In the preceding pages I have described the usual progress of the
small-pox from the inoculation. There are, however, deviations from
this course, and indeed not a few; some of the most material of which,
as they may embarrass the inexperienced, and create a real difficulty,
as well as apprehensions of danger, it seems necessary to describe, and
to point out the means that experience has suggested to remove these
symptoms, or the doubts respecting the event.
The first I shall take notice of, and which, though it very rarely
happens, sometimes gives much trouble, is great sickness, accompanied
with vomiting, coming on during the eruptive state of the distemper.
For this complaint it is always necessary in the first place to clear
the stomach; which may be effected, either by ordering the patient to
drink plentifully of warm liquids to promote vomiting; or, perhaps more
properly, by given one grain of emetic tartar to an adult, mixed with
ten grains of compound powder of crabs claws; taking care to lessen the
dose for very young and weak subjects.
This usually throws off some bilious matter by vomit, sometimes
procures stools, or occasions a moderate sweat, and generally
administers relief. If, however, no stools should follow from this
medicine, and the sickness should remain, a gentle laxative almost
certainly procures a respite, and the appearance of the eruption
removes the complaint intirely.
Another deviation, of still more consequence, which sometimes happens
towards the time of the eruption, and is often, though not always,
accompanied with great sickness, is an erysipelatous efflorescence.
This, if it shews itself on the skin partially, and here and there in
patches, is not very alarming, and soon wears off.
But sometimes the whole surface of the skin is covered with a rash
intimately mixed with the variolous eruption, and so much resembling
the most malignant kind of confluent small-pox, as scarcely to be
distinguished from it: and indeed some cases of this sort have
happened, where, being accompanied with petechiæ and livid spots, I
have been much alarmed; not being able, by inspection only, though
assisted by glasses, to determine whether what I saw was an inoffensive
rash, or tokens of the greatest malignity. Very strict attention,
however, has enabled me to distinguish the difference clearly; and the
following observations will, I hope, tend to relieve others from the
anxiety they would feel upon such an appearance.
The real and essential difference then is to be gathered from the
concomitant symptoms. In the erysipelatous or variolous rash, there
is not so much fever, nor is the restlessness, or a pain of the head
or loins, so considerable; neither is there that general prostration
of strength, which are almost never-failing attendants on a confluent
small-pox, especially when accompanied with such putrid appearances.
Besides, upon a careful examination, there may sometimes be discerned
a few distinct pustules, larger than the rest, mixed with the rash,
which are indeed the real small-pox. In these cases the patients are
ordered to refrain from cold water, or any thing cold, and to keep
within doors, but not to go to bed. If any sickness yet remains, a
little white-wine whey, or other moderate cordial, is advised; and this
method has hitherto been so successful, as to prevent any alarming
complaint. After two or three days, the skin from a florid changes to a
dusky colour, a few distinct pustules remain, and advance properly to
maturation, without any further trouble ensuing from this formidable
appearance[1].
[1] See Cases XIII. XIV.
This rash has often been mistaken for the confluence it so nearly
resembles, and has afforded occasion for some practitioners, either
ignorantly or disingenuously, to pretend, that after a very copious
eruption of the confluent pox, they can by a specific medicine
discharge the major part of the pustules, leaving only as many
distinct ones as may satisfy the patient that he has the disease. Such
pretensions have certainly been made; and the patient, who has been
deceived in this manner, has contributed to spread reports untrue as to
the fact, and probably prejudicial to the health of others, who in like
circumstances have been sent into the open air, by which, and other
cool means, the rash has been repelled, and the bad effects experienced
afterwards.
I must also observe here, that rashes of the kind I have described
frequently happen during the preparation (whether owing to the regimen,
or medicine, or both, I cannot say) and cause the operation to be
postponed: and I have observed, that in such cases they are apt to
return at the time of the eruption of the small-pox.
In general, as has been already said, the symptoms which precede
eruption commence at the end of the seventh, or in the eighth day,
inclusive from the operation; but it often happens that they appear
much sooner, and sometimes much later, than the time above-mentioned.
For instance, I have seen some cases wherein the disease has happened
so suddenly after infection, and with so little complaint or
uneasiness, that the whole affair has been terminated, purges taken,
and the patient returned home perfectly well in a week’s time; before
others, inoculated at the same time, from the same patient, and under
the same circumstances, have begun to complain.
In this case the inoculated part shews early certain marks of
infection, sometimes on the very next day, or the day after, when
the incision will often appear considerably inflamed and elevated.
The patient about this time frequently makes some of the following
complaints, viz. chillness, itchings, and small pricking pains in the
part, and sometimes on the shoulder, giddiness, drowsiness, and a
slight head-ach, sometimes attended with a feverish heat, but often
without any: the account they themselves give of their feelings, is,
in some, as if they had drank too much, and in others, as if they had
caught a cold. These complaints seldom last twenty-four hours, often
not so long, and with frequent remissions, and never, that I remember,
rise to a degree that requires confinement. The inflammation on the arm
at the time of the complaints, advances apace, and feels hard to the
touch; but upon their wearing off, the inflamed appearances gradually
lessen, and the part dries to a common small scab; the skin that was
before red, turns livid, and the party is quite well, and nothing more
heard of the distemper[2]. In some instances these symptoms attack much
later; even on the seventh or eighth day, when an eruption might be
expected in consequence of them, yet none appears; but the arm gets
well very soon, and the disease is at an end.
[2] See Case I.-XII.
In this irregular sort of the disorder there have, however, been
some examples where a few eruptions have appeared, and probably in
consequence of the inoculation; yet the pustules have not looked like
the true pocks, nor maturated like them, nor lasted longer than three
days; about which time they, for the most part, have dried away.
As I find it difficult to describe the variety and irregularity of
symptoms that occur in this short way of having the distemper, I will
give some cases, by way of illustrating the matter more to the reader’s
satisfaction.
When subjects of this sort first occurred in my practice, I was in
doubt whether they were quite secure from any future attacks of
the distemper; and in order to try whether they were so or not, I
inoculated them a second time, and caused them to associate with
persons in every stage of the disease, and to try all other means of
catching the infection; and this method has been practised with the
generality of such patients ever since, yet without a single instance
of its producing any disorder: so that I now make no scruple of
pronouncing them perfectly safe; and experience has enabled me, for the
most part, to foretell, in two or three days after the operation, when
the disease will pass in this slight manner.
Upon the second inoculation, however, the incised parts are commonly
inflamed for a day or two, just in the same manner as I have, in
numerous instances, found them to be, as well in those who, though
certain of having had the small-pox in the natural way, have submitted
to be inoculated merely for the experiment sake, that the result might
be observed; as in others, who, being doubtful whether they have had it
or not, have been inoculated, in order to be satisfied. But in all such
cases the parts soon became well; nor did any of those appearances
which have been described as the constant attendants on inoculation, as
pain in the head, giddiness, marks of infection in the arm, &c. ensue;
nor can they ever be produced upon a person who has had the small-pox
before, either in the natural way or by inoculation; and therefore it
cannot with reason be suggested, that the patients, whom I suppose to
get through the disease in the very slight manner above described, may
possibly have had the small-pox unobserved in some former part of their
lives.
Another irregularity deserving notice here, is, that sometimes, upon
the abatement of the fever and other symptoms, after the appearance
of several pustules, and when the eruptive stage of the disease seems
completed, it nevertheless happens that fresh eruptions come out,
and continue doing so daily, for 4, 5, or even 6 days successively;
preceded sometimes by a slight pain in the head, though more frequently
they appear without any new disturbance. These are generally few in
number, short-liv’d, and seldom come to maturity. But I have seen
four cases, in each of which, after a cessation of complaints, and
an appearance of few pustules, the eruptive stage of the disease was
thought to be over, yet in two or three days a fresh fit of fever has
attacked the patients, and after a short illness a quantity of new
pustules has broken out, far exceeding the first number, and these
remained, and maturated completely. Instances of this kind may be found
among the cases annexed[3].
[3] Vide Cases XV. XVI. XVII. XVIII.
Some of my own patients, and, as I am credibly informed, of other
inoculators in this way, have had considerable eruptions of this kind
after they have returned home; which have probably given occasion for
the reports of several having had the disease again in the natural way
after inoculation. But that these reports are ill-grounded, will appear
from this observation, to wit, that in all the cases of this sort which
have occurred in my own practice, or, as far as I can learn, in that
of others, the second or latter crop of pustules has always happened
within the time usually allowed for the progress of the small-pox
from inoculation, and before the inflammation on the arm has ceased,
and sooner than they could be supposed to be produced by infection
taken in the natural way; and whenever it has happened, it has been to
persons in whom, after a slight eruption, and abatement of symptoms,
the disease has prematurely been judged to be quite over, and they have
therefore been permitted to return to their families.
It will doubtless be asked, how cases of this kind should ever happen
among those who return home as cured? To which I answer, That it is
no unusual thing for industrious men, after a slight eruption, and
cessation of all complaints, to ask leave to return home to their
occupations and families; and where it has been thought that no danger
would accrue to others, their request has been often granted; for the
physician, no more than the patient, can foresee when these accidents
shall follow: but it may be observed here, that in all these cases
of my own knowledge, very repellent methods have been used in the
beginning; and a more generous diet or greater exercise afterwards, has
seemed to contribute to this secondary eruption.
Before I conclude this chapter, it may be proper to observe, that
inoculated patients, in some stage or other of the disease, may
possibly be attacked with diseases altogether independent of the
small-pox; such, for instance, as may arise from worms, or be the
epidemic of the season, or such as the patient may by constitution
be subject to; and some cases of this sort will be found among those
annexed.[4]
[4] Vide Cases XVII. XIX. XXI.
CONSEQUENCES of this Method of INOCULATION.
I shall now consider the consequences that follow this very cool and
repelling method, and how far the patient’s future state of health
may be affected by a practice so new, and opposite to all established
theory.
I need not say how much it has been thought right, in most or all
eruptive complaints, especially in the small-pox, to forward, by
every gentle means, the efforts of nature in producing an eruption;
and on the contrary, how dangerous to check it, either by cold air,
cold drink, or any considerable evacuations; or that the use of warm
diluents, therefore, and the lying in bed, especially if the fever
and symptoms run high, or at least confining to the house, have been
generally approved and recommended for the purpose. But when a practice
so foreign to this, and almost totally different, is inculcated, it is
no wonder if men’s minds are alarmed, and those evils expected that
were supposed to be the unavoidable consequences of it.
Experience, however, and instances of so many thousands succeeding
by this method, without any considerable bad effects from it, either
immediate or remote, are irresistible arguments for its support and
justification, and the best proof of its utility and safety. I have
said, without any considerable bad effects; for in reality I have seen
none that deserve that name, if compared with what sometimes follow
the natural small-pox, or frequently happen after the old method of
inoculation.
Every one who has had any share in this practice according to the
common or old methods, will allow, that after passing through the
disease in a very favourable manner, their patients (children
especially) were frequently liable to abscesses in the axilla and other
parts, tedious ophthalmies, and troublesome ulcerations in the place of
insertion; which though they could not be foreseen or prevented, yet
frequently gave more pain and vexation to the patients, and trouble
to the operator, than the disease itself had done: whereas on inquiry
into the fate of those who have been treated in the cool way, or this
new method, I can say, that in more than 1500 there has been only one
who has had so much as a boil in the axilla; and that was in a child
who had an issue in the same arm, and which was at that time dried up:
and I have only seen two very small superficial boils in others near
the place of insertion; and these seemed rather to be occasioned by an
irritation from the discharge, than from any other cause, and were all
soon healed with very little trouble.
In a few instances also there has been a slough in the incised part,
which has made a sore of short duration; but not one instance of an
ulcer of any continuance. Such little breakings out too, and scabs, as
are frequently known to succeed the mild natural small-pox, sometimes,
though rarely, happen to those inoculated this way; and as they are of
the same little consequence, are generally cured by the same method of
a few gentle purges.
With regard to ophthalmies from this kind of practice, I have never
had an example of one truly deserving that name; the coats of the eye
have been a little inflamed in a very few, but they soon became clear,
without any means used for that purpose. And I know but two cases where
I thought the inflammation great enough to require bleeding, and not
one where a blister was necessary. So that these complaints, heretofore
so frequent and grievous, seem by this new method to be much reduced: a
circumstance which, if it does not amount to a proof, admits at least
of a fair conjecture, that the state of health is better here, than
where those remains of putridity are so evidently existing in the habit.
Discoveries in physic, as in every other science, are in their
infancy liable to censure and opposition; and as the present system
of inoculation is of so extraordinary a kind, it would not be strange
if a greater portion of both than usual should fall to its share.
Accordingly, since no charge of fatality during the disease, nor
instances of bad effects soon after the recovery, can be produced,
recourse has been had to other measures to calumniate and discredit the
practice. It would be tedious to enter into a detail of the many false
and ridiculous reports that have been spread against it. In general,
the constitution is said to be injured, and the dreadful effects are
to appear at some distant period; but at what time, or what kind of
disease, nobody pretends to determine. To these general accusations it
cannot be expected I should give other than a general answer; which
is, that from the strictest observation and inquiry I have been able
to make, those who have been inoculated in this way, have continued to
enjoy as good a state of health as their neighbours; nay, many of them
have thought their constitutions better after the process than before.
But it seems as if these opposers expected that inoculation should not
only free the inoculated from the small-pox, and any early bad effects,
but must preserve them too from all other disorders through the rest of
their lives. To such I can say nothing; but if others, who are more
reasonable, require further satisfaction as to the consequences of
this method, I must desire them to make inquiry of those who have been
inoculated under my direction.
Another charge against this method of inoculation is, that some have
had the distemper afterwards in the natural way. What I have said under
the head of anomalous small-pox, will I believe sufficiently account
for the appearances which have occasioned these false reports; and if
that does not satisfy, I can only add this positive declaration, that
nothing of the kind has ever happened to any patient inoculated by me;
and I firmly believe, no one has ever had, or can have, the distemper a
second time, either in the natural way or from inoculation.
The EFFECTS of this TREATMENT applied to the natural SMALL-POX.
The very great relief which persons under inoculation experience from
fresh air, cold water, and evacuations by stool, during the fever
preceding eruption, soon determined me to make trial how far the
like treatment might be useful to those who might be seized with the
small-pox in the natural way; more especially in such cases, where,
from the violence of the symptoms, a confluent kind was justly to be
apprehended.
But opportunities of making experiments of this sort in a satisfactory
manner are rare. First, because a physician, or even medical assistance
of any kind, is not often called in till the eruption shews itself;
when it is too late to expect all the good effects that might be hoped
for, from an earlier trial of this method: and secondly, because the
first attack of the small-pox is so much like the beginning of some
other fevers as not easily to be distinguished; though a diligent
attention to the symptoms, will generally, if we are called in time,
enable us to form a pretty certain prognostic. For if the attack of the
cold fit be pretty severe, and the subsequent fever unusually high;
if a nausea and vomiting succeed, together with great pains in the
head, back, and loins, especially in the last; if a delirium, great
restlessness, disagreeable taste in the mouth, and a peculiar fœtid
smell in the breath, or even if several of these symptoms are observed,
the small-pox may with great reason be expected; and if upon inquiry,
which should always be made, it appears that the patient has been in
the way of infection, there will be little reason to doubt it.
It may be objected, that notwithstanding the closest attention and
inquiry, symptoms of the like nature may precede fevers of other kinds;
to which I answer, that some such cases, though few, have happened;
and the treatment I am about to recommend has been practised not only
without prejudice to the patient, but manifestly to his benefit.
But waving for the present all considerations respecting the treatment
of fevers in general, I shall only relate what has occurred to me in
respect to the natural small-pox.
In several instances where I have been concerned, and where the
symptoms and other concurring circumstances induced me to think the
small-pox was at hand, I have directed the like management as I
recommend to inoculated patients[5].
[5] See Cases XXIII. XXIV. XXVIII.
I have been called also to others at the time of eruption, where some
pustules having already appeared, made the matter clear; and in every
case of this kind, I have endeavoured to get the sick person into the
open air, have generally given the mercurial and antimonial pill,
and directed a laxative to be taken some hours after it, in order to
procure three or four stools; and this method I have more particularly
enjoined, and sometimes repeated, where the kind has appeared to be
bad, and where little or no relief has been found from the partial
eruption; the symptoms continuing to be such as portended great danger.
I have followed the same method during every part of the eruptive
fever, intending thereby to abate its violence, to check the eruption,
and prevent the conflux, and consequently the danger[6].
[6] See Cases XXV. XXVI. XXVII. XXIX.
The success attending this practice has hitherto exceeded my
expectations; though it must be confessed, that as the symptoms run
much higher in the natural, than they are found to do in the inoculated
disease, the relief has not been so considerable; and I have found
it extremely difficult to persuade such whose complaints have been
very severe, to quit their beds, and attempt to go abroad: indeed the
exceeding feeble state they are sometimes in, sufficiently shews that
great resolution is requisite to put this in practice.
Among those who have been treated in this manner under my own care
and inspection, not one has died, and the number amounts to about 40.
Some of the most remarkable cases will be subjoined, which will more
satisfactorily explain the practice, and demonstrate its success.
The immediate sensible effects of going into the open air, are, a very
great abatement of heat upon the whole surface of the skin, which,
though but just before intensely hot, generally in a short time feels
not much warmer than that of a person in health: the pulse, from being
very strong, full, and quick, becomes less hard and full, but continues
quick; and I have sometimes observed it to intermit; which, however
alarming it may seem, is not a dangerous symptom.
The pain in the head is always relieved, but that in the back and loins
does not abate in proportion: and although it costs no little pain and
trouble to persist in moving abroad under such circumstances, attended
for the most part with great lassitude, yet the patients are sensible
of the benefits they receive; and entertaining a good opinion of the
usefulness of the practice, commonly behave with great resolution;
and, what is very encouraging, in general think themselves stronger.
Upon going within doors to rest themselves, the pain in the head grows
worse, but is again relieved as soon as they return into the air.
The effects of the medicines are usually these:
If there has been much sickness at stomach, a vomiting frequently
happens soon after the pill: this the patients should promote by
drinking plentifully of some warm diluents; and till the fatigue
occasioned by it is over, they certainly ought not to go abroad.
By this operation, and the stools which succeed, the feverish and
internal heat, the thirst, sickness, and pains, are for the most part
considerably abated. The patients commonly complain of being very
low and faint after these evacuations; but the most urgent symptoms
being alleviated thereby, a disposition to receive nourishment hourly
increases. They are then allowed to drink thin mutton or chicken broth,
milk pottage, or tea, as the most grateful and refreshing cordial
sustenance they can take. Sleep likewise now most commonly comes on
spontaneously. But they are permitted to enjoy this refreshment by day
upon the bed only; for I always dissuade them from going into it till
night.
From the foregoing account it appears, that the fever preceding
eruption, and the most grievous symptoms accompanying it, are often
greatly mitigated by this practice; and I will here add, that the
eruption is most certainly retarded, that is, it does not appear so
soon after the attack of the disease, nor come out so precipitately
when it has begun to appear, as it seemed likely to have done if the
natural progress had not been interrupted; an effect, which, however
dangerous it may have been thought, may be produced with the utmost
safety, and clearly shews the utility of the practice. For it is
evident from experience, that the later the eruption shews itself
after the beginning of the disease, and the slower it comes out, the
more mild and favourable is the subsequent disorder. And I am of
opinion, that the eruption is not only retarded and protracted by this
method, but likewise that it is in some degree repressed; having had
strong reasons to apprehend, in several instances, that the number of
pustules, which appeared at first, were by such repression actually
diminished; and those that remained seemed larger, and of a milder kind.
What has hitherto been said on the subject, relates only to the disease
in its eruptive state, which is certainly a very interesting period;
but that which follows is not less so, though not always attended
to so much as it deserves: for when the eruption is completed, the
symptoms abate, the patients seem relieved, and often to such a degree,
that both they, and their attendants, flatter themselves with hopes
of a happy event, and think it unnecessary to apply for any medical
assistance; yet with all these hopeful appearances, the number and
kind of the small-pox are frequently such, as would make a judicious
practitioner apprehensive of much danger in the subsequent stages.
And where the practitioners themselves may see reason to doubt of the
event, yet few or none of them have attempted, I believe, to do much
towards preventing the danger; for, unless some pressing symptoms
call for immediate relief, it is the general practice to wait till
maturation comes on, and brings with it such a train of dreadful
complaints, as are more than enough to employ, and too often baffle the
best abilities.
In this neglected interval, from the eruption being completed, to
the accession of the fever of maturation, and its concomitants (an
interval which, in point of duration, is very different in different
constitutions and kinds of small-pox); I will venture in general to
recommend the same mercurial antimonial medicine as was prescribed
in the eruptive fever, to be repeated at proper intervals, till the
maturation advances; at which time it must certainly be discontinued:
and these circumstances can be regulated only by those who attend,
according to the urgency of the symptoms, and the strength of the
patients: a cupful of the following apozem should, if necessary, be
now-and-then taken after the mercurial medicine; often enough to
procure three or four stools a day, especially if the patient is
costive.
Take cream of tartar, two drachms; of manna, one ounce; dissolve
them in one quart of barley water, or the pectoral drink.
How far it may be safe or advisable for the patients to venture
out into the open air during this stage of the disease, I will not
yet pretend to say; but they will certainly be both refreshed and
invigorated, by being kept out of bed as much as they can bear, without
being over-fatigued; and by fresh air let in sometimes through an open
window.
As the violence of the eruptive fever, with its attendant complaints,
must necessarily exhaust the strength and spirits, both should in this
interval be recruited, by as much proper nourishment (such as has
been mentioned in the former part of this chapter) as can be taken
down without offending the stomach; and also, if occasion requires,
with medicines of a cordial and anodyne quality: for this is the time
to recover as much strength as possible, in order to be better able
to encounter and bear the pain and fever, which will most certainly
happen, as the state of maturation advances.
Medicines, except what have been already mentioned, seem at this time
unnecessary; and they would interfere with, and prevent the true relish
for, food.
But for the best method of treating the small-pox in its most dangerous
stage, I mean that of maturation, I must refer to the several learned
and eminent practitioners who have professedly written upon the
subject, whose opinions and practice I neither pretend to correct or
amend. I shall however take the liberty to recommend one medicine
to be used in that stage of the disease, which I have found to abate
heat, and allay thirst, in such a manner as to afford a very pleasing
refreshment.
Take of the weak spirit of vitriol one part, of the sweet spirit
of vitriol two parts; mix. Of this the quantity of half an ounce
may be added to a quart, or perhaps three pints, of barley water,
or the pectoral drink, or any other diluent, and to be drank of at
pleasure.
I have at present nothing farther to recommend; but what has been
said will I presume be sufficient, with the cases annexed (in which
the method will be more plainly described) to justify farther trials
of the cooling, repelling, and evacuating practice in the beginning,
at least, of the natural small-pox, till the eruption is completed;
especially where the physician has an opportunity of making the trial
before the eruption appears, and can be pretty certain, or has good
reason to conclude, that his patient’s disorder is variolous. And the
more violent the symptoms are in this stage of the disease, the more we
should be induced to employ the means which have been attended with so
much success, in the same stage of the disease after inoculation.
But it may be asked, if I was called to a patient in a bad confluent
small-pox, and finding the eruption completed, whether in such a case
I should venture to give and continue the use of the alterative and
purgative medicine; and advise the patient to go out, if he can bear
it, into the open air in cold weather, or direct air to be let in
through a window even while the mercurial purge may be operating.
Before I give a direct answer to this question, let me first ask the
most experienced practitioner, whether he knows any method of cure
which may in bad cases be safely relied on, to avert the impending
danger, and save his patients? The too well known fatality of all
kinds of small-pox, very clearly proves that he does not, and that no
such method has yet been discovered. And if this be the case, surely
a bold, and even hazardous practice, is very justifiable towards any
such unhappy patients, who lie as it were under sentence of a cruel
death, not to be prevented by what are called the regular and usual
methods. But still it may be urged, that no impending danger, however
great, can sufficiently justify the trial of any hazardous experiment,
unless supported by some degree of reason or experience. Happy, indeed,
it is, when we have these two guides before us; but when they are
separated, the latter is certainly most to be relied on, and her I have
endeavoured hitherto to follow.
For in the practice of inoculation experience has taught me, that
after as well as before the eruption, persons may safely take
mercurial purges, and go out during their operation (though I have
seldom advised any to do so) into the cold air, in inclement weather,
without suffering the least harm or subsequent ill consequence from
it. And by this experience I was led, though with great caution, to
try whether the same practice might not be safely employed in the
cure of the natural small-pox, as well as the inoculated; nor have the
trials been unsuccessful: for though among the patients I have treated
in this manner, some had confluent sorts, yet were the complaints
unusually moderate throughout the whole progress of the disease, and
the maturation was completed, without such troublesome and alarming
symptoms and events as might be expected under any other known method
of treatment; nor did any secondary fever ensue.
I would not, however, be understood to entertain so good an opinion of
this method, as to insinuate that it will save all who have the bad
confluent kind; too many of these are incurable; but I am not without
hopes, that it may give a chance of recovery, hitherto untried, to
many: and even if this alterative and evacuating course in the early
part of the disease should not succeed, so as to avert the approaching
danger, I think there is great reason to suppose that nourishment,
cordials, and opiates, which may be wanted in the state of maturation,
will be administered with more advantage and security after it, than
if that method had not been previously taken.
It seems necessary, however, to declare, that nothing which has
been said is meant to relate to practice in the bleeding or purple
small-pox; though very cold repellent methods may perhaps deserve to be
tried in these hitherto fatal cases, provided it can be done early; but
the mercurial evacuating course seems quite improper.
Upon the whole, what has been said on the natural small-pox, must wait
the award of time and experience, the only tests of the utility of any
practice; for I have lived long enough to have seen several instances
where very ingenious and well-meaning men have been greatly mistaken,
by relying too much on the first impressions made by a few successful
experiments.