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tificate is delivered to a health officer or deputy, who, upon receipt of the same, provided said certificate is completely filled out, is written in ink or indelible pencil and is otherwise acceptable, shall make out a burial permit, for which no fee shall be charged. When no physician is present at a death, and the householder can not be found, and it is not a Coroner's case, the health officer shall make out the death certificate and sign it. City and Town Health Officers shall immediately copy in their record books all death certificates they receive, and, carefully preserving said certificates, shall send them to the State Board of Health in the official envelopes by the 4th of each month for the month preceding, and there shall always be enclosed with the said certificates a monthly statement card filled out according to the blanks on said card. In the event any health officer has no deaths to report in any month, then he shall send to the State Board a no death card to show the matter of reporting has not been neglected. When a death occurs outside the State and the remains are brought into the State for interment, the burial permit shall be based upon the transportation permit.

County Health Officers shall proceed as directed for city and town offcers except they will make no record of deaths, as transcripts of the certificates for the whole county will be made out at the State Board of Health, and said transcripts will be sent to the county officer each quarter, and the county officer shall carefully preserve said transcripts and have them bound at the end of each year.

Rule 5. BIRTHS. All births shall be reported within fifteen days after occurrence to the health officer having jurisdiction by the physician or midwife in attendance, if any, otherwise by the householder. The health officer shall immediately record the birth in the proper record book, and if he be a health officer of a city or town, he shall, by the 5th of each month, send the original birth certificate to the County Health Officer who shall enter it in the record book for births. The county officer shall also, at the end of each quarter, fill out the birth blanks which he will receive from the State Board, and send the same to the State Board within twenty days after the end of each quarter. A child born dead at seven months of gestation, or over, shall be reported and recorded as a stillbirth and a burial permit is required as in the case of a regular death.

Rule 6. INFECTIOUS DISEASES. All cases of infectious and contagious diseases which are listed in Rule 12 shall be immediately reported on the official blank to the health officer having jurisdiction by the physician, if any be in attendance, otherwise by the householder or attendant. The health officer receiving said report shall immediately enter the same in his infectious disease record book, and in person or by deputy establish quarantine, as directed in Rule 13. All city and town health officers shall preserve the infectious disease reports they may receive and send the same to their county officer by the 5th of each month for the month preceding. Upon receipt of the said reports the county officer shall enter them in his record book for infectious diseases, and he shall each quarter, from said record, fill out the infectious disease blanks he receives from the State Board, and send said blanks to the State Board within twenty days after the end of • each quarter.

Rule 7. It shall be unlawful for any person other than licensed physicians to enter or leave any house or building infected with any communicable disease listed in Rule 12, without first procuring a permit from the health officer having jurisdiction, and obeying absolutely his directions as to all sanitary precautions which he orders.

Rule 8. It shall be unlawful for any person who is, or has been recently, affected with any communicable disease listed in Rule 12 (omitting pulmonary tuberculosis and typhoid fever), to travel or appear upon the public streets or highways, or to appear in any public place or gathering, or to travel in any public vehicle or vessel, until a certificate is made by the attending physician to the health officer within whose jurisdiction the case occurs, stating that all danger from infection or contagion by reason of such disease is passed, and such certificate is approved and endorsed by said health officer.

Rule 9. Whenever a health officer shall know or suspect or be informed of the existence of any communicable disease dangerous to the public health, and there be no physician in attendance, or should any physician while in attendance fail or refuse to immediately report such case to the health officer, it shall be the duty of said health officer, or deputy, to examine such case or cases of alleged communicable disease dangerous to the public health, and

act as required by the rules governing such cases of communicable diseases.

Rule 10. In all cases where there has been an exposure or a suspected exposure to smallpox of any person or persons, it shall be the duty of the health officer under whose jurisdiction said person or persons may be temporarily or permanently residing, to quarantine for fourteen days or keep under observation such person or persons as may be exposed or suspected of having been exposed to smallpox, and to advise vaccination or revaccination of all who may have been exposed. It shall be the imperative duty of the health officer to enforce this rule, and in case of refusal or neglect. by said health officer to comply with the requirements of this rule, or other rules, it shall be the duty of the Secretary of the State Board of Health to assume charge, and either in person or by deputy, enforce the foregoing rules. All vaccinations shall be made with nonhumanized virus, the only exception being that, during an' epidemic of smallpox, should a sufficient quantity of bovine virus not be obtainable, humanized virus may then be used when sanctioned by the Board of Health under whose jurisdiction said epidemic may occur. If in the judgment of the health officer, it is deemed safe for an exposed person to be at liberty after vaccination, and after disinfection in body and apparel, the said exposed person shall be given a certificate of health and not be placed in quarantine. If the said exposed person changes his or her location, the health officer having jurisdiction shall inform the health officer at the new location.

Rule 11. MARRIAGES. All ministers and other persons authorized to perform marriages, shall report on official blanks, each marriage they may perform, to the Clerk of the county within five days after the marriage, and the said clerk shall report said marriages to the County Health Officer on or before the 5th day of each month for the month preceding, and the County Health Officer shall record each marriage in the official marriage record book. The County Health Officer shall also, each quarter, fill out the marriage blanks he receives from the State Board, and then send said blanks to the State Board within twenty days after the end of each quarter.

QUARANTINE.

Rule 12. The infectious and contagious diseases which shall be immediately reported to the health officer having jurisdiction are hereby declared to be yellow fever, smallpox, cholera, diphtheria, membranous croup, scarlet fever, measles, typhus fever, typhoid fever, bubonic plague, leprosy, and pulmonary consumption.

Pulmonary consumption and typhoid fever shall not be quarantined, as they are to be reported for record only.

Rule 13. Health officers, upon learning in any way of the existence of any disease listed in Rule 12, within their jurisdiction, shall immediately, in person or by deputy, quarantine the infected house, rooms or premises, so as to effectually isolate the case, or cases, and the family, if necessary, in such manner and for such time as may be necessary to prevent transmission of the disease; and whenever a quarantine is establihed a placard shall be posted in a conspicuous position, giving the name of the disease in letters not less than two inches long, and also having upon the card, the following notice:

"All persons are forbidden to enter or leave these premises without special permit from the health officer having jurisdiction, and all persons are forbidden to remove or mutilate this card, or to in any way interfere with this quarantine without orders from said health officer.",

It shall be unlawful to violate a quarantine, either by entering or leaving the quarantined area, or to demolish or tear away the ropes or other marks whereby the boundaries of a quarantine are defined, and whoever tears down or destroys or mutilates a quarantine placard, or who violates a quarantine in any way whatsoever, except by permission or direction of the health officer having jurisdiction, shall suffer the penalty prescribed in Section 3, of Chapter LXXXIII of the Acts of 1903, to wit: A fine of ten to fifty dollars, to which may be added imprisonment in the county jail not exceeding six months.

Rule 14. When visiting patients known to be sick with smallpox, scarlet fever or diphtheria, health officers and attending physicians shall clothe themselves in a specially provided clean linen duster, oil-cloth or rubber coat, and close fitting cap made of silk,

5-Bd. of Health.

linen, oil-cloth or rubber, and take all other reasonable precautions.*

BURIAL.

Rule 15. Human remains shall not be buried without a permit issued by a health officer or deputy, and no permit shall be issued unless the health officer or deputy has in hand a certificate of death properly filled out in ink or indelible pencil. In all cases of death from cholera, bubonic plague, leprosy, typhus fever, yellow fever, smallpox, diphtheria, membranous croup, and scarlet fever, the funeral shall be strictly private, and the burial shall be made within twenty-four hours after death. No public or church funeral shall be held or any person permitted to enter the house containing the remains, excepting the undertaker and his assistants, unless by permission of the health officer.

Rule 16. Buried human remains shall not be disinterred nor removed without permission from the State Board of Health, and blank applications for disinterment and removal may be had at any time upon application to said State Board.

When, however, the disinterment and reinterment is to be made in the same cemetery, then no permit is required. Bodies which have lain over one week in a vault are to be regarded as buried, and must not be removed or buried without a permit. If remains are deposited in a vault and subsequently removed for burial in the same cemetery no permit is required.

The cap should well cover the hair. Before leaving the premises the physicians should cleanse hands and face with antiseptic soap and water, and use a disinfectant upon hands and face. The coat, cap, antiseptic soap and bottle of disinfectant should be carried in a special glazed leather valise or other approved receptacle, together with a pad of cotton, which is to be kept wet with formaldehyde. Health Officers and attending physicians should give full and explicit instructions to parents, nurses and attendants concerning every precaution to be taken against the spread of infectious diseases. When possible, patients should be placed in a room, which, for the time, should not be entered by others than those who nurse, and only the physicians and nurses should be admitted. Every article of tableware or of apparel used by the patient should be sterilized or destroyed by fire as soon as possible. Pieces of old, soft cloth should be used for wiping the mouth and nose of the sick. They should be used but once and then immediately destroyed by burning, or sterilized by boiling one-half hour or more in water.

The disinfectant recommended is a 1 to 5,000 solution of corrosive sublimate, a 5 per cent. solution of carbolic acid, or a 1 per cent. solution of lysol. A cake of sublimated or carbolic soap may be conveniently carried in a traveler's soap box. The cotton pad is kept in the case or bag to absorb the formaldehyde. This chemical is our greatest antiseptic and its vapor will destroy all germs.

It will be well to add to the above outfit a roll of paper napkins and a bundle of small flat, pine sticks to be used as tongue depressers. The paper napkins are suggested because towels can not sometimes be found at the houses of the poor, and it they were found might be infected. Having one's own napkins gives perfect independence. The wooden tongue depressers may be whittled out of pine, or better, obtain from seed dealers the flat pine markers for flower beds which gardeners use. They cost 70 cents per 1,000.

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