CASES OF COMMUNICABLE DISEASES REPORTED TO THE SECRETARY OF THE 1 BULLETIN OF THE VERMONT STATE BOARD OF HEALTH. Volume VIII. No. 2. Issued Quarterly at Brattleboro, Vermont. The Bulletin is published quarterly by the State Board of Health under the authority of Section 5 of Act No. 90, Legislature of 1900. It will be sent to all Boards of Health. A copy will be sent to any person in the state upon request addressed to the Secretary, Henry D. Holton, Brattleboro. It is essential that all town and city clerks should make prompt and accurate returns of all marriages, births and deaths occurring in their respective towns, semi-annually, as the law requires. See No. 140, of the Acts of 1904, as amended in 1906. Section 2 of this act reads as follows: Section 2. Town and city clerks shall receive, number and file, in the order in which they have occurred, all certificates of births, marriages and deaths, in their respective towns and cities; they shall preserve all certificates of births, marriages and deaths, and all burial, removal and transit permits returned to them under this act. Town and city clerks shall at least once in five years procure all certificates and permits received by them under the provision of this act to be bound in volumes of convenient size and indexed, and the same, as well as said certificates and permits before being bound, shall be kept and remain in each town or city clerk's office as permanent records. Marriage certificates shall be bound in one volume or series, birth certificates in another volume or series, and death certificates, burial, removal and transit permits shall be bound in another. Town and city clerks shall semi-annually, in the months of February and August, transmit to the secretary of the State Board of Health a certified copy of each birth, marriage and death certificate received by them during the six months last preceding the first days of January and July, respectively, of each year in which the copy is made, such copy to be upon blank forms furnished by the secretary of the State Board of Health. Town and city clerks shall receive the sum of ten cents for each birth, marriage and death certificate certified as above; which sum with the cost of binding the certificatès and permits specified in this section shall be paid from the town or city treasury. Section 1 provides that "the town and city clerk shall once each year notify each physician, midwife or other person required to make reports of births and deaths under this act, that he is prepared to furnish each with the requisite blanks." The copy of the birth, marriage and death certificate should be promptly and carefully made, the chief and contributing causes of death both being plainly stated. These returns should be in the office of the secretary of the State Board not later than February and August, respectively. If the town or city clerk fails to make these returns within the time required, he is subject to a penalty. See No. 190, of the Acts of 1906. Section 1 reads as follows: Section 1. A state, county, town, village, fire district or school district officer who willfully neglects to perform the duties imposed upon him by law, either express or implied, shall be imprisoned not more than one year or fined not more than one thousand dollars, or both. The secretary does not desire to see this penalty enforced, but not only WISHES the reports but MUST HAVE THEM, and if to get them, as the law provides, it is necessary, in certain cases to see that the penalty be enforced, the responsibility for such required enforcement will be upon the clerk who fails to comply with the statute. If any physician or midwife or other person neglects to make a return of a birth as required in Section 8, or if a physician who is last in attendance upon a deceased person fails to file a certificate of death as required in Section 9 of this act, the town clerk should take such measures as will cause a prompt compliance with the law. There is no excuse for neglect to report at the proper time. In too many instances failure to report both births and deaths has occurred, until weeks or even months after they should have been reported, such births and deaths sometimes being returned in the subsequent period, after the tables for the period in which they belong have been made up, thus requiring an entire change in many of the tables. The health officer should refuse to issue a burial permit until all the questions on the certificate of death are answered and the causes of death properly stated. The secretary has been obliged to write over 300 letters to physi sians and town clerks in order to get necessary accurate facts to enable him to properly classify the causes of death, as well as to make, as he is required to do, an acceptable return to the Census Bureau in Washington. For instance, the report gives as a cause of death, "hemorrhage"; inquiry is made as to the cause of the hemorrhage; the reply comes, "hemorrhage from the bowels, caused by typhoid fever." Either that important fact did not appear in the original certificate, or the town clerk failed to copy it. It should be kept in mind by every person having to do with either the certificates or the abstract reports that the secretary never sees the original certificates, which the law requires shall be kept in the town clerk's office as a permanent record. Hence the reason for urging that the certificates be accurately and fully filled out and plainly written. The same request applies to the filling out of the abstracts. The law provides that the physician, the health officer and the clerk shall each receive a fee for their respective labors in these cases and it also provides a penalty for failure so to do. Work of Laboratory. In the last three months the laboratory has accomplished a very large amount of work. About 1,600 specimens other than milk have been examined. Examinations of milk have been 138, of which two thirds have been practically clean milk; seven below standard; one was watered. This makes three specimens of watered milk found in the last six months. All of these venders have been fined each $50, which they paid. Inquiries having been made by some physicians relative to the quarantine in cases of diphtheria, the following statement is made: A circular was issued some time since, relative to diphtheria, in which certain regulations were promulgated, under the authority as given in Section 7 of No. 113, Acts of 1902, as amended in 1904 and 1906, for the control of this disease. (Copies of these regulations can be had on application to local health officers, or the secretary of the State Board.) It directs that the attending physician should immediately report the case to the local health officer, that a culture should be taken from the throat and nose and sent to the Laboratory of Hygiene, Burlington. This is a part of the duty of the attending physician. When, in his opinion, the time has come when the question of releasing the patient from quarantine is to be considered, there must be two specimens or cultures of the secretions from the throat and nose, taken three days apart, sent to the laboratory and each found free from the Klebs-Loeffler bacillus, before the patient should be released. The expense of taking these cultures and the postage for sending them to the laboratory should be charged by the attending physician as a part of his attendance on the case. Always remember that it is letter postage. Under the authority of Act No. 113, of 1902, the following rules and regulations are promulgated by the State Board of Health of Vermont relative to the care of slaughter houses, the conduct of the business in such houses and the care of the carcasses of slaughtered animals, or meat products contained therein. RULE 1. (a) All establishments in which animals are slaughtered, or the meats and meat food products are prepared, cured, packed, stored, or handled, shall be suitably lighted, ventilated, supplied with running water, and maintained in a sanitary condition. All employees shall keep themselves clean. All work in such establishments shall be performed in a cleanly and sanitary manner. All yards, premises adjacent to such establishments, or parts of the building, whether used or not, shall be maintained in a sanitary condition. The feeding of swine or other animals on the refuse of slaughterhouses will not be permitted on the premises and no use incompatible with proper sanitation shall be made of any part of the premises on which such establishment is located. (b) Ceilings, side walls, pillars, partitions, etc., shall be frequently whitewashed or painted, or, where this is impracticable, they shall, when necessary, be washed, scraped, or otherwise rendered sanitary. Where floors or other parts of a building, or tables or other parts of the equipment, are so old or in such condition that they cannot readily be made sanitary, they shall be removed and replaced by suitable materials or otherwise put in a condition acceptable to the local board. All floors upon which meats are piled during the process of curing shall be so constructed that they can be kept in a clean and sanitary condition, and such meats shall also be kept clean. (c) All trucks, trays, and other receptacles, all chutes, platforms, racks, tables, etc., and all knives, saws, cleavers, and other tools, and all utensils and machinery used in moving, handling, cutting, chopping, mixing, canning, or other process, shall be thoroughly cleansed daily, if used. (d) The aprons, smocks, or other outer clothing of employees who handle meat in contact with such clothing shall be of a material that is readily cleansed and made sanitary, and shall be cleansed daily, if used. Employees who handle meats or meat food products shall be required to keep their hands clean. (e) All toilet rooms, urinals, and dressing rooms shall be entirely separated from compartments in which carcasses are dressed or meats or meat food products are cured, stored, packed, handled, or prepared. They shall be sufficient in number, ample in size, and kept in a thorough sanitary condition. (f) The rooms or compartments in which meats or meat food products |