Third-The separation of regular from irregular practitioners. Fourth-The association of the profession proper for purposes of mutual recognition and fellowship. Art. III. The members shall be graduates of a recognized regular medical college, and shall be in good moral and professional standing. They shall be proposed in writing, at a regular meeting by two members of the Association, and may be elected by a majority vote at any subsequent meeting. Art. IV. No empirical or irregular practitioner nor any practitioner who shall consult with or recognize professionally any such irregular practitioner shall either be admitted to or retained in the membership of this Association. Art. V. The officers of this Association shall consist of a President, VicePresident, Treasurer and Secretary, who shall be elected semi-annually at the first meetings in January and July of each year by a majority vote of the members present. No member shall be eligible to the office of President for two successive terms. Art. VI. There shall be a Board of Censors consisting of three, appointed semi-annually by the President. Art. VII. The Association hereby reserves the right of punishing violations of its regulations with the concurrent vote of three-fourths of the members present at any regular meeting by reprimand, suspension or expulsion, and no member who shall have been expelled shall be again admitted to membership. Any member who shall have removed permanently from the county, shall be considered as having vacated his membership, and his certificate at any time thereafter may be recalled. Amendment. (See proceedings of meeting March 7, 1871.) Art. VIII. Any regular physician in good standing may be made an honorary member of the Association under the same rules of election as regular members. Honorary members shall have the privilege of taking part in all medical discussions, but shall have no vote or voice in the business of the Association and shall be subject to no dues or fines. BY-LAWS. Article I. This Association adopts the code of medical ethics of the American Medical Association and it shall be read by the Secretary at the meetings of January and July of each year. Art. II. The stated meetings of the Association shall be on the first Tuesday evening in each month. Special meetings may be called at any time by the President on the written request of five members. (A majority of all members of the Association shall constitute a quorum.) Art. III. The President, or in his absence, the Vice-President, shall preside at the meetings, and enforce the rules of order, appoint all committees not otherwise provided for, give the casting vote in case of a tie, and perform such other duties as his position requires. The fee bill which was referred to in the meeting of March 7, 1871, is likewise worthy of record: FEE BILL OF THE LOS ANGELES COUNTY MEDICAL ASSOCIATION. Adopted March 7, 1871. Miscellaneous. For each visit during daytime, $3 to $5. For each visit during nighttime, $5. Additional patients in same family, each $2. In cases of extraordinary service, detention, or attendance, or when for any reason the case is one of unusual importance of responsibility, the charge should be proportionately; and the duty to make such increased charge shall be obligatory upon the practitioner. For a visit in consultation, $5 to $10. In case of a consultation the attending physician may also charge the usual consultation fee for an ordinary visit. For each subsequent visit in consultation where the attendance is continuous, the fee may be from $3 to $5. For visits over three miles from town, $1 to $2 per mile additional. For advice at home or office, from $2.50 to $10. For an opinion involving a question of law in which the physician may be subpoenaed, $5 to $10. In case of an opinion involving special study or experimental investigation, such additional service shall be charged in proportion to the time and labor expended. For a post-mortem examination made at the request of friends of deceased, from $25 to $50. For a post-mortem in case of legal investigation, $100 to $500. Vaccination, $2.50. Gonorrhoea or syphilis, fee in advance $25 to $50. Obstetrics. Ordinary midwifery cases, $25 to $50. Delivery by turning or forceps, additional $25 to $50. Delivery by embryotomy, $100 to $300. Attendance after ninth day, ordinary rates. For attendance during tedious labor, it shall be considered obligatory to make such additional charges as in the discretion of the practitioner the extraordinary detention of service shall seem to demand. In cases of labor, when the child is born, but not the placenta, before the arrival of the accoucheur, the whole fee is to be charged. When both child and placenta are born before the arrival of the accoucheur, half or the whole fee bill may be charged according to circumstances. This rule is intended to apply to cases in which the services of the accoucheur have been previously engaged, and in which the delay does not arise from his fault. If in any case of labor a second physician is called in consultation and subsequently detained in joint attendance, both attending and consulting physicians shall be entitled to the full fee for attendance and also to such additional amount as may be deemed proper, in view of the importance of the case, the unseasonableness of the hour, or any extraordinary detention of service rendered. Surgery. For capital operations, or operations of unusual difficulty, such as amputation of large limbs; ligation of large arteries; operations for stone in the bladder; removal of breasts; or of other large tumors; operations for cataract; for strangulation of the hernia; for vesicovaginal fistula; for cleft palate, etc., $100 to $500, according to the importance of the case and pecuniary eir cumstances of the patient. For operations of secondary importance or difficulty, such as operations. for fistula-in-ano; for hare-lip; for the radical cure of hydrocele; tapping and injection of ovarian cysts; reduction of dislocation or fractures of large bones; tracheotomy; removing of small tumors, not involving important organs; ligature of arteries of secondary size; passing catheter in case of obstructions, etc., $25 to $100. For minor operations, such as excision of tonsils, removal of nasal polypi ; tapping in hydrocele or for ascites; opening abscesses, catheterism, stitching recent wounds, cupping, passing setins, amputation of fingers or toes, excision of wens, etc., $5 to $25. After surgical operations, all subsequent visits shall be charged as in ordinary cases of attendance. Any case not specified in the foregoing per table, to be charged at rates as nearly corresponding to the list of prices as practicable. Nothing here stated shall be construed to prevent any physician or surgeon from charging more than the usual rates in any case where a due regard for equity may seem to demand such an increase in price. * For some time after the Society came into existence it was the custom for each new member to sign his name with that of the college from which he graduated in the minute book of the Association. Page 5 of the original minute book contains the following very interesting list: At the meeting on January 4, 1876, the regulation of the practice of medicine was taken up: After a general discussion of the Society of the bill for the "Regulation of the Practice of Medicine," proposed by the State Board of Health, and now before the State Legislature, upon motion of Dr. Hoffman, the Association vote endorsed said bill, and directed the Secretary to so notify the Secretary of the State Board of Health, and the Representatives of Los Angeles county. And at the meeting of February 1, 1876, the following reference is made to the sanitary condition of the city and to the need of a Board of Health and Health Officer: "Upon motion of J. P. Widney, a committee of three was appointed to draw up a communication to the City Council upon the sanitary condition of the city, and urging the importance of establishment of a Board of Health, and an appointment of a Health Officer; the statement to be presented to the Medical Society at next meeting, subject to its approval and order. "President appointed as said committee J. P. Widney, H. S. Orme and J. H. McKee.' At the next meeting, held on February 15th, the following reference was made to the same subject: "Report of committee appointed at meeting of February 1st, to draw up a communication to City Council upon need of a "Board of Health," was received. Communication as drafted by committee was adopted, and by vote was ordered to be sent to City Council. "Same committee was continued and instructed to inquire into the State law upon the subject of 'Boards of Health' for cities." # According to the minutes April 4, 1876, there must have been malarial fever in Southern California, for the minutes of that meeting contain these particulars: "General discussion of the Society upon the peculiarities of malarial fevers manifested in this locality. Also upon the anti-malarial virtues of the eucalyptus tree." The efforts of the committee appointed to petition the Council to provide a Board of Health resulted in the following action being taken at the meeting of June 1, 1876: "In accordance with request of the Public Health Committee of the City Council that the Los Angeles County Medical Association should designate some suitable and competent person for the position of City Health Officer, the Association, upon third ballot, selected Dr. J. H. McKee. "Upon motion, the Secretary was directed to certify such action to the Health Committee of the City Council." The State law of California providing for a definite mode of procedure regarding dissection material, the Association, at its meeting of January 2, 1887, passed the following resolution: "Upon motion, the Secretary was directed to give to Dr. Barton a certificate that 'He is a person properly entitled to have in his possession a dead body for purpose of dissection," as specified by the California State law upon that subject. At the meeting of February 6, 1887, in a discussion of irregular practitioners, it was moved and seconded, "That the members of this Association, as individuals, report to the Secretary the names of irregular practitioners, known by them to be practicing medicine and surgery within the county limits contrary to law, and that he is hereby instructed to report the same in his official capacity to the District Attorney and urge the prosecution of the same. At the same meeting, “On motion, a ‘Committee on Ethics' was appointed, of which the President was to be the chairman, who were requested to present a report at the next meeting of the Association, in which they were to recommend such measures for the prevention of irregularities in the conduct of mem bers as are called for by the publication in the daily prints of cards calling attention to specialties, etc., the sending of matter through the mails, having reference to removals, etc., the publication of articles in the press signed by the title of M.D., the placing of signs, etc., in places other than the office or residence of the practitioner, and such other matters as in their judgment require attention. The committee as appointed consists of the following gentlemen: Chairman, the President, Dr. Widney; Dr. Orme, Dr. McKee and Dr. Barton. At the meeting of March 1, 1878, in a report of cases, it is stated that Dr. Joseph Kurtz reported the birth of a child weighing a little over 18 pounds. Delivery was performed by craniotonomy and the use of great traction. Several other interesting cases were presented. The Secretary reported receipts of the evening $12. * At the meeting of May 3, 1878, it is written that "Dr. J. Kurtz moved that a committee be appointed to prepare a blacklist to contain the names of practitioners with whom the members of the Society would not consult. Carried. "Drs. Kurtz, McGuire and Widney appointed as committee. "Dr. McGuire presented the following resolution, that was carried unanimously: "We, the members of the Los Angeles County Medical Association, urgently request as a special favor that neither the editors nor the local reporters of the daily and weekly papers of this city will permit any of our names to appear in connection with any accident or surgical operation or private professional matter in which we may be engaged. Such publication being in direct violation of the code of medical ethics adopted by the American Association and of the by-laws of our local Society. Minutes of June 7, 1878, contain the following reference to a seal for the Association: "Dr. Kurtz for the Committee on Seal reported in favor of a seal bearing the name of the Association, the date of its organization and the motto 'Scientia et Honos.' Report accepted, adopted and committee discharged. Secretary ordered to procure seal in accordance. "By the unanimous vote of the Association, Dr. was placed on the blacklist, thus prohibiting any member from consulting with him on pain of expulsion.' At the meeting of March 7, 1879, a new fee bill was established: "Night visit, $5. "Extraordinary time, service or responsibility, extra charge. CONSULTATIONS. "First consultation, $5 to $10. "Subsequent consultations, $3 to $5. "Attending physicians the same. "Advice at office, $2 to $10. "Visits in the country, $1 for each additional mile over two. "Opinion involving question of law, $50 to $100. "Post-mortem examination, $25 to $50, but if for legal investigation, $100 to $200. "Vaccination, $1. "Gonorrhoea or syphilis, $25 to $50 in advance. |