"reputable" institution. It was held that the law constitutes the Board judges of the standing of a college, and there is no power of review vested in any other body.

Mr. Justice Scholfield, in delivering the opinion of the Court, used the following language: "As a part of the current history of the times, and as an aid in arriving at the legislative intention, wel know there were colleges of different kinds authorized by the laws of States in which they were located, and in which there were pretended to be annually delivered full courses of lectures, and instruction upon the arts and sciences professed to be taught, that were not 'reputable' because they graduated for money, frequently without any reference to scholarship. A diploma from such an institution afforded no evidence of scholarship or attainments in its holder. It was a fraud, and deserved no respect from anybody, and it was as against such diplomas the law was intended to protect the public, and therefore required that the colleges be 'reputable.' Whether a college be reputable or not, is not a legal question, but a question of fact. So also are the requirements in regard to the annual delivery of full courses of lectures and instruction. These questions of fact are, by the act, submitted to the decision of the Board,-not in so many words, but by the plainest and most necessary implication. Their action is to be predicated upon the existence of the requisite facts, and no other tribunal is authorized to investigate them, and of necessity, therefore, they must do so. The act of ascertaining and determining what are the facts, is in its nature judicial. It involves investigation, judgment and discretion.

In the exercise of this judgment and discretion, the Board had decided that the curriculum of study and requirements for graduation of the Indiana Dental College, were not such as to entitle it to be classed as a 'reputable dental college,' and there is no power in the law given to any person or body to review and set aside or confirm the exercise of this discretion by the Board. So, upon the refusal of the Illinois State Board of Dental Examiners to grant a license to a person whose application was based upon a diploma issued by a dental college, mandamus will not lie to compel the Board to grant the license; because, to entitle the applicant to a license, the diploma must have been issued by a 'reputable' dental college, and whether the college is a 'reputable' one, is, under the statute, within the judgment and discretion of the Board to determine.'

It is also noted in this connection that two colleges which the STATE BOARD OF HEALTH has long refused to recognize as in good standing have recently met with signal and final defeat in their efforts to secure a legal rehabilitation. The New York Court of Appeals has affirmed the judgment rendered by the Supreme Court of that State about a year ago, in the case of the United States Medical College of New York, setting aside the charter of that institution. As this appeal was understood to be taken as a test case by the attorneys for the Buffalo College of Physicians and Surgeons, this decision is to be regarded as conclusive on this college also.

THERE have been fewer complaints made direct to the BOARD of unprofessional conduct, and fewer cases of this kind otherwise coming under observation during this quarter, than ever before in the history of the BOARD.

Anderson. The man J. E. Anderson, of the "American Surgical Institute" of Indianapolis, previously run out of Paxton, Tolono, and elsewhere, was arrested in Freeport the 9th of May for practicing in violation of the law. The case was clearly made out, Anderson pleaded guilty, a fine of $50 and costs was assessed, which he paid and at once departed for his Indiana home. A list of some of his victims in the northern part of the State has been furnished me.

Riley.-About the middle of June an itinerant, by the name of Riley, was arrested in Dixon for violation of the law, and was bound over for trial.

Williams.-Two of the Chicago quacks, Lucas R. and George J. Williams, arrested for circulating obscene and indecent literature through the mails, have recently been tried in the United States District Court, and fined $200 each, with costs. One of these cases was an aggravated one, many of the vile pamphlets having been sent to school girls at Englewood and elsewhere. I do not hesitate to pronounce the penalties inflicted in these cases as totally inadequate. Although the stereotype plates and the editions found were. understood to have been destroyed, one of these men is already again distributing his "Hidden Secrets." The only way to suppress these violators of public decency and morals is to imprison them.

Medical Education:

At the annual meetings of the various medical organizations, State and National, which have been held during the past three months, the subject of the preliminary education of medical students has received more than usual attention. Almost unanimously the individual members of the profession, and the various organizations, with one exception, have pronounced in favor of exacting proof of proper preliminary education before admitting candidates to the lecture classes. There is practically no opposition to the movement, the only dissentients being members of college faculties influenced, probably, by a fear of diminished classes. With few exceptions, and these diminishing in number from time to time, the better class of colleges has already adopted this requirement. Every announcement for the session of 1884-85 thus far received, makes this a distinctive feature; but it is to be wished that the colleges would state specifically in their announcements the kind of examination applicants would be subjected to, or the proof required of fitting education; instead of merely saying-as many of them do-"a preliminary education is required."

As illustrating the wide-spread influence of the effort to heighten the standard of professional acquirements, it may be stated, that at a recent meeting of the Nebraska State Medical Society, the qualifications for admission to membership were so amended as to require that applicants must be graduates of colleges which in all respects conform to the standard of minimum requirements of this BOARD.

In the further interest of medical education, I think it the duty of the BOARD to exert its influence toward securing legislation for the proper and adequate supply of material for the study of practical anatomy. Colleges in this State have been embarrassed during the past year or two in their efforts to properly instruct their students. in this most important branch, and the difficulty is increasing. Surgical knowledge and skill cannot be acquired without an intelligent practical study of anatomy; and in order to secure this, the methods and sources of the supply of material need to be recognized and regulated more definitely by law.

The Public Health:

Scarlet fever and small-pox prevailed to some extent during the first half of the quarter, mainly in the southern portion of the State. Except the few cases in Chicago, and those in Kendall county, all the small-pox cases occurred in the south half of the State, but scarlet fever was more generally diffused. Both diseases have been of a mild type, with a moderate death-rate. As the season advanced there has been the usual increase in the diseases of hot weather, but not characterized by any noteworthy features.

Although eight cases of small-pox have been brought into Chicago from other places since January 1st, 1884, only one case was contracted from any of these by a resident of the city. Three of these eight cases were Indians, brought in from the Indian Reservation; two were from Indianapolis; one from Cincinnati; and two from the town of Cicero-said to have been contracted from a tramp from Ohio. One of the Indianapolis cases reached Chicago four days before the appearance of the disease, and from him resulted the only case that originated in the city-a man with whom he slept one night contracting it from him. In no other case was there any spread of the disease; and the methods of dealing with cases as they appear, the details of disinfection, the general vaccinal protection of the community-especially of the 70,000 school children, and the large number of poor people are so thorough and perfect, that Chicago, notwithstanding the great railroad travel and large number of transients, is now one of the safest cities in the Union in this respect.

At the close of the last quarter small-pox existed in Centralia, Marion county; Charleston, Coles county; and Coulterville, Randolph county. Owing to municipal neglect and a mistaken idea of economy, the disease obtained a foothold in Centralia which it subsequently required great effort to overcome, besides creating alarm and apprehension in neighboring communities. In fact, the disease was conveyed from this place to Irvington township, Washington county; to Belle Rive in Jefferson county, and to Springfield. The first case in Centralia was treated, it is stated, by Alexander Jones, whose certificate the BOARD revoked, at the January meeting, for unprofessional and dishonorable conduct. It is alleged that Jones treated the case without any of the necessary precautions; not reporting it to the authorities, nor in any manner guarding against spread of the contagion. The patient was treated during the entire illness in a room separated only by a curtain from a shoe shop, on one of the most frequented streets of the town; and the shop was

visited daily by numbers of persons. It is believed that all the cases in Centralia-32 in number with 6 deaths-as well as those in Washington, Jefferson and Sangamon counties, were primarily due to the criminal conduct of this man Jones. The BOARD has exhausted its authority in dealing with him by revoking his certificate, since he claims the exemption of the ten-years prior-practice clause of the Medical-Practice act. In charging him, however, with being primarily responsible, it is not meant to exonerate the municipal authorities from all blame; for as early as the 8th of March they were duly notified of the existence of a case resulting from this first concealed case.

From the tramp who carried the disease into Charleston, Coles county, as reported at the April meeting, there resulted five other cases, making a total of six cases, and three deaths. The first of this last group of cases was a man who visited the tramp. In the usual time he came down with the disease, and died on the thirteenth day.

At Coulterville, Randolph county, also mentioned in my last report, there were five cases with one death in the first outbreak, which was caused by a negro roustabout who had contracted the disease on the river. Notwithstanding a rigorous quarantine, of isolation and other precautionary measures, some obscure cases of varioloid followed this first outbreak; and through failure to correctly diagnose the early cases of this second group (which were not characteristic) the disease still continues. The condition of affairs at this place, and a conflict of opinion as to some of the cases now under treatment, led me to visit the locality personally, on the 28th of June, when I found two well-marked cases of small-pox and one of varioloid. The severer of the two, which will probably prove fatal was in Perry county just over the line; but instructions were given to the Coulterville authorities to extend their quarantine jurisdiction so as to embrace this case, and to vaccinate, or revaccinate, all persons in the compromised area who had not been successfully protected within the last two and a half years. The spirit manifested by the village authorities, the physicians and citizens whom I met, warrant the belief that this outbreak will now soon be suppressed. I communicated also with the county commissioners and county clerk of Perry county, and feel assured of their coöperation and assistance.

The outbreak at Yorkville, Kendall county, was due to a young man recently arrived from New Orleans, who had an unrecognized case of varioloid. A large number of persons were exposed before the facts were known, and a total of nineteen cases with four deaths resulted. So much excitement was caused by the first group of these, some fourteen in number, eleven of which appeared in rapid succession between March 27 and April 2, and in several localities, that I found it necessary to visit the town personally. The published instructions of the BOARD were thoroughly carried out, a supply of vaccine virus obtained, and all unprotected persons at once vaccinated. Notwithstanding the number of centers of infection, only five more cases resulted-the last after an interval of fully a month. The speedy suppression of the outbreak, which promised to be very

serious at the date of my visit, was due to the prompt and efficient coöperative action of the authorities of the four separate jurisdictions in which the cases appeared.

The detailed reports of these cases have been received, and from them the usual state of facts concerning vaccination is found; that is, of the four fatal cases, three had never been vaccinated at all, and the remaining one had had small-pox when young, had been vaccinated seven or eight times unsuccessfully-"it never would work" -owing probably to the previous attack of small-pox, the protection from which seems to have been exhausted prior to this last exposure. Of the fifteen who recovered, two had never been vaccinated at all; one, not until after the febrile stage of the disease had begun; and four others, not until after exposure. None of those attacked had ever been revaccinated.

There have been seven cases of small-pox with two deaths among colored steamboat hands at East St. Louis, all contracted on the river. These cases were removed, as soon as discovered, from time to time, to the St. Louis small-pox hospital; and about the last of May, I received a communication from the Health Commissioner of St. Louis, stating that the East St. Louis patients were the only ones them in the hospital, and that the institution was kept open solely for the benefit of the latter place. While this is technically true, the relations of the two places are such, that what is done for the one in such a matter as this is really done for both. However, I again visited East St. Louis and discussed the situation with the authorities, and am glad to be able to state that a board of health has since been organized, the Burial-permit Ordinance prepared by the BOARD has been adopted, and there is some prospect of an improved sanitary condition.

Isolated cases of the disease have also occurred during the quarter at Mound City, Pulaski county, one case, probably contracted on the river, no spread; at Red Bud, Randolph county-one case contracted in Cairo, no spread; in Irvington township, Washington county-two cases contracted in Centralia, and one from these in the person of the nurse, who had had small-pox when young; at Belle Rive, Jefferson county-one case contracted in Centralia, no spread; in the country six miles south of Nashville, Washington county-one case contracted in Coulterville, and from this four more cases in the same family; Ashmore township, Coles countyone case contracted in nursing an unreported case on the county poor farm, patient had had small-pox when young; and in Springfield, Sangamon county-one case contracted in Centralia, no spread up to date.

Although the contagion has been repeatedly introduced into Illinois from without, during the past winter and spring, we have been fortunate in escaping it by immigrant introduction thus far. Neighboring States have been less favored, Iowa, for example, having now a serious outbreak, upwards of twenty cases in one county, all among immigrants landed at Baltimore from the steamer Salier, of the North German Lloyd's line. The want of appropriations, whereby the National Board of Health might continue its immigrant inspection service, is seriously regretted.