The view which I gave, in the first chapter, of the uncertainty of medicine, I trust, made it obvious to the reader, that a thorough education is pre-eminently necessary to the proper practice of the medical art. In endeavoring therefore to form an estimate of the qualifications of any physician, let the evidence of his having obtained such an education be well considered. But what is this evidence? Is it to be found in the bare fact that he has a diploma, obtained from some respectable medical institution? While a diploma is worth something as evidence, as there must be some improvement of the means of education, in order to pass the examination requisite to obtain it; yet it must necessarily be defective evidence. That the truth may be more fully ascertained, let the inquiry be made, how far the physician has improved the advantages he has had; for it must be remembered, that it is especially true of medicine, that a diligent and wise use of limited opportunities will impart more knowledge and skill, than can be acquired by a careless and unwise use of the most extensive advantages afforded by the profession. I will allow that there are difficulties in the way of arriving at the truth in this inquiry, and the public are often most grossly deceived by the parade which is made by some physicians, in regard to the opportunities which they have enjoyed. Still, I apprehend, that the erroneous judgment of the public in regard to such cases, arises from a too ready confidence in mere pretensions, and that it can be avoided for the most part by a little more pains-taking in making the inquiry, and by applying tests of another character, to which I shall soon allude. But education in the science of medicine is practically despised by quite a large portion of the community. Though this sentiment is not often distinctly avowed, yet it exists to a greater extent than is generally supposed. It shows itself in an indifference to the true evidences of a physician’s qualifications, and in a readiness to put the quack on a level with the thoroughly-educated physician, or even above him. These indications of the prevalence of this sentiment, are not confined to the ignorant; but they often appear among the well informed, and even the learned. Sometimes this sentiment is boldly avowed in language like the following: ‘I care little about the evidence of a physician’s having had an education. The fact that he is successful in treating disease is worth vastly more than a piece of parchment. Many a man has risen to eminence in other professions by his own exertions, without any great amount of education; and why should not this be the case in the practice of medicine? There was Franklin, who rose by his own efforts to a post of honor and usefulness far above multitudes of his cotemporaries, who had a most finished education; and why should there not be Franklins in medicine, as well as in other departments of knowledge?’