It was a direct challenge to West Virginia having passed "the nation's first genuinely restrictive physician licensing law in the early 1880s.

Marmaduke Dent appealed the decision to the West Virginia Supreme Court on the grounds that the state could not interfere with a citizen's right to practice a lawful trade.

Dent then filed an appeal to the U.S. Supreme Court in 1885 claiming a violation of his cousin's rights under the due process clause of the 14th Amendment.

[4] Later, the Court would extend its decision in the case Hawker v. New York, 170 U.S. 189 (1898) when it ruled that character was also an important qualification for doctors wishing to obtain a license.

As in any Supreme Court case, Dent has been cited numerous times, particularly in defining the legitimate role of state regulation versus Constitutional prohibitions on Bills of Attainder.