when the law went into effect. Of these about 1,400 have since left the State or quit practice. Three hundred graduated from medical schools in 1878, and probably another lot in 1879. The board has held eleven meetings for examinations in different parts of the State, at which were examined 371 practitioners, 150 of whom passed. The examinations were conducted in writing, and at each examination a new series of printed questions was placed before the class. Eighty per cent of correct answers was required. When the candidates had any special or peculiar views of theory and practice of medicine or of therapeutics, respect was paid to such differences of opinion, and they were allowed, upon request, to appear before individual members of the board for special examination in such branches. The branches required were Anatomy, Materia Medica, Theory and Practice, Gynæcology, Physiology, Pathology, Obstetrics, Chemistry, Surgery, and Hygiene. A complete set of papers, as a specimen, is printed in the report. To give some idea of the ground covered, we copy two of them.

EXAMINATION ON THE DISEASES OF WOMEN.

BY R. LUDLAM, M. D.

1. What critical periods are especially concerned in the clinical history of women?

2. What are the prominent symptoms of chlorosis? 3. Give the treatment for obstructive dysmenorrhœa. 4. How does abortion predispose to prolapsus uteri ?

5. What is the pathology of globus hystericus?

6. Is chronic metritis more common with those who have or with those who have not been pregnant?

7.

What are the causes and the consequences of sub-involution of the uterus? 8. In child-bed, what form of inflammation usually precedes puerperal perito

nitis?

9. In child-bed also, what disease precedes uterine phlebitis ?

10. In a case of puerperal mania, how would you know that the attack did not depend either upon cerebritis or meningitis?

1.

EXAMINATION IN PRACTICAL MEDICINE.

BY W. M. CHAMBERS, M. D.

What is the characteristic sound produced by auscultation in pleuritis?

2. What is the sound produced by auscultation in the first stage of pneumonia ? In the second stage? In the third stage?

3. In asthenic diseases it is not safe to let the patient remain long in one position. Give the reason.

4. What are some of the best means to arrest persistent vomiting?

5. Is obesity a disease? If it is not, may it produce disease? If yes, how?

6. Is anæmia a disease?

7. Are the diseases most prevalent in Illinois of a sthenic or asthenic character ?

8. Physiologists agree that any material containing hydrocarbon decomposable is food. With this view, can alcoholic preparations be considered food in the treatment of disease?

9. In a case of pleuritis, what would induce you to resort to thoracentesis? What is an idiosyncrasy?

IO.

The board issued in all 4,950 certificates of ability to practise, of which 3,646 were to allopathic physicians, 437 to homœopathic, 456 to eclectic, 37 to physio-medical, 38 miscellaneous, and 336 not stated.

The board found that about 400 bogus diplomas were held by parties who had either bought them directly, or obtained them upon a merely nominal examination.

Some had bought, with their diplomas, grand gold medals of honor for distinguished attainments in medical knowledge! The diplomas of nine chartered medical colleges were not recognized, because the board had positive knowledge that they sold their diplomas. Four more colleges were suspected.

Nearly all the vilest professional mountebanks, and the advertising specialists, quacks, and abortionists that have hitherto travelled through the State from town to town, promising to cure all the ailments that flesh is heir to, have as a rule been armed with bogus diplomas, which have been beautifully gotten up to assist in deluding an unsophisticated public. As works of art they are more imposing and exceed in style the diplomas of those institutions at which it is an honor to graduate. We copy the following from the report:

"Combining the State Board of Health Act with the Medical Practice Act is something that does not obtain in any other State, and in this respect Illinois leads. Our work and its results are watched with most intense interest by the medical profession throughout the United States, especially in adjoining States, owing to the fact that so many of those who could not comply with the requirements of the law have fled to them. At present, communications are almost daily received asking for copies of the laws, and wishing to know the results of our practical experience, desiring to profit thereby; and it is only a question of time when similar laws will be enacted in our neighboring States, the public and the medical profession of these States being deeply interested in procuring such laws. More interest is excited in our work from the fact that our board is a mixed one, composed of representatives from different schools of practice. So far, no diversity of opinion has occurred among the members of the board; all schools of practice have been treated alike, provided they came within the provisions of the law. In this connection it is proper to state that many organizations have been formed by practitioners of all schools to assist in carrying out the requirements of the Practice Act."

We are informed that already some of the impostors driven out of Chicago have found a refuge in New York and other Eastern cities. After a few more Western States have passed similar laws, we shall be

deluged. Michigan is now discussing a medical bill, and even in such a State as Texas, a bill has been introduced to compel every physician in the State, without regard to age or length of practice, to appear every three years before an examining board, and unless he proves to the satisfaction of the board that he is making satisfactory progress in the study of medical science, it will be considered as evidence that he is not a fit person to have charge of the public health, and his license to practise will be rescinded. We learn from a Southern medical journal that this bill is likely to pass.

We think that this is going a little too far, but there is no danger of such a custom becoming universal.

We wish that the three societies of Massachusetts might move at once in this matter. We do not think that there would now be any friction between the schools. All would unite against a common foe, in defence of the welfare of the community and for the protection of educated physicians. In support of this opinion of ours, we shall quote from two among several allopathic utterances with which we are familiar. The "Michigan Medical News," in an editorial on the subject, says:

“There are, moreover, a few sticklers who would not be contaminated by the contact with 'irregulars' which must be necessitated by any bill which stands any chance of becoming law. It is fortunate, however, that these contracted views are limited to an insignificant number of the profession, and we apprehend but little drawback from this source."

At the last annual meeting of the Medical Society of the State of New York, held at Albany, Feb. 4, 5, and 6, 1879, the president, Dr. D. B. St. John Roosa, of New York, in the course of his annual address, said, as reported in the "Medical Record"

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"While we might not ask the State to endow medical schools, we might certainly expect that it would protect its citizens from well-defined quackery. The State could not catalogue the drugs that might be used, nor name the doses; but it could see to it that no one was allowed to prescribe for disease who had not furnished evidence of a satisfactory knowledge of anatomy, physiology, and chemistry. It should also interfere to prevent the sale of so-called patent medicines and of adulterated medicines and food. A State that would not do that, should in all consistency allow mad dogs to run in the streets, lunatics to go at large, and gunpowder to be stored in every house, and leave its railroad crossings without guards or signals. What is wanted is a board of examiners made up of the best men from the colleges and the profession, who shall determine, not the orthodoxy of a candidate as to the doses of drugs or the uses of cold water and vegetable medicines, but as to whether he had been well grounded in the structure and functions of the human body, the remedies for poisons, the rules for action in emergencies, and the principles of diagnosis, a knowledge of which would, at least, protect his patients from scandalous malpractice."

The following is a full copy of the Act to Regulate the Practice of Medicine in the State of Illinois, approved May 29, 1877, in force July 1, 1877

SECTION I. Be it enacted by the people of the State of Illinois, represented in the General Assembly, That every person practising medicine, in any of its departments, shall possess the qualifications required by this Act. If a graduate in medicine, he shall present his diploma to the State Board of Health, if such Board of Health shall be established by law, or Board of Examiners herein named, for verification as to its genuineness. If the diploma is found genuine, and if the person named therein be the person claiming and presenting the same, the State Board of Health, if such Board of Health shall be established by law, or the Board of Examiners, shall issue its certificate to that effect, signed by all of the members thereof, and such diploma and certificate shall be conclusive as to the right of the lawful holder of the same to practise medicine in this State. If not a graduate, the person practising medicine in this State shall present himself before said Board, and submit himself to such examinations as the said Board shall require; and if the examination be satisfactory to the examiners, the said Board shall issue its certificate in accordance with the facts, and the lawful holder of such certificate shall be entitled to all the rights and privileges herein mentioned.

SECT. 2. In case a State Board of Health shall not be established by law, then each State Medical Society incorporated and in active existence on the first day of July, eighteen hundred and seventy-seven, whose members are required to possess diplomas or license from some legally chartered medical institution in good standing, shall appoint, annually, a Board of Examiners consisting of seven members, who shall hold their office for one year, and until their successors shall be chosen. The examiners so appointed shall go before a county judge and make oath that they are regular graduates or licentiates, and that they will faithfully perform the duties of their office. Vacancies occurring in a Board of Examiners shall be filled by the society appointing it by the selection of alternates, or otherwise.

SECT. 3. The State Board of Health, if such Board of Health shall be established by law, or Board of Examiners, shall organize within three months after the passage of this Act; they shall procure a seal, and shall receive through their secretary applications for certificates and examinations; the president of each Board shall have authority to administer oaths, and the Board take testimony in all matters relating to their duties; they shall issue certificates to all who furnish satisfactory proof of having received diplomas or licenses from legally chartered medical institutions in good standing; they shall prepare two forms of certificates, one for persons in possession of diplomas or licenses, the other for candidates examined by the Board; they shall furnish to the county clerks of the several counties a list of all persons receiving certificates. In selecting places to hold their meetings they shall, as far as is reasonable, accommodate applicants residing in different sections of the State, and due notice shall be published of all their meetings. Certificates shall be signed by all the members of the Board granting them, and shall indicate the medical society to which the Examining Board is attached.

SECT. 4. Said State Board of Health, if such Board of Health shall be established by law, or Board of Examiners, shall examine diplomas as to their genuineness, and if the diploma shall be found genuine as represented, the Secretary of the State Board of Health, if such Board of Health shall be established by law, or Board of Examiners, shall receive a fee of one dollar from each graduate or licentiate, and no

further charge shall be made to the applicants; but if it be found to be fraudulent, or not lawfully owned by the possessor, the Board shall be entitled to charge and collect $20 of the applicant presenting such diploma. The verification of the diploma shall consist in the affidavit of the holder and applicant that he is the lawful possessor of the same, and that he is the person therein named. Such affidavit may be taken before any person authorized to administer oaths, and the same shall be attested under the hand and official seal of such officer, if he have a seal. Graduates may present their diplomas and affidavits as provided in this Act, by letter or by proxy, and the State Board of Health, if such Board of Health shall be established by law, or Board of Examiners, shall issue its certificate the same as though the owner of the diploma was present.

SECT. 5. All examinations of persons not graduates or licentiates shall be made directly by the Board, and the certificates given by the Board shall authorize the possessor to practise medicine and surgery in the State of Illinois.

SECT. 6. Every person holding a certificate from the State Board of Health, if such Board of Health shall be established by law, or Board of Examiners, shall have it recorded in the office of the clerk of the county in which he resides, and the record shall be indorsed thereon. Any person removing to another county to practise shall procure an indorsement to that effect on the certificate from the county clerk, and shall record the certificate in like manner in the county to which he removes, and the holder of the certificate shall pay to the county clerk the usual fees for making the record.

SECT. 7. The county clerk shall keep in a book provided for the purpose, a complete list of the certificates recorded by him, with the date of the issue and the name of the medical society represented by the State Board of Health, if such Board of Health shall be established by law, or Board of Examiners issuing them. If the certificate be based on a diploma or license, he shall record the name of the medical institution conferring it, and the date when conferred. The register of the county clerk shall be open to public inspection during business hours.

SECT. 8. Candidates for examination shall pay a fee of $5 in advance, which shall be returned to them if a certificate be refused. The fees received by the Board shall be paid into the treasury of the medical society by which the Board shall have been appointed, and the expenses and compensation of the Board shall be subject to arrangement with the society.

SECT. 9. Examinations may be made in whole, or in part in writing, and shall be of an elementary and practical character, but sufficiently strict to test the qualifications of the candidate as a practitioner.

SECT. 10. The State Board of Health, if such Board of Health shall be established by law, or Board of Examiners, may refuse certificates to individuals guilty of unprofessional or dishonorable conduct, and they may revoke certificates for like causes. In all cases of refusal or revocation, the applicant may appeal to the body appointing the Board.

SECT. II. Any person shall be regarded as practising medicine within the meaning of this Act who shall profess publicly to be a physician, and to prescribe for the sick, or who shall append to his name the letters "M. D." But nothing in this Act shall be construed to prohibit students from prescribing under the supervision of preceptors, or to prohibit gratuitous services in cases of emergency. And this Act shall not apply to commissioned surgeons of the United States army and navy.

SECT. 12. Any itinerant vender of any drug, nostrum, ointment, or appliance of any kind, intended for the treatment of disease or injury, or who shall by writing or