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SCIEJSrCE. 



[Vol. VllI , No. 184 



The first is that of Alabama, the principle of 

 which is to organize the whole medical profession 

 of the state, and use it as the means of regulat- 

 ing the qualifications of practitioners and of car- 

 ing for the public health. The Medical society of 

 the state of Alabama, with its branches, the 

 county medical societies, thus forms a part of the 

 machinery of the government ; it apj)oints boards 

 of medical examiners, selects state and county 

 sanitary officials, supervises the registration of 

 vital statistics, the administration of quarantine, 

 etc., — in short, it is the state board of health, and 

 the county branches are the county boards of 

 health. This system has now been in operation 

 nine years, and has gradually been consolidated 

 and improved by educating local boards, and get- 

 ting all physicians interested in it, until it is now 

 working fairly well. 



The second system to which I will call your at- 

 tention, is that of the state of Illinois, which was 

 commenced in 1877, or about the same time as that 

 of Alabama. 



In Illinois any one who presents a' diploma, or 

 license to practise, from a legally chartered medi- 

 cal institution in good standing, is entitled to 

 practise, and the state board of health is to decide 

 as to what shall constitute ' good standing. ' The 

 board of health also examines all persons who do 

 not possess satisfactory diplomas, and who never- 

 theless wish to j)ractise in this state. 



One of the greatest practical difficulties in the 

 way of providing any system of state examina- 

 tions in medicine in the United States, is that 

 public opinion will not support any law which 

 can be supposed to condemn or in any way to in- 

 jure homoeopathic and eclectic practitioners or 

 their schools, and hence any proposed law relat- 

 ing to medicme, or to the organization of state 

 boards of health, which does not recognize the 

 existence of these sects, will in many states, at all 

 events, meet with enough opposition to defeat it. 

 In Ilhnois this difficulty was surmounted by the ar- 

 rangement, that of the five physicians on the board, 

 one should be homoeopathic and one eclectic. 

 The Kansas law, passed last year, goes further in 

 this direction, and provides that appointments 

 must be so made that no school of medicine shall 

 ever furnish a majority of the members of the 

 board. Much to the surprise of many, the Illinois 

 plan has worked very well — there has been no 

 quarreling in the board— and the homoeopathic 

 and eclectic members seem to have upheld quite 

 as high a standard of qualification as their fellow 

 members. The results of the work in Illinois 

 have been very good. A large number of igno- 

 rant charlatans were forced to leave the state. 

 The requirements of the board as to what shall 



constitute a medical college in good standing, have 

 been raised, and it has thus caused improvement 

 in the medical schools, not only of Illinois, but of 

 other states. Moreover, the neighboring states 

 have been stimulated to action, not only by the 

 force of example, but because they received the 

 men who had been driven out of Illinois, and 

 found the accession an unpleasant one. 



The relations of the general government to 

 medical education are indirect, but they have of 

 late years become of very considerable practical 

 importance, and are now exerting much influence 

 upon medical investigations and literature. This 

 is effected by the museums and libraries which 

 are now being formed under the auspices of the 

 government at Washington, and also, to some e?;- 

 tent, by certain special investigations undertaken 

 by the government in the interests of preventive 

 medicine. Of these various agencies one of the 

 most important is the Hbrary which has been 

 formed at Washington, under the auspices of the 

 medical department of the army in connection 

 with the Army medical museum. 



As regards investigations into the cavises of dis- 

 ease, undertaken at the expense of the general gov- 

 ernment, only a beginning has as yet been made ; 

 but it is sufficient to indicate future possibilities 

 and probabilities. The main importance of the work 

 of the National board of health, which was organ- 

 ized in 1879 under the stimulus of the great yeUow- 

 fever epidemic of the previous year, was due to 

 investigations upon the causes of yellow-fever and 

 diphtheria, the relations of soils and of water-sup- 

 ply to certain diseases, etc. Similar investigations 

 have been undertaken by state boards o' health, 

 and especially by the state board of health of 

 Massachusetts, and the fact that governmental 

 health departments are tending to work in this 

 direction is significant as to future co-operation 

 from such sources. 



In this connection should be mentioned the 

 National museum of hygiene, which has been 

 formed under the direction of the medical depart- 

 ment of the United States navy, which is now one 

 of the most instructive collections of the kind in 

 the world, and has also connected with it an ex- 

 cellent library and a well-equipped laboratory. 



Comparative and experimental pathology is also 

 receiving attention from the government under 

 the direction of the department of agriculture, 

 which is doing some good work in the investiga- 

 tion of the diseases of our domestic animals. 



As to the condition of medical science and art in 

 America, it partakes of the general progress, for 

 the press now makes all discoveries the common 

 property of the civifized world. The marked fea- 

 ture of the present epoch is the recent advance in 



