July 2019 Medicine’S Lunar Legacies • René T

OslerianaA Medical Humanities Journal-Magazine

Volume 1 • July 2019 Medicine’s Lunar Legacies • René T. H. Laennec Walter R. Bett • Leonardo da Vinci OslerianaA Medical Humanities Journal-Magazine

Editor-in-Chief Nadeem Toodayan MBBS

Associate Editor Zaheer Toodayan MBBS

Corrigendum: As indicated in the introductory piece to this journal and in footnotes to their respective articles, both editors are Basic Physician Trainees and therefore registered members of the Royal Australasian College of Physicians (RACP). In the initial printing of this volume (on this inner cover and on page 5) the postnominal of ‘MRACP’ was used to refer to the editors’ membership status. This postnominal was first applied to the Edi- tor-in-Chief in formal correspondence from The Osler Club of London. Subsequent discussions with the RACP have confirmed that the postnominal is not formally endorsed by the College for trainee members and so it has been removed in this digital edition.

Osleriana – Volume 1 Published July 2019

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, digital, print, photocopy, recording or otherwise, without the prior written permission of WOSANZ or the individual author(s).

Permission to reproduce any copyrighted images used in this publication must be obtained from the appropriate rightsholder(s). Please contact WOSANZ for further information as required.

Privately printed in Brisbane, Queensland, by Clark & Mackay Printers.

Journal concept and WOSANZ logo by Nadeem Toodayan. Journal design and layout by Zaheer Toodayan.

Cover image: William Osler, Notman Studios, Montréal, October 1881. From The William Osler Photo Collection, McGill University Library. Professionally colourised by Dynamichrome Ltd. (www.dynamichrome.com) Osleriana

Osleriana

A Medical Humanities Journal-Magazine

Volume 1 • July 2019

An Official Publication of

Brisbane

Contents

‘Embryon Philosophers’: Introducing The William Osler Society . . . . . 2-6 of Australia & New Zealand

Medicine’s Lunar Legacies ...... 8-55 Z. Toodayan

Apollo 11 – 50 Years ...... 56-61

René Théophile Hyacinthe Laennec: Advancing Auscultation . . . . . 62-70 E. Carson

The Centenary of William Osler’s Final Address: ...... 72-73 ‘The Old Humanities and the New Science’

‘The Iniquity of Oblivion’: Dr Walter Reginald Bett (1903-1968) . . . . 74-111 N. Toodayan

A New Centenary Portrait of Sir William Osler ...... 112

A Spot on the Moon ...... 113

Long Lives Leonardo ...... 114-129 Z. Toodayan

‘Gaspare Aselli (c.1581-1625)’ ...... 130-142 W. R. Bett, with notes by N. Toodayan

The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.

– William Osler (1849-1919) The Master-Word in Medicine, University of Toronto, 1st October 1903.

1 ‘Embryon Introducing Philosophers ’ The William Osler Society of Australia and New Zealand

29th December 2019 marks the centennial anniversary of the death of Sir William Osler (1849-1919), one of the most widely respected and celebrated physicians of the modern era. For generations of practitioners in English speaking countries, William Osler’s life in medicine has represented the very apogee of physicianhood, as he persistently personified eminently desirable character traits in both personal and professional spheres. A first class clinician, pathologist of considerable skill, beloved comrade, companion, essayist, and educator, Osler has been justly upheld by posterity as the embodiment of humane-scientific medicine. His cardinal influences on the profession relate to i) his broad grasp of clinical concepts as demonstrated in his classical encyclopaedia of general medicine, ii) his optimism towards scientific medicine and its future advancements as evidenced by his teaching practices and life-long encouragement of scientific methods, iii) his profound humanism as indicated in his many celebrated lay sermons and historical works, iv) his intuitive connectivity with people as recalled by almost every person who came into contact with him, and v) his overall vision for a healthier, happier, and more harmonious world.

Almost a full decade ago, Roxanas recapitulated William Osler’s influences on Australian medicine.1, 2 He reminded us that “Osler’s influence on Australia was similar to that on other countries” and provided several illustrative examples to prove the point. To these important connections may be added further associations of interest to Australian physicians. In the first edition of his Principles and Practice of Medicine, William Osler specifically refers to the “most striking figures”3 of his Australian contemporary Francis Hare (1856-1929), whose researches into the utility of cold-bath therapy for typhoid fever4 “from the Brisbane Hospital, Australia”3 led to him being known as a “conqueror of typhoid” by his contemporaries and as “one of the most intellectual and successful physicians the State of Queensland has ever known.”5 Reciprocal recognition of William Osler by Australian doctors is also of considerable interest, and a heritage listed historical doctors’ surgery in Townsville has been known as ‘Osler House’ since the 1930s.6 Australia is perhaps unique in retaining the only other known living doctor with the name ‘William Osler,’ in this case a gastroenterologist working in Hobart, Tasmania, who is a direct South African descendant of Sir William’s paternal great uncle Benjamin Osler (1775- 1821).7 Few if any other Australian doctors can trace their medical lineage directly back to Osler, although Sydney’s Isbister medical family provides a notable exception in this regard.8 Elsewhere in Australia, Osler’s name has been brandished by a personalised digital clinical portfolio application (Osler Technology),9 in several articles published in Australia’s premiere medical journal,10, 11, 12 and in various Osler related educational posts on Life in the Fast Line – a popular Australian open access medical education website.13 In New Zealand, the University of Otago’s online medical humanities forum Corpus directly refers to Osler’s writings in a formative context,14 and other New Zealanders have also turned to Osler’s example as a source of inspiration with regards to their daily clinical practice.15 Despite these generally affirmative trends, it should also be noted that some of the most striking revisionist perspectives on William Osler published in recent years have also come out of Australia. These notably divergent views, primarily the province of Melbourne physician Dr Patrick Fiddes (and his doctoral advisor Professor Paul Komesaroff)16, 17 – who has studied William Osler’s life in medical education through a particular philosophical lens – are reflective of Australia’s pluralistic society.

The William Osler Society of Australia and New Zealand – WOSANZ for short – is the brainchild of twin-brother physician-trainees and medical history enthusiasts, Drs Nadeem and Zaheer Toodayan (Figures 1a and b). Like Browne’s “two infants in the womb” they have often entertained “a dialogue… concerning the state of this world” and consider themselves to be – with just reverence for their literary hero Sir Thomas Browne (1605- 1682) – “but embryon philosophers”.18 Driven by an early curiosity towards eponymous clinical signs and

2 Osleriana syndromes in medical school, it was the second-born twin (Nadeem) who early focussed his historical interests on William Osler’s life and legacy. A decade onwards now, and the opportunity has arisen to further study and discuss Osler’s story before an Australian audience. It was in anticipation of the Osler centenary many years prior that plans for an Australian Osler society were first suggested. The Society’s constitution was duly drafted on Sir Thomas Browne’s 413th birthday last year (see page 5) and a number of commemorative meetings have been held since the 99th anniversary of William Osler’s passing on 29th December 2018 (Table 1). The society’s slogan ‘Exegi monumentum aere perennius’ – ‘I have erected a monument more lasting than bronze’, taken from the Odes (III, XXX, lines 1-5, 23 B.C.) of Horace (65 B.C.-8 B.C.) – has been chosen to indicate Osler’s perennial influence over the medical profession; the motto is included in our lettered logo which incorporates Osler’s portrait, the sacred staff of Asklēpiós, and the Southern Cross constellation (see constitution). Our official journal – Osleriana: A Medical Humanities Journal-Magazine – will serve as the major record for our historical studies and other commemorative contributions. With unlimited word counts and carefully produced high quality articles, Osleriana hopes to become an attractive option for contributing authors in areas of topical interest. Alongside the regular newsletters produced by the American Osler Society19 and The Osler Library of the History of Medicine,20 Osleriana is the only official journal specifically dedicated to publishing works in the area of Osler studies. Much else besides will also be included, but an underlying Oslerian link will be apparent in most contributions. In this inaugural issue for example, we cover several commemorative subjects – Osler would have been delighted to read of the lunar craters named for distinguished medical personalities, and would similarly have supported articles on Laennec and Da Vinci, both of whom he admired greatly. He would have enjoyed Walter Bett’s (1903-1968) article on Gaspare Aselli (c.1581-1625), and approved of a detailed biographical sketch of this oft-times forgotten scholar of medical history. Osleriana also includes much shorter articles published in a magazine-like format. These contributions aim to cover in summary form other activities of significant interest to the So- ciety. In this issue, we include brief editorials commemorating the Apollo 11 Moon landing fifty years ago and William Osler’s final public address which was delivered to the Classical Asso- ciation in Oxford one-hundred years ago. Details concerning proposals for an Osler lunar crater and an Osler centenary portrait campaign are also included.

But a society named for Sir William Osler cannot be about historical matters alone. As indicated in our constitution, it is our desire to include in this historical discourse, “matters clinical, scientific, philosophical, literary, and professional.” Only through a broader consideration of such subjects will we achieve our goal to become a clinically relevant contemporary professional medical humanities group. We look forward to such discussions in future issues of Osle- riana and hope to include contributions of compelling interest to our members and wider read- ership. Our journal content will appeal to those who believe in the inherent goodness and essential dignity of man.

N. Toodayan Z. Toodayan Editor-in-Chief Associate Editor

12th July 2019 Calamvale, Brisbane.

July 2019 3 a b

Figure 1: ‘Embryon philosophers’ – founders of the Society; (a) Nadeem Toodayan and (b) Zaheer Toodayan.

Meeting Date & Time Name & Location Summary & Comments

1 29th December 2018 WOSANZ prefatory Observed the 99th anniversary of William Osler’s passing. 10:00-15:30 meeting; University One-minute silence in memory of Osler; WOSANZ Constitu- of Melbourne tion recital and revision; historical ‘Journal-Magazine’ ideas; watched Osler YouTube video; read Osler’s The Master-Word in Medicine address, pneumonia section in Yung’s Infectious Diseases (2005), and selected excerpts from Sir Thomas Browne. Dr Edward Carson of Bendigo attended this meeting. 2 8th April 2019 Harvey Cushing Celebrated Harvey Cushing’s 150th birthday. Reviewed a 10:00-15:30 meeting; Calamvale, number of Cushing offprints by John Fulton; watched earlier Evening dinner. Brisbane. made Cushing video on YouTube; reviewed clinical features of Cushing’s syndrome with consideration of index case (Min- nie G) in The Pituitary Body and Its Disorders (1912); full readings of Cushing’s first historical essay (on Albrecht von Haller), Consecratio Medici (1926), Emancipators (1927), and William Osler ‘The Man’ (1920); watched original 1931 video of Harvey Cushing operating; dinner to end. 3 2nd May 2019 Leonardo da Vinci Observed the 500th anniversary of Leonardo da Vinci’s death. 13:00-16:30 meeting; Calamvale, Watched feature-length documentary on Leonardo da Vinci on Evening dinner Brisbane. YouTube. Read Osler’s commentary on Da Vinci; reviewed Carson’s paper on Laennec for the first issue of Osleriana; practice presentation of Nadeem’s Montreal talk on William Osler’s after-life. Evening dinner for da Vinci. 4 16th & 17th May 2019 Centenary of Wil- 16th May: Early morning flight from Montreal to Toronto; visit- Two whole days in liam Osler’s final ed various Osler related sites in Toronto and Dundas, including Ontario, Canada. public address on Trinity College, grave of W. A. Johnson in Weston, St John’s No strict schedule. The Old Humanities Church, and Osler’s Dundas home where the address was read and The New Sci- in a quiet evening ceremony (see page 73). ence; Toronto and 17th May: Visited more Dundas sites, including Osler cairn, Dundas, Ontario. Cootes Paradise canal, and Ellen Osler’s home; drove to Brad- ford West Gwillimbury/New Tecumseth where Osler was born. 5 12th July 2019 William Osler Celebrated William Osler’s 170th birthday. Readings from 09:00-17:00 birthday meeting; Tennyson’s In Memoriam, Osler’s 1892 Teacher and Student Evening dinner. Calamvale, Bris- address, and Browne’s Letter to a Friend; also read introduc- bane, Brisbane city. tory chapter of Talley and O’Connor’s Clinical Examination textbook; finalised most articles for first issue of Osleriana. Osler birthday dinner in Brisbane city afterwards.

Table 1: A tabulated summary of all official WOSANZ meetings to date.

4 Osleriana Here listed are the aims and aspirations upon which the above named medical humanities society is to be inaugurated:

That there be founded a new not-for-profit society for the study and appreciation of the history of medicine in the Australasia region. That the society be named ‘The William Osler Society of Australia & New Zealand’, or WOSANZ for short. That the society be established in the year 2019, to honour the life and memory of Sir William Osler (1849-1919) – widely admired physician and humanist par excellence – a century after his death. That the society should, through its various activities, cultivate historical aware- ness amongst practitioners and students of medicine by way of scholarly discourse on matters clinical, scientific, philosophical, literary, and professional. That the society’s aims be achieved through multifarious means, including occasion specific audio-visual and written commemorations, professional meetings, and a historical journal-magazine to be produced at least annually. That formal membership be granted to individuals who express and demonstrate a genuine interest in the society’s goals and operations. That the society serve as a sanctuary for wisdom and creativity, and that its doors remain ever open to those who, in the spirit of Sir William Osler, lead free and fer- tile lives:

“Let thy studies be free as thy thoughts and contemplations: but fly not only upon the wings of imagination; join sense unto reason, and experiment unto speculation, and so give life unto embryon truths and verities yet in their chaos.” – Sir Thomas Browne (1605-1682)

Faithfully compiled on this, Nineteenth eve of October Two-Thousand-and-Eighteen, At the residence of its founders in Calamvale, Brisbane, Under the light of the gibbous Moon in Capricorn.

Nadeem Toodayan Zaheer Toodayan MBBS MBBS

July 2019 5 References & Notes

1. Roxanas MG. Osler and his Australian associations — part 1: during his life. Medical Journal of Australia, 2010; 193(11): 686-689. 2. Roxanas MG. Osler and his Australian associations — part 2: continuing influence. Medical Journal of Australia, 2010; 193(11): 690- 693. 3. Osler W. The Principles and Practice of Medicine. New York: D. Appleton and Company, 1892, p. 36. Discussing the utility of cold- bath therapy for typhoid fever, Osler specifically notes that: “Among the most striking figures are those recently published by Hare, from the Brisbane Hospital, Australia.” 4. Hare F. The Cold-Bath Treatment of Typhoid Fever. The experience of a consecutive series of nineteen hundred and two cases treated at the Brisbane Hospital. London: Macmillan and Co., 1898. 5. [Unsigned]. Francis Hare. Noted Physician Passes. Conqueror of Typhoid. The Brisbane Courier, 20 March 1929, p. 16. 6. Queensland Government, Queensland Heritage Council. (2016). Osler House, 35 Sturt Street, Townsville (entry 600931). Availabkle at: https://apps.des.qld.gov.au/heritage-register/detail/?id=600931. Accessed July 2019. Under the ‘History’ tab is written: “It is thought that the building may have been named Osler House in the 1930s in honour of Sir William Osler, a distinguished Canadian physician who developed modern methods of clinical training and was the author of the influential Principles and Practice of Medicine.” 7. Toodayan N. ‘Cardiac Greetings’ from Down Under: Introducing a New Generation of ‘Ozlerians’. The Osler Library Newsletter, Fall 2014; 121: p. 12-13. 8. Isbister JP. Channelling medical truths from Sir William Osler. Internal Medicine Journal, 2018; 48(11): 1404-1407. 9. See Osler Technology website. Available at: https://www.oslertechnology.com/about. The company was founded by Sunshine Coast intensivist Dr Todd Fraser and businessman Mr Jeff Ayton. 10. O’Rourke MF. William Osler: a model for the 21st century? Medical Journal of Australia, 1999; 171(11-12): 577-579. 11. Van Der Weyden, MB. What is a doctor, and what does a doctor do? Medical Journal of Australia, 2005; 183(11): 560-561. 12. Irvine DH. Everyone is entitled to a good doctor. Medical Journal of Australia, 2007; 186(5): 256-261. 13. There are many educational posts regarding William Osler on the Life in the Fast Lane website. These have primarily been posted by the co-founders of the website Dr Chris Nickson (a New Zealand and Australian trained intensivist working in Melbourne) and Dr Mike Cadogan (an Emergency Medicine Physician based in Perth). See: ‘Becoming an Oslerphile’. Available at: https://lifeinthefastlane. com/becoming-an-oslerphile/, and ‘Lessons from Osler’. Available at: https://litfl.com/tag/sir-william-osler/). Accessed July 2019. 14. See the University of Otago Medical Humanities website – Corpus: Conversations about medicine and life. Available at: https://corpus. nz/about-corpus/. Accessed July 2019. The webiste states that “Corpus is co-edited by University of Otago historian Professor Barbara Brookes and writer Sue Wootton.” 15. MacLeod R. Learning from Sir William Osler about the teaching of palliative care. Journal of Palliative Care, 2001; 17(4): 265-269. 16. Fiddes P, Komesaroff PA. (2018). An emperor unclothed: the virtuous Osler. Hektoen International. Available at: https://hekint. org/2018/03/20/emperor-unclothed-virtuous-osler. Accessed July 2019. 17. Fiddes PJ. (2018). Sir William Osler’s life in medical education. A critical re-evaluation of his moral philosophies, his teaching practices and the construction of a legend. This doctoral thesis was undertaken by Fiddes at Monash University in Melbourne and was supervised by Professor Paul Komesaroff. 18. Browne T. Hydriotaphia, Urne-Buriall, or, a discourse of the sepulchrall urnes lately found in Norfolk. Together with the garden of Cyrus, or The quincunciall lozenge, or network plantations of the ancients, artificially, naturally, mystically considered. With sundry observations. London: Printed for Hen. Brome at the Signe of the Gun in Ivy-Lane, 1658, p. 23. To qoute Browne in full: “A Dialogue between two Infants in the womb concerning the state of this world, might handsomely illustrate our ignorance of the next, whereof methinks we yet discourse in Platoes den, and are but Embryon Philosophers.” 19. The Oslerian is a quarterly Newsletter produced by the American Osler Society since June 2000. All issues are available online at: http://www.americanosler.org/the-oslerian.php. Accessed July 2019. 20. The Osler Library Newsletter is produced 2-3 times a year and has been published since 1969. All issues are available online: https:// www.mcgill.ca/library/branches/osler/oslernews. Retrieved July 2019.

6 A waxing crescent Moon as seen through an eight-inch Newtonian telescope. Photo taken by Z. Toodayan on 8th April 2019 from Brisbane, Australia.

Medicine’s Lunar Legacies

Zaheer Toodayan*

Fifty years have now passed since Man first walked on the Moon and nothing quite so pioneering as the Apollo 11 mission has been accomplished since. The anniversary provides a suitable setting in which to reflect upon Earth’s only natural satellite, and for those whose lives predom- inantly revolve around healthcare, a useful opportunity to review the historical associations between medicine and the Moon. After providing some brief background information about the Moon’s craters and the nomenclature that applies to them, this monograph considers those physicians who made important contributions to selenology and presents a comprehensive tab- ulation of all eponymous lunar craters that are associated with the medical profession.

In vain to do individuals hope for immortality, Origins of the Moon and Craters or any patent from oblivion, in preservations below the Moon. It is thought that the Moon – Luna in Latin – was creat- – Sir Thomas Browne (1605-1682), ed in the aftermath of a violent cosmic collision.2 The Hydriotaphia, Urne-Buriall, 1658.1 giant-impact hypothesis postulates that around 4.5 billion years ago, a Mars-sized protoplanet named Theia3 ur Moon, the brightest celestial object in the collided with the young Earth and the material that night sky, has captured the imaginations of was ejected into orbit subsequently accreted to create Oonlookers in all ages. Its tranquility and re- the new Moon.4, 5, 6 moteness have enticed the adventurous spirit of Man, whose wanderlust culminated in a sensational series of There are a variety of craters that punctuate the lunar lunar landings fifty years ago. But even before Man surface with features corresponding to their age and lay foot upon it, the Moon was a metaphor for the mechanism of formation (Figure 1). Studies of lunar heroic and idyllic, and when the science of selenog- rocks and minerals suggest that many larger craters raphy first began this same sentiment found its way and impact basins8 were formed during a period of into systems of lunar nomenclature. A conspicuous intense instability in the solar system, around 3.9 bil- manifestation of this reverential tradition is the epon- lion years ago, which resulted in numerous massive ymous identification of the Moon’s craters. Bearing asteroid collisions with the rocky planets and their the names of distinguished doctors and medical scien- satellites.9 Populations of younger craters originated tists, many craters collectively chronicle the important more recently, in the last one billion years or so, and milestones and scientific breakthroughs that revolu- such craters are characterised by bright unweathered tionized modern medicine. ray systems of ejecta.10

Before we consider its medical associations, let us first All lunar craters were created through hypervelocity11 review how the Moon and its craters were formed, the impacts with meteorites, asteroids and derivatives of principles that govern visibility of the Moon’s surface, comets. Impacts between solid objects at these tre- and the historical development of lunar nomenclature. mendous speeds results in a series of high-energy events that excavate the target surface to form an impact crater. The craters are forged by a variety of forces during and shortly after impact, including melting, * Dr Zaheer Toodayan is a Basic Physician Trainee from Brisbane, vaporisation and the ejection and displacement of ma- Australia. Correspondence: [email protected]. terial from both projectile and target. In larger craters, Full Moon at dawn. The proximity of the Moon to the horizon creates two interesting effects – the illussion of a larger diameter gravitational forces may induce rim collapse and uplift and a warmer hue. Photo taken by author on 18th June 2019 from of the central meltrock within the transient cavity, re- Calamvale, Brisbane. sulting in complex crater configurations.12 9 Z. Toodayan

Figure 1: The crater rich plains of the central and southern highlands as seen through an eight-inch Newtonian telescope. Shadowing accentuates details of craters near the lunar terminator. The larger craters at the extreme left of the image are Hipparchus (150 km, seen partially) and Albategnius (129 km), both complex craters with central formations. Younger craters can be seen overlying older ones, whilst craters near the Moon’s southern limb (extreme right in this photo) demonstrate significant foreshortening.7 Photograph taken by author on 10th August 2016.

Visibility of the Lunar Surface The extent of the Moon’s near-side that appears illuminated to observers on Earth changes with the lunar Not all of the lunar craters are visible from Earth. Over phase. Although the sun-facing half of the Moon is time, tidal forces have caused the Moon to adopt a syn- always lit by sunlight, the changing position of the chronous rotation about our planet; that is, it takes the Moon in its orbit around Earth produces different per- same time for the Moon to complete a rotation about its spectives of this illuminated hemisphere, creating the own axis as it does to complete one revolution around lunar phases. The Moon’s phase waxes and wanes be- Earth. This results in the Moon always presenting the tween an unilluminated new Moon and a completely same hemisphere towards Earth (the near-side) with illuminated full Moon over the course of a lunar month the opposite hemisphere remaining unseen.13 Even so, (Figure 2). The shadowing effects created by the lunar due to the phenomenon of optical libration, slightly terminator, the demarcation band between lunar day more than fifty percent of the lunar surface is visible and night, allows for better appreciation of the Moon’s to observers during a lunar cycle. Libration exposes finer surface details. The first visions of the far-side an additional nine percent or so of the Moon’s surface of the Moon, the side that is always facing away from beyond the rim of the main disc and occurs due to the Earth, were provided by the Soviet Luna 3 space probe inherent geometry and dynamics of the Earth-Moon on 7th October 1959.17 system – the mild eccentricity of the Moon’s orbit (libration in longitude), the inclination of its orbital plane and axis of rotation (libration in latitude), the parallax A Brief History of Lunar Nomenclature created by the displacement of the Earth’s surface (and the Earth-bound observer) over the course of a single Man has probably had names for the Moon and its night (diurnal libration), and the small variation in the most visible features ever since language first originat- Moon’s speed of rotation about its polar axis as a result ed, but describing the Moon became a truly scientific of the tidal bulge of its nearside (physical libration).14 exercise with the invention of the telescope. Shortly

10 Osleriana Medicine’s Lunar Legacies

Figure 2: Phases of the Moon as seen from the southern hemisphere. The central lower image shows a thin waxing crescent, occurring shortly after a new Moon.15 The Moon’s face becomes increasingly illuminated thereafter, as demonstrated in the left to right progression of images: a broader waxing crescent, first quarter (semi-illuminated), waxing gibbous and full Moon – this semi-cycle occuring over approximately one fortnight. Following a full Moon, which occurs when its orbit places it farthest away from the Sun, the phases wane in a reverse order until a new Moon is made once again, completing the lunar cycle. An entire cycle of lunar phases (a lunation) defines the synodic (lunar) month, which is a period of about 29.5 days.16 Individual photographs taken by the author between August 2016 and April 2018. thereafter, in 1610, the Italian polymath Galileo Galilei The first true lunar cartograph20 is attributed to the (1564-1602) published some of the first telescope-as- Spanish astronomer Michael Florent van Langren sisted sketches of the lunar surface in his astronomical (1598-1675) – Royal Mathematician and Cosmogra- treatise Siderius Nuncius.18 In analysing the details pher to King Philip IV – whose 1645 engraved map of highlighted by the Moon’s terminator, Galileo noted the Moon entitled Plenilunii Lumina Austriaca Philip- the topographical diversity of the lunar landscape and pica (Figure 3) identified its various surface features asserted the existence of mountains and valleys there- for the first time.21, 22 In accordance with the Plutar- on. He was the first to see, write about, and illustrate chian view that perpetuated the notion of the Moon the Moon’s many craters; structures he called “small as a second Earth,23 Langrenus’ map distinguished the spots” in order to distinguish them from the “great or dark lunar seas (Maria, singular Mare) from the bright- ancient spots” (the Maria) readily visible from Earth.19 er surrounding lands (Terrae, singular Terra). Com- plying with royal instruction24 he also systematically Following Galileo, the improving optics of astronom- designated craters with the names of ‘illustrious men’21 ical telescopes in seventeenth century Europe enabled and ‘foreigners of excellence in the sciences’25 – his increasingly accurate observations of the lunar surface. ‘Land of Dignity’ (‘Terra Dignitatus’) was populated Alongside these advances, the astronomers of the age with identities of Catholic significance26 and the names recorded progressively detailed maps of the Moon to of a selection of influential stargazers were clustered describe, communicate, and distribute their findings. in the ‘Sea of Astronomy’ (‘Mare Astronomicum’).27 Of the many efforts undertaken in this emerging science of selenography, the contributions of some key Langrenus’ nomenclature was not adopted by Johannes astronomers played a pivotal role in establishing the Hevelius (1611-1687), the eminent Polish astrono- convention by which the Moon’s topographical fea- mer who discovered the longitudinal libration of the tures were classified and named. Moon28 and described seven of our modern constel-

July 2019 11 Z. Toodayan

Figure 3: The first true map of the Moon by Michael Florent van Langren. This map, titled Plenilunii lumina Austriaca Philippica (The Luminaries of Felipe of Austria on the Full Moon), was published in Brussels in 1645. Consistent with their natural appearance, the Mare assume a darker shade than the Terrae. Craters are given eponymous designations and quotations from the ancients are incorporated around the centrepiece. From the Digital Museum of Planetary Mapping.

12 Osleriana Medicine’s Lunar Legacies

a b

Figure 4: a) Johannes Hevelius, the ‘father of lunar topology’. This oil-on-canvas portrait by the Baroque painter Andreas Stech (1635-1697) depicts the Polish astronomer around 1677, aged sixty-six. The portrait was donated to Oxford University by Hevelius himself as a gesture of appreciation for his induction into the Royal Society of London.30 Courtesy of the History of Science Museum, Oxford. b) Hevelius’ collection of detailed lunar maps were compiled in his 1647 publication Selenog- raphia sive Lunae Descriptio (Selenography or a Description of the Moon), the ornate frontispiece of which is depicted on the right. The Selonographia is regarded as the first complete atlas of the Moon. Image reproduced with permission from the Linda Hall Library of Science, Engineering and Technology. lations29 (Figure 4a). In his 1647 milestone compen- an entire section dedicated to observations and conun- dium, Selenographia, sive Lunae Descriptio (Figure drums concerning the Moon (Figure 5). Riccioli’s lu- 4b), Hevelius adopted an alternate system of naming nar maps, which were delicately drawn by his assistant lunar features which utilised toponyms derived from a Francisco Maria Grimaldi (1618-1663),34 were an im- projection of the surface of the Classical World upon provement of earlier works by van Langren and Hev- the Moon.31 Although Hevelius’ lunar atlas, the first of elius, and although he adopted a system of nomencla- its kind, was of such import to astronomy that he be- ture which was similar in essence to van Langren’s, came renowned as the ‘father of lunar topography’,32 Ricciolli bestowed new names upon the lands, seas only a few of the appellations he bestowed on the and craters he observed31 (Figure 6) – the plains of the Moon’s features would endure – it was the approach Maria were affiliated with the Moon’s perceived influ- of a contemporary of his that established the scheme ences on Earthly fertility and weather and the higher of lunar nomenclature that remains with us to this day. lands took on the titles of opposing themes.35

In 1651, towards the end of the Counter Reformation, Riccioli also systemised the naming of the Moon’s cra- the Italian astronomer and Jesuit priest Giovanni Bat- ters. He divided the lunar surface into eight circumfer- tista Riccioli (1598-1671) published his Almagestum ential octants and named the larger formations in each Novum, a ten part astronomical encyclopaedia with after individuals from various historically significant

July 2019 13 Z. Toodayan epochs. He also maintained a kind of hierarchy in the intentions. For instance, although the revolutionary distribution of identities, with more revered figures ideas of Copernicus, Galileo and Kepler were known appearing closer to the north and centre of the Moon. to Riccioli, he disagreed with them on philosophical Names of ancient Greek philosophers and intellectuals grounds20 and his clustering of this intellectual trinity monopolised some octants (I, II and III), whilst craters of astronomy in his eighth octant has been suggested in others (IV, V and VI) were connected with influen- to have signified a philosophical and political agenda. tial identities from the Roman Empire. There was a Some say Riccioli’s pernicious placement of these as- place for the Arabian thinkers, space for Saints with tronomers constituted a covert gesture supporting the astronomical associations, and a section for the more Catholic Church, symbolising the distance of these dis- recent European scholars, writers, and philosophers. ruptive personalities from ancient theological author- Although the majority of individuals after whom the ity – their names were attached to features within and craters were named were explicitly honoured, it has around the Oceanus Procellarum (Ocean of Storms), been postulated that Riccioli may have listed some far from the security of the Church’s shores and farther of his contemporaries with altogether less charitable still from the wisdom of Athens and Rome.35

a b

Figure 5: Giovanni Battista Riccioli’s Almagestum Novum (New Almagest). Published in 1651, this was a ten part astronomical encyclopedia in which Riccioli introduced the system of lunar nomenclature that is still used today. The frontispiece (a) and title page (b) are pictured here. The detailed engravings of the frontispiece depict Urania, the muse of astronomy, weighing the Copernican heliocentric system against the competing Tychonic geoheliocentric model endorsed by Riccioli, with the latter symbolically dominating the balance. The old purely geocentric system lies discarded on the ground (lower right) and its instigator Ptolemy (author of the original Almagest) observes the newer theories from the background (lower left). The many-eyed Argus, with a telescope in his left hand, points towards the enlightening discoveries of the instrument which are borne by cherubs in the upper segment of the engraving. The cherub at the lower right can be seen carrying a Moon marked by many craters.33 Images reproduced with permission from the Linda Hall Library of Science, Engineering and Technology.

14 Osleriana Medicine’s Lunar Legacies

Figure 6: Riccioli’s map of the Moon, as published in the Almagestum Novum in 1651. His system of octants is appreciable. The map demarcates the combined limits of libration in longitude and latitude which are projected beyond the northeastern and southwestern limbs of the lunar disc. A significant proportion of the names Riccioli gave to the illustrated features are still in use today – those of the Mare, the darker regions on this map, as well as of many of the craters have remained entirely unchanged across almost four centuries. It was this system of Riccioli’s that was subsequently adopted as the framework for all lunar terminology. Image courtesy of the History of Science Collections, University of Oklahoma Libraries.

Regardless of the motives behind the choice and became the backbone for all future lunar nomencla- placement of Riccioli’s eponyms, his system of no- ture and we continue to identify many of the moon’s menclature was considered eloquent and inclusive. features by the names he originally introduced.36 His method became widely adopted and was popularised by its utilisation in increasingly detailed lunar The International Astronomical Union (IAU), founded maps that were published by leading astronomers over one-hundred years ago in 1919, is today’s recognised the forthcoming centuries. One of the most influen- authority for the naming of celestial bodies and their tial was Johann Heironymous Schröter’s (1745-1816) surface features. The Union’s first official report on Selenetopographische Fragmente of 1791 which pro- standardised lunar nomenclature, Named Lunar For- vided a particularly prominent platform for Riccioli’s mations, was published in 1935. This work was large- system. Succeeding in this way, Riccioli’s scheme ly the effort of one Mary Adela Blagg (1858-1944),

July 2019 15 Z. Toodayan an English astronomer who attended to discrepancies The Physician-Astronomers in the authoritative maps of the day, particularly those of Beer and Madler, Schmidt and Nelson.37, 38 Blagg’s The insight that accompanies an appreciation of our listing was updated in 1966 with The System of Lu- place in the Universe may be likened to the self-aware- nar Craters, a detailed catalogue of all the craters on ness evoked by the comprehension of human health the nearside of the Moon that was produced under and disease. Perhaps it was this self-discovery that the direction of the Dutch-American astronomer and propelled many past practitioners of medicine towards selenographer Gerard Peter Kuiper (1905-1973).39 the similarly satisfying study of the stars. Regardless Following a divisional re-organisation of the IAU at of their motivations, it is interesting to note that a por- a 1973 meeting in Sydney, Australia, the Working tion of historically significant contributions to the as- Group for Planetary System Nomenclature (WGPSN) tronomical sciences were made by this unique class of was founded – the body that currently administrates intellectual hybrids – the physician-astronomers. the task of formally approving the names of celestial bodies and their topographical features.37 Contributions of physicians to astronomy throughout the ages have been both broad and pivotal, but a When designating names to newfound features, the comprehensive overview of their lives and works falls WGPSN applies a standard of rules and conven- beyond the scope of this compendium. It suffices to tions that necessitate certain requirements for chosen acknowledge however, that the medical profession has names. The conventions specify a preference for the provided astronomy a great deal of important infor- expansion of historically established themes and al- mation, instrumentation, individuals and ideas. These though discouraging a primary purpose of honouring include Ali ibn Ridwan’s (c.988-c.1081) unrivalled ac- individuals, allow “in special circumstances” for the count of the brightest observed stellar event in record- eponymous commemoration of deceased individuals ed history,42, 43 the marvelous astrarium of Giovanni “of high and enduring international standing”.40 In re- Dondi dell’Orologio (c.1330-1388),44 the astronomi- lation to the naming of craters in particular, the rules cal globes and rings of Gemma Frisius (1508-1555),45 specify eponymous appellations as the preferred stan- the nova, eclipse and comet observations of Cornelius dard, with identities limited to “deceased scientists, Gemma (1535-1578),46 the calender reformations of and polar explorers who have made outstanding or Aloysius Lilius (1510-1576),47 the first ever Savillian fundamental contributions to their field”.40 Professor of astronomy, John Bainbridge (1582-1643), the starry-eyed Scotsmen John Craig (died 1620) and The standardisation of the names of planetary features Duncan Liddel (1561-1613), the Bohemian man Ta- became an increasingly important exercise since the deas Hajek z Hajku (Hagecius), the discovery of the Mariner and Voyager programs first beamed back de- asteroids Pallas and Vesta by Heinrich Olbers (1758- tailed photographs of the surfaces of the rocky planets 1840)48 and, perhaps most monumentally of all, the he- in the 1960s and 70s. The features of each celestial liocentric model of Nicolaus Copernicus (1473-1543) body were named in accordance with themes that ac- who in his younger years also qualified as a physi- knowledged their cultural and mythological connec- cian.49 tions. Many Martian craters were named after scientists and writers of the planet’s folklore, Mercurian formations were attached with the identities of promi- William Gilbert nent writers and artisans, and all of Venus was delegated to honouring both the ordinary and extraordinary But let us return to the Moon. Before the advent of women of the world.41 As modern missions contin- telescopes, unassisted visual sketches, carvings and ue to map still farther regions of the solar system, the paintings were the only way in which the Moon was names of the great achievers continue to enrich the figuratively represented and recorded. One of the ear- lexicon of space exploration. liest illustrations depicting the surface markings of the Moon without telescopic aid was that of William With this broad understanding of the Moon and its cra- Gilbert (1544-1603)50 – astronomer, physicist, and ters we may proceed to explore some of the interesting physician to Elizabeth the first (Figure 7b). Gilbert’s associations between medicine and the Moon. There drawing, which has been dated to around 1600, is a are two primary connections to consider in this regard: simple scheme of the lunar surface. Like his contem- physicians who have made important contributions to porary Johannes Kepler (1571-1630), he believed that astronomy and selenology, and those lunar craters that the Moon was Earthlike, the darker visible regions be- commemorate individuals whose works have played ing lands and the brighter vast bodies of water51 (Fig- an important part in the development of modern med- ure 7a). He also gave names to these regions but his icine. designations were superceded by the time his diagram

16 Osleriana Medicine’s Lunar Legacies

a b

Figure 7: a) William Gilbert’s unaided sketch of the Moon (c.1600). Gilbert identified the enclosed areas, which represent the visibly darker regions of the lunar surface, as lands (such as Continens Meridionalis and Regio Magna Orientalis) and the intervening areas as waters (for instance the Mare Medilunarium). Gilbert’s drawing, which some regard as the earliest map of the Moon, was published in 1651 in is his quarto volume De Mundo Nostro Sublunari Philosophia Nova (New Philosophy About our Sublunar World). Image courtesy of the History of Science Collections, University of Oklahoma Libraries. b) A 1796 engraving depicting William Gilbert. Courtesy of the Wellcome Collection. appeared in a 1651 posthumous publication titled De kind were forwarded by the von Beiberstein brothers Mundo Nostro Sublunari Philosophia Nova.52 Wil- (in 1802) and Karl von Moll (1760-1838) in 1810, liam Gilbert’s renditions of the Moon were certainly 1815 and 1820.55, 56, 57, 58, 59 It was a controversial idea pioneering but his works on ‘magnetic philosophy’ at the time. would prove to be far more influential in science.53

Another interesting medico-lunar connection can be Franz von Paula Gruithuisen found amidst the early debates upon the mechanism of formation of lunar craters. In the nineteenth centu- One of the early proponents of the impact hypothe- ry, prevailing theories on the origin of the craters con- sis of lunar craters, and the individual who is usually sidered their emergence, akin to terrestrial calderas, a credited with originating the complete theory, was the consequence of lunar volcanism.54 But the discovery German surgeon and astronomer Franz von Paula Gru- of smaller celestial bodies between the orbits of Mars ithuisen (1774-1852)57 (Figure 8b). Gruithuisen grad- and Jupiter in the early nineteenth century – of Ceres uated with a Doctor of Medicine from the University by Gussippe Piazzi (1746-1826) of Palermo in 1801, of Landshut in 1808 and his subsequent medical prac- and of Pallas by the German ophthalmologist-astron- tice included performing urological procedures.56 He omer Heinrich Willhelm Matthias Olbers (1758-1840) is now remembered for his pioneering instrumentation the following year: the ‘asteroids’, as German-British and techniques for the pulverisation and transurethral astronomer William Herschel (1738-1822) named extirpation of bladder stones.60 His German transla- them – inspired new theories about how the Moon’s tion of the works of Hippocrates was also a significant craters might have come into being.55 The notion that contribution to the literature of the medical profession. the Moon’s craters may have been forged through col- But Gruithuisen had a lifelong passion for astronomy lisions with members of this newly discovered family and he was a fastidious observer. He was the first to re- of smaller celestial objects emerged in the early nine- cord the bright polar hoods of Venus and, by 1822, was teenth century as extensions of accretion hypotheses established as Professor of Astronomy at the Universi- of lunar formation.56, 57 Rudimentary theories of this ty of Munich.56 In 1829, he proposed an impact theo-

July 2019 17 Z. Toodayan ry for the origin of the lunar craters and subsequently Joseph Nicéphore Niépce (1765-1833) utilised bitu- provided explanations for the mechanics of the impact men of Judea to produce what has been regarded as process that accounted for the circular configuration of the first permanent photograph. Niepce’s principle the craters, their elevated rims and central peaks.55, 61 of ‘heliography’ was enhanced by his work partner, Gruithuisen’s speculations about the formation of lu- Louis Daguerre (1787-1851), who used silver halides nar craters went by largely unacknowledged, perhaps for their more practical photochemical characteristics. due to his reputation for fanciful astronomical ideas, The ‘Daguerrotype’ became a public sensation in 1839 such as the plurality of inhabited worlds, the existence and the process was swiftly replicated by photogra- of lunar citizens called ‘Selenites’ and his ‘City on the phers around the world.68 The new technique enabled Moon’56 (Figure 8a). Regardless, the impact theory them to effortlessly capture, for the first time in human remained controversial in astronomical circles well history, accurate images of people, places and every- into the twentieth century, its eventual acceptance fol- day things. lowing mounting evidence in support of the Moon’s geological inactivity and a more comprehensive understanding of the nature of hypervelocity impact pro- John William Draper cesses.58, 64, 65 The adoption of photography into astronomy came Up until the mid-nineteenth century, the maps of lunar shortly after its invention and depended on the pio- cartographers were the only conduit that could con- neering contributions of the English-born American vey the dreamy details of the lunar surface to wider physician, philosopher, photographer and chemist, audiences. But a new way of capturing and preserv- John William Draper (1811-1882) (Figure 9a). Fol- ing the appearance of objects was emerging in France, lowing a move from England to Christiansville, Vir- a process which the French artist Antoine Hercules ginia in 1832, the young John Draper attended medical Romauld Florence (1804-1879) had termed ‘photog- studies at the University of Pennsylvania until 1836. raphie’ by 1832.66, 67 Earlier, in 1826, the Frenchman He became a professor of chemistry and botany at

a b

Figure 8: a) Gruithuisen’s sketch of a ‘lunar city’ exhibiting a regular array of ‘ramparts’ which he called ‘Wallwerk’. He conjectured that these unnatural structures proved the existence of civilisations of star-worshipping ‘Selenites’ on the Moon.62 The region of interest, located just north of the Schröter crater on the central near-side, hosts a series of shallow hills and furrows that can give an impression of unusual order when viewed through smaller telescopes during a local lunar sunrise or sunset.63 Image sourced from: Hill H. A Portfolio of Lunar Drawings. Cambridge: Cambridge University Press, 2003, p. 46. b) This portrait of Gruithuisen as a young man, which appeared in 1829, is one of only two accessible renditions of him. Sourced from: Sheehan WP, Dobbins TA. Epic Moon: A history of lunar exploration in the age of the telescope. United States: Willmann-Bell, Inc., 2001, p. 76.

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a b

Figure 10: a) English-born American physician and photographer John William Draper; oil-on-canvas portrait by Charles Lennox Wright. Image reproduced with the assistance and permission of the New-York Historical Society. Photograph © New-York Historical Society (ID 1955.71). b) One of Draper’s early Daguerreotypes depicting a third quarter Moon. This is the oldest surviving photograph of the Moon and indeed of any celestial object. Courtesy of New York University Archives.

New York University in 1839 and assisted in found- Of the physician-astronomers here mentioned, Frisius, ing the Medical School at that institution. He pub- Lilius, Hagecius, Olbers, Gruithuisen, Draper74 and lished extensively and served as the inaugural presi- Copernicus (Figure 10a) have lunar craters named af- dent of the American Chemical Society.69 Applying ter them.75 Copernicus is the largest and most prom- his own knowledge and experience of photochemistry inent of this collection and is situated near the lunar to improve Daguerre’s process and shorten exposure equator, some 400 km southwest of the southernmost times, Draper accomplished many pioneering feats summits of the Montes Appeninus (Appenine Moun- in the field of photography. He improved portraiture tains), almost midway between the smaller craters for instance, and is credited with producing the first Erastothenes and Kepler. Excavating a 96 km-wide clear photograph of a female face.70 But it was a few depression along the eastern edge of the Mare Insu- months prior to this that Draper had achieved a ma- larum (Sea of Islands) to a depth averaging 2.6 km, jor milestone in astronomy, as sometime before 23rd Copernicus exhibits a relatively flat floor with multiple March 1840 he had successfully produced the first central peaks, terraced inner walls, a crenulated rim, Daguerrotype of the Moon (Figure 9b). Draper’s in- and a broad nebulous system of higher albedo ejecta augural image, which was about one inch in diameter, that extends circumferentially over 300 km from the was taken with the assistance of a telescope from the crater.76, 77 Contrasting against the darker surrounding roof of New York University and an exposure time of plains, Copernicus and its ray system (Figures 10b and around twenty minutes.71, 72 The captured image was c) are readily appreciable under low magnifications. the first ever photograph of an astronomical object and with it was born the discipline of astrophotography. Craters tied to the names of the astronomising doctors John Draper’s son, Henry Draper (1837-1882), also a may be considered separately from the larger popula- physician and astronomer, followed in the footsteps of tion of ‘medical craters’ due to the fact that, although his father and likewise became a prominent astropho- they commemorate physicians, they chiefly concern tography pioneer. Henry Draper is credited with hav- contributions to astronomical rather than medical sci- ing taken the first photograph of the Great Orion Neb- ence.79 The table on page 21 provides further details ula (on 30th September 1880) and the first photo of the about these craters alongside the contributions of the spectrum of a star (Vega in the constellation of Lyra).73 physician-astronomers after whom they are named.

July 2019 19 Z. Toodayan

b c

Figure 10: Nicolaus Copernicus and the crater that takes his name. a) This oil painting, entitled Astronomer Copernicus, or Conversations with God, was completed by the Polish painter Jan Metejko (1838-1893) in 1873 for the quadricentenary of the subject’s birth. Image sourced from Gallery of Polish Painting, with courtesy of the Museum of the Jagiellonian Univer- sity, Krakow. b) The Copernicus crater, the prominent crater at the centre of this telescopic photo, is 96 km in diameter and lies within the Mare Insularum near a cluster of mountains called the Montes Carpatus (Carpathian Mountains) which can be seen just to the upper left of the crater. Copernicus’ extensive ray system is readily appreciable at this magnification. Photo- graph taken by author on 20th October 2018. c) This is part of a remastered version of an iconic photograph of the Copernicus crater that was captured by the Lunar Orbiter 2 spacecraft on 24th November 1966 from an altitude of 45 km. The mountains in the foreground are the central uplift features of Copernicus and the crater’s northern rim is visible in the distance, below the lunar horizon. At the time of its original release, the full photo was recognised as ‘The Picture of the Century’.78 From the Lunar Orbiter Image Recovery Project, National Aeronautics and Space Administration (NASA).

20 Osleriana Medicine’s Lunar Legacies

Coordi- Crater Name nates & Occupation & Namesake Contributions to Astronomy (Satellites)75 Diame- Honours ter75, 80 Copernicus81 9.6°N Nicolaus Polish physi- Independently formulated the heliocentric model of the 20.1°W Copernicus cian & astron- solar system.82 (A, B, C, D, (1473-1573) omer. Father Provided an explanation for the precession of the E, F, G, H, J, 96.1 km of the scientific equinoxes.82 L, N, P, R) revolution.82 Authored De Revolutionibus Orbium Coelestium (On the Revolutions of the Heavenly Spheres) (1543), a landmark in the history of science.82 Draper83 17.6°N Henry Draper American phy- Produced the first photograph of the spectrum of a star 21.8°W (1837-1882) sician, astrono- (Vega), of the Sun (1872) and of a comet’s head.73 (A, C) mer & telescope Produced the first photograph of a nebula (Great Orion 8.3 km maker. Nebula, 1880).73 Captured the first wide-angle photo of a comet’s tail.73 Draper machine – an instrument used for polishing glass mirrors (for telescopes).73 Gemma 34.3°S Gemma Dutch physi- Introduced the annuli astronomici (astronomical rings Frisius 13.4°E Reinerus cian, astronomer or Gemma’s rings) as an instrument in astronomy Frisius & cartographer. (1539).84 (A, B, C, D, 88.5 km (1508-1555) E, F, G, H, J, K, L, M, O, P, Q, R, S, T, U, W, X, Y, Z) Gruithuisen85 32.9°N Franz von Pau- German surgeon Early proponent of the impact theory of lunar crater 39.8°W la Gruithuisen & astronomer. formation.56 (B, E, F, G, (1774-1852) First to observe the bright polar regions of Venus.56 H, K, M, P. 15 km R, S) Hagecius 59.9°S Tadeas Hajek z Bohemian Recorded observations of the 1572 supernova in Cas- 46.6°E Hajku physician & siopeia (SN 1572, Tycho’s nova) and of the comets of (A, B, C, D, (Hagecius) astronomer. 1577 and 1580 C/1580 T1).86 E, F, G, H, J, 79.6 km (1525-1600) K, L, M, N, P, Q, R, S, T, V) Lilius 54.6°S Aloysius Lilius Italian physi- Laid down the proposals that eventuated in the Grego- 6.1°E (1510-1576) cian, astronomer rian calendar reformation of 1582. Regarded as the first (A, B, C, D, & chronologist. author of the Gregorian calendar. 47 E, F, G, H, J, 61.2 km K, L, M, N, O, P, R, S, T, U, W, X) Olbers 7.3°N Heinrich Wil- German oph- Helped found the world’s first astronomical society 76.1°W helm Matthias thalmologist & (Vereingte Aworldstronomische Gesselschaft, 1800).48 (A87, B, D, G, Olbers astronomer. Discovered the ‘minor planets’ Pallas (1802) and Vesta H, K, M, N, 73 km (1758-1840) (1807), later called ‘asteroids’.48 S, V, W, Y) Discovered the comets C/1780 U1, C/1796 F1, C/1798 X1 and 13P/1815 E1 (now 13P/Olbers).48, 88 Provided accurate explanations for the morphology of comets’ tails.48 Olbers method – for calculating the parabolic orbits of comets.48 Olbers’ paradox89 – the darkness of the night sky con- flicts with the notion of a static universe.48

July 2019 21 Z. Toodayan The Medical Craters accompanied by a satellite crater, Hippocrates Q, 36.2 km in diameter, which lies just to the southwest of the Of the 1,600 or so crater names that have been apparent feature.75, 76, 77 The crater is named after the an- proved by the International Astronomical Union, most cient Greek physician Hippocrates of Cos (460-375 of which are eponymous, there are more than seventy B.C.) (Figure 11b) – the ‘father of medicine’.75, 91 that are named after men and women whose works are associated with biology and medicine.75, 90 Spanning The remotest of all individuals whose name is as- around 2,500 years of human history, these esteemed sociated with a medical crater, Hippocrates, son of names are connected to an array of contributions with- Apollodorus, was an influential figure in the history in many subdisciplines of the life sciences, includ- of medicine. Though there is little first-hand informa- ing anatomy, physiology, biochemistry, pathology, tion about him, his influences on medicine may be felt pharmacology, biophysics, and surgery. Collectively through the writings of his contemporaries and through therefore, these ‘medical’ craters provide a broad per- disciples of the Hippocratic School. Hippocrates is spective of the historical development of the medical thus known for his teachings on the doctrine of the profession and individually represent some of the most four humours, the natural origins of diseases (such celebrated milestones in the science and art of healing. as epilepsy), the vis medicatrix naturae (the healing Details of ten of the more historically significant med- power of Nature), the art of careful clinical observa- ical craters are compiled in this section, alongside a tion, and humanitarianism in medicine.92 Hippocrates brief biography of their namesakes – a comprehensive also provided original descriptions of wound healing alphabetically-arranged table charting all the medical by primary and secondary intentions, and his name craters follows. In these compositions, a planetocen- is associated with clubbing of the fingers, the sucus- tric coordinate system80 has been employed to specify sion of pleural effusions and gastric outlet obstruction, the surface locations of craters upon the moon. and pre-terminal facies.93, 94 It was also during Hippo- crates’ lifetime (around 400 B.C.) that a term for ‘can- Hippocrates cer’ – the Greek word karkinos meaning ‘crab’ – first appeared in the medical vocabulary to refer to malig- The crater Hippocrates (Figure 11a) is a relatively sim- nant growths of tissue.95 Today, Hippocrates is well- ple impact crater located in the northwestern quadrant known for his aphorisms and the statute of the ethi- (70.3°N, 146.5°W) on the far side of the Moon. The cal conduct of the physician – the Hippocratic Oath. outer rim, which is still visible despite erosion, is 60 Albeit attributed to post-Hippocratic authors, the Oath km in diameter and is overlain with smaller, more re- remains an important expression of medical ethics in cent impact formations. Several small craterlets also the Western World, Sir William Osler (1849-1919) remark the interior floor of the crater. Hippocrates is ferring to it as “the ‘credo’ of the profession”.96

a b

Figure 11: a) An oblique view of the crater Hippocrates (centre) on the far north of the Moon. Image extracted from Legrand C, Chevalley P. Virtual Moon Atlas, Version 6.0. Microsoft Windows Application, 2012. b) A 17th-18th century engraving depicting Hippocrates of Cos – the ‘father of medicine’. Courtesy of the Wellcome Collection.

22 Osleriana Medicine’s Lunar Legacies Vesalius tially entrusted to the centuries-old conclusions of Ga- len, whose anatomy was drawn largely from animal Vesalius is a moderately-sized complex crater (Fig- dissections.97 Vesalius set out to enlighten his pro- ure 12b) positioned amongst the crater-rich plains of fession by studying anatomy from human cadavers, the southeast farside, not far below the lunar equator a difficult endeavour in itself, and corrected many of (3.2°S, 114.8°E). The patriarchal crater has a diameter Galen’s oversights and misconceptions. For instance, of 64.7 km. Its northwestern rim rises slightly more Vesalius showed that the mandible was but a single precipitously than the southeastern, which, alongside bone, not two as Galen had suggested, and found no a concordantly displaced central peak, suggests its evidence of communicating pores between the lower formation followed a low angle hypervelocity impact. chambers of the heart.98 Simultaneously, Vesalius was Very few craterlets interrupt the interior floor but a able to identify previously unseen anatomies and pa- number of large satellite structures excavate the sur- thology – he gave the ‘mitral’ valve its name, noting rounding plain. Within one patriarchal diameter are its resemblance to the bishop’s mitre99 and was the found Vesalius D (easterly, 51.5 km in diameter), M first to identify aneurysms of the aorta.98 But Vesali- (southerly, a deep crater, 30.4 km), C (20.5 km) and us’ greatest contribution to medicine was undoubtedly G (12.9 km). Farther to the southeast are two other his opus vitae, the De Humani Corporis Fabrica Libri satellite craters, Vesalius H (38 km) and J (23.6 km) Septem (On the Fabric of the Human Body in Seven in an overlapping configuration. The crater is named Books), an encyclopaedic composition of human anat- after the influential sixteenth-century Flemish anato- omy first published in 1543.100 The Fabrica presented mist Andreas Vesalius (1514-1564)75, 76, 77 (Figure 12a). the subject in seven embellished volumes, featuring remarkably beautiful illustrations that brought both bone Andreas Vesalius of Brussels is regarded as a path- and blood vessel to life. Even to this day, over half a finder in human anatomy. During his academic post millennium since the birth of Vesalius, the Fabrica re- at the University of Padua, Vesalius recognised the mains one of the most influential texts in the history of suboptimal nature of anatomical instructions offered medicine and faithfully guards its author’s right to the to medical students, which were at the time reveren- epithet of “the maker of modern anatomy”.101

a b

Figure 12: a) This woodcut engraving of Andreas Vesalius, the founder of modern anatomy, is attributed to Jan Stephan van Calcar (1499-1546) and formed the frontispiece of Vesalius’ 1543 anatomical encyclopaedia De Humani Corporis Fabrica Libri Septem. Courtesy of the US Metropolitan Museum of Art. b) The Vesalius crater complex as seen in a (much larger) photograph taken by Apollo 16 in 1972. The patriarchal crater is the largest in diameter – note its relatively steep northwestern rim (in shadow) and the corresponding displacement of the central feature suggesting an oblique trajectory of the meteorite that formed it. On the lower right are the satellite craters Vesalius C, D and G. Vesalius M is the deep crater at the lower left of the image. From the Apollo Image Archive, Arizona State University.

July 2019 23 Z. Toodayan Harvey the heart expels blood in its contraction and receives it during relaxation, and that the pulsation of the arter- Crater Harvey (Figure 13b), 60 km in diameter, is sit- ies was due to the impulse of the blood within them. uated on the far-side of the Moon in the northwestern He was able to demonstrate, by way of mechanical quadrant, slightly north of the lunar equator (19.4°N, conceptualisation and mathematical calculation, that 146.5°W). The crater’s western rim disrupts the the blood coursed in a continuous cycle or circulation northeastern edge and floor of the much larger crater through the lungs and the rest of the body. Harvey Mach – a walled-plain 180 km in diameter. Harvey later published his observations upon the circulation demonstrates a low central peak which rises up to 1.2 in a 1628 booklet entitled Exercitatio Anatomica de km from the surrounding floor. The eastern interior, Motu Cordis et Sanguinis in Animalibus (Anatomical which is marked by lesser, eroded craters, rises steeply Exercises Concerning the Motion of the Heart and to a rim that is over twice the elevation of the opposite Blood in Living Creatures) which was received with edge within Mach. Harvey also features a simple but much criticism at the time. Harvey’s approach to de- prominent 8.7 km crater on the western interior and a ciphering the circulation by means of scientific inqui- high albedo craterlet on the southern floor. The cra- ry heralded the dawn of the experimental study of the ter is named after the eminent sixteenth-century En- human body and mirrored the transition towards the glish physician and anatomist, William Harvey (1578- new methods of science that were pervading early sev- 1657)75, 76, 77 (Figure 13a). enteenth-century Europe.102 Today, William Harvey is widely regarded as a founding father of physiology, William Harvey is remembered for providing the first and the De Motu Cordis a recognised landmark in the accurate description of the circulation of the blood. history of medicine. Within its pages are exhibited the Educated in anatomy at Padua by the great anatomist author’s clarity of thought and purpose as well as a Fabricius ab Aquapendente (1537-1619), Harvey em- recipe for his successes: “I profess both to learn and to ployed various experimental methods to ascertain the teach anatomy” he writes, “not from books but from vital function of the movement of the heart and blood dissections; not from the positions of philosophers but in living organisms. As early as 1616, he reasoned that from the fabric of nature”.103

a b

Figure 13: William Harvey and the lunar crater named after him. a) This 1630 oil-on-canvas portrait is attributed to the Dutch painter Michiel Janszoon van Mierevelt (1566-1641). Image sourced from The Athenaeum (www.the-athenaeum. org) with courtesy of the University College London Art Museum. b) The Harvey crater. The western portion of Harvey overlies the eastern edge of the large walled-plain Mach, part of which can be seen in the lower left of this photo. Image extracted from Quickmap, NASA Lunar Reconnaissance Orbiter Camera, Arizona State University School of Earth and Space Exploration.

24 Osleriana Medicine’s Lunar Legacies

a b

Figure 14: a) The Jenner crater is a partially-flooded impact structure within the Mare Australe (Southern Sea). A nascent wrinkle ridge on its relatively featureless floor and a characteristic mineralogical signature suggests it was filled by basaltic lava as opposed to impact melt.104 Prominent central peaks and terraced peripheries rise above the lava level. Image sourced from the Lunar Orbiter Photo Gallery, Lunar and Planetary Institute. b) Edward Jenner pastel by John Raphael Smith (1751- 1812). Courtesy of the Wellcome Collection.

Jenner Edward Jenner of Gloucestershire, a pupil of the famous Scottish surgeon John Hunter (1728-1793), is The crater Jenner (Figure 14a) is a 73.6 km complex best known for popularising the principle of vaccina- impact formation that is located in the zone of libration by demonstrating that inoculations of fluid from tion of the southeastern quadrant (42°S, 96°E) and cowpox blisters would protect an individual from within the Mare Australe (Southern Sea). Earth-based smallpox infection. As the story goes, Jenner decided viewing is difficult but may be accomplished under to subject to experimentation the well-known fact that conditions of favourable phase and libration. Jenner individuals with a history of cowpox infection – ‘va- exhibits a relatively well preserved rim with consider- riole vaccinae’ as he called it – became immune to the able circumferential terracing that is most prominent more serious disease of smallpox. On 14th May 1796, along the inner southeast. An inspection of the crater’s he inoculated a boy of eight years, one James Phipps surroundings indicates that it may have been punched (1788-1853), with fluid extracted from a pustule upon out of a pre-existing local highland whose residual a young milkmaid and a fortnight later inoculated him structure appears to correlate with the distribution of with smallpox. Surely enough, and despite repeated terracing within the crater itself and the inclination of exposure to smallpox, the lad remained well. In 1798, its floor. Jenner features a gathering of prominent cen- after reproducing these results, Jenner published his tral peaks which rise above a relatively smooth plain findings in a small volume entitled An Inquiry into the of solidified basaltic lava that is thought to have flood- Causes and Effects of the Variolae Vaccinae.105 Al- ed the crater from the interior.75, 76, 77, 104 There are three though the concept of variolation was old and effec- satellite formations associated with the patriarchal cra- tive, Jenner’s work served to transform the tradition ter, Jenner X, Y and M that range from 10.6 km (M) into scientific principle and thus ensured the protection to 31.2 km (Y) in diameter. The crater is named after of countless lives from the disability and devastation the English physician Edward Jenner (1749-1843)75 of contagious diseases; a feat that has been called “one (Figure 14b). of the greatest triumphs in the history of medicine”.106

July 2019 25 Z. Toodayan Koch aged by his early successes, Koch set out to study other maladies including traumatic wound infections and The impact crater Koch (Figure 15b) is 94.7 km in consumption (tuberculosis), the latter an extremely diameter and stationed in the southeastern quadrant prevalent and incurable disease at the time. In 1882, (42.1°S, 150.3°E) on the far-side of the Moon. It is an Koch announced his discovery of the tubercle bacil- older structure demonstrating rim erosion and multiple lus (now Mycobacterium tuberculosis) as the agent smaller overlying craters. The eastern rim rises up to 5 responsible for tuberculosis. His publication on the km above the floor of the crater and forms a prominent topic, Die Aetiologie der Tuberculosis (The Aetiology mountainous ridge over 50 km in length. Small cra- of Tuberculosis) became a medical classic and his dis- ters are scattered throughout the floor and peripheries covery was of such significance that it earned him the of Koch, with a discrete pair located just north of the 1905 Nobel Prize in Physiology or Medicine. Koch’s crater’s centre. There are two satellite craters, Koch famous paper also articulated a set of criteria, known U (26.7 km), abutting the western rim, and Koch R as Koch’s postulates, whose fulfilment was useful in (23.1 km) whose nearest edge is situated about half a ascertaining the microbial causes of diseases. He later crater-diameter to the southwest of the parent feature. invented tuberculin, which, albeit not the cure he was The crater is named after the German physician and hoping for, remained a useful diagnostic test for tuber- bacteriologist Robert Koch (1843-1910)75, 76, 77 (Figure culosis. Koch introduced meat-infused liquid gelatin 15a). culture media, steam sterilisation, and, whilst working with cholera in Egypt, recognised the significance of Robert Koch was a pioneering figure in the study and public sanitation in preventing endemic outbreaks of development of infectious diseases. His discovery of infections.108 Widely regarded as the ‘father of bacte- the cause and transmission of ‘splenic fever’ (anthrax) riology’, Robert Koch’s contributions triggered a par- in 1876 was the first association of a human disease adigm shift in the understanding of infectious illnesses with a micro-organism and the finding triggered the – a transformation that instilled both physicians and identification, by contemporary investigators, of the patients with a newfound hope for the conquest of the origins of several other infectious diseases.107 Encour- dreaded diseases of the age.

a b

Figure 15: a) Robert Koch, German physician and bacteriologist. Courtesy of the Robert Koch-Institut, Berlin. b) The Koch crater. Being an older formation, the southern rim is considerably eroded and there are many smaller craters overlying the parent structure. Note the prominent ridge that forms the crater’s eastern rim. Image extracted from Quickmap, NASA Lunar Reconnaissance Orbiter Camera, Arizona State University School of Earth and Space Exploration.

26 Osleriana Medicine’s Lunar Legacies

a b

Figure 16: a) A photograveure portrait of Paul Ehrlich. Property of the author. b) The Ehrlich crater (centre) is a shallow structure that is surrounded by several, similarly-sized satellite craters. Ehrlich J and Z are seen here at the 4 o’clock and 12 o’clock positions respectively. The crater at the 7 o’clock position does not have a formal designation. Image extracted from Quickmap, NASA Lunar Reconnaissance Orbiter Camera, Arizona State University School of Earth and Space Exploration.

Ehrlich of the tubercle bacillus with a novel ‘acid-fast’ technique.109 Ehrlich’s role in the purification and stan- The Ehrlich crater (Figure 16b) is a small and sim- dardisation of Emil Behring’s (1854-1917) diphtheria ple semi-weathered structure that lies within a highly antitoxin was essential to the practicality and success bombarded region of the northwest quadrant on the of the new discovery, and later on, Ehrlich gave one of far-side of the Moon (40.8°N, 172.3°W). It has a di- the earliest explanations for the origin of humoral im- ameter of 33.6 km and is surrounded by a population munity in his side-chain theory, for which he was sub- of craters of similar size and appearance. The floor of sequently awarded one-half of the 1908 Nobel Prize Ehrlich, about 1.7-1.9 km below the level of the sur- in Physiology or Medicine.110 The words ‘antibody’, rounding plain, is smooth and featureless and a couple ‘complement’,111 ‘receptor’,112 and ‘chemotherapy’110 of minute craters adhere to the uplifted rim. There are were all concepts and terms that were, alongside many four satellite craters (Ehrlich N, J, W and Z) that are others, introduced by Ehrlich during his long and pio- located between half and two crater-diameters from neering researches on immunity and haemolysis. He Ehrlich’s rim and measure between 20.2 km (N) and was also the first to conceive the process of autoim- 29.7 km (Z) in width. The formations are named after munity which he referred to as “horror autotoxicus”,111 Paul Ehrlich (1854-1915) (Figure 16a), an esteemed – a name befitting his (erroneous) conclusion as to the German physician and scientist.75, 76, 77 incompatibility of such processes with life. In 1909, Ehrlich and his colleague Sahachiro Hata (1873-1939) Paul Ehrlich’s contributions to biology and medicine developed the very first synthetic antimicrobial agent, were revolutionary – so very fundamental in fact, that compound 606 or Salvarsan, an arsenical antisyphilitic without them, the modern profiles of these life scienc- that was the incarnation of his ‘magic bullet’ concept es would be all but unrecognisable. Early in his ca- and the preceptor of all modern targeted drug thera- reer, Ehrlich’s affinity for chemical dyes resulted in the pies. Alongside these advances, Ehrlich also compre- discovery of the ‘mast cell’, and soon thereafter he for- hended the concepts of treatment resistance and the mulated histomorphological classifications of white notion of the ‘chemotherapeutic index’.110 In the cen- cells, anaemias, and leukaemias that still serve as the tury since his passing, Ehrlich’s ideas have become so basis for modern haematology. He also developed an thoroughly integrated into the diagnosis and treatment important urinary test – the diazo-reaction – for the de- of diseases that it is difficult to envisage the practice of tection of bilirubin, and improved Robert Koch’s stain modern medicine without them.

July 2019 27 Z. Toodayan Pasteur man, Pasteur had performed pioneering studies on the optical isomers of tartaric acid, which were valuable The Pasteur crater (Figure 17a), a large walled plain in furthering the science of stereochemistry.114 His with a diameter of just under 233 km, is the largest of later experiments on fermentation of wines and beers the medical family of lunar craters.113 Located in the were imperative in substantiating the germ theory of far southeast quadrant (11.6°S, 104.9°E), few details disease, and laid the foundations upon which Joseph of the formation are visible from Earth, even during Lister’s (1827-1912) antiseptic surgical principle conducive libration. The vast plain lies between the was advanced.115 For these reasons, alongside Rob- prominent nearby craters Hilbert, Sklodowska, Ein- ert Koch, Pasteur is regarded as a founding father of thoven, and Meitner, and is considerably aged, with bacteriology. From 1865, Pasteur applied himself to multiple, sizeable craters overlying the floor and north- comprehending the microsporidial silkworm disease western rim. The large crater Backlund (75.5 km) sits pébrine whose aetiology he elucidated amidst a plague adjacent to the southern rampart, just to the west of of the infestation in Southern France. He also discov- Hilbert whose northwestern lip closely approximates ered a number of other micro-organisms, including the the southeastern edge of Pasteur. There are fourteen bacillus of malignant oedema, Vibrion septique (now formally-recognised satellite craters associated with Clostridium septicum) which was the first anaerobic Pasteur, four of which are situated within the crater’s pathogen to be identified as a cause of disease. Like boundaries and the remainder upon or beyond it. The Jenner before him, he subdued the burden of infectious largest of the satellite craters is Pasteur Y with a diam- diseases with his attenuated chicken cholera, anthrax, eter of 49.9 km. The Pasteur plain is named for Louis and rabies vaccinations,114 and it was in fact Pasteur Pasteur (1822-1895) (Figure 17b), the famous French who coined the term ‘vaccine’ (from vacca, Latin for chemist and microbiologist.75, 76, 77 ‘cow’) to refer to these preventive viral inoculations.116 Though not a doctor, Pasteur remains an internation- The name Pasteur is synonymous with the process of al icon in the history of medicine, not a few having heat sterilisation (Pasteurisation) undertaken to extend regarded him as the “most perfect man who has ever the shelf-life of perishable foodstuffs. As a young entered the Kingdom of Science”.117

a b

Figure 17: a) The Pasteur crater, a large walled plain with a diameter of 233 km, is the largest of the medical craters. This photograph was taken by the Lunar Orbiter 2 spacecraft in November 1966. Multiple satellite craters overly the parental structure. One of these, Pasteur T, which lies on the western rim of the plain (9 o’clock position in this image) features in the iconic Earthrise photograph captured by Apollo 8 astronaut William A. Anders. The larger crater encroaching the 7 o’clock segment of Pasteur’s rim is Backlund. The Northern half of the crater Hilbert is also visible in the lower right corner of this photo. From the Lunar Orbiter Photo Gallery, Lunar and Planetary Institute. b) Louis Pasteur, portrait photograph by Paul Nadar (1856-1939). Courtesy of the Wellcome Collection.

28 Osleriana Medicine’s Lunar Legacies Landsteiner important blood group system and their identification enabled physicians and surgeons to safely administer Under reasonable magnification, the crater Landstein- blood transfusions for a variety of conditions. For this er (Figure 18b), though small, is readily visible from monumental contribution Landsteiner was awarded Earth. Located very near the centre of the vast and the 1930 Nobel Prize in Physiology or Medicine. Lat- relatively featureless plains of the Mare Imbrium (Sea er in his life, in 1937, he described the Rhesus factor, of Rains), the crater stands out as a well demarcated, now recognised as the second most important blood concave depression. Estimated to have been formed group system. Landsteiner’s other contributions in- during the Erastothenean period, between 3.2 and 1.1 clude his independent realisation of the utility of dark- billion years ago, the crater shows minimal weather- field microscopy for the identification of the spirochete ing and is well preserved. It’s bowl-shaped interior is of syphilis, his co-description in 1904 of paroxysmal fairly smooth and uninterrupted and reaches a depth cold haemoglobinuria – a form of haemolytic anaemia of about 1,350 metres. Noticeable nearby structures caused by a thermosensitive autolysin which became that may be used to locate the little crater include the the first condition to be recognised as an autoimmune intra-Imbrial craters, Archimedes (81 km diameter, lo- disease – his 1909 discovery of the polio virus, and his cated 239 km westwards), Timocharis (34.1 km, 127 introduction of the term ‘hapten’ to refer to non-pro- km south-southeast) and the small (9 km) crater Carlini teinaceious substances that demonstrated an affinity D which appears similar to though slightly larger than for antibodies but no intrinsic immunogenicity (i.e. no Landsteiner (51.2 km north-northeast). The crater’s antibody-provoking ability). Landsteiner’s later work name pays tribute to Karl Landsteiner (1868-1943) included exploring the role of haptens in anaphylac- (Figure 18a), a high-achieving Austrian physician and tic reactions and desentisitisation. By way of recog- immunologist.75, 76, 77 nition of the allergenic potential of haptens, he was able to conclude that allergies were a manifestation of Karl Landsteiner is best known for his discovery, an immunological process. Much like Ehrlich, Land- in the year 1900, of the major ‘ABO’ blood groups steiner’s works in haematology and immunology have (haemagglutinogens) which he categorised whilst ex- revolutionised these specialties – it was said of Land- perimenting on the ability of individual serums (ag- steiner that he “threw the bridge” between chemistry glutinins) to clump together or agglutinate foreign red and serology at a time when the two sciences were blood cells. The ABO blood groups comprise the most deemed independent and irreconcilable.118

a b

Figure 18: a) A portrait of Austrian physician and immunologist Karl Landsteiner. Image sourced from Alamy (www.alamy. com) b) The Landsteiner crater; a simple bowl-shaped formation that stands out conspicuously against the uninterrupted plains of the Mare Imbrium. Image extracted from Quickmap, NASA Lunar Reconnaissance Orbiter Camera, Arizona State University School of Earth and Space Exploration.

July 2019 29 Z. Toodayan Fleming overshadowed by it, paved the way for Fleming’s forthcoming finding. The serendipitous circumstanc- Fleming (Figure 19a) is a large crater, 126.4 km in dies of Fleming’s discovery of penicillin is much-told ameter, located beyond terrestrial view in the far north- in the history of medicine: Amidst a seemingly dis- east quadrant (14.9°N, 109.3°E). The crater is signifi- organised laboratory, Fleming noticed that one of his cantly weathered with low-lying and gently sloping staphylococcal cultures had been contaminated with a northern, eastern and western rims, and an abundance mould and that bacterial colonies in the vicinity of the of lesser well-eroded craters upon the central and pe- fungal growth were completely inhibited whilst those ripheral interior, many of which appear to have been further away from the mould continued to survive. flooded with lava. Three more recent interior craters Fleming further applied himself to isolating and iden- stand out amongst a community of depressions that tifying the fungus and to investigating the antibiosis are mostly clustered about the southern patriarchal thus demonstrated by the ‘mould juice’.121 He identi- semi-circumference. Despite the abundance of nearby fied the bacteriocidal properties of the active principle craters, Fleming has been allocted only four formal and its non-injurious nature to host tissues. The sub- satellite structures. The smallest, Fleming N (23.1 sequent purification and stabilisation of penicillin was km), lies upon the southern rim and the largest, Flem- an arduous task that was successfully accomplished by ing Y (51.9 km), sits about 32 km from its northwest- Ernst Boris Chain (1906-1979), a German biochemist ern boundary. The farthest of the satellites is Fleming working at Oxford, by a process involving lyophili- D, located about 68 km from the northeastern edge of sation, dissolution in methyl-alcohol, and dilution in the parent feature. The crater is, in part,119 named after water. Clinical trials of the purified penicillin were or- Sir Alexander Fleming (Figure 19b), a Scottish physi- chestrated by Chain’s superior, Howard Walter Florey cian, microbiologist, and pharmacologist.75, 76, 77 (1898-1968), an Australian physician and researcher, with the first successful clinical reports coming out of Sir Alexander Fleming is best known for his discovery the Radcliffe Infirmary in 1941.122 The efforts of Flo- of penicillin, an antibiotic he identified as being pro- rey and Chain translated Fleming’s laboratory discov- duced by the fungus Penicillium notatum in 1928. Ear- ery into a clinically useful antibiotic and all three were lier, in 1921, Fleming had isolated lysozyme, the natu- awarded a share of the 1945 Nobel Prize in Physiology rally occurring antimicrobial enzyme that is abundant or Medicine for their individual contributions to the in tears, mucous, and saliva.120 This discovery, though development of this marvellous substance.123

a b

Figure 19: a) The Fleming crater. A significant number of overlying impacts and flooding have caused much attrition to the original formation. Image extracted from Quickmap, NASA Lunar Reconnaissance Orbiter Camera, Arizona State Univer- sity School of Earth and Space Exploration. b) Sir Alexander Fleming in his laboratory in 1944. From the National Portrait Gallery, London.

30 Osleriana Medicine’s Lunar Legacies

a b

Figure 20: a) Frederick G. Banting, one of the discoverers of insulin. Image courtesy of the Banting House National Histor- ic Site of Canada. b) Banting crater; a small but conspicuous impact site within the Mare Serenitatis. Image extracted from Quickmap, NASA Lunar Reconnaissance Orbiter Camera, Arizona State University School of Earth and Space Exploration.

Banting ting devised an experimental method for extracting the unknown ‘hormone X’ from the pancreatic islets Crater Banting (Figure 20b) is a relatively minor cra- of Langerhans, clusters of cells previous investigators ter, only 5.2 km in diameter, that is situated on the had proven to be associated with diabetes. Aided by central basaltic plains of the Mare Serenitatis (Sea of his surgical background, he acquired undigested pan- Serenity) (25.6°N, 16.4°E). It is among the smallest creatic extracts from dogs and administered it to ca- in the family of medical craters but is well-placed for nines with diabetes induced by total pancreatectomies. telescopic observation. The structure of Banting, like Banting and Best succeeded in temporarily treating a that of Landsteiner, is rather simple, consisting of a diabetic dog in July 1920, and, using a modified tech- plain bowl-shaped interior that deepens to about 1,100 nique for the extraction of hormone X (which the pair metres and a well-demarcated circular rim that rises had named “isletin”) from bovine pancreases, mirac- about 150-200 metres above its surroundings. Apart ulously treated a patient with type-one diabetes in from several tiny unnamed craterlets, Banting’s im- January 1921.124 For the first time in human history mediate neighbourhood is considerably vacant. The physicians were able to intervene into the natural his- nearest named structures include three very small sat- tory of this ancient illness and salvage diabetics from ellite craters, Linne A, Linne D, and Bessel D (all be- the a definite and dismal demise. At the suggestion tween 4-5 km in diameter), the crater Sarabhai (7.4 km of Banting’s research advisor – the Scottish physiolo- in diameter), and the prominent parent crater Bessel gist John James Rickard Macleod (1876-1935) – and (15.6 km). The Banting crater takes the name of Sir in keeping with the designation previously assigned Frederick Grant Banting (1891-1941) (Figure 20a), a by Sir Edward Sharpey-Schafer (1850-1935),125 isletin Canadian surgeon and scientist.75, 76, 77 was renamed “insulin”, and the new treatment rapidly brought in all the worldwide sensation of a medical Sir Frederick Grant Banting is renowned for being the miracle.124 Banting and Macleod shared the 1923 No- co-discoverer of insulin, the first specific therapeutic bel Prize in Physiology or Medicine for their discov- agent used for the treatment of diabetes. Whilst teach- ery of insulin – Banting, who was thirty-two years old ing at the medical school of the University of West- when he received the Prize, distributed a half-share of ern Ontario, Banting’s interest turned to the role of it with Best and to this day remains the youngest med- the pancreas in diabetes and he began his researches ical Nobel Laureate.126 Tragically, Banting died at the on the subject along with his assistant Charles Her- young age of forty-nine following the crash of a Lock- bert Best (1899-1978), a young medical student with heed Hudson aircraft in Newfoundland a few minutes a background in physiology and biochemistry. Ban- into its flight across the Atlantic.127

July 2019 31 Z. Toodayan Such are the natures and namesakes of some of the further crater names of medical relevance in 2009 – more notable medical craters. There are howev- there will undoubtedly be new identities to add to this er many more lunar craters with special links to the list in the future. medical profession, and a comprehensive account of all such craters has been tabulated below. The table But what does the recollection of these past pioneers lists the name of the crater, its selenocentric coordi- offer the profession today? To the modern- practi nates and diameter, and provides a brief overview of tioner, the collective import of these men and women the individual after whom it is named, including his should be plain and indisputable – the names of many or her occupation and important contributions as they linger in the lexicon of the medical sciences, attached relate to the medical profession. There are those cra- to some structure, instrument, procedure, illness, the- ters honouring the astronomical contributions of the ory or phenomenon, whilst others have fundamentally physician-astronomers but these have been left out rectified our comprehension of human health and dis- of the table, since in these instances, specific medical ease. Their lives indicate that much can be achieved contributions cannot be appropriated.79 On the other by an independent and motivated mind, and highlight hand, there are a few craters named after non-medical the intrinsic potential and ability of every individual personnel whose discoveries and inventions are very practitioner. Reflecting upon these personalities today, relevant to healthcare and these names have been ac- medical students, physicians, surgeons, and scientists commodated into this compilation. Considering that the world over may find great examples of productiv- undesignated craters are still able to be named – the ity and progress; examples that might inspire some to International Astronomical Union approving seven further our own medical frontiers.

Coordi- Crater Name nates & Occupation & Namesake Contributions to Medicine (Satellites)75 Diame- Honours ter75, 80 Aristoteles128 50.2°N Aristotle of Ancient Greek Authored early texts on zoology, biology, and anatomy 17.3°E Stagira (384 philosopher and (e.g. Historia Animālium, De Partibus Animalium, De (D, M, N) -322 B.C.) natural scientist. Generatione Animalium).129 87.6 km A founder of Undertook pioneering studies in comparative anatomy biology and the and embryology.129 first scientific Understood the relationship between the form of ana- anatomist.129 tomical structures and their purpose and conceptualised organs as individual functional parts of the body.129 Recognised the heart as being at the centre of the vascular system and noted that blood vessels pulsate in syn- chrony with the heartbeat.129 Described the meninges and distinguished the cerebrum and cerebellum.129 Provided the first reference to the Eustachian tube and described the structure and function of the epiglottis.128 Introduced the terms ‘part’, ‘gastrocnemius’, ‘hypo- chondrion’,129 ‘hypogastrion’, ‘ureter’,130 ‘aorta’131 and others. Avery 1.3°S Oswald Theo- Canadi- Recognised the influence of the antigenic make-up of 81.4°E dore Avery Jr. an-American encapsulated microorganisms upon their pathogenicity, (1877-1955) physician laying the foundations for immunochemistry.132 10.7 km and medical Identified (alongside others) ‘desoxyribonucleic acid’ researcher. (DNA) as the hereditary material that constituted genes and chromosomes.132 Avicenna 39.6°N Abu Ali Persian physi- Authored Al-Qānūn fī al-Ṭibb (The Canon of Medicine), 97.3°W Husain ibn Ab- cian, polymath, “the most famous medical text-book ever written”.134 (E, G, R) dullah ibn Sīnā and scholar. The Canon systemised Graeco-Arabian medicine into 73 km (Avicenna) The ‘Prince of an axiomatic discipline and remained an authoritative (c.980-1037) Physicians’.133 medical encyclopaedia for a longer period than any other medical work.134 Provided early descriptions of anthrax (‘Persian fire’) and the sweet tasting urine in diabetes.135

32 Osleriana Medicine’s Lunar Legacies

Banting 26.6°N Frederick Canadian sur- Co-discovered the pancreatic hormone insulin, the first 16.4°E Grant Banting geon & scientist. specific treatment for diabetes mellitus.125 (1891-1941) 5.2 km 1923 Nobel Prize in Physiol- ogy or Medi- cine.126 Bilharz 5.8°S Theodore Max- German Discovered (in 1851) the parasitic helminth (now Schis- 56.3°E imilian Bilharz physician and tosoma haematobium) that causes schistosomiasis (snail (1825-1862) parasitologist. fever, tropical haematuria, or Bilharzia).136 44.6 km Cajal 12.6°N Santiago Spanish neu- Developed the neuronal doctrine – the theory that the 31.1°E Ramón y Cajal roscientist & nervous system was composed of morphologically dis- (1852-1934) pathologist. continuous but functionally co-operative neurones.137 8.6 km Described dynamic polarisation of neurons – the direc- 1906 Nobel tion of conduction in dendrites is cellulipetal (towards Prize in Physiol- the cell body) and cellulifugal (away from the cell body) ogy or Medi- in the axis cylinder (axon).137 cine.137 Classified neuroglia.138 Introduction of several new and improved neurohisto- logical staining techniques.139 Interstitial cells of Cajal – myenteric pacemaker cells.138 Cajal-Retzius cells – ephemeral reelin-producing neurons in the developing mammalian telencephalon.140 Carrel 10.7°N Alexis Carrel French surgeon Devised a safe and reliable technique for the anastomo- 26.7°E (1873-1944) and biologist. sis of blood-vessels, enabling improved organ transplan- tation.141 15.6 km 1912 Nobel Co-developed, with Charles A. Lindbergh (1902-1974), Prize in Physiol- the organ perfusion pump for donor organs.142 ogy or Medi- cine.141 Cori143 50.5°S Gerti Theresa Czech-Ameri- Discovered, alongside her husband Carl Cori, the mech- 152.9°W Cori (1896- can biochemist. anism of glycogen metabolism through the lactic acid 1957) cycle (Cori cycle).145 67.2 km 1947 Nobel Identified glucose-1-phosphate (Cori ester) and glyco- Prize in Physiol- gen phosphorylase.145 ogy or Medi- Cori-Forbes disease – glycogen storage disease type III cine.144, 145 (limit dextrinosis, glycogen debranching enzyme deficiency or amylo-1,6-glucosidase deficiency).146 Crile 14.2°N George Wash- American sur- Performed the first successful direct human (artery to 46°E ington Crile geon. vein) blood transfusion (1906).147 (1864-1943) Developed the theory of ‘anoci-association’ – utilising 9.3 km a combination of opiods, regional and general anaes- thesia, alongside the mitigation of anxiety, to reduce the risk of intra-operative shock.148 Namesake for the Crile forceps.149 Cuvier 50.3°S Georges Cuvi- French natural- Ducts of Cuvier – the common cardinal veins that con- 9.7°E er (1769-1832) ist & zoologist. vey venous blood to the sinus venosis, a triangular cav- (A, B, C, D, ‘Father of verte- ity preceding the embryonic heart. They are anatomical E, F, G, H, J, 77.3 km brate paleontol- precursors of the sinus venarum, coronary sinus and a K, L, M, N, ogy’.150 portion of the superior vena cava.151 O, P, Q, R) Dale 9.6°S Henry Hallet English phar- Discovered the adrenaline-inhibiting (sympatholytic) 82.9°E Dale macologist & effects of ergotoxine and introduced it as the first adren- (1875-1968) physiologist. ergic antagonist.152 23.4 km Identified the physiological effects of primary and sec- President of the ondary amines.152 Royal Society Discovered the oxytocic and vasopressor activities of (1940-1945).152 posterior pituitary extract (1909).152 (continued) (continued)

July 2019 33 Z. Toodayan

1936 Nobel Identified the contractile activity of smooth muscle in Prize in Physiol- anaphylactic reactions.152 ogy or Medi- Described the physiological properties of β-iminazoly- cine.152 lethylamine (histamine) and demonstrated its natural occurrence in tissues.152 Identified the dual muscarinic and nicotinic effects of natural acetylcholine (1914), a finding which, alongside Otto Loewi’s (1873-1961) later experiments, proved the existence of chemical neurotransmission.152 Contributed to the international standardisation of posterior lobe pituitary extracts, neoarsphenamine, digitalis, and insulin.152 Coined the terms ‘sympathomimetic’, ‘adrenergic’, ‘cholinergic’, ‘cholinoceptive’, & ‘adrenoceptive’.152 Darwin153 19.9°S Charles English natu- Independently discovered the theory of evolution – the 69.2°W Darwin (1809- ralist. variation and speciation of all life occurs through nat- (A, B, C, F, 1882) ural selection which favours lifeforms best-adapted to G, H) 122.2 km their environmental conditions and implies, by way of divergence of character, a common ancestry for all living things.154, 155 Authored On the Origin of Species (1859), one of the most important scientific books ever written.154 Darwin’s tubercle (tuberculum auriculare) – an atavism featuring as ‘a little blunt tip projecting from the inward- ly-folded margin, or helix’ of the human ear.156, 157 da Vinci 9.1°N Leonardo da Italian Renais- Made substantial improvements to methods of anatom- 45°E Vinci (1452- sance polymath. ical illustration.158 (A) 1519) Described the concept of antagonistic muscles.158 37.5 km Gave the first accurate descriptions and drawings of the frontal and maxillary sinuses, and of human dentition.158 First to reveal the three-dimensional structure of a body cavity – the cerebral ventricles (using melted wax).158 Identified artherosclerosis and its role in coronary occlu- sion and death.158 Made the earliest drawing of the vermiform appendix (‘auricle of the colon’).158 First to identify the four-chambered nature of the heart, a patent foramen ovale, and the structure and function of the moderator band of the right ventricle.158 Provided the first description of the aortic sinuses and the correct explanation for the mechanism of closure of the aortic valve.159 Postulated the existence of minute circulatory channels;158 credited with introducing the term ‘capillary’.160 Recognised the correct number of human vertebrae as thirty-one and accurately depicted the double-curvature of the spinal column.158 First to recognise the unilocular nature of the uterus, the correct attitude of the foetus in utero, and the separation of foetal and maternal circulations in placenta and umbilical cord.158 Identified the role of arterial influx in establishing penile erection and the testicular origin of semen.158 Davy161 11.9°S Sir Humphry English chemist Utilised electrolysis to isolate and name several clini- 8.2°W Davy and inventor. cally relevant elements – potassium and sodium (1807), (A, B, C, G, (1778-1829) and calcium, strontium, barium and ‘magnium’ (magne- K, U, W) 33.9 km President of The sium) (1808).163 Royal Society Identified the anaesthetic properties of nitrous oxide (1820-1827).162 and named the substance ‘laughing gas’.164

34 Osleriana Medicine’s Lunar Legacies

Ehrlich 40.8°N Paul Ehrlich German physi- Discovered the mast cell (1892).109 172.3°W (1854-1915) cian and medi- Recognised the importance of the specific affinity of (J, N, W, Z) cal scientist. chemicals in the processes of life.109 33.6 km Provided early histomorphological classifications of 1908 Nobel leucocytes, anaemias, and leukaemias.109 Prize in Physiol- Devised the urinary diazo-reaction for detection of bil- ogy or Medi- irubin and an acid-fast stain for the tubercle bacillus.109 cine.110 Introduced serum standardisation techniques that enhanced yields and utility of diphtheria antitoxin.110 Devised the side-chain theory of humoral immunity (1897), an early theory of antibody production.110 Introduced the terms ‘antibody’, ‘complement’, 111 ‘receptor’112 and ‘chemotherapy’.110 First to conceive the process of autoimmunity (‘horror autotoxicus’).111 Co-developed the anti-syphilitic arsphenamine (Salvar- san, 1909) – the first successful synthetic antimicrobial agent designed to treat a human infection.110 Established the pharmacological notions of ‘therapeutic index’, treatment resistance, and combination therapy.110 Heinz-Ehlrich bodies – round oxyphilic inclusions composed of defective haemoglobin seen within erythro- cytes. They may be a marker of oxidative stress, hae- moglobinopathies, or hyposplenism for example.165 Ehrlichia – a genus of Gram-negative pleomorphic Rickettsiales bacteria; one of the causes of the tick- borne illness Ehrlichiosis.165 Eijkman 63.2°S Christiaan Ei- Dutch physician Discovered the association between beriberi and a diet 142.5°W jkman (1858- and physiolo- of polished rice (1893). These studies resulted in the (D) 1930) gist. discovery of vitamin B1 (thiamine) (and subsequently 56.4 km other vitamins) by other investigators.166, 167 1929 Nobel Eijkman test (differential coliform test) – a test to iden- Prize in Physiol- tify aqueous coliform bacteria from warm-blooded ani- ogy or Medi- mals, based on their ability to ferment glucose at 46°C. cine.166 Used as a test for faecal contamination of water.168 Einthoven 5.1°S Willem Eintho- Dutch physician Invented the string galvanometer which greatly facilitat- 110.1°E ven (1860- and physiolo- ed accurate electrical tracings of the heart’s activity.170 (G, K, L, M, 1927) gist. Introduced the term ‘electrocardiogram’.170 P, R, X) 73.9 km Einthoven’s triangle – a conceptual equilateral triangle 1924 Nobel comprised of the three limb leads of the electrocardio- Prize in Physiol- gram, with the apices positioned at the right wrist, left ogy or Medi- wrist, and left hip, all equidistant from the heart.169 cine.169 Einthoven’s law – the voltage in lead II of the electrocardiogram is equal to the sum of the voltages in leads I and III.169 Erlanger 87°N Joseph Er- American phys- Identified and classified the several varieties of nerve 28.6°E langer (1874- iologist. fibres and demonstrated the relationship between fibre 1965)171 diameter and velocity of action potentials.172 10.9 km 1944 Nobel Demonstrated the dependence of proteinuria on pulse Prize in Physiol- pressure (rather than systolic blood pressure) in ortho- ogy or Medi- static proteinuria.172 cine.172 Experimentally established the complete dependence of atrioventricular conduction on the bundle of His.172 Introduced the cathode ray oscilloscope into neurophys- iology.172 Fechner 58.3°N Gustav Theo- German philos- Introduced Weber’s law [based on the works of Ernst 125°E dore Fechner opher, physicist Heinrich Weber (1795-1878)] – a noticeable difference (T) (1801-1887) and experimen- in the perception of a stimulus is proportional to the rela- 59.3 km tal psychologist. tive difference of the stimulus (i.e. ratio of the size of the 174 (continued) difference to the size of the original stimulus). (continued)

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‘Founder of Developed a refinement of Weber’s law (Fechner’s law psychophys- or Weber-Fechner law175) – the magnitude of a subjective ics’.173 sensation is proportional to the logarithm of the magnitude of the stimulus expressed in terms of its threshold value (fundamental stimulus value). This implies that ‘an increment of stimulus causes an ever decreasing increment in sensation’.174 Coined the term psycophysics.173 Fechner’s colours (pattern induced flicker colours) – an illusion of colour that is perceived when viewing moving, contrasting (e.g. black-and-white) patterns.176 Fernelius 38.2°S Jean Francois French Renais- Authored the Physiologia (initially On the Natural Part 4.9°E Fernel sance physician of Medicine, as part of the three-volume Universa Me- (A, B, C, D, (Fernelius) and astronomer. dicina), a medical text that systematically comprehend- E) 68.4 km (1497-1558) ed the functions of the body in a manner conducive to the principles of scientific physiology.177, 178 First to use the word ‘physiology’ (‘physiologia’) in the scientific sense of the term.177 Credited with being the first to observe the hollow central canal of the spinal cord.179 Finsen 42.3°S Niels Ryberg Faroese physi- First to experimentally demonstrate the injurious effects 177.7°W Finsen (1860- cian and medi- of ultraviolet radiation (‘chemical rays’) on the skin.181 (C, G) 1904) cal scientist. Pioneered phototherapy with the successful application 73 km of violet and ultraviolet light (UVA radiation) for the 1903 Nobel treatment of lupus vulgaris (1895), a common cutaneous Prize in Physiol- manifestation of tuberculosis. This work laid the foun- ogy or Medi- dations for photobiology.181 cine.180, 181

Fischer 8°N Hermann Emil German chem- Isolated phenylhydrazine (1875) and created indole 142.4°E Louis Fischer ist. ‘Father of (1886), an intermediate in the synthesis of many dyes (1852-1919)180 biochemistry’.183 and pharmaceuticals.184 30.5 km Introduce the term ‘purine’ (1897) for the shared base 1902 Nobel structure of caffeine, theobromine, xanthine, adenine, Prize in Chem- uric acid, and guanine.184 Synthesised purines and rec- istry.184 ognised their significance in living cells183 and in gout.185 Deciphered the chemical structures of sugars, including the isomers of glucose.184 Discovered the amino acids valine, proline, and hy- droxyproline. Synthesised oligopeptides up to eighteen monomers in length.184 Introduced the concept of enzymatic stereospecificity in the ‘lock and key’ model of enzyme action (1894).184 Synthesised the first commercially available barbiturate [5,5-diethylbarbituric acid (Veronal) 1903] which was used as a sedative.184 Made the first synthetic nucleotide, theophylline-d-glu- coside phosphoric acid (1914).184 Fischer projection method – a method of representing three-dimensional chemical structures on a two-dimensional surface.183 Fleming 14.9°N Sir Alexander Scottish Discovered lysozyme (1921), the naturally occurring 109.3°E Fleming (1881- physician and antimicrobial enzyme that is abundant in tears, mucous (D, N, W, Y) 1955)119 pharmacologist. and saliva.120 126.4 km Discovered the antibiotic effect of penicillin (1928), a 1945 Nobel product of the fungus Penicillium notatum.121 Prize in Physiol- ogy or Medi- cine.123

36 Osleriana Medicine’s Lunar Legacies

Florey 87°N Howard Walter Australian Explored the biochemical and biological properties of 19.8°W Florey (1898- pharmacologist purified extracts of penicillin with Ernst B. Chain in Ox- 1968) & pathologist. ford.186 69.1 km Coordinated the first human trials of purified penicillin President of the at the Radcliffe Infirmary in Oxford (1941), demonstrat- Royal Society ing its efficacy in the treatment of staphylococcal and (1960-1965).186 streptococcal infections.187 Initiated efforts that resulted in the large scale produc- 1945 Nobel tion of penicillin in America, enabling the utilisation of Prize in Physiol- penicillin during World War II.187 ogy or Medi- cine.186 Fracastorius 21.4°S Girolamo Italian Renais- Investigated the disease known as ‘love-pestilence’189 or 33.1°E Fracastoro of sance physician, ‘French disease’ and named it ‘Syphilis’ after the pro- (A, B, C, D, Verona (1484- poet, & astron- tagonist of his classic poem about the malady190 Syphilis E, G, H, J, K, 120.6 km 1553)188 omer. sive Morbus Gallicus (1530), which has been described L, M, N, P, Q, as “the most successful medical poem ever written.”191 R, S, T, W, X, Authored the De Contagione et Contagiosis Morbis Y, Z) (1546), a three-volume essay on contagious diseases.191 Comprehended the modes of transmission of infectious disease, including contact transmission, ‘fomites’ (introduced the term), and airborne transmission.191 Differentiated various types of fevers.191 Provided the first description of epidemic typhus and noted the contagious nature of tuberculosis.191 Freud 25.8°N Sigmund Freud Austrian neu- Formulated pscychoanalysis – a non-scientific theory 52.4°E (1856-1939) rologist. Father and therapy for mental illnesses that regards the influ- of psychoanaly- ence of the unconscious on the conscious mind and body 2.9 km sis.192 as a cardinal cause for personalities, behaviours, physical symptoms and psychiatric disorders.192 Developed (from 1900) a topographical model of the mind composed of the conscious, subconscious and unconscious minds, and a model of the psyche (1923) comprised of the id, ego, and superego.192 Proposed different stages and aspects of psychosexual development that can contribute to personality and mental disorders.192 Authored The Interpretation of Dreams (1899), a book concerning the investigation of the unconscious mind through the analysis of dreams.192 Freudian slip (parapraxis) – a transient error in speech (‘slip of the tongue’), memory, or movement, that may be due to unconscious influences, distraction, strong association or mental fatigue.193 Galen 22°N Claudius Galen Greek physi- Proved that arteries contained blood (and not air) and 5°E of Pergamon cian, surgeon devised an explanation for the mechanism of respira- (A.D. 130- and philosopher. tion. Demonstrated the function of the laryngeal nerves 9.2 km 200)194 ‘The greatest in voice production, the consequences of sectioning the Greek phy- spinal cord, and the independence of the heartbeat from sician since its nervous connections.195 Hippocrates’.195 Postulated a primitive and influential theory of the circu- Physician to latory system197 that was founded upon Aristotelean and the gladiators Alexandrinian concepts.195, 198 of Pergamon, Understood the role of heart valves in directing the flow and to Roman of blood and appreciated that arteries and veins anasto- emperor-philos- mose by way of ‘extremely small vessels’.198 opher Marcus Credited with the first description of the cranial nerves Aurelius (A.D. (recognised seven of twelve pairs), the sympathetic 121-180).196 chain, the recurrent laryngeal nerve and other neuroana- tomical structures.198 (continued)

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Identified loss of function (functio laesa) as a fifth cardinal sign of inflammation.199 Established the tradition of assessing the pulse.200 Authored numerous medical works, most famously De Usu Partium193, that remained authoritative in European medicine for almost fifteen centuries.195 Namesake for the internal cerebral vein of Galen and great cerebral vein of Galen.201 Galvani 49.5°N Luigi Aloisio Italian physi- Demonstrated that the function of muscles and nerves is 84.6°W Galvani (1737- cian, biologist dependent on an intrinsic animal electricity.203 (B, D) 1798) and physicist. Postulated that electricity could be stored in muscles by 76.8 km Founder of way of a differential charge distribution on the internal electrophysiol- and external surface of muscle fibers.203 ogy.202 Namesake for the galvanometer, galvanic current, and galvanisation.203 Golgi 27.8°N Camillo Golgi Italian physician Golgi stain/method/impregnation – silver chromate or 60°W (1843-1926) and pathologist. black reaction (la reazione nera).204 Golgi apparatus/complex – internal reticular apparatus 5.6 km 1906 Nobel of the cell for the processing of proteins.204 Prize in Physiol- Golgi tendon organ/reflex – sensory receptors within ogy or Medi- muscles involved in the maintenance of muscle tone and cine.204 the afferent limb of tendon reflexes.204 Golgi cells – cerebellar inhibitory interneurons.204 Pericellular nets of Golgi – finely reticulated mesh of ex- tracellular hyaluronate-binding proteins in the vicinity of large neurones.205 Golgi-Mazzoni corpuscles – lamellar mechanoreceptors abundant in the fingertips.204 Muller-Golgi tubules – gastric parietal cell canaliculi.204 Cones of Golgi-Rezzonico204 – fixation artefact206 corresponding to Schmidt-Lanterman incisures.207 Golgi cycle – erythrocytic cycle of malarial parasites.204 Golgi law – relationship between tertian and quartan malarian fevers and the multiplication of blood-borne Plasmodium.204 Gruithuisen 32.9°N Franz von Pau- French surgeon Provided German translations of the works of Hippo- 39.8°W la Gruithuisen and astronomer. crates.56 (B, E, F, G, (1774-1852) Pioneered techniques and instrumentation for lithotri- H, K, M, P. 15 km ty (pulverisation) and transurethral removal of bladder R, S) stones.60 Gullstrand 45°N Allvar Gull- Swedish oph- Devised accurate mathematical models of the dioptrics 129.7°W strand (1862- thalmologist and of the eye, including astigmatism.209 (C) 1930) mathematician. Pioneered keratoscopy.209 45.1 km Contrived an intracapsular theory of accommodation.210 1911 Nobel Invented the reflexless ophthalmoscope.210 Prize in Physiol- Invented the slit-lamp biomicroscope (1911).209 ogy or Medi- Gullstrand exact schematic eye – a highly accurate re- cine.208 fractive model of the human eye featuring precisely positioned cardinal planes.209 Gullstrand lens – for indirect ophthalmoscopy.209 Haldane211 1.7°S John Burdon English evolu- Made pioneering contributions in the fields of mathe- 84.1°E Sanderson tionary biolo- matical evolutionary biology, population genetics, and Haldane (1892- gist. A founder biochemical genetics.212 40.3 km 1964) of population Introduced the terms coupling (cis) and repulsion (trans) genetics. for genetic linkage, and the units Morgan and Darwin for measuring linkage and evolutionary change.212 First to decipher the rate of mutation of a human gene (haemophilia, 10-5 per generation).213 Contributed theories on the origin of life (abiogenesis)214 and steady-state enzyme kinetics... (continued)

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... (Briggs-Haldane equation).212, 214 Haldane’s malaria hypothesis – sickle-cell disease con- fers some immunity to malaria.214 Harvey 19.4°N William English Authored Exercitatio Anatomica de Motu Cordis et San- 146.5°W Harvey (1578- physician and guinis in Animalibus (1628), a pioneering feat of exper- 1657) anatomist. imental physiology containing the first accurate descrip- 60 km tions of the systemic circulation.102 Helmholtz215 68.6°S Hermann Lud- German Work on physiological optics (e.g. theory of accommo- 65.3°E wig Ferdinand physician and dation of the lens) and audition.216 (A, B, D, F, von Helmholtz physicist. Invented the direct ophthalmoscope (‘eye-mirror’) for H, J, M, N, R, 110.2 km (1821-1894) examination of the living retina (1851).217 S, T) Young-Helmholtz theory – the trichromatic origin of colour vision.216 Hevesy 83.1°N George Charles Hungarian ra- Introduced the tracer principle and pioneered its biolog- 149.2°E de Hevesy diochemist. ‘Fa- ical application by way of various natural and synthetic (1885-1966) ther of nuclear radioisotopes.218 50 km medicine’.218 Identified (using phosphorous-32, 1935) the dynamic state of the body constituents (the incessant renewal of 1943 Nobel molecules in the body).218 Prize in Chem- Introduced the term ‘indicator’ as a label for radioele- istry.218 ments used in biological and chemical investigations.218 Heymans 74.8°N Corneille Jean Belgian phys- Conducted important experimental work on the chemo- 144.9°W François Hey- iologist and receptors and baroreceptors of the carotid body (glomus (D, F, T) mans (1892- pharmacologist. caroticum) that demonstrated their role in the regulation 46.5 km 1968) of respiration and blood pressure respectively.219 1938 Nobel Prize in Physiol- ogy or Medi- cine.219 Hippocrates 70.3°N Hippocrates of Greek physi- Taught the humoral theory of disease.92 146.5°W Cos cian. ‘The father Espoused humanitarianism and the importance of care- (Q) (c.460 - c.370 of medicine’.91 ful observation in medicine.92 59.2 km B.C.) Promoted the idea of the natural (rather than divine) origin of diseases (e.g. epilepsy) and the vis medicatrix naturae (the healing power of nature).92 Gave the first description of wound healing by primary and secondary intention.92 Recognised the association between gibbous spine (Pott’s disease) and phthisis (pulmonary tuberculosis).93 Hippocratic facies – preterminal facies.93 Hippocratic fingers – clubbing.94 Hippocratic succussion – dynamic splash of pleural effusions and gastrointestinal tract obstruction.94 Hippocratic Oath – ancient dictum enunciating the ethical responsibilities of physicians.94 Hooke220 41.1°N Robert Hooke English poly- Authored Micrographia (1665), a pioneering exhibition 54.9°E (1635-1703) math. of the natural world as it appeared through a micro- (A, D) scope and in which the term ‘cell’ was introduced.221 34.4 km Conducted early experiments in respiratory physiology, including artificial ventilation.221 Houssay 83.1°N Bernardo Al- Argentinian Discovered the role of the anterior pituitary in the regu- 98.5°E berto Houssay physiologist. lation of blood glucose.222 (1887-1971) Conducted experiments on renovascular hypertension 31.4 km 1947 Nobel that later led to the discovery of renin.222 Prize in Physiol- Houssay-Biasotti phenomenon/syndrome – resolution ogy or Medi- of diabetes following hypophyseal extirpation or hypop- cine.222 ituarism (vanishing diabetes).223

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Huxley224 20.2°N Thomas Henry English biolo- Studied Man’s evolutionary relationship to other pri- 4.5°W Huxley (1825- gist, palaeon- mates.225 1895) tologist and Huxley’s layer – a layer of cells in the inner root-sheath 3.5 km comparative of hair.225 anatomist.

President of the Royal Society (1883-1885).225 Jenner 42°S Edward Jenner English physi- Established vaccination as a scientific principle by 96°E (1749-1823) cian. demonstrating that inoculations of fluid from cowpox (M, X, Y) blisters would protect an individual from smallpox in- 73.7 km fection.105 Karrer 52.1°S Paul Karrer Swiss organic Derived the chemical structures of carotenoids and iden- 142.3°W (1889-1971) chemist. tified the structural relationship between beta-carotene and vitamin A (retinol, first vitamin whose structure was 55.6 km 1937 Nobel discovered, 1931).226, 227 Prize in Chem- Synthesis of vitamin B2 (riboflavin, 1935).227 istry.226 Contributions towards the structure and function of nic- otinamide adenine dinucleotide.227 Koch 42.1°S Robert Koch German physi- Discovered the causative agent of anthrax (now Bacil- 150.3°E (1843-1910) cian and micro- lus anthracis, 1876); the first association of a disease (R, U) biologist. Father with a specific microorganism.107 94.7 km of modern Discovered the causative agent of tuberculosis (Koch’s bacteriology. bacillus, now Mycobacterium tuberculosis, 1882)108 and cholera (now Vibrio cholerae).107 1905 Nobel Koch’s postulates.108 Prize in Physiol- Introduced tuberculin, meat-infused liquid gelatin cul- ogy or Medi- ture media106 and steam sterilisation.107 cine.108 Kocher 84.5°S Emil Theodor Swiss surgeon. Furthered knowledge on the physiology, pathology, and 134°W Kocher (1841- surgery of the thyroid.229 1917) 1909 Nobel Performed the first thyroidectomy for goitre (1878).229 24.0 km Prize in Physiol- Kocher incision – right subcostal incision for cholecys- ogy or Medi- tectomy.228 cine.228 Kocher manoeuvre – reduction of anterior shoulder dis- locations.228 Kocher-Debre-Semalaigne syndrome – infantile hypo- thyroid myopathy (muscular pseudohypertrophy and myxoedema) with cretinism.228 Krogh 9.4°N Schack August Danish phys- Discovered the mechanisms that regulate capillary cir- 65.7°E Steenberg iologist & culation in skeletal muscle.230 Krogh zoophysiolgist. Work on the mechanism of gas exchange in the lung 19.2 km (1874-1949) (diffusion theory) and tissues.230 1920 Nobel Krogh tissue cylinder model – a simple geometric model Prize in Physiol- allowing for a basic mathematical analysis of the diffu- ogy or Medi- sion of solutes and gases between capillaries and their cine.230 surrounding tissues.231 Contributed to the introduction and production of insulin preparations in Denmark.230 Landsteiner 31.3°N Karl Land- Austrian Discovered the polio virus (1909).118 14.8°W steiner (1868- physician and Discovered the ABO (Landsteiner classification232) 1943) immunologist. blood groups.118 6.1 km Identified Rhesus factor (1937).118 1930 Nobel Recognised the utility of dark-field microscopy for the Prize in Physiol- identification ofTreponema pallidum.118 ogy or Medi- Contributed to the understanding of allergy as an immu- cine.118 nological manifestation.118 Introduced the term ‘hapten’.118 (continued)

40 Osleriana Medicine’s Lunar Legacies

Donath-Landsteiner syndrome – paroxysmal cold haemoglobinuria; the first condition to be recognised as an autoimmune disease.118 Laveran 81.8°S Charles Louis French military Discovered the parasitic cause of malaria (paludisme) 159.8°W Alphonse physician. (Oscillaria/Haemamoeba malariae, now Plasmodium Laveran (1845- spp., 1880); the first disease to be associated with a pro- 12.5 km 1922) 1907 Nobel tozoan pathogen.233 Prize in Physiol- Contributed to the understanding of trypanosomal in- ogy or Medi- fections, particularly African trypanasomiasis (sleeping cine.233 sickness).234 Laveran bodies – erythrocytic malarial parasites.235 Laverania – old genus name for Plasmodia.233 Leeuwenhoek 29.3°S Antony van Dutch scientist. Provided the first description of micro-organisms (‘an- 178.9°W Leeuwenhoek ‘Father of mi- imalcules’, 1674),236 including protists and bacteria.237 (E) (1632-1723) crobiology’.236 Gave the first descriptions of spermatozoa, striations of 125 km voluntary muscle, the microscopic structure of the crys- talline lens,237 and crystals in gouty tophi.238 Gave an early description of red blood cells (1674),237 together with an accurate estimate of their size.238 Pos- sibly described vacuoles and cilia too.236 Conducted early studies on the capillary circulation.237 Leeuwenhoek microscope – a simple microscope with a single objective lens.236 Licetus 47.2°S Fortunio Liceti Italian physician First to systematically study human and animal malfor- 6.5°E (Licetus) and philosopher. mations by providing descriptions, classifications, and (A, B, C, D, (1577-1657) causes of congenital abnormalities.239 E, F, G, H, J, 75.4 km Authored De Monstrorum causis, natura, et differentiis K, L, M, N, (On the Reasons, Nature and Differences of Monsters, P, Q, R, S, T, 1616), a landmark publication in descriptive teratolo- U, W) gy.239 Linné 27.8°N Carl von Linné Swedish Introduced the system of binomial nomenclature into the 11.8°E (Linnaeus) physician and life sciences (i.e. representing living organisms with the (A, B, D, F, (1707-1778) botanist. Genus species notation).240 G, H) 2.2 km Authored Systema Naturae (1735 onwards) and Species Plantarum (1753) which introduced specific binomial names for animals and plants respectively.240 Ludwig 7.7°S Carl Fried- German Conducted important physiological researches on blood 97.5°E rich Wilhelm physician and pressure, urine excretion, lymph formation, salivary Ludwig (1816- physiologist. gland secretion, and many other physiological func- 23.3 km 1895) tions.241 Devised the glomerular filtration theory of urine production and discovered the innervation of the salivary glands.241 Introduced the graphic method of recording physiological data with the chymograph (1847).241 Pioneered the perfusion of excised organs.241 Depressor nerve of Ludwig242 – vasodilator branch of the vagus nerve.243 Ludwig’s ganglion – parasympathetic neuronal cell bodies within the interatrial septum.242 Ludwig’s labrynth – proximal and distal convoluted tubules of the nephron.242 Mechnikov 10.5°S Ilya Ilyich Russian zool- Discovered phagocytosis (1883), establishing the notion 149°W Mechnikov ogist of cell-mediated immunity.111 (C, D, F, G, (1845-1916) Conceptualised probiotics.111 U, Z) 58.8 km 1908 Nobel Coined the terms ‘phagocytosis’, ‘macrophage’, ‘micor- Prize in Physiol- phage’ (now neutrophil),109 and ‘gerontology’.244 ogy or Medi- cine.111

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Mendel245 48.8°S Gregor Johann Moravian monk Discovered the laws of biological heredity (Mendelian 109.9°W Mendel (1822- and scientist. inheritance).246 (B, J, V) 1884) Father of ge- 139.7 km netics. Paracelsus 22.9°S Philippus Swiss-German Espoused the use of metals, inorganic salts, and miner- 163.4°E Auereolus Hermetic physi- als in medicine.247 (C, E, G, H, Theophrastus cian, alchemist Discovered zinc.247 M, N, P, Y) 85.9 km Bombastus von and astrolo- Reintroduced tincture of opium (laudanum) to Western Hohenheim ger. Father of Europe.249 (Paracelsus) iatrochemistry Introduced the ideas of dosage dependence of toxicolog- (c.1493 -1541) and toxicology. ical effects and target organ toxicity.248 247, 248 Established the association between cretinism and endemic goiter.250 Gave the first descriptions of occupational diseases (diseases of miners).250 Developed the concept of an active principle (arcana) in therapeutic preparations.250 Pasteur113 11.6°S Louis Pasteur French chemist Described molecular chirality.114 104.9°E (1822-1895) and microbiol- Conducted pivotal experiments on fermentation, con- (A, B, D, E, ogist. firming the germ theory of disease.114 G, H, M, Q, 232.8 km Developed attenuated chicken cholera and anthrax vac- S, T251, U, V, cinations and the first vaccine against rabies.114 Y, Z) Introduced the term ‘vaccine’.116 Pasteur effect – the inhibiting effect of oxygen on fermentation.252 Pasteurisation – heat sterilisation of milk.252 Pasteurella – a genus of Gram-negative anaerobic bacteria.252 Pavlov 28.3°S Ivan Petrovich Russian physi- Pioneered surgical procedures such as gastro-oesopha- 142.4°E Pavlov (1849- ologist. gostomy, the Eck fistula (portocaval anastamosis) and (G, H, M, P, 1936) the innervated gastric pouch for physiological studies.254 T, V) 143.1 km 1904 Nobel Discovered the secretory innervation of the pancreas Prize in Physiol- (1888) and stomach (1889), the ‘psychic secretion’ of ogy or Medi- saliva, and enterokinase (enteropeptidase).254 cine253 Pavlovian (classical) conditioning – establishment of a conditioned reflex.254 Purkyně 1.5°S Jan Evangelista Bohemian Described the germinal vesicle.255 94.9°E Purkyně (1787- anatomist and Discovered the sweat glands and their ducts.255 (D, K, S, U, 1869) physiologist. Gave the first description of the intracytoplasmic pig- V) 50.3 km mentation of cells in the substantia nigra.256 Recognised the individuality of fingerprints and classified fingerprint patterns.255 Coined the term ‘protoplasm’.255 Purkyně cells – large neurons with piriform cell bodies located between the molecular and granular layers of the cerebellum.255 Purkyně fibers – subendocardial branches of the cardiac conduction system.255 Purkyně tree – a perceivable image of the retinal vascular tree created by its moving shadow.257 Blue arcs of Purkyně – entoptic visualisation of con- ducting neuroretinal elements.258 Purkyně phenomenon/shift – enhancement of sensitivi- ty to blue light with dark adaptation.257 Purkyně-Sanson images – four surface reflections produced at the interfaces between diaphanous media of the eye.257 Purkyně’s law of vertigo – the perceived direction of vertigo depends on the posture of the head and changes with head inclination.259

42 Osleriana Medicine’s Lunar Legacies

Röntgen 32.9°N Wilhelm Con- German Discovered X-rays (1895).261 91.4°W rad Röntgen physicist and Coined the term ‘X-ray’.261 (A, B) (1845-1923) mechanical Conducted the first human X-ray (1895).262, 261 128.4 km engineer. Röntgenogram – plain X-ray radiograph.261

1901 Nobel Prize in Physics. 260, 261

Sechenov 7°S Ivan Mikhai- Russian physiol- Provided the first experimental evidence of inhibitory 143.1°W lovich Sechen- ogist. ‘Father of functions of the brain and their role in modulating spinal (C, P) ov (1829-1905) Russian physiol- reflexes.264 63.8 km ogy & scientific Espoused the physiological basis of psychological phe- psychology’.263 nomena.264 Sherrington 11.1°S Sir Charles English neuro- Conceived the notion of the integrative action of the ner- 118°E Scott Sher- physiologist and vous system and the ‘final common path’.266 rington (1857- pathologist. Investigated the arrangement of nerves in plexuses and 18.8 km 1952) their relation to spinal nerve roots.266 President of the Postulated the spinal location of cerebral inhibition of Royal Society skeletal muscle reflexes.266 (1920-1925).265 Proposed the role of intrinsic muscle receptors in deter- mining muscle tone.266 1932 Nobel Described ‘decerebrate rigidity’, the crossed extensor Prize in Physiol- response, myotatic stretch reflex, and the motor unit.266 ogy or Medi- Introduced the term ‘propioceptive’.266 Credited with cine.266 introducing the term ‘synapse’.267 Liddell-Sherrington reflex – myotatic reflex.268 Schiff-Sherrington reflex – exaggeration of myotatic and other postural reflexes in the limbs below the level of a spinal cord transection.268 Sherrington’s first law – each dorsal spinal nerve root conveys sensory information from specific, overlapping areas of the skin (dermatomes).268 Sherrington’s second law – reciprocal innervation of muscle groups.268 Vulpian-Heidenhain-Sherrington phenomenon – slow contraction of denervated skeletal muscle caused by stimulation of residual autonomic cholinergic fibres.269 Sömmerring 0.2°N Samuel German physi- Introduced the modern twelve-pair classification of the 7.5°W Thomas von cian, anatomist, cranial nerves (1878).270 (A, P, R) Sömmerring anthropologist Identified the individuality of the facial and vestibuloco- 28.0 km (1755-1830) and palaeontol- chlear nerves,270 and of the glossopharyngeal, vagus, and ogist. accessory nerves.271 Introduced the term ‘nervus abducens’.271 Discovered the substantia nigra and macula of the retina (coined the term ‘macula lutea’).270 Identified a vomeronasal organ in humans.272 Söemmerring’s spot – macula lutea.270 Söemmerring’s ganglion – substantia nigra.270 Söemmerring’s nerve – long pudendal nerve.270 Söemmerring’s ligament – suspensory ligament of the lacrimal gland.270 Söemmerring’s bone – marginal process of the zygomatic bone.270 Söemmerring’s ring – peripheral annular intercapsular opacification of the lens.270 Spallanzani 46.4°S Lazzaro Italian priest, Conducted researches that concluded against the theory 273 24.7°E Spallanzani biologist and of spontaneous generation.274 (1729-1799) physiologist. Identified the digestive power of saliva and confirmed (A, D, F, G) 30.9 km the digestive property of gastric juice.274 Performed early researches on regeneration in animals275 and noted the regenerative capacity of the spinal cord.274

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Steno 32.6°N Niels Danish physi- Described the excretory duct of the parotid gland (1661) 161.8°E Stensen276 cian, geologist (Stensen’s duct, ductus Stenonianus).277 (N, Q, R, T, (1638-1686) and Catholic Discovered the lacrimal ducts and proposed the glandu- U) 32.3 km priest. lar origin of tears.278 Discovered the right lymphatic duct.279 Developed an early and accurate model of skeletal muscle contraction.278 Recognised the muscular nature of the heart.278 Gave the first description of tetralogy of Fallot (monolo- gy of Steno, Steno-Fallot tetralogy).280 Svedberg 81.7°S Theodor Sved- Swedish chem- Developed the ‘ultracentrifuge’.281 65.2°E berg (1884- ist. Conducted influential researches on colloidal chemistry 1971) and radiochemistry.281 15.3 km 1926 Nobel Demonstrated the uniformity in size and molecular Prize in Chem- weight of naturally-occurring soluble proteins (e.g. hae- istry.281 moglobin).281 Deciphered the molecular weight of the serum protein (immunoglobulin M) in Waldenström’s macroglobuli- naemia.281 Svedberg (S) – a non-metric unit of sedimentation rate/ molecular weight.282 Theiler 13.4°N Max Theiler South Afri- Devised viral attenuation and culturing techniques that 82.9°E (1899-1972) can-American contributed to the development of a vaccine for yellow virologist and fever, a mosquito borne illness caused by the yellow fe- 8.3 km physician. ver virus.284

1951 Nobel Prize in Physiol- ogy or Medi- cine.283, 284 Tiselius 6.9°N Arne Wilhelm Swedish bio- Pioneered the theory and practice of moving boundary 176.7°E Kaurin Tiselius chemist. and zone electrophoresis.285 (E, L) (1902-1971) Elucidated the complex nature of the serum proteins and 53.8 km 1948 Nobel introduced the denominations alpha (α), beta (β), and Prize in Chem- gamma (γ) globulin.285 istry.285 Recognised antibodies as gamma-globulins.285 Researches on adsorption analysis (chromatography of colourless substances).285 Vesalius 3.2°S Andreas Flemish Authored De Humani Corporis Fabrica Libri Septem 114.8°E Vesalius (1514- anatomist and (1543) the first complete textbook of human anatomy.100 (C, D, G, H, 1564) physician. Rectified many Galenic anatomical misconceptions – J, M) 64.7 km ‘Founder of e.g. proving the mandible was a single bone, that the modern human sternum was made of three, the absence of interventric- anatomy’.101 ular pores, and the true relations of the azygous vein.97 First to diagnose and describe aneurysms of the thoracic and abdominal aorta.98 Discovered and named the mitral valve.99 Os Vesalianum pedis – accessory ossicle at the base of the fifth metatarsal.286 Foramen of Vesalius – sphenoidal emissary foramen that transmits an emissary vein.286 Virchow 9.9°N Rudolf Ludwig German physi- Proposed the axiom omnis cellula e cellula – every cell 83.8°E Carl Virchow cian, pathologist comes from another cell – and promulgated the notion of (1821-1902) and anthropol- the cellular origin of disease.287 18.8 km ogist. ‘Father Authored Cellular Pathologie (Cellular Pathology) of cellular (1858), a highly influential publication in pathology.287 pathology’.287 Promoted the peicemeal method of the modern autopsy (Virchow method), consisting of removing and further assessing organs one-by-one 288

(continued)

44 Osleriana Medicine’s Lunar Legacies

Described and named arterial and venous ‘embolia’,289 ‘ochronosis’ (articular manifestation of alkaptonuria),286 ‘leukaemia’,290 ‘amyloid’ degeneration291 (Virchow’s degeneration292), ‘leontiasis ossea’287 (Virchow’s dis- ease293), and ‘spina bifida occulta’.287 Described the life cycle of Trichenella spiralis.294 Introduced the pathological terms (in addition to those above), ‘thrombosis’,295 ‘leucocytosis’,290 ‘hyperplasia’, ‘heterotopia’,296 ‘neuroglia’,297 ‘ischaemia’,298 ‘agene- sia’,287 and ‘zoonosis’.294 Virchow’s triad – conditions promoting thrombosis (hy- percoagulability, haemodynamic changes, and endothe- lial injury).299 Virchow’s node – left supraclavicular lymph node, enlargement of which (Trosier’s sign) may be seen in gastrointestinal malignancy.293, 299 Virchow-Robin spaces – perivascular lymph spaces that communicate with the subarachnoid space and surround the larger cerebral veseels.292 Virchow’s cell – a macrophage with effervescent appearing cytoplasm, seen in leprosy (Lepra cell).299 Also refers to osseous lacunae and their osteocytes, and to the corneal corpuscles (Toynbee’s corpuscles).293 Virchow-Seckel syndrome – bird-headed dwarfism.300 Virchow’s psammomas – microscopic calcified granules within tissue, prevalent in meningiomas.301, 302 Virchow’s metamorphosis – fatty infiltration of organs, particularly of the pancreas and liver. The condition has also been described in the parotid glands.303 Virchow’s angle – angle subtended by a line joining the middle of the nasofrontal suture and the base of the anterior nasal spine, and a line joining the latter to the external auditory meatus.293 Hassall-Virchow bodies – concentric clusters of thymic epithelial cells within the medullary thymus.292, 304 Virchow’s crystals – amber-hued ‘haematoidine’ crystals that may accompany extravasated blood.292 von Behring 7.8°S Emil Adolf von German physi- Discovered diphtheria antitoxin (1890) and its thera- 71.7°E Behring (1854- cian and medi- peutic utility.306 1917) cal scientist. Coined the term ‘antitoxin’.306 37.7 km 1901 Nobel Prize in Physiol- ogy or Medi- cine.305, 306 von Békésy 51.9°N Georg Von Hungari- Elucidated the tonotopic physiology of the cochlea.307 126.7°E Békésy (1899- an-American (F, T) 1972) physicist and 96.3 km physiololgist.

1961 Nobel Prize in Physiol- ogy or Medi- cine.307 Young 41,5°S Thomas Young English Described the accommodation of the eye and gave the 51°E (1773-1829) physician, first description of astigmatism.309 (A, B, C, D, physicist,308 and Young-Helmholtz theory – trichromatic theory of F, R, S) 71.4 km Egyptologist. colour vision.309 Young’s rule – a calculation for deriving children’s dosage of a medication from the equivalent adult dose. (Child dose = Adult dose × [Age ÷ (Age + 12)].310

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Figure 21: The Moon has intrigued people for aeons. The Italian painter Donato Creti (1671-1749) captured Man’s enthusiasm for lunar observation in this lovely post-telescopic era oil-on-canvas painting. The work, part of a series entitled Astro- nomical observations, was commissioned in 1711 and features the Moon as seen through an early telescope. Image reproduced with the assistance and permission of the Vatican Museum, Rome. (Photo © Vatican Museums. All rights reserved).

46 Osleriana Medicine’s Lunar Legacies Man and Moon Many surviving lunar legends and folklore are tied The Moon has been observed and admired by Man for to moving themes like love, longing, and liberation. aeons (Figure 21). Its influence on human civilization These tales are still faithfully recalled and passed on can be traced far back into antiquity and its presence in many cultures, and most are quite charming and en- manifests ubiquitously in all creeds and cultures. The tertaining to the modern imagination. Who wouldn’t Moon of our distant ancestors has been preserved in wonder at the Chinaman’s story of the bamboo maiden many myths and monuments from which we can ex- – Goddess of the Moon – who spent an exile within trapolate the roles it may have played in the customs the vegetable’s hollow interior and eventually placed and traditions of different societies. Whilst its astral herself beyond the reach of admiring men by returning movements were of significance to astrologers, it also to her luminous homeland.316 Who wouldn’t admire served as a public platform upon which allegories of the perseverance of Bromho the Hindu, attempting to romance, virtue, vice, and justice were variously en- sculpt the face of Doorja the beautiful, building and acted. Let us briefly consider then, in concluding this breaking his works over successive fortnights, repeat- work, a few historical examples that demonstrate the edly and forever, for he can never replicate her beau- place of the Moon in Man’s world. ty.317 And who wouldn’t enjoy envisaging the many mythical places and people associated with our Moon The earliest known record that may demonstrate the – the forests of Diana; the paradise of the Druids; the Moon’s participation in human culture can be found fruit gardens of the Polynesians, whose seeds had been in the prehistoric caves of Lascaux, France, where a carried skywards by white-winged Tahitian doves; the simple line of circles, thought to represent the Moon Slavonian’s receding maiden on the lake; the chastised in its cycle,311 features amongst exquisite illustrations husband of the Sun, cloven for his musings with the of beasts on the rocks. This, the oldest suggested lu- evening star;318 and Ina of the Samoans or the Vedic nar calendar, hints at the important role the lunar cycle Goddess Rakka, weaving with unbreakable needles may have played in the lives of Cro-Magnon Man who the garments of night and morning.319 roamed the region some fifteen-thousand years ago.312 The spectacular beauty and periodicity of the Moon, Many Stone Age monuments whose alignments con- manifesting in moonlight and tidal rythyms, is reflect- template the positions of the Sun and Moon also echo ed by the femininity of the identities it has been asso- such significance. It has been suggested that a series ciated with. Perhaps one of the most popular of these of Neolithic arc engravings carved into an orthostat mythological personalities is Artemis – Greek goddess at the Knowth passage tomb in Ireland may represent of Moon, chastity, wildlife, and wilderness. Her Ro- the Moon’s Maria. The foundations of this supposi- man equivalent was Diana the huntress and she was tion have been contested, but if correct, the mysterious also known by the names Phoebe, Cynthia, and Selene. etching would consititute the earliest rendition of the She was the daughter of Zeus (Jupiter) and Leto (La- Moon’s actual appearance by humans,313 and its asso- tona) and the full sister of Apollo – god of the Sun, ciation with the dead would signify just how much the medicine, and the fine arts. Artemis was coachwoman Moon may have meant to our ancestors. of the lunar chariot which conveyed the Moon across the sky during the course of a night. She enjoyed a It is not uncommon to find the Moon, one of the oldest pastime of hunting in the forests of Arcadia and de- objects of worship, in the scriptures and customs of veloped an infatuation with Orion the hunter. Diana many religions. Astarte, or Ashtaroth-Karnain – the also expressed an amarous tendency towards a young Hebrew Queen of Heaven who wore a ‘two-horned’ shepherd named Endymion, upon whom, in order to crescent – is mentioned in Genesis and was worshipped preserve his youth, she conferred an everlasting sleep. devoutly by many a child of old Israel.314 The ancient Often attended by one or more of her hunting dogs, Egyptians had two lunar dieties, Khonsu and Thoth, Artemis was represented as a comely maiden wearing who marked the inexorable passage of time, and with a truncated hunting dress and holding a bow with a whom the cat, a sacred animal, was sometimes associ- quiver of arrows on her back. A small crescent head- ated – perhaps by virtue of the phase-like transforma- piece embellished her locks and sufficed to identify her tion of feline pupils and the light that appears to shine as matron of the Moon.320 forth from them in darkness.315 In many religions, the Moon’s beauty and periodicity, alongside all other cre- Pareidolias321 in relation to the visible dark and bright ated marvels, were seen as exemplary manifestations patternations of the Moon’s surface have also result- of divine will and providence. The crescent Moon and ed in a multitude of myths linked to animals, or to a star remain an identifiable symbol of the Islamic faith man or woman in the Moon. The Hindu’s remember whose calender is still based on the synodic month. a self-sacrificing hare who showed Buddha the way

July 2019 47 Z. Toodayan out of the wilderness and lent himself as food before – and the victory of the Apollo 11 astronauts (Figure being transfixed onto the Moon by Buddha’s divine 22) continues to epitomise Man’s capacity for adven- and grateful hand.322 The Chinese and Japanese also ture and exploration. Ever since the lunar landing, the reference a hare, theirs endlessly pounding at rice in Moon has increasingly embodied the spirit and success a mortar for the making of mooncakes.322, 323 Other of science, and in this way continues to maintain an characters include the heartbroken wolf of the Amer- influential presence in human culture. ican-Indians, from whom a fascinating toad – the subject of his fancy – had sought salvation upon the Despite our changing perspectives on the Moon, it is distant lunar disc; the Orient’s nuptial officiant, who clear that it has always symbolised something signif- linked spouses with a thread unseen and severed only icant to us, its identity inextricably entwined with our by the touch of death;324 the banished men of the Dutch own. Many of Man’s triumphs and tribulations have – thieves of sheep, wood, or cabbage; and Hiawatha’s been projected onto it throughout history and these grandmother, who had been tossed asunder by the war- have beamed back in some form or another to gen- rior in a fit of anger before coming to rest upon the sil- erations of observers. We have seen that the saga of ver sphere where her features can still be seen today.325 modern medicine is also written on the Moon, each medical crater preserving the impact of an individual Perhaps their enduring mystery and meaning is the on the landscape of human health and disease. In re- reason so many lunar legends have persisted through flecting on the lives of these lunar luminaries, today’s the ages, but the old romance and mythology of the practitioners may admire their individual contribu- Moon, though still alive and engaging,326 is less widely tions and aspire towards the motives that united the appreciated today. The advent of the scientific revolu- efforts and endeavours of them all – a desire to further tion catalysed progressively empirical interpretations human knowledge for its own sake; a commitment to of Nature, and the early triumphs of this period were improving the lives of others; a love of the investiga- encrypted in the naming schemes of the first lunar car- tion of Nature; a solemn and sincere search for truth. tographers. The forthcoming centuries saw the enor- A Moon of such meaning may rise on a physician’s mous import of the scientific method – a method that horizon – an inanimate and icy world, enlivened and enabled Man to visit the Moon itself only fifty years ago ennobled by the legacies of the great medical pioneers.

Figure 22: A view of the Moon’s surface as seen from the Apollo 11 Lunar Module (LM) on 20th July 1969. The crater Schmidt (11.1 km) dominates the terrain below and dwarfs the Command and Service Modules (seen here near the crater’s lower-left rim) as they orbited over the southern edge of the Mare Tranquilitatis (Sea of Tranquility), within which the LM landed, bringing Man to the Moon for the first time. Image courtesy of the National Aeronautics and Space Administration.

48 Osleriana Medicine’s Lunar Legacies

References & Notes

1. Browne T. Hydriotaphia, Urne-Buriall, Or, a Discourse of the 18. The earliest surviving sketch of the Moon as it appeared Sepulchrall Urnes lately found in Norfolk. Together with the through a telescope is attributed to the English mathematician Garden of Cyrus, Or The Quincunciall Lozenge, or Net-work and astronomer Thomas Harriott (1560-1621) who produced a Plantations of the Ancients, Artificially, Naturally, Mystically lunar map around July 1609, about four months prior to Gal- Considered. With Sundry Observations. London: Printed for ileo’s observations. (Moore P. Guide to the Moon. London: Hen. Brome at the Signe of the Gun in Ivy-Lane, 1658, p. 28. Lutterworth Press, 1976, pp. 75-76). 2. This same event is thought to have caused the 23.5 degree tilt 19. Galilei G, Kepler J, Edward Stafford C. The Sidereal Messen- in the rotational axis of the Earth, which underlies the seasons. ger of Galileo Galilei: and a part of the preface to Kepler’s 3. In Classical mythology, Theia or Euryphäessa was a Titaness; Dioptrics containing the original account of Galileo’s astro- the wife of the Titan Hyperion and mother of Selene, the god- nomical discoveries. London: Rivingtons, 1880, pp. 14-30. dess of the Moon. (Morford MPO, Lenardon RJ. Classical 20. An early set of lunar engravings was produced by the French Mythology. Oxford: Oxford University Press, 1999, pp. 40- draughtsman Claud Mellan (1598-1688) around 1637 under a 42). According to some accounts, Selene’s identity was asso- commission of the French priest and astronomer Pierre Gas- ciated with the Greek goddess Artemis and her Roman equiv- sendi (1591-1655). Gassendi also provided some names for alent Diana. (Grueber HA. The Myths of Greece & Rome. the Moon’s surface features, such as ‘umbilicus lunaris’ which London: George G. Harrap & Co. Ltd., 1944, p. 90). referred to the prominent crater now named Tycho and its ray 4. Halliday AN. Terrestrial accretion rates and the origin of the system. The Gassendi-Mellan drawings, although predating Moon. Earth and Planetary Science Letters, February 2000; Hevelius’s work, were not complete lunar maps. (Brunner B. 176(1): 17-30. Moon: A Brief History. New Haven: Yale University Press, 5. Hartmann WK, Davis DR. Satellite-sized planetesimals and 2010, Ch. 3). lunar origin. Icarus. April 1975; 24(4): 504-514. 21. Whitaker EA. Selenography in the Seventeenth Century. In: 6. Cameron AGW, Ward WR. The Origin of the Moon. Abstracts Taton R, Wilson C, Hoskin M. Planetary Astronomy from the of the Lunar and Planetary Science Conference, March 1976; Renaissance to the Rise of Astrophysics, Part A: Tycho Brahe 7: 120. to Newton. Cambridge: Cambridge University Press, 2003, pp. 7. The foreshortening effect is an illusion that causes craters sit- 127-128. uated near the limbs of the lunar disc to appear ellipsoidal due 22. Montgomery S. The Moon & the Western Imagination. United to a perceived shortening of the dimension perpendicular to States: The University of Arizona Press, 1999, p. 157. the limb. It originates in the Moon’s sphericity which angles 23. Herczeg T. The Habitability of the Moon. Bioastronomy ‘99: A craters towards or away from the line of observation. (Wlasuk New Era in Bioastronomy, 2000; 213: 593-602. P. Observing the Moon. London: Springer-Verlag, 2000, p. 3). 24. Montgomery S, 1999. op. cit. p. 160. 8. Tera F, Papanastassiou DA, Wasserburg GJ. Isotopic evidence 25. Montgomery S, 1999. op. cit. p. 169. for a terminal lunar cataclysm. Earth and Planetary Science 26. Montgomery S, 1999. op. cit. p. 167. Letters, April 1974; 22(1): 1-21. 27. Whitehouse D. The Moon: A Biography. London: Weidenfeld 9. Our Moon harbours some of the largest known impact struc- & Nicolson, 2016, Ch. 7: The First Moon Race. tures in the Solar System – the Near Side Megabasin (mod- 28. Eckhardt HD. Theory of the Libration of the Moon. The Moon elled diameter of 6,690 km), the South Pole-Aitken basin (over and the Planets, August 1981; 25: 3-49. 2,600 km) and the Chaplygin-Mandel’shtam Basin (1,300 29. Marshall DW. Ancient Skies: Constellation Mythology of the km). (Byrne CJ. The Moon’s Near Side Megabasin and Far Greeks. New York: The Countryman Press, 2018, p. 160. The Side Bulge. New York: Springer, 2013, p. 42). constellations that were introduced by Hevelius and are still 10. Heiken G, Vaniman D, French BM. Lunar Sourcebook; A recognised in modern astronomy are Canes Venatici, Lacerta, User’s Guide to the Moon. New York: Cambridge University Leo Minor, Lynx, Scutum, Sextans and Vulpecula. Press, 1991, p. 116. 30. Grzybkowska T. Andreas Stech’s Portraits of Johannes Hev- 11. Hypervelocity refers to a speed of around 3 km/s (11,000 elius in Gdansk and Oxford. At the Origins of the Portrait of km/h) or higher. Typical impact velocities are between 15 to the Early Modern Scholar. Artibus et Historiae, 2012; 33(66): 25 km/s (54,000 to 90,000 km/h). (Heiken G, Vaniman D, 287-316. French BM, 1991. op. cit. pp. 61-62). 31. Whitaker EA. In: Taton R., Wilson C., Hoskin M, 2003. op. cit. 12. Heiken G, Vaniman D, French BM, 1991. op. cit. pp. 61-70. p. 134. 13. Wlasuk P. Observing the Moon. London: Springer-Verlag, 32. Abel PG. Visual Lunar and Planetary Astronomy. New York: 2000, pp. 5-6. Springer, 2013, p. 111. 14. Wlasuk P, 2000. op. cit. pp. 8-10. 33. Graney CM. Setting Aside All Authority: Giovanni Battista 15. A completely new Moon, which occurs when the Moon is po- Riccioli and the Science against Copernicus in the Age of Gali- sitioned between the Earth and Sun in its orbit, is entirely uni- leo. United States: University of Notre Dame Press, 2015, Ch. lluminated and is not visible from Earth except during partial 1. or total solar eclipses. 34. Francisco Grimaldi was an Italian Jesuit priest, mathematician 16. A synodic or lunar month is about two days longer than a side- and astronomer who is known for his discovery of the ‘diffrac- real month, the latter refering to the time taken for the Moon tion’ (a term he introduced) of light. (Graves D. Scientists of to complete one orbit around Earth (about 27.5 days). The Faith: Forty-eight Biographies of Historic Scientists and their difference is due to the Earth’s movement along its orbit be- Christian Faith. Michigan: Kregel Resources, 1996, p. 53). tween successive sidereal months which requires the Moon to 35. Montgomery S, 1999. op. cit. pp. 199-200. travel further along its next orbit to achieve the same relative 36. Montgomery S, 1999. op. cit. pp. 207-208. position to the Sun and therefore the same phase. (Heath R. 37. Astrogeology Science Centre (United States Geological Sur- Sun, Moon & Earth. Somerset: Wooden Books, 2012, p. 14]. vey), Working Group for Planetary System Nomenclature (In- 17. National Aeronautics and Space Administration Space Science ternational Astronomical Union). Gazetteer of Planetary No- Data Coordinated Archive. (2018). Earth’s Moon - Luna 3. menclature: History of Planetary Nomenclature. Available at: Available at: https://nssdc.gsfc.nasa.gov/imgcat/html/object_ https://planetarynames.wr.usgs.gov/Page/History. Accessed 1st page/lu3_1.html. Accessed 26th August 2018. September 2018. July 2019 49 Z. Toodayan

38. Blagg MA, Muller K. Named Lunar Formations. London: Per- Bodies Also, and On the Great Magnet the Earth), which is cy Lund, Humphries & Co. Ltd., 1935, pp. iii-v. widely regarded as ‘the first true work of modern science’. 39. Gerard Peter Kuiper is widely regarded as the father of plan- (Verschuur GL. Hidden Attraction: The History and Mystery etary astronomy. He spectroscopically identified methane in of Magnetism. New York: Oxford University Press, 1996, pp. the atmosphere of Saturn’s moon Titan (the first detection 17-19). of an atmosphere on a satellite) (Cruikshank D. Gerard Pe- 54. Mark K. Meteorite Craters. Tucson: University of Arizona ter Kuiper. In: National Academy of Sciences. Biographical Press, 1995, p. 104. Memoirs: Volume 62. Washington, D.C.: The National Acad- 55. Hoyt WG. Coon Mountain Controversies: Meteor Crater and emies Press, 1993, p. 265 & 278), and is the namesake for the the Development of Impact Theory. Tucson: University of Ar- trans-Neptunian Kuiper belt (Ridpath I. Oxford Dictionary of izona Press, 1987, p. 21. Astronomy. New York: Oxford University Press, 2012, p. 259). 56. Baum R. Gruithuisen, Franz von Paula. In: Hockey T et. al. Bi- 40. Astrogeology Science Centre (United States Geological Sur- ographical Encyclopedia of Astronomers. New York: Spring- vey), Working Group for Planetary System Nomenclature er-Verlag, 2007, pp. 448-449. (International Astronomical Union). Gazetteer of Planetary 57. Hartmann WK. History of the Lunar Surface. Tucson: Univer- Nomenclature: IAU Rules and Conventions. Available at: sity of Arizona, 1966, p. 6. https://planetarynames.wr.usgs.gov/Page/Rules, and: Catego- 58. Leverington D. Babylon to Voyager and Beyond: A History of ries (Themes) for Naming Features on Planets and Satellites. Planetary Astronomy. United Kingdom: Cambridge Universi- Available at: https://planetarynames.wr.usgs.gov/Page/Cate- ty Press, 2003, pp. 222-223. gories. Accessed 1st September 2018. 59. Cunningham C. Investigating the Origin of the Asteroids and 41. Astrogeology Science Centre (United States Geological Sur- Early Findings on Vesta: Historical Studies in Asteroid Re- vey), Working Group for Planetary System Nomenclature search. United States: Springer, 2017, p. 8. (International Astronomical Union). Gazetteer of Planetary 60. Zajaczkowski T, Zamann AM, Rathert P. Franz von Paula Gru- Nomenclature: Categories for Naming Features on Planets and ithuisen (1774–1852): lithotrity pioneer and astronomer. On Satellites. Available at: https://planetarynames.wr.usgs.gov/ the 150th anniversary of his death. World Journal of Urology, Page/Categories. Accessed 1st September 2018. May 2003; 20(6): 367-373. 42. Winkler PF. SN 1006: a thousand-year perspective. Highlights 61. Cunningham C, 2017. op. cit. pp. 127-128. of Astronomy, August 2007; 14: 301-302. 62. Sheehan WP, Dobbins TA. Epic Moon: A history of lunar 43. Goldstein BR. Evidence for a Supernova of A.D. 1006. The exploration in the age of the telescope. United States: Will- Astronomical Journal, February 1965; 70(1): 105-114. mann-Bell, Inc., 2001, pp. 82-83. 44. White Jr. L. Medieval Religion and Technology. United States: 63. Elger T. The Moon: A Full Description and Map of its Prin- University of California Press, 1978, p. 303. cipal Physical Features. London: George Philip & Son, 1895, 45. O’Connor JJ, Robertson EF. (2002). Regnier Gemma Frisius. p. 68. Available at: http://www-history.mcs.st-andrews.ac.uk/Biog- 64. Mark K, 1995. op. cit. pp. 105-109. raphies/Gemma_Frisius.html. Accessed 8th September 2018. 65. Hoyt WG, 1987. op. cit. pp. 21-26. 46. [Unsigned], University of Oklahoma Libraries. The First Book 66. Marien MW. Photography: A Cultural History. London: Lau- Printed on Tycho Brahe’s Printing Press at Uraniborg: Diari- rence King Publishing, 2006, pp. 7-8. um, 1586. The Lynx, November 2005; (2): 8-9. 67. In 1939 the English astronomer Sir John Herschel (1792-1871) 47. Hagen J. Aloisius Lilius. In: The Catholic Encyclope- had independently referred to the process of permanently cap- dia. (1910). Available at: http://www.newadvent.org/ turing images as ‘photographic’. Florence’s use of the term cathen/09247c.htm0. Accessed 9th September 2018. out of São Paulo was unknown to Europe at the time. (Marien 48. Solc M. Olbers, Heinrich Wilhelm Matthias. In: Hockey T et. MW, 2006. op. cit. p. 16). al. Biographical Encyclopedia of Astronomers. New York: 68. Marien MW, 2006. op. cit. pp. 9-15. Springer-Verlag New York, 2007, pp. 848-850. 69. Barker GF. Memoir of John William Draper. In: National 49. Williams HS. The Great Astronomers. New York: Simon and Academy of Sciences. Biographical Memoirs. Washington Schuster, 1930, p. 113. D.C.: National Academies Press, 1886, pp. 351-355. 50. A few unaided illustrations of the Moon predate William Gil- 70. The first female face to be photographed was that of John bert’s. The earliest known features in the background of Jan Draper’s sister Dorothy Catherine Draper (1807-1901) in June van Eycke’s thirteenth century painting Crucifixion and Last 1840 – in 1986 this Dageurreotype was regarded as the ‘ear- Judgement (c.1420-1425). The painting includes a gibbous liest good portrait to survive until modern times’. (Gernsheim Moon with appreciable surface detail low on the horizon and H. A Concise History of Photography. New York: Dover Pub- above distant mountains. [Montgomery SL. The First Natu- lications, Inc., 1986, pp. 31-32). ralistic Drawings of the Moon: Jan Van Eyck and the Art of 71. Trombino D. Dr John William Draper. Journal of the British Observation. Journal for the History of Astronomy, 1 Novem- Astronomical Association, 1980; 90(6): 565-571. ber 1994; 25(4): 317-320]. Crude sketches of the Moon were 72. Draper JW. Scientific Memoirs: Being Experimental Contribu- also made by Leonardo da Vinci (1452-1519) between 1505 tions to a Knowledge of Radiant Energy. New York: Harper & and 1514 and can be found in the Codex Atlanticus series of Brothers, 1878, p. 214. his notebooks [folio 310 recto (c.1505-08), and 674 verso 73. Gibson SJ. Draper, Henry. In: Hockey T et. al. Biographical (c.1513-14)]. [Reaves G., Pedretti C. Leonardo Da Vinci’s Encyclopedia of Astronomers. New York: Springer-Verlag, Drawings of the Surface Features of the Moon. Journal for the 2007, pp. 310-311. History of Astronomy, February 1987; 18(1): 55-58]. 74. The Draper crater is formally named after Henry Draper, John 51. Whitaker EA. Mapping and Naming the Moon: A History of Draper’s son, but it can also be thought of as a tribute to both Lunar Cartography and Nomenclature. Cambridge: Cam- astrophotography pioneers. bridge University Press, 2003, pp. 10-13. 75. Astrogeology Science Centre (United States Geological Sur- 52. Kopal Z, Carder RW. Mapping of the Moon: Past and Present. vey), Working Group for Planetary System Nomenclature Holland: Springer, 1974, p. 2. (International Astronomical Union). Gazetteer of Planetary 53. Sir William Gilbert discovered terrestrial magnetism and iden- Nomenclature: Individual crater information accessed through tified it as the reason compass needles converge to the North. nomenclature search results for craters of the Moon. Available This and other influential findings in the field were published at: https://planetarynames.wr.usgs.gov/SearchResults?tar- in his 1600 treatise De Magnete, Magneticisque Corporibus, get=Moon&featureType=Crater,%20craters. Accessed 13th et de Magno Magnete Tellure (On the Magnet, Magnetic October 2018.

50 Osleriana Medicine’s Lunar Legacies

76. National Aeronautics and Space Administration, Lunar Re- 89. Though it bears his name, Heinrich Olbers was not the first to connaissance Orbiter. (2018). Quickmap. Available at: https:// describe or propose a solution for the night sky paradox – he lunar.gsfc.nasa.gov/index.html. Accessed September 2018 - described and solved the connundrum (in 1823) independently July 2019. of Johannes Kepler (1571-1630), Edmond Halley (1656-1742) 77. Legrand C, Chevalley P. (2012). Virtual Moon Atlas, Version and Jean Loys de Chéseaux (1718-1751). (Solc M. In: Hockey 6.0. Microsoft Windows Application. T et. al., 2007. op. cit. p. 849). 78. Solar System Exploration Research Virtual Institute, National 90. Cocks EJ, Cocks JC. Who’s who on the Moon: A Biographi- Aeronautics and Space Administration. (2019). Iconic Lunar cal Dictionary of Lunar Nomenclature. North Carolina: Tudor Orbiter Image of Copernicus Re-released. Available at: https:// Publishers, Inc., 1995, pp. 455-486. sservi.nasa.gov/articles/iconic-lunar-orbiter-image-of-coper- 91. Garrison FH. An Introduction to the History of Medicine. Phil- nicus-re-released/. Accessed 25th April 2019. adelphia: W. B. Saunders Company, 1921, p. 88. 79. Gruithuisen alone, with recognisable contributions to both 92. Osler W. The Evolution of Modern Medicine. New Haven: medicine and astronomy, can be considered in a dual light and Yale University Press, 1921, pp. 58-68. his name is therefore included in both tabulations of craters. 93. Garrison FH, 1921. op. cit. pp. 90-91. 80. In the planetocentric system, the latitude of a surface point is 94. Firkin B, Whitworth JA. Dictionary of Medical Eponyms. defined as the angle that is subtended between a line connect- United Kingdom: The Parthenon Publishing Group, 1989, p. ing that surface point to the centre of the body and the body’s 237. equatorial plane. For truly spherical objects (as opposed to 95. Mukherjee S. The Emperor of All Maladies: A Biography of oblate spheroids) the planetocentric latitude is identical to the Cancer. New York: Scribner, 2010, p. 47. planetographic latitude – the angle defined by a line perpen- 96. Osler W, 1921. op. cit. p. 63. dicular to the surface point and the body’s equatorial plane. 97. Osler W, 1921. op. cit. pp. 146-151. As explained on their web page, the Gazeteer of Planetary 98. Garrison FH, 1921. op. cit. pp. 213-214. Nomenclature of the United States Geological Survey/Inter- 99. O’Malley, CD. Andreas Vesalius of Brussels, 1514-1564. national Astronomical Union is based on a spherical model United States: University of California Press, 1964, p. 177. of the Moon. In this monograph, longitude is prescribed a 100. Sigerist H. The Great Doctors. New York: W. W. Norton & value of 180° in either direction (east or west) from the prime Company, 1933, p. 129. meridian (direction specified). The Moon’s prime meridian 101. Osler W, 1921. op. cit. p. 148. (0° of longitude) is defined by the line that connects the lunar 102. Osler W, 1921. op. cit. pp. 163-173. North and South poles through that point on its surface which 103. Harvey W, Leake CD. Exercitatio Anatomica de Motu Cordis is closest to Earth. Therefore any longitude greater than 90° et Sanguinis in Animalibus. Springfield, Illinois: Charles C. corresponds to a location on the farside of the Moon and the Thomas, 1949, p. 6. longitude line defined by 180° east or west corresponds to 104. Lunar Reconnaissance Orbiter, National Aeronautics and the same plane (and the same plane as the prime meridian) Space Administration. (2011). Jenner Crater: Mare Flooded intersecting the lunar surface point farthest from Earth. In Floor. Available at: https://www.nasa.gov/mission_pages/ this context, the term ‘easterly’ is utilised for anticlockwise LRO/multimedia/lroimages/lroc-20110621-jenner.html. Ac- displacements upon the lunar surface when viewed from the cessed 25th April 2019. lunar north pole and ‘westerly’ for clockwise displacements. 105. Sigerist H, 1933. op. cit. pp. 261-263. Selenocentric latitude is given values between 0° and 90° in a 106. Garrison FH, 1921. op. cit. pp. 386-389. direction either north or south from the equator. A latitude of 107. Sigerist H, 1933. op. cit. pp. 366-372. 90° north and south corresponds to the lunar north and south 108. Garrison FH, 1921. op. cit. pp. 622-625. poles respectively. All crater coordinates and diameters have 109. Bosch F, Rosich L. The Contributions of Paul Ehrlich to Phar- been rounded to one decimal place. [Astrogeology Science macology: A Tribute on the Occasion of the Centenary of His Centre (United States Geological Survey), Working Group for Nobel Prize. Pharmacology, October 2008; 82(3): 171-179. Planetary System Nomenclature (International Astronomical 110. Kasten FH. Paul Ehrlich: Pathfinder in Cell Biology. 1. Chron- Union). Gazetteer of Planetary Nomenclature: Help using this icle of His Life and Accomplishments in Immunology, Cancer website. Available at: https://planetarynames.wr.usgs.gov/ Research, and Chemotherapy. Biotechnic & Histochemistry, Page/Website#coordinatesystems. Accessed 15th June 2019]. January 1996; 71(1): 2-37. 81. There is also a very large (301.8 km) Martian crater named 111. Kaufmann SHE. Immunology’s foundation: the 100-year an- Copernicus. niversary of the Nobel Prize to Paul Ehrlich and Elie Metch- 82. Gingerich O. Copernicus, Nicolaus. In: Hockey T et. al. Bi- nikoff. Nature Immunology, July 2008; 9(7): 705-712. ographical Encyclopedia of Astronomers. New York: Spring- 112. Prüll CR. Part of a Scientific Master Plan? Paul Ehrlich and the er-Verlag, 2007, pp. 252-254. Origins of his Receptor Concept. Medical History, July 2003; 83. A nearby rima (a long, narrow surface depression, also known 47(3): 332-356. as a rille) – the 244.2 km long Rima Draper – also shares this 113. There is also a Martian crater named Pasteur. name. 114. Garrison FH, 1921. op. cit. pp. 620-621. 84. Hallye F, Lammens C. Frisius, Gemma Reinerus. In: Hock- 115. Radot RV. The Life of Pasteur. New York: Doubleday, Page & ey T et. al. Biographical Encyclopedia of Astronomers. New Company, 1923, pp. v-xvi. York: Springer-Verlag, 2007, pp. 393-394. 116. Sigerist H, 1933. op. cit. p. 364. 85. There are two lunar domes in the proximity of the crater, Mons 117. Radot RV, 1923. op. cit. p. xvi. Gruithuisen Delta and Gamma, that also share this name. 118. Rous P. Karl Landsteiner, 1868-1943. Biographical Memoirs 86. Green DWE. Hájek z Hájku, Tadeá. In: Hockey T et. al. Bi- of Fellows of the Royal Society, 28 Febryuary 1947; 5(15): ographical Encyclopedia of Astronomers. New York: Spring- 294-324. er-Verlag, 2007, pp. 459-460. 119. The Fleming crater is jointly named after Sir Alexander Flem- 87. The satellite crater that was previously named Olbers A is now ing and the Scottish-American astronomer Williamina Paton called Glushko. Stevens Fleming (1857-1911). Williamina Fleming is noted 88. Heinrich Olbers made the discovery of comet C/1780 U1 infor her spectral classification of stars and her 1888 discovery dependently of Jacques Leibax Montaigne (1716-1785?) and of the horsehead nebula. (Waldee SR. (1990). The Horseh- the discovery of comet C/1798 X1 independently of Alexis ead Project: 19th Century Study of Bright and Dark Nebulae. Bouvard (1767-1843). (Solc M. In: Hockey T et. al., 2007. op. Available at: https://web.archive.org/web/20150106052626/ cit. p. 849). http://freescruz.com/~4cygni/horsehead/B33-19thC_4.htm.

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Anatomical Terms: Towards Development of Ter- this work is unlisted in the journal, the article was conceivably minologies (terminogenesis). European Journal of Anatomy, written by the journal’s editor, medical historian Walter Regi- 2016; 20(3): 249-280. nald Bett (1903-1968). 131. Garrison FH, 1921. op. cit. pp. 93-94. 159. Isaacson W. Leonardo Da Vinci: The Biography. United 132. Dochez AR. Oswald Theodore Avery. In: National Academy States: Simon & Schuster, 2017, pp. 432-435. The coronary of Sciences. Biographical Memoirs: Volume 32. Washington sinuses were rediscovered by the Italian anatomist Antonio D.C.: National Academies Press, 1958, pp. 32-49. Maria Valsalva (1666-1723) over two centuries later, whence 133. Garrison FH, 1921. op. cit. p. 120. they became known as the sinuses of Valsalva. 134. Osler W, 1921. op. cit. p. 98. 160. Based on American surgeon Elmer Belt’s (1893-1980) ‘care- 135. Garrison FH, 1921. op. cit. p. 121. ful study of Leonardo’s manuscript notes’ [[Unsigned]. 33 136. Tan SY, Ahana A. Theodor Bilharz (1825-1862): discoverer anatomic firsts of Leonardo da Vinci. Spectrum (Pfizer), Fall of schistosomiasis. Singapore Medical Journal, March 2007; 1966; 14(4): 35] an unnamed author (see reference/note no. 48(3): 184-185. 158) summarising Belt’s work writes that Leonardo da Vinci 137. Sherrington CS. Santiago Ramón y Cajal. 1852-1934. Obit- introduced the term ‘capillary’ (ostensibly refering to its usage uary Notices of Fellows of the Royal Society, 31 December in an anatomical context). 1935; 1(4): 424–441. 161. A nearby chain of twenty-three tiny craters (each 1-2 km in 138. Sanders K, Ward S. Interstitial cells of Cajal: a new perspec- diameter), the Catena Davy, also shares this name. tive on smooth muscle function. The Journal of Physiology, 1 162. Weld CR. A History of The Royal Society: With Memoirs Of November 2006; 576(pt 3): 721–726. 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Bristol: Biggs and Cottle, 1800, p. 556. 142. Scott Berg A. Lindbergh. New York: Berkley Books, 1999. pp. 165. Bartolucci S, Forbis P. Stedman’s Medical Eponyms. Balti- 220-225. more: Lippincott Williams & Wilkins, 2005, p. 210. 143. There is also a Venetian crater named Cori. 166. The Nobel Foundation. (2018). Christian Eijkman – Nobel 144. Gerti Theresa Cori was the first female recipient of the Nobel Lecture. Available at: https://www.nobelprize.org/prizes/med- Prize in Physiology or Medicine. icine/1929/eijkman/lecture. Accessed 15th October 2018. 145. American Chemical Society. (2004). Carl and Gerty Cori and 167. Semba RD. The Discovery of the Vitamins. International Carbohydrate Metabolism, National Historic Chemical Land- Journal for Vitamin and Nutrition Research, October 2012; mark. Available at: https://www.acs.org/content/acs/en/edu- 82(5): 310-315. cation/whatischemistry/landmarks/carbohydratemetabolism. 168. Batty-Smith CG. The Eijkman test for faecal coli in the bacte- html. Accessed 14th October 2018. riological examination of water supplies. The Journal of Hy- 146. Krishnani PS et. al. Glycogen Storage Disease Type III: diag- giene, January 1942; 42(1): 55-98. nosis and management guidelines. Genetics in Medicine, July 169. Garrison FH, 1921. op. cit. p. 735. 2010; 12(7): 446-463. 170. Firkin B, Whitworth JA, 1989. op. cit. p. 144-145. 147. Crile GW. George Crile: An Autobiography. Edited, with Side- 171. Interestingly, Joseph Erlanger undertook his internship under lights, by Grace Crile. United States: J. B. Lippincott Compa- William Osler at Johns Hopkins Hospital after graduating ny, 1947, pp. 165-167. from the affiliated School of Medicine in 1899. 148. Crile GW, 1947. op. cit. pp. 201-208. 172. Davis H. Joseph Erlanger. In: National Academy of Sciences. 149. ibid. p. 176. Biographical Memoirs: Volume 41. Washington D.C.: Nation- 150. Waggone B, University of California Museum of Paleontolo- al Academies Press, 1970, p. 110-139. gy. (1996). Georges Cuvier (1769-1832). Available at: http:// 173. Garrison FH, 1921. op. cit. p. 584. www.ucmp.berkeley.edu/history/cuvier.html. Accessed 14th 174. Fechner GT, Langfield HS. (1912). Elements of Psychophys- October 2018. ics: Sections VII and XVI. Available at: https://psychclassics. 151. Cunningham D, Robinson A. Cunningham’s Text-book of yorku.ca/Fechner/. Accessed 15th October 2018. Anatomy. London: William Wood and Company, 1918, 175. Garrison FH, 1921. op. cit. p. 498. p. 1035. 176. Bagley F. An Investigation of Fechner’s Colors. The American

52 Osleriana Medicine’s Lunar Legacies

Journal of Psychology, 1902; 13(4): 488-525. communicated only via small perforations in the interventric- 177. Sherrington C. The Endeavour of Jean Fernel: With a List of ular septum. Arterial blood, imbued with warm ‘vital spirits’ the Editions of his Writings. Cambridge: Cambridge Universi- from the left ventricle of the heart, the centre of the body’s ty Press, 1946, p. 91-93. heat, was converted into ‘animal spirits’ (which resided in 178. Welch GR. In Retrospect: Fernel’s Physiologia. Nature, No- nerves) in the brain and was cooled by the ‘pneuma’, spirits vember 2008; 456(7221): 446-447. that passed from the lungs to the heart via the pulmonary ves- 179. Sherrington C, 1946. op. cit. p. 63. sels and maintained the animal heat. Venous blood, emanating 180. Niels Finsen remains the only medical Nobel Laureate to be from the liver, was imbued with ‘natural spirits’ that nourished awarded the Prize for an achievement in dermatology. all the tissues of the body with nutriment. (Garrison FH, 1921. 181. Löser C, Plewig G, Burgdorf WHC. Pantheon of Derma- op. cit. pp. 103-107. And: Osler W, 1921. op. cit. pp. 74-83). tology: Outstanding Historical Figures. Berlin/Heidelberg: 198. Osler W. 1921. op. cit. pp. 74-83. Springer-Verlag, 2013, pp. 304-310. 199. Rather LJ. Disturbance of Function (Functio Laesa): The Leg- 182. The Fischer crater is also named for German organic chemist endary Fifth Cardinal Sign of Inflammation, Added by Galen Hans Fischer (1881-1945) who was awarded the 1930 Nobel to the Four Cardinal Signs of Celsus. Bulletin of the New York Prize in Chemistry for his researches into the constitution and Acad-emy of Medicine, March 1971; 47(3): 303-322. The four synthesis of haemin (ferric chloride haem) and chlorophyll. cardinal signs of inflammation originally described by Celsus (Barnes Z. Hans Fisher: 1881-1945. In: James LK. Nobel Lau- were rubor (redness), calor (heat), tumor (swelling) and dolor reates in Chemistry, 1901-1992. Washington D.C.: American (pain). Galen added a fifth sign to these four – functio laesa, Chemical Society and Chemical Heritage Foundation, 1993, the loss of function of the affected part. Some have attribut- pp. 187-190). ed the identification of this fifth sign to the much more recent 183. Nagendrappa G. Hermann Emil Fischer: Life and Achieve- German pathologist Rudolf Virchow (1821-1902) but this, as ments. Resonance – Journal of Science Education, July 2011; Rather explains in his article, is untrue. 16(7): 606-618. 200. Talley NJ, O’Connor S. Clinical Examination: A Systematic 184. James LK. Nobel Laureates in Chemistry, 1901-1992. Wash- Guide to Physical Diagnosis. Australia: Elsevier, 2006, p. xiii. ington D.C.: American Chemical Society and Chemical Heri- 201. Cunningham D., Robinson A, 1918. op. cit. p. 970. tage Foundation, 1993, pp. 8-12. 202. Garrison FH, 1921. op. cit. p. 333. 185. Garrison FH, 1921. op. cit. p. 736. 203. McComas AJ. Galvani’s Spark: The Story of the Nerve Im- 186. Fenner F. (1996). Florey, Howard Walter (1898–1968). In: pulse. New York: Oxford University Press, 2011, pp. 11-19. Australian Dictionary of Biography. Available at: http://adb. 204. Mazzarello P. Camillo Golgi’s Scientific Biography.Journal of anu.edu.au/biography/florey-howard-walter-10206. Accessed the History of the Neurosciences, 1999; 8(2): 121-31. 16th October 2018. 205. Bignami A, Asher R, Perides G, Rahemtulla F. The extracel- 187. Abraham EP. Howard Walter Florey, Baron Florey of Adelaide lular matrix of cerebral gray matter: Golgi’s pericellular net and Marston, 1898-1968. Biographical Memoirs of Fellows of and Nissl’s nervösen grau revisited. International Journal of the Royal Society, 30 November 1971; 17: 261-269. Developmental Neuroscience, August 1992; 10(4): 291-9. 188. The date of Fracastoro’s birth is variously given as 1478 and 206. Jacobson M. Developmental Neurobiology. New York: Spring- 1484. The date here chosen (1484) is in accordance with Osler er, 1991, p. 117. (Osler W. Fracastorius. The Proceedings of the Charaka Club, 207. Pannese E. Neurocytology: Fine Structure of Neurons, Nerve 1906; 2: 5-20) who agrees with Garrison (Garrison FH, 1921. Processes, and Neuroglial Cells. Switzerland: Springer, 2015, op. cit. p. 227). p. 166. 189. Sigerist H, 1933. op. cit. pp. 100-108. 208. Alvar Gullstrand was the first Swedish recipient of the Nobel 190. In Fracastoro’s poem, Syphilus is the name – derived from Prize and the first ophthalmologist to be awarded the Prize for the mythological second son of Niobe, Sipylus – given to the an achievement in ophthalmology. herdsman of King Alcithous who in the midst of a drought, , 209. Ehinger B, Grzybowski A. Allvar Gullstrand (1862–1930) – according to the legends of natives about the origins of the the Gentleman with the Lamp. Acta Ophthalmologica, Decem- disease, renounced the Sun-God and was chastised with the ber 2011; 89(8): 701-708. first occurrence of the illness. The disease then betook the 210. Garrison FH, 1921. op. cit. pp. 764-765. Spaniards of the New World who had killed the sacred birds of 211. There is also a Martian crater named Haldane. the Sun-God, in accordance with the admonition of one of the 212. Dronamraju KR. J. B. S. Haldane (1892-1964): Centennial escaped fowls. (Osler W. Fracastorius. The Proceedings of the Appreciation of a Polymath. The American Journal of Human Charaka Club, 1906; 2: 5-20. And: Sigerist H, 1933. op. cit. Genetics, October 1992; 51(4): 885-889. pp. 100-108). 213. Nachman MW. Haldane and the first estimates of the human 191. Osler W. Fracastorius. The Proceedings of the Charaka Club, mutation rate. Journal of Genetics, December 2004; 83(3): 1906; 2: 5-20. 231-233. 192. McLeod SA. (2018). What are the most interesting ideas of 214. Crow JF. Centennial: J. B. S. Haldane, 1892-1964. Genetics, Sigmund Freud? Available at https://www.simplypsychology. January 1992; 130(1): 1-6. org/Sigmund-Freud.html. Accessed 16th October 2018. 215. There is also a Martian crater named Helmholtz. 193. Jarvis M. Psychodynamic Psychology: Classical Theory and 216. Garrison FH, 1921. op. cit. pp. 571-573. Contemporary Research. London: Thomson Learning, 2004, 217. Helmholtz H, Shastid TH. Description of an Ophthalmoscope p. 33. for the Investigation of the Retina in the Living Eye. Chicago: 194. Galen’s year of nativity is given as A.D. 129 by Sigerest Cleveland Press, 1916. p. 7. (Sigerist H, 1933. op. cit. p. 68) and A.D. 131 by Garrison 218. Myers GW. Georg Charles de Hevesy: the father of nuclear (Garrison FH, 1921. op. cit. p. 103). His year of death is also medicine. The Journal of Nuclear Medicine, June 1979; 20(6): variously recorded as being A.D. 199 (Sigerest) and 201 A.D. 590-594. (Garrison). As in Osler’s work (Osler W, 1921. op. cit. p. 74 & 219. De Castro F. Towards the sensory nature of the carotid body: 78), intermediate years of birth and death (A.D. 130 and A.D. Hering, De Castro and Heymans. Frontiers in Neuroanatomy, 200 respectively) have been given here. 7 December 2009; 3(23): 1-11. 195. Garrison FH, 1921. op. cit. pp. 103-107. 220. There is also a Martian crater named Hooke. 196. Sigerist H, 1933. op. cit. pp. 68-77. 221. West JB. Robert Hooke: Early Respiratory Physiologist, Poly- 197. According to Galenic theory, arterial and venous blood ebbed math, and Mechanical Genius. Physiology, July 2014; 29(4): and flowed within the vessels of two separate systems that 222-233.

July 2019 53 Z. Toodayan

222. Young F, Foglia VG. Bernardo Alberto Houssay, 1887-1971. versary of the photograph, is somewhat an exception to the Biographical Memoirs of Fellows of the Royal Society, 1 De- usual convention which requires the namesake to have been cember 1974; 20: 246-270. deceased for a minimum period of three years. At the time the 223. Firkin B, Whitworth JA, 1989. op. cit. pp. 246-247. change in name was approved, William Anders was eighty- 224. There is also a Martian crater named Huxley. four years old. 225. Garrison FH, 1921. op. cit. pp. 551-552. 252. Firkin B, Whitworth JA, 1989. op. cit. p. 396. 226. The Nobel Foundation. (2018). Paul Karrer – Nobel Lec- 253. Ivan Pavlov was the first Russian Nobel Laureate. ture. Available at: https://www.nobelprize.org/prizes/chemis- 254. Anrep GV. Ivan Petrovich Pavlov, 1849-1936. Biographical try/1937/karrer/lecture/. Accessed 18th October 2018. Memoirs of Fellows of the Royal Society, 31 December 1936; 227. Shampo MA, Kyle RA. Paul Karrer – Research on Vitamins. 2(5): 1-18. Mayo Clinic Proceedings, April 2000; 75(4): 328. 255. Garrison FH, 1921. op. cit. pp. 486-488. 228. Firkin B, Whitworth JA, 1989. op. cit. pp. 282-283. 256. Usunoff KG, Itzev DE, Ovtscharoff WA, Marani E. Neurome- 229. Garrison FH, 1921. op. cit. pp. 759-760. lanin in the Human Brain: A Review and Atlas of Pigmented 230. Hill AV. August Schack Steenberg Krogh, 1874-1949. Bi- Cells in the Substantia Nigra. Archives of Physiology and Bio- ographical Memoirs of Fellows of the Royal Society, 1 No- chemistry, 2002; 110(4): 257-369. vember 1950; 7(19): 220-237. 257. Gillispie CC, American Council of Learned Societies. Dictio- 231. National Research Council. Physiology in the Space Environ- nary of Scientific Biography, Volume 11. New York: Charles ment: Volume II Respiration. Washington D.C.: The National Scribner’s Sons, 1981, pp. 213-217. Academies Press, 1967, p. 82. 258. Friedman B. The Blue Arcs of the Retina. Archives of Ophthal- 232. Firkin B, Whitworth, JA, 1989. op. cit. p. 298. mology, November 1931; 6(5): 663-674. 233. Bruce-Chuvatt LJ. Alphonse Laveran’s discovery 100 years 259. Bhattacharyya KB. Eminent Neuroscientists: Their Lives and ago and today’s global fight against malaria. Journal of the Works. Kolkata: Academic Publishers, 2011, p. 180. Royal Society of Medicine, July 1981; 74(7): 531-536. 260. Wilhelm Röntgen was the first recipient of the Nobel Prize in 234. Haas LF. Charles Louis Alphonse Laveran (1845-1922). Physics. Journal of Neurology, Neurosurgery and Psychiatry, October 261. Gillispie CC, American Council of Learned Societies, 1981. 1999; 67(4): 520. op. cit. pp. 529-531. 235. Firkin B, Whitworth JA, 1989. op. cit. p. 303. 262. The first medical X-ray (i.e. one depicting part of a human 236. Lane N. The unseen world: reflections on Leeuwenhoek (1677) subject) was that of a hand of Anna Bertha Ludwig (1839- ‘Concerning little animals’. Philosophical Transactions of the 1919) – Röntgen’s wife. The historic radiograph was taken by Royal Society B: Biological Sciences, April 2015; 370(1666): Röentgen on December 22nd 1895. (Gillispie CC, American 1-10. Council of Learned Societies, 1981. op. cit. p. 529-531]. 237. Garrison FH, 1921. op. cit. pp. 251-252. 263. Haas LF. Ivan Mikhailovich Sechenov (1829-1905). Journal 238. Snyder LJ. Eye of the Beholder: Johannes Vermeer, Antoni van of Neurology, Neurosurgery & Psychiatry, October 1998; Leeuwenhoek, and the Reinvention of Seeing. New York: W. 65(4): 554. W. Norton & Company, 2015. [Chapters and page numbers not 264. Boakes R. From Darwin to Behaviourism: Psychology and the listed in electronic version]. Minds of Animals. Cambridge: Cambridge University Press, 239. Bates AW. The De Monstrorum of Fortunio Liceti: A Land- 1984, pp. 106-109. mark of Descriptive Teratology. Journal of Medical Biogra- 265. Eccles JC, Gibson WC. Sherrington: His Life and Thought. phy, 1 February 2001; 9(1): 49-54. Berlin: Springer-Verlag, 1979, Ch. 4: The Years of the Presi- 240. Garrison FH, 1921. op. cit. pp. 315-316. dency of the Royal Society, 1920-1925. 241. ibid. pp. 598-602. 266. Liddell EGT. Charles Scott Sherrington, 1857-1952. Bi- 242. Bartolucci S, Forbis P, 2005. op. cit. p. 437. ographical Memoirs of Fellows of the Royal Society, 30 No- 243. Geison GL. Michael Foster and the Cambridge School of vember 1952; 8(21): 241-259. Physiology: The Scientific Enterprise in Late Victorian Soci- 267. Liddel notes that the introduction of the term ‘synapsis’ was ety. Princeton: Princeton University Press, 1978, p. 344. made in the seventh edition of Sir Michael Foster’s (1836- 244. Martin DJ, Gillen LL. Revisiting Gerontology’s Scrapbook: 1907) Text-book of Physiology (1897) and that although Sher- From Metchnikoff to the Spectrum Model of Aging. The Ger- rington was a co-author, the introduction of the term has been ontologist, February 2014; 54(1): 51-58. credited to Foster. (Liddell EGT, 1952. op. cit.). According to 245. There is also a Martian crater named Mendel. Bennett, Sherrington himself, in a reply to an enquiry by neu- 246. Weinberg RA. The Biology of Cancer. New York: Garland Sci- rophysiologist-historian John Farquhar Fulton (1899-1960) as ence, Taylor & Francis Group, 2013, p. 2. to the derivation of the term ‘synapse’, wrote that the term 247. Paracelsus, Waite EA. The Hermetic and Alchemical Writings was suggested by one Arthur Woollgar Verrall (1851-1912), of Aureolus Philippus Theophrastus Bombast, of Hohenheim, a classical scholar and friend of Michael Foster’s from Trin- Called Paracelsus the Great. London: James Elliott and Co., ity College, Cambridge. Foster had consulted Verrall after 1894, p. xiii. Sherrington, who was applying himself to authoring a section 248. Borzelleca JF. Paracelsus: Herald of Modern Toxicology. Tox- on the nervous system for Foster’s textbook, had written to icological Sciences, 1 January 2000; 53(1): 2-4. him about the need for a new name to refer to the junction 249. Osler W, 1921. op. cit. p. 137. between nerve cells (Sherrington himself suggesting the term 250. Garrison FH, 1921. op. cit. pp. 199-200. ‘syndesm’ at the time). (Bennett MR. History of the Synapse. 251. Pasteur T is no longer the name for this satellite crater. The Amsterdam: Harwood Academic Publishers, 2001, p 23). 40.2 km crater, the second-largest of Pasteur’s satellite fea- 268. Bhattacharyya KB, 2011. op. cit. pp. 198-199. tures and located on the western rim of the plain, was recently 269. Hinsey JC, Gasser HS. The Sherrington Phenomenon: V. Ner- (October 2018) renamed ‘Anders’ Earthrise’ in recognition of vous Pathways. The American Journal of Physiology, 1928; the fact that this crater was visible in the foreground of the 87(2): 368-380. iconic colour photograph of the Earth – ‘Earthrise’ – that 270. Aly I, Tubbs SR, Shoja MS, Loukas M. Samuel Thomas von was taken from lunar orbit by Apollo 8 astronaut William A. Söemmerring (1755–1830). International Journal of History Anders (b.1933) on 24th December 1968 as he and his fellow and Philosophy of Medicine, 2016; 6: 1-6. crewmen became the first people to circumnavigate the Moon 271. Pearce JMS. Samuel Thomas Soemmerring (1755–1830): The just over fifty years ago. The renaming of the crater, which Naming of Cranial Nerves. European Neurology, June 2017; was ostensibly undertaken in anticipation of the fiftieth anni- 77(5-6): 303-306.

54 Osleriana Medicine’s Lunar Legacies

272. The existence of a functional vomeronasal organ in humans 303. Turner DD. Virchow’s Metamorphosis of the Salivary Glands. is debated. [Stoyanov GS, Matev BK. Samuel Thomas von AMA Archives of Surgery, July1958; 77(1): 110-112. Sömmerring’s Contributions on the Cranial Nerves and Vom- 304. [B. Jain Publishers (P) Ltd], 2004. op. cit. p. 340. eronasal Organ. Cureus, 22 June 2018; 10(6): 1-4]. 305. Emil von Behring was the first recipient of the Nobel Prize in 273. There is also a Martian crater named Spallanzani. Physiology or Medicine. 274. Garrison FH, 1921. op. cit. pp. 329-330. 306. MacNalty AS. Emil von Behring. British Medical Journal, 275. Dinsmore CE. A History of Regeneration Research: Mile- March 1954; 1(4863): 668-670. stones in the Evolution of a Science. Cambridge: Cambridge 307. Shampo MA, Kyle RA. Georg von Békésy – Audiology and University Press, 1991, pp. 67-89. the Cochlea. Mayo Clinic Proceedings, July 1993; 68(7): 706. 276. Nicolas Steno is the Latinised version of the Danish name 308. Some of Thomas Young’s contributions to physics are also rel- Niels Stensen. evant to the physiology and pathology of the human body. An 277. Garrison FH, 1921. op. cit. p. 265. adapted version of the Young-Laplace equation for instance, 278. Kardel T. Stensen’s Myology in Historical Perspective. Trans- which relates the pressure differential across a stable spherical actions of the American Philosophical Society, 1994; 84(1): interface maintained by surface tension or tension in its thin 1–57. wall, finds applications in alveolar physiology. (Notter RH. 279. Loukas M et. al. The Lymphatic System: A Historical Perspec- Lung Surfactants: Basic Science and Clinical Applications. tive. Clinical Anatomy, 2011; 24: 807-816. New York: Marcel Dekker, Inc., 2000, pp. 122-124). Young’s 280. Tubbs RS et. al. “The heart is simply a muscle” and first de- modulus, a measure of elasticity or stiffness – defined as the scription of the tetralogy of “Fallot”. Early contributions to ratio of applied stress (force per unit area) to induced strain cardiac anatomy and pathology by bishop and anatomist Niels (deformation) within a solid material – is a property of solid Stensen (1638–1686). International Journal of Cardiology, 9 tissues measured in ultrasonic elastography (e.g. for the inves- February 2012; 154(3): 312-315. tigation of cirrhosis by hepatic elastography). (Barr RG. Elas- 281. Claesson S, Pederson KO. The Svedberg, 1884-1971. Bi- tography: A Practical Approach. New York, Suttgart: Thieme ographical Memoirs of Fellows of the Royal Society, 30 No- Medical publishers, Inc., 2017, Abbreviations/Terminology.] vember 1972; 18: 595-616. 309. Garrison FH, 1921. op. cit. pp. 359-360 282. Kyle RA, Shampo MA. Theodor Svedberg and the Ultracen- 310. Stedman TL, 1914. op. cit. p. 1040. trifuge. Mayo Clinic Proceedings, September 1997; 72(9): 311. The number of these spots has also been suggested as sym- 830. bolising the span of time – with each dot representing seven 283. Max Theiler was the first African-born Nobel Laureate. days – that separates the summer solstice and autumnal equi- 284. Frierson JG. The Yellow Fever Vaccine: A History. Yale Jour- nox (thirteen weeks) and the autumnal and vernal equinoxes nal of Biology and Medicine, June 2010; 83(2): 77-85. (twenty-six weeks). (International Council on Monuments and 285. Kekwick RA, Pederson KO. Arne Tiselius 1902-1971. Bi- Sites; International Astronomical Union. Case Study 1.4: The ographical Memoirs of Fellows of the Royal Society, 1 De- Astronomical Rock Panels in the Lascaux Cave, France. ICO- cember 1974; 20: 401-428. MOS-IAU Thematic Study on the Heritage Sites of Astronomy 286. Bartolucci S, Forbis P, 2005. op. cit. p. 726. and Archaeoastronomy, June 2010; 1: 24-27). 287. Garrison FH, 1921. op. cit. pp. 614-615. 312. Whitehouse D, 2016. op. cit. Ch. 1: The Moonwatchers of Las- 288. Finkbeiner WE, Ursell PC, Davis RL. Autopsy Pathology: A caux. Manual and an Atlas. Philadelphia: Saunders Elsevier, 2009, 313. If the supposition that the engravings at Knowth symbolise p. 6. lunar features is correct, it would be the oldest known depic- 289. Virchow R, Chance F. Cellular Pathology as Based Upon tion of the Moon by Man [Stooke PJ. Neolithic Lunar Maps Physiological and Pathological Histology. Alabama: Division at Knowth and Baltinglass, Ireland. Journal for the History of Gryphon Editions, Ltd. (Special Edition Reprint of the 1860 of Astronomy, 1 February 1994; 25(1): 39-55], predating Jan text for The Classics of Medicine Library), 1978, p. 204. van Eyck’s canvas painting Crucifixion and Last Judgement 290. ibid. p. 167. and Leonardo da Vinci’s sixteenth century Codex Atlanticus 291. ibid. p. 367. sketches (see note no. 50) by some 4,500 years. 292. [B. Jain Publishers (P) Ltd.]. Pocket Medical Dictionary of the 314. Proctor M. Romance of the Moon. New York: Harper & Broth- Principal Words used in Medicine and the Collateral Sciences, ers Publishers, 1928, pp. 247-248. New Delhi: B. Jain Publishers (P) Ltd., 2004, p. 799. 315. ibid. pp. 251-254. 293. Stedman TL. A Practical Medical Dictionary, Third Edition. 316. ibid. pp. 222-224. New York: William Wood and Company, 1914, p. 1020. 317. ibid. p. 230. 294. Schultz M. Rudolf Virchow. Emerging Infectious Diseases. 318. ibid. pp. 227-228. September 2008; 14(9): 1480–1481. 319. ibid. p. 232. 295. Virchow R, Chance F, 1860. op. cit. p. 199. 320. Grueber HA. The Myths of Greece & Rome. London: George 296. ibid. pp. 64-65. G. Harrap & Co. Ltd., 1944, pp. 60-63. 297. ibid. p. 277. 321. A pareidolia is the tendency to perceive meaningful images 298. ibid. p. 120. or information in a random and impersonal stimulus. It is a 299. Firkin B, Whitworth JA, 1989. op. cit. pp. 548-549. subcategory of apohenia (a tendency to perceive association 300. Sumanth KN, Vinod VC, Taneja P. Virchow-Seckel Type Bird and meaning between unrelated things). Headed Dwarfism (Seckel Syndrome) – A Case Report. Jour- 322. Proctor M, 1928. op. cit. pp. 230-231. nal of Indian Academy of Oral Medicine and Radiology. 2004; 323. ibid. pp. 225-226. 16(3): 223-227. 324. Moore P. Guide to the Moon. London: Lutterworth Press, 301: Paget J, Moore C. Tumours and Cancer. In: Holmes T. A Sys- 1976, p. 15. tem of Surgery, Theoretical and Practical in Treatises by Var- 325. Proctor M, 1928. op. cit. pp. 240-244. ious Authors: Volume 1 – General Pathology. London: Long- 326. Some old lunar narratives persist inconspicously in society. man, Greens, and Co., 1870, p. 526. It has been said, for instance, that the popular nursery rhyme 302. Kepes J. Observations on the Formation of Psammoma Bod- ‘Jack and Jill’ is based on an astronomical allegory – their go- ies and Pseudopsammoma Bodies in Meningiomas. Journal ings about the hill referring to the risings and settings of the of Neuropathology & Experimental Neurology, April 1961; Sun and new Moon. (Proctor M, 1928. op. cit. pp. 244-245). 20(2): 255-262.

July 2019 55 Apollo 11 lifts off from Launch Complex 39A, Cape Kennedy, Florida, at 13:32:00 GMT2 on 16th July 1969. With over 7.5 million pounds of thrust at sea level,3 the mighty Saturn V rocket, designed by German aero- space engineer Werner von Braun (1912-1977), remains one of the most powerful machines ever made by man.3 Image courtesy of the Project Apollo Archives (PAA). Apollo 11 - 50 Years

Apollo 11 was the fifth mission of The National Aeronautics and Space Administration’s (NASA) epic endeavour to realise President John F. Kennedy’s (1917-1963) goal of “landing 1 The official Apollo 11 in- a man on the Moon and returning him safely to the Earth”. signia featured an eagle, Launched on 16th July 1969 (see opposite],2,3 and featuring a symbol of the United the first ever lunar landing (see image below) and moonwalk States, alighting upon th st the lunar surface and four days later [between 20 and 21 July 1969], this peril- th bearing an olive branch, ous and pioneering mission was a tremendous success. 20 a symbol of peace, in its and 21st July 2019 mark the golden jubilee of this monumen- talons. A distant sunlit tal milestone in human history. Fortunately, there is a vast Earth - home of the visiting - was included in audiovisual archive preserving the story of Apollo 11, and a the background above the small selection of photographs from this collection are here Moon’s horizon. The en- shared, alongside a very brief summary of the mission. tire lunar space program was named after Apollo, the Greek mythological That Man reached the Moon is truly remarkable, but when we diety of the Sun, who was consider the broader dimensions of our solar system - to also the God of music, say nothing of the galaxy or wider Universe - we realise he poetry and medicine.6 hasn’t wandered far from the cradle of life. Nonetheless, Courtesy of NASA. Apollo 11 reminds us that we are, in Browne’s words, “that bold and adventurous piece of nature”,4 and erects an ideo- logical launchpad from which other great journeys may take their beginnings. “An optimism about technology” and “an enthusiasm for the future”, were, as Carl Sagan identified, among the many “gifts of Apollo”.5 It is with fond recognition of these gifts that we action this little tribute and celebrate the still-spectacular achievement of the men and machines that were Apollo 11.

The Apollo 11 Lunar Module at Tranquility Base - part of a larger photograph taken by Neil Arm- strong from the surface of the Moon on July 21st 1969 (GMT). Image courtesy of PAA. 57 The three astronauts of Apollo 11 are here pictured from a mission photograph dated 14th April 1969. From left to right: Mission Commander Neil Alden Armstrong (1930-2012), Command Module Pilot Michael Collins (b.1930) and Lunar Mod- ule Pilot Edwin Eugene ‘Buzz’ Aldrin Jr (b.1930). Armstrong and Aldrin were, respectively, the first and second humans to lay foot on lunar soil. Of the three, Aldrin and Collins are still living. Courtesy of NASA.

Apollo 11 ascending through the atmosphere. Plume expansion is appreciable. Prior to leaving Earth orbit, the rocket was accelerat- ed to a speed of around 39,000 km/h!7 Image Courtesy of PAA.

Apollo 11’s Lunar Mod- ule (LM) ‘Ea- gle’, seen here shortly after undock- ing from the Command and Service Modules in lunar orbit, carried Armstrong and Aldrin to the surface of the Moon. Image courtesy of PAA.

Apollo 11’s Command and Service Modules (CSM) ‘Columbia’, pictured here from the descending LM, was pi- loted by Collins and orbited the Moon while Armstrong and Aldrin investigated the lunar surface. The Command Module (CM) alone (whose reflective conical surface is visible here), housing all three astronauts, was the only part of the Apollo spacecraft designed to return to Earth. Courtesy of PAA.

Statio Tranquillitatis, or, Tranquility Base (0.71°N, 23.63°E) - the landing site of the Apollo 11 LM.8 58 Osleriana Four days into the mission, at 20:17:39 GMT2 on 20th July 1969, Apollo 11’s LM touched down on the lunar surface at ‘Tranquility Base’. More than 7.5 hours later (at 02:56;15 GMT on 21st July2), a dedicated camera recorded and televised Neil Armstrong’s descent down the module’s ladder (still frame pictured here), and his first step and words on the Moon: “That’s one small step for man. One giant leap for mankind”.2 Image courtesy of NASA.

During their 133 minutes of extravehicu- lar activity on the Moon,2 Armstrong and Aldrin erected the American flag (still frame from a LM camera pictured] and attended to scientific instruments and samples. From NASA.

The astronauts imaged the Moon’s surface from a never-before-seen perspective. This photo of Aldrin’s boot- print in the lunar regolith became an iconic image of man’s first Moonwalk. Image courtesy of PAA.

Following a rest period within the LM, and leaving the descent stage of the LM (with a commemorative plaque upon it) behind, Armstrong and Aldrin ascended to rendezvous with the CSM in lunar orbit. This photograph, taken by Collins from the CSM, shows the ascent stage of the LM prior to docking. Earth can be seen afar. Image courtesy of PAA.

A full Moon as seen from Apollo 11 during its return journey to Earth, featuring a portion of the lunar far-side not visible from Earth. Image courtesy of PAA. July 2019 59 Buzz Aldrin on the Moon. A footpad of the LM and the shadow of its landing strut are also visible. Photograph taken by Neil Armstrong on July 21st 1969. Image courtesy of PAA. This spectacular photograph of our planet was captured from the CSM during Trans- Earth Coast (the return to Earth). At 16:50:35 GMT2 on 24th July 1969, after a total mission time of 4 days, 3 hours and 18 minutes,8 the Apollo 11 CM and its crew splashed down safely in the Pacific Ocean (13.32°N, 169.15°W) - mission accomplished.

References & Notes

1. John F. Kennedy Presidential Library and Museum Archives. Special Message to Congress on Urgent National Needs, 25 May 1961. Available at: https://www.jfklibrary.org/asset-viewer/archives/JFKWHA/1961/JFKWHA-032/JFKWHA-032. Accessed 1st July 2019. 2. NASA. Apollo 11 Timeline. Available at: https://history.nasa.gov/SP-4029/Apollo_11i_Timeline.htm. Accessed 1st July 2019. The time used here is Greenwich Mean Time or Universal Coordinated TIme (UTC). The corresponding [American] Eastern Standard Time (EST) is GMT/UTC -5 and the corresponding Eastern Daylight TIme (EDT) is GMT/UTC - 4. 3. Hart-Davis A. Engineers. London: Dorling Kindersley Limited, 2012, p. 345. 4. Browne T. Religio Medici, A Letter to a Friend, Christian Morals, Urn-Burial and Other Papers. Boston: Ticknor and Fields, 1862, p. 32. 5. Sagan C. The Gift of Apollo. The Planetary Report, 1994; 14(3): 4-5. 6. Guerber HA. The Myths of Greece and Rome. London: George G. Harrap & Co. Ltd., 1944, p. 41. 7. NASA. Apollo 11 Translunar Phase. Available at: https://history.nasa.gov/SP-4029/Apollo_11f_Translunar_Phase.htm. Accessed 2nd July 2019. 8. NASA. (2019). Apollo 11 Mission Overview. Available at: https://www.nasa.gov/mission_pages/apollo/missions/apollo11. html. Accessed 1st July 2019. 61

René Théophile Hyacinthe Laennec (1781-1826): Advancing Auscultation

Edward Carson*

As the inventor of the stethoscope, René Laennec remains a popular figure for historical reflection. Born in 1781 Brittany, France, his childhood was marred by the French revolution, but he was supported in pursuing a medical career by a physician uncle who helped him enroll at a Parisian medical school under the tutelage of Professors Jean Noël Hallé (1754-1822) and Jean-Nicolas Corvisart (1755-1821). Laennec excelled as a student, showing a particular aptitude for pathological anatomy, and later became known as one of the nation’s leading pathologists. He invented the stethoscope in 1816 while working at the Necker Hospital in Paris, and subsequently published his discoveries in his famous textbook De L’Auscultation Médiate, which was first printed in 1819. Leannec eventually left Paris due to failing health and retired to the country where he died in 1826 at the age of forty-five. Two hundred years since his great publication, both the stethoscope and its inventor remain recognisable icons of the medical profession.

ené Théophile Hyacinthe Laennec was born in family home.3 All medical schools were closed, so in 1781 Brittany, France, on the seventeenth day 1795, aged only fourteen, Laennec enlisted as an assis- of February that year.1 At the age of five he tant surgeon at two local military hospitals which had R 4 lost his mother Michelle Félicité Laennec (1754-1786), a combined capacity of over four thousand beds. He who died a few days after giving birth to her fourth became increasingly committed to a future in medi- (still-born) child.2 This left René and his two young- cine around this time, and dedicated himself to reading er siblings in the care of their father Théophile-Marie medical textbooks between caring for injured patients Laennec (1747-1836), an intelligent but unreliable in the overcrowded wards. During his spare time, man who was then working as a magistrate at the civil Laennec would write about the adventures of one Dr court in Quimperlé. Considered incapable of provid- Cenneal, a character he created by spelling his own ing for his young family, Laennec the Elder sent his name backwards.5 daughter to live with her aunt, and his two sons to their respected uncle Guillaume François Laennec (1748- 1822), a physician in the city of Nantes.2 Guillaume Medical School and Private Practice was an accomplished doctor and directed the young Laennec towards the study of medicine. By 1801 the medical schools of Paris had reopened, and with the financial support of his father and uncle, This was a time of great political unrest and the rising the nineteen-year-old Laennec enrolled at the Hôpital ferocity of the French Revolution meant that execu- de la Charité where he was taught by Jean Noël Hallé tions were taking place directly outside Guillaume’s (1754-1822) and Baron Jean-Nicolas Corvisart (1755- 1821).6 Corvisart – personal physician to Napoleon Bonaparte (1769-1821) – was widely renowned in contemporary Parisian medicine for his revolution- * Dr Edward Carson is a Hospital Medical Officer from Bendigo, ary work on percussion, a technique he had learnt and Australia. Correspondence: [email protected]. perfected after reading a manuscript published in 1761 Lithograph of René Theophile Hyacinthe Laennec (1781-1826) by the Austrian physician Josef Leopold Auenbrugger from the workshop of Joséphine-Clémence Formentin (1802- (1722-1809).3,7,8 By percussing a patient’s body, Cor- 1850). Courtesy of the US National Library of Medicine. visart was able to determine the state of the internal or-

63 E. Carson gans, and he used this simple and effective technique ams, he was asked to disarticulate the shoulder joint to correlate his findings on the ward with what was of a cadaver with Dupuytren as an assistant. Laennec revealed at autopsy. wrote that he heard the examiner marvel at “the stroke by which I cut the tendons of supraspinatus, infraspi- Laennec soon acquired a reputation for his enthusiasm natus… and biceps, and the capsule of the joint at the and scholarship in medical school – in his first year same time I was rotating the arm below and inside so alone for example, he had compiled over four-hundred that the head of the humerus rolled under the blade of cases of patients he had seen on the wards. In line the instrument and came out the moment the incision with contemporary symptom-based nosological classi- was complete”.14 The accomplished dissector grad- fications of disease, medical students at this time were uated from medical school the following year after taught that the most important component of formulat- completing a thesis on the works of Hippocrates titled ing a diagnosis came through listening to the patient’s Propositions sur la doctrine d’Hippocrate appliquée own personal experience of their illness; signs found à la médicine-pratique which contended that Hippo- on physical examination were considered to be of cratic teachings supported the theory of pathological lesser importance.9 However, the emerging doctrine anatomy.15,16 After graduation, Laennec continued to of pathological anatomy, which explained a patient’s contribute to the Journal de Médicine and other aca- symptoms based on what was found on physical exam- demic periodicals. In 1806 he published a 200-page ination and autopsy, was becoming increasingly popu- thesis on the history of parasitology, tracing back the lar. Laennec was introduced to pathological anatomy study of parasites to the ancient works of Aretaeus of through his fellow student and friend Gaspard Laurent Cappadocia (1st century A.D.) and Galen of Pergam- Bayle (1774-1816), and soon began publishing his on (A.D. 130-200). During this time, he also began pathological investigations in Corvisart’s Journal de documenting his discoveries in the dissecting room in Médicine, a periodical created to report clinical find- an unpublished compilation titled Treatise on Patho- ings made in Parisian medical schools.10 Laennec’s logical Anatomy.17, 18 In the most well-known chapter first publication described a deceased twenty-two- of this treatise, Laennec coins the term “cirrhosis” to year-old man whose body was examined by Corvisart describe the tawny yellow appearance of a thirty-nine- just prior to autopsy. Corvisart diagnosed pleural ef- year-old woman’s liver. William Osler (1849-1919), fusions with cardiomegaly and a dilated right ventricle who was a great admirer of Laennec, referred to the with lesions to the left side of the heart; all of these same condition as “the cirrhosis of Laennec” in his findings were confirmed at autopsy.11 By the time his masterwork on the Principles and Practice of Medi- manuscript was printed however, the work had been cine.19 It was owing to the popularity of Osler’s text- thoroughly revised, and Laennec was infuriated with book that Laennec’s name came to be firmly associat- the extent of editing his work was subjected to prior ed with the disease, even though he was not the first to publication. He was similarly frustrated after sub- to describe it.20 mitting a one-hundred-page article on a new disease called “peritonitis”, a term he had himself introduced Despite these achievements, Laennec’s early to describe inflammation of the peritoneum; the work post-graduate years were fraught with uncertainty. pleased the editors so much that they requested his His application to the chair of ‘Hippocratic Medicine name be omitted from the authorship and that the ar- and Rare Disease’ at the Paris Faculty was declined, ticle instead be published as having been “collected even though he had earlier authored major works on under the eyes of Professor’s Corvisart and Leroux”, both Hippocrates and parasitology. His poor financ- despite neither being involved in this research.12 This es and busy schedule caused him great stress in these article however, showcased Laennec’s skill as an am- years, and began taking a toll on his physical health. ateur pathologist and clinical investigator, and he was He lost weight and developed anxiety and breathless- subsequently invited to work alongside the head of ness; his symptoms becoming so severe that he was anatomy Baron Guillaume Dupuytren (1777-1835). unable to tolerate the weight of his own shirt on his It was owing to such successes that Laennec’s close chest.21 Ill and impoverished, Laennec returned to friend Laurent Bayle introduced him to a royalist his childhood home of Kerlouarnec in Brittany where group known as the Congregation, through which he believed the clean air and rural lifestyle would al- both developed useful connections with the French leviate his symptoms and rejuvenate his health. His aristocracy.13 financial difficulties however had no such solution. Laennec was already providing an allowance to his In 1803 Laennec sat his medical exams. Unsurpris- sister Marie-Anne Laennec (1785-1853), but in 1809 ingly, he achieved his lofty expectations, receiving the he began sending money to his father as well. He was highest grade for surgery and sharing the top marks therefore greatly distressed when his brother Michaud for medicine. In the practical component of his ex- Laennec (1782-1810) discovered that their father and

64 Osleriana René T. H. Laennec step-mother had squandered their entire income on great distinctness with which we hear a scratch of a gambling, dinner parties, and endless court cases.22 pin at one end of a piece of wood, on applying our ear to the other. Immediately, on this suggestion, I rolled a The next few years were a tumultuous time for France quire of paper into a kind of cylinder and applied one – Napoleon had just been defeated in the disastrous end of it to the region of the heart and the other to my Russian campaign of 1812-1813 and the monarchy ear, and was not a little surprised and pleased, to find was reinstated to power the following year with the that I could thereby perceive the action of the heart ascension of King Louis XVIII. The hospitals were in a manner much more clear and distinct than I had filled with injured French soldiers and diseases like ever been able to do by the immediate application of typhus were rampant. Yet out of this political insta- the ear”.27 bility came Laennec’s opportunity. Through years of devoted service, Laennec had secured himself a repu- Over time this story was said to be inspired by chil- tation as one of the nation’s leading pathologists and dren playing with a wooden plank and nail. One child had become the physician of choice for many royalist would scratch the nail on one end of the wood, while families.23 In 1816 he was appointed chief physician a second child held their ear to the opposite end to de- at the Hôpital Necker in Paris, a position which fur- cipher a message.28 Whatever narration of events is ther enhanced his capacity for private practice, clini- preferred, Laennec recognised the potential clinical cal research, and authoritative contributions to several utility of this observation, and began experimenting medical societies.24 For his uncle Guillaume however, with different designs to further test his hypothesis. this was a notably difficult period; he lost his position He found hollow wood to be better at transmitting as Professor of Medicine at Nantes and was further vocal sounds, and solid wood superior at transmitting shunned for having anti-royalist sentiments. Offering heart sounds. Other materials such as glass and metal his support to the man who had nurtured his early in- were not utilised because they would be uncomfort- terests in medicine, Laennec allowed Guillaume’s son able when applied to the patient’s skin. After a full Mériadec Laennec (1797-1873) to move in with him. year of trial and error, Laennec was making good use Mériadec had come to Paris to study medicine himself, of a wooden cylinder roughly one foot in length with a and eventually become Laennec’s closest friend and quarter inch canal (Figure 1).29, 30 He famously named most loyal pupil.25 the device “stethoscope” – from the Greek words stethos for ‘chest/breast’ and skopein meaning ‘to look at/examine’. The Stethoscope and Research Laennec’s initial research with the stethoscope fo- It was whilst at the Hôpital Necker that Laennec first cused on heart sounds, but after finding noises reso- invented the stethoscope. Prior to this appointment, he nating from diseased lungs to be distracting, he soon had at times employed what was then called “immedi- changed his focus to the pulmonary system.31 He care- ate auscultation”, an examination technique where the fully examined breath sounds on the wards and then physician placed an ear directly on the patient’s chest correlated this with what was found at autopsy. One to listen to heart sounds. This method was first de- major contribution to come from Laennec’s daily use scribed by Hippocrates but was not widely used, and of the stethoscope was the clinical identification of the Laennec found it “inconvenient to both the physician different stages of pneumonia in living patients – en- and patient” with little clinical application.26 Imme- gorgement, hepatisation, consolidation and resolution. diate auscultation was of course particularly prob- Prior to his investigations, these stages were only de- lematic when a patient did not regularly bathe, was termined at autopsy, but with the use of a stethoscope, overweight, or of the female sex. Confronted with just Laennec learnt to identify each stage of pneumonia in such a situation, Laennec recounted the improvisation living patients.32 This insight not only influenced his behind his innovative instrument as follows: decisions regarding treatment, but also assisted in providing an accurate prognosis for each case. Another “In 1816, I was consulted by a young woman labouring major discovery to come from Laennec’s work with under the general symptoms of diseased heart, and in respiratory patients was what he called “pectoriloquy”. whose case percussion and the application of the hand This was a change in resonance of a patient’s voice, were of little avail on account of the great deal of fat- which, if heard on auscultation of the chest, indicat- ness. The other method [immediate auscultation] ren- ed the presence of underlying lung consolidation.33 dered inadmissible by the age and sex of the patient, I Laennec believed pectoriloquy was pathognomon- happened to recollect a simple and well-known fact ic for phthisis – or tuberculosis, as it would later be in acoustics, and fancied it might be turned to some called by Johann Lukas Schönlein (1793-1864) in the use on the present occasion. The fact I allude to is the 1830’s.34 Remarkably, by identifying pectoriloquy on

July 2019 65 E. Carson

Figure 1: A copy of the original plate published in De L’Auscultation Médiate (On Mediate Auscultation) showing Laennec’s design of the stethoscope. The illustration labelled ‘Fig 1.’ (far left) shows the stethoscope’s stopper (a), two halves (b and c) and auricular extremity (d) to which the listener’s ear is applied. ‘Fig 2.’ and ‘Fig 3.’ depict longitudinal sections through the device with stopper inserted and removed respectively. ‘Fig 4.’ shows the stethoscope’s stopper which consists of a wooden body (a) and a brass tube (b) to fix it into place. ‘Fig 5.’ portrays the upper segment of the stethoscope. ‘Fig 6.’ is an end-on perspective of the stethoscope, displaying the instrument’s actual diameter. On the opposing page are pictured some diseases of the lung. ‘Fig 7.’ (top) shows the superior lobe of a lung with various stages of phthisis illustrated in different regions – there is a large cavity (a) with columnar bands (b) and miliary granulations (d). ‘Fig 8.’ depicts a pulmonary fistula in the superior lobe of the left lung. Image courtesy of the French National Library of Medicine. physical examination, Laennec was able to confidently ising fluid cavities in the chest. He first came across diagnose phthisis in patients who had no other sub- this idea as a student when he read of Hippocrates’ de- stantial symptoms of the disease. In fact, he became scription of free fluid and air in the thorax producing so certain of this finding, that when he was once told the sound of “boiling vinegar”.36 Laennec initially an autopsy of a patient he had diagnosed with phthi- considered this to be one of the “great man’s mistakes”, sis failed to show any signs of the disease, he rushed however, he changed his mind after reviewing a thirty- to the morgue to examine the body himself – upon year-old patient who reported hearing sounds of swirl- inspection he found one of the lobes of the lung had ing fluid every time he rolled over in bed. Intrigued, been left within the thorax, which, when removed and Laennec auscultated this patient’s chest while turning examined, displayed clear signs of phthisis precisely him in different positions and localised the fluid to an where he had predicted.35 Laennec expanded on this area in the right lung. A successful thoracentesis was work and went on to describe the different stages of performed allowing ten pounds (or about 4.5 litres) of pulmonary tuberculosis, from caseation to calcifica- fluid with air mixed through to be removed from the tion and finally miliary spread. man’s thorax. Unfortunately, the patient soon deteri- orated and died not long afterwards – probably from Laennec also demonstrated the clinical utility of the infection – but this did not detract from Laennec’s stethoscope in surgical cases; for instance, when local- important verification of one of Hippocrates’ ancient

66 Osleriana René T. H. Laennec observations. In his description of the case, Laennec treatment.42 But even the critics had to embrace the also cited others such as Ambroise Paré (1509-1590), stethoscope for its overall novelty and clinical useful- Thomas Willis (1621-1675), and Giovanni Battista ness. François Joseph Victor Broussais (1772-1838) Morgagni (1682-1771), who had each described a for instance, one of Laennec’s most outspoken critics, similar phenomenon after being alerted to the condi- admitted that “what he has done will be used to advan- tion by their patients.37 Unlike his predecessors how- tage, and his mistakes… will fall into oblivion”.43 evere, Laennec accurately predicted where the fluid was collecting by using his stethoscope, and therefore Laennec’s textbook sold well. He continued to be determined the optimal site for drainage. sought after as a physician by the French aristocracy;

Publication of De L’Auscultation

Laennec’s seminal treatise on ‘mediate auscultation’ – De L’Auscultation Médi- ate – was first published two-hundred years ago in August of 1819 (Figure 2). Summarising all of his discoveries to date, the text focused on describing new bed-side clinical signs which aided in the diagnosis of conditions such as pneumonia, phthisis, pulmonary oedema, pneu- mothorax, asthma, and even emphysema, a condition which, prior to the introduction of the stethoscope, was only able to be diagnosed at autopsy. Overall the text was very well received, and one reader even stated that the author “had attained and even surpassed [the] goals of the Old Man from Cos”.38 Laennec’s uncle Guillaume wrote that “for 100 years doctors have written books using only other books, he [Laennec] alone has… shown new things, unheard, unknown and useful”.39

A year later in 1820, the Scottish physician Sir John Forbes (1787-1861) provided an English translation of Laennec’s masterwork, stating in his introduction that he had “no hesitation in pronouncing the following work to be one of the most valuable that has ever been presented to the medical profession”.40 Controver- sially, Forbes was found to have added additional notes and references citing the works of English researchers which Laennec had failed to acknowledge – he later apologised to Laennec for these changes, and when translating the second edition, he aligned it more strictly with the original text.41 Notwithstanding a generally positive reception, Laennec’s work also received significant criticism Figure 3: The cover page of the first (1819) edition of Laennec’s classical due to its predominant focus on diagno- treatise De L’Auscultation Médiate (On Mediate Auscultation). Courtesy sis at the expense of further discussion on of the French National Library of Medicine.

July 2019 67 E. Carson appointments which were acquired through his signif- pleurisy, and acute hydrocephalus.44 He also adhered icant professional and political contacts. His interest to certain Hippocratic teachings, recording for one pain ancient texts often influenced his clinical practice, tient “fever from furious delirium, crisis on day 14?”, such as his use of tartar emetics, which he initially em- a reference to the Hippocratic notion that a fever is ployed for the treatment of pneumonia, and later used most likely to fall on the seventh day of illness, and for a range of other conditions including rheumatism, every seven days thereafter.45

Death and Legacy

In 1825, having established himself as a professor at two institutions, Laennec married his housekeeper Jacquette Guichard (1779-1847).46 He lectured three times a week at the prestigious Collège de France, working tirelessly over thirty-week intervals to deliver a syllabus that would take two years to complete. From 1822-1826 he only completed the entire course twice. Combining these duties with ward work, writing, and a busy private practice, Laennec became overworked and his fragile health began to falter once again. In 1826, only two days after completing his second edition of De L’Auscultation Médiate (Figure 3), he again returned to Kerlouarnec but soon developed severe fevers and diarrhoea. He was examined by several physicians, and although no single diagnosis was made, he was suspected to be suffering from phthisis47 – the very disease he had studied for so long, and upon which his reputation as the father of auscultation rests to this day. Laennec never recovered from his illness and died on 13th August 1826 at the age of forty-five. He was buried at a cemetery in the nearby town of Qui- mperlé where a bronze statue of him was later erected in 1868 (Figure 4). His wife continued to live in Kerlouar- nec until her own death in 1847, when she was buried alongside him. All of Laennec’s works and manuscripts were left to Mériadec, much of which remained unpublished and forgotten for many years.48

Long after his death, Laennec’s works continued to influence and inform the practice of medicine worldwide. The Figure 3: A rare presentation copy of the second (1826) edition of De L’Aus- nineteenth century was a transitional cultation Médiate, signed by Laennec. Image courtesy of the French Nation- time for medical professionals, with al Library of Medicine. pathological anatomy reconceptualis-

68 Osleriana René T. H. Laennec ing diseases as organic processes occurring secondary identify the earliest signs of particular illnesses. Two to identifiable aberrations in individual organs and tis- hundred years onwards, the stethoscope remains an sues. Laennec’s stethoscope became the tool of choice indispensable item in the physician’s armamentarium, to detect these changes at the bedside, and ushered in a and has become one of the most recognisable features revolution in clinical diagnosis and the study of chest of a practitioner’s medical identity. As William Osler diseases in Parisian hospitals. Mediate auscultation quite aptly stated, Laennec’s contributions “laid the empowered physicians to distinguish between mild foundation of modern clinical medicine”.49 and severe cases, and further gave them the ability to

Figure 4: Bronze memorial statue of Laennec, sculpted by Eugène-Louis Lequesne and erected in the French town of Qui- mperlé, Brittany, in 1868. Courtesy of the Wellcome Collection.

July 2019 69 E. Carson

References & Notes

1. Laennec RTH, Forbes J. A Treatise on Diseases of the Chest 24. Laennec RTH, Forbes J, 1834. op. cit. p. xxi. and on Mediate Auscultation. Longman, Rees, Orme, Brown, 25. Duffin J, 1998. op. cit. pp. 105-106. Green and Longman; Whittaker and Co.; Simpkin and Mar- 26. Laennec RTH, Forbes J. 1834. op. cit. p. 4. shall; J. Chidley; E. Portwine; and Henry Benshaw, 1834, p. 27. ibid. p. 5. xvii. 28. Duffin J, 1998. op. cit. p. 122. 2. Duffin J. To See with a Better Eye. A life of R. T. H. Laennec. 29. ibid. p. 129. Princeton: Princeton University Press, 1998, p. 13. 30. Laennec RTH, Forbes J, 1834. op. cit. pp. 6-7. 3. Osler W. Men and Books. Canadian Medical Association 31. Duffin J, 1998. op. cit. p. 132. Journal, 1913; 3: 137-140. 32. ibid. p. 133. 4. Duffin J, 1998. op. cit. p. 18. 33. ibid. pp. 134-136. 5. ibid. p. 22. 34. Tomashefski Jr. JF et. al. Dail and Hammar’s Pulmonary Pa- 6. ibid. p. 31. thology: Volume I: Nonneoplastic Lung Disease. New York: 7. ibid. p. 32. Springer, 2008, p. 316. 8. Auenbrugger L. Inventum Novum ex Percussion Thoracis 35. Duffin J, 1998. op. cit. pp. 136-137. Humani ut Signo Abstrusos Interni Pectoris Morbos Deteg- 36. Laennec RTH, Forbes J, 1834. op. cit. p. 25. endi. Vindobonae: Typis Joannis Thomae Trattner, Caes. Reg. 37. Duffin J, 1998. op. cit. pp. 138-141. Majest. aulae typographi, 1761. 38. ibid. p. 211. 9. Duffin J, 1998. op. cit. p. 28. 39. ibid. p. 224. 10. ibid. p. 33. 40. Laennec RTH, Forbes J, 1834. op. cit. p. vii. 11. ibid. p. 35. 41. Duffin J, 1998. op. cit. pp. 212-213. 12. ibid. p. 36. 42. ibid. p. 160. 13. ibid. p. 44. 43. Broussais FJV. Examen des doctrines médicales et des sys- 14. ibid. p. 47. tèmes de nosologie, précédé de propositions renfermant la 15. Laennec RTH, Forbes J, 1834. op. cit. p. xix. substance de la médecine physiologique, Volume 4. Paris: 16. Duffin J, 1998. op. cit. p. 49. Chez Mlle. Delaunay, Libraire, 1834, pp. 334-335. 17. ibid. p. 70. 44. Duffin J, 1998. op. cit. p. 248. 18. Laennec RTH, Forbes J, 1834. op. cit. p. xx. 45. ibid. p. 251. 19. Osler W. The Principles and Practices of Medicine. New York: 46. ibid. p. 256. D. Appelton and Company, 1892, p. 441. 47. ibid. pp. 281-283. 20. Duffin J. Why does cirrhosis belong to Laennec?. Canadian 48. ibid. p. 291. Medical Association Journal, 1987; 137(5): 393-396. 49. Osler W. Medicine in the Nineteenth Century. In: Aequanim- 21. Duffin J, 1998. op. cit. pp. 79-80. itas. With other Addresses to Medical Students, Nurses and 22. ibid. pp. 90-91. Practitioners of Medicine. London: H. K. Lewis, 1904, p. 232. 23. ibid. p. 100.

70 A memorial cairn erected in William Osler’s memory at the place of his birth, near Bond Head, Ontario, Canada. Photo taken by N. Toodayan on 17th May 2019.

71 “The day of Isaiah seemed at hand, when a man’s life

A gold engraving of Osler’s should be ‘more precious than fine gold, Hardcover gilt title of famous Vernon plaque. even a man than the golden wedge of Ophir.’” Osler’s final address.

“There is a sentence in the writings of the Father of Medicine [Hippocrates] upon which all com- mentators have lingered... the love of humanity associated with the love of his craft! – philan- thropia and philotechnia – the joy of working joined in each one to a true love of his brother. Memorable sentence indeed! in which for the first time was coined the magic word philanthropy, and conveying the subtle suggestion that perhaps in this combination the longings of humanity may find their solution, and Wisdom – Philosophia – at last be justified of her children.”

Oxford’s historical – Photo by Elaine Bible; Divinity School room. Sir William Osler 9:20 am on 16th May 2019.

The Old Humanities and THe New Science k University of Oxford Divinity Room 16th May 1919 illiam f Sir W Osle y o r’s ar Fin en a t l A en The d C d e re h Old Humanities s Signage outside Osler’s T s Title page of the 1920 print- former Dundas home. and The New Science ing of Osler’s address. The centenary of William Osler’s final address on The Old Humanities and The New Science closely co- incided with the American Osler Society’s (AOS) 49th Annual Meeting in Montreal, which ran from 12th-15th May 2019 and was widely attended by many Oslerians. Original plans to visit Oxford for the centenary were hence set aside, but the editor was able to acquire a nice centenary picture of the historical ‘Divinity Room’ where Osler delivered his final oration 100 years ago. Furthermore, after the AOS conference, a trip was made to Osler’s childhood home in Dundas where we spent the night of 16th May 2019 – a quiet ceremony was held in one of the beautifully furbished lounge rooms on the ground floor, where an original printing of Osler’s magnificent address was read in full. Professor Charles S. Bryan, who has written a characteristically informative account of William Osler’s final address for the Journal of Medical Biography, presented on the same subject at the AOS’s Annual Meeting.

Nadeem reading Osler’s Zaheer outside Osler’s address in the lounge room. former Dundas residence. 16th May 2019

‘The Iniquity of Oblivion’: Dr Walter Reginald Bett (1903-1968)

Nadeem Toodayan*

The ongoing influence of Sir William Osler’s (1849-1919) life over the past one-hundred years since his death is a subject of current interest. In all corners of the globe, conscientious physicians and medical students have proudly styled themselves children of Osler, and the Gospel of Oslerian medicine has been faithfully preserved by many who never met their master. One of the more remarkable examples of such a devotee was Walter Reginald Bett (1903-1968), an En- glish-German doctor-librarian and medical historian who befriended Osler in his student days, founded the Osler Club of London, and remained for forty years an unrivalled scholar on the Oslerian tradition. As is the fate of many Oslerians, Bett quietly passed into the shadow of his hero when he died fifty years ago in November 1968 and has largely been forgotten by contemporary writers. It is the purpose of this commemoration to bring together from various primary

and other related sources, a fuller appreciation of the man than has hitherto been presented. “

n all ages no problem has so stretched to aching “Wonderful page, always impressed me as one of the the pia mater of the thoughtful man as that put great ones in B.”3 – So wrote William Osler (1849- in such simple words by Job, ‘If a man die, shall 1919) during his final illness in a marginal note to his I 1 he live again?’” Memorable words indeed, and how much loved 1862 edition of Browne’s collected writ- pertinent to the subject of this recollection – Dr Wal- ings (Figure 1a). The same page was of life-long inter Reginald Bett (1903-1968) – a man who, since his terest to Dr Walter Bett, who quoted and paraphrased passing fifty years ago, has remained with remarkable these lines in a number of historical lectures and pre- persistency the object of oblivion. As one of the first sentations.4 Three-hundred-and-sixty years since its second-generation Oslerians, and as a founder and na- original printing (Figure 1b), the quotation has not lost mer of the Osler Club of London, Walter Bett was an its significance, for Browne had written with uncon- early and enthusiastic guardian of the Osler tradition. scious foresight, the story of Walter Bett’s after-life. Throughout his life he produced remarkable works of literary and historical scholarship, works that warrant his ongoing remembrance, at least within the Osler so- A Hero-Worshipper is Born cieties. Born in Riga, Latvia on 8th April 1903, Walter Regi- But the iniquity of oblivion blindly scattereth her poppy, nald Bett was the son of an Englishman William Ed- and deals with the memory of men without distinction ward Bett (1863-1923), and his German wife Sophie to merit of perpetuity. Who can but pity the founder of Marie Theiss (1869-1946).5 Unbeknownst to him at the pyramids? Erostratus lives that burnt the Temple the time, he shared his birthday with two of his fu- of Diana; he is almost lost that built it. ture medical heroes, Harvey Cushing (1869-1939) and – Sir Thomas Browne (1605-1682), William Henry Welch (1850-1934), the latter whom he Hydriotaphia, Urne-Buriall, 1658.2 would go on to describe as “the most stimulating and the most charming person I have ever known.”6 But much more significant than this was the birthday of Bett’s older sister Erica on 12th July7, for the twelfth of * Dr Nadeem Toodayan is a Basic Physician Trainee from Brisbane, July – also William Osler’s birthday – was destined to Australia. Correspondence: [email protected]. become a day of yearly significance to Walter Bett for Walter Reginald Bett in his prime – aged fifty-nine. This photograph was taken for his Oslerian oration in July 1962. From all of his adult life. It is in fact through tracing Bett’s an original portrait in the archives of the Osler Club of London. activities in later years, that one can best appreciate

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Figure 1: a) Just three weeks before he died, on 6th December 1919, William Osler made a marginal note in pencil marking out one of his favourite lines in his prized 1862 copy of Browne’s collected works. Osler repeatedly refers to Browne’s “Iniq- uity of oblivion” throughout his essays and other published works. Image acquired with the assitance of the Osler Library of the History of Medicine, McGill University. b) An original 360-year-old printing of Browne’s famous line in Hydriotaphia Urne-Buriall (1658); note the misspelling of oblivion. From the author’s private collection. the early impressions the wider world must have made which never left him’.9 And yet, as Franklin notes, upon him. A born hero-worshipper, he epitomised his it was owing to his differences that Bett would grow own characterisation of that personality trait as: “a to greatly distinguish himself from his colleagues. rare gift bestowed by the jealous gods in-utero.”8 Reared in the company of those who revered their ancestors, he went to school “trembling with emotion”10, Bett was early educated in his mother’s homeland of eager to eye out a Patron-Saint and hero worthy of his Germany, attending the historical Gymnasium Am devotion. The passing away of the greatest physician Thie in Blankenburg, Harz, but relocated to London in the English speaking world at precisely this time at the end of the First World War for obvious reasons. would provide just such an opportunity, and so over Here he attended Saint Paul’s school, where – if we the proceeding decade Walter Bett would mark him- are to accept Franklin’s not altogether unbiased narra- self out as one of the purest protagonists of William tive of Bett’s life – he was looked onto as an outsider Osler’s posthumous legacy. because of his ‘Germanic appearance’ and ‘the accent

76 Osleriana Walter R. Bett A Student at St Bart’s always thinking for a few seconds before he opened his mouth. By his dignified bearing and charm of After graduating from Saint Paul’s school, Walter Bett manner he never failed to ensure perfect order and at- successfully matriculated in his London University tention at his lectures and visits to the wards… One of examinations in January of 1921.11 He signed inden- the outstanding features of his character was the great 15 tures to commence studies at St Bartholomew’s Hos- sobriety of his mind.” pital Medical School on 21st September 1922,12 and was soon steeped in the clinical sciences, attending Bett’s prize winning essay on Sir James Paget was lectures on diverse subjects from anatomy to zoology published in the 1925 November number of the St. 15 and beyond. But whether Bett was attentive at these Bartholomew’s Hospital Journal. In the same year, 20 lectures, or whether like his poetic predecessor John Harvey Cushing’s Life of Sir William Osler was orig- Keats (1795-1821) – also once a medical student – inally published, and Bett, one of the most receptive “there came a sunbeam into the room, and with it a readers of his generation, made the biography his bi- whole troop of creatures floating in the ray; and I was ble by 1927. “With infinite piety which may almost be off with them to Oberon and fairyland”,13 is interesting called a religion” he wrote in 1930, “Harvey Cushing to speculate. Early allured by the more artistic and has striven to make Osler live once again; and men in aesthetic aspects of medicine, Bett gravitated towards this country and beyond the salt sea, with unquench- the humanities with unerring pleasure in his formative able devotion to the faith that is in them, vie with one 21 years. Regarded by some as “the most unusual student another in keeping his memory green.” Inspired by of his year”, he appeared to his classmates to be “quite the exemplary life portrayed in Cushing’s great biog- disinterested in medicine”; “a rather literary layman raphy, Bett would have resumed his medical studies doomed to qualifying as a doctor” as a close colleague with renewed interest, taking special note, for exam- once put it.14 And yet despite these views, Bett nobly ple, of William Osler’s advice to medical students at persevered with his medical degree. Spurred on by St Bartholomew’s Hospital in December of 1913: “the the death-bed wish of his ailing father that he should future is with you young men, who are certain to see qualify in medicine, he applied himself deliberately to within the next few years radical changes in the med- his studies, attending a variety of classes and demon- ical schools of this country… The clinician should al- strations before successfully sitting all of his conjoint ways be in the fighting line, and in close touch with board examinations between October of 1923 and July the rank and file, with the men behind the guns, who 22 of 1929. His father passed away on Christmas eve of are doing the real work of the profession.” More 1923. compelling than this however, was William Osler’s lifelong appeal to physicians to familiarise themselves Bett’s student register at St Bartholomew’s shows with the history of their profession. Experiencing that he took almost seven years to qualify in medi- first-hand the vibrancy of Osler’s historical scholar- cine, graduating finally in 1929. Aside from recording ship through his many moving medical essays and which lectures he attended and the clinical appoint- sermons, Walter Bett vowed to adopt a similar strat- ments that he held, the register also reveals early egy in his own approach to practicing medicine, and signs of his scholarship in medical biography, for he so became a lifelong devotee of the Oslerian tradition. was awarded the 1925 ‘Wix Prize’ for his essay on Preserved letters from his early years show that he the ‘Life and Works of Sir James Paget’15, the great St took the nickname of ‘Willie’ in medical school, and Bart’s surgeon and pathologist whom he greatly ad- that he often signed his communications with William mired.16, 17, 18, 19 Unlike many of his later works, Bett’s Osler’s initials. essay is memorable for its majestic simplicity of style – an approach no doubt influenced by the writings of Sir James Paget (1814-1899) himself, whose works The ‘Osler Club’ of London Bett had evidently poured through with delight in the course of writing his essay. Even now, it is possible Walter Bett’s early determination to formalise his in- to trace Bett’s growing capacity for fact based fictive terests in medical history is best demonstrated in his narrative in this his first ever publication: 1927 conception of an organised students’ club for the study of the history of medicine. Afire with en- “Sir James Paget was tall and slender, his face rather thusiasm for his project, he befriended Alfred White long, his cheeks somewhat flushed and his eyes bright. Franklin (1905-1984), a like-minded Cambridge med- He was always well-dressed, wearing dark clothes, ical student who had just come off a summer 1926 vo- of a somewhat old-fashioned cut, especially the coat cational tour to America and Canada – “the land that collar. His voice was soft, clear and musical, with a gave Osler to medicine.” 23, 24 Circling the central foun- distinct Norfolk accent. He spoke quietly and fluently, tain in the courtyard of St Bartholomew’s, the two stu-

July 2019 77 N. Toodayan

dents fed off each other’s historical enthusiasm, and icine – scene at a table in the catering Co below Barts. Bett further encouraged in Franklin a love for Osler Hal Mansell & Tom McNair Scott arrived ten minutes and Osleriana: late & George Pickering three quarters of an hour! A preliminary skirmish about the name showed George “In 1927, we were idle fellows then, [Walter Bett] per- to be a good [?] shower bath – v. stimulating: TMcN suaded me that together we should found a students’ favoured Allbutt – ? out of patriotism, & Hal suggest- club for the study of medical history. As a good Cam- ed Allbutt-Osler! Willie & I stuck to our guns & point- bridge man my obvious choice for Patron Saint was ing out the encouragement W.O. always gave to young Sir Clifford Allbutt. But Bett had other views. The men to study [the] history of medicine carried the day Osler Club? Well, I relented, perhaps the Allbutt-Os- – a victory of conviction rather than logic. We meet 1° ler Club. And then we went down to Oxford, and on a month alternating the great with prof. vulg… Long March 3rd, 1928 we visited 13, Norham Gardens. discussion about activities – distinctly light hearted, Here Dr. Francis showed us the books, and he talked, but the human material is there – for Willie & I to get how he talked, of them and of the Catalogue and of his to work on. Geo is said to be the most brilliant man kinsman hero, William Osler. No-one ever talked or at S. Thomas’ & TMcN at S. Georges. Hal ex Scholar wrote like Bill Francis with such a mixture of learning Oxon (Classics) & Willie & I enthusiasts. After tea and fun… During that morning I was infected, as Bett C.F. Watts who I had approached some days ago signi- had planned, with the virus of Oslerolatry… [and] af- fied his desire to join – We are now six, god bless us.”34 ter that morning there was no more talk of what the Osler Club should be called.”25 And blessed they must have been, for the club proved an enormous success, meeting up to ten times a year Notwithstanding Bett’s primary impetus, Franklin for the first five years of its existence, and stirring an often maintained that he also played an independent ever expanding membership to discuss historical top- role in founding the Club: “Neither parent, neither I ics of interest for many years to come. Except for a nor Walter Reginald Bett” he once remarked, “would period of war-time inactivity from 1938-1947, the club claim sole credit for the idea of a student’s club for has continued to meet regularly to date and remains the study of medical history: it must remain an exam- one of the longest actively operating Osler societies ple of synchronised double parthenogenesis.”26 There in the world. It was from more humble beginnings, is some evidence suggesting early tensions between however, on the evening of Monday, 30th April 1928, Bett and Franklin about ‘parentage’ of the Club,27 and that six student enthusiasts convened in the drawing Franklin appears to have grown increasingly distant room of Franklin’s father’s home on 27 Wimpole from Bett over the course of his medical career.28, 29, Street to attend the Club’s first formal meeting. There 30 It is possible that such early rivalries between these they discussed the life and works of Louis Pasteur otherwise closely knit friends31, 32 may have led to fur- (1822-1895), a medical visionary of whom, it may be ther disparities in later years, but in a rare photograph recalled, William Osler approved as “the most perfect showing the two enthusiasts at work in 1928, the duo man who has ever entered the Kingdom of Science.”35 seem inseparable (Figure 2). “An informal discussion followed” according to the Club’s minutes, “dealing chiefly with Pasteur’s prede- On 16th March 1928, Reginald Harrison Hill (1894- cessors, Redi, Paracelsus, and Leeuwenhoek.”36 With 1976) – a co-compiler with Bill Francis of Osler’s Bib- the permission of the Royal Society of Medicine, Dr liotheca Osleriana – treated both founders to a guided Charles Joseph Singer (1876-1960), an Oxford con- tour of the Bodleian Library and its many treasures,33 temporary of Osler’s, shared accurate reproductions and just a week later, on 23rd March 1928, the ‘Osler of Pasteur’s early artwork and a selection of Pasteur’s Club’ was formally inaugurated at a meeting in the classical publications were also exhibited. Walter Bett catering company below St Bartholomew’s Hospital. contributed to the proceedings in a characteristically Franklin’s Cambridge friends: Harry Edward Mansell idiosyncratic summary presentation replete with Os- (1901-1941), George White Pickering (1904-1980), lerian references: Thomas Frederick McNair Scott (1901-2001), and Cecil Francis Watts (1902-1930), became its first se- “From the dawn of intelligence, ever since he first be- lected members. An entry in Franklin’s diary best tells gan to tread the wine-press of doubt, no problem has what happened on the day: so cruelly pulled at the heartstrings of man as that put into so simple a question by Job: If a man die, shall “March 23rd, Friday [1928]. This afternoon was found- he live again? Some there be who deny altogether ed the Osler Club for the study of the history of med- the life after death: who are happy in the strength of

78 Osleriana Walter R. Bett

Figure 2: Founders of the Osler Club of London: Walter Reginald Bett (aged twenty-five, right) and Alfred White Franklin (aged twenty-three, left) in 1928. This rare photograph, which appears to have been taken in the pathology museum at St Bartholomew’s Hospital, was reproduced by Alfred Franklin in the evening menu cards for Bett’s 1962 Osler oration – an original copy of the menu is pasted into the Club Minutes (Volume II). Dressed in full business attire and eagerly examining the museum’s historical specimens, this wonderful picture captures the zeal with which these two students pursued their medical and historical studies. From the archives of the Osler Club of London.

July 2019 79 N. Toodayan

their intellectual conviction. Others, rejecting the im- “May I tonight pass with you a brief half hour in re- mortality of the tomb, cling to the immortality of the calling and gossiping over those actors in the dramatic resurrection as to a rock of faith serene and comfort in- story of the lymphatic circulation whose names have calculable: to live again in those who come after them, floated down the stream of the centuries. Never, per- in whom they may be privileged to continue their use- haps, honoured in their generation which buried them fulness. Thus and thus only is man imperishable and with the burial of an ass, and forgotten by the next, his glory everlasting. So let it be with Pasteur.”37 out of the twilight of the past they pass us by in never ending procession. We who have taken our stand by After briefly surveying some of the successes at the the entrance to the cavern of Acherusia as spectators Pasteur Institute, Bett further explains why Louis Pas- of their lingering train, fail to recognize their features. teur was chosen as the subject of the Osler Club’s in- Their voices have grown thin and feeble across the augural meeting: gulf of time. Their footsteps sound hollow in our ears. And hovering about them all is the deathly atmosphere “The Osler Club has honoured itself by honouring so of a vast house which none has lived in for a great graciously the memory of its Patron Saint in a spe- long while. And whose pineal gland is so calcareous cial soirée devoted to a man who in Osler’s words had that he would separate the quick from the dead? In this opened a new heaven in medicine and a new earth in hour which is for the heart, not for the head, who does surgery. Was not Osler fond of urging students and not echo the tender words of Sir Thomas Browne, the doctors alike to make immortal Pasteur their clos- beloved friend of many of us here tonight: est friend? Did not [he] himself, ever heeding the flighty purpose, contribute an invaluable preface to The iniquity of oblivion blindly Vallery-Radot’s life, copies of which he distributed to scattereth her poppy, and deals with all Anglo-American medical school libraries, each ac- the memory of men without distinction companied by a presentation note?”38 to merit of perpetuity.”42

All throughout his talk, Bett conveys a closeness to his As an example of Bett’s early works in medical history, hero that defies mere historical or even plainly profes- his talk on Aselli’s discovery of lacteals – which has sional interest. His closing remarks to the Osler Club been published for the first time later on in this vol- at that pivotal first meeting indicate the intensity of his ume – makes for an engaging and entertaining read. devotion to commemorating his intellectual idol: Listening to Bett lecture today, one can imagine the keen attention of his audience at that early meeting, “With what joy would we not have welcome [William for the story is told with such feeling and devotion to Osler] here tonight, with his almost bloodthirsty inter- the characters involved, as to immediately bring to life est in the history of his Art, his unmeasured friendli- both their times and the historical conditions in which ness towards those of a younger generation. One who they worked. Alfred Franklin’s father, Philip Julius breakfasts on Aequanimitas, lunches on the Alabama Franklin (1880-1951) – himself an accomplished oto- Student, and dines on the Biography, is conscious of laryngologist and some-time correspondent of Osler’s him coming up the stairs with his curiously alert car- – proudly provided lodgings for the Club’s many forth- riage and his notably light tread. Age cannot weary coming meetings until the family home was destroyed him nor the years condemn. I cast my bread upon the in a fire on 10th November 1935. Sadly, Alfred’s moth- waters: to find it after many days.”39 er Ethel Julia Franklin (1878-1935) died in this tragic blaze.43 The Club’s second meeting on 18th May 1928 was cen- tred around the posthumous publication of Gaspare In his role as foreign secretary to the Club, Bett sought Aselli’s (c.1581-1625) discovery of lacteals three cen- to organize corresponding members and reported on turies earlier40 – a subject that was incisively chosen to international activities of interest. He kept a close contrast with the much more widely celebrated tercen- eye on historical medical literature of interest to the tennial anniversary of the publication of William Har- Club’s library, and further sought to befriend distin- vey’s (1578-1657) De Motu Cordis in 1628.41 Walter guished representatives abroad to help strengthen the Bett unleashed his historical genius at this meeting in Club’s cause. In March of 1928, Bett wrote to William a heartfelt presentation commemorating Aselli’s dis- Osler’s junior colleague, Francis Randolph Packard covery: (1870-1950) in Philadelphia – the inaugural editor of The Annals of Medical History journal – notifying him of the recently founded ‘Osler Club’:

80 Osleriana Walter R. Bett 26.III.28 life…. A classical scholar, a painstaking bibliographer, Dear Dr Packard, and an unsurpassed writer of whimsical letters… his seemingly infinite leisure was at the disposal of the “May I… interest you in a pet-hobby of mine, the dar- young and old who went to him for inspiration and for ling-object of my dreams: a narrow band of historical- help.”49 The Osler Club took a keen interest in Francis’ ly – and bibliographically – minded medical students masterwork – the Bibliotheca Osleriana – and Francis from the various London Hospitals have gathered reciprocated these interests by making special note of together to found a club for the bio-bibliographical the Club in the preface to his great labour of love.50 study of the History of Medicine – to be known as Walter Bett in particular was ecstatic about the new the Osler Club. Could we wish for a Patron saint Osler publication, and characteristically expressed more inspiring? It will be among our pleasant tasks his delight with the work and its subject in a 12th May to review the current medico-historical literature, in- 1929 letter to Alfred Franklin: cluding of course, your valuable Annals. We thought the club would thrive if it is happy enough to gain the “A dead man’s dream! Delicate as the wing of a beauti- patronage of the Editor of one of the foremost journals ful butterfly which the rude finger of reality reduces to devoted to the History of Medicine… If you come to golden-hued dust. How uninspiring [sic] is the pref- London, the Club would be pleased and honoured to ace. How glorious the introduction. There is so much have you as their guest. The ‘Oslerian’ spirit which inspiration breathing at one from every page that one prompts these importunities demands no apology.”44 forgets in the end one’s sorrow. What a perfect man Ys sincerely, W.R. Bett [Signed] he must have been: in his aspirations how like a God. And what a pigmy oneself is by way of comparison, In June of 1928, Walter Bett worked with Alfred with dreams and ideals running away with all one’s Franklin – who served as secretary to the Club – in clothes so that one runs about indecently naked. In drafting the formal rules for membership. Not sur- that state one is very cold. Effort means so little, and prisingly, both founders expected that elected mem- yet seems the hardest thing in the world. It is so dif- bers “should have respect for the memory of his pa- ficult to ask oneself: What would Osler have done? tron-saint” adding that “if the name of Sir William I have just written a personal note to [William Wil- Osler does not mean anything to him, he should on his loughby Francis] for the dedication.”51 honour make a valiant attempt to rectify his error.”45 “The object of the Club” according to the same doc- Aside from befriending Osler’s colleagues, club mem- ument, “shall be the bio-bibliographical study of the bers also made a concerted effort to familiarise them- history of medicine as it appealed to the heart of its selves with Osler’s own literary heroes, and the influ- patron-saint, the cultivation of the historical spirit in ence of Sir Thomas Browne (1605-1682) – the great its professional life, and the promotion of internation- Norfolk doctor-philosopher whose Religio Medici al good feeling in the sense of a universal fellowship (1643) famously influenced Osler to divert from divin- in the spirit of Osler.”45 On 12th July 1928, the first ity to medicine – was very potent in those early years. Osler oration was delivered by Sir Wilmot Parker Her- Alfred Franklin in particular was a learned admirer ringham (1855-1936) on Osler’s love of rare diseases. of Sir Thomas Browne and his writings, and Walter A successful symposium followed, and the Club saw Bett – himself no mean follower of Browne – further to it that notices of the event were recorded in both the encouraged Franklin in this regard. He sent Franklin British Medical Journal and Lancet.46, 47 post-cards with Brownian quotations in his student days (Figure 3), personally put together a Sir Thomas In a bid to bonify their budding society, the Club be- Browne photo album to give to Franklin as a gift in friended many of William Osler’s surviving colleagues, July of 1928, and later presented him with an offprint family, and friends: Lady Osler (1854-1928), Harvey of Osler’s tercentenary lecture on Sir Thomas Browne Cushing (1869-1939), Archibald Malloch (1887- before the Guy’s Hospital Physical society (Figure 4). 1953), Sir Humphrey Rolleston (1862-1944), Geof- Half sincere, half tongue-in-cheek, Walter Bett wrote frey Keynes (1887-1982), Francis Randolph Pack- to Franklin on the day before Browne’s 323rd birthday: ard (1870-1950), and of course William Willoughby Francis (1878-1959), were warmly welcomed. As 18.x.28 Dear Sir Thomas: Osler’s own cousin-nephew and personal ‘extension in time’,48 Bill Francis was an obvious go-to figure A little gift is on its way. I hope you and Alfred will for inspiration and advice. Bett later wrote of Francis like it. Put your arm around him and be very, very in his 1959 obituary for Nature: “‘Billy’ Francis was kind to him. Help him to cultivate the virtue of leisure. a charming man. Someone said of him that he was For the rest, there is little the matter with him. He born under a dancing star and sang his way through has helped me to accomplish what I have spent years

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Figure 3: A historical post-card in Walter Bett’s hand sharing one of Sir Thomas Browne’s (many) memorable quotations with Alfred Franklin: “Some have digged deep, yet glanced by the Royal Vein; and a Man may come unto the Pericardium, but not the Heart of Truth.” (Christian Morals. Cambridge: University-Press, 1716, Part 2, Sect III, p. 49). Akin to a modern-day Facebook notification, this post-card was sent to Franklin on the date of his 24th birthday. Note Bett’s adoption of the ‘W’ from William Osler’s signature. From the archives of the Osler Club of London. of my life in discussing, dreaming about, and praying ‘The Friendship of Words’ for: the establishment in this country of a medico-historical unit. Even before graduating in medicine, Walter Bett had established himself a reputation as a fine writer and All the Saints salute you, especially those of Osler’s rhetorician of considerable skill. He evidently early household. developed that baroque style so readily recognizable Your affectionate friend, to any reader of his writings, and some of his finest phrases can be found in his earliest publications. Bett Walter Bett valued highly the written word, and was fond of re- using his carefully chosen remarks – even decades Sir Thomas Browne, KT, M.D.52 old quotations – when the occasion suited. A lover of literature from the outset of his medical career, he Bett maintained a strong vision for the ‘Osler Club’ lamented the loss of literary style in medical publica- over the coming years. He worked tirelessly to pro- tions: mote the Club’s interests, and dedicated his days to producing scholarly historical works which he en- “The cultivation of literary style is being more and thusiastically shared with the profession. “You know more jeopardized by the conditions of modern life, what the Osler Club means to me,” he wrote to Alfred even for those who possess a natural aptitude and a Franklin in May of 1930, “the beginning of a new way genuine liking for fine literature. The overcrowded of life in medicine, a reformation, insidiously working medical curriculum leaves scant leisure for retreat- wonders, daily growing, and strengthened almost im- ing into the quiet backwaters of reflection in which to perceptibly.”53 It was primarily owing to Walter Bett’s cultivate the friendship of words. With the gradual determination and clear sense of direction that the Os- decline of a classical education there is no longer that ler Club would become firmly established as one of wide acquaintance with, and respect for, the meaning the foremost historical medical societies in London. of words.”54

82 Osleriana Walter R. Bett

b a

Figure 4: “The Religio Medici, one of the great English classics, should be in the hands – in the hearts too – of every medical student.” – William Osler, in After twenty-five years (The Montreal Medical Journal, 1899; 28: 823-833). Inscribed by Bett to Franklin on Sir Thomas Browne’s 323rd birthday (a), this original offprint of Osler’s tercentenary lecture on Browne (b) (the ‘gift’ referred to in Bett’s 18th October 1928 letter to Franklin) records the duo’s dual interests in the great Norfolk doctor-philosopher during their student days. Bett’s hand written inscription to Franklin (c) reads: “Sir William used to say that books belong to those that prize them most.” From the author’s private library.

And yet despite these conditions, Bett maintained and So full of feeling and emotional empathy, we can further developed a distinctive written style. A deep imagine the mindset that whirled the young Walter to thinker and even deeper writer, he was able to weave such heights of composition. He was only twenty-five profundity into perspective, using quaint phrases and years old at the time of this writing, but had acquired arresting metaphors to communicate a certain intima- through his love of literature and study of medicine, a cy with his subject. Listen to his fancied prelude to a keen sensibility for the sufferings of humanity. Ad- 30th October 1928 talk to the Osler Club on the history miring the potency of his pathos, it would be well of heart surgery: to point out Bett’s growing capacity for sermonis- ing, taking for example, the following reverential but “In the childhood days of the race, what tragedies must light-hearted reference to his ‘Patron-Saint’ in a talk to time and again have been enacted in the solitude of the the Osler Club on William Osler’s eightieth birthday: jungle: when some poor creature, half way between ape and angel, blood gushing forth from a wound in “Of my own Patron Saint I can speak without misgiv- his heart, inflicted by man or beast, hides in the dark- ing… He was an American Doctor, who lived a varied ness of his cave. Loneliness walks up and down in life – in the U.S. Army, in the North West, among the his soul like a starved beast of prey. How he longs to Indians, as a general practitioner in the North of Lon- interfere: how his fingers tremble: but his mind is a don. He was drowned in 1884 and his body was never blank. And if his lips formulate not the formula, yet recovered. He was the α [alpha] and the ω [omega], in his weary eyes the centuries read the unanswered the spring and the autumn of life, the black soil, the agony of the crucifixion: Eloi, Eloi, lama sabachthani! harvest, the thunder shaking its fish at the mountains, And as the vast night of forgetfulness closes over him, the peace that dreams over the waters when the eve is out there in the cold and the dark, the mocking voice cool, the communion of saints, the forgiveness of sins. of the wild life takes up his cry: My God, My God, Sanctificetur nomen tuum. Hallowed be thy name. why hast thou forsaken me!”55 How one strives to be like you, E.Y. Davis, of pious memory.”56

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The extent to which Walter Bett emulated William Os- flowing stream of conversation, the privileged visitor ler’s nom-de plume – Egerton Yorrick Davis – in his came to regard the galleries of the Museum as Elysian own writings is evident is a series of Rabelasian com- fields, across which he heard the unbroken and melo- mentaries he authored at different times in his career, dious echo of the voice of those who have left him the and most notably in an article on the ‘The Os-Penis glorious heritage of medicine.”64 in man and beast’. Reliving the risqué and ribaldry of his youth, he revisited an idea first recorded in his Like his esteemed surgical colleagues, Bett utilised his medical student days when he likened the ‘baculum’ early acquired literary skills to celebrate medicine’s or ‘os-penis’ of the male Eurasian red squirrel to the noble heritage. A large selection of his own handwrit- surgeon’s knife: ten transcripts are preserved in the archives of the Os- ler Club of London, although one of his best received “It has been somewhat fancifully suggested that its sole lectures on “The Religion of a Medical Historian”65 purpose is to perforate by a clean cut the extremely does not appear to have been retained. Given at the tough hymen of the female squirrel. Bland-Sutton Club’s twenty-third meeting on 19th March 1930, Bett thought this to be the earliest operation known to us orated “before a delighted audience including Lord – older even than the resection of a rib in the Garden [Berkley George Andrew] Moynihan [(1865-1936)], of Eden.”57 who was so impressed [with Bett’s talk] that he quoted extracts in his Royal Academy Banquet speech a Bett idolised the distinguished British surgeon Sir few weeks later.”66 The enjoyment was reciprocated John Bland-Sutton (1855-1936), whose classes he at- of course when the celebrated abdominal surgeon took tended as a medical student and whose biography he to the stand, and Bett recalled many years later how authored in 1956. To Walter Bett, Bland-Sutton was members “listened spell-bound to the silver-tongued in every aspect John Ray’s (1627-1705) “good chirur- orator, not only of his profession, but indeed of his geon”, for he possessed in full measure “an eagle’s eye, generation. Some thought it was Sir James Paget ris- a lion’s heart, and a lady’s hand (1670)”.58 Convert- en from the dead.”67 Moynihan encouraged the Osler ing the Chelsea Hospital for Women into “a Mecca for Club to launch the first ever medical history journal in pelvic surgeons from all over the world”, Bland-Sut- England, and although Bett found a publisher and also ton “created the gynaecological surgeon in place of a title – The Transmuter68 – he could not proceed with the gynaecologist”.59, 60 But aside from his technical the expensive project because “our time was not ripe, prowess and operating skills, Bett was equally im- and we could not ripen our time.”67 pressed by his teacher’s “piquant literary style” and “genius for transmuting his thoughts and ideas with Bett’s riveting impressions on such notable medical equal ease into the written and spoken word”.61 It was dignitaries as Berkley Moynihan led to further recog- a taste he admired in many of his surgical tutors, and nition of his historical scholarship and efforts to me- none less than in the Shakespearean scholar, anatom- morialize Sir William Osler. On 12th July 1930, Wil- ical curator, and gynaecological surgeon Alban Henry liam Osler’s great protégé and neighbour in Baltimore, Griffiths Doran (1849-1927), who presided over the Harvey Williams Cushing – who had just been award- Hunterian collection at the Royal College of Surgeons ed the Lister Medal by Lord Moynihan following a of England for many years. Though less technically lecture at the Royal College of Surgeons – delivered adept than Bland-Sutton, the young Walter Bett fell the third Oslerian oration to the Osler Club on his bi- in love with “Dear old Doran’s”,62 “exquisite courtesy, ography of Osler. After his oration, “he singled out his unembarrassed charm, his enviable sense of lei- each member of the Club in turn and talked with him” sure, his very skullcap”, which, he later recalled “gen- and “before the evening was over he came to appre- tly enticed the mind into thoughts of a gracious and ciate more fully what influence his labor of love [his statelier generation now no more.”63 Bett remained a biography of Osler] had exerted, and how the hope close friend of Doran’s until his death in 1927, and for expressed in his dedication [“that something of Os- many years afterwards he recalled with pleasure his ler’s spirit may be conveyed to those of a generation delightful interactions with him: that has not known him”] had indeed been realized”.69 Many years later, in a thanksgiving presentation giv- “An incessant talker and an unsurpassed raconteur, en in New Haven on Harvey Cushing’s 70th birthday – whose fund of anecdotes and out-of-the-way knowl- and Walter Bett’s 36th birthday – Arnold Meadowcroft edge was inexhaustible, Doran was an amusing man Muirhead (1900-1988), a representative of the Osler and a delightful and entertaining guide to the historical Club of London, accorded the Club’s sincere obliga- collections, over which he gloated with joy and affec- tions to the distinguished neurosurgeon, not only for tion. He took a kindly interest in young people. In the his ongoing encouragement of the Club and its activi- shadow of his small active figure and his pleasantly ties, but for being the actual impetus for its foundation:

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“The Osler Club really owes its existence to Dr Cush- day-old baby.77 Notwithstanding the topics of these ing, for it came into being as a direct result of the stim- publications, Bett appears to have had a preference for ulus inspired among a few enthusiastic young doctors surgical roles over medical ones; it is possible that he and medical students by his Life of Osler. Dr Cushing envisaged a career in the then fledgling specialty of from the start gave the Club encouragement, and he paediatric surgery. has enriched its collections of books with many gifts, and has delivered one of the annual Osler orations. Tempted by Osler’s advice – “Let the old men read The Club’s debt to him is a very real one.”70 new books; you read the journals and the old books”78 – Bett was one of the earliest to consistently point out the historical value of eponymous terminologies in To Have ‘Loved Too Much’ medicine.79 Early on in his career he contributed a series of articles on paediatric eponyms to the British Journal of Children’s Diseases, each of which traces Walter Bett was first registered to practice in England the original description of an eponymous paediatric on 8th August 192971 and soon commenced working clinical entity, and provides an associated biography at the East London Hospital for Children in Shadwell of the doctor for whom the entity is named.80, 81, 82, 83, where he was a resident medical officer from mid- 84, 85, 86 The first of these articles dates back to 1929,80 1930 through to early 1932. He acquired his MRCS and if we consider that the earliest known dictionary and LRCP in the same year he graduated, and, consid- of medical eponyms was first published in Berlin in ering a career in clinical paediatrics, he signed up for 1931,87, 88 we can further appreciate the contemporary three months of post-graduate study with the Medi- significance of Walter Bett’s encouragement of the cal Research Council in January of 1930, where he use of eponymous medical terminologies. Altogether, collected and abstracted the available literature on the Bett authored no less than seven detailed articles de- effects of diet on children’s teeth.72 Over the coming scribing commonly used paediatric eponyms; Osler’s year, Bett completed two six month terms as House influence on Bett is abundantly clear in these works: Surgeon and later Resident Casualty Officer at the East London Hospital before making an application to “The Oslerian method of teaching takes that fair young work as part-time Junior Casualty Officer at the Great lady, the History of Medicine, into the wards, to the Ormond Street Hospital for Sick Children. In stark bedside, and grants her a place of honour in the front contrast to certain (above quoted) derisory remarks row, even in a crowded gathering. Those who cher- made in Franklin’s obituary of Bett, original referenc- ish this method delight in reading the original words es supporting Bett’s application to Great Ormond’s re- with which the heroes of medicine handed their coin port him to have been “possessed of a very consider- to Charon.”89 able knowledge of practical and theoretical medicine, that he was an accurate observer, a keen worker and a Bett’s quest to bring the history of medicine to the bed- most agreeable colleague.”73 In his surgical role “he side was a life-long endeavour, and nowhere was this performed all the usual minor operations and also be- ideal more elegantly expressed than in his 3rd Decem- came proficient in giving anaesthetics” and was much ber 1930 lecture to the historical section of the Royal admired by staff for his work in both the wards and Society of Medicine on ‘Clio by the Bedside’.21 Using outpatient department which were “always conscien- the Greek goddess Muse of history, Clio, as a wor- tiously done” and with “great keenness”.74 He was thy protagonist, Bett calls upon doctors to cultivate a indeed “a most charming colleague with an enthusi- sense of historical curiosity in their daily lives, and asm for his work tempered by a sense of humour, that “triumphantly to lead Clio Medica into the wards, and carried him through his period as a resident with credit, to rejoice in her remarriage with her lord and master, and made us all regret very much the day he left us.”75 Clinical Medicine, from whom she has so long been Owing to such glowing references, Bett’s application divorced”.90 Expressing ability beyond his years, he to Great Ormond Street Hospital was successful. He made some astonishingly witty remarks: “The elab- nonetheless maintained ties with the East London orate edifice of modern medicine has not sprung up Hospital for Children, first as a locum Resident Med- from the ground like a mushroom in the night”91 he ical Officer, and later as a visiting anaesthetist. Bett’s stated; “Stop your ears against the Circean music of enthusiasm for clinical paediatrics at this time is ev- the Eternal City. Make up your minds to breed stu- idenced in his publication of a paediatric case report dents who approach their problems, their difficulties, recording recovery from Moraxella catarrhalis men- from the historical point of view, and all else shall be ingitis in a five-year-old girl.76 He also later gave a added unto you”.92 If Bett’s cries for ‘historical wis- short presentation on the incidental observation of dom’ were analogous to Osler’s own, it was because he hypertelorism with cleft palate in a dysmorphic seven- imbibed Oslerian essays and axioms on a regular basis.

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As he grew older, he adopted a more critical attitude to Poor Walter! For one who had been steadily advanc- the subject of eponymy in medicine,93 but nonetheless ing his outlook for the Club he had so closely nurtured maintained a lively interest in all sorts of historical over the years, it must have been a painfully difficult links to the clinic. As early as 1932 in fact, Bett had decision to sever ties. And yet there is evidence that already begun to express a more philosophic outlook Bett continued to maintain contact with the club af- on the value of medical history for practitioners of ter this letter was written98 and that he further distin- medicine: “We want a peep into the minute ahead, not guished himself at this difficult time in his life. On the minute that is past” he said; “This I think will be the advice of one of his lifelong friends, Mr Warren the greatest service the history of medicine can ever Royal Dawson (1888-1968) – a distinguished English render to medicine: from a conscious and philosophic Librarian, antiquarian, and Egyptologist – Bett edited understanding of the past to allow it a peep into the his first ever text-book on A Short History of Some minute ahead.”94 Common Diseases in 1934, a work which he himself described “in candour and without arrogance… as As a young man Walter Bett indeed set himself high an original venture in medical literature”.99 The book standards (Figure 5). In addition to running and must have enjoyed at least some success, as two de- contributing to his own historical Club, he official- cades later in 1954, a second edition of the same work ly joined many other learned societies including the was published in America,100 this time aimed at a more Royal Society of Medicine, the Medical Society of general audience. On top of Bett’s own entry on ap- London, the Oxford Bibliographical Society, and later pendicitis, the work contains contributions by many the Royal Society of Literature, to which he was first distinguished clinicians of the day, including such cel- elected a member in 1936.95 But Bett’s advancing as- ebrated authors as Sir D’Arcy Power (1855-1941) and pirations as a scholar of medical history and authori- Sir Humphry Rolleston (1862-1944). Through sheer ty on William Osler were not always matched by his determination and perseverance, even in the face of fellow colleagues: “[William Osler] would have sat opposition from those closest to him, Bett had over- a strange guest at the last meeting of a Club named in come the recent handicap sustained by his apparent his memory”, he wrote in May of 1930.96 Tensions resignation from the Osler Club. And what is more, in grew increasingly over the coming years, and even Al- a gesture of triumph over rejection, he proudly dedi- fred Franklin, who had once been Bett’s closest ally, cated the book “To my illusions, which have in perpe- started to distance himself from his sometimes utopi- tuity enriched my life.” Luckily for Walter Bett, how- an accomplice. The poor outcome of this unfortunate ever, Alfred Franklin evidently sought to maintain – at dispute are revealed in a shocking letter Bett wrote to least to some degree – their close friendship: Franklin on 22nd November 1933: 21st January 1934 “I can assure you – and please believe me – that my resignation has been very carefully considered by me, Dear Franklin, and has in no wise been impulsive. I cannot help feeling that the Osler Club can very well stand on its feet Thank you for your letter of the 17th. now and that by taking thought it could even add one My book ‘A short history of some common diseases’ cubit unto its stature. My services and my interest are will be published next Thursday, and I have asked the certainly no longer needed. The Osler Club worships [Oxford University Press] to send you a copy which Osler in its way and I in his, though I fully and perhaps I shall be glad if you will accept… Though I am no somewhat regretfully realize that I have a highly exag- longer on the Resident staff at Shadwell, I am attend- gerated idea of the man. As this may be my very last ing the Hospital in another capacity, and while it is formal letter to you, let me say quite frankly that so far pleasing to keep up one’s connections with a place to as I have been concerned the last few meetings of the which one has given one’s first love, one has yet to Club which I have attended (except the Oration), have look around for some work which will worthily fill out been a piteous waste of time. Even at an informal cir- one’s life. At present I have too much leisure to quiet cle like the Club the best should be good enough. If the troubled heart. you complain that I was becoming more and more out With kind regards, of sympathy with the Club may I suggest that I have lately had occasion to deplore the absence of common I am, sentiments and of a common pride and in you personally the gradual loss of a finer edge of kindliness and very truly yours, tolerance? All this is ended. I had hoped that the eye 101 of the Nation, perhaps of the World, may one day be WR. Bett upon the Club. I have shed my illusions.”97 86 Osleriana Walter R. Bett

Figure 5: Walter Reginald Bett MRCS, LRCP – a worshipper in Clio’s temple. The portrait is signed by Bett ‘with best wishes to Alfred W. Franklin’ on Walter Bett’s 27th birthday (8th April 1930). From an original framed portrait in the archives of the Osler Club of London.

July 2019 87 N. Toodayan Bett evidently did not feel fulfilled in his current role 13th Febr. 1935 as Medical Superintendent to the East London Hos- pital in Shadwell and began looking for further work. My Dear Dr Packard: His ‘troubled heart’ was outpoured that same year It must be 7 or 8 years ago [when] we last met at the 102 in The Short-Lived Spring, a poetical anthology of Osler Club in London one summer afternoon at Sir occasional verse he had authored over the preceding D’Arcy Power’s house. You might be interested to months. In addition to its literary and artistic value, hear that since the beginning of the year I am in New this rare publication gives precious insight into Bett’s York City as Medical Librarian of Columbia Univer- personal life circumstances. His heartache is apparent sity; and you can imagine how I revel in the opportu- on every page, as is his love of children, diplomacy in nities which this post provides. We have Prof. Hun- friendship, and pursuit of companionship. One out- tington’s fine collection of historical works. I have standing verse in particular, the closing lines to a poem many good friends here and have also met some very titled ‘Life is indifferent’, perhaps best surmises how attractive people, including Mr Hoeber. In the near Walter Bett felt at this time: future I hope to visit Philadelphia, where it would be a pleasure to see you again… For lonely stranger man, whose only worldly crime Has been that he has loved too much in his own day With kind regards, And now has reaped the penalty: for sped away Yours sincerely, All his illusions are, his dreams so sweetly blown Walter R. Bett108 Are dead. He turns for sympathy to grass and stone Bett maintained his contacts in Philadelphia and was W.R. Bett, 1934.103 said to have given the Kate Hurd Mead memorial lecture to the College of Physicians of Philadelphia in 1950.109 For reasons not clearly recorded,110 he left ‘The Doyen of Medical Librarians’ Columbia University in 1937 and became a medical advisor to Winthrop Pharmaceuticals, where he was But if Bett felt isolated or otherwise aggrieved in his the chief literature searcher and author of clinical ex- early thirties, there were those who looked out for and cerpts for the company. With the outbreak of the Sec- supported him, for he was deemed an asset to the his- ond World War, Bett left America and joined the Royal torically inclined medical community. In late 1934, Army Medical Corps in December of 1939, where he Harvey Cushing’s future biographer John Farquhar enlisted as a Captain in the Regular Army Emergen- Fulton (1899-1960) joined forces with Archibald Mal- cy Commission (R.A.M.C.). Over the following five loch (1887-1953) to help secure Bett the prestigious years, Bett travelled the world with the R.A.M.C., post of Head Medical Librarian at Columbia Universi- working at different times in South Africa, Egypt, Su- ty in New York. Considering his prior experiences ab- matra, Java, India, and Ceylon. As a medical officer stracting literature, and his love of libraries in general, in Ceylon, he reported on the increased incidence of Bett willingly accepted the welcome job offer and set crime in connexion to alcohol, and noted the medical sail for the United States late in 1934. Interestingly, properties of the fermented and unfermented sap of his arrival at Columbia in January of 1935 was report- the local coconut palm.111 His wider dealings abroad ed in The New York Times alongside a rare portrait of were well summarised in a letter to Warren Dawson Bett in his youth;104 the Science magazine also report- written on his eventual return to England in late 1945: ed his new appointment.105 Not long after arriving in New York City, Bett first met his soon-to-be-wife Ruth 1 September 1945 Irene King (1902-1991), a fellow medical librarian at 11 The Avenue, Columbia University and graduate in library science Bedford Park from Alma College.106 On 21st June 1935, Bett mar- London, W.4. ried Ruth King at a ceremony in Manhattan, although My Dear Dawson, the couple did not have any children. I have returned to civilization and civilian life – at last, During his relatively short term at Columbia, Bett of- having toured the world for nearly 5 years – South Af- fered his librarian services to local physicians and re- rica, Egypt (where I had an interesting time, visiting searchers, and would have been pleased to receive en- Max Meyerhof, the Institut o’ Egypte, etc.), Sumatra, couraging correspondence from distinguished medical Java, India, Ceylon. I have been constantly on the figures like Bernard Sachs (1858-1944), who wrote move, at many times existing rather than living. Now to Bett appreciating his assistance in 1936.107 Shortly that I am demobilised, I look forward to seeing and after his arrival to Columbia University, Bett wrote to hearing from my friends again, working in the London his Philadelphian correspondent, Francis Packard: libraries, and attending the various society meetings

88 Osleriana Walter R. Bett which I must confess I have missed greatly, particu- commemorating distinguished medical personalities larly the R.S.L. [Royal Society of Literature]. I have to the Medical Press journal alone in the 1950s,117 and joined the Royal Institution (Sir Arthur Keith proposed authored numerous other articles in various journals me) and shall enjoy their meetings and gatherings. all over the world. Franklin commented concerning Am quite busy with literary and bibliographical work: Bett’s publications that “there are three hundred and a life of Bland-Sutton, my bibliography of Laurence seventy-two of his reprints in the Saint Bartholomew’s Binyon, a book on Music & Medicine, and a number Hospital Library and this is but a fraction of what he of articles (including pot-boilers!)… The Wellcome wrote… There is much literary mining left for the ar- Museum and Library are shaping oh! so slowly… Let dent collector of Bettiana.”118 A recent inquiry con- me hear from you soon, giving me your news. cerning the subsistence of these reprints was unyielding, however it is hoped that a more detailed search of With kindest regards to Mrs Dawson, the relevant archive may potentially uncover this vast 119 th Yours ever, collection of ‘Bettiana’ in the near future. On 12 June 1955, Bett himself noted in a letter to Dawson W.R. Bett.112 how he was: “spending a quiet Sunday at home today, I took the opportunity of sorting out my various re- Bett was relieved to finally return back home to En- prints which have accumulated at a fearful rate (fortu- gland at the end of the Second World War in September nately, no one will ever have to compile a bibliography of 1945. He settled with his American wife in Chis- of my writings after my death!).”120 wick, West London, and became medical consultant for the Menley and James pharmaceutical company, Whatever the final number of Walter Bett’s publica- the first aspirin manufacturing chemist in the country. tions may have been, there is evidence to support that Whether out of choice or necessity, Bett’s preference he was widely admired for his work ethic and schol- for pharmaceutical consultancy jobs over clinical roles arship during his lifetime. It was in praising Bett’s gave him the much needed time to pursue his love of capacities as a medical librarian that fellow physi- literature, medical history, and writing. But it was not cian-writer John Hargreaves Harley-Williams (1901- only to pharmaceutical companies that Bett offered his 1974) recalled how: “Anyone who visited a medical medical services. As indicated in his letter to Daw- library in London during the 1930’s would be certain son, Bett was keen to work in the London libraries, to see an industrious fellow reader. He would be there and so successfully applied for the post of Research when we arrived, and after we had done our work he Librarian to the National Association for the Preven- would still be at his seat. In other libraries, too, Walter tion of Tuberculosis. He also worked as a consulting Reginald Bett was an assiduous cultivator of the field medical bibliographer for the British Association of of knowledge.”116 Harley-Williams’ more charitable Dermatology, The Institute for the Study & Treatment obituary comments concerning his bibliophilic col- of Delinquency, and was made editor of London’s new league provide great personal insight into Bett’s work ‘Medical Digest’ journal at this time.113, 114 Bett evi- as a librarian: dently kept himself busy through these appointments but also contributed to contemporary medical advanc- “During the 1940’s he was away as a British Army doc- es in his pharmaceutical consultancy roles. Notably, tor… Thereafter he reappeared as though he had never he was assigned by Smith, Kline and French in 1956 been absent, and if you glanced over his shoulder you to introduce the company’s nitrofurans – a then new would see his perfect script – like an illuminated man- class of antibiotics which had shown some promise in uscript – of endless medical and scientific references. urinary tract infections resistant to sulphonamides and There are some 6,000 medical journals in the world, penicillins – to medical personnel in India.115 Simi- and there can be few which Walter Bett did not know larly in 1960, he reviewed the utility of the phenothi- intimately. Walter could give the background. He be- azine antipsychotics in the West Africa Medical Jour- lieved that in order to see far into the future it was nal, particularly noting the uses of trifluoperazine as desirable to look into the past, and many a compiler of “a highly effective, yet safe” drug for treating chronic medical papers, writers of books, or those who mere- schizophrenia, and for “helping to decrease the size ly required references for their own pleasure, came to of the mental hospital population”.116 The drug’s ad- rely upon his infallible judgement.”121 ditional uses as a potent anti-emetic in hyperemesis gravidarum, and as an effective tranquiliser for agitat- Picture him, in a puff of his own smoke, pondering ed patients in lower doses were also noted. over the world’s medical literature:

Bett’s literary output during these years was immense. “He would move from the Mitteilungen der Deutschen He contributed no less than sixty-nine ‘historical notes’ Pharmazeutischen Gesellschaft to the Tokyo Jikeikai

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Ikadaigaku Zasshi or the Cleveland Clinic Quarterly. Revitalising the Osler Club of London His careful eye never missed or falsified a reference, and he would make an infallible summary of its con- Without Walter Bett’s enthusiasm and leadership, the tents for one of his numerous clients in the medical Osler Club’s declining activities throughout the mid- world. Those wishing to appear erudite without doing 1930s could no longer be sustained. The Club’s quar- the work delegated this library research to Walter Bett, ters on 27 Wimpole Street were destroyed in a fire in absolutely convinced that he would do it far better.”121 November of 1935 when Franklin’s family home was set ablaze, and meetings came to a complete halt in The historical medical libraries of London were evi- 1938 as Britain braced herself for the Second World dently a perfect match for this rare medical misfit: War. For the next nine years the Club existed in name only, and it would require the determination of its orig- “It was a strange specialisation of the medical mind. inal founder to revivify the Club to its former glory: Walter might be called the complete librarian – not in “What we owe to Bett in the second foundation of the the sense of one who gives out books to readers; but Club,” declared Alfred Franklin in 1959, “put in the as one who knows their contents thoroughly, and can minimum of words is everything”.122 Indeed, it was put his finger upon an obscure reference. Surely the as early as 23rd September 1945, that Bett had enthu- doyen of medical librarians, he was also the author of siastically written to Warren Dawson telling him how, several books… There can be no better instance in amongst other ambitions: “we are hoping to revive the which the culture of men’s minds was carried to the Osler Club in the near future”.123 Owing to freedom point where it became original creation.”121 from clinical work Bett was able to do just that, and

Figure 6: Members and friends of The Osler Club of London outside Christ Church Hall after their Osler birthday centenary luncheon with the Regius Professor of Medicine Arthur Duncan Gardner (1884-1977) on Saturday 16th July 1949. Pictured from left to right are: Walter Bett’s wife Mrs Ruth King Bett (1902-1991), June Carlyle Lyon, Mr and Mrs Hipkins, Dr Walter Reginald Bett (with what looks like a cigar), Dr Geoffrey Langdon Keynes (1887-1982), Dr Alastair Hamish Tearloch Robb- Smith (1908-2000), Frederick Noel Lawrence Poynter (1908-1979), A.H. Alexander (of the Radcliffe Science Library), Mrs Ruth Poynter, and Dr Alfred White Franklin. Robb-Smith later took the group on a conducted tour of the Osler exhibition at the Radcliffe camera which he had himself arranged. From the archives of the Osler Club of London.

90 Osleriana Walter R. Bett

Figure 7: The same group (see Figure 6) outside the main entrance to the almshouses in Ewelme where William Osler held an honorary Mastership. From the archives of the Osler Club of London. by 12th July 1947 the Club had officially reconvened at liam Osler in newspapers and professional journals its 72nd meeting at the Cadogan Hotel, and had made on both sides of the Atlantic. On 9th July 1949, two plans for further regular meetings in the future. The separate memorial articles of his were simultaneously Club’s constitution was redrafted on 4th November published in Nature126 and The Nursing Mirror;127 the 1947, and it was then laid down that the group should first commemorating William Osler’s inspiring legacy meet at least five times a year for ordinary meetings, for physicians; the latter pointing out his interest in and additionally on William Osler’s birthday for an the nursing profession. In both articles, Bett presents annual dinner.119 This was all just in time for Osler’s Osler as a “great physician” who had “a radiant per- birth centenary which was duly celebrated by the Club sonality” and “a genius for friendship”; he appreciated in July of 1949, firstly at an official commemorative the importance of skilled nursing for best patient care, meeting at the Royal College of Surgeons on July 12th, and noted how “nursing was a profession for women and later followed by a pilgrimage to Oxford on July of culture and intelligence.” On 12th July 1949 – the 16th (Figures 6 and 7), during which dedicated mem- 100th anniversary of William Osler’s birth – Bett’s ma- bers enjoyed a centenary luncheon at Christ Church jor article on ‘The Memory and Tradition of Sir Wil- Hall, visited designated Osler sites, and viewed a spe- liam Osler’ as a ‘Physician and Humanist’ was printed cial Osler centenary exhibition which was displayed at anonymously in The London Times.128 In this widely Oxford’s famous Radcliffe Camera.125 publicised commentary of Osler’s legacy, Bett praised Osler’s versatility as an accomplished clinician, pa- To Walter Bett in particular, a man who spent his thologist, and scientist, and furthered his commem- days marking out medical anniversaries and duly orative cause by portraying Osler as a humanist and commemorating great practitioners of the past, the classical scholar who had “a magnetism [for] attract- centennial anniversary of Sir William Osler’s birth in ing and holding younger men.” He concluded with a July of 1949 was of enormous significance. Keenly personal plea to the general public to embrace William anticipating the centenary, he contributed no less than Osler as a symbol for world peace: four timely editorials faithfully commemorating Wil-

July 2019 91 N. Toodayan “In these days of world unrest and political mistrust we Man and The Legend – which was first published in may well turn once again to Sir William Osler as an 1951.131 We know that Bett initially intended to have apostle of international medicine. Spiritually at home this work published for the centenary because he wrote in America, Britain, the Continent of Europe, and in a letter to Warren Royal Dawson on 18th October 1948 far-off China, and claiming friendship with the leading stating that: “I am writing a life of Osler which Heine- exponents of medicine throughout the world, he per- mann’s are publishing for his centenary next July.”132 sonified the truth of the saying that the art of healing Owing to other competing commitments however, the knows no boundaries, that it is international in the true work was not published until 1951, but it nonetheless sense of the term. Osler was more than a great schol- remains one of Bett’s most outstanding contributions ar-physician: he was a builder of world peace and uni- to the Oslerian oeuvre. All throughout the text, this ty. Those who follow his example and try to translate slim but savvy fourteen-chapter, 125-page compila- it into terms of modern life are still proud to guide tion of Osler’s life and legacy bespeaks the genius of a their daily lives by the question: What would Osler very widely read and broadly acquainted Osler scholar. have done?”128 Re-orientating his reader to reconsider Osler in a new and objective light, Bett presents his patron saint as a On 13th July 1949, The Medical Press published Wal- physician-humanist with a genius at making friends, ter Bett’s heartfelt tribute to William Osler as a medi- as an enormously self-disciplined yet ageless advisor cal historian in a special memorial issue dedicated to to young doctors, as a “quick but graceful” “artist in Osler’s memory. Undoubtedly one of Bett’s most de- living finely”, and as a whole-hearted advocate and lightful tributes to William Osler, the article provides apostle of international medicine. Keeping abreast a strikingly sober perspective of Osler’s engagements of the latest literature on Osler, Bett borrowed from with medical history: Joseph Hersey Pratt (1872-1956),133 this outstanding depiction of Osler’s likeness: “To Osler the history of medicine was essentially the story of ideas – unborn, still-born, prematurely born, “Of medium size and quick but graceful in his move- short-lived, resurrected, triumphant, immortal; a story ments, Osler possessed a curiously sallow complexion acted by men great and small, by seers of visions and which was extremely dark – almost to the point of be- by dreamers of dreams, by craftsmen and by scholars, ing olive-hued, and possibly an inheritance from Celt- by kings on the highway and by beggars on horseback ic ancestors in the Cornish birthplace of his parents. – all throbbing with life and human interest. Osler nev- His eyes, too, were very dark and lustrous, searching er bothered to acquire historical learning which like so at times, but often twinkling most merrily. In repose much dead weight might burden his mind and make his expression became more mellow and more genial him an owl-eyed pedant. He was content with culti- as he grew older. His contemporaries have comment- vating the sense of historical curiosity, which enabled ed on his well-formed hands and on their effective and him to think in terms of the past and in terms of the characteristic gestures. His laugh could be hearty and past to interpret his experiences in medicine and in infectious, and in his highly emotional way he was life.”129 easily moved to tears, but when in earnest his voice became grave and very deep. Osler cultivated a char- To William Osler, as to Willie Bett, the study of medi- acteristic pose, standing upright, his left hand in his cal history “assumed the stature of a religion”: trouser-pocket, his right smoothing down his heavy moustache which he allowed to flow down in the “Medical history to him was something which he lived Chinese style and which tended to conceal his strong every day in the course and sequence of his work as mouth. In class, he would often sit on the edge of the a physician and teacher. His interest in the history of table, with one leg swinging free.”134 medicine and of science assumed the stature of a religion, yet it never at any time degenerated into a static Although punctuated mid-way with a series of or contemplative religion of past accomplishments well-printed photo-plates showing Osler at work and but remained an active, dynamic, growing faith in the in his library, it is doubtful whether these images were promises and revelations of the future. To him the un- equipollent to the text in bringing Osler to life in the known in medicine was overwhelmingly greater than minds of Bett’s readers. Authored by a spectacular the known so that, if its past was full of interest and wordsmith and Oslerian scholar, Bett’s Osler (Figure its present thrilling, its future was fascinating beyond 8) remains one of the most readable and informative belief.”130 accounts of William Osler’s life and legacy available. The book has continued to influence latter-day writers Bett’s article in the Medical Press was reproduced in on Osler135 and may still be read with great benefit by his more definitive account of Osler’s life –Osler: The anyone interested in the Oslerian tradition.

92 Osleriana Walter R. Bett

a b

Figure 8: “Of all physicians in modern times Osler wielded a unique influence throughout the civilised world by the magnetism and charm of his personality and by raising the standards of medical education and thus the efficiency of his profession.” – pp. 114-115; Bett’s Osler (a) was destined to become an instant classic. Author’s copy depicted. b) A monochrome of this portrait of Osler by Seymour Thomas appeared as the frontispiece to Bett’s work. From the Bodelian Library, Oxford.

Bett’s initiative to keep the Osler Club running was In his capacity as secretary to the Osler Club – a post resoundingly successful. In the same year as his book Bett held for some eleven years – Walter Bett contrib- on Osler was published, the Club elected its first for- uted colourful ‘minutes’ recording the Club’s many mal president in the person of Sir Vincent Zachary meetings and activities. Several dozen entries in his Cope (1881-1974), and with Walter Bett as the Club’s own hand in the Club’s Minutes Book reveal his live- tireless secretary, the Club’s membership steadily in- ly, even puckish, commentaries on the group’s many creased over the coming years. In the Club’s rejuve- meetings and are of considerable historical interest. nation, Bett’s ally Dr Louis Carlyle Lyon (1899-1970), Aside from his masterful command of English, there a general practitioner from Ealing – who according exists in these on-the-fly excerpts important aspects to Franklin “seemed to believe that no doctor was of Bett’s personality; his whimsical nature, his candid a whole man who was not a member of The Osler informality at meetings, and his occasionally dry hu- Club”136 – played an equally important role. It was mour are abundantly evident in the record. Take for primarily on the suggestion of Dr Carlyle Lyon that example, his concluding remarks in the minutes to the Osler’s former home at 13 Norham Gardens was re- 151st meeting of the club which had been organised to furbished and affixed with a commemorative blue celebrate Carl von Linneaus’ (1707-1778) 250th birth- tile plaque in 1955137, 138 – the plaque was unveiled by day: “The garden was open for inspection both before the newly appointed Regius Professor George White and after the meeting, and the Club’s secretary [Walter Pickering (1904-1980) at a formal ceremony held by Bett], with his usual foresight and attention to detail, the Osler Club on Saturday, 8th October 1955.139, 140 had carefully arranged for the sun to shine with mod- Walter Bett and other surviving foundation-members erate brightness.”141 Elsewhere, Bett had written that: of the Club were present to see one of their own re- “As the minute book of the Club may one day become a open and later occupy the home of William Osler for valuable historical document, it is pointed out that the the first time since his death in 1919 (Figure 9). President’s traditionally clear and imperial signature

July 2019 93 N. Toodayan

Figure 9: Professor George Pickering unveils the blue Osler memorial tablet at 13 Norham Gardens on 8th October 1955 before members of the Osler Club of London. Also pictured from left to right are: [possibly] Ruth Bett, Walter Bett, Louis Car- lyle Lyon, Vivian Bartley Green-Armytage (1882-1961), and Harold Avery. From the archives of the Osler Club of London.

on this occasion degenerated into a Parkinsonian il- fully chosen remarks concerning many of the Club’s legible scrawl.” He swiftly added that: “The secretary, meetings that he took to his role with great skill and having retired from medical practice many years ago, devotion. Bett provided his own perspective on how is unable to suggest a diagnosis.”142 At times Bett was club minutes should be written in an anonymously au- lightly critical of speakers: “it was noted that the walls thored article published in 1954: of the American Embassy did not collapse when the speaker referred to one of the states in the U.S.A. as “Nor need the minutes themselves invariably be dull. I ‘Mitchigan’.”143; “Had he not raced through his type- know of one medical association where the minutes script with anti-Oxonian speed, the meeting would often include what the secretary calls “a little judi- still be continuing.”144; “Dr M. E. Arnold condensed a cious levity.” When the chairman asks for the minutes ‘Ten minutes visit to Oslerian shrines in Canada’ into to be read, the members sit up prepared to enjoy the 23 minutes… his exquisite coloured slides persist- secretary’s good-natured digs at the little foibles of his ed in getting stuck, with the result that the audience colleagues. As a result the audience is in high good was regaled with a prolonged view of the townhall humour from the start, and the lecturer is spared the of Dundas, Ontario.”145 Such remarks might explain ordeal of addressing his opening remarks to a sea of Franklin’s comment that Bett “was more than ready vacant faces.”148 to vent his pique in the minutes”;146 Dr Harold Avery (1903-1972) similarly referred to Bett as the Club’s And indeed one is left with this impression on read- “notorious secretary”147 and – noting Bett’s interest in ing the Club’s Minutes today. Bett’s role as secre- medical eponyms – further commented that: “Dr Bett tary came to an end in late 1959 when he accepted has an eponym; ‘Bett’s minutes’ are well known in another job in America as medical consultant to the this club [laughter]; and I think as long as this club Norwich Pharmaceutical Company. The recent death exists, Bett’s minutes will not be forgotten.”147 What- of William Willoughby Francis – whom Bett greatly ever these perspectives may suggest of Bett’s reputa- admired and whose obituary he authored – may also tion as a secretary, it is evident from reading his care- have influenced Bett’s decision to leave at this time.

94 Osleriana Walter R. Bett

Unlike his first departure in 1934, Bett’s colleagues ‘The Infirmities of Genius’ made a genuine effort to acknowledge his painstaking efforts as secretary to the Osler Club. On 23rd Septem- Like William Osler, Walter Bett had cultivated a fine ber 1959, during a council meeting which Bett was taste for great literature through his life-long incur- asked to leave, the Club appropriately decided to ar- sions into literary matters. An active Fellow of the range for a formal testimonial to Dr Bett “in token of Royal Society of Literature, he was brought into close its appreciation for all he had done to bring the Osler contact with London’s literary elite, and used his med- Club to its present strength.”149 The plan was duly ex- ical background to assess great literary figures from a ecuted in the Council Chamber of the Royal College psychological perspective. As early as 1946, Bett had of Surgeons of England on 5th November 1959 when indicated an interest in the “part played by drugs in a formal dinner was held in honour of Walter Bett and the lives and literary labours of so many distinguished his wife Ruth. After a series of heartfelt tributes and poets and novelists”,150 and through discussions with thanksgivings from Alfred Franklin, Arthur Dickson his distinguished literary friend and mentor Walter de Wright (1897-1976), and others, Bett was presented la Mare (1873-1956),151 he aspired to present a more with a collector’s copy of the Dictionary of National careful study of the relationship between literary ge- Biography, and an original George III silver tankard nius and various mental and physical illnesses. Bett made in 1769 (Figure 10). He was succeeded in the lectured variably on such topics in these years, and his secretarial role by the distinguished sarcoidologist researches were ultimately published in book-form in and medical history enthusiast David Geraint James 1952 as The infirmities of Genius.152 In this work, Bett (1922-2010). links the accomplishments of fifteen famous literary

Figure 10: Walter Bett’s original 1769 George III silver tankard – “presented in gratitude at a dinner in his honour at the Royal College of Surgeons, London 5 November 1959” – remains extant in the archives of the Osler Club of London. Pho- tograph taken by author on 16th May 2018 in the Thomas Cotton Room at the Royal College of Physicians of London.

July 2019 95 N. Toodayan figures to a certain medical or psychiatric condition, diction is still sub judice”156 – can be accounted for noting that “an intimate and sympathetic knowledge by a psychological conflict of interest bias caused by of an author’s medical or psychiatric case history will his faithful allegiance to the manufacturers of Benze- enable the reader to appreciate or enjoy his works all drine who employed him, and clear cut evidence that the more.”152 To the uninitiated, the work provides still the medication was indeed useful in many conditions fresh perspectives on many of Osler’s literary heroes, when appropriately prescribed. In fact, Bett was al- and includes striking tributes to many famous authors ways a faithful worker to the firms he consulted, and like Thomas Carlyle (1795-1881), John Keats (1795- even went so far as to dissuade doctors from William 1821), Percy Bysshe Shelley (1792-1822), Edgar Al- Osler’s warnings against receiving treatment advice lan Poe (1809-1849), and Charles Lamb (1775-1834). from commercial sources: “for the literature sent out by the ethical houses, though possibly tainted with the It is important to note that Walter Bett’s special inter- bias from which no sales talk can be dissociated, usu- est in drug addiction was not limited to such literary ally offers a useful epitome of current treatment”.157 escapades alone. As medical consultant to the Menley To the end of his days, Bett embraced the pharmaceuti- & James Pharmaceutical Company – the U.K. sub- cal industry as an important adjunct to clinical advanc- sidiaries of Smith, Kline & French (SKF) Laborato- es in medicine.158 ries – he was directly involved in studying the clinical applications of Benzedrine, the first widely sold Whatever his views on the addictiveness of Benze- amphetamine pharmaceutical. Originally introduced drine may have been, Bett maintained a respectable in America by SKF as an inhaler decongestant in late reputation as a learned author on addiction and relat- 1933, the addictive drug was rebranded in 1936 as a ed matters. In the same year as his book on amphet- panacea for all sorts of maladies and Walter Bett was amines was published, he was elected President of the inevitably involved in marketing the drug through his Society for the Study of Addiction to Alcohol and Oth- work with its manufacturer. In August of 1946, he pro- er Drugs, an office he held for three years (Figure 11). duced an exhaustive report on the uses of ‘Benzedrine Sulphate in Clinical Medicine’,153 putting to good use On 19th July 1955, Bett delivered his Presidential Ad- his broad medical learning and expertise as a librarian dress to members of the Society at Lettsome House abstracting medical papers. Still high off the success- on Chandos Street. To his credit, he chose to speak es of Benzedrine sulphate in World War II – “On many on the timeless topic of ‘Medical Societies and Inter- a dangerous mission Benzedrine helped tired men to national Understanding’,159 a subject as relevant today win the battle against sleep, when they could not be as back in 1955. With the same ideals he had formu- replaced by rested reserves” – the drug was presented lated for the Osler Club of London in his youth, Bett as a potential therapeutic agent for some thirty-nine urged his audience to adopt a spirit of international medical conditions. From narcolepsy to nyctalopia, co-operation and medical camaraderie in their fight and hypotension to heart-block, Benzedrine sulphate against addiction. He reminded them that: “We live was perceived to be “a drug with divers and valuable to-day in a world shaken by two devastating wars, a indications, if employed intelligently and with mild world of unrest, of prejudices, of misunderstanding, scepticism”. To be sure, Bett’s views accurately re- a world yearning for peace, security, and mutual tol- flected contemporary medical opinions of the time, as erance. How often is prejudice based on no sounder is evidenced by some 158 references sourced from foundations than ignorance, misunderstanding, and leading international medical journals. It wasn’t long gossip! And how often does it not melt like snow in however, before reports of recreational abuse sur- the warmth of personal intercourse and of good-fel- mounted and the drug’s addictive nature came more lowship that is so essential for fruitful cooperation!”. and more into the spot-light. Considering cultural relations between East and West, Bett used his address to encourage “an atmosphere In 1955, Bett co-authored a small handbook on am- of international understanding, of toleration, [and] of phetamines in clinical medicine, in which he and his mutual respect”. Speaking almost word for word as co-authors wrote about Benzedrine as a ‘basically Osler did in his 1902 address on ‘Chauvinism in Med- useful, but frequently misused drug’.154 The book icine’,160 he urged his colleagues to consider their role was translated into German155 and contains much use- in enhancing international relations: ful historical information on the clinical uses of amphetamines in the 1950s. Bett’s reluctance to accept “I believe and am immovably convinced that we must the addictive properties of amphetamines at this time rely on the medical profession to play its part, for to – “Purposely a special section has not been included no other profession is the word ‘universal’ applicable on addiction to amphetamine, as the existence of ad- in the same sense. Medicine is a universal brotherhood,

96 Osleriana Walter R. Bett The Delectable Mountains

Owing to his transatlantic reputation as an accomplished editor and medical historian, Walter Bett was offered the comfortable post of Medical Editor in the Scien- tific Information Division of the Norwich Pharmaceutical Compa- ny in late 1959.113 He set sail for Norwich, New York on board the steam ship Queen Elizabeth on 26th November 1959,161 and eventually made his new home at 15 Elm Street, where he settled with his wife Ruth, pet cat, and dog. Bett enjoyed the regular hours and financial security offered by his new post, and sought to adapt himself to suburban life. He edited the company’s International Urological News Bulletin in these years, offering his expert editorial services to authors for scientific contributions. Bett’s final major historical work – A Short History of Nursing 162 – was completed just before leaving England for this second time. Judging from a brief review of the book in his new company’s official newsletter 163 Figure 11: Walter Reginald Bett – President of the Society for the Study of Ad- (Figure 12), the work was well diction to Alcohol and Other Drugs from 1955 to 1958 – aged around fifty-one in received by his American col- this photograph. Image sourced from a 1954 editorial by Walter Bett [Bett WR. A leagues shortly after it was pub- little judicious levity in dermatology. Missouri Medicine, 1954; 51(10): 828-830.] lished in February of 1960: a member of which can – theoretically, at least – take “‘A Short History of Nursing’ is a new book by Dr. up his calling in any land bathed by the waters of the Walter R. Bett which was published Friday by Faber Seven Seas, to find brethren whose language, interests, and Faber, Ltd., of London, England… Although it is a and aims are identical with his own… Our work rec- small volume – 125 pages, digest size – “A Short His- ognizes no national, racial, or religious boundary.”159 tory” traces nursing from its first mention in 1250 B.C. to present day. The forerunners of the modern nurse A humanist at heart, Bett concluded his address with are brought to life for the reader through the author’s the practical suggestion that the society’s members warm style. The writer also covers such interesting might benefit from engaging in formal professional topics as nurse’s training, duties and salaries. There correspondences with peoples in other lands. He end- is an entire chapter on the changes in styles of nurses’ ed on this strikingly optimistic note: uniforms. Another chapter contains the absorbing sto- ries of the origin of the syringe, rubber surgical gloves, “You will play your part as bridgebuilders across and other ‘tools of the trade’… it should appeal to any this yawning gulf of international misunderstanding. student contemplating a career in nursing and to any- Building such a bridge stone by stone, arch by arch, one interested in the profession. In sum: For the busy bold in design, but firm in foundation, you may not reader, Dr. Bett has reduced the corpulent histories of live to see the final structure, but one day across your nursing to a slim, informative, and entertaining book bridge others will swarm, a triumphant and grateful without sacrificing the appetizing side dishes in serv- host. The happiness of mankind lies in your hands.”154 ing up the main course.”163

July 2019 97 N. Toodayan On the invitation of the Osler Club of London, Walter Bett returned to England one final time in July of 1962 to deliver the Club’s cov- eted Oslerian oration. Although his wife Ruth was unable to accompany him on this journey, Bett enjoyed seeing many of his old friends again during his short stay in London – a number of his older colleagues had passed away however, and he was sad- dened by the recent suicide (due to ill health) of his friend Wil- liam John Bishop (1903-1961), who was also the inaugural editor of Medical History.164 Bett’s oration was keenly anticipated by the Club who had gathered 144 strong to hear their founder and former secretary orate that evening at London’s Rembrandt Hotel (see frontispeice, page 74). The title he had chosen for the 25th Oslerian oration – The Epitaph of Adrian’s Horse – was faithfully drawn from Browne’s ‘wonderful page’ (vide supra) in Hydriotaphia Urne-Buriall, and Figure 12: Walter Bett in his 1960 Norwich office with an advanced copy of his the talk roughly recapitulated last book on A Short History of Nursing. Image sourced from Scope magazine.163 what Browne had written over three centuries earlier: “The iniquity of oblivion blind- pleasure on the commemorative plaque at 13 Norham ly scattereth her poppy, and deals with the memory of Gardens, now the home of a successor of yours in the men without distinction to merit of perpetuity… Time Regius Chair. In the bosom of this, the friendliest of hath spared the epitaph Adrian’s Horse, confounded all medical societies, the largest of all medical fami- that of himself”.2 Drawing on well over thirty years lies, where the crowned heads, the elder statesmen, the worth of scholarship relating to his subject, Bett de- veterans and the recruits of your profession, sit side by lighted his audience on William Osler’s 113th birth- side as they celebrate your birthday in happy mood, I day. He covered vast swathes of literary, historical, can see you standing among us, and, l can hear you and allegorical anecdotes relating to memorialisation whisper: ‘Lord, keep thus, my memory, green’.”165 in medicine, and spoke elegantly on his subject from various viewpoints for just over thirty minutes. Sav- Easily the crowning glory of Bett’s literary works, es- ing the best for last, he concluded his talk by conjuring pecially those pertaining to Osler, this heartfelt enco- up the very spirit of the Osler Club in this breathtaking mium to the inspiration of his life was warmly received dialogue with Sir William Osler: by the audience. On 18th October 1962, the Club’s President, Dr Harold Avery, recorded the following in “If, for a brief and beautiful moment you, Sir William the meeting’s minutes: Osler, our Patron Saint, could come back to us, and could see the memorials we have made of you in our “The 25th Oslerian oration was given by Dr. W.R. Bett, profession and in our hearts, what would be your founder member, friend, secretary, ‘notorious secre- thoughts? Seeing again, the spires of Oxford, in the tary’ of the Club. He delivered a fascinating address early misty blue of a summer morning, unearthly in entitled ‘The Epitaph of Adrians Horse’ and treated us their haunting beauty, would you approve of the sci- to a feast of Bettsiana. Mr. A Dickson Wright in appre- entific spirit that has invaded the teaching and practice ciation of the Oration, said he had looked forward to of medicine in the wards of the Infirmary which bears this more than any other, but had some doubts about Radcliffe’s name? But your eyes would light with the horse. The assembled company accorded the Ora-

98 Osleriana Walter R. Bett tion warm, long, loud approval. The President and son on 10th October 1962: “What a stupid, senseless Council, anticipating a wonderful evening of which world we live in! There is so much constructive work no minutes would be adequate record, arranged for to be done, and here we spend our time and money the whole proceedings to be recorded, so that we can forging weapons of destruction and trying to conquer enjoy again this memorable occasion.”166 the outer space”.169 Notwithstanding such sentiments, Bett diligently maintained Pfizer’s Spectrum over his In May of 2018, two original magnetic reel recordings five years as medical editor until December of 1966. of Bett’s Oslerian oration dated 12th July 1962 were Editorial notes and articles from issues in these years re-discovered in the archives of the Osler Club of Lon- demonstrate Bett’s rare gift for mixing art, science, don. The recordings were professionally digitised in and culture into a medical publication. Showcasing London and later uploaded online to YouTube – a pop- important contemporary medical breakthroughs – no- ular video sharing website – on the 50th Anniversary tably the oral poliomyelitis vaccine, the introduction of Walter Bett’s passing (on 17th November 2018).167 of modern cardiopulmonary resuscitation techniques, and the novel use of the electrocardiogram to diagnose On returning back home to New York on 23rd July heart conditions – and regular historical articles on a 1962,168 Bett eagerly resumed his role as Consulting variety of medical subjects, the publications are sur- Medical Editor of Pfizer’sSpectrum journal, a position prisingly modern in their presentation.170 Some years he had occupied since March of 1961. He was disap- later, Bett noted in a curriculum vitae application that: pointed however – as no doubt most Americans were at “My Medical Editorship of Pfizer Spectrum… coincid- that time – with the conditions leading up to the Cuban ed with a time when Spectrum had come to be widely Missile Crisis, writing to his friend Mr Warren Daw- accepted as one of the best-edited and best-read medical journals in the world. Some of the articles which I helped to write have been reprinted extensively and are used in many teaching institutions.”171 It is a pity that the journal was discontinued in 1966, which was around the same time Bett left Pfizer for other editorial opportuni- ties in New York.

Like Osler in Oxford, Bett enjoyed the slower pace of life in his new role, and spent much time outside work hours reading, lecturing, writing, and enjoying the “cultural and gastronomic amenities” of New York City (Figure 13).172 In his spare time, he attended local art galleries with his wife, making use of a home study course in ‘Under- standing Modern Art’ which he had signed up for with The University of Chicago some years prior. Express- ing some interest in applied linguis- tics, he also sought to learn foreign languages in these years, teaching himself elementary Dutch, Portu- guese, Singhalese, and Urdu to help pass the hot New York summers. In September of 1967 he was visited by his close friend of earlier years, Dr Alfred White Franklin, who was at that time President Elect of the Figure 13: Walter Bett poses for a picture in his office. This photograph was pro- British Paediatric Association. The duced in his obituary for the Health magazine: ‘The Perfect Medical Librarian’. two dined at The Gate of Cleve, a

July 2019 99 N. Toodayan German restaurant near Sheraton Hotel, where accord- could no longer be held back. Walter Bett was ad- ing to Franklin: “we had lived again our early Oslerian mitted to Norwich’s Chenango Memorial Hospital in days, and had devoured a memorable banquet and the the last quarter of 1968. Despite supportive efforts to reputations of our common friends.”173 Recalling this sustain him, he died suddenly from a second heart at- last ever meeting of theirs in a letter to Warren Daw- tack on the morning of Sunday 17th November 1968.178 son, Bett noted how: “The Osler Club seems to have Sudden death from angina pectoris was described by grown quite unwieldy – what a change from the old William Osler in 1897 as the “ideal death”; let us hope days when we gathered round informally in a small, it was just that for Walter Bett – “death like birth, ‘a friendly circle. But it is idle to play the part of Rip van sleep and a forgetting’.”179 Winkle”.174 Whatever the state of the Osler Club may have been, Walter Bett was evidently enjoying himself Records show that Walter Bett signed his will in De- in New York City. Compared to “the intellectual stag- cember of 1966, bequeathing all his property to his nation of Norwich”,172 the big city provided him with wife Ruth King Bett.180 The will was duly executed by all the stimulation he needed to live out his final years Ruth on 19th November 1968, who, in accordance with to full potential. He maintained house in Norwich but her rights to her husband’s property, sold all of Walter spent most of his time in New York City, and were it Bett’s books to the Old Hickory Bookshop in Brinklow, not for his final illness, it is possible that he may never Maryland for the grand total of 2,400 USD (equating have returned: to around 17,450 USD today).181 Also in accordance with her husband’s wishes, Ruth arranged for Bett’s ...why goest thou back to such annoyance? body to be immediately cremated at the Waterville Why climb’st thou not the Mount Delectable?175 Crematory without embalming or funeral service.182 In collaboration with Devine-Wilson Funeral Homes, the cremation took place at 10.00 a.m. on 18th Novem- 183 ‘In the Midst of Life We are in Death’ ber 1968, and the ashes were returned to Ruth Bett on 25th November, presumably in an urn. Ruth ap- In January of 1967 Walter Bett took on the new role parently kept the ashes until her own death in 1991, and made arrangements with her family to be buried in of editor to the New York publishing firm The Phy- 184 sician’s News Service Inc whose headquarters were her hometown of Saginaw, Michigan. Naturally, it based in the heart of Manhattan on 130 East 59th was assumed that Walter Bett’s ashes would have been Street.176 Staying some blocks away at 28 East 31st buried there also. Street, Bett continued to work with great devotion as an editor into his 65th year, and showed no signs of But Who knows the fate of his bones, or how often he is to be buried? Who hath the oracle of his ashes, slowing down. His final publication, a centenary trib- 185 ute to Karl Landsteiner (1868-1943) – “the man whose or whither they are to be scattered? discoveries have given renewed life to millions”177 – was as enthusiastically written as the articles he had After a prolonged search resulting in several stale- authored in his thirties and forties, but was also strik- mates, it was recently re-discovered that both Walter ingly succinct and seasoned in its narration. Bett en- and Ruth Bett’s ashes were finally buried in 2013 at joyed working regular hours in New York and looked Roselawn Memorial Gardens in Saginaw, Michigan, beside other members of Ruth’s family (Figure 14).186, forward to further projects for 1968. “The job is con- 187 genial”, he wrote in his last letter to Warren Dawson Intriguingly, no inscription or headstone exists over on 10 October 1967, “and I do not have to retire when the site of Mr and Mrs Bett’s internment today; and I reach 65 – next year.”174 But if the years weren’t perhaps this is how Walter Bett had preferred it: catching up with good old Willie Bett, his strict work ethic, smoking and eating habits, and sometimes cho- Society, as we have constituted it, will have no place leric constitution probably were: a large heart attack in for me, has none to offer; but Nature, whose sweet New York forced him to resign from his duties on or rains fall on unjust and just alike, will have clefts around 15th March 1968, and so he returned back home in the rocks where I may hide, and secret valleys in to Norwich to be nursed by his wife. Contemporary whose silence I may weep undisturbed. She will hang inflammatory events like the assassinations of Martin the night with stars so that I may walk abroad in the Luther King Jr (1929-1968) in April of 1968, and of darkness without stumbling, and send the wind over Senator Robert Francis Kennedy (1925-1968) in June my footprints so that none may track me to my hurt: of the same year, would have been a sore trial for Wal- she will cleanse me in great waters, and with bitter ter Bett’s failing heart. Add to this the anticipated 50th herbs make me whole. – Oscar Wilde (1854-1900), anniversary year of Sir William Osler’s death in 1969, 188 and the emotional strain on infarcted myocardium De Profundis, 1897.

100 Osleriana Walter R. Bett

Figure 14: The final resting place of Walter Reginald Bett and his wife Ruth; their ashes were interred close to other members of Ruth’s family in the Garden of Gethsemane area (Section 3, Block 3, spaces 1-2) at Roselawn Memorial Gardens in Sagi- naw, Michigan. Unadorned and without inscription, a special effort was made to mark out the site of Bett’s burial on the 50th anniversary of his death. Photograph taken by Gretchen A. Schulte on the morning of 17th November 2018 at around 10 a.m.

July 2019 101 N. Toodayan

‘The Iniquity of Oblivion’ same traditions. But such is the fate of most Osleri- In the fifty years since his passing, the fascinating life ans. Aspiring for a perfection higher than themselves, of Walter Reginald Bett has hardly been appraised or they would seek to perpetuate the legacy of one who chronicled. A largely forgotten icon of Oslerian schol- embodied their desired perfection – a mentor whose arship, his life story is full of valuable lessons for those example would aid in their own pursuit of a more ex- who would seek to flaunt the Osler flag in the 21st cen- alted form of beauty. And if, like most of us, Walter tury. Forty years of historical studies catapulted Wal- Bett sometimes fell short of these lofty ideals, he led a ter Bett into a career of medical editing and secured for rich and enriching life by maintaining an engaging di- him the good fortunes he enjoyed late in life. His and alogue with the history of the medical profession and his Club’s writings have left an indelible mark on the by exerting a warm and vitalising influence on the Os- Oslerian corpus and yet his name has essentially van- lerian tradition. Let this be a testament to his lapsing ished from contemporary discourse concerning these life, lest dull oblivion be his legacy.

Acknowledgements

The author would like to acknowledge especially Mr Richard Osborn and Professor Neil McIntyre for providing access to the archives of the Osler Club of London (in May of 2018) and otherwise making available important historical documents relating to this work. Without their assistance, this contribution would not have been possible. The author further acknowledges the very helpful assistance of Kathryn Greene (of the Guernsey Memo- rial Library in Norwich, New York), Joan Leib (of the Chenango County Historian’s Office), and Gretchen A. Schulte (of Roselawn Memorial Gardens, Saginaw, Michigan), for providing important information concerning Walter Bett’s final years and death/burial in America. These and others are specifically acknowledged in the text and references to indicate what type of assistance was offered. A number of librarians from the University of Queensland have been of considerable assistance in locating and later verfying many important references. An earlier version of this work was presented to the American Osler Society and the Osler Club of London on successive dates in May of 2018.

References & Notes

1. Osler W. Science and Immortality. Boston and New York: Gaspare Aselli’s (c.1581-1625) discovery of lymphatic capil- Houghton, Mifflin, and Company, 1904, p. 3. laries (see page 80). Bett quoted these same lines again thir- 2. Browne T. Hydriotaphia, Urne-Buriall, Or, a Discourse of the ty-four years later in his July 1962 Oslerian oration on ‘The Sepulchrall Urnes lately found in Norfolk. Together with the Epitaph of Adrian’s Horse’, a title drawn from the same ex- Garden of Cyrus, Or The Quincunciall Lozenge, or Net-work cerpt in Browne’s Hydriotaphia, Urne-Buriall. Plantations of the Ancients, Artificially, Naturally, Mystically 5. [Unsigned]. Former Eaton editor, author, dies. The Evening Considered. With Sundry Observations. London: Printed for Sun, Norwich, NY; 18 November 1968, p. 3. Hen. Brome at the Signe of the Gun in Ivy-Lane, 1658, p. 27. 6. Bett WR. William Henry Welch, April 8, 1850, to April 30, 3. Browne T. Religio Medici, A Letter to a Friend, Christian 1934. Proceedings of the Royal Society of Medicine, Novem- Morals Urn-Burial, and other papers. Boston: Ticknor and ber 1950 ; 43(11): 847-850. Fields, 1862, p. 345. William Osler’s own copy from his stu- 7. Memo of W. R. Bett in the archives of the Osler Club of Lon- dent days remains extant in the Osler Library at McGill Uni- don signed by his widow Ruth King Bett on 14th May 1969 versity; as shown in Figure 1, Osler’s dated comment is seen stating, among other things: “Sister, Mrs. Erica Robinson will in a marginal note on page 345 written in pencil. At the same be 71 years old on Osler’s birthday, July 12th.” time, Osler inscribed on the flyleaf of the book: “I doubt if 8. “The medical student notoriously is an iconoclast, incapable any man can more truly say of this book ‘comes via vitaeque’. of being taught hero-worship, a rare gift bestowed by the jeal- W.O. 6.12.19.” ous Gods in-utero”, W. R. Bett, in “The Epitaph of Adrian’s 4. As is later indicated in this article, Bett made recurring refer- Horse”, the 25th Oslerian oration, 12th July 1962. It is to be ences to Browne’s ‘iniquity of oblivion’ in his writings. Per- noted that this quote is not reproduced in the ‘expurgated and haps the earliest reference was made during his first official abridged’ offprint version of Bett’s oration; it is only included presentations to the Osler Club on 18th May 1928 celebrating in the original sound recording of Bett’s oration (see reference

102 Osleriana Walter R. Bett

no. 167). Archive (Ref: GB0100 TH/PP8) in 2002. 9. Franklin AW. Obituary: Walter Reginald Bett (1903-1968). 19. Bett WR. Osteitis Deformans before and after Paget. Annals St Bartholomew’s Hospital Journal, September 1969; 73(9): of The Royal College of Surgeons of England, December 1956; 372-373. 19(6): 390-393. 10. Bett WR. (1929). The Use and Abuse of Patron Saints. 20. Cushing H. The Life of Sir William Osler. Oxford: At The Clar- Hand-written transcript in the archives of the Osler Club of endon Press, 1925. London, dated 12th July 1929; p. 2. 21. Bett W. Clio by the Bedside. St Bartholomew’s Hospital Jour- 11. St Bartholomew’s Hospital Student Register (Ref: nal, July 1931; 38: 202-205. SBHMS/S/2/5, p. 440), St Bartholomew’s Hospital Archives. 22. Osler W. An Address On the Medical Clinic: A Retrospect and Retrieved with the assistance of the hospital archivist, Aman- A Forecast; Delivered before the Abernethian Society, St Bar- da Engineer, on 20th March 2018. tholomew’s Hospital, London, December 4th, 1913. British 12. St Bartholomew’s Hospital Student Signature Book (Ref: Medical Journal, 3 January 1914; 1(2766): 10-16. SBHMS/S/1/4, p. 89). Retrieved with the assistance of the 23. Franklin AW. Cambridge University Medical Society Tour to hospital archivist, Amanda Engineer, on 20th March 2018. America, 1926. The Landmark (The Monthly Magazine of The 13. Bett WR. John Keats (1795-1821), Tuberculosis and Genius. English-Speaking Union), January 1927; 9(1): 56-57. In: Bett WR. The Infirmities of Genius. London: Christopher 24. Lella JW. The Osler Club of London, 1928-38: young medical Johnson, 1952, p. 131. gentlemen, their heroes, liberal education, books, and other 14. Franklin AW. (1959). Toast to the health of Dr. and Mrs. Bett at matters. Canadian Bulletin of Medical History, 1995; 12(2): a dinner in their honour given by the Osler Club in the Council 313-38. Chamber of the Royal College of Surgeons, London, on 5th 25. Franklin AW, 5th November 1959. op. cit. p. 2, paragraph 4. November 1959. Mimeographed and “circulated to members 26. Franklin AW. The History of The Osler Club of London. St with Dr. Bett’s compliments”. Bartholomew’s Hospital Journal. March 1961; 65: 53-54. 15. Bett WR. Life and Works of Sir James Paget. St Bartholomew’s 27. Bett WR, 12th July 1929. op. cit. Bett concludes this lecture on Hospital Journal, November 1925; 33(2): 21-26. Bett’s deep The Use and Abuse of Patron Saints with an interesting remark admiration for Sir James Paget (1814-1899) is indicated by relating to the Club’s ‘parentage’ which is clearly directed at the number of works he authored on or otherwise dedicated to Franklin: “In conclusion I should like to say of your secre- Paget throughout his life. A number of these are listed below. tary [Alfred White Franklin] that he found the Osler Club ‘a 16. Bett WR. (1929). Sir James Paget. Original annotated type- sprawling infant of unknown parentage which he succoured to script of a presentation dated 31st May 1929, in the archives of a lusty youth.’ I pray that in the affairs of this Club he may ever The Osler Club of London. be on the side of the angels – the surgeons, who are privileged 17. Bett WR. The discovery of the Trichina spiralis. St Bar- to verify their reservations on the operating table. May he tholomew’s Hospital Journal, 1928, 36: 39-42. Bett later made never be doomed to the sad side of the physician who has to the suggestion that Sir James Paget’s original specimens of regret his errors at autopsy. Gentlemen, respect the Osler Club. ‘Trichina spiralis’ and of Paget’s Disease of the Nipple should Be not too much its parent. Trespass not on its solitude.” be put on permanent display in the St Bartholomew’s Hospital 28. Franklin AW. (1973). Proem for the Osler Club of London. Museum: “Our glowing affection for Paget’s name and our Offprint of a talk given at the joint meeting of the Osler Club legitimate pride in his illustrious achievements are inexhaust- of London and the American Osler Society at the Royal Col- ible, but our Museum takes little part in the exaltation of his lege of Physicians on Tuesday, 5th September 1972, during the memory. Some time ago (St Bartholomew’s Hospital Journal, 23rd International Congress of the History of Medicine. In this 1929, xxxvi, p.140) I suggested that a little cabinet might be paper, Franklin focusses primarily on the influence of his Cam- reserved in the Museum to display those historical specimens bridge friends who had toured with him to the United States which are milestones in the progress of pathology. Though en- and Canada in 1926. Commenting on Walter Bett only in pass- couragement has been lacking where it should have been insis- ing, he stated that “[I] will only say of him now that during tent, I am by nature an optimist. The day will come when my 1927 he began some conversations about a club for the study fond imagination will be like Adam’s dream, who awoke and of medical history by medical students, that he found in me found it truth.” [Signed W. R. Bett, Shadwell, E.; October 13th, a ready accomplice and in my father a willing host. In Osler 1930]. Bett WR. Correspondence: Museum Musings. Letter he had found inspiration, firstly through [Harvey Cushing’s] to the Editor. St Bartholomew’s Hospital Journal, November Life… [and] later through reading Osler’s Essays.” Discuss- 1930; 38(2): 36 ing surviving colleagues of the club, Franklin made it clear 18. Bett WR. Some Bart.’s Orators. I. Sir James Paget. St Bar- that he did not consider Bett to be his close friend at this time: tholomew’s Hospital Journal, November 1930; 38(9): 183- “Thomas Frederick McNair Scott was born in 1901, the son of 185. Bett’s continuing interest in Sir James Paget led him an Edinburgh trained doctor and, unlike my other three friends, to make contact with some of Paget’s living contemporaries and unlike Bett, brought up in affluence and security…”. for their views on his skills as an orator. In the first quarter 29. Franklin AW. The Osler Club of London. Medical Press, 13 of 1930, he wrote to Paget’s colleague and friend Sir George July 1949; 5749: 35-37. In this paper – which was Franklin’s Makins (1853-1933) seeking to further corroborate his views contribution to the Osler birthday centenary issue of The Med- on the great St Bart’s pathologist. “My view of Paget as an ical Press – Franklin reflects on the foundation of the Osler orator” Makins replied, “is that his speeches charmed the lis- Club in its 21st year of existence. Although accurately sum- tener by their finish and his exquisite command of language…. marising the Club’s significance to date, he made only passing There can be no doubt that he had a natural ability as a speak- mention of Bett’s influence and achievements. He described er”. Moreover “What you say as to his method of preparing an Bett’s concluding statements at meetings as ”a queer mixture address is familiar to me, as I was under secretary to the 1881 of confession, invocation and medical history, studded with Congress I had his MS neatly written without corrections to odd allusion, half song, half sermon, brought the meeting to a send to the printers. When he gave the address I had the proof close.” before me, and as far as I remember there was not a single de- 30. Franklin AW, St Bartholomew’s Hospital Journal, September viation from the written in the spoken word.” Quotations from 1969. op. cit. Although circulated in an offprint amongst club Makins’ valued correspondence (dated 16th April 1930) were members with the title ‘In Praise of Walter Bett (1903-1968)’, reproduced in this article. The letter was apparently kept by Franklin’s obituary included much else besides due praise for Walter Bett and later donated to St Thomas’s Hospital Medical Bett’s role as “the Founder of the Osler Club of London,” in- School Library in 1949. It was transferred to the King College cluding some quite harsh remarks. There is evidence in the

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archives of The Osler Club of London that Franklin shared the archives of the Osler Club of London. a draft version of Bett’s obituary with Sir Robert Platt (1900- 35. Osler W. Introduction. In: Vallery-Radot R. The Life of Pasteur, 1978) – nephrologist and former President of The Royal Col- Translated from the French by Mrs R. L. Devonshire, with an lege of Physicians. In a handwritten response dated 19th June introduction by Sir William Osler Bart., M.D., F.R.S. New 1969, Platt wrote to Franklin stating that: “Thank you so much York: Doubleday, Page & Company, 1923, p. xvi. Osler con- for sending me a copy of your appreciation of Walter Bett. I cludes this introductory note with the statement: “after re-read- think it’s superb! I mean it says so much, without adhering too ing for the third or fourth time the Life of Louis Pasteur, I am meticulously to ‘de Mortuis’ [referring to the Latin epigram of the opinion, expressed recently by the anonymous writer De mortuis nihil nisi bonum; ‘Of the dead, say nothing but of a beautiful tribute in the Spectator, “that he was the most good’] – yes it’s more offensive. I wouldn’t alter (or omit) a perfect man who has ever entered the Kingdom of Science.” word… I showed it to Sylvia Haggard [Bett’s secretary and 36. Entry titled “Pasteur Meeting, April 30, 1928” in the Osler close friend] – who knew him v. well of course and was very Club Minutes Book (Volume I), a now quite dishevelled red fond of him – tho’ perhaps had to be on the defensive now backed volume with entries for each meeting written large- and then! – and she thinks it’s very good.” Sir Robert did not ly in Franklin’s hand. Franklin notes in this entry that: “All end up attending the Club meeting where Bett’s obituary was the members were present, and the Club was honoured by read, and it appears from Ms Haggard’s response, that others the presence of Dr Charles Singer and Mr L.W.G. Malcolm.” may have felt Franklin’s comments were also a bit harsh in the Louis William Gordon Malcolm (1888-1946) was an Austra- setting of an obituary article. It seems likely that Franklin’s lian born anthropologist who was then seated as curator of the brief account of Bett’s life – which remains one of the only Wellcome Historical Medical Museum in London. more widely accessible records concerning Bett – steered later 37. Bett WR. (1928). The Osler Club – Pasteur Evening. Original writers away from Bett’s really remarkable influence on the typescript dated 30th April 1928 in the archives of the Osler Osler Club of London. Joseph Lella, for instance, who has Club of London, p. 1. Note the reference to Osler’s opening authored one of the most definitive accounts of the first ten lines in Science and Immortality (1904). See reference no. 1 years of the Osler Club, noted Bett in passing as “the other and corresponding text for details. prime mover” but referred to Franklin as “perhaps the most 38. Bett WR, 1928. ibid. p. 3. Bett is quoting Osler’s reference influential Club founder”. Notwithstanding Franklin’s pivotal to Pasteur in The Master-Word in Medicine (1903): “…while role in the Club’s foundation, and his ongoing influence as in the hands of Pasteur it [the Master-Word] proved a very a distinguished paediatrician and preserver of Oslerian ideals talisman to open to us a new heaven in medicine and a new throughout the 20th century, a detailed analysis of the Club’s earth in surgery.” [See: Osler W. The Master-Word in Medi- original files and transcripts show that the Club was unques- cine. British Medical Journal, 1903; 2(2236): 1196-1200]. tionably primarily Walter Bett’s brainchild, and that he enthu- 39. Bett WR, 1928. ibid. pp. 3-4. The closing two sentences are siastically took the lead in helping to establish the group as paraphrased from i) Laurence Binyon’s (1869-1943) famous one of London’s foremost medical historical societies. World War One poem ‘For the Fallen’: “They shall grow not 31. Franklin AW. Osler Transmitted – A Study in Humanism. old, as we that are left grow old: Age shall not weary them, nor Medical History, April 1972; 16(2): 99-112. Notwithstand- the years condemn. At the going down of the sun and in the ing his harsher earlier comments, Franklin later maintained morning, We will remember them.” (lines 13-16. In: Binyon L. that: “The Osler Club of London owes most to Walter Bett, For The Fallen. The Times, 21 September 1914, p. 9.); and ii) co-founder, seven years Foreign Secretary and eleven years The Hebrew Bible: “Cast your bread upon the waters, for you Secretary. A sensitive idealist, talented above most in tongue will find it after many days.” [Ecclesiastes 11:1, (ESV)]. and pen, Bett founded and refounded our Club, providing a 40. Aselli G. De lactibus siue lacteis venis, quarto vasorum century of successful meetings in a single decade. He served mesaraicorum genere, nouo inuento Gasparis Asellii Cremon, the Club generously and with distinction.” is anatomici Ticinensis, dissertatio. Qua sententie anatomicȩ 32. Franklin AW. Osler – The Man. In: Franklin AW. (ed) Oslerian multȩ, uel perperã recepte conuelluntur, uel parùm perceptȩ Anniversary, Incorporating the Fitzpatrick Lecture for 1975. illustrantur. Mediolani, Apud Io: Baptam Bidellium, 1627. A The Record of the 300th meeting of The Osler Club of London second edition of this work was published in Basel in 1628. held jointly with the Royal College of Physicians of London. 41. Harvey W. Exercitatio Anatomica de Motu Cordis et Sangui- London: Oxford University Press, 1976, p. 68-73. Eight years nis in Animalibus. Francofurti: Sumptibus Guilielmi Fitzeri, after Walter Bett’s death, Franklin expressed regret that his old 1628. friend was not present with him to celebrate the Club’s 300th 42. Bett WR. (1928). Gaspare Aselli. Original typescript dated meeting anniversary: “You can imagine with what pleasure I 18th May 1928 in the archives of the Osler Club of London, rise to speak at this, the 300th meeting of The Osler Club of p. 5. London… Like all good pleasures it is tempered with a lit- 43. McIntyre N. (2005). The Rebirth of the Osler Club of London. tle sadness, lest we enjoy ourselves too much and our cup of Abstract for the 36th Annual meeting of The American Osler happiness overflows. There is sadness because my co-founder, Society in Pasadena, California, 10-13th April 2005. Walter Bett, is not standing by my side and that he is not giving 44. Letter dated 26th March 1928, from Walter Reginald Bett to this talk in his idiosyncratic style so familiar to the first mem- Francis Randolph Packard (1870-1950); original letter locat- bers of this Club.” ed in the Francis R. Packard papers at the Historical Medical 33. Entry dated “March 16th, Friday” [1928] in Alfred Franklin’s Library of The College of Physicians of Philadelphia; Box 1, scantily filled hardback maroon medical student diary kept in File 5. The author is indebted to Professor Charles S. Bryan, the archives of the Osler Club of London. It is to be noted that who assisted him in accessing these important letters during a the later annotation (of 1927) in pencil is evidently wrong as visit to the College of Physicians of Philadelphia on 8th Janu- 16th March fell on a Wednesday that year. The relevant excerpt ary 2019. reads: “March 16th, Friday. At the Golden Cross Hotel, Ox- 45. The Osler Club. (1928). Resolutions put before the Club, June ford. Willie and I reached Oxford at lunch time today. This 4 1928. Original typescript and handwritten notes in the ar- afternoon we spent in the Bodleian Library. Hill showed us chives of the Osler Club of London. Bett’s and Franklin’s around – St Damian [Geoffrey Keynes] had given us a letter handwriting is surprisingly similar in style and appearance, of introduction.” Franklin then goes on to describe the rest of making it quite difficult to distinguish the exact author of the tour. otherwise unsigned excerpts. The typescript to the rules do 34. Entry dated “March 23rd, Friday” [1928] in Alfred Franklin’s mention that: “I [Franklin] asked Bett some week or two ago scantily filled hardback maroon medical student diary kept in to draft a scheme of regulations for our consideration, and this

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with his usual thoroughness he has accomplished.” Medical Association, 1930; 94(16): 1248. A brief note refer- 46. [Unsigned]. The Osler Club. British Medical Journal, 21 July ring to Bett’s talk is included: “The Osler Club, London, was 1928; 2(3524): 117-118. addressed, March 12 [sic], by Dr. W. R. Bett on ‘The Religion 47. [Unsigned]. The Osler Club. Lancet, 1928; 212(5473): 144. of a Medical Historian.’ J. Playfair McMurrich, Ph.D., Univer- 48. Fulton JF. William Willoughby Francis, M. D. 1878–1959. sity of Toronto, has been appointed corresponding member to Journal of the History of Medicine and Allied Sciences, Janu- the club for Canada.” Although dated incorrectly (the talk was ary 1960; 15(1): 1-6. on March 19th), Bett was evidently pleased with this notice, 49. Bett WR. Dr W.W. Francis. Nature. 1 August 1959; 184: 316. and sent Franklin a post card notifying him of the statement. 50. Francis WW, Hill RH, Malloch A. Bibliotheca Osleriana: a It is likely that Bett himself had corresponded with the editor catalogue of books illustrating the history of medicine and of the Journal of the American Medical Association in his role science. Oxford: At The Clarendon Press, 1929, p. xx. Refer- as Foreign Secretary to the Club. ence to the Osler Club is made in the conclusion to the editors’ 66. Franklin AW, Medical Press, 1949. op. cit. p. 34. preface as follows: “Professor A.W. Pollard, doyen of bibli- 67. Bett WR. Lord Moynihan and The Osler Club. In: Franklin, ographers, in a recent letter to the Osler Club (London), has A. W. (ed.) Selected Writings of Lord Moynihan: A Centenary written this of his much loved friend: ‘He was a fine bookman, Volume. London: Pitman Medical Publishing Co. Ltd., 1967, and had a dream of an ideal bibliography of epoch-making p. 10-11. books which was almost religious in its enthusiasm. I think 68. Original correspondence (dated 19th December 1929) between he really saw the projected catalogue of his library as a kind of Walter Bett and Sir Humphrey Milford (1877-1952) in the ar- pageant, which it will be hard to realize in print.’ With more chives of the Osler Club of London indicate elaborate plans hope than self-assurance we have tried to interpret the dream for a ‘Quarterly Journal of Medical History’ to be published by and to stage the pageant.” It may be noted here that Reginald Oxford University Press. Franklin also contacted independent Hill’s original “much used proof sheets” of the Bibliotheca publishers (John Wright & Sons Ltd.) to try and assist with the Osleriana remain in the archives of the Osler Club of London project. The Club’s plans evidently did not come to fruition to this day. in the end and it seems that the high costs of launching such a 51. Handwritten letter dated 12th May 1929 from Walter Bett to publication was a likely factor in this outcome. Bett’s chosen Alfred Franklin; one of several dozens of Bett’s preserved let- title – ‘The Transmuter’ – was derived from William Osler’s ters which are kept in a currently uncatalogued bundle in the April 1916 Shakespeare tercentenary address at the opening of archives of the Osler Club of London. the Bodleian Shakespeare exhibition. [See: Osler W. Creators, 52. Handwritten post-card in Walter Bett’s hand, dated 18th Oc- Transmuters, and Transmitters; as illustrated by Shakespeare, tober 1928, in the largely uncatalogued archives of the Osler Bacon, and Burton (Remarks at the opening of the Bodley Club of London; the card is enclosed in an envelope addressed Shakespeare Exhibition, Apr. 24, 1916.) London, Oxford Press, to ‘Sir Thomas Browne Kt, M.D.’ and ‘c/o’ to ‘Mr Alfred 1916. (Privately printed)]. Osler describes the value of ‘Trans- Franklin’. muters’ as follows: “The melting-pot of the transmuters has 53. Handwritten letter dated 25th May 1930 from Walter Bett to changed the world. They have been the alchemist at whose Alfred Franklin, p. 2. From the archives of the Osler Club of touch the base metal of common knowledge has been turned London to gold… The transmuters had given to man his world of do- 54. Bett WR. The Preparation and Writing of Medical Papers for minion... Only by the labours of transmuters has progress been Publication. London: Menley & James, Limited, 1953, p. 6. made possible, and their works will fill the shelves of the con- 55. Bett WR. (1928). The Rape of the Heart. Original typescript in centrated Bibliotheca Prima of the future.” the archives of the Osler Club of London, dated 30th October 69. Fulton JF. Harvey Cushing: A Biography. Springfield, Illinois: 1928, p. 2; with annotations and amendments in Bett’s hand. Charles C. Thomas, 1946, pp. 594-595. The inserted dedica- 56. Bett WR, 12th July 1929. op. cit. p. 5. tion note is from Harvey Cushing’s well known biography of 57. Bett WR. The Os Penis in Man and Beast. Annals of The Osler. Royal College of Surgeons of England, June 1952; 10(6): 405- 70. Harvey Cushing Society. Harvey Cushing’s 70th Birthday 409. Proof that Bett made early reference to the same matter Party April 8, 1939: Speeches, letters, and tributes: Publ. for as a medical student can be found in his October 1928 lecture the Harvey Cushing Society. Springfield, Illinois: Charles C. to the Osler Club on ‘The Rape of the Heart’ (see reference Thomas, 1939, p. 23, Address by Mr Arnold Muirhead. no. 55): “It is an anatomical curiosity which has baffled many 71. British Medical Register, on Ancestry.com. Available at: acute minds that the hymen in the female squirrel is extraordi- https://www.ancestry.com. Accessed March-April 2018. narily tough and resistant, effectively guarding the entrance to 72. Bett WR. And the Children’s Teeth. St Bartholomew’s Hospital paradise. A higher providence, however, has armed the male Journal, June 1930; 37(9): 164-165. Bett concludes his short with a neat surgical instrument: connected with the tip of its report with this amusing note: “The writer, having spent a few os penis or baculum by ligament or joint, a small spicule of months in inhaling the dust of the London libraries and suc- bone, sharp as a surgeon’s knife, quickly and cleanly effects cessfully getting most of the dust in his eyes, has come to the the necessary penetration… There is in a sense a surgical in- following conclusion: Live a sober life before you are born; be stinct animating man and squirrel alike”. circumspect in the choice of your parents; avoid champagne 58. Bett WR. Sir John Bland Sutton (1855-1936). London: E. & S. and burgundy like the plague, but drink freely of gin and claret, Livingston Ltd., 1956, p. 1. which are good for the soul and the teeth; eat a raw carrot 59. ibid. p. 21. three times a day like a tame rabbit and spend the rest of the 60. Bett WR. Sir John Bland-Sutton, BART. (1855-1936). Nature, day gnawing bones; and you will be saved from the deadly 16 April 1955; 175: 660-661. heritage of caries.” 61. Bett WR, 1956. op. cit. p. 75. 73. Typed reference letter supporting Walter Bett’s job application 62. Bett WR. Alban Henry Griffiths Doran (1849-1927).Annals of to Great Ormond Street Children’s Hospital; dated 19th De- The Royal College of Surgeons of England, August 1949; 5(2): cember 1931, by Leonard Findlay MD, Senior Physician to 106-109. the East London Hospital for Children. Preserved with Bett’s 63. Bett WR, St Bartholomew’s Hospital Journal, 1931. op. cit. original application in the archives of the Osler Club of Lon- Quoted in opening remarks on page 202. don. 64. Bett WR. Elysian Fields. St Bartholomew’s Hospital Journal. 74. Typed reference letter supporting Walter Bett’s job applica- February 1930; 37(5): 83-85. tion to Great Ormond Street Children’s Hospital; dated 20th 65. [Unsigned]. Foreign Society News. Journal of the American December 1931, by Wilfred F. Gaisford MD, Deputy Medical

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Supt. Alder Hey Children Hospital, late Hon. Assistant Phy- a lively interest in medical eponyms troughout his career, and sician, East London Hospital for Children. Preserved with referred to the subject again in his 1962 Oslerian oration. Bett’s original application in the archives of the Osler Club of 94. Bett WR. The Thyroid: Conquests, Failures, Mysteries, and London. Men. St Bartholomew’s Hospital Journal, Jaunuary 1932; 75. Typed reference letter supporting Walter Bett’s job application 39(4): 72-75. Quoted on p. 75. to Great Ormond Street Children’s Hospital; dated 21st Decem- 95. Personal communication from Martha Stenhouse, General ber 1931, by K. J. Acton Davis MCh, FRCS, Senior Surgeon/ Manager of The Royal Society of Literature, 15th March 2018. Consultant Orthopaedic Surgeon to the East London Hospital Bett was initially elected a Fellow in 1936 and then re-joined for Children. Preserved with Bett’s original application in the in 1945 on his return to England. archives of the Osler Club of London. 96. Handwritten letter dated 25th May 1930 from Walter Bett to 76. Bett WR. Traumatic Cleft Palate: Micrococcus Catarrhalis Alfred Franklin, p. 2; one of several dozens of Bett’s preserved Meningitis: Recovery. British Medical Journal, 21 March letters which are kept in a currently uncatalogued bundle in 1931; 1(3663): 494-495. the archives of the Osler Club of London. Another excerpt of 77. Bett WR. Hypertelorism with Cleft Palate. Proceedings of the the same lengthy letter is referenced above (see ref. no. 53). Royal Society of Medicine, June 1933; 26(8): 1016-1017. 97. Handwritten letter dated 22nd November 1933 from Walter 78. Osler W. Internal medicine as a vocation. Medical News, 1897; Bett to Alfred Franklin; one of several dozens of Bett’s pre- 71: 660-663. Quoated on p. 663. served letters which are kept in a currently uncatalogued bun- 79. Bett WR. Stellwag’s Sign. British Medical Journal, 1 July dle in the archives of the Osler Club of London. 1929; 2(3574): 33. 98. A year after tending his resignation to Franklin, Bett appears 80. Bett WR. Some Paediatric Eponyms – I. Pirquet’s Reaction. to have attended his final Club meeting (before leaving for British Journal of Children’s Diseases, 1929; 26: 276-282. America) at Mr Geoffrey Keynes’ house onrd 23 November 81. Bett WR. Some Paediatric Eponyms – II. Parrot’s Nodes. Brit- 1934. He signed in as a ‘member’ to the Club, and would ish Journal of Children’s Diseases, 1930; 27: 40-45. have enjoyed hearing his friend Warren Dawson lecture on 82. Bett WR. Some Paediatric Eponyms – III. Koplik’s Spots. ‘Herodotus as a medical historian’. The entry to this meeting British Journal of Children’s Diseases, 1931; 28: 127-136. is included apart from all other early entries in the second vol- 83. Bett WR. Some Paediatric Eponyms – IV. Sydenham’s Chorea. ume of the Club’s recorded ‘Minutes’. As Alfred Franklin was British Journal of Children’s Diseases, 1932; 29: 283-288. apparently not present at this meeting, the entry was penned 84. Bett WR. Some Paediatric Eponyms – V. Young’s Rule. British by one John Hunt. Journal of Children’s Diseases, April-June 1934; 31: 123-127. 99. Bett WR. A Short History of Some Common Diseases, by div- The contemporary significance of Bett’s article on ‘Young’s ers authors. London: Humphrey Milford (Oxford University Rule’ was noted in the British Medical Journal: “While the Press), 1934. The quoted comment is included in the preface term ‘Young’s modulus’ and ‘Young-Helmholtz theory’ of co- to the book which is signed by Walter Bett on January 1st 1934. lour vision are known to every student, the eponym ‘Young’s 100. Bett WR. The History and Conquest of Common Diseases. rule’ (for calculating the dosage of drugs suitable for children) Norman: Oklohoma University Press, 1954. is less familiar, and even those who are accustomed to its use 101. Handwritten letter dated 21st January 1934 from Walter Bett to may not necessarily associate it with Thomas Young. In the Alfred Franklin; one of several dozens of Bett’s preserved let- current number of the British Journal of Children’s Diseases ters which are kept in a currently uncatalogued bundle in the (April-June), Dr. W. R. Bett quotes the original wording of the archives of the Osler Club of London. The author is indebted rule taken from Young’s Introduction of Medical Literature to Professor Terence Ryan for sending him the (previoulsy un- (1813, p. 428).” See: [Unsigned]. Letters notes and answers: photographed) obverse section of this letter on 9 December Young’s Rule. British Medical Journal, 21 July 1934; 2(3837): 2018. 152. 102. Bett WR. The Short-Lived Spring: Poems of Youth and Desire. 85. Bett WR. Some Paediatric Eponyms – VI. Eustace Smith’s London: Arthur H. Stockwell Ltd., 1934. sign. British Journal of Children’s Diseases, July-September 103. Ibid. p. 16, ‘Life is Indifferent’. 1934; 31: 215-220. 104. [Unsigned]. Joins Columbia University Staff: Dr Walter Regi- 86. Bett WR. Some Paediatric Eponyms – VII. Fowler’s Solution. nald Bett. The New York Times, 10 January 1935, p. 17. British Journal of Children’s Diseases, October-December 105. [Unsigned]. Scientific Notes and News. Science, 18 January 1934; 31: 302-305. 1935; 81(2090): 66. The brief notice reads: “Dr. Walter Reg- 87. Fischer, I. Die Eigennamen in der Krankheitsterminologie. inald Bett, of the Royal College of Surgeons, London, has Wien Und Leipzig: Verlag Von Moritz Perles, 1931. been appointed librarian of the Columbia University Medical 88. Toodayan, N. (2016). The Art of Eponymy: Pure Water in a School to fill the vacancy caused by the death in October of ‘Dry-Age’; abstract presented at the 46th Annual Meeting of the Alfred L. Robert.” American Osler Society, 1st May 2016. 106. [Unsigned]. Ruth K Bett. Syracuse Herald Journal, 17 De- 89. Bett WR. British Journal of Children’s Diseases, 1930. op. cit. cember 1991, p. 113. It is noted in this obituary that: “Mrs. p. 41. Bett lived in Norwich before moving to Hamilton in 1968. 90. Bett WR. St Bartholomew’s Hospital Journal, 1931. op. cit. Her husband Walter (F) died in 1967 [sic]. She received a de- p. 203, right column. gree in library science from Alma College and was employed 91. Ibid. p. 202, right column. with the medical library of Columbia University before her 92. Ibid. p. 203, left column. marriage.” The author is indebted to Joan Lieb, Historical Re- 93. Bett WR. Medical History in Eponyms. Mississippi Valley search Assistant at Chenango County Historian’s Office, for Medical Journal, July 1954; 76(4): 151-152. In this brief ar- sharing this obituary article with him on 27th October 2018. ticle, Bett sums up some of the pros and cons of eponymous The date of Walter Bett’s marriage to Ruth King is available in medical terminologies. The following comment is of interest: an online marriage register on Ancestry.com. “Since my topic is ‘Medical history in eponyms,’ not ‘Indiscre- 107. In a short letter to “Doctor Walter R. Bett” dated October 27th tions of a misspent youth,’ let me pose this question: Is it better 1936, Bernard Sachs (1858-1944) writes: “My dear Doctor for a nurse to remain completely ignorant of the entirety of a Bett: I thank you for your kind offer to be of assistance in the great historical figure than for a medical student or practitioner way of keeping us posted on articles on Child Neurology. If to be vaguely aware that there was such a man, whom he is this will not prove a burden to you, your cooperation in this piously expected to imprison behind the ugly, though secure, matter will be appreciated. Very truly yours, [Signed] Ber- bars of an anatomical or medical eponym?” Bett maintained nard Sachs M.D. Director.” The original letter is pasted into

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Walter Bett’s own copy of The Normal Child, a 1926 child 114. Bett WR. The Present Plight of Medical Literature. Medical training manual authored by B. Sachs. Also pasted in (or oth- Digest, January 1956; 1(1): 2-3. Noting the excess of med- erwise transcribed in) the book are a number of reviews of ical publications worldwide, and the desirability of a more Sach’s work and Bett’s 1958 centenary article on the ‘Dean of condensed review of current medical literature for general American Neurology’: Bett WR. Bernard Sachs (1858-1944), practitioners, Bett justifies the addition of yet another medical of Tay-Sachs’ disease. Medical Press, 8 January 1958; 239: journal with the following comment: “The present plight of 41-42. medical literature is certainly a serious one, for we are reliably 108. Handwritten letter dated 13th February 1935, from Walter Reg- informed that nearly a million scientific articles of one kind or inald Bett (1903-1968) to Francis Randolph Packard (1870- another are published each year. And yet the picture is not one 1950); original letter located in the Francis R. Packard papers of unadulterated gloom. If we agree that the sum total of med- at the Historical Medical Library of The College of Physicians ical knowledge is made up of the contributions of individual of Philadelphia; Box 1, File 5. The author is indebted to Pro- workers, then it becomes the duty of every member, however fessor Charles S. Bryan, who assisted him in accessing these humble, of the profession to publish worthwhile observations, important letters during a visit to the College of Physicians of particularly case-histories. Though the statistician may frown Philadelphia on 8th January 2019. at reports of single cases, the case-report is the foundation of 109. Walter Bett’s obituary in the Norwich Evening Sun (reference clinical medicine… Besides benefiting the medical profession no. 5) states that he “was a Kate Hurd Mead Memorial Lectur- at large, case-reporting is also of great educational value to the er at the College of Physicians of Philadelphia in 1950.” The writer who in its preparation becomes familiar with the fun- College do not have any currently known record of Bett’s lec- damental process of research: observation, bibliography, and ture and so were unable to provide any further information interpretation.” Bett follows with an excellent contribution concerning it. Personal communication from Caitlin Ange- on ‘Topical Anaesthetics for Pruritus’, quoting vast swathes of lone (Reference Librarian of the Historical Medical Library at literature from Montaigne to more contemporary authors in a the College of Physicians of Philadelphia) on 22nd December relatively short three-page article. 2018. 115. Bett WR. A New Oral Nitrofuran Specific for Urinary-Tract 110. Columbia University archives do not hold any information re- Infections. Current Medical Practice (India), April 1957; 1(4): garding Bett’s departure. Franklin states that “he and Colum- 270-274. bia did not make an altogether happy mixture” but this could 116. Bett WR. The Phenothiazines in Psychiatry, with Special Ref- not be verified by Columbia University: “I’ve checked our erence to Trifluoperazine (“Stelazine”): A Review of the Lit- Dean’s files on the library for the period of Dr. Bett’s time as erature. The West African Medical Journal, February 1960; 9: director and found nothing of any biographical interest. I also 33-36. checked the minutes of the medical school’s library commit- 117. A large collection (at least sixty-nine cut-outs) of Bett’s pains- tee – which unfortunately aren’t complete for this period – and takingly catalogued offprints in the Medical Press journal are also found nothing. In fact, there’s absolutely nothing about included in a green-folder in the archives of the Osler Club his departure, simply a letter mentioning that his successor, of London; the folder is labelled ‘Papers by Walter Bett’ and Thomas Fleming, was starting as ‘the new library director.’ If includes numerous other papers and offprints authored by Bett. there was any controversy about his tenure here, it never made 118. Franklin AW, St Bartholomew’s Hospital Journal, September its way into our records.” Personal correspondence from Ste- 1969. op. cit. p. 373. phen E. Novak (Head, Archives & Special Collections, Au- 119. After writing to the St Bartholomew’s Hospital archives in gustus C. Long Health Sciences Library, Columbia University February 2019 seeking to verify the location of Bett’s offprints, Irving Medical Center) dated 30th March 2018. the author was advised to contact the Queen Mary University 111. Bett WR. Alcohol and Crime in Ceylon: A Preliminary Com- Library (QMUL) as: “The Library situated on the West Smith- munication. The British Journal of Inebriety, 1946; 43: 57-60. field site is now under the remit of Queen Mary University of 112. Walter Reginald Bett, signed letter to Warren Royal Dawson London.” (Personal communication from Amanda Engineer, dated 1st September 1945; from Bett’s correspondences with 12th February 2019). After some further correspondence, the Warren Royal Dawson, 1945-1967, held by the Natural His- QMUL advised that a preliminary search of the relevant ar- tory Museum, London (Ref: L MSS DAWS A). Retrieved 30th chive was unyielding; it was further noted that: “access to the March 2018 with the assistance of Lorraine Portch, Research- area was restricted... and... has not yet been restored. Once er Services Assistant and Reprographics Officer at the Natural we are able to access the stores again, I’ll arrange for a further History Museum, London. Many of Bett’s activities over the search, but I don’t have a final date as to when this may be coming years are preserved in his correspondences with War- possible at the moment.” (personal correspondence from Sar- ren Dawson and some thirty such letters written between 1945 ah Molloy, 30th May 2019). and 1967 remain extant in the archives of the Natural History 120. Walter Reginald Bett, signed letter to Warren Royal Dawson Museum in London. In these letters we find the two discuss- dated 12th June 1955; from Bett’s correspondences with War- ing current projects, historical items of dual interest, important ren Royal Dawson, 1945-1967, held by the Natural History events in both their lives, and other daily-doings of consid- Museum, London (Ref: L MSS DAWS A). It is not known erable interest to the medical biographer. It is interesting to whether Bett ever completed cataloguing all of his papers but read for example, that Bett had started his own medical history it seems likely that he was himself responsible for supplying magazine titled ‘Ninety-Nine’ shortly after settling in London the carefully annotated cut-outs of his articles from the Medi- and that Warren Dawson contributed articles. This endeavour cal Press (referred to in reference no. 117) and also other off- was short lived however, as the British Medical Association prints of his donated to the Osler Club of London. soon launched a popular health magazine against which it 121. Harley-Williams JH. The Perfect Medical Librarian. Health was difficult for Bett’s journal to compete. The death of Wal- Magazine, February 1969; 6(1): 18-19. ter Bett’s mother from an operation for carcinoma of the gall 122. Franklin AW, St Bartholomew’s Hospital Journal, September bladder in June of 1946 is also conveyed in these letters. 1959. op. cit. p. 3. 113. [The Norwich Pharmaceutical Company, Norwich, New York]. 123. Walter Reginald Bett, signed letter to Warren Royal Dawson Noted Medical Writer Joins Company. Scope, 23 December dated 23rd September 1945; from Bett’s correspondences with 1959; 3(17): 1 & 6. The author is indebted to Ms Kathryn Warren Royal Dawson, 1945-1967, held by the Natural Histo- Greene (Senior Library Clerk in Genealogy/Local History at ry Museum, London (Ref: L MSS DAWS A). the Guernsey Memorial Library in Norwich, New York) for 124. According to the Club’s formal minutes: “A meeting of an ad providing access to this publication on 25th October 2018. hoc policy Committee was held on Tuesday November 4th at

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Lister House, Wimpole Street, to discuss the future constitu- “Physically, Osler was of short stature by today’s standards, tion of The Osler Club. There were present – A.W. Franklin lithe and brisk in movement, with a wiry athletic figure. Coal (in the chair), W.R. Bett, A.P. Cawadias, J.H. Hunt, J.M. Jack- black hair over a high forehead, and penetrating dark brown son & G.L. Keynes.” The Club’s new constitution is then de- eyes with a humorous twinkle were engagingly set in a face tailed in five points, point four indicating that: “There should of distinctive mobility that took on a serious, almost stern, as- be 5 ordinary meetings in each year with a commemorative pect at rest. A large, black, flowing mustache and a peculiar, Dinner meeting on each July 12.” dark, almost olive complexion, reflective of his Celtic ancestry, 125. Lyon LC. Sir William Osler Centenary. British Medical Jour- added to his unique appearance. Dressed immaculately with nal, 6 August 1949; 2(4622): 335. a flower adorning the buttonhole of his dapper Prince Albert 126. [Unsigned]. Sir William Osler (1849-1919). Nature. 9 July coat, he briskly arrived for rounds each morning leading his 1949; 164: 56. Bett is noted as the author of this article on the entourage with invariable good humor.” Journal’s digitised online PDF document. 136. Franklin AW, Medical History, April 1972. op. cit. p. 100. 127. Bett WR. Osler’s Interest in the Nursing Profession. Nursing 137. Lyon LC. Osler Memorial Tablet. British Medical Journal, 19 Mirror, 9 July 1949; 89: 228-229. July 1952; 2(4776): 161. In this brief correspondence arti- 128. [Unsigned]. Physician and Humanist. The Memory and Tradi- cle, Dr Carlyle Lyon noted how, on a recent visit to Oxford, tion of Sir William Osler. From a Special Correspondent. The Osler’s “spacious and once beautiful house was empty and Times, 12 July 1949. Original clippings from The Times in in disrepair, and the huge garden a wilderness, overrun with the archives of the Osler Club of London have Bett listed as weeds.” He then made a formal pledge for a memorial tablet the article’s author. It is to be noted that the question posed – to be erected in Osler’s memory: “It makes one sad to think What would Osler have done? – can be traced back to Bett’s that this once famous house bears no tablet commemorating medical student days (see excerpt from letter dated 12th May the fact that Osler once lived there and, in his will, bequeathed 1929 in text on page 81; reference no. 51). The same question it to his own beloved college, Christ Church, as a suggested is used to conclude Bett’s most comprehensive publication on home for future regius professors of medicine at Oxford. May Osler: “He was an artist in living finely, and it is said that some I, Sir, suggest that a fund be opened at once to erect such a men used to test their conduct in a dilemma by asking: ‘What tablet, the balance of the proceeds from which to go towards would Osler have done?’ To them he was the founder of a some worthy cause such as the committee in charge of its ‘Way of Life’ infinitely wider in scope than that recommend- distribution might think fit? The council of the Osler Club of ed in his little book.” (From the conclusion to his 1951 book London, jointly with the council of the Osler Society of Ox- on Osler: The Man and The Legend, p. 121; see reference no. ford, would seem to me to be the appropriate body to put this 131). suggestion into effect; and I appeal to the profession in Great 129. Bett WR. Osler, The Medical Historian. Medical Press, 13 Britain, the United States of America, and Canada to give it July 1949; 5749: 35-37. Quoted on p. 35. their whole-hearted support.” 130. ibid. pp. 35-36. 138. Lyon LC. Osler Memorials. British Medical Journal, 19 July 131. Bett WR. Osler: The Man and The Legend. London: William 1950; 2(4673): 298. Listing a number of extant memorials Heinemann, 1951. to Osler, Lyon laments that there is “no tablet on the walls of 132. Walter Reginald Bett, signed letter to Warren Royal Dawson ‘The Open Arms,’ the Oslers’ home in Norham Gardens, Ox- dated 18th October 1948; from Bett’s correspondences with ford.” He had evidently been thinking of the memorial tablet Warren Royal Dawson, 1945-1967, held by the Natural His- for some years. tory Museum, London (Ref: L MSS DAWS A). Walter Bett 139. [Unsigned]. Osler Memorial at Oxford. British Medical Jour- also spoke of the desirability of a new appraisal of Osler’s life nal, 15 October 1955; 2(4945): 962-963. It is noted in this in his oration on the ‘Osler Legend’ which was given at the description how: “Professor Pickering… unveiled the plaque, Club’s 78th meeting on 12th July 1948 (Osler’s 99th birthday). which simply recorded the dates of Osler’s residence in the The Club Minutes for this meeting note: “W.R. Bett, in a char- house, and a vote of thanks was accorded to Professor Picker- acteristic oration, spoke on the ‘Osler legend’ and stressed the ing on the motion of Dr. W. R. BETT.” need for a re-evaluation of Osler, his life and works and his 140. [Unsigned]. Tribute To The Memory of Sir William Osler, For- influence upon his fellows.” mer home restored by doctors’ club. The Oxford Mail, 10 Oc- 133. Pratt JH. A Year With Osler, 1896-1897. Notes taken in his tober 1955. Original cut out of article in the archives of The Clinics in The Johns Hopkins Hospital. Baltimore: The Johns Osler Club of London. Page number not given. Hopkins Press, 1949, p. v. Pratt’s original account (which 141. Osler Club Minutes Volume II. Entry in Walter Bett’s hand Bett skilfully paraphrases) reads: “Sir William Osler was of recording the Club’s 151st meeting on Thursday, June 6th 1957; medium size, well built, and graceful in his movements. His “The meeting was in honour of Linne’s 250th birthday.” complexion was sallow, almost olive hued, possibly an inher- 142. Osler Club Minutes Volume II. Entry in Walter Bett’s hand itance from Celtic ancestors in Cornwall, the birthplace of recording the Club’s 152nd meeting on Friday, July 12th 1957. his parents. I have heard his friend, Dr George A. Gibson of Furthermore: “It being the 108th anniversary of Sir William Edinburgh, assert that no Anglo-Saxon could have his gayety Osler’s birth, the Secretary with his usual sentimentality (dif- of spirits. His eyes were luminous and searching, but often ferential diagnosis: pedantry) had carefully arranged for ex- twinkled most merrily. He wore a rather heavy, drooping actly 108 people to sit down to dinner. Of these 38 signed the mustache which partly concealed a strong mouth. A study of attendance sheet. The others, presumably, have yet to learn his photographs shows that his expression in repose became the difficult art of holding a full glass, a canape, and a cigarette more genial as he grew older. In his earlier pictures his face is in one hand and writing their names with the other.” rather stern. He himself said that sobriety was reflected in his 143. Osler Club Minutes Volume II. Entry in Walter Bett’s hand facies. His hands and wrists were unusually well formed and recording the Club’s 155th meeting on Wednesday, December how effective and characteristic were the gestures he made 11th 1957; held “In honour of the 100th birthday of John Ben- with them.” jamin Murphy.” 134. Bett WR, 1951. op. cit. p. 118, section subtitled ‘The Likeness 144. Osler Club Minutes Volume II. Entry in Walter Bett’s hand re- of the Man’. cording the Club’s 156th meeting on Wednesday, January 22nd 135. Golden RL. William Osler at 150: An Overview of a Life. 1958. Journal of the American Medical Association, 15 December 145. Osler Club Minutes Volume II. Entry in Walter Bett’s hand 1999; 282(23): 2252-2258. Alongside other authors, Golden recording the Club’s 161st meeting on Friday, June 13th, 1958. references Bett’s Osler for his depiction of Osler’s likeness: 146. Franklin AW, St Bartholomew’s Hospital Journal, September

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1969. op. cit. p. 372. University Medical Center) for sending him this historical re- 147. Original 12th July 1962 recording of Walter Bett’s Oslerian cord on 2nd April 2014 in response to a question about Walter oration on ‘The Epitaph of Adrian’s Horse.’ Post-presentation Bett over five years ago. remarks made by the president Mr Harold Avery. Two iden- 162. Bett WR. A Short History of Nursing. London: Faber and tical magnetic reel recordings were digitised by the author in Faber Ltd., 1960. May of 2018. 163. [The Norwich Pharmaceutical Company, Norwich, New York]. 148. [Oppidanus]. “It gives me much pleasure to introduce….” A Dr. Bett Has New Book Published. Scope, 22 February 1960; prescription for brighter branch meetings. The Alchemist, Oc- 3(21): 2-3. The author is indebted to Ms Kathryn Greene (Se- tober 1954; 18: 485-487. Although written under the penname nior Library Clerk in Genealogy/Local History at the Guern- of ‘Oppidanus’, this paper is included in a green folder of off- sey Memorial Library in Norwich, New York) for providing prints in the archives of the Osler Club of London which has access to this publication on 25th October 2018. been marked ‘Papers by Walter Bett’. The author’s reference 164. Bett refers to W. J. Bishop’s death in three of his letters to to a ‘A little judicious levity’ in this paper also hints to Bett’s Dawson: ”It was a great shock to learn of W.J. Bishop’s death. authorship considering that he concurrently wrote another ar- I had a very high regard for him, and always admired his learn- ticle with a similar title in the same month: Bett WR. A little ing and approachability.” (August 7th, 1961); ”W.J. Bishop’s judicious levity in dermatology. Missouri Medicine, October death was certainly a great shock to me. I am told he commited 1954; 51(10): 828-830. suicide, being worried about his health. Life must have been 149. Osler Club Minutes Volume II. Entry recording Council very trying for him.” (October 10th, 1961); ”W.J. Bishop’s sui- Meeting on Wednesday September 23rd 1959 at Dr Avery’s cide was a great shock to me” (October 10th, 1962). From the Harley Street Consulting rooms. Recorded under subsection Bett-Dawson correspondence, 1945-1967, held by the Natural titled “Testimonial to Dr Bett.” History Museum, London (Ref: L MSS DAWS A). Retrieved 150. Bett WR. Poppies, Dawamesk, and the Green Goddess: An 30th March 2018 with the assistance of Lorraine Portch, Re- Exotic Study of Literary Genius. The British Journal of Ad- searcher Services Assistant and Reprographics Officer at the diction, January 1947; 44(1): 5-12. Natural History Museum, London. 151. Bett WR. Tribute to Walter de la Mare, on his Seventy-fifth 165. Bett WR. (1962). The Epitaph of Adrian’s Horse. The 25th Os- Birthday. London: Faber and Faber Ltd., 1948. Although not lerian oration. The text quoted reflects Bett’s spoken words published in Bett’s name, the publisher’s preface notes: “This on the day as preserved in the original 12th July 1962 recording volume is a present to Mr Walter de la Mare, on his seven- of Bett’s oration. The offprint of the oration (also located in ty-fifth birthday, from those of his admirers who can pay their The Osler Club archives) is slightly edited, ‘expurgated, and tribute in his own coin. The idea of such a gift originated abridged’. with Dr. W.R. Bett, an old friend of Mr. de la Mare’s. Since 166. Osler Club Minutes Volume II. Typed entry recording minutes Dr. Bett is not himself a contributor and has modestly effaced for the Club’s 198th meeting on 12th July 1962. Signed on 18th himself as collector of [this] tribute, we take it on ourselves to October 1962 by the Club’s President, Dr Harold Avery. record the part he has played.” 167. LimewaveZ. (17 November 2018). ‘The Epitaph of Adrian’s 152. Bett WR. The Infirmities of Genius. London: Christopher Horse’: by Walter Reginald Bett (1903-1968). Full recording Johnson, 1952. Bett dedicated this book to Walter de la Mare with Bett memorial poster available at: https://www.youtube. “with admiration, affection, and gratitude for many delightful com/watch?v=_oUkyUGwsHw. Preliminary remarks by the and inspiring conversations and many delightful and inspiring Club’s President Dr Harold Avery (1903-1972), and a conclud- letters.” ing tribute to Bett by his esteemed colleague Dr Arthur Dick- 153. Bett WR. Benzedrine Sulphate in Clinical Medicine. Post- son Wright (1897-1976) are included in the recording. A few graduate Medical Journal, August 1946; 22(250): 205-218. short opening remarks by Alfred Franklin were (regrettably) 154. Bett WR, Howells LH, MacDonald AD. Amphetamine in Clin- removed to limit the length and size of the upload. The refer- ical Medicine: Actions and Uses. Edinburgh and London: E. & ence to Bett as ‘A First Generation Oslerian’ (on the memorial S. Livingstone Ltd., 1955. poster) is an error. Bett belonged to the first generation after 155. Bett WR, Howells LH, MacDonald AD. Amphetamin in der William Osler’s death who sought to perpetuate his influence, klinischen Medizin: Eigenschaften und praktische Verwend- but considering that many of Osler’s own colleagues also ung. Berlin, Gottingen, Heidelberg: Springer-Verlag, 1956. sought to preserve his memory, it would be more appropriate 156. Bett WR, Howells LH, MacDonald AD, 1955. op. cit. p. 6. to refer to Bett as one of the first of the second-generation 157. Bett WR. The Debt of Medicine to The Pharmaceutical Indus- Oslerians. try. Medical Press, 9 May 1951; 225(50): 484-487. 168. Original boarding pass for Bett’s flight back to America with 158. Bett WR. Pharmaceutical Literature: A Short Guide. Bulletin New York City admission stamp stating ‘admitted July 23 of the Medical Library Association, January 1961; 49(1 Pt 1): 1962’; sourced from ancestry.com. 63-67. 169. Walter Reginald Bett, signed letter to Warren Royal Dawson 159. Bett WR. Medical Societies and International Understanding. dated 10th October 1962; from the Bett-Dawson correspon- The British Journal of Addiction, 1956; 53(1): 3-6. dence file (1945-1967) held by the Natural History Museum, 160. Osler W. Chauvinism in Medicine. Montreal Medical Journal, London (Ref: L MSS DAWS A). Retrieved 30th March 2018 1902; 31: 684-699. Compare, for example, Bett’s excerpted with the assistance of Lorraine Portch, Researcher Services quotation with Osler’s statement that: “A second distinctive Assistant and Reprographics Officer at the Natural History feature [of the medical profession] is the remarkable solidari- Museum, London. ty. Of no other profession is the word universal applicable in 170. The author surveyed the cover and content pages of Pfizer’s the same sense… The profession in truth is a sort of guild or Spectrum journal for all the years that Walter Bett was listed brotherhood, any member of which can take up his calling in as ‘Consulting Medical Editor’ (Vol. 9, No. 3 – Vol. 14, No. any part of the world and find brethren whose language and 4). Almost all these issues include unsigned historical medical methods and whose aims and ways are identical with his own.” articles with diverse and interesting titles; for example: [Un- 161. Queen Elizabeth Passenger record; bound for New York; not- signed]. Mud, medicine, and Mrs. O’Leary’s cow… an infor- ing the ‘names and descriptions of British Commonwealth and mal history of Chicago. Spectrum (Pfizer), May-August 1962; Irish Republican passengers embarked at the port of South- 10(3): 59-64. It seems almost certain that Walter Bett person- ampton’ on 26th November 1959. The author is indebted to ally authored, procured, or otherwise edited these historical Jennifer McGillan (former Archivist, Archives & Special Col- editorials, as excerpts from the relevant articles include per- lections Augustus C. Long Health Sciences Library Columbia spectives given in other published writings of his; for example:

July 2019 109 N. Toodayan

“Though Leonardo should be credited with so many anatomic 180. Last Will and Testament of Walter Reginald Bett, signed 24th discoveries, not a single nerve, muscle, bone or canal in the December 1966. Considering the date of his will, it is possible body of man bears his name. In this respect he reminds us that Bett had been suffering from illness – probably angina of the fate of Vesalius, who wrote his signature across every pectoris – for some time before his death. It is noted that Bett page of the book of anatomy but had his name assigned by also listed his sister-in-law Marion Cooper as executrix of his posterity to two insignificant structures – a tiny foramen and will “in the event that my said wife shall predecease me.” The a rarely present tiny bone.” [Unsigned]. 33 anatomic firsts of author is indebted to Joan Lieb, Historical Research Assistant Leonardo da Vinci. Spectrum (Pfizer), Fall 1966; 14(4): 78-84. at the Chenango County Historian’s Office, for sending him Roughly the same views are recorded in Bett’s 1962 Osleri- Walter Bett’s signed will on 30th October 2018. an oration and other essays on eponyms. According to Ms 181. Ms Lieb also provided the author with a formal appraisal of Arlene Shaner (Historical Collections Librarian at the New Walter Bett’s library at the time of his death. In a sworn affida- York Academy of Medicine): “The Pfizer Spectrum ceased vit dated 4th February 1969, one Ms Johanna Grimes (a propri- publication around 1965 or 1966. For a while it was printed etor of the ‘Old Hickory Bookshop’ located in Brinklow Mary- inside of JAMA issues, but beginning in 1956 it was issued as land) declares: “That on or about the 5th day of December, a separate semi-monthly. The articles were all excerpted from 1968 she examined certain historical books in the residence JAMA.” (Personal communication with Arlene Shaner on 4th of Mrs. Walter Bett at 15 Elm Street., Norwich., New York. April 2018). That deponent paid the sum of TWENTY-FOUR HUNDRED 171. Typescript of curriculum vitae summarising Walter Bett’s ‘Po- DOLLARS ($2400.00) for certain books listed as follows: A sitions in the United States’ since December 1959; included in collection of books relating to medicine, surgery, pharmacy an uncatalogued bundle of documents containing Bett’s obitu- and similar subjects, being mainly histories and biographies, aries and other papers concerning his death in the archives of of fairly recent vintage. Deponent further states that the sum of The Osler Club of London. TWENTY-FOUR HUNDRED DOLLARS ($2400.00) is a fair 172. Walter Reginald Bett, signed letter to Warren Royal Dawson and reasonable value for said books. Deponent further states dated 7th August 1961; from the Bett-Dawson correspondence that the OLD HICKORY BOOKSHOP deals in rare medical file (1945-1967) held by the Natural History Museum, London books and that deponent knows the value of the books above (Ref: L MSS DAWS A). Retrieved 30th March 2018 with the stated.” The Old Hickory Bookshop is no longer in business assistance of Lorraine Portch, Researcher Services Assistant and Bett’s books have been presumably dispersed to other and Reprographics Officer at the Natural History Museum, dealers. In addition to a few presentation copies of Bett’s pub- London. lications, this author was able to secure two books from Bett’s 173. Franklin AW, St Bartholomew’s Hospital Journal, September personal library, the child training manual referred to in refer- 1969. op. cit. p. 373. ence no. 107 [Sachs, B. (1926). The Normal Child and How 174. Walter Reginald Bett, signed letter to Warren Royal Dawson to Keep it Normal in Mind and Morals. New York: Hoeber] dated October 10th, 1967; this was Bett’s final letter to Dawson. and a book of poems acquired by Bett in 1937 [Ratcliffe, D. From the Bett-Dawson correspondence file (1945-1967) held U. (1924). The Book of the Microcosm. Leeds: North Country by the Natural History Museum, London (Ref: L MSS DAWS Press]. A). Retrieved 30th March 2018 with the assistance of Lorraine 182. Devine Funeral Records, Salesbook I. Volume #19 of 24. No- Portch, Researcher Services Assistant and Reprographics Of- vember 2, 1967 – February 1, 1972. Entry dated November ficer at the Natural History Museum, London. 18th 1968; stating: “No embalming, no funeral service, im- 175. Alighieri D, Longfellow HW. The Divine Comedy of Dante mediate cremation… Body removed to funeral home and Alighieri, Translated by Henry Wadsworth Longfellow: Vol. I. taken directly to Waterville Crematory for cremation – ashes Boston: Ticknor and Fields, 1867, p. 4 (Inferno, Canto I). returned to widow Ruth K. Bett on Nov. 25th.” The author 176. Personal communication with Ms Arlene Shaner (Historical is indebted to Joan Lieb, Historical Research Assistant at the Collections Librarian at the New York Academy of Medicine) Chenango County Historian’s Office, for sending him these on 4th April 2018. Ms Shaner advised: “The Physicians News documents on 27th October 2018. Service, Inc., was located at 130 East 59th Street, New York, 183. Waterville Cemetery Crematorium ‘Request for Cremation’ NY… they were responsible for the publication of SCOPE authorisation form dated 18th November 1968, recording the Weekly, which was a medical newspaper published for physi- time of incineration as 10:00 a.m. on the same day. The form cians.” is signed by Ruth Bett. The author is indebted to administra- 177. Bett WR. Blood Transfusion before and after Landsteiner. tive staff (Kourtni) at the Waterville Cemetery for providing Health Magazine, December 1968; 5(6): 171-172. him with Bett’s cremation authorisation form on 13th October 178. Harley-Williams JH, Health Magazine, 1969, op. cit. Har- 2018. ley-Williams noted in Bett’s obituary for the Health Maga- 184. [Unsigned]. Ruth K Bett. Syracuse Herald Journal, Tuesday, zine that: “Now, after a second heart attack, Walter Bett is 17 December 1991, p. 113. Ruth’s obituary relevantly states: with us no more.” A brief typescript Memo from the estate “Services will be private for Ruth King Bett, 89, of Lebanon of W. R. Bett in the archives of The Osler Club of London in- Street who died Sunday at Van Duyn Home and Hospital Syr- cludes further information on Bett’s death “from the attending acuse. Burial will be in Saginaw, Michigan. A native of Sagi- dr. who was not present at death due to previous commitment naw, Mrs. Bett lived in Norwich before moving to Hamilton in elsewhere.” Dated 5th December 1968, the message records: 1968. Her husband Walter (F) died in 1967 [sic]… Surviving “The autopsy, the report of which I have just received… shows are a sister, Marion Passolt of St. Helena, a niece and a neph- very clearly that the terminal events were caused by the orig- ew. Burgess Funeral Home has charge of arrangements.” The inal myocardial infarction sustained by Dr. Bett in New York. author is indebted to Joan Lieb, Historical Research Assistant This was so located that the circulation to the remainder of at the Chenango County Historian’s Office, for sending him the heart was so impaired that the heart, in an effort to meet Ruth’s obituary on 27th October 2018. the demands put upon it, gradually enlarged and finally just 185. Browne T, 1658. op. cit. The Epistle Dedicatory, p. 1. wore out.” The Chenango Memorial Hospital do not have any 186. Numerous organizations were contacted to try and find out historical records of inpatients from 1968. where Walter Bett’s ashes were buried. In summary: The Wa- 179. Osler W. Lecture VII: Diagnosis, Prognosis, and Treatment of terville Cemetery provided cremation details and referred the Angina. In: Osler W. (ed.) Lectures on Angina Pectoris and author to Devine & Wilson Funeral Home. Wilson Funeral Allied States. New York: D. Appleton and Company, 1897, Home advised contact with the Guernsey Memorial Library – p. 155. although providing other items of interest, the librarian there

110 Osleriana Walter R. Bett

(Kathryn Greene) was unable to find definitive documents up on finding Walter Bett’s burial site, but decided to make relating to Bett’s burial and advised contact with the Chenan- one last inquiry just a day or two before the fiftieth anniver- go County Historian’s Office – a historian here (Joan Lieb) sary of Bett’s death; judge of his delight when he was told by found Bett’s funeral record (which stated that his ashes were Gretchen A. Schulte (a family service counsellor at Roselawn returned to his wife) and an obituary of Mrs Bett which in- Memorial Gardens) that both Walter and Ruth Bett were in dicated that she would be buried in Saginaw Michigan; as fact buried in an unmarked family plot in the Garden of Geth- Ruth Bett died outside Chenango County, further details of semane Section at Roselawn Memorial Gardens. A memorial her burial could not be confirmed. The author then wrote to wreath and previously designed poster were hastily arranged the Castle Museum of Saginaw County History to see if any for the anniversary and photos were duly taken of the site by details of Ruth’s burial could be found – the historian there Ms Schulte on 17th November 2018. Ms Schulte has since (Thomas Trombley) was unable to find any information on Mr been trying to track down relevant family members who may or Mrs Bett, but did provide a useful obituary of Bett’s sister- be able to provide further information about the burial. in-law Marion Cooper Passolt (1907-1995) which indicated 187. [Unsigned]. Passolt, Marion (Cooper), St. Helen, Michigan. that she was buried at the Roselawn Memorial Gardens in Sag- Saginaw News, 31 August 1995, p. D9. The author is indebt- inaw, Michigan; the author was however advised that there ed to Thomas Trombley (Vice President and Chief Historian, were no records indicating Bett’s burial at this cemetery. The Castle Museum of Saginaw County History) for sending him author had simultaneously contacted Burgess & Tedesco Fu- this obituary on 1st November 2018. neral Home (which took care of Ruth Bett’s funeral arrange- 188. Wilde O. De Profundis. New York and London: G. P. Putnam’s ments according to her obituary) who advised that they were Sons (The Knickerbocker Press), 1905, pp. 122-123. Walter unable to provide any information except that Ruth’s ashes Bett quoted these exact same words with great feeling and were sent to a family member outside New York state. Having emotion in his 1962 Oslerian oration on ‘The Epitaph of Adri- exhausted all known avenues, the author had essentially given an’s Horse’.

July 2019 111

Osleriana 112

Gill University. WOSANZ will continue to make further inquiries before deciding on the final beneficiary of the portrait. the of beneficiary final the on deciding before inquiries further make to continue will WOSANZ University. Gill

- Mc at Medicine of History the of Library Osler the and Medicine of School Hopkins Johns the include candidates Potential 2.

. London: The Royal Society of Medicine Press, 1991. Press, Medicine of Society Royal The London: . A. Sakula 1. The Portraiture of Sir William Osler William Sir of Portraiture The

be used and the eventual beneficiary of the portrait, the of beneficiary eventual the and used be will be provided at that time. that at provided be will

raise the required amount. Further details of the project, including the likely era of the Osler image to to image Osler the of era likely the including project, the of details Further amount. required the raise

be raised. WOSANZ will soon be commencing an international crowd-funding campaign to try and and try to campaign crowd-funding international an commencing be soon will WOSANZ raised. be

full-colour, oils-on-linen canvas portrait of Sir William Osler, provided that the required funds can can funds required the that provided Osler, William Sir of portrait canvas oils-on-linen full-colour,

interest in the project and has enthusiastically offered his services to complete a three-quarter length, length, three-quarter a complete to services his offered enthusiastically has and project the in interest

lection of high quality portraits – would be an ideal candidate for the job. Mr Newton has indicated an an indicated has Newton Mr job. the for candidate ideal an be would – portraits quality high of lection

- col astonishing an of painter and Prize Room Packing Archibald the of winner twice – Newton Paul

After some consideration, it was determined that the award winning Australian portrait artist, Mr Mr artist, portrait Australian winning award the that determined was it consideration, some After

example, and this would be especially appropriate in this centenary year of his passing. his of year centenary this in appropriate especially be would this and example,

several decades. A fresh professionally executed portrait will help to again make relevant Osler’s Osler’s relevant make again to help will portrait executed professionally fresh A decades. several

fact that there have been no really widely acclaimed paintings of William Osler commissioned over over commissioned Osler William of paintings acclaimed widely really no been have there that fact

medical career. The desirability of procuring a new professional portrait of Osler is indicated by the the by indicated is Osler of portrait professional new a procuring of desirability The career. medical

logically documented portraits depicting him at various stages along his monumentally successful successful monumentally his along stages various at him depicting portraits documented logically

- chrono of series a in afterwards and life his during perceived was he how showing Osler, William

Despite this minor oversight, Sakula provides an excellent iconography of of iconography excellent an provides Sakula oversight, minor this Despite

ral at the Montreal Neurological Institute painted in 1954 (pictured above). above). (pictured 1954 in painted Institute Neurological Montreal the at ral

do Del Maestro. Del do

- mu group a in Osler of depiction a – physician great the of likeness known

- Rolan Professor eran

of William Osler, William of although he does not include at least one less widely widely less one least at include not does he although

1 - vet MNI by institute

Osler. Alex Sakula (1917-2003) lists sixteen mostly well-known portraits portraits well-known mostly sixteen lists (1917-2003) Sakula Alex Osler.

afternoon tour of the the of tour afternoon

gating the possibility of procuring a new centenary portrait of Sir William William Sir of portrait centenary new a procuring of possibility the gating

2019, during a guided guided a during 2019,

- investi keenly been has (WOSANZ) Zealand New and Australia of Society

on Sunday 12 Sunday on May May

In the lead up to the Osler centenary later this year, The William Osler Osler William The year, this later centenary Osler the to up lead the In taken by the editor editor the by taken

(MNI). Photograph Photograph (MNI).

rological Institute Institute rological

of Sir William Osler William Sir of

- Neu Montreal the at

the meeting rooms rooms meeting the

displayed in one of of one in displayed A New Centenary Portrait Portrait Centenary New A

Harris Filer (1954) – – (1954) Filer Harris

by Mary Mary by Neurology

ral – – ral The Advance of of Advance The

- mu large a in greats

other neurological neurological other

picted amongst many many amongst picted

- de is Osler William A Spot on theMoon The William Osler Society of Australia and New Zealand (WOSANZ) has made inquires with the International Astronomi- cal Union’s Working Group for Planetary System Nomenclature (WGPSN) in relation to having a lunar crater named after Sir William Osler.

An initial letter outlining the request was sent to a geologist working with the United States Geological Survey’s Astrogeology Science Center on 30th December 2018. About a month later, WOSANZ was advised that the request would be placed before the Chair of the Lunar Task Group of the WGPSN.

An update on the matter was provided in June 2019. The former correspondent advised that “William Osler has been added to the lunar name bank. The name can now be requested for use by scientists requesting a crater name.” The respondent also emphasised that “the [WGPSN] does not approve names sole- ly for commemorative purposes” and that “there must be a scientific need for a name for a specific feature.”

Encouraged by the small increment forward, WOSANZ is considering engaging with professionals in the field to see if a suitable candidate crater can be found upon which to bestow the name of Osler. An update on the matter will be provided in due course.

Edited photo of the moon highlighting its many craters, most of which have eponymous designations. Original photograph taken on 24th March 2019 by Z. Toodayan.

July 2019 113 w

Long Lives Leonardo Zaheer Toodayan*

Few names enjoy profound fame and familiarity in ages long after their own, but ‘Leonardo da Vinci’ (1452-1519) is a name of precisely such distinction. The quincentennial anniversary of his passing this year provides a good incentive to revisit his life and labours, a cursory review of which is sufficient to demonstrate the capacity and calibre of a true Renassiance giant. Da Vinci’s anatomical works are especially celebrated in the history of medicine, preceding as they did Vesalius’ great anatomical corpus by some fifty years. The sheer diversity, originality, and aesthetic appeal of Leonardo’s many accomplishments continue to inform and inspire the arts and sciences five hundred years after his death.

ore than four-and-a-half centuries separate a particular paternal uncle.5 Apart from some early the earliest and latest biographies of Leon- mathematical tuition at an abacus school, Leonar- ardo da Vinci and it is interesting to note do didn’t receive a formal education and was mostly M 6 how little has changed in the opinions of their distant self-taught. He was left-handed and learned a tech- authors: “Leonardo was a genius, but more: he was nique of mirror writing which he later employed in his the epitome of the universal mind...”1 concludes Wal- notebooks. Hours of exploration in the fresh Tuscan ter Isaacson, whose biography Leonardo Da Vinci has countryside stimulated the sharp senses of the growing served as a primary reference for this historical syn- yoouth, each excursion nurturing a proclivity for intel- opsis. “Wherever he turned thought, brain, and mind, lectual freedom and a reverence for the machinations he showed such divine power in his works...”,2 wrote of Nature.5, 7 Giorgio Vasari (1511-1574) – the art historian who first printed the word ‘Renaissance’3 – some twenty generations prior; “Truly marvellous and celestial was Leonardo...”4 Foundations in Florence In 1464, following the deaths of his grandfather and step-mother, Leonardo moved to Florence to live with Bucolic Beginnings his father.8 At this time, the Republican city was gov- erned by the wealthy Medici family and it was during Legend has it that Leonardo di Ser Peiro da Vinci was th the upcoming rule of Lorenzo de’ Medici (1449-1492) born in the central Italian village of Anchiano on 15 – Lorenzo the Magnificent as he was known; anen- April 1542, the illegitimate son of Ser Peiro, a twenty- thusiastic patron of the arts – that Florence enjoyed five-year-old middle-class notary, and Caterina Lippi, a surge in Renaissance culture.9 There was no better a fifteen-year-old orphan girl. Little Leonardo took time for an inquisitive teenager to begin a career in the his surname, as did his father, from the nearby Tus- arts, and shortly after arriving in Florence, Leonardo can town of Vinci (Figure 1) where his paternal family enrolled as an apprentice in the workshop of the em- was stationed – he was ‘Leonardo of Vinci’. Many inent artist Andrea del Verrochio (1435-1488), where family members contributed to his early upbringing, he quickly developed a determination to excel.10 including his parents, step-parents, grandparents, and Leonardo was influenced by the early Renaissance polymaths Filippo Brunelleschi (1377-1446)11 and Leon Battista Alberti (1404-1472)12 but his resolve to distinguish himself may have also been fuelled by a * Dr Zaheer Toodayan is a Basic Physician Trainee from Brisbane, Australia. Correspondence: [email protected]. desire to invalidate the social stigma and pessimism that his illegitimacy brought upon him.7 Regardless Sketch of a man in red chalk by Leonardo da Vinci (c.1512); thought to be a self-portrait of the artist. Sourced from the Web of his motives, Leonardo prospered under Verrochio’s Gallery of Art, with the courtesy of Biblioteca Reale di Torino. guidance, and acquired great skill in painting and

115 Z. Toodayan

Figure 1: The Tuscan town of Vinci, where Leonardo’s paternal family originated. This etching was created by the Mac- chiaiolian artist Telemaco Signorini (1835-1901) in 1884. With permission; Private Collection: Dr. Rolando Del Maestro. craftsmanship. As an apprentice, Leonardo contrib- enterprise didn’t fare well, for in the five years that fol- uted to some of Verrochio’s own artworks, such as lowed, he received only three commissions for paint- his Tobias and the Angel,13 but the pair’s collabora- ings. One of these paintings was never begun and two tion culminated in the mid 1470’s with the painting of were never finished. One of the incompleted paintings, Baptism of Christ (c.1475),14 a piece which has been a project commissioned in 1481 by the monastery of regarded as Leonardo’s first great work.7 Among other San Donato, was Leonardo’s Adoration of the Magi.20 pursuits at Verrochio’s botegga, Leonardo participated This work was so enthralling, even in it’s immaturi- in the project that saw the successful placement of a ty, that it has been regarded as “the most influential two-ton copper sphere atop Brunelleschi’s dome at the unfinished painting in the history of art.”21 Amongst Florence cathedral in 147115 and engaged in drapery theories that attempt to explain Leonardo’s tendency studies on light and shadow.16 He completed his ap- to leave things undone was his search for perfection, prenticeship in 1472 and was admitted to the guild of Gian Paolo Lomazzo (1538-1592), an early biogra- St Luke as a painter,17 allowing him to work unsuper- pher writing: “so sublime was his idea of art, he saw vised on commissioned paintings and earn an income. faults even in the things that to others seemed mira- Leonardo delayed private painting however and cles.”22 Whatever the underlying reasons for this ap- continued to enhance his skills at Verrochio’s studio parent slackness at work, Leonardo’s life in Florence where he went on to produce some of his first indepen- seems to have become increasingly difficult. To make dent artworks. Perhaps the best regarded of these is matters worse, the Pazzi conspiracy to overthrow the the oil-on-wood portrait Ginevra de’ Benci which was Medici family had placed Florence and Naples at war completed around 1474 and provided a new perspec- with each other,7 and in 1482 Leonardo left Florence tive on female portraiture.18 Even at this early stage in for Milan where he would spend the next seventeen his career, the realism of Leonardo’s art began to set years of his life.23 him apart from his contemporaries; scenes and shapes were deepened with dimension, subtle contours were suggested by sfumato,19 movements were captured in Move to Milan a moment, and human subjects were brought to life with expressions of enigmatic emotion. As a larger city located in the borderlands of North- ern Italy, Milan was always vulnerable to invasion Leonardo left Verrochio’s workshop in 1477 and in the by the neighbouring French and Ottoman empires.7 same year opened a private studio in Florence. This Preparedness and proficiency in battle was therefore

116 Osleriana Leonardo da Vinci a matter of crucial importance to the district’s lead- tary engineering whilst at Florence, but the patronage ers. In the year prior to leaving Florence, Leonardo, of Ludovico Sforza enabled his mechanical mind to seeking stable employment, wrote to Ludovico Sforza mature. During his first Milanese period, Leonardo (1452-1508), the then de facto Duke of Milan, adver- initiated a habit of keeping notebooks to record the tising his ability to create superior defensive and offen- things he saw, thought and planned,25 and he populated sive weapons of war: “I have a sort of extremely light many pages with sketches and diagrams depicting an and strong bridges… indestructible by fire and bat- array of weapons and devices. Many of these machines tle”, “vessels which will resist the attack of the largest were not novel in nature, but Leonardo invented ways guns…, covered chariots, safe and unattackable” and of refining and supplementing them.26 He also quite “catapults, mangonels, trabocchi, and other machines characteristically sized up older mechanisms to un- of marvellous efficacy and not in common use.” His precedented, even fanciful scales. In addition to those talent for painting and sculpture was only given brief mentioned in his letter, Leonardo’s military schemes mention: “I can carry out sculpture in marble, bronze included a giant crossbow, a rapid-firing crossbow, a or clay, and also I can do in painting whatever may be scythed chariot, mobile field cannons, steam-powered done...”, and he offered to materialise Sforza’s wish cannons, rapid-firing guns, projectiles with stabilising to have a colossal bronze horse monument erected to fins, frangible mortars,27 an automotive wagon,28 div- the memory of his father, the Duke Francesco Sfor- ing equipment, and semisubmersible boats.29 Other za (1401-1466). Ludovico found utility for Leonardo devices and instruments he addressed included pulleys and employed him with responsibilities of, amongst and tackle, rope-makers, lifting jacks, drilling and bor- other roles, painter and military engineer to his court.24 ing machines, lathes, cranes, release mechanisms, fric- tion reducing bearings, chain drives and links, gimbal The date of Leonardo’s famous letter indicates he was ring suspensions, water-raising mechanisms (Figure already concerned with problems of general and mili- 2), windmills, and air and water turbines.30 He also

Figure 2: Codex Atlanticus, f. 26 verso. showing some of Leonardo da Vinci’s drawings of hydraulic machines. On the left is an Archimedean screw system for lifting water and on the right, a pump for removing water from a well. Reproduced with permission from the Biblioteca Ambrosiana, Milan.

July 2019 117 Z. Toodayan

Figure 3: Madonna (Virgin) of the Rocks, Louvre version (1483-86), oil on wooden panel (subsequently transferred to canvas). The painting features the Virgin Mary (centre) and Christ child (right) with an infant Saint John the Baptist (left) and an angel, (lower right) all seated in a stony landscape near a body of water. Image sourced from the Gallerix online museum (en.gallerix.ru), with courtesy of the Musée du Louvre, Paris.

118 Osleriana Leonardo da Vinci ventured into aeronautics with ideas for ornithopters, ty-three feet tall and weighing seventy-five tons.45 By parachutes, a helical airscrew, and an inclinometer.31 November 1493 Leonardo had produced an impres- Leonardo’s notebooks indicate that his fascination sive full-size clay model of the big horse, a feat which with mechanics occupied a substantial part of his life. itself earned him much admiration from the Duke’s Some of his drawings can be considered artworks court.46 But progress on the metal sculpture halted the unto themselves and several still stimulate the modern following year when the invasion of King Charles VIII imagination. Better befitting the age of industrialisa- of France actioned a diversion of bronze for the man- tion, Leonardo’s machines epitomise a man ahead of ufacture of cannons.47 The ensuing conquest of Mi- his times. lan in 1499 under King Louis XII saw the destruction of the clay horse and ousted Sforza from Dukedom.48 In order to secure financial stability, Leonardo kept Leonardo, now forty-seven and having lost his patron, painting, and several masterpeices are attributable to was on the move once more. his first Milanese period. These include his original version of Madonna of the Rocks (Figure 3), completed sometime during the 1480’s,32 a set of portraits depicting Sforza’s mistresses, such as Lady with an Er- Florence Again mine and La Belle Ferronnière,33 and one of his most famous paintings of all, completed in 1498 – The Last By March 1500, following brief sojourns at Mantua Supper34 – which has been called “the most spellbind- and Venice, Leonardo had returned to Florence, the ing narrative painting in history”35 and “the keystone town of his youth.49 In 1502, he was attached to the of European art.”36 It was also in Milan, during a pe- service of Cesare Borgia (1475-1507), Duke of Val- riod of study into human proportions, that Leonardo drew his now famous Vitruvian Man (Figure 4). This was a portrayal of the Roman architect Marcus Vitruvius Pollio’s (c.80-c.15 B.C.) canon of human proportions which stated that the extremities of a “well-shaped man”37 could simultaneously define the perimeter of both square and circle.38 Leonardo’s figure, representing the interface of man and mathematics and of humanity and Nature, not only became an icon of his own, but a recognisable symbol of the Renaissance itself.39

From 1489, Da Vinci’s inquiries into the human body extended into anatomical, physiological, and philosophical researches which included an exploration of the structure of the skull,40 the function of the eye,41 and a search for the seat of the soul.42 He also began observations on the flight of birds43 and, as theatrical impre- sario to the Sforza court, concerned himself with the production of stage- craft, plays, and pageants.44 He also laboured towards the tremendous equestrian monument which he had promised Ludovico as a memory to his father and for which a commis- Figure 4: Leonardo da Vinci’s iconic Vitruvian Man, showing the proportions sion had been granted in 1489. The of the human body according to Vitruvius. Note his characteristic mirror script sculpture was planned to be three above and below the diagram. Image sourced from Web Gallery of Art, with times larger than life, standing twen- courtesy of the Galleria dell’Accademia, Venice.

July 2019 119 Z. Toodayan entinois, a ruthless commander of the papal armies Rennaisance.58 But there was one more masterpiece of his father, Pope Alexander VI.50 Leonardo briefly that Leonardo was working on during these Florentine furthered his military and engineering achievements years that he did eventually complete; a portrait that under Borgia; his bird’s eye map of the town of Imo- was destined to become the most famous painting of la being an innovative contribution to military recon- all time – La Gioconda, or, the Mona Lisa.59 naissance and cartography.51 But Borgia’s tactics of betrayal, brutality and bloodlust, which featured in the Leonardo da Vinci’s identity is strongly affiliated with murder of one of Leonardo’s friends, soon drove away aeronautics. His researches in the field began in Milan “the city’s most famous artist and engineer.”52, 53 in the 1480’s and continued in some form or another for the next two decades.60 His interest in flight was Several famous paintings also belong to Leonardo’s fuelled by a fascination with Nature’s aviators; he re- second Florentine period. These include his Virgin ported his earliest memory as being (perhaps some- and Child with Saint Anne, which has been called his what fancifully) an encounter with a kite in the cra- “ultimate masterpeice”,54 Leda and the Swan and the dle61 and was said to have purchased caged birds in Battle of Anghiari. The latter work was commissioned the marketplace only to set them free.62 Leonardo’s in 1503 as a mural for Florence’s Council Hall in the initial investigations on flight were concerned with Palazzo della Signoria55 and put Leonardo into com- the creation of special theatrical effects.60 Later on he petition against a talented younger sculptor and art- studied avian anatomy and probed questions on the ist, Michelangelo Buonarroti (1474-1564)56 who was aerodynamics of flight, arriving at some remarkably likewise commissioned to produce a martial mural at insightful conclusions: He understood that “as much the Palazzo.57 Leonardo never completed his battle force is exerted by the object against the air as by the scene and the original work was lost,36 but even his air against the object”63 and that “the air above birds unfinished painting was of such a standard that it had is thinner than the usual thinness of the other air.”64 already made, alongside Michelangelo’s unfinished Leonardo compiled all his observations and studies on Battle of Cascina, an influential impact on art and the birds, which were the first to make use of illustrated

a b

Figure 5: Aeronautical studies. a) Structure of a mechanical wing. Extracted from: Gibbs-Smith C, Rees G. The Inventions of Leonardo da Vinci. London: Book Club Associates, 1978, p. 20. b) Part of a notebook page (folio 6 recto) from the Codex on the Flight of Birds (1504/05) showing Leonardo da Vinci’s studies of avian flight, as it appears in Teodoro Sabachnikoff’s (1869-1927) 1893 reproduction I Manoscritti di Leonardo da Vinci. Codice sul Volo deghi Uccelli e Varie Altre Materie. Note the use of streamlines to depict airflow. With permission; Private Collection: Dr Rolando Del Maestro.

120 Osleriana Leonardo da Vinci streamlines, in an eighteen-folio notebook that be- XII (1462-1515) to whom he became enlisted as “of- came known as the Codice Sul Volo Degli Uccelli (Co- ficial painter and engineer.”71 Leonardo preferred the dex on the Flight of Birds)65 (Figure 5b). Replicating intellectual diversity and culture of Milan and never his avian observations, he designed many mechanical officially worked in Florence again. Hereon he only re- wings (Figure 5a) and man-powered ornithopters that turned to the city of his youth to visit family or friends, employed a flapping mechanism to derive lift. He had and, in 1508, to settle an inheritance dispute with his great ambitions for his machines: “The large bird will half-brothers.72 take its first flight from the back of the great Swan66” he dreamed, “filling the universe with amazement, During his return to Florence in 1508, Leonardo be- filling all writings with its fame, and bringing eternal gan a second phase of investigations in human anat- glory to the nest where it was born.”67 Many of Leon- omy that would last five years. He had already wan- ardo’s ornithopters were bulky and impractical, but dered into this field during his previous Milanese his design for a fixed wing glider was later deemed years but now pursued his studies with considerable capable of sustentation.68 Despite his own challenges, dedication.73 Leonardo had access to human cadavers he remained optimistic that man would one day con- through the Hospital of Santa Maria Nouva,74 where quer the skies: “Spunteranno le ali!”,69 “there shall be he undertook meticulous dissections that informed the wings!” he predicted; “if the accomplishment be not exquisite illustrations of bone and sinew that filled his for me, ‘tis for some other. It shall be done. The spirit notebooks. Science and art converged in Leonardo’s cannot lie; and man, who shall know all and who shall pioneering anatomical diagrams which were diligent- have wings, shall indeed be as a god.”70 ly drawn to demonstrate the structure and beauty of a place or part of the body (Figures 6a-f75). He thus produced the first accurate depictions of the frontal and Milan Once More maxillary sinuses, of human dentition (these during his earlier studies on the skull), and of the vermiform In May 1506, Leonardo left Florence and travelled to appendix (“auricle of the colon”). He also made mag- Milan for a second time. Here he enjoyed the patron- nificent drawings of the gravid uterus and its associ- age of the French royal governor, Charles d‘Amboise ated vasculature which demonstrated the unilocular (1473-1511) and the esteem of the French King Louis nature of the womb, the correct lie of the foetus, and

a b

(Figure 6: See caption overleaf for descriptions).

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c d

e f

Figure 6: Some of Leonardo da Vinci’s anatomical drawings. a) (Previous page). Female dissection showing proximal car- diovascular, renal, and reproductive systems; black and red chalk, ink, yellow wash (c.1509/10). b) (Previous page). Studies on the aortic valve; pen and ink on blue paper (c.1512-13). c) Muscles and tendons of the hand; pen and ink with wash, over black chalk (c.1510/11). d) Saggital section through the skull and cervical spine; pen and ink over black chalk (c.1489). e) Foetus in the womb; pen and ink with red chalk (c.1511). All reproduced with permission from the Royal Collection Trust / © Her Majesty Queen Elizabeth II 2019.75 f) Ventricles of the brain and cranial nerves (with male urogenital apparatus), pen and ink (c.1506/08). Reproduced with permission; Copyright: Klassik Stiftung Weimar, Bestand Museen.

122 Osleriana Leonardo da Vinci the anatomical isolation of maternal and foetal circu- tagnositc muscles,82 and the understanding that volun- lations in placenta and umbilical cord. Leonardo cre- tary movements proceed by way of signals transmitted ated the earliest known cast of a body cavity when he to muscles in nerves from the brain.83 But Leonardo’s used molten wax to delineate the system of ventricles crowning contribution to anatomy and physiology in the brain. Additionally, he was first to recognise were his studies on the aortic valve. Fostered by a fas- the four-chambered nature of the heart, the moderator cination for fluid dynamics, he discovered the correct band of the right ventricle, and the correct number of mechanism by which the valve is shut, postulating and human vertebrae.76 Leonardo not only appreciated the proving that the closure was driven by vortices that existence of minute vascular channels in the body, but, develop between the root of the aorta and the valvu- it has been said, it was he who introduced the term lar cusps in the region of the coronary sinuses.84 Had ‘capillary’ into anatomy.77 Leonardo published his works, his may have eclipsed another great name in the history of anatomy, Andreas Leonardo da Vinci’s anatomical analyses were not Vesalius (1514-1564),85 who is widely regarded as the undertaken in intellectual isolation but were always father of the discipline. But the artistic elegance and accompanied by serious physiological and patholog- originality of da Vinci’s anatomy has still conferred ical speculation. He has been credited with what has him a place in the history of medicine and in the minds been called “the first description of arteriosclerosis as of many doctors. “Leonardo was the first of modern a function of time”,78 providing the following analogy anatomists,” remembered Sir William Osler (1849- of aging vessels after an autopsy performed on a cente- 1919), “and fifty years later, into the breach he made, narian at the hospital of Santa Maria Nouva in 1508:73 Vesalius entered.”86 “the network of vessels behaves in man as in oranges in which the peel becomes tougher and the pulp dimin- In addition to an admiration of the microcosm of the ishes the older they become.”79 Other physiological human body, Leonardo was interested in the macro- insights included a comprehension of the haemody- cosm of the universe. Although his contributions to namic origin of erections and the testicular source of greater astronomy were not considerable, he did make semen,80 an appreciation of the mechanism of move- some pioneering observations of the Moon. In Da Vin- ment of the joints81 together with a knowledge of an- ci’s day, there was still no credible explanation for the

a b

Figure 7: Studies of the Moon. a) Leonardo’s sketch of the Moon from the Codex Atlanticus (folio 674 verso, c.1513-1514) (only half of the near side is illustrated). The lunar North Pole is towards the top end of the diagram and the maria have been shaded in. This is one of the earliest unaided drawings of the Moon on record. b) Notebook page from the Codex Leicester featuring Leonardo’s description of earthshine. The sketch at the lower right illustrates the phenomenon accompanying a crescent Moon; the upper diagram depicts its cause, originating from the illumination of the Earth. Images courtesy of Le Gallerie Degli Uffizi, Florence.

July 2019 123 Z. Toodayan faint visibility of the darker portion of the lunar disc had that lustre and watery sheen which are always that accompanies a crescent Moon. Leonardo was the seen in the living creature... The nose, with its beau- first person to provide the correct explanation for this tiful nostrils, rosy and tender, seems to be alive. The observation, noting that the subtle illumination came mouth… appeared, indeed, to be not colours but flesh. from the sunlit Earth itself87 (Figure 7b). For this rea- Whoever intently observed the pit of the throat, saw son the impressive phenomenon – called ‘earthshine’ the pulse beating in it.”96 One of the most intriguing – is still sometimes referred to as the ‘Da Vinci glow’.88 and well known features of the Mona Lisa is her smile. Leonardo’s notebooks also contain some of the earliest It lingers enigmatically beneath the yellowing varnish, known drawings of the Moon. A set of crude sketch- evading the eye of the observer and becoming more es within the Codex Atlanticus, which are thought to noticeable when not directly looked upon.95 True to have been pencilled between 1505 and 1514, clearly the teaching of Alberti, that “movements of the soul depict the Maria of the lunar surface89 (Figure 7a) and are made known by movements of the body”,97 Mona precede William Gilbert’s (1544-1603) unaided draw- Lisa’s smile epitomises Leonardo’s lifelong endeavour ings by almost a century.90 to capture emotion with the paintbrush. “And in this picture of Leonardo’s,” Vasari continued, “there was a smile so pleasing, that the sight of it was a thing more Rome divine than human; and it was held to be a marvel, in that it was not other than alive.”98 The Mona Lisa Towards the end of 1513, Leonardo left Milan for was slowly perfected over a period of at least fourteen Rome, taking up residence at the Villa Belvedere. He years, gradually enriched with the artist’s deepening soon secured the sponsorship of the aesthete sons of understandings of both Man and Nature.99 It is this Lorenzo the Magnificent – Giovanni (1475-1521), deliberate and careful integration of thought and ex- who had become Pope Leo X of Rome, and Guiliano perience into the portrait that makes the Mona Lisa a de’ Medici (1479-1516).91 During this period, Leon- masterpiece. ardo continued to study various branches of science including botany and mirror-making. He also continued to study anatomy by way of dissections at the End at Amboise University of Padua. While in Rome, Leonardo didn’t receive more than a single new commission for his In 1515 Leonardo followed the papal procession of paintings and instead attended to artwork he had al- Pope Leo X through Florence to Bologna where he ready begun years before.92 Some of the paintings he met Francis I (1494-1547), the new King of France,100 worked on during his earlier period in Milan and then who would became his ideal and most devoted pain Rome included Saint John the Baptist, Angel of the tron.101 King Francis subsequently invited Leonardo Annunciation,93 and of course the Mona Lisa. to his court at Amboise in the Loire Valley, where Leonardo moved in the summer of 1516, securing a Any recollection of the life of Leonardo would be comfortable stipend and residence at the Château de unfinished without an account of his chef-d’œuvre, Cloux (now Château du Clos Lucé).101, 102 Leonardo the Mona Lisa. The sitter for this world-renowned continued to entertain the royal court with pageants painting has been confirmed as one Lisa del Giocon- and fantasias, and shared his knowledge of all subjects do née Gherardini (1479-1542), the young wife of a with the King who greatly admired and appreciated successful silk merchant, Francesco del Giocondo his many talents.103 By 1517, Leonardo may have suf- (1465-1542), who commissioned the project to Leon- fered a stroke that paralysed his non-dominant right ardo when he was still in Florence.94 The painting hand, but he continued to draw, paint and give tours (Figure 8), made with multiple coatings of light oil to the sovereign’s entourage.104 In the final few years glazes upon poplar panel primed with lead white, de- of his life he engaged in the planning of a new royal picts Madonna Lisa in a three-quarter pose, seated on palace at Romarantin and completed a collection of a loggia, clothed in undulating garments and beneath drawings depicting the turbulent motions of water.105 a thin and translucent gossamer veil. Gliding from a distant misty mountainscape is a calm river that merg- In April 1519 the aging Leonardo entered into a final es with the Madonna, conveying a message of harmo- illness, the details of which are unknown. He com- ny between Earth and individual. In reality, the paint- pleted his will and spent his last days at the Chateau ing flaunts a peculiar depth and dynamism, the sitter’s d’Amboise, where death came to him on 2nd May eyes appearing to follow the observer in a fashion that 1519.106 Vasari gave the following narration of Leonar- has been termed ‘the Mona Lisa effect’.95 The liveli- do’s final moments: “The King, who often and loving- ness with which the Madonna’s features were captured ly was used to visit him [Leonardo], came to see him: by Leonardo was described well by Vasari: “The eyes whereupon he [Leonardo], out of reverence, having

124 Osleriana Leonardo da Vinci

Figure 8: La Gioconda, or, Mona Lisa (1503 onwards), oil on poplar panel. The sitter is Lisa del Giocondo née Ghe- rardini (1479-1542), the wife of a silk merchant. Here depicted is a digitally restored version of the famous painting which reduces some of the yellowing affecting the actual portrait. Image sourced from Wikimedia Commons, with courtesy of the Musée du Louvre, Paris.

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Figure 9: The narrative of Leonardo da Vinci’s death popularised by his early biographer Giorgio Vasari (1511-1574), in which he was comforted by King Francis I, became the subject of many paintings and illustrations. This etching was produced by Giuseppe Cades (1750-1799) sometime during the second half of his life. Image sourced from The Metropolitan Museum of Art, with courtesy of the A. Hyatt Mayor Purchase Fund, Marjorie Phelps Starr Bequest, 2006. raised himself to sit upon the bed, giving an account of the church and many of its graves in the early nine- his illness, and the circumstances of it, showed withal teenth century. During subsequent excavations of the how he had offended God and mankind in not having unrepaired premises in 1863, a stone coffin was found laboured at his art, as he ought to have done. Where- in proximity to a slab bearing a few inscribed letters upon he was seized with a paroxysm, the messenger of that were thought to be part of Da Vinci’s Latinised death, by reason of which the King having risen, and epitaph. Bones believed to belong to Leonardo were having taken his head, in order to aid him and show then reinterred at the nearby church of Saint-Hubert, him favour, in the hope of alleviating his sufferings, a small neo-gothic chapel overlooking the Loire Val- his divine spirit, knowing that it could have no greater ley.110 Therein a simple granite grave preserves the re- honour, expired in the arms of the King...”107 Vasa- discovered remains; a bronze medallion bearing a re- ri’s narrative was subsequently popularised pictorial- lief portrait features towards the head-end of the tomb, ly (Figure 9), but the validity of his version of events and at the other, a simple inscription of the name of its have long been challenged by historians who have presumed occupant – ‘Leonardo da Vinci’.111 pointed out that King Francis I may not have been in Amboise on the day of Leonardo’s death.108 Leonardo – Man and Memory Following a provisional interment, Leonardo da vinci, the “First Painter, Engineer and Architect to the Apart from a few possible self-portraits (see frontis- King”,109 was ceremonially buried, in accordance with piece on page 114 for example) and one or two draw- his wishes, at Amboise’s Church of Saint-Florentin ings completed by his students, there aren’t many on 12th August 1519. There he lay in peace until the existing depictions of Leonardo da Vinci.112 Early bi- French Revolution brought about the destruction of ographers however, did preserve some contemporary

126 Osleriana Leonardo da Vinci descriptions of Leonardo the man. He was remem- “We do not lack devices for measuring these miserable bered as “a man of outstanding beauty and infinite days of ours, in which it should be our pleasure that grace”,113 “handsome, urbane, eloquent and dandyish- they be not frittered away without leaving behind any ly well dressed”,114 “he had long hair and such long memory of ourselves in the mind of men.”127 – These eyelashes and beard that he seemed to embody the lines, scribbled down by Leonardo in a moment of de- true nobility of learning,…”.115 Though he was a cor- spair,128 indicate that there were times when he was dial character with the fellowship of many friends,116 contemplating how he might be remembered. But by Leonardo never married,117 remained childless, and connecting himself to the perennial power of Nature, forged only a few truly close connections with oth- Leonardo leapt ahead of his contemporaries and seers. One such relationship was with Francesco Melzi cured firm foundations for a legacy. From our present (1491-1570) who became his personal assistant, stu- perspective, his life seems to stand out against the ob- dent, scribe, and surrogate son.118 Melzi drew the scurity of the old epoch, enduring with those equals in least-disputed portrait of Leonardo119 and to him was fortune and fertility whose memories have been spared bequeathed much of his work and belongings follow- from oblivion. Perhaps he would be pleased to know ing his death.120 Gian Giacomo Caprotti (1480-1524), that even long after his death his name is not unfamil- affectionately known by Leonardo as ‘Salai’ (or ‘Lit- iar, and his works continue to be studied and admired tle Devil’), was another close companion who accom- by people the world over. Five-hundred years have panied Leonardo through a vast period of his life.121 looked back favourably upon this “solitary colossus Leonardo enjoyed a lifelong love of theatre and stage- among mortals”129 and prodigious child of Vinci – so craft.122 He was a fan of Dante123 and could play the may his memory pass into ages long after our own. lyre “with rare distinction”.124 He was fond of all animals and observed a simple vegetarian diet.125 Even Like a wonderful work of art into old age he retained an insatiable curiosity for the Enduring time’s slow sfumato natural world and saw himself as a “disciple of expe- And the ceaseless sound of human heart, rience and experiment”.126 Long lives Leonardo.

References & Notes

1. Isaacson W. Leonardo Da Vinci: The Biography. United 18. Isaacson W, 2017. op. cit. pp. 63-67. States: Simon & Schuster, 2017, p. 519. 19. Sfumato refers to an artistic technique, popularised by Leon- 2. Vasari G, Horne HP. The Life of Leonardo Da Vinci. London: ardo da Vinci, in which the appearance of a painted object or The Sign of the Unicorn, 1903, p. 14. scene is softened by blending different shades and colours, “in 3. Isaacson W, 2017. op. cit. p. 7. the manner”, to qoute Da Vinci, “of smoke losing itself in the 4. Vasari G, Horne HP, 1903. op. cit. p. 9. air”. (Isaacson W, 2017. op. cit. p. 41). 5. Del Maestro RF. Sir William Osler’s Leonardo da Vinci Col- 20. Isaacson W, 2017. op. cit. p. 74. lection: Flight, Anatomy and Art. London, Ontario: DW Med- 21. ibid. ical Consulting 2007 Inc., 2019, p. 14. 22. ibid. p. 81. 6. Isaacson W, 2017. op. cit. p. 17. 23. ibid. p. 91. 7. The History Channel. (2005). Da Vinci and The Code He Lived 24. Gibbs-Smith C, Rees G, 1978. op. cit. pp. vii-viii. By. Available at: https://www.youtube.com/watch?v=6f7Kw- 25. Isaacson W, 2017. op. cit. p. 105. Zr0C_4. Accessed 2nd May 2019. 26. Gibbs-Smith C, Rees G, 1978. op. cit. p. ix. 8. Isaacson W, 2017. op. cit. p. 23. 27. ibid. pp. 28-47. 9. ibid. pp. 27-28. 28. ibid. p. 85. 10. ibid. p. 33. 29. ibid. pp. 76-77. 11. Filippo Brunelleschi (1377-1446) is best known as the Renais- 30. ibid. pp. 49-71. sance architect who designed the dome of the Florence cathe- 31. ibid. pp. 13-26. dral. He also pioneered the theory of linear perspective in art. 32. Isaacson W, 2017. op. cit. p. 224. (Isaacson W, 2017. op. cit. pp. 29-30). 33. ibid. pp. 239-248. 12. Leon Battista Alberti (1404-1472) was an Italian artist, ar- 34. ibid. p. 291. chitect and painter who whose 1435 treatise De Pictura (On 35. ibid. p. 280. Painting) considerably influenced the young Leonardo. (Isaa- 36. ibid. p. 281. cson W, 2017. op. cit. p. 30). 37. ibid. p. 150. 13. ibid. pp.48-49. 38. Gibbs-Smith C, Rees G, 1978. op. cit. p. 97. 14. ibid. p. 52. 39. Hart-Davis A. Engineers. London: Dorling Kindersley Limit- 15. ibid. p. 37. ed, 2012, p. 68. 16. ibid. p. 39. 40. Isaacson W, 2017. op. cit. p. 216. 17. Gibbs-Smith C, Rees G. The Inventions of Leonardo da Vinci. 41. ibid. pp. 270-273. London: Book Club Associates, 1978, p. 105. 42. Leonardo associated the location of the soul with the ancient July 2019 127 Z. Toodayan

notion of the ‘senso commune’, the ‘common sense’, an organ 919009, d) 919057, e) 919102. The images may be accessed situated at the centre of the head (corresponding to the conflu- through the following link: www.rct.uk/collection/RCIN ence of the senses) that was responsible for human judgment. (where RCIN is the Royal Collection Inventory Number of “The soul seems to reside in the judgment,” Leonardo wrote the desired image). “and the judgment would seem to be seated in that part where 76. [Unsigned]. 33 anatomic firsts of Leonardo da Vinci. Spec- all the senses meet; and this is called the senso commune. ” trum (Pfizer), Fall 1966; 14(4): 78-81. Although the author of (Isaacson W, 2017. op. cit. p. 218). According to this defi- this work is unlisted in the journal, the article was conceivably nition, he specualted that the soul was stationed in a region written by the journal’s editor, medical historian Walter Regi- of the brain just superior to the pituitary fossa, near the third nald Bett (1903-1968). ventricle. (Gibbs-Smith C, Rees G, 1978. op. cit. p. 95). 77. Based on American surgeon Elmer Belt’s (1893-1980) ‘care- 43. Del Maestro RF, 2019. op. cit. p. 20. ful study of Leonardo’s manuscript notes’ [[Unsigned]. 33 44. Isaacson W, 2017. op. cit. p. 112. anatomic firsts of Leonardo da Vinci. Spectrum (Pfizer), Fall 45. ibid. p. 162. 1966; 14(4): 78-81], an unnamed author (see previous note) 46. ibid. pp. 165-166. summarising Belt’s work, writes that Leonardo da Vinci intro- 47. ibid. p. 169. duced the term ‘capillary’ (ostensibly refering to its usage in an 48. Del Maestro RF, 2019. op. cit. p. 18. anatomical context). 49. Isaacson W, 2017. op. cit. pp. 299-300. 78. Isaacson W, 2017. op. cit. p. 396. 50. ibid. p. 335. 79. ibid. 51. ibid. pp. 342-344. 80. [Unsigned], 1966. op. cit. 52. ibid. pp. 345-346. 81. Isaacson W, 2017. op. cit. pp. 401-402 53. ibid. p. 337. 82. [Unsigned], 1966. op. cit. 54. ibid. p. 315. 83. Isaacson W, 2017. op. cit. p. 218. 55. ibid. p. 355. 84. Isaacson W, 2017. op. cit. pp. 416-419. The coronary sinus- 56. Michelangelo Buonarroti (1475-11564) was a distinguished es were rediscovered by the Italian anatomist Antonio Maria Italian painter and sculptor who produced some of the most Valsalva (1666-1723) over two centuries later, whence they renowned artworks in the modern world, as exemplified by his became known as the sinuses of Valsalva. scupltures Pietà and David, and by his famous Biblical fres- 85. Andreas Vesalius (1514-1564) is regarded as the founder of coes of the Vatican’s Sistine Chapel in Rome. (Isaacson W, modern anatomy. His 1543 textbook, De Humani Corporis 2017. op. cit. pp. 367-377). Fabrica Libri Septum (On the Fabric of the Human Body 57. Isaacson W, 2017. op. cit. p. 372. in Seven Books) was the first complete textbook of human 58. ibid. p. 379. anatomy and one of the most influential books ever written. 59. ibid. p. 320. (Sigerist H. The Great Doctors. New York: W. W. Norton & 60. ibid. p. 181. Company, 1933, p. 129). 61. ibid. pp. 18-19. 86. Osler W. The Evolution of Modern Medicine. New Haven: 62. Gibbs-Smith C, Rees G, 1978. op. cit. p. 30. Yale University Press, 1921, p. 163. Osler’s full appraisal of 63. Isaacson W, 2017. op. cit. p. 185. This statement contains the Leonardo da Vinci is as follows: “Insatiate in experiment, in- essence of what subsequently became known as Newton’s tellectually as greedy as Aristotle, painter, poet, sculptor, en- third law of motion – every action has an equal and opposite gineer, architect, mathematician, chemist, botanist, aëronaut, reaction [after Sir Isaac Newton (1642-1727), English mathe- musician and withal a dreamer and mystic, full acomplishment matician and physicist]. Leonardo’s application of this princi- in any one department was not for him! A passionate desire ple to flight is impressively accurate, for the Newtonian theory for mastery of nature’s secrets made him a fierce thing, replete of lift suggests that a wing that imparts a downwards trajectory with too much rage! But for us a record remains – Leonardo to the air flowing around it, itself experiences an opposite up- was the first of modern anatomists, and fifty years later, into ward force from the air. the breach he made, Vesalius entered.” 64. Isaacson W, 2017. op. cit. p. 186. This staement indicates that 87. Moore P. Guide to the Moon. London: Lutterworth Press, Leonardo da Vinci comprehended the role of air pressure in 1976, p. 16. the generation of aerodynamic lift. Put simply, the pressure of 88. NASA Science. (2005). The Da Vinci Glow. Available air flowing over the upper surface of a cambered airfoil is re- at: https://science.nasa.gov/science-news/science-at-na- duced in accordance with Bernoulli’s principle [i.e. by way of sa/2005/04oct_leonardo. Accessed 26th May 2019. an increase in its velocity; after Daniel Bernouli (1700-1782), 89. Reaves G, Pedretti C. Leonardo Da Vinci’s Drawings of the Swiss mathematician and physicist], and this creates a pres- Surface Features of the Moon. Journal for the History of As- sure differential between the upper and lower wing surfaces tronomy, February 1987; 18(1): 55-58. which produces lift. 90. William Gilbert (1540-1603) was an English physician, phys- 65. Isaacson W, 2017. op. cit. p. 184. icist and astronomer who drew the earliest existing map of the 66. Here Leonardo refers to the Swan Mountain (Monte Ceceri) Moon around the year 1600. Like Leonardo da Vinci, William near Fiesole. (Isaacson W, 2017. op. cit. p. 188.) Gilbert believed that the brighter regions on the Moon were 67. Isaacson W, 2017. op. cit. p. 188. seas, and the dark areas land. (Whitaker EA. Mapping and 68. ibid. Naming the Moon: A History of Lunar Cartography and No- 69. Merezhkovsky DS, Trench H. The Romance of Leonardo da menclature. Cambridge: Cambridge University Press, 2003. p. Vinci. New York: G. P. Putnam’s Sons, 1912, Part II, p. 328. 10-13). 70. ibid. p. 139. Many reproductions of this popular qoutation 91. Isaacson W, 2017. op. cit. pp. 454-456. substitute the word ‘lie’ for ‘die’, such that it reads “...the spirit 92. ibid. pp. 456- 459. cannot die...”. Trench’s translation of Merezhkovsky’s 1912 93. ibid. p. 463. biography (see reference no. 69) uses the word ‘lie’. 94. ibid. pp. 477-482. 71. Isaacson W, 2017. op. cit pp. 382-384. 95. ibid. pp. 482-490 72. ibid. pp. 387-391. 96. Vasari G, Horne HP, 1903. op. cit. pp. 34-35. 73. ibid. p. 394. 97. Isaacson W, 2017. op. cit. p. 87. 74. ibid. p. 213. 98. Vasari G, Horne HP, 1903. op. cit. p. 35. 75. The Royal Collections Inventory Numbers for these images 99. Isaacson W, 2017. op. cit. p. 475. (pages 121 and 122) are as follows: a) 912281, b) 919082, c) 100. ibid. p. 461.

128 Osleriana Leonardo da Vinci

101. ibid. p. 497. 109. Isaacson W, 2017. op. cit. p. 498. 102. ibid. pp. 499-500. 110. Del Maestro RF, 2019. op. cit. pp. 25-26. 103. ibid. pp. 498-499. 111. The Vintage News. (2017). Leonardo da Vinci’s tomb: the 104. ibid. p. 503. Re naissance genius was laid to rest in the Chapel of Saint 105. ibid. pp. 504-506. Hubert in Amboise, France. Available at: https://www.thevin- 106. ibid. pp. 511-513. tagenews.com/2017/04/06/leonardo-da-vincis-tomb-the-re- 107. Vasari G, Horne HP, 1903. op. cit. p. 44. naissance-genius-was-laid-to-rest-in-the-chapel-of-saint-hu- 108. In a note to his English translation of Vasari’s biography, bert-in-amboise-france/. Accessed 1st June 2019. the English poet, antiquarian and art historian Herbert Percy 112. Isaacson W, 2017. op. cit. pp. 445-454. Horne (1864-1916) indicates that King Francis had signed a 113. ibid. p. 129. decree on 1st May 1519 at Saint Germain-en-Laye, a town sit- 114. ibid. p. 368. uated over 200 km (and two days’ travel) northeast of Amboi- 115. ibid. p. 454. se, where the Court was celebrating the birth of the Queen’s 116. ibid. p. 129. second child. (Vasari G, Horne HP, 1903. op. cit. p. 44). Del 117. ibid. p. 70. Maestro, referencing Ludwig Goldscheider’s (1896-1973) 118. ibid. p. 385. 1967 biography, notes that King Francis was at the Court on 119. ibid. p. 447. May 2nd (Del Maestro RF, 2019. op. cit. p. 25). Both authors 120. ibid. pp. 512-513. also point out that Leonardo’s companion and beneficiary, 121. ibid. p. 131. Francesco Melzi (1491-1570), who was present by his death- 122. ibid. p. 44. bed, made no mention of the King’s attendance in subsequent 123. ibid. p. 71. correspondence about Leonardo’s passing. Isaacson reports 124. ibid. p. 116. that the King’s proclamation at St Germain-en-Laye was made 125. ibid. p. 130. on May 3rd and notes that it was not signed by the King himself 126. ibid. p. 17. but by his chancellor, permitting the King’s presence at Am- 127. ibid. p. 88. boise at the time of Leonardo da Vinci’s death. (Isaacson W, 128. ibid. 2017. op. cit. pp. 514-515). 129. Gibbs-Smith C, Rees G, 1978. op. cit. p. x

July 2019 129

‘Gaspare Aselli (c.1581-1625)’ by Walter Reginald Bett, 18th May 1928

with notes by Nadeem Toodayan*

Editor’s Introduction

On 18th May 1928, Walter Reginald Bett (1903-1968) delivered his first major historical paper to the Osler Club of London. The unpublished transcript of this talk is stored away from sight in the Thomas Cotton Room of the Royal College of Physicians of London, where the archives of the ‘Osler Club’ lay still and scantily catalogued behind the closed panels of two large wooden storage cabinets. Kept under lock and key, the editor was given the required access to this archive during his inaugural trip to London in May of 2018. Amongst numerous other items of exceptional historical interest, there were found in this wonderful collection many of Walter Bett’s original letters and manuscripts. One of these, a remarkably well preserved seventeen-page typescript, is conspicously kept in a specially designated brown envelope labelled only with the letters ‘Bett, W. R. Gaspare Aselli. 18:V:28’ and a pasted ‘Osler Club’ name-tag. The enclosed essay is one of Bett’s formative offerings to the Club and provides great insight into the early literary and professional influences that shaped him to become the exceptionally stylistic writer and author he was in later years. Held together firmly by a sturdy but rust-stained ninety-year-old paperclip, this never before published typescript (complete with Bett’s added annotations) is here reproduced in full for the first time as a timely tribute to its original author. We hope our readers will enjoy this historical gem from the archives of the Osler Club of London.

mong a steady stream of visitors there has pilgrimage to the medical libraries of the metropolis to come to my Library fresh from the postman’s come at last to that haven of refuge to those heavy of horn of plenty,1 to delight my heart and make heart and tired of feet, the British Museum whose liver A 2 my mouth water the 952nd Caxton Head Catalogue large with benevolence here and there shews ominous which like its lavender forefathers blushingly hides a signs of grevious congestion and theatrical evidence wealth of fascination. Every item a delight, the last of just a few subcapsular haemorrhages. There it one cited stopped the moving finger of time. greeted me, worn with age and bursting with conceit: a short length of originally white tape loosely held 134 [Wittie (Robert) Pyrologia Mimica, 1669 etc. its pages together. Which being removed, the cover ref.c to Aselli.]3 gave up the ghost. Verily, the worm of Time is no respecter of books: havoc it plays even with the rares Exophthalmic with the passion of anticipation I rarissimes. On page 246 the briefest of references to snatched at this fragile straw of allusion to my old the discovery of the ‘Milky Veins of the Mesentery’ friend in the spirit. Whereupon I undertook a weary by Asellius cynically stared me in the face. No more. No less. So cruel a beginning is portentous. I came down on my knees like a riderless horse. And so cruel was the shock that I aborted with much pain and flatus 4 * Dr Nadeem Toodayan is a Basic Physician Trainee from Brisbane, a lithopaedion all hard and shrivelled up. Surely the Australia. Correspondence: [email protected]. pia mater of its mother cannot be worth the ninth part 5 Gaspare Aselli, as he appears in the frontispiece to his masterwork of a sparrow. In this revolutionary age, the ambition De Lactibus (1627). From the Bibliothèque Nationale de France. is ripe to dispense altogether with the ether which be-

131 W. R. Bett ing present in such excess may safely be thrown over- The recipient of this letter, one Robert Morison [1620- board. To this same cruel fate so many of the profes- 1683], is known to Fame as one of the greatest pio- sion would treat the past. Yet it is the past alone that neers in botanical classification. is enduring. Like the poor it shall always be with us.6 It serves as the salt th[at] make[s] the food of today The footprints in the historical sands of the adventur- more appetizing to the palate. Without it, the bolus ous story of the lymphatics are scanty and so faint as sticks in the throat; our faces become bluer and bluer: ofttimes scarcely to be made out. Here and there it is and the tragedy of it all is that some of us are so busy true discovery follows upon discovery in almost un- that we do not notice it at all. All of a sudden, we stop seemly haste but for the most part only isolated and breathing. Then we have attained the Hercules Pillars7 disconnected fragments of fact can be gleaned from of our intellectual ambition: we have gained the whole the bundle of time. Of these discoveries a few ap- world and have lost our soul alive. peal to the scientific intellect as of singular merit but admiration is soon lost in a feeling of deadly gloom: While the tercentenary of the publication in Frankfurt- in the background the crouching figure of the bloody am-Main of a poorly printed quarto volume of 72 pag- Moloch13 Oblivion blurs the vision: grim, relentless, es containing an amazing number of misprints,8 the the very personification of destiny, it chills the heart. celebration of which will be marvelled at in history as There is no sadder spectacle in the history of human the most distinguished and distinguishing feature of endeavour than that of an acute and enthousiastic [sic] the intellectual life of this year, stretches the pia ma- mind battling for many laborious years with problems ter9 of the civilised globe, it may be well for us to turn solved by generations long decayed. Is there a figure aside and surreptitously glance at the strange currents more pathetic than that of Schacabac before whom and eddies swaying the eventful story of that other cir- empty plates were set at the feast of Parmecides?14 culation whose waters Janus-like reflect the weal of Hippocrene10 and the woe of ‘Sad Acheron of Sorrow, Generously fed on the pious votive offerings heaped black and deep’.11 Immortal Harvey, so near to the upon the altar of the Harveian cult, I crave forbearance heart of the Club personifying as he does the spirit of for venturing to think that your minds might not be science in the noble triumvirate of its Patron Saint12 strangers to those moments of intellectual respite from and of late in the minds and mouths of all men, with the serious affairs of the hour when, as Longfellow so his mind far in advance of his time and generation en- inimitably puts it, the clock of time ticks drowsily be- grossed by the circulation of the blood, failed to be hind the door, and trifles become the amusement of thrilled by the secrets of the larger circulation embrac- the wise and great.15 May I tonight pass with you a ing that of the chyle and lymph. In the pages of his brief half hour in recalling and gossiping over those own recovered writings, careless of his fame though actors in the dramatic story of the lymphatic circula- never for a moment forfeiting our sympathy by reason tion whose names have floated down the stream of the of the redeeming grace of moderation of language, he centuries. Never, perhaps, honoured in their genera- holds a candle to his unbelief in the accuracy and im- tion which buried them with the burial of an ass,16 and portance of the special contributions to the knowledge forgotten by the next, out of the twilight of the past of the blood system which his contemporaries made they pass us by in never ending procession. We who at the very time that he himself was pregnant with his have taken our stand by the entrance to the cavern of new ideas; for in a letter dated April 28, 1652, he says Acherusia17 as spectators of their lingering train, fail to recognize their features. Their voices have grown ‘With regard to the lacteal veins discovered by Aselli,.. thin and feeble across the gulf of time. Their footsteps I shall tell you freely, since you ask me what I think of sound hollow in our ears. And hovering about them them. I had already, in the course of my dissections, all is the deathly atmosphere of a vast house which I venture to say even before Aselli had published his none has lived in for a great long while. And whose book, observed these white canals,… But for various pineal gland18 is so calcareous that he would separate reasons, and led by several experiments, I could never the quick from the dead? In this hour which is for the be brought to believe that that milky fluid was chyle heart, not for the head, who does not echo the tender conducted hither from the intestines, and distributed words of Sir Thomas Browne, the beloved friend of to all parts of the body for their nourishment, but that many of us here tonight: it was rather met with occasionally and by accident, and proceeded from too ample a supply of nourish- The iniquity of oblivion blindly ment and a peculiar vigour of concoction… Although scattereth her poppy, and deals with there can be no question of the existence of the vessels the memory of men without distinction themselves, still I can by no means agree with Aselli in to merit of perpetuity.19 considering them as chyliferous vessels.!’

132 Osleriana Gaspare Aselli As is evident from a phrase in the Historia Animali- hand]. Bartolomeo Eustachio (1520-74) of Rome, a um, the Father of Learning appears to be the first to hero-wroshipper of Galen, [‘libro de vena azyga 1565 have seen lymphatic vessels in animals.20 He made opusc anat p280’ inserted in Bett’s hand] whose name no proper distinction between arteries, veins, and lym- we are pleased with a curious sense of irony to link up phatics, and it is tolerably certain that he never dis- with the auditory tube – a structure with which Alc- sected human bodies. The discovery of the lacteals is maeon of the Greek colony of Croton in Southern Italy usually attributed to Herophilus, the Father of Anato- had made anatomists familiar 1000 years before – in my, and to Erasistratus, the Father of Physiology. The 1563 discovered in the horse the thoracic duct or vena latter drew attention to the milky contents of certain alba thoracis, of which, however, he gives no figure. ‘arteries’ in young kids which had lately sucked, while In his description, he refers to the inferior enlargement the former traced their termination in the mesenteric of the duct which is now known in the anatomical lit- glands but he speaks of them as veins. The works of erature as the receptaculum chyli or cistern of Pecquet. both anatomists who are the glory of the Alexandrian There is no evidence that he recognised the true nature School of Anatomy have disappeared in the whirlpool of the duct which he says brings chyle to the heart. To of time but fragments can successfully be gleaned Nicolaus Steno or Stensen of Copenhagen belongs the from the Galenic writings. When Alexander the Great credit of having discovered the right lymphatic duct. died in the year 323, Egypt was usurped by his favourite general Ptolemy, who developed his capital Alex- Sir William Osler was fond of quoting Francis Dar- andria into one of the most flourishing cities on the win’s remark that in Science the credit goes to the man shores of the Mediterranean. His wonderful Library who convinces the world, not to the man to whom and museum constitute the first great medical school the idea first occurs.21 The truth of this observation of antiquity and the prototype of a modern University. is illustrated in the affairs and adventures of a man of Under his succesors, the intellectual fame of the city whom it is the fashion to speak as the discoverer of the reached its acme: it became the heart of the scientific lacteals. The year 1926 witnessed the terecentenary world. The memory of Herophilus of Chalcedon, a of the death of Aselli who, much against his will to be pupil of Praxagoras, is kept green among us by the sure, succeeded in convincing the world by rhetoric of term ‘torcular Herophili’ [‘confluens sinuum’ insert- mouth and pen and the sensational novelty of attrac- ed in Bett’s hand]. He made the first clear distinction tive coloured plates. His is the full credit. Yet to the between arteries and veins. He was a skillful obste- many he is but a name, dead and meaningless: while trician of who it was claimed that he is the first medi- the personal traits that made the man are buried with cal teacher in history to have had a woman pupil, one him in the grave. Upon his tombstone the cynic reads Agnodice. To him is attributed the aphorism ‘Drugs ‘Here lies one who for all the sweat of his brain has not [or Medicaments] are the hands of the Gods’. Of his taken the precaution of handing the coin to Charon to rival and younger contemporary Erasistratus of Chios ferry him across the river Styx22 to the Elysian Fields it is said that he came very near to a true conception of by giving his name to any part of the human fabric, the circulation of the blood. He regarded the heart as like those other anatomists whose doubtful immortal- the source of both arteries and veins and realized the ity is imprisoned in the mausoleum of an anatomical existence of the capillary system. The names of both eponym.’ are linked with the charge of dissecting living men. Galen [‘de usu part. Lib. IV ch19 de Heroph.’ inserted Take wings of fancy23 and travel with me to Cremo- in Bett’s hand], unable to confirm their observations na in Lombardy, enclosed by its mediaeval walls, rich on the lymphatics, dismissed them as gross delusions. in old churches. Founded by Romans in the infancy For wellnigh 2000 years the heavy hand of the Perga- of the third century B.C., its arteries were hardened mite stifled all thought. Vain to draw aside the curtain with age when the heart of our empire was just begin- of the Dark Ages. Vain to take up the tale until the hu- ning to pulsate. In the glorious heyday of grandeur man mind, vigorous and teeming, begins to rise out of and bliss, the emperor Vespasian in 70 A.D. breathed the slough of the Galenic depression. In the year 1532 upon the city the foul breath of destruction and in the Nicolaus Massa dramatically exploded the infallibili- twinkling of an eye changed this garden of Eden into ty of the Medial Pope by his description of the renal a howling wilderness. And for many a weary day its lymphatics [‘in libro introductorio anatom. Veneties. light of learning flickered almost to extinction. But 1536’ inserted in Bett’s hand], and the scientific world Time[,] the great Physician, has dealth kindly with its gaped with astonishment. In his footsteps followed fortunes. The fair names of Amati and Stradivarius24 Gabriele Falloppio (1523-62), the favourite pupil of have endeared it to the whole of the civilized world. It Vesalius at Padua, with an account of certain vessels is interesting to note in passing that the first record of terminating in the peripancreatic glands [‘in observat. a postmortem is linked with Cremona. The Franciscan Anat. libro de venis. Venetius. 1561’ inserted in Bett’s Salimbene of Parma in a chronicle dated 1288 writes

July 2019 133 W. R. Bett that a pestilence swept Italy in 1286 and that a phy- he recognized their nature. How this historic scene sician of Cremona opened a corpse to see if he could lives in the imagination. Picture a narrow band of find the cause of the disease. He could not. men with eager eyes staring at the dissected body of a dog, each in his own way expressing the feelings Within the walls of this historic city Gasparo Asel- uppermost in his mind. And among them a man still lio of Aselli (in Latin Asellius) was born in 1581, of in the full vigour of manhood, with a small beard, high patrician family, so one of his biographers, Cerioli, forehead, and calm, rather melancholy eyes [Figure assures us. Extremely scanty are the records of his 1]. Few words pass between them. Hearts are beat- life which may be said to be remarkable not so much ing anxiously. Suddenly the master shouts in triumph for its events as for its effects. Five lines are devoted ‘Eureka’, as a tiny prick with his scalpel brings forth to his memory in the Encyclopedia Britannica. His to his astonished circle a gush of white fluid just like personal history, more especially in his earlier years, milk from an ordinary looking nerve. That first look is wrapt in uncertainty. At an early age he served as on their faces must have been one of utter incredulity, Protochirurgo in the Royal army during the Cisalpine possibly of fear. What black magic was here enacted War, acquiring considerable skill as an operator. The before them? Astonishment gave way to awe and pro- greater part of his life he spent in Milan where he found joy. Here indeed was opened unto them a new taught anatomy privately and practised as a surgeon. world of whose existence no one before had dreamt. His practice seems to have been indeed lucrative, and And who could attempt to reproduce the feelings of the he enjoyed the confidence and esteem of many men, discoverer himself? What an inward light must have attaining fame among his fellows and favour among shone in his deepset eyes. His excitement was such the Senators, so that in due course there came to him that he could scarce control himself. One can hear the the freedom of Milan. For many years he occupied throbbing of his heart even across these years, beating the chair of Anatomy and Surgery in the Univeristy of like a drum. I venture to suggest in all humility – for I Pavia. He died in Milan April 24, 1626, at the early know full well that there is nothing easier in the world age of 45. [‘He was buried in the Church of St. Pistio than to entangle oneself in the snares of self-deceipt – Celestius in the chapel of the Tadino. His epitaph by that the word ‘Eureka’ which escaped Aselli in the hot his friends Settala & Tadino who were present at his monumental discovery movingly dwells on the sweet- ness of his character and his academic acheivements & erudition.’ Inserted in Bett’s hand at the end of the page]. It is a thankless task to attempt to give a portrait of this attractive personality, once so very living, his pen and tongue now forever idle. He was a learned man, a scholar steeped in the philosophy of antiquity. The one outstanding event in his life is his supposedly accidental discovery on July 23, 1622 in Pavia of the lacteals or venae lacteae as he called them in the mesentery of the dog. It is indeed significant how many of the epoch-making discoveries that are written in gold in the Annals of History are claimed to be the blind miscarriages of chance. Though to ‘see’ and to ‘observe’ are very close neighbours, yet their habitations are separated by a deep abyss spanned only by the bridge of genius.25 Aselli belongs to the post-Vesalian anatomists who from a study of comparative anatomy have enriched our knowledge of physiology, compar- itive and human.

To oblige some of his friends who had asked him to demonstrate to them the recurrent nerves, Aselli who appears to have been a very goodnatured and amiable personage, dissected a dog which had just been given a meal rich in fat. In the course of this investigation he came across the lacteals filled with chyle which at Figure 1: Gaspare Aselli (1581-1625); line engraving by first he mistook for nerves, but to his eternal glory he A. Locatelli. From the Wellcome Collection. (Image not conceived the idea of pricking them, when at once part of Bett’s original manuscript).

134 Osleriana Gaspare Aselli hour of triumph does not altogether support the idea of having laid hold of a very sharp scalpel, I pricked one accident but rather eloquently speaks of the agony of of those cords and indeed one of the largest of them. I untold nights spent in vigil, the shadow of an immense had hardly touched it, when I saw a white liquid like amount of plodding research, of inumerable sacrifices milk or cream forthwith gush out. Seeing this, I could of ease and pleasure. To the historically minded it is a hardly restrain my delight, and turning to those who pleasing temptation to quote the exact words in which were standing by, to Alexander Tadinus, and more par- a great master first annouced his discovery, or some ticularly to Senator Septalius, who was both a member great anatomist described the structure which has be- of the great College of the Order of Physicians and, come his monument more enduring than brass.26 The while I am writing this, the Medical officer of Health, language in which Aselli acquainted the world with his ‘Eureka’ I exclaimed with Archimedes, and at the same discovery is garrulous, it is true, but vivid and telling, time invited them to the interesting spectacle of such and adorned with a modesty uncommon to the time an unusual phenomenon. And they indeed were much in which he lived and moved and had his being.27 He struck with the novelty of the thing.”]28 produces a wealth of quotations in proof of the pre- tensions of the older writers to his discovery, Aristotle, Aselli also detected the presence of valves in the lacte- Herophilus, Erasistratus, and others. The atmosphere als and recognised that they prevented the backflow of around his book is thick with their memories and their chyle. To him the force which set up the current in the traditions. It may be truly writ that Aselli while en- lacteals seemed to be at least twofold: a vis a tergo29 gaged in deadly warfare with the spirit of Galen over supplied by the suction force of the liver. He further which he was never destined to triumph fought indeed believed that the lacteals themselves assisted in the with his mirror image. All the time he spoke the lan- propulsion of their contents. The suction force of the guage of Galen, and it was the voice of Galen tempt- liver he considered to be responsible for the emptying ing him. From his frequent qoutations it is possible to of the vessels which occurred on the death of the ani- make out a list of the books which he must have read. mal. He verified his discovery in many other animals, His writing gives us some idea of the man behind the demonstrating the existence of the chyliferous vessels scientist: it unsuccessfully conceals the treasures of in the dog, cat, lamb, cow, pig, and horse. Religious his mind. [‘quote from Michael Foster, History of considerations prevented him from verifying his dis- Physiology, 1924, 48’ written in Bett’s hand]: covery in living man. A strange perversity led him to spoil his magnificent observations. Pioneer as he [“On the 23rd of July of that year (1622) I had taken a was, Aselli was yet a child of his time. He ventured dog in good condition and well fed, for a vivisection forth from the womb of his period, but was not suf- at the request of some of my friends, who very much ficiently advanced to sever the umbilical cord which wished to see the recurrent nerves. When I had fin- chained him to the prejudices of the past. His wedded ished this demonstration of the nerves, it seemed good wife was that lovely creature, the new research, with to watch the movements of the diaphragm in the same the green years yet upon her: but the Galenic tradi- dog, at the same operation. While I was attempting tion was an exacting and alluring mistress with whom this, and for that purpose had opened the abdomen he shared a guilty bed. Galen taught that chyle was and was pulling down with my hand the intestines and conveyed from the digestive tract by the portal vein stomach gathered together into a mass, I suddenly be- to the liver there to be elaborated into venous blood held a great number of cords as it were, exceedingly and to be imbued with the natural spirits. This view thin and beautifully white, scattered over the whole of remained undisputed until the middle of the 17th cen- the mesentery and the intestine, and starting from al- tury. Even Vesalius did not venture to oppose it. In- most innumerable beginnings. At first I did not delay, fluenced no doubt by this misconception, Aselli whose thinking them to be nerves. But presently I saw that I respect for the ancients was unbounded and knew no was mistaken in this since I noticed that the nerves be- end, amounting almost to hero worship, claimed to longing to the intestine were distinct from these cords, have traced the lacteals to their termination in the liv- and wholly unlike them, and, besides, were distributed er; having entered the gateway of the liver, they lost quite separately from them. Wherefore struck by the themselves in the substance of that organ. A little novelty of the thing, I stood for some time silent while further observation would have convinced him of the there came into my mind the various disputes, rich in error of his ways, and it is a matter for regret that he personal quarrels no less than in words, taking place rested satisfied with the conclusions he had arrived at. among anatomists concerning the mesaraic veins and In his treatise he speaks of and figures the collection of their function. And by chance it happened that a few lymphatic glands situated in the mesentery of the dog days before I had looked into a little book by Johannes and other carnivora as the pancreas: whence arose the Costaeus written about this very matter. When I gath- term ‘Pancreas of Aselli’. ered my wits together for the sake of the experiment, He saw the lymphatic vessels of the liver but it is not

July 2019 135 W. R. Bett clear that he was able to distinguish between them and ‘Consultationes Medicae’ which among others contain the lacteals. This task was reserved for the Swedish an outline of the above two works. On Aselli’s jew- anatomist Olaus Rudbeck, Professor of Anatomy and els of knowledge the dust of neglect fell so that their Botany in the University of Upsala, who published bright spark became obscured and they lay forgotten his observations in his ‘Exercitatio anatomica exhi- in the sight of the world. Just as Galen had denied the bens ductus novos hepaticos aquosos et vas glandu- existence of the canals of Erasistratus and Herophilus, larum serosa, etc. Westeras, 1653; Leyde[n], 1654.’ so Jean Riolan and Harvey denied the existence of the Under the names ‘vasa serosa’ and ‘ductus aquosi’ lacteals of Aselli. His discovery remained an isolated he describes vessels like the lacteals in structure, but and barren fragment of knowledge for a quarter of a containing not milk or chyle but a clear watery liq- century. It was completed by the researches of [‘Jo- uid. These, the modern lymphatics, he saw first in the hann’] Vesling [‘of Minden’ inserted in Bett’s hand], liver and intestines and traced to the thoracic duct of Tulpius, Rudbeck, Ruysch, Wallee, and Pecquet. whose existence he says he knew in 1650 before Pec- quet had published his discovery. The researches of Jean Pecquet, the tercentenary of whose birth was cel- Aselli were published after his death by his two friends ebrated in his native town of Dieppe in 1922, is known Tadino and Settala or Septalius. The first edition ap- to fame as the discoverer of the receptaculum chyli, peared in Milan (Mediolani apud J.B.Bidelleum); De referred to in the French literature as the cisterne de Lactibus Sive Lacteis Venis, etc. Portrait. 4 plates. 4o Pecquet. He took his M.D. at Montpellier and prac- 1627, the year before the publication of the De Motu. ticed in Paris where in 1666 he became Membre de It may be regarded as certain that Harvey had not then l’Academie des Sciences. Apart from his anatomical seen it. The following editions may also be reffered to: preoccupations he seems to have delved also into poli- tics in his capacity of friend and medical adviser to the Basilae ex officina Henrici Petri, 1628,o 4 famous superintendent of finance, Nicolas Foucquet, Lugduni Batavorum ex officina Ioan. Maire, 1680,o 4 that great lover of books, who in his lifetime had little time for reading but promised himself the pleasure of Amstelodamii apud Ioh. Blaen, 1645, in Opera Omnia leisurely study in his old age when he would no lon- Adrian van der Spieghel. [‘1578-1625, c̅ comments by ger read a welcome in ladies’s eyes. He selected the Idr. Ant. n.d. Linden’ inserted in Bett’s hand]. learned Pecquet as his doctor that he might discourse The first edition is one of the most remarkable pro- with him about Physics and Philosophy. Pecquet ductions of the 17th century [Figure 2]. Among the shared his patron’s imprisonment for over three years. rarissima, it deserves to be bound in crushed levant Would not Pecquet always rhyme with Foucquet? Lat- and lettered in gold. What an education to glance at er he became the medical adviser of Madame de Sévi- its contents, its make-up. It may be claimed that it is gné who refers to him frequently in her letters. It is the first anatomical work with coloured illustrations: said of him that he drank himself to dWeath, dying at it contains four large multicoloured folding plates of the early age of 52. That gossipy chronicler Vigneul which the fourth figures the lacteals going into the liv- de Marville relates that after losing sight of him for er (lactearum in hepar insertio). Of these wood-cut several years he met him again in the country at the prints it may be said that though sensational they are house of a friend, and he goes on to say that his un- extremely effective [Figures 3 and 4]. In the later edi- certainty as to Pecquet’s identity was removed as soon tions these are replaced by much smaller copper plates as he came near enough to perceive the odour of his which are not coloured. This work of Aselli would breath. In 1649 while still a student he discovered in perhaps have fallen into oblivion if Pierre Gassendi a Molossian hound a double thoracic duct such as is of Paris with truly Oslerian genoristy30 which endears often met with in man, with communicating branches; him to the imagination had not bought a large num- [‘also the receptaculum chyli’ inserted in Bett’s hand]. ber of copies which he distributed widely. Without He shewed that Aselli’s lacteals pour their contents his book Aselli would be but a ghost. His published into this receptacle while the thoracic duct itself opens work is entirely anatomical [The MS. ‘Lectiones de into the venous system at the junction of the jugular Venis Lactis’ 1625 is kept in the Museo Civico at Pa- and subclavian veins, thus dealing the deathblow [to] via]. Barthelemi Curtius of Milan writes in his Notizie the Galenic theory that chyle passed via the mesentery Istoriche Interno a Medici Scrittori Milaneai, Milan, to the liver. This discovery which he verified in man 1718, that he left his manuscript notes on Toxicology was not accidental but the happy outcome of very [De Venenis] and on Surgery [Observationes Chirurgi- carefully planned experiments. His researches were cae] in the hands of his two friends already mentioned. published in 1651 in Paris ‘Experimenta Nova Ana- These have never been published and may be regarded tomica etc’. His discovery was met by much incre- as lost. In the Trivulziana Library in Milan are pre- dulity, especially on the part of Riolan who attacked served three large Mss. volumes by Aselli entitled Pecquet with considerable bitterness, suggesting that

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Figure 2: The title page of the first (1627) edition of Aselli’s masterwork describing his discovery of the lacteals – De Lac- tibus. This original copy is listed for sale online (AbeBooks.com) by a New York book seller (PrPh Books) for the price of 85,000 USD. (Image not part of Bett’s original manuscript).

July 2019 137 W. R. Bett

Figure 3: One of the original colour plates (plate II) in Aselli’s De Lactibus, showing the presence of engorged lacteals draining from the small bowel, alongside arteries and veins that are also suspended in the adjacent mesentery. From the Wellcome Collection. (Image not part of Bett’s original manuscript).

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Figure 4: Plate IIII in Aselli’s De Lactibus, erroneously showing the ‘chyliferous vessels’ (or lacteals) entering into the substance of the liver. As was later discovered, the lymphatic capillaries from the small bowel converge into larger vessels which drain through the receptaculum (or cisterna) chyli (of Pecquet) into the thoracic duct. From the Wellcome Collection. (Image not part of Bett’s original manuscript).

July 2019 139 W. R. Bett the dogs he had been dissecting had made him mad strangled, Dionis drove him home triumphantly in his [‘Responsio prima edita anno 1652 ad experimenta coach. nova anat. Joannis Pecqueti; Paris 1655’ inserted in Bett’s hand]. Riolan died in 1657; after his death, the Rudbeck had concluded from his researches that the opposition to Pecquet ceased. His observations were serous vessels exist throughout the body where they confirmed by the Danish anatomist Thomas Bartholi- form a special system. This attempt at generalisation nus: De lacteis thoracis, Hafniae, 1652; London, 1653; was confirmed and amplified by Bartholinus and an and by van Horne of Leyden [1621-1670]. Englishman named Jolyff [‘Jolive Joyliffe’ inserted in Bett’s hand]. The serous system of Rudbeck has The lymphatic valves were carefully studied by Freder- become the lymphatic system. The lymphatics have ick Ruysch and Swammerdam of Amsterdam who just had an adventurous history, spoiled only by those mis- before his death in 1680 in a fit of melancholy burnt erable priority claims which betray the absence of true all his papers. The lacteals were first demonstrated historical perspective. Now their origin, course, and in man by Nicolaus Claudius Fabricius De Peirescius termination in man’s body in Bland-Sutton’s words is in 1634 and again by Petrus Dionis in a ‘false coyner’ as palinly depicted in textbooks as roads are delineat- who one and a half hours before execution had been ed on motormaps. treated to a very substantial meal. As soon as he was Walter R. Bett [Signed]

Notes

1. The ‘horn of plenty’ or Cornucopia (from Latin ‘cornu’ for sician based in Yorkshire who famously wrote on the curative horn, and ‘copiae’ for abundance/plenty) is a mythological properties of the mineral waters at Scarborough (Scarbrough symbol of endless nourishment, most often associated with the Spaw, or, A description of the nature and vertues of the spaw classical Greek aition (or aetiological myth) regarding Zeus’ at Scarbrough in Yorkshire. London,: Printed for, and are to be foster-mother Amalthea, a divine nourishing goat who suck- sold by Charles Tyus, at the three Bibles on London Bridge, led Zeus in his infancy and protected him from his devouring and by Richard Lambert in York, neer the Minster, 1660). father Cronus. (Grueber HA. The Myths of Greece & Rome. 4. Lithopaedion, literally ‘stone baby’, refers to a calcified ab- London: George G. Harrap & Co. Ltd., 1944, p. 16). When dominal ectopic pregnancy. Rarely, when a fetus dies outside Zeus accidentally severed one of Amalthea’s horns during the uterus and is too large to be reabsorbed, it is warded off playtime, it transformed into a magical ‘Horn of Plenty’, pro- by the mother’s immune system through the formation of a viding nymphs and others with abundant sustenance. (Danet calcified granuloma which then becomes a ‘lithopaedion’. A P. A Complete Dictionary of the Greek and Roman Antiquities. lithopaedion may persist for many years undetected. London: John Nicholson At the King’s Arms in Little Britain, 5. From the 1609 Shakespearean tragedy Troilus and Cressida, 1700, [unpaginated], under the entry ‘AMALTHÆA’). Bett’s where the Greek slave Thersites insults Ajax the prince as fol- reference to ‘the post-man’s horn of plenty’ as an endless lows (Lines 925-930, Act II, Scene I – The Grecian Camp.): source of books for his Library will be appreciated by many “Lo, lo, lo, lo, what modicums of wit he utters! his evasions bibliophiles. have ears thus long. I have bobbed his brain more than he has 2. The Caxton Head Catalogue periodically advertised rare items beat my bones: I will buy nine sparrows for a penny, and his sold by one the most famous book sellers in London – the firm pia mater is not worth the nineth part of a sparrow. This lord, of James (1850-1926) and Mary Lee Tregaskis (1854-1900) – Achilles, Ajax, who wears his wit in his belly and his guts in initially located at 232 High Holborn Street, ‘at the sign of the his head, I’ll tell you what I say of him.” (Shakespeare W. The Caxton Head’. The firm later moved to 66 Great Russell Street Works of William Shakespeare. London: Ward, Lock & Co., and traded under the name of James Tregaskis & Son. For Limited, [undated], p. 922). many years one of the most lucrative book dealers in London, 6. Akin to Osler’s writings, Bett was fond of utilising biblical the firm was very popular amongst book collectors, until it was literary references in his works. Compare Bett’s remark to finally closed around 1934. the following verses: “For ye have the poor with you always, 3. Wittie R. Pyrologia mimica, or, An answer to hydrologia chy- and whensoever ye will ye may do them good: but me ye have mica of William Sympson, phylo-chymico-medicus in defence not always.” [Mark 14:7, (KJV)]; “You will always have the of scarbrough-spaw: wherein the five mineral principles of poor among you, but you will not always have me.” [Matthew the said spaw are defended against all his objections by plain 26:11, (NLT); John 12:8 (NLT)]; “For the poor shall never reason and experiments, and further confirmed by a discovery cease out of the land: therefore I command thee, saying, Thou of Mr. S. his frequent contradictions and manifest recanta- shalt open thine hand wide unto thy brother, to thy poor, and to tion: also a vindication of the rational method and practice of thy needy, in thy land.” [Deuteronomy 15:11 (KJV)]. physick called galenical, and a reconciliation betwixt that and 7. In Classical mythology, the Pillars of Hercules – the promon- the chymical: likewise a further discourse about the original tories that flank the entrance to the Strait of Gibraltar – rep- of springs/ by Robert Wittie. London: Printed by T. N. for J. resented the farthermost limits of Hercules’ western travels. Martyn, 1669. Robert Wittie (1613-1684) was an English phy- (Danet P. A Complete Dictionary of the Greek and Roman

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Antiquities. London: John Nicholson At the King’s Arms in spectfully complies with the multi-course imaginary feast Little Britain, 1700, [unpaginated], second page under the en- and is hence rewarded with a real feast: “you have had the try ‘HERCULES’). According to Renaiscance tradition, the complaisance to accommodate yourself to my humour, and the pillars were inscribed with the warning Non plus ultra, mean- patience to carry on the pleasantry to the end; but we will now ing ‘nothing further beyond’. Osler made a similar reference eat in reality.” (Forster E. The Arabian Nights, In Five Vol- in his famous May 1889 parting address – Aequanimitas – to umes, Vol. II. London: William Miller, 1810, pp. 295-307, The medical students at the University of Pennsylvania: “One History of the Barber’s Sixth Brother. Qoutation from p. 304). might have thought that in the premier school of America, in 15. From ‘The Epistle Dedicatory’ to Henry Wadsworth Long- this Civitas Hippocratica, with associations so dear to a lover fellow’s (1807-1882) first major work of prose Outre-mer: of his profession, with colleagues so distinguished, and with A Pilgrimage Beyond the Sea (1835): “Worthy and Gentle students so considerate, one might have thought, I say, that the Reader, I dedicate this little book to thee with many fears and Hercules Pillars of a man’s ambition had here been reached. misgivings of heart. Being a stranger to thee, and having nev- But it has not been so ordained, and to-day I sever my connex- er administered to thy wants nor to thy pleasures, I can ask ion with this University.” (Osler W. Aequanimitas and Other nothing at thy hands, saving the common courtesies of life. Addresses, etc. Philadelphia: P. Blakiston’s Son & Co., 1904, Perchance, too, what I have written will be little to thy taste; – p.11.) for it is little in accordance with the stirring spirit of the present 8. Bett is reffering to William Harvey’s (1578-1657) immortalDe age. If so, I crave thy forbearance for having thought that even Motu Cordis which was first printed in 1628: Harvey W.Exer- the busiest mind might not be a stranger to those moments citatio Anatomica de Motu Cordis et Sanguinis in Animalibus. of repose, when the clock of time clicks drowsily behind the Francofurti: Sumptibus Guilielmi Fitzeri, 1628. door, and trifles become the amusement of the wise and great.” 9. From Sir Thomas Browne’s (1605-1682) Religio Medici (Longfellow HW. Outre-mer: A Pilgrimage Beyond the Sea. (1643): “As for those wingy mysteries in divinity, and airy Boston: Ticknor and Fields, 1846, p. 7). subtleties in religion, which have unhinged the brains of better 16. [Jeremiah 22:19 (ASV)]: “He shall be buried with the burial of heads, they never stretched the pia mater of mine.” (Browne an ass, drawn and cast forth beyond the gates of Jerusalem.” T. Religio Medici, A Letter to a Friend, Christian Morals, 17. In Classical mythology, the cavern of Acherusia refers to Urn-Burial and Other Papers. Boston: Ticknor and Fields, a cave which was situated near the city of Heraclea in the 1862, Part I, Sect IX, p. 20). Osler often referred to the same Acherusian Peninsula (also known as the Promontory of saying, most notably in his opening remarks to his Ingersoll Tænarum in Laconia) that was believed to serve as an entrance lecture on Science and Immortality. to the Underworld. It was the same cavern through which Her- 10. Hippocrene, literally ‘Horse’s Fountain’, refers to a sacred cules dragged Cereberus (the three-headed hound) as his final mythological spring on Mt Helicon formed by the hooves of of twelve labours. Cereberus then became the guardian to the Pegasus. The fountains were consecrated to the Muses who underworld and prevented the dead from leaving. (Lempriere imbibed its waters for poetic and literary inspiration. (Danet J, Park W. Bibliotheca Classica. London: Thomas Tegg & P. A Complete Dictionary of the Greek and Roman Antiquities. Son, 1838, p. 429, under the entry ‘MARIANDȲNI. See also: London: John Nicholson At the King’s Arms in Little Britain, Grueber HA. The Myths of Greece & Rome. London: George 1700, [unpaginated], under the entry ‘HIPPOCRENE’ and on G. Harrap & Co. Ltd., 1944, p. 95-96). the second page under the entry ‘MUSÆ’). 18. The pineal gland was the seat of soul according to Rene Des- 11. From John Milton’s (1608-1674) Paradise Lost (1667) (Book cartes (1596-1650), who wrote in his correspondences: “My II, lines 572-581): view is that this gland is the principal seat of the soul, and the place in which all our thoughts are formed. The reason I “That dismal world, if any clime perhaps believe this is that I cannot find any part of the brain, except Might yield them easier habitation, bend this, which is not double. Since we see only one thing with Four ways their flying march, along the banks two eyes, and hear only one voice with two ears, and in short Of four infernal rivers, that disgorge have never more than one thought at a time, it must necessarily Into the burning lake their baleful streams; be the case that the impressions which enter by the two eyes Abhorred Styx, the flood of deadly hate; or by the two ears, and so on, unite with each other in some Sad Acheron of sorrow black and deep; part of the body before being considered by the soul. Now it Cocytus, named of lamentation loud is impossible to find any such place in the whole head except Heard on the rueful stream; fierce Phlegeton⁠ this gland; moreover it is situated in the most suitable possi- Whose waves of torrent fire inflame with rage.” ble place for this purpose, in the middle of all the concavities; and it is supported and surrounded by the little branches of the (Milton J. Paradise Lost, A Poem, in Twelve Books. Boston: carotid arteries which bring the spirits into the brain.” – 29th Timothy Bedlington, 1820, pp. 41-42). January 1640 (Cottingham J, Stoothoff R, Murdoch D, Kenny 12. Bett is here referring to the Linacre-Harvey-Sydenham trip- A. The Philosophical Writings of Descartes, Vol. III: The Cor- tych that hung in William Osler’s office in Baltimore and lat- respondence. Cambridge: Cambridge University Press, 1991, er Oxford. The portraits were inscribed with Osler’s ‘noble p. 19-20). triumvirate’ Litterae (Letters, under Linacre), Scientia (Sci- 19. From Thomas Browne’s (1605-1682) Hydriotaphia Urne ence, under Harvey), and Praxis (Practice, under Sydenham). Buriall. London: Printed for Hen. Brome at the Signe of the (Cushing H. The Life of Sir William Osler: Vol. 1. Oxford: At Gun in Ivy-Lane, 1658. p. 27. The Clarendon Press, 1925, Ch. XVII, p. 444.) 20. According to Sir D’Arcy Wentworth Thompson’s (1860-1948) 13. Moloch, or Moloc, was a Caaninite diety – God of the Am- translation of the Historia Animalium, Aristotle makes the fol- monites – to whom children were sacrificed in the Valley of lowing references to ‘lymph’: “In sanguineous animals the Tophet. (Danet P. A Complete Dictionary of the Greek and homogeneous or uniform part most universally found is the Roman Antiquities. London: John Nicholson At the King’s blood, and its habitat the vein; next in degree of universality, Arms in Little Britain, 1700, [unpaginated], under the entry their analogues, lymph and fibre…” (Book I, Part II); “The ‘MOLOC’). The Australian thorny dragon – Moloch horridus ines (or fibrous connective tissue) are a something -interme – derives its name from the same source. diate between sinew and vein. Some of them are supplied 14. This is a reference to a tale in the Arabian Nights in which with fluid, the lymph; and they pass from sinew to vein and a Parmecides elder (also Barmecides) treats a visiting slave from vein to sinew.” (Book I, Part VI). (Smith JA, Ross WD, named Schacabac to an imaginary banquet. Schacabac re- Thompson DW. The works of Aristotle, translated into En-

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glish… Volume IV. Historia animalium, by D’Arcy Wentworth my later life, was the discovery of the Trichina spiralis. Dr. Thompson. Oxford: At The Clarendon Press, 1949, p. 511 & Cobbold has told the story of the several steps leading to the 515). According to Loukas et al: In the fourth century B.C., discovery and following it, in his latest work on the Entozoa. Aristotle incisively described, ‘‘fibers which take a position My share was the detection of the ‘worm’ in its capsule; and I between blood vessels and nerves and which contain a color- may justly ascribe it to the habit of looking-out, and observing, less liquid.” [Loukas M. Bellary SS, Kuklinski M et al. The and wishing to find new things, which I had acquired in my pre- lymphatic system: a historical perspective. Clinical Anatomy. vious studies of botany. All the men in the dissecting-rooms, 2011; 24(7): 807-16]. teachers included, ‘saw’ the little specks in the muscles: but I 21. The full quote is from Francis Darwin’s (1848-1925) inaugural believe that I alone ‘looked-at’ them and ‘observed’ them: no February 1914 Galton Lecture: “In science the credit goes to one trained in natural history could have failed to do so.” (Pag- the man who convinces the world, not to the man to whom the et J, Paget S. Memoirs and Letters of Sir James Paget, edited idea first occurs. Not the man who finds a grain of new and by Stephen Paget, one of his sons. London: Longmans, Green, precious quality but to him who sows it, reaps it, grinds it and and Co., 1901, p. 55). Bett himself wrote on Paget’s discovery feeds the world on it.” [Darwin F. Francis Galton, 1822-1911. of Trichina spiralis in 1928: Bett WR. The discovery of Tri- The Eugenics Review. 1914; 6(1): 1-17]. Osler was fond of china spiralis. St Bartholomew’s Hospital Journal, 1928; 36: quoting this statement and it is included in his collected aph- 39-42. orisms. (Bean RB, Bean WB. Sir William Osler, Aphorisms 26. Taken from the Odes of Horace: ‘Exegi monumentum aere pe- From his Bedside Teachings and Writings. New York: Henry rennius’, meaning: “I have erected a monument more lasting Schuman, 1950, p. 108, Aphorism No. 221). than bronze.” (Horace, 23 B.C., Odes III: XXX, line 1). Read- 22. In Classical mythology, Charon was the ‘ferryman of the dead’ ers will note that this is also the chosen motto of the William who, for the price of a single coin, would transfer the souls of Osler Society of Australia and New Zealand (WOSANZ). the newly deceased across the river Styx (Grecian mythology) 27. Compare to William Osler’s closing statement in his 1894 or Acheron (Roman mythology) to the realm of the dead. For Wistar Institute oration on The Leaven of Science: “Within the this reason, the Greeks would bury their dead with a single bounds of this campus these influences will lead successive obolos coin on their tongues. (Grueber HA. The Myths of generations of youth from matriculation in the college to grad- Greece & Rome. London: George G. Harrap & Co. Ltd., 1944, uation in the special school, the complex, varied influences of p. 96). Art, of Science, and of Charity; of Art, the highest develop- 23. From In Memoriam (1850), Section LXXVI, by Alfred Lord ment of which can only come with that sustaining love for Tennyson (1809-1892): ideals which, ‘burns bright or dim as each are mirrors of the fire for which all thirst;’ of Science, the cold logic of which “Take wings of fancy, and ascend, keeps the mind independent and free from the toils of self-de- And in a moment set thy face ception and half-knowledge; of Charity, in which we of the Where all the starry heavens of space medical profession, to walk worthily, must live and move and Are sharpen’d to a needle’s end ; have our being.” (Osler W. The Leaven of Science; Address delivered at the opening of the Wistar Institute of Anatomy Take wings of foresight; lighten thro’, and Biology of the University of Pennsylvania, May 21, 1894. The secular abyss to come, University Medical Magazine, 1893-1894; vi: 573-586). And lo, thy deepest lays are dumb 28. The original quote is not included in Bett’s transcript but con- Before the mouldering of a yew ;” sidering his reference to a ‘quote’ from Michael Foster’s His- tory of Physiology, it seems likely that Bett read the original ([Macmillan and Co., Limited]. The Works of Alfred Lord translation out during his presentation. Quote sourced from: Tennyson, Poet Laureate. London: Macmillan and Co., Lim- Foster M. Lectures on the History of Physiology during the ited, 1909, p. 266). sixteenth, seventeenth, and eighteenth centuries. Cambridge: 24. Amati and Stradivarius were two famous Italian families of At the University Press, 1901, Lecture II, pp. 49-50. It is noted violin makers who were based in Cremona in the sixteenth and the Bett quoted from the second (1924) edition of this work. seventeenth centuries respectively. 29. Derived from Latin works, the term ‘vis a tergo’ literally 25. This idea is drawn from a statement made in Sir James Paget’s means ‘a force acting from behind’. The term was often used (1814-1899) autobiographical memoirs concerning his discov- nd by medical authors describing the heart as ‘a pushing or accel- ery of the nematode parasite Trichenella spiralis on 2 Feb- erating force’ upon the circulating blood. ruary 1835 during his first year in medical school: “Another 30. William Osler was fond of donating rare medical books to li- event, in this first year’s study, which had some influence on braries.

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