william osler and his welsh connections · postgraduate medical journal (1988) 64, 568-574 sir...

Postgraduate Medical Journal (1988) 64, 568-574

Sir William Osler and his Welsh connections

John CuleUniversity of Wales College of Medicine, Heath Park, Cardiff CF4 4XN, UK.

'If you would know a man you must first know his connections.'

This nationally practised Welsh aphorism is said toderive from the need to have called on all close anddistant relations to the ninth affinity to strengthenpleadings under the Ancient Laws of Wales.

The 'ancient Welsh cozens'

The Osler family had Cornish roots and therein liesa firm if distant Welsh connection. No less an

authority than the learned Dr Thomas Phaer ofCilgerran (1510?-1560), writing of the boisterousball game of knappan - of which we shall learnmore anon - refers to 'our ancient cozens theCornishmen who have the selfe same exerciseamonge them yett observed, which they callhurlinge'.

William Osler's grandfather lived in Falmouth,whence his father Featherstone Lake Osler movedto Canada with his young bride, Ellen FreePickton. She was a native of London, but bore a

distinguished Welsh name. William was the youn-gest of their family of nine, and was born in theparsonage at Bond Head in Tecumseth County inthe backwoods of Upper Canada.

Uncle Edward was the eldest of the nine childrenof Grandfather Osler. He was a favourite uncle, ofwhom WO wrote 'we cherished an amazing ven-eration'. And small wonder, for his books wereavailable for William to read from the shelves ofhis father's study, and Uncle Edward had many ofthe qualities that William also inherited.2Edward Osler (1798-1863) was a naturalist-

doctor. He qualified M.R.C.S. from Guy's Hospitalwhere he was a medical student at the same time as

Keats, and he too was a poet, though perhaps notquite of the same calibre. He wrote mainly hymnsand psalms, being of a somewhat religious turn ofmind. In a broader literary way, he was editor ofthe Royal Cornwall Gazette,. published at Truro,where he practised medicine from 1840 until hisdeath in 1863. Earlier he had been a naval surgeonand still earlier was a hospital surgeon at Swansea.

He was evidently proud of his association with thetown for on the title page of one of his books, TheChurch and Dissent, Considered in their PracticalInfluence, London, 1836, he describes himself as

'formerly one of the surgeons to the SwanseaInfirmary, and Surgeon to the Swansea House ofIndustry.' In 1911, the Regius Professor of Medi-cine at Oxford unveiled a brass tablet 'To thememory of Edward Osler, M.R.C.S., F.L.S. HouseSurgeon of this Hospital in 1825'.3

Griffith Evans and William Osler

When young William Osler was still a medicalstudent at Toronto, he met a Welshman for whomhe was to develop a great regard. Indeed, he laterrecognized his genius at a time when practicallyno-one else did. Griffith Evans (1835-1935) wasstationed there as a veterinary surgeon to theartillery during the time of the Fenian Rising.Because of his interest in microscopy he was invitedby Dr James Bovell, one of Osler's teachers at theuniversity, to help in the preparation of specimens.A friendship began between them in 1867, at thetime of their meeting in Bovell's rooms in TrinityCollege. Evans described Osler as 'a young man ofgreat charm' and helped him on microscope tech-nique, advising him to treat the instrument gently'as you would a lady'. Griffith Evans had pre-viously been stationed in Montreal, where thisindustrious army officer had used his posting toqualify M.D., C.M. (McGill) with a thesis on

tuberculosis, in addition to his veterinary diploma.4He read widely in medical science when the contro-versy over the significance of bacteria was at itsheight and himself came to rank amongst thepioneeers of the Germ Theory (Figure 1).

© The Fellowship of Postgraduate Medicine, 1988

Correspondence: J. Cule, M.D., M.A., F.R.C.G.P., Aber-einon, Capel Dewi, Llandysul, Dyfed SA44 4PP.

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SIR WILLIAM OSLER AND HIS WELSH CONNECTIONS 569

Figure 1 'Griff'. Griffith Evans, M.D. (McGill).Reproduced from Annals of Tropical Medicine & Par-asitology, 1918: 12, with permission.

Osler, Evans and Koch shared a common interestin the natural history of tuberculosis. In 1882,Robert Koch (1843-1910) published his brilliantclassical paper describing the infectivity of tubercu-losis. It is a well contrived and simple demon-stration of the nature and spread of the tuberclebacillus. It has often been said that Koch neverformally set out the famous 'postulates', which hadalready been suggested by Jacobe Henle (1809-1885).5 The criteria are, however, clearly stated inKoch's paper of 1882. 'To prove that tuberculosisis a parasitic disease, that it is caused by the invas-ion of bacilli and that it is conditioned primarily bythe growth and multiplication of the bacilli, it wasnecessary to isolate the bacilli from the body; togrow them in pure culture until they were freedfrom any disease-product of the animal organismwhich might adhere to them; and, by administeringthe isolated bacilli to animals, to reproduce thesame morbid condition which, as known, isobtained by inoculation with spontaneously de-veloped tuberculous material.'6

Griffith Evans did not have the laboratory facili-ties which were at the disposal of Professor Koch.His work was literally in the field, where he firstdescribed and demonstrated the pathogenicity ofthe trypanosome. He searched for the causativeorganism in the blood of infected animals known to

be suffering clinically from Surra. This invariablyfatal disease of horses was of major economicimportance to the British Army in India. In Sep-tember and October, 1880, at Dera Ismail Khan inPunjab, he worked with the microscope 'for manyhours a day out-of-doors at the sick lines, or else in astable, when the thermometer was 82°F within acool bungalow, and the sun pouring down its raysthrough a cloudless sky upon the surrounding baresandy ground'. The flies were an added torment,crowding on the stage of the microscope, disturbinghis vision, soiling the lenses and swarming all overhis face.7 Nevertheless, despite these trials, he suc-ceeded in inoculating healthy horses with trypano-some laden blood from infected animals andreproducing the disease. In the eloquent prose ofhis report he concluded 'There is, therefore, somevirus in the blood, which, when it is transferredinto a healthy animal, is as sure of growth andpropagation as if we introduced seeds into a gar-den, or the roe of a fish into a suitable stream: thelike reproducing its like, and no other.'8 For rea-sons largely unconnected with science, his work wasinterrupted. His suggestion that Trypanosoma evansicould possibly cause illness in humans has onlyrecently been confirmed in its taxonomic identitywith T.brucei, the cause of sleeping sickness, sothat by the rules of Zoological Nomenclature,T. brucei must henceforth be known as T. evansi.9

In 1918, WO wrote to Griffith Evans thankinghim for sending his papers to his alma mater, theuniversity of McGill. He promised to have theSurra paper 'nicely bound and go in the shelf withManson, Ronald Ross, Bruce and Cunningham' -AI Anglo-Indian Co. 'Tis a fine bit of work andwill carry the name of Griffith Evans a long waydown the track of time'.10Many, many years after Griffith Evans's major

work, in fact at least 30, WO addressed the CardiffMedical Society and asked if anyone there knew ofGriffith Evans and his achievements. At first, as heexpected, no one responded and then a diminutivelady, Dr Erie Evans, rose to her feet andannounced that she was his daughter. Many, many,many years later at a lecture on Griffith Evans tothe Honourable Society of Cymmrodorion at theManson theatre of the School of Tropical Medi-cine, a member of the audience rose to her feet toclaim affinity as his granddaughter, Jean Ware. Ashe himself reflected, when well on in years, his lifework still in relative obscurity, 'Os mynni glod bidfarw' - 'If you would seek fame, you must first die.'

The Welsh National School of Medicine

For Wales herself, WO's great contribution was his

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enthusiastic work in the founding of the WelshNational School of Medicine. He had shown aninterest as early as 14th November 1905, the year inwhich he took the Chair of Medicine at Oxford. Hewas then 56 years old and spoke at UniversityCollege, Cardiff showing concern for the financialneglect of its pre-clinical medical school, but per-sonally encouraging the medical students when hedined with them that evening. He saw the possibil-ities and the need for a teaching hospital. Threeyears later he was asked to open the 'ElectricalPavilion' in the new Out Patient Department at theold Infirmary. On his way to give his address hewas handed a magnificent golden key - a replica ofa key of the Charles First period - by the architect,Mr Edwin Seward (Figure 2).With his usual sense of mischief, he said in his

speech that he had just met a gentleman who hadasked him to accept something on behalf of theInstitution. He pretended neither to be sure of theidentity of the architect nor of the offering. 'But letus see if we can discover the nature of this veryacceptable gift.' He then placed the wood andleather case under the X-ray tube and revealed thesecret, observing that it would, of course, requireexposure to daylight to determine any detail. Theykey is still preserved at the school.11At the inaugural proceedings for the Welsh

Figure 2 'The golden key presented to Sir WilliamOsler at Cardiff. From University of Wales College ofMedicine, with permission.

National School of Medicine in Cardiff on 12thAugust 1915, Sir William Osler urged his proposi-tion that all clinical units must be units of theuniversity, in which the hospital was to play asgreat a role as had the pre-clinical departmentshitherto. The Royal Commission later supportedthis view and from 1921, the first clinical professor-ial units in Great Britain were established at theInfirmary. He was sensitive to the spirit of Welshnational pride in this 'small and comparatively poorcountry' and which had led to conflicting localambitions. His listeners were urged to settle theirdifferences within one University of Wales, thatshould retain its constituent colleges and which hadroom for only one school of medicine. He calledfor democracy on the lines of the universities ofOxford and Cambridge, where all academicappointments were made by small boards of elec-tors, each of whom would be an expert in theparticular subject in which there was a vacancy. Hewarned against the danger of having 'a localuniversity with only Welsh brains'. Instead, herecommended that they went 'into the market andbought the best brains of the country, because thebest brains of the country were not one whit toogood for Wales.'12

It was therefore a great pleasure for Professor SirWilliam Osler to be invited in April, 1916, to serveon a Royal Commission, which gave him theopportunity to take part in the establishment of acomplete clinical and pre-clinical Welsh NationalSchool of Medicine. The terms of the Commissionwere to enquire into the organisation and work ofthe University of Wales and and its constituentcolleges. It was to be a task of some complexity insatisfying the desire for individual autonomy in afederal structure.Lord Haldane, who was chairman of the Com-

mission, found Sir William to be a tower of strengthin framing and negotiating a scheme for 'anadequate college of medicine in the reformeduniversity'. There was a paramount need to estab-lish independence for the medical school: a needstrongly supported by Sir William, for it wasevident that University College, Cardiff not onlywished to retain the control it already had over thepre-clinical school, but it had the undoubted advan-tage in any argument that it owned the landon which the existing medical college stood. SirWilliam was believed by Lord Haldane to haveinfluenced the result by persuading a local lady,Miss Emily Talbot of Margam, to give £30,000 asan endowment for the new college. The money wasfor a Chair of Preventive Medicine and one of theconditions was that Sir William named the com-mittee of appointment for the new professor. Therewas also reference to the 'anonymous donor' of a

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magnificent sum. To establish the professorial unitsystem an approach was made to the Chancellor ofthe Exchequer for support of the building fund. Toencourage him, the 'anonymous donor' had madean important condition 'that the grant made by theTreasury shall in the opinion of Sir William Oslerthe Regius Professor of Medicine at Oxford be anadequate one for a first-rate, up-to-date medicalschool'.13'14 WO's breadth of effort fully justifiesthe comments of another member of the Commission,Sir Henry Jones, that they 'gladly leaned on hisexperience and strong common sense not only inmatters that concerned medical education, but werelargely influenced by his liberal views on educationin general. Moreover, the gentle playfulness at theback of his mind made him as ideal a committee-man as a companion, and because of his sympathe-tic understanding of the Welsh people their debt tohim is deep.'15

Sir William Osler and Mr Lynn Thomas (Figure 3)

On his joining the Commission, Sir William imme-diately began an active campaign to rally Welshsupport for the new school and chose as hisprincipal aide de camp a well known Cardiff sur-geon, Mr Lynn Thomas, later to become Sir John

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Figure 3 Proressor William Usler and Mr John LynnThomas at the Cardiff Infirmary, 1908. From theWestern Mail with permission.

Lynn-Thomas (1861-1939). WO seems to have beengreatly impressed by Mr Thomas, who is certainlyworthy of a brief diversion. Born the son of afarmer, Evan Thomas of Cwmgefeile, Llandysul, hehad won the Hutchinson Prize for his essay onfractures of the skull in 1890, four years afterqualifying M.R.C.S. He was regarded as having anexcellent operating technique, with a particularinterest in thyroid and prostate surgery. He hadcommanded the Welsh Hospital in South Africaduring the Boer War, for which he was awardedthe C.B. After his return home, he founded thePrince of Wales Hospital in Cardiff for limblesssoldiers and sailors, which was to become animportant orthopaedic centre. He became C.M.G.in 1917 and after a distinguished career was madeK.B.E. in 1919.

In April, 1916, Mr Lynn Thomas had a letterfrom Sir William Osler.

MondayDear Thomas,Get your mind on the question of a nationalpost-graduate scheme in connection with theschool. The Commission will visit Wales inJune (end of) and I should like to holdmeetings of the profession at Bangor, Aberys-twyth and Cardiff. Please help in this when thetime comes. We could bring the Tuberculosismen &C.15

This was during the early years of the King EdwardVII Welsh National Memorial Association, whosefirst president was Dr Marcus Paterson, formerlysuperintendent of Frimley Sanatorium. Theproblem of tuberculosis in Wales was a formidableone. Of 348 sputum specimens obtained frompublic footpaths in Swansea in 1914, tubercle bacillihad been found in 57%.16The next letter was a typically encouraging one,

but preparing the ground for the next step forward.He expressed his pleasure with the efforts of MrThomas.

You are moving along! The report of theHospital meeting shows a good spirit - I wasglad to see the suggestion of an ElectionCommittee. How can we get in touch with theProfession whose confidence should be sought?Is there not a Principality Branch of theB.M.A.? It will be a great matter to haveeverything cut and dried for the commission.The Hospital must be made to feel that it isthe Medical School for the last three years.Yours sincerely,15

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572 J. CULE

Osler was in his sixty-seventh year, but he busiedhimself with the fostering of enthusiasm by activediscussion with the doctors of Wales, which he sawas a necessary preliminary to a successful founda-tion. He wrote again to Thomas to say that heexpected to be in Cardiff on June 21st and 22ndand hoped that a meeting of the medical professioncould be arranged for a full and free exchange ofviews. He proposed to travel to the colleges ofAberystwyth and Bangor in the following week andwished to know whom he should approach toorganise meetings. Perhaps Thomas himself would'come up there and play the missionary'. Oslerwished 'to get the entire profession of the princi-pality interested in the medical school.' The empha-sis was to be on the people who were going to dothe work. 'Pick your men - men are the importantthing. The day is long past when big buildingsmean a big university or a big college - pick themfor two things, for their enthusiasm and for theirwork as researchers.'17

Sir John Lynn-Thomas

After distinguished careers the thoughts of medicalmen oft turn to medical history, occasionally with

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surprising results. Sir John later wrote some origi-nal, but eccentric papers on his archaeological'finds', on which he based his theories of the originsof the Welsh in the area between Cardigan Townand the mansion of Llwyndyrus at Llechryd, towhich he retired in 1921. Encouraged by TheWestern Mail, Sir John published two extraordinarybooks. The first was called 'Key Of All Wales' inSouth-West Cardiganshire, Cardiff: 1932 and dedi-cated to H.R.H. the Prince of Wales. A photographof Sir John appears anonymously in the frontis-piece, demonstrating an 'Estuarian Type' of mixedNordic and Mediterranean features (Figure 4). Thesecond book is arguably an even stranger onecalled Sequel to 'Key Of All Wales', published onSaint David's Day, 1934. Through an oval space inthe cover can be seen the roughly pyramidal top ofa stone with rays of light emanating from it.(Figure 5). When the book is opened the wholerock is revealed, looking remarkably like a Welshstone gate-post. From behind protrude an upliftedright arm and a firmly placed right leg, whichpossibly belong to Sir John (Figure 6).The contents reveal the material of a bitter feud

with the Cambrian Archaeological Association,

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which he felt was bent on preventing an unbiasedassessment of his views. His thesis of the Phoeni-cian Occupation of the countryside around Llech-ryd and Cenarth was based on three 'discoveries'.First, his belief that he had found certain 'incised'stones, which he imaginatively interpreted as show-ing the existence of an ancient civilisation on thesite. Second, the survival of a pygmy race, whichdemonstrated an African origin for the Estuariansas Sir John called them, or the Cardis as they aremore popularly known. The testimony for thiscould be studied in the photograph of Teiliwr bachDihewyd (the little tailor of Dihewid), 44 inches inheight, with his wife of five foot five inches andseven normal sized children (Figure 7). The third

7.

Figure 6 The Welsh Gate Post. Sir John has cap-tioned this - 'Has two burnished facets and left eyereflecting sun-rays at back of head. Found November5th, 1932, in a ruined temple of nine megaliths sculp-tured, some inscribed, similar to over fifty foundmostly in K.A.W. One of the two holes near lower endhas iron broken in it whilst the third, below right eye,shows no sign of use. Inferior mouthed with tail likebonnet headed Shark, not Beaumaris, bifid, wasembedded in concrete, 7ft 8in of Precelly granit.'(K.A.W. is Sir John's abbreviation of Key of AllWales). From Sequel to 'Key of All Wales', 1934,bearing the imprint of Western Mail, with permission.

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Figure 7 Teiliwr bach Dihewyd and his family,chosen by Sir John to demonstrate the African pygmyorigins of the Welsh people. Sequel from 'Key of allWales', 1932, bearing the imprint of the Western Mail,with permission.

piece of evidence was the discovery of a roundwooden ball amongst the stones in front of an oldtithe barn, known as Ydlan y Degwm. This hedecided must be the very ball used to play knap-pan, the game described by Thomas Phaer andwhich Sir John now claimed to be Trojan in origin.When he asked the National Museum of Wales forverification, he was undismayed when in reply theyasked him to send the stick along as well! They areremarkable documents, but they are not in SirWilliam's library for he never saw them.

The College of Librarianship at Aberystwyth

Oslerians will recognize the inevitability of SirWilliam Osler's association with the books andlibraries of Wales. In his sixties, he made severalvisits to the Sir Thomas Phillipps Library, then atThirlestaine House near Cheltenham, and herecords purchases of medical manuscripts in 1911,'all from the Phillips (sic) sale (but I am ruined!).'"8He was amongst those who encouraged the foun-

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574 J. CULE

dation of the College of Librarianship at Aberyst-wyth, a college which has since won internationalreputation. On 31st July, 1917, Sir Williamaddressed delegates at the opening of the SummerSchool of Library Services at Aberystwyth. He toldthem that 'The outlook for your profession isbright, and you may help to make it brighter herein Wales by encouraging in every way the improve-ment of the conditions under which you work. Onething I should dearly like to see - an up-to-dateSchool of the Book in connection with the NationalLibrary and this College; and if anything I havesaid here hastens its establishment I will feel inLucian's words "that I shall have had a share in itsbuilding if not in the dedicatory inscription; my

finger-tips will at least have touched their wetmortar".'19

Egerton Yorrick Davis, M.D.

The speculation that this friend of WO was identi-cal with Egerton Iorwerth Davies, an emigre fromTreherbert seems to have no foundation and cannotbe claimed as the last Welsh connection.

AcknowledgementI am grateful to my colleage, Professor RalphMarshall, of the Department of Medical Illustration,for his help with the illustrations.

References

1. Owen, G. In: (ed. Henry Owen) The Description ofPembrokeshire. London, 1892, I, p. 279.

2. Cushing, H. The Life of William Osler, chapter 1.Oxford University Press, London, New York, Tor-onto, 1940.

3. Gittings, R. Edward Osler and John Keats. In: Cule,J. (ed) Wales and Medicine. Llandysul, 1975, pp.107-111.

4. Ware, J. & Hunt, H. The Several Lives of a VictorianVet. London, 1979, pp 56, 99.

5. Henle, J. Von den Miasmen und Contagien. In:Pathologische Untersuchungen. Berlin, 1840, pp 1-82.

6. Koch, R. Die Aetiologie der Tuberculose. Berl klinWochenschr 1882, 15: 224. For translation see Clen-dening, L. Source Book of Medical History. DoverPublications, New York, 1960, p 399.

7. National Library of Wales. Griffith Evans MS IIIcontains 'Report on "Surra" disease ... dated Simla,13th November 1880'. p 61. para 8.

8. National Library of Wales. Griffith Evans MS IIIcontains 'Report on "Surra" disease... dated Simla,13th November 1880'. pp 65-66, para 24.

9. Cule, J. 'The postulates' of Griffith Evans, M.D.,M.R.C.V.S. (1835-1935) and the Specificity of Dis-ease. In: Kerkhoff, A.H.M., Luyendijk-Elshout, A.M.& Poulissen, M.J. (eds) De Novis Inventis. Essays inthe History of Medicine in Honour of Daniel deMoulin... Holland University Press, Amsterdam,1984, pp 81-93.

10. National Library of Wales. Griffith Evans MS III.'Holograph letter from William Osler to GriffithEvans.'

11. Holograph letter from Edwin Seward to Lady Osler,dated March 1st, 1923. University of Wales College ofMedicine.

12. The Welsh National School of Medicine. InauguralProceedings at Cardiff, 12th August, 1915. [Cardiff:Western Mail dated 1915].

13. Cushing, H. The Life of William Osler, OxfordUniversity Press, London, New York, Toronto, 1940,pp 1097, 1098n, 1277.

14. Evans, D.E. The University of Wales. University ofWales Press, Cardiff, 1953, pp 104-105.

15. Cushing, H. The Life of William Osler, OxfordUniversity Press, London, New York, Toronto, 1940,p 1210.

16. Jones, G.R. The King Edward VII National Memor-ial Association 1912-1948. In: Cule, J. (ed) Wales andMedicine. Llandysul, 1975.



19. Osler, Sir William, The Library School in the College.The Library Association Record, 19, 1917: p 308.

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