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

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department, the selection of the areas covered by the Laboratories involved decisions regarding the most promising frontiers in the two disciplines. Research in the Department can be viewed as directed toward two such frontiers. First, the goal of much of the work is to increase our understanding of the molecular basis of the energy transformations which underlie fundamental physiological processes such as muscular contraction, nerve conduction, active transport, and cell division. The second frontier involves the analysis of complex inte- grated physiological functions such as the mechanics of respiration, the activity of the brain, etc., with the use of modern analogue and digital computer techniques. Within the Division of Physiology the following Labora- tories are in being: Laboratory of Cellular Neurophysi- ology fChief, I. W. Moorej, Laboratory of Integrative Neurophysiology fChief, G. Somjenj, Laboratory of Muscle Physiology CChief, P. Horowiczj, Laboratory of Molecular Physiology CChief, I. Blumj, Laboratory of Cellular Endocrinology fChief, I. Kostyoj, Laboratory of Cardiopulmonary Physiology fChief, I. Salzanoj, and the Laboratory of Cellular Transport Processes fChief, D. C. Tostesonj. The Division of Pharmacology QI-lead, E. M. Renkiny presently comprises the Laboratory of Biochemical Pharmacology QChief, E. A. Iohnsonj and the Laboratory of Circulatory Pharmacology QChief, E. M. Renkinj. The Department's view of the role of physiology and pharmacology in medicine is well expressed by the fol- lowing remarks of Claude Bernard in his brilliant treatise An Introduction to the Study of Experimental Medicine cI865,I mln the empirical period of medicine, which must doubtless still be greatly prolonged, physi- ology and therapeutics could advance separately, for as neither of them was well established, they were not DR. RENKIN vv if.. Q- I -21.3 1 :.QE5' 4' ff M, 1' ' ij!! ? , 'f ...- - -. starr H . . 4 . A f4?v v'I, -.:':55:f5'3?.2f:,.z..2: 5 , , f nf. , . -, :--.. M.: + -,144 ,--:,-r-,.:-:...:.:- -vm-. ..-z..--...aa s w DR. BERNHEHXI called upon mutually to support each other in medical practice. But this cannot be so when medicine becomes scientific: it must then be founded on physiology. Since science can be established only by the comparative method, knowledge of pathological or abnormal condi- tions cannot be gained Without previous knowledge of normal states, just as the therapeutic action of abnormal agents, or medicines, on the organism cannot be scien- tifically understood without first studying the physi- ological action of the normal agents which maintain the phenomena of life. But scientific medicine, like the other sciences, can be established only by experimental means, i.e., by direct and rigorous application of reasoning to the facts fur- nished us by observation and experiment. Considered in itself, the experimental method is nothing but reason- ing by whose help we methodically submit our ideas to experience,-the experience of facts. ln the introductory courses, we seek not only to inform first and second year students about the most im- portant principles and facts in physiology and phar- macology, but also to provide an opportunity to practice the experimental method in Bernard's sense of sub- mitting ideas to experience, e.g., the experience of others as reported in scientific journals. An effort is made to reveal the relevance of physiology and pharmacology to clinical medicine by conducting clinical-physiological conferences in the introductory courses and by participat- ing in certain special courses for residents. To this end, the faculty of clinical physiologists and pharmacologists who hold appointments in a clinical department as well as in this Department has been very valuable. DANIEL C. TOS'fESON, M.D. Chairman of the Department sixteen

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PH TSIOLOGT PH ARMACOLOGT The Department of Physiology and Pharmacology seeks to provide a focus for growth of ideas in these disciplines within Duke University. Physiology is that branch of science which seeks to understand how living things work. Pharmacology is the study of how drugs modify physiological processes. To understand is to relate, in the mind, things new and unknown to things l already known and familiar. ln science, he things most known and familiar are the concepts of physics and chemistry. ln large part, physiology is the attempt to relate living processes to and through these concepts. Indeed, in IQI3 L. Henderson wrote uThe biologist studies living organisms as inhabitants of this world and, by holding fast to physics and chemistry, he has created modern physiology, a science which unites many, indeed, nearly all of the departments of physics and chemistry in the task of describing the processes of life. The De- partment of Physiology and Pharmacology comprises a group of scholars who are descendants in spirit from Henderson and the other founders of modern physi- ology. Like them, we are moved by the conviction that the modern physiologist and pharmacologist must ahold fast to physics and chemistry, but also, like them, our primary concern is to understand living processes. It is this emphasis on the actual function of natural cells, organs and organisms which distinguishes finsofar as a distinction is meaningfulj the physiologist from the biochemist and the biophysicist. DR. TosTEsoN In recognition of the fact that a few investigators working on closely related problems seem to proceed more effectively and happily than either a single scientist working alone or a large group, both Divisions of the Department fPhysiology and Pharmacologyj are or- ganized into a loose confederation of relatively autono- mous Laboratories. There are, at present, 7 such Labora- tories in Physiology and bg in Pharmacology. Upon completion of the new Medical Sciences Building fcon- struction will begin in the Fall of IQ64D, there will be X Laboratories in Physiology and 5 in Pharmacology. Since it is obviously impossible to represent the entire fields of Physiology and Pharmacology within any one DR. SALZANO DR. Kosryo fifteen

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PATHOLOGT Pathology has been defined as the science which deals with the causes, mechanisms of development and effects of disease. It is the bridge between basic medical science and clinical practice, and the study of Pathology pro- vides the student with his first experiences in his life long study-disease. At a medical school such as Duke much of the departmental effort is devoted to the teach- ing of Pathology to medical students. In addition, be- cause of the large amount of surgical and autopsy ma- terial available at Duke, it is possible to maintain a very active graduate training program. Young physicians who choose to specialize in Pathology or who wish to receive further grounding in the basic fundaments of disease before entering a clinical speciality spend from one to four years in the department as a member of the house staff. At this stage the training is predominantly by the apprentice approach with close association between the resident and senior members of the department. Usually after a period of four years of such training, the resident is eligible for certification by the American Board of Pathology. During this period of training the residents in pathology gain teaching experience so that the majority of those who complete this training con- tinue to hold an academic position in pathology either at Duke or some other medical school. Those residents who go into a clinical specialty after a shorter period of graduate training in Pathology have the security of a fuller and more precise knowledge of disease. Harvey Cushing once wrote that 'iapprenticeship in the patho- logical laboratories always has been and always will be the only way to reach the very top either for the surgeon or physicianf' and William Osler claimed that suc- cessful knowledge of the infinite variations of disease can be obtained by a prolonged study of morbid anat- omy. The Practitioner of Pathology specializes in the prac- tice of laboratory medicine for the purpose of providing physicians and surgeons with the scientific information they must have in order to treat their patients most efficiently and successfully. The hospital pathologist is responsible for the identification of the disease process in the surgical specimen removed at operation and for the final diagnosis at the autopsy table. ln many hos- pitals he also may supervise the laboratories of clinical chemistry, hematology, and bacteriology as well as the blood bank. The pathologist works in close cooperation with the patientls physician in arriving at a diagnosis and assisting with the patient's treatment by furnishing lab- oratory tests which aid in determining effectiveness of the patient's therapy. No specialist is called upon for consul- DR. KINNEY tation by others as frequently as is the hospital patholo- gist. 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 effort is made to provide opportunities for students and residents to participate in basic research programs and to develop their own skills and interests in the field. This gives the imaginative young doctor a chance to ex- plore unknown areas of medicine. Research offers a major challenge to the physician who desires the excite- ment of discovery for experimental medicine is one of the truly genuine adventures. TI-Ioxras D, KINNEY, M.D. Clzrzirman of the Department DR. KLAVINS DR. KAUFBIAN .S'EZ!6'71ff3671