Part 14 (1/2)
”Williaed thirty-two, servant to Mr cox of Almondsbury, in this county, applied to me the 2d of April, 1798
He toldin both his hands, which were so painful it ith difficulty he continued his work; that he had been seized with pain in his head, small of the back, and limbs, and with frequent chilly fits succeeded by fever On examination I found hireat prostration of strength Many parts of his hands on the inside were chapped, and on the ht hand there was a sing an ichorous fluid On the er of the same hand there was another ulcer of a similar kind These sores were of a CIRCULAR for so from a burn
He complained of excessive pain, which extended up his arm into the axilla These symptoms and appearances of the sores were so exactly like the cow-pox that I pronounced he had taken the diste cows He assured me he had not milked a cow forthe matter with them I then asked him if his master had a GREASY horse, which he answered in the affirmative, and further said that he had constantly dressed him twice a day for the [Footnote: HC--Vol88] last three weeks or more, and remarked that the smell of his hands was ain saw hi of pain in both hands, nor were his febrile symptoms at all relieved The ulcers had now spread to the size of a seven-shi+lling gold coin, and another ulcer, which I had not noticed before, appeared on the first joint of the forefinger of the left hand, equally painful with that on the right I ordered him to bathe his hands in warm bran and water, applied escharotics to the ulcers, and wrapped his hands up in a soft cataplas ot well He lost his nails froers that were ulcerated”
The sudden disappearance of the symptoms in this case after the application of the escharotics to the sores is worthy of observation; it seems to show that they were kept up by the irritation of the ulcers
The general symptoms which I have already described of the cow- pox, when coreat extent, will, I am convinced, from the many cases I have seen, be found accurate; but froht indisposition which ensues in cases of inoculation, where the pustule, after affecting the constitution, quickly runs into a scab spontaneously, or is artificially suppressed by some proper application, I am induced to believe that the violence of the symptoms may be ascribed to the inflammation and irritation of the ulcers (when ulceration takes place to any extent, as in the casual cow-pox), and that the constitutional sy the presence of the sore, while it assumes the character of a pustule only, are felt but in a very trifling degree This mild affection of the systeht local impression on those who have been accidentally infected by cows; and, as far as I have seen, it has unifor those who have been inoculated, when a pustule only and no great degree of inflammation or any ulceration has taken place frothen this opinion
The cow-pox appeared at a fare of Stonehouse, in this county, about Michaelradually to pass from one cow to another till the end of November, On the twenty-sixth of that month some ichorous matter was taken from a cow and dried upon a quill On the 2d of December some of it was inserted into a scratch, made so superficial that no blood appeared, on the arms of Susan Phipps, a child seven years old
The common inflammatory appearances took place in consequence, and advanced till the fifth day, when they had sofurther would ensue
6th: Appearances stationary
7th: The inflaan to advance
8th: A vesication, perceptible on the edges, for, as in the inoculated srain of wheat, with the cleft, or indentation in the centre
9th: Pain in the axilla
10th: A little headache; pulse, 110; tongue not discoloured; countenance in health
11th, 12th: No perceptible illness; pulse about 100
13th: The pustule was now surrounded by an efflorescence, interspersed with very minute confluent pustules to the extent of about an inch Some of these pustules advanced in size and maturated So exact was the reseeneral appearance of the inoculated seon, who took some matter from it, and who had never seen the cow-pox before, declared he could not perceive any difference [Footnote: That the cow-pox was a supposed guardian of the constitution from the action of the s time past; but the similarity in the constitutional effects between one disease and the other could never have been so accurately observed had not the inoculation of the cow-pox placed it in a new and stronger point of view This practice, too, has shewn us, what before lay concealed, the rise and progress of the pustule formed by the insertion of the virus, which places in aresemblance to the pustule formed from the inoculated smallpox] The child's arm noed a disposition to scab, and rean to run into an ulcerous state, and THEN commenced a febrile indisposition accompanied with an increase of axillary tu which time the child continued ill, when it increased to a size nearly as large as a shi+lling It began now to discharge pus; granulations sprang up, and it healed This child had before been of a reh health
Mary Hearn, twelve years of age, was inoculated with matter taken fro to appear, slight pain in the axilla
7th: A distinct vesicle fores very red; no deviation in its appearance at this time from the inoculated s
10th: The patient felt this evening a slight febrile attack
11th: Free from indisposition
12th, 13th: The same
14th: An efflorescence of a faint red colour extending several inches round the ar to shew a disposition to spread, was dressed with an oint cerce The efflorescence itself was covered with a plaster of ung hydr fort In six hours it was examined, when it was found that the efflorescence had totally disappeared
The application of the ointment with the hydr nit rub was made use of for three days, when, the state of the pustule re hydr nit This appeared to have a more active effect than the former, and in two or three days the virus see wasa disposition to inflaain applied, and soon answered the intended purpose effectually The girl, after the tenth day, when, as has been observed, she became a little ill, shewed not the least symptom of indisposition She was afterwards exposed to the action of variolous; matter, and coh a siiven the such ress of the pustule; and, secondly, to point out (what appears to be the fact) that the most material indisposition, or at least that which is felt most sensibly, DOES NOT ARISE PRIMARILY FROM THE FIRST ACTION OF THE VIRUS ON THE CONStitUTION, BUT THAT IT OFTEN COMES ON, IF THE PUSTULE IS LEFT TO CHANCE, AS A SECONDARY DISEASE This leads me to conjecture, what experiment must finally determine, that they who have had the smallpox are not afterwards susceptible of the pri that the simple virus itself, when it has not passed beyond the boundary of a vesicle, excites in the syste illness, thus induced may be lost in that which so quickly, and oftentimes so severely, follows in the casual cow- pox fro ulcers? This consideration induces me to suppose that I may have been mistaken in my former observation on this subject