lobby well lighted from either side. To his left is a finely furnished reception room and the trustees room in which are also held the meetings of the staff. This room has a carefully selected medical library, containing the latest and best works on medicine, surgery and the collateral sciences. Across the corridor and still to the left of the lobby are the pathological and bacteriological labratories which are equipped with the latest devices for the careful carrying out of this work. To the right of the lobby are the superintendent's and clerk's offices, while just ahead and to the right is the pharmacy. The corridor leading to the left as we enter takes us to the men's wards, medical and surgical. These are spacious and well lighted rooms, having six beds each with a capacity for four more in each ward. Here are also diet kitchen, nurses' room, convalescing room, bath and toilet rooms. The second floor of this pavilion is an exact reproduction of the first and is used for women. Coming again to the lobby on the first floor of the administration building and passing down the corridor to the right of the entrance we reach the west pavilion. This floor of the pavilion is devoted to private rooms and a solarium. The service rooms are similar to those in the east pavilion.

On the second floor of this pavilion are the obstetrical wards, the children's ward and private rooms for obstetrical and gynecological cases, delivery room and service rooms with a solarium to the south.

The second floor of the administration building contains rooms for the officers, dining-room, and sewing room. Beyond this and over the service building to the south, but wholly disconnected, are the isolation wards for contagious cases. On the third floor of the central or administration building are the main operating room and the septic operating room. The main operating room is probably not surpassed by any in the country. It is the best product of the best and latest thought. It is spacious and perfectly lighted by day or by night. Its equipment is right. To the left, as we approach the main operating room are the static electrical room, nurses' room,

the sterilizing room and the supply room. On the right are the etherizing room, the recovery room, surgeon's room, the X-ray room and the septic operation room. This floor is reached by stairway and by a large automatic electric elevator. To the back of the elevator shaft on the first floor of the administration building is the reception room for ambulance patients and the emergency operating room.

In the basement is a complete department for hydrotherapeutic work. Much attention has been given to the equipment of this department and it is relieved that few hospitals are so well fitted for carrying out the details of this important branch of therapeutics.

The foregoing gives briefly the main feature of the hospital. Plans are now in the hands of the architect for a nurses' home to cost $20,000. This building will be built just to the west of the hospital and will harmonize with it in its architectural features. It will be two stories in height and contain twenty-four rooms for nurses besides the lecture rooms, sitting room and dining room. It is designed to have it connect with the main building by an underground way.

To the back of the main building is the morgue which is especially equipped for anatomical study and for experimental surgery upon the cadaver.

The title to the Hackley Hospital and the annexed buildings and grounds. is vested in a board of nine trustees, the election of which board was placed by Mr. Hackley with the First Congregational church of Muskegon. While the control of the property is thus primarilly with this religious body, the hospital is in no sense denominational. Three members of the board of trustees are chosen each year for a period of three years. The detail work of this board is done by an executive committee, a committee on buildings and grounds, and one on the training school for nurses. Its meetings are held monthly. By them the medical staff is chosen, the superintendent and other employes. Large discretion is given the superintendent who works more directly under the executive committee with the board a court of final

resort.

The staff is appointed for one year, but any member may be removed for unbecoming conduct after an appropriate trial before the expiration of that term. Five departments have been created with a chief of staff over all and a head of each department. At the head of the staff is Dr. J. Vanderlaan. Dr. Vanderlaan is also head of the medical department. Associated with him are Drs. S. Bloch, C. L. Thompson, J. G. Jackson, H. A. Cummings, P. A. Quick, E. G. Appleton, C. Thomas and L. R. Marvin. The department of surgery has for its head Dr. F. W. Garber with Drs. G. L. Le Fever, J. F. Denslow, J. Vanderlaan and F. B. Marshall associated. The department of gynecology has Dr. L. R. Marvin for its head, aided by Drs. G. S. Williams, L. I. Powers, F. W. Garber and J. A. Fleming. At the head of the department of obstetrics is Dr. B. D. King and associated with him are Drs. L. I. Powers, G. S. Williams, C. L. Thompson and W. A. Campbell. The department of pediatrics is under the headship of Dr. L. I. Powers with Drs. F. L. Marvin, C. J. Durham, R. G. Oleson and G. J. Hartman as associates. The following gentlemen are appointed for special work:

Anæsthetist, Dr. A. A. Smith; Pathologist, Dr. O. C. Wicks; Bacteriologist, Dr. L. N. Eames; Electro-therapist, Dr. J. Osting; Hydrotherapist, Dr. J. P. Sullivan; Eye and Ear, Dr. V. A. Chapman; Nose and Throat, Dr. J. O. Bates; lecturer on Anatomy and Physiology, nurses' training school, Dr. W. A. Campbell; Materia Medica, Dr. R. G. Cavanagh; Bacteriology, Dr. O. C. Wicks.

A consulting staff composed of the following out-of-town physicians has also been appointed:-Dr. A. Vanderveen, Grand Haven; Dr. Henry Hull, Ravenna; Dr. B. F. Black, Holton; Dr. Geo .W. Nafe, Fremont; Dr. Frank W. Wilson, Shelby; Dr. Chas. F. Smith and Dr. L. N. Keyes, Whitehall; Dr. L. E. Jones, Montague; Dr. Hatch, Hart; Dr. Allen, Pentwater, and Dr. Rollison, of Hesperia; Dr. B. F. Baldwin, North Muskegon.

The superintendent of the hospital is Miss Clara W. Dyring, who is also principal of the training school. The latter department is not yet fully organized. It contemplates a three years' course and the admission of those only who have had a high school course or its equivalent. It is proposed to make the work of this department equal the best, and a most careful selection of applicants will be made.

This description of Hackley Hospital would hardly be complete without a brief sketch of the donor. While yet these lines were in preparation Mr. Charles H. Hackley passed on. The end came almost without warning February 10th, 1905. It is perhaps too early to form a just estimate of this simple mannered, great hearted friend of ours, but it is not too early to say that his death is felt as a personal loss by every citizen of Muskegon. With large wealth at his command, he lived without ostentation. For himself the simpler things of life sufficed. For his fellow citizens he was satisfied with the best only. Living with less display than many men of moderate means, he gave with lavish hand to the institutions which he founded and which have become an enduring part of our civic and social life.

Coming to Muskegon in 1856 a penniless youth of nineteen, by his own brain and brawn he early laid the foundations of that large fortune which

he so wisely used for the benefit of his fellow citizens. He identified himself at once with the lumber industry, and while his interests have since taken a wide range, he was always a lumberman. Taking a keen interest in poli

tics, he never cared for office. As a member and as president of the board of education of Muskegon, he was long identified with educational matters and it was in this direction that his earliest and in many ways most helpful benefactions were bestowed. How many and how varied these have been let the following record show:

Hackley Public Library (1888)

Endowment (1891)

.$ 155,000

75,000

Hackley Manual Training School and Gymnasium (1895, 1900)

220,000

Additional funds in maintenance of the school from its opening

Statues of Abraham Lincoln, Ulysses S. Grant, William Tecumseh

The foregoing donations were made during Mr. Hackley's life. By his will he has added $200,000.00 to the endowment fund of the hospital, $210,000.00 to the manual training school; $250,000.00 to the Hackley library; $15,000 to the Muskegon Humane Union, and an additional $2,000,000.00 to be given on the death of Mrs. Hackley. The city thus becomes the recipient of his bounties to the extent of over $4,000,000.00. 159 Jefferson St.

A CASE-HISTORY CLINIC.*

RICHARD C. CABOT, M. D., Boston, Mass.

(The following stenographic notes are a record of a demonstration by the author of a method of clinical instruction used by himself at the Harvard Medical school. No patient was present. Typewritten slips containing the case-history as given below, were distributed among the students. It was taken for granted that the physical examination had been made, clinical and laboratory findings, and the history all known. these at hand, the class is led to deduce the diagnosis, prognosis and treatment. great interest of this method and its value to the class is shown by the following report. The notes on one case have been deemed sufficient. -S., here means student.-Editor.)

With
The

"A factory overseer, 63 years old, had been subject to constipation for five years, and for two years had had righ inguinal hernia. Otherwise his antecedents from a medical point of view were excellent. On the day before his illness he had what he regarded as a satisfactory movement of the bowels. That night he ate heartily of clam-chowder and strawberries. The next afternoon he felt some abdominal discomfort. Later, while taking a bath, he found his hernia was down (as he had taken the truss off), and he found more difficulty than usual in replacing it. That night he vomited a great many times, the first vomitus suggesting strawberries, and he had great abdominal pain, diffuse, not localized. At 4 the next morning, when seen for the first time, he was not collapsed. The tongue was moist, with a slight white coat. Temp. 98.4, Pulse, 60, Respiration, 14. The abdomen was soft, not tender. The hernia was found to be perfectly reduced. Nothing abnormal was felt per anum. The pain required an injection of 1⁄2 grain morphia. Nausea

*Given before Dr. Dock's clinic, University Hospital, Ann Arbor, March 21, 1905.