It is not to be supposed that the method now practised in England so successfully, can be received in Russia without some alteration. The experiments however which I have made in England, in order to ascertain the most commodious manner of conducting the affair, may be of use here; which I shall therefore describe as clearly as possible. * * * * * * * * * * * * * * * * * * * * *
In the original published in Russia, there followed a circumstantial account of the house I had built for the accommodation of my patients in England, and the manner of conducting the process, &c. there; which, as it would be of no consequence or use to insert in this translation, I have omitted. * * * * * * * * * * * * * * * * * * * * * * * *
One, and indeed no inconsiderable advantage derived from a plan of this sort is, that by collecting all the patients together in one house, the physician will be enabled to attend a great number at the same time in a proper manner, and also to pay particular attention to such as may more immediately require his assistance.
And it is of no small importance to those who have been inoculated, that the necessary regulations in respect to regimen, as well as every other circumstance that requires the physician’s attention, may here be properly observed.
There is likewise another advantage obtained by this method, that, with proper caution, the Small Pox will not be communicated to others in the natural way of infection.
Notwithstanding all these conveniencies it will doubtless happen here, as it did in my neighbourhood, that many persons of distinction will rather prefer the inoculation of their families at their own houses. In this case it is submitted to the wisdom of government, whether it would not be proper to give orders that such persons should give public notice of their intention to inoculate, mentioning the time when the operation is to be performed, and also of their perfect recovery. By these means such as have not had the Small Pox, will have it in their power to avoid the infection.
So much with regard to the accommodation of persons of rank, who may be inoculated under one or the other abovementioned regulations. But the poor cannot enjoy those advantages. Humanity however and the interest of the state equally demand, that all possible attention should be bestowed for their assistance and preservation.
In order to attain this end, I know of no better or more certain method than that which I followed, on charitable motives only, in my own neighbourhood, by inoculating all the inhabitants of a village who had never had the Small Pox, on the same day: and, if this be performed in a proper manner, they might be all duly visited, and proper medicines administered at a moderate expence, and the whole be over in about three weeks: after which, this village would have nothing to apprehend from the Small Pox for some years. According to this plan, it will be unavoidably necessary that every child should be inoculated for the Small Pox soon after its birth, or that inoculation should be performed in every town or village once in five or six years. This last method I would rather recommend, and therefore, in order to make this proposal perfectly intelligible, I shall endeavour to explain it more particularly.
A list of the names and ages of such inhabitants of every town and village as have not had the Small Pox, is the first necessary step to be taken; and marks should be made against the names of those who on account of their ill state of health, or other reasons, are not thought fit subjects for the operation in the judgment of the inoculator; and such persons should be provided with a separate place of abode, where they may not be in danger of receiving the infection: the rest should be collected together in one place, inoculated at one time, and proper medicines, with directions specifying the time and manner in which they are to be taken, should be distributed to each individual. On the fourth day after the inoculation they should again be assembled together, the punctures examined, and such farther medicines given as the inoculator may think proper. After the seventh the patients should be examined daily; for from that time to the eleventh, or perhaps fourteenth, is a period that requires more particular attention. During the whole of this time, and indeed throughout the whole process, the sick may continue at their own houses. And it may be reasonably presumed, that there will be a sufficient number of such as are but slightly indisposed, who may be able to assist the others, so as to make the expence and trouble of nurses unnecessary. But we must also suppose, that of the very great number inoculated there will be some who may have the disease severely, or whose cases may require more constant attendance than they can possibly have at their own habitations. To provide for such extraordinary instances, therefore, a proper house and other conveniencies should be previously appointed, to which they should be removed when thought necessary.
It will be impossible to determine precisely how many patients may want such attendance, and consequently difficult to provide exactly the necessary accommodations; but I imagine there will not be more than four or five out of one hundred.