University of Maryland School of Medicine - Terrae Mariae Medicus (Baltimore, MD)

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ADMINISTRATION

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introduced to Auenbruggei- ' s methods of direct auscultation (percussion), but he was destined to add the practice of indirect auscultation (the stethoscope). He had observed children scratching one end of a beam and listening at the opposite end. He then set about experimenting with com- pact rolls of paper, then a solid rod ; he finally found that a cylinder with a central channel and a funnel-shaped end worked best. The method to knowledge : observe, hypothesize and then experi- ment. Laennec not only developed the stethoscope but also correlated the findings at autopsy with the sounds heard with the stethoscope during life. He thus learned how to use the instrument to diagnose disease states. It is of interest that the stethoscope was perfected about 8 years after the beginning of the University of Maryland Medical School in 1807. The Medical School was the fifth to be founded in the United States and it is significant that its founding set off mob scenes protesting against human dissection. One of these riots oc- curred in 1788 when Dr. Wiesenthal attempted a dissection, and another in September, 1807, when Dr. Davidge attempted to have students dissect a body in a small building constructed for this pur- pose near his home. Obviously, the long battle for the acceptance of dissection as a necessary part of medical education had not yet been won. In spite of this , dissections have been carried out each year since 1807, and the University of Maryland was one of the first schools to make dissection compulsory (1833), even though there was no Anatomical Law until 1882. The winding stairways and escape hatches in the old building now known as Davidge Hall are mute evidence of the hazards and dangers under which the students and professors worked. The situation today is entirely different. The Anatomical Law legalizes dissection and has been operating well for the past 60 years to supply an adequate amount of material. Because of the great strides made by medicine and popular education, people accept the fact that dissection is indeed ad- vantageous to medical progress and necessary to produce good doctors. There is no longer a fear of mob violence. Many of the educated members of our society recognize the need for anatomical ma- terial and are willing to donate their bodies after their demise for this purpose. Since various social agencies and the government supply money for the burial of indigent people, a scarcity of ana- tomical material has been created in .some areas. and the willing of one ' s own body is becoming an important source, perhaps eventually the only source. The major discoveries made in the 19th and the first part of the 20th centuries are numerous. One that has a profound influence is the invention of the hypodermic syringe by Pravaz in 1851. While this is not in the field of anatomy, its use involves a knowledge of anatomy ; that is, the layers such as skin and superficial fascia through which the needle must pass and the location of veins, arteries, and nerves which it must avoid. There are many other medical specialties that are not regarded as anatomical in nature today, but careful considera- tion reveals that they are either direct offspring of anatomy or are dependent on a knowledge or concept of the structure of the human body. For example, pathology started by Morgagni (1704) (Professor of Anatomy, University of Padua) and cellular pathology started by Virchow (1855) are basically the offspring of anatomy. Cellular pathology resulted from the formula- tion of the cell theory by Schwann in 1839 and the introduction of microscopes into medical schools soon after this. The microscope not only carried anatomy to the cellular level, but also eventually led to embryology, electron microscopy, genetics, and gerontology. Within the past 50 years, the dis- coveries and changes in medicine have been so rapid that they almost defy enumeration. These include great discoveries in physiology, the twin brother of anatomy, and the far-reaching discov- ery of x-rays by William Roentgen in 1895. As x-rays are increasingly used for diagnosis, the need to know anatomy has become more and more essential. Even the tremendous advances in anti- biotics, chemotherapy, anesthesiology, and tran- quilizer drugs require a knowledge of anatomy to appreciate the sites of absorption and action. This great rate of discovery and the accumulation of more and more knowledge has created problems in the medical curriculum; as more subjects are crowded into it, anatomy and other subjects are telescoped to less and less time. Many anatomists are apprehensive lest we attempt to limit the time for dissecting to such a degree that medicine slip as in the Dark Ages to the status of a mediocre empirical profession. Anatomy, as a subject, must be experienced in depth if medical practitioners are to be competent diagnosticians, therapists, or surgeons. Anatomy should be taught as anatomy — by dissection — there is no other way. 16

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The Honorable J. Millard Tawes Governor of The State of Maryland 18