NATIONAL LIBRARY OF MEDICINE Washington Founded 1836 U. S. Department of Health, Education, and Welfare Public Health Service ADDRESS OF THE COUNSELLORS TO THE FELLOWS / OF THS Massachusetts medical society, i V BOSTON: PRINTED BY JOHN ELIOT, J UN 1813. ADDRESS. IN consequence of the new organization of the Society, and the election of the greater part of those ph; sicians, Avho have been regularly educated, or who have been distinguished in the practice of medicine, the Fellows are noAv scattered over a large extent of country, and some of them have been unable to attend its stated meetings. The labours of the institution have necessarily deAolved on the Counsellors, Avho are chosen from the Society at large, and Avhose duty it is to Avatch over its interests. As the na- ture of this Institution has, Avithin the last ten years, been essential- ly altered, and the objects and designs of the neAV system have not been generally and fully understood, and as an important epoch contemplated in the last legislative act for organizing the Society is near at hand, the Counsellors have thought it a part of their du- ty to impress on the minds of the FelloAVs the objects, for which it Avas formed, the means by which these objects may be obtained, and the special inducements to regard them. The Massachusetts Medical Society was established by the Le- gislature of this Commonwealth for the public good, and its objects were to increase and diffuse medical knowledge. For these pur- poses it Avas requisite, that a systematic and regular education should be deemed necessary, previous to the commencement of pro- fessional duties, and that all possible inducements should be offer- ed to young meu to pursue with zeal, the course, which should be prescribed ,• and moreover to point out the modes by which the members of the profession might distinguish themselves, Avhiie the) diffused a knowledge of medicine, and promoted the pub.ic good, 4 What measures have been pursued, and Avhat influence they have had in advancing the interests of the scier.cc of medicine, may be shown by ev.hibiiirg a concise history of this Society. The original constitution of the Society Avas very different from that by Avhich it is now governed. The number of its FelloAvs Avas limited. It was confined to ihos-e, - ho had acquired a certain rep- utation, or Avho had distinguished themselves within their circle of professional occupations. It might have been thought, that the honour of ail election into such a body would operate as an induce- ment to the a ounger part of the faculty to exertion ; and in some instances no doubt this effect was produced. But to young men, Avho were engaged in their preparatory medical studies, or v. ho were just entering on the active duties of their profession, the pe- riod at Avhich they might hope to receive this honour, appeared too remote to have any pcrmauent beneficial influence on their con- duct. The limitation of the number of FelloAvs almost necessarily ren-. dered the Society local. The elections were made generally from Hiose physicians, A^bo resided in and near the metropolis, because their characters were best known, and from their vicinity they Avould be enabled to attend to the duties of the Society. For the game reasqn also, the laws of the Society could have no poAver tp regulate, in any degree, the profession at huge In this form, hoAvever, the Society was able to receive, select and publish communications; and a feAv years after its establish- ment the first number of their original papers was published. It A\as obvious, hoAvever after the experience of twenty years, that, whatever might havt been the pleasure and advantage which the members themselves derived from this association, the influence on the public at large v as not so great, as might have been expect- ed. On investigating the canse of this failure it A\as found to re- sult, eot from any neglect or error in the administration of the af- fairs of the Society, but from the imperfect state of its constitu- tion \ aud it A\as thought that some judicious clr nges in this, would be followed by corresponding advantages to the community. In 5 conformity with this opinion, and after a more perfect plan had been maturely considered, application Avas made to the Legislature, and the act of March, 1S03, Avas passed, coinciding Avith the views of the Society. The leading principles of the neAV system were as follows. First, to increase the number of the Fello- s, so that it might em- brace all the reputable practitioners of medicine and surgery al- ready established in business, in the different parts of the Com- monwealth. Secondly, to provide for the future admission of all persons of good character, Avho should proAre themselves qualified to perform the great duties of the profession, which admission might be claimed by individuals as a right, and not be subject to the controul of any body of men whatever. Thirdly, to combine and direct the efforts of the great body, which should thus be formed, to the extension and increase of medical science. Fourth- ly to employ the influence of all the respectable practitioners of medicine, who should thus be associated, in discountenancing those who should enter the profession Arithout due preparation for the great and serious duties, Avhich it imposes on them. It Avill at once be perceived, that by this neAV arrangement it Avas intended to form, of the great body of the respectable members of the profession, a medical council for the CommonAvealth; and as the Fellows of the Society are presumed to be necessarily exposed to expeuce, both of time and money, in their exertions for the pub- lic good, the Legislature thought proper to remunerate them in some degree for their labour. This compensation consisted in an exenn'ion from serving in the militia, an arrangement Avhich ex- perience has proved to be equally useful to the public, and satis- factory to the felloes. This exemption, taken in connection with the right which every regularly educated physician, after a certain period, has to claim admission into the Society, it is presumed will operate as a strong motive for undertaking a regular system of education. In order to increase the inducement to a regular and complete course of studies, there is a provision in on- Bye- Laws, for excluding from the countenance and patronage of the So- '?< 6 ciety all persons, who should engage in the active duties of. the profession, without having previously exhibited to them satisfacto- ry evidence of their qualifications for practice. On recurring to the Bye-La1 s it will be found, that, after June 4,1813, no person can be admitted to an examination by the Censors, Avho has not studied three years with a Fellow, or honor- ary member of the Society. To judge of the propriety of this re- gulation, it will be necessary to repeat what has already been re- marked, that, by the neAV organization of this Society, it is intend- ed to include all regular practitioners throughout the State. The object of this law is to ensure a good education to pupils, and to reuder the fellowship of the Society desireable. It would be easy to show, that the result of it must be beneficial to the medical stu- dent, to practitioners at large, and to the public. As the Society is supposed to rank among its members only those ivho have received a regular scientific education, the student will have a better chance of being correctly instructed and duly quali- fied with a FelloAv of the Society, than with an irregular practi- tioner. He is not, however, compelled by law to pursue this course. He may consult his feelings, or his convenience ; but if the former mode obviously held out advantages superior to any other, these alone may be considered by him as sufficient to cause him to comply Avith the requisitions of the Society. There is no danger from this rule, that the terms of tuition may be rendered so high as to deter the student from putting himself under the direc- tion of a Fellow of this Society, for the number of members is too great to allow of any monopoly of this kind. To the profession at large this law cannot be considered as a subject of complaint. Every respectable physician is here sup- posed (o be a member of the Society. The election of reputable practitioners is an object, which the Counsellors have uniformly and anxiously kept in view ; but notwithstanding they have made great exertions to effect it, they still are conscious that there must have been omissions, from the difficulty of obtaining accurate in- formation, and from the distance at which some of those, who merit 7 this honour, reside. It should he considered as a part of the duty of the bellows to point out from time to time to the Counsellors, those practitioners, v.hose education, habits and reputation may justly entitle thtm to admission into the Society. With respect to the advantages which the community is to de- rive from .his regulation, it is obvious, that if the number of teach- ers be diminished, the res;jous Vlity of those who are still to edu- cate tor the profession of medicine must be more sensibly experi- enced ; and thus if more attention be paid to this subject, the greater is the probability, that those, who engage in the awful du- ties of a physician, will be more duly qualified ; few there are who would not prefer the attendance of a regular scientific prac- titioner to the uncertain and desultory prescriptions of an empyiic. If it be granted, that the lives of our citizens are safer in the hands of the well informed and regularly bred physician, than when un- der the controul of a presuming and ignorant pretender, it is ob- viously for the interest of the public, that students should be induc- ed to place themselves under those best qualified to teach them. It will thus be evident, that the regulation under consideration is calculated to promote the all important object of medical edu- cation. . Does this regulation seem to sIioav, that there is a disposition to monopolize privileges ? The Society has been accused of foster- ing this spirit, but without foundation. A disposition of this sort could not easily have been engendered in a Society already com- posed of more than two hundred and fifty members, Avho arc scat- tered over a great territory. Besides, the attainment of such a monopoly is impracticable, since the law of 1803, passed at the request of the Society, provides, that every person intended for the profession, by adopting such measures as will ultimately establish his reputation, viz. receiving a regular education, may obtain ad- mission into the Society. The Institution and all its advantages are open to all those, Avho, even if the Society did not exist, would have too much honour, and too nice a sense of dufy, to engage in the practice of an arduous and responsible profession, before the-v 8 were satisfied of the justness of their claims to the public patron- age and support. To show the facility with which admission is conducted, and the extent to which it may be carried, we shall just advert to the modes provided for this purpose. These modes are tAvo. by Right and by Election. Admission of right may be claimed by Licen- tiates of the Society, and Medical Graduates at Harvard College,- with the proviso, hoAvever, that they have been reputably engaged in the practice of medicine three years from the reception of the licence or diploma, and have supported an honourable private character. The admission is gained on application, and exhibit- ing a certificate of the above qualifications, signed by two gentle- men of respectability of one of the learned professions, residing in or near the place, or places, Avhere the applicant has practised Medicine or Surgery ; or Avhen a District Society exists, a certifi- cate from said Society. Admission by election takes place in the following manner. lst< A candidate for admission must be nominated at a meeting of the Counsellors by some one or more FelioAvs of the Society. 2d. Af- ter three mouths nomination, the candidate may be balloted for at any stated meeting of the Counsellors; but previous to the ballot- ing, it is expected, that the person, Avho has made the nomination, Avill himself satisfy the Counsellors, that the candidate is a respec- table and honourable practitioner of medicine. If the requisite information cannot be obtained, the nomination is allowed to ret- main on file, for future examination. It is understood, Avith cer- tain exceptions, that the candidate for admission should not have commenced practice subsequent to the year 1805; because since that period every practitioner has had an opportunity of entering the Society by right, after obtaining a license to practice. The avenues for admission to the Society arc therefore as broad as they can consistently be made ; for it is obvious, that if individuals-, des- titute of the above qualifications, Avere allowed to becor. e Fellows, the intention of its es.tabli-htne-.it ayouM be defeated. The Coun- sellors do indeed apprehend, that they have not admitted all, whose 9 character entitles them to a connection with the Society ; but this has arisen, not from a Avant of disposition on tlieir part, but from the difficulty of obtaining an adequate knowledge of the candidates. The Counsellors therefore do earnestly call on the Fellows of the Society, and especially those situated in remote parts of the State, to give information of all such individuals, as are possessed of the requisites for admission into the Society ; Avhile at the same time they must recollect, that loose and general information, as being liable to produce the most injurious mistakes, Avill not promote the objects, Avhich the Counsellors have so much at heart. The honourable the Legislature of this Commonwealth, Avhcn they passed the act of March, 1803, relating to this Society, con- templated it not merely as a collection of individuals for the adop- tion of professional rules and regulations; but they vieAved it as an association calculated to improve the medical science of this State, " by a communication of cases and experiments, and a diffu- sion of knowledge in medicine and surgery." They foresaw, how- ever, from the great extent of territory, over which the fellows must bo tcaupved, thut frequent peisoual communications between them, at any general meetings of the Society, would be impracti- cable. In order to remedy this difficulty, and enable the Fellows to convene frequently for the purpose of improvement in medical science, the act of 1803 authorizes the organization of disli ict so- cieties. It enacts, " that the Counsellors, upon the application of "any two members of the Society,may establish within such districts " and portions of this commomvealth, as they shall think expedient, " subordinate societies and meetings, to consist of the Fellows of the " said Corporation, residing within such districts respectively ,Avhere- " in the communication of cases and experiments may be made ; and " the diffusion of knoAvledge in medicine and surgery euce::raged " and promoted," Arc. These Societies, which ought to be viewed as the-principal organs for the scientific improA'cment^f the Fellovr.-. never ha\Te been constituted in the extent, which the act oi the 2 10 Legislature contemplates, and the good of the profession requires. Tavo or three district societies have indeed been organized, and the advantages of these have sanctioned the opinion that was enter- tained of their utility. But in order to complete the original de- sign, and enable all the Fellows of the Society to become active in mutual and general improvement, it seems necessary, that every portion of the Fellows of the general Society should be embraced in some district Society. The Counsellors do therefore strougly recommend, that the Fellows in every part of the State sho. Id ef- fect the organization of such district Societies ; and support them with that spirit, which is demanded, in the present state of medical improvement, in this CommonAvealth. The Counsellors cannot conclude this address without congratu- lating the Society on its beneficial effects on the medical profes- sion, since the new organization. In the larger towns, the continual communication among physicians had produced arrangements, which in some respects anticipated the regulations of the Society ; while in the very remote parts of the State, its salutary influence has not yet been experienced. But in the great and populous coun- ties which constitute the body of the state, the Counsellors have great reason to believe, that the operation of the Society's regula- tions has produced the most beneficial consequences, and that these are daily becoming more sensible. A friendly intercourse has been established between distant members of the profession. The disposition for acquiring an adequate education has been cultivat- ed. Medical knowledge has been promoted by publications. Se- cret and dishonourable practice has been discouraged ; and the public have received a mark, which they may employ to distin- guish between the impostor, and the modest, well educated physi- cian, whose reputation brightens by time and examination. In fiie, the Counsellors are firmly persuaded, that the more the ob- jects and effects of this Society become known, the more must the institution be esteemed by the profession and the public. Thoy 11 do therefore most earnestly recommend that you will neglect no opportunity of publishing and explaining the design of this Society, its actual operation, and the advantages the public will derive from a continuance of its prosperity and vigour. In behalf of the Counsellors, JOHN WARREN, President. Boston, Feb. 10, 1813. Notice. The Fellows of the Society are informed, that a neAV publication of the original communications and dissertations,of the Society is now contemplated, and will probably be prepared for delivery, at the annual meeting in June. The Counsellors have also made arrangements for completing a neAV diploma, agreeably to the instructions of the Society, which will be ready for general distribution in the month of April. Officers of the Society for the present Year. JOHN WARREN, M. D. President JOSHUA FISHER, M. D. Vice President DAVID TOWNSEND, A. M. "| THOMAS WELSH, M. D. AARON DEXTER, M. D. ^> Censors. JOSIAH BARTLETT, M. D. WILLIAM SPOONER, M. D. J THOMAS WELSH, M. D. Corresponding Secretary. ' JOHN C. WARREN, M. D. Recording Secretary. JOHN G. COFFIN, M. D. Treasurer. SHIRLEY ERVING, Librarian and Cabinet Keeper. MexL.HtsD. wz JL70 I«I3