London, April 11, 1775.
S I R,
I HAVE carefully perused the case you have communicated to me, and am of opinion, that the disease you have described was not the small-pox.
The cold fit which preceded the other complaints, is what usually happens at the commencement of the small-pox in common with other fevers; with this exception, I do not find one symptom during the whole illness, that corresponds with the well known progress of that disease.
The eruptions (on which I presume the suspicion of the small-pox was founded) differed from that distemper in every essential point, viz. The time and manner of their appearance; the parts they occupied; and their form and progress. Neither am I of opinion that the disease was the effect of any variolous matter left in the blood, in consequence of the previous inoculation.
That the natural and inoculated small-pox, as well as other diseases which form critical discharges on the skin, may sometimes be succeeded by boils or breakings out, is well known; but these follow very soon, are free from danger, and easily cured by gentle purges. Now in the case before me, I find the patient passed through the inoculated disease, in a regular, complete, and satisfactory manner, and continued well for six weeks after, making no complaint: after which he was seized with a disease that I have not the least doubt was a fever of the putrid kind; but I do not think that the pustulary eruptions can with propriety be deemed critical, as they did not terminate the disease; I rather esteem them to have been marks or tokens of great malignity and danger.
In the course of my whole practice, which it is well known has been extensive, I never knew a single instance of any one having the natural small-pox, after having been inoculated; nor have I ever known any person to have the disease a second time in the natural way.
I shall not pretend to decide on what may have happened to others; but what I have said is true, so far as relates to my own experience.
The report of the gentlemen who opened the body, affords no material information.