THE WORK OF HEALTH OFFICERS, AND OF LOCAL BOARDS 
OF HEALTH IN MICHIGAN, INCLUDING DUTIES UNDER 
LAWS AMENDED AND PASSED IN 1883. 
[ Enough copies of this circular are sent to give one copy to each member of the local board of 
health, and this the officer receiving them is respectfully requested to do.] 
r 64.~i 
”Office of the Secretary of the State Board of Health, 
Lansing, Michigan, September, 8, 1883. 
To the Officers and Members of Local Boards of Health: 
Gentlemen :—Changes in the public-health laws having been made by the 
Legislature, and the circular of instructions to local boards of health being out 
of print, it becomes necessary, in order to meet inquiries frequently received, 
to issue this revised edition of the circular. It is hoped that you will give this 
circular careful attention and preserve it for ready reference. 
There is a board of health in every township, city, and village in Michigan,* 
and the appointment of a health officer is required of every local board of 
health in the State by section 1693 of the compiled laws of 1871, as amended 
by Act No. 203, Laws of 1881, which amended section is as follows: 
(1693.) Sec. 2. Every board of health shall appoint and constantly have a health officer who shall 
be a well-educated physician and act as the sanitary adviser, and an executive officer of the board: 
Provided, That in townships where it is not practicable to secure the services of a well-educated 
and suitable physician, the board may appoint the supervisor or some other person as such health 
officer. The board of health shall establish his salary or other compensation, and shall regulate 
and audit all fees and charges of persons employed by them in the execution of the health laws, 
and of their own regulations. Within thirty days after the annual township meeting in each year, 
the board of health shall meet for the transaction of business, and shall appoint or re-appoint a 
health officer, and shall immediately cause to be transmitted to the Secretary of the State Board of 
Health at Lansing, the full name and postoffice address of such health officer, and a statement 
whether he is a physician, the supervisor, or some other person not a physician. A special meeting 
of the board may be called by the order of the president or of any two members of said board. 
* Township boards of health are organized under section 1692, compiled laws of 1S71, as amended 
by act No. 56, laws of 1877, which section as amended is as follows: 
(1892.) Section 1. In every township the township board shall be the board of health. The 
supervisor shall be the president, and the township clerk shall be the clerk of said board. The 
clerk shall keep a record of the proceedings of the board in a book to be provided for that purpose 
at the expense of the township. 
The mayor and aldermen of every city, or the president and council of every incorporated village, 
in which no board of health is actually organized under the charter, are, by section 1740 of the com- 
piled laws of 1871, as amended in 1879, granted all the powers and required to perform all the duties 
of a board of health. The amended section, 1740, is printed on the page following this. 2 
WORK OF HEALTH OFFICERS AND OF LOCAL BOARDS. 
If no health officer is appointed in a township “ within thirty days after the 
annual township meeting,” it will still be necessary to appoint or re-appoint 
one after that time, as in the case of a vacancy; as will also be necessary if the 
officer appointed does not “qualify,” or file his oath of office. Vacancies 
occur whenever the incumbent of an office ceases to be an inhabitant of the 
district, county, township, city, or village for which he was elected or appointed 
an officer,—see section 617, compiled laws of Michigan, 1871. 
Before entering upon his duties the health officer should take and subscribe 
the official oath required by Sec. 1, Art. xviii., of the Constitution of this 
State, and file the same in the office of the clerk of the city, village, or town- 
ship of which he is the health officer. 
Some of the powers and duties of local boards of health are specified in Chap- 
ter 46 of the compiled laws of Michigan, 1871. This chapter was constructed 
more particularly with reference to township boards of health, but section 49 
of the same chapter (chapter 35 of the Revised Statutes of 1846, and chapter 
46 of the compiled laws of 1871) as amended by Act No. 145, Laws of 1879, 
makes it apply to cities and villages. That section, as amended, is as follows:— 
(1740.) Sec. 49. The mayor and aldermen of each incorporated city, and the presi- 
dent and council, or trustees, of each incorporated village in this State, in which no 
board of health is organized under its charter, shall have and exercise all the pow- 
ers and perform all the duties of a board of health as provided in this chapter, 
within the limits of the cities or villages, respectively, of which they are such 
officers. The provisions of this chapter, and the amendments thereto, shall, as far 
as applicable, apply to all cities and villages in this State, and all duties which are, 
by the provisions of this chapter, to be performed by the board of health of town- 
ships, or by the officers and inhabitants thereof, shall in like manner be performed 
by the board of health and the officers and inhabitants of such cities and villages, 
with a like penalty for the non-performance of such duties, excepting in cases where 
the charters of such cities and villages contain provisions inconsistent herewith. 
It is believed that there is nothing in the charter of any city or village in the 
State that conflicts with the general law which requires the appointment of a 
health officer by the council acting as a board of health, or by a board 
of health constituted under some charter provision. 
One great object in securing a physician as health officer is to enable each 
local board of health to lead and not, as too frequently heretofore, to follow 
the people in sanitary knowledge and action. As a rule our physicians are 
our leading sanitarians, and they know much better than other people what 
are the sources of danger to the public health in their several localities; and, 
as a rule, they know best how to avoid those dangers. It is therefore for the 
interest of the people to secure the benefits of that knowledge by paying for 
the services and advice of the best sanitarian, who will usually be the best 
physician in their locality. 
if it is true that responsibilities are in proportion to capacities and powers, 
then a local board of health, which, as in this State, has almost absolute power, 
must be held responsible for any sickness or death that might have been pre- 
vented by a proper use of its legal powers; and an individual health officer 
employed and paid for sanitary advice who does not use the sanitary knowledge 
of which he is possessed, in a way to make it as effective as possible for pre- 
venting sickness and deaths in his vicinity, is especially culpable. 
Although as “an executive officer of the board” the power and authority 
of the health officer to act will be mainly that given him by his board, as a 
“sanitary adviser” he should, and doubtless will, have influence in determin- 
ing the action of his board, in proportion to his knowledge of sanitary science 
and his honest effort for the promotion of the public health. 
Board of health 
in cities and vil- 
lages, who to 
constitute. 
Duties of officers; 
and inhabitants 
of cities and vil- 
lages. HEALTH OFFICER’S PAY SHOULD BE ADEQUATE AND CERTAIN. 
3 
The health officer should be a physician who has given and will give special 
study to sanitary subjects, and who is qualified to instruct and advise the local 
board of health in all matters relating to public health which may come before 
it. The law provides that he shall be a sanitary adviser of the local board of 
health; in order that his advice maybe had to the fullest extent, it seems 
necessary that generally the health officer should meet with the local board of 
health. 
The local board of health is authorized to fix the compensation, of the health 
officer, which should include his services at meetings of the board, compensation 
for his services in restricting and preventing contagious diseases, in reporting 
to the State Board of Health, etc. By section 3, Act No. 137, Laws of 1883 
(printed on pages 5-6), the health officer, unless the board of health has made 
other provision for compensating him, is entitled to receive from the township, 
city, or village, compensation at the rate of not less than two dollars per day 
for his services in investigating reports of small-pox, diphtheria, scarlet fever, 
or other commmunicable disease, dangerous to the public health, for his serv- 
ices in the execution of legal measures to restrict the spread of such diseases, 
and for his services in reporting to the president of his board of health and to 
the Secretary of the State Board of Health respecting outbreaks of such diseases 
and respecting sources of danger from such diseases. By Sec. 1693, compiled 
laws 1871, as amended by Act No. 202, Laws of 1881, every board of health is 
empowered to regulate and audit all fees and charges of persons employed by it 
in the execution of the health laws and of its own regulations, including the salary 
of the health officer. Such of the charges as are payable by the township must 
be paid by the township treasurer upon orders signed by the supervisor and 
clerk. The law gives the board of health the right to audit it own expense 
accounts, and, in townships, the supervisor and clerk, being members of the 
board of health, can easily sign the orders on the treasurer. 
The local board of health has two kinds of functions: 1. To utilize for its 
own people the sanitary knowledge already accessible, as indicated in sections 
I., III., V., VI., VII., VIII., following, and elsewhere in this circular; 2. To 
add to the general stock of such knowledge, by original research, by records 
of experience, and by reporting to the State Board of Health, which will 
thus be able to give to every local board the benefit of the experience of all the 
others. There are many ways in which the local board of health may put forth 
effort for lessening sickness and deaths within its jurisdiction :— 
I. Epidemics should he prevented.—This can generally be done, if local 
boards of health will but act efficiently in studying out and applying methods 
which are now practicable. 
As regards prevention of small-pox, the law authorizes the board of health of 
each city, village, and township in the State to offer free vaccination to every 
child not previously vaccinated, and to all other persons who have not been 
vaccinated within the preceding five years. 
The law (Act No. 146, Laws of 1879) is as follows: 
SECTION 1. The People of the Slate of Michigan enact, That the hoard of health in Board of health 
each city, village, and township may, at any time direct its health officer or health authorized to 
physician to offer vaccination, with bovine vaccine virus, to every child not pre- [|’0”lis'1 vaccina_ 
viously vaccinated, and to all other persons who have not been vaccinated within 
the preceding five years, without cost to the persons [person] vaccinated, but at the 
expense of such city, village, or township, as the case may be. 
Vaccination and revaccination are preventives of small-pox, and if the peo- 
ple are kept thoroughly protected in this way it is believed that no epidemic of 
that disease can occur. 4 
WORK OF HEALTH OFFICERS AND OF LOCAL BOARDS. 
A document on the prevention and restriction of small-pox has been pub- 
lished by the State Board of Health, for gratuitous distribution throughout 
the State, and copies may be had by addressing the Secretary, at Lansing.* 
But small-pox is not the disease most to be dreaded in Michigan. Ten times 
as many deaths occur in the State from either scarlet fever or diphtheria as 
from small-pox; in some years more than twenty times as many. And while, 
for these diseases, we have no such preventive measure as is vaccination for 
small-pox, they are believed to be as truly preventable by means of isolation of 
first cases, disinfection of infected material, etc., as is small-pox itself. 
Epidemics of communicable disease can frequently be prevented by restrict- 
ing outbreaks to the first cases which occur. 
II. Prompt notice op outbreaks op disease should be secured.—For 
the most effective restriction of all communicable diseases one of the first 
requisites is that your board shall promptly receive notice of every case of a 
communicable disease. The law makes provision therefor, and it is especially 
desirable that the attention of the public in your vicinity be called to the require- 
ments of the law, and the fact impressed upon the minds of the people that 
comparative safety from communicable diseases can be secured only by giving 
prompt notice of the first case and of all cases of any such disease, to the health 
officer or local board of health, in order that immediate steps may be taken for 
restricting and suppressing such disease. To complete the provision for such 
notices is one of the first duties of your board. It is again recommended that 
your board of health have a sufficient number of blanks for such notices for the 
use of householders and physicians distributed within your jurisdiction, in order 
to call attention to the law and secure the material for a complete record in 
your office and in the office of the clerk of your board. The two sections of 
law requiring such notices (1734 and 1735, as amended in 1883, together with 
the new section added in 1883 providing compensation for notices), and sum- 
mary statements of sections 6853, 6853, and 6855, and of Act No. 157, laws of 
1879, should be printed on the back of each blank. You can find the form 
for such blanks for notices, with the amended sections 1734 and 1735, and the 
new section, on the last leaf of this circular. Such blanks can be purchased 
of W. S. (leorge & Co., of Lansing, for one dollar per hundred. 
The law makes it the duty of the supervisor to prosecute for all failures to 
report cases of sickness in his township, in accordance with (amended) sections 
1734 and 1735. The law also makes it the duty of every other township officer 
to notify the supervisor of all such failures within his knowledge or reasonable 
belief. It is the duty of the prosecuting attorney, on request, to assist the 
supervisor in such prosecutions. Sections 6853 and 6853, compiled laws of 
1871, are as foil ws: 
Duty of super- 
visors to pros- 
ecute. 
(6852.) Sec. 12. It shall be the duty of every supervisor, whenever he shall know or 
have good reason to believe that any penalty or forfeiture has been incurred within 
his township, which shall be recoverable by action before a justice of the peace, 
according to the foregoing provisions of this chapter, forthwith to commence and 
prosecute a suit, in the name of the people of this State, for the recovery thereof. 
(6853.) Sec. 13. It shall be the duty of every other township officer, who shall know 
or have good reason to believe that any penalty or forfeiture has been incurred 
within his township, forthwith to give notice thereof to the supervisors. 
Duty of other 
township offi- 
cers. 
* The document has also been stereotyped by the Board, and any number of copies for distribu- 
tion may be purchased of W. S. George & Go., Lansing, at the following rates, cash to accompany 
the order. The order should state whether they are wanted in English, German, or Dutch. 
100 copies for 53.00 
200 “ “ 4.50 
300 » “ 6.00 
400 copies for 57 00 
500 “ “ 8.00 
1,000 “ “ 14.00 HEALTH OFFICER SHOULD BE INSTRUCTED TO ACT PROMPTLY. 
5 
Act No. 157, laws of 1879, makes it the duty of every health officer of a 
village or city to give notice, to the prosecuting attorney of the county,f of 
any failure in householders or physicians to report cases of communicable dis- 
eases to the health officer or to the local board of health. The act makes no 
exceptions on account of any other similar provisions in local charters or ordi- 
nances. Omitting the title, the act is as follows :— 
SECTION 1. The People of the State of Michigan enact. That it shall be the duty of 
the health officer of each village and city in this State, whenever he shall know, or 
have good reason to believe that any penalty or forfeiture has been incurred within 
his city or village, by reason of neglect to comply with section one thousand seven 
hundred and thirty-four or section one thousand seven hundred and thirty-five of 
the compiled laws of eighteen hundred and seventy-one, forthwith to give notice 
thereof, in writing, to the prosecuting attorney of his county, which notice shall 
state as near as may be, the time of such neglect, the name of the person incurring 
the penalty or forfeiture, and as near as can be ascertained, the name or names of 
persons sick with a disease dangerous to the public health, and not reported as the 
law requires. 
Health officers to 
notify prosecut- 
ing attorney of 
all failures to 
report. 
What notice to 
state. 
III, Communicable diseases should be restricted.—When notice or 
information of the occurrence of a case of communicable disease reaches the 
local board, the hoard should act promptly for the restriction of the 
disease. To neglect or postpone such action is a great violation of public 
trust. As so much depends on prompt action on the appearance of the first 
case of a communicable disease, and in order that no time may be lost, it is 
the duty of every board of health to make provision for prompt action by its 
health officer, authorizing and directing him to be prepared at all times, as 
executive officer of the board, to take certain action without waiting for a meet- 
ing of the board, whenever a case of scarlet fever, diphtheria, small-pox, or 
other disease dangerous to the public health occurs within its jurisdiction. 
Some of the duties which the health officer should be directed to perform are 
specified in Act No. 137, Laws of 1883, as follows:— 
AN ACT to specify certain duties of health officers and provide for compen- 
sation therefor, in townships, cities, and villages where the health officer is 
not otherwise instructed by the local board of health. 
Section 1. The People of the State of Michigan enact, That whenever 
the health officer of any township, city, or village in this State shall 
receive reliable notice or shall otherwise have good reason to believe 
that there is within the township, city, or village of which he is the 
health officer, a case of small-pox, diphtheria, scarlet fever, or other 
communicable disease dangerous to the public health, it shall be the 
duty of said health officer, unless he is or shall have been instructed by 
the board of health, of which he is an executive officer, to do otherwise,— 
Immediately to investigate the subject, and in behalf of the board of 
health, of which he is an executive officer,— 
To order the prompt and thorough isolation of those sick or infected 
with such disease, so long as there is danger of their communicating the 
disease to other persons;— 
To order the prompt vaccination or isolation of persons who have 
been exposed to small-pox;— 
Powers and du- 
ties of health 
officers in refer- 
ence to diseases 
dangerous to 
public health. 
| Section 6855, compiled laws of 1871, requires the Prosecuting Attorney to prosecute for any for- 
feiture within his county. That section is as follows: 
(6855.) Sec. 15. In the cases mentioned in the last preceding section, and In all 
other cases where the prosecuting attorney shall know or have good reason to' 
believe that a penalty or forfeiture has been incurred within his county, it shall be 
the duty of such prosecuting attorney, without delay, to prosecute for such penalty 
or forfeiture; and in all cases where any suit shall be instituted by the supervisor, 
as provided in this chapter, it shall be the duty of such prosecuting attorney, if 
requested by such supervisor, to attend to and conduct such suit on behalf of the 
plaintiffs. 
Duties of prose- 
cuting attorney. 6 
WORK OF HEALTH OFFICERS AM) OF LOCAL BOARDS. 
To see that no person suffers for lack ot nurses or other necessaries 
because of isolation for the public good;— 
To give public notice of infected places* by placard on the premises, 
and otherwise if necessary;— 
To promptly notify teachers or superintendents of schools concerning 
families in which are contagious diseases;— 
To supervise funerals of persons dead from scarlet fever, diphtheria, 
small-pox, or other communicable disease which endangers the public 
health ;— 
To disinfectf rooms, clothing, and premises, and all articles likely to 
he infected, before allowing their use by persons other than those in 
isolation;— 
To keep the President of his own board of health, and the Secretary 
of the State Board of Health constantly informed respecting every out- 
break of a disease dangerous to the public health, and of the facts so far 
as the same shall come to his knowledge, respecting sources of danger of 
any such diseased person or infected article being brought into or taken 
out of the township, city, or village of which he is the health officer. 
Sec. 2. In the absence of regulations conflicting therewith, made and 
published by the local board of health, and still remaining in force, the 
provisions of section one of this act shall have the force of regulations 
made and published by the local board of health; and whoever shall 
violate the provisions of section one of this act, or the orders of the 
health officer made in accordance therewith, shall forfeit for each such 
offense a sum not exceeding one hundred dollars. 
Sec. 3. In the fulfillment of the requirements of this act, the health 
officer, unless other provision shall have been made in accordance with 
law, shall be entitled to receive from the township, city, or village of 
which he is health officer, compensation at the rate of not less than 
two (2) dollars per day: Provided, That this section shall not be con- 
strued to conflict with any action by the local board of health, under 
section sixteen hundred and ninety-three, of the compiled laws of eight- 
een hundred and seventy-one, as amended by act number two hundred 
and two, of the laws of eighteen hundred and eighty-one. 
Provisions to 
have force of 
regulations of 
local boards of 
health in certain 
cases. 
Penalty for vio- 
lation of provis- 
ions. 
Compensation of 
health officer. 
Proviso. 
The local board of health and the physician in charge of a case of a com- 
municable disease should cooperate for its restriction. The local board of 
health should especially guard against its spread by cases where no physician 
is employed. 
IV. Oases of diseases which endanger the public health should 
be recorded.—Another duty incumbent upon the local board of health is 
the recording of the sickness from communicable diseases, and of the deaths 
of citizens and persons under its protection; such records to be for local use 
and also to be reported to this State Board, so that, when grouped with the 
records of other localities, the conditions may be studied, and new methods of 
prevention learned from such unhappy experiences which otherwise will con- 
tinually be repeated. 
A form of “Record of Diseases Dangerous to the Public Health” is printed (reduced in size), on 
page 271 of the Report of the State Board of Health for 1882. You can procure printed sheets of 
such a record, on paper 15>£ by 19>£ inches, of W. S. George & Co., of Lansing, for eighty cents per 
quire or three dollars per hundred. If desired, the same dealers will bind them at usual prices. 
(1732.) Sec. 41. When the small-pox, or any other disease dangerous to the public 
health, is found to exist in any township, the board of health shall use all possible ' 
care to prevent the spreading of the infection, and to give public notice of infected 
places to travelers, by such means as in their judgment shall be most effectual for 
the common safety. 
* Required by section 1732, Compiled Laws of 1871, as follows: 
Notice of infect 
ed places 
f For methods, see pamphlet entitled “Restriction and Prevention of Scarlet Fever,” issued by 
this Board, reprinted on pages 211-218 of the Annual Report of the Board, for 1881; also a document 
on “Restriction and Prevention of Diphtheria,” reprinted on pages 205-210 of the same Report; 
also a document entitled the “Prevention and Restriction of Small-pox,” issued by this State Board 
of Health, and printed on pages 289-304 of the Report for 1881, which documents maybe had by 
application to the Secretary of the Board at Lansing, BOARD OF HEALTH SHOULD LEAD IN KNOWLEDGE AND WORK. 
7 
V. Much sickness and many deaths from ordinary causes and 
diseases should be prevented.—Another important field of labor open to 
your local board of health, is the inauguration of measures for preventing 
sickness and deaths from the ordinary diseases in this State, a very great 
proportion of which are now believed by our best sanitarians to be preventable. 
Some of the prominent measures to be inaugurated are :— 
1. More thorough drainage of the soil, especially near dwellings. 
2. Better securities against the contamination of the water-supply, particu- 
larly in wells, by filth-saturated soil, etc. 
3. A strict guard over the purity of the air, and freedom from nuisances 
and unclean places. 
4. Better sanitary and hygienic arrangements and plans in the public schools, 
and in public buildings and institutions. 
In the execution of these measures, much may be accomplished by system- 
atic and thorough inspections and by published reports of such inspections, 
which shall attract attention to the subject, give definite knowledge of existing 
defects, and suggest methods of improvement. 
5. Typhoid fever is believed to be a disease often communicated by means 
of water or milk contaminated with the discharges from typhoid fever patients 
or with the remains of those who have died from the disease. Hence typhoid 
fever might often be prevented by a thorough disinfection of such discharges, 
and by requiring that those who have died from the disease shall be buried 
entirely away from all sources of water-supply, and by condemning sources of 
water-supply already thus contaminated. 
6. Cholera.—The same precautions recommended to prevent spread of 
typhoid fever, should be taken on an outbreak of cholera. The discharges of 
the initiatory diarrhea of cholera are infectious, and these as well as the later 
discharges should be immediately and thoroughly disinfected. 
7. Toy pistols.—The Legislature, in 1883, passed an act to prevent the 
sale and use of toy pistols. While it is not made the especial duty of boards 
of health to enforce the law, the importance of the subject makes it proper for 
them to notify prosecuting attorneys of violations of the law coming within 
their knowledge. 
8. Inspection of public buildings.—Act No. 226, Laws of 1879 as 
amended by Act No. 41, Laws of 1881, makes provision for inspection of 
public buildings in cities and villages, and makes it unlawful to use such 
buildings until they have been properly inspected and approved for use in 
accordance with the law. Boards of health in cities and villages might call 
attention of the proper officers to violations of this law, which is intended to 
guard against dangers to life. 
9. Registration of physicians.—The Legislature, in 1883, passed a law 
(Act No. 167) requiring all who are to be legally qualified practitioners of med- 
icine, surgery, or midwifery to file with the clerk of the county in which they 
propose to practice, a sworn statement relative to the opportunities they have 
had for gaining a knowledge of their profession. The health officer should be 
prepared to give information as to all the requirements of this law. The act 
makes it the duty of the health officer and the supervisor in each township, 
village, city, and ward to enforce this law. 
VI. Nuisances should be abated.—While it is not, as many suppose, the 
first and only duty of a health officer to smell out a cesspool or an offensive 
privy, he is the one to whom, from his official position and authority, the peo- 8 
WORK OF HEALTH OFFICERS AND OF LOCAL BOARDS. 
pie properly look to discover and abate any such nuisance. Freedom from 
such sources of sickness is believed to be one essential condition of good health 
in a community, and a duly empowered health officer or a board of health 
that from any considerations whatever does not do the utmost (and the power 
of a local board of health under the law is almost absolute) to prevent and 
remove such unsanitary conditions, is guilty of a plain neglect of duty and a 
violation of official trust. For a valuable discussion of the power of local 
boards of health in the abatement of nuisances, the reader is referred to a 
paper on the powers and duties of local boards of health, by Hon. LeRoy 
Parker, of Flint, published in the Report of this Board for 1879, pages 289-300; 
also a report by Homer O. Hitchcock, M. D., on Slaughter-Houses and Ren- 
dering establishments, on pages 65-80 of the same Report. 
VII. Sanitary information should be disseminated among the 
people.—The local board of health should be a center of sanitary and hygienic 
intelligence for its locality; its meetings should not be infrequent, and should 
be so managed as to secure papers or discussions on special subjects and on the 
application of the principles of sanitary science to the particular sources of 
danger in the immediate vicinity, and otherwise to encourage progress in sani- 
tary knowledge, among the members of the board as well as among the people. 
Charged, under an official oath, with the duty of guarding the life and health 
of fellow-citizens, the duty of members and officers of boards of health to seek 
out the best that is known in public hygiene and sanitary methods seems to 
be plain. The best sanitary work cannot be done except by the cooperation of 
the people with the board of health, and this can be secured when the people 
are well informed on sanitary subjects; the thorough distribution by local 
boards of health of all such documents as the one issued by this Board on the 
Restriction and Prevention of Scarlet Fever and the one on the Restriction and 
Prevention of Diphtheria will tend to disseminate useful information and 
greatly decrease sickness from such diseases.* 
Many sources of information in sanitary science and public hygiene are now 
accessible to those who can secure the literature of these subjects. You can 
doubtless find something of value without great effort. There are now many 
works on hygiene, and many periodicals devoted to the subject,—several of 
them giving especial attention to particular branches of the subject. A knowl- 
edge of some of the sources of greatest danger to life in this State may be 
gained by a study of the Registration Reports on Vital Statistics of Michigan, 
published by the Secretary of State. These are, or should be in your town- 
ship library. A few years ago a pamphlet compilation of the Public Health 
Laws of this State was sent to the health officer of each township, to be deliv- 
ered to the supervisor, if no other health officer was appointed. The laws have 
been much changed since the publication of this compilation. The Secretary 
has been able to supply amended copies of the pamphlet on application, but 
only a few copies are left. The first ten Annual Reports of this State Board 
* The documents on “ Restriction and Prevention of Diphtheria,” and on the “ Restriction and 
Prevention of Scarlet Fever,” have been revised and reprinted by the State Board of Health, and 
copies of either may be had free by addressing the Secretary, at Lansing; they have also been stereo- 
typed by the Board, and copies of either may be obtained by local boards of health and others of 
W. S. George & Co., Lansing, Mich., at the following prices, cash to accompany the order:— 
100 copies for $1.75 
200 » “ 2.50 
300 “ “ 3.50 
400 copies for §4.25 
500 “ “ 4.75 
1,000 “ “ . . 8.00 
Theorder should state whether they are wanted in the English, the German, or the Dutch lan- 
guage. PROMPT REPORTS OF OUTBREAKS OF DISEASE DEMANDED. 
9 
of Health have been sent as issued, and are, or should be, in your township 
library. 
The Annual Reports of the State Board of Health have been sent, year by 
year, to the health officers whose names and addresses have been returned to 
this office; but when no return of the name and address of the health officer 
is received, no Report is sent, because it is not known to whom to send the 
Report. 
You will find something relative to work of local boards of health and health 
officers on pages 6, 11, 15, 1G, 29, and 30 of the First Report (for 1873); on 
pages xi-xv, xxv, and xxviii-xxix of the Second Report; on pages xliii-xlv and 
1-10 of the Third Report; on pages 6, 7, 11-12, 127, 128, 129, and 130 of the 
Fourth Report; on pages xxxii-xxxv of the Fifth Report (for 1877); on pages 
ix-xviii and xxiii-xxxiii of the Sixth Report (for 1878); on pages lvii-xli, 66- 
80, 291-300, 329, 330-1, 332-4 of the Report for 1879; on pages Iviii, Ixii-lxxii, 
lxxiii—Ixxviii, lxxxiv-lxxxv of the Report for 1880; on pages 56-61, 299-304 of 
the Report for 1881; also on pages 7-15, 251-6, 262-73, 328-32 of the Report 
for 1882. 
VIII. Rules by the local board of health.—An important means of dis- 
seminating information among the people is the promulgation of rules by the 
local board of health respecting nuisances, sources of filth, and causes of sick- 
ness, particularly sickness from contagious diseases. Such rules every local 
board of health is authorized to make, by sections 1694, 1695, and 1696, com- 
piled laws of 1871. A set of rules recommended by the State Board of Health 
for adoption by local boards, was printed on pages xix-xxii of the Report for 
1875. 
Full public notice of such rules as may be adopted from time to time should 
be given, in accordance with section 1698, compiled laws of 1871, which is as 
follows:— 
(1698.) Sec. 7. Notice shall be given by the board of health of all regulations made Notice of regula* 
by them, by publishing the same in some newspaper of the township, if there be one ll0W Pub* 
published therein, and If not, then by posting them up in five public places in such 
township, and such notice of said regulations shall be deemed legal notice to all 
persons. 
The State Board of Health would be glad to receive copies of rules, regula- 
tions, and ordinances or blank forms adopted by the board of health of any 
township, city, or village. 
IX. Special reports to the state board of health.—Whenever there 
occurs, in your locality, any outbreak of a communicable or preventable disease, 
it is expected that the health officer will immediately send a special report* of the 
facts to the Secretary of the State Board of Health and also inquire into, study, 
and record the conditions coincident with the rise, progress, and decline of any 
such outbreak, and, besides making the local record be prepared to make a 
valuable final report to this Board. Every such instance of suffering in your 
locality should be made to yield some valuable data useful for advancing the 
cause of public health; and such prompt special reports are here officially 
demanded, under the law.f 
*For convenience in sending such immediate notice to the State Board of Health, a blank form 
[L] has been devised, as shown on next page. 
t Act No. 81, Laws of 1S73, Sec. 8: “It shall be the duty of the health physician, and also of the 
clerk of the local board of health in each township, city, and village in this State, at least once in 
each year, to report to the State Board of Health their proceedings, and such other facts required, 
on blanks, and in accordance with instructions received from said State Board. They shall also 
make special reports whenever required to do so by the State Board of Health.” 10 
WORK OP HEALTH OFFICERS AND OF LOCAL BOARDS. 
In order to be able to report to the State Board of Health as the law requires, 
the local board must collect facts. If the local board does not receive notices 
of cases of communicable diseases, this is, in some degree, its own fault; 
first, because the law requires each member of the township board, whenever he 
shall “have good reason to believe” that a forfeiture from neglect to report 
any such case has been incurred “forthwith to give notice” to the supervisor, 
and it is the duty of the supervisor “forthwith to commence and prosecute a 
suit; ” and in cities and villages, the law makes it the duty of the health officer 
to report to the prosecuting attorney all cases of forfeiture under sections 1734 
and 1735; and the prosecuting attorney is required to prosecute for all such 
forfeitures; and, second, the local board, by proper effort, may so educate the 
citizens under its care, as to the importance of promptly reporting all cases of 
diseases which endanger the public health, that prosecutions for neglect to 
report diseases will be unnecessary. 
It is hoped that you will freely correspond with this office concerning the 
needs and the success of public-health work in your locality. Any information 
from you will be thankfully received, and any that we may give will be gladly 
rendered. 
By direction of the State Board of Health. 
Very respectfully, 
Henry B. Baker, 
[Please preserve the circulars received from this office.] Secretary. 
REPORT OF OUTBREAK OF DISEASE DANGEROUS TO THE PUBLIC HEALTH. 
[L.] 
To be mailed to tbe Secretary of the State Board of Health, Lansing, Michigan, immediately 
on the occurrence of a case of small-pox, diphtheria, scarlet fever, cholera, typhus fever, yellow 
fever, or other disease dangerous to the public health. 
To the Secretary of the State Board of Health: 
Sir—There has come to my knowledge a case of 
(Name of disease.) 
in the of County of , 
(Township, city, or village. 
State of Michigan. The first person sick is 
, a 
(Male or female.) 
about old, who was taken sick with this disease on the 
(Age.) 
day of , 188 The number of cases which 
(Month.) 
have already occurred is There are now cases. 
The danger of the spreading of the disease from or into the jurisdiction of 
other boards of health is , for the reason that 
(Great, not great, etc.) 
Precautionary measures 
(Will be taken, have been taken, or are suggested to the State 
as follows 
Board of Health, as the case may be.) 
(Health Officer, President, or Clerk.) 
,188... 
(Date.) (Of what township, city, or village.) 
[Please till the blank spaces in this notice if possible, but having learned the name of the dis- 
ease, do not delay sending the report in order to learn other facts provided for in this blank.] NOTICES OF DISEASES ENDANGERING THE PUBLIC HEALTH. 
11 
[Form of Notice recommended by the State Board of Health for the use of Householders and Physicians, In complying with sections 1734 and 1735, Com- 
piled Laws of Michigan, 1871; as amended by Act No. 11, Laws of 1883; and section 1740, Compiled Laws of 1871, as amended by Act No. 145, Laws of 1879. See 
over.] [Fill as many of the blanks in this notice as possible, but having learned of the sickness do not delay sending the notice in order to learn other facts 
provided for in this form.] 
To the Clerk or Health Officer of the* of. , County of 
, State of Michigan, as Clerk or Health Officer of the Board of Health: 
Sir:—The following persons, within the jurisdiction of your Board, have been taken sick with “diseases dangerous to the public 
health.”! 
No. 
NAME OF PERSON. 
Sex. 
AGE IN 
Teaks 
Last 
Birth- 
day. 
Name of Disease. 
Taken Sick. 
Whether 
Dead, Still 
Sick, or Re- 
covered. 
Date of Death or Re- 
covery IF NOT STILL SICK. 
Month. 
Day. 
Tear. 
Month. 
Day. 
Tear. 
1 
2 
o 
So far as known, the source of the contagious or infectious cause of the disease as follows: For case 
No. 1, it was 
The residence of the sick persons above reported is as follows: Of case No. 1, it is at No 
street, ; of case No. 2, it is 
This notice is given by 
Dated at No street, ,188 
* Insert the word city, village, or township. 
[Includes Measles, Whooping-cough, Diphtheria, Scarlet Fever, Typhus Fever, Typhoid Fever, Puerperal Fever, Erysipelas, Small.pox, Cholera, etc. 
HOUSEHOLDER’S OR PHYSICIAN’S NOTICE OF A COMMUNICABLE DISEASE. 12 
NOTICES OF DISEASES ENDANGERING THE PUBLIC HEALTH. 
Sections 1734 and 1735, Compiled Laws of Michigan, 1871, as amended by Act No. 11, Laws of 1883, and the new section (50) added in 1883, are as follows: 
(1734.) Sec. 43. Whenever any householder, hotel keeper, keeper of a boarding house or tenant shall know, or shall be informed by a 
physician, or shall have reason to believe, that any person in his family, hotel, boarding house, or premises is taken sick with small-pox, cholera, diptheria, 
scarlet fever, or any other disease dangerous to the public health, he shall immediately give notice thereof to the health officer, the president or the clerk 
of the board of health of the township, city, or village in which he resides. Said notice shall state the name of the person sick, the name of the disease, the 
name of the householder, hotel keeper, keeper of boarding house, or tenant giving the notice, and shall, by street and number, or otherwise, sufficiently 
designate the house in which he resides or the room in which the sick person may be; and if he shall refuse or neglect immediately to give such notice he 
shall forfeit for each such offense a sum not exceeding one hundred dollars*: Provided, That this penalty shall not be enforced if a physician in attendance 
has given to the health officer or other officer hereinbefore mentioned an immediate notice of said sick person, and true name of the disease, in accordance 
with the requirements of this section. 
(1735.) Sec. 44. Whenever any physician shall know that any person whom he is called to visit, or who is brought to him for examination, is infected 
with small-pox, cholera, diphtheria, scarlet fever, or any other disease dangerous to the public health, he shall immediately give notice thereof to the health 
officer, the president, or the clerk of the board of health of the township, city, or village in which the sick person may be; and to the householder, hotel 
keeper, keeper of a boarding house, or tenant within whose house or rooms the sick person may be. The notice to the officer of the board of health shall 
state the name of the disease, the name, age, and sex of the person sick, also the name of the physician giving the notice; and shall, by street and number, 
or otherwise, sufficiently designate the house or room in which said sick person may be. And every physician and person acting as a physician, who shall 
refuse or neglect immediately to give such notice shall forfeit for each such offense a sum not less than fifty nor more than one hundred dollars* : Provided, 
That this penalty shall not be enforced against a physician if another physician in attendance has given to the health officer, or other officer hereinbefore 
mehtioned, an immediate notice of said sick person, and the true name of the disease, in accordance with the requirements of this section. 
' " “ Sec. 50. For each complete notice in writing to an officer of the board of health, in full compli- 
ance with the preceding section, requiring from physicians or other persons notices of diseases 
dangerous to the public health, the physician who gave the notice shall be entitled, on duly certi- 
fying that each notice was correct, and when the bill has been duly audited by the board of health, 
to receive from the township, city, or village, in which the notice was given, the sum of ten cents. 
♦Supervisors must prosecute for all such forfeitures; township officers must give notice to 
supervisor; prosecuting attorney to conduct suit if requested; see sections 6852, 6853, and 6855, 
Compiled Laws of Michigan, 1871. Health officers of villages and cities must notify prosecuting 
attorney of all violations of this section,—see Act No. 157, Laws of 1879; the prosecuting attor 
ney must prosecute for all such forfeitures incurred within his county,—see section 6S55, Com- 
piled Laws of 1871. Sections 6852, 6853, 6855 and the Act No. 157 are printed on pages 4-5 of this 
circular. 
[Blank Notices similar to this leaf may be obtained of W. S. George & Co., Lansing, Mich., 
for one dollar per hundred.] 
LAWS REQUIRING HOUSEHOLDERS AND PHYSICIANS TO REPORT COMMUNICABLE DISEASES. 
Notice of sickness of. 
Sick with 
Reported by 
Filed