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.


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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.

The following is a description of the courses given during the session
1920-21. Important changes, to be announced later, will be made for the
session 1921-22. Organic chemistry becomes a premedical requirement; a
larger amount of time will be given to Biochemistry in the first year; and
Laboratory (clinical) Diagnosis will be given in the second year.

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 by Anatomy 3 of the second year.
Dr. Bean, Dr. Speidel and Dr. Hoover.

Anatomy 2.Six hours weekly during the third 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.
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, Dr.
Speidel
and Dr. Hoover.

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 cells, 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. Nicholson.

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,
neoplasms and malformations. Dr. Jordan and Dr. Nicholson.

Organic Chemistry.Lectures and recitations three hours weekly, laboratory
work six hours weekly until January fifteenth.
This course includes the
systematic study of organic chemistry, with special reference to substances


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of importance in their relation to medicine. The course lays a thorough
foundation for subsequent work in Biochemistry, Pharmacology, etc. A
record of seventy per cent on this course is required for admission to Biochemistry.
Dr. Bird and Mr. Thurmond, assisted by Mr. Brading and Mr.
Waterhouse.

Biochemistry.—Lectures and recitations, three hours weekly from January
18 to the end of the second term, six hours weekly during the third term; laboratory
work, six hours weekly from February
1 to the end of the second term;
nine hours weekly during the third term.
The chemical structure and reactions
of carbohydrates, lipins, proteins, and other compounds occurring
in the body. Blood, milk, and bile. The chemical physiology of digestion,
secretion, excretion, internal secretion, intermediary metabolism, and
nutrition. The laboratory work includes the study of carbohydrates, fats,
fatty acids, soaps, proteins, purine compounds, etc; blood, milk, and bile;
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. Hough, Mr. Strang
and assistants.

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, Dr. Speidel and Dr. Hoover.

Physiology.—Lectures, recitations, and demonstrations, six hours weekly
during the first and second terms; four hours weekly 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 students who have obtained grades of seventy per cent in Histology
and Biochemistry. The satisfactory completion of the laboratory work
of this course is necessary for admission to Pharmacology. Dr. Hough
and Mr. Strang.

Bacteriology and Pathology.Twelve hours weekly throughout the session
and two additional hours a week in the third 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 and Dr.
Reynolds.


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Pharmacology.—Lectures, recitations and demonstrations five 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 the first two terms of Physiology together with the satisfactory
completion of the laboratory work of Physiology is required for
admission to the course. Dr. Waddell, assisted by Mr. Wood and Mr. Ottenheimer.

Clinical Diagnosis.—Six hours weekly during the second and third terms.
During the session 1920-21, this course is given both to second and third
year students. Dr. Bray.

Journals.—In connection with the work in Physiology, Bacteriology
and Pathology, the second-year students meet with their instructors for
one hour each week from the first of December to the end of the session
for reports and discussion of the current literature of the above sciences.
Three reports are made at each meeting by the students.

Physical Diagnosis.Four hours weekly during the third 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.—Lectures and recitations three hours weekly and
laboratory work three hours weekly, during the first half of the third year.

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. Wood.

Toxicology.—Lectures and recitations three hours weekly and laboratory
work three hours weekly, during the last half of the second term.
A
systematic review is made of the pharmacological action of such chemic
agents as are particularly liable to cause injury 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.

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


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equipped with the most modern instruments and apparatus. Dr. Bray, assisted
by Mr. Wright.

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
out-patient 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
and 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, and one hour weekly in X-ray diagnosis for one-fourth the session.

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. This also includes certain surgical specialties, e. g., orthopedics.
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
closely the outlines already described for surgery. The general principles
of gynecology are taken up in lectures and recitations. In addition,
the out-patient department affords practice in palpation, diagnosis and
treatment. Dr. Watts, Dr. Goodwin, Dr. Bigger and Dr. Setzler.

Urology and Proctology.—Of the total time assigned to surgery, one
lecture hour weekly for the first and second terms, and six hours weekly
in the out-patient department for one-fourth 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-fourth 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, urethroscopic and proctoscopic procedures. Dr.
Neff
and Dr. Setzler.

Roentgenology.Six lectures, and practical demonstrations to the class
in sections throughout the year.
The applications of the X-rays to medicine
and the interpretation of plates in diagnosis. Dr. Wiatt.

Phthisiotherapy.Six hours weekly for ten weeks, with each of the jour
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.


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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.
Klotz.

Obstetrics.Five hours weekly of lectures, recitations and manikin demonstrations
during the year,
supplemented by work with patients 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. 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 term.
In this course is given
also instruction in electrotherapeutics. Dr. Davis.

Pediatrics.Three lectures and recitations weekly, supplemented by clinical
work during the second 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. There is also a baby welfare
clinic once a week in the outpatient department. Dr. Davis and Dr. Rea.

Dermatology and Syphilology.One lecture weekly during the fall and
winter terms.
The importance, etiology, prophylaxis, pathology, clinical
history, diagnosis and treatment of syphilis are discussed. After a review
of the anatomic and the histologic structure and the physiology of the
skin, the diseases commonly met with are discussed. The available outpatient
material is utilized by the third year students; selected cases, admitted
to the hospital, are studied by the fourth year students. Dr. Smith.

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


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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.

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. 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 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 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. Neff,
and Dr. Setzler.

In addition to the above course, required of all students, the following
elective course is offered in the Department of Surgery:

Surgical Pathology.—An optional course. Two hours weekly during
one-half 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. Goodwin.

Clinical Pathological Conferences.—One hour weekly is assigned for
the study of pathologic material in connection with the clinical aspects of
cases coming to autopsy. A history of the case is presented by the student
in charge, the autopsy is reviewed, the tissue and microscopic sections
are examined, and all the information thus derived is collated and contrasted.
Dr. Marshall.

Obstetrics.—The student attends, under the guidance of an instructor,
the labor cases in the hospital, and is required to prepare the history of
patients and to follow up the cases through the puerperium. Instruction


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is also given in the care of the new-born. In addition the student has the
opportunity of attending patients in the out-patient department, and each
student is expected to attend at least six cases of labor. A clinic for third
year students is held one day in the week in the out-patient department for
recording and examining pregnant women. The patients are instructed in
prenatal care, and students are assigned to each care for attendance during
labor under the guidance of an instructor. Dr. Macon.

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. Klotz.

Diseases of the Eye, Ear, Nose and Throat.Two lectures weekly during
the first two terms, supplemented by regular two- to three-hour clinics twice
weekly 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. Compton.

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.