impulses from the nasal mucosa are transmitted by the trigeminal nerve to the breathing centres in the brainstem , and the generated response is transmitted to the bronchi , the intercostal muscles , and the diaphragm . The conchae are also responsible for filtration , heating, and humidification of air inhaled through

3431-509: The ministry and entered Trinity College of the University of Toronto , in the autumn. However, he became increasingly interested in medical science under the influence of James Bovell and the Rev. William Arthur Johnson , encouraging him to switch his career. In 1868, Osler enrolled in the Toronto School of Medicine, a privately owned institution that was not part of the Medical Faculty of

3504-415: The mouth should be closed and air should be inhaled hard into the nose. Inhaling forcefully through the nose will pull excess phlegm and nasal mucus down into the throat, where muscles in the throat and tongue can prepare to eject it. Once this is done, a U-shape should be formed with the tongue, while simultaneously forcing air and saliva forward with the muscles at the back of the throat. At this point,

3577-419: The nasal airway into four groove-like air passages, and are responsible for forcing inhaled air to flow in a steady, regular pattern around the largest possible surface area of nasal mucosa . As a ciliated mucous membrane with shallow blood supply, the nasal mucosa cleans, humidifies and warms the inhaled air in preparation for the lungs . A rapidly dilating arteriolar circulation to these bones may lead to

3650-435: The nasal passage, away from the flow of air. Glanosuchus has ridges positioned low in the nasal cavity, indicating that it had maxilloturbinates that were in the direct path of airflow. The maxilloturbinates may not have been preserved because they were either very thin or cartilaginous . The possibility has also been raised that these ridges are associated with an olfactory epithelium rather than turbinates. Nonetheless,

3723-523: The new Johns Hopkins Hospital in Baltimore, Maryland . In 1893, Osler was instrumental in creating the Johns Hopkins School of Medicine and became one of the school's first professors of medicine. Osler quickly enhanced his reputation as a clinician, humanitarian, and teacher. He presided over the rapidly expanding hospital's first year of operation, when it had 220 beds and 788 patients were seen for

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3796-604: The nose from the brain) into the nose. Some areas of the middle conchae are also innervated by the olfactory bulb. All three pairs of conchae are innervated by pain and temperature receptors, via the trigeminal nerve (or, the fifth cranial nerve ). Research has shown that there is a strong connection between these nerve endings and activation of the olfactory receptors, but science has yet to fully explain this interaction. Large, swollen conchae, often referred to clinically as turbinates, may lead to blockage of nasal breathing. Allergies , exposure to environmental irritants , or

3869-399: The nose. The inferior conchae are graded 1–4 based on the inferior concha classification system (known as the inferior turbinate classification system ) in which the total amount of the airway space that the inferior concha takes up is estimated. Grade 1 is 0–25% of the airway, grade 2 is 26–50% of the airway, grade 3 is 51–75% of the airway and grade 4 is 76–100% of the airway. There

3942-446: The nose. Of these three, filtration is achieved mostly by other more effective means such as mucus and cilia. As air passes over the conchae, it is heated to 32–34 °C (89–93 °F), humidified (up to 98% water saturation ) and filtered. The respiratory epithelium that covers the erectile tissue (or lamina propria ) of the conchae plays a major role in the body's first line of immunological defense. The respiratory epithelium

4015-431: The phlegm will be in the mouth and is now ready to be spat out as sputum . Phlegm can exist in different colors. The color could provide important clues about a person's health. Phlegm may be a carrier of larvae of intestinal parasites (see hookworm ). Bloody sputum can be a symptom of serious disease (such as tuberculosis ), but can also be a relatively benign symptom of a minor disease (such as bronchitis ). In

4088-748: The possible presence of maxilloturbinates suggests that Glanosuchus may have been able to rapidly breathe without drying out the nasal passage, and therefore could have been an endotherm. The bones of nasal turbinates are very fragile and seldom survive as fossils. In particular none have been found in fossil birds. But there is indirect evidence for their presence in some fossils. Rudimentary ridges like those that support respiratory turbinates have been found in advanced Triassic cynodonts , such as Thrinaxodon and Diademodon . This suggests that they may have had fairly high metabolic rates. The paleontologist John Ruben and others have argued that no evidence of nasal turbinates has been found in dinosaurs. All

4161-467: The pseudonym "Egerton Yorrick Davis", even fooling the editors of the Philadelphia Medical News into publishing a report on the extremely rare phenomenon of penis captivus , on December 13, 1884. The letter was apparently a response to a report on the phenomenon of vaginismus reported three weeks previously in the Philadelphia Medical News by Osler's colleague Theophilus Parvin. Davis,

4234-446: The role of didactic lectures and once said he hoped his tombstone would say only, "He brought medical students into the wards for bedside teaching." He also said, "I desire no other epitaph … than the statement that I taught medical students in the wards, as I regard this as by far the most useful and important work I have been called upon to do." Osler fundamentally changed medical teaching in North America, and this influence, helped by

4307-452: The sense of smell by increasing the area available to absorb airborne chemicals, and they can warm and moisten inhaled air, and extract heat and moisture from exhaled air to prevent desiccation of the lungs. Olfactory turbinates are found in all living tetrapods , and respiratory turbinates are found in most mammals and birds. Animals with respiratory turbinates can breathe faster without drying out their lungs, and consequently can have

4380-440: The sinuses from coming in direct contact with pressurized nasal airflow. Most inhaled airflow travels between the inferior concha and the middle meatus . In humans, they are usually as long as the little finger . The inferior conchae are the largest turbinates, can be as long as the index finger in humans, and are responsible for the majority of airflow direction, humidification, heating, and filtering of air inhaled through

4453-415: The throat or larynx . Excessive phlegm creation can be troublesome. There are basically two ways to get rid of excess phlegm: swallowing or spitting. Phlegm naturally drains down into the back of the throat and can be swallowed without imposing health risks. Once in the stomach , the acids and digestive system will remove the phlegm and get rid of the germs in it. In some cultures, swallowing phlegm

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4526-477: The upward march of the race." Uncovering this historical context, the journalists David Bruser and Markus Grill and the archivist Nils Seethaler reconstruct the shipment of several indigenous skulls by Osler from Canada to Germany, which were (previously unknown) in the custody of the State Museums of Berlin. Osler is well known in the field of gerontology for the speech he gave when leaving Hopkins to become

4599-419: The world is done between the ages of twenty-five and forty" and it was downhill from then on. Osler's speech was covered by the popular press which headlined their reports with "Osler recommends chloroform at sixty". The concept of mandatory euthanasia for humans after a "fixed period" (often 60 years) became a recurring theme in 20th century science fiction —for example, Isaac Asimov 's 1950 novel Pebble in

4672-811: Was "Listen to your patient, he is telling you the diagnosis", which emphasises the importance of taking a good history. The contribution to medical education of which he was proudest was his idea of clinical clerkship – having third- and fourth-year students work with patients on the wards. He pioneered the practice of bedside teaching, making rounds with a handful of students, demonstrating what one student referred to as his method of "incomparably thorough physical examination." Soon after arriving in Baltimore, Osler insisted that his medical students attend at bedside early in their training. By their third year they were taking patient histories, performing physicals and doing lab tests examining secretions, blood and excreta. He reduced

4745-696: Was born in Bond Head , Canada West ( Ontario ), on July 12, 1849, and raised after 1857 in Dundas, Ontario . He was named William after William of Orange , who won the Battle of the Boyne on July 12, 1690. Osler's mother, who was very religious, prayed that he would become a priest. Osler was educated at Trinity College School (then located in Weston , Ontario). In 1867, Osler announced that he would follow his father's footsteps into

4818-724: Was in October appointed founding President of the merged Fellowship of Medicine and Postgraduate Medical Association, which became the Fellowship of Postgraduate Medicine . The largest collection of Osler's letters and papers is at the Osler Library of McGill University in Montreal and a collection is also held at the United States National Library of Medicine in Bethesda, Maryland . Perhaps Osler's greatest influence on medicine

4891-553: Was invited to serve on HMS  Beagle as the science officer for Charles Darwin 's historic voyage to the Galápagos Islands , but he turned it down because his father was dying. In 1833, Featherstone Osler announced that he wanted to become a minister of the Church of England . As a teenager, Featherstone Osler was aboard HMS  Sappho when it was nearly destroyed by Atlantic storms and remained adrift for weeks. Serving in

4964-632: Was mortally wounded in combat in World War I at the age of 21, during the 3rd battle of Ypres (also known as the battle of Passchendaele ). At the time of his death in August 1917, he was a second lieutenant in the (British) Royal Field Artillery ; Lt. Osler's grave is in the Dozinghem Military Cemetery in West Flanders , Belgium. According to one biographer, Osler was emotionally crushed by

5037-467: Was one of the seven founding members of the Association of American Physicians , a society dedicated to "the advancement of scientific and practical medicine." When he left Philadelphia in 1889, his farewell address, " Aequanimitas ", was about the imperturbability (calm amid storm) and equanimity (moderated emotion, tolerance) necessary for physicians. In 1889, he became the first Physician-in-Chief of

5110-537: Was outrageous, but he wanted to make a fool of Molson by getting the piece to the brink of publication in the Montreal Medical Journal , of which Molson was the editor. Osler would enhance Davis's myth by signing Davis's name to hotel registers and medical conference attendance lists; Davis was eventually reported drowned in the Lachine Rapids in 1884. Throughout his life, Osler was a great admirer of

5183-645: Was then professor of medicine at Johns Hopkins University. Osler was a founding donor of the American Anthropometric Society , a group of academics who pledged to donate their brains for scientific study. His brain was donated to the American Anthropometric Society after his death and is currently stored at the Wistar Institute in Philadelphia. A study of his brain, conducted in 1927, concluded that there were differences between

5256-524: Was to insist that students learn from seeing and talking to patients and the establishment of the medical residency . The latter idea spread across the English-speaking world and remains in place today in most teaching hospitals. Through this system, physicians in training make up much of a teaching hospital's medical staff. The success of his residency system depended, in large part, on its pyramidal structure with many interns, fewer assistant residents and

5329-678: Was variously described as either a merchant seaman or a pirate . One of William's uncles, Edward Osler (1798–1863) , a medical officer in the Royal Navy , wrote the Life of Lord Exmouth and the poem The Voyage . William Osler's father, the Reverend Featherstone Lake Osler (1805–1895), the son of a shipowner at Falmouth, Cornwall , was a former lieutenant in the Royal Navy who served on HMS  Victory . In 1831, Featherstone Osler

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