INOCULATION. 
When the fever has come on, no particular medicines 
.are required ; but, if every circumftance be not favourable, 
the treatment mull be the fame as in the natural lmall- 
pox where fimilar fymptoms occur. Boerhaave fiift fug- 
gelled that an eruption was not neceffary 5 and there is lit¬ 
tle doubt but that the real difeafe confifts in the fever at 
the proper period after infection. Even after eruptions 
have appeared, we have feen them checked, without matu¬ 
ration, by free expofure to cold air 5 nor did the patient 
experience the flighted inconvenience. If then.a portion 
of our fluids is to be aflimilated by the ferment, it is ne- 
ceflarily a fmall one, and foon difappears. In faft, how¬ 
ever, the aflimilatory procefs takes place only in the puf- 
tules. 
Vaccine Inoculation , or Cow-pox .—Variolas vaccina, or cow- 
pox, is the name commonly given to a very Angular dif- 
eal'e, which for fome years palt has occupied a great lhare 
of the attention of medical men. It had been many years 
prevalent in fome of the great dairy-counties in England, 
particularly Gloucefterlhire 5 and it had been long under¬ 
stood by the farmers and others in thefe counties, that it 
for ever exempted all perfons who had been infefted with 
it from the contagion of fmall-pox. It is very furpriflng 
that, though they knew this faft, and although no perfon 
had ever been known to die of the cow-pox, they never 
thought of having recourfe to a voluntary infection of 
this kind, in order to free themfelves and their families 
from the poflibility of being infefted with the variolous 
poifon, which fo often proves mortal. In one cafe, in¬ 
deed, communicated to Dr. Pearfon by Mr. Dovvne of 
B rid port, the experiment was long ago tried by a farmer 
upon his own perfon, and with complete fuccefs ; but this 
only makes it the more wonderful that his example fhould 
not have been followed. In the town of Kiel, however, 
in the duchy of Ilolftein, where the difeafe is faid to be 
well known, as frequently affecting cows, we are told that 
children are fometimes inoculated, with cow-pox, (die fin- 
nen,) with a view to preferve their beauty ; but that the 
people in the country do not like this inoculation, be- 
caufe they pretend that it leaves behind it ieveral dif- 
orders. 
With thefe exceptions, Dr. Jenner was the firft perfon 
who introduced the vaccine inoculation ; and to him the 
public are alfo indebted for the firft careful and accurate 
xnveftigation of this iriterefting fubjeft. The following is 
his account of the origin and hiftory of the difeafe, and 
of its charafteriftic fymptoms. 
« There is a difeafe to which the horfe, from his (late 
of domeftication, is frequently fubjeft. The farriers have 
termed it the greafe. It is an inflammation and fwelling 
in the heel, from which iflues matter poffefling properties 
of a very peculiar kind, which feems capable of generat¬ 
ing a difeafe in the human body, (after it has undergone 
the modification which I (hall prefently fpeak of,) which 
bears fo ftrong a refemblance to the fmall-pox, that I 
think it highly probable that it may be the fource of that 
difeafe. In this dairy-county (Gloucelterfliire), a great 
number of cows are kept, and the office of milking is per¬ 
formed indiferiminately by men and maid fervants. One 
of the former having been appointed to apply dreflings to 
file heels of a horfe affefted with the greafe , and not pay¬ 
ing due attention to cleanlinefs, incautioufly bears his 
part-in milking the cows with fome particles of the in¬ 
fectious matter adhering to his fingers-. When this is the 
cafe, it commonly happens that a difeafe is communicated 
to the cows, and from the cows to the dairy-maids, which 
fpreads through the farm until mod of the cattle and do- 
fneftics feel its unpleafant confequences. This difeafe has 
obtained the name of the cpw-pox. It appears on the 
■nipples of the cows in the form of irregular puftules. At 
their firft appearance they are commonly of a palifh blue, 
dr rather of a colour fomewhat approaching to livid, and 
are furrounded by an eryfipelatous inflammation. Thefe 
puftules, unlefs a timely remedy be applied, frequently 
degenerate into phagedenic ulcers, which prove extremely 
VOX,. XI No. 737. 
or 
troublefome. The animals become mdifpofed, and the 
fecretion of milk-is much leflened. Inflamed fpots now 
begin to appear on different parts of the hands of the do- 
medics employed in milking, and fometimes on the wrifts, 
which quickly run on to fuppuration, firft affirming the 
appearance of the fmall vefications produced by a burn. 
Moft commonly they appear about the joints of the fin¬ 
gers, and at their extremities ; but whatever parts are af¬ 
fefted, if the fitualion will admit, thefe fuperficial fuppu- 
rations put on a circular form, with their edges more ele¬ 
vated than their centre, and of a colour diftantly approach¬ 
ing to blue. Abforption takes place, and tumors appear 
in the axilla. The fyftem becomes affefted, the pulfe is 
quickened, and fhiverings, with general laffitude, and 
pains about the loins and limbs, with -vomiting, come on. 
The head is painful, and the patient is now and then even 
affefted with delirium. Thefe fymptoms, varying in their 
degrees of violence, generally continue from one day to 
three or four, leaving ulcerated fores about the hands, 
which, from the fenfibility of the parts, are very trouble- 
fotne, and commonly heal fiowly, frequently becoming 
phagedenic, like thofe from whence they fprung. The 
lips, noftrils, eyelids, and other parts of the body, are 
fometimes affefted with fores ; but thefe evidently arife 
from their being needlefsly rubbed or fcratched with the 
patient’s infefted fingers. No eruptions of the (kin have 
followed the decline of the feverilh fymptoms in any in- 
ftance that has come under my infpeftion, one only ex¬ 
cepted ; and in this cafe a very few appeared on the arms j 
they were very minute, of a vivid red colour, and foon 
died away without advancing to maturation ; fo that I 
cannot determine whether they had any conneftion with 
the preceding fymptoms. Thus the difeafe makes its pro- 
grefs from the horfe to the nipple of the cow, and from 
the cow to the human fubjeft. 
“ Morbid matter of various kinds, when abforbed into 
the fyftem, may produce eftefts in fome degree fimilar ; 
but what renders the cow-pox virus fo extremely Angular 
is, that the perfon who has been thus affefted is for ever 
after fecure from the infection of the fmall-pox; neither 
expofure to the variolous effluvia, nor the infertion of the 
matter into the fkin, producing this diftemper. It is ne¬ 
ceffary to obferve, that puftulous fores frequently appear 
fpontaneoufly on the nipples of cows ; and inftances have 
occurred, though very rarely, of the hands of the fervants 
employed in milking being affefted with fores in confe- 
quence, and even of their feeling an indifpofition from ab¬ 
forption. Thefe puftules are of a much milder nature 
than thofe which arife from that contagion which confti- 
tutes the true cow-pox. They are always free from the 
bluifli or livid tint fo confpicuous in that difeafe. No 
eryfipelas attends them, nor do they fhow any phagedenic 
dilpofition, as in the other cafe, but quickly terminate in 
a fcab, without creating any apparent diforder in the cow. 
This complaint appears at various feafons in the year, but 
moft commonly in the fpring, when the cows are firft 
taken from their winter food and fed with grafs It is 
very apt to appear alfo when they are fuckling their young. 
But this difeafe is not to be confidered as fimilar in any 
refpeft to that of which I am treating, as it is incapable 
of producing any fpecinc effefts on the human conftitu- 
tion. However, it is of the greateft confequence to point 
it out here, left the want of diferimination fliould occa- 
Aon an idea of fecurity from the infeftion of the finall- 
pox, which might prove delufive.” Dr. Jenner, adds, that 
the active quality of the virus from the horfe’s heels is 
greatly increafed after it has afted on the nipples of the 
cow, as it rarely happens that the horfe aftefts his drefler 
with fores, and as rarely that a milkmaid efcapes the in¬ 
feftion when (lie milks infefted cows. It is molt aftive 
at the commencement of the difeafe, even before it has 
acquired a pus-like appearance. Indeed the doctor is ra¬ 
ther induced to think that the matter lofes this property 
entirely as foon as it is fecreted in the form of pus, and 
that it is the thin darkifh-looking fluid only, oozing from 
C e ' the 
