AN .

INQUIRY
QJJ iVavZ**)-.
INTO <Q D—
r#E CAUSES AND EFFECTS

OF THE

VARIOLM VACC1NJE,

A DISEASE

Difcovered in fome of the weftern countiea

of England,
PARTICULARLY GLOUCESTERSHIRE,
And known by the name of

THE jCOW POX.

By EDWARD JENNER,m.d. f. r.s. &c.

——""' ■"
I "I-IhH III iiti—-«-—B

Quid nobis certutf tpfis

Senfibus effe poteft, quo <vera ac
falfa notemus,
LUCRETIUS.

JB.OM THE SECOND LOXDON EDITION.

SPRINGFIELD :

M-printed for Dr. SAMUEL COOLET,

BV ASHLEY CJf BREWER,

18c?,.

§r"i:
 TO THE KING.

SIR,

wHEN I firft. addrefTed the Pub-

lie on a Phjfiological fubjerSr, which I.con^
ceived to be of the utmoft importance to the fu

ture welfare of the human race, I could not

prefume, in that early fhge of the investiga

tion, to lay the refult of my inquiries at your

Majefty's feet.

Subfequent experiments, inftituted not only

by myfeU, but by men of the firft rank in the

medical proieftion, have now confirmed the truth

 L "
J
pf the theory which I firft made known to the
world.

Highly honored by the permifTion to dedicate

the refult of my inquiries to your Majefty, I
am imboldened to folicit
your gracious patron
age of a difcovery which reafon fully authorizes
me to fuppofe will prove peculiarly beneficial
to the prefervation of the lives of mankind.

To a Monarch no lefs
juflly than emphati
cally ftyled the Father of his People, this Trea-
tife is inferibed with perfect propriety ; for,

cotifpicuous as your Majefty *s patronage h.s

been of Arts, of Sciences, and of Commerce,
yet the moit diftinguifhed feature of your char*

after is your paternal care for the deareft intcrefts

pi humanity. I am, Sir,

SIR,
With the moft profound refpeel,
Your Mijelty's rr.oft devoted

Subject and Servant,

EDWARD JENNER.
Berkeley, Gloucefteifhire,
Dec. 20th, 1799.
 An Inquiry, &c.

:©>:

A HE deviation of Man from the ftate in

which he was originally placed by Nature feems to
have proved to him a prolific fource of Difeafes.
From the love of fplendor, from the indulgences of
he
luxury, and from his foudnefs for amofement,ani
has tamiliarifed himfelf with a great number of
mals, which may not originally have been intend
ed for his affociates.
The Wolf, difarmed of ferocity, is now pillow
ed in the lady's lap*. The Cat, the little Tyger
of our illand, whofe natural home is the foreft, is e-

*
The late Mr. John Hunter proved, by expert-
Wests, that the Dogis the Wolf in a degeneratedfiatc.
 [ » ]

gaally domefticatedand careffed. The Cow, the Hog,

the Sheep, and the Horfe, are all, for a variety of
purpofes, brought under his care and dominion.
Ttiere is a difeafe to which the Horfe, from hi«
ftate of domeftication, is frequently fubjeft. The
Farriers have termed it the Greafe. It is an in
flammation and fwelling in the heel, from which
jffues matter poffefling properties of a very peculiar
kind, which feems capable of generating a difeafe
in the human body (after it has undergone the mo
dification I (hall prefently fpeak of) which bears fo
ftrong a reftmblance to the Small Pox, that I think
it highly probable it may be the fource of that
difeafe.

Dairy Country a great number of Cows

In this
are
kept, and the office of milking is performed in
discriminately by Men and Maid Servants. One
of the former having been appointed to apply dreff-
ings to the heels of a Horfe affefted with/A* Greafe,
and not paying due attention to cleanlinefs, incau-
tioufly bears his part in milking the cows, with
fome particles of the infectious matter adhering to
his fingers. When this is the cafe, it commonly
happens that a difeafe is communicated to the Cows,
and from the Cows to the Dairy. maids, which
fpreads through the farm until mott of the cattle
and domefticsfeel itsunpleafant confequences. This
difeafe has obtained the name of the Coiv Pox. It
appears on nipples of the Cows in the form of
the
irregular puftules. At their firft appearance they
are
commonly of a palilh blue, or rather of a colour
fomcwhat approaching to livid, and are furround-
ed by an inflammation. Thefc puftules, unlefs a
 C 3 ]
timely remedy be applied, frequently degenerate
into phagedenic ulcers, which prove extremely
troublefome*. The animals become indifpofed,
and the fecretion of milk is much leflened. Infla
med fpots now begin to appear on different par's of
the hands of the domeftics employed in milking,
and fometimes on the wrifts, which quickly run on
to fuppuration, firft
affuming the appearance of the
fmall vefications produced by a burn. Mod com
monly they appear about the joints of the fingers,
and at their extremities ; but whatever parts are
affecled, if the fituation will admit, thefe fuperfi-
cial fuppurations put on a circular form, with their
edges more elevated than their centre, and of a co
lour diftantly approaching to blue. Abforption
takes place, and tumours appear in each axilla. The
fyftem becomes affecVd, the pulfe is quickened ;
fhiverings, fucceeded by heat, general laffitude and
pains about the loins and limbs, with vomiting,
come on. The head is painful, and the patient is
now and then even affected with delirium+. Thefe
fymptoms, varying in their degrees of violence,
generally continue from one day to three or four,
*
Thry nuho attend lick cattle in this country find
a fpeedy remedy for flopping the progrefs of this com-.
plaint in thofe applications (which ail chemically upon
the morbid matter, fuch as the fslutions of the Viiriom
turn Zinci, the Vitriolum Cupri, &c,

t // will appear in the fequel that thefe fymptoms

arife principally from the irritation of the fores', and

not from the primary aQion of the vaccine virus upon

the ConjlituUQH.
 [ 4 ]

leaving ulcerated fores about the hands, which,

from the fenfibility of the parts, are very trouble-
fome, and commonly heal flowly, frequently be
coming phagedenic, like thofe from whence they
fprung. The lips, noftrils, eyelids, and othef
parts of the body, are fometimes affected with fores ;
but thefe evidently arife from their being heedlefs-
ly rubbed or fcratched with the patient's infected
fingers. No eruptions on the flcin have followed
the decline of the feverifh fymptoms in any inftance
that has come under my infpection, one only ex
cepted, and in this cafe a very few appeared on the
arms: they were very minute, of a vivid red co

lour, and foon died away without advancing to

maturation ; fo that I cannot determine whether
they had any connection with the preceding fymp
toms.

Thus the difeafe makes its progrefs from the

Horfe (as I conceive) to the nipple or the Cow, and
from the Cow to the Human Subject.
Morbid matter of various kinds, when abforbed
into the fyftem, may produce effects in fome degree
fimilar ; but what renders the Cow Pox virus fo
extremely Angular is, that the perfon who has been
thus affected is forever after fecure from the infec
tion of the Small Pox ; neither expofure to the va
riolous effluvia, nor the infertion of the matter in
to the fkin,
producing this diftemper.
In fupport of fo extraordinary
a fact, I fhall
lay
before my Reader great number of inftances : but
a

fiat it is neceffary to obferve, that

pullulous fores
frequently appear fpontaneoufly on the nipples of the
Cows, and inftances have occurred, though very
 L I 1
rarely, of the hands of the fervants employed in
milking being affected with, fores in confequence,
and even of their feeling an indifpofition from ab-
forption. Thefe puftules are of a much milder na
ture than thofe which arife from that contagion
which conftitutes the true Cow Pox. They are al
or livid tint Co confpicu-
ways free from the bluifh
bus in the puftules in that difeafe. No eryfipelas
attends them, nor do they fh.ew any phagedenic dif-
pofition as in the other cafe, but quickly termin
ate in a fcab without creating any apparent difor-
der in the Cow. This complaint appears at vari
ous feafbns of the year, but mod commonly in the
taken from their
fpring, when the Cows are firft It is
winter food and fed with grafs. very apt to
when they are fuclding their youngi
appear alfo
But this difeafe is not to be confulered as iimilar in
of which I am treating, as it is
any refpect to that
effects on the
incapable of producing any fpecificis of the
human Conftitution. However, it great-
eft confequence to point it out here, left the
want

of difcrimination ihould occafionan idea of fecurity

from the infection of the Small Pox, which might
prove delufive.

CASE L

Gardener to
JOSEPH MERRET, now an Under with a Far
the Earl of Berkeley, lived as a Servant
and occafton-
mer near this place in the year 1770,
in his mailer's cows. Several
ally afiiftcd milking
to have fore
horfes belonging to the Farm began
attended. The cows
heels, which Merret frequently
foon became arretted with the Cow Pox, and foco
B
 t rf J
after feveral fores appeared on his hands. Swell
ings and ftiffoefs in each axilla followed, and he was
fo much indifpofed for feveral days as to be incapa
ble of purfuing his ordinary employment. Previ-
oufly to the appearance of the diftemper among the
Cows there was no frefh Cow brought into the farm,
nor any fcrvant
employed who was affected with
the Cow Pox.
In April 179?, a general inoculation taking place
here, Mcrret was inoculated with his family •, fo that
':
period of twenty. five years had elapfed from his
having the Cow Pox to this time. However,
though the variolous matter was repeatedly infertcd:
into his arm, 1 found it impracticable to infect him
with it ; an efflorefcence only, taking on an ery-
fipelatous look about the centre, appearing on the
ikin near the punctured parts. During the whole
time that his family had the Small Pox, one of
vrhom hud it very full, he remained in the houfe
with them, but received no injury from expofure
to- the
contagion.
It is to obferve, that the utmoft care
neceffary
was taken afcertain, with the moft fcrupulous
to

precifion, that no one whofe cafe is here adduced

had gone through the Small Pox previous to thefe
attempts to produce that difeafe. ,

Had thefe experiments been conducted in a large

city, or in a populous neighborhood, fome doubts
might have been entertained ; but here, where po
pulation is thin, and where fuch an event as a per
son's having had the Small Pox is always faithfully
recorded, no riik of inaccuracy in this particular
can arife.
 [-7 J

CASE II.

SARAH PORTLOCK, of this place-, was. i«v

fccted with the Cow Pox, when a fervant at a Far
mer's in the neighborhood,
twenty-feven years ago*.
In the year 1792, conceiving herfelf, from this
circumftance, fecure from the infection of the Small
Pox, fhe nurfed one of her own children who had
accidentally caught the difeafe, but no indifpofition
enfued. During the time fhe remained in the in
—

jected room, variolous matter was inferted into

both her arms, but without any further effect thaii
in the preceding cafe.

CASE III.

JOHN PHILLIPS, a Tradefman of this town,

had the Cow Pox at fo early a period as nine years
of age. At the age of iixty.two I inoculated him,
and was very careful in feltcting matter in its moll
active ftate. It was taken from the arm of a boy
juft before the of the eruptive fever,
commencement
and inftantly inferted.
It very fpecdily produced a
fting-like feel in the part. An cfflorefccnce appear
ed, which on the fourth day was rather extensive,
and fome degree of pain and ftiffnefs were felt a-

*
/ have purpofely felecled feveral cafes in which
the had appeared at a very diftaut period pre
difeafe
vious to the experiments made ivilh variolous matter,
tojb-.vj that the change produced in the anflttutioif i;
not affiled by tine.
 I 8 3
bout the fhoolder ; but on the fifth day thefe fyrrip*
toms
began to difappear, and in a d.iy or two after
went entirely off, without
producing any effect on,
thpfyftem,
CASE IV.

MARY BARGE, of Woodford, in this parifh,

was inoculated with variolous matter in the year
red colour foon
1
79 1. An efflorefcence of a palifh
Appeared about the parts where the matter was in
ferted, and fpread itfelf rather extenfively, but di
ed away in a few days without producing any va
riolous fymptoms*. She has fince been repeatedly
employed as a nurfe toSmall-Pox patients, without
experiencing any ill confequences. This woman
h?.d the Cow-Poxwhen fhe lived in the fervice of a
Farmer in this parifh thirty. one years before.

*
// is temarlable that variolous ?natter, when tb*
fyfiem is difpoftd to rejeel it, fhould excite inflammation
en the
part to which it is applied more fpeedily than
when it produces the Small Pox. Indeed it becomes al-
nifi a criterion by v. huh we can determine whether
the infection will be received or net. It feems as if a
change, which endures through life, had been produ
ced m the action, or difpnfition to afiio?:, in the veffils
cf the fhni : and it is remarkable too, that whether
ihis change has been cffecled by the Small Pox, or the
Cvw For, thot the dupofitton tofudden cuticular inflam
mation is the feme on the cipph.:at:i:t of variolous mat
ter,

>
 C 9 j

CASE V,

MRS. H ,
a
refpectable Gentlewoman of thig
town, had the Cow Pox when very young. She
received the infection in a manner that is not
common : it was
given by means of her handling
fome of the fame utenfils* which were in ufe
among
the fcrvants of the family, who had the difeafe
from milking infected cows. Her hands had many
of the Cow Pox fores upon them, and they were
communicated to her nofe, which became inflamed
and very much fwoln. Soon after this event Mis,
H was
expofed to the contagion of the Small
Pox, where it was fcarcely poflible for her to have
efenped, had fhe been fufccptible of it, as fhe regu
larly attended a relative who had the difeafe in fo
violent a degree that it proved fatal to him.
In the year 1778 the Small Pox prevailed very
much at Berkeley, and Mrs. H not feeling per

fectly fatisficd refpecting herfalety (no indifpolition

having followed her expofure to the Small Pox) i
inoculated her with active variolous matter. The
fame appearance followed as in the preceding cafes--
an tftlcrefccnce en the arm without any effect or the

conftitution.

.
*
When the Cczv Pox has prevailed in the dairy,
it has often been communicated to thofe who have not
tn'ilked the Cows, by the handle of the milk pail,
 C «o
J

CASE VI.

IT is a fact fo well known among oqr DairyFar

mers, that thofe who have had the Small Pox either
cfcape the Cow Pox or aredifpofedto have it flight-
ly ; that as foon as the complaint (hews itfelf amongj
the cattle, afliftants arc procured, if poffible, who
are thus rendered kfs fufceptible of it, otherwif^
the bufinefs or the farm could fcarcely go forward.
In the month of May, 1796, the Cow Pox broke
Out at Mr. Baker's, a Farmer who lives near this
place. The difeafe was communicated by means of
a Cow which was pqrehafed in an infected ftate at

a
neighboring fair, and not one of the Farmer's,
Cows (confifting of thirty) which were at that time
milked efcaped the contagion. The family confift.
ed of a. man fervant, two dairy. maids, and a fer-
vant boy, who, with the Farmer himfelf, were
twice a day employed in milking the cattle. —

The whole of this family, except Sarah Wynne,

one of the dairy maids, had
gone through the Small
Pox. The confequence was, that the Farmer and
the fervant boy eicaped the infection of the Cow
Pox entirely, and the fervant man and one of the
maid fervants had each of them
nothing more than
a fore on one of their
fingers, vr hich produced no
diforder in the fyftem. But the other dairy maid,
Sarah Wynne, who never had the Small Pox, did
not
cfcape in fo eafy a manner. She caught the
complaint from the cows, and was affected with the
fymptoms defcribed in the 5th page, in fo violent
a
degree, that fhe was confined to her bed, and
 t xi
]
tendered incapable for feveral days of purfuing her
ordinary vocations in the farm.
March 28th, 1797, I inoculated this girl, and
carefully rubbed the variolous matter into two flight
incifions made upon the left arm. A little inflam
mation appeared in the ufual manner around the
parts where the matter was inferted, but fo early
as the fifth day it vanifhed entirely without produ

cing any effect on the fyftem.

CASE VII.

ALTHOUGH the preceding hiftory pretty

dearly evinces that the conftitution is far lefs fuf
ceptible of the contagion of the Cow Pox after it
has felt that of the Small Pox, and although in ge
neral, as I have obferved, they who have had the
Small Pox, and are employed in milking cows which
are infected with the Cow Pox, either efcape the
diforder, or have fores on the hands without feel
the animal econo
ing any general indifpofuion, yet
variation in this refpect, which
my is fubject to fome
the following relation will point out.
In the fummer of the year 1796 the Cow Pox ap
peared at the Farm of Mr. Andrews, a confiderable
It was
dairy adjoining to the. town of Berkeley.
communicated, as in the preceding inftance, by ::u
infected cow purchafed at a fair in the neighborhood.
The confuted of the Farmer, his wife, two
family
a man and a maid fervant ;
all of" whom, ex
fons,
Farmer was fearful of the confequcn^
cept the (who
the cows. The whole
ces) bore a part in milking
 '
i|W of them, exclufive of the man fervant, had regu-
lnr!y gone through the Small Pox ; but in this cale
no one who milked the cows
efcaped the contagiori.
All of them had fores upon their hands, and fome
degree of general indifpofition, preceded by pairs
and tumors in the axillae : but there was no com.
parifon in the fevcrity of the difeafe as it was felt
by the fervant man, who had efcaped the Small Pox,
and by thofe of the family who had not, for, while
he was confined to his bed, they were able, with*.
out much inconvenience, to follow their ordinary
bufmefs.

February the 1 3th, 1797, I availed my felf of an

opportunity of inoculating William Rodway, the
fervant man above alluded to. Variolous matter
was inferted into both his arms ; in the right by-

means of fuperficial incifions, and into the left

by
flight punctures into the cutis. Both were percep
tibly inflamed on the third day. After this the
inflammation about the punctures fcon died away,
but a fmall appearance of the eryfipelas was rr.anifcft
about the edges of the incifions till the eighth day,
when a little uneafmefs was felt for the fpace of half
an hour in the
right axilla. The inflammation then
haftily difappfcared without producing ths moft dif.
tant mark of affection of the fyftem.

CASE VIII.

ELIZABETH WYNNE, Pged fifty.feven, lived

fi-rvant with a neighboring Farmer thirty. eight
as a

years ago. She was then a dairymaid, and the

Cow Pox broke out among the cows. She caught
the difeafe with the reft of the
family, but, com
pared with them, had it iri a very flight degree"
one
very fmall fore only breaking out on the little
Anger of her left hand, and fcarcely any perceptible
indifpofition following it.
As the malady had fhewn itfelf in fo
flight a man
ner, and as it had taken place at fo diftant a period
of her life, I was happy with the
opportunity of
trying the effects of variolous matter upon her con-
ftitutipn, and on the 28th of March, * ln"
1797,
oculated her by making two fuperficial incifions on
the left arm, on which the matter was
cautioufly
rubbed. A little efflorefcence foon appeared, and a
tingling fenfation was felt about the parts where
the matter was inferted until the third day, when
both began to fubfide, and fo early as the fifth
day
it was evident that no indifpofition would follow*

CASE IX.

ALTHOUGH the Cow Pox fhields the conftitu-

tion from the Small Pox, and the Small Pox proves
a
protection againft its own future poifon, yet it
appears that the human body is again and again fuf
ceptible of the infectious matter of the Cow Pox,
as the following hiftory will demonftrate :

William Smith, of Pyrton in this parifh, con

tracted this difeafe when he lived with a neighbour
ing Farmer in the year 1780. One of the horfea
belonging to the farm had fore heels, and it fell to
his lot to attend him. By thefe means the infection
was carried to the cows, and from the cows it was

C
 C *4 3
communicated to Smith. On one of his hands were
feveral ulcerated fores, and he was affected with
fuch fymptoms as have been before defcribed.
In the year 1791 the Cow Pox broke out at ano
ther farm where he then lived as a fervant, and he
became affected with it a fecond time ; and in the
year 1 794 he was fo unfortunate as to
catch it again.
The difeafe was equally as fevere the fecond and
third time as it was on the firft*.
In the of the year 1795 he was twice in
fpring
oculated, but affection of the fyftem could be
no

produced from the variolous matter ; and he has

fmce affociated with thofe who had the Small Pox
in its moft contagious ftate without feeling any ef
fect from it.

CASE X.

SIMON NICHOLS lived as a fervant with Mr.

Eromedge, gentleman who refides on his own
a

farm in this parifh, in the year 1782. He was em

ployed in applying dreffings to the fore heels of one
of his mailer's horfes, and at the fame time aflifted
in milking the cows. The cows became affected in
confequence, but the difeafe did not fhew itfelf on
their nipples till feveral weeks after he had begun
to drefs the horfe. He quitted Mr. Bromedge's fer-

*
This is not the cafe in general a fecond attack is
—

commonly very flight* and fo, I am informed, it is a-

mong the cows. The reader will findfurther obfervtt*
tions on this fubfeft in thefequtU
vice, and went to another farm without
any fores
upon him ; but here his hands foon began to be af
fected in the common way, and he was
fed with the ufual muchindifpo-
fymptoms. Concealing the nature
of the malady from Mr. Cole, his new
mafter, and
being there alio employed in milking, the Cow
Pox was communicated to the cows.
Some years afterwards Nichols was
employed in a
farm where the Small Pox broke out, when I inocu
lated him with feveral other
patients, with whom
he continued
during the whole time of their con
finement. His arm inflamed, but neither the in
flammation nor his affociating with the inoculated
family produced the leaft effect upon his conftitution.
CASE XI.

WILLIAM STINCHCOMB was a fellow fer

vant with Nichols at Mr Bromedge's farm at the time
the cattle had the Cow Pox, and he was unfortu
nately infected by them. His left hand was very
feverely affected with feveral corroding ulcers, and a
tumor of confiderable fize appeared in the axilla of
that fide. His right hand had only one fmall fore
it, and no tumour difcovered itfelf in the cor-
upon
refponding axilla.
In the year 1792 Stinchcomb was inoculated with
variolous matter, but no confequences enfued be
yond a little inflammation in the arm for a few days.
A large party were inoculated at the fame time,
fome of whom had the difeafe in a more violent de
feen from inoculation. He
gree than is commonly
purpofely affociated with them, but could not re
ceive the Small Pox,
 During the fickening of fome of his companions,
theirfymptoms fo ftrongly recalled to his mind his
own ftate when fickening with the Cow Pox, that

he very pertinently remarked their ftriking fimi-

larity.

CASE XII.

THE Paupers of the village of Tortworth, in

this County, were inoculated by Mr. Henry Jen
ifer, Surgeon, of Berkeley, in the year 1795. A-
themfelves who
tnong them, eight patients prefented
had at different periods of their lives had the Cow
Pox. One of them, Hefter Walkley, I attended
with that difeafe when (he lived in the fervice of a
Farmer in the fame village in the year 1782 ; but
neither this woman, nor any other of the patients
who had gone through the Cow Pox, received the
variolous infection either from the arm or from
mixing in the fociety of the other patients who were
inoculated at the fame time. This ftate of fecurity
proved a fortunate circumftance, as many of the
poor women were at the fame time in a ftate of
pregnancy,

CASE XIII.

ONE inftance has occurred to me of the fyftem

being affected from the matter iffuing from the heels
of horfes, and of its remaining afterwards unfufcep-
tible of the variolous contagion ; another, where
the Small Pox appealed obfturely ; and a thud, in
 I' »7 1
which its complete exiftence was
pofitively afcer*
tained.
Firft, THOMAS PEARCE, is the fon of a
Smith and Farrier near to this
place. He never had
the Cow Pox ; but, in
confequence of drefling hor
fes with fore heels at his father's, when a lad, he
had fores on his
fingers which fuppurated, and
which occafioned a
pretty fevere indifpofition. Six
years afterwards I inferted variolous matter into
his arm repeatedly, without
being able to produce
any thing more than flight inflammation, which
appeared very foon after the matter was applied,
and afterwards I expofed him to the
contagion of
the Small Pox with as little effect*.

CASE XIV.

Secondly, Mr. JAMES COLE, a Farmer in

this Parifh, had a difeafe from the fame fource as
related in the preceding cafe, and fome years after
was inoculated with variolous matter. He had a
little pain in the axilla, and felt a flight indifpofi
tion for three or four hours. A few eruptions fhew.
ed themfelves on the forehead, but they very foon
disappeared without advancing to maturation.
*
// is a remarkable fad, and well known to ma

ny, that we
frequently foiled in our endeavours ta
are

communicate the Small Pox by inoculation to black-

f'miths, who in the country are farriers. They often,
as in the above inftance, either refijl the contagion en-

tirely, or have the dijeafe anomaloufly. Shall we not

be able now to account for this on a rational principle ?
 [ is ]

CASE XV.

ALTHOUGH in the two former inftances the

fyftem feemcd to be fecured, or nearly fo, from va
riolous infedion, by the abforption of matter from
fores produced by the difeafed heels of horfes, yet
the following cafe decifively proves that this can
not entirely relied upon, until a difeafe has been
be
generated by the morbid matter from the horfe on
the nipple of the cow, and paffed through that me.
dium to the haman fubject.

Mr. ABRAHAM RIDDIFORD, a Farmer at ,

Stone in this parifh, in confequence of drefling a

mare that had fore heels, was affected with very
painful fores in both his hands, tumours in each ax
illa, and fevere and general indifpofition. A Sur
geon in neighbourhood attended him, who,
the
knowing the
fimiiarity between the appearance of
the fores upon his hands and thofe produced by the
Cow Pox, and being acquainted alfo with the ef
fects of that difeafe on the human conftitution, af-
fured him that he never need to fear the infection
of the Small Pox ; but this affertion proved falla
cious, for, on being expofed to the infection up
wards of twenty years afterwards, he caught the
difeafe, which took its regular couife in a very
mild way. There certainly was a difference per
ceptible, although it is no: eafy to defcribe it, in "

the general appearance of the

puftules from that
which we commonly fee. Other practitioners, who
vifited the patient at my rcqueft, agreed with me
I
 [ *9 J

in this point, though thera was no room left fot

fufpicion as to the reality of the difeafe, asl inocu
lated fome of his family from the puftules, who
had the Small Pox, with its ufual appearances, in
Confequence.
CASE XVI.

SARAH NELMES, a
dairymaid at a farmer's
near this place, was infected with the Cow Pox
from her mailer's cows in May, 1796. She receiv
ed the infection on a part of the hand which had
been previoufly in a flight degree injured by a
fcratch from a thorn. A large puftulous fore and the
ufual fymptoms accompanying the difeafe were pro
duced in confequence. The puftule was fo expreflive
of the true character of the Cow Pox, as it com
monly appears upon the hand, that I have given a
reprefentation of it in the annexed plate. The two
fmall puftules on the wrifts arofe alfo from the ap
plication of the virus to fome minute abrafions of
the cuticle, but the livid tint, if they ever had a-
ny, was not confpicuous at the
time I faw the pa
tient. The on the
puftule fore finger {hews the
difeafe in earlier ftage. It did not actually ap
an

pear the
on hand of this young woman, but was ta
ken from that of another, and is annexed for the
the malady after it has new
purpofe of reprefenting
ly appeared.
CASE XVII.

of
THE more accurately to obferve the progrefs
about eight
the infection, I felected a healthy boy,
 £ *o ]
years old, for the purpofe of inoculation for the
Cow Pox. The matter was taken from a fore on
the hand of a dairymaid*, who was infected by
her matter's cows, and it was inferted, on the 14th
of May, 1796, into the arm of the boy by means
of two fuperficial incifions, barely penetrating the
cutis, each about half an inch long.
On the feventh day he complained of uneafinefi
in the axilla, and on the ninth he became a little
chilly, loft his appetite, and had a flight head-ach*
During the whole of this day he was perceptibly
indifpofed, and fpent the night with fome degree
of reftleffnefs, but on the day following he was per*
fectly well.
The appearance of the incifions in their progreft
to a ftate of maturation were much the fame as

when produced in a fimilar manner by variolous

mattert. The only difference which I perceived
was, in the ftate of the limpid fluid arifing from the
action of the virus, which affumed rather a darker
hue, and in that of the efHorefcence fpreading round
the incifions, which had more of an eryfipelatous
look than we commonly perceive When variolous
matter has been made ufe of in the fame manner
;
*
From the fort on the hand of Sarah Nelmes. —

Sie^
the preceding cafe and the plate.

+ This appearance was in great meafure new to me,

find I ever fb all recoiled the
pleafing fenfations it ex
cited ; as, from its fimilarity to the pufiule produced by
variolous inoculation, it
incontefiibly pointed out the
clofe connexion between the two dfcafes, and alt/toft
anticipated the rtfuh of my future experiments.
 i « 3
but the whole died away (leaving on the inoculated
parts fcabs and fubfe,quent efchars) without giving
me or my patient the leaft trouble.

In order to afcertain whether the boy, after feel

ing fo flight an affection of the fyftem from the
Cow Pox virus, was fecure from the contagion of
the Small Pox, he was inoculated the i ft of July
following with variolous matter, immediately ta
ken from a puftule. Several flight punctures and in
cifions were made on both his arrts, and the matter
was carefully inferted, but no difeafe followed.
The fame appearances were obfervable on the arms
as we commonly fee when a patient has had
vari
olous matter applied, after having either the Cov#
Pox or the Small Pox. Several months afterwards
he was again inoculated with variolous matter, but
ho fenfible effect was produced on the conftitution.

Here my refearches were interrtjpted till the fpring

of the year 1798, when from the wetnefs of the ear
the farmers' horfes
ly part of the feafon, many of
were affected with fore heels,
in this neighbourhood
in confequence of which the Cow Pox broke out a-

our dairies, which afforded

me an
tnong feveral of
opportunity of making further obfervations upon
this curious difeafe.
A mare, the property of a perfon who keeps
a

to have fore
dairy in a neighbouring parifh, began
heels the latter end of the month of February 1798,
fervant men
which were occafionally warned by the
William Wherret,
of the farm. Thomas Virgoe,
became
and William Haynes, who in confequence
followed by in
affected with fores in their hands,
flamed lymphatic glands in the arms and axilla^
 I M 1
fhiveringsfucceededbyheat, laffitude and general
pains in the limbs. A fingle paroxyfm terminated
hours they
the difeafe ; for within twenty-four
were free from general indifpofition, nothing re

Haynes and
maining but the fores on their hands.Small Pox frortf
the
Virgoe, who had gone through as very fimilar
inoculation, defcribed their feelings
to thofe which affected them on fickening
with that
the Small Pox,
malady. Wherret never had had
the milkers
Haynes was daily employed as one of
at the farm, and the difeafe began to (hew
itfelf a-
after he firft affified
mong the cows about ten days
in wafliing the mare's heels. Their nipples became
fore in the ufual way, with bluifh puftules ; but as
remedies were they did not ulcerate
early applied
to any extent.

CASE XVIII.

JOHN BiAKER, a child of five years old, was

inoculated March 16, 1798, with matter taken
from a puftule on the hand of Thomas Virgoe, one
of the fervants who had been infected from the
mare's heels. He became ill on the fixth day with
fimilar to thofe excited by Cow-Pox mat
fymptoms
ter. On the eighth day he was free from indifpo
fition.
There was fome variation in the appearance of
the puftule on the arm. Although it fomewhat re-
femblcd a Small -Pox puftule, yet its fimilitude was
not fo confpicuous as when excited by matter from
the nipple of the cow, or when the matter has paf-
fed from thence through the medium of the human
fubjcct. (See Plate, No. 2.)
32£?

»»:*»'•■•
 [ n 3
This experiment was made to afcertain the
pro-
grefs and fubfequent effects of the difeafe when thus
propagated. We have feen that the virus from the
horfe, when it proves infectious to the human fub,

ject, is not to be relied upon as rendering the fyftem

fecure from variolous infedion, but that the matter
produced by it on the nipple of the cow is perfect
ly fo. Whether its paffing from the horfe through
the human conftitution, as in the prefent inftance,
will produce a fimilar effed, remains to be decided.
—
This would now have been effeded, but the boy
was rendered unfit for inoculation from having felt

the effeds of a contagious fever in a work-houfe,

foon after this experiment was made.

CASE XIX.

WILLIAM SUMMERS, a child of five years

and a half inoculated the fame day with
old, was

Baker, with matter taken from the nipples of one

of the infeded cows, at the farm alluded to in page
21. He became indifpofed on the fixth day, vo
mited once, and felt the ufual flight fymptoms till
the eighth day, when he appeared perfectly well.
The progrefs of the puftule, formed by the infec
tion of the virus was fimilar to that noticed in Cafe
XVII., with this exception, its being free from the
Jivid tint obfervedin that inftance.

CASE XX.

FROM William Summers the difeafe was tranf-

ferred to William Pead, a boy of eight years old,
who was inoculated March 28th, On the fixth day
 [ *4 3
he complained of pain in the axilla, and op the
feventh was affeded with the common fymptoms of
a
patient fickening with the Small Pox from inocu
lation, which did not terminate 'till the third day
after the feizure. So perfcd was the fimilarity to
the variolous fever that 1 was induced to examine
the (kin, conceiving there might have been feme e-
fuptions, but none appeared. The efflorescent blufh,
around the part punctured in the boy's arm was lb
truly charaderiftic of that which appears on vario
lous inoculation, that I have given a reprefentation
of it. The drawing was made when the puftule
was
beginning to die away, and the areola retiring
from the centre. (See Plate, No. 3.)

CASE XXI.

APRIL 5th. Several children and adults were

inoculated from the arm of William Pead. The
greater part of them fickened on the fixth day, and
were well on the feventh, but in three of the num.

ber a fecondary indifpofition arofe in confequence of

an extenfive erysipelatous inflammation which
ap.
jietred on the inoculated arms. It feemed to arife
ixom the ftate of the puftule, which
fpread out,
accompanied with fome degree cf pain, to about
half the diameter of a fix- pence. One of thefe pa.
tients was an infant of half a year old. By the
application of mercurial ointment to the inflamed
parts (a treatment recommended under fimilar cir-
cumftances in the inoculated Small Pox) the com
plaint fubfided without giving much trouble.
HANNAH EXCELL, an
healthy girl of fevefl
yeais old, and one of the patients above mention^
(ft!, receivedthe infection from the infertion of the
virus under the cuticle of the arm in three diftind
points. The puftules which arofe in confequence,
fo much refembled, on the ninth day, thofe appear
ing from the infertion of variolous matter, that an
(experienced lnoculator would fcarcely have difcov
ered a fhade of difference at that period. Experi
ence now tells me that almcft the only variation
which follows confifts in the puftulous fluids re
maining limpid nearly to the time of its total dis
appearance ; and not, as in the dired Small Pox,
becoming purulent. —

(See Plate, No. 4.)

CASE XXII.

FROM the arm of this girl matter was tak.

en and inferted April 12th into the arms of John
Marklove, one year and a half old,
Robert F. Jenner, eleven months old,
Mary Pead, five years old, and
Mary James, fix years old.
Among thefe Robert F. Jenner did not receive
the iniection. The arms of the other three infla
med properly, and began to affed the fyftem in the
ufual manner ; but being under feme apprehenfions
from the preceding Cafes that a troublifome eryfip-
elas might arife, 1 determined on making an experi
ment with the view of cutting off its Source. Ac

cordingly after the patients had felt an indifpofition

of about twelve hours, I applied in two of thefe
Cafes out of the three, on the veficle formed by
the virus, a little mild cauftic, compofed of equal
pails of quick. lime and foap, and Suffered it to rc«
 [ »« ]
main on the part fix hours*. It feemed to give tho
children but little uneafinefs, and effedually an-
fwered my intention in preventing the appearance of
eryfipelas. Indeed it feemed to do more, for in
half an hour after its application, the indifpofition
of the children ceafsdi. Thefe precautions were
perhaps unneceffary, as the arm of the third child,
Mary Pead, which was Suffered to take its common
courfe, Scabbed quickly, without any eryfipelasj.

CASE XXIII.

FROM this child's arm matter was taken and

transferred to that of J. Barge, a boy of Seven
years old. He Sickened on the eighth day, went
through the difeafe with the ufual Slight fymptoms,
and without any inflammation on the arm beyond
the common efflorefcence furrounding the puftule,
an
appearance fo often feen in inoculated Small Pox.
After the many fruitlefs attempts to give the
Small Pox to thofe who bad the Cow Pox, it did
not appear neceffary nor was it convenient to me,
to inoculate the whole of thofe who had been the

*
Perhaps a few touches with the lapis fepticui
would have proved equally efficacious.
+ What effccl would a fimilar treatment produce in

inoculation for the Small Pox f

% The fubfequent part ofthitTreatifewillfufficient-

ty fbtw the proper praclice in cafes of inflammation of
the inoculated arm.
 ■~-^^

,<£
i*i"*tm*fe2-

■iff. #&&■
■^irKm~
■»'.'.!*'♦'■
',
 t 47 1
fubjects of thefe late trials ; yet I thought it
right
to fee the effeds of variolous matter on fome of
them, particularly William Summers, the firft of
thefe patients who had been infeded with matter
taken from the cow. He was therefore inoculated
with variolous matter from a frefh
puftule ; but, as
in the preceding Cafes, the fyftem did not feel the
effeds of it in the fmalleft degree. I had an op
portunity alfo of having this boy (Barge) and Wil
liam Pead inoculated by my Nephew, Mr. Henry
whofe report to me is as follows : " I have
Jenner,
inoculated Pead and Barge, two of the boys whom
you lately infeded with the Cow Pox. On the fe
cond day the incifions were inflamed, and there was
a
pale inflammatory ftain around them. On the
third day thefe appearances wereftill increasing and
their arms itched considerably. On the fourth day
the inflammation was evidently fubfiding, and on
the fixth it was fcarcely perceptible. No fymptora
of indifpofition followed."
To convince rnyfelf that the variolous matter
made ufe of was in a perfect ftate, I at the fame
time inoculated a patient with fome of it who ne
ver had
gone through the Cow Pox, and it produ
ced the Small Pox in the ufual regular manner.
Thefe experiments afforded me much fatisfadion,
they proved that the matter in paffing from one hu
man fubjed to another,
through five gradations,
loft none of its original properties, J. Barge being
the fifth who received the infedion fucceflively from
William Summers, the boy to whom it was com.
municated from the cow.
 C ** 3

t Shall now conclude this Inquiry with forte genen;

obfervations on the fubjed, and on fome othen
which are interwoven with it.

Although I prefume it may be unneceffary to pro.

duce further teftimony in Support of my affertjoo
*•
that the Cow Pox proteds the human confutation
from the infedion of the Small Pox," yet itaffbrdl
me confiderable fatisfadion to fay, that Lord So.
merville, the President of the Board of Agriculture,
to whom this
paper was fhewn by Sir Jofeph Bankj,
has found upon inquiry that the Statements were
confirmed by the concurring teftimony of Mr. Dol.
Ian, a furgeon, who refides in a dairy country re.
mote from this, in which thefe obfervations were
made. With refped to the opinion adduced " that
the Source of the infedion is a peculiar morbid mat.
ter
ariling in the horfe," although I have not beerl
able to prove it from adual experiments conducted
immediately under my own eye, yet the evidence
I have adduced appears Sufficient to eftablifh it.

They who are not in the habit of conducting ex

periments may not be aware of the coincidence of
circumftances ncceffary for their being managed fo
as to
prove perfedly decifive ; nor how often men
engaged in professional purfuits are liable to inter.
ruptions which difappoint them almoft at theinftant
^« of 'their being accomplished : however, I feel no
Nroom for hefitation refpeding the common origin of
fhe difeafe, being well convinced that it never ap
pears among the cows (except it can be traced to a
^ow introduced among the general herd which has
bietn previoufly infeded, or to an infeded fervant),
v

*
I
'
/
 [ 29 ]
uniefs they have been milked by fome one
who, at
the fame time, has the care of a horfe affeded with
difeafed heels.
The fpring of the vear 1797, which I intended
particularly to have devoted to the completion of
this inveftigation, proved, from its drynefs, re»
markably adverfe to my wiflies ; for it frequently
happens, while the farmers' horfes are expofed to
the cold rains which fall at that feafon that theic
heels become difeafed, and no Cow Pox then ap
peared in the neighbourhood.
The adive quality of the virus from the horfes'
heels is greatly increafed after it has acted on the
nipples nt the cow, as it ri rely happens that the
horfe affects his dreffer with f mos, ani as rarely
that a milk-maid efcapes 'the infect:on when fhe
milks infected cows. It is moft adiee at the com
mencement of the difeafe, even before it has acquw
red a pus. like appeatance ; indeed I am not confu
dent whether this property in the matter does not
entirely ceafe as for.n as it is frcreied in the form of
pus. I am induced to think it does ceafe*, and
th it it is the thindarkifh looking fluid only, oozing
from the newly-formed cracks in the h els, fimilar
to what Sometimes appears from er\ fipclatous blif-

ters, which gives the dife;«fe. Nor am I ceitain

that the nipplts of the cows are at all. times in a

*
// is very eafy to procure pus from oldfores on the
heels if horfes. this I have often inferted intoforatch-
es maie with a lancet, on the found nipples of cows,

and have feen us other eff. els from it than f.mple in*
flammation.
 t 30 i
flare to receive the infedion. The appearance of
the difeafe in the Spring and the early part of the
Summer, when they aie difpofed be affeded with
to

Spontaneous eruptions fo muchfrequently than

more

at other feafons, induces me to think, that the vi

rus from the horfe muft be received upon them when

they are in this ftate, in order to produce effeds :

experiments, however, muft determine thefe points.
But it is clear that when the Cow Pox virus is once
generated, that the cows cannot refift the conta
gion, in whatever ftate their nipples may chance
to be, if they are milked with an infeded hand.

Whether the matter, either from the cow or the .

horfe will affed the found fkin of the human body,

I cannot pofitively determine ; probably it will not,
unlefs on thofe parts where the cuticle is extremely
thin, as on the lips for example. I have known
an inftance of a
poor girl who produced an ulcera
tion on her lip by frequently holding her finger to
her mouth to Coal the raging of a Cow-pox fore by
blowing upon it. The hands of the farmers' Ser
vants here, from the nature of their employments,
are
constantly expofed to thofe injuries which occa
sion abrafions of the cuticle, to pundurcs from
thorns and Such like accidents ; fo that they areal- >

ways in a ftate to feel the confequences of expofuro J

to infedious matter.

It is Singular to obferve that the Cow Pox virus, J

although it renders the conftitution unfufceptible of ~i
the variolous, fhould, neverthelefs, leave it un
changed with refped to its own adion, I have af- '<
 [ 5' ]
ready produced an inftance* to
point out this, and
Shall now corroborate it with another.
Elizabeth Wynne, who had the Cow Pox in the
year 1759, was inoculated with variolous matter,
without effed, in the year 1797, and again caught
the Cow Pox in the year 1798. When I Saw her,
which was on the eighth day after fhe received the
infedion, I found her affeded with general laffi
tude, fhiverings, alternating with heat, coldnefs
of the extremities, and a quick and irregular pulfe.
Thefe fymptoms were preceded by a pain in the ax
illa. Op her hand was one large puftulous fore,
which refembled that delineated in Plate No. 1.+
It is curious alfo to obferve, that the virus,
which with refped to its effeds is undetermined
and uncertain previously to its paffing from the horfe
through the medium of the cow, fhould then not
only become more adive, but fhould invariably and
completely poffefs thofe Specific properties which
induce in the human conftitution fymptoms fimilar
to thofe of the variolous fever, and effed in it that
peculiar change which for ever renders it unfufcep
tible of the variolous contagion.

May it not then be reasonably conjedured, that

the Source of the Small Pox is morbid matter of a
peculiar kind, generated by a difeafe in the horfe,
and that accidental circumftances may have again

*
See Cafe IX.

+ As I have before ohferved, thefe fymptoms p rob a-

lly arofe from the irritation of the fare, which was
Very painful.
arA again arifen, ftill working new changes upon it,
until it has acquired the contagious and malignant
form under which we now commonly fee it making
its devaluations arr.or.gft us ? And, from a conside
ration of the change which the infedious matter
undergoes from producing a difeafe on the cow, may
we not conceive that many contagious difeafes, now

prevalent amongft us, may o.ve their prefent ap

pearance not to a fimple, but to a compound origin?
For example, is it difficult to imagine that the
iur:fles, the fcarlet fever, and the ulcerous fore
t!iro.:t with a Spoiled Skin, have all fprung from the
fame faurce, affuming Some variety in their forms
according to the nature of their new combinations ?
The fame qucftion will apply refped ing the origin
of many other contagious difeafes, which bear a
Strong analogy to each other.
i here ate certainly more forms than one, with
out
confidering the common variation between the
confluent and diftind, in which the Small Pox ap.
peirs in what is called the natural way. About
—

Seven yours ago a Species of Small Pox Spread through

many of the towns and villages of this part of
Glouccfterfhirc : it was of fo mild a naiur. that-
,

a fatal inftance was fcarcely ever heard

of, and con
sequently fo little dreaded by the lower orders of
the community, that they fcrupled not to hold the
fame intercourfe with each other as if no infedious
difeafe had been prcfent among them. I never Saw
heard of an inftance of its
: -)r
being confluent.
The molt accur,:::' manner,
perhaps, in which lean
convey an i.ua of it is, by faying, that bad fifty
individuals been t.ikcn promifcuouflv and infected
by expire to this cjne^ion, they wxui.l have
had as mild and light a difeafe as if they had been
inoculated with variolous matter in the ufual
way.
The harmkfs manner in which it Shewed itfelf
Could not arife from any peculiarity either in tlvj
feafon or the weather, for I watched its progreSs
Upwards of a year without perceiving any variation
in its general appearand-, i confide r it then as a va
riety ot the Small Pox*.
In fome of the preceding cafes I have noticed the
attention that paid to the ftate of the variolous
was

matter previous to the experiment of inferting it

into the arms < f thofe who had gone through the
Cow Pox. This I conceived to be of great impor
tance in conduding thefe experiments, and were it

always properly attended to by thofe who inoculate

for the Small Pox, it might prevent much Subse
quent mifchief and confulion. With the view of
enforcing fo neceffary a precaution, I Shall take the
liberty of digreffing fo far as to point out fome on-
pleafant facis, relative to mifmanagement in this
particular, which have fallen under my own obfer-
vation.
A Medical Gentleman (now no more) who for
many years inoculated in this neighborhood, fre
quently pivfervtd the variolous matter intended tor
his ufe, on a piece of lint or cotton, which, in its

My friend Dr. H'cks, ofErifd, who during the

*

prevalence of this difiemper was r,fident at Glouctfhr,

and Pkypcicn to the Hofp'ual there, (where it was
fien fj.:: after its firfl appearance in this country) had
c-
por:i:r.'t:ts of making numerous obfervations ujion it,
<wi';.ch ;.' :s his :/»/c.v.:i.* /: cjm.v:xi:,cz:e to the Public.
 a vial, corked, and convey.
fluid ftate was
put into
fa
ed into a warm pocket ; a fituation certainly
vorable for fpeedily producing ptitrefadion in.it.
In this ftate (not unfrequently after it had been ta
ken feveral days from the puftules) it was inferted
into the arms of his patients, and brought on in
flammation of the incifed pans, fwellings of the ax,
illary glands, fever, and fometimes eruptions. But
what was this difeafe ? Certainly not the Small
Pox ; for the matter having from putrefadion loft,
or Suffered a
derangement in its fpecific properties,
was no
longer capable of producing that malady,
thofe who had been inoculated in this manner being
as much fubjed to the contagion jof the Small Pox,
as if
they had never been under the influence of
this artificial difeafe ; and many, unfortunately
fell vidims to it, who thought themfelves in per-
fed Security, The fame unfortunate circumftance
of giving a difeafe, fuppofed to be the Small Pox,
with inefficacious variolous matter, having occur.
red under thediredion of fome other practitioners
within my knowlege, and probably from the fame
incautious method of Securing the variolous matter,
I avail myfelf of this opportunity of mentioning
what I conceive to be of great importance ; andi
as a further
cautionary hint, I Shall again digrefs
fo far as to add another observation on the fubjed
of Inoculation.
Whether it be yet ascertained by experiment,
that the quantity of variolous matter inferted into
the Skin makes any difference with refped to the
fubfequent mildnefs cr violence of the difeafe, I
know net ; but I have the ftrongeft reafon for Sup
posing that if either the punctures or incifions be
 [ 35 ]
made fo deep as to go through it, and wound the a1-
dipofe membrane, that the rifk of bringing on a
violent difeafe isgreatly increafed. I have known
"
an inoculator, whofe
pradice was to cut
deep e-
nough (to ufe his own expreflion) to fee a bit of
fat," and there to lodge the matter. The great
number of bad Cafes, independent of inflammations
and abfcefles on the arms, and the fatality which
attended this pradice was almoft inconceivable ;
and I cannot account for it on any other principle
than that of the matter being placed in this fituation
inftead of the Skin.
It was the of another, whom I well re
pradice
member, to pinch Small portion of the Skin on
up a

the arms of his patients and to pafs through it a

needle, with a thread attached to it previoufly dip
ped in variolous matter. The thread was lodged
in the perforated parts, and consequently left in
ccntad with the cellular membrane. This pradice
was attended with the fame ill fuccefs as the former.

Although it is very improbable that any one would

now inoculate in this rude way by defign, yet thefe

obfervations may tend to place a double guard over

the lancet, when infants, v/hofe Skins are compara
tively fo very thin, fall under the care of the inoc
ulator.
A very refpedablefriend of mine, Dr. Hard-
wicke, of Sodbury in this county, inoculated great
numbers of patients previous to the introdudion
of the more modern method by Sutton, and with
fuch fuccefs, that a fatal inftance occurred as rarely
as Since that method has been adopted. It was the
dodor's pradice to make as flight an incifion as
 L 36 ]
poffible uptn the tin, and there lodge to a thread
faturated with the variolous muter. When his

patients became indifpofed, agreeably to the cuflom

then prevailing, they were direded to go to bed,
and wer.: kept moderately war:.-.. Is it not proba
ble then, that the fuccefs of the modern pradice
may depend more upon
the method of invariably
depofiting the vims in or upon the Skin, than on
the fubfeqjent treatment of the difeafe i
I do not mean to infinuate that expofure to cool
air, and Suffering the patient to drink cold water
when hot and thirfty, may not moderate the erup
tive fymptoms and leffen the number of puftules ;
yet to repeat my former obfervation, I cannot ac
count for the uninterrupted fuccefs, or nearly fo,
of one praditioner, and the wretched date of the
patients under the care of .mother, where, in both
inftances, the general treatment did not differ ef-

fentially, without conceiving it to arife from the

different modes of inferting the matter for the pur-
pofe of producing the difeafe. As it is not the
identical matter inferted which is abforbed into the
conftitution, but that which Is by fome peculiar
procefj in the animal economy, generated by it, is
it not probable that different parts of the human bo
dy may prepare or modify the virus differently ?
Although the Skirt, for example, adipofe membrane,
or mucous membranes arc all capable of
producing
the variolous virus by the Stimulus
given by the
particles originally depofited upon them, yet I am
induced to conceive that each of thefe parts is ca.
pable of producing fome variation in the qualities
of the matter previous to its
affeding the conftitu.
tion. What dfe can conftitute the difference be-
 [ 37 3
tween the Small Pox when communicated
cafually
or in what has been termed the natural way, or
when brought on artificially through the medium
of the fkin ? After all, are the variolous particles,
poffeffing their true Specific and contagious princi
ples, ever taken up and conveyed by the lymphat
ics unchanged into the blood veffels ? I imagine not.
Were this the cafe, Should we not find the blood
fufiiciently loaded with them in fome ftages of the
Smdl Pox to communicate the difeafe by inferting
it under the cuticle, or by fpreading it on the fur-
face of an ulcer ? Yet experiments have determined
the impradicability of its being given in this way j
although it has been proved that variolous matter
when much diluted with water, and applied to the
fkin in the ufual manner, will produce the difeafe.
But it would be digrcfling beyond a proper bounda
ry, to go minutely into this fubjed here.
At what period the Cow Pox was firft noticed
here is not upon Record. Our oldeft farmers were
not unacquainted with it in their earlieft days,
when it appeared among their farms without any
deviation from the phenomena which it now exhi
bits. Its connedion with the Small Pox Seems to
have been unknown to them. Probably the general
introdudion of inoculation firft occafioned the dis
covery.
Its rife in this country may not have been of ve

ry remotedate, as the pradice of milking cows

might formerly have been in the hands of women
only ; which I believe is the cafe n'»w in fome
other dairy countries, and, consequently that the
cows
might not in former times have been expofed
 r 38 3
the matter brought by the men Serv
to contagious
ants from the heels of horfes*. Indeed a
knowledge
of the Source of the infedion is new in the minds
of molt of the farmers in this neighbourhood, but
has at length produced good conSequences ; and it
Seems probable from the precautions they arc now
difpcfed to adopt, that the appearance of the Cow
Pox here may either be entirely extinguished or be
come extremely rare.

Should it be afked whether this inveftigation is a

matter of mere curiofity, or whether it tends to a-

ny beneficial purpofe, I fhould anfwer, that notwith

standing the happy effeds of inoculation, with all the
improvements which the pradice has received fince
its firft introdudion into this country, it not very
frequently produces deformity of the fkin, and
fometimes, under the beft management, proves fa
tal.
Thefe circumstances muft naturally create in eve
ry inftance Some degree of painSul Solicitude for its
conSequences. But as 1 have never known fatal
effeds arife from the Cow Pox, even when im-
prt-ffed in the molt unfavorable manner, producing
extenfive inflammations and fuppurations on the

*
/ have been informed from refpefiable
authority
that in Ireland, although dairies abound in
many parts
of the Ifland, the difeafe is entirely unknown. The
reafjir feems obvious. 'The bufinefs of the dairy is con-
dueled by women only. Mere the mcanefl vaffal a.
mong the men, employed there at a milker at a dairy,
he would feel hisfituation
unplcafant all endu
beyond
rance.
 C 39 3
hands; and as it clearly appears that this difeafe
leaves the conftitution in a ftate of perfed Security
from the infedion of the Small Pox, may we not
infer that a mode of Inoculation may be introduced
preferable to that at prefent adopted, efpecially
among thofe families, which, from previous cir-
cumftances we may judge to be predifpofed to have
the difeafe unfavorably ? It is an excefs in the num
ber of puftules which we chiefly dread in the Small
Pox ; but, in the Cow Pox, no puftules appear,
nor does it feem poffible for the contagious matter
to produce the difeafe from effluvia, or oy any other
means than contad, and that probably not
fimply
between the virus and the cuticle ; fo that a fingle
individual in a family might at any time receive it
without the rifle of infeding the reft, or of fpread-
ing a diftemper that fills a country with terror. —

Several inftances have come under my observation

which juftify the affertion that the difeafe cannot
be propagated by effluvia. The firft boy whom I
inoculated with the matter of Cow Pox, Slept in a
bed, while the experiment was going forward,
with two children who never had gone through
either that difeafe or the Small Pox, without in
feding either of them.
A young woman who had the Cow Pox to a
great
extent, feveral fores which maturated having ap
peared on the hands and v/rifts, flept in the fame
bed with a fellow dairymaid who never had been in.
feded with either the Cow Pox or the Small Pox,
but no
indifpofition followed.
Another inftance has occurred of a
young woman

on whofc hands were feveral large fuppurations from

 r 45" 3
the Cow Tox, who was at the fame time a daily
nurSe to an infant, but the complaint was not com

municated to the child.

In fome other points of view, the inoculation of
this difeafe appears preferable to the variolous in.
oculation.
conftitutions predifpofed how
In to
fcrophula,
inoculated Small Pox roufe
frequently we fee the
into adivity that diftrcSsiul malady. This circum
stance does not Seem to depend on the manner in
which the difiemper has Shewn itfelf, for it has as
frequently happened among thofe who have had it
mildly, as when it has appeared in the contrary
way.
There are many, who from fome peculiarity in
the habit refift the common effeds of vaiiolous mat.
ter inferted into the fkin, and who are in confequence

haunted through life with thediftreffmg idea of be

ing infecure tiom fubfequent infedion. A ready
mode of diffipating anxiety originating from fuch a
caufe muft now appear obvious. Ar.d, as we have
Seen that the conftitution may at any time be made
to feel the febrile attack of Cow Pox,
might it not,
in many chronip difeafes be introduced into the fyf
tem, with the probability of affording relief, upon,
well known phyfiological principles ?

Although I fay the fyftem may at any time be

made to feel the febrile attack of Cow Pox,
yet I
have a fingle inftance before me where the virus
aded locally only, but it is not in the le;ifc
proba
ble that the fame perfen would refift theadion
both
pf the Cow Pox virus and the vatiolqas.
 [ 4' ]
Elizabeth Sarfenet lived as a dairymaid at New-
park farm, in this parifh. All the cows and the
Servants employed in milking, had the Cow Pox ;
but this woman, though fhe had feveral fores upon
her fingers, felt no tumours in the axillas, nor any
general indifpofition. On being afterwards cafually
expofed variolous infedion, fhe had the Small
to
Pox in mild way.
a Hannah Pick, another of the
—

dairymaids who was a tellow-fervant with Eliza

beth SarSenet when the difiemper broke out at the
farm, was at the Same time infected ; but this
young woman had not only fores upon her hands,"
but felt herfelf alfo much indifpofed for a day or
two. After this, I made feveral attempts to give
her the Small Pox by inoculation, but they all pro
ved fruitlefs. From the former Cafe then we fee
$hat the animal economy is fubjed to the fame laws
in one difeafe as the other.

The following Cafe, which has very lately occur

red, renders it highly probable that not only the
heels of the horfe, but other parts of the body of
that animal, are capable of generating the virus
which produces the Cow Pox.
An extenfive inflammation of erysipelatous kind*
appeared without any apparent caufe upon the upper
part of the thigh of a fucking colt, ihe property
of Mr. Millet, a farmer at Rcckhampton, a village
near
Beikeley. The inflammation continued feveral
weeks, and at terminated in the formation of
length
three four fmall abfeeff b. The inflamed parts were
or

fomented, and drefiings weie applied by fome of the

fime weie employed in milking the
[erfonsvvho
cows. The number of cows milked was uver.ty.
 four, and the whole of them had the Cow Pox.
The milkers, confuting of the farmer's wife, a man
and a maid fervant, were infeded by the cows.
The man fervant had previoufly gone through the
Small Pox, and felt but little of the Cow Pox. The
fervant maid had fome years before been infeded
with the Cow Pox, and fhe alfo felt it now in a
flight degree. But the farmer's wife who never
had gone through either of thefe difeafes, felt it?
effeds very Severely,

,
That the difeafe produced upon the cows by the
colt, and from thence conveyed to thofe who milk.

ed them was the true and not the fpurious Cow Pox*,
there can be fcarcely any room tor fufpicicn ; yet it
would have been more completely fatisfadory, had
the effeds of variolous matter been afcertaincd on
the farmer's wife, hut there was a peculiarity in
her fituation which prevented my making the ex
periment.
Thus far have I proceeded in an inquiry, found.
ed, as it muft appear, on the bafis of experiment j
in which, however, conjedure has been admitted
in order to prefent to perfons well Situated for fuch
difcuffions, objeds for a more minute inveftigation.
In the mean time I fhafl myfelf continue to profe-
cute this inquiry, encouraged by the
hope of its,
becoming effcntially beneficial to mankind.
*
See Page 4,
 t 45 J

FURTHER OBSERVATIONS

ON THE

Variolae Vaccinae.

xTLLTHOUGH it has not been in my

power extend the Inquiry into the caufes and

to
effeds of the Variola; Vaccinae much beyond its
original limits, yet, perceiving that it is beginning
to excite a general Spirit of inveftigation, I think
it of importance, without delay, to communicate
fuch fads as have fince occurred, and to point out
the fallacious Sources from whence a difeafe refem-
bling the true Variolae Vaccinas might arife, with
the view of preventing thofe who may inoculate,
from producing a Spurious difeafe ; and further, to
enforce the precaution Suggested in the former Trea-
tife on the fubjed, of Subduing the inoculated puf
tule as foon as it has fufiiciently produced its influ
ence on the conflitution. From a want of due dif-
crimination of the real exiitence of the difeafe ei.
ther in the brute or in the human fubjed, and alfo
of that ftage of it in which it is capable of produ
cing the change in the animal economy which ren-
 f 44 3
the Small
ders itunfufceptible of the contagion of
Pox, unpleafant confcquences might enfuc, the
Source of which, perhaps, might not be fufpeded
by one inexperienced in conduding fuch experi
ments.

Mv l.i te publication contains a relation of moft

of the fads which had come under my own infpec-
tion at the time it was written, interfperfed with
fome conjedural obfervations. Since then Dr. G.
Pearfon has eftablifhed an inquiry into the validity
of mv principal affertion, the refult of which can
not but be highly flattering to my feelings. It
contains not a Angle cafe which I think can be call
ed an exception to the fad I was fo firmly imprcffed
with—
that th<i Cow Pox proteds the human body
from the Small Pox. I have myfclf received fome,
farther confirmations, which fhall be Subjoined. I
have lately alfo been favoured with a letter from a
gentleman of great refpedability (Dr. Ingenhoufz),
informing me that, on imking an inquiry into the
fubjed in the county cf Wilts, he difcovered that a
farmer near Calne had been infeded with the Small
Pox after having had the Cow Pox, and that lira
difeafe in each inftance wasfo ftrongly charaderifed
as to render the fafts incontrovertible. The Cow
Pox, it Seems, from the Dodor's information, was
communicated to the farmer from his cows at the
time that they gave out an effenfiveflench from their
udders.

Some other inftances have likewife been rcpre.

fented to me of the appearance of the
difeafe, appa
rently marked with itscharaderiftic fymptoms, and
yet that the patients have afterwards had the Smsftl
 C 4? 3
rox. On th»fe cafes I Shall, for the prefent, fuf-
pend particular remarks, but hope that the ge
any
neral obfervations I have to offer in the Sequel will
prove of fufR ient weight to render the idea of their
ever
having had exiftence, but as cafes of Spurious
Cow Pox, extremely doubtful.
Ere I proceed let me be permitted to obferve,
that Truth, in this and every other Phyfiolgical
Inquiry that has occupied ray attention, has ever
been the objed of my purfuit ; and fhould it appear
in the prefent inftance that I have been led into
error, fond as I may appear of the offspring of my
labours, I had rather fee it perifh at once, than ex-
jft and do a public injury.
I fhall proceed to enumerate the fources, or what
appear to me as Such, of a Spurious Cow Pox.
ift. That arifing from puftules on the nipples oir
udder of the cow ; which puftules contain no Spe
cific virus.

2dly. From matter (although originally poffeflin*

th* Specific virus) which has Suffered a decompoli-
tion, either from putrefadion or from any other
caufe lefs obvious to the fenfes.

3dly. From matter taken from an ulcer in an ad

vanced ftage, which ulcer arofe from a true Cow
Pock.
4.thly. From matter produced on the human fkin
from contad with fome peculiar morbid matter ge
nerated by a horfe.
On thefe fubjeds I Shall offer fome commen's.
Firft To what length puftulous difeafes of the ud-
—

G
 r 4* i
may extend, it
is not in
.der and nipples of the cow

my power to determine but certain it is, that

;
thefe parts of the animal are fubjed to fome varie
of thefe
ty of maladies of this nature ; and as many
eruptions (probably all of them) are capable of gi
a difeafe to the human body, would it not be
ving
difcreet for thofe engaged in this investigation to
fufpend controversy and cavil until they can ascer
tain with precifion what is and what is not the gen
uine Cow Pox ?
For example. —
A farmer who is not converfant
with any of thefe maladies, but who may have
heard of the Cow Pox in general terms, may ac
quaint n neighbouring furgeon that the diftemper
appears at his farm. The furgeon, eager to make
an
experiment, takes away matter, inoculates, pro
duces a fore, uneafinefs in the axilla, and perhaps
fome affedion of the fyftem. This is one way in
which a fallacious idea of Security both in the mind
of the inoculator and the patient may arife ; for a
difeafe may thus have been propagated from a
fimple eruption only.
One of the firft objefls then of this purfuit, as I
have obferved, fhould be, to learn how to diftin-
guifh with accuracy between that peculiar puftule
which is the true Cow Pock, and that which is
fpurious. Until experience has determined this,
we view our
objed through a mill. Let us for in
stance fuppofe, that the Small Pox and the Chicken
Pox were at the fame time to fpread
among the in
habitants of a country which had never been vifited
by either of thefe difteropers, and where they were
'i- ire unknown before ; what confulion would arife !
 C 47 }
The refemblance between the fymptoms of the
erup
tive fever and between the puftules in either cafe
would be fo
Striking, that a patient, who had gone
through the Chicken Pox to any extent, would feel
equally eafy with regard to his future Security from
the Small Pox as the
perfon who had actually paffed
through that difeafe. Time and future observation
would draw the line of diftindion.

So I prefume it will be with the Cow Pox until

it is more
generally underftood. All cavilling
therefore on the mere report of thofe who tell ut
they have had this difiemper, and are afterwards
found to be fufceptible of the Small Pox, Should be
fufpended. To illuftrate this, I beg leave to give
the following hiftory :

SARAH MERLIN, of the parifh of Eaftington

in this county, when about thirteen or fourteen
years of age, lived as a fervant with farmer Clarke,
who kept a dairy, confifting of about eighteen cows,
at Stonehoufe, a neighbouring village. The nip
ples and udders of three of the cows were extend ve-
]y affeded with large white blisters. Thefe cows the
girl milked daily, the fame time fhe affified,
and at
with two others, in milking the reft of the herd.
It foon appeared that the difeafe was communicated
to the girl. The reft of the cows efcaped the infec-
tion,alt hough they were milked feveral days after the
three above Specified had thefe eruptions on the
nipples and udders, and even after the girl's hand
became fore. The two others who were engaged
in milking, although they milked the cows indif.
criminately, received no injury. On the fingers of
each of the girl's bands there appeared feveral large
 C 48 3'
white bliflers, fhe fuppofes about three or four on
each finger. The hands and arms inflamed and
conftitut tonal indifpofition tollowed,
fwdleu, but no

1 he fores were anointed with tome domestic oint

ment, and got well without ulcerating.
and re.
As this malady was called the Cow Pox,
Corded as fuch in the mind of the patient, fhe be,
carre legmdlefs of the Small Pox ; but,
on
being
to it fome years afterwards, She was lnicd.
expofed
ed arid had a full burthen.

Now had any one converfant with the habits of

the difeafe heard this hiltory, they would have had
no hefitation in picnounciig it a cafe of fpurious
Cow Pox ; confidering its deviation in ihenumer'ouf
bliflers which appeared on the girl's hands ; their
termination without ulceration ; its n> 1 proving
mere
generally contagious at the farmeither among
the cattle or thofe en ployed in miikitg ; and con
fidering alfo that the patievt felt no general indifpofi.
tion, although there was Jo great a number of vtjtcles.

perhaps the molt deceptious form in which

1 his is
an eiuptiye difeafe can be communicated from the
cow, and it ctrtainly requires fome attention in

discriminating it. The molt perfect criterion by

Which the judgment may be guided, is perhaps that
ar
opted by thofe who attend infeded cattle. Thefe
white blifteis on the nit: pies, they fay, never eat
into the fii/hy parts like thefe which are commonly
of a biuifli call, and which conftitute the true Covs
Pcx, but that they affed the fkin only, quickly end
in fcabs, and are not nearly So infedious.
1 hat which appeared to me as one caufe of
fpuri-
o-i
cu^tions, I have already remarked in the for-
 ■X 49 1
irer Treatife, namely, the tranfition that the Cow-
makes in the
fpring from a poor to a nutritious diet,
and irom the udder's
becoming at this time more
▼ afcular than ufual for the
lupply of milk. But
theie is another Source of inflammation and
puftules
winch I believe is not uncommon in all the
dairy
counties in the weft of
England. A cow intended
to be Small ud
expofed for Sale, having naturally a
der, is ptevioufiy for a day or two neither milk
ed
artificially, nor is her calf fuffered to have
acceti to her. Thus the milk is preternaturally ac
cumulated, and the udder and nipples become great
ly oiitcnded. The conSequences frequently are, in
flammation and eruptions which maturate.
. Whether a difeafe generated in this way has the
power of affecting the conftitution in any peculiar
manner, I cannot preSume pofitively to determine.
It has been conjedured to have been a caufe of the ttue
Cow Pox, though my inquiries have not led me
to adopt this
Supposition in any one inftance ; on
the contrary, I have known the milkers affeded by
it, but always found that an affedion thus induced
lett the fyftem as of the Small Pox as be
fufceptible
fore.
What is advanced in my fecond pofition, I con.
iitler alfo ot very great importance, and 1 could
wiih it to be Strongly impreffed on the minds of all
who may be difpuled to conclude haftily on my ob
fervations, whether engaged in their investigation
by experiments or not. To place this in its clear-
—

clt point of view (as the fimilarity between the ac

tion of the Small Pox and the Cow Pox matter is fo
obvious) it will be ncceffary to tor.fider what we
 C so ]
fometiroes obferve to take place in inoculation for
the Small Pox when imperfed variolous matter is
made ufe of. The concife hiltory on this fubjed
that was brought forward refpeding what I had ob.
ferved in this neighbourhood*, I perceive by a re.
ference fince made to the Memoirs of the Medical
Society of London, may be confidered as no more

than corroboration of the fads very clearly detail

a

ed by Mr. Kitet. To this copious evidence I have

to add ftill more in the following communications
from Mr. Earle, furgeon, of Frampton-upon-Severn,
in this county, which I deem the more valuable, as
he has with much candor permitted me to make
them public.

"
Sir,
"
I have read with fatisfadion your late publi.
cation on the Variola; Vaccinae, and being, among
many other curious circumftances, particularly
Struck with that relating to the inefficacy of Small.
pox matter in a
particular ftate, I think it proper
10 lay before
you the following fads which cam«
within my own knowledge, and which certainty
tend to Strengthen the opinions advanced in
pages
33 and 34 of your Treatife.
••
In March 1)84, a
general inoculation took
*
Inquiry into the Caufes and Effeds of the Variol*
Vaccina, page 3$.
+ See an
offame anomalous appearances con-
account

fequent to the inoculation

of the Small Pox, by Charles
Kite, Surgeon, of Gravefend, in the Memoirs of the
Medical Society of London. Vol. iv,
page 114,
 t 5i 3
place at Arlingham in this county. I inoculated
feveral patients with adive variolous matter, all of
whom had the difeafe in a favorable way ; but
my
matter
being all ufed, and not being able to procure
any more in the ftate I wifhed, I was under the ne-
ceffity of taking it from a puftule which, experience
has fince proved, was advanced too far to anfwer
the purpofe I intended. Of five perfons inoculated
with this laft matter, four took the Small Pox af
terwards in the natural way ; one of whom died,
three recovered, and the other being cautioned by
me to avoid as much as
poflible the chance of catch
ing it, efcaped from the difeafe through life. He
died of another difordcr about two years ago.
"
Although one of thefe cafes ended unfortunate,
yet I cannot fuppofe that any medical man will
think me carelefs or inattentive in their manage
ment ; for I conceive the
appearances were fuch as
might have induced any one to fuppofe that the
perfons were perfedly Safe from future infedion.
Inflammation in every cafe took place in the arm,
and fever came on with a confiderable degree of pain
in the axilla. In fome of their arms the inflammation
and Suppuration were more violent than is commonly
obferved when perfed matter is made ufe of ; in
one there was an ulcer which caft off feveral
large
Sloughs. About tbe ninth day eruptions appeared,
which died away earlier than common without ma.
turation.—
From thefe circumftances I fhould fup
pofe that no medical practitioner would Scarcely
have entertained a doubt but that thefe patients had
been infeded with a true Small Pox ; yet I muft
confefs that fome Small degree of doubt prefented
itfclf to me at the fpeedy disappearance of the
 t 5* 3
to ascer
eruptions ; and in or-'er, as far as I could,
tain their fafety, I fent one of them to a much
older praditioner than mvfelf. This gentleman on
hearing the circumftanceof the cafe, pronounced the
patient perfedly fecure from future infedion.
"
The following fads are alfo a ftriking proof
of the truth of your obfervations on this fubjed :
"
In the year 1789 I inoculated three children
of Mr. Coaley, of Hurft-farm in this county. The
arms inflamed properly, fever and pain in the axilla

came on precifely the fame as in the former cafes,

and in ten days eruptions appeared, which difap.
peared in the coutfe of two days. I muft obferve
that the matter here made ufe of was procured for
roe by a friend : but no doubt it was in an impro.

per ftate ; Sor, from the fimilarity of thefe cafes to

thofe which happened at Arlingham five years be
fore, I was fome what alarmed for their fafety, and
defired to inoculate them again ; which being per.
mitted, I was particulaily careful to procure matter
in its moft perfed ftate. All the children took the
Small Pox from this fecond inoculation, and all had
a very full burthen. Thefe fads I conceive Striking
ly corroborate your opinion relative to the different
ftates of matter ; for in both the inftances that I
have mentioned it was capable ot producing fome*
thing ftrongly refembling the true Small Pox, al.
though it afterwards proved not to be fo.
**
As I think the communication of thefe Cafe!
ij a duty I owe to the Public, you are at
liberty to
make what ufe you plcafc of this letter.
"
I remain, See. *'
JOHN EARLE.
Frampton upon Severn ,
■
-

Gloucefterfhire,
November 10, 1 79S*
 I 53 1
"
P. S. I think it ncceffarv to obferve, that t
Can pronounce with the greateft certainty, that the
matter with which the Arlingham patients were
inoculated was taken from a true Small Pox puftule.
1 took it myfelf from a fubjed that had a very full
barthen.*'
Certain then it is that variolous matter may u«-

Jergo fuch a from the putrefadive procefs,

change
as well as from fome of the more obfcure and latent

proceffes of nature, as will render it incapable of

jiving the Small Pox in fuch a manner as to fecure
the human conftitution from future infedion, al
of ex
though we fee at the fame time it is capable
citing a difeafe which bears fo Strong a refemblance
to it, as to produce inflammation and matter ir. the
incifed fkin (frequently indeed more violent than
when it produces its effeds perfedly,) fwelling of
the axillary glands, general indifpofition, and erup
tions. So Strongly perfuaded was the gentleman,
trhofc practice I have mentioned in page 33 of the
late Tteatife, that he could produce a mild Small
Pox by his mode of managing the matter, that he
fpoke of it as a ufeful difcovery until convinced of
bis the fatal confequence Which enfued.
error by
After this ought we to be in the fmalleft degree
furprifed find, among a great number of indivi
to
duals who by living in dairies have been cafually
expofed to the Cow Pox virus when in a ftate
ana

above defcribed,
logous to that of the Small Pox
fome, who may have had the difeafe fo imperfedly
as not torender them fecure from variolous attacks ?
For the matter, when burft from the puftules
on

the nipples of the Cow, by being expofed, from

fts lodgment there, the heat of an inflamed Sur
to

face, and from being the fame time in a Situation"

at
is oSten likely
to be occasionally moittened with milk,
to be in a ftate conducive to putrefadion ;
and thus.un-
der Some modification of decompofition, it muft of
courfe Sometimes find acceSs to the hand of the
milker in Such a way as to infed him. What con-
fufion Should we have, were there no other mode of
inoculating the Small Pox than fuch as would hap
pen from handling the
difeafed fkin of a perfon la
bouring under that difiemper in fome of its advanced
and loathfome ftages ! It muft be obferved, that
every cafe of Cow Pox in the human Species*
whether communicated by defign or otherwife, is
to be confidcred as a cafe of inoculation. And
here I may be allowed to make an obfervation on
the cafe of the farmer communicated to me by Dr.
Ingenhoufz. That he was expofed to the matter
when it had undergone the putrcfadive change, is
highly probable from the Dodor's obferving that
the fick cows at the farm gave out an offenfive flench
from their udders. However, I muft remark, that
it is unufual for cattle to fuffer to fuch an extent,
when difordered with the Cow Pox, as to make a
by-ftander fenfible of any ill fmell. I have often
ftood among a herd which had the difiemper with
out being confeious of its prefence from
any parti
cular effluvia. Indeed, in this neighborhood it
commonly receives an early check from efcharotic
applications of the row leech. It has been conceiv
ed to be contagious among cows without contact. ;
but this idea cannot be well founded, becaufe the
cattle in one meadow do not infed thofe in another
(althoBgh there may be no other partition than z
 [ 55 3
hedge) unlefs they be handled or milked by thofe
who bring the infedious matter with them ; and
of courfe the fmalleft particle imaginable, when
applied to a part fufceptible of its influence, may
produce the effed. Among the human fpecies it
appears to be very clear, that the difeafe is produ
ced by contad only. All my attempts, at leaft, to
communicate it by effluvia have hitherto proved in-
effedual.
As well as the perfed change from that ftate in
which variolous matter is capable of producing full
and decifive effeds on the conftitution, to that
wherein its Specific properties are entirely loft, it
may reafonably be fuppofed that it is capable of
undergoing a variety of intermediate changes. The
following fingular occurrences in ten cafes of inocu
lation, obligingly communicated to me by Mr.
Trye, Senior Surgeon to the Infirmary at Gloucefter,
feem to indicate that the variolous matter, previ.
oufly to its being taken from the patient for the in
tended purpofe, was beginning to part with fome
of its original properties, or, in other words, that
it had fuffered a partial decompofition. Mr.Trye fays,
"
I inoculated ten children with matter taken at one
time and from the fame fubjed. I obferved no peculi
arity in any of them previoufly to their inoculation,
nor did
any thing remarkable appear in their arms till
after the decline of the difeafe. Two infants of
three months old had eryfipelas about the incifions,
in one of them extending from the fhoulders to the
Singers ends. Another infant had abfeeffes in the cel
lular fubftance in the neighbourhood of the incifions,
and five or fix of the reft had axillary abfeeffes.
The matter was taken from the diftinft Small Pox
 t 5* J
fate in its progrefs, and when fome puftules had bee*
dried. It was received upon glais, and Slowly dri
ed by the rue. All the children had puftules which
maturated, So that i fuppofe them all Secure from tu.
ture infedion ; at leaft, as fecure as any others whom
I have ever inoculated. My pradice never afforded
a fore arm betore."
In regard to my former obfervation on the impro.
per and dangerous mode of preferving variolous
matter, I (hall here remark, that it Seems not to
iiave been clearly underftood. Finding that it has,
been contounded with the more eligible modes of
preservation, 1 will explain mySelf further. When
the matter is taken irom a fit puftule and
properly
prepared lor preservation, it may certaimy be kept
without lofing its Specific properties a
great length
of t.me ; tor inftance, when it is
previously dried
>n the open air on Some
compad body, as a quill or
a
piece of glals, and afterwards Secured in a Small
▼ ia.*. But when kept feveral days in a itate of
moiiture, and during that time expofed to a warm
temperature, 1 do not think it can be relied upon
as capable of
giving a perftl difeafe, although, as
I have before obferved, the
progrefs ot the SyropT
toms
aiifing lrura the adion of the impeded mat.
tcr bear fo
ttrong a rcfemblance to ihc Small Pox
When excited
completely.
y\iy. That the firft formed virus, or what coo-
Ititutcs the true Cow Pock
puftyle, invariably pof.
lelies the power I have alcnbed
to »t, namely, that

*
Thus the Cow Pox virus
prepared, was found
Perfectly adiie, and puffing ail itsfpecifc properties*
r
*
«t the end three
ojf mntks*
•f affecting the conftitution with a fpecific difeafe,
is a truth that no fubfequent occurrence has yet l«4
me to doubt. But as i am now endeavoring to

the much a* poffible againlt erro

public
guard as

neous conclusions, I (hall obferve, that when this

has degenerated into an ulcer (to which
Jniftule
tate it is Sometimes diSpofed to pafs unlets timely
Checked) 1 luSpect that matter poflefling very dif
ferent properties -may Sooner or later be produced ;
and although it may have paffed that ftage wherein
the fpecific of the matter Secreted are no
properties
longer preSent applied to a fore (as
in it, yet when
jn the caiual way) it might difpofe that lore to
would
ulcerate, and from its irritation the fyftem
probably become affeded j and thus, by affuming
fpme of its characters, it would imitate
ftrongeit
the genuine Cow Pox.

From the preceding obfervations on the matter

of Small Pox when decomposed, it mult, I con
ceive, be admitted, that Cow Pox matter in the
deScribed may diSeafe, the ef
ftate now produce a

fects ot which may be felt both locally and gener

be
ally, yet that the difeaSe thus induced may not
effectual in
obviating the future effeds of variolous
contagion. In the cafe of Mary Miller, related by
Mr. Kite in the volume above alluded to, it ap
and fuppuration ot the
pears that the inflammation
inoculated arm were more than ulually fevere, al
from
though the fyftem underwent no fpecific change
the action of the virus ; which appears tr«»m the
with the
patient's fickening feven weeks afterwardsits courfe.
natural Small Pox, which went through
borne of the Cafes communicated by Mr. Kaxle tend
 further to confirm this fad, as the matter there
manifestly produced ulceration on the inoculated
part to a confiderable extent.
Whether the Cow Pox is a fpontaneous
4thly.
difeafe in thecow, oris to be attributed to matter
conveyed to the animal, as I have conceived, from
the horfe, is a queftion, which though I (hall not
attempt now
Sully to diScufs, yet I Shall digreSs fp
far as to adduce fome further obfervations, and to
give my reafons large for taking up an
more at

opinion that to fome has

appeared fanciful. The
a&Srcgate °f thefe obfervations, though not amount
ing to pofitive proof, forms prefumptive evidence
of fo forcible a kind, that I
imagine it might on
any other perfon have made the fame impreffion it
did on without fixing the of
me, imputation cre

dulity.
Firft. I conceived this was its Source, from ob
serving that where the Cow Pox had
appeared among
ihe dairies here (unlefs it could be traced to the in
troduction of an infeded cow or
fervant) it had
been preceded at the farm
by a horfe difeaSed in the
manner
already deScribed, which horfe had been at.
tended by Some of the milkers.

Secondly. From its being a popular opinion

throughout this great dairy country, and from its
being infilled on by thofe who here attend fick cat.
tie.
Thirdly.From the total abfence of the difeafe
m Ireland and Scotland, where the men Servants
are not
employed in the dairies*.
*

„i 7%" "format'oa
tbefirjl authority ,
w« communicated to mi frotn
'
 t 59 1
Fourthly. From having obferred that morbid
matter generated by the horfe frequently communi
cates, ina cafual
Way, a difeafe to the human fub
jed fo like the Cow Pox, that in many cafes it
would be difficult to make the diftindion between
one and the other*.

Fifthly. From being induced to fuppofe from ex

periments,that fome of thofe who had been thus af

feded from the horfe refilled the Small Pox.

Sixthly. From the progrefs and general appear

ance of the puftule on the arm of the boy whom 1
inoculated with matter taken from the hand of a
man infeded by a horfe : and Srom the
fimilarity
to the Cow Pox of the
general conftitutional fymp
toms which followed+.
I fear it would be trefpafling too far to adduce the
general teftimony of our farmers in fupport of this
*
The found fkin does not appear to be
fufceptible of
this when inferted into it, but, when previoufly
virus

difeafedfrom little accidents, its effeels are often confpicuous

+ This Cafe (on which I laid no inconfiderable Jlrefs
in my late Treat ife, as prefumptive evidence of the fad
adduced) feems to have either been mflahen or overlook
ed, by thoje who have commented upon the fubjed. See —

Cafe xviii, page 22. The boy unfortunately died of a

fever at a parifh worhhoufe before I had an opportuni
ty of obfrving nvhat effeels nvould have been produced
by the matter of Small Pox. The experiments pub-
—

lifhed by Mr. Simmons of Manchefler, and others on the

fnbjeel, with the view of refuting this Theory appear
to have but little weight, as even the Cow pock virus

itfelf when repeatedly introduced into the found nipples

if cows
by means of a lancet, was
found to fro*
duce uo
effc8%
 C 60 J
•pinion ; yet I bej leave to introduce an extract
of a letter on this fubjrd from the Rev. Mr. Moore,
of Chalford Hill, in this county.
*'
In the month of November 17971 my horfe
had difeafed heels, which was certainly what is
termed the greafe ; and at a Short fubfequent pe.
riod my cow was alfo affeded with what a neigh
boring farmer (who was converfant with the com
plaints of cattle) pronounced to be the Cow Pox,
which he at the fame time obferved my fervant
would be infeded with : and this proved to be the
cafe ; for he had eruptions on his hands, face, and
many parts of the body, the puftules appearing
large, and not much unlike the Small Pox, for
which he had been inoculated a year and a half be
fore, and had then a very heavy burden. The puf* .

tules on the face might arife from contad with his

hands, as he had a habit of rubbing his forheadj J1
where the fores were the largeft and thickeft.
"
The boy affociated with the farmer's Sons dur
ing the continunnce of the difeafe, neither of whom
had had the Small Pox, but
they felt no ill effeds
whatever. He was not much
indifpofed, as the
difeafe did not prevent him from
following his oc
cupations as ufual. No other perfon attended the
horfe or milked the cow, but the lad abovemention- 1
ed. I am firmly of opinion that the difeafe in the
heels of the horfe, which was a virulent
was the
greafe,
origin of the Servant's and the cow's ma- '
lady."
But to return. to the more immediate objed of
this proposition.
From the
fimilarity of fymptoms, both conftito-
 [ *» ]
tional and local, between the Cow Pox and the dif-
eafa received Srora morbid matter generated by a
horfe, the common people in this neighbourhood
when infeded with this difeafe, through a
Strange
perverfion of terms, frequently call it the Cow Pox.
Let us fuppofe then fuch a malady to appear among
fome of the fervants at a farm, and at the fame time
that the Cow Pox were to break out among the cat
tle ; and let us fuppofe too that fome of the fervants
were infeded in this way, and that others received

the infedion from the cows. It would be recorded

at the farm, and among the fervants thcmfelves
wherever they might afterwards be difperfed, that
they had all had the Cow Pox. But it is clear that
an individual thus infeded from the horfe, would

neither be for a certainty fecure himfelf, nor would

he to others were they inoculated
impart Security
virus thus generated.
by He ftill would be in dan
ger of taking the Small Pox. Yet were this to
happen before the nature of the Cow Pox be more
maturely confidered by the public, my evidence on
the fubjed might be depreciated unjuftly. For an
exemplification of what is here advanced relative
to the nature of the infedion when received dired-

ly from the horfe, fee Inquiry into the Caufes and

Effeds of the Variola; Vaccinas, pages 1 6, 17, 18,
19, and page 22 ; and by way ot further example,
I beg leave to fubjoin the following intelligence re
ceived from Mr. Fewfter, Surgeon, of Thornbury,
in this county, a gentleman perfectly well acquaint
ed with the appearances of the Caw Pox on the
human fubjed.
• "
WILLIAM MORRIS, aged thirty- two, fer
vant to Mr, Cox of Almonfbury, in this county,
I
 t 6* 1
to me the 2d of April, 1798. He told mej
applied
that four days before, he found a ftiffnefs and fwel
it
ling in both his hands, which were fo painful,
was with difficulty he continued his work ; that he
had been feized with pain in his head, fmall of the
back, and limbs, and with frequent chilly fits Suc
ceeded by fever. On examination I found him ftill
affeded with thefe fymptoms, and that there was
a great proftration of ftrength. Many parts of
his hands on the infide were chapped, and on the
middle joint of the thumb of the right hand there
was a fmall phagedenic ulcer, about the fize of a

large pea, discharging an ichorus fluid. On the

middle finger of the fame hand there was another
«ilcer of afimilar kind. Thefe fores were of a dr.
mlar form, and he defcribed their firft appearance
as
being Somewhat like bliflers arifing from a burn.
He complained of exceflive pain, which extended up
his arm into the axilla. Thefe fymptoms and appear
ances of the fores were fo exadly like the Cow Pox,

that I pronounced he had taken the difiemper from

milking cows. He, affured me he had not milked a
cow for more than half a year, and that his matter's

cows had
nothing the matter with them. I then afk-
edhim if his mafter had agreajy horfe ? which he an-
fweted in ihe affirmative ; and further faid, that
he had constantly drefled him twice a day for the
Iaft three weeks or more, and remarked that the
fmell of his hands was much like that of the horfe's
heels. On the 5th of April I again faw him, and
found him ftill complaining of pain in both his
hands, nor wrre his febrile Symptoms at all relieved.
The ulcers had now fpread to the fize of a feven-
fiiilling gold coin, and another ulcer, which I had
 L 63 ]

pot noticed before, appeared on the firft joint of the

forefinger of the left hand, equally painful with
that on the right. I ordered him to baihe his
hands in warm bran and water, applied efcharotics
in a Soft
to the ulcers, and wrapped his hands up

cataplafm. The next day he

was relieved,
much
well.
and in fomething more than a fortnight got
that
He loft his nails trom the thumb and fingers
were ulcerated."
of the fymptoms in
The fudden disappearance
this cafe after the application of the efcharotics
to

feems
the fores is worthy of observation ; it
to

by the irritation of
fliew that they were kept up
(he ulcers.
de
The general fymptoms which I have already
in a
scribed of the Cow Pox, when communicated
lam convin
cafual way to any great extent, will,
have feen, be fouod
ced, from the many Cafes I
accurate; but from the very flight indifpofition
where the
which enfues in cafes of inoculation,
puftule after affeding the conftitution, quickly runs
into a fcab fpontaneouflv, or is artificially fupprefs-
am induced to be
ed by fome proper application, I
be
lieve that the violence of the fymptoms may
the inflammation and irritation of the
afcribed to
to any extent,
ulcers (when ulceration takes place
the conftitu-
asin the cafual Cow Pox,) and that
the preface
tional fymptoms which appear during
charade r ot a pul-
Of the fore while it affumes the
tuleonly, are felt but in a very trifling degree.
when the
This mild affedion of the fyftem happens
difeafe makes but a flight local impreffion on thofe
who have been accidentally infeded by cows ; and,
 [ H ]
as far as I have feen, it has uniformly happened a-
when a puf
mong thofe who have been inoculated,
tule only and no great degree of inflammation or
any ulceration has taken place from the inoculation;
The following Cafes will ftrengthen this opinion.
The Cow Pox appeared at a farm in the village
ef StonehouSe, in this county, about Michaelmas
laft, and continued gradually to paSs from one cow
to another till the end of November. On the 26th
of that month fome ichorus matter was taken from
a cow and dried upon a
quill. On the 2d of De
cember fome of it was inferted into a fcratch, made
fo fupeificial that no blood appealed, on the arm of
Sufan Phipps, a child feven years old. The com
mon inflammatory appearances to&k place in confe

quence, and advanced till the fifth day, when they

had fo much fubfided, that I did not conceive any
thing further would enfue.
6th. Appearances ftationary.
7th. The inflammation began to advance.
8th. A vefication perceptible on the edges, for
ming, as in the inoculated Small Pox, an appearance
not unlike a grain of wheat, with the clett or in.
dention in the centre.
9th. Pain in the axilla.
10th. A little head-ache; pulfe no; tongue
not difcoloured j countenance in health.
nth. —
I2ih. No perceptible illnefs ; pulfe a-
bout 100.

13th. The puftule was now furrounded by an ef-

floretcence, interfperfed with very minute confluent
puftules to the extent of about an inch, Some of
 [ *c ]
in fize and maturated. So
thefe puftules advanced
exad the rcfemblance of the arm at this ftage
was

to the general appearance of the inoculated Small

Pox, that Mr. D. a neighbouring furgeon, who

took fome matter from it, and who had never feen
the Cow Pox before, declared he could not perceive
The child's arm now fhewed a
any difference*.
difpofition to icsb, and remained nearly Stationary
for two or three days, when it began to run into
a febrile in
an ulcerous ftate ; and then commenced
with an increafe of axilla
difpofition accompanied
ry tumour. The ulcer continued fpreading near a
week, during which time the child continued ill,
when it incteaSed to a fize nearly as large as a Shil
ling. It began now to discharge pus ; granula
had be
tions fprung up, and it healed. This child
but
fore been of a remarkably Sickly conftitution,
is now in very high health.
was in
MARY HEARN, twelve years of age,
oculated with matter taken from the arm ot Sufan
Phipps.
That the Cow Pox vjas a fuppofed guardian of
*

has
the conftitution from the aclion of the Smalt Pox,
the fi
been a prevalent idea for a long time paft ; but
between one difiafe
milarity in the confiitutional effcls
and the other could never have been fo accurately obfer-
Cow Pox placed it
ved, had not the inoculation of the
and jlronger point of view. This pradice
in a new
concealed, the rife
Uo has fljewn us what before lay
the
and progrefs of the puftule formed by the vfertion of
its /rrr-
virus, which places a mofi confpicuous tight
m

the inoculated
king rcfemblance to the pufhueformed from
Small Pox.
 C ** J
6th day. A puftule beginning to appear, flight
pain in the axilla.
7th. A diftind veficle formed.
8th. The veficle increafing ; edges very red ;
no deviation in its
appearance at this time from the
inoculated Small Pox.
9th. No indifpofition ; puftule advancing.
10th. The patient felt this evening a flight fe
brile attack.
1 1 th. Free from indifpofition.

12th. 13th. The fame.

—

14th. An efflorefcence of a faint red colour ex,

tending feveral inches round the arm. The puftule
beginning to Shew a disposition to Spread, was dref-
fed with an ointment compofed of hydrarg. nit.
rub. and ung. ceree. The efflorefcence itfelt" was
covered wi;h a plafter of ung. hydr. fort. In fix
—

hours it was examined, when it was found that thq

efflorefcence had totally difappeared. The applica
tion of the ointment with the hydr. nit. rub. was
made ufe of for three days, when the ftate of the
puftule remaining ftationary, it was exchanged for
the ung hydr. nit.
. This appeared to have a mote
adive effed than the former, and in two or three
days the virus feemed to be fubdued, when a Ample
dreSfing was made uSe of ; but the fore again {hew
ing a difpofition to inflame, the ung hydr. nit. was
.

again applied, and foon anfwered the intended ptir-

pofe effedually. The girl atter the tenth day, when,
as has been observed, fhe became a little
ill, fhewed
not the leaft
Symptom of indifpofition. She was after
wards expofed to the adion of variolous
matter, and
completel) refilled it. Sufan Phipps alfo went thro*
a fimilar trial. Conceiving thefe Cafes to be ira.
 C *7 1
portant, t have given them in detail ; firft, to urge
the precaution of ufing fuch means as may flop the
progrefs of the puftule ; and fecondly, to point out
(what appears to be the fad) that the molt material
indifpofition, or at leaft that which is felt molt fen-
fibly, does not arife primarily from the firft acl'ton of
the virus on the conftitution, but that it often comes on,
if the puftule is left to chance, a< a fecondary difeafe.
This leads me to conjedure, what experiment muft
finally determine, that they who have had the
Small Pox are not afterwards fufceptible of the pri
mary adion of the Cow Pox virus ; for feeing that
the Simple virus itfelf when it has not paffed beyond
the boundary of a veficle, excites in the fyftem fo
little commotion, is it not probable the trifling ill.
fiefs thus induced may be loft in that which fo quick
ly, and oftentimes fo feverely, follows in the cafual
Cow Pox from the prefence of corroding ulcers ?
This confideration induces me to fuppofe that I may
have been mlftaken in my former obfervation on
this fubjed.
In this as well as many others, a paral.
refpefl,
lei may be drawn between this difeafe and the
Small Pox. In the latter, the patient firft feels the
effed of what is called the abforption of the virus.
The fymptoms then often nearly retire, when a
frefh attack commences different from the firft, and
the illnefs keeps pace with the progrefs of the puf.
tules through their different Stages of maturation,
ulceration, Sec.

Although the application I have mentioned in

the cafe of Mary Hearn proved fufficient to check
the progrefs of ulceration and prevent any fecondary
 [ « ]

fymptoms, yet, after the puftule has duly exerted

its influence, fhould ptefer the deftroying it
I
to anv other mode. The
quickly and effedually
term cauftic to a tender ear (and I conceive
none

will feel more interefled in this Inquiry than the

anxious guardians of a nurfery) may found harfh
and unpleafing, but every folicitude that may arife
rn this account will no longer exift, when it is un-
detftood that the puftule In a ftate fit to be aded
upon is then quite Superficial, and that it
does not
occupy the Space of a filver penny*.
As a proof of the efficacy of this pradice, even

before the virus had fully exerted itfelf on the fyf

tem, I Shall lay before my reader the following hif-
tory.
By a reference to the Treatife on the Variola
Vaccinae it will be feen, that in the month of April
1798, four children were inoculated with the mat
ter of Cow Pox, and that in two of thefe cafes the
virus on the arm was deftroyed foon after it had pro
duced a perceptible fickening. Mary James, aged
fevcn years, one of the children alluded to, was in
oculated in the month of December following with
frcfn variolous matter, and at the fame time was
expofed to the effluvia of a patient affeded with the
Small Pox. The appearance and progrefs of the
infeded arm was, in every refped, fimilar to that

*
/ mention efcharotics forflopping the
progrefs of the
puftule, becaufe I am acquainted with their efficacy ;
probably more fimple means might anfwer the purpafe
quite as well, fuch as mi^ht be found among the mine
ral and vegetable aftringents.
 [ 69 1
which we
generally obferye when variolous matter
has been inferted into the fkin of a
perfon who has
not previoufly undergone either the Cow Pox or
the Small Pox. On the eighth day conceiving there
was infedion in it, fhe was removed from her reli-
dence among thofe who had not had the Small Pox.
I was now anxioufly waiting the refult, conceiving
from the ftate of the girl's arm fhe would fall fick
about this time. On vifiting her on the evening of
the following day (the ninth) all I could learn from
the Woman who attended her was, that^ fhe felt
Somewhat hotter than ufual during the night, but
was not reftlefs ; and that in the morning there was

the faint appearance of a rath about her wrifts. This

went off in a few hours, and was not at all percep
tible to me on my vifit in the evening. Not a An
gle eruption appeared, the fkin having been repeat
edly and carefully examined. The inoculated arm
continued to make the ufual progrefs to the end,
through all the ftages of the inflammation, matura

tion, and fcabbing.

On the eighth day, matter was taken from the
arm of this girl (Mary James) and inferted into the
arms of her mother and brother (neither of whom

had had either the Small Pox or the Cow Pox) the
former about fifty years of age, the latter fix.

On the after the infertion, the boy

eighth day
felt indifpofed, andcontinued unwell two days,
when a meafles-like rafh appeared on his hands and
wrifts, and was thinly fcattered over his arms.
The day following his body was marbled over with
an appearance Somewhat fimilar,
but he did not
nor did he appear indifpofed,
A few
complain,
 r 7° i
puftules now appeared, the greater part o| which
went
away without maturating.
On the ninth day the mother began to complain.
She was a little chilly and had a headache for two
days, but no
pitftule appeared on the fkin, nor had fhfc
any appearance of a rath.
The family was attended by an elderly woman as

a nurfe, who in her had been expofed to the

infancy
contagion of the Small Pox, but had refilled it.
This woman was now infeded, but had the difeafe
in the flighteft manner, a very few eruptions
ap
pearing, two or three of which only maturated.
From a folitary inftance like that adduced of
Mary James, whofe conftitution appears to have
refilled the adion of the variolous virus, after the
influence of the Cow Pox virus had 'been fo foon
arretted in its .progrefs, no pofitive conclusion can
be fairly drawn ; nor from the hiltory of the three
other patients who were
fubfequently infeded, bat
neverthelefs, the fads colledively may be deemed
interesting.
That mild variety of the Small Pox has
one
ap.
peared,I have already plainly Shewn* ; and
by the
means now mentioned we
probably may have it in
our power to produce at will another.

At the time when the puftule was

deftroyed in
the arm of Mary James, I was informed fhe had
been indifpofed about twelve hours ; but I am now
affured by thofe who were with her, that the
Space
•
See
Inquiry into the Ceufei end Effeds of the V*.
Ttolee Vaccinat page 3a,
 [ 7* ]
of time was much lefs. Be that as it
may, in ca
fes of Cow Pox inoculation, I would not recom
mend any application to Subdue the adion of the
puf.
tule until
convincing proofs had appeared of the
patient's having felt its effeds at leaft twelve hours.
No harm indeed could enfue were a
longer period
to
elapfe before the application was made ufe of.
In fhort, it Should be Suffered to have as full aa ef
fed as it could, confiftently with the ftate of the
arm.

As the cafes ef inoculation multiply, I am more

and more convinced of the extreme mildnefs of the

fymptoms arifing merely from the primary adion

of the virus on the conftitution, and that thofe
fymptoms which (as in the accidental Cow Pox)
aired the patient with Severity, are entirely fe
condary, excited by the irritating proceffes of in
flammation and ulceration ; and it appears to me
that this Singular virus poffeffcs an irritating quali
ty of a peculiar kind, but as a Single Cow Pox puf
tule is all that is neceffary to render the variolous
virus ineffedual, and as we poffefs the means of al
laying the irritation, fhould any arife, it becomes
of little or no confequence.

It appears then (as far as an inference can be

drawn from the prefent progrefs of Cow Pox inocu
lation) that it is an accidental circumftance only,
which can render this a violent difeafe, and a cir
cumftance of that nature, which fortunately it is in
the power of almoft every one to avoid. I allude
to the communication of the difeafe from cows. In
this cafe, fhould the hands of the milker be affeded
with little accidental fores to any extent, every
 [ 7* ]
fore would become the nidus of infedion, and feel
the influence of the virus ; and the degree of vio
lence in the conftitutional fymptoms would be in
proportion to the number and to the ftate of thefe
local affedions. Hence it follows that a perfon,
either by accident or defign, might be fo filled with
thefe wounds Srom contad with the virus, that the
conftitution might fink under the preflure.

Seeing that we poffefs the means of rendering the

adion of the fores mild, which, when left to chance
are
capable of producing violent effeds ; and fee
ing too that thefe fores bear a refemblance to the
Small Pox, efpecially the confluent, fhould it not
encourage the hope that fome topical application
might be ufed with advantage to counterad the fa
tal tendency of that difeafe, when it appears in
this terrific form ? At what ftage or ftages of the
difeafe this may be done with the moft promifing
expedation of fuccefs, I will not pretend now to
determine. I only throw out this idea as the bafis
of further reafoning and experiment.
I have often been foiled in my endeavors to com
municate the Cow Pox by inoculation. An inflam
mation will Sometimes Succeed the Scratch or punc
ture, and in a (tw days difappear without produ.
cing any further effed. Sometimes it will even
produce an ichoras fluid, and yet the fyftem will
not be affeded. The fame thing we know
happens
with the Small Pox virus.
Four or five fervants were inoculated at a farm
contiguous to this pkee, laft Summer, with matter
juft taken from an infeded cow. A little inflam
mation appeared on all their arms, but died
away
 C 73 ]
without producing a puftule ; yet all thefe fervants
caught the difeafe within a month afterwards from
milking the infeded cows, and fome of them had it fe
verely. At prefent, no other mode than that com
monly pradilcd for inoculating the Small Pox has
been ufed for giving the Cow Pox ; but it is pro
bable this might be varied with advantage. We
fhould imitate the cafual communication more clear
ly were we firft, by making the fmalleft Superficial
incifion or pundure on the fkin, to produce a little
fcab, and then, removing it, to touch the abraded
thread
part with the virus. A fmall portion of
a

imbrued in the virus (as in the old method of inocu

lating the Small Pox) and laid upon the (lightly in-
cifed fkin, might probably prove a fuccelsful way
of giving the difeafe ; or the cutis might be expo-
fed in a minute point by an atom of buffering plaf-
In
ter, and the virus brought in contad with it.
the Cafes juft alluded to, where I did not fucceed
in giving the difeafe conftitutionally, the expeti-
ment was made with matter taken in a purulent
ftate from a puftule on the nipple of a cow*.

Is pure pus, though contained in a Small Pox puf

tule, capable of producing the Small Pox per-
ever
it
fedly ? I fufped it is not.— Let us confider that
is always preceded by the limpid fluid, which,
in conftitutions fufceptible of variolous contagion,
is always infedious ; and though on opening a puf-

*
Since this was written, I have fcarcely ever
in its limpid
found the virus fail to infed when taken
ftate fromthe inoculated puftule, and inferted immedi
ately.
 I 74 3
tule its contents may appear perfedly purulent, yet
a given quantity of the limpid fluid may at the
fune time be blended with it, though it would be
imperceptible to the only teft of our fenfes, the

eye. The prefence then of this fluid, or its me

chanical diffufion through pus, may at all times
render adive, what is apparently mere pus, while
its total abfence (as in flale puftules) may be at
tended with the impeded effeds we have feen.
It would be digreffing too widely to go far into
the dodrine of Secretion, but as it will not bo
quite extraneous, I fhall juft obferve that I confider
both the pus and the limpid fluid of the puftule as
fecretions, but that the organs eftablifhed by nature
to perform the office of
fecreting thefe fluids may
differ effentially in their mechanical ftrudure.
What but a difference in the organization of
glan.
dular bodies, conflitutes the difference in the
qualU
ties of the fluids fecreted ? From fome
peculiar de
rangement in the ftrudure, or, in other words, fome
deviation in the natural adion of a gland deftined
to fecrete a mild, innoxious fluid, a
poifon of tha
moft deadly nature may be created : for
example,
That gland, which in its found ftate fecretes
pure
faliva, may, from being thrown into difeafed ac.
ticn, produce a poifon of the moft deftrudive qual
ity. Nature appears to have no more difficulty in
forming minute glands among the vafcular parts of
the body, than fhe has in
forming blood veffels, and
millions of thefe can be called into
exiftence, when
inflammation i& excited, in a few hours*.

Mr. Home, in his excellent

differtation on pus and
mucus, fuftifies this affertion.
 r 15 n
In the prefent early ftage of the Inquiry (for faf.
ly it certainly muft be deemed) before we know for
an abfolute
certainty how foon the virus of the
Cow Pox may fuffer a
change in its fpecific proper
ties, after it has quitted the limpid ftate it poffeffes
when forming puftule,
a it
would be prudent for
thofe who have been inoculated with it to Submit
to variolous inoculation. No injury or inconven
ience can accrue from this ; and were the fame me

thod pradifed among thofe, who, from inoculation

have felt the Small Pox in an unfatisfadory manner
at any period of their lives, it might
appeaT that I
had not been too officious in offering a cautionary
liint in recommending a fecond inoculation with
matter in its moft perred ftate.

And here let me fuppofe for argument's fake (not

from convidion) that one perfon in an hundred af-
£er having had the Cow Pox Should be found fuf.
reptible of the Small Pox, would this invalidate
the utility of the pradice ? For,
waving all other
confiderations, who will deny that the inoculated
Small Pox, although abftradedly it may be con-
ftdered as harmlefs, does not involve in itfelffome-

thing that in mi m beliefs inftances proves baneful

to the human frame.
That in delicate conftitutions it Sometimes ex
cites fcrofula, is a fad that muft generall) be Sub
scribed to, as it is fo obvious to common observa
tion. This consideration is important.
As the effeds of the Small Pox inoculation on
thofe who have had the Cow Pox will be watched
with the moft Scrupulous eye by thofe who profe.
cute this Inquiry ; it may be proper to bring te
 1 75 ]
their recolledion fome fads relative to the Small
Pox, which I muft confider here as of confequence,
but which hitherto feem not to have made a due
impreffion.
It Should be remembered that the conftitution
cannot by previous infedion be rendered totally
unfufceptible of the variolous poifon, neither the
cafual nor the inoculated Small Pox, whether it
produces the difeafe in a mild or in a violent way,
can
pcrfedly extinguish the fufceptibility. The
fkin, we know, is ever ready to exhibit, though
often in a very limiteddegree^ the effeds of the
poifon when inferted there j and how frequently
do we fee among nurfes, when much expofed to the
contagion, eruptions, and thefe fometimes preced
ed by fenfible illnefs ! yet fhould any thing like an
eruption appear, or the fmalleft degree of indifpo
fition, upon the infertion of the variolous matter
on thofe who have
gone through the Cow Pox, my
affertions refpeding the peculiarities of the difeaft
might be unjuftly.difcicdited.
I know a gentleman, who many years ago was
inoculated for the Small Pox, but having no puftules
or
fcarcely any conftitutional affedion that was per.
c«ptible, he was diffatisfied, and has fince been re
peatedly inoculated. A veficle has always been
produced in the arm in confequence, with axillary
fwelling and a flight indifpofition : this is by no
means a rare occurrence. It is probable that the
fluid thus excited upon the fkin, would
always pro.
duce the Small Pox.
On the arm of a
perfon who had gone through
the Cow Pox many years before, I once
produced t
 C 77 3
Veficatipn by the infertion of variolous matter, and
With alittle Ot' the fluid, inoculated a
yodng wo
man who had a mild, but
very efficacious Small
Pox in confequence, although no conftitutional ef
fed was produced on the patient from whom the
matter was taken. The following communication
from Mr. Fewfter affords a ftill clearer elucidation
«
jof rhis fad.— Mr. Fewfter fays, On the 3d o£
April 1797, 1 inoculated Matter H ■, aged four-.
teen months, for the Small Pox. At the ufual time
he fickened, had a plentiful eruption, particularly
on his face, and got well. His nurfcmaid> aged
twenty-four, had many years before gone through
.Jhe Small Pox, in the naturaL way, which was evi
dent from her being much pitted with it. She hadl
ofed the child to fleep on her left arm, with her
left cheek in contad with his face, and during "his
inoculation he had moftly flept in that manner-
About a week after the child got wellj fhe (the
nurfe) defired me to look at her face, which fhe:
laid was very painful. There was a plentiful erup
tion on the left cheek, but not On any other pdrt of
the body, which went on to maturation.

"
On inquiry I fdund that three days before the
was taken
appearance of the eruption, fhe with
flight chilly fits, pain in her head and limbs, and
fome fever. On the appearance of the eruption
thefe pains went off, and now, (the fecond day of
the eruption) fhe complains of a little fore throat.
Whether the above fymptoms are the effeds of the
Small Pox or a recent cold, I do not know. On
the "fifth day of the eruption I charged a lancet
from two of the puftules, and on the next day I in-
 [ 1* I
ocutated two children, one two years, the othtt
four months old, with the matter. At the fame
time I inoculated the mother and eldeft filter with
variolous matter taken from Maftet H -. O*
the fifth day of their inoculation all their arms
were inflamed alike ; and on the
eighth dav, the
eldeft of thofe inoculated from the nurfe fickened,
»]nd the youngeft on the eleventh. They had bote
a plentiful eruption, from which I inoculated fever.

al others, who had the difeafe very

favorably. The
toother and the other child fickened about the fame
time, and likewise had a plentiful eruption.
"
Soon after a man in the village fickened with
the Small Pox, and had a confluent kind. To he
Convinced that the children had had the difeafe eft
fcdually, I took them to his houfe and inoculated
them in both arms with matter taken from him but
without effed."
Thefe are not brought forward as uncommon oc
currences, but as exemplifications of the human
fern's fufceptibility of the variolous
fyfl
contagion, al
though it has been previouily fenfible of its adion.
:
Happy it it for mankind that the appearance of
the Small Pox a fecond time on the fame
perfon be
yond a trivial extent, is fo extremely rare, that it
is looked upon as a
phcenomenon. Indeed, fince
the publication of Dr. Heberden's
paper on the
Fcrtcellar or Chicken Pox, the idea of fuch an oc
currence, in deference to
authority fo truly refped-
able, has been generally relmqoifhed. This I
con^
ceive has been without
jjift reafon ; for after wc
Crave Seen,
among many others, fo ftiong a cafe as
that Keorded
by Mr. Edward Withers, Surgeon*
 [ 79 1
ofNewbury, Berks, in the Fourth Volume of the
Memoirs of the Medical Society of London (from
which I take the following extracts) no one I think
will again doubt the fad.
"
Mr. RICHARD LANGFORD, a former of
Weft Shtfford, in this county (Berks) about fifty
years of age, when about a month old had the
Small Pox at a time when three others of the fami
ly had the fame difeafe, one of whom, a fervant
man, died of it. Mr. Langford's countenance was
ftrongly indicative of the malignity of the difiem
per, his face being fo remarkably pitted and Seam
ed as to attrad the n nice of all who faw him, fo
that no one could entertain a doubt of his
having
had that difeafe in a moft inveterate manner.*
Mr. Withers proceeds to State that Mr. Langtord
was Seizt-d a fecond time, had a bad confluent Small

Pox, and died on the twenty- firft day from the fei.
sure : and that four of the family, as alfo a Sifter
of the patients', to whom the difeafe was
convey
ed by her fon's vifuing his uncle,
fairing down
with the Small Pox, fully Satisfied the
country
with regard to the nature of the difeafe, which no
thing fhort of this would have done ; the filler —

died.
*'
This cafe was thought fo extraordinary a one,
as to induce the rector of the parifh to record the
particulars in the parish regifter."
It is Angular that in moft cafes of this kind, the
difeafe in the firft inftance has been confluent ; fo
that the extent of the ulceration on the fkin (as m
the Cow Pox} is not the procefs in nature which ai*
lords Security to the conftitution.
 [ 8o ]
As the fubjed of the Small Pox is fo interwoven
with that which is trie more immediate objed of
for fq
my prefent concern, it muft plead my excufe
often introducing At prefent it muft be confid-
it.
ered as a well underftood.
difiemper not The In
quiry I have instituted into the nature of the Cow'
Pox, will probably promote its more per fed inves
tigation.
The Inquiry of Dr. Fearfon into the Hiltory of
the Cow Pox having produced fo gieat a number of
jatteftaiions in favor of my affertion that it proves a
to the human body from the Small Pox,
Jrotedion
have not been afliduous in Seeking for more ; but
as fome of my friends have been fo good as to com
municate the following, I Shall conclude thefe ob
fervations with their infertion,
Extrad of a Letter from Mr. Darke, Surgeon,
atStroud, in this county, and late Surgeon to the
North Gloucefter Regiment of Militia*
♦c In the fpring of the year 1796, I inoculated
men, women, and children, to the amount of about
ftventy. Many of the men did not receive the in
fection, although inoculated at leaft three times and

kept in the fame room with thofe who adually un

derwent the diSeaSe during the whole time
occupied
by them in paffing through it. Being anxious they
fhould in luture be Secure agait.ft it, \ was very
particular in my inquiries to find out whether they
ever had
previcufly had it, or at any time been in
the neighbourhood of
people labouring under it.
'But after all, the only fatisfcidory information I
could obtain was, that they had had the Cow Pox.
Ai I was then
ignorant of Such a difeafe atfeding
 [ *t J*
-the human fubjed, I flattered myfelf what they
be the Cow Pox was in reality the
imagined to
Small Pox in a very flight degree. I mentioned the
circumftance in the pretence of Several of the officers,
at the fame time expreffing my doubts
it it were not
Small Pox, and was not a little furprifed when I
was told by the Colonel that he had Srequently
heard
mention the Cow Pox as a difeafe endemial to
you
Gloucestershire, and that if a perfon were ever af
feded by it, you fuppofed him afterwards fecure
from the Small Pox. This excited my curiofity,
and when 1 vifited Gloucefterfhire I was very in.
quifitive concerning the fubjed, and from the infor
mation I have fince received, both from your pub
lication and from conversation with medical
men

I
of thegreateft accuracy in their obfervations, am
what the fuppofed to be
fully convinced that
men

the Cow Pox adually fo, and I can fafely af

was
Pox." y\
firm that they effedually refifted the Small
Mr. Fry, Surgeon, at Durfley in this county, fa
vours me with the following
communication : .

I inocu
«
Puririg the Spring of the year 1797,
lated fourteen hundred and Seventy-five patients, of
all ages, from a fortnight old to Seventy years ;
had previous
amongft whom there were many who
the Cow Pox. The exact number
ly gone through
were near thirty,
I cannot ftate ; but if 1 fay they
was not
I amcertainly within the number. There
a finale inftance of the variolous matter producing
any conftituiional
efteel on thefe people, nor any
inflammation than it would
greater degtee of local
in the arm of a petlon
who had before
have done
it
gone through the Small Pox, notwxihftanding
 [ 8* 3
was
invariably inferted four, five, and fometime«
fix different times, to Satisfy the minds of the pa
tients. Jn the common courfe of inoculation pre*
vious to the
general one, fcarcely a year paffcd
without my meeting with one or two inftances of
perfons who had gone through the Cow Pox, re
filling the adion of the variolous contagion. I
may fairly fay, that the number of people 1 have
feen inoculated with the Small Pox, who at former
periods had gone through the Cow Pox, are not lefa
than torty ; and in no one inftance have I known a
patient to receive the Small Pox, notwithstanding;
they invariably continued to affociate with other
inoculated patients during the progrefs ot the dif
eafe, and many of them
purpofely expofed them-
fclvts to the
contagion of the natural Small Pox ;
whence I am fully convinced, that a
perfon who
had fairly had the Cow Pox, is no
longer capable
of being aded upon by the variolous matter.
"
I alfo inoculated a
very confiderable nutnbei
of thofe who had had a difeafe which
the neighborhood a tew
ran
through
years ago, and was called
by the common people the Swine Pox, not one of
whom received the Small Pox*.
"
There were about half a dozen inftances of
people who never had either the Cow or Swine
Pox,
yet did not receive the Small Pox, the
fyftem no*
being in the leaft deranged,
or the arms
.inflamed,
although they were
repeatedly inoculated, and affo-

tbat mild "*"'& °f tbt

„,1-
whichPA™*"
I have noticed the ktc
m
$w<M *°*

*'*>
Tteaufem the Com
f*ge 3Z,
 £ *i 1
ctared with others who were laboring tinder the dif
eafe ; one of them was the fon of a farrier."
Mr. Tierny, Afliftant Surgeon of the South
Gloucefter Regiment of Militia, has obliged me

with the following information :

*'
That in the fummer of the year 1798, he in-
oenlated a great number of the men belonging to
the Regiment, and that among them he found ele
ven, who, from having lived in dairies, had gone
throttgh the Cow Pox. That all of them refifted"
the Small Pox, except one, but that on making the
moft rigid and fcrupulous inquiry at the farm in
Gloucefteifhire, where the man faid he lived whea
he had the difeafe, and among thofe with whom at
the fame time he declared he had affociated, and
of a perfon in the parifh, who^n he
{Particularly
aid had dreffed his fingers, it moft clearly appear
ed that he aimed at an impofition, and that he ne
ver had been affeded with the Cow Pox*. Mr.
Tierny remarks, that the arms of many who were
inoculated after having had the Cow Pox inflamed
very quickly, and that in feveral a little ichorous
fluid was formed."
Mr. Cline, who in July laft was fo obliging
It my requeft'as to try the efficacy of the Cow Pox
virus, was kind enough to give me a letter on the
refult of it, from which the following is an extracl :
«
My Dba* Sir,
"
The Cow Pox experiment has fucceeded admi*

*
The public cannot be too much upon their guard
refpeding perfons of this defcriptieu*
 t .84 1
rably. The child fickened on the feventh day, and
the fever, which was moderate, Subsided on thfe
eleventh. The inflammation arifing from the infer:
tionof the virus extended to about four inches in
diarrcter, and then gradually fubfided, without ha
ving been attended with pain or other inconven
ience. There were no
eruptions.
"
I have Since inoculated him with Small Pox
matter in three places, which were Slightly inflam
ed on the third day, and then fubfid°.d.
"
Dr. Lifter, who was formerly Phyfician to the
Stmll Pox Hofpital, attended the child with me,
and he is convinced that it is not poffible to give
him the Small. Pox. I think the fubftituting the
Cow Pox poifon for the Small Pox, promifes to be
one of the
greateft improvernents'that has ever been
made in medicine ; and the more I think on the
fubjed, the more I am impreffed with its importance*
"
With great efteem
ti't«Vi linn
Fields, •«
I am, &c.
"
diffi** '793. HENRY CLINE."
From communications, with which I have been
favored from Dr. Pearfon, who has occafionally re
ported to me the refult of his private pradice with
the vaccine virus in London, and from Dr. Wood*
ville, who has alfo favored me with an account of
his more extenfive inoculation with the fame virus
attheSnull Pox Hofpital, it appears that many of
their patients have been affeded with
eruptions, and.
that thefe eruptions have maturated in a manner've-
ry fimilar to the variolous. The matter they made
ofe of was taken, in the firft
inftance, from a cow
 r sc ]
belonging to one of the great milk farms in Lon
don. Having never feen maturated puftules produ
ced either in my own pradice among thofe who were
cafually infeded by cows, or thofe to whom the
difeafe had been communicated by inoculation, I
was defirous of feeing the effed of the matter
gen
erated in London, on fubjeds living in the country.
A thread imbrued in fome of this matter was Sent
to me, and with it two children were inoculated,
whofe Cafes I Shall tranfcribe from my notes.
STEPHEN JENNER, three years and a half old.
3d day. The arm Shewed a proper and decifive
inflammation.
6th. A veficle arifing.
7th. The puftule of a cherry colour.
8th. Increafing in elevation. A few fpots novr
—

appear on each arm near the infertion of the inferior

tendons of the biceps mufcles. They are very
fmall, and of a vivid red colour. The pulfe nat
ural ; tongue of its natural hue ; no lofs of appe.
tite, or any fymptom of indifpofition.

9th. The inoculated puftule on the arm this ev

ening began to inflame, and gave the child uneafi
nefs : he cried, and pointed to the feat of it, and
was immediately afterwards affeded with febrile
fymptoms. At the expiration of two hours after
the feizure, a plafter of ung. hydrarg.fort. was ap
plied, and its effed was very quickly perceptible ;
for in ten minutes he refumed his ufual looks and
playfulnefs. On examining the arm about three
hours after the of the plafter, its effeds
application
in fubduing the inflammation were very manifeft.
10th. The fpots on the arms have difappeared,
but there are three visible in the face*
M
 t «« 1
i ith. Two fpots on the face are
gone ; the ofh.
er
barely perceptible.
13th. The puftule delineated in the fecond plate
in the Treatife the Variola; Vaccinae, is a cor-
on

rcd representation of that on the child's arm, as it

appears at this time.
14th. Two frefh fpots appear on the face. The
puftule on the arm nearly converted into a fcab.
As long as any fluid remained in it, it was
limpid.
JAMES HILL, four years old, was inoculated
on the fame
day, and with part of the fame matter
which infeded Stephen Jenner. It did not appear
to have taken effed till the fifth
day.
7th. A perceptible veficle : this evening the
patient became a little chilly j no pain or tumour
difco-verable in the axilla.
8th. Perfedly well.
9th. The fame.
10th. The veficle more elevated than I have
been accuftomed to fee it, and
affuming more per
fedly the variolous charader than is common with
the Cow Pox at this
ftage.
nth. Surrounded by an
about the fize of a
inflammatory redrefs,
fhilling, ftudded over with mi
nute veficles. The puftule contained a
till the fourteenth
limpid fluid
day, after which it was incrufted
over in the ufual manner
; but this incruftation or
fcab
being accidentally rubbed off, it was flow in
healing.
Thefe children were afterwards
tnebmall Pox
fully expofed to
contagion without tffed.
Having been reqnefted by my friend Mr. Henry
Hicks, ol Baftington, in thia county, to inoculate
 C «7 1
two of his children, and the fame time fome of
at
his fervants and the people employedin his manufac
tory, matter was taken from the arm of this boy for
the purpofe. The numbers inoculated were eighteen.
They all took the infedion, and either on the fifth
or fixth day a veficle was perceptible on the punc
tured part. Some of them began to feel a little
unwell on the eighth day, but the greater number
on the ninth. Their illnefs, as in the former cafes
defcribed was of fhort duration, and not fufficient
to interrupt, but at very fhort intervals, the chil
dren from their amufements, or the fervants and
manafadurers from following their ordinary bufinefs.
Three of the children whofe employments in the.
manufadory was in fome degree laborious, had an
inflammation on their arms beyond the common
boundary about the eleventh or twelfth day, when
the feverifh fymptoms, which before were nearly
gone off, again returned, accompanied with in.
creafe of axillary tumour. In thefe Cafes (clearly
perceiving the fymptoms were governed by the
ftate of the arms) I applied on the inoculated puf
tules, and renewed the application three or four
times within an hour, a pledget of lint, previoufly
Soaked in aqua iythargyri acetati*, and covered the
hot efflorefcence furrounding them, with cloths dip
ped in cold water.
The next day I found this Simple mode of treat
ment had fucceeded perfedly. The inflammation
was nearly
gone off, and with it the fymptoms
which it had produced.
Some of thefe patients have fince been inoculated

*
Gnulartfs Extrad of Saturn*
 [ 88 1
with variolous matter without effecYbeyond a little
inflammation on the part where it was inferted.
Why the arms of thofe inoculated with the vac
cine matter in the country fluuld be more difpofed
to inflame than thofe inoculated in London, it may
be difficult to determine. From comparing my own
Cafes with fome transmitted to me by Dr. Pearfon
and Dt. Woodville, thi6 appears to be the fad ; and
what Strikes me as ftill more extraordinary with
refped to thofe inoculated in London is, the ap
pearance of maturating eruptions. In the two in
stances only, which 1 have mentioned (thecnefrom
the inoculated, the other from the cafual Cow Pox)
a few red fpots appeared, which quickly went off
without maturating. The Cafe of the Rev. Mr.
Moore's fervant may indeed feem like a deviation
from the common appearances in the country, but
the nature of thefe eruptions was not afcertained
beyond their not poffefling the property of commu.
njcating the difeafe by their effluvia. Perhaps the
difference we perceive in the ftate of the arms may
be owing to fome variety in the mode of adion of
the virus upon fhe fkinot thofe who breathe the aif
of London, and thofe who live in the country. That
the eryfipelas affumes a different form in London
from what we fee it put on in the country, is a fa&
very generally acknowledged. In calling the in
flammation, that is excited by the Cow Pox virus,
erysipelatous, perhaps 1 may not be critically exad,
but it certainly approaches near to it.. Now, as
the difeafed adion going forward in the
part infec.
ted with the virus may
undergo different modifica
tions, according to the peculiarities of the confti
tution on which it is to produce its effed, may it
 vwi
not account for the variation which hat been ob
served i

To this it may probably be objeded, that fome

of the patients inoculated, and who had puftules in
confequence, newly come from the country ^
were

but I conceive that thechanges wrought in the hu

man body through the medium of the lungs, may
be extremely tapid. Yet, after all, further expe
riments made in London with vaccine virus gener
ated in the country, muft finally thiow a light on
what now certainly appears obfcure and myfterious.
The principal variation perceptible to me in the
adion of the vaccine virus generated in London from
that produced in the country, was its proving more
certainly infedious and giving a lefs difpofition in
the arm to inflame. There appears alfo a greater
elevation of the puftule above the Surrounding fkin.
In my former cafes, the puftule produced by the in.
fertion of the virus was more like one of thofe which
are fo thickly fpread over the body in a bad kind
of confluent Small Pox. This was moie like a puf
tule of the diftinft Small Pox, except that I faw no
inftance of pus being formed in it, the matter re.
maining limpid till the period of Scabbing.
-

Wifhing to fee the effeds of the difeafe on an in

fant newly born, my nephew, Mr. Henry Jenner,
at my requeft, inferted the vaccine virus into the
arm of a child about twenty hours old. His report
to me is, that the child went through the difeafc
Without apparent illnefs, yet that it was found ef
fectually to refift the adion of variolous matter with
which it was fubfequently inoculated.
i have had an opportunity of trying the effeds of
 C 90 1

the Cow Pox matter on a boy, who, the day pre

ceding its infertion, fickened with the mealies. The

eruption of the meafles, attended with a cough,
a

little pain in the cheft, and the ufual fymptoms ac

on the third day,
companying that difeafe, appeared
andfpread all over The difeafe went through
him.
itscourfe without any deviation from its ufual ha
bits ; and, notwithftanding this, the Cow Pox vi
rus excited its common appearances, both on the arm
and on the conftitution, without any fenfiblc inter
ruption ; on the fixth day there was a veficle.
8th. Pain in the axilla, chilly, and affeded
with head ache.
9th. Nearly well.
1 2th. The puftule fpread to a fize ofa large Split
but without any furrounding efflcrefcence. It
Jiea,
oon afterwards fcabbed, and the boy recovered his
general health rapidly. But it fhould be obferved,
that before it fcabbed, the efflorefcence, which had
fuffered a temporary fufpenfion advanced in the uSual
manner.

Here we fee a deviation from the ordinary habits

of the Small Pox, as it has been obferved that the
prefence of the meafles fufpends the adion ot vari
olous matter. However, the fufpenfion of the ef
florefcence isworthy of observation.
The very general investigation that is now
taking
place, chiefly through inoculation (and I again re
peat my earned hope that it may becondudtd with
that calmnefs and moderation which fhould ever ac
company philofophical refearch) muft foon place the
vaccine difeafe in its
juft point of view. The re-
fult of ali my trials with the virus on the human
 t V ]
fubjed, has been uniform. In every inftance, the
patunt who has felt its influence, has completely
loft the fufceptibility for the variolous
contagion ;
and as thefe inffances are now become numerous, I
conceive that, joined to the obfervations in the for
mer part of this paper,
they fufiiciently preclude me
from theneccffity of encering intocontroverfien with
thofe who have circulated reports adverfe to
my af.
fertions, on no other evidence than what has been
cafually colleucu.
 { 9* 1

A CONTINUATION Or?

Fa£h and Obfervations,

fjfr. fcfr.

i^INCE my former publications on the

Vaccine Inoculation, I have had the fatisfadion of
feeing it extend very widely. Not only in this
country is the fubjed purfued with ardour, but
from my correfpondence with many refpcdable
medical gentlemen on the Continent, (among whom
are Dr. De Carro of Vienna, and Dr. Ballborn of
Hanover) I find it is as warmly adopted abroad,
where it has afforded the greateft fatisfadion. I
have the pleafure too of feeing that the feeble ef
forts of a few individua's to depreciate the new
practice, are finking fall into contempt beneath the
immcnfe mafs of evidence which has rifen
up in
fupport of it.

Upwards of fix thoufand perfons have now been

inoculate,; with the virus of Cow Pox, and the far
grrttrr part of them have fince been inoculated
with that of Small Pox, and
expofed to its infedion
 C 95 3
in every rational way that Could be devifed, with
out effed.
It was very improbable that the
investigation of
a difeafe fo analagous to the Small Pox, Should go
forward without engaging the attention of the
Phyfician of the Small Pox Hofpital in London.
Accordingly, Dr. Woodville, who fills that de
partment with fo much refpedability took an early
opportunity of inftituting an Inquiry into the na
ture of the Cow Pox. This Inquiry was began in
the early part of the prefent year, and in May, Dr.
Woodville published the refult which differs effen-
tially from mine in a point of much importance.
It appears that three fifths of the patients inocula
ted were affeded with eruptions, for the moft pare
fo perfedly refembling the Small Pox, as not to be
diftinguifhed from them. On this fubjed it is ne-

ceffary that I fhould make fome comments.

When I confider that out of the great number of
Cafes of cafual inoculation immediately from cows,
which have from time to time prefented thcmfelves
to my obfervation, and the many fimilar inftances
which have been communicated to me by medical
gentlemen in this neighborhood ; when I confider
too that the matter with which my inoculations
were conducted in the years 97, 93,ando,9, was ta

ken from diff-rent cows, and that in no inftance any

thing like a variolous puftule appeared, I cannot
feel difpnfed to imagine that eruptions fim'-lar to
thofe defcribed by Dr. Woodville, have even been
Pock vi
produced by the pure uncontammated Cow
rus ; on the contrary, I do fuppofe that thofe which
the Dotfior fpeaks of, originated in the action of
N
 [ 94 J i
Variolous matter, which crept into the conftirutio*
With the vaccine. And this I prefume happened
fiora the inoculation of a great number of the pa
tients with variolous matter (fome on the third,
others on the fifth day) after the vaccine had been
applied ; and it fhould be obferved, that the matter
thus propagated became the fource of Suture inocu
lations in the hands of many medical gentlemen-
who appeared to have been previously unacquainted,
with the nature of the Cow Pox.

Another circumftance ftror.glv, in my opinion,

fupporting this (uppofition, is the following : The
Cww Pox has been known among our dairies time
immemorial. If paftnles then, like the variolous,
were to follow the communication of it from the.
cow to the milker, would nor fuch a fad have been-

known, and recorded at our farms ? Yet, neither

our farmers nor the medical
people of the neighbor
hood have noticed fuch an occurrence.
A few fcattered pimples I have Sometimes, though
very rarely feen, the greater part of which have
generally disappeared quickly, bur fome have re
mained long enough to fuppurate at their
apex.
That local cuticuW inflammation, whether
fpring,.
ingupfpontaneoufly, or arifing from the applica-
tion.of acrid fubftances, fuch, for inftance, as Can*
tharides, Pix Burgundica, Antimanium Tartarizatum,
,

&$. will often produce cutaneous affedii ns, not on

ly near the Seat of the inflammation, but on fome parts
of the fkin far. beyond its
boundary, is a well-
known fad. It is, doubtlefs on- this
the inoculated
principle that
Cow.pock puftule and its concomi
tant efflorefcence
may in very irritable conflitutioc*
 I 95 3

produce this affedion. The eruption I allude to,

has commonly appeared fome time in the thud week
after inoculation. But this appearance is too tri
vial to excite the leaft
regard.
The change which took place in the general ap
the vaccine inocu
pearance during the progrefs of
lation at the Small Pox rlofpital fhould Ukewife be
considered.

Although at fo much of the vari

firft it took on

olous character as to in three cafes

produce puftules
out of five, yet in Dr. Woodville's laft report pub-
lifhed in June, he fays,
"
fince the publication ot my
of inoculations for the Cow Pox, upwards
reports
of three hundred Cafes have been under my care ;
and out of thisnumber, had puf
only thirty-nine
of the firft hun
via. out
tules that Suppurated :

dred, nineteen had puftules ; out bt the fecond,

thirteen ; and out ot the laft hundred and ten, only
(even had puftules. Thus it appears that the difeafe
has become confiderably milder ; which I am in
clined to attribute to a greater caution ufed in the
choice of ihe matter, with which the intedion was
communicated ; for lately, that which has been
employed for this purpofe has been taken only from
thofe in whom the Cow Pox proved very
patients
mild and well charaderifed*."
The inference I am induced to draw from thefe

*
In a few weeks after the Cow Pax inoculation;
was introduced at the a mall Pox Hofpttal, I was fa.
vorrd with fome virus from this flock. In the firft »».
a few puftules, which did
not matu
fianceit produced
rate i but in the fubfequent cafes none appeared. E, J*
 [ 9« 1

rremifes is very different. The decline, and final.

Jy, nearly of thefe puftules, in
the total extinction
my opinion, are more fairly attributable to the
the
Cow Pox virus, aflimilaiing the variolous*,
former probably being the onginal, the latter the
fame difeafe under a peculiar, and at prefent an in.
explicable modification.
One experiment tending to elucidate the point
under difcuffion, i had m)felf an opportunity of
inftitutir.g. On the fuppoinion ot its being poffible
that the Low which ranges over the fertile meadows
in the vale ot Gloucelter, might generate a virus
differing in fume refpects in its qualities irom that
produced by the animal artificially pampered for
ihe produdion of milk for the metropolis, 1 procu-
jed, during my refidence there in the fpring, fome
Cow pock virus from a Cow at one of the London
mlk-farn<st. It was immediately conveyed into
(Jloucttttifhire to Dr. Mailhall, who was then exten-
fivtly engaged in the inoculation of the Cow Pox,
ihe general refult ot which, and of the inoculation
in particular with this matter, 1 Shall lay before

*
In my firfl publication on this fubjed, I expnffed
nn
opinion thai the i>mall Pox and the Lew Pox were

thefame difieijes under afferent modtftiations* In this

opinion L>r. Woodville has concur ud. ^ he axiom cf
the immortal lianter, that two difeafed actions can
not .take place at the fame time in one and the fau.c

part, will not be injured by the admffion of this

theory.
was lalcn by Mr.
+ // Tanner, then a (Indent ,:t
the Veterinary College, Jr:m a Lew at Air. Cl.r.':'s
Jaim at ktntjj/? i own.
 [ 97 3
my Readers in the following communication from
the Doctor.
"
Dear Sir,
"
My neighbour Mr. Hicks having mentioned
your wilh to be it. formed ot the ptogrcls ot the
inoculation here tor the Cow Pox, and he alfo ha.
ving taken the trouble to tranfmit to you my mi
nuter of the Cafes which have talitn under my care,
1 hope you will pardon the further trouble 1 now
give you in ftaung the obfervations 1 have made
upon the Subject. When firft informed ot it, ha
ving two children who had not had the Small Pox,
I deteimined to inoculate them lor the Cow Pox
whenever 1 fhould be So lortunate as to procure
matter proper tor the purpofe. I was therefore parti
cularly happy when I was informed that 1 could
had
procure matter from fome of thole whom you
inoculated. In the firft inttance I had no intention
of extending the difeafe further than my own fami
ly, but the very extenfive influence which the con
viction ot its efficacy in refifting the Small Pox has
had upon the mmds of the people in general, has
rendered that intention nugatory, as you will per
ceive the continuation of my Cafes enclofcd in
by
this letter*, by which it will appear that fince the
2zdot March, 1 have inoculated an hundred and
Seven petfons ; which, confidering the retired Situ
ation I relide in, is a very great number. There
are aifo dher confiderations which, belides that of

*
Dodor has detailed thefe Cafes with
Marfhall
would now be
great accuracy, but their publication
deemed fuperfluws. &> J'
 WT 9* 7~~""
to
its influence in refifting the Small Pox, appear
mild.
have had their weight ; namely, the pecubar
audits
pcSs of thediSeafe, the known Safety ot it,
the patient
not having in any inltance prevented
from following hi* ordinary bufinefs. In all the
Cafes under my c^re, there have only occurred two
required any application owing to
or three which
eryfipelatous inflammation on the arm, and they
immediately yielded to it. In the remainder t tie
conltituticnal illnefs has been flight but fufiiciently
marktd, and considerably lefa than I ever obferved
in the fame number inoculated with the Small Pot.
In only one or two of the Cafes have any other
eruptions appeared than thofe around the fpot where
the matter was inferted, and thofe near the infeded
part. Neither does there appear in the Cow PoU
to be the leaft
exciting caufe to any other difeafe,
whieh in the Small Pox has been frequently obfer.
ved, the conftitution remaining in as tull health and
vigour after the termination ot the difeafe as be
fore the infedion. Another important considera
tion appears to be the impofiibility of the difeafe
being communicated except by the adual contad of
the matter of the puftule, and confequently the per
iod fafety of the remaining part of the family,
lup-
pofing only one or two fhould with to be inoculated
at the fame time.
"
the whole it appears evident to me, that
Upon
the Cow Pox is a pleafanter, fhorter, and
infinitely
more fate difeafe than the inoculated Small Pox
when conducted in the moft careful and
approved
manner ; neither is the local affedion ot* the inocu

lated part, or the conltitutional illnefs near fo vio

lent. 1 fgeak with confidence the
on
iubjed, ha-
 f 99 I
ting*had an
opportunity of obfervlhg its effects up>
on a variety of conftitutions, from thn-e month*
eW to fixty years ; and to which I have paid parti
cular attention. In the Cafes alluded to here, yotai
will obferve that the removal from the original
{puree of the matter has made no alteration or
appearance of the difeafe, and that it may be
con

tinued, ad infinitum, (I imagine) from one perfoi*

to another (if care be obferved in taking the mat
ter at a proper period) without any neceflity of re*-
to the original matter of the cow.
curring
I fhould be happy if any endeavors of mine
"

could tend further to elucidate the fubjed, and-

mall be much gratified in fending you any further
obfervations I may be enabled to make.
"
I have the pleafure to fubferibe myfelf,
"
Dear Sir, &c.
"
JOSEPH H; MARSHALL.'8
iaftington, Gloucefterfhire,
April l&tk, 1799.
gentleman who favoured me with the above
Ttre
account,- has continued to profecute Ms inquiries
with unremitting induftry, and has communicated
the 1-efolt in another letter, which at his requcft I
Uy before the public without abbreviations
Da. MARSHALL'S SECOND LETTER.
Dear Sir,
"

Since the date of my former letter, I have

"

continued to inoculate with the Cow Pox virus.

number
Including the cafes before enumerated, the It
now amounts tofour hundred and twenty-three.
would be tedious and ufelefs to detail the progrefs

.
 [ ioo ]
«f the difeafe in each individual— it is fufficient to
obferve, that I noticed no deviation in any refpeft
from the Cafes I formerly adduced. The genera!
of the arm exadly correfponded with
appearances
the account given in your firft publication. When
they were difpofed to become troobJefome by ery
sipelatous inflammation, an application of equal
anfwered the de-
parts of vinegar and water always
fired intention. I muft not omit to inform you
that when the difeafe had duly aded upon the con
ftitution, I have frequently ufed the vitriolic acid.
A portion of a drop applied with the head of a
probe or any convenient utenfil upon the puftule,
fuffered to remain about forty feconds, and after
wards wafhed off with fponge and water, never
failed to flop its progrefs, and expedite the fortaa-
tion of a fcab.
I havealready fubjeded two hundred and ele
"

ven
patien s to the adion of variolous mat
of my
ter, but every one refifted it.
t(
The refult of my experiments (which were
made with every requisite caution) has fully convin
ced me that the true a fafe and infallible
Cow Pox is
preventative Pox ; that in no cafe
from the Small
which has fallen under my obfervation has it been
in any confiderable degree troublrfome, much lefs
have I feen any thing like danger ; for in no inftance
were the
patients prevented from following their
•rdinary employments.
*'
In Dr. Woodville's publication on the Cow
Pox, I notice an extraordinary fad. He fays that
the generality of his patients had
puftules. It cer
tainly appears extremely extraordinary that in all
 [ ioi 1
thy cafes there never was but one puftule, which
appeared on a
patient's elbow on the inoculated
arm, and maturated. It appeared exadly like
that On the incifed part.
"
The whole of my obfervations, founded as it
appears on an extenfive experience, leads me to
thefe obvious conclusions ; that thofe Cafes which
have been or may be adduced againft the preven
tive powers of the Cow Pox, could not have been
thofe of the true kind, fince it muft appear to be
abfolutely impoflible that I Should have Succeeded
in fuch a number of Cafes without a fingle excep
tion, if fuch a
power did not exift.
preventive
I cannot entertain doubt that the inoculated Cow
a

Pox muft quickly ftiperfcede that of Small Pox.

If the many important advantages which muft re-
fult from the new pradice are duly confidered, we
may reafonably infer that public benefit, the fure
teft of the real merit of discoveries, will render it
generally extenfive.
"
To you, Sir, as the difcoverer of this highly
beneficial pradice, mankind are under the higheffc
obligations. As a private individual I participate
in the general feeling ; more particularly as you.
have afforded me an opportunity of noticing the ef
feds of a lingular difeafe, and of viewing the pro
grefs of the moft curious experiment that ever waa
recorded in the Hiftory of Phyfiology.
"
I remain, Dear Sir, &c.
JOSEPH H. MARSHALL.
"

"
P. S. I Should have obferved, that ot the pa
tients I inoculated and enumerated in my letter, one
hundred and twenty-feven were infeded with the
matter you fant me from the London cow, I dif-
O
 [ 102 ]
covered no dissimilarity of fymptoms in thefe cafes,
'from thofe which I inoculated from matter procured
in this country. No puftules have occurred, except
in one or two cafes, where a
fingle one appeared on

the inoculated arm. No difference was apparent in

the local inflammation. There was no fufpenfion
of ordinary employment among the labouring peo
ple, nor was any medicine required.
"
I have frequently inoculated one or two in a
family, and the rem.iining part of it fome weeks
afterwards. The uninfeded have flept with the
infeded during the whole courfe of the difeafe with
out being affeded ; fo that I am fully convinced
that the difeafe cannot be taken but by adual contad
with the matter.
"
A curious fad has lately fallen under my ob
fervation, on which I leave you to comment.
"
I vifited a patient with the confluent Small
Pox, and charged a lancet with fome of the matter.
Two days afterwards I was defired to inoculates
woman and four children with the Cow Pox, and I

inadvertently took the vaccine matter on the fame

lancet which was before
charged with that of
Small Pox. In three days I dif:overed the miftake,
and fully expeded that my five
patients would be
infeded with Small Pox ; but I was agreeably fur-
prifed to find the difeafe to be the genuine Cow
Pox,, which proceeded without deviating in any
particular from my former cafes. I afterwards in
oculated thefe patients with variolous
matter, but
all of them refitted its adion.
"
I omitted
mentioning another great advantage
that now occurs to me in the
inoculated Cow Pox ;
I mean the
fafety with which pregnant women may
have the difeafe communicated to
them. I have
 [ *03 ]
inoculated a great number of females in that fitua.,
lion, and never obferved their cafes to differ in any ,

refped from thofe of my other patients. Indeed.

the difeafe is fo, mild, that it feems as if it might'
at all times be communicated with the moft pened.

frf«y-" .
r L ,
•
T.

I {hall here take the opportunity of thanking Dr.

Matfhall and thofe other gentlemen who have oblig
of their inocula
ingly prefented me with the refult
tions but, as they all in the fame point as,
; agree
that given in the above communication, namely,
the fecurity of the patient from the effeds of the
Small Pox after the Cow Pox, their perufal, I pre-
fume, would afford us fatisfadion that has not been
amply given already. Particular occurrences I (hall
of courfe detail. Some of my correfpondents huvc
mentioned the appearance of Small Pox.like erup
tions at the commencement of their inoculations ;
from the
but in thefe cafes the matter was derived
eriginal flock at the Small Pox Hofpital.
I have myfelf inoculated a very confiderable num,
ber from the matter produced by Dr. Marfhall's pa
without ob
tients, originating in the London cow,
serving puftules of any kind, and have difperfed it
among others
whohaJe ufed it with a fimilar effed.
he has
From this fource Mr. H. Jenner informs me,
above hundred patients without ob
inoculated an
nature of the virus
serving eruptions. Whether the
will change from being farther remo
undergo anv

ved from its original fource in paffing fucceffively

can deter
from one p-.rfon to another, time alone
has been
mine. That which I am now employing
leaft change
in ufe near eight months, and not the
isperceptible in its mode of adion either locally or
t tonftitutionally. There is therefore every reafon
 [ '04 1
to exped that its effeds will remain unaltered, and
that (hall
we not be under the neceflity of Seeking

frefh fupplies from the cow.

The following obfervations were obligingly fent
to the South
me by Mr. Tierny, Afiiftant Surgeon

Gloucefter of Militia, to whom I am in

Regiment
debted for a former report on this fubjed.
«'
I inoculated with the Cow Pox matter from the
1 1 th to the latter part of April, twenty-five per
women and children. Some on the
fons, including
jith wereinoculated with the matter Mr. Shrap-
nell (Surgeon to the Regiment) had from you, the
others with matter taken from thefe. The pro
grefs of the pundure was accurately obferved, and
its appearance feemed to differ from the Small Pox
in having lefs inflammation around its bafis on the
firft days, that is, from the third to the feventh ;
but after this the inflammation increafed, extending
on the tenth or eleventh
day to a circle of an inch
and an half from its centre, and threatening very
fore arms ; but this I am happy to fay was not the
cafe ; Sor, by applying mercurial ointment to the in
flamed part, which was repeated daily until the in
flammation went off, the arm got well without any
further application or trouble. The conftitutional
fymptoms which appeared on the eighth or ninth
day after inoculation, fcarcely deferved the name
or difeafe, as
they were fo flight as to be fcarcely
perceptible, except that I could conned a flight
head-ache and languor, with a ftiffnefs and rather
painful fenfation in the axilla. This latter Symp
tom was the moft
ftriking, it remained from twelve
to
forty. eight hours. In no cafe did I obferve the
fmalleft puftule, or even difcolouration of the fkin
 I 10* 3
like an
incipient puftule, except about the part
where the virus had been
"
applied.
After all thefe fymptomj hadfubfided, and the
arms were
well, I inoculated four of this number
with variolous matter, taken from a patient in
another regiment. In each of thefe it was inferted
feveral times under the cuticle, producing
flight in.
flammation on the fecond or third day, and always
disappearing before the fifth or fixth ; except in one
who had the Cow Pox in Gloucefterfhire before he
joined us, and who alfo received it at this time by
inoculation. In this man the pundure inflamed, and
his arm was much forer than from the infertion of
the Cow Pox virus ; but there was no pain in the
axilla, nor could any constitutional affection be ob
ferved.
"
I have only to add, that I am now fully Satis
fied of the efficacy of the Cow Pox in preventing the
appearance of the Small Pox, and that it is a moft
hfippy and Salutary
"
Substitute for it.
I remain, &c.
". M. J. TIERNY."

Although the fufceptibility of the virus of the Cow

Pox is for the moft part loft in thoSe who have had
the Small Pox, yet in fome constitutions it is only
partially deftroyed, and in others it does not appear
to be in the leaft diminished.
By far the greater number, on whom trials were
made, refiftea it entirely ; yet I found fome on
whofe arms the puftule from inoculation was formed
completely, but without producing the common ef
florescent blufh around it, or any conftitutional ill
nefs, while others have had the difeafe in the moft
perfed manner. A cafe of the latter kind having
 r^j
been prefented to me by Mr. Fewflerj Surgeon, of
Thornbury, 1 Shall infert it.
«•
Three children were inoculated with the vac

cine fent me. On calling to

matter you obligingly
look at theirthree days after, I was told that
arms

John Hodges, one of the three, had been inocula

ted with the Small Pox when a year old, and that
he had a full burthen, of which his face produced
plentiful marks, a circumftance I was not before
made acquainted with. On the fixth day the arm
of this boy appeared as if inoculated with vari.
olous matter, but the puftule was rather more ele.
vated. On the ninth day he complained of violent
pain in his head and back, accompanied with vom
iting and much fever. The next day he was very
well, and went to work as ufual. The pundured
part began to fpread, and there was the areola a.
round the inoculated part to a confiderable extent.
'*
As this is contrary to an affertion made in the
Medical and Phyfical Journal, No. 8, I thought it
right to"give you this information, and remain,
Dear Sir, &c. J. Fewster."
It appears then that the animal economy with re
gard to the adion of the virus is under the fame laws

as it is with refped to the variolous virus, after

previoufly feeling its influence, as far as
compari
sons can be made between the two difeafes.
Some Striking inftances of the power of the Cow
Pox in Suspending the progrefs of the Small Pox af.
ter the
patients had been feveral days cafually ex
pofed to the infedion have been laid before me, by
Mr. Lyford, Surgeon, of Winchefter, and
my ne.
phew the Rev. G. C. Jenner. Mr. Lyford, after
giving an account of his extenfive and fuccefsfui
 C *&7 ]
practice in the vaccine inoculation in Hampshire,
writes as follows :
"
The following Cafe occurred to me a Short
time fince, and may probably be worth your notice.
I was fent for to a patient with the Small Pox, and
on
inquiry found that five days previous to my fee-
.ing him the eruption began to appear. During the
whole of this time two children, who had not had
the Small Pox, were conftantly in the room with
their father, and frequently on the bed with him.
The motherconfulted me on the propriety of inocu
lating them, but objeded to my taking the matter
from their father, as he was fubjed to eryfipclas.
I advifed her by all means to have them inoculated
at that time, as I could not
procure any variolous
matter elfewhere. However, they were inoculated
with vaccine matter, but I cannot fay I flattered
myfelf with its proving fuccefsfal, as they had pre-
vioufly been fo long and ftill continued to be expo-
fed to the variolous infedion. Notwithftanding
this I was agreeably furprifed to find the vaccine
difeafe advance and go through its regular courfe j
and, if I may be allowed the expreflion, to the to
tal extindion of the Small Pox."
Mr. Jenncr's Cafes were not lefs fatisfadory.
He writes as follows :
"
A fon of Thomas Stinchcomb of Woodfords
near
Beikeley, was infeded with the natural Small
Pox at Briftol, and came home to his father's cot

tage. eruptions had appeared

Four days after the
upon the bov, the family (none of which
had ever
had the Small Pox) confuting of the father, mother,
and five children, was inoculated' with vaccine vi

rus. On the arm of the mother it failed to produce

 [ »P8 .1
the leaft effed, and fhe of courfe had the Small
Pox*, but the reft of the family had the Cow Pent
in the ufual mild way, and were not affeded with
the Small Pox, although they were in the fame
room, and the children flept.in the fame bed with
their brother who was confined to it with the nat
ural Small Pox ; and fubfequently with their mo
ther. I attended this family with my brother Mr*
H. Jenner."
The following Cafes are of too lingular a nature
to remain unnoticed;
Mifs R , a
young lady about five years old,
was Seized on the evening of the eighth day after
inoculation with vaceine virus, with fuch fymp
toms as commonly denote the acceffion of violent

fever. Her throat was alfo a little fore, and there

Were fome uneafy fenfations about the mufcles of the
neck. The day following a rafh was perceptible
on her face and neck, fo much
refembling the ef
florefcence of the Scarlatina Anginofa, that I was
induced to afk whether Mifs R had been ex
pofed to the contagion of that difeafe. An anfwer
in the affirmative, and the rapid
fpreadirtg of the
rednefs over the Skin, at once relieved me from
much anxiety refpeding the nature of the malady,
which went through its courfe in the ordinary way,
but not without fymptoms which were
alarming,
both to myfelf and Mr. Lyford, who attended with
me. There was no apparent deviation in the ordi-

*
Under fimilar circumftamts I think it would be
advifeable to
infert the matter into each arm, which
w,'.-ld be likely the fuccefs of the opera*
more to infure
t'cn. E. J.
 [ »°9 3
ftary progrefs of the puftule to a ftate of maturity^
from what we fee in general ; yet there was a to-,
tal fufpenfion of the Areola or florid discolouration
around it, until the Scarlatina had retired from the
Conftitution. As foon as the patient was freed Srom
this difeafe, this appearance advanced in the ufual
way*.
The Cafe of Mifs H R is
not lefs in-

terefting than that of her fiftet above related. She

was expofed to the
contagion of the Scarlatina at
the fame time, and fickened almoft at the fame hour-
The fymptoms continued fevere about twelve hours
when the Scarlatine-ralh fhewed itfelf faintly upon
her face, and partly upon her neck. After remain
ing two or three hours it fuddenly difappeared, and
fhe became perfedly free from every complaint.
My furprife at this fudden tranfition trom extreme
ficknefs to health, in great meafure ceafed when I
obferved that the inoculated puftule had occafioned,
in this cafe, the common efflorefcent appearance
around it, and that as it approached the centre iL
was nearly in an eryfipelatous ftate. But the moft:
remarkable part bf this hiftory is, that on the fourth
day afterwards, as foon as the efflorefcence began
to die away upon the arm, and the puftule to dry

up, the Scarlatina again appeared, her throat be-

*
I w'tneffed a fimilar fad in a cafe of Meafles*'.
The puftule from the Cow Pock virus advanced to ma
turity while the Meafles exifted the conftitution, but
in

no effljrefcence appeared around it until the Meafles

had ceafed to exert its influence.
*
See page 36".
 [ "o 1
<?sme fore, the rafh fpread all over her. She wen«
fairly through the difeafe, with its common fymp-
tcms.
That thefe were adually Cafes of Scarlatina,***
tendered certain by two fervants in the family fall
ing ill at the fame time with the diftemper, who
had been to the infedion with the young
expofed
ladies.
Some there are who fuppofe the Security from the
•
Small Pox obtained through the Cow Pox will be
•
of a temporary nature only. Thisfuppofition is re
futed not only by analogy with refped to the habits
>©f difeafes of a fimilar nature, but by incontrovert
ible fads, which appear in great numbers agaitift
it. To thofe already adduced in the former part of
my fit ft Treatife* many more might be added were
it deemed neceffary ; but among the Cafes I refer
to, one will be found of a perfon who had the Cow
Pox fifty. three years before the effed of the Small
Pox was tried upon him. As he completely refitted
it, the intervening period 1 conceive muft neceffa-
rily fatisfy any reafonable mind. Should further
evidence be thought neceffary, I Shall obServe that
among the Cafes prefented to me by Mr. Fry, Mr.
Darke, Mr. Tierny, Mr. H. Jenner, and others,
there were many whom they inoculated ineffedual-
ly with variolous matter, who had gone through
.the Cow Pox many years before this trial was made.
It has been imagined that the Cow Pox is capa
ble of Weing communicated from one perfon to ano
ther by effluvia without the intervention of inocula
tion. My experiments, made with the defign of
afcertaining this important point, all tend toeftab-
Hfh my original position, that it is not infedious,
*
Seepages 5, 7, 9, 13, cj/V.
 [ "' ]

except by contad. I have never hefitated to fuffw

thofe on whofe arms there were puftules exhaling
the effluvia, from affociating or even fleeping with
others who never had experienced either the Cow
Pox or the Small Pox. And further, I have re
peatedly among children caufed the uninfeded to
breathe over the inoculated vaccine puftules during
their whole progrefs, yet thefe experiments were
tried without the leaft effed. However, to fub-
mit a matter fo important to a ftill further Scrutiny,
Idefired Mr. H. Jenner to make any further expe
riments which might Strike him as moil likely to
eftabliSh or refute what had been advanced on this
"
fubjed. He has fince informed me, that he in
oculated children at the breaft, whofe mothers had
not gone through either the Small Pox or the Cow

Pox ; that he had inoculated mothers whofe fuck

ing infants had never undergone either of thefe dif
eafes ; that the effluvia from the inoculated puf
tules, in either cafe, had been inhaled from day to
day during the whole progrefs of their maturation,
and that there was not the leaft perceptible effed
from thefe expofures. One woman he inoculated a-
bout a week previous to her Accouchment, that her
infant might be the more fully and conveniently ex
pofed to the puftule ; but, as in the former in
ftances, no infedion was given, although the child
frequently flept on the arm of its mother with its
njftrils and mouth expofed to the puftule in the ful-
left ftate of maturity. In a word, is it not impof-
fible for the Cow Pox, whofe only raanifeftation ap
pears to confift in the puftules created by contad,
to

produce itfelf by effluvia ?

In the courfe of a late inoculation, I obferved an
 [ ««« 3

appearance which it may be proper here to felate,

1 he punduied part on a boy's arm (who was inocn-
la ed with frcfh limpid viius) on the fixth day, in
stead of (hewing a beginning veficle, which is ufual
in the Cow Pox at that period, was encrufted over
with a rugged amber coloured fcab. The fcab con
tinued to fpread and increafe in thicknels for fome
days, when at its edges a veficated ring appeared,
and the difeafe went through its ordinary courfe,
li.e boy having had Sorenels in the axilla, and Some
flight indiSpofition. With the fluid matter taken
from his arm, five perSons were inoculated. In one
it took notffed. In another it produced a perfed
puftule without any deviation from the common ap.
pearance ; but in the other three the progrefs of the
inflammation was exadly fimilar to the inftance
which afforded the virus for their inoculation ;
there was a creeping fcab ot a loofe texture, and
fubfequently the formation of limpid fluid at its
edges. As thefe people were all employed in labo
rious exercifes, it is poffible that thefe anomalous
appearances might owe their origin to the tridion
pt the clothes on the newly inflamed part ot the
aim. 1 have not yet had an opportunity of expos
ing them to the Small Pox.
In the early part of this Inquiry I felt far more
anxious refpeding the inflammation ot the inocula
ted arm than at prefent ; yet that tbisaffedion will
go on to a greater extent than could be wtfhed is a
circumftance Sometimes to be expeded. As this can
be checked, entirely lubdued by very Sim
or even

ple means. 1 See no reafon why the patient fhould

fi el an xineafy hour becaufe an
application may not
be absolutely neceffary. About the tenth or ere.
 [ "3 ]
vcnth day, if the puftule has proceeded regularly,
the appearance of the arm will almoft to a certainty
indicate whether this is to be expected or not.
Should it happen, nothing more need be done than
to apply a
tingle drop ot a\zAfua Lythargyr. Aceta-
ti* upon the
puftule, and having fuffeicd it to re
main two three minutes, to cover the tfRoref-
or

cence
furroundingthe puftule with a piece ot linen
dipped in the Aqua Lythargyr. Compost. The for
mer may be repeated twice or thrice during the day,

the latter as often as it may feel agreeable to the

patient.
When the fcab is prematurely rubbed off, (a cir-
cumltance not untiequent among children and wor
king people) the application of a little Aqua Lythar.
gyri Acct. to the part, immediately coagulates the
Surface, which tupplies its place, and prevents a
. fore.
In my former Treatifes on this Subjed I have re
marked that the human conftitution frequently re
tains it* fufceptibility ot the Small Pox contagion
(both from effluvia and contact) a;ter prcvioufly
feeling its influence. In further corroboration of
this declaration, many fads have been communica
ted to me by various correfpondents. I fhall lelect,
one of them.
'•
Dear Sir,
"
Society at large muft I think feel much indebt.
*
Extrad of Saturn.

+ Goulard Water. For further information on this

on the Var. I'ac. Dr. Mar*
fubjed fee the fitfi I reatife
fhall's Letters, CjV.
 [ "4 1
ed to you for your Inquiries and Obfervations on
the Nature and Effeds of the Variola; Vaccinae, &c.
&c. As I conceive what I am now about to com
municate to be of fome importance, I imagine it
cannot be unintercfting to you, efpecially as it will
ferve to corroborate your ailertion of the Suscepti
bility of the human fyftem of the variolous conta
gion, although it has previoufly been made fenfibla
of its adion. In November 1793, I was defired
to inoculate a perfon with the Small Pox. I took
the variolous matter from a child under the difeafe
in the natural way, who had a large burthen of dif-
tind puftules. The mother of the child being de
sirous of feeing my method of communicating the
difeafe by inoculation, after having opened a puf
tule, I introduced the point ot my lancet in the
ufual way on the back part of my own hand, and
thought no moie of it until I felt a fenfation in the
part, which reminded me of the tranfadion. This
happened upon the third day ; on the fourth there
Were all the appearances common to inoculation, at
which I was not at all furprifcd, nor did I feel my
felf uneafy upon perceiving the inflammation con
tinue to increafe to the fixth and feventh day, ac
companied with a very fmall quantity of fluid, re
peated experiments having taught me it might hap.
pen fo with perfons who had undergone the difeaSe,
and yet would eScape any conftitutional affedion :
but I w<is not fo fortunate ; for on the eighth day
I was feized with all the fymptoms of the eruptive
fever, but in a much more violent degree than when
I was before inoculated, which was about
eighteen
years previous to this, when I had a confiderable
number of puftules. I muft confefs that I was now
 i itS ]
greatly alarmed, although I had been much engag*
ed in the Small Pox, having at different times in
oculated not lefs than twothoufand perfons. I waa
convinced my prefent indifpofition proceeded from
the infertion of the variolous matter, and therefore
anxioufly looked for an eruption. On the tenth
day I felt a very unpleafant fenfation of ftiffnefsand
heat on each fide of my face near my ear, and the
fever began to decline. The affedion in my face
foon terminated in three or four puftules attended
with inflammation, but which did not maturate,
and I was prefently well.
(t
I remain, Dear Sir, &c.
"
Thomas Miles."

This is now fo much in its

Inquiry not infancy
as to reftrain me fromfpeaking more pofitively than
formerly on the important point of Scrophula as
conneded with the Small Pox.
Every praditioner in medicine, who has extenfively
inoculated with the Small Pox, or has attended many
of thofe who have had the diftemper in the natural
way, muft acknowledge that he has frequently feen
fcrophulous affedions, in fome form or another,
Sometimes rather quickly Shewing themfclves after
the recovery of the patients. Conceiving this fad
to be admitted, as I
prefume it muft be by all who
have carefully attended to the fubjed, may I not
afk whether it does not appear probable that the
general introdudion of the Small Pox into Europe
has not been among the moft conducive means in
exciting that formidable foe to health ? Having at
tentively watched the effeds of the Cow Pox in
this refped, I am
happy in being able to declare,
 [ m6 ]
that the difeafe does not appear to have the leaft
tendency to produce this deftrudive malady.
The fcepticifm that appeared even among the moft
enlightened of medical men when my Sentiments on
the important fubjed of the Cow Pox were firft pro
mulgated, was highly laudable. To have admit
ted the truth of a dodrine, at once fo novel and fo
unlike any thing that ever had appeared in the An
nals of Medicine, without the teft of the moft rigid
fcrutiny, would have bordered upon temerity :
but now, when that fcrutiny has taken place, not
only among ourfelves but in the firft profeffional cir
cles in Europe, and when It has been uniformly
found in fuch abundant inftances that the human
frame, when once it has felt the influence of the
genuine Cow Pox in the way that has been defcri
bed, is never afterwards at any period of its exift-
ence affailable by the Small Pox, may I not with

perfed confidence congratulate my country and fo.

ci'ety at large on their beholding, in the mild form
of the Cow Pox, an antidote that is capable of ex
tirpating from the earth a difeafe which is every
hour devouring its vidims ; a difeafe that has ever
been confidered as the fevereft Scourge of the hu
man rare J
Ned,. Hist.

CA