Some Account of Inoculating or Transplanting the Small Pox; And of the Benefit and Safety of the Practice.
THE Publick having been lately entertained with a very dark and partial Account of this New Method of receiving the Small Pox; and this Account being given as is pretended, from the very Letters of Dr. Timonius and Pylarinus; it is thought reasonable and fitting to lay before the Publick this following Abstract of what those Learned Gentlemen have said of this Practice. But because the Gentleman who only hath these Letters by him, refuses now to lend them; the Account here following is chiefly taken from a known Letter written by a Learned Gentleman of Boston to the Worthy Physicians of the Town.
A Faithful Abridgment of Two Accounts in the Philosophical Transactions.
I. OUR first Communication comes from Dr. Emanuel Timonius, a Renowned Fellow of the Royal Society at London, (well known to some in Boston, who also actually knew the Truth of the matter of Fact now going to be related,) who writes from Constantinople in December 1713. And he informs to this Effect; The practice of procuring the Small Pox by a sort of Inoculation, has been introduced among the Constantinopolitans by the Circassians, and Georgians, and other Asiaticks for about Forty Years. At the first the People were cautious and afraid; but the Happy Success on Thousands of Persons for Eight Years now past has put it out of all suspicion. The Operation [Page 2] has been performed on Persons of all Ages, both Sexes, differing Temperaments, & even in the worst Constitution of the Air; and none that have used it ever died of the Small Pox, tho' at the same time, it were so malignant, that at least half the People died, that were infected with it in the Common way.
They that have this Inoculation practised on them (he says) are subject unto very Slight Symptoms, and hardly sensible of any Sickness, nor do what Small Pox they have, ever leave any Scars or Pits behind them.
They make choice of as Healthy a Young Person as they can find, that has the Small Pox of the best sort upon him, on the Twelfth or Thirteenth Day of his Decumbiture. With a Needle they prick some of the larger Pustules, and press out the Matter coming from them into some convenient Vessel of Glass (or the like) to receive it, which ought first of all to be washed very clean with warm Water. A convenient quantity of this Matter being thus collected, is to be stop'd close, and kept warm in the bosom of the Person that carries it (who ought rather to be some other Person, than what visited the Sick Chamber for it, lest the Infection of the Small Pox be convey'd in the Garment, as well as in the Bottle, and the intended Operation be hurt by the Infection being first conveyed [Page 3] another way, and so it should be conveyed as soon as may be to the Person that is waiting to be the Patient.
The Patient being in a warm Chamber, is to have several small Wounds made with a Surgeon's Three edged Needle, or with a Lancet, in two or more Places of the Skin (the best Places are in the Muscles of the Arm) till some drops of Blood follow: And Immediately let there be dropt out a drop of the Matter in the Glass, on each of the Places; and mix'd well with the Blood that is issuing out. The Wound should be covered with half a Walnut shell, or any such concave Vessel, and bound over that the matter may not be rub'd off by the Garments for a few Hours; And now let the Patient (having Fillets on the Wounds,) keep House, and keep warm, and be careful of his Diet; The Custom at Constantinople is to abstain from Flesh and Broth for Twenty Days or more. They chuse to perform the Operation either in the beginning of Winter or Spring.
The Small Pox begins sooner in some than others, and with lesser Symptoms in some than others; but with happy Success in all. Commonly Ten or Twenty Pustules break out; here and there One has no more than two or three; Few have a Hundred. There are some, in whom no Pustules rise, but in the [Page 4] Places where the Incision was made: And here the Tubercles will be purulent: Yet even These have never had the Small Pox afterwards, tho' they have Cohabited with Persons having of it. No small Quantity of Matter will run for several Days from the Places of the Inscision. The Pocks arising from this Operation are dried up in a short time; and fall off, partly in thin Skins, and partly vanishing by an insensible wasting.
The Matter is hardly so thick a Pus as in the common Small Pox, but a thinner kind of Sanies, whence it rarely Pitts, except at the Place of the Inscision, where the Cicrtrices are never worn out, and where the matter is more of the common sort.
If an Apostem should break out in any (which is more frequent in Infants) yet there is no fear, for 'tis heal'd safely by Suppuration.
They scarce ever use the matter of the Inscitious Small Pox to serve the Designs of a new Inscition. The Inoculation being tryed on such as have had the Small Pox before, it had no effect at all on them. Dr. Timonius affirms, that he never yet observed any bad Consequence of the Practice, which now so many do come into.
II. SINCE this Communication from Dr. Timonius, there came to the ROYAL SOCIETY a further, from an Eminent Person whose Name is Jacobus Pylarinus; the Venetian Consul at Smyrna; and who appears to have had no knowledge, of what had been written by the former. It is Entituled, A New and Safe Method of Exciting the Small-Pox by Transplantation.
This Gentleman observes, That this Wonderful Invention was first found out, not by the Learned Sons of Erudition, but by a Mean, Coarse, Rude sort of People, for the Succour of Mankind under and against one of the most Cruel Diseases in the World. It was rarely if ever used among People of Quality, until after the beginning of the present Century. A Noble Groecian then in distress for his Four little Sons, lest the Small Pox might bereave him of them, consulted with him about using the Inoculation upon them. At first, his Ignorance of the Matter, made him decline giving any Advice upon it; But a Groecian Woman who was a notable Inoculatrix, happening to come in, while they were discoursing of the Matter, told them so much about it, that the Experiment was resolved on. The Woman managed in her way, upon all the Four Sons. The Three Younger, all of which were under Seven Years of Age, felt [Page 6] a very gentle Illness, had very few Pustules, and in about a Week all Fever and Hazard was over with them. The Eldest, about Eight Years old, was taken with a malignant Fever: and (tho' he had not many Pustules) narrowly escaped with his Life. Pylarinus imputes this, to an Atrabiliarious, and otherwise Humourous & Unhealthy Constitution of the Lad, and a neglect of using such Preparatory Expiation of his Body, as they had been advised unto. But upon this Happy Success, it was wonderful to see, what a Multitude of People of Fashion presently followed the Example. So that at this Day every one does without any Hesitation, and with all the security imaginable, practice the Transplantation; except here and there a few Cowards that are afraid of their Shadows. Indeed, the Turks whose Faith in Fate, is as we know, and who are a more Indocible sort of Animals, do not yet much come into it.
Pylarinus, instructed by his Greek Operatrix, directs to take, a Proper Season for the Inscition. She would use it only in the Winter, but he thinks the Spring may do as well.
The Fermenting Pus must be taken from the mature Pustules of a good Sort, in a Young Person of a good Constitution, kept Warm in a close Vial, and hastened unto the Application.
[Page 7] The Air of the Chamber must be kept very Temperate. The Greek Operatrix, prick't more places, and less fleshy ones than Pylarinus approved of; with an oblique stroke pricking the Places, with an Iron, or Golden Needle dropping, and thrusting the Pus into the Wound; and so binding all with Fillets. Her way was thus to prick the Forehead, the Chin, both Cheeks, both Wrists, both Insteps. This was doubtless overdoing. Pylarinus affirms that some have done the Business, with no more than One little Inscision in the Arm, and it has done very well. [So it has been with such Africans, as have shown us the Marks of their Inoculation.]
They must not keep their Beds more than is necessary. Wine, Flesh and Broth must be laid aside.
The Ferment comes into Action in some sooner than in others. Usually the Small-Pox (as far as it may be called so,) appears on the Seventh-Day; sometimes on the very First.
The Symptoms prove Remiss or Intense according to the various Constitutions of the Bodies. The Small Pox proves of the Distinct Sort; and there will be but few of them; it may be Ten, or Twenty; rarely a Hundred.
In some few the Inscision has produced no Small Pox at all; but the Persons have afterwards [Page 8] in the common way been taken and handled with it like other People. The Wounds made for the Inscision, prove often very sore. And with some they degenerate into Apostems. Yea, These do swell sometimes, and rise, and fall, and rise again▪ There has also happened on this Occasion an Abscess with Suppuration, in some Emunctory of the Body: But this is a very rare Occurrence.
In Fin [...], Pylarinus affirms; It was hardly ever known, that there was any Ill Consequence of this Transplantation, But the Business being well and wisely managed, & the Body being by a skilful Physician Well-prepared, you may depend upon it (he says) in [...]n ordinary way, there can be nothing but a Good Issue of it.
REMARKS.
I. LET it be considered, That these Communications come from Great Men, and Persons of Great Erudition and Reputation, and are address'd unto very Eminent Persons. Let it be also considered, that with the Approbation of the ROYAL SOCIETY (as Illustrious a Body as are in the World) their Secretary the celebrated Dr. Halley, has publish'd these things, as worthy to come into the notice of Mankind.
[Page 9] II. There is at this Time a considerable Number of Africans in this Town, who can have no Conspiracy or Combination to cheat us. No body has instructed them to tell their Story. The more plainly, brokenly, and blunderingly, and like Ideots, they tell their Story, it will be with reasonable Men, but the much more credible. For that these all agree in one Story; ‘That abundance of poor Negro's die of the Small Pox, till they learn this Way; that People take the Juice of the Small Pox, and Cut the Skin, and put in a drop; then by'nd by a little Sick, then few Small Pox; and no body dye of it: no body have Small Pox any more.’
Here we have a clear Evidence, that in Africa, where the Poor Creatures dye of the Small Pox in the common way like Rotten Sheep, a Merciful GOD has taught them a wonderful Preservative.
It is a Common Practice, and is is attended with Success. I have as full Evidence of this, as I have that there are Lions in Africa. And I don't know why 'tis more unlawful to learn of Africans, how to help against the Poison of the Small Pox, than it is to learn of our Indians, how to help against the Poison of a Rattle-Snake.
III. Is it possible to conceive, that this Practice should continue among People Forty Years [Page 10] together, and grow more and more into repute, and at last be put out of all Suspicion, and yet that there should be any Truth in the Reports of People's dying under the Operation, or being liable to the Small Pox after it? Had Peoples Limbs perished, or had they been liable to the Small Pox after it, we may be sure, a few Examples would have put an end to the Practice Forty Years ago. Good Readers, Judge calmly, and like reasonable Men.
IV. The Author of these Abridgments address'd them unto those, who had the Originals in their Hands; and therefore it cannot be thought, that it was not as Faithful a Report as he could make of the matter; But it having been insinuated, that there might be a more full and perfect Relation, The Author desires it, and I desire it my self, That the Accounts given in the Philosophical Transactions be permitted by the Owner to come abroad, and be publish [...]d Word for Word, that impartial Men may see with their own Eyes, the true state of the Case.
V. It might be easy for me to make Answers to the Scurrilous things lately Published against me, and satisfy the Publick of the Falshood and Basen [...]ss in them. But I think it rather becomes a considerate Man to decline foolish Contentions; especially at a time, when there is a grievous Calamity upon us, [Page 11] that calls us (instead of railing at one another) to Unite in Prayers to Almighty GOD, for His Mercies to us. And therefore if any think to go on with their Calumnies & Fooleries, I shall not think fit to take any Notice of them. What I do (I hope as it has hitherto done) will vindicate it self with People of Thought and Probity.
VI. I have made my Experiments with all the Disadvantages that can be imagined, on Old and Young, on Strong and Weak, on Male and Female, on White and Black, and in the worst Season of the Year; and on greater Numbers, than I judge proper (considering the unaccountable Rage of unadvised People) to mention; But more than twice Seven, I can assure you; and it has succeeded well in all, even beyond Expectation.
VII. We are yet but Learners; and hope through Experience to grow more expert in our Practice. In some of my Experiments hitherto, I have found the Fever somewhat more intense for a few Hours before the Eruption, and the Number of the Pustles to be somewhat more than usual in the Levant. Whether this be from the Season of the Year, or our Different Climate, or our high way of Living, or our want of more Experience I cannot say, till I see further. But Experience declares things to fall out for the main, [Page 12] just as the Renowned TIMONIUS and PYLARINUS have related. And I have hitherto by the Blessing of GOD been able with ease to manage what Fever my Patients have had, and have never done any thing, but what every body knows is done in other common Fevers. Upon the first Eruption this Fever abates and goes off, the Patients grow so easy, that one has much ado to keep them in the condition of Patients. They have not the least Touch of that Second Fever, which People generally dye of in the common way. The Pustules are very few in some; in others, they are two or three Hundred, but at the worst, nothing to what is usual in the ordinary way of Infection. They quickly dry away. The Patients are abroad again, sooner than they who are infected in the common way; and they are on all accounts as well as they were before.
The Sores of the Incision digest and heal as well as any other common Sores do, and if they should grow angry or troublesome, a very little Skill and Medicine will serve to cure them. From all I have hitherto seen, there can be no more ill consequence of them, than from a sore Finger neglected.
We are informed that there is now and then, but very rarely, a little Abscess in some Emunctory of the Body: but we have met with no such thing in our Practice, and we [Page 13] think when such did, or may happen, that it was, or may be from neglect or want of Skill in the Practitioner: nor have our Patients hitherto had the Boils or other Swellings which are common in the ordinary Small Pox, so much less is the Blood and other Juices corrupt in this, than the ordinary way. Now to form a Cry of the Plague on this occasion, as if the Practi [...]e would bring the Plague: This is so excessively ridiculous, that it is a wonder any People can think, much less, talk [...]o. Are there not a Thousand People in Town and Country, that have had such Swellings and Sores as Timonius and Pylarinus mention, that come from Colds, ill Habits of Body, or other causes as well as from the Plague? And was it ever known that the Plague was produc'd in this way of Practice? They that have hitherto been under the Operation among us, agree in declaring, that they have suffered in a manner nothing; and that they would rather undergo it several times, tha [...] so much as once undergo the Small Pox is 'tis generally suffered in the common way [...] they should be sure of surviving it. And [...] them (who are very religious People) [...] publish'd to the World, their Thanks to Almighty GOD for shewing them th [...] w [...] [...] escape Death and Misery. Indeed [...] any thing [Page 14] that yet appears, here is a Discovery, that is a great Blessing to Mankind, and should be thankfully receiv'd: A way to defend our selves against a dreadful and a deadly Disease, by over ruling the way of it's coming at us, when we see 'tis coming. Many Lives might be saved, some Time also, and some Charge, (which some it may be, consider) and the Health of the Town much sooner restored; if the Practitioners and the People in the Town would come more into this Practice.
The other Clamours and Bugbears having been conquered, all that now remains is this: The People will have the Small Pox again. The only Answer that need be given is this; we have never yet credibly heard any Instance thereof. And those, who have passed under the Inoculation or Transplantation, are every Day visiting, and attending the Sick; with all the assurance and safety that can be. Some will confidently affirm, that to their Knowledge a Man may have the Small Pox a Second Time in the common way. And yet this hinders not the Encouragement of them who have had it once to be no more afraid of catching it.
The Case of Conscience distresses many worthy Good People. The Case in short we take to be this. ‘Almighty GOD in His great Mercy to Mankind, has taught us a Remedy, to be used when the dangers of the Small [Page 15] Pox distress us; upon the use of which Medicine, they shall in an ordinary way be sure not to have it so severely as in the other way, and consequently not to be in such danger from this dreadful Distemper, and also to be delivered from the terrible Circumstances which many of them who recover of the Distemper do suffer for it.’
Whether a Christian may not employ this Medicine (let the matter of it be what it will) and humbly give Thanks to God for His good Providence in discovering of it to a miserable World; and humbly look up to His Good Providence (as wedoin the use of any other Medicine) for the success of it? It may seem strange, that any wise Christian cannot answer it.
And how strangely do Men that call themselves Physicians betray their Anatomy, and their Philosophy, as well as their Divinity in their invectives against this Practice? For in the First place, they make a mighty bustle about Malignant filth infus'd into the Mass of Blood, &c. as if there were no Difference between injecting a quantity of some poisonous Matter in some large Blood Vessel, and that of applying a Drop outwardly to the Scarified Skin, which when we consider appears to be only a drop of that which our Skins are fill'd with when we are full of the Small Pox, and a considerable part of which [Page 16] is return'd into the Blood again, and yet the Sick does very well. And further, when this Drop is apply'd to a Person who has had the Small Pox before, and altho' it enters, and is receiv'd by Nature in such, as well as others, as I have experienc'd, yet nature is able to cast it off without the Physicians help; and that agrees with what our Author Timonius tells us; that when it has been try'd on such as have had it before, it has had no effect. Secondly, And as to their Philosophy, that the People will have it again, this is a wonder to me; when I see the Fever produc'd as is necessary to seperate and cast out the Pocky matter, and that they have a fair Pock or Pustule, and this capable of Infecting and producing the Small Pox in the ordinary way on others, and to the same Degree, this renders it with me beyond all doubt, that they who have had it once thus in this way, are as well secur'd from having it again, as those who have had it favourably in the other way, which hath been prov'd by those that have had but one or two Pustules. Constant Experience has also confirmed it in many thousands of Instances. But what makes this Practice so valuable to us, in my Opinion is, that we shall escape the Violence, Rage and Hazard that we are expos'd to in the common way; except we are infected before, [Page 17] as we are certain poor Mrs. Esther Webb was—And even there we may hope that the Sores of the Inscisions may help to carry off the Morbifick matter, and save the Patient; for this Person is recovered, altho' she had one of the worst Sort that ever was known. And much more on this Head might be said, why this way of Infection is more safe and easy, than [...]hat of the Common way, but this may suffice for the present.
And as to the Divinity, they would limit God in His Blessing of some one or other particular part, or particle of His lower Creation, us'd by the Physician or Surgeon to prevent, moderate, alter, or cure a Disease in their Patient; the which I never yet heard was denied the Physician or Surgeon to use as aforesaid by God or Man.
But for this I refer my self to the following Quaeries.
N. B. As to the spiteful and scurrilous things written against me and this Practice, at present I shall take no further Notice of them, but remind the Writers of the ill natur'd Dog in the Fable, that would neither eat the Oats himself, nor let the Horse eat them: So neither will these use a true and certain way to save the Peoples Lives, nor are they willing to let any one else use it to save them.
A Few Quaeries humbly Offered.
I. IF it should be so that the Compassion of GOD to His Creatures, should Enlighten us with the Knowledge of a Sweat or a Purge, that would Certainly, or but Probably secure us from ever taking the Small Pox, I Enquire, Whether any People would be so very foolish, as to judge it Unlawful to take such a Remedy. Or, would not every Wise Man think, that all the Days of a whole Year, were too few to be turn'd into Days of Thanksgiving, for the Discovery of such a Blessing to a Miserable World? Let the matter of the Sweat or Purge be what they will; 'Tis all one [...]or that. Suppose it the Powder of Trade, or the Powder that Johannes Anglicus cured Agues with; or let it be a Succus [...]: 'Tis all one for that!
II. Physicians have very often given their Patients [...] Salivation, to remove, yea, and sometimes to Prevent grievous Diseases. Thousands have Died in and from that Operation; yet because Thousands have got Good by it, the Operation is every Day repeated. There is no [...]y so Impertinent as to call this, a Tempting of Providence. I Enquire, Why a Despumation, or, An Operation that will, we must not say, Salivate, but we may say, Despumate, the matter that [Page 19] would be fuel for the Small Pox, at proper Orifices, can be more liable to Exceptions; Especially, when it was never yet known, that One Person has died under it or by it? Or, why may not the Succus Variolatus be used, as well as Mercury?
III. It is Objected, That you Presume upon Providence in this Essay for the Prevention of the Small Pox; for you don't know whether you shall ever have the Small Pox, or no. I Answer, But what if it be as likely that I shall have it, as it is that my House will take Fire, when my Neighbours an Inch and half off, is in Flames. Pray, sit still, my Neighbour, your House is not yet on Fire: The Almighty can preserve it. But I Enquire, whether this Objection will not lie against all the Preventive Physick in the World? I don't Infallibly know, that I shall ever suffer the Disease I am going to prevent.
IV. The Objection here is, I make my self Sick, when I am Well. But I again say, Will any Man decry all Preventing Physick, as Unlawful? Why do our Physicians encourage People every Spring and Fall to take it? Don't People take the Poison of a Vomit into their very Stomachs, to prevent a Sickness a thousand times less to be feared, than the Small Pox? Why may not I as well take a Poison into my Arm, or my Leg, to prevent [Page 20] such a Malady. Many have Died of a Vomit. It is not yet known, that any one ever Died of the Operation, that is now so cavil'd at. To say that our SAVIOUR's words, The whole need not a Physician, forbid all preventing Physick, is a gross abuse of them. Besides, I am not whole, while I have the Fuel of the Small Pox lodging in me.
V. Meerly to prevent a little Headach, or some such sleight Malady, may not I apply such a Poison, as an Epispastic of Spanish Flies to my Arm; A Poison which will set the Humours of my Body all a working, and penetrate unto the very Bladder, and produce even a Bloody Urine there?
VI. But an Anxious Fear of the Small Pox; is not this an Evil Disease? Especially when I have it so near me, that 'tis next to a Miracle if I escape it? If I take Physick only to Remove and Prevent this Fear, it can't be said, that I make my self Sick before I have any Disease.
VII. The Celebrated Sydenham advises, That Purges be used, before the Infection of the Small Pox be taken, which hopefully prepare the Body, to feel [...] of the Small Pox, and of the better [...] ▪ Will any be so Ridiculous as to count this Unlawful, under a frivilous pretence that they [...] know whether they shall have the Small Pox or no.
VIII. I humbly Enquire, whether the Sixth Commandment has not required us to [Page 21] use Means that may be Lawfully used for the Preservation of our [...] & others? And what is there Unlawful in what is nowproposed?
IX. There is a silly Cavil; We pray that the Small Pox may not spread; and yet we do our selves by [...]ansplantation spread it. But I Enquire whether People know what they Pray for? Our Pr [...]yers are that a [...]an [...]rous and Destructive Small Pox may not Spread. We do not Pray, that the use of an Effectual means to save our Lives from the Danger of Destruction by the Small Pox, may not be Revealed, Practiced & Prospered.
X. It is Cavilled for to say Objected, would be too easy a w [...]rd for such Impertinence) that this Now Way comes to us from the Heathen, and we Christians must not Learn the Way of the Heathen I Enquire, whether our Hippocrates were not an Heathen? And whether our Galen were not an Heathen? And whether we have not our Mithradate from the Heathen? And whether the first Inventer of our Tr [...]a [...]l [...] were not Nero's Physician? And whether we have not learnt some of our very Good Medicines from our Indians? But this New Way has been used by many Thousands of Christ [...]ns; And it is from Christians we have the Communications of this New Way which we most rely upon. But are there none who pass for Cour [...] Chris [...]ns▪ [...]hat are worse th [...]n I [...]ide [...]s And, Gentlemen Smoakers, I pray w [...]m did you learn to Smoke of?
[Page 22] XI. If it should be so, that a Despumation of the Blood made by applying the Succus Variolatus, would (by the Blessing of GOD) generally save the Lives of them that come under it, I Enquire, What they will have to Answer for, that by their Menaces and Outrages put a stop to such a General benefit? And I Enquire whether a Physician, who makes the Experiment upon Himself, that so many Thousands of precious Lives may (if it succeed well) be brought into a likely way of being preserved, & prolonged, shall deserve to be treated as a Murderer; or not rather esteemed a General Benefactor.
XII. Were not the Physicians a Great Body of them, up in Arms, against the use of the Cold Bath? But since it has cured a vast Variety of Diseases, and saved Thousands of Lives, has not the use of it now obtained, whither they will or no? And now they also recommend it.
When the use of the Jesuits Bark was first introduced, was there not as loud a Cry against it, as can be imagined? Yea, Do not many to this Day ruine themselves by the use of it, with an indiscreet and preposterous management? But since Hundreds of Thousands of Lives have been saved by it, are not they generally counted very odd Physicians, who do not use it, as often as they have occasion!
I Enquire, whether any sort of Practice in the whole Art of Physick ever came to us with a stronger Recommendation than this of Inoculation or Transplantation.