AMERICAN MEDICAL COLLEGES AND DOCTORS. It has long been known that there are few among the medical colleges of this country whose diplomas are recognized in Europe, al enough many American physicians have obtained international reputations for their skill and learning. The reason for this high appreciation of individuals and apparent disrespect for the institutions from which some of them may have been graduated requires some attention. Is it a deliberate affront to our medical colleges, asks the New York Sun, or do they actually merit such reproach? Critics have intimated that there are striking defects in our system of medical education which would not be tolerated under any other government in the world. Among them are the lack of stringent requirements for preliminary education, deficiency in hospital facilities for students, the shortness of the time spent in actual preparation, and the in- sufficiency of the final examination which tests the qualification of a man for the degree of doctor. While these criticisms are no doubt perfectly true of the major- ity of the schools, there are, fortunately, several whose standards are as high as THOSE OF ANY OTHER COUNTRY. But while we acknowledge the exist- ence of these honorable exceptions, we must believe that the strictures upon the system are in the main just, and the ob- vious explanation of the origin of these fundamental defects must lie in the ease with which charters for such colleges are obtained and in the selfish ambi- tions of physicians. It has been possible for any group of six or eight practition- ers in a city or in a country town, de- sirous of obtaining the titles of profes- sors and of acquiring a consulting prac- tice in the neighborhood, to organize .hemselves into a medical faculty and to engineer a charter through the Legisla- ture empowering them to confer degrees with license to practice. The charter is easily secured, and W1thout any sort of guarantee that the proposed teachers possess the rudiments °L".p..^£D\(?.a.tion nr have any hospital con- nection, or.'n.fact, any facilities what- ever for givingproper instruction. With a charter, they open a college wherever they are able t« afford the rent of a few rooms or a bouse and to pay for the printing of tie magnificent prospectus, er the annual announcement, which, after ah, is the most important thing. 1 f the self-made professors forming the stock company were poor in this world's goods, the institution enjoyed but a flick- ering existence, semetimes dying out early, sometimes being resuscitated, but sure FINALLY OF BECOMING EXTINCT. If successfully established by the sheer persistence of the faculty, the jealousy of other practitioners in the town soon le^ds to the creation of one or several rival corporations upon a similar footing. As soon as one branch of the profession gets a college, then the homeopaths, the eclectics, and the like, and finally the women also, determine to enjoy the same inestimable privilege; and thus medical colleges have become preternaturally numerous. In this way Cleveland, Minne- apolis, Denver and Nashville each have three, Atlanta four, Louisville five, Balti- more six and Cincinnati seven medical colleges. We fear St. Louis will know a bitter pang when she learns that CHICAGO IS THE HAPPY POSSESSOR of eight of these precious institutions of learning, whereas she has but seven. Altogether there are 135 medical colleges in the United States, and from them be- tween four and five thousand young medi- cos are graduated every spring to recruit a profession which might perhaps other- wise suffer extinction. By making a little comparison with other countries we find that where, as in the United States, there is one institu- tion able to confer medical degrees to about every 600,000 of inhabitants, Ger- many has one for every 2,000,000, Great Britain one for every 3,000,000, Austro- Hungary one for every 5,500,000, and France one for every 6,300,000. One would imagine that we must be a singu- larly afflicted people to require so much professional care, but investigation proves that no other nation IS HEALTHIER THAN OURS. We are, therefore, led to justify our right to the possession of so many medi- cal colleges by presenting the fact of our enormous superiority in expanse of ter- ritory as compared with other nations, and we may be allowed the little pleasantry of suggesting that it is both just and proper to estimate the relative number of medical colleges by their rela- tion to acres of area. It certainly can not be the demand of a suffering popula- tion, or why should Pennsylvania, with just double the number of inhabitants, be content with but six medical faculties, while Missouri has fourteen? But the area of Pennsylvania is roughly 5,000 square miles, while that of Missouri is 69,000, and this gives us a probable clew to the increase as we go westward. Massachusetts, Connecticut, Vermont, and New Hampshire have together about the same population as Ohio, but they have altogether only six medical colleges, while Ohio rejoices in fifteen! But Ohio has nearly 10,000 square miles more of area than these four States taken to- gether. So it may be that there is some- thing in the relative proportion of med- I ica! institutions to acres after all. If this be true, we would suggest Alaska as being particularly well adapted for our surplus medical colleges, since at least 100 out of the 135 could readily be spared to make glad the hearts of the INHABITANTS OF THAT REMOTE LAND. There are some who argue that the ' East is becoming effete, that even culture is leaving our boundaries to take up its permanent abode in the West, and no doubt they will welcome any fact which may lend a support to their theory. Thus New York, Boston and Philadel- phia have fifteen medical colleges, but the new seats of culture, Chicago, Cin- cinnati and St. Louis, have twenty-two! Is there no remedy for this evil? Yes; fortunately the doctrine of the self-lim- itation of fevers and fermentation is ap- plicable, for it is in the nature of things that parasites of all kinds should finally be compelled to give up their existence when their pabulum is exhausted. The faculties grow tired when there are no students to pay rent, printing and sal- aries, and we are glad to quote the splen- did report for this year of the Illinois State Board of Health upon the medical colleges of the world, to the effect that since 1850 these institutions in the United States have been dying off at the rate of three a year. Oh, for some deadly virus TO INCREASE THAT MORTALITY. We are assured by this Illinois report of steady improvement in the colleges that remain. Most of them are extend- ing their curriculum to three years of six months each, in the place of two years of four months each, which was formerly the common requirement. The opportunities for gaining experience in diagnosis and treatment through hospital study before beginning practice upon an udsuspect ng public are very much greater than before. A fact of Stillmore importance is that some preliminary edu- cation is now considered as essential to the study of medicine; and entrance ex- aminations are required in 129 medical colleges in the United States and Can- ada. It is a pleasure to learn that two graduates are now studying reading, writing and arithmetic on probation for a license to practice in Illinois. So not only the young men on the threshold of professional life, but the older men who have passed through the doors, are influ- enced flavorably by THE NEW DEMANDS OF PROGRESS. By far the most important step in ad- vancing medical education in this country is the establishment of examin- ing licensingboards by the various States, such as are doing good service in Ala- bama, Minnesota, New Jersey, North and South Carolina, and Illinois. After September, 1891, such examinations will also be held in New York. Since no one can practice medicine in these States without securing a license by examina- tion, it will not matter how many medi- cal coliegas there are; but there will probably result a generous rivalry among existing instititutions to teach better, afford better facilities, require a higher standard of preliminary education, and togain a reputation founded upon the in- tellectual victories of their students. Facts About Medical Colleges, Editorial in Chicago Evening Journal. Febru- c ary 28. 1891. In another column of this paper will be found an interesting article on the sub- ject of medical colleges and diplomas of graduates from medical institutions, or those alleged to be such. The country needs protection from the swarms of quacks that are turned out by so-styled medical colleges, which are merely di- ploma mills, and exist, not to educate a class of accomplished and trustworthy physicians fit to practice medicine in all departments, but merely to gather rev- enue from selling their diplomas to any- 1 body who wtfJ.I few J-Jba®, That medical students should have a thorough preparatory education for the discipline of the mental faculties, and that they may be well grounded in gen- eral science as the best foundation for medical knowledge, and that no person should graduate in the medical schools who is not thoroughly fitted and worthy to receive a diploma, are admitted facts. That to elevate medical education and the medical profession is the real cause, not of the doctors, but or the people to whose ills the doctors minister, is a fact. It is less in the interest of science than of the public, where quacks and adven- turers find their victims, that the advo- cates of a better system for licensing medical practitioners have devoted their labors, and that the American Academy of Medicine has been instituted. Each State should provide for a thor- ough examination of every applicant for a medical license, whether coming with a diploma or without one, and no appli- cant should be licensed to practice unless he is proved to be thoroughly com- petent and thoroughly honest. With such a system thoroughly enforced in all the States the day of pretenders and empirics would soon pass away.