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Medical Legislation, 
BEING THE 
Annual before the State iftectieat 
j BY 
r 
Nicholas Senn. m._D.. President, 
OF MILWAUKEE. 
Reprint from the Transactions of the Wisconsin State Medical Society. 
MILWAUKEE: 
PRINTED BY THE SENTINEL COMPANY. 
1879. MEDICAL LEGISLATION. 
The Annual Address before the Wisconsin State Medical Society. 
A 
BY NICHOLAS SENN, M. D., PRESIDENT, 
OF MILWAUKEE. 
Medical legislation has always been a perplexing subject to the state 
and the medical profession. Laws regulating the practice of medicine 
have been established by almost every well-organized government from 
an early date to the present time. Changes in the form and requirements 
of such laws became necessary from time to time to adapt them to the 
existing condition of medical science, and the facilities for obtaining a 
knowledge of the same. Restriction and regulation in the practice of 
medicine have been exercised by autocratic and democratic forms of 
government; they can, therefore, not be considered as infringements 
upon the liberties of the people, but must be regarded as a part of gene- 
ral legislation, the latter having for its object the protection of life and 
property, and the preservation of health. The little republic of Switzer- 
land, with its model form of government, probably exacts higher attain- 
ments from its practicing physicians than any other country in the world. 
The object of medical legislation should be to protect the educated 
physician, to sustain the honor of the profession, and to guard the people 
against the impositions of ignorant pretenders. As this subject is now 
attracting well-merited attention in this and other states, I have deemed 
it appropriate to call your attention, on this occasion, to the history of 
medical legislation, at the same time alluding occasionally to the educa- 
tional advantages and social standing of medical men at different times. 
The organization of the medical profession is the gradual growth of 
the wants or necessities in the various localities, without any precon- 
certed or consistent plan. As a rule, the highest standard of medical 
education, and the most stringent restrictions in the practice of medicine, 
have at all times existed among nations of the highest degree of civiliza- 
tion, and endowed with the most perfect form of government. 2 
Mediml Legislation. 
During the infancy of nations medicine constituted a part of religion, 
and its practice a religious act. Medicine and religion are closely allied, 
outgrowths from the same noble desire to benefit mankind. The early 
priest, animated by a sense of duty and love, aside from his sacred duties 
ministered to those of his charge who suffered from accident or disease. 
Medicine became a science and a distinct profession as soon as civiliza- 
tion had advanced sufficiently that man was led to inquire into the 
mysterious structure of his own body, and into the nature of disease,— 
investigations which gradually developed a rational course of treatment. 
The office of physician appears to have become distinct and separate at 
an early day. 
Siracli alludes to the physician as follows: “ Honor to the physician! 
His knowledge allows him to walk with the head erect, and entitles him 
to the respect of princes. If you feel sick, pray to God and send for the 
physician; a wise man does not despise the remedies of the earth.” 
Among the Hebrews, the Levites acted as priests and physicians. In 
Egypt, the physicians were all specialists, each one devoting his whole 
time and attention to the diseases of some particular part or organ of the 
body. They were classified according to their degree of learning, and 
received about one-third the nation’s income. In India, the Brahmin, or 
priest, acted also as physician. From early childhood he received a 
careful theoretical and practical training. Many admirable qualities 
were required of him: He must be well built, impassionate, sober, 
affable, true, diligent, earnest, modest, virtuous, and not despise even the 
doctrines of his enemies. He must be cleanly in his habits, his finger- 
nails must be cut short, and his clothes perfumed. How many of these 
excellent and desirable qualities can be justly attributed to the physician 
of the present time? In Persia, the physician had to submit to a practi- 
cal test before he was permitted to practice. He was required to operate 
upon three unbelievers; if they all died he was rejected; if they all 
recovered he entered the ranks of the regular profession, and was allowed 
“to cut the believers as he may think proper; he may cure by cutting as 
he may deem necessary.” Among the aborigines of this country, the 
Tla-qill-augh constituted the spiritual and medical advisor. His duties 
were laborious and manifold. He was not only consulted as priest and 
physician, but his advice was sought on subjects of the most diverse 
nature. He commanded the respect of his people, and occupied a prom- 
inent position in public and private affairs. 
In China and Japan the medical profession has always been over- 
crowded, from the fact that with the exception of the court physicians, 
no examination has ever been required to admit them to the practice of 
medicine. They obtained their limited knowledge by reading their Medical Legislation. 
3 
books, which are quite numerous. In Turkey the same freedom exists 
to the present day; only the military surgeons are as a rule well quali- 
fied, being required to study ten years, four of which are spent in acquir- 
ing a preliminary education, and six years in the medical college. 
Greece, for a long time the cradle of art and science, and the home of 
distinguished philosophers, was the first country where ignorance and 
superstition yielded to rational medicine, based upon scientific principles. 
A thorough preliminary education in reading, writing, computations, 
geometry, astronomy, and music was required as a prerequisite to the 
study of medicine. The temples of AEsculapius, called the Asclepions, 
were the great centres of medical knowledge. They served not only as 
places for instruction, but as habitations for the sick, and may be regarded 
as the earliest attempts in the establishment of regular hospitals. The 
physicians in attendance, called asclepiadse, instituted a systematic course 
of medical instruction, embracing three distinct grades. After having 
undergone a process of purification before admission, consisting in an 
elementary training in arithmetic, geometry, stereometry, music, and 
astronomy, the student was admitted to the first grade, called illumination, 
or the study of theorems, logical, political and philosophical; in other 
words, the study of abstract principles. The next grade was called 
inspection, and had reference to practical training—the study of disease 
at the bedside. The last stage, termed coronation, was equivalent to our 
graduation. The candidate, after a solemn ceremony, was invested with 
a crown or wreath, and received authority to practice his profession, and 
impart his knowledge to others. To pass through these degrees required 
not less than five years. During the time of Hippocrates, some localities 
required a certificate of proficiency from some noted practitioner, to 
enable the applicant to practice medicine, but in most places no such 
restriction existed. As a natural consequence, the country became infested 
by innumerable quacks, “ against whom the regular physician had no 
redress, except a superior education, earnestness of purpose, a devotion 
to his duties, and the confidence of a discerning public.” The excessive 
competition, the envy, and, most of all, the dishonest practice of the 
charlatans, so lowered the medical profession in the estimation of the 
laymen, that by many the practice of medicine was considered a dis- 
honest, disreputable trade. With the exception of a few eminent men, 
the physicians were not honored, but despised by the people. Hippoc- 
rates attributed this loss of confidence to its proper source. He says: 
“The never-ceasing strife among medical men brings the'healing art in 
discredit among laymen to such an extent that they no longer believe in 
the existence of this art. In the treatment of acute diseases the practice 4 
Medical Legislation. 
among physicians is so varied, that what one adopts as a remedial agent 
is condemned as dangerous by another.” 
Sad as this picture may appear, it only reflects to a great extent the 
condition of things as they exist among us to-day. The same dishonest 
rivalry, the same satanic jealousy, the same shameful attempt to stain the 
reputation of a fellow practitioner, are manifested only too often at the 
present time; perhaps not so openly and directly, but by sly hints and 
insinuations that can leave no doubt as to their intentions. It is not 
surprising, then, that we are often estimated and judged by the people in 
about the same ungracious manner as our predecessors more than two 
thousand years ago. The blame rests not so much upon the people as 
upon the profession itself. To remedy this evil, and gain the confidence 
of the public, we must elevate ourselves and seek to expel from our ranks 
the element that has during all times dragged the profession into dis- 
grace—the quacks. To these Hippocrates fittingly alludes: “Medicine 
is of all the arts the most noble; but, owing to the ignorance of those who 
practice it, and of those who inconsiderately form a judgment of these, 
it is at present far behind all other arts.” “Their mistake appears to me 
to arise principally from this: that in the cities there is no punishment 
connected with the practice of medicine, except disgrace, and that does 
not hurt those who are familiar with it. Such persons are like the figures 
which are introduced in tragedies; for, as they have the shape, and dress, 
and personal appearance of actors, so also physicians are many in title, 
but few in reality.” 
During the time of Aristotle, the medical profession was divided into 
three classes: 1. Apothecaries, whose exclusive business consisted in 
preparing and dispensing medicines. 2. Physicians engaged in general 
practice. 3. The medical philosophers, who pursued the study of medi- 
cine as a liberal science only, without relying upon the practice of medi- 
cine as an industrial occupation. 
When Greece became involved in a succession of bloody wars with 
its northern neighbors, it no longer remained the centre of education in 
the world—a position it had occupied for centuries. The tender plant of 
art and science which had prospered in its fertile soil, withered from 
want of care, and was conveyed to Alexandria, where it received the 
most careful attention on part of the government. The first teachers in 
the Alexandria school were obtained from Greece. The system of instruc- 
tion was divided among the four faculties of literature, mathematics, 
astronomy,and medicine; to these special departments were added. For 
the purpose of stimulating study and of increasing the reputation of the 
school, prizes were awarded to the students that distinguished themselves. 
On one occasion, as a prize was about to he awarded for the best compo- Medical Legislation. 
5 
sition, Aristophanes, the grammarian, pointed to the very volume in the 
library from which it was copied verbatim. This illustrates how prizes 
are sometimes obtained. During the early history of the Alexandrian 
school, dissections were practiced, but were again abandoned on account 
of an uncontrollable prejudice and superstition among the people; and 
thus the study of medicine was reduced to a mere department of specu- 
lative knowledge. 
During the early history of Rome, the medical profession of that city 
was in a deplorable condition. Physicians occupied such an inferior 
position in society, that it was considered beneath the dignity of a Roman 
citizen to become a physician. The sick were attended by slaves. The 
first physicians of ability came from Greece, and soon established them- 
selves in the confidence of the people. Among the first who became 
prominent was Archagatus, who was made a citizen of Rome, and was 
held in high estimation. His career in Rome illustrates well the tran- 
sient character of public opinion. After he had performed several opera- 
tions, the results of which did not satisfy the expectations of the people, 
he wras called carnifex, and he, with many of his native colleagues, had 
to leave the country for their personal safety. This new outbreak of 
animosity towards the physicians was excited by the dishonest practice 
of quacks, by men who had come to Rome for the purpose of practicing 
medicine without being qualified, the only object being to acquire wealth. 
In many instances the people were not only maltreated, but robbed, by 
these pretenders. This was carried to such an extent that Galen was 
induced to say, “ There is no difference between robbers and physicians, 
except that the former live in the mountains and the latter in Rome.” 
That the people then were as incompetent to distinguish between the 
physician and quack as they are now, is evident from what Galen says 
further: “The public does not call into requisition the best physicians, 
but those who flatter their whims. Where nobody takes into considera- 
tion qualification, in the choice of a physician, but the skillful and 
ignorant are estimated alike, then each one of them will have in view 
what yields income with the least exertion.” 
Medicine again became appreciated by the Romans through the influ- 
ence of their philosophers, orators and statesmen. The study of philos- 
ophy was so intimately associated with that of medicine, that these 
persons became familiar with it during their pupilage. They learned to 
appreciate the value of medicine and respect it as an art. Cicero alludes 
to the profession as follows: “Licet enim omnibus, licet enim mihi, digni- 
tatem medicince artis tueri. 
Csesar, for the purpose of encouraging the emigration of educated 
physicians to Rome, decreed that all who practiced physics in the city 6 
Medical Legislation. 
should enjoy the privilege of citizenship. Several of the later emperors 
conferred important privileges upon the physicians of Rome. Asclepi- 
ades, Cicero’s intimate friend, instituted a new departure in the practice 
of medicine which restored public confidence and increased the sphere 
of usefulness of the healing art. He observed that the principal source 
of mistrust towards his predecessors arose from their crude and unfeeling 
practice; accordingly he rejected most internal remedies as liable to 
offend the stomach, and confined himself mainly to hygienic and dietetic 
measures. 
The medical schools at this time appear to have been private institu- 
tions, hence the great rivalry that existed between them. In Athens this 
spirit of emulation became most apparent among the different schools 
and their teachers. Among the students the same tendency prevailed. 
Each student attached himself to his teacher, and made it an object to 
canvass in his interest. The indigent class of students more especially 
bent themselves to this low business of recruiting, since, by so doing, 
they were exempted from class payment, and even received remuneration 
for their services if they were successful in securing a good supply of 
new comers. 
Although more than fourteen centuries have passed away, surrounded 
as we are by the graceful influence of Christian charity and the refine- 
ment of modern civilization, we observe the same selfish struggle for 
patronage among the rival educational institutions of the present time. 
It is not always the best schools that attract the largest number of 
students, but those that advertise most extensively, that possess money 
and influence, and that grant the degree after the least amount of 
exertion, and in the shortest space of time. 
The first hospitals were established during the reign of Emperor Con- 
stantine. The Asclepions, and other places of pagan worship, were 
transformed into hospitals and other charitable institutions under the 
auspices of the Christian church. The Emperor and his mother Helena 
took an active part in this noble work. In the year 373 Basil erected an 
immense hospital at Caesarea called Basilides, which was at that time 
considered as one of the wonders of the world. Many royal persons in 
those days acted as nurses, and contributed liberally towards assisting 
the poor and alleviating the suffering of the sick. 
Prior to the consolidation of the empire there existed no laws regulat- 
ingthe practice of medicine. The time spent in studying medicine was not 
less than five years, as may be inferred from Galen and other writers. At 
this time most of the medical schools in Rome were under the control of 
the government; the professors received a stated salary and had the priv- 
ilege to retire on a pension after twenty years’ active service. In the densely Medical Legislation. 
7 
populated parts of Greece and tlie Roman Empire, it became necessary 
to appoint a certain number of physicians who were paid a fixed salary 
for their public services. By a decree of Antoninus Pius the number of 
these state physicians was limited, in the metropolitan cities to ten, in 
cities of the second class to seven, and in the smaller cities to five. In 
Rome one was appointed for every ward. Their duties consisted in at- 
tending the poor gratuitously and superintending the educational work 
in the state. They were held in high esteem and were exempt from many 
public obligations. They usually served as teachers in the colleges, and 
examined all applicants for admission into the ranks of the profession in 
localities where the law made provision for such restriction. 
During the early part of the Christian era the clergy again assumed 
the duties of the physician. Some distinguished themselves as medical 
writers, prominent among them, Nemesius, bishop of Emesa. During 
that dark period in history, usually denominated the “ Dark Ages,” the 
progress of medical science was arrested. No material advancement 
was made until Italy became the seat of learning. Dissection of the 
human body was here permitted for the first time on a large scale, and 
thus the essential condition furnished which was necessary to advance 
medical science, and elevate the medical profession above the level of the 
empirics. A new and bright day began to dawn for science and the pro- 
fession. The people began not only to appreciate the value of a thorough 
medical education, but commenced to institute measures to suppress 
quackery. Roger, King of Sicily, in 1140, decreed a law which com- 
pelled every person to pass an examination before he was permitted to 
practice medicine. A failure to comply with this regulation, subjected 
the offender to imprisonment and confiscation of his property. Emperor 
Frederic II. required compliance with the following law regulating the 
practice of medicine: 
1. Any person is entitled to practice in the various departments of 
medicine, and assume the title of doctor, who has passed a satisfactory 
examination before the medical faculty at Salerno, and has received per- 
mission from the Emperor or his representative. Any person practicing 
without having complied with these requirements is subject to fine, and 
imprisonment for one year. 
2. Before the candidate is admitted to the examination, he must pro- 
duce evidence that he has studied logic three years, medicine and surgery 
five years, and must have practiced one year under the supervision of an 
experienced physician. 
3. The candidate is examined in the therapeutics of Galen, the aphor- 
isms of Hippocrates, and the first book of Avicenna. After having 
passed a satisfactory examination, he must take oath to be pure in life, 8 
Medical Legislation. 
to submit to the laws, to attend the poor gratuitously, and not to share 
the profits of the apothecary. 
Surgeons were divided into two classes. Surgeons of the first class 
were required to pass an examination before three professors, conducted 
in the Latin language, in the presence of the magistrates of the university. 
The diploma was signed by the three professors and the officers of the 
university, and had attached a notarial seal. Surgeons of the second 
class passed their examination before two professors, and received a cer- 
tificate signed by the examiners. This examination was conducted in 
their native language. Before surgeons were admitted to the final exam- 
ination, they had to show that they had attended the lectures of their 
professors, and had studied the subjects pertaining to their specialty, 
especially human anatomy, for at least one year. They were prohibited 
by oath from prescribing for internal diseases. Considering the imperfect 
form of government then existing, and the incompleteness of educational 
advantages, the above requirements may be regarded as stringent. This 
law was efficacious in removing quackery and elevating the standard of 
medical education, as well as the social position of medical men. 
The characteristic feature of medical instruction at that time consisted 
in inculcating a knowledge of ancient authorities, with occasional 
remarks and explanations on the part of the teacher. The duty of the 
scholar was to take copious notes and commit them to memory. Latin 
was the language among educated men, and became the language in the 
universities. 
In the year 1588, the university in Frankfurt-on-the-Oder received un- 
limited control to regulate the practice of medicine in the city and in its 
vicinity. The faculty passed an act by which no person was allowed to 
perform the function of a pliysican unless he had been promoted to the 
degree of a Baccalaureus. This degree preceded the degree of Doctor 
in Medicine. If the baccalaureate degree had been obtained in another 
university, the applicant was required to pay to the faculty eight gold- 
pieces, whereupon he received a license to practice. 
The medical departments of the universities in Frankfurt and Kcenigs- 
bergwere each conducted originally by two professors, one giving theoreti- 
cal and the other practical instruction. In 1(583 the substance of the law 
regulating the practice of medicine in Kcenigsberg read as follows: No 
person shall practice medicine unless he has received the degree Medicince 
Doctoris in the manner prescribed by law. In smaller cities no such high 
degree of proficiency shall be required, but all who intend to practice med- 
icine must pass a satisfactory examination before the faculty, and obtain 
a certificate to that effect. As the power to grant licenses rested solely with 
the faculties of the universities, they not unfrequently conferred them Medical Legislation. 
9 
upon persons not properly qualified, but for the sake of pecuniary con- 
siderations. Repeated endeavors on part of the government, as well as 
public opinion, proved utterly futile in arresting this abuse. This com- 
pelled the government of Prussia in 1725, under the reign of Friedrich 
Wilhelm I., to appoint state boards of examiners, whose duty it was to 
examine and license all candidates. Such a board of medical examiners 
was appointed for each province, and consisted of two physicians, two 
surgeons, and two apothecaries. These boards had to examine and 
license all surgeons, apothecaries, and midwives. In small places, where 
no physician resided, the surgeons and apothecaries were allowed to pre- 
scribe simple remedies, but were not permitted to resort to active drugs, 
as purgatives, emetics, emmenagogues, narcotics and mercury. Physicians 
who had graduated at any of the universities in the kingdom had to pass 
another and more rigid examination before the central board in Berlin, 
which, if the examination was satisfactory, issued a license to practice. 
This new regulation exerted a potent influence in elevating the standard 
of medical education throughout the entire kingdom. In 1868, the Ger- 
man government, for reasons difficult to explain, again vested the univer- 
sities with the power to confer licenses. Two examinations are now 
required, both conducted by members of the same faculty; the first, if 
successful, entitles the candidate to practice; the second, if satisfactory, 
secures for him the degree Medicinm Doctoris. That this new system is 
not operating satisfactorily is evident from a general expression of dis- 
satisfaction, and Germany before long will again be forced to resort to 
the old plan of establishing independent boards of medical examiners. 
Years ago, the study of medicine consisted of a routine memorizing 
of the teachings of ancient authors. It was a mechanical process, devoid 
of an independent process of reasoning and thinking on the part of 
student or teacher. To-day, “ Medicine is a science which has man, as 
a compound of matter and mind, for its subject; and an infinitude of 
substances derived from the animal, vegetable and mineral kingdom, for 
its instruments.” The study of medicine has become more comprehen- 
sive from year to year, necessitating a division of labor. Instead of two, 
as was formerly the case, every well organized medical college has now 
at least ten professors. The enlarged scope of study has correspondingly in- 
creased the labor on the part of the student. Many not essential branches 
have been erased from the curriculum. Philosophy has been gradually 
abandoned, and natural history reduced to a minimum; less stress is 
placed upon a classical education. Theoretical instruction has yielded 
to practical demonstration. Shorn of all non-essential branches, the 
objects for study are so numerous and varied that it is impossible for the 
student to obtain a thorough knowledge of them all. All that can be 10 
Medical Legislation. 
required is a knowledge of the general principles. Even the final exam- 
ination by which the student’s fitness to enter the ranks of the profession 
is measured, must he limited to the most important and practical ques- 
tions. The student can only lay the foundation,—the physician must 
erect the structure of medical knowledge, hy unwearied study and close 
observation. A vast amount of knowledge is not always a prerequisite 
to success. The physician must have energy and tact. A brain burdened 
with a weight of information on diverse subjects, can in many cases not 
apply itself to the practical task. Modern medical education consists in 
acquiring a knowledge of the structure and function of the human body 
in health and disease, and applying this knowledge at the bedside. The 
teacher and student are no longer the worshippers of ancient authors, 
but are constantly pursuing new thoughts, theories and experiments lead- 
ing into the still unknown regions of our art. The spirit of the age— 
investigation and discovery—is manifested in no department of science 
more conspicuously than in medicine. Philosophy and theory must 
succumb to facts—facts ascertained by repeated observations and demon- 
strations. 
Regular clinical instruction was inaugurated in Venice in 1517. The 
city government ordered that two physicians should visit the hospital at 
an appointed hour, and should give to the students practical instruction 
at the bedside. The same plan was adopted at Padua. This new field of 
study proved so attractive to the students that in 1796 the professors made 
complaint to the authorities that the students neglected to attend their 
lectures; whereupon clinical instruction was transferred to the regular 
professors. The catalogue of the University of Koenigsberg announced 
a course of clinical instruction in 1790. Since that time the European 
schools have made this the most prominent feature of medical instruc- 
tion. The large hospitals of the metropolitan cities furnish inexhaustible 
material for clinical instruction and the pursuit of practical anatomy. 
In England the medical profession is divided into three classes, more 
or less distinct: the physicians, surgeons and apothecaries. The physi- 
cians practice medicine exclusively, or in connection with obstetrics; 
the surgeons, strictly so-called, are confined to operations and the treat- 
ment of surgical affections; the apothecaries combine the occupation ol 
pharmacist, physician, obstetrician, and often the surgeon, under the 
name of general practitioners. Only those are entitled to the name of 
physicians who have graduated in a British or foreign university, or have 
become licentiates of the Royal College of Physicians of London. The 
charter of the College of Physicians of London provides that that body 
can prevent any one, who has not submitted to its examinations and 
received its license, from practicing medicine as a physician in London, Medical Legislation. 
11 
or within seven miles of that city, and may even enforce its privileges by 
line and imprisonment against any person who fails to comply with its 
regulations. In England and Wales, beyond the limits just mentioned, 
the only legalized physicians are the licentiates and extra-licentiates of 
the College of Physicians, and the licentiates of the universities of Oxford, 
Cambridge, and London. Extra-licentiates are those who are permitted 
to practice only beyond the limits of London and its vicinity. They 
undergo a different and probably less strict examination, and are required 
to pay less than one-half the diploma-fee demanded of the licentiates. 
Although practice may in a legal sense be thus limited, nevertheless, the 
graduates of Scotch and foreign universities have for a long time been 
admitted as licentiates by the college; graduation is in reality sufficient 
authority to practice. The surgeons proper do not seek a diploma in 
medicine, and have no special designation to distinguish them from other 
members of the community. To the eminent surgeon it is obnoxious to 
be called “doctor.” No one can practice surgery, or assume the title of 
surgeon, who is not legally entitled to it. Such authority is generally 
obtained from the Iloyal College of Surgeons of London, whose certifi- 
cate of membership, given after a certain specified course of instruction 
and a successful examination by the college, is everywhere received as 
sufficient guarantee to practice. The apothecaries or general practi- 
tioners have to serve an apprenticeship of five years; they must have 
attended three courses of lectures during the winter sessions, and two 
during summer sessions in some recognized shoo], and must have 
attended clinics for a year in some hospital containing one hundred or 
more beds, before they are permitted to examination before the London 
Society of Apothecaries, who grant all licenses to this class. They do a 
general business, similar to that of tin? country physicians in the United 
States. It seems to me that the time has come when this distinction 
between members of the same profession ought to be abandoned as a 
relic of the past, and all who minister to the sick and suffering should 
be united in one great body, measured by the same standard, governed 
by the same rules, and enjoying the same rights. This done, the interests 
of the profession, the advancement of science, and the welfare of the 
public will be promoted. 
In the infancy of our own country the medical profession was modeled 
after that in England. The early physicians came from Europe, and 
more particularly from England and Holland, and brought with them 
the habits and customs of their respective countries. They were gene- 
rally well educated, able men, who not only commanded the respect of 
the people, but were often entrusted with responsible political positions. 
The early settlers were so intently occupied with clearing away the 12 
Medical Legislation. 
forest, establishing industries, and developing the commercial interests 
of this new country, that medical education was neglected. The limited 
number of well educated medical men made it necessary for others to 
supply the demand for medical assistance. Many of the missionaries 
sent here from Europe, received a limited medical education, and served 
in the capacity of minister and physician in sparsely settled districts. 
At the time of the Declaration of Independence about three millions of 
people lived in the thirteen states, and they were attended by three or 
four thousand practitioners, of whom not more than four hundred had 
received a regular medical education. 
During the colonial existence of our country it was customary for 
students to become apprenticed for a term of three to six years to a prac- 
titioner, whose duty it was to give detailed and regular instruction in all 
departments of medicine. The student in return had to do a part of the 
work in the office; prepare medicines, cup, bleed, extract teeth, assist in 
operations, and, during the latter part of his apprenticeship, attend 
patients under the supervision of his teacher. Many of these students 
became successful practitioners without having entered a medical col- 
lege; few attended more than one course of lectures. The object of 
college instruction was not to supersede but to supplement the work of 
the preceptor. 
The early American student, if he went abroad for the purpose of 
acquiring a more complete medical education, attended in preference at 
Leyden or Edinburgh, Boerhave being in the former, and Cullen in the 
latter city, the great centre of attraction. 
That the colonies became infested with quacks at an early date is 
evident from the language of Smith, in his History of New York: “Few 
physicians among us are eminent for their skill; quacks abound like 
locusts in Egypt, and too many have recommended themselves to a full 
and profitable practice and subsistence. This is the less to be wondered 
at, as the profession is under no kind of regulation. Loud as the call is, 
to our shame be it remembered, we have no law to protect the King’s 
subjects from the malpractice of pretenders. Any man, at his pleasure, 
sets up for physician, apothecary or surgeon. No candidates are either 
examined or licensed, or even sworn to fair practice.” 
The first medical college in this country was organized in 1765, by 
Drs. Shippen and Morgan, and was made the medical department of the 
University of Philadelphia. This institution, after having undergone 
many changes in its plan of organization, lias continued to exist to the 
present time, and is now known as the Medical Department of the 
University of Pennsylvania. Previous to 1810, seven colleges had been 
established, and during that year had an attendance of 650 students, while Medical Legislation. 
13 
the population of the states numbered 7,239,881. From the year 1875 to 
1876, there were 64 medical colleges in active operation, with 6,650 stu- 
dents, and an entire population in the states of nearly 40,000,000. 
The early teachers were usually graduates from European schools. The 
plan of instruction, and the requirements for admission and graduation, 
w'ere modeled after those schools, only that the greater part of knowledge 
was obtained in the preceptory office, the time spent in college being short- 
er. The schools conferred two degrees—bachelor and doctor of medicine. 
The requirements for a bachelor’s degree were an apprenticeship with 
some respectable practitioner of two or more years, and attendance upon 
one course of lectures; for a doctor’s degree, three years’ office study, and 
two courses of lectures. The study of medicine was then less compre- 
hensive than now, and consequently required less time and fewer teachers. 
The medical department of Dartmouth College was for many years suc- 
cessfully conducted by a single professor. Since the reorganization of 
the University of Pennsylvania, in 1792, until recently, no preliminary 
examination has been required for admission by the colleges. Previous 
to 1792, the importance of a preliminary education was appreciated, and 
various measures were adopted to secure a fair standard before the stu- 
dent was permitted to enter upon the study of medicine. The Newr Jersey 
State Medical Society, which w’as organized in 1766, desirous of elevating 
the standard of medical education, required that “the apprentice must 
be refused unless he has a competent knowledge of Latin, and some 
acquaintance with the rudiments of Greek, and will serve not less than 
four years, one of which may be spent abroad, and pay one hundred 
pounds proclamation money, as apprentice fee.” 
Laws to prevent quackery and protect the regular profession, were 
enacted at an early date. The General Assembly of NewT York, in 1760, 
passed the following law for this purpose: “Whereas, many ignorant 
and unskillful persons in physick and surgery, in order to gain a subsist- 
ence, do take upon themselves to administer physick and practice surgery 
in the city of New York, to the endangering of the lives and limbs of 
their patients; and many poor and ignorant persons inhabiting the 
same city, who have been persuaded to become their patients, have been 
sufferers thereby; for preventing such abuses for the future, Be it enacted, 
by His Honor the Lieutenant Governor, the Council and the General 
Assembly, and it is hereby enacted by the authority of the same: That 
from and after the publication of this act, no person whatsoever shall 
practice as a physician or surgeon in the said city of New York, before 
he shall first be examined in physick and surgery, and approved of, and 
admitted by one of His Majesty’s Council, the judges of the Supreme 
Court, the King’s attorney-general, and the mayor of the city of New 14 
Medical Legislation. 
York for the time being, or by three or more of them, taking to their 
assistance for such examination such proper person, or persons, as they 
in their discretion shall think fit; and if any candidate, after due exam- 
ination of his learning and skill in pliysick and surgery as aforesaid, 
shall be approved and admitted to practice as a physician and surgeon, 
or both, the said examiners, or any three or more of them, shall give, 
under their hands and seals, to the person so admitted as aforesaid, a 
testimonial of his examination and admission.” A failure to comply 
with this law subjected the person to a fine of five pounds. A similar 
but still more strict law was enacted by the General Assembly of New 
Jersey in 1772. This law required all persons wdio intended to practice 
medicine to be examined and licensed under the supervision of the 
Judges of the Supreme Court. 
In 1799, the Medical and Chirurgical Faculty of the State of Maryland 
was incorporated. Power was conferred upon it to elect by ballot twelve 
persons of the greatest medical and cjiirurgical abilities in the state, who 
were called the Medical Board of Examiners for the State of Maryland. 
It was the duty of this board “to grant licenses to such medical and 
chirurgical gentlemen as they, either upon a full examination, or upon 
the production of diplomas from some respectable college, may judge 
adequate to commence the practice of the medical and chirurgical arts.” 
A supplementary act, passed in 1801, required all graduates of medical 
colleges, as well as those possessing no diploma, to submit to an examin- 
ation before this board, and obtain a license, before they were authorized 
to practice. Every person thus licensed, by virtue of the license, became 
a member of the state medical society. 
The territorial government of Orleans, in 1803, approved a law regu- 
lating the practice of medicine. It provided that every person intending 
to practice must have a diploma, and submit to an examination before a 
board consisting of four physicians or surgeons; if he was found quali- 
fied, he received a license from the board. In 1816, when the territory 
had been admitted into the Union as the state of Louisiana, the first law 
was repealed and one substituted which provided for an examining board 
consisting of four physicians and one apothecary, appointed by the 
governor. A diploma did not exempt from examination by the board, 
and was not received as an equivalent for a license. The examination of 
the candidates had to be conducted in presence of the mayor of New 
Orleans and two aldermen. In 1817 the lawT was changed, two examining 
boards being created in place of one, and ten years of continued practice 
was received as sufficient authority to practice, and exempted from further 
examination. In 1820, the law was still further amended so that graduates 
from medical colleges were licensed without further examination, pro- Medical Legislation. 
15 
vitled the applicant could furnish the hoard with satisfactory evidence 
of a good moral character. In 1840 the law was again changed to the 
effect that the plan of organization of the hoards was changed, and 
only the graduates from the Medical College of Louisiana •were exempt 
from examination hy the boards. In 1852, all previous legislative acts 
regulating the practice of medicine were repealed, and a law substi- 
tuted hy which any person with a genuine diploma or certificate from 
any chartered medical college or society in the United States, whether 
the same he allopathic or otherwise, was allowed to practice medicine, 
surgery and midwifery without any additional license. The law required 
at the same time that the person intending to practice medicine, unless 
lie had been in active business for ten years at the time it was passed, 
should go before any justice of the peace and make affidavit that he is a 
graduate from some incorporated medical institution in Europe or 
America; the justice to record this affidavit in the office of the register 
of deeds, and to give a copy to the person making the affidavit. 
The legislature of Delaware, in 1822, passed a law creating a board of 
medical examiners composed of twelve members, whose duty it should 
be to examine, and, if found qualified, to license all persons who prac- 
ticed or intended to practice without a diploma. These persons had to 
furnish evidence that they were twenty-one years of age, had studied 
medicine three years, and had attended at least one course of lectures 
before they were admitted to the examination. Graduates were licensed 
by the board without examination. 
The Medical Society of the District of Columbia was incorporated by 
an act of Congress in 1819, with power to appoint a board of censors com- 
posed of five members, whose duties were very similar to those appointed 
by the Delaware State Medical Society. 
In 1817 the legislature of South Carolina enacted a law providing for 
the establishment of two boards of medical examiners in the state. Their 
duty was to examine, and, if found qualified, to license persons intending 
to practice medicine without a diploma. Non-compliance with this law 
subjected the offender to a fine in a sum not exceeding $500, or imprison- 
ment for a term not exceeding two months. This law was in active 
operation until 1888, when it was repealed. 
In Georgia a law was in existence from 1826 to 1835 by which a pen- 
alty of $500 was provided for all persons who should practice medicine 
in that state without a license from the board of medical examiners. 
A labama, in 1828, had five boards of medical examiners, each consisting 
of three members elected by a joint vote of both houses of the state legisla- 
ture. They were located in different sections of the state, and their duties 
were similar to those of the medical boards of South Carolina. Mississippi 16 
Medical Legislation. 
had laws regulating the practice of medicine similar to those of South 
Carolina and Alabama, from the time it became a state, until 1834, when 
they were repealed. 
In New York the power to license to practice was conferred upon the 
state and county medical societies at the organization of the former in 
1806. No person was admitted to an examination before these bodies 
unless he was twenty-one years of age, and had studied medicine for a 
period of not less than three years with some respectable practitioner. 
In 1807 a tax of five dollars a month was imposed upon any person who 
practiced medicine or surgery without a license. In 1812 the fine was 
increased to twenty-five dollars for each and every offense. In 1843 the 
law was amended so that that part which related to fines was repealed. 
Ohio, Tennessee, Indiana, Michigan, and most of the New England 
states, during the early period of their existence, had laws regulating the 
practice of medicine somewhat similar to those of the state of New 
York. In most of these states the boards of censors of the state and 
county medical societies, had the power of examining and licensing 
candidates. In some instances these boards consisted of the faculty of a 
medical college in the state, and an equal number of censors elected by 
the state medical society. 
It will be seen that during the first half century of our national 
existence every state, with the exception of Pennsylvania, North Caro- 
lina and Virginia, had enacted laws restricting the practice of medicine. 
So potent was the influence brought to bear by the quack element upon 
the law-makers of the country, that during the years from 1840 to 1850, 
nearly all laws regulating the practice of medicine were repealed by the 
legislatures of the several states. For twenty years almost every state 
was without efficient medical legislation. The result has been an over- 
flowing of the country with quacks of every description. This element 
has increased to such dangerous proportions, that during the last six 
years efforts have again been made in different states to arrest its further 
growth by legal enactments. The legislatures of Kentucky, Missouri, 
Vermont and New Hampshire, passed laws for this purpose in 1875; 
Texas in 1873; California in 1876; and Illinois in 1877. The California 
law prescribes that the State Medical Society of California, and the 
Homoeopathic and Eclectic State Medical Societies, shall each appoint 
annually a hoard of medical examiners, consisting of seven members. 
The duties of these boards consists in ascertaining the genuineness of 
diplomas or certificates presented to them. If found genuine they issue 
a license to the applicant which entitles him to practice medicine and 
surgery in the state. All examinations of persons not graduates or licen- 
tiates, were made directly by these boards until Dec. 31, 1876; after this Medical Legislation. 
17 
date they could confer license to practice only to such persons as were in 
possession of a diploma or license from legally chartered medical insti- 
tutions in good standing. These boards are independent of each other, 
but no candidate rejected by one board can apply to another, and not 
to the same board until one year after such rejection. The boards have 
the power to revoke their license for unprofessional conduct. All 
licenses and certificates of revocation must be registered with the county 
clerk of the county in which the person resides. Traveling quacks are 
required to pay a license of one hundred dollars a month. Any person 
practicing medicine or surgery without having procured a license from 
one of the boards, shall be deemed guilty of a misdemeanor and shall be 
subjected to the penalties provided therefor. 
In Illinois every person practicing medicine and surgery is required 
to appear before the state board of health and present his diploma for 
verification and genuineness. If it is found correct the board issues a 
certificate to that effect, and such diploma and certificate are conclusive 
as to the right of the holder to practice. If the applicant have no 
diploma he has to pass an examination before the board of health of a 
practical and elementary character, and if found qualified he receives a 
certificate in accordance with the facts. Two kinds of certificates are 
issued, viz.: for graduates, and for candidates who have been examined 
by the board. The board furnishes the county clerks with a list of 
persons who have received certificates. Every holder of a certificate 
must record the same with the county clerk of the county in which he 
resides, the books in which such records are made to be kept open for 
inspection. The board may refuse certificates to applicants guilty of 
unprofessional conduct, and revoke certificates for like reasons. Itine- 
rant quacks are required to pay a monthly tax of one hundred dollars. 
Any person convicted of practicing medicine or surgery without having 
complied with the law is subject to a fine of not more than five hundred 
dollars, or imprisonment in the county jail for a term of not more than 
three hundred and sixty-five days. 
From the foregoing laws it will be noticed that, with but few excep- 
tions, a genuine diploma has been regarded as sufficient evidence of 
qualification, and if the law made provision for a license, this was 
conferred without any further examination. As colleges constituted thus 
not only institutions for instruction, but had at the same time power to 
confer upon their graduates authority to practice, it is not difficult to 
infer that the never-ceasing rivalry between them had a direct tendency 
to lower the standard of medical education. This evil was recognized 
at an early period, and measures were adopted to remedy it. At a meet- 
ing of the State Medical Society of New York, in 1839, the following 18 
Medical Legislation. 
resolution was reported by a committee and, after a free discussion, was 
adopted: “Resolved, That the right of teaching ought to be separated as 
much as possible from the power of conferring degrees or licenses.” 
The following year, a committee, consisting of Drs. Manly, Beck and 
McCull, submitted to the society an able report bearing upon this same 
subject, in which occurs the following language: “But in view of the 
diploma becoming depreciated by the rapid establishment of new schools, 
it may well become a question deserving serious consideration, whether 
at no distant period the rights of teaching and licensing should not be 
disjoined. An incidental difficulty to the adoption of this suggestion, 
is the fact that we are surrounded by institutions in other states, which 
might or might not follow it, and thus our own students induced to desert 
our own colleges.” 
In 1837 a petition, signed by one hundred and twenty-six physicians, 
residents of the city of Philadelphia, was presented to the legislature of 
the state, for the purpose of establishing an institution for examining 
candidates and conferring degrees independent of the business of teach- 
ing. The charter was not granted and the project failed. 
Dr. N. S. Davis, at a meeting of the New York State Medical Society 
in 1844, brought this matter again prominently before the profession; the 
discussion which followed resulted in a call for a convention of delegates 
from all medical colleges and societies in the United States, which was 
held in New York in 1846. The direct object for which this convention 
was called has never been realized, but the American Medical Associa- 
tion, which is the outgrowth of that meeting, has exerted a potent 
influence in elevating the standard of medical education throughout 
the land. 
During the last ten years representatives from the different medical 
colleges have formed an association of their own, and have held several 
meetings for the purpose of adopting a uniform standard of requirements. 
A few of our colleges have adopted a longer term of study, a graded course 
of instruction, and a more rigid test at the final examination for the degree, 
but the majority of them continue to repeat two courses of lectures to mixed 
classes, and to issue diplomas to half-educated young men at the end 
of two years. This vicious practice will continue just so long as a 
diploma is regarded as sufficient authority to practice. You may as well 
attempt to reverse the motion of the earth, as to expect that a uniform 
standard of requirements will be adopted and carried out faithfully and 
honestly, unless the power of licensing is transferred to independent boards 
of medical examiners. This has been the experience not only in this 
country but all over the world. Small institutions that vegetate on the 
income derived from the students are afraid to raise the standard, for fear Medical Legislation. 
19 
the students will desert them and seek institutions offering greater advan- 
tages. Under the present system the authority to license is vested in the 
small college, located in some obscure country village, equally as well as 
in the schools in our metropolitan cities, supplied with all the modern 
improvements for imparting theoretical and practical knowledge. Many 
of our students, for obvious reasons, attend those schools where the 
authority to practice medicine can be obtained in the shortest time, and at 
the least possible expense. If the licensing power were vested in an in- 
dependent board of medical examiners, the rivalry between the different 
schools would cease to be injurious; the noble desire to impart a thorough 
knowledge to their students would then predominate over the vain 
ambition to turn out the largest number of graduates. The student 
would then seek those colleges which have the most abundant clinical 
and demonstrative facilities. 
Medical societies exert a powerful influence over the educational 
interests of our profession. If the different medical societies, national, 
state, district, county and city will work harmoniously, by fixing a stand- 
ard for preliminary education, and a thorough course of medical instruc- 
tion, a great deal will be accomplished in forcing the colleges to follow 
the demands of the profession. The simplest and most certain method, 
however, to prevent the multiplication of medical colleges beyond the 
actual demand, and to secure physicians well trained in their profession, 
is to create a board of medical examiners in every state and territory, 
whose duty it shall be to examine every person practicing or intending 
to practice, without regard to a diploma or previous practice, and if 
qualified, to issue a license to practice. A license obtained from such a 
board should be considered the only lawful proof of qualification, and 
an essential prerequisite to practice. Unless some such laws are enacted 
our medical colleges will continue, from year to year, to flood the country 
with young men but partially prepared to discharge the duties of such 
an important profession. The ranks of our profession are already over- 
crowded. On an average we have one physician to every eight hundred 
inhabitants throughout the country. This overcrowding has been due to 
the fact that for years there have been no laws restricting the practice of 
medicine. To no other profession has the access been so easy and unre- 
strained. Any person has been allowed to assume the title of doctor, and 
tamper with human life. In the struggle for a livelihood the honest, 
educated physician has to contend with the unscrupulous, ignorant 
pretender. History abundantly illustrates the fact that wherever quackery 
was permitted to flourish without legal restraint, it not only lowered the 
dignity and honor of our profession in the estimation of the people, but 20 
Medical Legislation. 
in the unequal contest many worthy members were dragged into the 
most corrupt and disreputable practice. 
But T am told that during the early period of our national existence 
laws regulating the practice of medicine were enacted in almost every 
state, and were subsequently repealed without having answered the 
expectations of those who were instrumental in bringing them into 
existence. Several reasons may be advanced to explain this apparent 
want of success. In many instances the legislation was premature; 
undertaken at a time when it was impossible to obtain a sufficient num- 
ber of physicians to meet the requirements of the law. Again, in many 
instances, the board of medical examiners was a political body; its mem- 
bers were appointed by politicians, not as much for their ability as their 
political influence. This was a great mistake. A board, to be efficient, 
must be composed of honest, able men — men who will do their duty 
without regard to social or political influence. As long as such boards 
are controlled and influenced by politics, they will be failures—yes, worse 
than failures, they will be nuisances. The appointment of members, and 
the managment of such boards, should be conducted by medical men; 
they are the only competent judges to decide who is, and who is not, 
qualified for such an important position. The state medical societies, 
being the representatives of the profession, should make all such nomi- 
nations, and assist and co-operate with the board of medical examiners. 
Another great source of evil has been, is, and always will be, a lack 
of harmonious action on part of the members of the medical profession 
themselves. Too often, personal and selfish motives have usurped the 
place of the nobler desire to advance the interests of the community and 
profession at large. To our shame it must be said that no other profes- 
sion presents such a sad spectacle of envy and discord. Our daily walks 
in life are not only embittered by numerous disappointments in practice, 
and the never-ceasing accusations on part of an ungrateful and ungen- 
erous public, but at times are rendered almost unendurable by the rug- 
ged stones, thorns and thistles thrown around us by some, of our own 
brethren. The same deplorable spirit of jealousy becomes apparent in 
the adoption of measures that are intended not so much to secure indi- 
vidual prosperity, as the well-being of the entire profession. If we could 
only agree with each other, we could not only regulate the practice of 
medicine, but we could rule the state. Our united influence would be 
felt in every phase of society; it would equally pervade the hovel of the 
poor and the mansion of the rich, and thus insure the co-operation of the 
people and their representatives. 
The last, but not the least, cause of failure of past medical legislation 
in this country, has been that public opinion has usually failed to sustain Medical Legislation. 
21 
the laws. The people have always been, and are still, unable to distin- 
guish the physician from the quack. This assertion applies to the 
educated as w7ell as the ignorant. They may exhibit admiration and 
respect for operative midwifery and surgical operations, but the practice 
of medicine remains to them a mystery. Wonders and miracles are still 
believed in by all classes, and their belief is not unfrequently encouraged 
and strengthened by the press. The faculty to heal disease is regarded 
by them just as much as a natural divine gift as the result of profound 
study and long-continued observation. The quacks, as a rule, are shrewd 
observers of human nature, and resort to every possible means to operate 
upon human credulity. On account of these vague ideas regarding the 
practice of medicine, the sympathy of the people has been too often on 
the side of quacks. The mass of the people must be educated; they 
must be made to understand that disease is not a mysterious something 
which yields to personal magnetism, laying on of hands, or wearing 
liver-pads, but that it is more generally the result of a violation of nature’s 
laws, and amenable to a rational course of treatment. To enlist the 
attention and interest of the people, they must be made to understand the 
importance of a thorough knowledge of anatomy, physiology, and chem- 
istry as prerequisites to the practice of medicine. Unless the people 
learn to appreciate the value and necessity of a thorough medical edu- 
cation, medical legislation for the purpose of restricting practice will be 
in vain. Laws may be passed, but they are certain to be repealed unless 
popular opinion bearing upon this subject undergoes a radical change. 
But because medical legislation has not been so successful as we 
might desire, there is no reason that we should abandon such attempts. 
Every one of the laws previously passed has unquestionably been produc- 
tive of some good. The experience of the past has revealed their merits 
as well as their defects. It is only by a careful study of the history of 
past medical legislation, that we shall be enabled to adopt measures that 
will prove more successful and permanent. We have laws prohibiting 
murder, stealing, and a host of other crimes, but because, in spite of such 
laws, crimes continue to be committed, no man of sound mind would ask 
for a repeal of these laws. As governments enact laws for the protection 
of life, property, peace and happiness of their constituents, they have not 
only an inherent right, but it becomes their imperative duty to protect 
those afflicted with disease against the inhuman deceptions of ignorant 
pretenders. 
In this country medical legislation encounters another serious obstacle 
—the different schools of medicine. We can never expect that the state 
will adopt the practice of one particular school. In the treatment of 
disease an honest difference of opinion will always exist. What wre can 22 
Medical Legislation. 
and should ask for, is the enactment of laws that will prohibit any person 
from practicing medicine or surgery who has not acquired a liberal 
knowledge of the fundamental branches of medical science, anatomy, 
physiology, and chemistry. There can be no difference among the schools 
in the practice of the mechanical part of the healing art — surgery and 
obstetrics; hence all alike should be required to possess a fair knowledge 
of these, the most important departments of our profession. I can con- 
ceive of no reason why members of the different schools of medicine 
should not unite in their efforts to secure such common-sense legislation, 
that is intended, not to regulate the kind of practice, but to expel quacks 
who now disgrace all of them. As long as the different schools will 
quarrel among themselves in relation to this matter, just so long will it 
be difficult to pass, and next to impossible to sustain, such laws. What 
we want is a board of medical examiners, composed of the best men of 
the profession, who shall determine, not the proficiency of any peculiar 
practice, but the elementary standing of the applicant. No diploma, no 
ten years’ practice, ought to be accepted as sufficient evidence of quali- 
fication ; a license, obtained after a thorough and impartial examination 
by a competent board, should constitute the only legal authority to prac- 
tice. To enhance the probabilities of obtaining a strict law regulating 
the practice of medicine, it may be necessary to license in the beginning 
all who are in possession of a genuine diploma; but all those who settle 
in the state a specified time after the publication of such a law, should be 
examined irrespective of diplomas. Incompetent men, no matter how 
old they may be, or how long they may have pursued their wicked trade, 
should never receive the sanction of a license. With excellent medical 
colleges in almost every state of the Union, and with unequaled facilities 
for travel, there is no excuse for any person to-day to enter such an impor- 
tant and responsible calling without having obtained a thorough and 
practical education. The time has gone by when it was necessary to go 
to Europe for obtaining a medical education. Take away from our 
colleges the power to confer license, and they will be model institutions. 
We have the necessary capital, an abundance of brains, and an unequaled 
amount of energy and enterprise, that will at no distant future make our 
institutions the centre of medical knowledge in the world. 
CONCLUSIONS. 
1. Medical legislation should constitute a part of general legislation 
in every well organized government. 
2. Laws to suppress quackery are necessary, to protect the people 
against the impositions of ignorant pretenders, and to sustain the influ- 
ence and reputation of our profession. Medical Legislation. 
23 
3. Teaching and licensing should he disjoined. 
4. Partisanship among the different schools of medicine should give 
way to harmonious action, as far as medical legislation is concerned. 
5. Boards of medical examiners should be appointed and managed 
by medical men, and should be, as far as possible, independent of polit- 
ical influence. 
For your further consideration, I respectfully submit the following 
suggestions: 
1. The time has arrived when it must be deemed expedient to enact 
laws in this state for the purpose of suppressing quackery. 
2. The appointment of a committee of five members, who, with in- 
structions from the Society, shall confer with similar committees from the 
now existing state medical societies in this state, for the purpose of pre- 
paring a bill regulating the practice of medicine in the state, to be pre- 
sented to the next legislature for action. 
3. The bill should provide for the establishment of a Board of Med- 
ical Examiners, to be composed of seven members, the nominations to be 
made by the state medical societies, the governor to confirm the nomina- 
tions. 
4. Each state medical society now in actual existence to be allowed 
representation on that board, the now existing membership of each 
society to be taken as a basis for representation. 
5. The secretary of the board shall receive an annual salary of $500. 
The actual expenses of the remaining members of the board shall be 
defrayed, otherwise their services shall be gratuitous. 
6. The Board of Medical Examiners, upon application, shall issue a 
license to practice medicine and surgery in the state to any person who 
is twenty-one years of age, and in possession of a genuine diploma, or a 
certificate of membership from any incorporated state medical society, or 
who has passed a satisfactory examination before a majority of the members 
of the board. Six months after the passage of the bill all persons not 
then licensed, intending to practice medicine or surgery, shall be required 
to pass an examination before the board, irrespective of diplomas. 
7. Every licentiate shall be required to register the license in the 
office of the county clerk in the county in which he may reside. 
8. The board shall publish annually a catalogue, for distribution, 
containing the names, residences and credentials of every licentiate in 
the state. 
9. Any person who shall be convicted of practicing medicine or 
surgery without having complied with the requirements of the law shall 24 
Medical Legislation. 
be punished by a fine of not less than $25.00 or more than $500.00, or by 
imprisonment in the county jail for a term of not less than thirty days or 
more than three hundred and sixty-five days. 
Gentlemen of the Medical Society of the State of Wisconsin: I hope 
that the important subject to which I have alluded so imperfectly will 
receive your most earnest attention. I trust that after a free and impar- 
tial discussion concerning- this topic, you will adopt some measures 
towards securing early and effective legislation in this state. Wisconsin 
has always been one of the most progressive and enterprising of all the 
states. She lias been foremost in agriculture, commerce, and in the 
advancement of her educational interest. Her inhabitants are an ener- 
getic, intelligent people. Her medical men can favorably compare with 
those of any other state. Shall we have a law that will protect the honest 
educated physician and preserve the esteem and purity of our profession ? 
Shall we have a law that will prevent ignorant pretenders to prey upon 
the life-blood of our afflicted citizens to gratify their lust for gold? You 
must all agree that the time has come to take some action to exterminate 
this remnant of barbarism — quackery. The people of our state have 
always been willing and ready to adopt measures of reform, and I have 
no doubt its representatives in the legislature will co-operate with us, 
provided a bill is presented that will be reasonable and just to all. The 
people expect us to take the first steps. 
“No; things will never right themselves, 
’Tis we must put them right.” 
It is not only our duty to assist in enacting laws, but we are under 
obligation to help sustain and enforce them. The members of the Board 
of Medical Examiners will assume many unpleasant and responsible 
duties. In the discharge of their arduous labors they should be constant- 
ly encouraged by our advice, our assistance. Envy and selfishness should 
find no place in the heart of the true physician. To elevate our profes- 
sion, to advance science, to prevent disease, to prolong life, to alleviate 
suffering, should be our highest, our only aim.