Hi No. 3 BULLETIN OF St. Louis University < ~CiUy \ NOVEMBER, 1905 „ i~l ii " | Vol. 1 TABLE OF CONTENTS The Fundamental Branches in the Medical School Calendar 2 Executive Committee 2 Some Features of the Modern Medical School 3 Department of Anatomy 5 Department of Physiology, Physiological Chemistry and Pharmacology 12 Department of Pathology and Bacteriology 16 Department of Chemistry 21 Library 22 Research 25 Instructors in the Fundamental Branches of the Medical School 27 Publications of the Instructors of the Fundamental Branches of the Medical School 29 Published Quarterly by the St. Louis University Grand Avenue and Pine Street ST. LOUIS, MO. Entered June 13th, 1905, at St. Eouis, Mo., as second-class matter under Act of Congress of July 16th, 1894. 2 Bulletin of Calendar. 1905. Monday, October 2, Opening of Regular Session. Thursday, November 30, - - - Thanksgiving Day, Holiday. Friday, December 22, p. m., - - Beginning of Christmas Vacation. 1906. Monday, January 1, p m., Saturday, January 27, Tuesday, February 22 Tuesday, May 8, Saturday, May 19, End of Christmas Vacation. End of First Semester. Washington’s Birthday, Holiday. Senior Examinations Begin. End of Semester. Executive Committee. W. Banks Rogers, S. J., President. Young H. Bond, M. D., Dean. William G. Moore, M. D., Vice-dean. Hanau W. Loeb, M. D., Secretary. Hugo Summa, M, D. A. V. L. Brokaw, M. D. Albert C. Eycleshymer, Ph. D. Elias P. Lyon, Ph. D. St. Louis University Some Features of the Modern Medical School. (An address to prospective medical students.) The prospective medical student of to-day finds before him the four full years of the modern medical school which must be completed before he can obtain his degree and be admitted to practice. He knows that his father or his family doctor who studied medicine thirty years ago was able to complete his formal training in two years. The boy of the present time finding that he must take four years following a full high school course, will inquire (if he is thoughtful), why this change has come about. It is the purpose of this article to discuss the advance in medical education and the reasons which lie at the base of the present plan of study. Two great factors have been at work in the evolution of medical education. The first of these has been the advance of education as a whole, both as to distribution and as to methods of teaching. The man does not need to be very old to see that an enormous change has taken place in secondary and collegiate education during his own lifetime. The high school as we have it to-day existed only in few places and in an undeveloped form thirty years ago. Often it was a physical impossibility for the struggling lad of the frontier to get more than a common school education. The medical schools could not set a standard of admission, impossible of attainment. Moreover the degree of general culture and education in our communities was below that of the present time and less was expected of medical men than now. To-day, as always, the doctor must be in advance of the general type of citizenship in the community where he lives and that means a decided advance in general education over what was necessary a third of a century ago. This is reflected in the ad- vanced requirements for entrance to the medical schools. A further cause, and a very potent one for the advanced require- ments is the highly scientific character of medical knowledge to-day. The common school man is without the necessary educational basis to undertake the study of chemistry, histology, physiology and other subjects which lie at the foundation of medicine. Without going deeply into the matter at the present time, it may be said that even the best high school course is far from being the ideal preparation for medicine. The second great factor which has influenced the development of medical education has been already suggested. It is no other than the immense advance in medical knowledge itself. It is no exaggeration to say that the last hundred years have seen an advance in actual medical knowledge more than equal to all that had been accomplished in all the centuries before. And the greater part of this forward movement has been in the last thirty years. When the old family physician was sitting on the student’s bench, there was no science of bacteriology and consequently no aseptic surgery, no knowledge of the real cause of disease, no antitoxins, no rational hygiene. There was little chemistry (at least in medicine), and consequently there was little knowledge of what was going on in the body, in health and disease. The microscope had not found its way into medicine as the indispen- sable aid to the conscientious practitioner. The limitations of 4 Bulletin OF surgery did not then demand the exhaustive knowledge of anatomy which is needed to-day, when almost no part of the body is beyond the reach of surgical methods. Not to multiply examples, it is plain that if two years were necessary to master the essentials of medicine thirty years ago, four years are all too short a time to gather a working knowledge of the complicated subject matter of the present day medicine and to put the student in a way to keep pace with the progress which is sure to take place during his own years of active usefulness. It is evident that methods of teaching which were sufficient thirty years ago or which were at any rate, the best the day afforded, would be entirely inadequate in the face of the training demanded to-day. The recent tendency of education, both general and professional, has been to make the student know things; not simply to know about things. Therefore the present day school has equipped laboratories, founded clinics and built hospitals in order that its students might have first hand knowledge of the scientific facts on which medicine rests and of the diseases and methods of treatment, which form the subject matter of the later and so-called practical part of the course of study. The modern medical school has a hundred microscopes where the old fashioned school had one. It has a chemical equipment for every student instead of a few test tubes in the hands of the professor. It has physiological apparatus, bacteriological equipment — a multitude of appliances not needed or dreamed of by the old fashioned school. There can be no doubt that the change has been of great benefit in producing a higher grade of physicians. Finally, the advance in medical knowledge and education involves in these days a change in the organization of the medical faculty. The sciences of chemistry, anatomy, physiology and path- ology which underlie medicine have become so complex and the advances in them are so rapid that the best results in teaching these subjects can only be obtained at the hands of trained specialists. The old method of appointing practicing physicians in the fundamental branches has been given up in all the best schools. The busy practitioner can not give the time required to conduct laboratory courses. Instead of physicians, we find pro- fessional chemists, anatomists, physiologists, etc., who devote their whole time to teaching and research. This leads to an enormous improvement in the methods of teaching and the real advancement of the students, and involves a great increase in expense over the old plan. Hence only the medical schools of the strong universities are so organized; and this constitutes another potent reason why the thoughtful student will select a university medical school. The attention of prospective students is called to the descrip- tions of the fundamental departments of medicine in the St. Louis University, published in this number of the Bulletin. The annual catalogue containing further information will be sent on application. The University will gladly correspond with those who are looking toward a career in medicine and will advise them concerning their preparation and qualifications. Those who can visit the medical school will be welcome to examine its facilities and equipment. Students who intend to devote themselves seriously to study are desired. They will find, in St. Louis University, teachers whose earnest effort will be to develop them along the highest ideals of medicine. St. Louis University 5 Department of Anatomy. The work in the Department of Anatomy is divided into three parts, Gross Anatomy, Microscopic Anatomy and Research. Bach of these divisions comprises a number of closely related sub- divisions. In the following pages an attempt has been made to show the relationship of these subdivisions and to give a detailed description of each. Gross Anatomy. The work of Gross Anatomy covers a period of four semesters, being a continuous course throughout the first two years. The arrangement is such that each course is dependent upon those which precede it. During the first semester, the student does the preparatory part of the work and lays the foundation for the more difficult and more important parts which are to follow. During the second and third semester, he does the regular work in human dissection, and becomes thoroughly familiar with the individual parts of the body. The fourth semester is devoted to a knitting together of the facts learned in the previous semesters into a concrete whole, which is to be of practical value to the student in the remainder of his medical course and in the practice of his profession after leaving school. The preparatory semester’s work comprises the Comparative Anatomy, Descriptive Anatomy and Osteology, Arthrology and Myology. The Comparative Anatomy is the beginning course and is designed to give the new student a general conception of vertebrate anatomy and at the same time to serve as an introduction to human anatomy, histology, neurology, embryology and physiology. While each student is required to have completed a four years’ high school course before entering the medical school, it is assumed that his knowledge of anatomy is very meager, and for that reason the course in Comparative Anatomy is planned for the beginner. Each student dissects the digestive, urinogenital, respiratory, circulatory and nervous systems of the cat. The mouth cavity and the salivary glands are studied first and are followed by the study of the remaining portion of the alimentary tract in regular order. The other systems are studied in the order in which they are named above. Running parallel with and forming an integral part of this course of Comparative Anatomy is the course in Descriptive Anatomy. This comprises lectures and demonstrations on the human cadaver. The two courses are so correlated that the lecture upon a given organ or part precedes the laboratory work upon that organ or part, i. e. the demonstration of the human stomach comes the hour just preceding the two hours’ laboratory work upon the cat’s stomach. The demonstrations are made upon manikins pre- pared from formalin hardened cadavers, in which each organ retains its normal shape, size and position. The organs are so well hardened that they may be removed from the body and 6 Buixetin of studied by the demonstrator and students as though they were only the parts of the papier mache manikin. With his first impressions of the human organ fresh in mind, the student proceeds at once to the laboratory to make these impressions more permanent by handling the corresponding organ of the cat. The student’s attention is directed in particular to the organ or part under consideration and is not diverted to other organs in the neighborhood. Thus the student’s mind is not burdened with an overwhelming mass of anatomical facts before the essentials have been mastered. The cat is used in Comparative Anatomy because it is better adapted to the needs of the beginner than is the human body. On account of its size the body of the cat can be handled con- veniently. Bach student may have a cat to himself and thus does not interfere with another’s work as occurs when several are dissecting the human body. In order that the work of the dissecting room may be satis- factory and productive of the largest results, the student must master the technique of dissection and become conversant with the terminology of the subject. The technique of dissection is to be mastered only by practice, for dissecting is not a tearing and destroying of the various structures, but rather a separating of them into their component parts; for this purpose the body of an animal is quite as good as that of man. With a very few exceptions, the organs of the cat differ only in size from the corresponding organs of the human body, and have the sarnie names as the human organs. Thus the terminology can be learned as well from a study of the cat, as from the human; in fact, the student is required to use his textbook of human anatomy as his guide in dissecting the cat, attention being called to the cases wherein the textbook description differs from the conditions found in the cat. These differences are usually unim- portant. In some cases, as in the peritoneal cavity, the variation is of great advantage because in the cat it is much simpler and more readily understood than in the human. The two courses, Comparative and Descriptive Anatomy, require nine hours per week in the laboratory and lecture room. The dissection of the nervous system of the cat is followed by a dissection of the sheep’s brain, after which the human central nervous system is studied. The spinal cord and its mem- branes are examined in situ, and then sectioned in various regions. The external features of the brain are identified and a basal and a lateral view is drawn and labeled. The structure of the brain is studied from sections in the sagittal, horizontal and coronal planes. These sections are made from brains which have been hardened in situ by formalin injection and show very clearly the demarcation between the gray and white matter. All of the important masses of gray matter are located and accurately outlined, and the fiber tracts are traced throughout the important parts of their courses. This is the foundation for, and is followed immediately by, the course in Microscopical Neurology. The course in Comparative Anatomy leads directly into the course in Human Anatomy, but in order that the foundation for dissection may be as broad as possible, the course in Osteology, Arthrology and Myology runs through the first semester parallel with Comparative and Descriptive Anatomy. St. Louis University 7 Osteology, Arthrology and Myology. The course prescribed for the Freshmen class for the study of the human skeleton is so mapped out as to give not only a com- plete insight into this part of human anatomy, as regards the indi- vidual elements, but also a practical working knowledge of all the parts in their true relations with one another. As is well known, the usual course in Osteology comprehends the study of the bones as individual parts, without reference to the skeleton as a whole. In the course given, the first step is to make an exhaustive study of each bone of a region, taking the bones up in their turn in detail. When these have been mastered, a complete study is made of the part as a whole with the articulations and the muscu- lature of the region, so that the student may see the importance of each point and get a more practical knowledge of the subject. Four hours each week are devoted to this work. Each student is supplied with a complete disarticulated skeleton and is required to recite from the bones he studied, all of the details which are of any practical importance. This method of detailed study is continued (in each region) until all the bones of a certain section of the body have been thoroughly mastered. Then the relationships of the region are carefully considered so that the student may have a thorough insight into the mechanism of the part. The next step in the course is the study of the muscular and ligamentous relationships from the previously prosected cadaver. On account of the abund- ance of material at hand, it has been possible to have enough prosections made of all the soft parts connected with the bones so that by division of the class into small sections the student not only gets to see the demonstrations, but is himself also required to demonstrate them to the other students and the instructors. After having completed the courses in Osteology, Arthrology and Myology, Comparative Anatomy and Descriptive Anatomy, during the first semester, the student enters, in the second semester, upon his work in human dissection with a consciousness that he is only going farther into the subject of Anatomy rather than taking up a new subject. He recognizes each organ as soon as he comes to it, and knows from experience what to do in order to get the most from his efforts. Human Dissection. The two main objects of this course are to keep the student in the dissecting room as much as possible, and to fix the anatomy upon his mind by having him work out and demonstrate the various structures to those in charge. The dissection of the more difficult parts such as the perinaeum and peritoneum is preceded by demonstrations of models of those parts which together with what the student has learned from comparative anatomy enables him to dissect with a much better understanding. For dissection, each body is considered to be composed of four parts separated from each other by the planes: one transverse represented by the diaphragm, the other longitudinal by the median sagittal plane. The parts of the body thus divided are a right and left upper and a right and left lower. The upper includes 8 Buixetin of one lateral half of the head, neck, and thorax, and one upper limb. The lower includes one lateral half of the abdomen and pelvis and one lower limb. Every student is required to dissect two parts, an upper and a lower, which make one lateral half of the body. Such organs as the heart, stomach and intestines which are not symmetrical on the two sides of the body, are dissected by all the students working upon that part of the body. Each part is assigned to two students, thus there are eight students working on a cadaver at the same time. According to this assign- ment one half of the class are working upon uppers, and the other half upon lowers. The time required to dissect a part is three two-hour periods a week for one semester. One part is dissected during the second semester of the first year, and the other part during the first semester of the second year. The work for the semester is outlined and divided into as many parts as there are weeks in the semester. EVery student is given an outline and each week’s work must be done during that week so that the work is evenly divided throughout the semester. The laboratory work is overseen by demonstrators. Each demonstrator has assigned to him twelve or sixteen students, who are working upon the same parts. He not only sees that the structures are dissected out satisfactorily, but hears demonstra- tions of them by the students, and explains such things as are not understood. The demonstrators are present at all laboratory periods and keep a record of each student’s daily work which helps to determine the final grade. Quizzes are held twice a week throughout the period of dissec- tion. While a student is dissecting his first part, he is quizzed only upon that part, but while he is dissecting his second part, he is required to answer questions upon both parts. The object of this is to prepare the student for the cross-section or Topographical Anatomy, which follows this course, and which requires a thorough knowledge of all the individual anatomical structures. Cross-Section or Topographical Anatomy. This course is a resume and practical application of the facts learned by the preceding courses, and no student who has not dissected at least one lateral half of the entire body can do the work. It deals with the various structures in the position they occupy in the undisturbed body and not as they appear after they have been dissected away from all surrounding structures. Thus the student comes to consider each organ an integral part of the body as a whole and as having the same relations as in the living individual. He thinks of the body as a complex unit whose internal parts have definite relations to the surface as well as to the near by structures. This phase of anatomical teaching is of the greatest practical importance because it considers anatomy as the student will find it in his practice after he has left the dissecting room. This is best accomplished by studying a serial set of cross-sections of the body which has been so hardened that the various organs retain their normal position and relations. The course follows immediately upon the completion of the regular dissection and requires three two-hour laboratory periods a week for one semester. The cadaver which has been hardened with formalin is cut St. Louis University 9 transversely into sections about one inch in thickness. Eight students work upon each set of sections and during the semester each student studies every section. First the various structures are identified at the surface of each section and their change of relations noted as a higher or lower level is considered. Following this a traced drawing of the superior surface of the sections is made as follows: The exact outline of every structure is traced with ink upon a glass lying directly upon the section. This tracing is transferred to drawing paper by clamping the paper upon the glass and holding it to the light. The lines upon the glass can be seen easily through the paper, and are traced upon it so that an exact outline of the section is produced upon the paper. This outline is finished and all the structures labeled in ink. Every section of the trunk is drawn but only five or six of the arm and five or six of the leg. These drawings are examined and returned to the student for correction so that ultimately he has a set of drawings, accurate and complete, ' to which he can refer for many relations which cannot be obtained from a textbook. After the sections have been drawn the anterior view of the body outline, the skeleton and the viscera are projected upon millimeter paper by measurements taken from the sections them-" selves. In this projection, each set of structures is outlined in a different color of ink so that there is no confusion of lines. This sums up the facts that have been learned from the individual sections and shows the relations of an organ as a whole to the surface of the body, to the skeleton and to the adjacent organs. Quizzes are held twice a week in which the student is required to draw typical cross-sections of the body at various levels, as well as to answer questions relating especially to the position and relations of the various structures. The record of the quizzes, the accuracy of the drawings and a final examination determine the final grade in the subject. Microscopical Anatomy. The work in Microscopical Anatomy is introduced by a study of the microscope, and its accessories together with practical exercises in its use. For this purpose familiar objects are used, such as fabric fibres: cotton, linen, silk, wool. As soon as some knowledge of the microscope and its working is gained, the work in Cytology is begun by studying the simplest living animal cells. This is supplemented by the study of living plant cells for the purpose of emphasizing protoplasmic activity. When a clear idea of the cell and its structural elements is obtained, the methods of cell division and differentiation are studied in both animals and plants. The student then proceeds to a study of the variously modified cells found in epithelia, blood and lymph, connective tissues, muscle and nerve. When familiar with the elements of the tissues the work in Histology is begun in which the various tissues are studied and the specific micro-chemical tests are applied. By the time this part of the work is well in hand the students have become familiar with the various organs and their relations in the cat and are prepared to begin Microscopical Splanchnology. In this work the various systems of organs, such as the circulatory, 10 BUDDFTIN OF respiratory, digestive and genito-urinary are studied. The last two weeks of the course are devoted to the identification of unknown tissue and organs. The course is conducted in the following manner: In the earlier part of the work, the student is given specific directions for his laboratory work in the form of printed outlines; these are supplemented by textbook reading on the subjects studied in the laboratory and the textbook in turn is elucidated by explanatory lectures. As soon as possible, the use of detailed outlines is discontinued, and during the last two weeks of the course, the lectures are also discontinued. During these last two weeks all the recent text- books are brought into the laboratory, and the students use these in identifying and writing the descriptions of their unknowns. Throughout the course, drawings are made of each object studied. The drawings are arranged in the form adopted in publi- cations, the figures are lettered and explained, and a brief descrip- tion written of each. The course covers a period of nine hours per week during the first semester of the freshman year. Microscopic Neurology. The course in Microscopic Neurology comes in the second semester of the Freshman year. The student is at this time study- ing Embryology, and has had a semester’s work in Microscopic Anatomy. He has also dissected the central nervous system of the cat and has made a careful study of the brain of the sheep and man. The work begins with a study of the skin as a sense organ, followed by the various forms of nerve and organs, and the organs of taste, smell, sight and hearing. The study of the central nervous system is then begun in which the spinal cord forms the starting point. Then the principal tracts of the cord together with the commisural fibers and their cells of origin are traced. Sections are then studied at the level of the motor and sensory decussations, at the level of the olivary nucleus and the exits of the cranial nerves. In addition to this, the study of the cerebellar peduncles and the cerebellum, and of the cerebral peduncles and the cerebrum lays a foundation for a mental picture of the extent of the great sensory, motor and commissural tracts and their nuclei of origin. The laboratory work is carried out in the same manner as in Histology. Embryology. The study of Embryology extends through the second semester of first year. At the end of the first semester, the students have had a half year’s work in gross anatomy, and have finished a thorough course in Cytology, Histology and Microscopical Splanch- nology. Thus they come to the work in Embryology with consider- able knowledge of gross anatomy and a thorough grounding in the methods and results of histological work. The work in Embryology begins with the study of the structure of the ovum and spermatozoon. Both living and mounted specimens are drawn and described. The process of fertiliza- St. Louis University 11 tion is then studied in the ovum of Ascaris. The formation of the polar bodies, the formation, structure and union of the male and female pronuclei are observed and drawn. Segmentation, gastru- lation and some of the later stages of development are followed out in the frog’s egg. The chick embryo is used to illustrate the formation of the germ layers and the foetal envelopes. Each student is furnished with complete series of sections. Typical sections are drawn and described and the study of the formation of tissues and organs is begun. The earliest stages in the formation of the blood and the circulatory system, as well as the nervous system, the digestive system, etc, are observed. The development and structure of the amnion, allantois and placenta and the relations of the placenta to the uterus are studied in the rabbit and the pig, with illustrations and demonstrations from human material. A detailed study of the formation of the various tissues and organs of the body is made on the embryo pig. The twelve milli- meter pig is made the basis of this study. Drawings are made of the external features, and then each student makes a careful study of the embryo in serial sections. Selected sections are drawn and described in detail and then the various systems of organs, the digestive system, the circulatory system, the nervous system, the genito-urinary system are studied by tracing each through the series of sections. Having worked out the structure of the embryo of this size carefully, the earlier and later stages can be gone through more rapidly. The development of the human embryo in the earlier stages is also made by means of serial sections, each student studying several embryos in this way. For the later stages, each student makes drawings of a series of human embryos in various stages of development. The anatomy of the foetus in the later stages is studied in a series of preparations and dissections. Throughout the course, attention is called, as occasion arises, to the causes of congenital malformations and to the applications or Embryology to Anatomy, Pathology and Obstetrics. There are two lectures a week during a half year. Each lecture is preceded by a quiz and followed by two hours laboratory work. Written examinations are introduced at irregular intervals. In the lectures, references are given to the standard textbooks and to the recent literature of the subjects. The most important textbooks and journals are accessible to the students in the labora- tory or the library. 12 Bulletin oe Department of Physiology, Physiological Chemistry and Pharmacology. In this school the following arrangement of Physiology and Physiological Chemistry has been adopted: Physiology begins in the second semester of the Freshman year and therefore after the students have had their Histology and Com- parative Anatomy and some part of Chemistry. On account of their incomplete knowledge of Chemistry (the course in Chemistry being at that time only half finished), the students are first intro- duced to the Physiology of muscle, circulation, blood and respira- tion, subjects which are not so completely dependent on Chemistry as others. These subjects are, therefore, finished in time for Pathology which begins the second year of the course. In the first semester of the Sophomore year, the Physiology of the nervous system, for which the student has been prepared by his cat anatomy, and by his Neurology, is taken up, followed by the Physiology of the senses. Meanwhile also Physiological Chem- istry begins with the Sophomore year, having for its foundation the Organic Chemistry of the previous year. About the middle of the first semester of the Sophomore year the study of secretion, digestion, absorption, excretion and metabolism is begun and carried forward co-ordinately in Physiology and Physiological Chemistry, the former considering more the physical and nervous aspects of the phenomena; the latter, the purely chemical side. It is hoped by this plan to give the student a detailed yet unified knowledge of these all important subjects. The Physiological Chemistry con- tinues throughout the entire Sophomore year, the last semester being occupied more particularly with the analysis of excretions, of stomach contents, etc., involving practice in the methods used in actual medical examinations. The aim is to make this part of the course thoroughly practical. Pharmacology for many reasons should be studied in the Sophomore year. For other reasons, especially that it may take advantage of the preceding study of Physiology and Physiological Chemistry, it is best that Pharmacology be given in the third year. This plan has been adopted. Fnysiology Propel. This subject is begun in the second semester of the Freshman year. Two lectures, one recitation and six hours of laboratory work are given each week. The laboratory is well equipped with modern apparatus. Beginning with the subject of muscle and contractibility in general, the student is led to see that all external manifestations of life take the form of motion. In the laboratory it is not believed to be profitable for the medical student to go into the graphic study of muscle to any great extent. Enough experiments are given to acquaint him with the more important phenomena and make him reasonably familiar with the apparatus and methods. The circulation of the blood is studied largely on mammals. The students work six at a table and so each one has an active part in each experiment, one serving as anaesthetist, a second pre- paring the electrical apparatus, a third acting as operator, etc. The students open the chest and study the living heart; they make St. Louis University 13 blood pressure experiments; they study the effect of stimulation of various nerves on the heart and blood vessels. Great use is made of Porter’s artificial scheme for making clear the physics of the circulation. The human pulse and heart beats are graphically recorded. The blood is studied chiefly from the physical and functional point of view, the detailed chemistry being left to the physiological chemist. Each student learns how to count the red and white corpuscles; how to make the various tests for blood; quantitative and qualitative tests for haemoglobin, including the use of various haemoglobinometers and the spectroscope. Under respiration are considered chiefly the physical and nervous phenomena of external respiration, the actual use of oxygen in the body being left for consideration under metabolism. The usual graphic experiments are thrown into the background for some introductory work in percussion and auscultation, and for experiments on the effects of carbon dioxide, heat and cold on the respiratory center. A final examination on the work of this semester brings the Freshman Physiology to a close. In the first semester of the Sophomore year, Physiology is continued, beginning with the nervous system. The laboratory work on nerve, which is in most schools considered in connection with muscle, is here developed both in lecture and laboratory in connection with the central nervous system. It is believed that this arrangement is logical not only from the standpoint of the anatomical and functional relationships of the peripheral nerves to the central system, but also for the practical reason that the nerve experiments if given in the first year would crowd out more important work on the circulation, blood and respiration. Certain experiments, such as determination of reaction time, the behavior of the reflex frog, the stimulation of the cerebral cortex and of the anterior and posterior roots of the spinal nerves in mammals, and the removal of parts of the brain complete the laboratory work on the nervous system. About five weeks are devoted to the special senses. The lectures take up both theoretical and practical phases of the subject. In the laboratory Kuehne’s artificial eye is used to make the student better acquainted with the problems of refraction met with in vision. The use of the ophthalmoscope (at least on the Thoring- ton eye), perimetry and color blindness are other practical topics taken up in the laboratory. In the Physiology of digestion and secretion effort is made to keep pace with the great work now being done especially in Pawlow’s laboratory at St. Petersburg and by certain English investigators. The chemical work on digestion is left practically entirely to Physiological Chemistry. A part of the Physiology course is the reading by students of important articles concerning new investigations. Each student receives a subject and references. He must look up the latter in the library, and write up a report. The best reports presented are read before the class. It is felt that this work serves a variety of useful purposes. It helps the student to see that text- books are only compilations and that the sourfces of these are the various archives and journals where new discoveries are reported. It gives him some acquaintance with physiological investigations at first hand and shows him how such work is carried on and made known to the scientific world. It tends to develop the critical 14 Buixetin oe faculty by compelling him to compare the views and work of various investigators upon a given subject. It gives him some notion of the evolution of the science, as he studies the develop- ment of the knowledge of a given topic through a series of papers. Finally it affords him some valuable experience in writing up a subject from an investigation of the literature. The examinations in Physiology consist of (a) a laboratory examination in which the student is called on to repeat unaided an experiment of the course, (b) A written examination, (c) An individual oral examination. The final grade is founded on the results of these examinations, together with those of the weekly quizzes, frequent written tests and the laboratory books, which are corrected and graded every two weeks. Physiological Chemistry. As the thorough understanding of Physiological Chemistry pre- supposes, on the part of the student, a knowledge of inorganic and organic Chemistry, it is taught to Sophomore students. The aim of the course is to give to our medical students physio- logical chemistry which can be used in their practice of medicine. The scientific side is emphasized but not to the exclusion of the practical. In teaching this subject, both the didactic and laboratory methods are used, two lectures and one quiz a week being given to the former and two laboratory periods of three hours each being devoted to the latter. The course runs throughout the Sophomore year. The first part of the course is given up to the chemistry of the proteins, carbohydrates and fats. The various qualitative tests and a certain number of quantitative experiments are performed by each student. The chemistry of blood, bone, muscle, cartilage, etc., is then studied. The chemistry of the secretions follows, especial emphasis being laid on the analysis of stomach contents, faeces and urine. In teaching the chemistry of the secretions, the regular quali- tative and quantitative tests are made and then these are correlated with the shorter clinical methods. These clinical methods are demonstrated by the instructor and performed by each student. In other words, the aim is the application of Physiological Chem- istry to the needs of the physician. While the clinical methods are being given, some attention is paid to the meaning of the patho- logical changes found in secretions, in so far as this can be under- stood by students who have not yet had clinical medicine. Inductive teaching is followed, starting with the known normal secretions and passing to the unknown pathological secretions. Notes are required to be kept of the more important experi- ments and these are inspected by the instructor. Both oral, practical and written examinations are given. The laboratory is well equipped and each student has an individual set of reagents and a locker in which his individual chemical apparatus is kept. Pharmacology. The course in Pharmacology is planned to give to the student a knowledge of those drugs which will be of the most importance to him in the prophylaxis and therapeutics of disease. The course embodies the essentials of pharmacy, prescription writing, chem- St. Louis University 15 istry of drugs, pharmacognosy, toxicology, and pharmacology or pharmacodynamics. Pharmacology in its broad sense includes all of these branches, but in its restricted sense it refers to the action of drugs on the body and the action of the body on the drugs. The course differs from the usual courses given under the name of Materia Medica in that the physiological action of the chemical agents is thoroughly studied by the laboratory method, and receives the bulk of the time allotted to the subject, while the pharmacognosy or the botany of drugs, which in the old course was given much time, is treated in a more limited manner. Three lectures are given per week to the junior class during the first semester. A portion of each lecture period is used for review or recitation upon work considered in previous lectures, and upon the textbook references. Two laboratory periods of three hours each are required for each week. The laboratory work is supplemental to the lectures. In the earlier part of the course, the essentials of pharmacy, the methods of preparation and dispensing of drugs, the incom- patibilities likely to occur in prescribing, and a necessary amount of chemistry of drugs are presented to the student, both in the lecture and laboratory. This portion of the laboratory work is done in the Physiological Chemistry laboratory, which is thor- oughly fitted up for chemical work. The laboratory work on the physiological action of drugs consists chiefly of experiments upon mammals. Frogs are used whenever they serve the purpose fully. This part of the work is done in the physiological laboratory, which is well adapted to the purpose. The students carry on their experiments after the same general methods as were taught them in their Physio- ology of the preceding year. Such experiments are performed as the following: The production of tetanus in frog by strychnine; the effect of caffeine on blood pressure and kidney excretion; the effect of quinine on differentiated protoplasm; the production of diuresis by certain salts, as sodium sulphate and sodium citrate; poisoning by morphine and treatment; poisoning by carbolic acid and its treatment; effects of nitro-glycerin, digitalis, alcohol, etc., on the blood pressure, heart, kidney, etc. The student thus gains a knowledge of the action of drugs based upon experimental evidence which enables him to prescribe knowing just what result he can expect. Too much stress cannot be placed upon this, as empirical therapeutics is highly unsatis- fying and is doomed to be replaced by an exact and scientific therapeutics. 16 Bulletin oe Department of Pathology and Bacteriology. General Statement. Pathology is the connecting link between the laboratory and the clinic. Its understanding requires a knowledge and training in Anatomy and Physiology that is gained in the beginning of the medical school course and is explanatory of the phenomena that are seen in the hospitals and clinics later on. The regular class work, beginning in the second year, is devoted to the systematic study of pathological changes. Each organ of the body is taken up in turn and microscopical sections showing the most important and frequent alterations are studied. Knowledge gained in the intimate study of the lesion is applied in the examination of fresh material from the surgical operating table and the autopsy room. Effort is made to have every microscopical picture accompanied and completed by a demonstration of the same process in the gross material. The class is divided into small sections which are taken weekly to the City Hospital for instruction in autopsy technique and in the recognition of gross lesions. Other autopsies at the various affiliated hospitals are performed to class sections as the opportunity presents itself. Much surgical material is sent to the laboratories for diagnosis and all of this is utilized for class demonstrations. For a limited number of students who wish to become more practiced in the technique of laboratory methods, preparation of material, embedding, staining and the use of the freezing micro- tome for rapid diagnosis the facilities are at hand and such work is always encouraged. Equipment. The laboratories for this department consist of a large well lighted laboratory with ample capacity for over a hundred students, a research laboratory, preparation rooms and private rooms for the heads of the depatment. The laboratories are equipped with one hundred and fifty modern Leitz microscopes (which are used in common with histol- ogy), oil immersion lenses, microtomes and all necessary materials for teaching and research in Pathology and Bacteriology. In the pathological research laboratory is ample equipment for all kinds of histological work, including paraffin, celloidin and freezing methods of tissue preparation, microtomes, incubators, thermostats, reagents, Gruebler’s stains, museum jars, glassware, etc. Also there is complete equipment for serum and immunity work. The material for teaching and research purposes represents the accumulation of carefully selected tissues from autopsies and surgical operations that have been collected for a number of years and also examples of rare diseases that have been obtained from abroad. All material intended for microscopic study is preserved in Zenker’s fluid, formol, and alcohol, and is rendered available for instant use by means of a card catalogue system, which, used in connection with sample slides and careful descrip- tion of all material sent to the laboratory obviates any waste of time in finding any and all tissues desired. St. Louis University 17 Material for gross demonstrations comprises several hundred museum specimens covering a great variety of special lesion and including malignant and benign new growths. At present all specimens are prepared by the Kaiserling method whereby the normal colors of the tissues are preserved thus making them much more valuable for class demonstration. Outline of Course in Pathology. The course in pathology consists of laboratory work, demon- strations, post-mortem examinations, lectures and recitations. The aim of the course being to have practical work always predominate. Lectures are given twice a week. It is the object of the lecturer to cover in the course of a year all of the essential points in general and special Pathology. The topics of the lectures precede the laboratory work so that the student has fresh in mind a general survey of a given subject immediately before he begins its more specific study with tissue and miscroscope. The following order is observed in the study of pathologic processes: Inflammation (including exudation, proliferation, phagocytosis, regeneration and repair). Retrograde processes (including cloudy swelling, necrosis, cal- cification, fatty infiltration, fatty degeneration, awyloid, glycogenic and hydropic infiltration, hyalin, mucoid and colloid degeneration, pigmentation, etc.). Atrophy, hypertrophy and hyperplasia. The lesions produced by bacteria. The lesions produced by protozoa. Immunity. The pathology of the blood. The pathology of the circulatory system. New growths (malignant and benign). The pathology of the respiratory system. The pathology of the genito-urinary system. The pathology of glandular organs. The pathology of the nervous system. Six hours a week throughout the year are devoted to laboratory work. Each man mounts and keeps his own specimens. Every specimen must be drawn and objectively described and deduction made from the observation. Every drawing and description is submitted to an instructor and must be satisfactory before it is passed by him. There is one instructor to each fifteen men in the laboratory. The department is fortunate in having instructors only who have had special training in some of the best pathological labora- tories in this country and in Europe. In addition to the microscopic work, demonstrations are given of gross lesions, both by means of fresh material and Kaiserling preparations so that a knowledge of the gross appearance goes along with the study of microscopic changes. The autopsy work is done mainly at the City Hospital, and the class is divided into sections of ten or fifteen men so that each student can actually participate in the work and have the opportunity of closely observing and handling the organs and tissues. After seeing the autopsy, the student prepares a protocol 18 Bulletin oe which includes an objective description of the autopsy from begin- ning to end and a summary of post-mortem findings. While the work in the class room is mainly for the systematic study of lesions independently, the autopsy room on the other hand furnishes an opportunity for the study of organs in situ and a consideration of the interdependent relations of various lesions, as for example the combination of interstitial nephritis and cardiac hypertrophy. Modern methods of rapid microscopic diagnosis by means of teased preparations and frozen sections are taught and the im- portance of microscopic examination of all tissue removed surgi- cally is insisted upon. The following is a list of the specimens given to the class for study, description, drawing and diagnosis during the school year of 1904-1905: Blood clot. Normal rabbit’s ear. Normal tissue elements. Rabbit ear, hot water 54. Serous exudation. Rabbit ear, croton oil. Serous purulent exudation. Rabbit muscle of back, croton oil 24 hours. Purulent exudation. Lung, acute pleurisy, pneumonia. Mono-nuclear phagocytes. Lung, acute pleurisy, pneumonia (.emphysema). Mono-nuclear phagocytes. Lung, acute pleurisy, pneumonia. Polynuclear phagocytes. Diphtheria of trachea. Fibrinous exudation. Kidney abscess. Abscess of liver. Pleurisy, organizing. Repair. Pericarditis, organizing. Repair. Pneumonia. Repair. Muscle of rabbit five days after croton oil. Repair. Ovarian abcess, granulation tissue. Muscle suture four days after foreign body. Muscle suture forty-two days after foreign body. Cyst of the broad ligament. Giant cell phagocytes. Cloudy swelling. Degeneration. Cloudy swelling, liver. Liver, heart and kidney, fatty degeneration. Frozen section. Infarct of kidney and spleen. Degeneration, necrosis. Liver, central necrosis. Degeneration, necrosis. Liver, central necrosis with leukemia. Calcification. Lime salts. Colloid kidney. Gout. Liver, amyloid. Spleen, amyloid. Kidney, amyloid. Heart, brown atrophy. Atrophy and pigment. Liver, brown atrophy. Atrophy and pigment. Liver, pernicious anemia also central necrosis. Haematog. pigment iron reaction Liver, malaria. Haematog. pigment iron reaction Spleen, malaria. Haematog. pigment iron reaction. Liver, jaundice. Haematog. pigment iron reaction. Skin, Addison’s disease. Autochthonous pigment. Lymph Nodes, anthracosis. Extraneous pigment. Acute pericarditis. Acute endocarditis, mitral. Acute endocarditis, mitral. Acute myocarditis. Heart, hypertrophy. Chronic myocarditis. Heart, thrombus. Vein, thrombus. St. Louis University 19 Aorta, arterio-sclerosis. Aorta, arterio-sclerosis. Kidney, arterio-sclerosis. Lung, chronic passive congestion. Spleen, chronic passive conges- tion. Liver, chronic passive congestion. Heart, infarct. Spleen and kidney, infarct. Myelogenous leukaemia, blood clot. Myelogenous leukaemia, marrow. Myelogenous leukaemia, liver. Lymphatic leukaemia, liver. Heart abscess, S. P. Aureus. Abscess of lung. Skin, phlegmon, streptococus. Acute myostis, streptococcus. Acute meningitis, meningococcus. Acute meningitis, anthrax. Liver. Broncho-pneumonia, B. Cap. Diphtheria tonsil. Anthracosis and broncho-pneu- monia, lung. Anthracosis, lung. Liver, B. Aerogenes Cap. Lung, miliary tuberculosis. Liver, miliary tuberculosis. Spleen, miliary tuberculosis. Kidney, miliary tuberculosis. Lung, miliary T. B. caseous pneumonia. Lung, tuberculosis pneumonia. Lung, tuberculosis pneumonia. Lung, T. B. gelatinous infiltration Lung, T. B. Lung, T. B. bronchitis and peribronchitis. Lung, cavity wall. Lung, cavity wall. Intestine, tuberculosis. Testicle, tuberculosis. Fallopian tubes, tuberculosis. Kidney, T. B. pyelonephritis. Lymph node cervical, tuberculosis. Lymiph node cervical, tuberculosis. Pleura, tuberculosis. Pericardium, tuberculosis. Cord, tuberculosis. Brain, tuberculosis. Brain, solitary tubercle. Syphilis, gumma of testicle. Syphilis, gumma of liver. Syphilis, liver. Actinomycosis, liver. Actinomycosis, lung. Actinomycosis, cow’s udder. Colon, diphtheritic colitis. Colon, amoeba coli. Liver, amoeba coli. Ileum, early typhoid. Ileum, typhoid. Ileum, typhoid. Lymph node, typhoid. Spleen, typhoid. Liver, typhoid. Small-pox, pustule. Small-pox, vesicle. Fibroma durum. Fibroma multiple. Fibroma, oedematous. Myxoma. Chondroma. Chondroma. Lipoma. Leiomyoma. Sarcoma, spindle-cell. Sarcoma, round-cell. Sarcoma, giant-cell. Sarcoma, melanotic. Sarcoma, melanotic. Sarcoma, lympho. Adrenal of kidney and adrenal. Adrenal of lung. Cavernoma of the liver. Perithelial angio-sarcoma. Lymph endothelioma. Malignant adenoma. Breast in lactation. Carcinoma of breast. Carcinoma of breast, scirrhous. Carcinoma of stomach. Carcinoma, colloid. Carcinoma, epidermoid. Adeno-cystoma of ovary. Papillary adeno-cystoma of ovary. Intracanalicular pap. adeno- fibroma. Wen. Teratoma. Chorion epithelioma. Kidney, acute exudate glomeruli nephritis. Kidney, acute capsular glomeruli nephritis. Kidney, acute intracapsular glomeruli nephritis. Kidney, sub-acute. Kidney, chronic glomeruli nephritis. Kidney, amyloid nephritis. Kidney, acute pyelonephritis, 20 / BULLETIN OP Liver, atrophic cirrhosis. Liver, multilobular cirrhosis. Liver, hypertrophic cirrhosis. Liver, fatty cirrhosis. Liver, abscess. Fat necrosis of abdominal wall. Pancreas, diabetes. Liver, acute yellow atrophy. Acute interstitial nephritis. Trichinosis, muscle. Gliosis. Tabes, four levels. Surgical Pathology. The repair of wounds, the consideration of new growths and other conditions demanding surgical interference are dealt with in the general course; special instruction is given to those wishing advanced work in this department. Neuro-Pathology. An opportunity is given for special work in the pathology of the diseases of the nervous system. Research Courses. Every encouragement will be given to men who wish to undertake research work. A limited number who desire can receive instruction in methods of fixing, mounting and cutting sections, and in the various differential stains, and all essential features of pathological technique. Bacteriology and Parasitology. A course of lectures, quizzes and laboratory work in Bacter- iology is given, in which all the important pathogenic and non- pathogenic bacteria are studied. In the laboratory the student makes his own cultures, follows their development, and submits them to the various diagnostic tests. Whenever possible, the patho- genic effects of organisms are demonstrated by animal inoculations. Especial emphasis is laid upon the cultural, tinctorial, patho- genic, and other characteristics of the forms studied, in order to familiarize the student with the methods of bacteriological diag- nosis. The examination of water, milk, sputum, pus, etc., is made a feature of the laboratory course. The diagnosis of typhoid by the Widal reaction is carefully taught. The laboratory is equipped with the necessary reagents and apparatus, a separate outfit being assigned to each student and a homogeneous immersion objective for individual use in all sections not exceeding thirty students. About seventy different forms of bacteria are maintained in stock cultures for instruction and research. The large and growing importance of the study of animal parasites, especially the protozoa, as the causative factors of such diseases as malaria, syphilis, uncinariasis, trypanosomiasis, etc., constantly becomes more evident. Already they are second only to bacteria as pathogenic agents. Consequently no medical cur- riculum can be regarded as complete in which they do not receive adequate treatment. A brief course of lectures, quizzes and demonstrations is therefore offered, in which the structures, life- histories, pathogenic effects and diagnostic characters of the more important animal parasites of man are considered. Especial atten- tion is given to the pathogenic protozoa, inasmuch as these produce the most wide spread and clinically important of the parasitic diseases. As soon as feasible the course in Parasitology will be St. Louis University 21 expanded to a full laboratory course. Among others, the following parasitic diseases are discussed: Amoebic dysentery, typanoso- miasis of man and domestic animals, syphilis, relapsing fever, malaria, coccidiosis, pyroplasmosis of man and animals, distomiasis, taeniasis, ascaridiasis, trichinosis, filariasis, uncinariasis, scabies. So far as the facilities of the laboratory permit, every oppor- tunity and encouragement is afforded to men who are qualified and desire to undertake research. The methods of fixing, mounting and cutting sections, and differential staining, as well as the latest and best methods of cultivating and studying bacteria and other parasites are fully taught. The individual needs of the student will be considered rather than the giving of the same work to all, and an attempt made to allow the student to develop his personality along the lines which seem best fitted for him. Department of Chemistry. The work done in general chemistry necessarily comprises lectures on the principles and facts of the science, laboratory prac- tice and quiz and drill exercises. Research work is almost con- stantly carried on in this laboratory. Of course, students must have mastered more than the regular chemical course, now required, before they can pretend to do research work. During the past century chemical research has been prosecuted with great energy by able men and has resulted in a vast increase in knowledge of chemical facts, and of the underlying general laws of the science. Modern medicine utilizes many of these advances in both these directions. Since it has been found impossible to increase the time devoted to chemistry in medical schools, the effec- tive presentation of the facts and principles required, necessitates judicious selection of matter and improved methods of teaching. With this end in view, the history of the beginning of the “new chemistry” at the end of the 18th century is dealt with briefly in this laboratory. Manufacturing processes, to which some text books devote considerable space, are mostly obsolete, and are not required for the purpose in hand, hence the greatest stress is laid on the underlying general principles and laws which are of present and permanent value. The medical student of to-day must be made familiar with the leading analytical tests of inorganic and organic chemistry; he should be able to make delicate tests, say for arsenic and sub- limate, strychnine, cocaine and the like, and he should be able to distinguish synthetics and other organic chemicals now common in medical practice. Hence time must be saved by shortening chemical procedure. This is most readily and elegantly effected by making the use of the microscope as common and as essential as the use of the test tube. It is in this spirit that we have endeavored for many years to conduct the laboratory work in chemistry. 22 Bulletin of Library. \ Although a number of medical schools have provided trained instructors, good laboratories and equipments, but few have as yet realized that the maintenance of high grade work is largely depen- ent upon a good library. For the instructor it is a necessary aid. Not many years have passed since the instructor in the fundamental branches was like- wise a busy practitioner, who did all that could have been expected when he gave the student an outline of the ideas embodied in a chosen text. A decided advance was made when the instructor no longer relied upon a single textbook but gathered his information from the latest books in English, German and French. To-day the latest and best textbooks can be scarcely more than a general guide for the student. The information contained therein must be supplementea and corrected by the most recent advances recorded in the current journals. For the student, the library is likewise of great value. He is led to the sources of information. He learns how to find the literature on a given topic, and shortly realizes that the statements made by different writers are often widely at variance. He sees the vast amount of work that is being done in all lines and realizes the fact that comparatively little is known in any department of medicine. Above all he is brought in direct contact with the world’s greatest minds, and is thereby stimulated to contribute something to the progress of medicine. For the investigator, the library is indispensable. He must not only know what has been done in the past by those who have developed the various branches, but also know what is being done at present in his particular field. Moreover, he must be able to foresee from the present trend of investigation what lines are going to yield the most important results in the near future. Thus for the instructor, student and investigator, the library is as necessary as the laboratory. The nucleus of a library in the Medical School of St. Louis University has been formed by bringing together books belonging to the University and to members of the faculty and by the generous subscriptions of several members of the faculty, and friends of the University. The library is located on the second floor of the main building, and is open to students from 8 in the morning to 5 in the afternoon. The reading room, which is 25x25 ft., is well lighted and ventilated. The librarian is in constant attendance to issue books and journals. The library is intimately associated with and largely supported by the Students’ Co-operative Store. The store is intended to furnish students with all books, instruments and supplies necessary for their school work at or below the regular market prices. The store is given, free of cost, convenient quarters in connection with the library and the entire net proceeds are used for the support of the library. From the experience of other institutions it is confidently believed that the revenue derived from this source will be suffi- cient to maintain the present subscriptions for journals and to add such others as may be thought desirable. There will also be added to the library from time to time, as the fund will permit, important medical treatises, memoirs and monographs dealing with St. Louis University 23 anatomical, physiological, pathological, chemical and clinical sub- jects, also all the standard text-books; but for more expensive and valuable accessions, such as complete sets of the standard journals, the library must, in the future, as in the past, rely upon the kind- ness of its friends. In no way can friends of the University better aid it at the present time than by purchasing for the library the back files of important publications. In addition to the American weekly and monthly medical publications the following scientific journals are received: American Journal of Anatomy. American Journal of the Medical Sciences. American Journal of Physiology. American Naturalist. Anatomischer Anzeiger. Anatomische Hefte. Annales de 1* Inst. Pasteur. Arbeiten aus d. Kaiserl. Gesundheitsamte. Archiv f. Anatomie u. Entwickelungsgeschichte. Archiv f. d. Gesammte Physiologie. Archiv f. Entwickelungsmechanik der Organism en. Archiv f. Hygiene. Archiv f. Mikroskopische Anatomie. Archiv f. Pathol. Anatomie und Physio, und f. Klinishe Medicin. Archiv f. Physiologie. Archiv f. Protistenkunde. Archiv f. Verdauungs-Krankheiten. Archives de Biologie. Archives de V Anat. Microscopique. Archives de Medicine Experimentale. Archives de Zoologie Experimentale. Archives Italiennes de Biologie. Archivio Italiano di Anat. e. d’ Embryologia. Beitrage zur Pathologie. Berliner Klin. Wochenschrift. Bibliographie Anatomique. Biochemisches Centralblatt. Biological Bulletin. Biologisches Centralblatt. British Medical Journal. Bulletin de l’lnstitut Pasteur. Bulletin et Memoires de la Societe Anatomique de Paris. Bulletin of Johns Hopkins Hospital. Centralblatt f. Allgemeine Pathologie und Pathologische An- atomie. Centralblatt f. Bakteriologie. Centralblatt f. Innere Medicine. Centralblatt f. d. Med. Wissenschaft. Centralblatt f. Nervenheilkunde. Comptes Rendus Hebdomadaire des Seances de la Societe de Biol. Deutsche Medicinische Wochenschrift. Ergebnisse d. Anat. u. Entwicklungsgeschichte. Ergebnisse d. allgem. Pathol, u. Pathol. Anat. d. Menchen u. Thiere. Ergebnisse der Physiologie. Index Medicus. Internationale Monatsschrift fur Anatomie und Physiologie. Jahresberichte uber die Fortschritte der Anatomie und Ent- wickelungsgeschichte. 24 Bulletin oe Jahresberichte u. d. Fortschritte d. Lehre von. der patbologenen Mikroorganismen. Jahresberichte iiber die Leistungen und Fortschritte in der gesammten Medicine. Virchow and Hirsch. Jenaische Zeitschrift. Jour, de 1’ Anat. et la Physiol. Norm, et Pathol. Journal of Anatomy and Physiology. Journal of Comparative Neurology. Journal of Experimental Medicine. Journal of Experimental Zoology. Journal of Infectious Diseases. Journal of Medical Research. Journal of Pathology and Bacteriology. Journal of Physiology. Journal de Physiologie et de Pathologie Generale. La Cellule. Lancet. La Neuroaxe. Mittheilungen aus der Zoologischen Station zur Neapel. Morphologisches Jahrbuch. Muenchener Med. Wochenschrift. Nature. Neurologisches Centralblatt. Quarterly Journal of Microscopical Science. Revue Generale de Histologie. Schmidt’s Jahrbucher der in- und auslandischer gesammten Med. Science. Therapie der Gegenwart. Wiener Klinische Wochenschrift. Zeitschrift f. Allgemeine Physiologie. Zeitschrift f. Biologie. Zeitschrift f. die Gesammte Therapie. Zeitschrift f. Hygiene u. Infeetionskrankheiten. Zeitsch. f. Morphologie u. Anthropologie. Zeitschr. f Physiol. Chemie. Zeitschrift f. Wissenschaft. Mikroskopie. Zeitschrift f. Wissenschaft. Zoologie. Zentralblatt f. die Gesammte Therapie. Zentralblatt f. Physiologie. Zoologisches Zentralblatt. Complete files of some of these are already on the shelves, and others will be added as rapidly as funds become available. Physicians and friends of the Medical School are urged to send to the library any books or journals for which they have no immediate use and to subscribe, to the extent of their ability, to the library fund. The privileges of the library are, under proper restrictions, extended to physicians and others not directly connected with the College. Acknowledgment is made to the following for donations to the library: C. Barck, A. C. Bernays, Y. H. Bond, H. H. Born, O. H. Brown, C. G. Chaddock, G. C. Crandall, J. H. Duncan, A. C. Eycleshymer, Jacob Geiger, C. Hinrichs, B. M. Hypes, H. P. Johnson, J. R. Lemen, Bransford Lewis, C. Loeb, H. W. Loeb, E. P. Lyon, C. D. Lukens, M. C. Marshall, C. H. Neilson, C. M. Nicholson, Peter Potter, S. I. Schwab, M. G. Seelig, Hugo Summa, R. L. Thompson, J. M. Wilson, T. C. Witherspoon. 25 St. Louis University Research. ' ^ 1 The research method in medicine is hut the further develop- ment of the inquisitive method which in turn is as old as medicine itself. The problems which confront the practitioner are solved by methods essentially like those employed by the investigator. Rarely has the physician carefully followed a disease through its various phases without being rewarded by finding out something new. These new things may be stored away as a part of what is called experience and thus add to individual knowledge, or they may form the starting point of a systematic study, resulting in the discovery of new facts or the establishment of new laws, which through publication become an addition to human knowledge. The latter type of work, although an outgrowth of the former, embodies the highest ideals and is dignified by the term research. There is no longer room to question the value of research as a great factor in the growth of the modern medical school. The only question is how can it best be encouraged and fostered. The first step has usually been taken by securing men for instructors, who have been trained in schools where research as well as teaching has been emphasized. The importance of this initial step is nowhere better set forth than in an address by Barker, from which the following quotation is taken: “Each leader in a department of a true university is both a teacher and an investi- gator. The really great teachers have always been investi- gators. The really great investigators have always been teachers, though not always, perhaps, of large groups of students, nor always, it must be admitted, in their own gener- ation. It is highly desirable that the two faculties of teach- ing and discovering be combined in every university pro- fessor. There may be a place for the non-investigating teacher in a college or seminary, but he is certainly out of his sphere as the leader in a department in a university. The great investigator, on the other hand, who cannot teach students directly may probably be housed and cared for in a, university, for the sake of the contributions which he will make to knowledge, and the prestige his work will bring to the institution; but the department in which he works should also be represented by other men who can both investigate and teach. I am convinced that the influence for any considerable length of time, of a non-investigating teacher cannot fail to be actually harmful to a student.” Having secured the type of man as a teacher, the next question is how shall the student be trained that in later life he will contribute something to human knowledge. In the first place the inspiration received from a teacher, who is himself an investi- gator and an authority in his one particular field cannot fail to be a powerful stimulus in the right direction. In the second place, all the class work should be carried on in such a manner that it is preparatory to independent thought. In Chemistry, Anatomy, Physiology, Pathology and their sub- divisions, the basis for the student’s knowledge should be laid in laboratory observation. The objects from which the textbooks are made are before him and various devices are employed to encourage accurate observations such as careful records of his work in the form of notes or drawings or both. In beginning a subject specific directions are necessary, later general directions are sufficient, and finally suggestions should be adequate. 26 Bulletin of In like manner, the student may be carried from implicit reliance upon lecture and textbook to supplementary reading in scientific journals. He might, then be required to write brief articles on selected topics in which are embodied the information gathered from various sources, such as inquiry, textbooks, special articles and personal observations. These are only a few of the many methods of gradually leading the student from an attitude of complete dependence to one of more or less independence. But when the research idea has been carried out as fully as possible in the class work only a beginning has been made. Opportunity should be provided for the student to take another step in the same direction. There are a number of ways in which this could be accom- plished. He might either do a piece of work jointly with an instructor, or repeat the published work of another with a view of confirming or disproving the results. In either case, however, the existence of an already overcrowded curriculum at present precludes the possibility of such work. An opportunity could only be given through the introduction of electives. Another method would be the production of a thesis as a requirement for graduation following the plan now in existence in the German and French Universities. Whatever solution may be offered, one thing is certain, that if the physician is to add to the fund of human knowledge, he must have some idea of how to work up and present his facts so that they shall form a part of the medical literature of the future. i I i St. Louis University 'yr~ 27 Instructors in the Fundamental Branches of, (he Medical School. Albert Chauncey Eycleshymer, B.S., Ph.D., ^P rofessor and Director of the Department of Anatomy, Histology and Embryology. Assistant in Animal Morphology, 1889, and Botany, 1890, University of Michigan; Chief Assistant to the Director of the Allis Lake Labo- ratory, 1890-91; B.S., University of Michigan, 1891: University Fel- low in Biology, Princeton, 1891; Fellow in Animal Morphology, Clark University, 1891-92; Investigator, Marine Biological Laboratory, Woods Hole, Summer of 1892; Fellow in Biology, the University Ol C hicago, 1892-93; Assistant, ibid., 1893-95; Ph.D., ibid., 1894; Associate in Anatomy, ibid., 1895-97; Instructor, ibid., 1897-1902; Student in the University of Cambridge (England), 1895-96, and studying peda- gogical methods in Anatomy and Histology in Germany and France; Lecturer oh Human Embryology, Rush Medical College, 1897-98; As- sistant Professor of Human Embryology, ibid., 1898-99; Austin Fellow in Histology and Embryology, Harvard Medical School, 1900-01; As- sistant Professor of Anatomy, University of Chicago, 1899-1903. » ht n/r t» t t r> — — ■-> Albert C. Eycleshymer. 1892 — Notes on Celloidin Technique. American Naturalist, xxvi, pp. 354-358. 1892 — Club-root (Plasmodiopthora brassicae, Wor.) in the United States. Journal of Mycology, vii, pp. 79-90. 1892 — Paraphysis and Epiphysis in Amblystoma. Anatomischer Anzeiger, vii, pp. 215-217. 1892 — The Cleavage of the Amphibian Ovum. (With E. O. Jordan.) Ibid, pp. 622-624. 1893 — The Development of the Optic Vesicles in Amphibia. Journal of Morphology, viii, pp. 189-195. 1894 — The Cleavage of the Amphibian Ovum. (With E. O. Jordan.) Ibid, ix, pp. 407-415. 1894 — The Egg of Amia and its Cleavage. (With C. O. Whit- man.) Ibid, pp. 309-355. 1894 — The Early Development of Amblystoma with Observa- tions on Some Other Vertebrates. Ibid, pp. 346-419. 1897 — The Early Development of the Epiphysis and Paraphysis in Amia. (With Benjamin Marshall Davis.) Journal of Compara- tive Neurology, vii, pp. 45-71. 1898 — The Location of the Basis of the Amphibian Embryo. Journal of Morphology, xiv, pp. 466-480. 1899 — The Cleavage of the Egg of Lepidosteus. Anatomischer Anzeiger, xvi, pp. 529-537. 1900 — Observations on the Breeding Habits of Ameiurus Nebu- losus. American Naturalist, xxxv, pp. 910-919. 1902 — The Formation of the Embryo of Necturus, with Re- marks on the Theory of Concrescence. Anatomischer Anzeiger, xix, pp. 340-355. 1902 — Nuclear Changes in the Striated Muscle Cell of Nec- turus. Anatomischer Anzeiger, xxi, pp, 379-386. 1902 — The Histogenesis of the Striated Muscle Cell. American Journal of Anatomy, i, pp. 512-513. 1903 — The Early Development of Lepidesteus Osseus. Decen- nial Publications, University of Chicago, x, pp. 1-20. 1904 — A Sketch of the Past and Future of Embryology. St. Louis Medical Review, pp. 1-10. 1904 — Human Embryos, Their Value, Method of Preserving and Sectioning. Interstate Medical Journal, xi, pp. 1-8. 1904 — The Cytoplasmic and Nuclear Changes in the Striated Muscle Cell of Necturus. American Journal of Anatomy, iii, pp. 285-310. 1904 — Bilateral Symmetry in the Egg of Necturus. Anatomis- cher Anzeiger, xxv, pp. 230-241. 1906 — The Habits of Necturus Maculosus. American Natural- ist, xl, pp. 123-136. The Development of Chromatophores in Necturus. American Journal of Anatomy, vii, pp. 317-326. The Gastrulation and Embryo Formation in Amia Calva (Wit^TaniejS MereOLPh Wilson). Ame’doff-n I^vrnaJ- of Air Lon. v, v, pp. 133-162. The Growth and Regeneration of Gills in the Young-Nec- turus. Biological Bulletin, x, pp. 171-176. 1907 — The Closing of Wounds in the Larval Necturus. Ameri- can Journal of Anatomy, vii, pp. 317-326. Some Observations and Experiments on the Natural and Ar- tificial Incubation of the Egg of the Common Fowl. Biological Bulletin, Vol. xii, pp. 360-373. 1908 — Bichat, His Life, Researches and Character. Interstate Medical Journal, xv, pp. 1-20. The Reaction to Light of the Decapitated Young Necturus. Journal of Comparative Neurology and Psychology, xviii, pp. 303- 309. The Adhesive Organs in Amia (With James Meredith Wilson). Biological Bulletin, xiv, pp. 134-149. 26 Bulletin oe In like manner, the student may be carried from implicit reliance upon lecture and textbook to supplementary reading in scientific journals. He might, then be required to write brief articles on selected topics in which are embodied the information gathered from various sources, such as inquiry, textbooks, special articles and personal observations. These are only a few of the many methods of gradually leading the student from an attitude of complete dependence to one of more or less independence. But when the research idea has been carried out as fully as possible in the class work only a beginning has been made. Opportunity should be provided for the student to take another step in the same direction. There are a number of ways in which this could be accom- plished. He might either do a piece of work jointly with an instructor, or repeat the published work of another with a view of confirming or disproving the results. In either case, however, the existence of an already overcrowded curriculum at present precludes the possibility of such work. An opportunity could only be given through the introduction of electives. Another method would be the production of a thesis as a requirement for graduation following the plan now in existence in the German and French Universities. 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