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[[File:Oregon_State_Capitol_1909.jpg|left|thumbnail|300px|Oregon State Capital (1876-1935) in Salem, Oregon]]
In the 19th century, physicians lobbied state legislatures throughout the United States to pass medical licensing laws. Some doctors were more successful than others in passing these laws. Starting in 1870s, states began to slowly adopt medical licensing laws. In order to make these laws more palatable to skeptical legislatures, physicians often tied these laws to sanitation reforms. Still, physicians in some states struggled to accomplish anything.