HAVING too often found, with no ſmall Grief and Trouble, how little the Aſſi⯑ſtance of Art can avail in many Caſes of the Small-Pox, I was induced to try the Method of Inciſion or Inoculation, which came ſo well recommended by ſeveral Phyſicians from Turkey, and which had alſo been lately practiſed at London. This I thought was ſufficient to juſtify the Attempt; and what Succeſs it hath met with, I have here ſent, according to your Deſire, a faithful Account of, and of every thing that has been done or obſerv'd here relating to that Affair, that might be worth your Notice.
IT was in December laſt that I firſt began to put this Me⯑thod in practice, and finding it to ſucceed beyond my Ex⯑pectation in the firſt Inſtance, I was encourag'd to repeat it upon ſome others; and afterwards ſeveral ſeeing with how much Eaſe theſe got thro' the Diſtemper, were deſirous to have the ſame done to themſelves, or to their Children; ſo that there are now upwards of Forty here, who have re⯑ceiv'd the Small-Pox by Inoculation, who are all, through God's Bleſſing, in very good Health.
[4]WHAT was done by way of Preparation, was chiefly Pur⯑ging with Rhubarb, for Children, and ſometimes Vomiting, very rarely Bleeding; tho' that may be ſometimes neceſſary; and many have had no Preparation at all: But I always found, as far as I was able to judge, that thoſe whoſe Bodies were prepared, eſpecially by Vomiting, had more favourable Sym⯑ptoms than others in the ſame Circumſtances where that was omitted.
THE Method which I always took in the Operation, was to make two Inciſions, one in the Arm, and another in the oppoſite Leg; I believe it is not very material whether the Inciſions be large or ſmall, but I commonly found that when they were made pretty large (in grown Perſons ¾ of an Inch in Length, proportionably leſs in Children, and ſo deep as to cut thro' the Skin in the middle of the Inciſion) the Quantity of Matter diſcharged afterwards at thoſe places, was greater; and the more plentiful that Diſcharge, the more eaſy the reſt of the Symptoms generally are; and they are alſo by this means the beſt ſecured from any ill Conſequence afterwards.
AT firſt I collected ſome of the Matter from the Puſtules of one who had the Small-Pox of the natural ſort, into a Shell or a Viol, and infus'd two or three Drops of it into the Wound; but finding it ſometimes to be very troubleſom and difficult to get any Quantity of the Matter; and obſerving al⯑ſo that the leaſt imaginable will be ſufficient for the purpoſe, I generally take ſmall Pledgetts of Cotton, and ripping the Puſtules when they are ripe with the Point of a Lancet, roll the Pledgetts over them till they have imbib'd ſome of the Moiſture; I put one of theſe upon each Wound, covering them with any common Plaiſter 'till the next Day, when I commonly take away both the Cotton and the Plaiſter, lea⯑ving the Wound to itſelf, only covering it with a ſlight Lin⯑nen Roller to defend it from the Air. I have ſometimes rub'd the Pledgett only once over the Wound, without bin⯑ding it on, which I found to anſwer the End as well; and from ſome other Obſervations I have made, I have been ſur⯑priz'd [5]to ſee the Small-Pox produced this way, when I was very well aſſured, the Quantity of Matter receiv'd into the Veſſels cou'd not amount to the Hundreth Part of a Grain.
THE Perſons inoculated have not been confin'd to any Regimen, only to keep themſelves moderately warm; and thoſe who were grown up to live very temperate and regular, to keep their Minds eaſy and compos'd, and to uſe proper Means to drive away all Fear and Concern. Some have been obliged, from the time of the Inoculation, to ab⯑ſtain from Fleſh, and all ſtrong Liquors; but I found after⯑wards that the Eruption did not proceed ſo well, when they were obliged to live too low; perhaps, in warmer Cli⯑mates, where they are not ſo much accuſtom'd to live up⯑on Fleſh, ſuch Abſtinence may be neceſſary; but here I find it beſt to let them cat and drink as uſual, tho' ſome⯑thing more ſparingly, 'till the Fever begins to riſe, and then, but not before, we enjoin ſuch a Regimen as is uſu⯑al in like Caſes.
THE firſt thing that occurr'd after the Inciſion, was the Inflammation of the Wounds, which commonly happen'd about the fourth Day, when they began to appear very red round about, and to grow a little ſore and painful; in about two Days more they began to digeſt and run; in ſome they begin to run ſooner, and the Quantity diſ⯑charged is much greater than in others. I generally found, that in thoſe who diſcharged moſt this way, the Fever was more ſlight, and the Small-Pox fewer; tho' I have known ſome do very well, when theſe Places have only appear'd very red, but have not run at all, as it uſually happens when the Inciſion is made ſo ſuperficial as not to cut thro' the Skin.
ABOUT the ſeventh Day, the Symptoms of the Fever begin to come on, which are the very ſame that we al⯑ways obſerve in the Small-Pox of the diſtinct Kind in the natural Way; a quick Pulſe, great Heat and Thirſt, Pain in the Head and Back, and about the Region of the Sto⯑mach, [6]Vomiting, Doſedneſs, Startings, and ſometimes Con⯑vulſions. All were not ſeized with theſe Symptoms, nor in the ſame Degree or Continuance; ſome began on the ſeventh Day, and continued ill without any Remiſſion 'till after the eleventh; many not 'till the eighth or ninth Day; and the Fever in theſe was more moderate, with great In⯑termiſſions; but ſome have ſcarce had any Illneſs at all: During all this time the Places of Inciſion continued to be very ſore, and ſwell very much, ſo as to appear large and deep, and to diſcharge a great deal of Matter.
ON the tenth Day the Small-Pox moſt commonly did ap⯑pear, ſometimes on the ninth, and ſometimes not 'till the eleventh; but I never found that any Difference of Age, Conſtitution, or any other Cauſe, ever made them vary a⯑bove one Day from the tenth. The Number was very dif⯑ferent, in ſome not above ten or twenty, moſt frequently from fifty to two Hundred, and ſome had more than cou'd well be numbred, but never of the Confluent ſort: Their Appearance was the ſame with thoſe of the diſtinct Kind; they commonly come out very round and florid, and ma⯑ny times riſe as large as any I have obſerved of the natu⯑ral ſort, going off with a yellow Cruſt or Scab, as uſual; tho' it ſometimes happens, eſpecially when the Sores diſ⯑charge a very great Quantity of Matter, that they are both few in Number, and do not riſe to any Bulk; but having made their Appearance for four or five Days, they waſte in⯑ſenſibly away.
AFTER the Small-Pox comes out, the feveriſh Symptoms gradually abate; and when the Eruption is compleated they uſually ceaſe, without any ſecond Fever, or any farther Trouble in any reſpect.
WHILE the Puſtules were riſing, and for ſome time after they were gone, the Sores continued to ſwell, and to run very much; the longer they did ſo, the better; but they never fail'd to heal up, without any Trouble, after a certain Time.
[7]I very rarely ſaw occaſion for any Medicines in the courſe of the Diſtemper, only ſometimes, when the Symptoms run very high, I gave a gentle Anodyne, to be repeated as Oc⯑caſion ſhould require; and once or twice I thought it neceſ⯑ſary to Bliſter. After the Small-Pox is gone, they have al⯑ways been Purged twice or thrice, and ſometimes let Blood, which is all that has been uſually done.
IT has happen'd in one Inſtance or two, that the Symp⯑toms in the Diſtemper have been worſe than uſual; and ſome few, after the Small-Pox were gone off, have been ſubject to other Indiſpoſitions; of all which I ſhall give you a par⯑ticular Account.
THE firſt that was inoculated, Tho. Thorp's Son of Halli⯑fax. a Boy about a Year and half old, began to be ill on the eighth Day, and had a brisk Fever for about two Days; when the Puſtules began to appear, they were but few in Number, and roſe very large; the Child was ſoon well, and continu'd ſo for about three Weeks, when being carry'd out, and kept a long time in the cold, he fell into a feveriſh Diſorder, accompany'd with a Cough, and was ill for four or five Days; after that time it went off, and he has ever ſince been in very good Health.
THE ſecond was a Girl of two Years old, Jer. Turner's Daughter. in a Family where they had formerly bury'd their Children ſucceſſively of the Small-Pox, and this they fear'd might undergo the ſame Fate. The Fever came on about the ſeventh Day, and ſhe continu'd very ill 'till the tenth; on which Day about Noon ſhe had a ſtrong convulſive Fit; towards Evening the Puſtules appeared, and the Child grew better; and tho' ſhe had more in Number than uſual, yet ſhe grew well as ſoon as they were fully come out, and has continu'd ſo ever ſince.
THE eighth and ninth were in a Family where they had four Children, none of whom had had the Small-Pox. Mr. John Symp⯑ſon's Children. I was call'd to the eldeſt, who was ſeized in the common way with the moſt Malignant ſort I ever ſaw, attended with the worſt Symptoms that could be; ſo that he dy'd on the fourth Day, all full of Purple and Livid Spots. The Parents were [8]very deſirous that any Means might be uſed to preſerve the reſt; but here I was in great Doubt and Perplexity what Part to act. I knew very well, that if I ſhould venture to make the Inciſion, whatever ſhould happen would be char⯑ged upon that; and it was not improbable but ſome of them might have already taken the Infection; in which caſe it was very uncertain what the Event might be. On the other hand, if it was omitted, I thought it probable they might all dye, the Contagion which was got amongſt 'em being of ſuch a deſtructive Nature: Wherefore I was wil⯑ling to run the riſque of my Reputation, rather than that the Children ſhould all periſh. They were therefore all three Inoculated the Day before the eldeſt died, after ha⯑ving told the Parents that I cou'd not anſwer for the Con⯑ſequence, in caſe they had already catch'd the Infection; which wou'd be known if any of them fell ill before the ſeventh Day. According as we fear'd, one of them began on the ſecond Day, much after the ſame manner with the eldeſt; and the Small-Pox came out on the third Day, or rather an univerſal Redneſs all over the Skin, interſpers'd with many purple Spots. There were none of theſe Spots near the Places of Inciſion, which began to ſwell a little (as uſual) about the fourth Day, and the Small-Pox did riſe a little more about thoſe places than elſewhere; but Nature was too much oppreſs'd with the Violence of the Diſtemper; and tho' ſhe continu'd longer than her Brother, and was not Delirious as he was, yet ſhe dyed on the ſe⯑venth Day. I did not reckon this Child in the Number of thoſe who receiv'd the Small-Pox by Inoculation; for I thought there was ſufficient reaſon to conclude that ſhe had taken the Infection before; but of this we muſt leave all Per⯑ſons to judge as they pleaſe; I only give you a Relation of Facts The other two continu'd well 'till the eighth Day, when they both fell ill together; the Small-Pox came out on the tenth, of a very good Sort, tho' more in Number than ſome others had; and they both got very eaſily thro' the Di⯑ſtemper [9]without any Indiſpoſition ſince. It was obſerva⯑ble that the Elder of theſe Children two days before the E⯑ruption, had many red Spots which appear'd upon him, very much like thoſe of the other two Children, which changed in them to Purples afterwards; which the Mo⯑ther was very much concern'd at, fearing they would prove the ſame in this: But when the Small-Pox came out, theſe Spots grew gradually leſs, and at laſt quite diſappear'd. The other Child had been very ſubject to Convulſions for a long time when young, and it was afflicted with the ſame very much from the time that the Fever came on 'till the Small-Pox appear'd.
THE twenty ſeventh, was a married Gentlewoman aged a⯑bout twenty ſix, who got very well thro' the Diſtemper, but about a Week after, was ſeiz'd with a very great Coldneſs and Shivering, which were follow'd by a Burning-heat, with a violent Pain and diſorder in her Head, which continu'd for ſe⯑veral Hours: She had about two Years ago an intermitting Fe⯑ver, which I took this to be a Paroxiſm of, and expected its return; but ſhe felt no more of it, and has ever ſince conti⯑nu'd in good Health.
OF her two Sons who were both Inoculated about the ſame time, the Younger got thro' the Diſtemper with a great deal of Eaſe; the Small-Pox being few, and the Symptoms very ſlight: But the Elder (a Boy about five Years old) fared quite otherwiſe. The Symptoms before the Eruption were more than uſually ſevere, eſpecially the Vomitting; the Puſtules appear'd at the uſual time, but more numerous than ordinary; and when the Eruption was finiſhed, the Fever did not ceaſe as it has done in every inſtance but this: On the fifth day after he was ſeiz'd, the ſwelling of his Face began, which was follow'd by a Pain and Swelling in his Throat, and a Salivation, which continuing 'till the cleventh day, were ſucceeded by a ſwelling in his Hands and Feet, the uſual Symptoms of the Diſtinct ſort when they are very full; and tho' there appear'd ſome little Signs of Malignity, yet he got thro' the Diſtemper without any [10]Danger, but with much more Pain and Trouble than any of the reſt have endured. After the Small-Pox were gone off, we found a hard Swelling upon his Shoulder, which diſa⯑bled him for ſome time from moving his Arm; but by the uſe of ſome common Applications, that is in a great meaſure gone. In this Family, the only Child they had before theſe, dyed of the Small-Pox, of a very malignant Sort; and this Boy was of an ill Habit of Body, and has had many dange⯑rous Illneſſes.
THE twenty third was a Girl about nine Months old: Mr. Iſ. Hanſoo's Daughter. In this Child, about a Fortnight after ſhe was well of the Small-Pox, the Mother diſcover'd that one of her Thighs was a little ſwell'd, which was painful to her for ſome time, and made her unwilling to move that Part: Some of the Inguinal Glands were alſo ſwell'd; but theſe went off in a few Days, there only remaining a Hardneſs above the Knee, which alſo diſappear'd in a ſhort time, without coming to Suppuration.
THE thirty ſeventh was a Girl, Mr. Jo. Haigh's Daughter. ſix Years of Age; ſhe got ve⯑ry eaſily thro' the Diſtemper; but before the Small-Pox were gone, we found a ſmall Tumour upon the Muſcles of the Loins, which ripen'd very ſpeedily, and was open'd and heal'd up in a very ſhort time. Her Siſter, a young Woman about eighteen, had alſo a Swelling of the ſame Kind in her Leg, but it lay ſomething deeper, and gave her a great deal of Pain for three or four Days; afterwards it diſchar'd a great Quan⯑tity of Matter, and was heal'd without any farther Trouble.
ALL the reſt, excepting theſe I have mention'd, got ve⯑ry well thro' the Diſtemper, without any manner of Trou⯑ble, or Hazard, or any ill Conſequence afterwards. Whe⯑ther thoſe ſlight Indiſpoſitions which ſome have been ſubject to afterwards, were owing to the Inciſion, I have not been able to judge; but I preſume, what they have endured in the courſe of the Diſtemper, and what has follow'd after, is not to be put in the Ballance with what is undergone in the com⯑mon way, by thoſe who are thought to come off very well: And if this Method were more generally practiſed, 'tis pro⯑bable ſome Means would be found out to prevent even theſe [11]ſubſequent Diſorders, which are no more frequent, nor near ſo bad as thoſe which follow the natural Sort.
IN two Inſtances the Inoculation had no Effect; the Rea⯑of which in Michacel Bland's Daugh⯑ter. one was, becauſe the Child had the Small-Pox before; in the Wm. Clark's Son. other, the Matter was taken whenthe Pu⯑ſtules were wither'd, and almoſt gone, and that little Moi⯑ſture which they contain'd, I ſuppoſe, had loſt its Virtue: The Boy to whom it was made uſe of was no way affected, the Places of Inciſion did not at all Inflame and ſwell, as uſual, nor did any Puſtules appear, but about a Fortnight af⯑ter, he was ſeized with the Diſtemper in the common way, and did very well.
SOME of thoſe who have been Inoculated that are grown up, have afterwards attended others in the Small-Pox; and it has often happen'd, that in Families where ſome Children have been Inoculated, others have been af⯑terwards ſeiz'd in the common way; and they have laid together in the ſame Bed all the time; but we never found that ever any had the Diſtemper twice; neither is there a⯑ny reaſon to ſuppoſe it poſſible, there being no Difference that can be obſerved betwixt the Natural and the Artifi⯑cial Sort, (if we may be allow'd to call them ſo) but on⯑ly that the latter have commonly fewer. There is one Obſervation which I have made, (tho' I wou'd not yet lay any creat Streſs upon it;) that in Families where any have been Inoculated, thoſe who were afterwards ſeized, never had an ill Sort of Small-Pox, but always recover'd very well.
THUS, Sir, I have given you a ſhort and plain Ac⯑count of what has occurr'd to me, concerning this Me⯑thod of Inoculation. 'Tis not any Pains or Care I have taken in writing this Letter, will make it acceptable to you; for I am ſenſible it is deficient in every Reſpect, but a faithful Hiſtory of Matters of Fact. I could have In⯑oculated a much greater Number than I have done, if I would have preſs'd it; but I only took ſuch as deſired it of themſelves; being cautious of perſuading any body to it; becauſe I had no Authority hereabouts to ſupport me. I [12]know not whether I ſhall have an Opportunity of doing much more this way at preſent, the Small-Pox being in a great meaſure gone from this Town and Country; but I have already ſeen ſo much of it, that I ſhould never be afraid of its Succeſs.
THERE is only one thing more which I am oblig'd to mention, and which I wou'd rather have paſs'd over in ſilence, and that is, the vigorous Oppoſition it has met with from many honeſt well-meaning Perſons, who can⯑not but fancy it is an unlawful and unwarrantable Prac⯑tice: They have gain'd a great Majority on their Side here, as well as in other Places where it has been practiſed; I only wiſh, that as they act upon a Principle of Conſci⯑ence, they wou'd have been leſs buſy in raiſing and ſprea⯑ding falſe and groundleſs Reports, whereby this Matter has been much miſ-repreſented, and many entertaining a wrong Notion of it, have been deterr'd from making uſe of this Method for themſelves or their Children, who have ſince unhappily been taken off by the Small-Pox. But when this Affair it ſet in a true Light, and found to be always ſafe and effectual, I believe all the Objections raiſed againſt it will fall of courſe. It would be of the greateſt moment, that the World ſhould know more ful⯑ly what you think of it in Town, and how you have found it to ſucceed. 'Tis commonly objected here, that it is not approved of in London; but if thoſe Gentlemen who have juſtly gain'd the greateſt Honour and Reputa⯑tion in our Profeſſion, ſhould, by finding it ſucceſsful, ſee Cauſe to declare publickly in its Favour, that would be the greateſt Means to forward it in the Country, and ſoon reconcile People to a Method, which I believe has no where been put in practice with any other Aim, than to do ſome Service to Mankind; for which reaſon I doubt not but theſe Lines, tho' writ in haſte, will be acceptable to you, from,