If our cause is just and right, and the proposed changes proper and of advantage to the people of the State, we should not fear to advocate them and should be willing to fight for them if nec

essary.

I wish also to bring to your attention the great injustice of our present plan of representation in the house of delegates, which accords to each county society two delegates, whether the society numbers 10 or 200 members. This is an extreme case of recognition and acknowledgment of the "sovereignty of the counties" given in the first instance for the same reason which led to the creation of county examining boards-to favor and build up societies in the smaller and more sparsely settied counties. This apportionment of delegates was and is most unjust, and its continuance not only unjust but inexpedient. The larger county societies are entitled to larger representation in the house of delegates for exactly the same reason that they are entitled to and given larger representation in the College of Counsellors. Following in the footsteps of our President of two years ago, I recommend that each county society be empowered to send to the State Association one delegate for every ten members, or major fraction thereof, the representation of no county to be less than two delegates.

But the most important of all questions which will be submitted to you for decision during the session which is today inaugurated is that of the substitution of the new constitution, prepared by the State Board of Censors and submitted at the Montgomery session one year ago, for the somewhat time worn instrument under which he have lived and-let us say-prospered, for some thirty years or more. It is to be hoped that every counsellor and every delegate here present has read this new constitution, carefully compared its provisions with those of the old constitution, and thus become entitled to an opinion as to the respective merits of the two. I feel sure that every one who has done this will, without exception, grant that in clearness, precision and logical arrangement the proposed new constitution is superior to the old. But I am equally sure that those of you who have, without bias, studied the two instruments have marked one significant fact that the verbal alterations and additions made are in more than one instance designed to constitutionally recognize the State Board of Censors and State Health Officer as the controlling forces of the Association, and to increase their already preponderant powers. These proposed changes I regard as ill advised, inexpedient,

untimely and retrogressive, in that they serve to exaggerate the chief fault and the principal ground for criticism of our Association. Against this reactionary tendency I individually as well as officially protest, and for accomplishing its defeat I ask the aid of all members of the Association who think that we have had in the past a sufficient amount of centralized government, and who are willing to now make a stand against any further delegation of authority to those in whom, under our present system, the control of the Association is largely and inevitably vested.

I recommend that when the proposed new constitution comes before you for action you take careful note of and promptly expunge by adverse vote every word and clause which gives to the College of Counsellors, the State Board of Censors and State Health Officer greater control of the affairs of the Association than are granted them by the present constitution.

The time is opportune for going further than this.

The organization of the Association is at best undemocratic, and includes much that is foreign to the spirit of republicanism. Under the outward semblance of a representative legislative body it contains a skillfully devised oligarchic mechanism which time and experience has shown to be a thoroughly efficient means of keeping power out of the hands of the rank and file of its members, giving the control of affairs to a comparatively small body of office holders, and rendering any changes, distasteful to this governing body, difficult of accomplishment or impossible.

There may have been, in the then existent need for quickly bringing order out of chaos, some justifying reason for the creation many years ago of such an organization as ours, but it is sure that should the body of gentlemen here assembled. now undertake the construction of a State Medical Association, they would produce one differing in some respects from that which we now find ourselves possessed of-or rather-postessed by.

The evils of our present administrative system have given some just cause for complaint and offered a more or less vulnerable point of attack to those who feel themselves slighted or otherwise aggrieved, as well as those who are, in principle, opposed to the exercise, by others, of autocratic authority. Not only has our system of organization been made the object of

repeated attack from without, but members of our own body have not spared it criticism; have at one or other time advocated every kind of radical and subversive change, from abolition of the College of Counsellors and House of Delegates to general repeal of our medical law and complete overturn of existing order.

With any such movement of anarchistic or ultra-revolutionary nature I have no sympathy-as little, in fact, as for the equally objectionable tendencies to overgrowth of centralization which confront and endanger us on the other hand.

All of us are probably agreed that “ring rule" is in theory bad and ought not to be tolerated. The practical and real problem is to get something better. This most of us are unwilling to take the trouble to do. We are content to let a few men who are willing to take infinite trouble do our thinking, direct our action and steer the ship of state, only reserving to ourselves the privilege of occasional outbursts of vociferous and ofttimes misdirected criticism.

That administrative mechanism which is popularly denounced as a "ring," and its usual accompaniment, the much maligned "boss" are, we must acknowledge, probably necessary features of republican as well as of all other forms of government, and, after all is said, more objectionable in name than in fact. The duty of the independent minded citizen is not so much that of destroying the ring by a spasm of reform, subsequently sitting idle while a more objectionable one grows up to take its place, but of showing such continuous active interest in his organization; of so exercising his right as to make the governing body to which he delegates the duties of administration really representative, and of seeing to it that law, custom and long usage do not come in time to deprive him of the privilege of advocating, and if possible, making such changes as may seem to him expedient.

As a conservative first step in decentralization I recommend that the President of this Association, the two Vice-Presidents and the members of the State Board of Censors be by constitutional provision, made ineligible for re-election.

This recommendation embodies a principle of representative government which is by students of political science universally recognized as a desirable and proper limitation of the exercise of individual authority; is one which has recently been incorporated in the constitution of our own State and one

which long usage has already applied to the President and Vice-Presidents of the Society.

The practical effect of the enactment of this recommendation into law will be to make our central authority, the State Board of Censors, somewhat more accessible to and amenable to public opinion, and to infuse new life and blood into a body in which under existing conditions, long term of office is taken for granted.

It may be said that we are now under no compulsion to re-elect any officer. No more are we, but precedent and long habit oft times acquires the force of law. This habit we have and should be cured of. At this time it would be regarded by the Censors whose terms may be expiring, and by their friends, as a rebuke—as an intimation of dissatisfaction with their discharge of official duty, should they not be promptly re-elected. The proposed constitutional limitation would do away with the possibility of making a fight against the reelection of any particular individual.

It may also be objected that members of this Association should not be deprived of the privilege of voting for any man for any office. A moment's consideration of the existing restrictions of the right of suffrage and right of holding office in this Association should dispose of this objection.

It might likewise be urged that we should not willingly deprive ourselves of the privilege of re-electing a good man. Now we fortunately have had none but good men on our State Board. But I hold that good men may properly be sacrificed to good principle.

There is another quite important effect which would result from the adoption of the recommendation made. It will bring it to pass that the position of State Health Officer and Chairman of the Board of Censors may not be held by the same individual. Should the Association wish to, at this time, make no change in the policy of having the State Health Officer a member of the Board, and its Chairman, as well as its executive officer, a clause might properly be added expressly providing that election to the position of State Health Officer shall carry with it membership in the State Board of Censors. There is much to be said, however, in favor of a change which would leave the State Health Officer free to direct his energies to the multifarious and onerous duties of that position, leaving the general conduct of the Medical Association as such to the Chairman of the Board of Censors, and to other officers.

I submit these recommendations for your consideration None of them are revolutionary, nor in any way calculated to impair the working efficacy of the organized medical profes

sion.

I believe that their adoption will result in great advantage to the future of this Association.

The next order of business being the Reports of the VicePresidents, Dr. Walter Howard Bell, of Hargrove, Senior Vice-President, submitted the following report from the Northern Division of the State:

REPORT OF THE SENIOR VICE-PRESIDENT.

WALTER HOWARD BELL, M. D., ALDRICH, ALA.

Mr. President and Gentlemen of the Medical Association of the State of Alabama:

In making this report I follow the same plan of classification of the County Societies as I adopted last year, as follows:

Class I. includes those counties in which the organization and work are reported good.

Class II. includes those counties in which the organization and work are reported as fairly good.

Class III. includes those counties in which the organization and work are reported as unsatisfactory.

Class IV. includes those counties in which the methods are loose and irregular, and in which little or no work has been accomplished. In class I. I have put the following nineteen societies, viz:-Bibb, Calhoun, Chambers, Cherokee, Clay, Coosa, Cullman, Etowah, Fayette. Franklin, Jackson, Jefferson, Madison, Shelby, St. Clair, Talladega, Tallapoosa, Tuscaloosa and Walker. Eleven of these societies hold quarterly meetings, viz:-Bibb, Calhoun, Chambers, Cherokee, Clay, Coosa, Fayette, Franklin, St. Clair, Talladega and Tallapcosa, with an average attendance of fifty per cent. of their membership. Seven societies of this class hold monthly meeetings, viz: Cullman, Etowah, Jackson, Madison, Shelby, Tuscaloosa and Walker, with an average attendance of forty-one per cent. of their membership. One society. Jefferson, meets semi-monthly with an average attendance of 25.61 per cent. of its members. In all these societies papers are read and discussed and cases are reported. The boards of censors of these societies are reported as doing good work in