Mr. Maitland's account of inoculating the small pox

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Mr. Maitland's ACCOUNT Of INOCULATING the SMALL POX.

HAVING understood, since my Retirement into the Country, that the late Experiment of Inoculating the Small-Pox at Newgate, has been pretty much talk'd of; and finding withal, that the Reports of that Matter are various, and oftentimes contradictory: I thought it became me, to give the Publick a plain and honest Account of the Truth of Facts; both to prevent, if possible, any one's being impos'd upon, as to the Trials already made; or sear'd from the Practice of it for the future.

'Tis not here my Design to offer an Essay on the Theory of the Small-Pox; or to attempt the best Methods of Cure: I leave that to the learned Gentlemen of the Profession; who, I do not question, notwithstanding all their best Discoveries and Observations hitherto made, will certainly agree with me, That it is a Distemper of the most fatal and destructive kind; and that, far from being possess'd of any infallible Method or Remedy, they will own, 'tis many Times too too hard for them, and very often baffles the most celebrated Skill.

They cannot then be offended, (I am sure the better and more candid Part of the Faculty will not) if, out of a single View of doing good, I here publish to the World a certain Method of Relieving Mankind, and rescuing them from the Fears and fatal Effects of that very loathsome and malignant Disease.

The Method I here propose, is no other than that very plain one of raising the Small Pox by Inoculation. A Method, new indeed, and utterly unknown here, till of late, tho' universally practis'd with Success all over Turky these threescore Years past; and in other Parts of the East, an hundred, or, for ought we know, some hundreds of Years before. The Practice having thus obtain'd amongst an illiterate Sort of People, what I here offer to recommend it, shall be delivered in the plainest Manner, and suited to the meanest Capacity, without the labour'd Embellishments of Learning or Eloquence: And indeed, one would think, these should not be here wanted, to reconcile to this very safe and useful Method, even Persons or a higher Rank, and more delicate Taste; especially since they, of all Sorts of People, generally speaking, suffer the most; witness the Havock made in great Families, not many Months since, by that Mighty Disease, which seem'd then to go forth like a destroying Angel, subduing all before it, and contemning all human Means us'd to stop its Career.

It may therefore be hoped, that This Practice should meet with a kind Reception even by them, who, of all others, are most terribly fearful of the prodigious Loathsomeness of the Distemper, and of the ugly and monstrous Effects it leaves, both on them, and their Children: Yet being apprehensive, that Sloth and Laziness, illplaced Affection and Tenderness, and it may be, some worse Dispositions too, which I am not willing to suggest, may possibly stifle this safe and useful Method in its Birth; I shall here take a little Pains to obviate the Scruples and Objections, which are commonly rais'd against it. And in Order to this, shall, first of all, give a Short and Historical Account of what I have seen and practis'd, both in Turky and at London.

In the Year 1717, when I had the Honour to attend the English Ambassador and his Family at Constantinople, I had a fair Opportunity fully to inform my self of what I had long before heard, namely, the famous Practice of Transplanting, or raising the Small Pox by Inoculation.

My Enquiry chiefly turn'd upon two or three Particulars, which, I thought, could I be well satisfied in, would go a great way towards convincing me of the mighty Advantages and Safety of the Method, and resolving my greatest Scruples and Difficulties against it.

Having heard that this contagious Disease, which for many Centuries of Years has prov'd such a terrible Scourge to Mankind, had its first Rise in Egypt, Arabia, and other Parts of the East, I thought it proper to enquire, First, Whether it continues still to rage in the Turkish Dominions in that violent Manner it was anciently observ'd to do; and as at times, it is known to attack us here, and most other Parts of Europe: For should it be found to be always of a milder and more temperate Sort than ours, why should that People take so very strange and uncommon a Way to avoid it? I quickly found the Case to be quite otherwise, being assur'd, besides what I saw with my Eyes; that the Small Pox is rather more Malignant and Epidemic there, than with us; insomuch that, as some have affirmed, one half, or at least one third Part of the Diseased, at certain Times, do die of it; and they that escape, are terribly disfigur'd by it[†].

Again, I enquired what were the Symptoms which attend, this new and strange Operation? And whether the Issue is always known to be salutary? The Disorder both before and after the Eruption was so very slight and gentle, that, in Strictness of Speech, it could not be called a Disease, having none of the usual Complaints of Pain in the Back, Vomitings, Head-achs, Thirst, Inquietude, and the like, the Pulse being only somewhat fuller and higher than before; yet so far from a Fever, that it scarce deserves the Name of a Febricula, bating some singular Instances, which are so rare, that they are not One to a Thousand. And last of all, which I thought not a little material, The Pustules, whether many or few, (and they commonly were from 10 to an 100, sometimes more) never left any Marks or Pits behind them, except only in the Incisions, or Parts Ingrafted.

But still I had one Difficulty left, which I took to be the most considerable; and which, if not fully clear'd, would render, in my Opinion, the whole of the Process but trifling and precarious: And that is, whether every one who has undergone this Operation, is really secured against all future Danger of catching the Small Pox by Infection? Were I but well assur'd of this, I should then, I thought, be at Liberty to practise it my self, and likewise with Confidence recommend it to others. All my Enquiries here were fully answered beyond Expression: For I was assured by all, and they could have no Design to impose upon me, that there was not an Instance known of any one's being ever infected, who had had any Pustules at all, how few so ever rais'd by Inoculation; tho' for a further Trial, several had been once and again Ingrafted; and others also had been confined to the Room, and in the same Bed too with the Infected. This I rejoiced to hear, and from thence concluded the Practice to be universally safe and useful. And indeed wonder'd not a little, that, notwithstanding the Authentic Accounts thereof more than once transmitted into England, there had never been hitherto any fair and full Trial made of it.

Hence also I could not forbear admiring the very great Sagacity of the Men who first invented this Method; and the laudable and diligent Observation of them too, who so carefully practis'd it themselves, and so faithfully convey'd it to their Neighbours: They all indeed were sensible of the Benefit, and found their Account in it.

About this Time, the Ambassador's ingenious Lady, who had been at some Pains to satisfie her Curiosity in this Matter, and had made some useful Observations on the Practice, was so thoroughly convinced of the Safety of it, that She resolv'd to submit her only Son to it, a very hopeful Boy of about Six Years of Age: She first of all order'd me to find out a fit Subject to take the Matter from; and then sent for an old Greek Woman, who had practis'd this Way a great many Years: After a good deal of Trouble and Pains, I found a proper Subject, and then the good Woman went to work; but so awkwardly by the shaking of her Hand, and put the Child to so much Torture with her blunt and rusty Needle, that I pitied his Cries, who had ever been of such Spirit and Courage, that hardly any Thing of Pain could make him cry before; and therefore Inoculated the other Arm with my own Instrument, and with so little Pain to him, that he did not in the least complain of it. The Operation took in both Arms, and succeeded perfectly well. After the third Day, bright red Spots appear'd in his Face, then disappear'd; and thus interchangeably (as it commonly happens) till in the Night betwixt the Seventh and Eighth Day, he was observed to be a little hot and thirsty, yet remain'd so but a few Hours; and then the Small Pox came out fair: They became round and yellow, like those of the more gentle distinct kind; and the Red Spots which appeared first, were the fullest and largest of all: They began to crust a few Days after, and then gently died away; so that the young Gentleman was quickly in a Condition to go Abroad with Safety. He had above an hundred in all upon his Body; but without any the least Disorder but what I have mentioned: And they all fell off, without leaving any one Mark or Impression behind them. This Operation was performed at Pera near Constantinople, in the Month of March 1717.

The Honourable Lady abovementioned, who had been happily delivered of a Daughter some three Months before, seeing the great Success of the Operation upon her Son, had a Mind to have it tried also upon the Infant: But this, for certain Reasons, was then laid aside, and I hope very luckily, being reserv'd to set the First and Great Example to England, of the perfect Safety of this Practice, and especially to Persons of the First Rank and Quality, who have ever suffer'd so much by that fatal Distemper.

This Noble Lady sent for me last April, and when I came, she told me, she was now resolved to have her Daughter Inoculated, and desir'd me forthwith to find out Matter for the Purpose. I pleaded for a Delay of a Week or two, the Weather being then cold and wet; for indeed, I was unwilling to venture on an Experiment altogether new and uncommon here, in a cold Season; tho' I am now convinc'd it may, with due Care, be practis'd at all Times and Seasons, but still with more Safety in the temperate and favourable. I also pray'd, that any two Physicians, whom they thought fit, might be call'd, not only to consult the Health and Safety of the Child, but likewise to be Eyewitnesses of the Practice, and contribute to the Credit and Reputation of it. This indeed was at first deny'd me, it may be, out of a Design to keep it secret, or least it should come to nothing.

In the mean time having found proper Matter, I ingrafted it in both Arms, after the usual Manner; the Child was neither blooded nor purg'd before, nor indeed was it necessary, considering the clean Habit of Body, and the very cool, regular Diet she had ever been kept to from her Infancy. She continued easie and well, without any sensible Alteration, bateing the usual little Spots and Flushings, till the tenth Night, when she was observ'd to be a little hot and Feverish. An ancient Apothecary in the Neighbourhood being then call'd, prudently advis'd not to give the Child any Medicine, assuring them there was no Danger, and that the Heat would quickly abate, which accordingly it did; and the Small Pox began next Morning to appear, which was indeed some two Days later than usual, by reason of the uncommon Discharge of Matter at the Incisions from the Beginning. Three learned Physicians of the College were admitted, one after another, to visit the young Lady; they are all Gentlemen of Honour, and will on all Occasions declare, as they have hitherto done, that they saw Miss Wortley playing about the Room, chearful and well, with the Small Pox rais'd upon her; and that in a few Days after she perfectly recover'd of them. Several Ladies, and other Persons of Distinction, visited also this young Patient, and can attest the Truth of this Fact. I need not here be more particular in determining the several Periods of this Cafe, they being the very same with that abovementioned; except only that here the Pustules were not so many, nor did they ripen so soon; which may be easily accounted for, without having Regard to the Difference of Climates, for there is little or nothing in that, seeing the Circassians, and others inhabiting the Banks of the Caspian Sea, a Climate much colder and more difficult than ours, practise it with Safety.

Another Instance I shall give for the further Confirmation of this Practice; namely, one of the learned Physicians abovementioned, who had visited Miss Wortley, having some Years since fully inform'd himself of this Method of Practice, and being thoroughly satisfied of the Safety and Reasonableness of it, at length resolved to try it in his own Family: He had formerly lost some Children in a very malignant kind of the Small Pox, and therefore desired me to lose no Time to ingraft the only Son he had left. The Boy (who was not quite Six Years of Age) being of a pretty warm and sanguine Complexion, the Doctor ordered about five Ounces of Blood to be taken from him; and then, in ten Days after, having found Matter which he lik'd, I inoculated him in both Arms. This was performed the 11th of May; next Day having look'd at the Incisions, I found them both inflam'd, which convinced me the Thing had taken. Some Red Spots appeared about his Temples the third Day; and some two or three Pustules between the seventh and eighth; the Boy being all the while without any Thing of Thirst, Head-ach, or any other Disorder, only his Pulse was observ'd to be fuller and quicker; and then about the 10th or 11th, some more Pustules appear'd round and yellow; and in two or three Days more dy'd away: The Incisions continuing all the while inflamed, and discharging a thick well-digested Matter.

Here I could bring a great many Cases of Persons inoculated in Turky, to prove the constant and certain Success of this Practice; in all which I have never seen any Miscarriage, except in One, which was wholly owing to the Rashness and Inadvertence of a Surgeon at Constantinople. I would not here be thought to pretend to a Secret, or to make a Mystery of this Operation; no, my Design is, only to advise every one that attempts it to be cautious: For ill Consequences may sometimes happen, and never more than in Things common and easy, and adapted to vulgar Capacities. In it self indeed it is simple and obvious, and may, like other plain Chirurgical Operations, be in a manner Mechanically learn'd and practis'd: For, not to mention several Surgeons, whose Business it is; I knew an old Greek Woman, who, having been taught it from her Youth, had practised it with Success a great many Years.

Hence, if any Regard be due to Facts, and to the most certain Observation and Experience of others; which, in Matters of Practice, have ever been counted the best and surest Direction; I am perswaded, all impartial People will allow this Method to be not only safe, but useful; and highly worthy to be receiv'd with Esteem and Applause. Is it not a Matter of the greatest Importance to us, to know how to prevent the mighty Contagion of the Small Pox; and how to preserve our Children and Families from the violent Attacks, and fatal Effects of it? What would not tender Parents give to secure to them the Lives and Features of their beloved Offspring; when they behold them disfigured by the loathsome Disease, and struggling with the Pangs of Death? Do not we oftentimes see great Families extinguish'd by it, as by the Plague, and their Titles and Estates thereby transmitted to Strangers? And if they have the good Fortune to escape with their Lives, what an ugly Change from what they were before? What Pittings, Seams, and Scars in their Faces? What Films and Fistula's, and sometimes Blindness in their Eyes? What Ulcers and Imposthumes in their Bodies; Contractions of the Nerves, and even Lameness for Life? Again, to avoid the Infection, what Uneasiness and Disquiet of Mind, what Fears and Apprehensions do not even grown People labour under, especially the more delicate and tender? Don't they renounce all Commerce with their best Friends and dearest Relations? And if by chance they meet an Object that has but lately recover'd, how susceptible then are they of the Distemper? And how few thus seiz'd do ever escape?

In short then, to prevent all these, and many the like Calamities, the almost universal and inevitable Consequences of this fatal Disease; I may truly venture to affirm, that the Method here recommended is, of all others hitherto known, the safest; and I am sure far more infallible, than that of the most learned and most cautious Practice.

I have, however, in Conversation, met with several Scruples and Objections against this Method; some whereof relate to the manner of the Operation; which, I hope, by the Account already given, are in some measure satisfy'd: Some again concern the Lawfulness of it; and others would even seem to question the Fact, denying that the Small Pox are hereby rais'd; or that the Eruptions ought to be deem'd of that kind; since they are not preceded by a Fever, nor attended with the usual Periods of the Distemper.

They that scruple the Lawfulness of this Practice, are apt to call it, a Presumption, a forcing of Nature, a tempting of Providence, and the like. True indeed, were the Operation in it self dangerous; and the Issue generally doubtful, as several, both in Physick and Surgery sometimes are, yet neither presumptuous nor unlawful for all that; I should be ready to own the Charge, and yield it at once to the tenderhearted and the scrupulous: But pray, what are they afraid of? Is there any Thing here frightful, or shocking to the nicest and the most delicate? The Practice is most plain, rational, and easie, intended only to prevent the malignant Infection, and to preserve Life: not to give a Disease, and in this Sense, to force Nature before its Time; but in effect, to cleanse Nature from the latent Fomes or Seminium; and to secure against that popular Contagion. We have heard, and indeed it were much to be wish'd we had any that truly deserve the Name, of Preservatives against the Plague; And why may not This, which has elsewhere been so universally tried and approved, pass for One against the Small Pox?

But again, what do they mean by tempting of Providence? Can they imagine, that using the fair and proper Means of avoiding and preventing a Disease, is oftensive to Providence? Why then do they Bleed, Vomit, or Purge, or use any other Remedy, to prevent a Fever? And why don't they trust that Providence, rather than dare to abandon their Families, and desert the Distressed, to flee from this or any other Disease? Nay, so far am I from counting this Method tempting to Providence, that I rather esteem it a Motive of Thankfulness to the divine Providence, and a great one too, for, the Discovery.

As to the Objection against the Fact, denying the Small Pox to be hereby rais'd: Did the Eruptions come the natural and common way, I acknowledge it to be highly reasonable: For the only way we have to distinguish between the genuine Small Pox of the several kinds, and the spurious, or what they call the Chicken Pox, is not only by observing the Nature and Periods of the Pustules, but also by the first Invasion, and subsequent Progress of the Fever, and of the usual Symptoms attending it. The known Periods of the Small Pox are different, according to their different kinds; and this Difference ariseth, not only from the various Dispositions of the Juices and Habits of the Bodies affected; but likewise from the different Degrees and Qualities of the External Infection, howsoever communicated, as it is more or less subtil, malignant and epidemic.

Now in those rais'd by Inoculation, the Periods, tho' a little different from the common and natural, are, in their kind, as certain and regular as the other: A Difference indeed is observ'd of sometimes two or three Days, as to the Time of Eruption; but that is no more than what is common in the natural Sort. And thus too, it is with Respect to the other Stages of the Disease: I mean those of the Invasion, Maturation, and Declination; they are equal and regular, and what is more, the Process is certain, and the Prognostick infallible.

But the principal and most material Difference of all lies in the Fever, which here is so gentle, that it hardly deserves the Name; but in the natural, and especially the confluent kind, 'tis always violent, and often the immediate Cause of Death.

Were it not altogether foreign to my Design, and inconsistent with the Brevity I here propose, I could easily demonstrate the Cause of this Difference; and make it appear, that the small Quantity of the Matter inserted into the Capillary Vessels of the Skin, is not capable of altering or dissolving the Mass of Blood, as it happens in the Case of Infection; nor of raising an Ebullition sufficient to produce a Fever, and the dangerous Symptoms which always follow upon it: And yet it is certain, notwithstanding all this, that the Matter thus inserted does produce Eruptions of the right Small Pox kind, with good digested Matter, as hereafter describ'd; and without any Thing of the Danger and Loathsomeness, ever inseparable from the other.

That it is the right and genuine kind, may be further prov'd beyond all Exception, by a few plain Instances here subjoin'd; by which it will appear, that the Small Pox thus rais'd by Inoculation, is truly infectious and catching; and that several Adult Persons, who never before had them, have been actually seiz'd, by means of kissing and caressing a Child, not quite three Years of Age, while the Eruptions thus rais'd were upon it. What stronger Proof can reasonably be desired of the genuine Small Pox? And what need is there of more Words or Arguments to convince any one, that will not be perswaded by Facts?

I am hastening to give you an Account of those Facts, and do assure you, it shall be an honest and a true one. But before I come to it, I wou'd briefly take notice of a Question or two, which a learned Physician, one Day ask'd me, on the Subject. As first, Whether I was always sure, thus to give the Small Pox? And then, whether, when given, I cou'd engage the Patient should never take them again by Infection?

To the first, I answer'd, the Operation had never yet fail'd me, or any one else, that I know of; nor do I believe, it ever can, when duly perform'd, but upon Persons who have had them before: For I very much question, what some have affirm'd, namely, That there are People in the World, who are not susceptible of the Disease. In the mean time, I had a Mind, with great Submission, to have ask'd the Doctor a plain Question in Answer to his; and that is, Whether, when he prescribes a Purge or a Vomit, he is always sure, it will answer his Intention? For I have often heard, that Vomits have sometimes prov'd Purges; and Purges, Vomits too; and, which is worse, that People have had the Misfortune to die under both Operations; which has never yet happen'd, in the Case of Ingrafting.

As to the Doctor's second Question, I have said somewhat already; and now can add further, that besides the frequent Experiments which have been made in Turky; as, of Inoculating the fame Person a second and a third Time, and the like; I my self have lately made open and repeated Tryals, on one of the Six Inoculated Criminals of Newgate, reserved for that purpose, sufficient to convince any one, that there's no Danger of their Catching the Disease by any future Infection. This is, One [†] Elizabeth Harrison, of about nineteen Years of Age. Here I must observe to you, that this Girl, had the fewest Eruptions upon her, of any of the five, that were Inoculated at Newgate, but had a more than Ordinary Discharge at the Incisions.

I first employ'd her as Nurse to a Servant Maid, very ill and full of the continued-distinct Kind of the Small Pox, in the House of Mrs. Moss, in Christ's Hospital Buildings at Hertford, whom she attended during the whole Course of the Disease. This Maid had hardly recover'd, when one of the Boys, about ten Years Old, of the said Hospital, was also seiz'd with the very same Sort; I oblig'd her to lie every Night in the same Bed with this Boy, and to attend him constantly from the first Beginning of the Distemper to the very End: And thus she continued for Six Weeks together, without Intermission, or feeling any the least Head-Ach or other Disorder; tho', indeed, I once saw some Heats and little Pimples upon her, as Nurses commonly have under such Confinements. There's no Ground to question this Fact, being attested by a Cloud of Witnesses.

For a further Confirmation of what I have said, I once intended to have here subjoyn'd D. Timoni and Pylarini's Letters, publish'd in the Philosophical Transactions, No. 339 and 347. But being unwilling to enlarge this Account beyond its just Bounds, I must leave them to another Opportunity, and withal take the Liberty to refer the Reader to them.

A Journal of the Experiment at Newgate.

London August 9. 1721.

IN Obedience to their Royal Highnesses Commands, I performed the Operation of Inoculating the Small Pox, on Six condemated Criminals at Newgate; in Presence of several eminent Physicians, Surgeons, and other.

The Names of the Criminals are,

- 1. Mary North Aged 36 Years.

- 2. Anne Tompion Aged 25 Years.

- 3. Elizabeth Harrison Aged 19 Years.

- 4. John Cawthery Aged 25 Years.

- 5. John Alcock Aged 20 Years.

- 6. Richard Evans Aged 19 Years.

August 9. 1721. Being Wednesday, betwixt the Hours of 9 and 10 in the Morning, I made Incisions in both Arms and the right Leg of all the Six.

10 and 11. Thursday and Friday, I find little or no Alteration in any of them, except Mary North, who sometimes was troubled with Vapours, as usual to her: They all sleep well, dress, and walk about all day, and are hungry for their Food: Their Pulse a little rais'd, but without any sensible Disorder.

12. Saturday, In the Morning; observing the Incisions not so much inflamed, and tending to Suppuration as usual; and thence suspecting the Matter ingrafted to have been defective and languid, having been kept at least 15 or 16 Hours, for a very good, but unavoidable Reason; I search'd for fresh Matter, and having found it in. Christs Hospital, about 6 a Clock at Night I made new Incisions in each Arm of five of them, and ingrafted it as before. I had no Matter left for the sixth, Evans.

13. Sunday Morning, these five complain all of Pain in both Arms: Having taken off the Dressings, I find all the first Incisions inflamed and fester'd, but without any Sickness in the Patients; their Pulse sensibly higher, and their Water turbid.

14. Monday Morning, red Spots and Flushings appear on all the five; but most of all on Mary North, especially about her Face, Neck, and Breast: And so likewise on Ann Tompion: But without any Sickness, Head-ach, or Thirst; except a little they complained of in the Night; and a higher Pulse.

15. Tuesday, The same Spots and Flushings appear fresh in the Morning; but turn paler and darker towards Night, yet without any Disorder.

It is here to be observed, That the sixth, viz. Richard Evans, who had had the Small Pox in Prison last September, has had no manner of Pain, Heat, or Inflammation in any of his Incisions, nor any manner of Alteration otherwise: But all continuing pale from the Beginning, yesterday dry'd up entirely.

16. Wednesday, They all continue much as before, only their Incisions begin to discharge a thick, purulent Matter. Anne Tompion has a large yellow Pustule on the bending of her Thigh, and another on the outside of her right, Arm, like Small Pox: And John Alcock has more fresh Pustules appearing on his Face and Arms; having had a slight Febricula in the Night, with disturb'd Water. And John Cawthery has a large yellow Pustule on his left Cheek, and several small ones on his Face.

17. Thursday, The said Alcock has these Pustules appearing now fairly, with a yellow digested Matter, and red Bottoms, and a great many of them, but without Sickness. Ann Tompion has the same yellow Pustules on her right Arm and Thigh, with other fresh ones struck out about her Chin and Mouth.

18. Friday, Alcock's Small Pox appear still fair and yellow, but fuller and larger, with a bright red round them. All the others much the same, with their Incisions running.

19. Saturday, Last Night, this Alcock unaccountably pricks and opens all the Pustules he could come at with a Pin; which occasions them to fall and crust sooner: But they continue red at Bottom; and the Incisions in him abate of their Running.

It is here to be noted, that tho' he has had by much the greatest Number of Pustules or Small Pox upon him, yet the second Time he was touch'd in one Arm only, there not being Matter enough for the other Arm; whereas the other four had both Arms ingrafted, and Matter in Abundance.

20 and 21. Sunday and Monday, All of them continue as before: The Incisions on the other four, run still a thick, digested, yellow Pus.

Here I must observe, that the second Incisions in both Arms, by which a vast Discharge has been made, seem to me, in the Issue, to have been rather a Prejudice and Impediment to the Eruption, than to have, in any Sort, contributed towards it: But however, I believe them to be, in all Respects, as safe from any future Infection as Alcock, who had 60 Small Pox, at least upon him.

22 and 23. Tuesday and Wednesday, All of them continue well; and their Incisions cease running, and dry up apace.

24. Thursday, I purg'd Alcock and Cawthery for the first Time; and did design also to purge the three Women; but was prevented by their. Monthly Purgations, which, I was not a little surpriz'd to hear, seiz'd them all about the same Time; tho' some of them had been obstructed several Months before.

28. Monday, Mary North, before she was quite free, unaccountably wash'd in cold Water, and thence caught a violent Colic, which lasted near two Days.

30. Wednesday, They all three take a purging Potion, which answers the Intention, and perfectly carries off Mary North's Colic Pains.

31. The two Men are again purg'd, in Order to their being discharg'd: And so likewise, next Day, are the Women.

And on the Sixth of September, they were all dismiss'd to their several Counties and Habitations.

To conclude, The Thing has been successful on all the Five, far beyond my Expectation, considering their Age, Habit of Body, and Circumstances; and it has perfectly answer'd Doctor Timoni's Account of this Practice, and also the Experience of all who have seen it in Turky.

I cannot here forbear mentioning the very ample Testimony, which Mr. Cook, an eminent Turky Merchant, one Day gave to this Experiment, in my Hearing at Newgate; After having seen the Persons ingrafted, and fully consider'd their Incisions and Eruptions; He openly declared, they were the very same with what he had ever observed in Turky, of which he had seen a great many Instances: And that we might be assur'd, none of these here would ever be infected with the Small Pox again.

And it is particularly remarkable in this whole Affair, that tho' there was not the least encouraging or favourable Circumstance attending it before the Operation; yet after it, nothing in any sort dangerous or unsuccessful did happen: Although no Art, nor stimulating Medicine, was made Use of to promote the Eruptions; not so much as to oblige the Patients to keep their Bed; the whole having been left to Nature, assisted by a strict and regular Diet.

October 2. 1721. After due Preparation of the Body, I ingrafted Mary Batt, an Infant of two Years and an half old; Daughter of Thomas Batt, a Quaker, living at Temple, within three Miles of Hertford: The red Spots and Flushings appeared on her Face and Neck the fourth Day; and she kept playing about well till the seventh or eighth, when she became a little heavy and thirsty, with a fuller and quicker Pulse; then the Pustules came out fresh and full, and the Incisions discharged a thick welldigested Matter. She had not above 20 in all upon her; they continued about three or four Days, then dry'd away and fell off, and the Child recover'd perfectly.

Thus far all was well; but what happen'd afterwards was, I must own, not a little surprizing to me, not having seen or observ'd any Thing like it before. The Case was in short this; Six of Mr. Batt's Domestick Servants, viz. four Men and two Maids, who all, in their Turns, were wont to hug and caress this Child whilst under the Operation, and the Pustules were out upon her, never suspecting them to be catching, nor indeed did I, were all feiz'd at once with the right natural Small Pox, of several and very different kinds; for some had the round distinct Sort, some the small continued, and others the confluent; all of 'em had a great many, but especially the last, with the usual bad Symptoms, and very narrowly escap'd: But they all (God be thanked) did well, (except one Maid, that would not be govern'd under the Distemper, who dy'd of it) and now enjoy a perfect State of Health[†].

October 12. 1721. I Inoculated Joseph and Benjamin, Sons of William Heath of Hertford; the first of about seven, and the second of three Years of Age; both with the same Matter, and at the same Time: the last had a very gentle and favourable kind, in all Respects like the abovenamed Mary Batt; but the first, viz. Joseph, being a fat, foul, gluttonous Boy, who would not be confined to the Rules and Directions I had strictly charged his Mother withal, as to Diet and keeping warm; was taken very ill before the Eruption, and after it had a great Load of the continued small kind, but at last recover'd and did well.

What a mighty Difference is here to be observed between those two Boys! the Reason of it seems to be plainly this; The younger, who had the favourable kind, was of a clean Habit, moderate Appetite, and easily govern'd during the whole Process. The elder was not only, as I have said, of a gross, foul Constitution, but likewise had a voracious Appetite, always eating and filling his Belly with the coarsest Food; as Cheese, fat Country Pudding, cold boil'd Beef, and the like; which I saw my self as I came in by chance, the third Day after the Operation; nor was there any Care taken to restrain or keep him within in cold, windy, frosty Weather; he once wet his Feet in the Water; insomuch that had he taken the Small Pox by Infection, the World could not have sav'd his Life. Hence it appears how necessary it is to cleanse thoroughly those foul Habits before the Operation; and withal to keep them to a very strict Regimen under it.

'Tis also here very remarkable, further to evince the Power of Infection, and the Genuineness of the Inoculated Small Pox; that an Infant of about four Months old, then on Mrs. Heath's Breast, while she nurs'd her two Sons, and lay in Bed with them, was also seiz'd with the distinct natural Kind; and in due Time perfectly recover'd. Mrs. Heath also, by being Night and Day constantly with her Children, and always embracing and caressing of 'em, tho' she had had the Small Pox many Years before, struck out in several Pimples or Pustules on her Face and Hands, but without any Thing of Sickness or Disorder: which, we know, has often happen'd to Nurses, by attending People in this Distemper; and even by washing their Linen.

Not many Days after this, I met Mr. Hughes, Judge Advocate General of his Majesties Forces, who requested me, upon my Return to Hertford, to visit his two Children at his House in Herting for dbury, which I promis'd to do; and found, when I came there, his Son, a Child of about 18 Months old, actually ill of the Small Pox; I immediately acquainted Mr. Hughes, with this, and withal remov'd the Daughter, who was about three Years of Age, to a neighbouring Gentleman's House. Mr. Hughes then recommended to me the particular Care of his Son, and pray'd me, if the Small Pox shou'd prove of the favourable Kind, not to fail to inoculate his Daughter from him. The Boy had indeed the fair distinct Kind, and not a great many, and recover'd perfectly of them; but afterwards dy'd of a cancerous Tumour, which had been breeding in his Cheek and upper Jaw, long before his Seizure with the Small Pox. But to return, I took Matter from him, at the proper Time, and with it Inoculated his Sister, November 17th, having first gently purg'd her. The Thing took; she sicken'd, the 24th, and two Days after the Small Pox appear'd fair, and continu'd to fill and ripen to December the 3d, then crusted and gradually fell off in the usual Manner.

This Young Patient had above two Thousand Pustules or Small Pox upon her, that came out well, fill'd up, ripen'd and fell off, observing the most regular Periods of the natural Small Pox of the distinct Kind; yet she did not keep her Bed one Day, nor wanted a Nurse to watch with her one Night during the whole Process; never having been affected with the usual Complaints and Symptoms of the Natural Small Pox; nor in the least pitted or scar'd with them.

I thought it proper to be the more particular in relating this Case, because of the very false Account which had been given of it in the Post Man of December 2, which, in my Absence, the Gentleman himself was pleas'd to contradict in the St. James's Evening Post, December 7th.

December 17. I Inoculated two of Mr. John Colt's Children, at his House in Clement's Lane, Lombard Street: The one a Boy of 7, the other a Girl of about 4 Years of Age; their Bodies having first been duly prepar'd by a Physician's Order. They both sicken'd the 24th, the Small Pox appear'd on the Girl the 26th, and on the Boy the 27th; they came out gently, fill'd and ripen'd to the 3d and 4th of January; and then died away as usual. Those Children had at least 300 Small Pox each, all fair and round; but the Boy had rather more: His came out later, and kept out longer too than his Sister's; which can only be accounted for (the Ingrafted Matter having been the same, and in the same Quantity) by the Difference of their Habits and Juices. In the mean Time, neither of 'em from the Beginning cou'd be said to be downright ill; nor was oblig'd to lie in Bed; nor, in a Word, was affected with any of the dangerous or bad Symptoms ordinarily attending that Disease, or consequential to it.

They being perfectly recover'd; Saturday January 13th, I perform'd the Operation upon a third Child of the said Mr. Colt; a Boy of about 6 Years of Age, who was also design'd to have undergone it with the other two the Month before, had it not been that he was then out of Order; he continu'd chearful and well till the 20th, when he became ill and feverish; then the Small Pox appear'd the 22d, and three Days after, the Eruption being quite over, they grew fair, round, full and yellow; like the natural Small Pox of the distinct Kind, and thus went on to the 29th or 30th, when they began to crust and fall off after the usual Manner. This Child had a great many upon him, like the abovenamed Miss Hughes; and is also perfectly well recover'd of them: He was visited, while under them (as indeed were the other two) by several eminent Physicians, and other Persons of Distinction about the Town, who all unamiously agreed that it was the right Small Pox, and declar'd themselves fully satisfied with the Trial.

I do not here take notice of the little Heats and Flushings, which appear'd upon them in the Beginning; nor of the other more minute Circumstances generally common to all; nor of the proper Evacuations prescrib'd before and after; that I may avoid tedious Repetitions, as much as I am able. But I wou'd beg leave to add one Observation, the Reason of which is plain and obvious, namely, that the greater the Discharge of Matter at the Incisions is, the fewer commonly are the Eruptions; and on the contrary. Hence also the great Advantage of Issues in This, and other cuticular Diseases, may with great Probability be evinced and demonstrated.

But to conclude: From these few Instances, which I have here contracted into the narrowest Compass, several very obvious and useful Observations might be made, and unquestionable Proofs brought, to shew, in the most Satisfactory Manner, that the Small Pox thus rais'd are of the true and genuine Kind; that they may be always given and communicated to proper Subjects, young or old, without any Danger of a Relapse; and finally, that this whole Practice, prudently manag'd, is always Safe and Useful, and the Issue ever Certain and Salutary.

The Certificates from Hertfordshire.

THESE are to certify, That Elizabeth Harrison, one of the Five Persons Inoculated at Newgate, hath lived at our House in Christ's Hospital Buildings at Hertford for above Ten Weeks, and has during that Time attended our Servant Maid, and after her one of the Boys belonging to the said Hospital, both in the natural Small Pox, and lay with the said Boy from the Beginning to the End of that Distemper, without Sickness or receiving the least Infection from them.

As witness our Hands this 4th Day of December 1721.
Sign'd thus,

- Pris. Moss, the Mother.

- Sarah Moss, Daughter.

Sign'd in the Presence of us,

- Robert Biscoe.

- Christopher Sharp.

THESE are to certify, That Mr. Charles Maitland, Surgeon, did about the Beginning of October last, Inoculate the Small Pox upon my Daughter Mary, aged two Years and an Half, who had but a few of them, and perfectly recover'd in about Fifteen Days. I do declare that six of my Domestick Servants were seiz'd with the Small Pox, which I believe was owing to their carrying about and frequently conversing with my said Daughter, they having had no Correspondence during that Time, with any Person or Family who had them, which inclines me to think my Child had the true Small Pox:

As witness my Hand this 7th Day of December 1721.
Sign'd thus, Ann Batt.

Signed in the Presence of us, by our Mistress; and we likewise know the Contents to be true:

- Thomas Stimson ∽ his Mark. John Hutchins ✚ his Mark. Two Servants who receiv'd the Small Pox from the Child.

- Witness. L. Oakes of Hertingforbury.

THESE are to certify, That upon the 12th Day of October last, Mr. Maitland, Surgeon, Inoculated the Small Pox into my two Sons, Joseph and Benjamin Heath, at Hertford, who are both perfectly recover'd of that Distemper, which prov'd a true Small Pox; and these are likewise to testify, that I had a little Boy about four Months old, sucking at my Breast, while I attended my Inoculated Children, who was seized with a vomiting fit, &c. and continued ill for some Days, after which the Small Pox appear'd fairly upon him; and is likewise recover'd:

As witness my Hand this 4th Day of December 1721.
Sign'd Eliz. Heath.

Sign'd in the Presence of us,

- Nat. Stratton.

- William Anderson.

- Thomas Stratton.

- The Mark N of Nurse Warner, who attended the said Children.

FINIS.

Notes

†
Vid., D. Timoni & Pylarini Epist.
↵

†
See the Journal annex'd.
↵

†
See the Certificates annexed, pag. 34.
↵

Mr. Maitland's ACCOUNT OF Inoculating THE SMALL POX.

LONDON, Printed for the Author, by J. DOWNING: And to be Sold by J. ROBERTS, at the Oxford-Arms in Warwick-lane, 1722.

THIS ACCOUNT OF Inoculating the Small-Pox, Is most humbly Inscribed TO THEIR ROYAL HIGHNESSES THE Prince and Princess OF WALES,

By Their ROYAL HIGHNESSES Most faithful, and most obedient, humble Servant, Charles Maitland.

Advertisement.

THIS short Account of Inoculating the Small-Pox, bating the later Cases annexed, was ready for the Press some four Months since, and would then have been Published, had not their Royal Highnesses (at whose Command the Operation at Newgate was performed) been all this while generously intending further to oblige the Publick, by encouraging and promoting other Trials of that kind, both upon Parish Children and grown Persons. But these, for certain Reasons having hitherto been obstructed, if yet they shall be brought to bear, Care will be taken in due Time to give the World a true and faithful Relation of them; or failing them, of any other observable Cases in this Practice.

It has also been thought fit, for a further Confirmation of the Truth, to subjoin some Certificates from the Country, under the Hands of the Persons immediately concerned: Those Trials not having been made, as the others here related were, in the Presence of any one or more of the London Physicians.

Feb. 13. 1721-2.

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Mr. Maitland's account of inoculating the small pox

Arbuthnot, John, 1667-1735.

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http://ota.ox.ac.uk/id/4071

ID [isbn10]

1106010701

ID [isbn13]

9781106010704

ID [TCP]

K040928.000

ID [BIBNO]

CW3307118725

ID [ECMS]

0205300500

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— Mr. Maitland's account of inoculating the small pox, Arbuthnot, John, 1667-1735.. [4],35,[1]p. ; 4⁰. London :: printed for the author, by J. Downing: and to be sold by J. Roberts,. 1722.. [By John Arbuthnot.] ["Advertisement" to the reader dated: Feb: 13. 1721-2.] [Reproduction of original from the British Library.] [English Short Title Catalog, ESTCT41553.] [Electronic data. Farmington Hills, Mich. : Thomson Gale, 2003. Page image (PNG). Digitized image of the microfilm version produced in Woodbridge, CT by Research Publications, 1982-2002 (later known as Primary Source Microfilm, an imprint of the Gale Group).]

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