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NATIONAL LIBRARY OF MEDICINE
         Washington 
Information giran over telephone by Mrs. White, Librarian, Western
    Reserve Historical Society, May 22, 19S8

The Hamlin Family, by the Honorable H. Franklin Andrews.  Publ. by
   " the author, Exira, Iowa, 1900.

    Jabez Hamlin was a resident of Middletown in 1773•
    Appointed commissary for troops in 1745>*  Took part in expeditions
       to Canada and Great Britain  (?)
    Town clerk in 173U
    Deputy from Middletown to General Assembly of Connecticut for
       6£ sessions, 1731-1773.  Speaker 1770-1772.
    1735-17U5, Justice of Peace
    Chief Judge of Hartford County, 17SU-178U
    Judge of Probate at Middletown, 17S2-1789
    Mayor of Middletown, 178u-1789 
 
  HISTORY,
        L-Haywardfrom

            JDoct:jOiiiiOrboni,


INOCULATION.
    By M. De la Condamins,
Member of the Royal Academy of Sciences in France;
*%t}?lijhed April 24-th, 1754:
       N E W - H A V E Nj


Printed by T^ and S. Green, near the College, ijj$ 
CK
CONTENTS.
HE $rjt part contains the principal  UJlorical faffs,
  concerning  Inoculation.
 T
   In the fecond, the objettiom againjf its ufe are examined.
   Thy bird part  contains,  tonfequences  drawn from  tk
fa-bls of the preceding parts, and the  advantages of Inocula*
 tion let in a proper light. 
  THE  HISTORY  OF INOCULATION.

                 PART    I.

      THE artificial communication of the fmall-pofc, an
        operation move generally  known  at prefent under
  the name of inoculation, has been practifed time immer
  morial, in Circafiia, Georgia, and the countries bordering
  upon theCafpfan fea.  Tho' unknown in the greateft part
  of Europe,  it was in ufe in the principality of Wales in
  England.  It was formerly known, ana fince neglected in
  Greece and Turky, and was not revived again  at  Con-
  ftantinople till towards the end of the laft century, when a
  Thefialian woman praclifed it there with great  fuccefs ;
  but this  was only among the lower clafs of people.   This
  cuftom is very ancient, and generally received in the ifland
  ofCephalonia, fubject to the republic of Venice ; it is com-
  mon in theMorea, and the ifland of Candia.  If we go out
  of Europe, we ihall find it at Bengal, and fo long practifed
 .on the coaft, and  in the  interior of Africa, at Algiers,
  Tunis, and Tripoli, that its ortgin.is unknown, but proba*
  bly introduced in  the time of the Arabs.   In the begin-
  ning of the laft century, the fmall>pox was communicated
  at China, without incifion, but through  the nofe, by re-
  fpiring the matter of fome dried puftules reduced to pow-
  der.  All thefe facts were buried in oblivion,till Emanuel
  Timone, a Greek  phyfician, and member  of the univerfi-
  ties of Padua and  Oxford,  having undertaken  to bring
  inoculation into fome vogue, gave an ample difcription o£
  it in a letter to Dr. Woodward, written from  Conltantino-
  ple in  the njonth of December, 1713.  During the eight
  years he had attended the  operation In that capital, there
  were only two fatal events, whofe caufes  were  foreign to
  inoculation, one of the patients having died of a dyfentery
  the 3 2d day, and the other of a marafmus, the 40th  after ■*
* the operation.                                 Jamej^ 
~ fames' Pilaririi, another Greek phyfician, wlro "had lon<r
dilapproved the new method, at laft, fully convinced c?
its-utility from the evidence of facts, wrote an apology for -
the artificial fmall-pox, in  a  fmall Latin work, printed at if
Venice in 1715.   The Theffalian woman afllires us (he
had inoculated 6000 perfons  in the year  /713.  Of this
rinmbfir were the greater part of the Englifn, Butch, and
French merchants fettled at Conftantinople.   Anthony
■Le  Due, another  Greek, who was alfo inoculated by this
•woman, .received   afterwards, in 1722, the Dodtor's cap,
atLeyden, maintained publicly the practice of inoculation.
  Madam Wortlcy Montague, the Englifh Ambaflador-s
Lady at the Ottoman Porte, in 1717, had her only fon,
about fix years old, inoculated there by her  furgeon, and
afterwards her daughter, on her return to England, where
the example was followed by feveral perfons of diftinction.
It was by the defire of the College of Phyficians, at Lon-
don, that the experiment was made on fix criminals; it
faved a life they deferved to  lofe by  their crimes.   The
late Queen of England then Princefs of Wales, had two of
her younger daughters, the late Queen of Denmark;, and
the Princefs of Hefte-Caflel, inoculated  in  1722:  This
operation, conducted under  the Direction of Dr. Sloane,
contributed greatly to inhance the reputation of this new
prefervative. Whilft the moft famous phyficians of Great-
Britain, the Doctors Sloane, Fuller, Arbuthnot, Jurin,
Mead, &c. favoured the new method,or wrote in its favour;
whilft Dr. Shadwell, &c.  prattifed it on  their  children,
Blackmore and Wagftaffe, two phyficians little known,
r-nd MafTey, an apothecary, feemed to endeavour to get a
name by proscribing  it.   Whilft the Bifhop  of Salisbury
and other cafuifts fuftered their children to be inoculated,
other divines prete/.dedthat it brought down the wrath
of Heaven on  the nation :  To prove  this, fome were fo
abfurd as to aledge  the great numbers that died of the na-
tural fmall-pox, and one, in  particular, boldly aliened in
his  fermon, that the devil himfelf had given Job the fmall- t
pn::, by this intern.* d method.                     How-' 
  However, befides the' experiments #6f. Conftantinpplp,
where, in one year, upwards of i®,ooo perfons had happi-
ly pafled through this trial,a great number were inoculated
in England without any accident.   Dr. Jurin, Secretary
to the Royal Society, publilhed feveral pieces in  1723,
and 1724, whereof fome are  inferted in  the Philofopnical
Tranlactions, giving an account of the  fucccfsful eiperi-
ments made in Great-Britain and New-England, with :^ve-
ral letters by way of fupplement and proofs, and exact lifts
of the fick, and thofe that died of the natural and artificial
fmalLpox ; together with comparifons of their effects.   It
appears from his  calculations, confirmed by others more
recent, that at London, and even in the country, where the
diftemper  is reputed lefs dangerous, there died commonly
^ifeventh,  fixth,  and fometimes fifth of thofe,  who had
been  taken ill of the natural fmall pox, whilft fcarceone
died  in ninety-one, of  fuch as received it by  infertion,
though it could not be proved that this  death was  occafi-
oned  thereby, and though the method was not yet brought
to perfection.  In  thefe beginnings, feveral  experiments
were  hazarded upon infirm and ill-prepared fubjects ; and
it was in fuch circumftances, that, at Bofton in New-Eng-
land, of 300 perfons, young, old,women with child, inocu-
lated indifcriminately, from one year to feventy, with few
precautions, in a time of epidemy and  hot weather, five
died, that  is, one in fixty ; though it is  doubtful whether
they  died of the effects of the operation  •, however it is pre-
tended  that one  died in forty-nine,  and this misfortune,
having fallen upon fome perfons of diftinction,gave weight
to the clamours of fuch as fhewed themfelves prejudiced.
The Magiftracy interpofed, the  fpirit of party.interfered,
and the operation was not permitted but under certain re-
ftrictions that refembled a prohibitation.   It  was given
out that inoculation did not preferve from the natural linall-
pox,  and yet no example could  be  produced, to prove it.
The  wifer and more moderate concluded, that it was pru-
dent to wait till time and repeated  experiments had given
mo»e infight into  the matter. _ .             .    .   The 
   The iuccefs of the new method was grft known in
France, by a letter M. de  la Cofte, a  Doctor of phyfic,
addrelfed to M. Dodard,  the King's flrft phyfician, and
publifhed  at Paris in 1723, with the approbation of M,
Burette, a Doctor of the faculty of Paris.   In this letter,
followed by; fome others of M. Sloane, M. Amyand, &c. th
advantages of inoculation are properly ftated, the lifts and
calculations of M. Jurin are cited,  and fome new fads are
advaaced, with judicious arguments, and anfwersto objec-
tions.   Mention is alfo made therein of a confutation of  ,
nine of the moil famous Doctors of  Sorbonne, whom^he
author had the iatisfaction 0 fee conclude at laft,'.  that it
was licit, in the view of being fervieeable to  the public to
make experiments of that practice.'   'The fame letter fnpV
pefles, that M. Dodard, and feveral other famous phyficiT
ans,.as the  late M. Chirac, M. Helvetius, &c. approved
the new method.  In the fame work is quoted a letter of
M. Aftruc, wherein he expreffes himfelf,'  that he did nop
judge that  the operation could be attended with any dan-
ger, and that he was glad  it  was   intended to  be prac-
tlfed at Paris.
   The falfe reports that were induftrioufly  fpread of the
iHfuccefs of inoculation, at  Bofton, during the fummer of
1-723 ; the number carried off by the epidemy that fame
year at London, and falfely  attributed to  the operation -,
£6mt misfortunes caufed by the'imprudence of youngper-
fons newly  inoculated, who committed exceffes}  had di-
juini&ed the public  .confidence.  Thefe reports reached
Paris when the phyficians had refolved upon making their .
experiments.  After the fuccefs of thofe in England, aad
particularly on the Royal family,  it was  high  time for
making efiays in  France, at leaft in the hofpitals.  They  '
were favoured by the Duke of "Orleans, Regent of France -x .
but his eyes were fcarce clofed, when athefis  was main-'
rained  in the fchools* of  medicine,  which,  founding the
alarm againft the inoculators,  treated  their operation as
criminal, thofe that practifed as impoftors and execution-
errand the patients as dupes.                      Re- 
    Repeated blows being immediately  after given  to th£,
  fiew method, it foon fell into a fort of oblivion till the year
s  1738.   In that interval few were inoculated, even inEng-
  land, and fince that time the hiftory of that tlus pra6ticd
  became almoft unknown in France.
    Whilft it feemed to lofe  ground in Europe, it made
  new conquefts in Afia.  The epidemy of i723,the plague
  of Europe and America,  made  perhaps the tour of the'
  world.  The Tartars, among whom the fmall-pox is noc
  common, were infected, and the greater part of grown-up^
  perfons died ©f it.   Father DentrecoHes, a Jcfuit Mifliona-
  ry,  in his very curious letter of the nth of  May, 1726,
  at Pekin, relates that, in 1724, the Emperor of China fenc'
  phyficians from his palace  into Tartary, to fow there the
  artifical fmall-pox j this is the name the Chinefe give their
  method of infertion, of which we ftiall  fpeak initsplaceJ
  Undoubtedly the fuccefs of the Chinefe phyficians was
  fortunate, having brought back with them  a great num-
  ber of horfes, fkins, and  furs,  which  are the riches and.
  money of the Tartars.
    In other parts, the practice of inoculation, after the Eu-
  ropean manner, was perfected in filence.  during the tame*
  of its difgrace r  Its progrefs was lefs divulged, but its fa-
  lutary effects were not therefore lefs confpicuous, both In*
  the antientand new world.  Much about the year 1728,
  a Carmelite Miffionary, in the neighbourhood of the Pop--
  tuguefe colony of Grand Para, in Sou^h-America, feeing
  all the Indians of his miflion  dying one after cnother or
  an epidemical fmall-pox, and that not one infected perfon
  recovered, he faved all thofe that remained, by hazarding
  on them the method of inoculation, of which he had but
  a very iuperficial knowledge, from  an  European gazette.
  His example was followed not lefs fuccefsfuUy  by one of
  his brethren, a  Miffionary  on the banks of Rio Negro,"
  and by fome  Portuguefe of Para.  In a new epidemy that
  laid wafte  that province in 1750,  the fame prefervative'
  produced the fame effcft.  A terrible epidemy ravagedi
                                               Carolina 
Carolina in' 1738 ; all thofe who were taken ill could riot
refjft the violence of the diftemper.  Then it was that they
called to mind how efficacious the remedy was,which.they
had neglected fince the year 1724 -, they had again recourse
to inoculation, which fucceded better than ever, becaufe,
in the hot fultry months of June, July, and Auguft^ a fea-
ibn very contrary to inflammatory difeafes, and in a coun-
try where the method had not fucceded fo well as  in Eu-
rope, of a  thoufand perfons  inoculated, but eight died,
which is only one to  125.  It is very probable that in the
experiments made in America, on a  multitude of  negro-
flaves, lefs precautions wereufed in preparing the fubjects,
than in  the. ope rations made  inEurope on free-men,whofe
lives were more precious : Befides, the  generality of the
negroes  are originally infected with a veneral virus, which,
they bring from their country, and therefore the choice of
fit  fubjects  for  inoculation is  thereby  rendered more
difficult.
   The new fuccefs of the practice in Carolina,  in 1738;
was not equal to that of the  fame year in England, when-
it beo*an again to take place.   Of near 2000 inoculated
within twelve years at Winchefter, and the neighbouring
parts of Hampfhire  and Suflex,  none died, according- to
the account of D.\ Langrifh, but two women with child,
who were  diffuaded by their phyficians to expofe them-
felves to inoculation.
   The year 1746 was, at London, theepochaof thefoun-
dationofa houfe of charity,  as  well for  inoculating the
poor, and diminifhing by this means  the devaftation,made
by the fmall-pox,  of mankind, as for  fuccouring thofe who
might be taken ill of it  in - the natural way.   It was in the
church of this hofpiftl, and in the fame pulpit where,  30
years before, inoculation had been treated as the work of
devils, that Dr. Maddox,  Bifhop of Worcefter, preached
that famous fermon,  feveral  times reprinted, whereby he
excites the charity of his fellow-citizens in favour of this
practice, of which he demonftrates the advantages : The
                                             annexed 
 -Annexed'notes to this fermon, and the  work  publiflie4 by,
 M. Kirkpatrick, inform us that of 309 perfons  the great-
 er part adults, inoculated in the new hofpital, and of 1500
 inoculated by three differentPractitioners, that is, of 1809,
 but fix died, which does not  make one in 300  ; that M.
 Winchefter, Surgeon to  the Foundling hofpital,  loft but
 one child in 186.-,  and that, of 3 70 other experiments made
 elfe where, one only had proved unfortunate.   M. Freyin,
 afiures us, that, of upwards of 300 inoculations at Rye,
 but one  was tinfuccefsful.  "It is true, that at Salifbury
 four died out of 422, and three at Blandford out of 309.
 >  In the month  of November, 1747, M. Ranby, firft Sur-
 geon to his Britannic Majefty, had inoculated 827, and his
 Experiments, all fortunate, amounted  at the end of 1752 j
 to upwards of 1000.   The difference of fuccefs may be
 partly attributed to the greater or lefs degree of malignity ill
 the epidemy, partly to the greater or lefs fliare of precaution
 in preparing and tending the fick, and, laftly,  to the dif-
 ferent degrees of experience and abilities of the irioculators,
.butefpecially to the maxim of not hazarding inoculation
 on  perfons of a bad conftitation,unwholfome, or fufpected
 of other diforders.  The Greek woman at Conftantinpple
 was exceeding fcrupulousin all thefe points, and it  was td
 her exact obfervance of theiti,  that fhe attributed the  con-
 ftancy of her fuccefs.-
   In refumihg the foregoing facts, and feveral others of
 which I omit the detail, I find, that, in the whole, out of
 316 inoculated,  bnt one  died.
 , In 1748, one  Dr. Tronchin, a  hatiye of Geneva, and
 tnfpector of the College of Phyficians  of Amfterdam,
 having been on the point of lofirig one of his fons by the
 natural iaialhpox, fefolved  to inoculate his eldeft :  This
 Was the firft inoculation in Holland.   It- Was followed by
 nine others, which  M. Tronchin  took upon him the di-
 rection of.  Two years after, he recommended this practice
 at Geneva, which being  accordingly   adopted,  M. Calen-
 drini, a-famous Mathematician, and  one of the chief Ma-
 gistrates of the republic,  fet the example on his fori ; ho
                        B                       fatal 
------------------.    r—to—J
fatal event has fince  occafroned  there  any regret.   The
fame year, inoculation  was intrdduced  in  Italy, by Dr.
Peverini,  then phyfician of Citerna, in the Ecclefiaftical
State, with very happy and  fingular circumftances.   He
was imitated by feveral of his confraternity, and upwards
of 400 perfons, of all ages, were fuccefsfuUy inoculated in
thofe parts.
  In 1753,  inoculation began again at Amfterdam with
the epidemy, and the  moft  illuftrious  families at the
Hague were the firft to follow the example  of M. Tron-   .
chin.  The fuffrage of M.Swenke,Profeflbr of Anatomy,
and a phyfician of great  reputation in his profeflion, and
the continuity of fuccefs, brought the method into requeft
in feveral towns of Holland.  Switzerland^ well as Eng-
land, is indebted for it to the example of a tender mother,
a lady of Lauzane, who, feeing that her fon did not catch
the fmall-pox from his  twofifters,  gave it to him by the
way of infertion.
  • Such hare been for upwards of 30 years viciffitudes of
 fortune in the famous method of inoculation.   The eme-
 tic and bark did  not  meet with  lefs  contradictions, till
 their virtues were generally known.  But, before we pro-
 ceed, itwill not be amifs to give  a  diftinct idea of inocula-
 tion, as being ah effential part  of its hiftory,  and of the
 different  manner  of practifing it,  by thofe who know it
 but imperfectly.
   The  artificial fmall  pox is  probably  more ancient
 at China than elfewhefe.  Father Dentrecolles, obferves
 in  his  letter above-mentioned,  that if this  cuftom was
 introduced  from Circaflia,  or  the adjacent parts,  into
 China, it would, in all probability, have firft  extended
 into the weftern  provinces, and  the neareft  to  the  Caf-
 pian fea  ;  whereas it is in the  other  extremity of that
 empire, towards theEaft, and in the province of Kiangnan,
 on the fea of Japan, that the method of Tchong-teou, that
 is, of lowing the  fmall-pox, is more antiently known.  The
 Chinefe thruft into the nofe of children a tent of cotton
                                          impregnated 
                      .  (  II   )      .      .    -   -
   impregnated with the matter of the dried  puftules  of the
   fmall-pox reduced into  powder.  This trial was made in
*   England, in  1721, on a young woman under fcntence of
   death : She was more fick than any inoculated in the ufual
   way, and the Chinefe practice, of which fatherDentrecol-
   les relates three different receipts, was judged dangerous.
     Both in Greece and Turky,  the liquid matter, ftill hot,
   drawn, fome moment before, from puftules of a natural
   and favourable fmall pox, was introduced in feven or
   eight punctures, made in different parts of the body, with
   teveral fuperftitious  precautions accompanied with offer-
   ings of wax candles,by the means of which Timone fufpec-
   ted that the Greek inoculatrefs procured the good-will of
   the Grecian priefts, who fupplied her with a prodigious
   multitude of fubjects for inoculation.
     The fame Timone describes  the different operations of
   two Grecian old women : The one of Philippopolis,fome-
   what more fimple in her procefs ■,  the other of Theflalo-
   nica, who joined quackery to fuperftition,  but who, more
   fkilful than any of her fifterhood, had remarked, as the
   Chinefe, that it was indifferent to ufe for inoculation mat-
   ter taken from a natural or artificial fmall-pox.  LaMotraye
   relates the manner of his feeing the operation conducted
   in Circaflla, by an old woman, much after the way at Con-
   stantinople.   She only  made punctures on different parts
   of the body with three pins tied together ;  the patient was
   brought as, is ftill practifed in Barbary, to one fick of the
   natural fmall-pox.   This cuftom.is dangerous, the  inocu-
   lated party being thereby Qxpofed to receive the diftemper
   by  contagion, before the infertion produces its effect •,  but
   this conformity of practice between the Circaflians and the
   people of Barbary might be an inducement to prefume,
   that, among  the  great  number of Circaflian flaves, who
   compofe the militia of Cairo, by  the name of Mamelus,
   fome of them had brought the cuftom from  their country
   into Egypt, from whence it might have  been  propagated
   at Tripoli, Tunis, Algeries, and in the interior of Africa. 
           .            (  I2'  >
 fjfotheprincipality of Wales,  lefs formality was  ufedt*
Sgfobol-bOys gave one another the  fmall-pox by pricking
themfelves with a needle, or by only rubbing the  arm or
the hand till the blood appeared,with puftules of the fmall-
pox  that began to dry  ; he that was to  get it, gave two
or three pence to him from whom he borrowed the matter,
and  this cuftom had no other name  among the. Welch,
thafc of buying the fmall-pox.  Long experience has giv-
en in England  the preference to the following  method,
W/hich  has  been long practifed by M. Ranby, and fince at-
tended at Geneva with the greattii: fuccefs,both on children,
and adults to the age of thirty.
   After preparing the fubject during/ome days by a regi-
men and proper remedies, fuch as a moderate diet, one or.
two  gentle purges, a bleeding, if the  cafe requires it, and
fometimes bathing •, * an incifion, not exceeding an inch in
length, and fo as fcarce to cut through  the fkin, is  made
in the external  and middle part of both arms, beneath the
tendon of che mufcle deltoides, that the liberty  of motion
might not be under any reftraint; in the incifion is inferted
a thead of the fame length, impregnated with the matter of
a ripe  puftule, and without rednefs at its  bafe,  of a pock,
either  natural or artificial, taken  from a  wholfome child,   j
"■This matter has been found to preferve its virtue for feve-
ral months together and from Autumn  to Spring : The
Chinefe have made the  fame obfervation.   This  apparel,
after forty  hours is taken off, and the wounds are dreffed
                                                   once
   *  Do£t. Dimfdale, undoubtedly one of the moft ingenious  inocu-
lators, in  Europe, prefers the following method of infefting his pa-
rents.  The peiion to be inoculated, being in the fame  room, with
pne who has the difeafe, a little pus is taken from a  ripe puftule, oa
the point of a lancet.  With this lancet an.inciiion is made in that
fan of the arjn where ufnajiy ilTuesare placed, deep enough to pafs
«hc fcarf ftin about the  eighth of an inch in length.   The wound
being opened between the thumb and fingers of the operator, the mat-
ter an the point qf ti«e lancet  is wip'd  on  the wound.   Neither
plajficr, bandage, or covering is applied.  The Do&or obferves that
this iwf hod  had never ence fail'dhim.  At the time of Dimldale's
V ■;;';'- ::,c abce  i.£ bad incculuied 1500 p1 slants wiu.cut -a fingla 
                      c   *3  r
pncera day.   However, this long- delay  naay$4n^a gr«i*
meafure, be deemed an excefs of precautionj five or ft*
hours were though* fufficient  by the  Greek inoculators*
who, after pricking in four or  five places vere only careful
to mix  well the blood and variolous  matter with  their
needle, and to cover the punctures with a walnut-lhell.
  Though the firft days after  the operation the patient ig
in a condition of going out, yet he is made to keep hL,
chamber and to continue the regimen,   -f- He is put to bed
the 6th or 7th day, when the fever begins,which is feldom
accompanied by bad fymptoms, as  they ufually  ceafe by
the eruption on the 7th or  8th day :  Then the inflamma-'
tion of the wounds diminifhes •,  they yeild more matter,
and the greater part of the venom flows out by  that way.-
The 10th day after the eruption they begin to fill,  the 15th
to be cicatrifed, and the 20th they ufually clofe of them-'
felves;  if they are preceived ftill to flow, they fhould not
be clofed too haftily,   One incifion has been  found fuffici-.
ent ;  and, if two are made, it is not only to  be more cer-
tain that the infertion has taken  well,but alfo to facilitate,
by a double canal, the iflue of  the variolous matter, and?
in order thereby to render  that which  forms the puftules,
lefs abundant,  lefs acrimonious, lefs corrofive, and the na-
ture of the fmall-pox more benign.  Theory agrees  won^
dcrfully in this point with experience.
   Sometimes  all,  or almoft all, the venom flows  out thro'!
the two incifions,  and  the patient  has  but one or two/
puftules, fometimes even not  one ; he is not therefore lefs
                                                  fecure>
  t Since De la Condarrine wrote, great improvements  have been
made  by Jnvculators  in  Europe^and  America.   The piefent and
moft approved method of treating both the  natural,' and artificial'
fmall-pox, is that the patient goes abroad in all weathers, from- the-
time of inoculation, 'till the termination of the difeafe?  that a Sue'.
ufe of cold vater as common drink be indulged.  Cold air,  which'
phyficians fuppos'd would endanger the lives of thofe exp-a/d to  it,.
while under the influence of the fmall-pox, has been found, Firft  by
accident, and fince, by repeated, judicioos  experiments, to prevent,"
frequently, the  fecondary  feve', and always to leffen it.   Sec. Dimf-
d^le en inoculation, 
                       (   H   )
 fecure from  contra&ing the fmall-pox, when  inoculated
 anew.  The more the matter comes out abundantly from
 the wounds of the arms, the more the number of puftules
 are few and diftinft ; whereas each parcel of the matter
 of the internal heat forms  a particular puftule in the aa-
 tural  fmall-pox,  which often makes it  confluent,  and
 therefore much more dangerous.  Among the inoculati-
'%is at Geneva, that kind was  fcarce obferved ; and not
 one retained the leaft mark.   This was alfo obferved not
 only in England,  but in Greece and Circaffia, whereof the
 inhabitants adopted the  cuftom with the view only of pre-
 ferving the beauty of their daughters.
   What occafions the greateft danger in the natural fmall-'
 pox, is the fecondary fever that happens when the fepera-
 tion begins -, but  in the  artificial fmall-pox, that fever is
 very rare,efpecially in children, who fcarce ficken. Among
 20 perfons inoculated at Geneva, by  M. Guyot, one only,
 a woman, and the mother of feveral  Children had that fe-
 cond fever.
 ; This method of inoculating by incifion, adopted now
 upwards of 30  years,  by  all the Englifh furgeons, and
 commonly practiced  at Geneva, was  brought from  Con-
 stantinople to England, by M, Maitland, furgeon toLady
 Wortley Montague.   Maitland received it f romTimone,
 who had fubftituted  it   to the punctures  of  the Greek
 inoculators.   In  the firft eflays made in Italy,  the  lancet
 was fometimes ufed,  and fometimes  only the prick of a
 pin, in imitation of the fimplicity of the Greek operation,
 efpeciaily in country places,  where mothers, unknown to
 their hufbands, inoculated their children, while they were,
 afleep, and always with fuccefs.  M. Tronchin was the.
 firft, for aught I know, that ufed vefkatories, as lefs pain-
 ful and lefs terrible to children.   He applied them to the
 legs preferably to the arms, with the view of procuring,
 for the bed-rid patient,  a greater liberty in his  motions -,
 but, as the eftence cf inoculation  confifts intirely in the
 mixture of the variolous-matter .with the blood  of theper-
 fon inoculated, ic little fignifks,  provided the mixture
                                             operates. 
                      (   15   )
operates, whether the wound from whence the  blood is
drawn, be made on one or feveral parts of the body j with
a lancet as in England ;  with two or three  needles as in
Greece and Circaflia ; with one only as in Italy •,  by pair-
ing under  the fkin a thread imbued with  matter, as in
Barbary •, by rubbing the hand till the blood appears, as
in the principality of Wales ; or, laftly, in breaking the
texture of the epidermis with a veficatory,according to the
practice of M. Tronchin.   All  thefe routes conduct to
the fame end, and each may chufe that which feems moft
agreeable to him.
   Whoever has a mind to  fee this fubject treated more in'
detail, may confult Kirkpatric's Analyfis of inoculation.
An Eflay on the Advantages of very early Inoculation  :
by M. Maty, M. D. R. S.  Sec. London medical Obfer-
vations and  Inquiries, vol.  III. p. 287.   TifTot on  Ino-
culation.  Doct.  Rufton  on Inoculation.   AndDimf-
dale's prefent Method of Inoculation, publiftied  in  Novv
j 766.
                 PART    II.

  PHYSICAL  OBJECTIONS.

F' (i Oh' 3'   T^ 'lt the fmall-pox that is communicated '
   •'    J     ' A by inoculation ? And maynot the dis-
temper communicated be more dangerous than that whichN
is intended to be prevented ?
   Anfwer.   If it was ever doubted that the inflammatory
difeafe which  follows inoculation, was  a real  fmall-pox,
none now make the leaft doubt about it -,  it would be there-
fore unnecefTary to anfwer the firft part  of the objection.
As to the fecond  part, it may be faid,  that the natural
fmall-pox is not dangerous  in itielf,  but  only becomes fo
by a complication of diforders with it, or by the maligni-
ty of the epidemy.  Such  a perfon, cut off in the flower
of his age, might ftill have been living, wer-e it not for be-
ing attacked by the fmall-pox  in critical circumftances :
That young woman would  not have died, if the accidents
                                                  of 
                        ( -iS   )
 tofa laborious-pregnancy had not exhausted'her ftrength:
  That young man would have been out of danger, had not
  his blood been inflamed  by all manner of excefles : That.
  ficlcperion might have efcaped,  if a malignant fever and
 .trie purples had not aggravated his illnefs.   This is what
  we daily hear of the circumftances that make this diftem-
 per mortal.  Inoculation will prevent  them all.   The
 greateft art  of the preparation - confifts in preventing fo-
 reign accidents, a complication of diforders^ and the epi-
 .demy ;  a proper choice may be made of the feafon, time,
 •place, and the difpofitions of the fubjeft'S mind and body.;
 the fmall-pox thus prevented  is brought flowly from the
 circumference to the center,  in a wholefome  body pre-
 pared for receiving it :  Fermentation begins in the exter-
 nal parts •, the  artificial  wounds facilitate the eruption,
 by giving the virus  an eafy  iflfue.   Thus  the  inoculated
 fmall-pox is  always fimple,  and therefore without any
 danger.
    What CGmparifon,can be made between a premeditated
* diieafe and one contracted by chance, on a journey, in the
 .army, in critical circumftances, at\d efpecially for  womeri
 jn a time of epidemy, which multiplies accidents, which
 tranfports the feat of the  inflammation  in the  internal
 parts of a body,perhaps ex haufted by watching or fatigue? -
 How great  is the difference  between a difeafe which is,ex-
 pected, and one that  furprifes, difmays, and fear alone may
 make  mortal, or, appearing with  equivocal fymptoms,
 may .lead into an-error  the  ableft phyficians? Such are
 die dictates of good knk, and the  moft fimple reaToning;
 but experience is ftill more decifive ; it proves  that the
 matter of inoculation, though taken from a complicated
 finall-pox,  confluent,  even mortal  communicates, not-
 wklfftanding, a fimple, difcrete, benign fmall-pox,exen^pt
 from the  fever  of fuppuration, fo  frequently  fatal.;] w
foorr, a fmall-pox which  leaves  no  marks.   He-iceitis
 evident that the inoculated fmall-pox is not more danger-
ous than the natural- ,'■''"■.."
                                               Second 
              ,    .   (   '7   >
'  "Second ObjeRhn.  Does the  inoculated fmall-pox fav€
from the natural ?   t
  Anfwer.   This objection cannot be better  anfwered*
than by a hiftory of fa<5ts, whereby it  appears, that not
one inoculated perfon had contracted the fmall-pox'a fe-
cond time.   The enemies of this method have endeavour*
ed by all manner of ways to elude this truth, even by that
of impofture.    Dr.  Middleton  was obliged  to declare
publicly againft a  report,  that one  of thofe  he  had
inoculated   was again infected  with the  fmall-pox,- 5f
which  he  had  been  very ill.  Mention was  made  of
another, with  the  letter of one Jones, who aflerted the
fame thing of his fon ; ©r. Jurin examined carefully into
the fact •, the father refufed to fhew the  child's marks,
but offered afterwards to  tell the truth provided he  was
well paid for fo doing :  At  laft, he confefled, in a  letter
-to Dr. Jurin, that he knew nothing of inoculation.   Dr.
Kirkpatrick has inferted this letter in his work.
   But what does it fignify to know whether a complete
fmall-pox may  be-had twice naturally ?  Though this fact,
which feveral phyficians deny,  and which  Dr. Mead, in
the courfe of a long life, fays he had never feen, fhould be
well attefted,it would not neceflarily follow that a perfon,
after being inoculated, fhould  be fubject to have'it agafn.
 Granting that it is  poflible to have the fmall-pox, twice
 in the natural way, might not  it be maintained, with fome
 fhew of probability, that  the  natural caufes of  the con-
tagion do not fhoot* forth  perhaps but  imperfectly iri  a
body the bud of the diftemper, fo that fometives a fuffici-
'ency remains for a  new fermetation ; whereas the ferment
 of the fmall-pox, fet in motion by a virus ot "the fame na-
 ture introduced directly into  the blood by the  means'of
 feveral incifions, flows out m fo complete a manner, that
'no more mattertemains to form a fecond  eruption.   A
•fnore  powerful caufe ought to produce a  greater effect* :
 Milk  turns and coagulates more furely and effectually by
 the direct mixture or an acid,  than by  the  natural1 a&i'on
      •                   C                          of 
                       (   i»  )
 of air and' heat:  The  artificial fmall-pox may therefprc
 exhauft the leaven which the natural may not.  But, fet-
 ting afide thefe reafons, will it not be fufficient to fay, in  *
 order to avert the dread of a fecond fmall-pox after inocu-
 lation, that now, upwards of 30 years fince it became fre-
 quent in England, no  example can be produced  of any
 inoculated perfon, who had been again infected, either na-
 turally  or artificially ?  Thofe,on whom inoculation might
 have been attempted without effect, are improperly ranked
 in the number of the inoculated ;  the operation well or ill  "
 conducted, when it produces neither puftule nor fuppura-
 tion, leaves  the fuject in  the  fame ftate he was in -, if
 therefore he is afterwards attacked by the natural fmall-
 pox, it cannot be faid that he has had it twice.
   Some inoculated  children have been made to cohabit
 and lie with others ill of the fpontaneous  fmall-pox, and  '
 none of them took it a  fecond time,   Elifabeth Harris,  .
 one of fix criminals  inoculated on  the  firft trial, after re-
 cov.ry,  nurfed upwards  of twenty  perfons  fick of the
 imall-pox,  and the contagion  had  no  effect upon her.
 Inoculation has been repeated  feveral times on different
 fubjects -, but  the effects of the firft being over, theincifi-
 ons, notwithftanding the thread imbued with virus, healed
 as flight cuts : It  is  therefore evident that the variolic  •
 virus, though  mixed directly with the blood, is incapable
. of renewing the fmall-pox ;* from whence it may be con-
 cluded with good reafon, that the natural contagion, intro-
 duced by the air, will have no effect  on  a body pureed
 of this-leaven by inoculation.
   Third Objection.   The fmall parcel of venom, tranfmit-
 ted into the blood by the way of inoculation,  may be the  •
 bud or feed of other difrempers, which may be communi-
 cated the fame way, fuch as the fcurvy, King's evil, &c.
   Anfwer.  The rifque  of catching thefe  difeafes,  at the
. fame time-with the fmall-pox, would not be  lefs great,
 when it  is contracted naturally, than  when it is received
 by inoculation. However, as no inftance_ has been feenof  .
                                               fcurvy, 
fcurvy,Kingrs evil,&e. contracted in this manner by the con-
tagion of the natural fmall-pox •, why  fhould the danger
be greater in this refpect by the way of inoculation ? This
is not all :  There are pofitive proofs that this danger is
chimerical, and it is now known by experience, that the
variolic matter, though taken from a  body infected alfo
with a venereal-virus, communicated only a  fimple and
benign fmall-pox :  This fa&, decifive  and not admitting
a reply, is attefied in Dr. Maty's Britifh Journal, for April,
1754, pag. 403 •, yet, as the choice of matter  for inocu-
lation may be difcretionally made, nothing hinders the
taking of it from a wholefome fubjeft,  and efpecially from
a child who has noother diftemperthan the fmall-pox itfelf.
   Fourth Objettisn.   Inoculation is fometimes  attended
with  troublefome confequences, as wounds, tumors, &c.
   Anfwer.  Nothing is more unjuft than this  objection  :
Thefe accidents are  but too frequent after the natural
fmall-pox, but very rare after inoculation ;  they are pre-
vented by purgatives.
      MORAL   OBJECTIONS..
   Firft Objection.   It would be an ufurpation of the rights
of the Divinity  to afflidtVith a  difeafe one who has k
not, or to endeavour to withdraw him from it, who, in  the
order of Providence, was naturally  deftined for having it.
   Anfwer.  This objection, if it  can  be called fo, is that
of Fatalifts and rigid  Prcdeftinarians.  They might be
anfwered that the inoculated was predeftined for inocula-
tion, and that by inoculating him  the decrees of Provi-
 dence were accomplifhed •,  but, without retorting againft
them this fingular argument,  they may be afked, Whe-
ther  confidence  in Providence exempts and difpenfes us
 from preventing the ills  we forefee,  and which we  may
 fee ure ourfelves from by a prudent attention.   Thofe of
 this principle, if they  act  confequently  to it,  ought to
 profcribe  the ufe of all remedies  of precaution, and of all
 prefervatives ;  they ought  to  instate the example of the
" Turks, who, thro' fear of afting contrary to the views o£
                                           Providence^ 
                        (   20  )
 Providence, perifh by thoufands in  times-of*peftHence fo
 frequent at Conftantinople, whilft they  fee the  Franks,
 fettled among them, fecure themfelves from th e fatal e£  ♦
 fects of the contagion,both in town and country, by {hut-
 ting themfelves up carefully in  their houfes, to  avoid all
 exterior communication j  thofe who here plead the rights
 of Divine Providence, may therefore  be afked, Whether*
 when Providence permits the difcovery of a fure  method
 of prefervation from the ravages of the fmall-pox, we are
 forbid to make, ufe of it ? It is Providence that prefents us
 with the remedy, and it would  bean offence to reject its.
 gifts with contempt,
    Sixth QbjeElion. It is not allowable to infect with a cruel
 .and dangerous difeafe one who perhaps may never have it,
  .  Anfwer.   It cannot be faid, with any fhew of truth, that
 the inoculated fmall-pox is either cruel or dangerous.   An   ,
 incifion which only cuts through the lurface of the fkin, a
 fimple puncture, or the application of a veficatory, a flight
 fever  attended with fome fymptoms. which fcarce laft 24
 hours, cannot be faid to conftitute a cruel difeafe •, and a dif-
 eafe, by which not above one may die in 300,or perhaps not
 one in a thoufand, cannot be  called dangerous.   It may   j
 even be  doubtful, whether this death of one, out  of fo
 many, can be juftly attributed to  inoculation.
    But if, out of 320 perfons  taken at chance, one com-
 monly dies, how comes it to pafs  thatM. Ranbydid not
 lofe one in  1200 ?  The reafon is,  his choice was confined
 to young fubjects of found conftitutions.   When perfons
 .of allages are inoculated without choice or precaution, as
 wae done at Bofton in the firft trials, the greater part fuf-
 pected of corrupt  blood and humours, and in a time of
 epidemy, when feveral, before undergoing the operation,
 had already probably received the difeafe by natural con-
 tagion, there will be no  room for being furprifed that one
. died in,49 or  5°-
    It may therefore be granted* that the inoculated fmgll-
   -*:: '/neither dangerous, nor cruel,as  the objection fup-
    .. \i.  l But it will be faid, it cannot be denied to be a
                                               difeafe j 
                      (   21   )
difeafe; why  therefore fhould it be given gratis to one
who perhaps might never have it?' This is the moftfpeci-
ous of all the arguments that can be made againft this prac-
tice, and yet the eafieft to be refuted.
  I anfwer, firft, that this difeafe is not given to one who
might never have it naturally.   For, either all men, with-
out exception, are  fubjedt to the fmall-pox, or fome are
free from it: In the firft cafe,  it cannot  be faid that the
difeafe is given to one who might never have it: The fame
will hold good in the fecond,  it being proved  by experi*
ence, that fome  could not get the fmall pox by inoculation,
though  the operation  had  been »feveral times  repeated j
no doubt they were no way difpofed  to receive the diftem-
per.  He who has not the principle of it in his blood, will
be free from it by  an operation lefs painful than a bleed-
ing •,  the incifions-AYill dry up as a  flight cut : Thus he
will fee himfclf for ever delivered from the continual un-
eafinefs thofe are under, who have not yet paid the tribute ;
this proof will be afecurity to him that he is for ever fafe
from the contagion.   It is even the only way of banifhing
the fears of thofe, who, by not having the fmall-pox in a
decifive manner, or not knowing that they had it in their
infancy, fpend their days fo - as to make life a punifhment.
Therefore a  difeafe, as the objection fuppofes, is not given
to one who might  never have it.
 _I anfwer,  in the fecond place, that the fmall-pox is a
difeafe which may be called general,  and to which Provi-
dence  is willing  mankind  fhould  be  fubject -, that the
ntsmber of thofe who arrive at old-age  without having it,
is fo fmall, that  it fcarce forms exceptions to the commdn
law.  But what is done  by inoculating  the fmall-potf?
The very fame  thing  whereby a fit of the gout is excited,
when the particles  of that painful  diforder are difperfcd
throughout the  mafs of the blood •, in both cafes a diftem-
per is not k> much given to a body free from contracting
it, as the moft; favourable time is chofen to give vent- to
the ferment  thatoccafions it, and which .we all  have in our
            -----                               blood  5 
 f>l«od j the venting of which ferment is  almoft inevitable
 in regard to the  fmall-pox, and much  more  dangerous
 when it comes of itfelf,andefpecially in a time of epidemy.
   Seventh ObjebJion.  It is not allowable  to do a lefs evil'
 fo procure a greater good.
   Anfwer.  This objedion is founded on an equivocati-
 on.   Let us fuppofe that this principle  is in  rigour and
 generally true,  and that it admits no exception, no reftric-
 tion, as to moral evil; but it is very falfe in the applica-
 tion  madeofittophyfical evil.  Certainly it is allowable
 to pull down a  houfe to  preferve a town or city from a
 conflagration, though the*proprietor of this houfe, with his
 family,might be reduced to beggary by fo doing-, a whole
 province may be laid under water, or ruined for feveral
 years, in the view of preventing the further ravages of an
 enemy •, a fhrp, if fufpected to have the plague on board,
 though perhaps ready to perifh, is  refufed admittance into  '
 a port: And thus the inconfiderable phyfical evil of inocu-
 lation is nothing, if compared with the  evils  of all forts
 which are tolerated, permited, and  authorifed by the laws
 Of moft nations.  *
   Eighth Objection.  Inoculation is a moral evil; as  a
 proof of which, it  cannot be denied but fome inoculated
 perfons have died ;  the fuccefs of the  method is therefore  '
 aot infallible ;  one cannot therefore fubject himfelf to it
 without expofing his life, which he  is not allowed to dif-
 pofe of : Therefore inoculation runs counter to the prin-
 ciples of morality.
   Anfwer.  Firft,  the  objection  may  be cut fhort by
 maintaining, that none die of the inoculated fmall-pox,and
 that  the accidents, attributed to inoculation, are owing to  '
 up other caufe than the imprudence of the fick, or of the
 phyfician :  Several able phyficians have   been of this opi-
 nion : M. Tronchin was  fo thoroughly perfuaded  of it,
 that he declared openly,  if he  loft OFie fingle patient by
 t*e artificial faiall-pox, he would inoculate no more  while
lie Lved.
i
Secondly, y 
                        (  23   )
    Secondly, the argument, here advanced againft jnocuhf
  tion, may be retorted againft bleeding in the arm : Ho^
-  many have died by the pricking of arteries ? It is then cerj-
  tain that life  is endangered by bleeding in the arm, which
  cannot with the fame evidence be afcertained  in regard to
  inoculation ;  yet no cafuift has hitherto been fofcrupulous,
  as to forbid letting blood in  the arm.
    Thirdly, it may be obferved that the fuppofed fingularU
  ty of inoculation, that is, of  giving  a diftemper one has
  not, is common to this prefervative and all other remedies
  of medicine, no natural  diforder being cured  but by arti-
  ficial evils, which are not even exempt from danger, fuch
  as bleedings, purgatives,  cauteries,  veficatories,  vomi-
  tives, &c.
    It is granted that it is the  duty of every one to avoid the
  dangers  life may  be threatened with •, but what becomes
  of this obligation when the danger is inevitable ? It is evi-
  dently converted into that of leffening the danger as much
  as poflible •,  but  the rifque of  having fome time or other
  the fmall-pox, and perhaps dying of it, is inevitable in re-
  gard to him  who never had it •,  therefore inoculation is a
  fure means of diminifhing, in a great degree, this danger.
    It is evident, that, when the fmall-pox is expected from
  the hands of nature, the parties  expofe  themfelves to die
  fome time  or other -, but this rifque is beheld as far diftarjt,
  becaufe  it  feems it fhould not begin but when the attacks
  are felt,  which are not yet,  and perhaps,  as they flatter
  themfelves,  may  neyer be.  To determine exactly the
  refque of death incurred by him who never had the natural
  fmall-pox, it would be neceffary to know what part of
  mankind is not fubject  to the difeafe; but it may  be faid
  with good reafon, that the inftances of thofe who pafs thro*
  life, after  having arrived at manhood,  and  having  been
  within the reach of infection,without undergoing this  dire-
  ful difeale, are fo extremely few, as  fcarce to form an ex-
  ception  ; learned calculations have made it as one to many
  hundreds,
                                                    The 
    The rifque of dying one time or other of the fmall-pox,
 which feems fo far diftant m.  time of health, is  almoft as
 great as if one was already effected,   In.a word, of 70 fick
 of the fmali-pox,  10 die ; of 70 who exp-tct it, 9 will
 probably die : Could it be believed  that  between thefe
 (two rifques there was fo little difference ?
   The rifque of dying of the fmall-pox gradually increafes
 From the moment of birth.  This refque is of a fourteenth
 for a new-born  child $• of an eighth for one of a year old;
 of a feventh for the ufual  age of inoculation ; later, it is
i of a fixth, fifth, fourth, and perhaps there are only two to
 one, which upon a wager could- be laid for the  life of him3
 who arrives at the age of thirty without having paid the
 fatal tribute.
   The rifque of death one is expofed to by  waiting from
 nature for the fatal  prefent of the fmall-pox, is  therefore
 of 9 to 70, that is, of more than an eighth : The rifque of
 dying by inoculation  is computed at 1  to %y6,  by more
 than  600® experiments.   Hence it may  be faid,  that a
 father, in regard to  his  fon, has only the option, either to
 inoculate him  or not •, here are  two  hazards to run, of
 which one is  inevitable.  By inoculating his fon, againft
 375 fortunate events, one  is to be dreaded ; by not inocu-
 lating him there is more than one to be*laid againft feven
 that he will iofe him;  for, if out of  70 nine  die, the bett
 will be of nine againft 61, which is more than one againft
 feven; fo that, this laft rifque  being 50  times greater than
 the other, he cannot with reafon heutate in his choice.
   This calculation  is not exaggerated.   Dr. Jurin; hav-
 ing judged from his firft enumerations, that, one year with
 another, there died a feventh of thofe taken ill of-the fmall-
 pox, found on further and more exact information, firft in
 14,500, and afterwards in  upwards of 17,000 perfons, that
 often one in  five died,  and commonly two in eleven;  fo
 that the peril of the natural fmall-pox has not  been  exag-
 gerated by fuppofing one in feven.   As to inoculation, in-
 itead of the rifque of  one  againft 2J5,  as fuppofed, it is
                                               proved 
 proved  by the coriftant  fuccefs of this operation in the
 London fmall-pox hofpital, on perfons of all ages, that the
 peril of this method has  rather  by the calculation beert
 augmented than diminifhed.
   Whatever might be the advantage of the artificial fmall-
 pox, even though one fhould not die in io,coo, I would not
 advife a father to fubjeet his fon to it, if he could be fure
 that the natural fmall pox  would fpare him ; 'but fince, in-
 fteadofa like revelation,  which  we want, the father has'
 only the certainty of danger by far greater towhich he eX-
 pofes his fon, in letting nature act, it is evident that reafon
 counfels him, and that paternal tendernefs requires, he
 fhould  dimiriifh, as much as he poflibly can,  a rifque he
 cannot make void.                        *  "  .
   Such is the fate  of humanity :  Upwards  of a third of
 tnofe who are born, are deftined to die-,in the  firft year of
 their life, by incurable difeafes, or at leaft unknown :  Ef-
 caped from this firft danger, the  rilcjue ©f  dying of the
 fmall-pox becomes inevitable to them -,_ it fheds its influ-
 ence on the whole courfe of life,  and in every inftaht of
 time increafes j it is a forced  lottery  wherein we find our-
 felves concerned, in fpite of us •,  each of us has a ticket in
 it, and the longer it delays  coming out of the wheel, the
 more the danger augments.  What is done by the practice
 of inoculation ? The conditions of this lottery  are changed ;
 the number of fatal tickets is diminifhed: One in feven,
 and in more favourable  clifnates,  one in ten  was fatal, by
 the natural fmall-pox :  By inoculation, one in 300, one in
 500, one in iooo, of which we have examples.   All fu-
ture ages will envy ours this  difcovery ; Nature decima-
 ted, but art millefirfiifes us.
t)                PART III 
(  26   )
                 PART    III.

Containing new  Anfwers,  Conferences drawn  from Fatts-,
                    Refleflions, &c.

     HERETOFORE, to  avoid entering into longdifcuf-
      fions, I reafoned  according to the fuppofition that
there was fome rifque in the practice of  inoculation, and J
confined  myfelf to prove  that this rifque was  fo fmallj
compared with  that incurred by  the natural fmall-pox,
that it may be deemed, as  of no account.   And, indeed,
the rifque of one in 300, 500, or 1000,  is not of  the fame
kind,*and ftill lefs than that to which one is daily expofed
voluntarily  and  without  the leaft neceffity.  Some ufe
violent and dangerous exercifes,  fuch as hunting, riding
poll on horfeback,1 playing at  tennis, &c. others  traverfc
the feaSj  and have frequently certain  death  before  their
eyes.  Shall it be faid, that it is allowable to hazard one's
life habitually out of curiofity,paftime, humour,  or at beft
through a motive of convenience or pecuniary  intereft ;
and that it is criminal, I will not  fay  to run  once a very
fmall rifque in the view of preventing  a great danger,
but to convert a great rifque which cannot be annhiliated,
into one 10, 20,  30, &c.  times lefs ?  Such  is the confe-
quence theadverfaries.of inoculation are reduced to, and
that,fuppofing eVen  that it is not exempt from all danger :
What would it be if the pretended rifque  Was abfolutely
nothing, as feveral eminent phyficians are of opinion, and
as fome propofe to make it evident ?
   As I fli all no ten gage in a differtation on a fubject, which,
in order  to be  well treated, would  require a profound
knowledge both in  the theory and practice  of phyfic, I
ihall confine myfelf to fimple reflections.  What can be the
danger of inoculation ? Is it in the operation or in its effect ?
   New Objetlion.  It is in both :  A purulent matter, ta-
ken from a body infefted with a dangerous  difeafe, is in-
                                                ferted 
                      (  27   )
ferted into the blood of a found perfon.  Muft not this
create horror ? A like caufe cannot  fail of producing a
pernicious effect.
  Anfwer. Let us not take words for things: Let us leave
to children puerile  niceties, and let  us remember that if
reafon had not triumphed over prejudices, and the natural
repugnancy the eliffection of a human  body  infpires, all
the diforders anatomy has difcovered remedies for, would
be incurable.  Is not nature fhocked  at the fight of the
amputation of a limb, the perforation of the thorax in the
empyema, cutting for the ftone, the trepan, &c. All thefe
Operations are very cruel, their fuccefs very doubtful,  and
the danger of dying very great •, yet they are confidently
practifed every day : What a prodigious  difference between
them and inoculation !
  I made a diftinction between the operation and effetts of
inoculation.   As to the operation, it has nothing terrible
or dangerous.   Afuperficial incifion on the  fkin differs
from a fcratch only, in that the latter would be more pain-
ful : But will it be faid that one can die of a fcratch ?
  As to the effects of the operation, experience decides
what they are. I fhall not endeavour to examine whether ■
the contagious venom of the  epidemy  is only  in  the  air
that  is breathed, that is,in an exterior caufe •, from whence
k would follow that the choice of a fubject which furnifhes
the matter of inoculation is indifferent : All I fhall obferve
is,  that fince the choice not only of a fubject,  but alfoof
the moft benign, and beft conditioned  fmall-pox  can be
made, thofe who chufe it fuch, cannot be cenluied for in-
ferring in the veins of a lound man the produce of a dan-
gerous illnefs.   Befides, it is proved by the experience of
feveral ages, as  well in Afia as Africa,  and of near an age
in Europe, that, in  the hands of an able practitioner, de
danger' vanifhes by the choice of a iubject,by preparation,
&c. that inoculation occafions  only a fimple  fmall-pox,
which gives vent to the greateftpart of theVenomthrough
the  incifions,and which therefore is fcarce ever confluent,
                                                   but 
                    .  C  28   >
 but always more benign'than the natural.  It is. moreover
 proved, that "it leaves no marks^and that it is not attended
 wi;h the/ever of Juppuration^fo common and fo fatal in   *
 the natural fmall-pox. Can any thing more be wanting to
 conclude, that the.lifeof a patient isiecured in tl^ inocu-
 lated . fmall-poxi by the prefcribed precautions, and that
 the accidents- whichmight have attended it in a very fmall
 pumber of.caf s, ought to be attributed to foreign caufes ?
 Js it not evident by the laws of probability, that, amongj
 thoufands of inoculated fu bjects,fome one may and fhould   kf.
 die, not only forty days after,  but in the week, andper-
 haps on the day,, by the fame reafon that this perfon might •
 pay the tribute to nature eight days, one day, or one hour*
 before  the operation ? Inoculation prevents the dangers*
 •and confequences .of the natural fmall-pox •, but it  is not
 therefore a remedy againft all the diforders incident to fo*
 complex a machine as the human body,  and ftill lefs a    »
 prefervatiye againft fudden death.                    - '.'vM
   In order to  remove all impediments thrown in my way
 by the quibbles of the adverfaries of this mothod, I found-
 ed allmy calculations on fuppofitions made as they fancied
 tljemfekes •, but it is now time to lay in my claim to  truth, .
 Let us. then firft retrench, from  the number of the pre-
 tended victims of this operation,  thofe who die of foreign
 accidents, as, forinftance, children at the breaft, fuddenly
 cut off, in the  courfe of a very benign  fmall-pox,  by a
 convulfion or  choiic,  which happens but too frequently
 to other children of their age, who feem to enjoy the beft '
 ftate pf. health-j  let us not lay to the account of the artifi-
 cial fmalhpox the death of thofe,who,in a time of epidemy,
 have already received  the diftemperby the natural conta- '
 gion, before they were inoculated : This may well be
prefumeed,when the fymptoms appear before the time when
 it is yfual'with the operation to  produce its  effect  ; Let
 115 alfoexcepr,  as it is juft, on one fide, the deaths occa,fi-
oned by intemperance, or etherexceffes the patients were
fubject-to -y and,, on  the other, the accidents which ought 
v  29   )
 vfifibly to be attributed to the imprudence of mpcul^tor^
 :n making trials ; thefe accidents are now more rare, but
 were frequent enough When the  method was fTrft intro-
 duced.   When all thefe exceptions are made, of which we
 hitherto matte none, there will not remain perhaps a 'firu
 gle perfon whofe death can be properly imputed to ino-
 culation.
   Make choice of a found, young Tubject, and of a good
 conftitutioa ; let. a fkilful phyfician be careful in prepar-
 ing him ; preierye him from the  epidemical contagion ;>
 inoculate him •, his life is fafe.
   Laft Objection.   It is fuppofed that inoculation of itfelf
 is never mortal, but it may be faid, that he who might not
 have died perhaps of the natural fmall-pox till the age of
 fifty, after  having had children,  after having ferved his-
 country, would be loft for focitty, if he died in his infancy
 of the inoculated fmall-pox,
   Anfwer.   This objection  is more fpecious than  folid,
 being grounded on  the fuppofition of  the real danger of
 inoculation  ;  it will be therefore unneceffary to animad-
 vert upon its weaknefs, even the cafe of inoculation  being
 not abfolutely without  danger  : It is clear that even theft-
 the great inequality of rifques in the  natural and artificial
 fmall-pox, the uncertainty as to the time of  life in  being
 ittacked by the former, and the danger of dying fo much'
 the more great,  as age is more advanced, are fo many
 lecifive reafons in favour  of inoculation.
   What has been already mentioned, that the fmall-pox„
 deftroys, mutilates, or disfigures  the fourth of mankind,,
 may be taken for an exaggeration •, but I mean the fourth
 )f thofe who furvive the  firft  difeafes of  infancy : Thii •
 nay appear from the following reflections.
   Towards the end  of the  16th  century,  about > 5*
years  after  the difcovery of  Peru,  thfs  diftemper w<i$v
brought from Europe to Carthagena in America ; it-over-
ran the whole continent of the new world, and„ in the pro-
vince of Quito alone, deftroyed upwards of  100,000 In-
dians.   This remark has been taken from ah antient ma-
                                              nufcript
\ 
                       (  3°   )
nufcript of the cathedral of that city.  In the Portuguese
colonies the fmall-pox proved fatal to all the original in-^
habitants of the country. M. Maitland, to whom England
is indebted for the ufe  of inoculation,  relates that there
are years when the fmall-pox is a kind of plague in the
Levant, which kills at leaft the third of thofe it infects x
this terrible proportion is  not  rare  in Barbary.  If we .
confult  Dr. Jurin's lifts, or thofe annexed to his work,
among others, Dr. Nettleton's, who informed himfelf in.
feveral towns from houfe to houfe of the  number of the
fick and dead throughout the year (the  fureft way of being
exact) it will be feen that at  London, and in other parts,
of England, there died fome years a fifth, and fometimes •
more  of thofe taken ill of the fmall-pox -x but among thofe
who do  not die of it, how many remain deprived of hear-
ing or fight, intirely or partly ! How many affected in the...'
breaft and lungs, languifhing, valetudinarians, maimed !
How  many others, disfiguared for life by deformed feams;
and fears, become objects of horror to thofe that approach ]
them  I Laftly, in  the fex  where comlinefs is fo great aa
advantage, how many lofe their charms, fome the tender-
nefs of their hufbands, others the hopes of being fettled in '
the world, whence a real lofs accrues  to the ftate.
   The fmall-pox raifes a tribute of a fourteenth on man-.
kind,  and, though the number of victims wounded by its"
darts  fhould not   furpafs the  number of thofe it ftrikes,
mortally, it will notwithftanding be always true, that, out
of ioo perfons who have efcaped the firft dangers of in-
fancy, thirteen or fourteen aie cut off by this diftemper,'
and that a like number exhibit in themfelves, during their ..
whole life, all the difagreeablenefs of itsdifmal confequen-
ces.   There are  then, in ido perfons,'2.6 or '28 witneffes "
to prove that this plague deftroys or degrades the fourth
of mankind,
   The numoer of experiments already cited demonftrates,
»•--?.t inoculation prevents all thefe  calamities.  The  ino-
t-uisited ih.ail-i.ox is not only neither mortal  nor danger-
                                                 ous, 
 ous,  but it leaves nothing after it that might make it re-
 membered with regret ; .this confideration  alone  feems
 tlecifive for that half of mankind, to  whom beauty in .1
 great meafure is fometimes  dearer than life.  The afto-
 nifhing contraft, M. Maty fays, that may be obfe&ved in
 vifiting the fmall-pox hofpital,  between the inoculated,
 and thofe who had the natural fmall-pox, in regard to the
 effects of the diftemper on the face, would  be alone fulfi-
 cient to determine thofe who make  fome account of the
 advantage of not being disfigured.
   Thefe  are not  conjectures  hazarded by a  fyftematic
 genius:  They are the refult  of facts difcuffed contradicto-
 rily, and publifhed in the face of the world  by learned di-
 vines, fkilful phyficians, and able furgeons ; they are war-
 ranted, and have received a fufficient fanction  from the
 great names and authority of Sydenham and Boerhaave  •,
-the Bifhop of Worcefter ; Dr. Jurin, Secretary to the Roy-
 al Society ; Dr. Mead, the Englifh Hippocrates ; and
 M. Ranby, firft Surgeon to  his Britannic Majefty.  .
   Prudence advifed and directed  that too much  precipi-
 tation fhould be guarded againft in adopting a delufive no-
 velty ;  it was  neceffary that time fhould  throw  a new
 light on its utility : Upwards of thirty years experience
 has cleared up all doubts, and perfected the method •, the
 lifts of thofe that died of the  fmall-pox have diminifhed
 by a fifth in England,  fince the  practice of inoculation
 became more common •, it is a truth that feems no  longer
 contefted in London, that the inoculated fmall-pox  is infi-
 nitely lefs dangerous than the natural, and that it preferves
 from it.   Heretofore in England this operation  was bit-
terly inveighed againft, but now it has not one enemy that
 dares to attack it openly :  The evidence of facts,  and es-
 pecially the fhame of maintaining' a forlorn caufe, have
 fhup up the mouths of its moft paffionate adverfaries.
LETTER I- 
                     •  (   3*  )

  T-      L'E-Tf  £  R    I.

 :»    s  i  fc,  •  .      **  -

     TJ" AV^G well Confidered the fubjetf: of moc'ula*
     11  tidh, and the ftate  of the laws refpecting it in
  ttoisl Colony, and hkewife considering what great improve^-
  ments have been  made in  Europe and America, in the
  ifoariagement of Doth, the natural, and artificial fmail-pbx,
  fnice them laws were enacted :  Thought it  highly pro--
  bable if it could be made appear that  inoculation might.
  be practifed at the peft-hcufe at Middletown, with fafety
  tb the public we might be indulged.  Now it is a known
' fact'that when, fome years  fince, inoculation was practi-
 fed at feveral hofpitals in this government, the public fuf-
 f&red by its being communicated from almoft every  hof-
 pital.   I have  this to fay in favour of our beihg indulged
.at Middjefown, that near three hundred perfons have had
 the difeafe at our peft-houfe, without one inftanCe of the
 difordet being  communicated from faid houfe.   Farther,
 I believe any perfon of fenfe, will allow, that it is proba-
 ble, that betwixt October and May feflions, a  confidera-
 ble number of perfons may have the fmafl-ppx at Middle-
 town peft-houfe much to their intereft and peace of mind
 without the government being in the leaft expos'd there-
 by.  We will allow it poftlble the fmall-pox may be com-
 rrftm'cated from faid houfe •, can any  perfon be fo untea--
 finable as  to defire I fhould be prohibited frorn takino-
 t^e fmall-pox, wHich I conceive will be  much to my inte-
 reirand peaee;of mind, becaufethat it is poffible  he may
 ii>fome-eitrtohlinary Way  be expos'd to it, contrary to
 .the  gfeateft'probability ? .Ought a mere poflibihty ©f my
 afting being  ii^urioys  to  my neighbour to prevent  mv
 asking, when'it  i.s.apparqnt that my a&ing will be n^uch
 To toyjntereft artcfl ftahd ready togive him all thefecuri-
 tj$i&eat* deibl that my conduct!"Sll notinjurehimr'ai*d
                                 " -    '           'if 
  if it does that I will pay all reafonable dfcmdges ?  In moft
  of our concerns*ip lff^we are ofcligedAo a<J: on probabi-
  lity, now "i think it may be made appear,  that  it is is
  probable that I, with a number of n1y neighbours may
  have the fmall-pox at the peft-houfe in Middletown, wkh-
  but a fingle inhabitant of faid town  being injured there-
  by, as it is probable that a man could ride from New-
  f-Iaven to Hartford in a given time, (vis.)  10 hours.   I
  now beg it as a  favour of trie Government,  that I with a
  number morei (who two years fince, folicited the legifla-
  fure for liberty to fuffer inoculation  at the  peft-houfo irk
  MiddletoWn, our phyfician being our inoculator) may  be
  inoculated as above. We (land ready to give bond, for our
  prudent conduct, are willing to be under the infpection
  6f a committee, or the authority and felect men of laid
  Middletown, as the legiflative fhall think proper.  It is,
  I believe, evident that a greater number of people have
  fuffered the natural  fmall-pox  in this government con-
  fequent of inoculated patients coming from abroad wkh-
  Out being duly cleanfed,than from an internal inoculation.*
  Numbers of the inhabitants of this colony within this fix
  years have been inoculated atEufopus,Poughkeepfie, Nor-
  walk, and New-York, and have traverfed the government
  With infected apparel endangering the public, which dan-
  ger will be greatly leffened, if not wholly removed, by  a
  Well regulated internal inoculation.
     Farther, I think when it is confideted wnat great fums
  of money are yearly fent to New-York, to pay  them  for
  importing for UsEnglifh goods, it will  be an inducement to
.. indulge Us in our requeft, to be inoculated at home, when
  it may be demonftrated that we can be inoculated at home
  With greater eafe, lefs expence -j-  and yaftly more fafeiy
 , to the community.                     .LETTER If.
    * I myfelr was krrcwing to about fixty people liavir»» the lfriklf-
  iox two year; Lncein this governm&nt, cortfeqoeiu of  Ime performs
  comiog from inoculation abroa^,-wiihoui bemg^duly cleaoied.
    f'l haVfe kaott* feveral young gentleiflerj,  who prct.un'ng jnccpla-
  t»a abroad, have been exjo*'d l|< n\ 10 to 2.o.pobr.<Jp ex^icc.—
  iWe judge Inoculation witt»ot coft-us more tfjan th.ee pour •■- a h _v
  ifaidolged in our prefect reqaefl.      A E 
C  14   )
         LET  T  E   R      II.

     s  i  p,

I Have read over  the hiftory of inoculation  for the
   fmall-pox, you put into my hands* with pleafure •, the
author, I  think, has  fully refuted  the arguments againft
the practice, deduced from the tophics of religion and mo-
rality •, and there remains no reafonable objection againft
the admiffion of the full and free ufe of it, as the  nobleft
and beft prefervative againft the ravages of that  fatal dif-  <
temper in thofe Countries, where it prevails without re-
ftraint, efpecially if we  take into confideration  the great
improvements made  in the practice of inoculation  fince
MonfieurLa Condamine wrote j but as you  dented my  -
fentiments, whether it could be prudent  to introduce in-
oculation  for the fmall-pox (if permitted  by law) to ge-
neral ufe in this colony, I freely anfwer I think it would not;.
  The ftate of this colony  is fuch, that the greater num-  \\
ber of Inhabitants in it may for fome time yet to come,
probably pafs thro' life without being expos'd to that dif-
eafe, and  furely thofe who are in no danger, want no feT
curity againft danger,  but were inoculation fet up and
practifed by every phyfician, in every place they  thought
proper, it would lay  every one under a neceffity to inocu-
late, or ftand expofed to the diftemper in the natural way,
the former would load the colony with a great and unne-
ceffary expence, which fhe is liable to  bear ; the latter
would  be attended with ftill greater expence, and would
befides hazard the lives of numbers, efpecially of the old
and infirm and valetudinary. I am  therefore fully perfua-
ded that  the  indifcriminate practice of inoculation here
would be hurtful to us,  and that  the  legal reftraints it
now lies under are in the main, founded in good  policy.
✓
At 
                      (  35   )
  At the fame time 1 freely confefs to you I could heat
tily wifli that the legiflature would be pleafed fo far to dif-
penfe with the prefent act againft inoculation,  as to per-
mit  it to be practifed in fome  prelcribed  place in each
county, by  approv'd phyficians under the inflection  of
fome gentlemen capable to direct the due management
of  the hofpitals,  and guarded  with fuch regulations  as
fhall appear neceffary to prevent the infection's  being
communicated from the hofpitals.
  This would fave a great expence of money now carried
out of the colony, and fave to the inoculated the coft of a
long journey, which is greater than the coft of inoculation
after  the journey is made—it wculd put in the power of
parents who intend their children for fuch trades and pro-
feflions as will expofe them to  the fmall-pox, to give
them the diforder when  young,  by  which nearly all  the
remaining danger in inoculation  will be  avoided—and as
government could have the whole under their immediate
direction, the danger from perfons returning from inocu-
lation not well cleanfed, or with remaining infection upon
them will be greatly leffened, if not  wholly avoided.
  'Tis true the fmall-pox has been fpread  from the hof-
pitals for inoculation, which were fome years ago ufed  in
this colony, but that happened  I believe, principally be-
caufe no one had fufficient.powers, by law, to reftrain pa-
tients a competent length of time after their recovery from
the difeafe.
                           From yours, &c,

     Middletown, Sept. 7                     ?f  -ff'"7
        *4>  1773-      3                        * 
 
Med. Hist.
  WZ

LIH^m-E
  (773