These days, our minds are on epidemics (the rapid spread of disease to a large number of people in a given population within a short period of time) and pandemics (disease epidemics that have spread across large regions or worldwide).
One of my current projects is a book about the brilliant Canadian diagnostician and medical
educator Dr. William (Willie) Osler. Born in 1849 when people still thought diseases were
caused by bad air, Osler lived through the huge changes brought about by the discovery of
germs. There are several stories of his encounters with smallpox during his career.
Photo of William Osler from 1881 used with permission
of the Osler Library for the History of Medicine
In the nineteenth century, smallpox was a terrifying disease, often fatal. Survivors were left with bad scarring or blindness. Symptoms were fever, a rash, and characteristic pustules all over the body. Once diagnosed, smallpox patients had to be quickly isolated from other patients in a separate ward or hospital.
Vaccinations, successfully tested in 1796, had replaced variolation (an earlier form of inoculation used in Asia and Africa for centuries). Over the nineteenth century, widespread vaccination, sometimes mandated by law, had reduced the number of infections and deaths, but there were still regular outbreaks where vaccination rates were low.
In the spring of 1872 after his final year of medical school, Willie worked briefly at a hospital in Hamilton, Ontario. There he encountered a rare case of smallpox and drove the dying patient to mayor’s home to force the authorities to provide proper isolated accommodation for the man.
Quarantine poster image used with permission
of the Osler Library for the History of Medicine
Montreal was one part of Canada where vaccination rates were low. Willie was teaching at McGill University during the smallpox epidemic of 1875-1876 and he took time to work in Montreal’s smallpox hospital, earning $600. Although he had been vaccinated (like all his siblings), he caught a mild case of the disease.
In those days, medical students learned mostly from lectures, rarely seeing patients or working in a lab. One of Willie’s innovations as a teacher was to make sure that his students had microscopes, so they could see and understand the diseases they were studying. The $600 he earned went to pay for microscopes.
Willie was one of the founders of the Johns Hopkins School of Medicine in Baltimore. When it opened in the fall of 1893, he at last had the medical school he wanted – a place where learning, hospital work and research were intertwined and where students could learn by doing. Willie led a weekly general clinic at the hospital, where he and students would see patients.
By then, some diseases had become rare enough that many doctors and students had trouble diagnosing them. One resident proudly displayed what he thought was an interesting case of chicken pox to Osler and 30 or 40 students and doctors. When he threw back the sheet, a horrified Willie exclaimed, “My God, Futcher, don’t you know smallpox when you see it?” The patient was quickly isolated, the ward quarantined for six weeks and the students and staff hurriedly vaccinated.
In 1980, smallpox became the only human disease to be declared eradicated, thanks to a worldwide vaccination program in the 20th century.
More on William Osler and the history of medicine can be found at The Osler Library of the History of Medicine at McGill https://www.mcgill.ca/library/
The Osler Library Instagram page at https://www.instagram.com/
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