American Medical Biographies/Stillé, Alfred

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1826355American Medical Biographies — Stillé, Alfred1920William Osler

Stillé, Alfred (1813–1900)

Born October 30, 1813, the son of John and Maria Wagner Stillé, early Swedish immigrants, Dr. Stillé began his lifework with the generation which saw the new pathology and the new clinical methods. After joining in the "conic section" rebellion at Yale, which led to the retirement of one-half of the class, he seems to have had for a time a leaning toward the law. "During the years of probation," he says, "I tested the strength of my partiality for a medical career by some medical reading, including Bell's "Anatomy" and Bichat's "General Anatomy." and attending the anatomical instruction at the Jefferson Medical College, He took an A. B. at Yale in 1832 and at the University of Pennsylvania the same year, and the latter institution gave him an A. M. in 1835, M. D. in 1836 and LL.D. in 1889.

The best of luck awaited him when, in 1835–36, he became house physician at "Blockley," under W. W. Gerhard (q. v.), a clinical teacher of the very first rank, and fresh from the wards of the great French physician, Louis.

While still a medical student two of his fellow-townsmen returned from abroad glowing with the fire they had caught in Paris, the then acknowledged center of medical science. Gerhard and Pennock (q. v.) were the apostles of the school of observation under whose preaching he became a zealous convert and, as soon as it was possible, hastened to the enchanted scene of their European labors.

Method and accuracy were from the first characteristic of Dr. Stillé's work. He played an interesting part in that splendid contribution of American medicine to the differentiation of typhus and typhoid fever. I will let him tell the story in his own words. In a manuscript he says: "The year 1836 is memorable for an epidemic of typhus (t. petechialis) which prevailed in the district of the city which is the usual seat of epidemics caused or aggravated by crowding, viz., south of Spruce and between Fourth and Tenth Streets. A great many of the poor creatures living in that overcrowded region, who were attacked with typhus, were brought to the Philadelphia Hospital, where I had charge of one of the wards assigned to them. I had the great good fortune to study these cases under Dr. Gerhard. His permanent reputation rests upon the papers published by him in Hays' Journal, in which he fully established the essential differences between this disease and typhoid fever. Every step of my study of typhus in the wards and post-mortem revealed new contrasts between the two diseases, so that I felt surprised that the British physicians should have continued to confound them. I was very diligent in making clinical notes and dissections, spending many hours every day in the presence of the disease." In an unpublished memoir of Dr. Stillé read before the Medical Society of Observation (September 14 and 28, 1838), the two diseases are compared, symptom by symptom and lesion by lesion; and, apart from the phenomena of fever common to all febrile affections, the opposite of what is observed in the one is sure to be presented in the other. (Valleix, "Arch. gen.," February, 1839, p. 213.)

Between two and three years of study in Europe gave Dr. Stillé a fine training for his lifework. Returning to Philadelphia, he began practice, wrote for journals, taught students, and gradually there came to him reputation and recognition. After lecturing on pathology and the practice of medicine in the Philadelphia Association for Medical Instruction he was elected, in 1854, to the chair of practice in the Pennsylvania Medical College. In 1864 he succeeded Dr. Pepper (primus) (q. v.) in the chair of medicine at the University of Pennsylvania. While always a student, he was no hermit, but from the start took a deep interest in the general welfare of the profession. He was the first secretary of the American Medical Association, and president in 1867. The local societies recognized his work and worth, and he became president of the Pathological and of the County Medical Societies, and in 1885 he took the chair of the College of Physicians of Philadelphia. He was from the outset of his career a strong advocate for higher medical education, and from 1846—the date of his first address on the subject—to 1897—the date of his last—he pleaded for better preliminary training and for longer sessions. No one rejoiced more in the new departure of the University in 1876, and he was a consistent advocate of advanced methods of teaching.

His medical writings show on every page the influence of his great master. His first important work. "The Elements of General Pathology," 1848, was based on the modern researches, and every chapter echoed with his favorite motto. Tota ars medica est in observationibus.

Apart from numerous smaller articles in the journals, there are two important monographs by him—one on "Cerebrospinal Meningitis," 1867, and the other on "Cholera." In addition, two minor studies were on "Dysentery." in the publications of the United States Sanitary Commission, and on "Erysipelas."

Estimated by bulk, the most important of Dr. Stillé's works are the "Materia Medica and Therapeutics" and the "National Dispensatory." It was always a mystery to me how a man with his training and type of mind could have undertaken such colossal and, one would have thought, uncongenial tasks.

Dr. Stillé was not only a booklover, but a discriminating and learned student. Our shelves testify not less to his liberality than to his taste for rare and important monographs, while the Stillé Library of the University of Pennsylvania will remain a monument to his love of the literature and history of our profession- It interested me greatly, and I only knew him after he had passed his seventieth year, to note the keenness of his mind on all questions relating to medicine. He had none of those irritating features of the old doctor, who, having crawled out of the stream about his fortieth year, sits on the bank, croaking of misfortunes to come, and, with less truth than tongue, lamenting the days that have gone and the men of the past. Hear the conclusion of the whole matter—the lesson of a long and good life. It is contained in a sentence of his valedictory address: "Only two things are essential to live uprightly and to be wisely industrious."

Dr. Stillé was twice married. His first wife had to be kept in an asylum and when she died he married an old and intimate friend.

He died in Philadelphia, on September 24, 1900.

Abridged from a paper by Dr. Wm, Osler in the Univ. of Penn. Med. Bull., June, 1902.
Trans, of the Coll. of Phys. of Phila., 1902.