COLUMBIA UBRARIES OFFSITE 
 
 HEALTH SCIENCES STAAJDARD 
 
 HX64117413 
 RC1 83 .M58 1 882 Prevention and restr 
 
 RECAP 
 
 Michigan. State Board of Health. 
 Prevention and Restriction of 
 wSmall-pox. 1862. 
 
Columbia (Bnit^ensttp 
 
 intljeCitpoflmlork 
 
 CoUege of ^Ijpgictang anb ^urgeonsi 
 Hibrarp 
 
Digitized by the Internet Archive 
 
 in 2010 with funding from 
 
 Open Knowledge Commons 
 
 http://www.archive.org/details/preventionrestri1882mich 
 
CD 
 
 CO 
 
 S PREVENTION AND RESTRICTION OF 
 
 ^ SMALL-POX. 
 
 [54.] 
 
 DOCUMENT ISSUED BY THE MICHIGAN STATE BOARD OF 
 
 HEALTH. 
 
 (Edition of 1832,-30,000 copies reprinted; from the Annual Report of the Board for 1331.) 
 
 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 vaccina- 
 tion. No intelligent person need have small-pox. 
 
 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 revaccinatioii 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 Avho 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, R. 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 t^e twenty-one children referred 
 to had the slightest touch of the disease. 
 
 * "Among those -who outlive it, many either totally or ptirtially lose their sight or hearing; many 
 are left consumptive, weakly, sickly, or maimed; many are disligured for life by horrid scars, and 
 become shocking objects to those who approach them, immense numbers lose their eyesight by 
 it.'"— ia ConUa7ni)ic. 
 
2 PEEVENTION 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 43 years of duty, Dr. Marson, physician of the London small-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 immu- 
 nity was shared by those — a much larger number — whom I had revaccinated, 
 and who at the same time were living in epidemic centers." — Dr. Warlemont, 
 of Brussels. — [North Carolina MedicalJournal, January, 1880. Vol. v., p. 2.] 
 
 3. Who should be vaccinated — Everybody, old and young, for his own inter- 
 est 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. Ic is believed that all persons except those mentioned in 
 the following paragraph may, if the operation is properly performed, 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 susceptible 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 vac- 
 cinated. In all cases in which there is any doubt as to the propriety of vaccin- 
 ating 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 
 been vaccinated, should, with the exceptions previously made, in paragraph 4, 
 
VACCINE VIRUS. d 
 
 be vaccinated at once. Because the vaccination often loses its protective power 
 after a time, those who have been vacciiKited but once or twice should, in order 
 to test and to increase the protective power of the former vaccination, be 
 vaccinated again and as often as the vaccination can be made to work. For 
 the Grst three or four scars tlie protection afforded is believed to be somewhat 
 in proportion to tlie number of good scars, conditioned always that the scars 
 be the result of a proper vaccination witli 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 tlian among those who have but one scar. 
 
 Vaccination as late as the second day after known exposure to small-pox, has 
 prevented the small-pox; vaccination the third day after exposure has been 
 know to render the disease much milder than usual, and, in a recent 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 vaccination which does not pro- 
 duce a vaccine vesicle, wliile it affords but little or no lasting protection against 
 small-pox, may prevent subsequent vaccinations from working well and becom- 
 ing 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 cleaned 
 lancet be used, no harm will result to the person vaccinated, and a good vaccin- 
 ation 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 its vaccination. But 
 because harm has 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 fol- 
 lows: — (l.j By the use of the bovine virus tliere 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 communi- 
 cating syphilis. (3.) The bovine virus is far more effective than the human- 
 ized 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 propagation of bovine 
 virus, a greater supply can bo always at command, and always, but especially 
 in times of urgent danger from small-pox people can have a better guarantee 
 that they are vaccinated with genuine and pure vaccine virus. 
 
4 PREVENTION OF SMALL -POX. 
 
 7. 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 try 
 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 feeling of 
 security. To trust to vaccination by nurses and midwives is equally foolish. 
 A well-educated and experienced physician has the skill, and the special knowl- 
 edge necessary to the best judgment on all of the questions involved, without 
 which the operation may be a failure or worse than a failure. In work of 
 this kind the best is the cheapest, whatever it costs. 
 
 8. 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 accord- 
 ing to the directions of Griffin's circular within ten days of the receipt of the 
 package their efficiency is guaranteed by him. Dr. Henry A. Martin, of 27 
 Dudley St., Boston, Mass., who claims the honor of being the first propagator 
 of bovine virus in the United States, propagates virus of the Beaugency stock. 
 Both Dr. Griffin and Dr. Martin are believed to be reliable propagators of 
 bovine vaccine virus. By request of the Michigan State Board of Health, Dr. 
 George E. Ranney, of Lansing, Mich., supplies to persons in Michigan order- 
 ing through him, the virus propagated by Dr. Griffin, at Dr. Griffin's prices, 
 the money to accompany the order. 
 
 9. "Where should vaccination be performed. — In a room or place free from per- 
 sons 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. 
 
 10. How to vaccinate. — In remote places it is sometimes necessary to vaccinate 
 persons who are practically beyond the reach of a competent physician. 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 convenient place for vac- 
 cination 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 : ^^Sc 
 If blood flows, wait, and wipe it off before applying the lymph. The^r^ 
 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 cool water smeared over it with 
 the lancet. Then rub tlie point over the scarified surface hrisJcly 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. 
 
FIRST EFFECTS OF VACCINATION. 
 
 between which and the arm a loose, soft cloth may bo fastened. Do not put 
 on a tight bandage or any plaster. Let no saliva touch the scratched place, 
 neither to atlix a plaster nor in any way. "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 dariger of communicating dis- 
 ease. Vaccination sometimes fails because the arm is not well scarified and 
 the virus is not thoroughly rubbed into the scarified surface. A skillful vac- 
 cinator 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 blis- 
 ter 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 vaccina- 
 tion 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 an 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 ofE 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 revaccination, — 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 dis- 
 tinguished 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 modified by the 
 influence of the previous vaccination, no true vesicle forms, but merely a pap- 
 ular 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 scabbing 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 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 height show it to the doctor who performed the 
 
6 PREVENTION OF SMALL -POX. 
 
 vaccination. If it is satisfactory, ask him for a certificate stating when and by 
 whom yon 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, he vaccinated again and as soon as possible, and 
 in the best manner possible. This will be a test of the protection secured by 
 the former vaccination, and will itself afford increased protection. 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 important 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 sometime 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 successfully vaccinated, or had the vario- 
 loid, 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 it 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 per- 
 sonal 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 eJBficient 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 fresh 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 
 protection aginst small-pox, may be a hindrance to successful vaccination with 
 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 lias been suggested that this may bo 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 
 
RESTRICTION OF SMALL -POX. V 
 
 by the cold, dry air and by tlio more abundant ozone in winter, the sore throat 
 supplyi.ig a phice wliere small-pox may easily bo inoculated ; it is known also 
 that in a warm, moist air vaccino virus decomposes more readily than in a cold, 
 dry air, and tiie same is probably true of small-pox virus. This greater lia- 
 bility to small-pox in winter makes it important that one should not wait till 
 •winter and its dangers have come before being vaccinated, and also that he 
 should not suffer the winter to pass without being vaccinated. 
 
 20. Small-pox not spontaneoiislv 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 bo kept 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, watei'closets, 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, 
 page 9. 
 
 22. Rags. — No person should handle old clothing or rags without taking pre- 
 cautions 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-houses. 
 
 KESTEICTION OF 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 should immediately be done, and 
 several other things should without fail be done in their proper order, some- 
 ■what as follows : — 
 
 1. Notice to the local board of health. — The house-holder 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 sections 1734 and 1735 of the 
 compiled laws of 1871, and in cities and villages by section 1740 of the com- 
 piled laws of 1871, as amended in 1879. Sections 1734 and 1735 (sections 43 
 and 44 of chapter 46), compiled laws of Michigan, 1871, are as follows: — 
 
 (1734.) Sec. 43. Whenever any householder shall know that any person within his Houseliolders to 
 family is taken sick with the small-pox, or any other disease dangerous to the public Ej'*'® not'ce of 
 }iealt}i,ho shall immediately give notice thereof to the Board of Health, or to the for neglect." ^ 
 Health Officer of the township [city, or village*! in which he resides; and if he 
 shall refuse or neglect to give such notice, he shall forfeit a sum not exceeding one 
 hundred dollars. 
 
 (1735.) Sec. 44. Whenever any physician shall know that any person whom he is pej,a](y qq ^jjy 
 called to visit is infected with the small-pox, or any other disease dangerous to the eician neglectiu" 
 public healthy such physician shall immediately give notice thereof to the Board of to glvo notice. 
 Health, or Health Officer of the township [city, or village*] in which such diseased 
 person may be; and every physician who shall refuse or neglect to give such notice, 
 shall forfeit, for each offense, a sum not less than fifty nor more than one hundred 
 dollars. 
 
 Section 1740, as amended by Act No. 145, laws of 1879, is as follows: — 
 
 (1740.) SEC. 49. The mayor and aldermen of each incorporated city, and the presi- Board of Health 
 dent and council, or trustees of each incorporated village in this State, in which no j" cities and vil- 
 board of health is organized under its charter, shall have and exercise all the pow- constitute. 
 ers and perform all the duties of a board of health as provided in this chapter, 
 within the limits ef the cities or villages, respectively, of which they are such 
 officers. The provisions of this chapter, and the amendments thereto, shall, as far 
 
 *See section (1740) Sec. 49, as amended by Act No. 145, Laws of 1879, on this and following page. 
 
o RESTRICTION OF SMALL -POX. 
 
 as applicable, apply to all cities and villages in this State, and all duties which are, 
 Dnties of officers ^^ ^^^ provisions of this chapter, to be performed by the board of health of town- 
 and inhabitants ships. or by the officers and inhabitants thereof, shall in like manner be performed 
 of cities and by the board of health and the officers and inhabitants of such cities and villages, 
 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. 
 
 2. Vaccination of attendants and all exposed. — The attendants on the sick 
 with sinall-pox and all other persons who it is feared have been exposed to 
 small-pox or varioloid, should immediately be vaccinated. If properly vacin- 
 ated. 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 page 3, paragraph 5, — Preven- 
 tion of Small-pox.) Unless the eruption has already appeared, vaccinate. 
 
 3. 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, bed- 
 ding, etc., should not be attempted after they have been exposed to infection, 
 unless properly disinfected under the direction of the health officer. (See 
 paragraphs 12 and 15, page 10, of this document.) 
 
 4. 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. 
 
 5. 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 twelve or fifteen days. 
 
 6. 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. 
 
 7. Who may attend small-pox patients. — Any person who has recently been 
 successfully vaccinated or revaccinated, or has recently had small-pox or vario- 
 loid, may attend on small-pox patients with comparative safety to himself, 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-])ox more 
 than ten years previously should rely uj)on such experience for security from 
 small-pox, if exposed by attendance on a person sick with small-pox or vario- 
 loid. 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."— ^V. M. Welch, M. D., in Philadelphia Health 
 Eeport, 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. 
 
DISINFECTION. 9 
 
 This is novr known to bo absolutely true for many persons, Init there is no one 
 period applicable to all persons, the fact being that while vaccination affords 
 at first almost absolute protection, its inQucnce is gradually worn out. Its pro- 
 tective influence is lost much sooner in some persons than in others, but 
 experience has shown (as in Philadelphia in 1871-2) that many children vac- 
 cinated in infancy have varioloid before they are seven years of age, while in 
 some instances one vaccination or one attack of small-pox protects the indi- 
 vidual 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 suscep- 
 tible 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.* 
 
 8. 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 10. In 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 running 
 stream nor into a cesspool. 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 so 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 disinfecting- 
 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 12, page 10. 
 
 Cotton, linen, flannels, blankets, etc., should he 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 fumi- 
 gated 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. 
 
 9. 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. 
 
 10. 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. 
 
 11. Care of rooms, etc., during sickness. — So far as consistent with the welfare 
 of the patient, the room throughout the sickness should be constantly ven- 
 tilated 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 practicable, 
 
 * These methods of disinfection are applicable in other contagious diseases, such 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. S) issued by the National Board of Health. 
 
10 KESTEICTION OF SMALL -POX. 
 
 or by fines 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 (men- 
 tioned 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. 
 
 12. Disinfection after death, recovery, or removal. — After death, recovery, or 
 removal there should take place, under the supervision of the healtii 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 clothing, 
 blankets, bedding, and other articles which cannot be treated with zinc-solu- 
 tion, should be opened and spread out so as to be freely exposed during fumi- 
 gation. 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 dis- 
 infected, 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 spoonful of alcohol and 
 a lighted match, and allow the rooms to remain closed for several hours. For 
 a room about ten feet square, two pounds of sulphur should be burned ; for 
 a larger room a proportionally larger quantity should be used, that is at the 
 rate of one and a half to two pounds of sulphur to each one thousand cubic 
 feet of air-space. 
 
 13. Carefully avoid breathing the fumes of the burning sulphur. — After fumi- 
 gation for several hours, the room should be thoroughly opened and aired, 
 before it is again occupied. 
 
 14. 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, page 9, and 
 bnried at once. Metallic, metal-lined, or air-tight cofiins should be used when 
 possible, certainly when tlie body is to be transported for any considerable 
 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. 
 
 15. Disinfection of rooms, clothing, etc., incidentally exposed to infection. — Hotel- 
 rooms, stores,* cars, boats, hacks or other enclosures which may have been 
 exposed to infection should be carefully disinfected by fumes of burning sul- 
 phur, as specified in paragraph 12. 
 
 IG. Punerals — 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 after- 
 wards be thoroughly disinfected by exposure for several hours to the fumes of 
 burning sulphur, as described in paragraph 12. 
 
UUSriTALS. 11 
 
 17. Care of convalescents. — After recovery the patient sliould not be allowed 
 to go abroad or to receive visitors until his clothing, etc., has been carefully 
 disinfected under the supervision of tiie health officer, and until he has 
 received from tiie health officer or from eomo competent physician a properly 
 authenticated statement which is approved by the health officer that there is 
 no longer any dutiger of his communicating tlie disease. 
 
 18. Hospitals for persons sick with diseases dangerous to the public health. — 
 As a means of preventing the spread of disease, tlio law authorizes tlie inhab- 
 itants of townships, cities, and villages to be constantly provided with hospitals 
 for the reception of persons having small-pox, or any other disease dangerous 
 to the public hcaltii ; 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 hos- 
 pitals, 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 con- 
 nected with said hospitals or abodes of the sick to be subject to the regulations 
 of the board of healtii, or of a committee appointed by the board of health 
 for that purpose. Sections 172G-1733 of the Compiled Laws of 1871, relating 
 to this subject, and by amended section 1740 (being Sees. 35-42, and 49 of 
 chapter XLVI.) made equally applicable to cities, villages, and townships, are 
 as follows : 
 
 (17-26.) Sec. 35. The inhabitants of any township may establish -within their town- Hospitals for 
 ship and be constantly provided -with one or more hospitals for the reception of goJ^,g^{i'°"iQg P"* 
 pei'sons having the small-pox, or other disease -which may bo dangerous to the sQiall-pox, etc. 
 public health. 
 
 (1727.) Sec. 3C. All such hospitals shall be subject to the orders and regulations of By whom hospi- 
 the board of health, or a conamittee appointed by such board for that purpose; but [^{^^g^® '"®^"" 
 no such hospital shall be established within one hundred rods of any inhabited ' 
 
 dvrelling-house situated in an adjoining township, without the consent of such 
 adjoining township. 
 
 (1728.) Sec. 37. If any person shall inoculate any other person, or inoculate him- Penalty for in- 
 self, or suffer himself to be inoculated, with the small-pox, unless at some hospi- "^'J^^''"" ^'^'^ 
 tal licensed and authorized by law, he shall, for each offense, forfeit a sum not cept at hospitals, 
 exceeding two hundred dollars. 
 
 (17-29.) Sec. 38. When any hospital shall be so established, the physician attend- Physicians, etc., 
 
 ing the same, the persons inoculated or sick therein, the nnrses, attendants, and <° "^f subject to 
 
 .,„, ,,,t regulations of 
 
 all persons who shall approach or come within the limits of the same, and all such ijo^rd, etc, 
 
 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. 
 
 (1730.) Sec. 3'). When the small-pox or any other disease dangerous to the public when board of 
 health shall break out in any township, the board of health shall immediately pro- healih to provide 
 vide such hospital, or place of reception for the sick and infected, as they shall °^P' '' 
 judge best for their accommodation and the safety of the inhabitants; anil such 
 hospitals and places of reception shall be subject to the regulations of the board of 
 health, in the same manner as hereinbefore provided for established hospitals. 
 
 (1733.) Sec. 42. If any physician or other person in any of the hospitals or places Penalty for vio- 
 of reception before mentioned, or who shall attend, approach, or be concerned luting regula- 
 with the same, shall violate any of the regulations lawfully made in relation there- t^"".^ ° 
 to, 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. 
 
 19. 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. 
 
12 RESTRICTION OP SMALL -POX. 
 
 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 the sheet-iron jacket, 
 as described on pages 55-63 of the Eeport of the State Board of Health for 
 1879, and on pages 263-6 of the Report for 1880. 
 
 20. 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, com- 
 piled laws of 1871, being as follows : — 
 
 Board to make (1706.) SEC. 15. 'When any person coming from abroad or residing in any township 
 provision to pre- -within this State, shall be infected, or shall lately before have been infected, with 
 emall-pox etc. *^^ small-pox, or other sickness dangerous to the public health, the board of health 
 of the township where such person may be shall make eflfectual provision in the 
 manner in which they shall judge best for the safety of the inhabitants, by remov- 
 ing such sick or infected person to a separate house, if it can be done without dan- 
 ger 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 
 3 Mich. Eep. 475. may be liable for his support, if able; otherwise, at the charge of the county to 
 
 which he belongs. 
 When infected (1731.) SEC. 40, The board of health shall cause such sick or infected persons to be 
 persons to be re- removed to such hospitals or places of reception, unless the condition of the sick 
 tal^'^efc*^ ^°*^'' 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 residingin or in any way concerned with 
 the same, shall be subject to the regulations of the board of health, as before pro- 
 vided. 
 Provision Incase (1707.) SEC. 16. If any such infected person cannot be removed without danger to 
 infected persons his health, the board of health shall make provision for him as directed in the pre- 
 cannot be re- 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. 
 
 21. 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 person sick, or of those liable 
 for his support, if able (in which case the sick person will choose his own med- 
 ical 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, 
 
DUTIES UF LOCAL BOARDS OF HEALTH. 15 
 
 the board of health of the vilhige of Mt. Clemens, under section 170G, being 
 section 15 of chapter XLVI. of the revised statutes of 184C. 
 
 22. Houses, supplies, nurses, etc., paid by the county in certain cases. — Nurses and 
 attendants employed by the sherill or other oihcer in accordance with section 
 1709, owners of houses, stores, lodgings, or other necessaries taken possession 
 of by either of said ollicers in accordance with sections 1709-1712, 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, as follows: 
 
 (17U.) Sec. 2a. Whenever the sheriff or other officer shall take possession of any ComponBation 
 houses, stores, lodgings, or other necessaries, or shall employ any nurse or attend- f""" •'cii«ee, 
 ants, as iirovidcd 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. 
 
 23. Duties of the local board of health — In view of known means of preventing 
 and restricting small-po-T, it would seem to be the duty of the local board of 
 health : — 
 
 (I.) Frequently to offer free vaccination at any time to all persons who have 
 not been successfully vaccinated within the preceding five years ; and constantly 
 to place before the people the importance of vaccination. This the board of 
 health is authorized to do by Act No. 146 of the laws of 1879, which reads as 
 follows : — 
 
 Section 1. The People of the Stale of Michigan enact. That the board of health in Board of Health 
 
 each city, village, and township may, at any time, direct its health officer or health ai'^'ip^ized to 
 
 t- .> I J furnish vaccina* 
 
 physician to offer vaccination wilh bovine vaccine virus to every child not prevl- jiou. 
 ously vaccinated, and to all other persons who have not been vaccinated within the 
 preceding five years, without cost to the persons [person] vaccinated, but at the 
 expense of such city, village, or township, as the case may be. 
 
 (II.) To enforce the law (sections 1734 and 1735, compiled laws of 1871, 
 page 7 of this document), requiring householders and physicians to give imme- 
 diate 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 i^aopU to do without compulsion. The 
 board of health should have as prompt notice of the outbreak of a contagious 
 disease as the fire department has of the outbreak of fire, and as hearty coope- 
 ration of citizens for the suppression of the disease as is given the fire depart- 
 ment 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 extin- 
 guishing 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 
 1733, compiled laws 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 introduc- 
 tion of disease. 
 
 (1732.) Sec. 41. When the small-pox, or any other disease dangerous to the public Notice of fn- 
 health, is found to exist in any township [city or village*] the board of health shall fected places. 
 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. 
 
 (VI.) To secure and superintend the immediate and thorough disinfection 
 of infected houses, material, etc., as directed in paragraphs 8-15, pages 9-10 
 of this document. 
 
 * See Sec. 1740, compiled laws of 1871, as amended by act No. 145, laws of 1879, printed on pages 
 7-S of this document. 
 
14 EESTEICTION OP SMALL -POX. 
 
 (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 dangerous 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. 
 
 24. Board of health should instruct its health officer. — 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 dan- 
 gerous to the public health occurs within its jurisdiction. Some of these 
 duties which the health officer should be directed to perform may be briefly 
 suggested as follows : — 
 
 He should— 
 
 a. Promptly verify the reports of cases of small-pox, and investigate sus- 
 pected cases which are not reported, so that he may act intelligently. 
 i. Secure the isolation of those sick with or exposed to small-pox. 
 
 c. See that no person suffers for lack of nurses, etc., because of isolation for 
 the public good. 
 
 d. In case of an outbreak of small-pox, secure a prompt vaccination of all 
 persons who have been or may be exposed to the disease. 
 
 e. Give public notice of infected places. (See paragraph 6, page 8, also 
 Sec. 1732, compiled laws 1871, page 13.) 
 
 /. Eegulate funerals of persons dead from small-pox, etc. 
 
 g. Disinfect rooms, clothing, and premises. 
 
 h. Give certificates of recovery and of freedom from liability to communicate 
 the disease. 
 
 i. Keep his own board of health, and the State Board of Health, constantly 
 informed respecting every outbreak of a disease dangerous to the public 
 health. (See paragraph (vii.) above.) 
 
 25. Notices of regulations 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, should never be omitted, as on the giving of this notice might depend 
 the success of legal proceedings begun by the jjoard to enforce obedience to 
 its regulations : 
 
 Notice of regu- (1698.) SEC. 7. Notice shaU toe given by the board of healtli of aU regulations made 
 
 lations, how by them, by publishing the same in some newspaper of the township, if there be 
 
 one publisheil therein, and if not, then by posting them up in five public places! n 
 
 such township; and such notice of said regulations shall be deemed legal notice to 
 
 all persons. 
 
 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 the 
 provisions of all sections in chapter 46 of the compiled laws of 1871, including 
 sections 1692-1744 and the amendments thereto, apply so as far applicable 
 with equal obligation to the inhabitants and the boards of health in cities 
 and villages, unless chai'ter provisions conflict. (See Sec. 1740 in paragraph 
 1, page 7-8 of this document.) 
 
 26. 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 (made applicable to cities and villages by Act 145, laws of 
 1879) authorized to inspect travelers, and to restrain from travel within their 
 jurisdiction, except by license from the board of health, persons coming from 
 infected places in other States. Section 1708 is as follows : 
 
CARE OF INFECTED PERSONS, BAGGAGE, CLOTHING, ETC. 15 
 
 (1708.) Sec, 17. Tho board of lic.-jlth of any township near lo or bordering upon Boardmayre- 
 elther of the ncighborinK .Stiilcs, may aiipoint, by writing under tlicir liands, suita- ■"■"'." "'*^r[* ," 
 Dle persons to attend any places by wliicli travelers may pass from infected places f,.cted difitricts. 
 in other States; and the persons so ai)i)olnt(;d may examine such pasfiengcrs as they 
 may suspect of bringing with them any infection wliich may be dangei-oiis to the 
 public health, and. If need bo, may restrain them from traveling until licensed 
 thereto by tho board of health of the township to which such persons may come; 
 and any person coming from such inftcted i)lace, who shall, without license aa 
 aforesaid, travel within this State, unless it bo to travel by the most direct way to 
 tho State from whence he came, after ho shall be cautioned to depart by the persons 
 appointed as aforesaid, shall forfeit a sum not exceeding one hundred dollars. 
 
 27. Permits for removal of an infected article or sick person may be granted 
 
 by the board of liealth in its discretion. 
 
 (1705.) Sec. 14. The board of health may grant permits for the removal of any nui- Board may per- 
 sance. Infected article, or sick iicrson within the limits of their township, when pi't rcrnovalof 
 ..,.>. ..I -..., . ^ J infected articles, 
 
 they shall think it safe and proper so to do. gj^ 
 
 28. Restraint and removal of infected persons. — In case of travelers and other 
 persons infected with any disease dangerous to the public health, the law (sec- 
 tion 1706 compiled laws of 1871, in paragraph 20, page 12, 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, otlicrwiso at tlie 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 1 709 
 permits this, and is as follows : 
 
 (1709.) Sec. IS, Any two justices of the peace may, if need be, may make out a war- Removal of per- 
 rant under their hands, directed to the sheriff or any constable of the county, sons infected, 
 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 accom. 
 modation, safety, and relief of the sick. 
 
 29. Control of infected baggage, clothing, goods, etc — Bysections 1710-1713 the 
 board of health is authorized to procure the detention, examination, and purifi- 
 cation at the owner's expense of any baggage, clothing, or goods of any kind, 
 found within the township, city, or village, Avhich there is just cause to suspect 
 to be infected with any disease dangerous to the public health. These sec- 
 tions are as follows : 
 
 (1710.) Sec. p. Whenever on application of the board of health, it shall be made Infected bag- 
 to appear to any justice of the peace that there is just cause to suspect that any gagf'i clo'hing, 
 baggage, clothing, or goods of any kind found within the township are infected with secured. ' 
 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 tako with him as many men as the said justice shall deem 
 necessary to secure such baggage, clothing, or other goods, anrl to post said 
 men as a guanl 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. 
 
 (1711.) Sec. 20. The said justice may also, by the same warrant, if it shall appear Impressing 
 to him necessary, require the said ofliccr, under the direction of the board of health, houses, etc., for 
 . I , • .. 1 . ^ .1 r ■, c 1. keeping infected 
 
 to impress and take up convenient houses or stores for the safe keeping of such goods. 
 
 baggage, 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. 
 
 (1712.) Sec. 21. Such oflicer in the execution of such warrant, shall, if need be, „ , _ 
 
 , , , , ^, , ..•.■-, ... Power of officer 
 
 break open any house, shop, or any other place mentioned in said Avarrant, where executing -war- 
 such baggage, clothing, or other goods shall be; and he may require such aid as rant. 
 
16 RESTEICTION OF SMALL- POX. 
 
 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 ahle to do so. 
 Charges to be (1718.) SEC. 22. The charges of securing such baggage, clothing, or other goods, 
 
 paid by owner, and of transporting and purifying the same, shall be paid by the owners thereof, at 
 
 such rates and prices as shall be determined by the board of health. 
 
 30. 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. Sections 
 1715 and 1716 authorizing and prescribing the manner of such removal are as 
 follows : 
 
 When prlBoners (1715.) SEC. 24. Whenever any person confined in any common jail shall be attacked 
 
 attacked with -with any disease, which, in the opinion of the physician of the board of health, or 
 
 ease^may be re- °^ such other physicians as they may consult, shall be considered dangerous to the 
 
 moved. 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 he returned to such jail. 
 
 p . (1716.) Sec. 25. If the person so removed shall have been committed by order of 
 
 moved to be re- ^ny court, or under any judicial process, the order for his removal, or a copy thereof, 
 
 turned, and sot attested by the presiding member of said board of health, shall be returned by him, 
 
 to be considered ^^^^ ^^^ doings thereon, into the office of the clerk of the circuit court for the 
 88 naving 
 
 escaped. county; and no prisoner, removed as aforesaid, shall be considered as thereby hav- 
 
 ing committed an escape. 
 
 31. Small-pox in a poorhonse — On the outbreak in a county pooi'house or in 
 the vicinity thereof of any pestilence or contagious disease likely to endanger 
 the health of persons supported at the poorhouse, 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 dis- 
 charged. Section 1717 is as follows : 
 
 Whensuperin- (1717.) SEC. 26. Whenever any pestilence or contagious disease shall break out in 
 tendents of poor any county poorhouse in this State, or in the vicinity thereof, and the physician to 
 P8^er8°from such county poorhouse, or such other physician as the superintendents may con- 
 poorbouaes. suit, 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 poor- 
 house shall cause the persons there supported, or any of them, to be removed to 
 some 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. 
 
 In July, 1877, the Michigan State Board of Health passed a resolution advising and requesting all 
 boards of health to offer every year free vacclnaton with bovine virus to every child not previously 
 vaccinated and to all other i)er3ons jiot vaccinated within five years. The resolution was then, 
 and has since been widely distributed throughout the State. This tract more fully sets fortli the 
 importance of vaccination, and other means for the prevention and restriction of small-pox. 
 
 It is hoped that local boards of health, newspapers, and all public-spirited persons will aid in 
 spreading the information lierein contained. It is recommended that every local board of health 
 secure copies of this tract, and place one copy in every household within its jurisdiction. Although 
 large numbers are distributed by the State Board of Ileallh, its distribution will not reach 
 every household, but to facilitate this the State Board has secured electrotype plates of this 
 tract; in English, from which coiiies can cheaply be reprinted. Copies of this tract may be had 
 of W. S. George & (Jo., Lansing, Michigan, at the following terms, cash to accompany order: 
 
 lOOcopiesfor S3 00 i 400 copies for S7 00 
 
 200 " " 4 .W 600 " " 8 00 
 
 300 " •• 6 00 I 1,000 " " 14 00 
 
 A copy of this document may be obtained by any person in Michigan by addressing the Secretary 
 of the State Board of Uealth, Lansing, Michigan 
 
COLUMBIA UNIVERSITY LIBRARIES 
 
 This book is due on the date indicated below, or at the 
 expiration of a definite period after the date of borrowing, as 
 provided by the library rules or by special arrangement with 
 the Librarian in charge. 
 
 DATE BORROWED 
 
 DATE DUE 
 
 DATE BORROWED 
 
 DATE DUE 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 »: • 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 C28 (747) MlOO 
 
 
 
 
GAYLAMOUNT 
 
 PAMPHLET BINDER ' 
 
 MonufacluttJ by , 
 eAYLORD BROS. I«c. 
 Syracux, N. Y. 
 Stockton, C«lif. r 
 
 I 
 
 L5e 
 
 ^:qi?3 1582 
 
 Mchigan, otate board of health. 
 
 Prevention r-nd restriction of 
 sn.6ll-pox. 
 
 SEP 7 
 
 r ,* (5 
 
 ^* U. BINDitii^y 
 
 RCIS3 
 
 ma 
 I88Z 
 
-^,P(^^ippijF»— 
 
 
 
 '■