6*4 
cases of small pox, occurring a second time in 
the same subject, eacli of them authenticated 
far more completely than any one that lias 
been cited by the adversaries of vaccination. 
We are persuaded, indeed, that we shall be 
supported by every impartial person who 
makes himself master of the whole evidence, 
in saying, that there are not so many as ten 
cases of small pox, after perfect vaccination, 
proved in such a way as to be entitled to any 
sort of attention. Now the medical council, 
consisting of almost all the great practition- 
ers in Loudon, have reported that ‘ nearly 
as many persons have been already vacci- 
nated in this kingdom, as w r ere ever inocu- 
lated for the small pox since the first intro- 
duction of that practice ; so that if the two 
cases were exactly upon a footing, the risk of 
failure seems to be at least twice as great in 
the small-pox inoculation as in that tor the 
cow-pox.’ 1 And yet who is there in the pre- 
sent day who thinks for a moment of alle- 
ging possible insecurity as an argument 
against variolous inoculation ? It may be in- 
structive to state that this argument was how- 
ever used against the old at the time of its 
introduction, and urged much in the same 
spirit as it now is against the new. Dr. Wil- 
lan and others, in their respective treatises, 
have cited many examples of the mode in 
which the variolous controversy was carried 
on, a single one of which our limits will only 
permit us to extract. 
“ I fear they may be accounted physicians 
of no value and forgers of lies, who so confi- 
dently tell us what it is impossible for them 
to know, namely, that they who undergo 
their experiment (the inoculation for small 
pox) are for ever thereby secured from any 
future danger of infection.” Page 18, Rev. 
Mr. Massey’s sermon against the dangerous 
and sinful practice of inoculation. 
Against the suggestion of Mr. Goldson, 
that, although the natural cow-pox may se- 
cure from variolous infection, the inoculated 
disease may be more precarious and uncer- 
tain, we think it of consequence to notice 
in the first place, that were the variolous 
and vaccine inoculation to be judged and 
compared a priori upon the ground of ana- 
logy alone, the latter would have the fair- 
est pretensions to public confidence. 1 he 
natural and the inoculated cow-pox, we have 
already said, are ingrafted upon the system in 
nearly a similar manner; in the instance of 
variolous infection, this is not the case. Fur- 
ther, the vaccine matter, whether taken di- 
rectly from the cow, or from the arm of an 
inoculated person, produces an affection 
which is not so generally dissimilar as the in- 
grafted and naturally received smallpox; 
what authority then ’have we for inferring 
that the virus undergoes that specific change 
in the human body, which the theory ot Mr. 
Goldson supposes ? If then permanence of 
security is allowed to the natural (and the 
admission of this, from a man of such ability 
and candour as Mr. Goldson, is exceedingly 
material), we cannot but suppose it repug- 
nant to every principle of analogy, to deny 
it to the inoculated cow-pox. 
It is necessary to remark, that the cases 
which have been collected and recorded, do 
by no means serve to strengthen the suspi- 
cion of immunity for a given time; for the 
utmost irregularity has been shewn, with re- 
spect to the period of variolous subsequent to 
VACCINATION. 
vaccine infection. “ The cases , ’* says T)r. 
Willan, “ which- 1 have adduced of variolous 
eruption, took place without any certain 
order, from five months to "seven years after 
vaccination. If it is said that the preventive 
power of the cow-pox ceases in some per- 
sons at the end of a month or two, while in 
others it lasts sixty or seventy years, accord- 
ing to the varieties of constitution, the as- 
sertion is too vague to admit of an answer.” 
The inoculated small pox, when first intro- 
duced, was limited like the vaccine ; first to 
two, afterwards to three, and then to four 
years ; but experience has fully established 
the falsity of these assumptions, and the most 
determined sceptic no longer talks of tem- 
porarv immunity from variolous inoculation. 
To urge the argument further against the 
doctrine of partial and limited security, would 
be, we think, superfluous; unsupported by 
analogy, and unstistained by fact, it falls mole 
sua. 
We now proceed to extract from Dr. 
Willan’s treatise the characteristics of perfect, 
and marks of spurious, vaccination. 
“ Vaccination, “ says our author, “ is ac- 
counted perfect, when recent lymph has 
been carefully inserted beneath the cuticle, 
in a person free from any contagious disor- 
der; and has produced a semitransparent 
pearl-coloured vesicle, which, after the ninth 
day, is surrounded by a red areola, and after- 
wards terminates in a hard dark-coloured scab. 
The form and structure of this vesicle are pe- 
culiar; its base is circular, or somewhat ova!, 
with a diameter of about four lines on the 
tenth day. Till the end of the eighth day, 
its upper surface is uneven, being consider- 
ably more elevated at the margin than about 
the centre, and sometimes indented by one 
or two concentric furrows ; but on the ninth 
or tenth day, th.e surface becomes plane, and 
in a very few instances, the central part is 
highest. The margin is turgid, firm, shining, 
and rounded so as often to extend a little 
beyond the line of the base. 
“The vesicle consists internally of numerous 
little cells, filled with clear lymph, and com- 
municating with each other. The areola, 
which is formed round the vesicle, is of an 
intense red colour. Its diameter differs in 
different persons, from a quarter of an inch 
to two inches, and it is usually attended with 
a considerable tumour and hardness of the 
adjoining cellular membrane. On the 
eleventh and twelfth day, as the areola de- 
clines, the surface of the vesicle becomes 
brown in the centre, and less clear at the 
margins. The cuticle then begins to sepa^ 
rate, and the fluid in the cells gradually con- 
cretes into a hard rounded scab of a reddish- 
brown colour. The scab becomes at length 
black, contracted, and dry, but it is not de- 
tached until after the twentieth day from the 
inoculation. It leaves a permanent circular 
cicatrix, about five lines in diameter, and a 
little depressed, the surface being marked 
with very minute pits or indentations, denot- 
ing the number* of cells, of which the vesicle 
has been composed.” 
Such are the general characteristics of per- 
fect vaccination. Imperfect vaccination is 
not characterised by any uniform sign or cri- 
terion, but exhibits in different cases very 
different appearances, as pustules, ulcer- 
ations, or vesicles of an irregular form. The 
vaccine pustule is conoidal ; it increases ra*8 
pidly from the second to the fifth or sixth- 
day, when it is raised on a hard inflamed! 
base, with diffuse redness extending bevond- 
it on the skin. It is usually broken before- 
the end of the sixth day, and is soon after 
succeeded by an irregular yellowish-brown, 
scab. The redness disappears in a day or 
two, and the tumour gradually subsides. 
“ Vaccination is imperfect or insufficient,! 
1. When the fluid employed has lost some! 
of its original properties. 2 . When the pern 
sons inoculated were soon afterwards affected 
with any contagious fever. 3. When they! 
are affected at the time of inoculation, with! 
some chronic cutaneous disorders. 
“ 1. The qualities of the vaccine fluid are 
altered, soon after the appearance of an in- 
flamed areola round the vesicle ; and the- 
fluid, although taken out of a vesicle in the 
best possible state, may be injured by heat, 
exposure to air, rust, moisture, and other 
causes. 
“ When scales are formed over variolous 
pustules, and vaccine vesicles, the matter 
they afford is often acrid and putrescent • 
and if inoculated, it perhaps neither com- 
municates the vaccine pock nor the small 
pox, but produces a fatal disease, with symp- 
toms similar to those which arise from slight 
wounds received in dissecting putrid bodies. 
Should the pustules remain entire till the 
twentieth day of eruption, matter taken fromt 
them, even at that period, will sometimes 
communicate the disease in its usual form, 
though perhaps with considerable virulence. 
We are, however, now assured on good au- 
thority, that matter improperly kept, or the 
thick matter from collapsed and scabbing 
variolous pustules, and used for the purpose 
of inoculation, does not always produce the 
small pox, nor prevent the future occurrence 
of that disease, although the persons inocu- 
lated may have had inflammation and suppu- 
ration of the arm, and pains in the axilla, 
with fever and eruptions on the ninth or 
tenth day. In like manner, if the vaccine 
fluid employed is taken at a late period, as 
from the twelfth to the eighteenth day, it 
does not always produce the genuine cellular 
vesicle, but is in some cases wholly ineffici- 
ent, while in others it suddenly excites a pus# 
tide or ulceration, in others an irregular 
vesicle, and in others erysipelas. Failures; 
may have been occasioned by repeatedly 
puncturing or draining the vesicle, on two. 
or three successive days 
“ 2. Eruptive fevers, and other febrile dis- 
eases, interfere with the progress of the vac- 
cine vesicle. The measles, scarlatina, vari- 
cella, typhus, and influenza, appearing soon 
after vaccination, either render it ineffective* 
or suspend the action of (he virus. 
“ 3 . The cutaneous diseases which some- 
times impede the formation of the genuine 
vaccine vesicle, are herpes (including the 
shingles, and vesicular ring-worm), the dry 
and the humid tetter, and the lichen; but 
especially the porrigo (or tinea), comprising 
the varieties denominated crusta-lactea,. 
area, achores, and favi, all of which are con- 
tagious. To these should perhaps be added 
the itch and prurigo.” 
“ The right inference,” our author in an- 
other part of his treatise observes, “ from 
the mistakes or failures, and from the nicety 
of vaccine inoculation, is, that those only 
