physician can never be supported as an exclusively beneficent one; and it is defrauding, in some degree, the common funds for its support, when fees are dispensed with which might justly be claimed.

SEC. 10. When a physician who has been engaged to attend a case of midwifery is absent, and another is sent for, if delivery is accomplished during the attendance of the latter, he is entitled to the fee, but should resign the patient to the practitioner first engaged.

ART. VI.-OF 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 cases unfortunately occur, and cannot be immediately terminated, they should be referred to the arbitration of a sufficient number of physicians, or a court-martial.

SEC. 2. As a peculiar reserve must be maintained by physicians, towards the public, in regard to professional matters, and as there exist numerous points in medical ethics and etiquette, through which the feelings of medical men may be painfully assailed in their intercourse with each other, and which cannot be understood or appreciated by general society, neither the subject-matter of such differences, nor the adjudication of the arbitrators, should be made public, as publicity in a case of this nature may be personally injurious to the individuals concerned, and can hardly fail to bring discredit upon the faculty.

ART. VII-OF PECUNIARY ACKNOWLEDGMENTS.

Some general rules should be adopted by the faculty, in every town or district, relative to pecuniary acknowledgments 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.

Of the Duties of the Profession to the Public, and of the Obligations of the Public to the Profession.

ART. I.-DUTIES OF THE PROFESSION TO THE PUBLIC.

SECTION 1. As good citizens, it is the duty of physicians to be ever vigi. lant for the welfare of the community, and to bear their part in sustaining its institutions and burdens; they should also be ever ready to give counsel to the public, in relation to matters especially appertaining to their profession, as on subjects of medical police, public hygiene, and legal medicine. It is their province to enlighten the public in regard to quarantine regulations—the location, arrangement, and dietaries of hospitals, asylums, schools, prisons, and similar institutions-in relation to the medical police of towns, as drainage, ventilation, etc-and 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 suffering, even at the jeopardy of their own lives.

SEC. 2. Medical men should also be always ready, when called on by the legally constituted authorities, to enlighten coroners' inquests, and courts of justice, on subjects strictly medical-such as involve questions relating to sanity, legitimacy, murder by poisons or other violent means, and in regard to the various other subjects embraced in the science of medical jurisprudence. But in these cases, and especially where they are required to make post-mortem examination, it is just, in consequence of the time, labor, and skill required, and the responsibility and risk they incur, that the public should award them a proper honorarium.

SEC. 3. There is no profession, by the members of which, eleemosynary services are more liberally dispensed, than the medical, but justice requires that some limit should be placed to the performance of such good offices. Poverty,

108

PRACTICAL DIRECTIONS FOR CLINICAL URINALYSIS.

professional brotherhood, and certain of the public duties referred to in the first section of this article, should always be recognized as presenting valid claims for gratuitous services; but neither institutions endowed by the public or by rich individuals, societies for mutual benefit, for the insurance of lives or for analogous purposes, nor any profession or occupation, can be admitted to possess such privilege. Nor can it be justly expected of physicians to furnish certificates of inability to serve on juries, to perform militia duty, or to testify to the state of health of persons wishing to insure their lives, obtain pensions, or the like, without a pecuniary acknowledgment. But to individuals in indigent circumstances, such professional services should always be cheerfully and freely accorded.

SEC. 4. It is the duty of physicians, who are frequent witnesses of the enormities committed by quackery, and the injury to health, and even destruction of life caused by the use of quack medicines, to enlighten the public on these subjects, to expose the injuries sustained by the unwary from the devices and pretensions of artful empirics and impostors. Physicians ought to use all the influence which they may possess, as professors in colleges of pharmacy, and by exercising their option in regard to the shops to which their prescriptions shall be sent, to discourage druggists and apothecaries from vending quack or secret medicines, or from being in any way engaged in their manufacture or sale. ART. II-OBLIGATIONS OF THE PUBLIC TO PHYSICIANS.

SECTION 1. The benefits accruing to the public, directly and indirectly, from the active and unwearied beneficence of the profession, are so numerous and important, that physicians are justly entitled to the utmost consideration and respect from the community. The public ought likewise to entertain a just appreciation of medical qualifications; to make a proper discrimination between true science and the assumptions of ignorance and empiricism-to afford every encouragement and facility for the acquisition of medical education -and no longer to allow the statute-books to exhibit the anomaly of exacting knowledge from physicians under a liability to heavy penalties, and of making them obnoxious to punishment for resorting to the only means of obtaining it. [Adopted by the American Medical Association, May, 1847.]

PRACTICAL DIRECTIONS FOR CLINICAL URINALYSIS.

W. S. Haines, M.D., Professor of Chemistry in Rush Medical College, has furnished, by request, the following condensed method of Clinical Urinalysis.

I. HEALTHY URINE.-Should be clear, color varying from light straw to light brown; odor agreeable; quantity, varying with perspiration, etc., but about 40 oz. per diem. The reaction is usually slightly acid, may be neutral or slightly alkaline during digestion; (violet colored litimus paper is turned red by acid, blue by alkaline, and not affected by neutral urine.) Specific gravity varies between 1,015 and 1,030-the less urine the greater the sp. gr.

N. B. Urine may contain a deposit; the most frequent being Urates, Phosphates, Uric Acid, and Pus.

II. URATES.-Unhealthy urine is frequently more or less turbid when cool. If the turbidity or deposit, on heating a couple of drachms in a test tube, disappears there is present A LITHATE, or as is now more generally called A URATE. The deposit is usually pinkish red.

III. PHOSPHATES.-The turbidity may exist even when just passed in the form of a white flocculent deposit, a couple of drachms of which will immedi

PRACTICAL DIRECTIONS FOR CLINICAL URINALYSIS.

109

ately clear up on the addition of five or six drops of acetic acid; the deposit is A PHOSPHATE, and the urine will generally be found alkaline or neutral.

IV. URIC ACID.-A deposit resembling grains of red sand consists of URIC (formerly called lithic) ACID.

V. Pus.-The sediment may hang together and the urine be either acid or alkaline; PUS is probably present. Add to a little of the deposit,five or ten drops of liquor potassæ; if pus is present it will become gelatinous and ropy, which is more manifest as the mixture is dropped from the test tube.

N. B. Whether a deposit is present or not, the urine may hold in solution certain foreign substances, the most frequent being Albumen, Sugar, Blood, and Biliary Coloring Matter.

VI. ALBUMEN.-The specific gravity of albuminous urine is generally low. Allow gently to trickle down the sides of a test tube, containing about two drachms of the suspected urine, thirty or forty minims of nitric acid, holding the tube inclined at an angle of about forty-five degrees. The acid, being the heavier, will sink to the bottom of the test tube, the urine floating above it; if any ALBUMEN be present, an opaque layer will appear at the junction of the urine with the acid, which does not clear up on the application of a gentle heat. N. B.-If there be a deposit, use for the above test the clear urine decanted from the sediment.

VII. SUGAR.-The sp. gr. of saccharine urine is usually high.

Dissolve the sulphate of copper and glycerine in a portion of the water and the caustic potassa in the remainder; mix the two solutions, when a perfectly clear, transparent, dark blue liquid should result, which may be bottled and set aside for use. As usually made, it generally throws down a slight reddish deposit upon standing a week or two. This, however, does not affect its value as a test. In using, simply decant the clear liquid from the sediment.

DIRECTIONS FOR USE.-Take about one drachm of test solution and gently boil it, when no change should take place; now add ten or fifteen drops of suspected urine and again warm; if sugar be present an abundant red or yellowish red precipitate is thrown down; if no such red or yellowish red precipitate appears, no sugar is present.

N. B.-A white flocculent deposit, often thrown down, consists of phos. phates, and does not indicate sugar.

A few drops of honey, dissolved in an ounce of urine, produces an artificially saccharine urine, which may advantageously be employed by the beginner to learn the exact reaction produced by diabetic urine in the above

test.

VIII. BLOOD.-Take of tincture of quaiac and spt. of turpentine, each half a drachm; shake into an emulsion; then let about an equal quantity of the suspected urine trickle down the sides of the test tube, inclined at an angle of 45 degrees, and allow it to stand for a few moments The urine being the heavier sinks to the bottom of the test tube, while the emulsion floats upon it; if blood be present, a distinct bluish layer will appear between the two, while if blood be absent, the layer will be of a dirty yellow.

IX. BILIARY COLORING MATTERS.-Proceed exactly as directed above in testing for albumen by nitric acid. If biliary matters be present a play of green and blue colors will appear at the junction of the urine with the acid; if biliary matters be absent, a cherry tint of greater or less intensity will usually appear, from the decomposition of the normal coloring matter of the urine.

MEDICAL SOCIETIES.

AMERICAN MEDICAL SOCIETY. Meets annually. Next meeting will be held at Buffalo.

N. the first in June, 1878.

Officers for 1877-18-President, F. G Richardson, of Louisiana; Permanent Secretary, W. B. Atkinson, 1400 Pine street, Philadelphia; Assistant Secretary, E. W. Bush, Buffalo, N. Y.

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MERICAN PUBLIC HEALTH ASSOCIATION.-Meets annually. Next meeting at White sulphur Springs, Va., in August. 1878.

Officers for 1877-78-President, Elisha Harris, M. D., New York; Secretary, E. H. James. New York.

AMERICAN NEUROLOGICAL ASSOCIATION Meets at

Officers for 1877-78-President, J. S. Jewell, M.D., Chicago: Corresponding Secretary, J. J. Mason, M.D., New York; Recording Secretary, E. C. Seguin, M.D., New York.

ILLINOIS STATE MEDICAL SOCIETY, Meets annually on third Tuesday in May. Next place of meeting, Springfield. Committee of Arrangements--B. M. Griffith, J. Townsend, and A. A. Patterson, all of Springfield.

Officers for 1877-78-President, J. L. White, of Bloomington; Secretary, N. S Davis, Chicago; Assistant Secretary, H. B. Buck, Springfield.

CENTRAL ILLINOIS MEDICAL SOCIETY -Meets semi-annually (place designated at

each meeting), first Tuesday in May and November. Number of members 87. Officers for 1877-78-S. H. Birney, M.Ď., Urbana; Secretary, W. G. Cochran, Farmer City. ENTENNIAL MEDICAL SOCIETY.-Meets semi-annually (place designated at each meeting) second Wednesday in May and November. Officers for 1877 78-President-D. Schroeder, M D. Flora: Secretary, N. S. Marshail, M.D., Olney.

ENTRAL ILLINOIS DISTRICT MEDICAL SOCIETY.-Meets semi-annually at Pana, last Tuesday in October and April. Officers for 1877-78-President, F. B. Haller, M.D., Vandalia; Secretary, W. H. Cook, Hillsboro.

RIVER VALLEY MEDICAL ASSOCIATION.-Meets quarterly (place designated at Officers for 1877-78-President, F. H. Blackman, M.D., Geneva; Secretary and Treasurer, M. M. Robbins, M.D., Aurora.

Feach meeting), first Monday of January, pril, July, and October. Number of members, 41.

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LLINOIS AND IOWA CENTRAL DISTRICT MEDICAL ASSOCIATION.-Meets quarterly, on second Thursday in January, April, July, and October. Number of members, 54. Officers for 1877-78.-President, C. Truesdal, Rock Island; Secretary, Geo. L. Eyster, Rock Island.

LIVINGSTON DISTRICT MEDICAL ASSOCIATION.-Meets monthly (place designated

at each meeting), first Wednesday of each month.

Officers for 1877-78.-President, E. P. G. Holderness, M.D., Chenoa; Secretary, S. A. Dunham. M.D., Forest..

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ILITARY TRACT MEDICAL SOCIETY.-Meets semi-annually. Number of members. 106. Officers for 1877-78-President. A. V. T. Gilbert, M.D., Monmouth; Secretary and Treas urer, L. S. Lambert, M.D., Galesburg.

NORTH CENTRAL MEDICAL ASSOCIATION-Meets annually, at Wenon", first Tues

day in December. Number of members, 20.

Officers for 1877-78-President, A. Reynolds, M.D., El Paso; Secretary and Treasurer. Frederick Cole. M.D., El Paso.

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OUTHERN ILLINOIS MEDICAL ASSOCIATION.-Meets semi-annually-third Wednesday in January at Belleville; third Wednesday in June at Chester. Number of members, 58. Officers for 1877-78-President, L. Dyer, M.D., DuQuoin: Secretary, C. W. Dunning, M.D., Cairo; Assistant Secretary, A. N. Lodge, M.D., Marion.

ADAMS COUNTY MEner. In & PCIETY. Meets quarterly at Quincy, second Monday in

May, August, November, and February. Number of members, 45.

Officers for 1877-78-President, Wm. A. Byrd, M.D., Quincy; Secretary, L. H. Cohen, M.D., Quincy.

HAMPAIGN COUNTY MEDICAL SOCIETY.-Meets semi-annually (place designated at each meeting), second Tuesday in May and February. Number of members, 24. Officers for 1877-78-President. W. M. Goodwin, M.D., Urbana; Secretary, L. S. Wilcox, M.D., Champaign.

Cath Clark street, on second and fourth Monday evening of each mouth.
CHICAGO SOCIETY OF PHYSICIANS AND SURGEONS.-Meets semi-monthly at 188
Officers for 1877-78-President, W. H. Byford, M.D.; Secretary and Treasurer, Ed. Warren
Sawyer, M.D.

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HICAGO MEDICO-HISTORICAL SOCIETY.-Meets on
October and January.

last Tuesday of April, July,

Officers for 1877-78-Přesident, W. G. Dyas, M.D.; Secretary, P. S. Hayes, M.D.,

HICAGO MEDICAL SOCIETY.-Organized 1852. Meets semi-monthly at Washingtonian
Home, first and third Monday evenings of each month.
Officers for 1877-78-President, E. Ingals, M.D.; Secretary, D. W. Graham, M.D.

DEC

ECATUR MEDICAL SOCIETY.-Meets monthly at Decatur, on the fourth Thursday (2 P.M.,) of each month. Number of members, 18.

Officers for 1877-78-G. S. Allison, M.D., Mt. Zion; Secretary and Treasurer, A. Robertson Small, M.D., Decatur.

DEWITT COUNTY MEDICAL SOCIETY. Meets quarterly at Clinton on the 1st Tuesday

of January, April, July and October. Number of members, 15.

Officers for 1877-73-President, J. J. Starkey, M.D., Waynesville; Secretary, C. Goodbrake, M.D., Clinton.

GREEN COUNTY MEDICAL SOCIETY-Meets

Officers for 1877-78--President, C. P. Clemmons, M.D., Carrollton; Vice-President, Thomas McEnen, M.D., Road House Station.

AMILTON COUNTY MEDICAL SOCIETY.-Meets at

Number of members, 14.

H Officers for 1877-78-President, A. M. Brumbaugh, M.D., Dahlgreen; Secretary, W. F.

Hall, M.D., McLeansboro.

HANCOCK COUNTY MEDICAL SOCIETY.-Meets semi-annually at Carthage, on the 1st

Monday and

Officers for 1877-78-President, A. Spitler, M.D., Carthage; Secretary, J. J. Reaburn, M.D., Denver.

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ASPER COUNTY MEDICAL ASSOCIATION.-Meets monthly at Newton on the 1st Friday of each month. Number of members, 9. O.Hicers for 1877-78--President, P. S. McLaughlin, M.D., Newton; Secretary, A. B. Faller, M.D., Newton.

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ERSEY COUNTY MEDICAL SOCIETY.-Meets at on the 1st Tuesday of each month. Officers for 1877-78 --President, H. Z. Gill, M.D., Jerseyville; Secretary, A. K. Van Horn. M.D., Jerseyville.

OHNSON COUNTY MEDICAL SOCIETY.-Meets quarterly at on the 1st Monday evening of January, March, June and September. Number of members, 10. Officers for 1877-78-President, W. A. Looney, M.D., Vienna; Secretary, N. J. Benson, M.D., Vienna.

Mondays in May, August, November and February. Number of members, 14. Officers for 1877-78-President, H. A. Stokes, M.D., Chebanse; Secretary, B. Franklin Uran, M.D., Kankakee.

COUNTY MEDICAL SOCIETY at Kankakee on the 1st

MADISON COUNTY MEDICAL SOCIETY-Meets semi-annually. Annual meeting at

Edwardsville on the 1st Monday in May. Semi-annual meeting at Alton on the 1st Monday in November. Officers for 1877-78-President, A. M. Powell, M.D., Collinsville; Secretary, J. Maclay Armstrong, M.D., Edwardsville.