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134 from general practice. The actual cost of conducting the Johns Hopkins Medical School, with 297 students, is something over $100,000 a year, not including, however, the salaries of clinical professors, which are in this case paid out of the hospital funds. Including these, the total outlay would considerably exceed our estimate. Tuition fees are about one-half of this amount. The Harvard budget runs higher, $251,389, much more than double the income in fees from its 285 students; Michigan, with 389 students, spends $83,000 on its department of medicine and surgery, and $70,000 more on the university hospital; Columbia, with 312 students, requires $239,072 for the College of Physicians and Surgeons, including the Sloane Maternity Hospital and the Vanderbilt Clinic; Cornell (207 students) expends $209,888 at New York and $32,840 more at Ithaca, and gets back $24,410 in fees. The Toronto (592 students) medical budget is about $85,000, as against $64,500 received in fees; McGill (328 students), $77,000, as against $43,750 received in fees; the University of Minnesota, $71,336, as against $16,546 received in fees. More modest establishments, working towards the same ideals, make a similar exhibit: eighteen years ago the total budget of the Yale Medical School was $10,000; it is now $43,311,—three times the amount received in tuition fees and confessedly inadequate to the aspirations and capacity of the medical faculty. Cornell spends at Ithaca, on a two-year course, $32,840, not including the cost of heating, lighting, administration, etc.

Few of these institutions have developed all departments equally. Even the laboratory branches are not as yet all of the same type. Relatively few even of the best schools are able to cultivate pharmacology to any considerable extent; the same is true of preventive medicine. On the clinical side, makeshifts of which we cannot be too impatient are all but universal. In general, even where intelligent ideals prevail, resources do not suffice for an all-round organization. Wherever a department has been acceptably cared for, the expenditure is apt to exceed our schematic estimate: Johns Hopkins now spends $16,750 a year on anatomy, $14,171 on pathology (not counting $4791 spent on the clinical laboratory), $13,246 on physiology and physiological chemistry. Columbia spends $29,259 on anatomy, $18,400 on pathology, $17,838 on physiology. Cornell (New York) spends $37,000 on pathology, histology, and bacteriology, $15,895 on anatomy, $14,940 on physiology. These appropriations are not extravagant. On the contrary, they are closely approached—sometimes exceeded—wherever modern methods are effectively employed: at Ithaca, Cornell (18 students) spends $9500 on anatomy and $13,500 on physiology and pharmacology; New York University (408 students) spends $15,000 on pathology; Washington