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REGULAR QUARTERLY MEETING,

JUNE-JULY, 1831.

AT the regular quarterly meeting, held in Chicago June 30-July 1, 18 2, the members present were Drs. Gregory, Rauch, Bateman, Ludlam, Haskell and McLean-the President in the chair.

The Secretary presented a report on the progress of the smallpox epidemic. The number of infection-centers was shown to have increased during the last quarter from 18 to 190, while there remained only nine points in which the disease had not been suppressed, as compared with thirty-one at the date of the last report, this being the lowest number since September, 1881. Only one case had been reported among immigrants arriving in the State since the inauguration of the immigrant-inspection service.

The Secretary also presented a report covering the details of the immigrant-inspection service of the National Board of Health in the district under his charge, comprising the States of Illinois, Indiana and Missouri. The report set forth the establishment by the National Board, in response to requests from a number of State boards, of a system of sanitary inspection of immigrants, and indicated some of the principal points of inspection. The history and number of inspections in the district were shown, and the methods and agencies employed were detailed. Facts were stated establishing the importance and value of the inspection as conducted, and showing how little value should be attached to "protection cards" issued by steamship surgeons in the absence of other evidence of vaccination. The completion of arrangements with local authorities at various points for the reception and care of small-pox patients found among immigrants was also announced. The report concluded by calling attention to the gratifying results already attending the inspection, as shown by the diminution of new cases in Chicago (attributed by Health Commissioner De Wolf directly to this source), as well as by the contrast throughout the State at large between the present report and those for preceding months.*

This report was referred to a special committee, consisting of Drs. Bateman and Ludlam, with instructions to formulate an expression of the BOARD concerning the Immigrant-Inspection Service with

*For details concerning the Small-Pox Epidemic and this Service, see Appendix.

recommendations thereon, if such be necessary; a copy of the same to be forwarded to each State Board of Health interested, and to the Secretary of the National Board of Health. This committee. subsequently presented the following:

WHEREAS, Small-pox still continues to manifest itself in epidemic proportions throughout the Northwest, directly as the result of increased immigration; and

WEFREAS. Efforts of State and local authorities to cope with this disease are only measurably successful, owing to their inability to deal with the source of contagion beyond the confines of their respective jurisdictions, State or municipal; Therefore, be it

Resolved, That the action of the National Board of Health in establishing and maintaining, at the request of the various State boards. an immigrant-inspection service to prevent the further introduction of the contagion of small-pox into the United States, and from one State to another, by the medium of immigrants and their baggage, is hereby cordially approved by the ILLINOIS STATE BOARD OF HEALTH as a measure of vital importance to the health and welfare of this State, as well as of the entire Northwest.

Resolved, That during this, the first month's operation of the service, it has already demonstr ted its utility in reducing the number of importations from an average of ten per month for the past eight months, to one solitary instance during the present month, and has thereby established a sufficient claim for its further continuance and extension. Resolved. That the Senators and Congressional Representatives of this State be earnestly requested to secure such appropriation for the work of the National Board as will enable it to make this protective work as effective as possible-this request being further emphasized by the recent appearance of yellow fever both on the Gulf coast and on the Atlantic seaboard.

The preamble and resolutions were unanimously adopted, and the Secretary was instructed to telegraph them to Congressman Aldrich, at Washington.

Burial-Permit Ordinance:

The Secretary presented the form of an ordinance concerning burial permits, together with a letter to accompany the same, addressed to those interested.

On motion of Dr. Bateman, the papers were accepted and approved. Their text is as follows:

ILLINOIS STATE BOARD OF HEALTH.-NO. 102,

OFFICE OF THE SECRETARY,
SPRINGFIELD, July 15, 1882.

DEAR SIR: At a regular meeting of the STATE BOARD OF HEALTH, held April 13-15, 1882, the following resolution was adopted:

Resolved, That in order to protect the legal interests of survivors, to facilitate the detection of crime, and to secure fuller and more accurate knowledge of the causes of mortality, whereby preventive medicine and general sanitation may be promoted, the ILLINOIS STATE BOARD OF HEALTH earnestly recommends to the proper authorities of all cities and towns in this State, having populations of one thousand or over, the enactment and enforcement of a suitable ordinance requiring a burial permit from a designated official, and based upon the physician's certificate of death now required by the statute, as a condition precedent to interment within, or removal of a decedent without, the corporate limits of any such city or town.

A form of such ordinance is herewith presented, and it is hoped you may be able to secure its enactment.

It should be observed that wherever such an ordinance is adopted the certifying physician is relieved of the necessity of transmitting his certificates direct to the county clerk, but will simply return them to the designated city or town official, who will forward them to the county clerk after using them as the basis for the burial permit. This has been found to work well practically in places where burial permits are required. It helps to secure a more general compliance with the law requiring physicians to report all deaths occurring under their supervision, with certificates of the causes thereof.

The manifest object of the State law is to secure such knowledge of the causes of mortality as may lead to measures for removing or modifying such causes as are susceptible of removal or modification. This is of primary importance to cities and towns, since

a reputation for healthfulness or the reverse undoubtedly influences the growth and prosperity of any given locality. By means of the burial permit and its record, the facts contained in the physician's certificate may be made immediately available for this purpose, while they cannot be where returned direct to the county clerk. From the "suitable book," prescribed in section 4 of the ordinance, a weekly or monthly report may be compiled for publication, either in the newspaper press or otherwise, and thus the condition of, and the influences affecting, the public health may be accurately judged at any given time, and comparison made with other localities.

Where burial permits are required-as they are in many places-the existence of a contagious disease-as small-pox, scarlet fever, diphtheria-has often first been made known by the information given in the permit, which thus serves to direct preventive measures for arresting further spread of the contagion.

On the other hand, in the absence of a burial permit many evils arise, among which may be mentioned the fact that the bodies of murdered persons may be more easily disposed of. Within a very brief period three such instances have come to the Secretary's knowledge where the bodies of the victims were buried without exciting suspicion. Accidental clues led to disinterment, and discovery of the crimes.

Briefly, the reasons for the enactment of such an ordinance may be thus summarized: First. It will be of value in securing fuller, more accurate, and more readily available knowledge of the causes of death-a knowledge which is absolutely necessary to the profitable application of efforts for the preservation of health, the limitation of disease, and the prolongation of human life.

Second. It will be of value in the protection of life against criminal violence, by facilitating the detection of such violence through preventing the burial of victims of homicide, abortion, poisoning. etc., without proper investigation.

Third-It will be of value in the protection of property interests, by making the facts pertaining to a death and burial ma ters of record which may be useful in probating wills, settling estates, determining heirships, perfecting letters, adjusting life insurance and kindred matters.

For the foregoing reasons your interest and influence in behalf of the measure are confidently anticipated.

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1. That no burial or interment shall be lawful in the nor shall any dead body be removed from said burial, interment or removal shall have been first obtained from the said

until a permit for such .... of

2. That such permit shall be issued by the upon his receipt of the usual certificate of death, signed by (1) the attending physician in the case; or, if none, by (2) one of the parents of the deceased; or, if none, by (3) the nearest of kin not a minor; or, if none, by (4) the resident householder where the death occurred; or, if none, by (5) any reputable citizen cognizant of the facts and circumstances of the death; or, if the death be the subject of an inquest, by (6) the coroner or other officer holding said inquest.

3. That any undertaker or sexton, and each and every other person engaged or concerned in a burial in violation of the provisions of this ordinance, and the officers and employés of any transportation company, or any other person or persons engaged or concerned in the removal of a dead body from said in violation of the provisions of this ordinance, shall be subject to a fine of not less than .(...) dollars, nor more than . ...(....) dollars for each offense. 4. That the shall enter in a suitable book, to be kept for that purpose, a record of all burial permits issued, specifying the date of issue and to whom issued, together with all the items of information contained in the certificates upon wh ch the issue of such permits is based; and he shall forward to the county clerk of county, at the end of each month, all of said certificates so received

during the month.

5. That this ordinance shall be in force from and after its passage and approval, and due publication.

Vital Statistics-Return of Deaths:

The Secretary submitted the form of blank for return of causes of death, required by law to be made by county clerks, as also the manuscript copy of a list of synonyms intended to facilitate the work of making out the blanks.

On motion of Dr. Haskell, the blank was approved and the list of synonyms ordered printed.

U. S. Marine Hospital, at Cairo:

The following correspondence, concerning sundry evils arising from the location of the office of the surgeon and the provisions for the care of marine-hospital patients at the port of Cairo, was submitted:

ILLINOIS STATE BOARD OF HEALTH,

SECRETARY'S OFFICE, Springfield, June 9, 1882.

MY DEAR SIR:-I enclose you the petition of the citizens of Cairo concerning the marine-hospital service at that port, and addressed to the STATE BOARD OF HEALTH OF ILLINOIS, as also the letter addressed to me on the same subject. I have marked a passage in this letter and fully endorse the statements therein made, to-wit: that the conditions complained of are not justly chargeable to the officers, or to the administration of the marine-hospital service.

It is mainly on this account that I send you the petition, in order that it may assist you in the effort you are now making to secure an appropriation for a hospital of the service at that port, and which, when constructed, should remedy the evils of which complaint is now made. Of course, this will be the only satisfactory and adequate remedy.

I have written Senator Logan and Representative Thomas, and will do whatever else is in my power, as will also the BOARD, to assist you in securing the necessary appropriation. Meanwhile, I would ask: Is there no temporary arrangement which can be made to afford present relief? You will readily see that this appeal makes it imperative upon the STATE BOARD to take action in the premises; but it is in every way preferable that you take the initiative. Gov. Cullom, who has carefully read the petition and letter, is emphatic in his expression that something should be at once done in response to this wellfounded complaint; and in this. I need hardly say, I entirely concur.

Please return the petition and letter, together with your reply, on or before the 25th inst.. as it is necessary the matter should be laid before the BOARD at its forthcoming meeting, June 29, inst. Very truly yours.

To the Supervising Surgeon-General, U. S. M.-H. S..

JOHN H. RAUCH.

Washington, D. C.

ILLINOIS STATE BOARD OF HEALTH,

SECRETARY'S OFFICE, Springfield, June 9, 1882.

MY DEAR SIR:-A petition, signed by the mayor, city officers, aldermen, members of the board of health, and of the board of education. and upwards of 400 of the most prominent professional and business men of the city of Cairo, has been sent to this BOARD with regard to the evils arising from contagious and infectious diseases, owing to the inadequate and imperfect arrangements for conducting the marine-hospital service in that city. I have sent the petition and its accompanying letter to the supervising surgeongeneral, before calling the attention of the BOARD to it.

If you could make it convenient to look over the petition and letter before their return to this office I think it would repay you; since they present in a very forcible manner the grievance which, at the present time, forms a most important subject of discussion in Cairo.

Of course, the only permanent relief that can be afforded, is the construction of the proposed marine hospital at that point, which Representative Thomas has already taken steps toward securing. Very respectfully, JOHN H. RAUCH.

The Hon. JOHN A. LOGAN, U. S. S., Washington, D. C.

A similar letter was sent to Representative Thomas. The following is the text of the petition referred to:

To the Honorable State Board of Health, for the State of Illinois:

GENTLEMEN:-Your petitioners, residents of the city of Cairo, would respectfully represent, that the physician in charge of the marine hospital at this port, has his office in the custom house, in the second story over the post office, where all persons entitled to

enter said hospital have to report for examination; that said physician's office hours are from 10 A. M. to 4 P. M., and that frequently persons suffering with infectious diseases present themselves in the corridors of the custom house and post office, and lie down and lounge about for hours, waiting for said physician.

That the building used as a marine hospital is situated in one of the thickly settled portions of the city, where within two blocks are congregated, daily, nearly three-fourths of the school children of the entire city, and on the easterly side thereof, in which direction there is almost a constant breeze.

That in 1873 and in 1876 the small-pox, in 1878 the yellow fever, and within the past few weeks again the small-pox, was, and has been disseminated through the entire city, and that said outbreaks of infectious diseases have been directly traceable to marine patients.

For details we would respectfully refer you to the accompanying maps, showing location of wha: ves where vessels land, the custom house building and plan thereof, the marine hospital and the several school buildings contiguous, and to certificates of individuals, which can be verified.

And we respectfully ask that your honorable board have the marine physician's office immediately and permanently removed from the custom house and post office building to the marine hospital, and that as soon as possible you have the marine hospital removed to some point contiguous to the river, and away from the business and residence portions of the city, and for which we will ever pray.

Some relief had been obtained by securing access to the surgeon's office by another stair-case, but an adequate remedy could only be secured by the entire removal of marine-hospital patients from the city. The petition had been forwarded by the Secretary of the Treasury to the Speaker of the House, for the purpose of favorably influencing action on the pending proposition to construct a building for this purpose on a suitable site.

On motion of Dr. Ludlam, the Secretary's action in the premises. was approved, and he offered the following resolution, which was adopted:

Resolved. That, in view of the conditions that obtain at Cairo, with regard to the introduction of contagious and infectious diseases by patients of the United States MarineHospital Service at that port, the ILLINOIS STATE BOARD OF HEALTH respectfully urges the immediate construction of a marine-hospital building so situated, with reference to the business and residence centres of the town, as to obviate the dangers and injury to the public health which now result from the present inadequate provision and unsuitable location.

The BOARD then went into executive session, during which the following action was taken:

M. H. Rowland, of Moline:

In the matter of the petition of Mrs. M. H. Rowland, of Moline, asking that the BOARD grant her a permit to practice as a student, to reply that the BOARD has no the Secretary was instructed authority, under the law, to grant such permit.

J. F. Bantyn, of Chicago:

The application of Dr. J. F. Bantyn, of Chicago, for a re examination in anatomy, surgery and obstetrics-he having failed to obtain the requisite percentages in those branches, at the April examination was granted.

Chicago College of Physicians and Surgeons:

In the matter of the application of the Faculty of the Chicago College of Physicians and Surgeons, that the BOARD should appoint an Examining Board for the candidates for graduation of that institution, it was

Ordered, That the application be referred to a committee of three, which committee shall invite the faculty of said college to meet with the committee at an early day for further explanation of the proposition-the result thereof to be reported to the BOARD at its next regular meeting; and the Secretary is authorized to inform the faculty of this action.

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