STATE OF NEW-YORK. 
No. 346. 
IN ASSEMBLY, 
3Iay 9, 1840. 
REPORT 
Of the standing committee on medical societies and 
colleges, relative to the restrictions on unlicen- 
sed practitioners. 
Mr. Marvin, from the committee on medical societies and colleges, 
to whom was referred the petition of sundry inhabitants of this State 
who, believing that a well regulated system of the practice of medicine 
is essential to the welfare of community, pray the Legislature not to 
repeal the present restrictions, but to pass a law more effectually re- 
straining unlicensed practitioners ; and also to require from the medical 
student a still more extended and thorough course of study, 
REPORTS: 
That the committee have had the subject of the above petition under 
consideration, and although it is thus brief, they are aware that it em- 
braces objects and interests in which community feel too deeply con- 
cerned, not to require at their hands a thorough and careful examina- 
tion. 
Your committee, regarding the subject as one of great moment, and 
being convinced that the guardianship of the public health is a measure 
of sound policy with which it would be hazardous to the public welfare 
unnecessarily to meddle, would avail themselves of the opportunity to 
express their views somewhat at length, with the hope that this House 
as well as the community at large, may be led to wise and judicious 
conclusions on a subject, upon whkh-aaeh and every individual have 
so much at stake. <yw? 2 
[Assembly 
And first, your committee would premise, that the question or sub- 
ject submitted for the consideration of your committee, is not whether 
this or that theory, system or mode of practice in medicine, may or 
may not be adopted be any and every citizen of this state without 
imposing any obstacle or restriction whatever. If this were the true 
issue upon this subject, our duty would be plain ; for in medicine as 
in religion universal toleration is secured to every citizen by constitu- 
tional provisions; nor has any sect or party of physicians under 
existing laws any exclusive rights or privileges ; but all are left free to 
entertain and promulgate their own opinions, whether true or false 
without being subjected to any disabilities, or incurring any penalties. 
But the question at issue is not between this or that sect of physi- 
cians, but between the educated and uneducated practitioner in the 
healing art. Whether the learned and scientific physician, the igno- 
rant and conceited pretender shall be alike authorized and recognized 
by law, to assume the difficult and responsible office of physician and 
surgeon without discrimination. 
And the decision of this question, thus divested of all obscurity and 
made to appear in its true and proper light, might be safely left to the 
bold and daring empiric himself, could his calm and impartial con- 
sideration be directed to the subject but for a single moment. 
All men will admit that ignorance is a disqualification for the proper 
discharge of the duties of any trade or profession. 
None will deny that ignorance of the structure of the human body, 
ignorance of the functions of that body in health, and ignorance of the 
nature and effects of remedies on diseased organs of that body, or in- 
deed ignorance on either of these subjects, wholly unfit any man to be 
entrusted with the health and lives of his fellow citizens; and yet 
strange to say, many who fully accord in these sentiments are peti- 
tioning for laws for the protection of quackery, or to repeal those acts 
which have been passed for no other purpose, than to protect the health 
and lives of community from the hazardous experiments of ignorant 
or unprincipled men. 
And to illustrate this point still further, for a moment let the inquiry 
be made, who would entrust his valuable watch for repair, to the black- 
smith who shoes his horse ? What mariner would go to sea in the ship 
built by his tailor ? or what lady would commit her piano or music N o. 346.] 
3 
box, the inestimable gift of love or friendship, when either were out of 
tune, to the repairing hand of her shoemaker? To propose these 
questions, is to answer them. And yet, is it not strange, an anoma- 
lous paradox, even in this age of wonders, that ladies and gentlemen 
of refinement, education, accomplishments and fortune, and of high 
intelligence too, exhibited on all other subjects, do, nevertheless, com- 
mit their livers, lungs and brains, to the hazardous experiments of men 
whose ignorance would forbid their employment in the most menial 
offices ? And whence have we this strange anomaly ? Is it because 
of a wide spread misanthropy which leads to an indifference to the 
value of health and life ? Assuredly not. These very persons 
are those most anxious about their health, most sensitive of its loss; 
many of them would be ready to give quackery itself a world of 
wealth for an inch of time. But the mystery is nevertheless, easily 
solved. The public, generally, are well informed touching the intrica- 
cy of a watch, a ship, a piano and a music box, and the mass of the 
people are sufficiently enlightened to know that none but the skilful 
hand and practised eye can safely meddle with such complicated ma- 
chines. But is the human body less intricate ? Is the structure of 
man less delicate and complicated ? Are blood-vessels, nerves, and 
vital tissues in the living body, more safely handled by rude hands, 
and subjected to medicinal or poisonous agents, than are the wheels of 
a watch, the ropes of a ship, or the keys of a musical instrument ? 
Certainly not; but then the latter are subjects open to the senses, ap- 
preciable to every capacity and popular curiosity in relation to these 
forms of mechanism, has never been repressed. Every one knows 
that any one may be a watch-maker, a ship-builder, or a musical instru- 
ment-maker, who will give time and patience to the work; and all 
know, equally well, that none can safely undertake such employments, 
without having previously and regularly learned them. And this is 
the source of correct notions on such subjects, which every where 
prevails. 
But such is lamentably not the fact in regard to the noble science of 
medicine. The popular mind is radically wrong in all that relates to the 
healing art. An impostor has only to proclaim that hemlock is a mine- 
ral, and that castor oil is made of dead men's hones, and other than 
confessedly children and fools are shocked with the intelligence. 
Again it is gravely urged by some that the practice of medicine is so 
simplified by modern discoverers, that the great and fundamental prin- 4 
[Assembly 
ciples of medical science as taught in our schools, which have borne 
the scrutiny and received the approbation of the wise and learned in all 
ages ; the production of whole lives devoted to the unwearied and pa- 
tient accumulation of facts and principles, and which are recognized 
and established on the broad basis of truth as firm as the laws of at- 
traction and gravitation, wherever science and civilized man exists, is 
no longer even entitled to credit or worthy of consideration ; and that 
however ignorant and untaught a man may be on all other subjects, he 
may, in the space of a few days, as if by modern steam power, be 
suddenly forced through the preliminaries and rudiments of a medical 
education to maturity, and come forth to the public as a thorough bred 
physician and boldly demand their confidence and protection. An igno- 
rant clown has only to lay aside his awl and his waxen thread, for roots 
and yarbs, and thousands are to become the lapstones on which he may 
hammer out his fame and fortune ; if he only take the title of botanical 
or Indian doctor, and boast of vegetable remedies for all incurable dis- 
eases. The more ignorant he is of the learned lumber of the schools 
or even of his own mother tongue, the more confidence is reposed in 
his skill, especially if he be a seventh son of the seventh daughter, or 
profess to have obtained his larnin by inspiration or immediate revela- 
tion, whether from celestial or infernal agency. Superstition and even 
religious fanaticism are thus made tributary to the popular delusion, 
and multitudes become the victims of the stupid experimentalist upon 
popular gullibility. And it is alleged as a grievance that such should 
not be recognized by law on an equality of the rights and immunities 
of the profession, with the one who has foregone the pleasures of early 
life, and devoted his fortune, his talents and all his energies for years, 
in the accumulation of knowledge in his profession before he could 
justly be entitled to the confidence and protection of community. It 
has also been urged that a monopoly is granted to the latter, to the ex- 
clusion of the former, which is anti-democratic and contrary to the spirit 
of our institutions. All this, however specious, is utterly without foun- 
dation as will appear at a glance. Certain conditions are imposed by 
law in every civilized country upon a great variety of trades and occu- 
pations, and any man who can comply with those conditions can obtain 
a license for such trade or occupation. Is there any monopoly in this ? 
Is it anti-republican ? It is precisely so in regard to the practice of 
physic and surgery in this State under existing laws, which defines the 
conditions upon which a license may be obtained by all who choose to 
conform to those conditions. No. 346.J 
5 
If, therefore, after men are qualified by education and license, they 
choose to turn Homoepathists or animal magnetizers, steam doctors or 
Grahamites, or to adopt any other of the passing humbugs of the days ; 
—the law interposes no obstacle, but insists that none but the educated 
shall be recognized by the authority of the State, and hence defines the 
legal evidence of such education, provides means for its attainment, 
and directs the manner in which the proofs shall be exhibited, of the 
necessary kind and degree of education, before a license shall be 
granted. The question of the theory or system of practice to be 
employed, is then left by the law wholly at the discretion of such 
licensed physician upon his own responsibility, and at the option of 
his employers. 
And is it not indeed strange that in the 19th century, in the year 
1840, a virtual plea for ignorance should be urged upon a legislative 
body, and ignorance too, in relation to a subject, in which every indi- 
vidual in community has so deep and abiding an interest, as the 
preservation of health and life. Ignorant physicians have been justly 
denominated the most deadly enemies of community; the plague itself 
is not more destructive; and it is when they are looked up to as 
Saviours, with the confidence of hope, that they give speed to the 
progress of disease, and certainty to the stroke of death. 
* 
The prevalent system or theory of medicine in any country is 
believed to have a greater influence over the lives of its inhabitants, than 
the epidemic diseases produced by its climate, or the decisions of its 
government concerning peace and war. The devastations of the 
yellow fever or cholera, bears no comparison with the ravages com- 
mitted by certain ignorant and erroneous notions in medicines, which 
frequently become wide spread and influential upon the public mind— 
and the slaughter of the field of Waterloo counts not of victims a 
tithe of the number which certain dogmas in physic can boast. There 
is not a medical prejudice introduced by ignorance which has not 
slain its thousands, nor a false theory received into ignorant minds 
which has not immolated its tens of thousands. It is because of just 
apprehension of such conditions as these, that the authorities of this 
State have felt it an imperious duty to encourage learning in this 
department so essential to the public welfare. 
Still however, the law as at present constituted, imposes no restraint 
on any citizen of the State in the choice of his physician, nor in 6 
[Assembly 
renumerating him for his services. If he choose, in the exercise of 
his own sovereign will and pleasure to prefer ignorance to knowledge, and 
to entrust the health and lives of himself and family to any mountebank 
or quack he thereby incurs no penalty by our laws. 
True the law does not recognize the unlicensed practitioner, and 
he cannot therefore recover payment for his services by legal process; 
and for the obvious reason, that to practise without license is an un- 
lawful act, and the public safety demands that it should be so, nor 
has the individual practitioner any right to complain, for in almost 
every county in the State resides a licensing power, and by a com- 
pliance with the salutary requisitions of the law, and giving proof of 
qualifications for the business he pursues, such license is attainable by 
him on the same terms as by his neighbor, who is already licensed. 
Ignorance is the only disqualification, and it is such, or ought to be 
by law in every other calling. 
Your committee would further say, that so important is this subject 
regarded, and has been by the intelligent in all ages, that the authority 
and resources of the State have been freely extended to medical colle- 
ges, which, under the wise and judicious supervision of the Regents of 
the University, are yearly training up a succession of thoroughly edu- 
cated young men, who devote themselves to the study and practice of 
medicine, and in due time become the legally constituted guardians of 
the public health. 
Before they are permitted to assume this responsible office, they are 
required to furnish proof of their qualification, by age, moral character, 
term of study, attendance upon regular lectures in incorporated schools, 
and by examination on all the depaitments of the science, give evi- 
dence of a full preparation for the office upon which they enter. 
Thus far the State has been led by policy and duty to provide, as far 
as legislation can do, against ignorant practitioners in medicine, and that 
the public may not be imposed upon, such, and such only, are licensed 
as physicians and surgeons. 
Your committee believe that it is only among savage, and in rude 
and uncivilized societies, that such regulations do not exist; and the 
adoption of them may always be looked upon as one of the surest in- 
dications of progressive improvements in any community. It shows No. 346.] 
7 
the birth of liberal sentiments, and a juster appreciation of the value of 
professional knowledge. Without the existence of such regulations, it 
is impossible for a profession to become truly respectable. Knowledge 
not being an essential requisite, other passports to public favor are re- 
sorted to. Assurance then usurps the place of talent, gravity of wis- 
dom, boasting of knowledge, cunning of skill, and the whole practice 
becomes a mere play of knavery upon the weakness and credulity of 
mankind. This is strikingly illustrated in every community where 
laws do not exist to regulate the practice of medicine. 
Before the American Revolution, when no restraints existed, your 
committee would direct the attention of the House to a picture as given 
of the profession by competent judges. Douglass, who was himself 
a physician, and wrote an account of the North American Colonies, 
which was published about 1753, gives the following description in his 
work, of the practice in this country : “ In general,” he says, “ the 
physical practice in our colonies is so perniciously bad, that, excepting 
in surgery, and some very acute cases, it is belter to let nature, under 
a proper regimen, take her course, than to trust to the honesty or saga- 
city of our practitioners. Our American practitioners are so rash and 
officious, that the saying in the Apocrypha (38—15) may with pro- 
priety be applied to them. He that sinneth before his Maker, let him 
fall into the hands of the physician. In the most trifling cases, they 
use a routine practice. When I first arrived in New-England, I asked 
a noted facetious practitioner, what was their general method of practice; 
he told me their practice was very uniform ; bleeding, vomiting, blis- 
tering, purging, anodyne, &c. If the illness continued, there wras 
repetendi, and finally murandi.” Smith, in his history of this State 
before the Revolution, gives a picture not more flattering of the pro- 
fession, and boldly assigns the cause. 
“ Few physicians amongst us are eminent for their skill. Quacks 
abound like locusts in Egypt, and too many have recommended them- 
selves to a full practice and profitable subsistence. This is the less to 
be wondered at, as the profession is under no kind of regulation ; any 
man at his pleasure sets up for physician, apothecary and surgeon. 
No candidates are either examined or licensed, or even swoin to fair 
practice.” It was impossible that a state of things so disreputable to 
the profession, and injurious to the public, could long continue. The 
evil was too great, and dame too closely home to the person of every 
individual, to be long continued. Measures were accordingly adopted 8 
[Assemely 
to wipe off so foul a stain from our honor. These consisted of laws 
regulating the qualifications required of those who entered the profes- 
sion, and the establishment of medical societies in every county in 
the State, specially charged with the enforcement of those laws. An 
organized system, embracing, within the sphere of its operation, every 
portion of the State, was thus founded by law, which has been most 
salutary in its influence, and which is destined in future, under wise 
and judicious regulations, to confer still greater blessings, both upon 
the profession and the public. 
And your committee are deeply impressed with the belief that, to 
break down and remove all distinctions by law between educated and 
ignorant physicians, would be to encourage and perpetuate among our 
fellow-citizens the vast tribe of mountebanks and empirics who now 
infest our country, and prey on its health, its cupidity and its substance, 
and thus be offering, in effect, a bounty to quackery, and a price for its 
victims, and that such a state of things would tend hopelessly to de- 
grade the profession and to prevent the cultivation of the science of me- 
dicine. 
Who would long be the teachers of medical science, when their well 
trained pupils were to be placed, by law, on no higher ground than the 
mere pretender ? What young man of character, of talent and educa- 
tion would be induced to devote himself, in the morning of life, to years 
of diligent study and laborious toil; trimming the midnight lamp for 
months, while he inhales the sepulchral vapors of the dissecting room, 
in the thankless prosecution of the science of medicine, the investiga- 
tion of the diseases of the human frame, their seat and remedy, which 
has for its ultimate objects the alleviation of human woes, when, by the 
laws of the State, he is to be virtually levelled with the vilest impostor 
in the healing art. 
Your committee are not surprised that on this, as well as on all other 
subjects in which community are generally interested, there should be 
a great diversity of opinion. Many individuals, witnessing from time to 
time the destructive ravages committed by unlicensed practitioners, 
feel a strong interest in checking their acts. And it can not be con- 
cealed but that great misery, and even loss of life itself, is frequently 
caused by the incautious and improper use of various medicinal articles, 
recommended and administered by ignorant and conceited persons. And 
again, our public prints are filled with testimonials from many distin- No. 346.] 
9 
guished individuals, lawyers, clergymen, merchants, &c. whose opinions 
are entitled to great consideration, on all subjects which pertain to their 
own professions, of substances curing almost every human disease. In 
these different ways the hopes and fears of a great portion of society 
are operated upon, to their manifest injury. 
But while all intelligent men will readily concede that the evils in 
question are great, and should be remedied if possible, it is, in the opi- 
nion of your committee, at least doubtful, whether they can be remov- 
ed by further legislative enactments. Experience has shown that any 
law of this description would induce the cry of persecution to be rais- 
ed against the unlicensed practitioner ; and that at no subsequent peri- 
od in our State, has quackery been patronised with so liberal a hand as 
during the existence of the only law ever enacted for that purpose in 
this State. It is a well known fact, that men when incited by this 
idea, will adhere pertinaciously to their opinions, however monstrous 
or absurd. No matter how flagrant may be the case of permanent in- 
jury, or should it be even manslaughter itself, by an unlicensed practi- 
tioner, the public sympathy will be aroused among at least a portion of 
our citizens, especially if any medical man should attempt to do his 
duty in censuring the crime. Such is lamentably the condition of the 
public mind on this question. Probably on no other subject is the po- 
pular mind less informed, and in no other department is there so fruit- 
ful a field for imposture and fraud. All laws for the suppresion of 
quackery would only multiply its agents and victims, while the remon- 
strances of medical men are regarded merely as the idle and interested 
declamation of mercenary mystics; for in the languarge of Lord Ba- 
con, “ in the opinion of the multitude, witches, fortune-tellers and con- 
jurers have always held competition with physicians.” 
In the opinion of your committee, the only mode in which the evils 
complained of can be gradually removed, is by enlightening the public 
mind on the nature and condition of the human body, on the causes of 
health and disease, and above all, by proving to them in every practi- 
cable way, that the enormous consumption of these powerful substan- 
ces by them, must in the end exhaust and destroy their constitutions, 
for which they are taken to strengthen and invigorate. If to these we 
add additional requisitions for the purpose of increasing the knowledge 
of the medical profession, as asked for by your petitioners, thereby, in- 
stead of lowering, to elevate it still higher in the scale of usefulness, 10 
[Assembly 
it might reasonably be hoped that ere long the race of empirics and 
pretenders will diminish or even become extinct; and that quackery 
in all its forms would be thus shamed out of countenance, and banish- 
ed from the abodes of civilized men. 
There can be no just reason assigned, why the student of medicine 
should not devote as long a time in preparing for the important duties 
of his occupation, as the student in law oi theology. The rule applies 
in every description of business, that the larger the capital, if it be 
managed with prudence and skill, the larger will be the annual income. 
And the physician, if he be thoroughly grounded in the elements of his 
profession, and possessed of a common knowledge of men, need not 
fear the result. But it is society at large that will derive the greatest 
benefit—in being provided with a well educated body of men. 
The profession has, from time to time, urged the necessity of this; 
and even the requisitions as they now exist, have been, in a measure, 
forced from an unwilling community. Your committee are not prepa- 
red to digest and report a plan for extending the time and course of 
study for the medical student; but they look to the Regents of the Uni- 
versity, to whom this subject is in a measure committed by law, for 
suitable attention to this important subject. At the present advanced 
period of the session, it is not probable that any legislative action can 
be successfuly carried out; but your committee have deemed it pro- 
per to express their views on this subject thus at length. 
And in conclusion, your committee would beg leave to say, that it is 
their unanimous opinion, that instead of levelling all distinctions be- 
tween licensed and unlicensed practitioners, it is the solemn duty of 
the Legislature, a duty which they owe to the character of the State, 
the dignity of the profession, and the interest of the public at large, to 
rather make the distinction still broader than at present, by promoting 
and encouraging the still higher cultivation of the science of human 
health ; the still farther prosecution of the study which true philanthropy 
must ever regard as calculated, in proportion to its perfection, to miti- 
gate human suffering and prolong human life. 
And your committee ask leave to offer for the consideration of the 
House, the following resolution. No.346.] 
11 
Resolved, That the latter clause of section 25, chapter 15, title 7, 
part 1, of the Revised Statutes, regulating the practice of physic and 
surgery in this State, is manifestly inconsistent with the previous 
enactments of the same law, and ought to be repealed; yet from the 
advanced period of the session your committee deem it inexpedient to 
introduce a bill for that purpose.