them to bring their food from such wide areas, or the ruined health and the scourging epidemic will surely punish their neglect. Let it not be said, "our fathers did not care for all these things and they lived without fear or harm." They lived till they died; and the low average of life in their generations shows that the many died before their time and of preventable diseases. The history of the past gives no argument for the neglect of sanitary measures.

Public Buildings:

The city is the home of crowds. A great orator, singer, player or preacher, easily fills churches, halls or theaters with the dense masses of breathing human beings. Schools, courts, and all public assembly rooms are liable to be filled with daily crowds; and no deadlier foe to health and life can be found than the breath-poisoned atmosphere of a crowded room. Stringent ordinances in every city ought to forbid the erection of any public hall, theater, church, school house, or other building for public assemblies, till the plans are inspected and approved by competent sanitary authorities. It is a gross neglect of public health to allow such death-traps to be opened, as are many of the popular halls and meeting rooms. No hall, school room, theater or church is safe in which the whole volume of air cannot be changed as often as once in every ten minutes, and in no case can this be accomplished where the two sides of the room, at least, are not outer walls, with abundant and large windows reaching nearly from floor to ceiling, and where at least one-tenth of the roof space cannot, in case of need, be opened for the escape of the breath-loaded and body-heated air. It is astonishing ignorance or stupidity which allows an over-greedy builder to add a third story to his building in the middle of the block, and and fit it up as a public hall for lectures and concerts, cutting off the front, perhaps, as offices, or the rear as dressing rooms. Let the city itself erect, on some public square, a public building, with ample halls large and small, to be let to societies or traveling troupes and lecturers, in which the public health and safety can be fully cared for. If private parties can provide such halls at a profit, certainly a city can afford to supply them and take their revenue. If the city outgrows the one, let it add others at convenient points; and if it will provide in these public buildings, rooms for its offices, for public libraries, museums, scientific and art collections, for evening schools and lecture courses, it will help at once the civilization and sanitation of its citizenship. If cities must exist; if people will crowd together in great multitudes to live along the sides of narrow streets, and throng the public places, they must needs take care, at whatever expense, of that priceless but perishable good, bodily health.

While our young cities are eager and alert to attract trade and population, while they welcome capital and business, and pay bounties even for the incoming of manufactories and their crowds of operatives, let them not begrudge the expenditures to provide for the preservation of this mass of busy life and strength. Let them remember that the epidemic which they tempt is the most relentless of tax-gatherers. The contagions love cities as their warmest breeding places and richest harvest fields, and the health enfeebled

by public parsimony falls an easier prey to the fiery plague, and falls as fuel which feeds the flame and speeds its march. Save today your taxes for public health, and to-morrow, or within the year, they will be demanded of you four-fold for wasted health, for the buried dead, or for the business ruined by the epidemic scare of fever or of plague.

The City Board of Health:

An efficient board of health, with a good competent health officer, with all needful rules and facilities for the quarantine and care of those who are suffering from contagious diseases, has also a place, and a place of indispensable importance in the sanitary requirements. In the case of invasion by contagious disease, the prompt action of a board of health, with ample and recognized powers, is the only security against infinite disaster and distress. But a true board of health will not be merely a "life-saving service," for the occasion of a storm; it will be also the lighthouse to warn of danger and show the path of safety. The police board, that watches against crime and defends property, renders a more obvious, but not a more valuable service than the health board which watches against the more wasteful desolations of disease, and guards life itself from the stealthy assault of assassins that lurk in the tainted air, and breed in neglected sewers and cess-pools.

The members of this important board should be chosen, first, for their competency, not simply as physicians, but as sanitarians; and, second, for their energy and activity in public good. And thus chosen, they should be given ample authority to forbid nuisances in building and in business; to quarantine and control in contagions and epidemics; to placard all places of danger, and to provide for the public health. Even despotism may be endured when the alternative lies between despotism and destruction.

Conclusion:

Other provisions of city sanitation may easily be noticed by the thoughtful and the expert, but with the fulfillment of those already named the others will be readily seen and met as they rise. The health of our State depends largely upon the health of its citiesthose storm-centres of infection and epidemics. The sanitation of its cities will raise, by natural consequence, the better sanitation of its country homes and thus of the whole people.

REGULAR QUARTERLY MEETING,

OCTOBER, 1883.

HELD in the office of the BOARD, in the State House, at Springfield, October 5, 1882. Present Drs. Bateman, Ludlam, Clark and Rauch. Dr. Bateman presiding in the absence of the President. After the reading and approval of the minutes of the last meeting, the Secretary submitted the following

At the date of last report, June 30, there had been a total of 190 cities, towns and villages in which small-pox had appeared since November 1, 1881, of which number twenty-two had occurred in the preceding quarter, and there were still cases remaining at nine points. Since then there have been cases at Paxton, in Ford county, near Prairie du Rocher, in Randolph county, and on an island in the Mississippi river opposite Harrisonville, Monroe county. The disease has also been re-introduced into Jersey county through a suit of second-hand clothes bought in St. Louis.

The Paxton cases originated with a stock-dealer and importer of horses, who contracted the disease en route from France in the stock-boat Friga, on board of which was a mild case of varioloid. The boat, it is said, escaped inspection at quarantine in New York, and as Hefner, the importer, did not travel on an immigrant train in this country, he also escaped the inspection service. The disease was confined to Hefner's house, but his wife, son and daughter were attacked, and the son died.

The Monroe and Randolph county cases are believed to have originated from an infected mattress, supposed to have been thrown into the river and washed ashore on Staton's Island. Owing to failure of prompt recognition of the disease, a hired man who had been exposed was allowed to go to Randolph county, near Prairie du Rocher, where, together with himself, there have been in all nine cases, with five deaths. The disease seems to have been of a very mild type on Staton's Island, no deaths occurring out of the ten cases.

Presented in detail, as fairly illustrative of the work in the Secretary's office. + Subsequently ascertained that the contagion was brought from Springfield, Mo. See Appendix.

It is worth while calling attention, in this connection, to the markedly different results obtained in counties under township organization and in those where, in the absence of town boards, the county commissioners are charged with the duties of health authorities. While, of course, the most efficient work is done and the disease is most promptly "stamped out" in localities where there are regularly organized boards of health, it is yet true that, as a rule, the town boards have been only less efficient, and the disease has been generally promptly mastered by their efforts. On the other hand, in counties where the county commissioners alone have charge, there has, as a rule, been delay in action or neglect, resulting in a spread of the contagion beyond the first cases or families and an undue prolongation of the disease. In Alexander county, for example, the first case near Commercial Point occurred in the latter part of April, and the contagion was not finally eradicated until the 20th of July. The recent outbreak and spread in Monroe and Randolph counties, are, to some extent, due to similar causes.

At this date there is one remaining case near Prairie du Rocher, and three in the hospital in Chicago. Aside from these, there are

no cases known to exist in the State at present.

The decline of the epidemic in Chicago since the inauguration of the Immigrant-Inspection Service is clearly shown in the following table:

The members of the BOARD have been supplied from time to time with my reports, as Supervising Inspector of the I.-I. S. in the Western District, to the Secretary of the National Board of Health, and it will, therefore, only be necessary, in this connection, to present a summary of the work done up to the close of the quarter, September 30, 1882, which is as follows:

Immigrants arriving and inspected over the P., Ft. W. & C. R. R., 14,825, of which number 12,676 were more or less perfectly protected, while 2,145 were found to need vaccination or revaccination.

Over the L. M. & M. S. R. R., arrived and inspected, 11,402; protected, 9,352; requiring vaccination or revaccination, 2,020.

Over the Michigan Central, 19,131; protected, 14,026; requiring vaccination or revaccination, 5,105.

Over the Grand Trunk, 8,237; protected, 6, 186; requiring vaccination or revaccination, 1,751.

Over the Baltimore and Ohio Railroad, 8,193; protected, 6,418; requiring vaccination or revaccination, 1,745.

Passing the Indianapolis station for points west, 10,413; protected, 9,50; requiring vaccination or revaccination, 853.

Crossing the Mississippi at St. Louis, 6,785; protected, 6,440; requiring vaccination or revaccination, 345.

From the foregoing it will be seen that of the total 78,986 immigrants who have arrived in or passed through this district since the 1st day of June, nearly 14,000 were susceptible to small-pox, and capable of conveying and propagating the contagion throughout the vast region of the Northwest. As has been before remarked, the Service is not only a protection to Illinois, but to the entire western region beyond, north to Minnesota and south to Texas.

During the season nine cases of small-pox and varioloid have been detected and removed from trains before reaching the State, and within three weeks one case was removed to the Chicago small-pox hospital by the inspector, and four others were properly cared for by the St. Louis inspector. The former patient was destined for Neenah, Wis., and the latter (a party of Bohemians) for Missouri.

Vaccination of School Children:

During the last ten days of the quarter, there have been distributed between 18,000 and 19,000 copies of a circular letter (No. 112) calling attention to the necessity of perfecting and perpetuating the results of the School-Vaccination Order of the BOARD, issued in December last. A copy of this circular has already been sent to each member of the BOARD, so that it is probably unnecessary to add anything more on this subject.

There will be sent out within a few days, 17,500 copies of the Vaccination Return, Form 52, and some 80,000 Vaccination Certificates, Form 51, these amounts being still on hand from last winter's supply.

It may be incidentally remarked that the necessity for this effort on the part of the BOARD, to protect the public-school interests of the State, will receive very striking proof in the forthcoming history of the small-pox epidemic of 1881-2, and in the tabulation of the returns of vaccination from the various schools. It is almost incredible that so large a percentage of unvaccinated children should have been found as these will show.

Even in Chicago, the tabulation of which has been completed since the last meeting, a much greater number of imperfectly protected children were found than was anticipated.

The returns from Cook county alone, including Chicago, have occupied fully three months in tabulating. The amount of time. required for this work will probably render it impracticable to tabulate in such detail the returns from the entire State, but the salient points, at least, will be collated in due season.