of the general practitioner, who is persuaded that his highest effectiveness comes from caring for individuals rather than from treating morbid humanity.

Some day there will arise a genius who will map out for himself a community and go to the members and say that he will organize a staff of highly trained men and place them in an establishment in which they will have at their command the best of equipment and for an annual fee will always have at their service and call this fully organized machinery not only for the treatment of the sick but to counsel and guard against sick

ness.

As these words are written there comes to hand the record of the work which is done by the University of California. There it has been shown that by charging the students an annual fee of five dollars for medical service the institution can maintain a self-supporting body of salaried high-grade specialists who are at the command of the students at all times for advice, consultation and treatment. At the same time there comes the information that Harvard University, the University of Michigan and the University of Wisconsin have set on foot schemes of similar kinds; and that they are not only placing organized medical faculties at the service of the individual students, but that they are making medical examination, at stated intervals, compulsory.

The unrest in the medical profession, the general dissatisfaction of a lay public which has in recent years become better and better informed of the larger possibilities for a more economical and better medical service, presages a revolution, and the question to be determined is whether that revolution will be worked out by the

profession through organization from within, for the wider service and protection of the public, as the life insurance and fire insurance, the lighting of residences has been brought about by organizations which serve the individual for an annual fee; or whether it will be accomplished by the complete socialization of medicine, so that this service for the entire body of the public will be performed by salaried officials paid out of public funds, in the same way that the public provides the schooling for its children, its police protection, its fire protection, its water supplies and the sewerage of its cities and the lighting of its streets.

Whether the larger service is worked in one way or the other the tendency will likely be to raise the poor practitioner to a higher standard or eliminate him entirely and it will also mean a leveling down by doing away with the large monetary returns to the acknowledged leaders in medicine and surgery, but it will result in increasing the general average of income and satisfactions to the men in the profession. It will conduce to more conservatism, by the destruction of the vicious fee-splitting and commission-paying practices, that are indulged in by the unscrupulous and the self-seeking.

CHAPTER XXVIII.

MEDICAL LAWS.

The legislative requirements for the practice of medicine are interpreted for the several states by their respective boards of medical examiners. The standards vary greatly, and while in one state a person may lawfully prescribe for the sick, and operate upon the deformed, across the boundary in an adjoining state such service may be regarded as a misdemeanor. All these boards of examiners, however, require that the applicant for a certificate must be a person of good character, must possess a diploma from a reputable medical college and must pass examinations in anatomy, physiology, pathology, chemistry, hygiene, surgery, obstetrics and gynecology. In some states there are separate boards to examine the graduates in particular systems of medicine, and in states where there is a single board there are usually appointed to this board representatives of the regular, eclectic and homeopathic schools of medicine, and the applicant may request to be examined upon therapeutics and the materia medica by those members who represent his own system or school.

The boards of examiners of particular states usually accept certificates which are issued by other states whose standards of requirements are equal to their own; and by addressing a letter of inquiry to the board of medical examiners at the state capitol, applicants can find out whether, at the time, the certificate of examination which

they hold from any state is honored by another state. Holders of certificates or licenses to practice in one state are generally expected to pay a fee or tax in order to have their licenses validated for other states; but in most of the states there are special regulations which permit physicians licensed by adjoining states to wait upon patients in nearby counties across the state boundaries, and they also concede the right to physicians from other states to act as consultants; and allow the regular appointed officers of the army and navy or of railroads to follow their professional work within states in which they do not hold licenses.

Sections of the medical laws of the state of New York and Pennsylvania are given at some length. The applicant who can meet these requirements can qualify in any state. At the end of the chapter a tabular statement is given of the requirements for all of the states.

In New York the Board of Medical Examiners is constituted by the Regents of the University of the State of New York, which is the name by which the department of education is known, and this university. includes all duly organized schools controlled by the educational officers of the state.

No persons shall be licensed to practice who have been convicted of a felony; nor shall any person be licensed after 1891 except in accordance with this law. The regents shall admit to the medical examination any person who pays a fee of $25 and submits evidence verified by oath, and satisfactory to the examiners, that he is more than twenty-one years old, is of good moral character, has had, prior to entrance upon the second year of medical study, the academic education which is prescribed by law, and has studied medicine at a school

which has been duly registered as satisfactory by the Regents and been in attendance at such school for a period covering four different calendar years upon courses covering at least seven months of each year. Evidence of five or more years of reputable practice may be accepted as an equivalent for the requirements of the third or fourth years of the medical courses; and evidence of graduation from a recognized college may be accepted as equivalent to the work of the first of the four years in the medical school.

Applicants to practice osteopathy shall produce evidence that they have studied not less than four years, including courses of not less than seven months each, at a school satisfactory to the Regents. From time to time the board issues circulars of information in which the different schools maintaining satisfactory standards are listed. These circulars can be obtained by addressing the Board of Regents, Albany, N. Y.

The law prescribes that the Board of Medical Examiners shall submit to the Regents for their approval, suitable questions for examinations in anatomy, physiology, hygiene, sanitation, chemistry, surgery, obstetrics, gynecology, pathology, including bacteriology and diagnosis.

Examinations shall be held at four different places in the state, four times annually, and the examination shall be in writing and shall be conducted by examiners appointed by the Regents, who shall deliver the papers to the authorized committees. The papers shall be marked without delay and returned with an official report giving the percentages obtained by each candidate in each subject. A candidate who fails upon the