290 INFECTIVE DISEASES. 



for variolous lymph, and in 1840 small-pox inoculation was prohibited 

 by Act of Parliament. 



Stamping-out System. — The disappointing and dangerous 

 results of small-pox inoculation led to a widespread demand for 

 some new method for dealing with small-pox. This induced Haygarth 

 to turn his attention to the subject, and towards the end of the 

 eighteenth century to bring before the medical profession and the 

 public a plan for stamping out the disease. Haygarth, who was a 

 close observer and an able physician, studied the question of the 

 communicability of the disease from one person to another, and its 

 conveyance by infected clothing and other means, and ultimately 

 drew up rules and regulations for its prevention, the importance of 

 which we are only now beginning to fully acknowledge. Haygarth's 

 essential doctrine was " that mankind was not necessarily subject to 

 the small-pox, and that it was always caught by infection from a 

 patient or the poisonous matter," and might be avoided by observing 

 his Rules of Prevention. 



These rules comprised a regular system of notification and isolation. 

 Inspectors were to be provided to report cases of small-pox, and people 

 were to be rewarded for carrying out the instructions. Several examples 

 were given of the results at Chester, where the plan was adopted. 



Haygarth met with considerable encouragement from some of the 

 leaders of the profession. Dr. Fothergill wrote to him in 1778, saying, 

 " I have mentioned the intention of freeing this country from the 

 small-pox to divers of the faculty, and shall continue to do so as it falls 

 in my way. The proposal is variously received, but in exact proportion 

 to their humanity." 



In 1793 Haygarth made considerable addition to his rules, and urged 

 that legislation should follow to make them compulsory. Provision was 

 to be made to reward the poor for observing the rules, and public thanks 

 to the wealthy for their support were to be published in the parish church 

 and newspapers. Transgression of the rules was to be punished by a fine of 

 from £10 to £50, one half to go to the informer and the other half to the 

 fund which supplied the expense of rewards to the poor, and all details were 

 to be supplied to the press. It was further suggested that Great Britain 

 should be divided into districts, including a certain number of parishes 

 or townships, and that to each of them a surgeon or apothecary should 

 be appointed as inspector to see that the regulations were exactly 

 observed. In addition, there were to be directors of inspectors, superin- 

 tended by a commission of Physicians in London and in Edinburgh. All 

 salaries were to be paid by the county rates, and the rewards for observing 

 the rules of prevention were to be guaranteed out of the parish funds. 

 On the requisition of the director and inspector of a circuit, power 

 was to be given to two or more justices of the peace to appoint a separate 

 house for the reception of patients with the small-pox. In conclusion. 



