establishment of a pharmacy internship plan, adapted from present medical practices. Six pharmacy interns are quartered with the medical interns and enjoy the same privileges. The plan calls for the selection of a candidate from among the recent graduates of one of the member schools of the American Association of Colleges of Pharmacy. Such an applicant when accepted receives an appointment as junior grade pharmacist for one year. He may be reappointed for a second year as senior grade pharmacist.
The very first record available on any patient in the University Hospital is dated October 5, 1881. This is Case No. 1, which is listed in a leatherbound book and is the first of a series of records maintained by the Department of Gynecology, at that time under the direction of Dr. Edward Dunster. This book is entitled "Gynecological Clinic Record, Medical Department" and contains the records on patients seen in that department from October 5, 1881, to December 5, 1882.
The history sheets in this record book were outlined forms calling for routine statistical information about the patient, such as age, marital status, number of children, age of oldest, and age of youngest. Ten lines were reserved for enumeration of the symptoms and three lines for the physical examination. Space was also left for a rather detailed gynecological history. At the bottom of the sheet was a space for diagnosis. Opposite this page was a ruled sheet for recording treatment.
The diagnosis noted on this first patient was menorrhagia, and on the treatment sheet under date of October 26 is a note, "No abnormal condition of the interior of the womb. Mucous lining removed with curette." Under date of November 8 appears another note — "Uterine mucous lining again removed." Patient No. 3 was diagnosed "vesico-vaginal fistula traumatic." On the treatment sheet under date of October 28 is noted: "Fistula closed; eight sutures (silver) (one horse hair)"; November 4: "Stitches removed; operation incomplete due to neglect after operation (anesthesia, ether). Patient left Hospital." January 17: "Returned; second operation successful. Patient dismissed." These examples are typical of the extent to which examinations were written up and operations described at that time.
Record systems were apparently established about the same time in other departments, each one maintaining its own separate case number for the patient and retaining in the department all available information learned.
It was interesting to find a sheet in this original book entitled "Examination of the Urine." This contained statements as to the physical characteristics including reaction, color, and specific gravity. After this, was chemical examination, which called for urea, phosphates, bile, albumen, urates, and sugar. The microscopical examination called for crystals, anatomical elements, casts, and, finally, other morphological elements. At the end were reserved a few lines for pathological indications.
It is difficult to determine just when indexing of diagnoses was actually begun; however, shortly after the history forms were established, these various clinical departments formulated their own individual systems of recording diagnoses and operations. No uniform system was used, some preferring to list the diagnoses alphabetically, and some
