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IRCULAR LETTER
TO THE
PHYSICIANS OF KENTUCKY.
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  MAYSVILLE* KY.
LEWIS COLLEp—PsiNTaR.
      1842. 

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   The State  Medical  Convention of Kentucky  met at
 Frankfort, in January, 1841, and adopted a Constitution,
 elected  officers, &c. and resolved to meet again on  the
 12th of  January, 1842, but failed to meet-^-a quorum not
 being present.  On the 14th of January the  following
 gentlemen met: Drs. Hughes of Henry, Burnet of Trigg,
 Cox of  Nelson, Taylor of Union,  Walker of  Madison,
 Bennet of Kenton, Sharpe, Roberts, Watson and Sneed
 of Frankfort, Duke of Maysville, and Palmer and Linton
 of Springfield.  On motion, Dr. Palmer was appointed
 Chairman and Dr. Duke, Secretary.
  Dr. Duke read a paper on Medical Education.
  Dr.  Linton  read an address  upon the formation of a
 Board of Medical Examiners, and offered the following
 resolution, which  was unanimously adopted:
  Resolved, That the interests of the medical profession,
 and of  the public in general, would be promoted  by the
 establishment of a boar I of examining physicians, who
 shall meet annually for the purpose of confering diplo-
 mas on all candidates who may be found  worthy upon a
 rigorous examination.
  It was further resolved, that a committee be appointed
 to prepare an  address  to the profession  throughout the
 State, exhibiting  the advantages which would accrue to
 them, by carrying out the foregoing resolution, and invit-
ing them to join with this meeting in  praying the  Legis-
lature to establish such  a board at its next session.  Drs.
 Linton,  Duke, Burnet  and Bennef,  were appointed that
 committee.  The meeting then  adjourned until the 15th,
 when the following additional gentlemen  attended: Drs,
 Lewis, Sneed  and Dickinson of Frankfort, Hensley and
 Blackburn of  Woodford, Guilliam and Miles of Living
 ton, and Noe of Canton.
  Dr. Hughes introduced a resolution as to the manner
 of establishing  the  board which was approved by the
 meeting, and Drs. Hughes, Palmer and Burnet appointed
 a committee to draft its details.
  Dr. Linton,  from- the committee appointed,  read the
 following circular—it was unanimously adopted; and the
 Secretary  ordered to  print and distribute one thousand
 copies—the meeting then adjourned.
   K-n   m   n     o ,      R*  C'  PALMER, Pres't.
  J^o.  M. Dukb,  Sec'y. 
  Dear Sir;—In  compliance with the above resolution,
We proceed to lay before you, as briefly as possible, the
many and great advantages which we believe will neces-
sarily result from the establishment of the board alluded
to; and we doubt not that every physician in  the State
will  hail with  delight, and examine with  deep interest,
any  project for  the advancement of medical science, the
promotion of the  cause of humanity and  the  elevation
of the character of the profession.
  You have witnessed the late effort on the part of the
physicians of Kentucky, to organize themselves into a
State Society, and District Societies in correspondence
with it.  Their object was, no doubt, the advancement of
the great interests of the  profession and the public. Their
first  convention  was held in  Frankfort in the month of
January, 1841; some sixty  or seventy physicians from
the various parts of the State attended, but unfortunately
nothing was  done  at  all, adequate to  the grand object.
After  enjoying some scientific  repasts, in the  form of
learned papers and lectures, the convention adjourned,
fixing upon the  12th of January,  1842, for  its second
meeting.  In  the "mean  time  the physicians throughout
the State were notified thereof and urged to attend.  The
time for the  meeting arrived, and  as might  have been
expected, not  more than a dozen physicians convened,
and the meeting  immediately adjourned sine die.  What
 was there to induce them to  forsake their practice and
fireside comforts, and incur the fatigue and expense of a
of a winter  journey  to Frankfort?   Nothing.   The
manner in which the^s* meeting passed  off convinced
 them that their interests, and the interests of humanity
 were not likely to be subserved by a second.   In a word,
they had no motive to attend—a fact by which their ab-
 sence is at once explained and excused.
   Still we are  not disposed  to abandon the grand object 
4.
 alluded to, and have consequently sprung up into life and
 organization, as it were, from the ashes of the dead con-
 vention, with the determination of making another, and
 we believe far more rational effort to elevate our profes-
 sion to the high stand to which it is entitled  by its phi-
 lanthropic and God-like nature.   That  this  cannot be
 done  by  merely meeting in Frankfort  once a year, to
 hear  papers read and pass a few resolutions in relation
 to medical ethics and empiricism, we are ready to admit;
 for as to the papers, they can find a  vehicle to the door
 of every physician, through the press, and as to our pro-
 scriptions of quackery, time  will prove them to be una-
 vailing—'vox et prseterea nihil.'
  But to come directly to the question.  What will best
 promote our  interests and respectability as a profession?
 Our recipe is short and simple, but the facts  and  argu-
 ments by  which its efficiency is sustained, are  ample and
cogent.   Establish a board of Physicians and  Surgeons,
empowered, as  indicated in our  resolution, and let this
board or  college be sworn to require a higher degree of
qualification than has hitherto been required in the  State,
or we might say the United States.  All that this college
or board  of censors should require  oo the part of the
student, should be adequate professional qualification, not
one cent of that, the inordinate love of which is the root
of so many evils, as well in medicine as elsewhere.  To
be sure, if the State would defray the expenses of the
board, a fee might be required of the student to indemni-
fy the  State, which we think would be the  best possible
arrangement. Let it,  however, be clearly understood,
that we do not propose to tax the State without fully in-
demnifying it; nor do we desire any  enactment binding
present or future practitioners to undergo the severe ex-
aminations which it will be the duty  of the board to in-
stitute.  We wish it to stand upon its own intrinsic mer-
its, unsastained by Legislative coercion.
  Now, the  immediate  result of the  establishment  of
such a board would be to throw medical  teaching, in  a
 great  measure, into  the  hands  of  the  practitioners 
                          5.
throughout the State, and the result of this again would
be that every physician in the State would exert himself
to become  qualified to discharge the  duties of a medical
instructor; and thus rendering himself adequate to  the
profitable,  pleasing and honorable task of teaching  his
pupils, he  would  become  more learned in his profession
and, consequently, more useful to the public.
   But it may be asked, how would the establishment of
this board throw  these  important privileges  and incent-
ives to exertion into the hands of the practitioner?  The
answer is at hand.  The  board would require  nothing
but knowledge as a passport to its honors, without pre-
scribing the mode in  which  this knowledge should be
acquired.  Now,  the truth is, that this knowledge can be
acquired as well in the  shop of the intelligent practition-
er as in the halls of the schools, and at a much cheaper
rate— and  thus the question is  answered plainly enough
for the  apprehension of every one.
   But is the assertion true that the necessary knowledge
can be obtained, as well with the intelligent  practitioner
as with the professor?  Why, if this ground  be disputed,
we will take a bolder and  still quite as tenable a position,
viz: That nearly all the branches can be better taught and
more perfectly understood and digested with the former
than with  the  latter.   Who will deny this to be true of
materia medica?   It would  indeed be difficult to demon-
strate that the reading of standard works on  this depart-
 ment, under the supervision of an intelligent preceptor,
whose  shop affords nearly all the objects of the study,
would not be as advantageous to the student  as listening
to the  reading of a course or two of lectures, howevet
 learned on the same subject.
   Is  there any reason why  the practice of medicine  can-
 not 1 e  learned as well by the aid of the best works extant
and a good preceptor, whoso numerous patients present
 the various forms of  drsease, as by listening to the rend-
 ing of  lectures which, if published in the form of a book,
 would not surpass the scores of books on the same subject-,
 already in our possession? 
                        6.
   We put these questions  candidly, and assert, without
the fear of refutation,  that they apply equally to nearly
all the branches of the science.  We are sorry to be un-
der the necessity of instituting such comparisons, but the
nature of the subject demands them, and we cannot shrink
from our duty, though  in its performance we may assail
the  doctrines  and views of those whom we esteem, not
only as men, but as philosophers.  So confident are we,
however, of the justice and utility  of our measure,  that
we believe  every  one  who examines it dispassionately
will  forthwith  become its friend and advocate.
   We are free to admit that the remarks we have made
in regard to the greater number of the branches of med-
i<jme,do not so well apply to Chemistry, Anatomy, and
Surgery.   The former,  however, is not necessary in a
great degree  to the qualification of  skilful physicians
and surgeons.  There  are  not, perhaps, in the State, a
great many physicians qualified to teach Anatomy and
Surgery; still  there are some,  and if this board be es-
tablished, scores of others will spring up as by enchant-
ment, and  these important  branches will be cultivated
with a zeal hitherto unknown amongst us.  Let us exam-
ine, for a moment,  the mode of teaching these and their
kindred departments ot  science.
  It  is well known that a teacher of mediocre talents and
learning can instruct five or six students better than the
most  gifted and erudite can teach  five or six hundred.
The  reason i* obvious, and it is felt and acted upon
throughout Europe, but in a greater degree in Paris than
perhaps any where else.  The student would prefer the
private instructions  of Cruvelheir and Velpeau to those
of Barth and Chassaignac,  but the celebrity and the sta-
tion of the  former draw around them crowds that render
them inaccessible, whilst the latter are quite accessible,
and sufficiently qualified to teach.  Nothing is more easy
to demonstrate, than that private instruction is far more
advantageous  than  public.   In Paris, where there are
always thousands of students from the various nations of
the world, the  former mode  is in fall vogue.   The public 
                           7.
  lectures in the schools and hospitals are all gratuitous
  and accessible to every one; and yet the students neglect
  the lectures to attend private  instructions, though they
  are obliged to  pay for them.   Does the  student wish to
  acquire a practical acquaintance with the  stethoscope, he
  employs some  intelligent sub-physician of a hospital to
  teach him.   Does he  wish to study diseases of the skin,
 he goe3 to the hospital of St. Louis and engages some of
 the Internes to teach  him by showing him all the cases
 of Psoriasis, Eczema, Icthyosis, Lepra, &c.&c. &c. point
 out to him their distinctive marks, and acquaint him with
 the most approved modes of treating them.  This could
 not be done by the chief physician with several hundred
 students  in his train, much less by the lecturer in  the
 school.  The sub-physician or Interne never has more
 than  five or six students in  his class.   He could not  do
 justice to more.
   The same remarks apply to the teaching of Anatomy
 and Surgery, especially  operations on the dead body,
 bandaging,  obstetrics, and to all the branches of the pro-
 fession in  which  seeing and  manual dexterity are le-
 quired.   The reason of this is plain and  may  be  ex-
 pressed  in  the saying  so  common among the French,
 that "what one sees and feels make a  deeper and dearer
 impression  than what  one simply hears.1''  The  public
 teacher cannot make three  or four hundred  students see
 and handle, and deliberately examine these things  and
 afford them the necessary explanations—answering the
 queries and solving the difficulties of each  and every
 one.  The private teacher can afford  these incalculable
 advantages  to five or six.  If, then, reason and custom,
 and the highest authorities are to be regarded, attending
 lectures and following professors through crowded wards
are not the  best means of acquiring knowledge, in any
department of the profession.
  But suppos* that students do find it  necessary to go to
large  cities to complete their  studies of some of the
branches.   We say let them go,  We shall advise them, 
&.
 urge them to go and avail themselves  of all the means
 afforded by chartered colleges, private assoeiations and
 well qualified individuals.  We do not wish to tear down
 me schools, but to devise a plan by the operation of which
 those rights which are common to the entire profession,
 may not be entirely engrossed- by the/eu> to the manifest
 injurv of the many.
   We return, then', to-the proposition that the establish-
 ment of  an examining college would cause medical  lec-
 turing to devolve in part  upon practicing physicians.  It
 would  act for our good, prospectively, in stimulating our
 youth to higher attainments, and retrospectively, in urg-
 ing the present race of physicians to close study, in order
 to be enabled to discharge the profitable, honorable and
 responsible duties devolving upon them.   Inaccessible to
 sinister influences, its honors would be the reward of ge-
 nius and industry;—requiring nothing  but  that which
 study alone can bestow,  it would place the rich and the
 poor upon an equal footing;—the sworn guardian  of pro-
 fessional weal and public health, its sanction would  be
 sought with avidity by the student, and regarded as the
 highest evidence of adequate- qualification by the- com-
 munity.  It  would elevate the standard  of professional
excellence, pave the way by  which- that standard may
be reached by those who  aro  to succeed* us, and thus se-
cure to present and future generations the inestimable boon
of well qualified' practitioners in-the Divine art of healing.
In other words, it would promote the interests of the pro-
 fession and of the public.   Let us examine briefly  the ob-
jections which- may be urged against the establishment of
 such a board.
  Will it be said that there cannot be  found in the State-,
 five or six physicians sufficiently learned  to constitute it?
Such a charge would be alike unfounded and insulting,
notwithstanding the dearth of learned physicians caused
 by the state of things which we wish to reform.
  Will it be objected  that the board will not be respecta-
 ble and popular?   It cannot, in the nature of things, be
 otherwise, if  it  require the high degree of qualification
 alluded to. 
                          9.
  Will it be further urged that even under the  present
state of things, a portion of medical teaching  devolves
upon the practitioner, as it is his province to prepare the
student for the lectures?  This objection is destitute of
foundation; for, all that is necessary in order to the stu-
dent's  graduation, is, that he  attend two courses of lec-
tures With tolerable industry.  True we  believe that there
is something like a law with the schools, requiring young
men to study a year or two with a physician preparatory
to attending the lectures; but this law is a dead letter.
If the student  but attends the two courses and answers
with tolerable facility, the questions of an hour,  he is
forthwith an M. D.
  But suppose these institutions did rigorously require
on the part of the student a year or  so of  preparatory
study? What of it?   Student and preceptor both  know
that  the  former can pass  his examination without such
study.  The student feels independent  and the preceptor
careless;  and thus  the preparatory  study is "lost time,"
or to say the least of it, time not very profitably  spent.
Indeed, what is there under  the present state of things,
to stimulate the preceptor to exert himself for his pupil?
Neither gain  nor glory.  Students  will not nay for pre-
paratory  instruction, when they  are aware that the lec-
tures will  perform the double office of carrying them
in  triumph through  the green box and draining  their
pockets.   Money is far more important to them than pre-
 paratory instruction, and can they be expected to change
 the former for the latter?
   But suppose  that  well  qualified physicians should re-
quire a fee of their pupils?  Why, they would get no pu-
 pils—for there are always those  who are  not qualified,
 who would take them gratuitously, and such men,  we ad-
 mit,  can very well prepare  them  for obtaining  honors
 which can be obtained without any preparation at all!
   If it be urged  that the patronage of the  schools will
 be injured by the measure we advocate, we  would ask
 whether the general  good ought to be sacrificed  to the in- 
                          10.
 terests of the few?   But if the schools be necessary to
 qualify young men  for  passing rigorous  examinations,
 their patronage would be rather increased than diminish-
 ed; and if they are not necessary  why  impose upon the
 profession the necessity of paying extravagant sums for
 that  which can be obtained elsewhere  and upon better
 terms?  This would indeed be strengthening a  monopoly
 with a bonus, and purchasing oppression at the price of
 the means by which it should be countervailed.
   The truth is, that the establishment of  this board would
 place the schools  on the only ground  which they should,
 occupy—that of their real merit and utility—and that
 they possess both,  and are capable of a  great deal more
 we are free to admit.   Our object is not to injure them but
 to benefit the profession.   We do not wish to  see medical
 teaching wrested from their hands, but that a part  of it
 be  retained in the hands of their brethren.  We do not
 wish to dash thecupof nectar from-their  ITps, but to see
 the profession at large aroused  from a state  of collapse
 and lethargy by a  few drops of its inspiring contents.
   We think  it proper to make a distinction between  our
 professors and the schools to which they belong.  This
 is dictated alike by a sense of justice  and our own feel-
 ings.   The former, so far as any acquaintance  extends,
 are worthy of higher encomiums than  perhaps our pen
 can award—we respect them as men and' revere them as
 philosophers.  AH this, however, is perfectly compatible
 with  our objections  to the  present  economy  of theiv
 schools.  We shall not presume to propose what we think
 the necessary changes, we only  propose a measure which
does not touch their constitution, but which* will  afford to
the profession at large an incentive to indust rv and sci-
entific zeal which cannot fad to redound to our honor and
respectability as a body and  the good of our species.
  In  a measure so fraught  with advantages,  we have a
r.ght  to> expect the able and hearty co-operation of the
professors themselves.. It is not certain that they would
be  injured  by it even in a pecuniary point of view-be-
aause a h.gher standard  of qualification would render 
snore teaching necessary.  But even if their  income
should be a little curtailed, we have no right to fear that
they are not prepared for a greater sacrifice, if they  be-
lieve  it  will  be  offered up on the great altar of public
utility.
  It is a little surprising that we are politically a  repub-
lic and medically an  oligarchy, whilst in most of the na-
tions of  Europe medicine is a republic and government a
species  of oligarchy.  The state of things in regard to
medicine which we wish to bring about is essentially that
which exists in the old world,   Ireland, for example,  has
a dozen  medical schools and but one.examining college of
physicians.   The examining boards  of  Surgeons  and
Physicians in London, which are as high tribunals  as any
of the  kind  in  the world, do not  require candidates for
diplomas to attend prescribed courses of lectures.   They
require  a high degree of qualification, and this the can-
didate may obtain from private teachers or public  lec-
tures.  Moreover, any Physician  or  Surgeon may be a
lecturer, for there is no monopoly.   This gives a  power-
ful stimulus, fair  play and "ample room and verge  en-
ough" to talents and industry.   To this wise policy Eng-
land  is   indebted for her Hunters, her Abernethys,  her
Coopers, and her Lawrences.   This  is what we  want—
this is just, and this, the state of the profession imperious-
ly  demands.  A  thorough knowledge of human  nature
and the experience of ages have proven this to be the best
course and why it is so would not be difficult to demonstrate.
The concentration of  the various departments of  power
and patronage into the hands of the few not only leads to
abuses  but paralyzes the  energies of the many.  What
would be thought of placing the legislative, judicial  and
executive powers in the hands of one body without check
or  control?  Closely analagous to  what this would be in
government, is the present  condition of medical  affairs,
and the  result is deplorable.  Let us then have the neces-
sary check to balance, let us adopt  the plan which  experi-
ence and reason have proven to be best, and which com-
mon sense unites with common jnstice in demanding, that 
12.
we may enjoy the blessedness of republicanism in science
and letters as well as in government.
  The zeal with which  we believe you are inspired, for
the good of our common profession and the cause  of hu-
manity, has induced us to address you this circular.   We
have treated the subject as briefly as  possible, knowing
that all that  is necessary to the success of the  measure
proposed, is that the mind of the profession be brought to
bear upon it and contemplate its many and inestimable ad-
vantages.
  If you concur with us we hope you will immediately
call a meeting of your fellow-physicians, and  transmit
your names to our Secretary (Dr. Duke of Maysville,)
petitioning the Legislature to grant us a board,  such as
we have designated.   We would request you also  to  en-
gage in its favor your county representation and meet us
in Frankfort if you can, at the next session of the Legis-
lature.  The object  is worthy of your exertions, and we
do not  fear that you  will be wanting in the discharge of
your duty to yourselves individually, to the profession at
large,  and to the public.
                            M. L.  LINTON,
                            JNO.  M. DUKE,
                            J. BENNET,
                            J.  BURNET,