John Lothrop Motley - "History of the United Netherlands, 1592"

Arthur M. Winfield - "The Rover Boys in the Jungle"

John Lothrop Motley - "History of the United Netherlands, 1594"

Louisa May Alcott - "An Old fashioned Girl"

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PHILADELPHIA, Pa. -- The Philadelphia literary world will celebrate the launch of two new players today, April 10th: Kay Square Press, a new publishing company focused on Philadelphia-area artists, their stories, and their art; and Kay Square's first release, 'With the Rich and Mighty: Emlen Etting of Philadelphia' (ISBN: 978-0-9815129-0-7), a critical biography by Kenneth C. Kaleta.

FlatSigned Press Alleges Don Imus Remarks Damage Legacy of President Gerald R. Ford
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Books: The Harvard Classics Volume 38

V >> Various >> The Harvard Classics Volume 38




On the eighth day matter was taken from the arm of this girl
(Mary James) and inserted into the arms of her mother and brother
(neither of whom had had either the smallpox or the cow-pox), the
former about fifty years of age, the latter six.

On the eighth day after the insertion the boy felt indisposed,
and continued unwell two days, when a measles-like rash appeared
on his hands and wrists, and was thinly scattered over his arms.
The day following his body was marbled over with an appearance
somewhat similar, but he did not complain, nor did he appear
indisposed. A few pustules now appeared, the greater part of
which went away without maturating.

On the ninth day the mother began to complain. She was a little
chilly and had a headache for two days, but NO PUSTULE APPEARED
on the skin, nor had she any appearance of a rash.

The family was attended by an elderly woman as a nurse, who in
her infancy had been exposed to the contagion of the smallpox,
but had resisted it. This woman was now infected, but had the
disease in the slightest manner, a very few eruptions appearing,
two or three of which only maturated.

From a solitary instance like that adduced of Mary James, whose
constitution appears to have resisted the action of the variolous
virus, after the influence of the cow-pox virus had been so soon
arrested in its progress, no positive conclusion can be fairly
drawn; nor from the history of the three other patients who were
subsequently infected, but, nevertheless, the facts collectively
may be deemed interesting.

That one mild variety of the smallpox has appeared I have already
plainly shewn; [Footnote: See Inquiry into the Causes and Effects
of the Variolae Vaccinae, p. 54 (of original article)], and by
the means now mentioned we probably have it in our power to
produce at will another.

At the time when the pustule was destroyed in the arm of Mary
James I was informed she had been indisposed about twelve hours;
but I am now assured by those who were with her that the space of
time was much less. Be that as it may, in cases of cow-pox
inoculation I would not recommend any application to subdue the
action of the pustule until convincing proofs had appeared of the
patient's having felt its effects at least twelve hours. No harm,
indeed, could ensue were a longer period to elapse before the
application was made use of. In short, it should be suffered to
have as full an effect as it could, consistently with the state
of the arm.

As the cases of inoculation multiply, I am more and more
convinced of the extreme mildness of the symptoms arising merely
from the primary action of the virus on the constitution, and
that those symptoms which, as in the accidental cow-pox, affect
the patient with severity, are entirely secondary, excited by the
irritating processes of inflammation and ulceration; and it
appears to me that this singular virus possesses an irritating
quality of a peculiar kind, but as a single cow-pox pustule is
all that is necessary to render the variolous virus ineffectual,
and as we possess the means of allaying the irritation, should
any arise, it becomes of little or no consequence.

It appears then, as far as an inference can be drawn from the
present progress of cow-pox inoculation, that it is an accidental
circumstance only which can render this a violent disease, and a
circumstance of that nature which, fortunately, it is in the
power of almost every one to avoid. I allude to the communication
of the disease from cows. In this case, should the hands of the
milker be affected with little accidental sores to any extent,
every sore would become the nidus of infection and feel the
influence of the virus; and the degree of violence in the
constitutional symptoms would be in proportion to the number and
to the state of these local affections. Hence it follows that a
person, either by accident or design, might be so filled with
these wounds from contact with the virus that the constitution
might sink under the pressure.

Seeing that we possess the means of rendering the action of the
sores mild, which, when left to chance, are capable of producing
violent effects; and seeing, too, that these sores bear a
resemblance to the smallpox, especially the confluent, should it
not encourage the hope that some topical application might be
used with advantage to counteract the fatal tendency of that
disease, when it appears in this terrific form? At what stage or
stages of the disease this may be done with the most promising
expectation of success I will not pretend now to determine. I
only throw out this idea as the basis of further reasoning and
experiment.

I have often been foiled in my endeavours to communicate the cow-
pox by inoculation. An inflammation will sometimes succeed the
scratch or puncture, and in a few days disappear without
producing any further effect. Sometimes it will even produce an
ichorous fluid, and yet the system will not be affected. The same
thing we know happens with the smallpox virus.

Four or five servants were inoculated at a farm contiguous to
this place, last summer, with matter just taken from an infected
cow. A little inflammation appeared on all their arms, but died
away without producing a pustule; yet all these servants caught
the disease within a month afterwards from milking the infected
cows, and some of them had it severely. At present no other mode
than that commonly practiced for inoculating the smallpox has
been used for giving the cow-pox; but it is probable this might
be varied with advantage. We should imitate the casual
communication more clearly were we first, by making the smallest
superficial incision or puncture on the skin, to produce a little
scab, and then, removing it, to touch the abraded part with the
virus. A small portion of a thread imbrued in the virus (as in
the old method of inoculating the smallpox) and laid upon the
slightly incised skin might probably prove a successful way of
giving the disease; or the cutis might be exposed in a minute
point by an atom of blistering plaster, and the virus brought in
contact with it. In the cases just alluded to, where I did not
succeed in giving the disease constitutionally, the experiment
was made with matter taken in a purulent state from a pustule on
the nipple of a cow.

Is PURE PUS, though contained in a smallpox pustule, ever capable
of producing the smallpox perfectly? I suspect it is not. Let us
consider that it is always preceded by the limpid fluid, which,
in constitutions susceptible of variolous contagion, is always
infectious; and though, on opening a pustule, its contents may
appear perfectly purulent, yet a given quantity of the limpid
fluid may, at the same time, be blended with it, though it would
be imperceptible to the only test of our senses, the eye. The
presence, then, of this fluid, or its mechanical diffusion
through pus, may at all times render active what is apparently
MERE PUS, while its total absence (as in stale pustules) may be
attended with the imperfect effects we have seen.

It would be digressing too widely to go far into the doctrine of
secretion, but as it will not be quite extraneous, I shall just
observe that I consider both the pus and the limpid fluid of the
pustule as secretions, but that the organs established by nature
to perform the office of secreting these fluids may differ
essentially in their mechanical structure. What but a difference
in the organization of glandular bodies constitutes the
difference in the qualities of the fluids secreted? From some
peculiar derangement in the structure or, in other words, some
deviation in the natural action of a gland destined to create a
mild, innoxious fluid, a poison of the most deadly nature may be
created; for example: That gland, which in its sound state
secretes pure saliva, may, from being thrown into diseased
action, produce a poison of the most destructive quality. Nature
appears to have no more difficulty in forming minute glands among
the vascular parts of the body than she has in forming blood
vessels, and millions of these can be called into existence, when
inflammation is excited, in a few hours. [Footnote: Mr. Home, in
his excellent dissertation on pus and mucus, justifies this
assertion.]

In the present early stage of the inquiry (for early it certainly
must be deemed), before we know for an absolute certainty how
soon the virus of the cow-pox may suffer a change in its specific
properties, after it has quitted the limpid state it possesses
when farming a pustule, it would be prudent for those who have
been inoculated with it to submit to variolous inoculation. No
injury or inconvenience can accrue from this; and were the same
method practiced among those who, from inoculation, have felt the
smallpox in an unsatisfactory manner at any period of their
lives, it might appear that I had not been too officious in
offering a cautionary, hint in recommending a second inoculation
with matter in its most perfect state.

And here let me suppose, for argument's sake (not from
conviction), that one person in an hundred after having had the
cow-pox should be found susceptible of the smallpox, would this
invalidate the utility of the practice? For, waiving all other
considerations, who will deny that the inoculated smallpox,
although abstractedly it may be considered as harmless, does not
involve in itself something that in numberless instances proves
baneful to the human frame.

That in delicate constitutions it sometimes excites scrofula is a
fact that must generally be subscribed to, as it is so obvious to
common observation. This consideration is important.

As the effects of the smallpox inoculation on those who have had
the cow-pox will be watched with the most scrupulous eye by those
who prosecute this inquiry, it may be proper to bring to their
recollection some facts relative to the smallpox, which I must
consider here as of consequence, but which hitherto seem not to
have made a due impression.

It should be remembered that the constitution cannot, by previous
infection, be rendered totally unsusceptible of the variolous
poison; neither the casual nor the inoculated smallpox, whether
it produces the disease in a mild or in a violent way, can
perfectly extinguish the susceptibility. The skin, we know, is
ever ready to exhibit, though often in a very limited degree, the
effects of the poison when inserted there; and how frequently do
we see, among nurses, when much exposed to the contagion,
eruptions, and these sometimes preceded by sensible illness! yet
should any thing like an eruption appear, or the smallest degree
of indisposition, upon the insertion of the variolous matter on
those who have gone through the cow-pox, my assertions respecting
the peculiarities of the disease might be unjustly discredited.

I know a gentleman who, many years ago, was inoculated for the
smallpox, but having no pustules, or scarcely any constitutional
affection that was perceptible, he was dissatisfied, and has
since been repeatedly inoculated. A vesicle has always been
produced in the arm in consequence, with axillary swelling and a
slight indisposition; this is by no means a rare occurrence. It
is probable that fluid thus excited upon the skin would always
produce the smallpox.

On the arm of a person who had gone through the cow-pox many
years before I once produced a vesication by the insertion of
variolous matter, and, with a little of the fluid, inoculated a
young woman who had a mild, but very efficacious, smallpox in
consequence, although no constitutional effect was produced on
the patient from whom the matter was taken. The following
communication from Mr. Fewster affords a still clearer
elucidation of this fact. Mr. Fewster says: "On the 3d of April,
1797, I inoculated Master H--, aged fourteen months, for the
smallpox. At the usual time he sickened, had a plentiful
eruption, particularly on his face, and got well. His nursemaid,
aged twenty-four, had many years before gone through the
smallpox, in the natural way, which was evident from her being
much pitted with it. She had used the child to sleep on her left
arm, with her left cheek in contact with his face, and during his
inoculation he had mostly slept in that manner. About a week
after the child got well she (the nurse) desired me to look at
her face, which she said was very painful. There was a plentiful
eruption on the left cheek, BUT NOT ON ANY OTHER PART OF THE
BODY, which went on to maturation.

"On enquiry I found that three days before the appearance of the
eruption she was taken with slight chilly fits, pain in her head
and limbs, and some fever. On the appearance of the eruption
these pains went off, and now, the second day of the eruption,
she complains of a little sore throat. Whether the above symptoms
are the effects of the smallpox or a recent cold I do not know.
On the fifth day of the eruption I charged a lancet from two of
the pustules, and on the next day I inoculated two children, one
two years, the other four months old, with the matter. At the
same time I inoculated the mother and eldest sister with
variolous matter taken from Master H--. On the fifth day of their
inoculation ALL their arms were inflamed alike; and on the eighth
day the eldest of those inoculated from the nurse sickened, and
the youngest on the eleventh. They had both a plentiful eruption,
from which I inoculated several others, who had the disease very
favourably. The mother and the other child sickened about the
same time, and likewise had a plentiful eruption.

"Soon after, a man in the village sickened with the smallpox and
had a confluent kind. To be convinced that the children had had
the disease effectually I took them to his house and inoculated
them in both arms with matter taken from him, but without
effect."

These are not brought forward as uncommon occurrences, but as
exemplifications of the human system's susceptibility of the
variolous contagion, although it has been previously sensible of
its action.

Happy is it for mankind that the appearance of the small-pox a
second time on the same person, beyond a trivial extent, is so
extremely rare that it is looked upon as a phaenomenon! Indeed,
since the publication of Dr. Heberden's paper on the Varicellae,
or chicken-pox, the idea of such an occurrence, in deference to
authority so truly respectable, has been generally relinquished.
This I conceive has been without just reason; for after we have
seen, among many others, so strong a case as that recorded by Mr.
Edward Withers, Surgeon, of Newbury, Berks, in the fourth volume
of the Memoirs of the Medical Society of London (from which I
take the following extracts), no one, I think, will again doubt
the fact.

"Mr. Richard Langford, a farmer of West Shefford, in this county
(Berks), about fifty years of age, when about a month old had the
smallpox at a time when three others of the family had the same
disease, one of whom, a servant man, died of it. Mr. Langford's
countenance was strongly indicative of the malignity of the
distemper, his face being so remarkably pitted and seamed as to
attract the notice of all who saw him, so that no one could
entertain a doubt of his having had that disease in a most
inveterate manner." Mr. Withers proceeds to state that Mr.
Langford was seized a second time, had a bad confluent smallpox,
and died on the twenty-first day from the seizure; and that four
of the family, as also a sister of the patient's, to whom the
disease was conveyed by her son's visiting his uncle, falling
down with the smallpox, fully satisfied the country with regard
to the nature of the disease, which nothing short of this would
have done; the sister died.

"This case was thought so extraordinary a one as to induce the
rector of the parish to record the particulars in the parish
register."

It is singular that in most cases of this kind the disease in the
first instance has been confluent; so that the extent of the
ulceration on the skin (as in the cow-pox) is not the process in
nature which affords security to the constitution.

As the subject of the smallpox is so interwoven with that which
is the more immediate object of my present concern, it must plead
my excuse for so often introducing it. At present it must be
considered is a distemper not well understood. The inquiry I have
instituted into the nature of the cow-pox will probably promote
its more perfect investigation.

The inquiry of Dr. Pearson into the history of the cow-pox having
produced so great a number of attestations in favour of my
assertion that it proves a protection to the human body from the
smallpox, I have not been assiduous in seeking for more; but as
some of my friends have been so good as to communicate the
following, I shall conclude these observations with their
insertion.

Extract of a letter from Mr. Drake, Surgeon, at Stroud, in this
county, and late Surgeon to the North Gloucester Regiment of
Militia:

"In the spring of the year 1796 I inoculated men, women, and
children to the amount of about seventy. Many of the men did not
receive the infection, although inoculated at least three times
and kept in the same room with those who actually underwent the
disease during the whole time occupied by them in passing through
it. Being anxious they should, in future, be secure against it, I
was very particular in my inquiries to find out whether they ever
had previously had it, or at any time been in the neighbourhood
of people labouring under it. But, after all, the only
satisfactory information I could obtain was that they had had the
cow-pox. As I was then ignorant of such a disease affecting the
human subject, I flattered myself what they imagined to be the
cow-pox was in reality the smallpox in a very slight degree. I
mentioned the circumstance in the presence of the officers, at
the time expressing my doubts if it were not smallpox, and was
not a little surprised when I was told by the Colonel that he had
frequently heard you mention the cow-pox as a disease endemial to
Gloucestershire, and that if a person were ever affected by it,
you supposed him afterwards secure from the smallpox. This
excited my curiosity, and when I visited Gloucestershire I was
very inquisitive concerning the subject, and from the information
I have since received, both from your publication and from
conversation with medical men of the greatest accuracy in their
observations, I am fully convinced that what the men supposed to
be cow-pox was actually so, and I can safely affirm that they
effectually resisted the smallpox."

Mr. Fry, Surgeon, at Dursley in this county, favours me with the
following communication:

"During the spring of the year 1797 I inoculated fourteen hundred
and seventy-five patients, of all ages, from a fortnight old to
seventy years; amongst whom there were many who had previously
gone through the cow-pox. The exact number I cannot state; but if
I say there were nearly thirty, I am certainly within the number.
There was not a single instance of the variolous matter producing
any constitutional effect on these people, nor any greater degree
of local inflammation than it would have done in the arm of a
person who had before gone through the smallpox, notwithstanding
it was invariably inserted four, five, and sometimes six
different times, to satisfy the minds of the patients. In the
common course of inoculation previous to the general one scarcely
a year passed without my meeting with one or two instances of
persons who had gone through the cow-pox, resisting the action of
the variolous contagion. I may fairly say that the number of
people I have seen inoculated with the smallpox who, at former
periods, had gone through the cow-pox, are not less than forty;
and in no one instance have I known a patient receive the
smallpox, notwithstanding they invariably continued to associate
with other inoculated patients during the progress of the
disease, and many of them purposely exposed themselves to the
contagion of the natural smallpox; whence I am fully convinced
that a person who had fairly had the cow-pox is no longer capable
of being acted upon by the variolous matter.

"I also inoculated a very considerable number of those who had
had a disease which ran through the neighbourhood a few years
ago, and was called by the common people the swine-pox, not one
of whom received the smallpox. [Footnote: This was that mild
variety of the smallpox which I have noticed in the late Treatise
on the Cow-Pox (p. 233).]

"There were about half a dozen instances of people who never had
either the cow-or swine-pox, yet did not receive the smallpox,
the system not being in the least deranged, or the arms inflamed,
although they were repeatedly inoculated, and associated with
others who were labouring under the disease; one of them was the
son of a farrier."

Mr. Tierny, Assistant Surgeon of the South Gloucester Regiment of
Militia, has obliged me with the following information:

"That in the summer of the year of 1798 he inoculated a great
number of the men belonging to the regiment, and that among them
he found eleven who, from having lived in dairies, had gone
through the cow-pox. That all of them resisted the smallpox
except one, but that on making the most rigid and scrupulous
enquiry at the farm in Gloucestershire, where the man said he
lived when he had the disease, and among those with whom, at the
same time, he declared he had associated, and particularly of a
person in the parish, whom he said had dressed his fingers, it
most clearly appeared that he aimed at an imposition, and that he
never had been affected with the cow-pox." [Footnote: The public
cannot be too much upon their guard respecting persons of this
description.] Mr. Tierny remarks that the arms of many who were
inoculated after having had the cow-pox inflamed very quickly,
and that in several a little ichorous fluid was formed.

Mr. Cline, who in July last was so obliging at my request as to
try the efficacy of the cow-pox virus, was kind enough to give me
a letter on the result of it, from which the following is an
extract:

"My DEAR SIR:

"The cow-pox experiment has succeeded admirably. The child
sickened on the seventh day, and the fever, which was moderate,
subsided on the eleventh. The inflammation arising from the
insertion of the virus extended to about four inches in diameter,
and then gradually subsided, without having been attended with
pain or other inconvenience. There were no eruptions.

"I have since inoculated him with smallpox matter in three
places, which were slightly inflamed on the third day, and then
subsided.

"Dr. Lister, who was formerly physician to the Smallpox Hospital,
attended the child with me, and he is convinced that it is not
possible to give him the smallpox. I think the substituting the
cow-pox poison for the smallpox promises to be one of the
greatest improvements that has ever been made in medicine; and
the more I think on the subject, the more I am impressed with its
importance.

"With great esteem

"I am, etc., "HENRY CLINE.

"Lincoln's Inn Fields, August 2, 1798."

From communications, with which I have been favoured from Dr.
Pearson, who has occasionally reported to me the result of his
private practice with the vaccine virus in London, and from Dr.
Woodville, who also has favoured me with an account of his more
extensive inoculation with the same virus at the Smallpox
Hospital, it appears that many of their patients have been
affected with eruptions, and that these eruptions have maturated
in a manner very similar to the variolous. The matter they made
use of was taken in the first instance from a cow belonging to
one of the great milk farms in London. Having never seen
maturated pustules produced either in my own practice among those
who were casually infected by cows, or those to whom the disease
had been communicated by inoculation, I was desirous of seeing
the effect of the matter generated in London, on subjects living
in the country. A thread imbrued in some of this matter was sent
to me, and with it two children were inoculated, whose cases I
shall transcribe from my notes.

Stephen Jenner, three years and a half old.

3d day: The arm shewed a proper and decisive inflammation.

6th: A vesicle arising.

7th: The pustule of a cherry colour.

8th: Increasing in elevation. A few spots now appear on each arm
near the insertion of the inferior tendons of the biceps muscles.
They are very small and of a vivid red colour. The pulse natural;
tongue of its natural hue; no loss of appetite or any symptom of
indisposition.

9th: The inoculated pustule on the arm this evening began to
inflame, and gave the child uneasiness; he cried and pointed to
the seat of it, and was immediately afterwards affected with
febrile symptoms. At the expiration of two hours after the
seizure a plaster of ung. hydrarg. fort, was applied, and its
effect was very quickly perceptible, for in ten minutes he
resumed his usual looks and playfulness. On examining the arm
about three hours after the application of the plaster its
effects in subduing the inflammation were very manifest.