THE HISTORIC EVOLUTION OE VARIOLATION. 
 By Arnold C. Klebs, M. D., Lausanne, Switzerland. 
 
hj C> 
 
[From The Johns Hopkins Hospital Bulletin, Vol. XXIV. No. 265, 
 March, 1913.] 
 
 THE HISTORIC EVOLUTION OF VARIOLATION.* f 
 By Arnold C. Ivlebs, M. D., Lausanne, Switzerland. 
 
 Immunology, the latest child of medical science, has reached, [69] 
 after a short existence, a very considerable development, some 
 even think maturity. However true this may be, its creation 
 has certainly called forth efforts of the most varied nature 
 embracing and mobilizing almost all branches of physical 
 sciences. The very acuteness of these efforts is inimical to 
 retrospection. Only very recently some experimenters have 
 searched the earlier literature, of vaccination for instance , 1 
 for support of their conception. Variolation has entered very 
 little, if at all, into such investigations and it is really astonish- 
 ing how thoroughly it is forgotten, this most interesting epoch 
 in medical history, which kept greater and humbler minds in 
 fever heat during almost one whole century. This oblivion is 
 particularly curious because variolation called forth a unique 
 and extensive trial of a specific preventive method, the logical 
 consequence of which was vaccination. Tins fact does not 
 detract from the merits of Jenner, who by observation and 
 conclusive experiment was enabled to render an immortal ser- 
 vice. It is true that Jenner was unaware of the generic 
 identity of vaccinia and variola, that to him cowpox was a 
 disease sui generis, the inoculation of which conferred im- 
 
 * Authors in 18th century literature speak only of “ inoculation ” 
 (ingrafting, insertion). At present for the sake of clearness the 
 term “ variolation ” seems preferable. In retrospective reviews 
 of the subject the term vaccination is often used erroneously for 
 variolation and a similar confusion is likely to occur if modern 
 writers persist in using faultily the words “ vaccine and vaccina- 
 tion ” for protective and therapeutic inoculation generally. 
 
 t Paper read before The Johns Hopkins Hospital Historical Club, 
 October 14, 1912. 
 
 1 von Pirquet, op. cit., introduction. 
 
[69] munity to smallpox for some unknown mysterious reason. It 
 is this conception which stamped vaccination as a new de- 
 parture and it is largely responsible for the oblivion into 
 which variolation has fallen. Jenner’s belief 2 3 in the common 
 derivation of cowpox and smallpox from the grease of horses, 
 and Pearson’s and Baron’s vague suspicions of a more intimate 
 relationship between variola and vaccinia, passed unnoticed 
 for almost another century, after which the intrinsic analogy 
 of variolation and vaccination could be demonstrated. 
 
 In searching for the earliest origins of variolation I may 
 cite the words of Sir George Baker , 8 one of the most scientific 
 inoculators of his time : “ It cannot but be acknowledged that 
 the art of Medicine has, in several instances, been greatly in- 
 debted to accident and that some of its most valuable im- 
 provements have been received from the hands of Ignorance 
 and Barbarism.” This indebtedness to the intuitive genius 
 of popular reason and procedure is strikingly illustrated in 
 the reports of early practice of variolation. While the learned 
 since oldest times strained every effort towards the discovery 
 p of a Medicinal antidote, the simple-minded evolved the idea 
 of protective inoculation. It is difficult to ascertain any one 
 locality where variolation was first practised. From its wide 
 distribution it would seem that it arose spontaneously in 
 various places where the need for it occurred. The earliest 
 alleged reference to variolation in the chronicles of the Gth 
 century by Marius, Bishop of Avenches, I have been unable 
 to verify . 4 I found only the well known report of a deadly 
 
 [70] epidemic (570 and 571 A. D.) in Italy and Gaul of a disease 
 which for the first time is called “ variola.” 5 * * Clearly referring 
 to variolation is a remarkable verse of the School of Salerno 8 
 
 2 Jenner, Inquiry, 1798, 3d paragraph. 
 
 3 G. Baker, An inquiry, etc., 1766, p. 1. 
 
 4 Edit. Bouquet, Histoire des Gaules, II, 12. 
 
 5 Smallpox is hereby not defined with any certainty. Its root 
 varus as used by Celsus and Pliny is meant to indicate a pustulous 
 disease, especially of the face. 
 
 0 S. de Renzi, Flos Medicinae Scholae Salerni, Naples 1S59, p. 90 
 
 (3059, et seq.). A footnote of the editor gives as his opinion that 
 the first two lines refer to variolation, which was not invented in 
 
 the 18th century, or in Greece, but is older. 
 
 (2) 
 
(10th or 11th century) entitled adversus variola and which [70] 
 runs as follows : 
 
 Ne variant teneris variolae funera natis 
 lllorum venis variolas mitte salubres. 
 
 Sen potius morbi contagia tangere vitent 
 Aegrum aegrique halitus, velamina, lintea, vestes 
 Ipseque quae tetigit male pura corpora dextra , 7 
 
 For preventive purposes the voluntary transference of a 
 benign variola is surely recommended here, the venis , however, 
 may indicate “ system ” generally, in which case the disease 
 is to be transmitted by simple exposure or we may take it 
 more literally and an operation then suggests itself. The 
 last three lines giving preference in very modern-sounding 
 language to the avoidance of infection by contact, seems to 
 me to lend strength to the latter interpretation. 
 
 The first authentic reports of this practice we find in the 
 Ephemerides of the Academia Caesarea Leopoldino-Carolina 
 published at Leipzig between 1670 and 1705. Here Dr. 
 Vollgnad of Breslau 8 in 1671 and Dr. Schultz of Thom in 
 1677 clearly report instances of the custom of “buying the 
 smallpox.” There is, however, no reference made to the 
 actual inoculation with the pock scabs purchased in the plague 
 house, but that such was done is very likely, since Schultz 
 speaks of the rather serious illness which his own brother 
 acquired in this manner. It does not seem to me that these 
 cases have anything to do with the sympathetic transference 
 of disease, which agitated some medical minds of the day, and 
 as instances of which they obviously were reported. Creigh- 
 ton 9 gives an interesting example of this form of transplan- 
 tation in 1657 : “ Some persons in the smallpox keep a sheep 
 or a wether beside them in the chamber, those animals being 
 
 7 This may be rendered: In order that variola may not produce 
 
 death among tender babes, put into their veins a favorable variola. 
 Better still they should avoid touching the contagium of the dis- 
 ease: the sick person, the breath of the sick, the clothes, the cover- 
 ings, the garments and such clean bodies as he may have infected 
 ( tetigit male) with his hand. 
 
 8 H. Vollgnad (1634-1682), member of Academy, 1669. 
 
 0 Slatholm (Buntingford), 1657, cited in Creighton, History of 
 Epidemics in Britain, p. 475. 
 
 ( 3 ) 
 
[70] apt to receive the envenomed matter and draw it to them- 
 selves” — only a slight modification of the Jewish scape-goat! 
 Of course this has as little to do with variolation as the 
 Biblical passage cited by Massey in 1722 in condemnation of 
 inoculation : “ So went Satan forth from the presence of the 
 Lord and smote Job with sore boils from the soles of his feet 
 unto his crown” (Job, II, 7). 
 
 Further reports of the ancient practice all date from the 
 time of the medical introduction of variolation to Europe and 
 America. They were of the usual order, meant to show that 
 there is nothing new under the sun and some of them, there- 
 fore, have to be taken with caution. Thus we hear of a crude 
 variolation in Scotland (Monro I., & Kennedy), in Wales 
 (Perrot Williams), 10 in Auvergne and Perigord (de la Con- 
 damine), in Jutland (Bartholin), in the Duchy of Cleve 
 (Schwencke) and other parts of Germany. Of the inocula- 
 tions practised in Greece, whence it was introduced to 
 Western Europe by way of Constantinople, I shall speak later. 
 Phe earliest traces of variolation are found in Asia and in 
 Africa. In Africa the practice continues to this day among 
 certain tribes, chiefly negroes, in the eastern, central and 
 western regions. On the White Nile in the equatorial pro- 
 vince (Welson & Felkin) among the Bari, and further east 
 among the Somali (Stahlmann) a similar custom is found. 
 It seems to have been highly developed by the most important 
 of the native Bantu tribes, the Baganda, living northwest of 
 Lake Victoria in the old Kingdom of Uganda. Further west 
 we find the Wanjamwesi, and in the Sudan the Ashanti, and 
 some Moorish tribes practice inoculation on their children. 
 From northern Africa we have the report of the Tripolitan 
 Ambassador, Kassem Aga, which made the round of 18th 
 century literature, about the ancient variolation by Moham- 
 medan tribes in Tripolis, Tunis and the Kabyl mountains. 
 Not long ago we had a verification of tins latter report by a 
 French naval physician, Dr. II. Gros, 11 stationed at Eebeval 
 in Algeria. He has observed a considerable number of variola- 
 tions practised by Arabs and Kabyles and curiously enough 
 
 10 Philos. Transact., 1722. 
 
 lx La variolisation, Janus, 1902, VII, 169. 
 
 ( 4 ) 
 
comes to the conclusion that variolation ought to be resorted [ 70 ] 
 to if, for some reason or other, the supply of vaccine became 
 exhausted. This account contains many interesting observa- 
 tions which corroborate most of the historical records of the 
 18th century. 12 
 
 Exceedingly interesting accounts about smallpox inocula- 
 tions are available from Asia. I can only briefly refer to 
 them. China, of course, again is said to have known variola- 
 tion since remotest times. We have no reliable data as to the 
 age and extent of the practice; we must be satisfied with the 
 knowledge that a method of inoculating the virus into the 
 skin or in the form of dry powder blown into the nostrils, has 
 been known to exist before it reached Europe. 13 In India a 
 similar method seems to have been carried out on a systematic 
 plan by special delegates of the Brahmin caste in conjunction 
 with a religious cult of the smallpox deity. 14 
 
 None of these primitive variolations served to acquaint l" 1 ! 
 Western Europe with the practice. Only after it had reached 
 a certain development in Constantinople could it be studied, 
 reported and recommended. From this city Lady Mary 
 Wortley Montagu, wife of the British Ambassador to the 
 Porte, wrote to her friends at home about the method of 
 inoculation as practised under her eyes and expressed her in- 
 tention (to Sarah Chiswell, April 1, 1717, from Adrianople) 
 of introducing it to England. She even caused the inocula- 
 tion of her three-year old son Edward, by a Greek woman with 
 Maitland’s assistance, 10 and influenced that of the three chil- 
 dren of the Marquis de Chateauneuf, Secretary to the French 
 Embassy at about the same time (1718). Her inspiration 
 and these examples undoubtedly opened the doors for the in- 
 
 12 Other reports from travellers about variolation: Bruce (1790), 
 Levaillant (1790-1796), Michaux (ab. 1800) for Africa, Cook (ab. 
 
 1780) for Senegambia, Barbary, Bengal. 
 
 13 The “ Tchan-teoo ” or “ sowing the smallpox ” in d’Entrecolles, 
 Lettres edif. et cur. des missions 1726, XX, 34 (from Pekin) and 
 other reports in same letters. 
 
 “Holwell, op. cit. Also J. Moore, History of the Smallpox, 
 Lond., 1815, 26-34, with plate representing the religious rite, from 
 a Hindu drawing in the library of Mrs. Bliss of Kensington. 
 
 “Letter to Lord Montagu (of March 23, 1718) at Pera from 
 Belgrad. 
 
 (5) 
 
[71] troduction of the practice in England. There was already 
 some medical agitation on the subject, before Lady Mary be- 
 came interested, and it can safely be presumed that she was 
 not ignorant of it. Dr. Timoni, a Greek physician of Con- 
 stantinople educated at Oxford, published in 1713 an account 
 of the method of variolation as observed and practised by 
 him. In December of the same year he sent a personal com- 
 munication on the subject to Dr. Woodward, 16 who read it 
 before the Eoyal Society. A little earlier a similar report 
 reached the Swedes, sent to them from Bender in Bessarabia 
 by their exiled king, Charles XII, with the recommendation 
 to introduce the method. 17 
 
 Other medical men in England at this time had some per- 
 sonal knowledge of the method which they had seen practised 
 in Constantinople. We know of two, a Dr. Terry of Enfield, 
 who later is consulted about it by Sir Hans Sloane, and a 
 Scotch surgeon, Peter Kennedy, 18 who describes the method in 
 his book in 1715. A dissertation on inoculation appears in 
 Venice by a Dr. Pylarini 10 the next year. A friend and 
 former consular colleague of the latter in Smyrna, Dr. Wm. 
 Sherard, informs Sir Hans Sloane and, through him, the 
 Eoyal Society, of this publication with details about the 
 method and an account of Dr. Pylarini's experiences. Xow 
 the Eoyal Society becomes really interested and the pages of 
 the Philosophical Transactions of the following years are filled 
 with further accounts, which Douglass of Boston later (1730) 
 characterizes sneeringly as “ virtuoso amusements.” 
 
 At the same time something was heard of the “ Greek 
 
 “John Woodward (1665-1728) excellent geologist, but poor 
 physician. See Creighton’s (op. cit., p. 449) amusing account of 
 his duel with Mead in Gresham College where he was professor 
 of physic. Its cause, the smallpox controversy, involved also 
 Friend and later Dover. In 1718 he published a tract “ the State 
 of Physick ” in which he discussed the “ new practice of purgeing ” 
 in smallpox. 
 
 17 This report was probably written by the king’s physician, 
 Skraggenstyerna. 
 
 18 Peter Kennedy: Essay on external remedies (Chap. 37), 1715. 
 
 19 Pylarini, Nova et tuta, etc., 1715. Sloane in Phil. Trans., 
 XXIX, 1716. 
 
 (6) 
 
method” in France. Boyer 20 of Montpellier, later Dean of [71] 
 the Medical Faculty of Paris (1756), had travelled as a young 
 man in the Orient and had there become acquainted with 
 variolation. On his return to Montpellier he studied medicine 
 and wrote his inaugural thesis (1717) on inoculation and 
 the reasons why it might be imitated to great advantage in 
 France. Actual inoculations very probably were practised in 
 Paris at about this time by a Greek physician Carazza. Eller 
 tells us of making his acquaintance there, and how he was 
 taught the method and how he successfully inoculated a 
 child. Although Eller does not mention the exact date, it 
 is evident that it took place in or before 1720, because in 
 that year he went with Lord Peterborough to England and 
 returned from there to Germany in January 1721. 21 
 
 At this moment, when the new method knocked at the doors 
 of the universities, promising fresh hopes but also planting 
 the first seeds of discord among the sister faculties, the 18th 
 century is yet young. The glaring contrasts and contradic- 
 tions are not as apparent as they will become later, the genius 
 of Newton — he still presides over the Eoyal Society— is only 
 beginning to assert itself. In medicine Sydenham’s influence 
 is paramount, while Boerhaave in Leyden and Morgagni in 
 Padua are training men who are to found modern medical 
 science. Hoffmann and Stahl supply the cravings for theoret- 
 ical contemplation, while practice continues on old lines. 
 Everywhere reform is in the air, the struggle against super- 
 stition and for tolerance has begun. The realization that 
 
 20 J. B. N. Boyer, 1693-1768. 
 
 21 J. Th. Eller, Observationes cognoscendis et curandis morbis 
 praesertim acutis, Regimont. & Lips, 1762, p. 150. (French transl. 
 
 Par. 1774.) Eller was born in the Duchy of Anhalt in 1689, became 
 M. D. in 1716 then travelled in Holland and practised in the mines 
 of the Harz Mountains. From here he went to Paris and worked 
 under Hecquet, Astruc, Helvetius and Winslow, giving much atten- 
 tion to surgery, at the Hotel Dieu and the Salpetriere. In London 
 he frequented Cheselden, Mead, Sloane and Newton. He left 
 London in January, 1721, became court physician in Anhalt, in- 
 oculated several persons, and in 1724 he was at the court of Berlin, 
 teaching at the newly founded Medico-Surgical College. He and 
 Stahl (Halle) are largely responsible for the sanitary reform in 
 Prussia, which formed the basis for the present institutions. 
 
 (7) 
 
[ 71 ] the riddles of life and its problems are not to be solved by 
 pure metaphysical speculation begins to dawn upon the learned 
 and experiment is more and more resorted to for the final 
 criterion. 
 
 From the time of its introduction to the Occident in 1713 
 to the advent of vaccination in 1798 and its general accept- 
 ance in 1840, variolation does not follow a course of steady 
 progress. As we shall see, it enjoys a few years of the success 
 of novelty (until 1727), followed by twenty years (1746) of 
 indifference, after which it slowly gives rise to a remarkable 
 period of serious scientific investigation. 
 
 The honors of the first inoculation in the Occident (except- 
 ing that by Eller in Paris) will probably best be divided be- 
 tween London and Boston. Dr. Fitz, in an admirable account 
 of the early inoculations in Boston, tends to the belief that 
 Boylston, inspired by Cotton Mather, made his first attempt 
 
 [ 72 ] without knowing of the inoculations performed in London. 22 
 There is no direct evidence of his ignorance and he certainly 
 had time to learn about the London inoculations in April and 
 May, since he inoculated his son Thomas and the two slaves 
 on June 26. Undoubtedly he had courage enough to proceed 
 without any other assurance than that of his friends and the 
 older reports at hand, but the situation was precarious and it 
 looks as if the latest news may have been welcome and actually 
 determined him. 
 
 The merits of Lady Montagu in inciting the early trials in 
 London were undoubtedly great in that j^ear of 1721, when the 
 smallpox was raging on both sides of the Atlantic. A Portu- 
 guese physician in London, a Castro, had anonymously pub- 
 lished a pamphlet on the subject in March and Dr. Walter 
 Harris spoke recommendingly of inoculation before the Col- 
 lege of Physicians on April 17. Lady Mary probably did not 
 need these learned suggestions to remind her of her experience 
 in the Orient and with the danger of smallpox at the door, she 
 
 ^Professor Kittredge (op. cit.) has recently given valuable ad- 
 ditional information on the subject of early variolation in Boston. 
 It leads to the conclusion that Cotton Mather’s knowledge of it has 
 not been fully recognized and especially that he was acquainted 
 with variolation (among negroes) before he received the reports 
 about it from Europe. 
 
 ( 8 ) 
 
had Maitland inoculate, in April, her four-year old daughter, [72] 
 the future Lady Bute. One of the three interested spectators 
 from the College of Physicians, Dr. Keith, was sufficiently 
 impressed by the harmlessness of the operation to have his 
 own six-year old son inoculated on May 11. In this case, 
 bleeding was resorted to as a preparatory measure and we see 
 herein, as also in similar examples in Boston, the germ of that 
 “ preparation ” which is to play such an important role later 
 on. Lady Mary meanwhile does not stop with the inoculation 
 of her own child ; she takes up the personal propaganda begun 
 in her letters from the Orient, she finds it now easy to induce 
 many of her friends to follow her example, but her main 
 efforts she exerts towards winning the court. In this task she 
 is aided by her intimate relationship with the Princess of 
 Wales, later Queen Caroline, whom Yoltaire, because of her 
 intelligent interest in arts and sciences, addresses as the 
 “ philosopher on the throne.” George I is willing to permit 
 the inoculation of his grandchildren but a preliminary experi- 
 ment is deemed advisable. Here is the first beginning of 
 scientific procedure. Six condemned criminals in Newgate 
 prison are inoculated as test cases, the best medical men of 
 London are watching the experiment, with Mead at their head. 
 Nothing unusual happens; somewhat severe symptoms are 
 observed only in one girl, whom Mead inoculated with dried 
 virus in the nostrils (Chinese method), but she also recovers. 
 
 One man in whom the inoculation did not “ take,” is found 
 to have had smallpox before. A further test is made by 
 Mead and Steigerthal, who send one of the inoculated patients 
 to Hertford where a severe epidemic rages ; no infection takes 
 place. George I and his court feel reassured by the results 
 of these experiments, and further good reports having reached 
 the town from Halifax, in Yorkshire, where Nettleton had 
 inoculated with satisfactory results since December, the opera- 
 tions on the Princesses Amelia and Caroline take place on 
 April 19, 1722. The surgeon Amyand, attended by Sir Hans 
 Sloane, Teissier and Maitland, performs the inoculation. 23 
 The immediate result of this evident approval of variolation 
 
 23 A medal was struck to celebrate the event. Av. George I, 1721, 
 
 Rev. Inoculation instituted. (Pfeiffer, 373a.) 
 
 (9) 
 
[72] by the court was that the nobility hastened to follow the 
 august example and so we find the gazettes reporting on these 
 events, mentioning all the names of the ultra-fashionables. 
 The next result was the formation of two opposing factions. 
 Pamphlets were written, sermons preached for and against 
 the new method, mostly by people who knew nothing or next 
 to nothing about inoculation. This condition continues 
 through the whole epoch of variolation and as a matter of 
 fact long after its abandonment. In the vast literature there- 
 by produced it is often exceedingly difficult to find one’s way. 
 Wagstaff, the medical satirist, Blackmore, inferior medical 
 author and poet, Clinch, the surgeon, Massey, the apothecary 
 of Christ Hospital, are the chief opponents; the learned Dr. 
 Freind 21 wavers, but objects to the noise made about inocula- 
 tion, Arbuthnot, friend of Pope and Swift and commentator 
 of Boerhaave, Jurin, secretary of the Royal Society under 
 Newton, Mead and Sloane were, however, more or less active 
 in the recommendation of inoculation. 
 
 The arguments brought forth against variolation were, its 
 risks to the individual, the uncertainty of its protective power 
 and the danger of its spreading the disease. The last argu- 
 ment had received support when the news came of an accident 
 that had happened in Maitland’s experience at Hertford, where 
 he had gone to inoculate in the autumn of 1721. A child ill 
 with artificial smallpox had infected six servants of whom 
 one had died. This demonstration of the contagiousness of 
 inoculated smallpox offered the strongest point to the cause 
 of the opponents. They, however, resorted oftenest to personal 
 vituperation or bitter condemnation on religious and moral 
 grounds. On the other hand the inoculators and their up- 
 holders, although reiterating the most obvious advantages of 
 inoculation, viz., freedom in the selection of appropriate sub- 
 jects (children), favorable external circumstances (seasons), 
 and careful preparation, resorted almost exclusively to statisti- 
 cal data in their support. Jurin, 23 who excelled in mathe- 
 
 21 See reference to John Gaddesden in his “ History ” (1725) : had 
 he “ lived in our day, he would, I don’t question, have been at the 
 head of the inoculators.” (Creighton II, 478.) 
 
 25 Jurin to Cotesworth 1723. James Jurin horn 1684, secretary 
 and later president of Royal Society, was one of the first physicians 
 
 ( 10 ) 
 
matics, soon collected enough cases to figure out the ratios as: [72] 
 One death only in 91 inoculated (two in 182), while the 
 natural smallpox killed one in five or six. He refers to the 
 “ letter of Cotton Mather of the 10. March 1721 ” 20 in which 
 five to six deaths are reported among 300 inoculations, mak- 
 ing a ratio of one in 60. He concludes from it that inocula- l' 3 ! 
 tors in New England were less careful. 27 
 
 The technique meanwhile had seen considerable deviations 
 from its primitive Greek prototype. In Constantinople, 
 Maitland had already replaced the dirty needle of the woman 
 operator by the lancet. Nettleton, who probably had the 
 largest experience in these early years, thought it important 
 to make rather deep incisions and to keep them open so that 
 the wound would drain freely and allow the morbid humors 
 to escape. The arms or thighs were the favorite regions 
 chosen. 28 The virus was taken directly from a smallpox patient 
 and transferred, or it was collected on threads and dried for 
 later use. 
 
 It seems that the inoculations were not often performed by 
 the physicians themselves; they usually had a surgeon do it 
 and watched the case before and after. Thus a type of inocu- 
 lation specialist was evolved and all sorts of people took it up as 
 a lucrative profession. 29 Some of the failures may easily be 
 attributed to crude methods. Maitland seems to have created 
 the type of the itinerant inoculator, whom we can soon follow 
 all over Europe. We have already encountered Maitland in 
 Hertford ; a few years afterwards he is on the continent inocu- 
 lating Prince Frederick and others at Hanover. After this we 
 
 to Guy’s Hospital. The advocacy of his “ lixivium lithontripticum ” 
 brought him questionable fame. 
 
 28 A. L. (contemporary copy) in Sloane MSS. 3324, fol. 260 (see 
 Kittredge, op. cit., p. 477). The letter is also quoted by Douglass in 
 his “ dissertation ” of 1730. 
 
 27 The figures of Cotton Mather are quoted by the anti-inoculists 
 again and again with considerable success all over Europe. 
 
 28 In the Greek practice the forehead, shoulders, hands and other 
 parts of the body were chosen, the choice being determined on 
 religious grounds and it varied w'ith individual inoculators. 
 
 20 We know of a blacksmith who thus changed his occupation, and 
 a man-servant who gave notice to his employer because he could 
 earn more as an inoculator. ("Wafts, W’atson.) 
 
 (ID 
 
[73] find him in Scotland 30 where he has ill-luck, losing one in ten. 
 This experience, the Hertford case, and the deaths of several 
 prominent persons, duly registered in the gazettes, added 
 powerfully to the arguments of the opponents. The subject 
 was brought up in Parliament and inoculation declared dan- 
 gerous. This was in 1728. Up to that year Jurin 31 could 
 collect in his report 897 known inoculations with 17 deaths, 
 not all directly attributable to the operation. He considered 
 the practice now “ exploded,” while the otherwise sceptical 
 Douglass 82 admits that the opponents are now prepared to 
 acknowledge that “ inoculation, generally speaking, is a more 
 easy way of undergoing smallpox.” 
 
 The Continent, meanwhile, did hardly more than act 
 the part of the spectator. LeDuc of Constantinople writes 
 the first inaugural thesis on inoculation at Leyden ; it is 
 approved on July 28, 1721, and published together with the 
 dissertations of a Castro and Walter Harris of London in 
 1722. Boerhaave maintained an expectant attitude. We have 
 no reports of his having tried the method himself or persuaded 
 others to do so. Theoretically he surely approved, for we 
 find him saying at the end of his Aphorism 1403 (Edit., 
 Leyd., 1727). : Prophylaxis insitiva videtur satis certa tutaque. 
 Of his pupils Van Swieten continues in this reserved attitude, 
 while de Haen becomes one of its most persistent opponents 
 and Tronchin one of the most famous inoculators in Europe. 
 
 In Germany Eller, whom we have met already in Paris, has 
 returned to his home in Anhalt. As physician to the local 
 court he performs two inoculations, but, soon called to the 
 Prussian court, he is not allowed to see smallpox cases and 
 has to desist. In Breslau reports are received of inoculations 
 performed by one Reimarus in Hungary. 83 In the two uni- 
 versities, Altdorf and Erfurt, which have long ceased to exist, 
 doctor dissertations are published on inoculation by Miilich 
 
 30 Alex. Monro I, 1697-1767. 
 
 31 See also Scheuchzer (son of the Zurich naturalist) on success 
 in Great Britain, 1729. Another late endorser of the method was 
 Lobb in 1831. (His treatise on smallpox received the praise of 
 Boerhaave.) 
 
 32 Douglass, 1730, op. cit. 
 
 33 Breslauer Versuche, XVII, 253. 
 
 (121 
 
and Cramer, 34 but they report no new trials. In Hanover, [73] 
 however, the inoculation of Prince Frederick acted as a stimu- 
 lant. J. E. W reden publishes a treatise on it and his son John, 
 later body surgeon to the Prince of Wales, soon begins to 
 inoculate. 35 Outside of the Electorate of Hanover, naturally 
 influenced by England. Germany contributes very little to the 
 history of inoculation. Of Austria, Italy and Switzerland I 
 shall speak later. In Sweden we have one publication in 1737 
 by Spoering, but also no actual inoculation. 
 
 The history of variolation in France offers much of interest 
 and forms a valuable contribution to the annals of culture in 
 general. At the time when variolation first appeared in Eng- 
 land, medical science and practice in France had made little 
 progress since the days of Ambroise Pare and Guy Patin. 
 Montpellier showed more signs of progressive activity and in 
 later years especialty, the children of this Alma Mater were 
 prominent in the ensuing struggle. While in England inocu- 
 lation occupied minds rather intensely for eight years, only in 
 the one year of 1723 is this subject at all considered in France, 
 particularly in Paris, and then only academically. Louis XY 
 was then thirteen years old and the Duke of Orleans was 
 nearing the end of his regency and his life. Dr. de la Coste, 
 an enthusiast for inoculation, who had followed its intro- 
 duction to England, writes about it to Dodart, 36 formerly 
 physician to Louis XIV. He tells him all he knows about 
 the subject and especially that the English court is in favor 
 of it. At a solemn meeting at the Sorbonne he explains to 
 the learned dean and nine doctors the evident advantages 
 of inoculation. After a careful analysis of the moral and 
 religious factors involved, it was decided that experiments 
 might be made without interfering seriously with Divine 
 providence. This meeting had the effect of winning over 
 the Regent, who also probably was influenced favorably 
 by Helvetius 37 who was close to him at the time. It therefore 
 looked for a while as if experiments might begin. Then 
 
 34 1725 and 1726. 
 
 35 Report in 1739, London. 
 
 30 Cl. J. B. Dodart, 1664-1730. 
 
 37 J. Cl. Adr. Helvetius, 1685-1755. 
 
 (13) 
 
[73] appeared an anonymous pamphlet entitled: Raisons de 
 
 doute contre V inoculation, in which strong language was 
 used against la methode anglaise and its promoters. It 
 
 [74] was soon learned that the author was old Hecquet, 38 dean of 
 the Faculte de medecine, more theologian than physician and 
 a stubborn opponent of all innovations. His words carried 
 much weight and when the Regent died on December 3, the 
 chance of inoculation grew very faint and was entirely ex- 
 tinguished at a meeting in the Ecole de Medecine on Decem- 
 ber 30 39 where the qucestio medica, worded ominously “ Is it 
 a crime to inoculate ? ” was discussed under the presidency of 
 Claude de la Vigne, 40 the new king’s new physician. An 
 interesting contrast: the Sorbonne for, the Ecole de Medecine 
 against the new method ! As a child Louis XV comes to 
 power; he was of course not to blame in that, for 30 years 
 after his advent, inoculation was hardly mentioned in France, 
 but curiously enough, as a man, after 50 years of a disastrous 
 reign, he falls victim to the very disease the method was in- 
 tended to prevent. Voltaire, in his apartment quite close to 
 the Ecole de Medecine, at this moment is making a very 
 personal and most unpleasant acquaintance with smallpox, 
 nursed by his devoted friend Adrienne Lecouvreur. Two or 
 three years hence he is to begin his eloquent propaganda for 
 inoculation in one of his letters from that England which 
 is to influence so strongly his whole point of view. 
 
 During the 20 years following the practical abandonment 
 of inoculation in England, and while next to nothing was 
 done in Europe, events occur in America which later are to 
 help considerably towards a revival of the practice. An 
 epidemic of smallpox in Charleston in 1738 gives the incen- 
 tive. A surgeon, Mowbray, and a Scotch physician, Kilpatrick 
 (later as Kirkpatrick one of the foremost inoculators in 
 England), inoculate a very considerable number of persons 
 in that year. 41 Mowbray evidently started the inoculations 
 
 3S Phil. Hecquet, 1661-1731. 
 
 3J Duvrac’s account, 1755. 
 
 40 Cl. de la Vigne de Frecheville, 1695-1758. 
 
 41 Kilpatrick, op. cit., p. 44. On May 21, 1738, tlie first three 
 persons were inoculated in Charleston, the two daughters of a 
 Mrs. Sarah Blakeway and a Miss Baker. 
 
 (14) 
 
and seems to have done the greatest number. Kilpatrick’s [74] 
 account, which was published first in Charleston and then in 
 London in 1743, relates, with great frankness, the successes 
 and failures (about 800 inoculations with eight deaths). 42 
 They met with distinct opposition, especially on the part of 
 other practitioners. 43 Kilpatrick, in theory, favors careful 
 preparation of the patient before the operation. His guiding 
 principle is the cooling regimen of Sydenham with a “ few 
 remedies perhaps ” so that the “ Solids and Fluids may be 
 reduced from a greater, to less Inflammability.” His con- 
 ception, as these quotations show, is that of his time but he 
 admits, “ without prejudice, that preparation was too often 
 neglected with us.” We also learn from him, and this is an 
 important innovation, that Mowbray very often inoculated 
 with the virus taken from the pustules of a previous inocula- 
 tion and that he repeated the process up to six times, 44 with- 
 out perceiving any reduction of virulence. It would be inter- 
 esting to enter more fully into the excellent observations of 
 this essay. They are distinctly in advance of the time and I 
 believe mark a more valuable advance in the history of inocu- 
 lation in America than that presented in a pamphlet of Dr. 
 Adam Thomson, published eight years later and of which 
 Dr. Henry Lee Smith 4 ' ) has given a full account. From this 
 “ discourse ” of Thomson’s it appears that he had begun to 
 inoculate in Philadelphia at about the same time when Mow- 
 bray and Kilpatrick started their experiments in Charleston. 
 
 The crux of his method is specific preparation, applying 
 Boerhaave’s suggestion that mercury and antimony may act 
 as preventives against smallpox. He lays greater stress on 
 these medicines than does Kilpatrick, otherwise there is no 
 difference between the two methods. There is no doubt that 
 Thomson succeeded in impressing his patients and also some 
 doctors with his method of preparation. Dr. Gale of Connec- 
 ticut seems to have been his most enthusiastic follower. At 
 least I find him writing to Huxham 46 about it : Boerhaave’s 
 
 42 Kilpatrick, op. cit., p. 34. 
 
 43 Kilpatrick, op. cit., p. 44, controversy with Dr. Thomas Dale. 
 
 44 Kilpatrick, op. cit., pp. 49 and 50. 
 
 45 Johns Hopkins Hosp. Bull., 1909, XX, 49. 
 
 46 John Andrew, 1765, op. cit., pp. 9 and 44. 
 
 i 15) 
 
[74] “ intimation was improved, and mercury introduced into 
 practice, by physicians in the English American Colonies, 
 about 1745. Several American physicians claim the second 
 glory of Boerhaave; perhaps Dr. Thomas (sic.) of Virginia, 
 and Dr. Murison of Long Island.” Buston 47 a little later in 
 speaking of this method ascribes it, as does Gale, to Murison 
 and to Dr. Thomson of Virginia. Buston who is in favor of 
 a mild preparation, shies at this particular one for the secret 
 of which, he says, “ considerable premiums were offered.” 
 Ten to twenty grains of calomel every other night counter- 
 acted by a drastic purgative for two weeks seem to him 
 rather violent as a preparation for more trouble ! 
 
 We are now nearing the middle of the 18th century. The 
 failures of the introductory period in England were almost 
 forgotten and Europe in general was becoming more and 
 more receptive to such an innovation and, with the increasing 
 restlessness of the age, receptiveness developed into eager- 
 ness. In England Kilpatrick’s essay (1743) on the experi- 
 ence in South Carolina was very largely responsible for a 
 revival. He had arrived himself and at once set to work as 
 a specialist inoculator. Among those who followed his 
 example are Banby, Middleton, Hawkins, Frewen, Burges, 
 Archer, etc. The alleged necessity of an elaborate course of 
 preparation on hygienic and medicinal lines, of a surgical 
 operation requiring often a prolonged after-treatment, held 
 out golden promises to physician, surgeon and apothecary. 
 Mercenary calculation therefore entered very largely into the 
 advocacy of “ preparation ” and deep incisions. It is well to 
 bear this in mind. Some of the more earnest practitioners 
 object to these complications but, in spite of them, this cum- 
 bersome procedure maintains its vogue during the following 20 
 years. The fact that it is very costly rather increases the de- 
 mand for it among the wealthy and thus it gains influential 
 protectors. This leads to provision for the poor and here the 
 foundation, under the patronage of the Duke of Marlborough, 
 175] 0 f the Middlesex County Hospital for smallpox, and soon after- 
 wards that of others in London, 48 marks an epoch. There 
 
 47 Thomas Ruston, op. cit., p. 2. 
 
 4S This hospital changed its location several times shortly after 
 its opening in Windmill Street, to Mortimer Street and finally to 
 
 ( 16 ) 
 
was little effort made, at least at first, to utilize these institu- [75] 
 tions for a scientific study and an improvement of variolation. 
 
 As each patient, because of the preparation before inocula- 
 tion, had to stay a very long time, at least while a pre- 
 paratory period was thought to he necessary, the benefit which 
 the poor derived from these hospitals was very small, because 
 of the few that could be admitted. 
 
 The practice of variolation, thus taken up in all earnest 
 by energetic medical men, prevailed in spite of the opposi- 
 tion which continued unabated. The cause found a very val- 
 uable champion in Isaac Maddox, Bishop of Worcester, who 
 in his sermons intelligently and forcefully recommended 
 inoculation. Another churchman, de la Faye, on the other 
 hand, used the pulpit for the fiercest denunciation of inocula- 
 tion and inoculators. In medical circles all the questions 
 involving smallpox and variolation were ventilated. The war 
 of pamphlets is opened by a letter of one Dod Pierce to 
 Pierce Dod, physician of St. Bartholomew and author of 
 “ Several cases in physic.” 49 
 
 In 1747 Mead’s de variolis (with the translation of Rhazes’ 
 commentary) appears. He devotes a brief chapter (V) to 
 inoculation. He is decidedly in favor of it and does not 
 
 Lower Street, Islington. The other hospital soon after opened at 
 Bethnal Green (44 beds). After 1750 15 patients could be received, 
 prepared and inoculated at the Inoculation Hospital in Old Street, 
 
 St. Luke’s, whence they were taken for after-treatment to the 
 hospital at Fray Lane. In 1752 the governors of Charity opened 
 another large smallpox hospital at Coldbath Fields (130 beds) also 
 for preparation previous to inoculation. 
 
 49 1 do not find this delightful biting satire mentioned in any 
 history of inoculation and it well deserves notice as it gives an 
 invaluable picture of the manner of thought among certain 
 physicians of the day. The author, it may well be Kirkpatrick, 
 pretends that he is trying to expose “ the low Absurdity, or Malice, 
 of a late spurious Pamphlet, falsely ascribed ” to Dr. Dod, and 
 aims particularly at his principal case in physic: “giving an ac- 
 count of a person who was inoculated for the smallpox, and had the 
 smallpox on the inoculation, and yet had it again.” With banter 
 and derision, jeering and sarcasm, he parodies Dod’s bungling, 
 awkward language, denounces his absurd reasonings and faulty 
 observations. (In the Surgeon-General’s Catalogue the author is 
 given as W. Barrowby.) 
 
 (il) 
 
[75] know of relapses after it. According to him the great ad- 
 vantage of the inoculated disease over the natural one is the 
 opportunity afforded of selecting appropriate subjects and pre- 
 paring them “ by drawing away, where necessary, some blood, 
 and gently purging the humors,” in order to “ obviate the 
 violence of the approaching fever.” He cannot imagine much 
 benefit from the discharge of the wound of inoculation and in 
 general finds the artificial disease so mild that it hardly calls 
 for help from any physician. This common-sense point of 
 view was not shared by the majority of inoc-ulators, in whose 
 interest it was to emphasize the importance and gravity of 
 the operation. But Mead’s great influence and authority 
 helps to smooth the path for the method. And indeed, all 
 through the following years and considerably into the 19th 
 century, we see variolation in England in continual progress. 
 I need not enter into the details of its historic evolution here, 
 since this has been admirably done by Creighton. It may 
 be sufficient to point out that in the first 20 years of the revival, 
 during which the method was exploited by more or less un- 
 scrupulous practitioners as a lucrative occupation, we do not 
 find many evidences of a scientific improvement. In Kirk- 
 patrick, Mead and Frewen we can already observe attempts at 
 simplification and a desire for a better understanding of the 
 fundamental questions involved. But it is only after 1764 
 with the advent of Gatti, the Suttons, Dimsdale, Watson, 
 Mudge, Maty, Lettsom and others that a more scientific, 
 systematic spirit is infused into the growing movement. 
 
 The tendency now becomes manifest to “ prepare ” chiefly 
 by hygienic and dietetic means and to abandon frequent 
 bleedings and violent purgation. The Suttons 50 have certainly 
 a great share in the vulgarization of this practice. The 
 mystery with which they surrounded their method and their 
 
 50 Of Robert Sutton we hear already in 1753 as an inoculator in 
 Suffolk, where he experiments on himself and soon starts the busi- 
 ness with three sons and a son-in-law, Dr. Hewit. Ten years after- 
 wards his eldest son leaves him and begins on his own account at 
 Ingatestone near Chelmsford (Essex), where he opens a hospital 
 for inoculation and starts a flourishing enterprise with ramifica- 
 tions all over Great Britain and the Continent; his partner and 
 assistants were Peale, Worlok, Sutherland and others. 
 
 ( 18 > 
 
successful avoidance of accidents were powerful factors in [75] 
 their favor. Their hygiene consisted mainly in a continuous 
 open-air life before inoculation and during convalescence, to 
 which were joined cold water applications. The secret reme- 
 dies which they administered played probably an inferior 
 role in the regime, though in popular belief they were assigned 
 an important position. Their analysis (Euston) showed them 
 to contain the ingredients of Boerhaave’s antidote (calomel 
 and aethiops mineralis) and of the popular preventive pills 
 of Schulz and others (colocynth, aloes, cloves, etc.). 
 
 Of greater importance in Daniel Sutton’s regime were 
 probably the attempts at attenuation of the virus itself and, 
 in this regard, he probably learned from others, from Kirk- 
 patrick and especially from Gatti, although it cannot be 
 doubted that he himself was a capable observer and experi- 
 menter. 51 Attenuation of the virus was to be obtained in 
 various ways : first by passing it through several human sub- 
 jects (Kirkpatrick’s arm-to-arm method), 52 by inoculating very 
 small quantities of the virus and particularly by choosing it 
 at the proper moment of development (the crude, unripe 
 stage). We find all these points already suggested in Kirk- 
 patrick’s Charleston essay and, in passing, we may mention 
 that Beddoes had tried to attenuate the virus by dilution with 
 water, Woensel by mixing calomel with it, Kirkpatrick pro- 
 posing camphor and other “ scents.” 53 
 
 These efforts were all in the right direction, only it 
 appeared, particularly after Dimsdale 51 legitimized Sutton’s [76] 
 method, that the attenuation was often carried so far that the 
 result of the inoculation was sufficient to confer the desired 
 immunity. Hence examples of relapses were cited and Brom- 
 feild 55 had a right to fear that inoculation might become dis- 
 graced. 
 
 “George Baker in 1766 tells us of Sutton’s attempts at inocu- 
 lating measles with the conjunctival fluid of patients. 
 
 62 Thomas Frewen and others had already inoculated by this 
 method in 1749 and abandoned Nettleton’s deep incisions. Sutton 
 seems to have avoided the virus from smallpox cases altogether. 
 
 53 The admixture of musk to the virus practised by the Chinese 
 may have had a similar motive. 
 
 M Thomas Dimsdale, 1712-1800. 
 
 55 William Bromfeild, 1712-1792. 
 
 . (19) 
 
[76] Sutton, Dimsdale and the others who adopted the “new 
 method ” did away effectually with the deep incisions, inaugu- 
 rated by Nettleton and defended with so much tenacity. Slight 
 punctures or scratches were now found to be amply sufficient 
 and the disagreeable after treatment of the wounds was thus 
 prevented. Tronchin introduced the virus into an artificial 
 blister, a method followed extensively on the Continent and 
 also intended to avoid the prolonged suppuration of the wound. 
 This found little favor in England. 
 
 Thus the operation had reached a degree of simplicity, and 
 lessened discomfort and danger, not thought possible before. 
 Only the question of the protective value remained open. We 
 remember that vaccination passed through similar phases and 
 that relatively very late the necessity of re-vaccination be- 
 came apparent. The test of repeated inoculations was re- 
 sorted to quite frequently; we find reports of it all through 
 the literature of those days. But experiments were also made 
 to determine which part of the new regime and what kind of 
 virus guaranteed the success of the operation. Watson, 50 who 
 was physician at the Foundling Hospital where all children 
 were inoculated, made some interesting experiments in 1767. 
 Gatti was at that time in London and saw Watson often, 
 which makes it very probable that he played some active part 
 in them. Watson chose three parallel series of cases, 31 were 
 inoculated with the virus from a smallpox case in the ichorous 
 or watery state, 23 from another inoculated patient, but in 
 the purulent state, and 20 others also from artificial smallpox 
 with virus “ in perfectly concocted state.-” This latter series 
 was not “ prepared ” before inoculation, while the others went 
 through the customary dietetic preparation (10 of the first 
 series with calomel before and after inoculation). All of the 
 patients w r ere “ out in the fields during the whole process.” 
 Watson gives a careful analysis of the results observed, some 
 even in tabulated form, from which, as he puts it, every 
 person is at liberty to make such deductions as he may think 
 they will admit of. His personal conclusion is that the choice 
 of the virus is not very material, that the ichor gives slightly 
 better results, that the mercury has no specific effect and only 
 
 50 William Watson, 1715-1787. 
 
 ( 20 ) 
 
acts favorably as a mild purgative. A well regulated vegetable [76] 
 diet before and during the whole process, the avoidance of 
 heated rooms and heating liquors, he believes to be advanta- 
 geous but not essential. 
 
 Re-inoculation experiments were undertaken by John 
 Mudge 57 of Plymouth. Forty inoculations were made and 
 seemed to demonstrate that “ crude ” matter taken from in- 
 oculation vesicles five days old does not convey immunity 
 against a re-infection with natural or inoculated virus. 
 
 It is not evident that the results of these and other experi- 
 ments exerted any revolutionizing influence on the method 
 used earlier, but they must have helped towards perfecting 
 it. The operation as then practised seems to have given 
 satisfaction, for inoculations certainly became very popular in 
 England, so much so that vaccination, in spite of the advan- 
 tages which to us seem very clear, had first to subdue variola- 
 tion before it could make any appreciable headway. It took 
 'exactly 44 years after Jenner’s first vaccination, when, by act 
 of Parliament, variolation was declared a felony. 
 
 Throughout this stage of evolution the Continent of Europe, 
 in matters of variolation, is influenced by England. We see 
 physicians arrive in London from various parts of Europe to 
 study the method and on the other hand professional English 
 inoculators travel all over the Continent to perform the opera- 
 tion, helping thereby its introduction." 8 Nowhere, however, 
 did the practice reach the extent it had in England, although 
 there is more noise about it and publications abound. This 
 is a curious and notable fact, particularly when one considers 
 that vaccination later was taken up in some continental coun- 
 tries more immediately and readily than in England. The 
 first insistent plea for the introduction of variolation to the 
 Continent was made by Voltaire from England where during 
 his three years sojourn (after 1726) he had heard it discussed 
 
 57 For details the original ought to be consulted, also Creighton 
 op. cit., pp. 501 and 502. 
 
 58 See Ebstein (op. cit.) about inoculations by George Motherby 
 in Koenigsberg; Seitz about Baylies in Germany in Arch. d. Gesch. 
 d. Med. II, 410; Chais (op. cit.) about Sutherland in Holland; 
 Gardane (op cit.) about Worlok and Seeby in France; Power (op. 
 cit.) also in France. 
 
 ( 21 ) 
 
[76] and had seen it practised in that country. That friend of John 
 Locke’s, Lord Peterborough, who, as we have seen, had brought 
 Eller from Paris to London, took him also to his house. Vol- 
 taire made himself acquainted with everybody and everything 
 with that eagerness so characteristic of him. Inoculation was 
 on the wane just then, but its fundamental importance did 
 not escape his keen mind. One of the many letters addressed 
 to Theriot from England 69 is devoted to the subject of “ l’in- 
 sertion de la petite verole. ” It is a most eloquent appeal. 
 Motives common to all people, maternal tenderness and sel- 
 fish interest, 60 he says, introduced inoculation to the Cir- 
 cassians. Then, by experience and observation of the dis- 
 ease and its peculiarities, this primitive people gradually 
 evolves the idea of protective inoculation. How much more 
 
 [77] can an advanced nation profit from this by perfecting the 
 method ! And Voltaire did not, after the manner of some 
 philosophes , stop with this one dramatic appeal. We find 
 that through his life he continues to exert his influence in 
 favor of the method. Thus it was he who persuaded Cathe- 
 rine the Great, of Russia, to undergo the operation. Dimsdale 
 was called (1768) and also inoculated the Grand Duke Paul 
 and many nobles and others in St. Petersburg and Moscow. 
 Returning he left in his wake an inoculation hospital here 
 and indirectly one other in Irkutsk, Siberia ! Indeed an evi- 
 dence of Voltaire’s far-reaching influence! 
 
 France was, however, not yet ready for inoculation. Ouly 
 20 years later did it receive a general consideration. The 
 reason for this is not very easy to understand. De Mariveaux 
 
 69 “Lettres philosophiques,” at first called “ Lettres sur les 
 Anglais.” Letter IX written in 1727 and also published in “ Dic- 
 tionnaire Philosophique,” 1764. 
 
 60 The Circassian and Georgian beauties were much in demand 
 for the Turkish harems. Voltaire found the story of the Circassian 
 origin of inoculation in de la Motraye’s Voyages, etc., La Haye, 
 1727. Later travellers in the Caucasus found nowhere signs of 
 inoculation being practised there. Creighton waxes indignant 
 about this “ myth constructed in cold blood.” He thinks it is given 
 “ as a mere assertion in the manner of a philosophe ” and there- 
 fore needs no refutation, whereupon he proceeds to give a long 
 one. Evidently he is not Voltaire’s friend. (Creighton, op. cit., II, 
 473, note.) 
 
 ( 22 ) 
 
in a reply to that letter of Voltaire’s explained it thus: si [77] 
 nous n’inoculons pas en France comme en Angleterre, c’est 
 parce que les Anglais se decident par le calcul, et nous par le 
 sentiment. Whatever the reasons may have been, the fact re- 
 mains and we know only of isolated trials, principally in 
 Paris. We must note here one serious effort which seems to 
 have escaped most historians. Tenon, the excellent surgeon 
 of the Salpetriere, on his return from the campaign in Flan- 
 ders (1745), quietly establishes an inoculation service in 
 special premises annexed to the hospital. His interest in 
 inoculation becomes evident only 10 years later when he 
 inoculates the Comte de Chatelux, who in turn becomes an 
 ardent champion of the cause. While Frenchmen on the whole 
 were indifferent to the English example, the little republic of 
 Geneva 1,1 had among its citizens men who evinced a distinct 
 interest for everything English. Thus it may be explained 
 how very early and determined efforts to introduce inocula- 
 tion were made there. Already in 1748, Tronc-hin, 62 a Genevese 
 settled for some years in Amsterdam, the favorite pupil of the 
 old Boerhaave, had inoculated first his own son and then con- 
 tinued the practice among his patients. He introduced it also 
 to Geneva where, on a visit in the summer of 1749, he inocu- 
 lated a nephew, the son of the philosopher and magistrate 
 Colandrini. Then the surgeon Guyot began to inoculate in 
 September, 1750, and was soon followed by two physicians, 
 Cramer and Joly. Trembley, the naturalist, another Gene- 
 vese, had seen inoculations done in England and on the occa- 
 sion of a visit to his home he suggested experiments in the 
 hospital which were undertaken with encouraging results. In 
 1752 Guyot could report to Paris on his first 33 cases and 
 others give accounts of even more, among them Buttini, who 
 publishes an excellent essay. The practice is in full swing 
 when Troncliin returns to Geneva (1754) and strangers flock 
 into the town to be inoculated. In neighboring Lausanne 
 
 01 L. Gautier, La Medecine a Geneve, 1906, p. 391. Gautier gives 
 in this interesting medical history a full account of the progress 
 of inoculation in Geneva. 
 
 62 Theodore Tronchin, 1709-1781; see his biography hy H. Tron- 
 chin, Par. 1906. 
 
 
[77] Tissot, 03 who is already enjoying considerable fame as a 
 practitioner, has taken up inoculation and publishes, in 1754, 
 a treatise which was to be one of the most read and quoted in 
 all Europe. Tissot’s warm friend in Berne, the great Haller, 
 has his own daughter inoculated and becomes active in its 
 recommendation. J. Bernoulli does the same in Bale and 
 gives an address on the subject at the University. Mieg in the 
 same town, S. Schinz and I. K. Kahn in Zurich, report on 
 their results, but nowhere in this country we now call Switzer- 
 land does inoculation flourish as in Geneva, and it is here 
 that it is carried to its logical consequences on a smaller 
 scale but to the same effect as in England. 
 
 Two other countries, parts of what is now Germany 
 and Sweden, also obtained their inspirations in the matter of 
 variolation from England. Hanover, belonging to the English 
 Crown, saw the first inoculations, as already told. Haller was 
 in Gottingen from 1736 to 1753. There had been a little stir 
 about inoculation in Hanover nearly 12 j^ears before he 
 arrived, when Maitland came to operate on Prince Frederick 
 and Wreden had published his Vernunftige Gedanlcen. But 
 those events were forgotten and Haller had more pressing 
 things to attend to during his stay. That he took an active 
 interest in the subject becomes evident a few years after his 
 return to Berne in 1753. Another great man, Haller’s 
 friend Werlhoff, 04 at Hanover, was present at the inoculation 
 of three other English princes in 1754, and from then on con- 
 tinued to inoculate together with Berger and others. Zim- 
 mermann, 05 who in 1768 replaced Werlhoff on the recom- 
 mendation- of Tissot and Haller, kept up an interest in inocu- 
 lation. Murray, 06 in touch with England (Pringle) and 
 Sweden (Schulz), writes excellent pleas. At Gottingen 
 several inaugural dissertations were devoted to the subject 
 (Grimmann, Houth and others under Schroder) after Roed- 
 
 03 S. A. A. D. Tissot, 1728-1797, one of the most famous prac- 
 titioners and prolific writers of the 18th century. 
 
 04 P. G. Werlhoff, 1699-1767. 
 
 65 J. G. Zimmermann, 1728-1795. 
 
 06 J. A. M. Murray, 1740-1797. 
 
 ri>4> 
 
erer, 07 Haller’s successor, had shown the way. Wrisberg, 68 the [77] 
 eminent anatomist, devised a special instrument, by which the 
 depth of the incision could be regulated and we see later his 
 great pupil, Soemmerring, as one of the earliest and most 
 earnest supporters of vaccination. I have already referred to 
 the English itinerant inoeulators. At all the many little 
 courts of Germany we see them appearing. Baylies 60 seems 
 to have been the most active. His advent marks the introduc- 
 tion of the Suttonian method in Germany (announced by 
 Wichmann in Hanover). Between 1767 and 1775 we can fol- 
 low his tracks everywhere. Frederick the Great who, already 
 in 1755, had expressed his astonishment that so little was 
 done in Prussia for a promising method, calls Baylies to 
 Berlin in 1775. He is to teach 14 physicians from the pro- 
 vinces his method in the hospital. We have notes on this 
 course made by one of the physicians and from them it does 
 not appear that the teacher had anything new to teach. Bay- 
 lies had a dispute with Muzel, who, with the elder Meckel, 70 [78] 
 had inoculated some persons several years before with very 
 poor results, and this was probably the cause of his rather 
 sudden departure. Other eminent men, Pastor Siissmilch, 71 
 the founder of medical statistics, and Mohsen in Berlin, 
 Ludwig in Leipzig, 72 Tralles ,3 in Breslau, Hensler, 74 the medi- 
 cal historian, and Juncker 74 in a special Archiv , plead the cause 
 of inoculation, but these are all isolated instances without any 
 marked practical results, reflecting the political chaos which 
 was only very gradually focussing itself into a national unit. 
 
 Only during the last decade of the century do inoculations be- 
 come more numerous (Juncker) but these are soon given up 
 in favor of vaccination. 
 
 67 J. G. Roederer, 1726-1763. 
 
 68 H. A. Wrisberg, 1739-1808. 
 
 69 Will. Baylies of Bath, 1724-1789. 
 
 70 J. F. Meckel, 1714-1774. 
 
 71 J. P. Siissmilch, 1707-1767. 
 
 72 Chr. G. Ludwig, 1709-1773. Among his many writings is one 
 of peculiar interest in regard to the study of medicine, De medi- 
 cinae studio non praecipitando, 1772. 
 
 73 B. L. Tralles, 1708-1797. 
 
 74 P. G. Hensler, 1733-1805. 
 
 75 J. C. W. Juncker, 1761-1800. 
 
 ( 25 ) 
 
[78] In Sweden and Denmark also we see influences carried 
 directly from England and Hanover. Of the progress in 
 Sweden, Murray gives an excellent account and from Denmark 
 Callisen ‘ 8 is able to report numerous inoculations. In both 
 countries it is introduced at about the same time (1754 to 
 1756) ; in Sweden by a personal plea of the King on the 
 advice of the medical college and the support of eminent men, 
 among whom must be named Rosen, Bergius and Schulz, 77 
 the latter publishing one of the best treatises on variolation. 
 By the initiative of these men Sweden was receiving very 
 early the benefits of an excellent medical and sanitary organ- 
 ization and inoculation benefits by it. Already in 1757 we see 
 inoculation hospitals (Gotenborg) founded and we learn from 
 a letter of Baron Scheffer to la Condamine that systematic 
 inoculations in the public schools of Stockholm are under- 
 taken. In Copenhagen also an inoculation hospital is 
 founded, after Baroness Bernsdorff, probably on the sugges- 
 tion of Berger of Hanover, her physician, had submitted her 
 children to the operation. 
 
 Tronchin’s first inoculation did not immediately create a 
 following in Holland. Only six years afterwards, in the 
 year (1754), when he was leaving the country, we hear of the 
 first inoculation performed by a Dutchman, 78 the excellent 
 anatomist, Thomas Schwencke, at The Hague. In the same 
 town inoculation finds an ardent defender in Pastor Chais 
 and one of its most formidable opponents, Anton de Haen, 
 who, however, is just leaving The Hague to go to Vienna. 
 Thanks to the efforts of influential scientific men like 
 Hovius and Camper 78 in Amsterdam, the interest in vario- 
 lation is preserved and even carried to the Dutch Indies. 80 
 
 The greatness of Dutch medicine slowly vanishes after the 
 death of Boerhaave. Van Swieten 81 rapidly transplants the 
 
 78 H. Callisen, 1740-1824. 
 
 77 Nils Rosen (von Rosenstein), 1706-1773. P. J. Bergius, 1730- 
 1790. Dav. Schulz (von Schulzenheim) , 1732-1823. 
 
 78 Van Leersum’s account of inoculation in Holland in Janus, 
 1910, XV, 363. 
 
 79 Jacob Hovius, 1710-1786; Petrus Camper, 1722-1789. 
 
 80 van Hogendorp, v. d. Steeg, van Nielen (Batavia), op. tit. 
 
 81 Gerard van Swieten, 1700-1772. 
 
 ( 26 ) 
 
spirit of the Leyden school to Vienna. To count Van Swieten [78] 
 as one of the opponents to inoculation as is often done is 
 not correct. We find him writing on July 23, 1755, to Dr. 
 van Leempoel S2 from Vienna: “ I am in favor of inoculation 
 — and endeavor to introduce it here,” and again in February, 
 1757, to cle la Condamine that he is waiting for spring to 
 begin experiments with it. It is not certain that these trials 
 were then made, but we do know that later on experiments 
 were certainly made with his consent and interested attention. 
 
 The truth of the matter probably is that he kept above all 
 parties. De Haen 83 on the contrary, soon after his arrival in 
 Vienna, proclaimed his sweeping condemnation of inoculation. 
 
 In 1759, in his “ Questiones,” he asks: “Is inoculation per- 
 missible before God ? Will inoculated smallpox spare more 
 people’s lives than the natural disease ? Is it really true that 
 almost everyone must get the smallpox? Is it not doubtful 
 whether inoculation, after conveying the disease or not, pro- 
 tects against a new attack?” All these questions de Haen 
 answered emphatically in the negative, but with little solid 
 substantiation. His ruthless attack on the promoters of 
 variolation caused a literary stir. Tralles in Breslau, Tissot in 
 Lausanne and de la Condamine in Paris answered by letters 
 which really were treatises. De Haen thereupon pronounced 
 a summary “ refutation ” of inoculation. His character is ex- 
 tremely difficult to understand, but as a teacher of great merit 
 he undoubtedly helped Van Swieten in the reorganization of 
 the medical school, thereby establishing its fame. Though 
 ultraconservative, still interested in processes against witch- 
 craft, which explains his interest in the moral side of inocula- 
 tion, he was one of the first to utilize the thermometer clini- 
 cally, while percussion, or Haller’s teaching, did not interest 
 him. His bark, however, must have been worse than his bite 
 for he does not seem to stem the incoming tide of inoculation 
 in Vienna. The Empress Maria Theresa, 50 } r ears old, having 
 recovered from smallpox, in 1767, on the recommendation of 
 Pringle, calls Jan Ingen-IIousz, a Dutch pupil of Dimsdale’s 
 to Vienna for the inoculation of two archdukes and one 
 
 s - Janus, 1910, XV, 368 (van Leersum). 
 
 63 Anton de Haen, 1704-1776. 
 
 (27) 
 
[78] archduchess. The satisfactory result of the operation, after 
 an extensive series of 200 test cases, opens the doors wide to 
 the practice, which, particularly at the hands of Stoerck M and 
 Locher, receives a thorough application and investigation. 
 We have an excellent account of this period of inoculation in 
 Vienna by Eechberger. 
 
 It remains now to review the subsequent fate of variolation 
 in Paris, and in France and those countries more directly in- 
 spired from there. Paris was then, even more than it is now, 
 the center of all activities in France and therefore it must 
 appear strange that the most important local developments in 
 regard to inoculation issued from two strangers, Tronc-hin and 
 
 [79] Gatti. When Gatti 80 appeared in Paris from his home in 
 Pisa in 1760 he found, as he expressed it, “ more brochures for 
 and against inoculation than inoculations.” This must have 
 been very near the truth all through the whole period of 
 variolation in France, for nowhere do we find anything ap- 
 proaching the number of inoculations reported in England, 
 while we have to make our way through innumerable books, 
 letters, pamphlets, fugitive leaves, etc., in order to get at the 
 actual facts. Plentiful ideas are exposed with characteristic 
 vivacity and sprightliness but reports of actual experiments are 
 meager. When they do occur they almost always evince clear 
 and penetrating observations. The war of pamphlets began in 
 1754, when de la Condamine 66 returned from a voyage of ex- 
 ploration in South America, whence he brought back the exact 
 measurements of an equatorial degree, cinchona bark, rubber 
 and, what interests us most, a deep conviction of the value of 
 inoculation. A Carmelite missionary in Para had seen some- 
 thing in a European gazette about inoculation and, smallpox 
 being in evidence, he at once inoculated his flock with excel- 
 lent results. De la Condamine had seen him and his experi- 
 ments and became convinced. He had no medical training, 
 his leaning was towards mathematics and he had entered 
 
 o 
 
 84 Anton Frhr. von Stoerck, 1731-1803. 
 
 “Angelo Gatti of Mugello (Tuscany) was professor of medicine 
 in Pisa. 
 
 80 De la Condamine, 1701-1774. He bad already, once before, in 
 1732, attempted to interest tbe Academy in inoculation but failed. 
 
 ( — S ) 
 
the Academy of Sciences, as lie puts it, bv the door of chemis- [70] 
 try, the only one open. On April 24, 1754, a memorable day 
 in the French annals of variolation, he addresses, for the first 
 time, the Academy in favor of inoculation. His plea is based 
 almost entirely on the English experiences as given in Kirk- 
 patrick’s “ analysis ” and some later publications including 
 the reports from Geneva. As an embellishment are used the 
 picturesque details of the “ Greek method.” It is one of those 
 speeches the like of which we have often had occasion to hear 
 in our own fight against the “ white plague ” ; the danger is 
 graphically described, the simplicity of the preventive means 
 outlined, and the results to be achieved are mathematically 
 fixed. “ If inoculation had been introduced into France in 
 1723,” concludes de la Condamine, “ we would now have saved 
 the lives of about one million people without counting their 
 offspring.” The effect of this address was that it stirred up 
 great interest in inoculation. When one now reads the 
 literature on inoculation which followed de la Condamine’s 
 memoire, one gets the impression that, almost up to the advent 
 of Dr. Guillotin’s little instrument, nothing interested the 
 French so much as how to save lives either with or without 
 inoculation. That is probably what de Mariveaux meant by 
 French sentiment as against English calculi 
 
 Actual experiments, however, were very scarce. People in 
 general, even those who took de la Condamine’s views of the 
 matter, seemed deadly afraid of the operation. We hear of 
 the inoculation of some children on the advice of Turgot, a 
 young lawyer and later a powerful minister. The Marquis de 
 Chatelux was the first adult to go through the still dreaded 
 test. 8 ' An example from royalty was much needed. In almost 
 every European court variolation had entered comparatively 
 easily, probably because a preventive was most anxiously de- 
 sired in those palaces crowded by a suite often numbering 
 into the thousands and thus offering particular dangers. The 
 
 87 Button’s words, when addressing de Chatelux at his reception 
 to the French Academy in 1775, are: “Alone, without advice, 
 
 in the flower of your youth, but decided by a maturity of reason, 
 you went through the test then still dreaded.” 
 
 ( 29 ) 
 
[79] Duke of Orleans, grandson of the Regent, who, by his death in 
 1723, had disappointed the early hopes of inoeulators, was now 
 determined to make the experiment in spite of small en- 
 couragement from Louis XV. A friend of Tronchin’s, de 
 Jancourt, probably persuaded him, and Senac, 88 who only later 
 became an opponent, approved of it. Tronchin arrives very 
 quietly and the operation is performed towards the end of 
 March on the two children, the Duke de Chartres and Mile, 
 de Montpensier, with the assistance of Hosty and Kirkpatrick. 
 Everything goes well and Tronchin is the hero of the day. 
 The psychology of this moment and the individuality of the 
 principal actors are most interestingly analyzed in the 
 biography of Tronchin 83 by one of his descendants, re 
 viewed for American readers by Dr. F. C. Shattuck. Tron- 
 chin’s stay in Paris was short, he departed in June, but it 
 seems that during that time he performed a number of inocu- 
 lations among the nobility. I am inclined to think that the 
 number was very small and when the Due de Luynes in his 
 memoirs (March 28, 1756) says: “Tronchin pretends to have 
 inoculated 20,000 persons,” someone is grossly exaggerating. 
 From Tronchin, who was not given to writing, we have no 
 direct expression, but Roux, an eye-witness, gives (1765) a 
 most interesting description of the whole method of treat- 
 ment as carried out in the house Tronchin had hired for the 
 purpose of receiving his patients for inoculation. They were 
 “ prepared ” for it by a dietetic regime of one month. In the 
 particular case cited by Roux 26 days were required from the 
 time of inoculation to the final discharge, and 10 more for 
 the healing of the wound. There were some rather alarming 
 symptoms in this case and de l’Epine, referring to it later, 
 thinks it was as bad as the real smallpox, but Tronchin. in a 
 letter to Morel (1767), says that the patients treated by his 
 
 68 Jean-Baptiste Senac, ’1693-1770. 
 
 89 H. Tronchin: Un medecin du XVIII siecle, Theodore Tronchin 
 (1709-1781), Paris, 1906, Plon 8°. See also F. C. Shattuck in 
 Boston Med. and Surg. J., 1908, CLIX, 1-5. A less favorable judg- 
 ment of Tronchin is to be found in a paper by A. Geyl, based on 
 Dutch documents (Arch. f. Gesch. d. Med., 1908, 1, SI, et seq.). 
 
 ( 30 ) 
 
method in Paris were less ill than those treated by the old [79] 
 method . 00 One really cannot wonder that people did not take 
 to the old method and greeted the coming of Gatti a few 
 
 30 This case of Tronchin’s as reported by Roux (1765) offers so 
 good an illustration of the method as then practised, that an 
 extract may prove interesting: The patient is the son of d’Heri- 
 
 court ( intendant de la marine ), 12 years old, delicate, anemic. 
 
 13. March 1756 regime begins, one-half of ordinary diet, chiefly fari- 
 naceous, some veal, mutton, chicken and vegetables. 
 Every night tepid foot bath for one-half hour. 
 
 Roux moves with the young man, his pupil since 6 years, 
 to Tronchin’s house, where they sleep together in 
 same alcove. 
 
 Surgeon Saint-Martin applies vesicant to insides of both 
 legs. 
 
 Inoculation: Blisters are opened, threads with virus 
 applied. 
 
 Removal of threads, bandage with digestive ointment, 
 continued next day. 
 
 Around each wound red circle, beginning excavation. 
 Patient uneasy, headache, inguinal glands swell. Up 
 to here from day of inoculation only vegetables, soup 
 and barley water allowed. 
 
 Glands sensitive and painful, fever sets in 9 a. m. slight. 
 Fever higher, at 7 p. m. slight delirium, all night and 
 next day, papules on chest. 
 
 Slight delirium and fever until 7 p. m. In morning 
 slight epistaxis. During this febrile and eruptive 
 period only barley water allowed. 
 
 No fever, eruption finished, slight nose-bleed. 
 
 Papules grow in size rapidly, some paler. Sixty-six on 
 face and as many on body, distinct and with red 
 circles. 
 
 Suppuration of pustules, wounds which were almost 
 dry and covered by brown scab, begin to suppurate 
 abundantly. 
 
 Some pustules begin to dry up. Saint-Martin opens 
 some to take virus on threads. 
 
 (22d day after inoculation.) Exsiccation complete, 
 wounds discharge for 15 further days. During febrile 
 period, diet same as before fever set in. 
 
 Slight “ erysipelas ” of face and around one leg, which 
 continues for 3 to 4 days. “ Patient subject to this.” 
 No fever. Roux calls this a benign case. He mentions 
 by name seven other patients under the care of 
 of Tronchin at the same time. 
 
 10. April. 
 
 11. April. 
 
 12. April. 
 
 13. April. 
 
 18. April. 
 20. April. 
 
 21. April. 
 
 22. April. 
 
 23. April. 
 
 24. April. 
 
 25. April. 
 
 27. April. 
 
 28. April. 
 
 4. May. 
 
 9. May. 
 
 (31) 
 
[70] years later (1760). He indeed brought simplification and 
 perhaps went too far in the opposite direction, as some of his 
 failures seem to indicate. Gatti hails from Pisa where he 
 held the chair of medicine at the university. He was brought 
 [80] to Paris by his friend Baron d’Holbach 01 and inoculated his 
 children. Well introduced, he immediately found a great 
 following. In 1763, 1761 and 1767 he publishes his ideas 
 and the developments and results of his method in a direct 
 and frank manner, which contrasted favorably with the mass 
 of other writings. He co-operates with Roux, Antoine Petit, 
 Bordeu" 2 and others. His reflexions of 1761 particularly 
 maintain a standpoint far in advance of his time. He sets 
 out with a discussion of the etiology of smallpox. He objects 
 to the lax conceptions then prevalent, expressed in vague 
 terms of fermentation, ebullition, effervescence, humors, 
 leaven, germ, etc. They mean nothing. Variola is always pro- 
 duced by the action of a foreign body introduced into the 
 organism from the outside, by contagion or other communica- 
 tion. It is the constant and determinate effect of a specific 
 “ virus,” which reproduces itself and multiplies. He insists 
 especially on the specificity. Communication of the disease 
 takes place through contact, inhalation or ingestion. These 
 were revolutionary views then, and to-day we do not know 
 much more about variola. By inoculation, he goes on, the 
 poison is conveyed by intelligence, in the natural disease by 
 chance. A preparation of a subject for inoculation has sense 
 only if it tends to improve his general health; debilitating 
 measures like bleeding and purging, as practised by routine 
 even on feeble individuals, have sometimes brought tears of 
 pity and indignation to his eyes. As to the choice of the virus 
 it is of lesser moment whether it is “ crude ” or “ mature ” ; 
 the important factor is that the individual from whom it is 
 derived be in good general health and free from other con- 
 
 91 P.-H.-T. d’Holbach, 1723-1789, of German origin, hut settled in 
 Paris. He achieved some fame as a sceptic philosopher and enter- 
 tained at his table all the bels esprits of the day. Galiani called 
 him the premier maitre d'hotel de la philosophic. 
 
 92 Theophile de Bordeu, 1722-1776. 
 
 ( 32 ) 
 
tagious disease . 93 It is best to obtain the virus from another [SO] 
 inoculation and he replies to the objection made, that the 
 virus becomes hereby weakened : “ There would be nothing 
 left to desire in the art of inoculation, if we could arrive at 
 attenuating the variolous virus, but I do not know any means 
 by which this attenuation can be accomplished . 94 The passage 
 of the virus through several organisms may in time bring 
 about a marked decrease of virulence and he adds propheti- 
 cally : “ Perhaps one day we may become indebted to inocula- 
 tion for having brought about an attenuation of this poison 
 among men.” It is of no advantage to try and produce an 
 abundant crop of pustules, one well developed pustule has as 
 much protective value as a thousand. In case of doubt re- 
 inoculation ought to be resorted to. With great vehemence 
 Gatti turns against the unscrupulous practitioners, who, for 
 selfish reasons, surround the method with all sorts of compli- 
 cated details; he proclaims it a very simple operation and its 
 chief principles are a thorough knowledge of the patient’s 
 condition and the art not to do harm, partie la plus fine et 
 la plus importante de la medecine. He believes also that 
 women could be instructed to the best advantage in the 
 practice of inoculation. Gatti is absolutely convinced of the 
 protective power of inoculated smallpox. He even substan- 
 tiates this belief later by offering a considerable money prize 
 for any authenticated case of re-infection after inoculation. 
 Such cases, he thinks, can only happen when the eruption after 
 inoculation is not one of true smallpox but is mistaken for it 
 (he alludes here to chickenpox). He admits to have been 
 deceived himself. The celebrated case of the Duchesse de 
 Boufflers, illustrating such an instance, hurt Gatti’s cause 
 more than any other. 9 '* 
 
 93 Gatti admits that other diseases than variola can be conveyed 
 by inoculation; it has happened to him with scarlatina and measles. 
 Consumption (pulmonic) he does not believe to he thus transferred. 
 
 94 “Je suis persuade qu’il serait utile de pouvoir affaiblir la 
 matiere variolique, qu’il ne resterait plus rien d desirer dans Vart 
 d’inoculer, si on pouvait y parvenir, mats que je ne connais aucun 
 moyen d'obtenir cet affaiblissement.” 
 
 95 In the Gaz. litter, de l’Europe, Tome VI, p. 377 (also Gent. 
 Magaz. Nov., 1765) is given a statement of the case by the Duchesse 
 
 ( 33 ) 
 
[80] After a careful consideration of Gatti’s work and its proper 
 
 [81] position in historical sequence, one is forced to the conclusion 
 that the reformation which took place in the practice of 
 inoculation during the sixties issued from him and that the 
 success of Daniel Sutton and his followers is based on the 
 methods advocated by Gatti. On the other hand it is evident 
 that Gatti later on adopted some of the features of the Sut- 
 tonian regime, notably the cold water applications and the 
 open-air life. His adoption of the use of cold water is no 
 blind imitation; it was based on the observation that when- 
 ever the fever, which usually follows the local eruption after 
 three days, is delayed, the symptoms of the disease are lighter. 
 By cold water applications he was able to delay the fever 
 until the sixth day. But he makes no sweeping conclusions, 
 he insists on further experiments and particularly on watching 
 the relation of the local and general reaction. 
 
 The serious objection against inoculation, that of in- 
 creasing the spread of the disease, Gatti frankly admits, 
 but he believes that, since each infective focus is known, 
 proper isolation could obviate any real danger. He seems, 
 however, not to have been able to control all of his patients. 
 That some of them had been seen to mix unhindered with 
 others in public places was one of the chief causes of govern- 
 ment interference. In a decree of Parliament, dated June 8, 
 the General of Police alludes to the “ murmurs of the 
 Public ” at the indiscretion of certain partisans of the 
 method, which have “ reached our ears.” The “ general cry ” 
 raised against the inoculators makes necessary an investiga- 
 tion by the enlightened magistrates. The avocat du Roi, 
 Omer Joly de Fleury, then further enlarges on these reasons 
 and concludes his address to the magistrates : “ The fact of 
 inoculation which now must fix your attention, presents itself 
 naturally from two points of view, first as regards the prin- 
 ciples of religion, secondly as regards the advantages humanity 
 
 de Boufflers herself. It is widely discussed in France by de l'Epine. 
 Ant. Petit and de Baux during the deliberations of the Faculty of 
 Medicine. The best English account, with Gatti’s explanations, is 
 to be found in Langton, op. cit., pp. 18-25. (Creighton gives an 
 abstract in his book, II, 495.) 
 
 ( 34 ) 
 
may derive therefrom.” Experts in conscience and health will [81] 
 therefore have to be consulted. These of course are the 
 Faculties of Theology and of Medicine respectively. The 
 medical faculty is to give its advice first and then submit it 
 to the theologians. The question of a continuation of a pro- 
 visional tolerance to further “ free literary discussion and 
 various experiments ” is set aside and it is decided to sub- 
 stitute for it a provisional prohibition against inoculating 
 within the precincts of cities and suburbs until the named 
 faculties have been able to recommend the permission, or 
 prohibition, or tolerance of the practice. 
 
 From now on all inoculations have to be done outside the 
 barrier es and we see many go there, for the legally imposed 
 limit of six weeks, to submit to inoculation. We know 
 of numerous inoculations being performed under these restric- 
 tions by G-atti, Petit, Roux and others. Tronchin also sets up 
 an establishment there in 1766 and Worlock, 09 the father-in-law 
 of Sutton, and an assistant do the same. 
 
 Meanwhile the Faculty of Medicine goes to work on its 
 report. A commission of twelve members is appointed and 
 the procedure of investigation is outlined. This same faculty 
 which long ago had approved, then condemned antimony, 
 and rejected the discovery of the circulation, proposes to decide 
 this question again on similar evidence. Not the slightest 
 effort is made to adduce further experiments, only the litera- 
 ture is to be studied and the opinions which inoculators out- 
 side of Paris are asked to express. Regular meetings are 
 held by the commission, partly in camera, partly before the 
 assembled faculty, and tumultuous scenes occur in which 
 parliamentary methods are forgotten and personal encounters 
 are threatened. The commissioners soon found they could 
 not agree and decided to present two reports instead of one. 
 
 Two groups of six each were formed, one, of those in favor, 
 led by Petit, the other, of those against inoculation, headed by 
 de FEpine." 7 The former represented the younger, more pro- 
 
 “ li Gardane, Secret des Suttons. 
 
 97 The other commissioners in favor of inoculation with Antoine 
 Petit were E. L. Geoffroy, A. C. Lorry, Maloet, Thiery and Cochu, 
 while the opponents under G. J. de l’Epine’s lead were, Jean Astruc, 
 
 M. P. Bouvart, Th. Baron, J. Verdelhan de Miles and H. J. Mocquart. 
 
 ( 35 ) 
 
[81] gressive, the latter the older, conservative elements. Only 
 15 months after the parliamentary decree could the reports 
 be presented before the assembled faculty for the first reading 
 and, after acceptance, be put into the printer’s hands. The 
 publication, however, was delayed until 1766 and supplements 
 were added as late as 1767. The report of de l’Epine would 
 do honor to any prosecuting attorney; as such it is a very 
 clever presentation of the case against inoculation. It occu- 
 pies 125 quarto pages, mostly filled by the bibliographic re- 
 views of the literature in fine print. 88 The main points are 
 that smallpox is not so dangerous a disease as is usuallv 
 asserted. De Haim had treated 120 cases with only five deaths, 
 which may be explained as due to other causes. Bad treat- 
 ment is at the bottom of most deaths. Furthermore many 
 people never get smallpox and a fatal inoculation might strike 
 just those. One such case is enough to condemn inoculation. 
 Much is made of one of Gatti’s failures and of the Boston 
 reports (Delahonde) of an increase of smallpox following 
 inoculation. In conclusion an attempt is made to show that 
 the provisional prohibition has had already a favorable influ- 
 ence on the general health in Paris and “ one begins to 
 breathe again. The epidemic, no longer nourished and 
 perpetuated by this unfortunate practice, has lost much of its 
 force and is notably diminished.” 89 
 
 De l’Epine in his closing remarks suggests that the method 
 
 08 Three separate sessions of the faculty were needed for the 
 reading of this part of the report, viz., Oct. 20, 22 and 24, 1764. 
 
 9 “ The summary of the conclusions is given in “ nine incontest- 
 able truths” as follows: 
 
 1. Incertitude of conveying smallpox by inoculation, even if 
 
 repeated. 
 
 2. Unsuccessful inoculation does not protect in future. 
 
 3. If successful there is no guarantee that attack will be benign. 
 
 4. If death is not issue, frequent disturbances may follow. 
 
 5. Same risks as in natural smallpox, disfiguration, etc. 
 
 6. Escape from death after inoculation insures no protection 
 
 against other often more dangerous attacks. 
 
 7. Other diseases may be conveyed through inoculation. 
 
 8. Inoculated smallpox is sometimes fatal. 
 
 9. It can infect others and thus endanger society. 
 
 (36) 
 
is perhaps not sufficiently perfected and hopes that the English [82] 
 may succeed, then “ we shall thank heaven for such a precious 
 discovery and we shall render them due homage for the en- 
 lightenment which they have procured for us at their risk. 
 
 It would be unjust for us to envy them the very legitimate 
 advantage of enjoying the first fruits, reaped under such peri- 
 lous circumstances.” The inevitable advice of these six com- 
 missioners is neither to permit nor to tolerate inoculation. 
 
 Of the signers of this verdict Astruc 100 was undoubtedly the 
 most famous and influential. Eighty years old and only two 
 years before his death, it cannot be presumed, however, that 
 he took a very active part in the composition of this report. 
 Bouvart, 101 another member, we can safely make responsible 
 for several of the more extreme attacks against the inocu- 
 lators. He was a violent antagonist of Tronchin’s, whose 
 book on the colic of Poitou he had tried to drown under a 
 flood of ridicule and unjust criticism, and with Petit, the 
 editor of the other report, he had had a quarrel about the 
 very important question of belated childbirth. 102 
 
 The report of the other party, edited by Petit, 103 is not 
 nearly as carefully prepared as the de l’Epine document. One 
 feels that it is written by a busy practitioner who has little 
 time and inclination to enter into all the subtleties intro- 
 duced. He judges from what he has seen, simply brushing 
 aside the objections. It is not nearly as convincing for the 
 casual reader as the other, in which almost all the reports of 
 inoculators are dexterously turned against themselves, thus 
 exhibiting a formidable array of damaging testimony. Petit 
 did not follow such tactics in his first report, but, seeing that 
 he had failed to make an impression, comes out in 1766 with 
 a second report in which he shows the malice of de l’Epine’s 
 method. He points out the “ multiple errors and mistakes of 
 all sorts ” and these become evident enough when one com- 
 pares them with the sources. 
 
 100 Jean Astruc, 1684-1766. 
 
 101 M.-P. Bouvart, 1717-1787. 
 
 10 - The contention was about the legitimacy of a child born after 
 an 11% months pregnancy and 10% months after the death of the 
 76-year-old father. 
 
 103 Antoine Petit. 1718-1794. 
 
 (37) 
 
This second report is signed by only three of the commis- 
 sioners besides Petit, viz., Geoffroy, Lorry and Maloet, 104 the 
 other two are absent and the Doyen Belleteste and the censor 
 Le Thieullier therefore sign in their stead. 
 
 The endless discussions 1,13 about the merits of inoculation 
 during these several years must have exhausted the interest in 
 the subject and indeed, after the assembled faculty had ex- 
 pressed itself in favor of the tolerance of inoculation under 
 certain restrictions by 52 votes against 26, we hear little more 
 on the subject. Petit, in a later letter to the Doyen of the 
 Faculty, thinks that, up to the end of 1766, probably 15,000 
 inoculations had been performed in France, which seems little 
 against the 200,000 reported from England. Although the 
 acuteness of popular interest 106 had subsided, we have good 
 reason to assume that inoculation was continued in Paris and 
 the provinces on a much larger scale. We have, however, no 
 evidence that anything was done, as in England, to further 
 study and develop the method. 107 We should naturally expect 
 to hear of Gatti’s further work, but there is very little to be 
 found about him. In 1769 he receives permission to inoculate 
 in the military college, but of his results and the details of his 
 work I have been unable to detect traces. Louis XV dies of 
 smallpox in 1774 and this event decides his grandson and 
 successor, Louis XVI, to submit himself as well as his family 
 to inoculation. Neither with Louis XV’s illness nor with this 
 inoculation do we find Gatti’s name connected, although he 
 
 IM Etienne-Louis Geoffroy, 1725-1810, for 40 years one of the most 
 prominent Paris physicians; Anne-Charles Lorry 1726-17SG, good 
 observer and medical historian of merit; P. L. Maloet, 1730-1810, 
 able practitioner. 
 
 105 Dubourg, op. cit. 
 
 106 John Wilkes during his exile in Paris seems to have become 
 interested in inoculation to the extent of writing a farce about it 
 (op. cit.). 
 
 107 The principal clinical reports of this time, besides the ones 
 already cited, are those of Robert, Rast, Grassot, Rasoux. Dezoteux, 
 Le Camus, Gardane, Gandoger de Foigny, Mangin, Vernage (op. 
 cit.). Theophile de Bordeu, the founder of the theory of “vital- 
 ism” publishes (op. cit.), in defence of inoculation, a long his- 
 torical treatise, in which he analyses what attitude the founders 
 of all the medical doctrines since Hippocrates might have assumed 
 in regard to inoculation. 
 
 (3S) 
 
was physician extraordinary to the King. 108 Gatti’s appear- [82] 
 ance and activity marks the greatest advance in variolation 
 which was reached in France and, as a matter of fact, any- 
 where. His ideas and methods were those of the best scien- 
 tists at the end of the 19th century and it is indeed remark- 
 able how little his work is remembered. 103 
 
 In England, and to some extent also on the Continent, after 
 the technical principles of variolation became fairly well un- 
 derstood, we can see developing round it a social movement 
 for the eradication of smallpox very similar to the tuberculosis 
 crusade of our days. I have already alluded to the hygienic 
 features in the regimen ; they were enlarged upon and general- 
 ized for a wider application. Segregation of the infected 
 cases was insisted upon more strongly than before. Early 
 inoculation of infants was advocated by Maty and more em- 
 phatically by Lettsom. The demands for inoculation dispen- 
 saries became very loud and several were established (John 
 Clark at Newcastle, Haygarth at Chester, etc.). The number 
 of inoculations practised was exceedingly great. It went to 
 many thousands per year. We have, of course, no accurate re- 
 ports about it. But already in 1766 (Houlton) we hear that 
 Bobert Sutton had inoculated 2514 persons from 1757 to [83] 
 1767 and Daniel 13,792 from 1764 to 1766 and his assistants 
 6000 more. 110 As late as 1821 to 1822 John Forbes tells us 
 that a farmer, Pearce and son, of Busham (Sussex) associated 
 with some surgeons inoculated 13,000 persons ! 
 
 Jenner’s (born in 1749) interest in the subject dates from 
 
 I0S Report by de Lassone (op. cit.). 
 
 109 In his own country, Italy, he does not seem to have exerted 
 any great influence in favor of variolation. The considerable de- 
 velopment which it reached there was inspired chiefly from France, 
 Switzerland and Austria. The personal initiative of the Marchese 
 Bufalini in Rome in 1754, the opposition of the Papal physician, 
 Zanettini, and of Dr. Roncalli Parolino, and Tronchin’s inocula- 
 tion of a Bourbon prince in Parma are the main events of the 
 Italian history of variolation. The most active Italian inocula- 
 tors were Peverini, Lunadei, Lavizzari, Caluri, Targione, Manetti, 
 
 Berzi, Bicetti (op. cit.). In Spain there seems to have teen only 
 a literary reflex of the French efforts. 
 
 119 His income for 1764 is given as £2200 and for 1765 as £6300. 
 
 ( 39 ) 
 
[83] this period. John Hunter had told him already not to specu- 
 late but to observe and prove. With his natural gifts, with the 
 inspiration of that particular period and the opportunities of 
 his home surroundings it was inevitable that he should make 
 the greatest improvement in the method of inoculation. 
 
 In following variolation on its course through the civilized 
 world of the 18th century and, in noting the successive steps 
 of its evolution, it has been my aim rather to open avenues for 
 future research than to give a complete and detailed account 
 of the more important phases. Plentiful suggestions are to 
 be found everywhere which lead one to infer that variolation, 
 without the advent of vaccination, might have furnished the 
 world with an equally safe and perhaps more efficient method 
 of preventive immunization. We have every reason, however, 
 to be satisfied with the results of vaccination. Thanks to it 
 smallpox has been practically stricken off the list of the great 
 medical problems. Hone the less it is time that the epoch 
 which preceded vaccination should receive its proper place in 
 the history of medicine, and that the names of Kirkpatrick, 
 Gatti, Watson, Mudge and Dimsdale should be recalled with 
 that of Edward Jenner. 
 
 ( 40 ) 
 
BIBLIOGRAPHY OF VARIOLATION. 
 
 [Note. — In these lists, English, German, French or other trans- 
 lations are indicated by E., G., F., . . . respectively, with dates. 
 The American tracts and pamphlets of the eighteenth century 
 are subjoined as “ Americana.” Certain of these which have been 
 brought to light and identified in Professor Kittredge’s interesting 
 paper, “ Some Lost Works of Cotton Mather ” [Proc. Mass. Histor. 
 Soc., Feb. 1912, pp. 418-479], are marked “ K.” A star (*) denotes 
 an inaugural dissertation or thesis.] 
 
 I. XVIII Century Literature. 
 
 Aberdour (A.): Observations on the small-pox and inoculation. 
 8°. Edinburgh,. 1792. 
 
 Accademia delle scienze di Siena detta de’ fisiocritici. Gli atti 
 dell’ . . . dell’ anno 1760. Tomo i. (Storia generale degl’ innesti 
 del vajuolo fatti in Siena dall’ anno 1758, fino a tutto il 1760.) 
 4°. Siena, 1761. 
 
 Ackermann (J. F.): De insitione variolarum commentatio 
 
 epistolaris. Gottingen, 1771. 
 
 d’Alembert (L. le R.) : Inoculation. Opuscules mathem. 1765, 
 T. II and IV, p. 329. (S. also J. de med., chir., pharm., etc. Par. 
 
 1761, XIV, 73-82.) 
 
 Alexander (S.) : Observationes quaedam circa variolarum in- 
 
 sitionem. Sm. 4°. Duisburgi (1797). 
 
 Almroth (N.): In variolarum insitionem observationes. Sm. 
 
 4°. Upsalise (1788). 
 
 Andrew (John) : The practice of inoculation impartially con- 
 
 sidered. Letter to Sir Edward Wilmot, Bart., to which are added 
 the sentiments of Dr. Huxham and several other physicians, as 
 communicated to the author. Exeter, 1765. 
 
 Augier (C. J.) : Prolusio medica, an inoculatio tutissima sit 
 
 prophilaxis adversus instans a variolis periculum? 4°. Aran- 
 sione, 1783. 
 
 Avis aux peres et meres, sur l’inoculation de la petite verole. 
 8°. (n. p., n. d.) 
 
 Baader (F. M.) : Vertraute Briefe fiber eine ganz unerhorte 
 
 und nachtheilige Pockenkur. Verm. u. verbess. Ausg. Mtinchen, 
 1779. 
 
 Bachmetiev (G.) : De variolis inserendis. 8°. Edinburgh 1786. 
 
 ( 41 ) 
 
Baeck (Abraham): Ta] om farsoter, som mast harja ibland 
 
 rikets allmoge; hallit tor Kongl. Vetensk. Ac-ademien, vid Prae- 
 sidii nedlaggande den 25. Julii, 1764. Stockholm, 1765. 
 
 Baetge (J. C.): De variolarum lue insitionis beneficio pro- 
 
 scribenda. 8°. Traj. ad Viadr., 1798. 
 
 Bagard (C. ): Discours sur l’inoculation de la petite verole, 
 
 qui a ete lu dans la seance publique de l’Academie en 1755, que 
 le Roi de Pologne honora de sa presence. Nancy, 1755. 
 
 Baker (Sir George): An inquiry into the merits of a method 
 of inoculating the small-pox, which is now practised in several 
 counties of England. 1. and 2. ed. London, 1766. (S. also Med. 
 
 Jour. Roy. Coll. Phys., London, 1772, ii, 275.) 
 
 Balz (J. F.): De praestantiore variolas, vesicatorii ope, in- 
 
 serendi methodo. Sm. 4°. Stuttgardise, 1792. 
 
 Bandelow (A. D. ): Ueber die Pocken und ihre Einimpfung. 
 
 Dessau, 1792. 
 
 Barker (J. ): The nature of inoculation explained and its 
 
 merits stated (etc.). 8°. London, 1769. 
 
 Baumer (J. G.) : (Pr. ) monita qusedam de variolis earumque 
 
 curatione ac insitione. 4°. Giessae Cattorum, 1776. 
 
 de Baux (P. ): Parallele de la petite verole naturelle, avec 
 
 l’artificielle, ou inoculee, avec un traite intermediate de la petite 
 verole fausse, volante, ou adulterine. Avignon. 1761. 
 
 Baylies (Will.): Kurze Satze fiber die Pocken. Aus d. Engl, 
 von. A. B. Kolpin. Berl. u. Stettin, 1775. 
 
 Baylies (Will.): Memoire concernant l’etat de l’inoculation de 
 la petite verole a Berlin. Dresden, 1776. (Engl., Edinb., 1781.) 
 
 Beer (F. G.): * De variolarum exstirpatione insitioni sub- 
 
 stituenda. (Praeses Krause.) Lipsise, 1762. 
 
 Bergius (P. I.): Kon om en kopposmitta, som liknar ympning, 
 jamte skal til koppo-ympningens antagande har i riket. Hand- 
 lingar, 1756. 
 
 Bergius (P. I.): Ron ech Anmarkningar om en midt uti en 
 Koppympning inkommen Masslingssmitta. Kgl. Vetenskaps 
 Academiens Handlingar, 1776. 
 
 Bernoulli (Dan.): Rapport sur l’inoculation (1760). Acad. d. 
 sc. Par., 1765. (Also Hist. Acad. roy. d. sc., 1760. Par., 1766, 
 pt. 2, 1-45.) 
 
 Berzi (F.) : Nuova scoperta a felicemente suscitare il vajuolo 
 per artificioso contatto. Padova, 1758. 
 
 Bewahrung, dass die Einpfropfung der Blattern nicht nur 
 nicht wider die Religion und Vernunft ist, sondern vielmehr dem 
 Gehorsam gegen beide zur Pflicht oblieget. 1768. [From the 
 English.] 
 
 Bicetti de’ Buttinoni (G.) : Osservazioni sopra alcuno innesto 
 di vajuolo e un’ ode dell’ Ab. Farini su lo stesso argomento. 
 Milano, 1765. 
 
 ( 42 ) 
 
Bicker (L.) : Vertoog van de voornaamste redenen, welken de 
 ingezetenen van ons land, tot hier toe, van de inenting der kinder- 
 pokjes wederhouden, en oorzaak zijn, dat deze praktijk niet 
 algemeen bij ons in gebruik kome. 8°. Rotterdam, 1777. 
 
 de Bienville (D. T.) : Le pour et le contre de l’inoculation, ou 
 dissertation sur les opinions des sgavants et du peule (sic), sur 
 la nature et les effets de ce remede. 12°. (n. p., n. d.) 
 
 Billant (J.): Dissertation sur l’ancienne et la nouvelle in- 
 
 oculation. 4°. Paris, 1806. 
 
 Blackmore (Sir Richard): Treatise upon the small-pox, in two 
 parts. Lond., 1723. 
 
 Blake ( J.) : A letter to a surgeon on inoculation, containing 
 
 remarks on Dr. Dimsdale’s pamphlet upon that subject (etc.). 
 8°. London, 1771. 
 
 Boeckmann (Otto Reinhold) : Dissertatio. Om formon af 
 
 kopp-ympningens vidtagande i Finland, under Oec. Direct. Chem. 
 Prof., etc. Hr. Pehr Adrian Gadds inseende for lager-krantsen 
 utgifven och forfvarad. Abo d. 4. Jul., 1763. 
 
 Boehme (I. A. B.) : * De nonnullis ad morbillorum insitionem 
 spectantibus. (Prses. A. E. Buchner.) Magdeburg, 1766. 
 
 Bond (Thomas) : Defense de l’inoculation et relation des pro- 
 gres qu’elle a fait a Philadelphia en 1758. Strassburg, 1784. (G. 
 
 1787.) 
 
 deBordeu (Theophile) : Recherches sur quelques points d’histoire 
 de la medecine qui peuvent avoir rapport a l’Arret de la Grande 
 Chambre du Parlement de Paris, concernant l’inoculation, et qui 
 paroissent favorable a la tolerance de cette operation. Liege, 
 1764. (Re-ed. 1882, Par.) 
 
 Boretius (M. E.) : Observationum exoticarum specimen primum, 
 sistens famosam Anglorum variolas per inoculationem excitandi 
 methodum, cum ejusdem phasnomenis et successibus; prout nempe 
 in carcere Londinense (Newgate vulgo) auctoritate publica in sex 
 personis capite damnatis feliciter fuit instituta (etc.). 4°. Regi- 
 omonti, 1722. Also in Haller: Disp. ad morb. (etc.). 4°. Lausan- 
 ne, 1758, v. 671-682. 
 
 von Borstel (H. H.) : Dis. med. exhibens ephemeridem vari- 
 
 olarum corpori proprio insitarum. 4°. Gottingae, 1765. 
 
 Bosch (Jac. Imm.) : Abhandlung iiber die wahre Beschaffenheit 
 der Kinderpocken und ihre allmahlige und gewisse Heilung. a. d. 
 Holland. Stendal, 1792. 
 
 Boyer (J. B. N.): These sur l’inoculation, Montpellier, 1717. 
 
 Brady (S.): Some remarks upon Dr. Wagstaffe’s letter, and 
 
 Mr. Massey’s sermon against inoculating the small-pox; with an 
 account of the inoculation of several children, and some reasons 
 for the safety and security of that practice, in three letters to a 
 friend. 8°. London, 1722. 
 
 ( 43 ) 
 
Bromfeild (W.): Thoughts arising from experience, concerning 
 the present peculiar method of treating persons inoculated for 
 small-pox (etc.)- Loud., 1767. 
 
 Buonanni (M.): Rapporto (i-iii) delle osservazioni occorse nell’ 
 innesto del vaiuolo. 4°. Napoli, 1772-5-8. 
 
 Burges (James) : An account of the preparation and manage- 
 ment necessary to inoculation. London, 1754. 
 
 Butini ( J. A.) : Traite de la petite verole communiquee par 
 l’inoculation. Paris, 1752. (Danish, Kopenhag, 1753.) 
 
 Caldani (L. M. A.): Innesto felice di vajuolo instituito e de- 
 scritto. Padova, 1768. 
 
 Caluri ( F. ) : Dell’ innesto del vajuolo. Siena, 1760. 
 
 Camper (P.): Aanmerkingen over de inentinge der kinder- 
 
 ziekte (etc.). Leeuwaarden, 1770. (G. 1772.) 
 
 Camper ( P. ) : Les avantages de l’inoculation, et de la meilleur 
 methode de l’administrer. 8°. Toulouse, 1772. 
 
 Camper ( P. ) : De emolument et optima methodo insitionis 
 
 variolarum [1772]. Groning., 1774. 2d ed., Leiden, 1789. 
 
 Camus (Ant. Le) : Projet d’aneantir la petite verole. Paris, 1767. 
 
 “Candide”: Avis sur l’inoculation de la petite verole. Paris, 
 1763. 
 
 Cantwel (A.): Dissertation sur l’inoculation, pour servir de 
 
 reponse a celle de M. de la Condamine, sur le meme sujet. Paris, 
 
 1755. 
 
 Cantwel (A.): Lettre a M. de . . . Avocat en Parlement. Paris, 
 
 1756. 
 
 Carstens (C. A.): De insitione variolarum. Sm. 4°. Kilise, 
 
 1768. 
 
 de Castilla (P. F.) : El mundo enganado por la inoculation de 
 las viruelas. Cadiz, 1789. 
 
 a Castro (Jacob): Verhandeling over de nieuwe veylige en 
 
 vorderlyke methode of wyse om de pokjes te oculeeren of inteen- 
 ten. Amsterdam, 1722. 
 
 a Castro (J. ): Dissertatio in novam. tutam, ac utilem me- 
 
 thodum inoculationis seu transplantationis variolarum, Thessalia. 
 Constantinopoli et Venetiis primo inventam, nuncque in hac 
 civitate, auctoritate Regiae Majestatis Brittanies c-omprobatam, 
 28. Julii, 1721. 3. ed. 8°. Londini, 1731. 
 
 de Castro (J. P.): Diss. utrum ad insitionem in variola necne 
 debeat confugi ostendens. 8°. Edinburgi, 1793. 
 
 Chais (C.) : Essai apologetique sur la methode de communiquer 
 la petite verole par l’inoculation (etc.). La Haye, 1754. (Repr. 
 1775. G. 1774/5. Sw. 1756.) 
 
 Chais (C. ): Lettre a Dr. Sutherland, associe de M. Sutton, sur 
 la nouvelle methode d’inoculer la petite verole, et reponse du 
 Dr. Sutherland. La Haye, 1768. 
 
 (44) 
 
Chandler (Benjamin): An essay on the present method of in- 
 oculation. London, 1767. 
 
 Chatelux (Le Chev.) : Nouveaux eclaircissements sur l’in- 
 
 oculation de la petite verole, pour servir de reponse a un ecrit 
 de M. Rast. 1763. 
 
 Chatelux (Le Chev.) : Reponse a une des principales objections 
 qu’on oppose maintenant aux partisans de l’inoculation de la 
 petite verole. Paris, 1764. 
 
 Clark ( J. ) : Report of the Newcastle Dispensary. 1789. 
 
 Cleland (G.): * De variolarum insitione. Lugd. Bat., 1776. 
 
 Clinch (W.) : Rise and progress of the small-pox, with an 
 
 appendix to prove that inoculation is no security from the natural 
 small-pox. London, 1724, 1725, 1733. 
 
 Clossius ( Joh. Fr.) : Nova variolis medendi ratio. Amstel- 
 
 odami, 1766. (G. 1769.) 
 
 de la Condamine: Memoire sur l’inoculation de la petite verole, 
 lu a l’assemblee publique de l’Academie royale des sciences, le 
 24 avril, 1754. Paris, 1754. Avignon, 1755. (E. Lond., 1755, 
 
 New Haven, 1773.) 
 
 de la Condamine: Second memoire sur l’inoculation de la petite 
 verole, contenant son histoire depuis l’annee 1754, lu le 15 novem- 
 bre, 1758. Geneve, 1759. (Also Collect, acad. d. mem., etc., Par., 
 1786, XII, 415-418.) 
 
 de la Condamine: Lettre a M. . . . Conseiller a P. d. D., servant 
 de reponse a la lettre de M. Gaulard sur la maladie du fils de M. 
 Delatour. (Mercure de France, fevrier, 1759.) Merc, de Fr. de 
 juin, 1759. 
 
 de la Condamine: Seconde lettre a M. . . . Conseiller a P. d. D. 
 pour servir de reponse a la seconde lettre de M. Gaulard et a 
 son defi. (Mercure d’aout, 1759.) Merc, de Fr. de sept., 1759. 
 
 de la Condamine: Lettres a M. Daniel Bernoulli. Mercure de 
 France de mars et d’avril, 1760. 
 
 de la Condamine: Lettres a M. le Dr. Maty sur l’etat present 
 de l’inoculation en France: I. Sur la defense provisoire de l’in- 
 oculation, p. 1. II. Sur l’avis demande par le Parlement aux 
 Faeultes de medecine et de theologie au sujet de 1'inoculation, p. 
 33. III. Sur ce qu’on doit attendre de l’arret definitif du Parle- 
 ment au sujet de 1’inoculation, p. 69. IV. Notice des ouvrages qui 
 ont paru, depuis un an, pour ou contre 1’inoculation, p. 101. V. 
 Sur les trois dernieres assemblies de la Facuite de Medecine, etc., 
 p. 157. Paris, 1764. 
 
 de la Condamine: Memoires pour servir a l’histoire de l’in- 
 oculation de la petite verole, lus a l’Academie royale des sciences 
 en 1754, 1758 et 1765. 4°. Paris, 1768. 
 
 de la Condamine: Histoire de 1’inoculation. 2 vols. Amst., 1773. 
 Paris, 1776. 
 
 ( 45 ) 
 
de la Coste: Lettre a M. Dodart sur 1’inoculation de la petite 
 verole, comme elle se pratique en Turquie et en Angleterre. 1723. 
 Appendix: Sloane, Amyand. 
 
 Cotugni (D.): De sedibus variolarum syntagma. Viennse, 1771. 
 
 Cox (Daniel): A letter to a friend on the subject of inocula- 
 tion. London. 1757. 
 
 Cramer (A. G.): Curiosa variolarum per insitionem nostri 
 
 temporis prophylaxis, sive die Einpfropfung der Kinder-Blattern. 
 etc. Erfordi®, 1726. 
 
 Cramer and Joly (Geneve) : Lettre sur l’inoculation. Journal 
 de Neuchatel, aout, 1751. 
 
 Crantz (Henricus Joannes Nepomuc.) : Lettre a M. Tissot au 
 sujet de sa dispute avec M. de Haen. Vienna?, 1763. (G. 1763.) 
 
 Cremers (F. H.): Ostentationes excusationesque inoculatorum 
 super variolas simul cum Velsianis refutatae. 8°. Lovanii, 1778. 
 
 Cumenius ( E. J.): De praecipuis insitionis variolarum tutori- 
 
 arum in Finlandia factis. Pars prima. 4°. Aboae, 1817. Pars sec. 
 ibid., 1817. 
 
 Danemark: Le conseil de la raison; ou Lettre sur l'inoculation 
 de la petite verole. Copenhague, 10. mai, 1763. 
 
 Danneil (.J. F. ): Vergleich. der natiirl. und eingepfropften 
 
 Blattern. Quedlinburg, 1769. (Poem.) 
 
 D’Apples (Jacob): * Cogitationes problematic* de variolis 
 
 (etc.). Basle, 1724. 
 
 D’Apples (Jacob): Journal d’une inoculation de petite verole. 
 Act. helv. d. sciences 1765, VI, 194. 
 
 David (J. P. ): Observations sur la nature, les causes et les 
 effets des epidemies varioloques, et refutation de quelques ecrits 
 contre l’inoculation de la petite verole. Geneve, 1764. 
 
 Deering (C.) : An account of an improved method of treating 
 the sma.ll-pox. Nottingham, 1736. 
 
 Desmoncets (Pajon): Dissertation sur la petite verole et l'in- 
 oculation. Paris, 1758. (London, 1763.) 
 
 Desessartz, Portal and Le Roy (J. B.) : Rapport sur le projet 
 d’etablisseinent d’une maison d’inoculation, par le eitoyen Audin 
 Rouviere. 8° (n. p.), an V (1796). 
 
 Detharding (G. C.): Historia inoculationis variolarum (etc.). 
 4°. Rostochii (1722). 
 
 Dezoteux (F. ): Pieces justificatives des lettres concernant l'in- 
 oculation. Lons-le-Saunier, 1765. 
 
 Dezoteux (F.): Opuscule sur l’inoculation. P. L. M. D. Be- 
 
 sangon. 1765. 
 
 Dezoteux (F.) et Valentin (L.): Traite historique et pratique 
 de l’inoculation. Paris, an VIII (1800). 
 
 Dezoteux, Middleton, Maty: Lettres concernant l’inoculation h 
 Besangon. London, 1765. 
 
 ( 16 ) 
 
Dimsdale (T.) : The present method of inoculating for the 
 
 small-pox. London, 1767, 1769, 1772; Dublin, 1767, 1774; Phila., 
 1771. (G. 1768; I. 1768; F. 1772.) 
 
 Dimsdale ( T. ) : Thoughts on general and partial inoculation. 
 London, 1776. 
 
 Dimsdale (T.) : An introduction to the plan of the Inoculation 
 Dispensary. London, 1778. 
 
 Dimsdale (T.) : Remarks on Dr. Lettsom’s letter to Barker and 
 Stacpoole. London, 1779. 
 
 Dimsdale (T.): Tracts on inoculation. (St. Petersburg, 1768.) 
 London, 1781. 
 
 Dod (Pierce): Several cases in physic, etc. London, 1746. 
 
 (See Kirkpatrick.) 
 
 Van Doeveren (G.): Brief aan Edward Sandifort, behelsende 
 een bericht van den gelukkigen uitslag der inentinge der kinder- 
 pokjes, onlangs te Groningen ondervonden. 8°. ’s Gravenhage, 
 1770. 
 
 D’Origny: Examen de l’inoculation par un medecin de la faculte 
 de Paris. Paris, 1764. 
 
 Douglas (A.) : De variolse insitione. 8°. Edinburghi, 1775. 
 
 Dubourg (Jacques Barbeu) and consorts: Memoire a consulter 
 et consultation. Paris, 1768. Seconde memoire, 1768. 
 
 le Due (Antonio) : Dissertationes in novam, tutam, ac utilem 
 methodum inoculationis, seu transplantationis variolarum. Lug- 
 duni Bat., 1722. 
 
 Durand ( J. B.) : De variolarum inoculatione, 1791. In Lou- 
 
 vain Diss. 8°. Lovanii, 1796, IX, 354-359. 
 
 Duvrac (Louis): Est-il permis de proposer l’inoculation de la 
 petite verole? Paris, 1755. 
 
 Eggert (F. F. G.) : * De variis variolas inserendi modis. Lip- 
 sice, 1802. 
 
 Ehrhart (Theophil de) : Darstellung der Griinde fur und gegen 
 die Blatternimpfung; fur Leser aus alien Standen. Memmingen, 
 1789. 
 
 Eisen von Schwarzenberg (J. G.) : Die Blatter impfung erleich- 
 tert und den Miittern iibertragen, nebst Fortsetzung. Riga, 1774. 
 
 Eisner (C. F.): Ein paar Worte iiber die Pocken und die In- 
 oculation derselben. Konigsherg, 1787. 
 
 Enquiry (An) into the advantage received by the first eight 
 years’ inoculation. 12°. London, 1731. 
 
 de l’Epine (G. J.): Rapport sur le fait de l’inoculation de la 
 petite- verole. Paris, 1766. 
 
 Expositions on the inoculation of the small-pox and of the cow- 
 pox. 8°. London, 1805. 
 
 Eyerel (Jos.): Beitrage zur Geschichte der Kuh-und Kinder- 
 
 pocken. 8°. Wien, 1800. 
 
 ( 47 ) 
 
Ferguson (R.) : A letter to Sir Henry Halford, president of the 
 Royal College of Physicians, proposing a method of inoculating 
 the small-pox which deprives it of all its danger, but preserves 
 all its power of preventing a second attack. 8°. London, 1825. 
 
 Finke (L. L.): Specimen med. histor. sistens insitionis vari- 
 olar um in comitatibus Tecklaburgensi atque Lingensi exercitae. 
 4°. Lingae, 1792. 
 
 Flemming (C. A.): De inoculatione variolarum epidemico eon- 
 tagio varioloso longe praeferenda. 4°. Vitebergae, 1798. 
 
 de Fleury, Maitre (Omer Joly), avocat du Roi: Arrest de la 
 
 Cour de Parlement sur le fait de l’inoculation. Paris, 8 juin, 1763. 
 
 Forbes ( J.) : Some account of the small-pox lately prevalent in 
 Chichester and its vicinity. Lond. Med. Reposit., Sept. 1822, p. 
 218. 
 
 Frewen (T. ): The practice and theory of inoculation. London, 
 1749. 
 
 Frewen (T.) : De insitione variolarum. Sm. 4°. Traj. ad 
 
 Rhenum, 1755. Also in Haller: Disp. ad morb. (etc.). 4°. 
 
 Lausannae, 1758, v, 683-694. 
 
 Frewen (T.) : Some reasons given against an opinion that a 
 person infected with the small-pox may be cured by antidote with- 
 out incurring the distemper; with an attempt to explain the 
 manner of the propagation and eruption of the small-pox from the 
 practice of inoculation. 8°. London, 1759. 
 
 Frua (C.) : II pus del vajuolo umano spontaneo riprodotto tra 
 gli nomini per alcuni successivi processi di innesto (etc.). 8°. 
 
 Milano, 1850. 
 
 Further hints about inoculation. 8°. Gentleman’s Magazine, 
 London, 1752, XXII, 511-513. 
 
 Gale ( 33 . ) : Historical memoirs. London, 1765. (Phil. Tr.) 
 
 Gandini (C.) and Pizzorno (P. F.): Orazione eccitatoria all’ 
 introduzione dell' innesto del vajuolo. Lucca, 1759. 
 
 Gandoger de Foigny (P. L.): Traite pratique de l'inoculation 
 (etc.). Nancy, 1768. 
 
 Gardane (J. J.): Observations sur la meilleure maniere d’in- 
 oculer la petite verole. Paris, 1767. 
 
 Gardane ( J. J.) : Le secret des Suttons devoile ou l’inoculation 
 mise a la portee de tout le monde. La Haye and Paris, 1774. 
 (G. 1775.) 
 
 Gatti (A.): Lettre a M. Roux. Paris, 2 aout, 1763. 
 
 Gatti (A): Reflexions sur les prejuges qui s’opposent aux pro- 
 
 gres et a la perfection de l’inoculation. Bruxelles, 1764. 
 
 Gatti (A.) : Nouvelles reflexions sur la pratique de l’inoculation. 
 Paris, 1767. (E. 1768, G. 1772 and 1782, It. 1768.) 
 
 Gaubius (H. D.): De inenting der kinderpokjes gedaen, en ter 
 voller herstellinge toe behandelt. Zee Hollandse Matschappy de 
 Weetenseliappen te Harlem, 1755. 
 
 (4S) 
 
Gaubius (H. D.) : Lettre a la Faculte de Paris sur 1’inoculation, 
 21 nov., 1763. de l’Bpine rapport, p. 12. 1766. 
 
 Gaullard fils: Lettre apologetique a M. M., medecin; pour servir 
 
 de reponse §. la lettre de M. de la C(ondamine), inseree dans le 
 Mercure du mois de mars, 1760. 8°. (Paris, 1760.) 
 
 Genees- en Heelkundig Gezelschap te Rotterdam: De innting 
 
 der kinderpokjes in hare groote voordeelen aangewezen nit eene 
 vergelykinge derzelven met die door den natuurlyken weg komen. 
 8°. Rotterdam, 1757. 
 
 Van Ghert (A.) : Het verschil tusscben . . . der med. doctor, en 
 tusschen F. H. Cremers der med. licent., naamentlijk, of den jon- 
 gen beer Cassa na de inenting der pokken die andermaal door de 
 natuurlijke weg heeft bekoomen? 8°. Breda, 1771. 
 
 Giese (J. R. ) : Untersuchungen warum eingeimpfte Pocken eine 
 
 gelinde Krankheit verursachen. Miinster, 1790. 
 
 Glass (T.) : A letter to Dr. Baker on the means of procuring a 
 distinct and favorable kind of small-pox (etc.). London, 1767. 
 
 Glass (T.) : A second letter to Dr. Baker on certain methods of 
 treating the small-pox during the eruptive state. London, 1767. 
 
 Gleize (D.) : Imminens a variolis periculum, ab inoculatione 
 
 tuto profligari cui methodo palma debeatur? 4°. Arausione, 1784. 
 
 Gloucester (Bishop of): Sermon on inoculation. (1764.) 
 
 Gmelin (S. T.) : An achorum insitio, imitando variolarum in- 
 sitionem, pro curandis pueritis morbis rebellibus tuto tentari 
 possit. 4°. Tubings, 1762. 
 
 Goetz ( J. T.) : Traite complet de la petite verole et de 1’in- 
 oculation, etc. 16°. Paris, 1790. 
 
 Grassot: Memoire et observations sur la methode d’inserer la 
 petite verole. Bruxelles (1764). 
 
 Greding (C. G. ) : Epistola de primis variolarum initiis ear uni- 
 
 que contagio virulento. 4°. Lipsis, 1781. 
 
 Greenhill: Occasional letters on the practice of inoculation. 
 
 Guildford and London, 1767. 
 
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 (49i 
 
Haen (Ant. de) : Ad Balthasaris Ludovici Tralles epistolam 
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 ( 50 ) 
 
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 ( 51 ) 
 
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 (52) 
 
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 de la Llena (Jac. Menos) : Memoria contra la inoculacion, 
 
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 ( 53 ) 
 
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 (54) 
 
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 (55) 
 
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 (56) 
 
t 
 
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 (57) 
 
Remarks on Dr. Some’s ease of receiving the small-pox by in- 
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 Rosen von Rosenstein (Nils) : Underattelser om barn-sjuk- 
 
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 Rotterdam (Drs. v. Leempoel, Vink, de Bruas, de Monchy, 
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 Sammlung merkwiirdiger Erfahrungen iiber den Werth und 
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 (58) 
 
Schaeffer (J. U. G.) : Versuch einer Theorie deY euglischen 
 
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 Schinz (S.) : Sendschreiben an Herrn Anton von Storck. Ueber 
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 ( 50 ) 
 
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 ( 60 ) 
 
Tissot (S. A.): L’inoculation justifiee on dissertation pratique 
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 ( 61 ) 
 
Vieusseux (G.): Traite de la nouvelle maniere d’inoculer la 
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 12.) 2. and 3. ed. London, 1722. 
 
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 Watson (W. ) : An account of a series of experiments, instituted 
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 Watson (W. ): The same. Het nut in de veiligste wyze van de 
 inenting der kinderpokjes beschouwd in het verhaal van eene 
 reeks van proefneemingen. 8°. Amsterdam, 1769. 
 
 Watts (Giles) : A vindication of the new method of inoculating 
 the small-pox, against the arguments and objections of Dr. Lang- 
 ton and Mr. Bromfield, etc. London, 1767. 
 
 Way (N.): De variolarum insitione. 8°. Philadelphia, 1771. 
 
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 Whitte: Historiam contagii ab inoculatione, annis 1750, 1751. 
 
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 velle. La Haye, 1768. 
 
 Williams (P. ): Some remarks upon Dr. Wagstaffs letter 
 
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 Wolf (J. H. K. ): Die Pflicht, durch die Einpfropfung der 
 
 kiinstlichen, den natiirlichen Blattern zu entgehen. Griinstadt, 
 1768. 
 
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 1796. 
 
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 der Blattern. Hanover, 1724. 
 
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 London, 1779. 
 
 ( 62 ) 
 
Wrisberg (H. A.) : De insitione variolarum, etc. Goettingen, 
 1765. 
 
 Wrisberg (H. A.) : Beitrag zur Pockengeschichte. 1 Theil. 4°. 
 Goettingen, 1770. 
 
 Zadig (A.): Plan, nacb welchem die Einimpfung der Pocken 
 in einer ganzen Provinz allgemein eingefiihrt, und die langst 
 gewiinscbte Ausrottung der Seuche erreicht werden konnte. Bres- 
 lau, 1797. 
 
 II. America xa. 
 
 Boylston ( Z. ) : Some account of what is said of inoculating or 
 transplanting the small-pox by the learned Dr. Emanuel Timonius 
 and Jacobus Pylarinus. With some remarks thereon. To which 
 are added, A few queries in answer to the scruples of many about 
 the lawfulness of this method. Boston, 1721. 
 
 Boylston ( Z. ) : An historical account of the small-pox inocu- 
 lated in New England, etc. London, 1726. Repr. Boston, 1730. 
 
 Colman (Rev. Benjamin) : Some observations on the new 
 
 method of receiving the small-pox by ingrafting or inoculating. 
 Boston, 1721. 
 
 Colman (Rev. Benjamin): A narrative of the method and suc- 
 cess of inoculating the small-pox in New England. By . . . with a 
 reply to the objections made against it from principles of con- 
 science. In a letter from a minister at Boston (Rev. Wm. Cooper). 
 To which is now prefixed an historical introduction by Daniel 
 Neal. 8°. London, 1722. 
 
 [Cooper (W.)]: A reply to the objections made against taking 
 the small-pox in the way of inoculation from principles of con- 
 science, in a letter to a friend in the country. By a minister in 
 Boston. 3d ed. 8°. Boston, 1730. Dutch, Rotterdam, 1792. 
 
 Douglass (W.) : The abuses and scandals of some late pamph- 
 lets in favour of inoculation of the small-pox, modestly obviated, 
 and inoculation further consider’d in a letter to A. S., in London. 
 (With postscript.) 8°. Boston, 1722. 
 
 Douglass (William) : Inoculation of the small-pox as practiced 
 in Boston, considered in a letter to A(lexander) S(tuart), M. D. 
 and F. R. S. (dated Dec. 20, 1721). Boston, 1722 (Jan. 13). 12°. 
 
 Douglass (William): A dissertation concerning inoculation of 
 
 small-pox (etc.). Boston, 1730. 
 
 Faithful (A) abridgement of two accounts in the Philosophical 
 Transactions (on the inoculation for small-pox, by Dr. Emmanuel 
 Timonius and Jacobus -Pylarinus, Venetian consul at Smyrna). 
 12°. (Boston, n. d.) Repr. from Phil. Tr., 1700-20. London, 
 1721, v. 
 
 Faithful (A) account of what has occurred under the late ex- 
 periments of the small-pox managed and governed in the way of 
 inoculation. Published partly to put a stop unto that unaccount- 
 able way of lying, which fills the town and country on this 
 
 (63) 
 
occasion; and partly for the information and satisfaction of our 
 friends in other places. Boston (Gazette, no. 101), Oct. 30, 1721. 
 (Ascrib. by Fitz, 321, to Boylston, by Kittredge, 460, to C. Mather.) 
 
 Franklin (B.): Some account of the success of inoculation for 
 the small-pox in England and America. Together with plain in- 
 structions by which any person may he enabled to perform the 
 operation and conduct the patient through the distemper (by 
 Wm. Heberden). 4°. London, 1759. 
 
 Friendly (A) debate; or, a dialogue between Academicus and 
 Sawny and Mundungus, two eminent physicians, about some of 
 their late performances. (Feb. 15, 1721-2.) 12°. Boston, 1722 
 
 (by Isaac Greenwood). 
 
 Friendly (A) debate; or, a dialogue between Rusticus and Acade- 
 micus about the late performance of Academicus. 12°. Boston, 
 1722. 
 
 f Greenwood (Isaac) ] ; A friendly debate, or a dialogue between 
 Academicus; and Sawny and Mundungus. Boston, 1722. 
 
 Hamilton (Alex.) : A defense of Dr. Thomson’s discourse on the 
 preparation of the body for small-pox. Annapolis. Philadelphia, 
 1751. 
 
 Imposition (The) of inoculation as a duty religiously consid- 
 ered in a letter to a gentleman in the country inclined to admit 
 it. Boston, 1721 (Jan’y 1, 1722). 
 
 Kilpatrick ( J. ) : An essay on inoculation, occasioned by the 
 
 small-pox being brought into South Carolina in the year 1738. 
 London, 1743. 
 
 Letter (A) from one in the country, to his friend in the city 
 (Dr. Francis Archibald); in relation to their distresses occa- 
 sioned by the doubtful and prevailing practice of the inoculation 
 of the small-pox. Printed for . . . Nicholas Boone . . . and John 
 Edwards . . . Boston, 1721. 12°. 
 
 Letter (A) to Dr. Zabdiel Boylston; occasion’d by a late disser- 
 tation concerning inoculation (by Dr. Wm. Douglass), printed at 
 Boston. 8°. Boston, 1730. 
 
 MacLeane (L) : An essay on the expediency of inoculation and 
 the seasons most proper for it. 12°. Philadelphia, 1756. 
 
 Mather (Cotton) : “ Curiosities of the small-pox.” A. L.. July 
 12, 1716. Letter 10 to Dr. Woodward (11 curiosa Americana) for 
 R. S. (orig. draught and covering letter in poss. of Mass. Hist. 
 Soc. ). Fair copies missing. Not printed. Contemporary tran- 
 script among Sloane MSS. Brit. Mus. (First mention of negro 
 inoculation.) K. 
 
 Mather (Cotton); Address (letter) to the physicians of Boston 
 (June 6, 1721). A. L. not printed, lost. K. 
 
 Mather (Cotton); A vindication of the ministers of Boston, 
 from the abuses and scandals lately cast upon them, in diverse 
 printed papers. By some of their people. Boston, 1722. K. 
 
 (64) 
 
Mather (Cotton) : A letter to a friend in the country, attempt- 
 ing a solution of the scruples and objections of a conscientious or 
 religious nature, commonly made against the new way of re- 
 ceiving the small-pox. By a minister of Boston, 1721 (Nov. 20). 
 K. 
 
 Mather (Cotton): The Angel of Bethesda. MS. A. A. S., Chap, 
 xx, 134 negro inocul., 135-140 summary of Timonius and Pylari- 
 nus, 140-141 etiology (probably identical with “ Address,” not 
 printed, but ready Feb. 20, 1724.) K. 
 
 Mather (Cotton): Sentiments on the small-pox inoculated. 
 
 (Publ. Nov. 23, 1721.) On single fol. sheet together with Increase 
 Mather’s “ several reasons.” See parody of “ Sentiments ” in 
 New Engl. Courant, Nov. 27, 1721. K. 
 
 Mather (Cotton) : An account of the method and success of 
 inoculating the small-pox in Boston, New England. In a letter 
 from a gentleman there to his friend in London (Jeremiah 
 Dummer). London. Printed for J. Peele at Locks Head in 
 Paternoster Row, MDCCXXII (1722). Dated at the end “ Boston 
 in New England, Sept. 7, 1721.” Dedicated “ To Sir Hans Sloane, 
 Pres., and to the rest of the Coll, of Phys.” Signed “ Jer. 
 Dummer.” K. 
 
 Mather (Cotton) : Letter to Dr. John Woodward, March 10, 
 
 1721/22. A. L. (contemporary copy) in Sloane MS. 3324, fol. 
 260 (quoted by Jurin to Cotesworth, 1723, and by Douglass in 
 Dissertation, 1730). Not printed, K. 477; perhaps in some London 
 newspaper. (The curiosa variolorum in M.’s catalog and Diary.) 
 K. 
 
 Mather (Cotton) : The case of the small-pox inoculated; further 
 cleared. To Dr. James Jurin (sent probably May 21, 1723). Dated 
 May 4, 1723. Mather’s only draught in A. A. S., another copy 
 in Arch. R. S., 4 to 11 pp., same title; dated May 21, 1723; not 
 autograph, but signed and dated by Mather. K. 
 
 Mather (Increase) : Some further account from London of the 
 small-pox inoculated. 2d ed. (Appearance), Boston, 1721/2. K. 
 
 Mather (Increase): Several reasons proving that inoculating 
 or transplanting the small-pox is a lawful practice, by . . . 
 (Single fol. sheet with second piece attrib. to C. Mather; “ Senti- 
 ments.” Publ. Boston, Nov. 23, 1721.) K. 
 
 Morgan (John) : A recommendation of inoculation according to 
 Baron Dimsdale’s method. 8°. Boston, 1776. 
 
 Newman (H.) : Way of proceeding in the small-pox inoculation 
 in New England. (Phil. Trans. London, 1722, xxxii, 33. (As- 
 cribed to Cotton Mather by Kittredge.) 
 
 Rush (B.) : The new method of inoculation for the small-pox; 
 delivered in a lecture in the University of Philadelphia, Feb. 20, 
 1781. 12°. Philadelphia, 1781. German, Anspach, 1723. 
 
 ( 65 ) 
 
Rush (B.) : An account of a case of small-pox after variolous 
 inoculation. Phila. Med. Museum, 1808, v. 183-187. 
 
 Thomson (Adam) : A discourse on the preparation of the body 
 for the small-pox, and the manner of receiving the infection. 
 Philadelphia, B. Franklin and D. Hall. 1750. 
 
 Vindication (A) of the ministers of Boston, from the abuses 
 and scandals lately cast upon them in diverse printed papers. 
 By some of their people. 12°. Boston, 1722. 
 
 Williams (John) (al. Mundungus) : Several arguments prov- 
 ing that inoculating the small-pox is not contained in the law of 
 physick, either natural or Divine, and therefore unlawful. To- 
 gether with a reply to two short pieces, one by the Rev. Dr. In- 
 crease Mather, and another by an anonymous author, intituled 
 “ Sentiments on the small-pox inoculated,” and also, “ A short 
 answer to a late letter in the New England Courant.” By . . . 
 Boston. Printed and sold by J. Franklin, 1721 (probably Dec. 
 4, K.). 
 
 Williams (Nathaniel): The method of practice in the small- 
 pox with observations on the way of inoculation. Boston. 1752. 
 
 Williams (Nathaniel): The same. Taken from a manuscript 
 of the late Dr. ... of Boston, N. E., published for the common 
 advantage, more especially of the country towns who may be 
 visited with that distemper. 12°. Boston, 1752. 
 
 Ill Recent Literature. 
 
 Behrend (Gustav): Ueber Variolation. Ein historischer Riick- 
 blick bei Gelegenheit der Hundertjahrsfeier der Entdeckung Ed. 
 Jenner’s. Deutsch. med. Wchnschr. Berlin, 1898, No. 20. 
 
 Bohn (Heinrich): Handbuch der Vaccination. Leipzig, 1875. 
 
 Boing (H.): Neue Untersuchungen zur Pocken- und Impf- 
 
 Frage. Berlin, 1898. 
 
 Bradley: Inoculation for small-pox in Siam. Bangkok Calen- 
 dar, 1865 (quoted in Health Officer H. C. Highet’s report of year 
 R. S. 127, i. e., 1908-9, xii, 12; also Paul G. Woolley in paper Sect, 
 vi of xv Int. Congs. Hyg., 1912). 
 
 Creighton (Charles): A history of epidemics in Britain. 664 
 A. D.-1893 A. D. London, 1891-94. 
 
 Daniels (Dr. C. E.): De Kinderpok-inenting in Nederland, 
 
 marendeels naar onuitgegeven bescheiden bewerkt. 1875. (Neder- 
 landsch Tydsclirift voor Geneeskunde, 2e Reeks II, p. 52.) 
 
 Ebstein (W.) : George und William Motherby in ihren Bezie- 
 hungen zur Variolation und der Kuhpockenimpfung. Arch. f. 
 Gesch. d. Med., Leipzig, 1911, iv, 31. 
 
 Fitz (Reginald H.): Zabdiel Boyston, inoculator, and the epi- 
 demic of small-pox in Boston in 1721. Johns Hopkins Hosp. Bull. 
 Bait., 1911, xxii, 31-327. 
 
 ( 66 ) 
 
Grandivilliers (A. N.): Essai historique sur l’inoculation de la 
 variole. 4°. Paris, 1854. 
 
 Kittredge: Some lost works of Cotton Mather. Mass. Hist. Soc. 
 Proc., Feb., 1912, pp. 418-479. 
 
 Krul (R.) : De enting der ware pokjes, de variolatie, herdacht. 
 (Geneesk. Courant. 7. Mei 1904.) (Inoculation of true small-pox, 
 variolation recalled.) 
 
 Kiibler (P.): Geschicbte der Pocken und der Impfung. (Bib- 
 liothek v. Coler., v. 1.) Berlin, 1901. 
 
 Kussmaul (A.): Zwanzig Brief e iiber Menscbenpocken- und 
 
 Kuhpocken-Impfung. Freiburg i. Br., 1870. 
 
 Monteils (E.) : Histoire de la vaccination. Montpellier and 
 
 Paris, 1874. 
 
 Morat (E.) : * Etude sur les idees et les faits relatifs au virus 
 
 variolique au XVIII. siecle. Paris, 1911. 
 
 Neveux: Inoculation a l’bomme de la pustule de variole du 
 
 singe. Bull. soc. path, exot., Paris, 1910, III, 497. 
 
 Osborne ( J. ) : Success of inoculation in Boston. London, 1722. 
 (Phil. Tr.) 
 
 Pfeiffer (L.) : Litteraturgeschichte der Blattern- und Kuh- 
 
 pockenimpfung. I. Blatternimpfung. fob (Weimar, 1863, vel 
 subseq.) 
 
 Pfeiffer (L.) : Zur Jennerfeier des 14. Mai 1896. Medaillen, 
 Portrats und Abbildungen, betreffend E. Jenner, die Variolation, 
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