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Cornell University Library 
 R 747.H33A5 1906 
 
 The Harvard Medical School, 1782-1906. 
 
 3 1924 012 492 587 
 
WITH THE COMPLIMENTS OF 
 THE FACULTY OF THE HARVARD MEDICAL SCHOOL 
 
THE 
 
 HARVARD MEDICAL SCHOOL 
 
 1 782 -1 906 
 
A.-z-o s-^n r 
 
CONTENTS. 
 
 PAGE 
 
 LIST OF Illustrations v 
 
 Introduction vii 
 
 DATES OF establishment OF CHAIRS ix 
 
 BUILDINGS OCCUPIED BY THE MEDICAL SCHOOL . . . xi 
 THE DEPARTMENTS: 
 
 Anatomy and Surgery i 
 
 The Theory and Practice of Physic 15 
 
 Chemistry 31 
 
 Obstetrics 37 
 
 Legal Medicine 45 
 
 Surgery 49 
 
 Pathological Anatomy 63 
 
 Clinical Medicine 73 
 
 Physiology 87 
 
 Dermatology 97 
 
 Ophthalmology 105 
 
 Hygiene 109 
 
 Histology and Human Embryology 113 
 
 Laryngology 117 
 
 Gynecology 121 
 
 Otology 129 
 
 Bacteriology i33 
 
 Neurology i37 
 
 Orthopedics i43 
 
 Pediatrics i45 
 
 Comparative Pathology i57 
 
 Pharmacology and Therapeutics 163 
 
 THE WARREN ANATOMICAL MUSEUM 171 
 
 THE NEW MEDICAL SCHOOL 177 
 
 THE NEW MEDICAL SCHOOL BUILDINGS 185 
 
 LIST OF OFFICERS, SEPTEMBER I, 1906 19S 
 
 THE MEDICAL SCHOOL, BOSTON (general statement) ... 201 
 
 INDEX 203 
 
 (iii) 
 
ILLUSTRATIONS. 
 
 The New School Buildings, longwood avenue, Boston. 
 
 1906 Frontispiece 
 
 FACING PAGE 
 
 HARVARD HALL, CAMBRIDGE. 1782 xi 
 
 JOHN Warren i 
 
 Holden Chapel, Cambridge. 1783 3 
 
 Benjamin Waterhouse 15 
 
 JOHN GORHAM ^l 
 
 Walter Channing 37 
 
 forty-nine Mason Street, boston. 1816 .... 45 
 
 george hayward 49 
 
 north GROVE Street, boston. 1847 53 
 
 john barnard swett jackson 63 
 
 George Cheyne Shattuck 73 
 
 OLIVER Wendell Holmes 87 
 
 Henry Willard Williams 105 
 
 George Derby i°9 
 
 BOYLSTON Street, BOSTON. 1883 n3 
 
 JACOB BIGELOW 163 
 
 BASEMENT AND FIRST FLOOR PLANS OF THE NEW BUILDINGS, 189 
 
 (v) 
 
INTRODUCTION. 
 
 The history of the Harvard Medical School presented herewith 
 had its inception in two votes of the Faculty of Medicine under 
 date of January seventh and February fourth, 1905. The general 
 outline suggested by a special committee appointed for the purpose 
 was approved by the Corporation in a letter submitted to the 
 Faculty of Medicine on April first, 1905. 
 
 The plan adopted includes the attempt to present the history of 
 the School by Departments. With one exception the history 
 of each Department is written by or under the direct supervision of 
 its Head, and these accounts are arranged in historical sequence. 
 The exception is that of Chemistry. The plan of the book 
 was outlined and work begun upon it during the prolonged and 
 fatal illness of Prof. Edward S. Wood. Dr. James C. White, 
 Professor Emeritus of Dermatology, and formerly Professor of 
 Chemistry, has been good enough to write the sketch of that 
 subject. By the method adopted it is possible to follow the 
 growth of the School from a new point of view, and to note when 
 the demands for new branches of medical instruction have been 
 satisfied. 
 
 The "Department" in the Medical School has always had a 
 somewhat different significance from that attributed to it in other 
 parts of the University, and has been, loosely, held to indicate a 
 branch of instruction of sufficient importance to have its Head 
 rank higher than an annual appointment. Some years ago the 
 Faculty expressed its approval of a grouping of allied Departments 
 into Divisions, but the only one yet in existence is the Division 
 of Surgery. 
 
 Changes and expansion in instruction are going on all the time. 
 Some have been begun since this volume was undertaken, as is 
 
 (vii) 
 
Vm INTRODUCTION. 
 
 instanced by the establishment of the Chair of Comparative 
 Anatomy and the appointment of Professor Minot to organize the 
 Department. Indeed the immediate future may be looked upon 
 as lil<ely to be, in every way, a time of great activity and change 
 in the teaching given by the School. Definite movements are on 
 foot to enlarge the scope and variety of the instruction offered to 
 the medical students — to provide instruction of a primary nature 
 for those who may be interested in applied biology — and to 
 develop courses of the highest type that may lead to other 
 University honors than the Doctorate of Medicine. For all these 
 activities the new buildings offer ample space and facilities, and 
 the friends of the School seem justified in looking forward to the 
 development of medical teaching and research to a form and 
 extent that has not been before realized. 
 
 Perhaps the most important recent action taken by the Faculty 
 of Medicine is that by which a large addition to its numbers is 
 made with the opening of the new year. Appointments for 
 more than one year carry with them a seat in the Faculty and 
 fourteen annual appointments have been made to extend over 
 three years, so that the holders enter the Faculty upon the 
 beginning of the new term. In this instance it is noticeable that 
 a large majority of the promotions represent the clinical as con- 
 trasted with the laboratory branches of instruction. 
 
 The following pages form a summary of the growth of the 
 School for one hundred and twenty-four years up to this present 
 eventful point in its career. The use of portraits of individuals has 
 been governed by the rule that the first occupant of each chair 
 should be shown, provided he be not now alive. It has, how- 
 ever, been impossible to discover any portrait of Dr. Aaron Dexter, 
 the first Professor of Chemistry and Materia Medica. 
 
 September first, 1906. 
 
DATES OF THE ESTABLISHMENT OF CHAIRS. 
 
 (The dates here given are taken from the Quinquennia! catalogue of Harvard University — 
 edition of 1905. In some cases they differ from those in the text. When this is so reliance has 
 been placed by the writers upon the catalogues of the Medical School which, before 1871, did not 
 always agree in nomenclature with the records of the University.) 
 
 ANATOMY AND SURGERY . . 1782 
 
 (Hersey Professorship of Anatomy and Surgery after 1791.) 
 
 ANATOMY AND PHYSIOLOGY 1847 
 
 (Parkman Professorship of Anatomy and Physiology. Parl<man 
 Professorship of Anatomy after 1871.) 
 
 PHYSIOLOGY i866 
 
 (George Higginson Professorship after 1902.) 
 
 THE THEORY AND PRACTICE OF PHYSIC 1783 
 
 (Hersey Professorship after 1791.) 
 
 CHEMISTRY AND MATERIA MEDICA 1783 
 
 (Erving Professorship after 1791. Lectureship of Materia Medica 
 and Botany in 1818. Professorship of Materia Medica in i8i8.) 
 
 OBSTETRICS AND MEDICAL JURISPRUDENCE 1815 
 
 (Subjects separated in 1877.) 
 
 SURGERY 1835 
 
 (Professorship of the Institutes of Surgery and of Clinical Sur- 
 gery from 1835 to 1847. Moseley Professorship after 1898.) 
 
 PATHOLOGICAL ANATOMY 1847 
 
 (Shattuck Professorship of Morbid Anatomy from 1854 to 1879. 
 Shattuck Professorship after 1879.) 
 
 CLINICAL MEDICINE 1854 
 
 (Jackson Professorship after 1858.) 
 
 PHYSIOLOGY AND PATHOLOGY OF THE NERVOUS SYSTEM, 1864-1867 
 
 DERMATOLOGY 1871 
 
 OPHTHALMOLOGY 1871 
 
 (Williams Professorship after i8g8.) 
 
 Mental diseases 1871-1885 
 
 HYGIENE 1871 
 
 (ix) 
 
X DATES OF ESTABLISHMENT OF CHAIRS. 
 
 HISTOLOGY AND EMBRYOLOGY 1887 
 
 (Professorship of Histology and Human Embryology 1892-1906.) 
 
 LARYNGOLOGY 1888 
 
 (Assistant Professorship in 1882.) 
 
 GYNECOLOGY 1888 
 
 (Assistant Professorship in 1882.) 
 
 Otology 1888 
 
 bacteriology 1891 
 
 Neurology 1893 
 
 (Ofificially is Diseases of the Nervous System.) 
 
 ORTHOPEDICS 1893 
 
 (Orthopedic Surgery from 1903.) 
 
 PEDIATRICS 1893 
 
 COMPARATIVE PATHOLOGY . 1896 
 
 (George Fabyan Professorship from 1896.) 
 
 PHARMACOLOGY AND THERAPEUTICS I9OO 
 
 COMPARATIVE ANATOMY 1902 
 
 (James Stillman Professorship from 1902. Chair not filled until 
 1906.) 
 
 contagious diseases 1903 
 
 Warren anatomical Museum 1847 
 
 (The date of the appointment of the first Curator.) 
 
HARVARD HALL, CAMBRIDGE. 
 
 The first lectures were given in the basement of this building. 
 1782. 
 
BUILDINGS OCCUPIED BY THE HARVARD 
 MEDICAL SCHOOL. 
 
 1782. Harvard Hall, Cambridge. The first lectures were given in the base- 
 
 ment of this building. 
 
 1783. Holden Chapel, Cambridge. Occupied as soon after the opening of 
 
 the School as it could be fitted. 
 
 1810. Forty-nine Marlborough street, Boston (now 400 Washington street). 
 No illustration of this building can be found. 
 
 1816. The new building on IWason street, Boston. The first constructed 
 especially for the School. 
 
 1847. North Grove street, adjoining the Massachusetts General Hospital. 
 
 1883. Six hundred and eighty-eight Boylston street; "expected to be the 
 home of medicine for generations." 
 
 1906. Longwood avenue, Boston. Dedicated September twenty-fifth and 
 twenty-sixth, 1906 ; occupied by the School at the opening of the 
 term, September twenty-seventh, 1906. 
 
 (xi) 
 
THE DEPARTMENTS. 
 
JOHN WARREN (H.C. Hn)- 
 A.M.; M.D. (hon.) 1786. 
 
 Professor of Anatomy and Surgery (after 1791, Hersey), 1782-1815. 
 
THE DEPARTMENT OF ANATOMY. 
 1782. 
 
 Dr. John Warren, the first Professor of Anatomy and Surgery 
 (after 1791 Hersey Professor), was appointed November twenty- 
 second, 1782, and inducted into ofifice on October seventh, 1783. 
 He was not only a rising surgeon but an enthusiastic student of 
 anatomy. He must have been largely a self-taught man, though 
 he received instruction from his brother. Dr. Joseph Warren (later 
 General Warren), during two years. In his student days at 
 Harvard he had been a leading spirit of an Anatomical Club, the 
 members of which dissected and demonstrated the structures of 
 the lower animals and studied the bones of the human skeleton. 
 It is certain that during and after the War of Independence he had 
 opportunities to dissect human bodies. He profited so much by 
 these studies that in 1780 he gave a course of anatomical demon- 
 strations to medical men at the Military Hospital at Boston, which 
 he was asked to repeat the following year. This undoubtedly led 
 to his appointment by Harvard and perhaps even to the estab- 
 lishment of a Medical School by the University. 
 
 The first course of lectures which he gave as Professor took 
 place in the autumn of 1783, lasting six weeks. The Medical 
 School was in Holden Chapel in the College Yard, where it 
 remained for more than a quarter of a century. Dr. John Warren 
 was an excellent lecturer, attractive to the students by his good 
 voice and great earnestness. According to Dr. Holmes "the dryest 
 bone of the human body became in his hands the subject of ani- 
 mated and agreeable description." Dr. James Jackson wrote after 
 his death that the most peculiar charms of his teaching "were 
 derived from the animation of delivery, from the interest he dis- 
 played in the subject of his discourse, and from his solicitude that 
 
2 THE HARVABD MEDICAL SCHOOL. 
 
 every auditor should be satisfied both by his demonstrations and 
 by his explanations." It is needless to say of one blessed with 
 these advantages that he rarely used notes. His duties, as we 
 infer from a vote of the Corporation, were to "demonstrate the 
 anatomy of a human body with physiological observations and 
 explain and perform a complete system of surgical operations." 
 
 A list of Dr. Warren's lectures for 1790, which course began 
 October sixth and ended November seventeenth, would imply 
 that they were anatomical rather than surgical, though doubtless 
 applications of anatomy to surgery were not wanting. They cover 
 the field very creditably. One is struck by the wisdom with 
 which the viscera are brought into the front rank at the expense 
 of the muscles and vessels. Dissection began that year on 
 October fifteenth. 
 
 Cambridge was hard of access in those days and his lectures, 
 which lasted two or three hours, were a great strain upon him. In 
 1809 his son, Dr. John Collins Warren, was appointed Adjunct 
 Professor, which must have made his burden more tolerable. A 
 further relief was given him by the removal the following year of 
 the School to Boston. Instruction by this time had been length- 
 ened to eight weeks, and was further extended the following year, 
 when it began on the first Wednesday of November and ended on 
 that of February. The anatomical course was now split into two, 
 one for medical students on anatomy and surgery in the autumn 
 and winter, and one of twenty-six lectures on anatomy, given in 
 the spring to students of the undergraduate department. 
 
 It is certain that dissection was practised at this period and 
 also that at times the difficulty of getting bodies was very great, 
 and that "body-snatching" was in vogue. Dr. John Collins 
 Warren relates an adventure of this kind in which he took part, 
 the happy result of which gave his father much satisfaction, alloyed 
 as it was by anxiety for his son. His health was not strong and 
 
HOLDEN CHAPEL, CAMBRIDGE. 
 Occupied by the School, 1783-1810. 
 
iiiuijiffl 
 
THE DEPARTMENT OF ANATOMY. 3 
 
 one can imagine that anxieties of this kind in addition to his severe 
 professional work may have shortened his life. We are told by 
 Dr. Jackson that he was "particularly fearful of continuing in 
 office till that period of life when men cease to be aware of the pro- 
 priety of resigning responsible positions." Twice he resigned the 
 professorship only to have his resignation twice declined, and 
 finally he died in harness in 1815, in his sixty-second year. 
 
 On the death of John Warren his son John Collins Warren 
 became Hersey Professor of Anatomy and Surgery. He brought 
 to the place not only the experience of six years work as Adjunct 
 Professor, but that of other years freely given. He had had the 
 advantages of foreign study, was familiar with the teaching of 
 anatomy in Europe, and was an experienced as well as an enthu- 
 siastic dissector. While it may be questioned whether his natural 
 abilities as a teacher were as great as those of his father, he was 
 undoubtedly a more highly educated man and brought to his duties 
 an iron will determined to triumph over any natural difficulties in 
 the way of success. His personality was a striking one. Strict 
 with himself, he was exacting towards others. Although essen- 
 tially a surgeon, he was devoted to anatomy as a science as well as 
 an art, following it as faithfully as his large practice, his hospital 
 work and his teaching of surgery would allow. He held the 
 Hersey Professorship for thirty-two years. If we add to that the 
 six years during which he was Adjunct Professor, and remember 
 that he began to make dissections for his father in 1802, we may 
 say (without including his student days) that he was actively 
 engaged in anatomical pursuits for forty-five years. 
 
 Of the details of his teaching we know little. Conscious that 
 he did not have the ease as a speaker which distinguished his 
 father, he prepared himself with great care for his lectures and 
 looked forward to them with anxiety. So busy a practitioner must 
 have required help in preparing the dissections for his lectures, for 
 
4 THE HAKVAED MEDICAL SCHOOL. 
 
 which he probably depended upon students and young graduates. 
 In 183 1 Dr. Winslow Lewis was made Demonstrator, a new office 
 carrying a seat in the Faculty. This must be considered as a dis- 
 tinct advance in medical education. The list of the Demonstrators 
 during Prof. J. C. Warren's time is as follows : 
 
 Winslow Lewis, 1831-1835 ; Nathaniel B. Shurtleff, 1835-1836; 
 John Roby, 1836-1837 ; Winslow Lewis, 1837-1838 ; Jeffries 
 Wyman, 1838-1840; Samuel Parkman, 1840-1849. Of these Dr. 
 Lewis was remembered as a clever dissector (probably the same 
 could be said of all), but Jeffries Wyman alone attained to a great 
 reputation as an anatomist. 
 
 As implied above. Dr. Warren was an ardent dissector and as 
 such had to secure subjects as best he could. There was no 
 anatomy law, for we do not count as such the adding dissection 
 to the capital punishment for murder. We have no complete his- 
 tory of how bodies were procured. We know, indeed, that body- 
 snatching flourished ; but we do not know to what extent bodies, 
 which a more enlightened civilization would have given to science, 
 were procured by the connivance of officials, nor how many were 
 brought into the State. In 1825 the Faculty voted to appropriate 
 three hundred dollars annually to be at the disposition of the 
 Professor of Anatomy for the purpose of encouraging the study of 
 anatomy. Presumably no account of expenditures was required. 
 That affairs were most unsatisfactory may be inferred from this 
 passage in Dr. Warren's biographical notes: "Sometimes popular 
 excitement was got up and the medical college threatened. I had 
 reason at some periods to apprehend attacks on my dwelling-house. 
 Whenever the lectures approached, a state of incessant anxiety 
 came with them." An effort to obtain relief was made in 1825 
 when Dr. Warren and Dr. Jacob Bigelow were appointed a com- 
 mittee to draw up an act on dissection. We do not know what 
 became of it; but it is one of Harvard's great glories that through 
 
THE DEPARTMENT OF ANATOMY. 5 
 
 the efforts of John C. Warren, Massachusetts on February 
 twenty-eighth, 183 1, passed the first anatomical law* in the 
 United States, which preceded by one year the first one in Great 
 Britain. 
 
 The essential features of this law are as follows : After decreeing 
 penalties for the violation of graves, this act provides " that it shall 
 be lawful for the Board of Health, Overseers of the Poor and Select- 
 men of any town in this Commonwealth and for the Directors of 
 the House of Industry, Overseers of the Poor, and Mayor and 
 Aldermen of the City of Boston — to surrender the dead bodies of 
 such persons, except town paupers, as may be required to be 
 buried at the public expense, to any regular physician, duly 
 licensed, according to the laws of this Commonwealth, to be by 
 said physician used for the advancement of anatomical science, 
 preference being always given to the medical schools that now are, 
 or hereafter may be by law established in this Commonwealth, 
 during such portions of the year as such schools, or either of 
 them, may require such subjects for the instruction of medical 
 students, provided, always, that no such dead body shall in any 
 case be so surrendered if, within thirty-six hours from the time of 
 its death, any one or more persons claiming to be kin, friend, or 
 acquaintance of the deceased shall require to have said body 
 inhumed." It is then provided that bodies of strangers and 
 travellers shall be exempt. The act declares further that the 
 physician receiving the body shall give a bond that it shall be used 
 only for anatomical science, and only in this Commonwealth "and 
 so as in no event to outrage the public feeling," and that "the 
 remains thereof shall be decently mhumed." 
 
 In 1834 the time to elapse before delivering a body was reduced 
 
 *This Is sometimes referred to as the act of the Legislature of 1830, and so it is; for the 
 Legislature came in in that year ; but the act was passed in 1831, and, having been signed by the 
 Governor, became law on the above date. 
 
b THE HAKVAED MEDICAL SCHOOL. 
 
 from thirty-six to twenty-four liours, and unclaimed town paupers 
 were included. It is clear that while this law was a great advance 
 from the mere fact that it legalized dissection, yet it was far from 
 satisfactory on account of its being entirely dependent on the civil 
 authorities to surrender the body or not. What actually occurred 
 at this period we do not know. It is probable that Dr. Warren's 
 influence in the community was sufficient, for a time at least, to 
 have the spirit of the law observed ; but we are told that later 
 difficulties were opposed to its execution and the number of sub- 
 jects was consequently reduced. In March, 1845, 'the law was 
 amended in a radical manner, by inserting the word "shall," which 
 made it mandatory on superintendents, etc., instead of simply per- 
 missive. It further provided that " no such body shall, in any 
 case, be surrendered, if the deceased person, during his last illness 
 of his own accord, requested to be buried." Such was the law 
 during the remainder of Dr. Warren's professorship. Subsequent 
 changes shall be considered later. 
 
 Dr. John C. Warren resigned his professorship in February, 
 1847, being then in his sixty-ninth year ; but, at the request of the 
 Corporation, continued in office until the end of the academic year. 
 He was then made Emeritus Professor of Anatomy and Surgery. 
 
 The collection of specimens which Dr. Warren presented to the 
 College in the autumn following his resignation, and which was 
 named the Warren Anatomical Museum in honor of himself and 
 of his father, is treated of elsewhere. That it was already very 
 valuable may be inferred from the fact that it was stipulated that 
 it should be perpetually insured for not less than ten thousand 
 dollars. 
 
 One other gift from Dr. Warren must not be forgotten. He left 
 a provision in his will that his body should be dissected and his 
 skeleton placed in the School. It was doubtless to make clear that 
 if he had done things which to many were repulsive, he had done 
 
THE DEPARTMENT OF ANATOMY. 7 
 
 nothing to others which he would not have done to himself. His 
 skeleton is still in the Museum which bears his name. 
 
 Although in practice a surgeon, Dr. Warren might worthily have 
 filled the Chair of Anatomy had there been a distinct one for that 
 branch. While eminently practical he was also truly scientific in 
 his tastes, as is shown by his presidency of the Boston Society of 
 Natural History, and his other affiliations to science, such as his 
 private museum containing the mastodon skeleton. 
 
 On the resignation of John C. Warren in 1847, the Professorship 
 of Surgery was made a distinct chair. The Hersey Professorship of 
 Anatomy went to Cambridge, and Dr. Oliver Wendell Holmes 
 was made Parkman Professor of Anatomy and Physiology, the 
 chair being so named in honor of Dr. George Parkman. Dr. 
 Holmes brought to his office the experience of having given two 
 courses of anatomy at Dartmouth. He was thirty-eight years old 
 when he began to teach at Harvard. He had acquired a literary 
 reputation, and was in great request as a lecturer. He had already 
 relinquished practice. A sympathetic and entertaining speaker, he 
 was very attractive to the medical classes which continually passed 
 before him for thirty-five years. At the time of his appointment 
 he was undoubtedly well versed in the anatomy of the day, and 
 was, moreover, a pioneer in microscopy. During his time great 
 changes occurred in the School. Gradually the summer school 
 became more important, and in 1871 the present system of two 
 terms, extending throughout the academic year, was introduced. 
 In the earlier times Dr. Holmes lectured five times a week in the 
 winter term at one o'clock, to an exhausted class unfit to be taught 
 anything. It is hard to believe that any one but Dr. Holmes could 
 have been tolerated at that hour. 
 
 Dr. Cheever wrote of him: "As a lecturer he was accurate, 
 punctual, precise, unvarying in patience over detail, and though 
 not an original anatomist in the sense of a discoverer, yet a most 
 
8 THE HAEVAED MEDICAL SCHOOL. 
 
 exact descriptive lecturer ; while the wealth of illustration, com- 
 parison, and simile he used was unequalled." The mesentery was 
 compared to the shirt-ruiifles of a former generation, a sweat-gland 
 to a fairy's intestine, and the brain and its membranes to an 
 English walnut in its shell. Less brilliant, but more instructive 
 than his lectures, were his very careful recitations on osteology. 
 Perhaps his most enthusiastic worit was given to the microscope, 
 but he gave his attention more to the construction of the instrument 
 and to the resolving powers of lenses than to the subject matter of 
 the science. He began in the summer of 1858 " a course of 
 lectures illustrating the use of the microscope and microscopic 
 anatomy/* which he gave for many years. In 1871 physiology 
 was made a separate department. Dr. Holmes' title becoming 
 Parkman Professor of Anatomy. After this he did little beyond 
 giving his lectures and some recitations. He was deservedly popu- 
 lar with the class, not only from his charming personality but from 
 his real sympathy and kindness. He was, above all, the student's 
 friend. 
 
 A most important feature of Dr. Holmes' professorship was the 
 gradual rise in importance and influence of the Demonstrator, 
 Dr. Holmes was first of all a man of letters. He had neither the 
 time nor the inclination to busy himself with the practical details 
 of running a department ; to say nothing of the unsavory business 
 of obtaining subjects. As time went on he restricted himself more 
 and more to giving his lectures ; the Demonstrator became the 
 Autocrat of the Dissecting Table. Samuel Parkman resigned the 
 Demonstratorship in 1849. The subsequent list under Dr. Holmes 
 is as follows : 
 
 F. S. Ainsworth, 1849-185 1; Samuel Kneeland, 1851-1853; 
 R. M. Hodges, 1853-1861 ; David W. Cheever, 1861-1866; C. B. 
 Porter (Assistant), 1867-1868; C. B. Porter, 1868-1879; H. H. A. 
 Beach (Assistant), 1869-1879; H. H. A. Beach, 1879-1882; 
 
THE DEPARTMENT OF ANATOMY. 9 
 
 M. H. Richardson, 1882-1887. Dr. Hodges was the first of a 
 continuous series (extending beyond the above list) of brilliant 
 and able Demonstrators who developed into great hospital sur- 
 geons ; thus the position of Demonstrator came to be regarded 
 as a sure stepping-stone to a hospital appointment. Dr. Hodges 
 was a most skilful and zealous dissector. He made many beau- 
 tiful dried preparations, especially of the arteries, which have 
 adorned the Museum and are in active service for instruction 
 to-day. In those days the actual duties of the Demonstrator 
 (apart from procuring subjects, and preparing the dissection for 
 the Professor's lecture) consisted of one hour's work daily in the 
 dissecting room, overlooking and helping the students. About 
 1862, Dr. David W. Cheever started anatomical conferences in the 
 dissecting room, at which, a dissection having been made by picked 
 men, the students were examined in turn by the Demonstrator. 
 These exercises became very popular and later were held in the 
 spring term as well as in the winter one. They were developed 
 and continued under Dr. C. B. Porter and Dr. H. H. A. Beach. 
 
 Dr. Cheever became Assistant Professor of Anatomy in 1866, 
 and held the office for two years when he was transferred to the 
 Surgical Department. In addition to recitations he established a 
 very popular course of regional anatomy. 
 
 Dr. Thomas Dwight, who had taught histology since 1874, 
 was made instructor in topographical anatomy in 1880 and 
 gave a course of one lecture or recitation a week to the second 
 class. 
 
 In 1859 the proper conduct of anatomical teaching received a 
 severe set-back. The Legislature voted a revision of the statutes, 
 and, in spite of the opposition of representatives of the Medical 
 School, the committee in charge of the revision struck out the 
 word "shall" and reinstated "may" in the statute on dissec- 
 tion, thereby making it optional with superintendents to deliver 
 
10 THE HAEVABD MEDICAL SCHOOL. 
 
 unclaimed bodies (Chapter twenty-seventh of the General Statutes 
 adopted December twenty-eighth, 1859). During the remaining 
 twenty-three years of Dr. Holmes' professorship the difficulties of 
 obtaining subjects were at times very great. A superintendent 
 naturally found it more convenient to refuse bodies than to do what 
 might place him in an unpleasant position. Clearly it became nec- 
 essary to awaken his interest in the matter. Clearly also if the 
 disposal of dead bodies was a source of profit to him there was no 
 knowing that he did not sell them to the highest bidder even outside 
 of the State, nor that he did not sell bodies that should have been 
 buried. It is certain that during this disgusting condition of affairs 
 Harvard received bodies from beyond the State limits. It is not 
 impossible that body-snatching was actually practised in Massachu- 
 setts. The popular excitement caused by Benjamin F. Butler's 
 Tewksbury investigation had the good effect of making State Boards 
 in charge of certain institutions give their personal attention to the 
 matter. 
 
 In the autumn of 1882 Dr. Holmes received an offer from his 
 publishers in consequence of which he resigned his professorship. 
 The Corporation requested him to continue till December. It was 
 his intention to end without ceremony, but a closing lecture was 
 insisted upon. This was given on November twenty-eighth to an 
 overflowing audience composed of Faculty and students. The class 
 presented him with a loving cup ; enthusiasm was great ; emotion 
 was sincere; his closing scene was a triumph. He was made 
 Emeritus Professor of Anatomy. 
 
 It is worth noting that Dr. Holmes' term of service coincided 
 very closely with the occupancy of the building in North Grove 
 street. It began the year after this building was first used and 
 ended in its last scholastic year. 
 
 It is still more noteworthy that the two Warrens and Holmes 
 had occupied the Chair of Anatomy for almost precisely one 
 
THE DEPARTMENT OF ANATOMY. 11 
 
 hundred years ; John Warren having been appointed November 
 twenty -second, 1782. 
 
 Dr. Thomas Dwight, being requested to continue Dr. Holmes' 
 lectures through the year, resigned his instructorship in histology 
 and gave the lectures to the first class as well as his course of 
 topographical anatomy to the second. Every effort was made by 
 the Faculty to find either at home or abroad "a worthy successor to 
 Dr. Holmes." These efforts failing, it became necessary in June, 
 1883, to appoint Dr. Thomas Dwight to the professorship. As 
 it happened that he was the great grandson and grandson respect- 
 ively of the first two Professors, it is allowable to state that there 
 was no suspicion of nepotism in his appointment. Beside the 
 teaching above mentioned he had taught anatomy privately for 
 several years, and for five years had given the course in anatomy 
 at the Medical School of Maine. He had introduced into this 
 country the making and study of frozen sections. 
 
 The list of Demonstrators after 1883 is as follows : 
 
 M. H. Richardson, 1883-1887; S. J. Mixter (Assistant), 1884- 
 1887; S. J. Mixter, 1887-1893 ; William M. Conant (Assistant), 
 1890-1893; Franklin Dexter, 1893-1895; W. A. Brooks, 1895- 
 1901 ; John Warren, 1901. 
 
 There was continuous progress for many years in the manage- 
 ment of the dissecting room, the personal instruction being much 
 increased. Many instructors and assistants in anatomy were 
 appointed. We regret that space does not allow us to give them 
 the tribute which their fidelity deserves. The surgical members of 
 the above list of Demonstrators carried on and even increased the 
 prestige which former Demonstrators had given to the office. At 
 last, however, a radical change became necessary. On Dr. 
 Richardson's resignation in 1887 he was made Assistant Professor 
 of Anatomy. When Dr. Mixter resigned as Demonstrator in 1893, 
 Dr. Franklin Dexter became a candidate for the office. He had 
 
12 THE HAEVAED MEDICAL SCHOOL. 
 
 the advantage of being a pure anatomist, but one who had a med- 
 ical degree, and who had worthed for years in training himself to 
 teach anatomy. Apart from these qualifications he was desirable 
 from the absolute necessity of breaking with the Surgical Depart- 
 ment, if that of Anatomy was to be truly independent. In 1895 
 Dr. Richardson was transferred from the Anatomical to the Surgical 
 Department, and Dr. Dexter was appointed Assistant Professor of 
 Anatomy in his place. In 1900 he became Associate Professor, but 
 after three years he retired to the general regret. The School 
 owes a great deal to his influence in systematizing laboratory in- 
 struction, and in regulating it with military precision. After his 
 promotion he still gave much time to the dissecting room. He was 
 most sympathetic with students, especially with those who found 
 anatomy difficult. 
 
 Under Dr. Dwight original work was done for practically the first 
 time in the history of the department. A number of statistical 
 observations were made in the dissecting room and much attention 
 was given to variations, especially to those of the spine and of the 
 hand and foot. Very little had been added to the normal anatomy 
 collection in the Warren Museum since the days when Dr. Hodges 
 was Demonstrator. The collection of numerical variations of the 
 human spine is now one of the best in the world, containing speci- 
 mens of great rarity. An absolutely new occasional bone (the 
 intercuneiform) had been twice observed in the foot, and the sub- 
 capitatum has for the first time been found as a distinct bone in 
 both hands of one body. Many series of frozen sections have been 
 prepared, some of which are in the Museum, but most of which are 
 kept for study. Preparations of formalin-hardened bodies have 
 been made to show the true shapes and relations of the organs, and 
 some of these have been reproduced in papier mSch^. A series of 
 enlarged models of the bones has been made in the same material. 
 A fine collection of corrosion preparations has been added to the 
 
THE DEPARTMENT OF ANATOMY. 13 
 
 Museum, the most beautiful of which are some in celloidin by Dr. 
 S. J. Mixter. 
 
 At the beginning of Dr. Dwight's professorship the obtaining of 
 subjects was in a more satisfactory condition than it had been for a 
 long time, owing to the reforms following the Tewksbury investi- 
 gation. Nevertheless, a certain number still came from outside the 
 State. This was very properly stopped by the declaration of the 
 Corporation that they would pay nothing for such subjects. In 
 1898 the great reform brought about by John C. Warren in 1845, 
 and subsequently lost in 1859, was reestablished ; namely — the 
 word " may " was displaced and " shall " again put in, thus mak- 
 ing the law once more mandatory. New and important changes 
 were introduced. The privilege of applying for bodies was taken 
 away from individual practitioners, and it was arranged that a fair 
 division should be made among the schools. It was further pro- 
 vided that a body should not be used for fourteen days after death, 
 and should be so kept that it could be seen. 
 
 Subsequently the Attorney General ruled that it was unlawful 
 for autopsies to be made on these bodies by the hospital authorities 
 before surrendering them, but in 1902 the law was amended 
 allowing autopsies when the cause of death could not otherwise be 
 determined. 
 
 Space will not permit the account of the development of anatomi- 
 cal teaching since 1883. It may be said that for many years it was 
 continuously progressive. In 1888 histology became practically a 
 separate department under Assistant Professor Minot. Perhaps 
 the high-water mark of anatomical instruction was reached in 
 1897-8. The first class had three lectures weekly from Professor 
 Dwight throughout the first term, and one other from him till 
 January. Professor Dexter gave two a week from the end of 
 November to the close of the year. There was also one recitation 
 to an instructor, Dr. Benjamin Tenney, throughout the year. 
 
14 THE HARVARD MEDICAL SCHOOL. 
 
 Moreover, the dissecting room was carefully supervised and there 
 were exercises by the Demonstrator, Dr. Brooks, for sections of 
 the class during five months. In the second year there were two 
 lectures weekly by Professor Dexter till January, and two by Pro- 
 fessor Dwight in the second term. The fourth class had an elec- 
 tive course by Professor Dexter and a voluntary dissecting course 
 by the Demonstrator. In 1899-1900 the first year anatomy was 
 restricted to the first term and the second year anatomy to Febru- 
 ary and March, in which Dr. Dwight gave five lectures a week. 
 The following year he had three extra hours in the second year for 
 laboratory work. In 1903-4 the second year anatomy was sup- 
 pressed, so that the entire time now required in anatomy (exclusive 
 of histology and embryology) is half a day during the first year in 
 October, November, and December, and a whole day in January. 
 Beside this there are optional courses in the fourth year. Profes- 
 sor Dwight's protest against the suppression of second year 
 anatomy is in the records of the Faculty meeting of May second, 
 1903. 
 
Benjamin Waterhouse. 
 
 M.D. Leyden, 1780; M.D. (hon.) 1786. 
 
 Professor of the Theory and Practice of Physic (after 1791, Hersey);: fes- 
 
 1783-1812. 
 

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THE DEPARTMENT OF THE THEORY AND PRACTICE 
 
 OF PHYSIC. 
 
 J 782. 
 
 The plan for a medical department of Harvard College sub- 
 mitted by Dr. John Warren and adopted by the College on Sep- 
 tember nineteenth, 1782, provided for three new professors, one of 
 The Theory and Practice of Physic, one of Anatomy and Surgery, 
 and one of Chemistry. 
 
 The rules which were to govern the Professor of Theory and 
 Practice were that he should " teach the students by directing and 
 superintending, as much as may be, their private studies ; lecturing 
 of the diseases of the human body, and taking such of them as 
 are qualified to visit their patients ; making proper observations on 
 the nature of the diseases and the peculiar circumstances attending 
 them, and their method of cure ; and, whenever the professors be 
 desired by any other gentlemen of the Faculty to visit their patients 
 in difficult and uncommon cases, they shall use their endeavors to 
 introduce with them their pupils who are properly qualified." 
 Thus the name of the Department was to be borne out; there 
 should be the theory of medicine developed in the lectures, and the 
 application of these principles worked out as far as possible before 
 the student with the patient at hand. 
 
 Dr. John Warren was chosen to the Chair of Anatomy and 
 Surgery, on November twenty-second, 1782, with the proviso that 
 he should act for all the Departments until other men could be 
 secured. A month later, December twenty-fourth, 1782, Dr. 
 Benjamin Waterhouse, formerly of Newport, R.I., was chosen 
 Professor of Theory and Practice, and May twenty-second, 1783, 
 Aaron Dexter, a Boston physician, was chosen Professor of Chem- 
 istry. On October seventh, 1783, they were inducted into office 
 
 (IS) 
 
16 THE HABVAED MEDICAL SCHOOL. 
 
 in the Cambridge meeting-liouse before the highest civil authorities 
 of the Commonwealth, John Hancock, the governor, being present, 
 together with the representatives of the clergy, the college profes- 
 sors, and the general public. Dr. Warren and Dr. Waterhouse 
 were installed together, and each delivered a Latin oration. That 
 of the latter has been published, and called forth the comment 
 from some of the guests that it was not in " New England Latin." 
 Professor Dexter was not present. "The day," writes Dr. 
 Waterhouse, " was brilliant, and the night more so ; for the college 
 buildings were illuminated, together with several others." 
 
 Dr. Waterhouse, in his address, speaks of all the various 
 branches which are to be brought together and made one by the 
 Professor of Theory and Practice, enumerating anatomy, chem- 
 istry, botany, materia medica, and natural philosophy, and, in 
 closing, he makes an appeal for the scientific study of insanity. 
 
 The good doctor, evidently, had an exalted idea of the task he 
 was to undertake ; and the standard he set was high, so that from 
 that day to the present it has been the duty of the Department of 
 Theory and Practice to sum up the labors of many diverse depart- 
 ments, and to put upon them a practical interpretation ; of this we 
 shall see more later. 
 
 Dr. Holmes describes Dr. Waterhouse as rather a comical figure 
 about Cambridge. "A brisk, dapper old gentleman, with hair tied 
 in a ribbon behind and, I think, powdered, marching smartly about 
 with his gold-headed cane, with a look of questioning sagacity and 
 an utterance of oracular gravity. The good people of Cambridge 
 listened to his learned talk when they were well, and sent for one 
 of the other two doctors when they were sick." " He probably 
 liked to write and talk about medicine better than to practise it." 
 All this must have been late in life. At the time the Medical 
 Department was started, with festival and illumination, he had but 
 recently returned from his European studies; having graduated 
 
THE DEPARTMENT OF PHYSIC. 17 
 
 from the University of Leyden in 1780. He had studied also in 
 London, living in the family of Dr. John Fothergill, whom he calls, 
 in his " Treatise on Whooping Cough," " the founder and director 
 of his studies, in name, his proavunculus, in effect his father." 
 Edinburgh had been visited. He states in his diary that he never 
 missed a lecture while in Edinburgh, and that all the time he was 
 in Scotland he was secretary of the Royal Medical Society. He 
 finally took his degree at Leyden, having studied in Europe for 
 more than five years. Without doubt he was the young man of 
 learning then available for the place, just the man to quicken 
 students with a love for science and a desire for general knowledge. 
 Late in life, when writing of his early experiences, he says, " I 
 first taught or tried to teach the John Hunterian Doctrine, for my 
 colleague Warren saw not into Hunter's ' Philosophy of Man, or 
 Animated Nature.' " 
 
 Although a certain pomposity of style and cantankerousness of 
 action developed as he became an old man in the nineteenth 
 century, still his work shows that he must have been a thorough 
 man of the times during his early working years. To him is due 
 the introduction of the practice of vaccination into the United 
 States. That he was in close touch with the world's centers is to 
 be inferred from the fact that Jenner's book was read early in 1799, 
 and a little later Geotge Pearson's book upon Cow or Keinepox, 
 after reading which. Dr. Waterhouse published (in the "Columbian 
 Centinal," March twelfth, 1799) a short article on vaccination, 
 entitled, "Something Curious in the Medical Line." In Novem- 
 ber of the same year he printed a report of experiments which had 
 been made in England by Dr. Woodville. Then, "under serious 
 impression of effecting a public benefit, and conceiving it moreover 
 a duty in my official situation in this University," he obtained 
 some vaccine from England, preserved, on threads, and on July 
 eighth, 1800, vaccinated first of all his son, Daniel O. Waterhouse, 
 
18 THE HARVAKD MEDICAL SCHOOL. 
 
 and noted with satisfaction that " the appearance and symptoms 
 were alike in the new and the old world." In response to a 
 memorial presented by Dr. Waterhouse, the Boston Board of 
 Health in 1802 made its celebrated experiments to determine the 
 value of cow-pox as a preventative against small-pox. Dr. 
 Waterhouse wrote several books and pamphlets upon vaccination 
 and small-pox. After three unsuccessful attempts he succeeded in 
 getting some infected threads to Monticello, where President Jeffer- 
 son vaccinated all his immediate family and servants, and probably 
 himself; and from here the material was carried to Washington. 
 Later, Dr. Waterhouse received a silver snuff-box from Jenner, 
 containing vaccine and a set of lancets also, in a silver case. The 
 box is inscribed, " Edw. Jenner to B. Waterhouse." This is 
 reality, and not the mythical gold snuff-box told about by Lowell, 
 and said to have been inscribed, "From the Jenner of the Old 
 World to the Jenner of the New." Not only did Dr. Waterhouse 
 successfully fight with tongue and pen for vaccination, enough of 
 achievement for one man's life, but the Botanical Garden at 
 Cambridge was founded by him, as well as the Collection of 
 Minerals which, in part a gift from his friend. Dr. Lettson of 
 England, had its beginning in his broad enthusiasm for science. 
 In 1804 Dr. Waterhouse delivered at the close of the medical 
 course, before the students of the University in Holden Chapel, a 
 lecture on " Cautions to Young Persons concerning Health, con- 
 taining the general doctrine of Chronic Disease, showing the evil 
 tendency of the using of tobacco upon young persons, more espe- 
 cially the ruinous effects of smoking cigars, with observations on 
 the use of ardent and vinous spirits in general." Dr. Waterhouse 
 pictures in this lecture the rapid deterioration of the Harvard 
 student of the day. "Six times as much ardent spirits were 
 expended here (in Cambridge) annually as in the days of our 
 fathers. Unruly wine and ardent spirits have supplanted sober 
 
THE DEPARTMENT OF PHYSIC. 19 
 
 cider." The general health of the College has deteriorated. For 
 twenty-seven years, from 1769 to 1796, there had been but nine 
 deaths among the students. In the following eight years there 
 had been sixteen deaths, mostly from consumption. Indeed, never 
 in his twenty-three years of experience had Dr. Waterhouse seen 
 "so many hectical habits and consumptive affections as of late 
 years." All of which he ascribed to the evil effects of smoking 
 and drinking. It is a vigorous argument, not sparing the clergy, 
 and calculated to do great good. Six editions were printed during 
 the next fifteen or twenty years, and the lecture was translated 
 into several foreign languages. The fame of this lecture always 
 displeased Dr. Waterhouse. 
 
 Rather than the pompous old gentleman of Dr. Holmes' remem- 
 brance, let us think of Dr. Waterhouse as the enthusiastic student 
 of science, striving in far-distant America to keep in touch with the 
 best that was taking place in the centers of European learning, 
 vigorous and practical in his ability to seize upon the medical event 
 of the period, strong in the denunciation of existing evils, and with 
 a breadth of mind that prepared the way for the advent of Gray 
 and Agassiz. 
 
 As early as 1784 an attempt was made to secure clinical material 
 for teaching. Application was made to the town of Boston for the 
 use of the infirmary at the almshouse for the Professors of Surgery 
 and of Theory and Practice. 
 
 Dr. Waterhouse also made a plea for a marine hospital where he 
 should have control of clinical material for teaching, setting forth in 
 arguments, which are just as sound to-day, the need of the School 
 to have control of hospital wards. This, too, came to naught. 
 Finally the Boston almshouse was utilized for teaching purposes. 
 
 With the return from foreign medical study of Drs. James Jack- 
 son and John C. Warren a new era dawned. New ideas were 
 introduced and were in many ways opposed by the Professor of 
 
20 THE HARVARD MEDICAL SCHOOL. 
 
 Theory and Practice. It was needful that the School should 
 remove to Boston, as the students for the most part resided there, 
 working with their preceptors. This was accomplished finally in 
 1810, though against the desires of Dr. Waterhouse, who finally 
 capitulated and joined the petitioners. The young men practically 
 made a concerted effort to attack the unpopular professor and cause 
 his removal. They found him, however, a hard fighter, and it was 
 only after a very prolonged and acrimonious debate that the old 
 Jeffersonian Republican fell before the attacks of young men 
 representing new ideas in medicine and the Federalist party in 
 politics. 
 
 In 1812 James Jackson was promoted to the professorship of the 
 Theory and Practice of Physic. 
 
 Dr. Jackson cannot be considered and judged solely as the Profes- 
 sor of Medicine. He was too large and important a figure in both 
 the medical and social community of Massachusetts for that. As 
 Professor of Theory and Practice he had the position from which he 
 was able naturally to exert powerful influence on the people and 
 times. It was, however, his all-round judicial grasp of the needs of 
 medicine and medical education in Massachusetts that made him the 
 great man that he was. He was not what could be termed an orig- 
 inal teacher, investigator or writer. Dr. Jackson was a good, safe 
 teacher. He came back from Europe hoping to be the introducer 
 of vaccination into the Boston community, but he found himself 
 forestalled by Dr. Waterhouse. And later when he made the first 
 suggestion to the Boston authorities that they should make a prac- 
 tical test of the protective powers of vaccination the suggestion was 
 not accepted, and it was not until Dr. Waterhouse took the lead at a 
 later time, writing an elaborate argument in favor of the undertak- 
 ing, that the famous experiment was authorized. 
 
 Both Dr. Jackson and Dr. J. C. Warren returned to Boston from 
 their European studies imbued with the spirit of the scientific 
 
THE DEPARTMENT OF PHTSIO. 21 
 
 centers. They saw the need of clinical teaching, the need of a 
 sure basis for practice, the need of a diffusion of knowledge by 
 means of societies and journals. They clearly realized that in 
 order that there should be anything like a profession of medicine 
 the members [must join together, stand shoulder to shoulder and 
 not be afraid to tell of their failures as well as their successes. 
 These two men through their long professional lives worked 
 together supplementing each other's efforts — so that it is often hard 
 to say which was the originator of the multifarious schemes put 
 forth for the good of the community. To them it was largely due 
 that the Medical School was moved from Cambridge to Boston, 
 where most of the pupils lived and where there was material for 
 clinical teaching. The Massachusetts Medical Society was held 
 together largely through them, the formation of a rival society was 
 prevented, and with it a rival Medical School. A journal was 
 started, to which they were the most active contributors. The 
 Massachusetts General Hospital was founded largely at their insti- 
 gation. Dr. Jackson, in his plea to the benevolent citizens of 
 Boston for such an institution, makes the statement: "A hospital 
 is an institution absolutely essential to a medical school, and one 
 which would afford relief and comfort to thousands of sick and 
 miserable." He realized the fact that a hospital used for teaching 
 purposes afforded the best treatment for patients. In addition to 
 the hospital the new building for the Medical School on Mason 
 street was erected mainly through Dr. Jackson's efforts. 
 
 Of his teaching we have a good idea given us in a letter of his 
 son, the talented James Jackson, Jr., to Dr. J. B. S. Jackson, then 
 in Europe, telling of the Medical School and the professors. When 
 he writes of his father it is as follows : " You will not deem it an 
 affectation in me, I am sure, to say that I listen to him with infinite 
 delight and satisfaction. The object of attending lectures is to be 
 taught — and my word for it, he does understand the art of 
 
22 THE HABVAKD MEDICAL SCHOOL. 
 
 teaching better than any man with whom it has been my good 
 fortune to meet." 
 
 Dr. Jackson was a careful observer, was methodical in his study 
 of the symptoms of the patient, and was at the same time friendly 
 and sympathetic with both his students and with the patient. 
 
 In 1822 he wrote to the Hon. John Lowell that in addition to his 
 stated lectures it was his practice always to give one afternoon each 
 week, and usually two, to the consideration of subjects that would 
 otherwise have been crowded out — because the time allotted to the 
 lectures was not sufficiently long to cover all the ground which he 
 felt should be gone over in his branch of medicine. This illustrates 
 his enthusiasm for his teaching, even in the midst of a busy prac- 
 tice. Of Dr. Jackson's conduct at the bedside. Dr. Holmes is 
 moved to say, "I have seen many noted British, French, and 
 American practitioners, but I never saw a man so altogether 
 admirable at the bedside of the sick as Dr. James Jackson. " 
 
 Thus we have in Professor Jackson a well rounded physician and 
 man of affairs. The country was too new and the task of organ- 
 ization was too great to expect new discoveries, new lines of 
 thought. But James Jackson had the ability to teach the knowl- 
 edge that he had acquired and to inspire others with a zeal for 
 scientific truth. He was shrewd in the observation of his cases, as 
 was evidenced by his recognition of a serious disorder located in the 
 right iliac region — later called, by a successor of Dr. Jackson's, 
 "appendicitis." His broad philanthropy and humanity went far 
 towards making the traditions of the medical life of Boston the 
 most delightful that are to be found in the United States. 
 
 Dr. Jackson's term of office continued until 1836 when he 
 resigned his professorship — and in the following year his position 
 at the Massachusetts General Hospital. Some years previously, in 
 1832 — a year after the practical separation of the Medical School 
 from the University — he had asked for an assistant in his work 
 
THE DEPARTMENT OF PHYSIC. 23 
 
 and Dr. John Ware had been elected adjunct professor with the 
 provision that it should entail no additional expense to the students 
 of the Medical School. 
 
 Dr. John Ware, who succeeded Dr. Jackson, was a modest, 
 hard-working physician. He was possessed with a very pleasing 
 personality, and was popular as being a thoroughly good fellow, 
 who could both sing a good song and tell a good story after dinner. 
 As a physician he was possessed of sound judgment and clear 
 insight into his cases. He believed that the professorship which he 
 was called to fill was the place where, above all things, the students 
 were to look for conservative opinions. In addition to his profes- 
 sional work he was much interested in natural history. 
 
 We possess several addresses delivered by him before the 
 students of the Medical School — the first in 1833 immediately after 
 his selection as adjunct professor, the next in 1843, again in 1850, 
 and finally a farewell address to the class graduating in 1856. 
 From these we can gather the ideals which actuated him in his 
 teaching. John Ware was thoroughly imbued with the importance 
 of the medical profession and of its dignity, and at the same time of 
 the practical impossibility of its pursuit being attended with great 
 renown. Harvey and Newton he compared as men of the same 
 type of mind and both as producing great discoveries; " but who 
 knows of Harvey as compared with the popular fame of Newton ? " 
 "A physician's permanent reputation must be given to him by the 
 profession." He urges to general study, and says that a little 
 learning is not a dangerous thing, provided the elemental portions 
 are correctly acquired. The danger of practitioners becoming 
 simply students of the natural history of disease already impressed 
 him ; and in this, as in the several other addresses, he warns 
 against specialism bought at the risk of losing the well -developed 
 man. In the address of 1843 the opening theme is " Zeal for Study 
 and its necessity, in order to acquire a true knowledge and 
 
24 THE HARVARD MEDICAL SCHOOL. 
 
 appreciation of the medical profession." "The student comes to 
 the Medical School for the first time to study and acquire for him- 
 self." "Previous defects of education can be overcome by the 
 man who now cultivates his powers of observation." " The studies 
 of the humanities and of language," he says, "are not to be de- 
 spised, rather much to be desired." " Before, we have been taught 
 by others, now we are to learn for ourselves." Again he returns to 
 the charge against scientific studies for their own sake, and warns 
 his students not to get too much interested in them and neglect the 
 weighty matters of the physician's calling. He compares France, 
 where the interest of the medical fraternity has been scientific and 
 changing and unimportant, with the solid achievements of England. 
 "We can enumerate," he continues, "half a dozen English 
 writers whose works contain more lessons of practical wisdom than 
 the whole catalogue of the French. Where is their Sydenham ? or 
 their Hunter .' or, to come down to our contemporaries, I know not 
 a single work whose sound common sense, and practical lessons 
 that can alone fit a physician for his ordinary duties, is to be com- 
 pared for a moment to those of Heberden, Prout, Abercrombie, and 
 Holland." In spite of all this praise, he has no unstinted commen- 
 dation of English practice. 
 
 In the school circular of 1841-42 fifty plaster casts imported from 
 Paris, for the use of the Department of Theory and Practice, were 
 first mentioned. These were colored, and represented " many ele- 
 mentary forms of disease." They continued to be mentioned in 
 the catalogues as "recently imported " during the next fifteen years. 
 
 Dr. Morrill Wyman wrote out a complete description of these 
 casts and of his interpretation of them, which is still preserved in the 
 Warren Museum. In spite of the prominence given to their value 
 in the catalogue, they were rarely used by the professors to illus- 
 trate their lectures, as it was very difficult to move them from their 
 position in the Museum to the lecture-room. 
 
THE DEPARTMENT OF PHYSIO. 25 
 
 In Theory and Practice the course in 1850 embraced lectures 
 on the general principles of pathology and therapeutics, and the 
 history and treatment of particular diseases and clinical lectures at 
 the Massachusetts General Hospital. In 1852-53 Dr. J. B. S. 
 Jackson, besides being professor in his own Department of Morbid 
 Anatomy, was associated with Dr. Ware in Theory and Practice. 
 The following year, 1853-54, Dr. Morrill Wyman became Adjunct 
 Professor of Theory and Practice, which office he continued to hold 
 till 1857. In that year a change was attempted in the course of 
 study, and the first attempt to present anything like a graded 
 course was made. A two years' course was presented, in which 
 anatomy, pathological anatomy, surgery, chemistry, practical anat- 
 omy, and physiology were to be pursued during the first year, 
 while the second was to be devoted to botany, zoology, theory 
 and practice, midwifery, the diseases of women and children, 
 medical jurisprudence, materia medica, practical anatomy, and 
 clinical observation. Arrangements were also made so that the 
 full course could be crowded into a single year. Chemical analysis 
 and the use of the microscope are spoken of for the first time. The 
 statement is made also that the subjects formerly in charge of the 
 Hersey Professor are now divided amongst three professors, and 
 the lectures and examinations are held at the Medical College by 
 Dr. John Ware and Dr. George C. Shattuck. Dr. Wyman's name 
 no longer appears in the catalogue. The books used in the Depart- 
 ment that year were Watson's Theory and Practice as the text- 
 book, and, as collateral reading. Wood, Stokes and Bell, Graves 
 and Williams. 
 
 Dr. John Ware resigned and, in the circular of March of 1859, 
 Dr. George C. Shattuck is spoken of as the Adjunct Professor, and 
 in the fall announcement of the same year as Hersey Professor, 
 and Dr. Henry I. Bowditch appears as Professor of Clinical 
 Medicine. 
 
26 THE HARVARD MEDICAL SCHOOL. 
 
 Dr. George C. Shattuck held the position of Hersey Professor of 
 Theory and Practice of Physic until November, 1873. 't was the 
 time of instruction by the didactic lecture and Dr. Shattuck's teach- 
 ing was not different from that of other professors of the time. 
 Nevertheless he had decidedly advanced ideas as to what the 
 student needed to help him become a practical physician. And to 
 this end he encouraged the young men outside the School in their 
 clinical teaching. As Dean of the Faculty from 1864 to 1869 he 
 encouraged the development of the School and the introduction of 
 new men into the ranks of the instructors. That he acted as a 
 leader of the progressive party in those days is something that the 
 friends of the School should hold in kind remembrance. Of the 
 new men, Dr. Charles E. Buckingham joined Dr. Shattuck's Depart- 
 ment (Catalogue of 1866-1867), first as an instructor and later as 
 Adjunct Hersey Professor. In 1869-70 Dr. Francis Minot first 
 joined the Department. 
 
 All those who knew Dr. Shattuck speak of his genial manners, 
 his kind face, and invariable gentleness and courtesy. His medical 
 work was confined to his hospital service and his teaching, as he 
 gave up all active practice at an early date. He was always ready 
 to give help and advice to all those who were struggling to obtain a 
 medical education. Just at the end of Dr. Shattuck's term of 
 service great changes in the method of teaching were introduced, 
 coincident with the advent of President Eliot. The three years' 
 course of progressive and systematic study with examinations at 
 the end of each year appeared in the second edition of the catalogue 
 devoted to the Medical School in 1871-72. In the catalogue of the 
 School in which Dr. Shattuck's name appears for the last time 
 appears the first examination paper in Theory and Practice. Dr. 
 Francis Minot succeeded to the Hersey Professorship. He had 
 been, in the year 1869-70, an instructor in the same Department, 
 and in 1872-73 Adjunct Professor and the first lecturer in the 
 
THE DEPARTMENT OF PHYSIO. 27 
 
 School on the diseases of women and children. The subject of 
 diseases of women was an unpopular one with the conservative 
 members of the profession, as indeed, were the other specialties. 
 But the work of several men outside of the School forced the 
 Faculty to recognize the need of instruction in this particular 
 branch. 
 
 Dr. Minot's instruction consisted of lectures illustrated largely 
 from his own personal experience. Ward instruction was also 
 given to large groups of students, and the cases were carefully 
 explained to the class. 
 
 When the Medical School on Boylston street (1883) was opened. 
 Dr. F. C. Shattuck held recitations in Flint's Theory and Practice 
 of Medicine — questioning the students on the pages covered since 
 the last lesson. It was good training and made at least one book 
 read thoroughly and its doubtful statements explained. About this 
 time places as assistants at the hospital were not eagerly sought after 
 and cutting lectures and clinics for the sake of seeing patients in 
 the out-patient departments was considered a very doubtful pro- 
 ceeding by the students. The patients were not studied so com- 
 pletely, as is instanced by the patient who came back asking for the 
 doctor who looked at him as though he would look through him, 
 and then gave him some medicine that made him all right. 
 
 In 1888 Dr. Shattuck became Professor of Clinical Medicine and 
 was succeeded by Dr. Elbridge G. Cutler. 
 
 In 1890 Dr. Minot resigned and in 1892 Dr. Reginald H. Fitz 
 was transferred to the professorship of Theory and Practice. Dr. 
 Fitz at once gave up the old "hospital visit" as a means of 
 teaching and substituted in its place a clinical exercise in which 
 the student was put in front of the patient and made to obtain 
 the history, make the examination, call for or make examina- 
 tions of blood or urine or sputum or any other aids that would 
 enable him to get information regarding the condition of the patient. 
 
28 THE HAEVAED MEDICAL SCHOOL. 
 
 All of this had to be done under the watchful eye of the professor, 
 who insisted on accurate and logical statements as to the facts 
 obtained from the history or examination of the patient. At the 
 end of the exercise Professor Fitz is accustomed to sum up the 
 principal points of the case, treating the subject from the broadest 
 bearings of medicine. It is an exercise calculated to train the 
 student to use what he has learned in the laboratories and from 
 his books and other instructors, and to utilize it under fire. 
 
 The text-book recitations were continued until 1900, when a 
 scheme of sectional teaching was substituted. Four new assistants 
 were appointed. Dr. Mark W. Richardson, Dr. Elliott P. Joslin, Dr. 
 Franklin W. White, and Dr. George S. C. Badger. Dr. Richard- 
 son resigned in the middle of the year and Dr. Arthur K. Stone was 
 appointed to succeed him and in 1903 Dr. Joseph H. Pratt was 
 added to the number. 
 
 The students are taken in their second year fresh from the labora- 
 tory courses, and as yet unacquainted with actual cases, and taught 
 the value of symptoms and how to take histories. The importance 
 of special common symptoms is emphasized ; diseases are spoken 
 of in the order of their relative frequency and importance. 
 General symptoms are taken up and considered, such as cough, 
 jaundice, dropsy, constipation, and diarrhea. Then the value of 
 the methods of precision is considered and the aids to accurate 
 knowledge of the case that can be afforded by laboratory methods. 
 The limitations as well as the extent of the knowledge to be 
 obtained from the laboratory methods are discussed. Later still in 
 the year the students are given cases to study and they are 
 encouraged to apply all of the laboratory methods at their command 
 that they may know as much as possible about the case. This 
 teaching is continued during the first half of the third year with 
 more complicated cases and with still greater criticism of the work 
 done by the individual student. 
 
THE DEPARTMENT OF PHYSIC. 29 
 
 In 1905 Dr. Joslin was promoted to be Instructor and Dr. Henry 
 A. Christian was added to the teaching corps as Instructor. He has 
 charge of the ward teaching, overseeing men of the fourth year 
 who have cases assigned to them in the wards of the Massachusetts 
 General Hospital. He directs their observations of the patients 
 themselves and also their laboratory work, criticising their methods 
 and their accuracy. The cases are further discussed with Professor 
 Fitz on his daily visits to the wards of the hospital. 
 
 By this means the student is brought into still closer relations 
 with the cases, and is enabled not only to make diagnoses, but to 
 see patients under treatment and to observe changes in their 
 general physical condition from day to day ; still further, to observe 
 changes in their blood, urine, feces, stomach contents, and anything 
 else which it may be desirable to study in connection with the case. 
 
 In addition to this work of the sections Dr. Cutler gives ward 
 clinics and demonstrations throughout the third year and a clinical 
 lecture during the first half of the year. 
 
 To aid in the sectional work the Department has prepared a 
 little book of Outlines of Medical Diagnosis. This book contains 
 mention of points in history taking, methods of systematic exami- 
 nation of the body and the useful procedures in the examination of 
 the urine, blood, sputum, gastric contents, and other secretions. 
 The book makes practical all the work of the first years of study 
 at the School, and unifies and simplifies the teaching. The other 
 clinical Departments of the School have adopted this book as the 
 basis of their teaching, and thus it has tended to bring the teaching 
 throughout the School to a more uniform standard. 
 
 It must always be borne in mind that the laboratories are for 
 training in methods and theories ; the clinic is for the employment 
 of those methods which are of special value for the diagnosis, 
 prognosis, and treatment of disease in connection with the results 
 of the other methods of examining the patient. 
 
30 THE HAEVAKD MEDICAL SCHOOL. 
 
 As Dr. Waterhouse, in his inaugural address in 1783, called 
 attention to the various sciences which were adjuncts of this 
 professorship, so now judicious instruction is needed which shall 
 select from the work of the laboratories those procedures which 
 may be expected to yield real returns to the student and prac- 
 titioner, and shall insist that the student shall know both how and 
 when to employ laboratory assistance. 
 
 No student has the mental training or ability to pass critical 
 judgment upon the laboratory work of many different Depart- 
 ments. Hence the need of critical lectures and critical instruction 
 which shall point the way and help train those critical faculties 
 which, together with accurate observation, need to be developed to 
 make the student the intelligent practitioner ; further, by the repeti- 
 tion of valuable laboratory aids and other methods of examination, 
 to have the student learn to apply the practical part of his previous 
 instruction and to rely upon his own observations, making him, as 
 far as possible and as is desirable, independent of special expert 
 assistance; finally, the proper interpretation of the result of the 
 various methods of examination, whether of subjective symptoms 
 or physical signs, or chemical or microscopical investigation for 
 the best treatment of the individual case under consideration. All 
 this at the present time is the aim of the Department of Theory 
 and Practice. 
 
JOHN GORHAM (H.C. 1801). 
 A.M.; M.B. 1804; M.D. 1811. 
 
 Adjunct Professor of Chemistry and Materia Medica, 1809-1816, 
 Erving Professor of Ciiemistry, 1816-1827. 
 
THE DEPARTMENT OF CHEMISTRY. 
 J 783. 
 
 The Medical School of Harvard University was founded in 1782. 
 Dr. John Warren was elected Professor of Anatomy and Surgery 
 and Dr. Waterhouse was chosen Professor of the Theory and Prac- 
 tice of Physic, and either or both of them were desired, as may be 
 most convenient to them, to deliver lectures in chemistry and 
 materia medica till some gentleman is chosen for Professor in that 
 Department. On May twenty-second of the following year Dr. 
 Dexter was made Professor of Chemistry. The Medical School at 
 that time occupied the basement of Harvard Hall, but soon after 
 was removed to Holden Chapel, Cambridge. In 1784 the Corpo- 
 ration voted eighty pounds for the purchase of medical books and 
 clinical apparatus. 
 
 Aaron Dexter was born in Chelsea in 1750. He graduated from 
 Harvard in 1776 and studied medicine under Dr. Samuel Danforth, 
 called "the most scientific chemist then on the stage." He served 
 as ship-surgeon during the Revolution and was captured by the 
 British and taken to Halifax. He was highly respected as a 
 physician and citizen. He was a member of the Massachusetts 
 Historical Society and American Academy of Arts and Sciences, was 
 a member of the first staff of the Massachusetts General Hospital, 
 and one of the founders of the Massachusetts Humane Society. In 
 1791 Major William Ewing (H. C, 1753) left by will one thou- 
 sand pounds to the Corporation "for the sole use and purpose of 
 enlarging the salary of the Professor of Chemistry." Dexter held 
 the professorship until 18 16, when he was made Professor emeritus 
 on his resignation of his active duties. He died in 1829. In 1809 
 John Gorham had been appointed adjunct professor and on Dexter's 
 resignation in 1816 was chosen Professor of Chemistry. 
 
 (30 
 
32 THE HAEVARD MEDICAL SCHOOL. 
 
 Gorham was born in Boston in 1783. He received the degree of 
 A.M. at Harvard in 1801, studied medicine withi his future fattier- 
 in-law, John Warren, and was graduated Bachelor in Medicine from 
 Harvard in 1804. He then spent two years of study in Europe. 
 He was a popular and successful teacher. His friend, Dr. James 
 Jackson, said of him, "During twenty years and more 1 know not 
 that he has made an enemy." He was the author of two works on 
 chemistry. In 1810 the Medical Department was removed to 
 Boston, 49 Marlborough street (now 400 Washington street). 
 There it remained until 1816, when it moved to its own building in 
 Mason street. It was announced in 18 10 that "Dr. Gorham will 
 give a private course to the gentlemen of Boston after the conclu- 
 sion of the medical lectures." He was also obliged to give a course 
 to the seniors at Cambridge. 
 
 In 1812 the Corporation authorized the expenditure of |!i 70.00 to 
 fit up a laboratory suitable for the needs of the Professor in Chem- 
 istry. In 181 5 the lectureship in materia medica and botany was 
 established and given to Dr. Jacob Bigelow, Dr. Gorham being 
 still required to give a full course in chemistry and mineralogy to 
 the students at Cambridge, and to have charge of the laboratories 
 and apparatus there. In 1824, the Corporation having voted that 
 the Erving Professor should reside in Cambridge, and Dr. Gorham 
 having declined to accept this condition, a Professor of Mineralogy 
 and Geology was appointed who was to give the instruction in 
 chemistry there, whilst Dr. Gorham's duties were to be confined 
 to the Medical School. In 1827 Dr. Gorham resigned, and the 
 Corporation voted that the Erving Professor of Chemistry should 
 again reside in Cambridge and give lectures both to the under- 
 graduates there and at the Medical School in Boston. Dr. Gorham 
 died in 1829. His successor was John White Webster, appointed 
 in 1827. 
 
 Dr. Webster was born in Boston in 1793, graduated at Cambridge 
 
THE DEPARTMENT OF CHEMI8TBY. 33 
 
 in the class of 1811 and from the Medical School in 181 5. He prac- 
 tised medicine both in Cambridge and Boston. He was a member 
 of the American Academy and an associate of several foreign scien- 
 tific societies. His lectures in the Medical School were given at the 
 Mason street building until 1847, when the School removed to its 
 newly situated " Massachusetts Medical College," as it was called, 
 in North Grove street, and where the terrible tragedy occurred 
 which led to his resignation in 1850. 
 
 Professor E. N. Horsford was appointed lecturer in chemistry at 
 the Medical School for the course in 1849-50, as the records read, 
 " in the absence of the Erving Professor." 
 
 In 1850 Josiah Parsons Cooke (A.B. Harvard, 1848) was 
 elected Erving Professor of Chemistry and Mineralogy, and it was 
 stipulated that "he shall reside in Cambridge, be a member of the 
 College Faculty, and give the lectures in the Medical College in 
 Boston." A laboratory for students, six desks, was fitted up by 
 him in the basement of the building, and there for the first time, 
 about 1853, students studied analytical chemistry under the over- 
 sight of an instructor. A very small number of students followed 
 the course, using Galloway's small "Analysis" as their guide. 
 The writer of this sketch procured from abroad Lehmann's Physio- 
 logische Chemie, as no works in English were available, and was 
 the first medical student to carry the study of chemistry beyond 
 simple inorganic analysis. Professor Cooke gave, in his regular 
 course, a few lectures on the urine and on toxicology. In 1856 he 
 was relieved, at his request, from lecturing longer at the Medical 
 School, and Dr. John Bacon and Mr. Charles W. Eliot were 
 appointed lecturers in chemistry in the Medical School for that 
 year. Professor Cooke did much to broaden the character of chem- 
 ical instruction in the School, and deserves great credit for the intro- 
 duction of laboratory teaching into the curriculum. He remained 
 Erving Professor at Cambridge until 1894. He received the degree 
 
34 THE HARVARD MEDICAL SCHOOL. 
 
 of LL.D. from the College and the University of Cambridge, was 
 a member of the National Academy of Sciences, and President of 
 the American Academy of Arts and Sciences. He died in 1894. 
 
 In 1857 Dr. John Bacon (Harvard A.B., 1837; M.D., 1840) 
 was elected University Professor in Chemistry for the Medical 
 School, thus severing pre-existing connections between the teaching 
 of chemistry in the undergraduate and medical Departments. In 
 1858 a request having been made that the income of the Erving 
 fund, originally bestowed for the benefit of Dr. Dexter, be trans- 
 ferred to the Medical School, the Corporation decided it best that 
 existing arrangements should not be disturbed. Dr. Bacon, who 
 had previously given instruction in chemistry at the Boylston 
 Medical School, restored and enlarged the students' laboratory in 
 the basement of the Medical College, erecting sixteen desks. In 
 1858 the " Summer School " was established, and recitations 
 in chemistry were held throughout the year. Voluntary labora- 
 tory instruction was given during April, May, and June. In the 
 winter course there were two lectures a week. 
 
 In 1866 Dr. James C. White (Harvard A.B., 1853 ; M.D., 1856) 
 was appointed Adjunct Professor of Chemistry. 
 
 In May, 1871, Dr. Bacon resigned, which by University law 
 terminated the adjunct professorship held by Dr. White. During 
 these five years of joint administration of the Department much 
 more attention was given to physiological, toxicological, and clinical 
 chemistry than previously. Demonstrations in the latter branch 
 were also conducted at the Massachusetts General Hospital for the 
 benefit of the students. 
 
 Following the resignation of Dr. Bacon, who died in 1881, Dr. 
 Edward S. Wood (Harvard A.B., 1867; M.D., 1871) was appointed 
 Assistant Professor of Chemistry, and Dr. J. C. White was made 
 instructor to carry on the course during Dr. Wood's year of study 
 in Europe. During the year 1871 the chemical laboratory was 
 
THE DEPABTMENT OF CHEMISTRY. 35 
 
 enlarged so as to accommodate nearly one hundred students, and 
 Dr. Bacon presented all the clinical apparatus, cases, and other 
 furniture in the laboratory to the Corporation for the use of the 
 Medical School. 
 
 In 1873 it was voted that a satisfactory examination in general 
 chemistry and qualitative analysis should be accepted as an equiva- 
 lent for an examination in those branches in the Medical School. 
 This was the first step towards the elimination of general chemistry 
 from the curriculum. 
 
 In 1876 Dr. Wood was appointed full professor. 
 In 1883 the School removed to its new building in Boylston 
 street, where two large laboratories for the Chemical Department 
 had been constructed. In 1884 Dr. William B. Hills (A.B. Har- 
 vard, 1871 ; M.D., 1874) was chosen Assistant Professor of Chem- 
 istry, and in 1889 advanced to the position of associate professor. 
 In 1890 the Faculty voted that students who have passed a satis- 
 factory examination in general chemistry in the undergraduate 
 department may pursue the study of medical chemistry during 
 their first year. From this date the character of the instruction 
 became almost wholly medical and in its broadest sense; in 1898 
 a course on pharmaceutical and physiological chemistry under Dr. 
 Franz Pfaff was established. In 1903 it was voted that a course in 
 elementary organic chemistry should be added to the requisites for 
 admission after September, 1903. Professor Hills resigned in 1904. 
 Professor Wood died in the summer of 1905. 
 
 During the year 1905-1906 the Department has been carried on 
 by Dr. L. Alsberg and Dr. L. J. Henderson under the title, Instruc- 
 tors in Biological Chemistry. 
 
 The writer of this sketch desires to express his obligation to the History of the Medical 
 School by Drs. Harrington and Mumford for most of the Information above presented. 
 
Walter channing (H.C. 1808). 
 
 M.D. Un. Pa., 1809; M.D. (ad eun.) 1812 
 
 Lecturer on Obstetrics and Medical Jurisprudence, 1815-1818. 
 
 Professor of Obstetrics and Medical Jurisprudence, 1818-1854. 
 
 Dean of the Medical School, 1819-1847. 
 
THE DEPARTMENT OF OBSTETRICS. 
 I8t5. 
 
 A diligent searcli through old Harvard catalogues has revealed 
 but little about the methods of instruction in the early days of 
 the Obstetrical Department. 
 
 Previous to 1815 there was no ofificial instruction in obstetrics. 
 At that date Dr. Walter Channing was appointed lecturer in 
 obstetrics, becoming professor in 1818; and he held the chair until 
 1854, his full title being Professor of Obstetrics and Medical Juris- 
 prudence. Neither subject apparently was regarded as of sufificient 
 importance to merit a separate professorship, and they continued 
 thus combined until 1877. 
 
 The first definite statement about the course that has been found 
 is in the Catalogue of 1830, which states : 
 
 The Midwifery Department contains models from Florence to illustrate the 
 practice and to teach the anatomy of this branch of the profession. Besides 
 these, it is well supplied with plates and preparations to aid its study. 
 
 In 1841, in the "Circular" of Harvard University, it is stated 
 that there are fifty lectures on midwifery, and others on operative 
 midwifery. 
 
 The class is formed into divisions, and these meet the professor in the 
 afternoon and as often as may be necessary, and are examined on what has 
 been taught, and with the professor perform the operations with instruments 
 on a suitable machine. The lectures are illustrated by models made in 
 Florence and by every truly valuable work with plates as it appears. 
 
 There was in those early days no practical instruction other than 
 by accident or favor. It was the custom for many of the professors 
 to have a few medical pupils often actually living in their houses, 
 and theoretically absorbing learning. Presumably, such students 
 had chances to take charge of the labor of poor patients, or at least 
 
 C37) 
 
38 THE HARVARD MEDICAL SCHOOL. 
 
 to be present at them, though most of such labors were probably 
 conducted by old women, wise in such affairs. A certain amount 
 of practical instruction must thus have been given before students 
 were allowed to take important cases themselves. But this close 
 association with older doctors died out very largely in the thirties. 
 For many years afterward the names of various men appear after 
 those of students as their " instructors." Yet the relation was a 
 much less intimate one than would seem to be implied. From 1835 
 to about i860 it must have been a very rare thing for a man to see 
 a case of labor, until, as a full-fledged practitioner, he was brought 
 face to face with the awful problem of how that twelve-pound baby 
 — babies were always twelve-pounders before we carried scales — 
 was going to get through that tiny opening and learned to his great 
 surprise that generally his utmost effort could not prevent the 
 happy result. 
 
 Dr. Channing's lectures were interesting and amusing and, 
 naturally, in the then state of obstetrical knowledge, not especially 
 scientific. No mention of a text-book can be found, and the 
 " models made in Florence " must have appeared but rarely, as 
 the few of his pupils that have been reached do not remember 
 ever seeing any of them. 
 
 About the middle of the century there began to be an uneasy 
 sense that in obstetrics, as in other subjects, it was possible that 
 didactic lectures only were not the ideal method of instruction and 
 that they should be supplemented by clinical teaching. 
 
 In 1855 Dr. D. H. Storer took the chair. He had previously 
 been teaching obstetrics at the "Tremont Street Medical School," 
 the headquarters of which were a room at 39 Tremont street. 
 This was an institution started in 1838 by Bigelow, Edward Reyn- 
 olds, Storer, and Holmes, "for the purpose," in the words of its 
 catalogue, " of giving a full course of instruction to private pupils, 
 principally during that part of the year not occupied by the public 
 
THE DEPARTMENT OF OBSTETRICS. 39 
 
 lectures of the University." Tiie lectures were soon, if not from 
 the first, given only during the vacations of the University ; and it 
 thus became a summer school to augment the instruction given at 
 Harvard, becoming more and more closely connected with the 
 School, until finally, in 1858, it became the Harvard Summer 
 School. When started it was doubtless somewhat of a protest 
 against the cut-and-dried methods in vogue at the University on the 
 part of ambitious young men, full of zeal and eagerness to teach, 
 some of whom at least felt strongly the importance of clinical 
 instruction and experience, very little of which could then be 
 obtained in any Department of Harvard. In the earliest catalogue 
 of the Tremont School at hand, that of 1847, it is stated that 
 " the manikin is used ; and, during the last year of study, 
 arrangements are made for the student becoming practically 
 acquainted with the management of labor." This was many 
 years before Harvard held out any such promise. 
 
 When Storer took the chair, fresh from his experience at the 
 Tremont School and full of the great truth that instruction should 
 be practical, he soon attempted to supply at least some students 
 with cases, the arrangement being that two dollars were paid 
 to physicians for every case that they turned over to the School. 
 Of course, the Boston Dispensary was the great source of supply. 
 According to the catalogue of 1855 : 
 
 Lectures in the Department of Midwifery comprise the anatomy of tlie 
 pelvis and organs of generation, the functions and diseases of the external 
 and internal organs, the physiology of generation, the symptoms and dis- 
 eases of pregnancy. The different classes of labor are minutely dwelt 
 upon, and the use of instruments employed demonstrated upon the manikin. 
 Particular attention is paid to diseases of the puerperal state. The lectures 
 will be illustrated by specimens and plates. A distinct course is given on 
 medical jurisprudence, those subjects receiving special attention which have a 
 bearing on obstetrics ; namely, impotence, superfoetation, retarded gesta- 
 tion, abortion, pretended pregnancy, rape, infanticide, etc. 
 
40 THE HARVARD MEDICAL SCHOOL. 
 
 In 1858 the Harvard Catalogue, using the words of the Tremont 
 Street School, announces that there are "arrangements made by 
 which the student is enabled to become acquainted practically with 
 the management of labor." But cases were still few and far 
 between ; and fortunate, indeed, was the man that got one. In 
 that year " separate instruction was given in operative obstetrics; " 
 but, like the cases, the " separate instruction " was scanty, for the 
 professor, with the specter of puerperal fever ever present before 
 his eyes, advised leaving the case to nature under almost all condi- 
 tions. The books then in use were those of Churchill, Ramsbo- 
 tham, and Cazeaux ; and the professor, in his teaching that nature 
 should not be interfered with, was but carrying out the remark of 
 Ramsbotham, that all that was needed at an ordinary case of labor 
 was a lancet and a catheter. There was then no assistant; but 
 in 1865 Dr. H. R. Storer heard the recitations until Dr. S. L. 
 Abbot took his place in 1867, in which year Dr. C. E. Buckingham 
 was appointed adjunct professor to assist Dr. D. H. Storer. In 
 1869 Storer resigned, and Dr. Buckingham was advanced to the 
 full professorship, while Dr. J. P. Reynolds took the place of Dr. 
 Abbott. Methods of instruction continued about the same. Dr. 
 Reynolds writes that he "gave private teaching, pursuing an 
 individual course with the approval of the professor, and superin- 
 tending the assignment of cases as obtained from the Dispensary, 
 and encouraging students to call upon him for counsel and 
 assistance." 
 
 In 1871 Dr. W. L. Richardson became instructor. While the 
 catalogue announces that " students will be allowed to take charge 
 of cases in their third year," such cases were still not by any 
 means plentiful, and for several years thereafter enterprising 
 students bought in the public market, so to say, paying the regular 
 fee of two dollars, many cases in addition to the few supplied to the 
 School. 
 
THE DEPARTMENT OF OBSTETRICS. 41 
 
 In 1872 Dr. Richardson dropped out for two years. In this year, 
 for the first time, it was announced that instruction in obstetrics 
 was provided for graduates. Schroeder's book was added to those 
 in use. 
 
 In 1874 Dr. Richardson returned, this time as clinical instruc- 
 tor — an appointment that marks a distinct advance, as does also 
 the establishment of a course in operative midwifery, with practi- 
 cal illustrations upon the cadaver. Leischman, Schroeder, and 
 Cadeaux became the text-books. 
 
 The birth of modern obstetrics may be regarded as dating from 
 the early seventies, for at that time foreglimmerings of the meaning 
 of antisepsis began to filter into the medical mind, though the im- 
 portance of the theories of Semmelweiss, published in 1847, had till 
 then not been appreciated. The germ theory as applied to obstet- 
 rics was of course not yet wholly accepted, but its influence began 
 to be felt. 
 
 In 1877, upon the death of Dr. Buckingham, Dr. Reynolds was 
 appointed professor. Playfair became the text-book, with the 
 books of Winckel, Parker, and Barnes added to those previ- 
 ously in use. In 1880 the voluntary fourth year was established, 
 and for students of that year were provided one lecture weekly by 
 the professor, and two clinical and operative exercises weekly for 
 four months by the instructor. In this year was established Dr. 
 Charles M. Green's " summer course " in obstetrics ; and, although 
 Dr. Green was not connected with the School officially until 1883, 
 this may be justly regarded as having been part of the Harvard 
 teaching from its beginning. This course has always been invalua- 
 ble for the lucky few who could take it, affording them, besides the 
 benefit of Dr. Green's lectures, far greater opportunities for clinical 
 work than could possibly be supplied by the School, and also inval- 
 uable in that it has been the means of keeping together during the 
 summer the patients upon which the School is dependent for its 
 
42 THE HARVARD MEDICAL SCHOOL. 
 
 supply of cases for students during the winter. Beginning with ten 
 cases distributed among five students, the material at Dr. Green's 
 disposal has increased so that an energetic man can now easily 
 conduct fifty cases while taking the course. This summer course 
 has been practically the Out-patient Department of the Boston 
 Lying-in Hospital, under the auspices of which there were delivered 
 by students, in 1900, about eighteen hundred women. 
 
 In 1882 Dr. Richardson was appointed assistant professor. 
 Lusk became the text-book, and continued in use for many 
 years. 
 
 In 1883, for the first time, every third-year man was required to 
 attend and conduct two cases of labor before obtaining a degree, 
 and Dr. Green was appointed clinical assistant to help give the 
 necessary instruction. 
 
 In 1886 Dr. J. P. Reynolds resigned, and Dr. Richardson became 
 professor in his place. Three cases were now required, and the 
 staff of assistants was increased by the addition of Dr. Edward 
 Reynolds. 
 
 In 1887 still another assistant. Dr. C. W. Townsend, became 
 necessary. The books of Schauta and Kucher are added to the 
 collateral reading. 
 
 In 1888 four cases were required and two years later the number 
 was raised to six and the Clinical Conference in Obstetrics was 
 established. Three courses were now offered to graduates. In 
 1892 a valuable addition was made to the instruction, in that full 
 written reports of the six required cases was insisted upon. 
 
 In 1894 an additional assistant. Dr. George Haven, became nec- 
 essary, Dr. Green becoming assistant professor. The excellent rule 
 was made that each student must receive instruction in at least one 
 case. Previously, if a student's cases all happened to be normal 
 ones the chances were that he got no bedside instruction whatever. 
 
 In 1895 Dr. Edward Reynolds was made instructor, and. Dr. 
 
THE DEPARTMENT OF OBSTETRICS. 43 
 
 Haven having resigned, Drs. F. A. Higgins and F. S. Newell became 
 assistants. 
 
 In 1899 an elective course was started in operative obstetrics 
 under Professor Green, consisting of twelve practical exercises, 
 with a repetition of the same under the assistants, each student 
 receiving three two-hour exercises. 
 
 In 1901 Dr. Higgins took the place of Dr. Reynolds as instruc- 
 tor, while Drs. H. T. Swain and L. V. Friedman were appointed 
 assistants. 
 
 In 1904 Dr. Green became associate professor, Dr Newell took 
 the place of Dr. Higgins as instructor, while Dr. J. R. Torbert was 
 appointed assistant. The present teaching force consists of one 
 professor. Dr. W. L. Richardson ; one associate professor. Dr. 
 Charles M. Green ; one instructor. Dr. Newell ; three assistants, 
 Drs. Swain, Friedman, and Torbert. 
 
 The teaching scheme is as follows : In the third year there is 
 required attendance at sixty-four lectures upon the theory and 
 practice of obstetrics, and thirty-two recitations upon the same, 
 though practically, by allowing the instructor to base his recitations 
 chiefly upon the text-books it becomes possible for the professor to 
 devote most of his time to special subjects. In clinical obstetrics 
 each student receives four hours of instruction at the Boston Lying- 
 in Hospital from the teaching members of the staff. Each student 
 serves ten days as externe of the hospital, conducting from six to 
 twelve cases of labor and caring for them during convalescence, 
 written reports of each of which he is required to present. He 
 must receive personal instruction in one case and may call for it in 
 the other five required for a degree. This he receives from the 
 instructor and his assistants and of course unofficially obtains a 
 large amount of instruction from the house-officers of the hos- 
 pital in addition. Furthermore, students now have opportunities to 
 see normal cases delivered at the hospital before being called upon 
 
44 THE HARVARD MEDICAL SCHOOL. 
 
 to take charge of cases themselves — a privilege that must add 
 vastly to their peace of mind. In the weekly conference, inter- 
 esting cases and reports are discussed in the freest possible manner 
 before the whole staff. The summer course is still kept up under 
 the charge of Dr. Swain, but of necessity can be taken by only a 
 few. The course in operative obstetrics started in 1899 continues. 
 The books suggested for collateral reading are those of Reynolds 
 and Newell, Hirst, Lusk, and Dorland. 
 
 Last October the new rule making the whole fourth year 
 elective went into effect. The following course is offered in 
 obstetrics : 
 
 (i) Obstetrics. Half-courses, all day, throughout year. 
 
 The course will be given at the Boston Lying-in Hospital and at the 
 Medical School. During the first half of the course the student will lodge 
 at the Hospital, and devote his time chiefly to attendance on cases in the out- 
 patient clinic ; he will also be called upon to assist at operations, and, when 
 his other duties permit, to make ward visits with the physician on duty. In 
 the second half of the course he will conduct the convalescence of the cases 
 delivered by him during his resident service, write full reports of his 
 cases, and make daily ward visits, receiving clinical instruction on house 
 patients, and witnessing operations. In his clinical work he will have the 
 supervision and instruction of the Department and of the Hospital Staff on 
 duty. In the second half of his course he will also be given, at the Medical 
 School, a course of demonstrations in operative obstetrics, and each student 
 will practise the various operations on the manikin. 
 
 Graduates may take : (i) a course of clinical instruction at 
 the Lying-in Hospital, especial attention being paid to the manage- 
 ment of convalescence after confinement — opportunity is given to 
 witness labor cases and operations at the hospital ; (2) a course of 
 ten exercises in operative obstetrics with the manikin or cadaver ; 
 (3) clinical courses throughout the year as externe of the Lying-in 
 Hospital. The graduate delivers some twelve out-patients, and 
 receives clinical instruction from one of the assistants or officers of 
 the hospital. 
 
The MASSACHUSETTS Medical COLI.EGE, MASON Street, 
 
 BOSTON. ' ; .^„t^,. 
 
 The first building constructed especially for the use of the School.' 
 
 1816-1847. "^ 
 
THE DEPARTMENT OF LEGAL MEDICINE. 
 J8J5. 
 
 Originally, legal medicine was taught in the Harvard Medical 
 School as a lectureship; this was in 1815, when it shared with 
 obstetrics the attention devoted to it at that time. In 18 18 the 
 combined lectureship was promoted to a professorship and the first 
 to hold office as Professor of Obstetrics and Medical Jurisprudence, 
 in common, was Walter Channing, M.D. What considerations 
 promoted this affinity in medical teaching does not appear. 
 Whether some features in obstetrics seemed to present obvious 
 medico-legal relations or the obstetrical teachers of that date dis- 
 played exceptional aptness in imparting instruction in the science 
 and art of parturition, as well as forensic medicine, is not known. 
 But the combined arrangement proved acceptable to the School's 
 administration until 1878, when the days of the lectureship were 
 revived. A fortunate reform in the legislation of Massachusetts in 
 1877, with reference to the accepted method of investigation of 
 deaths supposed to be by violence, gave occasion for a new chapter 
 in the teaching of legal medicine. This reform substituted a new 
 office for the office of coroner and instituted the position of Medical 
 Examiner as an improvement upon its predecessor. This transfer 
 ol important duties to medical men appointed for their "discretion, 
 ability and learning in the science of medicine," clothed with 
 authority to investigate cases of death supposed to be by violence 
 and to determine the cause and manner of the death, supplied an 
 abundance of material which illustrated medico-legal principles, and 
 the occasion was promptly met to divorce legal medicine from 
 obstetrics. The senior Medical Examiner for Suffolk County, 
 whose territory comprised the southern section of the City of 
 Boston, was appointed lecturer in medical jurisprudence in Harvard 
 
 (45) 
 
46 THE HARVAED MEDICAL SCHOOL. 
 
 University and given charge of forensic medicine as an independent 
 Department. Tiius there came under his control and observation 
 for teaching purposes numerous cases illustrating all varieties of 
 deaths by violence, and one of the elements offered by his course 
 of instruction in legal medicine was the demonstration of such 
 deaths in autopsies for judicial purposes performed in the patho- 
 logical amphitheater at the Boston City Hospital. In this way, the 
 Department of Forensic Medicine came into possession of ample 
 material exemplifying, from week to week before the students, 
 abortions, various kinds of mechanical trauma, suicides, homi- 
 cides, sudden deaths from mysterious natural causes, infanticides, 
 the fatal effects of electricity, heat, cold, and starvation, noxious 
 gases, fatal burns and scalds, accidents of various kinds, furnishing 
 illustrations, as from a pathological laboratory, of didactic discus- 
 sions set forth in lectures according to the following syllabus : 
 
 1. Definitions and limitations of the subject. Special training required of 
 medical jurists. The calls to practise forensic medicine come without warn- 
 ing. Self-reliance, a result of medico-legal training. Proceedings of a crimi- 
 nal prosecution at law. 
 
 2. Medical evidence and the medical witness. Dying declarations an 
 exceptional form of ordinary testimony. The value and use of notes. 
 Expert testimony. Rights and demeanor of the medical witness. 
 
 3. Age as an element of Identity. Dentition. 
 
 4. Sex and doubtful sex. Hermaphrodites. 
 
 5. Personal identity. Scars. Tattoo marks. Identification of mutilated 
 remains. 
 
 6. Impotence and sterility. 
 
 7. Rape. Age of consent. Violation of little girls. 
 
 8. Rape of young women. Proofs of virginity. The hymen. Deflora- 
 tion. Seminal stains. 
 
 9. Rape of matrons. Anesthesia in rape. 
 
 10. Criminal abortion. Proofs of recent childbirth. The corpus luteum. 
 Drugs used as abortifaciants. Abortion induced by traumatism. Objective 
 evidences of abortion. The usual causes of death. 
 
THE DEPARTMENT OF LEGAL MEDICINE. 47 
 
 11. The signs of death. Scientific tests. Loss of animal heat. Post- 
 mortem lividities. 
 
 12. Rigor mortis ; time of manifestation, cause. Cadaveric spasm. Putre- 
 faction. 
 
 13. Sudden death due to natural causes. Heart disease. Brain disease. 
 The pancreas. 
 
 14. Death by drowning. 
 
 15. Death by hanging and strangulation. 
 
 16. Death by suffocation. Punctate suppurative ecchymoses. 
 
 17. Wounds in their medico-legal relations. Incised wounds. Contused 
 wounds. 
 
 18. Punctured wounds. Pistol shot wounds. 
 
 19. Wounds of regions. Wounds inflicted some time before death. The 
 manner and purpose of the wounding. 
 
 20. Infanticide. Was the child born alive or was it dead at birth? The 
 hydrostatic test. The cause and manner of the death. 
 
 21. Human blood in its medico-legal relations. Identification of suspected 
 stains. The haemin test. The microscope as an aid. The serum test. 
 
 22. Death by electricity. Lightning. 
 
 23. Death by heat, cold, and starvation. 
 
 24. Murder by poisoning. 
 
 25. Death by illuminating gas. 
 
 26. The physician's legal relations to his patients. Malpractice. 
 
 27. The technic of a medico-legal autopsy. 
 
 In 1877 Dr. F. W. Draper was appointed to the position of lect- 
 urer in forensic medicine and the composite teaching of obstetrics 
 and medical jurisprudence was discontinued. In 1884 he was pro- 
 moted to the grade of assistant professor, and in 1889 to the 
 position of Professor of Legal Medicine. To assist him in his duties 
 Dr. Edwin Wells Dwight was appointed instructor in legal medi- 
 cine. In consequence of impaired health, Professor Draper was 
 granted a leave of absence during the school year 1902, and in 
 1903 he offered the resignation of his professorship and the vacancy 
 was not filled. 
 
GEORGE HAYWARD (H.C, 1809). 
 A.B. Yale, 1809; A.M.; M.D. Un, Pa., 1812. 
 
 Professor of the Institutes of Surgery and of Clinical Surgery (after 
 1847, Professor of Surgery), 1835-1849. 
 
 Fellow of Harvard College, 1852-1863. 
 
THE DEPARTMENT OF SURGERY. 
 t835. 
 
 When the Harvard Medical School was founded, September 
 nineteenth, 1782, John Warren was placed in charge of the Ana- 
 tomical and Surgical Departments. He was elected professor on 
 November twenty-second of that year. The plan in use at the Uni- 
 versity of Edinburgh at the time appears to have been adopted — 
 as in that school the professorships of Anatomy and Surgery were 
 held by Monro, a teacher to whom many of our pioneers owed 
 their education. 
 
 John Warren had already had some experience in both these 
 branches of medicine. His anatomical society was the first medical 
 society of students formed in America (1771), and his experience as 
 a surgeon in the Revolutionary Army enabled him to obtain the 
 position of superintending surgeon of the Military Hospital at 
 Boston, where he had the opportunity of giving a course of anatom- 
 ical demonstrations. Although the scope of surgery at that day 
 was limited. Dr. Warren had shown his ability in that branch of 
 medicine by operating successfully upon a dermoid cyst of the 
 ovary and performing a successful amputation at the shoulder joint. 
 
 He appeared, therefore, to be competent to meet the requirements 
 laid down by the College authorities, viz.: "That the professors 
 demonstrate the anatomy of the human body on recent subjects if 
 they can be procured ; if not, on preparations duly adapted to the 
 purpose. That they elucidate this by physiological observations 
 on the parts and explain and perform a complete system of surgical 
 operations." 
 
 There existed at that period in Boston a military hospital and 
 Almshouse in both of which Dr. Warren had a service and in addi- 
 tion the apprenticeship method of instruction enabled him to give 
 
 (49) 
 
50 THE HAKVAKD MEDICAL SCHOOL. 
 
 his students the opportunities for clinical study which his practice 
 afforded. The necessity for clinical facilities for the School was 
 recognized at an early date by the Corporation of the College and 
 in 1784 they petitioned the overseers of the poor to place the sick 
 in the almshouse, the only hospital in Boston, under the care of 
 members of the Faculty of the Medical School "for the further 
 carrying into effect the designs of the Medical Institution." This 
 movement met with opposition from the profession in Boston and 
 it was not finally carried out until 18 10. Meanwhile surgery was 
 taught by means of lectures, text-books, and an occasional surgical 
 operation. The lectures were given at Cambridge in the basement 
 of Harvard Hall until Holden Chapel was rearranged for the pur- 
 poses of the School, and different rooms were assigned to the three 
 Departments, Anatomy and Surgery, Theory and Practice, and 
 Chemistry and Materia Medica. 
 
 The difficulties in carrying out these somewhat primitive 
 arrangements were quite out of proportion to the results obtained, 
 as only one of the professors resided in Cambridge and it was nec- 
 essary at that time to cross to Cambridge by ferry or to ride 
 through Roxbury, a distance of nine miles. The professor of this 
 Department of the School being engaged in active practice 
 petitioned the Harvard Corporation to grant him an assistant. 
 John Collins Warren was accordingly on May fourth, 1809, 
 appointed Adjunct Professor of Anatomy and Surgery, an office 
 created April twenty-seventh, 1808. 
 
 With the enlargement of the Faculty and the removal of the 
 School to Boston in 1810, instruction received a new impetus 
 which developed into the system which was to prevail more or less 
 universally throughout the country until the middle of the nine- 
 teenth century. 
 
 The pioneers in medical education were self-taught men. Their 
 knowledge of the masters, ancient and contemporaneous, was. 
 
THE DEPARTMENT OP SURGERY. 51 
 
 gleaned from the army surgeons who had had the advantage of 
 study in Europe. Books were scarce and costly, newspapers and 
 periodicals almost unknown, teaching was by word of mouth and 
 clinical advantages were limited, but yet we find in the methods 
 of those days one of the features of the most efficient teaching as 
 it exists at the present time, namely, section teaching. The 
 apprenticeship system as it had existed previous to the foundation 
 of the School was continued, as indeed it had to be in order to 
 furnish clinical material for the student. This brought the pre- 
 ceptor in close contact with the pupil and conditions obtained dur- 
 ing the early part of the century closely resembling what are now 
 considered as the most advanced modern methods. 
 
 The two men most intimately concerned in the development of 
 surgery at the Harvard Medical School during the first seventy 
 years of the nineteenth century were John C. Warren and Henry 
 J. Bigelow. 
 
 At the beginning of the century Warren had returned from 
 Europe, where he had studied under Sir Astly Cooper, Dubois, and 
 others, and entered immediately upon the duties of teacher. He 
 opened a private dissecting room in Boston and his clinic at the 
 almshouse was a valuable aid to the slowly developing Medical 
 School. 
 
 When the School was transferred to Boston, Dr. Warren shared 
 the labors of his father and taught surgery and midwifery, while 
 the elder Warren devoted his lectures and demonstrations to 
 anatomy and physiology. This arrangement prevailed until the 
 death of John Warren (April fourth, 1815) when John C. Warren 
 was elected Professor of Anatomy and Surgery (May tenth, 181 5) 
 and Walter Channing was elected to the newly created lectureship 
 on midwifery. 
 
 The Massachusetts General Hospital was first opened for the 
 reception of patients in 1821. Warren was chosen surgeon to the 
 
52 THE HARVARD MEDICAL SCHOOL. 
 
 hospital, and the students at the Medical School were admitted to 
 the operations upon the payment of a fee. It is true the number 
 of operations at that period was small ; anesthesia was still a 
 quarter of a century away and capital operations were few and 
 far between. In a circular issued by the Faculty in 1823 atten- 
 tion is called to the fact that during twenty months, from Sep- 
 tember twenty-first, 1821, to June eleventh, 1823, there had been 
 forty-six operations performed in the hospital. 
 
 The opportunities of the students if not extensive were fairly 
 varied in character and probably fairly well suited to the limited 
 needs of the time. Although the more important operations of 
 surgery were not often seen by the student, minor surgery was 
 considered well worth the attention of the teacher and formed the 
 bulk of the demonstrations and talk before the class. 
 
 The passage of the Massachusetts Anatomy Act of 1830 paved 
 the way for the separation of anatomy from surgery in the Medical 
 School curriculum. 
 
 The professorship of the Principles of Surgery was established 
 January fifteenth, 1835, it being provided that : " It shall be the 
 duty of the professors to give elementary lectures on the prin- 
 ciples of surgery and clinical lectures on the surgical cases in the 
 Massachusetts General Hospital." It was further provided that : 
 " The same attendance on the lectures in this Department shall 
 be required of the candidate for the degree of Doctor of Medicine 
 in the University as is required on the lectures in other Depart- 
 ments of the Medical Faculty." George Hayward was elected to 
 fill this position and it was arranged that Warren should teach 
 operative surgery, and that Hayward should teach clinical surgery. 
 This made many changes in the method of instruction and the 
 term was extended to four months. The most notable feature 
 of this period was the development of private medical schools 
 wherein a new generation of able young practitioners utilized the 
 
biJ THE BUltDlNGt)N'NORTHGk6vE STREET, BOSTON. 
 
 Built on land given by Dr. George Pafkman, and adjoining the50 
 Massachusetts General Hospitel, 5 
 1847-1883. 
 
THE DEPAETMENT OF StTBGERY. 53 
 
 clinical advantages of the growing hospital to a far more profitable 
 extent than had been done before. 
 
 The influence of the French school predominated at this period. 
 As surgical operating technic improved under the hands of the 
 masters of the early part of the century, speed and brilliancy 
 became the essential features at a time when the quivering nerves 
 of the conscious patient enforced ha§te. Operative surgery was 
 then principally surface surgery and was thus rapid and spectac- 
 ular. Surgery had not burrowed into the cavities of the body, 
 nor explored the crypts of the gall-bladder, the kidney, the pan- 
 creas, and the brain. The pose of the operator as the only actor 
 on the scene emphasized the fact that surgery was amphitheater 
 surgery. It was not, however, until the influence of anesthesia, 
 introduced about this time, had multiplied surgical operations that 
 ■this new type of operator reached its highest development. 
 
 Morton had applied to the head of the Department for an oppor- 
 tunity to try his new method of relieving pain in surgery ; he was 
 equal to the occasion and made the crucial test by which 
 anesthesia was given to the world (October sixteenth, 1846). 
 
 This event occurred as the School was being transferred from the 
 building in Mason street to the new building just finished on North 
 Grove street. The new building was opened on November fourth 
 of that year with appropriate ceremonies. Dr. Warren shortly after 
 resigned his professorship (February fifteenth, 1847), and was made 
 Emeritus Professor of Anatomy and Surgery ; Hayward was given 
 the title of Professor of Surgery (April third, 1847), and the pro- 
 fessorship of Anatomy was assigned to a new Department. Hay- 
 ward did not continue long to fulfil the duties of this office, and 
 after making an arrangement by which his colleagues at the hospital 
 relieved him of his clinical lectures, he resigned his professorship 
 March thirty-first, 1849, and on April twenty-eighth, 1849, Henry 
 J. Bigelow was elected Professor of Surgery. Dr. Bigelow had 
 
54 THE HARVARD MEDICAL SCHOOL. 
 
 been appointed surgeon at the hospital in 1846, shortly after his 
 return from Europe, and had already displayed that skill as an 
 operator and lecturer which later contributed so much to the 
 success of this Department of the School. At the outset of his 
 career the amphitheater and lecture-room became crowded with 
 students who marvelled at the dexterity with which he operated 
 and the genius of the teacher. The impetus given to surgery by 
 anesthesia increased enormously the number of operations and 
 many new and more elaborate methods were devised. All this 
 greatly increased the interest taken by the student in this Depart- 
 ment of Medicine. But the surgery of that day was surgery of the 
 experts, and availed little for the ordinary practitioner. Students 
 played the part of passive spectators. They learned by the sense 
 of sight alone. The few positions offered to students were those 
 of clinical clerks and dressers. The opportunities offered for study 
 of minor surgery in the Out-patient Department were very few. 
 Ward visits were superficial and hasty, diagnosis was not taught 
 here as in Germany, and our students began to visit that country 
 and go over the ground again. 
 
 With the advent of younger teachers, Drs. R. M. Hodges and 
 David W. Cheever, more clinical teaching was given, and as the 
 Boston City Hospital was then a novelty and in some sense an 
 experiment it happened that surgery there was carried on vigorously 
 in competition with the older hospital. Dr. Hodges was so fine an 
 anatomist that he impressed that element with his teaching, and 
 Dr. Cheever assiduously and laboriously explained and exhibited 
 more and more clinical material. The first purely clinical exercises 
 given in Boston were by him at the City Hospital, where visits were 
 made with small classes and with great care as to details in teach- 
 ing. On January twenty-seventh, 1866, Hodges was elected 
 Adjunct Professor of Surgery, and on January fifth, 1868, Cheever 
 was transferred from the position of Assistant Professor of Anatomy 
 
THE DEPARTMENT OF SURGERY. 55 
 
 to that of Adjunct Professor of Clinical Surgery. It was now 
 possible to make a step in advance, and the amphitheater and 
 lecture-room no longer dominated over bedside teaching. As the 
 amount of instruction given the student increased it was found 
 necessary to lengthen the course, and in 1867 the session was con- 
 tinued through the spring months. 
 
 In the reorganization of the School in 1871 surgery and clinical 
 surgery were assigned to the second and third years, and consisted 
 of three lectures and one recitation weekly during the first term ; 
 one recitation and one lecture during the second term with an 
 additional course on minor surgery and practical instruction in sur- 
 gical anatomy. The weekly exercises in clinical surgery were two 
 in the first term and three in the second term. 
 
 Professor Bigelow had now reached the height of his career and 
 had published his methods of reduction of dislocations of the hip 
 and his operation for litholapaxy, which added much to the reputa- 
 tion of the School. 
 
 In 1871 J. Collins Warren was appointed Instructor in the Med- 
 ical School and the following year he received the title of Instructor 
 in Surgery, and in 1873 Charles Burnham Porter received a similar 
 title. These were Faculty appointments, that is, they entitled the 
 holder to a seat in the Faculty, and were among the first of the 
 kind. 
 
 Instruction in surgical histology was now given for the first time. 
 This was made possible and effective by the introduction of stained 
 sections of tumors and morbid specimens. A course on bandaging 
 and the application of surgical apparatus was also begun at this 
 time. Both of these courses were given by Dr. Warren, who also 
 had recitations in surgery and surgical pathology. These exercises 
 were given to second year students. 
 
 To Dr. Porter was assigned the course in operative surgery and 
 instruction in clinical surgery. A full professorship of Clinical 
 
56 THE HAKVAKD MBDIOAL SCHOOL. 
 
 Surgery was established March twenty-ninth, 1875, ^"'^ David W. 
 Cheever was elected to fill that position, and in May, 1875, an 
 examination in clinical surgery was established. 
 
 In 1 88 1 orthopedic surgery was taught separately from general 
 surgery and placed under the charge of Edward H. Bradford, who 
 was elected Assistant in Clinical Surgery October tenth, 188 1. 
 
 Professor Bigelow resigned in 1882 and was made Emeritus Pro- 
 fessor of Surgery. On June twenty-sixth, 1882, Dr. Cheever was 
 elected Professor of Surgery, and Drs. C. B. Porter and J. C. 
 Warren were made Assistant Professors of Surgery (February 
 thirteenth, 1882). 
 
 Surgery was now taught more systematically ; a co-ordination 
 was attempted in the arrangement of the surgical demonstrations, 
 and cases were selected with a view to illustrate different topics, 
 rather than those which possessed a peculiar interest to the 
 teacher. Ward visits became a regular part of the plan of instruc- 
 tion and individual students were receiving and properly digesting 
 more knowledge of medicine and surgery than had hitherto been 
 attainable at any medical school in the country. The growth of 
 the School showed the eagerness with which medical students and 
 practitioners recognized these new advantages. About this time 
 (December tenth, 1883) Maurice Howe Richardson was added to 
 the Surgical Department corps of teachers as Assistant in Surgery. 
 During this period Dr. Porter had charge of the Department of 
 Clinical Surgery, while Dr. Warren assisted Dr. Cheever and also 
 gave lectures in surgical pathology. On March fourteenth, 1887, 
 Porter was elected Professor of Clinical Surgery and Warren was 
 elected Associate Professor of Surgery. 
 
 While the systematic course of lectures on surgery was enlarged 
 to cover more ground in surgical pathology, the increase of clinical 
 material permitted a greater elaboration in the course of clinical 
 surgery. The number of available cases grew from about 44,000 
 
THE DEPARTMENT OF SURGERY. 57 
 
 in 1870, to 100,000 in 1892, at which time the four years' course 
 was established. Instructors and assistants and lecturers on 
 special subjects were added to the teaching corps as necessity 
 demanded. Under Professor Porter's management a new depart- 
 ure was made in teaching in small sections at the two hospitals, a 
 method which has been maintained and amplified so as to become 
 a predominating feature of the course of study in the more 
 advanced schools. In 1895 'the operative course consisted of 
 sixteen exercises demonstrating surgical operations by Professor 
 Porter ; followed by twenty-four hours of laboratory work in the 
 repetition of the operations by each student under the supervision 
 of an assistant for each group of six students. As a sequel of the 
 clinical section work, each student was obliged to report three to 
 five surgical cases, which counted in his mark for a degree. He 
 was also required to examine and make a report upon one case of 
 fracture. The clinical conference case reported by the student 
 was gradually developed into an exhaustive paper on the subject 
 treated, and many contributions of merit were the outcome of this 
 exercise. 
 
 On May twenty-ninth, 1893, D""- Cheever resigned and was 
 made Emeritus Professor of Surgery, a position which he now holds. 
 Dr. Warren was elected Professor of Surgery. The title was sub- 
 sequently changed to that of Mosely Professor of Surgery on May 
 twenty-ninth, 1899. At this same meeting of the Corporation, 
 Herbert Leslie Burrell was elected Assistant Professor of Surgery, 
 he having completed the five previous years as Assistant Professor 
 of Clinical Surgery. Maurice Howe Richardson was elected Assist- 
 ant Professor of Clinical Surgery (June fourth, 1892). Both of 
 these teachers are now Professors of Clinical Surgery (elected 
 March second, 1903), promotions which followed the retirement of 
 Dr. Porter, who resigned his professorship the preceding year. 
 
 The development of the clinical facilities for instruction had made 
 
58 THE HARVARD MEDICAL SCHOOL. 
 
 it possible to further develop the teaching by a more elaborate 
 co-operation between the two Departments of Surgery and Clinical 
 Surgery. The two courses, which had been more or less independ- 
 ent, were gradually combined until at the present time with that of 
 orthopedic surgery and genito-urinary surgery they form the Divi- 
 sion of Surgery. This also includes what may be regarded as the 
 Department of Surgical Pathology. The first instruction authorized 
 by the Medical School under this latter title was in 1897, when Dr. 
 E. H. Nichols was appointed Demonstrator of Surgical Pathology 
 and gave an elementary voluntary course to members of the 
 second class. This included exercises on inflammation and repair, 
 and the pathology of various regions of surgical importance. There 
 were lectures and demonstrations combined with histological study 
 of the various lesions. In 1904-5 it was made required and the 
 mark received counted in the course in surgery. In 1901 Dr. 
 Nichols was made instructor in surgical pathology and in 1904 
 Assistant Professor of Surgical Pathology. In 1901 a laboratory of 
 surgical pathology was established and placed in his charge. 
 Opportunity is there given for surgical investigation. 
 
 After the reorganization of the Department following the retire- 
 ment of Professor Bigelow, instruction was given separately for the 
 first time in genito-urinary surgery. This was placed under the 
 charge of Dr. A. T. Cabot, who was appointed instructor in genito- 
 urinary surgery, and later by Dr. F. S. Watson, who held a similar 
 appointment. After Dr. Cabot's appointment as a member of the 
 Corporation of the University, instruction was continued in this 
 Department by Dr. Watson, who became lecturer in surgery, and 
 continued to give lectures in this field of surgery — (1901-2) . Dr. 
 Paul Thorndike, who was previously an assistant, was then made 
 instructor in genito-urinary surgery. This course consisted of 
 lectures to the third class and practical instruction in the clinics in 
 sections. At the present time there is a short required course in 
 
THE DEPARTMENT OP SURGEKY. 59 
 
 the third year with a brief examination and an elective course 
 during the fourth year. 
 
 The course on operative surgery has been and still is an elective. 
 It is designed to enable students to become familiar, by practice on 
 the cadaver, with the technic of surgical operations. Each student 
 has the opportunity of witnessing demonstrations of the various 
 operative procedures and of repeating them under the personal 
 supervision of an instructor. 
 
 These courses, which were originally given in the spring to a 
 large number of students, are now given throughout the year to 
 small sections at a time. The individual has an opportunity to per- 
 form not only the time honored ligations and amputations but is 
 instructed in all the new operations on the cavities of the body. 
 The course is at the present time under the charge of Dr. G. H. 
 Monks and is given to fourth year students. 
 
 The instruction given by the Division of Surgery at the present 
 time begins with the second year. In January of that year 
 a laboratory course in surgical pathology is given to the whole 
 class. These exercises are three hours each and amount to sixty 
 hours to each class. A series of clinical lectures follows, in which 
 the conditions studied in this primary course are illustrated. 
 These lectures are given three days a week during January at the 
 Boston City Hospital. During the second half of the second year 
 and in the first half of the third year the instruction consists of 
 systematic lectures and recitations at the Medical School, and the 
 subjects there discussed are illustrated by clinical lectures at the 
 hospital. Demonstrations of specimens are given at the hospital 
 and from time to time instruction in sections is given in the 
 ' Museum. 
 
 The course on surgical technic is given as early as possible in the 
 second year ; it consists of six hours of lectures to the entire class 
 and of twelve laboratory exercises of two hours each to the class 
 
60 THE HARVARD MEDICAL SCHOOL. 
 
 in sections. The student is taught the application of bandages and 
 surgical apparatus, and the preparation and application of surgical 
 dressings. There is also instruction in numerous necessary pro- 
 cedures such as the use of enemata, hypodermic medication, 
 heat and cold, and poultices. This is carried on by Dr. Howard A. 
 Lothrop. The student after this preparation is required to serve 
 one month in one of the hospital Out-patient Departments as 
 surgical dresser ; he here receives instruction in anesthesia and in 
 minor genito-urinary surgery. At the beginning of his third year 
 while still attending surgical exercises at the School he is brought 
 into personal contact with the patient at the bedside and has 
 practical experience in the study of the cases particularly with ref- 
 erence to diagnosis, prognosis, and treatment. The blending of 
 the instruction in systematic surgery, clinical surgery, orthopedics, 
 and genito-urinary surgery is as complete as it is possible to 
 arrange it. 
 
 In the fourth year the courses are entirely elective. These 
 electives are given as half courses and may be taken the entire day 
 for one month, or half days for two months. Each half course 
 counts one hundred and twenty-five hours (eight half courses, one 
 thousand hours of work, are required of each student in the year) . 
 The Division of Surgery offers half courses mornings throughout the 
 year in clinical surgery, surgical pathology, and in genito-urinary 
 surgery ; half courses afternoons throughout the year in ortho- 
 pedics and in surgical pathology. In surgery there are half courses 
 all day throughout the year. It is the aim of the Division to teach 
 its students what underlying conditions, both physiological and 
 pathological, are probably present in a given case, to train them in 
 good methods, to make them conversant with the opinions of 
 reliable authors, and, while skilled in the technic of surgery to be 
 conversative and safe in practice. 
 
THE DEPARTMENT OF SURGERY. 61 
 
 In conclusion a word may be said about the great advantages 
 which this Division of the School expects to enjoy in the new 
 buildings. 
 
 The Surgical Division is to have a laboratory in the David Sears 
 Building. Seven unit rooms have been set apart for the purpose. 
 The rooms will consist of one large laboratory and a small oper- 
 ating room, with a library and secretary's room across the hall. 
 The large laboratory will be filled with the furniture and appa- 
 ratus of a well-equipped pathological laboratory, and the operating 
 room with all the apparatus necessary for aseptic surgery. 
 There will be a departmental library which will serve as a meet- 
 ing place for members of the Division. The secretary's room 
 will be arranged to contain the records of this Department and 
 may be used by an artist. The management of the surgical 
 laboratory, under the Professor of Surgery, will be in the hands 
 of the Committee on Surgical Research. It is intended that 
 opportunity shall be given for any qualified student or graduate 
 to investigate surgical problems, whether of surgical pathology, 
 physiology, or operative surgery. 
 
 The laboratory for surgical pathology, under the charge of the 
 Assistant Professor of Surgical Pathology, is also to have admirably 
 equipped and adequate quarters. It is in the Collis P. Huntington 
 Building. There are special rooms for the director and his assistant 
 and rooms for special investigations. There is an excellently 
 equipped operating room and a room for the artist and secretary. 
 
 The X-ray laboratory occupies four rooms in the basement of 
 the Administration Building. They will be devoted to the follow- 
 ing uses : The largest is arranged for the accommodation of three 
 or four sets of X-ray apparatus, which shall represent the best 
 makes of machines to be found. There will probably be one to 
 represent each of the three types now in general use, that is : a 
 static machine, a simple induction apparatus, and a high frequency 
 
62 THE HARVARD MEDICAL SCHOOL. 
 
 apparatus. The room is so arranged that each can be kept in an 
 alcove by itself, separated by brick walls from the others. The 
 room is large enough to accommodate other forms which may be 
 invented in the future. Of the three smaller rooms, one is a dark 
 room for the development of plates. This is so arranged that a 
 number of students will be able to develop at the same time. 
 Another room is for the storage of plates and for the reception of 
 students or patients. The third small room is for the convenience 
 of the chief of the laboratory. 
 
 The scope of instruction in the X-ray laboratory includes two 
 kinds of teaching. First, routine instruction given to every student. 
 It is intended that each student who graduates from the Medical 
 School shall at least understand the general theory of the production 
 of X-rays, the method of taking an X-ray picture and the practical 
 uses, dangers, and fallacies of X-ray work in medicine and surgery. 
 The second kind of teaching will correspond to the advanced courses 
 in other Departments of the School and will aim to give an oppor- 
 tunity to all graduates to pursue original investigation in this work 
 and to equip themselves for taking up this branch as a specialty. 
 
 The accommodations for operative surgery are in the Anatomical 
 Building. There is one operating room large enough for six tables 
 and another one for four. There is a room for instruments, dia- 
 grams, models, etc., another for the prosector and still another for 
 the instructors, thus giving ample opportunities both for students 
 and graduates. Two large rooms in the Administration Building 
 have been set aside for the course in surgical technic. They are to 
 be fitted up with all the necessary appliances, including among others 
 thirty models for bandaging, benches with the necessary tools for 
 the making of metal and wooden splints, conveniences for the 
 application of plaster of Paris dressings, together with the necessary 
 furnishings and a store-room for the materials used in the course. 
 
JOHN BARNARD SWETT JACKSON (H.C. 1825). - 
 
 A.M.; M.D. 1829. , . : ' 
 
 Professor of Pathological Anatomy (after 1854 Shattuck, Morbid Anatomy), 
 
 I847-I879. jV 
 
 Dean of the Medical SchooJ, 1853-1855. 
 Curator of the Warren Anatomical Museum, 1847-1879. ' 
 
THE DEPARTMENT OF PATHOLOGICAL ANATOMY. 
 
 J 847. 
 
 This Department began with the appointment in 1847 of Dr. J. 
 B. S. Jackson as Professor of Pathological Anatomy and as Curator 
 of the Warren Anatomical Museum. Before that time it was the 
 custom for the clinicians to teach what little pathological anatomy 
 the students learned. The subject was not required for a degree 
 until 1856. It is of interest to know that Harvard was the first 
 medical school in this country to teach pathology as a special 
 course. 
 
 In 1854 the professorship of Pathological Anatomy was endowed 
 by George Cheyne Shattuck and received the title of Shattuck 
 professorship of Morbid Anatomy. In 1879 the title was changed 
 to Shattuck professorship of Pathological Anatomy. 
 
 Dr. Jackson studied in Paris under Dupuytren, Roux, and Lis- 
 franc; in London under Bright, Addison, Hodgkins, and others. 
 Although a practitioner of medicine during his entire life, his chief 
 interest lay in pathological anatomy. As curator of the Boston 
 Society for Medical Improvement he greatly developed its 
 "Cabinet" or museum. In 1871 this collection was given to 
 Harvard College under the name of the Jackson Cabinet, and 
 placed in the Warren Anatomical Museum of which he had long 
 been curator and which museum also he built up to a high degree 
 of usefulness. 
 
 Dr. Jackson's fame will rest chiefly and securely on his work as 
 curator, a position in which he showed unusual powers of intelligent 
 observation and great zeal in the collecting of useful and instructive 
 pathological specimens. Parts only of his labors as curator were 
 even published: in 1847 a Descriptive Catalogue of the Museum of 
 
 (63) 
 
64 THE HARVARD MEDICAL SCHOOL. 
 
 the Society for Medical Improvement; in 1870 a Descriptive 
 Catalogue of the Warren Anatomical Museum. 
 
 In 1879 Dr. R. H. Fitz was made the head of the Pathological 
 Department and held the position until 1892, when he was appointed 
 Professor of the Theory and Practice of Physic. His successor, 
 Dr. W. T. Councilman, the present head of the Department, was 
 called from the Johns Hopkins Hospital. Dr. Fitz was trained 
 under Virchow and Orth, and as a teacher of pathology was a 
 pathological anatomist with a strong leaning towards clinical med- 
 icine. Dr. Councilman, trained under Cohnheim, Chiari, von 
 Recklinghausen, Weigert, and Welch, is by nature a pathological 
 histologist. 
 
 The following is a list of the men who have held appointments 
 in the Pathological Department : 
 
 John Barnard Sweet Jackson, Professor of Pathological Anatomy, 
 1847 to 1854; Shattuck Professor of Morbid Anatomy, 1854 to 
 
 1879. 
 
 Reginald Heber Fitz, Instructor in Pathological Anatomy, 1870 to 
 1873 ; Assistant Professor of Pathological Anatomy, 1873 to 1878 ; 
 Professor of Pathological Anatomy, 1878 to 1879 ; Shattuck Pro- 
 fessor of Pathological Anatomy, 1879 to 1892. 
 
 William Thomas Councilman, Shattuck Professor of Patholog- 
 ical Anatomy since 1892. 
 
 Elbridge Gerry Cutler, Assistant in Pathological Anatomy, 1878 
 to 1882. 
 
 William Whitworth Gannett, Instructor in Pathological Anatomy, 
 1886 to 1891. 
 
 Henry Francis Sears, Assistant in Pathology, 1891 to 1892. 
 
 Frank Burr Mallory, Assistant in Pathology, 1891 to 1893 ; 
 Instructor in Pathology, 1894 to 1896 ; Assistant Professor of 
 Pathology, 1896 to 1901 ; Associate Professor of Pathology since 
 1901. 
 
THE DEPARTMENT OF PATHOLOGY. 65 
 
 William Herbert Prescott, Assistant in Pathological Histology, 
 1892 to 1896. 
 
 James Homer Wright, Assistant in Pathology, 1893 to 1896; 
 Instructor in Pathology since 1896. 
 
 Edwin Welles Dwight, Assistant in Pathology, 1893 to 1894. 
 
 Edward Wyllys Taylor, Assistant in Pathology, 1893 to 1896. 
 
 Edward Hall Nichols, Assistant in Pathology, 1896 to 1899. 
 
 Joseph James Curry, Assistant in Pathology, 1896 to 1897. 
 
 Arthur Howard Wentworth, Assistant in Pathology, 1897 to 
 1899. 
 
 George Burgess Magrath, Assistant in Pathology, 1898 to 1905. 
 
 Mark Wyman Richardson, Assistant in Pathology, 1898 to 1900. 
 
 Richard Mills Pearce, Instructor in Pathology, 1899 to 1900. 
 
 Joseph Hersey Pratt, Instructor in Pathology, 1900 to 1902. 
 
 Frederick Herman Verhoeff, Assistant in Pathology, 1900 to 
 1902. 
 
 Henry Asbury Christian, Instructor in Pathology, 1902 to 1905. 
 
 Ernest Edward Tyzzer, Assistant in Pathology since 1903. 
 
 Frederick Robertson Sims, Assistant in Neuropathology, 1903 to 
 1904. 
 
 Walter Remsen Brinckerhoff, Assistant in Pathology, 1903 to 
 1905 ; Instructor in Pathology, 1905 to 1906. 
 
 Elmer Ernest Southard, Instructor in Neuropathology, 1904 to 
 1906; Assistant Professor of Neuropathology, 1906. 
 
 Clarence Whittier Keene, Assistant in Neuropathology, and 
 Assistant in Pathology, 1904 to 1905. 
 
 Simon Burt Wolbach, Assistant in Pathology, 1905 to 1906; 
 Instructor in Pathology, 1906. 
 
 Harry Chamberlain Low, Assistant in Pathology, 1905 to 1906. 
 
 Alexander R. Robertson, Assistant in Pathology, 1906. 
 
 But little space was required in the early days of pathology in 
 the Harvard Medical School for the laboratory or workshop of the 
 
66 THE HARVARD MEDICAL SCHOOL. 
 
 Department. The chief work was the collection and preserva- 
 tion of gross anatomical specimens which were stored in the 
 Warren Anatomical Museum. With the development and intro- 
 duction of microscopes a large room was fitted up in 1871 in the 
 attic of the North Grove street building for the use of the students. 
 In the Boylston street building the pathological laboratory consisted 
 of a desk-room for students used in common with the Department 
 of Embryology and of a moderately sized room beneath the 
 Anatomical Amphitheater for the use of the teaching staff. 
 
 In 1890 the commodious Sears Laboratory, the gift of Dr. Henry 
 F. Sears, of Boston, was formally opened and given over entirely to 
 the Departments of Pathology and Bacteriology. From here these 
 Departments will move into the Huntington Laboratory, where 
 every opportunity, so far as a well arranged and splendidly lighted 
 building alone can afford it, is offered for the development of the 
 subject of pathology in its broadest sense. The only criticism that 
 can be made in regard to the arrangements in the new buildings is 
 that it is unfortunate that it has seemed advisable to place the patho- 
 logical collection in the Warren Anatomical Museum, which is so 
 far distant from the Pathological building. To obviate this difiSculty 
 to some extent, provision has been made in the laboratory for 
 housing a teaching collection of pathological specimens. 
 
 With regard to future work it must be recognized that pathology 
 is departing from the narrow anatomical point of view which dom- 
 inated it so long. The anatomical view was the important one 
 when the chief work in pathology was the classification of diseases 
 and the ascertaining of the series of anatomical changes which 
 were associated with more or less well defined clinical conditions. 
 Its work now is more in relation to the causes of disease, and the 
 manner in which the causative agents act in the production of 
 lesions. It seeks also to ascertain the relation between anatomical 
 lesions and clinical phenomena. The sure foundation for its 
 
THE DEPAETMENT OF PATHOLOGY. 
 
 67 
 
 successful work lies in the experiment. Its relations with the other 
 branches of medicine become closer each day. It must stand in the 
 closest relation with the clinic — for many of the questions which 
 are to be solved by the methods of the pathological laboratory 
 come from the clinic. With anatomy and embryology its relations 
 must be equally close, for without knowledge of normal develop- 
 ment that large part of the subject which concerns the tumors 
 would be an unknown field. The Department has derived great 
 advantage from having within it a number of men whose work is 
 in special fields. The work in neuropathology and in surgical 
 pathology has been especially valuable not only in bringing the 
 Department into closer relation with the clinic, but also by the 
 introduction of more accurate knowledge in obscure fields. The 
 special worker finds the general knowledge and the possibility of 
 comparison which the laboratory gives of equal value to him. 
 
 The Department has, in addition to its own laboratory, control 
 of the pathological laboratories of the Massachusetts General, 
 Boston City, Long Island, Children's, and Carney Hospitals. 
 The numbers in the staff of each are as follows : 
 
 Pathological Laboratory, H.M.S. . . . 
 
 B.C.H. ... 
 
 M.G.H.... 
 
 Ch.H 
 
 L.I.H 
 
 Carney Hospital 
 
 c 
 Sis 
 
 
 "Si 
 
 Work done at School laboratory. 
 
 The basis of the course of instruction in pathology as given at 
 the present time is microscope work in the laboratory. The 
 
68 THE HARVARD MEDICAL SCHOOL. 
 
 subject is presented chiefly from the point of view of general pathol^ 
 ogy. The students study and see for themselves the essential 
 changes produced in various tissues and organs by a great variety 
 of injurious agents. A thorough grounding in these changes 
 enables them to understand more intelligently the appearances 
 presented by altered organs seen at autopsies, and later to appreciate 
 more clearly the signs and symptoms present in the medical and 
 surgical cases which they study clinically. 
 
 In addition to the microscope work there are lectures on general 
 and special topics, usually illustrated with lantern slides, and 
 numerous demonstrations (to small sections of students) of fresh 
 organs obtained from autopsies at the different hospitals and of 
 preserved specimens from the pathological collection. Small groups 
 of students attend the post-mortem examinations at the hospitals 
 and often take an active part in them. A moderate amount of 
 histological technic is taught. 
 
 With fourth year students, who elect pathology, the attempt is 
 made to combine so far as possible the clinical symptoms with the 
 lesions found post-mortem. They, therefore, are required to obtain 
 the clinical history of each case which comes to autopsy and to 
 study it in comparison with the gross and microscopic changes 
 which they find present. 
 
 The Pathological Department resembles the Clinical Departments 
 in this respect, that its usefulness to a large extent depends on hos- 
 pitals from which it may obtain its pathological material. For this 
 reason the relations of the Department with the different hospitals 
 in Boston have always been intimate. At the present time, as 
 already stated, members of the Department are in charge of 
 the pathological laboratories of the Massachusetts General, Boston 
 City, Long Island, Children's, and Carney Hospitals. Students in 
 small sections attend the post-mortem examinations at these hos- 
 pitals and occasionally assist at them. The amount of fresh 
 
THE DEPARTMENT OF PATHOLOGY. 69 
 
 material which may be brought to the School for demonstration 
 purposes is, however, unfortunately very limited owing partly to 
 opposition of some of the hospitals to material being taken away 
 and partly to the desire of clinical men to keep and demonstrate 
 the autopsy specimens to their own classes. On this account, in 
 order to obtain more material for demonstration purposes, the 
 Department undertakes at moderate rates to make autopsies and 
 examine pathological specimens for private physicians. The money 
 thus obtained is used for laboratory expenses connected with the 
 work. 
 
 The kind of work which comes within the province of the pathol- 
 ogist is, aside from teaching, partly practical and partly theoreti- 
 cal. The practical work consists of (a) making post-mortem 
 examinations at the hospitals and in private practice in order to 
 determine for each case the causes of the signs and symptoms 
 presented during life and the cause of death. Physicians desire 
 autopsies in order to correct errors, broaden their experience, and 
 better enable them to diagnose and treat other cases presenting 
 similar symptoms in the future ; {b) the examination of surgical 
 specimens, fluids, blood, and so on, in order to determine the lesion 
 present and throw light if possible on prognosis and treatment. 
 
 The theoretical work possible is limitless. At the hospital 
 laboratories the investigations taken up are mainly problems sug- 
 gested by the material of various sorts, both pathological and 
 bacteriological, which comes to the laboratory for examination. 
 At the School no limitations are imposed. 
 
 It has been the policy of the Department for the past fourteen 
 years to afford every opportunity possible to young men interested 
 in pathology to obtain a deeper knowledge of the subject than is 
 possible in the regular course of instruction offered in the School. 
 The primary object of this policy has been to develop men trained 
 in pathology from whom the instructors in the Department could 
 
70 THE HARVARD MEDICAL SCHOOL. 
 
 be selected. It was considered foolish to expect that other schools 
 would develop men for the use of Harvard. These men have 
 received their training chiefly in the pathological laboratory of the 
 Boston City Hospital and from them the instructors at the School 
 have been selected. Many of these trained men have been 
 offered and have accepted good positions in other medical schools 
 and hospitals, or have gone into that branch of clinical work for 
 which their training fitted them. In fact the demand for well- 
 trained men has been greater than the supply. 
 
 The following is a list of some of those formerly in the 
 Department who now hold other positions : 
 
 E. H. Nichols, Assistant Professor of Surgical Pathology at 
 the Harvard Medical School. 
 
 R. M. Pearce, Professor of Pathology and Director of the Bender 
 Hygienic Laboratory, Albany Medical College. 
 
 H. A. Christian, Instructor in the Theory and Practice of 
 Medicine, Harvard Medical School. 
 
 E. E. Tyzzer, Director of the Caroline Brewer Croft Cancer 
 Commission, Harvard Medical School. 
 
 W. R. Brinckerhoff, Director of the U.S. Leprosy Investigation 
 Station at Molokai, Hawaii. 
 
 Several other men trained under this system, but never connected 
 with Harvard, hold important positions in other schools and hospitals. 
 
 T. Leary, Professor of Pathology and Bacteriology in the Medical 
 Department of Tufts College. 
 
 F. T. Fulton, Pathologist to the Rhode Island Hospital, Provi- 
 dence, R.I. 
 
 H. S. Steensland, Lecturer on Pathology, Medical Department of 
 Syracuse University. 
 
 R. L. Thompson, Assistant Professor of Pathology, Marion Sims- 
 Beaumont School of Medicine, St. Louis. 
 
 C. W. Duval, Pathologist to the Montreal General Hospital. 
 
THE DEPAETMENT OF PATHOLOGY. 71 
 
 The training which the men have received has been of two sorts, 
 drill in the practical work of bacteriology and pathology, such as is 
 found in connection with any large hospital ; and training in the 
 investigation of some of the interesting problems presented by 
 the hospital material. As a matter of fact it has been found that 
 the best men require little or no direction, only unhampered oppor- 
 tunity for developing themselves. 
 
 The pathological laboratory has a large library, containing full 
 sets of many of the pathological publications, for which it is 
 indebted almost entirely to the generosity, extending over many 
 years, of Dr. Henry F. Sears. This library is used not only by the 
 School laboratory staff but also by the men working in the hospital 
 laboratories and by graduate students. The library maintains most 
 of the current publications on pathological and bacteriological sub- 
 jects and has many of the most important pathological monographs. 
 The library forms, therefore, the central meeting-place for all men 
 in Boston interested in pathology. 
 
 For many years the members of the various pathological labora- 
 tories (in Boston), together with graduate workers in them, have 
 met during term time once a week in the evening at the School in 
 order to review pathological literature, discuss cases of interest 
 which have been seen, and present the results of special investiga- 
 tions. These meetings have served to keep the men in touch with 
 the results of pathological work going on all over the world as well 
 as locally, have stimulated them to their best endeavors, and have 
 promoted good feeling and generous rivalry. 
 
 The effect of having members of the teaching staff in the Har- 
 vard Medical School in charge of the hospital laboratories, of main- 
 taining a departmental library, and of having weekly meetings for 
 general instruction and consultation, has been to make the School 
 laboratory the pathological center of Boston and the neighboring 
 cities. 
 
72 THE HARVARD MEDICAL SCHOOL, 
 
 Research work in pathology has always been encouraged in the 
 belief that it is the best way to develop teachers and keep them in 
 a position to understand and appreciate the work going on in their 
 particular field in the rest of the world. On this account every 
 instructor is urged and is expected to produce a certain amount of 
 original work each year. As a result of this policy the publications 
 of the Department have been numerous and of considerable value. 
 
 Research work in pathology has not been confined to the 
 instructors only, however. The same policy holds for the assist- 
 ants in the hospital laboratories. In addition many graduates have 
 worked in the laboratories and some of them have produced very 
 creditable work. 
 
 The publications of the Department have been numerous and 
 important, but t.he list of them is unfortunately too long to be 
 inserted here. The catalogues published by Dr. Jackson have 
 already been mentioned. Next in chronological order are the very 
 important monographs of Dr. Fitz on appendicitis and pancreatitis, 
 to mention only two of his many valuable papers. The work of 
 the Department in the last thirteen years has been extensive along 
 many lines. It may be briefly summarized as follows : three 
 monographs on the subjects, epidemic cerebrospinal meningitis, 
 diphtheria, and smallpox ; a text-book on pathological technic ; 
 and many papers on the causal agents of certain diseases such as 
 actinomycosis, Madura foot, Aleppo boil, gonorrhea, glanders, and 
 scarlet fever ; on the histological changes in various pathological 
 processes such as acute and subacute nephritis, typhoid fever, and 
 necroses of the liver ; on bacteriological and microscopical tech- 
 nic ; and on tumors in general and gliomata in particular. 
 
Vilitabie work. 
 jj^ . George Cheyne Shattuck (H.C. 1831). 
 
 ^' A.M. ;M.D. 1835. ' '^^ ' nifpKfous an 
 
 n^iu dHi Professor of Clinical Medicine, 1855-18^9. ^"^"^ long to b 
 
 'Sip ^ ' 
 
 Hersey Professor of the Theory and Practice of Physic, 1859-1874. 
 ..jad) •T'-Dean of the Medicaii School,, i5§4^869. _ r a;t- the ver 
 
 iiwrt i, ..;, ,. ;. Or. y-'<tz on appendicitis and pancreatitis 
 
THE DEPARTMENT OF CLINICAL MEDICINE. 
 f854. 
 
 Although the Quinquennial Catalogue states that the professor- 
 ship of Clinical Medicine was first established in 1854 and first 
 named the Jackson professorship in 1858 (in honor of James Jack- 
 son, M.D.), the Medical School catalogues refer to the Professors of 
 Clinical Medicine at a much earlier date. 
 
 Apparently, James Jackson was himself the first to receive the 
 title. In 1810, when the Medical School was moved from Cam- 
 bridge to Boston, Dr. Waterhouse (then Hersey Professor of the 
 Theory and Practice of Physic) refused to be moved from Cam- 
 bridge and, in order practically to replace him, the new title, Pro- 
 fessor of Clinical Medicine, was created for Dr. James Jackson. 
 His compensation consisted of such fees as he could collect, and the 
 only clinical facilities at his disposal were those afforded by the 
 Boston Almshouse. He held the office but two years ; for in 1812 
 Dr. Waterhouse resigned, and James Jackson succeeded to his 
 position as Professor of the Theory and Practice of Physic, "con- 
 tinuing" (however) "to perform the duties of Professor of Clinical 
 Medicine until another should be chosen." With this understand- 
 ing, James Jackson taught wholly unaided for twenty years. 
 
 That the teaching was distinctly clinical during the earlier years, 
 or in fact up to the time of Dr. Bowditch (1859), we have little 
 reason to believe. Students came to the Medical School to attend 
 lectures ; and, if they had any clinical instruction, it was obtained 
 mainly under the supervision of private instructors not connected 
 with the School. The private patients of these instructors, seen 
 in their homes and in the instructor's office, furnished most of the 
 clinical experience of the student up to 1850. At its best this 
 clinical instruction must have been of great value, something 
 
 C73) 
 
74 THE HARVARD MEDICAL SCHOOL. 
 
 indeed to be envied by the student of to-day, who often enough 
 wishes that he might see something of the private practice of 
 medicine outside of the hospitals before he plunges into it for him- 
 self. Yet in some cases the student got little or no clinical experi- 
 ence through his instructor, and merely pursued a course of reading 
 under a supervision which was chiefly nominal. 
 
 In 1833 the Harvard College Catalogue makes the following 
 vague statement regarding the clinical opportunities offered to 
 students : " The lectures for medical students are delivered at the 
 Massachusetts Medical College in Boston. They continue four 
 months. During the lectures the students may find in the city 
 various opportunities (italics inserted) for practical instruction." 
 That is the whole description of clinical medicine in the catalogue 
 of that date. 
 
 The first mention of a hospital is in 1835, when it is stated in the 
 catalogue that students attending the lectures in theory and 
 practice may attend the medical visits at the Massachusetts General 
 Hospital. In the catalogue of this date there is no separate Depart- 
 ment of Clinical Medicine, nor does the phrase " clinical medicine " 
 occur in any catalogue between 1835 and 1844. 
 
 In this catalogue of 1844-45 we find that in the Department of 
 Theory and Practice and Clinical Medicine, Professors Ware and 
 Jacob Bigelow gave for fifteen dollars a course of clinical lectures 
 (two hours each) on cases at the Massachusetts General Hospital 
 (twice a week) . " Abundant opportunities " (says the catalogue 
 of 1844-45) "^re thus furnished for most important practical obser- 
 vation and study. Students have an opportunity of visiting all the 
 cases, of observing and learning the symptoms and treatment of each 
 case, and particularly of the exploration of the body for the PHYSICAL 
 SIGNS of disease by palpation, auscultation, and percussion." 
 
 During the whole of this period, and indeed up to the appoint- 
 ment of Dr. G. C. Shattuck in 1855, there was no separate 
 
THE DEPARTMENT OF CLINICAL MEDICINE. 75 
 
 examination in clinical medicine. The clinical aspect of medicine 
 was not sharply distinguished from the systematic study of diseases 
 by means of books and lectures, and Dr. Jacob Bigelow united the 
 professorships of Materia Medica and Clinical Medicine from 1847 to 
 1855. In the catalogue the sentences describing the clinical side of 
 the teaching of medicine remain unchanged. But with the begin- 
 ning of Dr. Shattuck's teaching " the subjects formerly in charge 
 of the Hersey Professor of Theory and Practice are now divided 
 among the professors, Professors Ware (theory and practice), 
 Shattuck (clinical medicine), and J. B. S. Jackson (pathological 
 anatomy)." 
 
 The teaching now consisted of " lectures, recitations, and exami- 
 nations " held by Dr. Shattuck at the Medical School, and of 
 "medical visits'' at "the hospital" {i.e., the Massachusetts 
 General Hospital). These medical visits apparently constituted 
 what we should call the clinical part of the teaching. They 
 occurred " twice a week during the winter months, and four times 
 a week during the summer term. Students have an opportunity of 
 practising physical exploration and of learning the uses of chemical 
 analysis and of the microscope in the study and treatment of dis- 
 ease," presumably for the first time in the history of the School.* 
 
 From some of those who attended these visits it is understood 
 that there were the same difficulties then as now in the acquisition 
 of medical knowledge from ward visits. The number of students 
 was too great and the amount of time too small to make it possible 
 for many of the students to get any first-hand acquaintance with 
 the cases until toward the end of the term, when the numbers 
 attending the visits had become greatly reduced. The faithful 
 remnant of students might then learn a good deal. 
 
 •With the appointment of Dr. John Bacon as Professor of Chemistry in 1857 began the teaching 
 of medical chemistry proper, although the actual instruction in this branch was given chiefly by 
 Dr. James C. White. Systematic urinary examination was lirst taught by Dr. White at the Mas- 
 sachusetts General Hospital in 1857 as a portion of the course In clinical medicine. 
 
76 THE HARVARD MEDICAL SCHOOL. 
 
 Examinations were still wholly oral, and placed at the end of the 
 student's three years of " study under the direction of a regular 
 practitioner of medicine." Two courses of lectures (eight months) 
 with each professor were required, but there is no indication of any 
 grading or progress in the studies from term to term. A separate 
 (oral) examination in clinical medicine, lasting, it is said, twenty 
 minutes, was given for the first time in 1856-57; and this system 
 of examination continued until 1871. 
 
 The first mention of clinical lectures given at the hospital is in 
 1859, when Dr. Henry I. Bowditch became Jackson Professor of 
 Clinical Medicine, replacing Dr. G. C. Shattuck, who was trans- 
 ferred to the Hersey professorship of Theory and Practice. These 
 clinical lectures were substantially the same as the method of 
 teaching now called by that name. A patient was brought from 
 the wards to the Jacob Bigelow lecture-room, at the northeast 
 corner of the Massachusetts General Hospital (where the engi- 
 neer's room now is), and his case demonstrated and explained to the 
 students, some of whom found opportunity, especially at the close 
 of the lecture, personally to examine the patient. 
 
 Instruction in the wards was continued, in the winter term by 
 Dr. Bowditch, in the summer by Dr. J. B. S. Jackson, Dr. Gould, 
 and other physicians, as well as at the dispensary. This is the first 
 mention in the catalogue (1859-60) of any clinical teaching given 
 by physicians not holding any stated position in the School. It is 
 also the first mention of teaching at the Boston Dispensary or 
 indeed at any institution other than "the hospital" {i.e., the 
 Massachusetts General). The Boston City Hospital was not 
 opened until 1864. The teaching at the dispensary was in charge 
 of " the assistants of the Professors of Clinical Medicine and Patho- 
 logical Anatomy and other medical officers." 
 
 The catalogue first gives indication in 1857-58 that the work of 
 the students was beginning to be arranged in groups of "studies 
 
THE DEPARTMENT OF CLINICAL MEDICINE. 77 
 
 for the first year and studies for the second year," but until i860 
 the "list of studies " includes nothing but books. In i860 we find 
 under the "Course of Study for the second year" not merely a 
 list of books, but the general statement, "Clinical Observation at 
 the Hospital and the Dispensary." Simultaneously we note that 
 there is a decided falling off in the number of students whose 
 names are linked in the catalogue with the name of some practising 
 physician (the "instructor") to whom the student was rather 
 loosely apprenticed. The system of apprenticeship continued until 
 1 87 1, but more and more men dispensed with it, and spent their 
 three years under the Harvard Medical School as sole instructor. 
 
 The Clinical Conference is first mentioned in the catalogue of 
 1862-63; that is, about the middle of Dr. Bowditch's term as 
 Professor of Clinical Medicine. It appears, however, that an 
 exercise more or less similar had previously been held by Dr. G. C. 
 Shattuck at his rooms on Staniford street. Dr. Shattuck's exer- 
 cises were not a stated part of the Medical School instruction, and 
 so are not referred to in the catalogue ; but, as the School was still 
 a proprietary institution, the distinction between stated and private 
 instruction was not sharp. 
 
 In 1865 with the accession of Dr. Calvin Ellis the catalogue gives 
 considerably more space and detail to the Department of Clinical 
 Medicine than in any previous year. We now begin to hear for 
 the first time of clinical instruction at the Boston City Hospital, 
 opened the year before, the Marine Hospital at Chelsea, and 
 the Eye and Ear Infirmary. 
 
 Hitherto the Medical School had been conducted wholly by the 
 eight teachers who composed the Faculty. At any rate, if there 
 were any others who gave instruction, the catalogue gives no hint 
 of their existence. But in 1865 we hear of ten professors and nine 
 assistants, though not all of the latter are named. 
 
 The beginning of the provision for separate instruction in those 
 
78 THE HAEVAKD MEDICAL SCHOOL. 
 
 departments of medicine now known as "the specialties" is seen 
 in the same year — 1865 ; and the name of Brown-Sequard appears 
 as Professor of the Physiology and Pathology of the Nervous 
 System. 
 
 Next year (1866-67) the number of teachers is increased to over 
 twenty, including fourteen professors, two assistants, and 
 "several" instructors. The amount of instruction in clinical medi- 
 cine appears to be nine hours a week from November to March. 
 This instruction consisted of two clinical lectures, one clinical con- 
 ference, and six medical visits (two at the Massachusetts General 
 Hospital, two at the Boston Dispensary, one at the Marine Hos- 
 pital, and one at the Boston City Hospital). In addition we note 
 that special instruction is given in hygiene, ophthalmology, der- 
 matology, syphilis, and psychological medicine. The first mention 
 of the stethoscope, ophthalmoscope, and laryngoscope occurs in 
 the catalogue of 1868-69, although the stethoscope had already 
 been in use for over thirty years. Next year (1870) the first 
 mention of the microscope occurs. 
 
 In 1868-69 Dr. Bowditch retired, and Dr. Ellis took the Jackson 
 professorship. 
 
 In 1871, with the accession of President Eliot, there occurred 
 the most important event in the history of the School — its reorgan- 
 ization and incorporation as an integral part of Harvard University. 
 Since 18 10 the connection of the School with Harvard had been 
 nominal rather than real. It had been a proprietary institution, 
 managed by its own Faculty, who collected fees from the students 
 and divided the proceeds in lieu of salaries at the end of each year. 
 The appointments were made by the Medical Faculty ; and Harvard 
 University had little, if any, control over its management. The 
 instruction consisted of two courses of lectures of four months each, 
 while the rest of the students' work was supposed to be supervised 
 by the extra-mural instructors to whom they were loosely appren- 
 
THE DEPAETMENT OF CLINICAL MEDICINE. 79 
 
 ticed for three years. Whether this apprenticeship amounted to 
 anything as instruction or not depended upon the habits and 
 inclinations of individual "instructors." It might be of great 
 value. It might be practically valueless. Some students saw 
 many cases of disease, some saw none at all. It has been men- 
 tioned that until 1871 examinations occurred only at the end of the 
 whole course, that they were wholly oral, and that twenty minutes 
 was the time allotted to clinical medicine, as to each of the other 
 main branches. 
 
 In 1871 the third-year graded course was adopted, the apprentice- 
 ship system was abolished, written examinations were established 
 and arranged to come at the end of each year, salaries and tuition 
 fees were fixed, and President Eliot began to preside at all Faculty 
 meetings. 
 
 There is no evidence, however, of any radical changes in the 
 methods of teaching clinical medicine. " Visits at the hospitals, 
 practical instruction on cases, and auscultation and percussion ' ' are 
 the methods as described in the catalogue. " The Clinical Confer- 
 ence affords an opportunity for more thorough preparation of cases, 
 more time being allowed for their study. The full written report 
 of a case is read by the student who has examined it. It is after- 
 wards criticised by the class, by the Professor of Clinical Medicine 
 and other teachers." From this time on there is no development 
 in this exercise, which has been continued without essential change 
 for over thirty years. 
 
 In 1 881 Dr. Ellis' illness forced him to retire, and pending the 
 appointment of a new Jackson Professor his duties were divided 
 between Dr. Francis Minot (Professor of Theory and Practice) and 
 Dr. R. T. Edes (Professor of Therapeutics). This continued until 
 1884, when Dr. Edes became Jackson Professor and Dr. E. N. 
 Whittier assistant professor. Dr. F. C. Shattuck was transferred to 
 the Department of Theory and Practice, while Drs. Cutler and 
 
80 THE HARVARD MEDICAL SCHOOL. 
 
 Gannett and, in 1885, Dr. Vickery, became assistants, bringing the 
 teaching force up to six. 
 
 Next year Dr. George B. Shattuck was made instructor in 
 clinical medicine ; but after 1888 his name is not found in the 
 catalogues, except in connection with the medical ward visits, of 
 which some further account will be given below. 
 
 In 1889-90 Dr. F. C. Shattuck succeeded to the Jackson pro- 
 fessorship, which had been vacant since the resignation of Dr. 
 Edes in 1886. 
 
 Under Professor Shattuck, in 1889, served : 
 
 Dr. A. L. Mason, Instructor and next year Assistant Professor. 
 
 Dr. W. W. Gannet, Instructor. 
 
 Dr. G. M. Garland, Instructor. 
 
 Dr. C. F. Withington, Assistant. 
 
 Dr. H. F. Vickery, Assistant. 
 
 In 1892 Drs. Garland and Withington retired, and Drs. Henry 
 Jackson, Vincent Y. Bowditch, and Augustus S. Knight became 
 assistants, bringing the total teaching force up to seven and next 
 year to eight (with the appointment of Dr. George G. Sears). 
 One more assistant (Dr. John L. Morse) was added in 1897-98, 
 after which there were no more changes until 1900. 
 
 In 1900 the Department consisted of : 
 
 The Jackson Professor, Dr. F. C. Shattuck ; five instructors 
 (Drs. McCollom, Withington, Vickery, Jackson, and Sears) ; six 
 assistants (Drs. Prescott, Ames, Bartol, J. M. Jackson, Cabot, and 
 Smith). 
 
 Since then the only noteworthy changes have been the pro- 
 motion of Dr. Sears to be Assistant Professor of Clinical Medicine, 
 of Dr. McCollom to be Assistant Professor of Contagious Diseases, 
 and the appointment of Dr. E. A. Locke as assistant, replacing Dr. 
 John L. Ames. 
 
 During the years in which the quantitative increase took place 
 
THE DEPARTMENT OF CLINICAL MEDICINE. 81 
 
 there were changes also in the quality of teaching, of which 
 mention must now be made. 
 
 THE EVOLUTION OF TEACHING METHODS IN THE 
 DEPARTMENT, 
 
 The desire to get the student into personal contact with cases of 
 disease, in order that he may learn to recognize their symptoms and 
 signs and may watch their development from day to day, is the 
 source of all the various methods of teaching in use in the Depart- 
 ment. To attain this end, clinical lectures, ward visits, personal 
 instruction in auscultation and percussion, and the clinical confer- 
 ence were the only methods in use up to 1895. These time- 
 honored methods have been used ever since with very slight 
 modifications, but others have been added. 
 
 1. The clinical lecture is to-day very much what it has been 
 for the last fifty years, except that since 1901 Dr. Shattuck has 
 allowed groups of students to examine patients under the super- 
 vision of Dr. W. H. Smith while the lecture is going on. These 
 students lose a part of the lecture, but gain some practice in 
 physical diagnosis. 
 
 2. Ward visits formed part of the instruction from 1835 until 
 1902, when they were discontinued. The method of instruction 
 has been essentially the same during these seventy years. It grew 
 in favor up to about 1880 or thereabouts, when visits were made at 
 three hospitals by eighteen different physicians in company with 
 sections of students. From this maximum, which was sustained 
 for some years, the "medical visits" have gradually fallen off. 
 They were abandoned at the Massachusetts General Hospital in 
 1897, continued at the Boston City Hospital until 1902, when they 
 ceased altogether. During the current year visits have begun 
 again at the Boston City Hospital. 
 
 3. The instruction in auscultation and percussion given by the 
 
82 THE HARVARD MEDICAL SCHOOL. 
 
 assistants in the Department to small sections of students has 
 continued without much change from 1872, when Dr. F. I. Knight 
 began to teach it, until the present day. The number of instruct- 
 ors has been increased to five, and the teaching extended to cover 
 the rest of the physical examination of the body (exclusive of 
 microscopic and chemical diagnosis) ; but the methods of work are 
 essentially the same. 
 
 4. The Clinical Conference represented the careful study of 
 one case by each student in the course of the year, but the need 
 for more opportunities of this sort led to the establishment in 1895 
 of a new requirement for the degree of M.D. The student must 
 not only have passed his examinations and written his Clinical 
 Conference, but 
 
 5. It was also required (1895-1902) that four dispensary cases 
 be taken by each student, who watched them (at the homes, under 
 the supervision of Dr. Henry Jackson) and wrote brief reports 
 upon them. This gave each student a chance to see something of 
 private practice — a most important feature in medical education, 
 and one which since 1871 had been entirely lacking. It was most 
 valuable for the students, but the administrative duties connected 
 with it proved so cumbersome and onerous that in 1902 it was 
 replaced by the system of 
 
 6. Required out-patient work, one month for every student, 
 in the clinic of some teacher in the School, but not necessarily 
 under a member of the Department of Clinical Medicine. The 
 cases seen by each student, the number of histories, physical 
 examinations, chemical and microscopic analyses made by each 
 student as part of the study of a case, is thus very much greater 
 than under the system of dispensary cases seen in their own 
 homes. But the opportunities for following cases from day to day 
 and for learning to deal with the family are not as good ; and, 
 unless he secures a hospital appointment, the graduate is still very 
 
THE DEPAETMENT OF CLINICAL MEDICINE. 83 
 
 inadequately instructed in these branches of medicine when he 
 takes up practice. 
 
 The examination in clinical medicine (after the twenty minutes' 
 oral test was dropped as insufficient in 1872) consisted of a series 
 of twenty written questions, not materially different from those 
 given in theory and practice. This was continued until 1876, and 
 was supplemented during that period by bedside examinations. 
 
 In 1876 these practical bedside examinations were dropped (and 
 never resumed) ; and the written questions were replaced by a 
 series of detailed histories of actual cases, from which the student 
 was to work out a diagnosis, prognosis, and treatment. This sys- 
 tem has continued up to the present day ; but at present it counts 
 for only sixty per cent of the mark, while twenty per cent is rep- 
 resented by the Clinical Conference paper and twenty per cent by 
 the medical out-patient work, so that two-fifths of the examina- 
 tion is practical. 
 
 Instruction for graduates by the Department has never been 
 taken very seriously. The head of the Department has never taken 
 part in it, and the instruction given by the subordinates has been 
 irregular and unsystematic. The first announcement of graduate 
 instruction was in 1872, when Dr. F. I. Knight offered a course in 
 auscultation, percussion, and laryngoscopy. This was continued 
 until Dr. Knight ceased to teach auscultation and percussion in 
 1879, and represented all the graduate instruction in this Depart- 
 ment up to this date. Then there was for ten years no instruction 
 for graduates whatever. 
 
 In 1889, when Dr. F. C. Shattuck became Jackson Professor, 
 there appears in the catalogue the first announcement of courses 
 for graduates since Dr. Knight ceased to teach in this Department. 
 Four courses were offered in 1889, two of eight weeks each in 
 clinical medicine and two in diseases of the digestive organs. Next 
 year two more courses in physical diagnosis were added. In 
 
84 THE HAEVAKD MEDICAL SCHOOL. 
 
 1891-92 there are eight courses announced, consisting of from 
 eight to twenty-four exercises and conducted at the Massachusetts 
 General Hospital, the Boston City Hospital, and the Boston 
 Dispensary. 
 
 In 1892 there were but four courses, in 1895 but three, in 1899 
 but two courses of one month each ; and at this low ebb the grad- 
 uate instruction continued until the present year, when the number 
 rises again and reaches eight courses, the largest number since 
 1891. 
 
 Thus far numbers and methods have been dealt with, not per- 
 sonalities. It remains to sketch as well as possible the character- 
 istics of the more important teachers in the Department of Clinical 
 Medicine. Leaving out those still living, those whose term of 
 office was very brief, and those who merged clinical medicine with 
 theory and practice, we have left but two concerning whose per- 
 sonality as teachers it has been possible to learn anything — Dr. 
 Henry I. Bowditch and Dr. Calvin Ellis. 
 
 These men are interesting in their contrasts as well as in 
 their likeness. Both were conscientious and faithful, and fulfilled 
 their function as teachers by thoroughness and painstaking drill 
 rather than by brilliancy or eloquence. There was nothing of 
 Methodistical fervor nor of literary polish in their lectures. So far, 
 they were alike. But one of Dr. Bowditch's most salient charac- 
 teristics was his contagious enthusiasm ; while Dr. Ellis was quiet, 
 composed, not easily roused to outbursts of any kind. Dr. Bow- 
 ditch not infrequently enlivened his lectures with snatches of 
 kindly humor. Dr. Ellis was earnest, but never humorous. Dr. 
 Bowditch had many interests. Dr. Ellis had one. Dr. Bowditch's 
 name is quoted as often in connection with anti-slavery agitation 
 as with medicine; and medicine easily associated itself in his 
 activities with public work, like the Sanitary Commission or the 
 Massachusetts Board of Health. Dr. Ellis' whole energy was 
 
THE DEPARTMENT OF CLINICAL MEDICINE. 85 
 
 concentrated in one direction. He shunned anything liice publicity, 
 and even private practice had less interest than teaching for him. 
 Teaching was his one hobby, and he would have been glad to give 
 it his undivided attention. Dr. Bowditch was a man who, among 
 his other activities, found time very ably to fill the Chair of Clinical 
 Medicine. 
 
 As we look back upon the personalities and the methods which 
 governed the teaching of the years between i860 and 1885, we see 
 that there were laid then the foundations for all that has been 
 developed since. Clinical methods, first-hand contact of student 
 with patient, was their ideal as well as ours ; but the impression 
 cannot be avoided that the personality of the teacher counted for 
 more then than it does now. Partly because the number of 
 instructors and assistants has been so largely increased, partly 
 because we have more confidence in the power of the individual 
 student to get his knowledge directly from the patient without the 
 mediation of book or teacher, the domination of a single powerful 
 personality over the students' ideas of medicine grows less and less. 
 That there is both gain and loss in this change there can be no 
 doubt. The modern teacher of medicine reverences the facts so 
 much that he is afraid of interposing his personality between them 
 and his pupils, and so draws himself more and more into the back- 
 ground. This is as it should be, provided the teacher does not 
 forget that facts mean nothing, and that it is his business to 
 see to it that the student knows what to do with his facts when 
 he has gathered the crude mass. In the interpretation and appli- 
 cation of data personality is as important as ever ; hence the great 
 teacher of medicine, in the future as in the past, will be first of 
 all a great man. 
 
Oliver Wendell holmes (H.C. 1829). 
 
 A.M. (hon.) 1889; M.D. 1836; LL.D. 1880; Edinb. 1886; Litt. D. Cambr., 1886; 
 D C.L. Oxford, 18B6. 
 
 Parkman Professor of Anatomy and Physiology, 1847-1882. 
 
 Professor Emeritus, 1882-1894. 
 
 Dean of the Medical School, 1847-1853. 
 
THE DEPARTMENT OF PHYSIOLOGY. 
 {866. 
 
 In investigating the functions of the various organs of the animal 
 body, students of the subject naturally at first contented them- 
 selves with inferences drawn from their anatomical structure. 
 Hence the union of anatomy and physiology for purposes of 
 instruction was a natural one, and in all the older medical schools 
 we find that the two subjects were at first taught from the same 
 chair. Thus, in the Harvard Medical School, the Parkman profes- 
 sorship of Anatomy and Physiology was established in 1847 and 
 named in honor of George Parkman, who gave the land upon which 
 the then Medical School was built. It was not till 1871 that the 
 title was changed to Parkman professorship of Anatomy, a separate 
 chair being created at that time for the teaching of physiology. 
 From 1847 to 1882 the Parkman professorship was held by Dr. O. 
 W. Holmes who until 1865 was solely responsible for the instruction 
 in physiology. At that time Dr. Josiah Stickney Lombard was 
 appointed lecturer in physiology, a title which, a year later, he 
 exchanged for that of assistant professor. This office he held till 
 1870 when he was succeeded by Dr. William Thompson Lusk 
 who, under the title of lecturer, gave instruction in physiology 
 during the year 1870-71. 
 
 With regard to the amount and character of the instruction given 
 during this period it is difficult to speak with precision. The 
 announcements of the School are couched in very general terms, 
 and the personal recollections of that generation of students are 
 naturally, after the lapse of thirty-five to forty years, quite vague 
 and discordant. Thus statements as to the number of lectures on 
 physiology delivered by Dr. Holmes vary from three or four to 
 twenty. A partial explanation of this discrepancy may be found 
 
 (87) 
 
88 THE HARVARD MEDICAL SCHOOL, 
 
 in the fact that physiological phenomena were not infrequently 
 described in connection with structural details. Thus the first five 
 lectures of the anatomical course were mainly devoted to a descrip- 
 tion of the physical and chemical properties of the elementary 
 tissues of the body such as is usually to be found in text-books of 
 physiology. 
 
 Few of Dr. Holmes' lectures were demonstrative in their char- 
 acter, but some of those who attended them can recollect witnessing 
 a demonstration of the lacteals in an animal killed during the absorp- 
 tion of fat and a few simple experiments in artificial digestion. 
 There is, moreover, still preserved in the physiological laboratory 
 an apparatus made by Dr. Holmes himself for showing that negative 
 after-images have colors complementary to those thrown upon the 
 retina. It consists of a disc, having three colored sectors for which 
 white sectors can be substituted by turning the disc through an 
 angle of sixty degrees. Dr. Holmes' lectures on physiology during 
 the winter course were supplemented during the first three months 
 of the summer course by recitations held twice a week. Dalton's 
 Human Physiology seems to have been the text-book used in these 
 recitations. 
 
 Dr. Lombard's instruction appears from the catalogues of the 
 period to have been confined to the summer term, recitations 
 having been held twice a week for three months with one lecture a 
 week in the month of May. No attempt was made to cover the 
 whole ground of physiology, but selected subjects, such as glyco- 
 genesis, the circulation of the blood, and respiration were treated 
 with considerable detail, and the demonstrative method of instruc- 
 tion was freely used. During his connection with the School Dr. 
 Lombard seems to have done a certain amount of original research 
 on the patellar reflex, the temperature of the head, and other work ; 
 but no laboratory to which students had access was established. 
 
 According to the Medical School catalogue of 1870-71 Dr. Lusk's 
 
THE DEPARTMENT OF PHYSIOLOGY. 89 
 
 instruction was given in three lectures a week during tiie winter 
 lecture term and in recitations during the summer term. Of the 
 character of this instruction it is possible to speak with some 
 accuracy for his son, Professor Graham Lusk, of New York, has 
 kindly furnished a copy of his father's memorandum of experi- 
 ments and demonstrations made in connection with his lecture 
 course. From this memorandum it appears that thirty-five out of 
 a total of forty-three lectures were thus illustrated, and that the 
 whole subject of physiology must have been quite well covered. 
 
 During the period we are considering a very important, though 
 temporary, addition to the teaching force in physiology was 
 effected by the appointment in 1864 of Dr. Charles Edouard 
 Brown-Sequard as Professor of the Physiology and Pathology of 
 the Nervous System. This brilliant investigator held office in the 
 School for three years, and according to the School catalogue for 
 1866-67 lectured twice a week during the winter term of four 
 months. Those who were privileged to listen to him will not 
 readily forget the enthusiasm which he awakened in his hearers for 
 medicine as an experimental science. It is interesting to note how 
 far the physiology thus taught was in advance of the then accepted 
 views. Thus, eighteen years before the publication of the well- 
 known work of Goldscheider on the specific energy of the 
 temperature-perceiving nerve terminations in the skin, we find 
 Brown-Sequard teaciiing that the sensibility of the skin to cold and 
 to heat was probably dependent upon two separate sets of nerve 
 terminations. 
 
 Another course of instruction, which must be mentioned in this 
 connection, was that of Dr. Robert Amory who in 1870-71 lect- 
 ured twice a week on the physiological action of drugs on man and 
 the lower animals. In this course, which was extensively illus- 
 trated by experiments on animals, was set forth the physiological 
 action of ether, chloroform, chloral, nitrous oxide, the bromides and 
 
90 THE HABVABD MEDICAL SCHOOL. 
 
 cyanides, belladonna, aconite, veratrum viride, iodide of potassium, 
 caffein, thein. 
 
 It should also be noted that medical students of this period had 
 access to the lectures on comparative anatomy and physiology 
 delivered in Cambridge by Professor Jeffries Wyman. Indeed it 
 was not uncommon for students of the School to be at the same 
 time special students of Dr. Wyman, and many sexagenarian 
 physicians of this community still gratefully remember the enthu- 
 siasm with which they followed the instruction of this distinguished 
 leader in biological science. 
 
 In 1 87 1 the method of instruction in the Harvard Medical School 
 underwent a radical change, the most important feature of which 
 was the adoption of the so-called graded course. Until that time 
 the students of the School were not classified according to the time 
 spent in study, but every student was expected to select from the 
 instruction offered such subjects as seemed to him best adapted to 
 his needs. Thenceforth the students were divided into classes, and 
 the subjects pertaining to an education in medicine were classified 
 as first, second, third, and fourth year studies, an examination at 
 the end of the year testing the student's fitness to advance from 
 one class to the next. Under this arrangement physiology was 
 classified as a first year study while, in recognition of its importance 
 as an experimental science, it was accorded a position as an inde- 
 pendent Department of the School and, by raising the roof of the 
 North Grove street building, room was made for a fairly com- 
 modious physiological laboratory. This newly created Department 
 was placed in charge of Dr. Henry Pickering Bowditch, who had 
 graduated from the School in 1868 and had spent three years in 
 Europe studying physiology in Paris, Bonn, Leipsic, and Munich. 
 Dr. Bowditch, after serving five years as assistant professor, was 
 in 1876 made Professor of Physiology, a title which in 1903 
 was changed to George Higginson Professor of Physiology, this 
 
THE DEPARTMENT OF PHYSIOLOGY. 91 
 
 professorship having been founded in memory of their father by the 
 children of George Higginson. 
 
 For the first six years instruction was given by the occupant of 
 the new chair with such assistance as could be furnished by 
 students, who volunteered for the work or whose fees were remitted 
 as compensation for services rendered. In 1877 an Assistant in 
 Physiology was for the first time appointed, Dr. George Minot 
 Garland being chosen for the position which he held for four years. 
 He was succeeded by Dr. Joseph Weatherhead Warren who served 
 as assistant from 1881 to 1887, and as instructor from 1887 to 
 1 89 1. Since that time more than twenty assistants and instructors 
 have held office in the Physiological Department, but no oificer of 
 higher rank was added to the teaching force till 1892, when Pro- 
 fessor William Henry Howell was called from the Chair of Physi- 
 ology in the University of Michigan to assume the position of 
 Associate Professor of Physiology at Harvard. The Harvard Medical 
 School enjoyed but temporarily the advantage of Professor Howell's 
 services, for in the following year he obeyed the summons of his 
 Alma Mater to take charge of the Department of Physiology in the 
 Johns Hopkins University. He was succeeded by Professor 
 William Townsend Porter, of the St. Louis Medical College, who, 
 after five years' service as assistant professor, was made Associate 
 Professor of Physiology in 1898. In 1902 Dr. Walter Bradford 
 Cannon, after two years' service as instructor, was appointed 
 Assistant Professor of Physiology. 
 
 It has been the constant aim of all the officers of instruction in 
 the Department of Physiology to develop and improve the methods 
 of instruction and research to the fullest extent. In view of the 
 great variety of subjects to be taught and of the diversity in the 
 mental equipment of the students it was felt that all the recognized 
 methods of instruction should be employed. Thus the didactic 
 lecture, the text-book, the recitation, the laboratory experiment. 
 
92 THE HAEVAED MEDICAL SCHOOL. 
 
 the demonstration, and the conference have all been in use. With 
 regard to these various exercises the name is, in most cases, suffi- 
 ciently indicative of their character, but as to the last on the list a 
 few words of explanation may be desirable. The physiological 
 conference was modelled upon the clinical conference which had 
 long been an approved method of instruction in the Department of 
 Clinical Medicine and which in turn had been more or less closely 
 copied from a method employed by the celebrated French clinical 
 teacher Louis. 
 
 In this exercise, which usually lasts half an hour, a student 
 reads a short essay on some previously announced special question 
 in physiology. The reader is allowed about ten minutes to present 
 his evidence and draw his conclusions. The subject is then thrown 
 open for discussion by the class and the students are encouraged to 
 question and criticise the reader. Finally the teachers in the 
 Department contribute their views to the elucidation of the subject. 
 The exercise is found to be particularly valuable in training students 
 to weigh evidence in fields of research where investigation has not 
 yet led to certain results. 
 
 With the establishment of the physiological laboratory in 1871 
 an opportunity for the systematic study of physiological problems 
 was for the first time afforded in this community. That workers 
 were ready to avail themselves of this opportunity was proved by 
 the fact that in 1879 it was possible to issue a volume of papers 
 consisting of eighteen collected reprints from various scientific 
 journals and representing work done in the physiological labora- 
 tory. In 1886 a second volume containing twenty-two papers was 
 issued. Since that date the productive activity of the laboratory 
 has been set forth in the annual reports of the dean of the Medical 
 School. 
 
 From 1892 to 1896 a small number of physiological experiments 
 were made by the students themselves. Excepting the year, 
 
THE DEPAETMENT OF PHYSIOLOGY. 93 
 
 1892-93, these experiments were entirely chemical, and in 1896 
 they were transferred to Professor Hills, of the Department of 
 Chemistry. Their place was taken by section work in other fields, 
 such as the circulation and the nervous system, under the direction 
 of Professor Porter. In 1896 each student spent two afternoons at 
 such experiments. In 1897 and 1898 this was increased unti\ each 
 student worked from two to three hours on twelve afternoons. 
 The class was, however, divided into sections, and the experimenta- 
 tion could not possibly be co-ordinated with the didactic instruction. 
 Moreover, since physiology and anatomy were both taught through- 
 out the first year of the curriculum, the physiological teaching could 
 not be properly co-ordinated with the teaching of anatomy. Indeed, 
 the function of organs was often expounded by the physiologist 
 before the student was acquainted with their anatomy. Finally, 
 as anatomy and physiology were pursued at the same time, the 
 student suffered from a divided mind. These considerations led 
 Professor Porter to urge a system of teaching distinguished by con- 
 centration and sequence. Under this system the student gives to 
 anatomy and histology his entire time during the first half of his 
 first year of medical study, and during the second half he gives his 
 entire time to physiology and physiological chemistry. Three 
 advantages are thereby gained : (i) The student is grounded in 
 structure before he considers function ; (2) he serves but one 
 master at a time 5(3) experimentation and didactic instruction can 
 be successfully co-ordinated. 
 
 In 1899 Professor Bowditch withdrew from the greater part of 
 his work, and the responsibility for the first-year instruction was 
 given to Professor Porter. The principal changes introduced by 
 the latter were a new method of teaching physiology, the pro- 
 vision of apparatus suitable for the laboratory teaching of physi- 
 ology, and the planning of a building for laboratory teaching and 
 research. 
 
94 THE HARVARD MEDICAL SCHOOL. 
 
 The new method of teaching physiology provides that the 
 didactic instruction in each field shall be closely preceded by 
 related experiments performed by the student himself. In the old 
 method the subject was developed by a series of lectures illus- 
 trated by demonstrations and, where possible, by a relatively 
 small number of experiments by the student himself. In the new 
 method, the classical experiments of physiology, arranged in the 
 most instructive sequence, are performed by the student and 
 afterward discussed by the lecturer, who then collates the student's 
 experiments and observations with those of other observers. In 
 the old method the stress is upon didactic teaching. In the 
 new, the stress is upon observation. 
 
 In 1900 two hundred and twenty students worked in the 
 physiological laboratory daily (except Saturday) during four 
 months. Experimentation on such a scale requires many thousand 
 pieces of apparatus, the cost of which would have been prohibitory. 
 This vital difficulty was overcome by the invention of many new 
 instruments and the re-designing of others to secure greater simplic- 
 ity without the sacrifice of accuracy. Even simple apparatus cannot 
 be made cheaply except in lots of from one hundred to one thou- 
 sand of each instrument. Thus, the making of these instruments 
 for the Harvard Medical School leaves inevitably a surplus. This 
 surplus is placed at the disposal of other universities at prices far 
 below the commercial values. The Harvard physiological appa- 
 ratus has been sent, in larger or smaller quantities, to more than 
 one hundred and sixty laboratories in the United States, and to 
 more than fifty laboratories in foreign countries, including Syria, 
 Russia, Japan, and Australia. 
 
 Certain experiments in physiology are laborious and time-con- 
 suming. To meet this condition the students are divided into 
 groups of eight. An experiment on metabolism, for instance, is 
 assigned to an entire group, two members of which are the subjects 
 
THE DEPARTMENT OF PHYSIOLOGY. 95 
 
 of the experiment, while the remaining members divide with them 
 the labor of the analyses. The results of such experiments are 
 reported to the whole class by the representatives of the groups. 
 With the group system in mind, the new physiological building was 
 designed. Each student room contains three rows of four desks 
 each, accommodating three groups of eight students together with 
 the necessary equipment. A library is also provided, with the 
 literature in physiology at hand, and the provision for research and 
 for the care of the experimental animals is ample. 
 
THE DEPARTMENT OF DERMATOLOGY. 
 J87J. 
 
 It is believed that the first special instruction having any cuta- 
 neous relations was given in the School as early as 1858, when Dr. 
 James C. White gave some lectures on parasites by invitation of 
 the Professor of Clinical Medicine. In 1861 Dr. White gave a 
 course of lectures on skin diseases to the class, and this was 
 repeated from year to year. Dr. B. Joy Jeffries gave similar 
 instruction later, for a year or two, at Professor Shattuck's request. 
 
 The first instruction authorized by the Faculty, however, was 
 given in 1864, when Dr. White gave a course of " University 
 Lectures " on skin diseases, and in 1867 Dr. White was appointed 
 lecturer in dermatology. In 1871 the professorship of Derma- 
 tology was created, the first to be established by any medical 
 school in this country, and Dr. White was appointed professor, a 
 position which he occupied until 1902. 
 
 In these earlier years the clinical resources for teaching derma- 
 tology were naturally meager. In i860 Drs. White and Jeffries 
 opened a dispensary for skin diseases in Eliot street, which con- 
 tinued until 1863 when Dr. White was appointed physician to out- 
 patients at the Boston Dispensary. Here there was considerable 
 material for dermatological instruction, which was made the most 
 of. In 1865 Dr. White was appointed physician to out-patients 
 at the Massachusetts General Hospital, this position at that time 
 including all diseases except those of a surgical nature. In 1870 an 
 Out-patient Department for the treatment of skin diseases was 
 established, which, under Dr. White's able and faithful administra- 
 tion, soon began to afford an abundant supply of material for teach- 
 ing and for investigation. In 1871 Dr. White, as has been said, was 
 appointed Professor of Dermatology. He immediately instituted 
 
 (97) 
 
98 THE HARVAED MEDICAL SCHOOL. 
 
 his systematic course of lectures and demonstrations, which were 
 repeated for many years. It consisted of two weekly exercises, or 
 rather one exercise spread over two days. This course included a 
 weekly afternoon lecture throughout the year, illustrated by photo- 
 graphs, wax models, and specimens in which was covered practi- 
 cally the whole field of dermatology. This lecture was given at 
 the Medical School, and the following morning, at ten o'clock, the 
 lecture of the preceding day was illustrated, as far as possible, by 
 patients at the hospital, other interesting cases that might happen 
 to be available being shown at the same time. This course was 
 continued, practically unchanged, during the whole thirty-one years 
 of Dr. White's professorship. 
 
 In 1871 Drs. Edward Wigglesworth and Francis B. Greenough 
 were appointed lecturers on syphilis. Dr. Wigglesworth appears 
 to have held this position but one year. Dr. Greenough, however, 
 was appointed yearly until 1875, when he and Dr. Wigglesworth 
 were made clinical instructors in syphilis, the instruction being 
 given at the Marine Hospital and the Boston Dispensary. Dr. 
 Greenough held this lectureship from 1875 to 1895, Dr. Wiggles- 
 worth from 1875 to 1881. In 1872 graduate courses in derma- 
 tology and in syphilis were offered for the first time. The graduate 
 course in dermatology was offered by Dr. White at the Massachu- 
 setts General Hospital, and consisted of two weekly exercises, with 
 an opportunity for examining all the cases presenting themselves at 
 the Out-patient Department. The graduate course in syphilis was 
 given at the Boston Dispensary and at the Marine Hospital. 
 
 In 1880 an optional fourth year was instituted in which Dr. 
 White gave courses consisting of three exercises a week at the 
 Massachusetts General Hospital, and Drs. Greenough and 
 Wigglesworth offered exercises in syphilis once a week in the 
 Marine Hospital and at the Boston Dispensary. In 1881 Dr. 
 Wigglesworth retired, and the instruction was carried on by 
 
THE DEPARTMENT OF DERMATOLOGY. 99 
 
 Dr. Greenough alone until the following year, 1882, when 
 Dr. Abner Post was appointed clinical instructor in syphilis, 
 together with Dr. Greenough. Dr. Post gave exercises to the 
 third class once a week for a half year on the practical diagnosis 
 and treatment of syphilis, and Dr. Greenough gave clinical 
 exercises two hours a week throughout the year to the fourth 
 class, all of these exercises being at the Boston Dispensary. In 
 the catalogue for the year 1889 there appears for the first time 
 the name of Dr. George H. Tilden, who had been appointed 
 special instructor in dermatology and syphilis. He remained in 
 the School for two years, giving instruction to the fourth year twice 
 a week for three months at the Boston City Hospital. 
 
 In 1892 the fourth year became obligatory, and dermatology 
 was included under the electives. The course was still conducted 
 by Dr. White, who gave two clinical exercises a week through- 
 out the year at the Massachusetts General Hospital. It was 
 always a popular course, as was Dr. Post's fourth year elective 
 in syphilis. 
 
 In the summer of 1893-94, summer instruction in cutaneous 
 diseases was given for the first time at the Massachusetts General 
 Hospital by Dr. John T. Bowen, during July and August. Instruc- 
 tion in these summer courses was, and has remained, purely 
 clinical and informal in character, and has attracted a goodly 
 number of students. 
 
 In 1896 Dr. Greenough retired, and Dr. Post was appointed 
 instructor in syphilis. At this time Dr. Post gave the instruction 
 in syphilis to the fourth year. Dr. Bowen in this same year was 
 added to the Department as instructor in dermatology, assuming 
 the instruction of the fourth year elective, hitherto conducted by 
 Dr. White. 
 
 In 1898 Dr. Charles J. White was appointed Assistant in Der- 
 matology. A special course in the histology of the skin was added 
 
100 THE HAKVARD MEDICAL SCHOOL. 
 
 to the fourth year elective during this year, instruction being given 
 at the Medical School by Drs. Bowen and C. J. White during 
 some of the spring months. 
 
 In 1900-1 syphilis was merged with dermatology, the Depart- 
 ment of Dermatology and' Syphilis being created under the control of 
 the Professor of Dermatology. The instruction continued the same 
 as before, however. Dr. White giving his weekly didactic lecture 
 to the third year, illustrated the following morning by patients 
 at the hospital, while two clinical exercises a week, with an 
 optional course in histology, were offered in the fourth year elec- 
 tive by Drs. Bowen and C. J. White. Dr. Post at this time was 
 doing all the teaching in syphilis, offering to the fourth year 
 didactic and clinical lectures once a week during the first half year, 
 and clinical exercises in sections three times a week, also during 
 the first half year. 
 
 In 1902 Dr. James C. White resigned the professorship of Der- 
 matology, which he had held since 1871. Dr. White's services 
 to the Medical School were attested by a vote of the Corporation, 
 appointing him Professor of Dermatology Emeritus, because of 
 their appreciation of the value of his services to the Medical School 
 during more than thirty years of devotion to his work. The 
 School is to be congratulated on retaining the services of Dr. 
 White for so long a period. A pioneer in dermatology, he has 
 contributed more to the upbuilding of the speciality and to the 
 advancement of dermatological education than any individual in 
 the country. He was also wise in counsel in the Faculty room, 
 and a prominent factor in promoting the modern changes in the 
 medical curriculum. Dr. Bowen was promoted to be the head of 
 the Department of Dermatology and Syphilis, with the title of 
 Assistant Professor of Dermatology. Dr. C. J. White was ap- 
 pointed instructor in dermatology. The courses were not altered 
 during this year. Dr. Bowen giving the lectures and clinical 
 
THE DEPARTMENT OF DEEMATOLOGY. 101 
 
 exercises to the third class previously given by Dr. James C. White, 
 and Dr. C. J. White assuming the fourth year instruction in der- 
 matology. Dr. C. M. Smith was added to the Department as 
 Assistant in Syphilis, aiding Dr. Post in the section work of the 
 fourth year. 
 
 In the autumn of 1903, great facilities were added to the derma- 
 tological teaching by the opening of the new Out-patient Depart- 
 ment of the Massachusetts General Hospital, and of the ward for 
 skin diseases. The new Out-patient Department affords much 
 larger space and rooms for examination of patients and for class 
 work ; and on the same floor with the skin Out-patient Department 
 is an amphitheater with abundant north light and with seats 
 especially arranged so that patients may pass in front of each of 
 the students for examination. 
 
 The ward for skin diseases was the generous gift of Dr. Charles 
 G. Weld, and contains sixteen beds for skin diseases, in separate 
 single and double rooms. It has been possible in this way to show 
 to the class many examples of cutaneous disease that it would be 
 difificult or impossible to demonstrate otherwise, especially cases 
 confined to their beds, and the class of bullous diseases. 
 
 In 1904, in accordance with the general policy of the Faculty, 
 the third year course, that had remained the same since 1871, was 
 somewhat modified. The number of didactic lectures, hitherto 
 occurring once a week through the year and numbering thirty-two, 
 was reduced to eight, given during October and November. No 
 attempt, therefore, could be made to cover the whole domain of 
 dermatology, as had previously been done, but the eight lectures 
 were made to serve as an introduction to the subject, covering some 
 of the most important points. These lectures, as well as the 
 weekly clinic in an amphitheater of the Massachusetts General 
 Hospital, were given by Dr. Bowen, who carried on clinical instruc- 
 tion in small sections during February and March in addition. It 
 
102 THE HARVARD MEDICAL SCHOOL. 
 
 will be noted that this was the first appearance in dermatology of 
 the division of the large classes into smaller sections in which more 
 individual instruction could be given. This plan has proved advan- 
 tageous to the students, and will undoubtedly be adhered to. 
 Probably there is no other branch of medicine in which there is so 
 much opportunity for training the powers of direct observation as 
 in dermatology. 
 
 The year I905hd6 has seen further changes in the dermatological 
 instruction, because of the revision of the fourth year by which all 
 the subjects of this year have become elective, and are so arranged 
 that the student passes his whole morning, or day, in working in 
 one Department. A further force of assistants was rendered neces- 
 sary, and Drs. Harvey P. Towle and Frederick S. Burns, pre- 
 viously assistants in the Dermatological Department of the 
 Massachusetts General Hospital, were appointed Assistants in 
 Dermatology. 
 
 The present instruction given in the Dermatological Department 
 of the Harvard Medical School may be briefly described as follows : 
 In the third year, eight introductory didactic lectures, illustrated by 
 drawings, photographs, and models, are given during October and 
 November at the Medical School by Dr. Bowen. For the same 
 class, the weekly morning clinic throughout the year is held at the 
 Massachusetts General Hospital by Dr. Bowen in the upper amphi- 
 theater. A dozen to twenty selected cases are examined by the 
 instructor in the presence of the students, and later by the students 
 themselves. These cases are taken from the out-patient clinic, or 
 brought up from the ward for skin diseases. When it is desired to 
 illustrate some special subject, larger numbers of patients are 
 brought into requisition. In addition to this, the class is divided 
 into sections which meet at the Massachusetts General Hospital 
 twice a week during the second half year, under the clinical 
 instruction of Drs. Towle and Burns. The third year instruction in 
 
THE DEPARTMENT OF DERMATOLOGY. 103 
 
 syphilis is given by Drs. Post and Smith. Dr. Post offers eight 
 didactic lectures during December and January at the Medical 
 School. These are supplemented by clinical exercises in sections 
 twice a week during the second half year by Drs. Post and Smith. 
 
 The fourth year elective is under the special charge of Dr. C.J. 
 White, although the entire Department unites in the instruction. 
 The students are divided into squads, each squad spending every 
 morning for two months in the skin Out-patient Department and in 
 the ward for skin diseases, where they may act as house officers, 
 and where certain cases are assigned to them for study. There is 
 also instruction in the microscopical examination of cutaneous 
 lesions and pathological products. 
 
 There are two kinds of courses offered for graduates. One — in 
 which each course lasts for eight weeks — comprises twenty-four 
 exercises given on Mondays and Thursdays at the Massachusetts 
 General Hospital. The instruction is continuous from October to 
 June. A second and more elaborate one, which has proved 
 unexpectedly popular, offers three hours daily of work and instruc- 
 tion for two months in the Out-patient Department and skin ward 
 of the Massachusetts General Hospital, and is similar to the elective 
 fourth year course. 
 
 Summer courses are offered by members of the Department 
 during June, July, August, and September. Courses in derma- 
 tology are given at the Massachusetts General Hospital and in 
 syphilis at the Boston Dispensary. During the month of August a 
 course exclusively for women is offered by Dr. Burns. These 
 summer courses are similar in character to the elective fourth year 
 and to the advanced course for graduates. 
 
HENRY WILLARD WILLIAMS. 
 M.D. 1849; A.M. (hon.) 1868. 
 
 Lecturer on Ophthalmology, 1866-1871. 
 Professor of Ophthalmology, 1871-1891. 
 
THE DEPARTMENT OF OPHTHALMOLOGY. 
 1871. 
 
 The first attempt to give any special instruction in ophthal- 
 mology in the Harvard Medical School was in October, 1869, when 
 the Faculty nominated Dr. Henry W. Williams and Dr. Gustavus 
 Hay as University lecturers in ophthalmology, and during the 
 succeeding winter and spring a few lectures were delivered at the 
 Medical School by each of these gentlemen. The following year 
 Dr. Williams and Dr. Hasket Derby were appointed University 
 lecturers in ophthalmology, and their appointments were renewed 
 annually till 1871. During these years the lectures given were few 
 in number and treated of fragments only of the general subject, 
 and the audiences, never large, included but few of the medical 
 students. 
 
 In October, 1871, Dr. H. W. Williams was made Professor of 
 Ophthalmology, and the catalogue announced a complete course on 
 the diseases of the eye. Lectures were given once a week during 
 the school year at the Boston City Hospital, and clinical instruction 
 once a week for six months. But no examination was held in 
 ophthalmology, and attendance by the students was irregular and 
 scanty. This condition lasted till the school year of 1880-1881, 
 when the advisory fourth year was established. Then ophthal- 
 mology was made an elective for the fourth year students, with an 
 examination at the end of the year, and clinical instruction was 
 offered twice a week for six months. Few students, however, 
 continued in the School for the fourth year and fewer still elected 
 ophthalmology. In April, 1881, Dr. O. F. Wadsworth was 
 appointed clinical instructor in ophthalmology and the following 
 year a voluntary course in ophthalmology, twice a week for four 
 
 (los) 
 
106 THE HARVARD MEDICAL SCHOOL. 
 
 months, was added to the instruction already offered. This course 
 was attended by some half dozen students. 
 
 In 1888-1889 ophthalmology was made an elective for students 
 of the third class also, and was chosen by a small number. 
 
 In May, 1891, Dr. Williams resigned, and in June Dr. O. F. 
 Wadsworth was appointed professor. In October, 1891, Dr. F. E, 
 Cheney was made clinical instructor in ophthalmology. During 
 this year the instruction was almost entirely clinical. In May, 
 1892, Dr. Myles Standish was appointed assistant in ophthal- 
 mology. 
 
 For the three following years lectures were given at the Medical 
 School and clinical instruction at the Boston City Hospital, Massa- 
 chusetts General Hospital, and the Massachusetts Charitable Eye 
 and Ear Infirmary. An average of about six students chose 
 ophthalmology as an elective yearly. 
 
 With the fall of 1895 came a decided change. Up to this time 
 ophthalmology had been only an elective study. But now, with 
 the required fourth year established, it became a required study for 
 the fourth class, with an examination at the end of the first term, 
 while it could be taken as an elective for the second term. The 
 instruction in the required course during the first term consisted of 
 a lecture once a week — after a few years twice a week for the 
 first half of the term — and fourteen to sixteen clinical exercises, in 
 sections. The lecture course comprised a brief review of the 
 anatomy and physiology of the eye, the rudiments of refraction, 
 and such of the diseases of the eye and its appendages as could be 
 understood without practical knowledge of ophthalmology. The 
 clinical instruction was confined to the same range. The lectures 
 were given by the professor, the clinical exercises conducted by the 
 professor and assistants. The voluntary course in ophthalmology 
 was abandoned and Dr. Cheney's title was changed to assistant. 
 The elective course in the second term was given by the professor. 
 
THE DEPARTMENT OF OPHTHALMOLOGY. 107 
 
 six hours a week, and comprised more advanced instruction, includ- 
 ing oplithalmoscopy, and was mainly clinical. In 1903 half of the 
 elective course was given by Dr. Edmund W. Clap. 
 
 In 1900 the examination in the required course, hitherto wholly 
 written, was made partly clinical. The number of assistants was 
 gradually increased to five to enable the clinical instruction to be 
 given to smaller sections. In June, 1901, Dr. Cheney resigned, 
 and Dr. Standish was made instructor. In September, 1903, Dr. 
 Wadsworth resigned. The Department has since been conducted 
 by Dr. Myles Standish, who was appointed assistant professor in 
 1904. The amount and character of the instruction has been much 
 the same. 
 
 In the required course the lectures have been given by Dr. 
 Standish, the clinical instruction by the assistants. In the elective 
 course Dr. Standish and three of the assistants have each given 
 instruction for one month. 
 
 In October, 1904, there was a rearrangement of studies in the 
 third and fourth years ; required ophthalmology was placed in the 
 third year, the elective continuing in the fourth. 
 
GEORGE DERBY (H.C. 1838). 
 M.D. 1843- 
 
 Lecturer on Hygiene, 1867-1871. 
 Professor of Hygiene, 1871-1874- 
 
THE DEPARTMENT OF HYGIENE. 
 
 The first mention of hygiene in the catalogues of Harvard Uni- 
 versity occurs in that for the year 1869-70, in which, in the list 
 of "Lecturers in the University Course on Literature," appears 
 the name of George Derby, M.D., University lecturer on hygiene. 
 In the catalogue of the Medical Department of that year. Dr. 
 Derby does not appear as an instructor, and no mention is made 
 of instruction. In the following year Dr. Derby's name appeared 
 among the annual appointments in the Medical School as lecturer 
 on hygiene. The only information furnished as to instruction is 
 the following : " Lectures on hygiene, ophthalmology, laryngo- 
 scopy, otology, and the physiological action of drugs on man and 
 the lower animals." 
 
 In the year 1871-72 Dr. Derby began service as Professor of 
 Hygiene, and the catalogue of that year contained the following 
 statement concerning instruction : " Hygiene. — A course of lectures 
 on hygiene will be given." 
 
 In the following year the tense of the statement was changed : 
 " Hygiene. — A course of lectures on hygiene is given." In addi- 
 tion, a course of study for graduates was announced ; this to con- 
 sist of lectures in the second term, for a fee of five dollars. These 
 courses were continued until Dr. Derby's death, in 1874, the 
 lectures being given on Tuesdays and Wednesdays, after May first. 
 
 After one year, during which the subject was not taught, Dr. 
 Frank W. Draper was appointed lecturer, but the study was not 
 given a place in the tabular view. 
 
 In the following year, however, it reappeared, the course consist- 
 ing of lectures to the third year students, on Thursdays, after 
 April fifteenth. Although so short a course can hardly have been a 
 
 (109) 
 
110 THE HAKVAKD MEDICAL SCHOOL. 
 
 severe tax on the time or strength of one instructor, the catalogue 
 of the following year shows two lecturers on hygiene — Dr. Frank 
 W. Draper and Dr. Charles F. Folsom. There was no increase in 
 the amount of instruction, the lectures being given on Wednesdays, 
 after April fifteenth, and, as before, to the third year class. This 
 announcement was followed by Dr. Draper's transfer to the field of 
 forensic medicine, leaving Dr. Folsom in charge of hygiene. The 
 course was somewhat increased in extent, lectures being given to 
 the third year students on Tuesdays in January, and on Wednes- 
 days after April first. This arrangement lasted but one year, when 
 Dr. Folsom's title was changed to " Lecturer on hygiene and 
 mental diseases," and the course of instruction in hygiene was 
 shortened to eight lectures. 
 
 In the following year Dr. Folsom's title was changed once 
 more ; this time to " Lecturer on mental diseases." In the 
 catalogue of that year no teacher of hygiene appears among the 
 list of those giving instruction, but the tabular view for the third 
 class includes lectures on hygiene, to be given on Tuesdays in 
 January, although in another place it is stated that the " course in 
 hygiene consists of eight lectures ; " but the name of the instructor 
 is not given. In the next catalogue, although the subject is men- 
 tioned as being a part of both the three and four years' courses, it 
 is not to be found under "Methods of Instruction," nor in the 
 tabular view, nor under "Special Pathology and Therapeutics." 
 
 From this time until the appointment of Dr. Samuel H. Durgin 
 as lecturer in hygiene, in 1882-83, no instruction was attempted. 
 In the year mentioned Dr. Durgin offered a voluntary course of 
 sixteen lectures and demonstrations to the first year students. 
 
 In the year 1885-86 the instruction was increased in amount. 
 Dr. Charles Harrington was appointed instructor in hygiene, lectur- 
 ing once a week to the first class, while Dr. Durgin transferred his 
 instruction to the fourth year men, to whom were given, during 
 
THE DEPARTMENT OF HYGIENE. Ill 
 
 the months of February and March, sixteen lectures in the applica- 
 tion of hygiene to practical municipal sanitation. These voluntary 
 courses were supplemented in the year 1886-87 by a laboratory 
 course to graduates, and in 1894-95 by an elective laboratory 
 course for fourth year students, both courses being given by Dr. 
 Harrington. 
 
 In 1897-98 hygiene became for the first time in the history of 
 the Medical School a required study, and was given by Dr. Har- 
 rington to the fourth class during the second half-year. At the 
 same time the students had the benefit of Dr. Durgin's long practi- 
 cal experience in municipal work, his lectures being continued, as 
 previously, as a voluntary course. In the following year Dr. 
 Harrington was promoted to be assistant Professor of Hygiene, and 
 at the same time an anonymous friend contributed a sum of money 
 sufficient for equipping the laboratory of hygiene with suitable 
 desks and apparatus. 
 
 The new scheme of instruction in the Medical School, so far as 
 it aifected the course in hygiene, went into effect in the year 
 1903-04, when by reason of a transfer of the study to the schedule 
 of the second year, a double course of lectures was required — one 
 to the second class and one to the fourth class, since the latter had 
 had no opportunity for instruction in the subject. It was necessary 
 to repeat the double course for the same reason in the year 1904- 
 05. In 1905-06 the instruction took its normal course and was 
 given only to the second class, with the exception that especially 
 qualified students were permitted to elect the laboratory course 
 offered to fourth year students. In March, 1906, the professorship 
 of Hygiene was revived, and Dr. Harrington was chosen to fill that 
 chair. 
 
The Building on boylston Street, boston. 
 
 Showing the Sears' addition, 1890. 
 1883-1906. 
 
THE DEPARTMENT OF HISTOLOGY AND 
 EMBRYOLOGY. 
 
 1887. 
 
 The development of this Department is very recent. The germ 
 of it is found in the instruction in anatomy as formerly given, and 
 Dr. Oliver Wendell Holmes, who retired from the School in 1882, 
 was accustomed to give more or less attention to histology and 
 embryology in his lectures and demonstrations. He contrived a 
 wooden frame to hold a microscope tube and a kerosene lamp for 
 illumination, thus making an apparatus which could be passed 
 around the class during the lecture, giving the students at least 
 some view of microscopical structures. This apparatus served a 
 useful purpose for many years, for Dr. Holmes considered the 
 teaching of histology an important part of his course, and questions 
 upon microscopic anatomy were not infrequently included in his 
 examination papers. 
 
 The microscope, however, made but little headway as a scientific 
 instrument in America, as compared with Europe. Its use in 
 medical science was introduced by the young physicians who went 
 abroad to study after the termination of our Civil War, most of 
 whom returned with an appreciation of the value of the instrument 
 to the physician. Under the influence of Dr. Calvin Ellis the use 
 of the microscope by students was stimulated in this School, 
 especially in connection with pathological work, and Dr. R. H. 
 Fitz contributed very much to put the new laboratory work on a 
 satisfactory basis. He was in charge of the laboratory until 1874 
 and gave instruction in both normal and pathological histology. In 
 the meantime the growing need for laboratories resulted in exten- 
 sive alterations in the attic of the old North Grove street building. 
 These alterations included a microscope room. When, in 1873, 
 
 (113) 
 
114 THE HARVARD MEDICAL SCHOOL. 
 
 Dr. Fitz became Assistant Professor of Pathological Anatomy, Dr. 
 Thomas Dwight was appointed instructor in histology. This step, 
 which placed the teaching of histology in charge of its own 
 instructor, may be considered the first toward the establishment of 
 a new department. Dr. Dwight remained instructor in histology 
 for nine years, and introduced actual practical work. His exercises 
 consisted of a short lecture in the laboratory, after which prepared 
 material was given out, from which the students cut and made 
 their own specimens. During a part of this time Dr. Dwight gave 
 also a short course on embryology, which was, however, entirely 
 didactic and diagrammatic. After the resignation of Dr. Holmes in 
 December, 1882, Dr. Dwight took up his work and became Pro- 
 fessor of Anatomy at Commencement, 1883. In 1880, before the 
 resignation of Dr. Holmes, Dr. Charles Sedgwick Minot was 
 appointed lecturer in embryology. After Dr. Dwight's assump- 
 tion of the work in anatomy a distinct course in histology and 
 embryology was established as voluntary work when the then new 
 building on Boylston street was occupied. This voluntary work 
 was placed in charge of Dr. Minot and Dr. Henry P. Quincy, who 
 had already been in charge of laboratory exercises in histology, and 
 at this time received an appointment as instructor. In the new 
 School building no distinct place for normal histology and embry- 
 ology had been provided, an omission upon which Dr. Holmes com- 
 mented in his address at the dedication of the new building. This 
 difficulty was not overcome until ten years later, when the addition 
 was made to the building by the gift of Dr. Sears. This addi- 
 tion took in the Departments of Pathology and Bacteriology and 
 left the old laboratory for the use of histology and embryology. 
 With this change the Department of Histology and Embryology 
 may be said to have been definitely recognized and established. 
 Dr. Minot became assistant professor in 1887, and professor in 
 1892 ; thus, at last, the Department became wholly independent. 
 
THE DEPABTMENT OF HISTOLOGY AND EMBRYOLOGY. 115 
 
 When the new building was opened the equipment of the Depart- 
 ment of Histology consisted of eighteen Hartnack microscopes and 
 very little else. There were no instructors and no assistants. An 
 annual appropriation of fifty dollars supported the Department. 
 
 From these modest beginnings the Department has steadily grown 
 and now has a considerable library, some two hundred and fifty 
 microscopes, a considerable variety of microtomes and other appar- 
 atus, and an important and very extensive collection of embryo- 
 logical preparations. The embryological collection is thought not to 
 be surpassed anywhere in the world. 
 
 The aim of the teaching in the Department has always been to 
 train the students in exact observation and reasoning, to make 
 them as expert as possible in the use of the microscope, to 
 accustom them to rely upon preparations rather than upon the 
 text-book as a source of information, and also to meet practical 
 requirements of medical education, providing for the students 
 that acquaintance with the microscopic structure of the body and 
 with the laws of development which is most likely to be of 
 value to them in their subsequent studies. In addition to this 
 the Department has steadily striven to promote scientific research, 
 and to contribute something toward the increase of scientific 
 knowledge. The list of scientific books and papers published 
 by the officers of the laboratory is now a long one. 
 
 By the recent rearrangement of studies in the first two years of 
 the School the time given to the work of this Department has 
 been much lengthened. Half of each day during October, Novem- 
 ber, and December is devoted to the subject, and about ten half- 
 days during January. A very close alliance between the work of 
 gross anatomy and minute anatomy has been established through 
 the direct, cordial, and highly-valued co-operation of Dr. Thomas 
 Dwight. This alliance has resulted in a marked improvement 
 in the laboratory work, and in great advantage to the students. 
 
116 THE HABVAED MEDICAL SCHOOL. 
 
 Lectures are given daily during October, and twice a week during 
 the rest of the half-year. The remainder of the time is devoted 
 to the laboratory work, which is considered of more value than 
 purely didactic teaching. It has not been found practicable to give 
 much training in the technic of section cutting, owing to the 
 insufficient quarters of the laboratory, and its very crowded condi- 
 tion when occupied by a large class. When the new buildings are 
 occupied the extent of the practical work in the laboratory will be 
 greatly increased, and every student will be thoroughly disciplined 
 in the making of preparations for himself, so that he will be ren- 
 dered, to some extent at least> capable of independent work. At 
 present, on the contrary, most of the specimens are given out cut 
 and stained, to be mounted by the students, and preserved for 
 their future use. Such specimens as are too rare to be thus used, 
 and are too difficult to be prepared each year, are loaned all 
 mounted to the student. While the method of work is scientific 
 it is the effort of the Department to choose, so far as possible, 
 human material, and to pay especial attention to such parts of the 
 subject as shall be of the greatest value to the men in their subse- 
 quent practice. The men make careful drawings, and their labors 
 are followed and criticised by the assistants. The drawing is 
 found to be of the greatest benefit and is regarded as an absolutely 
 indispensable factor in successful teaching. Weekly recitations are 
 held. Examinations are wholly practical, and consist of the exam- 
 ination and identification of specimens, upon which questions are to 
 be answered in writing or by drawings. One month of the work 
 is occupied by embryology. For students and others who wish to 
 pursue the subject further there are advanced elective courses for 
 the fourth year. 
 
THE DEPARTMENT OF LARYNGOLOGY. 
 1888. 
 
 Laryngoscopy, independently of the slight notice which it had 
 received in the courses in medicine, was first taught as a special 
 subject in 1866, when Dr. H. K. Oliver, one of the visiting 
 physicians of the Massachusetts General Hospital, was made Uni- 
 versity lecturer in laryngoscopy. The lectures, supplemented by 
 demonstrations of instruments and apparatus, were held in the 
 Medical School building on North Grove street. 
 
 Dr. Oliver was lecturer in laryngoscopy until 1873 with the 
 exception of 1870-71, for which year Dr. F. I. Knight was 
 appointed. Instruction was not confined to lectures, as is seen 
 from the announcement under clinical medicine that this includes a 
 regular course of supplementary instruction in auscultation and 
 percussion and in laryngoscopy, giving a thoroughly practical 
 knowledge of these methods of exploration. 
 
 In 1872, while in Europe, Dr. Knight was made instructor in 
 percussion, auscultation and laryngoscopy and, by the advice of 
 Dr. Calvin Ellis, made preparations for establishing a special clinic 
 for diseases of the throat and nose at the Massachusetts General 
 Hospital on his return. This clinic, the first in New England to 
 include laryngoscopy, was opened by Dr. Knight on his return in 
 1872 in a small room in the amphitheater building at the hospital. 
 In common with this clinic a course in laryngoscopy was given, 
 beginning in 1873-74 in the first half year, to the second class. 
 Instruction was largely confined to the methods of examination with 
 "the laryngoscope and rhinoscope and nasal speculum, and diseased 
 conditions received attention only incidentally. The class was 
 divided into sections, and each section had exercises daily for two 
 weeks, but there was no examination required. 
 
 ("7) 
 
118 THE HAEVAED MEDICAL SCHOOL. 
 
 The next year, and in subsequent years, a graduate course was 
 offered which was at first given at eight o'clock in the morning. 
 Examination of patients was made by the aid of the oxyhydrogen 
 light. In 1879 percussion and auscultation were separated from 
 laryngoscopy, and Dr. Knight's title became instructor in laryngo- 
 scopy. With the establishment of the voluntary fourth year in 
 1880 a course in laryngology was given to the fourth year class by 
 Dr. Knight. This course at first consisted of three exercises a 
 week for two months. The instruction was both clinical and 
 systematic, and was followed by a written examination. In 1882 
 Dr. Knight was made assistant Professor of Laryngology, but there 
 was no immediate change in the courses. With the opening of the 
 new out-patient building the accommodation for the clinic and for 
 instruction was much improved. 
 
 In 1888 Dr. Knight became clinical professor, and Dr. F. H. 
 Hooper instructor in laryngology. Instruction to the second class 
 consisted, as before, principally in practice in methods of examina- 
 tion. In the fourth class different diseases were shown, the 
 students were drilled in the diagnosis and treatment of patients, 
 and the whole subject was taught by lectures and demonstrations, 
 followed by a written examination at the end of the year. 
 
 In 1892 Dr. Knight resigned and instruction in laryngology 
 devolved upon Dr. Hooper. The same year Dr. Hooper died. 
 These were serious losses to instruction in the School. Dr. Hooper 
 had done much original work, especially in connection with the 
 physiology of the larynx ; he had introduced into this community 
 the operation for the removal of adenoids under general anesthesia ; 
 he had made and modified several instruments, some of which are 
 still in daily use ; he kept himself constantly informed of every- 
 thing of importance in the subject, and he applied that information 
 in the most practical and often ingenious manner to make his 
 teaching clear, accurate, and thorough. 
 
THE DEPARTMENT OF LARY5fGOLOGY. 119 
 
 After Dr. Hooper's death instruction in laryngology was again 
 put under the Department of Clinical Medicine. Drs. T. A. De 
 Blois, J. W. Farlow, and A. Coolidge, Jr., were appointed clinical 
 instructors in laryngology and the work divided between the City 
 Hospital, Boston Dispensary, and Massachusetts General Hospital. 
 For two years the sections of the second class were held at the two 
 former institutions and the course of the voluntary fourth class at 
 the latter. In 1895, with the establishment of the required four 
 years course, the second year sections were given up and in their 
 place the subject was made compulsory and given in the first half 
 of the fourth year. The class was divided into three sections, 
 each section being allotted to one of the three clinics, where they 
 were again sub-divided, so that each student received twelve hours 
 of clinical instruction, in a small section of five to ten. In addition 
 to this clinical instruction, the whole fourth class had one lecture a 
 week or sixteen in the half year, which lectures were given by the 
 three instructors in rotation year by year. The second half year 
 was used for graduate instruction only. This system continued 
 until 1905, when the compulsory course was moved back to the 
 second half of the third year and an elective established in the first 
 half of the fourth year. At the same time Drs. F. C. Cobb, 
 R. A. Coiifin, H. P. Mosher, and G. L. Vogel were made assistants. 
 
THE DEPARTMENT OF GYNECOLOGY. 
 (888. 
 
 Prior to the re-organization of tiie Medical School in 1871 no 
 special Instruction was given in the subject of diseases of women. 
 The Professor of Obstetrics made some incidental reference to 
 pelvic disease as related to his special subject ; the general surgeon 
 gave some casual instruction in the few gynecological operations 
 then performed, and professors of medicine dealt with symptoms 
 believed to proceed from the diseases of women as then under- 
 stood. But the pathology of the female pelvic organs was not yet 
 written, and the science of gynecology did not then exist. The 
 pioneers in this new field of research, both in this country and in 
 Europe, were few, and the literature meager. 
 
 In 1871 Dr. Francis Minot was appointed assistant Professor of 
 the Theory and Practice of Physic and clinical lecturer on the 
 diseases of women and children. In 1872 lectures on the diseases 
 of women and children were announced in the catalogue, and in 
 the following year recitations ; but no text-book was recommended, 
 and the instruction was devoted chiefly to the diseases of children. 
 Dr. Minot's appointment in this special field ceased after three 
 years. 
 
 In 1873 Dr. James Read Chadwick was appointed lecturer on 
 diseases of women — the first appointment limited to that one 
 subject. One lecture a week was given during the second term, 
 and a course of instruction in gynecology was offered to graduates 
 — the word "gynecology" thus appearing in the catalogue for 
 the first time. Outside the general wards of the hospitals there 
 as yet existed no facilities in Boston for the clinical teaching of 
 diseases of women ; but in the autumn of 1873 Dr. Chadwick 
 established on Staniford street the first dispensary in Boston for 
 
 (121) 
 
122 THE HARVARD MEDICAL SCHOOL. 
 
 the treatment of this class of cases ; and here he taught officially, 
 and unofficially, for many years. In 1874 Dr. Chadwick was 
 appointed one of the physicians to the newly-established Out- 
 patient Department for Diseases of Women at the Boston City 
 Hospital, and was thus enabled to increase his clinical teaching. 
 In this year also recitations were added to the instruction in this 
 Department. In 1875 Dr. Chadwick's title was changed from 
 lecturer to clinical instructor, and Dr. William Henry Baker was 
 appointed, with a similar title. Dr. Chadwick resigned in 1876, 
 but was re-appointed in 1881 and taught for six years. 
 
 In 1877 Dr. Baker was appointed instructor in gynecology 
 without limit of time, and thus became a member of the Faculty. 
 For the next four years Dr. Baker was the only teacher in the 
 Department, but considerable progress was made from year to 
 year in the development of clinical instruction. In his service at 
 the Boston Dispensary in the general medical room for women 
 Dr. Baker was able to obtain a limited amount of out-patient 
 material ; and at the Free Hospital for Women, which he had 
 established in 1875, students were afforded their first opportunities 
 in Boston for instruction in operative gynecology. 
 
 The academic year 1881-82, the year after the establishment 
 of a voluntary fourth year in the Medical School, showed a marked 
 advance in the development of this Department. Dr. Chadwick 
 resumed his position as clinical instructor, and Dr. Francis Henry 
 Davenport was appointed assistant in gynecology. For the first 
 time a text-book and books for collateral reading were recom- 
 mended in the catalogue, and the general plan of instruction was 
 announced. 
 
 Under this plan one lecture a week was given to the third and 
 fourth classes. To the third class clinical instruction was given in 
 small sections at the Boston Dispensary or at the Free Hospital for 
 Women. In the fourth year there were twelve introductory 
 
THE DEPARTMENT OF GYNECOLOGY. 123 
 
 lectures by Dr. Chadwick, with clinical instruction to small sections 
 at the Staniford street Dispensary and Free Hospital for Women ; 
 and a clinical conference was also held once a week by Dr. Baker. 
 The clinical facilities available for teaching were greatly increased 
 in 1881 by the establishment at the Boston Dispensary, through 
 the efforts of Dr. Baker and his associates, of a Department for 
 Diseases of Women. In 1882 Dr. Baker was promoted to the rank 
 of assistant professor. 
 
 The instruction in gynecology remained essentially unchanged 
 until 1886, when the amount of clinical teaching offered to fourth 
 year students was considerably increased. Dr. Baker gave one 
 clinic a week for eight months ; Dr. Chadwick, three clinics a week 
 for eight months ; and Dr. Davenport, two clinics a week for four 
 months. Moreover, Dr. George Hinckley Lyman and Dr. Orlando 
 Witherspoon Doe each gave a clinic a week for three and five 
 months respectively in the wards of the Boston City Hospital ; and 
 Dr. John Baker Swift, two clinics a week for four months at the 
 Boston Dispensary. Drs. Lyman, Doe, and Swift were not 
 appointed teachers by the University, but taught unofificially by 
 invitation of the Faculty. A course in operative gynecology on the 
 cadaver was also announced by Drs. Baker and Davenport, in 
 which each fourth year student was " expected to perform the 
 ordinary operations with his own hands." The following year Dr. 
 Chadwick gave up teaching in the School, and Drs. Charles Pratt 
 Strong and John Wheelock Elliot were added to the unofficial 
 teachers. 
 
 In 1888 Dr. Baker received his full professorship. Dr. Strong was 
 appointed assistant, and Drs. Doe and Elliot clinical instructors. 
 Dr. Lyman's clinics were discontinued ; but Dr. Swift continued to 
 teach unofficially. This year gynecology was made elective in 
 both the third and fourth years, with a two-hour examination. The 
 following year Dr. Davenport published a text-book on Diseases of 
 
124 THE HARVARD MEDICAL SCHOOL. 
 
 Women, which was added to the books recommended for collateral 
 reading ; and a course in operative gynecology on the cadaver was 
 offered to graduates, provided a sufficient number applied. In 1890 
 Dr. Davenport was promoted to be instructor. Dr. Elliot was 
 transferred to the Department of Surgery, and Dr. Swift was made 
 clinical instructor. Dr. Doe gave up his clinical teaching in 1891. 
 
 On the establishment of a compulsory four years' course in 
 1892, gynecology was made a required study in the third year, 
 with a one hour examination. This subject remained elective in 
 the fourth year, with a two hour examination ; and if a third year 
 student elected gynecology for his fourth year, he was not required 
 to take the third year examination. Dr. Strong died in 1893, after 
 a brief illness, from an infection received while operating, and the 
 Department lost thereby a brilliant surgeon and a good teacher. 
 Dr. Swift was appointed assistant in his place, and Drs. George 
 Hamlin Washburn and Walter Lincoln Burrage were made clinical 
 instructors. 
 
 Professor Baker resigned in February, 1895, ^fter a service of 
 twenty years. By vote of the Faculty the Department of 
 Gynecology was thereupon placed under the direction of the 
 Professor of Obstetrics, and was re-organized as follows: Dr. 
 Davenport was appointed assistant professor ; Dr. George Haven, 
 then assistant in obstetrics, was made also instructor in gynecology; 
 Dr. Edward Reynolds, then instructor in obstetrics, was appointed 
 also assistant in gynecology ; and Dr. Swift continued as assistant. 
 To Dr. Charles Montraville Green, assistant Professor of Obstet- 
 rics, was assigned the clinical teaching of the fourth year. 
 
 In the third year a lecture or recitation was given by assistant 
 Professor Davenport twice a week during the first half year, and 
 clinics were held six times a week until April, and thereafter three 
 times a week by Drs. Swift and Haven at the Boston Dispensary 
 and by Drs. Haven and Reynolds at the Boston City Hospital. 
 
THE DEPARTMENT OF GYNECOLOGY. 125 
 
 The fourth year instruction consisted of clinical and operative 
 exercises in the gynecological wards of the City Hospital twice a 
 week throughout the year by assistant Professor Green, and a 
 clinical conference once a week from December to May, also given 
 by Dr. Green. A written examination of one hour was again 
 required in the third year, and of two hours in the fourth year. 
 A number of courses for graduates were offered by the members of 
 the Department. 
 
 In 1899 Dr. Swift resigned after a faithful service, official and 
 unofificial, of thirteen years. Dr. Malcolm Storer was appointed in 
 his place, and thus the School was able to retain a daily clinic for 
 six months at the Boston Dispensary in addition to the tri-weekly 
 clinics in the Out-patient Department of the Boston City Hospital 
 throughout the year. In this year also the reconstruction was com- 
 pleted at the City Hospital of the accommodations for the Gyne- 
 cological Department, providing a service of sixty beds with modern 
 operating rooms and equipment. Opportunity was thus afforded 
 fourth year students and graduates to pursue a comprehensive 
 study of gynecology, from the simpler lesions requiring only minor 
 local treatment, or the various plastic operations, to the major cases 
 treated by capital surgery, and to observe convalescence and post- 
 operative treatment, and the treatment of inoperable cases. 
 
 With the close of the academic year igocnoi Dr. Reynolds 
 retired from the teaching corps, and soon after resigned his posi- 
 tions in the Boston City Hospital and Boston Lying-in Hospital. 
 He had taught obstetrics, as assistant and instructor, for fifteen 
 years, and the past six years had served also as assistant in gyne- 
 cology. To fill the vacancy thus caused Dr. Frank Albert Higgins, 
 who had served as assistant in obstetrics since 1897, was promoted 
 to the instructorship in obstetrics and was appointed assistant in 
 gynecology. In this latter position Dr. Higgins taught but one 
 year, however, owing to a change in his hospital service ; and in 
 
126 THE HARVARD MEDICAL SCHOOL. 
 
 1903 he resigned his hospital appointments and retired from the 
 School. Dr. Franklin Spilman Newell, who had served as assistant 
 in obstetrics since 1897 was, in 1901, appointed also assistant in 
 gynecology, and the following year Dr. Ernest Boyen Young, then 
 serving as assistant in anatomy, was also made assistant in gyne- 
 cology. On the retirement of Dr. Higgins, Dr. Newell was 
 appointed instructor in obstetrics in addition to his duties as 
 assistant in gynecology. 
 
 On September twenty -seventh, 1903, occurred the lamented 
 death of Dr. George Haven, who had served the School as assistant 
 in obstetrics from 1894 to 1897, and as instructor in gynecology 
 since 1895. He was a skilful surgeon and a painstaking teacher, 
 and by his early death the School sustained a great loss. 
 
 With the close of the academic year 1904-05 Assistant Professor 
 Davenport, who had resigned his active hospital work several years 
 previously, retired from the School. He had served as assistant, 
 instructor, and assistant professor for twenty-four years. He had 
 loyally supported Professor Baker in the establishment of this new 
 Department, and during his last ten years in the School had given 
 the didactic instruction of the third year. He was a careful and 
 conservative teacher, and his influence on his classes impressed 
 them with the dignity and worth of his field of professional work. 
 
 In 1904 Assistant Professor Green, who had taught obstetrics 
 and diseases of women, officially and unofficially, since 1880, was 
 made Associate Professor of Obstetrics and Clinical Gynecology. 
 Since the retirement of Dr. Davenport the following year the 
 instruction has remained essentially unchanged in the third year — 
 lectures and recitations, twice a week during the second term, are 
 conducted by Professor Green ; and clinical exercises are held by 
 Dr. Storer at the Boston Dispensary, and by Dr. Young at the 
 City Hospital, each student receiving six hours of instruction. A 
 written examination of one hour is required, as before. The work 
 
THE DEPAKTMENT OF GYNECOLOGT. 127 
 
 of the fourth year, however, was materially enlarged and broadened 
 on the adoption, in 1905, of the new curriculum, under which the 
 year is devoted entirely to elective courses. The instruction in 
 gynecology is offered in half courses, occupying the morning hours 
 daily for two months, and the teaching continues throughout the 
 year. The time of the student is apportioned between the wards 
 and out-patient clinic of the Gynecological Department of the 
 Boston City Hospital. In the wards he follows the work of the 
 clinic, witnesses operations, makes ward visits, observes convales- 
 cence and post-operative treatment, and each student is given some 
 opportunity to administer ether and assist in the clinical work. In 
 the Out-patient Department he assists in the work of the clinic, 
 and has practice in history taking, in making diagnoses, and in 
 giving minor treatment. Each student is also required to examine 
 and report on pathological specimens, and to write a thesis on some 
 approved subject of his choice. No stated written examination is 
 required ; but the marks are based on the student's thesis, written 
 reports of cases and pathological examinations, and on the character 
 of his clinical work. 
 
 Professor Green has general charge of the fourth year course, 
 and is assisted by his colleagues on the staff, Drs. Newell and 
 Young, assistants in gynecology. Dr. Leo Victor Friedman, assistant 
 in obstetrics, and Dr. Nathaniel Robert Mason, who teaches unof- 
 ficially. Professor Mallory and his associates co-operate with the 
 gynecological staff by supervising the pathological work done by 
 students in these courses. Under the vote of the Faculty, passed 
 in May, 1895, the Department of Gynecology remains under the 
 direction of the Professor of Obstetrics, Dr. William Lambert 
 Richardson. 
 
THE DEPARTMENT OF OTOLOGY. 
 1888. 
 
 Beginning witbi a lectureship on diseases of the ear in 1869, and 
 a lectureship on otology in 1870, the history of the Department of 
 Otology of the Harvard Medical School covers a large part of the 
 term of years of the existence of its subject as a recognized line of 
 special medical research, and a recognized branch of the practice of 
 medicine. 
 
 Its establishment was the fruit of work done abroad where aural 
 clinics had already been formed and where the facilities for study 
 thereby afforded were beginning to attract American students ; the 
 Anatomical Departments of the German Universities, that of Hyrtl 
 in Vienna and of Ruedinger in Munich, for instance, giving, in 
 addition, exceptional advantages in their wealth of material, and 
 the character of their instruction, for the study of the complicated 
 structure of the temporal bone and the results of disease processes 
 within it. 
 
 The beginning of teaching in the new Department, on the part 
 of the two incumbents of what, in 1875, became an instructorship, 
 was a direct transplantation of German methods of instruction, so 
 far as clinical teaching was concerned. The paucity of anatomical 
 and pathological material, the limited time allotted to the new 
 study, and the demand for the practical equipment of its students 
 as general practitioners, limited its work mainly to lectures and to 
 clinical training in diagnosis and, to a moderate extent, in treatment 
 of diseases of the ear. 
 
 The eagerness of the students to learn something of what was 
 practically a new field, and the rapid growth in the amount of 
 clinical material, when its existence had become recognized by the 
 creation of aural clinics, made out-patient clinical teaching a line 
 
 (129) 
 
130 THE HARVARD MEDICAL SCHOOL. 
 
 of least resistance. This was hampered by the short time 
 allottable to each student under conditions which are such as to 
 make the teaching, with the exception of its didactic portion, of 
 necessity individual, and by the fact that, with only an Out- 
 patient Department at command, it was impossible to follow the 
 more serious cases when they ceased to be ambulant patients. 
 
 One of the lecturers held the position of aural surgeon to out- 
 patients in the Boston City Hospital, and the other the newly 
 created aural surgeonship in the Massachusetts Charitable Eye and 
 Ear Infirmary. Both positions entailed the difficulties incident to 
 a new departure, but these difficulties were gradually overcome, an 
 efficient aid, so far as clinical material was concerned, being the 
 public recognition of the importance of the new special clinics. 
 
 The course of instruction consisted of lectures, twelve or more in 
 number, given at the Medical School, in which both instructors 
 participated, and of clinical teaching to the class in sections, varying 
 from eight to twelve in the number of their participants, the sec- 
 tions being equally divided between the two aural clinics men- 
 tioned. Graduate instruction was only occasional, and was either 
 extended to individual applicants, as a matter of courtesy, or given 
 to small private classes. 
 
 These methods of instruction continued, virtually unchanged, 
 except for their enlargement, in the time allotted for clinical 
 instruction and the increase in the number of the lectures, until 
 after the creation of two professorships, one of Otology and 
 the other of clinical Otology in 1888, the incumbents being the 
 two instructors. 
 
 By this time the work of the Department in clinical teaching 
 had come to be facilitated by provision made, in both the City Hos- 
 pital and the Eye and Ear Infirmary, for the admission of aural 
 out-patients to the wards, under the care or supervision of the 
 aural surgeons to out-patients. The opportunity was thus afforded 
 
THE DEPARTMENT OE OTOLOGY. 131 
 
 to demonstrate the more serious aural operations, but it was not 
 until the new building of the Eye and Ear Infirmary was opened 
 that a full and justifiable provision for cases of this class was made ; 
 thirty beds, with a further number available for emergency cases, 
 being placed at the disposal of the aural out-patient clinic. With 
 so good an opportunity for the consecutive study of material and 
 with a sentiment on the part of the board of managers of the 
 infirmary expressed, in a previous vote, favoring the use of the 
 clinics and wards for the purposes of instruction in the Harvard 
 Medical School, it seemed advisable to concentrate the clinical 
 teaching. The City Hospital clinic was abandoned for that pur- 
 pose, and its ophthalmic surgeon became a member of the infir- 
 mary staff. 
 
 The division of the instruction, both didactic and clinical, 
 remained unaltered by this change, the examination papers were 
 prepared jointly and the examination books marked individually 
 and then reported, upon the basis of the averages of the markings. 
 
 The increase in clinical work incident to the holding of the hos- 
 pital position, which supplied the clinical teaching material, rather 
 than the increase in the teaching work itself, soon demanded the 
 appointment of an assistant in otology, made in 1893, and held 
 until 1896. Other appointments under the same title were made 
 in 1895, 1896, and two in 1904, these appointments not only 
 increasing the value and efficiency of the clinical teaching, but also 
 making it possible to add a course of instruction on the minute 
 anatomy of the temporal bone, with boxes of bones for home 
 study. 
 
 In 1904 the incumbent of the clinical professorship of Otology 
 resigned, and the teaching staff of the Department now consists of 
 a Professor of Otology with four assistants in otology, the senior of 
 these having recently been raised to the grade of instructor. 
 
 While the creation of the fourth year elective course in the 
 
132 THE HABVAED MEDICAL SCHOOL. 
 
 Harvard Medical School at present lightens the work in this Depart- 
 ment, on account of the preferential election of more fundamental 
 courses, the time thus rendered available can be occupied in grad- 
 uate instruction for which the Department is well equipped, both in 
 its collected anatomical and pathological material, in the clinics at 
 its command, and in the training of its assistants, and a further 
 field of usefulness might be found for it in cross-relationships, in 
 instruction, with other Departments. 
 
THE DEPARTMENT OF BACTERIOLOGY. 
 I89I. 
 
 Instruction in this Department was first given in the fall of 1885, 
 and consisted of six lectures to the second year class. They were 
 delivered by Dr. H. C. Ernst, who was appointed demonstrator of 
 bacteriology in that year. They were complementary to the 
 course in pathological anatomy, then conducted by Professor R. H. 
 Fitz. From the beginning, however — and before it was repre- 
 sented in the Faculty — the Department has been independent and 
 left to its own resources. It is believed that these lectures in 1885 
 were the first in this country in the subject — given as a part of 
 a medical course by a special teacher. 
 
 The beginning of laboratory teaching was not extensive and took 
 place in an unoccupied small room of the School building on 
 Boylston street. No provision was made for practical teaching to 
 any but special students, but the number of these increased as 
 rapidly as space could be provided for them, and in the following 
 year a larger room was assigned to the work in addition to that 
 already in use. In 1889 Dr. Ernst was promoted to be instructor, 
 in 1 89 1 to be assistant professor, and in 1895 to be Professor of 
 Bacteriology. During this time the amount of instruction offered 
 had been continuously increased by lectures, laboratory instruction 
 to the whole class, electives, courses for graduates, and oppor- 
 tunities for research. In every form of instruction the problem of 
 methods was one to be worked out independently, for there was at 
 the time nothing to compare with elsewhere. 
 
 At first the lectures were placed in the beginning of the second 
 year. When the course was lengthened (in 1888) and required 
 laboratory work was added, the time assigned was in the second 
 term of the first year. When the " intensive " method was 
 
 (133) 
 
134 THE HAEVAED MEDICAL SCHOOL. 
 
 introduced — controlling the first two years of study — required 
 bacteriological instruction was moved back to the first term of the 
 second year, where it still remains. The courses now existing in 
 this Department correspond closely to those offered in others of the 
 School. The required course is intended to give every student a 
 reasonable familiarity with the principles governing the action of 
 pathogenic micro-organisms, a practical knowledge of the simpler 
 forms of manipulation, and especially to train him, so far as possi- 
 ble, in all methods that may be of practical value in clinical work. 
 
 There are electives offered to fourth year students covering, in 
 time and scope, the desires of as many as possible. A student 
 wishing to take one of the electives may choose from those so 
 short that only a single point can be covered, through a series of 
 varying length up to one that will occupy his active time for an 
 academic year, and in which a special line of research may be carried 
 on. Courses are offered to graduates (in medicine) and special 
 students, 'and are adapted to suit their special needs — whether 
 beginners or persons qualified to work alone. These courses have 
 for a long time been accepted in the division of biology of the 
 Faculty of Arts and Sciences as leading to other degrees than 
 that of the doctorate of medicine. 
 
 Opportunities for research are open to qualified persons at any 
 and all times, and every facility within the resources of the Depart- 
 ment is procured as the need arises. Summer courses have always 
 been given — at first by the head and later by the assistants. 
 These also are intended to cover the special needs of those wishing 
 to take them, although it has been found best to offer one among 
 them that is specially designed for beginners. In addition to the 
 duties of instruction the Department has always concerned itself 
 with research work and the practical application of the results of 
 research. Research work of importance has been carried on by 
 members of its staff or special workers in many directions — 
 
THE DEPARTMENT OF BACTERIOLOGY. 135 
 
 notably tuberculosis, rabies, glanders, smallpox, diphtheria, typhoid 
 fever, and various suppurations and septicemias. The money to 
 support any research whatever it has always been necessary to 
 secure from outside sources, for the finances of the School have not 
 permitted a reliance upon them. Practical points that have had 
 their origin in this Department are — among others — the first 
 application of "baked" dressings (by Dr. J. C. Warren at the 
 Massachusetts General Hospital) from an oven specially constructed 
 for the purpose ; the procedure of sterilizing milk in cases of 
 digestive disturbance in infants ; the determination of the value 
 of a bacteriological examination of the throat in suspected cases of 
 diphtheria (J. H. McCollom). This last led to a most active period 
 in the career of the laboratory, which became engaged in the prac- 
 tical work of making such diagnoses for a number of cities and 
 towns, as well as in the preparation of the then new curative agent 
 — the antitoxine of diphtheria. The demands of this sort of routine 
 work soon became so heavy upon the time of all connected with the 
 Department that serious injury was threatened to their more proper 
 duties, so that other arrangements were welcomed that offered relief. 
 The most important recent work — aside from teaching — in 
 which the Department has been engaged is in the successful 
 employment of the methods of ultra-violet photomicrography and 
 the improvement of the technic for the rapid diagnosis of rabies. 
 General literary activity has not been neglected, and it has always 
 been considered a duty to assist to the utmost the development of 
 research work in medicine. It has been the good fortune of the 
 Department, through its head, to take part in this development, by 
 actively assisting in the formation of the American Association of 
 Pathologists and Bacteriologists, and by the editorial control of the 
 Journal of Medical Research. The meetings of the former, with 
 the interest and enthusiasm there displayed, and the pages of the 
 latter bear witness to the effectiveness of this work. 
 
136 THE HARVAED MEDICAL SCHOOL. 
 
 As the instruction required of tiie Department has increased in 
 amount the number of assistants appointed has also increased, so 
 that now the staff consists of eight persons — one professor, one 
 instructor, five assistants, and one Austin teaching fellow. 
 
 For some years the space at command for teaching and research 
 purposes has been entirely too limited, but this will be remedied in 
 the immediate future. One-half of the C. P. Huntington labora- 
 tories is assigned to this Department — a marvelous change from 
 the small corner of the physiological laboratory on Boylston street 
 where work was first unofficially begun by permission of Professor 
 H. P. Bowditch. 
 
THE DEPARTMENT OF NEUROLOGY. 
 J893. 
 
 The department of instruction represented by the Chair of 
 Diseases of the Nervous System received its first recognition in 
 1872, when Dr. James Jacl<son Putnam was appointed lecturer 
 on the application of electricity in nervous diseases, ar;d in 1874 
 lecturer on diseases of the nervous system. The lectures and 
 demonstrations were given until 1895 under the auspices of the 
 Department of Clinical Medicine, from which neurology, here as 
 elsewhere, was an offshoot. 
 
 In 187s Dr. Putnam and Dr. S. G. Webber were appointed 
 clinical instructors. At that time and for many years thereafter, a 
 small room in the out-patient department of the Massachusetts 
 General Hospital served the purposes of the neurological service, 
 and the simple statement regarding instruction in diseases of the 
 nervous system was annually made in the Harvard University 
 Catalogue : " Lectures and demonstrations at the Massachusetts 
 General Hospital." At the end of about ten years the clinic had 
 so completely outgrown its limited space that two rooms were pro- 
 vided in another part of the building, which likewise rapidly 
 became wholly inadequate to meet the requirements both of 
 patients and physicians. 
 
 During this earlier period the instruction was given by Drs. Put- 
 nam and Webber unassisted. In 1885 Dr. Putnam was advanced 
 to the position of instructor, and Dr. George L. Walton was 
 appointed clinical instructor. In the same year Dr. Webber re- 
 signed, and the teaching was continued at the Massachusetts 
 General Hospital under the general direction of Dr. Putnam, 
 assisted by Dr. Walton. Dr. P. C. Knapp was appointed clinical 
 instructor in 1888, and, through his aflfiliation with the Boston 
 
 (137) 
 
138 THE HARVARD MEDICAL SCHOOL. 
 
 City Hospital, the neurological clinic of that institution began to 
 be used for the instruction of students. No changes were made in 
 the Department for a number of years, but the recognition of the 
 importance of special neurological work gradually increased, until in 
 1893 a Chair of Diseases of the Nervous System was established, 
 and Dr. Putnam, after a service of twenty-one years in minor 
 positions, was made its first incumbent. This position he still 
 holds, as do Dr. Walton and Dr. Knapp the instructorships to 
 which they were originally appointed. 
 
 For a period of three years, from 1895 to 1898, Dr. Morton 
 Prince also served as a clinical instructor, resigning at the end of 
 that time. Following the appointments of Dr. Walton in 1885 and 
 Dr. Knapp in 1888, Dr. Putnam devoted his chief attention to the 
 instruction of students of the third year, although neurology was 
 not made a required study until 1895. The work of the fourth 
 year, which was then, and which has remained, elective, has been 
 carried on mainly by Drs. Walton and Knapp, with the co-opera- 
 tion of Dr. Putnam, and a certain number of students each year 
 have manifested sufficient interest to undertake this course. 
 
 The teaching force has been further increased by the appoint- 
 ment of Dr. S. A. Lord (1900-1901), Dr. George A. Waterman 
 (1901), and Dr. E. W. Taylor (1904) as assistants. A signifi- 
 cant expansion in the teaching of neurology was made in 1896, 
 when an instructorship in neuropathology was created under 
 the auspices of the Department of Pathology. By somewhat slow 
 degrees, and with the liberal co-operation of Dr. W. T. Council- 
 man, a course was developed beginning with a few exercises in 
 connection with the general work in pathological anatomy for 
 students of the second year, and finally, under the " concentration 
 system," extending over fifteen exercises of three hours each. 
 The course was designed to give the students of the second year a 
 knowledge of the alterations underlying the important disease 
 
THE DEPARTMENT OF NEUROLOGY. 139 
 
 processes and to serve as an introduction to the more distinctly 
 clinical work of ttie third year. This instructorship was held by 
 Dr. E. W. Taylor until 1904, when Dr. E. E. Southard was 
 appointed, and the teaching in this Department devolved upon 
 him. 
 
 The affiliation between the Department of Pathology and the 
 Department of Neurology has illustrated the profit to be derived 
 from the establishment of close relations between a so-called scien- 
 tific and a clinical department. It has served to broaden the field of 
 practical neurology and has no doubt brought into the subject of 
 pathological anatomy a new interest. The recognition on the 
 students' part of the relationship of lesions to clinical signs and 
 symptoms is likewise a result of such affiliation of no mean impor- 
 tance, and this has, at least in a measure, been attained. 
 
 The opening of the new out-patient building at the Massachu- 
 setts General Hospital in 1903 meant much for the teaching of 
 neurology, as of many other subjects. Adequate room for patients 
 and physicians and the possibility of privacy in teaching or exam- 
 ination has proved a very distinct benefit to the Neurological 
 Department of the Medical School. It has led, also, to increased 
 post-graduate work, which should be still further encouraged, and 
 without which no department can be regarded as fulfilling its com- 
 plete function. The cases coming to this clinic, as well as to that 
 of the Boston City Hospital, afford admirable opportunities for the 
 study of the neuroses and of all types of structural disease in 
 their earlier stages. By the opening of the Weld ward, designed 
 principally for diseases of the skin, at the Massachusetts General 
 Hospital, an opportunity was afforded for the establishment of two 
 beds for neurological patients, which permits a limited but still valu- 
 able addition to the possibilities of teaching. An unusual opportu- 
 nity for the study of the more chronic and later stages of nervous 
 disease has been afforded during the past ten years by the Long 
 
140 THE HAEVAED MEDICAL SCHOOL. 
 
 Island Hospital in Boston Harbor, which is the pauper institution 
 for the city. Although, on account of the difficulty of transporta- 
 tion, no regular courses of instruction have been offered at this 
 hospital, many students have availed themselves of the opportu- 
 nity to see the patients who are there under observation, so that 
 the hospital may be regarded as a rich and an increasingly impor- 
 tant adjunct to the possibilities of neurological teaching. 
 
 Reviewing the period of thirty-three years since the recognition 
 of neurology as a subject worthy of a special place in the college 
 curriculum, it is seen that gratifying development has taken place. 
 Begun as a small side branch of general medicine, and adding to its 
 teaching force until, with the establishment of a professorship in 
 1893, it became virtually independent, the instruction has been 
 gradually extended and made in part compulsory, until at the 
 present time it continues over three years of the medical course. 
 The precise amount of neurological knowledge with which the 
 medical student should be equipped at graduation must be an 
 uncertain and constantly changing factor in his training, but the 
 time has certainly passed when neurology as a separate discipline 
 may be entirely neglected. 
 
 With the increasing attention paid to the general subject of neu- 
 rology the methods of teaching have naturally varied somewhat 
 from year to year. The difficulties of instruction in a subject which 
 demands much preliminary anatomical and pathological knowledge 
 are recognized, particularly when the time allowed is comparatively 
 limited. In general, the lecture system has been adopted with the 
 presentation of patients. The shortcomings of this method, due to 
 the fact that the students are not brought into intimate contact 
 with the patients themselves, have led to the attempt to instruct , 
 small sections in the clinic. A method of questioning, based on a 
 standard text-book, has met with a certain measure of success, but 
 on the whole it does not appeal to the student body with the same 
 
THE DEPARTMENT OF NEUROLOGY. 141 
 
 force as more direct methods with clinical demonstrations. Follow- 
 ing the suggestion made some years ago by Dr. W. B. Cannon, of 
 this School, the so-called case system was introduced into neurologi- 
 cal teaching, and has been found a valuable adjuvant, although it 
 cannot be regarded as taking the place of the actual demonstration 
 of patients. In order to carry out more completely and systemati- 
 cally the case method, Dr. J, J. Putnam and Dr. G. A. Waterman 
 published in 1902 a book of actual cases, which has been generally 
 used by the students and has served as a modified text-book for the 
 course given in the third year. Experience has shown that the 
 best results in the teaching of neurology are attained by a judicious 
 use of various methods. The lecture cannot be wholly superseded, 
 although the central factor in clinical instruction should be the 
 study of disease as it occurs in the individual patient. The methods 
 of questioning from text-books, and the use of the case system to 
 fill out the gaps in the clinical demonstration have certainly been 
 shown to be of value. That method or combination of methods, 
 which tends in the first place to interest the student in the subject, 
 and in the second place to present the clinical facts in as systematic 
 a fashion as possible, is likely to prove the most satisfactory. 
 
 In the present state of medical knowledge the future of the 
 teaching of neurology is a matter of more than passing interest. It 
 is apparent that a study of the nervous system by those devoting 
 their chief energies to it is desirable and inevitable. This will mean 
 a growing independence of neurological departments. It should 
 also mean a continually increasing dependence upon the other 
 fundamental branches of medicine. Neurology is and must remain 
 an integral part of the general subject of internal medicine, how- 
 ever much its boundaries may be pushed beyond what is ordinarily 
 included in that term. The future should, therefore, see a further 
 development in the study of the special problems which the 
 nervous system presents, and also a complete recognition of the fact 
 
142 THE HARVARD MEDICAL SCHOOL. 
 
 that the nervous system as a branch of scientific medicine cannot 
 be separated from the diseases of other organs and tissues. In 
 its special field the Department of Neurology should so far expand 
 as to provide anatomical and pathological teaching with direct refer- 
 ence to the relationship between these fundamental branches and- 
 the clinical course of disease. The separation now existing in the 
 student's mind between structure and function should, so far as 
 possible, be obviated by systematic instruction in anatomy and 
 pathology under the general supervision of the head of the Depart- 
 ment of Neurology. The applied anatomy of the nervous system 
 should be as much a part of the general neurological instruction as 
 the study of cases. Such an expansion of the teaching would in 
 no way infringe the rights and privileges of other Departments, 
 and would lend to the Neurological Department the element which 
 it requires for its complete development. The future is also 
 undoubtedly to see in this community a development of the some- 
 what neglected field of psychiatry, a subject which also demands 
 special students, but which should be brought into closer relation- 
 ship not only with its nearest neighbor, neurology, but also with 
 the more remote field of research represented by the general 
 subject of Internal Medicine. 
 
 The final need, which cannot be overlooked, is the necessity for 
 a certain number of hospital beds whereby patients suffering from 
 diseases of the nervous system may be adequately studied. Such 
 beds should be under the control of the head of the Department of 
 Neurology. The experience of foreign universities, as well as of 
 some in this country, has demonstrated the benefit to be derived 
 from this concession on the part of a deep-rooted prejudice ; that it 
 will be forthcoming in this community within a reasonable period 
 of time is not to be doubted by those who appreciate the full signi- 
 ficance of neurology as an increasingly important branch of medical 
 science. 
 
THE DEPARTMENT OF ORTHOPEDICS. 
 J893. 
 
 The teaching of orthopedic surgery at the Harvard Medical School 
 has developed as this specialty has grown in importance as a depart- 
 ment of Surgery. Although the establishment of a full professor- 
 ship of Orthopedic Surgery is of comparatively recent date in the 
 history of the School, the interest in this branch of surgery in 
 Boston has been active for more than half a century, the first 
 efforts here being cotemporary with the work of Little of London. 
 Dr. Buckminster Brown, of Boston, devoted himself exclusively to 
 the treatment of deformities as early as 1850, and was the first to 
 open a public hospital ward for this purpose in this country, avail- 
 ing himself of the charity of the House of the Good Samaritan, a 
 small hospital founded and directed by Miss Anne Robbins. His 
 father, Dr. John Brown, paid some attention to the subject, and 
 later associated his son with the work, which ended in the develop- 
 ment of the first American specialist in this field. 
 
 The result of a life devoted to this work is a valuable collection 
 of specimens and casts, chiefly of the deformities of the feet, 
 which was given to the Harvard Medical School by Dr. Brown at 
 his death as an evidence of his devotion to this Department. He 
 willed a considerable sum which was to serve as the foundation of 
 an endowed professorship of Orthopedic Surgery. His earnestly 
 persistent and thorough work was most effective in opening the 
 way to the generation of workers which has succeeded. 
 
 Dr. Henry J. Bigelow, Professor of Surgery at the Harvard Med- 
 ical School, whose contributions to general surgery were of such 
 great value, in the early part of his professional career elaborated 
 from a prize essay a most valuable contribution on orthopedic sur- 
 gery, which for many years served as a model of style and indicated 
 
 (143) 
 
144 THE HARVARD MEDICAL SCHOOL. 
 
 the interest in the subject at the time. The monograph gave to 
 English readers the best exposition of French orthopedic surgery of 
 the day. 
 
 The special teaching at the Harvard Medical School in this branch 
 began as a small voluntary course given by one of the instructors in 
 surgery to such students as were interested in the subject. At first 
 this specialty was overshadowed by the expansion of general sur- 
 gery following the introduction of aseptic methods, but the extraor- 
 dinary advance in the methods of treating various deformities 
 developed general interest on the part of the profession and by con- 
 sequence that of medical students, until at present orthopedic sur- 
 gery is regarded as one of the most important of the specialties in 
 the Surgical Department, with required instruction for all students, 
 elective courses for qualified undergraduates, who are especially 
 interested in the branch, and advanced courses for graduates. The 
 Department of Orthopedic Surgery is organized as a branch of the 
 Division of Surgery, but has a full professorship and a corps of 
 four associates. 
 
 The facilities offered by the wards and out-patient department 
 of the Children's Hospital, the Orthopedic Departments at the 
 Carney and Massachusetts General Hospitals, the surgical patho- 
 logical laboratory and the orthopedic cabinet of the Harvard Medical 
 School all combine to make the opportunities for the study of this 
 interesting specialty of unusual excellence. 
 
THE DEPARTMENT OF PEDIATRICS. 
 t8S8. 
 
 The history of the development of the subject of Pediatrics 
 extends over a period of thirty-five years. 
 
 Little recognition was given until 1888, when the position of 
 assistant professor was established with representation in the 
 Faculty. The first especial reference to the teaching of diseases in 
 children by a Harvard announcement was made when the whole 
 course of study was radically changed in 187 1. In this year Dr. 
 Francis Minot was given, in addition to his title of Assistant Pro- 
 fessor of the Theory and Practice of Physic, that of clinical lecturer 
 on the diseases of women and children. 
 
 It is interesting to note how the idea which had been dominant 
 for centuries still obtained — the combining of the teaching of 
 children's diseases with obstetrics and gynecology. 
 
 Dr. Minot was asked to introduce into his lectures some subjects 
 connected with children and he selected measles and scarlet fever. 
 This choice, while omitting the broad subject of feeding, the 
 important study of how to save the lives of premature infants and 
 the endeavor to lessen the tremendous mortality of gastro-enteric 
 diseases in infant life, yet recognized the value of describing the 
 exanthemata as diseases so prominent in early life, in comparison 
 with their manifestations in adults, as to warrant giving them an 
 especial place in pediatric teaching. Of great interest in the devel- 
 opment of the Department is the aid given by both the Professor of 
 the Theory and Practice of Physic, Dr. Minot, and the Professor 
 of Clinical Medicine, Dr. Calvin Ellis, in introducing and fostering 
 the study of the diseases of infants and children by special instruct- 
 ors. They believed that those who had made a special study of, 
 and who had control of, hospitals devoted entirely to early life 
 
 ('45) 
 
146 THE HARVARD MEDICAL SCHOOL. 
 
 could do better justice to the vital questions associated with infants 
 and children than could be done by men whose time and thought 
 were more than taken up by teaching well and thoroughly diseases 
 in adults. The belief was growing that the student should have 
 given to him a practical knowledge of what he surely would need 
 at once in his practice. 
 
 Those who were interested in obtaining for the students a means 
 to acquire a more exact knowledge of the clinical medicine of early 
 life have always taken the position that it was not diseases of 
 children which was in most cases to be taught, but the manifesta- 
 tions of disease as it occurred in children and how the symptoms 
 of the disease varied at different ages according to the stage of 
 development. 
 
 The need of special teaching in children's diseases having been 
 once recognized, the endeavor was made to so adjust the hours 
 given to this subject as not to conflict with the teaching in 
 other branches of medicine, but at the same time to have the 
 course continuous and unbroken by separating it completely from 
 the lectures on adult medicine. In 1873 Dr. Charles Pickering 
 Putnam was appointed lecturer on diseases of children. The 
 names "women " and "children " were separated, and thus recog- 
 nition was given to the fact that they were not kindred subjects. 
 Now also for the first time instead of the lectures on children being 
 interspersed among the lectures on adults, the course was devoted 
 exclusively to children. Dr. Putnam gave a clinical lecture once a 
 week during the second term at the Dispensary for Women and 
 Children on Staniford street. 
 
 In 1874 Dr. Minot ceased to be a clinical lecturer on children, 
 and the teaching hours were thus curtailed. In 1874-5 the three 
 years' graded course was adopted, and for the first time some ques- 
 tions on children's diseases appeared on an examination paper. 
 These questions were a part of Dr. Calvin Ellis' examination paper 
 
THE DEPARTMENT OF PEDIATRICS. 147 
 
 on clinical medicine. In 1875, in addition to Dr. Putnam's one 
 exercise a week in the second term, a course of didactic and clinical 
 lectures was given at the Boston Dispensary once a week during 
 the third year by Dr. Joseph Pearson Oliver, who was at this time 
 appointed instructor in children's diseases. Dr. Oliver also as- 
 signed cases to be studied in the dispensary districts, and a report 
 of these cases was made before the class. In this year, 1876, some 
 questions on children appeared on Professor Minot's examination 
 paper in theory and practice. In 1878-9 there was only one 
 exercise a week instead of two in the second half year, and no 
 questions on children's diseases appeared on any of the examination 
 papers. 
 
 Dr. Putnam retired from the School in 1878. In 1879 Dr. 
 Joseph Pearson Oliver and Dr. Thomas Morgan Rotch were 
 appointed clinical instructors. Dr. Oliver gave one clinical lecture 
 a week during the first term. Dr. Rotch conducted a systematic 
 course covering, so far as the limited time allowed, the principal 
 phases of disease which are especially prominent in early life. He 
 lectured once a week during the second half year at the Boston 
 Dispensary. Although these lectures were essentially clinical, yet 
 owing to the large and varied material at the dispensary clinic, it 
 was possible to map out the beginning of the system which has in 
 later years been elaborated in the Department. A prominent 
 feature in the system has always been that especial attention in 
 the teaching should be given to impressing on the student the 
 importance of knowing the normal conditions of infants and 
 children in the different stages of their development in order to 
 appreciate the diseased conditions in such stages. 
 
 In this year, 1879, some questions again appeared on the 
 examination papers. In 1880-1 the instruction in the third year 
 was carried on as before, and a voluntary course for students of the 
 fourth year was added. At this time Dr. Rotch introduced teaching 
 
148 THE HARVARD MEDICAL SCHOOL. 
 
 in children's diseases at the Boston City Hospital, giving the fourth 
 year men three exercises a week, followed by a special examination 
 in June. This was the first entirely separate examination given in 
 children's diseases in the School. From 1881 to 1884, when he 
 retired from the School, Dr. Oliver gave one lecture a week during 
 the first term, paying special attention to the therapeutics of early 
 life. In 1882 Dr. Rotch began to utilize the material at the 
 Children's Hospital, and in 1883-4 he was allowed to increase the 
 time of the course by giving an additional lecture during the second 
 term. 
 
 In 1885 Dr. Rotch was placed in entire charge of the teaching 
 and was given the title of instructor in diseases of children. From 
 this time the course was gradually increased according to the needs 
 and demands of the students. Two lectures a week were given to 
 the third class during the entire year. These lectures were illus- 
 trated by cases representing the subject. The instructor by keep- 
 ing in close affiliation with the physicians having charge of the 
 dispensary districts, where the material was very large, was sup- 
 plied with cases of all kinds and also was enabled to have the 
 students visit these cases in their homes. At this time the impor- 
 tance to the student of seeing, in connection with his course in 
 children, as many cases as possible of such infectious diseases as 
 scarlet fever, measles, varicella, diphtheria and congenital syphilis, 
 was so evident that the instructor used, to the fullest extent, the 
 opportunities for studying these diseases in the dispensary districts. 
 This was the beginning of the close affiliation with the contagious 
 wards of the Boston City Hospital, which the Department has 
 always considered so important for a complete understanding of 
 disease in early life. 
 
 The material for these lectures was also drawn from the Boston 
 City Hospital, the Children's Hospital, the Children's Room at the 
 Boston Dispensary, and the Infants' Hospital. The early lectures 
 
THE DEPARTMENT OF PEDIATRICS. 149 
 
 of the course were devoted to the exhibition and explanation of 
 infants and children in the different stages of development, touch- 
 ing upon such anatomical and physiological peculiarities as were 
 practically important. The students were next in a general way 
 told what they should know about nursery hygiene, the points of 
 practical importance in regard to bathing, clothes, ventilation, when 
 to go out and when to rest and sleep. They were then shown 
 what was necessary to know about the skin in health and disease. 
 Certain leading subjects were next systematically dealt with. The 
 feeding of infants was carefully taught in connection with the 
 Infants' Hospital, which provided an unusually well equipped 
 ■clinical laboratory for this large branch of pediatrics. This was 
 followed by the study of gastro-enteric diseases and the various 
 phases of nervous phenomena especially of reflex origin, which play 
 such a part in nursery practice. At this time, also, three clinical 
 exercises a week were given to the fourth year students. 
 
 In 1887, to meet the demand for instruction which had grown far 
 beyond the power of the instructor, an assistant was appointed. 
 This position was held by Dr. Herbert P. Whitney for one year, 
 when he went to Colorado where he has since been the Professor 
 of Children's Diseases in the Medical School at Denver. In 1888 
 the title of Assistant Professor of Diseases of Children and a seat in 
 the Faculty were given to Dr. Rotch. At this time a course was 
 offered to graduates, and graduate teaching has ever since been 
 carried on in the Department. The various instructors in the 
 Department have always been willing to receive in their courses 
 women physicians who were graduates. In this year Dr. Edward 
 Marshall Buckingham was appointed assistant in diseases of children, 
 succeeding Dr. Whitney. Although at this time the instruction 
 had come to represent a Department, its progressive development 
 was much interfered with by the system of electives permit- 
 ting the student to take his degree without any regular and 
 
150 THE HARVARD MEDICAL SCHOOL. 
 
 systematic course. The continuity of the instruction was also broken 
 because a part — consisting of one lecture and one clinical confer- 
 ence a week — was placed at the end of the second year. The 
 course of study was changed so that the student who took the 
 elective began in March and April of the second year and continued in 
 the third year with lectures and clinical lectures twice a week at the 
 Boston Dispensary and the Children's Hospital during the whole 
 year. An examination was held at the end of the third year, two 
 hours in length. The conferences were begun in March, 1899, and 
 were held for the last time in 1900, when the demand for sectional 
 teaching made it evident that the time should be given to the latter. 
 In this year, 1888-9, Dr. Buckingham gave especial clinical instruc- 
 tion to the fourth year students twice a week for three months in 
 the Out-patient Department of the Children's Hospital. In 1889 
 the demand for more teaching was so evident that an increase in 
 the teaching force was made by the addition of Dr. Thomas Foster 
 Sherman as assistant. In this year the contagious wards were 
 opened at the Boston City Hospital and instruction in diphtheria, 
 measles, and scarlet fever was immediately begun by the Children's 
 Department. This was made possible by Dr. Buckingham and Dr. 
 Rotch holding positions on the staff of the hospital and thus having 
 a service in and control of the wards. This was the first system- 
 atic teaching of contagious diseases in a hospital which had been 
 given in the School, and soon superseded the earlier system of see- 
 ing the cases, necessarily at intervals, in the dispensary districts. 
 At this time the material in the wards of the Infants' Hospital had 
 increased so much that clinical instruction was begun in it and has 
 been carried on ever since. It has proved to be of great value to 
 the students. Dr. Buckingham was made an instructor in 1890. 
 
 In 1892 instruction ceased to be given to the fourth year and was 
 not begun again until 1905 excepting in the contagious wards in 
 1903 and 1904. In this year all the teaching was confined to the 
 
THE DEPARTMENT OF PEDIATRICS. 151 
 
 third year. Two exercises a week were given throughout the year 
 and there was a compulsory examination of two hours at the end 
 of the year. Although these changes represented advance and 
 improvement, because of the opportunity given for systematizing 
 the Department and also to the requirement of an examination for 
 the degree, yet the time for teaching was so limited that it was 
 impossible to do justice to the various subjects already proved 
 necessary to the student as a practitioner of medicine. In 1893 Dr. 
 Rotch was made full Professor of Diseases of Children, and as Dr. 
 Sherman was obliged to resign on account of his health. Dr. Arthur 
 Howard Wentworth was appointed in his place with the title of 
 assistant. In this year sectional teaching in the wards was again 
 begun. At this time, also, under the direction of the Department, 
 much work was done at the Infants' Hospital in elaborating 
 the methods for the care of premature infants, thus increasing the 
 opportunity for teaching this important subject. 
 
 The Department especially fostered this branch of pediatrics and 
 this led up to still further advances in the subject of feeding. 
 Much encouragement and aid were given in founding the system of 
 milk laboratories, in the interest of pure milk and percentage feed- 
 ing, all over the country, in Canada, and London. Special attention 
 was given to insisting upon the careful supervision and perfect 
 equipment of the dairies belonging to and closely connected with 
 these laboratories, so that by using their products at the Infants' 
 Hospital both in the wards, and, by means of the milk fund estab- 
 lished for their purchase, in the out-patient department, important 
 investigations could be and were carried out by members of the 
 Children's Department during the summer months. 
 
 Through the use of this pure and exact milk supply the feeding 
 of atrophic infants becomes almost a special branch of the pediatric 
 teaching in the wards, and notably advanced work was done in the 
 investigation and treatment of the gastro-enteric diseases of early life. 
 
152 THE HAKVAED MEDICAL SCHOOL. 
 
 During the year the question of the desirability of treating 
 infants in a hospital separate from children was carefully considered, 
 and the conclusion was that there were good reasons for such separa- 
 tion. One reason was that the expense of caring for young infants 
 in the best way was so much greater than that necessary for chil- 
 dren that it would always be difficult in a children's hospital to 
 carry out the most advanced methods of treating infants, since the 
 question of expense inevitably gave rise to the feeling that too 
 much, comparatively, was spent on the younger individual to the 
 detriment of the older. As a corollary to this fact, which has its 
 parallel in the advisability for having children cared for in a sepa- 
 rate hospital from adults, it was evident that the study and teaching 
 of infants could best be carried on in a hospital especially devoted to 
 their use. Such a hospital, " The infants'," has fortunately always 
 been at the disposal of the Department. In 1894 the teaching force 
 was increased by the appointment of Dr. George Arthur Craigin 
 as assistant. Three exercises a week were given throughout the 
 year, one didactic and two clinical, and a clinical conference once a 
 week during the second half year. In 1895 ^ series of illustrated 
 lectures, mostly representing actual cases, were published in book 
 form, and have served since that time as a text-book for recitations. 
 
 In 1897 the work was still further amplified by arranging with 
 Dr. John Hildreth McCollom to give special instruction to the third 
 year students in contagious diseases at the South Department of 
 the Boston City Hospital during the first four months of the school 
 year. This was a great step in furthering one of the main princi- 
 ples which the Department had for years been striving to carry out 
 in regard to the teaching of contagious diseases. 
 
 In 1900 Dr. Buckingham was appointed clinical instructor, a 
 position which he held until 1903, giving instruction to the classes 
 in sections in the wards of the Children's Hospital. In this year, 
 1900, Dr. Wentworth resigned his position in the School and Dr. 
 
THE DEPARTMENT OF PEDIATRICS. 153 
 
 John Lovett Morse and Dr. Maynard Ladd were added to the 
 teaching force, the former with the title of instructor and the latter 
 with that of assistant. 
 
 The entire course was now rearranged and the time given to 
 sectional teaching much increased. In this connection it may be 
 noted that the Children's Department has always offered courses in 
 the Summer School. The exercises have been clinical and the 
 material large, as the members of the Department have had control, 
 for this purpose, of the Children's Hospital, the Infants' Hospital, 
 the Floating Hospital, and the Convalescent Home at Wellesley. 
 As the method of instruction for the third year students was prac- 
 tically the same from 1900 to 1905 it can in these years be 
 described in connection with the changes which took place in the 
 Department at the latter date. In 1903 Dr. Charles Hunter Dunn 
 was appointed an assistant in the Department. 
 
 In 1903 all the teaching of contagious diseases in the fourth year, 
 formerly under the direction of the Department of Clinical Medi- 
 cine, was transferred to the Department of Pediatrics. In this year 
 it became manifest that the great majority of the patients at the 
 South Department of the Boston City Hospital were children, and 
 that the diseases treated there were so closely connected with early 
 life that they should be especially taught in the Pediatric Depart- 
 ment. Dr. McCollom was therefore given a seat in the Faculty as 
 a member of the Pediatric Department with the title of Assistant 
 Professor of Contagious Diseases. At this time the name of the 
 Department was changed to Pediatric and the titles of the members 
 of the Department were changed to Professor of Pediatrics, Assistant 
 Professor of Contagious Diseases, instructor in, clinical instructor 
 in, and assistant in pediatrics, respectively. The instruction in the 
 third year at this time consisted of ten exercises a week during the 
 entire school year ; eight of these were in sections, the other two 
 were partly didactic and clinical to the whole class, and partly in the 
 
154 THE HARVARD MEDICAL SCHOOL. 
 
 form of recitations and case teaching. The didactic lectures are to 
 a great degree made introductory to the leading and important 
 subjects which are afterwards dealt with at the bedside. The reci- 
 tations from the text-book were few in number, but were upon 
 subjects in which a certain amount of memorizing was deemed 
 essential. They comprised, notably, the anatomical, physiological 
 and developmental characteristics of the different stages of growth 
 in infancy and childhood. Later in the course case teaching became 
 a prominent feature in the instruction. Every endeavor is made in 
 these exercises to make the students think for themselves. The 
 three preliminary and most important subjects dealt with in the 
 early preparatory didactic lectures are the exanthemata, feeding, 
 and gastro-enteric diseases. The lectures on the exanthemata are 
 followed by the demonstration of the actual cases in the contagious 
 wards. 
 
 In this connection it should be stated that especial instruction is 
 also given in the Department on diphtheria, a special lecture and 
 bedside instruction being given, as in scarlet fever and measles ; 
 also, whenever there is an opportunity, Dr. McCollom instructs the 
 students in the technic of intubation. Besides this, a considerable 
 amount of instruction is given at the Children's Hospital and the 
 Infants' Hospital on varicella, the efflorescences connected with 
 antitoxine, and the many irregular efflorescences of the skin which 
 so commonly appear in early life. 
 
 In like manner, brief explanations of maternal feeding, the prin- 
 ciples of percentage feeding, the milk laboratories and laboratory 
 farms given in the didactic lectures are immediately followed by 
 detailed and practical teaching of the modification of milk for use in 
 health and disease and by showing the students how to use practi- 
 cally the milk laboratories and the advanced methods of feeding 
 accomplished through them. In like manner, following the didactic 
 lectures, teaching is given on the stomach and intestines by means 
 
THE DEPARTMENT OF PEDIATRICS. 155 
 
 ot practical demonstrations of the various gastro-enteric diseases so 
 far as tiie material warrants. The opportunity is also given at the 
 Infants' Hospital to study normal fecal movements. These three 
 large subjects having been dealt with, the remaining phases of 
 disease characteristic of early life are divided between the lectures, 
 the recitations, and the case teaching. 
 
 It is now recognized that the teaching in pediatrics at Harvard 
 covers more ground and gives the individual student greater oppor- 
 tunities than in any other school in the country. 
 
 In 1905-6 the entire course to the fourth year students was 
 greatly increased and entirely remodelled, and instruction was 
 given by the Pediatric Department in accordance with the new 
 plan. Eight courses are now offered, each for one month beginning 
 October first and lasting until the end of the school year. Each 
 course occupies the whole of each day during the month and counts 
 for one hundred and twenty -five hours. A student may take more 
 than one course and may receive his instruction in the wards and 
 Out-patient Departments of the Children's Hospital, the Thomas 
 Morgan Rotch, Jr., Memorial Hospital for Infants, and in the con- 
 tagious wards of the Boston City Hospital. 
 
 The teaching is essentially clinical and each student receives the 
 personal attention of one of the members of the Pediatric Depart- 
 ment and can follow up any line of study which he wishes. 
 With the consent of the head of the Department a student may 
 take all the eight courses and thus devote the entire year to pediat- 
 rics. A student who does this will, after the first two or three 
 months, practically be in the position of an assistant in both the 
 Infants' and Children's Hospitals, and will have a great opportu- 
 nity for obtaining a most extended knowledge of pediatrics, a 
 practical preparation for private practice, and ample material for 
 original research. 
 
 The present arrangement for the instruction of graduates is to 
 
156 THE HAEVAKD MEDICAL SCHOOL. 
 
 admit them to the fourth year elective course, special provision 
 being made by which they can follow out any line of study which 
 they wish. They can make their instruction continue from one 
 month to eight, if they so elect, and all the advantages possible are 
 accorded them. The instructions to graduates will, in the future, be 
 amplified to meet their demands, just as the amount and character 
 of the teaching has rapidly grown and has been adapted to the 
 demands of the undergraduates. 
 
THE DEPARTMENT OF COMPARATIVE PATHOLOGY. 
 
 1896. 
 
 The professorship of Comparative Pathology has been in exist- 
 ence just ten years. On May eleventh, 1896, the Corporation of 
 Harvard College voted to establish it and at the same time Dr. 
 Theobald Smith was chosen to be the first incumbent. The 
 source, conditions, and objects of the endowment are best set forth 
 in the words of the founder, Mr. George F. Fabyan, of Boston. 
 His letter transmitting the gift to the Corporation of Harvard College 
 reads : 
 
 BOSTON, April fifteenth, 1896. 
 TO THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE : 
 
 GENTLEMEN: — It is my wish to testify to my deep interest in the 
 advancement of medical science and the higher medical education, an interest 
 originating in the fact that my father, George Fabyan, M.D., of Boston, was 
 a physician. I therefore offer to the President and Fellows of Harvard Col- 
 lege the sum of $100,000 (one hundred thousand dollars) in cash, payable on 
 the first day of July, 1896, as a fund for the endowment of a professorship of 
 Comparative Pathology in the Medical Department of Harvard University. 
 
 I desire that this fund shall be forever known as the George Fabyan Fund 
 in memory of my father, and that the professorship shall also bear his name. 
 
 It is furthermore my wish that the income of this fund shall be applied 
 forever, first, to the payment of the salary of the Fabyan Professor of Com- 
 parative Pathology, who shall also be a member of the Medical Faculty and 
 appointed to office in the same manner as are other professors in that body, 
 and who shall devote his time to the duties of the professorship, and shall not 
 engage in private practice, without the recommendation of the Medical 
 Faculty and the consent of the President and Fellows ; and second, if any 
 income remain after the payment of his salary, to the procuring of materials 
 or apparatus needed by him in giving his instructions or conducting his 
 researches. 
 
 The subjects to which 1 desire this endowment to be devoted are the com- 
 parative study of human and animal diseases and the prevention and cure 
 of diseases in both men and animals. — (Annual Report of the President and 
 Treasurer of Harvard College for 1895-96, p. 270.) 
 
 (157) 
 
158 THE HAKVAED MEDICAL SCHOOL. 
 
 In 1902 Mr. Fabyan generously contributed ;j!25,ooo more to the 
 permanent endowment of the chair. 
 
 Owing to the lack of space in the School building, facilities were 
 provided at the Bussey Institution of Harvard College near the Forest 
 Hills Station. Three rooms of medium size were fitted up, together 
 with a small animal house — a transformed unused greenhouse 
 attached to the building of the institution. One of the unused 
 barns on the grounds has been used from time to time for the study 
 of infectious animal diseases. During this period the occupant of 
 the chair has also been engaged, with the consent of the Corpora- 
 tion, in developing and directing the laboratory of the State Board 
 of Health for the production and free distribution of antitoxines 
 and vaccine lymph. For nine years, that is to say, since 1895, the 
 work of preparing antitoxines had been carried on in the scanty 
 space of the Bussey Institution laboratory. In 1904 a new labora- 
 tory was erected to be devoted exclusively to the preparation of 
 antitoxine and vaccine lymph and the investigation of problems 
 associated therewith. This building is leased to the State Board of 
 Health. 
 
 Though the association of the Professor of Comparative Pathol- 
 ogy with this work may appear, at first thought, a slight departure 
 from the aims and purposes of the foundation, it has proved a great 
 benefit in giving the needed stimulus for research into problems 
 of a practical nature, a stimulus likely to be wanting when con- 
 tact with actual disease is not provided for. It has also provided 
 the means and opportunities for investigations into certain diseases 
 of the horse of importance to general pathology, which are occa- 
 sionally met with in the production of antitoxines. 
 
 Ample space has been provided in the new medical buildings for 
 the Department. One-half of a wing of the building for hygiene 
 and pharmacology has been set aside and equipped according to its 
 needs. 
 
THE DEPARTMENT OF COMPARATIVE PATHOLOGY. 159 
 
 Since the foundation of the professorship in 1896 the work has 
 been divided into teaching and research. In the planning of courses 
 of instruction it was of importance not to duplicate work already- 
 going on. Since the work of the professor has been chiefly upon 
 infectious and parasitic diseases, two courses have been given each 
 year, one devoted to a broad discussion of the principles underlying 
 infectious diseases, the other to those protozoan and higher animal 
 parasites which are of importance to human pathology. At the 
 same time the laboratory at the Bussey Institution has been open 
 to a few advanced students, who are able to pursue special lines of 
 research. 
 
 From the beginning the professor has been greatly hampered for 
 want of assistance. In 1900 an Austin teaching fellowship was 
 added, but as these appointees hold their position for but one or 
 two years, as their usefulness with few exceptions begins after the 
 first year and as the number of good men available is small, this 
 fellowship has added but little to the equipment. 
 
 Since 1896 the laboratory has printed forty-seven papers. Of 
 these forty-three are by the professor either alone or in association 
 with students, and four are signed by students alone. The subjects 
 dealt with in these papers include general methods in bacteriology 
 and special studies of diphtheria bacilli, their toxines and the 
 standardization of diphtheria and tetanus antitoxines, six papers on 
 bovine and human tubercle bacilli, several papers on the epidemi- 
 ology of malaria in relation to mosquitos in Massachusetts, and on 
 several sporozoan parasites of the lower animals. Preliminary 
 papers have also appeared on heredity in its relation to the resist- 
 ance of animals to diphtheria toxine and on the resistance of red 
 corpuscles. Much other research has been done on the infectious 
 diseases of animals which, however, remains unpublished because 
 of inadequate facilities to complete and round out the work to some 
 definite conclusion. 
 
160 THE HARVARD MEDICAL SCHOOL. 
 
 The material equipment of the chair and the work done during 
 its first decade having been outlined, it remains to discuss in a more 
 general way its field of usefulness. 
 
 To present the claims and to justify the existence of a chair of 
 comparative pathology in a medical faculty does not seem neces- 
 sary at this time. Two currents have made the need of such a 
 chair plain. They are the development of bacteriology or micro- 
 biology and the growing importance of the comparative method in 
 investigating disease processes. These currents are closely inter- 
 mingled. They can hardly be distinguished one from the other. 
 The great importance of the phenomenon of parasitism in disease, 
 unfolded by the study of animal and vegetable parasites, has forced 
 the onward movement of medical science towards biology and 
 biochemistry and has drawn into its sphere of study first, the 
 infectious diseases of animal life, and later all phenomena in animal 
 life which may throw light on human disease. Thus was born the 
 need of the comparative method, so fruitful in other departments 
 of science. 
 
 This method was of the greatest influence in ridding the medicine 
 of the last century of its rigid conceptions of health and disease and 
 replacing them with the more flexible biological conceptions of 
 to-day. To learn that any given microbe which produces a well- 
 defined disease in man is harmless to animals, that a disease germ, 
 dangerous to one species, has no effect upon a closely-related 
 species, and that a human being may carry dangerous microbes 
 which are held in check by unknown forces within him are lessons 
 which in themselves have had a great influence in making medicine 
 begin to appreciate the flexibility as well as the enormous com- 
 plexity of the processes which protect us from disease or which 
 lead to recovery. 
 
 Departments in medicine as in other institutions of learning may 
 be considered as having a past, a present, and a future value. 
 Unless made over or remodeled some may have only a past value, 
 
THE DEPARTMENT OF COMPARATIVE PATHOLOGY. 161 
 
 others are at their best in the present, and still others have only 
 the future to point to. The study of animal diseases, the use of 
 their resources and the resources of animal life in general in the 
 elucidation of human maladies and their amelioration, is largely a 
 future task. 
 
 In applying the comparative method to medical problems, two 
 ways are open. We may begin with general biological phenomena 
 and trace them upward from the physiology of lower forms of life 
 into the pathological processes of the highest forms, or we may 
 begin with human diseases as a starting point and explore down- 
 ward into those of the higher animals, and from them to lower 
 forms if necessary. 
 
 To a Department in a medical school only the latter route is 
 available for obvious reasons. The field of work for the present 
 seems to be in the pathology of the higher animals, where informa- 
 tion of use to human medicine may be anticipated, since it is now 
 generally accepted that the laws underlying disease processes are 
 essentially the same in animals and in man. The study of disease 
 in the higher animals has already been developed to a remarkable 
 degree, and all large institutions devoted to the advancement of 
 medical science are at present equipped with animal houses of 
 superior construction, which are to the laboratory what the hospital 
 is to the practising physician. A similar building is very much 
 needed here to enable the Department to undertake researches 
 which belong to its legitimate sphere. 
 
 In estimating the relative output of useful knowledge by any 
 department, it is necessary to bear in mind that it is almost wholly 
 at the mercy of equipment and material in the choice of problems. 
 This is especially true of such as have a future value and whose 
 work for a time must be chiefly research. It should also be 
 added that in the study of the diseases of animals, as well of 
 human beings, the time cannot be chosen, but the student must 
 be ready when the disease presents itself. 
 
JACOB BIGELOW (H.C. 1806). 
 A.M.; M.D. Un. Pa., 1810; LL.D. 1857. 
 
 Lecturer on Materia Medica and Botany, 1815-1818. 
 
 Professor of Materia Medica, 1818-1855. 
 
 Rumford Professor on the Application of Science to the Useful Arts, 
 
 1816-1827. 
 
 Overseer of Harvard College, 1846-1854. 
 
THE DEPARTMENT OF PHARMACOLOGY. 
 1898. 
 
 This Department has been known under different names since its 
 origin. At first it was called Chemistry and Materia Medica, some- 
 what later Materia Medica and Therapeutics, now its title is Phar- 
 macology and Therapeutics. Under these different names it has 
 been the branch of instruction where the methods and agents 
 used in the treatment of disease were taught. Special attention 
 has always been given to the study of drugs. 
 
 In the earlier part of its career very little was known about the 
 true action of drugs so that most of the time was spent in studying 
 and teaching their physical and chemical properties and botanical 
 history. The entire subject was then known as materia medica. 
 When newer methods were adopted to study in an accurate manner 
 the action of the different drugs used in medicine, a new science 
 was founded under the name of pharmacology. 
 
 Materia medica, which previous to that time dealt with almost 
 every sort of knowledge which concerned drugs, was divided into 
 three distinct branches, namely, pharmacology or pharmacodyna- 
 mics, which treated of the action of drugs ; materia medica in its 
 narrowest sense, which comprised the knowledge of their physical 
 and chemical properties ; and therapeutics, which included the study 
 of the uses of remedial agents for the cure or alleviation of 
 disease. 
 
 As our knowledge concerning the action of drugs became greater, 
 less time was spent in the study of their botanical nature and of 
 their physical and chemical properties, while more was devoted to 
 the study of the action of drugs, on which must be based chiefly 
 their proper employment in the treatment of diseases. 
 
 Period i (from 1783 to 1816). — The history of the Department 
 
 (163) 
 
164 THE HAKVAED MEDICAL SCHOOL. 
 
 of Pharmacology began when Dr. John Warren suggested the 
 starting of a medical school to the Boston Medical Society at a 
 meeting in the Green Dragon Tavern. He proposed Dr. Danforth, 
 an eminent chemist of that time, as Professor of Chemistry and 
 Materia Medica. Dr. Danforth declined the offer of this chair as did 
 also Dr. Elliot that of theory and practice ; but this did not dis- 
 courage Dr. Warren, who, in 1782, carried the proposition before 
 the officials of Harvard University, who resolved to begin a medi- 
 cal school by appointing three professors of medical subjects ; one 
 of anatomy and surgery, one of theory and practice of physic, and 
 one of chemistry and materia medica. In 1782 Dr. John Warren 
 was appointed Professor of Anatomy and Surgery, and Dr. Water- 
 house, Professor of the Theory and Practice of Physic. These two 
 gentlemen were also entrusted with the instruction in materia 
 medica and chemistry until a professor in these two subjects was 
 apppointed. This occurred the following year, when Dr. Aaron 
 Dexter, a pupil of Dr. Danforth, was chosen Professor of Materia 
 Medica and Chemistry. 
 
 At first the lectures in materia medica were given in Cambridge 
 in the basement of Harvard Hall, but this was considered an inade- 
 quate place, and the corporation fitted up Holden's Chapel for the 
 purpose. In 1808, following the example of Warren, Dexter asked 
 for the appointment of an adjunct professor, and Dr. John Gorham 
 was made Adjunct Professor of Chemistry and Materia Medica in 
 1809. He was well adapted for the place as he had studied 
 medicine in London, Edinburgh, and Paris, as well as with his 
 father-in-law. Dr. John Warren. Gorham succeeded Dexter in the 
 professorship of Chemistry and Mineralogy in 18 16, but his duties 
 conflicted with his practice so that the chair was divided into two 
 parts. One of these he held until 1827. 
 
 The Professor of Chemistry and Materia Medica asked that 
 materia medica be detached from his Department and that this 
 
THE DEPARTMENT OF PHAEMACOLOGY. 165 
 
 subject be taught by a younger lecturer. In 1816 Dr. Jacob 
 Bigelow was appointed lecturer in materia medica. 
 
 PERIOD 2 (from 1818 to 1855). — Dr. Jacob Bigelow gave at 
 first his instruction under the title of lecturer on materia medica, 
 while he also served as Rumford Professor at the University. In 
 1824 he was promoted to the title of Professor of Materia Medica, 
 and in 1836 he received, in addition, that of lecturer in clinical 
 medicine. 
 
 PERIOD 3 (1856 to 1870).— In 1856 Dr. Edward Hammond 
 Clark was appointed Professor of Materia Medica to succeed Dr. 
 Bigelow. The professor was assisted by Dr. Fitch E. Oliver from 
 1 86 1 to 1869 under the title of assistant in materia medica and in 
 1870 under the title of instructor. The course, which was given 
 during June, July, and October, is described in the catalogue as fol- 
 lows : "An extensive collection of specimens and illustrations will 
 be exhibited during the ensuing course of lectures upon the subject 
 by Dr. E. H. Clark. Advantage will be taken of every opportu- 
 nity to present the subject to the eyes by experiments and other- 
 wise." Up to this period we find no attempt to teach pharma- 
 cology in an experimental way, and it will be observed that it is 
 only in a subsequent period that this was attempted. 
 
 Period 4 (1871 to 1884). — Dr. Robert T. Edes was appointed 
 Assistant Professor of Materia Medica in 1871 to succeed Dr. Clark. 
 He retained this position until 1875, when he was made full Pro- 
 fessor of Materia Medica. In 1884 he was made Jackson Professor 
 of Clinical Medicine, but he continued teaching therapeutics for one 
 year under his new title. We find the following description of the 
 course given under the direction of Dr. Edes: "Materia medica is 
 taught by recitations, as this mode of instruction is best adapted 
 for imparting that practical knowledge of drugs and their proper- 
 ties which can only be obtained from the examinations of 
 specimens and pharmaceutical preparations, of which there is an 
 
166 THE HAEVARD MEDICAL SCHOOL. 
 
 extensive collection. Therapeutics or the physiological action of 
 drugs and their application to disease is taught in the third year by 
 lectures." Until 1874 Dr. Edes gave all the instruction in the 
 Department excepting in 1871, when an instructor in materia medica 
 was appointed who taught materia medica while Dr. Edes devoted 
 himself entirely to the teaching of therapeutics. From 1874 to 
 1884 he gave three lectures a week in the third year upon therapeu- 
 tics. In 1884 and 1885 he gave one lecture a week on clinical 
 therapeutics at the hospital. During the year 1871 Dr. Robert 
 Amory gave instruction under the title of lecturer in the physio- 
 logical action of drugs. 
 
 Dr. George H. F. Markoe was appointed instructor in materia 
 medica in 1874, and until 1880 he held this position and gave one 
 lecture a week upon materia medica in the second year. He was 
 succeeded in 1880 by Dr. William P. Bolles, who gave the same 
 instruction until 1884. In 1884 Dr. Joseph W. Warren was 
 appointed instructor in experimental therapeutics and under this 
 title he gave during the ensuing year two lectures a week upon 
 that subject. At the same time Dr. F. H. Williams was appointed 
 instructor in materia medica to succeed Dr. Bolles, when he gave 
 two lectures on materia medica during the first half of the first year. 
 
 Period 5 (1885 to 1890). — In 1885 Dr. F. H. Williams was 
 placed in charge of this Department under the title of instructor in 
 materia medica. He was made assistant professor in 1886, and 
 retained this title until 1891, when he severed his connection with 
 the Department. In 1885 his instruction in materia medica con- 
 sisted of two lectures a week during the second half of the first 
 year, and two recitations or demonstrations a week during the 
 second year. The following year he gave in addition one lecture a 
 week on therapeutics with demonstrations. In 1887 he gave two 
 lectures on therapeutics and only one recitation. In i888 he dis- 
 continued recitations, and gave, instead, one exercise a week in 
 
THE DEPARTMENT OF PHAEMACOLOGY. 167 
 
 clinical therapeutics in sections. In 1886 Dr. Williams was assisted 
 by Dr. William H. Pomeroy as assistant in materia medica, and in 
 1887 by Dr. Elliott G. Bracket under the same title. In 1888 Dr. 
 Charles Harrington was appointed instructor in materia medica, 
 and gave, instead of Dr. Williams, two lectures in the first half year 
 on materia medica, while the latter continued giving instruction in 
 therapeutics until 1891. 
 
 PERIOD 6 (i8gi to 1898). — Dr. Harrington took entire charge 
 of the Department in 1891, and gave two lectures a week on 
 materia medica and therapeutics during the second year term. He 
 continued in this capacity until 1898. 
 
 In 1894 Mr. James O. Jordan was appointed assistant in materia 
 medica to give a course in pharmacy illustrating the compounding 
 of prescriptions. In 1893 and 1894 Dr. Arthur Chadbourne was 
 demonstrator of experimental therapeutics and pharmacology. 
 Under this title he conducted research and offered instruction to 
 advanced students. 
 
 In 1895 Dr. Franz Pfaff was appointed instructor in pharmacol- 
 ogy to succeed Dr. Chadbourne, and he gave one demonstration a 
 week. During 1896 and 1897 he gave eight demonstrations a 
 year showing the action of the principal drugs upon the lower 
 animals. 
 
 Period 7 (1898 to 1905). — In 1898 Dr. Pfaff was appointed 
 instructor in pharmacology to succeed Dr. Harrington, who was 
 then Assistant Professor of Hygiene. He continued in this capacity 
 until 1900, when he was promoted to the title of Assistant Professor 
 of Pharmacology. This position he held until June, 1905, when 
 he was created full professor. Until 1902 his course consisted of a 
 series of lectures upon drugs, including the description of their 
 physical and chemical properties, their action and their uses in 
 practical medicine. The action was demonstrated whenever feasi- 
 ble by experiments prepared by an assistant. During this period 
 
168 THE HARVARD MEDICAL SCHOOL. 
 
 considerable research was performed by Dr. Pfaff, his assistants 
 and others working in the Department. This research work was 
 conducted in the pharmacological laboratory of the School, and 
 in the chemical laboratory of the Massachusetts General Hospital 
 which was under the direction of Dr. Pfaff. 
 
 The first assistant in pharmacology, appointed under Dr. Pfaff, 
 was Dr. A. W. Balch. He retained this position until 1901. 
 During this time he prepared the demonstrations and heard a 
 few recitations. He conducted the course in pharmacy with Mr. 
 Jordan and had general charge of the laboratory under Dr. Pfaff. 
 He carried on research during his official connection with the 
 Department, and also before that period for several years as 
 volunteer assistant. 
 
 In 190 1 Dr. M. Vejux Tyrode was appointed assistant in phar- 
 macology to replace Dr. Balch. He had worked as volunteer 
 assistant with Dr. Pfaff since 1896, and in 1900 had been appointed 
 as Dalton Fellow at the Massachusetts General Hospital, where he 
 acted as Dr. Pfaff's assistant. His duties at the Medical School 
 were similar to those of Dr. Balch until 1902, when he was made 
 instructor in pharmacology. At that time materia medica was 
 detached from pharmacology and Dr. Tyrode took charge of this 
 course giving one lecture a week during the second half of the 
 second year besides some recitations in pharmacology, while Dr. 
 Pfaff gave three lectures a week on pharmacology and therapeutics 
 during the second half of the second year. In 1904 the course was 
 again changed, when Dr. Pfaff gave one lecture a week in the first 
 half of the third year on general therapeutics and two lectures a 
 week in the second half of the second year on pharmacology, and 
 Dr. Tyrode one lecture a week in the second half of the second 
 year in materia medica besides some lectures and recitations in 
 pharmacology. The latter course included extensive training in 
 practical prescription writing. 
 
THE DEPAKTMENT OF PHAEMAOOLOGY. 169 
 
 In 1905, Mr. James Jordan having resigned, Dr. Louis Nelson, 
 who had carried on research work in the laboratory for two years, 
 was appointed assistant in materia medica. During the first part of 
 this period of the history of the Department, and for some time 
 previously, the teaching consisted of two hours a week during the 
 second year, but in 1900, with the introduction of the "condensation 
 method " of teaching, four hours a week during the second half of 
 the second year were allotted to this Department. The exami- 
 nation took place in June at the termination of the course. This 
 system did not prove a success, as it was generally admitted by the 
 students and instructors that the four months during which the 
 course was given was too short a time to digest such an extensive 
 subject. In order to remedy this a course in therapeutics was 
 introduced in the third year and the examination given at the end 
 of both courses. This method has proved much more success- 
 ful. During the first part of this period a great weakness in pre- 
 scription writing was to be observed on the part of the students. 
 To remedy this extensive demonstrations and practical exercises in 
 the art were introduced with much success. 
 
THE WARREN ANATOMICAL MUSEUM. 
 1847. 
 
 As early as 1799 Dr. John C. Warren, realizing the value of ana- 
 tomical specimens as an aid to medical teaching, brought with him 
 from Europe a few models and preparations. This formed a 
 nucleus to which he gradually added during the first half of the 
 last century, until his collection became justly celebrated, and was 
 visited by physicians and students from near and far. 
 
 There was also presumably some kind of a collection at the 
 Medical School for, on April eighth, 1847, Dr. J. B. S. Jackson was 
 appointed Professor of Morbid Anatomy and curator, but it was 
 not dignified by a name or a permanent abiding place. With the 
 completion of the building on North Grove street, a large room, 
 which had been especially planned, was available for a museum. 
 
 Dr. Warren saw the opportunity and generously gave the speci- 
 mens of human anatomy, normal and pathological, in his collection,* 
 together with the sum of five thousand dollars as a permanent fund 
 for its endowment. In accepting the gift the President and Fellows 
 voted " That the collection be known and designated as the War- 
 ren Anatomical Museum, and that this name be placed in gold 
 letters over the door of entrance to the museum." 
 
 In those days bodies for dissection were obtained with difficulty, 
 and Dr. Warren wishing to furnish an example to the public, and 
 aid the students, bequeathed his to the School. The skeleton of it 
 was prepared and placed permanently in the museum. 
 
 Professor Jackson, the first curator, held his office for thirty-two 
 years, resigning in 1879. His interest and devotion were unceasing, 
 
 *The remainder of his coilection was preserved under the name of the Warren Museum of 
 Natural History in a separate building; on Chestnut street. It contained the celebrated skeleton 
 of the mastodon, found at Newburg, N.Y. This with the other specimens have been purchased 
 by the American Museum of Natural History this year (1906) , and the collection is now broken up, 
 
 (171) 
 
172 THE HAEVAED MEDICAL SCHOOL. 
 
 and the additions to the collection which he made are a lasting 
 monument to his zeal. 
 
 He had studied in the school of Louis and the careful and 
 minutely detailed descriptions of his observations, with the 
 unaided eye, are remarkable to the students of to-day, whose 
 range of vision has been extended by the microscope into the 
 realms of the infinitely small. He was a most frugal custodian, and 
 the original endowment had more than doubled when he laid down 
 his trust. 
 
 During his term of office he was ably seconded by Professor 
 Holmes from the side of normal anatomy, who recognized the 
 value of permanent preparations as an aid to teaching. From the 
 lack of fresh subjects for the class they were more needed then 
 than at the present time, and from such muscular, nervous, and 
 vascular specimens the greater part of the student's knowledge was 
 then obtained. Among his demonstrators the name of Dr. Hodges 
 stands out pre-eminent for the wonderfully skilful dissections 
 which he made for the daily lectures, many of which were pre- 
 served and are still in use to-day. 
 
 Since Professor Dwight has occupied the Chair of Anatomy, he 
 has always taken a deep interest in the welfare of the museum, as 
 the frozen sections, corrosions, and bone collections made by him 
 testify. This last, which comprises many series illustrating the 
 normal development and variation of the human skeleton, has been 
 beautifully mounted and arranged in a way that makes it of very 
 great value for reference. His demonstrators have also left their 
 contributions, and the celloidin and fusible metal corrosions of Dr. 
 Mixter are testimonials of his skill. 
 
 It would go beyond the purpose of this article to give any 
 detailed description of the pathological specimens which are in 
 the cases. It is sufficient to say that, thanks to the work of Dr. 
 Jackson, aided by the pathologists of the hospitals, there are few 
 
THE WAKREN ANATOMICAL MUSEUM. 173 
 
 diseases which are not shown in the effect which they have left 
 upon the body. In surgical pathology the collection is especially 
 rich in fractures and new growths, and they have been frequently 
 drawn upon to furnish illustrations for our standard text-books. 
 
 There are two specimens, however, which should be mentioned, 
 one for its intrinsic and the other for a sentimental value. 
 
 The first is the so-called "crow bar skull." It is the head 
 through which a tamping iron was driven by a premature blast. 
 The man lost one eye, but completely recovered and lived for thir- 
 teen years after the accident in full possession of his faculties. The 
 case has a world-wide recognition, and visitors have come from all 
 parts of the globe to verify with their own eyes the truth of the 
 statement. 
 
 The second might well be called our most valuable, for its date, 
 1783, is almost coincident with the birth of the School, and it is our 
 oldest specimen, one hundred and twenty-three years of age. It 
 is a little wax figure about ten and a half inches high of a parti- 
 colored negro child. The letters accompanying this model are here 
 recorded to insure their preservation. 
 
 " BOSTON, August eleventh, 1783. 
 Sir : Mr. Silas C. Brenton wishes his compliments may be presented to the 
 Corporation of Harvard College and begs their acceptance of the portrait of 
 a child, which the bearer will deliver you. All the history which can be 
 obtained here will be sent you to-morrow. 
 
 1 am. Sir, 
 
 Your most obed' Servant, 
 
 WILLIAM CRAFTS. 
 Ebenezer Stover, Esq." 
 
 With this letter of gift is another paper : 
 
 " This portrait was very exactly taken from a female child named Magdel- 
 aine. She was born in the Island of St. Lucia in the month of January, 
 1783, of a black mother, a native of the Island, who declares the father was 
 an African slave, at her birth she was the same color as at the time this copy 
 
174 THE HARVARD MEDICAL, SCHOOL. 
 
 was taken, which was last May. The child was remarkably healthy when Mr. 
 Silas C. Brenton saw her, who is a reputable merchant of the country, but 
 has for several years resided at Martinico, where the child was brought and 
 exhibited as a public show. Mr. Brenton declares as great a likeness subsists 
 between this portrait and the original as is possible between art and nature. 
 The child, before Mr. Brenton left the Island, was purchased at an immense 
 sum to carry to Europe as a curiosity of the human species. 
 
 August fifteenth, 1783." 
 
 Since then this little figure has accompanied the School in all its 
 wanderings, and will look as placidly from its glass case at the 
 stately hall, in which it will find a resting-place, as it did in its 
 humble room in Holden Chapel, where the School was just begin- 
 ning. 
 
 The value of the collection had increased so much, while in the 
 North Grove street building, that the danger of loss from fire was 
 a cause of grave apprehension. And this fear was one of the 
 strongest motives in making the appeal for funds to erect the build- 
 ing on Boylston street. As soon as that was completed, in 1883, 
 the museum was moved, and the " Cabinet of the Boston Society 
 for Medical Improvement" was added to it. This, which was also 
 in a great part the work of Professor Jackson, had been given some 
 time before, but with a condition that a safe depository should be 
 provided for it. 
 
 It was supposed that the room then arranged would be ample for 
 an indefinite time. But the growth of the museum has kept pace 
 with that of the School, and the number of specimens has about 
 doubled. There are now about ten thousand. 
 
 The crowded shelves testify that they are but waiting the 
 opportunity for expansion, which will be had in their new quarters, 
 so that the rare specimens which have been brought together with 
 such care can be properly exhibited. 
 
 With its transfer to the Morgan Building the future of the 
 museum can be looked upon as assured for generations. The 
 
THE WARREN ANATOMICAL MUSEUM. 175 
 
 Henry Jackson Fund, given by one who has also rendered great 
 aid to the new foundation, has raised the endowment of the 
 museum to one hundred thousand dollars. According to the deed of 
 gift the income of this is to be used for providing a suitable annual 
 salary for the curator of the museum, and for maintaining its 
 efficiency as an aid to medical and surgical education and research 
 in such manner as shall be recommended from time to time by the 
 Faculty. 
 
 The curatorship is to be known in the future as "The John 
 Barnard Swett Jackson Curatorship." 
 
 Each generation of teachers as it has passed has left its mark, 
 and their contributions to the museum are silent witnesses of the 
 stage which medical science had reached at their time. 
 
 To-day the efforts are in the direction of preserving tissues in 
 their natural colors. This has been partly accomplished in the 
 Kaiserling method and its modifications. The range of objects 
 which can thus be used is greatly increased, and if they can be 
 kept in a solidified gelatine medium indefinitely, a great problem 
 seems to have been solved. 
 
 The museum is not only a depository for valuable specimens, 
 but its material is used largely for teaching in surgery and 
 anatomy, and for study by numerous investigators whose publica- 
 tions have spread its fame far and wide. 
 
 It only remains to add that the same progress which is expected 
 in every other Department of the School will be attempted here, 
 and that is to have the museum rank as the finest teaching 
 collection in the country. 
 
THE NEW MEDICAL SCHOOL. 
 
 When the Medical School moved into the building on Boylston 
 street in 1883 it was thought that provision had been made for its 
 necessities for,' at least, another generation. 
 
 The rapid increase in the number of students, combined with 
 the great changes introduced in laboratory instruction during the 
 first two years of the course, brought about a condition of things 
 which made it plainly evident that another change could not long 
 be delayed. 
 
 It was also quite evident that the whole system of laboratory 
 accommodation must be organized upon a vastly greater scale than 
 had ever before been attempted. To Professor H. P. Bowditch 
 belongs the credit of first appreciating the situation and, in asso- 
 ciation with Professor J. C. Warren, of devising a scheme along 
 the broad lines on which the plans of the new School have been 
 worked out. He proposed a group of buildings arranged somewhat 
 on the plan of the modern German medical school — that the 
 various departments should be housed in separate "Institutes " — 
 such as the Institute of Anatomy, the Institute of Physiology. 
 
 In this way ample space would be provided for laboratory facili- 
 ties and for the teaching of students in small sections, isolated 
 more or less from one another. At the same time each Depart- 
 ment would be able to arrange its courses of study and to perform 
 research work without that friction which is inevitable when all are 
 crowded into one building. 
 
 It was also felt that the time had come when the School 
 required a more intimate association with hospital service than is 
 customary in this community, so that the Medical Department, 
 so far as its clinical professorships were concerned, should not be 
 the only one of the University which could not go beyond the 
 
 (177) 
 
178 THE HARVARD MEDICAL SCHOOL. 
 
 limits of the City of Boston in selecting a candidate for a vacant 
 chair. 
 
 It was appreciated that under such a system the associated 
 hospitals, by obtaining the best talent the clinical world could 
 afford, would be equal gainers by the arrangement. 
 
 The plan as thus outlined resulted in the acquisition of a tract 
 of land within the city's limits, so situated as to be easily 
 reached from the three great hospitals, and at the same time to 
 furnish a site for hospital service that would meet the wants of 
 the sick poor of the city. 
 
 (The land eventually acquired amounted to twenty-six acres. 
 A portion of this, about ten acres, was set aside for the School 
 buildings.) 
 
 After a careful study of the problem by the Medical Faculty a 
 general scheme was worked out by which teaching and research 
 quarters were provided for in four large laboratory buildings. 
 These buildings are connected by a covered way and face upon 
 a court at the head of which is situated a building for adminis- 
 tration, clinical lectures and the Museum. It was at one time 
 proposed that this building should be placed in the center of the 
 group, but the question of light decided the adoption of the 
 present plan. 
 
 The buildings themselves each consist of two large wings 
 attached by a central building, which contains a lecture room 
 and departmental library — the whole forming a U-shaped 
 structure. Allied departments such as Physiology and Chem- 
 istry occupy the wings, while the central portion is to be used 
 in common. 
 
 By the use of what is called the "unit system" (devised 
 by Professors C. S. Minot and W. T. Porter), the wings of the 
 various buildings could be divided to adapt them to all kinds of 
 laboratory work needed by the School. The unit room adopted 
 
THE NEW MEDICAL SCHOOL. 179 
 
 by the architects is an apartment twenty-three feet deep by ten 
 feet in width, lighted by one window in the middle of the ten- 
 foot exterior wall space. The partitions of terra-cotta separating 
 each unit were intended to be so arranged as to enclose any 
 given number of units, and to be removed or replaced from time 
 to time as necessity required, thus giving accommodation for 
 small sections, laboratories, professors' rooms, and research work 
 of all kinds. The plans were finally worked out by the architects 
 upon substantially this basis. 
 
 The great need for expansion was the proposition which the 
 School had to face, and the suggestions seemed impracticable to 
 many at first, because of their greatly extended scope as com- 
 pared with existing conditions. 
 
 There were, however, several large funds which the Corpora- 
 tion had recently acquired, such as the Henry L. Pierce and the 
 Billings Fund, from which it was hoped an appropriation might 
 be made for medical education. Moreover, the funds of the 
 Medical Department of the University had shown a steady 
 increase. During the preceding six years $680,000 had been 
 added to the endowments of the School, giving an average of 
 over $117,000 a year. This Indicates a distinctly friendly in- 
 terest in the work of the School by the rich men of Boston, 
 and the effect which had been produced by its very progressive 
 policy. Meanwhile the value of the land on which the School 
 building was situated had increased greatly, so that the resources 
 from this source had about doubled in value. The project, 
 therefore, was not so chimerical as it seemed to many at the 
 time. The first problem which presented itself was the acqui- 
 sition of land. This could not be purchased until the general 
 plan had been so far worked out that a practical scheme could 
 be elaborated upon the basis of which money could be asked 
 for, and yet without money no land could be secured. 
 
180 THE HARVARD MEDICAL SCHOOL. 
 
 It was due to the suggestion of Major Henry L. Higginson that 
 a syndicate was formed by which land was purchased. This 
 land was to be held until the School was able to buy it, 
 when it was to be sold at the purchase price plus interest and 
 taxes. 
 
 A rough estimate showed that at least two million dollars would 
 be needed for the purchase of land and buildings. This seemed 
 a large sum, but the School already had an endowment of a million 
 on the books of the University, and other resources above men- 
 tioned were capable of yielding another million. But it would 
 be folly to attempt such an undertaking without a great increase 
 of endowment funds. 
 
 The time, however, was favorable. The financial prosperity 
 of the country had never before risen to so high a level. Great 
 enterprises had been undertaken by our men of wealth on a scale 
 which had fairly startled the world. It was felt that the time 
 had arrived when practical men of affairs would appreciate the 
 work in which our profession was engaged and its bearing upon 
 the welfare of the country. 
 
 The first of the benefactors to respond to the appeal of the 
 School was Mr. J. Pierpont Morgan, of New York. Mr. Morgan's 
 father had been at one time a resident of Boston, and the 
 occasion seemed a favorable one for a memorial gift. Mr. Morgan 
 had an opportunity to become well informed as to the plans of 
 the new enterprise through his partner, Hon. Robert Bacon, and 
 he accordingly selected the Administration and the two flanking 
 buildings as his gift, involving an expenditure of ^1,135,000. 
 
 About this time Mr. John D. Rockefeller had become interested 
 in the advancement of medical science and its great possibilities, 
 and his attention was called to Mr. Morgan's gift by Dr. W. B. 
 Coley, of New York. Mr. Starr J. Murphy was requested to 
 make an investigation of the work in which the Harvard Medical 
 
THE NEW MEDICAL SCHOOL. 181 
 
 School was engaged. After a lengthy study of the problem Mr. 
 Murphy made his report, which was a most favorable one. 
 
 Mr. Rockefeller, finding that the corporation had 1:3,185,000, 
 including the Morgan gift, and that it would require 114,950,000 to 
 build and provide a suitable endowment, offered to give one 
 million dollars, provided that the balance — $765,000 — was pro- 
 cured from other sources. These figures were finally determined 
 after a conference between Mr. John D. Rockefeller, Jr., President 
 Eliot, Professors Bowditch and Warren. 
 
 The task still remained to raise the amount which was the 
 condition of Mr. Rockefeller's gift. Thus challenged as it were 
 by New York, Boston responded most spiritedly and in a short 
 time one half a million was subscribed. Out of the money thus 
 given a fourth, the David Sears Building, was made possible 
 and a Higginson and a Shattuck Professorship were endowed. 
 
 But New York also joined in the work and the Collis P. Hunt- 
 ington Building Fund and the Stillman Professorship Fund for 
 Comparative Anatomy were two conspicuous gifts among many 
 others. The money actually raised far exceeded the amount 
 needed to secure the Rockefeller gift and the completion of the 
 great project was assured. 
 
 Land was first broken for the erection of the buildings in Sep- 
 tember, 1903, and now in the spring of 1906 the finishing touches 
 are being placed upon the great work. This is true so far as the 
 buildings of the School are concerned. 
 
 There yet remains the development of the clinical side of the 
 new system. The Faculty has long recognized its limitations in 
 the selection of clinical teachers. This limitation is characteristic 
 of our American system and is due to the failure of hospital and 
 school to form a more intimate union than exists in the great 
 majority of teaching centers in this country. The Faculty has 
 had at its disposal the abundant clinical facilities which exist in the 
 
182 THE HARVARD MEDICAL SCHOOL. 
 
 various hospitals in Boston. The Massachusetts General Hospital 
 was founded nearly one hundred years ago by men interested in 
 medical education. No such intimate union of school and hospital 
 has ever been effected, however, as exists in Continental Europe, 
 and has been proved to be of great benefit to each. 
 
 The Faculty, having no hospital service within its gift, must limit 
 its choice of teachers to a selection from the staffs of hospitals in 
 its neighborhood. A hospital certainly cannot tempt a distin- 
 guished teacher from another city to accept a service in its wards 
 unless it is affiliated with a medical school. As a result the 
 Medical Department of Harvard has been hitherto the only depart- 
 ment of that University which could not go outside of Boston in 
 selecting many of its professors. With a hospital service at its 
 disposal it would feel justified in making a world-wide search for 
 an occupant of a vacant chair in medicine or surgery. Fortunately 
 the present movement of the School has coincided with the cul- 
 mination of a slowly maturing bequest for a new hospital in this 
 city, the Peter B. Brigham Hospital, and a sum of equal dimension 
 to that provided for the School it is hoped will soon be in the 
 hands of the Trustees of that fund. An agreement for the pur- 
 chase of a portion of the land has been made with the Corporation 
 of the University. 
 
 The nature of the relation between these two bodies is expressed 
 in the following clause taken from a letter from the Trustees of the 
 fund : 
 
 " So far as the charitable purposes of this trust shall in our 
 opinion permit, we hereby declare our desire to promote the 
 objects of your medical school by seeking advice from its Faculty 
 and by giving ample consideration to its nominations in making 
 its appointments to our Medical Staff and by permitting access for 
 students to the hospital." 
 
 Not only is a general hospital to form part of the new system 
 
THE NEW MEDICAL SCHOOL. 183 
 
 but special hospitals such as the Children's and Infants' Hospitals 
 have secured locations upon the School grounds. It is expected 
 that the relations between these hospitals and the School will be 
 of a similar character. 
 
 The number of students applying annually for admission to the 
 School, which at first had fallen off owing to the increased require- 
 ments for admission, is now beginning to increase. Recent statis- 
 tics have shown that the standard of excellence attained by her 
 scholars is higher than in any other school in the country.* In 
 short, there is reason to hope that a great Medical University 
 is in the process of evolution. 
 
 ^Report of Illinois State Board of Health. 
 
THE NEW HARVARD MEDICAL SCHOOL BUILDINGS. 
 
 J906. 
 In August of 1900 Drs. Henry P. Bowditch and J. Collins 
 Warren called at the office of Shepley, Rutan, & Coolidge, and 
 informed them that they were authorized by the Corporation of 
 Harvard College to consult with them and have sketch plans drawn 
 for the Administration and Laboratory and Research Buildings 
 which they considered necessary for a new Medical School ; these 
 buildings to embody the most modern methods of teaching and 
 research work. They stated that through the kindness of certain 
 gentlemen who were interested in the welfare of the University 
 a piece of land formerly belonging to the Francis estate had been 
 acquired. This lot of land is situated in Boston, and contains a 
 little over twenty-six acres bounded by Francis street, Huntington 
 avenue, Longwood avenue and extending beyond Vila street in a 
 westerly direction. 
 
 After many consultations it was decided that the highest portion 
 of the land, which is at the junction of Huntington avenue and 
 Francis street extending along the latter, should be reserved as a 
 site for a general hospital, and that that portion towards the west, 
 which was not needed for the Medical School buildings and their 
 enlargement in the future, should also be reserved for hospital 
 purposes. 
 
 The land where it was proposed to locate the Medical School falls 
 about twelve feet from that reserved for the general hospital, so 
 that the problem presented was quite difficult to solve, as one of 
 the first requirements in the new buildings was to have communi- 
 cation between all the buildings by a corridor which should be 
 level. 
 
 Several different schemes for the arrangement of the laboratories 
 
 (185) 
 
186 THE HAEVAKD MEDICAL SCHOOL. 
 
 and Administration Building were drawn up ; one being to place all 
 the rooms which are now in five buildings in two high buildings. 
 This scheme was very carefully considered, and the advantages and 
 disadvantages weighed against the plan finally adopted. 
 
 Although the two-building scheme is slightly cheaper in the 
 original cost, yet it requires elevator service for the students, 
 which is not the case in the present buildings. It also prevented 
 the laboratories and the instructors' rooms connected with them 
 being segregated as they are in the present scheme. 
 
 Where microscopes are used and a large number of students are 
 to be in one room it will readily be seen that the room must of 
 necessity be much higher than an ordinary research room where 
 only one individual is at work, and to group these successfully in 
 the scheme where only two large buildings were used was found to 
 be a very much more difficult matter than in the present arrange- 
 ment. 
 
 At the same time that these various ideas were being discussed 
 the heads of the different Departments were being consulted in 
 regard to the amount of space and arrangements in detail, and 
 before either scheme was decided upon definitely each Department 
 had gone into all the details which were deemed necessary in the 
 buildings to make them complete. 
 
 At this time Dr. Farrar Cobb was associated with the archi- 
 tects and was of great assistance in advising and in formulating and 
 compiling the mass of information and requirements which had 
 been obtained. 
 
 In most of the buildings which have been designed for our 
 American universities sufficient attention has not been paid to the 
 future and the possibility that, as the system of teaching may 
 change, the building should be so designed and constructed that it 
 can be adapted to these future ideas and needs. In both the 
 schemes which were worked out the future growth of the buildings 
 
THE NEW HARVARD MEDICAL SCHOOL BUILDINGS. 187 
 
 was considered and arranged for, in that the wings may be extended 
 to a sufficient depth to form a court in which the light will penetrate 
 to the rooms surrounding it and that these two wings may be con- 
 nected together at the far end by an additional parallel with the 
 front. Here again the plan adopted shows its superiority over that 
 of a high building, as the light on the entrance floor in the latter is 
 impeded by the height of the wings. 
 
 As soon as the general form and arrangement of the buildings 
 was decided upon, sketch plans and sketches were prepared and 
 pen and ink drawings, from which reproductions were made and 
 given to Dr. Bowditch and Dr. Warren, and to their untiring efforts 
 the completion of the new Medical School buildings is due. 
 
 While this was going on drawings were made in detail and 
 turned over to the heads of the Departments for their criticism and 
 revision, and changes were made until each one had expressed 
 himself as satisfied, after which a complete set of working drawings 
 were made which were gone over very carefully by President Eliot 
 and Drs. Walcott and Cabot, who represented the Corporation. 
 These were approved by them, and bids were taken. 
 
 Before the contract was signed. The Norcross Bros. Co. offered 
 to substitute marble from their quarries in Dorset, Vt., without 
 change from the contract price, and this was accepted by the Corpo- 
 ration and the architects. The contract was let to The Norcross 
 Bros. Co. on August twelfth, 1903, and work was at once begun. 
 
 The final lay-out of the buildings as shown in the perfected plan 
 is based largely on what is known as the unit system, but differs 
 from other unit systems in this fact: that all previous unit systems 
 duplicated each section teaching room, say of twenty -four feet 
 square as a unit, and the new Medical School takes a unit of ten 
 feet, which is a window and half a pier space on each side of the 
 window as a unit. These ten foot units are used for a single 
 research room, but as the walls of the building which are permanent 
 
188 THE HAKVARD MEDICAL SCHOOL. 
 
 are only the outside walls, and those along the corridors, it 
 permits the intermediate walls, which form the two sides of the 
 room, to be taken out at any time and new rooms formed which 
 may be ten, twenty, thirty, or any multiple of ten feet in length 
 as may be required in the future. 
 
 The general section teaching room throughout the buildings, 
 except that for pathology and bacteriology, is a room which will 
 accommodate twenty-four students with the apparatus and tables 
 which are necessary in their work. This, at the present time, 
 seems to be the most economical number for one instructor to have 
 under him in many of the Departments. Such a room consists of 
 three units of ten feet. All of the buildings except the Administra- 
 tion Building, which is in the center and raised above the labora- 
 tory buildings by a terrace which takes up the difference in level 
 of the ground from the south side of the buildings to Longwood 
 avenue, consist of two laboratory wings joined together by a 
 lecture room which is entered at either end, with the libraries of 
 the affiliated Departments over it. These lecture rooms can be 
 used by the men in one laboratory without disturbing those in the 
 other, as the doors by which they are entered are on opposite sides. 
 The lecturer's desk is on the ground floor level and adjoining are 
 two preparation rooms, one on each side, while the students enter 
 from the main floor. 
 
 The plan finally adopted consists of five buildings with their 
 fronts grouped around a quadrangle two hundred and fifteen by 
 five hundred and fourteen feet, with the Administration Building in 
 the center of the south end of the quadrangle. The corridor, which 
 connects them all, passes through the basement of the Administra- 
 tion Building, but is on the ground floor of the others and is carried 
 under the Administration Building terrace. Between the laboratory 
 buildings the corridor is one story above the ground, with only the 
 pipe tunnel under it. 
 
BASEMENT Plan of the New buildings. 
 
 Shepley, Rutan & Coolidge, Architects. 
 ' 1906. " ^3. 
 
A- ADMINISTRATION BUILDING 
 
 B- ANATOMY AND HISTOLOCY BUILDING 
 
 C- PHYSIOLOGY AND PHYSIOLOGICAL 
 
 CHEMISTRY BUILDING 
 D- BACTERIOLOGY AND PATHOLOGY BUILDING 
 E- HYGIENE AND PHARMACOLOGY BUILDING 
 r - ANIMAL HOUSE 
 
 PLAN or BASEMENTS 
 
First floor plan of the New Buildings. 
 
 Shepley, Rutan & Coolidge, Architects. 
 1906. 
 
A- ADMIN[STRAT10N BUILDING 
 
 B- ANATOMY AND HISTOLOGY BUILDING 
 
 C- PHT5IOLOCY AND PHYSIOLOGICAL 
 
 CHEMISTRY BUILDING 
 D- BACTERIOLOCY ^ND PATHOLOGY BUILDING 
 E.- HYGIENE. AND PHARMACOLOGY BUILDING 
 F ANIMAL HOUSE 
 
 PLAN OF FIRST FLOORS 
 
THE NEW HARVARD MEDICAL SCHOOL BUILDINGS. 189 
 
 The accompanying plans will explain more clearly than any 
 verbal description. 
 
 One of the advantages of the present arrangement is that the 
 front on the quadrangle is a completed fagade and allows additions 
 to be made to the different laboratories, as time may require, with- 
 out disturbing the architectural effect of the quadrangle. 
 
 In designing the buildings, the architects chose a style which per- 
 mitted great simplicity, and they relied on the relation of the 
 masses to produce the effect rather than upon any elaboration of 
 detail. The style is an adaptation of the original Greek. The 
 doorways of the laboratories are similar to those discovered in 
 Assos by the American expedition. 
 
 The distance between the buildings and the wings was deter- 
 mined by actual experiments on the site, and the buildings were 
 placed far enough apart to allow the sun, in winter, to reach the 
 basement windows. 
 
 In every case special attention was given to light. The windows 
 in the teaching laboratories go to the ceiling and are high enough to 
 allow the use of microscopes in the rear desks. 
 
 The large central building of the group is the Administration 
 Building, which contains, on the first floor, the Faculty room, and 
 adjoining it the offices of the Dean and Secretary, the telephone 
 exchange, janitor's room, a large reading room for the students 
 with a smoking room connected with it, and a room for the alumni. 
 
 On the second floor on the east side is an amphitheater for 
 lectures on surgery, and on the west side a large room for medi- 
 cine, obstetrics, theory and practice of medicine, and other sub- 
 jects. There are also two smaller lecture rooms at the head of the 
 staircase. 
 
 The Warren Anatomical Museum occupies the whole of the three 
 upper floors and is lighted by skylights, glass floors between the 
 cases as well as windows in every alcove, and is connected 
 
190 THE HARVARD MEDICAL SCHOOL. 
 
 with the unpacking room in the basement by a large elevator. 
 There are also rooms for the curator of the museum on the third 
 floor. 
 
 In the basement are the rooms for X-ray photography and 
 instruction in bandaging. There are also locker rooms and lavato- 
 ries for the students. 
 
 To one standing in the court facing the Administration Building, 
 on the left, next the Administration Building is that for anatomy 
 and histology. It contains also the Departments of Operative 
 Surgery and Comparative Anatomy. The Anatomical Department 
 occupies the south wing and Histology and Comparative Anatomy 
 the north wing. 
 
 The building opposite anatomy to the right of the Administration 
 Building is devoted to physiology and physiological chemistry, 
 physiology being in the south wing. Besides the section teaching 
 rooms there are rooms for research work, an operating room for 
 animals and sets of rooms for animals under observation, which 
 have been arranged with especial care. There are also animal 
 houses on the roof especially ventilated and arranged with yards 
 for exercise in the open air. 
 
 The laboratories for physiological chemistry are fitted with all 
 the most modern conveniences, and also have rooms devoted to 
 special research work by individuals. 
 
 The library in this building differs from the others in that the 
 books are arranged in stacks instead of wall cases. 
 
 This and the two preceding buildings were provided by Mr. J. P. 
 Morgan. 
 
 Next to the Anatomy Building on the same side and on Long- 
 wood avenue is the C. P. Huntington Building for pathology and 
 bacteriology. This differs from the others in that the teaching 
 laboratories take up one wing, and the professors', instructors', and 
 research rooms occupy the whole of the other or south wing. 
 
THE NEW HAEVARD MEDICAL SCHOOL BUILDINGS. 191 
 
 The teaching laboratories, of which there are four, are twenty 
 feet high, and this height allows two ten foot stories on the research 
 side for each teaching laboratory, so that the building in the teach- 
 ing wing is, including the entrance floor, three stories, and on the 
 research side five stories high. 
 
 The teaching laboratories each have a capacity of forty-eight 
 students. Besides the research rooms in the south wing there are 
 rooms devoted to gross photography, also photomicrography and 
 ultra violet photomicrography; four rooms are also devoted to 
 surgical pathology. 
 
 In the rear of the building is a separate structure for the housing 
 of animals. Besides the smaller animals it is arranged for large 
 ones, such as cows. 
 
 On the opposite side of the quadrangle from pathology and bac- 
 teriology is the David Sears Building, devoted to hygiene, pharma- 
 cology, therapeutics, and comparative pathology and surgical 
 research. Pharmacology and therapeutics occupy the south wing 
 with space on the third floor for surgical research. The north wing 
 has on the front the Department of Hygiene, which besides its 
 teaching laboratories has a museum for exhibiting foods and appli- 
 ances relating to public health. 
 
 The Department of Comparative Pathology occupies the rear half 
 of this wing on all floors. It has on the two lower floors labora- 
 tories for students and professors, a room for autopsies and small 
 rooms to be used in connection with the laboratories. The upper 
 floors are devoted to research and original work. On the top floor 
 are animal rooms with an operating room adjoining. 
 
 All the amphitheaters have two preparation rooms one on either 
 side and automatic screens for shutting out the light, worked by a 
 button at the desk. Special platforms for the lanterns are so 
 arranged that there will be no distortion in the image thrown upon 
 the wall. 
 
192 THE HARVARD MEDICAL SCHOOL. 
 
 The heating, ventilating, lighting, refrigerating and power plants 
 were worked out by Messrs. Densmore & LeClear in conjunction 
 with the architects, and the general scheme is as follows : 
 
 The central walls on either side of the corridors in all the build- 
 ings are hollow and contain all the heating and ventilating flues. 
 The system used is indirect hot water. The hot fresh air is forced 
 by fans from a plenum in the basement into the upper part of the 
 rooms and exhaust fans pull out the foul air from the lower level. 
 In the chemical laboratories the foul air goes out through the hoods 
 as well as the exhaust ducts. Sufficient direct radiation, however, 
 is installed to keep the buildings moderately heated during the night 
 and Sundays when the fans are not running. Below the corridor, 
 which gives communication between all the buildings, there is a 
 tunnel which connects with the power house on Vila street. In 
 this tunnel are carried the hot water pipes for the heating, hot 
 water for the hot water service in all the buildings, gas and steam- 
 pipes, electric conduits, brine for the refrigeration and all other 
 necessary pipes. This tunnel is large enough for men to work in 
 freely. In the power house are installed all the necessary appli- 
 ances for heating, lighting, refrigerating, and power. It is also 
 intended to supply the different hospitals from this same 
 station. 
 
 It is proposed to eventually close the end of the main quadrangle 
 on Longwood avenue with an iron fence and gates of a monu- 
 mental character, one at the entrance of the terraces on either side 
 and a large gate in the center of the quadrangle. This fence and 
 gates it is hoped will be contributed by the classes of the Medical 
 School on their graduation. 
 
 A boulevard one hundred feet wide will be constructed on the 
 north and south axis of the quadrangle connecting the Medical 
 School buildings with the Fenway. This will be planted with elms 
 on either side. 
 
THE NEW HARVABD MEDICAL SCHOOL BUILDINGS. 193 
 
 At the junction of Longwood avenue and the Boulevard there 
 will be a plaza starting on the line of the buildings in the quad- 
 rangle and sweeping in the arc of a circle until it intersects the 
 boulevard. Thus the buildings will have a suitable and dignified 
 approach. 
 
THE FACULTY OF THE MEDICAL SCHOOL FOR THE 
 ACADEMIC YEAR, 1906-1907.* 
 
 CHARLES W. ELIOT, A.M., LL.D., PRESIDENT. 
 
 WILLIAM L. mCHARDSOH, lA.D., DEAN, and Professor of Obsieirtcs. 
 
 CLARENCE J. BLAKE, lA.D., Professor of Otology. 
 
 HENRY P. BOWDITCH, M.D., LL.D., George Higginson Professor of 
 
 Physiology (Resignation to tal<e effect upon September first, 1906). 
 J. COLLINS. WARREN, M.D., LL.D., HON. F.R.C.S. (Eng.), Moseley 
 
 Professor of Surgery. 
 
 REGINALD H. FITZ, M.D., LL.D., Hersey Professor of the Theory and 
 Practice of Physic. 
 
 THOMAS DWIGHT, M.D., LL.D., Parkman Professor of Anatomy. 
 JOHN H. MCCOLLOM, M.D., Assistant Professor of Contagious Diseases. 
 JAMES J. PMl^AtA, M..D., Professor of Diseases of the Nervous System. 
 ELBRIDGE G. CUTLER, M.D., Instructor in the Theory and Practice of 
 Physic. 
 
 FREDERICK C. SHATTUCK, ^.D., fackson Professor of Clinical Medicine. 
 EDWARD H. 'e,'RKD¥ORD,^.V).,Professor of Orthopedic Surgery. 
 THOMAS MORGAN ROTQM.,^.^., Professor of Pediatrics. 
 WILLIAM F. WHITNEY, tA.D., John Barnard Swettfackson Curator of the 
 
 Warren Anatomical Museum. 
 CHARLES S. MINOT, S.D., LL.D., D.SC, James Stillman Professor of 
 
 Comparative Anatomy. 
 MAURICE H. m<ZVikR\yiO\\,^.V>., Professor of Clinical Surgery. 
 CHARLES M. GREEN, M.D., Associate Professor of Obstetrics and Clinical 
 
 Gynecology, and Secretary of the Faculty of Medicine. 
 HERBERT L. BVi'9.REL'L,^.D., Professor of Clinical Surgery. 
 WILLIAM T. COUNCILMAN, M.D., Shattuck Professor of Pathological 
 
 Anatomy. 
 MYLES STANDISH, M.D., Assistant Professor of Ophthalmology. 
 HAROLD C. ERnST, lA.r)., Professor of 'Bacteriology. 
 CHARLES HARRINGTON, M.D., Professor of Hygiene. 
 HERMAN F. VICKERY, M.D., Instructor in Clinical Medicine. 
 JOHN T. BOWEN, M.D., Assistant Professor of Dermatology. 
 
 *Arrange(J, with the exception of the President and Dean, on the basis of collegiate seniority. 
 
 («95) 
 
196 THE HAEVAED MEBICAL SCHOOL. 
 
 HENRY JACKSON, M.D., Instructor in Clinical Medicine. 
 GEORGE G. S^h^S, lA.Yy., Assistant Professor of Clinical Medicine. 
 ALGERNON COOLIDGE, JR., M.D., Assistant Professor of Laryngology. 
 FRANZ PFAFF, M.D., Professor of Pharmacology and Therapeutics. 
 THEOBALD SMITH, M.D., George Fdbyan Professor of Comparative 
 
 Pathology. 
 WILLIAM T. PORTER, M.D., Associate Professor of Physiology. 
 JAMES G. MUMFORD, M.D., Instructor in Surgery. 
 FRANK B. NiALLORY,Ni.Ti., Associate Professor of Pathology. 
 EDWARD H. WCHOLS, Ni.D., Assistant Professor of Surgical Pathology. 
 JOHN B. BLAKE, M.D., Instructor in Surgery. 
 HOWARD A. LOTHROP, M.D., Instructor in Surgery. 
 JOHN L. MORSE, M.D., Assistant Professor of Pediatric^. 
 CHARLES A. PORTER, M.D., Instructor in Surgery. 
 EDWARD W. TAYLOR, M.D., Instructor in Neurology. 
 RICHARD C. CABOT, M.D., Instructor in Clinical Medicine. 
 ELLIOTT P. JOSLIN, M.D., Instructor in the Theory and Practice of Physic. 
 JAMES H. '^mGWT,m..T>.,S.Yi., Instructor in Pathology. 
 CARL L. ALSBERG, M.D., Instructor in Biological Chemistry. 
 JOHN L. BREMER, M.D., Demonstrator of Histology. 
 WALTER B. Cm^OH,}A.Xi.,Assistant Professor of Physiology. 
 JOHN WARREN, M.D., Demonstrator of Anatomy. 
 FREDERIC T. LEWIS, lA.D., Assistant Professor of Embryology. 
 ELMER E. SOVTHARDr M..D., Assistant Professor of Neuropathology. 
 
 INSTRUCTORS, LECTURERS, AND ASSISTANTS.* 
 
 EDWARD COWLES, M.D., LL.D., Instructor in Mental Diseases. 
 
 SAMUEL H. DURGIN, M.D., Lecturer on Hygiene. 
 
 GEORGE W. GAY.M.D., Lecturer on Surgery. 
 
 ABNER POST, IK.Xi., Instructor in Syphilis. 
 
 GEORGE T. 'YMT'W^E.^^K.Yi., Clinical Instructor in Mental Diseases. 
 
 SAMUEL J. MIXTER, M.D., Lecturer on Surgery. 
 
 GEORGE H. MONKS, m.Xi^^K.^.d.'S,., Lecturer on Surgery. 
 
 FRANCIS S. WATSON, M.D., Lecturer on Genito- Urinary Surgery. 
 
 FRANCIS B. HARRINGTON, M.D., Lecturer on Surgery. 
 
 *Arrang:ed on the basis of collegiate seniority. 
 
THE FACULTY OF THE MEDICAL SCHOOL. 197 
 
 PHILIP COOMBS KNAPP, M.D., Clinical Instructor in Diseases of the 
 
 Nervous System. 
 ROBERT W. LOVETT, M.D., Instructor in Orthopedics. 
 WILLIAM NOYES, M.D., Clinical Instructor in Mental Diseases. 
 JOSEPH P. CLARK, }\.T)., Assistant in Laryngology. 
 ELLIOTT G. BRACKETT, M.D., Instructor in Orthopedics. 
 ARTHUR K. STONE, M.D., Assistant in the Theory and Practice of Physic. 
 FREDERIC C. COBB, tA.D., Instructor in Laryngology. 
 EDWIN E. JACK, M.D., Instructor in Ophthalmology. 
 PAUL THORNDIKE, M.D., Instructor in Genito- Urinary Surgery. 
 GEORGE A. CRAIGIN, M.D., Clinical Instructor in Pediatrics. 
 JOEL E. GOLDTHWAIT, M.D., Instructor in Orthopedics. 
 MALCOLM STORER, M.D., Assistant in Gynecology. 
 JOHN W. BARTOL, M.D., Assistant in Clinical Medicine. 
 WILLIAM E. FAULKNER, M.D., Assistant in Surgery. 
 ELISHA FLAGG, Ni.D., Assistant in Anatomy. 
 JAMES M. JACKSON, M.D., Assistant in Clinical Medicine. 
 ALEXANDER QUACKENBOSS, M..D., Instructor in Ophthalmology. 
 FRANKLIN G. BALCH, M.D., Assistant in Surgery. 
 EUGENE A. CROCKETT, M.D., Instructor in Otology. 
 JOHN DANE, Ni..Yi., Instructor in Orthopedics. 
 FRED B. LUND, M.D., Assistant in Surgery. 
 EZRA R. THAYER, LL.B., Lecturer on the relation of the Medical Profession 
 
 to the Law and the Courts. 
 HARVEY P. TOWLE, M.D., Assistant in Dermatology. 
 GEORGE W. W. BREWSTER, M.D., Assistant in Surgery. 
 ROCKWELL A. COFFIN, M.D., Assistant in Laryngology. 
 JOSEPH L. GOODALE, M.D., Assistant in Laryngology. 
 JAMES S. STONE, M.D., Assistant in Surgery. 
 PHILIP HAMMOND, M.D., Instructor in Otology. 
 HENRY H. HASKELL, M.D., Assistant in Ophthalmology. 
 HENRY F. HEWES, M.D., Instructor in the Clinical Laboratory. 
 CALVIN G. PAGE, M.D., Assistant in Bacteriology. 
 C. MORTON SMITH, M.D., Assistant in Syphilis. 
 CHARLES J. WHITE, M.D., Instructor in Dermatology. 
 FRANKLIN W. WHITE, M.D., Assistant in the Theory and Practice of 
 
 Physic. 
 
198 THE HARVARD MEDICAL SCHOOL. 
 
 OTIS F. BLACK, A.B., Assistant in Biological Chemistry. 
 
 ERNEST A. CODMAN, M.D., Assistant in Surgery. 
 
 FRANCIS P. DENNY, M.D., Assistant in Clinical Medicine. 
 
 WILLIAM P. GRAVES, M.D., Assistant in Gynecology. 
 
 WILLIAM H. ROBEY, JR., Assistant in Clinical Medicine. 
 
 GEORGE S. C. BADGER, M.D., Assistant in the Theory and Practice of 
 
 Physic. 
 EDMUND W. CLAP, M.D., Assistant in Ophthalmology. 
 ROBERT B. GREENOUGH, m.H., Instructor in Surgery. 
 DANIEL F. JONES, M.D., Assistant in Surgery. 
 
 HARRIS P. MOSHER, lA.H., Assistant in Anatomy, BX\A in Laryngology. 
 FRANKLIN S. nE^ELL,}A.T:>., Instructor in Obstetrics and Gynecology. 
 HENRY J. PERRY, m..\^., Assistant in bacteriology. 
 WILLIAM H. SMITH, M.D., Assistant in Clinical Medicine. 
 ARTHUR M. WORTHINGTON, M.D., Assistant in Bacteriology. 
 ERNEST B. YOUNG, M.D., Assistant in Gynecology. 
 CHARLES S. BUTLER, M.D., Assistant in Anatomy. 
 WALTER A. LECOMPTE, M.D., Assistant in Otology. 
 HENRY O. MARCY, JR., M.D., Assistant in Anatomy. 
 FRED M. SPALDING. M.D., Assistant in Ophthalmology. 
 HOWARD T. SWAIN, M.D., Assistant in Obstetrics. 
 FREDERICK S. BURNS, M.D., Assistant in Dermatology. 
 LE ROI G. CRANDON, M.D., Assistant in Surgery. 
 LINCOLN DAVIS, M.D., Instructor in Anatomy. 
 EUGENE E. EVERETT, M.D., Assistant in Bacteriology. 
 MAYNARD LADD, M.D., Instructor in Pediatrics. 
 GEORGE B. MAGRATH, M.D., Assistant in Hygiene. 
 JOSEPH H. PRATT, M.D., Assistant in the Theory and Practice of Physic. 
 HENRY A. CHRISTIAN, M.D., Instructor in the Theory and Practice of 
 
 Physic. 
 LEO V. FRIEDMAN, M.D., Assistant in Obstetrics. 
 CHANNING C. SIMMONS, M.D., Assistant in Surgery. 
 ROBERT J. TERRY, M.D., Teaching Fellow in Histology. 
 WILDER TILESTON, M.D., Assistant in Clinical Medicine. 
 JAMES R. TORBERT, M.D., Assistant in Obstetrics. 
 GEORGE A. WATERMAN, M.D., Assistant in Neurology. 
 CHARLES H. DUNN, M.D., Assistant in Pediatrics. 
 
THE FACULTY OF THE MEDICAL SCHOOL. 199 
 
 EDWIN A. LOCKE, M.D., Assistant in Clinical Medicine. 
 
 LUTHER D. SHEPARD, M.D., D.M.D., Instructor in Histology. 
 
 MAURICE V. TYRODE, M.D., Instructor in Pharmacology. 
 
 RICHARD G. WADSWORTH, M.D., Assistant in Anatomy. 
 
 HORACE BINNEY, M.D., Assistant in Anatomy. 
 
 DAVID CHEEVER, M.D., Assistant in Anatomy. 
 
 FREDERICK T. LORD, M.D., Assistant in Clinical Medicine. 
 
 ERNEST G. MARTIN, PH.D., Instructor in Physiology. 
 
 DAVID D. SCANNELL, M.D., Assistant in Anatomy. 
 
 ERNEST E. TYZZER, M.D., Assistant in Pathology. 
 
 JOHN AUER, M.D., Instructor in Physiology. 
 
 GEORGE L. BAKER, M.D., Assistant in Bacteriology. 
 
 LAWRENCE J. HENDERSON, M.D., Instructor in Biological Chemistry. 
 
 FRANCIS W. PALFREY, M.D., Assistant in Bacteriology. 
 
 SAMUEL ROBINSON, M.D., Assistant in Anatomy. 
 
 S. BURT WOLBACH, M.D., Instructor in Pathology. 
 
 FRANCIS H. MCCRUDDEN, S.B., Assistant in Biological Chemistry. 
 
 ALEXANDER R. ROBERTSON, M.D., CM., Assistant in Pathology. 
 
 AUSTIN TEACHING FELLOWS. 
 
 LANGDON FROTHINGHAM, M.D.V., in Bacteriology. 
 FRANK L. RICHARDSON, M.D., in Surgery. 
 PAUL A. LEWIS, M.D., in Comparative Pathology. 
 FRED W. THYNG, PH.D., in Histology and Emiryology. 
 
THE MEDICAL SCHOOL, BOSTON. 
 
 GENERAL STATEMENT. 
 
 Three professorships of Medicine were established at the University in the 
 years 1782 and 1783. The first degrees in medicine were conferred in 1788. 
 Before 181 1 the degree conferred upon graduates of the School was that of 
 Bachelor of Medicine; beginning with 181 1 the degree has been Doctor of 
 Medicine. In 1810 the lectures given in medicine were transferred from 
 Cambridge to Boston, where the first medical college was built in 1815. 
 
 The course of study required in this School for the degree of M.D. is of four 
 years' duration. This requirement was established at the beginning of the 
 year 1892-93. 
 
 The academic year begins on the Thursday following the last Wednesday 
 in September, and ends on the last Wednesday in June. In order that the 
 time of study shall count as a full year, students of all classes must present 
 themselves on the first day of the School year and register their names with 
 the secretary. 
 
 There is a Christmas recess from December twenty-third to January second 
 inclusive, and a recess of one week's duration in April. 
 
 Beginning with the year 1899-1900 a new arrangement of the subjects 
 taught in the first two years was adopted. During the first half of the first 
 year the students devote their time solely to anatomy and histology, and 
 during the second half of the first year to physiology and biological chemistry. 
 They devote the first half of the second year to pathology and bacteriology, 
 arid the remainder of the second year to a variety of subjects which more par- 
 ticularly prepare the student for the clinical work of the third and fourth 
 years. 
 
 Experience has shown that this logical arrangement of the subjects of the 
 first two years enables a student to concentrate his energies to a much greater 
 advantage than he can when his attention is divided among several subjects. 
 Each correlated group presents sufficient variety to avoid monotony. 
 Another advantage of this method is that it greatly increases the amount of 
 time which can be devoted to each subject. 
 
 In 1902 certain other changes in the curriculum were adopted, to take effect 
 with the class entering in the autumn of that year. The new course of study 
 is so arranged that the first three years are devoted to prescribed work, and 
 the fourth year entirely to elective courses. A minimum of one thousand 
 hours' work is required of each fourth year student ; and courses are offered 
 adapted to the student who wishes to fit himself to be a general practitioner, 
 and also suitable courses for those who intend to become specialists or 
 
 (201) 
 
202 THE HARVARD MEDICAL SCHOOL. 
 
 teachers in any department of medicine. The new elective curriculum of the 
 fourth year began in the autumn of 1905. 
 
 A series of written, oral, and practical examinations on all the required 
 subjects of medical instruction are distributed throughout the four years' 
 course of study. Every candidate for the degree of Doctor of Medicine must 
 pass these examinations in a satisfactory manner, and also fulfil all the other 
 requirements. 
 
 The degree of Doctor of Medicine cum laude is given to candidates who 
 obtain an average of eighty per cent or over in all the required examinations. 
 
 Beginning in 1906 special students, not candidates for the degree of Doctor 
 of Medicine, will be admitted, under certain conditions, to all courses in the 
 School and to certain courses specially designed for them. 
 
 Pamphlets descriptive of the many courses of study for graduates, and of 
 the summer courses, may be obtained on application. 
 
 Inquiries may be addressed to the Dean of the Harvard Medical School, 
 Longwood avenue, Boston, Mass. 
 
INDEX 
 
 PAGE 
 
 Abbot, Samuel L. .......... 40 
 
 Ainsworth, F. S ... 8 
 
 Alsberg, Carl L. . 35, 196 
 
 Ames, John L. . . 80 
 
 Amory, Robert 89, 166 
 
 Anatomy, The Department of . i 
 
 Anatomy, Comparative 181 
 
 Anatomy Act S> 52 
 
 Anesthesia 53 
 
 Auer, John 199 
 
 Bacon, John 33. 34. 35. 75 
 
 Bacteriology, The Department op 133 
 
 Badger, George S. C . . 28, 198 
 
 Baker, George L. . 199 
 
 Baker, W. H 122, 123, 126 
 
 Balch, Alfred W 168 
 
 Balch, Franklin G 197 
 
 Bartol, John W 80, 197 
 
 Beach, H. H. A 8, 9 
 
 Bigelow, Henry J 51-53.55.56,143 
 
 Bigelow, Jacob 4, 32, 38, 74, 75, 165 
 
 Binney, Horace '99 
 
 Black, Otis F 198 
 
 Blake, Clarence J i95 
 
 Blake, John B 19'^ 
 
 Bolles, William P 166 
 
 Boston 20 
 
 Boston City Hospital 77 
 
 Boston Dispensary 39 
 
 Bowditch, Henry 1 25, 73, 76, 77, 78, 84 
 
 Bowditch, Henry P 90,93,136,177,181,187,195 
 
 Bowditch, Vincent Y So 
 
 Bowen, JohnT 99,100,101,102,195 
 
 Brackett, Elliott G 167, 197 
 
 Bradford, Edward H 56, i95 
 
 (203) 
 
204 INDEX. 
 
 PAGE 
 
 Bremer, John L 196 
 
 Brenton, Silas C. 173, 174 
 
 Brewster, George W. W 197 
 
 Brigham, Peter B., Hospital 182 
 
 Brinckerhoff, Walter R 65, 70 
 
 Brooks, William A. . . . . . . . . . . 11, 14 
 
 Brown, Buckminster ... ....'. . . 143 
 
 Brown, John 143 
 
 Brown-Sequard, Charles E. 78, 89 
 
 Buckingham, Charles E . 26, 40, 41 
 
 Buckingham, Edward M 149, 150, 152 
 
 Buildings, The New Medical School 185 
 
 Burns, Frederick S 102, 103, 198 
 
 Burrage, Walter L 124 
 
 Burrell, Herbert L 57, 195 
 
 Butler, Benjamin F 10 
 
 Butler, Charles S 198 
 
 Cabot, Arthur T 58, 187 
 
 Cabot, Richard C 80, 196 
 
 Cannon, Walter B 91, 141, 196 
 
 Chadbourne, Arthur P 167 
 
 Chadwick, James R. . 121, 122, 123 
 
 Channing, Walter 37. 38, 45. S' 
 
 Cheever, David ........... 199 
 
 Cheever, David W. • 1 • • ■ ■ ■ • 7. 8, 9, 54, 56, 57 
 
 Chemistry, The Department of 31 
 
 Cheney, Frederick E 106, 107 
 
 Christian, Henry A 29, 65, 70, 198 
 
 Clap, Edmund W. 107, 198 
 
 Clark, Edward H 165 
 
 Clark, Joseph P. .... ig7 
 
 Cobb, Frederic C. ......... 119, 197 
 
 Cobb, Farrar 186 
 
 Codman, Ernest A 198 
 
 Coffin, Rockwell A n6, 197 
 
 Coley, W. B 180 
 
 Conant, William M. . . 11 
 
 Cooke, Josiah P. 33 
 
 Coolidge, Algernon, Jr . .119, 196 
 
 Councilman, William T. ...... . 64, 138, 195 
 
 Cowles, Edward ........... 196 
 
INDEX. 205 
 
 PAGE 
 
 Cow-pox i8 
 
 Crafts, William ly, 
 
 Craigin, George A 152,197 
 
 Crandon, Le Roi G loS 
 
 Crockett, Eugene A loy 
 
 Crow Bar Skull 173 
 
 Curry, Joseph J 65 
 
 Cutler, Elbridge G 27, 29, 64, 69, 195 
 
 Dane, John loy 
 
 Danforth, Samuel 31, 164 
 
 Davenport, F. H 122, 123, 124, 126 
 
 Davis, Lincoln igS 
 
 De Blois, T. A 119 
 
 Denny, Francis P igg 
 
 Derby, George 109 
 
 Derby, Hasket 105 
 
 Dermatology, The Department op ^y 
 
 Dexter, Aaron 15, 16, 31, 34, 164 
 
 Dexter, Franklin 11, I2, 13, 14 
 
 Dissection 2 
 
 Doe, O. W. 123, 124 
 
 Draper, F. W 47, 109, no 
 
 Dunn, Charles H 153, 198 
 
 Durgin, Samuel H no, in, 196 
 
 Duval, C. W 70 
 
 Dwight, Edwin W 47, 65 
 
 Dwight, Thomas . . . . 9, 11, 12, 13, 14, 114, 115, 172, 195 
 
 Edes, Robert T 79, 165, 166 
 
 Eliot, Charles W 26,33,78,79,181,187,195 
 
 Elliot, John W 123, 124 
 
 Ellis, Calvin 77,78,79,84,113,117,145,146 
 
 Ernst, Harold C. 133, 19S 
 
 Everett, Eugene E 198 
 
 Ewing, William .31 
 
 Fabyan, George 157 
 
 Fabyan, George F 157, 158 
 
 Farlow,J. W 119 
 
 Faulkner, William E 197 
 
 Fitz, Reginald H. . . . .27, 28, 29, 64, 72, 113, 114, 133, 195 
 
206 INDEX. 
 
 PAGE 
 
 Flagg, Elisha 197 
 
 Folsom, Charles F. . . . no 
 
 Fothergill, John 17 
 
 Friedman, Leo V 43, 127, 198 
 
 Frothingham, Langdon ......... 199 
 
 Fulton, F. T 70 
 
 Fund, Henry Jackson . 175 
 
 Funds 179 
 
 Gannett, William W 64, 80 
 
 Garland, George M 80, 91 
 
 Gay, George W 196 
 
 Goldthwait, Joel E 197 
 
 Goodale, Joseph L 197 
 
 Gorham, John 31,32, 164 
 
 Gould, ? 76 
 
 Graves, William P 198 
 
 Green, Charles M 41, 42, 43, 124, 125, 126, 127, 195 
 
 Green Dragon Tavern ......... 164 
 
 Greenough, Francis B. 97 
 
 Greenough, Robert B. 198 
 
 Gynecology, The Department of 121 
 
 Hammond, Philip .......... 197 
 
 Hancock, John 16 
 
 Harrington, Charles no, in, 167, 195 
 
 Harrington, Francis B. 196 
 
 Harvard Hall 3I) 5° 
 
 Haskell, Henry H 197 
 
 Haven, George . . 42, 43, 124, 126 
 
 Hay, Gustavus ........... 105 
 
 Hayward, George .......... 52, 53 
 
 Henderson, L. J. . 35, 199 
 
 Hewes, Henry F. .......... 197 
 
 Higgins, F. A 43, 125, 126 
 
 Higginson, George 91 
 
 Higginson, Henry L 180 
 
 Hills, William B 35, 93 
 
 Histology, The Department of, and Embryology . . .113 
 
 Hodges, R. M 8, 9, 12, 54 
 
 Holden Chapel i, 31, 50, 174 
 
 Holmes, Oliver Wendell . i, 7, 8, 10, 16, 19, 22, 38, 87, 88, 113, 114, 172 
 
INDEX. 207 
 
 PAGE 
 
 Hooper, F. H ii8, 119 
 
 Horsford, E. N 33 
 
 Howell, William H 91 
 
 Huntington, CoUis P. 61, 181 
 
 Huntington Laboratory 66, 190 
 
 Hygiene, The Department of 109 
 
 Jack, Edwin E 197 
 
 Jackson, Henry 80, 82, 196 
 
 Jackson, James 1,3,19,20,21,22,32,73 
 
 Jackson, James, Jr .... 21 
 
 Jackson, James M 80, 197 
 
 Jackson, J. B. S. . . . 21, 25, 63, 64, 72, 75, 76, I7i,'i72, 174, 175 
 
 Jefferson, Thomas 18 
 
 Jeffries, B.Joy 97 
 
 Jenner, Edward 18 
 
 Jones, Daniel F 198 
 
 Jordan, James 167, 169 
 
 Joslin, Elliott P 28, 29, 196 
 
 Keene, Clarence W 65 
 
 Knapp, Philip C i37. 1381 I97 
 
 Kneeland, Samuel 8 
 
 Knight, Augustus S 80 
 
 Knight, Frederick 1 82,83,117,118 
 
 Ladd, Maynard i53. 198 
 
 Laryngology, The Department of 117 
 
 Leary, T 7° 
 
 Lecompte, Walter A 198 
 
 Legal Medicine, The Department of 45 
 
 Lewis, Frederic T ^¥> 
 
 Lewis, Paul A >99 
 
 Lewis, Winslow 4 
 
 Locke, Edwin A 80. 199 
 
 Lombard, Josiah S 87, 88 
 
 Lord, Frederick T '99 
 
 Lothrop, Howard A 60, 196 
 
 Lovett, Robert W '97 
 
 Low, Henry C 65 
 
 Lowell, James Russell '8 
 
 Lowell, John ^^ 
 
INDEX. 209 
 
 page: 
 Oliver, Joseph P 14^, 148 
 
 Ophthalmology, The Department of 105 
 
 Orthopedics, The Department of 143 
 
 Otology, The Department of 129 
 
 Page, Calvin G igy 
 
 Palfrey, Francis W igo 
 
 Parkman, George .......... 7 
 
 Parkman, Samuel 4 
 
 Pathological Anatomy, The Department of . . . .63 
 Pathology, The Department of Comparative .... 157 
 
 Pearce, Richard M 65, 70 
 
 Pediatrics, The Department of 145 
 
 Perry, Henry J 198 
 
 Pfaff, Franz 35, 167, 168, 196 
 
 Pharmacology, The Department of 163 
 
 Physic, The Department of The Theory and Practice of . 15 
 Physiology, The Department of . . . . . . . 87 
 
 Pomeroy, William H. ......... . 167 
 
 Porter, Charles A. 196 
 
 Porter, Charles B 8, 9, 55, 56, 57 
 
 Porter, William T 91,93,196 
 
 Post, Abner 99, 100, loi , 103, 196 
 
 Pratt, Joseph H 28, 65, 198 
 
 Prescott, W. H 65, 80 
 
 Prince, Morton 138 
 
 Putnam, Charles P 146, 147 
 
 Putnam, James J 137,138,141,195 
 
 Quackenboss, Alexander 197 
 
 Quincy, Henry P 114 
 
 Reynolds, Edward 38, 42> 43. 124, 125 
 
 Reynolds, John P 40,41,42 
 
 Richardson, Frank L I99 
 
 Richardson, Mark W 28, 65 
 
 Richardson, Maurice H 9,11,12,56,57,195 
 
 Richardson, William L 4°. 4i. 42; 43. 127, 195 
 
 Robbins, Anne '43 
 
 Robertson, Alexander R 65, 199 
 
 Robey, William H.,Jr 198 
 
 Robinson, Samuel i99 
 
210 INDEX. 
 
 PAGE 
 
 Roby, John 4 
 
 Rockefeller, John D i8o, i8i 
 
 Rotch, Thomas M 147,148,149,150,151,195 
 
 Scannell, David D 199 
 
 School, The new Medical . . . 177 
 
 Sears, David 61,181,191 
 
 Sears, George G 80, 196 
 
 Sears, Henry F 64,66,71,114 
 
 Shattuck, Frederick C. 27, 79, 80, 83, 195 
 
 Shattuck, George B 80 
 
 Shattuck, George C 25, 63, 74, 75, 76, 77, 97 
 
 Shepard, Luther D 199 
 
 Sherman, T. F 150, 151 
 
 Shurtleff, Nathaniel B 4 
 
 Simmons, Channing C 198 
 
 Sims, Frederick R 65 
 
 Small-pox 18 
 
 Smith, C. Morton loi, 103, 197 
 
 Smith, Theobald 157, 196 
 
 Smith, William H 80,81,198 
 
 Southard, Elmer E. . 65, 139, 196 
 
 Spalding, Fred M 198 
 
 Standish, Myles 106, 107, 195 
 
 Steensland, H. S. .70 
 
 Stone, Arthur K. 28, 197 
 
 Stone, James S. .......... 197 
 
 Storer, D. H . 38, 39, 40 
 
 Storer, H. R 40 
 
 Storer, Malcolm 125, 126, 197 
 
 Strong, Charles P 123, 124 
 
 Summer School ........... 34, 39 
 
 Surgery, The Department of ....... 49 
 
 Surgical Pathology 58 
 
 Swain, Howard T 43, 198 
 
 Swift, John B 123, 124, 125 
 
 Taylor, Edward W 65, 138, 139, 196 
 
 Tenney, Benjamin .......... 13 
 
 Terry, Robert J 198 
 
 Thayer, Ezra R. . 197 
 
 Thompson, R. L. 70 
 
INDEX. 211 
 
 PAGE 
 
 Thorndike, Paul 58, 197 
 
 Thyng, Fred W igg 
 
 Tilden, George H on 
 
 Tileston, Wilder log 
 
 Torbert, James R. ^2, ing 
 
 Towle, Harvey P. . 102,197 
 
 Townsend, Charles W. ......... 42 
 
 Tremont Street Medical School 38, 39, 40 
 
 Tuttle, George T 196 
 
 Tyrode, Maurice V 168, 199 
 
 Tyzzer, Ernest E. 65, 70, 199 
 
 Unit System 178 
 
 Vaccination ly 
 
 Vickery, Herman F . ... 80, 195 
 
 Vogel, G. L 119 
 
 Wadsworth, O. F 105, 106, 107 
 
 WadsTvorth, Richard G igg 
 
 Walcott, Henry P 187 
 
 Walton, George L. ........ . 137, 138 
 
 Ware, John 23. 25, 74, 75 
 
 Warren, John 1,2,3,11,16,32,49,51,164 
 
 Warren, John (the younger) ....... 11, 196 
 
 Warren, John C. . . .2,3, 4, 5, 6, 7, 13, 19, 20, 50, 51, 52, 53, 171 
 
 Warren, J. Collins .... SS. 56, 57. 135- i77. i8i, 187, 19S 
 
 Warren, Joseph i 
 
 Warren, Joseph W 91, 166 
 
 Washburn, George H. 124 
 
 Washington, George . 18 
 
 Waterhouse, Benjamin ... 15, 16, 17, 18, 19, 20, 30, 73, 164 
 
 Waterhouse, Daniel 17 
 
 Waterman, George A. 138, 141, 198 
 
 Watson, Francis S 58, 196 
 
 Webber, Samuel G. . . 137 
 
 Webster, John W. 32 
 
 Weld, Charles G. loi 
 
 Wentworth, Arthur H. 65, 151, 152 
 
 White, Charles J. 99, loo, 103, 197 
 
 White, Franklin W 28, 197 
 
 White, James C 34> 7S> 97i 98, 100 
 
212 INDEX. 
 
 PAGE 
 
 Whitney, Herbert P. 148 
 
 Whitney, William F ^95 
 
 Whittier, Edward N 79 
 
 Wigglesworth, Edward 9^ 
 
 Williams, Frank H 166, 167 
 
 Williams, Henry W 105, 106 
 
 Withington, Charles F 80 
 
 Wolbach, S. Burt 65, 199 
 
 Wood, Edward S 34> 3S 
 
 Worthington, Arthur M 198 
 
 Wright, James H 6S. 196 
 
 Wyman, Jeffries 4' 9° 
 
 Wyman, Morrill . . • 24, 25 
 
 Young, Ernest B 126, 127, 198