No. 427.
Mr. Frelinghuysen to Mr. Wallace.

No. 169.]

Sir: I transmit herewith for your information the inclosed copies of dispaches No. 67, of January 18 last, and No. 323, of the 5th ultimo, from our consul at Beirut, Syria, and consul-general at Constantinople, in relation to the difficulties encountered by American citizens and graduates of the American college at Beirut in their endeavor to practice their profession in the Ottoman Dominions.

To some extent the onerous and unjust discriminations of the Turkish authorities in respect of this general subject are familiar to your legation, the case of the late Dr. Calhoun being a recent one in point.

In that case, where it was sought to impose unreasonable restrictions in regard to Dr. Calhoun’s medical practice, the Department endeavored to secure for him only such treatment in respect to his examination as was enjoyed by medical practitioners, citizens or subjects of other countries, residing and practicing in Turkey. So, too, in the present instance, where the cases are practically the same, we ask only fair and impartial treatment for our citizens who desire to follow their profession in that country.

It is difficult to believe that the Turkish Government would knowingly permit its local authorities to so unjustly discriminate against American medical practitioners. This is the more singular and to be regretted when it is remembered that our citizens have been regularly graduated from the college at Beirut, a chartered and trustworthy institution, having authority to confer such diplomas, and in view of the undoubted statement that no such exactions as are sought to be imposed upon our citizens are attempted or enforced against medical practitioners of other nationalities, even when they have not followed any prescribed course of study. Yet this is precisely the situation as represented by Mr. Robeson, whose strenuous efforts have unfortunately been thus far unavailing to stop or prevent so unjust a discriminatory practice. Nor, I regret to add, so far as Mr. Heap’s knowledge goes, have those which have been put forth by the legation or consulate-general for the relief of our citizens in such cases been hardly more satisfactory, notwithstanding the orders and promises of the Turkish Government. The faculty of the college at Beirut now hope for one of the following privileges:

  • First. A charter as an independent medical college, with power to grant legal degrees in medicine and surgery.
  • Second. The privilege of granting degrees in medicine and surgery, which, to be legalized, shall be forwarded to Constantinople through the American minister or consulate-general, to be signed and sealed by the Imperial College officials.
  • Third. Failing in either of these, the appointment of an examining board of Government physicians in Beirut or Damascus with power to grant a certificate to the graduates of the American college after they have passed a satisfactory examination before the said board, which certificate shall authorize the holder to practice medicine anywhere in the Ottoman Empire.

These propositions appear reasonable and just, and any one of them, if adopted, would doubtless afford a practical and satisfactory solution of the present difficulties surrounding American medical practitioners [Page 554] in that country. In the opinion of this Government, therefore, the Government of Turkey should be willing to grant one or the other of these privileges and enforce a compliance with its orders by the local authorities throughout the Empire.

The inclosed correspondence will enable you to fully and carefully present this subject to the Government of the Porte. This you “will accordingly do, and endeavor to obtain through the adoption of one of the courses suggested above, or some other equally satisfactory method, recognition of the competent diplomas issued by the American college at Beirut to its medical graduates.

This Government is disposed to admit that every country has the right to prescribe the mode of recognition of medical practitioners within its borders. While granting this, it is only reasonable to expect, therefore, that any regulations governing in such cases should be fair and impartial and not discriminate in favor of any one nationality. All that is demanded in the interest of our citizens is that the rule adopted shall be uniform and without any practical discrimination against duly graduated American practitioners. Common justice and international intercourse alike suggest that no other course should be recognized or permitted.

You will give this subject your earnest consideration, and, if possible, press it to an early and equitable conclusion.

I am, &c.,

[Inclosure 1 in No. 169.]

Mr. Robeson to Mr. Adee.

No. 67.]

Sir: I respectfully beg to submit for your kind consideration and such action as you may deem proper in the case a few statements regarding the difficulties under which the American Medical College in Beirut, the graduates, and Americans who wish to practice medicine in this part of Turkey labor, with the earnest hope of Americans in general, and the medical fraternity in Syria in particular, that the Department may use its best influence with the Sublime Porte to secure for them due consideration and fair treatment.

The medical department of the American Protestant College at Beirut was established in 1867, under the general law of the State of New York, the board of trustees consisting of the following distinguished and philanthropic gentlemen: William A. Booth, William E. Dodge, David Hoadley, Simeon B. Chittenden, of New York; Abner Kingman, and Joseph S. Ropes, of Boston, Mass. In 1870, before the first class was ready to graduate, application was made to the Sublime Porte, through the American minister, Mr. MacVeagh, for an authorization to the college by the Ottoman Government to confer medical diplomas which would be legal in Turkey. The Porte referred this question to the imperial faculty of medicine in Constantinople, which body declined to allow any school or examining body but its own to confer diplomas in medicine, but promised to recognize the Beirut school as a qualifying body, and to admit its students to examination without further preparation. The Porte promised further to defray the traveling expenses of the students, and to lodge and board them in the imperial school pending their examination. Our minister, Mr. MacVeagh, advised the college to accept this offer for the time being, assuming that it was made in good faith, and pointing out the difficulty and even impossibility of the Government’s overriding the decision of its own medical faculty unless it were proved incapable or corrupt in carrying out its decision. In no case, however, although frequently applied to by indigent students, has the Government afforded the slightest aid to any student in going or returning nor given them board and lodging, as promised. Soon after the announcement, of this decision the Ottoman Government began to send menacing communications to the college and stringent orders to the governments of Syria and Lebanon for the prevention of the unlicensed practice of medicine. During the last [Page 555] two years there has been a disposition on the part of the Turkish authorities in Syria to enforce the regulations that require all persons to present their diplomas in person and undergo an examination before the Imperial Medical College at Constantinople before being permitted to practice medicine in Turkey.

No one will deny the right of the Turkish Government to pass such laws, but the strange part of the laws and regulations regarding this matter is that they have been only enforced against American citizens who hold diplomas from American colleges and natives who have graduated at the American college in Beirut. No German, French, English, Italian, Austrian, nor any other foreigner practicing medicine has in any instance been molested by the Turkish authorities in Syria, while American doctors have been harassed, insulted, prohibited from practicing, and forced to go to Constantinople to pass an examination before the board of the Imperial Medical College there.

At the request of Mr. Heap, United States consul-general at Constantinople, I collected and furnished him during July last, at considerable trouble and expense, with a list of the names and residences of four hundred and eighty-two doctors practicing medicine in my consular district. I find that over four hundred of the number have no diplomas from the Imperial Medical College at Constantinople, mostly natives, and over three hundred have no diplomas from any college, never having studied medicine. I have called the attention of the governor-general of Syria to these facts, but no notice has yet been taken of the subject, nor is it likely that any will be given by the Turkish authorities to the matter. Dr. Skandarani, the chief municipal and sanitary physician of Damascus, the second city in the Empire, has never studied in any medical school, nor has he a diploma from any educating body. It is impossible for these ignorant native practitioners to pass an examination before a medical board, but no one here believes that they will be prohibited from practicing or in any way molested by the Turkish authorities. They may get diplomas, however, by paying the required fee, 7 Turkish pounds. In 1877 Dr. Post, of the faculty of the medical college of Beirut, spent several months at Constantinople endeavoring to obtain more favorable conditions for the graduates of the college. He received promises, but these pledges have been entirely ignored by the Imperial College. I am informed that in every case the candidates from Beirut college proved themselves capable of passing the examination at Constantinople, and, though they have been subject to many annoyances, they finally received diplomas which made no mention, however, of their studies in the American school at Beirut, but their Beirut college certificates have been confiscated. Drs. Bliss, Van Dyck, Post, Dennis, and other Americans have devoted many years of their lives to establishing the Protestant Medical College in Beirut, while large sums of money have been spent in buying ground and erecting suitable buildings, which are second to none in the country; but all this will prove comparatively futile unless proper concessions be granted to the college by the Ottoman Government. The instructions have lately been changed from the Arabic language to English in the medical department. The college is in a flourishing condition, having two hundred students, a considerable number of whom are studying medicine. The faculty request and hope for one of the following privileges:

A charter as an independent medical college, with power to grant legal degrees in medicine and surgery.
The privilege of granting degrees in medicine and surgery which, to be legalized, shall be forwarded to Constantinople through the American minister or consul-general, to be signed and sealed by the Imperial College officials.
Failing in either of these, the appointment of an examining board of Government physicians in Beirut or Damascus, with power to grant a certificate to the graduates of the American college after they have passed a satisfactory examination before the said board, which certificate will authorize the holder to practice medicine anywhere in the Ottoman Empire.

The course of instruction and standard of examinations in the college will be seen, from the inclosed catalogue, to be thorough, and the many graduates of the college now engaged in Government service or occupying high positions as private practitioners in the east have established its reputation on a firm basis.

Mr. Heap, our consul-general at Constantinople, has endeavored to get the Imperial Medical College to accept the diplomas of Americans who desire to practice medicine in Turkey (without having the parties appear in person to undergo an examination before the Imperial College), and after having their diplomas registered, to grant them permission or license to practice medicine in the Ottoman Empire, but in this he has not succeeded. It is in the interest of Americans in this part of Turkey and the American Medical College here that I have presumed to address yon this dispatch, with the sincere hope that the Department of State may use it best influence with the Sublime Porte to have it grant one of the three privileges desired by the American Protestant Medical College in Beirut.

I am, &c.,

[Page 556]
[Inclosure 2 in No. 169.]

Mr. Heap to Mr. Adee.

No. 323.]

Sir: Referring to Mr Robeson’s dispatch to the Department of State, No. 67, dated January 18, 1884, inclosed herewith, I beg to say that what he states in regard to the examination and licensing of the graduates from the American College of Medicine at Beirut deserves the earnest consideration of the Department. The efforts made here, whether by the legation or the consulate-general, to obtain some relaxation of the stringent rules of the faculty of medicine in their favor have been unsuccessful. It is true that no difficulty has been experienced in obtaining the license to practice when the candidate has presented himself for examination with a diploma duly certified to by the consul-general, whether it was granted by the college at Beirut or a medical college in the United States, and upon payment of the established fees to the Turkish faculty. The Porte appears to have taken stringent measures to prevent unauthorized persons from practicing in the provinces; but these measures do not seem to have been attended with success.

If a decree were obtained recognizing the validity of diplomas issued by the American college at Beirut, after registration here, without the presence of the candidate, and after the payment of the fees, which we have reason to believe is the principal concern of the College of Medicine of Constantinople, the ground of complaint would be lessened.

The examination or colloquium is a mere formality.

It may be well to state that no fee is charged at this consulate for the certification of diplomas.

I am, &c.,