Extracted from: [CHAPTER 82] LEICESTER: SANITATION versus VACCINATION BY J.T. BIGGS J.P.
The " Leicester Method" was, therefore, established as a regular system of treating smallpox by the late Dr. William Johnston, when Assistant Medical Officer of Health for the town, in 1877. It started with the segregation of a few smallpox contacts, and, from that humble beginning, has grown to the present uniquely successful, but simple, procedure. It has been a gradual process of evolution, and may be briefly summarised as :—
(1) Prompt notification ;
(2) The isolation and segregation of small-pox cases in hospital;
(3) Quarantine of all persons found to have been in contact with the patient;
(4) The vigilant inspection and supervision of all contacts during the incubation period of fourteen (now extended to sixteen) days ;
(5) Cleansing, and disinfection of clothes, bedding, and dwellings ; and
(6) The burning of clothes, bedding, etc., when necessary.
Our chief Sanitary Inspector, Mr. F. Braley, in a letter addressed to me, thus describes his system of setting to work when a case of smallpox is notified to his department :—
" When a case is reported, I at once go to the infected house, and try to ascertain where the disease was contracted, where the patient has been working, where he has been visiting, and his ; movements generally for the last ten or twelve days. I also make a point of seeing all persons who have visited the infected house during the time stated ; in addition, I visit all factories and workshops where other members of the family have been employed; and by this means have been able to get cases removed when the first symptoms of the disease appeared.
" Immediately on the removal of a patient, I superintend the fumigation of the house with sulphur liquid disinfectants are used freely in the drains and about the yard, and the ashpit is emptied and disinfected; the next day the bedding is taken to the disinfecting chamber, and subjected to the hot-air process.
" Up to the present time I have succeeded in getting almost every person connected with the infected houses into quarantine. In a very few cases I have experienced opposition."
The following is a copy of the procedure, under the "Leicester Method," as matured and put into practice in 1892, which has been maintained up to the present time :—
BOROUGH OF LEICESTER.
SMALL-POX.
At a meeting of the Fever Hospital Sub-Committee, held on 10th May, 1893, the Medical Officer of Health read the following notes:—
The method that is now being carried out in Leicester in connection with the treatment and prevention of smallpox outbreak is as follows:—
I.—The patient is removed at once to the Borough Fever Hospital, and the house (room or rooms), bedding, etc., disinfected
II.—The inmates of the infected house and others who may have come into contact with the small-pox case are placed under quarantine observation at their own homes, being visited, by the Inspector daily for sixteen days.
III.—Any case of illness amongst these quarantined persons is at once notified to the Medical Officer, who visits the case and removes it to the hospital if necessary.
IV.—The inmates of infected houses and others who may have been in contact with the small-pox case, if thought necessary, are strongly urged not to go to work for the whole or part of their quarantine period of fourteen to sixteen days, and during that time have been made such allowances as the Sub-Committee have thought fit, the sum advanced in each case being no more than sufficient to cover rent and maintenance. In the event of persons, however, being quarantined at the hospital, as all their food is found for them, only such allowance has been made as would cover the rent; whilst in the event of clothes, bedding, etc., being destroyed, fresh ones have been provided.
V.—Persons whilst under quarantine observation are allowed to go about, and are encouraged to take walks , into the country, but are advised not to enter anybody's house, any public institution or meeting under penalty of forfeiting their monetary allowance.
VI.—Quarantine wards within the same curtilage as small-pox wards may, in the opinion of some, be a source of danger to their inmates; this consideration, together with the largeness of the numbers to be dealt with, has led me to watch the suspected people at their own homes.
VII.—Those inmates of infected houses who are willing are sent up to the hospital to have a disinfectant bath and to have their clothes stoved, whilst their houses are fumigated with sulphur meanwhile. Those persons who refuse to go up to the hospital have disinfectants given them, and are asked to have a disinfectant bath at home.
Under conditions satisfactory to the Medical Officer of Health, certain of the people from infected houses arc allowed to continue at their work during the whole or part of their period of quarantine. In the case of a small-pox patient being a child recently attending school, the school manager is waited upon, a list obtained of absentees, who are then visited, and the schoolroom if necessary fumigated. So, too, where the patient is at work in a factory or workshop, the names of the absentees from that factory or workshop are obtained, and the absentees visited. The room or rooms in which the patient may have been at work whilst in an infective stage are, if thoroughly necessary, fumigated.