Information to parents respecting the vaccine inoculation: or, the inoculation for cow-pox. By F. Skrimshire, M.D.
THERE is a disorder often prevailing among Cows, known to the farmers and peasants of several parts of this country by the name of Cow-pox, and to those of Ireland by the name of Shinagh. It appears on the nipples of milch cows in the form of irregular pustules of a bluish or livid hue, with inflamed baſes, which afterwards become troublesome ulcers. The persons employed in milking these cows are frequently attacked with similar pustules on [Page 6] their hands, appearing at first like small blisters produced by a burn, and then degenerating into sores. In those parts of the kingdom where there are large dairies, and where, consequently, this disease more frequently occurs, it has for a long time been a prevailing opinion, that persons who are accidentally affected with the cow-pox previously to having the small pox, are no longer subject to the latter, and that, if inoculated with small-pox matter, or ever so much exposed to the infection, they will not take that disease. This curious opinion attracted the attention of Dr. JENNER to the subject, and induced him to make further enquiries concerning its authenticity. In 1798 he published his first Dissertation, containing a description of the disease, and a collection of cases tending to prove the fact, that cow-pox, or, as it is now called, the Vaccine Disease, destroys all susceptibility to the small-pox, in consequence of which, he strongly recommended [Page 7] the Vaccine inoculation, instead of inoculation for the small-pox. Since that period much has been done, not only by Dr. JENNER, but by various other medical men, towards establishing the preference for this kind of inoculation, and the practice has now to boast of, as its advocates, some of the greatest ornaments to the medical profession.
Being myself fully persuaded of the advantages of the vaccine inoculation, I wish to extend the knowledge of the discovery, and to dispense the benefits of it, to the inhabitants of this neighbourhood. With this view I am induced to draw up a correct statement of the advantages that are proposed by it, and the progress that it has already made, so that every parent may be enabled to judge for himself, whether he ought or ought not to prefer this kind of inoculation for his children.[Page 8]
The operation is performed in the same manner as for the small-pox, by inserting the matter under the scarf skin; and, to avoid unnecessary pain from the sores, it should be performed only on one arm. On the third or fourth day the part appears inflamed and elevated, in a few days more a pustule is evident on the incised spot, and sometimes one or more vescicles appear about its edge, and in a fortnight, more or less, the parts scab over, and become well. In many cases not the least general indisposition is apparent; in others the patients complain of sickness, head-ache, or other uneasines for a few hours, on the fourth, fifth, or in many cases not till the ninth or tenth day, according as the affection of the arm proceeds. Such is the usual progress of the disease, which in [Page 9] general is so mild as to require no confinement, and if any medicine at all, only a dose of opening physic. Some practitioners have met with several cases, where an eruption very like to, if not the same with, that of small-pox, has come out at the time of sickening, but this, it now appears, has generally arisen from their using matter not altogether pure, but taken from persons labouring under both, or a mixture of the two diseases, and from this source a spurious matter has been disseminated in various parts of the country. This at least is commonly supposed to be the true cause of those variolous-like eruptions, and Dr. JENNER having been particularly careful to use only genuine vaccine matter, has never met with a single case of them. Dr. WOODVILLE, who met with most of these eruptive cases, soon made this important observation, that by using only the matter taken from patients having no eruption, such an occurrence became less and [Page 10] less frequent; and Dr. PEARSON, in his last statement, gives their proportion as not more than one out of every two hundred cases, observing at the same time, that the disease is then as mild as the inoculated small-pox. It is the opinion of many, that by carefully avoiding every source of small-pox contagion, you may also avoid these cases of eruption. There is another kind of pimples, and rash, that has appeared upon persons inoculated for the vaccine disease, which is not of the smallest consequence, disappearing in a day or two, and is probably not at all connected with the disease. To prove that there is considerably less hazard in inoculating for this disease than for small-pox, allow me to inform you, that upon an average one case out of every four or five hundred of inoculated small-pox terminates fatally. You are aware too, that in some families it is almost always a very formidable disease. In some seasons too it is much more severe than [Page 11] in others, and very often it is impossible, by any treatment, to prevent inoculated patients from being marked. Now, more than six thousand persons have been inoculated for the vaccine disease, and only one has died, nor is it fair to state that this child died of this disease, for it was one of those who had an eruption very like to that of small-pox, and concerning which there is much reason to doubt, whether there was not also small-pox infection. In some cases the sore in the arm has proved troublesome, and been a good deal inflamed, but never dangerous, and a plan of treatment is now adopted to prevent even that. The disease seems to have been equally mild in all families and constitutions, and by it all pock-marks are effectually prevented. In short, its superior mildness alone would insure its preference, but there are other advantages to be derived from the inoculation for it, which, if it becomes general, are incalculable. The vaccine disease is not, [Page 12] like the small-pox, contagious. It cannot be communicated but by inoculation, accidental or artificial, so that one part of the family may be inoculated, and another run no risk of taking the disease. For the same reason you need never delay inoculation till the disease is in the neighbourhood, as is often the case in country towns and villages. In short, you may always choose both time and place, consulting only the health of the child, and your own convenience.
Moreover, if the practice becomes general, or even tolerably so, the small pox will become a rare disease, or may be even altogether exterminated; which, considering its present ravages, must be to the man of humane feelings a most desirable object. It is a point generally allowed among medical men, that the introduction of inoculation for small-pox has not by any means diminished its fatality, but that even more persons have [Page 13] died of it annually since, than before that period. The reason is obvious; previous to inoculation the small-pox appeared only now and then, and was in nearly a similar situation with the plague, whereas it is now a constant disease in every large town, and very frequently appears in the country, the contagion being kept constantly afloat by inoculation. The disease taken in the natural way is still very formidable, and, as inoculation is by no means generally adopted, thousands are every year carried by it to their graves. How much then ought we to rejoice at being offered the means of exterminating so dreadful a scourge, and how ready should we be, to commence and forward so benevolent a plan.
There is one more advantage, which even in this early stage of the practice seems to be generally admitted. The small-pox in certain constitutions has been often observed to excite [Page 14] the latent seeds of other disorders, and has in many cases been the cause of them. We frequently meet with persons afflicted with scorbutic eruptions, as they are commonly termed, with the king's evil, and sometimes with ſits, who date the origin of their complaints from the time of their having had the small-pox, and there is reason to believe that it does frequently excite these disorders in persons that are predisposed to them; and it is certain that many diseases of the eye, and sometimes deafness, have been produced by the confluent small-pox. Now it is asserted by those who have had most experience in the vaccine disease, that no such consequences have been observed from it, but that in some cases it has wrought beneficial changes in unhealthy and unthriving children.
To ensure the object of the present statement, I trust I have now nothing more to do, than to advert to the mass of evidence that [Page 15] has been brought to prove the sufficiency of the practice to destroy all susceptibility, in the persons inoculated, to receive the small-pox. I have said before that in many parts of the kingdom it is a prevailing opinion that the cow-pox prevents a person taking the small-pox. Dr. JENNER published upwards of twenty well marked cases, where persons who accidentally took the cow-pox fifteen, twenty, and some thirty years ago, have never had the small-pox, though inoculated for it, and in various other ways exposed to the infection. Dr. PEARSON has since published other cases to the same point, and many are related in the medical periodical publications of the day. Almost every surgeon has, in the course of inoculation for the small-pox, met with instances of his patients not taking the disease; in various cases of this kind, that have occurred lately, the surgeons, on further enquiry, have ascertained that such persons have been previously [Page 16] affected with the cow-pox. In opposition to all this evidence not one unexceptionable case has been found, to prove a person's having the small-pox after the cow-pox. The only one, that seems to have the least weight, is that published by Dr. BEDDOES in his "West Country Contributions," and again and again in various periodical publications. A gentleman at Bristol says he had the small-pox very severely some years after having the cow-pox, but considering that no reference is made to the medical gentleman who attended him, and that even medical men cannot always distinguish between one eruption and another, we may, without derogating from the discriminating powers of the Bristol attorney, suppose him, for once, to have mistaken some other disease for the cow-pox; at any rate a single case can by no means invalidate all the evidence we possess against it. To the above proof we have now to add those derived from experiments instituted for the purpose. Out [Page 17] of the six thousand persons inoculated in different parts of the country for the vaccine disease, more than one-half have been since inoculated for the small-pox, and in no individual case has the later disease been induced. What more authority can be wanted to prove the sufficiency and utility of the practice? We have the avowed concurrence of some of the most respectable medical characters in the kingdom, and the tacit concurrence of all; for who that knew but a single valid objection, would not give it to the world? All those parents then, who have been advocates for inoculating for the small-pox, must now, by a parity of reasoning, be advocates for the vaccine disease. For why did they inoculate? to substitute a mild for a dangerous disease. But here is a disease still safer than the inoculated small-pox, and equally certain of preventing those inoculated for it ever after taking the natural small-pox; you have therefore the same inducements [Page 18] now to prefer the vaccine inoculation, that you had to adopt inoculation in the first instance.
I have said that the discovery of Dr. JENNER has afforded us the means of very greatly diminishing, if not of entirely putting a stop to the havoc of the small-pox. This is only to be done by making the practice general, and it is therefore necessary to introduce it into the mansions of the poor. It has been usual for the overseers of parishes to contract with surgeons for the inoculation of all the poor willing to undergo the operation; [Page 20] it is for them now to consider, whether it would not prove a much more beneficial object to make the same contract for inoculating with vaccine matter. Another plan for extending the practice would be, to establish an Infirmary or Dispensary for the purpose of inoculating, and giving the proper advice and medicine to the poor, which might be supported at a very trifling expense, and that would, no doubt, be cheerfully defrayed by voluntary subscription. I leave it for others to determine, which of the two plans it would be preferable to adopt; but hope it will not be long before one or the other is set on foot, as the object it embraces is no less than the substituting a mild and manageable disease, for one that often defies the whole art of medicine, and of thus preserving annually the lives of thousands of our fellow-creatures.FINIS.