Page:Carnegie Flexner Report.djvu/148

130 alive to their responsibility are, as we shall see, at this moment able to provide on this scale for each of the fundamental departments; but they are in no doubt that these departments need such support; and they are straining every effort to procure it for them. A comparison of the estimates above given with corresponding budgets in German universities is highly suggestive. Despite the fact that the cost of apparatus, supplies, etc., is much lower in Germany than here, the sums spent in various universities on laboratory maintenance are as follows:

(From Etat des Ministeriums der Unterrichts- und Medizinal Angelegenheiten, 1909, Beilage 6.)

Still more significant is the ratio between expenditure for salaries and that for laboratory maintenance, and the steady encroachment of the latter: out of every 100 marks spent in German universities, there went in

(From Preussiche Statistik, 204: Statistik der preussischen Landes Universitäten, 1908, p, 7.)

Finally, the actual sums spent on salaries and laboratories respectively tell the same significant story: Total expenditure in Prussian universities in

(Ibid., p. 14.)

That is, in 38 years, total salaries have increased 141 per cent, total laboratory expense, 490 per cent. In the same period, the total attendance of medical students in the same univers/ties has risen 113 per cent (from 2771 in winter semester, 1868, to 5903, winter semester, 1906).

Paulsen (German Universities, translated by Thilly, p. 219, note) quotes from the Rector's Address of Adolph Wagner in 1896:

"Expenditures for salaries and institutes in the University of Berlin show the following growth:

All the seminaries in the mental sciences (there are 18) cost 17,650 marks annually; the 15 natural-scientific institutes and collections cost 379,798 marks; the 10 medical-scientific institutes 190,054 marks; the 10 clinical institutes, 617,691 marks.

The publications of the Prussian government mentioned above are models, which we would do well to adopt. They enable us to follow in minute detail the educational developments of the last seventy-five years, with their social implications. The American student of similar problems deals with chaos. It is difficult to obtain definite and complete statements from any one institution; and quite impossible to compare data from several institutions without exhaustive inquiry by way of ascertaining whether they cover the same ground. The German statistics prove clearly, however, the point at issue, i. e., the rapidly increasing cost of properly organized medical education.

On the clinical side, the problem is more complicated. We have seen that the relation of the medical school to its hospital must be of the same kind as its relation to its laboratories. But laboratories exist only for school purposes; the hospital dis-