November 8, 1907] 



SCIENCE 



617 



men having secured a charter in this state, 

 for example, could provide the money to 

 erect and equip a medical school which 

 should comply with the requirements of 

 law, and carry on therein the work of 

 medical education at a profit. Indeed a 

 very large balance on the wrong side of the 

 ledger must soon be shown if running ex- 

 penses and interest on cost of plant is to be 

 paid, and the school is to compete with 

 other established schools. If this be true 

 it must be evident that ordinary business 

 enterprise can not be depended upon to 

 establish and maintain medical schools, and 

 that the work of medical education must 

 sooner or later be done either by private 

 institutions enriched by wealthy bene- 

 factors, or in universities established and 

 maintained by the state. We are in a 

 period of rapid change. For a time the 

 old order will suffice, but it can not be for 

 long. Some of us view these impending 

 changes with anxious uncertainty; others 

 with apathetic indifference, and others still 

 see in the progressive movement that is 

 taking place the promise of the satisfactory 

 solution of a perplexing problem. For my- 

 self I can not for a moment doubt that 

 when the time comes for the people to de- 

 cide whether the avenues that lead to pro- 

 fessions like ours are to be kept open and 

 safe-guarded to all the people, or whether 

 they are to be narrowed by private control, 

 or maintained by the self-sacrifice or gen- 

 erosity of individuals, they will speak with 

 no uncertain voice. 



And now before we take leave of this 

 subject may I indicate some present tend- 

 encies which to my thinking need to be re- 

 strained, and which if not cheeked may 

 result in the evolution of such a cumber- 

 some and mechanical system of medical 

 education and licensure as may threaten its 

 overthrow, and in what I shall say, as also 

 in all that has been said, excepting only 



in the words of welcome with which as a 

 representative of the faculty I have greeted 

 you, I give expression to individual opin- 

 ions and am not speaking for my associates, 

 so that if there be error or fault in any- 

 thing said the blame is mine alone and 

 should be imputed in no degree to any 

 other. It behooves us, I think, to remem- 

 ber that our licensing boards are creatures 

 of the state and that our whole educational 

 system is subject to the will of the people 

 and is not controlled by educators, special- 

 ists and salaried officials. Those who favor 

 reasonable state control will therefore not 

 urge reform of too radical a nature lest 

 what has been gained be placed in jeop- 

 ardy. In the state of Minnesota last 

 winter so insistent a demand was made in 

 the legislature for the opening of the state 

 university to all applicants without regard 

 to preliminary training that the project, 

 though subversive and ill-advised, had to 

 be considered and a compromise efi'ected. 

 Conditions in the east are different, but if 

 the policy of cei-tain extremists, who are 

 influential at present in our state and 

 national associations, is adopted, opposition 

 will be aroused which may precipitate a re- 

 action. Those who favor higher standards 

 and extreme state control base many of 

 their arguments upon doubtful premises. 

 I am sometimes inclined, for example, to 

 disagree with those who hold that since the 

 adoption of a preliminary education re- 

 quirement by law in this state an improve- 

 ment has been effected in the class of men 

 entering the medical schools.. Men who 

 spell wretchedly and make bad work with 

 simple arithmetical calculations still enter, 

 armed with state credentials, and last year 

 in this school more first-year men were con- 

 ditioned than in any previous year within 

 my recollection. Nor am I inclined to be- 

 lieve that the average reputable American 

 physician to-day is in any recognizable de- 



