Medical Legislation 
IN THE 
UNITED STATES. 
A Discussion of the Principles Involved in American Laws, 
Regulating the Practice of Medicine, Showing 
their Character and Results. 
By J. P. DAKE, A.M., M.D., 
NASHVI 1.1.F, TKNN. 
[Reprint from Hahnemannian Monthly.] 
PHILADELPHIA: 
SHERMAN & CO., PRINTERS. 
1884. MEDICAL LEGISLATION 
IN THE 
UNITED STATES. 
J. P. Dake, A.M., M.D., Nashville, Tenn. 
The influence of legislative enactments upon the practice of 
medicine is a matter of interest to the laity as well as the pro- 
fession, to the subjects as well as the practitioners of the art 
of healing, and hence the propriety of its general discussion. 
The first American school for the education of medical men 
was organized in the city of Philadelphia justone hundred and 
twenty-one years ago, and the second, in New York city six 
years later. When it is remembered that Dr. Benjamin Frank- 
lin was president of the board of trustees, shaping and control- 
ling the Philadelphia College, and that Dr. Benjamin Rush 
was its brightest and most influential professor for more than 
forty years, it will not seem a matter of surprise when it is 
said, that to that institution is chiefly due the credit of having 
made the practice of medicine a liberal profession, a free and 
progressive calling, in America. 
In an introductory lecture to his class, eighty-two years ago, 
Dr. Rush, while enumerating the obstacles to the progress of 
scientific medicine, mentioned as one of the chief: “The inter- 
ference of governments in prohibiting the use of certain rem- 
edies and enforcing the use of others by law.” 
The effect of this mistaken policy, he considered, “ as hurt- 
ful to medicine as a similar practice, with respect to opinions, 
had been to the Christian religion.” And, as another ob- 
stacle, he mentioned : “ Conferring exclusive privileges upon 
bodies of physicians, and forbidding men of equal talents and 
knowledge, under severe penalties, from practicing medicine 
within certain districts of cities and countries.” He con- 2 
sidered “such institutions, however sanctioned by ancient 
charters and names, as the bastilesof medical science.’’ 
In speaking of these obstacles, Dr. Rush had in mind the 
laws, made in older countries, to check the introduction of 
new methods and new remedies, and so to prevent innovation 
and infringement upon what was time-honored and orthodox. 
He remembered the arbitrary and unjust discriminations 
made in favor of certain schools and societies of medical men 
and against others, whereby excellence was sacrificed to age, 
intrigue, and favoritism. 
As another important obstacle to medical progress the 
doctor mentioned, “the refusal in universities to tolerate any 
opinions in the private or public exercises of candidates for 
degrees in medicine, which are not taught nor believed by 
their professors, thus restraining a spirit of inquiry in that 
period of life which is most distinguished for ardor and in- 
vehtion in our science.” And he went on to sav: “ It was 
from the prevalence of this conduct that Dr. Adam Smith 
has called universities ‘ the dull depositories of exploded 
opinions.’ ” 
With such a lively remembrance of the barriers placed in 
the way of medical progress, it is no wonder that Dr. Rush 
and Dr. Franklin should have labored to prevent legislation 
calculated to favor medical guilds and drug monopolies in the 
New World. Actuated by a love of truth, and having little 
veneration for the simply antique or the orthodox, they op- 
posed all arbitrary laws, and favored the greatest liberty in 
scientific pursuits. 
Such was the progress of medical teaching, inspired by 
liberal sentiments that, not only Pennsylvania and New 
York, but also Massachusetts and Maryland, had, in a few 
years, each its university, with a medical department. And 
such was the excellence of the instruction given, that Dr. 
David Hosaek, in his introductory lecture to the Class, in 
New York, November 3d, 1813, said : 
“ In the profession of medicine it may already be said that, 
in the United States, we possess all the necessary resources for 
the most finished system of education that can be obtained in 
any part of the world, not excepting the justly-celebrated 
schools of Edinburgh, London, and Paris.” 
But, as the fathers of American freedom passed away, and 
those came into place and power who knew less of the evils of 
enforced conformity of and the advantages of a liberal policy, 
the spirit of pride and pomp grew apace, and medical schools 3 
and medical societies began to claim prerogatives, and seek a 
control such as exercised in the Old World. State enactments 
were called for, compelling every practitioner to possess him- 
self of a diploma or a license before assuming the care of the 
sick, and the diploma could be had only at the pleasure of the 
schools, or of the friends of the schools. 
One State after another yielded to the demand of the 
schoolmen, till the statute-books of several bore the record of 
the “ exclusive privileges ” and intolerance so much dreaded 
and denounced by the great and good Dr. Rush. 
After years of persecution and litigation to keep out 
“ Thomsonianism,” and to suppress “ irregulars,” and to 
protect orthodoxy, as represented by the schools, and, after 
mountains of proof had been accumulated, showing the de- 
structiveness of bloodletting and mercurial salivation, and 
the uselessness of many other like measures of orthodoxy, the 
practical sense of the people was shown by the repeal of the 
arbitrary enactments, or the consignment of them to the cate- 
gory of obsolete and neglected laws. New Jersey was the 
last to wipe out her acts, granting to certain orthodox colleges 
the exclusive right of conferring acceptable and authoritative 
diplomas upon medical men within her borders. 
In March, 1854, her laws, regulating the practice of medi- 
cine, were so amended as to allow a graduate of any duly 
chartered and organized medical school, regardless of his 
therapeutic tenets and peculiar means of cure, to collect fees 
for services rendered. 
hut, as legal restraints were removed from the reformers, 
and they came to have colleges and societies of their own, the 
process of crystallization and resistance to outside forces began 
in them. 
At the close of the great civil war, which had called a large 
number of medical men to positions of dignity and authority 
in the army and navy, there came a renewal of effort in be- 
half of a medical oligarchy. The party that had called itself 
“ regular,” wherever able, endeavored to seize the arm of the 
law, and to turn its force against all “ irregulars,” and, where 
not able to accomplish this, it sought its object by compacts 
with the reformers. 
In Texas and Alabama, all authority to regulate the prac- 
tice of medicine was handed over by legislative enactment to 
old-school medical associations. 
In Illinois and New York, and some other States, the au- 
thority was divided among the several schools of medicine, 4 
represented by State societies and college faculties. Illinois 
now has a board of health, made up of allopaths, homoeo- 
paths, and eclectics, to which is delegated power to determine 
what particular colleges may send their graduates to practice 
among her citizens, and to examine practitioners who have no 
medical diplomas in such manner and by such standards as 
may suit the views of its individual members. 
New York allows no physician to practice or sign the med- 
ical certificates required by law, unless he has a diploma, is- 
sued by some medical school, or one indorsed by some medi- 
cal school, chartered and governed by her laws. 
Alabama has authorized the old-school medical association 
of that State to pass upon the qualifications of all practition- 
ers offering service to the sick, and the agents employed to 
carry out the will of that medical inquisition, have proceeded 
to characterize and classify medical men after a fashion pecu- 
liar to the code under which they act. jn the list for 1882, 
published by the association, the following may be seen : 
“1. Names of members (of this Society), with their colleges, and post- 
offices : Anderson, W. H., University of Pennsylvania, Mobile. 
“ 2. Names of regular physicians, not members of this Society : Beatty, 
W. (f., Alabama Medical College, Whistler. 
“3. Irregular practitioners in the county: Murrell, William J. (homoe- 
opathist), college not given, Mobile.” 
The censors of Mobile County knew, or, if they did not 
know, any proper inquiry would have informed them, that 
Dr. William J. Murrell was not only a graduate from a 
homoeopathic college of high standing, but also a graduate 
from one of the best ‘‘regular” colleges in this country, and 
that he was likewise possessed of what very few of his allo- 
pathic neighbors cotdd boast, the diploma of a Master of 
Arts. 
The question of damages for defamation of professional 
character, in the ease of Dr. Murrell, is to be determined by 
the judiciary of Alabama. The term “irregular,” applied to 
a medical man, should have a judicial interpretation. 
But the “conferring of exclusive privileges upon bodies of 
medical men ” is not confined to State governments. 
The Surgeon-General of the United States Army has arbi- 
trarily determined that no applicant for position as a surgeon 
in the army shall be admitted to examination, unless he bears 
the diploma of a medical college belonging to a special class. 
The actual knowledge and skill of the applicant must pass 
“Mobile County. 5 
for nothing, and his claims be arbitrarily set aside, unless he 
has the indorsement of certain schools considered by the sur- 
geon-general as “ regular.” 
Not so, however, with the surgeon-general of the navy, 
who determines the qualifications of each applicant for a posi- 
tion in the naval medical service by a rigid examination, and 
admits or rejects upon merit, and not on the testimonials of 
any college of medical teachers whatever. 
But it is not my purpose to particularize the various legis- 
lative acts and arbitrary rules in force for the protection of an 
assumed orthodoxy, and to favor certain medical faculties and 
associations in this country. I only wish to show their char- 
acter and drift, in order to make myself properly understood 
in what I am about to say of the principles involved in 
American medical legislation. 
J. Medical colleges are convenient and useful to the student 
of medicine, but they are not indispensable. 
Nothing is taught in a medical school that may not be 
learned elsewhere, especially in this age of text-books and 
journals. With the increased facilities for recording and re- 
porting scientific discoveries and clinical observations, the dil- 
igent student may become familiar with all that is taught by 
medical professors, without ever entering a lecture-room. 
Private dissecting-rooms and a good preceptor’s office, and the 
chambers of the sick, in places remote from a medical college, 
have afforded the earnest student as much information as may 
be had in the medical schools and hospitals of a metropolis. 
That such institutions may afford him more conveniences, and 
may more readily fit him for professional life, no one will 
question. 
They are the legitimate outgrowth of medical experiences 
and the aggregation of individual efforts in furnishing medi- 
cal education. They are as the academy to the home schools 
of the governess and the tutor, as the theological seminary to 
the pastor’s study, and as the law school to the lawyer’s office. 
Who would assert that no classical education is to be ob- 
tained outside of a literary college, no ecclesiastical training 
without a theological seminary, and no adequate knowledge of 
law except in attendance upon a chartered law school ? 
Or, who would advocate the enactment of a law prohibiting 
the functions of a clergyman to every person not possessed of 
a diploma from a recognized divinity school ? Or, the prac- 6 
tice of law to all attorneys not having graduated from a cer- 
tain class of law schools ? 
If a diploma from some chartered medical college, some 
“ regular” college in the Alabama sense of the term, is a sine 
qua non, and if the surgeon-general of the army, or a State 
legislature, is to require it at t he hands of every physician or 
surgeon, before assuming the care of the sick or the injured, 
what should be done in the case of chaplains, and attorneys, 
and judges, who assume the care of human rights and human 
hopes of Heaven, without diplomas? But it is hardly neces- 
sary to argue the question as to the possibility of medical 
learning and skill in a practitioner who has received no col- 
lege training. 
A glance at the history of the healing art, and over the 
field of each one’s daily observation, will reveal striking in- 
stances of extensive medical learning, and also of great prac- 
tical skill in physicians who have never enjoyed the advan- 
tages afforded at a medical school, nor received the doctor’s 
degree. 
II. Medical colleges cannot insure a proper understanding 
of medicine, nor guarantee skill in those to whom diplo- 
mas are given. 
The differences in young men, coming from college with the 
doctor’s degree, must be noted even by the casual observer. 
One is modest and respectful, while another is blatant of 
medical phrases and offensively obtrusive. One attentively lis- 
tens to the old neighborhood physician, to whom no college 
had opened its friendly doors, and gathers in the fruits of his 
long experience, while the other scouts the wisdom of the sage 
who was, perchance, his own good grandmother’s medical 
attendant, warmly protesting that all such are quacks, de- 
serving immediate banishment from the field of medical prac- 
tice. 
One writes his prescriptions with exactitude and neatness, 
while the other worries the apothecary and the patient with 
bad spelling and horrid penmanship. 
One soon surrounds himself with a well-selected library, and 
has his table full of the latest and best medical journals, while 
the other drops medical reading, on receipt of his medical 
diploma, and devotes more time to horses and vehicles and 
sports than to the study of diseases and remedies. 
One is the friend of temperance and morality, the stay of 
the aged, and the thoughtful guide of the young, while the 7 
other is a debauchee and moral leper, scattering the seed8 of 
ruin in families where he is trusted. 
Both of these young doctors have diplomas, such as are ac- 
cepted in Illinois, and approved in New York, as showing 
their possessors to be fully qualified for practice, and deserving 
of confidence among the people. 
In the face of such differences and deficiencies among col- 
lege graduates, how can the State put her seal of authority 
upon all who bear diplomas from accredited schools, granting 
to them the exclusive right to practice the art of healing? 
And how can she rightfully deny the privilege of practicing 
that art to self-educated, painstaking and successful physicians, 
who have earned the confidence of the people among whom 
they reside, and are only lacking diplomas? 
Illinois and some other States provide that such a prac- 
titioner may be examined by a board of censors, and, if able 
to answer the questions propounded, may receive a license to 
practice without a diploma. The questions propounded are 
such as would be put to a candidate for graduation from col- 
lege and must embrace the subjects usually lectured on in an 
arbitrary curriculum. 
Were I now writing for medical readers alone, I should not 
consider it necessary to say that all the cunning and knowl- 
edge, requisite to the greatest skill in the physician, are not 
imparted in the curriculum of any one medical school on earth. 
It has been claimed in no mean quarter, that the healer of 
human maladies is born, not made,—that the underlying and 
actuating power to cure is a gift, an endowment, more than an 
acquisition gained by the study of other men’s opinions and 
recommendations. 
However that may be, and to whatever extent the power to 
heal is a natural faculty, it is a plain matter of fact that, out- 
side the lecture course, and outside the sweep of questions that 
a candidate for a diploma or a license is expected to answer to 
the satisfaction of a faculty or an examining board, there are 
ways and means of (mre that the successful physician must 
not ignore nor neglect. 
Ling, the Swedish ecclesiastic, discovered and developed 
the wonderful reparative influences of passive and gymnastic 
movements in the machinery of the human body. He sys- 
tematized and applied those movements for the cure of cases 
incurable by other means. And Priessnitz, the German peas- 
ant, led, as was Ling, by personal suffering and failure of cure 
by the practice of the day, discovered the wonderful influ- 8 
ence of water, variously applied, for the cure of otherwise in- 
curable cases. And to-day, so far as announced to the world, 
there is not a university nor a college, on the accredited list of 
Illinois and New York, that, in its curriculum, makes provision 
for the teaching of what was demonstrated and accomplished 
by Ling and Priessnitz and their followers. And there is not 
a board of medical censors in all this country, so far as I am 
informed, that is competent, if willing, to examine an appli- 
cant for a license, with regard to the Swedish movement and 
the water-cure. 
I speak of these things, not to detract from our many ex- 
cellent medical schools, but to show how futile is the idea that 
a diploma from any of them is a sufficient voucher that the 
holder knows all that is necessary or useful of the art of heal- 
ing, and that he is to be trusted everywhere and on all occa- 
sions. 
A diploma or a license is no more than a certificate that 
the holder has attended certain lectures, or answered certain 
questions upon some medical topics, considered important by 
a college faculty or an examining board. 
Let voluntary associations of physicians, medical societies, 
call for diplomas in the hands of their members and associates 
if they like, and let public sentiment favor their possession by 
medical practitioners in general; but, let the State forever 
abstain from coupling its seal of authority with any such tes- 
timonials, and from conferring exclusive privileges, in the 
practice of medicine, upon their possessors. 
III. There are no fixed standards in medicine, with which 
State legislation may enjorce conformity. 
Although much progress lias been made in the study of the 
human body, and the influences which bear upon its compli- 
cated machinery in causing sickness and in restoring health, 
the domain of medicine is yet shrouded in mysteries, and its 
professors and practitioners are forever differing among them- 
selves. 
I could cover many pages here with the acknowledgments 
of eminent medical writers, ancient and modern, showing the 
want of substantial progress and the sad state of uncertainty 
in the accepted measures for the prevention and. removal of 
human maladies. A wise saying is this,—u In certis unitas, 
in dubiis libertas, in omnibus caritas,”—and yet who has 
properly considered and counted the limited number of things 
in medicine that may be covered by the term “ certis.” 9 
Anatomy is the only branch taught in medical schools 
about which medical teachers do not differ. 
Some things in chemistry and physiology and surgery and 
midwifery are pretty well settled, while the teachings on pa- 
thology, materia medica, and practice are as various and often 
as contradictory as can well be imagined, and that, too, in 
colleges approved as “regular” in New York, Illinois, Ala- 
bama, and Texas. Look into the text-books and journals of 
medicine, just from the press, and see the variations and con- 
tradictions as to the causes of disease, and the measures and 
means of relief. 
As things often seen, much combated and constantly written 
upon, without agreement and without satisfaction, things only 
lately bearing death and desolation in portions of the earth, 
let me mention Asiatic cholera and yellow fever. How medi- 
cal journals and daily newspapers have been filled, time and 
again, with disputes concerning these, by medical men bearing 
diplomas from the same medical schools ! 
In medicine, as in any other science or art, wdicre discov- 
eries and improvements are sought for, where perfection has 
not been attained, it is not only absurd, but simply impossible 
to have fixed formulas and standards with an orthodoxy and a 
regulaHty based upon them. 
Suppose a State board of censors about to examine candi- 
dates for license; what kind of answers would be exacted 
touching the essential causes of intermittent fever, yellow fever, 
or cholera, or of small-pox, or scarlet fever, and the means 
of prevention and cure? What would be the standards? 
How about the germ theory, the nature of contagion and 
infection, and the hundred other unsettled and pressing prac- 
tical questions ? 
The attempt to erect standards by which to measure all 
practitioners of medicine, with a view of forcing them by legis- 
lative enactment to conform or to quit, is not only logically 
absurd, and practically useless, but, likewise, very damaging 
to medical discovery and improvement. 
Does any one imagine that the Illinois State Board of Health 
in driving out a fewT notorious quacks, and compelling some 
diplomaless physicians to practice as “ assistants ” under the 
authority of partners or neighbors, has cleared the State of 
medical ignoramuses and impostors? 
Look into Chicago, and see the medical tricksters, the quacks 
with diplomas, who flaunt their signs and posters in your face 
at every turn ! Ask a physician there about the next-door 10 
practitioner, and see him shrug his shoulders, and, if you 
promise secrecy, hear him tell how his neighbor stole through 
college, and how he tricks his fellows, and fools innocent 
people, and practices in ways that should send him to the pen- 
itentiary or the gallows! 
While there are many eminent medical practitioners and 
writers and teachers in Illinois, there are not a few ignorant 
and worthless ones, unworthy a place among honest and de- 
cent people. After all the sifting and winnowing, under legis- 
lative authority, quite as much professional chaff and cheat 
may be found there as in any other State, having the same 
number of medical men. And, looking at the signs and 
posters and newspaper cards, offering medical service, and 
claiming superior skill, in New York, does anyone believe 
that the State-right, home-college monopoly act of that great 
commonwealth has put an end to medical quackery? 
He who lacks a diploma, or makes unprofessional adver- 
tisements, or cures by secret or peculiar means, is not the only 
medical impostor. He who feigns the discovery in his patient 
of conditions not existing, or leads the weak and credulous 
into the belief that he has cured them of serious ailments 
which they never had, in order to filch their money, or make 
reputation for skill he knows he does not possess, all under 
cover of accredited diplomas, is the most genuine and dan- 
gerous of all impostors. He may not publish and honestly 
pay for newspaper advertisements, but he adroitly manages an 
“ interview,” or a report of some wonderful operation or cure 
for the city editor. His name, as the attending physician or 
surgeon of a person of rank or wealth, is never omitted in the 
news column. He manages to keep himself well before the 
public by many a trick, and greatly to impress those coming 
within his reach by devices not thought of by less cultured 
quacks. 
New York is not wanting in able and honest physicians, 
nor yet in highly-polished and most cunning medical trick- 
sters. 
The most effective influence of medical legislation in New 
York, Illinois, and Alabama, is to drive medical students into 
certain colleges and societies in those States, much to the 
profit of institutions and individuals possessed of “ exclusive 
privileges.” 
I believe I am writing for a class of readers who will not 
construe what I have said into an opposition, on my part, to 
The Alternative. 11 
medical education and medical schools, nor yet as an effort 
against some proper governmental protection of the people 
against medical deception and fraud. I yield to no one in 
appreciation of medical learning, and in advocacy of im- 
proved methods and extended terms at medical college ; but 
T do most earnestly object to the assumption that there is only 
one road for the student of medicine to travel, one style and 
measure of training for him to receive, and one set of opinions 
for him to adopt, in order to qualify him for the practice of 
medicine, and J protest, in the language of Dr. liush, against 
the “conferring of exclusive privileges upon bodies of physi- 
cians ” in this country, which owes its progress and its 
greatness to a freedom from such unjust discriminations and 
hind ranees. 
I believe, so far as possible, all persons, attempting to cure 
the sick, should have a thorough knowledge of what has been 
discovered and successfully employed in that direction, as well 
as an acquaintance with anatomy, physiology, and other fun- 
damental branches of a medical education; but I would not 
by legislative enactment prevent those from such humane 
work, who may have been denied college facilities; nor would 
I forbid, under heavy penalties, the exercise of the healing art 
to all who have not received a diploma, or been satisfactorily 
catechized by a board of examiners, made up of their asso- 
ciates and competitors on the held of practice. 
I am compelled to recognize the possibility of great discov- 
eries and good suggestions and eminent skill from outside the 
ranks of medical men in high places, when I remember Har- 
vey’s demonstration of the circulation of the blood and Jen- 
ner’s advocacy of vaccination for the prevention of small-pox. 
I say, put up no legal barriers, when I see John Howard, the 
grocery-boy, teaching sanitary reform and good hospital man- 
agement to the medical world ; when I see Florence Nightin- 
gale leading all the well-trained military surgeons of Great 
Britain in camp hygiene, and-Miss Dix removing from institu- 
tions for the insane abuses which had defied the endeavors of 
the most learned superintendents. 
Howard and Nightingale and Dix had been at no medical 
college, and held no medical diplomas, and yet they accom- 
plished reforms in the domain of medicine that will cause them 
to be remembered when the present holders of “exclusive priv- 
ileges,” the champions of a medical orthodoxy, will be entirely 
forgotten. 
To divert me from this line of argument, the question comes : 12 
“Is there nothing that the State should do for the protection 
of her people against medical imposition?” 
With great cheerfulness, I answer, yes. It is the duty of 
the State to so enlighten her citizens in regard to those who 
would assume the care of human health and life that they may 
be able to select medical advisers and attendants safely and 
with satisfaction. Let a law be enacted that every practitioner 
of the healing art, in any of its branches, shall register his 
name and age in a book (kept for the purpose and open to 
public inspection by the county clerk) with all his literary and 
professional titles attached. 
And let it be provided that, after the name, age, and titles, 
the practitioner shall state : 
1. Where, when, with whom, and for what term, he pur- 
sued the study of medicine; 
2. At what schools he received literary, scientific, and pro- 
fessional instruction, and from which, and in what 
year, he received diplomas, or certificates of proficiency; 
3. If previously in practice, where and for what length of 
time at each place ; 
4. If a member of any medical society or association, what 
its name and where its location. 
And let it be provided that the county clerk shall take the 
acknowledgment of the practitioner registering, that all the 
statements of his personal and professional record are true ; 
and thereupon let the clerk be required to issue a transcript of 
the record, as sworn to, bearing the official seal, and let this 
transcript be the only license required in the case of a resident 
practitioner. 
And let it, also, be enacted that each non-resident or tran- 
sient practitioner shall, in consideration of his not being as- 
sessed, and not being compelled to bear the usual burdens of 
taxation, be required to pay for his license the sum of two 
hundred dollars for each month, or fraction of a month. 
And let penalties be provided for practitioners who fail to 
report, and for such as may have made any false statements 
on the medical register. 
The effect of such legislation, in no wise unfair or oppres- 
sive, would furnish to the people, whose highest earthly in- 
terests are at stake, information upon which to judge as to the 
probable medical acquirements and skill of the physicians in 
their midst. In the absence of such authentic information, it 13 
is quite impossible for the laity to tell who have really de- 
voted time and study to medicine, who have been at the best 
medical schools, who have had experience, and, so, who are 
most to be trusted in the hour of suffering and danger. 
Legislation for the enlightenment of the people would call 
for no lordly boards of censors, and would stop the farcical 
play of a great State attempting to hunt down quack doctors 
for the benefit of a few medical colleges, when herself unable 
to distinguish a quack from a medical sage, both having the 
cover of a diploma. 
It would leave the responsibility of selection where it right- 
fully belongs, on those who employ medical attendants, and 
who must gain or lose by their ministrations. It would leave 
the guides to physical health as free as the guides to spiritual 
health, with no more State medicine than State religion. 
And, as regards medical colleges, while it would give them 
no exclusive privileges, no monopoly in medical education, it 
would elevate the standard among them by insuring free com- 
petition and the full rewards of merit. 
The State may not rightfully compel the possession of a 
diploma or a certificate from an examining board, that has 
measured all practitioners with the same line, or stretched 
them on one Procrustean bed, but she may properly and 
readily compel them to furnish facts, upon which they may be 
judged, at least, as to what they have done to qualify them- 
selves for practice. She may not prohibit the people their 
choice of medical attendants, but she may so enlighten them 
that they can wisely choose for themselves. She may not be 
able to force medical learning, but she can do much to en- 
courage and induce medical men to seek it earnestly, and where 
it may best be found, by compelling them to tell where and how 
they were educated. She may not forbid the coming of loud- 
mouthed charlatans, but she can wondrously moderate their 
deceptive brag by a little enforced autobiography. 
She may not directly stop the flow of her citizens’ money 
into the pockets of the peripatetic pretender, but she can ren- 
der the cost of his license such as to make his visits few and 
fur between. 
In closing, I must refer briefly to expressions on the sub- 
ject 1 am discussing, from two prominent representatives, one 
of the medical profession in America, and the other of the sci- 
entists of Great Britain. 
Professor William K. Bowling, the founder and long the 14 
peerless editor of the Nashville Journal of Medicine and Sur- 
gery, a few years ago, in noticing some medical bills, pending 
in the General Assembly of Tennessee, wrote as follows : 
“Every few years, some one gets up a bill in the legislature 
to ‘ protect ’ competent medical practitioners by fining incom- 
petent ones, and forcing them out of the field. This is to be 
accomplished by the exclusion of those who have no diplomas, 
or by examining boards to ascertain the qualifications of those 
who would practice medicine, irrespective of diploma-hold- 
ing-” 
Speaking of the laity, he said: “ Do they not know who 
does them most good when sick,and who lucks best? Quali- 
fications? Bah! Pretty is that pretty does! This is the 
logic of the masses, and the king of our country is the aggre- 
gate of the masses This Journal has set its face, like 
Hint, for a quarter of a century, against the meddling of non- 
medical men with medical affairs, its motto being : ‘ To med- 
ical men belong medical matters.’ Our State Society has taken 
similar ground. Every medical man we have seen and con- 
versed with upon the subject, is dead set against the pollu- 
tion that law can bring to medicine. The language of each 
is: ‘ If I cannot stand without props, let me fall,’and this 
is the language of common sense.” 
Professor Huxley, at the late opening of the medical school 
at the London Hospital, said : “ A large number of per- 
sons seem to be of the opinion that the State is bound to take 
care of the general public, and see that it is protected against 
incompetent persons and quacks. I do not take this view. I 
think it much more wholesome for the public to take care of 
itself in this as in all other matters.” 
He thought the only occasion for governmental interference 
in the affairs of the medical profession, was to be found in 
compelling proper death certificates, and proper qualifications 
for official positions. 
It is to be hoped that our national and State governments 
will return to the simple and wise ways of the fathers of the 
republic, and refuse the exercise of their authority in behalf 
of medical guilds and monopolies, and against the progress of 
medical discovery and improvement. 
In medical legislation, let the motto be: Light for the 
People, and Freedom for the Profession.