Dr. Maclean Downed

Lsst week, Dr. W. J. Herdman, Dr. V. O. Vaughan, Dr. Henry F. Lyster, and Dr. Obelz, of the medical faculiy, and Regent Cbailes R. Wbitman, appeared before the University commiltees of the legis-lature in Lansing at their rcquest. Dr. Maclean appeared there at the same time , without an invitation, and he heard Bomething that interested him. He was eompletely floored by facts and figures relative to hospital facilities in Ann Arbor, nd his own w ritten statements, made to the board of regents, were read to the oomroittees, statements wbich make bis present position appear singular. Dr. Maclean addrfissed the commiltees, repeating his aesertions that great clinical faoilities were to be obtained in Detroit, but he was eompletely knocked out by Drs. Herdman and Vaughan, who had o!ficial figures showing the falsity of those assertions. Dr. Maclean afterwards acknowledged that he was WHIPPED BEFORE THE COMMITTEES. Dr. Lyster addressed the committees and while be favored the hospital for Am Arbor, he indulged ia a lot of vague au unsubstantial talk about the Detroi (cheme, which, with the newsp-iper inier yiew since credited to himshow the f lly and danger of having any Detroit men in the iaculty, boldly violating the rule of the board of 'regen ts w hich requires the profes or to reside in Ann Arbor. Whatever may be said of the value of tbe service? renderec by Dr. Maclean, it cannot be clairoed that Dr. Lyster is worth $50 for each day he condescends to devote to the University Prof. W. J. Herdman, of Ann Arbor, made the most elabórate argument before the legislative commiitees. He addressec his remurks to two poiuts: 1. Whether it ws possible to eustain an ïllustralive medical elinic at Ann Arbor. 2. If the University needed $50,000 t)T tbat purpose. He showed that at Ann Arbor has been sustained a moro efficiënt ciinic than is furn8bed by almost any other mediaal college in the country, not excluding those looated in the cities. Within two years after the establishment of the hospital for the department of Medicine and Sureerv, that is, in the college year ot 1877-78, there were presented before the gtudenis, in clmics, 307 cases of disease. The following table gives the college year and numbers of individual cases of diseae treated in the University hospital : College Year. Nn m ber of case. 18"7-"8 _ __. S07 1878-7 S:i 1879 80 „ 4: 9 18S1 614 1881-82 „_ 1321 1882-83 1216 1883 84 J176 1884--5 _ 10SI 1885-86 11,84 1886-87 1093 1887-88 933 The-e are individual cases. Each case may be and is preeented to classes a number of time. These fieures do not include those patiënte in the Homeopathie hospital. Dr.Herdman explained that since the purpose of the establishment of our hospitals at Ann Arbor is piimarily to furnish clinic instruction to the studems ot the medical departments, no patiënt comes who does not expect to be used in this way. Every patiënt ebove recorded was so used. This, it is well known, is not true of the wbole number of patients that are inmates of other hospitals throuehout the country, that are orgHnized for chariiable purposes and controlled by trustees wholly or largely made up of laymen. The present daily average of patients in the hospitals at Ann Arbor is about 80. During tbe years 1882 and 1883 the ge was much higber. The following table shows the dailjr averages of patiënte in eeveral tiospital.4 : ü. of M. hosplul In Ann Arbor 80 Harper hospital, Detroit, 1887 „ „ 73 Khode I.slaud hospital, U86 „„ 81 BuBílo General bosuital, 18K6 83 Preyterian hospital, Philadelphla 71 Koseville hospital, New York 151 It will be Eeen írom this statement that the daily average of patients for clinical instruction at Ano Arbor compares very favorably with many large city hospital?, and when we take into consideraron that every one of the patients comirg to Ann Arbor is used for clinical purposes, and that it be safely stated that cot more than 50 per cent, reeeived into charitable hos-pitals, controlled by Iaymcn, are ever used for clinical insíructiou, the ulility to medical students of the hospitals at Ann Arbor in comparison is erea'.ly 6uperior. But, continued Dr. Herdtnan, it 1 as been said that the hospitals at Ann Arbor, located in a 8mall place, must of necessity receive a class of chronic cases which do not 8ufficiently Ilústrate disease. Of the 1176 cases which were presented to the medical cliniesof. the department f Medicine and Snrgery in 1883-84, 331 were surgical ; 301 medical ; 477 distases of eye and ear; and 67 diseases of women. Of the surgical cases that were presented during 1883-84, the hospital records show a very wide range of surgical disorders, illuurat[COHCIX'DKD ON SIO0MD PAUt.] Dr, MACLFAN DOWÑED (Conttnued irom First Page.) ing almost every fortn of surgical practice In ft report made to the board of regent in June, 1882, by the professor of surgery (Dr. Maclean), of the work done in the surgical cünic in that year, after the enumeration of a long list of interesting surgical cases that had been presented to the class and operaled on before them the following statement is made: WHAT DR MACLEAN HAS SAID. "From this partial lis-t it will appear that almos eve;y departmenti-f surgery bas been il.tiitrate by characterifclic cases.'' And ihe report of the house eurgeon for the same year contains the following statements as to the inadtquacy of ou. facihties for caring for the number o patients that were constantly applying lor tre?ment : "The capacity of the hospital has been êtralnec to the utmost. Wlih the excepti'n of a few days dnring the holldays. from the day of opening up to the time of closini?, the waids have been over crowded all the time. All avalla' Ie room has been oceupied, and patients were often glad lo sleep in cots.on st'etcherí.operating tablea, chaire or on ihe floor, rather iban be turned away. lf Ih s deparlment of this greal Uuiversily is 10 be al lowed to grow, as it must and will, more room wül be required. The lurge number of outdoor patients. and the great increase iu aitendauce upou the cliniis overprevious years must sugge-t some of iti possibilities. We feel thantful to you for the many improvements you have given us during ihe past year, Lut our needs are still many, and in conclusión X beg to culi your attenlluii to a tew mobt earnestly needed. asking ti era not for ourselve, but iu the name of 160U afflicted who will ask arimittance and proper accommodatious In the University hospital next ytar." In a similar report preented to the board of regents in 1880, by the professor of surpery, in which "240 iudtvidual cases ot Btri-ry were reponed, the following statements occur: DB. MACLEAN'S OWN STATRMENT IN 1880. "Of ihat number a very l&re number has been pre-ented lo ihe class on ïeveral dirlerent oi-easions, lor the purpo&e of illusiraliug tne various pha.ses assumed by the.'-e cases and ine alteraiions m treatmenl thereby reudere'i necessaty. An importaut public clinic ha been held every Wednesday and aturday, aud since the completidii of the ntw amphilheater. a úaily clinic has been held, and there never has been any stareity of practii'ul work to do. From the accmpanjiuif records it wlil appeaf that a large number ot important operalions have ieen perlormed aud almost every form of surgieal utfcciinn has been presentad and its treatment praciically Ilustra led It is hoped that brief and lragmeutary as this synopsis unavoiilablyis.it neverthel ts may aSbrd someihing like a satlsfactory oasis upon which to form a just opinión of ihe extent nnd nature of the clinical work perlormed In the depaitment of surgery.'' From these statements and detailed repons il will be seen that both in quantity and quality the clinic in the departmeüt of Medicine and Surgery during this period furnished excellent opportunities for clinical instruction. Ur. üerdman then asked : Who re those that are benefitted by this free dispn ing of p ofesional skilf at the expenso nf the state? Of the 1176 patiënte in 1883-84, 999 were resident ot Michigan; Oliio, 66; Indiana, 33; Ontario, 27; New York, 13; Illinois, 5; Dakot, 5; Pennsylvania, 5; Iowa, 4; Kansas, 3; Qubbec, Mi-souri, Nebraska, and Minneso io each two ; Montana T., Wi;consin, California, Tennessee, Maryland, Texas, each 1 ; from which it will be seen tbat although we draw from all parts of the Uüited States and Canada, more than fivesixths of them are residents of Michigan, oud as the treatment is desgaed for the poorer classes, for inmates of county house and asylutns, and such as are unable to pay for skilled medical and surgical attendance, the direct aeneflt to the state by the relief ot so arge a number of its citizens, enabling nany to become self-supporting who have nitherto been an expense and a burden to the state, is not only a charity worthy of support, but is directly, in the line of wise eoonomy. Trom the foregoing facts Dr. Herdman thinks it is apparent that we are able to sustain a clinic in Ann Arbor in all re spectg adequate to the needs of underjraduate medical students. The class of cases presentad to the gtudents in Ann Arbor will compare very favorably with oiher general hospitals in the range of diseases wnich it covers. It will algo be evident from the report of the house surgeon that the facilities for accomodatiog evea the number ot patienls already received are wholly inadequate, and when we have taken into consideraron that the present hospital buildings were put up for temporary purposes, not ;xpected to last more than five years betore they would be replaced by other and better ones, and that they bave been ased 13 years, and that they are in a 'rightfully unsanitary state, without proper leating or needed accomodations of any sort, the necessity of new buildings with modern improvements need no farther argument. In spite of the unsanitary condition of our hospitals, our death-rate has been less than one-kali.that of any other hospitals witb which we have compared thea, while the cost to the state of sustaining a ïatieüt at Ann Arbor is but little more han one-third of the amount necessary to ceep a patiënt for the same length of time in the Harper hospital at Detroit. DK. VACGHAS-S ADDBES3. Dr. Vaugban showed that sick people of' Michigan can be brought to Ann Arbor and can be cared for as cheaply as in Detroit. The mnjority of th cases must at all times be chronic. They require close siudy. The urine and the blood must be examined by the ehemist, and the tissues ty the pathologist. Laboratories for these purposes are in Ann Arbor. If the hospituls were in Detroit, these tacilities would have to be duplicated. It had been said that obstetrical cases would have to be kept in the hospital here two or three months and that the cost would be great. The average in the Ciacinnati genetal hospital is 40 days. The cost for each case here would not exceed $25. Dr. Vaughan said that the people of Detroit and those who have been urging the removal had never presented any definite proposition to the board of regents. Dr. Maclean was constantly sayng, come to Detroit and reap the great aarvest of clinical facilities in Harper's üospital. WHAT HARPER'S HOSPITAL AM0ÜNT8 TO. From Jan. 1, 1866, to Dec 31, 1887, a íeriod of 22 years, Harper's hospital in Detroit had 8,003 cases. That includes 12 months in the year. As the college year s only nine months, only three-fourths of those casen would have been available for use in clinic8, or about 6.000 cases in 22 ?ears. Prom July 1, 1881, to July 1 1887, there were 6,887 cases in the versity hospital. In six years the University hospital had had more cases than Harper's hospital had in 22 years. Harper's hospital hns orjly 29 free bed. Ia order to tnake any bed ree, it musí have an endowment of $5,000. Thore fore, for the state to.fiirnish 100 free b'-ds in Harper's hospital, it would have to ap propriate $500,000. Besides Harper's hospital is held under a charter by a board of trustees who can never sell or give the property to the state or University. WHAT REGENT WniTMAK SAID. Mr. Whitman told the comtnittee that all the dcctors were agreed os to the dbeessity of a new hospital. But Dr. Maelean c'aimed that it should be in Detroit. This position seems to be taken by him alone of all the mpmbers of the medical faculty. While Dr. Frothingham is leported as having made an argument before the committees in opposi'.ion to the appropriation, he states that he has been incorrectly reponed, and that his argument before the committees was really in favor of the appropriation to construct a hospital at Ann Arbor. There could be no doubt that this was the argument of' Dr. Frothinuhnm, because the board of regenta fully understood that those were his views. At the meeting of the board, when the subject of the appropriations which should be sought from ',he legilture was under discussion, a communication (rom a committee of the md c 1 faculty, which was t-igned by Dr. Frotl:ingham, was presented to the board recommending this appropriation, and in addition Dr. Frothingham oppeared before the board and made an oral argument in favor of construating a tiew hospital in Ann Arbor. In view of the statement by Dr. Maelean to the committee that the board had ■lever shown a dispoition or caoacitv to deal with this clinical question, Mr. Whitman stated a few facts to the committee. More than a year ago the board appointed a committee of three, of which the cbairman cf the medical committee was made chairman, to investígate the subject o' establishiog a clinic in Detroit. This committee made several trips to Detroit, mei Drs. Maelean aud Frothingham and the trustees of Harper ho'pital and others concerned in the proponed measure. They learned at the outset that Harper's hospital was for this purpose worse than private property : the title rested in a board of trustees who had neiiher the leal power nor disposition to deed it to the board of regents. ' They learned that every dollar that would be expended tiy the state for this hospi al would necessanly become the preperty of the trustees. They were met wiih visionary g atemens whicn presenlea do definite or feasible plan for the establishment of a clinic in Detroit. The committee devoted in the ueighborhood of six months to these in vestigations and finally reported unani niiusiy to the board aderse to the propot.al. President Argell l.o made a thorough acd careful study of the subject, and in his annual report to the board presen ts a coinprehensive and able summing up of the fkuation with the inevitable conclusión that ihe e-t.sb'.shment of a clinio in Detroit wa. impracticable; thst it would involre yreat expense; a large increase in the teaching coips, and would be destructive of the unity of the Uoiversity. Mr. Whitman placed copies of this leport iu the hands of the committee. He said that the board of regenta is a constitutional body to decide all questinns touching the policy of the University. The board consists of uien who are representatives of various parta of the state, and who as a body can have no interest? otherthan the true welfare of the University. If, at any futute time, it should appear to the board of regent", luwful and expedient to provide a clinic in Detroit, or elsewhere, then can be no doubt that the board would eet intelligently in the matter. The oniy object that can be served by his present agitation by the appearance of an employee lo defeat the will of his superiors, is to injure the Univ.-mity, and o deprive its medical dep rtment of needed facilities, to imperil ttiu very exstence of this department