THE CONFERENCE OF THE DELEGATES APPOINT- 
ED BY THE BOARDS OF CENSORS FOR THE DIS- 
TRICT MEDICAL SOCIETIES OF THE STATE OF 
MASSACHUSETTS. 
The conference of the delegates from the Boards of Censors of 
the District Medical Societies throughout the commonwealth met 
June 11, at 19 Boylston Place. Twelve members were present, 
accredited to the various societies. Dr. John Crowell of Essex 
North District was chosen chairman, and Dr. Albert N. Blodgett, 
of Suffolk, clerk. 
METHODS OF EXAMINATION. 
The first business was the report of the committee appointed last 
year for the purpose of ascertaining the methods employed by the 
various Boards of Censors in the State, in order to compare these 
methods and to adopt some system which shall be more nearly 
uniform in the various sections of the Commonwealth, and more 
thoroughly conform with the requirements of the By-Laws of the 
Massachusetts Medical Society than has heretofore been the case. 
After a few introductory remarks the following report was pre- 
sented :— 
The Committee appointed at the conference of Censors held in 
Boston, June 14, 1882, to “ascertain the methods of examination 
used by the several Boards of Censors, etc.” submit the following 
report. 
In the early part of May the following note was mailed to the 
secretary of each District Society:— 
MASSACHUSETTS MEDICAL SOCIETY. 
To Dr. 
Secretary District Society. 
Dear Sir,—At a conference of censors held in Boston, June 14, 1882, it 
was voted “ That a Committee of three be appointed, whose duty it shall be 
to ascertain the methods of examination used by the several Boards of 
Censors, and to request the censors to make such suggestions upon this 
subject as may occur to them.” 
An answer is respectfully requested before June 1st. 
The Committee would urge upon your Board the importance of sending 
two delegates to the Conference of Censors to be held in Boston during the 
next annual meeting of the Massachusetts Medical Society. 
«J. T. G. Nichols, Middlesex South. 
GLeoroe.C. McClean, Hampden. 
H. HArtwell, Worcester North. 
A. j Committee. 2 
Answers have been received from the following districts : Barn- 
stable, Bristol North, Bristol South, Essex North, Essex South, 
Hampden, Hampshire, Middlesex East, Middlesex South, Ply- 
mouth, Suffolk. 
For the Committee, 
J. T. G. Nichols, Chairman. 
The Barnstable District Medical Society appointed me to answer this 
communication. I can only say that our Society has endeavored to comply 
with all the requirements of the parent society in regard to admission of 
new members. Aside from documentary evidence (diplomas), we invariably 
institute a thorough oral, and frequently a written, examination, and pay 
particular attention to the Practice of Medicine and Obstetrics. We choose 
to insist upon a thorough practical examination rather than one directed 
to details of a more minute character. The fact that our society frequently 
rejects an applicant, I think is evidence of our thoroughness. 
Very respectfully yours, Benj. D. Gifford, 
for Barnstable District Medical Society. 
May 12, 1883. 
Taunton, May 24, 1883. 
Db. J. T. G. Nichols : 
Dear Sir,—The mode of examination for the Bristol North District is as 
follows, viz.: two written questions are submitted by each censor (each 
censor having a particular branch) to each candidate for admission. The 
answers to be in writing. If time permits, an oral examination follows the 
written. Hoping you will pardon delay in answering, 
I remain yours, etc., 
E. F. Galligan, Secretary. 
New Bedfobd, May 29, 1883. 
Dr. J. T. G. Nichols : 
Dear Sir,—In answer to your letter, I will state that it is the custom with 
our district society to require a written application from the candidate. 
This application is handed in six months before he comes up for examination. 
Our object in doing this is to make inquiries in regard to his character 
and standing in the community and with the profession. Our examinations 
are conducted orally. Each censor examines the candidate on one or more 
branches, and then if he has a majority of the votes of the censors he is 
admitted. 
The voting is by ballot. 
Our questions are mostly of a practical character. 
Very truly yours, 
A. Martin Pierce, 
Secretary Bristol South District Medical Society. 
Newburyport, May 11, 1883. 
Dr. J. T. G. Nichols : 
Dear Sir,—In reply to your circular, I am happy to state that the censors 
of the Essex North District Medical Society give candidates for admission 
to the society a practical oral examination in those branches which are 
taught in the recognized medical colleges. Drs. John Crowell of Haverhill 
and J. F. Terry of Newburyport have been appointed delegates to the 
Conference of Censors to be held in Boston during the next annual meeting 
of the Massachusetts Medical Society. 
Yours respectfully, 
George W. Snow, Secretary. 3 
Dear Doctor,—The note from your committee, asking about our methods 
of examination, etc., was duly received. 
In our examination we follow strictly Article I. of the By-Laws of the 
State Society; that is, we require candidate to exhibit diploma, and to 
show that he'possesses the other qualifications specified in Article I. We 
then examine upon the several branches named—each member of the Board 
being present, and hearing every answer given,—usually asking from five 
to ten questions upon each subject. We have usually confined the written 
part of the examination to the writing of prescriptions and reports of cases. 
Each candidate is examined in private, and a vote taken by the Board upon 
his admission. 
Very truly, 
T. Kittridge, 
for Essex South District. 
Dr. J. T. G. Nichols, Cambridge, Mass.: 
My dear Doctor,—Your favor received. My suggestion was not material, 
and your circular, as you say, covers the ground. It occurred to me, after 
writing, that you might have struck off your copies. The Committee of 
Councillors, to which you referred, and of which I was a member, after 
mature deliberation, got round to their starting point, and recommended 
that existing laws be enforced, as you know. 
I report for our district by sending you a copy of the questions used at 
our last meeting. There were three candidates, only one of whom was 
admitted, the other two will come up again in October. We mean busi- 
ness, and hope to keep the standard up here, at our end of the State. 
Sincerely yours, 
Springfield, May 18, 1883. Geo. C. McClean. 
To Dr. J. T. G. Nichols : 
Dear Sir,—Your communication from the committee of Censors is at 
hand. In reply I would say that nearly all the men who present them- 
selves for examination are men well known to the Board, whom we are 
anxious to pass with a merely formal examination: men with diplomas 
from first-class schools. 
When others present themselves, which has never been the case within 
my recollection, they are examined writh care. I would also call your at- 
tention to the fact, that the advantages of belonging to the “ Hampshire 
District Branch of the Massachusetts Medical Society” are not apparent to 
most of the physicians about here, and our greatest difficulty is in inducing 
the good men to join us, not in keeping the bad men out. 
If you legislate for this part of the State on the assumption that any one 
is, or is likely to be, hungering and thirsting to join the Society, you will 
make a sad mistake. 
Yours truly, 
Chas. W. Cooper, 
Sec. of Censors for Hampshire. 
Reading, June 6, 1883. 
Dr. J. T. G. Nichols : 
Dear Sir,—Our Censors have no suggestions to offer your committee. 
The Board will be represented at the meeting called for June 14th. 
I appreciate the importance of concerted action in the matter of elevating 
the standard for admission into our Society. 
Respectfully yours, 
George E. Putney, 
Secretary, Middlesex East District. 4 
Brockton, May 9, 1883. 
Dr. Nichols : 
Dear Sir,—In answer to your letter, as to the method of the different 
Boards of Censors in the examination of candidates, I will simply write 
that the examination of candidates, in the Plymouth District Medical So- 
ciety, is generally a written one, but sometimes it is partly written and 
partly oral. 
Each candidate has two questions in each branch of study, and each of 
the Censors takes one or more of the branches of study from which he 
formulates the questions. 
Generally the examination lasts about two hours, after which the papers 
are-examined, each Censor examining those which he furnished. Upon the 
result of the examination depends the admission or rejection of the candi- 
dates, provided their moral character, etc., are right. 
In regard to the sending of delegates to the conference of Censors during 
the annual meeting, as there will be no more meetings of our society until 
July, I will take the liberty of naming Drs. II. F. Borden of Brockton, and 
H. W. Dudley of Abington as delegates. 
I suppose they will receive proper notice of the time and place of holding 
the meeting. 
Yours truly, J. E. Bacon, 
Secretary of Plymouth D. M. S. 
The Censors of the Middlesex South District, having found that a candi- 
date is qualified for examination, subject him to an oral examination in the 
branches of study specified in Article I. of the By-Laws of the Massachu- 
setts Medical Society. Certain branches of study are assigned to each 
Censor. Of late years, a few written questions in two or more branches 
have been given. A ballot is then taken upon the admission of the candi- 
date. A majority of the present Board of Censors is in favor of making 
the written examination still more prominent. They think it quite as fair 
to the candidate as an oral examination, while it gives the Censors written 
evidence of the justice of their decision, should it be adverse to the candidate. 
J. T. G. Nichols, for the Censors. 
19 Exeter Street, May 9, 1883. 
My dear Sir,—In reply to your committee’s inquiry I would report that 
the method of examination, pursued by the Suffolk Board of Censors, is as 
follows:— 
(1.) The applicants first present their diplomas to the Secretary, who 
presents them to the Board. The Board then vote whether or not to admit 
said applicant to examination. 
(2.) The examination consists of an oral examination of each candidate 
by each Censor for from three to five minutes. 
The division of branches among the different Censors, i. e. of the subjects 
upon which it is required by By-Law I. of the Massachusetts Medical 
Society, that each candidate should be examined, is by mutual consent. 
The written examination is then held, the paper consisting of two ques- 
tions from each Censor, or sometimes only one; the time allotted for this 
examination is two hours. The books in which the candidates write are 
numbered and sent to the different Censors, to mark, who thus do not know 
the names of the men whose books they mark. At a subsequent meeting 
the marks are handed in, the oral and the written added together, and 
divided by two. No candidate falling below fifty per cent, is admitted, but 
the Censors do not consider themselves bound to admit those averaging over 
fifty per cent., if there is anything prejudicial to their moral character known. 
I enclose specimen examination papers. 
Very respectfully, II. C. Haven, 
Secretary Suffolk District Board of Censors. 5 
(1.) Give the position and relations of the kidneys. 
(2.) Diagnosis and treatment of impacted fracture of lower end of radius. 
(3.) State the uses of opium ; action; forms; doses ; active principle; 
antidotes. 
(4.) What is a tonic? a stimulant? an escharotic? an emetic? a se- 
dative? a cathartic? Give examples of each. 
(5.) What organs are concerned in digestion, and what part is played by 
each in the process. 
(6.) Classify Phthisis, and describe briefly the gross appearances of the 
most important changes found in the viscera. 
(7.) Give the diagnostic points which distinguish accidental and unavoida- 
ble haemorrhage at the time of labor. 
(8.) How is an arrest distinguished from an impaction of the head within 
the cavity of the pelvis ? 
(9.) Describe what you consider to be the proper method of disposing of 
the drainage of an inland country house 60 X -50 feet, standing on a lot of 
two acres, and dependent for its water supply on a well ten feet from the 
house. [There is no stream of winter in the vicinity.] 
(10.) Give the symptoms of, and the differential diagnosis between, 
Dilatation of the Heart and Pericarditis with Effusion. 
CENSORS’ EXAMINATION, JUNE 7, 1883. 
(1.) Give the contents of the right iliac region, and their relations. 
(2.) What are the varieties of club-foot—their causes and treatment? 
(3.) Describe the process of digestion. 
(4.) Enumerate and briefly describe the appearances of the chief affec- 
tions of the lungs. 
(5.) Whence are Arsenic, Iodine, Mercury, derived? Method of pre- 
paration? Forms of each for medicinal use? Signs of poisoning from each, 
and antidote. 
(6.) What is a stimulant? A tonic? A sedative? An emetic? A 
cathartic ? Action of each, with written prescriptions, and directions for 
use? 
(7.) Give the differential diagnosis between dysentery and catarrh of 
the large intestine. 
(8.) Describe a case of acute capillary bronchitis, with directions for 
treatment. 
(9.) Give a brief outline of a normal labor. 
(10.) Name any very dangerous complication which might arise during 
or after birth, and say what you would do. 
CENSORS’ EXAMINATION, JUNE 2, 1881. 
HAMPDEN DISTRICT MEDICAL SOCIETY. 
WRITTEN EXAMINATION, HELD APRIL 17, 1883. 
ANATOMY. 
(1.) Describe the hip joint. 
(2.) Describe the male urethra. 
(3.) Describe the female perinseum. 
PHYSIOLOGY. 
(1.) Composition and functions of the gastric juice. 
(2.) What is respiration? 
(3.) Functions of the anterior and posterior columns of the spinal cord. 
(4.) Functions of the sympathetic. 6 
(o.) Functions of the cerebrum. 
(6.) Forces producing the circulation of the blood. 
GENERAL CHEMISTRY. 
(1.) Sulphuric Acid, give composition, preparation, and compounds. 
(2.) Preparation of Hydrogen. 
(3.) Compounds of Iodine. 
MATERIA MEDICA ANI) THERAPEUTICS. 
(1.) Action and doses of (a) Iodine, (6) Iodide Potass. 
(2.) Citrates and acetates, how changed in the system. 
(3.) Action and doses of («) Aconite, (6) Pilocarpine, (c) Belladonna 
and Atropia. 
(4.) Name and give doses of mercurials in common use. 
(5.) Action of Opium. Give its alkaloids, and doses of principal ones. 
MEDICAL CHEMISTRY. 
(1.) Varieties and appearance of urinary calculi. 
(2.) Blood corpuscles, how distinguished. 
(3.) Tests for Arsenic. 
(4.) Tests for Albumen. 
(5.) Tests-for Sugar. 
PATHOLOGY. 
Give pathology and morbid anatomy of 
(1.) Stricture of the urethra. 
(2.) Pneumonia. 
(3.) Rheumatoid arthritis. 
(4.) Typhoid fever. 
THEORY AND PRACTICE. 
(1.) Diagnosis and treatment of acute articular rheumatism. 
(2.) Differential diagnosis of intercostal neuralgia and pleuritis. 
(3.) Diagnosis of apoplexy. 
(4.) Differential diagnosis of true croup and capillary bronchitis. 
(5.) Diagnosis and treatment of pneumonia. 
(6.) Diagnosis of chronic Bright’s. 
SURGERY. 
(1.) Hernia, varieties, diagnosis, and treatment. 
(2.) Dislocation of the shoulder joint. 
(3.) Describe ischio-rectal abscess, and how treated. 
(4.) What are the secondary symptoms of syphilis? 
(5.) Removal of foreign bodies from the ear. 
OBSTETRICS. 
(1.) At eight months, os undilated; liquor amnii escaped; no pains; 
no flowing; give the treatment. 
(2.) Treatment of post-partum hsemorrhage. 
(3.) Diagnosis of twin pregnancy. 
(4.) Treatment of prolapse of the funis. 
(5.) Treatment when an arm is found in the vagina. 
(6.) What are the usual signs of pregnancy? 7 
It was voted that the report of the committee be received and 
placed on file. 
Dr. Blodgett spoke of the increasing interest manifested by 
the Censors of the District Societies in the comparison of methods, 
and the great manifest diversity still existing in the requirements 
of the several Boards. The supposed existence of great diversity 
of opinion upon this point was the reason for calling the first 
general conference of censors, and the able manner in which the 
committee of last year has acquitted itself in the delicate mission 
which was intrusted to it, has proved the need for a nearer ap- 
proach to some definite standard of excellence as the requirement 
for admission to the Massachusetts Medical Society, which .shall 
find application throughout the State. 
SPECIAL MEETING OF DISTRICT CENSORS. 
Dr. Sabine, delegate from Norfolk, stated that at the con- 
ference of last year his society was not represented, owing to the 
fact that the then chairman took the ground that, according to the 
By-laws of the Massachusetts Medical Society, the Board of Cen- 
sors could not appoint delegates to the meeting. The annual 
meeting of that society is held in May of each year, and delegates 
cannot be appointed to attend the June meeting without the calling 
of a special meeting of the Censors of that district for this purpose. 
In the opinion of the chairman this could not be done, and there- 
fore the Norfolk Society was without representation at that time. 
Much good could doubtless be accomplished by meetings of dele- 
gates from the various local boards for consultation and comparison. 
Dr. Nichols, of Middlesex South, remarked that the Censors 
of the district societies were oidy allowed to hold meetings at the 
same time and place as the stated meetings of the district societies. 
No special meeting can be called for any purpose whatsoever. 
Dr. Blodgett proved from the records of the Suffolk Censors 
that a special meeting for the examination of candidates was held 
on certainly one occasion at a different date from either of the 
times specified in the By-laws; and there seems to be no good 
reason why such special meetings should not be held whenever the 
duties of the Censors toward the State Society demand. 
Dr. Cltter, of Middlesex South, stated that he has studied the 
by-laws, and finds nothing therein to prohibit the holding of special 
meetings of the Board of Censors. Acting upon this ground, the 
Censors of his district held such a meeting, and were called to ac- 
count for the same by the then President of the Massachusetts 
Medical Society, Dr. Williams, who contended that the By-laws 
did not allow the Censors to meet at other than the periods stated 
in Art. xx. 8 
Dr. Crowell has until recently supposed that no meeting of 
Censors could be adjourned, and thought that no special meeting 
could be called. 
Dr. Nichols said that the Censors were subject to a fine for 
failing to meet for the examination of candidates at the times 
specified in the By-laws. The Censors for his district held a 
special meeting for the examination of a candidate and were over- 
hauled by the President of the State Society and mulcted in the 
amount of their fee for the examination, which has never yet been 
paid bjr the treasurer. The conflict was with the President of the 
State Society, not with the Society itself. Dr. Cotting, of Nor- 
folk, has always been very positive that the Censors could hold no 
special meetings, and in those days they were not even allowed to 
adjourn. 
Dr. F. C. Shattuck, delegate from Suffolk, presented the fol- 
lowing motion, which was unanimously carried: Voted, “That in 
the opinion of this meeting, the Boards of Censors of the District 
Societies are at liberty to hold special meetings at their pleasure, 
whether for the examination of candidates or for any other business 
within the scope of their functions.” 
Voted, “ That the secretary of this meeting be requested to pre- 
sent this recommendation to the Board of Councillors of the Massa- 
chusetts Medical Society at their approaching meeting, in the ur- 
gent hope that they may consider the subject and take favorable 
action thereon.” 
CHARACTER AND PURPOSE OF EXAMINATION. 
Dr. Shattuck stated that in a former meeting of delegates 
from the various boards, the fact was learned that the greatest 
laxity existed in the examination of candidates, and that the By- 
laws were in no sense complied with. 
Dr. Cutter, of Middlesex South, observed that we may err in 
one direction as well as in the other. The effort of the Censors 
should be to gain all good men, and to exclude only those who are 
unworthy. Many members of the profession are no doubt ex- 
cluded from the society from a feeling of humiliation accompanying 
the examination. 
Dr. Nichols said that he could not agree with the remarks of 
the last speaker. The examinations are no more than any young 
man just out of college should pass. In his own (Middlesex 
South) Society a young man—a graduate within a year from a 
medical college—presented himself for examination before the 
Censors. In certain branches his examination was satisfactory, 
in some others it was very unsatisfactory, and he was not allowed 
to pass. Some feeling now exists in regard to the justice of the 
rejection of this gentleman. Had some part of the examination 9 
been conducted in writing, the Censors would have been able to 
present a much clearer defence of their action in excluding this 
candidate from the Massachusests Medical Society. The written 
examination may be more tedious, but it is much more satisfactory. 
If the examination is printed, as in the Suffolk District, the amount 
of labor is much modified, it is fairer for the candidates, and is a 
record of the degree of rigor of the examination. 
Dr. Hammond, of Hampden, said that he hoped to gain a 
clearer idea of the duties of Censors. He felt that in his district 
injustice had been done toward one or two gentlemen who pre- 
sented themselves for examination. The candidates were kept 
busy from eleven till four o’clock, but failed to pass. One of these 
men has been in practice for some years in another State, and was 
rejected because he could not answer the questions of the Censors. 
Dr. Cutter thought it wrong to send the names of unsuc- 
cessful candidates to all the Boards of Censors in the State as is 
now done. 
Dr. Davis, of Worcester, said that the present method of ex- 
amination is obstructed by want of time. In his district a written 
examination of a practical character is first held, and afterward a 
private oral examination, followed by an election to membership 
by ballot. 
Dr. Rich, of Worcester, thought the aim of the Society should 
be to win all good men. It might be wise to require a candidate 
to be a resident of the district for two years before admission to 
the Society, in order that he might become known to the Censors. 
There is an increasing interest in the Worcester District in a 
standard of examination which shall be uniform and of a suitable 
character. 
Dr. Smith, of Berkshire, stated that in his district the Censors’ 
examinations were the flimsiest he had ever known of; but that 
the character of the candidates wras beyond reproach. The Berk- 
shire Society is an earnest, active society. The presidents of the 
State Society can testify to the character of the Berkshire members. 
In that district the moral character of the candidates is first investi- 
gated; then the source of the diploma is ascertained. No questions, 
such as are used in Suffolk, are employed. We ignore some of 
the requirements of the By-laws. One recent candidate knows 
nothing of Latin, but is a successful practitioner in Sheffield. We 
don’t know how he writes his prescriptions. We think that all 
men of good moral character and fair education should be gathered 
into the Society. At present it numbers about fifty men—the 
strong, working elements of the profession in that district, who are 
growing with the times, and are a bulwark of strength for the 
Society. 
Dr. Sabine, of Norfolk, spoke of the desirability of a uniform 
standard foe the successive Boards of Censors in the same district, 10 
instead of having a hard examination at one time, and a much 
easier one at another. The same Censors always examine upon 
some subject assigned to them during their term of service. In 
Norfolk District twenty-five per cent, of the candidates of recent 
years have been rejected. Another desirable thing would be a 
full board at every meeting of the Censors. Three members con- 
stituting a quorum at present, it is possible for two of the Censors 
to reject a candidate for membership in the State Society. 
Adjournments of the Board are otherwise necessary, and the 
Censors as well as the candidates are put to much inconvenience. 
Dr. Crowell stated that the greatest reason for special meet- 
ings was found in the length of time required for the examination 
of the candidates on the day of the stated meetings of the Societies, 
by which the Censors as well as the candidates are prevented from 
participation in the proceedings of the Society. 
Dr. Shattuck thought that a great deal of good had come 
from the meetings of the Censors for conference. lie then made 
the mqtion “that the committee of last year be continued for the 
purpose of watching the results of their action during the past 
year, and be requested to make a report upon the same subject at 
the next Conference of Censors.” The motion was adopted. 
On motion of Dr. Shattuck it was voted “ that a copy of the 
minutes of this meeting be transmitted to the several Boards of 
Censors in the State, with the request that delegates be appointed 
from each Board to the next annual meeting.” Adjourned. 
To District Board of Censors of the Massa- 
chusetts Medical Society : In accordance with the vote contained in 
the last clause of the preceding report, you are hereby requested to 
appoint delegates to the next general rueetiug of the Censors, oc- 
curring at the time of the annual meeting of the State Society, in 
June next. 
Yours respectfully, 
Albert N. Blodgett, 
Clerk.