5. CONSTRUCTION OF THE TEN-YEAR EXEMPTION CLAUSE:

WHEREAS, In several instances, recently, where suits have been brought against persons for the violation of the "Act to Regulate the Practice of Medicine," advantage has been taken of the ten-year clause by those who do not strictly come within its provisions; therefore, be it

Resolved. That it is decided by this BOARD that the ten-year exemption clause, as a qualification, means that the person who avails himself of the said exemption must have actually been engaged in the practice of medicine as a means of gaining a livelihood, and must have publicly announced himself to be a physician for a period of ten or more years before July 1, 1877; further

Resolved. That persons who have only occasionally prescribed during that time are not by this BOARD considered as entitled to the benefits of the exemption.

Adopted, September, 1881.

REVOCATION OF CERTIFICATES.

SECTION 10 of the Medical Practice Act recites that "the STATE BOARD OF HEALTH may refuse certificates to individuals guilty of unprofessional or dishonorable conduct, and they may revoke certificates for like causes."

Concerning its duties and responsibilities under this section, the Hon. E. S. Williams, in a decision rendered at the October, 1878. term of the Circuit Court of Cook County (Nathan J. Aiken vs. State Board of Health,) says the BOARD is constituted, among other things, to have charge of medical practice and medical prac titioners in this State, and it is its right and duty to have surveil lance of the professional conduct of physicians by the language of the act of incorporation. Any persons guilty of unprofessional conduct may be by it refused certificates, and any persons having certificates who were guilty of unprofessional conduct may have their certificates revoked by the BOARD. The object of the incorporation of the BOARD is, among other things, to secure a higher professional standard in the medical profession. It is to exclude empirics and empiricism from the profession. The duties of the BOARD are various, and the interests intrusted to its keeping affect all classes of the community, and affect them in the most vital points. The character of its duties is in part set forth in the second section of the act creating the BOARD. "The STATE BOARD OF HEALTH shall have the general supervision of the interests of the health and life of the citizens of the State. They shall have charge of all matters pertaining to quarantine, and shall have authority to make such rules and regulations, and such sanitary investigations as they may from time to time deem necessary for the preservation or improvement of public health," and all police officers, sheriffs and other employés of the State are required to enforce its rules and regulations so far as the efficiency of the BOARD may depend on their co-operation. Such a BOARD must, from the necessity of the case, be vested with a large discretion. And, in the legitimate exercise of its discretion, it ought not to be, and cannot be, properly controlled by judicial tribunals. The duties of the BOARD, with reference to the sanitary condition of the people, bring it into such relations to the medical profession as to fit it to determine the necessary qualifications of its members, and to judge of the propriety or impropriety of their professional deportment. The law has devolved this and similar duties upon the BOARD, and it has created no other corporation in the State for a like purpose, nor has it given to any State officer supervision over

the BOARD in the discharge of its appropriate duties and the exercise of its legitimate discretions. A physician may be guilty of unprofessional and dishonorable conduct, and not of criminal conduct. It would have been a work of supererogation in the lawmakers to have vested the BOARD OF HEALTH with the supervision. of the unprofessional conduct of the medical practitioner, if unprofessional conduct and criminal conduct were synonymous. As a citizen, the physician is, with every other citizen, answerable to the criminal laws, and as an alleged criminal is liable to be arraigned before our Courts. It is only as a physiciann that he is liable to have his professional conduct inquired into and brought before the STATE BOARD OF HEALTH. The term "unprofessional" is therefore far wider than criminal. Many acts would be unprofessional that were not criminal; some acts that were criminal might not be esteemed unprofessional. What is professional conduct can only be determined by bringing the act to the professional criterion, and who so well qualified to judge of the proper professional criterion for the medical profession as a BOARD constituted as the bill shows this BOARD to be, of seven gentlemen, five of whom are physicians, and a BOARD created for sanitary purposes, and accustomed to sanitary investigation? The "unprofessional" conduct which authorizes the BOARD to exclude a physician from the profession does not, therefore, mean, necessarily, criminal or immoral acts, but such conduct as is inconsistent with the honorable practice of the profession; and in judging of such conduct, the BOARD OF HEALTH has a wide discretion, and in its exercise courts ought not to interfere with it.

It may be added that, in the test case above cited and which was carried up, on appeal from Judge Williams' decision, the Courts have refused to interfere with the BOARD's exercise of that discretion.

WHAT CONSTITUTES UNPROFESSIONAL OR DISHONORABLE CONDUCT:

The STATE BOARD shall define: The Legislature has constituted this Board, and has said that it shall be vested with the power to determine what is unprofessional and what is dishonorable conduct in a physician

Is it unprofessional in a physician, by falsely advertising as to his skill, to impose upon the weakness, the credulity, the ignorance of the people? Is it unprofessional to publish that he is a specialist in all chronic diseases; to pretend to a universal knowledge of all diseases? Is it professional to thus profess what every intelligent man knows is impossible? Is it professional to solicit correspondence? Is fraud professional, or fraudulent pretenses?

Whether these things are or are not unprofessional, is left by law to the STATE BOARD to decide; and there ought to be but little, if any, doubt as to what they would decide. Aikin vs. State Board of Health. Argument on the Appeal.

1. By Advertisement or Publication:

Resolved, That in response to the following written enquiry made to the BOARD by R. W. McAfee, general agent of the Western Society for the Suppression of Vice, "Is it professional for a physician to advertise or promiscuously to distribute or circulate 'marriage guides,' 'secret monitors,' pamphlets or circulars, describing or illustrating, by, means of pictures, venereal diseases; or to advertise directly or indirectly, or even impliedly, nostrums or medicines for preventing conception or for procuring abortion?' the BOARD decides that each and all of the above described acts are grossly unprofessional.

Adopted February 19, 1880.

2. By Fraudulent or Deceptive Transaction:

Resolved, That any fraudulent or deceptive professional transaction shall be deemed, in the sense of this BOARD, unprofessional and dishonorable conduct.

Resolved. That any medical man who practices medicine under two names, or any other name than his true name, shall be considered guilty of unprofessional and dishonorable conduct.

Resolved. That any advertisement, hand bill or means of attracting public attention or securing patronage, which shall be deceptive or convey to the public any false or fraudulent information, shall be considered unprofessional and dishonorable. Adopted February 19, 1880.

3. By Practicing under Assumed Name:

WHEREAS, Several parties throughout this State are practicing specialties under assumed names, and by a variety of dishonest and dishonorable means are imposing upon and defrauding both the people of this State, and every upright practitioner of medicine; therefore,

Resolved, That it is the duty of this BOARD to at once proceed to investigate such cases and to deal with them according to law.

Adopted February 19, 1880.

CHARGES BELONG TO THE RECORDS OF THE BOARD:

Resolved, That after action has been taken revoking a certificate for cause, the BOARD cannot return the charges that have been made against the holder of said certificate. Adopted January, 1880.

NOTICE TO BE SERVED UPON INFORMATION:

Resolved, That in cases where information comes to the notice of the STATE BOARD OF HEALTH that persons holding certificates from said BOARD are advertising in an unprofessional manner, or are in any way guilty of unprofessional or dishonorable conduct, it shall be the duty of the Secretary to notify such persons at once to appear before the BOARD and show cause why their certificates should not be revoked.

Adopted September, 1881.

DECISIONS AFFECTING MEDICAL COLLEGES.

TWO GRADUATING COURSES IN ONE YEAR:

Resolved, That on and after July 1, 1878, the BOARD will not consider any medical school in good standing which holds two graduating courses in one year.

Resolved, That on and after July 1, 1878, the BOARD will not recognize the diplomas of any medical school which does not require of its candidates for graduat on the actual attendance upon at least two full courses of lectures, with an interval of six months or more.-Adopted, November 15, 1877.

GOOD STANDING WITHIN THE MEANING OF THE STATUTE:

Whether or not a "legally chartered medical institution" is in "good standing" within the meaning of those terms as used in section 3 of the "Act to regulate the practice of medicine in the State of Illinois." in force July 1, 1877, so as to entitle graduates possessing diplomas or licenses from such medical institutions to certificates from your BOARD, authorizing them to practice medicine in this State, is a question of fact to be determined by your BOARD, at least in the first instance.

The words "in good standing" should be understood in the sense which would ordinarily be ascribed to them by those familiar with institutions where the science of medicine is taught. Any medical institution whose course of study prior to graduation is equal to that generally regarded by the medical profession as sufficient to entitle a student to graduate and receive a diploma as Doctor of Medicine, should be treated as in "good standing."

The most rigid and thorough course of study is not contemplated by these words, but that average standard which obtains among the medical schools of this country would seem to meet the requirements of the statute.

If a medical college or institution makes its course of study so brief as to fall materially below the average standard. I have no doubt that your BOARD has the power, and that it is your duty, to refuse certificates to its graduates, authorizing them to practice medicine in this State,

As to what length of time is generally considered requisite to be devoted to a course of medical study to entitle a student to a diploma, that is a question of fact, to be determined by your BOARD from the best information at your command:-Opinion of Attorney General Edsall, October 9, 1879.

No EQUIVALENT FOR ACTUAL ATTENDANCE: In conclusion, the BOARD reaffirms its resolutions of November 15, 1877, and furthermore declares that no prior practice, or proof of qualifications, will be accepted by it as an equivalent for actual attendance upon the two full courses of lectures, or any part thereof. The BOARD is well aware that this, like all general rules, may work seeming hardships in a few special cases: but it believes the good it will effect for the medical profession and for the public well-being, and for the advance of medical science and education demands that the medical colleges shall maintain with the utmost stringency their requirements for graduation, and that these shall include not less than actual, faithful, and regular attendance on the two full courses of lectures. The more of preliminary and concurrent reading and practice, in hospital or under the eye of an experienced physician, the better. There is no danger that the young physician's studies will be too thorough or extensive.-Hahnemann College Case, June 13, 1879.

MEDICAL ETHICS:

Resolved, That the BOARD recommends to all the me lical schools in this State that they make the necessary arrangements to deliver to their yearly classes a series of two or more lectures on medical ethics, setting forth the duties of the physician toward the public, and also toward the members of his own profession.-Adopted, February 5, 1880.

PROFESSIONAL RELATIONS:

Resolved, That the Secretary of the BOARD be, and hereby is, instructed to request the medical schools of the State to give one or more lectures each year on the relation of the profession to the public and to each other, believing the same to be in the interest of the people and of medical men.-Adopted September. 1881,

"STUDENTS" DEFINED:

Resolved, That the word "student" which occurs in section 11 of the law. 1877, regulating the practice of medicine, is construed by this BOARD to mean a person actually engaged in the study of medicine in the office, and under the instruction, of a physician.

Resolved, That students so engaged in the study of medicine are not permitted under said law, to prescribe for or treat patients without the daily and direct advice and supervision of their preceptors.-Adopted, April 29, 1881.