16th. The pustules were properly advanced, and the man seemed to be perfectly well. But there were now some appearances in the arm which I was dissatisfied with: for the inoculated part was covered with a great number of very small pale-coloured confluent pustules; and the incision, instead of being elevated, was depressed, and of a livid colour in the middle: this sometimes happens, and denotes an eschar and ulceration at the conclusion of the disease.
17th. He was seized in the middle of the day with a shivering fit, succeeded by great heat and pain in the head, back, and limbs, which continued all the following night. He likewise felt considerable pain at the incision, and in the shoulder, extending to the axilla.
18th. In the morning he complained of great pain at the incision up to the shoulder and the axilla of one arm. The pulse was very quick, and the fever high. In this situation I made no doubt but there would be a second eruption, and therefore persuaded him to get up and go into the air, and directed an infusion of senna and manna to be taken immediately.
This operated four times, and he was considerably relieved of all his complaints; but fresh pustules now made their appearance on the face and other parts, to the amount of double the number at least of the first. From this time he remained quite free from fever, and every other complaint; the last pustules, as well as the first, maturating in the most favourable manner. But what is very remarkable, both crops of pustules ripened nearly about the same time; for the progress of those which came out first seemed to be retarded by the second eruptive fever, and the latter pustules advanced quicker than usual.
CASE XVII.
June 2d. Twenty-two persons were inoculated, who lodged at two neighbouring houses.
On the 4th in the evening one of them, a man aged 30, had a shivering fit, succeeded by fever, with pain in the head, back, and side, which continued all night.
5th. In the morning, when I first visited him, the pulse was very quick, full, and strong, and the former complaints remained; but I found him walking about the house. On inspecting the incisions, both were quite well; while those of every one of his associates, which I saw at the same time, shewed evident marks of infection.
This patient had been very much in the way of infection, and I suspected that he was going to have the small-pox in the natural way: I therefore directed the mercurial and antimonial pill to be taken at night, and that he should go into the air as much as he could bear, but not go into bed.