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[10th October 1879]

To Dr. William Osler

Institutes of Medicine,

McGill University,

Montreal

Dear Will,

I look forward to your imminent arrival. Here in London our committee has been hard at work, and we excitedly await those attending the Annual Meeting. Please note we commence at 10 o’clock on the 16th, and your anatomical demonstration will be the first of two morning presentations. I warn you now that Buller follows you with a talk on pilocarpine in iritis — brace yourself!

And now on to a serious matter. The spread of tuberculosis is a current concern at the Asylum. At present, three of our patients have suspected cases, one of whom is a young man whose condition worries me greatly. His name is Thomas Darwin, the youngest son of England’s celebrated Charles Darwin.

Thomas’s story is a sad one. Travelling alone, he was admitted under Warrant to our Asylum just over three months ago and, though slightly malnourished, presented as physically well. In conversation, however, he was deluded on the most peculiar of matters, all confined in some way to eating utensils. Though now more settled, his odd beliefs persist. Yet he has worked well in the gardens, and the attendants have come to respect his courteous and eloquent presence with us.

One week ago, Thomas’s breathing became more rapid. Now febrile, he refuses almost all nourishment and barely rises from his bed. Although in obvious discomfort, he speaks only of forks and knives and spoons. We have tried analgesics and sedatives — I fear prayer is next.

If your schedule allows, I would be grateful if you would examine Thomas while in London. One opportunity may be the following — at the conclusion of Buller’s lecture, we will depart en masse to the Asylum for lunch. Afterwards, I have asked Sippi to lead the members on a tour of the grounds and, if time allows, an inspection of one or two wards. We might then part from the group in order to assess Thomas. He is now in one of the Cottages, and we could rejoin the meeting once the afternoon session begins. Your diagnostic opinion and treatment recommendations would be thankfully received — no doubt by the Darwin family as well.

In closing, please apprise us of any needed assistance with respect to lodging. A reminder — reduced railway fares are available to members of the Dominion Medical Association. Finally, I would be remiss if I did not indicate my profound respect for your work and its influence on my recent publication, which I have sent by separate post. We are truly fortunate to have your expertise in our midst!

Yours most sincerely,

Richard M. Bucke

Medical Superintendent

London Asylum