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46, Indiana, Colorado, look forward confidently to the high standard basis. Is there any reason founded in consideration for public welfare which holds back Illinois, New York, Pennsylvania, from similar action?

There is, however, still another standpoint from which the question under discussion ought to be viewed. We have been endeavoring to combat the argument in favor of admittedly inferior schools dependent on fees on the ground that in the east, north, and west, these schools have already outlived their usefulness; that, even in the south, the need, greatly exaggerated, will gradually disappear. Let us, however, for the moment concede that the south, and perhaps other parts of the country, still require some medical schools operating on the high school basis, or a little less. Does it follow that the proprietary or independent unendowed medical school has thereby established its place? By no means. It is precisely the inferior medical student who requires the superior medical school. His responsibilities are going to be as heavy as those of his better trained fellow practitioner: to be equally trustworthy, his instruction must be better, not worse. The less he brings to the school, the more the school must do for him. The necessity of recruiting the medical school with high school boys is therefore the final argument in favor of fewer schools, with better equipment, conducted by skilful professional teachers.

The truth is that existing conditions are defended only by way of keeping unnecessary medical schools alive. The change to a higher standard could be fatal to many of them without in the least threatening social needs. Momentarily there would be a sharp shrinkage. But forethought would be thus effectively stimulated; trained men would be attracted into the field; readjustment would be complete long before any community felt the pinch. Despite prevailing confusion—legal, popular, and educational—as to what good training in medicine demands, the enrolment in the five schools which have during the last four years required two or more years of college work is already 1186 students, and is increasing rapidly. When the Johns Hopkins plans were under discussion in the middle seventies, Dr. John S. Billings, the adviser of the trustees in things medical, suggested that the graduating class be limited to twenty-five. "I think it will be many years before the number of twenty-five for the graduating class can be reached," he said. The school opened in 1895; the first class, graduated in 1897, numbered 15; the third, graduated in 1899, numbered 32: so promptly did the country respond. Institutions that have switched from the high