NEW YORK CITY DEPARTMENT OF HEALTH

Corner Centre and Walker Streets 1916 O F F I C E R S Haven Emerson, M.D. (Commissioner of Health) John S. Billings, M.D. (Deputy Commissioner Leland E. Cofer, M.D. (Health Officer of the Port) Arthur Woods (Commissioner of Police ME D I C A L A D V I S O R Y B O A R D T. Mitchell Prudden, M.D., Abraham Jacobi, M.D. William M. Polk, M.D. John Winters Brannan, M.D. L. Emmett Holt, M.D. Simon Flexner, M.D., G. R. Butler, M.D. W. B. James, M.D. H. M. Biggs, M.D. Francis Carter Wood DIRECTORY OF THE DEPARTMENT OF HEALTH......OFFICES Borough of The Bronx, 3731 Third avenue Borough of Brooklyn, Flatbush avenue and Willoughby street Borough of Queens, 372-374 Fulton street, Jamaica, L.I. Borough of Richmond 514-516 Bay street,Stapleton, S.I. Office Hours: 9 a.m. to 5 p.m. Saturday, 9 a.m. to 12 m. HOSPITALS FOR CONTAGIOUS DISEASES Manhattan- Willard parker Hospital, foot of E. 16th st. The Bronx- Riverside Hospital, North Brother Island. Brooklyn- Kingston Avenue Hospital, Kingston avenue and Fenimore street. LABORATORIES Diagnosis Laboratory, Center and Walker sts. Serological Laboratory, Center and Walker sts. Research Laboratory, Chemical Laboratory. Vaccine Laboratory. Drug Laboratory. Foot of E. 16th st. DIAGNOSTIC CLINICS FOR VENEREAL DISEASES. Manhattan- Center and Walker sts. Week days, 9 to 10am 307 W. 33rd st. Wednesdays, 8 to 9p.m. Brooklyn- 29 3d avenue. Week days, 9 to 11am Tuesdays & Fridays 8 to 9pm. CLINICS FOR THE PASTEUR TREATMENT OF RABIES. Manhattan- Center and Walker sts. Week days, 1 to 4p.m. Brooklyn- 29 3d avenue. Week days, 10 a.m. to 1 p.m. The Bronx - 3d avenue and St. Paul's pl. Week days, 11a.m. to 1 p.m. Queens-- Cases attend Manhattan or Brooklyn Clinics on Week Days. Richmond-- Cases attend Manhattan Clinics on Week Days. Note: Sundays and Holidays all cases attend Brooklyn Clinic, 10am to 12p.m. TUBERCULOSIS CLINICS Manhattan-- West Side Clinic, 307 W. 33d street. Lower East Side Clinic, 111 E. 10th street Middle East Side Clinic, 229 E. 57th street Harlem Italian Clinic, 420 E. 116th street Southern Italian Clinic, 22 Vandam street Day Camp, Ferryboat "Middletown," ft of 91st street The Bronx-- Northern Clinic, St. Pauls pl. and 3d avenue Southern Clinic, 493 East 139th st. Brooklyn-- Main Clinic, Fleet and Willoughby sts. Germantown Clinic, 55 Sumner avenue Brownsville Clinic, 64 Pennsylvania avenue. Eastern District Clinic, 306 S. 5th street,Williamsburg. Bay Ridge Clinic, 215 60th street Parkville Clinic, 974 West Street Day Camp, Ferryboat "Rutherford," foot of Fulton street Queens-- Jamaica Clinic, 10 Union avenue, Jamaica Flushing, 112 Broadway, Flushing. Richmond-- Richmond Clinic, Bay and Elizabeth streets, Stapleton SANATORIUM FOR TUBERCULOSIS Otisville, Orange County, N.Y. (via Erie Railroad from Jersey City). TUBERCULOSIS HOSPITAL ADMISSION BUREAU Maintained by the Department of Health, the Department of Public Charities, and Bellevue and Allied Hospitals, 426 1st avenue. Hours 9 a.m.to 5 p.m. Telephone, 8667 Madison Square. LEGAL DUTIES OF PHYSICIANS TO THE DEPARTMENT OF HEALTH 1916 1. All physicians practising in the City of New York (Including those in public institutions) must be registered with the Department of Health. 2. An attending physician must furnish a certificate of death within thirty-six hours after the death of the patient, or, if death be due to a contagious or infectious disease, forthwith. 3. If a person dies from criminal violence, or by a casualty, or suddenly when in apparent health, or when unattended by a physician, or in prison, or in any suspicious or unusual manner, the case must be referred to a Coroner. 4. It shall be the duty of every physician to report to the Department of Health, in writing, the full name, age, and address of every person suffering from any infectious diseases within twenty-four hours of the time when the case is first seen. 5. Physicians must report births occurring in their practice within ten days after the event. 6. Every physician must preserve a duplicate record of every death and birth so reported. 7. Certificates of death will be returned for additional information which give any of the following diseases, without explanation, as the sole cause of death; Abortion, Cellulitis, Childbirth, Convulsions, Erysipelas, Gangrene, Gastritis, Haemorrhage, Meningitis, Metritis, Miscarriage, Peritonitis, Phlebitis, Pyaemia, Septicaemia, Tetanus. (Any one of these may be the result of an injury, and thus be a subject for investigation by a Coroner. If it is not, the certificate should make that fact plain.) 8. No certificate will be accepted which gives a mere sympton as the sole cause of death, such as "asphyxia," "debility," "dropsy," "heart failure," etc. unless accompanied by a satisfatory written explanation. 9. Certificates containing palpable errors of names, dates, etc., which are illegible will be returned, and a new certificate required, as no corrections, erasures, or interlineations will be permitted. (These certificates are permanent records of great legal importance, and it is necessary that they should show upon the face that they are original records and have not been tampered with.) 10. All changes of address and discontinuance of treatment on the part of their consumptive patients are to be reported promptly to the Department of Health once a month. 11. All necessary precautions must be taken to prevent the spread of the disease, e.g., isolation and quarantine in cases of cerebro-spinal meningitis, acute poliomyelitis, disinfection of typhoid excreta and of tuberculosis sputum. 12. It shall be the duty of every undertaker having notice of the death of any person within the City of New York of small-pox, diphtheria (croup), scarlet fever, yellow fever, typhus fever, plague, Asiatic cholera, measles, or any other infectious disease dangerous to the general health of the community, or of the bringing of the dead body of any person who has died of any such disease into such city, to give immediate notice thereof to this Department. No person shall retain or expose, or assist in the retention or exposure of the dead body of any such person except in a coffin or casket properly sealed; nor shall he allow any such body to be placed in any coffin or casket unless the body has been wrapped in a sheet saturated with a proper disinfecting solution, and the coffin or casket shall then be immediately and permanently sealed. No undertaker shall assist in the public or church funeral of any such person. No undertaker shall use, or cause or allow to be used, at any funeral, or in any room where the dead body of any person shall be, any draperies, decorations, rugs or carpets, belonging to or furnished by him or under his direction. 13. A public or church funeral shall not be held of any person who has died of small-pox, diphtheria (croup) scarlet fever, yellow fever, typhus fever, Asiatic cholera, measles, or plague; but the funeral of such person shall be private, and it shall not be lawful to invite, or permit at the funeral of any person who has died of any one of the above diseases, or of any infectious disease, or at any services connected therewith, any person whose attendance is not necessary, or to whom there is danger of contagion. MEDICAL SOCIETY OF NEW YORK STATE "PRINCIPLES OF MEDICAL ETHICS" (Adopted by the Medical Society of the State of New York, May 10,1906.) CHAPTER I THE DUTIES OF PHYSICIANS TO THEIR PATIENTS: Section I. Physicians should not only be ever ready to obey the calls of the sick and the injured, but should be mindful of the high character of their mission and of the responsibilities they must incur in the discharge of momentous duties. In their ministrations they should never forget that the comfort, the health, and the lives of those entrusted to their care depend on skill, attention and fidelity. In deportment they should unite tenderness, cheerfulness and firmness, and thus inspire all sufferers with gratitude, respect and confidence. These observances are the more sacred because, generally, the only tribunal to adjudge penalties for unkindness, carelessness or neglect is their own conscience. Section 2. Every patient committed to the charge of a physician should be treated with attention and humanity, and reasonable indulgence should be granted to the caprices of the sick. Secrecy and delicacy should be strictly observed; and the familiar and confidential intercourse to which physicians are admitted, in their professional visits, should be guarded with the most scrupulous fidelity and honor. Section 3. The obligation of secrecy extends beyond the period of professional services; none of the privacies of individual or domestic life, no infirmity of disposition or flaw of character observed during medical attendance, should ever be divulged by physicians, except when imperatively required by the laws of the State. The force of the obligation of secrecy is so great that physicians have been protected in its observance by courts of justice. Section 4. Frequent visits to the sick are often requisite, since they enable the physician to arrive at a more perfect knowledge of the disease, and to meet promptly every change which may occur. Unnecessary visits are to be avoided, as they give undue anxiety to the patient; but to secure the patient against irritating suspense and disappointment the regular and periodical visits of the physician should be made as nearly as possible at the hour when they may be reasonably expected by the patient. Section 5. Ordinarily, the physician should not be forward to make gloomy prognostications, but should not fail, on proper occasions, to give timely notice of dangerous manifestations to the friends of the patient; and even to the patient, if absolutely necessary. This notice, however, is at times so peculiarly alarming when given by the physician that its deliverance may often be preferably assigned to another person of good judgment. Section 6: The physician should be a minister of hope and comfort to the sick, since life may be lengthened or shortened not only by the acts but by the words or manner of the physician, whose solemn duty is to avoid all utterances and actions having a tendency to discourage and depress the patient. Section 7: The medical attendant ought not to abandon a patient because deemed incurable; for continued attention may be highly useful to the sufferer and comforting to the relatives, even in the last period of the fatal malady, by alleviating pain and by soothing mental anguish. Section 8: The opportunity which a physician has of promoting and strengthening the good resolutions of patients suffering under the consequences of evil conduct ought never to be neglected. Good counsels, or even remonstrances, will give satisfaction, not offense, if they be tactfully proffered and evince a genuine love of virtue, accompanied by a sincere interest in the welfare of the person to whom they are addressed. CHAPTER II THE DUTIES OF PHYSICIANS TO EACH OTHER AND TO THE PROFESSION AT LARGE ARTICLE I Duties for the Support of Professional Character. Section I: Every one on entering the profession, and thereby becoming entitled to full professional fellowship, incurs an obligation to uphold its dignity and honor, to exalt its standing and to extend the bounds of its usefulness. It is inconsistent with the principles of medical science and it is incompatible with honorable standing in the profession for physicians to designate their practice as based on an exclusive dogma or a sectarian system of medicine. Section 2: The physician should observe strictly such laws as are instituted for the government of the members of the profession; should honor the fraternity as a body; should endeavor to promote the science and art of medicine and should entertain a due respect for those seniors who, by their labors, have contributed to its advancement. Section 3: Every physician should identify himself with the organized body of his profession as represented in the community in which he resides. The organization of local or county medical societies, where they do not exist, should be effected, so far as practicable. Such county societies, constituting as they do the chief element of strength in the organization of the profession, should have the active support of their members and should be made instruments for the cultivation of fellowship, for the exchange of professional experience, for the advancement of medical knowledge, for the maintenance of ethical standards, and for the promotion in general of the interests of the profession and the welfare of the public. Section 4: All county medical societies thus organized ought to place themselves in affiliation with their respective State associations, and these, in turn, with the American Medical Association. Section 5: There is no profession from the members of which greater purity of character and a higher standard of moral excellence are required than the medical; and to attain such eminence is a duty every physician owes alike to the profession and to the patients. It is due to the patients, as without it their respect and confidence cannot be commanded; and to the profession, because no scientific attainments can compensate for the want of correct moral principles. Section 6: It is incumbent on physicians to be temperate in all things, for the practice of medicine requires the unremitting exercise of a clear and vigorous understanding; and in emergencies for which no physician should be unprepared a steady hand, an acute eye and an unclouded mind are essential to the welfare and even to the life of a human being. Section 7: It is incompatible with honorable standing in the profession to resort to public advertisement or private cards inviting the attention of persons affected with particular diseases; to promise radical cures; to publish cases or operations in the daily prints, or to suffer such publications to be made; to invite laymen (other than relatives who may desire to be at hand) to be present at operations; to boast of cures and remedies; to adduce certificates of skill and success, or to employ, any of the other methods of charlatans. Section 8: It is equally derogatory to professional character for physicians to hold patents for any surgical instrument or medicines; to accept rebates on prescriptions or surgical appliances; to assist unqualified persons to evade the legal restrictions governing the practice of medicine; or to dispense, or promote the use of, secret medicines, for if such nostrums are of real efficacy, any concealment regarding them is inconsistent with beneficence and professional liberality, and of mystery alone gives them public notoriety, such craft implies either disgraceful ignorance or fraudulent avarice. It is highly reprehensible for physicians to give certificates attesting the efficacy of secret medicines, or other substances used therapeutically. ARTICLE II Professional Services of Physicians to Each Other. Section I Physicians should not, as a general rule, undertake the treatment of themselves, nor of members of their family. In such circumstances they are peculiarly dependent on each other; therefore, kind offices and professional aid should always be cheerfully and gratuitously afforded. These visits ought not, however, to be obtrusively made, as they may give rise to embarrassment or interfere with that free choice on which such confidence depends. Section 2: All practising physicians and their immediate family dependents are entitled to the gratuitous services of any one or more of the physicians residing near them. Section 3: When a physician is summoned from a distance to the bedside of a colleague in easy financial circumstances, a compensation, proportionate to traveling esxpenses and to the pecuniary loss entailed by absence from the accustomed field of professional labor, should be made by the patient or relatives. Section 4: When more than one physician is attending another, one of the number should take charge of the case, otherwise the concert of thought and action so essential to wise treatment cannot be assured. Section 5: The affairs of life, the pursuit of health, and the various accidents and contingencies to which a physician is peculiarly exposed sometimes require the temporary withdrawal of this physician from daily professional labaor and the appointment of a colleague to act for a specified time. The colleague's compliance is an act of courtesy which should always be performed with the utmost consideration for the interest and character of the family physician. ARTICLE: III The Duties of Physicians In Regard To Consultations. Section 1 The broadest dictates of humanity should be obeyed by physicians whenever and wherever their services are needed to meet the emergencies of disease or accident. Section 2: Consultations should be promoted in difficult cases, as they contribute to confidence and more enlarged views of practice. Section 3: The utmost punctuality should be observed in the visits of physicians when they are to hold consultations, and this is generally practicable, for society has been so considerate as to allow the plea for a professional engagement to take precedence over all others. Section 4: As professional engagements may sometimes cause delay in attendance, the physician who first arrives should wait for a reasonable time, after which the consultation should be considered as postponed to a new appointment. Section 5: In consultations no insincerity, rivalry or envy should be indulged; candor, probity and all due respect should be observed toward the physician in charge of the case. Section 6: No statement or discussion of the case should take place before the patient or friends, except in the presence of all the physicians attending, or by their common consent; and no opinions or prognostications should be delivered which are not the result of previous deliberations and concurrence. Section 7: No decision should restrain the attending physician from making such subsequent variations in the mode of treatment as any unexpected change in the character of the case may demand. But at the next consultation reasons for the variations should be stated. The same privilege, with its obligation, belongs to the consultant when sent for in an emergency during the absence of the family physician. Section 8: The attending physician, at any time, may prescribe for the patient; not so the consultant, when alone, except in a case of emergency or when called from a considerable distance. In the first instance the consultant should do what is needed, and in the second should do no more than make an examination of the patient and leave a written opinion, under seal, to be delivered to the attending physician. Section 9: All discussions in consultation should be held as confidential. Neither by words nor by manner should any of the participants in a consultation assert or intimate that any part of the treatment pursued did not receive his assent. Section 10: It may happen that two physicians cannot agree in their views of the nature of a case and of the treatment to be pursued. In the event of such disagreement a third physician should, if practicable, be called in. None but the rarest and most exceptional circumstances would justify the consultant in taking charge of the case. He should not do so merely on the solicitation of the patient or friends. Section 11: A physician who is called in consultation should observe the most honorable and scrupulous regard for the character and standing of the attending physician, whose conduct of the case should be justified, as far as can be, consistently with a conscientious regard for truth, and no hint or insinuation should be thrown out which would impair the confidence reposed in the attending physician. ARTICLE IV: Duties of Physicians In Cases Of Interference. Section 1: Medicine being a liberal profession, those admitted to its ranks should found their expectations of practice especially on the character and the extent of their medical education. Section 2: The physician, in the intercourse with a patient under the care of another physician, should observe the strictest caution and reserve; should give no disingenuous hints relative to the nature and treatment of the patient's disorder; nor should the course of conduct of the physician, directly or indirectly, tend to diminish the trust reposed in the attending physician. Section 3: The same circumspection should be observed when, from motives of business of friendship, a physician is prompted to visit a person who is under the direction of another physician. Indeed, such visits should be avoided, except under peculiar circumstances, and, when they are made no inquiries should be instituted relative to the nature of the disease, or the remedies employed, but the topics of conversation should be as foreign to the case as circumstances will admit. Section 4: A physician ought not to take charge of , nor prescribe for, a patient who has recently been under the care of another physician, in the same illness, except in case of a sudden emergency, or in consultation with the physician previously in attendance, or when that physician has relinquished the case or has been dismissed in due form. Section 5: The physician acting in conformity with the preceding section should not make damaging insinuations regarding the practice previously adopted, and, indeed, should justify it if consistent with truth and probity; for it often happens that patients become dissatisfied when they are not immediately relieved, and, as many diseases are naturally protracted, the seeming want of success, in the first stage of treatment, affords no evidence of a lack of professional knowledge or skill. Section 6: When a physician is called to an urgent case, because the family attendant is not at hand, unless assistance in consultation is desired, the former should resign the care of the patient immediately on the arrival of the family physician. Section 7: It often happens, in cases of sudden illness, and of accidents and injuries, owing to the alarm and anxiety of friends, that several physicians are simultaneously summoned. Under these circumstances, courtesy should assign the patient to the first who arrives, and who, if necessary, may invoke the aid of some of those present. In such cases, however, the acting physician should request that the family physician be called, and should withdraw unless requested to continue in attendance. Section 8: Whenever a physician is called to the patient of another physician during the enforced absence of that physician, the case should be relinquished on the return of the latter. Section 9: A physician, while visiting a sick person in the country, may be asked to see another physician's patient because of a sudden aggravation of the disease. On such an occasion the immediate needs of the patient should be attended to and the case relinquished on the arrival of the attending physician. Section 10: When a physician who has been engaged to attend an obstetric case is absent and another is sent for, delivery being accomplished during the vicarious attendance, the acting physician is entitled to the professional fee, but must resign the patient on the arrival of the physician first engaged. ARTICLE V: Differences Between Physicians Section 1. Diversity of opinion and opposition of interest may, in the medical as in other professions, sometimes occasion controversy and even contention. Whenever such unfortunate cases occur and cannot be immediately adjusted, they should be referred to the arbitration of a sufficient number of impartial physicians. Section 2: A peculiar reserve must be maintained by physicians toward the public in regard to some professional questions, and as there exist many points in medical ethics and etiquette through which the feelings of physicians my be painfully assailed in their intercourse, and which cannot be understood or appreciated by general society, neither the subject-matter of their differences nor the adjudication of the arbitrators should be made public. ARTICLE VI: Compensation Section 1. By the members of no profession are eleemosynary services more liberally dispensed than by the medical, but justice requires that some limits hould be placed to their performance. Poverty, mutual professional obligations, and certain of the public duties named in Sections 1 and 2 of Chapter III should always be recognized as presenting valid claims for gratuitous services; but neither institutions endowed by the public or by the rich, or by societies for mutual benefit, for life insurance, or for analogous purposes, nor any profession or occupation can be admitted to possess such privilege. Section 2: It cannot be justly expected of physicians to furnish certificates of inability to serve on juries, or to perform militia duty; to testify to the state of health of persons wishing to insure their lives, obtain pensions, or the like, without due compensation, but to persons in indigent circumstances such services should always be cheerfully and freely accorded. Section 3: Some general rules hould be adopted by the physicians in every town or district relative to the minimum pecuniary acknowledgment 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. Section 4: It is derogatory to professional character for physicians to pay or offer to pay commissions to any person whatsoever who may recommend to them patients requiring general or special treatment or surgical operations. It is equally derogatory to professional character for physicians to solicitor to receive such commissions. CHAPTER III. THE DUTIES OF THE PROFESSION TO THE PUBLIC. Section 1. As good citizens it is the duty of physicians to be very vigilant for the welfare of the community, and to bear their part in sustaining its laws, institutions and burdens; especially should they be ready to co-operate with the proper authorities in the administration and the observance of sanitary laws and regulations, and they should also be ever ready to give counsel to the public in relation to subjects especially appertaining to their profession, as on questions of sanitary police, public hygiene and legal medicine. Section 2: It is the province of physicians to enlighten the public in regard to quarantine regulations; to the location, arrangement and dietaries of hospitals, asylums, schools, prisons and similar institutions; in regard to measures for the 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 people, even at the risk of their own lives. Section 3: Physicians, when called on by legally constituted authorities, should always be ready to enlighten inquests and courts of justice on subjects strictly medical, such as involve questions relating to sanity, legitimacy, murder by poison or other violent means, and various other subjects embraced in the science of medical jurisprudence. It is but just, however, for them to expect due compensation for their services. Section 4: It is the duty of physicians, who are frequent witnesses of the great wrongs committed by charlatans, and of the injury to health and even destruction of life caused by the use of their treatment, to enlighten the public on these subjects, and to make known the injuries sustained by the unwary from the devices and pretensions of artful impostors. Section 5: It is the duty of physicians to recognize and by legitimate patronage to promote the profession of pharmacy, on the skill and proficiency of which depends the reliability of remedies, but any pharmacist who, although educated in his own profession, is not a qualified physician, and who assumes to prescribe for the sick, ought not to receive such countenance and support. Any druggist or pharmacist who dispenses deteriorated or sophisticated drugs or who substitutes one remedy for another designated in a prescription ought thereby to forfeit the recognition and influence of physicians. This completes the total transcribing of "Principles of Medical Ethics." as listed in its entirety on Pages: 685-689 of the Medical Directory of New York, New Jersey and Connecticut-1916. Source: The Medical Directory of New York, New Jersey and Connecticut Publisher: The Medical Society of the State of New York Volume XVIII Copyright: 1916 Transcribed by Miriam Medina RETURN to PROFESSIONAL MAIN

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