*PRESIDENT'S ADDRESS.

By FREDERIC CLIFT. M.D.,
Provo, Utah

Fellow Members of the Utah State Medical Association; Ladies and Gentlemen-I felicitate you upon our once more meeting together. We as an association are now entering upon the fourteenth year of our organization. The many absent faces give evidence of the fact that time is the one factor that we cannot control. The year that has gone, however, has passed over us somewhat lightly; but, for many of us, the words of a grand old hymn seem to apply with much force

"A few more years shall roll,

A few more seasons come,

And we shall be with those that rest
Asleep within the tomb."

Life, however, has its duties. We older members of the profession do not wish to pitch our tents in the graveyard of the past. Today and the future is ours, and it is for us to strive to hand down an untarnished record to those who are preparing to take up our work.

Reviewing the events of the past year, the profession of this city is to be congratulated on the fact that Salt Lake City was selected as the place of meeting for the Western Surgical and Gynecological Association, and I desire to thank the members of our own association who contributed by their efforts to the enjoyment of those who visited us, and for the success of the meeting. Such meetings and the establishment of a medical department by the University of Utah tends to bring our city to the front as an educational center for this and neighboring states; and I look for the time when our friends of the East will send their boys and girls to seek not only education, but that rugged health which we associate with own snow-capped mountains, and the bathing and boating facilities of our Great Salt Lake. A further advance in the educational standard of our medical school will become effective after the present year, necessitating a preliminary college course. This will place the first two years of our course in medicine upon an equality with the best that is offered by Eastern schools. With our attractive climate and invigorating surroundings this city should become a Mecca for the multi-millionaires of the effete East and their hothouse bred children. Salt Lake will become the repair shop

*Read before the Utah State Medical Association, Salt Lake City, May 7-8, 1907.

of this continent, and we, as physicians must not forget to bring home to those less favored the natural advantages which should accrue from a residence among the plateaus of the Rocky mountains. Let us boost for our state-we know it contains the best of everything on earth. Why should we not begin to lay our plans for the holding of the American Medical Association meeting of 1910 in Salt Lake? It is already "the hub of all Western travel-the converging point for all traffic from the East and Middle West to the Coast." It is even now the most central city of Western America, including Canada and Mexico, and, by 1910, all the important railroads will have converged at this point and thus afford every accommodation that the A. M. A. can require. Let us begin from this very day to work for that end, and prepare to house the multitude that will gather to do honor to the City of the Inland Sea.

As an association we endorsed an act promoted by the University, whereby the unclaimed bodies of dead criminals, transients, etc., may be reserved for anatomical and scientific purposes. This will enable members of our profession to continue, or take up original research and other scientific work; which, in the past has been almost impossible in this state under the conditions that prevailed.

An effort was also made to provide for the payment of so-called expert fees for professional men of all classes, who are frequently called upon to give evidence involving special skill and knowledge, which can be obtained, only, after years of study and the expenditure of hard-earned money, but owing to the pressure of other business, the bill was not fully considered by the legislature, and it consequently failed to become a law.

The use of poisonous embalming fluids is one of importance to the profession from a medico-legal point of view. We recall the plot of many novels in which mysterious deaths of people seemingly in robust health, who usually occupied some high position, and disappeared at a time when their presence became an obstacle to an heir or competitor. Poison is usually suggested as the means of their undoing. Popes, kings and nobles did not disdain the use of it in the accomplishment of their ends. The science of toxicology might have been the undoing even of a Lucretia Borgia. Today, the methods of protection, by means of chemical and other methods, render the employment of a poison too dangerous unless the traces of such poison can be gotten rid of, or a possible and plausible cause for its presence in the cadaver can be found. In several recent cases it has been alleged that the

poison found in the body was placed there not by the person charged with the homicide, but by the embalmer or undertaker in the course of his business. The subject is one that comes home to the professional man. A patient dies; the body is embalmed; subsequently foul play is alleged. Arsenic, corrosive sublimate or other poison is found in the body. Is it a case of murder or suicide, or was the poison introduced into the body by the embalmer? Any one of us may be placed in the unenviable position of defending our ability to prescribe, or in cases where we dispense our own drugs, we may find ourselves directly charged with committing or aiding in "the crime of the century," with all its notoriety. The fact that the matter was thought worthy of discussion at the International Medical Congress at Lisbon last year, and later at the Congress of Criminal Anthropology at Turin is my excuse for urging consideration of the question. Professor Eckels, an expert chemist and embalmer, says: "Seventy per cent of the poison cases have been by women poisoning their husbands, and in ninety-six per cent of these cases arsenic and corrosive sublimate has been the poison selected." If autopsies had been made in these cases after the embalming process had been carried out, the mere finding of arsenic would not have been sufficient to prove criminality, for Professor Genning, another expert chemist, says: "A chemical analysis may detect poison, but no chemist or scientist living can positively decide whether they caused the death or were introduced by the embalmer." Answering a further question, he adds, "A human body can be successfully embalmed and disinfected without using a fluid containing any poison."

A bill was submitted to the Utah legislature based on similar bills or regulations passed into law by New York and New Jersey, but other matters blocked the way and prevented its consideration. The subject ought not to be a polemical one. The case of Patrick has been before the New York courts since 1900. The date for his execution has been set several times, but finally in December last, as the result of the intervention of the Medico-Legal Society, the death penalty was commuted, and further inquiry is still in progress, with a view to obtaining a full pardon. The occurrence of one such case in our midst would satisfy the public as to the importance of the matter, and I consider we should lead out and not wait for such a case to occur.

The pure food and drugs act will be of benefit not only to the public at large, but especially so to the physician. The artisan shows his ability and skill by using any tool that comes to hand. The quality of the pen and ink or of the pa

per upon which a prescription is written by the physician cuts no figure. His success or failure in a given case depends upon his ability to prescribe the right drug at the right moment. The physician from the moment the prescription leaves his hands has no control over the quality or strength of the drug he has prescribed the tool of his profession. His success or failure is largely dependent upon the drug, which, however, he rarely sees or controls; whereas the artisan, however defective his tool, controls it all the time. It is notorious that drugs are variable in strength and quality. The retail druggist purchases in the market. He is rarely an analytical chemist. He relies upon the name and honesty of the wholesaler and is not altogether to blame for the poor results which are occasionally so financially disastrous to the prescribing physician. If the passing of these acts result in the standardizing of our drugs in quality and strength, much will have been done towards making our prescriptions instruments of precision.

As scientists and psychologists we can congratulate the people of Utah upon the statute recently added to our code restricting marriage between near relatives and in cases of certain diseases in which mental or physical defects can be transmitted to the offspring of such marriage. It is an educational act, and will, I believe, prepare the ground for a further extension along similar lines, with a view to the prevention of tuberculosis, epilepsy and other neurotic conditions.

The bill providing a home for the feeble-minded and others, many of whom are capable o freceiving a limited education, thereby becoming in part self-sustaining, was also neglected and allowed to die of inanition.

A special meeting of the association was called in Janu ary to consider prospective legislation affecting our profession and in particular the bill prepared by the medico-legal com mittee to regulate the practice of medicine in this state. The committee was instructed to limit their efforts to this bill, and its passage into a law has been the chief achievement of a somewhat barren session. In the face of many difficulties the bill became an act, largely through the untiring efforts of the chairman and members of our committee. I feel that our thanks are due to them, as also to our attorney, Franklin S. Richards. We, of course, may not all agree as to the best form of enactment or the best methods of procedure, but I believe the views and wishes of the majority of our association have been achieved. Personally, I think the passage of this act is only a first step, and that it is yet capable of considerable improvement along the lines of abolishing all reference

to sectarianism. I fear that the provisions of the first clause may be found a stumbling block in arranging with other states for municipal reciprocity. Before the next meeting of the legislature we may have a body of magnetopaths, or half a dozen other sectarian bodies clamoring for separate examining boards, which forsooth our legislators in their wisdom will grant unless we consent to amend our act and put one or more representatives of such sects upon the board. All reference to any special methods of practice should be struck out. I trust that our osteopathic brethren will be prepared to assent to the excision from the present act of any reference to special methods of practice. This was done in the case of homeopathy, and I have heard of no complaint of unfair treatment in consequence. I commend the Colorado law to your consideration. It provides for the examination by one medical board of the several "cults" in the one group of subjects that must be common or basic to all, except quacks, and eliminates any examinations in the methods of cure claimed to be specific by each "cult." It has no reciprocity clause as usually understood, but it does justice to both old and new graduates from all and any states without requiring and regardless of the existence of any mutual reciprocity. Why should a good man in his profession be kept out of a state because of some squabble between the two state medical boards as to reciprocal conditions? Colorado takes into consideration not only the course of training called for and pursued by the applicant at the time of his graduation, but also the fact that the older practitioner, although possessing a ripened experience, necessarily becomes rusty on technical points. Colorado does not of necessity measure the qualifications of the man of sixty with the same yardstick as the recent graduate of twenty-four. It appreciates the fact that educational tests have progressively increased in severity each year during the past decades. It therefore makes the test accord with the actual. training given at our best schools at the time of graduation. To the experienced practitioner the Colorado board is empowered to grant a license without examination on evidence of educational attainments-records of hospital, government, or private practice-licensure by other states, and credentials as to professional and moral status as a citizen.

Reviewing the actual work done by the recent legislature, we as a body have not received the recognition that our responsibilities as professional men and citizens call for. In view of the difficulties we meet with in securing consideration and attention from the legislators and their committees, I suggest that we as physicians should in the future make our in