But it seems as if these opposers expected that inoculation should not only free the inoculated from the small-pox, and any early bad effects, but must preserve them too from all other disorders through the rest of their lives. To such I can say nothing; but if others, who are more reasonable, require further satisfaction as to the consequences of this method, I must desire them to make inquiry of those who have been inoculated under my direction.
Another charge against this method of inoculation is, that some have had the distemper afterwards in the natural way. What I have said under the head of anomalous small-pox, will I believe sufficiently account for the appearances which have occasioned these false reports; and if that does not satisfy, I can only add this positive declaration, that nothing of the kind has ever happened to any patient inoculated by me; and I firmly believe, no one has ever had, or can have, the distemper a second time, either in the natural way or from inoculation.
The Effects of this Treatment applied to the natural Small-Pox.
The very great relief which persons under inoculation experience from fresh air, cold water, and evacuations by stool, during the fever preceding eruption, soon determined me to make trial how far the like treatment might be useful to those who might be seized with the small-pox in the natural way; more especially in such cases, where, from the violence of the symptoms, a confluent kind was justly to be apprehended.
But opportunities of making experiments of this sort in a satisfactory manner are rare. First, because a physician, or even medical assistance of any kind, is not often called in till the eruption shews itself; when it is too late to expect all the good effects that might be hoped for, from an earlier trial of this method: and secondly, because the first attack of the small-pox is so much like the beginning of some other fevers as not easily to be distinguished; though a diligent attention to the symptoms, will generally, if we are called in time, enable us to form a pretty certain prognostic. For if the attack of the cold fit be pretty severe, and the subsequent fever unusually high; if a nausea and vomiting succeed, together with great pains in the head, back, and loins, especially in the last; if a delirium, great restlessness, disagreeable taste in the mouth, and a peculiar fœtid smell in the breath, or even if several of these symptoms are observed, the small-pox may with great reason be expected; and if upon inquiry, which should always be made, it appears that the patient has been in the way of infection, there will be little reason to doubt it.
It may be objected, that notwithstanding the closest attention and inquiry, symptoms of the like nature may precede fevers of other kinds; to which I answer, that some such cases, though few, have happened; and the treatment I am about to recommend has been practised not only without prejudice to the patient, but manifestly to his benefit.
But waving for the present all considerations respecting the treatment of fevers in general, I shall only relate what has occurred to me in respect to the natural small-pox.
In several instances where I have been concerned, and where the symptoms and other concurring circumstances induced me to think the small-pox was at hand, I have directed the like management as I recommend to inoculated patients[5].