History of the Medical Society of the State of New York

Front matter

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Preface

THE modern idea in writing history is to allow the contemporaries to tell their own story as far as possible, making due allowance for prejudice, and presenting as far as is feasible both sides of the question. The method employed in writing this history of the Medical Society of the State of New York for the centennial of its foundation, has been to use, wherever available, excerpts from contemporary writings. The writer has preferred to take the position of editor of such abstracts rather than to attempt to tell the story directly; for while the interest and the connection of the narrative may suffer somewhat by this method, historical accuracy gains much, and the frequent references to the sources of our knowledge may prove suggestive to students of medical history who care to pursue the subject further.

The writer wishes to thank many friends for their aid in preparing this work, notably Dr. A. Jacobi, of New York, and Drs. Albert Vanderveer and Frederick C. Curtis, of Albany. Special thanks for help at doubtful points are due to Mr. John S. Brownne, the librarian of the New York Academy of Medicine.

HISTORY OF THE MEDICAL SOCIETY OF THE STATE OF NEW YORK.

By JAMES J. WALSH, M.D., Ph.D., LL.D.

NEW YORK.

Chapter I

THE LEGISLATIVE CREATION OF THE MEDI- CAL SOCIETY OF THE STATE OF NEW YORK.

AS a result of meetings held by certain members of the medical profession, in Saratoga County, toward the end of the eighteenth and again at the beginning of the nineteenth century, it was resolved to make an attempt to secure the legal regulation of the practice of medicine, by the establishment of a corporate State medical body, composed of representatives from the different counties of the State, which should have the power of granting or refusing license to practice medicine. Considerable opposition was manifested at the beginning, and it was difficult for the members of the medical profession to agree upon a scheme satisfactory to all. As a consequence, nearly ten years elapsed before the required act of the Legislature was obtained. At first it was thought that the act for the regulation of the practice of medicine would be asked only for the counties in the northeastern part of the State. Fortunately, however, the committee in charge deemed it advisable to ask for the passage of a law for the whole State.

This law was passed April 4, 1806. Something of the history of the efforts required to bring about that community of interest that would secure the passage of the law, the difficulties that were encountered, and the change of base from the demand of a law for particular counties to that of one for the whole State, will be stated in a later chapter, in the words of Dr.

John Stearns, who was himself one of the chief actors in these proceedings, and who subsequently wrote an account of them in order to correct many false impressions that had begun to be current.

The act authorizing county medical societies in the various counties of the State and empowering delegates from them to organize a State medical society, was entitled: "An Act to Incorporate Medical Societies for the Purpose of Regulating the Practice of Physic and Surgery in this State," and passed April 4, 1806, in the twenty-ninth session of the Legislature. It runs as follows :

Whereas, well regulated Medical Societies have been found to contribute to the diffusion of true science and particularly the knowledge of the healing art, Therefore

I. Be it enacted by the people of the State of New York, represented in the Senate and Assembly, that it shall and may be lawful for the physicians and surgeons in the several counties of this State now authorized by law to practice in their several professions, to meet together on the first Tuesday of July next at the place where the last term of the Court of Common Pleas next previous to such meeting was held in their respective counties; and the several physicians and surgeons so convened as aforesaid or any part of them, being not less than five in number, shall proceed to the choice of a President, Vice-President, Secretary and Treasurer, who shall hold their offices for one year and until others are chosen in their places; and whenever the said societies shall be so organized as aforesaid, they are hereby declared to be bodies corporate and politic in fact and in name, by the names of the Medical Society of the county where such societies shall respectively be formed, and by that name shall be in law capable of suing and being sued, pleading and being impleaded, answering and being answered unto, defending and being defended in all courts and places in all matters and causes whatsoever, and shall and may have a common seal, and may alter and renew the same at their pleasure.

II. And be it further enacted that there shall be a general medical society to be composed of one member from each of the county societies in the State, elected by ballot at their annual meeting, who shall meet together in the City of Albany on the first Tuesday of February next, and being so met, not less than fifteen in number, shall proceed by ballot to the choice of a President, Vice-President, Secretary and Treasurer, who shall hold their offices for one year and until others shall be chosen in their places; and the said society being so organized as aforesaid, shall be and they are hereby declared to be a body corporate and politic in fact and in name, by the name of the Medical Society of the State of New York, and by that name shall be in law capable of suing and being sued, pleading and being impleaded, answering and being answered unto, defending and being defended in all courts and places, and in all matters and causes whatsoever, and shall and may have and use a common seal, and may change and alter the same at their pleasure.

III. And be it further enacted that the Medical Society of the State of New York and also the medical societies of the respective counties shall and may agree upon and determine the times and places of their next meeting and the time so agreed upon shall forever thereafter be the anniversary day of holding their respective meeting; and it is hereby made the duty of the Secretary of each of the county medical societies to lodge in the office of the clerk of their respective counties a copy of all the proceedings had at their first meeting within twenty days after such meeting, and it shall also be the duty of the Secretary of the Medical Society of the State of New York to lodge in the office of the Secretary of State a copy of their proceedings had at their first general meeting, and the said clerks and Secretary are hereby required to file the same in their respective offices, for which they shall each receive the sum of twelve and one-half cents.

IV. And be it further enacted that the medical sosieties established as aforesaid are hereby respectively empowered to examine all students who shall or may present themselves for that purpose, and to give a diploma under the hand of the President and seal of such society before whom such student shall be examined, which diploma shall be sufficient to empower the person so obtaining the same to practice physic or surgery or both, as shall be set forth in the said diploma, in any part of this State; and the person receiving such diploma shall, upon the receipt of the same, pay to the President of said society the sum of two dollars, for the use of the said society.

V. And be it further enacted that if any student who shall have presented himself "for examination before any of the medical societies of the several counties of this State shall think himself aggrieved by the decision of such society, it shall be lawful for such student to present himself for examination to the Medical Society of the State of New York, and if in the opinion of such Society, the student so applying is well qualified for the practice of physic or surgery or both, as the case may be, the President of said Society shall, under his hand and the seal" of such Society, give to the said applicant a diploma agreeable to such decision; such applicant paying therefor to the said President the sum of two dollars.

VI. And be it further enacted that it shall and may be lawful for the several medical societies so established as aforesaid, at their annual meetings to appoint not less than three nor more than five censors, whose duty it shall be carefully and impartially to examine all students who shall present themselves for that purpose and report thereupon in writing to the President of said Society.

VII. And be it further enacted that from and after the first day of September next no person shall commence the practice of physic or surgery within any of the counties of this State until he shall have passed an examination and received a diploma from one of the medical societies to be established as aforesaid; and if any person shall so practice without having obtained a diploma for that purpose he shall forever thereafter be disqualified from collecting any debt or debts incurred by such practice in any court in this State.

VIII. And be it further enacted that it shall and may be lawful for the medical societies of the respective counties in this State, which shall be established by virtue of this act, and also the Medical Society of the State of New York, to purchase and hold any estate, real and personal for the use of said respective societies,

PROVIDED such estate as well real as personal which the county societies are hereby respectively authorized to hold, shall not exceed the sum of one thousand dollars; and that the estate as well real as personal which the Medical Society of the State of New York is hereby authorized to hold, shall not exceed five thousand dollars.

IX. And be it further enacted that it shall be lawful for the respective societies to be established by virtue of this act, to make such by-laws, rules and regulations relative to the affairs, concerns and properties of said societies; relative to the admission and expulsion of members ; relative to such donations and contributions as they or a majority of the members at their annual meeting shall think fit and proper,

PROVIDED, that such by-laws, rules, and regulations made by the Society of the State of New York be not contrary to nor inconsistent with the constitution and laws of this State, or of the United States, and that the by-laws, rules and regulations of the respective county societies shall not be repugnant to the by-laws, rules and regulations of the Medical Society of the State of New .York, nor contrary to or inconsistent with the constitution and laws of this State or of the United States.

X. And be it further enacted that the treasurer of each society established as aforesaid, shall receive and be accountable for all monies that shall come into his hands by virtue of any of the by-laws of such society and also for all monies that shall come into the hands of the President thereof, for the admission of members or licensing students, which monies the said President is hereby required to pay over to the said treasurer, who shall account therefore to the society at their annual meetings; and no monies shall be drawn from thi treasury unless in such sums and for such purposes as shall be agreed upon by a majority of the society at their annual meeting and by a warrant for that purpose, signed by the President.

XL And be it further enacted that it shall be the duty of the Secretary of each of the medical societies to be established by virtue of this act to provide a book in which he shall make an entry of all the resolutions and proceedings which may be had from time to time and also the name of each and every member of said society and the time of his admission, and also the annual reports relative to the state of the treasury and all such other things as a majority of the society shall think proper ; to which book any member of the society may at any time have recourse, and the same, together with all books, papers and reports which may be in the hands of the Secretary and be the property of the society, shall be delivered to his successor in office.

XII. And be it further enacted that it shall be lawful for each of the medical societies to be established by virtue of this act, to be caused to be raised and collected from each of the members of such society a sum not to exceed three dollars in any one year, for the purpose of procuring a medical library and apparatus,, and for the encouragement of useful discoveries in chemistry, botany and such other improvements as the majority of the society shall think proper.

XIII. And be it further enacted that nothing in this act contained shall be construed to prevent any person coming from any other State or county from practicing physic or surgery within this State, such person being duly authorized to practice by the laws of such State or county, having a diploma from a regular medical society; nor to compel any student who may have commenced his studies previous to the first day of January, one thousand eight hundred and five, to be examined by such society and licensed in the manner aforesaid, if such student shall choose to study four years and be licensed in the manner now prescribed by law;

PROVIDED, however, that none of the societies established as aforesaid shall proceed to the examination of any student in order to license him for the practice until such student shall have produced satisfactory testimony that he has regularly studied physic or surgery or both as the case may be, with one or more reputable practitioner or practitioners for the term of three years.

XIV. And be it further enacted that it shall be in the power of the Legislature to alter, modify or repeal this act whenever they shall deem it necessary or expedient.

XV. And be it further enacted that the act entitled "An Act to Regulate the Practice of Physic and Surgery in this State" be and the same is hereby repealed from and after the first day of September next.

XVI. And be it further enacted that if there should not be a sufficient number of physicians and surgeons in any of the counties of this State to form themselves into a Medical Society, by virtue of this act, it shall be lawful for such physicians and surgeons to associate with the physicians and surgeons of an adjoining county for the purposes hereby contemplated.

XVII. And be it further enacted that if the physicians and surgeons of any county or counties of this State should not meet and organize themselves at such time and place as required by this act, it shall be lawful for them to meet at such other time as a majority of them shall think proper, and their proceedings shall be as valid as if such meeting had been had at the time as provided for by this act.

XVIII. And be it further enacted that this act shall be declared to be a public act.

Considering the circumstances preliminary to the passage of the act, and the fact that at first the creation of only certain county societies or a district society was to be asked for from the Legislature, it is not surprising that the county societies should have been given a place co-ordinate with that of the State society in the matter of licensing physicians for the practice of medicine. On the other hand, the State society was given a position of commanding importance, and of definite supremacy, inasmuch as it could review the refusal of a county society to allow a properly qualified medical student to practice, and furnish him with a license in spite of the negative action of the local society. It was evidently intended, however, that, though the two organizations, the State and the county society, drew their right to existence from the same act of the Legislature, they should be independent, and above all, that the State society should not be determined in its action by that of the county societies. It seems worth while noting this because, some seventy-five years later, there was question of the relationship between the county societies and the State society, and the independence of the State organization was somewhat impugned, though without sufficient reason.

Chapter II

REGULATION OF THE PRACTICE OF MEDI- CINE IN THE PROVINCE OF NEW YORK.

This act of 1806 was by no means the first attempt to regulate the practice of medicine in the State of New York, nor in the colony of New York before the Revolution. It is rather interesting to trace the gradual progress of the various attempts to give practitioners of medicine and surgery a dignified place before the people, and at the same time, while not infringing the liberty of the individual too much, keep quacks and charlatans from occupying too prominent a place in the life of the colony, and especially the city. The first mention of any legal regulation of the practice of medicine came in the shape of an answer to the petition of the barber-surgeons at New Amsterdam that they should have a monopoly of shaving and tending to the wounds of the inhabitants. It is couched in terms that would seem to indicate that there was some basic law in the colony to which the members of the chirurgical profession wished to have an amendment or a codicil.

The following is from the Dutch Records, February 2, 1652:

"On the petition of the chirurgeons of New Amsterdam, that none but they alone be allowed to shave ; the director and council understand that shaving doth not appertain exclusively to chirurgery, but is an appendix thereunto; that no man can be prevented operating on himself, nor to do another the friendly act, provided it be through courtesy, and not for gain, which is hereby forbidden. It was then further ordered that shipbarbers shall not be allowed to dress any wounds nor minister any potions on shore, without the previous knowledge and special consent of the petitioners, or at least of Dr. La Montague."

This, says the editor of the New York City Medical Register, is the earliest order on record regulating the practice of medicine in the State. — Medical Register, City of New York, 1865, p. 108.

Some five years later there is a city ordinance which attempts to place upon surgeons a burden against which the profession has always and very properly and successfully protested. It is Dr. Toner particularly who calls attention to the false spirit of the legislation, and we quote the passage from him :

"As showing the spirit of legislation of the times in relation to medical men, the following is worthy of note. The act aimed to impose a sort of detectiveduty upon the surgeon, which could not be submitted to by the profession, and no doubt was a dead letter.

In December, 1657, a city ordinance was passed by the schout, burgomaster and schepens, giving notice "to all chirurgeons of the city, that when they are called to dress a wound, they shall ask the patient who wounded him and that information thereof be given to the schout."

The first serious attempt at the formal regulation of the practice of medicine of which we have a definite account came shortly after the English took possession of New York City and assumed the government of the colony of New York and certain neighboring territory. It was in 1664 that Col. Nicolls, the personal representative of the Duke of York, appeared in Manhattan Bay with an English fleet, and forced the Dutch to surrender Manhattan Island. A new government was at once set up, and two delegates were sumrnoned from each town in the colony, to draw up a Code of Laws, the Duke's Laws, as they were called, which the colony in and around New York had to accept perforce. Dr. Toner calls attention to the fact that these laws applied to a number of other places besides Manhattan Island. We quote accordingly the passage from him, and also the special paragraph of the laws, referring to the practice of medicine:

"In these Duke of York's laws enacted about 1665 for the government of the Province of New York, when Nantucket, Martha's Vineyard, Normansland, and the Elizabeth Islands were all considered as lying within the Duke's patent, a stringent law relating to chirurgeons, midwives and physicians was passed, which, as it may be found to possess some historical interest and is not generally available to readers, is given in full :

'Chirurgeons, Midwives, Physicians: That no person or persons whatever employed about the bodys of men, women or children, for the preservation of life or health as chirurgeons, midwives, physicians, or others, presume to put forth or exercise any act contrary to the known approved rule of art in each mystery or occupation, or exercise any force, violence, or cruelty upon or towards the body of any, whether young or old, without the advice and consent of such as are skilful in the same art (if such may be had), or at least of some of the wisest and gravest then present, and consent of the patient or patients if they be mentis compotes, much less contrary to such advice and consent, upon such severe punishment as the nature of the fact may deserve; which law, nevertheless, is not intended to discourage any from all lawful use of their skill, but rather to encourage and direct them in the right use thereof, and to inhibit and restrain the presumptuous arrogance of such as, through confidence of their own skill or any other sinister respects, dare boldly attempt to exercise any violence upon or towards the body of young or old, one or other, to the prejudice or hazard of the life or limb of man, woman or child.' "

This is practically a copy of a law passed in Massachusetts in 1649.

Toner also calls attention to the fact that a number of the ordinances passed by the city council of Manhattan Island, referred in various ways to the practice of medicine, and he gives a list of the various acts with a short digest of their contents. This furnishes an excellent idea of the trend of opinion with regard to the proper practice of medicine, and also serves to show that members of the medical profession were gradually securing their rights as professional men, and that the efforts of the community to protect itself against contagious diseases of various kinds, and also against the allurements of quackery, were gradually crystallizing into proper shape.

The following laws were enacted in New York prior to the Revolutionary War. The Dutch records show that February 2, 1652, an order was promulgated, regulating the duties of chirurgeons. (See Medical Register, City of New York, 1865) : An act allowing physicians to travel on the Lord's Day, enacted 1695, Stat. N. Y., ed. 1691-1751, p. 23; An act exempting physicians and chirurgeons from performing the duties of constable or tax-collector, enacted 171 5, Stat. N. Y., ed. 1691-1751, p. 117; Physicians, doctors of physic, practitioners of physic, and surgeons exempt from performing military duty, except in case of an invasion, section 23, act 1755, Stat. N. Y., ed. 1752-63, p. 53 ; An act to prevent infectious distempers being brought into this colony, and to hinder the spreading thereof, enacted 1755, Stat. N. Y., ed. 1742-63, p. 157; An act to explain the foregoing act, enacted 1755, Stat. N. Y., ed. 1752-63, p. 57 ; An act to continue the same, enacted 1756, Stat. N. Y., ed. 1752-63, fol. 100; An act to appropriate the money raised by divers lotteries for erecting a college and pesthouse, enacted 1756, Stat. N. Y., ed. 1752-63, p. in; An act to prevent the bringing in and spreading of infectious distempers in this colony, enacted 1758, Stat. N. Y., ed. 1752-63, p. 137; An act to regulate the practice "of physic and surgery in the city of New York, enacted 1760, Stat. N. Y., ed. 1752-63, p. 188 ; An act to revive an act to prevent the bringing in and spreading of infectious distempers in this colony, with an addition thereto, regulating the practice of inoculation for the small-pox, enacted 1763, Stat. N. Y. ed. 1752-63, p. 432 ; An act continuing the foregoing act, enacted 1767, Stat. N. Y., p. 498; An act for the better support of the hospital to be erected in the city of New York, for poor and indigent persons, enacted March 24, 1772, Stat. N. Y., ed. 1763-73, p. 696; An act for regulating the practice of inoculation for the small-pox in the City of Albany, enacted 1773, Stat. N. Y., ed. 1763-73, p. 720; An act to repeal an act to prevent infectious diseases in the Counties of Westchester, Dutchess and Orange, so far as it relates to the borough and town of Phillipsborough, enacted 1773, Stat. N. Y., ed. 1763-73, p. 791.

The most noteworthy medical act for the regulation of medical practice was that passed in 1760. In his "Historical Sketch of the State of Medicine in the American Colonies from Their First Settlement of the Period of the Revolution," Dr. John B. Beck reviews carefully the necessities for regulation and the gradual evolution that brought about legislative enactments. Dr. Beck's paper was originally his annual presidential address, delivered before the Medical Society of the State of New York at its regular meeting, February 1, 1842. It was not published, however, until the volume of transactions for the years 1850 and 1852, which are all bound together under the title "Volume 8." It seems not unlikely that during the intervening nearly ten years, Dr. Beck made many additions to the original address, which in this volume occupies almost sixty pages.

Dr. Beck's address has been a mine of information for subsequent historians, and as he was himself a man of wide reading, of broad and liberal judgment, as well as of extensive experience, in medical practice and his relationship to his professional brethren, his opinions deserve to be quoted as originally set down. He does not hesitate to say that, though New York was not the first to attempt the legal regulation of the practice of medicine, the province of New York must be given undoubted priority in securing this much-to-be-desired result effectively. He says :

"The State of New York, I believe, is entitled to the honor of adopting the first effectual measures for regulating the practice of medicine. This was not, however, until so late a period as 1760, when the General Assembly of the Province ordained that, 'no person whatsoever should practice as a physician or surgeon, in the city of New York, before he shall have been examined in physic or surgery, and approved of and admitted by one of his majesty's council, the judges of the supreme court, the king's attorney general, and the mayor of the city of New York, for the time being, or by any three or more of them, taking to their assistance for such examinations such proper person or persons as they in their discretion shall think fit.' If the person so examined was approved, a certificate was given, allowing him to practice physic or surgery, or both throughout the province. In case of non-compliance, the penalty was a fine of five pounds."

This act that he mentions has seemed to us so important that we prefer to quote it entirely rather than to give the gist of it, for it is an historical document of primary importance, and represents for New Yorkers, particularly, the spirit of the inhabitants of the province, and the efforts of physicians to prevent quackery better than any possible statement of medical conditions would be able to furnish.

AN ACT TO REGULATE THE PRACTICE OF PHYSICK AND SURGERY IN THE CITY OF NEW- YORK, PASSED THE 10TH OF JUNE, 1760.

Whereas, many ignorant and unskilful Persons in Physick and Surgery in order to gain a subsistence, do take upon themselves to administer Physick, and practice Surgery in the City of New York, to the endangering of the Lives and Limbs of their Patients; and many poor and ignorant Persons inhabiting the said City, who have been persuaded to become their Patients, have been great sufferers thereby: For preventing such Abuses for the Future:

I. BE IT ENACTED by his Honor the Lieutenant- Governor, the Council, and the. General Assembly, and it is hereby ENACTED by the Authority of the same,

That, from and after the publication of this Act, no Person whatsoever shall practice as a Physician or Surgeon in the said City of New- York, before he shall first have been examined in Physick or Surgery, and approved of and admitted by one of his Majesty's Council, the Judges of the Supreme Court, the King's Attorney-General, and the Mayor of the City of New- York, for the time being, or by any three or more of them, taking to their assistance for such examination, such proper Person or Persons as they in their discretion shall see fit. And if any candidate after due examination of his Learning, and skill in Physick and Surgery as aforesaid, shall be approved and admitted to practice as a Physician and Surgeon or both, the said Examiners, or any three or more of them, shall give, under their hands and Seals to the person so admitted as aforesaid, a Testimonial of his Examination and Admission, and in the form following, to wit: To all to whom these Presents shall come, or may concern: