.'tu^n%. 
 
 
 V] 
 
 <^ 
 
 /2 
 
 "^ 
 
 V 
 
 '/ 
 
 >^ 
 
 IMAGE EVALUATION 
 TEST TARGET (MT-3) 
 
 1.0 
 
 I.I 
 
 1.25 
 
 liifOA 12.5 
 
 15.0 *^^ MIHI 
 
 Ki 1^ 12.2 
 2.0 
 
 m 
 
 1.6 
 
 1.4 
 
 6" 
 
 Photographic 
 
 Sdences 
 Corporation 
 
 4f< 
 
 23 WEST MAIN STREET 
 
 WEBSTER, N.Y. MSSO 
 
 (716) 872-4503 
 
 I 
 
CIHM/ICMH 
 
 Microfiche 
 
 Series. 
 
 CIHIVI/ICIVIH 
 Collection de 
 microfiches. 
 
 Canadian Institute for Historicai IVIicroreproductions / institut Canadian de microraproductions historiques 
 
Technical and Bibliographic Notes/Notes techniques et bibiiocraphiques 
 
 T 
 t< 
 
 The Institute has attempted to obtain the best 
 original copy available for filming. Features of this 
 copy which may be bibliographically unique, 
 which may alter any of the images in the 
 reproduction, or which may significantly change 
 the usual method of filming, are checked below. 
 
 D 
 
 D 
 
 D 
 D 
 
 D 
 
 D 
 
 Coloured covers/ 
 Couverture de couleur 
 
 I I Covers damaged/ 
 
 Couverture endommag^e 
 
 Covers restored and/or laminated/ 
 Couverture restaurte et/ou peliicuide 
 
 I I Cover title missing/ 
 
 Le titre de couverture manque 
 
 Coloured maps/ 
 
 Cartes g6ographiques en couleur 
 
 Coloured ink (i.e. other than blue or black)/ 
 Encre de couleur (i.e. autre que bleue ou noire) 
 
 Coloured plates and/or illustrations/ 
 Planches et/ou illustrations en couleur 
 
 Bound with other material/ 
 Reiii avec d'autres documents 
 
 Tight binding may cause shadows or distortion 
 along interior margin/ 
 
 La re liure serrde peut causer de I'ombre ou de la 
 distortion le long de la marge int^rieure 
 
 Blank leaves added during restoration may 
 appear within the text. Whenever possible, these 
 have been omitted from filming/ 
 II se peut que certaines pages blanches ajouttes 
 lors d'une restau ration apparaissent dans le texte, 
 mais, lorsque cela 6tait possible, ces pages n'ont 
 pas 6t6 film6es. 
 
 Additional comments:/ 
 Commentaires supplAmentaires; 
 
 L'Institut a microfilm^ le meilleur exemplaire 
 qu'il lui a 6t6 possible de se procurer. Les details 
 de cet exemplaire qui sont peut-Atre uniques du 
 point de vue bibliographique, qui peuvent modifier 
 une image reproduite, ou qui peuvent exiger une 
 modification dans la methods normale de filmage 
 sont indiquis ci-dessous. 
 
 r~n Coloured pages/ 
 
 D 
 
 Pages de couleur 
 
 Pages damaged/ 
 Pages endommagdea 
 
 □ Pages restored and/or laminated/ 
 Pages restauries et/ou peliicul^es 
 
 Pages discoloured, stained or foxed/ 
 Pages d6color6es, tachet^es ou piqui 
 
 Pages d6color6es, tachet^es ou piqu6es 
 
 Pages 
 
 Pages d6tach6es 
 
 Showthrough/ 
 Transparence 
 
 Quality of prir 
 
 Qualiti in^gaie de I'impression 
 
 Includes supplementary materif 
 Comprend du materiel suppltfmentaire 
 
 Only edition available/ 
 Seule Edition disponible 
 
 I I Pages detached/ 
 
 r~Tl Showthrough/ 
 
 I I Quality of print varies/ 
 
 I I Includes supplementary material/ 
 
 I — I Only edition available/ 
 
 Pages wholly or partially obscured by errata 
 slips, tissues, etc., have been ref limed to 
 ensure the best possible image/ 
 Les pages totalement ou partiellement 
 obscurcies par un feuillet d'errata, une pelure, 
 etc., ont 6t6 filmtes d nouveuu de fapon h 
 obtenir la meilleure image possible. 
 
 f 
 
 P 
 o 
 
 fl 
 
 C 
 
 b 
 
 tl 
 s 
 a 
 
 fi 
 
 8 
 
 
 "I 
 
 8 
 
 7 
 
 V 
 
 d 
 a 
 fa 
 
 ri 
 n 
 n 
 
 This item is filmed at the reduction ratio checked below/ 
 
 Ce document t>st f ilm4 au taux de rMuction indiquA ci-dessous. 
 
 10X 14X 18X 22X 
 
 26X 
 
 30X 
 
 X 
 
 12X 
 
 16X 
 
 20X 
 
 24X 
 
 28X 
 
 32X 
 
Th« copy filmsd har* has b««n rsproducad thanks 
 to the ganorosity of: 
 
 New Brunswick Museum 
 Saint John 
 
 L'axamplaira film* fut raproduit grAca A la 
 gAnirositi da: 
 
 New Brunswick Museum 
 Saint John 
 
 Tha imagas appaaring hara ara tha bast quality 
 possibia considaring tha condition and lagibility 
 of tha original copy and in kaaping with tha 
 filming contract spacifications. 
 
 Las images suivantas ont AtA raproduitas avac la 
 plus granu soin. compta ta^iu da la condition at 
 da la nattat6 da I'axamplairi' filmA, at an 
 conformity avac las conditions du contrat da 
 filmaga. 
 
 Original copias in printad papar covars ara filmad 
 baginning with tha front covar and ending on 
 tha last paga with a printad or illustratad impres- 
 sion, or tha back covar whan appropriate. All 
 other original copias ara filmed beginning on the 
 first paga with a printad or illustratad impres- 
 sion, and ending on the last page with a printed 
 or illustrated impression. 
 
 Les exemplaires originaux dont la couverture en 
 papier est imprimte sont filmAs en commen^ant 
 par la premier plat at en terminant soit par la 
 darniAre page qui comporte une empreinte 
 d'impression ou d'illustration, soit par la second 
 plat, salon la cas. Tous les cutres exemplaires 
 originaux sont filmAs en commen^ant par la 
 premiAra page qui comporte une empreinte 
 d'impression ou d'illustration at en terminant par 
 la derniire page qui comporte une telle 
 empreinte. 
 
 The last recorded frame on each microfiche 
 shall contain the symbol — ^ (meaning "CON- 
 TINUED "I, or the symbol V (meaning "END "), 
 whichever applies. 
 
 Un des symboies suivants apparaftra sur la 
 dernidre image de cheque microfiche, selon le 
 cas: la sytibola — »> signifie "A SUIVRE". le 
 symbole V signifie "FIN". 
 
 Maps, plates, charts, etc., may be filmed at 
 different reduction ratios. Those too large to be 
 entirely included in one exposure are filmed 
 beginning in the upper left hand corner, left to 
 right and top to bottom, as many frames as 
 required. The following diagrams illustrate the 
 method: 
 
 Les cartes, planches, tableaux, etc., peuvent dtre 
 filmAs A des taux de rMuction diffArents. 
 Lorsque le document est trop grand pour dtre 
 reproduit en un seul clich6, il est film* A partir 
 de Tangle supArieur gauche, de gauche A droite, 
 at de haut en bas, en prenant le nombre 
 d'imagas n6cessai/e. Les diagrammes suivants 
 illustrent la mAthoda. 
 
 1 
 
 2 
 
 3 
 
 1 
 
 2 
 
 3 
 
 4 
 
 5 
 
 6 
 
rv5 
 
 c 
 
 J 
 
I rV53f 
 
 /^J"/ 
 
 llUo 
 
 
 
 BY- LAW 5, :• 
 
 Extracts from the Medical Act, 
 
 gode of jladieal Sthieg 
 
 AND 
 
 TARIFF OF FEES 
 
 OF 
 
 ¥he J^eu3 BFunlmicli 
 
 MEDICAL SOCIETY. 
 
 SAINT JOHN, N. B. 
 
 J. & A. McMillan. 
 
 1891. 
 
1 1 
 
 BY-I^AW^S. 
 
 t 
 
 Article I. — Meetings. 
 
 Section i. — The Regular Annual Meeting of 
 the New Brunswick Medical Society shall be 
 held on the third Tuesday of July, at lo a. m. 
 The place of meeting to be determined at the 
 previous annual meeting. 
 
 Section 2. — Special Meetings shall be called 
 by the President at his discretion, or upon the 
 written request of five members. Ten members 
 shall constitute a quorum at all meetings. 
 
 Section 3. — Due notice of such special meet- 
 ing shall be sent to each member. The business 
 to be transacted at such meeting shall be stated 
 in the notice, and no other business shall be 
 entertained at such meeting. 
 
 Article II. — Membership. 
 
 All persons who are duly registered under the 
 New Brunswick Medical Act of 1881 shall be 
 members of the New Brunswick Medical Society-. 
 
 (3) ■■ 
 
Article III. — Officers. 
 
 Section i. — The officers of the Society shall 
 be a President, a First and Second Vice-Presi- 
 dent, Secretary, Corresponding Secretary, Trea- 
 surer, and three Trustees. 
 
 Section 2. — The officers shall be elected at 
 the regular annual meeting, and shall hold office 
 for one year, or during the pleasure of the 
 Society. The officers respectively shall be cho- 
 sen by nomination and written ballot on receiv- 
 ing a majority of all the votes cast. In case of 
 a third ballot, the candidate having the fewest 
 votes shall not be in nomination, and on each 
 succeeding ballot the lowest candidate shaii be 
 dropped until an election is had. 
 
 Article IV. — Duties of Officers. 
 
 Section i. — The President shall preside at all 
 meetings. He shall decide all questions accord- 
 ing to parliamentary usage, and discharge such 
 other duties as devolve on a presiding officer. 
 
 Section 2. — In the absence of the President, 
 
 t 
 
5 
 
 the First Vice-President shall preside and dis- 
 charge his duties. If both President and First 
 Vice-President be absent, the Second Vice-Pre- 
 sident shall preside. If neither of these officers 
 be present, the meeting shall elect a chairman to 
 
 preside. 
 
 Section 3. — The Secretary shall attend all 
 meetings of the Society, and keep a correct 
 record of the proceedings thereof. On the order 
 of the President, he shall issue notices for every 
 
 meeting. 
 
 Section 4. — The Corresponding Secretary 
 shall conduct the foreign correspondence of the 
 Society, and perform such other duties as per- 
 tain to his office. 
 
 Section 5. — The Treasurer shall have charge 
 of the funds of the Society, and render a finan- 
 cial statement at the Annual Meeting. 
 
 Section 6. — The Trustees shall have the con- 
 trol of all properties of the Society, and shall 
 submit a report of the same at each Annual 
 Meeting. 
 
Section 7. — The Officers shall enter upon 
 their duties at the close of the meeting at which 
 they are elected. 
 
 Article V. — Funds of the Society. 
 
 Section :. — Each member shall pay One 
 Dollar ($1) annually to the Treasurer to defray 
 the expenses of the Society. 
 
 Section 2. — No member shall be allowed to 
 vote at any meeting unless his Annual Fee be 
 paid. 
 
 Article V. — Order of Business. 
 
 1. Reading of Minutes of previous Meeting or 
 
 Meetings. 
 
 2. President's Address. 
 
 3. Correspondence, Bills, etc. 
 
 4. Receiving Reports. 
 
 5. Election of Officers. 
 
 6. Reading of Papers and Relation of Cases. 
 
 7. Deciding place of Annual Meeting. 
 
 8. New Business. 
 
 f 
 
 a 
 
ExtFa?t| ivom the Jlfledii^al ^(^\. 
 
 i 
 
 h 
 
 Hereinafter no person shall begin or enter 
 upon the study of Physic, Surgery, or Midwif- 
 ery, for the purpose of qualifying himself to 
 practice the same in this Province, unless he 
 shall have obtained from the Council of Physi- 
 cians and Surgeons a certificate that he has 
 satisfactorily passed a matriculation or rrelimi- 
 nary examination in the subjects specified in 
 Schedule B to this Act, or unless he has p^.ssed a 
 matriculation examination for an Undergraduate 
 Course in Arts and Science at some College in 
 Great Britain, Ireland, Canada, the United States 
 of America, or the Continent of Europe. 
 
 SCHEDULE B. 
 
 Uniform Stand of Matrictdaiion or Prelimi?iary 
 
 Examination established under this Act. 
 
 Compulsory — 
 
 English or French Langtmge, including Gram- 
 mar and Composition, and Writing from 
 Dictation. (7) 
 
Arithnieiic, including Vulgar and Decimal 
 Fractions, and Extraction of the Square 
 Root. 
 Algebra, to the end of Simple Equations. 
 Geometry, first two Books of Euclid. 
 Latin, one Book, Translation, and Grammar. 
 
 Optional — 
 
 One of t/iQ following : History of England, 
 with questions in Modern Geography ; 
 French Translation ; German Translation ; 
 One Greek Book ; Natural Philosophy, 
 including Elementary Mechanics ; Hy- 
 drostatics and Pneumatics ; History of 
 New Brunswick; History of Dominion. 
 
 No candidate shall be admitted to such matri- 
 culation or preliminary examination unless he 
 shall have, at least fourteen days previous to 
 such examination, given notice to the Registrar 
 of the Council of his intention to present himself 
 for such examination, and transmitted to the 
 Registrar a certificate shewing that he has com- 
 
 / 
 
 \ 
 
 li 
 
!♦ 
 
 I 
 
 ^ 
 
 \ 
 
 y 
 
 pleted his sixteenth year, and shall before the 
 examination have paid a fee of five dollars to 
 the Registrar. 
 
 No person shall be entitled to have his name 
 entered on the Register of the Council, or to 
 receive a license to practice from such Council, 
 unless he shall satisfy the Council that he has 
 passed the matriculation or preliminary exami- 
 nation; that after passing such examination he 
 has followed his studies during a period of not 
 less than four years (one of which may be under 
 the direction of one or more general practitioners 
 duly licensed) ; that during such four years he 
 has attended at some University, College, or 
 Incorporated School of Medicine in good stand- 
 ing, courses of lectures amounting together to 
 not less than twelve months on General Anato- 
 my, on Practical Anatomy, on Surgery, on the 
 Practice of Medicine, on Midwifery, on Chemis- 
 try, on Materia Medica and Pharmacy, and on 
 the Institutes of Medicine or Physiology, and 
 one three months' course of Medical Jurispru- 
 
10 
 
 dence ; that he has attended the general practice 
 of an Hospital in which there are contained not 
 les.s tnan fifty beds, under the charge of not less 
 than two Physicians,, or Surgeons, for a period 
 of not less than one year, oi two periods of not 
 less than six' months each ; that he has also 
 attended two three months' courses or one six 
 months' course of Clinical Medicine, and the 
 same of Clinical Surgery ; that he has, after ex- 
 amination in the subjects of the course, obtained 
 a degree or diploma from such University, Col- 
 lege, or Incorporated Medical School, if such 
 University, College, or Incorporated Medical 
 School, requires a four years' course in order to 
 the obtaining its diploma, or for want of such 
 degree or diploma that he has satisfactorily 
 passed an examination in the various branches 
 hereinbefore specified before examiners to be 
 appointed by the Council ; that he is not less 
 than twenty-one years of age ; that he has paid 
 to the Registrar of the Council a fee of ten 
 dollars; provided that the Council shall have 
 
 <f 
 
11 
 
 u 
 
 
 power, subject to the approval of the Gcvernor 
 in Council, to make such alterations in the fore- 
 going curriculum as may from time to time he 
 required ; provided also, that in the event of any 
 person applying for registration as a Practitioner 
 of any system of Medicine the registered Prac- 
 titioners of that system shall have the right to 
 appoint an examiner or examiners on the subjects 
 peculiar to that system, viz. : Materia Medica, 
 Pharmacy and Therapeutics, and if they shall 
 neglect so to do the Council shall have the power 
 to appoint such examiner or examiners. 
 
 The last preceding section shall not apply to 
 an/person in actual practice w^ho shall be entitled 
 to register under Section 38, and to receive a 
 license to practice under this Act on payment of 
 two dollars ; and notwithstanding the provisions 
 of such section, any person upon producing to 
 the Council conclusive evidence that he has 
 passed a matriculation or preliminary examina- 
 nation, such as is required by this Act for per- 
 sons beginning the medical studies in New 
 
12 
 
 Brunswick, tliat he has, before graduating or 
 taking a diploma, studied for at least four years 
 in the manner provided in Section 12 of this Act, 
 or pursued what the Council shall deem an 
 equivalent course of study, and has passed a 
 final examination in the subjects of such course ; 
 or for want of such requisites, ^hall have fulfilled 
 such conditions as the Council may determine, 
 and shall pay a fee of ten dollars, shall be en- 
 titled to be registered and to receive a license to 
 practice. 
 
 No person shall be entitled to recover any 
 charge in any Court of Law for any Medical or 
 Surgical advice, or for attendance, or for* the 
 performance of any operation, or for any medi- 
 cine which he shall have both prescribed and 
 supplied, unless he shall prove upon the trial 
 that he is registered under this Act. 
 
 If any registered Medical Practitioner omit to 
 pay the annual fee required to be paid by the 
 Council under the fifth section of chapter thirty 
 of forty-fifth Victoria, before the Registrar 
 
„ 
 
 18 
 
 shall cause the Register of the names to be 
 printed or published in the Royal Gazette, as 
 provided in section eight of " The New Bruns- 
 wick Medical Act, 1881," the Registrar shall not 
 cause the name of such Practitioner to be printed 
 and published as aforesaid, and such Practitioner 
 shall thereupon cease to be denied a Registered 
 Practitioner ; but such Practitioner shall at any 
 time thereafter, upon paying such fee, be entlded 
 to all his rights and privileges as a Registered 
 Practitioner from the time of such payment. 
 
 1 
 
 
j 
 
Code of Medical Ethics. 
 
 ., 
 
 OF THE DUTIES OF PHYSICIANS TO THEIR 
 PATIENTS, AND OF THE OBLIGATIONS 
 OF PATIENTS TO THEIR PHYSICIANS. 
 
 Art, \,— .Duties of Physicians to their Patients. 
 
 I. A physician should not only be ever 
 ready to obey the calls of the sick, but his mind 
 ought also to be imbued with the greatness of 
 his mission, and the responsibility he habitually 
 incurs in its discharge. Those obligations are 
 the more deep and enduring, because there is 
 no tribunal, other than his own conscience, to 
 adjudge penalties for carelessness or neglect. 
 Physicians should, therefore, minister tc the 
 
 ;i5) 
 
16 
 
 sick with due impressions of the importance of 
 their office ; reflecting that the ease, the health, 
 and the Hves of those committed to their charge, 
 depend on their skill, attention, and fidelity. 
 They should study also, in their deportment, 
 so to unite tenderness with firmyiess^ and conde- 
 scension with authority y as to inspire the minds 
 of their patients with gratitude, respect, and 
 confidence. 
 
 2. Every case committed to the charge of 
 a physician should be treated with attention, 
 steadiness, and humanity. Reasonable indul- 
 gence should be granted to the mental imbe- 
 cility and caprices of the sick. Secrecy and 
 delicacy, when required by peculiar circum- 
 stances, should be strictly observed; and the 
 familiar and confidential intercourse to which 
 physicians are admitted in their professional 
 visits, should be used with discretion, and with 
 the most scrupulous regard to fidelity and 
 honor. The obligation of secrecy extends be- 
 yond the period of professional services ; none 
 
 ! 
 
17 
 
 of the privacies of personal and domestic life, 
 no infirmity of disposition or flaw of character 
 observed during professional attendance, should 
 ever be divulged by the physician, except when 
 he is imperatively required to do so. The force 
 and necessity of this obligation are indeed so 
 great, that professional men have, under certain 
 circumstances, been protected in their observance 
 of secrecy by courts of justice. 
 
 3. Frequent visits to the sick are in general 
 requisite, since they enable the physician to 
 arrive at a more perfect knowledge of the disease 
 — to meet promptly every change which may 
 occur, and also tend to preserve the confidence 
 of the patient. But unnecessary visits are to 
 be avoided, as they give useless anxiety to the 
 patient, tend to diminish the authority of the 
 physician, and render him liable to be suspected 
 of interested motives. 
 
 4. A physician should not be forward to 
 make gloomy prognostications, because they 
 savor of empiricism, by magnifying the impor- 
 

 18 
 
 tance of his services in the treatment or cure of 
 the disease. But he should not fail, on proper 
 occasions, to give to the friends of the patient 
 timely notice of danger when it really occurs ; 
 and even to the patient himself, if absolutely 
 , necessary. This office, however, is so peculiarly 
 alarming when executed by him, that it ought to 
 be declined whenever it can be assigned to any 
 other person of sufficient judgment and delicacy. 
 For the physician should be the minister of hope 
 and comfort to the sick ; that, by such cordials 
 to the drooping spirit, he may smooth the bed 
 of death, revive expiring life, and counteract the 
 depressing influence of those maladies which 
 often disturb the tranquility of the most resigned 
 in their last moments. The life of a sick person 
 can be shortened not only by the acts, but also 
 by the words or the manner of a physician. It 
 is, therefore, a sacred duty to guard himself 
 carefully in this respect, and to avoid all things 
 which have a tendency to discourage the patient 
 and to depress his spirits. 
 
 ■ 
 
'f 
 
 19 
 
 5. A physician ought not to abandon a pati- 
 ent because the case is deemed incurable; for 
 his attendance may continue to be highly useful 
 to the patient, and comforting to the relatives 
 around him, even in the last period of a fatal 
 malady, by alleviating pain and other symp- 
 toms, and by soothing mental anguish. To 
 decline attendance, under such circumstances, 
 would be sacrificing to fanciful delicacy and 
 mistaken liberality, that moral duty which is 
 independent of and far superior to all pecuniary 
 consideration. 
 
 6. Consultations should be promoted in difti- 
 cult or protracted cases, as they give rise to 
 confidence, energy, and more enlarged views in 
 practice. 
 
 7. The opportunity which a physician not 
 unfrequently enjoys of promoting and strength- 
 ening the good resolutions of his patients, 
 suffering under the consequences of vicious 
 conduct, ought never to be neglected. His 
 counsels, or even remonstrances, will give satis- 
 
20 
 
 faction, not offence, if they be proffered with 
 politeness, and evince a genuine love of virtue, 
 accompanied by a sincere interest in the welfare 
 of the person to whom they are addressed. 
 
 i 
 
 Art. II. — Obligations of Patients to their 
 
 Physicians. 
 
 1. The members of the medical profession, 
 upon whom is enjoined the performance of so 
 many important and arduous duties toward the 
 community, and who are required to make so 
 many sacrifices of comfort, ease, and health, for 
 thf^ welfare of those who avail themselves of 
 their services, certainly have a right to expect 
 and require, that their patients should entertain 
 a just sense of the duties which they owe to 
 their medical attendants. 
 
 2. The first duty of a patient is, to select as 
 his medical adviser one who has received a re- 
 gular professional education. In no trade or 
 occupation do mankind rely on the skill of an 
 
I 
 
 1 
 
 21 
 
 untaught artist; and in medicine, confessedly 
 the most difficult and intricate of the sciences, 
 the world ought not to suppose that knowledge 
 is intuitive. 
 
 3. Patients should prefer a physician whose 
 habits of life are regular, and who is not devoted 
 to company, pleasure, or to any pursuit incom- 
 patible with his professional obligations. A 
 patient should also confide the care of himself 
 and family, as much as possible, to one physi- 
 cian ; for a medical man who has become 
 acquainted with the peculiarities of constitution, 
 habits, and predispositions of those he attends, 
 is more likely to be successful in his treatment 
 than one who does not possess that knowledge. 
 
 A patient who has thus selected his physi- 
 cian, should always apply for advice in what 
 may appear to him trivial cases; for the most 
 fatal results often supervene on the slightest 
 accidents. It is of still more importance that he 
 should apply for assistance in the forming stage 
 of violent diseases ; it is to a neglect of this pre- 
 
22 
 
 cept that medicine owes much of the uncertainty 
 and imperfection with which it has been re- 
 proached. 
 
 4. Patients should faithfully and unreservedly 
 communicate to their physician the supposed 
 cause of their disease. This is the more impor- 
 tant, as many diseases of a mental origin 
 simulate those depending on external causes, 
 and yet are only to be cured by ministering to 
 the mind diseased. A patient should never be 
 afraid of thus making his physician his friend 
 and adviser ; he should always bear in mind 
 that a medical man is under the strongest obli- 
 gations of secrecy. Even the female sex should 
 never allow feelings of shame or delicacy to 
 prevent their disclosing the seat, symptoms, and 
 causes of complaints peculiar to them. How- 
 ever commendable a modest reserve may be in 
 the common occurrences of life, its strict obser- 
 vance in medicine is often attended with the 
 most serious consequences, and a patient may 
 sink under a painful and loathsome disease, 
 
23 
 
 which might have been readily prevented had 
 timely intimation been given to the physician. 
 
 5. A patient should never weary his physi- 
 cian with a tedious detail of events or matters 
 not appertaining to his disease. Even as relates 
 to his actual symptoms, he will convey much 
 more real information by giving clear answers 
 to interrogatories, then by the most minute 
 account of his own framing. Neither should ne 
 obtrude upon his physician the details of his 
 business, nor the history of his family concerns. 
 
 6. The obedience of a patient to the pre- 
 scriptions of his physician should be prompt 
 and implicit. He should never permit his own 
 crude opinions, as to their fitness, to influence 
 his attention to them. A failure in one par- 
 ticular may render an otherwise judicious treat- 
 ment dangerous, and even fatal. This remark 
 is equally applicable to diet, drink, and exercise. 
 As patients become convalescent, they are very 
 apt to suppose that the rules prescribed for them 
 may be disregarded ; and the consequence, but 
 
24 
 
 too often, is a relapse. Patients should never 
 allow themselves to be persuaded to take any 
 medicine whatever that may be recommended to 
 them by the self-constituted doctors and doc- 
 tresses who are so frequently met with, and who 
 pretend to possess infallible remedies for ^he 
 cure of every disease. However simple some of 
 their prescriptions may appear to be, it often 
 liappens that they are productive of much mis- 
 chief, and in all cases they are injurious, by 
 contravening the plan of treatment adopted by 
 the physician. 
 
 7. A patient should, if possible, avoid even 
 the friendly visits of a physician who is not 
 attending him ; and when he does receive them, 
 he should never converse on the subject of his 
 disease, as aij observation may be made, without 
 any intention of inteiference, which may destroy 
 his confidence in the course he is pursuing, and 
 induce him to neglect the directions prescribed 
 to him. A patient should never send for a con- 
 sulting physician without the express consent oi 
 
 ^ 
 
 . 
 
 \ 
 
2.3 
 
 his own medical attendant. It is of great impor- 
 tance that physicians should act in concert ; for, 
 although their modes of treatment may be 
 attended with equal success when employed 
 singly, yet conjointly they are very likely to be 
 productive of disastrous results. 
 
 8. When a patient wishes to dismiss his 
 physician, justice and common courtesy require 
 that he should declare his reasons for so doing. 
 
 9. Patients should always, when practicable, 
 send for their physician in the morning, before 
 his usual hour of going out ; for, by being 
 early aware of the visits he has to pay during 
 the day, the physician is able to apportion his 
 time in such a manner as to prevent an inter- 
 ference of engagements. Patients should also 
 avoid calling on their medical adviser unneces- 
 sarily during the hours devoted to meals or 
 sleep. They should always be in readiness to 
 receive the visits of their physician, as the 
 detention of a few minutes is often of serious 
 inconvenience to him. 
 
snsHi 
 
 26 
 
 lo. A patient should, after his recovery, 
 entertain a just and enduring sense of the 
 value of the services rendered him by his phy- 
 sician ; for these are of such a character, that 
 no mere pecuniary acknowledgment can repay 
 or cancel them. 
 
 I 
 
1 
 
 27 
 
 OP^ THE DUTIES OF PHYSICIANS TO EACH 
 OTHER, AND TO THE PROFESSION AT 
 LARGE. 
 
 Art. I. — Dii for the support of Pro- 
 fessional Character, 
 
 I. Every individual, on entering the pro- 
 fession — as he becomes thereby entitled to all 
 its privileges and immunities — incurs an obli- 
 gation to exert his best abilities to maintain 
 its dignity and honor, to exalt its standings 
 and to extend the bounds of its usefulness. 
 He should, therefore, observe strictly, such 
 as are instituted for the government of its 
 members: — should avoid all contumelious and 
 and sarcastic remarks relative to the faculty,, 
 as a body ; and while, by unwearied diligence^ 
 he resorts to every honorable means of enrich- 
 ing the science, he should entertain a due 
 
28 
 
 
 respect for his seniors, who have, by their 
 labors, brought it to the elevated condition in 
 which he finds it. 
 
 2. There is no profession, from the members 
 of which greater purity of character and a 
 higher standard of moral excellence are re- 
 quired, than the medical; and to attain such 
 eminence is a duty every physician owes alike 
 to his profession and to his patients. It is due 
 to the latter, as without it he cannot command 
 their respect and confidence; and to both, 
 because no scientific attainments can compen- 
 sate for the want of correct moral principles. 
 It is also incumbent upon the faculty to be 
 temperate in all things, for the practice of 
 physic requires the unremitting exercise of a 
 clear and vigorous understanding; and on 
 emergencies — for which no professional man 
 should be unprepared — a steady hand, an 
 acute eye, and an unclouded head may be 
 essential to the well-being, and even to the life, 
 of a fellow -creature. 
 
 I 
 
 
29 
 
 3- It is derogatory to the dignity of the 
 profession to resort to public advertisements, 
 or private cards, or handbills, inviting the atten; 
 tion of individuals affected with particular dis- 
 eases — publicly offering advice and medicine 
 to the poor gratis, or promising radical cures ; 
 or to publish cases and operations in the daily 
 prints, or suffer such publications to be made ; 
 to invite laymen to be present at operations, 
 to boast of cures and remedies, to adduce cer- 
 tificates of skill and success, or to perform any 
 other similar acts. These are the ordinary 
 practices of empirics, and are highly reprehen- 
 sible in a regular physician. 
 
 4. Equally derogatory to professional char- 
 acter is it for a physician to hold a patent for 
 any surgical instrument or medicine, or to dis- 
 pense a secret nostrum^ whether it be the com- 
 position or exclusive property of himself or 
 of others. For, if such nostrum be of real 
 efficacy, any concealment regarding it is incon- 
 sistent with beneficence and professional liber- 
 
 t 
 
 ,11 
 
30 
 
 ality ; and if mystery alone give it value and 
 importance, such craft implies either disgraceful 
 ignorance or fi alent avarice. It is also 
 reprehensible for physicians to give certificates 
 attesting the efficacy of patent or secret medi- 
 cines, or in any way to promote the use of 
 them. 4» 
 
 Art. II. — Professiofial Services of Physicians 
 
 to each other. 
 
 'I 
 
 * 1 
 
 I. All practitioners of medicine, their wives, 
 and their children while under the paternal 
 care, are entitled to the gratuitous services of 
 any one or more of the faculty residing near 
 them, whose assistance may be desired. A 
 physician afflicted with disease is usually an 
 incompetent judge of his own case; and the 
 natural anxiety and solicitude which he experi- 
 ences at the sickness of a wife, a child, or any 
 one who by the ties of consanguinity is ren- 
 dered peculiarly dear to him, tend to obscure 
 
»vM.»;3rj 
 
 31 
 
 his judgment, and produce timidity and irreso- 
 lution in his practice. Under such circum- 
 stances medical men are peculiarly dependent 
 upon each other, and kind offices and profes- 
 sional aid should always be cheerfully and gra- 
 tuitously afforded. Visits ought not, however, 
 to be obtruded officiously; as such unasked 
 civility may give rise to embarrassment, or 
 interfere with that choice on which confidence 
 depends. But if a distant member of the 
 faculty, whose circumstances are affluent, re- 
 quest attendance, and an honorarium be offered, 
 it should not be declined; for no pecuniary 
 obligation ought to be imposed, which the 
 party receiving it would wish not to incur. 
 
 Art. hi. — Of the dtities of Physiciafis as 
 respects vicarious offices. 
 
 I. The affairs of life, the pursuit of health, 
 and the various accidents and contingencies 
 to which a medical man is peculiarly exposed, 
 
82 
 
 ! 
 
 sometimes require him temporarily to withdraw 
 from his duties to his patients, and to request 
 some of his professional brethren to officiate 
 for him. Compliance with this request is an 
 act of courtesy which should always be per- 
 formed with the utmost consideration for the 
 interest and character of the family physician, 
 and when exercised for a short period, all the 
 pecuniary obligations for such service should 
 be awarded to him. But if a member of the 
 profession neglect his business in quest of pleas- 
 ure and amusement, he cannot be considered 
 as entitled to the advantages of the frequent 
 and long-continued exercise of this fraternal 
 courtesy, without awarding to the physician 
 who officiates the fees arising from the dis- 
 charge of his professional duties. 
 
 In obstetrical and important surgical cases, 
 which give rise to unusual fatigue, anxiety, and 
 responsibility, it is just that the fees accruing 
 therefrom should be awarded to the physician 
 who officiates. 
 
33 
 
 Art. IV. — Of the duties of Physicimis in 
 regard to co7is2iltatio7is. 
 
 I. A regular medical education furnishes 
 
 the only presumptive evidence of professional 
 
 abilities and requirements, and ought to be the 
 
 only acknowledged right of an individual to 
 
 * the exercise and honors of his profession. 
 
 Nevertheless, as in consultations the good of 
 
 the patient is the sole object in view, and this 
 
 is often dependent on personal confidence, no 
 
 intelligent regular practitioner, who has a license 
 
 to practise from some medical board of known 
 
 and acknowledged respectability, recognized by 
 
 the Maritime Medical Association, and who is 
 
 in good moral and professional standing in the 
 
 place in which he resides, should be fastidiously 
 
 excluded from fellowship, or his aid refused in 
 
 consultation, when it is requested by the patient. 
 
 But no one can be considered as a regular 
 
 practitioner or a fit associate in consultation, 
 
 whose practice is based on an exclusive dogma, 
 
 c 
 
 i 
 

 34 
 
 % 
 
 to the rejection of the accumulated experience 
 of the profession, and of the aids actually fur- 
 nished by anatomy, physiology, pathology, and 
 organic chemistry. 
 
 2 In consultations, no rivalship or jealousy 
 should be indulged ; candor, probity, and all 
 due respect should be exercised toward the 
 physician having charge of the case. 
 
 3. In consultations, the attending physician 
 should be the first to propose the necessary 
 questions to the sick ; after which the con- 
 sulting physician should have the opportunity 
 to make such further inquiries of the patient 
 as may be necessary to satisfy him of the true 
 character of the case. Both physicians should 
 then retire to a private place for deliberation ; 
 and the one first in attendance should com- 
 municate the directions agreed upon to the 
 patient or his friends, as well as any opinions 
 which it may be thought proper to express. 
 But no statement or discussion of it should take 
 place before the patient or his friends, except 
 
35 
 
 in the presence of all the faculty attending, and 
 by their common consent; and no opiyiions or 
 prognostications should be delivered, which are 
 not the result of previous deliberation and 
 concurrence. 
 
 4. In consultations, the physician in attend- 
 ance should deliver his opinion first ; and when 
 there are several consulting, they should deliver 
 their opinions in the order in which they have 
 been called in. No decision, however, should 
 restrain the attending physician from making 
 such variations in the mode of treatment, as 
 any subsequent unexpected change in the char- 
 acter of the case may demand. But such vari- 
 ations, and the reasons for it, ought to be 
 carefully detailed at the next meeting in con- 
 sultation. The same privilege belongs also to 
 the consulting physician if he is sent for in an 
 emergency, when the regular attendant is out 
 of the way, and similar explanations must be 
 made by him at the next consultation. 
 
 5. The utmost punctuality should be ob- 
 
36 
 
 
 served in the visits of physicians when they 
 are to hold consultation together, and this is 
 generally practicable, for society has been con- 
 siderate enough to allow the plea of a profes- 
 sional engagement to take precedence of all 
 others, and to be an ample reason for the relin- 
 quishment of any present occupation. But as 
 professional engagements may sometimes inter- 
 fere and delay one of the parties, the physician 
 who first arrives should wait for his associate a 
 reasonable period, after which the consultation 
 should be considered as postponed to a new 
 appointment. If it be the attending physician 
 who is present, he will, of course, see the 
 patient and prescribe ; but if it be the consult- 
 ing one, he should retire, except in case of 
 emergency, or when he has been called from 
 a considerable distance, in which latter case he 
 may examine the patient, and give his opinion 
 in writiiig and under seal to be delivered to 
 his associate. 
 
 6. In consultations, theoretical discussions 
 
 I 
 
37 
 
 should be avoided, as occasioning perplexity 
 and loss of time. For there may be much 
 diversity of opinion concerning speculative 
 points, with perfect agreement in those modes 
 of practice which are founded, not on hypothe- 
 sis, but on experience and observation. 
 
 7. All discussions in consultation should be 
 held as secret and confidential. Neither by 
 words nor manner should any of the parties 
 to a consultation assert or insinuate that any 
 part of the treatment pursued did not receive 
 his assent. The responsibility must be equally 
 divided between the medical ^tendants — they 
 must equally share the credit of success as well 
 as the blame of failure. 
 
 8. Should an irreconcilable diversity of opin- 
 ion occur when several physicians are called 
 upon to consult together, the opinion of the 
 majority should be considered as decisive, but 
 if the numbers be equal on each side, then the 
 decision should rest with the attending physi- 
 cian. It may, moreover, sometimes happen 
 
38 
 
 I! I 
 
 that two physicians cannot agree in their views 
 of the nature of a case, and the treatment to 
 be pursued. This is a circumstance much to 
 be deplored, and should always be avoided, if 
 possible, by mutual concessions, as far as they 
 can be justified by a conscientious regard for 
 the dictates of judgment. But in the event of 
 its occurrence, a third physician should, if 
 practicable, be called to act as umpire ; and, if 
 circumstances prevent the adoption of this 
 course, it must be left to the patient to select 
 the physician in whom he is most willing to 
 confide. But, as every physician relies upon 
 the rectitude of his judgment, he should, when 
 left in the minority, politely and consistently 
 retire from any further deliberation in the con- 
 sultation, or participation in the management 
 of the case. 
 
 9. As circumstances sometimes occur to 
 render a special co7isultation desirable, when 
 the continued attendance of two physicians 
 might be objectionable to the patient, the mem- 
 
 ^ 
 
39 
 
 k 
 
 ber of the faculty whose assistance is required 
 ill such cases, should sedulously guard against 
 all future unsolicited attendance. As such con- 
 sultations require an extraordinary portion both 
 of time and attention, at least a double honor- 
 arium may be reasonably expected. 
 
 lo. A physician who is called upon to con- 
 sult, should observe the most honorable and 
 scrupulous regard for the character and stand- 
 ing of the practitioner in attendance ; the prac- 
 tice of the latter, if necessary, should be justified 
 as far as it can be consistently with a conscien- 
 tious regard for truth, and no hint or insinuation 
 should be thrown out which could impair the 
 confidence reposed in him, or affect his reputa- 
 tion. The consulting physician should also 
 carefully refrain from any of those extraor- 
 dinary attentions or assiduities, which are too 
 often practised by the dishonest for the base 
 purpose of gaining applause, or ingratiating 
 themselves into the favor of families and in- 
 dividual. 
 
w 
 
 40 
 
 Art. V. — Duties of Physicians in cases of 
 
 interference. 
 
 1. Medicine is a liberal profession, and those 
 admitted into its ranks should found their ex- 
 pectations of practice upon the extent of their 
 qualifications, not on intrigue or artifice. 
 
 2. A physician, in his intercourse with a 
 patient under the care of another practitioner, 
 should observe the strictest caution and reserve. 
 No meddling inquiries should be made — no 
 disingenuous hints given relative to the nature 
 and treatment of his disorder ; nor any course 
 of conduct pursued that may directly or in- 
 directly tend to diminish the trust reposed in 
 the physician employed. 
 
 3. The same circumspection and reserve 
 should be observed when, from motives of 
 business or friendship, a physician is prompted 
 to visit an individual who is under the direction 
 of another practitioner. Indeed, such visits 
 should be avoided, except under peculiar cir- 
 
 r 
 
41 
 
 
 cumstances ; and when they are made, no par- 
 ticular inquiries should be instituted relative to 
 the nature of the disease, or the remedies em- 
 ployed, but the topics of conversation should 
 be as foreign to the case as circumstances will 
 admit. 
 
 4. A physician ought not to take charge 
 of or prescribe for a patient who has recently 
 been under the care of another member of the 
 faculty in the same illness, except in cases of 
 sudden emergency, or in consultation with the 
 physician previously in attendance, or when the 
 latter has relinquished the case, or been regu- 
 larly notified that his services are no longer 
 desired. Under such circumstances, no unjust 
 and illiberal insinuations should be thrown out^ 
 in relation to the conduct or practice previously 
 pursued, which should be justified as far as 
 candor and regard for truth and probity will 
 permit; for it often happens that patients be- 
 come dissatisfied when they do not experience 
 immediate relief, and, as many diseases are 
 
p 
 
 42 
 
 naturally protracted, the want of success, in the 
 first stage of treatment, affords no evidence of 
 a lack of professional knowledge and skill. 
 
 5. When a physician is called to an urgent 
 case, because the family attendant is not at 
 hand, he ought, unless his assistance in con- 
 sultation be desired, to resign the care of the 
 patient to the latter immediately on his arrival. 
 
 6. It often happens, in cases of sudden ill- 
 ness or of recent accidents and injuries, owing 
 to the alarm and anxiety of friends, that a 
 number of physicians, are simultaneously sent 
 for. Under these circumstances courtesy should 
 assign the patient to the first who arrives, who 
 should select from those present any additional 
 assistance that he may deem necessary. In 
 all such cases, however, the practitioner who 
 officiates should request the family physician, 
 if there be one, to be called, and, unless his 
 further attendance be requested, should resign 
 the case to the latter on his arrival. 
 
 I'M 
 1^ 
 
 I 
 
43 
 
 e 
 
 7. When a physician is called to the patient 
 of another practitioner, in consequence of the 
 sickness or absence of the latter, he ought, on 
 the return or recovery of the regular attendant,, 
 and with the consent of the patient, to surrender 
 the case. 
 
 [The expression, '* Patient of another Prac- 
 titioner," is understood to mean a patient who 
 may have been under the charge of another 
 practitioner at the time of the attack of sickness,^ 
 or departure from home of the latter, or who 
 may have called for his attendance during his 
 absence or sickness, or in any manner given it 
 to be understood that he regarded the said 
 physician as his regular medical attendant.] 
 
 8. A physician, when visiting a sick person 
 in the country, may be desired to see a neigh- 
 boring patient who is under the regular direction 
 of another physician, in consequence of some 
 sudden change or aggravation of symptoms. 
 The conduct to be pursued on such an occasion 
 is to give advice adapted to present circum- 
 
44 
 
 stances ; to interfere no further than is absolutely 
 necessary with the general plan of treatment ; 
 to assume no future direction, unless it be ex- 
 pressly desired ; and, in this last case, to request 
 an immediate consultation with the practitioner 
 previously employed. 
 
 9. A wealthy physician should not give advice 
 gratis to the affluent; because his doing so is 
 an injury to his professional brethren. The 
 office of a physician can never be supported as 
 an exclusively beneficent one, and it is defraud- 
 ing, in some degree, the common funds for its 
 support, when fees are dispensed with which 
 might justly be claimed. 
 
 10. When a physician who has been engaged 
 to attenfl a case of midwifery is absent, and 
 another is sent for, if delivery is accomplished 
 during the attendance of the latter, he is entitled 
 to the fee, but should resign the patient to the 
 practitioner first engaged. 
 
45 
 
 Art. VI. — Of Differences between Physicians, 
 
 1. Diversity of opinion and opposition of 
 interest, may, in the medical as in other pro- 
 fessions, sometimes occasion controversy, and 
 even contention. Whenever such cases unfor- 
 tunately occur, and cannot be immediately ter- 
 minated, they should be referred to the arbitra- 
 tion of a sufficient number of physicians, or a 
 couri-medicaL 
 
 2. As peculiar reserve must be maintained by 
 physicians toward the public, in regard to pro- 
 fessional matters, and as there exist numerous 
 points in medical ethics and etiquette through 
 which the feelings of medical men may be pain- 
 fully assailed in their intercourse with each other, 
 and which cannot be understood or appreciated 
 by general society, neither the subject-matter of 
 such differences nor the adjudication of the arbi- 
 trators should be made public, as publicity in a 
 case of this nature may be personally injurious 
 to the individuals concerned, and can hardly fail 
 to bring discredit on the faculty. 
 
n 
 
 46 
 
 Art. \\\.-~ Of Pecuniary Ackjiowledgments, 
 
 Some general rules should be adopted by 
 the faculty, in every town or district, relative to 
 pectmiary acknoivledg^nents from their patients ; 
 and it should be deemed a point of honor to 
 adhere to these rules with as much uniformity 
 as varying circumstances will admit. 
 
 
OF THE DUTIES OF THE PROFESSION TO 
 THE PUBLIC AND OF THE OBLIGATIONS 
 OF THE PUBLIC TO THE PROFESSION. 
 
 Art. L — Duties of the Profession to the Public. 
 
 I. 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 rela- 
 tion to matters especially appertaining to their 
 profession, as on subjects of medical police, 
 public hygiene, and legal medicine. It is their 
 province to enlighten the public in regard to 
 quarantine regulations — the location, arrange- 
 ment, and dietaries of hospitals, asylums, schools, 
 prisons, and similar institutions — in relation to 
 the medical police of towns, as drainage, venti- 
 lation, etc. — and in regard to measures for the 
 
48 
 
 J 
 
 I > i 
 
 I i 
 
 m 
 
 m 
 
 prevention of epidemic and contagious diseases ; 
 and when pestilence prevails, it is their duty to 
 face the danger, and to continue their labors 
 for the alleviation of the suffering, even at the 
 jeopardy of their own lives. 
 
 2. Medical men should also be always ready, 
 when called on by the legally constituted autho- 
 rities, to enlighten coroners' inquests, and courts 
 of justice, on subjects strictly medical^ — such as 
 involve questions relating to sanity, legitimacy, 
 murder by poisons, or other violent means, and 
 in regard to the various other subjects embraced 
 in the science of Medical Jurisprudence. But in 
 these cases, and especially where they are re- 
 quired to make a post-7norteni examination, it is 
 just, in consequence of the time, labor and skill 
 required, and the responsibility and risk they 
 incur, that the public should award them a 
 proper honorarium. 
 
 3. There is no profession, by the members 
 of which eleemosynary services are more liber- 
 ally dispensed than the medical ; but justice 
 
49 
 
 
 
 
 requires that some limits should be placed to 
 the performance of such good offices. Poverty, 
 professional brotherhood, and certain of the 
 public duties referred to in the first section of 
 this article, should always be recognized as pre- 
 senting valid claims for gratuitous services ; but 
 neither institutions endowed by the public or by 
 rich individuals, societies for mutual benefit, for 
 the insurance of lives or for analogous purposes, 
 nor any profession or occupation, can be ad- 
 mitted to possess such privilege. Nor can it be 
 justly expected of physicians to furnish certifi- 
 cates of inability to serve on juries, to perform 
 militia duty, or to testify to the state of health of 
 persons wishing to insure their lives, obtain 
 pensions, or the like, without a pecuniary ac- 
 knowledgment. But to individuals in indigent 
 circumstances, such professional services should 
 always be cheerfully and freely accorded. 
 
 4. It is the duty of physicians, who are fre- 
 quent witnesses of the enormities committed 
 by quackery, and the injury to health and even 
 
 D 
 
^i 
 
 50 
 
 destruction of !'ife 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 
 artful empirics and impostors. Physicians ought 
 to use all the influence which they may possess, 
 as professors in Colleges of Pharmacy, and by 
 exercising their option in regard to the shops to 
 which their prescriptions shall be sent, to dis- 
 courage druggists and apothecaries from vending 
 quack or secret medicines, or from being in any 
 way engaged in their manufacture and sale. 
 
 Art. II. — Obligations of the Public to Physicians, 
 
 The benefits accruing to the public, directly 
 and indirectly, from the active and unwearied 
 beneficence of the profession, are so numerous 
 and important, that *' jians are justly entitled 
 to the utmost cor .ation and respect from the 
 community. The public ought likewise to enter- 
 tain a just appreciation of medical qualifications ; 
 to make a proper discrimination between true 
 
 
 it ,. 
 
51 
 
 science and the assumptions of ignorance and 
 empiricism — to afford every encouragement and 
 facility for the acquisition of medical education 
 —and no longer to allow the statute-books to 
 exhibit the anomaly of exacting knowledge from 
 physicians, under a liability to heavy penaldes, 
 and of making them obnoxious to punishment 
 for resorting to the only means of obtaining it. 
 
 ^ 
 
 I 
 
^mii of |^ee|. 
 
 1. Ordinary visit, 8 a. m. to 9 p. m. | i 00 to | 2 00 
 
 2. Ordinary visit, 9 p. m. to 8 a. m. 2 00 to 4 00 
 
 3. Each additional member of a 
 
 family in same house at same 
 
 t^"^e Half fee. 
 
 4. Detention per hour extra in day 
 
 ^'"^^ I 00 to 200 
 
 5., Detention per hour extra at 
 
 "^S:ht 2 00 to 400 
 
 6. Detention whole day 2000 
 
 7. Detention whole night 25 00 
 
 8. Visit in consultation with an- 
 
 other Practitioner 5 00 
 
 9. Each subsequent visit in con- 
 
 sultation 2 00 
 
 10. Office consultation i 00 to 5 00 
 
 11. Visit on board vessel in harbor 5 00 to 10 00 
 
 12. Visit on boqrd vessel at wharf.. 2 50 to 5 00 
 
 13. Mileage after first mile 50 to i 00 
 
 14. Visit if called in passing 2 ootoafullfee 
 
 15. Consultation bv letter 
 
 (53) 
 
 00 to 3 00 
 
54 
 
 1 6. Certificate of health, including 
 
 examination $ 2 oo to 
 
 17. Certificate of lunacy, including 
 
 examination 5 00 to 
 
 18. Medico legal opinion 20 00 to 
 
 19. Vaccination i 00 to 
 
 OBSTETRICS. 
 
 20. Natural labour, with ordinary 
 
 (one week) attendance 10 00 to 
 
 Detention per hour at usual rates. 
 
 21. Delivery by instruments, or 
 
 turning 15 00 to 
 
 22. Attendance removing placenta 5 00 
 
 23. For removing adherent pla- 
 
 centa 15 00 to 
 
 24. Attendance in labor with con- 
 
 vulsions 25 00 to 
 
 25. For attendance, labor com- 
 
 pleted 3 00 to 
 
 26. Cramotomy 25 00 to 
 
 27. Attendance, placenta praevia... 50 00 to 
 
 SURGERY. 
 
 28. Administering anaesthetic 2 00 to 
 
 29. Dressing simple wounds i 00 to 
 
 30. Introduction of catheter i 00 to 
 
 31. Opening abscess i 00 to 
 
 I 5 00 
 
 10 00 
 
 50 00 
 
 2 00 
 
 20 00 
 
 25 00 
 
 25 
 
 00 
 
 50 
 
 00 
 
 5 
 
 00 
 
 50 
 
 00 
 
 100 
 
 00 
 
 5 
 
 00 
 
 5 
 
 00 
 
 5 
 
 00 
 
 5 
 
 00 
 
')•) 
 
 Auipiitatiojts. 
 52. Amputation fingers or toes, 
 
 ^^^^'•i I 5 00 
 
 Zo' Amputation wrist, forearm or 
 
 ^^"^ 20 00 to 
 
 34- Amputation shoulder joint 100 00 
 
 35- Amputation foot, anl^le or ieg.. 50 00 to 
 
 36. Amputation thigh 100 00 
 
 Zl> Amputation hip joint 200 00 
 
 38. Amputation breast 
 
 39. Amputation penis 25 00 
 
 40. Amputation tonsil 5 00 to 
 
 Resections. 
 
 41. Resection of shoulder, elbow, 
 
 or wrist joint 
 
 42. Resectionof hip, knee, or ankle 
 
 50 00 
 75 00 
 
 50 00 to 100 00 
 
 25 00 
 
 jomt 
 
 50 00 to 100 00 
 75 00 to 150 00 
 
 Dislocations. 
 
 43- Reducing dislocation of shoul- 
 
 der joint JO 00 to 
 
 44- Reducing dislocation of elbow. 10 00 to 
 
 45. Reducing dislocation of hip 25 00 to 
 
 46. Reducing dislocation of pha- 
 
 ^a"§:es 5 00 to 
 
 47. Reducing dislocation of jaw.... 5 00 to 
 
 25 00 
 25 00 
 50 00 
 
 10 00 
 10 00 
 
se 
 
 M 
 
 Fractures. 
 
 48. Setting fracture of phalanges... | 5 00 
 
 49. Setting fracture of wrist, arm, 
 
 forearm, or clavicle 20 00 to 5000 
 
 50. Setting fracture of jaw 15 00 to 3000 
 
 51. Setting fracture of leg 20 00 to 4000 
 
 52. Setting fracture of thigh 30 00 to 50 00 
 
 53. Setting fracture of patella 30 00 to 50 00 
 
 54. Setting fracture of ribs 5 00 to 10 00 
 
 55. Each dressing after first i 00 to 5 00 
 
 Ligation. 
 
 56. Ligating radial or brachial 
 
 artery 25 00 to 5000 
 
 57. Ligating tibial artery 30 00 to 60 00 
 
 58. Ligating femoral artery.. 100 00 
 
 59. Ligating carotid artery 100 00 
 
 60. Ligating subclavian or iliac 200 00 to 300 00 
 
 Miscellaneous. 
 
 61. Circumcision 15 00 
 
 62. Ligating hemorrhoids 25 00 
 
 63. Operation for treating hemor- 
 
 rhoids by injection 5 00 to 2500 
 
 64. Operation for fistula in ano 10 00 to 25 00 
 
 65. Aspirating bladder 5 00 to 2500 
 
 66. Lithotomy and lithotrity 100 00 to 200 00 
 
 
 41! 
 
57 
 
 50 
 
 00 
 
 lO 
 
 00 
 
 25 
 
 00 
 
 10 
 
 00 
 
 100 
 
 00 
 
 100 00 
 
 50 
 
 00 
 
 50 
 
 00 
 
 100 00 
 
 67. Division stricture of urethra 
 
 (divulsion) $ 15 00 to $3000 
 
 68. Division stricture of urethra 
 
 (urethrotomy) 25 00 to 
 
 69. Tapping hydrocele 5 00 to 
 
 70. Radical cure of hydrocele 10 00 to 
 
 71. Reducing strangulated hernia... 5 00 to 
 
 72. Operation for strangulated her- 
 
 nia 50 00 to 
 
 73. Trephining 50 00 to 
 
 74. Operation for club foot 20 00 to 
 
 75. Operation for hare lip 15 00 to 
 
 76. Operation for staphylorraphy.. 50 00 to 
 
 77. Tracheotomy, laryngotomy and 
 
 cesophagotomy 20 00 to 
 
 78. Removal of foreign body from 
 
 throat or oesophagus 5 00 to 
 
 79. Removal of nasal polypus 5 00 to 
 
 80. Use of stomach pump 5 00 to 
 
 81. Application of plaster jacket... 5 00 to 
 
 82. Castration 3000 
 
 83. Laparotomy 100 00 
 
 Diseases of Females. 
 
 84. Introducing and removing tam- 
 
 pon I 00 to 500 
 
 85. Introducing catheter i 00 to 2 00 
 
 50 00 
 
 50 00 
 30 00 
 20 00 
 25 00 
 
58 
 
 ' 
 
 u. 
 
 I 
 
 86. Uterine and vaginal examina- 
 
 tion $ 2 oo to 
 
 87. Operation on vesico-vaginal 
 
 fistula 50 00 to 
 
 88. Operation on lacerated perin- 
 
 ceum (old) 25 00 to 
 
 89. Operation on lacerated cervix 50 00 to 
 
 90. Removal of uterine fibroids... 50 00 to 
 
 91. Treatment by electrolysis 3 00 to 
 
 92. Ovariotomy 200 00 to 
 
 Ophthalmic and Aural Surgery. 
 
 93. Extraction of cataract 50 00 to 
 
 94. Iridectomy 15 00 to 
 
 95. Enucleation 20 00 to 
 
 96. Strabismus 15 00 to 
 
 97. Lachrymal stricture 5 00 to 
 
 98. Removal of tarsal tumours ... 5 00 to 
 
 99. Correcting refraction 5 00 to 
 
 100. Catheterization of eustachian 
 
 tube (first operation) 5 00 
 
 loi. Politzerization 2 00 to 
 
 Venereal Diseases. 
 
 102. Venereal disease (first consul- 
 
 tation) 5 00 to 
 
 103. Venereal. disease (subsequent 
 
 consultation) i 00 to 
 
 $500 
 
 100 00 
 
 50 
 
 00 
 
 100 
 
 00 
 
 100 00 
 
 5 
 
 00 
 
 500 
 
 00 
 
 500 
 
 00 
 
 50 
 
 00 
 
 50 
 
 00 
 
 30 
 
 00 
 
 10 00 
 
 15 
 
 00 
 
 15 
 
 00 
 
 5 00 
 
 10 00 
 
 2 00 
 
t 
 
 59 
 
 In cases of fracture, dislocation, amputation, resec- 
 tion, or other major operations, the fee specified above 
 shall not include more than two weeks' subsequent 
 attendance. Subsequent visits in such cases at the 
 usual rates. 
 
 In applying the above scale of fees, it is intended 
 that due consideration should be made for patients in 
 poor circumstances. 
 
 The above scale of fees does not include payments 
 to assistants.