THE RISE AND FALL OF THE LICENSED 
PHYSICIAN IN MASSACHUSETTS, 
1781-1860. 
At the Ninth Annual Meeting op the Association op American 
Physicians in Washington, May 29, 1894. 
THE PRESIDENTS ADDRESS 
BY 
REGINALD H. FITZ, M.D., 
OF BOSTON. 
REPRINTED FROM 
THE TRANSACTIONS OF THE ASSOCIATION OF AMERICAN PHYSICIANS, 
1894. THE RISE AND FALL OF THE LICENSED PHYSI- 
CIAN IN MASSACHUSETTS, 1781-1860. 
REGINALD H. FITZ, M.D., 
OF BOSTON. 
Gentlemen : In calling to order the Ninth Annual Meeting 
of our Association I desire to express the highest appreciation for 
the honor yon have bestowed upon me in appointing me to preside 
over your proceedings. To conduct the affairs of so aristocratic a 
democracy has been made a task so easy that the gift of persuasion 
or the knowledge of parliamentary law become wholly unnecessary 
qualifications. The one obligation which has weighed somewhat 
heavily is the thought of the opening address which is to prepare 
the way for such communications as you are to make for the 
advancement of scientific and practical medicine—all the more as 
my own attention has been particularly directed for the past few 
months toward a class of practitioners who have no idea of scien- 
tific medicine, and whose only thought of the practice of medicine is 
how much money can be made out of it. It may not -be uninter- 
esting to learn what men like yourselves, many years ago, did in 
order to discourage such persons—what they planned, what they 
accomplished, and why they failed, I will, therefore, ask your 
attention to the rise and fall of licensed physicians in Massa- 
chusetts, 1781-1860. 
In the “ Records of the Governor and Company of the Massa- 
chusetts Bay in New England” (1854,111., 158) is to be found 
the first legislation concerning the regulation of medical practice in 
Massachusetts. On the 3d of May, 1649, the General Court, 
held at Boston, voted as follows : 
“Forasmuch as the lawe of God (Exod: 20 ; 13) allowes no man to touch 
the life or limine of any pson except in a judicyall way, bee it hereby 2 
FITZ, 
ordered and decreed, that no pson or psons whatsoeuer that are imployed 
about the bodyes of men, woemen, and children for preservation of life or 
health, as phisitians, chirurgians, midwives, or others, shall presume to 
exercise or putt forth any act contrary to the knowne rules of arte, nor 
exercise any force, violence, or cruelty vpon or towards the bodyes of any, 
whether young or old,—no, not in the most difficult and desperate cases—wth 
out the advice and consent of such as are skilfull in the same arte, if such 
may he had, or at least of the wisest and gravest then present, and consent 
of the patient or patients (if they be mentis compotes), much lesse contrary 
to such advice and consent, vpon such punishment as the nature of the fact 
may deserve; woh law is not intended to discourage any from a lawfull vse 
of their skill, but rather to encourage and direct them in the right vse 
thereof, and to inhibit and restrayne the presumptuous arrogance of such 
as through prsefidence of their oune skill, or any other sinister respects, 
dare be bould to attempt to exercise any violence vpon or toward the bodies 
of young or old, to the prejudice or hazard of the life or limme of men, 
woemen, or children.” 
Until the years immediately preceding the War of the Revolu- 
tion there was no more stringent regulation of medical practice 
than this. But in 1760 the city of New York had found it neces- 
sary to regulate the practice of medicine within its limits on account 
of the abundance of quacks preying upon the community. Five 
years later the Medical School of the University of Pennsylvania 
was established, and in the following year the New Jersey Medical 
Society was founded. In still another year the Medical School of 
Columbia College began its career; and in 1771 the colony of New 
Jersey passed its act regulating the practice of medicine, to be fol- 
lowed in 1774 by the abortive attempt in Connecticut. 
The years thus ripe in revolutionary ideas and acts produced 
their fruit in Massachusetts. 
Although there were excellent physicians in the larger cities and 
towns of the Commonwealth, and several of them possessed medical 
degrees received in Europe, they were few and far between. Most 
practitioners had served merely a sort of apprenticeship to their 
seniors. There was no medical school in the State, and but two in 
the country, and these almost as remote as the leading schools of 
Europe at the present day. Anyone undertook the study of medi- 
cine in such manner as he saw fit, and entered his practice with as 
little preparation as he chose. A considerable number of wholly 
unqualified practitioners thus were to be found, a source of danger THE LICENSED PHYSICIAN IN MASSACHUSETTS. 
3 
to the community, a disgrace to the name of physician, and a cause 
of jealously, contention, and distrust, among the members of the 
profession.1 
The example set by New Jersey' and New York was one which 
demanded a speedy following, and thirty-one of the leading physi- 
cians of Massachusetts, sixteen being from towns outside of Boston, 
became incorporated as the Massachusetts Medical Society, “ that a 
just discrimination should be made between such as are duly 
educated, and properly qualified for the duties of their profession, 
and those who may ignorantly and wickedly administer medicine 
whereby the health and lives of many valuable individuals may be 
endangered, or perhaps lost to the community.” 
That this purpose might be carried out, the President and Fel- 
lows of the Society or their appointees from its members were given 
“ full power and authority to examine all candidates for the practice 
of physic and surgery, who shall offer themselves for examination, 
respecting their skill in their profession, and if upon such examina- 
tion the said candidates shall be found skilled in their profession, 
and fitted for the practice of it, they shall receive the approbation 
of the Society in letters testimonial of such examination,” etc. 
They were obliged, under penalty, to hold this examination, although 
candidates were not obliged to present themselves for approval. 
The State thus did not prevent the practice of medicine by any- 
one, but it implied that the letters testimonial of the Society dis- 
criminated between the duly educated and properly qualified, and 
the ignorant and wicked. By the limitation of the maximum 
membership to seventy, admission to the fellowship became a proof 
of distinction which the better educated and higher-minded physi- 
cians were proud to attain. This number, furthermore, gave 
evidence of the comparatively few physicians in the State at that 
time who were considered worthy of this high distinction. In- 
deed, it repeatedly happened in the early life of the Society that it 
was impossible to secure the attendance of a sufficient number of 
Fellows to forma quorum to transact business. 
Two years after the incorporation of the Medical Society the 
Medical School of Harvard College was established; and it was 
1 Proceedings of the Massachusetts Medical Society, 1831,19. 4 
FITZ, 
feared that the power of Harvard College to examine medical 
students and grant degrees in medicine might interfere with the 
authority of the Society to examine candidates for practice and 
issue letters testimonial. According to the memorial of Dr. John 
Warren in 1811, this “ would have produced the most unhappy 
elfects, but for the repeal of an exceptionable article in that establish- 
ment, and the accommodating conduct of those who, at that time, 
were the guardians of science and the patrons of the healing art.”1 
But doubts arose with reference to the duties and powers of the 
Society concerning the examination of candidates and its authority 
to demand and receive compensation for its services, and an act in 
addition to the act of incorporation was passed in 1789. It was 
therein made the duty of the Society, “ in order more effectually to 
answer the designs of their institution, from time to time to describe 
and point out such a medical instruction, or education, as they shall 
judge requisite for candidates for the practice of physic and sur- 
gery, previous to their examination before them .... and 
they shall cause the same to be published in three newspapers in 
three different counties within this Commonwealth.” 
The Society continued to fail in its object to create a proper 
standard of medical qualifications. The population of the State 
rapidly increased, and the number of practitioners likewise. There 
was no sufficient inducement to lead physicians to apply for the 
approval of the Society; and in the first twenty years of its exist- 
ence only some twenty candidates had received the testimonials in 
approval of their professional skill.2 In the same period Harvard 
had conferred its medical degree upon thirty candidates. 
Early in the present century Dr. John D. Treadwell, a young, 
learned, devoted and public-spirited physician of Salem, impressed 
with the inability of the Society to accomplish its aims, endeavored 
to improve its usefulness. An extensive correspondence was insti- 
tuted among the members, and with the assistance of Mr, Sewell, 
afterward Chief Justice of the State, a bill was drafted, which, 
somewhat modified, was enacted in 1803. 
The Massachusetts Medical Society, as it now exists, was then 
1 Dr. S. A. Green’s Centennial Address, Med. Comm. Massachusetts Medical Society, 
1875-81, xii. 639, 654. 
2 Dr. James Jackson’s Speech at the Annual Dinner, 1856. THE LICENSED PHYSICIAN IN MASSACHUSETTS. 
5 
instituted; and its plan of organization became a model for other 
State societies. It was no longer a close corporation with a limited 
membership, but it was possible for every physician in the State to 
become a Fellow. It was only necessary that he should have been 
a student in medicine agreeably to the regulations of the Society, 
and pass a satisfactory examination before the censors, after which 
he received a license to become a practitioner of medicine or sur- 
gery ; “ and after three years of approved practice in medicine and 
surgery, and being of good moral character, and not otherwise,” 
he became a member of the corporation by subscribing to the 
by-laws. 
The medical graduates of Harvard University were made licen- 
tiates without passing an examination, since the right to confer 
degrees had been granted Harvard College long before the Massa- 
chusetts Medical Society was incorporated. “ The only means of 
avoiding collision with that ancient and respectable institution was 
by the compromise which was adopted.” 1 
A duly licensed physician in Massachusetts in 1804 was required 
to give satisfactory evidence of the following qualifications before 
being admitted to examination for the license: Some acquaintance 
with Latin and Greek, and with the principles of geometry and 
natural philosophy ; three full years of study under the direction of 
some respectable physician or physicians whose practice he must 
have attended. During this time he must have read the most 
approved authors in anatomy, physiology, chemistry, materia 
meclica, surgery, and the theory and practice of physic. He was 
examined in physiology, pathology, therapeutics, and surgery. 
There was still no obligation on the part of any practitioner to 
present himself for license; and the only privilege enjoyed by the 
licensed physician, apart from the right to attend the meetings of the 
Society and the use of its libraries, was exemption from service in 
the militia. 
Notwithstanding the Act of 1803 made it possible for every prop- 
erly qualified physician to become licensed and a member of the 
Society, it proved necessary to take farther steps to bring them 
within the fold, and in 1806 a by-law was passed in the following 
terms : 
1 Proceedings Massachusetts Medical Society, 1831, 26. 6 
FITZ, 
“To promote the laudable design of the Legislature, in forming and incor- 
porating this Society, to prevent as far as may he all unqualified persons 
from practising medicine or surgery, and in order to discourage empiricism 
and quackery: it shall he deemed disreputable and shall be unlawful, for any 
fellow of this Society, in the capacity of physician or surgeon to advise or 
consult with any person, who having been a fellow of the Society, shall be 
expelled therefrom, or with any person whatever, who shall thereafter com- 
mence the practice of medicine or surgery within this Commonwealth, until 
he shall have been duly examined and approbated by the censors of the 
Society or by those of some district society,” etc. 
The object of this by-law was to guard the public against igno- 
rant, designing, and unscrupulous pretenders. The Society had 
provided the means by which physicians could give evidence of 
having followed a suitable course of study, and it wTas its duty to 
inform the public that if it employed unlicensed practitioners it 
must suffer the consequences. 
Despite these attempts at compelling practitioners to become 
educated physicians, the standard was evidently too high for all to 
attain. Many could not comply with the requirements; others did 
not find a sufficient inducement in the honors and privileges be- 
stowed by the Society. The Thomsonians, then beginning their 
career, required no education and no license. There was no law to 
prevent their entering practice; and Chief Justice Parsons1 had 
then made his famous decision in the case of the Commonwealth v. 
Thomson, “ that if the prisoner acted with an honest intention and 
expectation of curing the deceased by this treatment, although 
death, unexpected by him, was the consequence, he was not guilty 
of manslaughter There is no law which prohibits 
any man from prescribing for a sick person with his consent if he 
honestly intends to cure him by his prescription; and it is not 
felony, if through his ignorance of the quality of the medicine 
prescribed or of the nature of the disease or of both, the patient, 
contrary to his expectation, should die.” 
The Chief Justice evidently felt that there was likely to be need 
of some legislation which should prevent the occurrence of such 
cases, for he closes his decision by saying :2 “Itisto be exceedingly 
lamented that people are so easily persuaded to put confidence in 
these itinerant quacks, and to trust their lives to strangers without 
1 Massachusetts Reports, 1809, yi. 134. 
2 Op. cit., p. 142. THE LICENSED PHYSICIAN IN MASSACHUSETTS. 
7 
knowledge or experience. If this astonishing infatuation should 
continue, and men are found to yield to the impudent pretensions 
of ignorant empiricism, there seems to be no adequate remedy by 
a criminal prosecution, without the interference of the legislature, 
if the quack, however weak and presumptuous, should prescribe 
with honest intentions and expectations of relieving his patients.” 
In 1811 an unsuccessful attempt was made to incorporate a rival 
society with the same privileges as those enjoyed by the Massachu- 
setts Medical Society, under the title of the Massachusetts College 
of Physicians. The announced reason was that two societies were 
better than one; the real object was thought to be the establishment 
of a new medical school. The Massachusetts Medical Society 
strongly opposed the scheme, on the ground that it was unnecessary 
and would lead to the rejected candidates of the one society being 
accepted by the other, whatever might be their qualification, thus 
producing disagreements and animosities injurious to the profession 
and to the public.1 
It is possible that in consequence of the recommendation of Chief 
Justice Parsons, certainly with the view of discouraging quackery, 
which was rapidly increasing under the influence of Thomson, the 
legislature in 1818 passed its first “ Act regulating the Practice of 
Physick and Surgery,” which was supplemented in 1819 by “an 
Act in addition to an Act entitled lan Act regulating the Practice 
of Physick and Surgery.’ ” 
According to the first of these Acts, no person entering the 
practice of physic and surgery within the State could recover by law 
any debt or fees for his professional services unless he had received 
a medical degree from some college or university, or had been 
duly licensed by some medical society or college of physicians, 
or by three Fellows of the Massachusetts Medical Society, desig- 
nated in each county by its councillors, with power to examine 
candidates and grant licenses. Copies of these licenses were to be 
deposited with the clerk of the town, district, or plantation in which 
the licentiate resided. 
In the Act of 1819, that the physician might recover his debts 
by law, it was necessary that he should be a licentiate of the Society 
1 Dr. S. A. Green, loc. cit., p. 651. 8 
FITZ, 
or a medical graduate of Harvard. If the candidate for the 
license was educated out of the State, the censors might waive a new 
examination if they were satisfied that he had received an education 
agreeably to the regulations provided by the Society. 
It is stated1 that this difficult trust was accepted' with reluc- 
tance,2 that the law was not sought for by the Society, and that it 
was doubtful whether its action was not rather injurious than ben- 
eficial. Of this law Chief Justice Shaiv said :3 
“It appears to us that the leading and sole purpose of this act was to 
guard the public against ignorance, negligence, and carelessness in the 
members of one of the most useful professions, and that the means were 
intended to be adapted to that object. If the power of licensing were given 
to the Medical Society exclusively, there would be much more plausible 
ground, at least, to maintain that the power was conferred on a body who 
would have a temptation to abuse it, so as to promote their private interests; 
but where the power is conferred equally on the university charged with the 
great interests both of general and professional education, and which can- 
not be perceived to have any such interest, that ground of argument seems 
to be wholly removed, and it seems difficult to perceive how a power which 
it is important to the community should be placed somewhere could be 
placed more safely. The courts are all of the opinion that the law in ques- 
tion is not repugnant to the Article of the Bill of Rights, above cited, and 
that its validity cannot be impeached on the ground that it is a violation of 
any principle of the constitution.” 
The licensing of physicians by the Society doubtless aided in 
restraining a certain number of practitioners from adopting some 
of the methods of the charlatan ; but it did not interfere with the 
encouragement of the latter by the community. I am indebted to 
Dr. John Homans, 2d, for the opportunity of quoting from a 
letter of Dr. George C. Shattuck to Dr. Homans, written July 26, 
1828. It gives evidence of the fondness for quackery in Boston 
at that time. 
“The city has 60,000 (inhabitants?) and seventy-one regularly bred physi- 
cians. About one-half, from either youth or age, have not much to do. 
The irregular physicians are numerous, at the head of which, in popular 
influence, we may place Thomson, who has formed his botanical society, 
who have individually learned his system of practice by hot drops and 
sweating, etc. The disciples of this system, perhaps, may embrace one- 
1 Proceedings Massachusetts Medical Society, 1840, p. 68. 
2 Loc. cit., 1831,10. 8 Hewitt v. Charier, Jr., 16 Pick., 355. THE LICENSED PHYSICIAN IN MASSACHUSETTS. 
9 
sixth of the population of Boston. The patent medicines are employed in 
about, I believe, another sixth of the cases.” 
In 1831 the Society had reached such a degree of success in 
carrying out the objects of its incorporation that it included in its 
ranks “ nearly every educated practitioner of medicine or surgery 
in the State.1 
The line of distinction was so strongly drawn between its mem- 
bers and irregular practitioners “ that the profession is no longer 
made responsible in the minds of men for the consequences of their 
ignorance and malpractice, nor its harmony disturbed by their mis- 
conduct ; and they are much less successful than formerly in divert- 
ing the confidence of the community from regular physicians to 
themselves.” 2 
At this time, however, there were certain discordant elements 
within the Society which threatened its prosperity and usefulness. 
Some of the younger physicians were dissatisfied with the clause in 
the act of 1803, which demanded a period of three years of proba- 
tion in practice before admission to full membership in the Society. 
The legislature was therefore requested to repeal this clause, which 
it did by a special act in 1831, and approved candidates became at 
once Fellows of the Society. 
A more serious disturbance, which menaced the harmony and 
influence of the Society at this time, was the appeal to the legisla- 
ture from the physicians of Berkshire county, in the western part 
of the State. They desired to be incorporated as an independent 
body, nominally on account of their distance from the headquarters 
of the Society, their limited privileges, and their dissatisfaction 
with the requirements of the censors. It was supposed that this 
action was largely planned in the interests of the Berkshire Medical 
Institution, a medical school incorporated in 1823, but without the 
authority to confer the degree of Doctor of Medicine.3 It was 
situated in Pittsfield, and was practically a department of Williams 
College (not far distant), which had the power to confer degrees, 
but no medical faculty or medical school. Williams College sanc- 
tioned the degree of the candidates educated at the Berkshire 
Medical Institution. The conditions of this alliance proved im- 
1 Proceedings Massachusetts Medical Society, 1831,18. 
2 Loc. cit., 1831,19. 3 x,o 
3 Loc. cit., 1836, 25. 10 
FITZ, 
portant in the courts1 when the honorary degree of M.D. from 
Williams College was offered in evidence as a legal qualification. 
It was decided that it was invalid, since the defendant must have 
both the education and the degree to be a legally qualified practi- 
tioner. 
In the year following the incorporation of the Berkshire Insti- 
tution it had petitioned the legislature to be granted the same priv- 
ileges as belonged to the medical graduates of Harvard University, 
the most important of which was that of being acknowledged and 
received by the Massachusetts Medical Society without examination 
as regular practitioners of medicine and surgery. At that time 
this petition was successfully opposed, on the ground that the 
Berkshire Institution had no independent board of overseers like 
Harvard College, and therefore was not under the same restrictions 
and oversight. The petition to form an independent society was also 
successfully opposed; but in 1837, with the approval of the 
Society, an act was passed, according to which graduates of the 
Berkshire Medical Institution were “ entitled to all the rights, 
privileges, and immunities granted to the medical graduates of 
Harvard College.” 
The rights and privileges of the licentiates of the Massachusetts 
Medical Society had been somewhat extended by the Anatomical 
Law of 1834, according to which “ the dead bodies of such persons 
as it may be required to bury at the public expense might be sur- 
rendered to any regular physician duly licensed according to the 
laws of this Commonwealth.” 
The State had thus definitely committed itself to the regulation 
of the practice of medicine by the acts of 1818 and 1819, and had 
placed the duty of licensing practitioners in the hands of the 
Massachusetts Medical Society. It conferred but few privileges on 
the licensed, namely, exemption from militia service and jury duty, 
the right to obtain and dissect the unclaimed bodies of those to be 
buried at the public expense, and to collect fees by law. But un- 
licensed physicians could take their pay in advance, and were not 
desirous of the privilege of consulting with the members of the 
Society. The Thomsonian movement was rapidly spreading 
throughout the country, appealing to the people by its simplicity 
1 Wright v. Lanckton, 19 Pick., 291. THE LICENSED PHYSICIAN IN MASSACHUSETTS. 
11 
and economy, its dogmatic assertions and reports of wonderful 
cures, its advocacy of vegetable remedies, and its cry of persecution. 
The eiforts of the Society to include within its ranks all educated 
practitioners, led in 1836 to the recognition of dentists as practi- 
tioners of medicine, since dental surgery was being studied and 
pursued scientifically by gentlemen of regular medical education.1 
In the following year a further attempt was made in this direc- 
tion by requiring that every licentiate or medical graduate of Har- 
vard or Berkshire entitled to admission to the Society must enter 
within a year after being so entitled or be deemed an irregular 
practitioner. This term was applied to all practitioners in the 
State who were not fellows or licentiates of the Society, or doctors 
in medicine of Harvard or Berkshire. The above regulation was 
repealed three years later, since it took away “ the freedom originally 
intended to be allowed to all regular physicians to join the Society 
or not, as they pleased,” and stigmatized “ as irregular practitioners 
gentlemen who have been recognized as competent physicians merely 
for the exercise of this freedom.”2 
In 1836, the Statutes of the Commonwealth were revised, and 
the report of the commissioners (1835, Part 1., 125) includes all 
the legislation previously enacted, placing the control of the licens- 
ing of physicians in the power of the Society. But the Legislature 
did not accept the first section, which read as follows : 
“No person who has commenced the practice of physic or surgery, since 
the year one thousand eight hundred and eighteen, or who shall hereafter 
commence the practice thereof, shall he entitled to maintain any action for 
the recovery of any debt or fee accruing for his professional services, unless 
he shall, previously to rendering these services, have been licensed by the 
officers of the Massachusetts Medical Society, as hereafter provided, or shall 
have been graduated a doctor in medicine in Harvard University, or in the 
Berkshire Medical Institution, by the authority of Williams College.” 
It also negatived a clause making the neglect to record a license 
a like disqualification to its non-possession. The Legislature ap- 
proved this part of the report of the committee with the above 
exceptions, and it became Chapter 22 of the Revised Statues en- 
titled “Regulations Concerning the Practice of Physic and Sur- 
1 Proceedings of the Massachusetts Medical Society, 1836,116. 
2 Ibid., 1840, 72. 12 
FITZ, 
gery.” According to Dr. J. Mason Warren/ the first section was 
omitted in accordance with the wishes of the greater part of the 
(State Medical) Society ... as being in its action adverse to 
their interests. It served merely to excite sympathy, especially for 
the Thomsouiaus, and could not prevent them from receiving fees 
for services rendered. 
The Society continued in its work of licensing physicians with- 
out apparent disturbance until 1848. At this time its effect in con- 
trolling the conditions of medical practice in the State is thus 
expressed by Dr. A. L. Peirson, of Salem, in behalf of a committee 
of which he was chairman:2 
“We have steadily elevated our profession, by improving medical educa- 
tion, encouraging the harmony and honorable intercourse of its members, 
and have protected from the mischief of quackery, by discouraging every 
show of it among regular practitioners. This simple and efficient plan of 
the Society has accomplished all that was ever intended by its organization 
in 1803. . . . It is to be regretted that from natural causes, no way to 
be attributed to the form of organization, the concentrated action of the 
Society has not been equally felt in all parts of this extended Common- 
wealth.” 
According to Dr. Z. B. Adams,3 there were at this time 1237 
medical practitioners in Massachusetts, most of whom belonged to 
the Massachusetts Medical Society. 
On the contrary, Dr. J. V. C. Smith presented the minority 
report of the same committee, in which he states:4 
“ The Society was once eminently useful in protecting the community 
from the encroachment of ignorant pretenders, . . . and it must be 
obvious to all that circumstances have greatly changed, our legislative tables 
have been completely turned, and will probably ever remain so. A license, 
or medical degree, is no longer requisite for the practice of medicine in 
Massachusetts, and no laws of the State, or of the Massachusetts Medical 
Society, are of any avail in guarding the entrance into the profession, or 
regulating the conduct of its members. . . . Less than one-half of the 
regular practitioners of medicine now nominally constitute the Society. In 
Berkshire, there are one hundred; less than twenty belong to the Society, 
In Hampden, one hundred and thirty (about) • and of this number only 
1 Transactions of the Medical Society of the State of New York, 1844,1845,1846, vi. app. 40. 
2 Proceedings of the Massachusetts Medical Society, 1848,142. 
3 Transactions of the American Medical Association, 1848, i. 366. 
* Proceedings of the Massachusetts Medical Society, 1848,150. THE LICENSED PHYSICIAH IN MASSACHUSETTS. 
13 
about twenty or twenty-five are members of the State Society. In some 
other counties there is doubtless a majority, while in others not one-half of 
the regular physicians are members. The number of Fellows of the Massa- 
chusetts Medical Society is not far from seven hundred, which is not prob- 
ably one-half of the physicians in the State.” 
These reports were called forth by a resolution presented by Dr. 
Childs, of Pittsfield, involving a change in the organization of the 
Society for the purpose of advancing medical science, promoting 
harmony and good feeling in the profession, thereby contributing 
to the best interests of society. 
Although the councillors largely favored the views expressed in 
the majority report, the existence of a considerable degree of dis- 
satisfaction and the necessity of remedying it was apparent in the 
appointment of a committee to consider the question of altering the 
by-laws. This committee consisted of Drs. John Ware, A. L. 
Peirsou, W. Lewis, J. Jeffries, J. Y. C. Smith, H. H, Childs, and 
John C. Dalton. The report of this committee is especially valu- 
able from the character of the latter and the recognition of the 
necessity of the Society to increase and consolidate its strength. 
They stated1 that many members had often expressed the opinion 
that the society as constituted did not accomplish all of the purposes 
of which it was capable—and failed to secure the favor of the pro- 
fession in remote parts of the State. Consequently only a limited 
number of physicians found it for their interest to become members. 
They were called upon to obey laws which they had no voice in 
making, and to contribute to the expenses of an organization in 
which they found it difficult to take part. The Society is but little 
known to those among whom they are thrown, thus has but little 
influence over them, and it is not necessary to their reputable stand- 
ing among physicians nor to their success with the community that 
they should be connected with it. 
The committee reported various amendments to the by-laws in- 
volving favorable action of the Legislature which took place in 
1850. By-law Y. permitted any reputable practitioner of medicine 
or surgery who had been in practice not less than fifteen years, to 
be admitted a Fellow, previously to 1852, by the District Society 
where he resides, by a vote of two-thirds of the members present 
at any stated meeting. 
i Ibid., 155. 14 
FITZ, 
The Society was thus endeavoring to increase its influence in the 
one direction by licensing as many educated and intelligent physi- 
cians as possible, and even without examination in certain instances. 
This liberality, however, was to be controlled by what many now 
see to have been an unwise policy, namely, the treatment of the 
homoeopathists. 
In 1846,1 an applicant for membership stated that he had great 
confidence in the efficacy of medicine “ especially when prepared 
and prescribed agreeably to the directions of Hahneman.” The 
councillors referred the application to the censors, with full powers 
to settle the matter, and they admitted the applicant to membership. 
In the meantime the influence of homoeopathy was increasing, 
and in 18502 it was moved “that all homoeopathic practitioners 
are, or should be, denominated irregular practitioners, and, accord- 
ing to the By-Laws of this Society, made and provided, ought to 
be expelled from membership.” This resolve was tabled on motion 
of Dr. Bigelow. 
At the next meeting Drs. Hayward, O. W. Holmes, and J. B. S. 
Jackson were appointed a committee “to devise some course of 
action, to be pursued by the Society, in regard to all homoeopath- 
ists.” This committee reported as follows :3 
“ (1) Resolved, That any Fellow of this Society who makes application to 
resign his Fellowship in consequence of having adopted the principles and 
practice of homoeopathy may be permitted to do so on paying his arrear- 
ages ; but he shall not be entitled to any of the privileges of Fellowship, 
nor shall his name be retained in the List of Fellows. 
“ (2) Resolved, That a diploma from a homoeopathic institution shall not 
be received as any evidence of a medical education ; nor shall the Censors 
of the Society regard the attendance on the lectures of such institutions, 
nor the time passed at them, as qualifications which shall entitle candidates 
to an examination for a license from this Society.” 
This report was adopted. Three years later the question of 
homoeopathy was again brought before the Society at the annual 
meeting.4 The Essex North District Society there presented the 
following resolution: 
“Forasmuch as there is no common ground of support or sympathy 
between homoeopathy and allopathy; 
i Loc. cit., 1846,108. 
3 Loc. cit., 1850, 51. 
2 Proceedings Massachusetts Medical Society, 1850, 82. 
* Loc. cit., 1853,102. THE LICENSED -PHYSICIAN IN MASSACHUSETTS. 
15 
“Resolved, That it the homoeopaths are allowed to retain their regular 
standing in the Massachusetts Medical Society, and claim fellowship and 
counsel with allopaths, we, as consistent and conscientious individuals, 
request to he honorably discharged from our allegiance and connection with 
the parent Society.” 
Dr. Spofford presented the following resolution : 
“ That, while we recognize the right of regular physicians to use medicine 
in any quantity or doses which they may consider useful to their patients, 
we consider all use of the name of homoeopathy in public papers, on signs or 
otherwise, as quackish and disreputable, and that all persons who make 
pretensions to homoeopathic practice ought to be excluded from the Society.” 
These resolutions, together with the whole subject, were referred 
to the councillors, who appointed the following committee to report 
upon them: Drs. Bigelow, Metcalf, M. Wyman, Spofford, and 
Alden. Dr. Jacob Bigelow reported in February, 1854, and his 
report was laid on the table. 
In the next year1 the censors of the Suffolk District Society 
rejected a candidate for admission who avowed himself practising 
upon the principles styled homoeopathy, on the ground that he was 
not “ fitted for the practice of medicine.” It was voted (February 
7, 1855), on motion of Dr. Bowditch, “that the councillors ap- 
prove of the course adopted by the censors of 'the Massachusetts 
Medical Society for Suffolk District.” 
In the following June this district society called the attention of 
the general society to defects in the By-laws concerning the expul- 
sion of members, with reference to a remedy; and this question, 
together with that concerning the admission of members, was re- 
ferred to a committee for a report. A few days later the latter 
reported. Their report was referred to the councillors for adoption. 
They, in turn, referred the report to a committee, which altered the 
recommendations; these were adopted by the councillors in Feb- 
ruary, 1856, and by the Society on May 29, 1856. 
These alterations made it possible to expel a member for any 
breach of the By-laws, for which censure, expulsion, or depriva- 
tion of privilege was a penalty, and for any conduct unbecoming 
and unworthy an honorable physician and member of the Society, 
in addition to causes hitherto deemed sufficient. A carefully 
i Loc. cit„ 1855, 7. 16 
FITZ, 
arranged method of conducting trials for offences was also pro- 
vided. The report of the committee of the councillors recommend- 
ing these alterations stated that they had no definite measures to 
offer with regard to homoeopathy, and submitted the subject to the 
judgment of the councillors. This part of the report was laid on 
the table without debate.1 
June 3, 1856, four days after the adoption of the amended re- 
port by the Society, the Homoeopathic Medical Society was incor- 
porated by the Legislature. It was authorized to examine all 
candidates for membership, and, if qualified, give them the appro- 
bation of the Society. Its members were declared exempt from 
militia service. 
In the following year the motion that all candidates for the Fel- 
lowship be examined by the censors was referred to a committee, 
reported upon favorably, and the Legislature passed a special act 
March 5, 1859, making this method the law. 
At this time the revision of the statutes was again under consid- 
eration, and the Commissioners had made their report to the Legis- 
lature, in which the existing laws concerning the regulation of the 
practice of medicine were included. This report was referred to a 
joint committee, which was subdivided into special committees. 
The general committee referred the chapter concerning the regula- 
tion of medical practice to one of these special committees on May 
16, 1859. It instructed this committee— 
“by special order, to inquire into the expediency of omitting all that part 
of the chapter relating to the Massachusetts Medical Society and to the 
regulation of the practice of medicine; and on the 21st of May they re- 
ported to the general committee amendments striking out every section, and 
every line, and every word in that chapter which gave the Massachusetts 
Medical Society any power to examine or license physicians or surgeons, 
or to prescribe a course of study and qualifications for physicians or sur- 
geons.” 2 
Four days later the councillors appointed a committee consisting 
of Drs. J. Bigelow, A. A. Gould, J. Jeffries, G. C. Shattuck, H. 
J. Bigelow, H. H. Childs, and J. G. Metcalf, and “ instructed them 
to look after the interests of the Society in the Legislature,” and 
1 Loc. cit., 1856, 35. 
2 Argument of J. H. Benton, Jr., before the Committee on Public Health, 1885. THE LICENSED PHYSICIAN IN MASSACHUSETTS. 
17 
they were “ authorized to take such measure to protect their inter- 
ests as they may deem expedient.”1 
But, in the words of Mr. Benton— 
“The general committee adopted these proposed amendments, with the 
addition of a change of title of the act from ‘ Regulations concerning the 
practice of physic and surgery’ to ‘ of the promotion of anatomical science/ 
and that chapter now stands, with the same title as Chapter 81 of the Public 
Statutes. All the amendments were adopted by the Legislature, and were 
enacted December 28, 1859 The Legislature then deliberately 
took out of the law of the Commonwealth every provision for the regula- 
tion of the practice of medicine or surgery, or for the examination or quali- 
fication of physicians or surgeons.” 
The committee of the Society appointed to look after its interests 
in the Legislature recommended, October 5, 1859, that “ no person 
shall hereafter be admitted a member of the Society who professes 
to cure diseases by spiritualism, homoeopathy, or Thomsonianism,” 
which was adopted. As evidence of the state of feeling at the 
time, it may be said that at the meeting at which this resolution 
was approved it was voted that the Society disclaim all responsi- 
bility for the sentiments contained in the annual address of the day 
previous. This had been delivered by Oliver Wendell Holmes, 
and was entitled “ Currents and Counter-currents of Medical 
Science.” 
Thus we see that the Massachusetts Medical Society was organ- 
ized in 1781 with the express purpose of making a just discrimina- 
tion between duly educated and properly qualified practitioners and 
those who ignorantly and wickedly administer medicine. For 
many years its Fellows acted most judiciously in endeavoring to 
include within their number every educated and moral practitioner 
in the State. They accomplished this largely by the force of ex- 
ample, association, and united encouragement. The State made 
them the sole source of licenses to practise. The progress of 
Thomsonianism left their responsibilities essentially intact. The 
advent of homoeopathy found them weak where they should have 
been strong—short-sighted where they should have been far-seeing. 
The leaders were obliged to follow, and the reproval of the censors 
prevailed against the wisdom of the councillors. 
1 Proceedings Massachusetts Medical Society, 1859,112. 18 
THE LICENSED PHYSICIAN IN MASSACHUSETTS. 
Homoeopathic diplomas and homoeopathic certificates are now 
accepted by the Society. Homoeopathic physicians have been found 
fitted to practise by the great public, which decides this question 
for all. Ten years of increasing intolerance destroyed seventy 
years of enthusiastic effort, devoted labor, tactful management, and 
wise counsel in the public interest. The State revoked the control 
of medical practice, and the people have been the sufferers. The 
history of Massachusetts in this respect is the history of the 
country. She was one of the last of the States to lay down the 
control, and she will be one of the last to resume it. 
Thanking you for the patience with which you have listened to 
an historical narrative which offers but little in the way of moral 
or example to our own Association, we will proceed to the business 
of the day.