NASHVILLE JOURNAL

-OF

MEDICINE AND SURGERY

C. S. BRIGGS, A. M., M. D., EDITOR.

VOL. LXXXI.

MAY, 1897.

Original Gommunications.

NUMBER 5.

SEVENTH ANNUAL REPORT OF THE SECRETARY AND TREASURER OF THE STATE BOARD

OF MEDICAL EXAMINERS.

BY T. J. HAPPEL, A.M., M.D., SECRETARY AND TREASURER. TRENTON, TENN.

To the State Board of Medical Examiners of Tennessee:

As your Secretary, it becomes my duty again to present to you an annual report of my work individually and of that of the Board.

Immediately upon the adjournment of the Board in annual session, February 27th, 1896, after issuing certificates and licenses to examinees who had been, either in person or by examination papers, before the Board, I proceded to notify all parties who held temporary licenses, whose credentials had been favorably passed upon by the Board, to send in their licenses, accompanied by the proper fee and postage, and receive in

return therefor certificates which would entitle them to register as practitioners of medicine and surgery in this State.

There was the usual delay in responding to the notices, as would be shown by an examination of the stubs of the various certificates issued. In spite of all precautions taken by the Board to license only reputable physicians, some, who present, when applying to the Board for temporary license, the best of credentials, prove to be arrant quacks and advertising humbugs -wolves in sheep's clothing-tares in the wheat.

Once having obtained license, there is no power conferred upon the Board to revoke the same. Men who are worse than robbers, drunkards and morphine-eaters, parties who have been convicted of rape and other high crimes, are allowed to continue to rob the people, and if any effort is made to prevent them, the cry of oppression is raised, and we appeal in vain to the courts to sustain us. It is not recognized by the people or the courts yet that the medical laws enacted in this State, and others, are for the protection of the people, rather than for that of the medical profession. That much good has been accomplished through the enforcement (as well as has been done without funds) of our own law cannot be denied. The peripatetic vendors of nostrums are not so open, nor do the traveling quacks from other States send out flaming handbills proclaiming their advent into different places of this State as of yore. The evil, while not entirely abated, has been considerably lessened. The advertiser must first locate before he can obtain a license, and after location he finds that he cannot perambulate without registration in every county in which he attempts to practice. Then, too, he must at least hold a diploma. Could that requirement of the act be stricken out, and all who desire to practice medicine in the State be required to undergo an examination as to fitness, then the vampires would be further decreased in numbers. The recent graduate does not undertake the role of the advertiser. If he has any ability, he soon builds up enough practice to become self-supporting, and then a pride in his profession keeps him in the ranks. As a rule, a quack is an immigrant from some other State. Having failed there, he is ready to take any course that will give him money, and he at once drifts to those States where there is no law regulating the practice of his profession, or where

the possession of a diploma is taken as sufficient evidence of his fitness to practice. Not one in ten of this class could stand an examination, and hence would fail to obtain license to practice; for, as a rule, their failure, where they begun, was due to ignorance and incompetency.

The qualified graduate would not object to an examination, as it would result in a further weeding out of the tares that have flourished with the wheat. Till our law requires this, it can not accomplish one-tenth of the good it ought to do.

The income from the examinations, whilst not adding at all to the profits of the individual members of the Board, whose fees are fixed by law, yet would enable the Board to arrange to have the law enforced in every county in the State. An attor ney could be employed, when needed, to look after the offenders, and the local profession could then be interested. Week after week letters come to me stating that a party holding no certificate in a given county is practicing, and asking that the matter be looked after, but that the name of the writer be not used in the matter. Thus any effort to reach such cases is prevented, and the Board is censured for not stopping such proceedings. A paid attorney would solve the difficulty in all such cases.

The thanks of the Board are due to Mr. John Caruthers for the efficient services rendered the medical profession in the case of the State against T. J. Slinkard, in which the constitionality of the law was tested. It is to be regretted that after as able an argument of the case was presented by Mr. Caruthers the Supreme Court did not hand down a written opinion in the case. The fact that the Legislature, after making it a misdemeanor for a vendor of any nostrum, medicine, or appliance to sell the same, or offer to cure the sick or afflicted, in passing a revenue bill, licensed peddlers of patent medicine, etc., and repeals all laws in conflict therewith, and this, under the construction put upon the law by the Criminal Court of Shelby County, permits such things to be done as are prohibited by our medical act. Such a construction was not placed upon the law by Judge Swiggert in a case sent up to him by myself.

I am glad to report that the cause of medical legislation is gaining ground, if not in Tennessee, at least in other States; and that each State, dropping into line, refuses to recognize diplomas

as conferring any right to practice medicine, but only showing that the party holding one has attended a medical college for a certain number of years.. Every State, too, requires an education test as a prerequsite to a medical course in a first-class college. It appears that it is generally being accepted that few can attain to a safe position in medicine or surgery who can not understand the technicalities of the text books; and that much less can one comprehend medicine who can not read English.

In the seven years of the existence of the Tennessee Board, a decided improvement has been noted in the educational qualifications of the examinees who have appeared before us. If the Board will adhere rigidly to its rule of minimun requirements in passing upon diplomas presented from different colleges, and will accept none from schools which do not come up to the standard, a further advance will soon be evident. Again, as long as diplomas are accepted as giving a right to practice, the resolution adopted at our last meeting, which is as follows: "Resolved, That the diploma of no medical college shall be accepted as coming from a reputable college which has been granted to the holder from and after this date, except in consequence of his having attended three separate and distinct courses of medical lectures, of not less than six months each, taken in separate years," should be strictly enforced. No diploma from any college not complying with this resolution should be verified.

Parties holding such diplomas should be required to undergo examinations just as are other undergraduates before they are granted certificates to practice. If our State schools do not comply with this rule, let it be known that their graduates must be examined. The number of "diploma mills" increases yearly. All sorts of circulars are sent out to young men, offering them diplomas, in some cases without ever having attended lectures, holding that they can give them sufficient instruction at home to enable them to practice, and offering them a diploma bearing a seal, showing that it has been granted by a chartered school. Such mills are stains upon the fair name of any State in which they are located. It would be a good rule to refuse to accept diplomas of new schools for a period of five years from the date of their first session till said schools have shown that they propose to uphold the standard of medical education. Graduates from such schools should be examined.

Several diplomas from new colleges have been presented during the past year. At our last meeting it was agreed to accept no diploma coming from a vito-pathic, physio-medical, or any other such departure from the normal type of medical schools, as in good standing. The experience of the year just ending has only served to confirm the wisdom of the Board's

course.

I would call the attention of the Board to the "Illinois Health University," of Chicago; "The American Eclectic College," of Cincinnati, and the "Wisconsin Eclectic College," of Milwaukee. All are reported as "diploma mills." The Woman's Medical School, of Minneapolis, should be put on probation. If they are aggrieved by this course the courts are open to them, and they can there obtain redress. Hampered as we are, much good can yet be done under all our discouraging surroundings. Medicine in this State is not organized. Of the 4,000 medical practitioners in this State about one in eight belongs to some medical society. The new men are taking more interest in such matters, and since the organization of the Board of Examiners the number of county societies has more than doubled. Wherever a medical society exists and flourishes it is easy to enforce the medical law. The younger men are, as a rule, more active than the older ones.

License was refused one or two parties who, after presenting diplomas, unguardedly admitted that they were expecting to travel in the interest of some of the notorious institutes. Such steps should be approved by the Board, and if our law is amended by the present General Assembly, so as to require a location before a license can be issued, then we can enforce, to a reasonable degree, this provision.

I regret to report that this Board has not been represented at any of the conferences of the "State Medical Examining and Licensing Boards." It would be well, if our funds will admit, to send a delegate to the next meeting, to be held in Philadelphia in June. The expenses of this delegate should be fully met. Of course, if our fees are not increased, we can not be represented, for no member of the Board can afford to pay his own expenses for the privilege of attending to the business of the Board. I have received from the Commissioner of Education, at