unrepresented in the Washington meeting were four in all, viz.: Louisiana, Wisconsin, Mississippi, and Arkansas, which sent an aggregate delegation of ten to the Tennessee meeting. The only other States which sent as many to the Tennessee as to the Washington meeting, were Georgia, Alabama, Kentucky, Tennessee, Michigan, Iowa, and Missouri; in other words, those in immediate communication with Nashville by railroads and by the river Mississippi. Again, the two great States of New York and Pennsylvania, which were represented by only rine delegates at Nashville, sent one hundred and thirty-nine to Washington; while Tennessee, which at Nashville had sixty-three delegates, or more than one-third of the whole assembly, sent only seven to the Washington meeting.

We have not deemed this analysis foreign to the purpose, for the twomeetings speak a language so diametrically opposite upon the subject now under discussion, that it cannot be unimportant to consider which of the two has the better claim to be considered as representing the will of the profession. The truth is, that the American Medical Association. is so omnipotent in the way of influence, and at the same time so spar-ingly furnished with direct legislative powers, that considerations of this sort are absolutely necessary in order to estimate the value of any decision which may be made. This at least is certain, that both these meetings cannot speak the will of the profession on medical education, for the conclusions they come to are as opposite as can be conceived. What then are these conclusions?

We have only to examine the two records. In the Nashville meeting,. an onslaught upon the medical colleges was evidently a foregone conclu-sion every stale anecdote of incompetence in graduates was eagerly. exhumed and galvanized into new life for the occasion; the existing mode of teaching was one mass of abuses from end to end; the Associa-tion was to model the whole thing anew; they were to prescribe the number of days the sessions should last; the number of sessions necessary to a degree; the number of professors; the departments upon which they were to lecture; the qualifications for diplomas, etc., etc.: no persons engaged in medical education were to be concerned in devising this plan; and delegates from the colleges were to be excluded from the Association itself, as soon as the provisions of the constitution allowed the question to be brought up.

We expressed the opinion,* soon after this meeting, that a persistence in this policy could only end in results most disastrous to the whole pro

*Memphis Medical Recorder, Sept.,. 1857.

fession; that if the large body of able men who have devoted their time and talents to the education of physicians, and invested large capital in acquiring the means of so doing, should find themselves dictated to by men, ever so able, who had no experience in teaching themselves, and that under the authority of a body from which an effort was to be made to exclude them expressly in future, there was every reason to suppose that they would take their own course, ignoring the action of a body in which it was sought to deprive them of a representation; that a rupture was then certain to take place between the schools on the one hand, strengthened by the respect and affection of the thousands of physicians in all parts of the country who owed their qualifications and. status as physicians to their instruction and recognition, and the Association on the other, weakened by its suicidal expulsion of so able and influential a body of men as had always attended among its college delegates a rupture fatal to the influence of the Association, deeply injurious to the schools, and utterly destructive to the unity and harmony of the profession. We also predicted, however, that this deplorable issue would not be presented, but that the meeting of 1858 would principally be engaged in reversing the action of that of 1857, so far as relates to this topic. So completely were our predictions fulfilled in this respect, that we are tempted to quote them:

"Our own expectation is, that so far as the action of the last Convention was hostile to the teaching members, it will be reversed in the next. We have already shown, that from the non-attendance of delegates from distant States, and the preponderance of certain local influences, the last meeting cannot in any sense be looked upon as representing the general state of feeling throughout the profession; and we shall not be surprised to see the motion of Dr. Lindsley laid upon the table, while the committee appointed under Dr. Currey's resolutions will doubtless report, and its report be treated with courtesy; but we anticipate no attempt to enforce its recommendations; and thus the only results of the unfortunate line of action pursued by the Association would be to defer for a year longer any concerted action on educational reform. Should this be the case, we think that then the schools themselves should initiate some well-concerted plans of improvement to be presented to the meeting of 1859 for its approval."

We scarcely ventured to anticipate that the result would fulfil so minutely as it did in all particulars the prediction above quoted. The report of the committee appointed under Dr. Currey's resolutions, as brought up by its chairman, Dr. James Wood, consisted of a very moderate recommendation of measures of improvement, together with a total

*Medical Recorder, Sept., 1856, p. 129.

abnegation of the competency of the Association to deal with this question without the counsel and sanction of the existing educational institutions. His recommendations are so completely in harmony with what we hoped for and recommended, that we give them in extenso:

First. Primary schools should be encouraged; but as office instruction will continue to be sought by students, practitioners should either give them the necessary advantages of demonstrations, illustrations, and recitations, or, if not prepared to do so, they should refer them to such primary schools or medical men as will give them proper instruction.

Second. The number of professorships should not be less than seven, viz.: a Professor of Anatomy and Microscopy, Physiology and Pathology, Chemistry, Surgery, Practical Medicine, Obstetrics, and Materia Medica. Third. There should be but one term annually, which should commence about the first of October, and close with the March following, thus lengthening the term to six months. The commencement of the term in October should be uniform in all the colleges throughout the country. During the session there should never be more than four lectures given daily.

Fourth. The qualifications for graduation, in addition to those now required by the schools, should be a liberal primary education, and attendance upon a course of clinical instruction in a regularly organized hospital.

In order to give our medical colleges an opportunity to consider the recommendations here advanced, and that this body may have the advantage of their wisdom and their mature views before any definite action is taken upon them, your committee submit to the Association the following resolutions:

Resolved, That the several medical colleges of the United States be requested to send delegates to a convention to be held at

uniform system of medical education.

for the purpose of devising at

Resolved, That the present report of the special committee on medical education be referred to such convention for its consideration.

Resolved, That said convention of delegates from the several colleges of the United States be requested to submit to the meeting of this Association in May, 1859, the result of their deliberations.

This report was afterward referred to a committee of delegates from medical schools and colleges, who reported the following preamble and resolution through their chairman, Dr. Hamilton:

Fully appreciating the value and importance of the resolution under which they were appointed, but a majority of the gentlemen constituting this committee not being authorized by the medical Faculties of the several colleges with which we are connected to act as their representative in this matter, and, therefore, regarding it quite impossible to secure a convention of delegates in the interim of the meetings of the Association;

Therefore resolved, That we recommend to all the medical colleges entitled to a representation in this body, that they appoint delegates, especially instructed to represent them in a meeting to be held at Louisville, on Monday, the day immediately preceding the Convention of the American Medical Association, for the year 1859, at ten o'clock, at such place as the Committee of Arrangements shall designate.

This report was accepted, and the preamble and resolution passed. Having referred to our own previous opinions in another place, we will take a short space to show that this conclusion of the Association is exactly what we recommended as the only satisfactory mode of settling the difficulty, as early as July, 1856. After recommending certain improved modes of procedure to medical colleges, we continued as follows:*

"But it is obvious that such a system could only become a reality by being adopted by all colleges recognized by the regular profession. The question arises, How can such a general concurrence be brought about? We think that something like a convention of medical colleges is becoming not only very desirable but absolutely indispensable. Might not. something of this sort be engrafted upon the meetings of the American Medical Association? These meetings are attended by delegates from most of the educational institutions recognized by the medical profession. Why might not those delegates be authorized by their constituents to form a separate Educational Convention, to agree upon the principles and provisions of a systematic reformation of the existing system of medical instruction? If a code of regulations could be agreed upon by such a convention, and accepted by a very large preponderance of medical colleges throughout the country, undoubtedly then one step farther ought to be made, which would complete the work. Those who adopted the regulations should also refuse to recognize diplomas or certificates of attendance from any college which did not; for of course it would be futile for an institution to propound any conditions to its own students which they were obliged to waive in the case of students from other colleges."

It is obvious that had the arrangements here proposed been carried out in the meeting of 1857, we should have arrived, two years ago, at exactly the same stage of proceedings as that attained by the Association

in 1858.

To conclude the narrative part of this article, however: the amendments to the constitution proposed by Dr. J. B. Lindsley, for the purpose of excluding delegates of Medical Colleges from the Association, were brought up at the closing session of the meeting, with other proposed amendments standing over from the last meeting, as is provided for all amendments affecting the constitution. Their fate seems to have

* Memphis Medical Recorder, July, 1856.

been summary and complete. "Each amendment was separately discussed, and each was lost by a large vote." This is all the record we find concerning them.

In showing how our writings have, in every respect, anticipated the conclusions to which the Association has finally arrived, by the decision of one of its meetings most deserving to be considered as CATHOLIC in its character, we trust we shall not be suspected of vainglorious purposes in doing so. Our object has rather been to show that our concurrence in what has been done cannot be otherwise than cordial and entire, since it is our own measures to which we are giving our approbation.

This being premised, then, we proceed to the momentous question, What should be done by this convention of teaching physicians when it meets? And the first question which occurred to us on reading the resolutions which invite them to assemble was, What can they do?

One day has been assigned for the consideration of all the conflicting views, the reconciliation of all the conflicting interests, the determination of all the doubtful questions of possibility and expediency, which spring up in the path of those who would advance towards the goal of amelioration in medical education. One day for every thing! Why, it is not sufficient for the disposal of the various questions that ought to be considered, if they were to be brought up one by one, and voted upon without discussion; how much more, then, is it insufficient for the cautious deliberation with which questions ought to be considered, so momentous in their nature that a false step in regard to one of them would result in evils to the profession such as years would fail to remedy. What then is to be done? Are we to relinquish this, the great opportunity for the colleges to commence, on their own account, the work of reformation? God forbid! But deliberation there must be, and discussion. Conflicting opinions and interests must have their due consideration. It was the great error of the meeting of 1857 that the question was vehemently stirred, while no one was ready with a well-matured plan; consequently the action taken was tumultuous rather than deliberative, and all that was done in '57 had to be ignored in '58. How, where, and when, then, can this preliminary discussion and deliberation take place, which is so essential to the auspicious termination of the labors of the proposed council?

THROUGH THE MEDICAL PRESS.

We can conceive of no other answer, and it was for the purpose of starting such a discussion that the present article was set on foot. Discussion can only take place to any purpose when some definite proposition is laid down; and to this end we have been led to devise a plan of