University of Virginia Library

COURSES OF INSTRUCTION.

In the following description of courses, the number of hours represents
the amount of time each student devotes to the course. In addition to the hours
scheduled in the third and fourth years of the course, each student devotes a
considerable amount of time to practical work which does not appear in the
schedule, but the satisfactory performance of which is essential to graduation.
Thus the taking of histories, the visits to his cases in the hospital, assisting at
operations, attendance upon cases of labor, the employment of microscopical and
chemical methods of diagnosis in the hospital, require much time which it has
not seemed possible to record in a rigid schedule. It should, however, be stated
that each student in the fourth year gives at least six hundred hours to this
required but unscheduled practical work.

The session, exclusive of the time devoted to examination, is divided into
a fall term of twelve weeks, a winter term of ten weeks, and a spring term of
ten weeks.

FIRST YEAR.

Anatomy 1.—Twenty-four hours weekly during the first term and twelve
hours weekly during the second term. This course begins with a systematic study
of the bones, on the completion of which a part is assigned to each student for
dissection and study. On the completion of this course each student has dissected
a lateral half of the body. The student obtains his knowledge at first hand and
by his own personal efforts. The work in gross anatomy is completed in Anatomy
3 of the second year. Dr. Bean, Dr. Speidel and Dr. Barr.

Anatomy 2.—Six hours weekly during the third term. This course consists
of a laboratory study of the anatomy of the central nervous system carried
out in considerable detail. The gross anatomy of the spinal cord and brain
is first considered, on the completion of which sections of the more important
regions are studied carefully with the aid of the microscope. Fresh brains and
series of sections of the cord and brain are thoroughly used. A reconstruction
of the central nervous system showing the more important pathways is prepared
by each student. Dr. Bean and Dr. Speidel.

Histology.—Three lectures or recitations and six hours of laboratory work
weekly during the first and second terms. This course aims to acquaint the student
with the microscopic structure of tissues and organs. Cytogenesis and histogenesis
are briefly considered in the case of many tissues studied. The relation
of histology to physiology and pathology is constantly kept in view. The
student is also given opportunity to acquaint himself with the principles and
practice of histological technique.

A record of seventy per cent. in this course is required for admission to
Physiology, and of eighty per cent. for admission to Pathology. Dr. Jordan
and Dr. Kindred.

Embryology.—Nine hours weekly during the third term. The laboratory
work (six hours weekly) with sections and dissections of mammalian embryos,
is supplemented by lectures, recitations, and the study of models. The course
aims to give the student a knowledge of developmental processes, in the light of
which he may the better understand the more abstruse normal conditions of adult
anatomy, as well as many anomalies and variations. Dr. Jordan and Dr.
Kindred.

Biochemistry.—Lectures and recitations, three hours weekly during the
second and third terms; and laboratory work six hours weekly during the second
and third terms. Course comprises the chemistry of proteins, fats, and carbohydrates;
digestion, intestinal putrefaction, feces; blood, milk, and bile; particular
attention is devoted to the chemical physiology of digestion, secretion,
excretion, internal secretion, intermediary metabolism, and nutrition. Laboratory
work includes the study of carbohydrates, fats, proteins, purine compounds,
etc.; gastric contents, blood, milk, and urine; the digestive enzymes and the digestion
of foods; and extensive qualitative and quantitative work on urine. A
grade of seventy per cent. on this course is required for admission to Physiology.
Dr. Chanutin and Dr. Angell.

SECOND YEAR.

Anatomy 3.—Four hours weekly through the first and second terms. This
course is the continuation of Anatomy 1, and consists of the systematic study
of topographic anatomy, with the aid of cross sections of the human body, special
dissections, and wet preparations with a review of the whole body in relation
to the needs of the student in general medicine and surgery. At the end of
this course a practical examination is given, covering the work of Anatomy 1,
2 and 3. Dr. Bean and Dr. Speidel.

Physiology.—Lectures, recitations, and demonstrations, six hours weekly
during the first term, five hours during the second term, two hours during the
third term; laboratory work, six hours weekly during the first term, two hours
weekly during the second term. The physiology of muscle and nerve; blood and
lymph; the circulation; respiration, secretion; digestion; and nutrition, and the
central nervous system. The work of the laboratory closely follows the lectures
as an integral part of the study of each subject. Open only to the students
who have obtained grades of seventy per cent. in Histology and Biochemistry.
An average grade of seventy per cent. and the satisfactory completion of the
laboratory work of this course is necessary for admission to Pharmacology.
Dr. Hough and Dr. Angell.

Bacteriology and Pathology.—Twelve hours weekly throughout the session
and four additional hours a week during the second term. The work in pathology
is open only to students who have obtained a record of passed in Histology.
Bacteriology and Pathology are taught in a combined course. Emphasis is laid
upon the medical and public health aspects of bacteriology. Autopsies and the
study of gross and microscopic specimens supply the practical work accompanying
the systematic study of pathology. Opportunity is given selected students for
advanced work. Dr. Marshall, Dr. Szilard and Dr. Rainey.

Pharmacology.—Lectures, recitations and demonstrations six hours weekly
and laboratory work six hours weekly, during the third term. The physical and
chemical characteristics and the mode of action of representative drugs and
other chemic agents are dealt with in both didactic and practical exercises. Special
attention is given to analysing and interpreting the results obtained in the
laboratory. An average grade of seventy per cent. on Physiology together with
the satisfactory completion of the laboratory work of Physiology is required
for admission to the course. Dr. Waddell and laboratory assistants.

Physical Diagnosis.—Four hours weekly during the third term. Instruction
is given in the principles and methods of physical examination. Attention is
given especially to the study of the normal subject. Dr. Flippin, Dr. Mulholland
and Dr. Wood.

THIRD YEAR.

Materia Medica.—Lectures and recitations six hours weekly and laboratory
work four hours weekly, during the first three-fourths of the fall term. A thorough
study is made of the sources, preparation, composition, properties and interactions
of medicinal substances to the end that they may be intelligently prescribed.

Special attention is paid to their standardization for purity and potency.
Prescription writing and incompatibility are dealt with in frequent practical exercises.
While the consideration of the more important preparations of the
Pharmacopeia and the New and Non-Official Remedies consumes the greater
portion of the allotted time, the course is concluded with a critical study of many
of the so-called patent medicines. Dr. Waddell, assisted by Mr. Jervey, Mr.
McPeak, Mr. Patton, Mr. Rollins and Mr. Warthen.

Toxicology.—Lectures and recitations six hours weekly and laboratory
work four hours weekly, during the last quarter of the fall term. A systematic
review is made of the pharmacological action of such chemic agents as are particularly
liable to cause injury to health or loss of life, special attention being
given to their quantitative effects. Practical instruction is given in the methods
of isolating and identifying. The treatment of poisoning is dealt with in detail.
Dr. Waddell, assisted by Mr. Jervey, Mr. McPeak, Mr. Patton, Mr. Rollins
and Mr. Warthen.

Clinical Diagnosis.—Six hours weekly during the first and second terms.
In this course the student is made familiar with those laboratory methods which
are helpful in the diagnosis of disease. These include, among others, the examination
of blood, urine, sputum, gastric contents, feces, spinal fluid, exudates and
transudates. Instruction is given in the Clinical Laboratory in the north pavilion
of the hospital, which is well equipped with the most modern instruments and apparatus.
Dr. Bray.

Theory and Practice of Medicine.—Three hours weekly of lectures and
recitations throughout the session; six hours weekly in the clinics for one-half
the session. A systematic course of lectures, supplemented by work in the outpatient
department and hospital. The class is divided into two sections, each of
which devotes itself for half the year to the medical service in the out-patient
department, and also twice a week receives instruction on selected cases in the
wards of the hospital. There is a general medical clinic once a week in the hospital
amphitheater. Dr. Davis, Dr. Flippin, Dr. Daniel, Dr. Nelson, Dr.
Smith, Dr. Mulholland and Dr. Wood.

Dermatology and Syphilology.—Two hours weekly of lectures during the
third term; six hours of clinic weekly for medical section. The importance,
etiology, prophylaxis, pathology, clinical history, diagnosis and treatment of
syphilis are discussed. This subject is completed in the fourth year, q. v. Dr.
Smith.

Surgery and Gynecology.—Four hours weekly of lectures and recitations,
and two hours weekly of surgical clinic throughout the session; with six hours
weekly in the out-patient department, two hours weekly in ward rounds in the
hospital. The study of surgery begins in the third year and continues through
the fourth year. In the third year the classroom work consists of lectures and
recitations, as arranged in the schedule, in which the principles and practice of
surgery, surgical diseases, surgical diagnosis, etc., are thoroughly discussed.
The out-patient department course in the third year gives opportunities for diagnosis
and treatment of clinical cases under close personal supervision. Experience

in dressings, bandaging, anesthesia and minor surgery is afforded. Surgical
appliances and technique are demonstrated to the students, divided into small
groups. The work in gynecology follows the outlines already described for
surgery. In addition, the out-patient department affords practice in palpation,
diagnosis and treatment. Dr. Watts, Dr. Goodwin, Dr. Bigger, Dr. Page, Dr.
Helvestine and Dr. R. J. Neff.

Urology and Proctology.—Of the total time assigned to surgery, two lecture
hours weekly for the first term, and six hours weekly in the out-patient
department for one-eighth of the session are devoted to urology and proctology.
In the classroom a general survey of the surgery of the genito-urinary tract
and rectum is made by lectures and recitations. Especial emphasis is placed
upon modern methods of diagnosis and treatment. In the out-patient department,
one-eighth of the class at a time obtains supervised experience in handling
clinical cases and performing minor operations. Ample opportunity is afforded
for the observation of cystoscopic and proctoscopic procedures. Dr. Neff and
Dr. Howze.

Orthopedics.—One hour weekly during the first and second terms; and two
hours weekly during the third term, with six hours weekly in the out-patient department.
Dr. Voshell.

Roentgenology.—Lectures, and practical demonstrations to the class in sections
throughout the year. The application of the X-rays to medicine and the
interpretation of plates in diagnosis. Dr. Archer.

Phthisiotherapy.—Six hours weekly for eight weeks, with each of the four
sections of the class. The work is given in three two-hour sessions a week, held
at the Blue Ridge Sanatorium, and consists of demonstrations, ward rounds and
assignment of cases for history taking and physical examination. At the end of
each clinic session the case history, physical signs, X-ray plates and laboratory
findings are compared in conference. The section is also invited to be present
at the fluoroscopic examinations on Friday mornings at the University Hospital.
The procedure followed aims to instruct in the diagnosis and treatment of tuberculosis
by systematically presenting each step separately at first and later combining
them all in the full consideration of the case, including the management
and treatment of the patient both in institutions and private practise. Dr. Brown.

Obstetrics and Gynecology.—Three hours of lectures weekly throughout
first and second terms, covering physiology and pathology of pregnancy, parturition,
and puerperium. In the third term is begun the practical observation of, and
participation in, the care of the pregnant and parturient woman, both in the outpatient
department and in the Hospital wards. This work is supplemented by
practicing certain of the more common procedure on the mannikin. Dr. Calkins
and Associates.

Pediatrics.—Two lectures weekly during the first term, three lectures weekly
during the second term. Students are instructed in the out-patient department
three times a week for two and one-half hours. Dr. Royster and Dr. Waddell.

Elective Courses.—In the second and third terms each student is required

to take an elective course of approximately five hours weekly. Elective courses
vary from year to year, and include both pre-clinical and clinical subjects.

FOURTH YEAR.

Theory and Practice of Medicine.—The same plan is followed in the clinical
work as that already described for the third year, each of the two sections
of the class devoting itself for half the year to the medical service in the wards
of the hospital. Full histories are taken of every case, thorough examinations
made, and management indicated by the students of each division. These records
are considered in the final grading of the student. The subjects treated with
the approximate division of time among them are as follows:

Nervous Diseases and Insanity.—Three lectures and recitations weekly,
supplemented by clinical work during the first and second terms. In this course
is given also instruction in electrotherapeutics. Dr. Davis.

Case Teaching, Medical Ethics and Economics, and Insurance Exam-
inations.—Two hours weekly during the third term. Dr. Davis.

Internal Medicine.—Two lectures weekly throughout the session. In this
course the endeavor is made to bring to the attention of the senior student the
more important problems of Internal Medicine. The relationship of recent investigations
in the fields of normal and pathological physiology, biochemistry,
immunology, etc., to internal diseases is especially emphasized. No text-book is
used; students are referred to the files and current issues of journals and to reference
works in the Medical Library as sources of information. Dr. Flippin.

Dermatology and Syphilology.—Two lectures weekly during the first term.
After review of the anatomic and histologic structure and physiology of the skin
the diseases commonly met with are discussed. Ward rounds once weekly for
one-half the year. The interesting cases seen in the out-patient department are
admitted to the hospital for detailed study. Dr. Smith.

Surgery and Gynecology.—Two hours weekly of surgical clinic throughout
the session; five hours weekly of ward classes, supplemented by clinical work
in the wards and operating room for one-half the session with each of the two
sections of the class.

Instruction in surgery is carried on by clinics and bedside demonstrations in
the hospital. In the wards the students are assigned cases, whose histories they
must take. They must also make complete physical and clinical examinations,
urine analyses, blood examinations, etc. In the ward rounds the diagnosis, operative
and other treatment, post-operative care of the cases, complications, prognosis,
etc., are discussed in detail. A large variety of cases is available and the
close contact of the students with their cases and with the routine of hospital
management offers many of the opportunities that an interneship affords. In the
operating rooms the students, in small groups, take part in the operations, thus acquiring
familiarity with technique, anesthetization, etc. Those of the class who
are not assisting witness the operations, whose important features are demonstrated
to them.

In gynecology, urology and orthopedics the students have the same general

work as in surgery, consisting of the examination and the recording of the cases
in the public wards, attendance on ward rounds, at which the cases are discussed,
and observation and assistance in the operating rooms. Dr. Watts, Dr. Goodwin,
Dr. J. H. Neff, Dr. Voshell, Dr. Bigger, Dr. Helvestine and Dr. R. J.
Neff.

Orthopedics.—One hour weekly throughout the year for ward rounds. Dr.
Voshell.

Surgical Pathology.—Two hours weekly during one-fourth the session.
This course is intended to supplement the general courses in pathology and surgery
and consists of lectures upon the pathology of surgical lesions, demonstrations
of fresh tissues obtained from the operating rooms, and examination of microscopic
sections. The student reviews pathological technique, and frozen
section work is emphasized. Dr. Bigger.

Obstetrics and Gynecology.—Continuation of practical work begun in third
year, throughout the first two terms. In the third term a course of three hours per
week in case analysis completes and rounds out the training in this branch.
Small groups of the class are also taught practical treatment by the ward round
method. Dr. Calkins and Associates.

Pediatrics.—Students are instructed in the wards of the hospital twice a
week in ward rounds. In addition all students serve as clinical clerks and have
cases assigned to them for their personal care under the direction of the professor
of this department. This includes the practical feeding of infants and the
preparation of the food. Dr. Royster and Dr. Waddell.

Medical Jurisprudence.—One lecture weekly during one term of the fourth
year. The application of medical knowledge and skill to the needs of the law is
presented. References to literature are assigned for the fuller development of
special topics. Dr. Waddell.

Phthisiotherapy.—Two lectures weekly for four weeks supplemented by
demonstration clinics at the Blue Ridge Sanatorium. Dr. Brown.

Diseases of the Eye, Ear, Nose and Throat.—Two lectures weekly during
the first two terms, supplemented by regular two- to three-hour clinics three
times a week throughout the session and clinical lectures to sections of the class
as suitable cases occur. The class is divided into small sections and each student
is taught the methods of examination and the use of the ophthalmoscope,
head mirror, and of the laryngeal and post-nasal mirrors. In the clinics each
patient is assigned to a student, who must take the history and keep the record
of that patient; the case is then demonstrated by the professor in charge, and, if
possible, each student makes his own examination under the personal supervision
of the attending physician. Clinical cases are abundant, and during the year the
student sees and handles practically all the common diseases of the eye, ear and
upper respiratory tract. Dr. Hedges and Dr. McCutchan.

Hygiene.—One hour weekly throughout the session, and thirteen additional
hours in the second term. The course begins with a historical sketch of the developments
of preventive medicine, including short biographical sketches of the

pioneers of hygiene. With this introduction the story of the natural history of
contagious and infectious diseases, modes of propagation and methods of prevention
engage the attention of the student. With this preparation, the chemical
and bacteriological contamination of food, water, air and soil is made an important
study. Instruction is also begun in the proper location and construction of
habitations, hospitals, schoolhouses, etc., with special reference to the modern
methods of heating, ventilating and draining. Notice is taken of the special relations
involved in military and naval hygiene. Dr. Lambeth.