But whence came the vaginal discharge? That it issued from the vagina was most certain; but whether it was furnished by that canal, or by the uterus, was not ascertained. To assert that it was menstrual, would be hazarding more than a prudent regard for truth would justify. But, if not, why the pain and spasms which preceded it, and the alternation of these symptoms with each other? and, especially, why the slimy appearance, mixed with red matter, without a trace of any thing like coagula? Certainly we do not find these appearances in ordinary cases of hæmorrhage. So that there is no other way of accounting for the discharge in this case, except by considering it as having been secreted by the vessels of the parts from which it came.
From the difficulty which the child experienced in swallowing, but little food could be taken; and the same difficulty precluded the administration of medicines. What caused this impediment could not be ascertained, but it was supposed to result from a spasmodic action of the muscles of the part.
The only medicine attempted to be given was a weak infusion of bark, and this was soon abandoned.
The spots, particularly the large ecchymosed surface on the head, exhibited no change in appearance, when viewed superficially, a few hours after death. No other examination was permitted.
Article III.—History of the Natural and Modified Small-Pox, or of the Variolous and Varioloid Diseases, as they prevailed in Philadelphia in the years 1823 and 1824. By John K. Mitchell, M. D., and John Bell, M. D. attending physicians at the then Small-Pox Hospital. With a Plate.
In a question of less moment, some apology might seem due for once more directing public attention to that which has been so oft discussed and described by many eminent physicians and experienced observers. But, if descriptions of any disease be valuable; if to record faithfully an evil be among the first steps for its removal and prevention; and, still more, if additional confidence, derived from enlarged experience, can be imparted to the means hitherto adopted to guaranty the human frame against a mortal and loathsome malady, our efforts at this time may claim the favourable notice of our professional brethren, and of the community at large.
Sedulously abstaining from the parade of erudite research or indulgence in speculations, however ingenious, it is our intention to describe with accuracy all that we saw; and if, in so doing, we shall be found repeating what others have said before us, and proposing inferences previously drawn, the observations and deductions are to be considered as not the less our own, since we only speak from conviction, founded on the evidence presented to our senses. Our opportunities for accurate judgment were most ample, being derived as well from an attendance of nine months on the hospital for the reception of the poor, labouring under the disease, as from one of us prescribing, during a part of the time, for the Philadelphia Dispensary, added to the cases furnished us by private practice, and very many others, the records of which have been kindly placed at our disposal by professional friends.
The ravages committed by the small-pox in Baltimore, and the fact of many who had been previously vaccinated having been attacked by the disease during the years 1821 and 1822 were notorious to us all, but were productive of little alarm in Philadelphia. The non-appearance of the scourge in the greater part of the period, when the former city was suffering under it, justified, to a certain extent, this feeling of security, and seemed to call more on our sympathies for our neighbours than on our fears for ourselves.