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In my former cases the pustule produced by the insertion of the virus was more like one of those which are so thickly spread over the body in a bad kind of confluent smallpox. This was more like a pustule of the distinct smallpox, except that I saw no instance of pus being formed in it, the matter remaining limpid till the period of scabbing.
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.
Thus a common pustule, or phlegmon, in a part of little sensibility does not excite an inflammatory fever; but if the stomach, intestines, or the tender substance beneath the nails, be injured, great sensation is produced, and the whole system is thrown into that kind of exertion, which constitutes inflammation.
As this can be checked, or even entirely subdued, by very simple means, I see no reason why the patient should feel an uneasy hour because an application may not be absolutely necessary. About the tenth or eleventh day, if the pustule has proceeded regularly, the appearance of the arm will almost to a certainty indicate whether this is to be expected or not.
From the consideration of animal parasites as the direct causes of disease, we naturally come to the contemplation of the subject of insects as the carriers of disease. The later years of the century have witnessed the demonstration of the fly's agency in the transmission of malignant pustule and typhoid fever, and that of certain mosquitoes in the conveyance of yellow fever and malarial disease.
"When I was young," he said, "many went there to pray and make offerings." This world was destroyed five times. The first time by a whirlwind; the second, by immense hail stones; the third, by smallpox, when each pustule covered a whole cheek; the fourth, all was destroyed by coughing; the fifth time Naiyenesgony and Tobaidischinni went over the earth slaying all enemies.
Miss H. has small pustules and great inflammation of her arms, with but one pustule likely to suppurate. After this day they gradually got well, and the pustules disappeared.
The efflorescent blush around the part punctured in the boy's arm was so truly characteristic of that which appears on variolous inoculation that I have given a representation of it. The drawing was made when the pustule was beginning to die away and the areola retiring from the centre. CASE XXI.-April 5th: Several children and adults were inoculated from the arm of William Pead.
The pustule on the arm nearly converted into a scab. As long as any fluid remained in it it was limpid. James Hill, four years old, was inoculated on the same day, and with part of the same matter which infected Stephen Jenner. It did not appear to have taken effect till the fifth day.
He sickened on the eighth day, went through the disease with the usual slight symptoms, and without any inflammation on the arm beyond the common efflorescence surrounding the pustule, an appearance so often seen in inoculated smallpox.
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