Annual report of the President of Harvard University to the Overseers on the state of the university for the academic year ..
Harvard University
zsss SS =g g3SCEKE5SSS5SS5 2»— ■ "a "s 3_,oo«-= o-oo- JSSS SS £S SSSCnSKEEKSSSSK «« oa sssa ss s= S33S3SSS3SSSSSS ««»» wia oo sggs SS 8 = S333S33SSSS3SSS sssc SS S" SSSSSSESSJSSSSS •a-- •Of oo -=«««.,«, 00--000 ssss ss s= SS3S33SSS2S$SS3 <BAtOU neoBngr-naoiom.'MO ssss ss s° sssssssssssssss ""-a »- «= «o. — g.3«o,.-«o sssx ■gs s= SSSSSSSZSSESSSS |j.i JllLl II ill's ill THE HEDIOAI. 80HOOL s=-a-»ss8- -s^s-s" "s-a-ssas--" ooooeooooo eooooooooooo s«-s-s2sa- -s-s-ssss'"- ^ooooooooo ooooooo 000000000000 •.,0-0-0 •|ss"3sss"'a ■^oeooooeoo 0000000 •^o-ogo "sss-ssss-^g ooooooo 000000000000 oeoeooeooo 0000000 000000000000 «,o--.2go '»S°g°SS2S-'"S ooooooo 000000000000 S-*" — ?-* -2-SSg» -*g«s«HgS3-'-a ««oooooooo ooooooo 000000000000 g « o 00 - 0, ^ g « O "S->SSS* 'g»S°5«S3"^S 000000000000 s'«— '-a-« ^«o-3j,^ -s-s-sa-s-'s ooooooo 000000000000 g^«.,o«-g^« — "=SS- -s-s-ss-a— s llllll ll I 1.1 V V I III 1 1 111 II] II I I pi Pi Pi ml 152 THE MEDICAL SCHOOL The fourth-year men who have taken ssrphilis as an elective have all mastered the use of the dark field in the search for spirochetae, the technique of the serological investigations, and the recognition of syphilis as disclosed by X-rays. The few patients in the ward for syphilis add greatly to the opportunities for teaching and also to the opportunities for pathological demonstration. Diseases of the Nervous System. — The consolidation of the three departments of Neuropathology, Neurology, and Psychiatry has been productive of considerable integration in the work of this department. The Psychopathic Hospital has given added scope to the work of Professor E. E. Southard and Assistant Professor H. M. Adler, who have spent virtually all their time in the process of organization. The work of the Neuropathological Department has continued upon the series of 500 brains which have been consigned to Professor Southard under the auspices of the State Board of Insanity. This collection b unusual and probably unrivalled, and particularly valuable on account of the systematic photography of each brain. Further publications have been made on the subject of the nature of Dementia Praecox as well as that of Maniac Depressive In- sanity. Professor Southard has also been working upon the asso- ciation of mania with lesions of the optic thalamus. Under the provisions of the Underbill gift, a large amount of work has been done upon cases having normal-looking brains and some progress has been made toward a definition of the problems of the functional psychoses. Professor Adler has made observations upon the exact effects of hydrotherapy in certain cases of excitement, finding that hydro- therapy worked by reducing the relative plethora of red blood cells in these cases. He has also worked upon the systematic control of arsenic therapy by determimng the rapidity of excretion in cases in which arsenic is administered, finding that the elimination is extremely slow in certain cases and that accordingly these cases are those which suffer from continued doses. Professor Adler has also done work upon the nitrogen and urea nitrogen constituents in the blood and cerebro-spinal fluid of the insane. The Wassermann Laboratory has been continued and statistical observations have been published therefrom. The work of this Laboratory is to be taken over by the State toward the end of 1914, thereby setting free some of our activities for other purposes. A volmne of 34 contributions from the Psychopathic Hospital has been edited by Professor Southard, who has also made several THE MEDICAL SOHOOL 153 communications upon the demographical aspects of insanity in the contributions of the State Board of Insanity of Massachusetts. The Department of Neurology has concerned itself largely with teaching, which has been more arduous owing to the policy of giving instruction in small sections. Dr. J. B. Ayer has continued his work on Syphilis of the Central Nervous System and has collected data of much importance for the future study of the subject and for the purpose of drawing deductions in many phases of the treat- ment by the newer methods. The results of his work on the so- called Swift-Ellis treatment up to that time was published in the Boston Medical and Surgical Joiimal, March 26, 1914, under the title '' Salvarsanized Senmi (Swift-Ellis Treatment) in Syphilitic Diseases of the Central Nervous System." Dr. G. A. Waterman has published an important article also in the Boston Medical and Surgical Journal under date of March 5, 1914, on '' The Relation- ship'between Epilepsy and Migraine." Otology. — Changes in the method of instruction have involved a great deal of increased labor in this department requiring the clinical teaching to be done in small groups. Publications have been made by Dr. E. A. Crockett on '' The Section on Operative Surgery of the Cerebral and Cervical Ear Complications," for Loeb's " Operative Surgery, Ear, Nose and Throat "; by Dr. G. L. Tobey, Jr., on " Acute and Chronic Sup- puration of the Middle Ear," " Operative Treatment on Lateral Sinus Thrombosis "; by Dr. Oliver Lothrop on " A Radiographic Study of the Mastoid," '' An Operation for Correcting the Aqui- line Nasal Deformity; Use of a New Instrument; Report of a Case," "The Use of Section of Scapular in correcting Nasal Deformity." Dr. Harry P. Cahill has spent six months in Professor Sieben- mann's clinic in Basle, studying Pathology of the Internal Ear. Laryngology, — The conditions and method of teaching in this Department are the same as in the Department of Otology. The most important publication from the Department during the year is a book on " The Tonsils," by Dr. H. A. Barnes. This 18 largely the result of work done in the pathological laboratory of the School, and the clinics. Warren Anatomical Museum, — The work of perfecting the Collection by recarding, remounting the specimens, and making a new card catalogue, has progressed well. This is being done first to the specimens most frequently used, and will be continued imtil the whole collection has been carefully studied. The work is 154 THB MEDICAL SCHOOL Dficeflsarily slow and it will be some time yet before it can be com- pleted. The moet notable single addition has been the specimens of Troincal Diseases, obtained by Dr. Strong in his trip to South America in the summer of 1913. They have been preserved in Eaiserling and will make a valuable addition when permanently displayed. A new exhibition case, probably, will have to be built, and it is hoped this will be the nucleus of a very important part of the Museum. The sioills in the Tello Collection have been carefully repaired and all the loose pieces of bone firmly fixed in place so as to prevent any possible loss in the future. Dr. Tello has made a preliminary report of his study of this collection in an article entitled " Pre- historic Trephining among the Yauyos of Peru.'' Students from the hospitals and groups of nurses with their supervisors have been frequent visitors, as well as dubs, and teachers with their classes from other educational institutions. Each year the int^est taken by the general public increases. Prodor Fund for the Study of Chronic Disease. — From the in- come of the Proctor Fund for last year there was impropriated an amount of money to Dr. C. C. Little for the study of heredity in relation to tumors, the work to be carried out under the direction of the Cancer Conmiission of Harvard University and the De- partment of Zoology. Results of importance have been attained and the work, which will necessarily cover a series of years of ob- servation is in active progress. Under this Fund appropriations have been made to Dr. C. H. Buchols for assistance in publication of " Studies of Diseases of the Spine,'' which work has since been published; to Dr. James O'Hare for work to be done in the Medical Laboratory under the direction of Dr. Christian (four publications on various types of e}q[)eri- mental nephritis have appeared from Dr. O'Hare under this grant) ; and to Dr. Hugh Greeley for experimental work in chronic dis- eases ; and to Dr. S. A. Levine for the study of experimental cardiac disease by means of the electro-cardiogram. Scholarshipe and Student Aid. — Dr. Franklin Dexter, Director of Scholarships and Student Aid, reports the aiding of 27 students, aid being given by the loaning of mon^, and in one mstance by a direct gift. The work of the Department involved extensive correspondence, holding interviews with a large number of students: 136 (340 interviews); $1520 loaned, $30 given, and $357 refunded. The THE MEDIOAL SCHOOL 155 / expenditures were from private funds, and anonymous gifts. The work of the Department requires much attention to the needs of the students and wisdom in furnishing aid where it can be of the greatest help without danger of pauperization of students or the support of those who are likely to be unequal to the demands of practice and should seek other channels of activity. Bureau of AppaitUmerUs far Medical Alumni. — The Bureau of Appointments for Medical Alumni, established through the aid of the Harvard Medical Alumni Association, has proved itself to be of much importance and has rendered valuable assistance to many recent graduates. This Bureau has had many and varied positions to offer men during the past year, haviog received the offer of 81 positions in addition to the opportunities, kept on file, for interne- ships, etc., at the various hospitals in and around Boston, New England, and New York. As was the case in the past year there have not been sufficient applicants to fill these numerous posi- tions, the applicants numbering but 39. Cancer Commission of Harvard University. — On account of the general interest in radium as a therapeutic agent, the efforts of the Commission have to a large extent been concentrated on an inves- tigation of the effects of this element on tissues, especially on those of cancer and other growths. During the past year an additional supply of radium has been purchased, so that there is now available an amount sufficient for the requirements of the Commission. Through methods devised by Dr. William Duane, the radium is employed in such a manner that only its products are used for therapeutic purposes. The danger of loss through accident or theft is thereby greatly diminished, and at the same time practi- cally the entire output of its activity is made continuously avail- able. The treatment of cases has been carried out either by or under the supervision of Dr. Thomas Ordway, Physician-in- chaige. Dr. R. B. Greenough, Consulting Surgeon, and members of other Departments of the School have seen many of the cases in consultation. An analysis of the cases treated is to be found in the annual report of the Collis P. Himtiugton Memorial Hospital, although the number of cases and the time elapsed is insufficient for a final report of the results. Dr. Ellis Eellert, Resident Physi- cian, has resigned in order to take the position of Director of the Bender Hygienic Laboratory at Albany, N. Y. Work on methods of application of radiation, with especial reference to measure- ments of intensity and quantity, is being continued. Dr. William T. Bovie has been appointed Research Fellow and is continuing his 156 THE MEDICAL SCHOOL investigations on the effects of ultra-violet light. Chemical in- vestigations on the metabolism of tumor-bearing animals have been completed by Dr. J. L. Morris, whose acceptance of a position at Washington University Medical School, St. Louis, leaves the Commission without a chemist. It is to be hoped that suj£cient funds may ultimately be obtained so that this branch of the work may be established on a permanent basis. In genetics investiga- tions have been carried on by Dr. C. C. Little in collaboration with Dr. E. E. Tyzzer, Director, on the subject of the inheritance of the susceptibility of animals to inoculated tumors. This work has been supported by a grant from the Proctor Fund for the Study of Chronic Diseases. A study of immunity to inoculated tumors has been completed. A number of addresses have been given by members of the Commission on the properties of radium and other radio-active substances and the methods of their therapeutic application. In addition to a number of papers which have been presented before scientific societies, an exhibit demonstrating the methods of applying radium with a series of illustrative cases under treatment was given at the annual meeting of the American Medical Associa- tion, for which a certificate of honor was awarded the Conmiission. Library. — During the year 1913-14 an agreement has been affected with the Peter Bent Brigham Hospital by which the Medical School shall furnish library room and place its libraries at the disposal of the Hospital both by day and evening, and in return for this service the Peter Bent Brigham Hospital gives up the acquisition of medical books, deposits those already obtained with the Medical School, and pays to the Medical School a certain sum of money each year. An agreement has also been made with the Children's Hospital by which the Committee on Library expends the three hundred dollars which are set aside for the Library of that institution. Another notable event in the year has been the transfer of the libraries in Building E to the Administration Building, and the unification of these with the Students' Library, to which various books and periodicals from the other libraries of the School have been added so as to make a considerable collection of books. By this transfer the libraries in the School have been reduced from six to four. It will be remembered that in the Old School some thir- teen small libraries existed, and that when the School moved into the new buildings provision was made for eight distinct depart- mental libraries in the new School. The combination of these THE MEDICAL SCHOOL 157 libraries has steadily progressed, and the usefulness of their com- bination is generally appreciated. It is of interest to note that during the year that the Library in the Administration Building has been open, the attendance has exceeded by fifty per cent that of all other libraries in the School together. There is no question but that in the coming year this Library will show a still larger gain. For the first tune, the libraries have been open continuously from nine o'clock in the morning until ten in the evening. The unification of the libraries and the presence of the main Library in the Administration Building have called to the attention of our friends the desirability of making gifts to the Library of the Harvard Medical School. During this year many valuable old and new books have been contributed, and the increase in these contributions has been notable as compared with previous years. GENERAL STATISTICS OF THE SCHOOL Candidates for ike Degree of Doctor of Medicine New mftferieoUuits 91 The number of stadents in attendance : — Fonrth Class 71 Third Class 88 Second Class 66 Firstdass 71 Special Students 18 Total 808 Applicants for Degree of M.D. (February) 8 Applicants for Degree of M.D. (June) 57 85 Rejected _0 Graduated 85 Of the 65 students who receiyed the degree of Doctor of Medicine, 22 receiTcd the degree cvm lavde. Candidaiee for ike Degree of Doctor of Public HecUik The number of students in attendance 4 Applicants for Degree of Dr.P.H. (June) 2 Rejected 0 Graduated ~% Students in courses of the regular medical curriculum . . . 808 Students in Doctor of Public Health courses 4 Total stodents, October 1, 1918, to October 1, 1914, . . 812 158 THE MEDICAL SCHOOL The Medical School has greatly profited in every possible way by the presence of Professor Archibald Gary C!oolidge upon the Committee on the Library. Professor Coolidge has given much time, thought and detailed attention to the needs of the School, and his services should be called to the attention of the Faculty, students, and alumni. Sunday Afternoon Pvblic Lectures. — There were nineteen lec- tures listed in the coiirse, one of which was omitted owing to Dr. Minot's illness. It is an interesting fact that this is the first time since the lectures began that any one has been omitted. No lecturer has ever been late, or has sought to change his lecture after the date had once been assigned. The attendance was somewhat less than the preceding year, but inasmuch as the total attendance amounted to 3,637, giving an almost capacity attendance for every lecture, the Committee has felt that the course should be continued. This feeling is strengthened by the continual applications that come in for information in regard to the lectures from a very widespread area. EDWARD H. BRADFORD, Dean. THE GRADUATE SCHOOL OF MEDICINE To THE President op the Univeesitt: — Snt, — As Dean of the Graduate School of Medicine, I have the honor of presenting my report for the school year 1913-14. The second year of the Graduate School of Medicine has been relatively uneventful. It has been a period devoted to the elabora- tion of the plans adopted in the first year, rather than to the in- auguration of new plans. Relatively few and unimportant changes have been made in the courses offered by the School. The Administrative Board remains the same as in my last re- port, as follows: Horace David Arnold, M.D., Dean; Edward Hickling Bradford, M.D. ; Harold Clarence Ernst, M.D. ; Alger- non Coolidge, Jr., M.D.; and Walter Clarke Howe, M.D., Secre- tary. There have been no important changes in the list of teachers. The number of students registered and the rieceipts from fees have both shown a slight falling off from the figures of the previous year, as shown in the following table: — QradoAte CoofMi Soinmer Connai Totak for Tear StQ- danto RaooipU Stu- dents Bsooipti Stu- dents Beoeipti 1907-08 1908-09 190^10 1910-11 1911-12 81 111 111 153 155 12,932.50 3,187.00 3,605.77 4,085.00 5,077.00 1908 1909 1910 1911 1912 136 210 197 267 219 $4,S86.50 8,729.50 8,622.00 13,370.00 11,634.50 217 321 308 420 374 $7,819.00 11,916.50 12,227.77 17,455.00 16,711.50 SumcABT OF Gbadxjatb School of Mudicinb FsU and Spring Terms Summer Term Totals for Year Stu- dents Baeeipts Stu- dents Beoelpts Stu- dents ReceipU 1912-13 1913-14 280 313 $8,850.72 9,064.60 1913 1914 272 220 $16,953.85 15,171.05 552 533 $25,804.57 24,235.65 lfi9 160 THE GBADUATE SCHOOL OF MEDIOINE This falling off has been due apparently to the general financial situation. Until the end of the Spring Term the attendance and receipts were better than in the previous year. The drop came chiefly in the last part of the summer, when an already bad finan- cial situation was aggravated by the Eiuropean war. It seems probable that the attendance and receipts of the Graduate School of Medicine will vary with the general condition of business and finances in the country. Hard times, with poor collections, will deter many physicians from leaving their professional work, who would otherwise be glad to undertake graduate study. One of the difficult problems of the Graduate School of Medicine is to decide what subjects should be taught and how many courses should be offered. The needs of physicians who seek to improve their medical knowledge vary widely, and they cover every depart- ment of Medicine. Furthermore, while one student may need elementary instruction, another may be prepared for the most advanced work. It has been the aim of the Administrative Board to meet these varying needs as far as possible, and it has therefore organized in all departments as many courses as it could arrange, provided the instruction promised to be of a satisfactory standard. With our best efforts, there have been many demands we could not satisfy. On the other hand, many of the courses offered have not been chosen by any students who have come to the School. The problem is very different from that of the Medical School, which requires a definite course of study as a preparation for the degree of Doctor of Medicine. The wisest solution can be reached only after an extended study of results in carrying out the present policy. Our statistics are at present too limited to warrant any definite conclusions. The figures in the following tables are siuprisingly uniform for the two years, yet there has been a greater difference in the choice of courses than these figures indicate. The number of coiu^es which have been attended by any stu- dents is shown in the following table: — 1012-18 19ia-14 Fall Term 65 57 Spring Term 54 76 Slimmer Tenn 102 90 Total 221 223 The following table shows the number of students taking these courses. As many students take more than one course, the num- THE GRADUATE SCHOOL OF MEDICINE 161 bers are, of course, greater than the number of students in the School. Those who took complete courses are separated from those who took partial courses. Full CounM Partial Courses Total 1912-18 1918-14 19ia-18 1918-14 1913-13 1913-14 FaUTenn 211 212 65 56 276 268 Spring Term 87 147 59 81 146 228 Summer Term .. . 252 188 188 212 440 400 Total 550 547 312 349 862 896 The European war must have a profound effect upon graduate medical teaching in this country. The first effect, as ahready indicated, is to reduce the number of students because of the dis- turbance of the financial situation. Graduate teaching at the medical centres of Europe has been practically abandoned, and it must be several years before it can be reorganized on its former basis. Physicians who would ordinarily go abroad to study must look for opportunities in this country. Already we are getting a number of students who turn to Harvard as the best available place. These men constitute the most desirable class of students we can hope to get, and the School is alive to the opportunity thus offered to establish a high reputation as a centre for medical teaching. In some departments we are fully able to satisfy the expectar tions of these students, but in other departments we are not. Efforts are being made to remedy these defects. A study of this problem has led the Administrative Board to the belief that a closer cooperation in graduate teaching is necessary on the part of some departments, in order to secure satisfactory results. The only logical plan seems to be that each department of the Medical School should r^ard graduate teaching as a legitimate part of its work, for which it should assume responsibility just as much as for imdergraduate teaching. It is believed that ihe cordial codp- eration of all departments can be secured. Under this plan the two schools will constitute but one teaching body, and they will be separate organizations only in the administration of different parts of the work. In my last report it was pointed out that the School is engaged in pioneer work and must develop standards which may serve as examples for other institutions engaged in graduate medical teach- ing. In no direction was improvement so necessary as in the regulations governing the granting of certificates by graduate 162 THE GBADUATB SCHOOL OF MEDIGDrE medical schoob. Our School, with the approval ci the Faculty, at once took the position of requiring at least four full months of organised study and the passing of an examination, before a stu- dent is eligible for a certificate in any subject. This position has been approved by other schools. At least one other school has already raised its requirements, and it is not unlikely that the above requirements will be generally accepted as the miniiniim standard for granting certificates. After a further study of this subject our Administrative Board recently recommended that the requirement of time be raised to eight months, and this reconmiendation has been approved by the Faculty. In the report a year ago announcement was made of the plans for a systematic course in Tropical Medicine, to b^in November 1, 1913, and to last six months. The success of the work of the De- partment of Tropical Medicine during the past year deserves special mention in this report. It has seemed appropriate that this de- partment of the Graduate School of Medicine should be known as the School of Tropical Medicine. The course of study was organized by Professor R. P. Strong, with the advice of the Con- sulting Board consisting of Doctors Harold C. Ernst, Theobald Smith, Milton J. Rosenau, and Henry A. Christian. An important feature of the plans for instruction is that several other departments of the University, some of them outside of the Medical School, are associated with the Department of Tropical Medicine in this work. The departments of Zoology, Entomology, Botany, Phjrsics, and Climatology have codperated with the de- partments of Pathology, Bacteriolc^y, Comparative Pathology and Hygiene of the Medical School, and with the department of Tropical Medicine of the Graduate School of Medicine. All of these departments have offered courses in the School of Tropical Medicine. It is believed that such cooperation and association on the part of the departments mentioned will be beneficial for the departments themselves as well as for the students concerned. Moreover, through this cooperation the University has been able to complete an organization in tropical medicine, the first of its kind in this coimtry, and probably the most complete in any country. The courses which are now offered are fifteen in number, as follows: Zodlogy, Protozoology, Helminthology, Venomous Ani- mals, Poisonous Plants of the Tropics, Entomology, Bacte- riology, Pathology, Clinical Laboratory Work, Comparative Pathology, General Course, Dermatology, Preventive Medicine THE OBADUATE SCHOOL OF liEDIOINE 163 and Hygiene, Climatology, and Sunlight. The course of instruc- tion lasts six months, and to those successfully completing it the diploma in tropical medicine is granted. During the year the de- partment not only offered instruction to students in the Graduate School and School for Health Officers, but also electives to mem- bers of the fourth-year class of the Medical School. In addition to the work of teaching, the Department has been active in continuing the studies begun in South America, in the summer of 1913, upon verruga peruviana and oroya fever. It has studied other pathological material collected on that expedi- tion. Papers relating to these subjects have been published, and the complete report of the first expedition sent by the Department to South America is now in press. In addition to this work articles relating to amoebic dysentery, baciUary dysentery, cholera, plague, and leprosy have been pub- lished from the Department. On a number of occasions it had been suggested that it would be advantageous for Harvard University to have a station situated in the tropics, with hospitals and laboratory facilities, where cer- tain features of the work in tropical medicine could be most satis- factorily pursued. Through the cooperation and assistance of the United Fruit Company of Boston and New York, facilities of this nature have now been secured in eight different stations in Central and South America. In July, 1914, Dr. Strong was appointed Director of the Labora- tories of the Hospitals and of Research Work of the United Fruit Company. Immediately thereafter he sailed from New York upon a tour of inspection of the various hospitals and stations of this company. Banes and Preston in Cuba, Guatemala, Spanish Honduras, Costa Rica, Panama, and Colombia were visited. In these localities the United Fruit Company has already established well-equipped hospitals with laboratories attached, where large clinics have been opened and where abundant material for the study of tropical diseases may be found. Owing to the different geographical position and physical features of the districts in which these hospitals have been constructed, the climatic conditions, the fauna, and the flora in their vicinity vary greatly. Variation in the incidence and character of disease also occurs in the different stations. From this inspection trip Dr. Strong was able to famil- iarise himself with the conditions in the different hospitals and stations, with the character of the clinical material in each, and with the opportunities for study and research in relation to the 164 THE GRADUATE SCHOOL OF MEDICINE most important medical and sanitary problems in the different stations. Arrangements have been made with the United Fruit Company by which advanced students in the School of Tropical Medicine may be sent to these stations to continue their studies. This rounds out the opportunities for the study of tropical diseases possessed by Harvard University, and makes them probably the most complete of any institution giving instruction in Tropical Medicine. During the past session the School of Tropical Medicine was especially fortunate in having the assistance of Passed Assistant Surgeon Philip E. Garrison, who was detailed to this work through the courtesy of the Navy Department. For the coming year the Department has been strengthened by the appointment of Dr. A. W. Sellards as Associate in Tropical Medicine. These opportunities for extensive study and research in Tropical Medicine have raised the problem of higher recognition on the part of the University than that given by the diploma in tropical medicine, which is granted after the regular course of six months. A degree in Tropical Medicine has been recommended, but this raises the broader problem of degrees, higher than the d^ree of Doctor of Medicine, in various branches of medicine. This problem is also brought to the front through the activity of the leaders in several of the specialties, in attempting to estab- lish standards for specialists. It seems advisable that Harvard University should define its attitude on this matter, especially as this problem is being taken up by some other universities. In informal discussion general approval has been given to the plan of one higher d^ree in medicine, which shall bear to the d^ree of M.D. something the relation that the degree of Ph.D. bears to the degree of A.B. As in the case of the degree of Ph.D., the special field in which distinction is won would be mentioned in this d^ree. The Faculty of Medicine has voted to appoint a committee to consider this problem and to make recommendations. The financial status of the Graduate School of Medicine, as a department of the University, is rather unique. The School began its work on October 1, and the continuous year of teaching is divided into three terms of four months each, beginning with this date. Since this makes the fall and spring terms coincide with the first and second half-years of the Medical School, this division of the year should continue. It has therefore been con- venient to reckon the financial year of the School as ending on THE GRADUATE SCHOOL OF MEDICINE 165 September 30 rather than on June SO, which is the rule in the University. Consequently the statement of the financial stand- ing of the School in the Treasurer's report, as of June 30, has little significance as an indication of the real financial status of the School. The following note from the Assistant Comptroller will explain the apparently poor showing of the School in the Treasurer's re- port for the year 1913-14: " The Graduate School of Medicine will show a book deficit of $3|849.84 for 1913-14. This is accounted for by the fact that the amoimt of $4,500 for tuition fees col- lected by you did not reach this office until July 1, and the financial year ends June 30." But for this delay in transferring funds to the Bursar's office, the School would have shown on Jime 30 a surplus of $650.16 as compared with a deficit in the previous report of $43.26. The real financial problem of the Graduate School of Medicine is not whether or not there will be a deficit at the end of its fiscal year, but what percentage of the fees shall be paid to the in- structors. The instructors do not receive fixed salaries, but are paid a certain percentage of the fees received from the students they have taught. This percentage varies from year to year, according to the ratio of expenses to income. Each instructor is guaranteed fifty per cent of the fees received from his own students, and this amount is paid at the end of each term. After other expenses have been paid, any surplus remaining on September 30 is distributed to the instructors, as a '' dividend," in proportion to the amounts they have received in the " guaranteed payments." For the year 1912-13, the instructors received a total of sixty-five per cent of the fees, although the initial expenses of the first year were unusually heavy. The figures for 1913-14 are not yet available. It is not the intention of the School to pay more than seventy-five per cent of the fees for instruction. If the expenses of the School can be reduced below twenty-five per cent of the receipts, the balance will constitute a fimd to be used for the general improvement of graduate teaching. HORACE D. ARNOLD, Dean. THE DENTAL SCHOOL To THE PbBSIDBNT OF THE UNIVERSITY: — Sib, — I have the honor to submit my report on the Dental School for the academic year 1913-14. The total number of students registered was 193, distributed as follows: — Post Graduates 1 Third-year studento 57 Seoond-year students 66 First-year students 78 Special students 2 193 Instruction was given as follows: — Anatomy. — Asst. Ph)fe8sor Wabben, Asst. Professor Lbwib, Asst. Professor Bbbmer, Instructors Bego, Grbbn, Assistants Thoma, Riblbt, MoBSB, Fbaber, Teaching Fellow Botdbn, Mr. V^nniNa. Physiology. — Ph)fes8or Cannon, Asst. Professor Mabiin, Instructor Stilbs, Austin Teaching Fellow Mendenhall, Teaching Fellow Mateer. Bacteriology. — Professor Eenst, Instructors FBarmNGHAM, Paqe, Flotd, Assistants Pebbt, Dana, Spooneb, Austin Teaching Fellow Auaim. Physiological and Dental Chemistry. — Lecturer H. Casutov Smtiv, Assistant Rice. Materia Medica and Therapeutics. — Professor £. C. Brigos, 10 lectures; Lecturer O'Connell, 30 lectures. Dental Pathology. — Professor Bbackett, 30 lectures. Neurology. — Instructor E. W. Tatlob, 4 lectures. Crown and Bridge Work, Seniors. — Professor Cooke, 15 lectures; Instructor HovBSTADT, 6 demonstrations. Crown and Bridge Work, Laboratory, Seniors. — Professor Cooke, Instruc- tors HovESTADT, Petbbs, Lane, Ruelbebo, Andbews, Assistant F. W. HovESTADT. 120 hours. Crown and Bridge Work, Juniors. — Professor Cooke, 16 lectures. Orthodontia, Seniors. — Professor E. H. Smith. 30 lectures. Orthodontia Practice, Seniors. — Professor E. H. Smttb, Asst. Professor Bakxb, Instructors Howe, Febnald, W. C. Mineb. 158 hours. Orthodontia, Juniors. — Asst. Professor Baxeb. 10 lectures. 166 THE DEITTAL SCHOOL 167 Prosthetic Dentistry, Lectures, Seniors. — Demonstrator Kazanjian. 32 lectures. Phwthetic Dentistry, Laboratory, Seniors. — Demonstrator Kazanjian, Instructors Hatdbn, Langlet, Wbston, Clark, Gould, FLago, McCxTLLAGH, Stkora, Provan, Assistsnts Caldsb, Hbrdbr. 3S4 hours. Prosthetic Dentistry, Lectures, Juniors. — Instructor Bsckford. 32 lectures. Prosthetic Dentistry, Laboratory, Juniors. — Instructors Beckford, Eldrbd, DoRT, Eames, Trayib, Morgan, Loomxr, Malmstbom, Suluvan, Strangman, GnjiAN, Wodbll. 695 hours. Prosthetic Dentistry, Laboratory, First Year. — Demonstrator Kazanjian. 64 hours. Extracting and Anaesthesia. — Professor Potter, Instructors Farrington, MiDGLBT, Norwood, Wolfe, Andrews, Ring. 477 hours. Inlays, Seniors. — Instructors Hadlet, Oldham, Nesbitt. 96 hours. Inlays, Juniors. — Instructors Hadlet and Sfbbbs. 48 hours. Radiography. — Instructor CumaNGB. — 6 lectures, 2 quizzes, 546 radio- graphs. Surgery, Surgical Pathology, and Oral Surgery. — Professor Monks, 27 lec- tures and demonstrations; Instructor Blake, 5 clinics; Professor Monks, Asst. Professor Miner, Instructor Taft. 160 hours. Syphilis. — Instructor C. Morton Smith. — 1 lecture, 32 clinics. Operative Dentistry, Seniors. — Professor Potter. 32 lectures. Operative Dentistry, Seniors. — Professor E. H. Smith. Demonstrations. Operative Dentistry, Seniors, Practice. — Professor Smtiv, Instructors Love- land, Jewell, Eddt, Blaisdell, Stanley, Paul, Furfbt, Chute, Elliott, Pike, Whitehill, Stone, Whitchurch, Davis, Leavitt, Spinney, Vaughan, Caswell, Catheron, Drea, Jameson, Estbs, Emerson, Assistants Crowley, Lawton, Thoma. 624 hours. Operative Dentistry, Juniors, Lectures. Lecturer Dill. 32 hours. ive Dentistiy, Juniors, Practice. — Lecturer Dill, Instructors Chase, McPberson, F. T. Taylor, Mackintosh, O'Connbll, Safford, Emerson, Quinby, Tishler, Wyman, Stevens, Freeman, Assistants Bubnham, Allen, Slack, White, Jewett. 535 hours. OPERATIVE DENTISTRY No. of treatments teeth and gums 6,071 " ** " pyorrhoea alveolaris 164 " sets of teeth cleaned 1,823 " fillings — gold 2,166 " " gutta percha 90 " " cement 1,768 " '* amalgam 2,089 " " amalgam and cement 2,269 " " silicate 1,135 168 THE DENTAL SCHOOL PROSTHETIC DENTISTRY Sbbyicb to Patientb No. of sets of artificial teeth 148 " repaired 153 " partial sets of artificial teeth 148 " artificial palates 6 " " noses 1 " nasal restorations 1 " max. prothesis 2 pRAcncB Work No. of sets of teeth 541 FRACTURED JAWS Skbyice to Patibntb No. of cases 21 " appliances . . . t 21 Practice Work No. of appliances 108 CROWN AND BRIDGE WORK Service to Patients No. of crowns and caps 278 " " repaired 55 " pieces of bridge work 197 Crown and Bridgb Work — Practice No. of crowns and caps 496 " bridges 110 ORTHODONTIA Service to Patients No. of patients treated for irregularities of the teeth . . . 109 ** appliances 228 ** models for regulating cases 218 Practice Work No. of appliances for irreguburities of the teeth 108 " models for regulating cases 54 INLAY WORK Service to Patobntb No. of porcelain inlays and tips 24 " gold inlays 31 THE DENTAL SCHOOL 169 Pbacticb Work No. of porodain inla3r8 94 " 09ld inlays 25 "  .. " " imbedded roots. (( If following fractures absorption due to pyorrhoea , antrum empyema angioma carcinoma cervical adenitis cysts epulis excision of f renum fracture of alveolar process facial paral3rsis f ribroma of hard palate . .. gangrenous pulp imbedded teeth and roots. necrosis of jaw odontoma papilloma pericementitis removal of cicatrix ranula sebaceous cysts trifacial neiuralgia 35 6 7 1 3 1 2 1 2 7  I,2d3 Operative Department 17,554 Surgical Department 5|089 23,936 It tt tt u The School has added to its equipment during the past year an excellent X-ray machine, the gift of Dr. Charles H. Abbot of Berlin, Class of 1885. By Dr. Abbot's generosity we were enabled to r^lace an inferior machine that we had been using with indiffer- ent success for a number of years. A new Taggart Machine for cast inlay work was presented to the School by Drs. Henry W. Gillett, George M. Holden, Bernard Cohen, Sebert E. Davenport, Sr., Sebert E. Davenport, Jr., Leo 170 THE DENTAL SCHOOL Green, William D. Riggs, Frederick A. Arnold, Mark Tishler, C. Franklin MacDonald, Jr., John W. Dickinson. A new course in General Pathology to the first-year students was given throughout the month of May. This course was in charge of Associate Professor Mallory and was successful in every way, the object of it being to prepare the students for the course given in the second year by Professor Brackett on Applied or Dental Pathology. By invitation from the Administrative Board, Professor Dr. Guido Fischer of the University of Marburg, Germany, gave a course in Local Anaesthesia. The course was open to practitioners in Dentistry and was largely attended. The senior students, in sections, acted as assistants to Professor Fischer and received valuable instruction. Dr. Eugene H. Smith gave two lectures on caries before the Fones School for Dental Nurses at Bridgeport, Conn. H. Carlton Smith has spent the greater part of his time outside of that given to the teaching of Chemistry, in a series of experi- ments on metabolism in conjunction with the work of Dr. W. B. Woodbury at the Bennett Street Dispensary. During the year Dr. Amos I. Hadley has given operative clinics before several state societies. Dr. L. M. S. Miner addressed the Bacteriological Club on Oral Infection, the public school nurses on Oral Hygiene, and the Mothers' Club of Newton on the Prevention of Dental Diseases. Dr. Miner has also continued his research work at the Hospital on the Relation of Oral Infection to General Disease. Dr. Lawrence W. Baker has continued his studies of the influ- ences of the forces of occlusion, confining his work to observation on the ruminates, which has resulted in several interesting findings which will be published later. Dr. Franklin Dexter, as Director of Scholarships, has continued his helpful work to Dental students. His report shows that he has aided by gifts or by loans ten Dental students during the past year. The library and Museum, under the direction of Dr. Boardman, has increased its efficiency by adding 112 volimies to the library, making the total nimiber of volumes 2,885; and by adding 99 specimens to the Museum, making the total number of specimens 2,980. In October, 1913, at the request of the Trustees of the Massa- chusetts General Hospital, we assumed the charge of their Dental THE DENTAL SCHOOL 171 Clinic. In order to properly care for that clinic it was necessary to appoint six additional teachers in Operative Dentistry. By this arrangement one graduate is in charge each day, assisted by student members of our Senior Class who are assigned for service on that day. A clinic of this kind is much needed in the quarter of the city where the Massachusetts General Hospital is located, as all of the Dental School clinics are now in the vicinity of the Fenway. EUGENE H. SMITH, Dean. REPORT OF THE DIRECTOR OF SCHOLARSHIPS IN THE MEDICAL AND DENTAL SCHOOLS To THE PbBSIDBNT OP THE UNIVERSITY: — Sm, — I respectfully beg leave to enclose an account of my work in the Medical and DentaJ Schools during the past year. Medical Dantal ToUl Number of applicants for firat-year scholarshipB 14 14 Number of applicants for other soholarshipe ... 53 53 Number of students interviewed 110 26 136 Total number of interviews 285 55 340 Number of letters received and answered 313 28 341 Total number of students aided (exclusive of scholarships) 16 10 26 Number to whom money was loaned 16 10 26 Number to whom money was given 1 1 Amount of money loaned $1,085 $435 $1,520 Amount of money given 30 30 Sources from which money was obtained: Private Fund 915 435 1,350 Anonymous Gifts 200 . . 200 Amount of money refunded 255 102 857 FRANKLIN DEXTER, Director of Scholarships. m THE LIBRARY To THE Prbsibent OP THE Univbrsitt: — Sib, — As Director of the University Library and Chairman of the Council of the College Library, I beg to submit my report cov- ering the year July 1, 1913, to June 30, 1914. The College Library has recently suffered losses that have been deeply felt. The two men who had been longest in its contin- uous service and were its strongest living links with the past have been taken from us before witnessing the new period in our history that will begin with the completion of the Harry Elkins Widener Library Building. William Hopkins Tillinghast, '77, had been connected with the Library since 1882 and Assistant Librarian since 1887. He was a man of scholarly training and much general knowledge as well as devotion to his task. His modest, unassuming nature, while endearing him to those who knew him, made it too easy to forget how valuable as well as self- sacrificing was the work that he so long did for the University. He came little in touch with the undergraduates, but his transla- tion of " Ploetz' Epitome " has been used with profit by thousands of them. In the years 1885, 1890, 1895, and 1910 he was editor of the Quinquennial Catalogue. Thomas J Eieman entered the emplo3rment of the Library in 1855 at the age of seventeen. He was then its sole attendant under the Librarian. Since 1877 he had been Superintendent of Circulation. During his fifty-nine years of service he met with and was helpful to many generations of undergraduates besides great niunbers of instructors, visiting scholars, and people of all kinds. His knowledge of the Library was unequalled and cannot be equalled again, for he had watched the collection grow from 60,000 to 600,000 volumes. His retentive memory and remark- able gift of knowing or divining where desired information was to be found, made him of invaluable assistance to the hosts who sought his aid, while his personal characteristics endeared him to many. In 1892 the College conferred on him the honorary degree of A.M. It is hard to think of the Library without him and he wiU not soon be forgotten. During the last twelve months the Harvard College Library has continued in temporary quarters in Randall Hall and elsewhere. ITS 174 THE LIBRARY There has been somewhat increasmg inconvenienoe, as these provi- sional accommodatioDS, none too ample from the first, have rapidly got overcrowded, and arrangements which did well enough for a Uttle while have become irksome as time has gone on. But such things can be patiently endured in view of the prospect ahead. 