est usefulness to the community, can be best maintained by allowing to the individual members of the profession a larger liberty than the over-zealous advocates of the old code are disposed to grant them. And I believe that it is unwise to stifle the discussion of this subject, or to use coercive measures to influence the action of medical men in opposition to their convictions of right.

THE QUESTIONABLE FEATURES OF OUR

MEDICAL CODES.

BY WILLIAM S. ELY, M.D.,

PHYSICIAN TO THE ROCHESTER CITY HOSPITAL.

The agitation which resulted in the recent revision of the Code of Ethics of the Medical Society of the State of New York, has led many to seriously consider the questionable features of our medical codes.

In the endeavor to examine the subject dispassionately, it soon became apparent that some change should be made in the rules which had governed the profession of the State, if our principles and practice are to be in accord. The evidence of this, was manifest in the existence of a wide-spread disbelief in the wisdom of certain restrictive features imputed to the old code, and in a growing conviction that many of its provisions are puerile or unnecessary. More than a third of a century has elapsed since its adoption. In this period the professional environment has undergone great change. Sects in medicine have received legal recognition, and the relation of the regular profession

to all forms of irregular practice has been for some years under discussion. In religion there has been a tendency to a simplification of creeds, and lessened sectarian hostility, and a similar movement is observed in medicine. The Committee, which was appointed in 1881 to revise the code, was thus led to recommend such a modification of existing rules as would be in harmony with tendencies which they hoped would finally be salutary for the profession. As is well known, the new code was adopted at the annual meeting held in 1882, and reaffirmed at the annual meeting of 1883. Converts to the changes made are now so numerous that it can hardly be expected that the old code can be reinstated in general confidence and respect. Apart from their number, the character and standing of the gentlemen who have felt that a change in medical ethics is advisable are a strong evidence of the significance of the movement. Many of them are leaders in medical thought-physicians of advanced years and wide experience, not a few of whom have been honored with the highest offices in the gift of the profession. These gentlemen feel that the movement to which they are committed is one which concerns the dignity, honor, and advancement of their calling.

Certain of the adherents of the old code have charged their opponents with having inflicted a lasting injury and disgrace upon the profession of the State. We claim that this assertion is both untrue and unworthy of its source. The authors of this statement fear that, in the breaking down of old barriers and the according of the right of private judgment to individuals in questions relating to medical practice, serious harm is to come to themselves and to the profession at large. So strong is this feeling, that coercive and proscriptive measures have already been brought to bear upon some of their brethern of advanced views, and other punitive procedures have been suggested which are discreditable to a liberal profession.

It has been repeatedly shown that the opponents of the new code, base their principal objections to it upon the clause which relates to consultations. Thus far most of the discussion

has turned upon this point. But with very many this is really a secondary consideration. The agitation was started and is being carried on largely by gentlemen who prefer no code at all-or would reduce it to a simple declaration. They deem a code with penalties impracticable, and the attempt to prescribe manners and con

duct for the sick-room, as offensive to good taste. They voted for the new code, and accept it provisionally, as a step toward their more advanced position, and thus better than no change whatever. Were the only question that of consultations, there would be with many no need for the controversy, for when they examine the old New York code adopted in 1823, and the code of the American Medical Association adopted in 1847, they find that neither furnishes absolute ground for a refusal to consult with legally authorized practitioners. The New York code of 1823 says: "All the individuals composing the Colleges and Medical Societies constituted by the Legislature of this State, are by them qualified physicians and surgeons"; and further on: "There is no difference between physicians, but such as results from their personal talents, medical acquirements or their experience, and the public, from the services they receive, are the natural judges of these intellectual advantages."

The code of the American Medical Association, Art. IV, Sec. I, says: "A regular medical education furnishes the only presumptive evidence of professional abilities and requirements." But no one can

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be considered as a regular practitioner, or a fit