practical inquiry is what a particular provision, clause or word means. It should be construed with reference to the leading idea or purpose of the whole. The whole and every part must be taken into account, while the general intent should not be lost sight of in determining the scope and meaning of any part. (Sutherland, Statutory Construction, 1st ed., par. 245, 247, 250, 254, et sequi). A careful analysis of both the medical and osteopathic statutes will convince a competent investigator that the legislative mind could not have had in view the establishment of two separate and distinct standards of such an important branch of medicine as surgery, the one having only 20 per cent. of the qualifications of the other. Legislation of this kind would not only be discriminative, but unconstitutional. It would have none of the elements of protection to the people. Section 4, of the amended Osteopathic Act of 1913, reads as follows, and which for convenience is again quoted. "The certificate provided for in section two of "this act shall entitle the holder thereof to prac"tice osteopathy in the State of Michigan (in all "of its branches as taught and practiced by the "recognized colleges or schools of osteopathy), "but it shall not authorize him to practice med"icine within the meaning of act number two "hundred thirty-seven of the public acts of eigh"teen hundred ninety-nine, or acts amendatory "thereto; Provided, That nothing in this act shall "be construed as to prohibit any legalized osteo"pathic (physician) in this State from practicing "medicine and surgery after having passed a sat"isfactory examination before the State Board "of Medical Examiners in the State of Michi"gan * It will be noted that an attempted amendment to the above section was made, by adding the words bracketed, i. e., "in all of its branches, as taught and practiced by the recognized colleges or schools of osteopathy," and "physician," to the section, and eliminating the words "or surgery" from the former reading, "it shall not authorize him to practice medicine or surgery." For convenience in analysis, this Section 4 can be discussed from three angles: First. The legal force of the words "practice osteopathy in the State of Michigan in all of its branches as taught and practiced by the recognized colleges or schools of osteopathy." Second. The legal significance and interpretation of the term "practice medicine," and the omission of "or surgery" from the original reading in the 1903 act. Third. The blending, or the harmonizing, of the titles and provisions of both the 1913 medical and osteopathic acts.. First. Under the first division of the section, the provision is attempted, permitting osteopaths to invade, without standard qualifications, branches of medicine outside of the field of osteopathy, as it has heretofore existed, and the regulation of which is already, and has been for a great many years, under the administration and control of state medical boards, created by the legislatures of the several states. And, incidentally, attention is called to the avowed purpose of the authors of Section 4 under discussion to create an indefinite and expensive definition of osteopathy, capable of unlimited expansion as circumstances might arise. Having the above in view, osteopaths, in legislative efforts, have always refused to incorporate into any proposed bill or act, anything having the slightest resemblance to a definition of osteopathy. There can only be one reason for this most important factor in an act being so persistently and strenuously opposed, and this Section 4 clearly demonstrates it. The delegation of authority to corporations and individuals, citizens of other states, and under no direct or indirect control, either by the state directly, or by a state board of licensure, to create standards of qualification for license and practice in Michigan, such standards involving departments or subdivisions. of medicine already under state and state board control, is, without question, an unconstitutional delegation of authority, and, in addition, a subject has been injected into the amended act, the object and purpose of which has not been disclosed in the title. The language used in section 4, i. e., "practice osteopathy **** in all of its branches as taught and practiced by the recognized colleges," etc., correctly construed, can only refer to osteopathy per se, not to organized and fundamental divisions of medicine, existing, as such, centuries before osteopathy existed. The word "practice" cannot be a factor in the sentence, for the reason that no state in the union permits an osteopath to practice general surgery, and practice, to be material, must of necessity be legal practice (Hooper v. Batdorff, 1905, 141 Mich., 353; 104 N. W. 6671). Legally considered, therefore, "taught and practiced" is an impossibility in law. It may be contended, that listing surgery in Section 2 of the 1913 Osteopathic Act, shows legislative intent to authorize osteopaths, under these amendments, to add general surgery to osteopathic practice. The creation of another subject, which is not disclosed in the title of the act, is again noticed. The mere citation of subjects for study and examination, in an act, and without specifying the degree of qualification required, does not warrant the assumption that authority is given for professional practice in such subjects. Surgery is only remotely connected with osteopathy, and can only be properly regarded as fundamental to the study of this system, or rather, method of treatment. All state acts regulating the practice of professions in volving specialties in medicine, and creating standards, provide courses in surgery and other fundamental subjects. In a large degree, the intent is to provide a method for diagnosis, with a view to the prevention of attempted treatments in unsuitable cases, and as a measure of safety to the public. The Druggist Act provides not only for the study of drugs, but also for expert knowledge of the therapeutic action of drugs on human beings, practically a similar course as given to medical students. The Dental Act provides for surgery of the jaws and teeth, a certain amount of drug therapy, and anesthesia. The Chiropody Act provides for courses and examinations in surgery. The Nurses Act provides for courses in surgery, medicine, obstetrics, gynecology, and materia medica and therapeutics. It can hardly be contended that any one of the above quoted acts provides for license to practice medicine, including surgery. Again, if Section 4, under discussion, gives an irresponsible body without the State, and under no State control, authority to add such an important department of medicine to a method of treatment, by the simple process of listing such department with the studies claimed to be taught in colleges not recognized by any one of our reputable universities, either in this, or in any other country, with authority to practice such department of medicine in a state requiring at least 500 per cent. greater qualifications, then it is reasonable to assume that this body can, by the same process, authorize future osteopathic graduates to practice dentistry, pharmacy, chiropody, law, and several other professional callings, without the necessity of their being authorized by the several state boards appointed by the state for that purpose. Second. The legal interpretation of the term "Practice of Medicine," in Section 4 of the osteopathic amendments. It will be plainly evident to the logically trained mind, that an attempt was made by the authors of the above section to camouflage its intended purpose with the object of creating the legislative intent of removing from the section the prohibited practice of surgery and obstetrics by osteopaths, through the method of changing (by omission) the wording of the section from "practice medicine and surgery" to "practice medicine." In order, however, to have accomplished this purpose, it was absolutely necessary, not only to change the technical word "medicine" from its universally accepted and used meaning by some rational language in the proposed statute, but also providing for the proposed change in the title of the act itself by amending it. Again, it was also necessary, in order to accomplish this object, to omit the words, "and surgery" from the succeeding words of the same section, which very plainly demonstrates the legislative intent to prohibit osteopaths from practicing surgery under the amended act. In connection with the above, while not necessary in view of the fact that "practice of medicine" is very broadly defined in Section 9 of the 1913 Medical Act, it seems proper to discuss the legal construction of the word "medicine" as it is used in medical practice acts, and allied acts. "Medicine" is a double entendre word. It may seem, and as commonly used does mean either of two things. In one sense it means a substance which has a curative property, and is synonymous with the word drug. But its common and well'established meaning is "the science or system of curing, healing, alleviating or preventing disease, physical disorders and injuries, without reference to the means employed to accomplish that end." "Medicine" in its generic sense as a science should be distinguished from the term "drug." The word "medicine" (Latin, medicina) is derived from mederi-to heal. It has been defined in all of the various medical and standard dictionaries, as well as by statutes and the courts. An analysis of these several definitions admit of but a single conclusion-the term is used only in its broadest sense in medical practice acts. (See Dunglison's, Gould's and Dorland's Medical Dictionaries, Webster's New International, Century, Standard and Encyclopedia Britannica Dictionaries). "Medicine" as defined by Legislatures and by the Courts. Bragg vs. State, 134 Ala. 165. Collins vs. Texas, 32 Sup. Ct. Rep. 286. State vs. Miller (Iowa), 124 N. W. 167. People vs. Mulford, 125 N. Y. 680. Kansas City vs. Baird, 92 Mo. App. 208. The "practice of medicine" consists of three essential things: First. Diagnosing or determining the nature. character and symptoms of diseases or ailments. Second. Determining the proper remedy for the same. Third.-Giving or prescribing the appropriate remedy. "The 'practice of medicine' as that term is more "generally understood, means the exercise or per"formance of any act by or through the use "of anything or matter, or by things given or "applied, whether with or without the use of "drugs or medicines, by a person holding himself "or herself out as able to cure diseases or the "causes of diseases, with a view to relieve, heal, "cure or having for its object the prevention "healing, curing or alleviation of disease." (Underwood vs. Scott, 43 Kan. 714. Green vs. Hodges (Kan.), 138 Pac. 605). "The term 'practice of medicine' may be taken as "embracing the art of preventing, curing and "alleviating disease and remedying as far as pos"sible the results of violence and accident. Ther"apy is the treatment of disease, and surgery is "operative therapy. Thus, the practice of med"icine necessarily includes surgery and any method "of treatment." (Stewart vs. Raab, 55 Minn. 20. "Holding one's self out as a physician together "with diagnosing, prescribing and charging there"for constitute the 'practice of medicine!" State vs. Van Doran, 109 N. C. 864. The above supreme court decisions are simply concrete examples of the very large number of similar opinions supreme courts of nearly all of the several states have given from time to time. An Ohio case, viz., State vs. Liffring (61 Ohio St. 39) was based on the applied doctrine of "noscitur a sociis," to the language, "medicine, drug or other remedy" as it appeared in the Ohio medical act. This act was subsequently amended as follows: . "Who shall prescribe or who shall recommend for a fee for like use any drug or medicine, application, operation or treatment of whatsoever nature for the cure or relief of any wound, fracture, bodily injury, infirmity or disease." The Liffring case was in effect overruled by the same court in the case of State vs. Gravett, 65 Ohio, St. 289. It would seem, therefore, that "medicine" as interpreted by the courts, and as generally understood the world over, is a technical word denoting a science and embracing not only therapeutic pharmacology, but the art of understanding the nature of diseases or ailments, the causes that produce them, and the art of knowing how to prevent them. These definitions are thoroughly supported and established by the history of medicine and by common usage in its practice as a science. Consequently, we have schools of medicine in connection with our state and national universities, teaching all of the branches of medicine, including surgery obstetrics, and physical-therapy. We also have national departments of medicine, including in its membership surgeons of the Army, Navy, and Marine Hospital Service. Also we have the Medical Reserve Corps, of the U. S. Army, composed of surgeons, graduates of reputable and recognized schools of medicine. At the beginning of the war, osteopaths attempted to obtain recognition in this branch of the service under the camouflage of extreme patriotism and service, but after an investigation of their claims. and status, the War Department ruled that osteopaths could not qualify as surgeons of the Army. Gunshot and bayonet wounds can not be remedied by rubbing, twisting, pulling or thrusting, neither can a mutilated face be restored by similar process. We have national and health departments charged with the duty of practicing preventive medicine and which does not involve the giving or prescribing of drugs. If the interpretation attempted in the osteopathic amendments had any force, it is reasonable to suppose that a preventive medicine official was charged with the enforcement of the Harrison Drug Act. The term "medicine and surgery" is simply a method of expression, and is used to emphasize an important branch of medicine. It comes under the doctrine of "noscitur a sociis" as applied in State vs. Liffring, (61 Ohio St. 39). A legislature can define terms used in an act in order that a court may more readily give effect to the enactment. (Territory vs. Newman, N. Mex. 72 Pac. 706). Act No. 368, of the Public Acts of 1913, Section 9, (Michigan) reads: "Any person who shall append the letters 'M.D.' "or 'M.B.,' or other letters in a medical sense, or "shall prefix the title 'doctor' or its abbreviation, "or any sign or appellation in a medical sense, "to his or her name, it shall be prima facie evi"dence of practicing medicine within the meaning "of this act. In this act, unless otherwise pro"vided, the term 'practice of medicine' shall mean "the actual diagnosing, curing or relieving in any "degree, or professing or attempting to diagnose, "treat, cure or relieve any human disease, ailment, "defect or complaint, whether of physical or men"tal origin, by attendance or by advice, or by "prescribing or furnishing, any drug, medicine "appliance, manipulation or method or by any "therapeutic agent whatsoever. The above definition, a most important of the part of the statute, should without further argument furnish the exact interpretation of the scope and meaning of the words "practice medicine" in Section 4, of the osteopathic amendments of 1913. The definition is placed in the statute for this purpose only. This definition has been commented upon by the Michigan Supreme Court as being extremely broad, but constitutional if applied in harmony with the title of the act, which reads: "An Act to provide for the Examination, Regulation, Licensing and Registration of Physicians and Surgeons," etc. This definition is without question broad enough to answer the purpose for which it was intended, and it certainly harmonizes with the title of the act from the constitutional standpoint. In a recent decision the Supreme Court (Michigan) Reaffirmed a former decision (People vs. Phippen, 70 Mich. 6), which found the defendant guilty of practicing medicine, he being a “magnetic healer" and not using drugs or instruments. (Looke vs. Circuit Judge of Ionia County, Mandamus). While not directly material to the case under discussion, it is interesting to note several supreme court decisions in which surgery is held to be not included in the method of treatment known as osteopathy. The psychology of the evolution of an osteopath from a method of treatment which not so very long ago designated surgery a crime against humanity, to the status of a regular physician and surgeon is, to say the least, very illuminating. Bragg vs. State, 134 Ala., 165. Smith vs. Lane, 24 Hun. 332 N. Y. State vs. Lawson, (Del) 65 Atl. 593. Concluding the discussion relative to the legal force of Sections 2 and 4 of the amendments of the osteopathic act, I have an official opinion from the Attorney General, at Lansing, in which it is held that osteopaths in this state are not given authority in above sections to practice surgery in Michigan. (See Attorney General's Annual Report, 1914-1915). This official opinion should afford sufficient warrant for the prosecution of osteopaths who practice and obstetrics without medical registration. Third. The blending or harmonizing of the titles and provisions of both the 1913 medical and osteopathic acts. The following general comments are intended as a resume of the discussion covering the legal disabilities involved in Sections 2 and 4 of the osteopathic amendments of 1913 and their conflict with the provisions of the 1913 medical act. The words of a statute are to be understood in the sense in which they best harmonize with the subject of the enactment, and with the object which the legislature has in view. That is, in the construction of a statute words are to be understood in their ordinary meaning as applied to the subject matter (title) with regard to which that are used. and as a result where technical words used in reference to a technical subject they are of necessity interpreted in the sense in which they are understood in the science or art in which they have ac quired it. (Endlich. Interpretation of Statutes. Pp. 94-96, Para, 73-75.) Again, as already referred to, in the "ex verceribus actus" of a statute, the practical injury is what a particular provision, clause or word means. It should be construed with reference to the leading idea or purpose of the whole, (Sutherland, Statutes and statutory Construction. Sect ed) Para, 245-254 et sequi). (1 Kent's commentaries). In comparing the titles of the two acts in question, the one provides for the registration, licensing, examination and regulation of Physicians and Surgeons, the other provides for the registration, licensing, examination and regulation of osteopathic practitioners. The subject matter of the one act is in harmony with its title; the subject matter of the other act is not indicated in the title and is in direct conflict with the provisions of the medical act-the prevailing act. The meaning and intent of the term "practice medicine" is clearly and specifically defined in Section 9 of the medical act and in Section 4 of the osteopathic act. In the latter act the term osteopathy is not defined even by inference. The courts have defined osteopathy as a method of treatment by manipulation and rubbing, with the claim of its being more scientific than a nurse or a masseur, the latter of whom are exempted in the osteopathic act, (Collins vs. Texas, 39 Sup. Ct. Rep. U. S. 286). If it is constitutional for the legislature to deligate authority under its police power to individuals and corporations without the state, and under no state control, to establish and maintain standards of qualifications for osteopathic practice in Michigan such standards must of necessity harmonize with the tile and provisions of both the medical and osteopathic acts. It is absurd to contend that the Michigan Legislature had in mind the establishing of two distinct and different standards of surgery, together with their administration, the one representing some 20 per cent. of efficiency as compared with the other. As medical legislation has solely to do with the protection of the public, the attempted construction of the osteopathic amendments does not meet the fundamental reasons for the creation and maintenance of state recognition of professional callings. Yours very truly, B. D. HARISON, Secretary. Mich. State Board of Registration in Medicine. Influenza Vaccine. So far but two definite reports of adequately controlled experiments on the use of influenza vaccine appear to have been published. That of Barnes concerned the use of the Leary vaccine, composed of strains of the influenza bacillus, and indicated that the vaccine was not of prophylactic value. The second report, by G. W. McCoy and co-workers, concerned a carefully controlled experiment on the use of a mixed vaccine similar to that brought out by Rosenow, and indicated that this vaccine was not efficacious as a prophylactic against the present epidemic (Jour. A.M.A., Dec. 21, 1918, p. 2094.) Deaths Doctor George W. Wagner died at his home in Detroit, December 15, of pneumonia following an attack of influenza. Doctor Wagner was associate professor of gastrology at the Detroit College of Medicine, and a member of the Harper Hospital staff. He had practiced in Detroit for about thirty years, coming there from Adrian, Michigan, where he was born in 1864. He was a graduate of the Jefferson Medical College of Philadelphia. Doctor Wagner is survived by the widow, mother, two brothers and three sisters. Doctor Clifford Kirkpatrick, of Adrian, died December 31st at the Bixby Hospital from a violent attack of peritonitis with which he had been ill but a few hours. Doctor Kirkpatrick was born in Bangor, Maine, May 13, 1855 and came to Adrian in 1878. He was a graduate of the University of Michigan. The widow and one sister survive him. In the death of Doctor Allison B. Stealy, of Charlotte, Eaton County loses one of its representative physicians and surgeons. Doctor Stealy died Thursday afternoon, January 9th at his home in Charlotte, after a rather long illness. He was 62 years of age. Doctor Stealy attended the University of Michigan and was a graduate of the Bush Medical College of Chicago of the class of 1886. Surviving are the widow, four children, and one brother. The deaths of Doctor Paul Leuschner, of Mt. Clemens, and Doctor S. B. Rolison, of Hesperia, not members of the Society have been reported. Benzyl Benzoate.-The Benzyl alcohol ester of benzoic acid. It lowers the tone of unstriped muscle and has been suggested as a remedy against renal, biliary, uterine and intestinal colic and other spasms of smooth muscle, including angiospasm. Its clinical use is in the experimental stage. The dose is from 0.3 to 0.5 Cc. (5 to 7 minims). Benzyl benzoate is a liquid at room temperature, insoluble in water, but miscible with alcohol, chloroform and ether. State News Notes COLLECTIONS. Physicians' Bills and Hospital Accounts collected anywhere in Michigan. H. C. VanAken, Lawyer, 309 Post Building, Battle Creek, Michigan. Reference any Bank in Battle Creek, KALAMAZOO MAN HEADS NEW STATE HEALTH BODY. The Michigan division of the American Public Health Association was organized at Lansing, January 7, by representatives of health departments of all cities in the State having fully paid officers. The intention is to establish a unit of the national association in Michigan. Co-operation, including the working for legislation which would be of benefit to health officers, is the aim of the new organization. Dr. A. H. Rockwell, of Kalamazoo, was elected President, A. C. Parnell, of Ann Arbor, Vice President, and William De Kleine, of Flint, Secretary and Treasurer. an T. B. CLINICS FOR WESTERN MICHIGAN. The Michigan Anti-tuberculosis Association nounced as schedule for free tuberculosis clinics in various counties in the State during the next two months as follows: Gratiot county, at Alma, January 30 and 31; Montcalm county, at Greenville, February 13 and 14; Ionia county, at Ionia, February 27 and 28; Barry county, at Hastings, March 13 and 14; Clinton county, at St. Johns, March 27 and 28; Branch county, at Coldwater, April 10 and 11. Dr. E. R. Vanderslice, medical director, and Miss Charlotte Ludington, field nurse, are in charge of the clinics and they will be assisted by local physicians, nurses and health workers. The next annual meeting of the Federation of State Boards will be held at the Hotel La Salle, Chicago, on Monday and Tuesday, March 3 and 4, 1919. This will be the Annual Congress on Medical Education and Licensure participated in by the Federation of State Medical Boards, the Council on Medical Education, of the American Medical Association, and the Association of American Medical Colleges. This meeting will be one of unusual importance since it will involve a discussion of numerous problems relating to medical education and licensure which have arisen as a result of the war. Col. V. C. Vaughan, head of the epidemiological section of the staff of the surgeon general of the United States and also head of the medical school of the University of Michigan, warned the people of Michigan that with the increase in respiratory diseases, there is apt to be an increase in tuberculosis. Dr. Arthur M. Hume, of Owosso, President of the Michigan State Medical Society is in New York where he is connected with the Michigan Soldiers' Bureau. He will pay particular attention to the sick and wounded in the hospitals and as they arrive from overseas. Detroit-"Doctor" fined $200 in Police Court Case Judge Jefferies Tuesday fined Costica Dumitrescio, Rumanian "doctor," who formerly conducted a "hospital" at 376 Adelaide Street, $200 with the alternative of three months' imprisonment. Dumitrescio paid the fine. The marriage of Captain Clayton Gregg Woodhull of the Base Hospital at the Air Service Depot at Morrison, Va., formerly of Decker, Mich., to Miss Winifred Susan Flaherty, C. N. U. S. Army, N. C. at Newport News, Va., December 21, 1918, is announced. Dr. E. G. Bellinger, recently mustered out from the medical corps at Camp Greenleaf, Ga., where he was stationed has returned to Lansing where he has opened his former office for general practice. Major Howard A. Grube, formerly chief surgeon at the Michigan Soldiers' Home has been promoted to rank of Lieut. Col., and is now with the Army of Occupation in Germany. The county secretaries are urged to send in their news items each month for publication, or if each doctor would report the "doings" in his vicinity direct to this office it would help us a great deal. Dr. Frank W. Hannum, who was commissioned a first lieutenant in the medical corps of the U. S. army has been discharged and will resume his practice at Muskegon. Dr. Joseph V. Dooling has been appointed health officer to succeed Dr. William H. Gale. Doctor James W. Inches has accepted the police commissionership at Detroit at a salary of $5,000.00 a year. The Sunfield township board has appointed Doctor James Crawford as health officer for the township in place of Doctor T. L. Peacock, resigned. Dr. J. N. Day has been appointed health officer to fill the vacancy caused by the resignation of Dr. T. J. Carney at Alma, Mich. Doctor R. N. Dunnington of Hartford has located in Benton Harbor having taken the suite of rooms connected with the office of Doctor W. E. Brown in the Bell Block, |