PREVENTION AND RESTRICTION OF 
SMALLPOX. 
DOCUMENT ISSUED BY THE MICHIGAN STATE BOARD OB' 
HEALTH. 
(Revised Edition of 1889.—10,0C0 copies reprinted from the Annnal Report of the Board for 1888.) 
[Reprint No, 291.] 
PREVENTION OF SMALL-POX. 
1. Small-pox a preventable disease.—It has long been known that small-pox 
can be prevented or modified by vaccination. It is now believed that a wide- 
spread epidemic of the disease can be attributed only to an equally wide- 
spread ignorance or willfulness concerning small-pox and its prevention by 
vaccination. 
2. Why vaccinate—Because unmodified small-pox is so deadly a disease, 
and so often disfigures and enfeebles those who recover,* and because by trav- 
eling or by travelers, by articles received in the mail or from stores or shops, 
or in various other ways any one at any time may without knowing it be 
exposed to small-pox, it becomes important so far as possible without injury 
to health to render every person incapable of taking the disease. This may 
be done so perfectly by vaccination and revaccination with genuine bovine 
vaccine virus that no question of ordinary expense or trouble should be 
allowed for a day to prevent the careful vaccination of every man, woman 
and child in Michigan, and the revaccination of every one who has not been 
‘vaccinated within five years. It is well established that those who have been 
properly vaccinated are far less likely to take small-pox if exposed to it, and 
that the very few who have been properly vaccinated and have small-pox 
have it in a much milder form and are much less disfigured by it than those 
who have not been thus vaccinated. The value of vaccination is illustrated 
by the following facts:— 
On March 13, 1859, Dr. E. M. Snow, of Providence, K. I., found, in a 
cluster of seven houses, twenty-five families, and in these families ten cases 
of small-pox, all apparently at about the same stage of the disease. In the 
same families there were twenty-one children who had never been vaccinated. 
The ten cases and the remaining members of the families including the 
twenty-one children were quarantined at home, and the children were all 
vaccinated and compelled to remain with the sick. Several other cases of 
small-pox occurred in persons previously exposed, but not one of the twenty- 
one children referred to had the slightest touch of the disease. 
♦■‘Among those who outlive it, many either totally or partially lose their sight or hearing; many 
are left consumptive, weakly, sickly, or maimed, many are disfigured for life by horrid scars, and 
become shocking objects to those who approach them. Immense numbers lose their eyesight by 
it.”— La Conaamine. PREVENTION OF SMALL-POX. 
In Sweden the average number of deaths in each year from small-pox per 
one million inhabitants was,— 
Before the introduction of vaccination (1774 1801), 1,973; 
During the period of optional vaccination (1802-1816), 479; 
And during the period of obligatory vaccination (1817-1877), 189. 
Vaccination was introduced in England near the beginning of the present 
century, and since 1853 compulsory vaccination has been attempted. In 
England the number of deaths in each year from small-pox per one million 
inhabitants was,— 
At the close of the last century, 3,000; 
From 1841 to 1853 (average), 304; 
From 1854 to 1863 (average), 171. 
In the Bavarian army revaccination has been compulsory since 1843. From 
that date till 1857, not even a single case of unmodified small-pox occurred, 
nor a single death from small-pox. 
During 42 years of duty, Dr. Marson, physician of the London sinall-pox 
hospital, has never observed a single case of small-pox in the officers and 
employees of the hospital, who are revaccinated when they enter the service, 
and who are constantly exposed to the infection. 
“Out of more than 10,000 children vaccinated at Brussels with animal 
lymph, from 1865 to 1870, and who went through the terrible epidemic of 
small-pox which in 1870 and 1871 frightened the world, not a single one was, 
to my knowledge, reported as being attacked by the disease. The same 
immunity was shared by those—a much larger number—whom I had revacci- 
nated, and who at the same time were living in epidemic centers.”—Dr. 
Warlemont, of Brussels.—[North Carolina Medical Journal, January, 1880. 
Vol. v., p. 2.] 
3. Who should be vaccinated.—Everybody, old and young, for his own 
interest and that he may not become a breeding-place for the distribution of 
small-pox to others, should seek that protection from small-pox which is 
afforded by vaccination alone. It is believed that all persons except those 
mentioned in the following paragraph may, if the operation is properly per- 
formed, at the proper time, and with pure bovine virus, be vaccinated with 
perfect safety to themselves. Even those who have had small-pox should 
be vaccinated, for otherwise they may take the disease; and it seems to be 
proved that a larger proportion of those who have small-pox a second time 
die than of those who have the disease after vaccination. 
4. Who should not be vaccinated.—Unless exposure to small-pox is believed 
to have taken place, or likely to take place, teething children, pregnant 
women, persons suffering with measles, scarlet fever, erysipelas, or suscep- 
tible to and recently exposed to one of these diseases, persons suffering with 
skin disease or eruption, and in general feeble persons not in good health, 
should not be vaccinated. In all cases in which there is any doubt as to the 
propriety of vaccinating or postponing vaccination, the judgment of a good 
physician should be taken. The restriction as to vaccinating teething 
children makes it important that children should be vaccinated before the 
teething process has begun, because small-pox is very much more dangerous 
than vaccination. Small-pox is exceedingly dangerous to pregnant women. 
5. When should a person be vaccinated,—The sooner the better as a rule, and 
especially whenever there is much liability of exposure to small-pox. Children 
should be vaccinated before they are four months old; those who have never WHAT VACCINE VIRUS SHOULD BE USED. 
3 
"been vaccinated, should, with the exceptions previously made in paragraph 4, 
be vaccinated at once. Because the vaccination often loses its protective 
power after a time, those who have been vaccinated but once or twice should, 
in order to test and to increase the protective power of the former vaccina- 
tion, be vaccinated again and as often as the vaccination can be made to 
work. For the first three or four scars the protection afforded is believed to 
be somewhat in proportion to the number of good scars, conditioned always 
that the scars be the result of a proper vaccination with genuine vaccine 
virus. In general, to insure full protection from small-pox, one should be 
vaccinated as often as every five years. It has been found that of those who 
have small-pox the proportion of deaths is very much less among those who 
have three or four good vaccination scars than among those who have but 
one scar. 
Vaccination as late as the second day after known exposure to small-pox 
is believed to have prevented the small-pox; vaccination the third day after 
exposure has rendered the disease much milder than usual, and, in a case in 
Iowa, vaccination on the seventh or eighth day after exposure to small-pox 
ran a partial course and was believed to have modified the attack of small- 
pox, which, however, it did not wholly prevent. 
6. With what should one be vaccinated—Virus taken from the arm of one 
vaccinated a second time is worthless because unreliable. Virus dissolved 
and carried about between glass slips in the pocket of the vaccinator is liable to 
contamination and fermentation; bovine virus dried on ivory or quill points 
is preferable. It should be remembered that a spurious vaccination which 
does not produce a vaccine vesicle, while it affords no protection against 
small-pox, may prevent subsequent vaccination which shall be protective. 
For this reason it is important to use only virus from reliable sources and 
free from contamination or decomposition. In a majority of cases, if the 
virus be taken at the proper time (eighth day after vaccination) from the arm 
of a healthy child having no taint of a hereditary or communicable disease, 
such as scrofula, consumption, syphilis, erysipelas, scarlet fever, etc., and 
undergoing the action of its first vaccination, and if a properly clean lancet 
be used, no harm will result to the person vaccinated, and a good vaccination 
may be secured. This method involves rupturing the vesicle on the arm of 
the child from whom the virus is obtained, and this is objectionable because 
it may interfere with the complete development of it3 vaccination. But 
because harm ha3 sometimes resulted from the use of virus taken from 
another person, because it is often impossible to tell whether a child has pure 
blood and is free from every disease, because it is so easy to obtain pure and 
fresh bovine virus, and because such bovine virus is efficient, it is better in 
all cases to use only the pure and fresh bovine virus. 
Reasons for preferring bovine virus to humanized virus may be given as 
follows:—(1.) By the use of the bovine virus there is secured a more perfect 
or typical development of the vaccine disease; and hence it may fairly be 
inferred a greater protection against small-pox. (2.) With the bovine virus 
and with a clean lancet, and with clean surroundings, there is no danger of 
communicating syphilis. (3.) The bovine virus is far more effective than 
the humanized virus in revaccination; and where the humanized virus fails 
and the bovine virus works it is probable that there was susceptibility to 
small-pox which the humanized virus did not remove but which has been 
removed by the bovine virus. (4.) Greater care can be taken in the propa- 4 
VACCINE VIRUS AND VACCINATION. 
gation of bovine virus, a greater supply can be always at command, and 
always, but especially in times of urgent danger from emall-pox people can 
have a better guarantee that they are vaccinated-'with genuine and pure vac- 
cine virus. 
7. Where to obtain fresh and pure bovine virus.—Dr. E. L. Griffin, of Fond 
du Lac, Wis., by a series of inoculations of young heifers propagates virus 
of the Belgian stock of cow-pox, obtained from Dr. Warlomont, director of 
the government vaccine establishment of Brussels. This virus, so far as 
known, never has passed through the human subject. It is stored on ivory 
points, each of which holds enough virus to vaccinate one person, and should 
be used only for one person. Ten points are sent by mail for one dollar; 
and if used according to the directions of Griffin’s circular within five days 
of the receipt of the package their efficiency is guaranteed by him. Dr. 
Henry A. Martin and son, Roxbury Station, Boston, Mass., propagate virus 
of the Beaugency stock. Dr. Martin claimed the honor of being the first 
propagator of bovine virus in the United States. Both Dr. Griffin and Dr. 
Martin are believed to be reliable propagators of bovine vaccine virus. Virus 
is for sale by most druggists. The State Board of Health does not supply 
vaccine virus. 
8. Where should vaccination be performed.—In a room or place free from 
persons suffering from disease, and from dust or vapors which may convey 
to the scratched surface germs of any communicable disease; certainly not in 
or near a room where there is erysipelas, nor in the presence of one who has 
just come from a person sick with erysipelas, diphtheria, or scarlet fever. 
9. By whom should one be vaccinated.—The operation of vaccination should 
be performed always by a competent and responsible physician, or by some 
one whom he has instructed and recommends to perform the operation. To 
hry to vaccinate one’s self or one’s family is poor economy, for it often results 
not only in a waste of money and of time but in a false and dangerous feel- 
ing of security. To trust to vaccination by nurses and midwifes is equally 
foolish. A well-educated and experienced physician has the skill, and the 
special knowledge necessary to the best judgment on all of the questions 
involved, without which the operation may be a failure or worse than a fail- 
ure. In work of this kind the best is the cheapest, whatever it costs. 
10. Row to vaccinate.—In remote places it is sometimes necessary to vac- 
cinate persons who are practically beyond the reach of a competent phy- 
sician. 'For the benefit of such, and not as an encouragement to others to 
dispense with the services of a skillful physician, the following suggestions 
are made as to the best method of vaccinating. As a rule the most conven- 
ient place for vaccination is found to be on the outer surface of the left arm, 
about one-half or two-thirds the way up from the elbow to the shoulder. An 
infant which its mother carries on her right arm should be vaccinated on its 
right arm in order to avoid rupturing the vesicle by pressure against its 
mother. With a sharp pointed and perfectly clean instrument (lancet) make 
six parallel scratches, barely sufficient to make a show of blood, but not to 
cause bleeding. Directly across these scratches make four or five similar 
scratches, so that the scarified place shall be as large as a split pea, and 
something like this illustration: If blood flows, wait, and wipe it off 
before applying the lymph. The virus is at and near the pointed end of 
the ivory carrier. Moisten the lymph upon the ivory point with half a drop of 
pure water, which has recently been boiled and cooled, smeared over it with COMMON APPEARANCES AFTER VACCINATION. 
5 
the lancet. Then rub the point over the scarified surface briskly for a minute so 
as to lodge the granules in the abraded surface. The lymph which may be 
deposited on the sound skin should be scraped upon the scarified place and 
allowed to dry there. When the arm is dry return its ordinary clothing, 
between which and the arm a loose, soft cloth should be fastened. Do not 
put on a tight bandage or any plaster. Let no saliva touch the scratched 
place, neither to affix a plaster nor in any way. Allow no water to touch the 
place unless it has been recently boiled. When an ivory point has been used 
throw it in the fire. Except there is urgent necessity, do not use the same 
point on two persons, and not then if there is danger of communicating 
disease. Vaccination sometimes fails because the arm is not well scarified 
and the virus is not thoroughly rubbed into the scarified surface. A skillful 
vaccinator can generally use sufficient care to insure success in a susceptible 
person. Never cut entirely through the skin. Virus should not be inserted 
under the skin. Except with young children, and with feeble persons, for 
whom only one place is recommended, two or more places an inch or more 
apart may be scarified and vaccinated. 
11. After vaccination.—Let the vaccinated place alone. Do not scratch it 
or otherwise transfer the virus where it is not wanted. 
12. Common appearances after vaccination.—For a day or two nothing unusual 
should appear. A few days after that, if it succeeds regularly, the skin will 
become red, then a pimple will form, and on the pimple a little vesicle or 
blister which may be plainly seen on the fifth or sixth day. On the eighth 
day the blister (vesicle) is, or should be, plump, round, translucent, pearly 
white, with a clearly marked edge and a depression in the center; the skin 
around it for about half an inch is red and swollen. This vesicle and the red 
inflamed circle about it (called the areola) are the two points which prove 
the vaccination to be successful. A rash, and even a vesicular eruption, 
sometimes comes on the child’s body about the eighth day, and lasts about a 
week; he may be feverish, or may remain quite well. The arm may be red 
and swollen down as far as the elbow, and in the adult there will usually be a 
tender or swollen gland in the armpit, and some disturbance of sleep for 
several nights. The vesicle dries up in a few days more, and a crust forms 
which becomes of a brownish mahogany color, and falls off from the twentieth 
to the twenty-fifth day. In some cases the several appearances described 
above may be delayed a day or two. The crust or scab will leave a well- 
marked, permanent scar. 
13. Signs of successful re vaccination.— When a person who has been once suc- 
cessfully vaccinated is afterwards revaccinated there sometimes results a 
vesicle which, as regards its course and that of the attendant areola, cannot 
be distinguished from the perfect results of a primary vaccination, and this 
is more likely to occur if bovine virus is used. But often the result is modi- 
fied by the influence of the previous vaccination, no true vesicle forms, but 
merely a papular elevation surrounded by an areola; and this result having 
attained its maximum on or before the fifth day, afterwards quickly declines. 
Or, if a vesicle forms, its shape is apt to vary from that of the regular vesicle, 
and its course to be more rapid, so that its maturity is reached on or before 
the sixth day, its areola declines on or before the eighth day, and the scab- 
bing begins correspondingly early. In either case the areola tends to diffuse 
itself more widely and less regularly, and with more affection of the areolar 
tissue than in primary vaccination, while the itching and feverishness may 6 
WHAT TO DO AFTER VACCINATION. 
be present much the same as in primary vaccination. When the results of 
a revaccination are not well marked, protection should not be presumed 
unless the same virus is proved to be efficient in a primary vaccination. 
14. What to do during and after vaccination—Do nothing to irritate the 
eruption, do not pull the scab off, when it drops off throw it in the fire. 
When the eruption is at its hight show it to the doctor who performed.the 
vaccination. If it is satisfactory, ask him for a certificate stating when and 
by whom you were vaccinated, whether with bovine or humanized lymph, in 
how many places and with what result at each place. When the arm is 
healed, if the vaccination did not work well, be vaccinated again as soon as 
possible, and in the best manner possible. This will be a test of the protec- 
tion secured by the former vaccination, and will itself afford increased pro- 
jection. Do not be satisfied with less than four genuine vaccine scars, or 
with four if it is possible to secure more than four. This vaccination a 
second or third time in close succession is believed to be hardly less import- 
ant than vaccination the first time, and hardly less valuable as a protection 
against small-pox. Without doubt many persons are living in a false sense 
of security from small-pox because at some time in their lives they have had 
a little sore on their arms caused by a supposed or a real vaccination, or 
because an imperfect vaccination failed to “work,” or because they were suc- 
cessfully vaccinated, or had the varioloid, or the unmodified small-pox many 
years ago. Until small-pox is stamped out throughout the world so that 
exposure to the disease shall be practically impossible, the only personal 
safety is in such perfect and frequent vaccination that one need not fear an 
exposure to small-pox through the recklessness of the foolish. Statistics 
abundantly prove that among the unvaccinated, small-pox has lost none of 
the deadly power which made b such a terror to former generations. 
15. Make a record of your vaccination.—Do not fail to procure and preserve 
the certificate mentioned in the preceding paragraph, and also to make a 
personal record of the facts with regard to any vaccination of yourself or in 
your family. From it you may sometime learn that it is ten years since you 
or some member of your family was vaccinated, when you thought it only 
five. 
16. Vaccination before admission to the schools.—In some places, and with 
good results, the board of education has made the possession of a certificate 
signed by some competent physician, stating that the child has been success- 
fully vaccinated within a given number of years or months, a condition to 
admission to the public schools. Such a regulation seems to be one of the 
most efficient means of securing a general vaccination of the young people. 
17. Corporations and large business firms may well prevent interruption of 
their business by small-pox by requiring employees to exhibit certificates of 
successful vaccination, and of revaccination. 
18. Do not delay to be vaccinated,—By setting about it at once there will be 
time to secure pure and ftesh vaccine virus, and neither sickness nor haste 
need prevent a successful vaccination. But if one puts it off, he may sud- 
denly be called away on an unexpected journey in which he may incur 
greater risk of exposure to small-pox, or small pox may appear in his vicinity 
and for want of time to procure reliable vaccine virus he may be compelled 
to accept vaccination with virus neither fresh and active nor of known 
purity; and vaccination with inferior virus, while it affords but little protec- 
tion against small-pox, may be a hindrance to successful vaccination with RESTRICTION OF SMALL-POX.—NOTICE TO THE BOARD OF HEALTH. 
7 
the best virus; or by his delay he may contract small-pox itself, with all its 
dangers and with an expense many times larger than the cost of thorough 
vaccination. 
19. Small-pox occurs at all seasons of the year, but as a rule is most preva- 
lent in cold weather. It has been suggested that this may be in part due to a 
lack of ventilation in winter, by which the poison becomes more concentrated, 
and to the greater irritation and rawness of the throat and air-passages 
caused by the cold, dry air and by the more abundant ozone in winter, the 
sore throat supplying a place where small-pox may easily be inoculated; it is 
known also that in a warm, moist air vaccine virus decomposes more readily 
than in a cold, dry air, and the same is probably true of small-pox virus. 
This greater liability to small-pox in winter makes it important that one 
should not wait till winter and its dangers have come before being vac- 
cinated, and also that he should not suffer the winter to pass without being 
vaccinated. 
20. Small-pox not spontaneously generated.—It is believed that neither small- 
pox nor any other strictly contagious disease is originated in Michigan, and 
that small-pox may in great part be kepj out of the State if proper measures 
are taken, such as the systematic inspection of immigrants and travelers and 
the isolation and disinfection of all infected material. 
21. Premises.—Privies, cesspools, waterclosets, drains, gutters, and all other 
such places liable to receive the contagium of a disease should be frequently 
and liberally treated with the copperas solution mentioned in paragraph 9, 
on a page preceding this. 
22. Rags —No person should handle old clothing or rags without taking 
precautions to prevent the spread of communicable diseases. Children should 
not be allowed to go near a rag-gatherer’s collection, nor into the rag-rooms 
in paper-mills or store-house. 
RESTRICTION OP SMALL-POX. 
When small-pox appears in a place it is generally possible to restrict it to 
the first case or set of cases. Five things (specified in paragraphs numbered 
23, 24, 25, 26 and 27) should immediately be done, and several other things 
should without fail be done in their proper order, somewhat as follows : 
23. Notice to the local board of hsalth.—The householder within whose family 
a case of small-pox occurs, and the physician called to treat a case of small- 
pox should at once give notice thereof to the health officer (or to the local 
board of health), as required in townships by section 1734 and 1735 of the 
compiled laws of 1871 (§§1675 and 1676 Howell’s Statutes), and in cities and 
villages by section 1740 of the compiled laws of 1871, as amended in 1879 
(§1681 Howell’s Statutes), printed in paragraph 56, on a following page. 
Section 1734 and 1735, C. L. 1871 (§§1675 and 1676, Howell’s Statutes), as 
amended by Act 11, Laws of 1883, and the section (50) added in 1883, are as 
follows: 
(1734). Sec. 43. Whenever any householder, hotelkeeper, keeper of a boarding house 
or tenant shall know, or shall be informed hy a physician, or shall have reason to believe, that any 
person in his family, hotel, boarding house, or premises is taken sick with small-pox, cholera, diph- 
theria, scarlet fever, or any other disease dangerous to the public health, he shall immediately give 
notice thereof to the health officer, the president or the clerk of the Board of Health of the town- 
ship, city, or village in which he resides. Said notice shall state the name of the person sick, the 
name of the disease, the name of the householder, hotelkeeper, keeper of boarding house, or tenant 8 
DUTIES OF HOUSEHOLDER, PHYSICIAN AND BOARD OF HEALTH. 
giving the notice, and shall, by street and number, or otherwise, sufficiently designate the house in 
which he resides or the room in which the sick person may be; and if he shall refuse or neglect im- 
mediately to give such notice he shall forfeit for each such offense a sum not exceeding one hundred 
dollars*: Provided, That this penalty shall not be enforced if a physician in attendance has given to 
the health officer or other officer hereinbefore mentioned an immediate notice of said sick person, 
and true name of the disease, in accordance with the requirements of this section. §1675, Howell’s 
Statutes, as amended by Act 11, Laws of 1883. 
(1735.) Sec. 44. Whenever any physician shall know that any person whom he is called to visit, 
or who is brought to him for examination, is infected with small-pox, cholera, diphtheria, scarlet 
fever, or any other disease dangerous to the public health, he shall immediately give notice thereof 
to the health officer, the president or the clerk of the board of health of the township, city, or village 
in which the sick person may be; and to the householder, hotelkeeper, keeper of boarding house, or 
tenant within whose house or rooms the sick person may be. The notice to the officer of the board 
of health shall state the name of the disease, the name, age, and sex of the person sick, also the 
name of the physician giving the notice; and shall, by street and number, or otherwise, sufficiently 
designate the house or room in which said sick person may be. And every physician and person 
acting as a physician, who shall refuse or neglect immediately to give such notice shall forfeit for 
each such offense a sum not less than fifty nor more than one hundred dollars *: Provided, That 
this penalty shall not be enforced against a physician if another physician in attendance has given 
to the health officer, or other officer hereinbefore mentioned, an immediate notice of said sick per- 
son, and the true name of the disease, in accordance with the requirements of this section. 1676 
Howell’s, as amended by Act 11, Laws of 1883. 
Sec. 50. For each complete notice in writing to an officer of the board of health, in full compliance 
with the preceding section, requiring from physicians or other persons notices of diseases dangerous 
to the public health, the physician who gave the notice shall be entitled, on duly certifying that 
each notice was correct, and when the bill has been duly audited by the board of health, to receive 
from the township, city or village in which the notice was given, the sum of ten cents.—Act 11, Laws 
of 1883. 
24. Upon receipt of such notice, the health officer and the local board of health 
has duties to perform in taking measures to restrict the spread of the disease, 
which it is a great violation of public trust for him or for the board to neglect 
or postpone. The law is very plain as to the nature and the importance of 
these duties. Three sections of the law are as follows : 
(1732) Sec. 41. When the small-pox or any other disease dangerous to the public 
health, is found to exist in any township, the Board of Health shall use all possible care 
to prevent the spreading of the infection, and to give public notice of infected places to 
travelers, by such means as in their judgment shall be most effectual for the com- 
mon safety.—(§1673 Howell’s Annotated Statutes.) 
Notice of in 
fected places. 
Board to make 
provision to 
prevent spread 
of disease. 
(1706) Sec. 15. When any person coming from abroad or residing in any township 
within this State, shall be infected, or shall lately before have been infected, with 
the small-pox, or other sickness dangerous to the public health, the Board of Health of 
the township where such person may be shall make effectual provision in the man- 
ner in which they shall judge best for the safety of the inhabitants, by removing 
such sick or Jnfected person to a separate house, if it can be done without danger to 
his health, and by providing nurses and other assistance and necessaries, which shall 
beat the charge of the person himself, his parents, or other person who may be 
liable for his support, if able; otherwise, at the charge of the county to which he 
belongs.—(§1647 Howell’s Annotated Statutes.) 
At expense of 
person or county. 
3 Mich. Rep. 475. 
51 Mich. p. 526. 
58 Mich. p. 454. 
N. W. Reporter, 
Vol. 16, p. 887. 
Provision in case 
infected persons 
cannot be re- 
moved. 
(1T07.) Sec. 16. If any such infected person cannot be removed without danger to 
his health, the Board of Health shall make provision for him as directed in the pre- 
ceding section, in the house in which he may be, and in such case they may cause 
the persons in the neighborhood to he removed, and may take such other measures 
as they may deem necessary for the safety of the inhabitants.—(§1648 Howell’s An- 
notated Statutes.) 
must prosecute for all such forfeitures; township officers must give notice to super- 
visor; prosecuting attorney to conduct suit if requested; see sections 8439, 8440, and 8142, Howell's 
Annotated Statutes. Health officers of villages and cities must notify prosecuting 
attorney of all violations of this section,—see §t684, Howell’s Statutes; the prosecuting attorney 
must prosecute for all such forfeitures incurred within his county,—see section 8442, Howell’s 
statutes. Sections 8439 and 8440 are printed on page 2 of this circular. RESTRICTION OF SMALL-POX.—DUTIES OF HEALTH OFFICER. 
9 
25. Duty of the health officer.—As so much depends upon prompt action on 
the appearance of the first case of small-pox, and in order that no time may 
be lost, it is the duty of every board of health to make provision for prompt 
action by its health officer, authorizing and directing him to be prepared at 
all times, as executive officer of the board, to take certain action without 
waiting for a meeting of the board, whenever a case of small-pox or other 
disease dangerous to the public health occurs within its jurisdiction. Some 
of the duties which the health officer should perform are specified in Act No. 
137, laws of 1883, as follows: 
AN ACT to specify certain duties of health officers and provide for com- 
pensation therefor, in townships, cities and villages where the health 
officer is not otherwise instructed by the local board of health. 
Section 1. The People of the State of Michigan enact, That whenever 
the health officer of any township, city or village in this State shall receive \ 
reliable notice or shall otherwise have good reason to believe that there is 
within the township, city or village of which he is the health officer, a case 
of small-pox, diphtheria, scarlet fever, or other communicable disease 
dangerous to the public health, it shall be the duty of said health officer, 
unless he is or shall have been instructed by the board of health, of which 
he is an executive officer, to do otherwise,— 
Immediately to investigate the subject, and in behalf of the board of 
health, of which he is an executive officer,— 
To order the prompt and thorough isolation of those sick or infected 
with such disease, so long as there is danger of their communicating the 
disease to other persons ; — 
To order the prompt vaccination or isolation of persons who have been 
exposed to small-pox 
To see that no person suffers for lack of nurses or other necessaries 
because of isolation for the public good ;— 
To give public notice of infected places* by placard on the premises, and 
otherwise if necessary ; 
To promptly notify teachers or superintendents of schools concerning 
families in which are contagious diseases ; 
To supervise funerals of persons dead from scarlet fever, diphtheria, 
small-pox, or other communicable disease which endangers the public 
health ;— 
Powers and du- 
ties of health offi- 
cers in reference 
to diseases dan- 
gerous to public 
health. 
To disinfect rooms, clothing, and premises, and all articles likely to be 
infected, before allowing their use by persons other than those in isolation ; 
To keep the President of his own board of health, and the Secretary of 
the State Board of Health constantly informed respecting every outbreak 
of a disease dangerous to the public health, and of the facts so far as the 
same shall come to his knowledge, respecting sources of danger of any 
such diseased person or infected article being brought into or taken out of 
the township, city, or village of which he is the health officer. 
Sec. 2. In the absence of regulations conflicting therewith, made and 
published by the local board of health, and still remaining in force, the 
provisions of section one of this act shall have the force of regulations 
made and published by the local board of health; and whoever shall vio- 
late the provisions of section one of this act, or the orders of the health 
officer made in accordance therewith, shall forfeit for each such offense a 
sum not exceeding one hundred dollars. 
Sec. 3. In the fulfillment of the requirements of this act, the health 
officer, unless other provision shall have been made in accordance with 
law, shall be entitled to receive from the township, city or village of 
which he is health officer, compensation at the rate of not less than two 
(2) dollars per day :• Provided, That this section shall not be construed to 
conflict with any action by the local board of health, under section six- 
teen hundred and ninety-three, of the compiled laws of eighteen hundred 
and seventy-one, as amended by act number two hundred and two, of the 
laws of eighteen hundred and eighty-one. 
Provisions to 
have force of 
regulations of 
local boards of 
health in certain 
cases. 
Penalty for vio- 
lation of provis- 
ions. 
Compensation of 
health officer. 
Proviso. 
♦Required by section 1732, compiled laws of 1871 (§1673, Howell’s), as follows 
(1732.) Sec. 41. When the small-pox, or any other disease dangerous to the public 
health, is found to exist in any township, the board of health shall use all possible care 
to prevent the spreading of the infection, and to give public notice of infected places 
to travelers, by such means as in their judgment shall be most effectual for the com- 
mon safety. 81673, Howell’s Statutes. 
Notice of in- 
fected place*. 10 
VACCINATE ALL EXPOSED OR LIKELY TO BE EXPOSED. 
26. Vaccination of attendants and all exposed.—The attendants on the sick 
with small-pox and all other persons who it is feared have been exposed to 
small-pox or varioloid, should immediately be vaccinated. If properly vac- 
cinated within a day or two after exposure to small-pox, a person has a good 
chance to escape small-pox entirely, and if he should come down with vario- 
loid or modified small-pox he will probably have the disease in a much milder 
form than if not recently vaccinated. (See paragraph 5,—Prevention of 
small-pox.) Unless the eruption has already appeared, vaccinate. 
27. Restriction of the infection.—As the contagium of small-pox harbors in 
carpets, bedding, clothing, etc., it is best to prepare the room in which one 
sick with small pox is to be cared for, removing the carpets, pictures, sofas, 
etc., the bedding and clothing not required for actual use in the room, and 
any other articles capable of harboring the infection and which it would be 
difficult to disinfect or not desirable to burn. Such removals of carpets, 
bedding, etc., should not be attempted after they have been exposed to 
infecdon, unless properly disinfected under the direction of the health 
officer. (See paragraphs 12 and 15, on a preceding page of this document.) 
28. Isolation—Those sick with small-pox or suspected small-pox should at 
once be separated from all other persons except the necessary attendants on 
the sick. 
29. Care of those exposed to small-pox.—All persons known to have been 
exposed to small-pox should at once be vaccinated, and should be, so far as 
possible, isolated from others until it is known whether they have contracted, 
small-pox. This “period of incubation ” is usually about 12 or 15 days. 
30. Notice of infected place.—Placard on house.—A signboard or large card as 
a signal of danger, with the words small-pox printed on it in large, plain 
letters should at once be displayed before a house, and a large card with the 
words small-pox in large, plain letters should be fastened on the door of a 
house in which is a case of small-pox; and without permission of the health 
officer no person should be allowed to come to the house or go from it. 
31. Who mav attend small-pox patients.—rAny person who has recently been 
successfully vaccinated or revaccinated, or has recently had small-pox or 
varioloid, may attend on small-pox patients with comparative safety to him- 
self, and in most cases with absolute safety so far as relates to danger from 
small-pox. No person who has been vaccinated or has had varioloid or small- 
pox more than ten years previously should rely upon such experience for 
security from small-pox, if exposed by attendance on a person sick with 
small-p<>x or varioloid. Such a person should immediately be revaccinated. 
“ It is now fully established that a typical vaccine scar is not proof of the 
immunity of the individual from small-pox. We have admitted to the hos- 
pital * * * 711 cases of small-pox exhibiting typical cicatrices; of which 
number 73 proved fatal.”—W. M. Welch, M. D., in Philadelphia Health 
Report, 1872. 
There is good statistical support for the common theory that the protective 
influence of vaccination, varioloid and small-pox dies out in seven years. 
This is now known to be absolutely true for many persons, but there is no 
one period applicable to all persons, the fact being that while vaccination 
affords at first almost absolute protection, its influence is gradually worn 
out Its protective influence is lost much sooner in some persons than in RESTRICTION OF SMALL-POX.—DISINFECTION. 
11 
others, but experience has shown (as in Philadelphia in 1871-2) that many 
children vaccinated in infancy have varioloid before they are seven years of 
age, while in some instances one vaccination or one attack of small-pox pro- 
tects the individual through life. Inasmuch as many persons are known to 
be susceptible to small-pox or vaccination as often as once in ten years, and 
as some are susceptible yet more frequently, this State Board of Health has 
advised revaccination every five years, as the most judicious measure for the 
prevention of small-pox. 
DISINFECTION'.* 
32. Disposal of infected material—All discharges from a small-pox patient 
should be received into vessels containing a strong solution of copperas (sul- 
phate of iron), or the zinc-solution mentioned in paragraph 34. Tn cities 
where sewers are in use the disinfected discharges may be thrown into the 
water-closet; in other places they should at once be buried at least 100 feet 
distant from any well; they should not by any means be thrown into a run- 
ning stream nor into a cess-pool. All cloths, rags, etc., used about the 
patient should at once be burned, or where that is impracticable should be 
thrown into a strong zinc-solution. If necessary, discharges from the patient 
may be received on old cloths which should at once be burned or disinfected 
and buried. All vessels should be kept clean and disinfected. 
Bedding, clothing, etc., should as soon as removed from the patient be 
burned. If it is too valuable to be destroyed, it should at once be disinfected 
by boiling in the zinc-solution, by heating in a specially prepared disin- 
fecting chamber to a temperature of 250° Fahr., or by long exposure in a 
close room or box to the fumes of burning sulphur, as stated in paragraph 
36, following. 
Cotton, linen, flannels, blankets, etc., should be treated with the boiling hot zinc-solution, intro- 
ducing them piece by piece, securing thorough wetting, and boiling for at least half an hour. 
Heavy woolen clothing, silks, furs, stuffed bed-covers, beds, and other articles which cannot be 
treated with the zinc-solution, should be hung in the room during fumigation, pockets being turned 
inside out and the whole garment thoroughly exposed. Afterward they should be hung in the open 
air, beaten and shaken. Pillows, beds, stuffed mattresses, upholstered furniture, etc., should be cut 
open, the contents spread out and thoroughly fumigated. Carpets are best fumigated on the floor, 
but should afterward be removed to the open air and thoroughly beaten, after which they may well 
be again exposed to fumes of burning sulphur. 
33. The copperas-solution may be prepared by dissolving sulphate of iron 
(copperas) in water in the proportion of one and a half pounds of copperas 
to a gallon of water. When much is wanted it may be prepared by hanging 
a basket containing about sixty pounds of copperas in a barrel of water. 
34. The zinc-solution may be prepared by dissolving sulphate of zinc and 
common salt in water in the proportion of four ounces of zinc-sulphate and 
two ounces of salt to a gallon of water. 
35. Care of rooms, etc., during sickness.—So far as consistent with the welfare 
of the patient, the room throughout the sickness should t e constantly venti- 
lated and frequently aired. To confine the poison in a close room is to 
retain its power of infecting others. It is well to provide for disinfecting 
the foul air withdrawn from the room, as by an open fire-place where this is 
* These methods of disinfection are applicable in other contagions diseases soch as scarlet fever, 
diphtheria, etc. For the statement of some of the methods herein described the State Board of 
Health is indebted to a circular on disinfection (No. 8) issued by the National Board of Health. 12 
DISINFECTION OF ROOMS, CORPSES, CLOTHING AND CARRIAGES. 
practicable, or by flues leading into furnaces, or kept constantly fumigated 
in some manner. It is well to keep in the sick-room a vessel containing the 
zinc-solution (mentioned in a preceding paragraph) for the reception of 
towels, sheets, and other articles of clothing which are not to be burned or 
disinfected in a specially prepared oven. 
36. Disinfection after death, recovery, or removal.—After death, recovery, or 
removal there should take place, under the supervision of the health officer, 
the most thorough and complete disinfection of the house and the contents of 
the house in which there has been a case of small-pox. It is far better for 
the community and cheaper for the board of health to pay a competent man 
to see that this is properly done than to take the risk of its not being done 
well. This disinfection should be done with fumes of burning sulphur. 
For this purpose the room to be disinfected must be vacated. Heavy cloth- 
ing, blankets, bedding, and other articles which cannot be treated with zinc- 
solution, should be opened and spread out so as to be freely exposed during 
fumigation. Close the doors and all large openings to the room as tight as 
possible, but do not use paste, or in any such way cover surfaces which need 
to be disinfected, nor prevent free entrance of the fumes to all cracks 
into which the contagium may have entered. Place the sulphur in iron pans 
supported upon bricks, set it on fire by hot coals or with the aid of a spoon- 
ful of alcohol and a lighted match, and allow the rooms to remain closed for 
several hours. For a room about ten feet square, three pounds of sulphur 
should be burned; for a larger room a proportionally larger quantity should 
be used, that is at the rate of three pounds of sulphur to each one thousand 
cubic feet of air-space. 
37. Carefully avoid breathing the fames of the burning sulphur.—After fumi- 
gation for several hours, the room should be thoroughly opened and aired, 
before it is again occupied. 
38. Care of the corpse.—The corpse should be wrapped in a sheet wet with a 
zinc-solution of double the strength specified in paragraph 10, preceding, and 
buried at once. Metallic, metal-lined, or air-tight coffins should be used 
when possible, certainly when the body is to be transported for any consid- 
erable distance. In no case should the body be exposed to view except in a 
perfectly air-tight coffin, and through glass; the coffin after its final closure 
having been exposed to fumes of burning sulphur of the strength specified 
above. 
39. Disinfection of rooms, clothing, etc., incidentally exposed to infection Hotel- 
rooms, stores,* cars, boats, hacks or other inclosures which may have been 
exposed to infection should be carefully disinfected by fumes of burning 
sulphur, as specified in paragraph 36. 
40. Funerals—No public funeral should be held at the house, and no one 
should go to a public funeral from the house where one has died from small- 
pox, or the inmates have been exposed to the disease. Should any one from 
an infected or exposed house ride to a funeral or a grave in a public hack, 
the robes, cushions, etc., and the interior of the hack should immediately 
afterwards be thoroughly disinfected by exposure for several hours to the 
fumes of burning sulphur, as described in paragraph 36. 
* Prof. Richardson, of Philadelphia says:—(Germ Theory of disease, Trarus. Pnila. Social Sci- 
ence Association, Penn Monthly, iYoo., 1878.) Some years ago cases of small-pox occurred in the 
house of a dealer in ready-made clothing near New York. The whole stock of coats, pantaloons, 
etc., numbering many hundreds, had an opportunity to become infected and should have been care- 
fully disinfected. They were, however, sold at retail, and may have given rise to many cases of 
“idiopathic” small-pox which no one could trace to any source of contagion. CONVALESCENTS, HOSPITALS, NURSES, REMOVALS. 
13 
41. Care of convalescents.—After recovery the patient should not be allowed 
to go abroad or to receive visitors until his clothing, etc., has been carefully 
disinfected under the supervision of the health officer, and until he has 
received from the health officer or from some competent physician a properly 
authenticated statement which is approved by the health officer that there is 
no longer any danger of his oommunicating the disease. 
42. Hospitals for persons sick with diseases dangerous to the public health—As 
a means of preventing the spread of disease, the law authorizes the inhab- 
itants of townships, cities, and villages to be constantly provided with hos- 
pitals for the reception of persons having small-pox, or any other disease 
dangerous to the public health; and directs local boards of health on the 
outbreak of any such disease to provide such hospitals or places of reception 
for the sick and infected as they shall judge best for their accommodation 
and the safety of the inhabitants, and to cause such sick or infected persons, 
if their condition will admit, to be removed to such hospitals or places of 
reception,—said hospitals, and (in case the sick cannot be removed to the 
hospital without danger to life or health) the houses where the sick may 
remain, and all persons connected with said hospitals or abodes of the sick 
to be subject to the regulations of the board of health, or of a committee 
appointed by the board of health for that purpose. Sections 1726-1733 of 
the Compiled Laws of 1871, (§1667-1674, Howell’s Statutes) relating to this 
subject, and by amended section 1740 * (§1681 Howell’s Statutes), (being 
Secs. 35-42, and 49 of chapter XLVI.) made equally applicable to cities, 
villages, and townships, are as follows: 
(1726.) Sec. 35. The inhabitants of any township may establish within their town- 
ship and be constantly provided with one or more hospitals for the reception of 
persons having the small-pox, or other disease which may be dangerous to the 
public health.—? 1667, Howell's Statutes. 
Hospitals for 
reception of per- 
sons having 
small-pox, etc. 
(1727.) Sec. 36. All such hospitals shall be subject to the orders and regulations of 
the board of health, or a committee appointed by such board for that purpose: but 
no such hospital shall be established within one hundred rods of any inhabited 
dwelling-house situated in an adjoining township, without the consent of such 
adjoining township.—? 1668, Howell's Statutes. 
By whom hospi- 
tals to be regu- 
lated, etc. 
(1728) Sec. 37. If any person shall inoculate any other person, or inoculate him- 
self, or suffer himself to be inoculated with the small-pox, unless at some hospi- 
tal licensed and authorized by law, he shall for each offense, forfeit a sum not 
exceeding two hundred dollars.—? 1669, Howell's Statutes. 
Penalty for in- 
oculating with 
small-pox. ex- 
cept at hospitals. 
(1729.) Sec. 38. When any hospital shall be so established, the- physician attend- 
ing the same, the persons inoculated or sick therein,’ the nurses, attendants, and 
all persons who shall approach or come within the limits of the same, and all such 
furniture and other articles as shall be used or brought there shall be subject to 
such regulations as shall be made by the board of health, or of the committee 
appointed for that purpose.—? 1670, Howell's Statutes. 
Physicians, etc., 
to be subject to 
regulations of 
board, etc. 
(1730.) Sec. 39. When the small-pox or any other disease dangerous to the public 
health shall break out in any township, the board of health shall immediately pro- 
vide such hospital, or place of reception for the sick and infected, as they shall 
judge best for their accommodation and the safety of the inhabitants; and such 
hospitals and places of reception shall be subject to the regulations of the board of 
health, in the same manner as herein for established hospitals.—§ 1671 
Howell's Statutes. 
When board of 
health to provide 
hospital. 
(1733.) Sec. 43. If any physician or other person in any of the hospitals or places 
of reception before mentioned, or who shall attend, approach, or be concerned with 
the same, shall violate any of the regulations lawfully made in relation thereto, 
either with respect to himself, or his or any other person’s property, the person so 
offending shall, for each offense, forfeit a sum not less than ten nor more than one 
hundred dollars. @1674, Howell’s Statutes. 
Penalty for vio- 
lating regula- 
tions of hospi- 
tals. 
* Printed on page 19 of this article. 14 
HOSPITAL CONSTRUCTION, REMOVALS, NURSES, SUPPLIES. 
43. Hospital construction, ventilation, warming, etc—In the construction and 
management of hospitals great care should be had for the comfort, safety, 
and health of those confined in or connected with them, as well as for the 
safety of the public. 
The proper size and plan for such a hospital may vary somewhat for differ- 
ent localities; but a few general principles which should be considered may 
be mentioned here. Particular attention should be paid to ventilation. The 
foul air should be drawn off through an opening or openings in the floor or 
in the wall at the floor-level, into a heated flue open at the top. In cold 
weather the fresh air should be warmed before it enters, or as it enters the 
room. This may be done by a furnace or by steam coils in fresh air ducts. 
If stoves are used this can be done by jacketing the stove and providing an 
inlet pipe for fresh air from out door to the back of the stove within sheet- 
iron jacket, as described on pages 55-62 of the Report of the State Board of 
Health for 1879, and on pages 263-6 of the Report for 1880. 
44. Removal of sick or infected persons.—The law provides that the board of 
health “shall make effectual provision in the manner in which they shall 
judge best for the safety of the inhabitants,” sections 1706, 1731, and 1707, 
compiled laws of 1871 (§§1647, 1672, and 1648, Howell’s Statutes), being as 
follows:— 
(1706.) SEC. 15. When any person coming from abroad or residing in any township 
within this State shall be infected, or shall lately before have been infected, with the 
small-pox, or other sickness dangerous to the public health, the board of health of 
the township where such person may be shall make effectual provision in the man- 
ner in which they shall judge best for the safety of the inhabitants, by removing 
such sick or infected person to a separate house, if it can be done without danger to 
his health, and by providing nurses and other assistance and necessaries, which 
shall be at the charge of the person himself, his parents, or other person who may be 
liable for his support, if able; otherwise, at the charge of the county to which he 
belongs. § 1647, Howell’s Statutes. 
(1731.) Sec. 40. The board of health shall cause such sick or infected persons to be 
removed to such hospitals or places of reception, unless the condition of the sick 
person be such as not to admit of removal without danger to life; in which case the 
house or place where the sick shall remain shall be considered as a hospital to every 
purpose before mentioned, and all persons residing in or in any way concerned with 
the same, shall be subject to the regulations of the board of health, as before pro- 
vided. § 1672, Howell’s Statutes. 
(1707.) Sec. 16. If any such infected person cannot be removed without danger to 
his health, the board of health shall make provision for him as directed in the pre- 
ceding section, in the house in which he may be, and in such case they may cause the 
persons in the neighborhood to be removed, and may take such other measures as 
they may deem necessary for the safety of the inhabitants. § 1618, Howell’s. 
Board to make 
provision to pre- 
vent spread of 
small-pox, etc. 
3 Mich. Rep. 475 
61 Mich. p. 526. 
68 Mich, p, 454. 
When infected 
persons to be re- 
moved to hospi- 
tal, etc. " 
Provision in 
case infected 
persons cannot 
be removed. 
45. Nurses and necessary supplies.—Persons thus restrained at hospital or at 
home should be permitted to provide themselves, or the local board of health 
should provide them with the best nursing and medical care. The duty of 
the board of health is not primarily to assume the care and medical treatment 
of the person sick with small-pox or other disease dangerous to the public 
health, but to place that care and treatment under such regulations as will 
protect the community from the spread of the disease; but persons thus 
restrained for the public good are generally prevented from earning their 
own support, and the public in thus enforcing unusual conditions is bound 
to provide proper care and medical treatment, food, etc., for those not able 
to provide for themselves. The board of health is authorized and required 
to “provide nurses and other assistance and necessaries/’ at the charge of the CITY OR TOWNSHIP IS IMMEDIATELY LIABLE BUT THE CO. MUST PAY. 
15 
person sick, or of those liable for his support, if able (in which case the per- 
son sick will choose his own medical attendants), otherwise at the charge of 
the county to which he belongs. This is provided for by sections 1706 and 
1707, compiled laws of 1871, printed above. See also Third Michigan Report, 
page 475, in which the supreme court in 1855 granted a writ of mandamus 
to compel the board of supervisors of Macomb county to pay a claim for care 
of an indigent person sick with small-pox, which claim had been audited by, 
and was for services ordered by, the board of health of the village of Mt. Clem- 
ens, under section 1700 (§1647 Howell’s Statutes), being section 15, of chapter 
XLYI of the revised statutes of 1846. See also 51st Michigan, page 527, 
where it is held that the city is immediately responsible, and that ‘fin provid- 
ing that what is done shall be at the charge of the individual, it is not 
intended to exempt the public from immediate liability.” See also 58th Mich- 
igan, page 454, where it is held that the board of supervisors must pass such 
accounts and can be compelled by mandamus to do so, that they cannot 
refuse on the ground that the patients were themselves able to pay or that 
sundry taxpayers considered the charges exorbitant. 
46. Houses, supplies, nurses, etc., paid by the county in certain cases Nurses and 
attendants employed by the sheriff or other officer in accordance with section 
1709 (§1650 Howell’s Statutes), owners of houses, stores, lodgings, or other 
necessaries taken possession of by either of said officers in accordance with 
sections 1709-1712 (§1650-1653 Howell’s Statutes), and other persons 
properly employed by said officers to assist in the duties enjoined by said 
sections, are entitled to just compensation, to be paid by the county. This 
is provided by section 1714 (§1655, Howell’s Statutes), as follows: 
(1714) Sec. 23. Whenever the sheriff or other officer shall take possession of any 
houses, stores, lodgings, or other necessaries, or shall employ any nurse or attend- 
ants, as provided in this chapter, the several parties interested shall be entitled to a 
just compensation therefor, to be paid by the county in which such person or prop- 
erty shall have been so employed or taken possession of. 
Compensation 
for houses, 
nurses, etc. 
47. Duties of the local board of health—In view of known means of preventing 
and restricting small-pox, it would seem to be the duty of the local board of 
health:— 
(I.) Frequently to place before the people the importance of vaccination, 
and to recommend general vaccination of all persons who have not been 
successfully vaccinated within the preceding five years. The board of health 
is authorized by Act No. 146 of the laws of 1879, to offer free vaccination. 
The law reads as follows: 
Section 1. The People of the State of Michigan enact, That the board of health in 
each city, village and township may, at any time, direct its health officer or health 
physician to offer vaccination with bovine vaccine virus to every child not previously 
vaccinated, and to all other persons who have not been vaccinated within the pre- 
ceding five years, without cost to the persons [person] vaccinated, but at the expense 
of such city, village or township, as the case may be.—§1685, Howell’s Statutes. 
Board of Health 
authorized to 
furnish vaccina- 
tion. 
(II.) To enforce the law (sections 1734 and 1735, compiled laws of 1871, 
pages 7-8 of this document), requiring householders and physicians to give 
immediate notice of cases of small-pox and other diseases dangerous to the 
public health. What it is the duty of the board of health to require the 
people to do for their own safety it is the duty of the people to do without 
compulsion. The board of health should have as prompt notice of the out- 
break of a contagious disease as the fire department has of the outbreak of 
fire, and as hearty cooperation of citizens for the suppression of the disease 16 
LOCAL ACTION FOR PREVENTION AND RESTRICTION OF SMALL-POX. 
as is given the fire department for the suppression of fire. And when the 
board is informed it should act as promptly, and continue to act as faithfully, 
as is done for the extinguishing of a fire. 
(III.) To secure complete isolation of those sick or infected with small-pox. 
(IV.) To give the public prompt and full notice of infected places (section 
1732, compiled laws of 1871, printed below). 
(V.) In general, and in compliance with the following section of law, to do 
all that may be done by prompt and intelligent action to prevent the spread 
of disease. 
Notice of in- 
fected places. 
(1732) Sec. 41. When the small-pox, or any other disease dangerous to the public 
health, Is found to exist in any township [city or village*] the hoard of health shall use 
all possible care to prevent the spreading of the infection, and to give public notice of 
infected places to travelers, by such means as in their judgment shall be most 
effectual for the common safety.—§1673, Howell’s Statutes. 
(VI.) To secure and superintend the immediate and thorough disinfection 
of infected houses, material, etc., as directed in paragraphs 8-15, of this 
document. 
(VII.) Promptly to notify, by its clerk or health officer, the State Board 
of Health upon the first outbreak of small-pox, or any other disease danger- 
ous to the public health, in accordance with published requirements of the 
State Board of Health under section 8 of act No. 81, laws of 1873. 
48. The local board of health should make and publish regulations to prevent the 
introduction of disease into or its spread within its locality. 
Respecting ar- 
ticles capable of 
conveying conta- 
gion, etc. 
(1695.) Sec. 4. The said board shall also make such regulations as they may deem 
necessary for the public health and safety, respecting any articles which are capable 
of containing or conveying any infection or contagion, or of creating any sickness, 
when such articles shall be brought into, or conveyed from, their township, or into 
or from any vessel; and if any person shall violate any such regulation, he shall for- 
feit a sum not exceeding one hundred dollars.—§1636, Howell’s Statutes. 
The foregoing section of law is a very important one; but it is useful only 
after action has been taken by the local board of health; therefore, every 
board of health should make and publish and constantly maintain regula- 
tions to prevent the introduction or movement of articles capable of “ con- 
veying infection or contagion.” Such regulations should relate to: 
(1.) Persons sick with a communicable disease. (2.) Bodies of -persons 
dead of a communicable disease. (3.) Persons who have been with the dead 
or living bodies infected with a communicable disease, or in a room or place 
occupied by such a body. (4.) Baggage, clothing, food, drink, or other 
articles capable of conveying a communicable disease. 
Such regulations may be in some such form as follows: 
Regulations Relative to infectious Persons or Substances. 
No person sick with cholera, small-pox, diphtheria, scarlet fever, or any other dan- 
gerous communicable disease; no corpse of a person dead from one of the above named 
diseases; or from any other dangerous communicable disease; and no article which has 
been infected or is liable to propagate or convey any such disease, shall be brought into 
or removed within this [township, city or village, as the case may be,J without the 
special permit and direction of the board of health thereof. 
The foregoing regulations shall remain in force until revoked by the board of health 
of this [township, city or village.] 
Whoever violates the foregoing regulations incurs the penalty of the law. 
♦This section is made to apply to cities and villages by section 1740, compiled laws of 1871, as 
amended by act No. 146, laws of 1879 (§1681, Howell’s Statutes), printed on page 19 of this document. REGULATIONS. INSPECTION OF TRAVELERS. PERMITS. 
17 
Permits for the removal of infected persons or articles, in accordance with law, may- 
be granted by this board, and by its health officer w hen the board is not in session, 
under circumstances and conditions as recommended by the State Boai'd of Health. 
Signed, 
Members of the Board of 
Health of the [township, 
city, or village] of 
Regulations should also be made and published relative to the restriction 
of communicable diseases at hospitals or houses where they may be. Sec- 
tions 1667 to 1674, Howell’s statutes, relate to this subject; some of them 
are printed on pages 13-14. 
49. Notices of reflations of local boards of health.—Though a more general 
notice than is required by law should always be given of regulations made by 
local boards of health, the notice required by section 1698, compiled laws of 
1871 (§ 1639, Howell’s Statutes), should never be omitted, as on the giving of 
this notice might depend the success of legal proceedings begun by the board 
to enforce obedience to its regulations: * 
(1698.) Sec. 7. Notice shall be given by the board of health of all regulations made Notice of regu- 
by them, by publishing the same in soiM newspaper of the township, if there be one latjops, how 
published therein, and if not, then by posting them up in five public places in such 
township; and such notice of said regulations shall be deemed legal notice to all per- 
sons. § 1639, Howell’s Statutes. 
Section 1698 applies also to boards of health in cities and villages; and in 
general it should be remembered that by the amended section 1740 (§ 1681, 
Howell’s Statutes,) the provisions of all sections in chapter 46 of the compiled 
laws of 1871, including sections 1692-1744 and the amendments thereto, 
apply so far as applicable with equal obligation to the inhabitants and the 
boards of health in cities and villages, unless charter provisions conflict. 
(See Sec. 1740 in paragraph 56, page 19 of this document.) 
50. Inspection of travelers, restraint of infected persons.—Boards of health of 
townships, cities and villages near to or bordering upon neighboring States 
are by section 1708 (§1649, Howell’s Statutes) (made applicable to cities and 
villages by Act 145, laws of 1879, printed on page 19 of this pamphlet) author- 
ized to inspect travelers, and to restrain from travel within their jurisdic- 
tion, except by license from the board of health, persons coming from 
infected places in other States. Section 1708 is as follows: 
(1708) Sec. 17. The hoard of health of any township* near to or bordering npon 
either of the neighboring States, may appoint, by writing under their hands, suitable 
persons to attend any places by which travelers may pass from infected places in 
other States; and the persons so appointed may examine such passengers as they 
may suspect of bringing with them any infection which may be dangerous to the 
public health, and, if need be, may restrain them from traveling until licensed 
thereto by the board of health of the township to which such persons may come; and 
any person coming from such infected place, who shall, without license as aforesaid, 
travel within this State, unless it be to travel by the most direct way to the State 
from whence he came, after he shall he cautioned to depart by the persons appointed 
as aforesaid, shall forfeit a sum not exceeding one hundred dollars.—§1649, Howell’s 
Statutes. 
Board may re- 
strain travelers 
coming from in- 
fected districts. 
51. Permits for removal of an infected article or sick person may be granted 
by the board of health in its discretion. 
♦Made applicable to cities and villages by Act 145, laws of 1879 (§1681, Howell’s Statutes), printed on 
page 19 of this pamphlet. 18 
CONTROL OF INFECTED PERSONS, BAGGAGE AND GOODS. 
Board may per- 
mit removal of 
infected articles, 
etc. 
(1705.) Sec. 14. The board of health may graut permits for the removal of any nui- 
sance, infected article, or sick person within the limits of their township, when they 
shall think it safe and proper so to do.—§1646, Howell’s Statutes. 
52. Restraint and removal of infected persons.—In case of travelers and other 
persons infected with any disease dangerous to the public health, the law 
(section 1706, compiled laws of 1871, in paragraph 20, page 7, of this docu- 
ment) requires the local board of health to make effectual provision for the 
safety of the inhabitants,—including removal of the sick person to another 
house when this is best and can be done without danger to the health of the 
person sick, otherwise at the house where he may be. 
In removing and caring for any person infected with contagious sickness 
the board of health may make use of the sheriff or any constable of the 
county, by procuring a warrant signed by any two justices of the peace. 
Section 1709 permits this, and is as follows: 
Removal of per- 
sons infected. 
(1709.) Sec. 18. Any two justices of the peace may, if need be, make out a warrant 
under their hands, directed to the sheriff or any constable of the county, requiring 
him, under the direction of the board of health, to remove any person infected with 
contagious sickness, or to take possession of convenient houses and lodgings, and to 
provide nurses, attendants, and other necessaries for the accommodation, safety, 
and relief of the sick.—§1650, Howell’s Statutes. 
53. Control of infected baggage, clothing, goods, —By sections 1710-1713 the 
board of health is authorized to procure the detention, examination, and 
purification at the owner’s expense of any baggage, clothing or goods of any 
kind, found within the township, city or village, which there is just cause to 
suspect to be infected with any disease dangerous to the public health. These 
sections are as follows: 
Infected bag- 
gage, clothing, 
and goods, how 
secured. 
(1710.) Sec. 19. Whenever, on application of the board of health, it shall be made to 
appear to any j ustice of the peace that there is just cause to suspect that any bag- 
gage, clothing or goods of any kind found within the township are infected with any 
disease which may be dangerous to the public health, such justice of the peace shall, 
by warrant under his hand, directed to the sheriff or any constable of the county, 
require him to take with him as many men as the said justice shall deem necessary 
to secure such baggage, clothing, or other goods, and to post said men as a guard over 
the house or place where such baggage, clothing, or other goods shall be lodged, 
which guard shall take effectual care to prevent any person removing or coming 
near to such baggage, clothing, or other goods, until due inquiry be made into the 
circumstances thereof.—§1651, Howell’s Statutes. 
(1711.) Sec. 20. The said justice may also, by the same warrant, if it shall appear 
to him necessary, require the said officer, under the direction of the board of health, 
to impress and take up convenient houses or stores for the safe keeping of such bag- 
gage, clothing, or other goods; and the board of health may cause them to be 
removed to such houses or stores, or to be otherwise detained, until they shall, in the 
opinion of said board of health, be freed from infection.—§1652, Howell’s Statutes. 
(1712) Sec. 21. Such officer in the execution of such warrant, shall, if need be, 
break open any house, shop, or any other place mentioned in said warrant, where 
such baggage, clothing, or other goods shall be; and he may require sucb aid as 
shall be necessary to effect the execution of the warrant; and all persons shall, at 
the command of any such officer, under a penalty not exceeding ten dollars, assist 
in the execution of the warrant, if able to do so. § 1653 Howell’s Statutes. 
(1713.) Sec. 22 The charges of securing such baggage, clothing or other goods, and 
of transporting and purifying the same, shall be paid by the owners thereof, at such 
rates and prices as shall he determined by the board of health. § 1654, Howell’s 
Statutes. 
Impressing 
houses, etc., for 
keeping infected 
goods. 
Power of officer 
executing war- 
rant. 
Charges to be 
paid by owner. 
54. Small-pox in a jail.—The board of health may by written order secure 
the removal from a common jail to a hospital or other place of safety of a 
prisoner attacked with a disease dangerous to the safety and health of the 
other prisoners or of the inhabitants of the township, city or village. Sec- SMALL-POX IN JAILS AND POORHOUSES. 
19 
tions 1715 and 1716 authorizing and prescribing the manner of such removal 
are as follows: 
(1715.) Sec. 24. Whenever any person confined in any common jail shall be attacked 
with any disease, which, in the opinion of the physician of the board of health, or 
of such other physicians as they may consult, shall be considered dangerous to the 
safety and health of the other prisoners, or of the inhabitants of the township, the 
board of health shall, by their order in writing, direct the removal of such person 
to some hospital or other place of safety, there to be provided for and securely kept, 
so as to prevent his escape, until their further orders; and if such prisoner shall 
recover from the disease, he shall be returned to such jail. § 1656, Howell’s Statutes. 
(1716.) Sec. 25. If the person so removed shall have been committed by order of 
any court, or under any judicial process, the order for his removal, or a copy thereof, 
attested by the presiding member of said board of health, shall be returned by him, 
with the doings thereon, into the office of the clerk of the circuit court for the 
county; and no prisoner, removed as aforesaid, shall be considerod as thereby hav- 
ing committed an escape. § 1657, Howell’s Statutes. 
When prisoners 
attacked with 
dangerous dis- 
ease may be re- 
moved. 
Prisoners re- 
moved to be re- 
turned, and not 
to be considered 
as having 
escaped. 
55. Small-pox in a poorhouse.—On the outbreak in a county poorhouse or in 
the vicinity thereof of any pestilence or contagious disease likely to endanger 
the health of persons supported at the poorhpuse, the superintendents are by 
section 1717 required to remove to some other suitable place any or all of the 
persons there supported until they can safely be returned or otherwise be 
discharged. Section 1717 is as follows: 
(1717.) Sec. 26. Whenever any pestilence or contagious disease shall breakjout in 
any county poorhouse in this State, or in the vicinity thereof, and the?physician to 
such county poorhouse, or such other physician as the superintendents may consult, 
shall certify that such pestilence or disease is likely to endanger the health of the 
persons supported at such poorhouse, the superintendents of such county poorhouse 
Shall cause the persons there supported, or any of them, to be removed tojsome other 
suitable place in the same county, there to be maintained and provided for at the 
expense of the county, with all necessary medical attendance and care, until they 
-can safely be returned to such poorhouse, or otherwise discharged. § 1668 Howell’s 
Statutes. 
When superin- 
tendents of poor 
may remove 
paupers from 
poorhouses. 
56. Boards of Health in cities and villages. Certain Laws to 
townships are made applicable to cities and villages:— 
Section 1740, as amended by Act No. 145, laws of 1879 (§1681, Howell’s 
Statutes) is as follows: 
(1740.) Sec. 49. The mayor and aldermen of each incorporated city, and the presi- 
dent and council, or trustees of each incorporated village in this State, in which no 
board of health is organized under its charter, shall have and exercise all the powers 
and perform all the duties of a board of health as provided in this chapter, within 
the limits of the cities or villages, respectively, of which they are such officers. The 
provisions of this chapter [*] and the amendments thereto, shall, as far as applicable, 
apply to all cities and villages in this State, and all duties which are, by the pro- 
visions of this chapter L*] to be performed by the board of health'of townships, or by 
the officers and inhabitants thereof, shall in like manner be performed by the board 
of health and the officers and inhabitants of such cities and villages, with a like 
penalty for the non-performance of such duties, excepting in cases where the charters 
of such cities and villages contain provisions inconsistent herewith. 
Board of Health 
in cities and vil- 
lages, who to 
constitute. 
Duties of officers 
and inhabitants 
of cities and 
villages. 
*Chapter 46 of the Compiled Laws of 1871. 
In July, 1877, the Michigan State Board of Health passed a resolution advising and requesting all 
boards of health to offer every year free vaccination with bovine virus to every child not previously 
vaccinated and to all other persons not vaccinated within five years. The resolution was then, and 
has since been widely distributed throughout the State. Act 146, Laws of 1879 embodied this recom- 
mendation in law. 
October 23,1888, the State Board, by resolution, requested the boards of health of all the cities, vil- 20 
PREVENTION AND RESTRICTION OF SMALL-POX. 
lages, and townships in Michigan “to recommend the vaccination of all unprotected persons within 
their jurisdictions.” A circular to this effect was sent to every health officer in Michigan. 
This tract is a revised edition of the document issued hy this Board in It more fully sets 
forth the importance of vaccination, and other means for the prevention and restriction of small- 
pox. 
It is hoped that local hoards of health, newspapers, and all public-spirited persons will aid in 
spreading the information herein contained. 
Since the State Board of Health was established, many thousands of people in Michigan have been 
vaccinated because of its recommendations; and the statistics of deaths, published hy the Secretary 
of State, show- that at the close of the year 1884 the death-rate from small-pox in Michigan had been 
so much less than before the Board was established as to indicate that over one thousand lives had 
then been saved from that loathsome disease. We have now (at the close of 1888) added to that 
record four more years of comparative freedom from small-pox, which means a further saving of 
human life, due, it is believed, to the preventive measures—vaccination and revaccination, and the 
increased efficiency of local boards of health in restricting the disease. 
A copy of this document may he obtained by any person in Michigan hy addressing the Secretary 
of the State Board of Health, Lansing, Michigan.