Duke University School of Medicine - Aesculapian Yearbook (Durham, NC)

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MICRGBIOLOGT Infectious diseases are responsible for a high per- centage of the ills which plague mankind. This per- centage has 110i diminished appreciably in spite of the availability and use of specific chemotherapeutic agents. Rather, the widespread indiscriminate use of such agents has created resistant organisms which maintain, if not increase, the infection rate as well as complicate the treat- ment and management of an infected individual. Also, the use of therapeutic or maintenance doses of steroidal compounds in the treatment of chronic debilitating dis- eases predisposes, in many instances, to concurrent in- fections by a variety of organisms probably by inter- fering with the host's immune mechanisms. Since the patient with a straightforward, uncompli- cated infectious disease can be treated effectively at home or in a small community hospital, the majority of the patients seen in a medical center such as our are referred because of such complications as those mentioned above. Therefore, the Department of Microbiology assumes its share of the responsibility for the training of medical students, house officers, postdoctoral fellows and nurses in the diagnosis, treatment and management of infec- tious diseases, while its staff also acts as a consultant to the medical center for those patients presenting extraor- dinary infectious disease problems. Because such pa- tients inevitably stimulate research from which informa- tion of practical value might result, the department maintains facilities wherein such studies may be under- taken and, indeed, every encouragement is given to utilize these facilities for clinical research. ln a university setting such as ours, however, the Department of Microbiology has an additional obliga- tiong namely, to make its several disciplines available to the total community. It accomplishes this purpose Du. Davin T. SMITH fume.: B. Duke Professor f if DR. CONANT by its affiliation with the Graduate School of the Uni- versity. This affiliation is not only desirable but neces- sary for the fullest use of its many disciplines essential to the development and growth of the life sciences. During the past two decades microbiology has as- sumed a unique position among the life sciences by virtue of its great span of living organisms which it makes available to its companion sciences as tools,' to be used for the study of the basic concepts of life. These studies have contributed not only to a more definitive knowledge of life processes via biochemistry but also they have allowed the study of the continuity of life itself to be carried to the molecular level via genetics. In this same setting microbiology must borrow tools provided by its companion life sciences for its own de- velopment and growth. Thus the cycle is completed and a department within a university finds its proper relationship with the total community. NORL'IAN F. CoNANT, PHD. Cfzairmun of the Department lames B. Duke Professor DR. SUYDAM OSTERHOUT fll'fl1f'V-lll'0

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assisting with the patient's treatment hy furnishing laboratory tests which aid in determining eilectiveness of the patient's therapy. No specialist is called upon for consultation hy others as frequently as is the hospital pathologist. All universities have as one of their chief responsi- bilities the development, dissemination, and application of new knowledge in the various fields of learning. For this reason, the Department of Pathology at Duke Uni- versity maintains an extensive research program. Every ellort is made to provide opportunities lor students and residents to participate in hasic research programs and to develop their own skills and interests in the field. This gives the imaginative young doctor a chance to explore unknown areas of medicine. Research oilt-rs a maior challenge to the physician who desires the eiccitel ment of discovery for experimental medicine is one ol the truly genuine adventures. Ti-iosms D. KINNHY, M.D. Clltlllfllltlfl of the Depizrtnzcnl llUElIl'y-OIIC'

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PSTCHIATRT Over the past four score years significant contribu- tions to the theory and practice of psychiatry have been made by such diverse figures as Pavlov, Freud, Meyer, Kraepelin, Bleuler and others. The challenge facing the psychiatrists of today is to fuse the outstanding lessons which each of these psychiatrists has produced. Prior to the turn of the century, the psychiatrist was primarily a custodian of the deranged individual. The treatment procedures were extremely limited and time was perhaps the great healer where mental illness was concerned. It was at this time that Kraepelin, Bleuler and Meyer began to pay increasing attention to the classification of mental illness and from then on there was a great increase in that body of knowledge called descriptive psychiatry. In the early part of the twentieth century the contri- butions that Freud made in the psychoanalytic under- standing of mental disorder was considerable. His con- tribution was limited by the controversy that was aroused and the schism which arose between Freud's followers and the rest of the medical profession. At about the same time in Russia, Ivan Pavlov was publishing his studies involving the conditioned reflex and was pro- viding a theoretical framework for the understanding of overt patterned behavior and changes in the various biological systems of the body. In the 1930's and especially since World War II there have been important achievements with the incorpora- tion of the somatic therapies in the treatment of various psychiatric disorders. These have been insulin shock therapy, and the convulsive therapies introduced by Bini, Gerletti, and Meduna. In the past decade, psychophar- macologic treatments have assumed particular impor- tance and have led to the increased discharge of many DR. Bussia chronically ill institutionalized mental patients and have given the psychiatrist increased opportunities to treat many more patients on an out-patient basis. Qne of the misfortunes of psychiatry has been that these various groupings of theories within psychiatry tended to isolate themselves. It is now becoming ap- parent that the concepts of Freud and Pavlov and others have many common links that are described using dif- ferent phrases and in different theoretical frameworks. The challenge now becomes the integration and amal- gamation of these theories leading to a fuller scientific understanding of the total normal and abnormal be- havior patterns with its basis in organic, psychological, psychodynamics. and psychosocial framework. The newcomer to the speciality of psychiatry today. feels the growing enthusiasm of participating in investi- gative undertakings utilizing skills and opportunities for the understanding of behavior coupled with neuro- amy DR. FREDERICK HINE DR. HANS LowENBAcH DR. LESLIE B. PIOHIXIAN lzvefziy-three