CASE XX.
In May 1776, I was desired to visit a considerable farmer, aged 68, to give my advice for a complaint in his legs.
About two years before he had been seized with a numbness and coldness in both legs and thighs, which it was apprehended would end in a palsy. For this disorder he took many medicines, and both his legs were blistered, by which he found relief; but from this time the legs were affected with troublesome itching and burning pains, attended with a sharp serous discharge through innumerable excoriations. These complaints destroyed his rest, and made him unhappy.
After relating this case, he told me, that as almost every body in the neighbourhood, who had not had the small-pox, was either under inoculation or preparing for it, he could scarcely expect to escape the infection, and had therefore a strong desire to be inoculated; and that his wife of the same age with himself, was likewise desirous of it.
This proposal induced me to examine the present condition of his legs more strictly. They were now, he said, in their best state; that is, not so full of pain as usual; they were dry and scurfy. His face was likewise scurfy, and of a settled deep red colour; the consequence, as he told me, of a repeated Erysipelas in it, and not of any intemperance.
Upon considering the case, and reflecting that the preparatory course of diet and medicine would probably amend the condition of his legs, I encouraged him to pursue his intention; and both he and his wife, after a fortnight’s preparation, were inoculated on the third of June.
On the 9th both made some slight complaints; and on the 12th the wife grew better, on the appearance of a very few distinct pustules, which maturated afterwards in the most favourable manner. But the man still complained of pain and weariness till the 13th, when he grew easier in that respect, and felt a smarting pain in his legs, which were very red, and had several pustules on them. Towards evening they grew more painful, more swelled, and a further eruption was discernable, though not easy to be distinguished, by reason of their diseased state.
He slept very little this night; but on the 14th I found him free from fever, and pretty well in all respects, except the pain in his legs; on which, and under the hams, a great number of distinct, but almost coherent pustules appeared. There were several also in the neck and face, but very few on the body or arms. He had all along been advised not to stir much, but had taken greater liberties of walking about than I had allowed.
15th. He had not slept a minute during the night. I found him up and walking about the house, complaining much of pain, but saying that in other respects he was well; but he was now rather cool than warm, his pulse very low, his aspect languid, the colour of the face inclined to livid and pale, and he complained of faintness and sickness. I could not avoid being alarmed. The legs also were swelled considerably, but not inflamed. I therefore ordered him instantly to bed; and as the tension was great, applied a cataplasm of bread and milk (being what was nearest at hand) all over each leg, and directed the following medicine to be taken as soon as possible.
℞ Mithrid. Ʒss. Decoct. Cort. Peruv. ℥ij. Tinct. Cort. Peruv. simpl. Ʒij. M. f. haust. quam primum sumend. & sexta quaque hora repetendus.
℞ Sal. Absinth. Ʒj. succ. Limon. ℥jss. Decoct. Cort. Per. ℥vi. Tinct. Cort. Per. simpl. ℥jss. Syr. é Cort. Aur. ℥ss. M. f. mixtura, cujus capiat Coch. iv. horis intermediis.
In the evening his pulse was raised, he was easier, and rested about an hour.
16th. In the morning, after he had rested some hours in the night, he was easier, warmer, and the pulse better.
17th. After a good night he found himself free from complaints, and from this time every circumstance went on favourably; the pocks maturated on the 7th day; his legs however were both considerably ulcerated for a fortnight after, but then soon healed. He remains at present in good health, and feels less uneasiness from his legs than he did before the inoculation.