At the June 1899 meeting of the National confederation of state medical examining and licensing boards the committee on minimum standards for admission to medical schools recommended graduation from a four years' high school course or its equivalent. This committee outlined an alternative examination that represents less than three years of high school work. It also provided for an allowance of the first year of professional study to graduates of reputable literary or scientific colleges after satisfactory examination on the work of the first year.

At the June 1899 meeting of the Association of American medical colleges, a special committee made an interesting report on the condition of medical education in the United States. The committee had corresponded with all the medical schools, 82 in number, which had appeared as members of the association in 1897 and 1898. The replies received from 56 schools show great discrepancy in teaching facilities and in the requirements for graduation. Following are some of the most significant facts:

Laboratory work, including dissections. I school makes no report; I gives less than 300 hours of laboratory work in four years; 5 give between 300 and 500 hours; 27 between 500 and 1000 hours; 14 between 1000 and 1500 hours; 8 over 1500 hours.

Practical work. 5 schools offer less than 100 hours; 10 give from 100 to 200; 13 from 200 to 300; 11 from 300 to 500; 16 over 500 hours.

come the strongest states, and the standard maintained by these states would act as a stimulus to weaker political divisions. In dentistry New York, Pennsylvania and New Jersey have already moved in this direction and in medicine there will be a similar movement when the regents have the statutory power on unanimous recommendation of a state board of medical examiners to indorse the licenses of those whose preliminary education and professional training meet the requirements of the New York law, The Wayne co. (Michigan) medical society has addressed a circular to licensing bodies asking 1) if reciprocity with political divisions that have practically the same licensing requirements would be favored, 2) if statutory amendments necessary to secure such reciprocity would be advocated. Sep, 14, 1899 favorable answers to both inquiries had been received from 30 political divisions. With few exceptions statutory amendments would be

necessary,

Obstetric cases. 5 schools offer their students no opportu nity to attend obstetric cases before graduation; 28 give students opportunity to attend personally from one to three cases; 7 from three to five cases; 6 from 5 to 10 cases; 7

over 10 cases.

Clinical cases yearly available. 3 schools furnish no evidence of having even one patient to present to their students before graduation; 4 have less than 500 patients all told from which to select clinical cases; 4 have less than 1000; 5 between 1000 and 2000; 9 between 3000 and 5000; 8 between 5000 and 10,000; 6 between 10,000 and 20,000; 6 between 20,000 and 40,000; 3 between 40,000 and 100,000. Minimum number of hours of clinical attendance by each student. 6 schools offer less than 300 hours of clinical work in four years; 6 give only from 300 to 400 hours; 7 from 400 to 500 hours; 19 from 500 to 800 hours; 14 from 800 to 1200 hours; 4 give over 1200 hours.

Didactic work. 2 schools give less than 1000 hours in four years; 7 from 1000 to 1500 hours; 22 from 1500 to 2000 hours; 13 from 2000 to 2500 hours; 4 from 2500 to 3000 hours; 8 give over 3000 hours.

Total number of hours' work demanded of medical students. 3 schools demand less than 2000 hours; 2 from 2000 to 2500; 11 from 2500 to 3000; 7 from 3000 to 3500; 7 from 3500 to 4000; 26 over 4000 hours.

The committee recommended a change in the constitution and by-laws of the association by the adoption of the following:

1 After July 1, 1900, and till more stringent rules be adopted, students beginning the study of medicine must possess a diploma from a high school giving a thorough preliminary education, or must pass a thorough examination in all the branches usually taught in such schools. This examination is to be conducted by a state superintendent of public instruction or some one delegated by him, or by members of the faculty of a university or college, who are not connected with the medical faculty of the school the student wishes to

enter, or by such a body as the regents of the University of the State of New York.

2 Before a student can enter an advanced class he must present certificates from a school whose requirements fully equal those of this association of having successfully passed the examinations in at least three fifths of the branches embraced in the curriculum of the previous years of the school he desires to enter or he must pass examinations on the same; on the remaining branches he may be conditioned, but these conditions must be removed by taking the work, providing it has not already been taken, and by passing examinations before he can pass on to the succeeding class (that is a man shall not carry conditions for more than one year), providing, however, that this shall not prevent schools from allowing students who have earned the B. A. or B. S. degree and who have had an adequate course in science, or graduates in dentistry or pharmacy, who possess the proper preliminary education, to enter the sophomore class.

3 Before a student can be eligible for the degree of doctor of medicine he must have attended in a well-equipped medical school, four courses of lectures of at least six months each. These courses must embrace at least 3300 hours' actual work in the school, including besides didactic lectures and recitations,

a 500 hours of laboratory work;

b 150 hours of practical work;

c One or more obstetric cases personally attended by each student;

d 750 hours of clinical teaching.

At least 45 months must intervene between a student's matriculation and the date of his graduation. All of the work should be fairly apportioned throughout the four years.

4 No school can be considered capable of giving the requisite instruction that can not command each year at least 3000 hospital or dispensary patients for presentation to its

classes.

Medical sects - As commonly understood, regular physicians have no distinctive theory or practice; homeopaths treat diseases with drugs that excite in healthy persons symptoms similar to the morbid condition treated; eclectics make use of what they regard as specific remedies, chiefly botanical; physiomedicalists use only botanical remedies, discarding those which are poisonous. In practice these distinctions are not always observed.

In addition to the medical sects to which detailed reference is made in this work a number of pathies flourish in many states unmolested under such names as osteopath, vitapath, electropath, hydropath, divine healer, magnetic healer, Christian scientist, faith curist, mind curist, sun curist, etc. Men and women without preliminary or professional training treat diseases under these or similar systems to such an extent that the health of the people is endangered. These so-called systems are followed with impunity in many states in what seems to be open violation of laws restricting the practice of medicine. This is due largely to the fact that so many statutes lack specific definitions as to what constitutes the practice of medicine, and without these definitions the conviction of such practitioners can not be secured through the courts.'

Osteopathy was "discovered" in 1874. It is based on the theory that "a natural flow of blood is health" and that the bones may be "used as levers to relieve pressure on nerves, veins and arteries." Osteopathy is now recognized by law in Iowa, Michigan, Missouri, North and South Dakota, Tennessee and Vermont. Practice of "the system, method or

'In Illinois the medical practice act provides special state examinations in obstetrics for midwives, and in anatomy, physiology, physiologic chemistry, histology and pathology and hygiene for those desiring to practise systems of treating human ailments in which medicines are not used internally or externally and operative surgery is not followed. The act does not apply, however, to any person who "treats the sick or suffering by mental or spiritual means, without the use of any drug or material remedy." It is encouraging to note that notwithstanding this broad exemption Justice Everett of Chicago ruled against "divine healing" in August 1899. If his opinion is sustained in the higher court the "Zion curers" can no longer practise the "laying on of hands."

science of osteopathy" is restricted to licensed physicians and to graduates of "a legally chartered and regularly conducted school of osteopathy." The use of drugs and operations in "major or operative surgery" are not permitted in the practice of osteopathy.

In Georgia, Kentucky, Nebraska, New Jersey, New Mexico, Montana, Ohio and West Virginia there are stringent laws against non-medical practitioners. In some other states, like Illinois, they receive such legal protection that any person may treat "the sick or suffering by mental or spiritual means, without the use of any drug or material remedy." Under these conditions any person in Connecticut, Maine, Massachusetts and New Hampshire is free to practise "the sun cure, mind cure, hypnotism, magnetic healing, Christian science, etc." The greater part of New England' seems to be on about the same footing in this respect with the Cherokee nation, Indian territory, where entire liberty is given to "enchantments in any form." In striking contrast Hawaii inflicts heavy fines on any person convicted of an attempt to cure "another by practice of sorcery, witchcraft, anaana, hoopiopio, hoounauna, hoomanamana, etc.'

In spite of this the court (6 Ohio Dec. 296) held in January 1897 that an osteopath was not practising medicine by kneading and manipulations, using only his hands and no medicines. In Kentucky and West Virginia, however, the courts have upheld the statutes which provide that manipulations or other expedient shall constitute the act of practising medicine. In Nebraska the court (40 Neb. 158) ruled in 1894 that the " object of the statute is to protect the afflicted from the pretensions of the ignorant and avaricious, and its provisions are not limited to those who attempt to follow beaten paths and established usages." In Americus, Georgia in 1899 six prominent citizens, Christian scientists, were sentenced to fines and imprisonment for refusing to submit to vaccination.

'In Customs and fashions in old New England Alice Morse Earle tells us that in “1631, one Nicholas Knapp was fined and whipped for pretending 'to cure the scurvey by a water of noe worth nor value which he sold at a very deare rate." One is almost tempted to suspect that this whipping took as much out of the New England officials as it did out of Mr Nicholas Knapp, for since that remote date scarcely a rumor has reached us of any equally vigorous remonstrance with unqualified practitioners. As a result New England has been a specially promising field for quacks, not many of whom were considerate enough to follow the example of the celebrated "rain water doctor." Of this worthy it is recorded that he "worked wondrous miracles and did a vast and lucrative business" till he opportunely ended his career by tumbling into a hogshead of his own medicine.