Robert carried with him in his medical bag, and in his heart, the words and teachings of his own medical heroes. My blog post of January 13, 2016, about Antiseptic Surgery  described the life changing work of Dr. Joseph Lister. Throughout the years of Robert's medical practice, and sometimes against resistance in the early years of pioneer medicine, he insisted on absolute cleanliness in his surgery and on the wards. This insistence, with its favourable results in lives saved after surgery, was a most important factor in Robert's success as a medical man.

Another  of his medical heroes was Sir William Osler.  Born in 1849, Osler was a Canadian physician who became a Professor of Medicine at McGill University in Montreal. He made many important contributions to medicine, but his own "top three" were the following:

First, he insisted that medical students would learn as much from talking to and listening to patients as they would from classroom teaching. This idea was revolutionary at the time.

Second, along with insisting that his students must know their patients, Osler  also established medical residencies. This meant that the doctors in training spent a large percentage of their time working and learning on the wards  under the close supervision of resident doctors.

Third, and this was considered by Osler to be his most important contribution,  was his idea of clinical clerkships...third and fourth year students (interns) worked directly with their own patients on the wards.

Osler greatly reduced the role of didactic lectures and insisted on bedside teaching. One of his most quoted remarks is,"the doctor who studies medicine without books sails an uncharted sea,  but the doctor who studies medicine without patients does not go to sea at all." 

Robert echoed the words of his hero in his oft stated belief that..."the science of medicine can be learned from textbooks, but  diagnosis is an art that can only be learned from time spent with patients."

To learn more about Sir William Osler, go to;
http://www.oslersymposia.org/about-Sir-William-Osler.html

Today, in 2016, researchers all over the world are searching for a vaccine for the latest virus to plague humanity...Zika. But disease causing viruses have existed for as long as humans have lived, and probably before that. A virus is an infectious agent that can only replicate itself within the living cells of another organism. It is too small to be seen, even with light microscopy, but at least 1000 years ago, Chinese scientists knew that something too small to be seen was causing infections and death.

There are at least 15 diseases for which vaccines are effective and recommended: Yellow fever, rabies, polio, tuberculosis, cholera, mumps, measles, diphtheria, and influenza, to name some of them.
 
Probably the most famous vaccination discovery was William Jenner's late 19th century discovery and development of a vaccine for small pox. Originally inoculation was used, but Jenner discovered a more effective method of immunization through the use of a vaccine. This vaccine was well known when Robert graduated from Queen's in 1908, as vaccination for small pox was compulsory in England from 1853 onward, and spread to other countries, thus eventually wiping out the scourge of small pox. It is estimated that before small pox vaccinations were instituted, this deadly virus killed 300 million people worldwide. Since the vaccine was developed from cowpox, perhaps the term "herd immunity" originated here?  "Herd immunity" is very important as it means that when the vast majority of a population is immune, the virus cannot replicate itself and spread.

While there has been some controversy surrounding vaccines in recent years, people tend to forget what a difference vaccines have made to our lives. Small pox is gone, and how often do you now hear about typhoid fever in developed countries? The first vaccine for typhoid was developed in 1896, but many physicians recognized that a lessening of typhoid epidemics could also be achieved by insisting on a clean, uncontaminated water supply. Robert campaigned ceaslessly for this, but knew that the vaccine was also invaluable.

​Diphtheria was another disease with which he had to deal.  It is almost never heard of now that the vaccine exists. It was first developed in 1923, and gradually perfected.

In 1927, a vaccine for tuberculosis arrived on the scene. We don't think too much about TB these days, but it was very prevalent in the early part of the 20th century, so Robert and other physicians of the time were grateful for this vaccine. And, unlike small pox, TB has not been eradicated and could come back. Remember what a vaccine does is make your immune system strong enough to fight off specific viruses....and thus prevent them from replicating within your living cells and spreading to others who have not been immunized..
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The power of the tiny virus is astonishing. Can you imagine yourself living in a world without vaccines to prevent and combat these killers?

To learn more about viruses go to:  http://www.news-medical.net/health/Virus-History.aspx

For as long as humans have lived, the why and how of our heartbeats have puzzled scientists , researchers, and medical men.  About 400 hundred years ago,  William  Gilbert, physician to Queen Elizabeth the First of England, introduced the term "electra" to the mysterious force that caused and regulated the heartbeat.

Fast forward  to the present day when sophisticated electrocardiograms are an invaluable clinical tool. Over the centuries, many, many physicians, scientists and inventors have built on one another's discoveries to develop this machine that we take for granted today.

The first recorded electrocardiogram was taken in 1817, and by 1905, Willem Einhoven of Germany  was able to transmit ECG results over a telephone cable. In  1911, Thomas lewis published his classic textbook, "The Mechanism of the Heartbeat".  By 1913 the ECG had become an important diagnostic tool in the hands of an American physician, Dr, Paul Dudley White, and in the 1920's, Einhoven won a Noble prize for his work in developing the electrocardiogram much as we know it today.  A related device, the pacemaker, was developed in 1926. It is interesting to note that it was a very controversial invention at the time, opposed by some on religious grounds as its use extended human life. 

​In 1949, a portable ECG machine called the Holter monitor was invented. In its initial version it weighd 76 pounds.