State argued: "We find on comparing this act with similar acts in other States that according to the decisions of those States, and according to the decision of the Supreme Court of the United States, the act is not unconstitutional, but is valid in every particular. It is of the utmost importance that all men lacking in skill, learning and honesty should be excluded from the profession. The tendency of legislation has always been to secure this result. Every effort by the legislature to protect and preserve the lives and health of the people of the State should be looked upon with favor by the courts." The decision of the Supreme Court was an indorsement of this position. When a test case (from Virginia, I think), was taken to the United States Supreme Court, Justice Field ruled (129 U. S. 114): "The power of the State to provide for the general welfare of its people authorizes it to prescribe all such regulations as, in its judgment, will secure, or tend to secure, them against the consequences of ignorance and incapacity, as well as of deception and fraud. . No one has a right to practice medicine without having the necessary qualifications of learning and skill; and the statute only requires that whoever assumes, by offering to the community his services as a physician, that he possesses such learning and skill, shall present evidence of it by a certificate or license from a body designated by the State to judge of his qualifications." Similar decisions have been rendered by the Supreme Courts of Illinois, Michigan, California, Mississippi, Ohio, Alabama, Iowa and West Virginia.

The establishment of these boards in all parts of the country is no longer a piece of experimental legislation. They are now operating successfully in twenty-four States, one territory, and even among the Cherokee and Choctaw nations. They have demonstrated their usefulness wherever they have been tried, and no State in which the system has been properly conducted has ever abandoned it. In a certain county of one State it is said that no one can be elected to the legislature who is in favor of any interference with the medical practice act. But let us take the evidence :

Dr. Perry H. Millard, St. Paul, Minn., says: "The (present satisfactory conditions) in this State are wholly due to efficient legislation, and the result of the act has been to enhance the welfare of

both the profession and the public." Dr. J. M. Hays, ex-Secretary of the North Carolina Medical Society, says in a private letter: "The effect of our medical license act has been exceedingly marked for good. When I say that for eight years about one-third of all applicants for license have been found to be unqualified it is very manifest what the public has escaped. The intelligent public in North Carolina gives our State law its earnest support, and if there has ever been a murmur of dissatisfaction with its operation from any source it has come from some one totally unfit for the practice of medicine, who aspired to obtain license and failed." In Virginia Dr. R. W. Martin, ex-President of the State Medical Society, says: "The law has protected the unsuspecting citizens of the Commonwealth both from the money-getting quackeries of cheats and adventurers, and the injudicious though honest efforts of unqualified doctors. The public recognizes the fact that this law has brought protection, and physicians are frequently congratulated on the improvement that has taken place. The State is almost clear of frauds and impostors. The young men entering: the profession have been stimulated to higher and nobler aims. The medical schools are doing better work; they are making greater effort to prepare their graduates to meet the requirements of the law." A private letter from Dr. Michaux, the present Secretary of the Virginia Board, fully corroborates these statements. The New York Medical Record (January 28th) testifies that "in those States in which the legal regulation of medical practice has been adopted, good results have followed. The people have been insured to some extent against quackery, and no one's just rights have been encroached upon. The laws have been for the benefit of the people." The Journal of the American Medical Association (February 18th) testifies that "wherever such boards have existed they have been of value not only to the State in affording protection to the people from charlatans and unqualified practitioners, but such boards have exercised a most valuable influence in elevating the educational standard of the medical profession."

Let me say in conclusion that this bill is fair, liberal and impartial, and free from reasonable objections. Those who framed it have sought for no favors for themselves or their school of medi

cine, nor asked for any discriminations against others. The selection of the board is entrusted to the judgment of the governor, with no restrictions except that the different schools are to be represented approximately in proportion to their numerical strength in the State. The bill defines itself as seeking to "protect the people from illegal and unqualified practitioners of medicine." It seeks to secure for the people only such physicians as are competent to practice their profession. That is all the people want, and they are certainly entitled to that much. If Georgia would like to furnish her citizens with this security; if she would like to divorce the right to practice medicine from the empty honor of having a diploma; if she would like to bring about higher standards in her medical schools and stimulate her students to higher aims; if she would like to improve the personnel of the medical profession in the State and endeavor to make it what it should be, an intelligent, honest and conscientious body of physicians; then let there be established a Board of Medical Examiners who shall be untrammeled of any college connections, and who shall determine whether a given applicant is qualified to practice medicine in Georgia.

SCIENCE IN MEDICINE AND SURGERY.*

BY J. MCFADDEN GASTON, M. D.,
ATLANTA, GA.

In the early history of the healing art, all the devices used were of an empirical nature, not even suggesting any kind of theory or explanation upon which a resort to treatment was based.

Old records touching upon the various medical and surgical appliances seem so absurd that it puzzles any intelligent physician of the present day to believe that a sane man or woman could have fallen into the delusion to adopt such means of treatment. It is

*Read at Americus before the Medical Association of Georgia, April 19, 1893.

not the purpose of this paper to convict the originators of such means as impostors, nor their victims as fools, but simply to adduce the facts in verification of the extreme gullibility of the human race, as to curative agents. This holds not alone in respect to the past, but also in regard to the present era, and has facilitated the sharp practice of quacks in all ages of the world.

After medicine and surgery emerged from the period in which sorcery and witchcraft dominated the people, there commenced a gradual development of measures founded upon the observation of facts, and the record of experience became the standard for the guidance of practitioners. What proved to give relief in given -conditions was regarded as applicable in similar cases, and thus a long array of data was accumulated upon which the materia medica has been established under the various classifications of purgatives, emetics, etc.

After the discovery of the circulation of the blood by Harvey, surgery was no longer working blindly as before, and surgical pathology has steadily gained ground, while operative measures have made remarkable advances since that time.

The germ theory of disease has wrought a revolution in the views and practice of physicians and surgeons during late years, which bids fair to place medicine and surgery upon a scientific basis. While there is a vast difference in the opinions of prominent men in the medical profession as to the bacterial origin of disorders, the investigations in progress must ere long culminate in a final adjustment of this question.

That micrococci are associated with the progress of diseases, involving the different structures, has been demonstrated clearly by the microscope; and experiments tend to prove that certain disorders are propagated from one person to another by means of such germs. The modes adopted for testing the introduction of microbes into the system have not afforded any conclusive evidence as to the etiological factor in the development of morbid products. But the observation of bacteriologists has gone very far towards establishing the existence of special forms of bacilli in different types of disease. Whether these various modifications of the bacterial order enter as a causative element, or simply as a concomitant of the several dis

orders with which they are associated, has not been satisfactorily elucidated.

If the investigations should be conclusive in regard to the constant appearance of distinct bacilli in a large proportion of diseases, so as to serve the purpose of diagnosis, it would conduce greatly towards placing medicine and surgery upon a scientific basis. This being attained, the next step to be aimed at is the therapeutic measure, which may prove efficacious in eliminating these morbific agents from the different structures of the body and correcting their ravages in the organs.

A grave point for consideration in connection with the development of bacteria in the physical organization is whether they are hurtful in the living condition or after losing their vitality and acting as ptomaines in the organs. If the analogy of the growth and the decay of hydatids in the tissues can hold in the case of bacteria, it may be inferred that the chief harm results from their death and decomposition.

A very interesting view of the relation of leucocytes to bacteria has been presented by Sutton, claiming that an interminable war is carried on between these infinitesimal antagonists in the organization. If the former prevail health is secured, but in case the latter exert a controlling influence, the result is disease. The object of medical science is to aid the leucocytes.

At this time the medical profession is undergoing a most interesting. transition from the extreme views which have been held by some in regard to the employment of germicides in surgical practice. There was a time within the past decade when it was deemed to be scientific and progressive to use antiseptic measures of the most energetic kind in all operations, whether there was a septic element to combat or not. But thanks to the mature investigation of the effects of germicides upon normal structures by bacteriologists of the highest order of qualifications for this class of work, it has been demonstrated that these so-called antiseptic agents are capable of setting up septic processes in healthy tissues. The tables are now turned, and instead of a surgeon being compromsied by eliminating germicides from his surgical procedures in ordinary cases, and confining his irrigation of recent wounds to simple sterilized