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308 The same is true in reference to laboratories and clinics. However small the sums applicable to building and equipping laboratories, conditions are needlessly aggravated when six plants are equipped instead of one. Fees that ought now to be used in providing better teaching are still paying for expensive buildings in Memphis and Nashville. The city hospitals of both places, small at best, are divided between two schools, though they do not furnish enough material for one.

Those who deal with medical education in Tennessee are therefore making the worst, not the best, of their limited possibilities. Their medical schools, treated on their merits, would speedily reduce to one: the utterly wretched establishments at Chattanooga and Knoxville would be wiped out; the more showy, but quite mercenary, concerns at Memphis would be liquidated. The University of Tennessee, with an annual income that does not as yet suffice for the legitimate needs of its own plant at Knoxville, should abandon for the present the effort to develop at Nashville a school that it can neither control nor support. The time may come when there will be a call for the state university to enter the field. But that time is not now. For the present it is dividing its own forces and hindering the most effective use of such resources as Nashville affords. The whole field is strangely confused: Lincoln Memorial University (which is an industrial school, not a university) at Cumberland Gap shelters a medical school at Knoxville; the University of Tennessee at Knoxville shelters an entirely superfluous school at Nashville.

If our analysis is correct, the institution to which the responsibility for medical education in Tennessee should just now be left is Vanderbilt University; for it is the only institution in position at this juncture to deal with the subject effectively. This does not mean that Vanderbilt has now any large sums of money available or that it should inaugurate impossible entrance standards. It can do neither, for the general situation countenances neither. The suggestion merely recognizes the facts that one school can do the work; that Vanderbilt occupies in Nashville the point of vantage; that, in the public interest, the field should be left to the institution best situated to handle it.

On the other hand, any such arrangement imposes upon Vanderbilt a very distinct responsibility. It would have to nurse its enrolment: having determined just how large a school local needs require, it must fix and enforce the strictest entrance requirement compatible therewith. At the present time this standard would be less than four-year high school graduation; but whatever it be, if only it is real and definite, it will operate to brace up general conditions. Improved teaching should compensate student defects. To this end, every effort should be made to secure endowment specifically applicable to the medical department; in the interval, fees must be employed not to wipe out old obligations, however incurred,' but to improve the school. The contract between Vanderbilt University and its medical department should be canceled. The practitioner teachers must make good their Ambition to advance medical education by being content with the indirect advantage accruing from school connections. If