INOCULATION. 



Vmguenew 

 of the doc- 

 trines on 

 this point. 



The chief 

 desidera- 

 tum. 



The present 

 state of the 

 faco. 



the genuine, ami more rapid in its progress ; that it is 

 not cellular, nor surrounded with a distinct circumscri- 

 bed areola, nor converted into ;i dark shining scab." 

 I!' these appearances are observed to take place, we, of 

 course, put no confidence in the preventive power of the 

 affection induced. Hut it would be more satisfactory to 

 have a precise knowledge of the causes even of this va- 

 riation. These causes, however, are merely enumera- 

 ted in a mass. Such a pustule is said to occur instead 

 of the genuine cow-pox, " in those who have had the 

 small-pox ;" it is said to be " produced by blunt or 

 ru.-ty lancets ; by matter taken from a spurious pus- 

 tule or from a genuine pustule at too late a period 

 in- by matter which has been too long kept or dried 

 before a fire." (Sec the article Cctv-pvx in Rees' Cy- 

 r!p:rdia, written by Mr. Ring.) All these circum- 

 stances (excepting the bluntness of the lancet,) may 

 be supposed to occasion a modification in the dis- 

 ease ; but is it probable that they all agree in the kind 

 of modification which they produce ? A cautious in- 

 quirer will suspect that there is here some defect of 

 observation something presumed rather than disco- 

 vered, unless numerous cases of this wonderful co- 

 incidence are minutely described ; while the captious 

 critic will exclaim that these assigned causes are only 

 so many hedges behind which the wary vaccinator pro- 

 vides for himself a variety of shelter in case of disap- 

 pointment. The only light in which reason and duty 

 view them is, as so many motives for more extended 

 inquiry. These remarks have indeed been elicited only 

 by the explanations given of a vesicle which " carries 

 its spurious character in its aspect." But we may de- 

 rive instruction, by contemplating a specimen of that 

 precipitance in forming conclusions, to which the me- 

 dical world is liable in other points connected with 

 this important subject. 



In order that vaccination may afford us the requi- 

 red advantages, we ought to be able to distinguish, 

 " without difficulty," all the cases in which the consti- 

 tution is secured by it either from disease or from dan- 

 ger. Vaccination has been chiefly in the hands of per- 

 sons not medical ; for this reason, it is among these that 

 the most numerous failures have occurred, and room is 

 left for ascribing the failure to some imperfection in 

 the cases of cow-pox, which escaped the observation of 

 all concerned, though it might have been ascertained 

 by better instructed individuals. If failure takes place 

 among those inoculated in the most approved manner, 

 and declared by good medical authority to have had 

 the genuine disease in the most perfect form, the neces- 

 sary conclusion is, that the faculty stand in need of more 

 accurate information. 



That some such cases have occurred is admitted ; but 

 they are declared to be extremely few ; and we are 

 justly reminded that cases of repeated natural small- 

 pox, as well as of natural small-pox after the best vari- 

 olous inoculation, have also occurred. The rule of se- 

 curity is not wholly without exception in either instance. 

 But, are the exceptions equally infrequent in both ? 

 This is what we are also told on very respectable au- 

 thority. Such exceptions, we are informed, appear to be 

 more numerous than they are, only because chicken-pox 

 occurring after vaccination, has been mistaken for small- 

 pox. There are various sorts of chicken-pox, according 

 totheaccounts given us in the writings of physicians, and 

 all of them are mild and safe diseases compared with 

 e small-pox. See the varying descriptions of this 

 disease given in the works of Drs. Morton, Sauvages, 

 lanSwieten, Burserius, Heberden, Cullen, and Wil- 

 ran. Some assert that there is another chicken-pox, at 



least an illegitimate small-pox of a severer kind, not Vcc-ii.c 

 clearly described by any of the older writers, and that 

 the rare exceptions to the^fficacy of vaccination have 

 been cases in which this form of disease has been er- 

 roneously taken for small- pox. The general fact we 

 have found to be, that, where parents have brought 

 their children, apparently under small-pox, to the prac- 

 titioner who had vaccinated them, and declared them 

 safe from that disease, he has told them that it could 

 not possibly be small-pox, and must be chicken-pox. 

 Each party continues to retain his own opinion. The 

 parent is certain that it was small-pox, the vaccinator 

 that it was chicken-pox ; but, since the children have 

 got well, the contest is not worth the maintaining, and 

 the inoculator enjoys his triumph. And who will deny 

 that he is entitled to this triumph, if the children always 

 get well ? Is that the fact ? We believe it is, or at least 

 exceptions to that most important of all results are ex- 

 tremely rare. HoweVer, therefore, we may in some 

 particulars acknowledge ourselves to be in the dark re- 

 garding the minute laws of the inoculated vaccine dis- 

 ease, this one fact must determine us to cling to it as a 

 sure preventive of all the dangers arising from small- 

 pox. We use the word sure not in an absolute sense, 

 but as admitting of exceptions so rare as to be totally 

 unworthy of being taken into calculation. 



The pathological principle by which the present state Most plau- 

 of our knowledge directs us to explain this fact is, that, s 'ble expla- 

 where the infection of the small-pox comes in contact nation of 

 with a vaccinated constitution, it meets with a dimi- ' lem- 

 nished susceptibility which, in most instances, obviates 

 every tendency to the actual production of small-pox, 

 and almost always obviates the fatal tendencies which 

 it otherwise brings along with it. 



From numerous other facts which presented them- Does vacci- 

 selves, we had been led lately to conclude that it affords nation pre- 

 a sure protection against the occurrence of the seconda- vent tlic se- 

 ry fever, the principal danger of small-pox. We have, '""""T' 

 indeed, recently heard of an exception to this conclusion; 

 a vaccinated person who has been known to die under 

 secondary fever. This is not in conformity to any thing 

 we have seen, and must be a phenomenon still more rare 

 than the exceptions to which we have referred. As tena- 

 cious advocates for vaccination, we are obliged to declare 

 it as our opinion, that those who agree with us in this 

 feeling, will do much less justice to this preventive, 

 by pronouncing all the alleged exceptions to its effica- 

 cy to be cases of chicken-pox, than by allowing that 

 small-pox may occur after it, and by insisting rather 

 on the comparative safety, than the great infrequency, 

 of the disease under such circumstances. 



It has sometimes been intimated that, " as the laws Theoretic 

 of nature are uniform, such exceptions are prime facie assumption 

 improbable ; and that it is most rational to infer, when considered. 

 they apparently occur, that either the cow-pox, or the 

 subsequent small- pox, is different from. the correspond- 

 ing disease, in the form in which the one is a preventive 

 of the other." This may be the case. The exceptions 

 may proceed from some cause of a powerful and decided 

 nature. That cause may be discoverable by human in- 

 quiry; or, it may lie so deep as to mock our researches. 

 But, let us remember that, in the present state of our 

 knowledge, we have other facts which warrant us, from 

 analogy, in allowing that such modifications of the ani- 

 mal system may not be absolute and invincible, but 

 may exist in different degrees. Here it will be use- 

 ful to revert to some well known circumstances con- 

 nected with small-pox. Even a person who has alrea- 

 dy had that disease, either from casual infection or ino- 

 culation, though most frequently secured against it in 



