still, it is well to bring a student face to face with at least one patient before intrusting him with a diploma and license to practice at large.
But practical work, at its commencement at least, means increased expense. There must be separate and well-appointed laboratories for chemical, physiological, anatomical, and pathological research, rooms for photography, germ-culture, delicate electrical apparatus, for hygienic and therapeutic demonstrations, for libraries, and for the reception and treatment of many classes of patients at clinics. Moreover, assistant instructors and demonstrators are needed, in order that each student may receive a fair share of personal attention. (At present the classes are so large that candidates for graduation are often unknown by sight even to a majority of their instructors.)
Suppose for a moment that the professors of a medical college put their hands in their own pockets and provide these improvements, as they have already done in some instances to a limited extent. Many students will leave for cheaper and easier colleges, and the fees are likely to fall off so much that professorships having no endowments to rely upon must be abandoned. Thus the lack of endowment is a virtual check upon all growth. Division of labor with a new assistant instructor means division of personal income with him. The expense of maintaining a new laboratory means a further reduction of the professor's income. As Dr. O. W. Holmes wittily says, "A school which depends for its existence on the number of its students, can not be expected to commit suicide in order to satisfy an ideal demand for perfection."[1] General Eaton (to whose admirable report on medical education[2] the writer is indebted for many of the statistics of this article) strongly advises that every medical school or college be required by law to procure forthwith an endowment of not less than $300,000.
Strangely enough, in some instances the professors themselves object to the endowment of their chairs, because they fear a sacrifice of their independent methods, or because it seems impossible to secure endowments which would yield as fair incomes as they at present derive from the students' fees. But there is no reason why the students should not continue to pay as they do now, and a certain amount of endowment, required by law, would prevent half a dozen men from forming a new medical college without proper laboratories, apparatus, or facilities of any kind. The experience of the past ten years proves this danger to be a real and increasing one.
The professorships and laboratories once endowed, the professors can be trusted to elevate the standard of medical education very rapidly throughout the country. But there should also be separate State or National Boards of Examiners who alone should have the power of granting licenses to practice medicine, based upon proofs of prac-
