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FIRST SI PERINTKNDENT OF 'liih lOliNS HOPKINS HOSPn \L BT niOMAS STEPHEN CIJTXEN IffSO K: ^4^i<.^ iu K>u>^^L^ HENRY MILLS KURD THE FIRST SUPERINTENDENT OF THE JOHNS HOPKINS HOSPITAL ST THOBfAS STEPHEN CULLEN TBI Johns Hopkiics Puss Baltimors 1920 Muxtaaaat m., v. ». *. PREFACE I have written this article at the request of Judge Henry D. Harlan, president of the Board of Trusteea of the Hospital, and of Mr. George K. McGaw, one of the trustees of the hospi- tal — one of Dr. Hurd's wannest friends and the donor of a large sum of money towards the erection of the Heniy M. Hurd Library Building which is to be on the hospital grounds. It was my good fortune to come to the hospital in 1891, just two years after it opened. In my early years I viewed Dr. Hurd's work from the immature standpoint of the junior intern, later as a senior house officer, and for at least 15 years Dr. Hurd has been one of my very best friends. I I has been a delight to browse through his early writings, to digest the chief events of the hospital as they were sketched by him in the yearly reports, and to epitomize the results of his labors since he retired from the active management of the hospital in 1911. I had always looked upon Dr. Hurd as an indefatigable worker, but until now I have never had the slightest conception of the tremendous amount he has accom plished and of how largely he has been responsible for f^e phenomenal success of The Johns Hopkins Hospital. The addition of "Some Random Recollections" written by Dr. Hurd himself will undoubtedly prove of interest to his many friends. Thomas 8. Cxjlles. (S) tin CONTENTS CHAFTBB PAOK I. Earlier Life 9 II. Papers on Psychiatry Prior to Residence In Baltimore. . 13 III. First Superintendent of Tbe Johns Hopkins Hospital. . 16 IV. Extracts from Annual Report of the Hospital, 1889 19 V. Extracts from Annual Reports, 1890-1897 31 VI. Extracts from Annual Reports, 1898-1906 43 VII. Extracts from Annual R^orts. 1906-1911 66 VIII. RelaUons with the Hospital Staff 63 IX. Papers Publish 1 while Superintendent of the Hospital. 69 X. Papers Published while Superintendent of the Hospital (Concluded) gl XI. Secretary of the Bofmi of Trustees of the Hospital 93 XII, Books written by Henry M. Hurd 100 XIII. Summary II3 XIV. Death of Qeorge Keen McOaw 117 XV. Some Random Recollections by Henry M. Hurd 119 Bibliography I37 Kt) tailliWpHi y iji j iii . ii ii i w iwwii * i»»n ILLUSTRATIONS TAoaa PASB Henry M. Hurd Frontispiece Henry M. Hurd. 1889 18 Henry M. Hurd and George Keen McOaw 118 Family Groups, 1849 and 1868 120 Family Groups. 1863 and 1868 124 Family Group, 1870, and Henry M. Hurd, 1874 ISO i7» »»^te|gjjigg*^^r^^^g^ftS|»affl| HENRY MILLS HUBD TH:' first superintendent of the JOHNS HOPKINS HOSPITAL Bt THOMAS S. CULLEN Chafteb I DR. HIJRD'S EARLIER LIFE The subject of this sketch, probably the best known hospital superintendent in the United States, an expert on hospital organization and management, professor of psychiatry, author and editor, was a product of Michigan, a state that has furnished many well-known figures in American medicine. Shortly after Dr. Hurd came to Baltimore a charming sketch of his early life and of his manifold activities in I'lala- mazoo and Pontiac appeared from the pen of Dr. C. B. Burr, his successor at the Eastern Michigan Asylum at Pontiac. This tribute appeared in the American Journal of Insanity, 1899, Vol. 46, p. 303. As it cannot l^ improved upon I shall give it in detail : Henry M. Hurd, A. M., M. D., the reemtly i^^polnted director of The Johns Hopkins Hospital, Baltimore, and the subject of oar photosravore, wa« bom May 8, 1843, at Unicm City, Branch Co., Michigan. His parents, Theodore C. and Ellen B. (Hammond) Hurd, were of New England (Connecticut) stock. His father, a pioneer physician, came to Michigan in 1834; and, worn out by laborlooa practice amid the hardships and privations of pioneer life in a malarioaa country, died at the early age of 39, leaving a wife and three little boya. (») r. HBNRT MILLS HURD 1 Hit mother remarried in 1848, and in 1864 the family remored to Oalesburs. 111. In 1868 he entered Knox College, where he ■pent two years. Subsequently he devoted a year to teaching and general study, and in 1861 entered the Junior class of the UnlTer- slty of Michigan. He graduated from the uniyerslty in 1868, and in the same year began the study of medicine with his stepfather, who was also a physician. He attended lectures at the Rush Medical College, Chicago, and at the University of Michigan, and graduated from the department of medicine and surgery of the university in 1866. The year following graduation he spent in New York in study and hospital work. Subsequently he removed to Chicago, where he engaged in dispensary and genera! practice for two years. It was during the time of his residence in Chicago, In 1870, that he received the appointment of assistant physician to the Michigan Asylum for the Insane at Kalamazoo, and entered that field of ffi Ileal practice in which he has achieved so much distinction. He served the asylum in the capacity of assistant physician for eight years, at the end of which time he became assistant superintendent On the opening of the Eastern Michigan Asylum at Pontiac In the fall of the same year he was appointed its first superintendent, and -:cupied this posiUon continuously for 11 years. Possessing ra»o skill as an organizer, broad cul- ture, literary attainments of a high order, a thorough medical training and a long asylum and hospital experience, he brought to the work of organizing the Eastern Michigan Asylum those qualities which enabled him to place It at once »"nong the progres- sive asylums of the country. He early identified himself with the Association of Medical Superintendents, and was an earnest, faithful and zealous member of this body. During the period of his administration of affairs of the Eastern Michigan Asylum he has seen the treatment of the Insane revolutionized. For the abolition of restraint, the employment of the insane, the extension of the system of night-nursing, the de- velopment of the "cottage plan," and the introduction of home comi;-U into the dull, unattractive institutional life of previous years, he has been an ardent and enthusiastic advocate. To him, perhaps, as much as to any other man among the present genera- (10) BARLIBR HISTORY ti(m of alienists In this eoantry, U due the npid frowth at pro- greealre methods in the ear* of the Insane, and the adranced posi- tion which American psychiatry Is taking. His mental eoltore, which enabled him to grasp intricate problems In all their details, his philanthropic instincts, his ready sympathies and his keen Insli^t into the needs of the insane, conjoined with the quick per- ception of the skilled physician, made him an ideal asylum super- intendent His p'^sonal presence was inspiring; he infused his own spirit of tireless energy among his subordinates, he nnlfled his staff and his corps of employes, and could always rely upon their thorough co5peration. In 1881 he Tisited Sunqw for trayel and InTestlgation In the special lines of work in which he was engaged. The results of this trip were the subject of a special communication to the Joint Boards of Trustees of the Michigan asylums, and were published in connection with the biennial re- port of the Eastern Michigan Asylum for 1882. His writings upon the subject of mental medicine have been Toluminous and of a high order. Aside fmn the numerous papers published in the American journal of Inaanity, as reference to its flies for the past 11 years will show, many of great merit hare appeared elsewhere. Among his recent and most scholarly productions is his presi- dential address in 1889 before the alumni association of the medi- cal department of the University of Michigan, on "The Mental Hygiene of Physicians." His reports of the Eastern Michigan Asylum are written In a masterly and finished style, and have been warmly received and favorably noticed by the precession of this and foreign countries. He was a vice-president of the Ninth International Medical Congress, is a member of the Michigan State Medical Society and of the Detroit Academy of Medicine, and is corresponding member of the Detroit Medical and Library Association. In June ot the presrat year there came to him, without preri- otts Intimation, the tender of the position of director of The Johns H(9kins Hospital. The dfer came as a gratifying surprise, but he hesitated to accept it He was reluctant to relinquish the work to which he had devoted his best years, to separate himself (11) HBNRT MILLS HURD !(■ from hla patient*— maoy of whom had lone hMn objoeta of his car* and aolldtad*— and from frlonds *nd«ar«d to him by th* •tronf«*t tl«*. H* h**lUted to abandon th* work In whleh h* had b«*n ao long and raocwMfuUy engaced, and In which th* pro*p*eta for ftttar* oacfiiln*** op*ned wld* and *r*r wld«r b*for* blm; but oonsldoratlon*. paramonnt among whleh ware th* Ineraaaad opportunltloa for the education of hla diUdren, oonatralned him to accept the poaltlon. By mental endowmenta and education he la peculiarly well fitted tor the reaponalble and delicate dutlea of a hoapltal direo- tor. He la thoroughly de**rT!ng of hla recent rwj great honor, and will adorn the poaltlon to which h* baa b*«n called; but aa we write theae Unea. the feeling retuma with erer-lncreaalng fwoe, that In the gain of The J(dina Hopklna Hoapltal, the proCeaalon of paychlatry auatalna an Irreparable loea, and the aaylum ayatem dsion In statement and practical atility. Thdr lack of uniformity is w^ illustrated br the varying num- ber of tables given In different reports, taken at random from a package before me. In concluding this article Dr. Hurd says : In this earnest plea for more sTStematlo thwapeutieal. clinical and statistical inquiries, I would not be understood as criticising the thintragh wwk now done in conneetion with as^ums. I have merely attempted t« p the duty of tbe staU to eonttnne to care for her Inswie In the staU asTltuns: that ao eonslderaUon of false eeonomy thould vnwtat her from dotng everjrthlnf whleh oan be dooe for the eomlbrt and restoratioo of •Ter7 Insane person. If he reqairea the restraint and sedosloB of an asylum for the dangwtms Insane, he should haye It If he reQulree euratlTe treatment In • hospital, or raffers from a form of disease which calls for constant narslng. he shoald hare that If his welfare will be promoted by glTlag him labor, the liberty of hom^ and a manner of life nearly resembling that of a private family, he shoald recelTe them. No money should be wasted upon buildings, surroundings, or care. Sufficient howerer. should be expended to render each unfortunate as comfortable as his oondl- Uon will permit Anything less than this Is unworthy a great state like Michigan. ^^ Dr. Hurd in 1883 also published "The Minor Treatment of Insane Patients." In 1886 he pubUehed an interesting article on "Paranoia.** During the year 1886 we find two articles from his pen " The Belation of General Paresis and Syphilitic Insanity** and "The Data of Becovery from In- 88:ity.** In 1887 "Gastric, Secretory and Other Crises in Geneml Paresis*' and "The Colony System of Michigan** appeared. In 1888 Dr. Hurd published an important article on The Beligious Delusions of the Insane,** sJso an article on « Imbecility with Insaniiy.** In 1889 he also contributed a paper entitled "A Case of Inebriety with Insanity: with Hemarks." (IS) ii HENRY MILLS HUaD It I ; i"' b Chapter III DR HUBD, THE FIRST SUPERINTENDENT OP THE JOHNS HOPKINS HOSPITAL Dr. Hurd was appoiBted superinteident of The Johns Hopkins Hospital in June, 1889, and assumed the duties of the position on August 1, at which time President Oilman, who had acted as director of the hospital since the preceding Pehruary, and Dr. John S. Billings, who had heen medical advisor to the Board of Trustees for 12 years, terminated their connection with the hospital. Dr. Hurd, as has already heea mentioned, was the first superintendent of the Eastern Michi- gan Asylum at Pontiac. Here he had taken charge of a hrand new institution, had worked out the details of its management and had piloted its destiny most successfully for 11 years. Here at the Hopkins he had a similar opportunity, dif- fering only in tiiat the patients were suffering from bodily inswad of mental ills. In this institixtion he was destined to establish later the most harmonious relationship between the hospital and The Johns Hopkins Medical School which opened its doors in 1893. His wise councU, his broad vista and his tact have in large measure been responsible for the continuous cordial and intimate relations that have always existed between the medical sdiool and the hospital. Dr. Burr in his tribute to Dr. Hurd said, ** His reports of the Eastern Michigan Asylum are written in a masterly and finished ttyl^ and have bean warmly received and favorably noticed by the profession of this and foreign countries.'* The . MEDICAL BOARD. AiAB P. 8MITB, M. D, wpwwBtii* HaKfUKltnmmt, Jakb Cabbt Thoma^ M. D^ r eprawitiB g Uaiwwltj W. &Halmbd,M.IX, Howabd a. Kbixt, M. D, HasBT M. HuBD^ If . D, Wiluak Oubb, M. D, WiLUAM H. Waua^ If . D. •-»»* HOSPITAL STAFF. B: U.Bva»,U.JK WauAV OoJB, M. D. HAvrr Tooumi, M. I>^ Bmncf A. LAWUfBm,M.lK lC.Dk Di WnuAK & HAunD^ M. D. F. J. BaoGKWAT, M. IX OfntealogitI mii (Hukkitkm HowABD A. Kbixt, M. D. Oaoaoa E. Clabsiv If. D. W. W. Fabb, m. r. BmidmU Qfumlotbtt: Bnm Rbaa,lLD A. L.O1 WnxiiJi H. Wi M.IX M.D. W. T. COVMOOMAM, If. IX AUDUVSBB G. Abbor, 1L D. M.IX OUT-PATIENT DEPARTMENT. Cki^ 4^ tk$ Dupmmrft WnxiAX 8. HAZBirBDk U. TX ^ OtMral JMieiM.- WxiuAX On.BB, M. D. % DeptrtmtHl pi Dimtm ^ OdUtm: WiLUAx Oaxm, M. D., nd W. IX S. IVpiirfw* ^ Nmmm Limtm: WnxiAX OUB, IL D., ud H. M. 'SmaauM, M. D. 4. Jiyiwwl ^ Ommd Awftry: W. a Hautbis M. D., Mriitad I7 J. M. T. Ftanrar, If. IX 5. Dipartmmt tg OmUo-Ur nu rf Ikmm: W. & HAunoH If: D., wd JAMBi Bbowx, M. D. 9. Btftrtmmt ^ Opuadoff: H. A. KaixT. M. D, — Irttd liy Hwrna Bcbb^ M. D. 7. Dto|MNMMl q^ QrfrtBJf'tfy Md (Hotoni a TMBOBAUk M. Dl, «ad B. L. Babsous, M. IX 8. Ikpartrnml ^ LmfHgobgf: Jamm N. Maocbbiii^ M. IX 4. JkpaHmmt *i Li r matohgi f: S. & MoBwm, IL IX Ifui luBBb A. Haxrob, ay(r< »< w d « rf y Amu L. WlBDBB BKOBT, Mm Baobbi. A. BobBbb, Mmkon. Staxuet UvtcasMB, O wflri ff w ^ 'i ! HBNRT MILLS HX7RD It 00UMI8 or XmiOAL INSTRUCTION Bcglnoinf with Jaanarr 6 of th« prtMBt jmr [1890] ooanM of pofltcnuluaU iutraetlon In madldn*. lorgarr uid sjrsMology har* b««n irnntantted at the l.otpitaL Dally iMtorM haT« ban flT«n In the dlnloal amphitheatre, and ellnlca In medldne. nir- gwr and gTneeology hare beeu glren three tlmee a week, at which time the wealth of ellDleal caaee afforded Ij the hoepltal and dlapensary hare been otlllied. Rare (qtportunltlee to ttadr dli- eaiee hare been afforded In the dlepenia'T and the hoepltal wards; and to wltueee enrfloal operatloni In the prlrate operating room*. UlBOBATOBIBS The wor.. of the patholoslcal laboratcwr, formerly carried on by the nnlrenlty, was astomed by the hoepltal September 1, 1889. No chance, howerer, has been made In any of Its arrangements or coursee of study, and the work of Instruction and original research has gone on as In former years. The pathological material afforded by the hospital has proren unusually ridi. It has been most carefully and thoroughly studied by Professor Welch and Drs. Councilman and Abbott The clinical laboratory uas been In successful operation under the direction of Professor Osier. Analyses of the blood have been made carefully and systematically as a matter of routine, both to determine Its constitution and to ascsrtaln the presence of malarial or other organisms and parasites. The hygienic laboratory ha:« also been equipped and made ready for practical work under the direction of Dr. Billings and Dr. Abbott Its work thus far has be«i confined to meteorological obsenratlons, the study of Tentilatl(m, the analysis of ground- air, and the bacteriological examination of watw. thb kxtbses' traikino school The Nurses' Training School was formally opened in October, 1889. A 11 report of this momentous occasion is (24) EXTRACTS FROM ANNUAL RBP0RT8 giren by Dr. Hurd in the fint number of Thi Johns Hop- KiKt Hospital Buluttik published on December 1 of that year. After a ihjrt addreM by the president of the Board of Trustees, Mr. Francis T. King, Hiss Hampton spoke at length on "The Aims of The Johns Hopkins Hospital Training School for Nurses," and was followed by Dr. Hurd who took as his theme " The Relation of the Training School for Nurses to The Johns Hopkins Hospital.'' I quote briefly from his address on that occasion : The benefloent work of The Johns Hogkiat Hospital antedates br many years Its tomial opening In May lart. From Its Inoep- tlon In the mind at Its tonnder, and the sabseqnent daboratlon at the Idea by the trastees so vrlady chosen by him— daring the pi'eparatlon of Its plans and In the whole ooonw of its erection— from the flnt foandatlon stone to the last tile apbUe now demand It Bo great. In fact, has been the force of Its (»» RBNRT MILLS HT7RO H •zampl* for (ood. I do not hooiuto to lar that had tho hoapltal DOTor rooolTod or trwtod • ttntU patint, tho work it hM alroadr •ooompllstaod In thowing tho war to bettor botpttal eoastmetion would hATO tnllT Joatiflod tho oxpondituro of trory d6ttar it coat To^ajr wo are aaaembled to witneaa the Inaufuratlon of one of the departmenta o( thia hoapital whieh we hope will Inflaenee in a cimtlar manner, oren if not In an eqnal degree, training achoola for naraea throughout the oountrr. Thla aehool haa been eatab- liahed In oomplianoe with the inatniotitma ot the fou;>der of the hoepltal. in the following language: " I deaire you to eatabllah in oooneetimi with the hoapital a trrining aehool for fenule nuraea. Thia wrovlaion will aecuro the aet-rloea of women competent to care for the aick in the hoapital warda, and will enable 70a to benefit the whole oommunit^ by aupplying it with a elaaa of trained and esperlenoed nuraea." The Board of Truateea haa carried into tf eot thia injunction in no grudging manner. No adiool in thia country haa been more worthily honaod or more fully equipped for claaa-room and practical work and none haa erer atarted out with broader Tiewa or mora comprehenalTe plana for the pnver training of nuraea. What baa the hoapital a right to expeet fr«n the pupila of thia aehool? L They ahoold hare an adequate ooneepticm eompllahment In lines of phllanthroplo work. They are not gained by fltfol toll or half-heartod endeavw. Lest there may be a mlseoneoptloii I oo^t to add that eathn- ■lasm In wwk. dorotlon to dnty. norestlng fldtflty to high Ideals of eOetenoy, kaon hnmaaltarlan Impulses and lore of sdeuttflo truth, cannot and must not bo eonsldorod oMlgatloos peeullar to nurses. Tho trustees and oflleors ot tho hospital aoospt similar obligations for themselrss. and oxpMt OQual enthusiasm and doro- tlon from all oonneetod with tho hospital In any respraslUo eapadty. What, on the other hand, has tho pupU In tho training school a right to expect from all who are o onn e et od with the hospitalT 1. Tho pupil nurso has reason to ezpoet, and should roeolTO, tho respect, confldonoe and cooperation of orary rl^t-mlndod person. 2. eho should enjoy orery facility tot seeurlng Instruetion, and an opportunity to obtain a higher training in orery toanch ot knowledge which promises to increase her ofBdency and uo- fulness. (tf> HBNRY MILLS HURD 1 5 3. She should Lave proper hours for work, proper hours for study and recreatlcm, pleasant apartments, healthful surround- ings, refining associations and every incentive to effort, and every aid to accomplishment of her work. Many hopes cluster about this training school. The work of many years of patient labor spent in construction is over. The scaffold has been swept away, and the completed edifice stands before us. The work of the hospital cannot be complete until this school is open and in successful operation. The poor of Baltimore in their homes, suffering; for lack of proper nursing and adequate attention, look to this school for a solution of the problem of district nursing among the poor. The homes of the wealthy reed no less the skilled nursing which this school aims to supply. The trustees and ofllcers of the hospital welc(»ne the school and bid it God-epeed. i PUBLICATIONS In the first annual report Dr. Hurd says : There has been established, as an organ of the hospital, a monthly publication known as Ths Johits Hopkins Hospitai. BtrtLBmr, which is to contain announcements, programs, reports of societies and minor medical contributions. The Bmxmif has met with much success and seems to have found a place in medical literature. In addition to the Brnxcrm a volume of Hotpitca Beporta is published in fasciculi which will constitute a volume of about 600 pages during the year 1890. The first fasciculus con- tained 64 pages, and had the following list of articles: " On Fever of Hepatic Origin, Particularly the IntermittAnt Pyrexia Asso- ciated with Gtell-Stones," by Dr. Osier Through the medium of The Johns Hopkins Hospital Bulletin the numerous activities of the hospital have been duly chronicled and many important events have been re- corded. The numerous discoveries in the various departments have uccu brought to the notice of the medical world through this journal. It has been a faithful mirror of The Johns (28) EXTRACTS PROM ANNUAL RBnPORTS Hopkins Hospital and its establishment was one of the moat important moves ever made by the hospital. Tt has enabled the institution to tell the civilized world p ^liptiy jiist Trhat it has accomplished. The Johns Hopkins I osp^tal Report contain the lengthy articles— those that are to< ex:en«ivefor i monthly journal. They now comprise 18 volmuej. Dr. Hurd started both the Bulletin and the Reports and was editor of both from the initial issue until he relinquished his position in 1911. He was the editor in every sense of the word. Many of the articles which were rather cmde in their English construction were entirely recast by him. Any mem- ber of the staff who wandered into the superintendent's office late at night when all was quiet or on a Sunday afternoon would find Dr. Hurd busily engaged in correcting galley proofs for the Bullbtin or for tiie Reports. Both of these publications possess a dignity and style rarely noted in medical periodicals. The printing has been good, the illustrations excellent and the text remarkably free from typographical errors. The Hopkins Bulletik and the Reports are to be found in medical libraries the world over. Dr. Hurd deserves the lion's share of credit for the marked success of these publications. ' BOOIBTIES In the first report Dr. Hurd refers to the medical societies of the hospital. A flonrlBhlns hospital medical soelfltr hat been estabUthed under the direction of Dr. Welch, whldi ueeU bi-monthly and li recolarly attended by memben of the hoaplul and dlqMUsary staff. At these meeUngt papers are read, patients are exhibited, morbid pathological spedmens are presented and the results of original InvestlgaUont In the clinical. path-^>>^_.^i..A^.^.^> EXTRACTS PROM ANNUAL REPORTS training school. Among them are Mary E. Oross (Mrs. John M. T. Finney), Georgia M. Nevins the superintendent of Garfield Hospital, Washington, D. C., M. Adelaide Nutting who later became superintendent of nurses in The Johns Hopkins Hospital Training School and who is doing such excellent work as professor in the Teachers' Training School at Columbia University, New York. This list also contains the name of Susan 0. Bead (the late Mrs. William Sydney Thayer). 1892 (February 1, 1892— -Jauuary SI, loM) ICBDICAL IN8TBUCTI0K In the report for the year ending January 31, 1893, Dr. Hurd makes a most important announcement relative to the opening of The Johns Hopkins Medical School. 3y the endowment of the medical school through the goieroslty of MlsB Garrett and others, the university is now in a condition to assume the responsibility of medical Instmetlcni, and com- mencing with October 1, 1893, both graduate and other work will cease on the part of the hospital. It is gratifying, In the review of the past three years, to notice that women have not In any respect proven a disturbing element They have pursued their work under the same conditions as men, and have done faithful, honest and successful work. Although the hospital ceases to do any more medical teaching, the fact that the governing idea in its erection was the promotion of medical teaching cannot be lost sight of. The c<«struction of the wards, the locatitm of the laboratories, the arrangement of the dispensary and amphi- theater, the divers systons of heating and ventilating, and the facilities for their demonstration, all point to a preoonoelved plan that the hospital should do its share in the work of prao* tical Instruction. It is confidently believed that no other hospi- tal in the United States is better equipped to do medical teaA- S (tS) ■f ■ HBNRT MILLS HURD In», or In Its brief eareor has done more thorouch and tucKeatlTe work. The same faithful work wUl be oontlnaed by the same men, under the direction of the university In future, as a part of the curriculum of the medical school 1 4 ! ; LTINO-IN AND ORILDBEN's WARDS The epproachlng opening of the medical 8Cho.v>«^.«*^m^>*».i,*«^»^..^ife«p^*^ HBNRT MIIXS HURD A tract of land on Ramiiiftmi Atvobo and Klnf Btr««t haa baaa imrehaaod as a pormanent alta for The Johns Hopkins Colorad Orphan Asylum, and tha chlldrsn har* baan ramorad to thair nafw homa. A detailed report of the committee on the colored orphan asylum follow* that of Dr. Hurd. 1886 (Febnxarr 1. 1895— Janoarr 81, 1816) In Dr. Hurd's report for the year ending January 81, 1896, we find an account of an addition to the diapensary : In acoordanoa with the raoommendatlon of the medical board, the trustees erected, durlnc the summer of 1886, in connection with the dispensary foor class4>ooms for the aocommodatl Min Nutting's report to the raperintendent for the yeu 1896 announcee the inangnration of the three-year course in the Training School for Nurses. The demand for Information oonoemlng tbe school remains about as nsoal: The nomber of written i^plleatlont for olreolars !!*• AppUoante formallr oonsldered IM Aeoepted awUeaats 91 Among the acknowledgments for the year ending January 81, 1897, Dr. Hurd mentions Mr. Spence's gift of a reproduc- tion of Thorwaldsen's statue of Christ: One «t tbe most notewortbr and wproprlato glfU irtiltih tbe bowltal bas ever reoelTod Is a reprodoetloa ol Tb«i>,U-«.^t>w;w»"'>:^t'"-'*v»^.»->">^.di»* t*. !» ii^ i.i ^...P^.f>,^\^l, HBNRT MILLg HURD r-f ir^.! 1897 (Fibruarr 1, 1897— JanoMT 81. 18M) In 1897 the first claH of The Johns Hopkim Medical School receiTed their degrees from The Johns Hopkins Unirersi^, and the 12 students who stood highest in their class were eligible for positions in the hospital. Dr. Hard in his report for the year ending January 31, 1898, says: BedDDljiff with the first of September. 1897, 12 members of the graduating class of The Johns Hopkins Medical School are In future to be appointed resident medical officers. These phTslelans are dlrlded Into three groups, and serve four months In each department of hospital service, the service being determined by lot. In this manner each resident medical officer secures four months service In medicine, surgery and gynecology. In addition to these resident medical officers, the resident physician, surgeltal for that year Dr. Hurd paid a fitting tribute to his worth. Recently Dr. Clement Andarlese Penrose, -""other member of this group, died. He received his A.B. deg. from The Jc^ns (40) Ai -.--^w t^^^&s^baSL. ■' ^gtig^jIfR-JMi^. . BXTRACT8 FROM ANNUAL RBPORTB Dr. Hurd'i report for this year also contaiiu an account of the addition to the gynecological operating room rendered poaaible by the generosity of Dr. Howard A. Kelly, who gave $6000 to auiat in defraying the expenses. Hopkins UnlTertity in 1893 and immedUtoly entorsd the Msdlcal School. After his year as Intern he located in Baltlmwe and In a few years was recognised as on* of the most promising of the yonnger physicians. In 1908 he serred as Vice-Director and Surgeon of the Bahama Expedition. His report of the medical condltii»ts noted on the trip is rery interesting. Ths most valuable paper was that on Leprosy. This paper graphically depicted i>c deplcnrable condition existing in the Bahamas due to leprosy snu to degeneracy resultiuir '^om close intermarriage. In the spring of 1917 he waa appointed Chairman of the ii_ timore Food Eommny Commission and did much to further food consenratiim. In August 1917 he was commissioned major in the United State* Army and was sent by the surgeon gr ^eral to make an exhaustlT* study oa army sanitation in the English and French armies. General Oorgas in speaking of Dr. Penroee's report said: "Tills report has been of great value to the Medical Department of the United SUtes Army." After completing his work on sanitation he took charge of a three-hundred bed hospital at Ckmdrioourt, France. Here he contracted a septic bronchitis irtildi nearly caused his death at the time. He partially recovered but was left with an Impaired heart He returned to America late in December and (or a time waa able to resume his practice. In Mardi 1919 the infection again became pronounced. He gradually lost ground and died early on the morning of July 4, 1919. Penrose was an excellent medical consultant, a man of rare Judgmmt, beloved by his patients and a loyal friend. His death was a great loss to the cltisens of Baltimore. <41> •^- '^■^*^- :.. '•TA-«^^Hi.w-g-.-fa'^»>-*"^->**-"'*^ngr*Tr I I I: ■I HBNRT MILLS HURD In Dr. Hurd'8 report for this year scholarshipg and honor- able mention in the Training School for Nuraes are recorded for the first time. Dr. Hnrdsays: The experience of anotber year has denumstrated the feasibUlty and dealrabUlty of extending the course of training of nurses from two to three years. The changes In the course of study hare enabled nurses to spend more time In learning the funda- mental branches of their work, and the shortening of hours of duty has enabled them to bring greater freshness and vigor of mind to their studies and regular dnUes. The result has been to improve the standard of nursing, and to give a greater state of efficiency to the school than it has ever prerloosly had. r r ? I. 4: U2( i' • ■ EXTRACTS FROM ANNUAL REPORTS Chapteb VI EXTRACTS PROM THE JOHNS' HOPKINS HOSPITAL ANNUAL REPORTS FOR 1898-1905 1888 (FebnuuT 1. IMfr-nJanoaiT 81, 18M) In his report for the year ending January 31, 1899, refer- ence is made to an incident that cast a pall over the hospital family. It is vividly remembered to this day : It is mr ud dntr to report the death of Dr. L. B. Livliicood who had filled the positicm of aaslstant resident patholoclst fw two years, and who had seenred a leave of a b se n ce to go to Barope for farther study. He left his dnties July 1 and was drowned a few days after in the destraotlon of thetlll4ated steamer La Bourgoyne. He possessed onnsnal ability, great in- dustry and a finely trained mind, a combination of goalities whieb gave every promise of snccess as a teacher and research worker. In his death the hospital and the medical nchodl have ezper^ enoed a severe loss. The hospital lost another of its young medical men during this year. Dr. Walter S. Davis died of Addipon's disease on September 27, 1898. In referring to him Dr. Hurd says : Dr. Davis was full of energy and enthosiasm, and daring his medical coarse tai^ his year of hospital rssidoiee showed him- self thorooA in his work, consdentioos in the disdiarge of duties and eOeient and faithful in all he attonpted to do. His taadiws and associates anticipated higji raoeass for him in his professiim. and all lament his untimely death. (M) ^m^^ki^&uMu. HBJNRT MILLS HURD 5 I h I ? i, - t J A glance through the list for this year of those who secured scholarships in nursing is particularly interesting. Among the names in the senior class is Elsie Lawler, our present superintendent of nurses. In the junior class the name of Agnes Hartridre, one of the present assistant superintendents of the hospital. The steady advancement of these two mem- bers of the training school for nurses is ample proof that Miss Nutting made no mistake in her selection of her pupils meriting scholarships. 1899 (February 1, 1899--Januar7 31, 1900) QBADUATES FILLING POSITIONS AS 8UPEBINTENDBNT8 OF TKAIN- INO SCHOOLS FOB NUB8B8 One of the most interesting items in the report for the year ending January 31, 1900, is a list of the graduates of the teammg school who are fiUing positions as super uitendents of trainmg schools for nurses. This list contains the names of 24 graduates of The Johns Hopkins Training School who are now themselves the heads of training schools. Nothing could show more graphically how much the gxaduates of this school are appreciated throughout the United States and Canada. 1900 (February 1, 1900-^anuary 81, IMl) In the report for the year ending January 31, 1901, Dr. Hurd refers especially to Volumes VIII and IX of The Johns Hopkins Hospital Reports: ITie past year has been one of considerable activity In the pub- llaitlon. of the hospital. Volume VIII of the Reports, containing exhauatlve studle. by Dr. Osier and hi. staff in typhoid fever ha. recenuy been pubUrtied. and Volume IX. which oontalw 88 (44) EXTRACTS FROM ANNUAL REPORTS elaborate articles impared origlnallr 1>7 hia ■tudents to celebrate the 26th annlTenary of the doctorate of Profenor W. H. Weldi, the pathologist of the hospital, was poUlshed in April last aod constltntes a Tplume of nearly 1100 pages. In point of ezceUence of matter and thorough presentation of seienUfle work the rolune is follr equal, if not snperior. to any of similar character erer pablished in this conntry. In addition, the Bvuxra has been regolarly published with increasingly valuable contributions each month. Volume ZI which was completed with the December issue, contains S40 pages and numerous illustratioas. 1901 (February 1. 1901— January 81, 1902) In the report for the year ending January 31, 1902, Dr. Hurd again refers to the great value of Thb Johks Hop- KIK8 Hospital Bullxtin and of the Reports. He says : Volume X of The Johnt HopMnt Hotpital Report* is in progress and will be completed during the present summer. The Buixbtih of the hospital has been issued monthly during the year and has now reached an annual volume of nearly 400 pages. It is gratifying to observe how extensively it is circulated and Quoted both ip this country snd in Europe. It U evident that this pub- licatiob has made a permanent place for itstif in medical literap ture and our publishers inform me that the series ol volumes is already in aeUve demand to supply libraries. The V9tn pre- sented in it during the past 12 years form, in fact, • good com- mentary upOT >Jie advance of sdentiflc medicine in America. During *' year, it may be added, the volume of the Buir inmrhas ^ upward of 900 octavo pages of reading mattw. Dr. Hi '- M mentions the substantial addition to the public gynecological ward : During the year, in order to furnish additional aocmnmodatioos for paUents recovering from gynecological operaticms. and to secure tftdlities for an examining room and laboratory in oonneo- (45) if HgNRY miXS H PRD Uon with thla ward. Dr. Kelly, with crMtt UberaUtir. gaT« to tli* hospital the tttin of $10,000. This anm haa been expended In bolld- Ing upon the north tide of the public gynecidoclcal ward, a large tw&etory annex which aftorde accommodations tar 12 patients. The superintendent also gave a complete list of the larger donations made to the hospitol from the time of its completion up to the end of 1901. 1902 (Pebroary 1. IMZ-Jannary 81, 1908) From Miss Nutting's report to Dr. Hurd for the year ending January 31, 1903, we learn of the esteem in which graduates of the training school are held. This is shown by the large number of requests for nurses to fill important positions m other schools : Letters requesting us to send our graduates to fill positions as ffdlows: Superintendents 26 Assistants C Head nurses . . .*. 15 1908 (FebnuuT 1, 1908— Janoarr 81, 1904) Nearly every hospital board of trustees has its period of anxiety and perplexity wonderng just how it will meet its financial obligations. The trustees of The Johns Hopkins Hospital have been men of affairs — ^men possessing r broad vision — and they have in every instance found their way out of the dilemma. Early in 1904,* however, without a day's wam- * As It often requires six months to assemble the data at the preceding year the annual r^ort ajwcvs about the middle of the following year; hence the Balttanere Are ct Febniary. 1904, was mentioned In the report for 1908. (4t) fl EXTRACTS FROM ANNUAL REPORTS ing, thdr annual income was for fhe time being maricedly impaired. Dr. Hnrd in his annual report published early in 1904 refers to this critical period in the hospital's career in detail: To X%« Board of Trutteet of The Johnt Eopkitu EotpUat: GKfiuicBir.— The dose of the past year of the hospital has been marked by the most serious calamity whldi has belSllSD the hospital daring its ezlstenee. On the morning of FAmary 7^ almost before it had beoi possible to sum up the results of the operations of the prerions flseal year, whldi dosed February 1, a general oonflagratlon swept orer the dty of Baltimore and pnnred most disastrous to the real and lease-hold property ot the hospltaL Dwlng the fire <4 stores, warehouses and offloe buildings, widely soattered in the business portion of the dty, re pr es en ting an aas essed Talnation of more than a million and a quarter dollars, were destroyed, entailing a loss of laoome for at least two years of about $120,000. ▲ portion of this loss was made up by insurance. In aooordaaee, howerer. with the policy of the hospital, an insurance liad not been secured against a total loss, but merdy for t sum which had been deoned suf- fldent to provide for rebuUdlng In ease of partial destrueUon by lire. The results, however, prored that such Insnranoe was wholly Inadequate to repair the efteoU of a widespread calamity, and a loss of c^tal funds ot between 1800.000 snd $400,000 resulted. For sereral weeks thereafter great anxiety was f dt lest it should beoome n»~8ssary to curtail seriously the work of the hospital by closing wards and cutting down the stalt of nurses and employes. Throuiji the liberality, howerer, ct Mr. John D. Rodte- fdler, of New York, who had familiarised himsdf thoroughly with the work of the hospital, its financial standing, and ita loss of income and capital, a half million ddlars hare been plaoed at the disposal of the trustees to repair these losses and to enable the work to go oa without diminution. Never was assistaaes man timely to the instltutloa. The magnitude of the work at the hospital and the need of laereaslag dialoal fs^lltles to (4T) HENRY MILLS HURD lil the growing demands of the medical 8cho<« had hitherto oon- earned all its Income and had left no arallahle fond to meet the unforeseen emergency of rebaUdlng Its warehouses. Hence the pecQliarly Umely character of the aid afforded by Mr. RockefeUer. and the critical condition of the insUtaUon wlthoat sndi assis- tance. The thanks of the medical staff of the hospital and of the officers of the medical school are due to him tot his prompt and generoas recognlUon of the educational work of the hospital. At a special meeting of the Board of Trustees of The Johns Hopkins Hospital on Thursday, April 7, 1904, the following action was unanimously taken in reference to the gift of Mr. Rodceteller: " In Tiew of the donation of 1600,000 made to The Johns Hop- kins Hospital by John D. Rockefeller: "RetolveA, That the Trustees of The Johns Hopkins Hospital desire to express their grateful appreciation of the gift of Mr. John D. Rockefeller to The Johns E(q>kins Hospital, announced to the trustees by his son, Mr. John D. Ro<*efeUer, Jr., in a letter to Dr. William Osier. This munificent donation will enable the hospital to continue its worits of charity, medical education medical research and the training 7aDaar7 81, 190B) Dr. Hurd in his report for this year refers to the new clinical building. The amphitheatre and surgical building, to which referesee was made In the last report, were completed and made ready for oocupancjr In October, 1904. A fnll description was given in the last report, and need not be repeated h«re. The building has proven eztronelj useful, and has added very much to the convenience of the surgeons In their erative work, and has afforded needed facilities for those who are engaged in teaching. The basement of the building has been fitted up tat a genito- nrlnary ellnle, under the charge of Dr. H. H. Toung. The new surgical building and clinical amphitheatre were tor- mally opened on October 5. 1904. Appropriate addresses were made by Henry D. Harlan, president of the Bok/d of Trustees; Dr. Lewis A. Stimson, of New York; Dr. T. ClUrord Allbutt, of Cambridge, England; Dr. A. Jaeobl, of New Tork; and Dr. D. C Oilman, ex-president of The Johns Hopldns University. At the unveiling of the tablet in mem(»y of Dr. Jeese W. Laiear, ad- dresses were made by Dr. James Carroll, of the United States Army, and by Dr. William S. Thayer. (SO) li MtaAl ^tl^m a^ EXTRACTS PROM ANNUAL RBP0RT8 Dr. Hurd in thii report •!«) refers to the opening of the Phippa TnbercnlosiB Diapensary. The Phippa dispenMry wm opened with epproprlete eeremcnlee on the 21»t of Pebnuur of the present yeer. Short eddreaeea were made by Mr. Henry Phlppe; Dr. Wlllltm Oeler; Dr. B. M. Blggi, of New York CJlty; end Dr. Henry Bulon Jeoobe, weel- dent of the Leennee Society, a aodety for the etady of tuber UMds. Mr. Phlppe eabeequently gaTO $6000 to be need for the vurdiase of book* and apparatus and for the endowment of the dispensary. Under the arrangements which were mad^ the sum of |10.ie. f / V^rB, N. " . and ao arranged aa to tell tbe time dorlag *\\ tram- portation of Uu> exhibit and fitting it up In St Louis, an indebted- ness of about li^BO waa Incurred, whieb waa assumed pe tonally by Mr. William *.. Marburg, one of the membera of tba Mary and commission and a trusl riuju ^ortc ^thi dtDr. i. who oer- 1«I3 Hard, auperintendent, to ^vhom ! absence to date trom Norem- timit the foUowlns report on f the hohi>ital diirl&> the year ending Jaaoary 81, 1M7. n iae «9or< was r~ ented the boapltal hae had a meet year, ant looka aa though the coming Tears oi carea and anxletlee which hare tike i,»at} 9 present year aids with a chron: lee the generous Marbni^ sncoeaefui flnan would hi ft 4* o troublet) th> hospital "tnall Hurplai? to Its ert Dr. inorton'- repoi ueqTip t. Mr. William Marbu mn 1 money s ezp<^!ide.>-»».iMci^iJ^a.«i^. ■:.j=^,T».i.Mfei««Ai.., HBNRT MILLS HURD i*¥ inoomplste bj naaon of the limitation of the iphere of phnlduui •ad none*, whok from the nature of their eonneeUon with patlmta, ne c ee ia rily oonflne themielTee to the treatment and care of their physioal allmenta onlr. When the care of the hoipltal la with- drawn and the patients return to their homee, they freanently loee the benefit which they recelre. because of bad sodal eondi- tlcms, lack of proper food and improper hygienic sorronndinss. With the hope of relierint many of these conditions and help- ins to rmder permanent the good received while under treatment, the trustees of the hospital, largely through the initlatlTe of Mr. John M. Olenn, one of their number, for many years dosely identified with the public and private charities of Baltimore, have established a department of social serrice under the spedal eharge of Miss Helen B. Pendleton, for many years a trusted and el5- dent agent of the Charity Organisation Sodety of Baltimore. It is her duty to lo ■- decided grewtli In the work, niere are ?■ (■•) ^HUiHB^ J HENRY MTLLS HURD now 980 caaes recorded as comysred with 414 in the preoedins year That the hospital physicians recognize the usefulness of this department is shown by the increase in the number of cases re- ferred to us from the wards. During the first year there were 48 cases, this year there have been 123 Maboabct p. BaooDBir, In charge of tocial tervice department. 1910 (February 1. 1910— January 31, 1911) Dr. Hurd's report for the year ending Jnnuir- 31, 1911, refers to the resignation of Miss Eoss, the superintendent of nurses and the appointment of her successor: At the beginning of the fiscal year Bliss Roes, in consequence of ill health, resigned her posiUon and Miss B. Bt Lewler was appointed superintendent of nurses and principal of the training school in her place. Miss Ross had been oimnected with the hospital since h« graduatlcm in 1894, and had serred ftilthfully in many capaciUes in nursing service. She devoted herself assidu- ously to her work, and her fiUlure in health was much deplored by aU connected with the hospital. Her successor. Miss Lawler. is also a graduate of the training school, and for a time was assistant superintendent Later she held responsible positfans In connecUon with hosplUls at Toronto. Ontario. Niagara Palls, N. Y., and Pittsburgh. Her training has been varied, her oppor- tunities for acquiring familiarity with the duUes of superin- tendent have been unusual, and she consequently comes to us an expert teacher. She has now given nearly a year's faithful ser- vice to the hospital, and her success gives every prospect of ocmtlnued and increasing usefulness. (00) J;l EXTRACTS FROM ANNUAL REPORTS THX PR07E880B OF PSTOHIATBT In this report Dr. Hurd also referred to the development of the psychiatric department and to its director who had recently joined The Johns Hopkins Hospital staff: The professor of psychiatrr, Dr. Adolf Meyer, has been «p- poiuted psychiatrist to the hospital, and althoofh the psychiatric clinic is not ready for occupation. Dr. Meyer has been able to do Tery effectlTe work in connection with the hospital wards and the out-patient department. It seems fortunate that prior to the opening of the Phipps Psychiatric ainic it has been possible to utilize his services in connection with various charitable agencies in Baltimore. There is reason to anticipate when the clinic is opened that these relations may be productive of great good by promoting cooperation with the clinic on the part of many char- itable organisations. In the report for 1910 Dr. Hurd gave a complete list of the large gifts made from the opening of the hospital in 1889 up to the ^d of 1910. leii (February 1, 1911--January SI. 19U) THS RBSIOKATIOK OV DB. HUBD In the 23d report of The Johns Hopkins Hospital f cr the year ending January 31, 1912, on the page headed ** Trustees *' we find : President, Henry D. Harlan ; vice-president, William A. Marburg; treasurer, John C. Thomas; secretary, Henry M. Hurd, M. D. On scanning the report still further we read [page 27] : In May, 1911, Dr. Henry M. Hurd resigned from the snperin- tendency of the hospital to become secretary of the Board of Trus- tees, and Dr. Winford H. Smith, general medieal snperlntendrat of Bellevne and Allied Hospitals. In New York, was appointed his successor. mi r* HBNRT WUJB HURD Dr. Hard wm the lint rapwrlntflodtiit of th« ho^tal, aiid held the office for 22 years. Dr. Hard'i wlie •dmlnlitratloB. his hish Ideals, his example and his readiness at all times to gire of his knowledge to others, hare eontrilnited largelr to the general derdopment ot hovitals thron^oat the oonntrr. The man of small calibre is prone to pick ont as his sac- cessor one who has even, less ability than he possesses — one who by contrast will compare unfarorably with him. The man of vision, on the other hand, is anxious to have the work that he has carried on so successfully continue to broaden out and will suggest for the post he is relinquishing the best available man. Dr. Hurd with his usual good judgment of men recommended the best man he could find. The wisdom of his chcMce has been continually evident and it has ever been a delight to see how happy and how proud Dr. Hurd has been of the well-merited success of his successor. Dr. Win- ford H. Smith. Dr. Hurd's pride has been akin to that of a father who views with the greatest satisfaction the striking achievements of his son; the more he accomplishes and the greater recognition his work receives the happier he is. Lll lii RBLATIOKS WITH HOSPITAL STAFF Chaptkb YIII DB. HUBD IN HIS RELATIONS WITH THE HOSPITAL STAFF When The John* Hopkins Hoopital opened there wu no medical school iram which to draw hospital interns and they consequently were oontinnally recraited from all parts of the United States and Canada. This system had its adyan- tages. Nearly ereiy man came from a diflnrent schooL The men c<»npared notes, told one another of the methods in vogue in the school or hospital from iriiich they had come^ and thus each man soon became fairly familiar with what was being done in a medical way all over the ooontry. Some of these interns had had sevoal years' training or by instinct immediately dropped into line. There were others of ns who wwe young and immatore and who needed carefol and persistent training. Dr. Hnrd was a past master in stimulating the house men to do their best He did not molly- coddle them in the least This good dd state of Maryland is cdebrated for its Maryland or beaten biscuits and it is a well-known fact that the mon they are hammoed in the mak- ing the better they are. Dr. Hurd with his keen pooeptiou soon learned this fact and he applied the principle to good purpose in his training of these men.* By a gentle but Arm hint here and a rather emphatic suggestion there he soon *I had often heard of aa iiit«r«eUii« iBterrtow the sivorla- tsBdeat had with an Ineowlng group of laUms sad also vagae (Ml HENRT MILLS HURD >,:■$: li **• ■ ii transfonned the raw recruit into a splendid house officer. Some of the men in the beginning hardly knew just how to take this discipline, but in a short time all thoroughly appre- ciated the value of the standards set by the superintendent, and they would, later on, view with amusement and pleasure the probationary period of those who came after them. One and all soon came to realize that Dr. Hurd was their best friend. Many a time when one of the interns was in deep water — when illness occurred at home and he was called suddenly away, some one would quietly slip up beside him, place his hand on his shoulder and casually say " Can't I do something for you ? '* accounts of a very apt story related by the director tm that occa- n. I asked Dr. Hurd if he would mind repeating it Here it Is: "THAT STORY" "When the men who had been selected for the positions of interns at The Johns Hopkins Hospital out of the first graduating class of The Johns Hopkins Medical School came on duty, they found an organization for their work which had already been in successful operation for about eight years. They were bright enterprising students who were peculiarly receptive to all new ideas and much Inclined to adopt them with little regard to their bearing upon the former routine of hMpital service. As all were men of marked ability, some of the Innovations which they wished to inaugurate were improvements without doubt and made for better service, but the general effect of their combined action caused confusion and a lack of coordination in the different departments. In fact, since the changes of hours of duty and general methods of work caused so much trouble, It was felt Ciiat some steps were needed to cheek a similar individualism on the part of equally active and zealous young men who were to enter hospital service in succeeding years. After the interns for the coming year had been appointed I called them into my office for a friendly talk about their duties and without referring to the '>■ ^n the same y sar W8. erence of Charities and Corrections held in Bait? -, 'uay, 1890. Immediately after raadint; thit report lie aOrsMed the assemblage on « ISie Belation of the General Hoq>ital to the Medical Profession.'' In this address he clearly outlined what the general hospital ahould stand for. Hia ideaf! for that period were so advanoed thaf I quote them. The Biasleii of tlie teneral hovitt: auiy be sv>rduarlaed to m: (1) TO tonlah raedioal treatmmt and proper nurslBc to the slek poor, aad eepwitellr to the homeiess and MesdleM- (S) to foralah similar trMtment to those who are aHe and wllljig to pay for It. and asp«dallF to thoae who are wtthoat faBlUes and HBNRY MILLS HURD I* .;•! « home*; (S) to proTlde aaeptlc operatlns rooms where tntlieptle ■urgerr majr be done with full omifldenoe In its resulfe— this ccmfldence being based upon the knowledge that ell selentlflc requirements have been met bjr proper construction and thwoogh management; (4) to provide Instruction in and full demonstrar tlons of the most approved methods of treatment of the sick to medical students and medical men; (6) to train capable, hi|^- minded, self-saerlfldng wonen as nurses; and flnallr (6) to advance medical study and Increase medical knowledge. It is evident that the old-time Idea that the hospital is designed for the destitute and homeless alone must be materially modi- fled to meet the present exigencies of modem life. Many persons in moderate circumstances live comfortably as long as they can labor and produce, but. when ill, can procure skilled medical attendance and proper nursing m HBNRT MILLS HURD ■!*■■»• and Inqulrr ia sedalonsly cnltiTated among the yoonttr mMB* teni ot a medical staff, the seal tor profeiMloiial adrancement spe^lljr disappears. 2. It proTides for the systematic aoqaisition of knowledge bjr a dlTision of labor: and the least possible wc^te of time on the part of eadi person oonoemed. This is an age of ooSperation In literary work. Ubrary and sabject oatalognes are undertaken by associated laborers; and enterprises which woold be impoe- sible to an indiTidual become practicable to the niany. Witness the sncoess of H. H. Bancroft's gigantic historical enterprises. The work which he has finished by the aid of collaborators would have consumed 400 years of individual effort, bad such a length r the better eare and treatment of the Insane; hence the reoMt (vmlng of the new McLean Hospital at Waverly, near Boaton, calls for more than a paaslnc notice. Dr. Hurd then describes in a most interesting manner this large institution for the care of the insane. He also gives illustratitms and plans of the various buildings. The paper is a most complete one, occupying 26 pages. (Tt) If # HBNRT MILLS HX7RD On February 17, 1897, Dr. Hurd gave an address on ** Hos- pital Organization and Management** before the Training School for Nurses at the hospital of the Uniyersi^ of Penn- sylvania. This was published in the Univenity Medical Magor zins, iz, p. 488. It contains much of interest and I quote some of the remarks made by Dr. Hurd on that occasion. I cannot resist the temptation to say a word respecting the Improrements which have be«i made in hospital construction during the past 80 yean. These improTements I bellere to be largely due to the experience of the Crimean War in Europe and of the ClTll War in America. The first gave us training schools for nurses and trained nurses, and the latter improved hoqtltal amstruction. These waves of progress from the East and West crossed the ocean in turn and brought to the whole world better facilities for the care of the sick and better methods of treatment The most noteworthy improvement in hospital construction has been in the directicm of better sites for buildings, which are no longer crowded into narrow, dingy streets with unpleasant surroundings, and amidst insalubrious and unsanitary conditions, but are placed in open squares, in commanding situations, where sunlight and fresh air can freely come upon their Joyous and health-glTing missions. The buildings themselves are more scattered, and sickness and suffering are diluted by differentiation and segregation rather than cmcentrated by piling one ward upon another. Hospital wards also have been more conveniently arranged to do their appointed work, and have had comforts and conveniences in the way of service-ro(»ns, tea-kitchens, rooms for the dangerously ill and dying, and the like, which have contributed Immeasurably to the comfort of the sick. Special efforts have been made in the construction of wards to provide for heating, ventilation, the isolation of infectious, harmful, or offsnalre patimts, and for all sanitery needs. Laboratories for the investigation of disease have also been built and fitted with instruments of precision for the more accurate and scientific study of disease processsa. Opera^ (T«) imm m PAPERS PUBUBHED WHILB SUPBailNTBNDBNT Ing nomu have beoi pUaned and «r«eted at laTlih ezpensa to oanr ont as strletlj aa In a labwatory all the reqalremanta of antiaeptio aurcaiy. Dlainftatins planta hara bean Jolaad to arary 'capital to deatroy the Kenna of dlaaaaa and to prerant tha trana- miaaion of infection from one patient to another. It la reUted that a aurgeon-ceneral of the United Statea Army, now deoeaaed, onoe aUted that it waa no r^ert of the work of the army medical corpa to atndy dlaoaae or to engage In any work of research, bat rather to cure sick aoldlers. fmrgetting that the cure of aiek B• weakneaa. ReaponaibiUty and authority must go hand in hand. If I were asked to indicate the beat madiinery fmr hospital goremment. I should say a Board of Trustees to be sororeign and reaponsible for the whole institution, a medical board to ad- Tlae the trustees in all medical matters, a chief ezecutlTe offloer to be known aa director, secretary, or auperlntendwit, whose duty it should be to coordinate and superrise all other departments, (TB) n I I m. j HBNRT MILLS HURD • pnrrvyor to look after food-rappU«a, a matroD to lopoiTlM tho household and a mperintandent of nonea to hare oharga of the traintnc idiool and the nnnee. Under theae heada oC d^art- menta there shoold be sabordlnato ehlefii of departments, like the enfflneer. ehlef eoc*. Unndrr man, dletsdiool teacher, store- keeper and the like. ▲ wwd as to disoipUne. From the eharaeter of the work of a hoapltal and the necessity of the development of kindly insUneU snd humane methods of thousht and action among all employta, it is unwise to estabUsh and enforce a semi-military discipline or eren p«ratiTa inaanity due to infaetion. In 1899 Dr. Hurd waa president of the Medical Psycho- logical Association. On that occasion he took m the theme for his address "The Teaching of Psychiatry." That his interest in the care of the insane never flagg«d is clearly shown hy the fact that from the first meeting of this association in 1879 ^p to the time of his presidency in 1899 he had missed but two annual meetings. In this address he paid a touching tribute to an old friend : WhUe encaged In writtns this address the emshlnc imwb oomes of the sudden death of Dr. Ooddinc. It la dllltealt to reallaa that our noble-hearted and caltlTated aaaodate haa gona from earth. He had a pceta «oul, the charity of a saint and the heart of a child. He loved poetry, Uteratore, art and miialc; above alL he lored hla fellow-men. ^^ In 1900 Dr. Hurd published a splendid article entitled " Hospitals, Dispensaries and Nursing.'* At the aid of this paper he gave a list of the principal hospitals of the United Stat<« that had been established during the last century. In the Bvn«tin of ihe Iowa BtaU IngtituHon for 1901 appears a paper by Dr. Hurd entitled « Reception Hospitals for Cases of Acute Insani^.** On November 81, 1901, Dr. Hurd deUvered an address on " Psychiatry in the Twerieth Century," at the opening of an additional building at the New Jersey State Hospital at Morris Plains. After paying a tribute to the late Miss Dorothea L. Dix, whose work had beoi such a benefit to New Jersey as well as to the entire country, he sketched the gradual changes that had taken place in the treatment of the insane (W) 4\ ■'\ HBNBT MILLS HUKD in tht United Stetn. He then pointed rat iHien imprort- ments might with profit be n.ade in the handling of mental cHee. The pith of his remarks is contained in his concluding paragraph: The fatore o( psTehlatry la Amerlea la bright with hopei The era o( foBBdatlaB and eoostraetloa Is nearlr erar; lostltatleBs have been evolved, dertfoped and perfseted; pathoioctaal IniH- tatas hava hew eataMlshed aad Uherally eoalwed aad mpportad; trained men with bread leamlag and tadiBtaal haowMie hava been ralaed op tor spaelal atody. and an earaeat spirit of Invaa* tlgatloB haa bean developed. Wa are on the thr«held eC new dlaeoverlea aad Importaat lasprovMseata la the traatOMBt of the (•0) '1 -^ PAPBR8 PUBUIRID WHILB lUPBUNTBNDINT CHARn X PAPEBSr PUBLISHED BT DB. HUBD WHILB SUPERINTENDENT OP THE JOHNS HOPKINS HOSPITAL (Coholudd) In 1909 Dr. Hurd uldrMMd th« gndiuting dan of the training Mhool of th« Oarfidd Hoapital at Waahingtcm, D. 0. He took as hia tlwme ** The Educated Nnrae and Her Future Work.* Thia paper waa later pnblidied by the FHedenwald Preaa in Baltimore. It ahonld be carefully read by every nndergradnate and graduate nurae. It will alao give to the lay reader a very clear idea of what real nuraing meana— it por< traya in no nnootain terma how much the medical profcHion owea to the trained nurae. Dr. Hurd gave a charming addreaa on '*The Duty and Reaponaibility of the Univeraity in Medical Education,'' at the graduating ezerdMa in the Yale Medical School on June 88, 1908. After briefly conaidering the aubject of hia dia- couneheaaid: To dlaeoia an edooatioBal qomUoii beflore ualvereUy bmb ear geata the iwproprteteneaa of the qootetfam from Coafudua with whtah an eiBlnent leienttit (met prebeed an ifldraaa made under similar elreamataaoM: "Avoid the appearauee of erll: do not atoop to tie yaw ahoe la your nelchbor^ meioa patflh." A aMm- tMr of the teadilBt ataff of one of the aeweet adioola of medlatae ooi^t to dlvlay a decree vt modaaty In the preaeuee of medical taaehcra whoae thooghta and aetlvttlea have been molded hy the tradlUooa o^ one of the oldeat aiedleal adiotdi la the United Statea. the alzth In point of Ume of eetaMtahment. and ihonld past destroyed all hope of oodperation and where the friends ot able physicians or surgeons formed two armed camps. Even the ladies become enlisted and fight under one or the other banner. I am glad to say, however, that the days of bitter rivalry between hospitals are passing away. The whole world is becoming more tolerant and the odium medicum is following tbe course of the odi«m theologicum. May its departure be as speedy. (S8) " 1 I I 'i .• PAPERS PUBLISHED WHILE SUPERINTENDENT In referring to the purchase of hospital supplies he men- tioned a method that has given splendid results : A Tvry obTlons form of cooperation is tor all t>*«i bospltala of the city to adopt a common standard of ordinary erery-day sap- pl*es and to arrange for their parchaae throofh a common pur- chasing a«ent In the city of New York recently also an attempt has been made with very graUfying success to esUbllsh a hospital bureau, which la a central supply bureau under a purchasing agent, whose duty it is to make contracts for gauzes, cottons, surgical Instm- uents, rubber goods, furniture, fixtures, bedding, blanketa. linen and the like. These supplies are purchased in Urge quantities according to a definite standard of ezcellmee and at the lowest market prices. The ssTlng of expense in the cost of supplies is considerable, but the saTing to the hospitals in the payment of salaries to the officers to purchase is probably equally great The same is true of breadstuffs. fuel, machinery, etc. Every depar^ ment of the Ne v York hospitals has profited by the central bureau. Hospital officers often do go. a in secret and the community at large does not appreciate how much is dme by the unpaid and unselfish men and women who are managing our great hospitals. The good work they do should be better known and this can only be known by a wide publication of their work. They should not put their candle under a bushel, but on a candlestick, w.wt all may see and coSperate in helping on their good work. There are hundred! of men and women who \any to do good, bnt who need to be set at work. Tell the public what you are doing and do not hesitate to aak for substantial support At the graduating exercises of thg Nurses' Training Sch;H)l of The Johns Hopkins Hospital or. May 19, 1910, Dr. Hurd gave a delightful address on " Florence Nightingale— a Force in Medicine.'' He said : I desire rather to speak of her career as a OMistmctl re philan- thropist as a sanitarian and as an organizer of nursing service in city end country, of her statesmanlike grasp ta the problems (87) HBNRT MILLS HURD of army nanlnc and of the influenoe of her life work apoa the medicine and snrgerT of he paat half oentuiy. In the course of !us address he refers to the visits the late Francis T. King, the late Mrs. Bobb, and Miss Nutting had with Miss Nightingale. Dr. Hard's address was most inter- esting from beginning to end. I shall quote a few paragraphs. It Is mj task this aftemomi to tell yon In what manner she tuup Suenced the wonderful prosress of medicine daring the past ^rst, and probably to a larger degree, she has wrought tor medical progress through her reform In nursing. She found it an occupation and has made it a calling. From the Tery begin* nlng of her career she Insisted that any woman who engaged In nursing should qualify herself as thoroughly for it as a man quall- fles himself for an^ ning in which he expects to succeed. She belleTed that the o...jt of training was to teach not only what was to be done, but how to do it The physician or surgeon should order whatever needs to be draie for the patient's care, but the training of the nurse should teach her how to do it to his order. Training, also, should teach the symptoms of disease, so that the nurse may know what certain symptoms indicate about any dls> ease and whether the patient is worse or better' when the symp* toms change. Telling the nurse what to do i5 not moui^ and cannot be enough to make her work perfec' 2. In all her writings Miss Nightingale . * ntly dwelt np Uier mii cripple It tor all time in order that it might b« open* years aooner. Dr. Hnrd then gaye a short account of Johns HopiuM^ Accompanying the article is a picture of the old 1 Hospital; the real estate plat of the present hoep: showing the position of the original Maryland Hob^ this ground and the location of the Joppa Boad. Tb (»i> Mf^. m fe! ¥•'' 1. -.J. R. J? HBNRT lOLLa HDRO pictaw ihowi tlM dto of th« praent hoipittl-* brotd fcnot •round it, a t«nt on the dte, and numy men and horsey nady to begin the tzcaTation for the foundation of The Johna Hopkina Hoepital. Etery one intereated in the inatitution will be delighted with Dr. Hurd'a article. I i'. {99t iM I PAPIRS PUPUSMBD WRILB nDORlTART OP BOARD CBAPTB XI D& HUBD, SECRBTABT OF THE BOABD OF TBUS'^ * OF THE JOHNS H .& HOSPITAL SlKwtly after Dr. >. .a relinquished hie dntiee m iuperin- tendent of the hospital he moyed ^acrosa town'' to 10S8 Si Paul Street where he hM since resided. Hio secretarial duties have occupied much of his time, but he has aeverthdesa always somehow made time for his literary work. The first artide from his pen after he became secretary was ** Early Days of The JoLns Hopkins Hospital and Medical SduKi.** A perusal of this splendid historic^ sketdi gives one a graphic picture of the hospital in its formative days. To one who was on the scene in those delightful days it brings back priceleaa memories. In order that the reader may recall some of the m -tones I will quote sections of this sketch : late J^ •' liH delayi ard disappolotmrats were due to flnuicial difflcnltiM, for which the tnutees of the unlTenity were In no way re- ■p'■» jK. Jfc p I in:' were Intereited In the derel(vment of the hoepltal, althooch It mast be acknowledged that some might have grown gray if they bad retained their original covering. All were wisely Interested in the public welfare and used their influoioe in the city, state and country at large to improve sanitaUm, to give better eare to the poor, earlier help to the tuberculous and to institute healthier conditions of living generally. .... In the Journal of the American Medical Association, 1912, Vol. \ix, p. 1677, Dr. Hurd published a paper on "The Proper DiTision of the Services of the Hospital." In 1912 he was president of the fourteenth annual meeting of the American Hospital Association. He took for his theme on this occasion " Hospital Problems." This address appeared in the Intematicnal Hospital Record for that year. In the Bulletin of the Medical and Chirurgicai Faculty of Maryland for 1912-3 he published an interesting paper en- titled "Extracts from the Laws of Maryland and Virginia Regarding the Early Care of the Insane." Dr. Hurd's paper " Three-Quarters of a Century of Institu- tional Care of the Insane in the United States " appeared in the American Journal of Insanity, 1912-3, Vol. liix, p. 469. He divided the care of the insane during this period into four stages: 1. The period of neglect 2. The era of awakening. 3. The period of state care of the insane. 4. The period of scientific care. After considering each of these stages in detail he took up : Laws for commitment of the insane in every state ; the criminal insane; detention hospitals; hospitals for the chronic insane; after-care of the insane; architectural changes and improve- ii*L I immm^aiMmmmmmmammmmmmm PAPERS PUBLI8HBD WHILE SECRETARY OF BOARD ments ; scientific work ; biographies, etc. The article is a very instimctive one even for those who know littie about psychiatry. In the Modem Hoapitai for 1913 we find two articles from Dr. Hnrd's pen, "The Hospital as a Factor in Modem Sociel^ " and " Hospitals and the Befonn of Medical Teach- ing." During the year 1914 Dr. Hnrd contributed eight papers to the literature, "Some of the Writings of the Late Eugene Fauntleroy Gordell^; "Belatic^. of the General Hospital to the Training School for Nurses'*; "Hospital Medical Sta- tistics"; "The Small Hospital a Factor in Medical Edu- cation"; "Mental Cases in General Hospitals"; "The Human Side of Florence Nightingale"; "Eupert Norton"; " State Registration of Nurses." Dr. Gordell was the medical historian of the Uniyersity of Maryland and had published a most valuable history of medi- cine in Maryland. His book is a very interesting one and will long remain the source of information relative to medical events in this state. Dr. Bupert Norton had been associated with Dr. Hurd for several years. He remained assistant superintendent when Dr. Winford H. Smith succeeded Dr. Hurd. In 1914 Dr. Norton developed typhoid fever and died. Dr. Hurd in his article paid a well-deserved tribute to his former associate. A reference to Dr. Hurd's bibliography shows that he pub- lished no less than eight papers in 1916. Among than were " The Early Years of The Johns Hopkins Hospital " ; " Forty- Five Tears Ago and Now "; " The Treatment of Mental Casea in General Hospitals"; "The General Government of State Hospitals." (»T) ! I HBNRT MILLS HURD In 1916 Dr. Hurd in addition to a tremendous amount of editorial work he had vnder way published six papers. They were " Some Sources of Friction in the Management of Hos- pitals"; "Another Source of Friction in Hospital Adminis- tration'*; "Who Shall Manage the Training School for Nurses?"; "The Advantages of the Budget System"; " Nathan Smith, Nathan R. Smith, and Alan P. Smith—* Medical Family "; " Need of Segregation of Imbecile Women." On March 12, 1917, Dr. Hurd read a paper on "Johns Hopkins and Some of His Contemporaries " before the His- torical Club. This was published in the July number of the BuLLETiK for the same year. In his introductory remarks Dr. Hurd says : The primary object of our Historical Club, when it wai founded, was the study of medical history. To-night I have thought it wise to speak of the Ufe of one who was not directly connected with the history of medicine, but who, because of the Influence which the university and hospital he established have had upon medical educaUon in this country, seemr dosely alUed to m HBNRT MILLS HURO th« MaoeUUon in th« matter (rf tti* pablleaUon of th« book. I ■haU bo Torr glad to haTo it modlflod, rovlsod, or In aar way ehanf«d m aa to brine out more oomplotalr the wlihoa of tho aaaodaUon in this mattor. I am not woddad to anr thaory of publioaUon, or any form of work. I am aaxlouf that tha work |o on with aa maeh rapidity aa poaalUa. It is eqaally important. howoTor. that tho work bo dooo thoron^ly, ao that in futara all may know who in the paat eontrlb'Ued to the aaooeaa of an iu- portant philanthropic achieranent. Volumes I, II and III of this stupendoiu work appeared from The Johns Hopking Prew in 1916 and Volume IV m 1917. These four volumes contain in all 2926 pages. A glance at the preface to Volume I gives the reader a clear idea of the tremendous amount of labor entailed in the prepa- ration of these volumes. After taking up nearly three pages of the preface in thanking ^.-uious men for their cordial coopera- tion in furnishing data the editor says : The obllcatlons of the committee to the Individual superin- tendents of nearly 200 InstituUons in the United State* and Canada are very great; in fact, without their cofiperation It would Itave been impracticable to prepare any adequate hUtory of the movements «n the various states and provinces. It is evident from a careful study of all the material which has oome into the hands of the cnnmittee that a gradual evolu- tion has occurred In the care of the Insane in America during the past half-century, which bids fair to change materiaUy the discouraging views as to the htvelessness of their cure which have prevailed for many year- in the United SUtee and Canada. The movement towards the promyt treatment of curable casea without the formality of legal CM^mltment and under the same CMditlons as in admission to a bfrplta! for general bodily disease, gives every hope that at an etiiiy day case* of recmt attack may be received everywhere promptly, and that greatly increased numbers can be cured. Cases of a chronic nature are also now much more satisfact(n11y dealt with In insUtaUana on the eo^ (iOS) iiL'i-i!"/' '' - .^f-- m m ^amgBSjsm itfii B OOM WRITTEN BY PR. HURD tag* pUB. with ootpljrlat oolonlM tor Um •mplonnwt of pAtlmta. •Bd taAT* • ooiTMpoadtafly b«W« oroortimltr to attalB Mlf- rapport Th«M moTMBMiU promUM to nuko matwUl dtaatM la tBtoro mothods of ewlBS for tho Iiimbo. Volmno I U hi«toricd in chMMter. It gires a dew account of the Awodation of Medical Svperintendenta of American iMtitutioni for the Irsane from 1844 to 1898 and of the American Medico-Peychological Aaaodation from 1898 to 1918. It then deecribes what the Am«riean Journal of Inr Manity hat accomplished. Volume I wae written by Dr. Hurd and the reader can beet obtain an idea of ♦' 'nj'.e range of •ubj«x:ti considered in thia volume by glan*^ •• .ug^ ite liata of contents: nonoir Chawb I pasb I. IntrodnetloD • II. The AasoclatloB ct Medical Soperlntendrata of Amorl* can Inatltatlona for tbo InaaB*. 1844-1898 U III. Tbo American Madloo^Paycfaolodcal AsaoeUtlon. 189M91S ** IV. Th* American Joomal of Insanity '• CHimn II I BarlT and Colonial Care of the Inaane 81 I\ . Th* Bra erf Awakening •• CKAvna III L Dwothoa Lyndo Dlx and Her Work IW CHAvm IV I. BrdnUon of Institutional Car* In th* United States. . 18f II. Coonty Car* of th* Inaan* 1** IIL Chronic and InenraU* Insan* IW IV. Th* Colony Systsm **• V. Btat* Car* *•• VL Th* WlaoMisln Systnn of Coonty Car* !•• (tOT) ir T '<■ 't 'if 4' ii 1 I' HENRT HILLS HI7RD BBCTI05 Chawm V y^^ L Brolntion of the Adminiitration of HosplUls 179 IL PreMDt OoTvmment of Initltutlons for th« Inaane 18S III. M«thodt of InTwtlcatlon of Public Iiutltntlona 196 IV. Otrelopmnit of HoaplUl Architecture 904 Chattb YI I. The ProposltlODi J17 II. Reforms In Caring for the Insane 228 III. Medical Treatment of the Insane 230 IV. N(»i-Medlcal Treatment of the Insane 284 V. Employment for the Insane 842 VI. Asylom Periodicals 260 VII. IndlTldoal Treatment 264 Vin. Experimental Removals 260 IX. Origin of the Psychopathic Hospital In the United States 268 X State Psychopathic Hospital at the UnlTCrslty of Michigan 266 XI. Bostmi Psychooathlc Hospital 276 XII. Research Work In Hospitals 281 CHAPm VII !. Training Schools for Norses and the First School In McLean Hospital 289 II. First Training Scho^T»«"**^ of ProTlndal Inrtltntlons 464 vr. System of Care In the Prtrrlnoee k as a souree-book for the historians of the fotore bat It is ondeabtedly a permanent hla> tory wbieb may be extaoded, bat will hardly be dnplieatad. The chapters are eompleto la thamselvee. the book Is well Ulustrated. (110) IM miS^ BOOKS WRITTEN BY DR. HURD and the style 1b charming In its slmpUeltr, sobriety and Its traces of delicate humor. The American Jowmal of Jrucmity for October, 1916, in the course of the review of Volumes I and II, says : Too much praise cannot be given to the manner In which the task Imposed upon this Editorial Committee has been carried out. and as wie of the members of the committee. Dr. Burgess, said at the meeting In New Orleans in April last, while all the eommiUee have tried to help, the harden of the work has been on Dr. Hard's shoalders. The Nation on February 8, 1917, says: No sarvey of the treatment of American insane daring the last two centuries has before appeared; it is pleasant to find the difficult task so well executed as in this volume. The British Medical Jowmal for December 8, 1917, in referring to the four volumes said : Dr. Hurd is to be congratulated upon the success with which he has carried out the collection and colllgaticm of the numerous interesting records contained in these volumes. Naturally they will appeal most strongly to readers across the Atlantic; but in their record and analysis of suooess and failure in attacking a problem of great importance in all dvillied oommunltie*— namely, the care of the insane— they should find many readers tbroughoat the world. in another foreign review we find the following tribute: This monumental work. is. in the main, the product of the veteran Dr. Hard, emeritus professor of psychiatry in The Johns Hopkins University, and formerly medical superintendent of the Pontiae State Hospital, who is well known on this side of the Atlantic as the most distinguished of American alienists. Dr. Hard has retired from active praetiee, but his abundant enwgy would not auffer him to be idle, and he has employed his leisure wisely and weU in predudng this great work, which will be a dassie from the day of poblloatioD. (Ill) imStl^ mm SiSS li HEa«mT MILLS HURO It must be remembered that during the immense amoimt of labor entailed in the preparation of these voliunes Dr. Hurd had been greatly troubled with his eyes and it was only his indomitable will that continually spurred him on to the com- pletion of these labors that were a fitting climax to his many successful years of hospital directorship. (118) i i i BUMMART Chapteb XIII SUMMARY Dr. Htird in addition to hia other editorial duties has been one of the editors of the American Journal of Insanity since 1897 and of the Modem HospUd since 1918. He is a member of the Association of American Physicians ; of the American Academy of Medicine, and was its president in 1896 ; of the American Medico-Psychological Association, of this he was secretary from 1892 to 1897 and president in 1898-9, he also edited three volumes of its proceedings; of the American Anthropological Association; of the American Hos- pital Association and its president in 1912. He is also a mem- ber of the American Public Health Association. In 1896 Dr. Hurd was given the degree of LL. D. by hi« alma mater, the University of Michigan. On September 16, 1874, Dr. Hurd married Miss Mary Doo- Uttle, of Utica, N. Y. They had three children, a son and two daughters. The son died in o' idhood. Mrs. Hurd was always greatly interested in her husband's labors and ever manifested the same cordial relati