clergymen and others who may take up their residence in the locality. No one, however, can plead ignorance of the law because no such special reminder is received. It is the duty of every assessor, registrar of vital statistics, and city clerk acting as registrar of vital statistics, to keep a list of all local ministers, magistrates, physicians, midwives and undertakers (see section 14, page 13), and, about May 1st, in each year, to send to each such person printed instructions relating to the requirements of the law concerning certificates of marriages, births and deaths, and also to furnish such persons free of charge a reasonable number of blank forms for making such certificates.

With the returns made October 15th of each year all registrars, assessors and city clerks are requested to send to this bureau the names and post-office addresses of any physicians who have commenced practice since the report of the previous year, and of any who have removed or died.

Orders on local treasurers for the payment of fees due on account of certificates of births, marriages and deaths will be transmitted when returns are received to April 1st each year.

All correspondence should be addressed to the State Board of Health and Bureau of Vital Statistics, Trenton, New Jersey. HENRY MITCHELL, M.D., Secretary and Medical Superintendent of Vital Statistics.

DALLAS REEVE,

State Registrar of Vital Statistics.

CIRCULAR 102, JUNE, 1901.

Small-pox.

PREVENTION OF SMALL-POX.

Small-pox has prevailed as a widespread epidemic in a number of the States during the past few years, and New Jersey, because of its being constantly traversed by travelers from all portions of the country, is especially exposed to the infection of this disease. Public attention has repeatedly been called by the State Board of Health to the vaccinal status of the inhabitants, and it has been shown that the

number of unvaccinated children has increased from year to year, and that at present nearly 24 per cent. of those within school age are unprotected against small-pox.

An extensive outbreak of small-pox can be prevented with absolute certainty if vaccination of all susceptible persons is secured, and the question now arises, Shall general vaccination be done before a great calamity compels resort to this preventive measure, or must there first be startling losses of life to arouse parents, guardians, school boards, the public, and in too many instances the health authorities also, to a realizing sense of their duty to institute precautions against the spread of this pestilential disease?

Detection of the First Case.-Small-pox has been so frequently mistaken for chicken-pox that the utmost care is necessary on the part of physicians to prevent falling into this error, and rigid isolation of the patient should be practiced in first cases of this and other affections which simulate small-pox, until a diagnosis can be conclusively reached.

In small-pox the shortest incubation period, the period between exposure to infection and the first appearance of symptoms of illness, is seven days; average, twelve days; longest, twenty days. The infective period begins with the onset of the initial symptoms (chill, backache, headache, vomiting and high temperature) and continues until all scabs have disappeared. The greatest infectivity is during the vesicular and pustular stages of the eruption.

Before the appearance of the rash, the liability to impart infection is not great, and therefore isolation of a case very shortly after the appearance of the eruption, when associated with measures for vaccination, re-vaccination and disinfection, is generally effective in preventing further spread of the disease.

In chicken-pox the shortest incubation period is thirteen days; average, fourteen days; greatest, nineteen days. The introductory fever in chicken-pox is usually less intense than in small-pox, and the eruption generally begins on the trunk, often appearing on the second day, and rarely becomes prominent on the face.

In measles the period of incubation is variable, the least being four days; average, eight to ten days; greatest, fourteen days. The fever does not abate upon the appearance of the eruption, but is generally increased. Coryza is a very prominent symptom of measles.

Vaccination. The protection afforded by successful vaccination is quite as effective as that produced by a previous attack of small

pox, but there is much uncertainty concerning the duration of this immunity. The operation of vaccination should be conducted with aseptic precautions, and none but glycerinated lymph from a trustworthy producer should be employed. After the arm has been bared the clothing should be securely held away from the site of the proposed abrasion, and the surface should be made clean by thorough washing with warm, sterilized water. After drying with absorbent cotton the skin is scarified in one or more places by the use of a needle which has been rendered sterile by passing it through the flame of an alcohol lamp. One drop of the glycerinated vaccine is then applied and rubbed in with the needle. The clothing should not be allowed to touch the wound until it is dry, and an improvised shield, made by using a large paper bottle cap, held in place by two strips of adhesive plaster, extending not more than half way around the arm, affords desirable protection for the first six hours. Vaccination has caused undesirable results only in cases when uncleanly methods have been employed in collecting or inserting the lymph, and as at present con-ducted the operation is free from all objection.

The following measures are recommended for adoption by local boards of health for preventing the spread of small-pox : 1. Offer free vaccination and re-vaccination to all persons who cannot or will not pay for this service.

2. Advise parents to cause every child to be vaccinated before reaching the age of one year.

3. Advise that re-vaccination should be practiced as often as once every five years, and if a case of small-pox appear in the neighborhood, all persons in the vicinity should be at once vaccinated or re-vaccinated.

4. Urge boards of education to enforce the provisions of section 22 of chapter 68 of the laws of 1887, which authorize exclusion from the public schools of all pupils who have not been vaccinated.

5. Call the attention of boards of education to sections 122 and 123 of chapter 96, laws of 1900, which authorize said boards tosecure the vaccination of pupils.

6. In factories, the superintendent should be advised to direct all employes to be vaccinated.

7. Provide a suitable isolation hospital and arrange for medical care, nursing and hospital supplies. It should be remembered that domestic quarantine is unreliable, and that no method for the isola

tion of infected persons is so effectual as that which attends hospital segregation.

8. Require physicians and parents to notify the local health officer of every case of chicken-pox. Authority for this requirement is contained in sub-section 3, section 12 of chapter 68, laws of 1887.

9. Prosecute vigorously every person who violates section 1 of chapter 260 of laws of 1895, which requires that the local board of health shall be immediately notified of every case of small-pox.

10. When recovery occurs the patient should not be discharged until desquamation has entirely ceased, nor until the redness at the bottom of the pocks has disappeared. The surface of the body should then be bathed in a solution of bichloride of mercury (1 to 1,000), and afterward washed with water. Clean clothing should be provided.

11. In case of death the body should be at once enveloped in sheets saturated with the solution of bichloride of mercury (1 to 1,000), and be placed in an hermetically sealed metallic coffin. The burial should take place without delay, and should be strictly private.

Disinfection.-Immediately after the removal of a patient from an apartment or building the infected rooms and all of their contents should be treated by the free application of a solution of bichloride of mercury (1 to 1,000). Garments, sheets, blankets, &c., should be immersed in the same solution in wooden tubs, and all other articles, including mattresses, pillows and carpet, should be saturated with the solution. The side walls and woodwork should be wetted with the solution by the use of a garden-pump and hose, with a spray-producing nozzle. Varnished surfaces should be immediately wiped with dry cloths to prevent the spotting caused by water.

After twenty-four hours the clothing, blankets, sheets, pillow-cases, towels, &c., should be boiled for at least two hours. Articles of little value should be burned in the sick-room. When practicable, remove all remaining articles which can be transported to a sterilizing chamber, and expose them to steam at a temperature of 240° for thirty minutes. In localities where no sterilizing plant is provided, the mattresses, pillows, carpet, books and all other articles which cannot be boiled should be destroyed by fire.

The State Board of Health should be at once notified by the local health officer, by wire (State House, Trenton), on the appearance" of small-pox, and co-operation will be undertaken when necessary to prevent the spread of the disease.

CIRCULAR 103, OCTOBER, 1901.

Foods and Drugs.

ACTS GOVERNING THE SALE OF FOODS AND DRUGS IN

NEW JERSEY.

AN ACT to secure the purity of foods, beverages, confectionery, condiments, drugs and medicines, and to prevent deception in the distribution and sales thereof.

BE IT ENACTED by the Senate and General Assembly of the State of New Jersey:

1. The term "food" as used in this act shall include every article used for food or drink by man, and every ingredient in such article, and all confectionery; and the term "drug" as used in this act shall include every article of medicine for internal or external use, and every ingredient in such article.

2. The following drugs shall be deemed to be impure within the meaning of this act: (1) any drug which, being known under or by a name recognized in the United States pharmacopoeia, possesses a strength, quality or degree of purity inferior to or different from that laid down in such pharmacopoeia; (2) any drug which, not being known under or by a name recognized in the United States pharmacopoeia, but which is found in some other pharmacopœia, or in some other standard work on materia medica, possesses a strength, quality or degree of purity inferior to or different from that laid down in such other pharmacopoeia or standard work, and (3) any drug whose strength, quality or degree of purity falls below the professed standard under which it is sold.

3. The following foods shall be deemed to be impure within the meaning of this act: (1) any food which is rendered poisonous or injurious to health, or whose quality, strength or degree of purity is injuriously reduced, lowered or affected by adding thereto or mixing therewith any other substance or substances; (2) any food for any of whose constituents there have been substituted any substance or substances inferior to or cheaper than the constituents naturally or customarily composing such food or any part thereof; (3) any food from which has been wholly or partially abstracted any valuable or necessary constituent; (4) any food which con