^■vt.* l*\  (D> Ht
 MEDICAL  REFORM
                AND THE

PRESENT SYSTEM OF MEDICAL INSTRUCTION.
         AN ADDRESS

DELIVERED AT THE SEMI-ANNUAL MEETING
Neto  Serseg  Jttebual  ©ocuty,
  HELD AT CAMDEN, NOV. 13, 1849.



 OTMIEL H.  TAYLOR,  M.  D.,

     ONE OF THE VICE PRESIDENTS.  .  ' • T i- :


PUBLISHED BY  ORDER OP THE  SOCIETY.
  CAMDEN, N. J.:
r .ISTBD BY GHAT & BLLIOTT,
     1860.
V 
 
ADDRESS.
     Gentlemen, Fellows, and Members of the Medical- Society of
 New Jersey,—The revolution of another semi-annual term, has
 once more brought about the assemblage of the representatives
 of our profession, from all  parts of the commonwealth  of  New
 Jersey; and in accordance with time-honored custom, and  your
 partial—I fear, too  partial  selection, it becomes my duty to ad-
 dress  you, at the commencement of our  deliberations,  on this
 occasion.
   In looking around for a suitable subject upon which to engage
 the attention, my mind was naturally directed in the first place,
 to the more recent and novel forms of disease, and  the improve-
 ments, or  proposed improvements in therapeutics, which  have
 been originated since our last semi-annual convocation; but  a lit-
 tle reflection convinced me, that subjects of this nature which will
 necessarily be discussed  more fully in the elaborate reports  from
 the several district committees, are more properly adapted to the
 regular monograph, or treatise, in an established journal, than to
 the ephemeral lecture with which it has become  customary to
 preface our labours.
   It seems more  consistent with the true  intention of such ad-
 dresses, that they should  offer for the consideration of  the Society
 plans of practical utility, and measures, calculated to uphold the
 dignity, and promote the usefulness of the medical profession, the
 object and  chief end of our foundation; than mere detailed narra-
 tives or even scientific arguments, such as may be properly intro-
 duced  at any stage of  our proceedings;  and in accordance  with
 this impression, I propose to offer some suggestions, calling for
 important and definite  action on the part of the Society.
   The rapid increase of empiricism, and the consequent extension
of human suffering,  disease, and death, during the last few years,
have awakened much anxiety on the  part  of the profession, and 
4
  ^iven origin to many and learned disquisitions upon the causes of
  the evil, though rare indeed have been the measures of practical
  reform, suggested by the able minds engaged in the investigation.
    To protect the community of New Jersey from the consequen-
  ces  of gross ignorance, unprincipled cupidity, and insolent as-
  sumption, in the profession of medicine ; the charter of the Med-
  ical Society of New Jersey, was originally granted, and in fur-
  therance of the same laudable object, its  provisions have been
  modified from time to time, by the legislature, at our request.—
  We have received from that instrument, many and singular pow-
  ers, in contrast with that of other states of our union; and we
  have necessarily become charged with delicate trusts and impor-
  tant duties.   The public has extended to us, privileges of impor-
  tant value, in consideration of our pledge to protect it from the
  dangers of empiricism and incompetence.  The  public has  per-
  formed its portion  of the contract faithfully.   Have we  been
  equally faithful in the moral and conscientious discbarge of our
  part of the  common obligation ?  In  attempting a reply to  this
 most serious question, it becomes requisite for me to  enter into an
 analysis of the more important rights and duties conferred and
 imposed upon us by the sovereign authority of the state; and we
 find  one great end  and purpose of our creation, as a body  of
 guardians  of  the  public weal, tersely and briefly summed up  in
 the fourteenth section of the act of incorporation, which commen-
 ces with this  significant provision:—" And be it enacted, That
 this act shall be so construed as  to prevent all irregular bred pre-
 tenders to the healing art, under the names or titles of practical
 Botanists, Root, or Indian Doctors, or any other name or  title,
 involving quackery  of any species, from practising  their decep-
 tions, and imposing upon the ignorance and credulity of their fel-
 low citizens,"  &c.  This section  concludes with the  proper refer-
 ence to the pains, penalties, and  processes, by means of which, it
 is prescribed that empiricism in  New Jersey, shall be extermina-
ted by this Society;  and no one will pretend that  these means art
 in any marked degree  deficient or defective.  By the  provision
of the twelfth section, it is made, not the privilege, but  the legal 
5
duty of the district societies, to prosecute the delinquent in every
instance of infraction of the law.
   Permit me now, to inquire, to what extent this imposed legal
duty has been performed by these district societies ?  Are there
no irregular bred practitioners, practical Botanists, or Indian Doc-
tors, ungraduated Homoepathists, Thompsonians, or Water Doc-
tors, at present imposing upon the ignorance and credulity of their
fellow citizens, within the immediate cognizance of the members
of our district societies, and who are permitted  to do so with im-
punity, and  in defiance of the  law of the land, through our cul-
pable supineness?
   The late President of our  Society, in his learned and eloquent
address, delivered at  our  last stated meeting, congratulated  the
profession upon the rapidly increasing confidence  of the commu-
nity of New Jersey in the counsel and skill of the regularly edu-
cated practitioner, and the subsequent decline of the evils of em-
piricism—but has he attributed this portrait to  the  happy and
important advantages derived from  the proper and legal exercise
of our duties ?  the redemption of our pledges in  accepting from
the state our chartered rights ?  Alas, no!   The  community has
grown wiser, and endued with power to discriminate between what
is true, and  what is false,  and  hence it  is, that the diffusion of a
superior  grade of education, has enabled an increasing number
of our fellow citizens to distinguish  between true and  false pre-
 tension.   The people, it may be truly declared, have commenced
to guard  themselves, in matters relative to health  and life, and
thus they are  performing for us, those  very functions which our
corporate existence was created to fulfil.
   Gentlemen—I should be false to you and to myself in permit-
ting  a spirit of  flattery or self-laudation  to  check the expression
 of this serious and  important  opinion.   So long as a single un-
 graduated empiric is permitted to  endanger with  impunity, the
health and lives of the citizens of New Jersey, in  contravention
of the laws  of which we are the regular constituted guardians, so
long the  Medical  Society of the State must be adjudged false to
 its trusts, and guilty of a  breach of our contract with the state. 
6
  If,  then, this opinion be correct, is it not  incumbent upon us,
to enter upon an investigation of the causes, and extent of our
dereliction of duty in relation to a subject in  which our honor is
directly concerned, as members  of a corporation that is  but a
creature of the  law and a servant of the public?   Policy, as well
as principle, obviously demands that we should act promptly and
efficiently.   The talented lecturer, who so recently addressed you,
forewarns those of our profession, who, neglecting  the opportu-
nities which surround them, fail  to become  solidly grounded in
the  art of  healing, or suffer themselves to fall in the rear of the
march of our science, that the public is becoming  momentarily
more  capable of estimating^he distinction between the intelligent,
well instructed, and accomplished practitioner; and the physician
who rests satisfied with adventitious  means  of success, and the
comparatively slender amount of  knowledge deemed requisite to
warrant a commencement in professional life.  If, then, our defi-
ciencies in technical  matters  are thus open to popular criticism,
how can we safely calculate upon the  forbearance of  the people,
under a much more obvious neglect of the plain letter of laws,
enacted at our request—Laws, from which we have derived,  and
are still enjoying, the full measure of  benefit.  But the civic du-
ties of the New Jersey Medical  Society  are not restricted to tbe
extinction of  extra  professional  quackery,  and  incompetence.
Where  is the  respectable  practitioner,  whose  indignation  has
slept, while witnessing the rapid deterioration of medical instruc-
tion,  and the constant diminution of the requisites of the degree
of the Doctorate, within the last twenty years ?
  Schools have been multiplied  to an  unprecedented  extent, by
the numerous sovereignties of the United States, and over these
schools preside, not the profession itself, whose interests are most
immediately involved—not the people, speaking through the gov-
ernment, who might probably endeavor, however blindly,  to leg-
islate for the protection of their own  health  and lives—but nom-
inally, at least, certain associations of men, of visible standing in
the community, elevated by their wealth and political influence,
and it may be, a certain  share of literary  acquirements—men, 
?
who,  nevertheless, are as ignorant as the general public, of the
science in which they are called upon to determine the awards of
merit.  To men of this class, residing  for  the  most part at the
principal  centres of intelligence, where their liability to  injure
life or limb, from the abuse of their high functions by the licens-
ing of the unworthy or incompetent, is reduced to almost a nullity*
we look for the legal certificates of medical ability, in the shape
of a diploma.
   Let us look a little  deeper into the operations of this system.
It is not to be supposed that men so well instructed as those who
constitute our Board of Collegiate Trustees, would undertake to
determine for themselves, the qualifications of aspirants for med-
ical honors, while conscious of their own profound ignorance of
the recondite principles of medical science ; and we find that they
have  not in  any instance assumed such  responsibility.   They
have invariably made over the duty of examining  candidates to
those  who are alone capable of performing that  all-important
task;  those who are practically familiar with the art of healing.
In this respect the dictates of common  sense and propriety have
been apparently obeyed.   But to what  class of practitioners has
the management of examinations been  referred ?   Invariable to
those, who are actually engaged in teaching, and who are there-
fore directly interested, not in extending the strongest  guardian-
ship over the health and lives of the community,  but in swelling
the proportional number of graduates  annually sent  forth from
their own particular schools—for who is not fully aware that the
reputation of easy examinations, and slender requirements, both
in money and science, as preparations  for the Doctorate,  consth
 tutes  the highest charm of a Medical School in the eyes of the
 trembling neophyte, who seeks to place his foot on the first round
 of  the professional ladder ?   What  intelligent practitioner needs
 to be  informed that the  popularity and reputation of a college
 are measured in the minds of the unitiated public by the number*
of its class, and that those numbers are dependent, primarily and
mainly, on the supposed lightness of examination and the facility
of graduation ? 
e
   The  only rational and worthy object of the institution of the
Medical Diploma, is the protection of the public from the results
of ignorant pretension in our divine art—yet there exists not in
the United States a single independent ordeal of medical merit.
   In every School, the first preliminary question addressed to the
candidate, is not, What do you know ? but  Where have  you stu-
died?   The second, is not, How long have you been reading and
observing t but,  Whose ticket have you taken ?   Now, there is no
Esculapian cave, like that of Delphos, from which, by the pecu-
liar favor of Apollo, the oracles of our art are uttered.  Whence,
then,  arises this universal system of constantly multiplying mo-
nopolies, in each of which  the  student,  in order to enjoy  the
teachings of the truly wise in  one or many  departments of the
Science, must be content to forego superior opportunities in other
departments, because a Board of unprofessional Trustees have
failed in securing the best talent, in every department for its own
particular laculty ?
   Why is the candidate, who  has expended the largest amount
of time and money, in obtaining the best instruction,  refused the
right to claim a  certificate of his qualifications, because, instead
of studying exclusively in one or two collegiate establishments,
he has chosen the best teachers from among all within his reach ?
   No disinterested observer will attempt to deny, that the exist-
ing system of exclusiveness, which confers the medical examina*
tions to the holders of a certain ticket of matriculation, and obliges
it to be conducted  by and before those  who have a direct and
heavy interest in fulfilling the wishes of the candidate, wisely or
unwisely, has degraded the teaching of medicine, from the loftiest
occupation  in the noblest of sciences, into a mere trade, to be con-
ducted upon mercantile principles.  That rivalry between schools
which should lead to constant  efforts  to elevate the character of
medical instruction, and to raise the moral value of the  diploma,
as a certificate, has been perverted, under  the  influence of this
mistaken system, to results,  precisely opposite.
   Where the reputation of the school, and the emoluments of the
professors are  made to depend, not on the  quality of  the instruc- 
9
tion, but directly upon the  number of the matriculants, and the
relative proportion of graduates, it would  be asking too much of
human nature to expect  the dignity and usefulness of the profes-
sion to be advanced, or even upheld, in the face of a vigorous,
and constantly increasing competition ; and it cannot be a matter
of surprise, nor will the fact  be denied,  that  the value of the
medical diploma is, and for years has been, depreciating, both in
public and professional estimation.
   Least any one  should charge me with  dwelling too strongly
upon this point, I will quote, as a series of public efforts to correct
this acknowledged evil,  a resolution offered by  Dr. Bartlett, at a
late meeting of the American Medical Association, at New York,
and referred by that body to an able Committee—
   "Resolved, That the union of the business of teaching and licens-
ing, in the same hands, is wrong in principle and liable to great
abuse in practice.  Instead of  conferring the right to license on
Medical Colleges, and State and  County  Medical Societies,  it
should be restricted to one board in each State,  composed, in fair
proportions, of representatives from its Medical Colleges and the
profession at large; and the pay for whose services as examiners
should, in no  degree, depend upon  the number licensed  by them."
   I shall not attempt to occupy your time and attention with a
critical analysis of the remedial measures  advocated in this reso-
lution.   I have quoted it, merely in proof of the wide spread ac-
knowledgement of the error of principle upon which the present
system of medical instruction has been founded  and hitherto con-
ducted ;  and it was no doubt owing to a clear appreciation of the
inevitable  consequences of  this system,  that the legislature of
New  Jersey imposed upon this Society,  the duty of overlooking
with care and watchfulness,  the simple,  or mere certificate of a
collegiate diploma, and discreetly,  for  the dignity of the profes-
sion, directed  that even the graduates of other  States  should be
subjected to an impartial examination by a board of our appoint-
ment, who were indifferent to personal interest,  or private advan-
tage, before being admitted to the legal privileges and immunities
of a regularly  initiated  practitioner of this State. Let me then
again solicit the question,  how far the New Jersey Medical So- 
10
ciety has, with integrity and moral  rectitude,  complied with its
obligations to the public in this  respect?   Those  amongst  you
who hav<  been called upon to fulfil the delicate duties of the ex-
aminer, are painfully aware  that while the legal tests of ability
have been rendered gradually less and less severe, partly through
a misplaced, or at least, a very  questionable lenity ; and partly, it
may be, from the apparent necessity  of the case, arising from the
deterioration of  elementary teaching.  The.  number of instances
in which our boards are compelled, unwillingly, to reject even the
graduate applicant, in consequence of ignorance,  too gross,  and
palpable, for concealment, is sufficient most amply to establish the
wisdom of the legislative restriction  and  the truthfulness of the
unpleasant portrait,  I have been compelled to represent before
you.
   Will any conscientious  medical practitioner, presume to con-
demn the  laws by which we have been empowered, and directed
to guard the citizens of New Jersey  against  the fictitious preten-
sions of graduates, who, upon our examinations,  have disclosed
before our official boards, such peculiar qualifications as these ?—

                      EXAMPLE, NO. 1.
   Examiner—What are those medicines called, which increase,
or promote the discharge from the bronchial tubes ?
   Candidate—That was the very part I intended to study before
examination.
   Examiner—What then do you  mean by an expectorant?
   Candidate—I can't exactly tell.
   Examiner—Well,  do you  prescribe  expectorants in  your
practice ?
   Candidate—Yes, Sir, by all means.
   Examiner—Now, as  you  have been in  practice for several
months, allow me to inquire what is  your favorite expectorant ?
   Cetndidate—Jayne's  Expectorant—and I use no other,  because
it is the best.
   Examiner—Can you tell me the  constituents of Jayne's Ex-
pectorant? 
11
   Candidate—No, Sir.   He will not tell that.

                      EXAMPLE, NO.  II.
  This young graduate came forward, with the strongest letters
of recommendation from the  highly distinguished professors of
his school, as one who had won his medical honors, with unusual
eclat.
   Examiner—What is the synonym of calomel ?
   Candidate—I can't say, exactly.
   Examiner—How would  you  write a prescription  for calomel,
and give me the full technical term ?
   Candidate—Hyd:  Chlo: Mit:
   Upon further  examination, this candidate insisted, that this
practical contraction was the proper chemical title of the  drug,
in its entire length, and breadth, and gave ample  evidence of
his conviction, that all similar contractions employed by pharma-
ceutists, were equally complete.   Numerous other questions were
answered by him, with  a  degree of ignorance  not  less plainly
manifest.
                      EXAMPLE NO.  III.

   A graduate not less strongly recommended, under  examination
for Obstetrics—
   Examiner—What do you mean by an hour-glass contraction ?
   The  candidate appeared embarrassed, and was unable  to an-
swer.   The test was therefore applied in a different form,  in or-
der to give  him time for reflection.
   Examiner—Well, then,  Sir, what would you do  in a case of
hour-glass contraction ?
   Candidate—I would pass a wire.
   Gentlemen, were I disposed to cite some of the replies of gra-
duated  candidates, before our Board of Examiners, to questions
in relation  to the dozes, and reagents  of the more active  medi-
cinal poisons, every tendency to satire, would be lost in  genuine
terror, for the safety of human life, when entrusted to the  guar-
dianship of such practitioners; but evidence has been  already 
12
 quoted, which may well cause us to frown with indignation, while
 blushing with shame and  trembling anxiety, at these natural re-
 sults of the existing condition of medical instruction, and the
 fearful negligence of those, who stand as sentinels before the  por-
 tals of professional  life.   It is not my object to dwell censori-
 ously upon the conduct of others, but simply to direct your atten-
 tion to the manner in  which  our own  legal duties have been
 fulfilled.
   In consideration of the rights and advantages, bestowed upon
 us by law, we are required, by those laws, to protect the commu-
 nity of New Jersey against the evil consequences of such gross
 ignorance, and palpable incompetence, as I  have just exposed.
 It is for  this purpose, and  no  other, that our charter prohibits
 even the regular graduate  from commencing  the practice of
 Physic or Surgery, within this  state, (except in cases  of consul-
 tation,) until he shall have passed  an examination and  received a
 diploma from the Medical Society of New# Jersey—that charter,
 exacting  at the same time, heavy penalties for  all breeches of
 this regulation, and making it  expressly the  duty of the district
 societies, in every county  where such penalty shall be incurred,
 to prosecute for the same.
  Fellows, and fellow members, have we fulfilled our  portion of
 this contract with  the State ?  Have we so prosecuted in every
 instance, as by the acceptance of our charter,  we stand virtually
 pledged to do ?  Plain truth demands  the acknowledgment,  that
 more than one of those young  graduates, whose replies to  the
 simple questions of the examiners just stated, and were of course
 refused the license of this Society, though bearing the diplomas
 of schools of the  very highest reputation,  are  now actually prac-
 tising upon the ignorance and  credulity of their  fellow citizens,
 here, in our very midst, and are so  permitted to do, in defiance of
 the laws of the State, and in the face of our legal obligation to
 abate the evil.
  The learned gentleman, to whose address I have  more than
 once alluded, compliments  the  community, and perhaps not un-
justly, upon its growing capacity to scrutinize  the attainments of 
13
medical practitioners, and remarks that "if they be men of su-
perficial attainments, and  undisciplined understanding,  the pro-
fession, no less than themselves, will suffer from the scrutiny."—
On the other hand, when the rapid,  and  seemingly brilliant  ca-
reer of dashing pretension, rendered fearless by the very want of
knowledge, is made a subject of sensorious comment  amongst us,
nothing is more common than the reply, that this  apparent suc-
cess,, isbut atransient evil—that, sooner or later, merit is sure to
find its proper level; and hence  the  removal of  such evils may
be safely entrusted to the public itself, without involving the pro-
fession, in the vain and  endless  task of endeavoring  to restrain
the inevitable and constantly recurring consequences of a system,
over which it cannot exercise control.
   This reasoning  is as  plausible,  as it is  convenient, to men,
whose daily avocations are painfully engrossing, and whose efforts
for the public weal are almost invariably attributed to selfish and
unworthy motives.  It is true, that the principles of the science of
life begin to be more widely discussed in popular lectures, and that
class books on the  subject, are rapidly becoming common in our
academies, and elementary schools; nor will any intelligent prac-
titioner venture to impugn the opinion of the  celebrated Rush,
who, in one of his introductory  lectures, contends that the general
diffusion of such knowledge, is the most powerful antitode to both
professional and unprofessional empiricism, provided the teacher
be fitted  for his office.   But will it  be pretended  that  the igno-
rance  and credulity of  our fellow citizens, have been  already so
far enlightened, and removed by the peripatetic lectures, on the
nature of man, and the compilers of school books on physiology,
that the necessity, which led to our foundation, has passed away ?
 If so_why do we not declare our occupation gone ?   Why does
our charter still burden  the  records of the State?  Why do w,e
 not at once relinquish to the Legislature,  the  immunities  confer-
 red upon us, in consideration of the guardianship over the public
 health, which we have so solemnly agreed to exercise ?
   There is an ethical question involved in these  considerations,
 which calls for serious reflection on the part of the society—does 
14
it not call for immediate  action also ?   Of what avail  it is, that
we reject the incompetent candidate for our license, when he ap-
pears before the confidential, and almost secret tribunal of a board
of examiners, if in defiance  of law and duty, we suffer him the
next day, to commence the very career, which  our examination
was instituted to prevent ?  If we permit him to pursue the  prac-
tice  of  a profession, in which such  ignorance inevitably leads  to
suffering, disease, and death, how shall we rebut the  charge  of
countenancing  homicide, by the mere pretext, that  in  time, such
merit, will be duly weighed by the discerning public ?
   Gentlemen, I fear this discernment of the public is overstrain-
ed.   While eome  of  the best talent of the country has been oc-
casionally employed in  popular lectureship, upon subjects, calcu-
lated to render the uninitiated, more cautious  in listening to the
claims of unblushing pretenders to the  healing  art—while  some
few  men of real ability, and moral worth, have written works
calculated to infuse into the minds of the young, a little genuine
knowledge, of the first principles of Physiology and Hygiene, the
country has been flooded with the open, or secret agents of the
worst of acknowledged empyrics—male and female professors of
crude, and dangerous absurdities—distributing  false facts, false
iheories, false dogmas, and  in many instances, catering even to
the vicious appetites  of their auditors, for the sake of spurious
popularity.   The employees  of a host of publishers of volumes,
miscalled cheap, are  perpetually travelling from city  to city__
from village to village, besieging the doors of every academy, and
invading every school-house, with the offer of their ill concocted
compilations—rude trophies of the scissors.
   I  have  taken some pains to ascertain, from competent authority,
the relative success of these imposters  upon  the  ignorance,  and
credulity, of even our learned fellow-citizens, whose avocations in
life have not induced  them to pursue the regular study of the di-
vine art, in healing, and have reason to believe,  that where one
individual in the community is found to  possess that happy dis-
crimination which enables him to recognize, and satisfy  his thirst
from the pure wells of physiological knowledge, there are  ten, 
15
who rest content with poisonous draughts from the stagnant mo-"
rasses of charlatancy and empiricism.
   How then can  professional merit find its proper level, under
the test of public scrutiny ?  Look around you and declare  in
what instances the medical practitioner has been liberally rewar-
ded by the proceeds of his practice—that there are a few men of
decided wealth, among the ornaments of our science, is not to be
denied—but whence was that wealth obtained ?   Some are rich
by marriage—some by hereditary fortune, or  paternal  estate—
some perhaps by speculation—but who are the millionaires of the
Esculapian art ?  In reply—we would respond to the truth, that,
they are  the venders of  Catholicons,  Panacea's,  Expectorants,
and Indian specifics—the manipulators in infinitesmal nonentities
and wet sheets.  Do these  men find their level ?   When they
have accumulated fortune, does the public discrimination at length
put limits to the growing mass ?  It may be said, that this law of
ultimate equilibrium, is only applicable within the ranks of the
profession ; but human nature is not modified  for  the accommo-
dation of costs, and experience teaches, that the diploma is no
talesman, endued with mystic power,  to  relieve the blindness of
the public—no touch stone,  by which to  test the  real metal,  or
expose the base alloy.
   If, then, merit in our profession,  tends ultimately to find its
level, its movements through the  adhesive mass of  charlatancy,
by which it is surmounted and surrounded, is so slow and gradual,
that death usually arrives in the midst of the precipitation, leaving
pretension still paramount, and consigning the family of modest
merit to the sympathy and kindness of its fellows, who have built
their faith upon this popular but illegitimate law.
   Let us, then, discard an unbecoming  apology for our  neglect,
in leaving unperformed an imperative, though disagreeable duty.
Let the society take immediate  measures to prevent their rejected
candidates from practising upon the ignorance and  credulity of
their fellow-citizens, at once, or request the Legislature to relieve
us from the cumbersome  machinery of a board of examiners,  to 
IT.
test qualifications, which, when found and declared deficient, are
Still imposed upon the public under our tacit sanction.
   Allow me, once more, to invoke your earnest attention to the
question, how far our action  under the existing  charter of the
New Jersey Medical  Society,  comports with the moral and legal
obligations, and with  the  proper dignity of a professional body,
endowed by their confiding countrymen,  and who, under a per-
suasion of our fidelity, have  committed to us,  important trusts
and high responsibilities.
   So much for the duties enjoined upon us by the  charter.  But
that instrument confers optional powers, as well as important pri-
vileges and essential obligations.
   In the course of my remarks, on the errors of the existing sys-
tem of medical instruction, I made allusion to the  opinion enter-
tained by many, that the root of these errors lies entirely beyond
our reach—that we are powerless in attempting to control  or
modify the system of  medical  instruction.   Before closing these
remarks, I will ask the attention of the society to a few sugges-
tions on this point.
   The same wise forethought, which induced  the  Legislature to
protect, by means of the New Jersey medical license  system, the
ignorance and credulity of  the public, against the  impositions of
incompetence, armed with  the diploma, or not,  appears also,  to
have engendered  the anticipation of a period when  the medical
diploma,  as uttered under  the sanction of  the  various  faculties,
established on the ancient  plan, would cease to be  a certificate of
merit—when the  multitude of young graduates poured forth from
schools, in which the period, or quality, of preliminary study has
been, and still continues to be  curtailed, in practice, if not in the-
ory, might fail to  supply the wants of the  public with a sufficient
number of real competent  physicians.  What other consideration
could have persuaded the Assembly of our State, to extend to us
the all-important  privilege conferred in the fifth  section of our
Charter ?
   " And  be it enacted, That the Medical Society of New Jersey,
(including both fellows and delegates) are  hereby authorized to 
17
institute regulations, which shall again be approved by a majority
of the whole number of fellows, acting separately, according to
which regulations the said Medical Society of  New Jersey, may
confer the degree of Doctor of Medicine."
   Thus it appears, that although we are not required, ice are per-
mitted to  extend to the profession of our choice and our affections,
a portion of that guardianship, which it is made our legal duty to
exert over the health of the community at large.
   If we  are not empowered to correct the abuses of the existing
system of medical instruction, we are at least allowed to institute
 another and a better plan, by which the requisite* for graduation
shall  be  re-elevated to a standard of respectability,  commensu-
rate with the dignity and vast importance of our Heaven-bom
 art.
   We have it wholly  and entirely within our power, to  establish
 a diploma which shall be a test of merit, because it would emanate
 from a body fully competent to determine the question of medical
 ability.   A body having no interest in the results of the exami-
 nation, and no stake, in point of reputation, involved in the rejec-
 tion of a pupil.
   The want of such a model is acknowledged on  every hand.—
 It was shown in the abortive attempt to act  upon the charter of
 the Medical  College of Philadelphia, in 1836.   It is proved by
 the action of numerous medical bodies, since that time, in various
 parts of  the  United States.  It re-appears in the resolution of
 Dr. Bartlett, before the  American  Convention, at New York.—
 Why, then, have so many efforts to palliate evils that are univer-
 sally condemned, proved unavailing, and in every instance futile?
   The answer is as obvious  as the fact.  The members of the
  several  faculties  of teachers, are among the  most  learned, the
  ablest, and most influential men, whose genius does honor and
  dignity to our art.  They are properly put forward, and naturally
  assume controlling stations, in all general  movements of the med-
  ical profession.  They have made heavy  investments in the bus-
  iness of teaching, and those investments  are secured to them by
  legal rights, really or seemingly exclusive.   Such faculties  exist 
18
 in almost all  the  larger States,  and everywhere the immediate
 teachers of our professional youth are made the immediate arbi-
 ters of their professional honors.
   Can it be expected of human nature, that reforms which would
 sap the very foundation of these rights—lessen perhaps, the value
 of  investments, and leave  hard-earned distinction to maintain
 itself by ceaseless struggles with  aspiring  merit, should  receive
 the unreserved sanction of the very holders of such valuable priv-
 ileges?  Can  we with reason, ask the valuable professor to grant
 his aid in removing the well-cushioned arms from the professional
 chair,  by throwing  open the green room to every  truly well
 educated candidate, without inspecting his  matriculation ticket—
 when we find  by our examinations, how readily the incompetent
 are permitted  to pass unscathed,  that  terrible ordeal by the aid
 of a small  pasteboard talisman,  endorsed with  the image of the
 appropriate school, and superscribed  to by the appropriate Dean ?
  Wherever the tocsin of radical reform in the teaching of med-
 icine  has been  sounded,  there the  hopes  of  the sanguine have
 been crushed,  and  energies of the cautious, enervated by alarm,
 through the natural influences of those who certainly cannot  be
 regarded as totally disinterested judges  of  the propriety of mea-
 sures, having direct influence on their emoluments and fame.
  But New Jersey has no medical school.   No  vested rights, as-
 yet, exist in the hands of teachers.  No ancient system, honored
 alike  in its  use and its abuse, interferes with the calm delibera-
 tion of disinterested  men upon the wants of the professional pub-
 lic, and the means of restoring and elevating the proper  dignity,
 of the noblest and most liberal  of  sciences.  Here then, if any
 where, we might cherish the  hope, for the foundation  of a medi-
 cal school, in which the requisites  for graduation, might be placed
 upon a proper basis.   Where  the  teacher should be forever cut
 off from the dangerous privilege of sitting in judgment, upon  the
results of his own  mental labors.   Where  the accomplished can-
didate, might be secure of justice, without irrevalent inquiry  as
to where his knowledge was acquired.
  And where  the diploma, rendered difficult of acquisition by the 
19
severity of the  scientific tests alone, might become what  it was
originally designed to be—a legitimate certificate of unquestion-
able ability.
   I am aware, that all action upon  the powers conferred  by the
fifth section of our charter, must be surrounded by difficulties, and
encumbered with questions, of the utmost delicacy.  Time, and
the most careful deliberation, would  be necessary at every step.
   Whether  the present be the proper season for a movement in
favor of a reform of the present system of medical instruction, I
leave the  society to decide; but in  calling your attention to this
subject, I  have performed a simple duty, in the hope of relieving
this venerable and time-honored  association, from  the charge of
luxuriating in  privileges unpaid for, or resting idle, in the midst
,of powers unexercised, and duties unperformed.
   Let me now conclude, with an apology  for the somewhat unu-
sual  character of this address.   A medical life, is a life of reflec-
 tion  and scientific observation.
    The avocations of the closet, and sick room, call us off from the
 details of  ordinary affairs, and perhaps no  class of the community,
 are more  habitually averse to the routine of  business.   Prone as
 we are, in hours of leisure, to meditative thought, and in our more
 active pursuits, to  recondite investigations,  and abstract discus-
 sion, we too frequently become neglectful in our civic duties.—
 This has been my motive in quitting the beaten track, and in-
 stead of occupying  your time, with a disquisition upon profes-
 sional ethics, or an essay upon some practical, or theoretical ques-
 tions in medical science, I have regarded the New Jersey Medi-
 cal Society, rather as a civic institution, the  creature of the law,
 established for a social purpose, than as a body of philosophers,
 engaged in the treatment of disease.
    New Jersey has contributed her full  quota of enterprise and
 talent, in all other departments  of  human affairs.   The walks of
 mercantile life, the theatres of industrial energy, the  bench—the
 bar—the halls of legislation, are  graced on every side by bright
 stars from the galaxy of genius, claiming the institutions of New
 Jersey, as the fountain of their  light, though  the illumination of 
20
their rays extend from ocean to ocean, and from the frozen plains
of the north to the southern boundaries of the Anglo-Saxon race.
  Has the most noble and dignified of all professions, contributed
its proper share to this assemblage of distinction?   Perhaps the
query may admit an affirmative reply—but the medical profes-
sion of New Jersey, holds at the .present moment, the power to
place her in advance of all her sisters, in the  march of medical
reform, and if in the few remarks, which time, and the important
objects of this meeting have permitted me to offer, I should elicit
an initiative thought, which, in its future developements, should
lead to a result so glorious, J shall feel myself in part  released
from the deep debt of gratitude, so justly due to the profession we
delight to honor—the State of  my adoption, in which  I  have re-
ceived so many proofs of courtesy and confidence, and my fellow
members of this Society, whose patient attention and kind coun-
tenance  demands,  as believe me, gentlemen, ,they beartfully re-
ceive—my warmest thanks.