Popular Science Monthly/Volume 67/May 1905/The Harvard Medical School

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WHILE the new building plant of the Harvard Medical School is approaching completion it seems a fitting time to give a brief account of the work of the school and its equipment. Harvard was the second of the American colleges to establish a school of medicine. The study of medicine in Harvard dates from the close of the war of the American Revolution, when in the years 1782 and 1783 three professorships of medicine were founded; and the first degree, that of M.B. (bachelor of medicine), was conferred in 1788. It was not until 1811 that the degree of M.D. began to be given. Up to 1810 the instruction was given in Cambridge, at which date the school was transferred to Boston, where in 1815 the first medical school building was erected. The second building that was occupied was completed in 1883.

The theory of medicine has of course been taught from the beginning of the Harvard Medical School and eminent men have lectured to its students, but outside hospital and clinic facilities had to be sought. In the first Harvard Medical School building there was no laboratory at all.

With the removal in 1883 to the buildings at present occupied by the school, limited laboratory facilities were provided, in which very important investigations have been conducted. The hospital and clinical service is still, however, so dependent on outside cooperation that this work has been much hampered.

For entrance into the school a college degree is required, or in exceptional cases its equivalent, and since 1892 a four years' course has had to be pursued in order to obtain the degree of doctor of medicine.

The present policy of the school is to so arrange the studies that the student can give his time fixedly for lengthy periods to one subject or group of subjects. Thus anatomy and histology are given the first half of the first year, and physiology and physiological and pathological chemistry during the second half. In the second year pathology and bacteriology are studied during the first half year. It has been the rule to lay down a rigidly required course, throughout. in the study of medicine, but beginning in the fall of the present year the fourth year work will be elected in order to give the student an opportunity to specialize in the department of medicine that he proposes to adopt for his practise.

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Model of the Harvard Medical School.

The Harvard Medical School has numbered among its faculty from the first some of the most eminent physicians of our country. The professors have not been practitioners only, but men of high scientific attainments who have made notable contributions to the science of medicine. Among the most important things accomplished in the recent studies by the Harvard medical faculty may be mentioned discoveries concerning congenital dislocation, cancer, acetonemia, blood pressure, small-pox and scarlet fever.

The contributive activity of various departments of the Harvard Medical School is indicated by the list of publications made during the year from October 1, 1903, to October 1, 1904. Anatomy, 7; physiology, 9; histology and embryology, 3; bacteriology, 7; pharmacology and therapeutics, 2; pathology, 22; comparative pathology, 4; surgery, 14; hygiene, 8. Probably nearly as many more investigations were being carried on but were not published within the period mentioned.

The school is about to enter upon a new and distinct period in its history as the possessor of the finest equipment for medical study of any medical school in the world. In its new location the Harvard Medical School will be enabled to carry on in the most satisfactory manner the study of medicine in theory, practise and laboratory investigation. It, of course, remains to be seen how thoroughly the conditions will be utilized by the faculty and students in furthering the' advance of medical knowledge and medical study, but the excellent work done with limited facilities bespeaks a great future activity.

The provisions made in the new buildings for the study of medicine are those that are demanded by the medical knowledge and the advanced methods of the times. Apropos of this it has been well said that the advance in medicine during the past thirty years has been greater than in all preceding time.

The distribution of the buildings, which are being erected at an expenditure of about $2,000,000, and their general style of architecture is shown in the accompanying illustration, from a photograph of a model that was exhibited at the St. Louis Fair, in which the administration building appears in the center at the head of the court, while on the right (facing the picture) the front building is to be devoted to the subjects of hygiene and pharmacology, and the second one to physiology and physiological chemistry. The front building on the left is to be occupied by the departments of surgery, bacteriology and pathology; and the one behind it to anatomy, histology and embryology.

Work upon these new buildings was begun in September, 1903, but it is not expected that they will be completed until towards the close of 1905. which will preclude their being occupied until the fall term of 1906.

he design of the buildings, which are of marble, is distinctly Grecian, and when completed they will form a noteworthy group merely from the architectural point of view. The work of construction is being pushed forward as rapidly as possible. At the time of present writing, the building to be devoted to hygiene and pharmacology is farthest advanced towards completion; the walls are up on the one for surgery, bacteriology and pathology; the iron framework and the walls are in position for the one for physiology and physiological chemistry, and the building for histology and embryology is nearly as far advanced. Only the foundation and a little of the upper portion of the administration building have been erected.

It is of interest to note that much of the funds that have been so generously contributed to enable the Harvard Medical School to make this forward leap is New York money. Mr. J. P. Morgan gave the three buildings at the back of the group, and Mrs. Collis P. Huntington and Mr. David Sears gave the buildings in the foreground. According to the treasurer's report and other accounts, Mr. Morgan gave $1,135,000; Mrs. Huntington, $250,000; Mr. Sears, $250,000, and to these sums must be added a million from Mr. John D. Rockefeller, nearly $371,000 from Henry L. Pierce (1898) and about a half million dollars from other sources.

In the erection of such an extended plant for the medical school all possible precautions have been taken to make it suit its purpose in all respects, and to allow for the expansion of the school and for increased demands on the part of medical instruction.

The four main laboratory buildings have each two wings; and not only have the assignments of location for each department been carefully considered as regards the school as a whole, but the allied or supplementary subjects are placed in the wings that are united through a common center. Connecting these wings is an amphitheater over which are placed the special libraries pertaining to the departments occupying the wings. The arrangement of these departments is such as to place in the same building those that are most intimately connected. The actual arrangement adopted has already been outlined in the mention of the various buildings at the beginning of this article. It must be remarked in addition that the study of surgery is provided for in various departments. The arrangement of the wings is such that they may be extended as the school grows so as to ultimately have three-fold the working capacity at present provided for. In the construction of the various buildings and their adaptation to their special purposes, the questions of light, heat and ventilation have been carefully considered; especial use of the principle of lighting by high windows has been made since ibis insures a good light at the rear of the rooms.

In general, each laboratory wing is divided longitudinally by a broad corridor, and the rooms on each side, which are in most instances of convenient size (23 feet by 30 feet), have adjustable terra cotta walls whereby the rooms may be enlarged or reduced in size according to needs in individual cases. But in the case of the physiological chemistry building there is no medial corridor, and the laboratories are placed across the wing. Also in the building devoted to pathology and bacteriology one wing contains two large teaching laboratories, while the other wing is divided up into smaller rooms for research work.

In the administration building there are the school offices, a general reading room, an alumni room, four lecture rooms and the Warren Museum occupies the third floor.

The general public associates the names of Pasteur and Koch with single discoveries, but fails to realize that those men have introduced

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new methods of work and study, and that the things that their names are especially associated with are but incidents in broad systems; and it is the encouragement of such studies and their practical application that the Harvard Medical School has especially in mind in the arrangement of its new laboratory equipment.

We wonder that the great improvements and discoveries in medicine are not more widely applied. How can they be when the great majority of practitioners have not had the scientific training necessary to enable them to understand and apply what is being done by the most advanced workers and discoverers? The training that the medical student must undergo in order to enable him to comprehend and apply with intelligence the new methods and discoveries in medicine can not be obtained in a poorly equipped institution nor by poorly equipped minds. It is for this reason that Harvard has hailed with such joy the incoming of the means to equip her medical school properly, and has so raised its standard of admission that the equivalent of a college degree is demanded of those permitted to enter the school.

The study of medicine, broadly considered, has reached such a stage that its present day aspect can be taught only in a great university and by university methods. The old-fashioned medical school served its purpose; but it has had its day, and it can no longer prepare its students to meet the demands of modern medical science.

The new equipment of the medical school will greatly strengthen the connection between it and the college at Cambridge. Hitherto it has been a school apart from the main university, and many a man has graduated from Harvard College without being made practically aware that there is such a thing as the Harvard Medical School. It will be possible under the new conditions to greatly enlarge the scope of the electives that bear on a medical education that may be taken by members of the college or other departments of the university. The departments of psychology and physics in the university can now be properly correlated with the Medical School both in pedagogy and in original investigations.

Hitherto the lack of space facilities and apparatus has made the lecture room and the clinic the main features of student contact with the professors of the school, and this has of necessity kept the feeling of a technical school alive in the student body. The new equipment will incite and foster the growth of the broader university spirit in both study and research. The medical school will now be able to do what it could not do before, that is, to offer facilities to students and investigators of other departments of the university for special study and research under medical school auspices.

One of the most important features of the improved systems of medical study is the learning how to use medical literature and the acquirement of the habit of using it. It is only a small proportion of the physicians of the country who can come directly in contact with the special fields of investigation in medicine, and so the chief available channel for keeping up with current progress is through medical literature. The Harvard Medical School possesses unusual facilities for the training of its students in the proper use of the literature of the science. In the first place there are the great general libraries of Boston and Harvard College forming cojointly one of the best collections of books in the world. Next, there is the Boston Medical Library, which is freely open to the Harvard medical students and which possesses one of the most complete collections of medical books in existence, besides containing an unrivaled display of medical journals, which number between seven and eight hundred and embrace the publications of all important countries.

In the various departments of the Harvard Medical School collections of books have been made that serve as technical working libraries; and in the plans for the new buildings this very important feature has been duly provided for. Thus in connection with each laboratory there will be such books, pamphlets, reports and journals as, in the opinion of the person in charge, are the most necessary reference books for students pursuing that specialty. A medical student so trained in the use of medical literature can hardly be content to depend upon antiquated text-book knowledge in his practise in after years.

In that most important matter of applied medicine—hospital service and clinics—the new conditions of the Harvard Medical School promise to be as nearly ideal as the forethought of man can plan. When the grounds for the new site were purchased, enough land was secured to permit the erection of a number of hospital buildings adjacent to the medical school group. Appreciating the advantages of a close connection with the Harvard Medical School, the trustees of several of the new local hospital movements have availed themselves of the opportunity offered and have secured building sites convenient to the school. Moreover, they have signified the intention of joining forces as completely as possible in the carrying on of their humane work. There is first of all the new Brigham Hospital with its foundation of about five millions. .

The trustees of the Brigham Hospital fund have signified their intention, after some legal complications have become settled, of purchasing ten acres of the Harvard Medical School grounds as a site for their proposed buildings; but without restriction or accompanying agreement of alliance. Cooperation will mean much to the Harvard Medical School, and quite as much to the hospital. The new Children's Hospital has a location on the west of the medical school buildings, and the Thomas Morgan Botch Infant's Hospital will build on the school grounds. Near by is the new building of the Samaritan Hospital which was commenced last May; and within easy reach by cars is the Free Hospital for Women. The affiliation of the Harvard Medical School with these institutions will give it the best hospital connections of any medical school in America.