(c) An inspection of the genitalia and anal region to determine the presence or absence of gonorrhea.

It shall be the duty of every physician making such medical examination to file with the department of health of the city of New York within 24 hours thereafter a report of the result of each examination upon official blank formas furnished for such purpose.

REG. 2. Specimens of blood and bodily discharges to be obtained.-It shall be the duty of every physician making a medical examination in accordance with the provisions of section 343m, chapter 264, laws of 1918, to obtain at the tit of such examination specimens of blood from the person so examined for the purpose of making the complement fixation tests for syphilis and gonorrhea, specimens of the bodily discharges from the urethra and the prostate gland. in the case of male persons, and from the urethra, vagina, cervix, and Bartholin'glands in the case of female persons, for the purpose of laboratory examination, and from suspicious lesions for microscopic examination to determine the presence or absence of Spirochete pallida. Such physicians shall place ali specimens obtained as aforesaid in suitable containers, to each of which sail containers shall be affixed a label or tag, upon which said label or tag the following information shall be clearly and legibly set forth in English:

(1) Name, age, and address of the person from whom such specimens have been obtained.

(2) Date when such specimens were obtained.

(3) Name and address of physician obtaining such specimens.

Such specimens shall thereafter be delivered to a laboratory of or one approved by the board of health of the department of health of the city of New York within 24 hours from the time such specimens have been obtained.

REG. 3. Specimens of blood and bodily discharges to be promptly examined.— All specimens of blood and bodily discharges, delivered by a physician to a laboratory of, or one approved by, the board of health of the department of health of the city of New York, in accordance with the provisions of regulation 2 of these rules and regulations, must be examined by a duly qualified person, who shall, within 24 hours after the receipt thereof, report the result of such examination, upon official blank forms furnished for such purpose, to the director of the bureau of preventable diseases of the department of health of the city of New York and to the physician delivering such specimens to the laboratory.

REG. 4. Treatment.-Every person who by the examination as provided for in section 343m of chapter 264, laws of 1918, is found to be suffering from or infected with any infectious venereal disease shall submit to the following prescribed course of treatment, administered at regular intervals over a sufficient period of time and until such person is no longer likely to infect or be a source of infection to any other person:

(a) If such person is found to be suffering from syphilis, treatment shall consist of the intravenous use of arsphenamine, or its analogues; the intramuscular injections of a suitable preparation of mercury or the administration of a suitable preparation of mercury by rubbing; and the local application of suitable medicinal preparations to prevent the spread of infection from open lesions or sores; or such treatment shall consist of such other suitable trestment as is recognized and administered by standard authorities, as Indicated in each particular case.

(b) If such person is found to be suffering from gonorrhea, treatment sha♬ consist of the use of suitable medicinal preparations, recognized by standar 1 authorities, administered by means of irrigation, injection, and instillation, as may be indicated in each particular case.

REG. 5. Isolation.-Every person who by the examination as provided for in section 343m of chapter 264, laws of 1918, is found to be suffering from or infected with any infectious venereal disease shall be removed to a hospital of, or one designated by, the board of health of the department of health of the city of New York, unless the following accommodations, facilities, and requirements can be and are provided at the home of such person for the proper isolation, medical care, and treatment of such infected person:

(a) Such infected person shall be attended by a duly licensed physician engaged by such person, who has been approved by the department of health of the city of New York, and such infected person shall visit, or be visited by, such physician at regular stated intervals.

(b) The room or rooms occupied by such infected person shall be separate and apart from the room or rooms occupied by other persons.

(c) Such infected person shall have a separate bed for his or her exclusive use. (d) A separate toilet and separate washing facilities must be provided for the exclusive use of such infected person.

(e) All the personal and bed linen, wash cloths, and sponges used by such infected person shall be kept separate and apart from those used by any other person and when soiled must be boiled or otherwise properly sterilized on premises.

(f) Whenever such person is suffering from or infected with syphilis, in communicable form, and likely to infect or to be the source of infection of any other person, all eating and drinking utensils used by such person must be kept separate and apart from those used by other persons and shall be boiled after each and every use.

(g) Whenever such person is suffering from or infected with syphilis, in communicable form, and is likely to infect or to be the source of infection of any other person, combs, hairbrushes, nail files, toothbrushes, and other toilet articles used by such person, shall be used exclusively by such infected person and shall be kept separate and apart from those used by other persons and shall be thoroughly cleansed after each use.

REG. 6. Prohibited acts and employment.-Whenever such person is suffering from or infected with syphilis, in communicable form, and is likely to infect or to be the source of infection of any other person, such infected person shall not eat or drink in any hotel, restaurant, drug store, saloon, or other public eating or drinking place, nor shall any such infected person use any eating or drinking utensil at any place where food or drink is served, sold, or dispensed to the public, nor engage in the preparation or manufacture of food, drink, beverages, cigars, tobacco, liquors, smoking pipes, cigar or cigarette holders, toothbrushes, intended for human use, except for the sole and exclusive use of the person so engaged, nor shall any such infected person sell or distribute any such articles.

REG. 7. Removal of convicted person to hospital of, or one approved by, the department of health of the city of New York.-Whenever a convicted person, as defined by section 343n, chapter 264, laws of 1918, has been found, after the medical examination provided for in section 343m of chapter 264, laws of 1918, to be suffering from or infected with an infectious venereal disease, and who has been committed by a court of competent jurisdiction to a correctional or penal institution, and who, at the termination of the period of commitment, is found by a physician of the department of health, or, at the option of the person to be examined, by a licensed physician who, in the opinion of the director of the bureau of preventable diseases, is qualified for this work and is approved by him, to be suffering from or infected with an infectious

venereal disease and is likely to be a source of infection to other persons, such infected person shall be removed to a hospital of, or one designated by, the board of health of the department of health of the city of New York, unless I'v accommodations, facilities, and requirements prescribed by regulation 5 of the rules and regulations, for the isolation and medical care and treatment of such person can be and are established and provided at his or her home.

REG. 8. Duty of attending physician.-No physician shall examine or treat any suspected or convicted person as provided for in section 343m and section 344% chapter 264, laws of 1918, unless such physician shall have first received the approval, in writing, of the director of the bureau of preventable diseases of the department of health of the city of New York. Upon receiving the approval of said director it shall be the duty of every such physician immediately upa discovering that such suspected or convicted person is suffering from or in fected with an infectious venereal disease to cause such person to be isolated n accordance with regulation 5 of these rules and regulations. If such physic.n suspects the presence of venereal disease in the person so examined, but is un able to make a positive diagnosis at the time of such examination, but is of the opinion that the patient may be infected with an infectious venereal diseas he should secure the isolation of such patient and take such other necessary precautions as will prevent danger of the spread of the disease until a positive diagnosis is made. Every such physician shall promptly report, in writing, to the director of the bureau of preventable diseases of the department of hea'th the refusal, neglect, or failure of any person suffering from an infections venereal disease, who is under his care and treatment, to comply with the requirements of regulations 4 and 5 of these rules and regulations.

REG. 9. Termination of isolation and treatment.-Whenever it shall appear to the satisfaction of the director of the bureau of preventable diseases of the de partment of health of the City of New York that a person, who by the examination provided for in section 343m, chapter 264, laws of 1918, is found suffering from or infected with an infectious venereal disease is no longer likely to infect or to be a source of infection to any other person, the said director of the bureau of preventable diseases may terminate the isolation and treatment of such person, provided for in these rules and regulations.

REG. 10. Removal of persons infected with infectious venereal diseases.—— Whenever an inspector or other duly authorized representative of the de partment of health shall report, in writing, to the director of the bureau of preventable diseases of said department that any person infected with an infectious venereal disease has failed, neglected, or refused to comply with the provisions of regulations 4 or 5 of these rules and regulations and that the continuance of such person in the place where he or she resides is dangerous to the lives and health of other persons, said director may cause the removal of such person to a hospital of, or one designated by, the board of health of the department of health of the city of New York. The report referred to shall contain a detailed statement showing the facts and evidence including the clinical and laboratory findings, if practical, and facts as to home conditions upon which such inspector or other duly authorized representative bases his opinion that such person is a danger to others. Upon the receipt of said report. the said director of the bureau of preventable diseases shall carefully review the facts and evidence embodied in or accompanying said report and if. In his opinion, the person referred to therein is, under the circumstances, a menace la the lives and health of other persons, he shall make an order directing the medical officer in charge of a hospital of, or one designated by, the board of health of the department of health of the city of New York, authorizing and

directing [sic] the removal of such person from the place where he or she may be to such hospital. The original order authorizing and directing the removal of such person to the hospital shall be delivered to the medical officer in charge of said hospital and shall constitute his authority to remove to, and detain such person at, such hospital for proper medical care and treatment. During the period of such detention, the prescribed course of treatment, provided for in regulation 4, of these rules and regulations, shall be administered to such person. Such person shall be detained at such hospital until such time as the medical officer in charge of such hospital determines that such person is no longer likely to infect or to be a source of infection of any other person. Upon determining such fact, the said medical officer in charge, of such hospital shall make a written report to the director of the bureau of preventable diseases of the department of health recommending the discharge of such person. The director of the bureau of preventable diseases shall thereupon order the discharge of such person from such hospital: Provided, however, If the medical officer in charge of a hospital wherein such person is detained does not recommend the discharge of any person in the manner hereinbefore provided, such detained person may make application to the director of the bureau of preventable diseases to be discharged. The said director shall thereupon make an investigation of the facts and circumstances surrounding the detention of such person and determine whether or not such person can be discharged without danger to the lives and health of other persons. If such director shall determine that such person is no longer likely to infect or be the source of infection to other persons, he shall direct the medical officer in charge to discharge such person from such hospital. If the said director, however, determines that such person, if released from such hospital, is likely to infect or be a source of infection of other persons, he shall deny the application and notify such detained person of his decision.

Syphilis and Gonorrhea—Dispensaries—Conduct and Maintenance. (Reg. Bd. of H., June 28 and July 31, 1917.)

SEC. 223. Dispensaries; communicable disease; regulations.-No public dispensary where communicable diseases are treated or diagnosed shall be conducted or maintained otherwise than in accordance with the regulations of the board of health.

REGULATIONS GOVERNING THE CONDUCT AND MAINTENANCE OF DISPENSARIES WHEREIN HUMAN BEINGS AFFECTED WITH SYPHILIS OR GONORRHEA ARE TREATED OR CARED FOR, AND RELATING TO SECTION 223 OF THE SANITARY CODE.

A.

SYPHILIS.

REGULATION 1. Treatment of syphilis; special department.-The treatment of syphilis, whatever its manifestations, shall be conducted in a special department maintained for such purpose, or in the department for dermatology connected with the dispensary or hospital: Provided, however, When the nature of the part affected, such as the eye, throat, viscera, etc., necessitates treatment in some other department of the dispensary, treatment may be given jointly by the two departments.

REG. 2. Microscopical examination required.—Every department for the treatment of syphilis shall make microscopical examinations of all suspected lesions.

REG. 3. Wassermann_tests.-Laboratory facilities for making Wassermann tests should be provided in every dispensary. If such laboratory facilities are not so provided, provision shall be made for the prompt delivery of specimens to the department of health or other approved laboratories where such tests are made.

REG. 4. Number of patients to be treated. The number of patients to be treated at a dispensary shall be regulated by the number of physicians in attendance and the equipment and facilities provided in the dispensary. The maximum number of patients treated by a physician shall not exceed 10 per hour.

REG. 5. Salvarsan or its analogues to be administered.—In view of the fact that the obligation to render a person affected with an infectious disease innocuous at the earliest possible moment rests on the institution to which the patient has applied for treatment, salvarsan or its analogues, in sufficient quantities and at proper intervals, shall be administered, with the addition of mercury or other accepted means of treatment, to all cases of syphilis.

REG. 6. Records.—A complete and adequate record shall be kept of every case of syphilis treated at a dispensary. Such records shall not be open to inspection by the public or to any person other than the representatives of the department of health of the city of New York, and such persons as may be authorized by law to inspect such records.

REG. 7. Follow-up system.-A follow-up system, approved by the department of health, to secure regular attendance by patients shall be established and maintained.

REG. 8. Procedure governing the discharge of patients.—A standard procedure governing the discharge of patients shall be followed. Such standard shall embrace suitable tests and subsequent persistent observations.

REG. 9. Dispensaries to be open at least three days a week.-Dispensaries shall be open at least three days a week.

B.

GONORRHEA.

REGULATION 1. Microscopical examination required.-Systematic microscopical examinations of all discharges shall be made in every department of a dispensary wherein persons affected with gonorrhea are treated or cared for.

REG. 2. Facilities to be provided.-Every department of a dispensary wherein persons affected with gonorrhea are treated or cared for shall be provided with and employ proper facilities for asepsis and antisepsis.

REG. 3. Urethroscopic and cystoscopic work to be performed.-Every dispensary shall be provided with facilities for urethroscopic and cystoscopic work, and such facilities shall be regularly employed by the physicians in attendance. REG. 4. Complement fixation test to be performed.-Every such dispensary should be provided with facilities for making a complement fixation test for gonorrhea. If such facilities be not provided at the dispensary, proper provision shall be made for the prompt delivery of specimens to the department of health or other approved laboratories where such tests are made.

REG. 5. Number of patients to be treated.-The number of patients to be treated at a dispensary shall be regulated by the number of physicians in at tendance and the equipment and facilities provided in the dispensary. The maximum number of patients treated by a physician shall not exceed 10 per hour.

REG. 6. Records.-A complete and adequate record shall be kept of every case of gonorrhea treated at the dispensary. Such records shall not be open to