152 Second Letter to Mr. Tilloch on the Cow-Pock. 



the puncture. Patients admitted into the inoculation hos- 

 pital have often pustules on the body, after vaccine matter 

 has been inserted in the arm, from the following cause : 

 They are mostly persons from the country, who, alarmed 

 on finding sorne of the inhabitants of the houses where they 

 lodge, or'visit, affected with the small-pox, endeavour to an- 

 ticipate the disorder by means of inoculation, at some asylum 

 opened to them by public benevolence. But the applica- 

 tion is probably too late : some of them have already re- 

 ceived the infection, and, before the vaccine pock can reach 

 the end of its second stage, an eruption of variolous pus- 

 tule's takes place in the usual manner In attending at the 

 hospital last summer, while Dr. Woodville was on his mis- 

 sion to Paris, I observed four instances of persons so cir- 

 cumstanced, in whom the eruptions appeared, on different 

 days, between the third and the eighth from inoculation*. 



The cow-pock producing no pustules, no quantity of 

 fluid is re-absorbed into the constitution, producing a se- 

 condary fever, as is often in small-pox, and the constitu- 

 tional affection is also much slighter, when it occurs, than 

 with the small-pox. 



The small-pox when inoculated, or taken naturally, 

 usually is ushered in by convulsion in children at all ages. 

 " Paint to yourself," says Dr. Macdouald, " one of these 

 little innocent sufferers, stretched out, and covered with one 

 continued sore; threatened with suffocation, uttering the 

 agonies he feels by piercingly heart-wounding groans. — Ob- 

 serve how his mouth foams ; listen to the grmding of his 

 teeth; sec how he thrusts his little tremblmg tongue be- 

 twixt them, and how piteously it is wounded ! — Look! how 

 he is agitated with the most dreadful convulsions! his 

 feeble limbs are twisted and contorted, and threaten dislo- 

 cation; his frame bends backwards; is lifted up and thrown 

 down again! — These fits now increase, — then cease, alas! 

 only to return with redoubled violence. — Misery calls aloud 

 for help, help; — but calls in vain. — New convulsions suc- 

 ceed; — he foams,— struggles, gasps, — gasps again, and 



expires !" 



The cow-pock is never ushered in by convulsions. 



about the seventh day, but they subsided in two or tliree days. This 

 Tittle eruption was merely the strophulus candidus, debcribed in theTrea- 

 tise on Cutnneous Diseases, page 32. 



* From this cause some confusion arose in Dr. Woodville's first re- 

 ports; for, from inoculating at the same time with variolous matter, and 

 cometimes fiom the contagion of the small- pox, pustular casts were not 

 unfrtfjutntly produced. 



[To be continued.] 



XXV. Seventeenth 



