QUARTERLY MEETING, SPRINGFIELD, NOVEMBER, 1884.

THE regular quarterly meeting of the STATE BOARD OF HEALTH was held in the rooms of the BOARD in the Capitol Building at Springfield, on Thursday, November 20, and Friday, November 21, 1884. Present, Newton Bateman, President, and Drs. Clark, Mackenzie, Kreider, and Rauch.

After the reading and approval of the minutes of the last meeting, the BOARD suspended the regular order of business for the consideration of charges against certain practitioners under the Medical-Practice Act.

At the evening session the Secretary presented the following

QUARTERLY REPORT:

During the quarter ended Sept. 30, 1884, there were received in the Secretary's office, 1,623 communications, letters, reports, etc., and 3,472 letters, postals, and other written communications were sent out. Of printed matter there were distributed 2,680 copies of the Fifth Annual Report and upwards of 200,000 copies of other printed matter-the mail and express packages sent out during the quarter aggregating 8,982 pounds' weight, or over four tons.

Among the more important written and printed documents distributed were those

Concerning vaccination of School Children, sent to about 12,000 school districts, through the County Superintendents.

Concerning the Sanitary Inspection of Public Buildings-especially of alms-houses, jails, and similar institutions-sent to County Commissioners, Boards of Supervisors, and other officers.

Concerning the Sanitation of Railway Buildings, Grounds and travel, sent to the general officers of thirty-three railway companies operating in this State.

Concerning Preventable Diseases, sent to localities in which smallpox, scarlet fever, diphtheria, or typhoid fever appeared.

In connection with these latter circulars, the blanks for Reports of Epidemic Diseases have been revised, and a new edition has been partly printed, together with a circular of instructions for their

use.

A pamphlet of 51 octavo pages has also been prepared, printed, and distributed, containing the Public Health Laws of Illinois; the Form of an Ordinance for the Protection of the Public Health, sug

gested for adoption by communities which have no health organization, and for substitution for existing health ordinances which have been found defective or inoperative; Rules and Regulations Concerning Contagious Diseases; Concerning Vaccination; Concerning the Sanitation of Smaller Cities and Towns; and Concerning the Principles and Practice of General Sanitation.

Medical Practice:

State certificates, entitling to practice medicine and surgery in Illinois, were issued to 105 graduates, eighty-eight of which were granted upon the diplomas of medical colleges in good standing; six, upon examination in omitted branches, to graduates of colleges which had not fully complied with the Schedule of Minimum Requirements of the BOARD; and eleven, upon presentation of evidence of proper preliminary education, to graduates of colleges, otherwise in good standing, but which had not yet enacted a matriculation examination at the beginning of the session of 1882-84. There were also issued eight duplicate certificates upon affidavits of the loss or destruction of the originals, and one certificate based upon length. of practice in the State.

To midwives, six certificates have been issued upon the diplomas or licenses of recognized schools of midwifery, and three upon satisfactory examination.

Quacks and Disreputables:

With the exception of those in Chicago, the fraudulent advertising quacks and disreputable specialists seem to have been pretty well weeded out of the State. For the first time during a like period since the passage of the Medical-Practice Act, there have been no complaints received concerning this class, except as above indicated. After repeated attempts, a grand jury was at last found which indicted eleven of the more prominent of those in Chicago, during the month of July; but thus far none of the number have been convicted.

R. C. Flower.-The noted quack R. C. Flower, of Boston, Mass., has finally abandoned his efforts to secure a foothold in Chicago. By means of insidious and plausibly worded advertisements, frequently over a column in length, he succeeded in doing quite a thriving business for a time, and charged the most exorbitant fees. Unable to comply with the law and obtain a State certificate, and being refused an itinerant license, he was compelled to make appointments with his patients at Michigan City, Indiana, and at Davenport, Iowa, only venturing to stay in the State for a day or two at a time, and leaving before his arrest could be effected. Some of his dupes and victims have lodged complaint against him, and are now anxious to secure his arrest and punishment.

Frank B. Smith.-The suit of Frank B. Smith, one of the "K. & K. Surgeons," against the Secretary of the BOARD for $50,000 damages, alleged to have been sustained by the revocation of his certificate on charges of unprofessional and dishonorable conduct, was brought in the United States District Court at Detroit, Mich., and the plaintiff mulct in costs.

Public Health:

Small-pox, noted as existing in isolated localities in the southern portion of the State at the date of the last report, was practically extinct at the close of the quarter, with the exception of a few cases in Marshall county, the contagion of which was introduced from Indiana. Reports of a serious epidemic of the disease in Ballard county, Ky., threatening Cairo and the line of the Illinois Central Railroad, led me to visit the locality early in August, after communicating with the Secretary of the Kentucky State Board of Health. The precautions necessary to protect the threatened region of our own State were instituted, and these were efficiently supplemented by the action of the management of the Illinois Central, under the direction of the Superintending Surgeon, Dr. John E. Owens.

Notwithstanding the freedom of the State from this disease at the present time, and its subsidence abroad, the necessity for vaccination and revaccination in all localities where there are still unprotected individuals is likely to become apparent upon the approach of cold weather, and it is incumbent upon local health authorities to secure the fullest protection in season.

There has been a diminution in the prevalence of scarlet fever during the quarter, but toward its close there is noted an increase of diphtheria and of typhoid fever. The demand for the Preventable-disease Circulars of the BOARD has, in consequence, been much greater than usual, and that on diphtheria has been reprinted, in part or whole, by many newspapers.

In response to a telegram from Dr. Salmon, the veterinary expert of the Department of Agriculture at Washington, I went to Peoria. on the night of the 17th of August, and on the following day examined some cattle suspected of being infected with pleuro-pneumonia. The post-mortem examination of one of these animals confirmed the diagnosis, and since that date the disease has been detected in several other localities. Occasional cases continue to be reported, but the State Veterinarian believes the outbreak is in a fair way to be suppressed. The necessity for additional legislation on the subject of the contagious diseases of animals, already suggested from time to time in these reports, is emphasized by this outbreak. Sanitary Inspection and Work:

The results of the efforts made in accordance with the instructions of the BOARD at the last meeting, to secure a general inspection and improvement of sanitary conditions, have been very gratifying. Reports from 230 cities, towns and villages have thus far been received in reply to the circulars sent out, and an immense amount of work has already been accomplished in remedying the defects disclosed by the inspection. In many localities it is known that reports are deferred until the completion of work already being pushed forward in anticipation of the advent of cholera next year. I have personally inspected a number of the State institutions, and find them in as good sanitary condition as could be expected in view of obvious faulty construction, or location, from a hygienic standpoint. Such suggestions of improvement as I have found it necessary to make, have been carried out as far as practicable.

Responses to the special circular concerning Railway Buildings, Grounds, and Travel, have been received from sixteen companies, comprising the more important of all the roads operating in Illinois.

On the whole, there is cause for congratulation in the progress already made in this effort of the BOARD to secure the best attainable sanitary condition of the State as the most efficient and valuable mode of warding off an epidemic of Asiatic cholera.

It is to be wished, however, that the newspaper press, especially in the smaller cities and towns, would devote some of their space to articles urging the fundamental importance of individual sanitary effort. Without this, boards of health and health officers are to a great extent inadequate to cope with some of the more serious evils. A large portion of the community needs to be taught that personal cleanliness and cleanliness of the household and premises are among the highest results of sanitary science, and that of themselves they constitute the best safeguards against contagion and preventable disease.

The Cholera :

Soon after the adjournment of the last meeting of the BOARD the spread of Asiatic cholera in Europe and the indications of its possible cis-Atlantic extension became so threatening that on the 17th of July I addressed a communication to the Hon. Erastus Brooks, of New York, Chairman of the National Conference of State Boards of Health, suggesting that a session of the Conference be held in Washington City, with the view of securing concert of action on the part of all those charged with the administration of public health affairs, of devising some general and efficient system of supervision and notification at all seaports, and of ascertaining authoritatively the plans of the General Government with reference to measures for the prevention and limitation of the threatened epidemic. To this meeting it was proposed to invite the health officers and quarantine authorities of all seaports and boundary towns, the health authorities of important inland cities-especially those in States having no State Boards of Health-and the health authorities of the Dominion of Canada.

The suggestion was favorably received and the time of the meeting was fixed for August 7, but, before that date, the President and the members of the Cabinet, with whom it was desired to confer, had left Washington, so that the chief object for deciding upon the National capital as the place of meeting was frustrated, and this fact, coupled with more favorable news from Europe, led me to propose a postponement to the regular period of meeting, namely, during the session of the American Public Health Association.

The National Conference accordingly met in the city of St. Louis, on October 13, delegates from State boards of health, and from various health organizations in twenty States, and representatives of the Provincial Board of Health of Ontario, and of the government of the Dominion of Canada, being in attendance. The session, which was continued on the 14th and 15th, was devoted entirely to the consideration of the questions above indicated, and the report, formulated on the discussions, addresses, and papers, and adopted by

the Conference, was subsequently indorsed by the American Public Health Association, ordered to be printed, and copies forwarded to the President of the United States and his Cabinet, to each of the Senators and Representatives in the National Congress, to the health officers of cities, to the various State Boards of Health, and to the officers of the Dominion of Canada, and of the Provincial Board of Health of Ontario.

Copies of the report of the proceedings, including the text of a paper by Dr. C. W. Chancellor, Secretary of the Board of Health of Maryland-"Can Epidemic Diseases be excluded by Sanitary Cordons?"; of a memorandum of Quarantine and Sanitary Methods, formulated by the National Board of Health in re Asiatic Cholera, prepared by Dr. Charles Smart, U. S. A., member of the National Board of Health, and of my address at the opening of the Conference-"Practical Recommendations for the Exclusion and Prevention of Asiatic Cholera in North America"-have already been furnished to the members of the BOARD. It is not necessary, therefore, at this time, to do more than refer to one illustration, furnished by recent developments, of one of the points made in my address, to-wit: "That we may not know how widely spread the disease is now on the European continent, and we do not know how soon its arrival on our own shores may be announced." The proof of systematic and persistent suppression of damaging information by European authorities, which I then submitted, and is since corroborated by the disclosure of the existence of cholera in Paris for months before the fact was reported, justifies us in suspecting a much wider extension of the area of infection than is acknowleged or known to exist.

The action of the BOARD has already anticipated all the practical measures which have been recommended in the interim since our last meeting; and I do not know that there remains anything more for the BOARD to do in its official capacity beyond a formal indorsement of the report of the National Conference.

Recommendations and Suggestions:

I have to respectfully recommend-.

1. That a thorough and systematic sanitary survey of the State be inaugurated by the 1st of January, 1885.

2. That a committee be appointed to prepare revisions and amendments of the laws regulating the practice of medicine and the protection of the public health.

3. That action be taken with reference to the forthcoming meeting of the National Conference of the State Boards of Health, on the subject of Asiatic cholera.

JOHN H. RAUCH, Secretary.

Upon the conclusion of the reading, the report was accepted, the recommendations and suggestions were taken up for consideration, and the following action was had: