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.
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.
Footnotes:
[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.
[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.
[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.
[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.