June 2d. Twenty-two persons were inoculated, who lodged at two
neighbouring houses.
On the 4th in the evening one of them, a man aged 30, had a shivering
fit, succeeded by fever, with pain in the head, back, and side, which
continued all night.
5th. In the morning, when I first visited him, the pulse was very
quick, full, and strong, and the former complaints remained; but I
found him walking about the house. On inspecting the incisions, both
were quite well; while those of every one of his associates, which I
saw at the same time, shewed evident marks of infection.
This patient had been very much in the way of infection, and I
suspected that he was going to have the small-pox in the natural way:
I therefore directed the mercurial and antimonial pill to be taken at
night, and that he should go into the air as much as he could bear, but
not go into bed.
6th. In the morning I was informed that he had been sick and vomited,
without having a stool: and that all his complaints remained, though
not quite so violent. I prescribed half an ounce of Glauber’s salt,
and half an ounce of manna, dissolved in water-gruel, to be taken
immediately.
In the afternoon I found him in bed, but was told he had been in the
air, and that the purge had operated four times. He was now disposed
to sweat, and his pains were abated; but the fever remained as before,
with a white dry tongue: he had a troublesome cough, difficult
respiration, and great oppression at his stomach; but there was not the
least sign of infection in the arm.
7th. In the morning he was much in the same state, only weaker. I
prescribed a salt of wormwood mixture, with Mindererus’s spirit, an
oily mixture for his cough, and one grain of emetic tartar mixed with
10 grains of compound powder of crabs claws, to be taken in the evening.
8th. He had four stools in the night, sweated pretty well, and got some
sleep; but he coughed much, breathed with difficulty, expectorated
some thin frothy phlegm, and complained of great pain in his breast
and side. Eight ounces of blood were directed to be taken away; the
antimonial powder was repeated, with an addition of one grain of
calomel; and he was directed to drink frequently a cup-full of pectoral
decoction, to a quart of which was added one ounce and a half of
Mindererus’s spirit.
9th. The blood taken away yesterday was very fizy, the pain in the
breast and side much abated, but the cough very troublesome, and the
expectorated phlegm streaked with blood. The inoculated parts were now
discoloured, shewed evident signs of infection, and that we should
soon have the small-pox to encounter together with the peripneumonic
disorder.
10th. Very restless all the night, coughed much, and with great
difficulty expectorated brown viscid phlegm. The bleeding was repeated,
and the use of the antimonial powder and other medicines continued;
which had every day procured some stools, and supported a constant
breathing sweat.
11th. The blood was still found fizy, and the fever, cough, difficulty
of respiration and of expectoration were increased. The progress of
infection in the arm was slow, but shewed, however, that the eruptive
fever would soon come on; and I was apprehensive that it would be
so confounded with the peripneumonic disorder, as to cause much
perplexity. I determined nevertheless to attempt to relieve the latter
by whatever means I could, and wait the event; and therefore ordered
more blood to be taken, a blistering plaister to be applied between
the shoulders, and a small quantity of gum ammoniacum to be added to
his pectoral medicines. In the evening I was informed that all the
troublesome symptoms were considerably abated.
It must here be noted, that all the company, who had been inoculated
at the same time, were now ill, and most of them had some eruptions.
12th. He had had more rest; but though most of his complaints were
relieved, yet the fever still continued, and he expectorated with
difficulty some very dark-brown phlegm, so that no alteration was made
in his medicines.
The appearance on the incisions spread, but did not look as usual when
the eruptive complaints are begun.
13th. The fever, pain in the side, cough, and difficulty of
expectoration, being again increased, I ordered a vesicatory to the
side, and some oxymel of squills in a pectoral mixture.
14th. The fever and pain of the side were abated, and he had obtained
some little sleep, which was however much disturbed by sudden
startings. The skin at the incisions had an unusual appearance, not
easily to be described; and instead of being inflamed, as it usually
is, where the progress of the infection is favourable, and not
interrupted by some extraordinary accident, it was of a pale hue.
15th. He had rested ill, and the cough was so troublesome, that I
ordered more blood to be taken, and the medicines to be continued. The
incisions this day looked like pustules irregularly shaped, and a fluid
appeared under the cuticle.
16th. All symptoms were more moderate; two pustules were discovered in
the face, and those at the incisions seemed tending to maturation.
17th. All complaints much easier; the pustules at the incisions were
more elevated, and had matter in them; but the others were but little
advanced, and looked pale.
18th. He was in all respects so much better, that he ventured to ride
out on horse-back, and I was released from my attendance; nor did I see
him afterwards till he called at my house in good health on the 5th
of July. But he then informed me, that in the afternoon of the 19th of
June, the day after I took my leave of him, he had been extremely hot
and feverish; was relieved on the 20th from all feverish symptoms, and
discovered a great number of pustules, which rose, filled, and ripened
without any further illness; so that he did not think it necessary to
send me any notice of them. Looking in his face, I saw about thirty
marks of small-pox, which confirmed the truth of his report.
I have also since received a very satisfactory account that many
pustules in his face and other parts which came out after the time I
saw him, stayed a proper time, and maturated completely.