weaken 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 gentleman understands 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 patient, nor to give his advice, excepting in instances of sudden attacks, without a regular consultation; and if such previously attending gentleman has been dismissed, or has voluntarily relinquished the patient, his practice should be treated with candor, and justified so far as probity and truth will permit; for the want of success in the primary treatment of the disorder is no impeachment of professional skill and knowledge. It frequently happens that a physician, in incidental 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 admit of his declining to pay attention to them. Under such circumstances, his observations should be delivered with the most delicate propriety 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. DIFFERENCES OF PHYSICIANS. The differences of physicians, when they end in appeals to the public, generally hurt the contending parties; but, what is of more consequence, they discredit the profession, and expose the Faculty itself to contempt and ridicule. Whenever such differences occur as may affect the honor and dignity of the profession, and cannot immediately be terminated, or do not come under the character of violation of the special rules of the Association otherwise provided for, they should be referred to the arbitration of a sufficient number of members of the Association, according to the nature of the dispute; but neither the subject-matter of such references, nor the adjudication, should, if it can be avoided, be communicated to the public, as they may be personally injurious to the individuals concerned, and can hardly fail to hurt the general credit of the Faculty. DISCOURAGEMENT OF QUACKERY. The use of quack medicines should be discouraged by the Faculty, as disgraceful to the profession, injurious to health, and often destructive even of life. No physician or surgeon, therefore, should dispense a secret nostrum, whether it be his invention or exclusive property; for, if it is of real efficacy, the concealment of it is inconsistent with beneficence and professional liberality; and, if mystery alone give it value and importance, such craft implies either disgraceful ignorance or fraudulent avarice. CONDUCT FOR THE SUPPORT OF THE MEDICAL The esprit du corps is a principle of action founded in human nature, and, when duly regulated, is both rational and laudable. Every man, who enters into a fraternity, engages, by a tacit compact, 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 respectability 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 scepticism concerning the efficacy and utility of the healing art. FEES. General rules are adopted by the Faculty, in every town, relative to the pecuniary acknowledgments of their patients; and it should be deemed a point of honor to adhere to them; and every deviation from, or evasion of, these rules should be considered as meriting the indignation and contempt of the fraternity. Gratuitous services to the poor are by no means prohibited the characteristical beneficence of the profession is inconsistent with sordid 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. It is obvious, also, that an average fee, as suited to the general rank of patients, must be an inadequate compensation from the rich (who often require attendance not absolutely necessary), and yet too large to be expected from that class of citizens who would feel a reluctance in calling for assistance, without making some decent and satisfactory remuneration. EXEMPTION FROM CHARGES. All members of the medical profession, together with their families, should be attended gratuitously; but visits should not be obtruded officiously, as such civility may give rise to embarrassments, or interfere with that choice on which confidence depends. But distant members of the Faculty, when they request attendance, should be expected at least to defray the charges of travelling. Omission to charge, on account of the wealthy circumstances of the physician, is an injury to the profession, as it is defrauding, in a degree, the common funds for its support, when fees are dispensed with which might justly be claimed. VICARIOUS OFFICES. Whenever a physician officiates for another by his desire, in consequence of sickness or absence, if for a short time only, the attendance should be performed gratuitously as to the physician, and with the utmost delicacy towards the professional character of the gentleman previously connected with the patient. SENIORITY. A regular and academical education furnishes the only presumptive evidence of professional ability, and is so honorable and beneficial, that it gives a just claim to preeminence among physicians at large, in proportion to the degree in which it may be enjoyed and improved. Nevertheless, as industry and talents may furnish exceptions to this general rule, and this method may be liable to difficulties in the application, seniority among practitioners of this town should be determined by the period of public and acknowledged practice as a physician or surgeon in the same. This arrangement, being clear and obvious, is adapted to remove all grounds of dispute among medical gentlemen; and it secures the regular continuance of the established order of precedency, which might otherwise be subject to troublesome interruptions by new settlers, perhaps not long stationary in the place. JOHN WARREN, |