1$22.] Mr. Asbury’s Plan to exterminate the Natural Smallpox.’ 
between 1667 and 1722, the average 
number of deaths occasioned by the 
small-pox was, to the whole number 
who died, as 72 to 1000; but, in 
ty-two years after inoculation was 
in full use, from 1731 to 1772, the 
proportion was 89 in 1000, being an 
increase of nearly one-fourth. This 
circumstance has beenattributed to the 
act of inoculation ; and practitioners 
in some districts have, since the prac- 
tice of vaccination, refused to inoculate 
in those families where they have not 
been successful in recommending the 
cow-pock, which refusal has led to very 
lamentable consequences. It is true 
that inoculation increases the source of 
contagion, at the same time that it ren- 
ders the disease itself milder in the 
constitution which receives it: but, 
from the observations of Dr. Haygarth, 
and other physicians of eminence, it 
appears that the contagious property is 
not communicated to any great extent 
through the medium of a circulating 
atmosphere ; on the contrary, it espe- 
cially requires contiguity of persons, or 
exposure to a current of air strongly 
pC ae or a confined air in which 
exhalations, from a body labouring 
under the disease, are taking place ; 
and Lam led to infer, from many recent 
cases which have occurred to me in 
practice, that, where the contagion 
cannot be traced toa direct communi- 
eation with the infected body, the 
disease is propagated, with matter in 
the state to which I have before al- 
Inded, by the general intercourse of 
society. If, therefore, inoculation ex- 
cite a mild form of the disease, and yet, 
during the practice of it there has been 
an imereasing mortality, though the 
disease be not communicated by an 
open atmosphere, it follows that the 
number of deaths are to be attributed, 
in the first place, to the extreme neeli- 
gence and want of attention in the 
parents themselves, to avoid all com- 
munication with other families ; and, in 
thie ‘sécond, to their not having all the 
ehildren of the same neighbourhood 
inoculated at the same time. 
“Tt may be'as well a point of curiosity 
as of interest to notice the practice of 
inoculation in Turkey, prior to its intro- 
duction in England. Ina letter by Lady 
Mary W. Montague, dated “ Adriano- 
ple, Aptil Ist; 0.8. 1718/7? we find! 
“The smuall-pox, so fatal and so general 
among ws, is here entively harmless, by 
the invention of ingratting, which is the 
term they give it- There is a’set of old 
Montrity Mac, No. 368. 
417 
women who make it their business to 
perform the operation every autumn, in 
the month of September, when the 
great heat is abated. People send to 
one another to know if any of the 
family has a mind to have the small- 
pox: they make parties for this pur- 
pose; and, when they are met (com- 
monly fifteen or sixteen together,) the 
old woman comes with a nut-shell full 
of the matter of the best sort of small- 
pox, and asks what vein yon please to 
have opened. She immediately rips 
open that you offer to her with a large 
needle, and puts into the vein as much 
matter as can lie upon the head of her 
needle, and after that binds up the little 
wound with a hollow bit of shell.” 
The practice here, it will be observed, 
is adopted by consent of parties, and 
no child remains in the same district to 
have the disease in the natural way. 
If it were practicable to vaccinate, 
every child under six months old, it 
would be found unnecessary to offer any 
other means than that of vaccination, 
in order to exterminate that ten-fold 
plague, the small-pox. It may be 
asked, then, how is it that so many 
cases of natural small-pox have occur- 
red in the constitutions said to have re- 
ceived effectually the cow-pock ?’ This 
question admits of an easy and satisfac- 
tory explanation, and may be referred 
to one or other of the following causes: 
ist. To a want of experience in the 
medical profession generally at the com- 
mencement of vaccination: the disease 
being entirely new in the human constitu- 
tion, what peculiarities of it rendered the 
practice unsuccessful was then unkrowa. 
2ndly. To the practice of vaccination 
not being confined to the medical world, 
but practised by unskilfnl hands, and who 
can have no correct knowledge either of 
the healthy functions or diseased actions 
of the body. ( 
3rdly. To there being two kinds of cow- 
pock, a local and a constitutional one ; the 
former producing a pustule, and subse- 
quently a mark on the arm, without-con- 
stitutional fever; by which-means the indi- 
vidual is still liable to;receive the :small- 
pox. hive 
Of failure from this latter cause,a re- 
markable instance has occurred in my 
practice. Five children were vacci- 
nated in one family, twelve years. ago, 
by a professional gentleman ; the pock 
on the arm, in each of them, presented 
its regular and progressiye stages ; fuur 
suffered from restlessness and fever, but 
the fifth was entirely free from any con- 
stitutional complaint. In the month of 
3 i March 
