July S, 1910] 



SCIENCE 



47 



all these proposed schools belong to state 

 universities, and even at St. Louis the co- 

 operation of the state university may prove 

 feasible. A close relation may thus be se- 

 cured between agencies concerned with 

 public health and those devoted to medical 

 education. The public health laboratory 

 may become virtually part of the medical 

 school — a highly stimulating relation for 

 both parties. The school will profit by con- 

 tact with concrete problems; the public 

 health laboratory will inevitably push be- 

 yond routine, prosecuting in a scientific 

 spirit the practical tasks referred to it 

 from all portions of the state. The direct 

 connection of the state with a medical 

 school that it wholly or even partly main- 

 tains will also solve the vexed question of 

 standards : for the educational standard 

 which the state fixes for its own sons will 

 be made the practise standard as well. 

 Private corporations, whether within or 

 without its borders, will no longer be per- 

 mitted to deluge the community with an 

 inferior product. 



6. Seven thinly settled and on the whole 

 slowly growing states and territories form 

 .the farther west: New Mexico, Colorado, 

 Wyoming, Montana, Idaho, Utah, Arizona. 

 Their increase in population was last year 

 about 45,000. They contain now one doc- 

 tor for every 563 persons. In view of local 

 conditions, let us reckon one additional doc- 

 tor for every additional 750 persons : 60 

 will be required. And, further, let us make 

 up the death-roll man for man: 60 more 

 would be needed — altogether 120. There 

 are at the moment in this region only two 

 .available sites. Salt Lake City and Denver. 

 At the former the University of Utah is 

 :situated ; the latter could be occupied by the 

 University of Colorado, located at Boulder, 

 practically a suburb. The outlying por- 

 tions of this vast territory will long con- 

 .tinue to procure their doctors by immigra- 



tion or by sending their sons to Minneapo- 

 lis, Madison, Ann Arbor, Chicago or St. 

 Louis. 



The three states on the Pacific coast, 

 California, Oregon, Washington, are some- 

 what self-contained. They increased last 

 year by 53,454 persons, requiring 36 more 

 physicians; 50 more would repair one half 

 the losses by death: a total of 86. Avail- 

 able sites, filling the essential requirements, 

 are Berkeley and Seattle. The former, 

 with the adjoining towns of Alameda and 

 Oakland, controls a population of 250,000 

 or more; the medical department of the 

 University of California concentrated there 

 would enjoy ideal conditions. At present 

 the clinical ends of two divided schools 

 share San Francisco, and the outlook for 

 medical education of high quality is rend- 

 ered dubious by the division. With unique 

 wisdom the University of Washington and 

 the physicians of Seattle have thus far re- 

 frained from starting a medical school in 

 that state. They have held, and rightly, 

 that in the present highly overcrowded 

 condition of the profession on the coast, 

 there is no need for an additional ordinary 

 school; and the resources of the university 

 are not yet adequate to a really creditable 

 establishment. The field will therefore be 

 kept clear until the university is in posi- 

 tion to occupy it to advantage. 



8. In Canada the existing ratio of physi- 

 cians to population is 1 : 1030. The esti- 

 mated increase in population last year was 

 239,516, requiring 160 new physicians; 

 losses by death are estimated at 90. As the 

 country is thinly settled and doctors much 

 less abundant than in the United States, 

 let us suppose these replaced man for man : 

 250 more doctors would be annually re- 

 quired. The task of supplying them could 

 be for the moment safely left to the iini- 

 versities of Toronto and Manitoba, to 

 McGill and to Laval at Quebec. Halifax, 



