In Michigan University the fee is quite small, only $25 per annum; in Missouri it is only $20 the first year and $50 the second and third; in Iowa and Minnesota it is less than $50.

Notwithstanding the large endowment funds of such institutions as Harvard, Yale, Columbia College, and the University of Pennsylvania, the annual charges to medical students are higher than in other schools. The tuition fee in the medical department of Harvard University is $200, and cost of the entire course about $714; in the College of Physicians and Surgeons, Columbia College, New York, tuition $200, entire cost about $850; in University of Pennsylvania, tuition $150, entire cost $612. In the collegiate departments, which receive the main benefit from the endowment funds, the charges to students are not apparently diminished. On the contrary, as the productive funds have increased, the costs to students have seemingly endeavored to keep pace with them. If one of these schools were now to receive a legacy of an additional million of dollars, it is quite probable that the charges to students would be increased. In justification of this it is said that the receipt of a large fund enables the institution to secure additional instructors of the highest attainments, to erect buildings specially adapted to the purposes intended, and to secure all necessary apparatus. Consequently, in consideration of the quality of instruction offered to students, the charges for tuition can not be considered unnecessarily high. Moreover, the attendance of a much larger number of students would diminish the possibility of the high quality of instruction which might otherwise be

bestowed.

On the contrary, it seems scarcely possible that an institution with no endowment fund and no assistance from State appropriations can be able to afford full and complete facilities for acquisition of medical knowledge, unless it has a large attendance of students who pay ample fees for laboratory, clinical, and other instruction. If such instruction is not given, and students are left to gather what information they can from lectures read by young men seeking a reputation as physicians or by old physicians struggling to retain one, the institution may, of course, be conducted with little cost, but the instruction given will be correspondingly meager.

MEDICAL PRACTICE LAWS.

Besides the District of Columbia and the Cherokee Nation of the Indian Territory, there are 21 states which require an examination of every candidate for a license to practice medicine. These states are Alabama, Delaware, Florida, Georgia, Louisiana, Maine, Maryland, Minnesota, Mississippi, Montana, New Jersey, New York, North Carolina, North Dakota, Oregon, Pennsylvania, South Carolina, Utah, Virginia, Washington, and West Virginia.

It is noticeable that the South Atlantic States without a single exception require an examination, the District of Columbia also requiring an examination now according to a late law of Congress. In fact, in every Southern State east of the Missis sippi, except Kentucky and Tennessee, an examination is required, and two of these states, Virginia and North Carolina, were among the first to adopt restrictive medical regulations. The District of Columbia law was approved June 3, 1896.

In Texas the medical law is interpreted differently in different parts of the State. A new law regulating the practice of medicine in Ohio was passed February 27, 1896, requiring a diploma from a reputable college.

It is an auspicious promise of the further development and extension of restrictive measures that the two most influential States of the Union in wealth and population, New York and Pennsylvania, are among the strongest supporters of restrictive medical laws, and require of every candidate for a medical license that he shall first submit to a strict examination in order to determine whether be is qualified to take the health and lives of citizens in his hands. In the State of New York still other safeguards have been adopted in order to insure both general education and professional skill.

While examinations are not required in the populous State of Illinois, other measures have been adopted and have hitherto been enforced with such rigid adherence by the State board of health that not many quacks and impostors could can find a resting place there.

In fourteen States and Territories no one can practice medicine who is not a graduate of some medical school recognized as reputable by the State or Territorial board. Although examinations are not required in these States, in some of them the laws are so strictly enforced that only those who have received full and complete medical training are allowed to practice.

In ten States and Territories the diploma of any chartered medical college gives the right to practice, and in one other State not even a diploma is required. In Massachusetts anyone with a diploma from a medical school in that State can practice medicine; all others must undergo an examination.

uirements for the practice of medicine in the United States.

Requirements.

Examination by State or county board of medical examiners.
Registration of diploma.

Diploma of college in good standing, or examination by State or county
board of medical examiners.

Diploma of college in good standing,'

Do.

Diploma of a college "recognized as reputable by one of the chartered medical societies of the State."

Examination by one of the two State boards.

Examination by one of the three boards.

Examination by State or district board of medical examiners.

Examination by one of the three State boards after showing diploma of a college requiring three years of six months.

Diploma.

Diploma of reputable college.

Examination by one of the two State boards after showing diploma of college in good standing.

Examination by State board of registration.

Examination by one of the two State boards of examiners.

Diploma of some medical college in the State, or examination by State board.

The words "in good standing" denote that the regulations of the college comply with the conditions established by the State boards.

2 The law is interpreted differently in different parts of Texas, or rather is not enforced.

MEDICAL BOARDS.

Effort has been made to ascertain what States and Territories have separate boards for different schools of medicine, what States have mixed boards, number of members in each, and how appointed. Over one-half of the States with medical boards do not mention different schools of medicine at all. Seven States have special boards appointed by the Governor without regard to schools of medicine, viz, Arkansas, Maine, Massachusetts, Minnesota, Montana, Oregon, Washington. In 8 States the boards of health constitute the medical boards, viz, Illinois, Iowa, Kentucky, Mississippi, Missouri, Rhode Island, South Dakota, West Virginia. In 6 States and the District of Columbia there are three separate medical boards, regular, homeopathic, eclectic, viz, California, Connecticut, Georgia, New York, Pennsylvania, Vermont. In 3 States there are two boards, regular and homeopathic, viz, Delaware, Louisiana, and Maryland. Seven States have mixed boards, Colorado, Nebraska, New Jersey,

New Mexico, North Dakota, Ohio, Virginia. In 9 States and Territories there are no medical boards at all, and all laws on the practice of medicine are left to enforce themselves, and consequently have little effect, as can be seen in Kansas and Wisconsin.

In New York the medical examining boards are placed under the direction of the State Board of Regents, in Pennsylvania under a Medical Council, in the District of Columbia under a Board of Medical Supervisors.

a Board of censors of Alabama State Medical Association; also county boards under its authority. Appointed by governor; medical schools not mentioned.

€ Each.

46 regular, 2 homeopathic, 1 eclectic.

el for each judicial district, and 1 for the State at large for homeopaths and eclectics.

f2 regular, 1 homeopathic, 1 eclectic, and 3 ex-officio-governor, attorney-general, superintendent of public instruction.

regular, 3 homeopathic, 1 eclectic.

regular, 2 homeopathic, 1 eclectic.

i Appointed by State medical society.

36 regular. 2 homeopathic, 1 lawyer.

No one school to have a majority of the board.

11 board for each judicial district; appointed by the district judge.

Must have 5 homeopathic.

A full report of the results of the examinations conducted by the different boards has not been obtained, but the following presentation was made by Dr. Perry H. Millard, of St. Paul, Minn., before the American Academy of Medicine, at Baltimore, May 6, 1895:1

One of the difficulties liable to arise from having independent boards for the different schools of medicine is that the character of the examinations may vary so much as to have a serious effect on the applications of students. If one examining board allows all applicants, except 5 per cent, to pass successfully, while another board rejects 30 or 35 per cent of its applicants, it will not be long before the students will be seeking the lenient board, for after receiving a registration certificate there is nothing to hinder a candidate from practicing according to whatever system he prefers, even if he be registered by another board; and unless he choose to make known what system he follows it need not become known at all except to those who examine the records. It is useless to expect students to apply to one board when they have a far greater probability of being successful before another. The leniency of the boards will be considered by students when beginning the study of medicine. Even if the different boards had no intention whatever of influencing students in this way, the result would be the same, the student never considering the motive at all. Some variation must necessarily occur in the per cent of students rejected, just as the per cent rejected at different times by the same board will vary. In New York the results of the examinations for the year ending August 1, 1895, were as follows:

There should be as near an approach to uniformity as possible in the per cent of rejections, and in order to secure this all applicants might be required to pass the same examination in all subjects except practice and materia medica. In such subjects as anatomy, physiology, and chemistry there certainly can be no room for different schools, and the same applies equally well in obstetrics and surgery. This method is probably adopted where there are mixed boards, or else the boards avoid questions which would be answered differently by different schools.

BENEFACTIONS.

In 1894 Mr. William Deering gave to the medical school of Northwestern University, Chicago, Ill., $50,000 to endow the N. S. Davis professorship of physiology. He had given in 1890 $20,000 toward the purchase of the land on which the schools of medicine and pharmacy are located.

In 1893 Dr. Ephraim Ingals gave the medical school of Northwestern University $10,000 to aid the construction of the laboratory building.

SCHOLARSHIPS IN MEDICAL SCHOOLS.

Reference is intended to be made here to schools of medicine, for scholarships and theological schools are almost contradictory terms. The chief end of a scholarship being instruction without cost to the student, and tuition fees occurring as rare exceptions in theological schools, there is little association between the words. The benefits of scholarships in medical and law schools would be recognized at once,

1 Some slight errors will be observed in the table, but we give it as found.