Of course it may be thought that this was due entirely to the great Emperor Frederick, who was far ahead of his time and who, therefore, anticipated the progress of medical teaching by many centuries. We have, however, many other documents which illustrate the state of medical education at this time. The charters of the medical schools were granted by the Popes and were very explicit in what they required of the new faculties in order that standards might be maintained. Pope John XXII, for instance, at the beginning of the fourteenth century, issued charters for medical schools at Perugia and Cahors. He required that there should be four years of medical study and three years of preliminary work. He went into details to secure the maintenance of standards. The original faculties of these schools would all have to be doctors in medicine from either Paris or Bologna, and it must be their duty to establish in the new schools the standards of their {125} Almae Matres. Examinations were to be conducted under oath, men were not to be granted degrees unless they deserved them, the votes of professors rejecting candidates or graduating them were to be under oath-bound secrecy, so as to have them absolutely free from personal influence, and every precaution was taken to secure the highest possible standards. It was as a consequence of their direct attachment to these old mediaeval medical schools that the medical schools founded here in America in the sixteenth century at once began with high standards. Three years of preliminary work was required and four years of medicine. In the United States no preliminary requirements were demanded; and for a full century only two years of medical study, which really consisted of but two terms of four months each, was the requirement. The old mediaeval medical schools were originally attached to the universities, and it is a well-known rule in the history of education that whenever the medical schools are independent then standards are sure to be low. Whenever the university controls the medical school and it is a real graduate department, then standards of admission and of graduation are properly maintained. It is surprising to think that the old mediaeval universities should be able to give us lessons in this matter and should put us to shame for our slip-shod nineteenth-century medical education in the United States, but this is a simple fact. Contrast {126} the South American countries where the mediaeval traditions with which they were founded constrained them to give four, five and even six years to medicine before granting a degree. Go a step further and see how devoted to science were the Universities of Lima (Peru) and Mexico, centuries before we did any serious scientific work in the United States, and all because they were direct descendants of the old mediaeval universities.