THE PROPOSED SITE OF THE MEDICAL SCHOOI 
 
 (THE PRESBYTERIAN^HOSPITAL) 
 
 ARLOTT] 
 
 AS THE LOCATION OF THE 
 CLINICAL YEARS OF THE 
 
 Medical Seliool of 
 Mortli Garoliea 
 
 PREPARED AND PUBLISHED BY 
 
 THE CHAMBER OF COMMERCE 
 

IJL?. 
 
 
 Cliarlotte m the Loeatiee of the Clieieal 
 Yesiirs of the Mediesil Sehool 
 of North Carolma 
 
 C HK CHARLOT.1K CHAjMIjKR C)1^ C(3\I]\1KRCK of the Citv of Char¬ 
 lotte presents the following facts and arguments in sup])ort of its petition 
 that the clinical years of the proposed North Carolina Medical College he 
 ])laced in the City of Charlotte: 
 
 The supreme consideration in deciding on the location of the clinical years of 
 a medical school, are: 1st, amount and variety of clinical material, and 2nd, the 
 ability of local physicians to furnish such assistance as the school authorities may 
 desire in connection with teaching. In both of these regards we respectfully submit 
 that Charlotte surpasses any other possible location in the State. 
 
 The Clinical School of Medicine, in order to be prepared to teach and to heal, 
 to bless and to serve, must be planted where its needs can he met. W'e shall here 
 demonstrate that Charlotte can he expected to supply the essential resources for such 
 a school. Here is offered the location where need and resource can best meet. 
 
 I. Charlotte’s Clinical Material 
 
 In considering a given location and its possibility as a clinical material ])roduc- 
 ing territory, consideration should he given both to the number of inhabitants and 
 their character; that is to say, whether or not they are the kind of people who will 
 be likely to patronize a charitable or semi-charitahle hospital and out-patient clinic 
 and allow themselves to be used for clinical study. According to the latest direc¬ 
 tory, Charlotte and the territory closely adjacent thereto and which is considered a 
 part of the city, has a population of 61,000. There is an interurban car line leading- 
 through the industrial section of Mecklenburg and Gaston Counties, making about 
 54,000 additional persons accessible to the hospital and out-patient department by 
 cheap electric car transportation. Three systems of railroads enter Charlotte, and 
 railroad tracks come in from eight different directions, and more than 100 pas¬ 
 senger trains enter and leave the city every day. Also there is a veritable net work 
 of good roads around the city and leading to adjacent towns, which have great 
 industrial populations. Patients from every section of the region may he i)rought 
 to Charlotte quickly and comfortably. Within a radius of twenty-five miles of 
 Charlotte, according to the official United States Census, there live 211,425 people; 
 within a radius of fifty miles of Charlotte there lives 585,000 people, which is 
 115,000 more than the number living within a like distance of Richmond. Within 
 100 miles of Charlotte, there is a population of 1,972,000, which is 68,000 more 
 than the population within the same distance of Atlanta, Ga. 
 
 The United States Census Bureau reports as of January 1, 1920, the follow¬ 
 ing populations within the stated distances of the following cities. 
 
Twentv-Five Miles Radius—Charlotte, 210,000; Winston, 194,000; Creens- 
 horo, 1<S6,000; Raleigh, 172,000; Durham, 148,000. 
 
 Moreover, Charlotte is the center of this territory—the commercial center, 
 the l)anking center, as well as the center of the greatest hydro-electric power 
 develo])ment in the United States, with its attendant industrial ex])ansion. And 
 Charlotte is now the acknowledged medical center of this vast industrial region. 
 It is not simplv located in the center of this region, hut is the huh toward which all 
 this region gravitates. 
 
 Uhe po])ulation which will furnish the greatest amount of clinical material is 
 the industrial ]) 0 ])ulation accessible to the hospital and out-patient de])artment hy 
 electric car lines. It is well enough to consider the accessibility by rail and motor 
 transportation, it is true that a large number of people in moderate circumstances 
 have automobiles, hut it is an undeniable fact that the people who will patronize 
 the hosi)ital and the out-patient department will he largely of the class which does 
 not have money to s])end purchasing automobiles or paying taxi fare. The out¬ 
 patient department will he chiefly dependent on ])ersons who can come on the elec¬ 
 tric cars. Of course, every one knows that persons attending an out-patient depart¬ 
 ment are persons with minor ailments, and they will not he willing to come any 
 great distance by automobile or train. Also, we believe that persons who will he 
 useful for teaching ])urposes in the hospital will necessarily l)e persons who will 
 come on the car. The hos])ital clinic must have a large number of persons who 
 have acute and infectious diseases. Persons with these diseases cannot come anv 
 great distance l)y automobile or rail. They recpiire immediate transportation. Con¬ 
 sequently, while we are advancing the net work of good roads and railroads as a 
 persuasive argument, we l)elieve that the outstanding fact which makes the j) 0 ])ula- 
 tion in and adjacent to Charlotte available for clinical purposes, is the electric car 
 lines reaching all parts of the city and extending out through ^Nfecklenhurg and into 
 the mill sections of Gaston County. Even if we disregard altogether the territory 
 served by the interurhan system which leads into Charlotte, we are convinced that 
 the inhabitants of the City of Charlotte and its immediate suburbs will furnish 
 unaided a wealth of clinical material which will he amply sufficient to su])plv the 
 hospital and out-patient department. 
 
 4'en years ago there was located in Charlotte the North Carolina Afedical Col¬ 
 lege, which conducted an out-patient clinic. This out-patient clinic had an average 
 of 60 persons |)er day. When we realize that in these ten years Charlotte and 
 territory immediately adjacent thereto have increased enormously in ]) 0 ])ulation, 
 it will he seen that a college and out-patient clinic serving only Charlotte and its 
 adjacent territory could easily furnish many more than the required 100 ])atients 
 per day. 
 
 The Health Department of the City of Charlotte now o])erates a charity clinic 
 and it has an average of seventy-five ])atients ])er day. In this connection, it must 
 
 4 
 
be rememl^ered that this is run as a municipal clinic with all its drawbacks and 
 limitations. Patients outside the county are refused treatment. There is no effort 
 made to develop the clinic and it is looked upon merely as a method for takin" care 
 of the city’s indigent. Therefore many patients are discouraged from a])plying. 
 This clinic is not adequately housed. The city Health Officer gives it as his opinion 
 that it could he easily enlarged and prol)ahly doulded if proper encouragement were 
 given to persons attending it. A clinic of double this size could easily he developed 
 by a University Hospital. 
 
 The American Medical Association puts down as one of the requirements for 
 a Medical College, the necessity of having an out-patient clinic with an average of 
 100 patients per day. The foregoing facts aljout the old North Carolina Aledical 
 College and the present-day municipal clinic clearly demonstrate that with any sort 
 of care, attention and organization, a college clinic would be attended by anywhere 
 from 100 to 200 persons per day coming from Charlotte itself. As the present 
 municipal clinic is managed, little attention is paid to many of the specialties, such 
 as Eye, Ear, Nose and Throat, Neurology, Gynecology, etc. 
 
 CHARLOTTE^S PRESENT HOSPITAL FACILITIES 
 
 There are at present seven hospitals in Charlotte, with a capacity of 365 beds, 
 as follows: 
 
 Presbyterian Hospital _ 
 
 Charlotte Sanatorioum_ 
 
 St. Peter’s Hospital- 
 
 Mercy General Hospital- 
 
 Charlotte Eye, Ear, Nose and Throat Hospital- 
 
 Tranquil Park Sanatorium- 
 
 Good Samaritan Hospital- 
 
 Total_ 
 
 Patients in Hospital- 
 
 Surgical --- 
 
 Medical - 
 
 Practitioners - 
 
 Specialists - 
 
 1911 
 
 1921 
 
 42 
 
 93 
 
 48 
 
 78 
 
 40 
 
 65 
 
 16 
 
 45 
 
 
 30 
 
 — — 
 
 25 
 
 15 
 
 24 
 
 161 
 
 360 
 
 3,600 
 
 8,212 
 
 2,500 
 
 4,808 
 
 1,100 
 
 3.404 
 
 42 
 
 108 
 
 8 
 
 60 
 
 In 1921 there were admitted to the Charlotte Hospitals 8,212 patients, and 
 of this numlier 40 per cent came from outside of iMecklenlmrg County. 1 his 
 demonstrates that Charlotte is already a medical center fully capable of maintaining 
 
a teaching hospital of 200 beds. Besides the quantity of clinical material, the 
 question of variety is of considerable moment. Of the 8,200 hospital patients in 
 Charlotte last year, 4,808 were surgical cases, and 3,404 were medical cases of 
 stiff dent gravity to he in bed for study or treatment. 
 
 In addition to the persons who are confined in hospitals in Charlotte, it must 
 also be borne in mind that there are an enormous number of persons who receive 
 treatment from physicians in Charlotte that do not go to the hospital. We do not 
 mean to say that all of the persons who are confined in hospitals in the City of 
 Charlotte, or all of the persons who receive treatment at the hands of Charlotte 
 physicians will be available for clinical study, but we think it perfectly sound 
 argument to say that 20 per cent of this number would he available in connection 
 with the hospital and out-patient department of the University Medical College, 
 and any unusual case at any time could be used for teaching purposes. In such 
 clinics as G. U. and surgery 50 to 60 per cent of private patients are available for 
 teaching purposes. 
 
 The patients who are in the medical college hospital must be selected as to the 
 diseases from which they are suffering and consequently it is absolutely essential 
 that the territory surrounding the hospital be such as will furnish a mixed variety 
 of every known kind of physical disease and ailment in proper proportion in order 
 that the clinical training of the students may be well rounded. The primary object 
 of this hospital is not to furnish charity for certain of North Carolina’s indigent, 
 but to furnish the young doctors of North Carolina with typical cases of every 
 known disease and ailment; the hospital should have such a clientel as the young 
 doctor would expect to have in after life. The hospital should have: 
 
 OBSTETRICAL MATERIAL 
 
 The American Medical Association lays down the following as its standard for 
 a iMedical College in reference to obstetrics: 
 
 “At least six maternity cases should he provided for each senioi 
 student, who should have actual charge of these cases undei the supei 
 vision of the attending physician. Careful records of each case should he 
 handed in by each student.” 
 
 It is reasonable to assume that when the Medical College becomes firmly estab¬ 
 lished it will have an average of fifty seniors per year. This would require 300 
 maternity cases. Charlotte can easily furnish this number of mateinity cases, as 
 
 evidenced by the following figures; 
 
 In 1921 there were born in the City of Charlotte 1,769 babies and 714 
 additional babies were horn in the county, making a total of 2,483. 
 
 It is certain that about 500 of these would he availalile for clinical study. We 
 
are here not taking into consideration the material which would also be available 
 by reason of the development of such a department in the school and by reason of 
 the proximity of industrial centers, such as Belmont, Mount Holly, Lowell and 
 other mill towns which are nearl)y and served by the electric interurban. These 
 cases are available for study during the entire course of their pregnancy, in view 
 of the fact that they are all within easy reach of the proposed Medical College by 
 car line, all of them being within a maximum ride of 50 minutes and most of them 
 being within a ride of 20 to 30 minutes. 
 
 There is also in Charlotte a Maternity Home run by the Florence Crittenton 
 Board. This Board has an average of 50 mothers and 22 babies. There is a pos¬ 
 sibility that this material might be available. At least the rare operative cases 
 could prolmbly be used. There is also soon to be a Detention Home for Delinquent 
 Women. This would furnish material for gynecologic and obstetrical work. 
 
 PEDIATRICS MATERIAL 
 
 There are two children’s homes in Charlotte containing 113 children at present 
 and an infirmary of 22 beds for infants under four years of age is now in process 
 of construction. There are four physicians in Charlotte who are specializing in 
 pediatrics and their work is developing this field in Charlotte very rapidly, and 
 they have a number of referred cases which would also be availaljle for study. 
 
 ORTHOPEDIC MATERIAL 
 
 The only orthopedic hospital between Baltimore and Atlanta is the State 
 supported institution at Gastonia, which is within 50 minutes’ ride of Charlotte by 
 train, electric car or automol)ile. This fact shows that at no other place in North 
 Carolina would it be possil)le for the students to get such a wealth and variety of 
 training in orthopedics as would be available in this hospital which is so close to 
 Charlotte. 
 
 NERVOUS AND MENTAL CLINICS 
 
 There is a nervous and mental disease hospital in the City of Charlotte of 25 
 beds. The patients in this hospital together with the patients in the general hos¬ 
 pitals of the city would furnish a proportionate variety of cases of this nature for 
 study. 
 
 EYE, EAR, NOSE AND THROAT CLINICS 
 
 The only eye, ear, nose and throat hospital in the South will be completed in 
 Charlotte by the end of the current year. This hospietl will have 30 beds and will 
 be equipped with all of the latest apparatus for treatment of diseases of these 
 organs. To indicate the great variety of diseases in this line of work in Charlotte, 
 there were 2,500 tonsil and adenoid operations in 1921. There are 13 physicians 
 
 8 
 
in the City of Charlotte who are specializing in eye, ear, nose and throat work, 
 resulting in Charlotte’s already having become one of the great eye, ear, nose and 
 throat centers in the entire South. 
 
 GENITO-URINARY AND SKIN DISEASES 
 
 The largest private clinic specializing in genito-urinary and skin diseases in 
 the South is located in Charlotte. One of the leading medical educators of North 
 Carolina was recently heard to say that this clinic was the third best genito-urinary 
 clinic in the United States, being surpassed only by Hopkins and Alayo. There 
 are connected with this clinic eight physicians. In the year 1921 this clinic treated 
 an average of 100 patients per day. In addition to the cases treated in this private 
 clinic, the City Health Department had 2,343 venereal cases under treatment in the 
 year 1921. 
 
 TUBERCULAR CLINIC 
 
 The city maintains a tuberculosis clinic, and on January 1, 1921, it had under 
 treatment 402 tubercular patients. During the year 366 new cases were examined 
 at the clinic, 140 being discharged as not tubercular, leaving 628 cases of tubercu¬ 
 losis under treatment during 1921. This clinic is conducted in connection with the 
 Charlotte Co-Operative Nurses’ Association, and during the year 1921 these nurses 
 paid 2,311 visits to these tubercular patients. Arrangements are now being made 
 to build the first unit of a tuberculosis hospital which unit will cost about $20,- 
 000.00. Mecklenburg County levies an advalorem tax of two cents on the one 
 hundred dollars valuation to assist in the erection and maintenance of this hospital. 
 This entire material will be available for teaching purposes. 
 
 CLINICAL PATHOLOGY 
 
 Clinical Pathology has reached a high state of development in the Charlotte 
 hospitals under the unitary direction of an eminent pathologist whose oiiginal 
 investigations are well known to the medical profession. Foi a numbei of \ears 
 he has been training laboratory technicians and sending them out to othei paits of 
 
 the State. 
 
 CLINICS FOR TREATMENT OF DEGENERATIVE DISEASES 
 
 The usual County Home of 100 lieds is available for the study of chronic 
 diseases and those incident to old age. 
 
 X-RAY AND RADIUM 
 
 Remarkaljle development is now taking place in Charlotte in X-Ray work. 
 There are already d2 N-Rav machines in Charlotte. One clinic is piepaiing to 
 install a deep therapy machine of the most modern type. In this clinic, in addition 
 
 9 
 
to their X-Ray machines for diagnostic and treatment purposes, there is a supply 
 of radium for the treatment of appropriate cases. 
 
 GENERAL SURGERY 
 
 There are 15 surgeons in Charlotte, four of these being recent arrivals. In 
 1921 these 11 surgeons performed 4,808 major operations, exclusive of numerous 
 minor operations and treatment of ambulatory cases. 
 
 GYNECOLOGY 
 
 There are five men in Charlotte who do principally gynecological surgery. 
 This indicates a high development of this branch of surgery which would furnish a 
 large clinic to the Medical School. 
 
 The Home for Delinquent Women would add materially to this clinic. 
 
 INTERNAL MEDICINE 
 
 In 1921 there were 3,404 medical cases hospitalized in Charlotte. There are 
 eight physicians specializing in internal medicine, with an average of 5,000 cases 
 per year. 
 
 ACUTE DISEASES, INCLUDING CONTAGIOUS AND INFECTIOUS 
 
 In 1921 there were in Charlotte many cases of diphtheria, typhoid, pneumonia, 
 scarlet-fever, whooping-cough, measles and mumps. This indicates a wealth of 
 acute diseases that could be utilized for immediate study. Most of these cases could 
 not be transported because of the State laws requiring quarantine. 
 
 G ASTRO- ENTEROLOG Y 
 
 Gastro-enterology is represented by two specialists who have a large clinic and 
 devote themselves exclusively to disease of the stomach, intenstines and bile tract. 
 
 PUBLIC HEALTH WORK 
 
 There are three whole-time public health officers carrying on the work of the 
 City and County, and the quality as well as the scope of this work would afford 
 valuable practical training in both urban and rural public health activity in meeting 
 the Southern climatic and racial health problems. 
 
 II. Charlotte’s Medical Personnel 
 
 When the proposition of placing the last two years of the Medical School in 
 Charlotte was first discussed with President Chase and Doctor Manning, they were 
 given definitely to understand that the University authorities would not be embar- 
 
 10 
 
rassed hy the local medical profession seeking professorships. The University 
 is free to import a complete whole or part-time faculty, as may seem best. All 
 clinical medical schools, however, must have a clinical, adjunct, or assistant teaching- 
 staff, varying from 26 at the University of Virginia to 269 at the College of 
 Physicians and Surgeons in New York City. Should the school be placed at Chapel 
 Hill, these instructors will have to he employed for their whole time; should the' 
 school he placed in Charlotte, such instructors could he largely recruited from the 
 local profession. Charlotte has a greater number of medical men and men in a 
 greater variety of special branches of medicine than any other city of North Caro¬ 
 lina. There are here the following specialists: 
 
 General Surgery_ 11 
 
 Internal Medicine_ 8 
 
 Gynecology _ 3 
 
 Neurology _ 2 
 
 Pediatrics_ 4 
 
 Orthopedic Surgery_ 1 
 
 Psychiatry _ 2 
 
 Ophthalmology _ 2 
 
 Genito Urinary_ 7 
 
 Skin and Syphilis_ 2 
 
 Eye, Ear, Nose and Throat_11 
 
 Clinical Pathology_ 3 
 
 X-Ray_ 3 
 
 Obstetrics_ 4 
 
 Gastro-Ent,erology _ 2 
 
 Tuberculosis_ 1 
 
 Anaethesia_ 5 
 
 Rectal_ 1 
 
 Health Officers_ 3 
 
 Hospital Administration_ 2 
 
 Radium Therapy_ 1 
 
 Among the physicians listed above are many of the men who composed the 
 faculty of the North Carolina Medical College. This college was in existence for 
 eight vears and these men obtained teaching experience during the time of their 
 connection with this college. Some of the clinics enumerated above not only 
 specialize in subjects, but the different divisions of these specialties have been highly 
 developed. Eor example, in one of the eye, ear, nose and throat clinics, it appears 
 there is an ophthalmologist and bronchoscopist in addition to two specialists who 
 are following the ordinary line of work. In another genito-urinary and skin clinic, 
 the work is likewise divided and highly specialized. In this clinic more urethral 
 stones have been removed consecutively without operation than in any other like 
 clinic in the world. 
 
 In Charlotte the men devoting themselves to internal medicine are equipped 
 with all the modern contrivances for diagnostic work and theropeutic activities, 
 including" not only the X-Ray apparatus 1)ut the only Electio-Caidiagiaph in the 
 State, besides machines for making metabolism estimations. 
 
 There are 15 members of the College of Surgeons in the City of Charlotte, 
 which is probably twice as many as can lie found in any other town in the State. 
 
 The entire clinic m Charlotte is highly developed, one man alone having 
 
 11 
 
operated upon 503 goitres. This clinic is more highly developed than any similar 
 clinic in North Carolina. 
 
 Other outstanding medical facts might he enumerated, but the Chamber of 
 Commerce is only bringing forward specific facts to make its claim good. The 
 Charlotte profession is not desirous of being paraded or claiming its superiority, 
 but the honest desire is being made to set forth what Charlotte’s assets really are. 
 
 MEDICAL LIBRARY 
 
 The Charlotte Medical Library has been in existence for about ten years. It 
 has several hundred volumes. It is primarily a Journal Library. It has bound 
 copies of 30 of the leading Medical Journals. Some of these have been completed 
 by filling in back numbers. These bound medical journals are one of the greatest 
 assets to the student of medicine. The Library is growing every year. 
 
 THE MECKLENBURG MEDICAL SOCIETY 
 
 The Mecklenburg County Society has most of the doctors in the county as 
 members. It meets twice each month. Its meetings average about 40 members. 
 The papers presented are scientific and well prepard. Men of prominence are 
 often invited to read papers. In fact it is taken as an index of the idealistic and 
 scientific spirit dominating the profession of Charlotte. 
 
 PROFESSIONAL BUILDINGS 
 
 Charlotte has two Medical Buildings. There is the Medical Building, with 
 ofifices for about 15 doctors. There are only physicians in this building. There is 
 in process of erection, to be finished about the first of 1923, the Professional Build¬ 
 ing. This is to cost $240,000. It will have 157 ofifices. It will be open to physi¬ 
 cians, dentists and medical and surgical supply stores. 
 
 Ill. Finances 
 
 Charlotte offers a 100 bed hospital, located upon a magnificent site. The 
 appraised value of this property is One Half Million Dollars. The real estate 
 comprised in this offer amounts to ten acres, is located on a high hill and 
 overlooks the entire city. It is in the midst of the residential section and is 
 closely connected with the heart of the city by a double track car line, having 
 7j/2 minute service. 
 
 To equip the last two years of a medical school will require, in the matter 
 of buildings, a 200 bed hospital, in which should be class rooms, laboratories, 
 museum, library, and dispensary. Dr. Manning’s report estimated the cost 
 of hospital construction at $3,500.00 a bed, so that such buildings at Chapel 
 
 12 
 
Hill would cost from $750,000.00 to $1,000,000.00. Charlotte is ready to offer 
 
 a 100 bed hospital already m operation, with a separate nurses’ home on 
 the site. 
 
 The cost of maintaining hospitals is about $3.50 a day per patient where- 
 ever located.The cost of maintaining 200 patients constantly in Chapel Hill will 
 necessardy fall almost entirely on the State, as sick people will not pay for the 
 privilege of going to a small, out-of-the-way village for medical or surgical 
 service unless such service is admittedly far superior to that nearer their 
 home. Will the University be able to employ better medical men or surgeons 
 than those m the neighboring towns of Durham and Raleigh? Should the 
 hospital be located in Charlotte, the pay-patients will furnish a considerable 
 part of the expense of hospital maintenance. The income of the Presbverian 
 Hospital for 1921 was $125,000. 
 
 The cost of maintaining a medical faculty in Chapel Hill means full time 
 heads of from 12 to 20 departments as. there can be no half-time! men in 
 Chapel Hill, an idea relied on in the previous report in estimating the cost of 
 a Medical Faculty at Chapel Hill at $50,000.00. 
 
 There would have to be as 
 heads of departments of: 
 
 the lowest 
 
 estimate for a meagre school 
 
 1. 
 
 General Surgery 
 
 7. 
 
 Eye 
 
 2. 
 
 Orthopedic Surgery 
 
 8. 
 
 X-Ray and Radium 
 
 3. 
 
 Gynecology 
 
 9. 
 
 General Medicine 
 
 4. 
 
 Obstetric 
 
 10. 
 
 Therapeutics 
 
 5. 
 
 Skin and Genito Urinary 
 
 11. 
 
 Neurology and Psychology 
 
 6. 
 
 Ear, Nose and Throat 
 
 12. 
 
 Pediatrics 
 
 
 No provision is made in this list for any teacher of public health, serology, 
 
 immunology, gastro enterology, tropical medicine, clinical microscopy, etc., 
 and no provision is made for research workers of any sort, nor for assistants 
 and many subjects are lumped together, such as skin and genito urinary. One 
 State University in a small city last yesr spent $20,000.00 on the Skin Department 
 alone. 
 
 With $50,000.00 as previously estimated, these 12 professors would each 
 receive $4,166.00 a pear. As a matter of fact no school can run on 12 teachers ; 
 Columbia, for instance (1921), had 91 professors and 269 instructors and 
 assistants ; a total of 360. The University of Michigan has 38 professors and 
 62 associates at Ann Harbor, population 19,516; the University of Virginia 
 has 19 profesosrs and 26 instructors at Charlottesville with 10,688 population; 
 the State University of Iowa has 35 professors and 27 lecturers at Iowa City, 
 po])ulation 11, 267. 
 
 13 
 
Thus the University of North Carolina will need something- between the 
 19 professors of Virginia and the 91 of Columbia and between the 26 assistants 
 of Virginia and the 269 of Columbia, and as these men will need entire support 
 at Chapel Hill, any estimate below $150,000 would hardly give a sufficient 
 faculty. 
 
 IV. Charlotte’s Wealth and Liberality 
 
 Charlotte’s Bank Clearings at close of business, September 14, 1922 (as 
 reported to the Federal Reserve Bank Iw Charlotte Clearing House Association) 
 amounted to $7,620,650.00; on September 15, 1922, her banking assets were $38,- 
 387,072.99; the deposits in her banks, $30,567,612.23; her banking capital and 
 surplus was $7,819,460.76. The 1922 taxable value of her property was $85,000,- 
 000.00 in round figures, and the 1922 City budget provides for an expenditure of 
 $892,771.24. The assessed value of the taxable property of Mecklenburg County 
 for 1922 is approximately $125,000,000.00, and the County’s budget is approxi¬ 
 mately $950,000.00. 
 
 As to her liberality, reference should be made to her subscriptions for 
 Liberty Bonds, exceeding her quota on each of the five great loans. Public 
 subscriptions to meet the demands have been regularly made to the Y. M. C. 
 A., the Y. W. C. A., to the Red Cross and to the Salvation Army. The 
 statistics of the steady gifts of her people, year in and year out, would be very 
 impressive were they readily available. 
 
 We feel confident that the clinical school of medicine of the University 
 would be safe financially, if it put itself on the heart of wealthy and generous 
 Charlotte. The school should not be condemned to a struggle for mere 
 existence, nor should it be located so as to be dependent exclusively upon the 
 State for support. Place it where it will have the greatest chance to invite 
 private benefactions and local public support. In Charlotte, the financial 
 strain would be less—the potential resources greater. 
 
 V. The Geographical Location of a Medical School 
 
 Should be considered from the following angles : 
 
 1. The centre of unoccupied Medical School Territory. 
 
 2. Ease of access to Medical Students and Universitv Offi- 
 cials of North Carolina. 
 
 3. Location drawing the largest clinical material. 
 
 4. The situation of the largest medical centre. 
 
 1. The centre of unoccupied medical school territory.—At present, there 
 
 14 
 
are medical schools around N(:)rth Carolina at Richmond, Va., Charlestpn, S. C., 
 Atlanta, Ga., and Nashville, Tenn. Certainly North Carolina’s clinical medical 
 school will have to compete Avith these schools. To obtain the advantage as 
 to ability to draw students, the logical solution would seem to be the central 
 point between these cities. Charlotte more nearly meets that requirement 
 than any other city. Any clinical school situated at Chapel Hill or Durham 
 must compete strongly with Richmond to its great disadvantage. Rich¬ 
 mond’s clinical superiority would prevent the growth of any great clinical 
 centre near it. 
 
 2. The ease of access of medical students and university officials is a 
 question of a little railroad fare and time in travel, a few times a year and 
 should have a minor consideration in comparison to the vast advantages 
 off'ered by the clinical possibilities of a large centre of population. 
 
 v3. The location drawing the largest clinical material is of great import¬ 
 ance in North Carolina. The drawing power of any medical centre is regional. 
 Each centre draws from the region contiguous to it. Few patients are drawn 
 long distances. The region, therefore, more densely populated offers the 
 o-reatest possibilities. The Piedmont section of North Carolina around Char¬ 
 lotte is the most thickly settled part of the State. Charlotte’s future growth 
 Avill certainly be fast and large. 
 
 4. The situation of the largest Medical center should count much in the 
 consideration of the location of the Clinical Medical College. The tendency 
 of the medical colleges toward the medical centres is undisputed. The 
 clinical medical school not in a large city is a marked exception. The medical 
 student wants his clinical training in the medical centre with a large and 
 varied clinical material. Charlotte with its population of 61,900 people and 
 211,000 in a radius of 25 miles and now draAving 40 per cent of its hospital 
 patients from outside Mecklenburg' County is by far the largest medical 
 centre in North Carolina. 
 
 A city is the natural home of the medical school. Placed elsewhere, 
 Avhere the situation is artificial or induced, the anomaly always calls for 
 comment, explanation, defense, criticism, qualification. Not so in a city. The 
 people are there, not only its OAvn citizens, but thousands from all parts' of its 
 territory thronging its streets, trading in its stores, filling its hospitals. Stu¬ 
 dents Avill gather in a city. It is a “patent fact that students tend to study 
 medicine in their OAvn States, certainly in their own section. In general, 
 therefore, arrangements ought to be made to provide the requisite facilities 
 Avithin each of the characteristic groups. There is an added advantage that 
 local conditions are thus headed and that the general profession is at a 
 
 16 
 
variety of points penetrated by educative influences.” (Medical Education in 
 U. S. and Canada, P. 145). 
 
 Yet, it would be an unfortunate waste of resources if, while suplving 
 adequate facilties for the needs of the unserved region, they were so placed 
 as not to appeal to the seeker after medical education of the highest standard. 
 Statistics show that our own students prefer to study medicine in cities. 
 Many of these students are placed for the clinical years of their student life 
 in these City Medical Schools by North Carolina’s Medical Educators in the 
 schools at Chapel Hill and Wake Eorest, showing conclusively, we believe, that 
 these educators encourage their own students to attend medical schools where 
 a large number and a wide variety of clinical cases can be produced. IMedical 
 students for the year ending 1922 numbered 340 distributed among 33 schools. 
 Of these, 213 attended medical schools in cities. Of the remainder, 110 were 
 enrolled in the two year schools at Chapel Hill and Wake Eorest, leaving only 
 17 out of the total of 340 attending four year schools in small towns. 
 
 Due regard must be had to this established tendency. Let us remember 
 that students may decide to go elsewhere if thei State’s supported school is 
 not intellig'ently placed from a clinical and geographical standpoint. Raleigh, 
 Durham, Greensboro, and Winston-Salem are all near the northern border of 
 the open region and just beyond are cities to which they may go, cities with 
 larger populations and with long established medical schools of sustained 
 reputations. 
 
 VI. A School of Dentistry for the Future 
 
 North Carolina will eventually have a Schocl of Dentistry, and it should have 
 a close organic relationship with the School of Medicine. As more becomes known 
 a1)OUt the influence of the teeth upon the general health, dental students must not 
 only be taught the fundamental branches of medicine, but must take more of the 
 clinical courses. The School of Medicine should therefore maintain close contract 
 with the teaching of dentistry. 
 
 It has never been contended that students of dentistry could l)e trained outside 
 of the city. Schools of Dentistry have been located with relation to the need of 
 clinical instruction. Each student must be given large oppoitunities to leain 1)} 
 doing. Teachers must specialize, which means that the community must he large 
 enough to supply each one with a sufficient numlier of patients in his special line 
 
 Place the Clinical School of Medicine in Charlotte and, when the State is iead\ 
 to add the School of Dentistry, ideal conditions will exist for its location and no 
 additional problem will then be presented. 
 
 17 
 
VII. Relation of Location of Hospital to Teaching of 
 
 Nursing 
 
 The State should take the lead, when it establishes the University Hospital, 
 in the training of nurses. Assuming that we could persuade forward-looking young 
 men that a substantial clinic in a small town will yield to them the same results as 
 an abounding clinic in a populous center, the State would fall short of its duty to 
 the people if it offered to its young women no greater advantages for the study 
 of nursing' than would he afforded by a clinical hospital thus deliberately and inten¬ 
 tionally limited in its capacity. The location of the Clinical Medical School in 
 Charlotte with its alrge resources would present far greater opportunities for 
 development of clinical hospitals and consequently for the training of young women 
 as nurses. 
 
 VIII. Charlotte Is More Desirable As a Location for the 
 
 Medical School Than Chapel Hill 
 
 In this connection, we beg to say that we see no sufficient reason for uprooting 
 the splendid first two years of the Medical School at Chapel Hill, to place all four 
 years in some larger town. Our reason for taking this attitude is because the 
 University up to date has been conducting with splendid results a split medical 
 school. The chief reason why it will not continue to operate this split medical 
 school with the same splendid results is because it is having difficulty in finding 
 places to send its men for the last two years of its work, it being necessary to 
 divide them up among a number of colleges in various parts of the country, not 
 in accordance with the wishes of the students, but in accordance with the number 
 of students each is able and willing to take. 
 
 In the early consideration of this subject Charlotte representatives visited 
 Chapel Hill and Charlotte was visited by representatives from Chapel Hill at our 
 earnest invitation, because of the desire to avoid the abolition of the first two years 
 at Chapel Hill. This we were informed was imminent, as the Schools of Medicine 
 teaching the first two years only were fast disappearing. Also there was the great 
 difficulty of ])lacing the students when they left Chapel Hill, as the other schools 
 hesitated to i)romise to take students far ahead. Charlotte’s desire, originating in 
 the iMecklenburg Alumni Association, has always been to complete for the Uni¬ 
 versity its School of Medicine and so save to the State this efficient first two year 
 Medical School. The representatives of the University visited medical experts in 
 the North and we understood that their information was that while there were 
 disadvantages in a split medical school, that on account of the unique conditions 
 in North Carolina it might he feasible, permissible, and advisable to establish a 
 s])lit medical school. 
 
 There are, according to the American Ivledical Association Journal, August 
 
 18 
 
19, 1922, the following split medical schools in the United States: 1. The Uni¬ 
 versity of California, at Berkley and San Francisco. 2. College of iMedical Evan¬ 
 gelists, at Lorra Uinda and Los Angeles. 3. Stanford University School of i\Iedi- 
 cine, at Polo Alta and San hiancisco. 4. IJniversitv of Colorado, at Bonlder and 
 Denvei. 5. Indiana Univeisity School of Medicine, at Bloomington and Indian¬ 
 
 apolis. 6. University of Kansas School of Medicine, at Lawrence and Rosedale, a 
 suhurh of Kansas City. 7. Cornell University, at Ithica and New York City. 8. 
 University of Oklahoma, at Norman and Oklahoma City. Some of these are 
 ])lanning to comliine, hut the fact that they have existed successfully for practical 
 reasons shows that this ])rocedure is a possible one for North Carolina. 
 
 Earlier in this pamphlet we have called attention to the fact that the su})reme 
 consideration in deciding on the location of the clinical years of the Aledical School 
 is the clinical material. In oth^r words, it is not possible to train phvsicians with¬ 
 out having sick people for them to study. The American Medical Association 
 insists that there he clinical material sufficient to maintain a 200 bed hospital which 
 shall have a full variety of cases; also an out-patient department averaging 100 
 patients a day. Chapel Hill, itself, of course, cannot afford any such hospital or 
 out-patient department. The people who patronize such a charitable or semi- 
 charitable hospital or out-patient department do not have automobiles in which to be 
 transported to Chapel Hill; also it will be impossible for such a hospital and out¬ 
 patient department to receive and treat acute, infectious and contagious diseases. 
 The department of obstetrics will he almost impossible to handle on account of the 
 fact that in order to get sufficient maternity cases to supply the seniors, it would he 
 necessary to allow these patients to go to Chapel Hill fully two months prior to 
 deliA^erv and they would have to he retained there for fully a month after delivery, 
 which would be an enormous expenses to this State. This is assuming that these 
 cases would go to Chapel Hill, which we consider a very violent assumption. If 
 we assume that 300 cases would he necessary for a senior class of 50 students, 
 which is the minimum requirement set down by the American Aledical Association, 
 and if we figure the cost of each of these patients at $3.50 per day for 60 days, we 
 have an expense of $63,000.00, and, of course, this is unthinkable. 
 
 However, if we assume that it were possible to maintain the required hospital 
 and out-patient department at Chapel Hill, there would he another enormous 
 expense which would have to he met. In Charlotte there is a sufficient numhei 
 of trained phvsicians who would he willing to serve as clinical teachers at low cost, 
 whereas at Chapel Hill it would he necessary to employ these clinical teacheis at a 
 full salary, the cost of which would he enormous. In Charlotte, theie aie cei- 
 tainlv a sufficient number of men who can serve as clinical teacheis. The ph\- 
 sicians in Charlotte are highly specialized along the lines and in the manner required 
 for clinical teaching. It is to lie noted also that these men aie m Chailotte in laige 
 numbers and everv vear the number is being increased. \ oung men with highh 
 
 19 
 
specialized training are rapidly coming to Charlotte and the body of men which 
 can be used for the clinical teaching stafif in Charlotte will be sufficiently large to 
 enable the force to be rotated, thereby keeping the interest and enthusiasm in 
 clinical teaching up to a high standard. 
 
 IX. Charlotte Is More Desirable As a Location for the 
 
 Medical School Than West Durham 
 
 Charlotte has a population of 61,900 people, with a street car population 
 of 54,000. This presents more sick people in Charlotte and vicinity than there are 
 in Durham and proportionately means a greater opportunity to have a great medical 
 school. Charlotte has a medical profession of 106. This means that Charlotte 
 numerically could produce more teachers than Durham. In addition, the men in 
 Charlotte are more highly specialized, showing 63 specialists. The teaching experi¬ 
 ence gotten by formerly conducting a medical school in Charlotte is another con¬ 
 sideration to be counted for Charlotte. 
 
 By reason of the fact that Charlotte is already established as a medical 
 centre, it will continue to draw men who have a highly specialized training. 
 This means that, as time goes on, the number of available medical men in 
 Charlotte to assist in the operation of the Medical College as clinical teachers 
 or otherwise, as may be desired, will be greater and greater. Charlotte is 
 growing rapidly. It is the centre of the textile industry of the Piedmont 
 region and a large amount of wealth is being accumulated here. As this 
 textile industry increases, the amount of clinical material available in Char¬ 
 lotte will increase. We do not foresee any such development for the city of 
 Durham as we see for the city of Charlotte and, therefore, we do not think 
 that a mdical school located there would have anything like the future that 
 one located in Charlotte would have. 
 
 It has been advanced as an argument in favor of West Durham that it is 
 within 10 or 12 miles of Chapel Hill and, therefore, the administration prob¬ 
 lems will not be as great as if the clinical years were further away from the 
 President’s office. We respectfully submit, in the first place, that when the 
 last two years are separated as far as 10 miles from the President’s office, 
 they might as well be separated as far as 150; and, in the second place, that 
 this is a minor consideration and should have no weight when set up beside 
 the other arguments wdrich are of supreme importance. It is also to be 
 noted here that, at the present time, the last two years of the Chapel Hill 
 Medical School are now located all over the United States, being scattered all 
 the way from New Orleans to Boston and as far West as the Pacific Ocean. 
 For this reason, we respectfull}^ insist that anything that may be said against 
 
 20 
 
a split medical college applies to Durham with equal force as to Charlotte. 
 One of the arguments against a split medical school is the fact that the last 
 two years should be controlled by campus influence and University ideals. If 
 the campus influence and University ideals at Chapel Hill are strong enough 
 to bridge the 10 mile gap from Chapel Hill to West Durham, they certainly 
 will be strong enough to extend to Charlotte. West Durham is certainly no 
 more aflfected by the campus influence and University ideals than Charlotte is. 
 
 University spirit and ideals are transmissable. Else, why educate our 
 students in Universities, if they cannot carry this spirit and these ideals with 
 them through life? The converse of this proposition would have confined 
 all progress to the spot where the first ideal originated. We 1)elieve that too 
 much stress is being laid on the thought of physical promimity, as related 
 to unitary administration, while the main consideration is unity of purpose 
 and of ideals. Distance can impede or even prevent a certain commerce 
 between dififerent parts of the University, but it cannot prevent all parts being 
 actuated by the same spirit. 
 
 With the University at Chapel Hill and its clinical school of medicine in 
 Charlotte, both guided by the spirit of service to the State, l)oth under the 
 same control, with their policies outlined and their aft'airs guided by the same 
 ofificials, and with the ideals of both derived from the same source, we feel 
 certain that the interests of one would l^e the interests of the other. 
 
 It is worth considering, too, that the fact that the University occupies the 
 field of Charlotte would prevent the possibility of a rival medical school being- 
 established at hat location in the future. 
 
 If these clinical years are located at West Durham, we do not believe 
 that the hospital and out-patient department vdll get the full benefit even of 
 Durham’s population on account of the fact that West Durham is several 
 miles from the city of Durham and there is only a single car line operating 
 between the two places upon which cars run at great intervals. This will 
 render the hospital and out-patient department more or less inaccessible even 
 to the people in Durham and, therefore, makes it problematical as to whether 
 or not this hospital and outpatient department would be patronized even by 
 the citizens of Durham itself. 
 
 There would be a strong competition of Richmond with the clinical 
 school at Chapel Hill or Durham. Two of the hospitals in Richmond in the 
 last five years treated 1,763 patients from North Carolina; 50 counties in 
 western North Carolina contributed 186 of these, while the 50 counties in 
 eastern North Carolina contributed 1,677. This shows the relatively dom¬ 
 inating medical position of Richmond over northeastern Carolina. The pos¬ 
 sibility of Durham ever becoming a great medical centre is very remote on 
 
 21 
 
account of the nearness to Richmond and the drawino- of Riclimond, Norfolk, 
 and Raleigli in competition. 
 
 The drawing power of a liospital is strictly regional and there is no rea¬ 
 son to think that there will he any considerable increase in the number of sick 
 ])eople in the territory of either Chapel Hill or Durham. The Chapel Hill- 
 Durham territoryTvill always be limited on the north by Richmond, on the 
 east by Raleigh and on the \vest by (ireensboro; each of which places prob¬ 
 ably draws patients from Orange and Durham Counties. To overcome this 
 the University will have to offer very much better medical and surgical serv¬ 
 ice than can be (d)tained in Raleigh, Richmond or Greensboro, which seems 
 wholly improbable, or they will have to offer similar service free at a tre¬ 
 mendous ex])ense to the State. 
 
 As bearing- on Durham’s future ])OSsibilities, it is to be noted that it is 
 served by only three railroads, each one of which is a branch line. 
 
 d'he Ih'esident of the University of Tennessee has said that by having the 
 r^fedical School established in Memphis, away from the Lfniversity, the influence 
 of the University is made stronger in that locality. The contention is made that 
 by i)lacing the Clinical Medical School at Charlotte the interest in the University 
 would he intensified in this populous Piedmont Section. This should give the peo])le 
 of this section the ideals of the University. It should give to the University more 
 of the hnancial support and the legislative influence of this section. 
 
 In this connection Dr. Arthur Dean Bevan, who is one of the best known and 
 most experienced medical educators in the country, and who is Chairman of the 
 Council on Medical Education of the American IMedical Association, has this year 
 declared : 
 
 “The medical school should be located in and about the hospital and the dis¬ 
 pensary because it is here that we can have access to the patient who is the object of 
 our study. The opposite point of view, that the sciences of anatomy and physiol¬ 
 ogy, j^harmacology and pathology together form the science of medicine and that 
 medicine is simply the application of these sciences, and that because of that fact 
 the medical school should he located at the University, in touch with these depart¬ 
 ments, is not sound and should not he considered by University trustess in organiz¬ 
 ing and locating the medical department.” 
 
 22 
 
PRESBYTERIAN HOSPITAL 
 
 CHARLOTTE, N. C. 
 
 TEN ACRES, OF OVER 300 TREES, WITH 50 VARITIES, 
 THE STATELY OAK PREDOMINATING 
 
 One hundred Beds, handsomely furnished rooms, with and 
 without connecting baths. Seclusive Obstetrical Department. 
 The best of Operating Rooms (Four). Always ready for 
 emergency cases. Well equipped X-Ray and Bacteriological 
 Laboratories, in charge of specialist of experience. Hydro- 
 theraphy Massage and Exercise Departments now open. 
 Full corps of trained nurses. 
 
 PRESBYTERIAN STANDARD PUB. CO., CHARLOTTE, N. C. 
 

 
 
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