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"The State of Indiana has no more need of four boards, or of one board, of examiners 'to regulate the practice of medicine' than the human body has of four sets, or of one set, of supernumerary digits to regulate the circulation of the blood. No lineal descendant of Hippocrates consciously possessed of respectable attainments, of true professional dignity, and of a spark of patriotism, would seek, or condescend to accept, such an office; he would reflect that things belonging to the infancy of medical organization are unbecoming its maturer years, that any fool may ask questions which a wise man cannot answer, and that to take fees of no reciprocal benefit is "highly reprehensible in a regular physician." It is only the unprincipled quack that would become a politico-medical 'supe'."
So begins an 1880 opinion written by Dr. Henry Winans of Muncie, Indiana, in reaction to the proposed medical legislation for Indiana. Dr. Winans was a practitioner of "regular" medicine, and asserted that the proposed legislation, which provided for separate licensing boards for other, "irregular" medical sects would legitimize what he considered "quackery". He continues:
"The rational and progressive way to regulate the practice of medicine, or rather, to elevate the standard of medical education, and thus to eliminate the quacks tuto et juende, is to regulate the medical colleges - to fix by statute the number of professors that shall constitute the faculty, the course of study and the time of pupilage which they shall adopt, the anatomical, physiological, chemical, materia-medical, clinical and other means of demonstration and illustration which they shall provide, and the qualifications which they shall require for matriculation and for graduation; and in the same, or in a simultaneous, act to forbid that any person shall hereafter begin and continue to practice medicine, or any general or specific branch thereof, in this State, who shall not have received a diploma from a medical college thus regulated, either of this or of some other commonwealth. We use this word hereafter for the reason that the Legislature cannot rightfully or constitutionally deprive any person of patronage lawfully acquired.... Observation and reflection for thirty years incline us to the opinion that people must and will have quacks, prohibitory law or no prohibitory law."
Winans' emphasis on the need to regulate medical education in order to improve the quality of medical care in Indiana is not unfounded. Medical colleges were poorly regulated, particularly in the first half of the nineteenth century. Consider the case of Dr. John Cook Bennett.
(information provided courtesy of Benita K. Mason, New Albany/Floyd County Public Library)
Professor Gerald O. Haffner, writing for the 100th Anniversary of the Floyd County Medical Society, provides the following biography of Dr. Bennett:
"Dr. John Cook Bennett was born during 1804 in Washington County, Ohio. He learned his profession under Dr. Samuel P. Hildreth. Dr. Bennett concluded that learning by preceptorship was too long and time-consuming, a conclusion which eventually have him at odds with members of the regular medical profession.... In 1829, he tried unsuccessfully to establish a university in Ohio. During 1830, Dr. Bennett attempted to start a university at present-day Wheeling, West Virginia. Although a charter was granted, his efforts were once again unsuccessful.
"Then he appeared in New Albany. As a non-conformist, Dr. Bennett cared not how or how long one acquired his medical knowledge. The important factor was could one pass a medical examination. If one could, then that person was entitled to a diploma and a license to practice....
"At New Albany, Dr. Bennett ... [appealed] to the Hoosier General Assembly for a charter to establish a "Christian College at New Albany". Approval for that charter was given on January 24, 1833.... Dr. Charles A. Bonsett ... states that the charter 'did not specifically authorize the formation of a medical school'. On the other hand, it did not prevent 'the development of such a school'. Thus, this early school, often referred to as the Bennett Medical College, turned out to be fraudulent. Bennett "certified" that men had completed a course in medicine when there was no evidence that a course had been organized. In fact, he was issuing diplomas within forty days after the state legislature had approved the institution. On the diplomas, Bennett designated himself as chancellor of a college that did not exist. Furthermore, Bennett even falsified the name on the diplomas; instead of Christian College, he used the term "University of Indiana". Today, his operation would be called a 'diploma mill'.... After a time and after the local trustees had disassociated themselves from him, Dr. Bennett left New Albany for greener fields....
"His dream of founding a medical school did not vanish. He made three more unsuccessful attempts. According to Dr. Bonsett, had Bennett been more conventional in his approach to medical training, 'he might have become the father of medical education in Indiana'."
The controversy surrounding the degree to which medical legislation addressed the legitimacy of medical colleges in Indiana did not abate with the 1885 law. The Act of 1897 was also criticized in this regard. The following excerpt from an opinion in the Indiana Medical Journal illustrates the frustration with the law's definitions:
"The Attorney General has recently given his construction of certain points in the Indiana Medical Practice Act, which are of considerable interest, a brief synopsis of which we lay before our readers:
"1. Every institution, whether incorporated or unincorporated, organized in good faith for scientific instruction in medicine, surgery or obstetrics, and in which such scientific instruction is systematically imparted, without regard to the school of medicine under whose control or management it is, is a reputable medical college within the meaning of the statute....
"According to his construction of a 'reputable medical college', the phrase is a mere jumble of words without meaning or sense. By the common consent of the profession a medical college is not 'reputable' unless it possesses certain facilities for teaching medicine and surgery, among which is a thoroughly competent faculty, an abundance of anatomical and clinical material, all the scientific apparatus necessary to supplement and illustrate didactic teaching, and, as a prerequisite for granting the degree of M.D., must require students to have studied medicine at least three years, to have attended at least two full courses of lectures, and finally, to have passed a satisfactory examination.
"It is to be regretted that the Attorney General did not consult the opinions of the profession before attempting to define a 'reputable medical college'. If a medical college is not reputable with the profession, how can it be reputable in law?"