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speak. I said in 1802, that a cerrect definition, accurately discriminating the spurious pustule from the true, was not to be found in any book I had ever examined. It is to be learnt by the eye, and we know that the eye, as well as the ear, admits of cultivation: a finished connoisseur painting can discriminate the copy a portrait from the original, by e same hand. But who can teach it skill by words?

We know from experience that
ccine matter taken at an advanced
riod of a forward pustule, will oc-
ion nearly the same local appear-
es, and excite a severe but falla-
is disorder; as not possessing the
cific prophylactic power. Ac-
ding to my own observation, these
acious cases appear under two
ns. The first arises from the
lication of matter impoverished
t respects the specific virus, pro-
ly weakened by being diluted
lymph, serum, or the aqueous
tion of the blood; or else deteri-
ed by long keeping, or by ex-
ive hot weather, or by being fro-
and then thawed, for

Here frost performs th' effect of fire."*
atter thus impoverished, appears
fect the skin merely; and seems
ruggle on to raise the specific in-
mation, and operate the propa-
on of the specific virus, but fails
vant of sufficient strength to car-
on. Most commonly its stimu-
not great enough to excite the
hatics to absorb it; hence there
efflorescence, and, of course,
nstitutional affection whatever.
e is only a soft scab formed,
ing gradually round the punc-
part, having a cranberry-col-
I base, which, fading away,
s behind a crustaceous, amber-
red scab, whence a transparent
sometimes issues, but most com-
ya purulent one.

he second form of the spurious
e, owes its origin to matter ta-

* Milton.

ken from an originally genuine kine pock pustule, but at so late a period, that the specific virus is absorbed; hence we may learn the uncertainty of SCABS for the purpose of re-inoculations. Sometimes the scab is thrown off, and the part ulcerates, and pours forth a glairy fluid, which some have mistaken for the true pellucid virus. After this, pus is formed, and sometimes the pus is changed to putridity and then it is a sort of acrid poison. The hard scab produced from this is always fallacious. This is a rapid, angry-looking bile, with a deep red efflorescence, producing, now and then, severe symptoms, as severe head ache, rapid pulse, thirst, and every other mark of fever, from a local cause. This sore differs greatly from the slow and reluctant one, before mentioned. Very many such cases occurred amongst us in the autumn of 1800; and from both causes here mentioned. Dr Jenner experienced the like perplexity with myself, at his first setting out in the practice. Dr Woodville, as well as Dr Pearson, insisted that the vaccine matter was capable of producing variolous pustules; and these London Physicians confused the matter greatly,* and led many into error.

Dr Jenner complained more than once, in his letters to me, that the most arduous task he had to perform, was that of making practitioners sensible of the absolute necessity of attending to the QUALITY of the vaccine matter. "The vaccine fluid," says he, "is extremely delicate in its texture, and subject, from a variety of causes, some of them apparently trifling, to partial, and to general decomposition: to partial, when it retains its qualities imperfectly-to general, when these qualities are entirely destroyed." The perfect Kine Pock virus only, can produce the perfect vaccine pustule. The perfect small pox mat

Jenner

ter only, can produce the perfect variolous distemper, that which shall destroy the predisposition, or consume the pabulum that gives rise to small pox.

It is a prevalent notion among people, that the distinct and the confluent small pox is owing to the mild, or the malignant quality of the matter used in inoculation. But it is owing rather to the state, condition, or idiosyncrasy of the patient himself, depending on a cause hitherto inscrutable, as hidden as that which prevents all other animals from taking small pox, be they ever so much exposed to breathing a variolous at mosphere, or ever so many times inoculated.*

Many years ago, I endeavoured to solve the problem by saying thatf In a healthy person, inhabiting a clean place, breathing a salubrious air, and living temperately, a train of salutary processes are going forward in his system; digestion is well performed, the chyle is proper; blood made from that chyle is perfect, and the secretions and excretions natural and regular.

Should a simple wound be inflicted, with a clean instrument, on such a person, the inflammation thence arising, would be regular in all its stages; the pus formed, would be replete with white globules, and perfectly sweet, being as void of smell as the blood: the subsequent granulations, a consequent effect of the same cause, would be florid and firm, and a perfect restoration of the wounded part would soon follow. If such a person should be inoculated with matter from the most confluent case, his pustules shall nevertheless be distinct; the basis of each encircled by a border of crimson; the intermediate spaces will approach the

The celebrated JOHN HUNTER tried this experiment till he was tired, on dogs -cats-cows-horses-asses, and monkies. ↑ Practical observations on Kine Pock,

119.

colour of the damask rose; the matter in each pustule will, in due time, acquire a yellow colour, and "laudable" consistency; and the reason is, -the vires vitæ are bere sufficiently strong to throw up a redoubt against the enemy, and repel his advances.

The febrile symptoms accompanying such a state are of the true synocha type.

But in a person otherwise situated, and predisposed, other and different symptoms will appear if inoculated with the same matter and from the same subject, and the inoculation performed at the same time. In him the eruptions come on sooner, are more numerous, appear in clusters, like measles, and do not maintain their circular figure, and spheroidal form; but run one into another and become flat; and when the pustules are in any measure distinct, their bases are not bounded as in the former case, by an inflamed margin; while the skin that is free from pustules is pale and flabby. The mafter in these vesicles is a whitish, or brownish sanies, and the accompanying fever is typhoid, while the concomitant inflammation is of the erysipelatous species, or that sort which shows a disposition to spread, or rather, no disposition to set bounds to itself, as in the distinct small pox.

At this period, should the depressing effects of fear unfortunately concur, the edges of the eruptions will soon show that they are too weak to resist the encroaching evil, and will all run into one shocking sore. Now instead of yellow matter, or pus, ichor only is produced. Soon after, purple spots appear, profuse hæmorrhages of thin corrupt blood pass off by the several outlets of the body, and the sufferer sinks under his weight of misery.

In such cases the violence of the disease is not occasioned by the greater "malignity" of the variolous virus used in the inoculation; but it is owing to some cause which de

presses too far the "VIRES NATURE MEDICATRICES ;" and so the potentia nociva prevail. Hence the imperfect inflammation, and imperfect suppuration; hence the symptoms of approaching dissolution, indicated by the incapacity of each pustule to confine its own matter which appears confluent throughout the skin.

From the preceding narrative it appears, that the anomalous appearances in small pox and kine pock were detailed, and cautionary advice given, as far back as 1802, but neglected. Now indeed the collective symptoms come before the public as a new and strange distemper, breaking in upon the regularity of the order of Exanthemata, filling the public mind with apprehension and anxiety; while the difficulty is with erring man, and not in unerring Nature, who never creates a new disease without an adequate and steady

cause.

I found but one person disposed to devote undivided attention to the new inoculation; and to him I gave all the aid in my power; and have ever reflected upon it with satisfacfaction; because his benevolence was commensurate with his industry and judgment. Among the vast number he has vaccinated, and the many whom he has tested with small pox, we hear nothing of VARIoloid.

Your correspondent, to me unknown, seems duly impressed with a sense of our false security. He speaks of blameable negligence; and adds, that "when so many things may occur to interrupt the progress and annul the effects of vaccination, what can we expect but that ninetenths of the cases are imperfect?" This is speaking rather stronger than my own experience would justify. Some persons, I know not whom-applied to Congress, the last session, to establish an officer whose duty it should be to preserve and distribute, under certain regulations, genuine vaccine virus, with proper

directions for conducting this highly important practice; and a Bill was brought in for that purpose, and passed two readings; but left among a heap of neglected business.

To carry this PRESERVATIVE against the greatest plague that ever inflicted mankind, into full effect, it is needful that the matter should emanate from ONE RESPONSIBLE ESTABLISHMENT; and not from twenty-four as has been suggested.

BENJAMIN WATERHOUSE.

Cambridge, June 14th, 1826.

DR DANA'S CHYMISTRY.
This is an epitome of chymical philoso-

phy, or an extended syllabus of the author's lectures on that subject, in the medical department of Dartmouth College. The most prominent trait in the character of the work, is its complete adaptedness to the situation of students

attending lectures, and to all who desire a general acquaintance with the philosopyh of the science, without the embarrassments of technicalities, idle speculations, and useless minutiæ. We are sensible of no good reason why the scanty time that is required of students to be devoted to medical education, should be at all encroached upon by an examination of mere matters of opinion and unsettled points. These, we conceive, should not find place, except by notes or reference, in books of the principles of science ;—for

if crude speculations which attend the progress of knowledge, are admitted to the dignity of a place among what are received as established principles, inducements must be lessened to mature research. The student has enough to do during the short period of his pupilage, to become properly acquainted with facts, and the immediate objects of medicine. Bordou, one of the greatest physicians which France has produced, while enumerating the various courses of lectures proposed for medical instruction, used to say, "Why do they not institute a course of common sense?" Simultaneous atten

tion to the variety of objects that are frequently crowded upon the student's mind, especially in lecture terms, excludes the advantage which might be derived from those that are really important, and although the appearance of attending the instruction of a large number of teachers may be very imposing, the advantages must be lessened in proportion to the number of objects presented to the mind at the same time. Beddoes used to complain that so much was crowded into the period assigned for medical study, that the body and mind were kept in perpetual hurry. Seneca taught that "the attention must be confined to a small number of objects, if it be expected that the mind is to receive durable impressions."

Objections like these, which are frequently urged against the use of most systematic works as text books, are, in the one which is the subject of this sketch, entirely avoided-it being the object of the author to give the facts and received doctrines of chymistry, independent of what to the student and general reader is little better than useless lumber. The first part contains an exposition of the general principles of the science, and the chymistry of inorganic substances. The second, the chymistry of organic substances, or a chymical examination of Nature. The arrangement and divisions of the subjects are happy, the expositions clear, the illustrations perspicuous and entirely satisfactory.

The work is also highly creditable to the author on the score of originality, though professing to be a compilation, and must add something to his acknowledged high reputation as a practical chymist, and public teacher in the oldest and one of the most useful medical schools in New-England. Our limits at present will not admit of any thing like a critical examination of the work, but we take this opportunity of recommending it to students, and all others who desire a view of the present state of the science, in its most intelligible and condensed form.

RESUSCITATION.

Few discoveries of the kind are destined to so great practical utility, as the farfamed Stomach Syringe. This simple instrument, by an easy process, unattended by difficulty or danger, and giving but a shadow of pain, is made to draw from the stomach its contents, and with equal facility to convey substances into that organ, in cases where there exists stricture of the oesophagus, tumours in the fauces, and indeed whenever circumstances require such aid. In instances of poisoning, its utility is evident. The new light

which has been thrown on the means of resuscitation, and the causes of the great difficulties which occur in the restoration of drowned persons, opens a new field for the operation and usefulness of this instrument.

When any person is taken out of the water insensible, and apparently lifeless, and means employed for his resuscitation, if they are at all successful, frequent retching and vomiting takes place, and large quantities of cold water are discharged from the stomach. This invariably takes place before recovery is complete. The mechanical and chilling effects of such a body of cold water on the stomach, must present an essential barrier to resuscitation; and it is not to be regarded but with attention and satisfaction, that the immediate discharge of this water by means of the stomach syringe, has been found greatly to facilitate and expedite the restoration of the natural and healthy functions.

No physician ought to be without se efficient an instrument for fulfilling the humane designs of his profession; and we are happy to find that a number of them have been imported for sale by Messrs Bartlett and Brewer, Apothecaries in this city.

NAMES OF DISEASES.

Giving names to diseases has been ridiculed by some of the greatest physicians in the world. These talented and distinguished men have pronounced it a

66

system of quackery, and when their patients have asked if they had scarlet fever, they have been in the habit of answering, you may call it scarlet, or black or white, just which you choose," and have I the rheumatism or the gout? is followed by, "both, or either, as you please to call it; you have a pain in the foot, and when you have followed my prescriptions, you will have it no longer," &c. &c.

Now the argument offered by these gen

valid that his doctor does not understand
his case, if some name—no matter wheth-
er right or wrong, whether they under-
stand it, or have ever heard of it before or
not-be not readily given to it.
In a
profession, therefore, success in which is
so dependent on whim and caprice as
ours, the evils alluded to must exist, and
ought not to bring into the shade the ob-
vious advantages of a correct and practi-
cal nosology.

OF VENESECTION.

tlemen, when they condescend to give ON THE OCCASIONAL ILL CONSEQUENCES reasons, is, that there is such an infinity of forms to disease, and one runs so into Secondary Hæmorrhage, occurring another, that it is impossible to draw at a period more or less remote durlines, and we must therefore take the ing the first twenty-four hours after symptoms as we find them, and do our bleeding, is not an unfrequent occur. best to restore health. Now this is all rence. Sometimes the quantity of true; but the same is true of all branches blood thus lost is inconsiderable, yet of science. Even men differ from each it seldom occurs without exciting distrust in the mind of the patient of other, like diseases. We can trace a rethe skill or care of the operator. semblance in the heads and intellects of This accident may take place from some Europeans and some Africans, and many Africans differ but little in either the imperfect adaptation of the bandage and compress, or from their ed. I have known it occur by the giving way after having been adjustpatient having taken off the bandage within a few hours after being bled, and thus lose a quantity of blood far exceeding what any remedial intention would justify.

from

some apes and ourang-outangs. Yet because we can see a gradual decline in the form of the head from the Apollo even to the frog, it is no reason why men should not be divided into different races, and each race be distinguish ed by its appropriate name.

There are many cases in which practitioners give a wrong name to a disease, from a misapprehension of the nature of the complaint, or because, not being able to class the symptoms at all, they save themselves some trouble by giving the

But

name most at hand; and it is such cases,
we apprehend, which have induced ma-
ny high and gifted minds to be disgusted
with the plan of giving a name to every
set of symptoms we meet with.
does not this savor a little of pettishness?
There are cases, again, in which the strange
combination of symptoms, real and imagi-
nary, defy the greatest skill at classifi-
cation, and yet the patient will not be
satisfied without the name of his disorder;
and many a friend will persuade the in-

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A young surgeon, in a maritime' town, bled a seaman, and from some cause or other, which was not satisfactorily explained, hæmorrhage from the orifice recurred; this, however, did not prevent the patient from going to sea when his ship was ready; the hæmorrhage returned from time to time, and before the vessel returned which she sailed, the unfortunate pato the port from tient had died. No doubt, in the well-meant endeavours of his companions, their attempts to stop the bleeding had been very unskilful, but that circumstance did not prevent the opinion spreading through the town, that the untimely death of the poor fellow was the consequence

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