CONVERSATIONS 
BETWEEN 
DRS. WARREN AND PUTNAM 
ON THE SUBJECT OF 
MEDICAL ETHICS 
WITH 
AN ACCOUNT OF THE MEDICAL EMPIRICISMS OF 
EUROPE AND AMERICA 
Frank Hastings Hamilton, M.D. 
BY 
28 Union Square, East 
New York 
BERMINGHAM & COMPANY 
20 King William St., Strand 
London 
1884 Copyright, 1884, 
By FRANK H. HAMILTON. PREFACE. 
The “ Conversations,” written in moments of 
enforced idleness, while recovering from a 
serious illness, and published originally in suc- 
cessive numbers of the Medical Gazette, were 
intended to represent the conflicting opinions 
of medical men in this country on the subject 
°f a written Code of Ethics, and substantially, 
the grounds upon which these opinions are 
based. 
By a large proportion of the profession the 
question has seemed to be one of importance, 
uot only in its relations to the interests of the 
public at large, but also in its relations to the 
tuorals and character of the profession, and the 
progress of medical science. 
If, therefore, the discussions which have 
arisen have been characterized by earnestness, 
and perhaps by a certain degree of acerbity, it 
should be ascribed to the magnitude of the issues 4 
PREFACE. 
apparently involved and not to personal or in- 
terested motives. 
The writer does not deny that he feels ear- 
nestly upon this subject, but he trusts that 
nothing he has written indicates acerbity or illib- 
erality on his part. Among those who differ 
from him are not a few of his most intimate and 
beloved personal friends, and for whose opin- 
ions in most matters he entertains the highest 
respect. It would be painful, therefore, for 
him to know that he had said anything by 
which he should inflict a wound, or forfeit their 
friendship and esteem. CONVERSATIONS. 
FIRST CONVERSATION. 
A demand for liberty—Liberty is not license—We 
are bound to obey, but are not bound to respect all 
laws—Moonshiners. 
Dr. Warren. Have you interested yourself 
in the struggle for liberty which some of us are 
making in our effort to free ourselves from the 
bondage of the Code of Ethics, which has 
hitherto held us in a most degrading subjec- 
tion ? 
Dr. Putnam. I have noticed the “ struggle 
for liberty,” as you are pleased to call it, but I 
cannot say that I sympathize with its objects. 
It seems to me rather a struggle for license, 
than a struggle for liberty. 
Dr. Warren. Is it possible that you, the de- 
scendant of a family famous for its love of free- 
dom, should hold such views; and be willing 
to remain in a kind of moral slavery, in which 10 
CON VERSA TIONS. 
your masters forbid you to do as you please in 
matters of conscience ? How can you call 
yourself a freeman while you remain in this con- 
dition of servitude ? I hold that in matters of 
conscience every man should be free to think 
and act as he chooses.* 
Dr. Putnam. Your idea of freedom is per- 
haps a little too broad. There never was a 
time in any civilized government in which men 
were permitted, without restraint, to act accord- 
ing to the dictates of their conscience. They 
might indeed be permitted to think as they 
pleased, but not to act as they pleased. To per- 
mit this would be subversive of social order and 
of all government. It would permit a man to 
take the life of his own child, if he thought it 
his duty to do so. As every jurist will tell you, 
you will have to abandon this ground, which I 
see some of your friends have taken, if you wish 
to commend your present struggle to the sym- 
* “ But even among medical men who have so long quietly sub- 
mitted to be hampered by artificial restrictions, the irrepressible 
demand for free thought, free action, with no restriction but the 
high and noble aspirations of what pertains to physicians and gen- 
tlemen, will certainly arise. . . . 
“ Freedom of thought and action are the palladium of our in- 
stitution.”—S, Oakley Vanderpoel, M.D., President N. Y. Co. 
Med. Soc. FIRST CONVERSATION. 
pathies of an intelligent and civilized world. 
It was not this liberty for which your fathers 
and mine shed their blood. 
Dr. Warren. Conceding what you have said 
to be true, you will not deny that all good citi- 
zens are bound to respect and obey the laws; 
and the laws of the State of New York declare 
that the diplomas of the Homoeopathists and 
Eclectics are legal qualifications to practice. 
To refuse therefore to consult with them is vir- 
tually to disobey and to disrespect the laws of 
the State. For this view of the subject we have 
the authority of at least one distinguished jurist.* 
Dr. Putnam. I reply that, if by “ respect” 
is meant approval, the statement is not correct, 
but if it means obedience it is correct. Our 
Legislators pass many laws which I cannot re- 
spect in the sense of approval, but which I pro- 
pose to obey. 
That I must obey the laws is undoubtedly 
true ; but our legislators have not passed a law 
declaring with whom I shall or shall not consult. 
If they had done so then indeed would our 
liberties have been invaded. If a law were en- 
acted legalizing a policy-shop, or any other 
* Letter to Dr. C. R. Agnew, from Theodore W. Dwight, Prof. 
Columbia College Law School, The Medical Record, May 13, 1882. 12 
CON VERSA TIONS. 
more infamous establishment, this would not 
make it our duty to frequent such establish- 
ments. 
The time has been in this State (and may be 
again), when any man who chose could prac- 
tise medicine. If your argument is sound, we 
ought then to have consulted with any ignorant 
charlatan who called himself a doctor. 
Dr. Warren. Well, but, Dr. Putnam, we 
assume that these men with whom we propose 
to consult are not ignorant, but that some of 
them are as well instructed in the science of 
medicine as we are. What then ? 
Dr. Putnam. I doubt the correctness of the 
supposition; but if it were true it would not 
justify your proposed action. If a man learned 
in all that pertains to the science of medicine 
were to declare publicly that he prescribed in 
all cases nothing but moonshine, and even to 
advertise himself as a moonshine doctor, would 
you seriously claim that I ought to consult 
with him in a case of pneumonia, or of stran- 
gulated hernia? 
Dr. Warren. You have made an extreme 
case, which does not apply to either of the par- 
ties with whom we desire to associate ourselves. 
Dr. Putnam. Not at all. Study for yourself FIRST CONVERSATION. 
13 
the medical theories of these gentlemen, and 
see if you can make of them anything more 
than moonshine. They consist of nothing but 
the most absurd and ridiculous antitheses of 
common sense. 
Dr. Warren. But, as you ought to know, 
some of them have openly and publicly declared 
that they have renounced the practice of pre- 
scribing moonshine, and that they are now giv- 
ing the same medicines which we do. 
Dr. Putnam. If this be so, then all that re- 
mains for them to do is to renounce their self- 
assumed and distinctive title, by which they 
ostentatiously separated themselves from the 
regular profession, and we are ready to consult 
with them. But I very much fear that so long 
as there are so many people who believe in 
moonshine, that they will not consent to do 
this. There are a good many excellent people 
who sincerely think that these gentlemen are 
continuing to administer to them the genuine 
article in its most attenuated form, and who, if 
undeceived, might no longer patronize the 
“new school.” In fact, however, a pretty large 
Proportion of the disciples of Hahnemann, re- 
tain their faith in infinitesmals, and continue to 
prescribe what may properly be called moon- CON VERSA TIONS. 
shine. But suppose we drop this subject for 
the present, to be resumed, perhaps, at some 
future time, when we have both more leisure. 
Dr. Warren. Certainly, I will do so with 
pleasure ; but, before parting, I wish .to say that 
I cannot but think that the Code of Ethics is an 
encroachment upon our rights as free American 
citizens—a worm at the root of the precious 
tree of Liberty which our fathers planted; and 
I for one, whatever may come, propose to stand 
by the flag of revolt which our leaders have 
raised. SECOND CONVERSATION. 
Moonshiners do not practise what they preach—They 
retain only the title for purposes of business. 
Dr. Warren. I omitted to say to you in 
our last conversation that, while it is true that 
many of the class of gentlemen who have been 
so long and so cruelly ostracized by the code, 
have indeed declared that they no longer rely 
exclusively, or in fact in any measure, upon the 
impossible infinitesimals of Hahnemann as a 
remedy for disease, giving instead our own 
medicines in full doses. They still adhere to the 
doctrine of similia similibus curantury and can- 
not therefore consistently drop their peculiar 
and distinctive name; but the fact that they 
hold this doctrine ought not to prevent our con- 
sulting with them, since their practice does not 
differ from ours. If they wish to open the 
bowels they do not give opium or morphine, 
which would be in accordance with their doc- 
trine, but they give castor oil or epsom salts or 
some other recognized cathartic in good full CON VERSA TIONS. 
doses. In case you were to consult with them 
and should wish to give any remedy in your 
materia medica, they would not object. They 
only preach, but do not practise similia simili- 
hus curantur. What do you care about their 
preaching ? 
Dr. Putnam. Nothing. Only that it is ap- 
parent that both their preaching, and the pecu- 
liar title which they continue to retain, is in- 
tended to attract those clients who still believe 
in homoeopathic doctrines, and who think that 
honest men practise what they preach; and who, 
therefore, innocently suppose that by employ- 
ing these gentlemen they are sure of being 
treated with their favorite medicine—the genu- 
ine and original Hahnemannic moonshine. To 
sail under false colors on the high seas is called 
piracy, and these gentlemen are sailing under 
false colors.* 
* Dr. Fowler, President of the New York Medico-Chirurgical 
Society (Homoeopathic), speaking of the title “ Homoeopathist” 
as heretofore employed by himself and his professional brethren, 
says: “ The theory contained in the term is not to any appreciable 
extent entertained at the present day; it does misrepresent the mass of 
those who allow it to be used to distinguish their belief or practice; 
and a proper regard for the correct appreciation of their intelligence 
by the public, and of honesty in themselves, demands that the term 
be put away in the garret as worn-out medical furniture, which has 
no fitting space in the edifice of real science SECOND CONVERSATION. 
17 
I could respect the honest simplicity with 
which the earlier pupils of Hahnemann ac- 
cepted of the doctrine of infinitesimals, under 
which practice it was impossible to say whether 
the medicine (!) was acting under the law of si- 
inilia similibiLs or not—but I cannot respect the 
Homoeopathist who repudiates homoeopathy, 
and who gives a dose of castor oil to overcome 
constipation, and still pretends that he is follow- 
ing the teachings of Hahnemann in any respect 
whatever. 
You may think it desirable, in certain points 
of view, to countenance this fraud, but for my- 
self Ido not; nor have I ever felt that my liber- 
ties were seriously encroached upon when the 
niedical profession adopted a code which de- 
clared consultations with those who practised 
such impositions to be disreputable. To say 
the least, I am not over-anxious to extend to 
them the hand of professional fellowship. 
You do not seem to understand that the code 
does not affect your rights as a free American 
citizen. It is not apart of the State or Federal 
law. The code is simply a social arrangement, 
°f a purely voluntary character. 
Dr. Warren. Beg your pardon, but I do 
understand that. Yet I submit whether it is CONVERSA TIONS. 
wise or liberal to voluntarily place ourselves 
under such restraints. I know as well as you 
do that moonshine is not medicine, and that 
some Homoeopathists have themselves publicly 
declared that it is not; and it is probable that 
I would not consult with any of them if the 
code were abolished, but I am unwilling to be 
bound by a written compact not to do so. 
Dr. Putnam. It is unfortunate for your 
cause that your friends have not been as out- 
spoken upon this latter point as you have. 
They seem generally unwilling to say publicly 
that they hold the doctrines and practices of the 
disciples of Hahnemann in honest contempt, 
and that they do not expect to counsel with 
them ; indeed, they have publicly said that they 
intend to do so ; and it is this very fact which 
seems, in my opinion, to render a code neces- 
sary. 
If every man practised virtue and morality 
strictly, no church organizations would be ne- 
cessary, unless it were for the sole purpose of 
propagating a religious faith or dogma. Indeed, 
there would be but little need of law, or re- 
straints of any kind. THIRD CONVERSATION. 
Code of Ethics in law, divinity, and in war—A rep- 
resentative of the “ Slyhooven” sect in law—Why 
is a medical code needed here, and not in Europe ? 
Dr. Ptdnam. Does your zeal hold out in 
the cause of Liberty ? 
Dr. Warren. It is not one whit abated. 
If a code of ethics is needed in the profession of 
Medicine, why is it not needed, also, in the pro- 
fessions of law and divinity ? 
Dr. Putnam. So far as the lawyers are con- 
cerned, I reply, that law is in many respects 
like the military art—a profession of war, in 
which it is deemed justifiable often to resort to 
deception, and to openly declare that you be- 
lieve or intend to do what you do not believe or 
]ntend to do. A code of ethics made to sit 
easily and comfortably upon a lawyer would 
have to be as loose as a Roman toga. It must 
Permit him to insult the opposing counsel in 
the presence of the Court; to blacken the char- 
acter of witnesses whose reputation he knows 
to be as pure as his own, and to do a thousand 20 
CONVERSA TIONS. 
other things which no man could do outside of 
the courts and be considered a gentleman. Not 
that all lawyers do this ; but many of them do, 
and rarely incur the censure of the Court in 
consequence, and pretty uniformly receive the 
approbation of their clients. 
Nevertheless it is not true that lawyers have 
no code of ethics. All bodies must have 
bounds ; and there are offences, such as taking 
a client’s money under false pretences, for which 
a judge is permitted to disbar a lawyer; forbid- 
ding him any longer to practice in the courts. So, 
also, there is in the allied profession of war a 
code of ethics, which renders infamous the man 
who enters the lines in disguise. He is not 
treated as an honorable enemy would be, but is 
tried by drum-head court-martial and gibbeted, 
and buried without a mark to indicate the 
spot. 
Imagine, if you can, a lawyer when his case is 
called in court, addressing the judge as follows : 
Your Honor, I wish to say a word in refer- 
ence to Mr. Kraft, my associate counsel in this 
case, as the conditions of his employment and 
his mode of practice are peculiar, and perhaps 
unusual; yet my client insists that he shall take 
part in the conduct of his defence. Mr. Kraft THIRD CONVE^SAT/OJV. 
21 
is a regularly authorized practitioner, according 
to the laws of this State, but he is a “Slyhooven” 
lawyer. He belongs to the “ Slyhooven school.” 
The Judge. What is a Slyhooven lawyer ? 
Counsel. I beg your Honor’s pardon, but I 
thought you must have heard of this famous 
sect in law, although, hitherto, they have not 
practised in our courts. A Slyhooven lawyer 
is one who adopts the principles of Slyhooven, 
a celebrated German jurist, who has written a 
book upon the subject. He holds that the less 
the evidence the stronger the testimony, and 
that if you can make the evidence infinitesimal 
you are certain to persuade the jury and to win 
the case ; provided, however, that in all cases 
you use that kind of evidence, which does not 
antagonize or contradict the evidence presented 
on the other side. The “ hair of the same dog 
cures,” is his cardinal maxim. 
Thus, for example, my client being accused 
of stealing a horse, Mr. Kraft will present to the 
Court the smallest possible amount of evidence 
that he did actually steal a horse—the less, the 
the better for our client. Or if no testimony 
can be found that he stole a horse, we shall avail 
ourselves of the next best 'form of testimony, 
namely, that he stole something closely resem- 22 
CON VERSA TIONS. 
bling a horse. Now a mule resembles a horse, but 
it is not a horse. So we will present an infin- 
itesimal fraction of testimony to prove that he 
stole a mule. 
That, in short, your Honor, will be Mr. 
Kraft’s course of procedure, in so far as he has 
the management of the case. 
The Court. You certainly cannot be serious 
in what you say, Mr. Dobbins. 
Mr. Dobbins.—l certainly am serious, your 
Honor. A good many lawyers in Germany 
have tried this system of practice and have 
proved successful. Some lawyers who were 
doing little or nothing before, have got rich by 
it, and there are several reputable lawyers in 
this city who have invited Mr. Kraft to aid 
them in the trial of cases, if the courts are once 
opened to him. 
The Court. Well, Mr. Dobbins, this court 
has only to say, that it cannot waste its time in 
listening to such nonsense ; and that your client 
will have to go to some other court if he wishes 
his case tried by these methods. 
Mr. Dobbins. Then your Honor proposes to 
exclude from this court a regularly licensed 
practitioner of law, and to deprive an humble, 
but free American citizen of what he considers THIRD CONVERSATION. 
23 
his only chance of escaping punishment and 
perpetual disgrace. 
The Court. Yes, this is what I propose to 
do. Judges have always exercised certain dis- 
cretionary powers not specifically named in the 
laws ; and one of these is not to permit idiots 
or lunatics to practise in the courts. 
Mr. Dobbins. But, your Honor, we are not 
idiots or lunatics. Neither Mr. Kraft nor my- 
self believe a word in all this foolery, but our 
client does; and it has generally been found 
easy to persuade a jury, composed of the most 
intelligent citizens, to believe in it, and to in- 
duce them to give their verdict in our favor. 
The Court. I might have added that the 
judges have always exercised the right, also, of 
excluding from the bar self-acknowledged 
rogues, criminal offenders and self-convicted 
impostors. 
It is our duty, also, not only to protect the 
court from such insults, but to protect the peo- 
ple as far as possible from imposition, by refus- 
mg to give our official countenance and support 
to impostors. 
If you are not ready to try this case without 
the aid of Mr. Kraft and his peculiar system, 
the clerk will call the next case on the calendar. 24 
CON VERSA TIONS. 
Dr. Warren. Allegory is not argument; but 
where do you find any thing like a code of 
ethics in the profession of divinity ? 
Dr. Putnam. As to the profession of divinity, 
it is encompassed with a code of ethics as firm 
and inelastic as a coat of armor. 
The canons and rules forbid its priests to 
teach false doctrines, or doctrines contrary to 
the teaching of the Church, while they wear 
the sacerdotal robes. To do otherwise is to 
challenge censure and expulsion. Outside of 
the church one may adopt such doctrines as he 
chooses ; and sensible men generally withdraw 
from the church when they change their re- 
ligious opinions, rather than incur the chances 
of being thrust out. 
Our medical code is gossamer compared with 
the iron-clad code of the churches. Think of 
it, Dr. Warren. Among some of our most 
numerous and influential religious sects, a 
clergyman is not permitted to dispense the 
Gospel of Christ to the people in a church 
which has not been regularly and officially 
dedicated by a priest of their own denomina- 
tion. A man who is not a member of the 
church may even be denied a Christian burial, 
unless he applies to the ‘Tittle church around THIRD CONVERSATION. 
25 
the corner.” And yet it is no unusual thing 
for these same men to declaim against our lack 
of liberality in refusing to consult with Hom- 
coepathists, or Eclectics. 
We could justify a Christian clergyman in 
refusing to hold a private consultation with a 
Mormon or a Mahometan priest over the case 
of a dying man, in which the two were to de- 
cide how to save his soul; but it is another 
thing when he refuses to preach in a building 
not consecrated. 
Our code does not teach or intimate, that I 
may not tie an artery or give my medical or 
surgical opinions in a charlatan’s house or hos- 
pital. 
Dr. Warren. Permit me to ask one more 
question. If we need in this country a medical 
code of ethics, why it is not needed also in 
Europe and other counties ? 
Dr. Putnam. That is a very pertinent ques- 
tion, and one which perhaps naturally suggests 
rtself to every medical man not born and edu- 
cated under our peculiar republican system,— 
a system which differs in many essential points 
from even the republican systems of other 
countries. It is a system of States within a 
State ; each State has a limited, not absolute 26 
CON VERSA TIONS. 
autonomy, so also have counties and muni- 
cipalities. There is in reference to most mat- 
ters no such thing as national centralization of 
authority; and to this peculiar feature of our 
political institution must be traced many of 
our social institutions, including many of the 
restraints which we voluntarily continue to im- 
pose upon ourselves, and without which, ex- 
perience has taught us, there would grow up 
gradually the rankest social evils. What gov- 
ernment cannot do, or has not done, for us, 
because of its lack of centralization, and per- 
haps partly because of its intensely democratic 
tendencies, we combine to do for ourselves. 
We do, I repeat, by association what law can- 
not or does not do for us. But I must beg 
you to permit me to defer a more full reply to 
this question to another occasion. FOURTH CONVERSATION. 
Why we need a Code, continued—Low standard of 
Education required by our medical colleges—Na- 
tional legislation impracticable; State legislation in- 
efficient—The medical associations unable to reg- 
ulate medical education—Our medical colleges are 
private enterprises—“ Color” line. 
Dr. Warren. Just before we parted the 
°ther day, you began to answer my question, 
“ Why, if we stand so much in need of a code 
°f ethics, is it not needed also in Europe ?” 
Medical men in all other civilized countries 
seem to get along very well without any written 
code. You began to say something about the 
social and political peculiarities of this country, 
yhen, for some reason, our conversation was 
interrupted. 
Dr. Putnam. Yes, and I think this is the 
Very point which those intelligent foreign phy- 
sicians who have within the last few years 
come among us—for I ought to say that the 
earlier importations were very bad—have found 
lt most difficult to understand. 28 
CON VERSA TIONS. 
The answer is, in brief, that in this country 
medical men have to supplement the duties of 
the State It is the plain duty of the State to 
regulate the standard of medical education, or 
to declare what qualifications are necessary to 
enable a man to practice medicine intelligently 
and safely. It is so understood in Europe ; and 
their several governments have done their duty 
so well in this regard as to leave little or noth- 
ing to be desired. 
It is very different here. Our Government 
is less centralized, and the matter of education 
is one of those subjects which the general gov- 
ernment has always thought it best to relegate 
to the State Governments. We have at Wash- 
ington a “ Bureau of Education,” but it has no 
duty to perform, except to gather statistics and 
other facts relating to matters of education, 
and to disseminate this information, accom- 
panied, perhaps, with suggestions, among the 
people. 
It is well that the power of regulating the 
amount and character of medical education is 
not assumed by the Federal Government, since 
it could not be exercised satisfactorily to the 
people, unless all classes of medical opinions 
were represented in the central board. FOURTH CONVERSATION. 
29 
The States have always claimed and exercised 
this power, and have, through their representa- 
tives in Congress, shown great jealousy when- 
ever any attempt or proposition was made in 
Congress to take it from them. How the States 
have exercised this power you need not be told. 
Our present system (!) of medical education 
is the product of State legislation. In some 
States there were until recently no laws regulat- 
ing the practice of medicine. In no two States 
are they probably exactly alike ; and in all of 
the States they are subject to radical changes 
from year to year. The experience of the 
past, therefore, would seem to show that, if the 
standard of qualifications to be demanded for 
graduation in medicine is ever materially raised 
in this country, it must be done by the efforts 
of medical men and by the medical colleges, 
and not by State legislation. 
Dr. Warren. Excuse me, Doctor, but I 
Would like to interrupt you for a moment at 
this point, and to ask, if, as I assume you are 
mtending, to attribute the necessity for a code 
wholly to the low standard required for gradua- 
tion in medicine in this country, and that prac- 
tically the only remedy for this lies in the hands 
of the medical profession itself, why, then, does 30 
CON VERSA TIONS. 
not the medical profession labor to effect a 
change in this matter, rather than occupy itself 
in establishing a code of ethics, the necessity 
for which this state of things has created ? 
Sublata causa tollihir effectus. 
Dr. Putnam. Certainly ; I excuse the inter- 
ruption. In the first place, I have not said 
that the necessity for a code was due to this 
cause solely ; but this is one of the circum- 
stances which render it necessary. 
And in the second place, you seem to assume 
that the profession has not hitherto made any 
such efforts. This assumption will not be sus- 
tained by the facts. 
One of the chief purposes of the organization 
of the American Medical Association was de- 
clared to be the elevation of the standard of 
medical education ; and this subject has consti- 
tuted the most prominent theme in the ad- 
dresses of its various presidents, and in the an- 
nual reports of its committees on the subject of 
medical education, from the time of its organ- 
ization until now. For this purpose alone the 
American Academy of Medicine was instituted ; 
and upon this subject an infinite number of 
commencement and alumni orators, and writers 
for medical journals have uttered their eloquent FOURTH CONVERSATION. 
31 
appeals. That no result has followed, it would 
not be proper to say; but certainly no result 
has followed adequate to the almost universal 
demand or desire. 
Dr. Warren. But certainly the medical col- 
leges have it in their power to demand any 
standard of qualifications they choose on the 
part of those upon whom they confer their de- 
grees ; and by uniting upon a standard, they 
can make it uniform throughout the United 
States. 
Dr. Putnam. There has been in existence 
for several years an organization of medical col- 
leges instituted for this purpose ; but after seve- 
ral meetings they have failed utterly to agree, 
and many or most of the colleges have with- 
drawn. It is now apparent that unanimity or 
anything approaching unanimity is impossible. 
Dr. Warren. What then is to hinder any 
°ne of the medical colleges from establishing 
its own standard, and from making it as high as 
A pleases ? Do you not think the medical pro- 
fession would at once throw its influence and 
Patronage in favor of this college ? 
Dr. Putnam. The medical colleges in this 
country, are, with few exceptions, private enter- 
prises, established and sustained by the profes- 32 
CONVERSA TIOEfS. 
sors themselves. They give to these colleges 
a large portion of their time and money, for 
which there is no pecuniary return except in 
the fees received from their students. To 
make these colleges even pay their annual ex- 
penses, they must have large classes. The 
most prosperous never pay large dividends to 
their professors. The standard under which 
some of the more favorably situated colleges 
might continue to live, would be quickly and 
absolutely fatal to others. 
If any one of these colleges, no matter how 
able were its corps of professors, nor how favor- 
able were its surroundings and conditions for 
clinical teaching, were to announce that it 
would demand of each of its matriculants a 
thorough academic or collegiate education, such 
as is supposed to be represented in this country 
by the degree of Bachelor of Arts, but which 
supposition is unfortunately not always true; 
that it would demand, also, a five years’ course 
of medical study, with examinations for ad- 
vancement at the close of each year ; a course 
of clinical instruction in a hospital; a final 
examination for the degree of Doctor in Medi- 
cine ; and a subsequent examination by an in- 
dependent State or National Board to decide FOURTH CONVERSATION. 
33 
upon his right to practice medicine and surgery 
-—if any college in this country, I say, were to 
announce and enforce this curriculum, which is 
essentially the curriculum of most European 
schools, it would virtually close its own doors. 
In an experiment of this sort the best colleges, 
or those with the highest standard, would, 
where other things are equal, have to close their 
doors first. 
Dr. Warren. You said our colleges were, 
with few exceptions, private enterprises; how is 
it with the exceptions ? 
Dr. Putnam. I mean by the “exceptions,” 
those few colleges which are partially endowed; 
for none of them are fully endowed. Such 
colleges have made some little advancement in 
their requisitions; enough to indicate their 
sincere desire to do all they can in this direc- 
tion ; but they have stopped far short of their 
own wishes, for the reason that they are still in 
a great measure dependent for their support 
upon the numbers, not quality, of their pupils. 
When, as at Ann Arbor, Michigan, the State 
has attempted to partially endow the college, 
has also insisted upon its right of adding 
Hornoeopathists, or any other class of dogma- 
tists it may select, to its corps of teachers. 34 
CON VERSA TIONS. 
Dr, Warren, Doctor, one question more in 
this connection, before we return to the subject 
of the code. How does it happen if our system, 
is so bad, that we have furnished to the world 
in our brief existence as an independent nation, 
so many illustrious examples of men who have 
acquired a national and European reputation, 
as surgeons, physicians and writers in the various 
departments of medical science—as many per- 
haps as any other nation in the same period of 
time ? and with very rare exceptions these men 
were American born, and were educated under 
that very system which you consider so defec- 
tive. 
Dr. Putnam. There is nothing in our system 
which prevents a man of genius, intelligence and 
industry from acquiring medical knowledge ; 
indeed, he has at home and at his command 
every facility for doing so. The fault of the 
system lies in the fact that while the mills grind 
well enough, they winnow badly. They do not 
properly separate the wheat from the chaff. 
With the really excellent men there have been 
admitted too many who are imperfectly edu- 
cated, and sadly unqualified for the responsible 
duties they are called upon to assume. 
Dr. Warren. But Ido not see how the Code FOURTH CONVERSATION. 
35 
of Ethics is to remedy these acknowledged im- 
perfections of our system. 
Dr. Putnam. By drawing a line between 
regulars and irregulars ; or more correctly speak- 
ing, between doctors and charlatans. The 
State has failed to draw this line, and we must 
do it ourselves. 
Dr. Warren. This State has drawn a line, 
and one which seems to me unobjectionable. 
It declares that a man who has not a diploma 
from a legally constituted medical college, shall 
not be authorized to practise. He is therefore 
practically declared to be a charlatan. 
Dr. Putnam. True, but, in the first place, 
this line has only been established in a few 
States. In the second place, it may be changed 
at any time by an act of the Legislature, and 
niade to include those who are now excluded 
from its protection; and third, admitting that 
the line drawn by the State is useful and im- 
portant, we need also a “color line,” which will 
Separate the white from the black. 
Dr. Warren. You have admitted that there 
are a great many men graduated from our reg- 
medical colleges who are imperfectly edu- 
Cated. According to your own statement there 
does not seem to be any natural point of sepa- 36 
CON VERSA TIONS. 
ration between our poorest scholars and their 
best. 
Dr. Putman. I don’t agree with you upon 
that point. Between our poorest men and their 
best there is, with rare exceptions, a very 
marked difference. If you entertain any serious 
doubt on the question of their relative scholar- 
ship, read their medical journals, and inform 
yourself in other ways, as you may have oppor- 
tunity. Recite to me their contributions to 
medical science. The interval between the two 
classes—the Regulars and the Irregulars—is at 
every point of the line, even where they ap- 
proach most closely, too wide, in the matter 
of scholarship alone, not to be easily recog- 
nized. 
But if it were otherwise, this is not the only 
line which medical men have to draw. We need, 
I repeat, a color line, drawn between the white 
and the black, so as to prevent their mingling 
with each other. Experience has shown that, 
when inferior races become closely intermingled 
with superior races, neither one is improved, but 
that in the unnatural embrace both go down 
together. 
The code draws the line at a point where there FOURTH CONVERSATION. 
37 
is not only a considerable intermediate space, 
due to differences in culture and education, but, 
what is much more important, at a point where 
the whole nature and the aspirations begin to 
diverge. On the one side there is a hereditary 
tendency to improve, and on the other a heredi- 
tary tendency to depreciate. On the one side 
We are sustained by the high examples, tradi- 
tions and lofty purposes and teachings of the 
fathers in medicine; while on the other side 
there is no incentive to conduct but present 
gain, and the ignoble examples of famous char- 
latans. 
Dr. Warren. Then you propose to draw the 
line where it will include a good many very 
Poorly qualified doctors. Are those men worth 
so much care and anxiety on your part ? 
Can you afford to take them to your em- 
brace ? 
Dr. Putnam. Yes; and for the same reason 
that a wise shepherd saves and nurses the sickly 
lambs. He knows that if they are of good 
breed, and they are properly fed, they may in 
time become healthy and useful. A great many 
of the young men who are born into the pro- 
fession of medicine feeble and sickly, sub- 38 
CON VERSA TIONS. 
sequently by dint of study and teaching become 
strong and prove to be an honor to their pro- 
fession ; but in order to do this their instincts 
must be right, and they must be protected from 
the social pitfalls into which their unsteady 
limbs are apt to precipitate them. FIFTH CONVERSATION. 
Homoeopathy—The Abracadabra—Peculiarities of 
American Character, Customs, and Empiricisms— 
Dr. Warren’s letter to Dr. Putnam describing the 
Medical Empiricisms of Europe. 
Dr. Warren. You seem to think, Doctor, 
that one of the greatest duties of the code is 
to take in its gentle but strong arms the weakly 
lambs and to coddle them: to build around 
them a high fence, to prevent them from tum- 
bling into pitfalls; and to dry-nurse them when 
they are taken from the breast of their Alma 
Mater. 
Dr, Putnam. I do, Doctor. 
Dr. Warren. If this is one of our duties as 
tnedical men, I think we ought to publicly ad- 
vertise ourselves as professional nurses for sickly 
and badly disciplined babes, under the sign of 
the nursing bottle and slipper. 
Dr. Putnam. I am glad to see that you have 
that nice sense of humor which enables you to 
see the funny side of a serious proposition. 40 
CONVERSA TIONS. 
Have you ever read Hahnemann’s Organon de 
Medicini ? 
Dr. Warren. No, Doctor. 
Dr. Putnam. Then I will ask you to read 
at your leisure a few paragraphs which I have 
copied somewhat at random, from this famous 
work, written by the originator and founder of 
the Homoeopathic School, You will find in 
them much which your love of humor will en- 
able you to appreciate.* 
* “ Diseases are dynamic (spiritual) aberrations, which our spirit- 
ual existence undergoes in its mode of feeling and acting—that is 
to say, immaterial changes in the state of health.” p. 19. 
(As diseases are all considered dynamic, so the medicine must 
be rendered dynamic.) 
“A homoeopathic dose, however, can scarcely ever be made so 
small as not to amend and indeed perfectly cure, etc.” p. 157. 
“It will stand good as a homoeopathic rule of cure, refutable by 
no experience whatever, that the best dose of the rightly selected 
medicine is ever the smallest.'" p. 187. The medicines cannot be 
prepared in two minute a dose. p. 192. The appropriation of a 
medicine depends “also upon the minute quantity of the dose 
which is administered.” p. 202. 
Medicines are prepared thus: two drops of the medicine are 
diluted with 98 of alcohol, which, when twice shaken, is exalted in 
power to impotence. The same process is to be continued through 
29 other phials—taking 2 drops from each preceding phial, and 
adding to the 98 of each succeeding phial—giving each just two 
shakes.—“ These manipulations are to be conducted thus through 
all the phials, from the first up to the 30th or decillionth develop- 
ment of power, which is the one in most general use.” p. 200, 
The effect of shaking, on homoeopathic medicines, “is so ener- FIFTH CONVERSATION. 
41 
It was this funny side of the doctrines of 
Hahnemann—and indeed there seems to be 
no other side to his doctrines—which event- 
ually, under the continued assaults of the sat- 
Setic that latterly I have been forced by experience to reduce the 
number of shakes to two, of which I formerly prescribed 10 to 
each dilution.” p. 205. 
“ The best mode of administration, is to make use of small glo- 
bules of sugar, the size of a mustard seed ; one of these globules 
having imbibed the medicine, and being introduced into the vehi- 
c^ei forms a dose containing about the three-hundredth part of a 
rop ; for three hundred of such globules will imbibe one drop- of 
alcohol.” (It is to be understood that this drop of alcohol contains 
but an infinitesimal quantity of medicine, or the decillionth dilu- 
bon.) “By placing one of these on the tongue, and not drinking 
anything after it, the dose is considerably diminished. But if the 
Patient is very sensitive, and it is necessary to employ the smallest 
dose possible, and attain at the same time the most speedy results, 
d will be sufficient to let him smell once.” p. 207. 
“Hep. Sulph. (flower sulphur) ‘can rarely be given in sub- 
stance ’ ” (thus diluted), “ or by smelling, at shorter intervals than 
every fourteen or fifteen days.” p. 190. 
The directions for smelling are as follows: “The patient should 
hold the phial containing the globule under one nostril, when one 
Momentary inhalation of the air in the phial is to be made ; and if 
dose is intended to be stronger, the same operation may be re- 
peated with the other nostril.” p. 191. 
Mesmerism is considered a homoeopathic remedy by Hahne- 
diann. “This curative power, of whose efficacy none but madmen 
ean entertain a doubt—which through the powerful will of a well- 
ddentioned individual, influences the body of the patient by the 
toUch, acts homceopathically, by exciting symptoms analogous to 
those of the malady,” p. 210. 
“I recognize nobody as my follower,” says Hahnemann, but 
Mm who gives medicines in such small doses as to preclude the 42 
CON VERSA TIONS. 
irists, drove his disciples, one after another, to 
renounce moonshine; so that to-day it is quite 
exceptional to find among them a man who 
will openly confess that he has any faith in that 
portion of the Hahnemannic teaching, or any 
other portion of his doctrines, except the doc- 
trine of Similia similibus curantur. 
They could successfully withstand the as- 
saults of argument, inasmuch as there was 
nothing in Hahnemann’s doctrines to argue 
about. It was safely anchored beyond the 
natural limits of reason; but they could not 
hold out when they saw the finger of ridicule 
pointed at them from every direction. 
The doctrine of “ Similia,” etc., they saw, also, 
could not be applied practically when they re- 
nounced the infinitesimal doses, without again 
subjecting themselves to ridicule; nor indeed, 
in many cases, without hazarding the lives of 
their patients. So they retained these three Lat- 
in words as their trade-mark, and for no other 
purpose. In its application to their practice it 
perception of any thing medicinal in them by means of either sen- 
ses or chemistry,” “The pellets may be held near the young in- 
fant when asleep.” “ Gliding over the patient with the hand will 
cure him.” (Organo7t de Medicini. First Am. ed. Philadelphia, 
1836.) FIFTH CON VERSA TION. 
43 
has no more meaning than the famous talis- 
manic word of the ancient Roman quacks, ab- 
racadabra. 
Dr. Warren. You intimated, Dr. Putnam, 
that there were other reasons why in this 
country a code of ethics is more needed than 
m Europe. 
Dr. Putnam. Yes. Our peculiar institutions 
have created a peculiar people. In very many 
Aspects we differ from any other people in the 
World. Every observing foreigner recognizes 
the fact; and what is true of our manners and 
customs and habits of thinking in general, is 
true in matters pertaining to the cure of disease. 
this matter, also, I say, our people have their 
°Wn peculiar way of thinking and reasoning, 
ft is not necessary for my present purposes that 
should explain to you satisfactorily the causes 
°f these peculiarities, but I am only required 
to convince you that they exist; and to this 
eud I need only refer you to the well-known 
fact—well known to medical men, and often 
rcferred to by them—that quackery has always 
found here a genial soil for growth and propa- 
gation. 
Dr. Warren. There is more intelligence 
among our people than is usually found among 44 
CON VERSA TIONS. 
the people of other civilized States, and there 
ought to be less inclination to run into quackery. 
Dr. Putnam. Intelligence, or a knowledge 
of matters in general, is much more widely dif- 
fused here than in most other countries; but 
you will excuse me, Doctor, for saying that I 
am not attempting to show you what ought to 
be, but what is the fact; and the fact is that 
medical charlatanism has always prospered in 
this country. 
Dr. Warren. There is no country in Europe 
or in either of the four quarters of the globe, 
where charlatanism has not flourished, and does 
not continue to flourish. Throughout most 
Catholic countries the people resort to shrines 
and churches and saints—to pictures and bones 
of saints—to holy relics, to amulets, to holy 
water and consecrated beads to cure their mala- 
dies. Protestant countries also have always had 
and still have their peculiar forms of medical 
charlatanism—as for example the “ Royal 
touch” of the English Sovereigns, whether 
Catholic or Protestant, from the time of Ed- 
ward the Confessor down to Queen Anne. 
I will send you to-morrow a memorandum of 
a few of the European varieties of medical 
charlatanlism, and I think you will see that the FIFTH CONVERSATION. 
45 
soil of Europe and of most other countries is 
quite as well suited to the propagation of medi- 
cal delusion as ours. 
Dr. Warren’s letter to Dr. Putnam, de- 
scribing the Medical Empiricisms of Eu- 
rope. 
42 Independence Square, 
July 4, 1883. 
My Dear Doctor— 
In fulfilment of my promise that I would give 
you a few facts of history in order to convince 
you that medical charlatanism is not peculiar to 
°ur country I beg leave to call your atten- 
tion to the following statements and historical 
uotes, authenticated by my own personal obser- 
vation and my casual reading: 
When I was in Sicily some years since I 
visited the catacombs of the Capuchins near 
Monreale. In one niche I was shown the 
skeletons of a grandfather, son, and grandson. 
The Capuchin who served as my guide assured 
I:ne that whoever touched three times one of 
these skeletons was speedily cured of any fever 
With which he might chance to be afflicted, 46 
CON VER S A TIONS. 
The testimony upon this point, he said, was 
abundant and conclusive. 
Near Palermo, also, are buried the remains 
of Santa Rosalia, the patron saint of the city, 
and “more than once has this saint, when her 
bones were carried three times in solemn pro- 
cession about the city, rescued its inhabitants 
from the ravages of the plague.” 
This will stand as an example of what you 
will find all over Europe, wherever the Roman 
Church is established; in which countries it 
would be difficult to find a hamlet so small or 
remote that it did not have its shrine or relic, 
famous for the cures it had wrought. Some of 
these, such as our Lady of Lourdes in France 
and Knock in Ireland, have recently acquired 
world-wide reputation. 
A few of the churches are very rich in saintly 
and other holy relics, which are capable of heal- 
ing the sick, such as the Dom Kirke in Aix La 
Chapelle, where Carlo Magno was originally 
buried; this church having no less than fourteen 
sacred relics. Santa Pauolo, in Naples, is the 
depository of two saints and fifty-two martyrs. 
Santa Gennaro in the same city, less endowed 
so far as the number of its healing relics is con- 
cerned, has however the head and blood of the FIFTH CONVERSATION. 
47 
patron saint; the latter of which liquifies mirac- 
ulously once a year, and at such a time marvel- 
ous cures are often wrought. 
But let me call your especial attention to the 
famous church of St. Medard, in Paris, where 
St. Paris, the Jansenist, is buried. Jansen was 
the real originator of the science of animal 
magnetism, having preceded Mesmer by a cen- 
tury or more. In this church the “ Convulsion- 
ists” for more than twelve years practised their 
contortions and feats of endurance; and here 
Were enacted miracles which rival in marvel- 
lousness anything which Mesmer ever achieved. 
The subjects were uniformly females, and they 
came to the sepulchre of the sainted Paris for 
a cure of their various maladies. When under 
the influence of the mysterious and supernatural 
agency they declared themselves insensible, and 
falling upon their backs they would call upon 
the “Freres” to throw large paving stones upon 
them and to jump upon them; and when the 
blows were suspended they would cry out “ en- 
core, mon chere Frere, encore.” At last, in 
1732, at the instance of the King, the public 
authorities interfered, and the persecuted Con- 
vulsionists placed the following placard over 
the church door: 48 
CON VERSA TIONS. 
“ De par le Roi, defense a Dieu 
De faire miracle en ce lieu.” 
In the Catholic Calendar of Saints it is 
more or less understood that St. Apollonia is 
especially skilled in the cure of tooth-ache, St. 
Martin in the treatment of scabies, and that 
several other Saints have devoted themselves 
to specialties. 
But it is not alone in the Catholic Church that 
such medical superstitions prevail. They will 
be found existing to a certain extent—greater 
or less—in different sections of the country, and 
among different nations. They exist in the 
Greek Church and the Protestant; although in 
the latter, as for example in Scotland, while they 
retain usually their supernatural character, they 
are in general not so intimately connected with 
their religion. 
Mohammedans and Pagans of every variety 
and shade of religious beliefs have their national 
and hereditary supersitions in reference to the 
cure of disease. 
I am, however, extending my letter to a 
greater length than I had intended ; and, not to 
weary your patience, I will call your attention 
to only one more signal example, in a country 
partly Catholic and partly Protestant, and FIFTH CONVERSATION. 
49 
among a people highly refined and intellec- 
tual. 
It is well known, by most medical men, and 
I presume it is to you, that the kings of Eng- 
land, from the time of Edward the Confessor 
(1041) down to the time of George the First 
(1714) professed to cure scrofula by the touch— 
“ tactus regalis”—and also that many of the 
kings and queens of France claimed the same 
power. 
In England the belief was almost universal 
oven among the most learned—indeed, to 
doubt was considered infidel and disloyal—in 
testimony of which I quote the following from 
an old work on Surgery, published during the 
reign of Charles the Second, in 1676, by Richard 
Wiseman, “ serjeant-chirurgeon to the king.’ 
It was, I believe, the second work upon sur 
gery published in England; and Wiseman was 
justly esteemed the most eminent surgeon of 
his day. 
I will copy so much of the chapter as may 
be necessary to show how general was the 
belief and how firm was the author’s convic- 
tion, and also the mode of argument employed 
by the skeptics; omitting, however, his dis 
cussion as to whether the king of France also 50 
CON VERSA TIONS. 
possessed the power, which he seems to 
doubt: 
By others we are told that King Charles the 
Second cured by his touch in five years 23,621 
cases of scrofula! But in George the First the 
power was lost—or rather, we should say, in his 
reign it was transferred from the king to the 
finger of an executed felon! And even to this 
day, many of the lower classes in England, 
afflicted with this malady, resort to the gallows 
for the purpose of being cured! 
“ Chap. I.—OF THE CURE OF THE EVIL BY 
THE KING’S TOUCH. 
“What great difficulty we meet with in the 
cure of the king’s-evil, the daily experience 
both of physicians and chirurgeons doth show. 
I thought it therefore worth my while to spend 
a whole treatise upon the subject, and very 
particularly to go through the description of it, 
informing thereby the young chirurgeon what- 
ever is requisite to the cure, at least as far as it 
cometh within the compass of our art. But 
when upon trial he shall find the contumacious- 
ness of that disease, which frequently deludeth 
his best care and industry, he will find reason of 
acknowledging the goodness of God ; who hath FIFTH CONVERSATION. 
51 
dealt so bountifully with this nation, in giving 
the kings of it, at least from the Confessor 
downwards (if not for a longer time), an extra- 
ordinary power in the miraculous cure thereof. 
This our chronicles have all along testified, and 
the personal experience of many thousands 
uow living can witness for His Majesty that 
now reigneth, and his royal father and grand- 
father: His Majesty that now is having exer- 
cised that faculty with wonderful success, not 
only here, but beyond the seas in Flanders, 
Holland and France itself.” 
“ But it is not my business to enter into 
divinity-controversies: all that I pretend to is, 
first, the attestation of the miracles; and, 
secondly, a direction for such as have not op- 
portunity of receiving the benefit of that stu- 
pendous power. The former of these, one 
Would think, should need no other proof than 
the great concourse of strumous persons to 
Whitehall, and the success they find in it. I 
myself have been a frequent eye-witness of 
many hundreds of cures performed by His 
Majesty’s touch alone; without any assistance 
of chirurgery; and those many of them, such 
as had tired out the endeavors of able chirur- 
geons before they came thither. It were end- 52 
CON VERSA TIONS. 
less to recite what I myself have seen, and 
what I have received acknowledgments of by 
letter, not only from the several parts of this na- 
tion, but also from Ireland, Scotland, Jersey, and 
Guernsey. It is needless also to remember what 
miracles of this nature were performed by the 
very blood of his late Majesty of blessed mem- 
ory, after whose decollation by the inhumane 
barbarity of the regicides, the reliques of that 
were gathered on chips, and in handkerchiefs, by 
the pious devotees, who could not but think so 
great a suffering in so honorable and pious a 
cause would be attended by an extraordinary 
assistance of God, and some more than ordi- 
nary miracle ; nor did their faith deceive them 
in this point, there being so many hundred that 
found the benefit of it. If his dead blood were 
accompanied with so much of virtue, what shall 
we say of his living image, the inheritor of his 
cause and kingdom ? whom though it hath 
pleased God to deliver out of those dangers 
that overwhelmed his royal father; yet it was 
with so long an exercise of afflictions, that 
though (God be thanked), he be not now like 
to increase the catalogue of martyrs, yet he 
may well be added to the number of confessors. 
This we are sure, the miracle has not ceased.” 
Yours truly, 
Warren. SIXTH CONVERSATION. 
American Empiricisms—ls it our Duty to Assist the 
Charlatan in making a Diagnosis?—The Duty of an 
Engineer. * 
Dr. Putnam. I have read your letter, con- 
taining copious references to foreign medical 
delusions; which I value the more because 
your notes are enriched by your own personal 
experience, obtained in your extensive travels 
abroad. 
Dr. Warren. I trust you will see that the 
closing proposition made by me in our last in- 
terview is sustained. 
Dr. Putnam. It may seem ungracious in me 
to say so, but, Doctor, I must declare to you 
frankly that you have by your superior learn- 
ing furnished me with new weapons of defence 
for my own opinions, and given an edge to those 
which I had intended to use. 
Dr. Warren. I shall not regret it, if only we 
are enabled thereby to reach the truth. 
Dr. Putnam. The medical delusions of other 54 
CON VERSA TIONS. 
countries, so far as they have been cited by 
you, and so far as my own reading has informed 
me, have been, with few exceptions, associ- 
ated with religious beliefs or in some other 
way they belong to the supernatural. The be- 
lievers in them attribute their cures to a divine 
or superhuman agency. No one derives any 
pecuniary profit from them, not even the 
priests, although a fee is sometimes accepted by 
them; but it has never been charged against 
these priests that they put the fees into their 
own pockets. They accept the money, or 
other presents voluntarily offered them, and 
put them into the common treasury of the 
church. They do not make a trade or a pro- 
fession of curing disease, and they never be- 
come personally enriched by it. Observe, Dr. 
Warren, that while I recognize the medical 
superstitions to which you have referred as 
gross errors, I hold them to be only representa- 
tions of religious faith. In this country medical 
delusions of this class rarely secure even a tem- 
porary footing, and they never spread widely, 
or indeed beyond very narrow circles. To take 
root here and to propagate successfully the 
medical belief must be human in its source, and 
be able to present a theory for its existence. SIXTH CONVERSATION. 
55 
It may not be necessary that the theory should 
be sound, or even specious, or one which any 
finite mind can comprehend, as is the case with 
the doctrines of Hahnemann, but without a 
theory of some sort it can take no hold upon the 
popular mind. Of the class of medical beliefs 
and charlatanisms last described, we have now, 
and have always had, more than our share. 
Dr. Warren. But most of them are of 
foreign origin. 
Dr. Putnam. Some of them are, but in most 
of these cases they failed to show any vigor, or 
they almost died out, until they were trans- 
planted to America. For example, Hahne- 
mann was a German, and after he had fully an- 
nounced his doctrines he left Leipsic, in which 
city he commenced the practice of medicine, 
and having subsequently taken up his residence 
successively in a score of German towns, he 
finally left Germany altogether. Says his biog- 
rapher, in the British edition of his Organon 
de Medicini, “ The author of the Organon has 
been persecuted with the utmost rigor; and in 
1820 he quitted his native country in disgust.” 
The doctrines of Hahnemann, and the cognate 
science of animal magnetism, with its offshoots 
hypnotism, artificial trance, mind reading, and 56 
CON VERSA TIONS. 
clairvoyance, have never flourished in Germany 
as they have here. The ingenuity of German 
handicraft weaves these curious fabrics, but they 
find their best market on this side of the At- 
lantic. 
Dr. Warren. Do you call hypnotism, arti- 
ficial trance, and mind reading offshoots from 
animal magnetism? 
Dr. Putnam. They are the same old sheaves 
of straw threshed by new flails. 
Dr. Warren. But, Doctor, do you not think 
there is something in these old sheaves of straw, 
as you call them? 
Dr. Putnam. Yes; where grains of wheat 
are so scarce one might chance to find a dead 
weevil. 
Dr. Warren. A good many intelligent med- 
ical men in this country, and a good many 
shrewd scholars, including lawyers and doctors 
of divinity, think differently. 
Dr. Putnam. I am not surprised; but I was 
speaking of imported eccentricities in medical 
literature as having less reputation at home 
than here. This will apply to all those which 
I have named, and also to hydropathy as taught 
by Preissnitz, and to many others. 
Our indigenous products of this class, less SIXTH CONVERSATION. 
57 
ingenious perhaps in most cases, in their con- 
struction than the German, are by far the most 
numerous, and have been the most successful. 
Among which we may enumerate Perkinsism, 
or the Metallic Tractors; Thompsonianism, or 
the Steam and Pepper doctrines; Botanic 
Doctors, Root Doctors, Indian Doctors, Eclec- 
tics; the clergyman “ the sands of whose life 
are nearly run out;” a thousand panaceas, pain- 
killers, magnetic ointments and magnetic cui- 
rasses, soothing syrups, blood purifiers, brain, 
nerve, muscle, and bone regenerators ; many of 
the inventors of which have realized large for- 
tunes from their sale, notably, Swain, Morri- 
son, Brandreth, Helmbold, Ayres, Moffat. 
Of all of which modes of medication it must be 
said that not one of their inventors ever claimed 
that there was anything supernatural in their 
action. Accompanying each medicine there 
has always been a lucid explanation of its mode 
of operation. Without this satisfactory ex- 
planation no genuine American could ever be 
induced to try the medicine. 
Americans have, by inheritance from their 
British sires, thoughtful and inquiring minds. 
They want to look into things. Our young 
men go to see Herrmann, the prestidigatateur, CON VERSA TIONS. 
or the Davenport brothers,, not so much to see 
the tricks, as to try and find out how the thing 
is done. 
It is my opinion that the original Paul Pry 
was a Yankee. 
Dr. Warren. He was an Englishman, I 
believe. 
Dr. Putnam. Perhaps he was; but I don’t 
think he could be duplicated anywhere but in 
the United States of America. 
I omitted to enumerate among the charla- 
tanisms peculiar to this country one form which 
is of comparatively recent origin. I refer to 
the infinite number of preparations invented 
by druggists, pharmacists, and pharmaceutical 
chemists, which are placed by the manufacturers 
upon the tables of physicians. In the circulars 
accompanying which they assume to instruct 
the medical profession as to the proper doses 
of the various ingredients found in their new 
compounds, and which they claim to have put 
together in the best manner to insure the best 
results. 
This system, or scheme of charlatanism, has 
in a great measure driven the so-called patent 
medicines from the field; but it is the same 
thing in another and no less objectionable SIXTH CONVERSATION. 
59 
phase. It presents itself in the specious form 
of direct appeal to the medical profession, and 
not to the people; for the purpose of first se- 
curing the endorsement of physicians, and 
through them the patronage of the people. 
Dr. Warren. They give you the formulae, 
and those who sell patent medicines do not. 
Dr. Putnam. There is no patent medicine 
which cannot be easily analyzed by a chemist; 
and the constituents of most of them are known, 
and may be found published in the pharma- 
ceutical journals. 
But of what use is it to know the formula, 
when you are told by the manufacturer that 
his preparation is the only genuine article of 
this kind in the market; and it is apparent 
that the process of manufacture, which perhaps 
he will describe to you, is so complicated that 
neither you nor any ordinary pharmacist could 
make it to order. 
Dr. Warren. Is it of no use to know the 
formula, so that you can intelligently approve 
of it or not? 
Dr. Putnam. I can do the same with any 
patent medicine. To me it is plain that this is 
but a new phase of the manufacture and sale of 
quack medicines. But the plan contains an CONVERSA TIONS. 
element of impertinence which would never be 
tolerated in any other country but this. The 
manufacturers assume to instruct the profession 
as to the quality and proportions of medicine 
they ought to give. I venture to say you will 
not find these samples and circulars of advice 
crowded upon the doctors in any other country 
in the world as they are here. 
Dr. Warren. As I said to you before, I do 
not think I would ever wish to hold a consulta- 
tion with an empiric in the formal manner in 
which consultations are usually held; but I can 
see no reason why any person suffering from 
an obscure disease, no matter who may have 
charge of his case, may not have the benefit of 
my opinion as an expert upon the question of 
the nature of his disease. Common humanity 
seems to me to demand that I shall make this 
concession to his wishes. 
Dr. Putnam. He can, under the American 
code, have your expert opinion if he will dismiss 
the empiric ; and the lack of humanity is, there- 
fore, in your supposed case, on the part of him- 
self or his friends. 
Dr. Warren. But he prefers the empiric’s 
practice to mine, although he prefers my diag- 
nosis. SIXTH CONVERSATION. 
61 
Dr. Putnam. Would you, as a physician, 
think a man who could not make a proper di- 
agnosis, and who, on the diagnosis being made 
by you, refused to accept your suggestions as to 
treatment, a safe man to trust with the life of the 
patient? and especially if he frankly declared 
to you that in this, as in all other cases, his 
views of treatment were diametrically opposed 
to yours ? 
Dr. Warren. No, Dr. Putnam, but that is 
a matter which in no way concerns me. 
Having made the diagnosis and put the em- 
piric on the right track, my responsibility ceases. 
Don’t you think so? 
Dr. Putnam. It is a case of uraemia 
perhaps; and to-morrow the empiric seeing 
that the patient is suffering from constipation, 
may—and he certainly will if he is a sincere 
believer in the doctrines of Plahnemann— 
similia similibus curantur—give him a dose of 
morphine, or some other equally inappropriate 
medicine, and kill him outright. 
Doctor, excuse an interruption. There is a 
man waiting in the reception room who wants 
my professional advice. May I call him in? 
You need not retire. 
Dr. Warren. I am in no haste, Doctor. 62 
CON VERSA TIONS. 
Dr. Putnam. (Addressing the man who has 
taken a seat.) Mr. Jenkins, you are an engi- 
neer? 
Mr. Jenkins. Yes, sir, lam what some call 
an engineer, but I call myself an engine- 
driver. 
Dr. Putnam. Where do you run an en- 
gine ? 
Mr. Jenkins. I run out from Jersey City on 
the Pennsylvania Central. 
Dr. Putnam. Suppose the superintendent 
of your road were to send for you, and tell you 
that he wished to go to Newark on an engine, 
but that his engineer did not know how to 
switch it on to the right track; and upon in- 
quiry you were to learn that the engineer he 
had selected was a man you knew very well; 
that all the knowledge of engineering he ever 
had, he obtained in a blacksmith shop, where 
he sometimes made bolts and coupling-rods for 
the repair of engines. Suppose, further, that 
you knew he entertained a full belief that he 
was an accomplished engineer; and that he 
had such a plausible way of talking, that he 
often persuaded intelligent people who were 
not engineers that he understood perfectly the 
construction of an engine and how to run it. SIXTH CONVERSATION. 
Or, you may suppose that he did understand 
fully the construction, joinings, and purposes of 
all parts of an engine, but that you knew also 
that he claimed to have made some important 
discoveries in the matter of the running of an 
engine; one of which was, that the proper way 
to run an engine was to put on all the steam he 
could, and then shut off the steam escapes, and 
tie down the safety valves. Suppose you knew, 
in short, that he was filled with all sorts of 
cranky and absurd theories relating to this sub- 
ject, of which the one I have cited will serve 
as a fair specimen. Would you, knowing that 
the superintendent, who knew nothing of en- 
gineering, had chosen this man to take him to 
Newark, and could not be dissuaded from his 
purpose, would you, I ask, obey his order and 
put the engine on the right track? 
Mr. Jenkins. That is a queer question to 
ask, Dr. Putnam. 
Dr. Putnam. But you ask me queer ques- 
tions sometimes, and I answer them. 
Mr. Jenkins. And I knew all about this 
crank, and the superintendent did not? 
Dr. Putiiam. Yes. 
Mr. Jenkins. No, I wouldn’t obey the 
order; for I would be morally certain that he 64 
CONVERSA TIONS. 
would blow up the engine before he had run a 
mile. 
Dr. Putnam. If you refused to obey, the 
superintendent would discharge you. 
Mr. Jenkins. That would make no differ- 
ence. I would rather be discharged than to 
help blow up the engine with all on board. 
If I did so, I think I would deserve to be dis- 
charged not only, but to be hung up on the 
nearest lamp-post. 
Dr. Putnam. That is pretty strong lan- 
guage, Mr. Jenkins. 
Mr. Jenkins. I think any honest engineer 
wTould answer the same way. 
Dr. Putnam. You would sacrifice your 
place for a sentiment? 
Mr. Jenkins. I don’t know what you mean 
by a sentiment, but I would lose my place be- 
fore I would help blow up the engine. You 
see, Doctor, I love an engine; I was brought up 
among engines. I know every piece of metal 
there is in an engine, and when they are put 
together she is the most beautiful thing in the 
world. She is intelligent; I talk to her and 
she understands me, and obeys me; and she 
talks to me; telling me when she wants more 
coal, and when I am running her too fast. SIXTH CONVERSATION. 
65 
She knows more than some men; and I half 
think she has a soul, and that I may meet her 
in another world; and if I should blow her up 
I would expect to be haunted by her ghost as 
long as I live. I don’t think I would care so 
much for the addle-headed superintendent, or 
for the engineer, but I couldn’t knowingly hurt 
the engine, or help any other man to do it. 
Would you help kill a man, Doctor? 
Dr. Putnam. No. 
Wr. Jenkins, Nor would I help kill an en- 
gine. 
Dr. Putnam. But you would not yourself 
hurt the engine, you would only put it on the 
right track. 
Mr. Jenkins. Your philosophy is too fine 
for me. If neither I nor any other engineer 
did put her on the right track, the superinten- 
dent wouldn’t take his foolish ride, and the en- 
gine wouldn’t be blown up. 
Dr. Putnam. Mr. Jenkins has given you 
my answer to your question, Dr. Warren. 
If I have anything more to say in reply, it is 
to repeat what I have already intimated, that I 
am under no obligation to sacrifice my own 
self-respect for a man who wilfully and ob- 
stinately refuses to make any sacrifice on his 66 
CONVERSA TIONS. 
part in order that he may obtain my pro- 
fessional services. 
The object which the patient and his medical 
attendant has in view, in asking an expert to 
give an opinion in such a case, is seldom or 
never fairly stated. The charlatan has never 
intimated to his patient that he has any doubt 
as to the nature of his disease. That is not 
the way with men of that class. He has con- 
sented to the consultation only to gratify a 
whim of the patient, and with the ultimate 
purpose of convincing his patient that he un- 
derstood the case better than any one else; and 
inasmuch as he will be left thereafter in ex- 
clusive charge of the patient, he will have no 
difficulty in convincing him. Even in case of 
the patient’s death, and he is permitted to make 
an autopsy, the proof that he was right and the 
expert was wrong will not be wanting. How 
can a physician consent to occupy such a posi- 
tion for the sake of the fee, and for nothing 
else? for no other profit can come of it to any 
of the parties concerned. Please read this 
paragraph which I have copied from the 
Homoeopathic Code of Medical Ethics : 
“ § 6. As the patient has an undoubted 
right to dismiss his physician for reasons satis- SIXTH CONVERSATION. 
factory to himself, so, likewise, the physician 
may, with equal propriety, decline to attend 
patients when his self-respect or dignity seem 
to him to require this step.” 
May the attending physician indulge in that 
self-respect which is denied to the consulting 
physician? or may a homoeopathist exercise a 
degree of personal freedom which is denied to 
a Doctor? SEVENTH CONVERSATION. 
Old “Fogyism”—The Hippocratic Code of Ethics— 
The “ Gentleman’s” Code—Trades-union. 
Dr. Warren. Our long and intimate person- 
al relations encourage me to say some things to 
you which, under other circumstances, I would 
not feel at liberty to say. 
Dr. Ptitnam. You are not likely to say or 
do anything which will disturb our friendly re- 
lations. 
Dr. Warren. You are by some years my 
senior ; and while it is undoubtedly true that age 
brings with it many advantages of mental dis- 
cipline and experience, don’t you think that old 
men are apt to fall into ruts from which it is 
difficult to extricate themselves? and that they 
move so slowly that they eventually block the 
road, and become obstructionists in the way of 
the car of progress? 
Dr. Putnam. Become old fogies? Yes; but 
you see how it happens that they get into a 
rut. They have, in the course of their lives, SEVENTH CONVERSATION. 
69 
tried a great many roads, and, having at last 
found out which is the best, they are apt to 
stay in it. I don’t think, however, that they 
often seriously block the way ; since I have 
noticed that those on the car of progress man- 
age to switch off, and to go past me with ban- 
ners and a shout ; and this is, in many cases, 
the last I ever hear of them. 
I understand you mean to imply that in my 
adherence to the code I am somewhat old 
fogy? Yes, I am; for a medical code is as old 
as Hipprocrates. The father of medicine had 
that instinctive appreciation of a humane art 
which led him to construct a code of ethics for 
his pupils, and to bind them to its observance 
by a solemn oath, which they were required to 
take before entering upon the practice of their 
profession. This code has been quoted and ap- 
proved by each succeeding generation of medi- 
cal men in all parts of the world, from that time 
until the present day. Some of its precepts, 
especially that relating to the disclosure of se- 
crets entrusted by patients to their physicians, 
for the purpose of obtaining such medical ad- 
vice as they could not otherwise obtain, have 
become embodied in the laws of most civilized 
countries. CONVERSA TIONS. 
You must permit me to remind you, how- 
ever, that the American National Code was 
engrafted upon our modern civilization not 
many years ago; and that the term “ old fogy” 
can, therefore, scarcely be applied to the friends 
of this code. 
Dr. Warren. I am in favor of a code; but I 
would much prefer the unwritten, yet in polite 
society the well-understood code, known as the 
“gentleman’s code.” 
Dr. Putnam. You are, I believe, a member 
of one of the most prosperous and aristocratic 
of our city clubs. You are not ignorant of the 
fact, therefore, that a gentleman of your stand- 
ing in society, who has always carried about 
with him the gentleman’s code, cannot be ad- 
mitted into any of the best clubs of this city 
without first subscribing to its written code of 
ethics. 
To be admitted to the club of which you are 
a member you were required to say, over your 
own signature, that you would not play cards 
for money in the club-house; or in any place 
utter a disloyal sentiment against the Govern- 
ment. 
Dr. Warren. I trust you do not intend to 
intimate, Dr. Putnam, that in rejecting the SEVENTH CONVERSATION. 
71 
code we are playing cards for money, or con- 
templating treason against our profession? 
Dr. Putnam. Certainly not, Dr. Warren, 
but I only referred to these facts to show you 
that your unwritten gentleman’s code was not 
accepted as a passport to membership. 
Dr. Warren. These are by-laws and regula- 
tions—not a code of ethics. 
Dr. Putnam. The same thing under another 
name. If you think otherwise, let me ask you : 
if our code of ethics were placed under the 
head of by-laws and regulations, would you 
sign it? 
Dr. Warren. I am not prepared to say 
whether I would or not. I think I would 
not. 
Dr. Putnam. Your by-laws and regulations 
declare, also, that no game of cards, even when 
there is no wager for money, shall be played 
in the club-house. This is not in your gentle- 
man’s code. 
They declare, also, that “if any person dis- 
loyal to the Government of the United States be 
knowingly introduced to the club-house by a 
member of the club, such member shall be ex- 
pelled for the offence.” A by-law which ex- 
cluded from membership and from admission 72 
CON VERSA TIONS. 
as casual guests, all those gentlemen who were 
lately in active rebellion against our Govern- 
ment or who sympathized with them in their 
rebellion, and continues to exclude most of 
them; for, although the rebellion is ended, no 
one doubts but that most of those who partici- 
pated in, or sympathized with it, continue to 
justify their conduct. Believing as Ido that 
most or all of them were sincere believers in 
the justice of their cause, I would not expect or 
ask them to change their opinions; and yet 
among them may be found multitudes of men 
who have always respected the gentleman’s 
code, and who are even chivalric in their ad- 
herence to its precepts. 
Dr. Warren. But, Doctor, the club to which 
you refer was organized for a specific purpose— 
to support the Government in its struggles 
against rebellion—and it had to be constructed 
under specific rules, intended to further the 
great purpose of the organization. The found- 
ers considered themselves the best judges as to 
what rules of government or of discipline were 
most likely to accomplish the ends proposed, 
and adopted them. 
Dr. Putnam. Even to the extent of regulat- 
ing their social intercourse ? SEVENTH CONVERSATION. 
73 
Dr. Warren. Yes ; and I see no reason why 
it should not in this case. 
Dr. Pzitnam. The American Medical Asso- 
ciation, also, was organized for a specific pur- 
pose, namely, the advancement of medical 
science; and its members have adopted rules 
which, in their opinion, are best calculated to 
accomplish this end, among which rules or 
regulations is the National Code of Medical 
Ethics. 
Referring to your opinions on the subject of 
freedom of thought and action, as expressed to 
me on a former occasion, I would say you ought 
at once to withdraw from your club. 
Dr. Warren. I don’t see it in that light, 
Doctor. 
Dr. Putnam. No; but the reason you do 
not, I think, is that you do not look at the two 
pictures in the same light. To my sight, the 
one is as nearly as possible a copy of the other ; 
but as you change your position in looking at 
them, certain shadows are thrown upon the one 
which are not seen upon the other. 
There is one other point that I am surprised 
you have not hitherto alluded to. Your friends 74 
CON VEX SA TIONS. 
compare our code to trades-unions, and thus 
seek to cast upon us the odium which, in the 
opinion of many, justly attaches to these busi- 
ness combinations. 
Dr. Warren. I did not allude to this matter, 
Doctor Putnam, for the reason that I never 
thought it a fair representation of the nature 
and objects of the National Code. 
Dr. Putnam. I am glad you say so, Dr. 
Warren. The trades-unions are formed for the 
purpose of controlling the market and to pre- 
vent underselling; and not for the purpose of 
keeping inferior or worthless articles out of the 
market. If in any instance they have this latter 
object in view, in so far at least their object is 
commendable, and they ought to receive the 
approbation of all good citizens. 
There is in our code an article (article vii.) 
which reads as follows : “ Some general rules 
should be adopted by the faculty in every town 
or district relative to pecuniary obligations 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." 
This is the only allusion to this subject in a code 
which occupies more than ten octavo pages of 
closely printed matter. Practically the sugges- SEVENTH CONVERSATION. 
75 
tion has had very little influence with medical 
men, since very few medical societies have ever 
seen fit to adopt a fee bill, and when they have, 
the range of fees has been so wide as to suit 
the varying circumstances of every citizen, and 
has not therefore in any business sense “ gov- 
erned or controlled the market,” Many of the 
fees of lawyers are regulated by statute, and in 
other cases the judges are authorized to declare 
the value of legal services; but this has not 
subjected them to the serious imputation of 
having united in a trades-union conspiracy 
against the public. 
The medical code repeatedly calls attention 
to our obligation to perform gratuitous services 
in certain cases, and to avoid always the suspi- 
cion of being actuated by mercenary motives. 
Can such suggestions be found in any of the 
codes adopted by trades-unions ? 
Every medical man knows that the object of 
our code is not to monopolize the market and 
to enhance the value of our services. Such an 
insinuation is only worthy of those outside of 
our profession who have no means of knowing 
to the contrary; but for any one who has spent 
most of his life in intimate social relations with 
his medical brethren in this country, and in CON VERSA RIO NS. 
common with them has practiced his profession 
under the existing National Code—and there- 
fore by this time ought to understand its real 
purposes, and to know in what light it is re- 
garded by medical men,—for such a man to 
utter such a sentiment is in the highest degree 
unfair and disingenuous. If he does not know 
better, he certainly ought to know better. 
Dr. Warren. You know, I presume, that 
the courts have in several instances refused to 
recognize the right of medical societies to dis- 
cipline or expel, for offences against the code, 
any member who has a legal right to practice 
medicine: and in one case, I think, a manda- 
mus was issued to compel a society to admit to 
fellowship a man whose empirical practices ren- 
dered him obnoxious. If the courts compel us 
therefore to associate with these men, of what 
use is the code ? Of what use is it that you 
seek through the code to dissever yourself from 
those whom you cannot keep out of your so- 
cieties, or discipline if they are actual members? 
Dr. Putnam. It never was the purpose of 
the code to discipline anyone. Not one word 
is said about discipline in the code. It simply SEVENTH CONVERSATION. 
77 
informs the reader what conduct is, by those 
who sign the code, considered becoming medi- 
cal men in their relations to each other, their 
patients, and the public; and what conduct they 
deem derogatory to the honor of the profession. 
It is true that the medical societies which, 
having adopted this code, have attempted to 
enforce its precepts by discipline, have some- 
times been restrained from doing so by the 
courts. But this fact only shows that the courts, 
which are supposed to interpret and enforce the 
laws, understand that the laws intend to make 
no distinction between certain classes of em- 
pirics and physicians; and their occasional, but 
not uniform decisions upon this point only 
tend to confirm my opinion already expressed, 
that what the laws and the courts fail to do, we 
must do for ourselves. The laws make no dis- 
tinction between honest, industrious citizens 
and street vagrants; both are alike entitled to 
vote, and to enjoy in all other respects the priv- 
ileges and immunities of citizens; but it does 
not follow that society is not at liberty to make 
a distinction, or to draw a social line of absolute 
separation. 
But really it is to us of the smallest possible 
importance whether we can keep irregulars out CON VER SA TIONS. 
of our societies or not. If admitted, they would 
render themselves more uncomfortable than 
they would us; but they seldom or never of late 
ask for admission. As for those who are actual 
members, an open and premeditated violation 
of the code on their part, or of any of the reg- 
ulations of the society to which they have sub- 
scribed, and have thus given their formal ap- 
proval and acceptance, would be certain to bring 
upon the offender a punishment more humiliat- 
ing than any official action of the society could 
contemplate or inflict—he would be left to his 
own companionship—as would be the case, 
also, in any other social organization, whether 
religious, political, or commercial. EIGHTH CONVERSATION. 
What Fruit has the Code Borne?— There Cannot be 
two Schools in Medicine—Perkin’s, the Botanic, 
Eclectic, Homoeopathic, Hydropathic “ Schools”— 
Mesmerism, Clairvoyance, Mind-Reading, Graham- 
ism; Indian, Cancer and Salve Doctors. 
Dr. Warren. A tree is known by its fruit 
What are the fruits which you can justly claim 
as having been borne by the code ? I have been 
looking for some time, and especially since we 
began to talk upon this subject, but I am un 
able to see any valuable results which can be 
legitimately ascribed to the code. 
Dr. Putnam. In what direction are you look- 
ing? 
Dr. Warren. In the direction of the profes- 
sion, and in the direction of the people. 
Dr. Put7iam. And you see nothing ? 
Dr. Warren. Nothing that indicates that 
the code has exerted any healthful influence. CON VERSA TIONS. 
Dr. Putnam. What did you expect to see, 
Doctor ? 
Dr. Warren. I hoped to see improvement 
in both directions; but according to your 
own statements, young men continue to press 
their way into the medical profession imperfectly 
qualified, and the people are given over almost 
wholly to quackery. If the code has had any 
effect in matters of this sort, it seems to have 
been a bad effect. 
Dr. Putnam. A man must have a very wide 
range of vision who can look over the medical 
horizon for a space of forty years, and estimate 
correctly the losses and gains for that period of 
time ; and the same would be true of any other 
public question of equal breadth and impor- 
tance. Especially is it difficult through so long 
a period to trace back results to their proper 
causes. Open and secret violations of the laws 
continue to exist; men steal, cheat, swear 
falsely, gamble and commit murder daily, in 
spite of the laws; and one would find it difficult 
to say what causes have operated to produce 
this state of things. Yet one thing is certain : 
no one would ever think of ascribing it to the 
existence of laws; nor indeed would any one 
doubt that the laws have had a restraining in EIGHTH CONVERSATION. 
fluence, even if it could be shown that matters 
in these regards were worse than before laws 
were enacted. 
Instead of attributing the general moral de- 
cadence to the laws, some other explanation 
would be sought, such as the changed and pe- 
culiar condition in which the people live ; or 
the opposing influence of certain other power- 
ful agencies which would probably overwhelm 
us, if their force were not in some measure 
broken by existing laws. 
I will ask you now to confine your attention 
for a moment exclusively to the progress of 
medicine in this country; and to consider es- 
pecially its progress during the last forty years. 
You say young men continue to find their way 
into the ranks of the profession imperfectly 
qualified ; but I must remind you again that the 
regulation of this matter is not within the scope 
of the purposes of the code, and therefore the 
code is in no sense responsible for this failure. 
This evil will continue, I have sought to con- 
vince you, until medical colleges are established 
upon a basis of pecuniary and political in- 
dependence. They must be fully endowed, and 
they must be, so far as their management is 
concerned, free from political, State or Federal 82 
CON VERSA 7 lONS. 
control. How long we may have to wait for 
this I do not know, but the code will not 
accelerate or delay the advent of this consum- 
mation so much to be desired. 
Dr. Warren. Pray, then, what remains to 
be expected or hoped for from the code ? 
Dr. Putnam. I have in one of our earlier 
conversations indicated one of the chief pur- 
poses of the code. 
Dr. Warren. To dry-nurse and coddle the 
sickly infants ? 
Dr. PiUnam. Yes, and to some extent to 
continue this sort of fostering care to all the 
members of our profession, whether old or 
young, feeble or strong, so long as they remain 
members of the profession. There are many 
perhaps who could get along well enough 
without it, but there are many who will need 
it as long as they live. 
The code is intended, among other things 
and most especially, to elevate the tone—that 
is, to improve the general morale of the profes- 
sion, using the term morale in its widest and 
most liberal sense, as applied to character, con- 
duct, and the courtesies of life,—and thus, in- 
directly or directly, to secure for ourselves EIGHTH CONVERSATION. 
83 
public respect and to advance the interests of 
the science of medicine. 
Dr. Warren. I do not see any natural con- 
nection between the morale of the profession 
and progress in medical science. 
Dr. Putnam. I do. Upon the morale of a 
man will depend chiefly the decision of the 
question whether he will make his profession a 
trade or a science ; whether he will use it for 
purposes of selfish gain or of public good ; 
whether he will prey upon the misfortunes of 
his fellow men, or contribute to science such 
facts as may tend to alleviate their physical suf- 
ferings. I regard a sound morale in the medi- 
cal profession as the foundation stone of the 
growing edifice of medical science. 
When you were enumerating the objects 
which you saw or failed to see in your telescopic 
search for the fruits of the code, you did not 
mention that you saw progress in medical 
science. 
Dr. Warren. No ; and because I did not 
recognize that as one of the fruits of the code. 
Dr. PiUnam. It is true, however, as you 
will admit, that for some time past medical 
science has been making great progress in this 
country. Such as to attract the attention and 84 
CON VERSA TIONS. 
to secure the admiration of medical men in 
other countries. 
Your own friends often refer to this progress 
as a reason why we should throw off the re- 
straints of the code, and thus place ourselves be- 
fore the public as making the same progress in 
liberality of sentiment and freedom of thought 
and practice which we have made in medical 
science. 
Dr. Warren. And you ascribe all this 
progress to the code ? 
Dr. Putnam. It has occurred under the 
code, and those who have contributed to the 
advancement of medical science in this country 
are, almost without exception, men who have 
subscribed to the code and have lived under it. 
The code was instituted having this as one of 
the ends it sought to accomplish. It seems to 
me, therefore, that we have a right to claim it 
as one of its fruits. Certainly, in view of the 
facts known to you, you cannot claim that it 
has arrested or retarded progress in medical 
science. 
In addition it is pertinent to remind you of 
the universally accepted maxim, that in most 
cases, sooner or later, wholesome advice brings 
about good results. EIGHTH CONVERSATION. 
85 
Dr. Warren. It seems apparent that quack- 
ery has flourished under the system of proscrip- 
tion enjoined by the code, and I am, according 
to your own line of argument, warranted in 
ascribing this condition to the code. It is quite 
probable also, I think, that the attitude of an- 
tagonism and hostility, on the part of medical 
men toward certain forms of empiricism, has 
rather tended to popularize them, by creating 
in the minds of the people an impression that 
the apostles of these creeds were being martyr- 
ized by us. 
Dr. Putnam. So you would have said noth- 
mg? 
Dr. Warren. No, I think it would have 
been better if we had preserved a dignified 
silence in reference to these matters. 
Dr. Putnam. In your opinion, then, we 
never should have allowed ourselves to say that 
it was detrimental to the interests of medical 
science, and therefore derogatory to the char- 
acter of a medical man, to countenance and 
encourage those who practice under exclusive 
dogmas, and who publicly proclaim this fact, 
who assume a distinctive title in order to sepa- 
rate themselves from other physicians, and de- 
clare themselves to be in open hostility to the 86 
CON VERSA TIONS. 
science of medicine as hitherto taught; and 
who, in short, ostentatiously renounce all the 
accumulated experience of many centuries, de- 
claring that the science of medicine began with 
their own wonderful discoveries. 
Dr. Warren. You do not interpret my re- 
mark correctly. I know very well that the 
science of medicine is a unit, and is incapable 
of being divided into schools. I think it our 
duty to teach the public that this is our attitude ; 
that while we are not Homoeopathists, we 
regard it as equally disreputable ’to be called 
Allopathists. 
Dr. Putnam. A nickname given to us by 
Homoeopathists; and which ingenious device 
on their part has done more to increase their 
patronage than anything else ; since it is calcu- 
lated, as no doubt it was intended, to convey 
the impression to the people that our practice, 
also, was controlled by a dogma, and that like 
themselves, we constituted a “sect.” The peo- 
ple had, therefore, only to decide which of these 
two classes of dogmatists or sectarians they pre- 
ferred ; while the fact is, that we do not know 
or care whether a medicine acts in obedience to 
the law of similia similibus, or the law of con- 
traria contrariis, provided only it cures. EIGHTH CONVERSATION. 
Dr. Warren. I was proceeding to say, Doc- 
tor, that I do not object to medical men declar- 
ing publicly that they are not sectarians or dog- 
matists, but I think it unwise to enter into per- 
sonal disputes with empirics, or to make any 
public and specific denunciation of a particular 
sect. It is this which enables them to assume 
the air of martyrs, and thus to excite public 
sympathy in their behalf. 
Dr. Putnam. There is not one word in the 
code naming or pointing to any special class of 
empirics. It says nothing which, if I under- 
stand you correctly, you would not permit and 
encourage medical men to say ; and it cannot 
therefore be regarded as responsible for the 
spread of any medical heresy among the peo- 
ple. 
Dr. Warren. It says that it is considered 
derogatory to the character of a medical man to 
counsel with empirics. 
Dr. Putnam. Don’t you hold the same opin- 
ion ? 
Dr. Warren. If I do I would not place this 
opinion in a code of ethics, to be read by every 
one who chose to look at it. In fact I hold, as 
I have said before, that this is a matter for my 
own conscience to decide in any given case, and 88 
CON VERSA TJONS. 
there may be cases of emergency when I might 
choose to act differently. 
Dr. Putnam. I do not think any one has 
ever construed the code as teaching that you 
may not meet an empiric in an emergency, and 
do for the patient yourself, or assist him in doing 
whatever may seem necessary; but to consult 
with a blacksmith who calls himself a doctor, 
or with every medical crank that our legislators 
may choose to recognize as a doctor, is another 
thing. 
But, Doctor, if our antagonism to and perse- 
cution of Homoeopathy has done so much to 
popularize this species of empiricism, why has 
it not benefited and popularized, in like manner, 
all the other forms of empiricism ? They have 
all shared alike in our persecutions. 
Dr. Warren. I am not certain but that it 
has. 
Dr. Putnam. If this is your opinion or sus- 
picion, then I shall have to ask you to avail 
yourself of one of the advantages which age 
usually brings with it, namely, my longer vision. 
I think I shall be able to point out to you some 
facts, which will show that the prosperity and 
decay of medical errors, have very little or no 
relation to the amount of persecution which EIGHTH CONVERSATION. 
89 
they receive from medical men. It seems prob- 
able, indeed, that while some of them are in- 
digenous to certain climates, and to certain con- 
ditions of soil and society, and may continue 
to exist under favorable conditions for an in- 
definite period of time, most of them are ephem- 
eral, and only continue to live until they are 
supplanted by others. 
I shall attempt to show you that a large por- 
tion of the people, including even persons of 
the highest culture and intellectual endowments, 
are easily deceived in matters pertaining to the 
science and practice of medicine ; and that the 
number of these credulous people is about the 
same in each succeeding generation. The de- 
lusion varies, but the number who are deluded 
remains the same. 
Dr. Warren. “ Populus vult decipi, decipi- 
atur.” 
Dr. Putnam. Yes, “the people like to be 
deceived,” but I am not willing to add, “let 
them be deceived.” 
Dr. Warren. If you will not consider me 
pedantic in my frequent reference to Latin 
maxims, I will give you another, which I think 
you will accept more readily, “ Homo animal 
est credulum et mendax.” 90 
CONVERSA TIONS. 
Dr. Putnam. That is not far from the truth ; 
only that I would prefer to have said aut men- 
dax. Mankind is, in this regard, composed of 
two distinct classes; of which the mendacious, 
being the most intelligent, habitually prey upon 
the credulous. There is, indeed, another class, 
which is neither mendacious nor credulous, but 
I am afraid they are in the minority. 
I will now, with your permission, proceed to 
the task which I have imposed upon myself. 
In 1806 the legislature of the State of New 
York—the same legislature whose opinions on 
the subject of medical science we are called 
upon by you and your friends to respect—pur- 
chased of J. N, Crouse a secret remedy for the 
prevention and cure of hydrophobia; paying 
him, I think, S3OOO. 
The recipe being given to the public by the 
humane legislators was found to be: 
“ One ounce of the jaw-bone of a dog, burned 
and finely pulverized ; the false tongue of a 
newly foaled colt dried and pulverized ; one 
scruple of verdigris, raised on old copper by lay- 
ing in moist earth (the coppers of George Ist 
and 2d are purest and best). Mix these to- EIGHTH CONVERSATION. 
91 
gether, and if the patient be an adult, give one 
common-sized tablespoonful a day,” etc. 
The Legislature of the State of New York 
further directs: If you cannot obtain coppers 
of the date above named, you may use “ a small 
increase of quantity of a baser metal.” 
Our medical records, as well as the State rec- 
ords, are silent as to the number of cures there- 
after wrought by this valuable recipe. 
About this time a Doctor Perkins, of Con- 
necticut, announced his discovery of the healing 
properties of certain combinations of metals, 
or of the “ metallic tractors,” as he called them. 
Dr. Perkins was not at first, nor at any time 
while he continued the old fogy practice of 
medicine, very successful. He therefore aban 
doned the practice altogether, and engaged in 
the business of breeding mules for the West 
India market, which was at one time quite a 
lucrative trade. After a time, the demand for 
mules having greatly fallen off, he gave up this 
business also, and in his subsequent hours of 
retirement he invented the metallic tractors, 
and the theory upon which their action was 
based. His success in this new adventure must 92 
CONVERSA TIONS. 
have exceeded his most sanguine expectations, 
for in a few years his tractors had won for them- 
selves a wide reputation. Several hundred 
clergymen—to whom he always sent his trac- 
tors gratis, although he declared that he could 
scarcely afford to sell them for less than S2O a 
pair—certified to their wonderful powers. The 
public pressure was so great here in New York, 
that at one time the managers of the New York 
City Hospital felt compelled to permit him to 
try his tractors on some of the patients then 
suffering from yellow fever. The result of the 
experiment Ido not know; but I have been in- 
formed that he himself subsequently died of yel- 
low fever; after which both the man and his 
tractors passed into history. 
Before his death, however, he went to Lon- 
don, and opened a hospital, and for a time at- 
tracted great crowds of people, among whom 
he claimed were some of the nobility; but his 
career in London was brought to a sudden and 
ignominious close by the ingenious exposure 
made by Dr. Hogarth of Bristol, and he soon 
after returned to this country to find that his 
tractors no longer “ drew.” In his absence they 
had been supplanted in a great measure by 
other practices and other theories. EIGHTH CONVERSATION. 
93 
While in London, a Vermont poet of no 
mean pretensions, Peter Fessenden, was em- 
ployed by him to write a book, entitled “Ter- 
rible Tractoration,” which was intended to 
satirize those medical men who had ridiculed 
his pretensions. You would be entertained by 
reading this book, which is scarcely inferior to 
Butler’s famous Hudibras, in its attempt to 
satirize medical men and medical science. 
I have in my possession a pair of these trac- 
tors, one of which is evidently brass and the 
other iron. By drawing the pointed ends of 
these tractors in parallel lines over the surface 
of the body, the cures were wrought. The per- 
son who presented to me these curious relics 
was a member of the Perkins family, but she 
frankly acknowledged to me that their healing 
properties had gone out from them, and that 
they no longer wrought cures. 
The next form of empiricism which attracted 
much attention, was the Botanic practice. 
The disciples of this “school” based their 
practice upon the ingenious theory that man is 
not a mineral, and therefore calomel and other 
minerals could not be proper medicines. They 94 
CON VERSA TIONS. 
probably never suspected that, possibly also, 
man was not a vegetable, and that therefore 
vegetable medicines might be equally inappro- 
priate. 
The “new school” published books on bo- 
tanic medicine, and was for many years very 
prosperous; so that one or more Botanic doc- 
tors were to be found even in the smallest towns, 
and in the most thinly settled districts. 
The only name, however, in their ranks which 
has come down to us is that of a Quaker lady, 
well known at that time in this city as a lady of 
culture, refinement and of aristocratic connec- 
tions, who went about the country as a mission- 
ary, giving free lectures on this subject. 
Samuel Thompson, an honest but unedu- 
cated citizen of Western New York, was the 
next conspicuous laborer in the fertile fields of 
medical charlatanry. His “theory” of man 
was, that he was composed of four elements; 
earth, air, fire and water. His “theory” of dis- 
ease—“ formed,” he says, “ after mature con- 
sideration,”—was “animal heat confined;” and 
his Materia Medica consisted of about ten 
articles, belonging chiefly to the vegetable king- EIGHTH CONVERSATION. 
95 
dom; for, like the Botanic doctors, he held that 
minerals were poisonous. The medicines upon 
which he chiefly relied to expel the heat from 
the body were lobelia, red pepper and steam. 
Dr. Warren. It is within my recollection 
that we had lobelia doctors and pepper and steam 
doctors. I presume these were the Thomp- 
sonians ? 
Dr. Pzdnam. Yes, and Thompson became 
famous among the people as a profound and 
original thinker, and as the founder and de- 
fender of the “new school.” He published a 
book on medicine, consisting of about twenty- 
four pages duodecimo. His chapter on furun- 
culus, consisting of about ten lines, commences 
as follows: “The bile is a distressing visitor;” 
and the next chapter, which is of about the same 
length, and which treats of carbuncle, opens in 
a similar classic style: “ The carbuncle is a large 
bile.” 
In Poughkeepsie, a journal, called the 
“Thompsonian,” was published, exclusively in 
the interests of this “ school;” the clientelage of 
which school was for many years very large. 
The learned Dr. Benjamin Waterhouse, who 1 
believe was a disciple, estimated it at not less 
than 3,000,000. 96 
CON VERSA TIONS. 
Thompson secured a patent for his system; 
which entitled the purchaser to use it in the 
case of his own person or of his family ; but 
not in cases of sickness outside of his own 
family. 
Application was finally made to the Legisla- 
ture of the State of New York, by the friends 
of Thompsonianism, to authorize the formation 
of a society under the title of the “ New York 
State Thompsonian Botanic Medical Society,” 
which should exercise powers similar to those 
exercised by Medical Colleges, namely, the 
power to confer licenses to practise Thompson- 
ianism, after one year’s pupilage with a Thomp- 
sonian doctor. 
I have seen only the minority report upon 
the subject; in which the writer says that the 
petition ought not to be granted, for the reason, 
among others, “ that to give legislative coun- 
tenance, in such cases, would be to encourage 
gullibility and credulity; to advocate the cause 
of quackery in the case of medical science ; to 
set at naught all those rules of plain common 
sense which, in other matters, usually govern 
mankind.” 
Inasmuch as the minority repor recommend- 
ed that the prayer of the petitioners should not EIGHTH CONVERSATION. 
97 
be granted, I am compelled to assume that the 
majority report was in favor of the petitioners. 
Dr. Warren. I hope the Legislature did 
not dishonor itself, and cast odium upon the 
science of medicine by elevating these char- 
latans to the rank of regular physicians. 
Dr. Putnam. No, it did not; but I am un- 
able to see where you make the distinction be- 
tween the conduct of the Legislature at that 
time, and the conduct of the same Legislature 
more recently. It has within a few years elevated 
to the rank of regular physicians certain classes 
of charlatans whose doctrines are infinitely more 
absurd, and more opposed to “ all those plain 
rules of common sense which, in other matters, 
usually govern mankind,” than any thing ever 
taught by Thompson. And these are the men 
with whom you ask to be permitted to consult. 
Dr. Warren. What became of Thompsoni- 
anism after this ? 
Dr. Putnam. It died. 
Dr. Warren. Killed by legislative persecu- 
tion ? 
Dr. Putnam. I don’t know what caused its 
death ; but it seems to have grown into a healthy 
manhood, and, having lived its allotted period, 
to have died a natural death. 98 
CON VERSA TIONS. 
The time and circumstances were favorable 
for new products. Perkinsism and Thompso- 
nianism had scarcely disappeared when foreign 
importations began to arrive ; as if shrewd ob- 
servers had discovered the scarcity of food for 
the homo credulum in the American market, and 
had determined to supply the demand, and reap 
the profits. Homoeopathy, Hydropathy, Mes- 
merism, Clairvoyance and Phrenology were sent 
to us from Germany in, I think, a single cargo. 
Dr. Warren. You do not regard Phrenol- 
ogy as a medical delusion ? 
Dr. Putnam. No, but I speak of it as one 
of the products of German industry, sent to us 
when we were well-nigh famished, owing to the 
failure of our home products. Americans were 
quite willing that the importers should reap the 
profits, provided only their most pressing wants 
were supplied. 
The Plydropathic “school” at first took the 
lead. The “theory” of Preissnitz and his dis- 
ciples was that water caused a “ crisis,” as indi- 
cated by the eruptions consequent upon its use, 
and thus wrought a cure of nearly all human 
maladies. The theory proved satisfactory to 
the people, and water “ privileges,” for the EIGHTH CONVERSATION. 
99 
establishment of baths, were in great demand in 
all parts of the country. Man was, by almost 
universal consent, decided to be an aquatic ani- 
mal, and to attain perfection nowhere but in his 
natural element. 
We supplemented, also, these importations 
by Grahamism, or by the doctrine that man was 
not, as had been supposed, an omnivorous ani- 
mal, but a vegetarian. Some distinguished 
physicians, and nearly all of the charitable in- 
stitutions for children, including the “Shepherd’s 
Fold,” attached themselves to this “school.” 
Its doctrines appeared to them to be both sound 
and economical. 
Halsted announced, and sold a secret cure for 
indigestion, (what would not Mr. Carlyle have 
given for it; yet the price. Which was $5O, 
might have placed it beyond his reach.) Halsted 
knew that every American citizen had indiges- 
tion, and he had sufficient business tact to render 
this knowledge profitable. 
Dr. Warren. You have omitted to speak of 
the Eclectics. 
Dr. Putnam. The Eclectics also are indig- 
enous. As their name implies, they choose 
their remedies from every available source; and 
in so much, they are in no respect different from 100 
CON VERSA TIONS. 
regular physicians. If this were their only pe- 
culiarity, there would have been no need of their 
separation from us ; but the fact is, they have 
other peculiarities. 
They have constructed a school on the basis 
of the inclusion of all the schools ; but with 
special reference to the inclusion of Homoeop- 
athy, Hydropathy, Clairvoyance, Mesmerism, 
“the laying on of hands,” etc. lam not cer- 
tain that it does not include the “ chestnut-in- 
the-pocket” school, and the “ liver-pad” school. 
Whatever has been rejected as worthless by the 
regulars, is deemed especially valuable by the 
Eclectics. 
Most of these “ schools” are now growing 
old, and are showing signs of decay, or they are 
actually dead. 
Dr. Warren. Do you not except Homoeop- 
athy ? 
Dr. Putnam. No, I do not. It would be 
difficult to find to-day in this city ten Homoe- 
opathists who accept the doctrines and practice 
of Hahnemann. The tree is therefore dying at 
its roots, while its branches still furnish a grate- 
ful shade for the lambs which are waiting to be 
sheared. * 
* Says the Hahnemannian Monthly: “A few years, ago the cdi- EIGHTH CONVERSATION. 
101 
Homoeopathy had in its organic construction 
certain elements of success which did not be- 
long to either of the others. The conception 
of disease as dynamic, or as a spiritual force, and 
of resisting its progress by medicine exalted by 
diffusion to a spiritual force, was much more 
in accord with the transcendental and aesthetic 
spirit of the age, than the simple theories of 
other “ schools,” or than the vulgar Saxon 
doses of Botanic Doctors and of Lobelia Doc- 
tors, and of the Regular Doctors. Children 
took the tasteless, colorless and harmless sugar 
pellets, without a shudder; and, what was 
practically also of more consequence to the 
mother, they often got well; but not more 
often than do a majority of persons suffering 
from physical ailments, without the aid of med- 
icine, if only the nursing and hygienic condi- 
tions are properly attended to. 
tors of the New York Medical Times (another Homoeopathic jour- 
nal), dropped from the title of their journal the distinctive word 
‘Homoeopathic;’ now they boldly urge the renunciation of the 
word as applied to our school of medicine. If we are emancipated 
from the thraldom of sect, we shall not only save our school from 
imminent dissolution, but shall also become an integral part of the 
medical profession of the day, honored as true, broad, liberal, pro- 
gressive physicians. But if we cling to a name which by no means 
represents the catholicity and spirit of the new school, we are 
doomed to annihilation,”—Medical Record, Aug. u, 1883. 102 
CON VERSA TIONS. 
Dr. Warren. Probably you believe as I do, 
that Homoeopathy as originally practised, served 
a useful purpose, in substituting no medication 
for excessive medication. 
Dr. Putnam. Yes, and I could have wished 
that, for the sake of the good they did in this 
way, they had never changed their doctrine and 
practice. 
Dr. Warren. Homoeopathy has still a great 
many patrons in all classes of society. 
Dr. Putnam. Very true. Most of those 
people who belong to the class which you call 
“homo credulum,” now employ Homoeopa- 
thists ; and probably for the reason that nearly 
all the other empirical “ schools” have lost the 
vigor of their youth and are no longer active 
competitors. At the present time Homoeop- 
athy is a satisfactory substitute for all the others. 
Dr. Warren. The largest serpent has swal- 
lowed all the smaller ones. 
Dr. Putnam. Some years ago, Dr. Warren, 
when the American Medical Association met 
in Baltimore, I found myself one evening in 
the drawing-room of Barnum’s old hotel with 
Drs. Wm. Gibson and Nathaniel Chapman, of 
Philadelphia, and Dr. , an equally cele- 
brated physician of New York. The subject EIGHTH CONVERSATION. 
103 
of conversation being snakes, Dr. , of New 
York, said he knew it as a fact that snakes not 
only at times make a hissing sound, but that 
they would swallow their young. “ Having 
surprised a female serpent,” said he, “ while she 
was warming herself in the sun, she suddenly 
made a hissing sound, opened her mouth wide, 
when full half a dozen young snakes ran down 
her throat and disappeared.” 
Dr. Chapman having listened attentively, 
immediately leaned forwards and said: “ Dr. 
dose of Serpentaria ?” 
Now, Doctor, I do not think that Homoeop- 
athy, originally constructed with a throat only 
large enough for sugar pellets of the size of 
millet seed, could ever swallow so large a dose 
of Serpentaria as your suggestion must imply. 
In this enumeration many of the different 
forms of quackery which have prevailed in this 
country, since about the time that we became an 
independent nation, are not included; such as 
the Indian Doctors, Root Doctors, Salve Doc- 
tors, Cancer Doctors, etc.; but which swarm 
like locusts along our frontier settlements, and 104 
CON VERS A TIONS. 
far back in the interior where the population is 
sparse, or where it is composed chiefly of the 
laboring classes. 
Dr. Warren. I confess, Doctor, you have 
brought to my knowledge some facts with 
which I was not familiar. And so you really 
think there are no more people employing 
empirics to-day than there were forty years ago; 
and that the apparent prosperity of Homoeop- 
athy does not indicate that such is the fact? 
Dr. Putnam. The evidence to my mind is 
rather that the people are less inclined to quack- 
ery now than formerly; but the probability is 
that in this respect the people are not much 
changed, nor would I look for much change 
in the future. About the same number of 
people will always be credulous. Says Sir 
Walter Scott, in his curious book entitled “De- 
monology”: “ Sailors have a maxim that every 
man must swallow his peck of dirt, and it seems 
quite clear that every generation of the human 
race must swallow a certain measure of non- 
sense.” 
Homoeopathy may continue in its present 
lorm for some time—that is, as a name, without 
actual substance—but it will disappear so soon 
as another and newer empirical “school” ap- EIGHTH CONVERSATION. 
105 
pears to challenge its pretensions, and to lay 
claim to a share of the enormous profits which 
will never cease to flow from the commerce in 
human credulity. 
Dr. Warren. And you don’t think that per- 
secutions add to the number of its patrons ? 
Dr. Putnam. No, I don’t. What you call 
persecutions—but I do not—have been prac- 
tised in the same way, and to the same extent, 
by us and others, toward all the other forms of 
empiricism, and yet they have, in a great meas- 
ure, lost their patronage. If persecution sus- 
tains Homoeopathy, why did it not sustain or 
why does it not resuscitate the others ? NINTH CONVERSATION. 
Newspaper opinions of the ethical war—Proprietary 
Medicines—“ Interviewers”—Our obligations to the 
public do not imply an obligation to consult with a 
charlatan. 
Dr. Warren. Allow me to read to you an 
editorial paragragh which I found this morning 
in one of our city papers. 
“ The doctors are still quarrelling over the 
abstract question of old code, new code, or no 
code. It is essentially a question of consulta- 
tion between Allopathists, Homoeopathists and 
certain other sects in medicine, upon which the 
combatants have formally arranged themselves 
upon opposite sides, and have commenced to 
throw stones at each other. In which contest 
the old code men have for the present numeri- 
cally the advantage, while the more liberal and 
progressive members of the profession, now 
temporarily in the minority, are driven to the 
wall. The latter have, however, the sympathy NINTH CONVERSATION. 
107 
of the public, which, in this country, always 
inclines toward those who are contending for 
liberty, and who are making war upon narrow- 
minded bigotry.” 
In a similar tone a majority of the newspapers 
of this city have from time to time discussed 
this subject; and it seems to me very unwise 
for the medical profession to put itself in a posi- 
tion of antagonism to the public press. 
Dr. Putnam. In what respect is it unwise ? 
Dr. Warren. In this respect, that it de- 
prives us of the moral support of a very influ- 
ential class of men. 
Dr. Putnam. Not because they are right in 
their views, but because our failure to acquiesce 
in them insures their displeasure. 
Dr. Warren. Partly both ; for I hold that 
an intelligent independent press, such as we 
justly boast in this country, is generally right 
in its estimate of public questions ; and whether 
right or wrong, its open hostility is dangerous 
to our interests as a craft. 
Dr. Putna7n. I will answer your several 
points in the inverse order of their statement. 
Our interest as a craft, in the sense of the term 
as it is employed by you, is a commercial one, 
and in no wise connected with our interest as CON VERSA TIONS. 
the representatives of a science. This latter 
interest, and this is the only one we have to con- 
sider, cannot be affected by their displeasure. 
Moreover, this is not in any proper sense a 
public question, or one which the press is espe- 
cially fitted to discuss. The editors of most 
of our city newspapers are men of culture and 
intelligence ; and so far as they undertake to 
speak of matters which come habitually and 
closely under their special observation, they may 
generally be regarded as authority; but in ref- 
erence to the matter now under consideration 
by us, I would much prefer the opinions of an 
equal number of equally intelligent medical men. 
Indeed, the paragraph to which you have called 
my attention, and which, as you say, is in the 
same tone with many other newspaper editorials 
upon this subject, shows that they do not under- 
stand the question now being discussed by med- 
ical men. 
Dr. Warren. The press is generally re- 
garded with us as a representative of public 
opinion ; and what the people think is, in most 
cases, very near the truth ; Vox populi vox Dei. 
Dr. Putnam. If this be so, then the voice 
of God gives a very uncertain sound ; for noth- 
ing can be more capricious, according to my NINTH CONVERSATION. 
observation, than popular opinion. It is sel- 
dom the same through two consecutive years; 
and is almost never the same in different coun- 
tries, or in different districts of the same coun- 
try. It is very often the case, also, that the 
press does not know what public opinion is. 
Its principal or only sources of knowledge are 
in what people say publicly, or in private con- 
versation, and in what they write in the daily 
newspapers and journals. They have no means 
of knowing the opinions of those who neither 
write nor speak, but only think. The unex- 
pected results of some of our recent elections 
ought to be considered conclusive upon this 
point. 
Dr. Warren. When you were enumerating 
the various forms of medical quackery in this 
country, you spoke of the immense number of 
proprietary medicines with which the manufac- 
turers have lately flooded the country; and 
you said they were only substitutes for the pa- 
tent medicines, which they had, in a great meas- 
ure, driven out of the market; and that they 
were practically as much secret remedies as the 
nostrums they had supplanted. I am con- 
vinced that you are correct upon this point. CON VERSA TIONS. 
We may be informed in the accompanying 
circular, with much confiding frankness that 
“ blisterine ” and “ listerine ” are fluid extracts 
from the Spanish fly and Mr. Lister, respec- 
tively, obtained by ingenious chemists through 
very complicated chemical processes; which 
processes are carefully described; but this infor- 
mation is accompanied with the supplementary 
information that no one except the manufac- 
turer’s trained employee, could obtain the ex- 
tracts from the same sources in a pure, harm- 
less, unadulterated state. 
Yet, Doctor, these nostrums are sustained 
chiefly by the endorsements and certificates of 
medical men ; in most cases by men of the 
highest standing in the profession, and who 
have subscribed to that article of the code 
which reads : “ It is also reprehensible for phy- 
scians to give certificates attesting the efficacy 
of patent or secret medicines, or in any way to 
promote the use of them.” It is true that 
some of these medicines thus advertised and 
endorsed are not nostrums, but simple and use- 
ful medicinal agents,, well-known to the profes- 
sion : such, for example, as mineral waters, 
wines, articles of diet and certain drugs; but 
the certificates are uniformly attached only to NINTH CONVERSATION. 
those which are brought into the market ex- 
clusively by a particular firm; or their firm 
claims to be the only one which furnishes them 
in the most useful form, and in the greatest 
purity. 
The endorsements are given therefore to 
those who claim a monopoly of the remedy. 
They are given to what are practically proprie- 
tary medicines. 
I observe also that the men whose names are 
most used, probably because they are most 
sought, are such as hold professorships in the 
medical colleges, and whose titles are never 
omitted. 
Of what use is a code of ethics which is thus 
openly violated in its spirit and letter by the 
most distinguished men in our profession ? 
Dr. Putnam. I agree with you entirely that 
this is a manifest violation of the spirit of the 
code ; but it is not so plain that it is a violation 
of the letter. When the code was constructed 
the class of proprietary medicines now so com- 
mon and so freely endorsed by medical men, 
did not exist, and the framers of the code, 
therefore, had no occasion to allude to them. 
They are not, “patent or secret remedies,” as 
the term secret was then understood. 112 
CON VERSA TIONS. 
It is probable that most of these certificates 
have been given under a conviction that it was 
not a violation of the code; or because the 
writers had persuaded themselves that, to say 
the least, it was not a violation of the letter of 
the code. But I fail to see in this any reason 
for casting discredit upon the code, or for 
questioning its salutary influence. It may be 
a reason why it should be modified and made 
to meet the exigencies of this new develop- 
ment of empirical art. It is a reason for ren- 
dering the code more specific and stringent 
upon this particular point, but not a reason for 
its abolition. It demonstrates most conclu- 
sively how prone medical men are to go astray 
in this country, on such matters of sound ethics 
as have, by accident, been omitted from the 
code, or in which the code is not sufficiently 
explicit. 
There are some other violations of the spirit 
of the code on the part of medical men, which 
are equally reprehensible with those you have 
named. 
The trustees, or the ostensible managers of 
medical colleges, with the consent at least of NINTH CONVERSATION. 
113 
the medical faculties, occasionally announce in 
their circulars the special and extraordinary 
qualifications of their several professors for the 
chairs which they have been called upon to oc- 
cupy. These certificates of qualification are 
sometimes given to the medical men employed 
in dispensaries devoted to the treatment of 
special diseases; but I cannot say, presumably 
without the knowledge of the medical attend- 
ant himself. This is an evasion of the spirit, 
but not of the letter of the code, which needs 
to be met by a new clause. 
Dr. Warren. How can you reach those men 
who write long articles for medical societies, or 
for medical journals, and then, under the cover 
of a scientific paper, press the claims of a pro- 
prietary medicine ? 
Dr. Putnam. I don’t think they can be 
reached. They will have to be left to suffer 
the penalty which a just suspicion of their mo- 
tives may impose ; but if our code cannot reach 
them, suppose, Doctor, you try to discipline 
them under the gentleman’s code, and advise 
me of the result. 
Dr. Warren. In order that you may under 114 
CON VERSA TIONS. 
stand fully that neither myself, nor any of my 
friends who have rejected the National Code, 
are in any sense disloyal to the profession, I 
wish to call your attention to the fact, that at 
the stated meeting of the County Medical So- 
ciety, May 28, 1883, we proposed the following 
amendment to the by-laws : 
“No member of this society shall assume 
any sectarian designation indicating that his 
practice is based on any special doctrine, or 
dogma, or specified method of treatment.” 
Dr. Putnam. You will not permit “moon- 
shiners” to join your society, organized for the 
advancement of medical science, but you will 
consult with them professionally. 
Dr. Warren. Yes. 
Dr. Putnam. You refuse to labor in the 
same vineyard with them, and thus deny your- 
selves and them the benefit of your mutual 
skill in the culture of the vine; but when the 
season arrives, you go arm and arm with them 
to gather the grapes. 
Dr. Warren. Your remarks reflect on our 
motives. 
Dr. Putnam. No, Doctor. I have stated 
only facts, or an unavoidable corollary from ex- 
isting facts. You have given me your reasons, NINTH CONVERSATION. 
or the motives of your action, and I am not 
permitted to question your sincerity. Nor will 
my intimate personal knowledge of many of 
the gentlemen associated with you in this 
movement, permit the inference that their mo- 
tives are not as pure as my own ; and I beg of 
you, as this is the second time you have inti- 
mated that my remarks were capable of an op- 
posite construction, to accept of my statement 
that I have never intended to reflect injuriously 
upon your motives, nor do I justify any one 
else in doing so. 
Dr. Warren. We have also in another matter 
relating to ethics, gone at least one step beyond 
the limits of the old code. 
We have declared that it is unprofessional 
for medical men to address the public through 
newspaper correspondents. 
Dr. Putnam. You have voluntarily put your- 
selves under this restraint; and have, in doing 
so, deprived yourselves of one of your rights 
as free citizens. I do not think 1 would have 
done it. 
Dr. Warren. You forget that there is a sec- 
tion in the National Code which declares that CON VERSA TIONS. 
“it is derogatory to the dignity of the profes- 
sion to resort to public advertisements,” etc. 
Speaking to the public through newspaper cor- 
respondents, or “ interviewers,” is, we think, re- 
sorting to public advertisements ; and we seek by 
our recent action, to enforce what is evidently 
the spirit, if not the letter, of this section. 
Dr. Ptitnam. You have overlooked also an- 
other section of the code, which may be con- 
sidered explanatory of, or supplementary to the 
one you have just quoted. 
“As good citizens, it is the duty of physi- 
cians 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 re- 
gard to quarantine regulations ; the location, 
arrangement and dietaries of hospitals, asylums, 
schools, prisons and similar institutions ; in re- 
lation to the medical police of towns, as drain- 
age, ventilation, etc. ; and in regard to meas- 
ures for the prevention of epidemic and con- 
tagious diseases ; and when pestilence prevails, NINTH CONVERSATION. 
it is their duty to face the danger, and to con- 
tinue their labors for the alleviation of the suf- 
fering, even at the jeopardy of their own lives.” 
It has often been a source of serious regret 
among medical men; that they had no suit- 
able channel of communication between them- 
selves and the public. The precepts of re- 
ligion are taught from infancy to the grave, in 
the nursery, from the pulpit and in a thousand 
other ways ; the principles of law are expounded 
daily in the courts, by judges and expert 
counsel, and their opinions are published 
everywhere for the instruction of the people. 
But to medical men no avenues of direct 
communication with the public at large have 
seemed to be opened. 
At length, however, there has been developed 
another peculiarly American institution, or 
perhaps I ought to designate it as a profession; 
for I think it has by its wonderful growth and 
achievements acquired a right to this distinc- 
tion—l refer to the interviewers profession. 
The American newspaper interviewer, or cor- 
respondent, as he is sometimes called, interro- 
gates lawyers, doctors, clergymen, bishops, 
cardinals, statesmen, soldiers, politicians, rail- 
road kings, brokers, actors, singers, stage man- CONVERSA TIONS. 
agers, merchants, tailors, shoemakers, milk 
manufacturers and all distinguished travellers 
from abroad. 
All, or nearly all, who have been subjected 
to this inquisition, have courteously and with- 
out protest replied to his questions as they were 
able to do, or as they thought proper. Em- 
boldened by conquests at home, he is now sail- 
ing around the world in his own yacht, inter- 
viewing successfully, either directly or indirectly, 
the Czar—Emperor of all the Russias—the 
Sultan, the Khedive, the Emperor of China, 
and the Pope; and yet you think the doctors 
should shut the door in the faces of all inter- 
viewers. 
Dr. Warren. Yes, but courteously. 
Dr. Putnam, To my mind there are several 
reasons why they should not. 
First. It is an established custom of our 
country, and neither our own most respectable 
citizens, nor distinguished foreigners living 
temporarily with us, refuse to comply with the 
custom. 
Second. It furnishes precisely that avenue to 
the public which is so much needed by us, 
while it is not obtrusive. Medical opinions are 
given only in response to the invitation of the NINTH CONVERSATION. 
119 
people, who, you say, are represented by the 
press. It enables us therefore to comply with 
that clause in the code of ethics to which I 
have just referred you. 
Third. If we do not answer the question of 
the interviewer, he will answer them himself. 
An expert interviewer is able often to deter- 
mine precisely what a man would have said if 
he had spoken, by a cursory inspection of his 
office, by the color of his hair, and the cut of his 
whiskers—all of which “interview” he will 
give carefully and in detail to the public, and 
then draw his conclusions as to what the sphinx 
must necessarily have said if he had opened his 
mouth. 
In the case of the late President Garfield, 
day by day, from the moment he was wounded 
until his death, the nation demanded to know 
his condition and the prospect of his recovery, 
and it was the plain duty of his physicians, who 
were, of all others, most competent to speak 
intelligently upon these matters, to give such 
information as they possessed. 
Dr, Warren. But Mr. Garfield was the 
chief magistrate of the nation, and his was, 
therefore, an exceptional case ; and consider, 
also, how, in this case, the privilege was abused 120 
CON VERSA TIONS. 
by some physicians who were in no way con- 
nected with the treatment of the case. Reput- 
able lawyers never thus publicly criticise the 
practice of a professional brother during the 
progress of a trial, and I cannot but regard the 
public criticism of medical men under such cir- 
stances as disreputable. 
Dr. Putnam. I recognize the right of any 
man to give to the public his opinion in regard 
to a case like this, provided he is, by virtue of 
his superior talents, learning, experience, or op- 
portunity, qualified to give a sound opinion ; 
and especially if his qualifications are notori- 
ously superior to the qualifications of those who 
are in immediate attendance. 
If, for example, the men chosen by the Pre- 
sident were men of no practical experience, 
and the progress of the case did not appear 
satisfactory to the public, then I think it would 
be the plain duty of physicians of large experi- 
ence to endorse the conduct of the gentlemen 
in attendance in case it met their approval, and 
thus relieve the public anxiety ; or, in case it 
did not meet their approval, to say so frankly, 
and thus enable the friends to correct the evil 
before it was too great. 
Dr. Warren. It would seem hardly just to NINTH CONVERSATION. 
121 
impose upon medical men the latter duty, as it 
would probably expose them to the suspicion 
of having been actuated by improper motives. 
Dr. Putnam. I think not, if the circum- 
stances and the relative standing of the atten- 
dants and critics were such as I have supposed. 
If, however, they were reversed, then the pub- 
lic might be so uncharitable as to question the 
motives of the critics. 
You call this an exceptional case ; but every 
town and county has its important man, in 
whose life and welfare the people have a great 
interest. If you permit yourself to be inter- 
viewed in reference to the chief magistrate of 
the nation, you are equally bound to speak, if 
requested to do so, in reference to the chief 
magnate of the village. 
There is another and more important class 
of cases included in your recent act of personal 
restraint; more important, because it affects 
personally and practically a much larger num- 
ber of people. You decline to give informa- 
tion, through interviewers, to the daily press 
upon even matters relating to general or special 
hygiene. But let me recall to your mind a re- 122 
CON VERSA TIONS. 
cent case in which a medical opinion thus ob- 
tained and published was productive of great 
public good. 
A serious disaster having occurred on one of 
our railroads, in consequence of the color-blind- 
ness of the engineer, an interviewer called upon 
one of our most distinguished specialists in 
diseases of the eye—a gentleman of skill and 
authority in these matters, and who has a well- 
deserved national reputation—and obtained 
from him a full and intelligent account of what 
he knew upon this subject. I read it myself 
with interest and instruction. This interview 
has led to efforts, on the part of those interested 
in steamboats and railroads, to protect their 
property and their passengers from this source 
of danger. Plainly this doctor did his duty. 
Dr. Warren. I do not recognize myself in 
your picture, if it is intended for me. The 
coloring is too high ; but in the circumstance 
you relate I recognize my own somewhat in- 
considerate act in conversing with a reporter. 
Dr. Putnam. You have no cause to regret 
your conduct, and I am sorry that you sought 
to reprove yourself by voting that such acts 
shall hereafter be deemed derogatory to pro- 
fessional dignity. NINTH CONVERSATION. 
123 
You have emancipated yourself from what 
you consider a troublesome and humiliating 
bondage only to put your neck under a heavier 
yoke. Why do you not reserve the right to 
exercise your own judgment in these cases, as 
you have declared your intention of doing in 
regard to consultations with charlatans ? 
Dr. Warren. Because in the latter case the 
interest of the suffering patient demands it, 
while in the former case it does not. 
Dr. Putnam. I deny that the interest of the 
patient demands your consultation with a char- 
latan. It may demand your actual services in a 
case of emergency, but not a consultation, and 
this, I have said before, is the letter and spirit of 
the code. But suppose the code were to teach, 
as you certainly know it does not, that we could 
not go, when summoned, to the relief of a man 
who was in distress, because an empiric was 
in attendance, why should you insist upon your 
right to minister to the sufferings of one man 
when requested to do so, and deny yourself the 
right to minister to the sufferings of ten thou- 
sand, through the public press, when requested 
to do the same ? 124 
CON VERSA TIONS. 
Letter from Dr. Putnam to Dr. Warren, 
Suggesting Certain Amendments to the 
National Code of Medical Ethics. 
Dr. Warren, My dear Doctor: Since the 
somewhat abrupt termination of our long, and 
I hope, mutually instructive conversations upon 
the subject of the Medical Code, it has seemed 
to me that a just concession to your opinions, 
and a proper vindication of my own would re- 
quire me to say, that I do not consider the code 
as in all respects perfect. I will therefore in- 
dicate to you briefly wherein I consider it im- 
perfect, and as capable of improvement. 
In the first division of the subject therein dis- 
cussed, entitled, “ Of the duties of physicians to 
their patients, and of the obligations of patients 
to their physicians,” the whole of Article Sec- 
ond, relating only to the obligations of patients 
to their physicians, should be expunged. 
The suggestions contained in this article are 
excellent, and if made in any other place than 
in a code of ethics designed for the guidance of 
medical men, might command the attention and 
respect of those who employ us; but here they NINTH CONVERSATION. 
125 
are not read by the people, and can therefore 
serve no useful purpose to either of the parties 
concerned, while they add considerably to the 
length of the code. 
The second general division of the Code, en- 
titled, “ Of the duties of physicians to each other 
and to the profession at large,” contains a clause 
(Section 3 of Article 1) declaring it to be 
“ derogatory to the dignity of the profession to 
resort to public advertisements,” etc.; at the 
close of which section there should be added: 
“Nor is the gravity of the offence lessened, 
when such or similar acts are committed by 
medical men, or by their permission, when act- 
ing in their official capacity as teachers, or as 
officers in public or private hospitals, dispens- 
aries, colleges or other organized associations. 
In no case can a private or public, paying or 
eleemosynary institution, make special or gen- 
eral mention of the qualifications of its medical 
officers, without violating the spirit and intent 
of this article.” 
The last clause of Section 4, Article 4, reads: 
“ It is also reprehensible for physicians to give 
certificates attesting the efficacy of patent or 
secret remedies, or in any way to promote the 
use of them.” It should be amended so as to 126 
CON VERSA TIONS. 
read: “Of patent, proprietary, or of secret 
remedies.” 
In Section i, Article 4, of the same general 
division, the words: “A regular medical educa- 
tion 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,” should be stric- 
ken out. This was embodied in the code when 
there were no medical colleges regularly author- 
ized to grant medical diplomas to a class of 
men whom we had always regarded, and still 
continue to regard, as charlatans; but recent 
legislation in this State has rendered it necessary 
to change the phraseology, but not the spirit or 
intent of this article. 
In the second line following, the words “ in- 
asmuch as,” should be placed between the words 
“ and,” and “ this.” 
The last part of the last clause reads: “ But no 
one can be considered 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.” NINTH CONVERSATION. 
For this I would substitute, “ But no one can 
be considered a regular practitioner, or a fit 
associate in consultation, whose practice is based 
upon an exclusive dogma, and who publicly 
announces his intention to practice under the 
precepts of this dogma; supplementing his title 
as Doctor in Medicine with a term to indicate 
his peculiar doctrines. Such “trade marks” 
have always been recognized by medical men 
as the expedients adopted by charlatans to im- 
pose upon the credulous, or upon those who 
are incapable of estimating the value of medical 
theories.” 
Section 9th, Article sth, relating to the ren- 
dering of services without charge to those who 
are able to pay, should be amended in its last 
clause by adding: “ The same rule in reference 
to fees, should apply to medical services ren- 
dered in hospitals, dispensaries, college clinics,” 
etc. 
Article 7th, entitled, “ Of pecuniary acknowl- 
edgements,” should be stricken out; for the 
reason that, although its range of application 
is discriminating and conditional, it is liable to 
misconstruction, and can easily be made to 
seem to some minds out ofi harmony with the 
general spirit of the Code. 128 
CON VERSA TIONS. 
In the concluding division, entitled, “ Of the 
duties of the profession to the public, and of 
the obligations of the public to the profession,” 
Section 3, of Article 1, is intended to specify 
more particularly in what direction we should 
or should not exercise our charities. It is nec- 
essarily incomplete, since it is impossible to 
indicate all the circumstances which ought to 
govern our conduct in this regard. It should 
therefore be stricken out. 
Section 4 of the same article reads as fol- 
lows: “ It is the duty of physicians, who are fre- 
quent 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 sub- 
jects, to expose the injuries sustained by the 
unwary from the devices and pretensions of art- 
ful 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.” NINTH CONVERSATION. 
129 
I would omit from this section the whole of 
the last clause, commencing, “ Physicians ought.” 
The whole of Article n., entitled, “Obliga- 
tions of the public to physicians,” should be 
stricken out, as having no proper place in a 
code of ethics intended solely for the regulation 
of the conduct of medical men. 
Yours, truly, 
Putnam.