mm N« .rff?;;."■;* ?V" iifc £;?.. 5Kl(r ..->V' •■•■-.' i/^'f ^ ¥; ;/4^;; UNITED STATES OF AMERICA WASHINGTON, D. C. GPO 16—67244-1 M&STON MEDICAL POLICE. BOSTON ." HINTED BY SNELUNG AMD SIMON*, BEVONSHIRE STREET. X808- BOSTON MEDICAL POLICE. THE Standing Committee of the Affociation of Bofton Phy- ficians for the year, commencing on the firft Wednefday of March, 1807, having been inftruded to propofe a code of Medical Police, to be fubmitted to the confideration of the Affociation at their next an- nual meeting, beg leave to report: 1. That having examined the different publications of Gregory, Rufh and Percival upon this fubjed, they firft feleded from them fuch articles, as feemed mod applicable to the circumftances of the profeflion in this place. 2. That with thefe articles as a ground work, they have pro- ceeded to form a fhort fyftem of police, containing general principles for the government of this Affociation, by making fuch alterations, or additions to them, as they thought neceffary for rendering them both pradicable and ufeful. 3. That they have added fuch new articles, as they judged con- ducive to the general views of this Affociation, and adapted to the particular fituation of medical pradice in America. The refult of which is Admitted in the form following : 4 CONSULTATIONS. Consultations fhould be encouraged in difficult and protrafted cafes, as they give rife to confidence, energy, and more enlarged views in pradice. On fuch occafions, no rivalfhip or jealoufy fhould be indulged; candour, juftice and all due refped fhould be exercifed towards the phyfician who firft attended ; and as be may be prefum- ed to be beft acquainted with the patient and his family, he fhould deliver all the medical directions as agreed upon. It fhould be the province, however, of the fenior confulting Phyfician to propofe the neceffary queftions to the fick. The confulting Phyfician is never to vifit without the attending one, unlefs by the defire of the latter, or when, as in fudden emer- gency, he is not to be found. No difcufiion of the cafe fhould take place before the patient or his friends ; and no prognoftications fhould be delivered, which were not the refult of previous deliberation and concurrence. Theoretical debates, indeed, fhould generally be avoided in confultation, as occafioning perplexity and lofs of time ; for there may be much diverfity of opinion on fpeculative points, with perfed agreement on thofe- modes of pradice, which are founded, not on hypothefis, but on experience and obfervation. Phyficians in conful- tation, whatever may be their private refentments or opinions of one another, fhould diveft themfelves of all partialities, and think of no- thing but what will moft effedually contribute to the relief of thofe under their care. If a Phyfician cannot lay his hand to his heart and fay, that his mind is perfedly open to convidion, from whatever quarter it may coifce, he fhould in honour decline the confultation. All difcufiions and debates in confultations, are to be held fecret and confidential. 5 Many advantages may arife from two confulting together, who are men of candour, and have mutual confidence in e-ch other's honour. A remedy may occur to one, which did not to another, and a phyfician may want refolution or a confidence in his own opinion, to prefcribe a powerful, but precarious remedy, on which, however, the life of his patient may depend ; in this cafe, a concurrent opinion may fix his own. But when fuch mutual confidence is wanting, a confultation had better be declined, efpecially if there is reafon to be- lieve, that fentiments delivered with opennefs, are to be communicated abroad, or to the family concerned ; and if, in confequence of this, either gentleman is to be made refponfible fpr the event. The utmoft punduality fhould be obferved in confultation vifits; and to avoid lofs of time, it will be expedient to eftablim the fpace of fifteen minutes, as an allowance for delay, after which, the meeting might be confidered as poftponed for a new appointment. >ccccccc:< INTERFERENCES. Medicine is a liberal profefiion ; the praditioners are, or ought to be, men of education ; and their expedations of bufinefs and employment fhould be founded on their degrees of qualification, not on artifice and infinuation. A certain undefinable fpecies of affidui- ties and, attentions, therefore, to families ufually employing another, is to be confidered as beneath the dignity of a regular praditioner, and as making a mere trade of a learned profefiion ; and all officious interferences in cafes of ficknefe in fuch families, evince a meannefs of difpofition, unbecoming the charader of a Phyfician or a Gentleman. No meddling inquiries fhould be made concerning them, nor hints 6 given relative to their nature and treatment, nor any felfifh condud purfued, that may, diredly or indiredly, tend to weaken confidence in, the Phyficians or Surgeons, who have the care of them. When a Phyfician is called to a patient, who has been under the care of another gentleman of the faculty, before any examination of the cafe he fhould afcertain, whether that gentleman has difcontinued his vifits, and whether the patient confiders himfelf as under his care, in which cafe, he is not to affume the charge of the patient, nor to give his advice, (excepting in inftances of fudden attacks) without a regular confultation ; and if fuch previoufly attending gentleman has been difmiffed, or has voluntarily rehnquifhed the patient, his pradice fhould be treated with candour, and juftified fo far as probity and truth will permit; for the want of fuccefs in the primary treatment of the diforder, is no impeachment of profeflional fkill and knowledge. It frequently happens, that a Phyfician, in incidental communica- tions with the patients of others, or with their friends, may have their cafes ftated to him in fo dircd a manner, as not to admit of his declining to pay attention to them. Under fuch circumftances, his obfervations fhould be delivered with the moft delicate propriety and referve. He fhould not interfere in the curative plans purfued ; and fhould even recommend a fteady adherence to them, if they appear to merit approbation. —£S>: MJM09. --- i DIFFERENCES OF PHYSICIANS. The differences of Phyficians, when they end, in appeals to the publick, generally hurt the contending parties ; but, what is of more 7 confequence, they difcredit the profefiion, and expofe the faculty itfelf to contempt and ridicule. Whenever fuch differences occur, as may affed the honour and dignity of the profefiion, and cannot im- mediately be terminated, or do not come under the charader of vio- lation of the fpecial rules of the affociation otherwife provided for, they fhould be referred to the arbitration of a fufficieht number of members of the affociation, according to the nature of the difpute ; but, neither the fubjed matter of fuch references, nor the adjudication, fhould, if it can be avoided, be communicated to the publick, as they may be per. fonally injurious to the individuals concerned, and can hardly fail to hurt the general credit of the faculty. ■:MMM:< DISCOURAGEMENT OF QUACKERY The ufe of Quack medicines fhould be difcouraged by the faculty, as difgraceful to the profefiion, injurious to health, and often deftruc- tive even of life. No Phyfician or Surgeon, therefore, fhould dif- penfe a fecret noftrum, whether it be his invention or exclufive pro- perty • for if it is of real efficacy the concealment of it is inconfiftent with beneficence, and profeffional liberality ; and, if myftery alone give it value and importance, fuch craft implies, either difgraceful ignorance, or fraudulent avarice. tSL~ :a s CONDUCT FOR THE SUPPORT OF THE MEDICAL CHARACTER. The efprit du corps is a principle of adion, founded in human nature, and, when duly regulated, is both rational and laudable. Every man, who enters into a fraternity, engages, by a tacit compad, not only to fubmit to the laws, but to promote the honour and in- tereft of the affociation, fo far as they are confiftent with morality and the general good of mankind. A Phyfician, therefore, fhould cautioufly guard againft whatever may injure the general refpedability of the profefiion, and fhould avoid all contumelious reprefentations of the faculty at large, all general charges againft their felfifhnefs or improbity, or the indulgence of an affeded or jocular fcepticifm, con- cerning the efficacy and utility of the healing art. FEES. General rules are adopted by the faculty in every town, relative to the pecuniary acknowledgements of their patients ; and it fhould be deemed a point of honour to adhere to them ; and every deviation from, or evafion of thefe rules, fhould be confidered as meriting the indignation and contempt of the fraternity. Gratuitous fervices to the poor, are by no means prohibited; the charaderiftical beneficence of the profefiion, is inconfiftent with 9 fordid views and avaricious rapacity. The poor of every defcription fhould be the objeds of our peculiar care. Dr. Boerhaave ufed to fay, they were his beft patients, becaufe God was their paymafter. s It is obvious alfo, that an average fee, a9 fuited to the general rank of patients, muft be an inadequate compenfation from the rich, (who often require attendance not absolutely neceffary) and yet too large to be expeded from that clafs of citizens, who would feel a rc- ludance in calling for affiftance, without making fome decent and fatisfadory remuneration. ■•■OltNOOa: EXEMPTION FROM CHARGES. The clergymen of the town, and all members of the medical pro- feffion, together with their families, fhould be attended gratuitoufly ; but vifits fhould not be obtruded oflicioufly, as fuch civility may give rife to embarraffments, or interfere with that choice on which confi- dence depends. But diftant members of the faculty, when they requeft attendance, fhould be expeded to defray the charges of travelling ; and fuch of the clergy from abroad, as are qualified by their fortunes or incomes, to make a reafonable remuneration for medical attendance, are not more privileged, than any other order of patients. B • 10 Omission to charge, on account of the wealthy circumftances of the Phyfician, are an injury to the profefiion, as it is defrauding, in a degree, the common funds for its fupport, when fees are difpenfed with, which might juftly be claimed. •.omw- VICARIOUS OFFICES Whenever a Phyfician officiates for another by his defire, in con- fequence of ficknefs or abfence, if for a fhort time only, the attend- ance fhould be performed gratuitoufly as to the phyfician, and with the utmoft delicacy towards the profeffional charader of the gentle- man previoufly conneded with the patient. >.Mj)m< SENIORITY. A regular and academical education furnifhes the only prefump- i tive evidence of .jrofefiional ability, and is fo honourable and benefi- cial, that it -iv«j a juft claim to pre-eminence among Phyficians at ia-.ye, in proportion to^thc degree in which it may be enjoyed and improved. Neverthel*. fs as induftry and talents may furnifh excep- tious to this genera! rule, and this method may be liable to difficnl- 11 ties, in the application, feniority, among practitioners of this town, fhould be determined by the period of publick and acknowledged prac- tice as a Phyfician or Surgeon in the fame. This arrangement being clear and obvious, is adapted to remove all grounds of difpute amongft medical gentlemen ; and it fecures the regular continuance of the eftab'ifhed order of precedency, which might^otherwife be fubjed to troublefome uterruptions, by new fettlers, perhaps not long ftation- ary in the place, JOHN WARREN. LEMUEL HAYWARD. JOHN FLEET. Mcmc:* AT a meeting of the Bofton Medical Affociation, held at Vila's •n the firft Wednefday in March, 1808, the Committee of the pre- ceeding year, having, in conformity with their inftrudions, reported on a code of Medieal Police, which was read and accepted by fedions, it was voted, That the Report of the Committee be recommitted, with inftruc- tions to print five hundred copies of the fame and that they prefent to each member of the Affociation three copies of the Report, and diftribute the remaining copies to fuch other Phyficians of the State as they may think proper. Voted likeivife, That the thanks of the Affociation be prefented t» the Committee for their judicious and ufeful Report. J. GORHAM, Secretary. ■*. wz. B7tU \%o%