unfolded to the student. His crowning conception is, therefore, of such or such an ailment with its remedies and measures of relief grouped about it. Remedies whose properties and varied applications he has already learned in the Department of Pharmacology are now gathered for a definite purpose about a particular problem. This problem being but one of many he is to face, and the whole object of all his studies in medicine being to learn their solution, it is most proper that as a finality, problems and solvents should be comprehensively and clearly impressed on his mind. It is the purpose of the Department of Therapeutics to do this work. It cannot be done by teaching alone, for each case can present but a fragment of the whole ailment at any one demonstration. A series of didactic presentations are therefore necessary, at which, as has been said, the entire treatment of any one disease, including complications and sequels, is spread as a whole before the student. This method, supplemented with adequate clinical demonstrations, ought to give any student having the preparation given in the years preceding this course (this being in the fourth) adequate knowledge for service in any hospital. It will be noticed that the field occupied by this chair is virtually the practice of medicine, but confined to treatment, the Professor of Medicine being free to develop his subject along the lines of etiology, pathology, diagnosis, prognosis, and clinical medicine. There has been so great an extension of all the subdivisions of the practice of medicine, that the time gained through this arrangement for their development at the hands of the Head of the Department can be fully occupied. Professor Meara assumes charge of the Department of Therapeutics.

The creation of a Department of Experimental Therapeutics was necessitated by the increasing demands of sero-therapeutics. At the same time it is expected to lend itself, as its working staff increases, and as occasion requires, to any problem in conjunction with the Departments of Pathology, Pharmacology, or Therapeutics, which may be sufficiently promising of results. Assistant Professor Beebe assumes the direction of this Department, it being an extension, in fact, enlargement, of the work in which he has already won distinction.

I regret to report the resignation of Professor Adolf Meyer. He goes to Johns Hopkins Medical School where he takes charge of the Department of Psychopathology. Assistant Professor August Hoch takes his place. Professor Hoch has served as an assistant to Professor Meyer and given much evidence of his special fitness for the work to which we have had pleasure in advancing him. Similar expressions apply to Assistant Professor Newcomb of the Department of Laryngology, who since the foundation of the school has served as Chief of Clinic and First Assistant to Doctor Knight. He has been advanced as Assistant Professor to the place made vacant by Doctor Knight's resignation.

I now beg to append extracts from the reports of several of the departments as examples of the kind of work they carry on.


The work of the instructors and assistants is efficient and satisfactory.

More experimental work than usual has been carried out.

Various assistants have taken an active part in the clinics of the Head of the Department, also in ward work, being called upon to demonstrate before the class various special lines of research in which they were proficient. Doctor Armstrong has demonstrated examination of gastric cases. Doctor Niles has demonstrated thoracic measurements in tuberculosis. Doctor Barringer has shown methods of cardiometery. Doctor Beebe has frequently given advice regarding the use of sera and organic extracts before the entire class. At the clinic in Bellevue Hospital, Doctor Hartwell has assisted in combined medical and surgical clinics; Doctor Barringer has demonstrated cases of unusual cardiac disease; the X-Ray Department has been frequently made use of; Doctor Hastings has provided microscopic specimens of parasites, etc., derived from the patients who were presented. Doctor Hastings has attended these clinics regularly and has been called upon for opinions regarding cases where the blood examinations, etc., were important. An unusually varied and interesting series of cases were thus presented. Doctor Bailey also gave one or two demonstrations of cardiograms, etc., at these clinics.

In the ward service at the Presbyterian and Bellevue Hospitals pathological material has been presented when possible, after the death of the patient, in confirmation of a diagnosis.

Three new methods have been adopted at Bellevue Hospital which have added to the efficiency of the service and stimulated the interest of the house staff, thereby benefiting all the students.

First. All the surgical staff, including the surgical visiting and assistant visiting members, have made joint rounds at stated regular intervals, and the medical staff have made occasional rounds with the surgeons, in the medical and surgical wards.

Second. Assistant Visiting Physician, Doctor Hastings, has made daily rounds with the Head of the Department and special cases have been assigned to him for research.

Third. A number of the assistants in the College, not necessarily connected with the hospital, have been ecouraged to prosecute research work in the wards. For example, Doctor Barringer has been studying the value of digitalis suplied by the Hospital in comparison with other preparations. He has also made many tracings of the heart action pulse waves with an apparatus of his own device.

Doctor Beebe has been studying the nitrogen output in cases of anemia with Doctor Thompson, and read a paper on the subject at a meeting of the American Medical Association.

Doctor Coleman has been continuing his researches in typhoid fever.

With Doctor Bailey Doctor Thompson has been studying intravenous and intramuscular use of strophanthine, using preparations furnished by Doctor Hatcher.

Doctor Hastings has assisted Doctor Thompson in making vaccines from blood cultures in a series of cases of malignant endocarditis, so that it was possible to report a number of cures at a recent meeting of the Association of American Physicians in Washington.

These various investigations outlined above have been brought to the attention of the students in their ward sections and have added much of value to their work.

In the College Dispensary and at the Bellevue Dispensary, Doctors Niles, Barringer, and Sicard have been conducting original researches in various important matters. Doctor Niles has also taken charge in Doctor Thompson's Service in Bellevue of the Calmette and von Piquet tuberculin reactions, and these cases, together with those studied in the Dispensary in connection with Doctor Hastings' laboratory, will shortly comprise a report of some 2,000 cases. Doctor Niles in Doctor Thompson's Bellevue Service has conducted a series of vaccine experiments in pneumonia with Doctor Thompson.

The Department has in preparation a second number of original papers, to which there will be a dozen or more contributors.

Next year an additional arrangement is proposed whereby Doctor Ewing or one of his assistants will attend the hospital clinics

in medicine with Doctor Thompson, in order to discuss before the class the exact pathological changes present in patients whose symptoms are being simultaneously demonstrated.

In regard to the recitations and other phases of teaching in the Department next year it is believed that more concentration of the work among somewhat fewer teachers will yield more satisfactory results in future. Doctor Camac, having resigned from physical diagnosis, will be able to give more time to ward work at the City Hospital. It is unnecessary to fill his place in physical diagnosis as other instructors can cover the ground. The clinics of Doctors Nammack and Lambert can be supplemented by the Professor of Therapeutics.

Special mention should be made of the work engaged in by Doctors Wolf of the Department of Chemistry) and Lambert who were engaged in the study of the metabolism of certain infectious diseases, and the results of this investigation were found to be extremely satisfactory and instructive.


Instruction in the various branches has been conducted along the same lines. The standard has been satisfactory.

Histology: The small class of the new curriculum permits closer contact of the student and teacher. Much more detailed instruction has been given and the course in histological technics has been carried through with great success; a system of students' theses has been employed with gratifying results. Much credit is due to Doctor Ferguson for the energy and discretion with which he has met possibilities of the new curriculum.

Doctor Stockard's course in Comparative Morphology was much enlarged for the new students and has filled a distinct gap in the scientific foundation of the medical course. A series of mounted skeletons illustrating the bony frameworks in the various orders of animals has been added to the equipment. It is believed that this course has introduced in students a new and stimulating interest in the study of anatomy.

Doctor Elser's course in Bacteriology was given as usual. Nothing need be added to the high estimate previously given of its excellence. Increased attention has been given to the hygienic aspects of bacteriology

Gross Pathological Anatomy: Doctors Schultze and Neal have demonstrated the usual rich collection of recent material. The increasing opposition of hospital authorities towards autopsies is a very serious prospect which this Department, and medical education in general, has to face. Pathological Anatomy is the cornerstone of medical education. A knowledge of this subject distinguishes the regular school of medicine more than anything else from medical cults. Every possible influence should be brought to bear upon the hospital authorities to facilitate post-mortem examinations: unless this is done the American school will fall still farther behind continental universities in this important field. In view of the increasing difficulty of securing autopsies Doctor Ewing has begun systematically to add to the Pathological Museum, and during the year about 100 permanent specimens were added through the care and industry of Mr. Gudernatsch. There is a lack of suitable quarters for exhibition of these specimens.

General Pathology: This course has been conducted as heretofore. The new curriculum, however, will require extensive changes in the entire plan of instruction and in the personnel of the staff. Some of these changes, as announced in the catalogue, are the development of more extensive courses in pathology of the specialties, including neuropathology, surgical pathology, gynecological and obstetrical pathology, medical zoology, and chemical pathology.

Neuropathology: Doctor Schlapp being relieved of the work of neurohistology will be able to enlarge the scope of instruction. The Department is greatly in need of larger sources of material in this field.

Surgical Pathology: Some worker who plans to enter clinical fields through the laboratory must be secured to develop this course as has been done at Harvard and Johns Hopkins. The same method must be followed in gynecology. It is earnestly recommended that the policy be adopted of requiring candidates for clinical positions to perfect themselves in the laboratory side of their specialties, and it is specially urged to consider the superior advantages of pathological over purely anatomical training for the surgeon.

Medical Zoology: It is thought that this subject can be handled by Doctor Stockard, Mr. Gudernatsch, and Doctor Ewing.

Chemical Pathology offers peculiar difficulties, but a beginning should be made of a systematic course in this subject. “At present I have in mind for this work, at first for lectures, Doctors Beebe and Shaffer. The opportunity to appoint a special assistant for this Department who shall work under Doctor Norris is of great im

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