qualification, but because the institution to which he applied had adopted a rule not to comply with the law by endorsing diplomas.

We have nothing to do with the wisdom of the law-nor have we power to change it in any respect. Administering it as we find it, we are constrained to hold that the registration of the respondent is erroneous, having been made without the production and placing upon the record of the only evidence which the law requires to authorize the prothonotary to make the entry upon the record.

This certificate forms no part of the record. It was not filed with the prothonotary, but is procured on the hearing of this rule, and is claimed to be equivalent to the endorsement of the diploma required by the act of 8th June, 1881, entitled "An act to provide for the registration of all practitioners of medicine and surgery."

This certificate signed by the secretary is in the words following:

UNIVERSITY OF PENNSYLVANIA,

MEDICAL DEPARTMENT, PHILADELPHIA, July 11, 1883.

To the Prothonotary of

county:

"This is to certify that I have examined the diploma of Dr. Joseph L. Bauer, purporting to have been issued by the Missouri Medical College to Dr. Joseph L. Bauer, believe it to be genuine and legally issued to Dr. Bauer whose name it bears."

By the fourth section of the act before mentioned, pamphlet laws, 1881, page 72, it is enacted that, "any person who may desire to commence the practice of medicine or surgery in this State after the passage of this act, having a medical diploma issued or purporting to have been issued by any college, university, society or association in another State or foreign country, shall lay the same before the faculty of the medical colleges or universities of the Commonwealth for inspection, and the faculty, being satisfied as to the qualifications of the application and the genuineness of the diploma, shall direct the deant to endorse the same, after which such person shall be allowed to register as required by section two of this act."

These are plain words clearly conveying the meaning that the applicant shall not be allowed to register until he shall have obtained the specified endorsement. Under the act of 1875 in any controversy in respect to the right of a physician or surgeon to practice, resort was necessarily had to parole evidence to show the qualifications of the practitioner. This was found to be insufficient to protect the public as well as inconvenient and vexatious to the qualified physician or surgeon. The act of 1881 was intended to remedy the defects of the former law and to relieve the public and the doctors from the mischief arising under it, by requiring that all physicians and surgeons should register in a public office, and that the record of the

registry should upon its face contain all the law requires to entitle a person to practice medicine.

In respect to persons coming from other States or countries claiming to be qualified to practice and having a diploma from some medical college outside of the State, statute makes special provision.

It constitutes the faculty of the several medical colleges and the universities of the State, tribunals with authority to examine not only the diplomas presented to them, but also the person to whom granted, to ascertain whether the former are genuine, and the holder thereof is qualified to practice.

The judgment of these medical tribunals when rendered is conclusive, and is the only evidence upon which a prothonotary is authorized to register any applicant.

The printed record provided by the prothonotary is not appropriate to every case that may come up for registry-as entered in this case the record makes the respondent say he has been in continuous pracin St. Louis and Pennsylvania since 1871, when in fact he graduated in 1874. The prothonotary should be careful to see that the printed form is adapted to the circumstances of the particular case, and if not, to erase or make it conform to the facts.

We have reluctantly come to the conclusion that this registration cannot be sustained. While we are satisfied that the respondent intended to comply with the law we have no doubt in respect to the conclusion which we have reached. The entry having been made without authority ought not to stand as valid registry. It is the duty of the court to see that the records made by their clerks are such as the law permits. Being of the opinion that this is not such record, we must make such order as will annul or set it aside. And now, July 1, 1884, rule made absolute.

BY THE COURT.

III. REPORT OF THE COMMITTEE ON PREVENTABLE DISEASES AND THE SUPERVISION OF TRAVEL AND TRAFFIC.

The Committee on Preventable Diseases and the Supervision of Travel and Traffic beg leave respectfully to report that during the past year it has, in obedience to the instructions of the Board, prepared a manual of camp hygiene for the use of the National Guard of the State of Pennsylvania, and of other bodies civic, and religious, desiring to form encampments during the summer season. This manual has been submitted to the criticism of officers of the Guard and has met their approval. It has been extensively circulated among both officers and men during the encampments of the past summer and has no doubt contributed to the efficiency of the sanitary police

of the camps. The report on the sanitary condition and needs of the mining towns and regions of the State, is now nearly ready for presentation and the committee request that it may appear in the Annals of Hygiene after having been submit to the Secretary for approval. Respectfully submitted.

JOSEPH F. EDWARDS,

Chairman.

IV. REPORT OF THE COMMITTEE ON WATER SUPPLY, DRAINAGE, SEWERAGE, TOPOGRAPHY AND MINES.

The Committee on Water Supply, Drainage, Sewerage, etc., respectfully reports that it has had under consideration the questions of the drainage of the Schooley shaft in Wyoming and Exeter boroughs, Luzerne county; of the disposal of the sewerage of the city of Altoona; of the drainage and sewerage system of the State Hospital for the Insane at Norristown, and of the drainage of the military camp near Norristown. In regard to the first mentioned matter, it has suggested that the proper steps be taken to bring Nelson Cowan, the proprietor of the Schooley shaft, to trial for refusing to comply with the order of the Board to carry the waters of his mine to the Susquehanna as suggested in the committee's report. The report of Dr. Dudley of Altoona reviews the subject of the drainage of that town very thoroughly and is referred to the Board with the suggestion that it be published. The drainage of the Hospital for the Insane at Norristown was found to be working very successfully so far as filtration of the water of the system was concerned and could not be held responsible for the reported offensive condition of Stony creek, but there is a question in the minds of the committee whether, in the late autumn, when vegetation has ceased to appropriate the fecal and other decomposing organic matters deposited entirely upon the surface of the ground, the atmosphere of the immediate neighborhood might not become seriously contaminated. They were inclined, however, to the belief that the typhoid fever which had prevailed in the institution the winter previous had not been due to that cause. The drainage of Camp Slemmer, as well as the arrangements for its water supply, called only for commendation. In view of the constantly increasing prevalence of typhoid fever in our towns and cities and the admitted connection between the occurrence of this disease and the use of impure drinking water, your committee consider it expedient to call attention to the careless manner in which sources of drinking water are selected for many of our towns and the entirely irresponsible character of the companies which furnish the supply. The State should certainly inter ere to protect its citizens in this important respect, and your committee would suggest that a measure be 6 BOARD OF HEALTH.

introduced into the next Legislature to place such enterprises under proper supervision.

Respectfully submitted.

HOWARD MURPHY, C. E.,

Chairman.

REPORT OF THE COMMITTEE ON THE POLLUTION OF WATER SUPPLIES APPOINTED BY THE AMERICAN PUBLIC HEALTH ASSOCIATION.

[Read at the Annual Meeting at Milwaukee, Wis., November 20-23, 1888.] In its report at the last meeting of the Association your committee explained in brief the ground of its belief in the harmfulness of sewerage in waters used as potable supplies, whether these were derived from wells or larger sources; whether the water supply of an isolated dwelling or that of a populous city. Cheminal analysis was shown to be in most instances inadequate to the detection of sewage, unless the sewage was present in unusual quantity, or the water unusually free from other organic matters; and the conclusion was reached that the inability of the chemical methods is of no practical importance, as the presence of sewage in the water supply can be determined by the sanitary inspector; and further, that for protective purposes, the knowledge that sewage enters the water is all that seems to be required, because where there is sewage there is danger of typhoid infection.

Your committee desires to give special emphasis to the last stated clause, because it believes that the endemicity of typhoid fever in our cities is in great part due to the sewage in the water supply. Many of our public water supplies contain sewage, and its harmfulness in a general way is unquestioned even by those who have a financial interest in them. Yet there appears to be a hesitancy to acknowledge the real, the specific, danger. Typhoid fever is present in all our cities, giving annual death-rates of from 15 to 100 and over in every 100,000 of the population; but in the enumeration of its causes its prevalence is ascribed to many insanitary conditions before mention is made of the public water supply. It is allowed in certain local epidemics to be propagated from Tells which have become infected by an infected sewage, but the sewage in the public supply is seldom considered other than as a sentimental objection to the use of the water. It is allowed in many instances to arise from leaks in the plumbing of houses, by which exhalations from infected sewers reach the interior of the dwelling, but the water supply into which the sewage of these very sewers is poured is used without a thought of its deadly qualities, unless, as in the case of Plymouth, Pa., the fact is forced upon the public mind that a public water supply has as little disinfecting power over the germs of typhoid fever as the private water

supply of an infected well. Health officers condemn the well, and generally it is closed as soon as it is found that sewage percolates through its area of drainage;-they should condemn the public supply on the same grounds.

The large financial interests involved in the establishment of a public water supply may be assumed to be at the bottom of this hesitancy to acknowledge the specific danger attaching to the presence of sewage. Millions of dollars, perhaps, have been invested in that water supply, and many more millions would be required to replace it by water from a purer source. These large sums are alone considered, and not the vast and annually increasing totals of the loss by sickness and death that might have been prevented. A public or private well involves but a small sum, so small that it does not stand

in the way of sanitary progress. It is closed, and with its closure. one more possible center of typhoid infection is removed; but the decreasing influence exercised by this on the annual rate of prevalence is small indeed if the public supply continue to disseminate the disease. The dollars and cents represented by the existing water works may be regarded as a barricade to sanitary progress, or an altar on which typhoid fever sacrifices its victims.

The efforts that have been made from time to time to quiet the public mind by demonstrating the destruction of sewage and the selfpurification of the water which contained it, are in part attributable to these financial interests; but only in part, for many sanitary inquirers have been deceived by partial or imperfect observations. Unfortunately, however, those analysts who have had much practical experience in following the track of sewage in its passage down stream recognize in this so called self-purification only the results of sedimentation and dilution. Undoubtedly the natural processes of purification-the transformation of organic matter into ammonia, and the nitrification of the latter-operate in the current of a running stream; but these account for but a small proportion of the seeming purification, and there is no ground for supposing that the infectious principle of typhoid fever is given up to the action of these purifying agencies. We acknowledge that typhoid fever is propagated by an infected sewage in a well-water when all organic trace of the sewage has disappeared through the instrumentality of the agencies referred to. There are two kinds of organic matter in the dangerous sewage. matter which, by the absence of life, is given up to decomposition and reduction to harmless inorganic forms, and matter which by its vitality is preserved from these influences; and we acknowledge that in the well water the former may be reduced, while the latter retains the full measure of its virulence. Analogy shows conditions of a similar character affecting our river supplies, and the seeming apathy with which they are regarded can only be accounted for by assuming