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analyses of his medicine and his own confession in his old

age,

that Daniel Sutton, in strictness, invented nothing, but judiciously combined remedies which had been found out independently by others. Sydenham had discovered the utility of exposing small-pox patients to the cool air, and of allowing them to drink cold water, but he did not venture to deviate so much from ordinary rules as to prescribe purgatives. Subsequent physicians bad ascertained that great benefit arose from opening medicines, and particularly from mercurial purges; but in conformity to old theories, they at the same time confined their patients to bed, covered them warmly, and promoted perspiration. But Sutton had the sagacity to extract what was beneficial in both these plans, and to reject what was injurious. Almost every modern essay now recommended purgatives, and our reformer only made choice of the prescription which was most in vogue.'

We have introduced these remarks on Sutton's plans of treatment, merely in conformity with our wish to give as satisfactory an explanation as possible of the eventual success of inoculation; which now spread rapidly through almost the whole of Europe, with the exception of Spain. That country, as our author states, in the present case, profited by its sluggish indisposition to adopt the improvement of neighbouring nations; for, after some partial and feeble attempts to introduce the practice, the endeavour was relinquished; and it is a notorious fact, and highly worthy of remark, that Spain has suffered incomparably less from small-pox than any other European state : the reason is sufficiently obvious; and the fact furnishes an equally obvious objection, as above hinted, against the practice of artificially disseminating a distemper so infectious, and so fatal. It is indeed beyond dispute that even the mortality from small-pox increased with the progress of inoculation, “from the impossibility of prevailing upon the whole population to adopt medical counsel;' and of two estimates by two accredited physicians made of deaths from small-pox during the last thirty years of the preceding century, and laid before a committee of the House of Commons, 'the one stated the average numbers at 34,260, adding that he believed those deaths to be under the truth: the other physician made them amount to 36,000.'

' But this immense and increasing consumption of human lives, was not the sole evil produced by this distemper; for a considerable portion of the survivors were pitted and disfigured; some lost one of their eyes, a few became totally blind, and others had their constitution impaired, and predisposed to a variety of complaints, which were productive of future distress, and sometimes of death.'

In this state, then, did things stand in reference to small-pox, natural and acquired, when the newly suggested substitute presented its claims to the consideration of mankind; and the momentous business now devolves on us of investigating the legitimacy of

these

these claims, or of ascertaining the grounds upon which such high pretensions are preferred.

Dr. Jenner' (whose name requires no formal introduction) was originally employed in general practice in a district in Gloucestershire. It was in the year 1768 that he first heard the report of those sores which infested the teats of cows, and which infected the chapped hands of the milkers, being sometimes a preventive of small-pox; and, in connexion with this report, it struck him as a remarkable fact, which came under his own cognizance, that many of the peasants whom he endeavoured to inoculate resisted the infection. Although these circumstances made at the time some impression on his mind, he did not systematically prosecute the investigation to which they ultimately led until after his return from London to establish himself at Berkeley. Then it was that he commenced the inquiry in earnest; and in the relation which he has given of the progress of his labours in this very extraordinary pursuit, he informs us, • That the disease (the cow-pox) had been known in the dairies from time immemorial, and a vague opinion prevailed that it was a preventive of small-pox. This opinion I found was comparatively new; for all the old farmers declared they had no such ideas in their early days, a circumstance which seemed easily accounted for, froin my knowing the common people were very rarely inoculated for the small-pox, till that practice was become general, by the improved method introduced by the Suttons ; so that working people in the dairies were very seldom put to the test of the preventive power of the cow-pox.'

As Dr. Jenner proceeded with his inquiries, he found that several persons contracted the small-pox after they had been subjected to the disease from the cow; and moreover that the medical practitioners in the neighbourhood all agreed in declaring, from experience, that the cow-pox was only an occasional, and a very uncertain preventive of small-pox. These discoveries were certainly of a disheartening nature, but, although they might damp the ardour of hope, they did not cause the abandonment of the pursuit. On further investigation he ascertained that the cow had occasionally several varieties of eruptions on her leat, all of which were indiscriminately named cow-pox when productive of sores on the hands of the milkers; and it occurred to him as very probable that only one species of these eruptions possessed the preventive power; and that this was the true explanation of the observed irregularity in point of effect. One obstacle thus appeared to be done away; but lo! another now presented itself, which by most persons would have been considered insuperable ;--' to his great mortification, Jenner found several examples of milkers who were seized with the small-pox, after having contracted sores on their hands from

the

the genuine cow-pox.' In spite even of this, our indefatigable investigator pursued his researches; and as it seemed to bim inconsistent with the general uniforinity of the laws of nature that this difference of susceptibility should so widely obtain, it occurred to him that the specific influence of the poison might not improbably vary with the progressive changes it underwent, after having been first secreted from the ulcerated surfaces of the cow's teat; and, · after much investigation, he at length ascertained, that the milkers, who acquired the cow-pox from vesicles on the teats of the cows, while advancing to maturity, were secured from the small-pox; while those contaminated by cows, in an advanced period of the disease, remained susceptible of the small-pox. In fine, from a multitude of cases he was enabled to draw these conclusions, that the property of preventing the small-pox appertained only to one of those diseases which were vulgarly denominated the cow-pox; and that this power principally resided in the liquid secreted during the early stages of that disease.'*

With these exceptions then of a spurious matter in the one case, and of a matter taken at a wrong time in the other, Jenner conceived that he had made out the fact of cow-pox being a preventive of small-pox for life; for he exposed in various ways individuals, who had been the subjects of the former, to the latter infection, (after the lapse of fifteen, twenty-seven, and even fifty years,) and found that they resisted its influence.

Thus a clear way was opened for the important application of this singular discovery. May not this preventive be propagated from man to man, and thus supersede the small-pox virus ? was the idea that suggested itself to the mind of the discoverer, a suggestion, which it is needless to say has been extensively acted on, and which has given rise to one of the most important problems ever proposed, viz. İs vaccination an actual, a permanent, a safe, and unobjectionable security against small-pox infection?

For a moment we will suppose its preventive efficacy to be admitted, in order to advert to a separate charge which has been adduced against its employment,-for the vaccine virus has been said to be a means of engendering foul humours, to lay the foundation

* Not with a desire to prejudice the case, but merely for the purpose of pointing out that analogy subsisting between the variolous and vaccine secretions, which is contended for by some writers, we subjoin the following extract from Mr. Moore, as a continuation of and comment upon the above quotation:

• Jenner,' says Mr. Moore, ' perceived that these opinions corresponded with remarks thac had been made on the small-pox, as the liquid most active for variolous inoculation is that which is first secreted; but the thick matter of pustules which have crusted, though it may excite local inflammation and suppuration, yet frequently fails of producing the real small-pox.'

of several chronic diseases, and to be therefore in the highest degree objectionable. This charge can only be substantiated by an appeal to facts; what then do these testify ? Have chronic cutaneous eruptions (the disorders alleged to be the consequences of vaccination) recently been on the increase ? All medical records and reports, presented to the world for the last twenty years, agree in the diminution rather than the augmentation, both of the number and severity of the complaints in question; and what may be considered as decisively to the point, is the following statement from a respectable surgeon to the Infirmary at Gloucester :

"A more healthy description,' says this gentleman, of human beings does not exist, nor one more free from chronic cutaneous impurities, than that which suffers most from cow-pox, by reason of their being employed in dairies; and the Gloucester Infirmary, one of the largest provincial hospitals, is situated in a county in which accidental cow-pox has been prevalent from time immemorial; many hundreds among the labouring people have had the cow-pox since the establishment of that institution, and that more severely than is generally the case in artificial vaccination, and yet not a single patient has applied to the Infirmary in half a century for the relief of any disease, local or constitutional, which he or she imputed, or pretended to trace to the cow-pox: and let it be repeated and remembered, that the artificial in no respect differs from the natural, except in being generally less virulent.'

This document, backed by the concurrent testimony of impartial and unprejudiced records from medical observers, that scrophulous and cutaneous affections are (as we have said) upon the decline, will, it is presumed, serve as a sufficient refutation of those partial and garbled statements which in the early stages of the controversy were made for the purpose of confirming the apprehensions of the timid, and giving strength to ungrounded prejudices. The question therefore of vaccine efficacy remains unicumbered by minor considerations, and it is now for us finally to observe upon the evidence by which the following proposition has been maintained, viz. that the vaccinated and the inoculated child stand upon precisely the same footing in respect of security against small-pox.

In spite of our professions of impartiality, we suspect that our readers have by this time set us down as determined defenders of the vaccine cause. We shall probably, therefore, excite some surprise by expressing it as our opinion, that the absolute truth of the above proposition does not appear to us to have been hitherto fairly established. It does, we confess, seem probable that there may be a shade of difference in the preventive efficacy of the vaccine and variolous virus; even this, however,

we

we must allow to the advocates of vaccination, has not been proved, and we hasten to adduce the evidence on either side.

Mr. Moore, who is a professed partizan of vaccination, argues for its identity as to effect on the ground of analogy, and contends that the exercise of the virus of only a partially preventive power would be an anomaly in nature. This argument is in itself forcible, and is managed by our author with considerable adroitness. It is needless, however, to remark, that it must fall powerless even out of Mr. Moore's hands unless backed by actual observation:the preventive efficacy of vaccination is a question not of theory but of fact. That there have happened cases of small-pox of an indisputable nature, subsequently even to proper vaccination, no one can deny; but then it is urged that small-pox has likewise been known to occur twice to the same individual, and to have succeeded to inoculation in the same manner as it has to vaccination. The point, however, at issue is whether these anomalies are proportionately as frequent in the latter as in the former case; and, in determining this, Mr. Moore contends that the comparative estimates have not been made with due attention to every necessary particular.

• In making this estimate,' he says, ' an error has been committed by comparing the results of the primary practice of vaccination with those of the most approved state of variolous inoculation, forgetting that, when the latter operation was introduced, failures of every kind were far more frequent than of late, and that even the deaths amounted in early practice to one in fifty. In like manner, vaccination, on its first introduction, was so misconducted, that two children in a workhouse were actually destroyed by it, although, when skilfully practised, it is really less dangerous than opening a vein or cutting a corn. A multitude of lesser mistakes were then committed by the ablest men in the profession, who, deceived by analogy, imitated too nearly the plan of the small-pox inoculation; and many were not sufficiently aware either of the deterioration to which vaccine lymph is subject, or of the mischiefs which arise even when the lymph is pure from the vaccine

process being interrupted or disturbed by violence, or by disease. The number of failures from all these sources of error in early practice has been considerable; it is therefore too soon at present to compute and compare the number of cases in which small-pox has occurred after inoculation and vaccination.'

We are not sure whether this be not rather too much in the spirit of a systematic advocate. Mr. Moore talks of failures from inoculation when first practised being one in fifty; but it ought to be recollected that such failures were rather referable to the mode of communicating and managing the disease, than to the occurrence of

second affection. Now the case is far different with vaccination; for although two children in a workhouse were actually deVOL. XIX. NO. XXXVII.

stroyed

any

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