I have carefully perused the case you have communicated to me, and am
of opinion, that the disease you have described was not the small-pox.
The cold fit which preceded the other complaints, is what usually
happens at the commencement of the small-pox in common with other
fevers; with this exception, I do not find one symptom during the
whole illness, that corresponds with the well known progress of that
disease.
The eruptions (on which I presume the suspicion of the small-pox was
founded) differed from that distemper in every essential point, viz.
The time and manner of their appearance; the parts they occupied; and
their form and progress. Neither am I of opinion that the disease was
the effect of any variolous matter left in the blood, in consequence of
the previous inoculation.
That the natural and inoculated small-pox, as well as other diseases
which form critical discharges on the skin, may sometimes be succeeded
by boils or breakings out, is well known; but these follow very soon,
are free from danger, and easily cured by gentle purges. Now in the
case before me, I find the patient passed through the inoculated
disease, in a regular, complete, and satisfactory manner, and continued
well for six weeks after, making no complaint: after which he was
seized with a disease that I have not the least doubt was a fever
of the putrid kind; but I do not think that the pustulary eruptions
can with propriety be deemed critical, as they did not terminate the
disease; I rather esteem them to have been marks or tokens of great
malignity and danger.
In the course of my whole practice, which it is well known has been
extensive, I never knew a single instance of any one having the natural
small-pox, after having been inoculated; nor have I ever known any
person to have the disease a second time in the natural way.
I shall not pretend to decide on what may have happened to others; but
what I have said is true, so far as relates to my own experience.
The report of the gentlemen who opened the body, affords no material
information.
The appearance of the spots, is such as might be reasonably expected on
any person who died of a malignant fever. Dry scabs frequently remain
on the inoculated parts, for some months after the disease.