I' " ._"

ANNIVERSARY ADDRESS
TO THE
^jVay/t
NEW YORK MEDICAL AND SURGICAL SOCIETY,
TT
F. CAMPBELL STEWART, M.D.
DELIVERED JANUARY 3, 1846.
V?
jfLu~f /^
NEW YORK.
  1846
N 
 
ANNIVERSARY  ADDRESS
TO THE
NEW YORK MEDICAL AND SURGICAL SOCIETY,
BY
F. CAMPBELL  STEWART, M.D.
DELIVERED JANUARY 3, 1846.
 ,pOfi -'* ■■:'3 ..",
 *°     %'
■■> LIBRARY. ?
 : ¥4-7^
 NEW YORK.
    1846.
/, 
 
ADDRESS.
THE ACTUAL CONDITION OF THE MEDICAL PROFESSION
     IN THIS COUNTRY; WITH A BRIEF ACCOUNT OF
         SOME OF THE CAUSES WHICH TEND TO
              IMPEDE ITS PROGRESS, &c, &c.
 Gentlemen of the Medical and Surgical Society :—At  a  period when the
 attention of the profession has been called to the subject, by a recommend-
 ation from our State Medical Society, that a convention of representatives
 from all the medical corporations throughout the country, should assem-
 ble  in this city in the month of May,  for the purpose of considering its
 wants and endeavoring  to remedy  the evils by which our profession is
 surrounded, I conceive that I  cannot  better fulfil the duty with which
 you have honored me than  by asking your attention to this matter, and
 endeavoring  to lay before you an exposition of what I believe to be the
 actual condition of the medical profession in this country, and the causes
 which tend to impede its progress,  or  interfere with its  honors and in-
 terests.
  But before proceeding  to discuss this subject,  I wish distinctly to state,
 least some of the remarks that I may have occasion to make may be mis-
interpreted, that it is not my aim nor my desire to attack individual asso-
ciations ; occupying a strictly neutral position ; bound by no alliance with
cliques or parties; and feeling that  I am influenced  by none other than
the  purest  motives, I shall, whilst disclaiming all feelings of prejudice or
partiality, consider myself at liberty to discuss  the question that  I  have
raised in all its bearings—in a frank and free spirit, and without fear or
hindrance.
  First then,  what is the actual condition of the profession in this coun-
try ? and what is its relative position here as compared with that which it
occupies in other countries ?
  In considering  this subject we must draw a distinction between  the 
4
social standing of the profession—the position  which its members are
allow to occupy in society—and that which is accorded to it  as a profes-
sion, and in consideration of its claims and intrinsic merits.
  In its social relations to the community, I am proud to declare that the
medical profession of the United  States, occupies a more elevated and
lofty station than that enjoyed in any other country of the world.  Here,
owing to the nature and tenor of our institutions, members of the learned
professions occupy the first rank in general society ; and in  the absence
of all hereditary distinctions, physicians, with lawyers, hold an enviable
position,  and are regarded by  the community in so favorable a light as
to be second  only  in its estimation to the pious and  educated  divine.
The road to honors and distinction in every department of the public ser-
vice, and  in every station in  life  is open to us  as well as to others j
and we often see members of our profession occupying distinguished poli-
tical situations of emolument and  trust,  from which, in the  older  coun-
tries of Europe, they are, for the most  part, from the simple  fact of their
being medical men, almost wholly  excluded.
   Here,  in all parts of  the country, we  are individually honored and
esteemed ;  in  the  smaller  towns  and settlements, we are  looked up
to on important occasions for assistance and counsel,  and  our opinions and
advice ever command the most respectful attention and consideration.
Our society is everywhere courted by the  intelligent and honest citizen;
and we are always regarded in the light  of honored  family friends by
those who  employ us, and place a degree  of confidence and reliance in
our honor and integrity,  which, whilst most flattering and grateful, should
lead us to  contemplate seriously the nature and extent of the obligations
which it forces us to incur, and which it  should be our duty and pleasure
to render ourselves  capable  of discharging in  a becoming  and proper
manner.
   In  some parts of the old world, so low  is the condition of our profession
in its relation to the general community, that physicians are considered
rather in the light of hired menials, than as gentlemen and scholars, enti-
tled by education to be regarded as on a footing of perfect equality with
the most accomplished members of every civilized and refined society.
Abroad, the medical man belongs to a caste which is considered compara-
tively low, and, although sometimes tolerated by  his supposed superiors
belonging to the higher  circles, he is but rarely  received either in Eng-
land or  France on a footing of acknowledged equality by the  higher aris-
tocracy,  and in some parts of Italy and other portions of the Continent, he
occupies a position almost degrading.
   Here, on the contrary, we claim and receive from the community the
high  consideration to which we conceive  ourselves to  be entitled, and
which, notwithstanding  occasional attempts to injure us collectively, we
always find freely accorded to  us in our  individual capacities.
   It is this flattering and honorable  social  position which we  occupy that
contributes materially to excite the  ambition of many of the thousand
applicants for admission to our ranks, some  of whom thus  see a road
opened  for access to a society  which it might be much more difficult for
them to reach by other more laborious and circuitous routes.
   Such then is the relation of medical men individually, to general  socie-
ty ;  but what is the relation that  they bear to it  collectively ?  How is
the profession regarded by the  public at large ?
   That there is a great want of respect and regard  for what  is called the 
5
regular profession, is, I think, abundantly manifested by the unconcealed
and open efforts to  injure it, as evinced both by the encouragement of
quackery in all its multiplied forms and varieties, and by a constant en-
deavor  to find fault with, condemn, and ridicule the art, and those who
practise it.
   The  action of the representatives of the  people  in the legislatures of
some of our States, proves likewise that our profession is not held in high
estimation ; these gentlemen  seem, by their course of action, to desire to
cast down and destroy every barrier of protection which had been  raised
by their predecessors, and considered by them to be quite as essential to
the welfare of the  people  generally, as to our interests.   In some in-
stances they have succeeded in throwing the practice of medicine open,
and making it free to all who  choose to engage in it, without requiring
from them  any guarantee of their capability to treat disease, or affording
to the  people the slightest  protection from impostors, who, by arrogating
the title of physician, may with impunity  pursue a course of chance
 practice, calculated to produce the most serious  consequences to their
 health, and endanger  the lives of those  who submit themselves to their
 care.                                                             .
   The evils  resulting, not to us, but to the public, from the application
 of the principles of free-trade to the practice of medicine, are numerous and
 most serious, but it is not my intention to indicate them at present, and I
 will only reiterate  the assertion, that as a profession we are not held  in
 high estimation in this country.  If required, other proofs in  support of
 the declaration may be found in the instances  which I  shall cite, when
 I come to speak of the causes which tend to operate against our united
 interests.
    Let us now examine the question, whether  we are really entitled by
 our intrinsic merits to the same scientific consideration as our professional
 brethren in other parts of the world !  In a word, is our standard of learn-
 ing and acquirement as high as it should be, to entitle us to consider our-
 selves as on a footing of scientific equality with the physicians of other
 countries, and such as to justify us in demanding, as a matter of right, an
 unbounded confidence from those who  employ us,  and  place faith in our
 professions of capability ?
    This is  a most delicate  question, and demands a careful and attentive
 examination.  We are all, for the most part, unwilling to admit  our in-
 feriority in anything to which  we have devoted a special attention, and in
 which we desire to be considered proficients ; it is only natural and to be
 expected,  that we should hold  ourselves equal to others of the same call-
 ing •  and  it is but  very rarely that we can bring ourselves tb admit, par-
 ticularly in the cases of professional men, that we have superiors.
    At  the  threshold of this investigation, I am bound to acknowledge that,
 in science at least, the profession in this country is far  behind the medi-
 cal  communities of  other countries, and this, I think is wholly owing  to
 the wrong and faulty system  of medical education established amongst
  us- a system so defective as not  only to have attracted the attention ot
  foreigners, but to have led to a loud call from the disinterested and well-
  informed portion of our own Faculty, for a thorough remodelling.
    With the exception of some few attempts to support the  present system,
 orieinating with parties whose position is such as to warrant the conclu-
  sion that  they must be more or less  influenced  by personal  interest m
  advocating it,  I believe that  the  feeling may be considered as almost 
6
 universal in favor of the adoption of a more extensive course of general
 and professional instruction, and the establishment of a higher standard
 of medical acquirement.
   To aid us in investigating this subject, I will present a statement of
 what is required by our Medical Colleges of their students, before  they
 will allow them to apply for an examination, or accord  them the honors
 of a Degree, and by comparing these with the  requirements exacted by
 the medical boards of other countries, we shall Be  able to see in what the
 difference  consists,  and why it is that  our  physicians,  at least at the
 period when they first become such, are not entitled to be considered on
 an equal scientific footing with those of other parts of the world.*
   At most, if not all the chief Medical Schools of the United States, it is
 exacted  from  Students who apply for Degrees, that they shall produce
 evidence,
   1st. Of their having studied in the office of a Practitioner.
   2d.  Of their having attended during two courses of lectures at a Medi-
 cal College.
   3d.  That they shall have composed a Thesis; and
   4th. That they shall  have complied with some minor  general regula-
 tions.
   There is no preliminary examination,  and no means  are resorted to
 for ascertaining whether a young man is capable, by previous preparation,
 of profiting by the lessons of his instructors, or likely to  make  hereafter
 a competent and useful Physician.  He may be thoroughly well grounded
 in the various branches of science,  and his general knowledge may be
 most extensive; or he may be, as I have known, so ignorant and illiterate
 as to be unable to write his own language, or translate the Latin of the
 Diploma which he is striving to obtain.   He is not put to the proof,  and
 no evidence is exacted of his having complied even with these few rules,
 other than his simple assertion, or at most the exhibition of his  tickets,
 which is rather required as a proof of  his having  paid for them,, than as
 any  evidence that he has attended the lectures to which they give him
 admission.
  Having fulfilled these obligations, he is. admitted to an examination,
 and receives his Degree, or is rejected.
  The character of this examination is generally  such, that a  student
 who cannot  undergo it  must be  wofully ignorant  indeed.  Hence,  the
 rejection of candidates is, with us,  a matter of exceedingly rare occur-
 rence, and almost all who have complied with the most essential requisite
of paying their teachers, are sure to be honored  with the title to  which
they aspire.
  At all  the principal Universities and Colleges in Great Britain, Ireland,
and on  the  Continent, where medicine is taught, the courses of instruc-
tion are much  more complete and  perfect than with  us.  At  London,
 Edinburgh, Paris, Dublin, and other seats of Medical  schools,  students
are afforded many more, and much greater facilities for acquiring a tho-
rough medical education, and the period of study is not only much longer,
and the subjects taught  more numerous, but the preliminary  and  final
  * For a detailed statement of the regulations established by the principal colleges
in this country and in Europe, in reference to the Degree of M.D., see Appendix to
this address. 
7
examinations are of a character to render it certain, that  the  candidate
who obtains their  Diploma must be a qualified  and thoroughly  well-
educated physician.
  The courses of instruction at our Colleges embrace, for  the most part,
six subjects, which are professed to  be taught in two years, or rather in
two periods of less than four months each, so that with a moderate degree
of attention, and a fair share of common sense, any one,  with  us, may
acquire the knowledge considered as necessary for a physician, and obtain
a license to practise, after about eight months' college study ! And this too
under circumstances in every respect unfavorable ; such as a continual
and irksome attendance on lectures on different subjects, during a great
part of every day, leaving neither time  for  study  and preparation,  nor
for relaxation or dissection.  More time is devoted in other countries to
the study of the fundamental science of anatomy alone, than  is  allowed
to our students  for perfecting themselves in all the branches of a medical
education.
   Whilst for the  most part, then, seven or eight  months' attendance on
lectures is required by the regulations of our Medical Colleges,  in Europe
 four years are  considered  as  scarcely  sufficient;  and  that  too after a
 preparatory course of study  calculated to enlarge and  strengthen the
mind, and render it fit for receiving the more difficult and important pre-
 fessional knowledge which is to be subsequently imparted.
   All the  more  important subjects,  and especially  practical anatomy,
 and clinical medicine and surgery, are there thoroughly taught.   The
 student is not only required to  dissect,  but  is examined  on  Dissection,
 whereas, here a very irregular attendance on the Dissecting-room, proba-
 bly during a few evenings only in each session, is all that is expected of
 our pupils, and indeed, in some cases,  they are notified publicly, before-
 hand, that though advised to do so,  they will not  be required  to dissect
 at all.   Whilst  it is considered of paramount importance abroad, and is so
 in  reality, little  or no attention to Hospital practice  is  required from
 the student here.  Some of our colleges exact from him  that  he shall
 purchase a ticket of admission to a hospital, when one is convenient, but
 there the matter rests.   And this  even is  not always required ; .and if
 not obligatory  on them  to do so,  how can it be expected that students,
 when they have so much else to attend to, will go to the expense of  pro-
 curing a ticket, or after  getting  it,  will take the  trouble to  attend   the
 practice of these institutions ?  That they do not do so, is, I think, very
 evident, from the fact that out of upwards of six hundred in  attendance
 at the New York Colleges during the present session, only about one  in
 eight have applied for the privilege of visiting our City Hospital!  And
 yet this is known to be  the only  one  here to  which they  can  obtain
 access.   The all important branch of clinical  instruction then  is  not
 taught  to  students here,  at all events in a satisfactory manner; for the
 cliniques attached to the schools in this city, in Philadelphia, and else-
 where, though  useful, can never present to them the advantages  that
 they would derive from  examining patients, and following  their treat-
 ment, in a regular and well organized hospital, and under the direction
 of qualified teachers.
    Botany, Medical Jurisprudence, Practical Chemistry  and  Pharmacy,
 Pathology, and some other subjects considered essential to a medical edu-
 cation abroad,  are nowhere taught properly, or as separate branches, in
 the medical schools of our country; and the student's knowledge of them, 
8
if obtained at all, must be gained by close study and application at home,
after he has gotten his diploma, and left college.
  It is the want of a thorough and efficient course of education here, that
induces so many of our young graduates to go abroad for the purpose of
gaining knowledge  which they ought to  be able to obtain at  home ;  and
I may venture  to assert, that if proper use was  made of the advantages
possessed by our large cities for  affording  medical instruction in^ all its
departments, and if our schools would at once adopt a high standard of
professional acquirement, Paris and London would  soon  cease to present
the superior attractions which they now do, and our young  men would
seek at home the information which  it now costs them so much  trouble
and expense to obtain in foreign countries.
  It is most humiliating to us to know that none of our  colleges are re-
cognized by European schools as on  a footing of full equality, and  that
alumni here are not thought entitled  to be held  as equals with  students
there.  And yet such is the fact, and most, keenly do some of our spirited
and high-minded young men feel it to be so.  I have known them ashamed
to acknowledge that they were graduates, and the M.D., so coveted, and
so ostentatiously displayed at home, at least whilst it is new,  I have seen
erased from their cards when abroad.
  So satisfied are some of them that they are  not prepared to defend the
title with which they have been inconsiderately honored,  that they prefer
to appear simply as students, from whom  much less is to be expected than
might be looked for in persons bearing the full and highest honors of the
profession.   It is for the  want of a thorough education here, that our
young physicians are compelled  to enter themselves as the students of
students when  they go abroad, and thus to admit, that though graduates,
they  are wanting in the knowledge possessed by under-graduates.
   It is a gross error to suppose that the high standard of medical educa-
tion established in Europe  is the result of wealth, and that it is imprac-
ticable to introduce it into this country, as has  been asserted by a  venera-
ble author  here, whose lecture on the subject,  and  in defence of our pre-
sent  system, has been so severely criticised, that I shall make  no other
commentary on it, than to point to the bright examples to be found amongst
the most eminent and renowned physicians of Paris and London, many of
whom have had to encounter a degree of abject  poverty  unknown in our
country, and who have, nevertheless, gradually risen to fill the proud po-
sitions which they now occupy.*
   Besides the estimate in which  it is  held abroad, in  what light is this
subject considered at home ?  The editors of many of our medical jour-
nals admit frankly that our  whole plan of  education is most  faulty; and
numerous recent writers, in advocating the call for a general convention,
declare that the defects of the present system are so glaring, that a change
is absolutely required.  One of them  makes use of the  following strong
language in reference to the subject:

  " We have always advocated a higher standard of  medical attainment for gra-
duating in medicine, and a sufficient preparatory education to place  physicians on
  * The celebrated Velpeau, one of the most distinguished men in our profession,
was so poor when a student, that he was forced to live on coarse ammunition bread
and water.  For a long period his daily expenses were limited to nine cents, and he
supported himself for three months, in Paris, on twenty dollars. 
9
 a par with the other learned professions ; but we have seen so much of the level-
 ling system;  so much pandering to popularity ;  such audacious promises on the
 part of medical schools, to  gull pupils; such pretensions to cheapness in board ;
 such mock examinations for degrees ; such drumming up of students; and such
 underbidding in the price of tickets; in short, 6uch artifices, and tricks, and ma-
 noeuvres, for the sake of putting a few dollars in the pocket, that we have almost
 lost our early faith in the practicability of medical reform, at least to that extent
 to which it ought to  be carried in order to accomplish the desired end."

   There is no school here, whose certificate our  army and  navy exami-
 ners can take as a sufficient guarantee of the  qualifications  of candidates
 for admission as medical officers into either of these branches of the  pub-
 lic service;  they are obliged to form a  standard of  their own, and the
 numerous rejections of young men, mostly graduates, whom  they  exa-
 mine, show conclusively that it is  higher than that of the colleges gene-
 rally.*
   The possessors of them do not always appreciate  the diplomas which
 are so easily obtained, and which  they in many instances know and feel
 that they do not deserve.   A young man applied to  me a short time since
 to take him  as a pupil, and on my asking if  he  had yet undergone his
 examination, he  answered me  " yes, he was  a graduate of such  a  col-
 lege ;" but with great naivete added, " that he did  not think he ought to
 have a diploma,  or that it could be worth much."
   A gentleman, likewise a graduate, in indicating to another,  in my  pre-
 sence,  some  of the numerous  advantages which he might derive from
 visiting Paris, stated that " he had, on obtaining  his  diploma here,  con-
 sidered himself to  be a good  anatomist, a good chemist, and a  good  sur-
 geon ; that he thought he was a competent physician, and quite as  well
 informed in his profession as any one else.   He had gone abroad, however,
 and he had been but a short time in France when he was ashamed to find
 how ignorant he was,  even in the branches  in which  he  had supposed
 himself accomplished.    He scon  ascertained that his whole  course of
 stndy was to be gone over again, and that he literally knew  nothing, and
 was far behindhand with  junior colleagues  with  whom he  was brought
 into contact."
   A system then,  which is so universally admitted to be defective, must
 stand in need of amendment, and it appears to me that a period has  now
 arrived when a  bold step may be advantageously  taken in favor of re-
 form, and the introduction of, if not a European, at least a higher stand-
 ard of medical education amongst us; and the  school or schools that shall
 adopt it, though they may for a time experience a loss in the diminished
 number of their  pupils, will eventually, and certainly, find  their reward
 in the increased value that will attach to  their  diplomas.
   We can most of us recollect the time when the Edinburgh or London
 Degree was almost necessary for the physician who expected  success in
 his profession ;f  it is now almost equally necessary for those who  would

  * " A medical board for the examination of applicants for appointment to the me-
 dical staff of the army, was convened in the city of New York, on the 1st of  July
 last.  Before this board 15 candidates were invited to present themselves, 10 of whom
 only appeared and were examined; and of these last but 2 were approved and re-
 commended for appointment."—Report of the Surgeon General U.  S. Army.
  f There  are, however, numerous exceptions to this general rule, for we  have
 amongst us some fully qualified  and highly accomplished  physicians who are self-
 made men, and who never enjoyed the advantages afforded to those who study in Eu-
rope. 
10
succeed, to have enjoyed the advantages of Paris.   The  public, having
no other sure guide, formerly esteemed a physician in  proportion as the
university from which he received his degree was estimated ; and now
that we have so many schools, and so many incompetent physicians, and
are so surrounded  by quacks—renegade doctors—or those who arrogate
to themselves the title,  people  will  begin to  look about them again,
and make inquiries as to the relative standing of the  various colleges,
with the view of employing  those physicians who shall  bear the diploma
of that institution which is known to give the most full and perfect course
of instruction.
  It would almost  seem from the course pursued by them, that many  of
our colleges are disposed to offer bounties to young men, and entice  them
away from  honest mechanic trades, to engage in the study of medicine.*
So easy and cheap do they make it  appear, is  the effort necessary for
gaining a license, that  numbers  are induced to study, who would never
for a  moment think of doing so, if moderate restrictions  were imposed,
and they were required to devote a reasonable proportion of time to at-
tendance on lectures.
  The result of this is, that hundreds  gain entrance to the profession who
are wholly unfitted for fulfilling the  high duties devolving upon practi-
tioners ; and this evil must continue so long as the efforts  of our medical
schools  are directed to the end of obtaining the largest classes, and send-
ing forth the greatest number of graduates.  So long as  they trust for re-
putation on  the number,  rather than  the character, of their alumni, our
country will be annually flooded with imperfectly and half-educated physi-
cians, many of whom must, from absolute necessity, be forced to resort
to means for gaining a livelihood, calculated to degrade them in  their own
and in  the public  estimation, and to produce a ruinous  influence on the
profession.
  I regret that time does not permit  me to enter more fully into  the ex-
amination of this important subject, which  is worthy of the closest consi-
deration, and demands the earnest attention of medical men.   I  have said
as much, however, as  the occasion warrants, and  I will now proceed  to
indicate some of the causes,  which, in my  opinion, tend to interfere mate-
rially with the honor and interests of  our profession.
  These are of two kinds: such as are produced by the acts of the pro-
fession itself, and such as are caused by the acts of the community Gene-
rally, or those not belonging to our society.  Of these, the first, it  appears
to me, are by far the most important, and  productive of incalculable in-
jury ; and I think that  we might find, if  we  examined carefully, that
many of the evils of  which we have cause to complain, fire the direct
consequence of the suicidal  course pursued by the profession itself; and
that in fact most of the difficulties by which we are surrounded are'occa-
sioned by ourselves.
  Can all members of our faculty conscientiously assert  that they have
ever acted with the view, and in a manner to promote the interests of the
profession to which they belong ?  And are all guiltless of having  at times
pursued indirectly, if not directly, a  course calculated both to impair the
   At some of our country medical schools, students are allowed to pav their profes-
sors with due-bills, or notes, to be redeemed at some future period, when the voumr
men shall have accumulated enough money to enable them to cancel the obligation 
11
credit of the general body, and lessen the estimation  in  which it should
be held by the public at large ?   It cannot be expected of any one  that
he should admit  the charge openly, and yet we all know that there are
numbers who feel, and who are obliged to admit to themselves, that they
have too often pursued a course in furtherance of their own individual
interests,  which was calculated to impair that of the body generally.
   The  professional and social intercourse of medical men,  in this  city
especially, is on a wrong and improper footing; there is to  as great, if
not  to a greater  extent here, than  elsewhere, a degree of jealousy and
unkind feeling which ought nowhere to exist.
   It would appear that many of our body fall into the gross error of con-
sidering that their individual  success  depends on decrying their profes-
sional rivals, and indirectly leading patients to conclude,  that they alone,
of all others, are able and capable of rendering effectual assistance.   This
has been  everywhere noted as a common and general fault of the Facul-
ty, and those who indulge in  the  practice are most wofully mistaken  in
the  result which they  hope it may produce.  I have yet to learn  that a
single instance can be found in our annals, in which eventual or lasting
success has attended the exertions of individuals who have endeavored to
gain a  position by so  unfair and dishonorable a course.   The public is
generally sufficiently versed in these matters to be able to distinguish
between genuine merit, and boastful pretension, and it rarely or ever ac-
cords confidence,  to those whom  it cannot esteem.  All who are in the
habit of indulging in this very censurable and disloyal course, would do
well to bear in mind the established truism  " That every physician  who
decries another,  injures himself by depreciating the general estimation ini
which his profession should be  held."   Or in the words of Mr. Percival:—

   " A physician should  (from motives of interest) cautiously guard  against'
whatever  may injure  the  general respectability of  his profession; and  should
avoid all contumelious representations of  the faculty at  large, or of individuals;
all general charges against their selfishness or probity ; and the indulgence of an
affected jocularity or scepticism concerning the efficacy and utility of the healing
art."

   That this evil exists to a deplorable extent amongst us cannot  be de-
nied ; and it is the more to be regretted, because it is so generally  unjust, from
the  circumstance of its being almost impossible to ascertain the real quali-
fications of medical men (after graduation),  and from depreciating  lan-
guage being  frequently used  in reference to individuals with whom the
party has no personal acquaintance, and whose impressions are often
formed from hearsay, or are the result of some  pique, or  supposed cause
of complaint, for real or imaginary injuries, and rivalry.
   A part of this evil results from the fact that social meetings of medical
men are not of sufficiently frequent occurrence amongst us.*  The advan-
  * It is, I am sorry to say,  a very rare circumstance for the physicians of New
York to meet together sociably at each other's houses, or indulge in an interchange
of friendly civilities.  Here, there are no convivial assemblings of those whose tastes
and occupation should draw them frequently together; and although some laudable
efforts have been  made to break through the icy circle that surrounds us, they have
not been responded to in a proper manner, and consequently have failed to accom-
plish the desired end. 
12
tages of this  kind  of intercourse are most  manifest, and  it should be
heartily encouraged, as it always serves  the purpose, by bringing indi-
viduals together in a friendly way, of engendering kindly sentiments, and
exciting mutual regard and  esteem, which will ever be accompanied by
courteousness  of demeanor and general respect.
  The Faculty has  been injured by the course pursued by some of its
members, in reference to their intercourse with those, who are debarred
by their  owh  acts from being entitled to  be  considered  on a footing of
equality  with  honorable and respected members of our society.   It is
sometimes very difficult to  draw the line of distinction between those
members of the profession who retain a right, as honest members of it, to
enjoy all its privileges and honors, and those who, by their acts, have for-
feited all  claim to its countenance and support.  The moment, however,
that it shall be proven satisfactorily, that a  medical  man  has departed
from a strict line of professional conduct, and  pursued a course calculated
to impose on  the public, and degrade his calling, he should cease to be
regarded  as an equal by high-minded physicians,  and it becomes  their
duty to expose him, and to refuse to lend  him their aid and  assistance in
consultation.
   I  am happy to add, that I believe the evil resulting from this source is
now at an end—at all events in our own city ; for I do not know of any
practitioner of respectability,  who will now  consent to consult with, or
meet on  a footing of equality, any one who is openly known to pursue a
course at variance with the  honor and interests of his colleagues.
   Conscientious and highly honorable members of the Faculty have at
times lent them the  influence of their names, and given certificates to ven-
dors of quack medicines, thereby contributing, probably, without intending
it, or indeed, without considering that such must be the result, to favor impos-
ture and weaken the bonds by which the profession should be united to the
public.   Such a course is sometimes  pursued even now, and I believe it
to be a most fertile source of mischief and  injury to us.   When the signa-
ture of a regularly graduated physician  is appended to these notices of
'drugs, the valuable qualities of which are  certified to by him, how can it
ibe expected that the public shall  refrain  from purchasing  them ?   We
nave had some striking examples of the evils  ensuing from  the practice,
and  we should unite in our efforts to put a stop to it.
  By our charges we sometimes excite  in the public mind a feeling of
doubt and distrust;   in some instances  by demanding more  for our  ser-
vices than they are really worth, and in other instances so far undervaluing
them, or rather allowing them  to  be  undervalued, as  to lead  people to
think that, when thus tacitly acknowledged to be worth so little, they mav
in reality be worth  nothing.  This is one of the great difficulties with
which we have to  contend,  and  unfortunately it would scarcely  seem
capable of "being remedied.   No  fixed and satisfactory tariff, applicable
to all cases, can be established, and it is  a matter which had probably
better be lelt to the  judgment and discretion of each individual.  A just
medium in charges, however, should always  be observed, and we should
never be so unreasonable  as to ask $100 for a single and  inactive con-
sultation  visit  in the city, nor yet condescend to allow our services to be
estimated  at the value of ten cents a visit, or  one shilling for vaccination
or venesection.  When persons are really able to do so, they are, for the
most part, both ready and willing to grant a fair and adequate remunera-
tion  for professienail services, and when  too  poor to pay more than the 
13
paltry sums last indicated, we should  refer them to the public charitable
institutions provided for them, or, at all events, a feeling of pride should
lead us to reject  all compensation, and find our reward in the conscious
pleasure of doing a good action.
  Feuds amongst ourselves are of too frequent occurrence ; they should
always be condemned and  avoided, as they are the means of retarding
the progress of the profession, and frequently throw  impediments in the
way of science.   These, however, when strictly confined within profes-
sional limits, cannot produce the great and  serious evils which must ever
result from their being made public.  All of our faults and errors should
be kept within our own bounds, and on no account should medical men
allow their feelings to get the better of their judgments, so far as to lead
them to commit a  positive and  irreparable injury on the  profession, the
evil consequences of which they are sure to experience themselves, in the
depreciation of public respect and confidence in their profession.  They
should recollect the advice given by the venerable Hufeland, and bear in
mind his declarations on this subject, to  the effect that:—

  " In proportion as the public is made acquainted with the faults and defects of
physicians, and  as they are  made  to appear suspected and  contemptible in its
eyes, so is the estimation in which medicine is  held, lowered ; and as this dimi-
nished confidence is extended from  the science  to those who practise it, the cen-
surer soon experiences the consequences of it himself.  Public malice against
physicians would certainly be less indulged in, and their faults would much less
frequently furnish  food for general conversation, if they never themselves set the
example."

   Our intercourse in consultation is not regulated by any well-understood
or  generally approved rules, and hence there are  occasionally serious
difficulties occurring in instances in which they would not occur, if good
and established forms were  universally known and  rigidly adhered  to.
That advantage  is sometimes  taken,  by those called on for consultation
advice,  to  supplant the regular or  family  aitendant, is well  known ;
and hence, that degree of confidence  so necessary for the interests, both
of the patient and  the profession, cannot exist where such a result may
even be apprehended.   It is impossible to conceive that a more degrading
and baneful influence could be brought to  bear against our body, than a
practice of this kind, and I cannot, for my life, see how an honorable and
liberal-minded man could for a moment indulge in so disreputable a habit.
With  those who profess the feelings of gentlemen, the compliment con-
veyed in the simple fact of confidence being reposed by a brother practi-
tioner, to  the  extent  of leading him to seek for friendly  advice  and
assistance, from  a source from which  he thinks that  he may obtain both,
is more than  enough  to outweigh any  feeling of sordid interest which
might arise in  his breast.   The simple fact of his being called  to a family
or patient, with the consent, and generally at the solicitation of  the ordi-
nary attendant, renders it  impossible for  him, at any future period,  to
attend such family or patient, without a full and honest understanding
with the other, unless in cases of emergency, and then only as a locum
tenens, until the  regular attendant can be found.
   It is much the practice with us to entrust our patients  to the care  of
some friend during temporary absences from business, or  in case of sick-
ness, and any  undue attempt to  supplant those for whom  we act,  is as
unjust as it is  dishonorable, and I regret ever to have learned, what  I 
14
 did with shame, that a distinguished physician of our city had urged to
 one in a neighboring town, as an excuse for not prolonging a visit that he
 had made, " that he was  afraid that if he did  not  return home,  those
 left in charge would steal his patients from him."
   I have now alluded, but very cursorily however, to some of the faults
 of the faculty itself, which are, I think, positive  causes operating injuri-
 ously on our general interests.   The remarks that I have  made, though
 applying in full force to the condition of things  amongst  us, are by no
 means confined exclusively to the profession in this country; the evils to
 which I  have called attention, are  most of them acknowledged to  exist
 elsewhere; they are not for this reason, however, the less serious, or the
 less to be regretted;   it behoves  us all to unite  in  endeavoring to
 remedy them ; and I feel confident that, as far as its influence and power
 extends, this Society will, whilst pursuing its  course  of general useful-
 ness,  strive  to inculcate sound and wholesome  doctrines  in  Medical
 Ethics.
   I will now proceed to point out  some  of the  non-professional causes
 which tend to produce  an  injurious  effect on the  interests of the faculty.
   The influence of the Press is severely felt by  our  profession  as being
 frequently exerted to its prejudice  and discredit.
   The most prominent and striking manner in which this  injury is expe-
 rienced, is through the facility  afforded to Quack advertisers, for insert-
 ing in popular and extensively  circulated  papers, notices of their secret
 remedies, and astonishingly successful modes of treatment.  To such an
 extent has this evil grown, that whole columns of our most  respectable
 newspapers are filled with them.   A recent writer declares that  he  had
 counted eleven out of twenty columns comprised in one paper, filled with
 these quack notices.
   It is wholly impossible to calculate the amount of injury that accrues
 to the community, as well as to us,  from this pernicious  and  degrading
 practice.   For, besides lending to  impostors, facilities for puffing and
 making  themselves known,  these  advertisements are frequently of a
 character both indelicate and criminal, producing a baneful influence on
 public morality, and often leading to the commission of offences  against
 the laws both of God and the State.
   I am aware that the  space occupied in newspapers in the manner indi-
 cated, is well paid for,  and that it may appear unfair and  unreasonable
 to expect their proprietors to deprive themselves  of so  fertile a source of
 revenue.   But have  these gentlemen no other object than pecuniary
 gain ? Are they not bound, as  directors of public opinion, and as guardi-
 ans of the public interests, to abstain from pursuing a course calculated
 not only to injure us, but directly prejudicial to the public weal ?  Is it so
 clear that they would necessarily incur a loss by refusing to promulgate
 information such as is usually contained in these notices ?  If they could be
 induced to devote the space occupied in this disreputable manner to mis-
 cellaneous information of a general  character, they would soon  find
 their subscribers to increase in a proportion amply sufficient  to  compen-
 sate them.  The experiment has already been tried abroad, and we hear
 of no complaints of loss from those interested in such  journals  as  have
 refused to serve as a medium for imposition.
   The opinion of the  publisher  of  one of these papers on  the  evils
resulting from  the course  generally pursued, is expressed in such strong
 a nd forcible language, that I cannot resist the temptation to quote it.  He
 says,— 
15
  " We fell into the current and followed the bad example  of pre-existing  peri-
odicals ; but reflection has led us to see our mistake, and we hasten to repair it,
assured that we shall give satisfaction to all our readers, who  properly estimate
the true character of modern quackery, which is one of the vilest and foulest of
all foul and vile vocations, and is sustained to an incredible extent by fraud,
forgery, and falsehood, and fraught with delusion, disease, and death. To publish
their nostrums is to partake of their deeds.  To receive their money is to share
their spoils and aid them in making war upon mankind."

   May we not hope that the example set by  this Editor may be speedily
and generally followed on this side  of the Atlantic, and that editors  here
may likewise be found—

  " Cheerfully to abandon the publication of all advertisements of quack medi-
cines, which will be an act of homage to their own taste and judgment, no less
than a concession to  the strongly  expressed  opinions of some of their  best
friends, who, with ourselves, deeply  deplore  the disease and mortality occa-
sioned by the nostrums of medical quacks, published daily in this great metro-
polis."

   By following so independent and  wise an example,  this foul blot on the
body of our Press will soon be entirely and permanently erased.
   But this is not the only complaint that we have to make against  pub-
lishers and editors in this country.  We have to find fault with many of
them for their editorial encouragement of new  systems, and innovations
on our established methods of practice, by which,  if possible, more  than
by inserting  advertisements,  they injure  us, and make  dupes of the
public.  The frequent, and often well written articles which appear  in
the editorial columns of our newspapers, in praise of various quack sys-
tems of medical practice, and  urging upon the community their value
and importance, do much harm.   For, besides being more generally read,
they carry  with them a great degree of weight, as emanating from  indi-
viduals supposed to  be impartial, disinterested,  and capable of forming a
correct judgment.
   The Press  is likewise guilty of injustice  towards us in sometimes  pub-
lishing garbled or incorrect reports of the acts of medical men, or bodies
of medical men, which are calculated to cast ridicule on them and on the
profession to which they belong.  The professional transactions of Medi-
cal societies, and the reports of medical  lectures, are not  proper or  fit
subjects for insertion in other than medical journals.   But,  at all events,
when they are published, it is but a matter of common justice to report
them correctly  and with accuracy.
   The remarks sometimes made by the Press in reference to dissection,
are often injudicious,  and calculated to maintain feelings of prejudice
against it, and against those who are obliged to  resort to it.  Practical
anatomy is one of the branches of our profession, with which every medical
man should be  familiar, and as it is impossible that a proper and correct
knowledge  of it can be obtained otherwise than by the actual dissection
of dead bodies, it appears to me that the intelligent writers for newspapers
would be doing a positive good, if, in place of exciting their feelings by
using harsh language in reference to this subject  when it  is  spoken of,
they would endeavor to bring people to view it as indispensable for  their
own interests;  as, without it, it is  wholly  impossible for  us to qualify
ourselves to make  good  physicians or skilful  surgeons, the influence 
16
of the press should be exerted to lead the public to look upon it as a matter
of course, and our authorities should be induced  to  make suitable  legal
provisions for furnishing students with the means  of prosecuting  their
studies in this department of science.*
 ,  I think we have fair  grounds for making complaint against the  legal
profession, for interference with our interests, in the manner in which
charges are sometimes given to juries,  and examinations sometimes con-
ducted in cases of a medico-legal character.
   I need  not remind  you that,  in their endeavors to get evidence  from
medical  witnesses,  lawyers often  travel  out of their way, and go far
beyond  the record,  in order to endeavor if possible—not  to  shake the
testimony of those whom they may be examining, or cross-questioning;
for this they have a perfect and undeniable right to do if they can; it  is
their duty to  get all the facts of a case, and  elicit the truth from every
source—but to impair the confidence of a  jury, in medical  testimony, as
such.  They are often satisfied if they can make it appear that a physi-
cian falters, or is unable to answer at once, and without a moment's  hesi-
tation and reflection, all and every question that  they may choose to put
to him;  forgetting that whilst theirs is an exact science, ours  is as yet
far from being such, and that an apparently trifling question may involve
so much, and  be capable of so  many various  interpretations, that every
honest and upright man will naturally pause and hesitate, before pro-
nouncing an opinion on which  much may depend, and which  it is  often
requisite for  him to  study well, before he can  Come  to  a conclusion
that  shall  be satisfactory even to himself.  Does a  lawyer make up his
mind, and pronounce an opinion directly,  when  a legal question  is
submitted to  him 1   Undoubtedly  not; he demands and takes time to
consult his books and the various authorities on the subject, and after due
reflection and study, and a repeated and calm examination of all the  facts
and bearings of the case, he decides, and returns an answer to his client.'
How then ought it to be expected of us, that we should  be able to reply,
without timely consideration, to the many  futile and  irrelevant questions
that are often put to us by counsel ?  Have we no authorities to consult,
and no examinations to make before we can come to a correct conclusion ?
Assuredly  we have; and from their great number, and the  want of  esta-
blished standards to go by, as a general rule, we should  have much  more
time even allowed us, than would be accorded to the lawyer, in which to
make up our minds.
   Though an excuse may sometimes  be  found  for  the course pursued
towards us, by examining attorneys, whose task, I  am ready to admit,  is
occasionally a difficult one, I conceive  that none whatever can be urged
in favor of judges, who, in summing up evidence, and giving charges  to
juries, occasionally make use of language calculated to produce an un-
favorable  impression  against medical  testimony, and   thus  indirectly
against the profession.
   We have two striking examples of the  existence of the evil of which
I complain, recorded in the New   York Journal of Medicine ; the one
  * It is but just to state that, since this address was delivered, an editorial article
has appeared in one of our most popular city journals, noticing and advocating the
call for a National Medical Convention, and admitting the existence of some of the
evils here complained of. 
17
as occurring in a case of trial for malpractice, in vaccinating on the arm,
but not exactly at that portion of it usually selected for this operation;
and the other, very recently, in a trial for murder and arson.
   In the first instance,  the Judge, one of the most eminent in a  neighbor-
ing State, after listening to the positive testimony of most intelligent and
competent medical witnesses, which  testimony tended  to exonerate the
operator from all  blame in the case, is  reported to have charged to his
jury, " that in performing the operation of vaccination or inoculation, the
physician is liable for all consequences if he neglects the usual precau-
tions, or fails to insert  the virus  in that part of the arm  usually selected
for the purpose j notwithstanding many other parts of the body might be
proven to be equally proper, and even more suitable localities;"  and he is
reported to have gone on to illustrate his position, by likening us to com-
mon carriers, who would be liable to damages, if, in the transportation of
public or private property, they departed from the usual route.
   As might well be supposed,  the jury, under these directions, brought in
their verdict against  the physician, and awarded heavy damages, besides
the costs.   Let us hope that this very learned gentleman may never re-
quire the services of a  surgeon, who, in order to save  his life, might have
to modify an operation, or depart from a usual course ; for in such case,
he might fear the consequences, and hold himself justified in refusing to
interfere.
   The other instance  to which  I  have alluded, occurred in the trial  of
" Polly Bodine ;" it  is, if possible, more  serious than  the  one which I
have just briefly narrated.   It may be recollected that, in this case, physi-
cians  were  called upon to  institute  a post-mortem examination of the
remains of a female and child, who were supposed to have been murdered,,
and afterwards burned.  These physicians discharged their duties with
credit to themselves,  and in a manner which should  have given general
satisfaction, as far as they and their evidence went.  But what acknow-
ledgment did they receive for their  performance of the unpleasant task
imposed upon them—one for which I may venture to say they were
allowed  a very inadequate, if any pecuniary  compensation at all ?—why,
the  presiding Judge took occasion, in his summing up to the jury, to
make these uncalled for and unjust remarks :—

   " Was the death here by violence ?  Unfortunately very much of the difficulty
which we now encounter, at this stage of the case, arises from the very inadequate
manner in which the physicians discharged their duty. Had they made a judicious,
active, and scientific post-mortem examination, they could have increased, in a
great extent, the evidence of the guilt or of the innocence of the  prisoner; and
it is greatly to be regretted that this was not the case.  They did not  even make
a memorandum of the examination,  such  as it, was. They made  no inquiry
whether there had  been strangulation or suffocation, whether poison, or some
narcotic drug, had been administered; even their examination with respect to the
marks of violence was imperfect and unsatisfactory.  They have left us, there-
fore, in that state of uncertainty, in regard to  the cause of death, which is very
much to be regretted both by you and me."

   When  the acumen  of judges and  lawyers is  insufficient to detect
whether a prisoner is guilty or innocent, it seems rather hard to throw the
blame upon the  unfortunate  doctors whom they may have called upon for
assistance, particularly in a case where, from the testimony of the medi-
cal gentlemen alluded to, it appears that the bodies submitted to their ex- 
18
  amination  were so much charred and  altered, that it was impossible to
  derive from their inspection more satisfactory or accurate information than
  that which they obtained and communicated to the court.   I  would par-
  take with these gentlemen of the gratification which would be afforded to
  us all, if the learned judge would inform us by what  means we could be
  able to obtain the information which he charges them with carelessness in
  not obtaining.  I fear it would puzzle that prototype of wisdom—as he is
  always referred to as an ultimate resource—the Philadelphia  lawyer—or
  even their honors themselves, to do more or better, than  was done by the  '
  respectable medical gentlemen implicated in the cases  to which I  have
  alluded; and I can but think that they  would act more wisely, and  more
  in conformity with the ends of  justice, by augmenting, rather  than depre-
  ciating the value of  medical testimony.
    Gentlemen,  we are entitled  to a  little more courtesy in these matters
  from our brothers of the bar;  and as the most important results follow
  from it, and the greatest stress  should be laid upon the evidence of physi-
  cians,  it would appear to be the soundest policy, and a public duty,  so to
  conduct  the  examination  of medical witnesses as to  get at the positive
  truth, and elicit all  the facts of a case, without endeavoring to make an
  impression against their evidence, which must affect a class, the object of
  all whose scientific  researches  is the elucidation of truth, and whose col-
  lective aim and desire is to be useful to their fellow-men.
    Besides the manner in which I have indicated, it is asserted that mem-
  bers of the legal profession are  frequently active propagators of new  theo-
  ries and  quack notions, all of which tend more or less to the positive in-
 jury of our profession.  A late writer says, in relation to this subject:

   " The lawyer himself, though he sees his own profession hemmed in by the
  strict limits of a prescribed education, and by a formidable array of antiquated
  technicalities, thus opposing to the  intrusion of quackery a firm, though time-worn
  and moss-covered wall that it cannot scale—even he is often seen encouraging in
  our profession empiricism of the grossest kind, and perhaps cheers on and assists
  an ignorant populace in pulling down our modern wall, which has been so recent-
 ly built that its uniting cement is yet hardly dry."

    These remarks were appropriately introduced  into the address  from
 which  they are quoted (Dr. Hooker's Dissertation), and although I do not
 think that lawyers are as often  given to the encouragement of quackery
 as many other  members of the  community, I do consider that, being high-
 ly educated and accomplished   scholars  and gentlemen—fully capable of
 appreciating the difference between what is absurd and what is rational__
 between  ignorance and  intelligence—they should  always discountenance
 the former, and on all occasions lend their influence to the furtherance of
 science,.
   We feel  severely the  influence of  the clergy, as operating  against our
 collective interests,  and through their countenance of empiricism, to the
 positive detriment of the public at large.
—- Let  me speak with reverence of the  ministers of God, whom we are
 all taught from our earliest youth to honor and  respect, and for whose
 holy calling I  entertain feelings of the greatest veneration; and let  us
 consider  the course that is pursued towards us by  many of that body, as
 the result of thoughtlessness and want of consideration, rather  than as' an
 evidence of ill will, or intentional desire  to injure us, and deceive such as
 confide themselves to their spiritual charge, and place unbounded confi. 
19
dence in assertions supported by the testimony of pastors whom they re-
vere and esteem.
  I would on no account lay myself open to the imputation of making an
unjust or harsh attack on ministers of the Gospel; and yet when their in-
fluence is sought, and their credit  obtained, to defraud the public by re-
commending persons  wholly unworthy of regard, it becomes a duty to in-
dicate in plain terms  the evil consequences that ensue from such patron-
age being extended to such individuals, and likewise to show how detri-
mental is such a course to the  interests of a profession with  which they
are so closely allied,  and the object of which is, as  well  as that of their
own, to do good, and  to heal and succor such  as stand in need of assist-
ance.   No class of men have a better opportunity of witnessing the un-
tiring devotion of  physicians to their sick  charges  than  clergymen, who
are so frequently brought into contact with them in the abodes of sickness
and  misery, and  in  the hour of death ; none are  better informed than
clergymen of the  innumerable sacrifices made by medical men in minis-
tering relief to that unfortunate class of the community, whose  want of
means and poverty, render it impossible for them to proffer or afford any
remuneration to those who have assisted them in their sufferings, and re-
lieved their wants.  Clergymen are, or ought to be, aware that the servi-
ces rendered by medical men to all our public non-political charitable in-
stitutions are entirely gratuitous, and that  in  most  instances they do not
receive, directly or indirectly, any consideration whatever for their loss
of time, anxiety of mind, and the  numerous inconveniencies to which
they are subjected.   Do they not  know that our hospitals, asylums, and
dispensaries are regularly visited and carefully attended by honest, honor-
able, and competent members of that profession whose credit and useful-
ness they should endeavor to extend, and  not  to impair ?
   Again, are not the  clergy held in the highest respect and esteem by our
profession at large ?   Do we  not tender  them our professional services
gratuitously, and with free cordiality ?  Are not theological students, and
the children of  divines, permitted to attend the lectures of our medical
colleges without the  usual fees being required from them ?   For these
and numerous other reasons—not  urged in a  boastful spirit, for it would
but ill become us to ask credit for charitable acts which carry with them
their own reward, and for which  we  desire no remuneration other than
that afforded by a  satisfied conscience, and the pleasure derived from the
knowledge  that we are fulfilling a great Christian duty—for these, then,
and for many other  reasons, I conceive that  our profession has strong
and  peculiar claims on the preachers of religion for their countenance
and support, and it appears to me that they should be the last men in the
world  to lend the influence of their sacred characters and position to those
who are ever so ready to avail themselves publicly of both.
   It is a notorious fact, that the venders of quack medicines, and what
are usually called " advertising doctors," exert themselves to the utmost
—and too often  with  success,—to obtain the signatures of clergymen, or
certificates from them attesting to the high virtues of their medicines, or
the superior skill  and knowledge which they possess.   In  proportion to
the number and influence of the clergymen whose interest they can thus
bring to bear, is their success.  So  far is this  system in some  instances
carried, that the fortunate individuals in whose favor they operate, suc-
ceed, in a comparatively short space of time, in  amassing large fortunes.
I do not pretend to assert that  the  success of these  persons is to be at- 
20
  tributed to the influence of clergymen's certificates  alone, for without a
  certain degree of practical knowledge in the  other  arts of gulling, and
  an abundant stock of assurance and cool impudence, their exertions could
  not be crowned with  entire success.  I am only maintaining  that this is
  one of the most sought for and valuable adjuvants that the charlatan can
  obtain, as through its means he may, at least, hope to gain  notoriety and
  consideration  from congregations whose ministers recommend  him and
  his drugs in terms of high praise  and  commendation.
    In support of this assertion, and to illustrate how much importance is
  attached to a clergyman's name,  I will allude to an advertisement which
  has long been a standing  one in  an  extensively circulated daily paper.
  It is  headed, appropriately enough, "Remarkable  Cures," and after
  describing, very briefly, some three or four desperate cases, all of which
  were, of course, speedily and perfectly relieved, and which are well cal-
  culated to strike the minds of non-professional  persons  as being truly
  wonderful proofsof the dexterity and skill ofthe advertiser, it concludes with
  a certificate from no less than six reverend gentlemen, to the effect that they
  have witnessed his astonishing performances, and highly recommend him
  as " safe  and skilful" in the treatment of the diseases which  he  pro-
  fesses to cure.
    I attach more importance to an advertisement of this kind than I should
  probably do, were  it not that the  names  of the  reverend endorsers are
  known to the public, and considered by it as occupying respectable posi-
  tions  in which they  can  command  a certain degree of influence.  I
  would ask the eloquent Baptist clergymen ; the learned Catholic  priest •
 and their  reverend co-signers,  what  they conceive to be the object  and
 aim of a notice of this kind ?  Whether they have thoughtlessly appended
 their names as an act of charity, and with the view of lending  the assist-
 ance of their influence, to an  individual whom they conscientiously be-
 lieve to be worthy of their confidence  and esteem ?  Whether it is from
 ithe desire of seeing their names daily  circulating in print ?  Or whether
 it is that they truly think, that they are  conferring a benefit on the pub-
 lic in recommending to its notice and  consideration, a person whom they
 in their hearts believe to be letter instructed, and letter able to  afford re
 lief in the class of diseases which he treats, than others?  Are thev
 sufficiently versed in the knowledge  of our science to be able to vouch
 for the  learning and skill  of an operator ?  Or do they infer from  the
 advertiser s diploma, which they have doubtless inspected, and which is
 presumed to  have been obtained after  a careful and sufficient  examina-
 tion, by those competent to  judge of his  capabilities, that  thev  are at
 liberty to recommend him as both  " safe and skilful ?"
   I might adduce numerous other instances, in  support of the  assertion
 that the influence ofthe clergy is often  used to further the objects of those
 who seek for notoriety and patronage through  advertisements in the pub-
 lic  prints, and to the positive detriment of the medical profession   The
 one instance, however, already cited, is amply sufficient to illustrate  the
 tact, and there is no further necessity for particularizing
  It would scarcely be believed that  clergymen, though they might be
 willing to sign certificates, and vouch for impostures, would so  far fonret
 their duties, and the sacred character of the religion which they profess
 as to permit the churches over which  they preside, and which  are dedi
 cated to the worship of God, to be  used as  theatres  for the exhfbTtion of
shows and  juggleries; and yet, that this is occasionally done, mLy be 
21
easily proved, and I now hold an  advertisement announcing, that, " by
request," a lecture  on  " Animal Magnetism" will  be delivered, on  an
evening indicated, in a certain church, belonging to a sect held to be one
of the most devout amongst us; and this advertisement goes on to  state
that persons will  be magnetized ;  and closes with  the very significant
notice that '; twenty-five cents will be charged for admission."
  The question may be asked, how can such a use of a holy temple, though
admitted to be wrong, tend to the  injury  of the medical profession ?   I
reply, is it not well known that these pretended  clairvoyant magnetizers
assume,  unquestioned and unlicensed, the high  duties of the Physician,
and pretend, with the aid of something like supernatural lights, to be able
to elucidate the  most intricate pathological states, and suggest remedies
to repair evils,  the  existence of which they are alone acquainted with ?
Do  they not sometimes assume, or have  awarded  to them, besides his
duties, the honored title of the Physician, and thus not only defraud the
public, but do a positive injury to the profession  of which  they are sup-
posed to be members ?  It is for these reasons,  then, and because it is a
profanation of the house of God, that we should call upon  the clergy to
pause, before  they  allow  the  temples committed to their charge to be
violated in the manner that I have pointed out.
  But in  the remarks  that I make on  this  subject, let it not be for a
moment supposed, that I condemn  or censure  the whole mass of clergy-
men  for the faults  or  errors of a few ;  I am well  aware  that the  most
respectable and  worthy  portion of the members of the holy  order of reli-
gious instructors very rarely accord their  influence to unworthy objects,
or  intentionally sanction measures calculated to degrade the standard of
public morality, or act injuriously on the  welfare of  the general commu-
nity.   Still, as the evils of which I complain are no  chimera of the ima-
gination, and do in reality exist to an extensive  degree, I have thought it
both  opportune  and proper to point them out.   By directing attention to
the subject, we may lead  educated and respectable clergymen, of exten-
sive influence, to discountenance openly such  irregular and overt acts on
the part of their religious associates, which tend as  well to the degrada-
tion of their own order,  as  they are  calculated to act injuriously upon
the interests of our Profession.
  Of the influence of Quackery as operating to  the injury of our profes-
sion here, I shall have but little to say.   That it occasions a large pecu-
niary loss  to us cannot be  denied; but when  practised openly, and  by
persons  not lona fide members of  the faculty, I do  not conceive that it
acts in a manner otherwise hurtful to our  interests or reputation.
  It is only when degenerate members of our own body condescend,  from
the desire of pecuniary gain, to  embrace the  trade of the charlatan,
that they are capable for a time of  influencing public opinion, and may,
until  found out, which  they  invariably have  been,  and always will be,
sooner or later, produce an impression  injurious  to our general character
and interests.
  I consider it bad policy, as well  as  bad taste, to  indulge in  abusive
language against this class of persons, who should always be left to the
upbraidings of their own  consciences, and that  severe and most  keenly
felt  punishment  which  consists in an entire exclusion from their society,
and from all association with  their professional contemporaries.   They
may succeed for a  time, and accumulate money, but what shall repay
them for loss of  caste, and that inward feeling of shame and degradation 
22
which they must experience on  finding themselves despised and rejected
by their fellows, and eventually sinking to an oblivion from which they
may never again  hope to emerge—leaving behind them  when they die,
as an inheritance to their children, a patrimony which,  though it may
be rich in the blessings of the world, can never be disconnected from the
recollection of the manner in which it was obtained ?
  These persons are most truly to be pitied ; and their bowed head, and
downcast look, evincing shame and inward suffering, should rather  excite
in our breasts  feelings of commiseration than of ire; and although we
can never permit ourselves to regard them in the light of fit  associates,
we should charitably hope that they have been led astray, and that their
minds are so constituted  as  to  render them  incapable of experiencing,
in its full  force, that  acute sense of degradation which would  be  so
severely felt by honorable men of cultivated intellect.
  That  some  few of them  honestly  believe in the virtues and superior
advantages of a system that  they may  have adopted, is most certain ; but
that  numbers  of them  profess  what  they cannot believe,  and do not
practise, is equally certain, and may be  easily  proved; it is the latter
class to whom I would  have these  remarks apply—those who make use
of a novelty as a stepping  stone  to success,  and cheat  the  public by
promising to pursue a course which they know to be  wrong,  and  which
they rarely, if ever, in reality follow.
  There can be no harm in  it, nor can a physician be justly blamed for
practising according  to any method that  he may conclude, after proper
study and inquiry, to be best;  it is  his duty to follow the  course that he
conscientiously believes will prove most conducive to the interests  of hia
patients;  but, then, he should do so quietly and  unostentatiously—as  a
man who is entitled to the privilege of judging and acting independently—
and scorn to call  himself, or allow others to call him,  the blind follower
of a master, or of a particular and  exclusive system, for  the  purpose of
attracting attention, and  gaining notoriety; thus acting  the  part of an
impostor, whose province and aim is to deceive.  The answer  of a  friend
of mine to a lady, when questioned by her as to what " class of doctors"
he belonged, will  illustrate what I desire to say better, probably, than  I
have explained.   " Madam," said he, " I am a physician who has studied
his profession in all its branches and departments;  I have  examined, and
continue to examine, every new theory and everything proposed as use-
ful, and I  practise in all instances for  the  good of my patients."
  I would  congratulate the Society upon  the gradual declension  from
public favor and sympathy which Animal Magnetism, Homoeopathy, and
similar delusions are now daily  experiencing, as it evinces a return of
the sound  common sense of the people, which has been for a time diverted
by plausible theories and amusing practical exhibitions.
  All that might in any way be gleaned of useful or interesting, from
these innovations, has long since been adopted by the regular  profession,
and incorporated  into our system  of  treatment.   As was our duty, we
have examined and  studied  thoroughly, as it  has ever been our interest
to do,  everything that has been supposed to be calculated to extend our
field of knowledge, or enable us  to render ourselves more useful  to our
fellow creatures;  what little wheat has  been  met with, has   been  most
cautiously and industriously separated from the mass of chaff with  which
it was encumbered, and .although the grains are found to be  both small 
23
and  imperfect, they may possibly produce, if properly cultivated, some
little fruit.
  No sooner, however, is one method of imposture on the wane, than we
find  another brought forward to supply its place; so it has ever been,
and so it must and will be always.  Homoeopathy, lately so fashionable
amongst us, finding no resting place in Europe, at least out of Germany
—scouted  in  France, where its absurdities were fully demonstrated by
positive and actual  experiment—rejected in Italy—discountenanced in
England—some few years since took  its  flight across the Atlantic, and
implanted  itself in our soil.  Here it took root, and  after supplanting
Thomsonianism, and making sad inroads in the fertile fields ofthe " Herb
Doctors," it flourished for a time.  Its  day, however, is now nearly at an
end, and it is rapidly retiring before the enterprising and successful
rivalry of  Hydrosudopathy, and the  Crono-Thermal  system, which, like-
wise, will  have their turn, and flourish  until  novelties of more recent
date, such as the Russian " Mud Baths," or perhaps  a revival of the old
" Water Casting," come to usurp their places and their profits.
  All  the endeavors of the profession can never accomplish much against
new and plausible medical theories,  and by far the most prudent and the
wisest course  is to abstain from all abuse against them.  When asked his
opinion of their merits,  it is the duty of  the upright  and  conscientious
physician to express it frankly,  and  if in disapprobation, let it be done in
courteous  language, devoid of all abusive epithets.   By such a course
we  are sure to obtain a fair hearing  ; and our friends will be ever ready
to acknowledge the force of remarks and reasoning directed to their un-
derstanding, and  which shall be unaccompanied by evidences of personal
pique, or the expression of feelings of dislike and  hatred, evincing undue
prejudice,  or a desire to condemn unheard.
  Having indicated, in a very  imperfect manner however, some few of
the many evils that exist in our profession, and endeavored to convey a
just impression of its present condition, and of some  of the causes which
operate to  injure  it, I shall  not  trespass  longer on your time by offering
suggestions as to the best and most proper means for remedying  them.
The most important, and  perhaps the only subject entirely within  the
control ofthe  profession, is that of education.  But I leave this very diffi-
cult and  embarrassing question to the united wisdom of the gentlemen
who will, I hope, shortly assemble in our city for the special purpose of
investigating it.  Amongst them there will doubtless be found competent
and able representatives of this  Society. 
; 
APPENDIX.
Regulations of  the  Principal Medical  Schools in the United  States and in
                  Europe, in Relation to the Degree of M.D.

                            I.-UNITED STATES.*

   University of Pennsylvania.—" The following  are  the Rules in force in
relation to the Degree of Doctor of Medicine.
   " I. The candidate must have attained the age of twenty-one years, have applied
himself to the study of Medicine for three years, and have been, during that time,
the private pupil, for two years at  least, of a respectable practitioner of Medicine.
   " 2. The candidate must have attended two complete courses of the following lec-
tures in this Institution :—Anatomy; Theory  and Practice of Medicine ; Materia
Medica and Pharmacy;  Chemistry;  Surgery;  Obstetrics  and the  Diseases of
Women and Children ;  Institutes of Medicine.
   " 3. The candidate must also have attended one  course of Clinical  Instruction in
the Philadelphia Hospital (Blockley), or the Pennsylvania Hospital, or some other
Institution approved of by the Faculty of Medicine.
   " 4. Medical students who have attended one complete course in a respectable
Medical School, where the attendance on  two complete courses is necessary to a
degree, where the same branches are taught  as in this, and which is placed upon
the ad Eundem of this school, are permitted to become candidates by an attendance
here upon one full course. They are also exempted from the payment of fees upon
attending here a second term.
   " 5. When a candidate applies to the Dean for admission, he must exhibit his
tickets to prove that the above Rules have been complied with.
   " 6. The candidate, at the  time of his application, must deliver to the Dean ofthe
Medical Faculty a Thesis, composed by himself, on some medical subject.   This
thesis is referred to one ot the Professors, who shall examine the candidate upon
it, and make his report thereon to the Medical Faculty.
   " 7. When a candidate  is  rejected,  his  essay will be retained by the Medical
Faculty.
   " 8. When a candidate withdraws his essay before examination, he will, upon re-
application, be placed at the  foot of the list.
   " 9. The essay must be  in  the  candidate's own hand-writing, and must be
written uniformly on  letter paper of the same  size, the alternate pages being left
blank.
   " 10. General  bad  spelling in a Thesis, or  general inattention to the rules of
grammar, win preclude a candidate from examination for a degree.
   "11. A Thesis may be published by the candidate if he desire it, the permission
of the Professor by whom he was examined thereon being first obtained; but no
alteration shall be afterwards made in such  thesis without the consent of the said
Professor.
  " ] 2. The voting on the case of each  candidate is by private  ballot, and three
negative votes shall reject him.
  " 13. The candidate shall pay the fees of graduation, at  the time of his examina-
tion, or before receiving notice of his success ; and before his name can be entered on
the Register of passed candidates, for the purpose of being reported to the Board of
Trustees and included in the mandamus for a  Degree.
  * It will be perceived that the oldest and the most flourishing of our Schools have been selected
nsstandardsi their course of instruction and requirements are believed to be quite as extensive as
h ose of any Colleges in the country. 
26
   " 14  Candidates who have passed their examination, and in other respects com-
 plied with the regulations, are to be reported by the Dean  to the Provost, who will
 communicate such report to the Board of Trustees, in order that, if approved of by
 them, their mandamus be issued for conferring the Degree.
   " 15. The  Degree will not  be  conferred upon a candidate, who absents himself
 from  the public  Commencement, except by  special permission of  the Medical
 Faculty.
   " 16. Graduates of Medical Schools, on the ad Eundem list, by attending, on a
 full set of Tickets, one complete course in this Institution, are put upon the same
 footing  with students who have attended two complete courses here.

         Rules of Examination for the Degree of Doctor of Medicine.

   " The names and essays of the candidates are to be presented to the Dean on or
 before the first day of February in each year.   The  candidates are then to  be di-
 vided, either by  their own arrangement or by that of the  Dean, into classes of
 eight persons each.
   " These classes will  be designated  numerically by lot, and then formed into
 groups of seven each.
   " The examinations will  begin regularly on the last Monday of the Session.
   " No person's name will be received on a class unless his essay be  in possession
 of the Dean;  nor is his  name  to be attached to a class by any other than the Dean,
 unless he shall have signified his desire to that effect.
   " The classes are to call at the houses of the several Professors, or at some other
 place designated  by the latter ; and when in attendance, each of the individuals
 composing a class is to be examined separately, and in the order of  his name on
 the list of his class.
   " Each Professor is to keep a list of those examined by him, and opposite to the
 name of each candidate  is to note the  result of his examination,  with the view to
 vote in the affirmative or negative, as to his qualifications for the Degree.
   " As the examination of each group  of classes shall be completed, the Faculty
will meet; the names of the candidates examined are to be read by the Dean ; and
 as each  name is called,  the Professors are to consult their memoranda, and if no
 remarks be  made, are to proceed to vote by ballot.  If there should  not be three
 negative votes, the candidate is  to be  considered as having  passed,  and is to be
entitled to his Degree.   Should  three black balls be  cast,  the  candidate is not
to be  considered  as definitively rejected, but is to have the privilege  of another
examination before the  whole  Faculty  in joint session.
   " A candidate who may not have succeeded in the first ballot shall, upon declining
 an examination before the  Faculty in  joint session,  have the  privilege of  with-
drawing his Thesis, without being considered as rejected.
   " If, upon the name of a  candidate being called  out, one or more of the Faculty
 have remarks to make in relation to his qualifications, they are to be  heard  before
the vote is taken.
   " The candidates in classes being thus disposed of, the Faculty will then proceed
with  those who may prefer an examination before  the Faculty  in joint session,
and afterwards with  those  who, having  received  three negative votes, may still
choose to avail themselves of the opportunity of  a  final  examination  offered by
the Faculty.
   " Formal notice of a successful  examination will be delivered upon the fees of
graduation being paid, after which the candidate will  insert his ownjiame with the
title of  his Essay, upon  the Register of Graduates.   No diploma win be made out,
or passed candidate reported to the Board of Trustees, except from an entry upon
the Register.
   " If a Thesis be found remarkable for any good quality, the fact  is to be reported
by the Professor having charge of the Thesis, to the Faculty at their meeting, who
may take  upon it  such  action as  they  may deem  advisable."—Extract from the
Report to the Alumni of the School, 1845.

   College  of Physicians  and  Surgeons  of  the City  of New York.__
"  Graduation.—Candidates for  the Degree of Doctor of Medicine  must  have
attended two full Courses of Lectures, the last in this  College ; they must also have
studied Medicine three years under the direction of a regular  physician, and  have
attained the age of twenty-one.  Each  candidate is required to write  a Thesis on
some subject connected with the  Science of Medicine, and to deposit it with the
Secretary of the Faculty.  Previous to his examination, full and formal certificates
of time and age must be  furnished. 
27
    " The examination of candidates takes place semi-annually.  That for graduation
 in March, on or before the first of March ;  and that for graduation in the fall, on the
 second Tuesday in September."—Extracted from Catalogue of 1845-46.
    There are six Professors attached to this school, besides  the  President; the sub-
 jects taught are the same as at the University of Pennsylvania; the Lectures com-
 mence on the 1st November, and are continued until 1st March.   There are likewise
 fall and spring courses of lectures, to which students are admitted free of charge.

    Medical Department of the University of New  York.—" VI. Regula-
 tions for the Terms of Lectures, Sfc.  Requisites for Graduation.  The  lectures
 commence on the last Monday of October, and are continued until the last day of
 February following.
    " The examination for degrees will commence about the 1st of March, and will be
 continued daily, until all the candidates shall have been examined.
    " The following are the requisitions for the  Diploma:
    " 1st.  The Candidate must be 21 years of age.
    "2d. He must  have attended  two  Courses of Medical Lectures; one  of which
 must have been delivered in the Medical Department of the University of New York.
    " 3d. The Candidate must  have studied Medicine for three years  (the terms of
 attending Lectures  being included in  these),  under the  direction of a respectable
 Medical Practitioner.
    " 4th. He must write a Medical Thesis,  either in the  English, Latin, or French
 language.
    '• Two Commencements take place annually in the University, at either of which
 Candidates who have complied with the above requisitions may graduate.
    *' The first takes  place early in the month of March, and the  other about the
 middle of the month of July.  The great  body of the Candidates will, no doubt,
 graduate at the  Spring Commencement; but those who  wish to postpone it will
 nave the opportunity of coming forward in July.
    " The examination for  Degrees is conducted in private by the Professors individu-
 ally."—Extract from Annual Announcement of Lectures, Sfc., 1844-5.
    There are six Professors attached to this school;  subjects taught, same as in the
 two above-mentioned institutions.

   Jefferson  Medical College,  Philadelphia.—" Regulations, fyc.—The
 regular courses  of lectures commence  on the first of November, and end on the last
 day of February.
    " During the month of October, the anatomical rooms are open, and the Professor
 of Anatomy and the Demonstrator give their personal  attendance thereto.   Clinical
 instruction on  Medicine  and Surgery is likewise  given at the Dispensary of the
 College.
   " The examination of candidates for graduation commences on the first of March.
   " The candidate  must be of good moral  character,  and at least twenty-one years
 of age.
   " He must have attended two full courses of lectures in some respectable Medical
 School, one of which, at the least, shall have been in this College, and must exhibit
 his tickets, or other adequate evidence thereof, to the Dean.
   " He must have studied medicine for not  less than three years, and have attended
 at least one course of clinical instruction  in an Institution approved by the Faculty.
   " He must present  to the Dean of  the Faculty a thesis of his own composition,
 correctly written, and  in his own  handwriting, on some medical subject, and exhibit
 to the Faculty,  at his examination, satisfactory evidence of his professional attain-
 ments.
   " If,  after examination for a degree, the candidate, on ballot, shall  be found to
 have received three negative votes,  he shall be  entitled to a fresh  examination.
 Should  he decline this, he may withdraw his thesis, and shall not be considered as
 rejected.
   " The degree  will not be conferred upon  any candidate who absents himself from
 the public commencement, except by special permission of the Faculty."—Extract
from Catalogue of Jefferson Medical College, 1845.
  This College has seven  Professors, and the subjects  taught by them are the same
 as at the University of Pennsylvania. 
28
                            II.  GREAT  BRITAIN.

[The following regulations are extracted  from the last circular ofthe Edinburgh University, and from
               the " Student's Guide," published in Edinburgh and London.]

  University of Edinburgh.—" Statutes of the  University  of Edinburgh
relative to the Degree  of M.D— Sect. I.   No one shall be admitted to the exami-
nations for the degree of doctor of medicine who has not been engaged  in medical
study for four years, during at least six months of each, either in the University of
Edinburgh, or in some other University where the degree of M.D. is given ; unless,
in addition to three Anni Medici in an University, he has attended, during at least
six winter months, the medical or surgical practice of a general hospital, which ac-
commodates  at least eighty patients, and during the same period, a course of prac-
tical anatomy ; in  which case three years of University study will be admitted.
  " Sect. II.  No one shall be admitted to the examinations for the degree of Doctor
who has not given  sufficient evidence,—
  "  1. That  he has studied, once at least, each of the following departments of
medical science, under professors  of medicine in this or in some other university, as
already defined, viz.:—Anatomy ;  chemistry ; materia medica and pharmacy ; insti-
tutes of medicine; practice  of medicine;   surgery;  midwifery, and  the diseases
peculiar to women and children ; general pathology; practical anatomy (unless it has
been attended in the year of extra-academical study allowed by Sect. I.)—during
courses of  six months.   Clinical medicine, that  is, the treatment of patients  in
a public hospital, under a professor of medicine, by whom lectures on the cases are
given—during a course  of six months, or  two  courses of three  months.   Clinical
surgery; medical jurisprudence ; botany ;  natural history, including zoology—during
a course of at least three months.
  "  2. That in each year of his academical studies in medicine, he has attended at
least two of the six months' courses of lectures above specified, or one of these and
two  of the three months' courses.
  " 3. That,  besides the  course  of  clinical medicine already prescribed,  he  has
attended, for at least six months of another year, the medical or surgical practice of a
general hospital, either at Edinburgh  or elsewhere, which accommodates not fewer
than eighty patients.
  " 4. That he has attended for at least six months, by apprenticeship or otherwise,
the art of compounding and dispensing drugs at  the laboratory of a hospital, dispen-
sary, member of a surgical college or faculty,  licentiate of the  London  or Dublin
Society of Apothecaries, or a  professional chemist and druggist.
  " 5. That he has attended for at least six months, by apprenticeship or otherwise,
the out-practice of a hospital, or the  practice of a dispensary, or that of a physician,
surgeon, or member of the London or Dublin Society of Apothecaries.
  "  Sect. III. No one shall obtain the degree of doctor who  has not studied, in the
manner already prescribed, for at least one year previous to his graduation in the
University of Edinburgh.
  "  Sect. IV. Every candidate for the degree in medicine must deliver, before the
24th of March ofthe year in which he proposes to graduate, to the dean ofthe faculty
of medicine,—
  " First. A declaration, in his own hand-writing, that he is twenty-one years of age,
or will be so before the day of graduation ; and that he will not be then under articles
of apprenticeship to any surgeon or other master.
  "  Secondly.  A statement of his studies, as well  in literature and philosophy as in
medicine, accompanied with proper certificates.
  "  Thirdly. A medical dissertation composed by himself, in Latin or English ;  to
be perused by a professor, and subject to his approval.
  " Sect. V.  Before a candidate be examined in medicine, the medical faculty shall
ascertain, by examination, that he possesses  a competent knowledge of the Latin lan-
guage.
  " Sect. VI.  If the faculty be satisfied on this point, they shall proceed to examine
him, either vivd. voce, or in writing; first, on anatomy, chemistry, botany, institutes
of medicine, and natural history  bearing chiefly on zoology ;  and, secondly, on  ma-
teria medica, pathology, practice of medicine, surgery, midwifery, and medical juris-
prudence.
  " Sect. VII.  Students who profess themselves ready to submit to an examination
on the first division of these  subjects, at the end of the  third year  of their studies,
shall be admitted to it at that  time.
  " Sect. VIII.  If any one, at these private examinations, be found unqualified for 
29
the degree, he must study for another year two of the subjects prescribed in Sect. II.,
under  professors of medicine, in this or in some other university, as above defined,
betore  he can be admitted to another examination.
  "Sect. IX.  Should he be approved of, he will be allowed, but not  required, to
print his thesis ; and if printed, forty copies  of it  must be delivered before the 25th
day of July to the Dean of the medical faculty.
  " Sect. X.  If the candidate have satisfied  the medical faculty, the Dean shall lay
the proceedings before  the  Senatus Academicus, by whose authority the candidate
shall be summoned, on the  3lst of July, to  defend his thesis; and, finally, if the
Senate think ht, he shall be admitted, on the  first lawful day of August, to the degree

  " Sect. XI.  The Senatus Academicus, on the day here appointed, shall assemble at
ten o clock, a.m., for the purpose of conferring the degree ;  and no candidate, unless
a sufficient reason  be assigned, shall absent himself, on pain of being refused his
degree for that year."

  Royal College of Surgeons, London.—" I. Candidates will be  required to
bring proof:  1. Of being twenty-two years of age   2. Of having  been engaged six
years in the acquirement of professional knowledge.  3. Of having studied Anatomy
and  Physiology, by attendance  on lectures  and demonstrations, and bv dissections,
during two anatomical  seasons.   4. Of having  attended at least two courses of
lectures on Surgery, delivered in  two distinct periods or seasons, each course to
comprise  not  less  than  sixty  lectures.   5. Of having attended lectures  on the
Practice of Physic, on Chemistry,  and on Midwifery, during six months ;  and on
Botany and  Materia Medica during three months.  6. Of having attended during
twelve months the Surgical Practice of a recognized hospital  in  London, Dublin,
Edinburgh, Glasgow, or  Aberdeen; or for six months  in any one such hospital,
and twelve months in any recognized provincial hospital.
  "  II. Members and Licentiates in Surgery of any legally constituted College of
Surgeons  in  the United Kingdom, and Graduates in Surgery of any University
requiring residence to  obtain  degrees, will  be admitted for examination, on pro-
ducing their diploma, license, or  degree, together with  proofs of being  twenty-two
years  of age,  and of  having  been occupied  five years  in  the acquirement of
professional knowledge.
  "  N.B.  Certificates will not be  recognized from any hospital, unless the Surgeons
thereto, or a majority of them, be members of one of the legally constituted Col-
leges of Surgeons  in the  United Kingdom ;  nor from  any School of Anatomy,
Physiology, Surgery, or Midwifery, unless  the respective teachers be  members of
some legally constituted  College of Physicians cr Surgeons in the United Kingdom.
  "  Certificates will not be received on  more than two branches of science from
one  and the  same lecturer, but Anatomy  and  Physiology, Demonstrations  and
Dissections, Materia Medica and Botany, will be respectively considered as one
branch of science.
  " In the certificates  of attendance on  Hospital Practice, and  on Lectures, the
dates of commencement and termination are  to be inserted in words at full length.
  " All the required certificates are to  be delivered at the College ten  days before
the candidates can be admitted  to examination."

                               III.—IRELAND.

  Univf.rbity of  Dublin.—For the  Bachelor's Degree.—"The candidate must
present to the Registrar  of Trinity College  certificates  of having  attended  lectures
on the  following branches, viz., Anatomy,  Surgery, Chemistry, Botany, Institutes
of Medicine, Practice of Medicine, Materia Medica, and  two courses of  Clinical
Lectures,  given in immediate  succession.   These  certificates must all be taken
from the Professors in Trinity College,  and the King's Professors,  appointed  by the
Act  for establishing a complete School of Physic in Ireland, unless some three
certificates  for the same courses in  the University of Edinburgh  be produced,
which  are admitted by the Board  : but  the certificates from any other university or
college, or from any private school, are not received as qualifications.
  " The Statutes, after stating generally, that  three years must elapse  after taking
the degree  of A.B. before  that of  M.D. can be obtained, provide that it  may be
taken in three different ways :—
  "I.  If any one commence his  medical studies immediately on his  entrance or
matriculation, then  he may seek the degree of M.B. after twenty-four terms—(that
if, six years). 
30
   " 2.  If he begins after taking the degree of A.B., then after three years.
   " 3.  If he begins after taking the degree of A.M., then after two years.
   " On the production of the above certificates by the Registrar, the  Board grant
 permission to the candidate to be examined  by the four Medical Professors of the
 University, viz., the  Regius Professor of Physic, the Professor of  Anatomy,  the
 Professor of Chemistry, and the Professor  of Botany, provided the  proper time,
 according  to  the  statutes,  has elapsed from the period of his graduating  as  a
 Bachelor of Arts, which examination  is conducted in the Latin language.  If the
 candidate be found qualified, the Professors individually certify the same, on which
 he is permitted to perform the exercises mentioned in the statutes, and at  the
 next half-yearly commencement, the degree  of Bachelor of Medicine is conferred
 on him by the Vice-Chancellor of the University.
   " If  the degree  of  Master  of Arts  be taken previously  to that of  Bachelor of
 Medicine, the degree of M.B. can be obtained in either the University of Oxford or
 Cambridge, which  qualifies the person for  being  elected a Fellow of the  College
 of Physicians of London, to whom several privileges and advantages belong.
   "Doctor of Medicine.—The degree of M.D. may be taken in three  different
 ways, as was stated of  the degree of M.B. :—
   " 1. Those who obtain the degree of M.B.  after twenty-four terms, or six years,
 from matriculation, must  complete six other  years  before  they  can  obtain  the
 degree of M.D.
   " 2. Those who have previously taken the  degree of A.B. may obtain  M.D. in
 five  years after taking the degree of M.B.
   " 3. Those who have previously taken the degree of A.M  may obtain  M.D. in
 four years after taking  the degree of M.B.
   "  The candidate for the degree of Doctor  of Medicine is required to dispute in
 the Hall, and to write and print a thesis.
   " The degrees of Bachelor and Doctor  of Medicine from Trinity College, rank
 with the degrees of M.B. and M.D. of  Oxford  and  Cambridge."

                                1V.-FRANCE.

   Paris School of Medicine.—There are eighteen distinct  chairs established in
 the  Paris School of Medicine,  and twenty-six regularly appointed Professors, who
 are aided in the discharge of theirduties by a number of Agreges or assistant Professors.
   "  Courses.—The instruction  is at present  embraced  in  eighteen  courses of
 lectures, which are divided into a winter and summer session.   The former com-
 mences with the month of November and terminates in March ; the latter begins on
 the first Monday in April, and is continued until the end of July ; August, Septem-
 ber and October  are a vacation.   The winter course comprises lectures on Anatomy,
 Medical  Chemistry,  Legal Medicine, Surgical  Pathology,  Medical   Pathology,
 General Pathology and Therapeutics, Clinical  Surgery, Clinical  Medicine,  and
 Clinical Midwifery.
   " The summer session embraces courses on Medical Physics, Hygiene,  Medical
 Natural History, Accouchements, Physiology, Surgical Pathology, Medical Pathology,
 Pharmacy and Organic Chemistry, Therapeutics, Pathological Anatomy, Operative
 Surgery, Clinical Surgery, Clinical Medicine, and Clinical Midwifery.
   " The clinical lectures are delivered at the hospitals during five mornings of the
 week, and usually commence about nine o'clock, or immediately after  the visit to
 the wards.  All the other lectures are delivered  at the  School of Medicine,  and
 between the hours of ten and four o'clock.
   "Inscriptions  and  Qualifications required from  Students.—An inscription
means the registering one's name in a register kept for the purpose.  This has to be
repeated every three months, and on each  occasion the  student will receive a card
 certifying to the  fact of his having inscribed.  When a young man, whose intention
it is to study medicine, presents  himself at the bureau of the faculty to take out his
first inscription (which, as well as in the case of all subsequent ones,  must be done
in person), he is required to deposit with the secretary the following documents :
   " 1st. His certificate of birth.
  "2d. His parent's or guardian's consent for  him  to study medicine, should he be
a minor.
  " 3d.  A certificate of his morality.
  " 4th. His diploma of Bachelor of Letters.*
  * In lieu ofthe diploma of Bachelor of Letters, the student may submit to an examination, of one
hour's duration, on the French, Greek, and Latin languages, general history, and geography.
  f For the degree of Bachelor of Sciences, the examination is made on Mathematics, Chemistry,
Zoology, Botany, Physics, and Mineralogy. 
31
  " A diploma of Bachelor of Sciences! is required after the fourth inscription and
prior to the first examination.
  " If the father or guardian of a student does not reside in Paris, he must introduce
some known and respectable  citizen, who is willing to become responsible for his
good conduct.
  " The full term  of study comprises four years, or sixteen quarterly terms.
  " Examinations.—Every pupil,  before he can  gain a  diploma from  the  Paris
faculty of medicine, must submit to five examinations, one of which takes place at
the end of his first year of study, and the rest at stated intervals after.
  " The first  examination  is on the subject of Chemistry,  Physics,  and Medical
Natural History.
  " The second embraces Anatomy  and Physiology.
  " The third, Internal and External Pathology.
  " The fourth, Hygiene, Legal Medicine, Pharmacy, Materia Medica, and Thera-
peutics.
  " The fifth and  last  is a practical one, and is conducted at the hospital  of the
faculty (hopital des cliniques);  it consists in selecting two patients  from the wards
of the  hospital,  and examining  and prescribing for them in the presence of a com-
mittee of three professors.
  " The first four  examinations  are conducted by two professors  and  one assistant
professor, and three candidates are examined at the same time ; for the fifth exami-
nation only two candidates  at a time are admitted.
  "  Physicians and surgeons, graduates of foreign schools, who may be desirous of
obtaining  a diploma from  the Paris faculty, must submit to all  the  examinations
required from students; they must  likewise exhibit their diplomas of Bachelor of
Letters  and Bachelor of Sciences  If they can show, by proper certificates, that they
have studied in a foreign university  during two years longer than is required in the
Paris faculty, they are entitled to an immediate examination, on the payment of all
charges exacted for the five separately.   If they cannot produce proof of having been
six years engaged in study, then such time as they have studied will be allowed them,
in the  proportion  of two-thirds; for instance, proof  of three years study abroad is
admitted as equivalent to two years in the Paris school, and hence attendance on lec-
tures will be required for two years only, and so  on.  The King has the privilege of
granting unconditional licenses to foreigners to practise in France.
  " The examinations are conducted in French, and by the professors themselves, or
by the assistant professors (agreges).  A student  is always notified, four days before-
hand, of the time appointed for an examination ;  and if he does not present himself
at the hour  indicated, he  is  not allowed  to apply for another  examination until
after the expiration of  three months, which are thus lost to him.
  " Theses.—By an order of the Council Royal  of Public Instruction (1838), the
theses of  all candidates for medical  degrees are to consist of written  answers  to four
questions, which are to be drawn for by lot.  The  questions  embrace the subjects
ofthe physical sciences, anatomy and physiology, surgery and medicine.   A number
of questions on each of these branches are proposed by the Council Royal, and those
relating to the different subjects are deposited in separate urns, from each of  which
the candidate  draws one in the presence ofthe Dean ofthe faculty, and after having
undergone his second examination.   The thesis is to be deposited in the hands of the
Dean when the student offers himself for his final examination, and it is referred to some
member of the faculty to examine, prior to its being supported in public by the author.
  " All theses must be printed at the expense ofthe student."—Hospitals and Sur-
geons of Paris.

  Notwithstanding the severe restrictions that are now imposed in France, the na-
tional medical congress which lately met at  Paris,  has recommended to the govern-
ment, that additional requirements shall be made of candidates for the M.D. degree,
and that the courses of instruction shall be still further enlarged.