during his course is simply devoted to aid him in his every-day dealing with cases in practice. The course in Clinical Medicine, therefore, takes the student at the beginning of the Second Year and carries him by progressive steps through the remainder of his stay in the School. The First Year he has devoted to the study of the normal body, its normal development and functions; and in the Second Year the student is brought for the first time face to face with disease. The work in Clinical Medicine begins with the acquisition of the knowledge of the methods. for diagnosis. The first half-year is devoted to auscultation and percussion, the class being divided into sections, so that each man shall have personal instruction. Also, there are two hours a week at the hospitals, when methods of diagnosis and the methods of history-taking and casereporting are taught. During the second term the men are taken into the wards and shown the practical application of their first term's work. This year's work is specially under the charge of Drs. Mason, Gannett, Withington, and Vickery.

In the Third Year there are four hours a week of clinical instruction under the direction of Drs. F. C. Shattuck and Mason, from the material furnished by their respective clinics at the Massachusetts and City Hospitals. It is the Fourth Year, however, where the greatest advances have been made. First, there is a clinic each week, at which special reference is made to practical therapeutics, as presented by the symptoms of the special patient under consideration; such, for instance, as the various methods of the application of baths to the reduction of temperature in typhoids, the full bath, the wet pack, and the sponge bath, all being demonstrated. Towards the close of the year there will be a number of lectures devoted to psychical therapeutics, or the relations of the physician to his patient. This course will help to do away with the criticisms that have been made upon the non-practicality of the Harvard medical course.

The Clinical Conference has been moved into the Fourth Year, as being a more practical exercise, which should be undertaken only after a man has had full instructions in the methods of investigation of cases. This exercise is conducted as of old. A case is assigned and worked up and read before the Class and criticised by the Class and the instructors. Finally, each member of the Class has to report upon three clinical cases which he has treated at their homes under the supervision of the clinical instructor, giving the history and diagnosis of the case and the treatment while it is under observation. This is the first year that this has been tried, and it is hoped in future that the number of cases will be increased as the means of supplying them and the requisite instruction increases.

The mark for the degree depends upon three elements: First, the

clinical conference paper; second, the report of the three home-treated cases; third, the examination paper. Thus it will be seen that it is the purpose of this department to give continuous progressive instruction, beginning in the Second Year with the methods of diagnosis of case-taking, continuing in the Third Year with the application of this knowledge, as demonstrated by Professors Shattuck and Mason, while in the Fourth they are expected to make distinct practical application of their knowledge by themselves as far as possible. To carry out this scheme necessarily involves the presence of a large corps of instructors, so that this department alone has two professors, three instructors, and four assistants. And this is true in all medical teaching. As the number of students increases the number of instructors for these students must be proportionately greater than for the smaller number.

A. K. Stone, '83.

THE HEMENWAY GYMNASIUM.

Through the generosity of Mr. Hemenway, the Gymnasium is receiving a new addition that will greatly add to its usefulness. The increased demands upon this department during the past ten years in consequence of the extensive growth of the University have rendered the original plant entirely inadequate. This inefficiency was especially felt in the meagre bathing and dressing room facilities, which were intended to accommodate 500 students, instead of the 1,500 that have been using the Gymnasium during the past few years. The new addition consists of an extension of the two wings of the old building on the east side by a structure 48 by 26 feet, and the union of these two wings by a structure of 60 by 24 feet. Running back from this part toward the main building, connecting with the old shower-bath room, is a central structure of 28 by 37 feet with open areas on the north and south sides. The basement of this structure will be lined with white, glazed brick, and fitted up with 50 or more separate bathing fixtures. Running up through the centre of this shower room will be a large light well and ventilating shaft, the east side of which will also serve as a stairway. Opening off from this ventilating shaft, which is 36 feet high and lined with glass, are two galleries that will be used for wiping and drying rooms. These rooms will be connected on the east side with locker rooms, and on the west side with the old shower-bath room. The greater part of the new addition will be given up entirely for dressing-room purposes. It will consist of four floors or stories, including the basement, and will contain about 2,500 lockers arranged according to the alcove plan, with 40 lockers in each section placed back to back. The fronts and backs of the lockers will

facilities for furnishing

be covered with open iron grating, and the rows in each section will be placed far enough apart to allow a passage for steam pipes in the rear between them, which will answer for warming, drying, and ventilating purposes. To improve further the facilities of the dressing rooms for ventilation, the four stories will be connected by an open space between the lockers from floor to floor and a large light well extending all along the inner wall of the new addition about five feet wide, and running from the basement to the roof, where it is covered by a large skylight. The arrangement of the windows admits of a cross draught when it is necessary to air the dressing-rooms and clothing. Most of the lockers. will be furnished with combination locks, which, it is hoped, will do away with the key nuisance. Twenty-four feet of the addition to the south wing on the fourth floor will be appropriated for the enlargement of the present trophy room, and an equal space on the same floor in the north wing will be added to the Director's office for a photographing room, etc. The old locker room will be fitted up for a meeting or a lounging room, and the north end possibly for a fencing room. The boiler room will be enlarged, two new boilers will be put in, and the both hot and cold water will be greatly increased. All of the old lockers and bathing apparatus will be removed from the main building to the new addition, so that the gymnasium proper can be used solely for exercising purposes. The additional floor area gained by this improvement will be over 15,000 square feet, while fully a third as much floor space will be reclaimed in the main building for other uses. To increase the facilities of the Gymnasium in this direction, Mr. Hemenway will have the baseball cage floored over, the bowling alleys repaired and refurnished, and five hand-ball courts constructed on the west side of the basement. In order to meet the demands for more out-of-door exercise in connection with the Gymnasium, the Corporation have supplemented Mr. Hemenway's efforts by having an area of some 12,000 square feet of the ground on the north side of the building graded and covered with asphalt. This area will be inclosed by a board fence and growth of shrubbery, and will be connected with the Gymnasium by means of an iron stairway leading from the main hall. This open space will be used for class, squad, and team exercises when the weather permits, and will greatly relieve the crowded condition of the Gymnasium. The architects of the new addition are Messrs. Peabody & Stearns, of Boston, and the builders are Messrs. J. W. Bishop & Co., of Providence, R. I.

D. A. Sargent.

VOL. IV. — NO. 14.

17

THE INFIRMARY.

The experience of the past year demonstrates still more forcibly Harvard's need of an infirmary. The following table shows the distribution of cases of illness during the year, and the analysis of cases there given is sufficiently close to enable us to discuss the problems involved in an infirmary plan more intelligently than was possible last year. The num. ber of cases remaining in Cambridge (not in homes) during illness is especially significant, showing as it does what the tax upon an infirmary would have been if all such cases had been thus cared for. The number of days' illness gives the total aggregate number of days the patients were absent from college duties. The average number of days' illness is, however, a statistical result obtained by dividing the total number of days' illness for the month by the number of individuals ill during the month. The result is low, since the cases of illness varied in number from day to day, depending largely upon the weather conditions. The number ill at one time is also a statistical result obtained by dividing the total number of days' illness by the number of days in the month. Bad weather gave rise to a largely increased number of cases, even double the average, and of course this must enter into the estimate of accommodations for the infirmary.

CASES OF ILLNESS FOR THE YEAR '94-'95.

In the separation of the cases into two classes, those who went home and those who remained in Cambridge, it must be borne in mind that doubtless many went home who would have been very glad to go to an infirmary; hence the number stated as remaining in Cambridge is not an exact basis for the determination of the demand for accommodation. At present we can only guess at the conditions, but upon the basis shown in

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86

48

419

2,506

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5.6

99

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23.3

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260

304

188

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1,935 1,062

1414280

2,169

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the table it would seem that the building should contain room for not less than thirty non-contagious cases, preferably more, and for nearly as many contagious cases.

During the past year nearly 700 students were visited in their rooms during illness, and the observations gathered emphasize still more strongly the importance of the immediate establishment of an infirmary, to include if possible a diet kitchen, from which food adapted to invalids can be distributed. There has been considerable agitation of the subject in the college papers, and we are fortunately able to report some tangible progress. Several sketch-plans of buildings have been generously drawn by architects who were interested, and the Corporation offers a site, to be determined by a committee, consisting of President Eliot and Dr. Walcott.

The problems in connection with the infirmary are: 1, to raise a building fund; 2, to raise a fund for furnishing; 3, to raise a reserve fund for such running expenses as will not be covered by current income; and, 4, to devise an equitable scheme insuring the best and most comprehensive usefulness of the institution to members of the University.

The first of the problems should be very quickly solved. The site is already promised by the Corporation, and the raising of $50,000 for such a purpose should be a comparatively easy matter, considering the large body of graduates devoted to this important institution. We may not be too sanguine in hoping that some individual will desire the right to associate his name with the building, as has been done so generously in the history of Harvard's development. Dr. Clarence J. Blake of Boston has interested himself in this special problem, has inspired architects to make plans, and is working enthusiastically for the fund.

The second problem ought to promise a speedy solution. If the students interest their parents and others, as was done for the Yale infirmary, the raising of the money may be easily accomplished, and this fund might best be raised in this way in small sums. Fifteen thousand dollars would go very far toward equipping the building for full usefulness, and may answer for a working basis in the creation of the fund.

The third problem is easier, inasmuch as the need for repairs and the excess of expenses over income will be a slow development. A reserve fund, which could be put at interest for future use, may be expected to accumulate, especially as it is hoped the infirmary will attract bequests or the endowment of beds bearing the names of the donors. The expenses of the infirmary cannot be accurately stated at this time, but may be estimated at between $5,000 and $10,000 a year, depending upon the size of the building and the accommodations.

1 Dr. Blake will receive contributions toward any fund named. His address is 226 Marlborough Street, Boston.