GRAHAM, JAMES ELLIOT, physician, author, and teacher; b. 12 June 1847 at the family homestead, Richview, in Malton, Upper Canada, youngest son of Joseph Graham and Ann Brown (LeBrun); m. 15 July 1873 Mary Jane Aikins, daughter of James Cox Aikins*, and they had three daughters and one son; d. 7 July 1899 in Gravenhurst, Ont.

James Elliot Graham’s education began at Weston Grammar School, where he was a good student, winning prizes in both Latin and Greek. He attended Upper Canada College and then the Toronto School of Medicine [see William Thomas Aikins], receiving an mb in 1869 and an md the following year from the University of Toronto. At the school he met William Osler*, who remained a close friend during the next 30 years. Osler would commemorate their friendship in 1900 by dedicating a monograph on cancer of the stomach to his recently deceased colleague. Both studied with Dr James Bovell*, who guided them in the subtleties of microscopy and served as an enduring role model.

After graduating in medicine, Graham spent a year training at the Brooklyn City Hospital in New York and then pursued post-graduate studies in Europe. While he was studying in Germany, he volunteered for service in the Prussian army as an unpaid military surgeon during the Franco-German War. During his stay he developed a lasting admiration for the German people and their culture. His interest in diseases of the skin, which was to play such a prominent role in his professional life, also probably dates from this period. After he left Germany, Graham studied in Vienna and in London, where he became a licentiate of the Royal College of Physicians.

Having completed this self-prescribed and informal course of study, not unusual at that time, Graham returned to Toronto in 1872. His practice there became large and successful, and he acquired the reputation of studying his patients carefully and painstakingly. Accounts of his findings on a wide range of subjects, including diseases of the skin and of the liver, typhoid fever, and tuberculosis, frequently appeared in publications such as the Canadian Journal of Medical Science and the Transactions of the Association of American Physicians. His advice was increasingly sought by individual patients and by other physicians. A member of the medical staff of the Toronto General Hospital from about 1875, he taught both there and at the Toronto School of Medicine. He has been identified as “the father in this country of clinical teaching,” a claim of some importance given the increasing emphasis about that time on clinical teaching rather than lecturing. This development signalled the beginning of modern medical education.

As his practice increased Graham found it more and more difficult to maintain his high standards, and ultimately, about 1880, he became one of the first North American practitioners to limit his professional efforts to consultancy. His personal fascination with diseases of the skin continued to grow, and he became noted for his expertise in this largely neglected area. He was an early member of the American Dermatological Association (founded in 1876) and was elected its president in 1888. He occupied positions of responsibility in other professional organizations and was president of the Toronto Medical Society, the Toronto Pathological Society, the Ontario Medical Association, and the Canadian Medical Association. Professor of clinical medicine at the University of Toronto from 1887 and professor of medicine from 1892, he served two terms on the senate of the university.

Graham’s contributions to North American medicine, although substantial, often went unnoticed by his contemporaries. Fortunately, William Osler, already a noted professor of medicine at the University of Pennsylvania, was painstaking in his recognition of the achievements of others; he pointed out, for example, that the Association of American Physicians (founded in 1885) was formed as a result of a suggestion made by Graham to Dr James Tyson of Philadelphia. Of particular significance was Graham’s role in directing talented young Canadian physicians in the 1890s to study under Osler and his colleagues at the Johns Hopkins University medical school in Baltimore, one of the best in the world. These men, among whom were Llewellys Franklin Barker, Thomas Barnes Futcher, Thomas McCrae, and Thomas Stephen Cullen, became, in turn, leaders of the profession throughout North America in the first half of the 20th century.

Graham’s health had begun to decline in the early 1880s, as he was afflicted with late-onset diabetes mellitus. Although it could be largely controlled by diet, in 1899 he contracted pneumonia and the diabetes became uncontrollable. In June he travelled to Muskoka hoping to regain his strength, but he died there in diabetic coma on 7 July. His house, at 70 Gerrard Street East, became a centre for homeless young people in 1982.

Charles G. Roland