£743 d 1849 DOVER MEDICAL ASSOCIATION DOVER MEDICAL POLICE. WITH THE RULES AND REGULATIONS £V 1 \Xi^/ i F MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIB T 1VNO.LVN 1NI3I01W JO A»V«•I 1 TVNOI1VN 1NIOI01WJO K/ I OF MEDICINE N A T I O N A I I I B R A R Y OF M E D I C I N E NATIONAL III * 5. * II 1VNOI1VN 3NI3I03W JO ASVHBI1 1VNOI1VN 3NOI03WJO OF MEDICINE N A T I O N A I I I B R A R Y O F M E D I C I N E NATIONAL II ^ DOVER WITH THE RULES AND REGULATIONS OF THE DOVER MEDICAL ^ASSOOATION;. ("Xxbeaky ^ ' cuHCEON 6CKERAUS 0;•-.*- i^GtC-iDOi 1849, r / D743J 1843 C?35> A MEETING OF THE PHYSICIANS O" DOIT1 WAS HOLDEN FEB. 19, for the purposo »f fa:•--.:?» * Medical Association. At.said meeting Drs. Low, Martin and Hern«,^*e<^ . ■'■■ i.h> a committee to prepare a set of Rules and Regulations for <.t>« Association. At a meeting holden March 20 1849, the Committee re- ported that they had attended to the duties assigned them and submitted the following code of Medical Police. Where- upon it was roted that the report be accepted and that we be governed by said police. NATH'L. LOW, NOAH MARTIN, JOS. H. SMITH, ROBERT THOMPSON, P. A. STACKPOLE, JEREMIAH HORNE, N. L. FOLSOM, ALBERT G. FENNER, J. H. PAUL, LEVI G. HILL, ALPHONSO BICKFORD. G. WOODHOUSE, J. E. LOTHROP, T.J. W. PRAY, | DOVER MEDICAL POLICE. consultations. Consultations should be encouraged in dif- ficult and protracted cases, as they give rise to confidence, energy, and more enlarged views in practice. On such occasions, no rivals hip or jealousy should be indulged ; candor, justice, and all due respect should be exericiBed towards the physician who first attended ; and as he may be presumed to be the best acquainted with the patient and his family, he should deliver all medical directions as agreed upon. The consulting physician is never to visit without the attending one, unless by the de- sire of the latter, or when, as in sudden emer- gency, he is not to be found. No discussion of the case should take place before the patient or his friends ; and no prognostications should be delivered, which were not the result of pre- vious deliberation and concurrence. Theoreti- cal debates indeed, should generally be avoided in consultation, as occasioning perplexity and loss of time, for there may be much diversity of opinion on speculative points, with perfect agreement on the modes of practice, which are founded, not on hypothesis, but on experience and observation. Physicians in consultation, whatever may be their private resentments or opinions of one another, should divest themselves of all partialities, and think of, nothing but what 6 will most effectually contribute to the relief of those under their care. If a physician cannot lay his hand on his heart and say that his mind is perfectly open to con- viction, from whatever quarter it may come, he should in honor decline the consultation. Many advantages may arise from two consult- ing together, who are men of candour, and have mutual confidence in each other's honor. A remedy may occur to one which did not to another ; and a physician may want resolution or confidence in his own opinion, to prescribe a powerful, but precarious remedy, on which, how- ever, the life of his patient may depend ; in this case, a concurrent opinion may fix his own.— But when such mutual confidence is wanting, a consultation had better be declined, especially if there is reason to believe that sentiments deliv- ered with openness, are to be communicated abroad, or to the family concerned ; and if, in consequence, of this, either gentlemen is to be made responsible for the event. Courtesy requires, and the safety of the pa- tient may often demand that the attending phys- ician should have the privilege of selecting his adviser; and this should be insisted on, in a be- coming manner, in all cases, unless there exist peculiar circumstances strongly indicating a dif- ferent course. INTERFERENCES. Medicine is a liberal profession ; the practi- tioners are, or oug\t to be men of education 7 and their expectations of business and employ- ment should be founded on their degrees of qualification, not on artifice or insinuation. A certain undefinable species of assiduties and at- tentions, therefore, to families usually employing another, is to be considered as beneath the dig- nity of a regular practitioner, and as making a mere trade of a learned ptofession ; and all of- ficious interferences in cases of sickness in such- families, or obstrusive visits, under whatever pre- tence to patients while under the care of another, and all offers of service to such, whether person- ally or by procurement, evince a meannes of disposition, unbecoming the character of a phys- ician or a gentleman. No medling inquiries should be made concerning them, nor hints giv- en relative to the nature and treatment of their diseases, nor any selfish conduct pursued that may directly tend to weaken the confidence in the physicians or surgeons, who have the care of them. When a physician is called to a patient, who has been under the care of another gentleman of the faculty, before any examination of the case, he should ascertain whether that gentlemen un- derstands that the patient is no longer under his care ; and unless this be the case, the second physician is not to assume the charge of the pa- tient, nor to give his advice, (excepting in in- stances of sudden attacks) without a regular con- sultation ; and if such previously attending gen- tleman has been dismissed, or has voluntarily relinquished the patient, his practice should be treated with candor, and justified so far asprob- 8 ily and truth will permit; for want of success in the primary treatment of the disorder, is no impeachment of professional skill and knowledge. And it may frequently happen that through some caprice of the patient, or an officious friend, or some other sinister influence, the at- tending physician may find himself supplanted by another, at a moment, when the disease is about to take a favorable turn, thus verifying the proverb, that "one soeth and another reap- eth," for the latter reaps the credit of a cure, that was justly due to the skill and assiduity of his predecessor. It frequently happens, that a physician, in in- cidental communications with the patients of others, or with their friends, may have their cases stated to him in so direct a manner, as not to ad- mit of his declining to pay attention to them.— Under such circumstances, his observations should be delivered with the most delicate pro- priety and reserve. He should not interfere in the curative plans pursued ; and should even recommend a steady adherence to them, if they appear to merit approbation. DISCOURAGEMENT OF QUACKERY. The use of quack medicines should be dis- couraged by the faculty, as disgraceful to the profession, injurious to health, and often destruc- tive even to life. No physician or surgeon, there* lore should dispense a secret nostrum, whether it be his invention, or exclusive property ; for if it be of real efficacy, the concealment of it is in* 9 consistent with beneficence and professional lib- erality, and, if mystery alone give it value and importance, such craft implies either disgrace- ful ignorance or fradulent avarice. CONDUCT FOR THE SUPPORT OF THE MEDICAL CHARACTER. To enhance the dignity and elevate the char- acter of the body or pursuit with which one is connected, is to increase it capabilities or useful- ness. The duly moderated indulgence of such a desire is therefore, both rational and laudable, and is founded in a just self-respect. Every man, who fraternizes with those of a similar call- ing, tacitly engages not only to submit to the laws, but to promote the honor and interest of the association, so far as they are consistent with morality and the general good of mankind, A physician, therefore, should cautiously guard against whatever may injure the general respect- ability of the profession, and should avoid all contumelious representations of the faculty at large, all general charges against their selfishness or improbity, or the indulgence of an affected or jocular skepticism, concerning the efficacy and utility of the healing art. EXEMPTION FROM CHARGES. All medical attendance upon practicing phys- icians in this town, and their families should be rendered gratuitously ; but their widows 10 and children, when in easy and affluent circumstances, are not entitled to this exemp- tion. The same courtesy may also be extended to resident clergymen, when in the opinion of the attending physician, their income or fortunes will not enable them to compensate for medical services without embarrassment. In no instance, should visits be obtruded offic- iously as such civility might interfere with that freedom of choice, which is essential to confi- dence. Where expenses of travel are incurred, the above two classes of patients will be expected to defray them in like manner as others. VICARIOUS OFFICES. Whenever a physician officiates for another by his desire, in consequence of sickness or ab- sence, if for a short time only, the attendance should be performed gratuitously as to the phys- ician, and with the utmost delicacy towards the professional character of the gentleman previous- ly connected with the patient. RULES AND REGULATIONS OF THE DOVER MEDICAL ASSOCIATION. 1. There shall be an annual meeting of the Dover Medical Association, on the first Monday in January annually. 11 11. At the annua] meeting there shall' be chosen a President and Secretary by ballot, and a standing Committee of three members, includ- ing the President, who shall continue in office until the next annual meeting, and until others are elected in their stead. 111. It shall be the duty of the Secretary to keep a record of the proceedings of the Associ- ation and those of the Standing Committee, whose meetings he shall attend for this purpose, and to perform such other services as are point- ed out in other regulations. IV. It shall be the duty of the Standing Committee to attend to and decide on all mat- ters, which regard the honor or interest of the Association, especially to act upon all infringe- ments of its regulations, which may come to their knowledge, and to call special meetings of the Association, when they judge proper. In all cases, there may be an appeal from the judg- ment of the Standing Committee to the Associ- ation. This Committee shall fill any vacancy in their own body, or in the office of Secretary, which may occur by death or resignation, until the next stated meeting of the Association. V. It shall be the duty of the Secretary to call a special meeting of the Association, when- ever directed so to do by the Standing Commit- tee, and likewise whenever five members of the Association request him in writing so to do.— In cases of both stated and special meetings, he shall send a notification, printed or written, to each member, three days at least before the day of meeting. 12 VI. If any member becomes acquainted with the conduct of another member, which he consid ers as a breach of the rules and regulations oi the Association, it shall be his duty to make the same known to the Standing Committee, who shall inquire into the case, and decide upon the same as they may think proper. VII. No member of this Association shall consult with, or voluntarily meet in a profession- al way, or aid or abet any practitioner resident in this village, who is not a member of this As- sociation. VIII. If a physician be called to a patient who has usually been attended by another phy- sician, on account of the urgency of the case, or the absence of the regular physician, he shall before leaving, direct that the latter be sent for to continue the attendance, if necessary ; and in no case shall he continue his visits unless he receive subsequent notice from the patient, that his continued attendance is desired. IX. The members of this Association shall charge for their professional services the fees in the following table, subject, however, to the sev- eral rules contained in this code relative to the same. Gratuitous services to the poor are by no means prohibited ; the characteristical bene- ficence of the profession is inconsistent with sor- did views and avaricious rapacity. The poor of every description should be the objects of our peculiar care. Dr. Boerhaave used to say they were his best patients, because God was their paymaster. 13 For a visit, 60 For Medicines Apothecaries prices, For a visit in the night, 1.00 For the first mile travel, 50 For every mile travel after the first, 25 The visit is to be charged in all cases in addition to travel. For advice at office from 25 cts. to 1,00 For Venesection, 50 For visit and venesection, 75 For extracting a tooth, 25 For visit and consultation, 1,00 For accouchment, 5,00 For instrumental delivery, 8,00 For amputation of large limbs, 25,00 For amputation of fingers and toes each, 3,00 For trepanning, ZbfiO For fistula in Ano, 5,00 For empyema, 5,00 For tapping in asctites first time, 5,00 " '• Subsequently, 3,00 For reducing fracture of the the thigh, 10,00 For reducing fracture of other large limbs, 5,00 For reducing fracture of Clavicle, 3,00 For reducing luxation of the hip joint, 10,00 For reducing luxation of other large bones, 3,00 For operation for Cataract, 25,00 For operation for Strangulated hernia, 25,00 For reducing hernia by taxis, 5,00 For exterpation of mammary gland, 25,00 For excision of tonsils, 5)00 For operation for hare-lip, 10,00 For opening an abscess, 25 For excision of a single small tumor, 2,00 For excision of large tumors from 6,00 to 10,00 For cupping, 5°. For fistula lachrymalis tube or style extra, 10,00 For employing stomach pump, 6,00 For operation for Talipes, 10,00 For Strabismus, . 10,00 For introducing Catheter, bougie or probang first time, 1,00 " " subsequently, 50 For operation for hydrocele, 3,00 " " permanent cure, 5,00 Extras to be charged in all cases. X. The foregoing table is designed to state the regular fees which shall be charged for the 14 services to which they are respectively annexed ; and they are the lowest fees which the members of this Association shall demand, with the excep- tions mentioned in the following regulations.— And in all cases of extraordinary detention or attendance, also in proportion to the importance of the case, and of the responsibility attached to it, and to the service rendered, when these are extraordinary, the charges shall be increased ac- cording to the judgment of the practitioner con- cerned and the duty to make such increase in the charges, shall be considered obligatory on the members of this Association. XI. It shall be the duty of the members of this Association to endeavor to effect a settlement of their bills with all persons not members of resident families, within three months after the termination of the sickness for which such services were rendered, and with all families having a permanent residence, annually. XII. No member of this Association shall make deductions from his regular charges, un- less in cases where he is satisfied that the neces- sity of the patient really demands it. In all cases, the full bill shall be made out, and the amount of deduction specified on the bill. XIII. The regulations of this Association, shall be offered by the Secretary for subscription, to all candidates for Medical practice in.this vil- lage, who are recognized as regular practition- ers. XIV. Every candidate at the time of becom- ing a member, of.the Association, shall sign the 15 following obligation, which shall be in a book deposited with the Secretary. The undersigned approve of the Regulations of the Dover Medical Association, and agree up- on their honor to comply with the sams. It shall be his duty to transmit a circular note signed by the Secretary, to every member, in- forming him of his admission ; and he is not to be entitled to the rights and privileges of the Association, until this has been done. For these Circulars, he shall pay one dollar to the Secretary. XV. The Secretary shall pay all expenses of this association and once in a year, at least and oftener, when any considerable expense has been incured, he shall assess the amount due to him upon the members of the Association, equally. If any member refuse or neglect to pay his as- sessment, when called upon for the same, his connection with the Association shall thereupon cease, and the Secretary shall inform the mem- bers of the same by a circular note ; and the assessment left unpaid shall become a charge against the Association. XVI. The Secretary's records and accounts shall be subject to the examination of the Stand- ing Committee, and by the Association when they judge proper. XVII. AH resignations of members shall be made in writing to the Secretary who shall im- mediately lay them before the Standing Commit- tee who shall either notify each member, or cal a meeting of the Association, as they may think proper. 16 XVIII, No rule or regulation of this Associ- ation shall be altered, amended or repealed, nor any additional regulation, adopted at any meet- ing unless the proposed alteration or amendment, has first been referred to a Committee, who shall report on the same, at a subsequent meet- ing, which shall be held at a time, not less than one month from the time of the appointment of the Committee. And no amendment or addit- ional regulation shall be adopted except by a vote ol two-thirds of the members present. f NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MED ?\W* W/^x| JjNOiaJW JO AUVSSM IVNOUVN 3NIDI03W JO A » V K 9 II 1VNI ■ NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MED s \ ^ INI3ICUW JO AXVXflll IVNOUVN 3NIDI01W JO UVUI1 1VN ir i i ^V I NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MED n iNiDiaaw jo n«nn ivnouvn snoioiw jo aiyiiii i*n SPEEDY BINDER ^^ Syracuse, N. Y. 5fe.' i-----Stockton, Calif.