that there had been sufficient progress in sanitary science and the practice of disinfecting and preparing dead bodies for shipment to warrant a modification of Rule No. 1, and to permit the transportation of bodies dead of certain specified diseases which are now prohibited under that rule: Provided, Such bodies are prepared for shipment by funeral directors known to be skilled in the practice of disinfecting the dead.

In submitting the appended rules for your consideration, it should be understood that we recommend that they be put into effect only in those states and provinces where those practicing the art of disinfecting the dead are examined and licensed by competent judges, whose license should be approved by the state or provincial board of health, or other state authority. We believe transportation companies should be authorized to carry through to destination bodies prepared in conformity with these rules, and would urge that in the meantime a united effort be made to secure in all the states the necessary legislation to enable the people to transport their dead under the safeguards proposed.

This is recommended both as a humane and sanitary measure. It is conceded that legal control of the practice of medicine is necessary. Physicians should be competent; so, also, should everyone entrusted with sanitary work, and especially of such highly important work as disinfecting dead bodies, which, if not thoroughly and scientifically done, may as well be left undone. If legal precautions concerning physicians are in the interests of the people and the public health, and intended to prevent loss of human life and spread of contagious and infectious disease, through ignorance, then the interests of the people should in like manner be protected by preventing the ignorant or unprincipled from invading homes and assuming to prepare bodies for shipment or burial when by so doing they are likely to cause the spread of disease and death.

We believe the matter is not without remedy. There are a number of schools and colleges where a technical knowledge of disinfecting and of scientific methods of preparing the dead may be obtained by those wishing to fit themselves for the work; and we believe that all proposing to engage in this special work should be required to prepare themselves to pass a satisfactory examination, and should be licensed as recommended above. Said license should confer the special legal title of embalmer.

With these precautions, we believe that bodies dead of diphtheria, scarlet fever, glanders, anthrax, and leprosy may be prepared so as to be transported without danger to the public bealth.

It may be urged that immediate burial will insure protection against the spread of disease. Granted; but, is it humane, or have we the right to insist upon this when there are those sufficiently

skilled in the art of preparing dead bodies for shipment to make the transportation of such bodies perfectly safe? Persons anxious to bury their dead in home cemeteries and in their own lots, often prepared at great expense, should not be deprived of this privilege.

We believe that human sentiments which surround the dead often tempt the bereaved, also the physicians and undertakers, to make misrepresentations in order that bodies dead of contagious diseases may be transported. If, as there is reason to suspect, bodies dead of diphtheria and scarlet fever are now sometimes transported in the face of the rules to the contrary, is it not in the interests of the public health to control such shipments rather than undertake to prohibit them?

These recommendations do not contemplate that undertakers or funeral directors, not licensed by state authority as provided in the rules herewith submitted, shall be prohibited from practicing their profession in cases where death has resulted from a non-contagious disease, or where the body is not to be transported. Our contention is, that bodies dead of certain contagious diseases, when properly prepared may be transported without danger to the public; and that only those who have shown by examination a sufficient knowledge of the subject should be permitted to prepare such bodies for transportation.

As the transportation of bodies dead of a contagious disease is now practically prohibited, these rules would not materially change the present status of the undertaker, as regards his business relations.

To remove any apprehension that burdensome charges may be imposed for preparing bodies for transportation as here recommended, we would call attention to declarations of members of the National Funeral Directors' Association, who publicly stated at the Cleveland meeting that the expense of such preparation should not exceed twenty-five dollars.

In the interest of uniformity, and to enable state health officials to more closely supervise the transportation of dead bodies as herein suggested, we recommend that a uniform form of transit permit be adopted-a combined physician's or coroner's certificate, health officer's permit for removal, and funeral director's paster to be made in duplicate. The signature of physician or coroner, health officer and funeral director, should be on both original and duplicate copies, the original to accompany the body to destination, and the duplicate to be forwarded to the official in charge of the baggage department of the initial line, and by him to the secretary of the state or provincial board of health of the state or province from which said shipment was made.

On account of the danger (in contagious diseases) from members of the household of the deceased who accompanied the body, we would recommend that in such cases the local board of health, or health officer should be required to certify in the transportation permit that proper precautions have been taken to prevent the conveyance of disease in this manner, and to name in the permit the persons authorized to go with the corpse."

Rules Recommended for the Transportation of Dead Bodies as Corrected and Approved by the National Conference of State Boards of Health.

Rule 1. The transportation of bodies dead of small-pox, Asiatic cholera, yellow fever, typhus fever, or bubonic plague, is absolutely forbidden.

Rule 2. The bodies of those who have died of diphtheria, (membranous croup), scarlet fever (scarletina, scarlet rash), glanders, anthrax, or leprosy, shall not be accepted for transportation unless prepared for shipment by being thoroughly disinfected by (a) arterial and cavity injection with an approved disinfectant fluid; (b) disinfecting and stopping of all orifices with absorbent cotton, and (c) washing the body with the disinfectant, all of which must be done by an embalmer holding a certificate as such, approved by the state board of health or other state health authority. After being disinfected as above, such body shall be enveloped in a layer of cotton not less than one inch thick, completely wrapped in a sheet and bandaged and encased in an air-tight zinc, tin, copper or lead lined coffin, or iron casket, all joints and seams hermetically soldered, and all closed in a strong, tight wooden box. Or, the body being prepared for shipment by disinfecting and wrapping as above, may be placed in a strong coffin or casket, and said coffin or casket encased in an air ght zinc, copper or tin case, all joints and seams hermetically soldered and all enclosed in a strong outside wooden box.

Rule 3. The bodies of those dead of typhoid fever, puerperal fever, erysipelas, tuberculosis and measles, or other dangerous and communicable diseases, other than those specified in Rules 1 and 2, may be received for transportation when prepared for shipment by filling cavities with an approved disinfectant, washing the exterior of the body with the same, stopping all orifices with absorbent cotton, and enveloping the entire body with a layer of cotton not less than one inch thick, and all wrapped in a sheet and bandaged and encased in an air-tight coffin or casket: Provided, That this shall ap ply only to bodies which can reach their destination within fortyeight hours from time of death. In all other cases such bodies shall be prepared for transportation in conformity with Rule 2. But when the body has been prepared for shipment by being thoroughly disin

fected by an embalmer holding a certificate as in Rule 2, the air-tight sealing may be dispensed with.

Rule 4. The bodies of those dead of diseases that are not contagious, infectious or communicable, may be received for transportation when encased in a sound coffin or casket and enclosed in a strong outside wooden box: Provided, They reach their destination within thirty hours from time of death. If the body cannot reach its destination within thirty hours from time of death, it must be prepared for shipment by filling cavities with an approved disinfectant, washing the exterior of the body with the same, stopping all orifices with absorbent cotton and enveloping the entire body with a layer of cotton not less than one inch thick, and all wrapped in a sheet and bandaged, and encased in an air-tight coffin or casket. But when the body has been prepared for shipment by being thoroughly disinfected by an embalmer holding a certificate as in Rule 2, the air-tight sealing may be dispensed with.

Rule 5. In case of contagious, infectious or communicable diseases, the body must not be accompanied by persons or articles which have been exposed to the infection of the disease, unless certified by the health officer as having been properly disinfected; and be fore selling passage tickets, agents shall carefully examine the transit permit and note the name of the passenger in charge, and of any others proposing to accompany the body, and see that all necessary precautions have been taken to prevent the spread of disease. The transit permit in such cases shall specifically state who is authorized by the health authorities to accompany the remains. In all cases where bodies are forwarded under Rule No. 2 notice must be sent by telegraph to health officer at destination, advising the date and train on which the body may be expected. This notice must be sent by or in the name of the health officer at the initial point, and is to enable the health officer at destination to take all necessary precautions at that point.

Rule 6. Every dead body must be accompanied by a person in charge, who must be provided with a passage ticket and also present a full first class ticket marked "Corpse" for the transportation of the body, and a transit permit showing physician's or coroner's certificate, health officer's permit for removal, undertaker's certificate, name of deceased, date and hour of death, age, place of death, cause of death, and if of a contagious, infectious, or communicable nature, the point to which the body is to be shipped, and when death is caused by any of the diseases specified in Rule No. 2, the names of those authorized by the health authorities to accompany the body. The transit permit must be made in duplicate, and the signatures of the physician or coroner, health officer and undertaker must be on both the original and duplicate copies. The undertaker's certificate 28--19--98

and paster of the original shall be detached from the transit permit and pasted on the coffin box. The physician's certificate and transit permit shall be handed to the passenger in charge of the corpse. The whole duplicate copy shall be sent to the official in charge of the baggage department of the initial line, and by him to the secretary of the state or provincial board of health of the state or province from which said shipment was made.

Rule 7. When dead bodies are shipped by express the whole original transit permit shall be pasted upon the outside box and the duplicate forwarded by the express agent to the secretary of the state or provincial board of health of the state or province from which said shipment was made.

Rule 8. Every disinterred body, dead from any disease or cause, shall be treated as infectious or dangerous to the public health and shall not be accepted for transportation unless said removal has been approved by the state or provincial health authorities having jurisdiction where such body is disinterred, and the consent of the health authorities of the locality to which the corpse is consigned has first been obtained; all such disinterred remains shall be enclosed in a hermetically sealed (soldered) zinc, tin or copper lined coffin or box. Bodies deposited in receiving vaults shall be treated and considered the same as buried bodies.

The chairman of your committee attended the Conference of State Boards of Health at Nashville, Tenn., August 18 and 19. There were also in attendance Mr. J. H. Sharer, president, National Funeral Directors' Association; Professor Hohenschuh, of the Western College of Embalming, and Professor Barnes, of the Chicago College of Embalming, and by special vote of the association, all of the above named gentlemen were requested to participate in the discussion of the subject of disinfecting the dead and preparing dead bodies for shipment, which was made a special order of business for the morning of the second day, but it occupied nearly the whole of that day. It would appear that the National Conference was not only willing but anxious to meet us, and, as a matter of act, they had already started the discussion in their association as to the advisability of modifying the rules, and had appointed a committee of their members more than a year ago to make a special report on the subject at the National Conference, and some of the gentlemen members of that committee attended the joint conference at Cleveland, and the special report we have quoted above, therefore, is substantially a joint report, and the rules as submitted for your consideration, stand approved (without a dissenting vote of the members present) by the National Conference of the State Boards of Health, who are pledged to assist us in obtaining necessary legislation to make them effective, and will co-operate cordially with the railways to that end.