(J90 SUPPLEMENTARY APPENDIX. 



" Rules of Prevention " based on Haygarth's views of infection. In the 

 report of the Society, called shortly u The Small-pox Society," dated 

 September 1782, it is stated that in the four and a half years of its 

 existence two general inoculations had been held, and that the deaths 

 from small-pox had been greatly lessened. Great difficulties, however, 

 were met with. " A large proportion of the inhabitants " refused inocula- 

 tion, and a large proportion also, " being fearless, or rather desirous, that 

 their children should be infected with the natural small-pox," refused to 

 obey the Rules of Prevention. Hence, though the same report states 

 that the example of Chester had been followed by Liverpool, where 

 " a general inoculation was successfully executed in the autumn of 1781 

 and another in the spring of 1782," and in Leeds, where a general 

 inoculation was held in 1781 and another proposed in 1782, with such 

 success that the Royal College of Physicians in Edinburgh appointed a 

 committee to inquire into " the modes of conducting the general inocula- 

 tions of the poor " thus adopted in these places, the plan met with such 

 difficulties that it was ultimately abandoned. It will be observed that a 

 general inoculation was an essential part of the plan proposed and 

 carried out in 1778-82 ; but, writing in 1784, Haygarth looked forward 

 to being able ultimately to dispense with inoculation, and in the preface 

 to his later edition, published in 1793, he states more definitely that the 

 adoption of his Rules of Prevention without any general inoculation 

 might exterminate small-pox in some country other than Great Britain. 

 It must be remembered, however, that Haygarth entertained the opinion 

 that the infection of small-pox could not be carried through the air above 

 about half a yard, and that no one could -be infected by the clothes of a 

 person visiting a small-pox patient provided that he kept beyond this 

 distance from the patient. It is obvious that if this had been established 

 the control of the disease by isolation would be a much simpler matter 

 than it really is. 



In the Medico-Chirurgical Review for 1796 there appeared an account 

 of a work by Dr. Faust, of Leipsic, entitled " An Essay on the Duty of 

 a Man to separate persons infected with the Small-pox from those in 

 " Health, thereby to effect the extirpation of that disease equally from 

 " the towns and countries of Europe," in which it was argued that the 

 first person ill in a place is the only source from which all the rest, 

 perhaps hundreds and thousands, become affected, and that if he were 

 put immediately into a situation where he could not injure by contact 

 those who had not had the disorder, the spread of the disease would be 

 prevented. 



In the same Review for 1799 appeared an account of establishments 

 for the extirpation of small-pox. The failure of inoculation to attain the 

 desired end is referred to, and legislation is urged to facilitate isolation. 

 It is further stated that in 179(3 the Prussian College of Physicians re- 

 ported favourably to the King on the project, and that at Halberstadt it 

 had been resolved to establish a house for the purpose. At Cote d'Or in 

 France a similar plan had been tried with success. 



In 1 798 Jenner's " Inquiry " was published, and in the early years of this 

 century inoculation began to be discouraged ; for a while the prospects of 



