In consequence of the investigations made by Dr Flay garth of Chester, and other eminent physicians, into the laws of the contagion of various fevers, especially typhus and scarlatina, it was found that the dissemination of these dis eases depended chiefly on deficient ventilation, and on the promiscuous contact of the healthy-with the sick, through the medium of clothes and various other solid substances, which is always most apt to happen where cleanliness is neglected, and that, when measures are taken to prevent such communication, the infection loses its virulence by dilution and decomposition.
The first house of recovery was established at Man chester. In that populous town, a large proportion of the working classes live in confined dwellings, are slovenly in their domestic habits, and in their morals dissolute and in temperate. Fevers, when once introduced, used to spread rapidly from house to house, and from one neighbourhood to another, till the families even of the wealthier ranks were ultimately assailed. Occurrences of this sort, from their great frequency. excited much general alarm, and, when the physicians sketched a plan for the suppression of these evils, their representations met with a ready at tention among the public spirited inhabitants.
In the year 1795, a fever prevailed at Ashton-under Line, which had been introduced by a patient from Man chester. On that occasion, a temporary institution, on the plan of a fever hospital, was formed at Ashton. This ex ample animated the inhabitants of Manchester in the same cause. A plan was drawn up by Dr Fe'riar, containing his matured views of this subject, which he had atten tively studied, and in which his zeal was deeply engaged. He pointed out the following fertile sources of fever among the poor : 1. Crowded lodging-houses ; 2 Dwell ings in cellar stories, which were damp and ill ventilated; and, 3. Cotton mills, which were kept close, warm, and crowded with people. The advantages he pointed out that would arise from a house of recovery were, That air and convenience wou,d be better consulted, proper nurses would be protided. and the spreading of the infection ar rested. This measure was not at first readily acquiesced in by all. It was conceived that the bringing of many in fected persons under one roof would render that place a focus of contagion, which, in any pepnlous quarter of the town, would be pregnant with clanger. That prejudice,
however, was in a short time removed. The point of doc trine which had been previously ascertained by the learn ed was gradually impressed on others by experience,— that, when several persons are brought together in a well ventilated place, the efiluvia emanating from each patient, instead of uniting with those from others, are dissipated by the qualities of the air, and by the means employed ; whereas, in ill ventilated private dwellings, the bad air, in which the people habitually live, cherishes and rapidly disseminates the contagion generated by a single case. In the proposed institution, the attention, and the whole con duct of the nurses, were to be placed under the best in spection. The access of unnecessary visitors was to be prohibited, and the visits of near relations prevented from becoming dangerous, by the enforcement of precau tionary regulations in the mode of their intercourse with the sick. The clothes of the patients were to be stripped off as soon as they were brought into the house, put im mediately into water, and afterwards well purified. The patients, while under treatment, were to wear clothes be longing to the institution, and dismissed in their own clothes, now in a clean state.
The patrons of this institution formed themselves into a, Board of Health, which watched over the sources of in fection, and encouraged the people to give them the ear liest information of every appearance of fever. This board also actively propagated all that information requi site for promoting the general health, which was derived from the most enlightened sources.
The patrons of the Manchester Infirmary co-operated cordially with the Board of Health. Poor persons under fever had been formerly attended at their own houses by the physicians of that munificent charity ; and a facility was thus afforded to the object in view, as these gentle men, who were the best judges of the case, were to be authorised to send such patients to the House of Reco very. The means of conveyance were provided, all unne cessary delay was thus prevented, and orders were even given, when it was thought proper, to have the houses from which the patients were taken white-washed and thoroughly purified.