An Inquiry into the Causes and Effects of the Variolae Vaccinae Part 2

One instance has occurred to me of the system being affected from the matter issuing from the heels of horses, and of its remaining afterwards unsusceptible of the variolous contagion; another, where the Small Pox appeared obscurely; and a third, in which its complete existence was positively ascertained.

First, THOMAS PEARCE, is the son of a Smith and Farrier near to this place. He never had the Cow Pox; but, in consequence of dressing horses with sore heels at his father's, when a lad, he had sores on his fingers which suppurated, and which occasioned a pretty severe indisposition. Six years afterwards I inserted variolous matter into his arm repeatedly, without being able to produce any thing more than slight inflammation, which appeared very soon after the matter was applied, and afterwards I exposed him to the contagion of the Small Pox with as little effect[1].

[Footnote 1: It is a remarkable fact, and well known to many, that we are frequently foiled in our endeavours to communicate the Small Pox by inoculation to blacksmiths, who in the country are farriers. They often, as in the above instance, either resist the contagion entirely, or have the disease anomalously. Shall we not be able now to account for this on a rational principle?]

_CASE XIV._

Secondly, Mr. JAMES COLE, a Farmer in this parish, had a disease from the same source as related in the preceding case, and some years after was inoculated with variolous matter. He had a little pain in the axilla, and felt a slight indisposition for three or four hours.

A few eruptions shewed themselves on the forehead, but they very soon disappeared without advancing to maturation.

_CASE XV._

Although in the two former instances the system seemed to be secured, or nearly so, from variolous infection, by the absorption of matter from sores produced by the diseased heels of horses, yet the following case decisively proves that this cannot be entirely relied upon, until a disease has been generated by the morbid matter from the horse on the nipple of the cow, and pa.s.sed through that medium to the human subject.

Mr. ABRAHAM RIDDIFORD, a Farmer at Stone in this parish, in consequence of dressing a mare that had sore heels, was affected with very painful sores in both his hands, tumours in each axilla, and severe and general indisposition. A Surgeon in the neighbourhood attended him, who, knowing the similarity between the appearance of the sores upon his hands and those produced by the Cow Pox, and being acquainted also with the effects of that disease on the human const.i.tution, a.s.sured him that he never need to fear the infection of the Small Pox; but this a.s.sertion proved fallacious, for, on being exposed to the infection upwards of twenty years afterwards, he caught the disease, which took its regular course in a very mild way.

There certainly was a difference perceptible, although it is not easy to describe it, in the general appearance of the pustules from that which we commonly see. Other pract.i.tioners, who visited the patient at my request, agreed with me in this point, though there was no room left for suspicion as to the reality of the disease, as I inoculated some of his family from the pustules, who had the Small Pox, with its usual appearances, in consequence.

_CASE XVI._

SARAH NELMES, a dairymaid at a Farmer's near this place, was infected with the Cow Pox from her master's cows in May, 1796. She received the infection on a part of the hand which had been previously in a slight degree injured by a scratch from a thorn. A large pustulous sore and the usual symptoms accompanying the disease were produced in consequence. The pustule was so expressive of the true character of the Cow Pox, as it commonly appears upon the hand, that I have given a representation of it in the annexed plate. The two small pustules on the wrists arose also from the application of the virus to some minute abrasions of the cuticle, but the livid tint, if they ever had any, was not conspicuous at the time I saw the patient. The pustule on the fore finger shews the disease in an earlier stage. It did not actually appear on the hand of this young woman, but was taken from that of another, and is annexed for the purpose of representing the malady after it has newly appeared.

_CASE XVII._

The more accurately to observe the progress of the infection, I selected a healthy boy, about eight years old, for the purpose of inoculation for the Cow Pox. The matter was taken from a sore on the hand of a dairymaid[1], who was infected by her master's cows, and it was inserted, on the 14th of May, 1796, into the arm of the boy by means of two superficial incisions, barely penetrating the cutis, each about half an inch long.

[Ill.u.s.tration]

On the seventh day he complained of uneasiness in the axilla, and on the ninth he became a little chilly, lost his appet.i.te, and had a slight head-ach. During the whole of this day he was perceptibly indisposed, and spent the night with some degree of restlessness, but on the day following he was perfectly well.

The appearance of the incisions in their progress to a state of maturation were much the same as when produced in a similar manner by variolous matter. The only difference which I perceived was, in the state of the limpid fluid arising from the action of the virus, which a.s.sumed rather a darker hue, and in that of the efflorescence spreading round the incisions, which had more of an erysipelatous look than we commonly perceive when variolous matter has been made use of in the same manner; but the whole died away (leaving on the inoculated parts scabs and subsequent eschars) without giving me or my patient the least trouble.

In order to ascertain whether the boy, after feeling so slight an affection of the system from the Cow-pox virus, was secure from the contagion of the Small-pox, he was inoculated the 1st of July following with variolous matter, immediately taken from a pustule.

Several slight punctures and incisions were made on both his arms, and the matter was carefully inserted, but no disease followed. The same appearances were observable on the arms as we commonly see when a patient has had variolous matter applied, after having either the Cow-pox or the Small-pox. Several months afterwards, he was again inoculated with variolous matter, but no sensible effect was produced on the const.i.tution.

Here my researches were interrupted till the spring of the year 1798, when from the wetness of the early part of the season, many of the farmers' horses in this neighbourhood were affected with sore heels, in consequence of which the Cow-pox broke out among several of our dairies, which afforded me an opportunity of making further observations upon this curious disease.

A mare, the property of a person who keeps a dairy in a neighbouring parish, began to have sore heels the latter end of the month of February 1798, which were occasionally washed by the servant men of the farm, Thomas Virgoe, William Wherret, and William Haynes, who in consequence became affected with sores in their hands, followed by inflamed lymphatic glands in the arms and axillae, s.h.i.+verings succeeded by heat, la.s.situde and general pains in the limbs. A single paroxysm terminated the disease; for within twenty-four hours they were free from general indisposition, nothing remaining but the sores on their hands. Haynes and Virgoe, who had gone through the Small-pox from inoculation, described their feelings as very similar to those which affected them on sickening with that malady. Wherret never had had the Small-pox. Haynes was daily employed as one of the milkers at the farm, and the disease began to shew itself among the cows about ten days after he first a.s.sisted in was.h.i.+ng the mare's heels. Their nipples became sore in the usual way, with blueish pustules; but as remedies were early applied they did not ulcerate to any extent.

[Footnote 1: From the sore on the hand of Sarah Nelmes.--See the preceding case and the plate.]

_CASE XVIII._

JOHN BAKER, a child of five years old, was inoculated March 16, 1798, with matter taken from a pustule on the hand of Thomas Virgoe, one of the servants who had been infected from the mare's heels. He became ill on the 6th day with symptoms similar to those excited by Cow-pox matter. On the 8th day he was free from indisposition.

There was some variation in the appearance of the pustule on the arm.

Although it somewhat resembled a Small-pox pustule, yet its similitude was not so conspicuous as when excited by matter from the nipple of the cow, or when the matter has pa.s.sed from thence through the medium of the human subject.--(See Plate, No. 2.)

[Ill.u.s.tration]

This experiment was made to ascertain the progress and subsequent effects of the disease when thus propagated. We have seen that the virus from the horse, when it proves infectious to the human subject is not to be relied upon as rendering the system secure from variolous infection, but that the matter produced by it upon the nipple of the cow is perfectly so. Whether its pa.s.sing from the horse through the human const.i.tution, as in the present instance, will produce a similar effect, remains to be decided. This would now have been effected, but the boy was rendered unfit for inoculation from having felt the effects of a contagious fever in a work-house, soon after this experiment was made.

_CASE XIX._

WILLIAM SUMMERS, a child of five years and a half old was inoculated the same day with Baker, with matter taken from the nipples of one of the infected cows, at the farm alluded to in page 35. He became indisposed on the 6th day, vomited once, and felt the usual slight symptoms till the 8th day, when he appeared perfectly well. The progress of the pustule, formed by the infection of the virus was similar to that noticed in Case XVII., with this exception, its being free from the livid tint observed in that instance.

_CASE XX._

From William Summers the disease was transfered to William Pead a boy of eight years old, who was inoculated March 28th. On the 6th day he complained of pain in the axilla, and on the 7th was affected with the common symptoms of a patient sickening with the Small-pox from inoculation, which did not terminate 'till the 3d day after the seizure. So perfect was the similarity to the variolous fever that I was induced to examine the skin, conceiving there might have been some eruptions, but none appeared. 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. (See Plate, No. 3.)

[Ill.u.s.tration]

_CASE XXI._

April 5th. Several children and adults were inoculated from the arm of William Pead. The greater part of them sickened on the 6th day, and were well on the 7th, 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 six-pence.

One of these patients was an infant of half a year old. By the application of mercurial ointment to the inflamed parts (a treatment recommended under similar circ.u.mstances in the inoculated Small-pox) the complaint subsided without giving much trouble.