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I inoculated several patients with active variolous matter, all of whom had the disease in a favourable way; but the matter being all used, and not being able to procure any more in the state I wished, I was under the necessity of taking it from a pustule which, experience has since proved, was advanced too far to answer the purpose I intended.
Affection of the arm, resembling malignant pustule, after removing the placenta of a patient who died from puerperal fever. Reference to cases at Wurzburg, as proving contagion, and to Keiller's cases in the Monthly Journal for February, 1846, as showing connection of puerperal fever and erysipelas. Kneeland. Contagiousness of Puerperal Fever. Am. Jour. Med. Se., January, 1846.
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.
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 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.
The greater part of them sickened on the sixth day, and were well on the seventh, but in three of the number a secondary indisposition arose in consequence of an extensive erysipelatous inflammation which appeared on the inoculated arms. It seemed to arise from the state of the pustule, which spread out, accompanied with some degree of pain, to about half the diameter of a sixpence.
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.
11th: Surrounded by an inflammatory redness, about the size of a shilling, studded over with minute vesicles. The pustule contained a limpid fluid till the fourteenth day, after which it was incrusted over in the usual manner; but this incrustation or scab being accidentally rubbed off, it was slow in healing. These children were afterwards fully exposed to the smallpox contagion without effect.
The pustule had greatly increased in size; but this the doctor looked upon as a good sign: and after applying fresh poultices, and administering a hot posset-drink, he covered the patient with blankets, and recommending as much tranquillity as possible, he proceeded, at Bloundel's request, to ascertain the state of health of the rest of the family. Bloundel's chamber, and was instantly admitted.
The path of infection is usually through an abrasion of the skin, and the primary manifestations are local, constituting what is known as the malignant pustule. In other cases the disease is contracted through the inhalation of the dried spores into the respiratory passages. This occurs oftenest in those who work amongst wool, fur, and rags, and a form of acute pneumonia of great virulence ensues.
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