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Summary: The absence of medical licensing laws in most states during the years following the American Civil War made it possible for unscrupulous individuals to capitalize upon the weak governmental role in medical practice and educational charters. The practices of John Buchanan during much of his tenure at the Eclectic Medical College of Pennsylvania, in issuing thousands of dubiously earned diplomas, caused a national and international scandal. The traffic in diplomas became so flagrant that regulatory oversight of physicians and their practice, such as that conducted by the Illinois Board of Health led by Dr. John Rauch, developed rapidly across the United States. Though multiple factors prompted the rebirth of medical licensing laws, professional, educational, journalistic, and public concerns for bogus diplomas played an important role.
Keywords: John Buchanan, diploma mill, Eclectic Medical College of Philadelphia, medical licensing, John Rauch, Illinois Board of Health
In the early hours of August 17, 1880, the Philadelphia-Camden ferry launched for another run across the Delaware River. The night was mild after a pleasant day topping out just below eighty degrees.1 The boat carried only a handful of people at one o'clock that morning, but among them was a short, heavyset man standing near the rail named John Buchanan-dean of the Eclectic Medical College (EMC) of Pennsylvania and the architect behind the country's most notorious diploma mill. The prior week had been emotionally and financially draining for Buchanan. A federal grand jury indicted Buchanan for mail fraud, forcing him to use his home as security to obtain funds for his fifteen-thousand-dollar bail. While arrest and indictment would understandably weigh heavily upon any man, for Dr. John Buchanan this hardly represented a new experience. Authorities arrested him four times between 1872 and 1876 for medical malpractice, printing "obscene" circulars, and obtaining money under false pretenses.2 Two of the arrests stemmed directly from his apparently thriving business in medical diplomas.
A combination of good fortune, connections and perhaps "connivance" by those who should have moved these cases forward had saved Buchanan in each instance. Indeed, none of the cases ever came to trial but were quietly dropped. As he stood near the railing observing the dark waters below, Buchanan surely sensed this time was different. The luck, pluck, and...