During smallpox epidemics, cities established dedicated isolation facilities—often called pesthouses, fever hospitals, or smallpox hospitals—to centralize care and prevent spread. A prime example was the London Smallpox Hospital (later the Highgate Hospital), which operated for over a century. Similarly, in the United States, New York City used Riverside Hospital on North Brother Island, and Boston managed cases at the South Boston Almshouse. These facilities adopted rigorous approaches to care:
Strict Isolation: Hospitals were often built in remote locations (islands, outskirts) to physically separate patients.
Barrier Nursing: Staff wore gowns and gloves, practiced handwashing, and sometimes lived on-site to avoid transmitting the virus.
Symptomatic Management: Since no cure existed, care focused on hydration, fever reduction, and preventing secondary infections. Skin was treated with antiseptics to minimize scarring.
Quarantine Enforcement: Patients were isolated until all scabs fell off—typically 3–4 weeks—ensuring they were no longer contagious.
These methods, though basic by modern standards, proved effective in breaking chains of transmission and laid the groundwork for future infectious disease control.