duly registered and reported to them by the local regis-
trars. And if any such births not heretofore registered,
shall come to their notice, then they shall immediately
fill out a certificate of birth, as required by this act,
signing the certificate as supervisor or assessor as the
case may be, and shall file the same with the local regis-
trar, together with a statement of the name and address
of the physician, midwife, or person responsible for fail-
ure to file the certificate of birth immediately after birth,
as required by this act, and for each added certificate of
birth, duly and properly filled out and filed with the
local registrar, the supervisor or assessor shall be en-
titled to twenty-five cents, to be paid by the county
treasurer upon warrant from the Secretary of State in
the same manner as to other informants. And it shall
be the duty of the Secretary of State to investigate su:h
cases and to prosecute wilful or repeated violations of
this act
Sec. 9. Each physician, midwife, father of the child,
householder or owner of the premises, manager or super-
intendent of public or private institution, or other person
acting as informant and filing with the local registrar
within three days after the birth of a child a proper
certificate of birth, correctly and legibly made out in
permanent black ink and containing all the i;ems re-
quired by Section Three of this Act, shall be entitled to
be paid the sum of twenty-five cents. Only one certificate
shall be received for the birth of the same child, the
right to file the certificate of birth being the same as the
order of responsibility for filing the certificate as given
above and in Section One of this Act Certificates in
which certain items are omitted, including the given or
christian name of the child, shall be regarded as incom-
plete, and shall not be entitled to payment, unless the
missing information, when possible to obtain, is promptly
supplied. All amounts payable to any informants enti-
tled to compensation under this section for all certifi-
cates of births occurring during any calendar year shall
be payable by the treausrer of the county in which the
district of registration was located upon presentation of
warrants issued by the Secretary of State as soon as
practicable after the close of the calendar year, specify-
ing the number of certificates filed by each informant
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314
39th ANNUAL MEETING
Jour. M. S. M. S.
containing as subsequently completed and corrected if
necessary, all of the information required by this act,
and promptly delivered to the local registrars of the dis-
tricts in which the births occurred within the time fixed
by this act.
Sec. 10. The Secretary of State shall, upon request,
furnish any applicant a certified copy of the record of
any birth registered under the provisions of this ftct, for
the making and certification of which he shall be enti-
tled to a fee of fifty cents, to be paid by the applicant
And any such copy of the record of a birth, when prop-
erly certified by the Secretary of Stote to be a true copy
thereof shall be prima facie evidence in all courts and
places of the facts therein stated. For any search of the
files and records, when no certified copy is made, the
Secretary of State shall be entitled to a fee of fifty
cents for each hour or fractional hour of time of
search, to be paid by the applicant. And the Secretary
of State shall keep a true and correct account of all fees
by him received under these provisions, and turn them
over to the State Treasurer.
Sec. 11. All superintendents or managers, or other
persons in charge of hospitals or lying-in ins.itutions, to
which women resort for confinement, are hereby re-
quired to make a record of all the personal and statistical
particulars relative to the inmates of their institutions,
there residing for the purpose of confinement, at the
date of taking effect of this act, that are required in the
form of certificate herein provided for, in addition to
such other record as may be required by existing laws
or the circumstances of the case. And thereafter such
record shall be by them made, for all future inmates, at
the time of admission.
Sec. 12. Every physician and midwife residing in at
the date of taking e£Fect of thia act or thereafter estab-
lishing a residence in any registration district, shall forth-
with register his or her name, address and occupation
with the local registrar of the district in which he or she
resides, and shall thereupon be supplied by the local
registrar with a copy of this act, together with such
rules, regulaticms and instructions as may be prepared
by the Secretary of State relative to its «enf orcement. A
physician or midwife changing residence shall forthwith
register his or her name, occupation and address with
the local registrar of the district to which he or she
removes. Within thirty days after the close of each cal-
endar year, each local registrar shall make a return to
the Secretary of State of all physicians and midwives who
have been registered in his district during the whole or
any part of the preceding calendar year, and in issuing
warrants in payment of physicians or midwives for certi-
cates of birth filed by them, the Secretary of State shall
not include any physicians or midwives who have not
complied with the requirements of this section: Pro-
vided, That no fee or other compensation shall be
charged by local registrars to physicians or midwives for
registering their names under this section or making re-
turns thereof to the Secretary of State.
Sec 13. Any physician or midwife in attendance
upon a case of confinement who shall neglect or refuse
to file a proper certificate of birth with the local regis-
trar within the time required by this act, shall be
deemed guilty of a misdemeanor, and, upon conviction
thereof, shall be fined not less than five dollars nor
more than fifty dollars, or shall be imprisoned not
to exceed thirty days, or shall suffer both such
fine and imprisonment at the discretion of the
court. If there was no physician or midwife in
attendance upon any case of confinement, then the
father, if he shall refuse or neglect to file a proper
certificate of birth with the local registrar within the
time required by this act, shall be deemed guilty of
a misdemeanor, and, upon conviction thereof, shall be
liable to the same penalty as that incurred by the physi-
cian or midwife in case of violation of the law, as above.
And in the absence of the father, then the householder
or owner of the premises upon which the birth occurred,
the superintendent or manager of the public or private
institution, shall individually be liable, in the order of
their responsibility, and in case of conviction for failure
or neglect to comply with the requirements of thia act,
shall be subject to the penalty imposed upon the physi-
cian or midwife in case of similar refusal or neglect.
Any registrar who shall neglect or fail to enforce the
provisions of this act in his district, or shall neglect or
refuse to perform any of the duties imposed upon him by
this act or by the instructions and directions of the
Secretary of State shall be deemed guilty of a misde-
meanor, and, upon conviction thereof, shall be fined
not less than ten dollars nor more than one hundred
dollars, or be imprisoned not over thirty days, or shall
suffer both such fine and imprisonment at the discretion
of the court. Any person who shall wilfully alter any
certificate of birth, or the copy of any certificate of birth
on file in the office of the local registrar, except to cor-
rect same in the manner provided in this act, shall
be deemed guilty of a misdemeanor, and, upon conviction
thereof, shall be fined not less than ten dollars nor more
than one hundred dollars, or shall be imprisoned not
exceeding sixty days, or shall suffer both such fine and
imprisonment at the discretion of the court And any
other person or persons who shall violate any of the
provisions of this act, or shall wilfully neglect or refuse
to perform any duties imposed upon them by this £Ct,
shall be deemed guilty of a misdemeanor, and, upon
conviction thereof, shall be fined not less than five dol-
lars nor more than one hundred dollars, or shall be im-
prisoned not exceeding thirty days, or shall suffer both
such fine and imprisonment at the discretion of the court
Sec. 14. Local registrars are hereby charged with the
strict and thorough enforcement of the provisions of this
act in their districts, under the supervision and direc-
tion of the Secretary of State. And they shall make an
immediate report to the Secretary of State of any viola-
tions of this law coming to their notice by obervation or
upon complaint of any person or otherwise. The Secre-
tary of State is hereby charged with the thorough and
efficient execution of the provisions of this act in every
part of the State, and with supervisory power over local
registrars, to the end that all of its requirements shall
be uniformly complied with. He shall have authority to
investigate cases of irregularity or violation of law, per-
sonally, or by accredited representatives, and all regis-
trars shall aid him, upon request, in such investigations.
When he shall deem it necessary, he shall report cases of
violation of any of the provisions of this act to the
prosecuting attorney of the county, ^ with a stotement of
the facts and circumstances, and when any such case is
reported to them by the Secretary of State, all prosecuting
attorneys or officials acting in such capacity shall forth-
with initiate and promptly follow up the necessary court
proceedings against the parties responsible for &e alleged
violation of the law. And upon request of the Secretary
of State, the Attorney General shall likewise assist in
the enforcement of the provisions of this act.
Sec. 16. All that part of Act number one hundred
ninety-four of eighteen hundred sixty-seven, as amended
by Act number twenty-five of eighteen hundred sixty-nine,
being Sections four thousand six hundred and five to
four thousand six hundred and thirteen of the Compiled
Laws of 1897, and inconsistent with this act, is hereby
repealed, except that the births in Michigan during the
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July, 1904.
STATE MEDICAIv SOCIETY.
315
jrear 1903 shall be enumerated, returned and compiled in
accordance witl\ said former acL This act shall go into
«ffect for the registration of births in Michigan on Janu-
ary 1, 1984, but the Secretary of State shall take such
preliminary steps as may be necessary to secure its
enforcement on and after that date immediately upon it%
becoming a law.
THE RELATION OF THE NATIONAL AUX-
ILIARY CONGRESSIONAL AND LEGIS-
LATIVE COMMITTEE OF THE AMERI-
CAN MEDICAL ASSOCIATION TO THE
PUBLIC, AND TO THE MEDICAL PRO-
FESSION.
EMIL AMBERG,
Michigan Member, National Legislative Council of
the American Medical Association.
All living beings, with very few exceptions, are
eager to live a long life, a life without pain and
without affliction. If the conditions of life and
the conditions of living would be simple, if all
our surroundings would be of a nature which
would not be inimical, under circumstances, to
human welfare, if all people at all times would
knowingly and unknowingly do only what would
be conducive to their health and that of others,
the field of medicine would be narrowed to a
great extent
Unfortunately, the human race does not live jn
a paradise of perfection and there are many ills
to which the human flesh is heir and many from
which he should be protected.
The very nature of men and things prevents
the ordinary individual from being able to look
into the nature of diseases, to recognize its ex-
istence in a given case and to follow a treatment
suitable for the same. Hence, he looks to the
medical profession for information, for recogni-
tion of his affliction and for help.
The afflictions endangering the individual citizen
are either of a personal nature, referring to him
alone, or of a general nature (epidemics), refer^
ring to a number of individuals.
So far as the medical profession is concerned,
in connection with afflictions of the human race,
they are on the one hand of a nature requiring the
services of some consulting colleagues as individ-
uals, and on the other hand of a nature requiring
the information and advice of the' medical pro-
fession as a body. The medical profession is ex-
pected to give their information and advice not
only by virtue of their knowledge, but also by
virtue of their membership in the community.
All this is so clear that it requires no further ex-
planation. The question arises: How can the
medical profession best perform its duty as a
conservator of public welfare? It can do so by
having only physicians of the highest t}rpe in the
ranks of the medical profession and by being or-
ganized, so that their recommendations, advice and
warnings carry the full weight required and ne-
cessary.
The way of proceeding must necessarily be
based on the following conditions and plans :
1. There must exist something which requires
the attention of the medical profession.
2. The medical profession, as a whole, not be-
ing able to act quickly on matters of importance,
must have certain trustworthy representatives who
must act for them. They must be able to say the
proper thing at the proper time.
3. Whenever the necessity for work arises,
things must be said in a way that they may be
understood by those public officials whom the
public addresses through their mouthpiece.
4. It is necessary to be so organized that should
individual physicians be asked to endorse certain
matters the response should be quick and de-
cisive.
5. It is imperative that the efforts should be
continued until success is achieved.
Let us regard for a few moments these five
points. There always existed, there exists and
will exist, something which requires the attention
of the medical profession on account of the con-
tinued progress of natural science. The necessity
for the existence of a smaller body within the
larger body, viz.: a committee, is obvious. Such
a committee represents a public within the med-
ical profession and the medical profession within
the public. This gives the nature of our com-
mittee in a nutshell. The character of our pro-
fession gives the assurance that only just de-
mands will receive any support. In order to over-
come prejudice and to reach a certain goal, in our
time, when fakirs and medical frauds of all de-
scriptions reign supreme, when the laws of nature
are trampled upon by those who blind the eyes of
the multitude in order to gain unjustified material
profit, ^ well regulated army is wanted which must
be ready for any emergency. It would also be er-
roneous to assume that only a loose relation ex-
ists between proper medical organization and
scientific medicine. Medical organization is of
prominent significance for our daily medical work.
Proper organization will be felt at the blade ol
the surgeon's knife, at the tender wounds of the
patient's body, in the sick room of the distant and
lonely farmhouse, where the proper diagnosis in
a given case must be determined, and in the lab-
oratories where the advance guard of the medical
profession comes in touch with^he outposts of the
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39th ANNUAL MEETING
JounM.S.M.S.
death-dealing afflictions. Only a well constructed
machine, of which all the parts are in good order,
can run smoothly. Any derangement affects the
whole apparatus.
Our committee work is of a nature in which
every physician and every citizen should be in-
terested. In our country, a republic with a dem-
ocratic form of government, the men in respon-
sible positions feel carefully, conscientiously and
expectantly the pulse of the nation. So far the
pulse of the medical profession was little percep-
tible and mostly intermittent, until the mighty
stimulus of the reorganization of the medical pro-
fession regulated somewhat the hearts of the med-
ical citizens.
From this point of view, the National Auxiliary
Congressional and Legislative Committee of the
American Medical Association is a needed factor
for the public. It is the natural outcome of the
efforts of a united profession in the United States,
of which the American Medical Association is at
present the most powerful representative.
How is the Committee constituted?
As you know, the American Medical Associa-
tion has appointed a committee on Medical Leg-
islation, consisting of three members.
This committee is enlarged by adding to its
number, for certain purposes, one member from
each State, and medical representatives from the
United States Navy, the United States Army and
the United States Public Health and Marine Hos-
pital Service. This enlarged committee is called
The National Legislative Council of the American
Medical Association.
Besides this National Legislative Council there
exists the National Auxiliary Congressional and
Legislative Committee of the American Medical
Association. This committee consists of repre-
sentatives of each county.
Dr. Reed, chairman of both committees, whom I
had invited to this meeting, has sent me a letter
which reads in part :
"My Dear Doctor Amberg:
"I would like very much indeed to meet with
you and the County Auxiliaries at Grand Rapids
on the 25th of May. Unfortunately, however, my
engagements are such that I cannot see my way
clear to going away at that time. I wish, how-
ever, you would present my most cordial greetings
to our colleagues in Michigan."
"May I ask you to do one favor, and that is to
insist upon the importance of attention to the
work that is sent to the county auxiliaries. Every
man holding the position of county auxiliary,
ought either to do the work or to resign. It is
_jiot fair to the medical profession that it should be
cheated out of the influence to which it is en-
titled from the territory accorded to any man
who gives no attention to its duties. It is per-
fectly safe to say this thing in Michigan, because
it ought to cause less ofFecse there than in almost
any other State. The co-operation that we have
received from the county auxiliaries in Michigan
is, for the most part, very satisfactory. There
are some men, however, who may have been giv-
ing attention to every request that has been sent
them, but from whom it has been impossible for
this office to receive either directly or indirectly
any evidence of action. I hope you will bring
this matter home very pointedly and that you will
put the machinery in motion for perfecting or-
ganization in your State. It is not enough that
we should have an influential doctor, but it is
simply essential that we should have a doctor
who will work. The man of lesser importance
who will attend to the business of the committee
is of vastly more importance than a man of
greater importance who gives no attention what-
ever to the matter. I am quite sure that you will
take hold of this idea and work it out to a prac-
tical conclusion."
All the States are represented in the Legis-
lative Council with the exception of Idaho, In-
dian Territory, Minnesota, Nevada, and Oregon.
County Auxiliaries are organized in all the States
with the exception of Idaho, Indian Territory,
Massachusetts, Nevada, New Jersey, New
Mexico, North Carolina, Oregon, South Carolina,
Utah, Virginia and Washington.
i-vs our committee necessarily comes somewhat
in touch with the prominent representatives of
the people we may well ask to what extent shall
a physician participate in politics?
I think that we physicians should be better rep-
resented in Washington, and we undoubtedly
will be in the course of time.
In order to illustrate the necessity of such a
representation let me recall to you the efforts
in regard to the pure food and drug bill, which
is at present before the nation.
Much more good could be accomplished if the
necessary consideration would be given to well
established facts. Any violation of the laws of
nature is without fail revenged by nature, either
on the individual or on the community. The
dust question, tuberculosis, epidemic diseases,
overexertion, and other conditions will demand
our attention.
It is characteristic of our profession that our
conception of things tries to be free from preju^
dice, that our deductions are based on plain and
simple facts, that our advice is given solely for
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STATE MEDICAL SOCIETY.
317
the best possible good of those who ask for it,
that our efforts are invariably and continually
bent to create harmony between human life and
the laws of nature, and that our achievements
are only the stepping stone for further work.
Without referring to other measures, I can
say that our influence has already been felt at
\vashington in connection with the work on the
Panama Canal, and that the interest of the medi-
cal profession and of the public in the Pure Food
and Drug Bill has been awakeped.
In view of all this our duty lies plainly before
us. The public has the right to demand from us
to stand by them, and we have no right to with-
hold our assistance. Therefore permit me to say:
First — ^That it is absolutely essential that a
clear conception should exist as to the nature, the
object and the duties of our committee, in the
mind of the Society and that of the public.
Second — That the committee member should
always be prepared to act quickly and with
energy.
Third — That the committee and the Society, as
a whole, should be in constant touch with each
other, and assist each other so that all work can
be done smoothly and without friction.
The memories of lasting value which we take
home with us from meetings of this character,
are the steps which advance our thought towards
betterment of conditions, the incentive towards
wholesome efforts, and the feeling that we are
enabled to do more good than we did before. I
ask every one of you individually to-night to fa-
miliarize himself with the working of a commit-
tee which is so essential for the welfare of our
country, and in conclusion, I beg you to consider
yourself as individual members of the State Medi-
cal Society, a permanent committee of 'one, whose
object is to work out the old problem before the
medical profession, which has existed for thou-
sands of years, which exists to-day, and which
will continue to exist to the end of time,— namely,
the purity and strength of the craft, the welfare
of all our fellow citizens, and the continued in*
crease of health and happiness of the human race.
REPORT OF COMMITTEE TO SECURE
DATA REGARDING THE PREVALENCE
OF VENEREAL DISEASES IN MICHI-
GAN.
A. E. CARRIER, DETROIT, CHAIRMAK.
Before submitting the report of the committee
Dr. Carrier said in part:
"There is among the profession an apathy re-
garding the presence of venereal diseases. I do
not think that we realize the number of cases
that are present with us in every community, no
matter how small nor how large, in this State
to-day. It is said that "familiarity breeds con-
tempt," and I think it does regarding these dis-
eases. We have come to regard them as rton-
dangerous, because the individuals are appar-
ently well as they travel among us, while they
are in fact centers of infection, where innocent
people may contract the disease readily. Our
report then will be a very meager one ; it is
simply a matter of statistics. Before, however,
reading the report I desire to say a few words
regarding venereal diseases and the methods of
controlling them; and I hope the Society will
discuss this report most thoroughly.
Regarding the prophylaxis or the prevention,
in a medical way, is there any way of prevent-
ing the spread of venereal diseases? From our
reports we have to-day 2,500 centers of infec-
tion in Michigan from individuals who are suf-
fering with syphilis in the primary stage. W«
have sixty-five hundred cases, or center of in-
fection from syphilis in its secondary stage —
nine thousand centers of infection. If you had
a case of smallpox every newspaper in the city
and every doctor would be up in arms in a
moment to have it isolated. Yet the danger
resulting from smallpox does not begin to com-
pare with the danger which results from the con-
traction of this one disease. More than this,
syphilis is a disease capable of transmission by
inheritance; it is capable of transmission by acts