The distinction made in the law of California (Laws 1913, c.
354, as amended by Laws 1915, c. 105) passed for the regulation of
the practice of medicine and other modes of healing, between
treatment employing prayer and religious faith only and a species
of treatment which, while reliant upon the creation of mental
states and processes in the patient, involves for its proper
application special skill and experience and ability to diagnose
diseases, is not necessarily an arbitrary distinction denying equal
protection of the laws under the Fourteenth Amendment.
When a party assails a state law upon the ground that it
violates his rights under the Fourteenth Amendment, the law will be
considered only in its application to his situation as revealed in
the record, and all uncertainties of fact will be resolved against
the complainant and in favor of the law.
233 F. 334 affirmed.
The case is stated in the opinion.
MR. JUSTICE McKENNA delivered the opinion of the Court.
Appeal from an order denying an interlocutory injunction, three
judges sitting. The court took jurisdiction of
Page 242 U. S. 340
the action citing
Raich v. Truax, 219 F. 273, 283, but
denied the injunction on the ground that the averments of the
complaint did not justify it.
Complainant is a drugless practitioner, he avers (we state the
facts averred narratively), and has practised his profession in the
City and County of Los Angeles for the last seven years, and is
dependent upon it for making a living. He does not employ either
medicine, drugs, or surgery in his practice, nor is there anything
harmful in it to the individual or dangerous to society, but he
does employ in practice faith, hope, and the processes of mental
suggestion and mental adaptation.
Under a statute of the state that went into effect August 10,
1913, amended in 1915, a board of medical examiners was created
which was empowered to prescribe a course of study and examination
for those practising medicine (using this word in a broad sense for
convenience), and to issue certificates of qualifications and
licenses.
Three forms of certificates were required to be issued: first, a
certificate authorizing the holder thereof to use drugs, or what
are known as medicinal preparations, in or upon human beings, and
to perform surgical operations, which certificate shall be
designated, "physician and surgeon certificate." Second, a
certificate authorizing an opposite treatment to that which the
first certificate authorized (we are using general description),
which certificate shall be designated, "drugless practitioner
certificate." Third, a certificate authorizing the holder to
practise chiropody. And the statute also provides for the issuance
of what it designates as a "reciprocity certificate." Any of these
certificates, on being recorded in the office of the county clerk,
as provided in the act, shall constitute the holder thereof a duly
licensed practitioner in accordance with the provisions of his
certificate.
Applicants must file with the board testimonials of good
Page 242 U. S. 341
moral character and diplomas of a school or schools, and, in
addition, each applicant for a "physician and surgeon certificate"
must show that he has attended four courses of study, each to have
been not less than thirty-two weeks' duration, with some other
additions, and each applicant for a "drugless practitioner
certificate" must show that he has attended two courses of study,
each of such courses to have been not less than 32 weeks' duration,
but not necessarily pursued continuously or consecutively, and at
least ten months shall have intervened between the beginning of any
course and the beginning of the preceding course, and the course in
chiropody is to be of not less than 39 weeks' duration, consisting
of not less than 664 hours. There is a provision that, in lieu of a
diploma or diplomas and preliminary requirements in the other
courses, if the applicant can show to the board that he has taken
the courses required by the statute in a school or schools approved
by the board, totaling not less than 64 weeks' study of not less
than 2,000 hours for a "drugless practitioner certificate," or 128
weeks' study of not less than 4,000 hours for a "physician and
surgeon certificate," he shall be admitted to examination for his
form of certificate.
The statute sets out the course of instruction which the
respective applicants must have pursued, giving the course that is
necessary for a "physician and surgeon certificate" and the course
for a "drugless practitioner certificate." The descriptions are
very elaborate and technical. The statute also prescribes the
manner of examination, states the exemptions from its provisions,
the penalties for its violation, and for what conduct and upon what
conditions the certificates may be revoked. Among the latter is the
following:
"Ninth. The use, by the holder of a 'drugless practitioner
certificate,' of drugs or what are known as medicinal preparations
in or upon any human being, or the
Page 242 U. S. 342
severing or penetrating by the holder of said 'drugless
practitioner certificate' of the tissues of any human being in the
treatment of any disease, injury, deformity, or other physical or
mental condition of such human being, excepting the severing of the
umbilical cord."
By ยง 22 of the original act (unaffected by the Act of 1915), it
is provided:
"Nor shall this act be construed so as to discriminate against
any particular school of medicine or surgery, or any other
treatment, nor to regulate, prohibit, or to apply to any kind of
treatment by prayer, nor to interfere in any way with the practice
of religion."
It is alleged that the statute violates the Fourteenth Amendment
of the Constitution of the United States, especially the equal
protection clause thereof, in that it imposes greater burdens upon
complainant than upon others in the same calling and position; that
it discriminates in favor of the Christian Science drugless
practitioner, distinguishes between the treatment of the sick by
prayer, the treatment of the sick by faith, mental suggestion, and
mental adaptation, and treatment by laying on of hands, anointing
with holy oil, or other kindred treatment.
Complainant does not employ prayer in the treatment of disease,
and is therefore not exempt from examination by the medical board,
and is subject therefore to the penalties of the act if he
practices his profession, for which he has fitted himself by study
and practice, and upon which he is dependent, and by reason of his
age he is in large measure unable to take up any new branch of
work. That defendants, appellees here, are threatening prosecutions
under the act, and he is without remedy at law.
There is an allegation that the Supreme Court of the State of
California has decided that the statute is not offensive to the
Fourteenth Amendment, in habeas corpus proceedings prosecuted by
one Chow Juyan, who was
Page 242 U. S. 343
convicted of practising some form of Chinese healing which was
adjudged a violation of the act.
The allegations of the bill set forth complainant's particular
grievance to be that the statute discriminates between forms of
healing the sick and the use of prayer and other drugless methods,
and invoke the equal protection clause of the Fourteenth Amendment
of the Constitution of the United States. In other words, he
attacks the classification of the statute as having no relation to
the purpose of the legislation. Of course, complainant is confined
to the special discrimination against him; he cannot get assistance
from the discrimination, if any exist, against other drugless
practitioners. The case therefore is brought to the short point of
the distinction made between his practice and certain forms of
practice -- or, more specifically, between his practice of drugless
healing and the use of prayer.
The principle of decision needs no exposition, and the only
question is whether it was competent for the state to recognize a
distinction in its legislation between drugless healing as
practiced by complainant and such healing by prayer. That there is
a distinction between his practice and that of prayer, complainant
himself, it seems to us, has charged in his bill. He has not only
charged that he does not employ either medicine, drugs, or surgery
in his practice, but that he does employ faith, hope, and the
processes of mental suggestion and mental adaptation. These
processes he does not describe. Presumably they are different from
healing by prayer -- different from the treatment by Christian
Science. But he alleges that, for his practice he has become
"particularly fitted by many years of study and practice therein."
In other words, the treatment is one in which skill is to be
exercised, and the skill can be enhanced by practice, and the
objects of the treatment are diseased human beings whose condition
is to be diagnosed. To treat a disease, there
Page 242 U. S. 344
must be an appreciation of it, a distinction between it and
other diseases, and special knowledge is therefore required. And
this was the determination of the state; but it determined
otherwise as to prayer, the use of which, it decided, was a
practice of religion. We cannot say that the state's estimate of
the practices and of their differences is arbitrary, and therefore
beyond the power of government. And this we should have to say to
sustain the contentions of complainant, and say besides, possibly
against the judgment of the state, that there was not greater
opportunity for deception in complainant's practice than in other
forms of drugless healing.
Because of our very recent opinions, we omit extended reply to
the argument of counsel and the cases cited by him, not only of the
general scope of the police power of the state, but also of the
distinctions which may be made in classifying the objects of
legislation. And for like reason we do not review or comment upon
the cases cited in opposition to complainant's contentions.
It is to be observed that the order of the court was put upon
the narrow ground of the averments of the complaint, no opinion
beyond such averments being expressed.
Decree affirmed.