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the cafe is much the fame here with refpect to this febrifuge, as in mortifications, in which it is known to be of fignal fervice* and it was from a reflection, that mortifications are always accompanied with a fever, that I have propofed the fame medicine in the bloody fmall-pox, interfperfed with black fpots, or, in other words, with fmall gangrenes +.

Here it may not be improper to lay down one general rule, which is, that whatever acute difeafe comes upon the fmall-pox, requires to be treated with its own peculiar medicines, and generally bears them very well.

By this time I hope I have thrown fufficient light on the moft material circumftances of this part of my fubject. But before I clofe it, it feems well worthy of notice, that this difeafe is generally very mild, when it is contracted foon after fome confiderable evacuation, whether natural or artificial. Thus a woman in childbed has generally a kindly fort of the fmall-pox; if she has recovered fomewhat of ftrength, by the time fhe is feized with the diftemper; and therefore reaps benefit from her late fufferings. The fame thing may be faid of fuch as are newly recovered from fome acute difeafe. And I have formerly feen many patients in the hofpital, who, after falivation for the venereal difeafe, caught the fmall-pox, while they were yet vaftly emaciated; and all of them went through it with great fafety; a manifeft proof, that any evacuation, by withdrawing fuel from the fire, agrees particularly well with this difeafe. Laftly, to all that I have hitherto faid, this one remark more is * Vid. medical effays, Edinb. vol. v. part 1. artic. 10. † Chap. iii.

proper

proper to be added. Though this be naturally a dreadful difeafe, yet it is fometimes found to produce very good confequences. For in conftitutions, where the blood is vitiated, either from an original taint, or by the manner of living; and glandular tumours are occafioned by the vifcidity of the lymph; the smallpox, by purifying the juices, contributes to a better ftate of health for the future.

TH

CHA P.

V.

Of the inoculation of the fmall-pox.

HE cuftom of inoculating, or transferring the fmall-pox from an infected perfon to one that is found, has prevailed among us for fome years. This matter has drawn our physicians into parties; fome approving, and others difapproving this new practice. I fhall therefore freely interpofe my opinion in the cafe.

Our nature is fo formed, that although we are always inclined to avoid whatsoever may be hurtful; yet, when any evil is to be undergone, which can only be fuffered once, this we are impatient to go through, even with a certain boldnefs; with this view, that the remainder of life may be paffed without the uneafinefs which arifes from the continual apprehenfion of its coming upon us.

It having therefore been found by experience, that nobody was feized with the fmall-pox a fecond time, and that scarce one in a thoufand efcaped having it once ; men began to confult how the disease might be communicated; it manifeftly appearing to be con

tagious,

tagious, and it was obvious to conjecture, that the feeds of that contagion lay hidden in the puftules.

But I have often wondered how fuch a notion could come into the heads of people almoft quite ignorant of what relates to phyfic. For, as far as I have been able to find out by inquiry, this was the invention of the Circaffians, the women of which country are faid to excel in beauty; upon which account, it is very common, especially among the poorer fort, to fell young girls for flaves to be carried away into the neighbouring parts. When therefore it was obferved, that they who were feized with this diftemper, were in lefs danger both of their beauty and their life, the younger they were; they contrived this way of infecting the body, that fo the merchandise might bring the greater profit. Neither did the thing require the affistance of a physician or surgeon. It was fufficient to make a small wound in the skin, in any part of the body, and put into it a very little of the matter taken out of the ripe puftules; and this even the women had learned to practise *: in like manner as our artists now, making a very flight incifion in each arm, and putting upon it a small thread of lint or cotton, imbibed with the corruption, very rarely frustrate the hopes of their defirous patients.

In process of time, not many years ago, this art began to be used at Conftantinople and Smyrna; not by the Turks, who imagining all things in life to come to pafs by unavoidable fate, think it impious to oppofe and refift it; but among the Grecians, Armepians, and the people of other countries living there,

See Philofophical Tranfactions, No 339. and 347.

who

who gave the knowledge of it to our countrymen *.

But that I may omit nothing relating to this affair; a learned † author has given an account, that the practice of fowing this difeafe, as they call it, has been known to the Chinese above thefe hundred years; and that they do it in another manner, which is this, They take the skins of fome of the dried puftules, which are fallen from the body, and put them into a porcelain bottle, ftopping the mouth of it very close with wax. When they have a mind to infect any one, they make up three or four of thefe fkins, putting between them one grain of mufk into a tent with cotton, which they put up the noftrils.

It was indeed not difficult for fuch ingenious people, when they faw thofe who were converfant with the fick, contract the fame infection, to guess that the air, tainted with the foul breath of the difeafed perfon, did, when drawn in, corrupt one who was found; and therefore they might rationally argue, that the fame contagious matter might be taken in at the noftrils. Nor were they mistaken in this point.

It is however certain, (whatsoever the author of this narration, more skilled in theological than in medical learning, may fay to the contrary), that this Chinefe way of implanting the diftemper is attended with much more danger than the Grecian one. For the morbid particles inspired violently offend the brain, by

*See Maitland's account of inoculating the fmall-pox, London, 1722; et Differtatio medica de Byzantina variolarum incifione, auctore Le Duc. Lugd. Bat. 1722.

+ Vid. Lettres edifiantes & curieufes des miffionaires, recueil xx. page 304.

reafon

reafon of its nearnefs to the nerves which perform the office of fmelling; and we have in another place proved, that contagion is propagated, not by the blood, but by the nervous liquor *.

I myself have had an opportunity of making an experiment to this purpofe. For, when in the year 1721, by order of his Sacred Majefty, both for the fake of his own family, and of his fubjects, a trial was to be made upon feven condemned malefactors, whether or not the fmall-pox could fafely be communicated by inoculation; I eafily obtained leave to make the Chinese experiment in one of them. There was among thofe who were chofen out to undergo the operation, a young girl of eighteen years of age: I put into her noftrils a tent, wetted with matter taken out of ripe puftules. The event anfwered: for fhe, in like manner with the others, who were infected by incifions made in the skin, fell fick, and recovered; but fuffered much more than they did, being, immediately after the poifon was received into the nofe, miferably tormented with fharp pains in her head, and a fever, which never left her till the eruption of the puftules.

Since that time, this practice has been followed, without much fear, and indeed (as it usually happens in new experiments) fometimes with a degree of rafhnefs; as promifing a milder kind of fmall-pox, than when taken in the natural way. For, by † the accounts

* Introduction to the mechanical account of poifons. + See Dr Jurin's letter to Dr Cotelworth, containing a comparison between the mortality of the natural smallpox, and that by inoculation; and His account of the fuccefs of inoculation in the years 1724, 25, and 26.

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