THE COLUMBUS MEDICAL JOURNAL. A MONTHLY MAGAZINE OF MEDICINE AND SURGERY. EDITORS. JAMES U. BARNHILL, A. M., Ph. D., M. D., 248 E. State Street. COLLABORATORS. W. D. INGLIS, B. S., M. D. ERNEST SCOTT. B. Sc. M. D. H. H. SNIVELY, B. A., M. D. C. W. MCGAVRAN B. S., M. D. Communications relating to the editorial department should be addressed to Dr. J. U. Barnhill 248 East State Street; those relating to business management should be addressed to Dr. W. J. Means, 715 North High Street. Per annum, in advance, subscription price, including postage ..15 cents. $1.00 2.00 Original articles, scientific and clinical memoranda, correspondence and news items are cordially solicited from the profession. OCTOBER, 1905. Editorial. THE NEW ERA OF MEDICAL TEACHING. The last two years have witnessed many improvements in medical teaching, and with them great advance in the science of medicine. Notwithstanding these evident improvements there is a feeling that there should yet be radical changes in our methods, and especially in reference to improvements in the first years of the course, and the separation of the purely scientific and clinical parts of the course. We are just coming to realize in this country as the profession is in Europe the great importance of clinical instruction. As clinical instruction constitutes the best part of the course, a relatively larger amount of it should be given in the hospitals. On the other hand we are coming more to appreciate the fact that the preliminary studies of the first two years can best be given in connection with literary college work. The University of London inaugurated, with the opening of the medical schools for the current year, what promises to be a new era of teaching which "will have as its chief characteristic an endeavor to place the study of medicine upon a basis more truly scientific than that upon which it has hitherto rested, and to restrain the element of empiricism, using the word in its proper sense, within the narrowest limits which circumstances will allow." In this University arrangements have been made "for the conduct of the preliminary anatomical, scientific, and laboratory teaching of students whose subsequent clinical education will be conducted elsewhere; and will in this way be enabled, as time goes on, to furnish the metropolitan hospitals with a constant supply of men well grounded in anatomy and pyhsiology, and prepared, by a preliminary study of the methods and results of physical science, to take part in the observation and investigation of vital actions and phenomena, and of the manner in which these actions and phenomena may be modified by what we call disease." Among the considerations which have led to this change has been the fact, as well stated editorially in The Hospital, that "the work of teaching, in too many instances, has been regarded mainly as a condition of preferment; and, in these circumstances, it can hardly have failed to lose something of the earnestness and force which would have been infused into it by a professor to whom it would represent the primary duty of his life, and the chief end to which his energies should be directed." The defects here pointed out are, of course, more evident in schools farther removed from the great centers of learning. The example set in the University of London will doubtless have a marked influence on teaching elsewhere. "Medicine is essentially the study of the relations between man and his environment, and of the methods in which those relations may be modified either by nature or by art. A large proportion of what we cal! diseases are only the symptomatic expressions of perversions of the chemical processes of metabolism, and can neither be undertsood nor rationally treated by practitioners to whom organic chemistry is either a sealed book, or even a verbal collection of the hypotheses of two or three years ago. Another enormous proportion are only the symptomatic expressions of struggles for survival between man and inferior organisms, and require for their due comprehension and proper treatment, a knowledge of biology of a far more accurate and comprehensive kind than is generally either possessed, or even recognized to be necessary." COLUMBUS STATE HOSPITAL. We are in receipt of the sixty-sixth annual report of the trustees of the Columbus State Hospital. The institution, says this report, has been quite successful during the past year. The average daily population for the year has been 1,437 patients; 773 were males and 664 were females. The cost of maintenance for the year has been $145.74 per capita, and including expenditures from all appropriations, excepting repairs and improvements and permanent improvements, $147.27 being somewhat in excess of the per capita rate of the preceeding year, but taking into account the increased price of many articles entering into the consumption, we regard this as low a rate as possibly could have been obtained, having regard to the comfort and welfare of the patients. The current expenses for the year ending November 15, 1904, were $200,863.35; officers' salaries, $8,567.22; making a total drawn from the state treasury of $209,430.77. No changes have been made in the medical staff of the institution which consists of the following: George Stockton, M. D., Columbus, Superintendent; George T. Harding, Jr., M. D., Marion, Assistant Physician; Earle E. Gaver, M. D., McCuneville, Assistant Physician; Guy H. Williams, M. D., Richmond, Assistant Physician; William W. Richardson, M. D., Washington, D. C., Assistant Physician; Isabell A. Bradley, M. D., Akron, Pathologist; Angus MacIvor, M. D., Columbus, Assistant Physician. The superintendent, Dr. Stockton, under the head of the medical administration, reports admissions for the year, 341 men, 222 women. Total number under treatment during the year 1,126 men, 897 women. Discharged as recovered! 56 men, 45 women. Discharged as improved 50 men, 31 women. Discharged as stationary or unimproved 96 men, 74 women. Died, 88 men, 42 women. Not insane, one man, no women. Number of discharges 291 men, 192 women. Percentage of recoveries based on admissions, 16.42 for men, and 20.27 for women. Table number one shows that 50 men and 50 women were received from county in firmaries and other state hospitals, and figuring upon the number of admissions, exclusive of these chronic cases, the percentage of recoveries is for the men 19.24, and for women 26.16. Percentage of death based on total number under treatment, 7.81 men, 4.67 women. Actually in the hospital at the close of the year, 797 men and 681 women. Daily average of those actually in the hospital, 773 men and 664 women. COLUMBUS STATE HOSPITAL TRAINING SCHOOL NURSES. From the above report we learn that as far back as 1887, the late Dr. C. M. Finch, who was then superintendent of this hospital, and a man in advance of his time, saw the benefit to be derived from these lectures. During the two succeeding administrations this work was dropped, but under the late Dr. A. B. Richardson it was revived, then during the administration of Dr. E. G. Carpenter the work was broadened, and the instruction systematized. It is evident that the training school secures for the institution better service in the way of nursing, while it also qualifies a class of nurses for special nursing in caring for the insane. As stated by the superintendent, those whose knowledge of the nature of mental diseases, and of the tendencies of the insane is increased' by systematic instruction, become more observing, more thoughtful, more companionable, and more just toward their patients, and altogether render much more satisfactory service. TUBERCULAR TENT COLONY AT STATE HOSPITAL. During the year 1903, twenty-four tubercular insane patients were treated at Columbus State hospital in open air colony with, as stated by the superintendent, in his annual report, most gratifying results. In the following year eighty-four patients were treated, and during last summer ninety-six were treated, of whom fiftynine were women and thirty-seven men. Of these ninety-six cases, fourteen were admitted in the third stage of the disease, twentynine in the second stage, and fifty-three in the first stage. There were five deaths in the camp during the summer, all of which were patients admitted during the last stage of the disease. Two of the cases who died were complicated, one by cancer of the breast, the other by arterio sclerosis of old age. Of the remaining nine cases admitted in the third or last stage, seven did not show any |