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Tuesday, October 28, 2014

Ind. Gov't. - Quarantine and infectious disease in Indiana at the end of the 19th century

One of my prize possessions is a copy of The Hoosier Health Officer, A Biography of Dr. John N. Hurty. Hurty was Secretary of the Indiana State Board of Health from 1896 until about 1922.

The book quickly reminds one that it is not that long ago that the control of infectious disease was one of the most basic functions of Indiana government. Here are a few quotes from p. 81 of the volume:

Diphtheria had been epidemic in all parts of the State for two or three years when Hurty came into office. He threw himself into the fight with a zeal for health which had never been seen before in Indiana. There are so many tales to tell of his efforts to stamp out the disease that it is hard to choose a particular one as being the most interesting. We shall let him tell of his experiences at West Baden and French Lick (Indianapolis News, Sept. 15, 1896):
J.N. Hurty, secretary of the State Board of Health, reached home this morning after an experience with a diphtheria epidemic in Orange county. He found a telegram awaiting him from Mitchell, also at once, as the disease bad broken out there. The telegram was from the clerk and auditor of the county.

"The towns of West Baden and French Lick have been quarantined against this district. A proclamation has been declared enforcing the strictest of quarantine and sanitary regulations. There are, or have been seventy-five cases in the district and twenty deaths, but I believe the cases will now be controlled. Supplies of disinfectants, antitoxin and other things needed have been left where they can be had. Filth and an utter disregard of sanitary regulation as to carding houses, public funerals, etc. are causes of this epidemic, and it would be better for the whole community if some of the worst infected places could be destroyed by fire."

In his struggle to find ways of stopping the dread disease he made great effort to find the best methods of quarantine and isolation. It was comparatively easy to say what should be done but very hard in those times to get quarantine enforced. In particular it was hard to get the doctors themselves to understand what was needed. Many of the physicians of that time had never been to a real medical school and by far the most of them had never had any sort of course in bacteriology. It was customary in those times for the physician to carry in his pocket a metal tongue depressor which folded up like a knife, and was used on one patient after another without any sort of adequate disinfection. There was much derision when Hurty advocated that the doctors provide themselves with little wooden paddles or tongue depressors which were to be burned after being used once. * * *

The State Board of Health made a set of rules which required that the physicians should provide themselves with a gown which they would wear when visiting an infectious case such as diphtheria, scarlet fever or smallpox. Explicit directions were set out as follows (Ind. Med. J. 15 : 231-233):

Rule 1. When visiting patients known to be sick with smallpox, scarlet fever, diphtheria or other contagious disease, physicians shall clothe themselves in a specially provided clean lined duster, oil cloth or rubber coat, and a tight-fitting cap made of silk, linen, oil cloth or rubber. The cap shall well cover the hair. Before leaving the house, physicians shall cleanse hands and face with antiseptic soap and water, and use a disinfectant upon hands and face. The coat, cap, antiseptic soap, bottle of disinfectant, etc. shall be carried in a special glazed leather valise, together with a pad of cotton, which is to be kept wet with formaldehyde.
This requirement was met with much resistance by the physicians. The members of the Shelby County Medical Society (Ind. Med. J. 15: 297-298) were very outspoken in their criticism.

Posted by Marcia Oddi on October 28, 2014 09:20 AM
Posted to Indiana Government