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which examinations should be had might well be specified in the statute; and I incline strongly to think that it would be most wise to omit any examination in those obscure topics of therapeutics and materia medica, upon which all medical heresies have been begotten by unscientific minds. One who should creditably pass his examinations in botany, chemistry, physics, anatomy, surgery, physiology, hygiene, diagnosis, obstetrics, and microscopics, especially if his clinical examination should show him to be educated in a true sense to observe and draw sound deductions from observation, rather than crammed like a parrot, might well be trusted to form his own conclusions and pursue his own studies as judg. ment should dictate in the terra incognita of therapeutics.

It has been already said, but it cannot be repeated too often, that the law has nothing to do with medical theories. The utmost it can do successfully is to prescribe that none shall practise medicine except persons educated in those branches of science that all admit are essential to an understanding of morbid conditions of our species, and possessed besides of a fair general education. It cannot prohibit the practice of sectarian medicine and such delusions as mind-cure and Christian science, for this would be an assumption by the law to prescribe what system of healing shall be followed ; and it might as reasonably command — as, indeed, I believe it does in Mormondom - that all the sick should be treated by anointing with oil in conjunction with prayer by the elders.

If a man who has passed his examinations in such branches as above indicated shall conclude to adhere uniformly in practice to the doctrine of similia or of contraria, or even to the profundities of Mumbo Jumbo, or mind-cure, the law cannot prevent him. For his errors, he will be liable always in damages, no matter what system he adopts; and, with that, we must be content. If the education required of him does not keep him to the faith, we may perhaps find in some cases that his departure from it is the opening of a new way to fresh truth. (6) Finally, the law should not recognize any diploma as of itself conferring a right to practise medicine. Even if the possession of such a document should be required as an antecedent to examination by the health board, it should not be allowed to take the place of such examination. It is to the interest not only of the public, but of every medical college of high standard, that the diplomas of what have become known as “diploma mills ” shall be deprived of the licensing power, which is their sole value.

Any scheme of medical legislation will hereafter, of course, embrace that great safeguard against imposture and efficient tracer of frauds, the system of registration, whereunder no one is allowed to practise medicine who has not made a public record under oath of his name, origin, and credentials for license.

Beyond the point here indicated, it would not be wise for legislation to go. The chief desiderata in a good law are brevity, simplicity, and lack of detail. If a diploma standard is to be maintained, it would certainly be desirable that the statute should provide that only diplomas of colleges giving graded instruction and requiring preliminary examination of their matriculants should be received as licenses.

But it may be well to say once more that the mere enactment of a law against a vicious practice will be no deterrent to the transgressor, and, therefore, of no service to the cause of education. He must realize that the law is enforced ; and, in order that it be enforced, somebody must be charged with carrying out its provisions. In the State of New York, the regular medical societies

. have of late charged themselves with the duty of executing the medical act. Such acts have been upon the statute book for more than a hundred years. But prior to 1880 they had fallen into neglect, largely owing to the clumsiness with which they were drafted. In that year, the State Medical Society secured the passage of a new law, and in 1887 of a codification or revision of all the medical statutes; but the law in this State is yet far from perfect, and chiefly for the reason that there is no central body having control of its execution. The most that the medical societies can do is to punish those who practise without diplomas. They are powerless to exercise any supervision over those granting the license. In this regard, the statute of the State of Illinois is far more efficient than ours; and the Health Board of that State has entitled itself to the commendation of all who are informed of its excellent and efficient work.

But the County Society of New York has done enough to show that even a poor law can be of advantage to the cause of medical education. The example of its prosecutions has stirred up allied societies to action, and has constantly called public attention to the fact that the practice of quackery is not safe within their jurisdiction. Adopting the new code of ethics, it has shown conclusively to all who have watched its course that its members have not had in mind the suppression of any system of healing the sick only because they disapproved the methods of that system. It has recognized that the utmost limit to which the law can properly go is to provide that nobody shall practise medicine at all, by which term the courts understand the use of drugs and instruments, unless he has the slender educational qualification prescribed by the statute. If possessed of that qualification, the society concede that the practitioner has a right to use whatever system may commend itself to his understanding or lack of understanding

The prejudices and jealousies that prevented the passage of the Examiners Bills have been already alluded to. But, although those bills failed to become law, nevertheless, when the present statute incorporating their points of agreement was obtained by an alliance of all parties, a distinct advance was made, in that the homeopaths and eclectics were convinced that, whether the other societies agreed or not with them in matters of practice, they were willing to join hands with them in securing, if not the best legislation, at least the best possible under the circumstances; and that they were quite capable of bringing forward in good faith a bill actually what it appeared to be, and not secretly designed for the destruction of schismatics. And it is very safe to say that it is only a question now of agitation of public and professional opinion that is necessary in the State of New York to bring about such legislation as will obliterate all sects in medicine, not indeed by harassing the individual practitioner or legislating against any system of practice, but by educating the public mind to the fact that no one should be intrusted with the practice of any system who has not a fair attainment in those branches of study which all admit must be necessary to any one expecting to devote himself to the treatment of disease ; and that every one is entitled to the name of physician who is learned in his science, skilled in his art, and capable in his profession of trying all things, holding fast what is true, facing bravely the errors of others, and admitting candidly his own, and, above all, recognizing the possibility of honest differences of opinion, which can be settled only by honest investigation and kindly exposition.

If the law will forbid the practice of medicine to all but those who give proof of a fair general education and reasonable attainments in the branches of sciences and medical study as to which there are no “schools," it will do all that can be asked. Its licentiates will be too intelligent to indulge, as a class, in vagaries, sectarian medicine will disappear or dwindle to insignificance, and the physician will be free to follow where the torch of Truth lights the way.

DISCUSSION OF MR. PURRINGTON'S PAPER. Dr. ANDERSON.— I would like to inquire if there is not in Philadelphia an institution which issues bogus diplomas.

Dr. Curtis.— The Buchanan diploma factory is closed for the season. There are others, unfortunately, qualified by legislative enactment to issue diplomas, with no specifications. The number is becoming less every year, and this is chiefly due to Mr. Purrington and to the Illinois Health Board. It was this Board that exposed the Bellevue Medical College of Boston, which was incorporated under the Manufacturing Act. The courts of Massachusetts decided that it was impossible to recall the diplomas granted by the Bellevue Medical College, because, although incorporated under the Manufacturing Act, it had been given the right to issue diplomas; and so they issued them for $125 apiece. But an end has been put to that.

Mr. SANBORN.- Has not New Hampshire a law similar to that of Illinois ?

Mr. PURRINGTON.— It has a similar law, but a very mild one, known as the “Medical Tramp Act.” It acts against the peripatetic quack as it would against any other vagrant.

Dr. F. BONNEY, of Hadley, Mass.— All who have had any experience know that it is difficult to do anything in regard to these subjects by legislation. It took ten years in Massachusetts to get a law protecting the community against the ignorance of pharmacists. When the bill was first introduced, it was laughed down, not because it had not merits, but because the pharmacists themselves — those not well educated — did not favor it, and the people felt that it was making a class, that it was favoring physicians in a certain way, and therefore they opposed it. I suppose all legislation must look to the interest of the community, and must be kept as far as possible away from the idea of favoring any particular class. I can remember some of the things of which Mr. Kingsbury speaks, and can see the progress that has been made; should certainly give us great courage in thinking of the future. Great progress is still to be hoped for. The allied sciences of chemistry and microscopy, and all those collateral studies, have an immense influence in this matter, as Mr. Sanborn has shown. It was the misfortune of the earlier physicians that they had not our present opportunities; for these sciences did not exist in those days. It is therefore to the younger men of this country that we are to look for progress in medicine. The public must be taught to co-operate before we can accomplish anything by legislation. But there is reason to hope that in the future we shall have proper laws, and that they will result in elevating the profession as well as in protecting the community.




Better education is the watchword of these closing decades of the nineteenth century. The demand for it does not respect the masses only (though the diffusion of education had its own obstacles to encounter), but it concerns the professions also - and all of them. The old standard of trust cannot be maintained without that better education of professional men, which will preserve the relative advantage, heretofore a marked feature of civilization. The high motives and keen sense of responsibility, without which any man is only a hireling and his “honorarium” is only wages, plead for more knowledge and ampler training, both in and before professional life. Every profession must claim breadth, if the need it meets is broad, and depth, if that need is deep. Therefore, its right to exist is a right to have educated men enter it. Every profession has its store of accumulated facts and a philosophy of those facts (or several philosophies contending for acceptance); and these things represent centuries of mental stress, not without some distress. Such accumulations and even unfinished philosophies (nay, the more because unfinished) entitle it to a share of the best intellectual stock the world contains, wherein it may graft and from which it may (and the world may) hope for a perfect fruitage. And, surely, the interests which the world has at stake in the professions demands that they shall be thrust ahead and kept ahead. As no professions exist except as creations of social necessities, so no social need is so necessitous (not even those which lie at the bottom) as this which lies at the top. The masses demand leaders. The armies must have pioneers. There must be physical, mental, and moral, political and religious investigators. These always have been and always will be the professions. On with them, then! society cries. Tell us which is the way out of this wilderness of suffering, and ignorance and vice, and official corruption and doubt! There is no social surface which does not play at making echoes of this demand for better professional education.

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