upon the rectitude of his judgment, he should, when left in the minority, politely and consistently retire from any further deliberation in the consultation, or a participation in the management of the case. § 9. As circumstances sometimes occur to render a special consultation desirable, when the continued attendance of another physician might be objectionable to the patient, the member of the faculty whose assistance is required in such cases, should sedulously guard against all future unsolicited attendance. As such consultations require an extraordinary portion both of time and attention, at leasta double honorarium may be reasonably expected.

§ 10. A physican who is called upon to consult, should observe the most honorable and scrupulous regard for the character and standing of the practitioner in attendance; his practice, if necessary, should be justified as far as it can be, consistently with a conscientious regard for truth and honesty, and no hint or insinuation should be thrown out, which could impair the confidence reposed in him, or affect his reputation. He should also carefully refrain from any of those extraordinary attentions or assiduities, which are too often practiced by the dishonest for the base purpose of gaining applause, or ingratiating themselves into the favour of families and individuals.

ART. V.-Duties of Physicians in cases of interference.

§ 1. Medicine is a liberal profession, and those admitted into its ranks should found their expectations of practice upon the extent of their qualifications, not on intrigue or artifice.

§ 2. A physician, in his intercourse with a patient under the care of another practitioner, should observe the strictest caution and reserve. No meddling inquiries should be made; no disingenuous hints given relative to the nature and treatment of his disorder; nor any course of conduct pursued that may directly or indirectly tend to diminish the trust reposed in the physician employed.

§ 3. The same circumspection and reserve should be observed, when, from motives of business or friendship, a physician is prompted to visit an individual who is under the direction of another practitioner. Indeed, such visits should be avoided, except under peculiar circumstances, and when they are made, no particular inquiries should be instituted relative to the nature of the disease, or the remedies employed, but the topics of conversation should be as foreign to the casc as circumstances will admit.

§ 4. A physician ought not to take charge of, or prescribe for a patient who has recently been under the care of another member of the faculty in the same illness, except in cases of sudden emergency, unless it be in consultation with the gentleman previously in attendance, or the latter has relinquished the case, or been regularly notified that his services are no longer desired. Under such circumstances no unjust and illiberal insinuations should be thrown out in relation to the conduct or practice previously pursued, which should be justified as far as candor and regard for truth and probity will permit; for it often happens, that patients become dissatisfied when they do

not experience immediate relief, and, as many diseases are naturally protracted, the want of success, in the first stage of treatment, affords no evidence of a lack of professional knowledge and skill.

§ 5. When a physician is called to an urgent case, because the family attendant is not at hand, the care of the patient ought to be resigned to the latter as soon as his attendance can be obtained, unless assistance in consultation be desired.

§ 6. It often happens, in cases of sudden illness, or of recent accidents and injuries, owing to the alarm and anxiety of friends, that a number of physicians are simultaneously sent for. Under these circumstances courtesy should assign the patient to the first who arrives, who should select from those present any additional assistance that he may deem necessary. In all such cases, however, the individual who officiates, should request the family physician, if there be one, to be called, and on his arrival, should resign the case to him, unless his further attendance be requested.

§ 7. If a physician be called to the patient of another practioner, in consequence of the sickness or absence of the latter, he ought, on the return or recovery of the former, with the consent of the patient, to su rrender the case.

§ 8. A physician, when visiting a sick person in the country, may be desired to see a neighbouring patient, who is under the regular direction of another physician, in consequence of some sudden change or aggravation of symptoms. The conduct to be pursued on such an occasion is to give advice adapted to present circumstances; to interfere no farther than is absolutely necessary with the general plan of treatment; to assume no future direction, unless it be expressly desired; and in this case, to request an immediate consultation with the practitioner antecedently employed.

§ 9. A wealthy physician should not give advice gratis to the affluent; because it is an injury to his professional brethren. The office of a physician can never be supported as an exclusively beneficent one; and it is defrauding, in some degree, the common funds for its support, when fees are dispensed with, which might justly be claimed.

§ 10. When a physician who has been engaged to attend a case of midwifery is absent, and another is sent for, if delivery is accomplished during the attendance of the latter, he shall be entitled to the fee, but shall resign the patient to the practitioner first engaged.

ART. VI.-Of difference between Physicians.

§ 1. A diversity of opinion, and opposition of interest, may in the medical, as in other professions, sometimes occasion controversy and even contention. Whenever such cases unfortunately occur, and cannot be immediately terminated, they should be referred to the arbitration of a sufficient number of physicians, or a court medical.

And as peculiar reserve must be maintained by physicians towards the public, in regard to professional matters, and as there exist numerous points in medical ethies and etiquette through which the feelings of medical men may be painfully assailed in their intercourse

with each other, and which cannot be understood or appreciated by general society, neither the subject matter of such differences nor the adjudication of the arbitrators should be made public, as such publicity may be personally injurious to the individuals concerned, and can hardly fail to bring discredit on the faculty.

ART. VII.-Of Pecuniary Acknowledgments.

§ 1. Some general rules should be adopted by the faculty, in every town or district, relative to the pecuniary acknowledgments from their patients; and it should be deemed a point of honour to adhere to this rule with as much steadiness as varying circumstances will admit.

CHAPTER III.

Of the Duties of the Profession to the Public, and of the Obligations of the Public to the Profession.

ART. I.-Duties of the profession to the public.

§ 1. As good citizens, it is the duty of physicians to be ever vigilant for the welfare of the community, sustaining its institutions and burdens, and in addition they should be ever ready to give counsel to the public in relation to matters especially appertaining to their profession, as on subjects of medical police, public hygiène, and legal medicine. It is their province to enlighten the public in regard to quarantine regulations, the location, arrangement, and dietaries of hospitals, asylums, schools, prisons, and similar institutions; in relation to medical police of towns, as drainage, ventilation, &c., and in regard to measures for the prevention of epidemic and contagious diseases; and when pestilence prevails, it is their duty to face the danger, and to continue their labours for the alleviation of the suffering, even at the jeopardy of their own lives.

§ 2. Medical men should also be always ready, when called on by the legally constituted authorities, to enlighten coroners' inquests and courts of justice on subjects strictly medical, such as involve questions relating to sanity, legitimacy, murder by poisons or other violent means, and in regard to the various other subjects embraced in the science of Medical Jurisprudence. But in these cases, and especially where they are required to make a post-mortem examination, it is just, in consequence of the time, labour and skill required, and the responsibility and risk he incurs, that the public should award him a proper gratuity.

§3. There is no profession by the members of which eleemosynary services are more liberally dispensed than the medical, but justice requires that some limits should be placed to the demands for them. Poverty, professional brotherhood, and certain public duties, referred to in 1 of this chapter, should always be recognized claims for gratuitous services; but neither institutions endowed by the public or by rich individuals, societies for mutual benefit, the insurance of lives or for analogous purposes, or any profession or occupation, can be admitted to possess such prerogative. Nor can it be justly expected of physicians to furnish certificates of inability to serve on juries, to per

form militia duty, or to testify to the state of health of persons wishing to insure their lives, obtain pensions, or the like, without a pecuniary acknowledgment. But to individuals in straitened circumstances, professional services should always be cheerfully and freely accorded. § 4. It is the duty of physicians, who are frequent witnesses of the enormities committed by quackery, and the injury to health, and even destruction of life caused by the use of quack medicines, to enlighten the public on these subjects, to expose the injuries sustained by the unwary from the devices and pretensions of artful empirics and impostors. Physicians ought to use all the influence which they may possess as professors in Colleges of Pharmacy, and as having the option, in a great measure, of the shops to which they send their prescriptions, to discourage druggists and apothecaries from vending quack or secret medicines, or from being in any way engaged in their manufacture and sale.

ART. II. Obligations of the public to physicians.

§ 1. The benefits accruing to the public directly and indirectly from the active and unwearied beneficence of the profession, are so numerous and important, that physicians are justly entitled to every consideration and respect from the community. The public ought likewise to entertain a just appreciation of medical qualifications;-to make a proper discrimination between true science and the assumptions of ignorance and empiricism-to afford every encouragement and facility for the acquisition of medical education,-and no longer to allow the statute books to exhibit the anomaly of exacting know. ledge from physicians, under liability to heavy penalties, and of making them obnoxious to punishment for resorting to the only means of obtaining it.

TO THE MEDICAL CONVENTION ASSEMBLED IN PHILADELPHIA IN THE MONTH OF MAY, 1847.

Report of the Committee on the Organization of the National Medical Association, as ordered by the National Medical Convention held in the city of New York in the month of May, 1846.

The Medical Convention held in the city of New York, in May last, having resolved, "That it is expedient for the Medical Profession of the United States to institute a National Medical Association," and having appointed a committee of seven, consisting of Drs. John Watson, John Stearns, and F. Campbell Stewart, of the city of New York; A. Stillé, of Philadelphia; N. S. Davis, of Binghamton, N. Y.; W. H. Cogswell, of Plainfield, Conn.; and E. D. Fenner, of New Orleans, "To report a plan of organization for such an association, at a meeting to be held in Philadelphia, on the first Wednesday in May, 1847;" the said committee, after carefully deliberating on the business entrusted to them, beg leave respectfully to report.

Plan of Organization for a National Medical Association. Whereas, the Medical Convention, held in the city of New York in

May, 1846, have declared it expedient "for the Medical Profession of the United States to institute a National Medical Association ;" and,

Inasmuch as an institution so conducted as to give frequent, united and emphatic expression to the views and aims of the Medical Profession in this country, must at all times have a beneficial influence, and supply more efficient means than have hitherto been available here, for cultivating and advancing medical knowledge, for elevating the standard of medical education, for promoting the usefulness, honour, and interests of the Medical Profession; for enlightening and directing public opinion in regard to the duties, responsibilites and requirements of medical men, for exciting and encouraging emulation and concert of action in the profession, and for facilitating and fostering friendly intercourse between those who are engaged in it;— therefore,

Be it resolved, in behalf of the Medical Profession of the United States, that the members of the Medical Convention held in Philadelphia, in May, 1847, and all others who, in pursuit of the objects above mentioned, are to unite with, or succeed them, constitute a National Medical Association ;-and that, for the organization and management of the same, they adopt the following

REGULATIONS.

1. TITLE OF THE ASSOCIATION.

This institution shall be known and distinguished by the name and title of The American Medical Association."

II. MEMBERS.

The members of this institution shall collectively represent and have cognizance of the common interests of the medical profession in every part of the United States; and shall hold their appointment to membership either as delegates from local institutions, as members by invitation, or as permanent members.

The Delegates shall receive the appointment from permanently organized medical societies, medical colleges, hospitals, lunatic asylums, and other permanently organized medical institutions of good standing, in the United States. Each delegate shall hold his appointment for one year, and until another is appointed to succeed him, and shall participate in all the business and affairs of the association.

Each local society shall have the privilege of sending to the association one delegate for every ten of its regular resident members, and one for every additional fraction of more than half of this number. The faculty of every regularly constituted medical college or chartered school of medicine, shall have the privilege of sending two delegates. The professional staff of every chartered or municipal hospital containing a hundred inmates or more, shall have the privilege of sending two delegates; and every other permanently or ganized medical institution of good standing shall have the privilege of sending one delegate.