The Left Atrium

Room for a view Whither medical botany?

“I wish you had been with us last Tues- courses were dropped from medical day down at the Peat Swamp, there are school curricula. such splendid flowers down there …. My awareness of medicine’s current We got the smallest and rarest variety indifference to botany increased when I . )

of Ladies Slipper or Indian Moccasin learned that an older William (no s e i r e

plant … the most beautiful of all Cana- longer “Willie”!) Osler professed to a S t n

1 i dian wild flowers.” — “Willie” Osler, lack of botanical interests. In 1872, r p e R

aged 17, after a field trip along the Osler declined the first academic ap- c i s s a banks of Ontario’s Humber River in the pointment offered to him. l C ( d

spring of 1867. e t i

[T]he kind offer made me of the lectureship m i L

in Botany [at McGill]. I am afraid you will g n ir William Osler is world i h s

not be pleased at it, but I really can not do i l

renowned as an icon of medi- b otherwise. If I knew anything of Botany at u P e cine. Yet my first introduction present; if I had nothing else left to do for v o S r g to Osler’s writings came not as a med- two or three years it might be thought of; l A m

ical student, but as a student of but as matters stand now I would only make o r f

a fool of myself in accepting such a posi- n o

botany. A professor presented me with i s s

tion. I would feel far too keenly the anom- i

a volume of Osler’s essays, encourag- m r

alous situation of holding a chair in Botany e p

ing all his botany students to read Ae- h t

& knowing absolutely nothing of the Flora i

4 w quanimitas, Osler’s essay about the of my native land. d e t n i

virtues of equanimity. r p e

On entering medical school in 1982, Yet Michael Bliss, in his recent biog- R I hoped to parlay my graduate training raphy of Osler, recounts that Osler’s in- Cypripedium acaule, the stemless in botany into instant academic suc- terest in natural history bordered on lady’s slipper, may be the plant re- cess. I soon realized those hopes were obsession. The discipline, then called ferred to with such enthusiasm by old-fashioned — botany in medical natural philosophy, consisted of 4 sub- “Willie” Osler in his letter of 1867. school today is not only unimportant, jects: botany, zoology, geology and but is usually considered irrelevant. Yet physics. Osler’s favourite classes and the histories of medicine and botany favourite instructors were those of nat- dropsy. Osler had obtained a packet of have been intertwined since antiquity. ural philosophy.1 Osler’s first scientific Withering’s correspondence and From the times of Hippocrates, Aristo- paper was on taxonomy of freshwater planned to present his discoveries to tle, Theophrastus and Dioscorides, diatoms, published in 1870 when he the group.5 through to the era of herbals and the was 20 years old, and the first society to Did Osler exhibit any continuing in- “Doctrine of Signatures,” the historical elect Osler a member was the Montreal terests in field botany after his youthful basis of medical therapeutics is Natural History Society. Decades later, collecting days along the Humber? My botany.2,3 Many of the most influential the final society to elect Osler a mem- review of Bibliotheca Osleriana,6 a list

7 naturalists of the scientific age, for ex- ber was Oxford’s Ashmolean Natural of 7783 texts and papers held in Osler’s 2 5

0 ample, Carolus Linnaeus (father of the History Society. In 1919, as president of personal library, revealed no titles on 6 0 . j

a modern classification of plants and an- the Ashmolean Society, he prepared an botany or natural history to suggest an m c

/ imals) and Thomas Huxley (passionate address on William Withering, the active interest in anything but the his- 3 0 5

1 defender of Darwin’s theory of evolu- British botanist known in medical cir- tory of famous physician-naturalists. . 0 1

: tion), were also trained in medicine. It cles as the physician who introduced This supports the contention of Osler’s I O

D was only in the last century that botany digitalis leaf for the treatment of biographer, Harvey Cushing, that,

Historically, the field of medicine PINK OR STEMLESS LADY’S SLIPPER. MOCCASIN FLOWER. has been inextricably allied with the CYPRIPEDIUM ACAULE (ORCHIS FAMILY) discipline of botany, nevertheless the WEIRDLY beautiful, this plant is becoming alarmingly rare subject of medical botany has been dis- in settled neighbourhoods. Like its cousin, the yellow lady’s slipper, it is too shy a plant to thrive near the carded from the modern medical edu- haunts of men. In the shades of primitive forests, in deep cation. With the recent rise of alterna- mountain ravines, where the traffic and turmoil of the tive medicine in North America has world are yet afar, it finds a fit setting for its wild grace come the call for physicians to become and loveliness…The specific name, acaule, alludes to the apparently stemless habit of the plant. It would seem more aware of the roles of plants in 11 more appropriate to call this forest plant “moccasin medicine. Whether to learn the bene- flower”, than “lady’s slipper”. ficial effects or the toxic effects of Excerpt from The Wildflowers of Canada (1908). Much of this book used illustrations and text from herbal preparations, there is once again The Wildflowers of America, first published in 1894. Reprinted with permission from Algrove Publishing Limited (Classic Reprint Series) a place for some instruction in botany for medical students. Evidence indi- cates that Osler and Schweitzer, two “Botany and its allied sciences had no Regarding the notion that natural icons of modern medicine, knew their claim on him except through his inter- medicines are somehow safer than plants and valued the discipline of nat- est in their historical aspects.”4 How- manmade medicines, Schweitzer ural history. Even with today’s surfeit of ever, Osler lent his first editions of wrote: medical information, physicians will Dioscorides (De Materia Medica) and still benefit from the understanding Theophrastus (On the History of Plants Of the roots, bark, and leaves which the na- and appreciation of the natural world and Causes of Plants) to an exhibition tives [of Gabon] use for all sorts of dis- around them. on the Early History of Botany pre- eases, many have the peculiarity of irritating sented by the Botanical Society of the the kidneys severely, others of attacking the Scott A. Norton heart. Some of them, if given in excessive Dermatology Department British Isles. He also procured and do- quantities, endanger life itself. ... Euro- nated copies of 17th and 18th century peans who let themselves be treated with Uniformed Services University botanical correspondence to the Botan- medicines used by the natives, paying for of the Health Sciences ical Society as well. Upon Osler’s death, this sometimes a heavy penalty, are not so Bethseda, Md. 9 G. Claridge Druce, FRS, the curator of few in number as one would like to think. Oxford University’s herbarium, pub- Acknowledgements: Jenny Bull and Dr. Tim lished a several-page obituary in a Re- Schweitzer’s caution may arise from Dickinson from the Green Plant Herbarium at the Royal Ontario Museum in Toronto provided port of the Ashmolean Natural History his pharmacology training under Os- valuable information on the orchids of the Hum- 5 Society. wald Schmiedeberg at University of ber Valley. During my first year of medical Strasbourg from 1905–1911. Schmiede- school, I also encountered a letter of berg, considered the founder of mod- advice from another medical icon, Al- ern pharmacology, pushed materia REFERENCES bert Schweitzer. In 1948 Schweitzer medica out of the medical curriculum 1. Bliss M. William Osler: a life in medicine. Oxford: wrote these words of advice to pre-med in favour of a more analytic approach to Oxford University Press; 1999. 2. Osler W. The evolution of modern medicine. New student William Larimer Mellon. pharmacology. Haven: Yale University Press; 1923. Schmiedeberg’s move away from 3. Porter R. The greatest benefit to mankind: a med- At the beginning of your studies, concen- materia medica also influenced the ical history of humanity from antiquity to the present. New York: WW Norton; 1997. trate on the essentials: anatomy and physi- Johns Hopkins Medical School during ology. As for zoology and botany, only learn 4. Cushing H. The life of Sir William Osler. Oxford: the Osler era. Another pupil of Clarendon Press; 1926. what you need in order to pass your exams. 5. Druce GC. Obituary: Sir William Osler. Rep Botan- I, myself, made the mistake of getting too Schmiedeberg’s (although much ear- ical Soc Exchange Club Br Isles 1920;5:622-5. deeply involved in these two subjects.7 lier than Schweitzer) was John J. Abel, 6. Osler W. Bibliotheca Osleriana: a catalogue of books illustrating the history of medicine and science. an American who transformed the Montreal: McGill-Queen’s University Press; 1969. There certainly is evidence that field of therapeutics from materia 7. Schweitzer A. Brothers in spirit: the correspondence of Albert Schweitzer and William Larimer young Schweitzer was well versed medica into the experimentally-based Mellon, Jr. Syracuse: Syracuse University Press; in botany. In his autobiography, science of pharmacology. After study- 1996. Schweitzer wrote that the ing with Schmiedeberg in the 1880s, 8. Schweitzer A. My life and thought: an autobiography. London: George Allen & Unwin; 1933. Abel established a pharmacology de- 9. Schweitzer A. On the edge of the primeval forest & study of the natural sciences brought me partment at the University of Michigan more from the primeval forest. New York: Macmil- lan; 1948. even more than the increase of knowledge I in 1891, and later did the same under 10. Parascandola J. The development of American had longed for. It was to me a spiritual ex- Osler at Johns Hopkins. At Hopkins, pharmacology: John J Abel and the shaping of a perience. ... Through my study of … botany discipline. Baltimore: Johns Hopkins Univ Press; … I became more than ever conscious to Abel’s title was Professor of Pharma- 1992. cology, the first time in the United 11. Kemper KJ, Amata-Kynvi A, Sanghavi D, et al. Ran- what an extent truth in thought is justified domized trial of an internet curriculum on herbs and necessary, side by side with the truth States that materia medica was not part and other dietary supplements for health care pro- which is merely established by the facts.8 of the job description.10 fessionals. Acad Med 2002; 77:882-9.

CMAJ • June 20, 2006 • 174(13) | 1878