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life which modern science has made possible. The citizens of the State can secure these benefits, however, only when the local health officer is so well informed of the later achievements of science, so well acquainted with the new methods for the recognition, treatment and prevention of disease, and so intelligently devoted to the interests of his constituents, that he can and will make available for them all the resources for the public welfare which the New York State Department of Health now affords. Most of the medical schools are so lax in affording such knowledge and training as the modern health officer requires, that the Council found it necessary three years ago, in endeavoring to fix a standard of qualifications for local health officers, to appeal to various colleges and schools of the State to establish special courses for the instruction of present and prospective health officers. The response to this appeal from most of these institutions has been appreciative, generous, and helpful. The gratitude of the citizens of the State of New York is due to all those who have so unselfishly devoted time and energy to this significant public service.

Although the times have been unpropitious for these extra activities, often involving considerable absences from their homes and regular professional activities, and sometimes notable personal expense, many present and prospective health officers have availed themselves of the privileges thus secured and have taken the special courses.

The Council has heretofore adopted qualifications for the local health officers of the State, but owing to many complex conditions and in order to allow the various health officers ample time for the completion of their courses, the time when these qualifications were to go into effect was made June 1, 1917, instead of November 1, 1916.

In many cases the health officers entered the military service of the United States immediately upon the declaration of the war. This at times left a health district without any qualified physician to attend to the duties of health officer. The Council therefore resolved that in case a man was appointed as a temporary health officer, pending the return of a health officer who had entered military service, but who had not resigned, the official

qualifications might be waived. In addition to this, the Council. has acted upon applications for exemption from qualifications of seventy-two health officers in the State of New York.

The Council approved legislation requiring a sworn statement in applications for marriage licenses that neither of the parties had been infected with a venereal disease within five years next preceding the application, or if so infected had had a laboratory test showing that they had been cured. The Council further approved legislation providing for deputy health officers; changing the qualifications of health officers of second class cities; providing for the pasteurization of skimmed milk and whey used as food for calves; and for the licensing of laboratories.

Appended hereto and marked appendix "A" are the amendments to the Sanitary Code adopted by the Council during the year.

Also appended and marked appendix "B" is the model sanitary code recommended for adoption by the local health districts. All of which is respectfully submitted.

HERMANN M. BIGGS

SIMON FLEXNER

ELLA L. BLAIR

T. MITCHELL PRUDDEN

HENRY N. OGDEN

WILHELM GAERTNER

MARCH 5, 1918.

APPENDIX A

The Sanitary Code of the State of New York was amended by adding thereto a new chapter, to be known as chapter VIII, and to read as follows:

Chapter VIII

Boarding Houses

Regulation 1. No license shall be issued by the board of health of any city or town under the provisions of section four hundred eighty-two of the penal law to any person to receive, board or keep any nursing children or any children under the age of twelve years not his relatives, apprentices, pupils or wards, without legal commitment, unless the health officer or person performing the duties of health officer of such city or town shall have made an inspection of the premises proposed to be occupied by such children, and shall have filed a written report thereon with the local board of health. Such inspection shall include an examination of each room proposed to be occupied by such child or children, and of the sanitary condition of the premises.

Regulation 2. No license shall be issued to any person to receive, board or keep any child or children unless each such child shall sleep in a room having one or more windows opening into the outer air. Provision must be made for the free entrance of fresh air into every such sleeping room and every such room shall be aired at least once in each twenty-four hours.

Regulation 3. Every such license issued by the board of health of any city or town shall be on a form to be prescribed by the state commissioner of health. Every such license shall expire on the thirty-first day of May after its issue, and may be renewed after a reinspection of the premises by the local health officer and a written report thereon to the local board of health. Any such license may be revoked at any time by the state commissioner of health or by the board of health issuing the same.

Regulation 4. It shall be the duty of every health officer to inspect in the municipality under his jurisdiction every boarding house or lodging house where a person or persons affected with tuberculosis may be boarded or lodged and it shall be his duty to see that the requirements of the public health law and the sanitary code are complied with.

Regulation 5. It shall be the duty of every local health officer to furnish the proprietor or other person in charge of such boarding house or lodging house with such sections of the sanitary code and the public health law as may be required by the state commissioner of health.

Regulation 6. It shall be the duty of the proprietor or other person in charge of any boarding or lodging house in which a person or persons affected with tuberculosis may be boarded or lodged to post in a conspicuous place such provisions of the sanitary code and public health law as may be required by the state commissioner of health.

Regulations 1, 2 and 3 took effect on March 1, 1917, and regulations 4, 5 and 6 on June 1, 1917.

Regulations 13 and 14 of chapter III of said code were amended to read as follows:

Regulation 13. Designations of milk and cream restricted. All milk sold and offered for sale at retail shall bear one of the designations provided in this regulation, which constitutes the minimum requirements permitted in this state.

No term shall be used to designate the grade or quality of milk or cream which is sold or offered for sale, except

as

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Certified. No milk or cream shall be sold or offered for sale Certified" unless it conforms to the following requirements:

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The dealer selling or delivering such milk or cream must hold a permit from the local health officer.

All cows producing such milk or cream must have been tested at least once during the previous year with tuberculin, and any cow reacting thereto must have been promptly excluded from the herd. The reports of such tuberculin tests must be filed with the local health officer and the milk

commission of the County Medical Society in the municipality and county respectively in which such milk is delivered to the consumer.

Such milk must not at any time previous to delivery to the consumer contain more than 10,000 bacteria per cubic centimeter and such cream not more than 50,000 bacteria per cubic centimeter.

Such milk and cream must be produced on farms which are duly scored on the score card prescribed by the state commissioner of health, not less than thirty-five per cent for equipment and not less than fifty-five per cent for methods. Such milk and cream must be delivered within thirty-six hours of the time of milking.

Such milk and cream must be delivered to consumers only in containers filled at the dairy or central bottling plant.

The caps must contain the word "certified" and bear the certification of a milk commission appointed by the County Medical Society organized under and chartered by the Medical Society of the State of New York, and must also contain the name and address of the dairy as well as the date of milking.

Every employee before entering upon the performance of his duties shall be examined by a duly licensed physician and the reports of such examination shall be sent to the milk commission certifying the milk from such dairy.

The milkers and all persons handling the milk must be provided with suits and caps of washable material which shall be worn while milking or handling the milk and shall not be worn at other times. When not in use these garments must be kept in a clean place free from dust. Not less than two clean suits and caps must be furnished weekly. The hands of the milkers must be washed with soap and hot water, and well dried with a clean towel, before milking.

Grade A raw.

No milk or cream shall be sold or offered for sale as "Grade A raw" unless it conforms to the following requirements:

The dealer selling or delivering such milk or cream must hold a permit from the local health officer.

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