Some share in the fatality of 18th century smallpox must be charged to the treatment of the disease. What was described as the cool regimen was no secret, yet its practice appears to have been limited to few; whilst with the multitude, patients were confined to close and heated rooms, under heavy bed-clothes, plied with hot drinks, cordials, and alcohol, and kept in foul linen until killed or cured. Frequently, when symptoms of smallpox appeared, bleeding, blistering, and purging were energetically resorted to. If a family of children were affected, they were commonly stowed away in one bed, and their skins would stick together with pus and sweat. It was much the same in hospitals and workhouses. “I have seen above forty children,” says Dr. Buchan, “cooped up in one apartment, all the while they had this disease, without any of them being admitted to breathe the fresh air.” The same course was pursued with other fevers, and the effluvia of the sick-room was overpowering. Take this instance from Jenner’s own household. His nephew, Henry, and a maid-servant, were seized with typhus, and Jenner wrote--
The stench from the poor girl is so great as to fill the house with putrid vapour; and I shall remove Henry this morning, by means of a sedan chair, to an adjacent cottage.[79]
Indeed, the cleanliness and ventilation we consider so salutary were sedulously avoided. Cold air was accounted specially pernicious, and occasionally when the poor, afflicted with smallpox, were exposed to the weather, astonishment was expressed that recovery instead of death was the issue. It is related in Hutchins’s _History of Dorset_ that Blandford was burnt down in 1731, and several patients in smallpox were laid under the arches of the bridge as a place of refuge, and, to the general surprise, all got well, although many had died in their beds before the fire. John Birch a London surgeon of high repute, writing in 1814, sums up the case for us on this head in saying--
I consider the natural smallpox a mild disease, and only rendered malignant by mistakes in nursing, in diet, and in medicine, and by want of cleanliness, which last is the fomes of hospital fevers, and all camp and contagious disorders.