MEDICINE. WU LIAM WATT KERR, M.A., M.B., C.M., Professor of Clinical Medicine. HERBERT C. MOFFITT, B.S., M.D., Professor of the Principles and Practice of Medicine. GEORGE E. EBRIGHT, M.D., Instructor in Medicine. R. LEONA ASH, M.D., Instructor in Medicine. MILTON B. LENNON, A.B.. M.D., Assistant in Medicine. JAMFS LYMAN WHITNEY, M.D., Assistant in Medicine. Work in the Department of Principles and Practice of Medicine is carried on by Professor Moffitt, Dr. Allen, Dr. Ash, Dr. Whitney, and Dr. Bine. The material of the University Hospital offers unusual advantages to students, because it is made up wholly of acute cases, and because of the opportunities of working up material in the various laboratories of the school, of following borderline cases into the surgical wards and of correlating clinical signs with autopsy findings. Didactic work has been almost wholly dropped, except in occasional reviews of important diseases that may not have presented themselves during the year. Professors Kerr and Moffitt so arrange their courses of instruction that each gives special attention to different diseases in alternate years and thus between them cover the entire subject of medicine annually. Instruction in clinical medicine is founded upon practical work based upon the available clinical material. Direct contact with disease in its varied manifestations can alone train the student in the accurate observation of sickness, in the judicious application of the methods of diagnosis, and in the rational employment of therapeusis. The material in internal medicine at the disposal of the staff of instructors and students is large in quantity and rich in quality. General medical work constitutes the greater bulk of the work of physicians, and, therefore, properly requires a large portion of the time of the student. The general plan of the department is to ground the students in the fundaments of medicine during the third year, and during the four years to place the students upon individual practical work. 1. Clinics in Internal Medicine. Professor KERR. It consists This course continues through the third and fourth years. of clinics, clinical conferences, lectures, and demonstrations upon the material in the medical wards of the City and County Hospital and University of California Hospital. Students are assigned to the beds for study of individual cases. 3 hours a week, third and fourth years. 2. Bedside Instruction. Professor KERR, Drs. EBRIGHT, CASTELHUN, BEERMAN, and LENNON. The class is divided into sections for ward class work. These sections consist of not more than six students who are assigned to the wards twice weekly. In the wards they are taught the proper taking of histories and the recording of medical phenomena, learn the physical and other signs of disease, and follow the progress of diseases. Through their regular attendance, the students are enabled to follow closely the therapeutic treatment. In connection with the ward work there is a well equipped clinical laboratory in which the students conduct analyses of the blood, gastric contents, urine, and do such other laboratory work as may arise in connection with the ward studies. 3. Clinics in Medicine. Dr. MOFFITT. Beginning with the next year year a different method of instruction will be followed in the University Hospital. The third year students who have had no previous training in physical diagnosis will, during the first semester, give their entire time in medicine to this subject. Sections will be taken in the wards and the out-patient department by Dr. Ash, Dr. Bine, and Dr. Whitney. Clinical lectures will not begin until the second semester. During the first half of the senior year two hours a week will be devoted to clinical lectures and a two-hour period to a clinical conference. Case teaching and reports based upon library work will occupy a portion of this time, cases seen in the wards will be reviewed and, when possible, the results of post-mortem examinations will be compared with the clinical findings. In the second semester senior students will enter the wards as clinical elerks and will be held responsible for the proper investigation of cases assigned them. 4. Physical Diagnosis. Dr. EBRIGHT and Dr. WHITNEY. This work is devoted to medical diagnosis and is carried on by means of work at the bedside in the wards and in the clinics. Didactic work is reduced to a minimum. As material is abundant, each student is assigned a case and is taught methods of handling and examining patients. A suitable text-book is used as a guide and regular quizzes are held. Case records are kept throughout the year. The first semester is devoted to thorough exercise in the elicitation of physical signs and the inculcation of the methods of examination of the cardio-vascular, lymphatic, respiratory, and the alimentary systems and the abdominal organs and the central and peripheral nervous systems. The student is made acquainted with the use of the instruments of precision, including the blood pressure apparatus, the cardio-sphygmograph, stomach tube, etc. Frequent use is also made of the ophthalmoscope and laryngoscope. The second semester is a continuation of the work of the first, but greater attention is given to the correlation and interpretation of physical signs, the student making complete physical examination of his patients. Stress is laid upon exactness and rapidity of examination in addition to tactfulness at the bedside. Third year, 5 hours a week, throughout the year. 5. Applied Therapeutics. Dr. BEERMAN. Dr. Beerman lectures upon therapeutics and gives demonstrations of applied therapeutics in the wards. He also, with Drs. Lennon and Castelhun, conducts the afternoon ward classes in the City and County Hospital. 6. Out-Patient Clinic on Nervous Diseases. Dr. LENNON. In addition to his ward work, Dr. Lennon conducts a clinic on nervous diseases at the dispensary. SURGERY. ROBERT A. MCLEAN, M.D., Emeritus Professor of Clinical Surgery. HARRY M. SHERMAN, A.M., M.D., Professor of the Principles and Practice of Surgery. THOMAS W. HUNTINGTON, A.B., M.D., Professor of Clinical Surgery. HENRY B. A. KUGELER, M.D., Instructor in Surgery. HAROLD BRUNN, M.D., Instructor in Surgery. Instruction in surgery is given during the third and fourth years, and while considerable emphasis is laid on the didactic lectures covering the principles of general surgery, the importance of practical training is reailzed. This feature of the department's work is covered by ward classes, clinics, a course in surgical pathology, and operative courses on the cadaver. The clinical material is found in the wards of the City and County Hospital, the University of California Hospital, and the U. S. A. General Hospital at the Presidio. Cases of minor surgery are treated in the Out-Patient Dispensary. During his last year the student is brought into contact with patients in the ward classes, where he is required to follow a certain number of cases throughout their course. * Absent on leave, April 1 to October 1, 1911. Operative surgery is taught in the public clinics which occur at regular periods during the entire year. In the fourth year conferences are held once in three weeks, in which papers are read and discussed under the guidance of the professor of the principles and practice of surgery. Α similar meeting is conducted for the third-year class by one of the assistants. 1. General Surgery. Professor SHERMAN. The principles of general surgery are discussed in lectures and recitations illustrated by diagrams, photographs, wet and dry specimens, and a series of demonstrations on the cadaver. In this course prominence is given to those subjects which are of practical importance to the general surgeon. From December to April ward classes and operative clinics are added to these. Third and fourth years, 2 hours a week, throughout the year. 2. Clinical Surgery. Professor HUNTINGTON and Assistants. This course includes clinics, practical demonstrations, and bedside teaching in the wards and operating room of the University of California Hospital and the City and County Hospital. Surgical pathology, general questions of diagnosis, wound treatment and asepsis are discussed at the bedside. Special attention is paid to the treatment of fractures and dislocations. During the work the student is afforded ample opportunity for the frequent inspection of wounds in all stages of repair, and in addition is given the responsibility for the care of a certain number of cases whose histories must be followed accurately. In the lectures the choice of anaesthetics in ordinary and special cases, their administration in both local and general form, the preparation of instruments and dressings, and the selection and disinfection of ligatures and sutures are discussed. In addition there is an explanation of the application of modern technique in the numerous cases that are presented for operation. Third and fourth years, 3 hours a week. throughout the year. 3. Surgical Pathology. This course will present in a practical way the application of many of those points in the previous work of pathology, bacteriology. and histology which apply especially to clinical surgery. Wound healing in the skin and the formation of cicatrices, reparative processes of the different tissues and their reactions to surgical manipulations are shown experimentally. Considerable attention is paid during the course to the surgical infections and their effects on the organism. The principles of bacteriolysis, the excretion of microorganisms by means of the lymphatics through the lungs, liver and kidneys, the new formation of blood vessels and lymphatics, and the fate of absorbable suture material are demonstrated on animals. The students are required to make nakedeye descriptions of fresh surgical material and to carry through various portions of these tissues for subsequent microscopic ex amination. The special pathology of tumors and the infectious granulomata is discussed and illustrated by means of fresh preparations and Kaiserling specimens. The work in this course is given entirely in the laboratory and will be wholly practical. Third year, 12 hours a week, 9 weeks. 4. Operative Surgery on the Cadaver. Dr. KUGELER. The classical operations are performed by the students of the class individually on the cadaver, imitating as closely as possible the arrangement and technique of the operating room. Fourth year, 2 hours a week, 9 weeks. 5. Wound Dressing, Minor Surgery, and Bandaging. Dr. TERRY. This course includes the technique of wound dressing and operative treatment. Various methods of bandaging of minor surgical operations are included in this course. Third year, 3 hours a week, one half-year. 6. Ward Classes. The students under the direction of the officers of instruction are given charge of a series of cases for which they are made responsible. History taking, routine clinical examination, diagnosis, treatment, and subsequent care of the patient are included in this course. Fourth year, 2 hours a week, through 1 half-year. 7. Surgical Dispensary. Drs. Russ, ROBARTS, and SCHWARTZ. This course is given upon the ambulatory material at the out-patient department, and presents in an advantageous manner the particular aspects of surgical ambulatory material. The instruction is entirely practical. Students are assigned to cases, take their histories. conduct their examinations, and carry through the treatment in large part themselves. Third year, 6 hours a week, 1 half-year. MICROSCOPICAL AND CHEMICAL DIAGNOSIS. HERBERT W. ALLEN, B.S., M.D., Instructor in Clinical Pathology. It is the purpose of this instruction to give the students practical and effective training in the use of those methods and principles of microscopic anatomy, pathology, and physiology which are of assistance to the clinician in reaching a diagnosis. It aims to act as a connecting link between the work of the preclinical and clinical years. The course is given almost exclusively by the laboratory method; short explanatory talks are given as the subject-matter demands. A simple, effective, welllighted laboratory is provided in the University Hospital, from the wards of which much of the material is derived. The wards of the City and County Hospital and of St. Luke's Hospital are also utilized for material. |