NOTES ON THE HISTORY AND ORGANIZATION

OF THE PHILADELPHIA HOSPITAL SINCE 1860.

BY CHARLES K. MILLS, M.D. AND ROLAND G. CURTIN, M.D.

We will not attempt a continuation of Dr. Agnew's elaborate medical history of the Philadelphia Almshouse, as the allotted space in the present volume will not permit this to be done, but will simply note some of the most important historical facts of the last thirty years, and record the main changes and new departures in the organization of the medical board. The notes given would be much assisted by tables of the physicians and surgeons who have been connected with the hospital, but although, as stated in the preface, such tables have been nearly completed, their publication will have to be postponed to another volume of Reports, as the present has already extended to the full limits assigned in the authority given for its publication.

According to the rules of 1861, the medical board of the hospital consisted of four physicians, four surgeons, and four accoucheurs. The hospital was divided into three departments, medical, surgical and obstetrical, and the term of each physician, surgeon and accoucheur was three consecutive months, each staff regulating the order in which its different members served. It was the duty of each member of the staff in attendance to visit the institution four times a week, or oftener, if necessary. At various periods since 1861, efforts have been made, sometimes successful and sometimes not, to increase or decrease the number of members of the different staffs' of the hospital. Four on each staff remained the constitution of the board until 1874. During this year the surgical and obstetrical staffs were increased from four members to five, the medical staff practically remaining at four, although Dr. D. D. Richardson, superintendent of the insane department, made five, as he was regarded officially as a member of the medical staff. Those added to the staffs were Dr. S. W. Gross to the surgical, and Dr. J. R. Burden, Jr., to the obstetrical. A sudden jump was taken in 1875. The physicians and surgeons were increased to eight members each, while the accoucheurs remained at five. To the surgical staff were added Drs. N. L. Hatfield, J. William White and W. G. Porter; to the medical, Drs. John M. Keating, E. T. Bruen, J. C. Wilson and J. Guiteras. These new names appear in the Annual Statement of the board of guardians as full members of the medical

board, and were so recognized officially from the first; but for a time the impression seems to have existed with some that the new members were to be regarded as juniors, not possessing all the privileges with reference to lectures and some other matters as the four seniors, a view which, for a time, caused some friction. Soon, however, all the members of the three staffs were considered as upon the same footing.

In 1876 and 1877, important changes were made. The staff of obstetricians was increased to eight members to correspond with the surgical and medical staffs. Of the staff of 1875, only Drs. Edward L. Duer and W. A. Warder remained. Dr. R. M. Girvin and J. R. Burden Jr., had resigned, Dr. J. R, Parry had died, and the new members added to the obstetrical staff were Drs. J. B. Walker, E. E. Montgomery, S. S. Stryker, J. W. Linn, M. D. Musser and W. H. Parish. In September, 1877, three new special departments were added to the hospital, namely, the neurological, ophthalmological and dermatological. Dr. Charles K Mills was appointed to organize and take charge of wards for nervous diseases; Dr. E. O. Shakespeare was made ophthalmologist, and Dr. L. A. Duhring dermatologist. Subsequent to this time the changes in the organization of the medical board have not been many, although some of them have been important. The membership of the neurological staff has been increased until now it numbers four; the ophthalmological and dermatological staffs have each been enlarged to two members; and in 1890, a laryngological department was founded, and two laryngologists, Drs. C. Jay Seltzer and George Morley Marshall were appointed. Several important changes have been made with reference to the positions of pathologist, assistant pathologist, curator and microscopist, and in 1890, a bacteriologist was appointed.

From 1880 to 1884, the medical and surgical staffs numbered nine. One reason for this abnormal increase was probably the great pressure brought upon the governing board in behalf of gentlemen who had command of powerful influence. When in 1884, it was suggested to decrease the staffs, the medical board united in opposition to this, possibly influenced to some extent by the uncertainty as to who would be selected for the axe. Notwithstanding this, however, at a meeting of the board of guardians, October 27, 1884, a rule was adopted reducing each staff to six. The rule in full was, that the medical board should consist of a medical, surgical and obstetrical staff, not exceeding six members each; also of a neurologist, a dermatologist, a pathologist, who should serve as curator, a microscopist, and a physician to the insane department.

In December, 1889, numerous changes were made in the personnel of the medical board.

The rules for 1890 divide the hospital into four departments, viz., a medical, surgical, obstetrical and neurological; the medical including the medical wards only; the surgical, the surgical, venereal, eye and skin wards; the obstetrical, maternity, gynecological and convalescent wards, the nursery and the children's department; the neurological, the nervous wards and the insane. department. In addition special wards are under the care of ophthalmologists, dermatologists and laryngologists. The terms of service of the visiting medical officers is fixed by their respective staffs.

The medical board under the present rules is elected annually in December, by a vote of the majority of the members of the board of charities and correction, and vacancies on the board are filled by a similar vote for the unexpired term, at the next stated meeting of said board, following the one at which the vacancy is declared. The medical, surgical, and obstetrical staffs are composed of eight members each; the neurological staff of four; in addition, the board consists of two ophthalmologists, two dermatologists, two laryngologists, a pathologist, with two assistant pathologists, and a bacteriologist. The board elects annually by ballot a president and a secretary.

OFFICERS OF THE MEDICAL BOARD.

It may be of some interest to record the names of those who have been honored at various times by election to the offices of the medical board. The president of the board has, as a rule, been chosen from the older and more distinguished members. The record of these positions is not a complete one, but from the minutes of the medical board some facts in regard to them have been obtained. The minute book now in the hands of the secretary begins in 1859, but for several years no minutes appear.

At a meeting of the board, held August 13, 1859, Dr. Samuel D. Gross was nominated and unanimously elected chairman, and Dr. John Wiltbank was appointed secretary. Dr. Edward L. Duer subsequently became secretary; March 30, 1867, he resigned, and Dr. William Pepper was appointed in his place. January 15, 1868, Dr. Alfred Stillé was elected president, and was re-elected for several years, resigning March 8, 1872, when Dr. J. L. Ludlow was elected. January 4, 1869, Dr. Pepper resigned the secretaryship, and was succeeded by Dr. Jonn S. Parry, who continued in this position until February 17, 1871, when he resigned and Dr. Harrison Allen was elected. Dr. Allen was succeeded by Dr. John Guiteras, October 7, 1878. The next year Dr. Guiteras having resigned from the hospital to go into the Marine Hospital service, Dr. E. T. Bruen was elected secretary, and continued to serve as such until his death in 1889. Dr. Ludlow was succeeded as president by Dr. James Tyson, March 10, 1885.

Dr. Roland G.

Curtin was elected president January 6, 1890. Since the death of Dr. Bruen Dr L. Steinbach has been secretary.

LIST OF MEMBERS OF THE MEDICAL BOARD.

WITH ADDRESSES, PLACE AND TIME OF GRADUATION, DATE OF APPOINTMENT TO THE PHILADELPHIA HOSPITAL, AND POSITIONS HELD IN OTHER INSTITUTIONS.

In the main, this list as arranged represents the order of seniority of the different members of the medical board. In a few instances, however, it does not, as present members of the board are serving for a second period. Dr. James B. Walker was first elected in 1876. During a few months in 1885 he was not a member of the board, but was re-appointed during the same year. Dr. E. E. Montgomery was first elected in 1877; ceased to be a member of the board in 1885, and was re-appointed in 1886. Dr. James Hendrie Lloyd was elected to the neurological staff in place of Dr. Roberts Bartholow, who resigned January 1, 1888; he served until December, 1889, and was re-appointed in December, 1890. Some members of the different staffs have been elected during the same year, or even at the same meeting of the governing board, and practically the latter do not differ in seniority. In these cases we have taken the names in the order in which they appear in the printed Reports of the department.

WILLIAM G. PORTER, M.D., 1223 Spruce street. Graduate of Univ. Penna., 1868. Appointed 1875. Surgeon to the Presbyterian Hospital; Consulting Surgeon to the Philadelphia Dispensary.

JAMES B. WALKER, M.D., 1617 Green street. Graduate of Univ. Penna., 1872. Appointed 1876; served until 1885; re-appointed same year. Professor of the Practice of Medicine in the Woman's Medical College of Pennsylvania; Consulting Physician and Lecturer on Clinical Medicine in the Woman's Hospital of Philadelphia; Secretary of the American Climatological Society, etc.

E. E. MONTGOMERY, M.D., 1818 Arch street. Graduate of Jefferson Medical College, 1874. Appointed 1877; served until 1885; re-appointed 1886. Professor of Gynecology in the Medico-Chirurgical College; Gynecologist to the Medico-Chirurgical Hospital.

CHARLES K. MILLS, M.D., 1909 Chestnut street. Graduate of Univ. Penna, 1869. Appointed 1877. Professor of Diseases of the Mind and Nervous System in the Philadelphia Polyclinic; Lecturer on Mental Diseases in the University of Pennsylvania; Lecturer on Nervous Diseases in the Woman's Medical College of Pennsylvania.

E. O. SHAKESPEARE, M. D., 1336 Spruce street.

Graduate of Univ. Penna., 1869.

Appointed ophthalmologist, 1877; curator, 1880; pathologist, 1882; bacteriologist, 1889.

HENRY F. FORMAD, M.D., 3535 Locust street.

Graduate of Univ. Penna., 1877.

Appointed microscopist, 1878; pathologist, 1887. Demonstrator of Pathology in the University of Pennsylvania; Coroner's Physician, Philadelphia.

ROLAND G. CURTIN, M.D., 22 South Eighteenth street. Graduate of Univ. Penna., 1866. Appointed 1880. Consulting Physician to the Rush Hospital for Consumptives, and to St. Timothy's Hospital and the Midnight Mission; Visiting Physician to the Presbyterian Hospital; Lecturer on Physical Diagnosis in the University of Pennsylvania; Assistant Physician to the Hospital of the University of Pennsylvania, West Philadelphia.

W. JOSEPH HEARN, M. D., 1130 Walnut street. Graduate of Jefferson Medical College, 1867. Appointed 1882. Visiting Surgeon to the Jefferson Medical College Hospital; Lecturer on Clinical Surgery in the Jefferson Medical College. CLARA MARSHALL, M.D., 131 South Eighteenth street. Graduate of Wom. Med. Coll. Penn., 1875. Appointed 1882. Dean and Professor of Therapeutics in the Woman's Medical College of Pennsylvania; Attending Physician to the Girls' Department of the House of Refuge.

THEOPHILUS PARVIN, M.D., 1626 Spruce street.

Graduate of Univ. Penna., 1852.

Appointed 1884. Professor of Obstetrics and the Diseases of Women and Children in Jefferson Medical College, etc.

LEWIS W. STEINBACH, M.D., 716 Franklin street. Graduate of Jefferson Medical College, 1880. Appointed 1885. Surgeon to the Jewish Hospital; Professor of Surgery in the Philadelphia Polyclinic.

A. W. RANSLEY, M. D., 1222 S. Tenth street.

Graduate of Univ. Penna., 1875.

Appointed 1885. Surgeon to St. Agnes' Hospital.

JOHN H. MUSSER, M.D., N. E. corner Fortieth and Locust streets. Graduate of Univ. of Penna., 1877. Appointed 1885. Assistant Professor of Clinical Medicine in University Pennsylvania; Physician to the Presbyterian Hospital; Consulting Physician to the Woman's Hospital, and to the West Philadelphia Hospital for Women.

GUY HINSDALE, M.D., 4011 Chestnut street. Graduate of Univ. Penna., 1881. Appointed 1886. Assistant Physician to Presbyterian Hospital; Assistant Physician to Orthopedic Hospital and Infirmary for Nervous Diseases; Curator of the College of Physicians.

HENRY W. STELWAGON, M.D., 1411 Spruce street. Graduate of Univ. Penna., 1875. Appointed 1887. Clinical Lecturer on Dermatology in the Jefferson and Woman's Medical Colleges; Physician to the Skin Departments of the Howard Hospital and of the Northern Dispensary.

FRANCIS X. DERCUM, M.D., 636 North Eighth street. Graduate of Univ. Penna., 1877. Appointed 1887. Instructor in Nervous Diseases in the University of Pennsylvania; Assistant Physician to the Orthopedic Hospital and Infirmary for Nervous Diseases.

G. E. DE SCHWEINITZ, M.D., 1401 Locust street. Graduate of Univ. Penna., 1881. Appointed 1887 Ophthalmic Surgeon to the Children's Hospital, and to the Orthopedic Hospital and Infirmary for Nervous Diseases; Surgeon to the Dispensary of the University Hospital for Diseases of the Eye. JOHN BLAIR DEAVER, M.D., 120 South Eighteenth street. Graduate of Univ. Penna., 1878. Appointed 1887. Professor of Surgery in the Philadelphia Polyclinic; Demonstrator of Anatomy and Lecturer on Surgical Anatomy in the University of Pennsylvania; Attending Surgeon to the German, St. Mary's and St. Agnes' Hospitals; and Consulting Surgeon to St. Timothy's Hospital.