PRESIDENT'S ADDRESS 
DELIVERED BEFORE THE 
N.H. MEDICAL SOCIETY 
AT 
Concord, June 17, 1884, 
BY 
tf, W. PARSONS of Portsmouth. 
MANCHESTER: 
PRINTED BY JOHN B. CLARKE. 
1884.' PRESIDENT'S ADDRESS 
DELIVERED BEFORE THE 
N.H. MEDICAL SOCIETY 
AT 
Concord, June 17, 1884, 
BY 
J. W. PARSONS of Portsmouth. 
MANCHESTER: 
PRINTED BY JOHN B. CLARKE. 
i884- PRESIDENTS ADDRESS. 
DR. J. W. PARSONS, PORTSMOUTH, N. H. 
Fellows of the New Hampshire Medical Society:— 
The swift, unceasing roll of time has added to the irrevocable 
past another year with its vast written and still vaster unwritten 
history, and has borne us on to another anniversary, which we are 
to celebrate by such professional work as shall raise our former 
excellent standard still higher, and by such social intercourse as 
will render our affiliations still stronger. 
It is my very agreeable privilege to extend to you from this 
chair a hearty salutation on this the ninety-fourth anniversary of 
our society, and welcome you with all the cordiality which simi- 
lar occasions enable us to express to one another once a year. I 
most keenly realize that this privilege is an honor, and a mark of 
your confidence, of which I hasten to declare to you my fullest 
appreciation. 
I wish I had the diction of a Shakespeare, the philosophy of 
an Emerson, and the wit of a Holmes, to aid me in a satisfactory 
performance of this portion of the duties which our regulations 
make incumbent upon the presiding officer to discharge. The 
medical society of an adjoining state once adopted a resolution 
requiring the president to prepare and read, or present, an anni- 
versary dissertation, or, in default of the same, to pay to the 
society the sum of fifteen dollars. 
Gentlemen, if we had such a regulation, I should like to exhibit 
to you with what alacrity and liberality it would be my conven- 
ience to contribute to the exchequer of this association on this 
occasion. But, unfortunately for my audience, no such evasion 
of this duty has ever been countenanced by this society, and I must therefore conform to a wise requirement, and, with the assur- 
ance of your earnest coSperation to make this convention a suc- 
cess, I beg your indulgence for my deficiencies in attempting to 
impartially serve you while in this honorable position- 
The subject to which I shall first ask your attention for a few 
minutes is— 
The Importance and Welfare of Medical Associations, espe- 
cially our own Society. 
We have assembled from the remotest districts of our state in 
the interests of the profession which it is our pride to represent, 
and to add another chapter to the already eventful history of our 
venerable society. Although this chapter may not contain the 
record of a discovery such as only occasionally bursts upon medi- 
cal science, yet it will indicate to the profession throughout the 
country, and to those who are in the progress of knowledge to 
more than fill our places in the future, that we are not idle or 
unmindful of the magnitude of the work which lies beyond pres- 
ent medical acquirements, but that we are active, watchful and 
earnestly striving as individuals to do our part towards elucidat- 
ing the many mysteries which beset our daily work, and laboring 
as a society for the emendation of the profession. 
Much has been accomplished, but much more remains to be 
accomplished, for the possibilities of the future far exceed the 
realities of the past. Progress is the world’s motto, and it is as 
boundless as eternity. 
Medical associations have a portion of this work to perform, 
which can be achieved by no separate individual effort. Although 
associations do not make discoveries, they serve to stimulate the 
members to greater exertions and to a spirit of healthful rivalry, 
and to divert their minds from an unconscious routine into which 
all inadvertently fall, into new and broader channels of thought 
and investigation. All societies and associations are progressive 
in their tendencies. Although not incapable of mistakes, and 
although sometimes disturbed and divided by questions which all 
men cannot view with the same understanding, yet the combined 
wisdom and experience of the many must eventually determine 
the right. Members of every trade and profession have interests 
in common, for the advancement and protection of which associ- 
ation and concerted action are necessary. 5 
The power and influence of association in every sphere in life 
are seen and felt on every hand in the world’s general progress. 
The application of the arts and sciences to the wants of man- 
kind, in the development and completion of the wonderful en- 
terprises of the present age, could not have been made except by 
associated wisdom and capital. Nations and states are but asso- 
ciations for the better protection of their citizens, who are willing 
to submit to certain restrictions that other liberties may be the 
more securely obtained and completely enjoyed. 
Civilization itself is but the gradual outgrowth and result of 
society and association. Its experiences and increasing necessi- 
ties are lessons and demands which create the inventor, and stimu- 
late the statesman and the student to deeper thought in the 
solution of the intricate problems of political economy, sociology 
and science. 
The individual may originate a thought or a discovery, but it 
must be given to society in reality or imagination, that its power 
or practicability may be tested before its influence can be meas- 
ured or its worth estimated. 
There is an interdependence, an action and reaction, constantly 
existing between persons and society. In unity of purpose there 
is strength in action. The common good becomes a personal 
benefit. The members make the body, but the body makes th£ 
members potent. 
It has been said with much truth, that there is a lack of associ- 
ation, a want of mingling among the people of this country, and 
among no class of its citizens has this want been more apparent 
and detrimental than in the medical profession. 
Familiarity may breed contempt, but fellowship and acquain- 
tance will engender respect. Much of the jealousy, bicker- 
ing and want of harmony, which characterized the profession 
in former days, arose from lack of opportunity for communion, 
for the comparison and discussion of individual opinions and 
interests. 
Quackery and empiricism, with their boasting pretensions, did 
much to cause this suspicion and want of confidence among phy- 
sicians. But in this day of higher education, and the multiplica- 
tion of opportunities for direct and indirect intercourse through 6 
societies, medical journals and books, medical men have become 
more harmonious and liberal. The beneficial results of organ- 
ization in advancing the cause of medical education and elevat- 
ing the tnorale of the profession cannot be questioned, and may 
be more fully comprehended when we consider with what con- 
fusion and professional chaos we should now be afflicted, if there 
had never been an opportunity for conference over the many 
questions vital to ourselves and mankind. 
So important are medical societies to the profession and the in- 
dividual that a medical man’s acquirements should not be con- 
sidered complete until he has affiliated with some medical asso- 
ciation. The duty to self and those he is to serve demands it, 
as well as the well recognized principle of unselfishness which 
characterizes the physician in freely donating to the world all 
discoveries. 
Who can for a moment doubt the influence of this society upon 
the profession of the state ? There is not a physician in the 
commonwealth, whether a member or not, who is not in sQme 
measure indebted to this society through its efforts to promote 
the individual interests of the profession, and advance the cause 
of medical science. Indeed the debt due this society does not 
wholly rest with the members of the profession ; every citizen 
the state are under obligation to us for the unselfish regard 
which we bestow upon all questions of public concern pertaining 
to our chosen vocation. We have been, and are, more eager to 
advise and labor in the cause of sanitary science than the people 
have ever been liberal in contributing to this eird. 
The individuals of no trade or vocation labor so sedulously to 
abridge the necessity of their calling, as those of the medical 
profession, as is abundantly shown in the vast amount of work 
bestowed upon preventive medicine. The watchful practitioner’s 
duty to his patrons to-day is as much to instruct in the preven- 
tion of disease as to cure it by drugs, and the extensive amount 
of practical information in this direction, which has been freely 
given to the public, places every state and the nation under obli- 
gation to the medical faculty. 
When the importance of medical societies, with their attendant 
opportunities for mental improvement, for elevating the ethical 7 
standard of the profession and for social enjoyment, is considered, 
it becomes a lamentable fact that out of the five hundred or six 
hundred (this is only a rough estimate) regular physicians in this 
state, the names of only about two hundred appear on our roster. 
The real cause for this indifference to association and society 
work is not so apparent as to be easily stated. If the old or 
young physician stands aloof because of timidity to mingle with 
his professional brothers, which has arisen from a vague apprehen- 
sion that he may be their inferior, he only adds to his weakness, 
and discards the occasion which will give to him the mental 
strength and the confidence to become their equals or superiors. 
If he excludes himself because of a selfish belief in his senten- 
tious superiority over the common fraternity, he displays an ego- 
tism the value of which he would be better able to estimate by 
placing himself in a position to compare his own with the short- 
comings of others. A sound self-respect and true professional 
devotion are increased by these reunions, which afford occasion 
for the most intimate interchange of ideas upon the many practi- 
cal and theoretical topics pertaining to our life’s work, the study 
and cure of disease. The' attrition of honest, friendly criticism, 
and fraternal meetings, quicken the intellect, polish the man- 
ners and arouse a degree of self-reliance which goes a great way 
towards securing public estimation. . To the workers, associa- 
tions afford opportunities which excel those of medical journals 
for the announcement and discussion of the results of their labors; 
to the drones, these conferences must serve as a stimulant to arouse 
their pride to a degree of healthful activity. 
The influence of this society is an important educational power 
in the profession of the state, and for our own interests we should 
urge every physician who can affiliate with us to become a member. 
Every reputable member of our calling should be one of our num- 
ber, if he values his own welfare and entertains a.dutiful apprecia- 
tion of the trust placed in him by his patrons for the care of their 
health and lives. He should avail himself of every means to en- 
hance the personal and general progress of the profession, and no 
more fruitful occasions will be found for this purpose than in these 
reunions, where discussions of the difficulties which oppose us on 
every side are pregnant with experience, and where can be taken 8 
that concerted action necessary to meet all topics of common 
import. Our meetings should be so attractive that their reputa- 
tion should secure to us the united support of our medical men. 
To attain this end, every member must show some disposition to 
work. It is not enough to come here once a year, pay our dues, 
eat a dinner and depart, leaving those who have essays to read 
after the feast to talk to empty benches. 
If we have imposed the task, for it is a task to many of us, of 
essayist upon a member who is ready to respond, we should at 
least accord to him the courtesy of an attentive audience. And 
here I must stag? that it does not seem to me that we receive the 
greatest measure of the benefit which we ought to derive from 
these papers, by allowing them to go into the hands of the com- 
mittee on publication without discussion, as has been the custom. 
I am aware that the two days’ session, which in reality includes 
only about twelve hours, is a short time in which to read and 
discuss many papers. But I think there can be no doubt that 
greater advantage would accrue from the reading and discussion 
of a few theses, than we now receive from the mere formal read- 
ing of many, which allows all the debatable points to fall flat and 
almost profitless upon our ears. If a member desires the discus- 
sion of an important topic which he has comprehensively stated 
to the society, it is almost impossible to obtain it under our pres- 
ent methods. An order of exercises and some system is neces- 
sary for the guidance of the meetings, and it would be a most 
useful innovation if disputants for every debatable paper could 
be appointed to open the discussion ; and if members would indi- 
cate a greater willingness for work, no matter how slight, the 
executive committee could easily arrange a programme that could 
not fail to excite the liveliest interest and increase the practical 
value of our anniversary. Believing as I do in the profitableness 
of discussion of papers, I shall take the liberty, unless objection 
is made, of calling for debate of each paper read at this meeting. 
I would suggest that discussion immediately follow each disserta- 
tion while the subject is fresh in mind, and that each speaker be 
limited to five minutes, and that no member speak twice upon 
the same paper. 
Although our meetings have as a rule yielded results indicating 
a commendable earnestness on the part of a few, yet there is a 9 
want of that general enthusiasm which is necessary to the per- 
formance of the best work of which we are capable. Every 
member should be as willing to contribute to the general good as 
to enjoy the fruits of others’ labor. My experience as a mem- 
ber of the executive committee for five years has given me op- 
portunity to realize the difficulties of that committee in securing 
the necessary number of essayists to insure the success of each 
succeeding meeting. 
The performance of any literary work by the majority of ac- 
tive practitioners must be a most laborious work, not wholly dis- 
agreeable, but nearly impossible from the constant interruptions 
to which they are liable, and from the wearing anxieties and per- 
plexities which encompass them on every hand and which serve to 
distract them from the unusual labor. 
But however feebly the duty may be performed, it should be 
done from that sense of obligation to the society which is due 
from every member, who should always show a spirit of willingness 
to assume the responsibility of any task which may be imposed 
upon him for the common good.. 
I believe much of the ever-present unwillingness of members 
to actively participate in society work arises from a lack of con- 
fidence in their ability to satisfactorily perform many of the 
duties pertaining to useful membership. 
To these let it be said, that we are a band of co-workers labor- 
ing in the same cause, having the same interests, which induce 
mutual respect, and that in this hall we are all peers in the right 
which we possess to express our views upon any topic, be they 
ever so homely. If a member has doubtful opinions upon any 
subject, or perchance displays his ignorance, he is in a position to 
have his doubts discussed and his ignorance charitably and profit- 
ably exposed. 
This is a school in which we are simultaneously teachers and 
students, and no man should be so selfish, or recreant to his duty 
to the profession, that he would not be willing to assume the posi- 
tion of the former in return for the enjoyment of the opportuni- 
ties of the latter. I have heard it from the lips of those who 
take back seats at our meetings, and those who decline to join us 
when importuned, that they cannot perform any literary work ; that they cannot make reports ; that they cannot formulate their 
ideas in a manner satisfactory to themselves. This is an un- 
founded supposition in many instances, for the effort has never 
been made. It has been said that a man may write at any time 
if he will set himself doggedly to it. We all have opinions, 
somewhat notorious for their diversity, based upon study and 
experience, and if the trial is made, words can be found for 
their expression, and if not novel to all, they may be instructive 
to some. The time and labor spent in the preparation of a 
thoughtful dissertation does not operate solely to the advantage 
of others, for the mental exercise will so develop the latent ability 
of the author as to increase his self-knowledge and insure greater 
future success. “Nothing succeeds like success.” The momen- 
tum of one successful effort is felt in each succeeding struggle. 
As it is with the student who acquires his knowledge so gradu- 
ally that it is almost imperceptible, so it is with our society. 
Although a single meeting may not seem to yield the fullest meas- 
ure of our expectations or desires, yet the influence flowing from 
these annual assemblages is a potential agency in promoting the 
prosperity of our profession not easily stated in brief words. 
The duties of no occupation are more confining or exacting 
than those of a physician, and strict attention to any business is 
commendable; but when a medical man entertains the belief that 
his patrons can demand his whole time to the exclusion of a 
day’s recreation, or the devotion of a few hours to the society of 
his fellow physicians for the purpose of giving and receiving new 
facts and experiences which we as students are constantly observ- 
ing, he falls into an error which serves to limit his knowledge, 
deprives the profession of his experience, and does injustice to 
his patients. 
Our profession is one in which Dives is very chary of- his 
favors, and especially in our state, where practitioners are so 
largely located in the country that, with the long distance to 
travel and the meagerness of fees, the number of working hours 
consistent with even the rugged constitution of the average coun- 
try doctor is not sufficient for him in which to accumulate such 
a competency as will permit extravagance or careless expenditure. 
But when a physician makes the plea that he cannot afford to be- 11 
come a member, or attend the meetings of this society, he enter- 
tains a misapprehension, and fosters a delusion which will tend to 
lessen his success, and contract his already narrow sphere, and 
place him in unfavorable comparison with his progressive neigh- 
bor who can foresee the substantial return from an investment in 
a membership to this association. Both the time and money 
spent at our annual meetings are well employed and profitably 
invested. 
I cannot believe that a single member of this society, who has 
been a constant attendant, can have so far failed to profit by them 
that he does not revert to them with satisfaction, and anticipate 
them with warm impatience. Such at least has been my experi- 
ence. I feel under obligations to the society which I cannot re- 
pay. It has been a source of knowledge, and has given to me an 
opportunity to compare my own with others’ qualifications and 
short-comings, which has served to give to me a confidence and 
an understanding of my profession which has been of daily profit, 
and which I could have secured from no other source. It has 
given to me the opportunity to* form many pleasant associations 
and friendships which go far to make life more enjoyable. Indeed 
the personal acquaintance with the profession of the state alone 
more than repays a man for attendance here. 
Medical education has received an immense impetus in the past 
ten years, and in no profession is there still such a cry for a higher 
education as among physicians. The strides in the various de- 
partments are so numerous, and the work of advancement so 
refined, that the uneducated mind cannot grasp and apply the 
knowledge which is necessary for the successful pursuit of a phy- 
sician’s labor at the present time. We are not in a position to 
dictate to medical schools any higher course of study, but we can 
exert an influence for which the time has come, for preventing the 
entrance upon the study of medicine of young men whose prepar- 
atory education is deficient. Few young men enter upon the 
study of medicine without consulting or placing themselves under 
the tutorship of a physician, and this opportunity should be seized 
by us to discourage every aspirant who cannot exhibit the proper 
qualifications. The doors should be wide open to the educated, 
but carefully guarded against the entrance of the ignorant, even 12 
at the risk of occasionally excluding a brilliant mind. There is 
no way in which we can so easily and effectively enhance the 
standing of the profession as this. 
We can do no more to carry out the design of the founders of 
this society as expressed in the words of its first president, Dr. 
Josiah Bartlett, who said: “ I have long wished that the practice 
of medicine in this state, upon which the lives and health of our 
fellow-citizens depend, might be put under better regulations 
than in times past; and have reason to hope that the incorpora- 
tion of the New Hampshire Medical Society, if properly attended 
by its Fellows, will produce effects greatly beneficial to the com- 
munity, by encouraging genius and learning in the medical sci- 
ence, and discouraging ignorant and bold pretenders from prac- 
ticing an art of which they have no knowledge.” 
The original charter for this body limited the number of mem- 
bers to seventy. An amendment passed in 1816 increased the 
number to two hundred. I would suggest that as the physicians 
in this state have largely increased since 1816, a committee be 
appointed to petition the legislature at its next session for an 
amendment increasing the number to five hundred. 
We are rapidly approaching our one-hundreth anniversary, an 
occasion which we should celebrate by more than ordinary exer- 
cises ; and as has been before suggested from this chair, it is ex- 
pedient that some measures should be considered for the proper 
observance of our centennial anniversary. And perhaps it would 
be advisable to appoint a committee to consider what action, if 
any, it is necessary to take at this early date. 
This brief plea for our medical society, and appeal for more 
willing, earnest performance of the duties of membership are 
made with the hope of arousing and encouraging, among some of 
us, an enthusiasm and confidence which will result in a more spon- 
taneous participation in the work which must be performed to 
attain that reputation of which each member would be proud to 
boast, and which I firmly believe we have the ability to acquire. 
At the risk of wearying you, permit me to occupy a little time 
in glancing at some of the defects of our registration law in which 
certain radical changes have been made during the past year. 
Any one who has given the subject of registration any consider- 13 
able attention will at once realize that it is impossible, in the 
present state of the law, to obtain perfect registration returns, 
and that under any law the same conclusion would be true to 
some extent. So far as relates to births and deaths, the law looks 
to the medical profession for the proper returns. The burden of 
the work is put *ipon physicians. This arose from the fact, it is 
presumed, that they were the first to discover the great advantages 
of registration, and to urge its adoption, and because from all 
time they have been expected to perform any eleemosynary and 
gratuitous work required of them. This may have been right 
once, but it is believed the time is past when we should be re- 
quired by law to write up genealogical and biographical sketches 
of those innocents whom we assist into an independent state of 
existence, and of those not so innocent whom our skill can no 
longer save from the inevitable death. Every individual at birth 
and death we are required to immortalize by preparing for record 
a brief personal and family sketch, for the benefit, not of physi- 
cians specially, but of the public, and the compensation for this 
historical work is the munificent sum of twenty-five cents for each 
record made. 
By the recent modification of the law we are required to per- 
form this misplaced service even for those who have no extra- 
uterine life, only a bodily existence. Indeed the still-born re- 
quire duplicate favors of us, for each must be returned as a birth 
and death. And except for the general integrity of the mem- 
bers of the profession, and the meagreness of the fee, there might 
be some fears that the last mentioned requirement would operate 
as an incentive for the occurrence of more still births than other- 
wise would be if this double premium was not offered. What 
advantage can be derived from compelling the medical profession 
to return births and deaths, the writer has never been able to un- 
derstand, after an annoying experience of ten years in perform- 
ing this duty. If it is an advantage based on a greater degree of 
intelligence of physicians than could be obtained by delegating 
similar authority to other persons, we most gracefully acknowl- 
edge the compliment, but must still advocate a trial of other 
methods. There is no justice or necessity in asking us to perform 
public service for a mere pittance, which can be better accom- 14 
plished by the proper public authorities, in the case of deaths at 
least, and should be performed by the persons more intimately 
interested in the case of births. There is no more reason or 
right in exacting this labor from a physician, than there would be 
in asking him to render any other information which might in- 
cidentally come to his knowledge through his business, and 
which would be of public benefit. At the first thought it would 
be considered a trivial duty to fill out a blank certificate of death, 
and so it is under favorable circumstances. But how many of us 
are present at the death of our patients to obtain the desired in- 
formation, and if present, what an unpropitious moment to seek 
the practical details from friends distracted with grief! These 
details many cannot give except upon consulting records and 
other friends, and thus we are frequently compelled to make a 
special visit to obtain the desired information. And perchance 
if the family is a large one, we may find it inconvenient to spend 
an hour in prescribing for every ache and pain which can be 
remembered, because the family know it is an unsolicited visit, 
and therefore a good opportunity to secure gratuitous advice. 
As an illustration of the effect of the present law upon the 
time of a busy practitioner, permit the relation of a suppositive 
case : A physician is summoned ten miles to visit a patient sick 
with diphtheria. He visits and prescribes for the person and 
promises to call the next day. The following morning the phy- 
sician receives a message that the patient is dead. The family 
reside miles from the post-cffice, and perhaps never go to it, so 
that communication by letter is impossible. The law demands 
that the physician shall make an immediate report of this death. 
If he does not wish to incur the risk of being complained of by 
some jealous rival or watchful enemy, or is anxious and particu- 
lar to observe the law, he must leave important and urgent busi- 
ness and drive, it may be, over almost impassable roads to obtain 
the necessary information to make up this person’s necrological 
record, and to inform the proper authorities that a disease dan- 
gerous to the public health has occurred in the town. And the 
unfortunate physician’s duty under the law does not end here. 
He has obtained the information, but the law is not satisfied. It 
directs him to deliver these items of public and private interest 15 
to the undertaker, town clerk, or other person superintending the 
burial of said deceased person. The physician is in a strange 
town and, perhaps with the risk of losing his route, he is directed 
to the proper person, who, unfortunately lives miles away, and 
who upon the doctor’s arrival is not at home, he having gone 
with his family to the nearest village to procure the necessary 
funeral outfit. In despair the doctor tucks the certificate under 
the door, creeps with a smothered exclamation into his carriage, 
turns his horse homeward and deeply meditates on the wisdom 
of the law and the magnanimity of the state, which pays him 
twenty-five cents for his day’s work, and as a penalty for being a 
physician. 
Section four of the present law requires that the physician attend- 
ing at last sickness — it does not state that the last medical attend- 
ant of a deceased person — shall fill out and deliver a certificate. 
This last sickness may extend over a period of months or years, 
and in the time, as is frequently the case, many physicians may 
have been in attendance, any one of whom may be called upon, 
or even all, to fill out the certificate under penalty of one hun- 
dred dollars’ fine if he refuses. If the deceased person had only 
one medical attendant it is very doubtful whether that physician 
should state of what disease the patient died, if he has not been 
visited for weeks or months prior to his decease, for the reason 
of the possibility that some acute, intercurrent malady may have 
caused death, and thus make the statement worse than useless 
that he died of the chronic trouble. 
In the case of suddenly fatal sickness, although the physician 
has seen the patient only when in a state of articulo mortis, 
with no opportunity perhaps to learn the history of the patient 
except from friends, he is still expected to fill the necessary cer- 
tificate. For the benefit of accuracy in cases of positive diagno- 
sis, all doubtful cases should be recorded as doubtful, unknown, 
or the probable cause of death stated as probable, rather than 
guess at the cause for the sake of recording something. 
It is well known that a large percentage of births occur with- 
out the attendance of a physician. 
To meet this fact, section two of the law requires that the 
“ midwife or other person in charge, who shall attend, assist or 16 
advise at the birth of any child, living or still-born, shall report 
the birth.” This is so general in its application, that in many 
cases what becomes the duty of all concerned will be observed 
by none, and thus the law will defeat itself and often become in- 
operative. There are but few professed midwives, and any elderly 
woman of experience may be occasionally called upon to do all 
that is necessary at a natural labor as a mere act of kindness, and 
in most cases be as ignorant of her legal responsibility as the 
child around whose umbilical cord she puts the ligature. 
Section ten of the registration law constitutes the town clerk’s 
record of any birth or death prima facie evidence of such birth 
or death, in any judicial proceeding. In the instance of deaths, 
so far as relates to the physician’s certificate, this is inventing a 
remarkable species of prittia facie evidence. How many physi- 
cians sign their names to the certificate with the knowledge from 
personal inspection that the person is dead? In the writer’s own 
experience in the past ten years, he could not state before a court 
of justice that one-half of the persons to whose death he has cer- 
tified were dead from his positive, personal knowledge. They 
died in his absence, and he only knew of their death from hear- 
say, it may be of friends. But as the law now stands, with the 
addition of the undertaker’s certificate, there can be but little 
opportunity for deception or mistake, and this matter is touched 
upon merely to show how loosely we may certify to that which 
we know but little about. We certify to the age, place of birth, 
name, and occupation, when in fact we may have no knowledge 
whatever of these data, and only take them from hearsay. 
It is a great mistake to suppose that registration laws are for 
the sole purpose of ascertaining the number of births and deaths, 
and the causes of death. This is a small measure of the benefit 
for which a good registration law should be made. The chrono- 
logical and genealogical record accompanying the certificate of a 
birth and death is the most valuable part of the record for future 
reference. Property questions of vast importance, family histo- 
ries of the keenest interest, will constantly arise in the future, 
only to be settled by a thorough system of registration. And, in 
this connection, attention is called to a most egregious mistake of 
the present law, which directs that a birth shall be returned within 17 
six days. It is a matter of fact of which we are all cognizant, 
that children rarely receive a name within this time. As it is by 
name that a person is known and designated in all social, business 
and legal relations, it is at once evident that the omission of the 
name from the birth record is omitting from the registration the 
most important item, if, as the writer believes, the registration is 
not a mere table of vital and mortuary statistics, but a most 
valuable genealogical record. 
It may be said to this that the sex and date of birth would 
settle future questions and establish identity. But upon examina- 
tion this will not appear so clear. Although sex would be easily 
established, perhaps the date could not be, as it is not a matter 
of daily reference among persons, and if there were a succession 
of births of the same sex in the same family, it would be difficult 
to identify the person in a future generation, a difficulty which 
would not be encountered if a full name were registered. 
The writer does not design that these criticisms of the law shall 
be interpreted as indicating in any sense that he does not strongly 
advocate a good registration law, or that he is not fully aware of 
the difficulties which will present themselves in the attempt to put 
into execution any law which would insure more perfect registra- 
tion. It is believed, however, that the law can be simplified and 
made more efficient, for as now observed it falls far short of yield- 
ing results sufficiently reliable for the solution of any of the 
important problems relating to the study of vital statistics. 
It is easier to destroy than to construct, and to point to the 
defects of the law than to suggest the remedies ; but the follow- 
ing recommendations are offered, with the belief that, if adopted, 
they would yield better results than could be secured in any 
other way. 
First. The medical profession should not be the medium 
through which the returns should be made. If it must be done 
by physicians, then give them sufficient authority to secure as 
complete returns as possible, and reward them with some ade- 
quate compensation. The only material information which the 
physician should furnish in Jthe case of deaths is the cause of 
death, and this he would willingly supply without reward, upon 
application of the proper authority. So far as relates to the re- 
turn of deaths, the subject can be disposed of in a few words. 18 
The necessary data should be obtained by the public authorities 
upon the application for a burial permit. No interment should 
be allowed without a permit, and no permit should be granted 
till the required facts are furnished so far as possible. This would 
place the responsibility where it belongs, and impose the duty 
upon persons who are elected, or appointed, and paid to perform 
such public work. 
This, excepting for the unavoidable incompetency of public 
officials, would insure the most perfect registry possible. Some 
one person would be responsible, and greater accuracy and less 
confusion than now would be obtained. The proper person to 
perform this work should be the town or city clerk, or some per- 
son especially appointed. 
The registration of births presents many greater obstacles than 
that of deaths, for obvious reasons. A large percentage of births 
occur without the attendance of a physician or a professional 
midwife, and, as the law now stands, hundreds of births must 
pass unrecorded. 
A circular from the State Board of Health last year stated that 
6,124 births and 5,000 deaths were reported ; and that compar- 
ing these returns with the average percentages as given by accu- 
rate registration in other states and countries, there must have 
been 2,400 births and 1,800 deaths unreported. This of itself 
is a sufficient commentary on the inefficiency of the law as it ex- 
isted last year, and doubtless will apply wjdl to the results of the 
present year, at least so far as relates to births. 
A full return of births can only be realized by making the pa- 
rents the responsible parties for the record, under penalty of a 
heavy fine. It would require several years in which to educate 
the public to perform this duty, but when once fully adopted the 
results would be such as can be reached in no other way. 
As has been already stated, the name of a person establishes 
his identity and individuality, and at once becomes an important 
factor in his relation to the state. If it is necessary that a per- 
son should obtain special legislation in order that he may have 
his name changed, how equally important it is that a name and 
the person’s identity should be secured by law at the beginning 
of life ! 19 
For obvious reasons the naming of a child within six days after 
birth cannot be expected, and as a substitute for this period, in 
connection with the above suggested change in the law, that pa- 
rents make the return of births, the time should be changed to 
thirty days, and within this time the naming of the child should 
be compulsory, for the purpose of making the returns more per- 
fect, especially as a genealogical record. 
The law demands that a record shall be made of still-born 
children, and that these shall also be returned as deaths. The 
advisability of this requirement has been questioned, but for the 
purpose of family history and avoiding as few exceptions to the 
application of the law as possible, it is better that it 
remain as it is, although the mere numerical fact can afford little 
information of value to the student of vital statistics. Other 
data relating to the real or probable causes of still-births would 
be essential to make them of practical value, but to obtain these 
would so complicate the returns as to render it impracticable. 
The return of a still-birth as a death seems at first thought a 
superfluity, but for the reason of making the law as effective as 
possible in relation to burial permits, the continuance of the re- 
quirement is advisable. It would be of great additional service 
if all abortions and miscarriages, with the attending circum- 
stances, could be obtained, but from manifest reasons this would 
be impossible. 
To simplify and define the law, a reasonable decision of the 
State Board of Health informs us that it is not expected that still- 
births prior to the seventh month will be recorded. 
Perhaps I have made much ado about nothing in going into 
the details of this subject, but I have been so annoyed by the 
requirements of the law in the past, that I cannot believe that I 
am an exception, and I feel that it is the duty of some one to 
utter sentiments which I think must be those of the profession 
generally. I therefore earnestly hope that our State Board of 
Health will take measures to secure such modification of the law 
as will relieve physicians of this misplaced duty, and such altera- 
tions as will insure a more reliable and valuable record. 
In conclusion permit me to congratulate you upon the harmony 20 
which has pervaded our former meetings and to express the hope 
that the same spirit may characterize those of the future, and 
may we leave such 
as shall give no uncertain signs of our devotion and loyalty to 
the New Hampshire Medical Society. 
“ Footprints on the sands of time ”