strengthening it against the destructive tendency of an inherent constitutional defect, and finally enabling it to rid itself of it for

ever.

Other changes of less importance have, from time to time, lent their aid towards securing for our Society as much of finish and beauty as are compatible with the imperfection of the human understanding. By the aid of committees, all disturbing influences, such as once convulsed the Assembly, are quietly disposed of, and a stranger present during hours of business would regard it as equal in dignity and decorum to any representative body in the world. Though a little late, perhaps, in arriving at the full proportion and stature of manhood, the induration of its ligaments, fusion, and condensation of parts, with general unity and individuality, are doubtless the more perfect, and, in consequence, giving earnest of prolonged youth and an old age that shall know no decay. As of man so with his works-from the beginning of his life to manhood, his entire existence revolves around himself. The first third of his life he must devote to himself. He may afterwards bless his kind with new creations or discoveries-become a Moses or a Washington. All the past years of the existence of the Association were necessary to its own developmentfor its crystallization, the hardening of its shell and elaboration of its organs-all this for itself. It may now look abroad for the accomplishment of ends worthy of so prolonged an apprenticeship. Can it now, in the glory of its early manhood, take any profitable step towards the greatest end indicated by its fathers, and thus accomplish all the objects of its creation? Or shall it, after all the waiting in hope all these years, for its maturity, concede that its creation was a mistake, and its existence a failure?

If, then, this body has not of itself accomplished all its friends hoped for in the beginning, in elevating the standard of medical education, they must be satisfied to know that that standard, notwithstanding, has been regularly going up, fully abreast with the progress of our new country in every other department of human learning, and all the arts and appliances of a rapidly developing civilization. The spring can only well up the waters sent to it, purifying them in the process, and the sea is but the representative of many waters. The schools must take such material as they can get, and make the most of it, and the American Medical Association, as in the past, so now and hereafter, is obliged to consist of such representative medical men as the schools may VOL. XXVI.-6

prepare and fashion for its use. The stream cannot rise higher than its sources. A vast area, with a thin spread population, "few and far between," may only boast of a log-cabin schoolhouse, so remote from the scattered homes of many that a faraway boy is indebted to his pony for ability to reach it. He learns to read, and thus possesses himself of a magic key to store-houses "undreamed of in his philosophy," but his wildest reverie never sketched the shadowy outline of a college of any kind. Natural bone-setters and seventh sons may be blessings in an emergency, but the urgent medical wants of any community soon reach immeasurably beyond their ability, and the pony boy, who "reads like a book," is proud to see his parents besieged by their neighbors to make a doctor of him. A copy of Thomas's Blunderbus, redeemed from kindred loft rubbish, is procured for him, and he goes into it with all his might; and from the beginning of January to the end of September, he reads it through six several times, from contents to index, inclusive. He gets an idea of a medical college from this book, and, after a consultation with the blacksmith, writes, pretty much at random, to the President of a medical college of some distant city, where he imagines there ought to be such a contrivance of human ingenuity to help young gentlemen engaged in prosecuting their studies under difficulty. He is soon startled and surprised with a kind reply, and a "catalogue" thrown in. Kith and kin are laid under contribution to raise the required sum; the whole neighborhood is astir in lending a helping hand, and at the end of a week our hero, with huge saddle-bags, is astride his ever faithful pony, with blessings, like a storm of snow-flakes, bringing up the rear, on a journey of a thousand miles, many hundreds of which are threaded by a bridle-way through a wilderness. The old folks at home are full of the event, and the distant settlers receive and dispense the intelligence to those still more

remote.

At college he works like a Trojan. At the end of the session he returns to his forest-home; and his text books, a pocket case of instruments, and a hundred medicines, in gold-leaf labelled jars and bottles, follow him. An office, of poles and cat and clay, awaits him in the corner of his father's yard. He is a marvel and a wonder to all that country, and jumps into an overwhelming practice! His people are happy in him, and he is happy in his people. Who would disturb these relations if he could? and

who could if he would? When that country is developed, with roads and wealth, and refinement, its medical men, to the manor born, will be like it, as their predecessors were, generations before, like it then.

Learning and genius are lost upon semi-barbarians, and recoil instinctively from their habitats. You may resolve as much as you please, after eloquent and interminable whereases, and in the future, as in the past, multiply reports that it ought not to be so, but the fact will still stare you in the face that it is so.

That the schools are all that their hopeful, faithful, and earnest teachers can make them, and that they accomplish all that is possible with the material entrusted to them, none ought to doubt; and that the country at large selects as good material as it possesses for the schools is equally indisputable. Nor should any believe that the youth selected for medical schools are, in respect of preparatory education, a whit inferior to those selected for the law or divinity.

The question returns to us-What can the Association now do, in its early manhood, honestly, towards redeeming implied pledges of its infancy? Much, if it have nerve or back-bone; nothing, if these be absent! The plan is simple, as all plans are that succeed. Logic and truth are simple, but without nerve the whole moral world is like an empty sack, utterly incapable of standing erect. The barrier to success has been removed by the abolition of school representation, as such, and reducing the whole body to "lay" members. It was to secure the success of the plan to be proposed, to elevate the standard of medical education, that the resolution was introduced at Nashville in 1857, to remove the schools from the Association.

In the arbitrary numbering of the objects for the promotion of which this body was created, that of number eight is declared to be "To take cognizance of the common interest of the Medical profession in every part of the United States." A very comprehensive power, assumed in the beginning, and never denied in all these years, will not be questioned now, when the moral frown of the Association would be fatal to whoever, or whatever, connected with medicine, should oppose the grand and benevolent objects that lie at its foundation. In taking cognizance of the common interest of the medical profession in every part of the United States, it must go back upon itself, and acknowledge its recreancy to the high objects of the fathers, who wore away their

lives in an unswerving devotion to it, not to exercise the sum total of its legal and moral force in securing a higher standard of medical education in this country than existed at the time of its inauguration.

Therefore, let it be solemnly resolved by this meeting, that it shall be regarded as derogatory to the character of any physician, in any part of the United States, to take under his care, as a student of medicine, any one who cannot exhibit evidence of having taken a degree in a regularly chartered college, or a certificate of qualifications necessary to become a student of medicine, from a board of examiners appointed for that purpose by the American Medical Association. This will do the work.

Territories and new States, in a country like ours, in a formative state, will provide themselves with medical helps in the mode we have described, which, existing outside of this body, and independent of it, will occasion it no concern whatever. Nor would the schools suffer pecuniary loss under this rule. When it was generally known, as it soon would be, young men desiring to enter the profession would earnestly devote themselves to the duties of preparation, nor relax their efforts till possessed of the degree or the certificate.

Again, many educated young men, under this rule, would turn their attention to medicine, whose votaries were to consist of their peers, who, under the existing rule, would not risk its levelling influences. Let the doctorate imply something more than "two full courses of lectures, the last of which in this institution." Besides, it would give the college an ample excuse for not receiving every uneducated lazy dolt who desired to make a living under false pretences.

There is nothing really binding in the rule suggested. The only power in the matter is the great moral weight of the Association. It enacts nothing, but simply asserts what every member of it knows to be right. After a few years, such a certificate of the examining board, or evidence of a college degree, might be declared necessary in order to enable an applicant for membership in this body to secure admission; for surely it is the common privilege of all organizations to judge of the qualifications of their own members. Then will the certificate of membership here pass the holder anywhere as a gentleman and scholar.

It is precisely in this way that the Medical Department of the Army and Navy are purified. The adoption of this addition to

the Code of Ethics would furnish medical gentlemen an excuse for getting rid of applicants for office study whose preliminary education they know to be defective, and whose relations they would dislike to offend by saying so.

Neither would this rule exclude any one from being a doctor. In a vigorous republic there will always spring up men who, by genius and long self-training, literally hew their way to greatness, in all of the professions, while many more will pass through colleges, winning all their honors, to shrink into insignificance, and pass through the world unknowing and unknown. For the former heaven has made ample provisions, and stamped them as the nobility of nature, whom this body can neither depress nor elevate―nay, nor could an association of angels.

Under the old plan, as under the new, the schools must furnish the Association with delegates; but under the new, the delegate was passed upon and accepted before he was medically born. In this latter case the Association begins de novo, with the beginning. It is present at both ends of the line. In the former case it proposed to arrange the plumage of another party's chicken, to groom the steed of another. The proposition was arrogant, and excited opposition and clamor. The chicken was from the prairie and the steed from the desert, captured by the schoolswere theirs; and they naturally threw about them the ægis of protection. Examining boards, after two courses of lectures, were boards born out of time, and their tender mercies to the callow brood were not to be trusted, and the preposterous suggestion was scouted. The new plan is a medical sandwich. The schools are a slice of ham between an upper and lower layer of Association bread. It must be clear to every thinking mind: that the plan, while eminently just and proper, places medical education in the United States where it ought to be, with everything else pertaining to the profession, in the power of the American Medical Association. Medical education, per se, will take care of itself, the emulation of the schools being altogether sufficient for the maintenance of its great interest. It is the preliminary education of those who would enter the profession that must be looked to. It must be everywhere known that no medical college, nor any other contrivance short of the fiat of the Almighty, can make a physician out of an uneducated man-that medicine is the capsheaf of all knowledge, and the belief that prevails that it can exist in the absence of its legitimate supports