change their sky but not their affections (Cœlum, non animum, mutant). Like other moving bodies they travel along the lines of least resistance until they find some place still willing to receive and patronize them. The situation in Massachusetts to-day is proof of this statement. Dr. Draper, of Boston, says:

"One State after another has passed restrictive laws of greater or less stringency with the single aim of discouraging quackery. Massachusetts (and we will add Georgia) stands almost alone in her attitude of toleration. The action of neighboring States, near and more distant, in requiring irregular practitioners to move on and to stand not upon the order of their going, has brought to our too hospitable territory a horde of medical pretenders who have not been slow in discovering the advantages of an asylum here.”

The experience of Illinois demonstrates how the personnel of the profession may be affected by such legislation as we now contemplate. In the thirteen years ending January 1st, 1891, the State Board of Health rejected 2,283 candidates for license. In 1877, when their law went into effect, there were 7,400 physicians in the State, 3,600 graduates and 3,800 non-graduates. Ten years later there were 6,065 physicians, of whom 5,327 were graduates, 738 non-graduates. In 1877 the percentage of graduates was 48; in 1886 it was 87. In 1877 the percentage of non-graduates was 52; in 1886 it was 13. In spite of large increase in population during the ten years there was a decrease of 1,335 in the number of physicians in the State, and a decrease of 3,062 in the number of nongraduates, with an increase of 1,727 in the number of graduate physicians. All of which means that Illinois now has a capable, honest and intelligent profession, the result solely of efficient restrictive legislation.

One of the most important and salutary results of this sort of legislation is its effect upon medical education. The existence of so many of these examining boards in the States has been one of the most potent factors in arousing the colleges of the country to better work. The latter know and appreciate that the character and thoroughness of their teaching will be measured by the fitness or unfitness of their graduates as determined by *Dr. W. L. McCreary, in Southern Journal Homeopathy, January, 1893.

these examinations. The consequence has been that our system of medical education has been overhauled and improved within the last five years as never before. In this respect the Southern colleges have not done their duty. There are about 140 medical schools in this country and Canada; 130 of these require a reasonable preliminary education before matriculation. How many of this number are in the South? Only three. Of the remaining ten which make no effort to ascertain if the applicant is capable of receiving a medical education, nine are Southern colleges. Of the seventy-eight American colleges which require three or more years of study and three terms of attendance upon lectures only six are in the South, and three of these are schools for negroes. There are not over fifteen colleges in this country which now graduate students at the end of their second course of lectures. Twelve of these are Southern colleges, and it is from these that Georgia gets her doctors, or the greater part of them. The science of medicine has made such progress within the last few years that it is no longer possible for a student to obtain a reliable medical education in two courses of study. This is a fact which no one will deny unless he be one of those who worships the commercial ideal in medical teaching. The schools of the North, for the most part, in spite of every facility of laboratory and hospital, require of their students a preliminary education and three or four terms of study and observation. But we of the South exact no previous preparation, and undertake in two ungraded courses of lectures of five months each to make doctors of those who come up from the farms. In medical education the proper solution lies in the application of the Malthusian principle: "Fewer conceptions and a prolonged period of gestation." As it is, we are having a premature delivery of young doctors every Spring. They come

Deformed, unfinished, sent before their time

Into this (medical) world, scarce half made up,

and there is nothing to stand between them and the people among whom they choose to locate. One of these men once said that the foramen magnum transmitted the arch of the aorta; another, that in post-partum hemorrhage he would ligate the post-partum artery;

another, that for oedema of the glottis he would amputate in about two weeks; another, that rectocele was an inflammation of the cele of the rectum; another, that pyelitis was an inflammation of the pylorus; another said that the endothelium was a worm generally found in the rectum; and another, that in "hypertrophy of the heart we have a full cavity, while in dilatation we have a reservoir full of gas." In the hands of such persons the lives of the people are not safe, and there is properly no place for them in the medical profession; but some of these very ones, or their equivalents, are now practicing serenely in Georgia.

I am glad to say that an attempt has been made to correct this state of things. The Southern Medical College Association was organized in Louisville last Fall for the purpose of "elevating the standard of medical education by requiring a more thorough preliminary training and an increased length of medical study." Certain qualifications for matriculation were agreed upon and the three-term course adopted. But now what do we see? Every Southern college, except one, entered cheerfully into the spirit of this Association, anxious to place the status of medical education upon a higher plane in the South. The only one that refused is a Georgia college (the Atlanta Medical College), and to it now belongs the inglorious distinction of being probably the only school in this country that insists upon adhering to the old system. The refusal of one college may nullify the desires of all the rest. If so, the cause of higher medical education must languish in the South; the two-term system must prevail; and the colleges must continue to confer diplomas without giving an education; all because "Ephraim is joined to his idols" in Atlanta.

Every possible objection is going to be urged against the passage of this bill by those whose interest it is to oppose it. The regular, irregular, quack and legal affinities above alluded to will labor with one accord for its defeat. Our esteemed eclectic cousins have on their war paint and are already in the ring. The clans gathered in February last and selected a "strong committee" to "present to the rext legislature the protest of their State Association against the passage of this bill." We are assured that this committee "will not be idle"; that the "eclectics of the State are thoroughly organ

ized, and, in the event that the dominant school insist upon securing this legislation, will be on hand in force when the legislature convenes."

As a substitute for this bill the eclectics will propose a law requiring the medical colleges of the State to adopt the three-term course, and not admitting any one to practice in the State who cannot present the diploma of a three-term college. That is just exactly what the present bill will require, but evidently that is not enough. A man's fitness for practice is to be judged not by the length of time he has spent in college, but by what he has learned there. The people don't inquire how long a student has attended lectures, and they don't care; but they do want to know if he is competent, and that can be determined only by a personal examination. Moreover, by the proposed substitute the colleges would still grant licenses while conferring diplomas, the very condition which fosters looseness and inefficiency in medical instruction.

Our brethren of the vegetable persuasion will insist further that, if there is to be an examining board at all, there should be one for each school of medicine represented in the State. There are 200 eclectics in Georgia and 25 homeopaths. With only this numerical strength these schools could not maintain efficient examining boards. The strength of the combined boards would be only the strength of the weakest, and such an arrangement would give little protection to the people. After all, there is but one science of medicine. There are differences between the schools on general prin-. ciples of treatment, but we all have one anatomy, one practice, one surgery and one obstetrics. Wherever these mixed boards are made. up of reputable and intelligent practitioners, united upon a common purpose, there is no friction. Mixed boards are now operating smoothly in Minnesota, Iowa, Montana, Missouri, North Dakota and other States. The secretary of one of these says "that they render better service to the public than is done in the few instances where separate boards have been created in compliance with the demands of the several schools of practice. In the States possessing mixed boards that conscientiously perform the duties of a public servant I have yet to hear of any clashing or jealousy among the members thereof."

It

It will be alleged that this bill is unconstitutional. This old argument, which has done duty in many a weak cause, will be brought out again. But when, in the name of law and morals, did it become unconstitutional for a State to protect the lives and health of its citizens against ignorance and fraud? The general government does not find it unconstitutional to exact the most rigid qualifications of its army, navy and marine surgeons in order that our soldiers and sailors may receive only the best medical attention. is constitutional for us to establish certain standards of qualification for steamboat pilots and engineers in factories, mills, public and private buildings, etc., in order that the lives and property of people may not be endangered. We require that our lawyers and drug clerks be examined in order that the incompetent may be excluded; nothing unconstitutional about that. We have laws for the prevention of cruelty to animals; there are laws for the protection of our game; the law protects the buzzards of the air, and the terrapins in our mudholes; and all these are regarded as beneficent and constitutional. But when we ask the State to pass a measure which will protect its citizens against illegal and unqualified practitioners of medicine and surgery, a cry is raised by some who appear really to believe it and others who are paid for it that this would be unconstitutional.

The Journal of the American Medical Association says: "In view of the important interests committed to the charge of the physician, the necessity that he should possess the necessary qualifications of learning and skill is so great, and his want of them likely to be attended with results so injurious to health and destructive of life, that the power of the State to enact such laws regulating the practice of medicine and surgery as are calculated to exclude and protect the people from ignorant pretenders and charlatans, has been established by repeated adjudications, and is now too firmly settled

to admit of doubt."

The "unconstitutional" theory does not work. State after State has rejected it. The Supreme Court of Kansas has ruled (44 Kansas, 565): "The power of the legislature to regulate the practice of medicine, dentistry or surgery is undoubted." The constitutionality of the Nebraska act has just been tested. (State vs. Wo.) The