Then we have a sort of "olla podrida," a mixed complaint that there is too little study, too little examination, too brief lectures, too easy requirements in general; in all of which medical schools, medical journals, and the profession at large mutually criminate the other. Our own idea about this is that each party is in a large degree at fault, and it is certainly by no means easy to define who shall exactly take the initiative, or to what extent and time desired reforms shall be introduced. But, for example, two of the oldest and most influential medical schools in this country retain the bare seven professors of thirty years ago, with no important advance in the material for demonstrative teaching, and scarce any advance in the lecture term; and yet the profession crowd these schools with remunerative classes, at full fees; while schools with able teachers, fuller plans, largely increased facilities, a disposition to greatly extend the lecture term, are struggling for existence. And just here, perhaps, we may say a word about Fees. The American Association at its last meeting indicated very clearly its sentiment, though wisely we think in a strongly advisory way. The connection between fees and medical teaching is just this: no person can afford to teach medicine any more than anything else carefully, fully, patiently, except he is compensated in some way. Two or three members of every Faculty are supposed to have such prominence given to them as that they are paid by reputation and increased practice; some are contented with the general glory attendant on the professional title, some really love teaching and are willing to make some sacrifices for the gratification. But after all few persons are willing to persistently continue their earnest, faithful duties as medical teachers except with a reasonable compensation or its anticipation; and most of those schools based on the "cheap idea," are conducted at the expense of the Faculty. Cheap rates grow out of the sad system of supposed competition: one school of reasonable character and facilities at nominal rates makes a necessity for all its neighbors taking an approximate position, this goes out like the ripple of a wave, indefinite in its influence, so that in the end none are benefited and all suffer. We say none, we include students as well as schools. To some extent pride and the motives already named that keep men in medical schools, also impel them to a degree of preparation for their duties, and the accumulation of illustrative material; but we can not doubt but a fairer amount of compensation would secure ampler provision for all the features of a complete system of medical education; men would be stimulated to better work, better resources, a higher fitness in all respects, even were the question of remuneration settled by the impossible theory of disbanding a large number of the schools and thus concentrating large and paying classes in a few colleges, we do not think the profession would be benefited. On this point, however, we desire to be explicit. We do not agree with our friends who concentrate all the morals of this question in the idea of Fees! We believe there are various directions of reform, of which this is by no means the most important. We believe certainly that it will be better, wiser, in all respects for increased compensation as one of the elements stimulating to improved teaching facilities and enterprise; but after all, we see no particular question of morality whether a school charges $50 or $150 for its course of instruction; but as a matter of mutual courtesy and general good policy, it is important that the Fees be made as nearly uniform as possible, and among the schools of this particular region elevated say to $120. Now to come back to the general question. We can not accept the standard dictated by any man or school, however excellent it may be abstractly, because herein is no accepted authority: even so respectable a body as the late Convention of Teachers failed for want of any power to carry out its plans. We suppose, however, the following are among the chief wants of the profession at present: more thorough preliminary education, to both fit the student for his special training and study and to more completely place him in full rank as a cultivated gentleman in society; such remodeling in the whole system of teaching as will facilitate and ensure thoroughness. In this we may embrace a longer period of pupilage, longer terms of lectures, more courses, more definite clinical study, more systematic plans of private pupilage, systematic grading and examinations, as, perhaps, expressing the idea of our best practical teachers of medicine. Much of all this was embraced in theplan of the Convention of Teachers, but various reasons have interfered with the general adoption of that plan as we all have seen. Now we say, that there is evident a crystallizing of purpose to take some decided advance ground, and we believe the American Association alone has the power to take the initiative. We think there is an expectation and purpose that she will take positive ground next year, and we expect to sustain that ground and abide by it, whatever it is. Neither have we any disposition to dictate the position to be taken, so the plan is complete. To make it so we suggest: That the Association determine and declare by report of a judicious committee as basis, perhaps, a standard-the actual standard of the Association, not an ideal standard, but such an one as the state of the country and the profession will easily accept now, expecting, of course, to progress beyond this as fast as necessity demands. Let this standard express the preliminary requirements, the general course of study, the length of the pupilage, number of courses of lectures, their length and general plan, together with all that is deemed right and wise for the present day; include if best and we think it is, a proper scale of fees. Then refuse representation in the Association to all schools or associations that disregard this plan, or refuse to adopt it. If all this increased and stricter requirement should diminish classes and perhaps disband schools, so be it: doubtless, in both respects, the profession at large and the community would be vastly the gainers. In some exceptional cases, a greater difficulty in securing access to the ranks of the profession, might operate hardly; but the improved status, the greater excellence, would make a position in the profession so much more desirable as fully to compensate for the greater difficulty of its attainment. MEETING OF THE MEDICAL CONGRESS.-The second session of the "Medical Congress of all Nations" commences on September 20th, in Florence, and will last two weeks. According to the printed circular, just received, the following questions will be discussed at that meeting: 1. Marsh Miasm-the conditions which favor its development in different countries; its effects on the human system; and the most efficacious means for counteracting its causes and effects. 2. The therapeutic value of the different local methods of treatment in cancerous affections; as well as the value of general remedies. 3. The treatment of gunshot wounds, in their relations to the progress of the art of war, and to modern international law. 4. The hygienic conditions of hospitals and the value of domiciliary assistance. 5. The influence of railways on human health. 6. The conditions which favor the origin of general diseases (endemic and epidemic) among the populations of large cities; the means of their prevention, and the advantages to be derived from the great rivers and the sea which washes them. 7. The rights and duties of physicians in relation to the laws of different countries; and what improvements can reasonably be expected. The Congress will be presided over by Prof. Bouillaud, of Paris, until the election of a new president, which will take place at the first meeting. The Journal of the Gynecological Society, of Boston.-We have received the first number of this Journal, J. ly, 1869, and heartily commend it to our readers. It is in this initial number somewhat objectionable to many of us, in its fulsome laudation of its editors, which we, with Mr. Campbell, could see with a genial professional eye; but aside from this it has a double excellency as the organ of the Boston Society, and as particularly devoted to this specialty. As applicable to some who enter over zealously and from improper motives upon the practice of Diseases of Women we reproduce the following quotation, which we find incorporated in its editorial department: "Foolish and unscrupulous men have a peculiar tendency, easily accounted for, to cultivate the diseases of the sexual organs. And the history of the progress of gynæcology in our day would, if truly given, cast as much disgrace on some individuals as honor upon others. Fortunately, its worst side will probably never be thoroughly exposed; for the fittest of fates, oblivion, awaits much that is now vaunted: the discovery and diligent treatment of diseases which do not exist; the use of treatment, the danger of which is greater than that of the disease; the recommendation of remedies and operations regarding which little more is known than their names; the facile juggling with remedies of which it is the one sufficient recommendation to have a new name; the systematic concealment of disasters resulting from such treatment. These evils, rife in our own day, should be forgotten, and medical men should combine to bring the intellect into, and expel the imagination from, so noble and so important a subject as therapeutics. If a laborer in gynecology discovers a single new fact, whether pathological or therapeutic, or establishes a new principle, he secures something forever for science and humanity. In gynecology great progress is being made; but 'blinding dust' is the chief result of the labor of many of its most notorious if not famous promoters."* * On Perimetritis and Parametritis. Adam and Charles Black, 1869, p. 215. by it, whatever it is. Neither have we any disposition to dictate the position to be taken, so the plan is complete. To make it so we suggest That the Association determine and declare by report of a judicious committee as basis, perhaps, a standard—the actual standard of the Association, not an ideal standard, but such an one as the state of the country and the profession will easily accept now, expecting, of course, to progress beyond this as fast as necessity demands. Let this standard express the preliminary requirements, the general course of study, the length of the pupilage, number of courses of lectures, their length and general plan, together with all that is deemed right and wise for the present day; include if best and we think it is, a proper scale of fees. Then refuse representation in the Association to all schools or associations that disregard this plan, or refuse to adopt it. If all this increased and stricter requirement should diminish classes and perhaps disband schools, so be it: doubtless, in both respects, the profession at large and the community would be vastly the gainers. In some exceptional cases, a greater difficulty in securing access to the ranks of the profession, might operate hardly; but the improved status, the greater excellence, would make a position in the profession so much more desirable as fully to compensate for the greater difficulty of its attainment. MEETING OF THE MEDICAL CONGRESS.-The second session of the "Medical Congress of all Nations" commences on September 20th, in Florence, and will last two weeks. According to the printed circular, just received, the following questions will be discussed at that meeting: 1. Marsh Miasm-the conditions which favor its development in different countries; its effects on the human system; and the most efficacious means for counteracting its causes and effects. 2. The therapeutic value of the different local methods of treatment in cancerous affections; as well as the value of general remedies. 3. The treatment of gunshot wounds, in their relations to the progress of the art of war, and to modern international law. 4. The hygienic conditions of hospitals and the value of domiciliary assistance. 5. The influence of railways on human health. 6. The conditions which favor the origin of general diseases (endemic and epidemic) among the populations of large cities; the |