authorized representative of the Illinois Department of Public Health is strictly prohibited. The health officer shall hand the attendant or some responsible member of the household a copy of these rules and instruct such person in their requirements.

RULE 4. Isolation of patient and other necessary precautions.-Any person having influenza, together with the necessary nursing attendant, shall be confined to a large, well-ventilated room of proper temperature, remote from other occupants of the premises.

The period of isolation shall continue during the course of the disease and until all clinical manifestations of the disease have disappeared and the temperature has been normal for five successive days.

None other than the necessary medical and nursing attendants shall enter the sick room or come in contact with the patient. The attendant shall avoid contact with other members of the household. He should wear a face mask of gauze or other approved material when in attendance upon the patient, and such mask shall not be removed from the sick room until it has been properly sterilized.

Visiting on premises on which a known or suspected case of influenza exists is strictly prohibited.

All discharges from the respiratory tract, mouth, throat, and nose of the patient shall be received in cloths, which shall be burned immediately after using or placed in vessels containing an approved disinfecting solution.

Soiled body and bed clothing shall be disinfected by boiling or by immersion in an approved disinfecting solution, such as a 5 per cent compound cresol solution. Any article used by the patient or attendants, such as knives, forks, spoons, glasses, cups, plates, etc., must be disinfected before leaving the sick room. Floors, furniture, and woodwork should be wiped up daily, employing cloths moistened with an approved disinfecting solution.

When the foregoing precautions are properly observed, other occupants of the premises who show no evidence of illness need not be confined to the premises. It is required, however, that persons residing on premises on which a case of influenza exists shall refrain from attending public gatherings and avoid unnecessary contact with other persons.

It shall be the duty of the local health authority to determine if the foregoing precautions are being observed, and wherever it is discovered that proper observance is not exercised to immediately place the premises and all inmates thereof under strict quarantine, prohibiting inmates from leaving the premises and others from entering the premises, excepting the necessary medical attendant.

Whenever a case of influenza is found in an indigent family, the same shall be promptly reported to the overseer of the poor (usually the supervisor) in order that such family may be provided with necessities.

RULE 5. Hospital regulations.-Whenever influenza is epidemic or threatens to become epidemic in the community visitors shall be excluded from hospitals, asylums, and other similar institutions, except in case of actual emergency, such as impending death, and shall be admitted then only when every precaution has been taken to protect the patient, attendants, and other inmates, the visitor, and the public.

Whenever patients suffering from influenza are treated in a hospital housing patients suffering from other diseases, the quarters assigned to influenza patients shall be so isolated as to avoid contact with uninfected persons.

When more than one patient suffering from influenza is housed in a ward or room, sneeze sheets of approved pattern shall be employed for each patient.

Whenever any patient suffering from influenza develops pneumonia, that patient shall be promptly removed from the quarters occupied by other influenza patients and properly isolated, either in a private room or with other patients who have developed pneumonia in association with or following influenza.

RULE 6. Instruction; duty of physicians.-It shall be the duty of every physician attending a case of influenza to see that the patient and attendant are properly isolated in accordance with these rules, to advise the patient, the members of the family and household, and the attendant as to the nature of the disease, the means whereby infection may be avoided, and the provisions of these rules.

RULE 7. Removals.-No case of influenza shall be removed from the premises on which found unless consent to such removal be first obtained from the local health authority or from the Illinois Department of Public Health.

No case of influenza shall be removed from any city, village, township, or county in which it is found unless consent to such removal be first obtained from the health authorities of the jurisdiction from and to which removal is contemplated, and from the Illinois Department of Public Health: Provided, however, That whenever a contagious disease hospital maintained by a municipality or county is located in another health jurisdiction from that in which the case is found, the patient may be removed to such contagious disease hospital without first obtaining the permission of the Illinois Department of Public Health.

RULE 8. Exclusion from school, public and private gatherings.—It shall be the duty of the principal or any other person in charge of any private, public, parochial, or Sunday school to exclude therefrom any child, teacher, or other person afflicted with influenza or suspected influenza until such child, teacher, or other person shall have presented a certificate issued by the local health authority, if he is a physician, or by the attending physician, countersigned by the local health authority, certifying that such child, teacher, or other person is noninfectious.

Any child, teacher, or other person who is an inmate of a household in which there is any person suffering from influenza shall be excluded from any private, public, parochial, or Sunday school and from public or private gatherings, until the termination of the quarantine of the premises.

RULE 9. Disposal of the dead.-Disposal of the body of anyone dead from influenza shall be effected within 48 hours. The undertaker or person acting as such shall wash the body with an approved disinfecting fluid and close all orifies with absorbent cotton. The body shall then be placed in the casket or coffin which shall be immediately closed and shall remain in the sick room until removal for burial or other disposal. The casket or coffin shall be air-tight and permanently sealed and must not be opened under any pretext whatever: Provided, however, That a plate of glass of sufficient size to disclose the face of the decedent may be fitted into the coffin cover in such manner as to be airtight and not removable.

Prior to the removal of the body the undertaken or person acting as such shall secure a burial permit from the local registrar of vital statistics in accordance with the provisions of the statutes.

Every human body dead from influenza, interred in any burying ground or cemetery in Illinois shall be buried so that the top of the outside coffin shall be at least 4 feet below the natural surface of the ground and shall be immediately covered with at least 4 feet of earth, soil, or sand: Provided, That this shall not apply where bodies are placed or buried in properly constructed private vaults so as to prevent the escape of gases therefrom.

When the body of anyone dead from influenza is to be transported by railroad or by other common carrier, the official rules of the Illinois Department of Public Health for the transportation of the dead shall be strictly observed. In preparing the body the undertaker or person acting as such shall take such precautions as not to cause, contribute to, or promote the spread of the disease.

Public funerals are permissible in deaths from influenza when the foregoing conditions are observed.

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RULE 10. Terminal disinfection.-Upon the termination of the case, the premises occupied by the patient shall be given a thorough cleansing, airing, and sunning.

RULE 11. Spitting in public places.-Inasmuch as the infective organism of influenza is harbored in the respiratory tract, nose, mouth, and throat, discharges from same shall not be cast in public places. All such discharges should be received in handkerchiefs or cloths which, after using, shall be burned or be disinfected by boiling or immersion in any approved disinfectant.

Trachoma-Reports of Cases-Isolation-Information to Be Given Patient and Members of Household-Precautions by Patient-Duties of Local Health Authorities-Removal of Patient to Another Health JurisdictionAttendance at Schools and Gatherings. (Reg. Dept. of Public H., Effective Oct. 1, 1920.)

RULE 1. Reports.-Every physician, nurse, or other attendant, superintendent of any hospital, asylum, orphanage, jail, or similar institution, teacher in any school, proprietor of any drug store, proprietor of any hotel, lodging or boarding house, parent, guardian, householder, or any other person having knowledge of a known or suspected case of trachoma, shall within 12 hours of such knowledge of such known or suspected case of trachoma coming to his notice, report the same in writing or by telephone to the local health authority. Every case reported by telephone shall be followed with a written report within 12 hours. Upon receipt of such report the local health authority shall within 12 hours forward copy of the same to the State department of public health, Springfield, Ill. Every case developing on the premises subsequent to the first reported case shall likewise be reported.

Note. The term "the local health authority," as employed in these rules shall be understood to mean the local health officer, health commissioner, or chairman of the board of health, as the case may be.

If the municipality has no health officer, reports must be made to the mayor of the city, president of the village, or the official designated by ordinance to receive the same. Cases occurring in territory outside of the limits of a municipality must be reported to the persons designated by the rules of the township or the county board of health to receive such reports, or, if there be no such person designated, reports must be made to the supervisor of the township or, in counties not under township organization, to the county board of health.

RULE 2. Information to be given in report to health authorities.—The written report of a known or suspected case of trachoma, required by these rules, shall set forth at least the following information: (1) Place and date of report; (2) name, exact address, age, sex, color, and occupation of the diseased person; (3) number of children and adults in household; (4) school attended or place of employment, giving names and [addresses of] employers and mentioning particularly any engaged in handling milk or foodstuffs; (5) type of disease; (6) date of onset of illness; (7) precautions taken to prevent spread of infection; (8) name and address of person making the report.

RULE 3. Isolation.-Unless the person suffering from trachoma is under the care of a physician and complies with the rules governing the control of the

disease, he shall be isolated during the persistence of the inflammation of the conjunctiva and discharges therefrom.

RULE 4. Advice to be given to patient and contacts; and by whom.-It shall be the duty of the attending physician to advise the patient, the patient's family, and any other members of the household, of the nature of the disease, the means whereby the spread of infection may be avoided, and of the provisions of these rules. In the absence of an attending physician it shall be the duty of the local health authority to impart this information and advice to the persons specified above.

RULE 5. Minimum precautions to be observed. At least the following precautions must be observed: Patients must wash their hands frequently and as often as their hands become soiled by discharges from the eyes. An ample supply of towels, basins, water, and an approved disinfectant must always be on hand for the disinfection of the hands of the patient.

All discharges from the conjunctiva shall be received in cloths or paper and immediately destroyed by burning. Such cloths or paper may be kept in paper bags until the bag and contents can be destroyed by burning. Towels, handkerchiefs, etc., which can not be burned shall be disinfected by boiling for 20 minutes or immersion for 5 minutes in a 5 per cent cresol solution.

RULE 6. Investigation of case. The local health authority shall make diligent investigation as to the source or sources of infection of all cases of trachoma reported to him., If the source or probable source is discovered, the State department of public health shall be immediately apprised of the facts. However, in no case shall the original report of a case of trachoma be delayed by reason of such investigation.

RULE 7. Removals.-No person having trachoma in its communicable stage shall move or be moved from one health jurisdiction to another without first securing permission to do so from the local health authorities of the place from which and to which removal is to be made or from the Illinois Department of Public Health. Such permission may be granted under the following conditions:

(1) Removal can and will be made without endangering the health of others, either in transit or at destination.

(2) Patient agrees to report in person to the local health authority immediately upon the arrival at destination, or agrees to place self under the care of a reputable physician, who shall report the presence of such patient to the local health authority.

In the event that it is necessary for a patient to go at intervals from one health jurisdiction to another for treatment, the permit issued in accordance with the foregoing provisions may authorize such necessary and frequent removals, one permit and one report to the local health officer at destination being sufficient under such circumstances.

RULE 8. Exclusion from school, public and private gatherings.-No person suffering from trachoma in its communicable stage shall be permitted to attend any public, private, or parochial school or any public gathering until there is no longer any discharge from the eyelids. Readmittance at school by certificate.

It shall be the duty of the principal or any other person in charge of any private, public, parochial, or Sunday school to exclude therefrom any child, teacher, or other person afflicted with trachoma until such child, teacher, or other person afflicted with trachoma shall have presented a certificate issued by the local health authority, if he be a physician, or by the attending physician, countersigned by the local health authority, certifying that such child, teacher, or other person is noninfectious.

INDIANA.

County Tuberculosis Hospitals—Admission, Maintenance, and Treatment of Patients from Other Counties. (Ch. 19, Act July 26, 1920.)

SECTION 1. That section 7 of "An act1 relating to the establishment and maintenance of county hospitals for the care of persons afflicted with tuberculosis, providing for the maintenance thereof and matters properly connected therewith," approved March 10, 1913, be amended so as to read as follows:

SEC. 7. In any county not having a county hospital for the care and treatment of persons suffering from tuberculosis, the county commissioners of any such county may by contract arrange for the care and treatment of citizens of said respective county in any institution of any other county operating under this act. And said board of commissioners shall have the power and authority to enter into such contract with such county having such institution, fixing in said contract the minimum number of patients to be sent to said institution for any one year, the amount of compensation to be paid per patient by said board of commissioners to the other county for the care and treatment

f said patients, which said compensation, however, shall be no higher than that fixed in section [s] 5 and 8 of this act. And the county council of said county so contracting for the care and treatment of said tuberculosis patients shall appropriate out of the general fund of such county a sum of money sufficient for said purposes, and said fund shall constitute a special fund for said purpose providing that said county shall have the right to levy such tax as may be necessary for the purpose aforesaid.

Any person residing in a county in which there is no such hospital, who desires treatment in the hospital of another county as aforesaid, may apply therefor in writing to the county auditor of said county on a blank to be provided by the superintendent of the institution of the other county, submitting with such application a certificate signed by a reputable physician on a blank to be furnished by said superintendent, stating that such physician has within 10 days examined such person, and that in his judgment such person is suffering from tuberculosis. The auditor as aforesaid on receipt of such application and certificate shall forward the same to the county commissioners, and the county commissioners, after they find the facts contained in said application to be true, shall make a record thereof and send the application to the superintendent of any such county hospital organized under and pursuant to this act, with whom they may have contracted. After such patient be accepted by such hospital, said board of commissioners shall provide for the transportation thereto and for his maintenance therein and [at?] the rate fixed as provided in other sections of this act.

That section 8 of "An act relating to the establishment and maintenance of a county hospital for the care of persons afflicted with tuberculosis, providing for the maintenance thereof and matters properly connected therewith," approved March 10, 1913, be amended to read as follows:

1 Reprint 264 from Public Health Reports, p. 152.