Decisions of the Attorney-general. honorable Board, and perhaps by the local board of health in the locality, the patients had been islolated and were under treatment. It is further stated that after the continuance of this isolation and treatment for nine days, the restrictions were raised and communication permitted between the patients and other persons who might come in contact with them. As I understand the matter, the restrictions were raised by the local board of health of the town. You now ask whether this local board of health had authority to change the status that had been established under the regulations above mentioned. Section two, chapter one hundred and fifty-one, of the acts of Eighteenth General Assembly, provides as follows: * * * * * * "The State Board of Health shall have the general supervision of the interests of the health and life of the citizens of the State. They shall have charge of all matters pertaining to quarantine. They shall have authority to make such rules and regulations as they may from time to time deem necessary for the preservation or improvement of public health; and that it shall be the duty of public officers, sheriff, constables and other public officers of the State to enforce such rules and regulations, so far as the efficiency and success of the Board may depend upon their official co-operation." My attention is called to the regulation adopted in relation to cases of Scarlet Fever and Diphtheria by your Board, and which is as follows: "Isolation-separation of the sick from the well. Whenever a child has sore throat and fever, and especially when this is accompanied by a rash on the body, the child must be immediately isolated as completely as possible from other of the household and from other persons until a physician has determined whether it has Scarlet Fever or Diphtheria. All persons known to be sick with either disease must be promptly and thoroughly isolated from the public for not less than forty days." The adoption of the foregoing regulation is undoubtedly within the power of the State Board. I think it is the purpose of the law to give the State Board superior control over all matters relating to public health. Local boards have the power and are required within their respective jurisdictions in case epidemic disease is developed to take such measures as may be deemed necessary for the safety of the inhabitants. See section twenty-two, chapter one hundred and fifty-one of the acts of the Eighteenth General Assembly. But even the local board has no authority to do away with the restrictions that have been previously established by the State Board, nor any right or authority to change a condition with respect to a patient that had been established under the regulations of the State Board. The object of this law is to furnish methods, means or agencies for preserving and protecting life and health. The State Board is invested with power in this matter extending over the whole State. It is the duty of all persons to observe the regulations it has established, because in legal contemplation, as well as in fact, they have been established for the public good. Local boards act within their respective localities, but they have no power to take action in conflict with the action or regulations of the State Board. I am, therefore, of the opinion that the act complained of as stated in the Decisions of the State Board. first part of this communication was without authority, and that it is the duty of the public officers, sheriffs and constables in the locality where this infraction has occurred, to enforce the order of the State Board of Health, and to see to it that the regulations of said Board are carried out. Respectfully yours, JOHN Y. STONE, Attorney-general. DECISIONS OF THE STATE BOARD. LOCAL BOARDS. Whose duty is it to put up placards in cases of contagious diseases? Answer.-In cities and towns the council usually designates the marshal or police. In townships, the board may designate some person, or it may be done by some member of the board. It should not be done by the health physician, as it would be manifestly unjust for the health physician to go to a house where a rival physician was in attendance, to put up a placard. Where a quantity of illuminating oil is of superior quality, purchased in Chicago, and bearing the brand of an Illinois inspector, as being "Test of one hundred and fifty degrees," must such oil be inspected again before uŝe in this State? Ans. The statute says, all oil for illuminating purposes, before sale or use in this State, must be inspected within this State. An inspection made in Illinois is of no value in this State. All oil sold or used within this State must previously be inspected by an Iowa inspector, and bear his brand of inspection. It is proper to state here, that the refiner's brand of "one hundred and fifty deg. Fire Test," or "one hundred and seventy-five deg.", is little or no indication of the quality or standard of the oil under Iowa inspection law. The flashing point, and not the burning point of oil is the standard in this State. Decisions of the State Board. Has a local board power in case of doubt regarding a case of suspected contagious disease, contrary to the wishes of the family in which the disease exists, to call competent physicians, when the diagnosis of the attending physician is questioned? Ans.-A local board has unlimited power to adopt such measures as they deem best to protect the people from contagious diseases. In the case cited, professional courtesy would dictate that the attending physician should be notified and invited to be present. Where there is probable danger from an outbreak of Small-pox, should the local board require all children to be vaccinated, or only issue a general recommendation ? Ans.-General vaccination should be required. The board should do all in its power to protect the people from, and prevent the spread of the disease. Is vaccination obligatory upon pupils in the public schools? Ans. By virtue of power therein vested, the State Board has made the following rules: RULE 1. Every person entering any public school of Iowa must give satisfactory evidence of protection by vaccination. RULE 2. The fact of vaccination and protection must be entered with each name on the school record, and on transfer and promotion lists. The Attorney-general says in an official opinion, that rules and regulations made by the State Board of Health are binding upon the people. If a person has Scarlet Fever the second time, and the eruption is well developed, would you expect infection by exposure to it? Ans.-Yes. If, during an epidemic of Scarlet Fever, an adult die of a disease difficult of diagnosis, but developing symptoms of malignant Scarlet Fever, and a child, constantly with such adult person, is taken sick on the eighth day (the adult dying on the sixth), is it safe to treat the case of the child as a contagious disease? Ans. The local board must decide in all cases whether or not a disease is contagious, where there is a doubt. The board should always take the safe side, and suspicious cases should be treated as Decisions of the State Board. contagious until proven otherwise. In the case cited, the presumption is in favor of contagion, but that would depend wholly on the possibility of exposure, a fact to be determined by circumstances. Where there is a conflict among physicians in the diagnosis of suspected contagious disease, who is to decide? Ans. The local board. The statute vests them with unlimited power to make such regulations and investigation as they deem best, and their decision is final until set aside by the courts. Is ice suitable for potable use when taken from a pond into which the sewage of a city is discharged? Ans. If the pond is still, without a rapid outlet, the ice would undoubtedly be polluted. As a precautionary measure, such ice should be prohibited by local boards for potable use within their jurisdiction, until the fact of its purity can be determined by analysis. Freezing does not remove the impurity, and water polluted with sewage is one of the most prolific sources of Typhoid Fever known. Where a physician refuses to report contagious diseases to the local board, obstructs the enforcement of regulations of the local board, and advises his patients, sick with contagious disease, or their friends, to totally disregard quarantine regulations, who is to enforce the penalty provided for violations of regulations of a local board? Ans. If in a city, prosecution should be made by the city attorney, on complaint of the local board. If in a township, complaint should be made before a justice of the peace, and the county attorney notified, whose duty it is to prosecute the case. In either event it is the duty of the local board to enforce the law. The State Board has no authority to do so. A physician, who, for any reason, will encourage his patients sick with, or convalescing from a contagious disease, to mingle with the well, and those susceptible to the disease, or who will not promptly and cheerfully aid, in all possible ways, the restriction and prevention of such diseases, is unworthy of his profession, should have his certificate revoked, and be remanded to some less responsible and honorable business. 1. Has a local board of health power to require the vaccination of children before entering the public schools as a means of protection against the spread of Small-pox? Decisions of the State Board. 2. Has a local board of health power to exclude from the public schools, as a means of preventing the spread of Small-pox? 3. Has a local board of health power to require vaccination of all persons within their jurisdiction, as a means of preventing the spread of Small-pox? As these questions involved a construction of law, and were deemed of considerable importance, they were referred to the Attorney-general, who gives the following as his decision thereon: OFFICE OF ATTORNEY-GENERAL, J. F. KENNEDY, M. D., Secretary of the State Board of Health, Des Moines, Iowa: DEAR SIR-At the last regular meeting of the State Board of Health, held on the 29th ult., there was submitted to me by the said board a communication from Robert E. Crylie, of Glidden, Iowa, respecting the subject of vaccination. It seems that the health officer of the town of Glidden had ordered the teachers of the public schools to require that the pupils attending school should be vaccinated. There was opposition made to this by the directors of the school, and the teachers were by them directed not to obey the orders of the health officer until further directions from the board of school directors. The question raised is one of authority on part of local boards of health to require pupils attending the public schools to be vaccinated. The health laws of the State of Iowa, in so far as they provide for boards of health to regulate their powers and duties, are contained in chapter one hundred and fifty-one of the Laws of 1880. Section two of that act provides that: * "The State Board of Health shall have the general supervision of the interests of the health and life of the citizens of the State. They shall have charge of all matters pertaining to quarantine; * * they shall have authority to make such rules and regulations, and such sanitary investigations as they may from time to time deem necessary for the preservation or improvement of the public health; and it shall be the duty of all police officers, sheriffs, constables, and all other officers of the State, to enforce such rules and regulations, so far as the efficiency and success of the board may depend upon their official co-operation." This confers upon the State Board of Health the power to determine when it becomes necessary to resort to quarantine, or to require vaccination, or to take other precautionary measures for the prevention of the spread of contagious or infectious diseases; and it would be the duty of local boards of health to co-operate within their several jurisdictions with the State board in carrying out the regulations which may be prescribed by the said State board. Section thirteen of the same act provides that the mayor and aldermen of each incorporated city, and the mayor and councilmen of any incorporated |