The Eastern Practitioners, with great modesty, arraign the European practice of Phlebotomy and Cathartics in any stage of the disease, but more particularly when designed to prevent, or mitigate the second fever; alledging, that the first weakens the natural powers, and that the latter counteracts the regular course of nature, which in this disease invariably tends to throw out the offending cause upon the skin; that she often proves unequal to the intire expulsion of the enemy, in which case, her wise purposes are to be assisted by art, in that track, which she herself points out, and not by a diversion of the usual crisis into another chanel; that this assistance can only be attempted with propriety, by emptying the Pustules, as thereby fresh room is given in them for the reception of the circulating matter still remaining in the blood, and which could not be contained in the first eruption; by which means every end and purpose of averting, or subduing the second fever is obtained, with a moral certainty; whilst Phlebotomy and Cathartics, administered with this view, are both irrational and precarious; as being opposite to the constant operation of Nature in her management of this dreadful disease.
It remains only that I add a word or two upon the Eastern manner of opening the Pustules, which (as before mentioned) is directed to be done with a very fine sharp pointed thorn: Experience has established the use of this natural instrument in preference to either the scissars, launcet, or needle; the Practitioners perforate the most prominent part of the Pustule, and with the sides of the thorn press out the pus; and having opened about a dozen, they absorb the matter with a callico rag, dipt in warm water and milk; and proceed thus until the whole are discharged: the orifice made by the thorn is so extremely small, that it closes immediately after the matter is pressed out, so that there is no admission of the external air into the Pustule, which would suddenly contract the mouths of the excretory vessels, and consequently the further secretion of the variolous matter from the blood would be thereby obstructed; for this consideration, the method recommended by Doctor Tissot, of clipping the Pustules with sharp pointed scissars, is certainly liable to objection, as the aperture would be too large; when in the true confluent kind, no distinct Pustules present, they perforate the most prominent and promising parts, in many places, at the distance of a tenth of an inch, usually beginning at the extremities; and I have often seen the Pustules in the contiguous, and the perforated parts in the confluent kind, fill again before the operation has been half over; yet they do not repeat the opening until a few hours elapse, conceiving it proper that the matter should receive some degree of concoction in the Pustules before it is again discharged.
If the foregoing Essay on the Eastern mode of treating the Small Pox, throws any new and beneficial lights upon this cruel and destructive disease, or leads to support and confirm the present successful and happy method of Inoculation, in such wise as to introduce, into regular and universal practice, the cool regimen and free admission of Air, (the contrary having proved the bane of millions,) I shall, in either case, think the small time and trouble bestowed in putting these facts together most amply recompensed.
Chilton Lodge, Wilts,
September 1, 1767.
FINIS.
FOOTNOTES:
[1]. The instrument they make use of, is of iron, about four inches and a half long, and of the size of a large crow quill, the middle is twisted, and the one end is steeled and flatted about an inch from the extremity, and the eighth of an inch broad; this extremity is brought to a very keen edge, and two sharp corners; the other end of the instrument is an ear-picker, and the instrument is precisely the same as the Barbers of Indostan use to cut the nails, and depurate the ears of their customers, (for in that country, we are above performing either or these operations ourselves.) The Operator of Inoculation holds the instrument as we hold a pen, and with dextrous expedition gives about fifteen or sixteen minute scarifications (within the compass abovementioned) with one of the sharp corners of the instrument, and to these various little wounds, I believe may be ascribed the discharge which almost constantly flows from the part in the progress of the disease. I cannot help thinking that too much has been said (pro and con) about nothing, respecting the different methods preferred by different Practitioners of performing the operation; provided the matter is thrown into the blood, it is certainly a consideration of most trivial import by what means it is effected; if any claims a preference, I should conclude it should be that method which bids fairest for securing a plentiful discharge from the ulcer.
[2]. In an epidemic season of the confluent Small Pox, Turkeys, Chittygong Fowls, Madrass Capons, and other poultry, are carried off by the disease in great numbers; and have the symptoms usually accompanying every stage of the distemper. I had a favourite Parrot that died of it in the year 1744; in him I had a fair opportunity of observing the regular progress of the disorder; he sickened, and had an ardent fever full two days before the eruption, and died on the seventh day of the eruption; on opening him, we found his throat, stomach, and whole channel of the first passages, lined as thick with the pustules as the surface of his body, where, for the most part, they rose contiguous, but in other places they ran together.