GULSTONIAN LECTURES: On Malignant Endocarditis

London 1885 Lancet Vol. I, pp. 415-418; 459-464; 505-508, 1885. 4to (26.1 x 18.1 cm). Articles bound in brown cloth with cream endpapers. Title page from second volume of Lancet for 1885. The articles appeared in earlier March issues, viz. March 7, 14 and 21, 1885. There is a separate bound Xerox reading copy of these lectures."In March 1885, the young William Osler (1849-1919), recently appointed Professor of Clinical Medicine at the University of Pennsylvania, delivered his three Gulstonian Lectures on 'Malignant Endocarditis' to the Royal College of Physicians. They were soon published in the British Medical Journal (Osler 1885). The subject was then, as now, of major medical importance. A century on, the intellectual scope of Osler's extensive and acute observations on the disease still provide us with object lessons for the conduct of clinical investigation… They contain a historical resume of accounts of the condition and a detailed study of 23 cases which he had personally supervised at Montreal General Hospital, reinforced with evidence drawn from two very large unselected postmortem series which he had also seen and noted, though he is not specific about their origin.Although his knowledge of the relatively new science of microbiology was not first-hand, or profound, he summarized all the recent developments which seemed to him to be relevant and quite obviously realized their implications. Osler's characteristic clarity and thoroughness allowed him to dissect from his various series certain fundamental strands of thought on the classification and clinical presentation of the disease, and thereby forge a conceptual route which found its final expression in his 1909 paper on endocarditis (G&M 2827 & Osler's Nodes observed in 1888). In his longstanding role as a medical educator and as the author of the pre-eminent medical textbook of its time, he was able to draw the attention of his contemporaries to a poorly understood disease and its detailed clinical signs, and thereby hoped to improve on the then ante-mortem diagnosis rate of only about 50%. Very Good Brown cloth (Item ID: 0000660)


Osler had a profound sense of medical history. It is clear that he thought these lectures should not be taken out of historical context, and that they represented simply anotherstep towards understanding a disease which had baffled succeeding generations of medical scientists. Historically, the importance of these lectures is Osler's summary of the existing state of knowledge and the use he puts this to in exploring possible future paths of research." (Jour. Roy. Soc. Med. 78]12]:p. 1039)

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