Osler's legacies to dermatologists.

A century ago, Dr William Osler was the best-known physician in the world. Although not yet Sir William, an honor bestowed in 1909, his encyclopedic Principles and Practice of Medicine of 1892 had been translated into many languages and was to see several further editions. Meanwhile, his fame as a teacher, speaker, essayist, educational administrator, clinical investigator, medical consultant par excellence, kind and wise mentor and friend, humanist, bibliophile and collector, practical joker, and loving family man had made him a legend when he was barely 40 years old. A native of Canada, who at the age of 35 came to the United States for 21 years and then moved to England for the final 14 years. Osler's stunning list of achievements continued until his death in 1919 and has since become a myth in its magnitude, aided substantially by the 1925 Pulitzer-prize-winning, huge, and adoring biography by his student and acolyte, Harvey Cushing. Today, dermatologists can recite the cutaneous signs of Cushing's disease, but may be less secure in stating (or, more importantly, identifying) a variety of lesions associated with Osler's name. This article reviews those lesions which commemorate the name and dermatologic contributions of this great physician. In addition, other contributions and important personal characteristics that justify keeping his memory alive are discussed.

Preclinical science course "preludes" taken by premedical students: do they provide a competitive advantage?

BACKGROUND: Premedical students often elect advanced science courses whose content will reappear during preclinical courses. Are such "preludes" useful? METHOD: The study participants were the 176 first-year students entering the University of Iowa College of Medicine in 1992. Their grades in medical school courses in biochemistry, gross anatomy, histology, physiology, and microbiology were compared with their grades in similar premedical courses. RESULTS: The students who had taken a premedical prelude in advanced science performed no better than their classmates except in biochemistry, where the 118 students (67%) with prior biochemistry exposure had a significantly higher mean score (96.3 vs 87.6, p < .0001 using Student's t-test). A biochemistry prelude appeared to benefit all students, especially those from minorities underrepresented in medicine. In addition, among the 13 students who failed biochemistry in medical school, a number of them had low grades in organic chemistry and had not taken a premedical course in biochemistry. To test the replicability of the findings, an analysis was undertaken of the biochemistry performances of the 162 students who had entered in 1991, and again a significant difference was found between the students who had and those who had not taken a biochemistry prelude. CONCLUSION: A premedical biochemistry course, required by only two schools in 1995-96, appears advantageous, especially for students with weak academic preparation. Lack of such benefit from other preludes suggests that premedical students might better choose electives in arts and humanities to enhance their educational breadth.

How fingerprints came into use for personal identification.

The use of fingerprints for personal identification became widespread early in this century. How the fingerprints slowly became standardized involves many persons, including Nathaniel Grew, Johannes Purkinje, William Herschel, Henry Faulds, Charles Darwin, Francis Galton, Mark Twain, Juan Vucetich, Edward Henry, and J. Edgar Hoover. Although fingerprints have been noted and used since antiquity, a 25-year burst of activity that secured adoption of their use for identification began in about 1880. New modifications and applications have continued to the present. The history of fingerprints offers an excellent example of how society adopts innovations. This story also includes a bitter struggle for appropriate credit for various crucial steps in developing and adopting this important tool. More recent technical advances, including computers and molecular biology, now supplement the ease and usefulness of fingerprints, although the word fingerprinting continues in use by metaphoric extension.