I X O C U L A T I O N. 



139 



An luipur 



l.r. : .M- 



\'*eane future, is not always secure. Some are attacked even 

 Inoculation. w hen the exposure) is casual, and not remarkably inti- 

 *"" ~~~ mate or long continued. Others are secured in a great- 

 er degree, so as never to take the disease unless in close 

 anil long, contact with a variolous patient. On such 

 exposure, a disease which has been called local, and 

 which certainly is partial, may be generated. A nurse 

 who has passed the small-pox has found variolous pus- 

 tule* breaking out on her breast while she suckled a 

 child under that disease. These pustules, though their 

 number may be considerable, are generally confined to 

 one part of the body. They are seldom attended with 

 any fever ; yet, in other instances, febrile symptoms 

 have in a slight degree appeared. Such symptoms are 

 then generally attributed to mere irritation, and their 

 true variolous nature is denied. It appears most philo. 

 sopbical to consider all these varieties as evidences that 

 the correction of this susceptibility is liable to grada- 

 tions. Such gradations, we think, take place remarka- 

 bly in the influence of cow-pox. But, obscure as their 

 causes are, and unable as we yet are to tell in what de- 

 gree they depend on constitution, on habit, on unknown 

 varieties of vaccine matter, or unknown varieties of va- 

 riolous infection, we have the valuable consolation of 

 concluding that, in every case of cow-pox " not evi- 

 dently spurious," the susceptibility is so far subdued 

 as to secure the individual, in all human probability, 

 from all the ilil^iii and (it i* not unimportant to 

 add) from all the deformities occasioned by the small. 

 pox. U remains for future inquirers to ssihetantiatr- a 

 still more select form of cow-pox, by which the securi- 

 ty will be more perfect. In the mean time, we ought 

 to be thankful fur the valuable advantage* attending it 

 even in its most questionable MOB. 



Sean-pas: These observations are celled for by a most import- 

 atCupar 



ant circumstance, the < 



ence of an epidemic small. 



pox in Cupar. in Fifirshire. m the spring of 1817, of 

 which an account has been published by the author of 

 the present article, fmnihd on inquiriM which he made 

 in the form of domiciliary visit*, while the 



ttt Menl 



stance* were fresh in the memories of the parents of 

 those who had recovered, and while some patients still 

 laboured under it in its different stagn. From this ac- 

 eoont we shall take the liberty of extracting some of 



1 J* * -- 



" Though I was there only sixteen hoars, that is, 

 *iff ht h.Mir* on the 51 st of Mar, and eight on the 4th 

 of June. I received accounts o/ seventy patients. 



mr of these were said to have gone through 

 the vaccine disease. 



xteea kad either not been inoculated, or no vessel* 

 had appeared after the iinertiun of the vaccine virus. 



In almost the whole, both the inoculated and those 



who were not, there was a well marked eruptive fever. 



ry few of the cajas were mild during their whole 



course, vis. about eight of the onJiliri. and two of 



the uninoruUted. 



was not easy to classify them with greater mi- 

 natrnes* as to their severity. There seemed to be, in 

 IBM respect, an insensible gradation. 



I the fifty-four who had been inoculated, one 

 died. Of the six* een w do had not been inoculated, ac. 

 counts were received of six death*. 



lere we have, in the one class, one death in fifty- 

 four ; in the other, more than one in three. Hut the 

 cases taken into computation ought to be much more 



namsmiis in order to afford an average on which we 



~ n * i 

 can uepenu. 



"fll-^Sn were attaclud, time kad t<tn inoculattd 

 ocsVA the 



This last fact seemed to justify a remark which the Vaccine 

 author afterwards makes, and which has been subse- Inoculation. 

 ijiiently animadverted on, that, ' as a sure preventive ^^ "Y"*' 

 of an attack of suiall-pox, there is a marked distinction 

 between cow-pox and the variolous inoculation." The 

 security afforded by the Utter has had some rare excep- 

 tions; but, on this occasion, we have found it securing 

 the system from an epidemic which attacked numbers 

 of vaccinated persons, while many who had received 

 the old inoculation must have been equally exposed. 

 This is a real difference between the two inoculations 

 in one obvious point ; but is perfertly consistent with 

 the confidence which cow-pox claims in obviating a 

 very extensive and a very alarming danger. For the 

 features of the different cases, and some casual sugges- 

 tions for the further prosecution of the subject, as well 

 as some marked instances of protection even from the 

 attack of the same epidemic, we must refer to the ac- 

 count itself. We shall only further transcribe the sum- 

 mary of general practical conclusions there given, which, 

 though differing in some instances from the belief pre- 

 viously entertained, are in their nature consoling. 



" We are justified by the following considerations in Infercncej 

 steadily adhering to this practical conclusion, that vac- a PPreniljr 

 cination ought still to be valued, and universally recom- Warr4nte<lt 

 mended. 



I hat by vmtetMtimm me do not potilively endanger 

 life. By the old inoculation, a disease was produced 

 which was sometimes fatal. The danger artificially 

 created we* imenndutr, while that which it was intend, 

 ed to obviate was remote. Yet the Conner was compa- 

 ratively so small, a* to prevail on the reflecting part of 

 the community to concur in encountering it. In the 

 vaccine inoculation, however, we are saved all these 

 painful calculations, because we communicate an affec- 

 tion attended wish no danger, and the power of which 

 over the constitution i* great but silent 



" Again, allowing that the individual who has been 

 vaccinated is equally liable to small- pox with any other, 

 (which no person will be bold enough on the large 

 scale to assert,) he u not liable to it in the tame Jam at 

 ifmttcmmtian had ** omitted. This point cannot be 

 longer doubted ; and, if we proceed at first on the sup. 

 lion that the small-pox succeeding vaccination is 

 exactly equal in risk to the disease which used to be 

 conMHinicated in the old inoculation, it must be al. 

 lowed that <. gain time in the life of the individual by 

 ring vaccination. He is not subjected to the risk 

 in the tint instance Years may elapse before he is ex- 

 posed to the contagion of small. pox : When so exposed, 

 he will, in most cases, be protected from it by the cow- 

 pox ; and, if at last he is attacked, lie encounters a risk 

 only equal to that which would have been earlier in- 

 cured by a previous inoculation with variolous matter. 



" liut this suppotition is much less favourable than 

 the truth. The risk even at that late period is far from 

 being so great. The twiaU-poJt occurring in a vaccina- 

 ted perton it much lafrr than ike inoculated small-pox. 

 It has never been maintained, that the disease induced 

 by the variolous inoculation was always exempt from 

 the occurrence of secondary fever. On the contrary, 

 some of the few who died of the inoculation, were cut 

 off by that fever. 



The most unfavourable conclusion, therefore, that 

 can be admitted, is, that there may lie the tame risk of 

 death* from rmnU-pox after vaccination, at of deaths in 

 the early flage of the inoculated tmaU-pox. Thus, the 

 risk is not only deferred to a later period, hut is ulti- 

 mately far inferior to what it was under the use of tin- 

 best inoculation previously to the discovery of the cow- 



