mental Departments which will affect the work of the Board and becoming effective January 1, 1923. In this Reorganization Chapter 29, approved March 1, 1922, Section 16 says, "The Department of State Employment and Registration is established and provides that the head of this Department shall be the 'State Employment Commissioner' -assigning various Boards of this Department, among which is the 'Board of Medical Examiners.'" That you may understand how the Board of Medical Examiners will be affected by this law we quote Section 3: "Upon the taking effect of this Act, and annually thereafter, and also from time to time as may be necessary, each of the Boards and agencies mentioned in Section 2 hereof shall submit to the Board of Public Works an itemized estimate of the amount of fees and other income which it will receive during the ensuing year, and also an itemized estimate of its expenses and disbursements during the ensuing year. The Board of Estimates shall approve all or such portion of said estimated expenses and disbursements as it deems proper, and each of said Boards and agencies shall make no expenditures except for purposes approved by the Board of Public Works, which shall in each case determine the time for such annual estimates to be submitted. "Section 4. All money remaining in the hands of any of said Boards and agencies at the close of each year, after the payment of the expenditures authorized and approved under the preceding section hereof shall be annually accounted for and paid into the General Treasury of the State. The Board of Public Works shall determine the time or times for such annual accounting in each case, and if they find it necessary, the said Board may authorize a working cash balance to be carried over to the credit of any said Boards or agencies. "Section 5. Upon the taking effect of this act the Board of Public Works shall determine which of the Boards or Agencies mentioned in Section 2 can discharge its duties, or part of its duties, with equal or greater efficiency and greater economy at the office of the Commissioner of State Employment and Registration, and thereupon, after such notice as the said Board may find necessary, it shall be the duty of each such board or agency so notified thereafter to maintain its office and discharge its duties, or to discharge such part of its duties as the Board of Public Works may so determine, at the office of the said Commissioner of State Employment and Registration; and the said Commissioner shall provide the necessary quarters, means, facilities, paraphernalia and clerical assistance therefor." The effect of this radical change in administration can not be foretold. It involves regulation and direction by officials necessarily unfamiliar with the purposes of the Medical Practice Law, its scope and methods of administration. Where a great latitude has been granted the Faculty and the Board by law, under which it has been operating radical departures therefrom have been created. When legal advice was needed we sought counsel familiar with and interested in our work. As new conditions arose requiring investigation and money expenditure the judgment of the Board determined. If by reason of economies or unexpected receipts a surplus occurred, the Board was free and glad to take care of the Faculty's needs as funds were available. In 1920 and 1921, $1000.00 was paid over to the Treasurer, and on March 31, 1922, $500.00 was likewise paid. Similar donations were made during the construction of our building as shown by our Report. Under the new law such payments will be uncertain, as any surplus remaining after budget expenses have been made will be paid into the General Treasury of the State. We count the new law effective January 1, 1923, as of probably far greater influence upon the regulation of medical practice, the educational uplifting of the profession and the protection of the general health, than the many-sided discussions by the Congress held in Chicago and to which we have made much reference. Whether this law will work good or evil is at present of grave uncertainty. Respectfully, J. McP. SCOTT, REPORT OF THE LIBRARY COMMITTEE The Library Committee has met throughout the past year, and while the attendance has not been all that might be desired the Committee has been enabled to supervise the purchase of new books and journals, an itemized report of which is appended in the report of the Librarian. We have endeavored, as far as possible, with the money at our disposal, to take the most useful journals and to buy the better of the new books. During the past year we have endeavored to fill in the journal sets, and have succeeded in a very large number of instances in completing many of our most valuable journals. This we regard as a very important thing, because it is becoming increasingly more difficult each year to replace missing numbers or volumes. We have also added a considerable number of books relative to bibliography, biography and medical history, one notable one being the "Evolution of Modern Medicine," by Sir William Osler, recently issued by the Yale Press. During the past year the book stacks have been completed, the entire stack cleaned and the books rearranged. I trust that the members of the House of Delegates will avail themselves of the opportunity to inspect the completed stacks at this meeting. This suggests that the time is at hand to consider the ways and means for increasing the size of the building. At the present rate of growth of the library our stacks will be outgrown in a very few years, and it will be necessary to take advantage of the large lot at the rear of the building, and build new stacks, and a new Osler Hall, with ample room for the storage of duplicates, and workrooms for the Librarian's assistants. We would suggest that a committee be appointed to consider this matter as it will necessitate very careful planning in order to make the most of the opportunities. There has been some rearrangement of the working staff, which we hope will lead to greater efficiency, and the cataloging of the new accessions is going on as well as the available funds will permit. There is great need for more reference work in the library, the growing interest in medical literature has led to the establishment of a reference service in the American Institute of Medicine, The American College of Surgeons, Nelson's Loose Leaf System, Tice's Loose Leaf System, the Hospital Library and Service Bureau and other agencies with which we must compete. Some of the larger libraries have workers who are able to do a considerable amount of reference work, and we have in the past year accomplished a great deal in this direction in aiding readers, having a skilled worker in this line. Among the new accessions in the past year is the library of Dr. John Mackenzie, which has been very generously given us. We have also received books and pictures from the estate of Dr. William D. Booker, and also the library and furniture of Dr. John G. Jay. We should like again to call your attention to the fact that for a library of such age, size and importance as the one we own we have received very few bequests in money, and we urge the members in making their wills to remember us not only in gifts of medical books, but by making some provision for the library in the future. There are at least a dozen or more funds that could be started to fill out the various departments of medicine. Such funds could bear the name of the donor, and thus secure a memorial which would be as lasting as those established by Sir Thomas Bodley and Dr. John Radcliffe. JOHN RUHRÄH, Chairman. Mr. Chairman, and members of the Library Committee: It is a real pleasure to be able to report that the rearrangement of the books on the new shelving in the book stack has been completed. This means that service to our readers may be more prompt and that the time required to render such service has been greatly lessened. It also means that we have room to complete our sets of journals, many of which have already been received from abroad, and that the duplicates that will be most used may be available. Another great aid in our work has been the installation of modern lifts, both in the book stack and in the dumbwaiter shaft. We are fortunate to have the use of the banquet room in the basement for the unpacking of books and in making shipments for the Exchange, as the old dumb-waiter was unsafe and necessitated carrying all books up two flights of stairs to the Library floor. In December the memorial tablet, dedicating the new shelving to Dr. R. B. Warfield, in whose memory it was completed, was hung over the door leading into the stack; new lights were installed in the offices of the staff and quite recently these rooms were cleaned and repainted, adding tremendously to the attractiveness of the Library. We hope that the reading-room may be decorated in the near future. There has been a slight increase in the use made of the reading-room and in the number of books borrowed, but the actual figures are small compared to the extent of the service that has been given in many instances. In this day all agencies tend to take the library to the man, either in the form of bibliography, abstract, or reprint bundles, but we must not neglect to maintain our collections of books even though a new field develops for making their contents known. The reference librarian is the most valuable asset for a medical library and a great deal of reference work has been done, that we may not be behind the other agencies that have come into being to serve the busy practitioner, and the members who have received such assistance are most appreciative. It is hoped that we may soon be in a position to have a special reference worker, who can give all the time that may be required by our members, as these demands increase. The following tables show the additions that have been made since the last report, and several gifts have not yet been assimilated. Gift of Department of Health, Baltimore... Gift of Dr. Harry Friedenwald.. Gift of National Organization for Public Health Nursing.. Gift of Royal Institute for Public Health.... Gift of Dr. John Ruhräh..... Gift of United States Navy Department. 1 1 1 1 1 1 8 225 Gifts in 1921 Miscellaneous Journals: American child hygiene association, 1-Barker, L. F., 29-Boggs, T. R., 186–Booker, W. D., 152—Brack, C. E., 44—Cullen, T. S., 211Friedenwald, Harry, 187-Grieves, C. J., 385-Hoopes, Fannie, 62-Jacobs, H. B., 114-McGill University, 35-McGlannan, Alexius, 265-Pels, I. R., 417-Pleasants, J. H., 73—Pollack, Flora, 59-Ruhräh, John, 66-Russell, W. W., 37-Sheppard and Enoch Pratt hospital, 284-Fisher, W. A., 49. Reprints, Monographs and Pamphlets: Bagley, Charles, 1-Bainbridge, W. S., 5-Blodgett, S. H., 1-Bloodgood, J. C., 2-Booker, W. D., 54-Brickner, W. M., 11-Bulkley, L. D., 3-Bureau of social hygiene, 1-Duncan, Rex, 2-Ely, L. W., 2—Ewing, A. E., 25-Federal board for vocational education, 3-Fox, Howard, 6— Friedenwald, Harry, 161-Grieves, C. J., 3—Hoeber, P. B., 58–Hunt, J. R., 3— Jacobs, H. B., 1-Johns Hopkins University Pathological laboratory, 20-McGlannan, Alexius, 27-Massachussetts general hosital, 1-Metropolitan life insurance company, 8-National organization for public health nursing, 62-Peter Bent Brigham hospital, 31-Pollack, Flora, 11-Prudential insurance company, 81— Ruhräh, John, 5-Sheppard and Enoch Pratt hospital, 8-Solis-Cohen Meyer, 47-U. S. public health service, 111-U. S. Surgeon general of the Army, 2-University of Washington, 1-Vail, D. T., 3-Vaughn, V. C., 1-Warbasse, J. P., 25-Wilson, Gordon, 2-Witherbee, W. D., 6. Books: American academy of ophthalmology and otolaryngology, 1-American gynecological society, 1-American laryngological society, 1-American national red cross, 1-American proctologic society, 1-American surgical association, 1-American urological association, 1-association of American physicians, 1-Association of life insurance presidents, 1-Baetjer, F. W., 1-Barker, L. F., 2-Booker, W. D., 84-Buck, Jeffries, 6-Bureau of social hygiene, 1-Burnham. F. W. E., 1-Canadian medical association, 1-Chatard, J. A., 2-College of physicians of Philadelphia, 2-Columbia university, 1-Community health station, Framingham, Mass., 1Connecticut state medical society, 1-Friedenwald, Harry, 15-Garrison, F. H., 3-Grieves, C. J., 4—Jacobs, H. B., 2—Jay, J. G., 223—Library of congress, 1— Macmillan, 1- Marsh, W. H., 48-New Hampshire medical society, 1- Philadelphia academy of surgery, 1-Prudential insurance company. 1-Rockefeller Institute studies, 2-Ruhräh, John, 1-Sheppard and Enoch Pratt hospital, 5-Superintendent of documents, 12-U. S. department of commerce-Bureau of the census, 1 -U. S. Surgeon-General of the Army, 1-University of California, 1-Waters, C. A., see Baetjer-Wood, William, and company, 1. 1921 Frick Fund (Library statistics) Number of readers in 1920, 3186; 1921, 3295 Number of books borrowed in 1920, 2042; 1921, 2044 Number of books added to the Library in 1920, 34; 1921, 53, making a total of REPORT OF COMMITTEE ON MEDICAL EDUCATION The annual Congress on Medical Education, Licensure, Public Health and Hospitals held each year in Chicago the first week in March has come to be such an important gathering, particularly of the great medical educators of this and even other countries, the papers there read and discussed covering not only the changes advised or suggested but also those that have been put into effect in various schools or states, and also widely published in the complete reports disseminated in the Journal of the American Medical Association, that every physician of this Faculty at all interested in the subject may read and digest at his leisure or if not interested may pass them over and give his time to something more to his taste,-that it seems to me rather superfluous to present to this House of Delegates a report on medical education which can be only a brief resumé, much too incomplete for the few who are interested and on account of that interest have already read the published papers, and for the majority of you who are not interested a bore to be compelled to listen to what they have already skipped over some weeks ago in the Journal. However with this preface I may perhaps be allowed to call to your attention a few of the things which impressed me personally at the last congress. For example, there seemed to be a general feeling that there should be changes in the curriculum of the medical schools-that if the time now required for preliminary education, medical college course and interne year cannot be shortened, at least the curriculum should be changed so that the time could be more profitably employed. The time now given some subjects could be shortened and that the correlation between the so-called primary or fundamental subjects as anatomy, physiology and medical chemistry and practical clinical medicine should be emphasized, the fact being that many of the details of these subjects so laboriously learned during the first or second year have been entirely forgotten before the time or opportunity comes for the application of this information in the later clinical years. That there should be more personal clinical instruction has been demanded for some years. Now, some teachers think that if some practical clinical instruction were given even in the first year the relation |