BOOKS RECEIVED. Primary Studies for Nurses: A Textbook for First Year Pupil Nurses. By Charlotte A. Aikens, formerly Superintendent of Columbia Hospital, Pittsburg, and of the Iowa Methodist Hospital, Des Moines. 12 mo. of 435 pages, illustrated. Philadelphia and London: W. B. Saunders Company, 1909. Cloth, $1.75 net. Practical Dietetics with reference to Diet in Disease, by Alida Frances Pattee, graduate, Boston Normal School of Household Arts. Late Instructor in Dietetics, Bellevue Training School for Nurses, Beilevue Hospital, New York City. Fifth edition. 12 mo, cloth. 300 pages. A. F. Pattee, Publisher, Mt. Vernon, N. Y. New York Office, 52 West 39th St., N. Y. (Price, $1.00 net. By mail, $1.10. C. O. D. $1.25.) Refraction and How to Refract, including sections on Optics, Retinoscopy, fitting of Spectacles and Eye Glasses. By James Thorington, A.M., M.D., professor of diseases of the eye in the Philadelphia Polyclinic and College for graduates in medicine, etc. Fourth edition. Two hundred and twenty illustrations, thirteen being in colors. Philadelphia: P. Blakiston's Son & Company. 1909. (Frice, cloth $1.50.) Parcimony in Nutrition, by Sir James Crichton-Browne, M.D., LL.D., F.R.S. 12 mo. Funk & Wagnalls Company, New York. (Cloth, 75 cents, net.) Report of the United year ended June 30, 1908. ing Office. 1908. States Commissioner of Education, for the Theory and Practice of Infant Feeding with notes on development, by Henry Dwight Chapin, A.M., M.D. Professor of Diseases of Children. New York Post-Graduate Medical School and Hospital. Third edition, revised, with illustrations. New York: William Wood & Co. 1909. New and Nonofficial Remedies. Articles which have been accepted by the Council on Pharmacy and Chemistry of the American Medical Association, prior to January, 1909. Chicago: Press of the American Medical Association, 103 Dearborn Avenue. (Paper, 25c; cloth, 50c.) Epoch-Making Contributions to Medicine, Surgery, and the Allied Sciences; being reprints of those communications which first conveyed Epoch-Making observations to the scientific world, together with biographical sketches of the observers. Collected by C. M. B. Camac, M.D., of New York City. Octavo of 435 pages, with portraits. Philadelphia, London. W. B. Saunders Company, 1909. Artistically bound, $4.00 net. A Textbook of Medical Chemistry and Toxicology. By James W. Holland, M.D., Professor of Medical Chemistry and Toxicology, Jefferson Medical College, Philadelphia. Second revised edition, octavo of 655 pages, fully illustrated. Philadelphia and London: W. B. Saunders Company, 1908. (Cloth, $3.00 net.) A Textbook of Materia Medica, Pharmacology and Therapeutics. By George F. Butler, M.D., Professor and Head of the Department of Therapeutics and Professor of Preventive and Clinical Medicine, Chicago College of Medicine and Surgery. Medical Department Valpariso University. Sixth edition, revised and enlarged. Octavo of 708 pages. Philadelphia and London: W. B. Saunders Company, 1908. (Cloth, $4.00 net, half-morocco, $5,50 net.) International Clinics. A Quarterly of Illustrated Clinical Lectures and especially prepared articles on Treatment, Medicine. Surgery. Neurology, Pediatrics, Obstetrics, Gynecology, Orthopedics, Pathology, Dermatology. Ophthalmology, Otology, Rhinology, Laryngology, Hygiene and other topics of interest to students and practitioners. Edited by W. T. Longcope, M.D., Volume I. Nineteenth series. Philadelphia and London: J. B. Lippincott Co. 1908. (Cloth. MISCELLANY. SCIENTIFIC DIETIST.-Philippine Service.-The United States Civil Service Commission announces an examination on April 14. 1909, to secure eligibles from which to make certification to fill a vacancy in the position of scientific dietist, $900 per annum, for duty in the Philippines, and vacancies requiring similar qualifications as they may occur there. Board and quarters are furnished to the occupant of this position. Competitors will not be assembled for any of the tests. The examination will consist of the subjects mentioned below, weighted as indicated: · SUBJECTS. I. Thesis of not less than 500 words on a subject WEIGHTS. C 25 2. Experience (rated on application Form 375).. 75 Total 100 Applicants must show in their applications that they have had extended experience in supervising and directing the formulating, preparing and serving of dietaries suitable to the needs of invalids or convalescents, such experience to have been acquired in an executive capacity in hospitals or similar institutions. Both men and women will be admitted to this examination. Age limits. 20 to 40 years on the date of the examination. No application will be accepted unless properly executed and. with the material required, filed with the Commission at Washington prior to the hour of closing business on April 14. 1999. In applying for this examination the exact title as given at the head of this announcement should be used in the application. THE Messina earthquake is to be effectively described in the forthcoming Century. Mr. Robert Hichens, the novelist, will present a narrative of his observations and experiences during and after the catastrophe, and Professor Perret, who has been an assistant in the observatory of Vesuvius has contributed a scientific account of it. BUFFALO MEDICAL JOURNAL. VOL. LXIV. MAY, 1909. No. 10 ORIGINAL COMMUNICATIONS. Improved Medical Course By I. NEWTON SNIVELY, A, M., M. D. Dean and Professor of Materia Medica, Therapeutics and Clinical Medicine in the THE TEMPLE UNIVERSITY CORRELATED SYSTEM OF TEACHING HE modern phenomenal growth in the medical sciences, both basic and collateral, has added to the labor of acquiring a medical education far out of proportion to the college term.. Co-incident with this growth has come the natural demand for broader and higher medical training. This has necessitated changes in college work and has led to the introduction and development of a system, in which a preponderance of time is given to the minor branches and to special forms of laboratory work and other clinical and auxiliary methods of instruction. But these innovations, by which an ever-increasing proportion of the college hours has been devoted to so-called practical and laboratory instruction, have only served to emphasise what leading men in this department of work now recognise as a great error in present-day medical instruction. DEMANDS OF OLD SYSTEM PRACTICALLY IMPOSSIBLE TO STUDENT. This error is the common practice of over-loading students with an array of facts, figures and formulæ for which he has no use, because he has not yet acquired the mental acumen to place them in their true relations to the remaining subjects of the course. Each department of instruction, with its course of didactic lectures and its independent supplemental laboratory work, is a complete unit, if not intentionally, then at least in effect "a water tight compartment" as one critic most aptly designates it The professor in charge, be he a general practitioner or a specialist, always in effect unduly exalts and isolates his own department and minimizes that of his colleagues. The medical course has been lengthened and in many instances the teaching force increased to a small army. But the major increase was always in the subject matter in the curricu lum, and each year has only augmented the disparity between materials and time of instruction. Hitherto the students' powers have been largely overlooked, save only in the doubling up of his entrance requirements. The effect, where the student could measure up to the demands of the college, was to make multispecialists of the undergraduates. But it is a legitimate question whether any of the matriculates adequately measure up to these exacting requirements. Be this as it may, it is a frequently lamented fact that niany of the medical graduates in the past entered upon their life work with minds crammed with knowledge, the bulk of which they had neither the inclination nor the training to systemise and which they simply had to forget. Fortunately for the student very much of this almost endless attention to details and overlapping of subjects is neither necessary nor advantageous. This we hope to elucidate below. It is strange that medical schools have in the past so disregarded the great laws of education and mind culture and that their methods of instruction are still, in the main, those employed in the district public schools twenty-five and more years ago.—"the pouring in process." Each professor systematises his own work, but quite independent of the work of the other professors. There is no pre-arrangement of subjects; no effort to coördinate instruction. The method of instruction is haphazard. In one college day the student is required to take up as many widely differing subjects as there are study periods. At one and the same time he may be taught the physiology of the brain, the anatomy of the liver, diseases of the heart, pathology of the kidneys, and therapy of lung diseases. There is no logical sequence in the order in which he is obliged to take up these several subjects. The resuit to the student is failure to correlate and assimilate much that has been presented and inevitable discouragement. NEW DEPARTURE IN MEDICAL COLLEGE INSTRUCTION: What solution of this problem has been found? Clearly enough the demand of the day is for concerted effort on the part of the teaching force. The relationship and interdependence of the several branches of study, particularly the manner in which the principles of one study elucidate the facts of another, must be emphasised. By pre-arrangement of the subject matter and mutual cooperation of the instructors the entire course of study must be kept, in bird's-eye view, before the student. In other words, the solution is to be sought in a correlated curriculum. Several years ago the Medical Department of Temple University, recognising this need, adopted somewhat tentatively and in part, a correlated plan of instruction. The results were so favorable that the present correlated course was formally introduced in 1902 as a new departure in medical college instruction. Since then the scheme has been elaborated from year to year till now practically the entire curriculum is embraced. FUNDAMENTAL PRINCIPLES OF CORRELATED SYSTEM: A statement of a few of its fundamentals will help to understand this correlated course, physiology and anatomy, the best established sciences of the entire course, are basic sciences. Disease—that is, pathology-is morbid physiology and morbid anatomy. All nature tends rather to health than to disease. Clinical phenomena are largely expressions of the efforts of nature to regain the normal. The practice of medicine and surgery, therefore, is the art of applying the sciences so as to aid rature to the highest degree. In the above will be observed two keystones from which is constructed the double arch of the correlated curriculum-namely, (1) physiology and anatomy of the normal, and (2) physiology and anatomy of the abnormal; and these two are a unit-namely, "The Science of Man in Health and Disease." The former is basic of the first two years and the latter of the third and fourth years of the correlated curriculum. First, all knowledge is imparted in one of three ways; by repetition, association, or by logical conclusion. The correlated system makes the fullest possible use of each of these three methods. Second, medicine consists of a few massive subjects which are as suns around which revolve, with lesser orbits, the much smaller satellites or specialties. The correlated system focalises the students' attention upon great central luminous factors of medical knowledge and shows the proper sphere of the attending satellites, which but reflect the rays of the central truths. In other words, the student acquires a better knowledge of proportionate values and finds that the specialties do not teach so many new facts, but reflect in different ways the principles of certain basic subjects. Third, the practice of medicine treats of disease in various ways, the professor of practice giving definition, etiology, symptomatology, diagnosis, prognosis and treatment. In the correlated system the practice of medicine has each of these branches taught by a specialist who emphasises the minutia of the particular topic. The professor of practice, therefore, gives a connected outline of the subject, all the other chairs reiterate the outline and fill in the details. HOW THE STUDENTS' WORK IS CORRELATED. By the correlated system a different phase of the same general subject is taught each class simultaneously in the several depart |