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Rh the second. It may be set down as fundamental that a good dispensary will not run itself; that nothing in the way of equipment will be used that is not actually there. Economy of time is of such importance to both teachers and students that makeshift inevitably means neglect. The well conducted dispensaries are the well equipped and well organized dispensaries. The moment that equipment and organization fail, omission begins; no general rule prescribes where it will stop.

Vanderbilt Clinic—the dispensary attached to the College of Physicians and Surgeons, New York (Columbia University)—represents in respect to facilities the school dispensary at its best. Teaching and treatment rooms, ample in size and equipment from the standpoints of both students and patients, are provided; a clinical laboratory, with working space for every student on duty, is part of the building; close correlation of physical examination and laboratory tests is feasible. An admirably kept card index facilitates the keeping and use of data; there was an attendance in 1908 of almost 50,000 patients, making over 160,000 visits. The Johns Hopkins Dispensary and the Lakeside Dispensary, operated by Western Reserve, are equally ef- ficient. Less sumptuously housed, but adequate in all essential respects, are the dis- pensaries of Cornell, New York University, the three Philadelphia schools, and those open in Boston to Harvard and Tufts. The Polhemus Clinic controlled by the Long Island College Hospital, the Homeopathic Medical Dispensary controlled by the Boston University School of Medicine, must be included in the number of excellently housed, equipped, and organized institutions of this kind. Yale has an excellent building, which the application of a few thousand dollars yearly will readily convert into an effective teaching adjunct.

The first break comes in the care with which an abundant attendance is handled. It would seem probable that, where the records are careless and incomplete, the treatment of patients is likely to be hurried. The compilation and arrangement of data slow the pace. They conduce to, and usually indicate, thoroughness and deliberation,—of fundamental importance if the student is to acquire a cautious habit. Lack of system and superficiality tend too run together. Mere mass of material, swiftly handled, may be useful to experienced practitioners in affording a variety of cases among which occasionally something rare and interesting may turn up; but a student who is in such a dispensary initiated into the routine of practice will be fortunate ever to form methodical and thorough working habits. The Los Angeles clinical branch of the University of California possesses a thoroughly admirable dispensary building. Some of the rooms are well, some ill equipped; the records are brief and non-significant; no report is compiled; and the clinical laboratory, indispensable to intelligent conduct of an out-patient department concerned to mould the student's