SMALL- POX. 291 



Haygarth maintained that the plague had been completely exterminated 

 from this country, for above a century, by civil regulations, and that 

 there seemed to be little doubt that the small-pox was propagated on 

 principles similar to the plague, and that it also might certainly be 

 exterminated from this island. 



Haygarth's teachings had a profound influence upon both the profession 

 and the educated public, but his system of compulsory notification was 

 never carried out, for no legislation followed to enforce his recommenda- 

 tions. This is a matter deeply to be regretted, for towards the end of the 

 eighteenth century small-pox was declining in London, general sanitation 

 was making rapid advances, small-pox inoculation, which created fresh 

 centres of infection, was falling into disfavour, small-pox hospitals were 

 built, which served to limit centres of infection, and the profession and 

 the public were influenced by the teaching of Haygarth with regard to 

 the various ways of avoiding the spread of the disease. 



It only required the compulsory adoption of Haygarth's system 

 uniformly all over the country to have kept the disease in control, 

 if not to have entirely extirpated it from Great Britain. That a 

 similar conviction existed at the time is evidenced by an article which 

 appeared in 1779 in the Medical and Chirurgical Review, in which 

 the following statements were made : 



k< Plans for the extirpation of the small-pox have been suggested. . . . 

 To do this, however, the exertions of the physician are incompetent unless 

 they be aided by the powerful hand of Governments, but this has hitherto 

 been withheld. The grand means, however, of extirpating this destructive 

 malady is an early and strict separation of the infected from those that 

 are sound." 



Small-pox in the present century has been largely controlled by 

 legislation, especially in recent years, by the Public Health Acts for 

 England and Wales, for Scotland, and for Ireland ; the Epidemic and 

 other Diseases Prevention Act ; the Public Health Amendment Act ; 

 the Labouring Classes' Dwellings Acts ; the Housing of the Working 

 Classes Act ; the Public Health (Ships) Act ; the Local Government 

 Board Act and various orders and memoranda of the Local Govern- 

 ment Board ; the Infectious Diseases Notification Act ; the Infectious 

 Diseases Prevention Act ; and the Public Health (London) Act. 



By the Public Health Act of 1875 England was divided into 

 Urban and Rural Sanitary Districts, and powers were given to 

 enforce regulations of the Local Government Board for guarding 

 against the spreading of infectious diseases ; to provide medical aid 

 and accommodation for infected persons, to promote cleansing, 

 ventilation, and disinfection, to provide hospitals, to provide for 



