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part of the student of the control imposed by the regula-tions which are necessarily devised for the orderly conductof such institutions. Nevertheless, the select society, andeven the inevitable restraint, of such institutions are of greatservice, especially to young students who have reason todread nothing more than solitude and an irresponsible controlof any considerable proportion of their own time. On theother hand, the cost of board and lodging in such institu-tions is not greater than the average cost of the same accom-modation in private lodgings in their neighbourhood. The

following is a list of London schools for medical students,complete so far as the Editors have been able to make it,which have residential colleges attached :-St. Bartholo-mew’s Hospital, Guy’s Hospital, King’s College, St. Mary’sHospital, and Middlesex Hospital.At many schools a register is kept of suitable lodgings

which can be recommended to students. It is known thatsuch registers are kept at the following schools, but it isfeared that the list is imperfect :-London Hospital,St. Thomas’s Hospital, Westminster Hospital, Aberdeen

University, Anderson’s College, Glasgow, and the CatholicUniversity, Dublin.A very excellent plan, and one that involves no inordinate

expense, is to place a student in the house of a medical

practitioner in the neighbourhood of the school which he isattending. It will be found that when the educationalfacilities thus placed in his way are taken into account, inaddition to the mere commercial value of his board and

lodging, the arrangement is usually a very economical one.The opportunities for doing this are, of course, not unlimited,but they are sufficiently numerous to merit mention here.Passing to the next item in our typical account, that of

food, we may observe that here again our Leeds correspondenthas set a standard which will be rarely attainable. It can be

paralleled in a very few instances only from our returns.The cost of board is generally not less than that of lodging,and may fairly be taken at about the same figure. As amatter of fact, the similarity is closer than would be at firstsupposed, and, speaking broadly, it may be said that wherethe one item is low the other is low also. It would seem asif the prevalence of high prices or of low prices, as the casemay be, affects both items, and affects them equally. Itwould then be more proper in an ordinary case to put thisitem down at £30 a year than at ;t15. The remaining itemsin the statement may be accepted without much comment,except perhaps that which is entered under the head ofclothes. This is an item of expenditure not properly charge-able to the education account, since the student would in anycase be clothed, and the amount expended upon his ward-robe will be determined by his personal habits, and in nosense by his professional studies.

It is very undesirable, and a matter to which more thanone of our correspondents has referred in a tone of irritation,that the incidental expenses should be overlooked. We have

already alluded to them above, but it seems not unimportant,for the purpose of preventing misunderstanding, to refermore pointedly and specifically to them here. The com-

position fee which is published by the various schools, andis in a sense a comprehensive charge, may easily be sup-posed to be more comprehensive than it is. A glance atour tables will show exactly how it is arrived at andwhat it covers. Broadly it may be said to include all theprofessorial fees. But it does not include books-this is amatter of course. Eqnally it does not include instruments,and these two items together cannot be fairly written downat less than ;E8 a year in an ordinary case. Many circum-stances may occur to falsify this estimate. A successfulstudent may largely supply himself with books by prizewinning, or access to a suitable library may minimise hispersonal requirements in this respect. With instruments,bones, parts for dissection, and the like, the case is somewhatdifferent, and the expenditure under these heads can onlybe avoided at the expense of the student’s education. A

niggard hand in such matters makes therefore a grievousmistake, and this should be clearly appreciated at first,otherwise the temptation to undue parsimony will besupported by a grudging mind in their bestowment. Anotheritem which is for very good reason omitted from the com-position payment is the charge for examination fees. Thereason of this will be at once apparent if it is only consideredthat the teaching bodies and the examining bodies arc

distinct, and that whereas the composition fee represents asum payable to institutions of the former class, the exami.nation fees are receivable by institutions exercising the exa.

mining function. It will be hard to quarrel with an arrange-ment which is justified by the importance of paying the fceto the right person. Less obvious, but of the same kind,is the explanation of the circumstance that tutorial feesare not included in the composition. Many studentspass through their curriculum by the aid of lectures and pro-fessorial instruction only. This is very possible when onlycrucial examinations are attempted. But for competitiveexaminations additional instruction is generally an indispen-sable preparatory. Such additional instruction must ofcourse be paid for, but its occasional character prohibits itsinclusion with the indispensable items in the comprehensivepayment. From what has last been said it will be perceivedthat the cost of the professional course, especially in theselatter items, will be laTgely affected by the nature of thequalifications upon which the student sets his mind. A listof examination fees appears on page 541, from which a suffi-ciently precise estimate may be formed of the amount whichit will be necessary to expend in this direction. It will, ofcourse, be borne in mind that failure to pass an examinationat the first sitting may involve the payment of a second feeupon a subsequent occasion. In forming an estimate ofprospective expenditure this contingency should not beoverlooked.

NOTES AND NOTE-TAKERS.

" IF a man write little," says Lord Bacon in one of hisbest known Essays, "he need have a great memory." The

passage refers to the habit of taking down notes of whatis observed or read-a habit which all students, but moreespecially the medical student, cannot too assiduously culti-vate. The power of taking notes efficiently does not come bynature, as many suppose, but is an art which improves withcultivation, and through which some of the highest qualitiesnecessary to a successful medical career are developed. Weare not now referring to the expert note-taker who hasdevoted years of hard study and long practice to the

acquirement of the degree of skill which is necessary for thepractice of his vocation, but to the student note-taker whotakes notes of lectures for the guidance of his own study andas an aid to his memory. Indeed, it is very questionable ifthe student note-taker would gain much by attempting averbatim note, or whether a good deal of the educationalvalue of the note would not be lost in the effort. The edu-cational value of note-taking depends on the habits which itdevelops. One of these, in a very marked degree, is thehabit of punctuality. The professional note-taker is rarelylate for his engagements, and so the student note-taker willnot care to lose the connexion between one lecture andanother on a subject in which the lecturer has interested him.He is rarely absent from his class, and the habit of regularityis thus markedly developed. A lost lecture or two leaves ahiatus in his note-book which costs much reading and re-search among complicated text-books to fill up. As a rule,it will be found that students attend to whatever is worth

hearing; but the student who has developed a habit of

note-taking is never caught napping in his class or furtivelyperusing newspapers. The attention which is necessary tocareful note-taking has become habitual with him. He has de-

veloped the habit of continuous attention, one which a studentqualifying himself for any career in life will find most valuable.Thoroughness is another attribute which note-taking tends tofoster. Points are noted in the class-room and at the clinicallecture which after-study will expand, and which in manyinstances give the keynote to future research. These are themain qualities which go to make a successful practitioner ;and, if proof were wanted, the success of those medical menwho have cultivated this habit will afford it. It would ofcourse be invidious to specify them by name, but probablyhalf a dozen of the most successful medical men in London,taken at random, would be found to be excellent note-takers,from habits acquired in their career as students.The student’s note-book reflects the character, not only ’

of the lecturer, but of the teacher. Diffuseness in a lectureris a common and sometimes fatal cause of discouragement tothe student at the outset of his career. The young note-takerfinds it impossible to lay hold of any definite statement. Wehave known lecturers on subjects in the medical curriculumwho seemed to think they fulfilled their mission as teachersof students by muttering in a low tone of voice from manu-

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script at the rate of 250 words per minute. Such a travestyof teaching inspires in the student undisguised contempt.The matter is not assimilated if it ’is even heard or listenedto by the student. An expert note-taker would probably,despair of learning anything from such perfunctory in-struction.

Again, notes to be of service to the student must be spon-taneous and must be taken con amore. If full benefit is to beobtained the note-taking must be inspired by the lecturerand by the nature of the instruction. The principal objectsof note-taking are defeated by compulsion, or by bribery inthe form of prizes offered for the best note-books. The

process in this case becomes mechanical and loses its edu-cational value. Perhaps the most useless of all kinds ofnotes are those which are dictated to the students by thelecturer. Notes to be useful must be made with brains,and the brains must be supplied by the students.

Note-taking has a stimulating effect on the teacher, and itwould be exceedingly useful to lecturers to take an occasionalglance through the note-books of their students. The resultswould confirm the excellences of the lecturer and improvehis deficiencies. It is said that students do not care to usenotes and so do not trouble about acquiring the art of takingthem. Students are the best judges of the value of note-books.Some teachers, of whom Professor Struthers, who has

done so much in the interests of medical students, maybe taken as the type, object to note-taking. Address-

ing the General Medical Council on one occasion, hesaid: "The student takes his notes, puts his book in hispocket, and walks out, knowing no more about the subjectthan a mere reporter would do." If the student knowsat the end of the lecture as much as the experienced reporterwould do after listening; to it, he would have reason to con-gratulate himself on the success of diligent note-taking. The

very habit which the reporter has acquired at so much

pains gives him the power, which was so highly developed inLord Macaulay, of recalling the points of a long lecture, andof being able in many instances to quote without referenceto his note-book the exact words of the lecturer, and toremember them. There are many who believe that lecturesand note-taking alike are merelv so much useless expenditureof time and energy. The information," " it is said. can bebetter got out of a text-book."

" We prefer Professor Gaird-ner’s view, who in a lecture so long ago as 1877 said : Thetext-book must be rewritten or completelv revised, editionafter edition, or it must perish. Professors’ lectures must befreshly brought up, altered, amended, often completely re-modelled, almost from year to year, or they are naught."" Systematic lectures, which are mere repetitions of a text-book, are not indeed wholly useless, but they can never riseabove the usefulness of the text-book, any more than water,can rise above its fountain-head. But systematic lectures thatare informed by the spirit of a living man are valuable to youabove a text-book, just in proportion as you have reason tohave a living faith in that man and in his ability toguide you aright." It is the living voice of the teacherthat makes all the difference from the lifeless page.Medical students cannot afford to neglect any of the aidswhich render their task lighter or their knowledge moreaccurate in the wide domain of medical science ; and whenin the search for knowledge they are brought face to facewith useful facts it is well to fix them by doing what CaptainEdward Cuttle advised in reference to the search for his

quotations, "When found, make a note of."It is not every clinical teacher who has the power to im-

press his students with a lasting picture of a disease as itcomes under his notice. Details are forgotten in afteryears-it may be in months or even in weeks. The impressionhas faded, and nothing of the demonstration remains in thememory of the student to testify to his honest ward work orto aid him in his future practice. Herein the value of goodnote-taking is manifest. Dr. Gowers, who has publishedsome of the most erudite and valuable works to be found inmedical literature, has frequently expressed his deep indebted-ness to his notes. He has said: "I am deeply indebted toshorthand, for without it I never could have accomplishedany of my work." The records of his cases are probablyunique in the history of note-taking. The written letter

remains, and no detail of any case which has come under hisobservation is ever forgotten or lost sight of.The practical question for the student is--How am I to take

notes in the class ? The answer is very simple. Manystudents know a little shorthand. To them the task will be

more easy, and the only advice which it is necessary to giveto these students is to task them to improve their shorthand,to be contented with a. few well-summarised notes written onthe left side of their note-book only, leaving the right handpage free for home use. For it is an essential that the roughclass notes should be extended. Those students who haveno knowledge whatever of shorthand will speedily acquire anabbreviated form of longhand which will probably serve theirpurpose. The general direction about writing upon one sideof the note-book in the class-room should also be attended toby them. The last point of practical interest is to advisestudents to secure well-bound, substantial note-books whichwill be useful for reference in future years.

Note-takers nowadays have a very easy time of it com.pared with what existed in days gone by. If students referto the early numbers of THE LANCET published in the years1823-24-25-26 they will find some specimens of note-takingwhich will excite their admiration, and which excited theconsternation of most of the medical teachers in London atthat period. Sir Astley Cooper’s lectures had never beenpublished--had never indeed been written-when in fullarray, in the year 1823, an almost verbatirn report of a

most important lecture appeared in the first number ofTHE LANCET. Complete ignorance prevailed as to theindividuality of the reporter and of the editor of the new

, medical paper. The reports of these lectures were con.

tinued week by week, and, all efforts at discovering theauthor having failed, a notice was printed and posted up

: in Guy’s Hospital threatening any student found reporting: for THE LANCET with instant expulsion from the hospital., At length suspicion fell upon Mr. Thomas Wakley, and

Sir Astley Cooper determined to ascertain whether he: was the offender. Mr. Wakley was one night sitting in. his consulting-room in Essex-street, Strand, reading over

the proof sheets of one of these lectures, when, before he hadl time to conceal the pages, Sir Astley Cooper was announced.i The eminent baronet sternly eyed the young journalist forL a brief space, but gradually his features relaxed into a genial smile. A similar smile made its appearance on the) face of Mr. Wakley, thus caught as it were red-handed.

They shook hands. however, and after some conversationit it was arranged that the remaining reports of Sir Astley3 Cooper’s lectures should be sent to him for revision before- they were published in THE LANCET, and to this the Editor at once agreed. On another occasion a report appeared ini THE LANCET of the clinical instruction given by Sir Antony3 Carlisle at the Westminster Hospital, which so enraged- the physician that he told his students that they had his full’

authority to drive the note-taker from the hospital with "large- sticks." The note-taker had to be protected from the students by some coalheavers and brewers’ men.r But students nowadays live in better times. No sucht restrictions are imposed upon them, and it simply remainsi for them to seize the opportunities which abound for) acquiring information, and when they have obtained it) "meet it is " for them, as it was for Hamlet, "to set itr down. "

UNITED HOSPITAL ATHLETICS.

NOTHING remarkable has occurred during the past year in

hospital athletics. Guy’s have shown themselves to be thebest all-round athletes by winning the challenge cup for

cricket, athletic sports, cross-country running and lawn-tennis, St. Thomas’s, St. Bartholomew’s and St. George’swinning Rugby football, Association football, and rowingrespectively. Several of the competitions were most keenlycontested, notably that for the Association football cup,the final tie of which had to be fought out no less thanthree times.The scheme of Amalgamated Sports’ Clubs is slowly spread’

ing, and is now adopted at most of the leading hospitals; itnot only saves an immense amount of trouble and time, but italso adds largely to the incomes of the different clubs.Hospital clubs are proverbially poor, and it really seems thatthe old system of small subscriptions to each separate clubhad more to do with their poverty than an absence of espritde corps. Interest in the success of his hospital at sports ishowever, as a rule, of a spasmodic nature to the ordinarymedical student; it may be that the absorbing interest ofhis work precludes him from being very energetic as re-