May 15, 1903.] 



SCIENCE. 



771 



lived past the time when they can be of 

 value. The continuation of these institu- 

 tions henceforth will be harmful. They 

 can not command the money to build, equip 

 and maintain the laboratories and hospitals 

 which a proper and adequate medical edu- 

 cation demands. In the past their gradu- 

 ates have furnished the many great and in- 

 fluential medical and surgical clinicians 

 of this country. In former days a gradu- 

 ate poorly pi-epared has been able, by inde- 

 fatigable labor and post-graduate work, to 

 place himself in the front rank as a clinical 

 physician and surgeon. 



To-day medical science demands primary 

 instruction to fit a man as an investigator 

 and scientific physician. If not properly 

 educated he can not grasp the great prob- 

 lems which medicine presents to-day as he 

 did the more simple clinical facts which 

 comprised the art of medicine and surgery 

 a few years ago. In the future medicine 

 must be taught in the large universities of 

 the country and in the state universities 

 which are situated in or near large cities, 

 where an abundance of clinical material 

 may be commanded. 



The state university and the college 

 which desires to teach medicine, and is so 

 situated that it can not command clinical 

 material, should confine itself to teaching 

 the ■ sciences fundamental to medicine. 

 These should be taught as pure sciences, 

 and should be included in the covirse for 

 the degree of S.B. A college or state uni- 

 versity ambitious to teach the medical sci- 

 ences can do so without great cost. To 

 attempt to teach applied medicine without 

 proper and adequate hospitals, and with 

 an insufficient number of patients, would 

 be irrational, nor can they command the 

 necessary funds with which to do it. From 

 such colleges and state universities the 

 students could go to the larger institutions 

 which are able to furnish the proper facili- 



ties for teaching applied medicine and sur- 

 gery. 



The general hospitals of many of the 

 cities, now used by proprietary schools, 

 could be utilized as clinical schools for both 

 undergraduate and post-graduate teaching, 

 conducted by the clinical teachex's in the 

 existing proprietary schools. Indeed, these 

 hospitals could be utilized as university 

 extension clinical courses. Necessarily, 

 they would have to be under the control 

 and direction of a tmiversity medical 

 school. 



How many schools may be necessary to 

 educate the number of doctors of medi- 

 cine required annually in the United 

 States? The question one can not answer, 

 but it is safe to say that 2,500 graduates 

 annually will fully supply the demand. 

 This would Imply about 10,000 to 12,000 

 matriculates. A minimum number of 

 twenty-five and a maximum number of 

 thirty-five medical schools should offer suf- 

 ficient facilities to educate 10,000 students. 

 The various state universities and the col- 

 leges which offer adequate science courses 

 would educate a great number of students 

 in the fundamental branches, or in the first 

 two years of the medical course. 



MEDICAL RECIPROCITY BETWEEN THE STATES 

 OP THE UNION. 



The low requirements of some medical 

 colleges, and the want of uniformity in the 

 requirements for a license to practice in 

 the different states, has resulted in a con- 

 dition which entails much hardship on a 

 physician who desires to remove from one 

 and to engage in practice in another state. 

 The rules of most state boards of medical 

 examination and of health are so stringent 

 that a physician or surgeon of years of 

 experience and of acknowledged skill and 

 education, and the specialist who may be 

 renowned in his field of work, are obliged, 

 like the recent graduate, to take an exam- 



