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Rh Surely the territory in question can be supplied by these seven medical centers. Chicago alone is likely to draw a considerable number of students from a wider area. It has long been a populous medical center. Nevertheless the number of high-grade students it just now contains is not large. If the practice of medicine in this area rested on a two-year college basis, as it well might, there would to-day be perhaps 600 students of medicine in that city. Coöperative effort between the two universities there and the state university at Urbana would readily provide for them.

(5) The middle west comprises eight states, Minnesota, Iowa, Missouri, Oklahoma, Kansas, Nebraska, South Dakota, North Dakota, with a gain in population last year of 216,036, requiring 140 more physicians, plus 160 to replace half the deaths: a total of 300. To supply them, urban universities capable of conducting medical departments of proper type are situated in Minneapolis and St. Louis; and both deserve strong, well supported schools. For Minneapolis must largely carry the weight of the Dakotas and Montana; St. Louis must assist Texas and have an eye to Arkansas, Oklahoma, and the southwest. The University of Nebraska, now dispersing its energies through a divided school, can be added to this list; for it will quite certainly either concentrate the department on its own site (Lincoln, population 48,232), or bring the two pieces together at Omaha, only an hour's distance away. The University of Kansas will doubtless combine its divided department at Kansas City. The State University of Iowa emulates Ann Arbor at Iowa City. These five schools must produce 297 doctors annually. Their capacity would go much farther. Oklahoma and the Dakotas might well for a time postpone the entire question, supporting the work of the first two years, which they have already undertaken, on a much more liberal basis than they have yet reached. With the exception of St. Louis, all these proposed schools belong to state universities, and even at St. Louis the coöperation of the state university may prove feasible. A close relation may thus be secured between agencies concerned with public health and those devoted to medical education. The public health laboratory may become virtually part of the medical school,—a highly stimulating relation for both parties. The school will profit by contact with concrete problems; the public health laboratory will inevitably push beyond routine, prosecuting in a scientific spirit the practical tasks referred to it from all portions of the state. The direct connection of the state with a medical school that it wholly or even partly maintains will also solve the vexed question of standards: for the educational standard which the state fixes for its own sons will be made the practice standard as well. Private corporations, whether within or without its borders, will no longer be permitted to deluge the community with an inferior product.

(6) Seven thinly settled and on the whole slowly growing states and territories form the farther west: New Mexico, Colorado, Wyoming, Montana, Idaho, Utah, Arizona. Their increase in population was last year about 45,000. They contain now