(c) A patient sick of a communicable disease should be isolated and one member of the crew detailed for his care and comfort, who, if practicable, should be immune to the disease.

(d) Communication between the patient or his nurse and other persons on board should be reduced to a minimum.

(e) Used clothing, body linen, and bedding of the patient and nurse should be immersed at once in boiling water or in a disinfecting solution.

(f) The compartment from which the patient was removed should be disinfected and thoroughly cleansed. Articles liable to convey infection should remain in the compartments during the disinfection when gaseous disinfection is used.

(g) Any person suffering from malaria or yellow fever should be kept under mosquito bars and the apartment in which he is confined closely screened with mosquito netting. All mosquitoes on board should be destroyed by fumigation. Mosquito larvæ (wigglers or wiggle-tails) should be destroyed in water barrels, casks, and other collections of water about the vessel by the use of petroleum (kerosene); where this is not practicable, the receptacle should be covered by mosquito netting to prevent the exit of mosquitoes from such breeding places.

(h) In the case of bubonic plague, special measures must be taken to destroy rats, mice, fleas, and other vermin on board, and in case of pneumonic plague, the patient should be isolated, the body discharges disinfected, especially sputum, and the attendant should wear a mask.

(i) In the case of typhus, special measures should be taken to destroy vermin.

(j) In the case of cholera, typhoid fever, or dysentery, the drinking water should be boiled and the food thoroughly cooked. The discharges from the patient should be immediately disinfected and thrown overboard.

21. An inspection of the vessel, including the steerage, should be made by the ship's physician once each day.

22. Should cholera, yellow fever, smallpox, typhus fever, plague, or any other communicable disease appear on board a ship while at sea, those who show symptoms of these diseases should be immedi

ately isolated in a proper place; the ship's physician should then immediately notify the captain, who should note same in his log, and all of the effects liable to convey infection which have been exposed to infection should be destroyed or disinfected. In the case of smallpox, the entire personnel should be vaccinated.

23. The hospital should be cleansed as soon as it becomes vacant. 24. The dead, except those dead of yellow fever, should be enveloped in a sheet saturated with one of the strong disinfecting solutions, without previous washing of the body, and at once buried at sea or placed in a coffin hermetically sealed.

25. A complete clinical record shall be kept by the ship's surgeon of all cases of sickness on board, and the record delivered to the quarantine officer at the port of arrival.

26. The following disinfecting solutions are recommended for use at sea:

Formula for strong disinfecting solutions.

It is suggested that a vessel should carry for every 100 passengers: Bichloride of mercury, 5 pounds; carbolic acid, 10 pounds; alcohol, 10 pounds; formalin, 10 pounds; 100 pounds of sulphur and 12 Dutch ovens, about 12 inches diameter, and an adequate supply of fresh vaccine virus.

CHAPTER IV.

GENERAL REQUIREMENTS AT DOMESTIC PORTS.

27. At or convenient to the principal ports, quarantine stations should be equipped with all appliances for the inspection and treatment of vessels, their passengers, crews, and cargoes.

28. For all ports where such provisions have not been made, and where quarantine inspection is required, inspection stations should be maintained.

29. At a fully equipped maritime quarantine station there should be adequate provision for boarding and inspection, apparatus for mechanical cleansing of vessels, apparatus for disinfection by steam, by sulphur, by formaldehyde, by disinfecting solutions, or any other methods prescribed in these regulations; also a clinical laboratory, hospitals for contagious and doubtful cases, a steam laundry, detention barracks for suspects, bathing facilities, a crematory, a sufficient supply of good water, and a proper system for the disposal of sewage.

30. The personnel of quarantine stations in the yellow fever zone should be immune to yellow fever, and at all stations the personnel shall be vaccinated against smallpox. Officers when entering upon a tour of duty at a quarantine station should be vaccinated against smallpox, and the same shall apply to all subordinates and their families on the station.

31. At quarantine stations south of the southern boundary of Maryland the reservation shall be free of Aedes (stegomyia) calopus, and general antimosquito measures shall be enforced on the reservation and environment.

32. At quarantine stations, all articles liable to convey infection should be handled only by the employees of said station, unless the services of the crew of the vessel in quarantine are indispensable.

33. The following regulations are the required minimum standard and do not prevent the addition of such other rules as, for special reasons, may be legally made by State or local authorities.1

INSPECTION.

34. Every vessel subject to quarantine inspection, entering a port of the United States, its possessions or dependencies, shall be considered in quarantine until given free pratique. Such vessel shall fly a yellow flag at the foremast head and shall observe all the other requirements of vessels actually quarantined.

35. Vessels arriving at ports of the United States under the following conditions shall be inspected by a quarantine officer prior to entry:

(a) All vessels from foreign ports except those covered by paragraph 3. Vessels from a foreign port shall be inspected only at first port of call in the United States, except vessels from ports suspected of yellow fever arriving during the active quarantine season at southern, via northern, ports.

(b) Any vessel with sickness on board.

(c) Vessels from domestic ports where cholera, plague, or yellow fever prevails, or where smallpox or typhus fever prevails in epidemic form.

36. The inspection of vessels required by these regulations shall be made between sunrise and sunset, except in case of vessels in distress. Exception may also be made in the case of vessels carrying perishable cargoes, and regular line vessels under regulations approved by the Secretary of the Treasury.

37. In making the inspection of a vessel the bill of health and clinical record of all cases treated during the voyage, crew and passengers' lists and manifests, and, when necessary, the ship's log shall be examined. The crew and passengers shall be mustered and examined and compared with the lists and manifests and any discrepancies investigated. The clinical thermometer should be

1 Penalties for violation of these regulations are provided in sec. 10, act of Mar. 2, 1901, and in sec. 4, act of June 19, 1906.

used in the examination of the personnel of vessels under suspicion. When a freight manifest shows that articles requiring disinfection under these regulations are carried by the vessel, a certificate of disinfection, signed by a United States consul or a medical officer of the United States, shall be exhibited and compared with same. If no certificate of disinfection is produced, the collector of customs at the port of entry shall be notified of same by the quarantine officer. The collector of customs shall then hold such consignment in a designated place, separate from other freight, pending the arrival of the certificate of disinfection; and in the event of its nonarrival the articles shall be disinfected as hereinbefore prescribed, or shall be returned by the common carrier conveying same.

38. Medical officers of the United States duly clothed with authority to act as quarantine officers at any port or place within the United States, when performing the said duties, are hereby authorized to take declarations and administer oaths in matters pertaining to the administration of the quarantine laws and regulations of the United States. (Act of Mar. 2, 1901, sec. 12.)

39. No person, except the quarantine officer, his employees, or pilots, shall be permitted to board any vessel subject to quarantine inspection until after the vessel has been inspected by the quarantine officer and granted pratique, and all such persons so boarding such vessel shall, in the discretion of the quarantine officer, be subject to the same restrictions as the personnel of the vessel, or otherwise, action may be taken as provided for in section 10, act of March 2, 1901: Provided, however, That the United States customs officials may be permitted to board a vessel that has been inspected and held in quarantine for detention or treatment, they being subject to the same restrictions as the personnel of the vessel.

40. When a vessel arriving at quarantine has on board any of the communicable but nonquarantinable diseases, the quarantine officer shall promptly inform the local health authorities of the existence of such disease aboard and shall make every effort to furnish such notification in ample time, if possible, to permit of the case being seen by the local authorities before discharged from the vessel.