medicine. Of course, the school has privileges elsewhere; but this small hospital is all that it controls, though two years of college work are required for admission. The Starling-Ohio Medical College (Columbus) uses several hospitals: in one 150 beds are open, "mostly surgical;" in another 40 beds, "mostly surgery." The Detroit College of Medicine has access to two hospitals; one of them, with 100 teaching beds, is fortunate in a fairly equal division between medicine and surgery; the other describes its work as nine-tenths surgical. The clinical instruction of Epworth University (Oklahoma City) is given in a hospital within which 30 to 40 beds are available, two-thirds to three-quarters of the cases being surgical. Drake University uses 30 beds during a weekly total of twelve or fifteen hours in two hospitals, in neither of which is the student essentially other than a passive witness. The Chicago College of Medicine and Surgery, being the medical department of Valparaiso University-has a hospital of 75 beds, about one-fourth usable for teaching; the Bennett Medical College (Chicago) has a hospital of 40 beds, 20 claimed as free; at Chattanooga, the city hospital contained, all told, in the course of the year 1908 something over 500 patients; at Augusta, about 300. Temple University(Philadelphia) has a hospital with 20 free beds; the Woman's Medical College (Philadelphia), 27; the New York Eclectic Medical College sends parties limited to three students to the Sydenham hospital twice weekly. The Physio-Medical College of Chicago got along last year with 167 patients; Western University (London, Ontario) has access to an average of less than 30 beds a year. At Trinity Hospital (Milwaukee), with 75 beds, mostly pay, a part of Milwaukee Medical College,—nine-tenths of the cases or more are surgical.
We have, however, by no means even yet exhausted the subject of arbitrary clinical limitations. As a rule, only the general medical and surgical wards are open at all. Few of the hospitals possess an isolating ward, and not all of these permit students to see infectious diseases. The instruction in that important branch is therefore usually didactic. This holds true of some schools that ask two years of college work for entrance, Yale and the University of Kansas among them. It is true, too, of the New York Medical College for Women, the University Medical College (Kansas City), the Starling-Ohio (Columbus), the University of Tennessee, Baylor University and Southwestern University (Dallas), Louisville, Little Rock, Memphis, etc. At Albany it was stated that the hospital has a pavilion for infectious diseases, which the school might use: "it does n't, because the students are afraid." But the very worst showing is made in the matter of obstetrics. Didactic lectures are utterly worthless. The manikin is of value only to a limited degree. For the rest, the student requires discipline and experience. The safety and comfort of both patients—mother and child—depend on the trained care and dexterity of the physician. The practice is a fine art which cannot be picked up in the exigencies of out-patient work, poorly supervised at that. Principles, methods, technique, can be learned and skill acquired only in an adequately equipped maternity hospital; only after that is the student fit to be
