BY FRED. A. DAVIS, M. D.

President of Surgical and Gynæcological Society.

Among the many questions of interest and profit for medical men to consider, stimulated by the remarks of my predecessor concerning "Reciprocity in Medical Registration" and the discussion which they aroused, I have chosen for my subject this evening, "Medical Registration." This is a subject in which every physician should be interested, both as a physician and as a citizen. As a citizen, because the laws governing the right to practice medicine are essential for the protection of society; as a physician, because without the protection of proper laws, men of attainments in this branch of science are put upon a level with frauds and charlatans.

Whenever restrictive legislation has been attempted, immediately the cry of monopoly has been raised, and so effectively that for many years legislation was delayed. That this is untrue, it is scarcely necessary for me to state in an association of physicians. So far as any personal or selfish motive governs the physician, it is purely one of self-protection. Upon this point I cannot do better than quote from Dr. H. N. Myers' address before the Mississippi Valley

Medical Association: "The matter of medical legislation is a delicate one from a professional standpoint. The passage of medical practice acts has been urged by the medical profession, and we have been distinctly misunderstood in our attitude toward legislation. There is a feeling in the community and on the part of legislators that in some way the medical profession wishes to put a fence around the practice of medicine, in order that those who are on the inside may fatten. It is persistently charged that we wish to create a medical oligarchy, to which only the few shall be eligible. For selfish reasons it is said that we desire to limit the number of medical men, to the end that we alone may occupy the chosen field. To the credit of the better elements in the community it must be said that such charges largely eminate from those whose interests are identical with the diploma mills and the various forms of quackery. The profession urges medical legislation, not from selfish and interested motives, but in the interest of the public health. At no time has it desired legislation which shall limit the number of medical men, but it has insisted that those who pose as practitioners of the healing art should be in effect what they claim masters of medical science.

The government licenses pilots and engineers in the interests of the public. We merely point out that the same precautions should be taken in protecting the individual life, that are taken for the many. It is the duty of government to ascertain the qualifications of medical men who pose as qualified practitioners. This is the attitude of the medical profession upon this question, and so far as we are personally concerned, we would rather there were no medical practice acts, because they are not necessary for our protection, but simply for the protection of the public.”

Another objection which has always been urged with great force is that it restricts the liberty of the individual. Any person has absolute right to select any method of treatment in a supposed or real illness that he sees fit, or to choose any

person to attend him that he pleases, and so far as the individual is concerned this may be right, but as far as the community is concerned it is essentially wrong; for the reason that no individual has the right to endanger the life of his neighbor or the community in which he lives by the failure of the medical attendant, whom he chooses to employ, to recognize diseases dangerous to the public health.

We have also heard an objection raised, that you cannot by legislation educate people to the necessity of recognizing those who have ability and those who have none. That is very true, and for that reason registration is necessary. You cannot legislate people to be honest, therefore laws are passed to punish theft. You cannot legislate people to be moral, therefore laws are passed to protect the community from immorality. You cannot legislate people against sudden rage or a spirit of vengeance, consequently laws are passed against murder and violence. And although you cannot by law enact as to what physician, or what class of physicians, or what means of skill, medical or otherwise, people may choose to employ for the cure of their ailments, it is right and proper that registration should be passed, protecting the community from the deplorable consequences of ignorance in all matters pertaining to the cure of the sick. As one of the many instances where this lack of sufficient knowledge has worked irremediable harm, resulting in the death of the individual, I cite from the New York Medical Journal of March 10, 1900, with editorial comments thereon: "A case recorded in the Western Medical Review for December 15th, comes, if accurately stated, clearly within the limits of criminality. A professing Christian Science Healer of Fort Dodge, Iowa, undertook the sole charge of the case of a child suffering from post-pharyngeal abscess. The burrowing nature of this disease is well known, and the importance of providing an outlet for the pus is beyond question. This was not done, and the consequence was that the child died from asphyxia. Mr. Lincoln, the healer in question

signed the certificate as the attendant nurse,' giving the
cause of death as 'spasms.' Many of the cases where
death ensues under Christian Science treatment are those of
incurable disease, concerning which, while it is probable that
proper skilled aid would have ameliorated suffering if not
prolonged life, it is yet impossible to assert positively that
such would have been the case, and still more impossible to
state that Christian Science was in any sense a cause of
death. But the case now recorded is one in which proper
treatment would undoubtedly have saved life, and death was
directly due to its being withheld. Although we believe
that Iowa is one of the states that have legalized this pestif-
erous and unscrupulous charlatanry, there should still be a
remedy in firm application of the law of malpractice." Also,
in the same issue of the New York Medical Journal, I cite
an editorial entitled "Faith Healing and the Law."
"Ac-
cording to the New York Tribune for March 5th, the aid of
the law is to be invoked to rescue a young woman in Chicago
from the criminal folly of the faith healing community. The
young woman is said to be suffering from brain fever,'
which from the reference to her screams of agony we take to
be tuberculous meningitis, and these wiseacres, led by a
former regular physician,' are attempting to cure her by
casting out devils, anointing the head with oil, and other
methods." The Humane Society and the health department
having no legal ground to interfere, a judge has been ap-
pealed to for an order to commit her to the Detention Hos-
pital for treatment. The absurd blasphemy of these people
is exemplified in the following statement, which purports to
have eminated from one of the before mentioned physician's
disciples: Miss Bettison's illness is due to the rapidity of
her spiritual experience. It is due to the struggle between
the Holy Ghost and whatever of evil there is in her for mas-
tery. The Holy Ghost seems to have come to her all at
once, and it is more than her body can stand. We feel
sure she will be well in a few days if we are only left alone

and allowed to care for her as Dr. Gentry says.' We are no advocate for any undue interference with the personal liberty of the individual adult, in full possession of his facul ties, to get his treatment in disease done for him as he gets his laundry — anywhere and by any method that pleases him. But children, who are incompetent to take care of themselves, and adults who are mentally incapacitated, either per manently or temporarily, have a right to protection from the vagaries of fanatics," As to the right and interest of the community to enact laws for sufficient protection in this respect, I cannot do better than repeat the words of Mr. Justice Field, of the Supreme Court of the United States, in the case of Dent vs. West Virginia, in delivering the opinion, he said : "The power of the state to provide for the general welfare of its people authorizes it to prescribe all such regulations, as in its judgment will secure, or tend to secure them against the consequences of ignorance and incapacity, as well as of deception and fraud. Few professions require more careful preparation by one who seeks to enter it than medicine. It has to deal with all those subtle and mysterious influences upon which health and life depend, and requires not only a knowledge of the properties of vegetable and mineral substances, but of the human body in all its complicated parts, and their relation to each other, as well as their influence on the mind. The physician must be able to detect readily the presence of disease, and prescribe appropriate remedies for its removal. Every one may have. occasion to consult him, but comparatively few can judge of the qualifications of learning and skill which he possesses. Reliance must be placed upon the assurance given by his license, issued by an authority competent to judge in that respect, that he possesses the requisite qualifications. Due consideration, therefore, for the protection of society may well induce the state to exclude from practice those who have not such a license, or who are found upon examination not to be fully qualified. No one has a right to practice