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 labour, the employment of
microscopial 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 two hundred hours to this required
but unscheduled practical work.
The session, exclusive of the time devoted to examinations, 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.—Six hours weekly until November 1st; twelve hours
weekly from November 1st to the end of the winter term. This course
begins with a systematic study of the bones, on the completion of
which a part (either the head and neck with the upper extremity
and thorax, or the lower extremity and abdomen) is assigned to
each student for dissection and study. For this purpose each cadaver
is considered as composed of four parts; on the completion of
this course and Anatomy 3 each student has dissected a lateral half
of the body. Emphasis is placed upon the benefit to be derived by
the student who obtains his knowledge at first hand and by his own
personal efforts. While practical dissection and the consideration
of topographical relations make up the essential features of the
course, there are occasional lectures and frequent recitations, followed
by a final written examination in March. The satisfactory
performance of the laboratory work is essential to a passing grade.
Dr. Whitehead.
Anatomy 2.—Six hours weekly during the spring term. This course
consists in 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. For the purposes of the course the
laboratory is well equipped. Fresh brains are obtained each year
from the dissecting material of the departments; and several excellent
series of sections of the cord and brain both of infants and
adults stained by the Weigert-Pal method are thoroughly used. The
laboratory work is supplemented by recitations and occasional lectures.
Dr. Whitehead.
Histology.—Three lectures or recitations and nine hours of laboratory
work weekly during the fall and winter terms. The student's record
in the course will depend upon his recitations, laboratory drawing
books, and final examination, both written and practical. The
course aims to acquaint the student primarily with the microscopic
structure of cells, tissues, and organs. Cytogenesis and histogenesis
are briefly considered in the case of many tissues studied;
and the relation of the whole subject of histology to pathology is
never lost sight of. The student is also given opportunity to acquaint
himself with the principles and practice of histological technique.
The laboratory is excellently equipped with microscopes,
paraffin baths, microtomes, a micropolariscope, a projectoscope and
other accessories essential to the most favorable presentation of this
course.
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 Mr. Steele.
Embryology.—Nine hours weekly during the spring term. The
laboratory work (six hours weekly) is accompanied by lectures,
recitations, and the study of models and text-books. 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, neoplasms and malformations. The close correlation
of obstetrics is recognized, and a correct knowledge of the fetus
and its membranes is taught from the embryological approach.
The course is made as practical as possible for the student and
practitioner of medicine. It begins with a consideration of maturation
phenomena, fertilization, segmentation, and the development of
the germ-layers. This study is made chiefly upon the ova and early
stages of an invertebrate, followed by a comparison in an amphibian.
The chick is used for the primary relations of the systems
to one another; and this is followed by the study of pig embryos,
where each system is taken up separately and the organology and
histogenesis of its parts are studied. Finally, the fetal membranes
and their relations to the fetus and uterus are studied in their variations
among the amniota. Dr. Jordan and Mr. Steele.
Organic Chemistry.—Lectures and recitations three hours weekly,
laboratory work six hours weekly during the fall and winter terms. This
course includes the systematic study of organic chemistry or the
chemistry of the compounds of carbon, with special reference to
substances of importance in their relation to medicine. The object
of this course of study is to familiarize the student with the more
important organic compounds and with the methods at present employed
in chemical synthesis and to lay the foundation for subsequent
work in physiological chemistry, pharmacology, etc., etc.
A record of seventy per cent. on this course is required for admission
to Physiological Chemistry. Dr. Edgar and Mr. Diggs.
Physiological Chemistry.—Three lectures, three recitations and nine
hours of laboratory work weekly during the spring term. This course
has for its object to afford instruction in the fundamentals of physiological
chemistry, especially the chemical structure, properties, and
reactions of the most important compounds with which the student
must deal in his subsequent studies of physiology. The laboratory
work, for which ample facilities are provided, consists of the thorough
study of the properties of the carbonhydrates, fats, soaps, fatty
acids, and proteins, and of the more important members of each of
these groups; the composition of blood, milk, muscle, pancreas, and
other organs; the action of the more important digestive enzymes and
of the bile; and the chemistry of the urine. Accurate quantitative determinations
are required of urea (Folin), total nitrogen (Kjeldahl),
uric acid (Hopkins-Folin), ammonia (Folin), sugar (Fehling and
Benedict), and kreatinin (Folin). Other processes of quantitative
analysis, such as the Soxhlet method of fat determination and the
silver nitrate method of determining the total purins, are either
demonstrated or their essential manipulations carried out by the
student himself. The exceptional preparation of students not only
in general but also in organic chemistry makes it possible to acquire
in this course both a clear understanding of the problems of physiological
chemistry, and also skill in the use of the fundamental
qualitative and quantitative methods.
A grade of seventy per cent. on this course is required for admission
to Physiology. Dr. Hough, Dr. Edgar, and Mr. Diggs.
SECOND YEAR.
Anatomy 3.—Ten hours weekly from October 1st through the fall
and winter terms. This course is the continuation of Anatomy 1,
and consists of the systematic dissection and study, by essentially
the same methods, of the parts not studied during the first year.
Mr. Williams.
Physiology.—Four hours weekly of lectures, recitations, and demonstrations
throughout the year; six hours weekly of laboratory work in
the fall and winter terms. The physiology of muscle and nerve; blood
and lymph; the circulation; respiration; secretion; digestion and
nutrition; excretion; the sense organs; and the central nervous system.
The laboratory is equipped with kymographs, induction coils,
signals, muscle and heart levers, tambours, manometers, apparatus for gas
analysis, etc., for thirty men working at one time in pairs. The work of
the laboratory closely follows the lectures and is an integral part of the
study of each subject. The student becomes practically acquainted with
the methods of modern physiological investigation and is required
to hand in tracings or other records together with full descriptions
of his experiments. The satisfactory completion of the laboratory
work is as necessary to a clear record on the course as is the passing
of the final examinations.
Open only to students who have obtained a grade of seventy
per cent. in Histology and in Physiological Chemistry. The satisfactory
completion of the laboratory work of this course is necessary
for admission to Pharmacology. Dr. Hough and Dr. Crider.
Bacteriology and Pathology.—Thirteen hours weekly throughout
the year, and two additional hours a week in the third term.
In Bacteriology the student is taught to prepare culture media
and to employ the usual methods necessary for the isolation and
identification of bacteria, and he studies the microörganisms concerned
in the common bacterial diseases.
After a few days have been spent in making culture media, sterilization,
etc., the general technique is learned by isolating the bacteria
from the air, soil, water and milk, and from exposed body
surfaces. Bacterial counts are made from water and milk. Following
this, the pathogenic bacteria are taken up serially. Those receiving
special attention are the bacteria concerned in wound infections,
in respiratory and intestinal diseases, and in tuberculosis.
At intervals mixed cultures are given out to the class and the students
are required to isolate and identify the bacteria in the mixtures.
Experimental work upon infection and immunity accompanies
the course in Bacteriology and Pathology. The students inoculate
animals with certain pathogenic bacteria and report to the class
upon the course of disease resulting from the inoculation. In fatal
cases the students perform autopsies upon the experimental animals
and attempt to recover the bacteria in cultures. Sections are made
from the organs of the animals which succumb to inoculation and
are studied by the students.
Groups of students prepare vaccines and immunize animals. The
serum of these animals is employed by the class in studying the
technique of the more important immunity reactions. In this way
the work in Bacteriology is integrally combined with the work in
Pathology, the two courses overlapping.
The lectures and quizzes which accompany the Laboratory work
are designed to set forth clearly the relations existing between bacteria
and disease and to give a knowledge of the fundamental facts
and theories of immunity and of the important principles of preventive
medicine.
The course in Pathology extends from January to June. The
greater part of the practical work is devoted to the study of the
microscopic changes occurring in disease. This is supplemented by
the study of autopsy material and museum specimens. Selected
types of diseases are studied experimentally. The practical work includes
the consideration of the vascular disturbances, degeneration,
inflammation, regeneration, and of benign and malignant tumors.
The diseases produced by animal parasites are considered briefly.
During the course the student has an opportunity to learn the standard
methods employed in preparing tissues for examination, and he
is called upon to witness and assist in the autopsies.
A lecture and quiz precedes the practical work each day and
in addition selected topics are discussed more fully in lectures.
Both in Bacteriology and Pathology frequent recitations are held
and the standing of the student is determined largely from these and
from the character of his daily practical work.
In addition to the regular course outlined above, opportunity
is afforded for qualified students and doctors to engage in advanced
work. During the present session, six selected students, who have
completed their work in Bacteriology and Pathology, and one interne
from the Hospital are engaged in advanced work upon problems
relating to pathologic histology and bacteriology. A special
room is reserved for this purpose.
The work in Pathology is open only to students who have obtained
a record of eighty per cent. in Histology. Dr. Marshall, Dr.
Mundy, Mr. Dale, and Mr. Jackson.
Pharmacology.—Five hours of lectures, recitations, and demonstrations
and six hours of laboratory work weekly during the third term.
In this course a study is made of the chemical characteristics and
physiological action of representative drugs from the different
pharmacological groups. The satisfactory completion of the laboratory
work of Physiology is required for admission to the course.
Dr. Waddell and Dr. Crider.
Physical Diagnosis.—Four hours weekly during the spring term.
Instruction is given in the principles and methods of physical examination.
Attention is especially given to study of the normal
subject. Dr. Flippin.
THIRD YEAR.
Materia Medica.—Three hours of lectures and recitations and four
hours of laboratory work weekly during the first half of the third year.
The more important drugs and preparations of the Pharmacopeia,
together with newer non-official remedies which bid fair to attain
or have attained considerable use, form the subject of study. In the
laboratory the student becomes familiar with the peculiarities and
methods of preparation of the different preparations of the Pharmacopeia,
as well as with the solubilities and other characteristics of
the more important drugs. Especial attention is paid to chemical
and pharmaceutical incompatibility. Prescription writing is dealt
with by lecture and frequent practical exercises. Dr. Waddell.
Toxicology.—Three hours of lectures and recitation and three hours
of laboratory work weekly during the last half of the second term.
This course is to a considerable extent a review of the pharmacological
actions of poisons and their antagonists. The treatment
of poisoning is dealt with in detail. Some attention is given to the
methods of separation and identification. Dr. Waddell.
Clinical Diagnosis.—Six hours weekly during the fall and winter
terms. In this course the student is made familiar with those modern
laboratory methods which are practically helpful in the diagnosis of
disease. These include, among others, the systematic examination
of blood, sputum, urine, gastric contents, feces, exudates, transudates,
and milk. The student is not only required to understand
the methods employed in such examinations, but by practice to
acquire the skill necessary for accurate results. The instruction
is given in the new Clinical Laboratory, situated in the north wing
of the Hospital. This laboratory is well equipped with instruments
and apparatus, and the wards of the Hospital furnish ample material
for the proper presentation of the subject. Dr. Flippin and Dr.
Woodberry.
Theory and Practice of Medicine.—Three hours weekly of lectures
and recitations throughout the year; nine hours weekly in the clinics
for one half the session. A systematic course of lectures, supplemented
by work in the Dispensary and Hospital. The class is
divided into two sections, each of which devotes itself for half the
year to the medical service in the Dispensary 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 for the third and fourth year students.
Dr. Davis,
Dr. Flippin, Dr. Magruder, Dr. Nelson.
Surgery and Gynecology.—Five hours weekly of lectures and recitations,
and two hours weekly of surgical clinic throughout the session,
with six hours weekly in the Dispensary for one half the session.
The study of Surgery begins in the third year and continues
through the fourth year. In the third year the class room 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. This also includes the
surgical specialities, Orthopedics, Genito-urinary Surgery, etc.
The Dispensary 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 closely the outlines already
described for surgery. The general principles of gynecology are
taken up in lectures and recitations. In addition, the dispensary
affords practice in palpation, diagnosis and treatment. Dr. Watts
and Dr. Goodwin.
Obstetrics.—Three hours weekly of lectures, recitations, and manikin
demonstrations during the year, supplemented by work with living
subjects in the wards of the Hospital.
The class is divided into sections of five for manikin instruction
and for examination of patients in the Hospital. The manikin
course forms an important part of the work, not only for teaching
presentation, position, and posture, but also the mechanism of normal
and abnormal labor and the application of forceps. When the
section is taken into the wards of the Hospital, the methods of
examination, particularly abdominal palpation, are practiced on the
living subject. Dr. Macon.
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. The records thus obtained
are kept up by the student assigned to the case, which he is
expected to follow until its discharge. The accuracy and completeness
with which this is done constitutes a large element in the determination
of fitness for graduation.
The subjects treated with the approximate division of time between
them are as follows:
Nervous Diseases and Insanity.—Three lectures and recitations
weekly supplemented by clinical work during the fall term. In this
course is given also instruction in electro-therapeutics. Dr. Davis
Pediatrics.—Three lectures and recitations weekly supplemented by
clinical work during the winter term. This course of lectures is intended
to point out in a brief way how disease is modified by childhood
and to indicate how the difficulties of diagnosis and treatment
due to early age may best be encountered. The principles of infant
feeding are emphasized and the student is taught how to prepare
the food. Instruction in the practical details of the subject is given
by work at the dispensary and in the wards of the Hospital. Dr.
Davis and Dr. Rea.
Dermatology.—A brief course of lectures is given on this subject
embodying a consideration of the commoner diseases met with in
medical practice. At the Dispensary two clinics a week throughout
the year are devoted to the diseases of the skin. The senior class is
divided into sections for the work in this branch. After a brief review
of the anatomic and histologic structure and of the physiology
of the skin, the diseases most commonly met with are discussed.
The clinical material available at the University Dispensary is
utilized to the best advantage to give the students a practical working
knowledge of the diagnosis and treatment of affections of the
skin. Dr. Davis and Dr. Rea.
Case Teaching, Medical Ethics and Economics, and Insurance
Examinations.—Two hours weekly during the spring term. Dr. Davis.
Therapeutics.—Two lectures weekly during the fall and winter
terms, with five hours weekly of ward rounds for one half the session.
The treatment of internal diseases is discussed in a systematic
course of lectures and practically demonstrated in the wards of the
Hospital. Especial attention is given to the clinical side of the
teaching of this subject, the student being required to suggest treatment
for cases assigned to him and to follow closely and make a
record of the results of the therapeutic agents employed throughout
the course of the disease.
The course includes a discussion of the preparation of food for
the sick; demonstrations of the preparation of stupes, plasters, and
poultices; and the methods of giving therapeutic baths, electrical
treatment, massage, and other therapeutic measures.
Dr. Flippin.
Surgery and Gynecology. Two hours weekly of surgical clinic
throughout the session; three 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, make complete physical and
clinical examinations, urine analyses, blood examinations, etc. In
the ward rounds the diagnosis, operative and other treatment, postoperative
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 offer many of the opportunities that an internship
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 the students have the same general work as in
surgery, consisting of the examination and recording 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 and Dr. Goodwin.
In addition to the above course, required of all students, the following
elective course is offered in the Department of Surgery.
Surgical Pathology.—Two hours weekly during one half of the
year. The work in this course comprises lectures upon the pathology
of surgical lesions, with especial emphasis upon the clinical
diagnosis of tumors and inflammations, the examination of microscopic
sections, and the study of fresh tissues in the gross, obtained
from the operating room. The purpose of the course is
to supplement the general courses in pathology and surgery, and
to acquaint the student with the appearance of fresh pathological
material from surgical cases. Dr. Goodwin.
Obstetrics.—The student attends, under the guidance of an instructor,
the labour cases in the Hospital, is required to prepare
the history of patients, and to follow up the cases through the
puerperium. Instruction is also given in the case of the new born.
In addition the student has the opportunity of attending patients
in the outpatient department and each student is expected to attend
at least six cases of labour. Dr. Macon.
Forensic Medicine.—One lecture weekly during one term of the
fourth year.
Diseases of the Eye, Ear, Nose, and Throat.—Two lectures weekly
from the beginning of the session to the first of March, supplemented by
regular clinics twice weekly throughout the year and clinical lectures
to sections of the class as suitable cases occur.
No attempt is made to train specialists, but every effort is made
to render the class familiar with such common diseases of the eye,
ear, nose and throat as the general practitioner meets in his daily
work. To this end 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.
At the operations in the Hospital only as many students are allowed
to be present as can really see and appreciate what is being
done.
Valuable work is also given in the dissecting room, where the
technic of operative work is shown in a way that cannot be employed
with the living patient. Students do this work as far as
possible for themselves, especially in tracheotomy and intubation
of the larynx.
Finally the attempt is made so to ground the student in the
anatomy, physiology, general pathology, and in methods of examination
and treatment that he may diagnose and treat intelligently
many of the cases that cannot afford to go to a perhaps
distant specialist; that he may treat successfully that large class of
emergency cases that first come to the general practitioner and in
which immediate treatment is imperative; and, lastly, that he may
recognize and intelligently refer those cases that need the services
of one specially trained to this branch of work. Dr. Hedges and
Dr. Compton.
Hygiene.—Three hours weekly throughout the year.
The course begins with a historical sketch of the development
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
habitation, 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.
FACILITIES AND OPPORTUNITIES FOR RESEARCH.
The Department of Medicine not only fosters in its methods of
instruction the inductive study by the student himself of the phenomena
presented by the human body in health and disease, but also
encourages the spirit of investigation of unsolved problems of medical
science and practice on the part of the instructors and students.
During the past few years there have appeared annually a number
of papers from its laboratories embodying the results of such investigations,
and it is the policy of the department to enlarge this
feature of its work in the future. Students are encouraged to engage
in research as they are prepared for it, usually assisting an
instructor in some special study or else conducting the research
under his guidance and advice. For this purpose the scientific and
clinical laboratories offer the necessary facilities and heads of departments
will always be glad to suggest and outline problems for
investigation by any medical student or by others possessing the
necessary training therefor.
