In May 1776, I was desired to visit a considerable farmer, aged 68, to
give my advice for a complaint in his legs.
About two years before he had been seized with a numbness and coldness
in both legs and thighs, which it was apprehended would end in a
palsy. For this disorder he took many medicines, and both his legs
were blistered, by which he found relief; but from this time the legs
were affected with troublesome itching and burning pains, attended
with a sharp serous discharge through innumerable excoriations. These
complaints destroyed his rest, and made him unhappy.
After relating this case, he told me, that as almost every body in
the neighbourhood, who had not had the small-pox, was either under
inoculation or preparing for it, he could scarcely expect to escape the
infection, and had therefore a strong desire to be inoculated; and that
his wife of the same age with himself, was likewise desirous of it.
This proposal induced me to examine the present condition of his legs
more strictly. They were now, he said, in their best state; that is,
not so full of pain as usual; they were dry and scurfy. His face was
likewise scurfy, and of a settled deep red colour; the consequence, as
he told me, of a repeated Erysipelas in it, and not of any intemperance.
Upon considering the case, and reflecting that the preparatory course
of diet and medicine would probably amend the condition of his legs, I
encouraged him to pursue his intention; and both he and his wife, after
a fortnight’s preparation, were inoculated on the third of June.
On the 9th both made some slight complaints; and on the 12th the wife
grew better, on the appearance of a very few distinct pustules, which
maturated afterwards in the most favourable manner. But the man still
complained of pain and weariness till the 13th, when he grew easier in
that respect, and felt a smarting pain in his legs, which were very
red, and had several pustules on them. Towards evening they grew more
painful, more swelled, and a further eruption was discernable, though
not easy to be distinguished, by reason of their diseased state.
He slept very little this night; but on the 14th I found him free from
fever, and pretty well in all respects, except the pain in his legs;
on which, and under the hams, a great number of distinct, but almost
coherent pustules appeared. There were several also in the neck and
face, but very few on the body or arms. He had all along been advised
not to stir much, but had taken greater liberties of walking about than
I had allowed.
15th. He had not slept a minute during the night. I found him up and
walking about the house, complaining much of pain, but saying that in
other respects he was well; but he was now rather cool than warm, his
pulse very low, his aspect languid, the colour of the face inclined to
livid and pale, and he complained of faintness and sickness. I could
not avoid being alarmed. The legs also were swelled considerably, but
not inflamed. I therefore ordered him instantly to bed; and as the
tension was great, applied a cataplasm of bread and milk (being what
was nearest at hand) all over each leg, and directed the following
medicine to be taken as soon as possible.
℞ Mithrid. Ʒss. Decoct. Cort. Peruv. ℥ij. Tinct. Cort. Peruv.
simpl. Ʒij. M. f. haust. quam primum sumend. & sexta quaque hora
repetendus.
℞ Sal. Absinth. Ʒj. succ. Limon. ℥jss. Decoct. Cort. Per. ℥vi.
Tinct. Cort. Per. simpl. ℥jss. Syr. é Cort. Aur. ℥ss. M. f.
mixtura, cujus capiat Coch. iv. horis intermediis.
In the evening his pulse was raised, he was easier, and rested about an
hour.
16th. In the morning, after he had rested some hours in the night, he
was easier, warmer, and the pulse better.
17th. After a good night he found himself free from complaints, and
from this time every circumstance went on favourably; the pocks
maturated on the 7th day; his legs however were both considerably
ulcerated for a fortnight after, but then soon healed. He remains at
present in good health, and feels less uneasiness from his legs than he
did before the inoculation.