In recognition of the leading position and progress of the Medical Department, and in order to at least partially provide for the increased expansion to the teaching as well as to the hospital facilities, it is intended to entirely renovate the present large hospital building, to add a substantial wing for private patients, and to start the erection of a new woman's hospital.

We meet to dedicate this handsome library building to the cause of education and to humanity, and in behalf of the Board of Trustees of Stanford University, I welcome you.

It is no severe strain upon the imagination to believe that, as time rolls on, the three great metropolitan cities of the United States will be Chicago, in its center, and New York and San Francisco upon its two seaboards. A city becomes a metropolis, in the broad acceptance of the term, at that stage in its development when, the commercial and financial resources being firmly established, it can turn attention to the Arts and Sciences and adorn itself with libraries, museums, art galleries, opera houses, and other evidences of the cultural side of life.

Today, in opening this Medical Library to the public, our city by the Golden Gate has met one more requirement for entrance into the metropolitan sisterhood, she is one step nearer the brilliant destiny awaiting her.

The cities of the Unites States in which special buildings are devoted to medical libraries are few in number, and this building, in addition to marking an epoch in our metropolitan progress, has the distinction of being the first structure of a strictly non-utilitarian character (other than churches) to be completed in the rebuilding of our municipality. The collection of books it contains may also well be a subject of civic pride, since it ranks among the greatest in size and importance of the medical libraries in America.

We have met today to mark a milestone in the history of Stanford University on the one hand, and in the history of medical education on the other. It is a milestone that we mark, not an epoch, for epoch-making events do not often appear more than once in a life time. But a milestone marks progress even though after it is set up all shall go on as before.

Stanford University is now twenty-one years old. Its days were opened on a hopeful morning of October in California, where all days are hopeful, just twenty-one years ago. It has come of age. It is old enough to be doing the work of a grown university.

And there is no work of the University more worthy or more needed than medical instruction and medical research, the training of men who shall help their fellows in all their bodily ills, on the basis of the best and fullest knowledge, while themselves adding day by day to the world's stock of wisdom. In these days medical research stands on the firing line of the advance of science. There is no branch of knowledge which is moving more rapidly and there is none which contributes equally to the aggregate of human welfare.

We dedicate today the home of the Lane Medical Library of Stanford University to medical practice and medical research. It is the gift of the will of Mrs. Levi Cooper Lane. It begins its existence with a handsome building adequate for its needs for years to come. When it must be extended we hope that the grateful people of San Francisco will be here to see that all its needs are met.

It has already on this initial day a library of nearly forty-thousand volumes, all relating to medical practice and medical research, a good number of books as you will see when you compare it with other libraries devoted elsewhere to the same subject.

The importance to San Francisco of such a collection of medical books kept up-to-date by a steady inflow of the best journals and monographs is obvious. The library is the natural center for creative effort hence for all research, since there is no loss of energy so needless as in the doing again that which has been well done before. All new work must be based upon knowledge that has gone before. The breath of life of all research is the joy of seeking for the unknown. Chance discoveries of great moment in medicine are no longer to be made at random. Piece by piece must new truths be found and correlated. Each investigator must rest his work upon that of others. He must stand on the shoulders of the past if he is to look into the future. . . .

The new Lane Medical Library Building, in which the volumes of the University's Department of Medicine are now shelved and at the service of the students of the Department and of the medical profession, is not only thoroughly modern and convenient, but beautiful as well. Constructed on a steel frame, the exterior is of smooth Colusa sandstone of a soft gray color, while the interior gives an impression of spacious substantiality and quiet. ^{[7] [8]}

The general reading room, with its open shelves of reference volumes, its broad reading tables and its quiet green walls, is particularly fortunate . . . The forty-thousand volumes which at present constitute the library and make it the largest of any of the university medical libraries in America, are easily accommodated on the shelves, which can hold half as many more, without further addition. ^{[9] [10]}

The dedication of the Lane Medical Library Building marks the completion of the first stage in the development of the Stanford University Medical Department. In fact its possession is a great asset in the development of proper medical teaching and makes the new Medical Department unique in this country.

Lane Medical Library, San Francisco

see larger image »

The high standard that Stanford set in medical education, requiring three years of University work for admission into medicine, placed the Medical Department at once in the front rank of such institutions. The requirements are equal to those of Cornell and Western Reserve University and not unlike those of Harvard, Columbia and Pennsylvania. Johns Hopkins requires an A. B. degree for admission; Harvard admits upon an A. B. degree but permits students who have covered certain special subjects to enter after two years of University work.

It has been a source of gratification that, in spite of these high requirements, forty-six students have registered in Medicine even before a single class has been graduated. The class of five, sent up to San Francisco in January, 1910, has now been increased to ten, two students having joined it from the University of California last year, and one each from Johns Hopkins, the University of Chicago and Cooper Medical College this year. It is anticipated that there will be a slow but steady growth in the number of students but that the number admitted will always be small.

The space made available in the Clinical and Laboratory Building by the removal of the Library, together with a portion of the former auditorium, is being remodeled and within a month the Medical Department will have the best equipped outpatient clinics west of Chicago. On 1 July 1912, the control of Lane Hospital passed into the hands of the Clinical Committee of the Medical Department so that the University Hospital is now under the direct supervision of the instructing staff, a most important advantage in proper medical teaching and one possessed by but few American medical schools. Furthermore, arrangements have been made by the Board of Trustees to facilitate the business management of the Hospital and Medical Department in San Francisco and to improve the service for the private rooms. It is of sentimental interest that the home formerly occupied by Dr. and Mrs. Lane, which is in the block opposite the hospital, is now being used as a temporary nurses' home.

As at present organized - with the Lane Medical Library, Lane Hospital; the outpatient clinics and the laboratories in San Francisco; the excellent services at the San Francisco Hospital; and with the laboratories of Chemistry, Physiology, Anatomy, Bacteriology, Pharmacology, Physics, Zoology and Botany on the campus - there is no better Medical Department for a limited number of students in this country.

Like all growing things, the Medical Department has many pressing needs. Among them are the construction of a new nurses' home and women's clinic, for which land is likewise available, and the construction of a new children's hospital. The further endowment of Lane Hospital and the endowment of certain professorships is very much needed in order that the institution may grow in the best way. A number of alumni and others have contributed books and money to the Library and money to the Hospital, both for the upkeep of beds and for special expenses. . .

In general, it can be said that for the short time that Stanford has been engaged in medical education, she has made a good record. Future development has been planned for in such a way that advantage can be taken of any help, great or small, that comes to the Medical Department.

The advent of Stanford into San Francisco is of much significance. The number of people concerned is alone worthy of mention. Besides the Faculty and students, there is a metropolitan hospital with an average of 150 patients, changing from day to day, a Training School of 80 nurses, and employees of like number and from 50,000 to 60,000 visits per year in the out-patient clinical departments.

20 November 1908:

Dear Dr. Rixford:
It has been suggested that the designation of the medical organization as "Department" or "School" may have some influence on the prestige of the school or department in the future development, and the members of the Medical Committee might consider that question.

I enclose for reference a list of the official titles of the medical organizations of a number of the prominent universities of this country.

If there occur to you any reasons for believing that there would be a gain in adopting the designation of "School" instead of the name "Department" which is at present the only unit recognized in the University, I should be pleased to hear from you. Also I should be pleased to hear your individual preference as to the name which would be most advantageous and dignified.

Very truly yours,
J. M. Stillman

Resolved, That the recommendation of the President of the University that the use of the term "Medical School" be authorized to designate the professional work within the Department, the relation of the Department of Medicine and its students to the University at large to be in no wise changed by the use of this phrase, be approved;

Resolved, that in the opinion of this Board, the University funds and income will be insufficient to adequately extend and develop all departments of the University, and that it will therefore be necessary to select such courses of education as may be so developed to the highest point, abandoning or reducing other courses; and that the President is requested to submit to the University Committee of this Board his recommendations relative to such action by the Board.

The Trustees, realizing that our funds are not equal to the task that the medical school imposes, are looking for a way out of the dilemma. They think it possible for me to so overhaul things here at the University that a lot of what they regard as purely ornamental departments can be done away with and that this will release funds enough to keep the medical school going. It is unnecessary to tell you that it cannot be done. Only very small economies are possible in the University. The medical school wants at least $100,000 a year, in addition to hospitals and equipment in an expensive city. . . Can you not give some encouragement to abandon this medical school? How can it be done? I'm ready enough to do anything that human effort can do. It will make an awful row, I know, but if I can save the University I don't mind either the row or the personal roasting I shall get. Some of the Trustees will stand by me, others will fight me to the finish, as will all the members of the medical faculty and their friends. I fancy that most of the faculty outside of the medical school will support me, but I am not sure about it at all.

Dr. Jordan looks on the medical school as the child of his old age, and the finest one in the family, but I am at liberty to disregard his personal views.

That the Medical Department, including anatomy and bacteriology, receive no further financial support from Stanford University after July 31, 1914.

That the entire equipment (of the Medical Department) be turned over to the University of California upon such terms as the Trustees may be able to arrange with the Regents of the University of California through a committee of experts suggested below. Or, if for any reason, such a disposal is impossible, that some such disposition be made of the Department and its appurtenances as will entirely relieve Stanford University from all expense in connection with it.

That a committee of three disinterested men, whose knowledge of medical education and administration will entitle their views to the highest respect and consideration, and who are not likely to be influenced by local interests, be appointed to settle the conditions of the transfer upon terms honorable and satisfactory to both units.

1. Appointed a special committee of the Board consisting of Trustees Eels, Hopkins and Hoover to confer with a similar committee of the Regents of the University of California. (Of the three members of this committee one, in Dr. Branner's opinion, was amenable to reason (Eels); one was strongly in favor of Stanford's keeping its Medical Department (Hopkins);the third was Hoover, a close friend of Dean Wilbur, and therefore also likely to favor retaining the Department.)

2. Approved an attempt of the two medical deans to arrive at a possible basis of union.

3. Acquiesced in Dr. Branner's proposal to bring President Pritchett of the Carnegie Foundation and Dr. Welch of the Johns Hopkins Medical School to the Coast for a survey of the situation and conference with the Trustees and Regents.

Whereas, the President of the University, evidently acting under a misapprehension of the University's resources arising from the terms of the Trustees' resolution of August 29th, 1913, submitted on December 20, 1913 to the Board of Trustees recommendations that the Medical School of Stanford University, including the Departments of Anatomy and Bacteriology, receive no further financial support from the University after July 31, 1914; and that its entire equipment be turned over to the University of California upon such terms as the Trustees may be able to arrange with the Regents; and that, for that purpose, a committee of three disinterested men be appointed to settle the conditions of the transfer upon terms honorable and satisfactory to both universities.

And Whereas, the University Committee has considered these recommendations and is unable to agree that such course is now necessary

Now Resolved: That the University Committee reports to the Board of Trustees:

1. That in its opinion the financial condition of Stanford University does not now require, and may never require, such drastic action as the abandonment of medical education; and that for the abandonment of any important department the dignity and reputation of the University demand much longer preparation and notice than one semester.

2. That the University Committee is prepared to recommend some system of joint action with the University of California in the conduct of the two medical schools, if such a system can be suitably formulated and agreed upon; but that it does not approve turning over the entire equipment of the medical school to the University of California; and that, if the Medical School is ever to be abandoned, the only course open to the Trustees, in the opinion of this Committee, is to return the School and its property to the Cooper Medical College, from which we obtained it under pledge that we could carry it on.

The claim is made . . . .that we have money enough to care for all departments, medicine included. I am unable to speak confidently on the subject for it has been the policy of the Board hitherto not to allow the President to know about these financial details. . . One unfortunate feature of the situation is that the Medical Department is in San Francisco, thirty miles away from the University, that it is not in vital touch with the University, that it has the ear of the Trustees and that they agree about new buildings, and about equipment and construction and other matters concerning which the President is not consulted. The result is that large sums of our general funds are spent without the President knowing about it until after it is done, and even then by accident or courtesy.. . . .

(Later, on 12 March 1914, he wrote:) Now that the budget has been increased by $62,000 the Trustees seem to think I am silenced. But at least $10,000 of that increase is for the Medical Department, and it also has backdoor access to the treasury. It will cost next year $110,000 to $150,000.

It would, I think, facilitate definite action of some sort in regard to the possible union of the Medical Schools of our two Universities to ask for prompt consideration by the authorities of both institutions of the following points:

1. Is it desirable that the Universities should unite their resources in Medicine into one large Medical School under common management rather than continue the support and development of two good schools?

2. If the first is settled in the affirmative, would the following be an acceptable plan for the management and control of the one School?

A.. -- The administration to be in the hands of a Board of Managers of nine members constituted as follows:

• Two regents
• Two trustees
• The Presidents of the two Universities
• Three members chosen by the above

B. -- A Dean, the best available man regardless of locality, to be selected by the Board of Managers.

C. -- A Faculty administration committee to be selected by the Board of Managers.

The Universities to continue their present financial support until endowments make the School independent financially.

All funds to be administered by the Board of Managers.

3. Is it desirable, if one school is decided upon, that all departments of this school be gotten together and that the courses given in Palo Alto and Berkeley which form part of the curriculum of Medicine be concentrated in San Francisco.

It would be more feasible at the present time for both Universities to give instruction leading to the degree of A. B. and covering the first year in Medicine, but an ultimate plan could include the combination of all work together in San Francisco.

If the University authorities agree to the above premises, then I think that the detailed plan submitted by me to you at a previous time should be at once carefully considered. Until the above principles are decided upon, the less time spent upon details, the better. I do not agree with you that it is necessary to call in an outside man or men to settle upon a plan provided the Universities decide that it is desirable to unite their forces in Medicine. Certainly we should not call in anyone until we have exhausted all reasonable means of bringing about a mutually satisfactory arrangement.

I will send a copy of this letter to the President of the University and to the Committee of the Trustees in the hope that it will bring about prompt and conclusive action as far as the above enumerated items are concerned.

The position taken by Stanford has been to thoroughly analyze the question of a union and to favor it, should it prove to be the proper solution financially and educationally of the Medical situation in San Francisco. The following extracts from letters written to the President, I think, illustrate the point of view of the Medical Faculty: (Emphasis added.)

The ambition of the Medical Faculty has been to develop a small medical school of high quality to do the character of work done previously by the Johns Hopkins Medical School without falling into their error of overcrowding their facilities by large classes.

Convinced that the small teaching unit is the best particularly under the Stanford scheme and of the desirability of "setting standards" so often insisted upon by Chancellor Jordan when the buildings of Cooper Medical College were remodeled, provision was made for classes of only twenty-five students each. We assume that since the State University has begun medical education that it will continue to develop it, but that it can never limit the numbers or be independent of certain political and community influences that will necessarily hamper the real progress of medical education.

It is striking in this connection that the Rockefeller Foundation, in its efforts to set certain medical standards that seem to it desirable, has recently made gifts to the medical schools of two private institutions, Johns Hopkins of Baltimore, Maryland, and Washington University of St. Louis, Missouri, instead of to the State Universities of the State in which these schools are located or the more prominent State Universities elsewhere.

I think that I express the feeling of the Medical Faculty in regard to the proposed union with the University of California in the following:

We have been willing and have proposed an association provided it would maintain our present standards and permit of growth enough to handle the necessarily enlarged classes. This would in no way reduce the responsibilities or present expenses of Stanford and would, we feel, not really advance medical education unless someone came promptly forward with four or five million dollars to endow the new medical school founded on the resources of the two now in existence. To merely crowd in more students, introduce politics and divide management would be no real advance. We wish to be convinced that we will do a real service to Medical education by giving up our present strong position and ideals. It would be far better for us to handle small classes in true Stanford fashion than to be immersed into a large institution struggling to care for large numbers of students with a meager budget.

If, with increasing endowment and hospital facilities, it becomes feasible and desirable to educate larger classes, arrangements for such purpose can readily be made without handicapping existing work or crowding existing buildings and hospitals. Stanford is at present in good position for growth, first into a complete unit for small classes and then later into additional units of like strength and size. The day of large medical classes taught for the most part by lectures is gone, and with its disappearance there has been an abrupt increase in the expense of medical education.

If the plan limiting the upper classes of Medicine to twenty-five students each is continued, Stanford can estimate about what the expenses are to be including the number of hospital beds required.

In case of a union, there are three possible plans.

1. The present Stanford site to be chosen and made the basis for the new and greatly enlarged school.

2. The Parnassus Avenue site of the University of California to serve as the nucleus.

3. Both present sites to be abandoned and land to be purchased near the new San Francisco Hospital and a complete plant to be erected there.

Plan No. 1 is the most economical as far as new construction is concerned and the best one also for the care of all classes of patients. Assuming then its selection as the site for the combined schools and that only the strictly clinical years are to be taught there, the problem is about as follows:

Stanford now has 18 students in the Sophomore class in Medicine and the University of California has 45 students. In 1914-15, the Junior class of the combined school would probably total at least 65 students. Our present facilities could be made to do double work and be used for two sections of 25 each. We would have to expect classes of 75 within a very few years. Naturally while there might be some saving of expense from the larger classes, Stanford would inevitably have to pay the half of the education of all students so that its expense would be greater than with its own classes of 25 each. No limit could readily be set to the number of medical students by the University of California while Stanford could do as Johns Hopkins has done and refuse admission beyond a certain maximum. In other words, there would be no saving to Stanford in a union but only increased responsibility and increased expense. The question then should be, is one large medical unit so desirable that Stanford should increase its responsibility and its expense along medical lines to bring it about? As indicated previously, unless a gift of $3,000,000, or more is given to the combined school it would, to maintain Stanford standards, be placed in a precarious financial position.

The principal objection to a union from the standpoint of Stanford University is based upon the financial side of the question. It is not necessary to discuss the details of the expense required for additional buildings, for the duplication of work, the increase in hospital facilities and the increase in the Instructing Staff to take care of the teaching of numerous small sections, to show that without considerable endowment, a union of the Medical Schools would be a larger burden upon Stanford University. If Stanford desired only to put in a limited amount of money, it could not demand equal representation in the management. If it did not care to go beyond a certain amount and had equal representation, it might interfere greatly with the combined Medical School.

Both Universities are so established that they could not make the sacrifice of their present sites and facilities and disturb the work given at Berkeley and on the Stanford campus without having independent funds bringing in at least $ 100,.000 to $150,000 per year available for the united schools. It is unfortunate that while the Hooper endowment may be of great service to Medicine on this Coast eventually, at present the speculative features of the endowment make it more of a liability than an asset in making financial plans for a united school.

That there would be some advantages in uniting the schools provided funds were available is apparent. Without such funds, there is certainly great advantage to Stanford remaining in its present independent position. It is probable that this question will soon be permanently settled and that some recognized expert will be asked by the University authorities to review the situation and give Stanford an opinion as to the wisest and most economical course to pursue.

20 April 1914

Dear Dr. Moffitt:
Following your verbal request of today, I presented to the Special Committee on Medicine the proposition outlined by you. The Committee did not feel that it could give a definite answer by ten o'clock tomorrow morning, since a meeting of the Trustees had been called for Friday of this week and they would have to wait until that meeting to come to a decision. I am enclosing herewith a copy of a letter written to Mr. Hopkins, President of the Trustees, in which I am presenting your statement. If this does not meet with your approval in any particular, please communicate with me at once as I wish to have it authoritatively brought before the Trustees at this coming meeting.

Very truly Yours,
(Signed) R. L. Wilbur

20 April 1914
Mr. Timothy Hopkins, President
Board of Trustees, Stanford University
510 Nevada Bank Bldg. San Francisco

Dear Sir:
The Dean of the University of California Medical Department, Dr. Herbert C. Moffitt, asked me this morning to obtain if possible from the Medical Committee or the Special Committee of the Stanford Board of Trustees, a definite answer on the union of the Medical Schools before ten o'clock Tuesday morning, 21 April 1914. Dr. Moffitt wished to make at that time a report to the Committee of the Regents of the University of California. He wished to obtain a statement as to the attitude of the authorities of Stanford University on certain propositions concerning medical education which have been up for discussion. This was in order to bring about prompt and final action through a joint meeting of the Board of Trustees and the Regents should it seem likely that a union of the Medical Schools could be brought about.

When I informed him that Stanford was waiting until Professor Welch of Johns Hopkins could come west before making a decision, he stated that he did not see how they could keep their building and other plans in abeyance so long nor did he see how Professor Welch could contribute materially to the decision on the essential points upon which decision must be reached.

The proposition advanced, as I understand it, by the Regents through Dr. Moffitt is as follows: They consider it desirable for the two Universities to unite their interests in Medicine either upon the Parnassus Avenue site - the present site of the University of California Medical School - or in the Mission near the new San Francisco Hospital on the adjoining land now owned by the Catholic Church. This land the Archbishop is willing to sell at a reasonable figure, considerably less than $ 200,000. It is part of the plan of the University of California to construct a private pavilion, since they see the opportunity in this way of producing income for the care of teaching patients. The present site of the Stanford University Medical School will not be an acceptable site for a joint school.

If Stanford goes into a union, it will not be asked to contribute more than the amount now being spent for medical education including Physiology, Anatomy, Embryology, etc. The Regents of the University of California realize that there will have to be an increasing amount put into medical education with an increasing number of medical students, but will not ask Stanford to share it with them. The Board of Managers is to be constituted of five regents and three Trustees or upon some similar basis. Future representation will depend upon the amounts actually put in by the two institutions. With the majority of Regents upon the Board, it apparently will not be necessary to have a constitutional amendment in order to permit joint control of funds by the Regents and the Stanford Trustees. The University of California states that its present budget for Medicine is about $200,000. This includes apparently the hospital expenses and the Hooper Foundation.

I trust that you will be able to get a definite answer to this proposition at the earliest possible date. I judge though that it cannot come up before the meeting of the Board of Trustees on Friday. If I can give you any further information, please command me.

Very truly yours,
(Signed) R. L. Wilbur

San Francisco, 24 April 1914
Doctor R. L. Wilbur, Dean
Stanford Medical School
Sacramento & Webster Streets
San Francisco

Dear Doctor Wilbur:
Following your suggestion in your note of April 20th, it has seemed to me wise to amplify certain paragraphs of your communication to Mr. Hopkins. It is the earnest wish of the Committee of the Regents to bring about a union of the medical departments of the two Universities. Members of the Committee feel that such a concentration of forces would be of tremendous importance to the cause of medical education on the entire Pacific Coast and they stand willing to make all reasonable concessions to effect it. They would not wish to seem hasty and to urge an immediate decision on the ground of the necessity of developing at once the plans of the University Hospital. They would be perfectly willing to await the arrival of Doctor Welch provided certain fundamental propositions can be accepted.

The Committee feels that the authority of the State is invested in the Board of Regents and cannot be transferred to others and that the State will be called upon in future to put more money into Medicine and that the majority control of the Board of Management of the united school must rest with the Board of Regents. As you say in your note "The Board of Managers is to be constituted of five Regents and three Trustees or upon some similar plan."

The availability of different sites seems of secondary importance and will be discussed later. The Committee feels, however, that the present site of Lane Hospital does not admit of suitable future expansion. Certain minor corrections of your note may here be in order. It is part of the future plan of the University of California to build a private pavilion in connection with the (County) Hospital, but the chief aim of this private department will not be to provide funds for the maintenance of the teaching hospital. The budget for the support of medicine this coming year is $ 157,000. This does not include the hospital earnings or the income of the Hooper foundation.

Trusting that this note may be transmitted with your communication to Mr. Hopkins and to the Trustees of Stanford University, I remain,

Very truly yours,
Herbert C. Moffitt, Dean
Medical School , University of California

24 April 1914
Dr. R. L. Wilbur, Dean
Stanford Medical School
Sacramento & Webster Streets
San Francisco

Dear Sir:
The Board of Trustees has considered the correspondence which has recently passed between yourself and Dr. Herbert C. Moffitt, Dean of the University of California Medical School, relative to a proposed consolidation of the medical schools of the respective universities.

The Board has requested me as President to transmit to you the following resolution so as to enable you to reply to Dr. Moffitt's letter:

Resolved: that in the opinion of the Board of Trustees of Stanford University the trusts which they are administering do not permit their turning over either property or income to be managed and disbursed by any institution in which they do not have at least an equal voice, and that they consider it impossible to formulate any plan for the union of the medical schools of the two universities on any other basis.

Yours truly,
(Signed) Timothy Hopkins
President

P. S. The letters referred to above are those of yourself of the 20th to me as President and Dean Moffitt's letter to you of April 24th.

25 April 1914
Dr. Herbert C. Moffitt, Dean
Medical Department, University of California
2d & Parnassus Avenues, San Francisco

Dear Dr. Moffitt:
Please find enclosed copy of a letter received this day from Mr. Timothy Hopkins, President of the Board of Trustees of Stanford University, in reference to the proposed union of the Medical Schools of the two Universities. You will note by it that the Board does not see its way clear to enter into a union upon the basis which you have stated in your letter of April 24th is considered by the University of California authorities as fundamental. I refer to the majority control of the Board of Management of a united school resting with the Board of Regents of the University of California.

I judge therefore that this permanently settles the question of uniting the two Medical Schools. The trusts of the two institutions apparently do not permit a satisfactory arrangement to be made. I wish to express my appreciation of the spirit in which you personally have considered this whole question and to congratulate you upon the forward steps which you have made in medical education. I trust that there will be no difficulty in securing close cooperation of the two Medical Schools in the advancement of higher medical standards upon the Pacific Coast and wish to assure you of my willingness to assist you in all efforts along those lines.

Very sincerely yours,
(Signed) R. L. Wilbur

After careful consideration of all that has hitherto transpired (the California Regents) voted to express officially to the Stanford Trustees their deep desire that an amalgamation be consummated of the work in medicine of the two schools. They are convinced that the welfare of medical education will be so much advanced by such a merger that the opportunity of united effort in this field by the two universities ought not to be lost. The Regents, therefore, in earnest hope of the realization of a plan of so much moment to the community, would request your Board to suggest a basis on which in your opinion such a merger in medical education may be brought about.

Resolved, that this Board of Trustees, after full deliberation, is reluctantly convinced that no basis of merger of the said two medical schools can be formulated, or exists, which is compatible with the legal powers and duties of either university; and further that, if such merger could be formed, it would cause no material saving in expense to either university, and that the interests of each university and of the public will be best served by the maintenance of the two separate schools, each pursuing its own methods and standards and so far as possible supplementing each other.

Ann Arbor, Michigan, June 9, 1914
President J. C. Branner
Leland Stanford Junior University,
Palo Alto, California.

Dear Doctor:
In compliance with your telegraphic request I have visited Palo Alto and San Francisco and inspected the libraries, laboratories and hospitals of Stanford University. The laboratories of chemistry (general, physical, inorganic, organic and physiological), biology, histology, neurology and physiology are well housed, adequately equipped and exceptionally well manned. In all these, high grade work is being done. The laboratories of bacteriology and anatomy need better housing and I understand that this is to be provided in the near future. But in the buildings now occupied, most excellent work is being done. In fact, each of the scientific departments at Stanford is under the direction of an eminent man supplied with able and enthusiastic assistants and with necessary equipment. There is abundant evidence even in a hasty inspection that the appropriations have been economically and wisely expended and that good work is being done both in instruction and in research. I wish to compliment the trustees and president upon the evident wisdom which they have displayed in the development of these departments of the university.

What I have said of the scientific branches is equally true of the other departments of Stanford University. Although one of the youngest of the higher institutions of learning in this country, Stanford ranks as one of the best in all departments, both scientific and humanistic. In all branches it represents the highest aims and ideals. While I am not fitted to express anything more than a general opinion as to other than scientific education, I wish to emphasize the fact that all learning is one and the same spirit should pervade the whole. This I believe to be true at Stanford. It furnishes a wholesome atmosphere in which the student can grow whatever special line of training he may follow later. The greatest need of our country is the man whose fundamental knowledge is broad and comprehensive and whose special training is exact. No man can have useful knowledge of a part unless he has general knowledge of the whole. The working of the part must be in harmony with the movements of the whole, otherwise disaster is the result. While I am especially interested in medical education, I recognize the fact that it is futile to try to develop a good medical man out of one whose fundamental training has not been sound. The young man who has learned to work with the right spirit whether it be in Greek or biology, in philosophy or chemistry, will enter medicine, law or any profession in the right frame of mind and will be likely to prove an honor in his chosen profession.

In his preliminary college training the prospective medical student should not be confined to the physical or biological sciences. It is desirable that he know the classics, history and philosophy and it is most desirable that the training that he gets along these lines should be of the highest grade. I believe that Stanford University furnishes suitable conditions for the development of the young man who is going into medicine. Therefore, I hope that the medical work done at Palo Alto may continue. If the medical school should be closed, this would relieve Stanford of only one of the laboratories at Palo Alto. Physics, chemistry, biology, physiology, histology, embryology, neurology and bacteriology must be taught and research work in these branches must be done in a university of the high rank Stanford holds. Closing the medical school would give only trifling financial relief to the university. I therefore recommend that the premedical and medical work now done at Palo Alto be not only continued but be developed as fast as the finances of the university permit.

I make this recommendation not only for the good of the medical school, but, as I believe, in the interest of the university as a whole. If the medical department should be discontinued, anatomy is the only subject which could be dropped at Palo Alto and even then this should not be done. Anatomy is one of the great and fundamental biological sciences and even human anatomy should be taught in a great scientific university. Anatomy is no longer taught as a mere foundation for medicine and surgery. It includes the development of structure from the lowest to the highest forms of life.

I went to San Francisco and made an inspection of the library, hospital and laboratories of the medical school.

The Lane Library is one of the best medical libraries in the country. It is supplied with practically all the best medical journals so arranged as to be most available to members of the faculty and students. Its location in regard to the hospital and laboratories is quite ideal. It is worth much to both the clinical and the research man to have at his hand the best contributions of the world. When a problem comes up for solution the first thing to learn is to ascertain what has already been done along this line. A medical school without a library is like a boat without a pilot, and much time is likely to be lost in drifting. The medical department of Stanford is fortunate in the possession of its library.

While the present hospital building is somewhat out of date it is, so far as I can see, admirably managed both in caring for the sick and in the instruction of students. The out-patient department, systematized as it is, is both a great, broad and needful charity and at the same time a source of varied and comprehensive instruction to students. The addition soon to be made to the hospital will modernize the institution. It will bring more pay patients to the institution and thus furnish funds with which the less fortunate can be cared for. I was greatly pleased with the management of the hospital. The laboratories in the hospital are ably conducted and fairly well equipped. Some of them will probably have enlarged and improved quarters when the addition is made to the hospital.

As I understand, the total cost of the medical department is now about one hundred thousand dollars per year. This cost will slowly increase. Notwithstanding this fact, I strongly urge that the medical school be not only continued but be developed. In its development the quality of its work should be constantly held in mind. The number of medical students should be kept small. Quality and not quantity should be the aim.

I believe that in the near future the medical department will be a source of strength to the university in many ways. First, in the importance of the research done and the benefits that such research will confer on the race. Within the past thirty years the average human life has been increased nearly fifteen years and the whole of life has been made more comfortable. This is a work to which a great university should contribute. The opening of the Panama Canal will bring to the Pacific Coast many health problems which can be best solved in such a school of instruction and research as I believe Stanford will develop. Second, I am firm in the belief that the medical school will attract large donations, both for research and the clinical work. Philanthropists will see that the best service they can render lies in the direction of improved health conditions. Third, medicine is now attracting to its ranks many of the best of our young men and this will be a source of strength to the university.

Lastly, I come to the matter on account of which I was called to visit you. The time may come when it may be wise to consolidate the two university medical schools in San Francisco, but I do not believe that this would be wise at present. Stanford, from what I can learn, can afford to develop its medical school without material hindrance in the growth of other branches and I believe that this is the wise thing to do.

I am aware of the fact that a hasty visit, such as I have made, may give erroneous impressions and I would not have you attach any great importance to this report, but I have tried to look at matters from a broad viewpoint, and to hold constantly in mind the good of Stanford University as a whole. I have considered it unnecessary to go into financial or other details with which you are much more familiar than I am.

In conclusion I wish to thank you, . . . .and Dr. Wilbur and other members of your faculty for the many courtesies shown me and to express the hope that the growth of Stanford University during the past quarter of a century, phenomenal as it has been, may be surpassed in its future developments.

With great respect, I am,
Yours most respectfully,
V. C. Vaughan.

If President Pritchett were alive today he would be surprised to see how far off was his estimate on the medical needs of the Pacific Coast. No one could foresee the great expansion in population and in medical practice. It now seems clear that the medical profession of any community of a half million or so inhabitants can best serve that community by developing a medical institution of some sort where students are accepted either for the medical course or for training in their postgraduate work.