habits and to do well by its patients, is both defective and disorderly: the surgical instrument case contained a tack-hammer, candle-ends, and other equally incongruous miscellaneous objects among its instruments. In the medical department of the University of Cincinnati, there is a card index alphabetically arranged; but the results of the physical examination are not given, nor is there any note of the treatment advised. The Starling-Ohio Medical College (Columbus) has a clean dispensary, with adequate attendance, but no records in a proper sense at all; Halifax Medical College requires attendance at a city dispensary that possesses little equipment for treatment, still less for teaching; besides, the college has no voice in its conduct. The students of Syracuse University also attend a city dispensary, but the head clinical professors know nothing about what they get, or fail to get, there. Utterly destructive of good habits of observation or treatment must be a dispensary like the North End Dispensary, Kansas City, attended by the students of the state university; equipment and records are alike defective and confused. But there are others much worse. Dispensary suites are found at the Barnes Medical College and the College of Physicians and Surgeons (St. Louis). The former claims an annual attendance of 10,000 cases. Several rooms are provided, those devoted to branches like gynecology and surgery being especially filthy. The equipment for internal medicine consists of a small dirty room and a few miscellaneous bottles of proprietary drugs scattered on the shelves of a bookcase. The dispensary of the College of Physicians and Surgeons is of the same general character: the gynecological room, for example, is without a window, water, or instruments; all is dark and dingy; there are no records of cases; evasive answers are made to all questions. The fact is that a dispensary, costing little to keep and nothing to run beyond the expense of a drug room, cannot answer for teaching. Nor can youthful volunteers be usually relied on to form an efficient staff. The expenditure on the score of dispensary must be greatly increased if the material that presents itself is to be effectively handled in the training of students.
These schools shade off imperceptibly into those that make no pretense to a dispensary at all, passing on the way institutions like Birmingham Medical College, with a department both small and poor; Augusta, without case records, not even prescriptions put up in the pharmacy being numbered; Portland (Oregon), claiming two to seven a day; the Jenner (Chicago), claiming two to ten nightly; the PhysioMedical (Chicago), with perhaps 250 all of last year; the Eclectic (New York), using "what comes to the college;" Charlotte, with loose unnumbered cards, mostly unintelligible, the prescription files showing an average of four or five a day. At the Detroit Homeopathic College one finds prescriptions written on scraps of paper, envelope backs, etc., with neither numbers nor names; at the Cleveland Homeopathic Medical College "medical cards are kept in pigeonholes that are cleaned out every spring." The Kansas City Eclectic school is hopeful, if not ambitious: its dispensary attendance averages now "about three daily;" they hope to be able "to work it up to six." The medical department of Bowdoin College uses a dispensary at Portland that
