Reprinted from University Medical Magazine, November, 1898. 
SUGGESTIONS REGARDING A LABORATORY OF NEU- 
ROLOGY AND PSYCHOLOGY AT THE UNI- 
VERSITY OF PENNSYLVANIA. 
Charles K. Mills, M.D., 
PHILADELPHIA, 
Professor of Mental Diseases and of Medical Jurisprudence in the 
University of Pennsylvania. 
Of the subjects set apart as specialties by universal consent, neu- 
rology—under which general designation psychiatry should be in- 
cluded—is one of the broadest. In investigation and in literature more 
advances have been made in recent years in this than in any other 
of the special branches of medicine. Far-reaching discoveries in psy- 
chology, and in the anatomy and physiology of the nervous system, 
have been made, while new and more valuable methods of histologic 
investigation and of studying the symptomatology of the diseases of 
the nervous system have been developed. Much of this work Has 
been done abroad, although, during recent years, some zealous and 
energetic American workers have successfully entered the field. The 
methods of neurological teaching have made comparatively little ad- 
vancement in this country; and to prepare for research, teaching, 
and practical work at home the American student seeks the well- 
equipped neurological and psychological laboratories of Europe. 
One of the special objects of this communication is to call at- 
tention to some of these deficiencies, to make suggestions as to their 
remedy, and to appeal to those interested to assist in putting on a 
firm foundation the teaching of this subject at the University of Penn- 
sylvania. 
It is not the intention of the writer to criticise the university 
authorities or any of its teachers. The conditions which exist are 
due largely to a lack of clinical and laboratory facilities, which has 
necessitated the perpetuation of methods not fully abreast of the times; Charles K. Mills. 
2 
and it is our hope that, if attention is clearly called to this need, the 
friends of advanced medical education, and especially those interested 
in psychology and neurology, will come forward with material assist- 
ance. 
Although the methods of teaching neurology at the University 
o£ Pennsylvania are as good, if not better, than those followed in 
nearly all the American medical schools, they are but little better than 
those which prevailed twenty years ago. One clinical lecture a week 
is delivered by the clinical professor of nervous diseases in the hos- 
pital of the university, this instruction being supplemented by some 
practical work in nervous diseases and electrotherapeutics by assist- 
ants. In addition, the writer gives during four months of the regular 
medical course a weekly clinical lecture on either mental or nervous 
diseases to those students of the fourth year who elect such instruction. 
The material for these lectures is drawn from the neurological depart- 
ment of the Philadelphia Hospital, in the arena of which institution 
the lectures are delivered. The professor of the practice of medicine 
and the professor of clinical medicine also give limited attention to 
nervous diseases. Neurology, so far as examinations are concerned, 
is ranked among the “ major electives” of the fourth year, the stu- 
dents being examined for their standing in this elective by the clinical 
professor of nervous diseases. Practically all neurological courses at 
the university are optional. 
The results attained by this imperfect method of teaching a sub- 
ject so important are sometimes shown in the examinations for in- 
ternes by the hospitals of Philadelphia, The student will learn to 
respect the subject and to pursue it with diligence when it is made one 
of the compulsory branches, one on which he must pass a satisfactory 
examination before receiving his diploma. The neurological instruc- 
tion offered to students of the university should not be limited to that 
furnished by one or even by two chairs. 
If the medical department of the university had in official connec- 
tion with it a hospital for the insane, or well-equipped and well-en- 
dowed wards for patients suffering from mental disease, it might be 
well to have the chair of Psychiatry entirely separate from that of 
neurology (excluding psychiatry); but under the conditions it is prob- 
ably best, as at present, to have two clinical professors, each teaching 
both psychiatry and general neurology. In any case the teacher of 
psychiatry should be classed with the other professors, having the 
same recognition as is accorded to others holding chairs of equal im- 
portance. 
By extramural professors and lecturers the abundant and valu- 
able neurological material of various hospitals in the city of Phila- Suggestions for a Laboratory of Neurology and Psychology. 
3 
delphia could be easily made accessible to those university students 
who are especially interested in neurology. 
A hospital or hospital wards for nervous and mental diseases 
should be organically united with laboratories of research. It is only 
by supplementing careful work in hospital and private practice by 
laboratory research and teaching that the best results in the diagnosis 
and treatment of diseases of the nervous system can be achieved. 
Why should not the alumni and friends of the university, and those 
interested in maintaining the pre-eminence of Philadelphia as a medi- 
cal centre, lend their assistance to this end by contributing the funds 
to erect on the grounds of the university a building which, I would 
suggest, might well be made a testimonial to Dr. S. Weir Mitchell, 
by designating it the Weir Mitchell Laboratory of Neurology and 
Psychology? 
The name of Weir Mitchell holds first place in the neurological 
history of this country. As physician, investigator, and author he is 
one whom all should desire to honor. It is fit that a recognition of 
his position and services, recalling the field of medicine in which he 
has so successfully labored, should be made in connection with the 
University of Pennsylvania, to the development of which he has so 
largely contributed. 
Should the project be realized, it might be best to combine under 
one roof, or in connected buildings, opportunities both for research 
and for teaching, so that to advanced undergraduates and to post- 
graduates instruction in experimental psychology, and in the anatomy 
and pathology of the nervous system, could be offered either in in- 
dependent courses or in connection with clinical neurology, while 
special researches could at the same time be pursued in rooms set 
apart and properly equipped. 
The neurological laboratory should contain models, diagrams, 
and gross preparations of the brain, spinal cord, peripheral nerves, 
and sense-organs; mounted specimens of both normal and abnormal 
tissues; and the preserving fluids, reagents, jars, microtomes, micro- 
scopes, and other appliances, necessary both for research and for 
teaching. It is impossible to gain any adequate knowledge of nervous 
pathology except by an actual study of specimens. In the teaching 
of students, and even in research, such study is too often divorced 
from clinical investigation. In this laboratory would be gradually 
accumulated an invaluable collection representing the pathological 
anatomy of nervous diseases. 
In connection with this laboratory should be a photographic 
room, with all the necessary appliances for taking photographs of 
cases which appear at the out-door and in-door services of the hos- Charles K. Mills. 
4 
pital. Much material, valuable in illustrating neurological lectures 
and contributions, is lost for lack of such facilities. 
With a laboratory of psychology closely connected with such a 
neurological laboratory and with hospital wards, psychometric and 
reaction-time researches, studies in sense phenomena, and in memory, 
and psycho-physiological investigations in general, could be made on 
the diseased as well as on the healthy. 
From such laboratories would go forth publications containing 
the results of much original investigation. 
The director of such a laboratory, or of its neurological subdivi- 
sion, should be professor of neuropathology, and for the more effi- 
cient development of the subject should also be one of the physicians 
to the neurological w'ards. 
It may be said that other matters of greater importance wait 
completion before the energies and the material aid of the friends of 
the university should be directed to the development of a special sub- 
ject or branch of instruction like neurology; but experience has shown 
that often several movements of a somewhat similar character can 
be carried forward together with almost as much ease as one. A 
specially announced purpose in the development of the University 
of Pennsylvania during the ensuing year is the erection and endow- 
ment of new laboratories. It is to be a “ laboratory year” pre-emi- 
nently; and why should not a neurological and psychological labora- 
tory, which has so much to commend it in the needs of the medical 
department, be included in the list of important additions soon to be 
made to the university? 
If four years, the time now embraced in the full course of instruc- 
tion in the University of Pennsylvania, as in other medical schools 
of equal rank, is not sufficient to carry out methods of instruction 
such as would be indicated by the suggestions as to the teaching of 
neurology in this communication, a course of five years should be 
speedily established; but it may not be absolutely necessary to do 
this at present if the curriculum was thoroughly reorganized.