SMALL-POX. 



vided the time of their rifing be not protrafted beyond the 

 ufual hmits by diarrhoea, pain, or deprefling paflions. The 

 more diltinftly fuppuration takes place about the eighth 

 day, and the more rofy the interftices around the puftules, 

 the lefs danger is to be apprehended. A fudden ceflation 

 of the fwelling of the face about the eleventh day, and the 

 non-appearance of that fweUing about the eighth day, 

 when the puftules are very numerous, are indicative of great 

 danger ; as are alfo a fudden fuppreffion of the falivation 

 in adults, and of the diarrhoea in children, at the former 

 period ; efpecially if the hands and feet liave not exhibited 

 any ftt-elling about that time. If, in the diftinft fraall-pox, 

 convulfions occur m children after the eruption is come out, 

 ar after incruftation has taken place, death commonly en- 

 fues ; or, if the patient furvives, a paralyfis of fome of the 

 limbs often remains. The difcharge of pale and clear urine, 

 with frequent urging to pafs it, in any period of the dif- 

 cafe, denotes great danger. 



On the other hand, regular gentle fweats, and a free dif- 

 charge of urine, which depofits a fediment, are favourable 

 fymptoms in every fpecies of fmall-pox. If, in the turn of 

 the confluent fmall-pox, the puftules, which were before 

 pale and flat, fhould acquire a rednefs or damafli-rofe colour 

 round their bafes, and fuppuration come on, the patient 

 generally recovers. 



When the fmall-pox attacks women in a llate of preg- 

 nancy, it is attended with confiderable danger, and com- 

 monly produces mifcarriage or premature labour. It has 

 been a qucflion among pathologills, whether the conneftion 

 between the child in the womb and the mother was (uch as 

 to admit of the infeftion of the former with the fmall-pox 

 under thefe circumllances. Whatever hypothetical differ- 

 ences might exift upon this topic, experience has proved 

 that fuch infeftion often takes place in the fcetus in utrro, 

 though not invariably. It would appear, too, that the 

 ;'hild is not afFeited at the fame moment with the mother, 

 but foon afterwards by fubfequent infeiftion. For, in a cafe 

 related by Dr. Laird, a woman in tlie fifth month of her 

 pregnancy paffed through a fevere fmall-pox, which com- 

 menced about the end of Auguil : flie felt the motion of 

 the child till the month of Oftober, on the 28tb of which 

 month (he was delivered of a child, which was thought to 

 be of fix months' growth, and wiiich had been dead fome 

 days. " On the back, fhoujders, and fide, and particularly 

 about the upper part of the thighs, v;here the integuments 

 were perfeftly found, there were feveral puilular elevations, 

 with central depreflions, ftrikingly charafterillic of the ap- 

 pearances which dillinguifh fmall-pox. The fcetus was placed 

 1 the mufeum of Guy's Hofpital, and Itill diftinftly ex- 

 ihits the charafters of the eruption." See Edinburgh 

 Med. and Surg. .Journal, for April, 1807. 



A IliU more extraordinary circumftaiice, in refpeft to the 

 infeftion of the child in the womb, occafionally occurs ; 

 namely, the produftion of fmall-pox in the child, in confe- 

 quence of the mother's expofure to the contagion, although 

 the latter may have been prevented from iuffering the dif- 

 •■afe herfelf, by liavirg previoufly undergone tliat difeafe, or 

 the cow-pox, and therefore efcapes the influence of the in- 

 ieftioii. Dr. Jenner relates the following cafe, which came 

 under his obfervation, in the inltance of a lady in London. 

 " A few days previous to her contincment, (he met a very 

 difgufting object, whofe face was covered witii the fmall- 

 pox. The fmell and appearance of the poor creature af- 

 feftcd her much at the time ; and though flie mentioned the 

 circumllance on her return home, (he had no idea that her 

 infant could fufler from it, having had the fmall-pox her- 

 lelf when a child. During a few days after its birth the 



little one feemed quite well ; but on the fifth day it became 

 indifpofed, and on the feventh the fmall-pox appeared. The 

 puftules, which were few in number, maturated completely. 

 Dr. Croft, who attended her, being curious to know the 

 effeft of inoculation from one of the puftules, put fome of 

 the matter into the hands of a gentleman eminently verfed 

 in that praftice, which produced the difeafe correftly. 

 Mrs. W. was not fenfible of any indifpofition herfelf from 

 this expofure, nor had (he any appearance of the fmall- 

 pox." Another cafe is mentioned by Dr. Jenner, in which 

 the child in utero was infefted with fmall-pox contagion, 

 and born with the eruption upon it, five weeks after the 

 mother had been vaccinated, and 2 month after (he had been 

 expofed to the contagion of fmall-pox from three of her 

 children. Whence, as Dr. .Jenner juftly infers, it is ob- 

 vious, " that the fmall-pox virus may affeft the human 

 frame, even to its inmoll receffes, although apparently 

 fecured from its effects, and yet give no evidence of its 

 prefence by exciting any perceptible diforder." (See Me- 

 dico-Chirurgical Tranfaftions, vol. i. p. 272. Alfo, Van 

 Swieten, Comment, ad Aphor. 138 1 ; and Dr. Mead's 

 Difcourfe on Small-pox, chap, iv.) Dr. Mead ftates the 

 following analogous faft. " A certain woman, who had 

 formerly had the fmall-pox, and was now near her reckon- 

 ing, attended her hulband in the diftemper. She went her 

 full time, and was delivered of a dead child. It may be 

 needlefs to obferve, that (he did not catch it on this oc- 

 cafion ; but the dead body of the infant was a horrid fight, 

 being all over covered with the puftules ; a manifeft fign 

 that it died of the difeafe before it came into the world." 



Though the confluent fmall-pox (hould not be imme- 

 diately fatal, yet the more violent kinds are often followed 

 by a morbid ftate of the body, under which various dif- 

 agreeable and dangerous complaints arife. Whether thefe 

 confequences may be afcribed, with Dr. CuUen, fometimes 

 to an acrid matter, generated by the preceding difeafe, and 

 depofited in difterent parts, and fometimes to an inflamma- 

 tory diathefis produced, and determined to particular or- 

 gans of the body, is a theoretical inquiry, which we are 

 not difpofed to puzzle ourfelves and our readers by purfuing. 

 It is manifeft, in general, that the conftitiition is often left 

 in a ftate of great debility ; does not thrive under the ordi- 

 nary nutrition ; and in many cafes exhibits a great tendency 

 to fcrofulous inflammation, cipecially of the glandular fyf- 

 tem, to chronic derangements of the lungs, mefentery, and 

 other vifcera, and to various local affcdions of the (]<in, 

 membranes, and bones. Another feries of evils, which the 

 confluent fmall-pox is hablc to inflift, is the various degrees 

 of injury and deftrudiion which it occafions in the organs of 

 fenfe, efpecially in the eyes and ears. Deafnefs of one or 

 both ears, and the lofs of fight in one or both eyes, is no 

 uncommon refult of this formidable malady. It appears 

 indeed, from the records of the humane " Inftitution for 

 the indigent Blind," that a very large proportion of all that 

 claim its protection have been blinded by the fmall-pox. 



Caufts of Sninll-pox, and of its Furitties.— The only ex- 

 citing caufe of fmall-pox is the ipcci(ic contagion, generated 

 in the puftules of the difeafe itfelf. In what manner, or at 

 what period of time, this gre.-'.t depopulator of the human 

 race was generated, or what phyfical circumllances con- 

 curred to give it cxiftcnce, hillory affords us no means of 

 afcertaining" The abfurd fpcculations of the Arabian phy- 

 ficians, refpefting the origin of the difeafe from fome con- 

 tamination of the fcKtus with the mcnftrual impurities of the 

 mother, deferve no notice. The obvious origin of a dif- 

 eafe, (fo analogous to fmall-pox, as to fuperfcde the in- 

 fluence of its contagion on man, ) from a difeafe of the Ikin 



of 



