May 15, 1903.] 



SCIENCE. 



763 



expense in maintaining it was the cost of 

 dissecting material, which was usually de- 

 ficient in quantity and poor in quality. 

 Medical schools were organized all over the 

 country, without reference to the needs of 

 the people. Medical education was prosti- 

 tuted. To obtain a sufficient number of 

 students many institutions showed a most 

 degraded disregard of the moral and mental 

 qualifications of the matriculates. The in- 

 come of the school was wholly derived from 

 the tuition of students, and no applicant 

 was turned away who had the cash with 

 which to pay his way. To add to the fa- 

 cility of obtaining a medical college course, 

 there were organized in some cities evening 

 schools, the hours of college attendance 

 occurring from 7 to 9 or 10 o'clock at 

 night. These sundown institutions enabled 

 the clerk, the street-ear conductor, the jan- 

 itor and others employed during the day 

 to obtain a medical degree. 



In spite of the general tendency to in- 

 crease the facility by which a medical de- 

 gree could be obtained, there was a force at 

 work to improve the methods of medical 

 education. A few older medical colleges 

 and an occasional new one set the standard 

 high in relation to the existing status of 

 medicine. There were earnest, forceful 

 medical men in some of the schools who 

 fought for a higher standard for matricu- 

 lation and graduation. 



The medical college associations exerted 

 a splendid moral influence for good, and 

 the state boards in all the more advanced 

 states have, by mandatory legislation, com- 

 pelled the colleges to raise the requirements 

 in reference to the preliminary education, 

 the length of the annual session, the time 

 of medical college study, the character of 

 the curriculum, etc. As a result, the status 

 of medical college education has been very 

 much improved in the last twenty, and 

 chiefly in the last ten years. But, im- 



proved as it is, there are evils which menace 

 us, the chief of which still are too many 

 medical schools, too many students, and 

 inadequate facilities for the proper teach- 

 ing of medicine. 



The improvement in medical college re- 

 quirements has increased the cost of the 

 maintenance of the medical college to a 

 degree that it is no longer a profitable 

 financial venture. There can be no divi- 

 dends. Indeed, the proprietors of the 

 private institution must often make up a 

 deficiency in the annual budget. In spite 

 of this fact, medical colleges have continued 

 to increase steadily. 



In 1877 there were sixty-five medical 

 schools in the United States. In 1882 this 

 number had increased to 89, and 1901-2 

 to 156. The enrollment of students and 

 the number of graduates have also in- 

 creased, in spite of the fact that the re- 

 quirements for matriculation and gradua- 

 tion have been increased. In 1882 there 

 were* 14,934 matriculates, and this number 

 was increased in 1901 to 26,417, and in 

 1902 to 27,501, an increase of about 100 

 per cent, in twenty years. ' 



The number of graduates in 1882 was 

 4,115; in 1901, 5,444; in 1902, 5,002, an 

 increase of about 25 per cent, in twenty 

 years. If, in 1850, there were too many 

 medical schools and too many students, 

 what can we say of the condition to-day? 



It has been estimated that there is an 

 average of one physician to 600 of the 

 population of the United States at the 

 present time. The natural increase in the 

 population of the country, and the deaths 

 in the ranks of the profession, make room 

 each year for about 3,000 physicians, based 

 on the proportion of one physician to 600 

 of the population. With 5,000 or more 

 graduates each year, a surplus of 2,000 

 physicians is thrown on the profession, 



* The Journal A. M. A., Vol. XXXIX., No. 10, 

 p. 574. 



