BY-LAWS OF THE MEDICAL SOCIETY OF THE COUNTY OF ERIE : TOGETHER WITH THE IiAWS OF THE STATE OF NEW-YORK,.. * RELATIVE TO THE MEDICAL PROFESSION, AND A SYSTEM OP MEDICAL ETHICS. r PUBLISHED FOR THE SOCIETY. BUFFALO: CHARLES FAXON, PRINTER. UDCCC XXXIV. V WB AM6 E6M4b If 3 4 BY-LAWS OF THE MEDICAL SOCIETY'OF THE COUNTY OF ERIE. The. Medical Society of the County of Erie, by virtue of thep*ambl9- statute in such cases made and provided, do hereby make, ordain, and declare the' following By-Laws, Rules and*Regulations, for the better government of the members of thd said Society, and for the purpose of carrying into execution 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 Society Name of So- of the County of Erie. It shall consist of all legajly authorized Of^*omjit ' practicing Physicians and Surgeons who do now reside, or who5 . may hereafter come to reside in the county of Erie, and who have been admitted, or who shall be hereafter admitted, members of said society, pursuant to the subsequent provisions of these by-laws/ex- cepting such as shall be at any time expelled the said society, pur- suant To said by-laws, and the statutes of this state. ARTICLE II. Officers. The Officers of the said society shall be a President, Vice Presi- °J?^ dent, Secretary, Treasurer, Librarian and five Censors. The said Officers shall be chosen by ballot at the anniversary meeting, and shall hold their offices one year, and until others shall be chosen. And the said society shall, once in four years, and as often as a va-Deieg*^ cancy shall occur, elect a delega'e to the State Medical Society. soc^t* ARTICLE III. Meetings. » § 1. The Medical Society of the County of Erie shall hold tw°Me regular meetings in each year, in the City of Buffalo : The annual e< 4 when heii. meeting on the second Tuesday of January, and the semi-annual Extra Meet-meeting on the second Tuesday of June. Extra meetings may be ,n6s' appointed by a 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 of five members. mu'raluct' § 2# ?n case cnarges should be preferred against any member for misconduct in his profession, or of immoral conduct and habits, pursuant to the statute upon that subject, (Revised Statutes, part I. chap. 14. Title 7.) or for a violation of any of the laws regulating the practice of physic and surgery, the President, on such charges Thereon'"6" being presented to him, may call a special meeting without the ap- plication of five members, giving at least ten days previous notice in one or more of the newspapers printed in the county. Quorum. ^ 3 £jot jesg ^^ gve mernbers shall constitute a quorum. ARTICLE IV. Order of Business. when organ- § 1. As soon as the presiding officer shall have declared the mee- ting organized, the order of business shall be as follows : Minutes of ) # Reading the minutes of the last meeting and correcting the previous mee- ° O 0 tins- same, if necessary, by a vote of the society. 2. Reception of members. 3. Communications from abroad. 4. Reports of officers and committees of this society. 5. Appointment of committees. Order of bu- J r •ineu. 6. The Oration. 7. Miscellaneous business. 8. Appointment of succeeding orator. 9. Election of Officers. 10. Valedictory address, by the President. 11. Adjournment. special mee. ^ 2. At all special meetings, the business for which the society Ruiei of or.raay be convened, shall be first considered. Member. t« § 3. Every member, previously to his speaking, shall rise from his seat, and address himself to the President. § 4. When two or more members rise at once, the President shall name the one who is to speak. 5 § 5. No question on a motion shall be debated or put until theMotlon?,e- aame be seconded. When a motion is seconded, it shall be stated by the President before debate, and every such motion shall be re- duced to writing if any member desire it. §6. If a motion is stated by the President, it shall be deemed toM.°'ion w,,eB J _ withdrawn. be in the possession of the society, but it may be withdrawn at any time before amendment or decision. § 7. No member shall interrupt another while speaking, unless N° intemip. it be to call another to order, or to correct a mistake. § 8. When a question is under debate, no motion shall be re-J^j^f"" ceived unless debate 1. To amend it. 2. To commit it. 3. To lay it on the table. 4. To postpone it. 5. To adjourn. § 9. A motion to lay on the table shall be decided without de-£*£y °" *• bate. §10. A second amendment shall not be received until the previ-8*00"4 *■ . r mendment. ous one is disposed of, except with the consent of the mover of the first amendment. § 11. If the question in debate contains several points, any mem-^^^"^ ber may have the same divided in voting concerning the same. § 12. Every member shall vote upon a question put, unless ex-bEe,rIetr0'V0^m" cused by the society. § 13. When a motion has been once put and decided, it shall be in order for any member who voted in the majority to move for a re-consideration thereof, but no motion for re-consideration shall^008"*'* be received more than once, except by unanimous consent. §14. A member called to order shall immediately sit down, un- , , .„ i j /• i Calls toordet less permitted to explain, and the society if appealed to from thedtcided. decision of the President shall decide on the call, but without de- bate. If there be no appeal, the decision of the President shall be submitted to. § 15. All motions shall be put in the order they are moved, ex-Motiol- cept in filling blanks, when the longest time and largest sum shall i» o«i«. be first put. Names enter- § 16. Upon a division, the names of those who vote for or against a question or motion, shall be entered on the minutes. R«poru. § 17. Whenever a report is received from any officer or .officers of the society, or from any standing or select committees, Jf-jthe. re- port be accompanied with resolutions requiring the consideration of the society, the question, on accepting the report, shall be consider- ed distinct from that on the resolutions. committee!, ^ ^ ^j| committees shall be appointed by the presiding officer ed- unless specially otherwise directed by the society, in which case they shall be appointed by ballot, and a plurality of votes shall pre- vail. President pro § 19. In case of the absence of the President and Viee Presi- teinpore. J dent, the society shall appoint a president pro tempore. Select com- § 20. Select committees to whom references are made, shall in mittee to re- . . . , .... . . port in wri-all cases report in writing, together with their opinions,, signed by ting. _ the Chairman. § 21. A committee shall be appointed at each regular meeting of the society, whose duty it shall be to select some member \vho is present at the said meeting, to deliver an address at the next reg- Orator, hcwular meeting of the society ; and such selection shall be forthwith k when cho- ° J ' * , »e»- made public, and be entered on the book of the Secretary. And if any member so selected shall fail to deliver an appropriate written r-enait address at the next regular meeting of the society, he sha.ll forfeit and pay to the Treasurer the sum of five dollars. Provided al- ways that in case of disability to read the same, the manuscript shall be delivered in due time to the society. ARTICLE V. Admission of Members. WmUtedyand § ** Every Physician or Surgeon residing in the county of Erie, iow. 0f temperate habits, good moral character, and legally authorized to practice phyisic or surgery in this state, who may hereafter wish to become a member of this society, may be admitted by a vote,of two thirds of the members present at a regular meeting. membcrfin § 2* It shall be the duty of each and every member to give all piSTnu0 ap'the information in his possession concerning the character and standing of every candidate proposed for membership. 7 § 3. Iso candidate shall be present until the question of his ad-noatn^bae0prt. mission be determined by the society. § 4. Every member when admitted shall pay the Treasurer five^u^i "f dollars, sign the by-laws and then be entitled to a certificate ofc«tific*te. membership. ARTICLE VI. Duties of Officers—President. 4 § 1. The President shall preside at all meetings, maintain order^d,e,n\sofrre' and decorum, decide all questions of order subject to an appeal to the society, and shall appoint all committees, unless otherwise di- rected by the society. On all motions made and seconded, he shall state the question, Motion. and tilke 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. The President shall at the annual meeting and at the end of each f i • i /»• i. • i- • President to year after Ins election to ornce, deliver to the society a dissertation deliver au ad- on some appropriate subject, and in case of default in delivering ten dollars. the same, he shall forfeit and pay to the society the sum often dol- lars. Provided always, that if the President shall duly cause to berrovuo. presented to the society a copy of his anniversary dissertation, he may, if the society deem proper, be excused from delivering the same ; but he shall not be exonerated from the fine of ten dollars, for not composing and presenting such dissertation ; and a copy of such dissertation so presented shall be read by the Vice President or President pro tempore. The President on receiving a certificate of approval from the president to Censors in favor of any candidate for a diploma, shall endorse on^.1 ip0* said certificate lhat such diploma has been granted by him, and shall hand the same to the Secretary, to be by him filed and kept as part of the records of the society ; and for every diploma thus gran- ted, the President shall exact the sum of five dollars from such can- didate, which he shall forthwith pay to the Treasurer of the society. The President shall give the notice in writing, required by ste-d^bTA* tute, to Physicians and surgeons residing in the county, who have"esiden,> not becomo members of the society. 6 v. President in the absence of the President, the Vice President shall preside to preside. g * and e;:ercise the like powers. um'rio're"1 pr° *n tne absence of the President and Vice President, the society may appoint a President pro tempore. Secretary. § 2. The Secretary shall record the proceedings, and have D»tie« of the charge of all the papers of the society. He shall read all letters Secretary. ° . , J and communications, shall keep the cabinet, attest all writings, no- tify all meetings by the authority of the society or the President, and deliver to the Chairman of all committees, a list of the mem- bers composing the same, stating the object of the committee— shall note members absent and present at each meeting, and report the names of the absent, at the annual meeting, to the Treasurer. Report to 8-He shall likewise transmit annually to the State Medical Society, Med.Society. J J a copy of such proceedings as may be required by that body. He hames"ofhe s^a^ a'so recorcl the name of every member and the time of his ad- membe™. mission ; 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 removed cords. frorn the archives of the society, but shall allow the same to be exa- mined by every member. Treasurer. § 3. The Treasurer of this society shall receive and account for Treasurer, all moneys that shall come into his hands by virtue of any of the by- laws of this society, and, also, for all moneys that shall come into the hands of the President for the admission of members or li- censing of students ; which moneys#the President is hereby re- quired forthwith to pay over to the said Treasurer, who shall ac- p»ymtnt of count therefor, at their annual meetings: No moneys shall be drawn from the Treasury, unless such sums and for such purposes as shall be agreed upon by a majority of the society at their annual meeting, and by a warrant for that purpose signed by the President, or in case of his absence or death by the Vice President. Tocoiiect an And it is furthermore made the duty of the Treasurer, to collect, by prosecution or otherwise, all debts, dues and demands belong- 9 ing to this society and which shall have been due more than three months. He shall also give security to be approved and retained G'T*boD4* 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. And the Treasurer is furthermore required to deliver over to his successor in office, all moneys, books and other property belonging to the society. Librarian. § 4. The Librarian shall have charge of the library, apparatus and other property belonging to the society; he shall make an al-Duties of the phabetical catalogue of the same, designatinglhe name of the donor of all such books or other property as may have been presented to the society, and the value, whether received as a donation or pur- chased. The Librarian or his deputy shall deliver to and receive from Deliver and any member of the society not prohibited by its regulations, any ^eC€"^obo*k, volume or pamphlet in the library, provided always that such mem- ber deposit with the librarian twice the value of such volume or pamphlet, in cash or other approved security; and the librarian shall enter in a book to be kept for that purpose, the name of the person receiving such book—the title and number of said book— the time when drawn, and when returned—the damage, if any—and the fine imposed for the same. Any member who is not indebted to the society, and who resides within ten miles of the library, may draw one or more volumes, in Member* re- the discretion of the Librarian, at anytime, and retain the same tin mUei.thl" one month. Any member residing over ten miles may retain suchovertenmiiw book or books three months ; but all books must be returned on or before 2 o'clock of the day of each regular meeting of the society. For not returning by that time, such member shall be fined not less than a third of the value of the book or books drawn by him— and an additional sum of twenty-five cents for every thirty days un- til the same is returned to the Librarian. The Librarian shall fine cad; and every member three centsaFiM#( day for retaining a book after it is due at the Library. 2 10 On the return of each book, the Librarian shall carefully examine the condition, and note any damage it may have received in the ipooks injured nan^s of the last drawer, and impose such fine as he may deem rea- sonable. If the book is materially injured, or lost, the Librarian 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 equi- table price. If a member lend a book to any person not a member, or to any person not entitled to draw books from the library, he shall forfeit the value of the volume. Any member considering himself aggrieved by reason of any de- cision of the Librarian may appeal in writing to the society at their next regular meeting. The Librarian shall deliver or cause to be delivered the cash or other security, in his possession, to the person by whom it was de- posited, whenever said book shall be safely returned ; or in case the same is damaged or detained beyond the time specified by ihe regulations for the library, whenever said damage or fine for deten- tion is paid. The Librarian shall also pay to the Treasurer all mo- neys by him received for such damage or fine, together with such pledge or pledges as shall be forfeited by reason of the detention of such book or books for which the sum is left beyond the term of one year from the time when the same was drawn. No book shall be drawn from the library by any member, until all fines or assess- ments due from said member, shall have been paid. The Librarian shall at each and every annual meeting of the so- theTreasurerciety make a full and minute report of the condition of the library— the moneys received—together with such suggestions as he may deem of importance relating to the duties of his office generally— and shall faithfully deliver to his successor in office all the books and other property belonging to the society, which may be in his possession. m Censors. Duty of Cen- § 5. The Censors, or a majority of them, shall carefully and im- partially examine all students who shall present themselves for that purpose, and who are entitled to s.uch examination, pursuant to the Appeal. Securities, When to be retained. Moneys to Whom paid. 11 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 than the payment of their expenses. The questions and answers shall be written in a book appropria-Mode ofeia- ted to such use ; and the time of such examination shall be only at the annual or semi-annual meetings of the society. / The result of each examination, if approved by the Censors, shall Rep0rt. be immediately reported to the President of the society, under a penalty of one dollar for each omission. Three Censors shall con- stitute a quorum. For non-attendance at an examination after suitable notice has been given by the candidate, each delinquent shall pay to the Penalty- Treasurer of the society a sum not less than three nor more than five dollars, unless he can render a reasonable excuse, which shall be accepted by a vote of two thirds of the members present at a regular meeting. Any officer of this society neglecting or refusing to perform the officers r« duties of his office, and any committee neglecting to perform the ty' duty assigned them, shall forfeiland pay to the treasurer of this so- ciety a sum not less than two no^nore than ten dollars. il and pay to lo^nore thai ICXE VII. ARTH § 1. Every practicing physician or surgeon residing, or wnoAnnugl tM may hereafter reside in the County of Erie, shall at the annual one dollar. meeting in January in each year, or within thirty days thereafter, pay to the Treasurer of this society the sum of one dollar for the purpose of procuring a medical library, apparatus, &c. § 2. Any member of this society, under the age of sixty years, and who resides within ten miles of the place of meeting, who shall ft fof neglect to attend .each stated meeting of the society, shall forfeit™n;*ttend- and pay to the Treasurer 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 penalty, and which sum shall be paid within thirty days thereafter. § 3. No member of this society shall conceal his art of curing diseases, or pretend to any nostrum, or superior knowledge or skill 12 Quackery. Duties of members. \ Penalty for refusing to comply with the require- ments of the ■ociety. Manner of trial. Verdict-- how given. Medical Ethics. Appeal. Members ex pelled- in the treatment of diseases generally ; nor shall any member pro- fessionally consult, attend patients or associate with any known quack, or any person professing the healing art who is not regular- ly authorized by the laws of the state to practice physic or surge- ry, or both; or with any physician who does not attach himself to the medical society, after residing in the county one year. § 4. The members of this society shall attend punctually, and give advice unreservedly in consultations, and shall vindicate the professional character and practice of each other as far as oppor- tunity, propriety and justice may require. § 5. Every member who shall neglect or refuse to comply with the by-laws and regulations of this society, or the by-laws and re- gulations of the medical society of the state of New-York, or the medical law of said state, shall be expelled from said society, upon a vote of a majority of the members present. § 6. The manner of trial of a member, with a view to expulsion under this article, and the notice to be given to him, shall be deter- mined on whenever an accusation shall be preferred. § 7. Said trial shall be fair and impartial, and the verdict of the members shall be given by ballot on the day of trial. § 8. The Code of Medical Edtics, revised, adopted and repub- lished by the state medical social in the year 1832, shall be, and hereby is adopted by this society, and shall be scrupulously adhe- red to by each and every member thereof; and any departure from the true spirit and meaning of said code of ethics shall sub- ject every such member to the discipline of this society. § 9. Any member, feeling himself aggrieved by the official or personal acts of another, may appeal for redress to the society, whose decision shall be final. § 10. It shall be the duty of every member to advise and ac- quaint the President with the names of all such persons as are practicing physic or surgery in the county contrary to law. $ 11. No physician who has been expelled from this or any oth- er medical society, shall be again admitted into this society unless four fifths of the members present at an annual meeting concur by ballot in bis admission. 13 . V. ARTICLE VIII. Charges op Gross Ignorance or Misconduct, and of Immoral Conduct .Isd Habits. § 1. Charges of the character above specified, may be presented charges—1« to the President, or in case of a vacancy to the Vice President, ted?mpre* when the society is not in session, or to the society at any of its meetings. Such charges shall be in writing, and shall contain spe-?0^^'*8 cifications setting forth, with certainty and precision, the offence charged. And it shall be the duty of the President or Vice Presi-President:and dent, when the charges are presented to them, and of the society,lation^w- when said charges are presented at a meeting thereof, before ta-to' king any steps to call a special meeting, to satisfy themselves, by taking legal advice or otherwise, that the said charges and specifi- cations are conformable to the statute, and that they set forth facts sufficient to enable the judges of the county courts to proceed there- on, in case they should be found well founded by the society. § 2. The President or Vice President, or the society, to which- The person ever the said charges shall be presented, after becoming satisfied charges are of the matters mentioned in the first Section, Article 8th, shallciiiaTue'cill cause such special meeting to be called, and such notice to be gi-mee 10g' ven, as is required by the statute on that subject; and when the so- ciety shall be convened at such speqal 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 declaration, Licentiates. which shall be kept on file by the Recording Secretary : " I, A. B., do solemnly declare that I will honestly, virtuouslyD«laration- and chastely conduct myself in the practice of physic and surgery,scribed- with the privilege of exercising which profession I am now to be invested ; and that I will, with fidelity and honor, do every thin<* in my power for the benefit of the sick committed to my charge." 14 § 2. Every person admitted to the practice of (tiysic and sur- gery by this society, shall receive the following licence to practice, viz: " To all to whom these presents shall come, or may in anywise contern: The President and members of the Medical Society of the Coun- ty of Erie, State of New-York, send greeting :— Whereas (name and place of candidate,) hath exhibited unto us satisfactory testimony that he hoth studied physic and surgery for the term and in the manner directed by law ; and hath, also, upon examination by our Censors, given sufficient proof of his proficien- cy 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 practicing physic and surgery in this state, together with all the rights and immunities 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. § 1. Any proposed amendment to these by-laws shall be made ts in writing at a regular meeting of the society, and may be adopted at the next regular meeting by a vote of two thirds of the members present. LAWS OF THE STATE OF NEW YORK, RELATIVE TO THE MEDICAL PROFESSION. ceneral regulations concerning the practice of physic and surgery 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 be 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 hear and determine charges ; their judgement. ■ 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 county students 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 examiued 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 oT license in county clerk's office. 20. Persons under 21, not entitled to practice. 21. Certain degrees not to be a license ; restrictions as to faculty. 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-fryeiphtosi.ev" mitted into such society, within the county in which the society of£u™ *nd which he is president is situated, requiring such physician or sur- geon, within 60 days after the service of such notice, to apply for and receive, a certificate of admission, as a member of such so- ciety. § 2. The service of every such notice shall be made personally,How sery on the physician or surgeon, to whom it shall be directed; and if ^t^d™to* such physician or surgeon shall not, within the time specified in thej?rfeit thpT notice, or within such further time as may be allowed by the presi-they d° not dent under the regulations of the society, apply for a certicate 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 physicians, until upon a special application, he shall be admitted a member of the medical society, in the county in which he shall reside. 16 Ch»rgef.r § 3- If there shall be preferred to any county metVical society, misconduet. 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 mentors ivcsent at such meeting shall thereon. j^ 0f 0pinion, 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 hereinafter provided. Charge, to § 5. The district attorney to whom the charges shall be deliver- Md'n^tice of ed, shall serve a copy thereof without delay, on the member ac- heanns- 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 at- § 6. The district attorney shall conduct the prosecution of the 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. Judeei to § ^' "^ne Judges °ftne 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 T . shall make an order, which shall be valid in law, expelling the member accused from the society, and declaring him for ever there- after incapable of practising physic and surgery, within this state : or suspending him from such practice, for a limited period: if they 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 Burgeon. Or suspend, 17 § 8. No student shall be admitted to an examination by any mc-£f^fc»t[0M dical society, until he shall have completed, with some physician and surgeon, duly authorized 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 ^u5mof 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 me- dical college in this state, or elsewhere, one year shall be, deducted. § 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. & 11. If the term of study shall be intended to be for less than Order for J J ... term of study. four years, upon either of the grounds mentioned in the ninth section 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 exceed- ing 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. § 12. No person shall receive from the regents of the university Requi9ites for a diploma, conferring the degree of doctor of medicine, unless heft^egenu. shall have pursued the study of medical science for at least three years, after the age of sixteen, with some physician and surgeon, duly authorized 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 at- tended the last of such courses, in the college by which he shall be recommended for his degree. 3 18 inwhatconn- § 13. No student shall be admitted to an examination by any to be exam- county medical society, except of the county in which he shall have pursued his medical studies for four months immediately preceding his examination; but if the student, during that period, shall have attended the lectures in either of the incorporated medical colleges of this state, he may be examined and licensed, either by the medi- cal 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, to ^ 14> No person, who shall have been examined by the censors of any county medical society, as a candidate for the practice of 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 reject § 15. No person, who, either upon an original examination or ted by state 3 r c i_ society. upon an appeal, shall have been rejected by the censors of the state medical society, shall thereafter be admitted to an examination, before the censors of any county medical society. Who toprac- § 16. No person shall practice physic or surgery, unless he shall tice physic. , y . \ ,. ,.,/.,*. c have received a license or diploma, for that purpose, trom one ot 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 authorized to practice by the laws of some other state or country, and have a diploma from some incorporated college of me- dicine, or legally incorporated medical society, in such state or country. Persons from § 17. No person coming from another state or country, shall or country, practice physic or surgery in this state, until he shall have filed a copy of his diploma with the clerk of the county where he resides, and until he shall have exhibited to the medical society of that coun- ty, satisfactory evidence that he has regularly studied physic and surgery, according to the requisitions of the ninth section of this Title. Diplomas to § 18. No diploma, granted by any authority out of this state, to certain',n an individual who shall have pursued his studies in any medical school*, not sch00i within this state, not incorporated and organized under its 19 laws, shall confer on such individual the right of practicing physic or surgery within this state. § 19. Every person licensed to practice physic or surgery, or LjceMMin both, shall deposit a copy of such license with the clerk of the county jl}^*"*101* 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-on^ years shall heP?rsoMunder entitled to practice physic or surgery in this state. § 21. The degree of doctor of medicine conferred by any col lege J*6?1"' co»- in this state, shall not be a license to practice physic or surgery; leges, &c. nor shall any college have, or institute, a medical faculty, to teach the science of medicine, in any other place than where the charter locates the college. § 22. Every person, not authorized by law, who for any fee or Penalties for practicing reward, shall practice physic or surgery within this state, shall be without au- incapable of recovering, by suit, any debt arising from such practice. RELATING TO THE PRACTICE OF PHYSIC AND SURGERY. An act concerning the Practice of Physic and Surgery in this Slate, Passed April 7, 1830. Chap. 126, p. 141. [From the Revised Statutes, Vol. HI. 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. §2. Every person not authorized by law, who shall practice peMhy for physic or surgery within this state, shall for each offence of whichwuhoutau- he may be duly convicted, forfeit and pay a sum not exceedingthonty- twenty-five dollars, to be recovered, with costs of suit, before any justice of the peace of the comity 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 shall have been abolished. But the provisions of this section shall 20 Exemption Mnot be deemed and taken to extend to or debar any person from IndX'rta"1" using 0r applying, for the benefit of any sick person, any roots, barks, or herbs, the growth or produce of the United States. An act to amend an act entitled '< An act concerning the practice of physic and surgery in this state, passed April 7m, 1830.—Passed April 3, 1834. The People of the State of New-York, represented in Senate and Assembly, do enact as follows : Amendment k j# The last clause of the second section of the act entitled " An act concerning the practice of physic and surgery in this state," passed April 7th, 1830, in the following words : "But the provi- sions of this section shall not be deemed and taken to extend to, or debar any person from using or applying for the benefit of any such person, any roots, barks or herbs, the growth or produce of the United States," is hereby repealed. § 2. The act hereby amended shall not be so constructed as to apply to any person or persons who shall without fee or reward, use or apply, 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 Medical Societies, for the purpose of regula- ting the Practice oj P/tysic 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, Count di- § 1. Be it enacted by the People of the state of New-York, repre- cai *°cietiei^senied {n Senate and Assembly, That it shall and may be lawful for "rated- the physicians and surgeons in the several counties of this state, now authorized by law to practice in their several professions, ex- cept in those counties wherein medical societies have been already incorporated, to meet together on the first Tuesday of July next, at 21 the place where the last term of the court of common pleas next previous to such meeting was held in their respective counties; and the several physicians and surgeons so convened as aforesaid, The office„ or any part of them, being not less than five in number, shall pro- °£each S0C1*" ceed 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 societies shall be so organized as aforesaid, they are hereby declared to be bodies corporate and politic, in fact and in name, by the names of the its corporate medical society of the county where such societies shall respective- ly be formed, and by that name shall be in law capable of suing andAndPriTae- being sued, pleading and being impleaded, answering and being an- swered 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 always, That if the said physicians and surgeons shall not meet and organize themselves at such time and place as afore- said, 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. 6 2. And be it farther enacted, That the medical societies of The present . . . county socie- counties already incorporated, shall continue to be bodies corporate iies}° contin- .... ue incorpora- and politic, in fact and in name, by the name of the medical societyted- _ * . ,••, ••,/. Their privi- of the county where such societies have respectively been formed, leges and gen- and by that name shall be in law capable of suing and being sued, pleading and being impleaded, answering 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, and that the president, vice-president, secretary and treasurer, of such in-A|»uoffice«- corporated societies, shall hold their offices for one year, and until others shall be chosen in their places. § 3. And be it further enacted, That the medical society already The medical incorporated, by the style and name of the Medical Society of thej££^f°{^ state of New-York, shall continue to be a body politic and corpo-Xork.toeon' J r r tinue incor. rate, in fact and name, and by that name shall be in law capable of Por»ted- suing and being sued, pleading and being impleaded, answering and being answered unto, defending and being defended, in all courts 22 and places, and in all matters and causes whatsoever; and shall and may have and use a common seal, and may change and alter How consti- tne same at tne*r pleasure ; and that the said society shall be com- tuted and DOsed of one member from each of the county societies in the state, composed. r * elected by ballot at their annual meeting, who shall meet together at the time and place appointed by the said society for that purpose, and being met, not less than fifty in number, may annually elect by its officers, 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 sod- § 4. And be it further enacted, That the medical society of the dies' anni- yersary meet-state pf New-York, and also the medical societies «f the respective 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 meet- ings ; and 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 proceed- Proceedings ings had at their first meeting ; and it shall also be the duty of the iug—where secretary of the medical society of the state of New-York, in like 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 society § 5. And be it further enacted, That the members now compo- ciusei'! mt° sing tne 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. *?en of1™ § 6- And be it further enacted, That it shall be the duty of the g ^ie^niethe secretary of the medical society of the state of New-York, whenever the seats of any of the members shall become vacant, to give infor- mation 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 the § 7. And be it jurther enacted, That in case there shall be an state society .... . , „ mar be varied addition to the number of members composing the medical society of the state, that in that case it shall be in the power of the said socie- 23 ty 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 maybe, shall annually go out of office. § 8. And be it further enacted, That if the seat of any member v*™?jf of the medical society of the state of New-York shall be vacated, how filled. 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 estab-Med^oc.- lished as aforesaid, are hereby respectively empowered to examineine ^iel^- all students who shall and may present themselves for that purpose, and to give diplomas, under the hand of the president and seal of To give di- or' , plomas which such societv before whom such student shall be examined, which shall author- .... ize the party diploma shall be sufficient to empower the person so obtaining tne to practice. same, to practice physic or surgery, or both, as shall be set forth in the said diploma, in any part of this state. & 10. And be it further enacted, That if any student who shall stndents if /. • c u A- irefused diplo- have presented himself for examination before any of the medicalma by county societies of the several counties of this state shall think himselfappeai to the aggrieved by the decision of such society, it shall be lawful for such9 ? student to present himself for examination to the medical society of the state of New-York; and if in the opinion of such society the**»£j£- student so applying is well qualified for the practice of physic or^*pto»» surgery, or both, as the case may be, the president of said society v^- shall, under his hand and the seal of such society, give to the said applicant a diploma, agreeable to such decision. § 11. And be it further enacted, That it shall and maybe lawful ^^^^bj* for the several medical societies so established as aforesaid, at theirthe societies 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 all stu- Their duty. dents who shall present themselves for that purpose, and report their opinion iu writing to the president of the said society. § 13. And be it further enacted, That it shall and maybe lawful Medical soci- for the medical societies of the respective counties of this state, ana^^csa.nd also the medical society of the state of New-York, to purchase andtate. hold any estate, real and personal, for the use of said respective so- 24 Proviso. defies: Provided, Such estate, as well real as personal, which the" county societies are hereby respectfully authorized to hold, shall not exceed the sum of one thousand dollars ; and that the estate, as well real and personal, which the medical society of the state of New-York is hereby authorized to hold, shall not exceed five thou- sand dollars. Societies— § 14. And be it further enacted, That it shall be lawful for the po«eI6toera respective societies to make such by-laws and regulations relative m e y- a*sj0 fae affairSj concerns and property of said societies, relative to the admission and expulsion of members, relative to such donations or contributions as they or a majority of the members at their annual Proviso. 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 constitution 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 re- pugnant to the by-laws, rules and regulations of the medical society of the state of New-York, nor contrary to, nor inconsistent with, the constitution and laws of this state, or of the United States. Treasurer of §15. And be it further enacted, That the treasurer of each so- each county _ J J •ocietyiiabie ciety established as aforesaid, shall receive and be accountable for for moneys. all moneys that shall come into his hands by virtue of any of the by-laws of such societies, and also for all moneys that shall come into the hands of the president thereof for the admission of members, or licensing students ; which moneys the said president is hereby Andtow- required to pay over to the said treasurer, who shall account there- for, for to the society at their annual meetings, and no moneys shall be Moneys how drawn from the treasurer, unless such sums and for such purposes drawn. as snaii ^e agreec[ Up0n by a majority of the society at their annual meeting, and by a warrant for that purpose signed by the president. Iadjesooet°f § 16' ^nd be it further enacted, That it shall be the duty of the to keep its secretary of each of the said medical societies, to provide a book. minutes, &c. .,...,, ""««, in which he shall make an entry of all the resolutions and proceed- ings 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 admis- sion, and also the annual reports relative to the state of the treasu- ry, and all such other things as a majority of the society shall think proper; to which book any member of the society may at any time 25 have recourse ; and the same, together with all books, papers andAnddeiive* records which may be in the hands of the secretary, and be the his successor. property of the society, shall be delivered to his successor in office. § 17. And be it further enacted, That it shall be lawful for each A medical k- /• , i • i • • * in, brary and ap- of the said medical societies, to cause to oe raised and collected paratus,8ic f i n i • maT De Pro' from each of the members of such society, a sum not exceeding cured by each three dollars in any one year, for the purpose of procuring^, medical how. library and apparatus, and for the encouragement of useful discove- ries in chemistry, botany, and such other improvements as the ma- jority of the society shall think proper. § 18. And be it further enacted, That any student who may re-™*"™^ ceive a diploma from the medical society of this state, shall pay to^^sd'P1* the president thereof, on receiving the same, ten dollars ; and for each diploma that a student may receive from the medical society of any county, he shall pay to the president thereof, on receiving the same, five dollars: Provided, That the* students who have been examined previpus to the twenty-sixth day of May, one thousand eight hundred and twelve, and were entitled to receive diplomas, 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 this State society J " J may annually state may elect by ballot at their annual meeting, eminent and re-elect two ■' J ... members spectable physicians and surgeons residing in any part of this state, thereof,and which persons so elected shall be permanent members of the soci- ety, 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 of Legislature the legislature to alter, modify or repeal this act whenever they oTrepeai this shall deem it necessary or expedient. § 24. And be it further enacted, That if there should not be awhenphysi- sufficient number of physicians and surgeons in any of the counties onTcounty0 of this state to form themselves into a medical society agreeably"embenT to this act, it shall be lawful for such physicians and surgeons to ^•erty°ua' associate with the physicians and surgeons of an adjoining county, for the purposes hereby contemplated. 4 £6 TMswtd* x25. And be it further enacted, That this act shall be, and clared a put* w ... ... .* I lie act. r hereby is declared to be a public act.* 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 be § 3 £n . . shall annually elect not more than twelve, nor less than six censors, any three of whom shall be a quorum for the examination of students. Anniversary § 5. And be it further enacted, That in those counties whe,re eCuty^ocie-the anniversary meetings of any county medical society shall occur aiterTdLbe on the same day on which the court of common pleas shall meet, certain cases.it ghall be iawfui for such"«ociety to alter the time of their anniver- sary meeting to such day as a majority of the said, society present may think proper. rereMuuhe § 6- And be it further enacted, That each of the colleges of colleges of me(iicine in this state, may elect a delegate to represent their col- medtcine. J D * 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. Tax § 1. Be it enacted by the People oj the State oj 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 col* lected from each practicing physician and 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 •The original acl for establishing Meftdal SdcietfcJ in lhi» State", tad % kntM SHU MediW 27 incorporate medical societies for the purpose of regulating the prac- tice of physic and surgery in this state," passed April 10, 1816. 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 ofihe State of New-York, rep-Annual meet- resented in Senate and Assembly, That it shall and may be lawful 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: Provi- proviso. ded, 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 regularmeeting of the society.* ♦It will be observed that the Revisort have omitted the following sections as not in force----In the act passed April 10,1813, sections 13,20,21,22----In the act passed April .0, 1818, sections 1 j,^ f.___In the act passed April 13,1919, section 2. All the above are repealed by enactments contained in the " General Regulation" contained in pages 17, &c. A SYSTEM OF MEDICAL ETHICS. [The following code of Medical Ethics was reported to the State Medical Society in February, 1323,by a committee consisting of Drs. Manley, Pascalis and Steel, and unanimously adopted. It is now re-printed 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 gene- ral, in private and confidential cases, as well as in their intercourse 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: 1*/. Personal Character of Physicians. 2d. Quackery. 3d. Consultations. 4:th. Specifications of Medical Police in Practice. 5th. Forensic Medical Police. • FIRST DIVISION. Personal Character of Physicians. Quaiifica- It would be difficult to determine which of the three learned pro- 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 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 unfrequently against ingratitude,* exclusive of the personal hazard among the sick, the fatigue, and the loss of ordinary comfort and rest which it necessa- rily involves. I. A physician can not successfully pass through his career without the aid of much fortitude of mind, and a religious sense of all his obligations of conscience, honor, and humanity.-j- His per- mit uufortunately happens that the only judges of medical merit, are those who have sinister views in concealing and depreciating it. John Gregory, M. D. Lee. 1, on the duties of Phvti. cianSfp. 17. l*on, Ed, J * fAence appear, the necessity of a physician having a large share of good sense, and knowledge otT the world, as weU as medical genius and learning. Jhid.p. 17. Requisites. 29 sonal character should therefore be that of a perfect gentleman, and above all, be exempt from vulgarity of manners, habitual swearing, drunkenness, gambling, or any species of debauchery, and contempt for religious practices and feelings.* II. The confidence of the public can not be awarded to a phy- sician who has rendered himself notorious for felony or misdemea- nor, or who has incurred penalties for crimes. III. A physician in indigent circumstances is not permitted toNootherbos. embrace or exercise any business which would degrade the charac-embraceddtf* /.,.-. ring theprac- ter of his profession ; such as keeping a tavern, lottery office, gam-Uceofmedi- bling, victualling, or play-house. Any low trade or servile merce- nary occupation, is incompatible with the dignity and independence 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 and 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 nractices with nostrums, secret medicines, or patent remedies, is Nostrum* 1 and secret guilty of quackery. medicines. V. The right of a patent medicine being incompatible with the duty and obligations enjoined upon physicians to advance the know- ledge of curing diseases, it constitutes quackery, and can not be pro- fessionally countenanced. VI. Public advertisements, or private cards, inviting customers Advertise. 1 ments, cards, afflicted with defined diseases; promising radical cures; engaging**. •The 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 invocation to the Supreme Ruler. F. E. Fa- dere. Vid. Diction its science* medicalti, art. Med. Police. 30 for no cure, no pay / offering advice and medicines to the poor, gratis; producing certificates and signatures, even from respecta- ble individuals, in support of the advertiser's skill and success, and the like, are all absolutely acts of quackery, which medical institu- tions should also repress, and punish by the rejection or expulsion of those who commit them. THIRD DIVISION. Consultations. Consultation ^ji fae 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. Q ... ^ The examination by the censors of the county and state societies, tions, &C of candidates for the degree of license, and by the professors of col- leges for the degree of doctor^ are equally directed to embrace in their exercises, the elements and doctrines of both sciences, estab- lishing 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. Prac- tical surgery is more properly attended to by the younger members, but the more experienced should be deemed competent to direct 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 propnety, and if adhered to, arises from the wish to indulge in personal or interested motives. It is admitted, however, that when the question is merely 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 proper,) to perform a necessary operation, and by no means invalidates the principle established in the state of New-York, in conformity to medical ethics.* ♦Among the moderns, the arts of physic and surgery have often been promiscuously practiced by the same person: for example, Aildanus, Severimu, Barthfiline, and many ethers it distinguished genius and leaning. 31 VII. A consultation of one or many physicians is like a delibe- rating committee, over which a senior in age or experience presides, each one, however, being equally responsible for the trust assigned to him of the cure and relief of the patient. The attending physi- cian is exclusively charged with the execution of the treatment 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-0^^^" nior practitioner of surgery in the consultation, or on one especially appointed* VIII. A diversity of opiuion 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 '.hat a correct sense of delicacy will i.i 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 delibe- rative votcf IX. A great reserve, and even secrecy respecting the delibera-Reservei ^ tions of a consultation, is indispensable. No communication is tOi™*5^1* be made to the patient or friends, but by unanimous order and con- 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. X. It is the duty of a consulting physician to take care that his v!'!b ofLC0B/ J ° r J suiting physi- visits be not multiplied without necessity. He is, through courtesy,cian,and,,lr- at liberty to decide, when to discontinue his attendance. A consul- ting physician, however, can not be dismissed without the consent of the patient as well as of the attending physician. XI. Physicians are justly censurable if their patient be in danger Advice. and they do not in time procure advice and responsibility besides their own. Whatever be the motive that induces them to dispense *Iu consultations, the junior physician (or the physician in ordiuary) should deliver his opinion first, and the others in the progressive order of seniority. T Percival. Med. Ethics, p. 19 f " Every physician must rest on his own judgment, which appeals for its rectitude to nature and tipericnce alone." J. Gregory, Lect. 1. on the duties and qualities, tfc. Land. Ed. p. 14. " But an obstinate adherence to an unsuccessful method of treating a disease, is self-conceit J it ^newHy proceed framignoiwtf—ttJUsttfcieitfpjidt t9 wfcfolt Um Ijvel 6f IWuiruxlJ hive 32 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 patients 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 practicing physician who can not 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. D ti XII. Physicians are often requested to declare to the patient his danger, and to urge his observance of religious and testamentary acts ; but medical aid, in extremely dangerous cases, would seldom be of any avail, if in place of composing the mind of the sufferer, 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 authorized 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 various family claims and pretensions; and a physician's inteference in their distribution may be taxed as arising from interested motives, or be thought by those concerned to be a disgraceful violation of the confidence reposed on his humane functions as medical atten- dant. In order to protect himself, and to place his name beyond the reach of any implication, he should, Notice of lst* Give timely and explicit information of the dangerous situa- daoger.fce. tjon 0f the patient, to those who have the best right to advise him in his religious and temporal concerns. 2d. He should inform them of a possibility of a change in the prognostic, in order to prevent any relaxation of care and attention 33 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.* XIII. 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 obser- vance 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, to promote immorality, or to* be accessory to vicious and criminal conduct. XIV. Honor and justice particularly forbid a medical practi-priviieg< tioner's infringing upon the rights and privileges of another who is a eD "' 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 services *" It is as much the business»of a physician to alleviate pain and to smooth the avenues pf death, when unavoidable, as tb cure diseases." Vid. 7 QrtgoiVs Ltctvrtt. Diti. Ed.p- S9t and B$n- jdmtn Rdth*i opptnllva o* tht dutfe* of a physician, dn. XL 34 Visits, 4c. they receive, are the natural judges of these intellectual advantages* In all probability, every good physician would receive a merited share of patronage, were there not many who usurp a portion through artful insinuations, and slanders of others, or combinations against, or improper interferences with, the more worthy practitioner. Any physician thus molested or injured, is justifiable in applying for re- dress to the county medical society to which he is attached. 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 at- XVI. Libellous attacks among physicians are no doubt subject taeks, &c. Dr ; J to the same mode of redress by damages as the law points out to other citizens ; but we hold that matters of libel include professional 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 pro- fessional reputation of a physician. This identical principle was adopted by the supreme court of Pennsylvania in the trial of Benp 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 mali- cious representation of the plaintiff's practice, made to the public by the defendant. Medical con- XVII. If medical controversies are brought before the public in trorersies. . s _ * 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; 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 revengeful deportment, so contrary to what is expected from literary and scien-< tific gentlemen. Such papers are therefore to be reported by the censors to their respective county medical societies, and the authors are liable to such punishment as the case may require. Confidential- It is a matter of justice, necessity and propriety, that the business **cy' c' of a physician and surgeon should be always considered of a confi- dential nature. Even secrecy, in certain circumstances, as will be explained hereafter, is the privilege of the faculty* and iny^ofcbje 35 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 captan- dum, yet in most cases they produce but an equivocal admiration for the narrator, and prove besides his very imperfect knowledge of human nature. Those who are not familiar with the subjects ofWr°"Sinfe- J renees. medical art and study, are liable to draw mistaken and contradictory inferences from what they hear concerning them. Hence many people suppose that a physician is an unfeeling man; and assimi- late a good surgeon to a butcher. The more talk, therefore, the more numerous the misrepresentations set afloat, and the greater the diffidence, 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 di- rections 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. XX. In urgent cases of sickness, or of injuries occasioned bycaiistohe accidents, a call for medical or surgical help should be obeyed im-£be^d%cs> mediately, unless such compliance be to the detriment of someSSJ^Jjj^ other sufferer. It often happens in such cases that many physicians,11"- and more than are required, meet on the spot. Courtesy then as-Courtesy, fce. signs the patient to the first physician or surgeon who arrives, and if he should want assistance, he has a right to request it from a phy- sician or practical surgeon present, according to the nature of the case. But if the physician or surgeon who usually attends the fa- 36 mily or patient, be of the number, then the present urgent case is assigned to him. Concerning In tne event of concurring attendance of many medical gentlemen, attendance. n0 fee IS to De exacted for the trouble of coming, unless called upon by some authorized person. An accidental injury is distress, and help for a fellow-being in distress, is claimed by the laws of nature.* _ XXI. The fees for the compensation of medical services are x ees, com- * pensation, &c.regulated by the value of currency, and the price of necessaries in different countries and cities; by the customs approved and estabr 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 me- dical services. A strict sense of justice and honor towards each fellow member pCrh&nrcs, Jus* Ifceandhoa- of the profession, should prevent a physician from undervaluing his 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 terms he pleases, but he has no right to make the low charges an established usage to the prejudice of his brethren. The reputation of a cheap doctor, after all, is neither dignified nor enviable. Demands— Others will follow quite a contrary method. They will place an Iheir charac- . . J • J r ter. exorbitant value on their time and labor, and exact oppressive de- mands for their services. The conduct of such has a very injurious influence over the lower and middling classes of society, who, need- ing 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 grati- fies his vanity, if not his resentment, by divulging how much money he has been willing to bestow, what liberality he has exercised, or to what imposition he has been exposed! ♦Dr. Gregory says (p. 179) "that under such circumstances, considerations of benevolence, hu- manity and gratitude are wholly set aside ; for when disputes arise, they must be suspended or ex. ingmshed and the question at fssue can alone be decided on the 'principle of commulaUve »«»• Uce.' » If a nhysic.an would, herefore, contend for remuneration, it could not be as a mtdiclk /ee.but an iniemni y only for the e.penses of transportinghimself there, where he tnZhtbew tpd. The question is the more easily settled, »s it na, uoVlher refere^to wdtoV wan- 37 Some physicians, more intent on acquiring wealth than a good Law"*u!,fc name, exact from their patients their charges, whether great or small, with unrelenting severity, refusing time to procure the necessary 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 me- dical 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 Hippocrates 9.1*i.nMof m*" oical precep- imposed upon the pupils of the noble science of medicine and sur- i°n and mas- gery, which is also the model of the like engagement offered to the candidates for graduation in this and other countries, that they shall respect and assist their preceptors and masters, their seniors by ex- perience or age, and shall contribute as far as in their power, to the honor, improvement, and utility of their professions. According 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 improvement, because much can yet be done to extend its usefulness. This ob-Estrange- ligation is unbecomingly violated by many physicians who pretend dSsiveness'of to eminence ; they estrange themselves from medical associationsmember*- ■—never have any observation or improvement to communicate— their degree of skill and experience always remains unknown and mysterious—they screen themselves from scientific labors and con- troversies ; and, as if incompetent, never contribute by any effort, however small, to the advancement of the medical character. Such practitioners, although they are frequently popular and wealthy, are, nevertheless, only comparable to drones in the bee-hive; medical associations should refuse to confer upon them offices, appointments, 38 or even employments in committees, on the principle that proofs are wanting of their talents, zeal, judgment and professional emulation. 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 Judicial in- °riginating could be perpetrated in ways so disguised to conceal quisitions. the authors, or the means by which they were accomplished, were it hot that juries can be assisted by medical men in evidence rela- ting to physiology. A physician should always be in readiness to Rules there- an3wer in these judicial inquisitions, and to give an opinion, on facts referring to his judgment, according to the approved doctrines of medicine and surgery, as far as these are ascertained. Ignorance, or an imperfect knowledge upon matters which place life, honor and innocence in a fatal predicament, is unpardonable, and should sub- ject 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 nature and extent of the secrecy which they are bound to maintain in relation to their patients. Decisionsof 1st. When physicians engaged in the decision of a forensic ques- tion are unbiassed by the parties, and have no interest for plaintiff or defendant, (being well informed of all the facta alleged in evi- dence,) they have only to decide by known medical principles, and can therefore rarely disagree. It is their duty to obtain every pos- sible information upon the case, and before giving in their declara- tion, candidly and conscientiously to canvass each other's opinions, so that erroneous ideas may be removed, and information participa- ted.* Two or more physicians on one side of a question, should •When two or more gentlemen of the faculty are to offer their opinions or testimony, it would sometimes tend to obviate*contrariety, if they were to confer freely with each' other, before their public tsasBiaatiaii. T- FtrtiVal, Med. EtAt'c»,cA» 4, page lOT. 39 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 Secrfcy 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 judg- ment and treatment of syphilitical 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-excePtin»*- J . . ,es °* treason lie Confessional, which admits of no disclosures except in cases of «>d murder. treason or murder.* This inference has been acknowledged by the judiciary of New-York, and, in its application to medical mat- ters, admitted by that of Pennsylvania in the year 1800.f The Revised Statutes of our state have, however, prescribed the duty of physicians on this point. In the second volume, (page 406,) is the following enactment:— " No person duly authorized to practice physic and surgery, shall No disele* 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 patient 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: *The sacred duty or privilege of a Catholic priest not compellable to disclose the secrets of Suricular confession, was maintained by a decision of the court of sessions of New-York, 14th of une, 1813, in the case of the Rev. Mr. K refusing his testimony on a matter of felony. Vid. Cathol. guest, report, by PTwi. Sampson, Esq. fMany persons would rather suffer or die than be exposed to shame or disgrace from the com- tfaints they are Iaboring under. It is a law of nature that they should seek for cure or relief) and »nisji«ilfcifrrt^ 40 Whereas a great diversity of opinion exists amongst the medical profession of our state, on the powers of Medical Societies as td the admission of member's ; and wheroas 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, 1S33. Doctors M'Call, Burwell and Taylor. Gentlemen,—In pursuance of the request of the Medical Society of this state, communicated through you, I have given a brief con- sideration to the powers of the County Medical Societies, relating to the admission and expulsion of members. The first act authorizing the incorporation of Medical Societies, 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. This act, after reciting that "well regulated 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 m 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 societ*"s were empowered at their annual meetings, to make by-laws & ".- regulations "relative to the affairs, concerns and pro- perty of said societies, relative to the admission and expulsion of members, 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 vii. 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 41 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 courts, the society can have no power over its members, other than such as this statute has provided. 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 maybe 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 regulations, may either expel a member, or may deliver charges to the district attorney; and the member may be expelled from the society by the judges of the county court. In the first case the member loses no- thing but the benefits of the association : in the last case he may be for ever disqualified from pursuing his profession, or be suspen- ded 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 of New-York. 3 Wend. 426. I am, with great respect, Your obedient servant, GREENE C. BRONSON.