CRESSY L. WILBUR, M. D. 99 



is far in advance of many cities in this country with respect to 

 the thorough registration of births. It is perhaps fortunate that 

 this meeting of the Association for Study and Prevention of 

 Infant Mortality should be held in this good city of Baltimore, 

 the Athens of higher medical education, because it is probably 

 that large city of all the earth certainly of all the civilized 

 nations of the earth in which the registration of births is most 

 shamefully deficient. It is true that it has close rivals in Chi- 

 cago and New Orleans. It is a little difficult to decide in which 

 of these great and progressive cities of the United States, Bal- 

 timore, Chicago, or New Orleans, the registration of births is 

 most utterly worthless ; but it is certain that it would not be 

 possible to find their equals for worthlessness in any other 

 country where vital records are maintained. 



What is the remedy for this condition? It may be simply 

 stated as consisting of only two items, namely, (1) the enact- 

 ment of adequate laws for the complete registration of births 

 and deaths in all States that do not, at present, possess them ; 

 and (2) the thorough enforcement of the present laws and of 

 the new laws when enacted. 



The principles upon which registration laws must be con- 

 structed in this country in order to be successful are thoroughly 

 settled upon the basis of practical experience, and are set forth 

 as Rules of Statistical Practice adopted by the American Public 

 Health Association and approved by the United States Bureau 

 of the Census, which may be found on page 37 of the annual 

 bulletin of Mortality Statistics, 1909, copies of which are here 

 for distribution. A model law, based upon these principles, has 

 been constructed and indorsed by the American Medical As- 

 sociation, the American Public Health Association (whose 

 Section on Vital Statistics includes all the leading State and 

 city registration officials of the United States), and by the 

 Bureau of the Census; copies are here for distribution in the 

 American Medical Association Bulletin of January 15, 1909, 

 which also contains a discussion on "Why Should Vital Stat- 

 istics be Registered?" The co-operation of the organized med- 

 ical profession of the country has been very effective in securing 

 the rapid extension of proper methods of registering vital stat- 

 istics, despite the occasional opposition encountered from some 

 unenlightened physicians, or even county societies, who com- 

 plain, chiefly, that the model law as recommended by the House 

 of Delegates of the American Medical Association, compels 

 them to make returns of births and sign medical certificates of 

 cause of death ''without compensation" the petty sum of 25 

 cents being in mind. This law has been put into force in various 



