THE MEDICAL POLICE 
AND 
RULES AND REGULATIONS 
OF THE 
BOSTON MEDICAL ASSOCIATION, 
"WITH A CATALOGUE OF THF. 
\ 
OFFICERS AND MEMBERS. 
BOSTON: 
PRINTED BY JOHN WILSON & SON, 
22, School Street. 
1852. THE MEDICAL POLICE 
AND 
RULES AND REGULATIONS 
OF THE 
BOSTON MEDICAL ASSOCIATION, 
* 
WITH A CATALOGUE OF THE 
OFFICERS AND MEMBERS. 
BOSTON: 
PRINTED BY JOHN WILSON & SON, 
22, School Street. 
1852. BOSTON MEDICAL POLICE. At a meeting of the Boston Medical Association, held at Vila’s on the 
first Wednesday in March, 1808 ; 
The Committee of the preceding year having, in conformity with their in- 
structions, reported on a code of Medical Police, which was read and accepted 
by sections,— 
It was Voted, That the Report of the Committee be recommitted, with 
instructions to print five hundred copies of the same; and that they present 
to each member of the Association three copies of the Report, and distribute 
the remaining copies to such other physicians of the State as they may 
think proper. 
Voted, likewise, That the thanks of the Association be presented to the 
Committee for their judicious and useful Report. 
J. GORHAM, Secretary. BOSTON MEDICAL POLICE. 
The Standing Committee of the Association of Boston 
Physicians for the year commencing on the first Wednes- 
day of March, 1807, having been instructed to propose a 
code of Medical Police, to be submitted to the considera- 
tion of the Association at their next annual meeting, beg 
leave to report: — 
1. That, having examined the different publications of 
Gregory, Rush, and Percival upon this subject, they first 
selected from them such articles as seemed most applicable 
to the circumstances of the profession in this place. 
2. That, with these articles as a groundwork, they have 
proceeded to form a short system of police, containing 
general principles for the government of this Association, 
by making such alterations or additions to them as they 
thought necessary for rendering them both practicable and 
useful. 
3. That they have added such new articles as they 
judged conducive to the general views of this Association, 
and adapted to the particular situation of medical practice 
in America. 
The result of which is submitted in the form following : 6 
CONSULTATIONS. 
Consultations should be encouraged in difficult and 
protracted cases, as they give rise to confidence, energy, 
and more enlarged views in practice. On such occasions, 
no rivalship or jealousy should be indulged; candor, jus- 
tice, and all due respect, should be exercised towards the 
physician who first attended ; and, as lie may be presumed 
to be best acquainted with the patient and his family, 
he should deliver all the medical directions, as agreed 
upon. It should be the province, however, of the senior 
consulting physician to propose the necessary questions to 
the sick. 
The consulting physician is never to visit without the 
attending one, unless by the desire of the latter, or when, 
as in sudden emergency, he is not to be found. No dis- 
cussion of the case should take place before the patient or 
his friends; and no prognostications should be delivered, 
which were not the result of previous deliberation and 
concurrence. Theoretical debates, indeed, should generally 
be avoided in consultation, as occasioning perplexity and 
loss of time; for there may be much diversity of opinion 
on speculative points, with perfect agreement on those 
modes of practice which are founded, not on hypothesis, 
but on experience and observation. Physicians in con- 
sultation, whatever may be their private resentments or 
opinions of one another, should divest themselves of all 
partialities, and think of nothing but what will most effect- 
ually contribute to the relief of those under their care. 
If a physician cannot lay his hand to his heart, and say 
that his mind is perfectly open to conviction, from what- 
ever quarter it may come, he should in honor decline the 
consultation. 
All discussions and debates in consultations are to be 
held secret and confidential. 7 
Many advantages may arise from two consulting to- 
gether, who are men of candor, and have mutual confidence 
in each other’s honor. A remedy may occur to one which 
did not to another; and a physician may want resolution, 
or a confidence in his own opinion, to prescribe a powerful 
but precarious remedy, on which, however, the life of his 
patient may depend: in this case, a concurrent opinion 
may fix his own. But, when such mutual confidence is 
wanting, a consultation had better be declined, especially 
if there is reason to believe that sentiments delivered with 
openness are to be communicated abroad, or to the family 
concerned; and if, in consequence of this, either gentleman 
is to be made responsible for the event. 
The utmost punctuality should be observed in consulta- 
tion-visits ; and, to avoid loss of time, it will be expedient 
to establish the space of fifteen minutes, as an allowance 
for delay, after which the meeting might be considered as 
postponed fofa new appointment. 
INTERFERENCES. 
Medicine is a liberal profession; the practitioners are, 
or ought to be, men of education; and their expectations 
of business and employment should be founded on their 
degrees of qualification, not on artifice and insinuation. A 
certain undefinable species of assiduities and attentions, 
therefore, to families usually employing another, is to be 
considered as beneath the dignity of a regular practitioner, 
and as making a mere trade of a learned profession; and 
all officious interferences, in cases of sickness in such fami- 
lies, evince a meanness of disposition, unbecoming the 
character of a physician or a gentleman. No meddling 
inquiries should be made concerning them, nor hints given 
relative to their nature and treatment, nor any selfish 
conduct pursued, that may, directly or indirectly, tend to 8 
weaken confidence in the physicians or surgeons who have 
the care of them. 
When a physician is called to a patient, who has been 
under the care of another gentleman of the Faculty, before 
any examination of the case, he should ascertain whether 
that gentleman understands that the patient is no longer 
under his care; and, unless this be the case, the second 
physician is not to assume the charge of the patient, nor 
to give his advice, — excepting in instances of sudden 
attacks, — without a regular consultation; and if such 
previously attending gentleman has been dismissed, or has 
voluntarily relinquished the patient, his practice should be 
treated with candor, and justified so far as probity and 
truth will permit; for the want of success in the primary 
treatment of the disorder is no impeachment of professional 
skill and knowledge. 
It frequently happens that a physician, in incidental 
communications with the patients of others, or with their 
friends, may have their cases stated to him in so direct a 
manner as not to admit of his declining to pay attention 
to them. Under such circumstances, his observations 
should be delivered with the most delicate propriety and 
reserve. He should not interfere in the curative plans 
pursued, and should even recommend a steady adherence 
to them, if they appear to merit approbation. 
DIFFERENCES OF PHYSICIANS. 
The differences of physicians, when they end in appeals 
to the public, generally hurt the contending parties; but, 
what is of more consequence, they discredit the profession, 
and expose the Faculty itself to contempt and ridicule. 
Whenever such differences occur as may affect the honor 
and dignity of the profession, and cannot immediately be 
terminated, or do not come under the character of violation 9 
of the special rules of the Association otherwise provided 
for, they should be referred to the arbitration of a sufficient 
number of members of the Association, according to the 
nature of the dispute; but neither the subject-matter of 
such references, nor the adjudication, should, if it can be 
avoided, be communicated to the public, as they may be 
personally injurious to the individuals concerned, and can 
hardly fail to hurt the general credit of the Faculty. 
DISCOURAGEMENT OF QUACKERY. 
The use of quack medicines should be discouraged by 
the Faculty, as disgraceful to the profession, injurious to 
health, and often destructive even of life. No physician 
or surgeon, therefore, should dispense a secret nostrum, 
whether it be his invention or exclusive property; for, if it 
is of real efficacy, the concealment of it is inconsistent 
with beneficence and professional liberality; and, if mystery 
alone give it value and importance, such craft implies 
either disgraceful ignorance or fraudulent avarice. 
CONDUCT FOR THE SUPPORT OF THE MEDICAL 
CHARACTER. 
The esprit du corps is a principle of action founded in 
human nature, and, when duly regulated, is both rational 
and laudable. Every man, who enters into a fraternity, 
engages, by a tacit compact, not only to submit to the 
laws, but to promote the honor and interest of the Asso- 
ciation, so far as they are consistent with morality and the 
general good of mankind. A physician, therefore, should 
cautiously guard against whatever may injure the general 
respectability of the profession, and should avoid all con- 
tumelious representations of the Faculty at large, all gen- 
eral charges against their selfishness or improbity, or the 10 
indulgence of an affected or jocular scepticism concerning 
the efficacy and utility of the healing art. 
FEES. 
General rules are adopted by the Faculty, in every town, 
relative to the pecuniary acknowledgments of their pa- 
tients ; and it should be deemed a point of honor to adhere 
to them; and every deviation from, or evasion of, these 
rules should be considered as meriting the indignation and 
contempt of the fraternity. 
Gratuitous services to the poor are by no means prohi- 
bited : the characteristical beneficence of the profession 
is inconsistent with sordid views and avaricious rapacity. 
The poor of every description should be the objects of our 
peculiar care. Dr. Boerhaave used to say they were his 
best patients, because God was their paymaster. 
It is obvious, also, that an average fee, as suited to the 
general rank of patients, must be an inadequate compen- 
sation from the rich (who often require attendance not 
absolutely necessary), and yet too large to be expected 
from that class of citizens who would feel a reluctance in 
calling for assistance, without making some decent and 
satisfactory remuneration. 
EXEMPTION FROM CHARGES. 
All members of the medical profession, together with 
their families, should be attended gratuitously; but visits 
should not be obtruded officiously, as such civility may 
give rise to embarrassments, or interfere with that choice 
on which confidence depends. 
But distant members of the Faculty, when they request 
attendance, should be expected at least to defray the 
charges of travelling. 11 
Omission to charge, on account of the wealthy circum- 
stances of the physician, is an injury to the profession, as 
it is defrauding, in a degree, the common funds for its 
support, when fees are dispensed with which might justly 
be claimed. 
VICARIOUS OFFICES 
Whenever a physician officiates for another by his de- 
sire, in consequence of sickness or absence, if for a short 
time only, the attendance should be performed gratuitously 
as to the physician, and with the utmost delicacy towards 
the professional character of the gentleman previously con- 
nected with the patient. 
SENIORITY. 
A regular and academical education furnishes the only 
presumptive evidence of professional ability, and is so 
honorable and beneficial, that it gives a just claim to pre- 
eminence among physicians at large, in proportion to the 
degree in which it may be enjoyed and improved. Never- 
theless, as industry and talents may furnish exceptions to 
this general rule, and this method may be liable to diffi- 
culties in the application, seniority among practitioners of 
this town should be determined by the period of public 
and acknowledged practice as a physician or surgeon in 
the same. This arrangement, being clear and obvious, is 
adapted to remove all grounds of dispute among medical 
gentlemen; and it secures the regular continuance of the 
established order of precedency, which might otherwise be 
subject to troublesome interruptions by new settlers, per- 
haps not long stationary in the place. 
JOHN WARREN, 
LEMUEL HAYWARD, 
JOHN FLEET. SOME REMARKS 
ON THE 
PROPRIETY AND ADVANTAGES OF A FEE-TABLE. 
An agreement among physicians in regard to a Fee-table 
would not be justifiable on the score of humanity, if such 
agreement implied that a physician would not afford 
his aid unless he received a stated compensation, nor in- 
deed if it made any compensation essential for his services. 
It will hardly be disputed, that medical men do not fall 
short of those of any other profession in their gratuitous 
services to the poor. Strange indeed would it be, while 
their studies are constantly bringing before their minds the 
wisdom and goodness of God their Creator, if they should 
not be disposed to extend their aid to the sick and suffering 
from any other motive than a reward to themselves. But 
men without fortune would not enter the profession of medi- 
cine, if they did not look to their labors, as men do in other 
professions, for an adequate maintenance, and, if successful, 
for the accumulation of some property. With us, almost 
every one who engages in medical studies is altogether 
dependent on his business for support. The fees are indis- 
pensable ; so much so that the young practitioner is liable 
to the temptation of undervaluing his services for the at- 
tainment of immediate support; and those who are no 14 
longer young may also offer their services at a low price, 
hoping to compensate themselves by an increased amount 
of business. This will be done by those who think more 
of the amount of business than of the services due to their 
patients. 
It is at this point that we may consider what is for the 
interest of the public,—what is for the interest of the sick, 
who look to the physician or surgeon for their care. Which 
would be best, that the medical men should contend who 
would do the work for the lowest fees, or that they place 
their claims on their education, or their devotion to their 
profession, and on whatever goes to make up the qualifica- 
tions for the proper management of the sick, — in short, on 
their professional skill and merit ? It is true that profes- 
sional skill and merit are not always duly recognized and 
rewarded: the battle is not always to the strong. But, in 
general, the strong will ultimately succeed in the contest; 
and it is better for the community that every medical 
man should rely on his qualifications to be truly useful, 
than that he should be compelled to struggle with his 
neighbor and brother as to which would serve the sick at 
the lowest rate. 
From this view of the subject, we conclude that the es- 
tablishment of a uniform fee-table among physicians and 
surgeons living in the same city, or in a near vicinity, is 
justifiable and proper. 
In this country it is believed that the fees are more or 
less definitely adjusted by the members of the Faculty 
in the larger towns and cities. In Boston a fee-table was 
established probably more than a century ago. We know 
that there was one about the year 1788, the period of the 
greatest depression after the Revolution. The fee for a 
visit was four shillings, or sixty-seven cents; and other fees 
were in proportion. About ten years later, there was an ad- 
vance on the fees of about fifty per cent; that for a visit being 15 
a dollar. In 1808, the expenses of living, as well as the 
wealth of the town, had greatly increased ; and the charge 
for a visit was raised to a dollar and a half, with additions, 
more or less, for other services. Since that time, there have 
been occasional alterations; but there has not been any 
general change in the tariff for medical services. In the 
table of 1808, a new principle was introduced, authorizing 
a reduction of the fees to persons of moderate property, or 
of very limited incomes. 
The ground on which an increase of fees for medical 
and surgical services is now deemed requisite and proper 
is, that, since the last fee-table was adopted, the expenses 
and style of living have increased very much, and most 
especially within the last fifteen years. It is, no doubt, on 
that account that the medical fees have been raised in New 
York, Philadelphia, and Baltimore within a few years; 
while it is well known that house-rent and other necessary 
expenses are at least as high in Boston as in those cities. 
With regard to the principles on which a fee-table should 
be constructed, it may be assumed that the fees should be 
high enough both to induce men of talents and good char- 
acter to enter the medical profession; and also to satisfy 
them, so that they should never cease to study their art, 
and to cultivate all branches of science which would aid 
them in it. The physician should be able to obtain a 
subsistence in the early years of his life by such a moderate 
share of business as can be obtained in those years; and, if 
successful and fully occupied after he has arrived at middle 
life, he should be able to live in a style consistent with his 
rank in society, and to make provision for his old age, or 
for such a family as he may leave behind him. Likewise 
it would be well that there should be so much latitude in 
the arrangements respecting fees, that the younger members 
of the profession should be allowed to make lower charges 
than would be satisfactory to those in full practice. 16 
Physicians and surgeons would never obtain a support 
from the poor: they must be served without charge. With 
us, in Boston, there is abundant provision for them in the 
Dispensary, the Alms-house, or House of Industry, and the 
Massachusetts General Hospital. Besides, none of our 
medical men refuse to render their gratuitous services, 
when necessary; and this is done, not only to those known 
as poor, but to many who have “ seen better days,” and yet 
struggle to maintain a style of gentility. 
There is a large middle class, able and willing to render 
a compensation for medical services, who cannot pay such 
fees as those services are entitled to, especially for long 
sicknesses. If dependent on such as these only, the in- 
comes of physicians would not be sufficient to attract to 
their ranks men of talents, nor such as are able to devote 
much time and money to their preliminary education. 
In all large cities, there are multitudes of men whose 
wealth enables them to pay for the best services from 
medical men, and who will not be satisfied unless they 
obtain what they consider as such. Boston has its full 
share of these wealthy men. A reliance on the support to 
be derived from them encourages the student to resort to all 
proper means to qualify himself for their service. 
Under the circumstances here stated, the proper course 
seems to be to make a discrimination in the recompense 
demanded for medical services. Such a result must pro- 
bably be brought about in all instances, more or less 
perfectly, by the necessity of the case, without any special 
arrangement. In the fee-table adopted in Boston in 1808, 
and in that which has now been adopted, and which here 
follows, the principle is openly recognized and acted upon. 
This fee-table does not state absolutely what the full fee 
shall be in any case. The general plan of it is to state a 
minimum in each case. In the table of 1808, a minimum 
was stated for the charge; but it was provided that a 17 
deduction of one-third might be made from the amount of 
a bill, whenever the circumstances of the patient seemed 
to require it. In the present table, there is named for each 
service the limits within which the fee shall be placed, 
though not designing to prohibit a higher charge where 
the time devoted, or the great importance of the service 
rendered, should call for it; nor, on the other hand, to forbid 
a deduction to those in limited circumstances, in proportion 
to the exigencies of the case. RULES AND REGULATIONS. At the Annual Meeting of the Members of the Boston Medical Association, 
held May 5, 1851, — 
The subject of the Revision of the Fee Table, and of the consideration of 
By-Law VI., was referred to a Committee, consisting of Drs. J. Mason 
Warren, N. B. Shurtleff, and J. Wright Warren, with instructions to 
report at the next annual meeting. 
At the Annual Meeting, held May 3, 1852, it was — 
Voted, That the Report of the Committee be accepted. 
Voted, That the Fee Table, as modified by the Committee, be adopted by 
the Association. 
Voted, That the Secretary be requested to have printed, under the direc- 
tion of the Standing Committee, a new edition of the Medical Police and 
Rules and Regulations of the Association, as emended by the Special 
Committee; together with a Catalogue of the Officers and Members. RULES AND REGULATIONS. 
I. There shall be a stated meeting of the Boston Medi- 
cal Association on the first Monday in May, annually. 
II. At every stated meeting there shall first be chosen 
a Chairman to preside at the same; and then there shall be 
chosen by ballot a Secretary and a Standing Committee 
of five members, who shall continue in office until the 
next stated meeting, and until others are elected in their 
room. 
III. It shall be the duty of the Secretary to keep a re- 
cord of the proceedings of the Association and those of the 
Standing Committee, whose meetings he shall attend for 
this purpose, and to perform such other services as are 
pointed out in other regulations. 
IV. It shall be the duty of the Standing Committee to 
attend to and decide on all matters which regard the honor 
or interest of the Association, especially to act upon all 
infringements of its regulations which may come to their 
knowledge, and to call special meetings of the Association 
when they judge proper. In all cases there may be an 
appeal from the judgment of the Standing Committee to 
the Association. This Committee shall fill any vacancy 
in their own body, or in the office of Secretary, which 
may occur by death or resignation, until the next stated 
meeting of the Association. 22 
V. It shall be the duty of the Secretary to call a special 
meeting of the Association, whenever directed so to do by 
the Standing Committee, and likewise whenever seven 
members of the Association request him in writing so to 
do. In the cases of both stated and special meetings, he 
shall send a notification, printed or written, to each mem- 
ber, one week at least before the day of meeting, and shall 
advertise the same during the week preceding the meeting, 
twice in two newspapers printed in the city. 
VI. No member of this Association shall consult with, 
or voluntarily meet in a professional way, or aid or abet 
any practitioner resident in this city, who is not a member 
of this Association. 
VII. If any member becomes acquainted with the con- 
duct of another member, which he considers as a breach of 
the rules and regulations of the Association, it shall be his 
duty to make the same known to the Standing Committee, 
who shall inquire into the case, and decide upon the same 
as they may think proper. 
VIII. If a physician be called to a patient who has usu- 
ally been attended by another physician, on account of the 
urgency of the case or the absence of the regular physician, 
he shall, before leaving, direct that the latter be sent for to 
continue the attendance, if necessary; and in no case shall 
he continue his visits, unless he receive subsequent notice 
from the patient that his continued attendance is desired. 
IX. When a physician, engaged to attend a case of mid- 
wifery, is absent, and a second delivers the patient, the 
second shall receive the fee, and relinquish the patient to 
the first. If the first arrive while the second is present, and 
before the patient is delivered, the second shall resign the 
patient to the first. 
X. The members of this Association shall charge for 
their professional services the fees in the following table, 
subject, however, to the several rules contained in this 23 
code relative to the same; the fee to be modified according 
to the circumstances of the patient: — 
For a visit $1.00 to 2.00 
For a visit and first consultation ..... 5.00 
For a visit and each subsequent do., if the attendance be 
continuous ........ 3.00 
For a visit on board a vessel in the stream, above Fort 
Independence . . . . . . .5.00 
For a visit on board a vessel off or below do. . . . 10.00 
For a visit out of town,* for every mile from the centre of 
Boston ......... 1.00 to 2.00 
For a visit out of town in consultation,! the fee as above 
for a visit and consultation; with the addition, for 
every mile except the first, of . . . 1.00 to 2.00 
In like manner, for every other service, when out of town, 
the fee for the service shall first be charged, and for 
every mile except the first 1.00 to 2.00 
For the introduction of the catheter in cases of obstruc- 
tion ......... 5.00 to 10.00 
For a visit and passing catheter 5.00 
For a visit and passing catheter, when frequently re- 
peated, and for that purpose only .... 1.00 to 2.00 
For a visit, prescribing, and performing venesection . 3.00 
For a visit and performing venesection only, without ad- 
vice ......... 1.00 to 2.00 
For a visit and dressing only ...... 1.00 to 2.00 
For venesection or dressing at the surgeon’s house . 1.00 to 2.00 
For prescription and venesection at do 2.00 to 3.00 
For rising in the night J and visit ..... 5.00 to 10.00 
For rising in the night and visit in consultation . . 10.00 
For rising in the night and advice at the physician’s 
house 3.00 to 5.00 
For advice at the physician’s house, according to the im- 
portance of the case and the time occupied . . 1.00 to 10.00 
For a letter of advice 5.00 to 10.00 
For an opinion involving a question of law, in which a 
physician may be subpoenaed 10.00 to 50.00 
* If by railroad, from 50 cents to $1 per mile, according to the time saved to the 
practitioner. 
•f The fee for visits, consultations, and other medical services, in Roxbury, 
Charlestown, Cambridgeport, and Chelsea, may be the same as in Boston. 
% The night, in this table, is considered as beginning at 10 o’clock, p.m., and 
ending at 6 o’clock a.m., or at sunrise, when that is later than 6 o’clock, a.m. 24 
For a post-mortem examination, in a case of legal investi- 
gation ........ $20.00 to 50.00 
For do. made at the request of the family or relations of 
the deceased 5.00 to 25.00 
For a certificate of health . . . . . 3.00 to 5.00 
For a case of midwifery in the daytime * . . . 10.00 to 20.00 
For do. if any part of the attendance be in the night . 15.00 to 25.00 
For capital operations, such as amputations of large 
limbs, lithotomy, lithotrity, trepanning, extirpation 
of large tumors, operation for cataract, &c. . . 50.00 to200.00 
For the operation of fistula in ano ..... 20.00 to 50.00 
For the operation for harelip 20.00 to 50.00 
For tapping for dropsy, and for reducing luxations or 
fractures of large bones 10.00 to 50.00 
For amputations of fingers or toes, and for excision of 
small tumors ....... 5.00 to 20.00 
For tapping for hydrocele . . ... 5.00 to 10.00 
For the operation for the radical cure of hydrocele . 10.00 to 30.00 
For reducing luxations or fractures of small bones, for 
stitching recent wounds, opening large abscesses, and 
similar operations 5.00 to 10.00 
For vaccine inoculation 2.00 to 5.00 
For revaccination 1.00 to 3.00 
For cupping 2.00 to 3.00 
It is recommended that in all cases of gonorrhoea and 
syphilis a retaining fee of from $5.00 to $10.00 be 
required in advance ; the subsequent charges to be 
made as in ordinary cases of attendance or advice. 
XI. The foregoing table is designed to state the regular 
fees, which shall be charged for the services to which they 
are respectively annexed; and they are the lowest fees 
which the members of this Association shall demand. And 
in all cases of extraordinary detention or attendance, — also 
in proportion to the importance of the case and of the 
responsibility attached to it, and to the service rendered, 
where these are extraordinary, — the charges shall be in- 
* Whenever it is necessary to make more than three visits to women after de- 
livery, all additional visits shall be charged as in ordinary cases. 
N. B. In all cases stated in the table, following that of midwifery, a visit is 
implied; yet the charge should be the same, if performed at the practitioner’s house. 25 
creased according to the judgment of the practitioner con- 
cerned ; and the duty to make such increase in the charges 
shall be considered obligatory on the members of this 
Association. 
XII. It shall be considered proper, but not obligatory, 
to charge from two to five dollars for a first visit in every 
case. Likewise, all visits made at a late hour in the 
evening shall be considered as extraordinary attendance, 
and may be charged accordingly. In common cases of 
consultation, the attending physician may charge a larger 
fee than for ordinary visits, provided that he does not 
charge more than the usual fee for consultation. 
XIII. If, in any case of midwifery, a second physician 
is called in consultation, both the attending and consulting 
physician shall charge at least the usual fee for delivery; 
except that, where the consulting physician in such a case 
pays only a consultation-visit, and is not detained in at- 
tendance on the case, he may charge the fee for a consulta- 
tion-visit. 
XIV. In cases of midwifery, when the child is born, 
but not the placenta, before the arrival of the accoucheur, 
the whole fee is to be charged. When both the child 
and placenta are born before the arrival of the accoucheur, 
half or the whole fee is to be charged, according to the 
circumstances. This rule is not to be applied to cases 
where the delay arises from the accoucheur. 
XV. It is not designed by these regulations to prevent 
the members of this Association from rendering their 
services gratuitously to persons who are incapable of re- 
munerating them without distressing themselves or their 
families; and in every case, in settling his account, the 
practitioner may make any deduction which he consci- 
entiously believes that the circumstances of the patient 
render necessary. 26 
XVI. No member of this Association shall omit charg- 
ing any necessary visits made on the same day, on account 
of their number. 
XVII. No member of this Association shall make a 
previous contract with any family for a definite sum, as a 
remuneration for his annual attendance on that family. 
XVIII. Those physicians of the adjoining towns who 
are members of the Massachusetts Medical Society, or 
have been licensed by it, shall be requested to conform, in 
their charges, to the fee-bill of this Association, whenever 
they attend patients in this town. 
XIX. It is recommended that physicians present their 
accounts semi-annually, on the 1st of January and the 1st 
of July, or as much oftener as they may deem proper. 
XX. Printed blanks may be used of the following 
form : — 
Mr. to Dr. 
For Medical Attendance on 
XXI. The regulations of the Association shall be offered 
for subscription to all candidates for medical practice in 
this city, with whom the Fellows of the Massachusetts. 
Medical Society may lawfully hold consultation; and the 
Secretary shall be charged with the execution of this regu- 
lation, with which he shall comply in every instance, so 
soon as he shall learn that any candidate of the above 
description may have -established himself in this city; or, 
in case the Secretary has doubts, in any instance, respect- 
ing the propriety of offering the articles to any candidate 
above described, he shall call on the Standing Committee 
for advice and direction ; and, in case any person to whom 
he offers the regulations shall refuse or neglect to sign the 
same, the Secretary shall make known such refusal or 
neglect to the Standing Committee. 27 
XXII. Every candidate, at the time of becoming a 
member of the Association, shall sign the following ob- 
ligation, which shall be in a book deposited with the 
Secretary: — 
“ The undersigned approve of the Regulations of the Boston Medical 
Association, and agree upon their honor to comply ivith the same. ’ ’ 
It shall also be his duty to transmit a circular note, 
signed by the Secretary, to every member, informing them 
of his admission; and he is not to be entitled to the 
rights and privileges of the Association until this has been 
done. For these circulars he shall pay one dollar to the 
Secretary. 
XXIII. The members of this Association, after arriving 
at the age of sixty, shall be exempted from all assessments, 
but in other particulars shall be governed by the rules and 
regulations of this Association. 
XXIV. The Secretary shall pay all expenses of this 
Association; and once in a year at least, and oftener when 
any considerable expense has been incurred, he shall assess 
the amount due to him upon the members of the Asso- 
ciation, equally, with the exception stated in the twenty- 
third rule. He shall employ, at the expense of the members, 
a person to collect the assessments; and, if any member 
refuses or neglects to pay his assessment, his connection 
with the Association shall thereupon cease, and the Sec- 
retary shall inform the members of the same by a circular 
note; and the assessment left unpaid shall become a charge 
against the Association. 
XXV. The Secretary’s records and accounts shall be 
subject to examination by the Standing Committee, and 
by the Association, when they judge proper. 
XXVI. All resignations of members shall be made in 
writing to the Secretary, who shall immediately lay them 
before the Standing Committee, who shall either notify 28 
each member, or call a meeting of the Association, as they 
may think proper. 
XXVII. No rule or regulation of this Association shall 
be altered, amended, or repealed, nor any additional regula- 
tion adopted at any meeting, unless the proposed alteration 
or amendment has first been referred to a Committee, who 
shall report on the same at a subsequent meeting, which 
shall be held at a time not less than one month from the 
time of the appointment of the Committee. And no 
amendment or additional regulation shall be adopted, ex- 
cept by a vote of three-fourths of the members present. MEMBERS 
OF THE 
BOSTON MEDICAL ASSOCIATION, 
FROM ITS FORMATION IN 1806 TO JUNE, 1843. 
ORIGINAL MEMBERS. 
James Lloyd 
Samuel Danforth 
Isaac Rand 
John Jeffries 
Charles Jarvis 
Lemuel Hayward 
David Townsend 
Thomas Kast 
John Warren 
Thomas Welsh 
Aaron Dexter 
William Spooner 
John Fleet, jun. 
Isaac Rand, jun. 
William Ingalls 
Thomas Danforth 
Asa Bullard 
John G. Coffin 
Jacob Gates 
John Dixwell 
James Jackson 
Benjamin Shurtleff 
John C. Howard 
John C. Warren 
Cyrus Perkins 
Horace Bean 
William Gamage 
John Randall 
John Gorham 
Thomas I. Parker 
MEMBERS OF THE STANDING COMMITTEE. 
Elected. 
Resigned. 
John Warren 
1806 . 
. 1819 
Lemuel Hayward . 
1806 . 
. 1817 
John Fleet, jun. 
1806 '. 
. 1813 
Thomas Welsh 
1808 . 
. 1817 
James Jackson 
1808 . 
. 1811 
William Spooner 
1811 . 
. 1819 30 
Elected. Resigned. 
Aaron Dexter 1813 . . 1817 
John G. Coffin ..... 1817 . . 1828 
John Gorham ..... 1817 • • 1829 
George C. Shattuck .... 1817 . . 1823 
Samuel Adams ..... 1819 . . 1820 
.John Randall ..... 1819 . . 1843 
Jacob Bigelow 1823 . . 1851 
George Hayward ..... 1823 . . 
John Ware . . . . . . 1828 . . 
John B. Brown 1829 . . 1843 
John Homans 1843 . . 1851 
Enoch Hale ...... 1844 . . 1848 
0. W. Holmes 1849 . . 1851 
J. Mason Warren ..... 1850 . . 
D. H. Storer 1851 . . 
N. B. Shurtleff ..... 1851 . . 
SECRETARIES 
Elected. Resigned. 
John Fleet, jun 1806 . . 1807 
John Gorham 1807 . . 1811 
George Bates 1811 . . 1813 
John B. Brown ..... 1813 . . 1815 
George Hayward . . . . 1815 . . 1818 
E. I). Cushing 1818 . . 1819 
John Ware 1819 . . 1825 
J. P. Spooner 1825 . . 1827 
J. G. Stevenson 1827 . . 1829 
Winslow Lewis, jun 1829 . . 1831 
Joseph M‘Kean 1831 . . 1833 
Martin Gay 1833 . . 1835 
D. H. Storer . , 1835 . . 1837 
Francis J. Iligginson .... 1837 . . 1837 
Henry I. Bowditch .... 1837 . . 1838 
J. B. S. Jackson 1838 . . 1842 
A. Thomas 1842 . . 1843 
George A. Bethune .... 1843 . . 1845 
Charles E. Ware 1845 . . 1846 
Samuel Parkman 1846 . . 1848 
William J. Dale 1848 . . 1849 
E. W. Blake 1849 . . 1852 
Francis Minot 1852 . . 31 
MEMBERS 
1806. 
♦James Lloyd 
♦Samuel Danforth 
♦Isaac Rand 
♦John Jeffries 
♦Charles Jarvis 
♦Lemuel Hayward 
♦David Townsend 
♦Thomas Kast 
♦John Warren 
♦Thomas Welsh 
*t | Aaron Dexter 
♦William Spooner 
♦John Fleet, jun. 
♦Isaac Rand, jun. 
♦William Ingalls 
♦Thomas Danforth 
♦Asa Bullard 
♦John G. Coffin 
| Jacob Gates 
♦John Dixwell 
James Jackson 
♦Benjamin Shurtleff 
♦John C. Howard 
John C. Warren 
t Cyrus Perkins 
♦Horace Bean 
♦William Gamage 
♦John Randall 
♦John Gorham 
Thomas I. Parker 
1807. 
Daniel Adams 
♦Samuel R. Trevett 
1808. 
George C. Shattuck 
♦Daniel Newcomb 
| George Bates 
1809. 
John B. Brown 
t Benjamin James 
♦Joshua Thomas 
1810. 
Walter Channing 
#t Nathaniel Bemis 
Jacob Bigelow 
f Auguste Lemosy 
*tJoseph Lovell 
t Daniel Cook 
1812. 
♦Shirley Erving 
#f John Revere 
♦ Peter St. Medard 
♦Elisha Clap 
George Hayward 
1813. 
♦Benjamin Read 
1814. 
*f Oliver Prescott 
♦George Parkman 
It Amos Farnsworth 
♦John Gardner 
♦f Ezekiel D. Cushing 
♦Nathaniel Lovell 
f La Fayette Perkins 
1815. 
♦Asa Bucknam 
♦j-Andrew Foster 
♦Theodore Dexter 
fWilliams Bradford 
♦James Mann 
Abner Phelps 
1816. 
♦f Pliny Hayes 
♦f Josiah Batchelder 
*| Samuel Clarke 
♦J Edward H. Robbins, jun. 
Zabdiel B. Adams 
Solomon D. Townsend 
1817. 
f Benjamin Austin, jun. 
♦Joseph Bossuet 
John Ware 
♦f Peter G. Robbins 
David Osgood 
If Nathaniel Niles 
|{ Samuel A. Shurtleff 
♦Samuel Hemmenway 
♦Enoch Hale 
* Deceased. 
f Left the city. 
X Relinquished practice. 32 
1818. 
♦f Samuel Adams. 
Edward Reynolds, jun. 
#f + John W. Webster 
*j Thomas Pratt, jun. 
*f J John S. Bartlett 
_ 1819. 
Woodbridge Strong 
f William Sweetser 
John Jefiries, jun. 
f Thomas W. Parsons 
♦f Frederick A. Parker 
*f Jesse Smith 
*7 Gamaliel Bradford 
Josiah F. Flagg 
Shelometh S. Whipple 
1820. 
j- John Locke 
*George B. Doane ' 
*Chandler Robbins, jun. 
George Russell 
f John P. Spooner 
*f John D. Wells 
1821. 
♦Caleb H. Snow 
*f Joseph 0. Osgood 
1823. 
*f |Daniel Ingalls, jun. 
Jerome V. C. Smith 
George W. Otis, jun. 
Edwin Adams 
♦Warren Abbott 
1824. 
Samuel Morrill 
f Erastus H. Bartlett 
f William B. Duggan 
♦Moses Gage 
Winslow Lewis, jun. 
f Augustus Plympton 
j Joshua H. Hayward 
1825. 
♦Thomas 0. Folsom 
♦William H. Bass 
J Hezekiah Eldredge 
♦Charles T. Hildreth 
James Wilson 
D. Humphreys Storer 
| Joshua B. Flint 
Horatio Robinson 
t James M. Whittemore 
1826. 
f Theodore Kittredge 
f Charles W. Windship 
*J. Greely Stevenson 
John Flint 
John C. Hayden 
f Ralph Farnsworth 
Jonas H. Lane 
J Joseph Palmer 
*t Edward G. Davis 
* Joseph W. McKean 
*Martin Gay 
1827. 
Alexander Thomas 
♦John D. Fisher 
Nathan C. Keep 
Frederick A. Sumner, jun. 
*f Francis Shurtleff 
♦f Henry S. Wade 
♦John E. Stebbins 
f Walker Booth 
1828. 
f Joseph Clark 
f Charles Choate 
♦f Benjamin Lincoln 
•f-John 0. Fay 
♦William Grigg 
*f Philip I. Dumaresq 
■f George Stearns 
* f Charles Walker 
Benjamin T. Prescott 
+ Charles G. Greene 
♦JJohn H. Richards 
•(•Nathaniel Peabody 
*t John A. Bulfinch 
Charles H. Stedman 
Giles H. Lodge 
f Francis J. lligginson 
*7 John C. Howard 
1829. 
+ Charles T. Jackson 
Daniel T. Coit 
f Nathaniel B. Shaler 
♦Thomas Gray, jun. 
John B. S. Jackson 
John Homans 
|D. H. Gregg 
Edward J. Davenport 
Henry Dyer 
1830. 
J Daniel Harwood 
Augustus A. Gould 33 
* Calvin Ellis 
Marshall S. Perry 
Abraham A. Watson 
*f Thomas H. Thompson 
Levi B. Gale 
* Samuel H. Smith 
* Albert Williams 
George Bartlett 
f J. Wilson 
f Edward Warren 
1831. 
fj Benjamin F. Wing 
f Ambrose Seaton 
*f James Wood 
William G. Hanaford 
| Paul Simpson, jun. 
*Ebenezer Parker 
Ezra Palmer, jun. 
1832. 
Joseph Roby 
* George W. Lane 
Howard Sargent 
fj Josiah D. Hedge 
j Edward L. Cunningham 
1833. 
| Caleb S. Whitman 
Asa B. Snow 
f John Appleton 
ft Jesse Chickering 
*William E. Foster 
Henry A. Ward 
Charles G. Putnam 
f Alpheus Proctor 
f Austin Flint 
James B. Gregerson 
1834. 
* James Jackson, jun. 
f Josiah Kittredge 
John Odin 
f Samuel B. Swett 
f William W. Dwight 
Nathaniel B. Shurtleff 
* j- Henry Tuck 
Francis H. Gray 
j Joseph J. Fales 
H. I. Bowditch 
1835. 
*Joseph Moriarty 
Henry G. Clark 
* Abner B. Wheeler 
J. Mason Warren 
f Lewis J. Glover 
*f Solomon Keep 
George G. Shattuck, jun. 
*E. W. Leach 
Andrew Alexander 
1836. 
f Henry A. Dewar 
Robert W. Hooper 
*f J. Cullen Ayer 
| Oliver Wendell Holmes 
f Albert T. Smith 
John W. Warren 
f William Ingalls, jun. 
Richard H. Salter 
J Francis Dana 
*Henry B. C. Greene 
Warren J. Whitney 
f Jonathan Leonard 
j Alonzo Chapin 
*Marcellus Bowen 
Luther Clark 
John H. Dix 
Herman B. Inches 
*Henry G. Wiley 
George A. Bethune 
Charles Gordon 
1837. 
Charles H. Peirce 
fC. M. Weld 
Ephraim Buck 
f John W. Gorham 
George Hubbard 
f Jacob Hayes 
ft Jeflries Wyman 
f Moore R. Fletcher 
Charles E. Ware 
f Charles H. Wheelwright 
Horace Dupee, jun. 
John Stevens 
f Benjamin Haskell 
f Benjamin E. Cotting 
1838. 
*Samuel Wigglesworth 
*f William Eustis 
t Stephen Salisbury 
f Richard S. Young 
f Samuel Fish 
Joshua Tucker 
J Thomas M. Brewer 
fj Nathaniel S. Tucker 
f J. T. Gilman Leach 
*S. S. Bugbee 
t William Gordon 34 
1839. 
|J. H. Dorr 
fC. C. Yates 
Benjamin B. Appleton, jun. 
Samuel Parkman 
♦Ephraim Buck, jun. 
1840. 
Stephen Ball, jun. 
Aaron P. Richardson 
Henry J. Martin 
Phineas M. Crane 
Ephraim Marston 
f Augustus Whiting 
f J Ward N. Boylston 
J. F. W. Lane 
|C. C. Holmes 
f Nathan Warren Oliver 
f Benjamin Mann 
Daniel Mann 
William Hawes 
William J. Dale 
1841. 
George Tower 
♦Frederick A. Eddy 
Jonathan Small 
| Charles Thacher 
t John S. Butler 
f William W. Cutler 
j Samuel Trull 
Samuel L. Abbot, jun. 
William A. Briggs 
f C. F. Foster 
fE. 0. Phinney 
f Henry Orne Stone 
Silas Durkee 
1842. 
Charles Mifflin 
fW. T. Parker 
t George A. Hammett 
George Heaton 
tOtis E. French 
John A. Cummings 
Louis M. I. Mignault 
♦t Geo. Friedrick Hartmann 
1843. 
Eli Whitney Blake 
William E. Coale 
t G. Ware Gay 
Rufus L. Hinckley 
George Hayward, jun. 
1843. 
t Edward Hall 
William W. Morland 
♦John Spence, jun. 
Edward D. G. Palmer 
George N. Thomson 
Cyrus S. Mann 
Peter Renton 
Samuel Cabot, jun. 
Willard W. Codman 
t J. Frazier Head 
Moses W. Weld 
t Alexander Jackson 
f E. P. Le Prohon 
Moses C. Greene 
Henry J. Bigelow 
♦Edward Brooks, jun. 
Jasper H. York 
Joseph S. Jones 
Charles A. Phelps 
Le Baron Russell 
f Alvan Becon 
Chas. E. Buckingham 
fWm. P. Dexter 
E. G. Tucker 
t Wm. Henry Thayer 
1844. 
f J. W. Holman 
tThos. F. Saxton 
♦Alfred A. Lane 
Buckminster Brown 
Wm. E. Townsend 
f Estes Howe 
f Calvin Newtown 
f Horace Thurston 
George Derby 
f Benjamin L. Ball 
Ebenezer Stevens 
♦Albert G. Upham 
fj Elijah C. Drew 
♦John B. Walker 
f Jona. G. Morse 
James M. Phipps 
Calvin Stevens 
t John P. Carter 
1845. 
David Thayer 
Horace Stacy 
f Levi Merrill 
f Albert A. Hazzard 
f Kimball Hill 
Samuel Kneeland, jun. 
Fytch E. Oliver 
George H. Lyman 35 
t Francis M. McLellan 
M. Aurelius Moore 
Henry S. Lee 
W. S. Coffin 
t F. AVillis Fisher 
AVm. Read 
Luther Parks, jun. 
*J. B. Upham 
f Nathaniel Downes 
Benj. F. Gilman 
M. Mattson 
A. B. Malcolm 
f Thomas Andrews, jun 
t Wm. Pitt 
1849. 
Henry W. Williams 
F. A. Willard 
John Bacon, jun. 
1850. 
Franklin F. Patch 
1851. 
T. Fletcher Oakes 
J. Randolph Lincoln 
Henry Willard 
George F. Bigelow 
J. L. Williams 
S. F. Parcher 
E. T. Eastman 
E. A. W. Harlow 
Josiah Curtis 
1852. 
Robert Greer 
J. M. Sharkey 
D. McGowan 
J. E. Herrick 
James Ayer 
Robert W. Newell 
t Nathaniel Downes 
t Pierre B. Mignault 
Robert White 
t Elie Laurte 
184G. 
C. W. Calkins 
G. S. Jones 
*Samuel Hamblen 
fE. G. Kelley 
f John McCrillis 
f D. W. Parker 
Daniel V. Folts 
f Jesse Merrill 
f Wm. R. Lawrence 
John B. Alley 
Fred. S. Ainsworth 
Henry Osgood Stone 
I. W. Tobie 
J. W. Hinckley 
Edward H. Clarke 
f M. 0. R. Reedy 
1847. 
James F. Harlow 
Patrick E. Molloy 
Benjamin P. Randall 
James W. Stone 
Charles F. Heywood 
f Robert T. Davis 
Francis Minot 
f L. B. Coles 
D. D. Slade 
E. B. Moore 
f Joseph Hagar 
1848. 
James Ilyndman 
Alanson Abbe