Now! Then! During the wartime Serbian typhus epidemic, Clifford Allbutt recalls the open-air treatment he used in the 1865-66 outbreak in Leeds

13 April 1915: During the wartime Serbian typhus epidemic, Clifford Allbutt recalls the open-air treatment he used in the 1865-66 outbreak in Leeds

T. Clifford Allbutt. 1915/04/15. The Serbian Fever. Times. London. Get it:

Excerpt

As in the sixties of the last century I had the entire charge, as honorary physician of the Leeds Fever Hospital (about 100 beds) through two several virulent epidemics of typhus, I venture to offer at least one result of my experience. I read in a recent issue of The Times that the Serbian Army suffered far less than the civil population because of the open-air life of the soldier. The two Leeds epidemics were, as I have said, virulent; my house physicians were all attacked save one; three died, and one, after passing through the convulsive form of the disease, barely escaped with his life. Still my brave colleagues, one after another, devoted themselves to this duty. The mortality was very heavy, 16-17 per cent. The late Professor Rolleston, of Oxford, casually remarked to me, concerning the Irish fever during the Great Famine, that not a few of the patients carried out into the hedge bottoms as moribund nevertheless recovered. This remark dwelt in my mind for a few days and led me to determine to test open air as a principle of cure. Nothing was then known of “open-air treatment”; every “fever case” was sheltered and coddled. Happily the fear of infection served me where prejudices did not. I clothed the staff warmly and had all the windows taken out of the building or clamped widely open with screws. Our mortality of all cases fell promptly from 16-17 to 6-7 per cent, and the infective activity was much reduced.

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To facilitate reading, the spelling and punctuation of elderly excerpts have generally been modernised, and distracting excision scars concealed. My selections, translations, and editions are copyright.

Abbreviations

Comment

Via Rolleston, who has more good quotes, and notes that, while Allbutt had tried the open-air treatment of typhus and typhoid fevers and smallpox at the Leeds House of Recovery, “he had never thought it advisable to try this method in scarlet fever and measles, as it might do more harm than good.” Apparently “routine and prejudice gained the upper hand” after he lost sole charge of the Leeds House of Recovery, and the technique was abandoned (Rolleston 1929).

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Original

THE SERBIAN FEVER.
TO THE EDITOR OF THE TIMES.
Sir,-As, happily, typhus fever has almost died out in this country few English physicians have had experience of it. As in the sixties of the last century I had the entire charge, as honorary physician of the Leeds Fever Hospital (about 100 beds) through two several virulent epidemics of typhus, I venture to offer at least one result of my experience. I read in a recent issue of The Times that the Serbian Army suffered far less than the civil population because of the open-air life of the soldier. The two Leeds epidemics were, as I have said, virulent; my house physicians were all attacked save one; three died, and one, after passing through the convulsive form of the disease, barely escaped with his life. Still my brave colleagues, one after another, devoted themselves to this duty. The mortality was very heavy, 16-17 per cent. The late Professor Rolleston, of Oxford, casually remarked to me, concerning the Irish fever, that not a few of the patients carried out into the hedge bottoms as moribund nevertheless recovered. This remark dwelt in my mind for a few days and led me to determine to test open air as a principle of cure. Nothing was then known of “open-air treatment”; every “fever case” was sheltered and coddled. Happily the fear of infection served me where prejudices did not. I clothed the staff warmly and had all the windows taken out of the building or clamped widely open with screws. Our mortality of all cases fell promptly from 16-17 to 6-7 per cent., and the infective activity was much reduced.
I strongly urge that in Serbia every typhus patient should be carried out into the open air, in wet weather a waterproof coverlid would be sufficient protection. Every attendant should wear glazed cotton overalls, not forgetting thus to protect the neck and hair also.
I am, Sir, your obedient servant,
CLIFFORD ALLBUTT.
The Athenæum, Pall-mall, S.W., April 13.

344 words.