§ \Jrtr<JL£~ [ ft.  I.J
AN  ADDRESS
READ AT THE FIRST MEETING
A. M E R I O ^l N
ACADEMY OF MEDICINE
BY THE SECRETARY,
R. LOWRY SIBBET, A. B., M.  D.,
IN PHILADELPHIA, SEPTEMBER 6, 1876,
Necessity of an Organization which shall Encourage a Higher
 Standard of Qualifications in the Medical Profession in the
 United States.
CARLISLE, PA.:

PRINTED BY HERALD PRINTING AND PUBLISHING COMPANY.

             1877. 
 
AN   ADDRESS
READ AT THE FIRST MEETING
AMERICAN
ACADEMY  OF MEDICINE
BY THE SECRETARY,
R. LOWRY SIBBET, A. B., M. D.,
IN PHILADELPHIA, SEPTEMBER 6, 1876,
Necessity of an Organization which shall Encourage a Higher
 Standard of Qualifications in the Medical Profession in the
 United States.
        CARLISLE, PA.:

printed by herald printing and publishing company

              1877.
 
 
A-IDJJI^ESS.
  Mr.  President and Gentlemen of the Medical  Profession :—We
have assembled to-day under circumstances of unusual interest and
responsiblity.  As a  nation  we have reached our first Centennial.
Starting  with three millions of people  we have  become forty-five
millions, and are multiplying at  a prodigious rate.  In addition to the
natural increase at home, Europe, Asia, Africa and the Islands of the
sea are pouring in upon us their surplus populations.  With a vast
territory yet unoccupied, except by the Indian, a rich  and varied soil
and moderate climate, mineral resources of untold value, a Republi-
can for of government and free institutions, we are rapidly assuming
the first place among the nations.
   Taking a retrospect of the past century, we see much that has been
done by our people.  In agriculture, in manufactures, in  commerce,
in literature, in science and in art,—in all that contributes to national
prosperity and growth, we have become distinguished.   In the achieve-
ment of  these results, all classes of our people have taken an  active
part—the statesman, the scholar, the merchant, the artist, the farmer,
the mechanic,—and  when necessary, the soldier—all have  labored
together, and all enjoy the blessings of their industry, their  patriot-
ism and their toil.
   But  looking forward into the  future—into the century upon which
we have just entered, we see much more that is yet to be done.  In
a brief space of time, perhaps within the space allotted to some  of us,
our people will have  actual possession of our broad country,  extend-
ing from the Atlantic to the Pacific.  Over the grave of the Autoch-
thon of North America,  the plowshare will soon pass, and in the whirl
of business he  will  be  forgotten.  In  every territory, as well  as  in
every State of our Union, there  are evidences of rapid development
As the forest is  subdued and the earth  yields her  rich treasures, the
inventive genius of our people  is stimulated ;  the channels of  trade
multiply ; the avenues of thought expand.  Our geographical  position
gives us importance.  Willi Europe on the one band and Asia  on the
other,  who can  tell what we shall  be in the near  future ?  Including
the possessions  of Great  Britain  on the north  and Mexico on the
south,  our  population in a short time, from present indications, will 
4                 AMERICAN ACADEMY OF MEDICINE.
equal that of  any other  continent.  With a civilization  truly Amcii-
can, which under a kind Providence, we are working  out for  our-
selves,  who can place limits to our growth and achievements ?
  As the so-called learned professions—theology, law and medicine —
have had a prominent place in society in the past, so will they in the
future.   Each will have a work  to do, and each will have a corres-
ponding responsibility to  bear.   In the order of Providence, there is
committed to us the health, and in some measure the happiness and
the lives of the people.   Ours is a special work, and for it there is re-
quired  a special fitness and preparation.   All that nature has done for
us is needed ; all that art can contribute is  required—education, re-
finement and skill.
  Although our profession, in the trying circumstances of a new coun-
try, has accomplished a  noble work, there is evidently room for im-
provement.   The meagre attainments  of many of  those who enter
upon the study of medicine, the  ease with which they matriculate in
our medical   schools, and afterwards obtain the degree  ot  Doctor of
Medicine, are matters of popular criticism at home and abroad.   Pre-
cisely what should be done in the premises, is  a question,  which re-
quires more  than a passing notice.   The theologian has no familiarity
with the  subject; neither has the  attorney-at-law.   The  illiterate arc
not in a position to make even a suggestion ;  and those who are pro-
fessors in rival medical institutions are trammelled.
  We do  not propose  at present to inquire  what should be done by
the State.  Efficient legislation is  certainly needed.   The  afflicted,
THE SIMPLE-MINDED AND  TEE  CREDULOUS  CHOULD BE PROTECTED BY  LAW.
The  States,  however, are independent of each other, and  claim the
right to enact their own laws, and to charter institutions ad libitum.
Congress cannot interfere, except to secure competent surgeons  to the
army and to the navy.
  But what  may be done by the profession ?   In other  words, what
may we do for ourselves ?  As already intimated, we are representa-
tives of classical  and literary institutions in which we feel a just and
honorable pride.  We  are  also alumni of  medical  schools, whose
honors we appreciate and whose reputation  we are ever ready to de-
fend.   Whatever may  be affirmed of others, it cannot be said of us,
that we have hastily assumed the responsibilities of professional wotk.
We are, therefore, in a position to do what others cannot do—lead the
profession, in this age  of rapid development to a higher plain.  We
may express  our sentiments ; we may set an example.
  It is  proposed, therefore, during this Centennial year, to organize  a 
ADDRESS.
0
medical society, college, or  academy,*  whose active members have
pursued regular courses of study in respectable institutions of learning ;
and as a result  have obtained the usual degrees  conferred by them.
These degrees have long been recognized in foreign countries and in
our own, as evidences of scholarship and professional fitness   The
first, that of Bachelor of Arts, is  conferred by respectable institutions
in the United States after a course of study somewhat varied, embr?c-
ing languages, ancient and modern, mental and moral philosophy, rhet-
oric and logic, the elements of mathematics and the natural sciences,
including  geography, natural  philosophy, chemistry, geology  and as-
tronomy.   As a rule, two years of careful preparatory study, in acad-
emies or high schools,  are  required before  entering upon the regular
College course.  This embraces four additional  years, during which
lime the student passes  through the freshman, the sopbomore, the ju-
nior and the senior classes, under  the  direction of  properly qualified
tutors and professors.   Six years of faithful study may, therefore, be
taken as the average equivalent of what is required by respectable lit-
prary institutions in the United States, before graduation and  the re-
ception of the degree of Bachelor of Arts.
   Three or four years after graduation the degree of Master of  Arts is
usually added by the same  institutions on  application, not, however,
as a matter of honor, but of merit.   It is, of course, limited to those
who have taken up professional studies, or  have engaged in scientific
or literary pursuits.  This degree  is sometimes conferred upon those
who have not pursued  regular courses of study under the direction of
preceptors or professors ; in which case it is regarded simply as hon-
orary.
   The degree of Doctor of  Medicine is  conferred by respectable insti-
tutions upon those  who have spent a variable period of time,  not less
however than  three years, in the study of  human anatomy, human
physiology, pathology, chemistry, materia medica,  obstetrics, the prac-
tice of medicine and surgery, and public hygiene, under  the supervis-
ion of preceptors and professors.  In Great Britain and Ireland, when
the degree of Bachelor of Arts has not been previously obtained, ex-
aminations are instituted;  and although complaints have frequently
been made, their standard is far above our own.   On the continent of
Europe, the degree of Doctor of Medicine is conferred only upon those,
who, prior to the study of medicine have pursued regular courses of
study in classical schools such as we have referred to, and have taken
  * These names were suggested : " National Medical Society''—" American College of Physi-
cians and Surgeons"—"American Academy of Medicioe." 
6                 AMERICAN ACADEMY OF MEDICINE.
 degrees, or have passed frequent creditable examinations before legal-
 ly constituted boards of examiners.
   In our own country, we are sorry to say, no such attainments  arc
 required ; no such examinations are instituted.   As far as we aieablc
 to learn, the degree of Bachelor of Arts is not required by any Medi-
 cal School in the United States ;  nor is any other degree of less value
 required  It may not be generally known  to the public, but it never-
 theless appears to bo  a fact, that  our best medical institutions do  not
 require of their matriculants any definite amount of preparatory study.
 And by this we mean that they are  not  required to pass an examina-
 tion, either private or public, in any of the branches of study taught in
 our classical or literary schools.   A few lines from an interested pre-
 ceptor  are generally all that is  required for matriculation.
   Referring to a recent catalogue  of Harvard University, which is
 making a noble effort to elevate her" standard, and to  institute exami-
 nations before matriculation, we find  that 68 medical students out of
 192 are credited  with the degree of  Bachelor of Arts.  Referring to
 the catalogue of another University,  we find that 10 out of 124 gradu-
 ates carry  with them this degree.   Referring again to the catalogue of
 a third University,  we find that only one out of a class of 36 graduates
 has  the degree of Bachelor of Arts.   And looking over the long list of
 medical schools  of  every grade and persuasion, and  taking into  ac-
 count the fact that  in some of  them, at least, it  is a rare thing to find
 a graduate of a classical or  literary  school, we cannot escape the con-
 clusion, that a very large  proportion of the students of  these institu-
 tions—perhaps 95 per cent—go out to practice medicine without aca-
 demic  degrees.  And  taking into consideration this additional fact,
 that many practitioners in our Middle, Western  and Southern  States
 are not even graduates of medical schools,  we are probably nearly cor-
 rect when  we state that not more than four per  cent, of the 80,000 in
 the whole  country arc graduates of  literary schools.   How many of
 this large army of doctors iu the United  States are  capable of contrib-
 uting to the literature of tho profession may not be easily ascertained  ;
 but it is quite certain that the proportion does not exceed 15 per cent
   That  the medical schools of  our country are  largely responsible for
 this  state of things, thercf can be no  doubt.  Having  obtained their
 charters, for the most pai t,  from the legislatures of the several States,
 they  are expected to fur; lish  competent  practitioners to  the people.
 The degree of Doctor of M edicine, which they are authorized to confer,
 is  supposed to be an indie; ition of professional fitness, and apparently
with very good reason.  T h§ States however bejng sovereign, and  the 
ADDRESS.                             t
Federal  government having no constitutional  right to interpose  re-
straints, the faculties of many of the schools, having a pecuniary  in-
vestment in them, arc inclined to use the privileges of their charters
for money-making purposes ;  and thus far, the jealousy which natu-
rally exists, has prevented  any efficient concert of  action looking  to-
wards the adoption  of a higher standard.  In these  circumstances
there seems to  be no help for the profession in  the United States, ex-
cept  in voluntary associations and in example.
   We have many medical societies in our  country, and I believe they
all have noble objects in view.   Some of them have a local  character
and  interest.  They have been organized in our cities and larger towns
for the advancement of medical science.  But to the profession at
large, they can  never be  of any great advantage.  Our numerous
county medical societies, our State societies,  and our American Medi-
cal Association, present to the profession a much  wider field of use-
fulness.   In these, practical questions may be discussed, new methods
of preventing and treating diseases  may be considered, and by their
influence in the State eleemosynary institutions may be  established and
sustained.
   It must be conceded, however, that these associations cannot insist
upon a high standard of qualifications in  the profession.   The State
medical societies cannot rise much  above the level  of the county socie-
ties ; nor can the  American Medical Association rise much  above the
level of the State societies,  for the reason that it is also a representative
body.  In none of them can we insist upon  full  courses of study
in literary institutions, as  the  prerequisites of membership.   To  in-
troduce a subject of  this kind would certainly not  be agreeable to the
majority, and it would soon be dismissed.   As a result we must con-
tinue to  be depreciated by the profession  in all European  countries
and  even by the profession  in the Canadas and in the South American
States
   In a Republic such as ours, there is a disposition to allow the profes-
sions to determine for themselves the qualifications of  their members.
In religion, the several denominations decide what  shall be  the quali-
fications  of those who minister.   In law, the courts are allowed to de-
termine who shall be admitted to practice.   So also in medicine. The
profession is allowed, and  even expected to  make use of  instrumen-
talities ontsidc  of legislation, to secure competent practitioners for the
people.
   Attempts have been made again and again, to  induce the legisla-
tures of  the several States  to interfere, and to fix by statute  the quali- 
8
AMERICAN ACADEMY  OF MEDICINE.
fications of those who practice medicine and surgery ; but without any
very flattering results, as is well known.   The argument which seems
to  carry with it the greatest weight, and which  is generally used
against legislation, is this —that as far as the people  are able to dis-
cover, many of the graduates of chartered medical schools, are quite
as incompetent to practice, as those who have never attended medical
lectures.  Hence the unwillingness of our legislators to prevent non-
graduates from engaging in the practice of medicine.
   Under  these  circumstances, there remains  to us who have spent
many years in preparation  for professional work, but one  alternative
—the organization of a society whose aims and honors arc the highest
—a society whose portals are open to all who have the qualifications,
whether at home or  abroad,  in the army or in the navy, in public or
in private practice, or in retirement.  National boundaries and ethno-
logical differences should form no barrier to membership.
   The general objects of the society to which  we refer may be stated
as follows, namely:
   The extension of  the bounds of medical science ; the elevation of
the profession ;  the  relief of  human suffering, and the prevention of
disease.
 The special objects of the society might be given in the following terms :
   1st. To encourage young men to pursue regular courses of study in
classical, scientific  or literary institutions, before  entering upon the
study of medicine.
   2nd. To bring the alumni  of such institutions in the profession into
c'oser relations with each other, and to perpetuate their names in the
history of the society.
   3d. To secure recognition abroad by medical  associations of the
highest attainments.
   It is apparent  that a society, college or academy whose objects and
aims arc such as these, should be simple in its organic structure. The
constitution might provide for a president, four vice presidents, a cor-
responding secretary, a recording secretary and a treasurer ; and these
might be  elected annually.   The president in concert with the vice-
presidents, might appoint a judicial council, to which all applications
for membership  might be referred ; and to whom all questions of eth-
ics  might also be referred for final adjustment.  This  council might
consist of seven, nine, eleven or thirteen representatives of as many
classical schools ; and to secure an  ever-rising standard of qualifica-
tions, these  might be taken from the schools whose courses of study
are the most extensive. 
ADDRESS.
y
  It is understood that other degrees might be substituted instead of
Bachelor of Arts and Master of Arts, when the courses of study have
been equal as to  time.  A good moral and professional  character is,
of course, implied, and to these  qualifications' might be  added three'
years  of regular practice.   Annual meetings might be held in the prin-
cipal cities in our country, or as  has been suggested, in the towns in
which the leading classical schools are located.  Attendance might be
optional, except in the case of officers.
  The exercises might consist of  an annual address by the president.
one or more prize essays,  reports  of committees appointed to consider
special subjects, and voluntary contributions read in the order in which
they are entered upon the calendar.   To inspect and to arrange these
might be made the work of a special committee ; and the contributors
might be limited to what they have seen, to what they have done, or
to what they have experienced ; thus imitating the Germans and other
continental nations in their contributions to science.
  Accepting, as we  propose  to do, the Cede of Ethics adopted by the
American Medical Association, what should be our relations with other
societies in our country?   To this inquiry there is but ore answer—
We  are benefactors  of our race.   We should, therefore, consider it
our duty to work in other associations, as heretofore, for the good of
our fellow-men and  our profession.  "Our motto might be—Independ-
ence, good will to all, hostility to  none
  In  conclusion,  allow me to  refer to the importance of  securing the
hearty co-operation of the alumni of the leading classical schools in
our country.   With these institutions as the rock upon which to base
our  organization, there can  be no  doubt of  success.  In supporting
and encouraging  them we sustain our profession.  Abandoning them,
we bring dishonor upon ourselves and upon our profession.   The Al-
umni  catalogues  of  these institutions will be  our guide.  In them
we will  find the names of those who have the qualifications for mem-
bership.  Rising, therefore, above the influences of locality, and giving
to our association, what it is  our  privilege to do, a national or cosmo-
politan character, we cannot  fail  to command the respect of the edu-
cated at home and abroad.  In hoc signo vinces.
  Carlisle, Pa.,  Sept. 6, 1876. 
10
AMERICAN ACADEMY OF MEDICINE.
LETTER OF  INVITATION.

         printed june 17, 1876.
-M-&-
                  DEAR SIR-:—You are respectfully invited to assist
in the organization of  a Medical  Society in  the United  States during
this Centennial year, whose active members shall have conferred upon
them by respectable institutions the degrees represented by the abbre-
viations A. B., A. M. and M. D.   It is understood that  other degrees
may be substituted instead of the first two, when the courses of study-
pursued have  been equal as to time.   A good moral character is, of
course, implied ; and to these qualifications may be added three years
of practice.
   Annual meetings may be held  in the principal cities of our country,
but attendance may be optional, except in the case of officers.  The
exercises may be brief, and  limited to a  certain number of  addresses
and prize  cssjiys.  Active members  may be  required to pay a small
suin of money annually to defray necessary expenses.
   Those who have become  distinguished in the  profession, without
the usual  academic degrees, as well as those who have received de-
grees of less value, may be made corresponding members.
   The special objects aimed at may be stated as follows :
   1st.  To encourage young men  to pursue regular courses of study in
classical, scientific  and literary schools of the highest grade, before en-
tering upon the study  of medicine.
   2d. To bring together into closer relations, the  alumni of such in-
stitutions, and to perpetuate  their names in the history of our profes-
sion.
   3d. To secure recognition abroad, by medical societies of the high-
est respectability.
   The general objecis may be briefly stated as follows, namely :
   The extension of the bounds  of medical science;  the elevation of
professional character ; and the promotion of all measures adapted to
relieve the suffering, improve the health and protect the lives of the
people.
   To   secure these objects, in harmony with our  excellent Code of
Medical Ethics, we propose, as a first step, to place before the young 
LETTER OF INVITATION.
11
men of our rapidly growing country, a position of honor, the highest
known among men which can be reached only by patient study and
graduation.
  In  all enlightened  countries, medical  societies are numerous, and
in most cases (our own country being the exception) these are founded
upon degrees.  Conferred by chartered institutions of high grade, de-
grees are everywhere  regarded as evidences of scholarship and pro-
fessional fitness ;  and we  may add, that  they are made the prerequi-
sites of admission into all respectable associations of the kind in Eu-
rope
  It must be plain to  every one who has given this subject any atten-
tion, that if, as  members of American medical societies, we are ever
recognized by European societies, we  must command their respect;
we must show by our actions, that we  appreciate  learning ; and  most
of all, we must do as  they do. separate ourselves from the illiterate.
  We would not, however, coming out  upon an independent basis,
as we propose to  do,  undervalue  the work of  others ;  nor would we
relax our efforts to advance the interests of the medical societies with
which we are at  present connected ; but gathering  up  one here and
there scattered over our own and other countries  alumni of classical
and literary schools—we would,  whilst discussing  the leading ques-
tions  of  medical science, point out the  true path to honor and distinc-
tion.
  To escape the prejudices cf locality, it is proposed to secure the ac-
tive co-operation of one representative from each of the leading classi-
cal  schools in our country, whose duty it shall be  to invite the eligible
alumni of his school,  with whom he is supposed  to  be  acquainted, to


attend a  meeting to be held in                               on the


             day of                        , next, commencing at 3
o'clock in the afternoon, for permanent organization.

  Signed....................................................................................................................................

In behalf of the Alumni of.............................................................................................