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12 partment of Northwestern University, and which in 1859 initiated a three-year graded course. Early in the seventies the new president of Harvard College startled the bewildered faculty of its medical school into the first of a series of reforms that began with the grading of the existing course and ended in 1901 with the requirement of an academic degree for admission. In the process, the university obtained the same sort of control over its medical department that it exercises elsewhere. Towards this consummation President Eliot had aimed from the start; but he was destined to be anticipated by the establishment in 1893 of the Johns Hopkins Medical School on the basis of a bachelor's degree, from which, with quite unprecedented academic virtue, no single exception has ever been made. This was the first medical school in America of genuine university type, with something approaching adequate endowment, well equipped laboratories conducted by modern teachers, devoting themselves unreservedly to medical investigation and instruction,and with its own hospital, in which the training of physicians and the healing of the sick harmoniously combine to the infinite advantage of both. The influence of this new foundation can hardly be overstated. It has finally cleared up the problem of standards and ideals; and its graduates have gone forth in small bands to found new establishments or to reconstruct old ones. In the sixteen years that have since elapsed, fourteen more institutions have actually advanced to the basis of two or more years of college work; others have undertaken shortly to do so. Besides these, there are perhaps a dozen other more or less efficient schools whose entrance requirements hover hazily about high school graduation. In point of organization, the thirty-odd schools now supplying the distinctly better quality of medical training are not as yet all of university type. Thither they are unquestionably tending; for the moment, however, the very best and some of the very worst are alike known as university departments. Not a few so-called university medical departments are such in name only. They are practically independent enterprises, to which some university has good-naturedly lent its prestige. The College of Physicians and Surgeons of Chicago is the medical department of the University of Illinois, but the relation between them is purely contractual; the state university contributes nothing to its support. The Southwestern University of Texas possesses a medical department at Dallas, but the university is legally protected against all responsibility for its debts. These fictitious alignments retard