Section 1 -

William Osler and the Teaching of Microscopy at McGill University: 1874 to 1884 Richard Fraser McGill University Montreal

The following announcement appeared in the McGill University course calendar of 1878/79: Practical Histology—normal and pathological A course of 25 lessons—Microscopes, re-agents and material provided. It comprises thorough instruction the use of the Microscope and the preparation of the tissues, each student preparing for himself during the course a cabinet of 100 or more specimens. This was the first formal recognition of the course which William Osler had begun two years earlier and, along with other courses given by Osler and his young colleagues at McGill, marked a significant advance in medical student teaching at the University. Osler's initial interest in microscopy was closely linked to the 19th century pass-time of the study of natural history. The craze was quite widespread, particularly in the middle and upper classes, and was an important social phenomenon. Numerous popular books were published on the subject and many proved remarkably successful; for example, the one titled "Common Objects of the Country" by the reverend J.G. Wood sold over 100,000 copies in just one week in 1858. [1] Two aspects of this craze are particularly important with respect to Osler's introduction to microscopy as adolescent. First, was the microscope itself, which became less expensive and more accessible to the public in the mid 1800s and lent itself particularly well to the investigation of all sorts of "natural bodies" too small to be appreciated by the naked eye. The second was the fact that the study of nature was often popular with those in the clergy who, in many instances, were also teachers. It is in this context that Osler came to know two of the most influential individuals in his early life: The Reverend William Johnson and Dr. James Bovell. Johnson was an eclectic man who had been engaged in medicine, military service, farming, and religious activities as a priest in the Anglican Church of England. He founded the school at Weston, Ontario, which Osler attended between 16 and 18 years of age, and was also an ardent naturalist. It was with Johnson's microscope and through Johnson's passion for nature that Osler first came to have an interest in the very small. James Bovell was a physician and teacher with Johnson at Weston, and at the Trinity College in Toronto, where Osler was to go after his Weston studies. Bovell was also a passionate naturalist who published a number of articles in scientific and natural history journals. Bovell and Johnson took Osler under their wing and the three engaged in expeditions in the country hunting for specimens which they would take with them for study in Bovell's or Johnson's office. There could be little doubt that Osler was impressed by these expeditions and in the microscopic experience to which they led. In a letter to his cousin Jeannette in 1867 (when he was 17), he wrote of the pond scum he had recently seen: "And if you could only see the Algae, green stuff that you see on the pond in the stagnant water, it is so beautiful, the thousands upon thousands of small animals all alive and kicking that are in it." [2] Osler's fascination with natural history persisted into his early adulthood and was reflected in his earliest publications. The first, "Christmas and the Microscope", was published in the 1869 edition of Hardwicke's Science-Gossip Magazine; the second, titled "Canadian Diatomaceae", was published in the Canadian Naturalist Journal in 1870/71 and was also used as the basis for a presentation to the Montreal Natural History Society. Osler's interest in microscopy continued during his medical training, during which he broadened his study to include normal human histology and pathology. At the end of his medical studies at McGill University in 1872, he was presented with a special prize for his thesis on "morbid structure", which included 33 microscopic preparations from various cases that he had seen at the Montreal General Hospital. After graduating from McGill, Osler traveled to Great Britain where he enrolled in Burdon Sanderson's laboratory course on practical physiology, which included sessions on "Practical Histology" and "Histologic Pathology". It is likely that this study impressed Osler, since his own series of courses at McGill which he developed several year later followed very much the same pattern. Following his return to Montreal in 1874, Osler maintained his interest in both medical and "natural" aspects of microscopic study. His studies in natural history led him to being elected to a member of the Natural History Society in 1874. On the clinical side, he accepted a position as physician of the smallpox ward at the Montreal General Hospital, which had been opened to handle a local outbreak of the disease. He used the $600.00 stipend that he received from the hospital for his smallpox work to buy twelve Hartnack microscopes for use in medical student teaching. Although these may have been used informally as early as 1875, an official course was not offered by the Faculty until the 1876 summer session. It consisted of 25 "lessons" and was given in the Medical Building cloakroom. It was a clear success. According to one student: "After we become somewhat familiar with the normal tissues we were given the abnormal tissues and we then laid the foundation of our knowledge of pathology. We did not regard this as work. It was made so interesting that our Saturday afternoons were looked to as a real half-holiday." [3] In the 1878/79 university calendar, the course was described as being "a full course of didactic lectures upon the structure and function of the various organs of the body in health." Practical demonstrations were held every Saturday afternoon from two to four o'clock, during which time histologic preparations were exhibited and explained. The students were "invited to propound and discuss any questions which may not have appeared clear to them". A second course titled "practical histology" was also offered, again consisting of 25 lessons which included instruction in the use of microscope and preparation of tissues as well as study of both normal and pathologic material. Both courses were refined in the next few years, and in the 1883/84 calendar they were included under a single entry, "histology". The first course covered normal histology and consisted of biweekly lessons throughout the fall/winter session; the second focused on abnormal (pathologic) tissue – including study of the microscope "in relation to practical medicine" – and was held during the summer session. As an addition to the didactic and practical portions of these courses, Osler decided to prepare a manual to aid student teaching. [4] This was published in 1882 and was approximately 65 pages in length. It began with a section on the general principals of microscopy, including technical aspects related to fixation, cutting and staining. There followed detailed descriptions of the normal histologic findings of virtually every body organ and tissue. In his introduction to the manual, Osler stated that "a practical course on normal histology is advantageous in many ways: it affords you a practical acquaintance with the appearance and modes of preparation of tissues in health; it familiarizes you with the use of the microscope, and it assists in the formation of those habits of accurate observation which should form an important part of your training." The descriptions in the book are not just related to examination of fixed material, but also to what one might refer to as microscopic physiology. For example, in one section, students are instructed how to view amoeboid movement in white blood cells and in another how to observe phagocytosis. There are also occasional allusions to pathology, such as in the description of an enlarged thyroid in which there is a reference to goiter. Most of the material used by the students in these courses was prepared by the students themselves. They were instructed to put hardened tissue fragments in small paper boxes, into which they poured an embedding mixture such as olive oil/wax or paraffin/lard. They would then cut the tissue block by hand with a straight razor. The resulting sections were stained, put on glass slides and mounted with one a variety of mounting mediums; the latter are discussed in detail in Osler's book, the one he preferred being Canada Balsam. The book also includes information on how to prepare organs for histologic examination; for example, for the trachea, the student received the following instructions: "With a syringe or large pipette distend lungs of a cat… with 1/6% chromic acid solution; tie the trachea, and suspend in large quantity of same fluid; change after two days for a ¼% solution, or (a) chromic acid and spirit solution; and in 8 to 10 days cut into small pieces and complete the hardening in alcohol." In summary, Osler's exposure to natural history as an adolescent and his studies of pathologic anatomy as a medical student and young postgraduate laid the groundwork for his introduction of microscopy to the medical curriculum at McGill in the 1870's. When he emigrated from Montreal to Philadelphia in 1884, he left behind a solid foundation for teaching of both normal and pathologic histology. References Barber, Lynn. The Heyday of Natural History. 1820 –1870. Jonathan Cape, London. 1980. page 14. Bliss, Michael. William Osler. A life in medicine. University of Toronto Press. Toronto. 1999. page 41. Armstrong, George. Student Reminiscences, Montreal period. Bulletin of the IAMM No. IX. 1926. page 176. Osler, William. Students' Notes. I. Normal histology for laboratory and class use. Dawson Brothers. Montreal. 1882.