Transportation of Corpses. THE STATE OF IOWA. HEALTH DEPARTMENT. OFFICE OF THE IOWA STATE Board of HEALTH, To all Railroad Cornpanies, General Baggage Agents, Train Men, Station Complaint is made by several railroad General Baggage Agents, who are endeavoring strictly to enforce the Regulations of the State Board of Health, and of the National General Baggage Association, regarding the transportation of corpses, that bodies are delivered from connecting roads, when the transportation permit accompanying the body states cause of death was diphtheria. Transportation of persons dead from diphtheria is positively prohibited within this State, under any conditions. Diphtheria has been changed from the permissible transportable to the prohibited list of diseases, for the protection, not only of the public, but of railroad companies and train-men. As a matter, therefore, of protection, justice, economy, and obedience to law, it is imperative that these regulations be rigidly observed on all railroads operated in this State. It having come to the knowledge of the State Board that physicians, through ignorance, or design, in many instances, give the cause of death as "heart failure," which is a sequala of diphtheria, when the real cause was diphtheria, the State Board ordered that a return giving "heart failure" as cause of death, must not be accepted by the county clerk, but returned to the physician for the proper specification. Railroad train men, and station agents would, therefore, be fully justified in deeming as suspicious, if not in absolutely rejecting a corpse accompanied with a permit in which the cause of death is given as “heart failure," where the age of deceased is under thirty years, unless there is positive statement in the permit, that the "heart failure" was not the result of diphtheria. It is known that serious results, and the loss of many lives, have followed the shipment of a corpse under such a false return of the cause of death. In accordance with the rules and regulations adopted by the National Association of Railroad General Baggage Agents, and the Iowa State Board of Health, whenever it is desired to disinter the dead body of a human being for removal or transportation, application for permission so to do, must be made to the State Board of Health. No disinterred body must be received for transportation, by any railroad, unless accompanied by a special disinterment permit from the State Board of Health, which is additional to the regular transportation permit. The disinterment permit must be approved by the local board of health of the jurisdiction where the body was interred. Transportation of Corpses. Depositing bodies in a receiving vault is deemed a burial, and a disinterment permit is required for removal. J. F. KENNEDY, M. D., Secretary. STATE OF IOWA. HEALTH DEPARTMENT. OFFICE OF THE IOWA STATE BOARD Of Health, To all Undertakers and Railroad Companies: By reason of the frequent shipment of the bodies of persons dead from diphtheria, under the statement that the cause of death was "heart failure" or some other sequela of that disease, and non-contagious, thereby greatly endangering human life, at a meeting of the Iowa State Board of Health, held Thursday, Nov. 20, 1890, it was ordered that the transportation of the bodies of persons dead from diphtheria be prohibited in this State, and that the word "Diphtheria" be stricken from Rule 2, of the Rules and Regulations for the Transportation of Corpses, and that the word "Diphtheria" be inserted in Rule 1, after the words "Small Pox." Undertakers, baggage men and railroad station agents, are hereby notified to govern themselves accordingly. The following resolution was also adopted: Resolved, That a return of a death made by a physician giving "heart failure" as a cause of death shall not be deemed a sufficient return, and such must be returned to the physician who made it for the proper correction and and definition. J. F. KENNEDY, M. D., The following is the form of a disinterment permit: Secretary. STATE OF IOWA. HEALTH DEPARTMENT. DISINTERMENT PERMIT. Application having been made for the disinterment of the dead body of ( give the full name here, whether it be one, two or three, use no initials.)now lying buried at. the county of of Iowa, and who died on the State aged...... which is a (contagious or non-contagious) disease, as shown by the certificate of death, of said deceased, given by..... .., attending Transportation of Corpses. physician, this is to certify that permission is hereby given for such disinterment by the Local Board of Health of the.... ......of..... .....this .18.., upon approval thereof by the State Board of .day of....... The foregoing application for the disinterment of the body of is hereby approved, it being understood and provided that nothing herein shall be deemed as contravening or in anywise modifying or releasing the regulations of the State Board of Health governing the transportation of corpses, or the requirements for a transit permit, and all transportation companies will be governed accordingly. Given under my hand, and seal of the State In accordance with the rules and regulations adopted by the National Association of Railroad General Baggage Agents, and the Iowa State Board of Health, whenever it is desired to disinter the dead body of a human being, for removal or transportation, application for permission so to do, must be made to the State Board of Health. The application must state the full name of the deceased, also the age, cause of death, name of physician who made certificate of death, place of burial and where to be reinterred. No disinterred body will be received for transportation by any railroad unless accompanied by a special disinterment permit from the State Board of Health. which is additional to the regular transportation permit. The disinterment permit must be approved by the local board of Health of the jurisdiction where the body lies buried. Depositing bodies in a receiving vault is deemed a burial, and a disinterment permit will be required for removal. Undertakers and others will save possible delay and trouble by strictly conforming to these instructions. These regulations apply equally to all express companies. J. F. KENNEDY, M. D., Puerperal Fever. PUERPERAL FEVER. ITS CAUSE AND PREVENTION. One of the saddest occurrences that can come to any home is to have the wife and mother stricken down with child-bed fever. The happy, and yet responsible, consummation of motherhood, has been looked forward to for weeks and months with interest, and on the part of many, with fearful forebodings. Hope and the natural maternal instincts afford pleasurable anticipations as the time for "confinement" approaches:-And yet these pleasurable anticipations are mixed with fear, as the expectant mother hears of one here and there who has died in this trying hour. The long looked for time, however, has come, the trial is over, and mother and babe are safe. The mother is happy because of her babe-the babe contented because it has a mother to supply its limited wants. The husband congratulates his wife, and the doctor or midwife leaves the house with the benedictions of father and mother, and congratulates himself on his skill. Three or four days pass by, and the midwife or medical attendant, is hastily summoned with the information that the mother has had a chill, and there is fever and abdominal soreness. Puerperal fever is found to have set in, and in a few days the husband is wifeless, and the babe motherless! All the fond hopes of the husband and wife and friends have been ruthlessly crushed. Too often the calamity is regarded as a mysterious providence, and the real cause is overlooked. There is no fact in medicine better established than that puerperal fever is a clearly preventable disease, and if so, every case that occurs does so because some one has blundered-has done something that should have been left undone; or neglected something that should have been done. This leads to the question as to what puerperal fever is, and what produces it? A great deal of discussion has taken place upon this point. Some contend that it results from a peculiar microorganism which produces that disease alone, and that the disease is propagated by contagion-a contagion that is especially virulent. Others claim that it is puerperal septicæmia-a surgical fever, Puerperal Fever. and results wholly from the absorption into the system of decomposing products-a septic fever; that this poison may be generated, or supplied by the woman herself by decomposing substances which are absorbed through lacerations and abrasions occurring during labor. At other times, the poison may be communicated to the woman by the hands or clothing of the nurse or medical attendant from some case of erysipelas, or a previous case of puerperal fever. Many claim that child-bed fever may result from carelessness on the part of persons attending cases of erysipelas, diphtheria, and scarlet fever. One fact is well established, that puerperal fever may become epidemic-not through atmospheric conditions, but by being conveyed directly from one lying-in woman to another. It has often happened that a physician or midwife has had several cases in succession, and has only been able to break up the succession by refusing to attend such cases for a time, or by practicing the most rigid and thorough disinfection. The mortality from this disease in lying-in hospitals has often been most fearful, so that the use of hospitals for such purposes was greatly discountenanced. Under proper anti-septic methods, however, the death rate has so diminished that scarcely one per cent of the persons confined have puerperal fever, and in general hospitals, where erysipelas and other surgical affections are treated, it has been found that lying-in wards can be maintained with but little risk. From all this, the generally accepted opinion is, that puerperal fever and puerperal septicæmia are identical—that both are a surgical fever to be successfully prevented by antisepsis. There is reason to believe that milk fever, milk-leg, `puerperal mania, and several other child-bed accidents are the result of the absorption of septic material-poisonous products resulting from animal decomposition-which find their way into the circulation through puerperal wounds. If this theory is generally accepted, and acted upon, the time would soon come when, instead of one case of this dread disease occurring in every one hundred and twenty-five women who are confined, the disease would be unknown, or occur only often enough to warn attendants upon cases of labor that carelessness would still result in the production of the disease. |