BY-LAWS OF THE MEDICALSOCIETY OF THE COUNTY OF ONEIDA: TOGETHER WITH THE LAWS OF THE STATE OF NEW-YORK, RELATIVE TO THE MEDICAL PROFESSION, ) AND A c SYSTEM OF MEDICAL ETHICS. PUBLISHED FOR THE SOCIETY. UTICA: R. NORTHWAY, Jr. PRINTER. M DCCC XXXIII. BY-LAWS OF THE MEDICAL SOCIETY OF THE COUNTY OF ONEIDA. The Medical Society of the County of Oneida, by virtue of the statute in such case made and provided, do hereby make, ordain, and declare the following1 By-Laws, Rules, and_______ Regulations, for the better government of the members of the said society, and for the purpose of carrying into execu- tion the several purposes and objects of their incorporation; that is to say :— ARTICLE I. Persons who may be Members. This society shall be known by the name of the Medical Nat?e of Society of the County of Oneida. It shall consist of all the of whom i( legally authorized practising physicians and surgeons who s!iallcon" do now reside, or who may hereafter come to reside, in the county of Oneida, and who have been admitted, or shall be hereafter admitted, members of said society, pursuant to the subsequent provisions of these by-laws, excepting such as shall be at any time expelled the said society pursuant to said by-laws, and the statutes of this state. ARTICLE II. Officers* The officers of the said society shall be a President, Vice Officers. President, Recording Secretary, Corresponding Secretary, Treasurer, Librarian, and five Censors. The said officers Howcho- shall be chosen by ballot at the anniversary meeting, andsen* shall hold their offices for one year, and until others shall be chosen. Vacancies occasioned by death, resignation, or re- vacancies, moval without the county, shall be filled at the first meeting 4 SSe8SSdi-which sha11 happen thereafter. And the said society shall, cai Society, once in four years, and as often as a vacancy shall occur, elect a delegate to the State Medical Society. ARTICLE III. Meetings. Meetings. § i .There shall be annually, two regular meetings of this When held, society, viz : An anniversary meeting on the first Tuesday in July, to be held at the city of Utica ; and a semi-annual meeting on the first Tuesday in January, to be held at such place as a majority of the society, at its previous meeting, Extrameet-shall determine. Extra meetings may be appointed by a ,D8'" resolution of the society, or called by the President—or in case of a vacancy in his office*, by the Vice President, on ap- plication by five members. Charges for § 2. In case charges should be preferred against any mem- misconduct, j-jgr for misconduct in his profession, or of immoral conduct and habits, pursuant to the statute upon that subject, [Re- vised Statutes, Part 1st, Chapter 14th, Title 7th,] or for a violation of any of the laws regulating the practice of phy- proceedings sic and surgery, the President, on such charges being pre- thereon. gented to him, may call a special meeting without the appli- cation of five members, giving at least ten days' previous notice in one or more of the newspapers printed in the county. Quorum. § •*• Nine members shall constitute a quorum for transact- ing business. ARTICLE IV. Order of Business* When orga- § 1. As soon as the presiding officer shall have declared mzed. t^e meeting organized, the order of business shall be as fol- Minutesof lows:—1st. The minutes of the previous meeting shall be. meciin"8 reaoo to the end that any mistakes in the same may be cor- rected. Communi- 2d. Communications, and reports of committees shall SSST1 tben be received. Addresses. 3d. The reading or delivery of addresses shall then be in order, and shall commence at 12 o'clock M. 5 4th. Election of officers shall then take place. oSSS! °' 5th. Miscellaneous matters may then be disposed of. MisceUano- § 2. At all special meetings, the business for which the special society may be convened shall be first considered. meetings. § 3. Every member, previously to speaking, shall rise from R"Ies ofor- his seat, and address himself to the President. When two or more members rise at the same time, the President shall name the one who is first to speak. No member shall speak more than twice on the same question, without leave of the society, nor more than once until every member wishing to speak, shall have spoken. ARTICLE V. Admission of Members. & 1. Whenever an applicant shall present himself for Duty of the 3 i i-« • i i • i President in membership, it shall be the duty of the President, during the regard to recess of the society, (and the society reserves to itself thef0prPmember- right to exercise the same powers whenever in session,) toship- become well satisfied that the moral character and standing of the candidate are good. And if the same be not good, every such applicant shall be rejected. § 2. It shall be the duty of each and every member to give.^"*fb°£ in all the information in his possession, concerning the charac- regard to i-i e i i • applicants ter and standing of every candidate proposed for membership, for member- § 3. No candidate shall be present until the question of Candidate his admission be determined by the society. jSsl°ii.e 6 4. Everv member, when admitted, and before he shall Kequfcitea •> J . of member- be entitled to vote, or .take any part in the discussions, shall ship, and sign the by-laws, and pay three dollars to the Treasurer jKon'm'pro- and shall be entitled to a certificate of membership, which ^ socfety. shall be substantially in the following form : "These are to certify, that Dr. is a member Certificate. of the Medical Society of the county of Oneida, in the state of New York, incorporated in the year of our Lord one thou- sand eight hundred and six. In testimony whereof, we have affixed our hands and the seal of the society. President, Secretary." /~ 6 ARTICLE VI. Duties of Officers—President. § 1. The President shall preside at all meetings, maintain order and decorum, decide all questions of order, subject to an appeal to the society, and shall appoint all committees, unless otherwise directed by the society. On all motions made and seconded, he shall state the ques- tion, and take the sense of the society, and shall have the privilege of speaking thereon ; and in case of a tie, shall be entitled to give a casting vote. He shall also designate, at the annual meeting, two or more members to deliver disserta- tions on medical subjects. He shall, moreover, deliver a discourse on some medical subject, at the first anniversary meeting after his election. In the absence of the President, the Vice President, or senior Censor, shall preside, and exercise the like powers. The society, however, may appoint a Presidentp-o tempore, in the absence of the President and Vice President. The Vice President shall deliver a discourse on some medi- cal subject, at the first semi-annual meeting after his election. Notice to be The President shall give the notice in writing, required by president, statute, to physicians and surgeons who have not become members of the society. Corresponding Secretary. Duties of § 2. The Corresponding Secretary shall conduct, under the ing'sec're'ta- direction of the society, its correspondence; retain copies of rj" all letters and communications, and submit the same to the society; and perform all such other duties as appertain to his office. In case of absence or sickness of one of the Secreta- ries, the other shall attend to the duties of both. Recording Secretary. Duties of § 3. The Recording Secretary shall record the proceed- L^euty! ings> and nave charge of all the papers, of the society. He shall read all letters and communications, shall keep the cabinet, attest all writings, notify all meetings by the autho- rity of the society or the President, and deliver to the chair- Duties of President. Motions. Casting vote. In his ab- sence. President pro tern. 7 men of all committees, a list of the members composing the same, stating the object of the committee—shall note mem- bers present and absent at each meeting, and report the names of the absent, at the annual meeting, to the Treasurer. He shall likewise transmit annually to the State Medical Report to Society, a copy of such proceedings as may be required by cai Society. that body. He shall also record the name of every member, and the time of his admission; and shall deliver all books and papers belonging to the society to his successor in office, and do such other duties as it shall deem proper to direct. He shall not permit any paper, book or record to be re- r^0rdsand moved from the archives of the society, but shall allow the same to be examined by every member. Treasurer. § 4. The Treasurer shall collect and recover all bequests, Duties of donations and monies due the society; he shall also demand, and if necessary, sue for and recover all fines and assess- ments. Under the direction of the society, he shall sell or lease any property or estate it may possess, and execute all necessary papers and writings, and have the care and man- agement of its fiscal concerns. He shall keep an accurate account of all receipts and disbursements, in a book provided for that purpose. He shall pay out monies on the order of Payment of the President, or in case of a vacancy, the Vice President, and report his accounts to the society, and submit the same to the examination of an auditing committee, at each annual meeting—or at such other time as the society shall require, which report shall be recorded. He shall also give a bond, with one or more sureties, to be Giring of approved of by the President, conditioned for the faithful management of the funds of the society, and that he will account for and pay over, when lawfully required, all sums of money which may remain in his hands. Librarian. § 5. The Librarian shall keep a catalogue of all books and Duties of pamphlets belonging to the society, in which he shall men- tion the price of each book which shall have been purchased, 8 and the donor's name, of those which have been presented to the society. JecdrV and The Librarian, or his deputy, shall deliver and receive all books. books drawn from and returned to the library, enter, in a book provided for that purpose, the time of drawing, and to whom delivered ; on the return of each book, carefully exa- mine its condition, and note any damage it may have received in the hands of the last drawer, and impose such fine as he Books lost may deem reasonable. If any book or pamphlet be essen- tially injured, or lost, he shall assess the member by whom it was drawn, a sum sufficient to purchase another ; or if the book belonged to a set of volumes, he shall require the drawer to pay for the whole set, at a fair and equitable val- uation. Members Any member residing: within ten miles of the library, may residing J = . . within ten draw one volume or two pamphlets at a time, and retain the OveTten same one month. Any member residing over ten miles may vaile*' retain such book or pamphlets three months. The Libra- Fines. rian shall fine each and every member three cents per day for the book or said pamphlets retained after the time thus specified; and one dollar on every member for loaning said book or pamphlets to a person not a member of the society. He shall likewise assess a fine of fifty cents on the drawer of each book, and twenty five cents for every two pamph- lets not returned on or before 12 o'clock of the day of each annual and semi-annual meeting. No member shall be al- lowed, on said days of meeting, to draw a book or pamphlet until after 12 o'clock M. Monies, to The Librarian shall pay to the Treasurer, at each annual whom paid. .<,.■,* • r meeting, all the monies in his hands, received on account ol fines, assessments, or for damages done to books. Report to He shall likewise report to the Treasurer the name of eve- urer. ry member, together with the amount assessed, who shall refuse or neglect to pay his fine or assessment, and he shall not permit such member to draw a book or pamphlet, until he shall exhibit the Treasurer's receipt that the fine or as- sessment has been paid, or that the same has been remitted by the society. 9 Censors. 6 6. The Censors shall examine all students who shall be Duty of . Censors. entitled to such examination, pursuant to the provisions of the statute of this state upon that subject, and who shall moreover exhibit satisfactory evidence that they are of good moral character :—For which examination the Censors shall receive no other compensation from each student thus exa- mined, than the defrayment of their expenses. The Censors shall report annually the name of every stu- To rePoA dent examined and recommended for a diploma, under the penalty of one dollar for each omission. Three Censors shall constitute a quorum. Quorum. § 7. There shall be a standing committee, consisting of Committee three members, whose duty shall be to recommend and pur- ^book*" chase books for the Library, and to report to the society on the state and condition thereof, at each annual meeting. ARTICLE VII. Duties and Privileges of Members. 5 1. The members shall vindicate the professional charac- P„uti« of * Members. ter and practice of each other as far as opportunity, propriety and justice may require. § 2. Every member shall attend punctually, and give ad- vice unreservedly in consultations ; but shall not advise or consult with, or encourage in any way or manner, any em-Noempyr- pyric or pretender; but shall use all lawful means to counter-1 act and prevent all such persons from imposing on the public. § 3. No member shall engage in manufacturing or vend- No nos- ing any nostrum or secret medicine. Nor shall he use or ruIM• recommend, by certificate or otherwise, the same to any per- son or in any complaint whatsoever. 6 4. Any member who divides his responsibility with a Penalty for * , • i i • • K ,. associating known quack, or associates with him in consultation, or prac- withquacksf tices with nostrums, secret or patent medicines, or exposes,&c* advertises or vends the same, or any of them, shall be con- sidered guilty of quackery, and shall be expelled from this society, upon a vote of a majority of the members present at any meeting. 2 10 Penalty for § 5. Every member who shall neglect or refuse to comply comply with with the by-laws and regulations of this society, or the Uwtoof'E by-laws and regulations of the medical society of the state society. of New_York, or the medical law of said state, shall be ex- pelled from said society, upon a vote of a majority of the members present. Manner of § g »r^e manner of trial of a member, with a view to ex- trial. 3 pulsion under this article, and the notice to be given to him, shall be determined on whenever an accusation shall be pre- ferred. Verdict— § 7. gajd trial shall be fair and impartial, and the verdict of the members shall be given by ballot on the day of trial. Medical § 8. The Code of Medical Ethics, revised, adopted and Etb,c'* republished by the state medical society in the year 1832, shall be, and hereby is adopted by this society, and shall be scrupulously adhered to by each and every member thereof; and any departure from the true spirit and meaning of said code of ethics shall subject every such member to the dis- cipline of this society. Penalty for § 9. Any member residing within ten miles of the place anceatsta- of meeting, who shall neglect to attend each stated meeting ings™eet" °f tne society, shall subject himself to a fine of one dollar ; and each member residing at a greater distance, who shall fail to attend one regular meeting in the year, shall be liable to a like fine. -Appeal. ^ jo. Any member, feeling himself aggrieved by the offi- cial or personal acts of another, may appeal for redress to the society, whose decision shall be final. § 11. It shall be the duty of every member to advise and acquaint the President with the names of all such persons as are practising physic or surgery in the county contrary to law. ARTICLE VIII. Charge* of Gross Ignorance or Misconduct, and of Immoral Conduct and Habits« tohwrfonT" § ** Charges °^tne character above specified, may be pre- prcsented. sented to the President, or in case of a vacancy, to the Vice 11 President, when the society is not in session, or to the soci-Tobemade ety at any of its meetings. Such charges shall be in wri- m wri "'s' ting, and shall contain specifications setting forth, with cer- tainty and precision, the offence charged. And it shall be the D. of Ae duty of the President or Vice President, when the charges President and society are presented to them, and of the society, when said charges in relation are presented at a meeting thereof, before taking any steps to call a special meeting, to satisfy themselves, by taking legal advice or otherwise, that the said charges and specifications are conformable to the statute, and that they set forth facts sufficient to enable the judges of the county courts to pro- ceed thereon, in case they should be found well founded by the society. §2. The President or Vice President, or the society, to The person whichever the said charges shall be presented, after becoming charges are satisfied of the matters mentioned in the first Section, Article JJflf*"j£.'° 8th, shall cause such special meeting to be called, and such cial meet- notice to be given, as is required by the statute on that sub- ject. ; and when the society shall be convened at such special meeting, the said charges shall be distinctly read, and the sense of the meeting taken thereon by ballot; and if two thirds of the members present shall be of opinion that said charges are well founded, the President shall make out and deliver such certified copy, and such notice as are required by the statute in such case made and provided. ARTICLE IX. Licentiates* § 1. Every licentiate shall subscribe to the following Licentiates. declaration, which shall be kept on file by the Recording Secretary: " I, A. B., do solemnly declare that I will honestly, virtu- Declaration ously and chastely conduct myself in the practice of physic '^^ and surgery, with the privilege of exercising which profes- sion I am now to be invested; and that I will, with fidelity and honor, do every thing in my power for the benefit of the sick committed to my charge." § 2. Every person admitted to the practice of physic and 12 surgery by this society, shall receive the following license to practice, viz: License. « To all to whom these presents shall come, or may in any- wise concern: The Piesident and members of the Medical Society of the County of Oneida, State of New-York, send greeting:— Whereas (name and place of candidate,) hath exhibited unto us satisfactory testimony that he hath studied physic and surgery for the term and in the manner directed by law ; and hath, also, upon examination by our Censors, given suf- ficient proof of his proficiency in the healing art, and of his moral character—Wherefore, by virtue of the power vested in us by law, we do grant unto the said the privilege of practising physic and surgery in this state, together with all the rights and immunties which usually appertain to physicians and surgeons. In witness whereof we have granted this diploma, sealed with our seal, and testified by our President and Secretary, at this day of 18 President. Secretary." ARTICLE X. Amend- jjo alteration or amendment shall be made to these by- ments. •* laws, unless by a vote of two thirds of the members present at an annual meeting. LAWS OF THE STATE OF NEW YORK, RELA- TIVE TO THE MEDICAL PROFESSION. GENERAL REGULATIONS CONCERNING THE PRACTICE OF PHYSIC AND SURGERT IN THIS STATE—PASSED IN 1827. {From the Revised Statutes, Vol. 1. Part 1. Chap. 14. Title 7.] Sec. 1. Medical societies to require physicians and surgeons to apply for admission. 2. If persons notified do not apply, license to be forfeited. 3. Charges may be preferred to society against members for misconduct, &c. 4. When charges to bt delivered to the district attorney. 5. District attorney to serve copy on accused, and give notice of hearing. 6. He shall conduct prosecution, and issue subpoenas for both parties. 7. County judges to bear and determine charges ; thcii judgment. 8 & 9. Qualifications for admission to an examination ; term of study, &c. 10. Certificates of commencing of studies to be filed with president of society. 11. Order of president specifying period of study, to be annexed to certificate. 12. When regents to grant degrees of doctor of medicine. 13. In what couniiesstudents to be examined. 14. Candidates rejected in one county, not to be examined in another; appeal. 15. Persons rejected by state censors, not to be examined by county censors. 16. No person to practice without license, &c. from this or some other state. 17. Persons coming from another state, &c. to file copy of diploma with county clerk. 18. Certain diplomas not to confer right of practising in this state. 19. Persons licensed, to deposit copy of license in county clerk's office. 20. Persons under 21, not entitled to practice. 21. Certain degrees not to be a license ; restriction as to faculties of medicine. 22. Penalty for practising without authority. § 1. The president of every county medical society shall give Notice to be notice in writing, to every physician and surgeon not already ad- t^bysT* mined into such society, within the county in which the society of°*"*0nnd which he is president is situated, requiring such physician or sur- geon, within sixty days after the service of such notice, to apply for and receive, a certificate of admission, as a member of such society. § 2. The service of every such notice shall be made personally, How serv- on the physician or surgeon, to whom it shall be directed; and if notified to forfeit their such physician or surgeon shall not, within the time specified in the licenses if notice, or within such further time as may be allowed by the presi-5^,° not 14 dent, under the regulations of the society, apply for a certificate of membership in such society, his license shall be deemed forfeited, and he shall be subject thereafter, to all the provisions and penal- ties of the laws of this state, in relation to unlicensed physi- cians, until upon a special application, he shall be admitted a member of the medical, society, in the county in which he shall reside. Charges for § 3. If there shall be preferred to any county medical society, " specific charges against any member thereof, of gross ignorance or misconduct in his profession, or of immoral conduct or habits, a special meeting of the society to consider the charges shall be call- ed, of which at least ten days' previous notice shall be given, in one or more of the newspapers printed in the county. Proceedings § 4. If two-thirds of the members present at such meeting shall be of opinion, that the charges preferred are well founded, the pre- sident of the society shall, without delay, deliver a certified copy of the charges and of the vote of the society thereon, to the dis- trict attorney of the county, and shall give notice of such delivery to the member accused, who from that time shall be suspended from the practice of physic and surgery, until the determination of such charges, in the manner herein after provided. Charges to § 5. The district attorney to whom the charges shall be deliver- and notice ed, shall serve a copy thereof without delay, on the member ac- Mr,ng' cused, and at the same time shall give him notice, of the time and place at which the judges of the court of common pleas of the county will meet, for the purpose of hearing and determining the same ; such notice shall be served at least fourteen days, before the time of hearing appointed. District «t- § 6. The district attorney shall conduct the prosecution of the torney to ji.ii- prosecute, charges, and shall issue process to compel the attendance of such witnesses, as the president of the society and the member accused shall severally require. Judges to § 7. The judges of the county court, at the time and place of determine. hearing appointed, or at such other time and place as they shall fix, shall proceed to hear and determine the charges, and shall examine, on oath, the witnesses produced: if they, or a majority of them, shall be satisfied, from the evidence, that the charges are true, they 15 shall make an order, which shall be valid in law, expelling the To expel, member accused from the society, and declaring him forever there- after incapable of practising physic and surgery, within this state; or suspending him from such practice, for a limited period : if they Or suspend, shall be of opinion, that the charges are not established, the sus- pension of the member accused shall cease, and he shall be re- stored to all his rights and privileges, as a practising physician and Or acquit. surgeon. § 8. No student shall be admitted to an examination by any £1'of stu- medical society, until he shall have completed, with some physician dents. and surgeon, duly authorised by law to practice his profession, the term of medical study, prescribed in the following sections of this Title. § 9. The regular term of the study of medical science shall be Tt*d™ of four years, but a deduction from such term, in no case to exceed one year, shall be made in either of the following cases: 1. If the student, after the age of sixteen, shall have pursued any of the studies usual in the colleges of this state, the period, during which he shall have pursued such studies, shall be deducted. 2. If the student, after the age of sixteen, shall have attended a complete course of all the lectures delivered in an incorporated medical college in this state, or elsewhere, one year shall be de- ducted. § 10. The physician and surgeon with whom a student shall Certificates. commence his studies, shall file a certificate with the president of the county medical society to which he belongs, certifying that such person has so commenced his studies ; and the term of study shall be considered as commencing, from the day on which such certifi- cate is filed. S 11. If the term of study shall be intended to be for less than Order for j • u • u term of four years, upon either of the grounds mentioned in the ninth sec- study. tion of this Title, the president with whom the certificate shall be filed, upon satisfactory proof that a deduction ought to be allowed, shall annex to such certificate, an order specifying the period, not exceeding one year, which, according to the proof exhibited to him, ought to be deducted from the term of four years, and directing that the term of study of the student shall be for the period that shall remain. 16 Requisites § 12. No person shall receive from the regents of the universi- fi°om re°-maS ty a diploma, conferring the degree of doctor of medicine, unless iWt3' he shall have pursued the study of medical science for at least three years, after the age of sixteen, with some physician and sur- geon, duly authorised by law to practice his profession, and shall also, after the same age, have attended two complete courses of all the lectures delivered in an incorporated medical college, and have attended the last of such courses, in the college by which he shall be recommended for his degree. In what § 13. No student shall be admitted to an examination by any snuTenuto county medical society, except of the county in which he shall beexamm- nave pursueci his medical studies for four months immediately pre- ceding his examination ; but if the student, during that period, shall have attended the lectures in either of the incorporated medical col- leges of this state, he may be examined and licensed, either by the medical society of the county in which such college is situated, or by that of the county in which he shall have resided, previous to such attendance. If rejected, § 14, £jc person, who shall have been examined by the censors to appeal. y .... ,• , c , <• of any county medical society, as a candidate tor the practice ot physic and surgery, or either of them, and shall have been rejected on such examination, shall be admitted to an examination before the censors of any other county medical society ; but such person may appeal from the decision of the censors by whom he shall have been examined, to the medical society of the state. Persons re- § 15. No person, who, either upon an original examination or itat'e socle- uPon an appeal, shall have been rejected by the censors of the state ty# medical society, shall thereafter be admitted to an examination, be- fore the censors of any county medical society. Who to § 16. No person shall practice physic or surgery, unless he shall physic" have received a license or diploma, for that purpose, from one of the incorporated medical societies in this state, or the degree of doctor of medicine from the regents of the university ; or shall have been duly authorised to practice by the laws of some other state or coun- try, and have a diploma from some incorporated college of medi- cine, or legally incorporated medical society, in such state or country. 17 § 17. No person coming from another state or country, shall Persons practice physic or surgery in this state, until he shall have filed a er state 0r copy of his diploma with the clerk of the county where he resides, country" and until he shall have exhibited to the medical society of that county, satisfactory evidence that he has regularly studied physic and surgery, according to the requisitions of the ninth section of this Title. § 18. No diploma, granted by any authority out of this state, Diplomas to to an individual who shall have pursued his studies in any medical certain school within this state, not incorporated and organized under its not valid. laws, shall confer on such individual the right of practising physic or surgery within this state. § 19. Every person licensed to practice physic or surgery, or licenses in both, shall deposit a copy of such license with the clerk of the be filed. county where he resides, who shall file the same in his office; and until such license is so deposited, such person shall be liable to all the penalties provided by law, in the same manner as if he had no license. § 20. No person under the age of twenty-one years shall be Persons un- entitled to practice physic or surgery in this state. § 21. The degree of doctor of medicine conferred by any col-Degrees lege in this state, shall not be a license to practice physic or surge- by colleges, ry; nor shall any college have, or institute, a medical faculty, to &c' teach the science of medicine, in any other place than where the charter locates the college. § 22. Every person, not authorised by law, who for any fee or Penalties reward, shall practice physic or surgery within this state, shall being without incapable of recovering, by suit, any debt arising from such practice. authority' RELATING TO THE PRACTICE OF PHYSIC AND SURGERY. An act concerning the Practice of Physic and Surgery in this State. Passed April 7, 1830. Chap. 126, p. 141. [From the Revised Statutes, Vol. III. Appendix, p. 104.] § 1. All that part of section twenty-second of Title seventh of Repeal. Chapter fourteenth of the First Part of the Revised Statutes, after the words "such practice," at the end of the third line, be and the same is hereby repealed. 3 18 Penalty for § 2. Every person not authorised by law, who shall practice mtfaout'lu- physic or surgery within this state, shall for each offence of which thonty. ke may jje jujy convicted, forfeit and pay a sum not exceeding twenty-five dollars, to be recovered, with costs of suit, before any justice of the peace of the county where such penalty shall be in- curred, by any person who will prosecute for the same; and the justice before whom such conviction shall be had, shall pay the same to the overseers of the poor of the town where such convic- tion shall be had, for the use of the poor of such town, or of the county poor, where the distinction between town and county poor Exemption shall have been abolished. But the provisions of this section shall as to roots, not De (]eeme(j anc| taken to extend to or debar any person from barks and - r herbs* using or applying, for the benefit of any sick person, any roots, barks, or herbs, the growth or produce of the United States. MEDICAL SOCIETIES. An act to incorporate JWedical Societies, for the purpose of regu- lating the Practice of Physic and Surgery in this state. Passed April 10, 1813. Sess. 36. Chap. 94. {From the Revised Statutes, Vol. III. p. 304.] Preamble* Whereas, well regulated medical societies have been found to contribute to the diffusion of true science, and particularly the knowledge of the healing art: Therefore, County § 1. Be it enacted by the People of the state of New York, rep. cieties, how resented in Senate and Assembly, That it shall and may be lawful ted?rP°ra* f°r tne physicians and surgeons in the several counties of this state, now authorised by law to practice in their several professions, except in those counties wherein medical societies have been already incorporated, to meet together on the first Tuesday of July next, at the place where the last term of the court of common pleas next previous to such meeting was held in their respective The officers counties ; and the several physicians and surgeons so convened as ciety. " aforesaid, or any part of them, being not less than five in number, shall proceed to the choice of a president, vice-president, secretary and treasurer, who shall hold their offices for one year, and until others shall be chosen in their places; and whenever the said soci- 19 eties shall be so organized as aforesaid, they are hereby declared to be bodies corporate and politic, in fact and in name, by the its corpo- names of the medical society of the county where such societies rate name* shall respectively be formed, and by that name shall be in law ca- And pnvile- pable of suing and being sued, pleading and being impleaded, an- swering and being answered unto, defending and being defended, in all courts and places, and in all matters and causes whatsoever; and shall and may have a common seal, and may alter and renew the same at their pleasure: Provided ahvays, That if the said physicians and surgeons shall not meet and organize themselves at such time and place as aforesaid, it shall be lawful for them to meet at such other time as a majority of them shall think proper ; and their proceedings shall be as valid as if such meeting had been at the time before specified. § 2, And be it further enacted, That the medical societies of The present counties already incorporated, shall continue to be bodies corporate ^3^0011- and politic, in fact and in name, by the name of the medical socie-tinue incor- * , , porated. ty of the county where such societies have respectively been form- Their privi- ed, and by that name shall be in law capable of suing and being general sued, pleading and being impleaded, answering and being answer- Powers« ed unto, defending and being defended, in all courts and places, and in all matters and causes whatsoever, and shall and may have a common seal, and may alter and renew the same at their pleasure, and that the president, vice-president, secretary and treasurer, of ^nd oflv- such incorporated societies, shall hold their offices for one year,cers« and until others shall be chosen in their places, § 3. And be it further enacted, That the medical society al- The medi- ready incorporated, by the style and name of the Medical Society of the state of the state of New-York, shall continue to be a body politic and York to corporate, in fact and in name, and by that name shall be in law ca-commue ™- pable of suing and being sued, pleading and being impleaded, an- swering and being answered unto, defending and being defended, in all courts and places, and in all matters and causes whatsoever ; and shall and may have and use a common seal, and may change and alter the same at their pleasure: and that the said society shall •Howconsti- r ... tuted and be composed of one member from each of the county societies in composed. the state, elected by ballot at their annual meeting, who shall meet together at the time and place appointed by the said society for 20 that purpose, and being met, not less than fifteen in number, may Its officers, annually elect by ballot, a president, vice-president, secretary and treasurer, who shall hold their offices for one year, and until others shall be chosen in their places. Medical so- ^ 4 ^ncj 0e ft further enacted, That the medical society of the niversary state of New-York, and also the medical societies of the respec- meeiings. , ... tive counties, shall and may agree upon and determine the times and places of their meeting; and the time so agreed upon shall forever thereafter be the anniversary day of holding their respective meetings; artd it is hereby made the duty of the secretary of each of the county medical societies, to lodge in the office of the clerk of their respective counties, if not already done, a copy of all the pro- Proceed- ceedings had at their first meeting; and it shall also be the duty of ings of first .... „ _, meeting— the secretary of the medical society of the state of New-York, in posited.C' ^^c manner, to lodge in the office of the secretary of this state, a copy of their proceedings had at their first general meeting ; and the said clerks and secretary are hereby required to file the same in their respective offices, for which they shall each receive the sum of twelve and an half cents. State socie-. § 5. And be it further enacted, That the members now com- into'clasges. posing the medical society of the state of New-York from each of the four great districts, shall remain divided into four classes, and one class from each of said districts shall go out of office annually. Notice bow § 6. And be it further enacted, That it shall be the duty of the cancies^na" secretary °f the medical society of the state of New-York, when- the state so- ever the seats of anv of the members shall become vacant, to give ciety. . - . /. 1 , information of the same to the respective county societies, to the end that such county societies may supply such vacancy at their next meeting. Classes in § 7. And be it further enacted, That in case there shall be an ciety may addition to the number of members composing the medical society andVhow!' of the state, that in that case it shall be in the power of the said society at any of their annual meetings, and as often as they shall judge necessary, to alter and vary the classes in such manner as that one-fourth of the members from each of the great districts, as near as may be, shall annually go out of office. KtateS- § 8* Md be U further e^acted, That if the seat of any mem- ffih°W ber of the medical society of the state of New-York shall be va- 21 cated, either by death, resignation or removal from the county, it shall be the duty of the medical society of such county to fill such vacancy at their next meeting after such vacancy shall happen. § 9. And be it further enacted, That the medical societies es- Medical so- J _ -> cieties to tablished as aforesaid, are hereby respectively empowered to exam- examine ine all students who shall and may present themselves for that pur- pose, and to give diplomas under the hand of the president and To give di- seal of such society before whom such student shall be examined, whicTshall which diploma shall be sufficient to empower the person so obtain- f]"gborise ing the same, to practice physic or surgery, or both, as shall be set practice. forth in the said diploma, in any part of this state. § 10. And be it further enacted, That if any student who shall Student if , , , • i/» /• • refused di- have presented himself for examination before any of the medical ploma by societies of the several counties of this state shall think himself e°y may ap- aggrieved by the decision of such society, it shall be lawful for such pea'to li}e student to present himself for examination to the medical society ly« of the state of New-York: and if in the opinion of such society And staf6 1 J society may the student so applying is well qualified for the practice of physic award di- or surgery, or both, as the case may be, the president of said soci- such ap- ety shall, under his hand and the seal of such society, give to the pea' said applicant a diploma, agreeable to such decision. S 11. And be it further enacted, That it shall and may be law-Censors t0 . •'be appoint- ed for the several medical societies so established as aforesaid, at ed by the so- their annual meetings, to appoint not less than three, or more than five censors, to continue in office for one year and until others are chosen, whose duty it shall be carefully and impartially to examine Their duty. all students who shall present themselves for that purpose, and re- port their opinion in writing to the president of said society. § 13. And be it further enacted, That it shall and may be law-Medical so- ClCtlCS ED 3 V ful for the medical societies of the respective counties of this state, hold real and also the medical society of the state of New-York, to purchase a"estate!0"" and hold any estate, real and personal, for the use of said respective societies : Provided, Such estate, as well real as personal, which Proviso. the county societies are hereby respectively authorised to hold, shall not exceed the sum of one thousand dollars; and that the estate, as well real as personal, which the medical society of the state of New-York is hereby authorised to hold, shall not ex- ceed five thousand dollars. 22 Societies— § 14. And be it further enacted, That it shall be lawful for the HT'oleretorespective societies to make such by-laws and regulations relative make by- to tne affairs, concerns and property of said societies, relative to the admission and expulsion of members, relative to such dona- tions or contributions as they or a majority of the members at their Proviso. annual meeting shall think fit and proper: Provided, that such by- laws, rules and regulations made by the society of the state of New-York, be not contrary to, nor inconsistent with, the constitu- tion and laws of this state, or of the United States ; and that the by-laws, rules and regulations of the respective county societies shall not be repugnant to the by-laws, rules and regulations of the medical society of the state of New-York, nor contrary to, nor in- consistent with, the constitution and laws of this state, or of the United States. Treasurerof § 15. And be it further enacted, That the treasurer of each so- society Ua- ciety established as aforesaid, sliall receive and be accountable for „ies.°r mo" all monies that shall come into his hands by virtue of any of the by-laws of such societies, and also for all monies that shall come into the hands of the president thereof for the admission of mem- bers, or licensing students ; which monies the said president is here- countthere- Dy required to pay over to the said treasurer, who shall account for' therefor to the society at their annual meetings, and no monies shall Monies how be drawn from the treasurer, unless such sums and for such purpo- ses as shall be agreed upon by a majority of the society at their an- nual meeting, and by a warrant for that purpose signed by the president. Secretary § 16. And be it further enacted, That it shall be the duty of ciety to " the secretary of each of the said medical societies, to provide a meinutes,&c Dook'in wnicn ne sna11 make an entry of all the resolutions and proceedings which may be had from time to time ; and also the name of each and every member of said society, and the time of his admission, and also the annual reports relative to the state of the treasury, and all such other things as a majority of the society shall think proper; to which book any member of the society may A A d r at any **me nave recourse 5 ana" foe same, together with all books, them,&c. to papers and records which may be in the hands of the secretary, sor. and be the property of the society, shall be delivered to his succes- sor in office. 23 § 17. And be it further enacted, That it shall be lawful for each A medical of the said medical societies, to cause to be raised and collected JJJJSlS from each of the members of such society, a sum not exceedinff &c- may be . J ° procured by three dollars in any one year, for the purpose of procuring a medi- each socie- cal library and apparatus, and for the encouragement of useful dis- y,a" coveries in chemistry, botany, and such other improvements as the majority of the society shall think proper. § 18. And be it further enacted, That any student who may What sums receive a diploma from the medical society of this state, shall pay 0° rearing to the president thereof, on receiving the same, ten dollars; and d'Plomas* for each diploma that a student may receive from the medical soci- ety of any county, he shall pay to the president thereof, on receiving the same, five dollars: Provided, That the students who have been examined previous to the twenty sixth day of May, one thou- sand eight hundred and twelve, and were entitled to receive diplo- mas, but who have not received the same, shall not pay therefor more than two dollars. § 19. And be it further enacted, That the medical society of state socie- this state may elect by ballot at their annual meeting, eminent and j^it3^^.. respectable physicians and surgeons residing in any part of thistw0 mem- state, which persons so elected shall be permanent members of the and how. society, and entitled to all the privileges of the same: Provided, That not more than two such members shall be elected in any one year, and that they receive no compensation for their attendance from the funds of the society. § 23. And be it further enacted, That it shall be in the power t- -gi of the legislature to alter, modify or repeal this act whenever they may modify shall deem it necessary or expedient. this act. § 24. And be it further enacted, That if there should not be a whenphy- sufficient number of physicians and surgeons in any of the coun- s'cian3>&c- ties of this state to form themselves into a medical society agreea-'y may D°- bly to this act, it shall be lawful for such physicians and surgeons bers of ano- to associate with the physicians and surgeons of an adjoining coun- society!"1^ ty, for the purposes hereby contemplated. § 25. And be it further enacted, That this act shall be, and This act de- hereby is declared to be a public act.* dared a *The original act for establishing Medical Societies in the state, and a general State Medical Society, was passed April 4,1806. 24 An act to amend an act, entitled "An act to incorporate Medical Societies, for the purpose of regulating the Practice of Physic and Surgery in this State." Passed April 20, 1818. Chap. 206, p. 192. Censors to § 3. And be it further enacted, That the state medical society shall annually elect not more than twelve, nor less than six cen- sors, any three of whom shall be a quorum for the examination of students. Anniversa- § 5. And be it further enacted, That in those counties where of county8 the anniversary meetings of any county medical society shall societies occur on the same day on which the court of common pleas shall may be al- J r tered in cer- meet, it shall be lawful for such society to alter the time of their tain cases. . . ••».,• i • . anniversary meeting to such day as a majority of the said society present may think proper. Delegates to § 6. And be it further enacted, That each of tho colleges of Jhe'co'ie* °s me(hcine in this state, may elect a delegate to represent their col- of medicine, leges, respectively, in the medical society of the state, who shall be entitled to all the privileges, and subject to the same regulations, as the delegates from the county medical societies. An act further to amend "An act to incorporate Medical Societies for the purpose of regulating the Practice of Physic and Surgery in this State." Passed April 13, 1819. Chap. 237, p. 308. § 1. Be it enacted by the People of the State of New-York, rep- resented in Senate and Assembly, That it shall and may be lawful for each medical society in this state, to cause to be raised and Tax* collected from each practising physician or surgeon, residing in the county or counties where such society is by law established, a sum not exceeding one dollar in any one year ; which sum, when col- lected, shall be a part of the fund of said society, to be applied as directed by the seventeenth section of the act, entitled "An act to incorporate medical societies for the purpose of regulating the prac- tice of physic and surgery in this state," passed April 10,1813. 25 An act to enable the County Medical Societies in this State to alter the time of holding their Annual Meetings. Passed April 23, 1823. Chap. 228, p. 281. § 1. Be it enacted by the People of the State of New York, rep- Annual resented in Senate and Assembly, That it shall and may be lawfulmeetu,e' for any society, incorporated under the act, entitled "An act to in- corporate medical societies, for the purpose of regulating the prac- tice of physic and surgery in this state," at any anniversary meeting of such society, to change the day of holding their annual meeting to such other day in the year as may be more convenient: Provided, Proviso. That two-thirds of the members present concur in voting for such change: notice of intention to move the same having been first given at some previous regular meeting of the society.* * It will be observed that the Revisors have omitted the following sections as not in force----In the act passed April 10, 1813, sections 12, 20, 21, 22----In the act passed April 20, 1818, sections 1, 2, 4, 7----In the act passed April 13, 1819, section 2. All the above are repealed by enactments contained in the "General Regulations" con- tained in pages 17, &c. 4 A SYSTEM OF MEDICAL ETHICS. [The following code of Medical Ethics was reported to the State Medical Society in February, 1823, by a committee consisting of Drs. Manley, Pascalis and Steel, and unanimously adopted. It is now reprinted by order of the Society, with a few alterations.] A system of Medical Ethics comprises all the moral principles and regulations which should govern physicians and surgeons in the exercise of their professional avocations with the public in gen- eral, in private and confidential cases, as well as in .their inter- course with other medical men, and before magistrates and courts of justice. Such a system may be reduced to the form of a code of medical police, exhibiting maxims and precepts in five respective divisions of medical ethics, under the following heads : 1st. Personal Character of Physicians. 2d. Quackery. 3d. Consultations. 4ith. Specifications of Medical Police in practice. 5th. Forensic Medical Police. FIRST DIVISION. Personal Character of Physicians. Qualifica- It would be difficult to determine which of the three learned pro- Uons, &c. fessions in society requires the most virtue, or the most purity, and Trials, &c. perfection of personal character. Those only can judge who are themselves acquainted with the difficulties to be surmounted in the study of medicine and surgery, and the labor and extent of the long course of experimental observation which it is necessary to pursue, before the confidence of the public can be attained. The life of a physician is, on the whole, a continual struggle against prejudices and erroneous habitudes of the mind, and not unfre- quently against ingratitude,* exclusive of the personal hazard among the sick, the fatigue, and the loss of ordinary comfort and rest which it necessarily involves. I. A physician cannot successfully pass through his career *It unfortunately happens that the only judges of medical merit, are those who have sinister views in concealing and depreciating it. John Gregory, M. D. Lee. I, on the dutiei of Physician*, p. 17, Lon. Ed. 27 without the aid of much fortitude of mind, and a religious sense of all his obligations of conscience, honor, and humanity.* His Requisites. personal character should therefore be that of a perfect gentleman, and above all, be exempt from vulgarity of manners, habitual swear- ing, drunkenness, gambling, or any species of debauchery, and contempt for religious practices and feelings."!" II. The confidence of the public cannot be awarded to a phy- sician who has rendered himself notorious for felony or misdemea- nor, or who has incurred penalties for crimes. HI. A physician in indigent circumstances is not permitted to No other embrace or exercise any business which would degrade the charac- beSembra-° ter of his profession; such as keeping a tavern, lottery office, c®d during gambling, victualling, or play-house. Any low trade or servile mer- of medicine. cenary occupation, is incompatible with the dignity and indepen- dence of medical avocations. In such extreme and derogatory situations, a physician forfeits the privileges of his profession. SECOND DIVISION. The importance of the medical profession requires that it should be exercised with fidelity to its scientific principles and approved doctrines •; with honor to all its members, and with justice and hu- manity to the sick. A departure from the above principles consti- tutes Quackery, which degrades the medical character by ignorance, artifice, unap- Quackery. proved methods of practice, and by the use of remedies dangerous to health and life. IV. Any physician or surgeon who divides his responsibility with a known quack, and associates with him in medical consulta- tions, receiving a fee, or the usual charges for such services, or Nostrums practices with nostrums, secret medicines, or patent remedies, is ^ediS. guilty of quackery. V. The right of a patent medicine being incompatible with the * Hence appears the necessity of a physician having a large share of good sense, and knowledge of the world, as well as medical genins and learning. Ibid. p. 17. tThe most celebrated physicians, who to this day remain our models and masters, were religious men. I know none among the living who can be judged greater than Stahl Boerhaave, Linnaeus and Haller, who always headed their works by an invoca- tion to the Supreme Ruler. F. E. Fodere. Vid. Diction del tciences medicate*, art. Mtd. Police. 28 Advertise- ments, cards, &c duty and obligation enjoined upon physicians to advance the know- ledge of curing diseases, it constitutes quackery, and cannot be professionally countenanced. VI. Public advertisements, or private cards, inviting customers afflicted with defined diseases, promising radical cures; engaging for no cure, no pay; offering advice and medicines to the poor, gratis; producing certificates and signatures, even from respectable individuals, in support of the advertiser's skill and success, and the like, are all absolutely acts of quackery, which medical institu- tions should always repress, and punish by the rejection or expul- sion of those who commit them. Consulta- tions. Qualifica- tions, &c. THIRD DIVISION. Consultations. All the individuals composing the colleges and medical societies constituted by the legislature of this state, are by them, qualified physicians and surgeons. The two professions of medicine and surgery are blended by the law, both in the schools and in practice. The examinations by the censors of the county and state societies, of candidates for the degree of license, and by the professors of colleges for the degree of doctor, are equally directed to embrace in their exercises, the elements and doctrines of both sciences, es- tablishing thereby the candidate's proficiency, not only in medicine, but in surgery. There are no degrees of qualifications, nor are different rights assigned to the members of the same profession, but such as result from their individual choice, skill, and fitness. Practical surgery is more properly attended to by the younger mem- bers, but the more experienced should be deemed competent to di- rect or inspect either the theoretical or practical departments. These remarks are offered, to show that the distinction frequent- ly adopted in practice, and especially in consultation, between phy- sicians and surgeons, confining each other to surgical or medical, external or internal cases, has no foundation in propriety, and if adhered to, arises from the wish to indulge in personal or interested motives. It is admitted, however, that when the question is mere- ly to perform some operative process, a practical surgeon should be selected in preference; but this exception is only applicable, when a physician declines (on such accounts as he may think pro. 29 per,) to perform a necessary operation, and by no means invalidates the principle established in the state of New-York, in conformity to medical ethics.* VII. A consultation of one or many physicians is like a delib- erating committee, over which a senior in age or experience pre- sides, each one, however, being equally responsible for the trust assigned to him of the cure or relief of the patient. The attend- ing physician is exclusively charged with the execution of the treat- ment from day to day, nor is any consulting physician ever allowed to visit or inspect, unless it be with his colleagues, or by agreement, or in cases of emergency. When a surgical operation is required, it devolves upon the se- Operations nior practitioner of surgery in the consultation, or on one especially tions. appointed."}" VIII. A diversity of opinion in consultation is to be regretted, for if unavoidable, it must cause much delay and many inconven- iences before a medical umpire can be obtained. It is needless to point out what a correct sense of delicacy will in this case require from a gentleman who, in spite of his opposition, finds himself in the minority; he should politely retire from the consultation, and if he be the family physician, he should consistently resign his de- liberative ro/e.J IX. A great reserve, and even secrecy respecting the delibera- Reserve, tions of a consultation, is indispensable. No communication is to^fo*! be made to the patient or friends, but by unanimous order and con-&c* sent; because, whatever opinions are emitted, become subject to frequent alterations or inversions from mouth to mouth, and may become a source of contradiction, perhaps injurious to some of the physicians in attendance. + Among the moderns, the arts of physic and surgery have often been promiscuously practised by the same person : for example, Aildanus, Severinus, Barthohne, and many others of distinguished genius and learning. + * * * The separation of physic from surgery in modern times, has been productive of the worst consequences. /. Gregory, Led. 11, p. 44. ■f In consultations, the junior physician (or the physician in ordinary) should deliver bis opinion first, and the others in the progressive order of seniority. T. Percival. Med. Ethics, p. 19. J "Every physician must rest on his own judgment, which appeals for its rectitude to nature and experience alone." J. Gregory, Led. 1, on the duties and qualities, frc. Lond. Ed. p. 14. "But an obstinate adherence to an unsuccessful method of treating a disease, is self- conceit ; it generally proceeds from ignorance—it is a species of pride to which the lives of thousands have been sacrificed." Ibid. p. 28. 30 Visits of X. It is the duty of a consulting physician to take care that his physicklfs visits be not multiplied without necessity. He is, through courtesy, and sur- . \[^erty to decide when to discontinue his attendance. A con- suiting physician, however, cannot be dismissed without the consent of the patient as well as of the attending physician. Advice. XI. Physicians are justly censurable if their patient be in danger and they do not in time procure advice and responsibility beside their own. Whatever be the motive that induces them to dispense with a consultation, they certainly may expose their reputation by an incorrect judgment or misapprehension of their patient's case, and weaken the confidence reposed in them. And a physician does not acquit himself correctly towards his patient if he does not benefit him with the best advice that can be procured. Poverty, or the narrowness of means to remunerate an additional practitioner, is no reasonable excuse, for he can scarcely deserve the name of a practising physician who cannot find at least one medical friend to consult, when the life or limb of a fellow creature is in jeopardy. FOURTH DIVISION. Specifications of Medical Ethics in Practice. Duties. XII. Physicians are often requested to declare to the patient his danger, and to urge his observance of religious and testamenta- ry acts; but medical aid, in extremely dangerous cases, would sel- dom be of any avail, if in place of composing the mind of the suf- ferer, physicians were to doom it to despondency and despair. Such services are incompatible with their duty of administering hope and comfort, without the influence of which, many doubtful cases of disease might at once become positively fatal. To a christian minister alone, or to some other authorised per- son, therefore, appertains the task of disclosing to the patient his alarming situation, and preparing his mind to meet with composure that event, which to his friends may appear inevitable. Physicians should not interfere in the final settlement of their patient's worldly affairs. These are eventually composed of vari- ous family claims and pretensions ; and a physician's interference in their distribution may be taxed as arising from interested motives, or be thought by those concerned to be a disgraceful violation of 31 the confidence reposed on his humane functions as medical at- tendant. In order to protect himself, and to place his name beyond the reach of any implication, he should, 1st, Give timely and explicit information of the dangerous sit-Notice uation of the patient, to those who have the best right to advise him in his religious and temporal concerns. 2d. He should inform them of the possibility of a change in the prognostic, in order to prevent any relaxation of care ad attention on the part of nurses and others, that no chances of the patient's recovery be lost through neglect. 3d. The physician in such a case, should continue his personal attendance, which is the more proper, as he entertains or has ac- knowledged some hopes of a favorable change ; should he be dis- missed from pecuniary motives, his responsibility nevertheless re- quires a friendly or gratuitous attention.* XII. It is not intended in this system of medical ethics to in- struct physicians and surgeons upon every felonious act of infanti- cide, murder, &c. for which the penal statutes of this country have made sufficient provision. It is incumbent upon medical authori- ties to consider, condemn and punish as criminal, such acts of med- ical practitioners as offend the respective obligations of married per- sons, or the chastity and modesty of the youth of both sexes. This restrictive definition is to be applied, 1st. To the personal conduct of medical men, who abuse the confidence of families, and become exposed to legal damages for crim. con. or seduction, &c. 2d. To those, who, with a view of curing diseases or correcting certain natural imperfections, prescribe remedies or advise remedial means that must interfere with matrimonial rights and the observ- ance of a chaste and moral life. The scope of opinion on this subject may be wide, and the pre- texts in palliation numerous, but the dependence of the public upon our labors for the preservation of health, and the cure of diseases, ought to be held sacred ; nor can confidence be granted to a pro- fession, that should allow any of its members to violate hospitality, * "It is as much the business of a physician to alleviate pain and to smooth the ave- nues of death, when unavoidable, as to cure diseases." Vid. 7 Gregory's Lectures. Lon. Ed. p. 35, and Benjamin Rush's appendix on the duties of a phytician, art. XI. 32 to promote immorality, or to be accessory to vicious and criminal conduct. Privileges, XIV. Honor and justice particularly forbid a medical practi- ' ' tioner's infringing upon the rights and privileges of another who is legally accredited, and whose character is not impeached by public opinion, or civil or medical authority ; whether he be a native, or a stranger settled in the country. There is no difference between physicians but such as results from their personal talents, medical acquirements, or their experience; and the public, from the servi- ces they receive, are the natural judges of these intellectual advan- tages. In all probability, every good physician would receive a merited share of patronage, were there not many who usurp a por- tion through artful insinuations, and slanders of others, or combina- tions against, or improper interferences with, the more worthy prac- titioner. Any physician thus molested or injured, is justifiable in applying for redress to the county medical society to which he is attached. Visits, &c. XV. A physician is not to visit a patient placed under another practitioner's care, without previous and ostensible friendship or business, nor without first informing the attending physician ; if then he thinks it proper to advise, he may do it, but it must be in con- formity to the rules of consultation as above explained. Libellous XVI. Libellous attacks among physicians are no doubt subject ' " to the same mode of redress by damages as the law points out to other citizens ; but we hold that matters of libel include profession- al and practical acts whether true or false, published or stated to any person who is not a competent judge, with a view to injure the professional reputation of a physician. This identical principle was adopted by the supreme court of Pennsylvania in the trial of Benj. Rush, v. Wm. Cobbett, alias Porcupine, in which a verdict of $4,000 damages was awarded to the plaintiff for a libel founded in a malicious representation of the plaintiff's practice, made to the public by the defendant. Medical XVII. If medical controversies are brought before the public in newspapers or pamphlets, by contending medical writers, and give rise to, or contain assertions or insinuations injurious to the personal character or professional qualifications of the parties, such papers are unquestionably disreputable to the medical community ; controver sies, 33 for those who should be foremost in the pursuit of truth, ought to be the last to set an example of an illiberal, indecorous, and re- vengeful deportment, so contrary to what is expected from literary and scientific gentlemen. Such papers are therefore to be report- ed by the censors to their respective county medical societies, and the authors are liable to such punishment as the case may require. It is a matter of justice, necessity and propriety, that the business Confiden- of a physician and surgeon should be always considered of a con- secrecy, fidential nature. Even secrecy, in certain circumstances, as will be &c" explained hereafter, is the privilege of the faculty, and inviolable even in a court of justice. In ordinary practice, common sense, decency and delicacy should, in familiar conversation with females, and persons uninstructed in medicine, always exclude such topics as patients, diseases, remedies, operations, and the like. A display of terrific and wonderful relations of diseases, remedies, wounds, operations and cures, is frequently indulged in, no doubt ad cap- tandum, yet in most cases they produce but an equivocal admiration for the narrator, and prove beside his very imperfect knowledge °^Wronwjn. human nature. Those who are not familiar with the subjects of ferences. medical art and study, are liable to draw mistiken and contradictory inferences from what they hear concerning them. Hence many people suppose that a physician is an unfeeling man ; and assimilate a good surgeon to a butcher. The more talk, therefore, the more numerous the misrepresentations set afloat, and the greater the dif- fidence, distrust, or disrespect excited. XVIII. The exposure of the nature of the complaint which a physician is called upon to judge or cure, subjecting the patient to public shame, or impeaching his moral character, is an unpardona- ble breach of medical ethics. XIX. "The poor," says Boerhaave, "are the best customers, Patronage, because God will be the paymaster." Instead of fee, they give in exchange the benefit of experience, of useful observation, and fre- quently the gratification of successful advice, which is more exactly followed by them than by the rich, who too often spoil the best directions by their whimsical notions and love of comfort. The most lucrative and extended patronage a physician can enjoy, far from being an honorable pretext for not affording some attention to the poor, stands as a proof of his selfishness or want of humanity. 34 Cailstobe XX. In urgent cases of sickness, or of injuries occasioned by promptly accidents, a call for medical or surgical help should be obeyed im- obeyed, in . . cases of ac- mediately, unless such compliance be to the detriment of some juries. " other sufferer. It often happens in such cases that many physi- Courtesy, cians, and more than are required, meet on the spot. Courtesy then assigns the patient to the first physician or surgeon who ar- rives, and if he should want assistance, he has a right to request it from a physician or practical surgeon present, according to the na- ture of the case. But if the physician or surgeon who usually at- tends the family or patient, be of the number, then the present urgent case is assigned to him. Concurring In the event of concurring attendance of many medical gentle- men, no fee is to be exacted for the trouble of coming, unless called upon by some authorised person. An accidental injury is distress, and help for a fellow being in distress, is claimed by the laws of nature.* Fees com- XXI. The fees for the compensation of medical services arc pensauon, regulated by the value of currency, and the price of necessaries in different countries and cities; by the customs approved and estab- lished among experienced and reputable practitioners ; and some- times by a recorded rate of charges, such as individuals belonging to any trade or profession adopt by general consent. Public opin- ion in civilized nations, and among the more enlightened classes of society, will always highly estimate and liberally compensate medi- cal services. A strict sense of justice and honor towards each fellow member justice^and of the profession, should prevent a physician from undervaluing his honor. services, by items and charges in his bills beneath the customary rate, with a view to draw patronage by exciting comparisons. A practitioner may settle his demands with his patrons on whatever ^erms he pleases, but he has no right to make the low charges an established usage to the prejudice of his brethren. The reputation of # cheap doctor, after all, is neither dignified nor enviable. * Dr. Gregory says (p. 179.) "that under such circumstances, considerations of benevolence, humanity, and gratitude are wholly set aside ; for when disputes arise, they must be suspended or extinguished, and the question at issue can alone be decided on the 'principle of commutativejustice.'" If a physician would, therefore, contend for remuneration, it could not be as a medical fee, but an indemnity only for the expenses of transporting himself there, where he might be wanted. The question is the more easily settled, as it has no further reference to medical service. 35 Others will follow quite a contrary method. They will place an Demands- exorbitant value on their time and labor, and exact oppressive de-their cha" mands for their services. The conduct of such has a very injuri- ous influence upon the lower and middling classes of society, who, needing medical aid, are deterred from applying to any physician, lest they should incur ruinous charges. These expensive doctors should be reminded, that whenever a person pays a bill which he thinks extravagant and unreasonable, he easily repays himself, and gratifies his vanity, if not his resentment,'by divulging how much money he has been willing to bestow, what liberality he has exer- cised, or to what imposition he has been exposed ! Some physicians, more intent on acquiring wealth than a good ,. . . . i-i 11 Law-suits. name, exact from their patients their charges, whether great or small, with unrelenting severity, refusing time to procure the ne- cessary means, often having recourse to law-suits, disregarding the plea of low circumstances, or absolute want, thus creating much distress ; such conduct is as disreputable to the physician as it is disgraceful to humanity; for the highest aim of the profession is to reach its utmost requisitions. These extortioners, as they dishonor the medical profession by a single act of such oppression, deserve a public reprimand, if not a prompt expulsion from their county medical society. Whenever a physician is reduced to obtain his professional fees by compulsory measures, it is his duty first to propose, and to pre- fer the settlement of the matter in contention by a reference to ar- bitrators. XXII. It is enjoined in the sacred obligation which Hippocra- claims of tes imposed upon the pupils of the noble science of medicine and med»calpre- .... ceptors and surgery, which is also the model of the like engagement offered to masters. the candidates for graduation in this and other countries, that they shall respect and assist their preceptors and masters, their seniors by experience or age, and shall contribute as far as in their power, to the honor, improvement, and utility of their professions. Ac- cording to this precept, physicians and surgeons have something more to do than to procure their livelihood. As they are indebted to the labors, talents, and experience of their predecessors in the healing art for all that constitutes its admirable body of doctrine ; so present and future generations look to them for some additional 36 Estrange- ment and exc.Iusive- ness of members. improvement, because much can yet be done to extend its useful- ness. This obligation is unbecomingly violated by many physi- cians who pretend to eminence; they estrange themselves from medical associations—never have any observation or improvement to communicate—their degree of skill and experience always re- mains unknown and mysterious—they screen themselves from sci- entific labors and controversies; and, as if incompetent, never con- tribute by any effort, however small, to the advancement of the medical character. Such practitioners, although they are fre- quently popular and wealthy, are, nevertheless, only comparable to drones in the bee-hive ; medical associations should refuse to con- fer upon them offices, appointments, or even employments in com- mittees, on the principle that proofs are wanting of their talents, zeal, judgment and professional emulation. Juridical inquisitions FIFTH DIVISION. Forensic Medical Police. XXIII. There are numerous accidents and offences, the nature and degree of criminality of which are determined by medical opin- ion. Human passions daily occasion acts of violence which fall under the cognizance of public justice; and diseases of the mind, whether arising from vice, intemperance, sickness or accident, have also their share of influence in the commission of crime ; and often lead their unfortunate victims to suicide and murder. Crimes so originating could be perpetrated in ways so disguised as to conceal the authors, or the means by which they were accomplished, were it not that juries can be assisted by medical men in evidence re- lating to physiology. A physician should always be in readiness to Rulesthere-answer in these juridical inquisitions, and to give an opinion, on facts referred to his judgment, according to the approved doctrines of medicine and surgery, as far as these are ascertained. Igno- rance, or an imperfect knowledge upon matters which place life, honor and innocence in a fatal predicament, is unpardonable, and should subject any physician so illiterate, to disqualification for the privileges of his profession. XXIV. To well instructed physicians, only two rules need to be recommended. The one relating to their conduct when they are called upon to give professional evidence; and the other, to the 37 nature and extent of the secrecy which they are bound to maintain in relation to their patients. 1st. When physicians engaged in the decision of a forensicDecisionsof 1 ° ° . physicians. question are unbiassed by the parties, and have no interest for plain- tiff or defendant, (being well informed of all the facts alleged in evidence,) they have only to decide by known medical principles, and can therefore rarely disagree. It is their duty to obtain every possible information upon the case, and before giving in their decla- ration, candidly and conscientiously to canvass each other's opinions, so that erroneous ideas may be removed, and information partici- pated.* Two or more physicians on one side of a question, should in the same manner freely communicate, in order to guard against versatile and contradictory declarations, for which the trivial sar- casm, "doctors differ," is no excuse, as they always invalidate their opinions, authority, decisions and respectability. 2d. The second rule is that of secrecy upon facts with which Secrecy, physicians become professionally acquainted, or are invited to as- certain ; such as, whether an apparent pregnancy be real; the ges- tation and birth of a child; its parentage, color, and age ; the judgment and treatment of syphtlitical and gonorrhceal diseases ; the able or disabled state of a person, in limb or constitution ; the falla- cy of virginity, and other circumstances, to the confession of which a degree of shame, and the idea of exposure are attached, and which are never mentioned but with an engagement to secrecy. This duty has been defined by comparing it to that of the Catho-except in -.cases of lie Confessional, which admits of no disclosures except in cases of treason and treason or murder.']" This inference has been acknowledged bymur er" the judiciary of New York, and, in its application to medical mat- ters, admitted by that of Pennsylvania in the year 1800.J The Revised Statutes of our state have, however, prescribed the duty * When two or more gentlemen of the faculty are to offer their opinions or testimony, it would sometimes tend to obviate contrariety, il they were lo confer freely with each other, before their public examination. T. Percival, Med. Ethics, ch. 4, page 107. J The sacred duty or privilege of a Catholic priest not compellable to disclose the secrets of aunculir confession, was maintained by a decision of the court of sessions of New York, 14th of June, 1813, in the case of the Rev. Mr. K. refusing his testimony on a matter of felony. Vid. Cathol. quest, report, by fVm. Sampson, Esq. J Many persona would rather suffer or die than be exposed to shame or disgrace from the complaints they are laboring under. It is a law of nature that they should seek fur cure or relief, and be protected by professional secrecy, even it a matter of prosecution should arise therefrom. 3S of physicians on this point. In the second volume, (page 406,) is the following enactment:— "No person duly authorised to practice physic and surgery, shall be allowed to disclose any information which he may have acquired in attending any patient in a professional character, and which in- formation was necessary to enable him to prescribe for such pa- tient as a physician, or to do any act for him as a surgeon." EXTRACT From the Proceedings of the Medical Society of the State of New York, at its annual Session in February, 1833. Dr. M'Call offered the following resolution with its preamble, which were adopted : Whereas a great diversity of opinion exists amongst the medical profession of our state, on the powers of Medical Societies as to the admission of members; and whereas a perfect understanding of said law is important to the harmony and usefulness of the pro- fession—Therefore, Resolved, That a committee be appointed to obtain the opinion of the Attorney General upon the same. Resolved, That Drs. M'Call, Burwell and Taylor, be said com- mittee. Dr. M'Call, from the committee appointed to wait on the Attor- ney General, reported the following opinion of that officer : Albany, February 6, 1833. Doctors M'Call, Burwell and Taylor. Gentlemen,—In pursuance of the request of the Medical So- ciety of this state, communicated through you, I have given a brief consideration to the powers of the County Medical Societies, re- lating to the admission and expulsion of members. The first act, authorising the incorporation of Medical Socie- ties, was passed in 1806. 4 Web. 537. This act was revised and re-enacted on the 10th of April, 1813, and is still in force. 2 R. L. 219. 3 R. S. 304. The act, after reciting that "well regulated 39 Medical Societies have been found to contribute to the diffusion of true science, and particularly the knowledge of the healing art," provided that a society might be formed in each county, by the voluntary association of not less than five physicians and surgeons, and the choice of certain officers. By the 14th section of the act, the societies were empowered at their annual meetings, to make by- laws and regulations "relative to the affairs, concerns and property of said societies, relative to the admission and expulsion of mem- bers," and relative to donations or contributions. It has never been doubted that the act of 1813 gave the several societies ample discretion, as well in relation to the admission as the expulsion of members. They were not compelled, without their consent, to associate either with licensed quacks, or men of bad moral character. But it has been said that title vn. of chapter xiv. of the first part of the Revised Statutes, (1 R. S. 452,) has introduced a different rule on this subject. That inasmuch as every physician is required to apply for admission into the Medical Society of his county, on pain of the forfeiture of his license, the society can have no right to reject him on the ground of his moral or professional character; and that inasmuch as provision is made for the expulsion of mem- bers by the judges of the county court, the society can have no power over its members, other than such as this statute has pro- vided. On both of these points, I entertain a different opinion from the one above mentioned. The Revised Statutes do not profess to repeal the act of 1813, or any part of it. Both acts relate to the same subject, and should be construed together ; and it is believed that they may be interpreted in such a manner as to give effect to all their provisions. First. Every physician, not already a member, must apply for admission into the society of his county, on pain of the forfeiture of his license. Second. The society, in pursuance of its by-laws and regula- tions, may either admit or reject the applicant. If rejected, he loses nothing but the benefits which he might have derived from the association. His license is not forfeited. Third. The society, in pursuance of its by-laws and regula- 40 tions, may either expel a member, or may deliver charges to the district attorney ; and the member may be expelled the society by the judges of the county court. In the first case the member loses nothing but the benefits of the association: in the last case he may be forever disqualified from pursuing his profession, or be sus- pended from practice for a limited period. This opinion will derive some support from the decision of the Supreme Court, in the case of The People against The Medical Society of the county oj New York. 3 Wend. 426. I am, with great respect, Your obedient servant, GREENE C. BRONSON.