WA P536r I 8 95 RULES GOVERNMENT Board of Health CITY OF PHILADELPHIA. Adopted by the Board, 1895. PHILADELPHIA.: Detre & Blackburn, Printers and Publishers, 35 North Seventh Street. ^ . -"* 1895. ^ y '• V WA P536r 1895 63030590R NLM 05130fi3T 7 NATIONAL LIBRARY OF MEDICINE NLM051308397 \7*<\?K/ [ vm^v [ w - \**. w * 3NIDIQ3W JO ABVaail IVNOIIVN 1NI3I01W JO A a V ■ a I 1 IVNOIIVN 3NIDI03W JO ABVBBIT IVN NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEO 3NI5IOJW JO AaVaail IVNOIIVN INI3IQ9W JO AtVIIM IVNOIIVN 3NI3IQ3W JO IIYIII1 IVN 3NIDIQ3W JO AlViail IVNOIIVN 3NI3IQ3W JO A • V B B I 1 IVNOIIVN 3NI3I03W JO A«V«ail IVN > \ /^\y£ NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEI RULES u*> FOR THE GOVERNMENT Board of Health CITY OF PHILADELPHIA. hi . &>fa*4&, •;■ ^: Adopted by the Board, 189. Presented, to the Statistical Division, Surgeon-General's Detrk & BLJ SiaiM"*-*" A„„v T« Street. Library, United States Army Washington, D. C. BY The Prudential Insurance Co. of America Newark, New J«ri«y NATIONAL LIBRARY OF MEDICINE BETHESDA 14, MO. INDEX TO RULES. PAGE Bill and Warrant Clerk.........................................'. 12 Bills of Health............................................................................ 35 Bone-Boiling Establishments........................................... 39 Chief Clerk.................................................................................. 12 Chief Iuspector of Nuisances..........,............................................... 27 Chief Inspector of Milk................................................................. 32 Chief Inspector of House Drainage.......................................'........... 62 Chemist............................................',........................................ 33 Collectors of Milk Samples............................................................. 33 Collectors of Vital Statistics............................................................ 18 Contagious Diseases....................................................................... 50 Committees.................................................................................. 5 Committee on Accounts, Office and Library....................................... 8 Committee on House Drainage.......................................\ ................ 9 Committees on Nuisances.............................................................. 10 Disinfedor.................................................................................. 73 Disintectors, Assistant................................................................... 73 Disinfection................................................................................. 75 Disinfectants, Use of...................'............................ .................... 77 Depositories of Dead Auimals......................................................... 39 Health Officer....................................................:......................... 10 House Drainage Rules................................................................... 52 House Drainage, Assistant Inspectors oI............................................ 63 Inspectors of Privy Cleaning........................................................... 29 Inspector of Vessels........................ ............................................ 29 Inspection of Milk...................................................................... 31 Inspectors of Milk, Assistant......................................................... 32 Lazaretto Committee....................'................................................ 8 Lazaretto, steward of the...........................--- ............................. 34 Laboratory of Hygiene................................................................. 69 Ly ing-in Hospitals ....................................................................... 25 Licensed Privy Cleaners................................................................ 63 M eetin s of Board....................................................................... 3 Medical Inspector........................................................................ 20 Medical Inspectors, Assistant.......................................................... 20 Messenger.................................................................................... 30 Measurers................................................................................... 30 Municipal Hospital...................................................................... 81 Municipal Hospital, Steward of...................................................... 82 Municipal Hospital, Matron of...................................................... 87 Miscellaneous............................................................................... 42 Nuisance*!, Assistant Inspectors of.............••...................,................. 27 Nuisances......................................•........................................... 35 Nnisances, Removal of................................................................... 40 Office Hours................................................................................ 3 Permit Clerk................................................................................ 14 Port Physician ..............................................................•........... 31 Quarantine Duti Vaccine Physicians......................................................................•• 87 V RULES OF THE BOARD OF HEALTH. ADOPTED 1895. 1. The Board shall be organized on the first Monday in July, in each and every year, by the election of a President pro tempore, and Secretary, to serve for the ensuing year. 2. The Board shall hold stated meetings on Tuesday of every week at 12 o'clock M.; and it may hold special meet- ings when convened by order of the President ex-officio, President pro tempore, or any two;of its members. 3. All meetings of the Board shall be public except in the case of a member objecting to the consideration of sanitary or other business; such business to be postponed until the other matter has been acted upon. 4. The hours for the transaction of the business of the Health Office shall be from 9 o'clock A. M. to 4 o'clock P. M., daily, Sundays excepted. Special hours shall be fixed for Sundays and holidays. THE PRESIDENT, ex-officio. 5. The Director of Public Safety shall, ex-officio, be a mem- ber and President of the Board, and shall preside at the meetings of the Board, and preserve order and decorum. (3) 6. He shall, as chief executive thereof, subject to the reso- lutions and orders of the said Board, appoint, supervise, and control all of the subordinate officers and employees attached to the Board, and all warrants shall be approved by him, after being signed by the President pro tempore and Secretary of the Board, before being countersigned by the City Controller. THE PRESIDENT, pro tempore. 7. In the absence of the President ex-officio, the President pro tempore shall preside at the meetings of the Board, and preserve order and decorum. 8. In the absence of the President ex-officio and the Presi- dent' pro tempore, a Chairman for the meeting shall be ap- pointed. 9. The President pro tempore shall appoint the members of the Standing Committees. THE SECRETARY. 10. The Secretary shall keep accurate minutes of the pro- ceedings of the Board, and conduct such correspondence as the Board may direct and approve. SUBORDINATE OFFICERS. 11. The subordinate officers of the Board shall consist of a chief clerk, five assistant clerks, a chief registration clerk, nine assistant registration clerks,'a medical inspector, fifteen assistant medical inspectors, a stenographer and type- writer, a chemist, a chief inspector of nuisances, clerk to chief inspector of nuisances, twenty inspectors of nuisances, two collectors of vital statistics, two inspectors of privy cleaning, one vessel inspector, two sworn measurers, one disinfector, six assistant disinfectors, one chief inspector of house-drainage and plumbing, twelve inspectors of house- drainage and plumbing, one clerk of house-drainage and plumbing, one messenger, one physician-in-charge of the Municipal Hospital, two resident physicians, a steward and a matron of the Municipal Hospital, one chief inspector of milk, five assistant inspectors of milk, five collectors of milk, a chief bacteriologist, two assistant bacteriologists, and such employees as are hereinafter provided for. COMMITTEES. 12. The following Standing Committees shall be appointed annually at the first meeting after the organization of the Board: a. A Sanitary Committee, consisting of three members, two of whom shall constitute a quorum. b. A Lazaretto Committee, consisting of three members, two of whom shall constitute a quorum. c. A Committee on Accounts, Office and Library, consist- ing of three members, two of whom shall constitute a quo- rum. d. A Committee on Burial Grounds and the Registration Act. consisting of three members, two of whom shall con- stitute a quorum. e. A Committee on House-Drainage and Plumbing, con- sisting of three members, two of whom shall constitute a quorum. /. Two Committees on Nuisances, viz: District Committee No. 1, consisting of three members—all that portion of the city south of Market street and west of the Schuylkill river; District Committee No. 2, consisting of three members—all that portion of the city north of Market street and east of the Schuylkill river; two members of a committee shall constitute a quorum. 13. The President pro tempore shall be ex-officio a member of all committees. (> SANITARY COMMITTEE. L4. The Sanitary Committee shall be intrusted, subject to the general superintendence, orders and by-laws of the Board, with the exercise and performance of those powers and duties vested by law in the Board of Health, so far as relates to the prevention and spread of contagious diseases (see Section 18th of the General Health Law), and likewise with the management of the Municipal Hospital, and of such other temporary hospitals as the Board shall at any time order to be opened: Provided, That ho important addition, alteration or improvement-be undertaken in rela- tion to the same, without the sanction of the Board. The said Committee shall likewise have supervision over the division of milk inspection, of pathology, bacteriology and disinfection, and of chemistry. 15. The said committee shall hold stated meetings upon the call of the Chairman, or of any two members thereof. 16. At the first stated meeting subsequent to their ap- pointment, the committee shall elect a Secretary, who shall keep, in a book provided for that purpose, fair minutes of all their proceedings. 17. The committee shall cause every reported case of malignant or contagious disease existing within the limits of the jurisdiction of the Board of Health to be visited without delay, and shall be authorized to take such other measures in relation thereto as a majority of the members shall deem proper. 18. Whenever a report shall be received at the Health Office that a case of any malignant or contagious disease has occurred within the limits of the jurisdiction of the Board of Health, notice thereof shall forthwith be given to the port physician, or to any other physician appointed to inquire into the nature of the case, who shall visit the same and send to the Health Office, without delay, a written report in relation thereto. If the report of the physician 7 be such as to require the attention of the committee, the Chief clerk shall notify the members of the same im- mediately. 19. When necessary, there shall be appointed one or more physicians to perform the duties specified in the preceding section, and the Board shall determine the compensation to be paid for the services of the same. 20. No fine shall be imposed on any physician for failure to report contagious diseases in compliance with the Act of Assembly, except upon the report of the Sanitary Commit- tee after an investigation of the case; and no fine shall be imposed in any case until the party accused of a violation of the law has been notified personally by an employee of the Board to appear before the committee to make answer to such charges as may be preferred. 21. Whenever the Board, upon a representation from the Sanitary Committee, shall determine it to be expedient to provide and hold in readiness one or more temporary hos- pitals, the committee shall select the location of the same, secure the services of competent nurses, and otherwise put those establishments in condition to be opened with the least delay possible for the reception of patients, and there shall be appointed one or more physicians to attend the sick, at such compensation to be paid to them, and also to nurses, for their services as shall be determined by the Board. 22. As soon as practicable after the Board has determined to provide temporary hospitals, the Sanitary Committee shall arrange and submit to the Board for its approbation a plan of hospital operations, so that everything may be conducted economically and efficiently from the day the hospital shall be opened. 23. All requisitions for medicines and hospital supplies shall be made in writing upon the chairman of the committee by the physician in attendance, and for all other articles 8 necessary for the proper management of these hospitals a requisition in writing shall be made by the steward. 24. No patient shall be admitted into the Municipal Hos- pital, or such temporary hospitals as may be provided, under any circumstances whatever, excepting upon an order of a member of the Board, the chief clerk, the port physician, the health officer or the medical inspector, after the case has been verified by the medical inspector, port physician, or an assistant. The rate of board to be paid by the patients shall be fixed by the Sanitary Committee agreeably to the provisions of the health law. LAZARETTO COMMITTEE. 25. The Lazaretto shall be under the management of the Lazaretto Committee. The said committee shall hold stated meetings once every month, and special meetings upon the call of the chairman, or of any two members thereof. 26. The committee, shall, at their first meeting, elect a secretary, who shall keep a full and accurate record of its proceedings. 27. The committee shall take an inventory of the effects of the Board at the Lazaretto at the commencement and termination of the lease of the property, or whenever else directed by the Board, and file a copy of same in the office. COMMITTEE ON ACCOUNTS, OFFICE, AND LIBRARY. 28. All bills, being first certified as correct by a majority of the committee by whose order they were incurred, shall be approved by the Committee on Accounts before being presented to the Board, or an order being passed for their payment. 29. The monthly accounts of the Health Officer shall, when presented to the Board, be referred to the Committee on Accounts; said committee shall compare said accounts 9 of the Health Officer with the monthly lists of vessels visited by the Vessel Inspector and subject to health fees. 30. The committee shall have the charge and general superintendence of the building or rooms occupied as the Health Office, and of the fixtures, furniture, and library belonging thereto. They shall direct to be procured all the necessary supplies for the use of the said office, and for the accommodation of the Board at its meetings. They shall have all the officers, when appointed to serve under the Board, sworn or affirmed to perform faithfully the duties assigned to them, and to keep private all business connected with the office. REGISTRATION ACT. 31. It shall be the duty of the Committee on Burial Grounds and the Registration Act to assist the health officer with their advice in the publication of the bills of mortality and the annual statement of deaths, and generally to super- intend the preparation and publication of the same, in detail, weekly. 32. The Committee shall have charge of the registration division of the office, direct the necessary supplies, see that the clerks carry out the rules and other requisitions of the Board, and report to the Board any delinquencies of duty that may occur in this department. 33. They shall have examined by the Chief Inspector of Nuisances, all burial grounds, cemeteries and vaults within the city, when referred to them by the Board as nuisances, and report such action thereon as may be necessary. COMMITTEE ON HOUSE DRAINAGE AND PLUMBING. 34. The Committee on House Drainage and Plumbing shall have supervision over the officers and work of said division, and shall see that the rules relating to the same are carried out; and shall also see that the law and rules 10 relating to the cleaning of privy wells are enforced, and that the penalties incurred for infringement of said laws and rules, when approved by the Board, are paid to the proper officer for the use of the city. COMMITTEES ON NUISANCES. 35. It shall be the duty of the Committees on Nuisances to examine all nuisances complained of wuthin the bound- aries of their respective districts, and referred to them by the Board, either directly or after an examination and report by the inspectors, and to report to the Board what action may be necessary thereon. 36. Whenever the cost of removing a nuisance reported upon by the inspectors, or otherwise, shall exceed the sum of twenty-five dollars, the case shall be referred to the com- mittee on the district in which such nuisance is situated, who shall report to the Board, at the earliest practicable moment, the character of said nuisance and the probable cost of removing it; upon which report the Board shall take action, and instruct the Health Officer in regard to the same. HEALTH OFFICER. 37. The Health Officer shall examine the weekly accounts of the Inspector of Vessels, of coasters subject to health fees, and shall report monthly to the Board the list of vessels visited by the said inspector. 38. He shall keep a cash-book, in which entries shall be made daily of the receipts as they occur, and pay over to the City Treasurer, daily, all moneys received bv him according to law. 39. He shall furnish the Board, at its first meeting in every month, a detailed statement of the receipts of th office during the preceding month. 40. He shall, whenever any bill is referred to him 11 the same, together with a full description of the claim upon which the said bill is founded, upon a docket kept for that especial purpose, and note opposite to the said entry such action as may be taken, from time to time, in relation thereto. 41. He shall, at the expiration of four months after date of said bills, turn over to the City Solicitor for lien all claims remaining unpaid, and furnish the City Controller with a transcript of the same. 42. He shall, in all business referred to him and requiring legal proceedings, prosecute the same, but take such proceed- ings only in conjunction with the City Solicitor or his deputy. 43. He shall, whenever this Board directs a nuisance to be removed under his supervision, abstain from employing any person who is or may be under prosecution for any violation of the health laws. The same prohibition is hereby extended to any other agent of the Board to wdiom such duty may be assigned. 44. He shall execute all contracts for abating nuisances within twenty-four (24) hours after the order of the Board has been placed in his hands, and shall impose a condition in said contracts that the work must be commenced within forty-eight (48) hours after acceptance, and prosecuted con- tinuously to completion. He shall strictly enforce the penalties provided for under the Act of 1818. 45. He shall, from time to time, furnish to the House- Drainage and Plumbing Committee a list of the names of the licensed cleaners, with the number of their licenses, and shall also report to them at any time all information given him, or any knowledge he may have obtained re- specting defalcations, breaches of faith, or violation of the law or rules on the part of licensed cleaners, or the men in their employ. 46. He shall keep a book, in which he shall record all cases of contagious or infectious diseases reported to the office, with the date of the report, the location and name of 12 the patient, the disease under which he labors, and the name of the physician in attendance. 47. He shall, when any notice of contagious or infectious disease is received at this office, notify, as far as possible, all the inmates of the house in which such disease occurs within twenty-four (24) hours of the receipt of said report: Pro- vided, That nothing in this rule is intended to lessen in any way the responsibility of the physician in charge of the case. 48. He shall have the general superintendence of the Registration Division, see that the clerks carry out the in- structions of the Board, and shall report any delinquencies on their part to the Committee on Registration. 49. He shall publish weekly over his signature the re- turns of deaths as made to the office, in such form and manner as shall be directed by the Board, and annually prepare for publication a report of the births, marriages and deaths recorded in the office during the year, to be sub- mitted to Councils and the Mayor through the Board of Health, in accordance with the Registration act. THE CHIEF CLERK. 50. The Chief Clerk shall transcribe the minutes taken by the Secretary into a book provided for the purpose. 51. In the absence of the Secretary of the Board he shall act as clerk of the meeting. 52. He shall insert in a letter-book copies of all important communications written by the Secretary or other officers of the Board, and also keep copies of all agreements and letters made or written by order of the Board, and of such other documents as the Board may direct. 53. He shall copy, in a book to be provided for the pur- pose, all resolutions not of a temporary nature, that may be hereafter passed by the Board, with marginal notes. 13 54. He shall notify the Chairman of all Committees of the business referred to them by the Board; he shall also notify all officers of their appointment. 55. He shall grant licenses to clean privies, under the rules of the Board, when so directed, and for each license he shall see that the sum of fifty dollars has been paid to the city, and he shall renew the said license from time to time, as the Board may direct, upon the payment of the like sum to the city. 56. He shall grant orders for the admission of patients into the Municipal Hospital (he being first furnished with the usual certificate of a physician), and shall require satis- factory security for the payment of the board and medical attendance of the said patients, in cases where they are able to pay for the same. 57. He shall furnish the Health Officer a true copy of all resolutions passed by the Board concerning the duties of said officer. 58. He shall place in the hands of the Health Officer, for execution, all orders to abate nuisances, where the owners or agents have failed to comply with the notice of the Board: Provided, The cost of removing any such nuisance shall not exceed the sum of twenty-five dollars: Provided, That this restriction shall not apply to the cleaning of privy wells. 59. He shall keep an accurate account of all carriages ordered for the different committees, and register the names of the member who gives the order, and the date thereof. He shall also keep an accurate account of all railroad tickets issued to members and employees of the Board, and register the name of the recipient, and the date of issue, in a book kept for that purpose. 60. He shall keep the rough minutes and the minute-book under lock and key, in the safe of the fire-proof, unless they be in use, and allow no access to them, except to a member, or on an order from the Board. 14 61. He shall officially notify the lowest bidders for supplies for the department of the award of contracts to them imme- diately after such award, and retain a copy of the notice in the office; an acknowledgment to be required of the receipt of such notice. 62. He shall have the entire superintendence of the office, answer all questions appertaining to the business of the Board and office, keep the keys of the fire-proof, and furnish the Office Committee with a list of such supplies as may be needed; keep in a book an account of all articles furnished to the Health Officer and the employees of the office; report to the Committee on Office any delinquency of duty on the part of those in the employ of the Board; preserve good order in the office, and perform such other services as the Board may direct. ASSISTANT CLERKS. Bill and Warrant Clerk. 63. It'shall be the duty of the bill and warrant clerk to audit and enter all bills submitted to the Board for work done and materials furnished, make out the pay-rolls of employees and contractors, and when approved, draw warrants for their payment. He shall once every month furnish to the City Controller a return of all warrants drawn, and shall submit to the Board or Committee on Accounts, Office, and Library, a statement of the condition of the various items of the appropriations whenever required. He shall discharge the duties of the chief clerk and Health Officer during the absence of either of said officers. Permit Clerk. 64. It shall be the duty of the permit clerk to issue per- mits to clean privy wells, in accordance with the Act of March 16, 1855, and the rules of the Board relating thereto. 65. He shall refuse permits to cleaners whose licenses have 15 been suspended, or upon whom fines have been imposed for violating the poudrette laws, until said suspension is revoked or fines are paid. 66. He shall, on application being made for a permit to land hides, direct the vessel inspector to examine said hides, and report as to their condition. Should they be found sound, the permit so applied for shall be issued; but should they be reported unsound, the application shall be referred to the Board for action. 67. He shall (from June 1st to October 1st,) issue permits for the landing of vegetables and fish, when in sound con- dition, to the captains or owners of all vessels arriving at the wharves on the rivers Delaware and Schuylkill, for which permit a charge of fifty cents shall be made. 68. He shall issue to captains and owners of steamboats plying regularly on the rivers Delaware and Schuylkill, upon application and filing a bond conditioned not to land any unsound fish or vegetables, a permit for the season, upon payment of five dollars. 69. He shall keep a record of all permits issued by him and the charges therefor in a book provided for that pur- pose, and report to the Board monthly a statement of tho same, for transmission to the Receiver of Taxes. Recording Clerks. 70. It shall be the duty of the Recording Clerk and his assistants to receive all complaints of nuisances, having the name and residence of the complainant thereto attached, and place them in the hands of the chief inspector for ex- amination. He shall record the same, when returned by the inspector, in a book kept for the purpose, specifying the date, the location, the character of the nuisance, and the- name of the inspector, and make out a duplicate notice of that served upon the owner or agent. He shall transmit to the chief clerk all notices that have not been complied withr 16 and shall keep on file, in numerical order, the original com- plaints and return of the inspector, together with any special resolution or action of the Board relating thereto. He shall submit to the Board at each stated meeting, for confirmation or otherwise, the action of the inspectors upon complaints of nuisances, and shall report to the chief clerk any neglect of duty upon the part of the inspectors in making their examinations and returns. He shall notify committees and witnesses to attend meetings whenever so directed by the chairman thereof. He shall append to all notices for removing nuisances that part of Section- 27 of the General Health Law, imposing a penalty for neglect or refusal to remove such nuisances. REGISTRATION CLERKS. Ihe Chief Registration Clerk. 71. The Chief Registration Clerk shall have the entire charge of all books and papers belonging to the Registra- tion Division. He shall see that all entries are accurately made, and the books kept in good order and condition. He shall see that the clerks in his division carry out the instructions of the Board, and shall report any delinquencies 9 on their part to the Health Officer for the Registration Committee. 72. He shall examine carefully the returns of births, marriages, and deaths, and should any omission or errors occur therein it shall be his duty to notify the parties mak- ing said returns to make the necessary corrections, and any neglect or refusal on their part shall be reported to the Board through the Committee on Registration. 73. He shall keep, in a book provided for the purpose, a record of the names and residences of physicians, practi- tioners of midwifery, clergymen, clerks of meetings, alder- men, sextons, undertakers, and others required by law to make returns to the Health office; and should any person 17 or persons so required when notified, neglect or refuse to call at the office and record their names and residences, he shall report the fact to the Board, in writing, through the Com- mittee on Registration. 74. He shall fill up all permits for the removal of dead bodies from the city for interment, having first obtained the certificate of the attending physician or the coroner, accom- panied by that of the undertaker, together with the approval of the Health Officer, whose signatures shall in all cases be appended thereto, but in no case where the body is to be re- moved by transportation, without first having obtained a certificate from the Medical Inspector, or the affidavit of a reputable undertaker, to the effect that the body has been enclosed in a hermetically sealed case. 75. He shall issue permits for the removal of dead bodies from one cemetery to another, or from one grave or vault to another in the same cemetery, within the bounds of the city, the period from June 1st to October 1st except- ed, unless by special order of the Board. 76. He shall make out and deliver, under the approval of the Health Officer, all transcripts of births, marriages or deaths applied for from the registration records, with the name of the Health Officer appended. 77. He shall have charge of the books containing the blanks for birth, marriage and death certificates, and deliver them, when applied for, to such persons as are required by law to make returns : Provided always, That the names and residences of the applicants are on record in the office, or shall be registered at the time of receiving the blanks. He shall also keep an account of all blanks delivered by him, together with the date of delivery and the name and resi- dence of the receiver. 78. He shall assist the Health Officer in the preparation of his weekly statement of deaths, and of his annual report of births, marriages and deaths. 18 79. He shall at all times during office hours give to law- yers, physicians and clergymen access to the registration books, and allow them to take notes of the contents; and to all other persons desirous of examining into the merits of the system, he shall furnish every necessary facility. 80. For all permits to remove dead bodies from vault or grave or from the city for interment, and for all certified transcripts from the registration record, there shall be made a charge of fifty cents to be paid to the proper officer for the use of the city. 81. He shall furnish to the collectors of vital statistics every information necessary to facilitate their work of col- lecting returns, and report to the Committee on Registration any neglect or refusal on their part to discharge faithfully the duties assigned to them. The Assistant Registration Clerks. 82. The subordinate clerks in the Registration Division shall be required to perform such duties as may be assigned to them by the Committee on Registration and the chief registration clerk, in connection with the registration of births, marriages, and deaths. COLLECTORS OF VITAL STATISTICS. 83. It shall be the duty of the collectors of vital statistics to collect the monthly returns of births from the practitioners of midwifery, make weekly reports upon the record book of the number of physicians visited, and also the number of births collected, and under the direction of the Committee on Registration and chief registration clerk to perform such other services as may be required of them, in order to carry out the law for the registration of births, marriages and deaths. In the event of any person or persons refusing or neglecting to make out and furnish their returns, the col- lectors of vital statistics shall report their names and resi- dences to the chief registration clerk. When not engagul in this duty, they may be called upon for other services." 19 Special Rules relating to Certificates of Death in cases unpro- vided for in the Code of Regulations. 84. When a patient suffering from small pox or other con- tagious disease dies while being taken to the hospital, the physician in charge shall fill up the certificate with such information as he may have; if incomplete, he shall send such certificate to the Health Officer to supply the wanting information, in case the body is buried in the hospital grounds. This certificate, if complete, and the undertaker's certificate, filled up in every case by the steward, shall (if the body is buried in the hospital grounds) be sent direct to the registration office. 85. Whenever a certificate of -burial, incompletely filled up, is received at the registration office (especially when received from the Municipal Hospital) the chief registration clerk shall send it to the Health Officer for the purpose of obtaining the desired information. 86. Whenever a person dies of smallpox or other con- tagious disease without the attendance of a physician, either the Coroner or the Health Officer must furnish a certificate of death, as provided by law, before the body shall be per- mitted to be buried in the hospital grounds. Such certifi- cate must be sent to the hospital with the body, and the steward shall fill up the undertaker's certificate, and return both certificates to the registration office; and he shall like- wise keep a careful record of all such cases. He shall do likewise in all cases dying in the hospital, when the bodies are interred in the hospital grounds. MEDICAL INSPECTOR. 87. All questions requiring special medical knowledge in their investigation shall be referred to the Medical Inspector. He is required to be present at the office during all meet- ings of the Board, and at all such other times, between the hours of 9 A. M. and 4 P. M., daily, as his duties will permit. 20 88. The Medical Inspector shall return at each meeting of the Board a full report of the derelictions of duty on the part of attending physicians who violate the Act of Assem- bly of January 29, 1818, giving in each case, the date of the notice, the date of its receipt, and such circumstances as lead him, after investigating the case, to the belief that the act has been violated. 89. He shall keep a book, in which lie shall record all cases of contagious or infectious diseases reported to the office, with the date of the report, the location and name of the patient, the disease under which he labors, the name and residence of the physician in attendance, the termina- tion of the case, and such other information as may make the record complete. RULES DEFINING THE DUTIES OF THE MEDICAL INSPECTOR AND HIS ASSISTANTS. 90. The Medical Inspector shall have the supervision of the management of contagious and infectious diseases; and shall direct and supervise the work of the assistant medical inspectors. 91. He shall, from time to time, with the aid of his assist- ants, make a thorough examination of all school buildings, with the object of discovering and of having remedied, all conditions having a tendency to affect injuriously the health of the children. He shall, from time to time, report to the Board the results of his investigation with such recom- mendations as he may deem proper. On the first Tuesday in January and July of each year, he shall make a full report of his work for the preceding six months. 92. The assistant medical inspectors shall be under the immediate direction of the Medical Inspector. They shall report in person daily to him at 12 o'clock noon, or as often as shall be required. They shall be assigned to districts over which they are expected to have sanitary supervision. 21 They shall visit and examine infected houses and all cases of contagious or infectious diseases assigned to them, and make a full report with recommendations in writing, and when necessary also by telephone or telegraph. They shall insist upon the application of all neccessary sanitary and prophylactic measures. In all cases in which diseases can be spread, either directly or indirectly, from one person to another, the isolation of the patient and the disinfection or destruction of the infectious material are of primary impor- tance. Isolation may be accomplished by removing the sick at the earliest possible moment from the house to the Municipal Hospital if it is not possible in the house, or, in some cases, by removal of the well, if accomplished at the outbreak of the disease. 93. The Medical Inspectors shall placard houses in which cases of Asiatic cholera, relapsing fever, yellow fever, scarlet fever, diphtheria or membraneous croup, typhus or ship fever, epidemic cerebro-spinal meningitis or spotted fever, smallpox or varioloid exist; the exceptions being those houses which are watched by a quarantine guard or where the responsible head of the family gives a reliable and posi- tive guarantee that the rules and regulations governing contagious diseases will be strictly carried out. The placard shall be affixed by the Assistant Medical Inspector, and removed by this officer or under his direct supervision. 94. The arrest of the spread of the disease is further.to be attempted by thorough ventilation and cleanliness of the sick room, the prompt and efficient disinfection of the ex- creta, the disinfection of bedding, clothing and all articles in the sick room before their removal; and after recovery or death of the patient, by disinfection of the clothing, rooms, houses, cesspools, etc. Disinfecting chambers have been provided on the grounds of the Municipal Hospital for the immediate purification, by heat and other means, of all soiled clothing, bedding and other infected articles that cannot be properly treated at home. Whenever such 22 is required the Health Officer should be notified. Printed circulars describing particularly the measures necessary to employ in cases of contagious and infectious diseases should be sent to or left at the house. 95. Whenever the sick " cannot be properly attended to at < home,w a recommendation for their removal to the Munici- pal Hospital should be furnished the Health Officer by the Medical Inspector or Port Physician. The duty of visiting houses where there are cases of contagious or infectious diseases should be performed with great discretion, so that, while nothing necessary to be known shall escape observa- tion, the service shall not excite opposition by its obtrusive- ness and unnecessarily inquisitorial character. 96. All cases of diseases mentioned in the " notification blanks" are required to be reported and should be kept under observation, but it is not expected that all cases shall be visited daily; discriminating judgment must be exercised in this matter; the reports furnished by physicians will aid in forming a judgment. Systematic and frequent inspec- tion is always necessary where there is reason to suppose the sick are not isolated, disinfection and sanitary and pre- cautionary measures are not employed, and where inter- course with the sick and the public is not prevented, in order to correct these faults. In such cases a watchman mu.st be employed, and may be secured by notifying the Medical Inspector. 97. Whenever a certificate of death from tubercular con- sumption is returned to the Health Office, the Medical In- spector shall visit the house where such death has occurred, and satisfy himself that thorough official or private disin- fection has been performed. 98. The Chief Registration Clerk shall communicate daily to the Medical Inspector, upon a blank prepared for the purpose, all deaths from consumption, giving the name age, sex, residence, and date of death of the decedent. 23 99. All cases of tuberculosis reported to the Board of Health must be entered in a book kept for the purpose in like manner as other cases of contagious diseases are re- corded. 10<). The assistant medical inspectors should provide themselves with small packages of chloride of lime, carbolic acid, sulphur and corrosive sublimate, to be taken on the tour of inspection for immediate use where necessity re- quires it. 101. The assistant medical inspectors should note what- ever is not sanitary about the house, premises or locality, and report the same for correction. 102. Their duties in reference to contagious and infectious diseases shall be performed as herein described, and as further explained in circular upon " Sanitary Inspection in Relation to Contagious and Infectious Diseases." 103. Whenever a case of contagious or infectious disease occurs in a family in which any member thereof attends school, the assistant medical inspector shall promptly fill out printed blanks of notification of such disease and send the same to the principals of the schools (Sunday and week- day) where such child or children of the family attend. Whenever such case has terminated, either in recovery or death, the assistant medical inspectors shall require and supervise the destruction of all books likely to have become infected by having been brought in contact with the person sick or his effects. They shall, upon recovery of the sick, issue a certificate of recovery, permitting the return of the child to school, which certificate alone shall be recognized as valid for this purpose. They shall also direct when the other children of the family may be safely permitted to attend school. The following are designated as safe periods after convalesence for issui-ng such certificates: Three (3) weeks after fall and absolute recovery from scarlet fever; two (2) weeks after diphtheria, and two (2) weeks after smallpox. 24 104. Whenever a case of cholera occurs (or even a case of ''suspected cholera," and until such suspicion is disposed of by a biological test, which must be made in all cases) the Medical Inspector shall place an assistant medical inspector in the house where the sickness has occurred, and such offi- cer shall be on duty (being relieved by one of the corps at proper intervals) to enforce instructions, for at least five days after the removal of the patient to the Municipal Hospital, or after death. A disinfector shall be at the ser- vice of said officer to disinfect under his instructions. Being on duty means to be present sufficiently often and long to have complete knowledge of everything that takes place in the house. If it be necessary to guard the house, the Medi- cal Inspector shall employ watchmen for the purpose. The object of this order is to intercept and completely control the first cases, and thereby prevent the spread of the disease. 105. A circular of instruction in the management of con- tagious and infectious diseases shall be left at every house where such disease occurs, independent of the public distri- bution of this information. 106. Articles that cannot be properly disinfected at home, such as beds, bedding, carpets, etc., must be sent to the dis- infecting establishment at the Municipal Hospital by an order on the steward of the hospital. Disinfection of other articles must be promptly carried out at home under the supervision of the assistant medical inspectors. The disin- fector must be promptly notified when and how the room or house are to be disinfected. 107. The assistant medical inspectors shall make written report of the condition of the premises where the sick reside, with such recommendations as they may deem advisable for the improvement of its sanitary condition. 108. When a house is placed "under quarantine restric- tions," the assistant medical inspector shall state whether "complete" or "partial;" if the latter, they shall name the 25 person or persons of the family, not coming in contact with the sick, who may be permitted to leave and enter the house, and the Medical Inspector shall place these names upon the order furnished the watchman. 109. They shall visit and examine public schools and other school buildings located in their districts whenever so directed, and make thorough inspection of the buildings and appliances in the manner laid down in " Principles of Sanitary Inspection" issued by the Board of Health. 110. They shall have the general sanitary supervision over their districts and report whatever faults need correc- tion. They shall visit industrial establishments with a view of discovering nuisances therein or caused by the process of manufacture; they shall observe the condition of the streets and public places, note defects in surface drainage, and all offenses against sanitary laws and rules without waiting for sspecific complaint to be made; and they shall inquire dili- gently into all natural and acquired conditions having a tendency to affect injuriously the health of the people. Ill. The Medical Inspector shall analyze the reports of his assistants and refer them to the Board, or to the Health Officer, or to the Nuisance Department, as the case may be, for the necessary action; blanks and books shall be kept for this purpose. RULES AND REGULATIONS FOR THE GOVERN- MENT OF LYING-IN HOSPITALS, HOSPITAL WARDS OR OTHER PRIVATE PLACES FOR THE RECEPTION, CARE AND TREAT- MENT OF WOMEN IN LABOR, AS PROVIDED FOR BY ACT OF ASSEMBLY APPROVED APRIL 26, 1893. 112. The principal of every lying-in hospital, hospital ward or other private place kept for lying in purposes, other than an institution duly incorporated for such purposes, shall keep a record in a book kept for that purpose contain- ing the full name and address of each person admitted, the date of admission, the date of birth of every child, the date of its removal, and the place to which such child shall be removed. Such hospital, hospital ward or other private place, shall be visited by the Medical Inspector or one of his assistants prior to the granting of said license, and full inquiry made as to the location, accommodation and sani- tary surroundings of the proposed ward, and of the ability and fitness of the.applicant to carry on the work, and such other information bearing on the subject as may be obtain- ed, and make a full report to the Board with his recom- mendation, upon which the Board of Health may base their action for granting or rejecting the application for license. 113. Such licensed hospital, hospital ward or other private place shall be visited once each month by the Medical In- spector or his assistant, and a report be made accordingly thereon. 114. The principal of every hospital, hospital wrard or other private place for lying-in purposes to which a license has been granted, shall, within five days after the birth of any child, report the same to the Board of Health ; the date and place of said birth, name of mother, address of mother, date of removal, place to which child is removed, name, sex and color of child, as required by Act of Assembly. 115. Any violation of Section 1 of Act of the Assembly to provide for the licensing and regulation of lying-in hos- pitals, hospital wards or other private places for lying-in purposes, approved April 26,1893, by keeping such a hos- pital, hospital ward or other private place for the reception, care and treatment of women in labor, for hire or 'reward, without licenser, shall be punished by a fine not exceeding one hundred dollars (§100) for the first offense, and two 27 hundred dollars ($200) and imprisonment of not more than one }^ear, or either, or both, for the second offense, at the discretion of the Court. CHIEF INSPECTOR OF NUISANCES. 116. It shall be the duty of the Chief Inspector to have general supervision of investigating and reporting upon all nuisances as directed by the Board. He will be required to be present at the office during all meetings of the Board, and at all such other times, between the hours of 9 a. m. and 4 p. m., daily, as his duties will permit. All complaints of nuisances received at the Health Office shall be immediately referred by the chief clerk to the Chief Inspector of Nuisances, who shall make a report and recommendation thereon to the Board, and he shall consult the Medical Inspector or Chief Inspector of House Drainage in such cases as may be necessary. 117. He shall see that all special orders of the Board are faithfully obeyed, and report to the Board any neglect of duty upon the part of the inspectors. And it shall be his duty, assisted by the other inspectors, to see that all the rules of the Board touching bone and horse-boiling establishments, slaughter-houses, and other nuisances are enforced, and he shall make report weekly to the Board. ASSISTANT NUISANCE INSPECTORS. 118. It shall be the duty of the inspectors to examine and report upon all complaints of nuisances placed in their hands within twenty-four hours thereafter. 119. They shall, whenever any nuisance may-be found, immediately serve a notice upon the owner or agent of the premises upon which such nuisances exist, to abate said nuisance in accordance with law and the rules of the Board- In the event of the owner or agent not being found after diligent search, the notice shall be left upon the premises and the fact reported and entered upon the record. 28 120. They shall notify the owners or agents of properties upon which nuisances exist arising from full, foul, or leaky privy wells, upon the service of notice to remove the same, that the penalty provided under the xVct of Assembly will be strictly enforced. 121. They shall, in making their returns, give an accurate description of the property or properties whereon the nuisance exists, together with the nature, character, or cause of the nuisance. 122. They shall strictly follow the schedule of time allowed in service of notices for the abatement of nuis- ances, when not otherwise specified by resolution of the Board. 123. They shall, at the expiration of notice (Sundays and days set apart as holidays excepted), re-examine said nuis- ance and report what action has been taken in the premises. 124. They shall, with all returns of non-compliance with notice (except in the case of privy wells), present an estimate of the probable expense of removing said nuisance, and also give the offset of all privy wells taken by accurate measure- ment. 125. They shall serve the bills for removing nuisances upon the owners or agents of the premises on which such nuisances are situated, and if not found after careful in- quiry they shall leave the bills upon the premises. 12(5. They shall carefully abstain from giving, or causing to be given, to any privy cleaner or cleaners, their agents or others, any information respecting nuisances reported to the Board, or any complaint whatsoever, or respecting the action of the Board relative to a nuisance or nuisances. Such offence shall be considered a misdemeanor in office and render the inspector so offending subject to immediate dismissal. 127. They shall, whenever complaints are made and veri- 29 tied of dead animals lying on private property, have them removed by burial or otherwise, under the direction of the Health Officer: Provided, The cost of removal of each animal does not exceed the sum of fifty cents. 128. They shall report daily at 12 o'clock m., and confine themselves to their own department in the office until 1.30 o'clock P. M., unless excused or otherwise directed by the chief clerk. 129. They shall strictly comply with the above rules, and any dereliction upon their part will be cause for immediate dismissal. INSPECTORS OF PRIVY CLEANING. 130. It shall be the duty of the two inspectors of privy cleaning to see that the poudrette laws, and the rules and. regulations of the Board relating to privy wells, are strictly enforced, and report to the Board the name of any cleaner or company violating said rules. They shall present them- selves at the office daily at 10 o'clock A. M., and obtain from the permit clerk the location of wells to be cleaned that day. They shall report to the Board any delinquencies of the cleaners whose apparatus or appliances are not in conformity with the rules of the Board, and also any violation of the poudrette laws, and also make a monthly report to the Board, giving in detail the results of their observations in regard to the cleanliness, condition, and efficiency of the apparatus in use, and furnish such other information as will acquaint the Board fully of the manner in which the work is performed. INSPECTOR OF VESSELS. 131. It shall be the duty of Vessel Inspector to see that no hides, fish, or vegetables, or any sick person is landed from any vessel, in either river, without a special permit of the Board of Health. He shall likewise demand and collect from the captains, owners, or consignees of all 30 vessels arriving in either river during quarantine season, which are not required to stop at the Lazaretto, the health fee which by law they are respectively chargeable, and pay the same over to the Health Officer daily. 132. He is required to report all violations of the Rules of the Board relative to the cleaning of sturgeon and other fish in the vicinity of the wharves or in the docks, during quarantine season. 133. He shall, when directed by the chief clerk, examine all hides, and report whether the same be in a sound or unsound condition. 134. He shall be required to make a report every Tuesday of the work done by him during the previous week. When not engaged in his specific duties, he shall report to the Health Office for such duty as may be assigned him. MESSENGER. 135. The Messenger shall attend to keeping the office, rooms, furniture, etc., of the Board always in good and com- plete order, perform errands for the members, Health Officer, chief clerk, and assistant clerks, and such other duties as the Board may from time to time direct. 136. He shall not leave the office during business hours without permission of one of the above-named officers. MEASURERS. 137. The Measurers shall, under the direction of the Health Officer, measure all wells cleaned by order of the Board, and shall furnish said officer with a duplicate copy of an account of the measurement. If the cost of cleaning said wells exceeds the sum of twenty dollars, they shall receive as compensation therefor a sum equal to six per cent, of the amount of the bills. In all other cases the sum of one dollar only shall be paid equally by the cleaners and the owners of property from whence the nuisances are 31 removed. They shall not grant a certificate of measure- ment until the rule of the Board "requiring the entire contents of the well to be removed," has been complied with, unless otherwise ordered by the Board. 138. They shall refuse a certificate of measurement, unless furnished with the original order and permit to clean said well. They shall present the Health Officer with the cer- tificate of measurement, accompanied by the original order and permit for cleaning said well, within forty-eight hours after the receipt of the order from the cleaner. PORT PHYSICIAN. 139. The Port Physician shall be first assistant medical inspector, and shall act in the place of the Medical Inspec- tor, and perform his duties during his absence. 140. He shall be guided by the rules describing the duties of the Medical Inspector and his assistants as herein set forth. 141. He shall be required to be present at the office during the meetings of the Board, and at such other times, as designated by the Medical Inspector. 142. He shall not perform his duty by deputy, unless by the express approval of the Board. RULES GOVERNING THE INSPECTION OF MILK. 143. For the purpose of milk inspection the city shall be divided into four districts, to each of which an assistant inspector of milk and a collector of samples shall be assigned. First District.—All the City of Philadelphia lying south of Market street. Second District.—That portion of the city lying between Market street and Girard avenue. Third District.—That portion of the city lying between Girard avenue and Lehigh avenue. on Fourth District—All of the City of Philadelphia lying north of Lehigh aVenue. CHIEF INSPECTOR OF MILK. 144. The Chief Inspector of Milk shall have supervision of the inspection of milk and the immediate direction of his subordinates. 145. He shall keep a record of the names, residences, and places of business of all dealers in milk. 146. He shall keep an accurate record of the business of his department, the results of inspection and of analysis, and of persons accused of selling adulterated milk, and the result of trial upon charges preferred by him when ordered by the Board of Health. 147. He shall have a general supervision over all the districts, shall make personal inspection, and when necessary shall personally verify the reports of adulteration made by the assistant inspectors, in order that cases brought before the Court shall be properly authenticated upon the best of evidence. 148. He shall make weekly and monthly reports to the Board of Health of the workings of his department. 149. He shall see that the assistant inspectors properly canvass their districts and faithfully perform the duties assigned to them, and shall report to the Board of Health any dereliction of duty coming under his observation. 150. He shall early in January of each year make a report to the Board of Health of the workings of his divi- sion for the preceding year. ASSISTANT INSPECTORS OF MILK. 151. The Assistant Inspectors of Milk shall make them- selves conversant with the places of business, routes of all dealers in milk, shall visit such places systematically as 33 frequently as time will permit, giving special attention to the shops of those dealers whom they may suspect of dealing in adulterated milk. 152. They shall devote their entire time to the duties of their position, and shall not engage in any other vocation. 153. They shall keep accurate reports of their inspections upon blanks furnished for the purpose, and shall report daily to the Chief Inspector at 12 o'clock noon. 154. They shall strictly carry out the law and rules and regulations pertaining to milk inspection, and obey the orders of the Chief Inspector. COLLECTORS OF MILK SAMPLES. 155. A Collector of Milk shall be assigned to the Chief Inspector and to each Assistant Inspector, whom they shall accompany in their visits of inspection. 156. They shall carry the apparatus used in making examinations, assist the inspectors in the performance of their duties, make notes of inspections, and when required, take samples of milk under the direction of the inspector. 157. They shall report to the Chief Inspector at 12 o'clock noon. CHEMIST. 158. The Chemist shall have charge of the laboratory and be responsible for the apparatus and materials belong- ing thereto. 159. He shall make analyses of samples of milk and re- port the results to the Chief Inspector of Milk upon blanks furnished for the purpose; he shall also make analyses of samples of water and foods, etc., when furnished him through the chief clerk, and report the results in writing to the said official. 160. He shall keep in a proper register all data connected with the analyses which he may make from time to time. 34 161. He shall early in January of each year make a report to the Board of Health of the results of the workings of his division for the preceding year. THE STEWARD OF THE LAZARETTO. 162. Before entering upon the performance of his duties, the steward shall enter into a bond, with security, to be ap- proved by the Board, in the sum of one thousand dollars^ conditioned for the faithful performance of his duties. He shall relinquish, at the expiration of his term of office, or upon his removal by the Board, all right or claim in and to any and every kind of fruit or produce which may be in that portion of the grounds set apart for his use; he shall have no right of property in or to anything upon the Laza- retto, except the same be confirmed to him by special action of the Board ; he shall remove or dispose of no part or parts of the fruits or produce of the grounds of said Lazaretto under his charge, except for his own immediate use, or that of the officers or members of the Board, without the written permission of the Lazaretto Committee; and, further, he shall deliver over to his successor in office, or such other person as may be designated by the Board, at the period aforesaid, all property, goods, chattels, or produce belonging to or purchased by the Board, as the same are or may be confided to his care, in the same condition as they are or may be at such times (reasonable use, wear and tear, fire, or unavoidable injury, excepted). 163. In the event of the appointment to the office of stew- ard of a person other than the actual incumbent, the indi- vidual so appointed shall be required to take, at a valuation made by disinterested parties mutually chosen, all the property allowed by the Lazaretto Committee as belonging to the retiring steward, provided the said retiring steward shall agree to accept this mode of arrangement. 161. The steward shall reside pemanently at the Lazaretto, and be allowed, for himself and family, such apartments in 35 the main building as the Lazaretto Committee shall designate. 165. He shall be required to communicate, in writing, to the Board or Lazaretto Committee, whatever alterations, improvements, or observations he may consider will have a tendency to promote the interests of the Board and preserve the grounds and property of the Lazaretto placed in his charge. BILLS OF HEALTH. 166. It shall be the duty of the President pro tempore, and Secretary to furnish, under their hands and the seal of the Board, bills of health permit to vessels sailing from the port of Philadelphia, whenever the same shall be applied for: Provided, always, That no contagious or malignant disease is prevailing at the time. For every bill of health so furnished, there shall be paid the sum of one dollar for the use of the city. NUISANCES. 167. The business of bone and horse-boiling shall not be allowed, except in sparsely-settled rural districts, subject always to the judgment of this Board; and under no circumstances shall it be allowed, unless conducted under cover, the building to be provided with smoke consumers, and a due regard be had to cleanliness in the disposition of the offal. 168. The keeping of hogs in the city and county of Philadelphia is absolutely prohibited. 169. Any violation of the above regulations shall subject the individual thus offending, upon conviction, to the fine for maintaining a nuisance, in accordance with the General Health Laws of 1818. 170. The cleaning of sturgeon and other fish in the vicinity of the wharves or in the docks during quarantine season, is a nuisance prejudicial to public health, and is hereby prohibited. 36 171. All cellar tenements deprived of light and ventila- tion, except such as are procured through the doorway, or which are without proper flooring, and all tenements above ground in like condition, are declared to be nuisances preju- dicial to public health, and the owners, agents, or occupants thereof are required to vacate and close the same within five days from the date of the notice so to do. In the event of such requisition not being complied with, the Health Officer is directed to close the said tenements, and hand over the occupants thereof to the Guardians of the Poor, unless otherwise provided for. 172. All privy wells that are full, or where the contents thereof shall be within three feet of the surface of the ground, or leak into the cellars or basements adjacent thereto, are hereby declared nuisances prejudicial to health, and the owners, agents, or occupants of the premises to which said privies are appurtenant, shall, upon notice, have the contents of said well entirely removed. 173. The emptying of the contents of privy wells and cess-pools into the common sewer is a nuisance preju- dicial to public health, and in violation of Section 5 of Act March 16, 1855; and all such violations shall be prosecuted according to law. 174. All slaughter-houses located within the city, except those in the rural portions thereof, not having the floors paved with asphalt or some other impervious material, properly sloped to a well-trapped and permanently-grated inlet having a direct communication with the sewer, or not having the walls covered to a height of seven feet, with smooth impervious material, or not having graded, paved, and well-drained yards, or that are unprovided with ade- quate water supply and a suitable arrangement of hose or pipes to enable the walls, fioors, and yards to be effectively washed, or not having the floors and wralls of apartments in which animals are kept, previously to slaughtering, likewise covered with asphalt, or some other impervious 37 material, or not being ventilated by openings on to the public ways or other places, or by the roof, are hereby declared to4>e nuisances prejudicial to public health; and the owners, agents, or occupants shall be required to abate such nuisances within ten days from the date of notice. Should this not be done, the Health Officer is hereby directed to effect the abatement of the nuisance at the expense of the owner, and to prosecute the parties for the penalty of maintaining a nuisance. 175. No blood pit, dung pit, offal pit, or privy well shall remain or be constructed within any slaughter-house. Any one offending against this rule shall be guilty of creating and maintaining a nuisance prejudicial to public health, and shall be required to remove the nuisance within ten days from the date of notice. Should this not be done the Health Officer is hereby directed to effect the removal at the expense of the owner, and to prosecute the parties for the penalty of maintaining a nuisance. 176. The owners, agents, or occupants of all slaughter- houses located within the city, except those in the rural portions thereof, are required to provide movable receptacles with tightly-fitting covers, for the purpose of receiving and conveying away blood, offal, filth, and other offensive matter, and these matters are to be deposited in 'the receptacles immediately after the slaughtering, and removed, with all fat, hides, skins, tripe and bones, daily, between the hours of 7 P. M. and 7 A. M., during quarantine season (June 1st to October 1st), and at least twice a week, between 6 P. M. and 8 A. M., during the other parts of the year.v No blood and offal shall be permitted to flow into the sewer. Any one violating these regulations shall be prosecuted for the penalty of maintaining a nuisance prejudicial to public health. 177. The owners, agents, or occupiers of all slaughter- houses within the city, including those in the rural districts, are required, during quarantine season, to distribute twice 38 in each week not less than twenty-five pounds of chloride of lime about their premises, and also to remove the con- tents of any manure pit or manure pile on the premises (except in rural districts) twice in each week (except where only several head of cattle are slaughtered weekly), the said premises and contents of manure pits being hereby declared to be nuisances prejudicial to public health, unless subjected to frequent disinfection and cleansing as herein indicated. Should the above requirements not be complied with, the Health Officer is hereby directed to carry out the orders of the Board, by disinfecting the same, and re- moving the contents of said pits at the expense of the owner, and to prosecute the owner for the penalty of main- taining a nuisance. 178. The sale of a,nj tainted or unwholesome meat or fish, or the veal of any calf less than three weeks old when killed, is prohibited, and the Health Officer is hereby directed to prosecute any person so offending, in accordance with Acts of Assembly March 31, 1860, and April 17, 1861. 179. The keeping of cows and cow stables within the city (the rural districts excepted), as a business for the sale of their products, and the keeping of swine and cattle in any slaughter-house, or upon the premises, except for immediate slaughtering, is hereby declared to be a nuisance prejudicial to public health, and the owners, agents, or occupants of the premises are required to remove the nuisance within ten days after notice; should this not be complied with, the Health Officer is directed to have the said nuisance removed, in accordance with the third section of the Act of Legis- lature, "Supplementary to an Act establishing a Health Office," passed April, 1849, and to prosecute the parties for a violation of the laws. 180. The following schedule of time shall be allowed in the service of notice upon parties to abate nuisances, when hot otherwise specified by resolution of the Board, to wit: 39 To remove dead animals, slaughter-house offal, and other matter in a state of decomposition; and to cleanse and dis- infect infected houses, twenty-four (24) hours. To cleanse overflowing and leaky privy wells and water- closets, to disinfect foul wells, and to cleanse slaughter- house manure pits during season from June 1st to October 1st, three (3) days. To cleanse full privy wells and manure pits, filthy houses, cellars, yards, alleys, and vacant lots; to repair and regulate surface drainage and leaky and defective drain pipes, to cleanse slaughter-houses and cow stables, five (5) days. To fill up or drain ponds of stagnant water, ten (10) days. REGULATIONS FOR . BONE-BOILING ESTABLISH- MENTS AND DEPOSITORIES OF DEAD ANIMALS. 181. No bone-boiling establishment or depository of dead animals shall be kept or erected within the limits of the City of Philadelphia without a permit from the Board of Health, and for each permit so granted a charge of ten dollars per annum shall be made, but no permit shall be granted for any bone-boiling establishment, or. compost manufactory, or depository of dead animals within the First, Twenty-fourth, Twenty-sixth, Twenty-seventh and Thirtieth Wards, which are prohibited by Acts of Assembly. 182. No permit shall be granted to any person or persona to carry on the business of boiling bones and dead animals until after a careful inspection of the locality, buildings, apparatus, and the plans for conducting the business, and the approval of the Sanitary Committee. 183. No bone-boiling establishments and depositories of dead animals shall be kept or erected in or near to a thickly- Inhabited neighborhood. 184. The floors of all bone-boiling establishments and 40 depositories of dead animals shall be paved with asphalt, or with brick or stone well laid in cement, or with some other impervious material, and shall be well drained. All such establishments shall have an adequate water supply, and a proper arrangement of hose or pipes, as will enable thorough cleanliness to be maintained. 1S5. The boiling of bones and dead animals, etc., shall be conducted in steam-tight kettles, boilers or cauldrons, from which the foul vapors shall first be conducted through scrubbers or condensers, and then into the back part of the ash-pit of the furnace fire, to be consumed, or by other apparatus equally efficient in preventing or counteracting the offensive effluvia. 186. When bones are being dried after boiling they shall be placed in a close chamber, through which shall be passed, by means of pipes, large volumes of fresh air, the outlet pipe terminating in the fire-pit. 187. All proprietors of bone-boiling establishments not having permits to carry on the business, and violating these regulations, shall be fined fifty dollars "for every such offence, and for each month's continuance of the same after notice," and also be liable to indictment at common law for creating and maintaining a nuisance. 188. The Permit Clerk shall have provided a book in which to enter the names of all persons engaged in the business of boiling bones and having depositories of dead animals; also, the location of works and appliances as re- ported by the Medical Inspector, whether licensed or not, the number and date of permit, and remarks. REMOVING NUISANCES. 189. Whenever the cost of removing any nuisance (privy wells excepted) shall exceed the sum of twenty-five dollars but not exceed the sum of one hundred dollars, the Health Officer shall invite proposals, and the bids shall be opened 41 in the presence of the Committee of the district in which said nuisance is located, and awarded to the lowest bidder, subject to the approval of the Board. Whenever the cost shall exceed the sum of one hundred dollars, the contract shall be awarded in the presence of the Board, after due advertisement. 190. The contractor shall strictly adhere to the stipula- tions and terms of the contract. No extra allowances will be granted upon bills for work done or materials furnished, unless specially ordered by the Board. 191. The contractor shall not proceed in executing his contract if he shall find that the owners have in the mean- time commenced operations, or partly abated the nuisance. He shall notify the Health Officer of the fact, and await further orders. 192. The contractor shall strictly conform to the lines and levels furnished by the District Surveyor (in whose district the nuisance is located), for grading, paving, and laying drain pipe. EXPENSE OF REMOVING NUISANCES. 193. All bids submitted to the Board for removing nui- sances, not exceeding twenty-five dollars, shall be itemized, and a charge made for each separate item. A charge shall be made for every incidental expense incurred. The Dis- trict Surveyor shall furnish the Board with bills as per measurements for all contracts wherein he is required to give the lines and levels, and make out bills divided pro- portionately against the properties chargeable with the cost of abating said nuisance. The price to be charged by this Board for cleaning privy wells shall be twelve cents per cubic foot. 194. In all cases until otherwise ordered, where nuisances are directed to be removed forthwith, if the same are not removed within twenty-four hours, the ITealth Officer is 42 hereby directed to have the same done at the expense of the owner, in accordance with law and the rules of the Board. 195. In all cases of nuisances to be removed by the owners of property, who have been notified to that effect by this Board, it shall be understood that should he or they com- mence the removal within the time prescribed in the notice, the Board will not interfere. ' MISCELLANEOUS. 196. No communication shall be received by the Board from its officers or servants, or from any other person what- ever, unless the same be in writing and directed to the Board, or through the Presidents or Secretary thereof officially. 197. When any nuisance is referred to a committee, with power to act thereon, the said committee shall report in writing what action they have taken in relation to it. 198. Each Standing Committee shall direct all expendi- tures that may be necessary to carry out the object of its appointment; Provided, each of said expenditures shall not exceed one hundred dollars, and no contract shall be made for any amount over that sum, unless first directed and approved by the Board. 199. The minutes of all committees shall be read at any meeting of the Board, upon the call of a member. 200. Police officers, constables, and watchmen are enjoined, and citizens a,re respectfully requested, to give information to the Board of Health of any violation of the Health laws, or of the rules and regulations of the Board, so that the sanitary measures adopted by the latter to ensure the cleanliness and health of the city, may be fully carried out, and all offenders promptly punished. 4:J RULES FOR THE GOVERNMENT OF PHYSICIANS, UNDERTAKERS, SUPERINTENDENTS OF BURIAL GROUNDS AND VAULTS, SEXTONS, AND OTHERS. 201. The removal of any body from its place of original interment is declared to be a nuisance prejudicial to public health, and is prohibited, unless the same be done under the direction and by permission of the Board of Health. 202. All disinterment permits must be returned to the Health Office by the sexton or superintendent ®n the Sat- urday following the reinterment. For every permission granted for such removal there shall be paid to the proper officer, for the use of the city, fifty cents. 203. All disinterments shall be made during daylight, and superintendents of burial grounds are prohibited from allowing any dead body to be removed from, or interred in their respective grounds, between sunset and sunrise. Bodies may be disinterred and removed from grave to grave, in the same cemetery by permits, between June 1st and October 1st. 204. Permission may be obtained for the disinterment of bodies buried prior to' July 1, 1860; provided, no record of the same can be found at the Health Office, and the applicant makes affidavit that the person died prior to July 1, I860, and not of any contagious disease. The above rules apply as well to the removal of a body from one grave or vault to another in the same cemetery, as to its removal to another burial ground. 205. a. No interment of the dead body of any human be- ing or disposition thereof in any tomb, vault or cemetery, nor the removal of any body from the city for interment else- where, shall be allowed without a permit therefor be granted by the Board of Health upon presentation of the certificate of death; and no sexton, superintendent or other person shall assist in, or assent to, or allow any such interment, for 44 any such body for which such permit has not been present- ed authorizing the same. Every certificate of death must be signed either by a physician, the coroner or health officer, to which must be appended the certificate of the under- taker. Undertaker's certificates must state the place of death (see Act of Assembly, March 8, 1860). The place from which the deceased is to be buried, may be added. No charge shall be made for permits except in cases of disinterment or removal from vault, when the usual fees of fifty (50) cents must be paid. Hereafter a burial permit will not be issued on the cer- tificate of death of " Heart Failure," when unaccompanied with the disease from which the heart failure occured. Whenever a certificate or permit or satisfactory informa- tion is presented to the Chief Registration Clerk by an undertaker, for the interment of a body from another city or town, previous to the arrival of said body in this city, the Chief Registration Clerk shall issue a permit for said burial, allowing the person to retain the original certificate until the arrival of the remains in this city. b. Certificates of death bccuring in this city must be written in ink upon the printed forms supplied by the Board of Health. c. All bodies brought from beyond the limits of the city for interment, if in charge of a city undertaker, must have his certificate, in ink, affixed to the written or printed cer- tificate of death. In these cases the undertaker's certificate must state the place from which the deceased is to be buried. d. The returns of all permits for interment, enclosed in a schedule, are to be made to the Health Office before 12 o'clock M., on the Saturday of each week. e. The burial of a body in thickly inhabited and built up portions of the city at a less distance than eight feet below the surface of the ground, or the burial of a body in 45 the rural districts at a less distance than six feet below the surface of the ground, is, in either case, according to a reso- lution of the Board of Health, a nuisance, prejudicial to public health, and is positively forbidden. The placing of a dead body in any unsealed over-ground vault, catacomb or other receptacle above ground or in underground vaults, except such as are fitted with a stone covering to be tightly cemented after each interment, is strictly prohibited, unless the coffin or casket containing the remains, shall be first permanently and hermetically sealed in a metal case. This rule does not apply to receiving vaults. /. All receiving vaults within the city shall be cleared, cleaned and disinfected before the first day of May in each and every year, and the keeping of a dead body in a receiv- ing vault for more than seventy-two hours is prohibited be- tween the first day of May and the first day of November, and under no circumstance shall flowers be placed in a re- ceiving vault. The chief inspector of nuisances shall cause an examination to be made of each receiving vault in the city after the first day of May in each year, and report to the Board whether this rule has been obeyed. g. When a person dies beyond the limits of the city and the body is brought into the city for burial unaccompanied by a certificate of death, it is the duty of the undertaker to call at the Health Office and obtain a certificate from the Health Officer. h. Should a death occur in the city and the physician in attendance refuse or neglect to furnish a certificate within forty-eight hours, it is the duty of the undertaker, or other persons superintending the burial, to report the same to the Health Office and obtain a certificate from the Health Officer. i. Physicians and undertakers are required to furnish their certificates in ink, and to give all the information as laid down in the printed blanks, as far as may be practi- 46 cable, in order that the Registration Division may have a complete record for future reference. j. The removal from or the bringing into the City of Philadelphia the dead body of any person, except in the manner prescribed by the Board of Health, and without first obtaining a permit from the Health Office, is declared to be a nuisance, prejudicial to public health, and is hereby prohibited. k. No body of a person who has died of any of the follow- ing diseases, viz.: Asiatic cholera, yellow fever, epidemic cerebro-spinal meningitis or spotted fever, small-pox or varioloid, diphtheria or membranous croup, relapsing fever, typhus or ship-fever, or scarlet fever, shall be placed in an ice box, or be removed from the City of Philadelphia, ex- cept for the purpose of interment in the adjacent rural districts (that is, Bucks, Montgomery and Delaware Coun- ties), and such removal shall not be made by public con- veyance, and in all such cases the body shall, immediately after death, be completely enveloped (and remain so en- veloped) in a sheet saturated with a 4 per cent, solution of Chloride of Lime, or a 5 per cent, solution of pure Carbolic Acid, or a one-tenth per cent. (1:1000) solution of Corrosive Sublimate, and be encased at once in a coffin or casket, the entire inner surface of which (lid and all) shall be thor- oughly and completely lined with a layer of raw cotton of a thickness of not less than one inch; and said coffin or casket shall be tightly closed with screws or clamps, and remain so closed, or the body, wrapped as above, shall be en- cased in a coffin or casket of metal, with all joints and seams closely soldered. Burial must take place within thirty- six (36) hours. No other vehicle but a hearse or undertaker's wagon shall be used to carry the body to the place of interment. Ferryboats may be used to transport such bodies only when carried in a hearse or undertaker's wagon to Glouces- ter or Camden, N. J. Ruling of January 6, 1893. No body of a person who has died of any of the above- 47 named contagious diseases shall be brought into the City of Philadelphia for interment until a special permit of the Board of Health has been first issued for that purpose. Except that bodies may be brought from adjoining counties (that is, from Bucks, Delaware or Montgomery Counties), for interment in Philadelphia if prepared as prescribed by the rules of this Board. Camden and Gloucester Counties, New Jersey, are not abjoining counties under this resolution. (See resolution of January 17, 1893.) No permit shall be issued from the Board of Health for any such removal or interment unless the person or persons in charge of such removal or interment shall first present an affidavit that the above rule (sec. k) has been complied with. Where death has been caused by any one of the conta- gious diseases above named, physicians are hereby requested to use the same term, if possible, in indicating the cause of death 'as that used by them in reporting the case to the Board of Health, and to furnish the certificate of death within twelve hours after death. The Board will hold undertakers responsible for the acts of their assistants. Undertakers must inform the occupants of infected houses of the requirements of the Board of Health in such cases. See rule 243, sections d and /. Whenever any person shall die from any of the contagious or infectious diseases named in Section k, the undertaker having charge of the preparation and interment of the re- mains shall be the only person authorized to insert the pub- lic notice of death, and shall be held responsible therefor, and such notice shall contain only the residence, name of deceased, cause of death and date of death and the words no funeral and, if desired, the names of the parents. I. In all cases of the removal from the city, by public conveyance, of the bodies of persons who have died of any non-contagious disease, the remains must be placed in a coffin 48 or casket and the said coffin or casket must be encased in a strong outer box made of good sound lumber not less than one inch thick. All joints must be ploughed, grooved and glued ; top and bottom put on with cleats and cross-pieces, all put together with screws. All joints must be tightly closed with pitch or white lead, and a rubber band placed on the upper edge between the lid and box; and there must be strong handles on each side and end of said outer box. m. No permit shall be granted for the removal of a dead body of any person who has died of a non-contagious dis- ease out of the city by public conveyance without the affi- davit of an undertaker, to the effect that the body, when presented for shipment, will be encased as prescribed by the Rules and Regulations of the Board of Health. n. In all cases of removal of the bodies of persons who have been buried in the ground or deposited in vaults, public or private, for the period of one month or longer, the coffin, casket or case containing such body must be placed, before its removal, in an outer box similar in all res- pects as described in paragraphs I and m of this rule, except- ing when such remains are to be shipped out of the city by public conveyance, when in such cases the outside box shall, in addition, be lined with zinc, copper, lead or gal- vanized iron, and closed hermetically. This rule shall not be construed as applying to bodies removed from one por- tion to another in the same cemetery. No dead body shall be removed from one cemetery to another during the months of June, July, August and September, except by special permission of the Board of Health. In all such cases the remains shall not be exposed to view without a special permit from the Board of Health. The disinterment of bodies of persons who have died of any of the contagious diseases named in Section k is prohibited except by special permission of the Board of Health but no such permit shall be granted within ten (10) years after the interment of such person. 49 All permits for disinterments from vaults or graves shall become void unless used within seventy-two (72) hours after date of issue. o. Any undertaker or other person who obtains a permit as described, and who neglects or refuses to carry out ex- plicity the rules of this Board, shall be debarred from receiving any other permit, and shall be liable to a penalty aud prosecution under Section 28, Act of Assembly, Janu- ary 29, 1818. p. All permits for interment under Section a of this rule 'must be obtained at the Registration Office during office hours, which will be during the week from 9 o'clock A. M. until 4 o'clock P. M. Permits for transportation of dead bodies or for interment in contagious diseases only will be issued from 7 until 8 o'clock P. M.; and on Sundays and holidays from 9 until 10 o'clock A. M., and from 6 until 7 o'clock P. M. When dead bodies, in transit, are to be taken immediately from train to train in the same station, or from one railroad station or ferry to another, within the city limits, the permit accompanying the remains from the place of shipment shall be sufficient authority to pass the body through the city. The lid of a coffin or casket must not be removed before the incineration of a dead body (the handles, however, may be removed, if desired), except when permits are issued to inter the ashes of incinerated bodies in the same coffin or casket in which the remains were conveyed to the cemetery. In case of contagious diseases, the coffin must, under no cir- cumstances be opened, but must be burned with the body. Whenever any person shall die from any of the conta- gious or infectious diseases named in Section a, the person authorizing the public notice of the death shall have the cause of death always appear in such public notice of the death. Burial, in cases where death has taken place from any of the contagious or infectious diseases named in Section a, NATIONAL LIBRARY OF MEDICINE C^V BETHESDA 14, MD. 50 shall take place within thirty-six hours after death, and funerals, in all such cases, shall be attended only by the immediate family and the necessary attendants. Immediately after the illness is over, whether ending in death or recovery, the room, clothing, bedding, etc., should be promptly cleaned and disinfected, according to directions given in circulars issued by the Board of Health. Disinfecting chambers have been provided on the grounds of the Municipal Hospital for the immediate purification, by heat and other means, for all soiled cloth- ing, bedding and other infected articles that cannot be properly treated at home. Whenever such is required, notify the Health Officer. When advice or assistance is required it will be promptly given, if notice is left at the Health Office. Undertakers must not use street cars, omnibuses or other public conveyances immediately after visiting infected houses or handling bodies of persons who have died of cholera, or other infectious or contagious diseases. See resolution of October 18, 1892. RULES AND REGULATIONS RELATIVE TO THE SPREAD OF CONTAGIOUS DISEASES DANGEROUS TO THE HEALTH OF THE COMMUNITY. 206. Sec. a. No person suffering from any of the following- named diseases, to wit: Asiatic cholera, relapsing fever, yellow fever, typhus or ship fever, epidemic cerebro-spinal meningitis or spotted fever, small-pox or varioloid, scarlet fever, or diphtheria or membranous croup, shall enter any cab, hansom, carriage kept for hire or for use by the public, or any public conveyance whatsoever, nor shall any person in charge of one so suffering permit the sufferer to enter any such vehicle, without previously making it known to the owner or driver thereof that he or the person in his charge, as the case may be, is so suffering; and the owner 51 or driver of any such public vehicle which has conveyed any such sufferer shall immediately provide for the disin- fection of such conveyance after it has, with the knowledge of such owner or driver, conveyed any such sufferer. And the person suffering# from any of the diseases above men- tioned, or having charge of any person so suffering, shall cause the Board of Health to be notified immediately after the use of any such vehicle for the purpose aforesaid of such use. b. No person suffering from any of the diseases named in Section a shall wilfully expose himself in any street or public place, or omnibus, street car, railroad car, or other public conveyance, nor shall any person in charge of one so suffering thus expose the sufferer. c. No person shall, without previous disinfection, give, lend, sell, transmit or expose, any bedding, clothing, rags or other articles which have been exposed to infection; such restriction not to apply to the transmission of articles with proper precautions for the purpose of having the same dis- infected or destroyed. d. No person shall let or permit any other persons to occupy any room, house or part of house in which any one suffering from any of the contagious or infectious diseases named in section a has been, without previously disinfect- ing, to the satisfaction of a qualified medical practitioner, as testified by a certificate, given by him; such room, house or part of a house, and all articles therein liable to' retain infection. The keeper of a hotel or boarding house shall be deemed to let a part of a house to any person who shall be admitted as a guest into such hotel or boarding house. e. Any person violating any of the above rules, shall, on being thereof legally convicted, forfeit and pay a sum not exceeding five hundred dollars, to be recovered and appro- priated as directed by Act of Assembly of January 29th, 1818. f. Every person practising physic in the city of Phila- 52 delphia who shall have, a patient laboring under a pestilen- tial or contagious disease, viz.: Asiatic cholera, relapsing fever, yellow fever, typhus or ship fever, cerebro-spinal meningitis or spotted fever, small-pox or varioloid, scarlet fever, diphtheria or membranous croup, or typhoid or enteric fever, shall make a report in writing to the Health Officer, and for neglecting so to do shall be considered guilty of a misdemeanor and subject to a fine not exceeding fifty (50) dollars, as provided by Act of Assembly. 207. RULES AND REGULATIONS For the Registration of Master Plumbers and persons en- gaged in the Plumbing business, and relating to Plans and Specifications for House Drainage and the Ventila- tion thereof, in the City of Philadelphia, under the powers vested in the Board of Health, by the Act of As- sembly, June 30, 1885. Rule 1. Every person engaged in the plumbing business in the city of Philadelphia as a master plumber, or every person coming from other places for the purpose of doing plumbing work in the city of Philadelphia as a master plumber, shall appear in person at the office of the Board of Health and register his name and business address, upon forms prescribed by the Board of Health, and receive a certificate of registry upon presenting satisfactory proof that he is a bona fide master plumber; and no person other than a registered plumber shall be allowed to carry on or engage in the plumbing business, or make any connection with any sewer, drain, soil or waste pipe, or any pipe con- nected therewith. Rule 2. Every registered plumber shall give immediate notice of any change in his place of business, and upon his retirement from business shall surrender his certificate of registry to the Board of Health. Rule 3. The drainage of all buildings, public or private, and the alterations of the same, shall be executed in accord- ance with plans and specifications previously approved in writing by the Board of Health. Rule 4. There shall be a separate plan for each building, public or private, accompanied by specifications describing the drainage of said buildings, on blanks prescribed and furnished for this purpose, showing size and kind of pipe, also traps, closets and fixtures, etc., to be used, the same to be placed on file in the office of the Board of Health; said drawings and description to be furnished by the owner or his authorized agent, and prepared by the architect or builder, where one is employed; and applications for a change in plan must be made in writing, by the owner. Rule 5. Drawings and descriptions of the drainage of buildings erected prior to 1886, may be placed on file in the office of the Board of Health. Rule 6. Blanks for drawings and specifications for drain- age, will be furnished on application at the office of the Board of Health. One vertical drawing will be sufficient for a building where it can be made to show all the work; if the work is intricate and cannot be shown by one draw- ing, two or more shall be made. Rule 7. When the drainage of buildings erected prior to 1886 has been inspected and condemned, plans must be filed, and the new work or alterations shall be executed in accord- ance with these rules and regulations. Rule 8. Plans will be approved or rejected within twenty- four hours, when practicable, and under no circumstances will a delay beyond ten days be permitted. Rule 9. All material shall be of good quality and free from defects, and the work must be executed in a thorough and workmanlike manner. Rule 10. The main drain of every house or building shall be separately and independently connected with the 54 street sewer, where one is provided; and where there is no sewer in the street, and it is necessary to construct a private sewer to connect with one on an adjacent street, such plans may be used as may be approved by the Board of Health; but in no case shall a joint drain be laid in cellars parallel with street or alley. All house-drains laid beneath the ground inside of buildings or beneath the cellar floor, shall be of plain, extra heavy cast-iron pipe, with well leaded and ■caulked joints, or of wrought-iron, with screw joints, made with a paste of red lead and treated to prevent corrosion. Outside of buildings, where the soil is of sufficient solidity for a proper foundation, cylindrical terra cotta pipes, of the best quality, free from flaws, splits or cracks, perfectly burned, and well glazed over the entire inner and outer surfaces may be used, laid on a smooth bottom, with a special groove cut in the bottom of trench for each hub (in order to give the pipe a solid bearing on its entire length) and the soil well rammed on each side of the pipe. The spigot and hub ends shall be concentric. The space between the hub and pipe shall be thoroughly filled with the best cement mortar, made of equal parts of the best American natural cement and bar sand thoroughly mixed -dry, and water enough afterward added to give it proper consistence. Trie cement must be mixed in small quantities at a time, and used as soon as made. The joints must be carefully wiped and pointed, and all mortar that may be left inside thoroughly cleaned out and the pipe left clean and smooth throughout, for which purpose a swab shall be used. No tempered-up cement shall be used. A straight-edo-e shall be used, and the different sections shall be laid in perfect line on the bottom and sides; but in no case shall terra-cotta pipes be permitted within five (5) feet of any foundation wall, or for extensions to connect with rain water conductors, surface or air inlets. Note.—After the test has been approved by the inspector 00 iron drain or soil pipes may be tar-coated. But in no case shall any coating be applied to cast-iron soil or drain pipes until test has been applied and approved by the inspector. Rule 11. The house-drain shall not be less than four (4) inches, and not more than ten (10) inches in diameter, and the fall shall not be less than one-half (|) an inch to the foot, unless by special permission of the Board of Health; it shall be laid in a trench cut at a uniform grade, or it may be constructed along the foundation walls above the cellar floor, resting on nine (9) inch brick piers laid in cement mortar (said piers to be not more than seven (7) feet apart), and securely fastened to said walls; no test shall be made by the inspector until said pipes are secured as above described. Rule 12. The arrangement of soil and waste-pipes shall be as direct as possible. All changes in direction on hori- zontal pipes shall be made with Y-branches, one-sixteenth (it) or one-eighth (J) bends. Rule 13. The house-drain shall be provided with a hori- zontal trap, placed immediately inside the cellar wall nearest to the sewer, or at the curb. The trap shall have a hand- hole, for convenience in cleaning, the cover of which shall be properly fitted, and the joints made air-tight. Note.—if the trap on the main drain is placed inside of the cellar wall, there shall be no clean-out between the water seal of the trap and the sewer. Rule 14. There shall be an inlet for fresh air entering the drain, just inside of the water-seal of the main trap, and also at the rear end of system when the vertical line of soil-pipe is located in the central part of the building and the main fresh-air inlet is deemed insufficient to venti- late the entire system. Said inlets shall be at least four (4) inches in diameter, leading to the outer air and opening at any convenient place, with an accessible clean-out. Where air inlets are located off the foot-way, on grass plots, lawns, etc., they shall extend not less than six (6) nor more than fifteen (15) inches above the surface of the ground, and be protected by a cowl securely fastened with bolts. Rule 15. Where the drain passes through a new founda- tion wall, a relieving arch shall be built over it with a two (2) inch clearance on either side of drain-pipe. Rule 16. Every vertical soil-pipe shall extend at least two (2) feet above the highest part of the building or contiguous property, and shall be of undiminished size, with the out- let uncovered, except with a wire-guard. Such soil-pipe shall not open near a window nor an air-shaft ventilating living-rooms. Rule 17. Every branch or horizontal line of soil pipe to which a group of two (2) or more water-closets is to be con- nected, and every branch line of horizontal soil pipe eight (8) feet or more in length, to which a water-closet is to be connected, shall be ventilated, either by extending said soil pipe, undiminished in size, to at least two (2) feet above the highest part of the building or contiguous property, or by extending said soil pipe and connecting it with the main soil pipe above the highest fixture, or by a ventilating pipe connected to the crown of each water-closet trap, not less than two (2) inches in diameter, which shall be increased one-half (-1) an inch in diameter for every fifteen (15) feet in length, and connected to a special air pipe, which shall not be less than four (4) inches in diameter, or by connecting said ventilating pipe with the main soil pipe above the highest fixture. Rule 18. Where a separate line of waste-pipes is used, not connected with sewer-pipes, it shall also be carried two (2) feet above the highest part of the building or contiguous property, unless otherwise permitted by the Board of Health. Rule 19. There shall be no traps, caps, or cowls on soil or waste-pipes which will interfere with the system of ven- i ' tilation. Rule 20. All soil, waste, anti-siphon pipes, and traps, in- side of new buildings, and of the new work in old build- ings, and also of the entire system when alterations are made in old buildings, and the owner or agent of said building or buildings shall have contracted to have the en- tire drainage system tested, shall have openings stopped and a test of not less than three (3) pounds atmospheric pressure to the square inch applied. Rule 21. The drain, soil, and waste-pipes, and the traps shall, if practicable, be exposed to view for ready inspection at all times, and for convenience in repairing. When placed withinxwalls or partitions and not exposed to view, or not covered with woodwork fastened with screws so as to be readily removed, or when not easily accessible, extra heavy pipes shall be used at the discretion of the Board of Health. Rule 22. No drainage work shall be covered or concealed in any way until after it has been examined and approved by a House-drainage Inspector, and notice must be sent to the Board of Health, in writing, when the work is suffi- ciently advanced for such inspection; and immediately on the completion of the work, application must be made for final inspection. The failure on the part of a master plum- ber to make said application for final inspection or the violation of any of the rules of the Board of Health in the construction of any drainage work, and failure to correct the fault after notification, will be deemed sufficient cause to place his name on the delinquent list, until he has com- plied with said rules and regulations. Any attempt on the part of a master plumber to construct or alter a system oi drainage during the time his name appears on said delin- quent list, will subject him to criminal prosecution. Rule 23. All drain and anti-syphon pipes of cast-iron shall be sound, free from holes, and of a uniform thickness, and shall conform to the following relative weights: 58 2 inch 3 " 4 " . 5 " 6 " 7 " 8 " 10 " 12 " Rule 24. All drain and anti-syphon cast-iron pipes shall have the weight per foot and the name of the manufacturer cast on the exterior surface directly back of the hub of each section, in characters not less than one-half (|) inch in length. Rule 25. Lead waste pipes may be used for horizontal lines that are two (2) inches or less in diameter, and shall have not less than the following prescribed weights: 1 inch pipe, 2 lbs. 0 oz. 1£ " " 2 " 8 " U " " 3 " 8 " 2 " " 4 " 0 " Rule 26. Lead bends or traps for water-closets shall not be less than one-eighth Q-) of an inch in thickness. Rule 27. Waste pipes from wash-basins, sinks and bath- tubs, shall not be less than one and one-quarter (1£) inches in diameter, and wash-tray waste pipes not less than one and one-half (1|) inches in diameter. Rule 28. All joints in cast-iron drain, soil and waste pipes shall be so caulked with oakum and lead, or with cement made of iron filings and sal-ammoniac, as to make them gas-tight. Rule 29. All connections of lead with iron pipe shall be made with a brass ferrule not less than one-eighth (|) of an inch in thickness, put in the hub of the iron pipe and caulked in with lead, except in cases of iron water-closet traps or old Avork when drilling or trapping is permitted. STANDARD. EXTKA HEAVY. pipe, 4 lbs. per foot. 2 inch pipe, 5£ lbs. per foot. " 6 " 11 3 u 11 9k is u " 9 " I 1 4 " 11 13 k ii " 12 " 11 5 11 11 17 u u " 15 " " 6 11 11 20 ii ii " 20 " 11 7 11 " 27 ii u " 25 " " 8 11 11 33* d " " 35 " II 10 11 11 45 u 11 " 45 " 11 12 (1 li 54 u it 59 The lead pipe shall be attached to the ferrule by a wiped solder joint. Rule 30. All connections of lead pipe shall be by wiped solder-joints. Rule 31. Every water-closet, sink, basin, wash-tray, bath, and every tub or set of tubs, shall be separately and effec- tually trapped. Rule 32. The trap must be placed as near the fixture as practicable. All waste-pipes shall be provided with strong metallic strainers. All drains from hydrants shall be tapped, and in a manner accessible for cleaning out. Rule 33. Traps of fixtures shall be protected from siphon- age. All anti-siphon pipes shall be carried up and through the roof, or connected with the main soil-pipe above the highest fixture. Rule 34. Every anti-siphon pipe shall be of lead, of galvanized gas-pipe, or of plain cast-iron pipe. Where these pipes go through the roof they shall extend two (2) feet above the highest part of the building or contiguous property ; they may be combined by branching together those which serve several traps. These pipes, where not vertical, must always have a continuous slope, to avoid collecting water by condensation. Rule 35. All drip or overflow-pipes from safes under wash-basins, baths, urinals, water-closets, or other fixtures, shall be by a special pipe run to an open sink, outside the house, or some conspicuous point; and in no case shall any such pipe be connected with a soil, drain, or waste-pipe. Rule 36. No waste-pipe from a refrigerator or other recep- tacle in which provisions are stored, shall be connected with any drain, soil, or other waste-pipe. Such waste-pipe shall be so arranged as to admit of frequent flushing, and shall be as short as possible. 60 Rule 37. The over-flow pipes from tanks, and the waste- pipe from refrigerator, shall discharge into an open fixture properly trapped. Rule 38. All water-closets within buildings shall be sup- plied with water from special tanks or cisterns, which shall hold not less than eight (8) gallons of water when up to the level of the overflow pipe for each closet supplied, ex- cepting automatic of syphon tanks, which shall hold not less than five (5) gallons of water for each closet supplied, the water in said tanks shall not be used for any other pur- pose. The flushing pipe of all tanks shall not be less than one and one-quarter (1J) of an inch in diameter. Rule 39. No closet, except those placed in the yard, shall be supplied directly from the supply pipes. Rule 40. A group of closets may be supplied from one tank, but water-closets on different floors shall not be flushed from one tank. Rule 41. Water-closets, when placed in the yard, shall be so arranged as to be conveniently and adequately flushed, and their water supply pipes and traps shall be protected from freezing by placing them in a hopper-pit, at least three and one-half (3|) feet below the surface of the ground, the walls of which shall be of brick or stone laid in cement mortar. The waste water from the hopper stop- cock shall be conveyed to the drain through a three-eighths (f) inch pipe, properly connected. Rule 42. The enclosure of the yard water-closet shall be ventilated by slatted openings, and there shall be a trap door in the floor of sufficient size for access to the hopper-pit. Rule 43. Water-closets must not be located in the sleep- ing apartments of any building, nor in any room or apart- ment which has not direct communication with the external air, either by a window or an air-shaft, having an area to the open air of at least four (4) square feet. 01 Rule 44. The containers of all water-closets shall be sup- plied with fresh air, and be properly ventilated, as approved by the Board of Health. Rule 45. All water-closets, within a building, using lead connections shall have a cast-brass flange, not less than three-sixteenths (T3¥) of an inch in thickness (fitted with a pure rubber gasket of sufficient thickness to insure a tight joint), bolted to the closet. Rule 46. Where latrines are used for schools they shall be of iron, properly supplied with water, and located in the yard at least twenty (20) feet from the building when prac- ticable. Rule 47. Rain-water conductors shall be connected with the house drain or sewer, and be provided with a trap, the seal of which shall be not less than five (5) inches. Said trap shall have a hand-hole for convenience in cleaning, the cover of wdrich shall be made air-tight. Rain con- ductors shall not be connected outside of the main trap, nor used as soil, waste or vent-pipes; nor shall any soil, waste, or air-pipe be used as a rain conductor, and, if placed within a building, shall be of cast-iron pipe with leaded joints. Rule 48. No steam exhaust or waste from steam-pipes shall be connected with any house-drain or soil-pipe. Rule 49. No privy-vault, or cesspool for sewage, shall hereafter be constructed in any part of the city where a sewer is at all accessible. Rule 50. No connection from any cesspool or privy-well shall be made with any sewer, nor shall any water-closet or house drainage empty into a cesspool or privy-well. Rule 51. In rural districts waste pipes from buildings may be connected with c?sspools constructed for that special purpose, properly flagged or arched over, and not water- tight, by special permission of the Board of Health. Rule 52. Privy vaults must be constructed as follows: t,2 Each building situate on an unsewered street must have a privy vault not less than four (4) feet in diameter and ten (10) feet deep in the clear, lined with hard brick nine (9) inches in thickness, laid in cement mortar, and proved to be water-tight. Rule 53. Privy vaults shall not be located within two (2) feet of party lines, or within twenty (20) feet of a build- ing when practicable; and before any privy vault shall be constructed, application shall be made and a permit for same issued by the Board of Health. Rule 54. No opening will be permitted in the drain-pipe of any building for the purpose of draining a cellar, unless by special permission by the Board of Health. Rule 55. Cellar drains shall be constructed as follows: By a system of French drains, or field tile, to a catch-basin, flagged over; the outlet pipe shall be properly trapped and connected with the house drain, and shall also be provided with a back pressure valve or stop-cock the required size. DUTIES OF THE CHIEF INSPECTOR OF HOUSE- DRAINAGE, ETC. 208. He shall examine and recommend to the Board, in a weekly report, all plans of house-drainage submitted to his department for approval or disapproval, giving the number of plans for the drainage of new and old buildings, new and old buildings previously reported, of inspection visits made by the district inspectors, nuisance complaints respecting house-drainage that have been referred to his department, violations of rules, and approved plans, privy-wells con- structed where a sewerage is not accessible, and the number of persons engaged in the plumbing business, and shall exercise a supervision over the assistant inspectors, and cause to be made in writing any complaint of dereliction of dutv on the part of said inspectors; and also report to the Board in writing, the names of all persons neglecting or refusing 63 to comply with the rules and regulations governing house drainage. DUTIES OF THE ASSISTANT INSPECTORS. 209. They shall report to the office daily, receive and keep a record of all plans of drainage of new and old buildings in their respective districts, that have been re- ferred to them, and shall make the necessary inspection for the proper completion of the systems in course of con- struction until final inspection has been made, when they shall make a proper return of each plan and specification that has been referred to them; they shall report to the chief inspector all persons constructing drainage systems who shall refuse or neglect to comply with the rules and ap- proved plans governing h,ouse drainage. DUTIES OF THE CLERK. 210. He shall keep a register of all persons engaged in the plumbing business in the city, and note all removals or changes in their business when receiving information of the same; he shall also keep a record of all plans and specifica- tions submitted to this department, and duly arrange the same and file for reference; and shall draw up all reports and resolutions pertaining to house drainage and plumbing, and shall send out all notices pertaining to house drainage and plumbing. LICENSED PRIVY CLEANERS. 211. On and after the 15th day of April, 1876, no part of the contents (except substances not soluble in water) of any privy, vault, sink, or cesspool within the limits of the City of Philadelphia, shall be removed therefrom, nor shall the same be transported through any of the streets, avenues or- public places of the said City, except the same be removed and transported by means of air-tight apparatus, or in such manner as shall prevent the contents of said privy, vault, 64 sink, etc., from being agitated or exposed in the open air during the said process of removal or transportation. 212. Applications for licenses to clean privy wells, vaults, sinks or cesspools must state the name of the applicant, his residence and place of business, the names of the sureties proposed to be given on his bond, their occupations and places of residences, the number of air-tight tanks, pumps, trucks, horses, and other appliances to be employed by said applicant, and the accommodations he has for keeping his apparatus when not in use. They must also state that the applicant is the bona fide owner of the number of the appar- atus, horses, etc., named, and that he is not in collusion or combination with any person or persons to deceive and defraud the Board, and further, that his tanks are air-tight, and securely constructed in all respects. 213. Upon every such application being referred to the Health Officer, he shall make the necessary inquiries and examinations; and report to the Board thereon as early as practicable; and upon his report that the applicant is of good moral character, and bona fide the owner of the num- ber of apparatus, horses, etc., stated by him, that the tanks are air-tight, and properly and securely constructed, and that the applicant has the necessary accommodations for keeping his apparatus under cover, or from public view, when not in use, the Board may, if fully satisfied with his bond, and as to the fulfilment of the requirements of the laws and of the rules of the Board, direct the Chief Clerk to issue a license (or renewal thereof) to him, in conformity with the laws and rules governing the subject; which license shall bear date of the day on which it is ordered to be issued; and every issue of license and renewal thereof shall be reported to the Board at the next meeting thereafter. 214. Whenever a license or renewal thereof is granted, the Health Officer shall register in a book the name resi- dence, and place of business of the party so licensed the number of his license, the number of tanks, pumps, trucks Go horses, etc., to be employed by him, the names, residences, and occupations of his sureties; Provided, however, That before any license or renewal thereof is furnished by the Chief Clerk, the Health Officer shall certify to him that each and every tank and truck has permanently painted on both sides thereof the proper name of the licensed party, and the number of his license, plainly and intelligently displayed, which name and number shall always be kept clean and exposed to public view when the tanks, etc., are in use, and subject to the inspection of any police officer or citizen at all times. 215. The period for the termination of licenses for clean- ing privy wells, vaults, sinks, etc., shall be the 31st day of December in each and every year; after which date, how- ever, licenses may be granted upon the full payment of fifty dollars by the applicant, and his compliance with the law and the rules of the Board. 216. A permit for emptying or cleaning a privy well, vault, sink, or cesspool shall be issued in the name of the licensed party applying for the same, stating therein the location of the premises and the name of the owner, agent, or occupant thereof so employing him. It must be obtained before said cleaning, and shall specify the day for the removing of the contents, but may be extended for two days longer, if, in the judgment of the clerk, the work was defer- red or postponed in consequence of some unavoidable cir- cumstances. Permits shall only be good for forty-eight (48) hours from date of issue (not including Sunday or any legal holiday that may intervene), and parties cleaning a well on a permit upon which the time or extension herein specified has expired, will be considered as cleaning said well without a permit, and will subject themselves to the penalty of $25, as provided by the Act of Assembly, for every violation thereof. 217. When the cleaning of a privy well is commenced it must be prosecuted continually to completion. Privy 66 wells ordered to be cleaned by the Board must be emptied to the bottom; the failure of the cleaner to obey this rule being of itself sufficient to suspend their licenses. No privy well, vault, sink or cesspool shall be cleaned and the contents thereof removed or transported after sunset or before sun- rise in any day. 218. Every person, persons, or company licensed to clean privy wells, sinks, etc., shall have a pit for depositing the contents of said wells, sinks, etc. (the location to be approved by the Board), and said pit shall not be located within two hundred yards of any public road, lane or street, and shall be screened from public view. 219. The Health Officer shall, from time to time, furnish to the House Drainage Committee a list of the names of the licensed cleaners, with the number of their licenses, and shall also report at any time any information given him, or knowledge he may have of defalcations, breaches of faith, or violations of the law or rules on the part of any licensed cleaner, or the men in his employ. 220. It shall be deemed unlawful for any licensed cleaner to make any contract or engagement for the cleaning of a privy well or sink, except with the owner, agent, or occu- pant of the premises upon or at which the work is td be done, and if at any time it shall be ascertained that a cleaner is violating this rule, the Clerk shall refuse him a permit, and the Board may revoke his license. 221. Any violation of law, or of the rules of the Board, will, in addition to the punishment imposed by the Acts of the Legislature, subject the offender to the forfeiture of his license, or a suspension thereof, at the option of the Board. 222. Every party licensed shall receive with his license a printed copy of the rules and extracts of laws on the sub- ject, so that he cannot set up the plea of ignorance of their existence. 67 223. Permits shall be submitted for examination at the place where the work is being done, when required by inspectors, police, and other properly qualified officers. 224. a. The apparatus for the removal of the contents of privy wells, vaults, sinks, etc., shall consist of pumps, tanks, hose, deodorizing furnaces, or other efficient deodorizing apparatus, tents or hoods, dunnigans or barrels, and trucks as hereinafter described. b. The pumps shall be suitable for the purpose required, and shall have valves not less than four inches internal diameter, which will allow obstructive rubbish and some solid excrementitious matter to pass freely through the pump, and be forced through the hose to the tank c. The hose shall be of rubber, or some other material impervious to water, and shall have an inside diameter of not less than four inches, and shall be well secured at the joints by efficient couplings. No strainer or other device to prevent the free ingress of material shall be used while the induction end of the hose is in the well or vault. d. Each tank shall have its capacity measured and the number of cubic feet it contains stamped or branded on the rear end by a sworn measurer of the Board of Health. Each tank shall have an indicator, conspicuously placed on the rear end, which shall correctly indicate the quantity in the tank. e. The gases escaping from the tank while being filled shall be thoroughly deodorized. If by fire, a suitable fur- nace, protected by the intervention of a screen or other suitable device, between the fire and the ignitable gasses in the tank, to prevent explosion, shall be used. /. The tent or hood shall be made of canvas, and so con- structed as to give space for one or more barrels, and so erected as to form a close joint with the walls of the privy building and the pavement or ground, completely enclos- 68 ing the door, and so secured that no odor can escape through the air hose. g. The air hose shall be made of some air-tight material, expanded by a spiral wire or other suitable device, and shall have an inside diameter of not less than five inches, and shall be at least ten feet in length. When in service the air hose shall be attached with a tight joint to the tent, at a point not less than four feet from the ground, by one end, and the other connected by a practical air-tight joint, with the deodorizing apparatus or furnace, when used, so that no air can enter below the grate of the latter, except through the air hose from inside of the tent. h. The pitting furnace shall be so constructed that the air hose connection shall give its only supply of air below the grate, and shall always be full of burning material while in operation to ensure a strong draft from the inside of the tent. i. The dunnigans or barrels shall be water tight, and have their capacity measured and branded, or stamped thereon by a sworn measurer of the Board of Health. The lid shall be of iron, secured to the barrel by clamps or cams, and made tight by means of a rubber casket between the lid and the chime. j. The trucks for conveying the dunnigans or barrels, and the pump and hose shall be suitably constructed, and the name and number of the licensee distinctly painted thereon. k. The entire apparatus and appliances shall at all times present a clean appearance, be free from obnoxious odors, and always in good and efficient working order. The work- men shall be well instructed in their duties, and orderly while in the performance of their work. I. No license for cleaning privy wells shall be issued until each licensee shall contract with the Board of Health to dc the work for the Board and for citizens at rates not to exceed 69 twelve (12) cents per cubic foot, upon penalty of forfeiture of the license. m. No part of the contents of any privy well shall be re- moved by the pitting process, except in cases where it is im- possible to remove the same by pumping. RULE AUTHORIZING THE BOARD OF HEALTH TO ACT DURING THE ABSENCE OF THE QUARANTINE PHYSICIAN IN CER- TAIN CONTINGENCIES. 225. When the State Quarantine is suspended by the Governor, the Board of Health shall, when notified by the Quarantine Physician, or, if the Quarantine Physician is not on duty or cannot at once be found, without such noti- fication, have power if any vessel shall arrive with con- tagious or infectious disease on board, to deal with the said vessel, its cargo, its passengers, the crew and their baggage as may be deemed best to protect the people of the Com- monwealth against the introduction of the disease then in- fecting the vessel, cargo, passengers or crew\ Section 11, Act of Assembly approved June 5, 1893. RULES AND REGULATIONS GOVERNING THE DI- VISION OF PATHOLOGY, BACTERIOLOGY AND DISINFECTION, AND THE LA- BORATORY OF HYGIENE OF THE BUREAU OF HEALTH. 226. There shall be organized a Division of Pathology, Bacteriology and Disinfection, to be called the "Division of Pathology, Bacteriology and Disinfection of the Bureau of Health." There shall also be organized and established in connection with the above-named division, a laboratory for bacteriological investigation and experimental research on 70 questions pertaining to public health and hygiene. The Division of Pathology, Bacteriology, etc., shall be in charge of a chief, who shall be a physician and an expert in bacteriology, and well versed in pathology and the methods of investigation. He shall be called the " Chief of the Division of Pathology, Bacteriology and Disinfection," and "Director of the Laboratory of Hygiene" of the Bureau of Health. 227. He shall have an office in City Hall in connection with the offices of the Board of Health. The laboratory shall be located in City Hall, where the best facilities for conducting the entire experimental work of the division shall be provided. 228. The Chief shall be held responsible to the Board of Health for the reliability of the work of his assistants and the proper use and custody of the property connected with the division, and for the active, progressive, and efficient work of the office. He shall, so soon as appointed, prepare a plan for the establishment of the laboratory, and furnish an outline of the work to be undertaken, and draft rules and regulations for the government of this work, to be submitted for the approval of the Board of Health. 229. The scope of the work imposed under this new divi- sion shall be extended, so far as practicable, to all questions which affect the public health, relating both to preventive and curative medicine; the latter, so far as it includes the preparation of means for the prevention and curtailment of diseases by such processes as vaccination, the preparation and directions for the use of such material as the anti-toxin of diphtheria, and sterilized serum of rabies, etc., etc. 230. There shall be two assistant bacteriologists, one clerk and two helpers. 231. As soon as practicable, after the establishment of the laboratory, steps shall be taken to prepare, in ample quan- tity for the use of the City, the anti-toxin of diptheria after 71 Behring's or Roux's method. Steps shall also be taken at once for the prompt examination of all specimens of exudate from throats of "suspected" cases of diphtheria and report thereon, the proper announcement being made to physicians of the facilities afforded for making prompt and reliable tests and the means of taking advantage of them. 232. The Chief of the Division of Pathology, Bacteriology, etc., shall report regularly to the Board of Health upon the work of his division, and as the work more particularly concerns measures for the management and suppression of contagious and infectious diseases, he shall be in close com- munication with the Sanitary Committee of the Board of Health, and subject to their direction and control. 233. The Laboratory shall be provided with a telephone to facilitate communication. 234. The Chief shall keep himself in constant communi- cation with the Medical Inspector, so as to place at his dis- posal all information that will be of practical aid in the successful management of the Division of Contagious and Infectious Diseases, especially such information as has a bearing upon the duration of the period of isolation and of quarantine, and the time for disinfection, as determined by bacteriological examination. 235. The Chief shall prepare, for the purpose of making bacteriological diagnosis in suspected cases of diphtheria, the necessary culture-outfits and printed forms for distribu- tion to stations at convenient points throughout the city. A list of these stations shall be published, at which physicians can obtain the outfits free of cost. The culture-tubes shall be collected once a day, or oftener if deemed advisable by the Chief. When cultures are not taken by the attending physician, they should be taken by an Assistant Medical Inspector, when no objection is raised by the attending phvsician. A report in all cases should be made as soon as practicable to the attending physician of the results of the bacteriological test, either by mail or telephone. 72 236. Diagnostic tests shall also be made for physicians who desire it, in all cases of suspected tuberculosis, when- ever specimens of the expectoration are left at the station or sent direct to the Laboratory. 237. The Chief shall prepare printed forms to be filled out by physicians, and to be filled out in reporting to phy- sicians the results of the cultures, and such other forms as may be used in the office. 238. The Chief shall make requisition upon printed forms to the Sanitary Committee for all supplies needed. He shall mark as correct all bills that meet his approval. 239. The Chief of the Division of Pathology, Bacteriology, etc., shall advise, from time to time, the best means of increasing the efficiency of the work of the disinfecting corps, and shall arrange for a practical course of instruction on "Disinfectants and their Uses" to be given to the mem- bers of the corps. 240. The work of the Laboratory of Hygiene and of the Chemical Laboratory shall be co-operative in furthering the chief purpose of their organization. 241. The Laboratory shall be kept open from 9 A. M. to 6 P. M., and, as the interruption of the work of making diagnostic tests may jeopardize life, provision shall be made for the continuous and uninterrupted prosecution of this special branch of investigation. 242. The Assistant Bacteriologists shall be under the special supervision of the Chief, and shall be responsible to him for the faithful and efficient performance of the duties assigned to them. 243. The object of the establishment of the Laboratory of Hygiene is not merely the application of knowledge for the benefit of the community, but also for the utilization of ac- cumulated data by drawing deductions therefrom, experi- mental research in the field of the Etiology of Disease and 73 the study and investigation of all subjects related to pre- ventive and curative medicine so far as they appropriately come within the scope of such an institution. RULES DEFINING THE DUTIES OF THE DISIN- FECTOR AND HIS ASSISTANTS. 244. The Disinfector shall be at the Health Office at 9 o'clock A. M. and 1 P. M. to receive instructions and to make the necessary record of his work in books kept for the purpose, and he shall devote his entire time to the duties of his office. 245. He shall have control of the Assistant Disinfectors, instruct and direct them in their duties and supervise their work, and be responsible for the work entrusted to his and to their care. He shall classify and distribute to them lists of houses to be disinfected when received from the Medical Inspector, and shall return the reports, properly filled out, to the Medical Inspector upon the completion of the work in each case. 246. He shall be provided with a horse and wagon for the transportation of disinfecting apparatus and materials, and for quick transit from place to place in the discharge of his duties. 247. He shall promptly carry out the orders of the Medi- cal Inspector, and report to him in writing the results of his work and of the work' of his assistants. 248. He shall have charge of all disinfecting materials and apparatus, and shall be held responsible for their proper use. He shall distribute the materials to his assistants, and see that nothing is wasted or misused. He shall keep an account of all the supplies received, and furnish the warrant clerk with a list of all articles received upon their delivery. 74 249. The Assistant Disinfectors shall report for duty every morning at 9 o'clock and at such other times as they may be required. They shall visit such premises as are designated, and thoroughly disinfect the same by fumigation or other means; using for fumigation not less than three (3) pounds of sulphur for every thousand cubic feet of air space of the apartment to be disinfected, or an equivalent of liquid sulphur dioxide. The cubic feet of air space of a room may be determined by multiplying the height, length, and breadth in feet. When engaged in the act of disinfection they shall use an outer suit provided for the purpose, said suit to be dis- infected after use, and care being taken to disinfect the hands, person, etc., as well. 250. Bedding, carpets, hangings, and all articles that have been used in the sick room and that cannot be disinfected at home should be removed to the disinfecting station. Thereafter, and before disinfecting the apartment, all the furniture and other articles to be disinfected in the room should be moved out from the walls, so that every part shall be thoroughly exposed to the disinfecting agent. By the use of the Disinfecting Sprayer, walls, partitions, floors, slabs, hangings, furniture, and rubber goods, leather, furs and other articles which cannot stand the action of heat can be thoroughly and promptly disinfected, and this method is to be preferred. When used, fumigation by sulphur and disinfection by other methods of the room and articles therein, mjay be dispensed with. Under certain conditions, the papered walls which will not admit of the use of the spray can be well disinfected by careful and thoroughly rubbing them down with large bits of bread, thereafter carefully sweeping up the crumbs and burning the same. 75 INSTRUCTIONS FOR WORKING THE DISINFECT- ING SPRAY'ER FOR DISINFECTING WALLS, PARTITIONS, FLOORS, SLABS, HANGINGS, FURNITURE AND SKINS, LEATHER, FURS, AND INDIA RUBBER AND OTHER ARTICLES WHICH CANNOT STAND THE AC- TION OF HEAT. 251. After having opened the two upper taps and the funnel half way down the cylinder (the discharge tap at the foot of the cylinder being closed), the antiseptic solution is poured into the funnel and then all the taps are closed. The pump is then ready for action after one or two strokes of the piston. Connect the tap (for the liquid) on the side towards the handle of the lever with' the lateral (red) India rubber tube of the sprayer, and the air tap on the other side with the other (white) India rubber tube. As soon as the two taps are opened a finely sprayed jet is immediately discharged from the sprayer. This jet should be directed on to the surface which are to be dis- infected in such a way as to moisten them thoroughly and uniformly. In order to maintain the pressure in the apparatus it is sufficient to work the pump from time to time. A solution of bi-chloride of mercury combined with sul- phate of copper, or antiseptic tablets may be used. Add the contents of one of the small bottles to sixteen (16) pints of water, which the apparatus will more than con- tain. This forms a solution of ± per 1,000 parts. Two (2) bottles, of course, will make the proportion of 1 per 2,000 parts. When the spraying is completed, and if the pump is not to be used again for some time, the discharge tap at the bottom of the cylinder must be opened and the antiseptic liquid remaining in the apparatus flrawn off. This tap must then be closed and ordinary water poured in the funnel and the pump must be worked a few times in order to cleanse the apparatus, and then the latter must be again emptied. This is to avoid corrosion. Take care to keep the leather of the piston greased in the ordinary manner. In order to do this, it suffices to unscrew the cap on the top of the pump; take out the piston, grease it with tallow and replace it. The disinfecting sprayer should be used for moistening ceilings, walls, hangings, carpets, etc.; in fact, the surface of everything in the room. A solution of 1 per 2,000 is to be preferred. This does not injure articles treated, and if thoroughly applied is efficient. The solution is slightly acidulated. A one (1) per cent, solution of Formaline* (six (6) ounces of formaline to fifteen (15) pints of water or nine (9) ounces to twenty-one (21) pints of water) may be used in the same way. The spray must be brought in contact with the surface of everything in the room; ceiling, walls, floors, furniture, windows, shutters, etc.; and the room closed for twelve (12) hours. Afterward it may be cleaned in the usual manner. A disinfecting sprayer shall be supplied to every two assistant disinfectors, and for the purpose of facilitating their work a wagon shall be placed at their disposal. 252. The disinfectors shall revisit the places disinfected or fumigated within forty-eight (48) hours after the work has been done to ascertain if their instructions have been complied with. 253. They shall make a complete report of each place visited; stating what has been done, the kind and quantity of disinfectant used, the instructions given, and the char- acter of nuisances found. 254. They shall be guided in the performance of their * Formaline—a 40 per cent, solution of formic-aldehyde. 77 work by instructions contained in circulars on "The Man- agement of Contagious Diseases," and circular No. 3, "Dis- infection and Individual Prophylaxis against Infectious Diseases." They are to exercise tact, and be polite and re- spectful to all persons to whose premises they are sent. 255. Whenever it is necessary to remove articles to the public disinfecting plant at the Municipal Hospital for dis- infection or destruction, they shall report the fact to the Medical Inspector. DISINFECTANTS. 25(5. Disinfectants are commonly used to absorb impure exhalations, prevent decomposition, and destroy noxious gases, but in no instance should they be considered or employed as substitutes for a pure atmosphere, obtained by free ventilation. "They are simply aids in restoring and preserving healthful purity, and not substitutes for cleanli- ness and pure air." They may be employed in cellars, yards, privies, vaults, sinks, water-closets, sick rooms, bed-pans, stables, and in other places about premises, or, wherever practicable, when there are offensive odors emitted. DISINFECTANTS AND HOW TO USE THEM. Quick Lime.—This may be employed as a purifier, to act upon moist and hurtful effluvia, and as a dryer in damp apartments. It may be strewn as dry lime on the earth, or placed upon plates, or better still, in the shape of white- wash {milk of lime) upon the walls. In the latter form, the addition of a small quantity of carbolic acid increases its efficiency. Most useful when employed in privies, vaults, latrines, stables, etc. Charcoal is a powerful oxidizing agent. It may be used as a deodorant and purifier. "The sole condition necessary is the free access of atmospheric air, which the charcoal uses in oxidizing the putrid miasms." It should be freely 78 strewn on the floors of cellars, and in all places which may be damp and mouldy. It, should always be used in a crushed and fresh state. An excellent deodorizing compound may be made by mixing one part of peat charcoal, one part of quicklime, and four parts of sand or gravel. Sulphate of Iron (Green Copperas), Sulphate of Zinc and Sulphate of Copper.—Dissolve one or two pounds of any of these salts in a gallon of water and use the solution to cor- rect decomposing and offensive matters. Sulphate of iron is the cheapest of these substances. Eight or ten pounds of it dissolved in five or six gallons of warm water, with one pint of crude carbolic acid added, makes the cheapest and one of the best disinfecting fluids for common use in privies, water- closets, drains, and sewers. Before the emptying of privies or cess-pools the contents should be disinfected. For effective disinfection a solution of two pounds of sulphate of iron (copperas) in a gallon of water, or of one pint of liquid chloride of zinc in a gallon of water (to each of which two ounces of strong carbolic acid has been added) should be used in the proportion of one pint to each cubic foot of contents. After thorough disinfection a quantity of either of these solutions should be poured down daily to keep the cess-pits in good condi- tion. Chloride of lime in the proportion of one pound to a gallon of water may be used for the same purpose with excellent results. * DISINFECTION PROPER. Fire.—The burning of infectious material, infected cloth- ing, etc., is an effectual way of disposing of it. Articles of little value which have been soiled with infectious material (especially old clothing and bedding) had better be burned. ♦Disinfection, in its restricted sense, means the destruction of the infective power of infectious material. " There can be no partial disinfection of such material • either its infecting power is destroyed, or it is not. In the latter case, there is failure to dis- infect. Nor can there be any disinfection in the absence of infectious material." 79 Heat.—Boiling for half an hour will destroy all known disease germs. This is the cheapest and best way of disin- fecting clothing, and articles which are not injured by the ordinary operations of the laundry. Moist heat (steam) at 230° Fahr. destroys germs of all kinds, even the most re- sistant spores, in twenty minutes. ' Sulphur Fumigation is an excellent method of purification. Place the sulphur in an iron dish, supported upon bricks in a wash-tub containing a little water; set it on fire by hot coals or with the aid of a spoonful of alcohol. All doors, windows and all other openings should first be closed, and allowed to remain so at least twelve hours; the room should then be opened and well ventilated. Three pounds of sul- phur will be required for a room ten feet square (1,000 cubic feet of space). The amount should be increased for larger rooms in the same proportion. Chloride of Lime.—This is one of the cheapest and most efficient of disinfectants. For the purpose of correcting offensive matters, and for utensils, sinks, water-closets, drains, bed-pans, etc., it may be mixed with water in the proportion of one pound to one gallon. Infected bed and body linen, towels, etc., which cannot be immediately boiled, may be disinfected by immersion in a solution of chloride of lime in the proportion of two ounces to the gallon of water, and left for four hours. Corrosive Sublimate.—This is a powerful disinfectant, but on account of its highly poisonous quality should be used with the greatest care. Dissolve in wTater in the proportion of two drachms to the gallon, and add one drachm of per- manganate of potash to give color to the solution. Label it carefully—Poison. Use one pint of this solution for the disinfection of each discharge in cholera, typhoid fever, etc., or for vomited matter. Leave in vessel ten or fifteen min- utes before throwing into cess-pool or water-closet. It will injure lead pipes if used constantly; it should not be placed in metal receptacles. 80 Carbolic Acid.—Yery useful for disinfecting soiled cloth- ing, discharges from the bowels, vomited matters, etc., and for the general purposes of disinfection. A wineglassful (two ounces) of the pure liquid well mixed with a quart of warm water, for use in night vessels, water-closets, sinks, or for wetting a sheet to hang in the doorway of a sick chamber. Half a wineglassful to one quart of warm water, for washing furniture, walls, etc. Two ounces to the gallon of water, for clothing, etc. One pint of strong carbolic acid added to five gallons of warm water should be occasionally poured into sinks and drains leading into sewers. One ounce of the crystals mixed with four pounds of slaked lime forms a good powder for covering over offensive heaps of filth or refuse that it is impossible or unwise to remove. Liquid acid diluted with two thousand times its bulk, for' street sprinkling. Carbolic acid soap for the hands. Carefully note, that " it appears to be characteristic -of cholera, not only of the disease in its developed and alarm- ing form, but equally of the slightest diarrhoea which the epidemic can produce, that all matters which the patient dis- charges from his stomach and bowels are infective; that the patient's power of infecting other persons is represented almost or quite exclusively by those discharges; * * ***** ***** and that if they be cast away without previous disinfection, they impart their own infective quality to the excremental mat- ters with which they mingle in filth-sodden earth, or in depositories and conduits of filth, and to the effluvia which those excremental matters evolve; that if the infeetive material, by leakage or soakage from drains or cesspools, or otherwise, get access even in the smallest quantity, directly, or through porous soil, to wells or other sources of drinking water, it can infect, in the most dangerous manner, very large volumes of water; that the infective influence of the choleraic discharges attaches to whatever bedding, clothing, and like things that have been imbued with them, and 81 renders these things, if not disinfected, capable of spread- ing the disease."—Chief Medical Officer of Great Britain. MUNICIPAL HOSPITAL. The Physician-in- Charge. 257. The Physician-in-Charge shall visit the hospital daily or oftener, if the circumstances of the patients shall require it. He shall have entire direction of the medical treatment of the patients, and the general direction and management of the hospital, subject to such rules and regulations as the Sanitary Committee may, from time to time, impose. 258. All requisitions for medicines and hospital supplies shall be made by the Physician-in-Charge, in writing, upon the Chairman of the Sanitary Committee; and for all other articles necessary for the proper conducting of the institu- tion; a requisition in the same manner shall be made by the Steward. 259. The Physician-in-Charge shall have the control of the nurses, assistant physicians and all connected with the hospital, and shall promptly report to the Sanitary Com- mittee any irregularity committed by them, and shall sus- pend them, if necessary, and report the facts to the Sani- tary Committee for action thereon. 260. He shall record in a book to be provided for the purpose, the name of every patient, with the date of admis- sion, age, sex, color, nativity, occupation, disease and the date of discharge or death, as the case may be, and such other matters as he, or the Sanitary Committee, may con- sider important or necessary. 261. He shall make a weekly report to the Sanitary Com- mittee or Board of Health, stating the number of patients admitted since the last report, with disease, recoveries, deaths, and such other information as he, or the Sanitary Committee may think requisite. 82 262. He shall also make a monthly report to the Sanitary Committee or the Board of Health, which shall contain a summary of the weekly reports, and such other matter as he, or the Sanitary Committee, may consider requisite. The Steward. 263. Before entering upon the performance of his duties, the Steward shall enter into a bond, with security, to be approved by the Board, in the sum of one thousand dollars, conditioned for the faithful performance of his duties. He shall have no right of property in or to anything at the hospital, except the same shall be confirmed to him by special action of the Board; he shall remove or dispose of no part or parts of the fruits or produce of the grounds of the said hospital under his charge, except for his own im- mediate use, without permission of the Board; and, further, he shall deliver over to his successor in office, or such other person as may be designated by the Board, all property, goods, chattels or produce belonging to or purchased by the Board, as the same are or may be confided to his care in the same condition as they may be at such times (reasonable use, wear and tear, fire or unavoidable injury excepted). 264. The Steward shall reside permanently at the hospi- tal, and be allowed for himself and family such apartments in the building as the Sanitary Committee may designate. 265. He shall not use, or allow to be used, the horses, vehicles, or other property of the Board, except for the legitimate purposes of the hospital, or by permission of the Sanitary Committee. 266. The buildings, grounds, and property of the Board at the hospital shall be under the general charge of the Steward, subject to such general rules and regulations as the Sanitary Committee may, from time to time, impose. 267. He shall require all persons under his supervision to perform such duties as may be assigned them; and, in 83 case of their failure, refusal, or neglect to perform such duties, he shall suspend them from all duty, and report the facts to the Sanitary Committee for action thereon. 268. No employee shall absent himself from the premises of the Municipal Hospital without permission from the Physician-in-Charge or the Steward, or communicated through them. Application for leave of absence, except temporary, shall be made in writing through these officers to the Chairman of the Sanitary Committee. 269. He shall require that the hospital shall at all times be kept scrupulously clean ; that the clothing and bedding of patients shall be frequently changed, and thorough ven- tilation maintained; and, to accomplish these ends, he shall have authority, subject to the approval of the Physician- in-Charge, to prescribe the duties of all nurses and attend- ants, and indicate the time and manner in which such duties shall be performed. 270. He shall take charge of and inventory the effects of all patients that may be admitted into the hospital, and return them, after having been disinfected, to the owner when discharged; or in the event of the decease of the patient, a report of such effects shall be made to the Sani- tary Committee. 271. He shall superintend the work of disinfecting cloth- ing, beds, bedding, etc., and see that it is efficiently done, and must enforce the rule—that every patient, immediately before leaving the hospital, must take a bath and be sup- plied with non-infected clothing. 272. The Disinfector shall have special charge of the Disinfecting Plant under the general supervision of the Steward. He shall take charge of all materials delivered to him for disinfection, see that they are promptly disin- fected and thereafter promptly delivered for return to their owners. 84 273. He shall have the Plant always in first-class work- ing order and the process of disinfection conducted system- atically and efficiently. 274. He and his assistants when conducting the work must wear an outer protecting garment which, from time to time, must be disinfected, and they must not leave the building until the necessary precautions have been taken to prevent carrying contagion upon their person or in their clothing. 275. He shall fill in charges on blank bills furnished by the Steward (in those cases where charges are to be made) for disinfecting according to the schedule of charges, the same to be sent by the Steward to the Health Officer for collection. 276. When articles are sent to the hospital for disinfec- tion, the Medical Inspector or other officer shall state if the work is to be done free of cost. When not so specified, charges must be made according to the schedule. The following is the schedule of charges for disinfection: Mattresses and beds, each................................... SO 75 Pillows and bolsters, each................................... 0 20 Blankets, comfortables, etc., each......................... 0 10 Carpets, each.................................................... 1 00 Curtains and hangings, each................................ 0 15 Wearing apparel, suits of clothing....................... 0 25 Small articles, per lot........................................ 0 10 Other things in relative proportion. The exposure of articles for at least 30 minutes to live steam at a temperature of not less than 230° F., and 20 pounds pressure is the minimum limit of exposure. Care must be taken not to damage articles by exceeding this limit. Moist steam is to be depended on for disinfec- tion, the dry heat being used more particularly for drying articles at the close of the process. 277. The Steward shall make an inventory, in a book provided for the purpose, of all articles sent to the hospital S5 for purification, in which shall be noted the premises from which removed, the condition in which received, the dispo- sition made of them, when received and when returned. All such articles must be purified as soon as possible after being received at the hospital. 278. Great discretion and judgment must be exercised by the Physician-in-Charge and the Steward in permitting per- sons to visit the hospital; and in no case shall visits to the wards be allowed, unless under circumstances of a very special nature. 279. The Steward shall have authority to select such in- dividuals as he may think proper to take charge of the various departments—bakery, laundry, etc.—and shall re- port such action to the Sanitary Committee. 280. He shall invariably treat the patients with kindness and civility; and never suffer any degree of cruelty, insol- ence, neglect or unkindness on the part of the nurses, or servants, toward them to pass unnoticed. He shall also see that the nurses and attendants treat the sick with care and humanity, that the diet directed by the Physician-in-Charge is properly prepared and supplied, and generally that the orders of the Physician in relation to the treatment of the sick, and the management of the wards and departments more especially under his charge are fully and regularly exercised. 281. He shall in no instance permit intoxicating liquors or any provisions to be given to the patients, except by direction of the Physician-in-Charge. 282. He shall see that all fires and lights are extinguished in every apartment of the premises under his control before ten o'clock at night, excepting such as may be absolutely necessary, and these he shall leave under proper care. 283. Whenever a patient dies in the hospital, the Steward shall have his or her body decently interred in the burial- 86 ground of the institution; see that such of his or her cloth- ing as require it is, within twenty-four hours after the de- cease of the patient, properly washed, disinfected, ironed, and put away, or destroyed when so directed by the Physi- cian. 284. So soon as a patient is discharged from, or dies at, the hospital, the Steward shall make out and transmit forth- with to the Board, a bill for his or her board and attendance, at the rate of one dollar for each day the said patient has remained at the hospital, counting the days of entrance and departure each one day; and in the case of his or her death an additional sum of five dollars for burial expenses. He shall also be required to make a similar record of patients who are unable to pay their board, and transmit a copy to the Board at the end of each quarter. 285. He shall see that the nurses and other employes are suitably provided for as regards board, lodging and washing. 28(5. He shall be required to communicate, in writing, to the Board or Sanitary Committee, whatever alterations, im- provements or observations he may consider will have a tendency to promote the interests of the Board, preserve the grounds and the property at the hospital, or increase the comforts of those under his care. 287. On the first day of May and November, annually, the Steward shall take an inventory of all the household goods and other property belonging to the hospital, and shall record said inventory in a book specially provided for the purpose, and shall present a copy of the same to the Sanitary Committee. 288. He shall make out and transmit to the Sanitary Committee, at the close of each month, the pay-roll of all nurses and attendants employed at the hospital. 289. No patient shall be employed in the work of the house, without the consent of the Sanitary Committee. 87 The Matron. 290. The Matron shall take care that each patient has the diet prescribed, superintend its preparation, and have it served at regular stated hours. 291. She shall have charge of the bedding, bed-clothing, and such wearing apparel as may be provided for the patients; shall have general supervision of the laundry, and shall see that cleanliness is maintained throughout the hospital. 292. She shall have charge of the table for the -Steward and other officers, and for the employees of the hospital, and, in conjunction with the Steward, shall have control of the servants and nurses. VACCINE PHYSICIANS. 293. It shall be the duty of each of the Vaccine Physicians to vaccinate gratuitously in their respective wards, all per- sons who may make application, either at his own office, or at their respective places of abode, according to the option of the applicant; and he shall continue to visit every such patient as often as may be necessary to enable him to ascer- tain whether the person or persons so vaccinated have passed through the genuine disease. ^Each of the said Vaccine Physicians shall keep, in some convenient part of the ward, an office, writh a sign in front, having on the words "Vaccine Physician,----Ward" (the blank to be filled with the number of the respective ward), where application may be made at all reasonable hours, in relation to the duties of his appointment; and each of said physicians shall preserve and keep on hand a sufficient quantity of genuine vaccine matter, for distribution, without fee or charge, to all prac- tising physicians residing within the City of Philadelphia, who may make personal application therefor. 294. The Vaccine Physicians shall each furnish the Board of Health, quarterly, with a list, alphabetically arranged, of 88 the names, ages, birthplaces, residences and occupations (and; when children, of the occupation of their parents) of the persons whom he may have successfully vaccinated. In making up the list, place the "primary" and "secondary" cases (re-vaccinations) on separate sheets. 295. The Vaccine Physicians are required to send, every month, to the Chief Clerk of the Board of Health, an approxi- mate statement of the number of successful operations. 296. It shall be the duty of the Vaccine Physicians to call on each and every family residing in the ward or wards for which he may be elected, and inquire whether any, and if any, what members thereof may be liable to smallpox dis- ease, and if he find any person or persons so liable, he shall offer gratuitously his services, as Vaccine Physician of the ward, to vaccinate such person or persons. The Vaccine Physician shall receive forty cents for each and every case of successful vaccination performed in any part of the City of Philadelphia. 297. In vaccinating observe the following instructions: a. The Vaccine Physicians are required to vaccinate, gratuitously, all persons willing to have the operation per- formed. b. When requested, Vaccine Physicians are required to give a certificate of vaccination, when such operation has been successfully performed by them or by their predecessors. c. Re-vaccination is to be performed when the evidence of vaccination is unsatisfactory, or when vaccination has not been performed since infancy or early childhood. Effective vaccination in infancy or early childhood, and re-vaccina- tion at or about the age of fourteen (14) years, is a well established rule. When there is liability to infection, vac- cination may be repeated at any period of life, but not when a less period than seven (7) years has intervened since the last successful operation, provided the primary vaccine marks are typical. 89 d. A child that has been vaccinated in infancy and has a typical mark, should not, as a rule, be re-vaccinated in a less period than seven (7) years. A child that has been vaccinated in infancy and has a typical mark, and who has been successfully re-vaccinated at any time under fourteen (14) years, need not be again vaccinated until at or about the fourteenth year. e. Vaccine Physicians are earnestly requested to furnish certificates of vaccination to all school children who are protected by good vaccine marks. As the arms have to be examined in order to determine if vaccination has been performed, it will impose very little additional labor to fill a blank certificate in those cases where the mark is good and re-vaccination is not required. While the furnishing of these certificates is not exacted by law, it would seem to be a branch of work comprehended under the benificent pur- pose of the vaccine law, although not so specified. Vaccine Physicians who do not consider themselves obligated to undertake this work, and therefore refuse to perform it without extra compensation, will so inform the Board of Health in order that a prompt understanding may be arrived at. No response will be construed as a willing acceptance of the proposition. /. Except so far as any immediate danger of smallpox may require, vaccinate only subjects who are in good health. As regards infants, ascertain that there is not any febrile state, nor any irritation of the bowels, nor any unhealthy state of the skin; especially no chafing or eczema behind the ears, or in the groin, or elsewhere in folds of skin. g. Do not, except of necessity, vaccinate in cases where there has been recent exposure to the infection of measles or scarlatina, nor where erysipelas is prevailing in or about the place or residence. h. In all ordinary cases of primary vaccination, if you vaccinate by separate punctures, make such punctures as 90 will produce at least four separate good-sized vesicles, not less than half an inch from one another; or, if you vaccinate otherwise than by separate punctures, take care to produce local effects equal to those just mentioned. i. Direct care to be taken for keeping the vesicles un- injured during their progress, and for avoiding afterwards the premature removal of the crusts. j. In cases of primary vaccination, register as " successful" only those cases in which the normal vaccine vesicle has been produced; in cases of re-vaccination, register as " suc- cessful " only those cases in which either vesicles, normal or modified, or papula? surrounded by areola?, have resulted. k. Consider yourself strictly responsible for the quality of whatever virus you use or furnish for vaccination. Be careful to keep separate, vaccine virus obtained from different subjects, and to affix to each crust the name or number in your record of the subject from whom it has been derived. 1. Keep such note of all virus which you use or furnish as will always enable you, in case of complaint, to identify the origin of the virus. Never use crusts from cases of re- vaccination. Take crusts only from subjects who are in good health, and, as far as you can ascertain, of healthy parentage; preferring children whose families are known to you and who have elder brothers or sisters of undoubted healthiness. Always carefully examine the subject as to any skin disease, and especially as to any signs of hereditary syphilis. When bovine virus is used, the virus must be such as is endorsed by the Board of Health. m. Scrupulously observe in your inspection every sign which tests the efficiency and purity of your virus. Note any case wherein the vaccine vesicle is unduly hastened or otherwise irregular in its development, or wherein any un- due local irritation arises; and if similar results ensue in other cases of vaccination with the same virus, desist at once from employing it. Consider that your virus ought to be 91 changed if your cases, at the usual time of inspection, on the day week after vaccination, have not, as a rule, their vesicles entirely free from areola?. n. Keep in good condition the lancets or other instruments which you use for vaccinating, and do not use them for other surgical operations. When you vaccinate have water and a napkin at your side, with which invariably to cleanse your instrument after one operation before proceeding to another. RULES OF ORDER. 298. The order of business shall be as follows: a. A quorum (i. e., three members) being present, the Presi- dent shall take the chair and call the Board to order. b. The minutes of the last meeting shall be read, if neces- sary, corrected and adopted. c. Communications may be presented and disposed of: Provided, however, That from the first of June until the first of October, business appertaining to the Lazaretto shall have the precedence. d. Reports of Committees may be made and considered. e. Resolutions may be offered and discussed. 299. When a member is about to speak in debate, or to communicate any matter to the Board, he shall rise and re- spectfully address himself to " Mr. President," confining his remarks to the subject before the Board. 300. Those members desiring to be heard upon any motion or resolution before the Board, shall not be allowed to speak more than five minutes on any one subject; nor shall they speak oftener than twice on any motion or reso- lution. 301 The President shall not speak on any question be- fore the Board while in the chair; should he desire to en- gage in debate, he must call another member to the chair. 92 302. If any member in debate transgresses the rules of the Board, the President shall, or any member may, through the President, call him to order; the member so called shall immediately sit down, unless permitted to explain. 303. On questions of order there shall be no debate, ex- cept on an appeal from the decision of the President, sus- tained by two members. 304. No member, when speaking, shall be interrupted, unless by a call to order, or by a member to explain. 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