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Medical and Surgical

JOURNAL.

NEW SERIES.

EDITED BY

J. G. WESTMORELAND, M. D.,

Professor of Materia Medica and Therapeutics in the Atlanta Medical College.

W. F. WESTMORELAND, M. D.,

Professor of the Principles and Practice of Surgery in the Atlanta Medical College.

AND

J. M. JOHNSON, M. D.

Pax et scientia, sed veritas sine timore.

PUBLISHED MONTHLY AT $4.00 PER ANNUM, IN ADVANCE

VOLUME VII.

ATLANTA, GA.:

PRINTED AT THE ATLANTA INTELLIGENCER BOOK & JOB OFFICE.

1866.

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Outlines of the History of Variolous Inoculation and Vaccination, with remarks. By S. H. STOUT, M. D., Professor of Surgical and Pathological Anatomy, in the Atlanta Medical College.

Now that small pox is prevalent in almost every city on this continent, and there is a reasonable probability that almost every practitioner in the country will be called on to treat cases of it, and to direct the means of prevention, it is deemed desirable to present to the profession a condensed statement of what is known in regard to variolous inoculation and vaccination, compiled from the best and most recent authorities. The recent civil war has terminated, leaving many of the members of the profession in the South destitute of libraries, and too much impoverished to refurnish their shelves. If I shall succeed in presenting to them such a condensed compilation as will be useful to them, though unable to propose anything new, all will be accomplished that is now proposed.

Origin of Variola.

This disease was introduced into Europe from Arabia, where it is said first to have shown itself about the time of the birth of Mahomed. It is not certain that it was known to the Greeks and Romans. Prior to the discovery of the ameliorating influence of inoculation, no disease was more dreaded or more destructive of life.

Inoculation.

The inoculation of variolous matter, taken from a mild case of distinct small pox, as a means of ameliorating the disease, was first introduced into England by Lady Mary Wortly Montague, in 1721, from Constantinople, where she had been previously sojourning, and had witnessed its favorable result in her own child. In 1726 the royal family submitted to it, and from that time the practice was adopted throughout the civilized world, until it was superceded by the announcement of Jenner's experiments with cow pox virus.

Long prior to the above period, it is stated that the practice was in use in the South of Wales, in the Highlands of Scotland, and among the negroes of the Guinea Coast.

Our predecessors of two generations ago had better opportunities of observing and treating small pox than the practitioners of the present day; for it was often their duty to conduct whole families, or even communities, through the stages of the disease. Hospitals were set apart for the purpose. Skill in this department of practice was necessary to secure a high professional standing. The successful inoculation was necessary to avoid the patient's taking the disease in the natural way; for a case of small pox was in general much milder when acquired by inoculation than when produced in the natural way. The improved practice of avoiding heating remedies, and of securing free and full ventilation was universally adopted by intelligent practitioners.

After appropriate preparation, the virus was inserted under the cuticle in the same manner now in vogue, when we inoculate the vaccine virus. The lymph was prepared, and if the scab was used, it was preferred fresh. Variolous virus, as well as vaccine virus, does not retain its virtues so well in warm or moist as in dry and cool weather; for the process of putrefaction, which is destructive of its vitality, is set up more rapidly in the former than in the latter case.

This truth it is well to bear in mind when undertaking to disinfect buildings or clothing infected with small pox virus; and it accounts, in part, for the greater facility with which

the disease is propagated in cool than in hot moist weather. In choosing a subject for inoculation, if circumstances permitted an election, reference was had to the state of his health; none but the healthy were voluntarily subjected to it. Great care was paid to diet and regimen, with reference to overcoming a predisposition to inflammation. The plethoric and gross were reduced, by gentle purgatives, and even sometimes by the administration of mercurials or antimonials. Very old persons, and children under four months of age, were, if not exposed to the contagion, avoided. The cool season of the year was preferred. Very cold weather, which might necessitate the building of large fires, or the closing of windows and doors, was avoided. So, too, very warm weather was considered unfavorable to the safety of the operation.

The virus was preferably taken from young, healthy subjects, who were laboring under a very mild case of distinct small pox.

It has been my fortune to have seen and examined the scars upon the arms of many persons, who, in childhood, had undergone the operation; but few had more than one pock while suffering from the disease, and consequently only one scar, which in its characteristics resembled that following vaccinia.

Vaccination.

To Edward Jenner, born at the vicarage of Berkely, in Gloucestershire, in England, is due the distinguished honor of having practically first demonstrated the power of cow pox as a protective against small pox. An impression had long prevailed among the dairymen and women in Gloucestershire, that there was a certain disease, which occasionally occurred among the cows, characterized by a vescicular eruption, generally upon the udder, that if acquired by man, was a preventive of small pox. When, in 1770, he went to London as a student of medicine, Jenner frequently mentioned this popular rumor to his preceptor, John Hunter. In 1775 he gave more attention to it. Probably in 1780 he

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