The following is the wording of the proclamation:

Society never stands still. It either increases its activities, broadens its views, and makes real progress, or it deteriorates and becomes indifferent to the public welfare. The principle that "that government is the best that governs the least" is founded upon the theory that it is better for both the individual and society to achieve their goal uninterfered with and unassisted by government. One of the great objects of government in this country has been, therefore, to promote the happiness of the people by protecting them in their efforts to help themselves, that they might individually make their proper contributions to the public welfare.

And just in the degree the individual and society fail to do their duty in these respects government is forced to have that service performed by official mandate. Recognizing this fact, this proclamation is issued with the view of arousing a greater interest on the part of citizens in public affairs, and especially in the matter of public health. Sanitary conditions bear directly upon this problem, and if citizens of their own initiative do not deal wisely and effectively with these conditions, they must of necessity be regulated and controlled by law. That this is a legitimate function of government, whenever unsanitary conditions are neglected by society until they imperil the public interest, has long been held by the most advanced thinkers:

"Health raises and disease lowers the standard of purity and morals."-Seneca. "The health of its people is the greatest asset a state can have. Improve the public health and you increase the resources of the commonwealth. You cut off waste, public and private, promote community prosperity and individual welfare, and encourage happiness. What greater deed could you do to earn the gratitude of the people of your state? An ounce of prevention is worth tons of cure."-Straughn.

"That government is the best which secures for its citizens the greatest free

dom from disease, the highest degree of health and the longest life; and that people which most fully secures the enjoyment of these blessings will dominate the earth.”—Vaughn.

"In the health of the people lies the strength of the nation."-Gladstone.

Congratulations Received.

When it became known a few weeks ago that this proclamation was contemplated, the humane and public-spirited Nathan Straus, of New York, wrote me thus:

"You have done a splendid thing in planning for the observance in your state of a 'Disease Prevention day,' and I want to congratulate you on taking this important step. I regard this one of the greatest ideas ever originated in this country, and I am sure it will be copied in other states."

When reference is had to the facts, it is easy to understand why these eminent thinkers are so solicitous regarding this serious subject. In a recent address made by that great student of public affairs, Secretary Redfield, of President Wilson's cabinet, he makes this startling statement:

"Now, there have died in the United States in the last six months from preventable causes more people than were slain in the civil war, and more, many times more, than all that have died in the Mexican troubles. We know how to prevent these people from dying, but still they die. We know how to prevent their deaths. We do not prevent them." The tragedy of today is magnified, when we consider that, according to the showing made by our own state board of health, more than eight thousand persons died in 1913 in Indiana from preventable diseases. When contemplating such a disaster our moral sense is so shocked that we hesitate to figure in dollars the vast millions in loss it entails upon our commonwealth. The havoc appears still greater when we consider the property loss through fires occasioned by the unsanitary accumulations of rubbish.

Health Greatest Blessing.

To poison men in factories and mines, to pollute drinking water supplies, to adulterate foods, to drug with nostrums, to maintain conditions causative of preventable diseases is criminal. Health is the greatest of blessings and the source of efficiency and power. The enjoyment of life, and the achievement of liberty and happiness are impossible without it. There is nothing strikingly glorious in a civilization not founded upon intellectual and moral as well as physical strength, for physical health is the surest foundation of mental and moral health.

Now, therefore, I, Samuel M. Ralston, Governor of Indiana, in consideration of these truths, do hereby designate and proclaim Friday, October 2, 1914, as Disease Prevention Day, within the confines of said state; and I respectfully urge that such exercises be given in the public schools, and such action be taken by the various municipalities and civic and other organizations in Indiana, as will emphasize the importance of public health, the joint responsibility of all citizens therefor, in the light or its relation to good society and good citizenship, and will inspire in every one a desire to meet that responsibility by an active co-operation in all sane efforts for the prevention of physical diseases.

SAMUEL M. RALSTON,
Governor.

I read this proclamation in the Indianapolis News of August 25, while on my fishing trip at Star Island, Mich. I showed it to representatives from five leading states, and it was unanimously agreed that I had reason to be proud that I hailed from the progressive state, Indiana. So far as I know, this is the first time any governor has issued such a document. This is one of the many things in which Indiana is a leader.

S. E. EARP.

HOW TO KEEP YOUNG.

In the September Woman's Home Companion Ralph Waldo Trine, writing an article entitled "What Is Youth? What After Youth?" writes in part as follows:

"A very general rule with but few exceptions can be laid down as follows: The body ordinarily looks as old as the mind thinks and feels.

"Shakespeare anticipated by many years the best psychology of the times when he said: 'It is the mind that makes the body rich.' An eminent mod

ern writer has given utterance to the same truth more fully and more helpfully, perhaps, in the following: 'The prevailing state of mind, or character of thought, shapes the body and features. It makes us ugly or pleasing, attractive or repulsive to others. Our thought shapes our gestures, our mannerism, our walk. The least movement of muscle has a mood of mind, a thought, behind it. A mind always determined, has always a determined walk. A mind always weak, shifting, vacillating and uncertain, makes a shuffling, shambling, uncertain gait. The spirit of determination braces every muscle. It is the thought-element of determination filling every muscle. * If you send from you in thought the elements of worry, fret, hatred, or grief, you are putting in action forces injurious to your mind and body. * Look at the discontented, gloomy, melancholy, and ill-tempered men or women, and you see in their faces proofs of the action of this silent force of their unpleasant thought, cutting, carving, and shaping them to their present expression. Such people are never in good health, for that force acts on them as a poison, and creates some form of disease.'

AN EYE TO BUSINESS.

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MEDICAL EDUCATION IN THE UNITED STATES.

The tabulated statistics for the year ending June 30, 1914, are based on reports received from the medical colleges or from other reliable sources.

The total number of medical students (matriculated) in the United States for the year ending June 30, 1914, excluding premedical, special and postgraduate students, was 16,502, a decrease of 513 below last year, a decrease of 1,910 below 1912 and a decrease of 11,640 below 1904, when 28,142, the highest number of students, were enrolled. Of the total number of students, 15,438 were in attendance at the non-sectarian (regular) colleges, 794 at the homeopathic and 270 at the eclectic colleges. The attendance at the nonsectarian colleges shows a decrease of 481 below that of last year, a decrease of 1,839 below 1912 and a decrease of 9,492 below 1903, when 24,930, the largest number of nonsectarian students were enrolled. In the homeopathic colleges there was a decrease of 55 below the attendance of last year, a decrease of 31 below 1912 and a decrease of 1,105 (58 per cent.) below 1900, when 1,909, the largest number of homeopathic students, were enrolled. The eclectic colleges show an increase of 14 over the registration of last year but a decrease of 38 below 1912 and a decrease of 744 (73 per cent.) below 1904, when the largest number of eclectic students were enrolled.

The total number of graduates for the year ending June 30, 1914, was 3,594, a decrease of 387 below 1913, and a decrease of 889 below 1912. The total this year is 2,153 (37.5 per cent.) less than in 1904, when 5,747, the largest number, were graduated. The number of graduates from the non-sectarian colleges was 3,365, or 314 less than last year, and 841

less than in 1912. It is a decrease of 1,825 below 1904, when 5,190, the largest number, were graduated from non-sectarian colleges. From the homeopathic colleges there were 154 graduates, or 55 less than in 1913, and 31 less than in 1912. It is a decrease of 266 below 1903, when 420, the largest number of homeopathic physicians, were graduated. The eclectic colleges graduated 70, or 23 less than last year, and 40 less than in 1911. It is a decrease of 151 below 1890, when 221, the largest number of eclectic physicians, were graduated.

Graduates Holding Degrees in Arts.

Of the 3,594 medical graduates, 807, or 22.5 per cent., were reported to hold also degrees in arts or science, as compared with 18.9 per cent. last year, 17 per cent. in 1912, 16.5 per cent. in 1911 and 15.3 per cent. in 1910. Of the 3,365 non-sectarian school graduates, 794, or 23.5 per cent., were reported to have baccalaureate degrees, while of the homeopathic graduates, 7, or 4.5 per cent., were so reported, and of the eclectic graduates, 6, or 8.6 per cent., were reported as holding degrees from colleges of liberal arts. It is noted that, as expected, the percentage of graduates holding colle giate degrees is gradually increasing and will continue to increase, particularly in the non-sectarian colleges, because a larger number of medical schools are requiring college work for admission.

During the past year there were 631 women studying medicine, or 9 less than last year, a decrease of 48 below 1912 and a decrease of 498 below 1904, when 1,129 women students, the largest number, were reported. The percentage of all medical students was 3.8, the same as last year. There were 121 women graduates this year, or 3.4 per cent. of all graduates. Of all the women matriculants, 135 were in attendance at the two medi

cal colleges for women, while the remaining 496 were matriculated in the 54 coeducational colleges.

Until last year no exact data were available on which absolute statements could be made regarding the number of medical schools existing in the various years prior to 1900.

Since June 30, 1913, six colleges have suspended or merged with others, leaving 101 medical colleges still existing. The number of colleges is the smallest number since 1880. It was about that time that the movement toward establishing commercial medical colleges became most marked, and the rapid increase in the number of colleges has been paralleled only by the rapid decrease since 1904. There has been a net decrease of sixty-one colleges since 1906, when there were 162 and when this country had about one-half of the world's supply of medical colleges! Eighty-five colleges have been closed by merger or otherwise since 1904, but in the same time twenty-four new colleges were organized, leaving 101 medical colleges which still exist.

The non-sectarian (regular) colleges number 87, a decrease of 5 since last year. The homeopathic colleges number 10, the same as last year, and the eclectic colleges number 4, a decrease of 1 since last year.

medical colleges

Of the eighty-five which have ceased to exist since 1904, forty-nine were closed by merger and thirty-five became extinct. It is noteworthy that this rapid diminution in the number of colleges began with the creation of the Council on Medical Education in 1905. The largest numbers closing in single years were ten in 1907, when the Council's first classification of medical colleges was prepared, thirteen in 1910, when the second classification was published, and fourteen in 1913, when the third classification was made public.

While the total number of colleges is growing smaller, however, and approaching more nearly the normal supply for this country, it is encouraging to note that the number of high-grade, stronger medical colleges is constantly increasing.

In 1904 only four medical colleges were requiring any preliminary education in advance of the usual high-school education; now there are eighty-four requiring one or more years of advance college work and several others which begin the higher requirement next year. Of these eighty-four colleges, there are thirty-four which are requiring two years or more of collegiate work for admission. Many of the colleges have been remarkably improved also in regard to buildings, new laboratories, better equipment, larger hospital facilities and-most important-more and better full-time, salaried instructors.

There are still eighteen cities each of which has two or more medical schools, and in seven of these mergers are scarcely possible, owing to the fact that the schools differ as to sect or race, leaving eleven cities where mergers are still possible. These cities and the number of colleges in each are as follows: acgo, 8; New York, 7; Philadelphia, 6; Boston, 4; San Francisco, 4; St. Louis, 4; Baltimore, 3; Los Angeles, 3; Washington, 3; Dallas, 2, and Omaha, 2. In 1904 there were twenty-four cities having each from two to eight non-sectarian medical schools.

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Each of the most famous medical centers in Europe-for example, Berlin, Paris, Vienna-has but one large medical school which makes systematic and practical use of the clinical facilities of the respective city. There is no valid reason why this country should not have equally famous medical centers, but the highest development is prevented by the existence of too many competing medical schools. For the further improvement not only of undergraduate but also of postgraduate medical instruction in this country, there should be other mergers in the eleven cities named.

The length of term of each college fluctuates somewhat from year to year, but on the whole, during the last twelve years there has been a decided lengthening of college terms. This has reference to the weeks of actual work exclusive of holidays. Only two colleges this year reported sessions shorter than

twenty-nine weeks, whereas in 1901, one hundred colleges reported sessions of from twenty-three to twenty-eight weeks.

Special attention is called to the total amount charged by the various colleges per annum for tuition, matriculation, laboratory and graduation fees for each student. Although thirty-seven colleges listed in Class A charge fees ranging from $150 to $275 per year for each student, the actual expense for teaching that student in these colleges amounts to from two or three, to several times these sums. In fact, accurate data secured from sixtyfive medical colleges a few years ago showed that the average amount received each year from the individual student was $122, while the average amount actually expended in the training of that student for a year was $410! The excesses of cost over income per student in several schools were, respectively, $2,744, $1,863, $897, $747, $730, $673, $518 and $500. The excess of expense over income from fees per student was over $200 in twenty-eight of the medical colleges which reported. It is also clearly evident that with the same equipment and at practically no additional expense these schools could easily accommodate two, three, or in some instances several times the number of students at present enrolled, which would greatly reduce the disproportion of expense over income from fees.

Illinois has heretofore had the largest number of medical colleges, but now, as shown in Table 14, the first place is held by New York, where there are ten colleges. California and Illinois each has eight and Missouri and Pennsylvania each has seven colleges. Illinois still has the largest number of students enrolled, having 2,474 matriculants last session, followed by New York with 2,153, Pennsylvania with 1,675 and Tennessee with 1,209. In regard to the graduates, the same relative position obtains.

The influence of the proximity of the medical school is seen in the fact that states having medical colleges contribute more students in proportion to the pop

ulation than those which have no colleges.

The state furnishing the largest number of students this year was New York, with 2,100. Pennsylvania contributed 1,341 and Illinois 1,258. The next states, in the order of the number of students contributed, are: Ohio, 791; Massachusetts, 701; Georgia, 598; Texas, 573; Missouri, 528, and Tennessee, 499. Four states had less than 20 each, these being Arizona, 16; Wyoming, 11; New Mexico, 7 and Nevada, 3. There were 126 students from Hawaii, Porto Rico and the Philippine Islands, and 555 students from foreign countries.

The effects of higher requirements are shown in two ways: smaller enrollments for the colleges which have adopted the higher requirements and larger enrollments for the colleges which have retained the lower requirements. The House of Delegates of the American Medical Association in June, 1912, adopted a report instructing the Council on Medical Education to omit from the acceptable list any medical college which after January 1, 1914, does not require for admission in addition to the fouryear high school education, at least one year of higher preliminary work, including courses of college grade in physics, chemistry and biology. The Association of American Medical Colleges has adopted a similar requirement. The medical profession in the United States, therefore, has gone on record for entrance qualifications which bring medical education in this country more nearly on a par with the requirements of other countries.

Relations with Better Hospitals.

Another great wave of improvement, already well begun, is the establishing of closer relationships between hospitals and medical schools, whereby each of the hospitals will have on its attending staff the most skilled physicians who are engaged in teaching and research, and the medical school will possess a teaching hospital in which students may see and study patients at the bedside. This relationship means that medical students