“SALU S.” 
BY- LAWS 
OF THE 
M edical Society 
OF THE 
County of Albany, 
Together with the Organization of the Society, and the 
Code of Medical Ethics, 
PRINTED BY ORDER OF THE SOCIETY. 
ALBANY: 
THE ARGUS COMPANY, PRINTERS. 
1877. PREFACE. 
This society is, perhaps, the oldest incorporated medical 
society in the State, having been organized almost immedi- 
ately after the passage by the Legislature of the statute for 
the purpose, in 1806, and six months before the State society 
itself was organized. In membership, it ranks as the fourth 
among the county societies, or including non-resident mem- 
bers, it is the third, being preceded only by New York and 
Kings counties. 
Upon the organization of the society a committee was 
appointed, consisting of I)rs. Hunloke Woodruff, William 
McClelland and C. D. Townsend, the newly elected president, 
vice-president and secretary, to prepare a set of by-laws, 
and their report, after having had three readings, was 
adopted April 14, 1807, and signed by the members of 
the society. It will be found in the first volume of 
the printed Annals of the Society. Committees to amend 
these by-laws were appointed in 1808, 1819, 1825 and 1881, 
resulting in additions of minor importance. On these com- 
mittees are the names, yet well remembered, of John G. 
Knauff, Charles D. Townsend, T. Romeyn Beck, Platt 
Williams, Joel A. Wing, Jonathan Eights, William Bay 
and James McNaughton. The by-laws were first printed 
in 1821, and again in 1828, together with the State law and 
a catalogue of the library: no copies of these publications 
are known to be in existence. 
In 1889 a committee, consisting of Drs. Jonathan Eights, 
Peter Van Olinda and Peter Van Buren, was appointed to 4 
Prkfa ce. 
revise the by-laws, and they reported a code, not very essenti- 
ally differing from the by laws as previously existing, which 
was adopted June 28, 1840. The printed copy in the hands of 
members of the society, bears the date of 1851. These are 
the by-laws which, for thirty-seven years, have been used for 
the ruling of this society. 
The lack of completeness of these by-laws, and their ineffi- 
ciency for various circumstances, has repeatedly forced itself 
upon the attention of the society, and in 1876 a committee 
was again appointed, consisting of Drs. Win. H. Bailey, J. R. 
Boulware, Joseph Lewi, Thomas Beckett, W. G. Tucker and 
Lewis Balch, to revise the by-laws and draw up a new and 
more perfect code. At an adjourned annual meeting, held for 
the purpose, November 28, 1876, the report of this committee 
was received, and with some amendments adopted, and a 
copy forwarded to the State Medical Society for approval, 
in accordance with section 1, chapter 5 of their by-laws. 
Two amendments having been suggested by the standing 
committee on by-laws, to which the copy was referred, these, 
with certain others, were adopted at the annual meeting, held 
November 13, 1877; and the perfected code having received 
the approval of the authorized committee of the State society, 
as in conformity with the laws of the State and with the 
organization and by-laws of the Medical Society of the State 
of New York, became the law of this society. 
F. C. CURTIS, 
B. U. STEENBERG, 
LEWIS BALCH, 
Committee of Publication. ORGANIZATION OF THE SOCIETY. 
On Tuesday, July 29, 1806, the following physicians and 
surgeons of the county of Albany met in the city of Albany 
for the purpose of forming a Medical Society, in conformity 
with an act to incorporate Medical Societies, passed April 4, 
1806, viz. : Wilhelmus Mancius, Hunloke Woodruff, 
Wm. McClelland, John G. Knauff, Caleb Gauff, A. 
Harris, J. W. Hegeman, C. Vrooman, Jr., A. G. Fonda 
and C. I). Townsend. 
The following officers were elected : 
Hunloke Woodruff, - - - President. 
William McClelland, - - Vice-President. 
Ciias. I). Townsend, - - - Secretary. 
John G. Knauff, - - - Treasurer. 
It was resolved “ That this society be known by the name 
of the Medical Society of the County of Albany.” It was 
further resolved that the Board of Censors consist of five 
members, and the following were elected : William McClel- 
land, William Anderson, Charles D. Townsend, Joseph 
W. Hegeman and Elias Willard. 
A committee was appointed to draught a code of by-laws, 
and the second Tuesday in January was fixed upon as the 
time for holding the anniversary meeting. B Y-L A W S 
OF THE 
CHAPTER I. 
TITLE, OFFICERS AND MEETINGS OF THE SOCIETY. 
Art. 1. This society shall be entitled the Medi- 
Title. 
cal Society of the County" of Albany". It shall 
consist of resident, non resident and honorary members. 
Art. 2. The officers of the society shall consist 
of a president, a vice-president, a secretary, a treas- 
urer and five censors, who shall be elected by ballot, by a 
majority vote, at the annual meeting. They shall hold office 
for one year, and until their successors shall be chosen. In 
case an office shall become vacant, in consequence of death, 
resignation, removal, or from any other cause, a special 
meeting shall be held, of which at least ten days’ previous 
notice shall be given, for the purpose of filling such 
vacancy. 
Art. 3. This society shall hold regular meetings 
in each year, as follows: An annual meeting: to be Regular 
~ meetings.' 
lmld upon the second Tuesday in October, and a 
semi annual meeting to be held upon the second Tuesday in 
May, at three o’clock, p. m., in the city of Albany. During 
the interval between the annual and the semi-annual meet- 
ing, regular meetings shall also be held for the presentation 8 
By-La ws. 
of papers, the exhibition of specimens, scientific discussion, 
and such other business as is consistent with these by-laws, 
not less frequently than once in each month, at such time 
and place as the president and censors may deem convenient. 
Art. 4. Special meetings may be called by the president 
at his own option, or at the request in writing of 
not less than five resident members of this society. 
Art. 5. At all meetings of this society, fifteen resident 
members shall constitute a quorum ; but a quorum 
shall not be requisite at a meeting devoted solely 
to scientific discussion. 
Special 
meetings. 
Quorum. 
CHAPTER II. 
ORDER OF BUSINESS AND RULES OF ORDER. 
Order of 
business. 
Art. 1. At the annual meeting, the order of busi- 
ness shall be as follows : 
1. Reading the minutes of the last semi-annual meeting. 
2. Reception of reports from officers of the society 
and from committees. 
3. Election of members. 
4. Motions and resolutions. 
5. Miscellaneous business. 
6. Amendment of by-laws. 
7. The annual address. 
8. Election of officers and delegates. 
At the semi-annual meeting, as follows : 
1. Reading the minutes of the last annual meeting. 
2. Reception of reports. 
3. Election of members. 
4. Motions and resolutions. 
5. Miscellaneous business. 
6. Semi-annual address. 
At the intervening regular meetings, as follows : 
1. Reading the minutes of the last intervening regular 
meeting. By-La ws. 
9 
2. Nominations for membership. 
3. Reception of reports. 
4 Communications, discussions, reading of papers, 
and presentation of specimens in the order 
directed by the presiding officer. 
5. Miscellaneous business. 
Art. 2. The following shall be the rules of order 
of this society: 
1. Any member who may speak on any subject or question 
before the society, shall rise and address the presiding officer. 
2. Every member shall have the privilege of speaking 
twice on any question under consideration, but not oftener, 
unless by permission of the society. 
3. Any member called to order while speaking, shall dis- 
continue his remarks until the point of order is settled. 
4. All resolutions and amendments shall be offered in 
writing, when required by any member. 
5. No motion or resolution shall be considered, unless 
seconded; nor question, unless stated by the presiding 
officer. 
, 6. When a question is under debate, no motion shall be 
received but to adjourn, to lay on the table, for the previous 
question, to postpone, to refer or to amend ; which several 
motions shall have precedence in the order in which they are 
here arranged. The first three shall be decided without 
debate. 
7. The yeas and nays on any question, when called for by 
live members present, shall be taken without debate, and 
recorded on the minutes. 
8. All questions of order, not provided for by these rules, 
shall be determined by parliamentary usage. 
Rales of 
ordijr. 
CHAPTER III. 
Art. 1. It shall be the duty of the president to preside at 
all meetings of the society, to call the meeting to 
President. 
order at the appointed time, and to preserve order 
DUTIES OF OFFICERS. 10 
By-Laws. 
and decorum. He shall take the sense of the society on 
every motion made, and shall have the right to vote on all 
questions ; but if he vote, and there be a tie, the question 
shall, in every such case, be considered as lost, All ques- 
tions of order shall be decided by the chair, subject to an 
appeal, which shall be determined by vote without debate. 
He shall confer a diploma of license on such persons as are 
certified by the censors to be qualified for the practice of 
physic and surgery, on receiving for such diploma the sum 
of five dollars for the use of the society. He shall deliver an 
address at the annual meeting closing his official year. He 
shall be, ex officio, a member of the board of censors, of 
which he shall be the presiding officer. 
Art, 2. The vice president, in the absence of the 
president, shall preside and perform the duties of 
the president. He shall deliver an address at the semi- 
annual meeting. He shall be, ex officio, a member of the 
board of censors. 
Art. 3. The secretary shall perform the duties 
directed by the statutes and the by-laws and reso- 
lutions of the society. He shall keep in his book a full 
and distinct record of all the transactions of the society. 
He shall keep a chronological list of the members of the 
society, designating them as resident, non-resident or hon- 
orary, and also a list of those resident members who are 
not “ in arrears with the treasurer,” which shall be known 
as the “ list of active members.” He shall give due notice 
of all meetings of the society, in such a manner as it shall 
direct. He shall inform all persons proposed for member- 
ship of their nomination, and all persons admitted to mem 
bership, and all officers chosen, of their election, and notify 
members of committees of their appointment. He shall 
conduct the correspondence of the society, and keep on file 
Vice-presi- 
dent. 
Secretary. By-La ws. 
11 
a record of the same. He shall transmit, annually, to the 
secretary of the State Medical Society, at or soon after 
the meeting of said society, a list of the officers, delegates 
and members of this society. 
Art. 4. The treasurer shall perform the duties 
directed by the statutes, aiid the by-laws and reso- 
lutions of the society. It shall be his duty to present a bill 
of the annual dues to each member every year, showing 
all arrearages, and to demand payment of the same, if 
unpaid, at least twice during the succeeding year. For 
this purpose the treasurer is authorized to have the necessary 
blanks printed, and to employ a competent collector. He 
shall keep all funds of the society deposited in some solvent 
bank in the city of Albany, in the name of the society. 
He shall draw the same therefrom by checks signed by him 
as treasurer, approved by the president. On the written 
approval of the president, he shall pay all bills of the 
society as they become due. He shall render an account at 
every annual meeting of all the moneys received and 
expended by him, and of the balance remaining in his 
hands. He shall report to the society at the annual meeting 
the names of those on the “list of active members,” and 
of those suspended for unpaid dues. 
Art. 5. The censors shall perform the duties pre- 
scribed by the statutes and the by-laws and reso- 
lutions of the society. They shall examine the credentials 
and investigate the professional and personal character of 
each candidate for admission to membership, and report 
thereon to the society at the succeeding annual or semi- 
annual meeting. It shall be the duty of the censors to 
examine all candidates applying for license to practice 
physic and surgery, who have complied with the requisitions 
of the statutes of the State and the by-laws of this society; 
Treasurer. 
Censors. 12 
By-Laws. 
and they shall, after such examination, if they find the 
candidate qualified, grant him a certificate to that effect, 
signed by each censor, which certificate shall entitle him 
to the diploma of this society on application to the presi- 
dent. Not less than three censors shall constitute a board 
for the examination of candidates. In case of the absence 
of one or more of the board of censors, the president may 
appoint a censor or censors pro tempore. 
CHAPTER IV. 
MEMBERS. 
Art. 1. The members of this society shall be 
divided into three classes; resident, non-resident 
and honorary members. They shall be elected at the 
annual or semi-annual meeting. 
Art. 2. Resident members shall consist of phy- 
sicians and surgeons who, being residents of the 
county of Albany, shall have been regularly elected, 
paid the initiation fee and signed the by-laws. Each resi- 
dent member shall pay yearly treasurer, for the use 
of the society, the sum of y/o which shall be due, 
in advance, at the annual meeting, at which time the liscal 
year of the society shall commence. Members who shall 
not have paid the annual dues for two years in succession, 
after having been twice in each year called upon to do so, 
are declared to be, at the expiration of that time, “in 
arrears with the treasurer,” and their names shall appear 
on his list of members suspended for unpaid dues. Mem- 
bers “in arrears with the treasurer” shall neither be eligible 
to office nor entitled to vote at any annual meeting ; neither 
shall they be entitled to the privilege ot being notified of 
the meetings of the society. Any member who shall con- 
tinue “in arrears with the treasurer” for one year, after 
Classes. 
Resident 
members. B y-La ws. 
13 
having twice received due notice of the existence of this 
by-law and of the amount due from him, shall have his 
name dropped from the roll, and he shall not be reinstated 
except upon the payment of all arrears, unless the society 
shall, vote of two-thirds of those present at a regular 
meeting, otherwise determine. 
This by-law shall be printed on all bills sent to members 
by the treasurer. 
Akt. 3. Any member, not in arrears with the 
society, who may permanently remove, from the 
county of Albany, shall be known as a non-resi- 
dent member. Such member shall not be required to con- 
tribute to the funds of the society ; shall not vote at any 
election, be eligible to any office or appointment, or receive 
notices or publications from or through the society, but, 
in all other respects, shall enjoy every right and privilege 
of a resident member. All questions of residence of mem- 
bers of this society shall be determined by the statutes 
regulating the residence of citizens in election districts. 
Physicians residing out of the county may be elected to 
non-resident membership, privileges as herein stated 
and in conformity with chapter five of these by-laws. 
Art. 4. Honorary members may be nominated at 
any regular meeting and elected by a two-thirds 
vote at any subsequent annual or semi-annual meet- 
ing, provided they are recommended lor election by the 
board of censors, to whom all nominations for honorary 
membership shall be referred. They shall be non-residents 
of the county. Not more than three honorary members 
shall be annually elected. Honorary members may take 
part in debate, but shall not be entitled to vote, nor shall 
they be eligible to any office. 
Non-resi- 
dent mem- 
bers. 
Honorary 
members. 14 
B y-La tvs. 
CHAPTER V. 
ADMISSION OF MEMBERS. 
Applica- 
tions for 
member- 
ship. 
Art. 1. Applications for membership may be 
made at any regular meeting upon a printec 
blank prepared for that purpose and furnished by the sec 
retary, which shall state the full name and post-office 
address of the applicant. No application shall be consid 
ered unless accompanied by the initiation fee, which fee 
shall be returned if the applicant be rejected. During the 
interval between the semi-annual and annual meetings, appli 
cations may be made to the secretary. All documents anc 
testimonials, relative to the candidate’s professional and per- 
sonal qualifications, shall be placed in the hands of the 
secretary, who shall lay them before the censors. 
Art. 2. When the censors shall have made a 
report upon an application to the society, as pro- 
vided for in chapter three, article five, the candidate, 
upon receiving a two-thirds vote of those present, shall be 
declared elected a member of the society. If demanded by 
any resident member, a separate vote may be taken upon 
each candidate. 
Art. 3. The initiation fee shall be live dollars, anc 
the annual dues shall commence at the next annua 
meeting after admission. 
Action on 
application. 
Initiation 
•fee. 
CHAPTER VI. 
ETHICS AND DISCIPLINE. 
Ethics. 
Art. 1. The system of medical ethics,* and the 
by-laws, rules and regulations of the Medical Society 
of the State of New York, which have reference to county 
* This system of ethics was adopted by this society in 1824; it may be found 
at page 2;il of the first reprint of the State Society Transactions. By-La its. 
15 
societies, together with the precepts ot the code ot medical 
ethics of the American Medical Association, shall be binding 
on the members of this society, and any intentional violation 
or disregard of the same shall be cause for discipline. 
Art. 2. The board of censors shall take cogni- 
zance of all complaints of breaches of the code of 
ethics which may be laid before it, and endeavor to 
reclaim offenders before proceeding formally against them. 
Art. 3. Charges of violations of the laws of ethics 
of the society, or immoral conduct, shall be presented 
to the president in writing, inclosed in a sealed envelope, and 
with the words, “ charges against a member” written 
thereon. 
Art. 4. The president, on receiving such charges, 
shall notify the censors to meet and examine the 
same and the evidence thereon. 
Art. 5. If the majority of the censors shall be of 
the opinion that the charges are well founded, they 
shall serve a copy of them upon the accused, and 
cause a special meeting of the society to be called to investi- 
gate them. Of this meeting the accused shall have at least 
ten days’ notice in writing with an invitation to be present. 
Due notice of this meeting shall be advertised in at least two 
papers published in the county. 
Art. 6. After the investigation of charges, the 
society may, at its option, dismiss them, or proceed 
to discipline the accused. 
Art. 7. Discipline by the society may be of thret 
kinds: Admonition, suspension and expulsion, and 
shall require the affirmative vote of three-fourths of all the 
resident members present. 
Action of 
censors. 
Charges. 
Action 
of the 
president. 
Further ac- 
tion of the 
censors. 
Action 
of the 
society. 
Mode of 
discipline. 16 
By-La frs. 
CHAPTER VII 
LICENTIATES. 
Diploma of 
licentiates. 
Art. 1. Every person who, upon examination by 
the censors, in conformity with chapter three, article 
five of these by-laws, shall be found qualified for the prac- 
tice of physic and surgery, shall receive from the censors a 
certificate to that effect addressed to the president of the 
society, who shall thereupon confer upon him the following 
diploma: 
“ To all to whom these presents shall come, or whom they 
may in any wise concern : 
The president, and members of the Medical Society of the 
county of Albany, send greeting: Whereas (name of candi- 
date) hath exhibited unto us satisfactory testimony that he 
has studied physic and surgery for the term and in the man- 
ner directed bylaw ; and has also, upon examination by our 
censors, given sufficient proofs of his proficiency in the heal- 
ing art, and of his moral character; therefore, by virtue of 
the power vested in us by law, we do grant unto the said 
(name of candidate) the privilege of practicing physic and 
surgery in this State, together with all the rights and immu- 
nities which usually appertain to physicians and surgeons. 
In witness whereof we have granted this diploma, sealed 
with our seal and testified to by our president and secretary, 
at” (place, day and year). 
Art. 2. Every person admitted to the practice of 
physic and surgery shall sign the following decla- 
ration : 
I, A. B., do solemnly declare that I will honestly, virtu- 
ously and chastely conduct myself in the practice of physic 
and surgery, and that I will, with fidelity and honor, do 
every thing in my power for the benefit of the sick commit- 
ted to my charge. 
Declaration 
of candi- 
dates. By-La ws. 
17 
This declaration, so signed, shall be preserved in the 
archives of the society. 
Art. 3. Every person receiving a diploma ol 
license shall be notified by the secretary that he 
must deposit a copy of the same with the clerk ol 
the county in which he may reside, and that until 
this is done, he is subiect to uenaltv as an illegal Dractitioner. 
Candidate 
to record 
his diploma 
with the 
county 
clerk. 
CHAPTER VIII. 
AMENDMENTS TO BY-LAWS. 
Art. 1. Amendments proposed to these by-law? 
can only be adopted at*annual meetings. They shal] 
be proposed in writing at a previous regular meeting. A 
concurrent vote of three-fourtlis of the resident members 
present shall be necessary for their adoption. 
Art. 2. At any regular meeting, any by-law may 
be suspended for any length of time, short of the 
next annual meeting of the society, by the concurrent vote 
of three-fourtlis of the resident members present, the motion 
to that effect being presented in writing. 
Art. 3. All by-laws, rules and regulations of this society 
inconsistent with these by-laws are hereby repealed. 
Manner of 
amending. 
Suspension 
of by-laws. Code of Ethics 
OF THE 
American Medical Association, 
ADOPTED BY THE 
Medical Society of the Codnty of Albany, 
November 28, 1870. 
OF THE DUTIES OF PHYSICIANS TO THEIR PATIENTS, AND OF 
THE OBLIGATIONS OF PATIENTS TO THEIR PHYSICIANS. 
Akt. I. — Duties of physicians to their patients. 
§ 1. A physician should not only he 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 conscience to adjudge penalties for care- 
lessness 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 con- 
descension 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 indul- 
gence 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 inter- 
course to which physicians are admitted in their professional visits 
should be used with discretion, and with the most scrupulous regard 20 
Code of Medical Ethics. 
to fidelity and honor. The obligation of secrecy extends beyond the 
period of professional services ; none of the privacies of personal and 
domestic life, no infirmity of disposition or flaw of character observed 
during professional attendance should ever be divulged by the physi- 
cian, except when he is imperatively required to do so. The force 
and necessity of this obligation are indeed so great that professional 
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 prognosti- 
cations, because they savor of empiricism, by magnifying the import- 
ance 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 
whenever 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 expiring life, and counteract the 
depressing influence of those maladies which often disturb the tran- 
quility of the most resigned in their last moments. The life of a 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 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. 
§ 6. Consultations should be promoted in difficult or protracted Code of Medical Ethics. 
21 
cases, as they give rise to confidence, energy, and more enlarged 
views in practice. 
§ 7. The opportunity which a physician not unfrequently enjoys 
of promoting and strengthening the good resolutions of his patients, 
suffering under the consequences of vicious conduct, ought never to 
be neglected. Ilis counsels, or even remonstrances, will give satisfac- 
tion, not offense, if they be proffered with politeness 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. 
§ 1. The members of the medical profession, upon whom is enjoined 
the performance 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 them- 
selves 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 mankind 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 pi’ofessional 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 become 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 precept that medicine owes 
much of the uncertainty and imperfection with which it has been 
reproached. 
§ 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 22 
Code of Medical Ethics. 
depending on external causes, and yet are only to be cured by minis- 
tering 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. However commendable a modest 
reserve may be in the common occurrences of life, its strict observance 
in medicine is often attended with the most serious consequences, and 
a patient may sink under a painful and loathsome disease which might 
have been readily prevented had timely intimation been given to the 
physician. 
§ 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 symptoms, he will convey much more real infor- 
mation by giving clear answers to interrogatories 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 treat- 
ment dangerous, and even fatal. This remark is equally apjdicable 
to diet, drink and exercise. As patients become convalescent, they 
are vei’y 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 themselves to be persuaded to take any medicine 
whatever that may be recommended to them by self-constituted 
doctors and doctresses who are so frequently met with and who pre- 
tend 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 friendly visits of 
a physician who is not attending him — and when he does receive 
them he should never converse 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 Code of Medical Ethics. 
23 
should never send for a consulting physician without the express con- 
sent of his own medical attendant. It is of great importance that 
physicians should act in concert; for, although their modes of treat- 
ment may be attended with equal success when employed singly, yet 
conjointly they are very likely to be productive of disastrous results. 
§ 8. When a patient wishes to dismiss his physician, justice and 
common courtesy require that he should declare his reasons for so 
doing. 
§ 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 inter- 
ference 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 
inconvenience 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 LARGE. 
Art. I. — Duties for the support of professional character. 
§ 1. Every individual on entering the profession, as he becomes 
thereby entitled to all its privileges and immunities, incurs an obliga- 
tion 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 diligence, he resorts to every honorable means of enriching 
the science, he should entertain 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 character 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 24 
Code of Medical Ethics. 
and confidence; and to both, because no scientific attainments can 
compensate 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 unremitting 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. 
§ 3. It is derogatory to the dignity of the profession to resort to 
public advertisements, or private cards, or handbills, inviting the 
attention of individuals affected 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 opera- 
tions; to boast of cures and remedies; to adduce certificates of skill and 
success, 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 disgrace- 
ful ignorance or fraudulent avarice. It is also reprehensible for 
physicians to give certificates attesting the efficacy of patent or 
secret medicines, or in any way to promote the use of them. 
Art. II. — Professional services of physicians to each other. 
§ 1. All practitioners of medicine, tlieir 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 assist- 
ance may be desired. A physician afflicted with disease is usually an 
incompetent judge of his own case, and the natural anxiety and solici- 
tude 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 gratuitously afforded. Visits ought not, how- ever, 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 circum- 
stances 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. 
Code of Medical Ethics. 
25 
Art. III. — Of the duties of physicians as respects vicarious offices. 
§ 1. The affairs of life, the pursuit of health, and the various acci- 
dents and contingencies 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 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 frequent and long-continued exer- 
oise 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. 
§ 1. 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 acknowl- 
edged respectability, recognized by this Association, and who is in 
good moral and professional 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 the 
accumulated experience of the profession, and of the aids actually 
furnished by anatomy, physiology, pathology and organic chemistry. 26 
Code of Medical Ethics. 
§ 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 consult- 
ing physician should have the opportunity to make such further inqui- 
ries of the patient as may be necessary to satisfy him of the true 
character of the case. Both physicians should then retire to a private 
place for deliberation, and the one first in attendance should communi- 
cate 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 previous deliberation and 
concurrence. 
§ 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 restrain the attending physician from 
making such variations in the mode of treatment as any subsequent 
unexpected change in the character of the case may demand. 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 consulting physician, if he is sent for in an emergency, when 
the regular physician is out of the way, and similar explanations must 
be made by him at the next consultation. 
§ 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 precedence of all 
others, and to be an ample reason for the relinquishment of any 
present occupation. But as professional engagements may sometimes 
interfere and delay one of the parties, the physician who first arrives 
should wait for his associate a reasonable period, after which the con- 
sultation should be considered as postponed to a new appointment. 
If it be the attending physician who is present, he will of course see 
the patient and prescribe; but, if it be the consulting one, he should 
retire, except in case of emergency, or when he has been called 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. Code of Medical Ethics. 
27 
§ 6. In consultations, theoretical discussions should be avoided, as 
occasioning perplexity and loss of time. For there may be much 
diversity of opinion concerning speculative points, with perfect agree- 
ment in those modes of practice which are founded, not on hypothesis, 
but on experience and observation. 
§ 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. 
§ 8. Should an irreconcilable diversity of opinion occur when several 
physicians are called upon to consult together, the opinion of the 
majority should be considered 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 pursued. This is a circumstance much to be deplored, and 
should always be avoided, if possible, by mutual concessions, as far 
as they can be justified 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 cii’cumstances 
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 manage- 
ment of the case. 
§ 9. As circumstances sometimes occur to render a special consulta- 
tion desirable, when the continued attendance of two physicians might 
be objectionable to the patient, the member of the faculty whose assist- 
ance 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 least a double 
honorarium may be reasonably expected. 
§ 10. A physician who is called upon to consult should observe the 
most honorable and scrupulous regard for the character and standing 
of the practitioner in attendance; the practice of the latter, if neces- 
sary, should be justified as far as it can be, consistently with a 
conscientious regard for truth, and no hint or insinuation should be 
thrown out which could impair the confidence reposed in him or 28 
Code of Medical Ethics. 
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 gain- 
ing applause or ingratiating themselves into the favor 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 circum- 
stances ; 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 
case 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, 
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 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 pro- 
tracted, 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, he ought, unless his assistance in consulta- 
tion be desired, to resign the care of the patient to the latter imme- 
diately on his arrival. Code of Medical Ethics. 
29 
§ 6. It often happens in cases of sudden illness, or of recent acci- 
dents and injuries, owing to the alarm and anxiety of friends, that a 
number of physicians are simultaneously sent for. Under these cir- 
cumstances 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 practitioner Avho 
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 consequence of the sickness or absence of the latter, he ought, on 
the return or recovery 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 under- 
stood that he regarded the said physician as his regular medical 
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 direc- 
tion 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 inter- 
fere no further than is absolutely necessary with the general plan 
of treatment; to assume no future 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 afflu- 
ent, because his doing so is an injury to his professional brethren. The 
office of a physician can never be supported as an exclusively benefi- 
cent 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 is entitled to the fee, but should 
resign the patient to the practitioner first engaged. 30 
Code of Medical Ethics. 
Art. VI. — Of differences betxceen physicians. 
§ 1. 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 can- 
not be immediately terminated, they should be referred to the arbi- 
tration of a sufficient number of physicians or a court-medical. 
§ 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 PROFESSION. 
§ 1. 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, arrange- 
ments and dietaries of hospitals, asylums, schools, prisons and similar 
institutions; in relation to the medical police of towns, as drainage, 
ventilation, etc., and in regard to measures for the prevention of 
epidemic and contagious diseases; 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 
Art. I. — Duties of the profession to the public. Code of Medicai. Ethics. 
31 
courts of justice on subjects strictly medical — such as involve ques- 
tions 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 pi’ofession 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 services; 
but neither institutions endowed by the public or by rich individuals, 
societies for mutual benefit, for the insurance of lives or for analogous 
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 wishing to insure their 
lives, obtain pensions or the like, without a pecuniary acknowledg- 
ment. But to individuals in indigent circumstances, such 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 by exercising 
their option in regard to the shops to which their prescriptions shall 
be sent, 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 the 
utmost consideration and respect from the community. The public 32 
Code of Medical Ethics. 
ought likewise to entertain a just appreciation of medical qualifica- 
tions ; to make a proper discrimination between true science and the 
assumptions of ignorance and empiricism; to afford every encourage- 
ment and facility 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 liability to heavy penalties, and 
of making them obnoxious to punishment for resorting to the only 
means of obtaining it.