932 
juilt and crops were to be raised. In the 
midst of these exactions, institutions of 
higher learning were established, and to an 
extent patronized, and some strong men 
were produced. But it must be recognized 
as true that society in general had but lit- 
tle time and less money to devote either to 
schooling or to the amenities of life. The 
medical profession, under these circnm- 
stances, was precisely like the community 
of which it was a part. There were but 
few medical colleges, and they, for the most 
part, were but meagerly equipped. Many 
doctors became such while going from one 
town to another. Ignorant inventors of 
alleged systems of cure hawked their wares 
in the highways and the byways. Dogma- 
tism that was destructive to intelligence was 
rampant, while schism was fostered by the 
baneful commercialism that too generally 
pervaded the heterogeneous mass of forty 
thousand people that comprised the medi- 
cal profession. In eight of the twenty-six 
then existing States, no laws affecting medi- 
cal practice had ever been enacted; in 
eleven, laws previously enacted had been 
repealed ; in three only were there any re- 
strictive laws, and these proyed inefficient; 
while the facts could not be ascertained 
relative to the remaining four States. 
THE ERA OF ATTEMPTED VOLUNTARY 
LATION OF MEDICAL PRACTICE. 
REGU- 
To remedy these evils, and actuated by 
the love of science, the promptings of self- 
interest, and by devotion to the interests of 
humanity, representatives of the various 
State medical societies met in convention 
over half a century ago and organized 
the American Medical Association, with 
the avowed object of having its members 
represent and take cognizance of ‘ the com- 
mon interests of the medical profession in 
every part of the United States.’ It sought 
to cultivate medical knowledge among its 
members, to elevate the standard of medi- 
SCIENCE. 
[N.S. Vou. XIII. No. 337. 
cal education, to promote the honor and in- 
fluence and interests of the medical profes- 
sion and to enlighten the public concerning 
the relation between the medical profession 
and society. Emulation and concert of ac- 
tion in the profession and friendly inter- 
course among those engaged in it were ad- 
ditional aims of the founders of this great 
body of representative American medical 
practitioners. A constitution, by-laws and 
certain rules of conduct were adopted. The 
constitution provided for a delegate body, 
delegates being accredited from recognized 
medical societies, medical schools and elee- 
mosynary institutions. The rules of con- 
duct prescribed in detail the deportment of 
a physician, the deportment of the patient, 
interdicted the licensure of sectarian physi- 
cians, and proscribed from consultation 
those whose practice was based upon an ex- 
clusive dogma. The influence of the new 
Association was extended chiefly through 
the avenues of the various State societies, 
many of which adopted the rules of conduct 
that had been prescribed by the newly 
formed national body as the basis of affilia- 
tion. Several of the State societies, notably 
those of Massachusetts, Rhode Island and 
Mississippi, finding either that the pre- 
scribed rules of conduct were not suit- 
able to their respective local conditions, 
or feeling that they were sufficiently in 
touch with the ordinary forces of civi- 
lization to require no such formule, never 
adopted the rules of conduct prescribed 
by the national body. The medical 
association of Alabama adopted the rules 
with rather a naive proviso that some- 
body be appointed to call attention to such 
of the special teachings of these rules ‘as 
may seem to require elucidation in view 
of special circumstances and conditions.’ 
Other State societies adopted more or less 
modifying resolutions, but the general spirit 
of ostracism and aloofness was maintained 
during the succeeding three decades. The 
