618 



SCIENCE 



[N. S. Vol. XXVI. No. 671 



.gree superior to his predecessor of a 

 quarter century ago as a result of state 

 supervision. State control may eliminate 

 ignoramuses and charlatans, although in 

 many states the laws are so framed as to 

 apply to physicians of established schools 

 of practise while irregulars of many kinds 

 and "healers" are exempted from their 

 provisions, but however effectual they may 

 be as restrictive measures laws are much 

 less effective in elevating the people in any 

 direction than many enthusiasts would 

 have us believe. The educational systems 

 in European countries where bureaucratic 

 methods prevail do not always produce the 

 most enlightened citizenship, and in a de- 

 mocracy institutions thrive best if the 

 people are not governed too much. I think 

 that our medical schools themselves may 

 be trusted in greater measure to bring 

 about needed reforms and advance medical 

 interests than some noisy reformers who 

 clamor for more and more stringent law'S 

 seem to suppose. It seems to me to be time 

 that the medical profession asserted its 

 dignity once more and resented the imputa- 

 tion that so large a number of its members 

 are incompetent or unworthy that the 

 public needs further protection by special 

 legislation. Whatever others may think I 

 shall not hesitate to raise my voice in op- 

 position to such utterances as the follow- 

 ing. Says the Journal of the American 

 Medical Association in its issue of Septem- 

 ber 14, in the leading editorial : 



Stronger safeguards should be placed about ad- 

 mission to medical practise in many of the states. 

 The examining boards should be given supervision 

 of all medical colleges within their respective 

 states, with authority to pass on the entrance 

 requirements of prospective medical students and 

 to issue or to have issued to medical students 

 entrance certificates. They should have the right 

 to inspect the medical colleges and to close such 

 as are not sufficiently equipped or are not doing 

 satisfactory work. . . . Without this right the 

 boards are not in position to protect the public 

 from incompetent physicians. 



And this is the utterance of a journal 

 which is supposed to represent the profes- 

 sion of the United States, but which, under 

 its present management, is, in the opinion 

 of some, representative of commercialism 

 in medicine in a preeminent degree. It 

 floods the mails with circulars urging 

 graduates of the schools against whom it 

 brings this general charge of incompetency 

 to ally themselves with the association and 

 to subscribe for the journal, and it solicits 

 the advertisements of the colleges with un- 

 wearying persistence. In the issue in 

 which this editorial appears I find the ad- 

 vertisements of no less than ten medical 

 schools which, according to its own statis- 

 tical tables published in its issue of May 

 25, ranked in the lowest class as judged by 

 the percentage of failures of their gradu- 

 ates before state examining boards during 

 the year 1906. Now I do not hesitate to 

 say that in my opinion there is not an 

 examining board in any state in the union 

 which could safely be invested with such 

 authority as the Journal recommends. In 

 our own state, for example, this board is 

 so constituted that although eighty-five per 

 cent, of the physicians in the state are 

 "regulars" they are represented by but 

 four members upon a board of nine. In 

 many of our states men of only average 

 ability and capacity are drawing salaries 

 and exercising a little brief authority 

 under the laws in places often secured 

 through political influence. What shall be 

 thought of a proposal to place the medi- 

 cal schools of this country under their 

 absolute control. We have been shame- 

 faced too long, fearing perhaps that if we 

 in the schools raised our voices in protest 

 against these insistent demands it might be 

 thought that we feared investigation or op- 

 posed reasonable and proper supervision. 

 Such is not the fact, but silence may be 

 construed at times into an admission of 



