Did Sir William Osier Have Carcinoma of the Lung? – The Rumor and its Origin

CarcinomaIn the summer of 1971 a story was going the rounds of the North American continent, which soon crossed the Atlantic, that Sir William Osier was a heavy smoker and had died, not from empyema, but from carcinoma of the lung. The stage was set for a Tonypandy phenomenon, so called by Josephine Tey after a notorious nonevent during the 1910 Welsh coal strike and defined by her as “a completely untrue story grown to legend, while the men who knew it to be untrue looked on and said nothing.” The unravelling of this Oslerian rumor proved more complex than had been expected.

Sir Richard Doll was appointed Regius Professor of Medicine in the University of Oxford on February 13, 1969. A week later he was speaking at the Royal Northern Hospital on “Unwanted Drug Effects.” After the lecture, the Dean, Dr. D. G. James, an able physician and ebulient medical historian, gave Doll a photograph of the Osiers in the garden of the “Open Arms,” 13 Norham Gardens, for Sir Richard would be the second Regius to enjoy Osiers benefaction by residing there. The picture showed Osier holding a cigarette, and Dr. James, recalling that Osier had died from complications of pneumonia, and Doll’s interest in the association of lung cancer and smoking, raised the question as to whether a pulmonary neoplasm had been the real cause of his death; so the seed was sown. Of course Gerry James, as President of the Osier Club, should have known Osier’s medical history better, but it is his uninhibited Cymric exuberance that is so endearing.

Two years later the Regius Professor had a visit from Mr. G. S. T. Cavanagh, the Director of the Medical Center Library of Duke University, and it was not surprising that the conversation turned to the carcinogenic effect of tobacco, for James Buchanan Duke’s munifenee was derived from the tobacco fields of North Carolina and in certain quarters in Durham the views of Berkson are preferred to those of Hal Dom.

While discussing the statistical evidence, Sir Richard suggested that if Osier’s lungs had been affected by his smoking habits, mentioning that many photographs showed him with a cigarette, this might not have been recognized at his death, as pathologists in the 1920s were relatively unfamiliar with the appearances of bronchial neoplasms. One could not expect the Regius to be an authority on Oslerian iconography or aware that the picture which Dr. James had given him was very unusual, for of the numerous photographs of Osier in the Osier library at McGill, there are only five which clearly show him smoking; in each he is holding an oval cigarette in the negligent way customary in the days when, at most, a cigarette might be smoked after a meal. On the second point it is true that there was confusion between mediastinal lymphosarcoma and oat cell carcinoma of the bronchus until 1926 when Barnard’s paper appeared, but pathologists had no difficulty in recognizing lung cancer, though it was not until the 1920s that questions arose as to its increased frequency. Be healthier with well-qualified remedies of My Canadian Pharmacy (learn more about My Canadian Pharmacy).

Naturally, Mrs. Cavanagh sent home an account of her stay in Oxford, the visit to 13 Norham Gardens and Sir Richard’s casual remarks about Osier; of course one of the letters went to Wilburt C. Davison, in his 79th year, living in retirement in Durham, a little remote, from the medical school which he had created but as ardent an Oslerian as ever. His unswerving devotion stemmed from that day early in Michaelmas term 1913 when, as a young Rhodes Scholar with a problem, he hesitatingly approached the “Open Arms” to be greeted by a Regius who not only resolved his difficulties in a typical Oslerian manner, but watched over the “young colt” from Grand Rapids, Michigan, persuading the JAMA to publish his papers, though he was still an undergraduate, just as he encouraged the Radcliffe Infirmary to appoint Davison as a casualty house officer two years before he graduated. Furthermore it was a letter of commendation which Osier wrote in 1918 that caused Davison to be selected as Dean of Duke University 20 years later.

It was not very surprising that Dave sent Mrs. Cavanagh’s news to his Oslerian cronies, but the facets had been published, so that the Regius’ casual remark became a definite statement, “Sir Richard Doll, the new Regius Professor of Medicine at Oxford, who is an authority on lung cancer and smoking, told a friend of mine last week that Sir William died of lung cancer and that he was a heavy smoker.” So the myth developed, but what are the facts?

See also “Did Sir William Osier Have Carcinoma of the Lung? My Canadian Pharmacy Gives Explanations“.