REGULATIONS AND SYSTEM OF ETHICS OF THE MEDICAL ASSOCIATION OF THE DISTRICT OF COLUMBIA. FEBRUARY, 1884. WASHINGTON : PRINTED BY JUDD & DETWEILER. 1884. REGULATIONS AND SYSTEM OF ETHICS OF THE MEDICAL ASSOCIATION OF THE DISTRICT OF COLUMBIA. FEBRUARY, 1884. WASHINGTON: PRINTED BY JUDD & DETWEILER. 1884. Wfwew of the IMtal 3JwMod)rtioB, 1883. 1). R. Hagner, M. D. ..... President. D. W. Prentiss, M. D. C. H. A. Kleinschmidt, M. 1). Vice-Presidents. J. F. Hartigan, M. D. Secretary. G. L. Magruder, M. D. Treasurer. COL NSELORS. -STANDING COMMITTEE. William Gray Palmer, M. D. Joseph Taber Johnson, M. D. J. W. H. Lovejoy, M. D. C. W. Franzoni, M. D. John W. Bulkley, M. D. W. H. Taylor, M. D. D. C. Patterson, M. D. C. E. Hagner, M. D. T. E. McArdle, M. D. CENSORS. J. O. Stanton, M. D. T. C. Smith, M. I). T. E. McArdle, M. D. EX-PRESIDENTS. Frederick. May, M. D., elected January, 1833. Alexander McWilliams, M. D., elected February 8, 1847. William Jones, M. D., elected May 7, 1850. Joshua Riley, M. D., elected May 13, 1858. Noble Young, M. D., elected April 7, 1868. ]. W. H. Lovejoy, M. D., elected April 5, 1870. Thomas Miller, M. D., elected April 1, 1873. F. Howard, M. I)., elected October 7, 1873. S. C. Busey, M. D., elected April 6, 1875. Louis Mackall, M. 1)., elected April 4, 1876. James E. Morgan, M. D., elected April 1, 1879. Johnson Eliot, M. D., elected April 6, 1880. J. Ford Thompson, M. D., elected April 5, 1881. A. Y. P. Garnett, M. D., elected April 4, 1882. REGULATIONS. 1. This Association shall be known as the Medical Asso- ciation of the District of Columbia, and shall consist of practitioners of this District, who shall have become mem- bers or licentiates of the Medical Society of the District of Columbia. It shall hold stated meetings, on the first Tues- day in April and October, at eight o'clock p. m., at such place within the city of Washington as may be designated by the presiding officer, and on its own adjournment. At each meeting any number of members not less than ten shall constitute a quorum. 2. All applications for membership shall be made in writing, addressed to the President, who shall refer the ap- plication to the Board of Censors, which shall inquire into the qualifications of the applicant and report upon the same to the Association. Upon report a ballot shall be taken, and on favorable vote of two-thirds of the members present he shall be admitted to membership on signing the regula- tions, in accordance with Article 26, within one month after such election. 3. The officers of this Association shall consist of a Pres- ident, two Vice-Presidents, a Secretary, a Treasurer, nine Counselors, and three Censors, who shall be elected by ballot by a majority of the members present at the stated meeting in April of each year. Any vacancy shall be filled at the meeting next succeeding its occurrence. The delegates to the American Medical Association shall be elected at the stated meeting in April, or at an adjourned meeting held within ten days thereafter. The delegates elected shall signify to the Secretary of the Medical Associa- tion, in writing, within ten days, their acceptance and de- 4 termination to serve. In cases of declension or failure to accept, the Secretary shall notify the Standing Committee, and thereupon the Standing Committee shall fill the vacan- cies, and shall immediately certify to the Secretary of the Medical Association the names of those so elected. Creden- tials shall be issued only to those who shall have expressed their determination to serve. 4. The President shall preside at the meetings of the Association, and in his absence one of the Vice-Presidents. In the absence of these officers a temporary chairman shall be chosen from the members present. "). The Secretary shall keep a record of the proceedings of the Association, and conduct all correspondence. He shall give notice (by order of the President) of both stated and special meetings of the Association, by advertising the same at least three times in one of the public newspapers. He shall notify officers of their election, and persons elected to membership, calling the attention of the latter to the neces- sity of signing the regulations ; he shall also notify dele- gates elected to the American Medical Association immedi- ately on their election, and request them to inform him of their acceptance or non-acceptance, within ten days, as re- quired by section 3. He shall also send a printed copy of the regulations to every physician, upon his final settlement in the District. He shall have printed annually, about the 1st of May, a roster of the resident practitioners members of this Association, together with their addresses for the use of the members. 6. The Treasurer shall collect all assessments and disburse the same on the certificate of the member or members, expending the amount by authority of the Association ; and at the stated meetings he shall render to the Association an account of all the funds received, with the vouchers for his disbursements. He shall also furnish the Secretary, annu- ally or otherwise, a list of delinquent members, as provided for in section 10. 5 7. The Counselors shall constitute a Standing Committee to attend to and decide on all matters which regard the honor and interest of the Association, and especially all in- fringements of the regulations which may come to their knowledge, and shall require special meetings of the Asso- ciation to be called when they deem it necessary. The Standing Committee shall appoint its chairman and secre- tary from its own members and define the duties of the same. Five members shall constitute a quorum for the transaction of any business. 8. Investigation in cases of alleged violations of regula- tions shall proceed only upon written charges made by one or more members of the Association to the Committee, ac- companied with the names of the party or parties cognizant of the alleged facts. The Committee shall then proceed to investigate the accusation and to collect the testimony, both of the witnesses whose names may have been furnished, and such other testimony as may come to their knowledge. The Committee shall have authority to summon and examine members, and in the event of the failure or refusal of any member to give evidence, they shall report such failure or refusal to the Association for such action as that body may deem proper. 9. Should the Standing Committee, by a vote of two-thirds, find any member guilty of a violation of the rules of the As- sociation, they shall require the President to immediately call a special meeting of the Association, to which they shall report their decision, with the facts and the evidence ad- duced, all of which shall be read forthwith In open meeting, and should such decision be confirmed by a vote of two- thirds of the members present at an adjourned meeting, which shall be held within ten days, the member accused shall receive such punishment as may be determined by a vote of two-thirds of the members present. Minor com- plaints and differences between members may be adjusted by the committee without reporting to the Association. Tn 6 all cases, however, an appeal may be made from the decision of the committee to the Association. 10. The Standing Confimittee shall assess the amount re- quired for the contingent expenses of the Association equally upon all the members: Provided, The amount of such as- sessments shall in no one year exceed the sum of two dol- lars; and if any one shall refuse or neglect for the period of two years to pay his assessment, his connection with the As- sociation shall thereupon cease, and the Secretary shall in- form the members of the same by a circular note. 11. The Standing Committee shall keep a full record of all their acts and proceedings, and submit the same to the Association, if required by one-third of the members of the Association present. 12. Special meetings of the Association shall be called by the President, or, in his absence, by a Vice-President, when required by the Standing Committee, or on written applica- tion of three members of the Association. Meetings of the Standing Committee shall be called at the discretion of its chairman, or on the written application of two of its mem- bers. 13. It is expected that every member who becomes ac- quainted with any breach of the regulations of this Associa- tion will make it known to the Standing Committee, which shall inquire into the same. 14. The following fees shall be charged for professional services, subject, however, to the several rules which are ap- pended : First visit or prescription $2 to $5 Each subsequent visit 2 " 3 First consultation visit 5 " 10 Each subsequent consultation visit 3 " 5 The attending physician is entitled for each meeting to 3 " 5 Visit at night, (night is understood to commence at 10 p. m. and end at 8 a. in.,) 5 " 10 Advice at night at physician's house 3 " 5 7 Visiting out of the city, in addition to the usual fee for the visit, for every mile from the centre of the city $2 Detention in any case at patient's house 5 to $10 Visiting at an hour specified by the patient, the usual consultation fee. All cases of small-pox, for each visit 3 " 5 Cases of midwifery, natural 15 " 30 " " preternatural 30 " 200 Extracting placenta alone 10 " 15 (All obstetrical services Cash.) For every necessary subsequent visit in cases of midwifery after the fifth day, the usual fee for visits. Capital operation, as for example, amputating large limbs, lithotomy, trepanning, excision of large tumors, operation for strangulated hernia, for aneurism, extirpation of cancerous breast, ligation of large arte- ries, &c- 50 " 300 Operation for lacerated perineum 20 " too Operation for lacerated cervix uteri 50 " 200 Operation for removal of uterine tumors100 " 500 Operation for vesico-vaginal or recto-vaginal fistula50 " 500 °variotomy100 " 500 Important operations on the eye 50 " 300 Minor operations on the eye 5 " 20 Extraction of foreign bodies from eye 3 " 15 Operation for piles 25 " 200 Tracheotomy 30 " 100 Operation for sub-cutaneous tenotomy 20 " 100 Operation for hare-lip 20 " too Each subsequent dressing, at the usual rate for dressing wounds. Reduction of strangulated hernia 20 " 50 Paracentesis abdominis 15 " 5° Operation for hydrocele 15 " 30 " " radical cure 20 " 50 Operation for fistula in ano: 25 „ 50 Operation for fissure of anus 10 " 50 Each subsequent dressing, at the usual rates for dressing wounds. Extirpation of polypus 10 to 30 " " tumors of minor importance 10 " 50 " " tonsils, each 10 " 30 Amputations of fingers or toes 20 " 30 " through tarsal or metatarsal bones 25 " 50 Reduction of dislocation 20 " 50 Adjustment of fractures of long bones 15 " 30 Subsequent attendance at the ordinary rates, and each renewal of bandages or apparatus 5 " 15 Application of truss 5 " 15 Passing catheter or bougie 5 " 15 Use of speculum for vagina or rectum 5 " 15 Introduction and adjustment of pessary 5 " 15 Examination of eye by opthalmoscope 5 " 15 Microscopic examinations 5 " 15 Special examination of chest by auscultation and percussion 5 " 15 Removing foreign bodies lodged in cesophagus 5 " 15 Dressing recent wounds, &c., in addition to visit... 3 " 10 All subsequent dressings, in addition to visit 2 " 3 Opening abscess 5 « 13 Administering medicine by hypodermic injection, 2 " q Vaccination 3 Re-vaccination 2 8 Venesection $2 to $5 Cases of gonorrhoea, first examination and prescription (Cash) 5 " 10 Each subsequent perscription (Cash) 3 " 5 Case of syphilis, first examination and prescription (Cash) -- io " 15 Each subsequent perscription (Cash ) 3 " 5 For each assistant in surgical operations 10 " 25 For post mortem examinations, when ordered 10 " 50 For a post mortem examination in a case of legal investigation 20 " 100 For attendance upon court, per day 50 " too For an examination involving a question of law in a case in which the physician may be subpoenaed, and in all cases in which the physi- cian is required to give a medical opinion before a Committee of Congress 10 " too For services, to distant patients, in addition to expenses of travel, per day 50 " 250 For a letter of advice, or written opinion 5 " 25 All certificates of life insurance, insanity, &c 3 " 10 Office instruction, $100 per annum ; $50 semi-annually in advance. 15. The foregoing table contains the standard fees which shall be demanded ; they shall be increased according to the judgment of the practitioner concerned, in all cases of extraordinary detention or attendance; also, in proportion to the importance of the cases, of the responsibility attached to it, and to the services rendered, when these are extraor- dinary. They shall be diminished at the discretion of the physician when he believes that the patient cannot afford to pay the regular fees, and yet is able to make some com- pensation. It shall be considered, however, as unprofessional to diminish the standard fees, except from motives of charity and benevolence. Medical officers connected with the staffs of the hospitals and dispensaries of the District of Co- lumbia, shall be entitled to charge the usual fees for medi- cal services rendered to patients able to pay for medical attendance. It is not designed by these regulations to prevent gratui- tous services to those who are incapable of making remu- neration without distressing themselves or families. 16. When a physician engaged to attend a case of obstet- rics is absent, and a second attends the patient, the latter may charge the full fee, but shall relinquish the patient to the first; and in no case shall the second continue to attend, except to render indispensable service during the continued absence or disability of flic first. 9 In cases where a consulting physician is called in, both the attending and consulting physician shall charge at least the ordinary fee for delivery ; but when the latter is not detained in attendance, he should only charge the usual fee for consultation. 17. It is recommended to the members of this Association to present their accounts for professional services at the close of the attendance; and it shall be the duty of each member to obtain a settlement from all his families at least once in three months, viz: the first of January, the first of April, the first of July, and tho first of October. 18. No member of this Association shall make a contract, expressed or implied, to attend an individual or family by the year, or on any other terms than those authorized by these regulations. 19. No member of this Association shall consult with any resident practitioner of this District who is not a member thereof, after said practitioner shall have resided six months in said District. The privilege of consultation may be extended beyond that between members, to medical officers of the army and navy not members of this Association, provided such officers do not engage in general practice among civilians ; also to associate members, to women practitioners, and practition- ers of African descent who have received a license from the Medical Society of the District of Columbia, provided such practitioner act in conformity to the ethics of the American Medical Association. 20. While the privilege of selecting the consulting phy- sician is conceded to the patient or his immediate family, nevertheless, as the good of the patient is the sole object in view, it shall be allowable for the attending physician to express his preference. 21. All resignations of members shall be made in writing 10 to the President, by whom they shall immediately be laid before the Standing Committee, who shall either notify each member of the Association, or call a meeting of the Asso- ciation as they may think proper. 22. Medical practitioners holding clerkships in the Gov- ernment offices, or engaged in any business not connected with the regular practice of medicine, shall not be eligible to membership in the Association, but may become associate members. And after any member shall accept a clerkship in the Government offices, or engage in any business not connected with the regular practice of medicine, he shall ipso facto become an associate member. The associate members shall be entitled to the benefits of consultation, but to no other privilege of the Association. Candidates for associate membership must be licentiates of the Medical Society of the District of Columbia, shall make application and be recommended and elected in the same manner as the members, and shall sign, within one month, the approval and pledge contained in the 26th article of the regulations, of which the Secretary shall keep a copy for their signature, separate from that for members, and they shall be subject to the same liabilities, except assessments, as the members. 23. The Code of Ethics of the American Medical Associa- tion is hereby adopted as the code of ethics of this Associa- tion, and made a regulation binding upon its members. 24. Members shall rank as to seniority, according to the order in which they have affixed their names to the rules and regulations, as provided in regulation 26. 25. All propositions for repealing, altering, or amending these regulations shall be made in writing at the stated meeting in April or October, and shall be acted on at an adjourned meeting, which shall not be held for that pur- pose sooner than one month from the time of offering such proposition, and it shall then require the concurrence of two-thirds of the members present for its adoption. 11 26. Every practitioner, at the time of becoming a mem- ber of this Association shall sign the following obligation, viz : " The undersigned do approve of the regulations and system of medical ethics adopted by the Medical Association of the District of Columbia, and do agree, on their honor, to comply with the same." When elected. 1 Frederick Alay, Al. D.*__ 1833 2 A. McWilliams, M. D.*__ 1833 3 George W. Alay. AL D.*__ 1833 4 William Jones, Al. D.*1833 5 Henry Huntt, Al. D.*1833 6 Joseph Lovell, M. D.*1833 7 N. P. Causin, Al. D*1833 8 Richmond Johnson, M.D.* 1833 9 Thomas Sewall, M. D.*_ 1833 10 Thomas C. Scott, Al. D.*_ 1833 11 Thos. Henderson, M. D.*_ 1833 12 Harvey Lindslv, Al. D1833 13 N. Younsr, Al. D*1833 14 Frederick Dawes, AL D.*_ 1833 15 James C. Hall, AL D.*1833 16 Thomas Miller, AL D.*__ 1833 17 Joseph Borrows, M. D 1833 18 A. McD. Davis, Al. D* 1833 19 W. N. Waters, Al. D.f*__ 1833 20 H. F. Condict, Al. D.f.__ 1833 21 R. Briscoe, Al. D. + 1833 22 Thomas J. Boyd, AL D.*_ 1833 23 Henry Haw, AL D.f* 1833 24 William Baker, Al. D.*__ 1833 25 J. Waring, AL D.f1833 26 B. J. Miller, Al. D*1833 27 L. Osborne, M. D.* 1833 28 J. M. Thomas, M. D.*___ 1833 29 Robert T. Barry, M. D.*_ 1833 30 W. B. Alagruder. Al. D.* 1833 31 B. King, AL D.f 1833 32 George R. Clarke, Al. D.* 1833 33 Albert Dorman, AL D.*__ 1833 34 Moreau Forrest, AL D.f1833 35 Charles McLean, AL D.*_ 1834 36 Alason L. AVeems, Al. D.* 1834 37 Baily Washington, Al. D.* 1834 38 John A. Kearney, AL D.* 1835 39 Chas. AlcCormick, Al. D.f 1835 40 James Hagan, Al. D.*1835 41 J. M. Foltz, M. D* 1835 42 G. B. McKnight, Al. D.*_ 1835 43 Samuel Jackson, AL 1835 44 A. J. Schwartze, Al. D.*_ 1835 45 T. D. Jones.f|| 1835 46 AV. Draine, Al. D.f 1836 47 John AL Roberts, Al. D.*_ 1836 When elected. 48 B. Randall, Al. D.* 1836 49 John M. Thomas, AL D.* 1836 50 J. AL Munding||* 1837 51 Jas. G. Coombe, Al. D.*[_ 1837 52 Daniel Brent, AL D.* 1837 53 Spencer Mitchell, Al. D.*_ 1837 54 G. Al. Dove, Al. D.*1838 55 B. J. Perry, Al. D.f1838 56 Samuel Forry, Al. D.*1838 57 J. B. C. Thornton, Al. D.* 1838 58 John Fred'k Alay, Al. D._ 1838 59 Edw'd F. Rivinus, Al. D.f 1838 60 James A. Young, Al. D.f 1838 61 Henry Hoban, AL D.*1839 62 W. R. Rose, Al. D * 1839 63 Flodoardo Howard, Al. D. 1840 64 Wm. P. Johnston, AL 1).* 1840 65 Thos. G. Clinton, Al. D.*_ 1842 66 S. C. Smoot, Al. D.* 1842 67 Anthony Holmead, M. D.* 1843 68 Johnson Eliot, Al. D.*1843 69 J. H. Causten, Jr., AL D.* 1843 70 C. H. Liebermann, AL D.f 1843 71 T. B. J. Frye, AL D.f1843 72 G. W. Bodef|| 1843 73 W. H Van Buren, Al. D.f 1843 74 Peregrine Warfield,Al.D.* 1844 75 Cornelius Boyle, Al. D.*__ 1844 76 AV. AIcK. Tucker. Al. D.fl 1844 77 Chas. H. Cragin, Al. D1844 78 John W. Tyler, AL D.*__ 1844 79 J. F. J. AlcClery, AL D.*_ 1845 80 H. P. Howard, AL D*1845 81 James E. Alorgan, Al. D._ 1846 82 Alfred H. Lee, Al. D.f1847 83 Samuel E. Tyson, AL D.* 1847 84 Bob't King Stone, Al. D.* 1847 85 Joseph Walsh, AL D.*1847 86 W. H. Saunders, Al. D.*_ 1848 87 Grafton Tyler, Al. D 1848 88 Alex. Alatthews, Al. D.f__ 1848 89 Isaac S. Lauck, Al. D.* 1848 90 Hez'h Alagruder, AL D.*_ 1848 91 Joshua Riley, Al. D.*1848 92 John I. Dyer, Al. D 1848 93 Benj. S. Bohrer, AL D.*_. 1848 94 Joshua A. Ritchie, AL D. 1848 12 When elected 95 Samuel C. Busey, M. D. 1848 96 A. W. Miller, M. D.*1849 97 J. B. Edelin, M. D.f 1849 98 A. S. Wotberspoon. M. D.* 1850 99 A. Y. P. Garnett, M. D._ 1851 100 S. W. Everett, M. D.*1851 101 J. M. Austin, M. D.* 1852 102 W. Gray Palmer, M. D._ 1852 103 S. B. Blanchard, M. D.*_ 1852 104 J. M. Snyder, M. I).*1853 105 Theo. Hansman, M. D 1853- 106 Joseph D. Stewart, M. D.j- 1854 107 Leopold Dovilliers, M. D. 1854 108 W. J. C. DuHamel, M.D * 1854 109 Rich. H Coolidge, M. D.* 1855 110 J. J. Waring, M. D.j- 1855 111 Louis Mackall, Jr., M. D. 1856 112 J. M. Grymes, M. D.*1856 113 L. A. Edwards, M. D.j-*~ 1856 114 1). R. Hagner, M. D 1856 115 Charles F. Force, M. D.f_ 1856 116 H. C. Simms, M. D.j-*1856 117 J. M. McCalla, M. D.+ 1856 118 John B. Keasbey, M. D.j- 1856 119 John Richards, M. D.*_ 1856 120 M. V. B. Bogan, M. D .. 1856 121 J. W'. H. Lovejoy, M. D. 1856 122 John C. Riley, M D.*__. 1856 123 Wm. Marbury, M. D.*__ 1856 124 W. F. Lippitt, M. D.j-__ 1856 125 B. J. Hellen, M. D.*1856 126 James M. Wilson, M. D.f 1856 127 A. J. Semmes, M. D.f1856 128 B. F. Craig, M. D*1856 129 J.V. D. Middleton, M.D.f 1856 130 J. W. Stettinius, M. D.*_ 1856 131 N. S. Lincoln, M. D. 1856 132 S. J. Radcliffe, M D. 1856 133 J. M. Toner, M. D 1856 134 R. H. Speake, M. D* 1856 135 T. Purrington, M. D.*__ 1856 136 John F. King, M. D.*- 1856 137 Wm. H. Berry, M. D.*_ 1856 138 John C. Grayson, M. D.f 1856 139 Wm. B. Butt, M. 1856 140 Wm. P. Young, M. D +_ 1858 141 George McCov, M. D.* 1858 142 J. G. F. Holston, M. D.*_ 1859 143 Thos. F. Maury, M. D.*_ 1859 144 Rich. C. Croggon, M. D.* 1860 145 Frank W. Mead, M. D.*[ 1860 146 John W. Davis, M. D.j- 1860 147 Fras. C. Christie, M. D.*_ 1860 148 Jno. L. Gibbons, M. D.f* 1860 149 H. B. Trist, M. D.f 1860 150 Thomas Antisell, M. D- 1861 When elected. 151 G. P. Fenwick, M. D1861 152 Warwick Evans, M. D. 1861 153 J. A. Chamberlin, M. D.* 1863 154 H. E. Woodbury, M. D.f 1863 155 T. F. Joyce, M. 1863 156 J. T. Howard, M. 1) 1864 157 Charles Allen, M. 1864 158 H. H. Lowrie, M. D.f1864 159 J Ford Thompson, M. D. 1864 160 S. J. Todd, M. D.* 1865 161 C. M. Ford, M. D 1865 162 H. P. Middleton, M. D.*_ 1865 163 S. W. Bogan, M. I) 1865 164 Patrick A. M. Croghan.||* 1865 165 Samuel S. Bond, M. D1865 166 Wm. Lee, M. D 1865 167 Jas. Phillips, M. D.f 1865 168 Carlos Carvallo, M. D j-*_ 1865 169 A. F. A. King, M. 1) 1865 170 James T. Young, M. D 1865 171 W. H. Combs, M. D.*1865 172 J. W. Herbert, M. D 1865 173 W. E. Roberts, M. D. 1865 174 Armistead Peter, M. D. 1865 175 Bodisco Williams, M. D.* 1865 176 Eph. C. Merriam, M. D._ 1865 177 James R. Reily, M. D. 1865 178 Joseph Scholl, M. D. 1865 179 Sam'l A. Amery, M. D.f* 1865 180 Thomas W. Wise, M. D 1865 181 Chas. McCormick, M. D.* 1866 182 G. L. Pancoast, M. D.* 1866 183 H. A. Robbins, M. D. 1866 184 W. B. Drinkard, M. D.*_ 1866 185 W. G. H. Newman, M.D.* 1866 186 John W. Bulkley, M. D._ 1866 187 Adolphus Patze, M. D.__ 1866 188 Dan'l W. Prentiss, M. D. 1866 189 Adajah Behrend, M. D. 1866 190 Jas. Otey Harris, M. D.*_ 1866 191 J. H. Thompson, M. D.j- 1866 192 A. J. Borland, M. D.lf*1866 193 Thomas Emory. M. D.f 1866 194 L. J. Draper, M. D.f* 1866 195 Thomas C. Smith, M. D. 1866 196 S. A. H. McKim, M. D1866 197 John K. Walsh, M. D.<[_ 1866 198 Charles H. Bowen, M. D.J 1866 199 Charles M. Tree, M. D.*_ 1867 200 John C. Norris, M. D f 1867 201 John E. Smith, M. D.f__ 1867 202 F. O'Donnoghue, M. D.f* 1867 203 F. B. Culver, M. D.5[* . 1867 204 Rufus Choate, M. D. f 1867 205 Louis W. Ritchie, M. D._ 1867 206 Fred. W. Ritter, M. D.<[_ 1867 13 When elected. 207 Robert Reyburn, M. D 1867 208 R. J. Southworth, M. D.f 1867 209 Henry Gray, M. D.f1867 210 C. H. A. Kleinschmidt, MD 1867 211 Benj. R. Raines, M. D.f 1867 212 James E. Dexter, M. D.__ 1867 213 A. R. Brown, M. D.f*__ 1868 214 Wm. H. Whitley, M. D.1[ 1868 215 D. P. Wolhaupter, M. D. 1868 216 C. F. Nalley, M. D.*_ 1868 217 G. V. N. Callan, M. D1868 218 Geo. R. Miller, M. D.*___ 1869 219 F- A. Ashford, M. D.*__ 1869 220 O. M. Muncaster, M. D. 1869 221 Geo. A. Fitch, M. D.*.__ 1869 222 J- Lee Adams, M. D 1869 223 B. Thompson, M D.* 1869 224 Chas. E. Hagner, M. D. 1869 225 Valentine McNally, M. D. 1869 226 D. C. Patterson, M. D._ 1869 227 Robert'n Howard, M. D.f 1870 228 K. V. Aulick, M. D* 1870 229 J- H. McBlair, M. D 1870 230 A. E. Johnson, M. 1). 1870 231 Wm. T. S. Duvall, M. I). 1870 232 Jos. D. Barnes, M. D.* 1870 233 J- F. Hartigan, M. D1870 234 Howard H. Barker, M. D. 1871 235 J- O. Stanton, M. D 1871 236 R- S. L. Walsh, M. D1871 237 W. W. Johnston, M. D.__ 1871 238 W. Bowie Tyler, M. D. 1871 239 H. A. Duncanson, M. D * 1871 240 J- F. R. Appleby, M'D. 1871 241 George C. Samson, M. D._ 1871 242 W. W. Potter, M. D.f___ 1871 243 W. C. Briscoe, M. D 1871 244 Geo. H. Torney, M. D.f 1871 245 John Parsons, M. D. 1871 246 G. L. Magruder, M. D. 1871 247 A. McWilliams, M. D1871 248 C. M. Hines, M. D.*[* 1871 249 J. L. Suddarth, M. D. 1871 250 J. K. P. Gleeson, M. D. 1871 251 Bobert Farnham, M. D1871 252 Basil Norris, M. D 1871 253 Smith Townshend, M. D. 1871 254 Joseph T. Johnson, M. D. 1871 255 A. Brockenbrough, M. D.f 1871 256 Wm. T. Ramsey, M. D.f. 1871 257 John Stearns, M. D.f 1871 258 Robert Fletcher, M. D._ 1871 259 Sam'l B. Fisher, M. D.. 1871 260 J. H. Baxter, M. D. 1871 261 E. W. Latimer, M.D.*1871 262 Wm. J. Armstrong, M. D. 1871 When elected. 263 John T. Winter, M. D 1871 264 Francis Salter, M. D.*1871 265 Chas. D. Maxwell, M. D._ 1871 266 J. A. Tarkington, M. D._ 1872 267 C. M. Hammett, M. D1872 268 D. S. Lamb, M. D 1872 269 C. W. Franzoni, M. D1872 270 F. M. Gunnell, M. D 1872 271 C. V. Boarman, M. D1872 272 Wm. V. Marmion, M. D. 1872 273 J. S. Beale, M. D* 1872 274 Wm. H. Ross, M. D.f 1872 275 Z. T. Sowers, M. D 1873 276 P. J. Murphy, M. D 1873 277 Wm. F. Harvey, M. D.f 1873 278 J. S. McLain, M. D.f 1873 279 Thos. M. Healey, M. D.f 1873 280 W. H. Triplett, M D.f1873 281 Richard G. Mauss, M. D._ 1873 282 P. Glennan, M. D 1873 283 Robert Harris, M. D.f*__ 1873 284 A. B. Shekel!, M. DJ1873 285 James T. Sothoron, M. D. 1873 286 Charles Bittinger, M. D.f* 1873 287 F. D. Squires, M. D.f1873 288 G. S. Palmer, M. D. 1873 289 J. A. McCauley, M. D.*_ 1873 290 Wm. H. Taylor, M. D.__ 1873 291 James M. Mackall, M. D. 1873 292 E. A. Adams, M. D1873 293 E. M. Schaeffer, M. D 1873 294 William W. Ward, M. D. 1873 295 David Blair, M. D.■___ 1873 296 J. T. Coumbe, M. D1873 297 A. C. Adams, M. D 1873 298 J. A. Sladen, M. 1873 299 G. M. Kober, M. D.f1873 300 B. M. Beall, M. D.f[ 1873 301 Theodore Mead, M. D 1874 302 J. H. Brooks, M. D.1[ 1874 303 E. A. Zevely, M. D *1874 304 H. T. Porter, M. D.f*1874 305 R. A. Page, M. D *1874 306 P. G. Young, M. D 1874 307 Jas. M. Gassaway, M. D.f 1874 308 Wm. L. Hudson, M. D.f_ 1874 309 J. H. Bushnell, M. D1874 310 S. B. Crew, M. D 1874 311 William L. Naylor, M. D. 1874 312 Geo. W. Offutt, M. D.*1874 313 D. H. Hazen, M. D.1874 314 John Walter, M. D 1874 315 Franck Hyatt, M. D 1874 316 S. J. Waggaman, M. D.f_ 1875 317 GeorgeS. King, M. D. 1875 318 P. T. Keene, M. D.f1875 14 When elected. 319 Daniel J. Kelly, M. D1875 320 J. W. Joyce, M. D 1876 321 M. B. Melvin, M. D1876 322 D. W. Bliss, M. D 1876 323 J. Llewellyn Eliot, M. D. 1876 324 C. A. Hoover, M. D.f1876 325 H. M. Newman, M. 1) 1876 326 A. N. Williamson, M. D. 1876 327 J.H.Thompson, Jr., M.D.f 1877 328 Benj. L. Holt, M. D.f1877 329 F. B. Loring, M. D 1877 330 Geo. M. Davis, M. D.f1877 331 H. C. Yarrow, M. D1877 332 Christ'r C. Cox, M. D.*1877 333 O. C. Ketcham, M. D1877 334 T. A. R. Keech, M. D 1877 335 Swan M. Burnett, M. D1877 336 M. Bruckheimer, M. D 1877 337 L. E. Newton, M. D1877 338 Arthur Christie, M. D. 1877 339 L. T. Bremerman, M. D.* 1877 340 J. E. Brackett, M. D1877 341 H D. Fry, M. D 1878 342 W. O. Eversfield, M. D.f 1878 343 Charles A. Ball, M. D1878 344 Walter S. Wells, M. D.f_ 1878 345 William F. Byrns, M. D. 1878 346 W. E. Poulton, M. D 1878 347 James C. Bird, M. D1878 348 E. A. Sellhausen, M. D 1878 349 Joseph W. Little, M. D._ 1878 350 Thos. M. Healey, M. D.f_ 1878 351 E. C. Morgan, M. D 1879 352 Geo. N. Acker, M. D.1879 353 S. O. Richey, M. D.1879 354 G. Wythe Cook, M. D1879 355 Hora'o R. Bigelow, M. D. 1879 356 Sam'l W. Budd, M. D.f_ 1879 357 Leroy M. Taylor, M. D. 1879 358 Lachlan Tyler, M. D1879 359 Irving C. Rosse, M. D1879 360 Hend'on Suter, Jr., M. D. 1879 361 F. C. Van Vliet, M. D.f__ 1879 362 T. E. McArdle, M.*D 1879 363 SamuelS. Adams, M. D1879 364 J. Stew. Harrison, M. D.f 1879 365 H. E. Leach, M. D 1879 366 W. P. C. Hazen, M. D.__ 1879 367 John W. Bayne, M. D1879 368 D. B. Street, M. D1880 369 B. G. Pool, M. D1880 370 F. A. Hassler, M. D.f1880 371 P. H. Heller, M. D.f 1880 372 Turner Torrey, M. D 1880 When elected. 373 B. B. Adams, M. D1880 374 A. A. Marsteller, M. D.__ 1880 375 Thomas H. Trott, M. D1880 376 G. Byrd Harrison, M. D._ 1880 377 William Nicholson, M. D. 1880 378 Harrison, Crook, M. D1880 379 Thos. J. Chew, M. D1881 380 Thos. S. Blackwell, M.D.j- 1881 381 Step'n A. McVarv,M.D.t 1881 382 B. B. Jolley, M. D 1882 383 R. Reyburn, Jr., M. D1882 384 Wm. H. Hawkes, M. D.__ 1882 385 A. A. Hoehling, M. D1882 386 L. W. Clapp, M. D.f1882 387 John R. Menke, M. D.*__ 1882 388 J. Ash. Thompson, M. D.f 1882 389 H. L. E. Johnson, M. D._ 1882 390 Thomas F. Malian, M. D. 1883 391 D. K. Shute, M. D1883 392 L. L. Friedrich, M. D1883 393 William May, M. D1883 394 J. H. Yarnall, M. D1883 395 John L. Dow, M. D.f1883 396 K. T. Holden, M. D1883 397 J. R. Bromwell, M. D1883 398 Geo. C. Ober, M. D 1883 399 John H. Mundell, M. D._ 1883 400 Geo. W. West, M. D 1883 401 Louis K. Beatty, M. D1883 402 Chas. I. Osmun, M. D1883 403 John B. Hamilton, M. D. 1883 404 J. Stinson Harrison, M. D. 1883 ASSOCIATE MEMBERS. 1 W. P.'Lawyer, M. D.1874 2 J. W. Van Arnum, M. D. 1874 3 J. P. Richardson, M. D.f 1874 4 C. F. Rand, M. D.f1875 5 P. H. Flood, M. D.f1875 6 G. F. Johnston, M. D1876 7 Arthur W. Adams, M. D.f 1878 8 R. DeL. French, M. D. 1878 9 Thomas B. Hood, M. D.__ 1878 10 Wm. R. Goodman, M. D. 1879 11 Henry Richings, M. D.f__ 1879 12 R. A. Foster, M. D. 1879 13 L. A. Ferry, M. D.f1879 14 Thomas Robinson, M. D._ 1879 15 Douglas Binns, M. D1879 16 Alex. M. Stout, M. D.f__ 1880 17 W. H. Colesberry, M. D.* 1880 18 Nathan E. Rice, M. D.f1880 19 W. B. Reynolds, M. D. 1881 20 C. T. Caldwell, M. D1882 21 J. H. DeMeritt, M. D..__ 1882 * Dead, t Removed from the District. J Resigned. 1] Dropped. || Licentiate, Med. So. ORDER OF BUSINESS : 1. Reading of the Minutes. 2. Unfinished Business. 3. Nomination and Election of Candidates for Membership. 4. Reports of Officers. 5. Reports of Committees. 6. Election of Officers. 7. Election of Delegates to the American Medical Association 8. Miscellaneous Business. MEDICAL ETHICS OF THE AMERICAN MEDICAL ASSO- CIATION AND OF THE DISTRICT OF COLUMBIA. OF THE DUTIES OF PHYSICIANS TO THEIR PATIENTS, AND OF THE OBLIGATIONS OF PATIENTS TO THEIR PHYSI- CIANS. Art. I.-Duties of physicians to their patients. $ i. A physician should not only be ever ready to obey the calls of the sick, but his mind ought also to be imbued with the greatness of his mission, and the responsibility he habitually incurs in its discharge. These obligations are the more deep and enduring, because there is no tribunal other than his own con- science to adjudge penalties for carelessness or neglect. Physicians should, therefore, minister to the sick with due impressions of the importance of their office; reflecting that the ease, the health, and the lives of those committed to their charge, depend on their skill, attention, and fidelity. They should study, also, in their deportment, so to unite tenderness with firmness, and condescension with authority, as to inspire the minds of their patients with gratitude, respect, and confidence. § 2. Every case committed to the charge of a physician should be treated with attention, steadiness and humanity. Reasonable indulgence should be granted to the mental imbecility and caprices of the sick. Secrecy and delicacy, when required by peculiar circumstances, should be strictly observed; and the familiar and confidential intercourse to which physicians are admitted in their professional visits, should be used with discretion, and with the most scrupulous regard to fidelity and honor. The obligation of secrecy extends beyond the period of pro- fessional services; none of the privacies of personal and domestic life, no infirm- ity of disposition or flaw of character observed during professional attendance should ever be divulged by the physician except when he is imperatively required to do so. The force and necessity of this obligation are indeed so great, that pro- fessional men have, under certain circumstances, been protected in their observ- ance of secrecy by courts of justice. 3. Frequent visits to the sick are in general requisite, since they enable the physician to arrive at a more perfect knowledge of the disease-to meet promptly every change which may occur, and also tend to preserve the confidence of the patient. But unnecessary visits are to be avoided, as they give useless anxiety to the patient, tend to diminish the authority of the physician, and render him liable to be suspected of interested motives. § 4. A physician should not be forward to make gloomy prognostications, be- cause they savor of empiricism, by magnifying the importance of his services in the treatment or cure of the disease. But he should not fail, on proper occasions, to give to the friends of the patient timely notice of danger when it really occurs ; and even to the patient himself, if absolutely necessary. This office, however, is so peculiarly alarming when executed by him, that it ought to be declined when- ever it can be assigned to any other person of sufficient judgment and delicacy. For the physician should be the minister of hope and comfort to the sick ; that, by such cordials to the drooping spirit, he may smooth the bed of death, revive ex- piring life, and counteract the depressing influence of those maladies which often disturb the tranquility of the most resigned in their last moments. The life of a 17 sick person can be shortened not only by the acts, but also by the words or the manner of a physician. It is, therefore, a sacred duty to guard himself carefully in this respect, and to avoid all things which have a tendency to discourage the patient and to depress his spirits. # 5. A physician ought not to abandon a patient because the case is deemed incurable ; for his attendance may continue to be highly useful to the patient, and comforting to the relatives around him, even in the last period of a fatal malady, by alleviating pain and other symptoms, and by soothing mental anguish. To decline attendance, under such circumstances, would be sacrificing to fanciful delicacy and mistaken liberality, that moral duty, which is independent of, and far superior to, all pecuniary consideration. g 6. Consultations should be promoted in difficult or protracted cases, as they give rise to confidence, energy, and more enlarged views in practice. g 7. The opportunity which a physician not unfrequently enjoys of promoting and strengthening the good resolutions of his patients, suffering under the conse- quences of vicious conduct, ought never to be neglected. His counsels, or even remonstrances, will give satisfaction, not offense, if they be proffered with polite- ness, and evince a genuine love of virtue, accompanied by a sincere interest in the welfare of the person to whom they are addressed. Art. II-Obligations of patients to their physicians. ?. I. The members of the medical profession, upon whom is enjoined the per- formance of so many important and arduous duties towards the community, and who are required to make so many sacrifices of comfort, ease, and health, for the welfare of those who avail themselves of their services, certainly have a right to expect and require, that their patients should entertain a just sense of the duties which they owe to their medical attendants. ? 2. The first duty of a patient is to select as his medical adviser one who has received a regular professional education. In no trade or occupation do man- kind rely on the skill of an untaught artist; and in medicine, confessedly the most difficult and intricate of the sciences, the world ought not to suppose that knowledge is intuitive. $ 3. Patients should prefer a physician whose habits of life are regular, and who is not devoted to company, pleasure, or to any pursuit incompatible with his professional obligations. A patient should, also, confide the care of himself and family, as much as possible, to one physician; for a medical man who has be- come acquainted with the peculiarities of constitution, habits, and predispositions of those he attends, is more likely to be successful in his treatment than one who does not possess that knowledge. A patient who has thus selected his physician should always apply for advice in what may appear to him trivial cases, for the most fatal results often supervene on the slightest accidents. It is of still more importance that he should apply for assistance in the forming stage of violent diseases; it is to a neglect of this pre- cept that medicine owes much of the uncertainty and imperfection with which it has been reproached. g 4. Patients should faithfully and unreservedly communicate to their physician the supposed cause of their disease. This is the more important, as many diseases of a mental origin simulate those depending on external causes, and yet are only to be cured by ministering to the mind diseased. A patient should never be afraid of thus making his physician his friend and adviser ; he should always bear in mind that a medical man is under the strongest obligations of secrecy. Even the female sex should never allow feelings of shame or delicacy to prevent their disclosing the seat, symptoms, and causes of complaints peculiar to them. How- ever commendable a modest reserve may be in the common occurrences of life, its strict observance in medicine is often attended with the most serious conse- quences, and a patient may sink under a painful and loathsome disease, which 18 might have been readily prevented had timely intimation been given to the phy- sician. $5. A patient should never weary his physician with a tedious detail of events or matters not appertaining to his disease. Even as relates to his actual symp- toms, he will convey much more real information by giving clear answers to in- terrogatories, than by the most minute account of his own framing. Neither should he obtrude upon his physician the details of his business nor-the history of his family concerns. $ 6. The obedience of a patient to the prescriptions of his physician should be prompt and implicit. He should never permit his own crude opinions as to their fitness to influence his attention to them. A failure in one particular may render an otherwise judicious treatment dangerous, and even fatal. This remark is equally applicable to diet, drink, and exercise. As patients become convalescent, they are very apt to suppose that the rules prescribed for them may be disregarded, and the consequence, but too often, is a relapse. Patients should never allow them- selves to be pursuaded to take any medicine whatever, that may be recommended to them by the self-constituted doctors and doctresses who are so frequently met with, and who pretend to possess infallible remedies for the cure of every disease. However simple some of their prescriptions may appear to be, it often happens that they are productive of much mischief, and in all cases they are injurious, by contravening the plan of treatment adopted by the physician. 7. A patient should, if possible, avoid even the friednly visits of a physician who is not attending him-and when he does receive them, he should never con- verse on the subject of his disease, as an observation may be made, without any intention of interference, which may destroy his confidence in the course he is pursuing, and induce him to neglect the directions prescribed to him. A patient should never send for a consulting physician without the express consent of his own medical attendant. It is of great importance that physicians should act in concert; for, although their modes of treatment may be attended with equal suc- cess when employed singly, yet conjointly they are very likely to be productive of disastrous results. g 8. When a patient wishes to dismiss his physician, justice and common cour- tesy require that he should delcare his reasons for so doing. g, 9. Patients should always, when practicable, send for their physician in the morning, before his usual hour of going out; for, by being early aware of the visits he has to pay during the day, the physician is able to apportion his time in such a manner as to prevent an interference of engagements. Patients should also avoid calling on their medical adviser unnecessarily during the hours devoted to meals or sleep. They should always be in readiness to receive the visits of their physician, as the detention of a few minutes is often of serious inconveni- ence to him. $ 10. A patient should, after his recovery, entertain a just and enduring sense of the value of the services rendered him by his physician; for these are of such a character, that no mere pecuniary acknowledgment can repay or cancel them. OF THE DUTIES OF PHYSICIANS TO EACH OTHER, AND TO THE PROFESSION AT LARUE. Art. i.-Duties for the support of professional character. £ I. Every individual, on entering the profession, as he becomes thereby en- titled to all its privileges and immunities, incurs an obligation to exert his best abilities to maintain its dignity and honor, to exalt its standing, and to extend the bounds of its usefulness. He should, therefore, observe strictly such laws as are instituted for the government of its members:-should avoid all contumelious and sarcastic remarks relative to the faculty as a body ; and while, by unwearied dili- gence, he resorts to every honorable means of enriching the science, he should 19 eiffertain a due respect for his seniors, who have, by their labors, brought it to the elevated condition in which he finds it. $ 2. There is no profession, from the members of which greater purity of char- acter, and a higher standard of moral excellence are required, than the medical; and to attain such eminence is a duty every physician owes alike to his profession and to his patients. It is due to the latter, as without it he cannot command their respect and confidence, and to both, because no scientific attainments can com- pensate for the want of correct moral principles. It is also incumbent upon the faculty to be temperate in all things, for the practice of physic requires the unre- mitting exercise of a clear and vigorous understanding; and, on emergencies, for which no professional man should be unprepared, a steady hand, an acute eye, and an unclouded head, may be essential to the well-being, and even to the life, of a fellow creature. g 3. It is derogatory to the dignity of the profession to resort to public adver- tisements, or private cards, or handbills, inviting the attention of individuals affec- ted with particular diseases-publicly offering advice and medicine to the poor gratis, or promising radical cures; or to publish cases and operations in the daily prints, or suffer such publications to be made ; to invite laymen to be present at operations, to boast of cures and remedies, to adduce certificates of skill and suc- cess, or to perform any other similar acts. These are the ordinary practices of empirics, and are highly reprehensible in a regular physician. £ 4. Equally derogatory to professional character is it for a physician to hold a patent for any surgical instrument or medicine ; or to dispense a secret nostrum, whether it be the composition or exclusive property of himself or of others. For, if such nostrum be of real efficacy, any concealment regarding it is inconsistent with beneficence and professional liberality; and if mystery alone give it value and importance, such craft implies either disgraceful ignorance or fraudulent ava- rice. It is also reprehensible for physicians to give certificates attesting the effi- cacy of patent or secret medicines, or in any way to promote the use of them. i. All practitioners of medicine, their wives, and their children while under the paternal care, are entitled to the gratuitous services of any one or more of the faculty residing near them, whose assistance may be desired. A physician afflict- ed with disease is usually an incompetent judge of his own case; and the natural anxiety and solicitude which he experiences at the sickness of a wife, a child, or any one who, by the ties of consanguinity, is rendered peculiarly dear to him, tend to obscure his judgment, and produce timidity and irresolution in his practice. Under such circumstances, medical men are peculiarly dependent upon each other, and kind offices and professional aid should always be cheerfully and gra- tuitously afforded. Visits ought not, however, to be obtruded officiously; as such unasked civility may give rise to embarrassment, or interfere with that choice on which confidence depends. But, if a distant member of the faculty, whose cir- cumstances are affluent, request attendance, and an honorarium be offered, it should not be declined; for no pecuniary obligation ought to be imposed, which the party receiving it would wish not to incur. Art. II.-Professional services of physicians to each other. £ i. The affairs of life, the pursuit of health, and the various accidents and con- tingencies to which a medical man is peculiarly exposed, sometimes require him temporarily to withdraw from his duties to his patients, and to request some of his professional brethren to officiate for him. Compliance with this request is an act of courtesy which should always be performed with the utmost consideration for the interest and character of the family physician, and when exercised for a Art. III. - Of the duties of physicians as respects vicarious offices. 20 short period, all the pecuniary obligations for such service should be awarded to him. But if a member of the profession neglect his business in quest of pleasure and amusement, he cannot be considered as entitled to the advantages of the fre- quent and long-continued exercise of this fraternal courtesy, without awarding to the physician who officiates, the fees arising from the discharge of his professional duties. In obstetrical and important surgical cases, which give rise to unusual fatigue, anxiety, and responsibility, it is just that the fees accruing therefrom should be awarded to the physician who officiates. Art. IV.-Of the duties of physicians in regard to consultations. # I. A regular medical education furnishes the only presumptive evidence of professional abilities and acquirements, and ought to be the only acknowledged right of an individual to the exercise and honors of his profession. Nevertheless, as in consultations the good of the patient is the sole object in view, and this is often dependent on personal confidence, no intelligent regular practitioner, who has a license to practice from some medical board of known and acknowledged respectability, recognized by this Association, and who is in good moral and pro- fessional standing in the place in which he resides, should be fastidiously excluded from fellowship, or his aid refused in consultation, when it is requested by the patient. But no one can be considered as a regular practitioner or a fit associate in consultation, whose practice is based on an exclusive dogma, to the rejection of tlje accumulated experiences of the profession, and of the aids actually fur- nished by anatomy, physiology, pathology, and organic chemistry. # 2. In consultations, no rivalship or jealousy should be indulged ; candor, probity, and all due respect should be exercised towards the physician having charge of the case. $ 3. In consultations, the attending physician should be the first to propose the necessary questions to the sick; after which the consulting physician should have the opportunity to make such further inquiries of the patient as may be necessary to satisfy him of the true character of the case. Both physicians should then re-' tire to a private place for deliberation; and the one first in attendance should communicate the directions agreed upon to the patient or his friends, as well as any opinions which it may be thought proper to express. But no statement or discussion of it should take place before the patient or his friends, except in the presence of all the faculty attending, and by their common consent; and no opinions or prognostications should be delivered which are not the result of pre- vious deliberation and concurrence. g 4. In consultations, the physician in attendance should deliver his opinion first; and when there are several consulting, they should deliver their opinions in the order in which they have been called in. No decision, however, should re- strain the attending physician from making such variations in the mode of treat- ment as any subsequent unexpected change in the character of the case may de- mand. But such variation, and the reasons for it, ought to be carefully detailed at the next meeting in consultation. The same privilege belongs also to the con- sulting physician if he is sent for in an emergency, when the regular attendant is out of the way, and similar explanations must be made by him at the next con- sultation. g 5. The utmost punctuality should be observed in the visits of physicians when they are to hold consultation together, and this is generally practicable, for society has been considerate enough to allow the plea of a professional engagement to take pjecedence of all other, and to be an ample reason for the relinquishment of any present occupation. But as professional engagements may sometinies inter- fere, and delay one of the parties, the physician who first arrives should wait for his associate a reasonable period, after which the consultation should be consid- ered as postponed to a new appointment. If it be the attending physician who is 21 present, he will, of course, see the patient and prescribe; but if it be the consult- ing one, he should retire, except in case of emergency, or when he has been call- ed from a considerable distance, in which latter case he may examine the patient and give his opinion in writing, and under seal, to be delivered to his associate. 6. In consultations, theoretical discussions should be avoided, as occasioning perplexity and loss of time. For there may be much diversity of opinion con- cerning speculative points, with perfect agreement in those modes of practice which are founded, not on hypothesis, but on experience and observation. g 7. All discussions in consultation should be held as secret and confidential. Neither by words nor manner should any of the parties to a consultation assert or insinuate that any part of the treatment pursued did not receive his assent. The responsibility must be equally divided between the medical attendants-they must equally share the credit of success as well as the blame of failure. g 8. Should an irreconcilable diversity of opinion occur when several physicians are called upon to consult together, the opinion of the majority should be con- sidered as decisive; but if the numbers be equal on each side, then the decision should rest with the attending physician. It may, moreover, sometimes happen that two physicians cannot agree in their views of the nature of a case, and the treatment to be purfued. This is a circumstance much to be deplored, and should always be avoided, if possible, by mutual concessions, as far as they can be justi- fied by a conscientious regard for the dictates of judgment. But in the event of its occurrence, a third physician should, if practicable, be called to act as umpire ; and, if circumstances prevent the adoption of this course, it must be left to the patient to select the physician in whom he is most willing to confide. But, as every physician relies 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 participation in the management of the case. g 9. As circumstances sometimes occur to render a special consultation desira- ble, when the continued attendance of two physicians 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 con- sultations require an extraordinary portion both of time and attention, at least a double honorarium may be reasonably expected. g 10. A physician who is called upon to consult, should observe the most hon- orable and scrupulous regard for the character and standing of the practitioner in attendance; the practice of the latter, if necessary, should be justified as far as it can be, consistently with a conscientious regard for truth, and no hint or insinu- ation should be thrown out which could impair the confidence reposed in him, or affect his reputation. The consulting physician 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 them- selves into the favor of families and individuals. Art. V.- Duties of physicians in eases of interference. i. 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. iji 2. A physician, in his intercourse with a patient under the care of another practitioner, should observe the strictest caution and reserve. No meddling in- quiries 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 promoted 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 22 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 case as circumstances will admit. g 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 ill- ness, except in cases of sudden emergency, or in consultation with the physician previously in attendance, or when the latter has relinquished the case, or been regularly notified that his services are no longer desired. Under such circum- stances 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 be- come dissatisfied when they do not experience immediate relief, and, as many diseases are naturally protracted, the want of success, in the first stage of treat- ment, 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, he ought, unless his assistance in consultation be desired, to resign the care of the patient to the latter immediately on his arrival. £ 6. It often happens in cases of sudden illness, or of recent accidents and in- juries, 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 ad- ditional assistance that he may deem necessary. In all such cases, however, the practitioner who officiates should request the family physician, if there be one, to be called, and, unless his further attendance be requested, should resign the case to the latter on his arrival. $ 7. When a physician is called to the patient of another practitioner, in con- sequence of the sickness or absence of the latter, he ought, on the return or re- covery of the regular attendant and with the consent of the patient, to surrender the case. [The expression, " patient of another practitioner," is understood to mean a patient who may have been under the charge of another practitioner at the time of the attack of sickness, or departure from home of the latter, or who may have called for his attendance during his absence or sickness, or in any other manner given it to be understood that he regarded the said physician as his regular medi- cal attendant.] $ 8. A physician when visiting a sick person in the country may be desired to see a neighboring patient who is under the regular direction of another physician, in consequence of some sudden change or aggravation of symptoms. The con- duct to be pursued on such an occasion is to give advice adapted to present cir- cumstances ; to interfere no further than is absolutely necessary with the general plan of treatment; to assume no further direction unless it be expressly desired ; and, in this last case, to request an immediate consultation with the practitioner previously employed. $ 9. A wealthy physician should not give advice gratis to the affluent; because his doing so is an injury to his professional brethren. The office of a physician can never be supported as an exclusively beneficient 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 attend- ance of the latter, he is entitled to the fee, but should resign the patient to the practitioner first engaged. Art. VI. - Of differences between physicians. g i. Diversity of opinion and opposition of interest may, in the medical as in other professions, sometimes occasion controversy and even contention. When- 23 ever 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. ft 2. As peculiar reserve must be maintained by physicians towards the public in regard to professional matters, and as there exist numerous points in medical ethics 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 publicity in a case of this nature may be personally injurious to the individuals concerned, and can hardly fail to bring discredit on the faculty. Art. VII.- Of pecuniary acknowledgments. Some general rules should be adopted by the faculty, in every town or district, relative to pecuniary acknowledgments from their patients; and it should be deemed a point of honor to adhere to these rules with as much uniformity as varying circumstances will admit. OF THE DUTIES OF THE PROFESSION TO THE PUBLIC, AND OF THE OBLIGATIONS OF THE PUBLIC TO THE PROFES- SION. Art. I.- Duties of the profession to the public. § i. As good citizens, it is the duty of physicians to be ever vigilant for the welfare of the community, and to bear their part in sustaining its institutions and burdens; they should also 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 hygiene, and legal medicine. It is their province to enlighten the public in regard to quarantine regulations-the location, arrangement, and dieta- ries of hospitals, asylums, schools, prisons, and similar institutions; in relation to the medical police of towns, as drainage, ventilation, etc., and in regard to meas- ures for the prevention of epidemic and contagious diseases; and when pesti- lence prevails, it is their duty to face the danger, and to continue their labors 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 sub- jects 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, labor, and skill required, and the responsibility and risk they incur, that the public should award them a proper honorarium. § 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 performance of such good offices. Poverty, professional brotherhood, and certain of the public duties referred to in the first section of this article, should always be recognized as presenting valid claims for gratuitous ser- vices ; but neither institutions endowed by the public or by rich individuals, socie- ties for mutual benefit, for the insurance of lives, or for anolagous purposes, nor any profession or occupation, can be admitted to possess such privilege. Nor can it be justly expected of physicians to furnish certificates of inability to serve on juries, to perform militia duty, or to testify to the state of health of persons wish- ing to insure their lives, obtain pensions, or the like, without pecuniary acknowl- edgment. But to individuals in indigent circumstances, such professional services should always be cheerfully and freely accorded. 24 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 by exercising their option in regard to the shops to which their prescriptions shall be sent, to discour- age 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. # i. 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 the utmost consideration and respect of the com- munity. The public ought likewise to entertain a just appreciation of medical qualifications; to make a proper discrimination between true science and the as- sumptions of ignorance and empiricism; to afford every encouragement and facil- ity for the acquisition of medical education, and no longer to allow the statute books to exhibit the anomaly of exacting knowledge from physicians, under a lia- bility to heavy penalties, and of making them obnoxious to punishment for resort- ing to the only means of obtaining it. Alphabetical List of Living Resident Members. [Numbers indicate order of signatures to the Constitution.] NAME. RESIDENCE. 352 Acker, George N. 1403 New York avenue N.AV. 297 Adams, Arthur C 709 11th street N.W. 373 Adams, B. B 1616 7th street N.AV. 292 Adams, E. A 422 8th street S.E. 222 Adams, J. Lee 1335 E street S.E. 363 Adams, Samuel S Antisell, Thomas Appleby, James F. R. 831 14th street N.AV. 150 1311 Q street N.AV. 240 1430 33d street N.AV. 262 Armstrong, William J. _ Ball, Charles A Barker, Howard H 1629 Connecticut avenue N.AV 343 233 G street N.AV. 234 1116 H street N.AV. 367 Bayne, John W 210 B street S.E. 260 Baxter, J. H., U. S. A_ 1504 H street N.AV. 401 Beattv, Louis K. 189 Behrend, Adajah 709 H street N.W. 355 Bigelow, Horatio R 1228 N street N.W. 347 Bird, James C 1336 G street N.W. 295 Blair, David 1814 14th street N.W. 322 Bliss, D. AV Boarman, C. V. 1329 F street N.AV. 271 1114 Alaryland avenue S.W. 120 Bogan, Al. V. B 606 Alassachusetts avenue N.AV 163 Bogan, 8. W 421 G street N.W. 165 Bond, Samuel S 813 1st street N.W. 17 Borrows, Joseph 921 E street N.AV. 340 Brackett, John E 219 A street S.E. 243 Briscoe, AV. C 317 C street N.AV. 397 Bromwell, J. R. 1138 Connecticut avenue N.W. 336 Bruckheimer, Al 748 6th street N.AV. 186 Bulkley, John AV 805 12th street N.W. 335 Burnett, Swan Al 1215 1 street N.AV. 95 Busey, Samuel C - 1525 I street N.AV. 309 Bushnell, J. H. 1212 10th street N.AV. 345 Byrns, AVilliam F 35 B street S.E. 217 Callan, C. V. N 1422 F street N.AV. 379 Chew, Thomas J._ 1210 31st street N.W. 338 Christie, Arthur 2 Anacostia. 354 Cook, G. AVvthe 1418 14th street N.W. 296 Coumbe, J. T 1304 9th street N.W. 77 Cragin, Charles H. 3123 Dunbarton avenue N.W 310 Crew, S. B 156 6th street S.AV. 378 Crook, Harrison 424 7th street S.W. 212 Dexter, James E 1333 F street N.W. 107 Dovilliers, Leopold 1221 13th street N.W. 231 Duvall, AV. T. S 1009 L street N.AV. 26 NAME. RESIDENCE. 92 Dver, John I. 1021 15th street N.W. 323 Eliot, J. Llewellyn 510 E street N.W. 152 Evans, Warwick 1107 9th street N.W. 251 Farnham, Robert 1242 Uth street N.W. 151 Fenwick, George 1' 504 6th street S.W. 259 Fisher, Samuel B 307 East Capitol street. 258 Fletcher, Robert 1326 L street N.W. 161 Ford, C. M 150 Pennsylvania avenue S.E. 269 Franzoni, C. W 810 H street N.W. 392 Friedrich, L. L 323 East Capitol street. 341 Fry, H. I) 819 14th street N.W. 99 Garnett, A. Y. P. 1317 New York avenue N.W. 250 Gleeson, J. K. P 1316 R street N.W. 282 Glennan, P 404 Boundary N.W. 270 Gunnell, F. M., U. S. N._ 600 20th street N.W. 224 Hagner, Charles E 1400 H street N.W. 114 Hagner, Daniel R 1812 H street N.W. 403 Hamilton, John B. 9 B street N.W. 267 Hammett, C. M 644 F street S.W. 105 Hansman, Theo. 724 13th street N.W. 376 Harrison, Geo. Byrd 1345 F street N.W. 404 Harrison, J. Stinson 827 I street N.W. 233 Hartigan, James F 608 14th street N.W. 384 Hawkes, William H 1330 New York avenue N.W. 313 Hazen, David H 407 6th street S.W. 366 Hazen, W. P. C 511 East Capitol street. 172 Herbert, J. W 205 H street N.W 396 Holden, R. T 802 6th street S.W. 63 Howard, Flodoardo 1019 F street N.W. 156 Howard, J. T 1126 9th street N.W. 315 Hyatt, Franck 900 K street N.W. 230 Johnson, A. E. 101 B street S.E. 389 Johnson, H. L. E Columbia Hospital. 254 Johnson, Jos. Taber 926 17th street N.W. 237 Johnston, W. W. 1603 K street N.W. 382 Jollev, B. B , 401 3d street N.W. 320 Joyce, J. W. 601 E street N.W. 334 Keech, Thomas A. R 645 Pennsylvania avenue S.E. 319 Kelly, Daniel J 1635 19th street N. W. 333 Ketcham, O. C 37 C street N.E. 169 King, A. F. A 726 13th street N.W. 317 King, George S 1113 G street S.E. 210 Kleinschmidt, C. H. A- 3113 N street N.W. 268 Lamb, Daniel S 1324 V street N.W. 365 Leach, Hamilton E 400 7th street S.W. 166 Lee, William 2111 Pennsylvania avenue N. W 131 Lincoln, N. S 1514 H street N.W. 12 Lindsly, Harvey 824 Connecticut avenue N.W. 349 Little, Joseph W Anacostia. 329 Loring, F. B 1407 New York avenue N.W. 121 Lovejoy, J. W. H 900 12th street N.W. 291 Mackall, James M Portland. 111 Mackall, Louis 3040 Dunbarton avenue N.W. 246 Magruder, G. L 815 Vermont avenue N.W. 390 Malian, Thomas F 216 2d street S.E. 272 Marmion, William V 1108 F street N.W. 374 Marsteller, A. A 219 D street N.W. 27 NAME. RESIDENCE. 281 Mauss, Richard G 1701 6th street N.W. 265 Maxwell, Chas. D. ,U. S. N. 1716 I street N.W. 58 May, John Fred'k 2022 G street N.W. 393 Mav, William 2022 G street N.W. 362 McArdle, Thomas E 707 12th street N.W. 229 McBlair, J. H 439 9th street N.W. 196 McKim, S. A. H. 25 5th street S.E. 225 McNally, Valentine 510 E street N.W. 247 McWilliams, A 607 44 street S. W. 301 Mead, Theodore -902 22d street N.W. 321 Melvin, M. B 721 44 street S.W. 176 Merriam, E. C 622 New Jersev avenue N. W. 351 Morgan, E. Carroll 918 E street N.W. 81 Morgan, James E 905 E street N.AV. 220 Muncaster, Otho M 1405 New York avenue N.W. 399 Mundell, John 11 . - 1022 18th street N.AV. 276 Murphy, P. J. Columbia Hospital. 311 Naylor, William L. 456 M street N.W. 325 Newman, H. M 2403 Pennsylvania avenue N.AV. 337 Newton, Lewis E 413 L street N.W. 377 Nicholson, William 1322 I street N.W. 252 Norris, Basil, U. S. A 1829 G street N. W. 398 Ober, George C. 822 K street S.E. 402 Osmun, Charles J 807 9th street N.W. 288 Palmer, G. S 1113 Massachusetts avenue N.AV. 102 Palmer, William Gray 929 H street N.W. 245 Parsons, John 8 I street N.E. 226 Patterson, D. C 919 I street N. W. 187 Patze, Adolphus 420 10th street N.W. 174 Peter, Armistead 3044 O street N.W. 369 Pool, B. G 1422 11th street N.W. 346 Poulton, AV. E 426 44 street S.AV. 188 Prentiss, D. W 9th street N.AV. 132 Radcliffe, 8. J. 1211 F street N.W. 177 Reily, James R 221 44 street S. W. 207 Reyburn, Robert .--1321 F street* N.W. 383 Reyburn, Robert, Jr 2129 F street N.AV. 353 Richey, S. O 1426 New York avenue N. W. 94 Ritchie, Joshua A. 3259 N street N.W. 205 Ritchie, Louis W 3259 N street N.W. 183 Robbins, Henry A 813 14th street N.W. 173 Roberts, AV. E 715 G street S.E. 359 Rosse, Irving C 1730 H street N.W. 241 Samson, George C 2423 Pennsylvania avenue N.W. 293 Schaeffer, E. M 1321 F street N.W. 178 Scholl, Joseph 615 D street N.AV. 348 Sellhausen, E. A 636 G street N.AV. 391 Shute, D. K AVashington Asylum. 195 Smith, Thomas C. 1133 12th street N.W. 285 Sothoron, James T 1919 I street N.W. 275 Sowers, Z. T 1324 New York avenue N.AV. 235 Stanton, J. O 1344 G street N.W. 368 Street, D. B 61 H street N.W. 249 Suddarth, J. L 2 I street N.E. 360 Suter, Henderson, Jr 1207 31st street N.W. 266 Tarkington, J. A 217 D street N.W. 357 Taylor, Leroy M. - 701 Al street N.AV. 28 NAME. RESIDENCE. 290 Taylor, W. II 619 M street N.W. 159 Thompson, J. Ford 1401 II street N.W. 133 Toner, J. M 615 Louisiana avenue N.W. 372 Torrey, Turner Anacostia. 253 Townshend, Smith 221 4?> street N.W. 375 Trott, Thomas H 232 New Jersey avenue S.E. 87 Tyler, Grafton 1300 30th street N.W. 358 Tyler, Lachlan 1206 G street N.W. 238 Tyler, W. Bowie 2918 P street N.W. 236 Walsh, Ralph 332 C street N.W. 314 Walter, John 1010 F street N.W. 294 Ward, William W 1735 Pennsylvania avenue N.W. 400 West, Geo. Wm 1102 14th street N.W. 326 Williamson, A. N._ 486 F street S.W. 263 Winter, John T 1528 9th street N.W. 180 Wise, Thomas W 606 M street N.W. 215 Wolhaupter, D. P 801 II street N.W. 394 Yarnall, J. H 3028 P street N.W. 331 Yarrow, H. C. 814 17th street N.W. 170 Young, James T. 1336 New York avenue N.W. 306 Young, Parke G 1317 8th street N.W. ASSOCIATE MEMBERS. NAME. RESIDENCE. 15 Binns, Douglas 1014 F street N.W. 20 Caldwell, C. T 1749 11th street N.W. 21 DeMeritt, J. II. 1335 Vermont avenue N.W 12 Foster, R. A. '24 I street N.W. 8 French, R. D. DeL 1316 T streeet N.W. 10 Goodman, William R 216 13J street S.W. 9 Hood, Thomas B. 1009 6 street N.W. 6 Johnston, G. F 420 6th street N.W. 1 Lawver, W. P 1912 I street N. W. 19 Reynolds, W. B * 10 5th street N.E. 14 Robinson, Thomas 1328 T street N.W. 2 Van Arnuni, J. W. 1626 14th street N.W.