VACCINATION. 



With very few exceptions, indeed, perfons who have 

 undergone both the local and conftitutional affeftion of cow- 

 pox, are thereby rendered unfufceptible of fmall-pox. 



It is not meant to aflert, however, as has been too gene- 

 rally imagined, that every perfon who has been inoculated 

 for the cow-pox, is rendered fecure againft the contagion of 

 fmall-pox. As Mr. Bryce has ably explained, there are 

 many circumftances, befides the mere inoculation, abiolutely 

 necelTary to be afcertained, before this fecurity can be gua- 

 ranteed. 



Again, fays Mr. Bryce, it is well known, that a perfon 

 having undergone the fmall-pox is not abfolutely fecure from 

 a future attack of the fame malady, as well authenticated 

 inftances are recorded, where the fame perfon has under- 

 gone this difeafe a fecond time, and thefe attacks were nei- 

 ther of them local, but very certainly general conftitutional 

 affeftions. See the cafe of Mr. R. Langford, recorded in 

 the fourth volume of the Memoirs of the Medical Society of 

 London. This gentleman was infefted with the fmall-pox 

 at a very early period of life, and was much marked from 

 the feverity of the difeafe. Many years afterwards, he was 

 again infetled with the fmall-pox, which was of the con- 

 fluent kind, and proved fatal on the twenty-firft day from 

 the attack. See alfo Dr. Woodville's Hiftory of Inocula- 

 tion, p. 217 ; Mr. Ring's Anfwer to Dr. Mofeley, where 

 many fuch cafes are recorded ; and the cafe of lord Weft- 

 meath's child, publilhed in the Medical and Phylical Jour- 

 nal, vol. xiv. p. 256. 



Now, as Mr. Br)-ce remarks, with regard to the cow- 

 pox, it may alfo happen, that a perfon who has undergone 

 that affeftion, may yet be afterwards affefted with fmall- 

 pox ; but, as is well known in the former cafe relative to 

 fmall-pox, fo alfo in the latter relative to cow-pox, the in- 

 ilances of the fecond attack from fmall-pox, or of the 

 failure of the cow-pox to prevent the fmall-pox, are fo very 

 rare, as by no means to affeft the general eftablifhed rule ; 

 that perfons who have once undergone the fmall-pox, or the 

 cow-pox, as a conftitutional atfeftion, may thenceforth be 

 reckoned fecure againft all future attacks of variolous con- 

 tagion. (SeeBryce's Praclical Obfervations on the Inocu- 

 lation of Cow-pox. ) Befides the examples of the recurrence 

 of fmall-pox a fecond time in the fame individual, to be 

 found in the publications already fpecified, additional in- 

 ftances are recorded by Dr. Jeniier himfelf, Mr. Bryce, and 

 ill the Reports of the National V'accine Eftabhftiment. 



We ftiall here prefent the reader with the hiftory of two 

 remarkable cafes publiftied by this laft inftitution ; the one 

 illuftrating the occurrence of fmall-pox a fecond time in 

 the fame perfon, the other exemplifying the equally un- 

 common circumftance of an individual who had perfeftly 

 undergone vaccination, being afterwards affected with the 

 fmall-pox. 



Dr. Bree was called to vifit Mifs Sarah Booth, of Co- 

 vent Garden theatre, on Monday, June 25th, 181 1. She 

 was faid to be ill with the fmall-pox, and the following cir- 

 cumftances were reported by the mother and fifters. 



Mifs Booth was then eighteen years of age. She had 

 been inoculated for the fmall-pox at five years of age, and 

 had been affeifted with the ufual degree of fever. The arm 

 had been violently inflamed, and an eruption of fmall-pox 

 puftules had appeared round the inoculated part, from which 

 matter had been taken by Mr. Kennedy, the furgeon who 

 attended her. Mr. Kennedy exprefled himfelf fatisfied that 

 Mifs Booth had paffed regularly through the difeafe. 



The ufual Icar of fmall-pox inoculation was perfedly 

 evident on the arm. 



On Thurfday, June 20th, 18 11, Mifs Booth was feized 



with fever, diftinguilhed by vomiting, violent head-ache, 

 and pains in the back and loins. 



The fymptoms continued till Saturday, June 22d, in the 

 evening of which day, forae puftules came out on the fore- 

 head and fcalp. 



Sunday, June 23d, a more complete eruption appeared 

 on the face and neck, and ihe was relieved from the violence 

 of the fever. The vomiting however continued, the throat 

 became very fore, and a fahvation began. 



Monday, June 24th, the eruption extended itfelf on 

 the body, the fever was ftill more abated, but the falivation, 

 forenefs of the throat, and vomiting, were urgent f)Tnptoms. 



Tuefday, June 25th, the fourth day ot the eruption, 

 the falivation and retelling continued, with forenefs of the 

 throat. 



Wednefday, June 26th, fifth day of the eruption, puf- 

 tules were noticed on the lower extremities, thofe on the 

 face advanced, the eyes were fweUed ; and the number of 

 puftules on the head and face was about two dozen. 



Thurfday, June 27lh, fixtli day of the eruption, the 

 puftules on the face began to turn. She ftill fuffered from 

 fore throat and falivation. 



Friday, June 28th, the puftules on the face turned, 

 thofe on the lower extremities were few in number but well 

 filled, and not yet changed. 



Saturday, June 29th, eighth day of the eruption, ftie 

 only complained of ficknefs. After this day, the puftules 

 turned and dried on the lower extremities, and no complaint 

 remained. 



Dr. Bree confidered this as a mild cafe of diftinft fmall- 

 pox. 



On Sunday, May 26th, 1 8 1 1 , the Hon. Robert Grofveuor, 

 who was recovering from the hooping-cough, became much 

 indifpofed and threw up his dinner. Fever followed, and 

 he complained moft particularly of excruciating pain in his 

 back. He dwelt on this fymptom until Thurfday, when 

 he became delirious, and there were obferved on his face 

 about twenty fpots. 



He had been vaccinated by Dr. Jenner, in his infancy, 

 about ten years ago, and the mark left ia his arm indicated 

 a perfect difeafe. 



On Friday morning, the eruption had not increafed ma- 

 terially in point of number, but the appearance of the fpots 

 and the previous fvmptoms, fuggefted ftrongly a fufpicion 

 that the diforder was the fmall-pox. 



Sir H. Halford had occafion to go to Windfor in the 

 afternoon of Friday, and did not fee Mr. Robert Grofve- 

 nor until the Monday following, (June 2d,) but he learned 

 from fir W. Farquhar, who attended him moft carefully 

 during fir Henry's abfence, and fubfequently, that the 

 eruption had increafed prodigioufly in the courfe of Friday; 

 that on the evening of that day, Mr. Robert Grofvenor 

 began to make bloody water, and that he continued to do 

 fo until Monday morning. 



On the tenth day of the difeafe, the puftules began to 

 dry upon the face, which was fwollen to a confidcrable de- 

 gree, but not to the extent of clofing his eyes, and was 

 attended by a falivation which lafted feveral days. Petechias 

 had occurred in the interftices of feveral of the fpots, par- 

 ticularly on the limbs, and there was that particular fmell 

 from the whole frame which is remarkable in bad cafes of ' 

 conflluent fmall-pox. ' 



It was obvious that the firft fymptoms of which Mr. 

 Grofvenor complained, were fuch as indicated a violent 

 difeafe about to follow, and fir Henry confefles that he 

 entertained a moft unfavourable opinion of the iff^ue of fuch 

 a malady, when it was fidly formed ; having never fecn an 



inftancc 



