Chapter VII: Preface (7)

10. I wish it to be observed, that I have condemned the mixture of different aliments in the stomach only in a few cases, and under certain circumstances. It remains yet to determine by experiments, what changes are produced upon aliments by heat, dilution, addition, concentration, motion, rest, and the addition of uniting substances, before we can decide upon the relation of aliments to each other, and the influence of that relation upon health. The olla podrida of Spain is said to be a pleasant and wholesome dish. It is probably rendered so, by a previous tendency of all its ingredients to putrefaction, or by means of heat producing a new arrangement, or additional new relations of all its parts. I suspect heat to be a powerful agent in disposing heterogeneous aliments to unite with each other; and hence the mixture of aliments is probably less unhealthy in France and Spain, than in England, where so much less fire is used in preparing them, than in the former countries.

As too great a mixture of glaring colours, which are related to each other, becomes painful to the eye, so too great a mixture of related aliments oppresses the stomach, and debilitates the powers of the system. The original colours of the sky, and of the surface of the globe, have ever been found the most permanently agreeable to the eye. In like manner, I am disposed to believe that there are certain simple aliments which correspond, in their sensible qualities, with the intermediate colours of _blue_ and _green_, that are most permanently agreeable to the tongue and stomach, and that every deviation from them, is a departure from the simplicity of health and nature.

11. While nature seems to have limited us to simplicity in aliment, is not this restriction abundantly compensated by the variety of tastes which she allows us to impart to it, in order to diversify and increase the pleasure of eating? It is remarkable that salt, sugar, mustard, horse-radish, capers, and spices of all kinds, according to Mr. Gosse's experiments, related by Abbé Spallanzani[58], all contribute not only to render aliments savoury, but to promote their digestion.

[58] Dissertations, vol. I. p. 326.

12. When we consider, that part of the art of cookery consists in rendering the taste of aliments agreeable, is it not probable that the pleasure of eating might be increased beyond our present knowledge upon that subject, by certain new arrangements or mixtures of the substances which are used to impart a pleasant taste to our aliment?

13. Should philosophers ever stoop to this subject, may they not discover and ascertain a table of the relations of sapid bodies to each other, with the same accuracy that they have ascertained the relation of the numerous objects of chemistry to each other?

14. When the tongue and stomach agree in the same kinds of aliment, may not the increase of the pleasure of eating be accompanied with an increase of health and prolongation of life?

15. Upon the pleasure of eating, I shall add the following remarks. In order to render it truly exquisite, it is necessary that all the senses, except that of taste, should be as _quiescent_ as possible. Those persons mistake the nature of the appetite for food, who attempt to whet it by accompanying a dinner by a band of music, or by connecting the dining table, with an extensive and delightful prospect. The undue excitement of one sense, always produces weakness in another. Even conversation sometimes detracts from the pleasure of eating: hence great feeders love to eat in silence, or alone; and hence the speech of a passionate Frenchman, while dining in a talkative company, was not so improper as might be at first imagined. "Hold your tongues (said he); I cannot taste my dinner." I know a physician, who, upon the same principle, always shuts his eyes, and requests silence in a sick chamber, when he wishes to determine by the pulse the propriety of blood-letting, in cases where its indication is doubtful. His perceptions become more distinct, by confining his whole attention to the sense of feeling.

It is impossible to mention the circumstance of the senses acting only in succession to each other in the enjoyment of pleasure, without being struck with the impartial goodness of Heaven, in placing the rich and the poor so much upon a level in the pleasures of the table. Could the numerous objects of pleasure, which are addressed to the ears and the eyes, have been possessed at the same time with the pleasure of eating, the rich would have commanded three times as much pleasure in that enjoyment as the poor; but this is so far from being the case, that a king has no advantage over a beggar, in eating the same kind of aliment.

THE

NEW METHOD OF INOCULATING

FOR THE

SMALL-POX.

DELIVERED IN A LECTURE IN THE UNIVERSITY OF PENNSYLVANIA,

ON THE 20TH OF FEBRUARY, 1781.

GENTLEMEN,

It must afford no small pleasure to a benevolent mind, in the midst of a war which daily makes so much havoc with the human species, to reflect that the small-pox, which once proved equally fatal to thousands, has been checked in its career, and in a great degree subdued, by the practice of INOCULATION.

It is foreign to my purpose to deliver to you the history of this art, and to mark the various steps that have attended its progress to its present state of improvement. We have yet to lament the want of uniformity and of equal success in the practice of it among physicians. A great number of pamphlets have been written upon the subject without exhausting it. There is still ample room left for the man of genius to exercise his talents for observation and reasoning upon it. The facts I mean to lay before you are so inconsiderable, compared with what still remain to be known upon this subject, that I have to request, when your knowledge in it is completed, that you would bury my name in silence, and forget that ever I ventured to lay a single stone in this part of the fabric of science.

In treating upon this subject, I shall

I. Consider the proper subjects, and seasons for inoculation.

II. I shall describe the method of communicating the disease.

III. I shall consider the method of preparing the body for the small-pox.

IV. I shall mention the treatment proper during the eruptive fever. And,

V. Point out a few cautions that are necessary after the disease is over.

I. Formerly there were great difficulties in the choice of subjects for inoculation. But experience teaches us, that it may be practised in every stage of life, and in almost every condition of the human body. In infancy, the periods before and after dentition are to be preferred. But we seldom see any great inconveniences from submitting to the general necessity of inoculating children between the ages of three months, and two years. Indeed we often see children cut three or four teeth during the preparation and eruptive fever, without the least addition being made to any of the troublesome symptoms which accompany the small-pox. There is one inconvenience attending the choice of the first months of infancy for inoculating, and that is, the matter often fails of producing the disease in such young subjects. I have frequently failed in two or three attempts to communicate it to children under four months old, with the same matter that has succeeded in a dozen other patients, inoculated at the same time. When the inoculation succeeds in such tender subjects, they generally have less fever, and fewer pustules, than are common in any future period of life.

Although a physician would prefer a patient in good health to any other as a subject for inoculation, yet cases often occur in which it is necessary to communicate the small-pox while the body is affected with some other disease. I can with pleasure inform you, that the small-pox is rendered so perfectly safe by inoculation, that there are few chronic diseases which should be considered as obstacles in the way of it. I have inoculated patients labouring under a tertian fever, obstructed viscera, the hooping cough, the hypochondriasis, the asthma, the itch, and other cutaneous diseases, and even pregnant women, with the same, and, in some instances, with greater success, than persons in perfect health. Doctor Cullen informs us, that he has seen inoculation succeed in scrophulous patients. A physician in Jamaica informed me, that he had inoculated negroes with success in the worst stage of the yaws. To these facts I must add one more extraordinary than any that has been yet mentioned: Doctor Brown, my late colleague in the care of the military hospitals, informed me, that he had seen inoculation succeed in patients who were seized, after the infection was communicated, with the hospital fever. The preparation of the body should be accommodated to the disease which affects it. Some physicians have thought the small-pox, received in this way, was a remedy for other diseases; but my experience has not confirmed this opinion: on the contrary, I am inclined to think that no other change is produced by inoculation, than by the regimen and medicines that are used to prepare the body for the small-pox. Nor does the small-pox, during its continuance, afford any security against the attacks of other diseases. I have seen the most alarming complication of the small-pox and measles taken in _succession_ to each other, in the same person.

The seasons commonly preferred for inoculation, in this country, are the spring and fall. It may be practised with equal safety in the winter, a due regard being had to the temperature of the air in the preparation of the body.

The principal objection to inoculating in the summer months in this climate, arises from the frequency of bilious diseases at that season, to which the preparation necessary for the small-pox probably disposes the body. This caution applies more directly to children, who, at a certain age, are more subject than grown people to a disease in their bowels in warm weather.

II. The methods of communicating the small-pox by inoculation, have been different in different countries, and in the different æras of its progress towards its present stage of improvement. The scab, dossel of lint, and the thread impregnated with variolous matter, and bound up in a gash in the arm, have been laid aside.

We are indebted to Mr. Sutton for the mode of communicating it by a slight puncture with the point of a lancet, or needle, dipt in fresh matter. As it is difficult sometimes to procure matter in a fresh state, I have been led to use it with equal success by preserving it on lint in a box, and moistening it with cold water just before I used it. Matter may be kept in this way for a month, without losing its infectious quality, provided it be not exposed to heat or moisture. The former destroys its power of infecting as certainly as the salt of tartar destroys the acidity of vinegar. Moisture, by remaining long upon the matter, probably destroys its virulence, by subjecting it to fermentation. The longer matter has been kept in a general way, the longer the distance will be between the time of communicating the disease, and the eruptive fever. It will be proper always to yield to the prejudices of our patients in favour of matter taken from persons who have but few pustules. But I am persuaded from repeated observations, that the disease is no ways influenced by this circumstance. I am satisfied likewise that there is no difference between the effects of the matter, whether it be taken in its watery and purulent state. The puncture should not be larger than is sufficient to draw one drop of blood, but it should always be made by a _sharp_ lancet, for the sudden inflammation and suppuration, excited by a dull lancet, sometimes throw off the matter, so as to prevent its infecting the body[59]. No plaster or bandage should be applied over the puncture. It should be made in the left arm of all subjects. The objections to inoculating in the leg are too obvious to be mentioned. I have heard of the disease being communicated by rubbing the dry skin with the matter. My own observations upon this subject, give me reason to suspect the facts that are contained in books relative to this mode of infecting the body. I have bound large pieces of lint dipt in fresh matter for twenty-four hours upon the arm, without producing the disease. A practitioner of physic in New-Jersey informed me, that he once gave a considerable quantity of fresh variolous matter in a dose of physic, without infecting his patient. I suspect the matter that produces the disease is of the same nature with certain poisons, which require to be brought in contact with a wound or sore in the body, before they produce their effects. I deliver this opinion with diffidence. The subject stands in need of more experiments and investigation.

[59] I am disposed to believe that the external applications which are
used by the Indians for the cure of the bite of poisonous
snakes act only by exciting inflammation and suppuration, which
discharge the poison from the wound before it is absorbed. All
their external remedies are of a _stimulating_ nature.

III. I come now to consider the best method of preparing the body for the small-pox. This must be done, 1st, by DIET, and 2dly, by MEDICINE. The DIET should consist chiefly of vegetables. I have never seen any inconvenience from the free use of milk, as a part of the preparative diet. In some habits, where a morbid acid prevails in the stomach, we may indulge our patients in a little weak flesh broth two or three times a week with safety. A little salted meat may likewise be taken daily in such cases. Tea, coffee, and even weak chocolate, with biscuit or dry toast, may be used as usual, by persons accustomed to that kind of aliment. Wine and spirits of all kinds should be withheld from our patients, during the preparation. The more acescent their drinks are, the better. It is unnecessary that this change in the diet should take place till a day or two before the time of communicating the disease. The system accommodates to a vegetable and low diet in the course of three weeks or a month, so as to defeat in some measure the advantages we expected from it. The good effects of it appear to depend in a great degree upon the _suddenness_ with which we oblige our patients to conform to it. For this reason, when we are called upon to inoculate persons who have lived more than three or four weeks upon a low diet, we should always direct them to live a few days upon animal food, before we communicate the disease to them. By these means we may produce all the good effects of the _sudden_ change in the diet I have already mentioned. 2. The MEDICINES most commonly used to prepare the body for the small-pox are antimony and mercury. The latter has had the preference, and has been given in large quantities, under a notion of its being a specific antidote to the variolous matter. Many objections might be made to this opinion; I shall mention only three.

1. We often see the disease in a high degree, after the system is fully impregnated with mercury.

2. We often see the same salutary effects of mercury, when given before the disease is communicated to the body, that we perceive when it is given after inoculation; in which case we are sure the mercury cannot enter into the mixture with the variolous matter so as to destroy it.

3. If mercury acted specifically in destroying the variolous matter, it would render every other part of the preparation unnecessary: but this we know is not the case, for the neglect or improper use of the vegetable diet or cool regimen is often attended with an extraordinary number, or virulence of the small-pox, even in those cases where mercury is given in the largest quantity.

The way in which mercury prepares the body for the small-pox, seems to be by promoting the several excretions, particularly that by perspiration, which, by diminishing the quantity of the fluids, and weakening the tone of the solids, renders the system less liable to a plentiful eruption of the small-pox. But I object to the use of this medicine for the following reasons:

1. It effectually deprives us of all the benefits of the cool regimen; for mercury, we know, always _disposes_ the system to take cold.

2. All the good effects of mercury may be produced by PURGES, which do not subject the body to the above-mentioned inconvenience.

The PURGES may be suited to the constitutions, and in some cases, even to the inclinations of our patients. I have seen jalap, rhubarb, senna, manna, aloes, soluble tartar, glauber and Epsom salts, and the butter-nut pill, all given with equal success. The quantity should be sufficient to procure three or four stools every day. A little magnesia should always be mixed with rhubarb and jalap in preparing children. It will be sufficient for the mothers and nurses of infants to conform strictly to the vegetable diet. I have never seen any advantages from giving them even a single dose of physic.

It is hardly necessary to observe, that the quality, dose, and number of purges are to be determined by the age, sex, and habits of our patients. A constitution enfeebled by a previous disease forbids the use of purges, and requires medicines of a restorative kind. Patients afflicted with cutaneous diseases bear larger and more frequent doses of physic, than are indicated in more healthy subjects.

In adult subjects of a plethoric habit, blood-letting is very useful on the third or fourth day after inoculation. We are not to suppose, that every fat person labours under a plethora. A moderate degree of fat is so far from rendering the disease more violent, especially in children, that I think I have generally found such subjects have the small-pox more favourably than others.

Moderate exercise in the open air should be used during the preparation. But hard labour, and every thing that promotes sweat or fatigue, as also the extremes of heat and cold, should be avoided.

IV. We come now to consider the treatment of the body during the eruptive fever. On the eighth day after inoculation our patients are _generally_ seized with the common symptoms of fever. Sometimes this fever appears on the sixth and seventh day after inoculation. But when it is irregular, it is often delayed till the ninth and tenth days. I have seen many instances of it on the fourteenth, a few on the fifteenth and sixteenth, and _one_ case in which it did not come on till the eighteenth day after the infection was communicated to the body[60]. The place where the puncture was made with the lancet, or needle, generally serves as a harbinger of the approaching fever. A slight inflammation appears about it, and a pock rises up in the centre. But this remark is liable to some objections. I have seen _four_ instances in which the fever came on at the expected time, and the disease went through all its stages with the greatest regularity, and yet there was no sign of an inflammation or pock near the spot where the puncture was made: even the puncture itself became invisible. On the other hand, we sometimes see an inflammation and pock on the arm appear on the eighth and ninth days, without any fever accompanying them. Some physicians suppose that this inflammation and solitary pock are sufficient to constitute the disease; but repeated experience has taught me to be very cautious in relying upon these equivocal marks. It is true, I have sometimes seen patients secured against the small-pox, both in the natural way and by inoculation, where these marks have appeared; but I have as often seen such patients seized afterwards with the small-pox in the natural way, to the great distress of families, and mortification of physicians. Upon this account, I make it a constant practice to advise a second or third inoculation, where a fever and eruption have been wanting. As the absence of these symptoms is probably occasioned by the weakness or age of the variolous matter, or the too high state of preparation of the body, we should always guard against both, by making the puncture the second time with _fresh_ matter, by subjecting our patients to a _less_ abstemious diet, and by giving fewer doses of physic. I have heard it remarked, that if a slight redness and a small pimple appeared on the arm on the third day after inoculation, it was a sign the matter had infected the whole constitution. I acknowledge I have often seen a greater degree of redness on the third than on the second day after inoculation, but I have not been able to establish a diagnostic mark from it; for I have seen the disease produced on the usual days where the redness has appeared on the second day, and in some cases where it has not appeared until the eruptive fever.

[60] Since the publication of the first edition of this lecture, I have
heard of two cases, in one of which the fever did not come on
till the twentieth, and in the other till the twenty-first day
after the infection was communicated to the body. In some of
these tedious cases, I have seen an inflammation and suppuration
on the punctured part of the arm on the eighth day without any
fever. Perhaps in these cases the inflammation and suppuration
are only cuticular, and that the small-pox is taken from the
matter which is formed by them.

I am led here unwillingly to discuss the old question, Is it possible to have the small-pox in the natural way after inoculation?--In many of the cases supposed to be the small-pox from inoculation, it is probable the matter has been taken from the chicken-pox, which resembles the small-pox in many of its peculiarities, but in none more than that of leaving pits or marks on the skin. But there are certainly cases where there are the most irrefragable proofs of the infection implanted by inoculation being of a variolous nature, where the disease has been afterwards taken in the natural way. In these cases I would suppose the variolous matter produced only a topical or cuticular disease. We see something analogous to this in nurses who attend patients in the small-pox. But further, this topical or cuticular infection may be produced by art in persons who have had the small-pox in the natural way. Some years ago, I made a puncture on my left hand with a lancet moistened with variolous matter. On the eighth day an inflammation appeared on the place, accompanied by an efflorescence in the neighbourhood of it, which extended about two inches in every direction from the spot where the puncture was made. On the eleventh day I was surprised to find two pocks (if I may venture to call them such), the one on the outside of the fourth finger of my left hand, and the other on my forehead. They remained there for several days, but without filling with matter, and then dropped off, rather in the form of a soft wart, than of a common scab. Doctor Way of Wilmington repeated the same experiment upon himself, but with an issue to his curiosity more extraordinary than that I have just now related. On the eighth day after he had made a puncture on his hand, a pock appeared on the spot, which in the usual time filled with matter, from which he inoculated several children, who sickened at the usual time, and went through all the common stages and symptoms of the small-pox. It would seem from these facts, that it is necessary the small-pox should produce some impression upon the _whole_ system, in order to render it ever afterwards incapable of receiving an impression of a similar nature. A fever and an eruption therefore seem necessary for this purpose. As the inflammation of the arm on the eighth day is a sign of the _topical_ and cuticular infection, so an eruption (though ever so small) seems to be the only certain sign of the infection of the _whole_ system. The eruption is the more decisive in its report, in proportion as it comes out and goes off in the usual manner of the small-pox in the natural way. In those cases where patients have been secured against a second attack of the disease, when there have been no _obvious_ fever or _visible_ eruption, I think I have observed an unusual inflammation, and a copious and long continued discharge of matter from the arm. Perhaps this may serve as an outlet of the matter, which in other cases produces the fever and eruption. I am the more disposed to embrace this opinion, from the testimony which several authors have left us of the effects of ulcers in securing the body from the infection of the plague. The effects of issues are still more to our purpose. We observe a plentiful discharge of matter from them every time the body is exposed to cold, and the febrile effects of it upon the system are thereby frequently obviated. How far a ratio exists between the degrees of inflammation and the discharge of matter from the arm, and the degrees of fever and eruption, must be determined by future and very accurate observations. If it should appear, that there are the least inflammation and smallest discharge, where there have been the highest fever and most copious eruption; and, on the contrary, if it should appear that there are the greatest inflammation and discharge, where there have been the least fever and smallest eruption, I must beg leave to add, without attempting in this place to explain the reasons of it, that the remark, if generally true, is liable to some exceptions. But the subject is involved in darkness; I shall be satisfied if I have brought you within sight of the promised land. Your own ingenuity, like another Jewish leader, must conduct you thither.

The indications in the treatment of the body during the eruptive fever are,

I. To regulate the degree of fever.

II. To mitigate troublesome and alarming symptoms.

The fever which produces the eruption is generally of the inflammatory kind. It sometimes, therefore, comes on with the symptoms of great heat, preceded with chilliness, and determination to the head and breast, and a full hard pulse. The remedies proper in this case are,

1. Blood-letting. The quantity to be drawn must be regulated by the violence of the symptoms, the constitution, habits, and even country of the patient, and by the season of the year. I have never found more than one bleeding, to the quantity of twelve or fourteen ounces, necessary in any stage or degree of the eruptive fever of the small-pox by inoculation.

2. Cool air is of the utmost consequence in the eruptive fever. The use of this remedy in fevers marks an æra, not only in the management of the small-pox, but in medicine. The degrees of cold should always be increased in proportion to the violence of the fever. Stove-rooms, so common in this country, should be carefully avoided. The more we oblige our patients to sit up and walk in the open air, the better. Even in those cases where they languish most for the bed, they should be encouraged rather to lie upon, than _under_ the bed-clothes. Children should be stript of flannel petticoats that come in contact with their skins; and even clouts should be laid aside, if possible without great inconvenience, and at any rate they should be often removed. Great and obvious as the advantages of cold air appear to be in the eruptive fever, it has sometimes been used to an excess that has done mischief. There are few cases where a degree of cold below fifty of _Fahrenheit's_ thermometer is necessary in this stage of the small-pox. When it has been used below this, or where patients have been exposed to a damp atmosphere some degrees above it, I have heard of inflammations of an alarming nature being produced in the throat and breast.

3. The bowels, more especially of children, should be kept open with gentle laxatives. And,

4. Cool subacid drinks should be plentifully used until the eruption be completed.

Sometimes the small-pox comes on with a fever the reverse of that which we have described. The heat is inconsiderable, the pulse is weak, and scarcely quicker than ordinary, and the patient complains of but slight pains in the back and head. Here the treatment should be widely different from that which has been mentioned when the fever is of the inflammatory kind. Bleeding in this case is hurtful, and even cool air must be admitted with caution. The business of the physician in this case is to excite a gentle action in the sanguiferous system, in order to produce the degree of fever which is necessary to the eruption of the pock. For this purpose he may recommend the use of warm drinks, and even of a warm bed with advantage. If the eruption delay beyond the third day, with all the circumstances of debility that have been mentioned, I have frequently ordered my patients to eat a few ounces of animal food, and to drink a glass or two of wine, with the most desirable success. The effects of this indulgence are most obvious where the weakness of the fever and the delay of the eruption in children, have made it necessary to allow it to mothers and nurses.

The small-pox by inoculation so seldom comes on with the symptoms of what is called a malignant fever, that little need be said of the treatment proper in such cases. I shall only observe, that the cold regimen in the highest degree, promises more success in these cases than in any others. I have repeatedly been told, that when the small-pox appears confluent among the Africans, it is a common practice for mothers to rub their children all over with pepper, and plunge them immediately afterwards into a spring of cold water. This, they say, destroys a great part of the pock, and disposes the remainder to a kindly suppuration. From the success that has attended the use of the cold bath in malignant fevers in some parts of Europe[61], I am disposed to believe in the efficacy of the African remedy.

[61] In a dissertation entitled "_Epidemia verna quæ Wratislaviam,
Anno. 1737 afflixit_," published in the appendix to the Acta Nat.
Curios. Vol. X. it appears, that washing the body all over with
cold water in putrid fevers, attended with great debility, was
attended with success at _Breslaw_ in _Silesia_. The practice has
since been adopted, we are told, by several of the neighbouring
countries. CULLEN'S FIRST LINES OF THE PRACTICE OF PHYSIC.

The fever generally lasts three days, and the eruption continues for a similar length of time, counting the last day of the fever, as the first day of the eruption. But this remark is liable to many exceptions. We sometimes observe the eruption to begin on the first, and often on the second day of the fever; and we sometimes meet with cases in which a second eruption comes on after the fever has abated for several days, and the first eruption considerably advanced in its progress towards a complete suppuration. This is often occasioned by the application of excessive cold or heat to the body, or by a sudden and premature use of stimulating drinks, or animal food.

I come now to treat of the best method of mitigating troublesome and alarming symptoms.

The only _alarming_ symptom is convulsions, to which children are subject during the time of dentition. These have been less frequent, since the liberal and judicious use of cool air in the eruptive fever than formerly. They are often relieved by putting the feet in warm water. But a more effectual and speedy method of curing them, is to expose our patients suddenly to the open air. The colder the air the quicker relief it affords in these cases. To prevent the return of the fits, as well as to allay any disagreeable and troublesome startings, a few drops of laudanum should be given. They generally yield in a little while to this excellent remedy.

The next symptom which demands the aid of our art, is the inflammation and sore on the arm. Poultices of all kinds should be laid aside, as tending to increase the inflammation and sore. Instead of these, the part affected should be washed three or four times a day with cold water[62]. This application is not only agreeable to our patients, but soon checks the progress of the inflammation, and disposes the sore to heal about the time the eruption is completed. The eyes should likewise be washed frequently with cold water, to secure them from pustules and inflammation. With respect to those alarming or troublesome symptoms which occur in those cases where the pocks are numerous, or confluent, they happen so seldom in inoculation, that they do not come properly under our notice in this place. They are moreover fully discussed by Doctors Boerhaave, Huxham, Hillary, and other practical writers.

[62] Where the inflammation on the arm has been so considerable as not
to yield immediately to the application of cold water, I have
used the vegeto-mineral water with advantage.

V. I come now, in the last place, to deliver a few directions that are necessary after the eruption and suppuration are over.

It is well known that eruptions of an obstinate nature sometimes follow the small-pox. These I believe are often occasioned by a too _sudden_ and speedy use of animal food. To guard against these disagreeable consequences of inoculation, it is of the utmost importance to enjoin a cautious and _gradual_ return to the free use of an animal diet; and at the same time it will be necessary to give our patients a dose or two of purging physic.

Thus, gentlemen, have I delivered to you a short history of the new method of inoculating for the small-pox. I am aware that prejudices are entertained against some parts of it by physicians of the most ancient name and character among us. I have witnessed the effects of the old and new methods of preparing the body upon many thousand patients, and I am satisfied, not only from my own observations, but from the experience of gentlemen upon whose judgments I rely more than upon my own, that the new method is by far the safest and most successful. Added to this, I can assure my pupils, that I have never known a single instance of a patient, prepared and treated in the manner I have described, that ever had an abscess after the small-pox, or even such an inflammation or sore upon the arm as required the application of a poultice.

AN INQUIRY

INTO THE

_EFFECTS OF ARDENT SPIRITS_

UPON THE

HUMAN BODY AND MIND.

WITH

AN ACCOUNT OF THE MEANS OF PREVENTING,

AND OF THE

_REMEDIES FOR CURING THEM_.