western University,[1] between Roosevelt Hospital and Columbia University. The reluctance of the hospital to go the whole length is in these latter cases the most formidable obstacle to perfecting a relation that would be of incalculable advantage to all concerned. For assuredly the university medical schools just named, if offered complete teaching control, could cope with the problen of procuring means with which to reorganize their clinical fculties on a scientific and pedagogical basis. The enlightened action of its trustees is rapidly perfecting the same connection between the admirable Lakeside Hospital of Cleveland and Western Reserve University. The new Barnes and Children's Hospitals of St. Louis have engaged to do as much for the reconstructed medical department of Washington University. McGill, Toronto, the University of Manitoba (Winnipeg), and Tulane are in practically secure possession of clinical facilities that are adequate in respect alike to extent and control. It is to be noted that the schools above named do not own the hospitals in-which their clinical teaching is given. Western Reserve and Lakeside thus prove the feasibility of a smooth working connection between a university department of medicine and a private hospital; Toronto proves the same as between a university medical school and a municipal hospital. Technically, neither set of trustees can renounce control; they must ratify appointments; but that set can either be reduced to a formality or expanded into meddlesome supervision,as the trustees choose. In the twoinstances cited, it has become a mere form; and two objects, both precious, are most effectively promoted in consequence. On the strength of these instances it is perhaps worth while to make one more plea for an understanding between existing hospitals and deserving medical schools. Cannot an arrangement be consummated by which the administration and financing of a private or a municipal hospital shall be left to the trustees and their appointed agents, while equally, even though not technically, complete and separate responsibility for the medical conduct of the hospital and for teaching within its wards is left to the medical faculty? As these functions are absolutely distinct from each other, there is no reason why two bodies of intelligent men, desirous of doing right in their respective spheres, should not thus coSperate. If, of course, the trustees are every now and then going to overrule the university in the securing of a teacher or to overrule a physician in his treatment of patients, the situation becomes intolerable and impossible. Instances have occurred, for example, in which the board of women managers of a children's hospital has forbidden the use of lumbar puncture. It is not strange that these things have happened, because neither party to the arrangement has had definite ideas as to the limits of its province. Now, however, that there is no further doubt as to just what the trustees ought to do, on the one hand, and as to just what the university ought to do, on the other, it would appear an auspicious time for extending the experiment. The list of teaching hospitals as above given is so far not large. It may, however, to some extent be lengthened by
- ↑ At present, clinics at Wesley Hospital are not limited to Northwestern University students.
