HARVARD UNIVERSITY MEDICAL DEPARTMENT, BOSTON, MASS. ONE HUNDRED AND SEVENTEENTH ANNUAL ANNOUNCEMENT (1899-1900) CHARLES W. ELIOT, LL.D. President. WILLIAM L. RICHARDSON, M.D., Dean and Professor of Obstetrics. FACULTY. OLIVER F. WADSWORTH, M.D., Williams Professor of Ophthalmology. FRANK W. DRAPER, M.D., Professor of Legal Medicine. CHARLES B. PORTER, M.D., Professor of Clinical Surgery. J. ORNE GREEN, M.D., Clinical Professor of Otology. J. COLLINS WARREN, M.D., LL.D., Moseley Professor of Surgery. JAMEŠ J. PUTNAM, M.D., Professor of Diseases of the Nervous System. FREDERICK C. SHATTUCK, M.D., Jackson Professor of Clinical Medicine. SAMUEL H. DURGIN, M.D., Lecturer on Hygiene. T. M. ROTCH, M.D., Professor of Diseases of Children. HAROLD C. ERNST, M.D., Professor of Bacteriology. CHARLES HARRINGTON, M.D., Assistant Professor of Hygiene. THEOBALD SMITH, M.D., George Fabyan Professor of Comparative Path FRANZ PFAFF, M.D., Instructor in Pharmacology and Physiological Chemistry. ALFRED L. T. SCHAPER, M. D., Assistant Professor of Histology. INSTRUCTORS. ELBRIDGE G. CUTLER, M.D., Instructor in the Theory and Practice of Physic. GEORGE H. MONKS, M.D., Instructor in Clinical Surgery and Assistant in MYLES STANDISH, M.D., Assistant in Ophthalmology. FRANCIS S. WATSON, M.D., Instructor in Genito-Urinary Surgery. JOHN T. BOWEN, M.D., Instructor in Dermatology. WILLIAM M. CONANT, M.D., Assistant in Clinical and Operative Surgery. GEORGE HAVEN, M.D., Instructor in Gynecology. HENRY JACKSON, M.D., Instructor in Clinical Medicine. JOHN C. MUNRO, M.D., Instructor in Surgery. EDWARD REYNOLDS, M.D., Instructor in Obstetrics and Asst. in Gynecology. CHARLES L. SCUDDER, M.D., Assistant in Clinical and Operative Surgery. EDWIN E. JACK, M.D., Assistant in Ophthalmology. WILLIAM H. PRESCOTT, M.D., Assistant in Clinical Medicine. PAUL THORNDIKE, M.D., Assistant in Genito-Urinary Surgery. GEORGE A. CRAIGIN, M.D., Assistant in Diseases of Children. EDWIN W. DWIGHT, M.D., Instructor in Legal Medicine and Assistant in FRANK A. HIGGINS, M.D., Assistant in Obstetrics. EDWARD H. NICHOLS, M.D., Demonstrator of Surgical Pathology. JOHN W. BARTOL, M.D., Assistant in Clinical Medicine. JOHN B. BLAKE, M.D., Assistant in Clinical Surgery. ALLEN CLEGHORN, M.D., Assistant in Physiology. ELLIOTT P. JOSLIN, M.D., Assistant in Physiological Chemistry. CHARLES J. WHITE, M.D., Assistant in Dermatology. FRANKLIN W. WHITE, M. D., Assistant in Physiological Chemistry. give Special Clinical Instruction: JOHN HOMANS, M.D., in the Diagnosis and Treatment of Ovarian Tumors. Mental Diseases. The following gentlemen will GEORGE W. GAY, M.D., and HENRY H. A. BEACH, M.D., in Surgery. GEORGE L. WALTON, M.D., and PHILIP COOMBS KNAPP, M.D., in Diseases of the Nervous System. THOMAS A. DEBLOIS, M.D., JOHN W. FARLOW, M.D. and ALGERNON COOLIDGE, JR., M.D., in Laryngology. Every candidate for admission, not holding a degree of arts, literature, philosophy, or science, must pass a written examination on entrance to thi School, in the following subjects: 1. English. 2. Latin. 3. Physics. 4. Chemistry. 5. Either French or German. 6. Algebra, Plane Geometry or Botany. Th admission examination for the coming year will be held June 28th, at Boston, Quincy, Andover, Groton, Southborough, Worcester, Mass., Exeter, Concord N. H., New York, Albany, Buffalo, Philadelphia, Washington, Cleveland, Cincinnati, Chicago, St. Louis, Minneapolis, Denver, San Francisco, Portland Oregon; Bonn, Germany, and Tokyo, Japan; on September 24th, at Boston only. In and after June, 1901, candidates for admission must present a degree in arts, literature, philosophy, or science from a recognized college or scientific school, with the exception of such persons, of suitable age and attainments, as ma be admitted by special vote of the Faculty, taken in each case. All candidates, whether presenting a degree or not, are required to satisfy the Faculty that the have had a course in theoretical and descriptive (inorganic) chemistry and qualitative analysis, sufficient to fit them to pursue the courses in chemistry given a the Medical School. Students who began their professional studies elsewhere may be admitted to advanced standing; but all persons who apply for admission to the advanced classes must pass an examination in the branches already pursued by the class to which they seek admission. The course of study required in this School for the degree of M. D. is of four years' duration. This requirement was established at the beginning of the The year begins September 28, 1899, and ends on the last Wednesday in June, 1900. Instruction is given by lectures, recitations, clinical teaching, and prac tical exercises distributed throughout the academic year. In the subjects of Anatomy, Histology, Physiology, Chemistry, and Pathology, laboratory work forms arge part of the method of instruction. ORDER OF STUDIES. year 1892-93. First Year.-First Term. Anatomy and Histology. Second Term. Physiology and Physiological Chemistry. Second Year.--First Term. Bacteriology and Pathology. Second Term. Anatomy, Clinical Chemistry, Materia Medica and Therapeutics, Theory and Prac tice, Clinical Medicine, Surgery, and Clinical Surgery. Third Year. Theory and Practice, Clinical Medicine, Surgery, Clinical Surgery, Obstetrics, Pediatrics, Dermatology, Neurology, Gynecology, an Fourth Year. Required Studies: Clinical Medicine, Clinical Surgery, Ophthalmology, Otology, Laryngology, Orthopedics, Legal Medicine, Syphili and Hygiene. Elective Studies: Ophthalmology, Otology. Orthopaedics, Gynecology, Dermatology, Neurology, Bacteriology, Physiology, Physiological an Clinical Chemistry, Hygiene, Operative Surgery, Operative Obstetrics, Anatomy, Embryology, Clinical Microscopy. Mental Diseases. For information in regard to Requirements for a Degree, Fees, or for a Catalogue, address DR. WM. L. RICHARDSON, Dean, Harvard Medical School, Boylston Street, BOSTON, MASS. Press of S. J. Parkhill & Co., 226 Franklin Street, Boston. Medical and Surgical HARVA COLLEG LIBRARY JUL 13 1900 CARRINGS MASS Vol. CXLIII. No. 2. ADDRESS. JOURNAL. Published Weekly by DAMRELL & UPHAM, corner School and Washington Streets. PAGE THURSDAY, JULY 12, 1900. Five Dollars per Annum. 33 Manuel Complet de Gynécologie Médicale et REVIEW OF RECENT STUDIES ON THE NATURE ORIGINAL ARTICLE. CASE OF MURAL ENDOCARDITIS. By Harold Williams, M.D., Boston, Professor of Theory and Practice of Medicine, Tufts College Medical School; with Pathological Report by T. Leary, M.D., Boston, Professor of Pathology, Tufts College Medical School.............. CLINICAL DEPARTMENT. PAGE 43 44 REPORTS OF SOCIETIES. EDITORIALS. ENTH ANNUAL MEETING OF THE HARVARD 36 THE HARVARD MEDICAL ALUMNI ASSOCIATION. 44 The entire nutritive constituents of beef and wheat in a A nourishing, restorative, stimulant, liquid food of incom- A complete food, containing the albuminoids, carbohydrates Manufactured by FAIRCHILD BROS. & FOSTER, New York. Entered at the Post-Office at Boston as second-class matter. McK. & R. Compound Stearates. COMPOUND STEARATE OF ZINC (McK. & R.) is the most satisfactory dusting powder for all purposes. It does not cake, never becomes rancid nor "sticky," resists moisture and does not soil the clothing. It is a perfect preventive of chafing in infants or adults. It can be applied to the nose, throat or other passages without causing irritation or discomfort. Supplied plain or with antiseptics, together with pamphlet containing full list of combinations and uses, on application. MCKESSON & ROBBINS = New York. This is a disease the ravages of which are constantly spreading into a wider circle and before which, in the majority of cases, in spite of the wonderful advances of surgery, we still feel ourselves almost powerless. The knife has undoubtedly accomplished much for which we are to be thankful, and the number of those who have been rescued from what was at one time supposed to be an incurable disease is constantly growing. These successes should not, however, lull us into a sense of security, but should rather stimulate us to further effort; for, although we do not now look upon every case as hopeless, as our fathers did, there seems to be but little doubt that the disease is on the increase, and that it still remains — as it has ever been one of the scourges of the human race. It is hardly necessary to remind you that we are living in a wonderful period of progress in medical science, and that this branch of medicine, still perhaps looked upon as theoretical by many of you, has accomplished tasks of the highest practical value not only to the physician and surgeon in his practice, but for the well-being of civilized communities. I have intimated that this disease is on the increase, and one of the first questions which naturally presents itself to the inquirer relates to the accuracy of this statement. I will, therefore, take the liberty of calling your attention to the study of the geographical distribution of cancer, and to the probabilities of the disease having increased in frequency in some of its favorite localities. Unlike tuberculosis, which seems to be spread pretty evenly throughout the globe, sparing no races, cancer appears to be confined to certain tolerably well-defined regions of the earth's surface. It appears to be almost unknown in the far north, including the northern coast line of Europe and Asia, and in the tropics it is also exceedingly rare. Again, in parts of southern Europe, such as Greece, and particularly Turkey, we hear little of cancer. The commonest forms of cancer, such as those of the uterus and breast, are very rare in the latter country. A female physician having an extensive practice in Constantinople during nine years saw but 20 cases of uterine cancer, and 34 of cancer of the breast. In the other portions of southern Europe, such as Spain and Italy, it maintains a high average. In northern Asia, in Siberia, according to Behla, cancer is almost unknown and only observed sporadically in southern Asia. Thus we find it rare in Persia, Arabia and India, except in the western and southern portions of the latter country. In northern China and Japan the disease is more on a par with that in Europe. In southern China, and in fact in the greater part of that country, the inhabitants do not appear to be susceptible to the disease, although those who come to this country are said to lose this immunity. Turning to Africa, we find Egypt and Abyssinia almost exempt. In Algiers and in Madeira the disease is more frequent. In western and central Africa, according to Livingstone, the disease was in his time almost unknown. I need hardly tell you that cancer is common in Great Britain, though the mortality appears to be lower in Ireland than in other parts of the United Kingdom. Coming west to North America, we find the disease is found all over the United States and Canada, but in the more northern portions of the continent, such as Alaska and the most northerly parts of British North America, the disease is rare. In New York State in 1895 there were 5.3 deaths to 10,000 inhabitants, and in Massachusetts the rate was 6.4 to 10,000 inhabitants; and in San Francisco it is quoted as high as 7.9 to 10,000 inhabitants. In the tropics of America it is absent, and it is little known in the lowlands of Mexico; but in the high tablelands of that country it is common. In South America it is said to be most common in Peru, but in Brazil and the more southern portions it is said to be extraordinarily rare. In Australia the disease is said to be quite common, In Queensland in 1891 the rate was 2.60 to 10,000 living persons, and in 1895 this rate had risen to 3.67. In New South Wales in 1896 it took third place in the mortality list. In New Zealand the rate in 1895 was 5.53 to 10,000 (Behla). The disease appears to abound and to be pretty Bearing these data in mind, a glance at the map of evenly distributed throughout the larger part of the Eastern Hemisphere will show a dark belt exmiddle and southern Europe. The northern border tending across Europe and Asia from the Atlantic to of this region extends as far north as Norway, where the Pacific. This belt is widest at its western end, we find that in 1893 6.39 deaths occurred to 10,000 taking in as it does the whole of the Atlantic coast living persons; and Sweden, where in 1894 the rate line of Europe. It gradually narrows towards its was 8.5 deaths to 10,000 living persons. Coming eastern extremity, which includes Japan. The breadth farther south to Denmark, we find the rate computed for five years (1890-95) as 11.9 to 10,000. In Holland it is said to be as high as in any country of Europe. The above figures give what was probably the average of deaths from cancer in middle Europe from this disease during the last decade. On the other hand, in Greenland, Iceland, the Faroes, Hebrides and Shetland, it is an extremely rare disease. Lange saw no cancer in Greenland, and Panum had but one case to report in the Faroe Islands. of the cancer belt in the Western Hemisphere is somewhat greater than the average of that of Europe; but, like the latter, it is situated in the temperate zone. This does not hold true of the Southern Hemisphere, however, for we find it there encroaching more extensively upon the tropics. Much, however, remains to be worked out as to the geography of the disease in this region of the world. In connection with mention of the tropics it is worth noting that malaria and cancer are said to be in an inverse ratio to one another; where malaria is 1 Read at the Annual Meeting of the Maine Medical Association, common, as in Jamaica and the east coast of Africa, June 14, 1900. |