ACCOUNT OF THE iNT RODUCTIO ' OF TKfi COW POX iNtO INDIA. f aiNTBD By M0R03A DAMOTHERJEE Prabhoob^ 1803* (SI r X HE following account of the fuccefsful iiitrodudtion of the vaccine difeafe into Bom- bay, and its diifufion throughout India, is ref- pecSfully infcribed to the HONORABLE JONATHAN DUNCAN, to whofe humane andzealous interpofition, the Indian worldare effentially indebted for the bleffings that have already marked the progrefs of vaccination, as well as for the incalculable benefits that mud ultimately arife from it, to every quarter of the Eritifli Dominions in Afia. By his Very Obdt. Humble Servt, ^ GEORGE KEIR, MED.CHTR.SOC. ^ ABERDEEN. Digitized by the Internet Archive in 2013 http://archive.org/details/accountofintroduOOkeir ACCOUNT OJ" THE INTRO DV Ct 10 N OF THf COW POX INTO INDIA. ^' JL^HE principal objeS in view in colletfting the following reports, after tracing from authentic do- cuments the hiflory of the introdu(5lion of the difcafc into this country, is co enable Gentlemen in the Cotp- pany*s fervicc to propagate it in different fitua- lions, where they are frequently employed at a diftance from Medical men, In doing this, forae apology may be neceffary for making ufc of the corrcfpondcnce of different Gfendcmen without their permiirioni and for omitting to take notice of many valuabk^od important letters on this fubje^l, which would have encrcafcd the fize of this pamphlet beyond th^ limits allotted to it, and could not have ^nfwered any good purpofe, as the objc<5l is to pre- fent to tjie public a ihorc acpoqnc of the introdu£lion of the difeafe Into Afia, which at a future period may be interefting. The Human fpecies, whether in a (late of rude- nefs or civilization, may be confidered as inheriting the probability of fufFering once in their lives, from the influence of certain difeafes, occafionaily loath- fome, and frequently fatal. How much is confequently due to the man, whofe difcoveries confer a blelling on mankind, capable of heightening the enjoyments of life,, by fecuring it from thofc maladies by which it may be rendered. inif<^rable, or extinguished altogether. Such has been the late important dlfcovery of Dr. Jenner, fo joftly acknowledged by his country, and which cannot fail to tranfmit his name to pol- terity,as one of the greatelt benefactors of the Hu- man race. The pcrfeverlng zeal of Dr. Jenner has furmount- cd every difficulty, and he now enjoys the h^^arc-fclt fatibfadtion of obfcrving, that his endeavours to make the world acquainted with the lingular difeafe of cow-pox, has been attended with the dt fired fuccefs ; and that his dodlrines are as generally re- Gcivcd, as the importance of the Tub je«5l defer ves. There C 7 ] - There is no country where the fmall-pox proves lb great a fcourge as it docs in Indiaj owing to the climate, as well as the prejudices of the inha- bitants. In Europe, much had been accomplilhed by attention to a falutary regimen; here, the unhap-- py fufferer is often deprived of the chance there might be of his deriving benefit, from either re- gimen, or medical treatment. The beneficial confequences to be expelled from the communication of fo mild a difcafe as the cow- pox, in fubftitution of one fo generally loathfome and fatal to all ranks of men in India, are great beyond all calculation. The vaccine difeafe was Introduced at Bombay in June' 1802, and for fome months pad it has been difleminated throughout the Peninfula of India, the ifland of Ceylon, Bengal, the Malabar pro- vinces, and elfewhere; this affords a very facisfadory proof of the benevolent zeal of the medical facul- ty in India, and is certainly highly honourable to them. The difficulties which they daily experience at many ftations, in procuring fubjefts for continu- ing the difeafe, can fcarccly be judged of by Prac- titioners in Europe. Wedded to cuflom, and the ufages of their Anceftors^ the Natives of India view t « J view with diflruft and apprchcnfion every innoo vation, and few of them can yet be perfuaded thai a difcafc fo mild and harmlcfs as the vaccine af- fpCtiony can fhield their offspring from fo ferious a>nd deplorable a calamity as the variolous contagion. The account of Dr. JcnntT*s difcovery foon reached India, and excited in the mind o( every Profcfllonal man, the mofl: lively anxiety to be poffciTed of an agent reputed fo harmlcfs, and ca« pabic of fecuring mankind againit the Small Pox. It is very probable however, that the zeal and ciTorts of medical men might have been unavailing^ had not the inEuence of Government been intcr- pofed to forward their endeavours; this acknow- Itdgemerit more particularly applies to the Ho^ norable Jonathan Duncan Governor of Bombay^ He was early imprefied with a juft fenfe of the value of extending vaccination to India, and he judged that the mofl likely way to fecure the fpeedy com« pletion of fo defirable an object, would be to in- tereil His Majefries Minifter at Condantinople, to afford his co-operation, by direding virus to be forwarded from time to time for Bombay, by the way of Bagdad and BulTorah. The followhng correfpondencc on this interefting fubjecl will {hew how much we owe to Lord Elgin, and Mr, Duncan. ExtraSf E § \ Mxtra^i of a Letter from the Honorahle J, Duucaiti ' to His Eiccellency th^ Right Honorable, the Earl of Elgin, dated Bombay, March 2^th 1801. " I beg leave to avail myfelfof this opportuni- ty to requell your Lordfhip's kind attention to the accompanying Extrafl of my letter of this date, to Mr. Jones the Refident at Bagdad, and to folicic the favor of your caufing to be tranfmicted to that Genderhan, in one or two phials, and an equal number to mc dired to this place, fome of the frefh- cft and bed matter of the cow-pox, that may be procurable at Conftantinople or in the neighbour- hood, rcfpefling which, the Hon'ble Mr. Bruce willalfol believe, have written to your Lordfhip^ and I need only add that if we may rely on the ac- counts publilhed of the mild nature of the cow-pox^ Europic cannot beftow a greater favor on India^, than by the fubftitution of this benign contagious matter, to the very deflrudlive one, that now an^* nually carries off fo many of our inhabitants," ExtraB of a Letter from the Honorahle J, Duncan^ to H, Jones Efq, Refident at Bagdad dated Bom^ bayy 2^th March 1801. " If you could procure from Condantinople fomc of the matter of the cow-pox, fo carefully pu: up [ 10 ] up in phials, or any other fccure method, as to reach Bombay in a (late fit to give the infcdlion^ it woukl be rendering great benefit to India, where thoiifands now annually fall vidims to the ordinary kind. Perhaps to lecure the matter ar« riving here in a proper rtate, it may be expedient to have it renewed by inoculation at Bagdad: — but of this Mr. Short the Phyfician with you, muft be the beQ js-Jdge. Mean while, in aid of the endea- vours which I doubt not you will make to fo good an end as the prcfent; I have requeued the favor of his Excellency Lord Elgin, to countenance and affi[l whatever means, on your application, the Me- dical Gendemen at Conftantinople may judge the bcfl adapted to tlie fecuring of its tranlmiflion in the f>efhtft pradicabie ftate. I need not fuggeft that the matter of the cow- porw fnould not b^ tumigaredi as that dtftroys its virLUCj or rifles doing fo, as was experienced lately, in the indance of fome that the Hon'bie Mr. Bruce brought wich him to Bombay. '£xfratl cf a Letter frcm His Excellincy the Fight Ihnble tJie Earl of EAgin^ lo the Hcn'bk Jona- than DunCiVi fjq. djted ^ifi July iSoi. ] liavc t!iis mDiiifnt the honor of receiving your Letters oi the and 25th tf March, and tho' C " 3 Cho' it is ImpofTible for me to anfwer them by the prefcnc occafion; yet I am anxious to aiTure you, without delay, of their arrival. 1 lhall pay early at- tention to your wi(he3 — and in a particular manner to your defire of receiving the cow-pox m:^-tcer. The difficulty of conveying the infcftion, rendered abortive feveral attempts 1 have made this fpring, to bring it here. But as I have direded, that fome fhould be fencto me from Vienna by every poff, I hope to have ic in my povver to con vey to you iome €re long, E^'tracl of a Letter from Lcrd ^-Ig^n^ to the Honble Jonathan Dune an ^ dated '6th Sept, j 3oi. I have the honor to inclofe you one quill, con- taining vaccine marrer, I do this merely, in die vicv/ , of attempting every thing— Hut my great hopcs^ arj thro' Mr. Maneilvj — I had fcnt him the rnartcr lad year which failed; — But have now faiily trila- blifhed it at Confrantinoi.^k-', and the bell proof I can offer of its mildncfs is. that 1 have ip.ocul.ued my child, on the 6ch of Septembtr, cho* only born on the 3 I ft of Augult. I have had the marre- put up by Dr. Scott, a very able Phyrici;jn in rny family, in various fnaj^es, and with every polfible degree of care^— this I h:^ve [ 12 3 fcnf to Mr. Manefty, with directions for Km to proceed in his experiments with thefe lancets &c. until the difeafe takes at BufTorahi then to fend forward to you, what remains of them, together with fome frefh matter from Bufforah, with a Book lately pubiifhed at Vienna, on the hidory and nature of the vaccine. I fincerely trufl, that thefe means will be effedlu- al in extending fo innapreciable a benefit, to your part of the world. Extra^f of a Letter from the Hon'hle Jonathan Dun-- can EJq, to His Excellency the Earl of Elgin ^ da^ ted Bombay ^th February 1802. *^ I have the honor to acknowledge your letter of the 8th of September refpedting the vaccine mat- ter, which I received, but on the trial, it has failed, as was indeed, to be apprehended from the length of its pafTage, fince it did not reach me till the 3 id Decemberi — I think it very probable, that the me- thod your Excellency has propofcd to Mr. Ma- nefty, may prove more fuccefsful, and in that cafe your Excellency will indeed have proved the me- dium of conferring an ineilimablc benefit on India.'' It was not however by fca only that cfForts were piade to get the cow-pox to India, as the following letter t '3 ] letter from the Medical Board, and the recomm*-!!- dation of Government to the Court of Dirc-tora will fhow. Copy of a Letter from the Medical Board, datei Bombay, Atigufi ^ih 1801, to the lionhk % Dune an, ^c. ifc, HoN*BLE Sir, The late very happy difcovery that the difeafc produced by inoculation from the cow-pox, fe- cures the human body, ever afcerwards, froai ciie fmall, akhough of great importance in Europe, jlioukl we imagine, beoflliii more conlequence ia this country. The fmall-pox from inoculation, is certainly here, a much more dangerous difeafe than in Europe; for a greater proportion die of it, and of thofe who cfcape, great numbers fufFer feverely from it. We think that one third of thofc who get the difeafe naturally, are deftroyed by it; at times indeed, ic appears under a much milder form, but occafional- Jy, the mortality from it is fiiil more deplorable. From what we have faid, it will be evideiu that a difeafe like the cow-pox, would be a great blciTing to this country, and we have reafon to believe ^hac the natives from thcii prejudices in favour of the [ 14 ] (he cow, wouH generally communicate it to theif children; *hic]i will never be the cafe with regard to the fmall-pox. Several attempts have already been made to bnng the cow-pox to India, but without efFcdl, for the maitcr on its arrival here, has not been found to communicate the difeafe: we are under particu- lar obligations on thisfubjefl, to Mr. Barclay Apo- thecary of London, who got, unfoiicired, the mat- ter of cow-pox, and fent it to Portfmouth to Mr. Forbes, Surgeon of the Lord Hawkcfoury; beg- ging of him to inoculate with it during the pafiage, and by that means to carry it to India, in a recent fiate: Mr. Forbes on his part was not wanting in every attention; for foon after he received it, he inoculated feveral perfons on board of the fhip, but he was not able in a fingle inftance to produce the difeafe. The plan recommended by Mr. Barclay feems very judicious, and if a fufficient number of people vvho never had the fmall-pox, were fent in a fhip, we imagine it could hardly fail of fuccefs, perhaps it migliE be proper to lend fomc cows with the fair.e intenuon, k might alfo be defirable to have the matter of cow-pox feni fi'om Conilantiooplc to our Surgeon at t 's 3 -at Bagdad, who would inoculate with k, from v;hence it might be carried to the Surgeon of Buf- forah, and finally with a prolpedl of fuccefs, to this place. In order to encourage excrdon, it might be jh-o-^' per to offer fome reward to the perfon who fbould fird bring this difeafc to India. The influence that the cow-pox may produce on chc happincfsand the life of fo great a fociety of mankind, is of fo much importance, that wc can- not doubt but your Hon'ble Board will be ready lo forward all our wifnes for its introdudion into India, W. MOIR. H. SCOTT. Extras of a Letter from the Ihmrahle the Governor in Council of Bombay , to the Honorable the Court cfDireSlorsy dated Augujti^tb i8oi. Para. 55. We have the honor to enclofe Copy of a Letter from the Medical Board relative to the vaccine pox, on which we have earneflly to folicit your Hon'bk Court's alfiftance for the fecure tranf- miflicn of the matter to this country, in the manner • fuggefted h f them, or in any other, that may ap^ pear to your Hon'ble Court flili more efficacious and likely, to fucceed. [ '6 ] Para. 56. Our Prcfidcnt has written on the fame fubje^l, to the Earl of Elgin, and the Rcfi- dents at BufTurah and Bagdad, have alfo, been in f- trufied by our Secretary to the effecl of the Me- dical Board's further recommendations. J. A. GRANT, Secretary to Gonjernment, His Excellency Lord Elgin readily gave every fupport to the requeft of ihe Governor of Bombay. He dire6lcd vaccine virus to be forwarded froai time to time, to Mr. Jones the Hon'ble Company's Refident at Bagdad. The Surgeon attached to that Refidency Dr. Ja- mes Short, was particularly qualified to attend to fo intcrefting a fubjed, and early in the year i 802, for- tunately fuccecded in producing the true vaccine difcafc at Bagdad. Dr. Short loft no time in forwarding virus to our Surgeon at the Refidency of BufTorah Mr. Milne ; who alfo was fortunate in eftablifhing the difeafc at that place. It was peculiarly lucky that fuch men as Dr. Short, and Mr. Milne, had the management of the difeafc at Bagdad and Bufibra, and the public owe thefc [ 17 ] fhefe Gentlemen no tri filing obligation for theif care and zeal in preferving the difcafe under many very difcouraging circumftances. Mr. Milne was aware of the importance of fpeedi- ly fending on matter for Bombay, which he did by i ' every opportunity that offered. For fome time however we were not more fortunate with the vari- ous fupplies we received fiom Mr. Milne, than mih feveral packages which were at different pe*» riods fent to us from Europe, I y fea conveyances. One of the mod important fteps that the vaccine matter made was from Conftantinople to Bagdad^ altho' the diftance is a journey of from 25 to 30 days. From Bagdad to Bufforah the diftance is much fliorter, fo that Mr, Milne received it in a few days, and was lefs likely to fail in fuccecding with ic© The next difficult ftep, perhaps the moft difficult of the whole, was to produce it in Bombay, after a fea voyage, and after it had been kept for weeks before we could ufe it. This will account for the many failures that we experienced before we were fuceefsfuL The Recovery left Bufforah late in May^ and as she feafon was favorable for making a quick paf-» [ '3 1 fagc, reached Bombay m three weeks. Captnia Groube brought from Mr. Milne fupplies of vi- rus carefully put up in diuerenc ways^ — On our re- ceiving ic, between 20 and 30 fubje^bs were inocu- lated with the threads impregnated with the virus^ in various modes, and by different Surgeons. Only one indance of fuccefs occurred in all thofc inoculated. Anna Dufthall, the Child of a female fervanc belonging to Captain Hardie, was inocula- ted by Dr. Scott on the 14th of June, with many others; Anna was about 3 years of age, healthy, and certainly never had had the fmail pox. She was remarkably good tempered, and to her quictnefs and patience in fulFei ing the operation, its fuccefs is in fome meafurc to be attributed. The puftule beg:in to fliow itfclf about the end of the 3d diy, afterwards ilie had flight fymptoms of fever, and fome drgrce of fwelling and uneafmcfs in the axillary ghmds : thrfe lymptoms gr.ve us hopes, and led us to watch the progrefs of the dif- eafe v.'ith careful anxiety. On the bih day, the pullule was of the proper lize, it was raifcd and Sat, and confined of many cells, which on being punc- tured, gave out a traniparent fluid. This [ '9 ] ■ This circumftance, if any evidence had bft*n ne» ceiBry to convince us of the genuine nature of the difcafc was deciOve. It was now certain ^hac we were in poflciTion of the Cov/-pox, snd that our h^rretofore fruitlefs endeavours were crowned whh fuccefs. There was only one puftule on the inoculat- ed fpot, nor did the child fuffer any material incon- venience during the whole progrefs of the complaint. On the 22d of June, the 8th day of the difcafe, five children were inoculated with virus from cl-.e puftule; thefe fubjedts were all aifecled in the fa^pe way, and as the local, and conftitutional fyniptoir.s were fitnilar in ail of them, every medical nlan v/ho examined the pudule, was decidedly of opinion, rr.ac the difeafe we had produced Vv'as of a genuine na- ture. The following Letter was vow pihlifhed hy the Me,*^ dical Bo'ird for general informatiGn, To The EDITOR of the BOMBAY COU- RIER. For the fatisfacllon or the public, and the infor- mation of profeflional men in India, we beg of yoti to publifh the following account of the intr:Kiuction of the Cow pox into this place. \Vc have it now in our power to commuaicaie the benefit of this impo.tariC [ 20 ] important difcovery to every part of India, perhaps to China, and the whole eaftern world. We fhall fpare no pains in accomplifhing a purpofe fo defi- rabk, by which one of the grcateft evils that has afflidled humanity, may be diminiflied in a great de- gree, or even extinguilhed altogether. In the courfe of the lad twelve monchs, we have repeatedly received by fea from England the vac- cine matter, with which many children have been inoculated to no purpofe. We were not more fuc- cefsful with matter which was fent to us diredlly by ]and from Conftantinople. Fortunately Dr. Short, ^ Surgeon on this Eftablilhment, refiding at Bagdad, produced the difeafe at that place. He immediately forwarded the matter to Buflbra, where Mr. Milne, the Surgeon of that Refidency, alfo fucceeded in infedling a patient with itj — Mr. Milne foon afterwards inoculated a number of other chil- dren, and he fent the vaccine matter to us by fe- veral fhips. Even with this matter, we were for a time unfuccefsful, and after thirty or forty trials by various methods and by different Surgeons. A fortunate inoculation at length produced the vac- cine difeafe in Anna Dullhall, who is perhaps the firft human being who underwent it in India. This child, the daughter of afervant of Captain Hardie, is r 21 ] is about three years of age. She is very healthy, and certainly never had the fmall pox. It is necef- fary to mention thefe circuaiflances, as from her alone the whole of the matter that is about to be fenc all over India was at firfl: derived. We have received no hiflory of the patients from whom it was taken at Bagdad and Buffora, but v/e trufl: with confidence, from our knowledge of the medical gentlemen at thofe places, that no pains have been fpared to make it pafs thro, unexcepii- onabie bodies. From Anna Dufthall, on the 8th day of her dif- eafe, and on the 2id of laft month, leven children were inoculated: five of tliofe, who certainly never had the fmall-pox, took the infecflion, and have al- ready gone thro* nearly the whole courfc of the vaccine difeafe. The other two were not infeded, but there is fome probability that one of them has had the fmall-pox. From the five children that were infefled, about thirty more have been inocu- lated, and a great number of them no doubt will take the difeafe. From thefe lafc we Oiail fejid the vaccine matter to the other Prefidencies, to Surat, Poona, tec. &c. and care •hali ; e taken tliac none (hall be employed, but frooi an uaexceptior.abla fource. The C " I The vaccine difeafe in Anna Dudhall pafled, we have faid through its ordinary courfe, as defcri- bed by writers on the fubje6t. The pufcule began to-fnovv iffeiraboL'!: the third day. During the courfe of the fifth and fixth, fhe had flight fymptoms of fe- ver, and fbme nneafinefs in the arm-pit of the ino- eolatcd fide. The puftule on the 8th day, was of the proper fize for that period. It was fiat and rather concave, and it confiiled of rnany cells, which on being pricked gav'e out a tranfpafent fluid. By the tenth day, the inflamed aredia ronnd the puflule was extenfjve, and very difl:In6l in fpite of the blacknels cf her fldn. She had only a fingle pudule on the inoculated part, nor during the whole time did fhe faffer any oiaterial inconveniency fforn the cofu- plaint. All the five children who were inoculated from ker had a flmilar train of fymptoms. On two of then?,, whofe parents were European, the inflamed areola, from the whitenefs of their fkins, was much more diflinfl: than it had been on Anna Dufl;halL We have thus detailed the progrefs of the fympw ton:»s, and vie have no doubt but that this is the genuine Cov/-pojc. Some Surgeon:, here who have fecn diedilearcin Eusope^aic of the fame opinion. C 23 3 We hope dierefore, that this will tend to quiet thti apprchenfion^ of parents, which in fome indanccs we find to be very great, and that our experience at this place, fo far as it has gone, vvill give confidence to pra(5ticioners. Aim oft all the medical men at this prefidency have wicnefled this dileafe, many of thecn are inoculating for it, nor do we underfiand that any diSerence of opinion has arlfen concern- ing its nature. One teft indeed we want of its genuine na« ture, and that is, its power of preventing the vario^"' lous infection, to tills teft iz lliall fliortly be put- As this lOand does not contain lefs than 150 thoufand people, fufficient fupplies of children muft ^rife to keep up the dlfeafe, ev^en without any dc-» pendance on Salfette or the neighbouring Continent* The Hindoos and Parfees, both here and at Su« rat (liew the utmoft dcfire of having their Childreii inoculated vv^ith the vaccine difeafe. We (hall in- (IrU'fl the Native Praiflicioners ofPhyfic regardijig it, but on this part of the fubjed \vc arc not with- out apprehenfions. Whoever is fa/Ficlently ac-» quainfed with what has bten done in Europe with regard to the Cow Pox, is arc that fome foreign poifon, fuch as that of the fmall Pox, is spt to be mhcd with ir^ when a compound difcsfc ^arifes, <3r fome [ n ] lone other poifbnous matter may be from various caijf'^s incroduced, inft^ad of the vaccine virus, a difcaf altogether different is produced. The hiftory of the Count de Moffet as lately detailed by Dr. de Carro affords a moft inflrudtivc leflbn on the fubjed. The greateft care therefore fhould be em- ployed to warn the Native Pradlitioners, that the vaccine matter may be degraded by many caufes, and that their ucmoft attention is neceffary to pre- vent if. We can aflrr-n from our own knowledge, that this Governcnent have anxioufly aiTifted our wifhes for procuring the vaccine difeafe by the v/ay oi Buf- fora. They reprelented to Lord Elgin the impor- tance of it to this great fociety of mankind, and- they called for the aid of the Rendents of BufTora and Bagdad. Doclor de Carro or Vienna, who has dillinguiihed hiitifelf fo honourably in this career, tranfmitted in the firfl: inftance the vaccine matter to Lord Elgin, who feveral times before had flicwn us his attention to the fubjecl. By his Lord* Clip's orders it wasfent to our Refident at Bagdad, and acrain to the Refident at Bufibra. To both o thofe Gentlemen the public are under great obli- gation for the intereft they took in the fubjedt. Fi- nally it fell into the hands of Dr. Short and Mr. Milne as we hive already faid, nor could ic have been more fortunately placed. We [ 25 3 We have been more particular than was necef- fary for the medical profefTion, who mu^t be fup- poled CO be in pofTcfTion of every fa6l that has oc- cured on the fubjed in Europe, but as we fhail difperfe the vaccine difeafe very widely, as it will effect, and as we hope it will promote, the hap- pinefsof every family, we wifh to fatisfy the pub- lic at large concerning the fources from which we have derived it, and the foundation of our be- lief, that it is of a genuine kind. WILLIAM MOIR, HELEN US SCOTT. Bomhay^ July id, 1802. The Medical Board impreffed with a jud fenfc of the important confequence of the acquificion they had made, and anxious to difFufe it throughout In- dia, direded virus to be forwarded to Bengal- Fort St. George, Ceylon, and to all the other prin- cipal Stations every v;eek, until they had the fatis- faction of learning that the difeafe was produced at Hyderabad, Mafjlipatam, atdifTerenc Stations oc the Ifland of Ceylon, andclfewhere. It then became unnecelTary to fend virus fi'om Bombay, ast fupplies could be got wirh greater qiiicknef?. t 1 qiilcknefs, and probability of fucccfs, from Stations nearer to thofc parts. 1 he rainy feafon was pro- bably unfavourable to the matter's retaining its Specific properties for any length of time, altho, every precaution was taken to prefcrve it. Flattened filver canulas were prepared about an inch in length, and the threads carefully foaked in the virus, after being pcifcdly dried, v.ere put in- to thofe tubes, and the ends fecured with wax. Thefe canulas were forwarded by pod, to all the principal ftations, until accounts were received as 1 have faid, that this extraordinary attention was no longer necefiary. The following communications (hew how ra- pidly the difeafe v/as conveyed fromi place to place, and afford a proof of the humane attention of the Medical Gentlemen at the different Stations. Copy of a Letter from Mr, Ure at Hyderabad to Dr. Anderjon^ Port St. George, dated ^ugufi i^th, 3^02. Dear SiR, I have the plcafing fatisfaflion of informing you that wc have at laft fuccecded in getting the Cow- pox at Hyderabad, and I nO';v fend you by exprcfs fomc [ 27 ] fome threads well dipped in the vaccine matter, ta- ken from the arm of a healthy child who had four dif- tinfl puftules, near the place where the matter was inferted. This child was inoculated on the i 8th of this month with vaccine matter, which was difpatch- ed from Bombay to me by Dr. Scott on the i ith inftanc. In about eight days hence I fliall fend you another fupply of the vaccine matter. I have alfo by this exprefs fent fome of it to Dr. Harris ac lylafulipatam. Copy of a Letter from Colin Rogers Ffq, MedU cnl Supsrifitendmt T rincomallie to Dr, AnderJ^n Fort St. George dated September this \^th 1802, Dear Sir, Youmufl long ere this have heard with pleafure of the fuccefsfal jntroduilion of the Cow-pox ac Trincomallie, where I had fird the good fortune to produce ithe difeafe, by inoculation with matter fenc from Bombay on the loth of July, by Dr. Hele- nas Scott. On the nth of Augufl, the day on which this matter arrived here, 1 inoculated fix children, out of which number one fucceeded in John Sybclie, a boy of ten years oldj from liim a facccmon of hib- jeds have been inoculated, and in all ihc genuine vaccine C 28 ] vaccine difeafe appeared. It has fincc been pro* pagated to the diftricts ofMolative & Jaifnapatam, from wticnce it will foon be extended to the coaft. As you have not yet fucceeded at Madras, I take the liberty to inclofe you fomc cotton threads, im- bued with Vaccine matter, taken this day the 9th from inoculation, from a child of European parents, the puftule on whofc arm furniflied matter for feveq children befidcs. Every friend to humanity mud widi you fuccefs in your endeavours to introduce and difFufe this va- luable difeafe, which is proved to be a fafe and mild antidote, for that mod loathfome and fatal one the fmall pox, which 'tis to be ardently hoped will foon be extirpated from this country. His Excellency Governor North imprefled v/ith the importance of the difcovcry, has prohibited the further admifTion of patients into the fmall pox Hofpital, which he means to fupprefsac the end of the prefent month> when the attention of the Me- dical Superintendants and overfeers of that Ella- blifhment will be confined to the propagation of the vaccine difeafe; thus completing the chain of humane and liberal improvements for which His JiKCcllency is (o eminently diftinguifncd:*' The t 89 5 The f'lccefs of Mr. Rogers, with virus up* wards of a month from Bombay, affords a proof as well as our fuccefs with that from Buflbrah; that the fpecific virtues of the vaccine poifon, is in fomc cafes prcferved for a longer period, even in this country, than is generally fuppofcd. The matter that produced thedifeafe on Ceylon, was fcnt in a canula by Dr. Scott, to His Excel- lency Governor North, and was received about the loth of Auguftj by His Excellency who was at that time at Trincommallie. Mr. Rogers after inoculating with the virus, was obliged to proceed to JafFnapatnam on urgent bufinefs; and on leav- ing his ftation, entrufted the care of his vaccinated patients to Mr. Gilbert Hall, Surgeon of His Ma* jefty's Malay Regiment. This Gentleman watched the progrefs of the inoculauon, and on the 8th day had the happinefs to find, that one of the fubjcifts was affeded with flight Fever ; on examination he found a genuine vaccine poftule formed, with the ufual local and conftitutional fymptoms, necelTary to afford a pcr- fefl convidlion, of the patients being affeded v/ith the true Cow-pox. Mr. Hall immediately ufed every endeavor to procure fubjcds for inoculation, but without fnc- ccfsi ' t 30 ] ccfs ; all his attempts to convince the natives of the blcffmg of the difcovery, the fafety and mildnefs of the dlfeafc, were without cfFedb. As a laft refourcc they were tempted with Gold, and by the influence of chi$ agent, Mr. Hall procured 12 fubjeds, which were fpeedily inoculated from the puftule. From thcfe, an abundant fupply of matter was ob- tained, and rapidly difleminated throughout the ifland. Great merit is certainly due to Mr. Hall, for his zeal and perfeverance, in taking advantage of the fortunate inoculation of Mr. Rogers. The practice of vaccine inoculation foon became general at Cey- lon;-*— the faculty there, as well as elfe where, have evin- ced uniform 2eal and humanity, altho'at fome (lati- ons it has been found difBcult to procure fubjefls for fuccelTive inoculations. On the ifland of Ceylon however, from the inditution of Small pox Hofpi- tals, the natives being accuftomed to the pradlice of inoculation, have wifely preferred the vaccine to the variolous difeafe. Copy of a Lett &r From fV, Prkhard, Efq, Chtngle- futy OBohir %ih, 1802, to Dr. Anderjcn^ Fort St. Georgia It is with real fatisfaclion I forward to you a natWs^ -cWki fix years of age, whom 1 inocij]atc4 on t 3« 3 on the tft inftant, wUh the vaccine roatter you favored rae wich, and which from the appearance of the child's arm, I have rcafon to hope has taken the infedion. The firfl: fymptom obfervable was on the fixth day after inoculation, when the child complained of pain in the axilla, and forenefs where the in- cifion was made, fhe had alfo fome fever — cn the fevcnth in the morning, the edges were confiderably raifcd, and had a gloiTy appearance, with a depref* Con in the center, and it has now every other ap- pearance of the puftule defcribed by authors who have written on the interefting fubje(5l of cow-pox inoculation, however fhould 1 in the prefent caic be deceived, and fhould it not prove what I fin- cercly hope it is, rhe genuine cow-pox, 1 truft you will favorably accept my intention. The bearer of this is the child's father, who will give you any information refpecling the fymptoms which may appear from the date of this — I have ySil inoculated two children with the matter from the puftule, and will inform you of the fuccefs.** EyAraSt of a Letter from Mr. Gourlay^ Affijlant Surgeon^ dated Tdlicherryy Scpemhr iph iZoz^ to Dr. Keir^ Bombay. " I arrived here in good time, — the two boys you fo carefully inoculated, I v/as happy to find during [ 3^ 3 during the paffage were affefled with the difeafe in the mofl: faciiraifrory manner, — I have from ihefe fubjcs5ls inoculated 23 Children here, and 1 have fent the difcafe to Cannanore, Callicut &c. &c, &c. fo that the vaccine difeafe may be confidercd as introduced into Malabar. The natural fmall pox is now raging in the Pro- vince, and the natives are anxious for the Cow pox." Copy of a Letter from Dr. Meek at Cochin^ to Dr. Anderfon Madras^ dated Cochin^ \oth Oc- tohevy 1802. " Having on the ifl: inftant, received a fupplf of vaccine matter on plates of glafs, on Ivory lan- cet points, and on thread, from Dr. Keir at Bombay, taken on the eighth day after inoculation, the mat- ter being exa6lly eight days old when it reached me, I inoculated four children from each of the four parcels of matter, and I feel peculiar fatisfadion in communicating to you that, with eight of the twelve, I have fucceedcd in the moft fatisfadory manner. The difeafe in all, ran its courfe in the ufual way^ nor was the attendant fever of fuch moment as to occafion the fmalleft uneafinefs or inconvenience to cither the parents or children, each punflure was [ 33 1 ^as followed by a finglc puftule, nor was more to be perceived cither on the arms or body. Thofe inoculated from the glafs have all fuccccd^ cd, but two that vvcrc inoculated from the Ivory Ian* cct points, and an equal number from the thread, have failed, i have this day from the fuccefsful cafes inocii. Jated 2 • more; (of which number arc three young ladies) I have fent by Tapa}, matter to the fcnior Surgeon at Pajlamcottah, and to Mr. Robcrtfon Afliftant Surgeon Anjengo, fo that there now re. mains but litde doubt of this moft important difco. Very and blefllng being foon very generally dilTc* minated throughout the Peninfuja, Extra^f of a Letter f rem Mr, J. Flay^ to VoSlor dit* derjon^ dated Err ode 061 i igtb l8o2, " The chara^er and appearance of my Cov> pox pudule in every refpc<5t coincide with that of the genuine difeafe given us by Dr. Jenner, and with the plate In vol. i. Med. and Phyfical Jour» nal p. !20 given by the Engraver, flawing the pro- grefs of the puflulein the arm of his ovm child, ex- cepting that, no vtficle whatever has appeared in any one cafe unlci's where the lancet introduced virus; and thac the f^abbing nrocefi is fooncr pcrfeded. [ 34 ] Only three ofthcpcrfons inoculated by me bav€ been fenGblc of any diforder of conftirution, and in none of them has it occafKDiicd a difeafe requiring -any medical relief whatever, nor fcarcely fuch as to render a change of diet neceffiry — the three who wre indifpofed fay they had flight fever, and this happening in the night, I did not obferve it in any of them. The only fymptom common to all of tl em, bc- fides the puftuk, is a flight afFedlion of the axillary glands. No fymptomatic Fever has fliown itfelf, nor has the general conftitution been affeded in any way. The fpreading red areola around the veficle has been more extcnfive than in the inoculated fmall pox, but except when touched, it has given little pain, and has always foon difappeared. From the difeafe being fo very mikl here, I am of opinion that the fubjccl from v/honi Mr. Carnic fupplied me \vith matter molt probably had the di- feafe in the moft favorable manner, and that too much attention cannot be paid to the choofing only fuch fubjeds from whom matter is to be taken, as have the vaccine in the mildcft pofljble manner. Dr. Woodvillc and Fearfon's ^' reports of inocula- lion I 35 1 rion for the Co v; pox'* ihew in the firongeft light of how great importance to the public it is, that maccer for communicating the infection, betaken only from ft^ch perfons, as have the difeafe in the mod mild way." Dr. Dcfborah Surgeon to the Refidency at Poonah, having failed in producing the infedion ^ith virus fent to him at different periods. Govern- ment humanely direded that fubjet^s afFcfled with the Cow-pox, might be fenc to fecure the inrroduc* tion of the difeafc, into the capital of the Maharatta empire. The following letter fhov/s the fuccefsre- fulting from this meafurc, ExtraB of a htter from Charles Defhorah EJq. Sur* geon to the Rejidtncy at Poona dated Otl. %oik to Dr. Keir. The Brsm.In who was fent by Governmenc with two children under the vaccine infeclion, arriv- ed here on the 15th with one of them, the bringing of both wotld have retarded his journey. — He reached this place in fjx days according to his en- gagemenc, and at the very point of time. On the Bram.ins arrival I inoculated feveral chiU dren, and I have now the farisradion of informing you. I 36 ] you, that the operations have fucceeded compleatly, and that I have to day, the fixth from inoculation- inoculated feveral children with the matter from my firft patients, fhc Brarnjn has alfo cotpmencecj his pradlice in the town of Poona,— I dogbt not of his fuccefs, for he appears to have made himfelf under your inftrudtions, perfedly mader of the me- thod of operating, and of the whole progrefs of the infeflion." ZxtraSi of a letter from Mr, Hoyef A£lflant Surgeon ^ dited Cundapore Out. 20th 1802, to llr. Keir Bombay, " I wrote you a few lines informing you that the Cow-pox has ^uccttditd in three patients. From thefe chree 1 have inocuhired 30 more who have hacj the difeafc i(j the moft unequivocal manner, and v/ithouc any complaint, except flight pain anci fwel'» ling in the axilla of the infeded arip. I have now upwards of cne hundred patients in different ftages of ihe diforder^ afid exped many rxK)re in a few days.*^ The fallowing very fatlsfaflory ^Cco^^Tit of the dlffufion of the vaccine difeafe throughout the ifland of Ceylon, as publifhtd in the Government Gazette fey the Medical Superintendant General, Thomas Cluiaie [ 37 ] Chriftie Efq. will bcconfidered as- elucidating the hiftory of the difeafe on that ifland. " The extenfivc difFufion of the Cow-pox through* out this ifland, and the great attention of the Me- dical Gentlemen at the different ftations to this fub- j£(5b, enable me to ftate feveral fadls regarding the hiftory of this difeale, which from the great impor- tance of the fubjedl will, I think, prove interesting to many of your readers, and akho* few of the cir- cumftances hereafter to be oientioned, can appear novel to profefTional nien, who arc acquainted with the various writings on the vaccine difcale in Eu« rope, they may 1 think afford facisfadion to them, in as far as they tend to prove, that the Cow-pox, v/hen imported into the Torrid Zone, continues to preferve the fame benignant fpecilic charader, and to be governed by the fame laws, as in the more temperate regions of Europe. Above two thoufand fubjeds of all ages and def- er ipiions, have been inoculated with Cow pox in th^:^ diftria of Columbo during lafl: month, and although I hive not yet received the regular reports from the more diltapt Nations, I have reafon to believe from occafioml communications, that the number of perfons inoculated throughout Ccvlon during Odober, has not been lefs than three thoufAuJ five hundred. Jn t 3^ 1 in all thefe the difeafe has prefervcd its origmal fnild nature^ and in no cafe, have any bad ccnfe* ^ueaces, or even dangerous fymptoms, been oc* Cafioned by the inoculation. In all cafes in which the inoculation fucceeds, flight inflamadon and elevation of the fkin are perceptible on the 2d, 3d, 4th or 5th day, and. about the 6th, a veficle is in general diftinctly form- ed. This veficle of a cellular ftruilure, dcprefled in the center, and containing pelkicid lymph, con- tinues to encreafe till about the 4th day, V'hcn the niattcr begins to ooze out, and the areola to form, or what I confider more dcfcriptive in a native fub- ject, a circular inflacration not unlike a Common boil, the elevation and hardncfs of which, can be plainly felt to extend for half an inch or more round the veficle. In European fubjecbs this af- fumes the appearanc of a beautiful fcariet areola and is the principal diflinguifhing characteriliic of the difeale, without which the inoculation can- not bf* confidered as effective. About the 12th day, this circular inflamation gradually fubfidfs, and the whole of the matter having oozed from the ve- ficle, now forms a fliining fcabof a brown colour, which in a few days drops off, and foipetimes leaves a fuperncial fore behind it. The [ 39 1 T he fi^e of the puftule b various in different iubjects, but the circumference qf the vcficle in general exceeds fomcwhat that of a large pea. Pain in the axilla, though not always prefent, is z very conllant attendant of the difeafe, and generaN ly comes on about the 5th, and lafts to the loth riay. Some degree of fever is alfo in mod inftan^ ce:iprefcnc for a day or two, and generally accedes about the 4th, ych, or 8th day, I have alfo obferved in a few inftances, a fiiort -paroxyfm of Fever on the i. 2. or 3 days from ino*» .culations, and have been the more particular in rc*- marking this circumftance, in confcqueL^ce of an «bfervation of Mr. Kennedy at Hyderabad on this fubje6t, but as it happened with us in only a very fmall proportion of cafes, I am apt to believe that in thcfe its occurrence was accidental, and not at all connedled with the inoculation, fince fimilar flight attacks of fever are by no means unfrequenr, with the inhabitants of this ifland. We have generally at Columb*) inoculated in . both arms for the fake of fecuricy, except i.i the cafe of young infants, and 1 think this precaution cer« tainly diminiflies the rifk of failure and alfo tends to cncrcafe the fever, which in an adult I confidcras rather t 40 ] rather a dlfcrcabh object, fince it never proceeds to any alarming heights, and its occurrence feems ia general to fatis/y the roinds of the patients thcmfel* ves more completely, than when the fymptoms arc confined to the mere local affedion. In two or three Children, where the fever was unufaally fmart, the irritation feemcd to have beeri kept up by worms in the intefiines, as immediate relief was obtained on voiding fomc of thefc. fn one cafe of this defcription the patient, r.n European child of two years of age, wa^ afSicTced on the £th day from inoculation, with fpafms of rather an alarming nature, but thcfe 1 believe proceeded en- tirely from worms, as bis abdomen was hard and tenfe, and he appeared to refer his complaints to that part. Thefe difagreeablc fymptoms were rea- dily removed in this child, as in other inftances, by the operadon of a fmall dofc of calomel, which brought away fome worms. In one patient, a native, Tafcorin aged 24 years, who accompanied me from Maturato Wcmbaug- tottc, (a diftanec of fifty miles) in order to intro- duce the difeafe at the latter fiation, there was on the 8th day from inoculation an evident encieafc of the fulivary difcharge, and m addition ta the ula- [ 41 3 ai fymptoms of pain in the axilla, flight fever, and head ache, he complained of forencfs of his throat, and difficulty of fwallowing, for that and the follow- ing day, but his co;nplaints on the whole, were at- tended with fo little inconvenience, that although he tra'vclled on thofe daysi he preferred walking to riding in a Doolie, which was provided for him. The forencfs of the throat, and encreafe of the fili- vary difcharge might pofTibly be accidental, buc from analogy- with the fmall pox, and the circumf- tancc of thefc fymptoms keeping pace with the vac«. cine fever, I am apt to believe they v/ere really connected wirh the difcafe, and indeed in one or two cafes which have occurred fince, the patients have complained of flight forenefs of the throat, on the day on which they had the Cow-pox fever; Although the occurrence of any puflule except on the inoculated parts, is an extremely rare occur* rence in the true vaccine difeafe, and is I belie v^i flill doubted by Dr. Jenner,^ yet we have on Ceylon certainly feen three or four in-TtanceSy where one or more puftules, bearing ali the charafleriftrcs of the vaccine, have appeared on parts' of the body diftant from the frat of inoculanon, and which I cannot conceive were occafioned either by an accidental prick of the lancet^ or from a fccondary inocuia- tiois C 44 ] tlon by means of the patient fcratching the pullute^ and afterwards another part of his body, as the fe- condary puftule has fhewn itfelf on a diflant part of the body, and at a time when no virus was for* nied in the inoculated puftule. This is moft ftrongly exemplified in the cafe of a boy, now, under the care of Mr. Orr, in whom a diftind well marked vaccine puftule, appeared on the back part of the thigh, on the 4th day after inoculation in both arms. The inoculated parts .Oiewed the ufual appearance of incipient puftule on the 3d day, and on the following that on the thigh appeared, fmce which time the three puftules have ran their courfc regularly. Mr. Carnie formerly inoculated at Jaffnaparam, •with matter taken from a fccondary puftule on the v/rift, and with it produced the true vaccine dif- cafe. Mr. Orr has this day inoculated three per- fons, mzh matter from a puftule on the thigh of his patient, and if he fuccceds in producing the true vaccine difeafe, the experiment will 1 think be con- clufive, as to the poftibility of fecondary puftules, and alfo of their containing the fame fpccific virus as the inoculated ones. I have never fcen any ge- neral eruption, which with reafon I could attribute to [ 43 ] to the vaccine inoculation. Patients under vaccine inoculation have occauonally fticwn flight erup- tions of pimples or prickly heat, at the appearance of which they were alarmed, but thefe have foon died away, and feemed to me to be only cafual eruptions, which are fo common at all times in this country, and mud nccefTarily be more frcquenc when the patient labours under any febrile affec- tion. Nine or ten patients who have pafTed thro' the Cow-pox on this Ifland, have already been fubjec- £ed ro the experiment of inoculation with fmall poj; matter, and all of them have perfedly refifted the adion of that virus, fo that the fad, that a perfoa that has paffed thro' the Cow-pox, is ever afterwards fecure againft the expofure to fmall pox cantagion, may now be confider'd r^s fully dcmonftrated in this country, as well as in Europe, The exiftence of the natural fmall pox, has how* ever alfo given us an opportunity of feeing verified an obfervation of Dr. Woodviile's, that alcho' a pa- tient that has pafTcd thro* the Cow- pox is for ever afterwards fecure againft the effed of expofure to fmall pox contagion, yet that inoculation for the former difeafe, will not anticipate the f nail pox, or prcyenc C 44 ] prevent its progrefs, if the infe^lion has been recejv* cd previous to inoculation, or even previous to the acceflion of the Cow pox fever. In two cafes at Columbo, the patients on the day after inoculation were feized with fcvere fever, and qn the third day, an eruption of fmali-pox took place, which however could be traced to natural infeilion, the difeafe being in the neighbourhood. The cow-pox puflule formed at the ufual time, and both difeafes purfued their progrefs without inter- ruption. One of thefe cafes terminated fatally, and theii occurrence ought to teach us the necefiity of cau- tioning our patients, againd expofing thcmfclves tp the infection of fmall-pox, until the cow-pox has finiflied its courfe, and of preparing them in all cafes when the fmall-pox is prevalent, for the pof- fibility of the occurrence of both difeafes. From the prevalence of Meafles at Point de Galle, we have alfo had an opportunity in two cafes, of ob- fervrng the combination of Meafles with Cow- Pox, cr rather the occurrence of both difeafes at the f^mc time, in the fame fubjedl, for they both ran their courfe feperately and didindlly. In one of |hcfc cafes which i favv, the eruption of Meafies ap- C 4S ] pearcd on the 3d day after Inoculation, and neither the eruption or fever feemed at all encreafed, by the prefcnce of the vaccine infedion. The vaccine veficle formed in the uiual time, but it was the opi- nion of Doctor Yate's Medical Superintendant of the Gallc diftrict, who carefully watched the pro- grcfs of thefe cafes, that the formation of the areola^ was in both retarded ont or two days. The fhortnefs of time finrc the cow-pox has been introduced into this Ifland, docs not enable me to fay much with refpcdl to its effedls in removing, prevendng, or alleviating other ailments. On this fiibje6l I have only to remark, that in an Euro* pean child who was cutting teeth, an J for fomc days had been fubjefl to an eruption of veficles^ which came out in a few hours on different parts of his body, and left a diflrcffing rawnefs and ex- coriaiion, this complaint was removed on the ac- ceffioti of the cow-pox fever, and formation of the areola round the puQuk, foon after which the fkin became clean, and free from eruption. The cow-pox has in general been propogated from one (ladon to another on this IHand, by means of inoculated patients, for we have found dried matter on threads, or glafs, a very uncertain means of t 4« ] of conveying the infection to any dlflance. The only cafes in which dried matter has fucceeded on Ceylon, are thofe of John Sybclle at Trincoraailcc, with matter from Bombay thirty two days old, and that of Anatchie at Columbo, with matter from Trincomallce fix days old. In the latter the fever was very confiderable, and the pudule from the nature of the inoculation by incifion, was oval, and much larger than uiual. In confequence of this it would appear that the virus in the puftule was in a very diluted (late, for out of eighteen patients in« oculated from her, only one child took the difeafe, while of an equal number inoculated from this child, who had a fraall veficle, fcarccly one failed. As foon as matter can be procured from the vc<* ficle, it appears to be effective, and continues fo till the areola begines to form. I have occafionally made ufc of matter on the 6th, 7th, 8th and 9th days with effect, but generally prefer it on the 7th or 8th. The inoculation widi recent matter has always been performed at Celumbo, in the fame way as is ufua| for the Small Pox, by inferting in an oblique di- rection the point of a hncct armed with virus, im* mediately under the cuticle, and retaining it there feme feconds. The inoculation in this way, gene- rally takes place in both arms, (if both arc punctu. red) t 47 3 red) and fcldom fails altogether, our failures have not I think exceeded one in fifteen cafes, and in thefc I have always found the padents cheerfully liibmic to a fecond or third trial. Indeed the cagcrnefs which the natives of Ceylon, particularly on this fide of thelfland, Ihew to benefit by this difcovcry, is really wonderful, and truly gratifying. The inocularion having fometimes aflumed a doubtful appearance, the operation has been re- peated, and in feveral of thefe cafes, the firft in- oculation has afterwards put on the regular appear- ance, and the fecond alfo has taken effe6l, having produced another puftule, which ran its courfe at the fame time with the original one, although in a different ftage. The pofsibility alfo of producing the vaccine puftule on a perfon who has had the fmall-pox, has been put to the teft of experiment by Mr. Cairniej who inoculated himfelf and feveral children, who had pafTed thro' the fmall-pox, and in one of thefc a diftinct vaccine puilule was produced, though not attended v/ithany fever or pain in the axilla. Our rapid fuccefs in extending the defeafe here, is I think in a great degree to be attributed, to the minds of the natives having been familiarized to the Idea [ +8 ] Idea of inoculation, by means of the benevolent inditutions which have for Tome time been fftablifh- cd on this IQand, for Inoculation vvith the Small Vox'y and to the Vv^ife meafure of Government, in circulating addrcITes in the native languages, ex- plaining the numerous and important advantages of vaccine Inoculation. This praflice is now happily introduced at even the mofl: remote flations on this Ifland, and 1 en- tertain the motl fanguine hopes, that by means of it, we fhall in a very fev; months eradicate the Small Pox emirely from thcfc fettlcments/' The intereft occafioned by (he account of the introduclion of the vaccine difeafe at Bombay, v*'as great and general. — Dr. James Anderfon Phy- fician General at Fort St. George, humanely corv- fidcred that it would be of importance, to circulate through the medium of the Madras Gazette, all the reports that were tranfmitted to him on this fubjcdl. Thefe communications enabled medical men to compare the appearances in their own patitnrs, with what occured to others, and informed them of the progrcfs of the difeafe, from (lacion to ftation. The r 49 1 The exertions of Dr. Andcrfon were zesbus and unccafingi — he forwarded to every medical maoj and to many others, copies of his printed corrcf- pondcnces— 'the foregoing letters, as well as thofc that follow, in proof of the genuine nature of the difeafc, and of its power in preventing the fmall- pox, I have been enabled to collcft from thefc printed papers, and I gladly embrace the oppor- tunity of expreffing my acknowledgements for his great artention in fending them regularly. It mafl: give pleafure to Dr. Anderfon to refleft, that the extenfivc difT^jnination of the vaccine di- ftafe throughout India; has been greatly promoted by his care and humanity. FORr fFILLUM,— December i, 1802. The Governor General in Council is pleafed to dlred, that the following letter, with its enclofures, addreffed by John Fleming, Efq. firft Member of the Medical Board, co His Excellency in Council, be publifhed for general information. To His Excellency the Marquis IVelleJly, K, P; Go- V'^rnor General in Council, My Lord, It is with the higheft fatisfaclion I do myfelf the honour of acquainting your Excellency;^ thac afccr repeated C 50 ] repeated dirappointments we hiwc atlaft through the benevolent attention of Dr. Andeifon at Madras, been lo fortunate as to obtain the recent matter of the cow-pox, and that we have tliereby been cna- bled to inrroducf the pra^^ilice of vaccination into this jcttleinent. I herewith cnclofo the letter^ wkh ^vhicn 1 was favcured by the Doctor on the Tub- je.fl, together with one,, which 1 have received from Captain Anderfon, commander of the fhip Hunter, u'hofe afiiduoQS attention to eniure iirccels to the important corr.miffion, with wliich he was entrull- cd, in very meritorious. John Norton the boy vaccinated by Captain An- derfon on the 12th inftant, arrived in Calcutta on the 17th, with fuch evident and decisive marks on his arm of being infeded v;ith the genuine cow- pox, as left no room for doubt or hesitation. As the matter was already ripe for communicating the infedion, three children born of European parents^ belonging to His Majelly's 10th Regiment, were vaccinated by Mr. William I\ussell on that day ; and on the day following the operation was per- formed on eight others. Among thefe were two children of Mr. Barlow, o.p.e of Colonel Dyer, one of Mr. Birch, oneof Mr. 'I rail, and one of Mr. Bin^ ny, in ali ot whcm, as util as in the three children of [ 5« ] of the loth Regiment, I liad an opportunity of ob* fcrving the progrefs of the infedion, and from corn- paring the fymptotns and appearances produced by it, with the minute and circuiii(l;intial defcriptions given bvDoclor Jenner, Mr. Atkin, and Dr. De Carro, and with the coloured plates, by which their dcfcriptions are illufi rated, I am perfeclly fati.sned, that it was the true vaccine-dikafe. Messrs. Ruf- fells. Hare Shoo] bred, and other Medical Gentle- men, who had an opportunity of feeing the cliildren, are fully impressed with the fame convi:"!:ion. la confirmation of this important fact, I tiiink it pro- per to mention, that three children who were ino- culated with the thread fcnt me by Captain An- derlbn from Kedgeree, as mentioned in his letter, received the infeaion, and fliewed in the progrelk of the difcafe the fime charadcnlVic fymprom and appearances on the arm, as thole that were inocu- lated r7om Norton. The fame fatisfactory refulc "Was experienced in refpe'"!: to two children inocu- lated by Mr. Shoolbred on t'le 2Cih, and two or!:er3 on tiic 2 1 ft, from matter taken from Norton''; arm or ti.e 1 9di, all of whom, he aflures tne, exhioice.! in tiiC moit unequivocal m^inncr, the diilhiguidiing fyn-ptomisof the genuine cow-pox. The fettlemenc being now, as' I conceive, in complete poncilion cf the bench: derived to m^ni- kind C 52 3 kind from Do6lor Jenner's celebrated dlfcovery^ I cake the liberty cf fubmitting to your Excellen- cy's confideration, my opinion on the bed mode of preferving the continuance of fo great a bleQlng, and fpreading it as rapidly as pcITible throughout the provinces. For attaining the firfi: of thefe important objentially different from each other, awd very far from putting on the appearances of the true difeafe. The fiffh variety occurs moft frequtritly, and on every account merits attention j it runs its courfc very rapidly. On the 2d day the inflammation is confiderable; about the third day, it is very much increalcd^-and furrounded with a confidca-able de- r 6j ] gree of rednefs. About the 6ch day, inftead of a vcficlc, which ought to be formed with rhc ufual charaderidic marlcR, the part has the appearance of an irregular feftered fore, and on being punflurcd or rubbed, a little pus or difcoloured fluid, is dif- charged infteadof the limpid vaccine virus already defcribed. The puftule, or fefter*d fpot is never flat, it has never the lucid edges, nor is there any dcprtflion or fpeck in die centre ; it is alfo fmaller, and has never the fmooth, round, or oval ap- pearance, that the genuine vaccine puftule has, It refembles a fmall fefter'd fore, from any poifon, or the wound of a thorn, and has a fimilar du- ration. The whole procefs of the difeafe is over about the 8rh or 9th day, as the fcab generally falls off about this period. No conftltucional fymptoms^ attend this variety, nor have I ever obferved any fullnefs in the axillary glands; after all however, in requires experience and attention not to millake this kind, for a very mild fort of cov/ pox. In fome cafes I have obferved a fpongy, or warty- like variety of fpurious cow-pox, in this as in the former cafe, the inflammation comes on coo csdy, about the 3d day, there is a confiderablc degree of rednefs, and a difcharge of a coloured, or fcrous fluid, a good dealrcfcmbling pug i this continues to ex- t 66 3 ude from time to time, and when the part is not rub* bedj forms a cruft^ or fpongy-like fubftance, which increafes in fize from continued exudation, and becomes dry in the air, I have feen a few cafcs^ v^here the niatter was of the fize, and a good deal refembied a fplit rough almond, laid on the inocu- lated fpot. In a few cafes I have obfcrved a diiferent ap- pearance, but whether it be a variety of the hi\, or another ipccies of fpurious difeafe, it is difficult to determine. About the 2d day from inoculation, the cuticle appears railed, as if a fmall blifter had been applied, the vefjcation gradually continues to increafe, for two or ihree days ; I have fecn a few cafes where the bhPcer'd-like appearance was of the fize of a half- pennyion being punctured a thin ferous fluid is dif. charged, by the 8th day, the cuticle is ready to fall oir, leaving an excoriation which heals readily. neither of thcfe cafes, could I difcover any confli- tiitional affeflion,. or fwelling, or tenfion, of the <.ilancl5 in the armpit. On re-inoculating the fame lubjevfls v/kh frcfn virus, a genuine affeclion was produced, which ran its courfe with the ufual local, ^nd contlituuional fymptoms. Of [ 67 ] Of thcfe three varieties of fpurloiis cow-pox, if they may be fo called, the firft is by much the mod comrnon, and moft hkely to be mlftaken fur the true difeafe. The two laft mentioned varieties cannot well be midaken, but I confidered it ne- ceflary to mention them. I: is of importance to decide on certain circiimrtances, v;hich may always be confider'd as diftinguirhing the real difeafe, from every variety that can occur. In the genuine dif- eafe, the progrefs is (low and regular; the inflarnma- tion at the inoculated part, never comes on before the end of the jd, or 4th day, this condnues to en- creafc progrefTjvely until! the 9th day; on or before this time, there is a general affection of the fyftem, and fome Avelling of the axillary glands, and pain and uneaOnefs aboat the arm pit. When the fkin is white or of a light colour, there is alfo an areola or Eryfipelas-like bluQi, farrounding the puflub; the veficle is always dillinfl, and never has that full or hemifphericai appearance, that marks the variol- ous puftule; it is always round or oval in its bafc, and aicho' raifed, it is flat, and pitted' in the middle. The nuld contained in the veficle is always limpid, "and colourlefs, unci.U after the 9th day, and a wliite gloiTy ring or border always furrounds, or marks tl^ie bound ary of the vefjclc;-— on puncturing ir, the fluid t 68 1 fluic? IS found in cells, ciiflin nor a vcflige of the punc- ture on rhc 6th or 7th day; yet afcer this period, in- flammation has conje on, and the difeafe has regular* ly run its courfe, with the ufual local and co^^ftitu- tionai affeclions. As thefe cafes of protraded vac- cination t h 1 dnation are however very rare, it Is, always proper tore-inoculate on the 5th day, provided rhc fucccfj of the former inoculation fcems doubtful. I have frequendy obferved that a vaccine puflule has been produced, containing the limpid virus, butofafmall size, and warty appearance, I have uniformly considered myfelf juflified in viewing fuch cafes with diftruft, and in confcquence, I fubje^^ the patients to a new inoculation. It appears from the teftlmony of many ref* pe6lablc authors, who have written on this fubjcft^ that fecondary puftuks on different parts of the bodvr, are not uncommon. I have never however feen ope inftaqce, of any puftule being produced, Vnlcfs on the fpot where the matter was inferted. From the valuable communications of the Me- dical Gentlemen at Ceylon, it appears however that fecondary puRules, have in feveral cafes appeared. In two or three cafes, I have obferved puftules oa the face and neck, but thefe cafes were fatisfadori- ly accounted for, by the accounts of the mothers, ornurfe^ of the patients, for it was evident rhac by fcratching the puftule, and afterwards ufing the nails to perforin the fame offices oa other parts of the [ 70 1 the body, that a frefh inoculation was in fact per- formed; and in confequence a new puftule pro- duced. In a few cafes I have obferved fmall pimples, near to the vaccine puftule, in thefc cafes the local affedion was unufually fevere; thefe pim- ples never contained any virus, or if any fluid was prcfent, it was of a coloured appearance, and dif- ferent from the contents of the vaccine veficle. 1 am difpofed to confidcr thefe pimples, as fpring- ing from local irritation, rather than arifing from the influence produced on the conlUcution, by the inoculated veficle. The natives of this country negled to perform, their accuftomed daily ablutions, as foon as they perceive that their children are affeded with the fmall-pox, they obferve the fame rule after inocula-* tion with the vaccine virus: among the lower orders of them difeafes of the fl^:in, or an itchy eruption is very common, and is fometimes their companion from the cradle to the grave, Jt follows necefTarlly that with this tendency to difcafe on the ficin, their neglcding to bathe, al- lows the eruption to become more virulent. In this manner I am difpofed to account for a particular Eppearance, which cccured in one of our villages in I 71 3 id the country. Dr. Scott and myfelf inoculated, all the children in the diftrift alluded to, who had not gone through the fmalKpox. The difeafe ran its courfe regularly, but about the 1 5th day, vvc were informed that many of the children had caught the natural fmall-pox; on examining them an crup-? tion was very evident, the pimples were fmall but contained no fluid that was perceptible, nor had they any con-flitutional afFedtion. This eruption was evidently not the fmall-pox, but it is very probable, that it was prickly heat, or the itch, which had gained an afcendancy by their ne- glefling their ufual ablutions. When the vaccine difeafe is introduced at any ftanon, it becomes neceirary to guard with vigilance, fo great a trcafure, for if it be once lofl:, it may be diii:cult or impoffible foon to recover it. Here, as in England, we cannot have recourfe to the parent flock, for unfortunately the cows of this region, are not endowed by providence with fo great a bleffing to man : whether therefore we confider the f aluc cf communicating the difeafe to the individual, or of prefcrving it for poftcrity, fome cautions become necelTary for prefcrving it. Scarcely any medical treatment is neceflary, during any ftage of this difeafe, if the fever br. fcver« Khe [ 72 ] the common means may be had recourfe to, to mlti* gate it, and the local afFcdion is ^ucce^^fully ma- naged, by adopting when neccflary the means al- ready mentioned. 1 have when inoculating ftle6led thofe only for the purpofe of obtaining matter, where there exifted all the local affeclions well marked, and where there had been forne degree of fever, and Avelling of the axillary glands. I have always taken matter from a , uftule, on the 8th compleat day from inoculati- on, and if any part of it gave out coloured mat- ter, I have rejedled it, and taken only fuch as was Jimpid or coiourlcfs. I may mention that the fame veficle, will be often found to contain the limpid virus, and coloured matter not capable of producing the genuine difeafe ; indeed a fmall quantity of pus is in general formed in the centre of the veficle, where the pujifture is made, the outer glofiey ring only containing the limpid virus. By attending to thefe cautions no mif- take is likely to happen. 1 have pafTed the difeafe thro' fome thoufand fubjefts, and I have it now as diilindly marked, and as adive in its elFeds, as it appeared in Anna Dufthall the firft fubjedt infcded in India, Medical [ 73 ] Medical mfri ^v^lO have performed vaccire irio^* Culiuion, or have intcreded themfclves in propogat# ing the difcafc, mufl have fieqiiently txperlcnccj great difappoiniment and vexncion, from the nuni* ber of failures, even where the inoculations have bec-i> performed, under the moft favorable circumfiancrs. Many caufes combine, in increafing the dffficuhy "We labour under. Our patients hitherto,' have gene- rally been more difpofcd to ccnfider themfclves conferring a favor, than receiving a benefit, and TV-hate yer injundions may be laid on them, they are often difregarded or very litde attended to. It follows of ccnfequence that no care is taken to pre- vent the fubjefl from fcratching, or rubbing the part, and the virus is in confcquence occafionally loft, before it has exerted any influence on the conf- ticution. I have lately perfofmed my inoculations in the follovvirig manner, with very good fuccefs, as on a medium I have not more than one infrance of fai- lure in 8 or lo cafes. After pun6luring the cells gently, ft) as 'o fccjre an abundant e^cudation of the iimpkl virus.and wi[i]- out performing this fo roughly as to draw blood, I apply the point of a lanctr, and carefully cove:- both fiJes C 74 ] fides of it v.'-th the limpid matrer. I allow tliJs to dry flightly, and afterwards, before infcriing it, I a fecond tirne apply the point of the lancet to the virus. The lancet is introduced obliquely under thr cuticle, about the infertion of the deltoid mufcle or in any other part of the arrnj intwo or three places in each fubjefV, and about an inch from each other* This is done in one or both arms, and the lancet is always cleaned before being ufed a fecond time. I endeavor [o perform the inoculation fo flightly, as not to draw blood, bu if any follow, the fpeck is allowed to dry, and if pofTiblethe fubje(fl is prevent:- ed from touching it, until this take place. It does not appear neceflliry, or ufefu! to apply cither bandage, orplaiftcr, v/hen frefh virus is ufed. 1 have perfuaded myfclf that inferting virus in both arms ge.'ieraily fecures fome degree of fever, and as the occurrence of this fymptom is always fatisfaclory, I think Uiat in grown-up people, or in cafes where there is any danger from the contagion of the fmall pox, that the inoculation fhould be performed in three or four places. It frequ^'-ntly becomes a matter of importp.ncr, to prefervc the vaccine matter for a fnort time ; cirh.er for inoculation on the fpot, or for the pur- poic of conveying it to a diftancc. Various me- thods [ 75 ] lliods have been recommended for attaining this objed, and as we experienced no fmall degree or difficulcy, in conveying the matter in an active flare, even to a fhort diftance, v/e had recourfc to various expedients. We preferved virus on threads, between plates of glafif, and on Ivory lancets, and although wc not unfrequently failed in all our endeavors; we were led to prefer the firft method. The threads after being carefully and repeatedly foaked in the puliule, and after being dried, were put into fiiver tubes, and conveyed by poll; in this way we wore generally fucceeded than in any other, I freq'jenrly ufe matter kept for fome days on th-s elongated (lopper of a glafs Phial, fuch as is ufcd by the vaccine Inditute in London, and I fucceed occafionally in this way, yet ic cannot be denied that fuccefs is very uncertain vv'hcn virus is ufcd, that has been dried for only a few hours. The only certain mode of effectually conveying the di- feafe from one pLice to another, is by means of fubjccls under the influence of the difcafe. It has been recommended in v/hatevcr way the snatter be kept, to moifien ic before ic is ufeu, tiiis wc have found a dangerous praflice, for wc have conRantly tailed^ when the kail moiHure was ap- plied. The C 75 ] The mode recommended by Dr. de Carrb of Virnna, when the virus is prcferv^ed on threads, i$ Certainly the beft. He cuts the threads into fmall portions, eich in length about a quarter of ari inchj the cuticle is then divided in two or more phces, near to each other, the threads are laid into the incifi )ns, and afterwards a fmall portion of cloth is placed over the whole, to defend them from the plainer which is fubfcquently put on; a bandage i$ lad of all applied over the whole. When the vaccine vjrus has been prefcrved on glafs, a fpear pointed lancet after being dipped in cold v^ater, fo as to take up the fmalleft pofllblc portion adhering to the point of it, is to be ap- plied CO thr virus, and gently rubbed on it, fo as to form a kind of mucilage, the lancet being im- pregnated in this manner, the inoculation is to be performed as already mentioned, this is the only cafe in which it can be neceffary, or is advifeabk to moillen the virus. Dr. de Cairo of Vienna, finding that the mode I have mentioned of prefcrving virus on threads frequently failed, was in confequence led to adopt the following method, as communicated in a letter to Z.ord El^m, ^^d forwarded by His Excellency |o phc tlonorabU J, Duncan. I 77 1 " I have palJ the greatcft and moft minute at* tenrion, to die vari his mcchods invcnced for fend- ing vaccine matcrr in every form; they are all inn- per^efl except one or two. The Ivory lancets of niv irii^ention fecm to be a very valuable improve- ment, for which'! have already received innume- rable thinks frorri the mod cnlightned vaccinators. One metho'.i al )ne is infallible and precifeiy as cafyforhiin who receives the virus, asifhchadto take it in a treih pullule. I have dcfcribed it ac- curately p. 97. and 98, of my Second Edition, 1 mufl: only add that fome further experience has tau.^;it me, that whenever a child en ijwed with patience can be found, ic is no: fo ditBcuk as I once chougnt; thit one or two pullules are fuf* ficient t) 611 the Chupie," but only that the o jeration is tedious, as it la(U more than half an h )ur. In order to inpregnare this charpi^ well, the p'jlUije (houU be opened by three or four punc- tures, becaufe it is not like that of the fmall-pox, a fingle bladder, from which all the matter flows from one pun'liure, but an aggregation of a great number of cells, covered wi:h one pellicule, which reprefent the fame order as a rafp or mulberry hue tranlVerfcly. By one punflure therefore, one On- gle ceil is emptied. A very fmali quantity of cbarpic t 78 ] charpic about the fizeofhalf a green pea, fliould belaid fiat on the open ceils, and the fluid is very quickly pumped> when one bit of charpie is im- pregnated, or rather facurated; another fhould be laid on till it fills the concavity of one of the glafifcs. 1 he two glafles well tied up, and dipped in a fo- lution of fcaling wax in fpiiit of wine, prevent fo well the acccfs of air, that no evaporation can take place, and the virus can be fent to any didance, and kept fluid any length of time. I have my* felf ufed fome coming from Hanover and from Milan, which arrived as fluid at Vienna, as v/hen it was put between theglific-s. I forgot to fay that the charpie, when impregnated fhould be transfer- red from the pudule to the hollow glafs with the f>oint of a pin, or a lancet, in order that no par- ticle of it rtiould be loft on the fingers," The vaccine matter now in our hands, has al- ready pafTed through many lubjecls; we cannot obferve any change in the regulir train of lymp- toms, marking the ufi»al progrefs of this difeafe, or in the local alfedion of the inoculated Ipot. Thofe fubjeds irioculatcd in June 3802, exhibited the fame appearances, that we at prefcnt obferve in our patients, labouring under the difeafe. On tny kft inoculating day, i had upwards of 50 fob- [ 79 ] jr&Sy with the difeafe didinflly marked as I have defcribed it; many of them fufFcred a good deal, fo much fo, that I believe they ^ould have been confidered as cafes of a'51:ive difcafe in Europe. From thefe and other circiimdances of a like nature, I am of opinion that we do not run any rilk, of finding our difeafe become milder, fo as in pro- cef: of lime to exhaud iticif, and fail of producing the necciiary confticutionai affection, or to prevent the inPiuence of variolous contagion, I have not found as far as my experience goes, that any caufe, or complaint fnould operate as an objedioo to communicating this difcafe, where wc are in danger from fiiiall pox. We have inoculated young and old, robuiland delicate, healthy and fick- Jy fubjedts, and numbei-s covered with herpetic, and pforic affections of the fkin. I have not obferved that any of thefe circumftances, have altered in any rcfpect, the appearance or progrefs of the difeafe. A great proportion of the natives of this ifland, are contlantly afHicled wich the itch, in a greater or left degree ; the vaccine pox has feldom altered the charader of this complaint. In fomc cafes the difeafe of the flcin has been apparendy Hibdued, by theprcfence of the conRicutional fymptcms attend- 1 [ 8o 3 ingtlif cow pox. In general however, there does not appear to be any change produced, unlefs I liavealready mentioned, thcchildrenare negledtcd for fomc v/ecks, when the itchy fymptoms appear to gain ground. In fadt from all that we have fcen, wc can declare that the vaccine afftdion is never dan- gerours, and feldom produces, any unpleafant or alarming fymptom, and that no circum fiance of age, er even debility fhould prevent us having recourfe to it. I am even of opinion, that fcvcral children that were weakly and frequently ailing, have ac- q-uired renovated health and (Irength, after going thro* the cow pox. It would ill become mc to hazard an opinion oil many points connected with the origin and hiflory of this difeafe, and which have engaged the atten- tion of thole ingenious and I^^arned men who have Vvritten on this fubjedt in Europe. Here unfottu- natcly, alcho' the cow is held in religious veneration, by the great clafs of natives in India, nothing as far as wc can find our, like the difeafe of Jenner is known, which is probably confined to particular dif- trids even in England, and depends on caufes which wc may never be able to explain. Any theory on thisfubjccl however, ought not materially to in- tercd us, our bufmefs is with the inoculated puf^ule ; and E 8t ] and as Dr. Jcnner has pointed out to mankind, thp value of fo unexpedlcd, and i'o valuable a dilcovcry^ and as it is fo fully dcmondrated that we arc in pof- fcfTion of the genuine difeafe, which wc find occafion.g little inconveniency to the pati-^nc, and fccures for ever from die fmall pox J we have cnly to guard uica care fo valuable a blciTing, for if once loft, wc ma/ not cafily recover it. The inociilated frnall-pox in Europe, from every tcftimony, appears a much mikier diltafe ihaa what it proves to be in this part of ludh; very fc^v unfortunate terminations occur there; In India or more properly fpeaking in this I (land, we have nc: been fb fortunate. It is the opinion of the mofb eminent and difcernir.g of our medical men ac this place, that one cafjaky rakes place in 40 or 50 cafes, including the fcquelas of the dilbrder, which are, blindnefs, fuppuracions' about the jcr'mts, difeafed livers, dyftntery and afrcclions of the mefcnteric glands, dyfpncea, &c. ic has been fufpe^lcd that a certain ciifs of tlx difeaies of Europe have become more prevalent Hncc the t^e- neral praflicc of inoculation for the fmail-pox; and it fecms to be admi:red that fn cafes where there cxids a tendency to fcrophuia, the variolotjs .matter frw^uendy gives afliviLV :o the l?:rnr dii- C S2 1 thcfls, and frequently produces lamcnefs, or Jays the foundation of fatal difcafes. Thofc mod averfeto the general introduaion of the vaccine, as a fubfticure for variolous inocula- tion, do not apprehend the occurrence of any of thofe evi!s> as a confequence of" the vaccine difeafe; this circumdance if no other ground of preference were claimed, is furely no immaterial, or triffling matter, and places in a ftrong and juft point of view the importance of Dr. Jcnner's difcovery, v^hich bids fair to mitigate the ravages, if not foon to extin- guifli entirely, the prevalence of a loathfomc and fual difeafe, which in every country, and under every circumftance, has ever proved one of the treated evils which has afiiidled humanity. The following communications prove that the vaccine difeafe fo fuccefsfully eflablifhed through- out Indi?, pofTefics the fame v/onderful powers in Hiielding the liuman conftiuuion from the fmiall pox, that it has beea found to do in Europe, Extras of a letter to Dr, Anderjcn Fort St, George from Mr, Carnie jaffncjpatam, O^ober 20th, I 8o2. " You will be happy to hear that fix of the pcribns that had gone thro' the cow pox at this place r 83 ] place, have been inoculated with a£l!ve matter from different imall pox patienis, and that all of them refifted its adion on the fyftem. I therefore think that I may now venture to pronounce with certainty, that we have got upon the ifland, ihat genuine mild difeafe, for the introdudion of which the world are fo much indebted to Dr. Jenner." EiitraB of a letter from Gilbert HaU Efq. Surgecn of His Majejiy's Malay Regiment dated ■Jrincomulles November Gth, 1802. " I have much pleafure in dlfcharging what I conceive to be my duty, by acquainting you that we have lately put the virtues of the vaccine difeafe, now eftablifned on this ifland, to the lafl tefl", by the moH:, interelling experimenf, of inoculating fubjeds who had paiTed thro' it, wiih variolous matter, and of the refult anfvvering our mofi fangcine expectation. On the 24th ultimo being informed by a native Dodor that there was a patient in the neighbour- hood, a young man labouring under the natural fmall pox in the eighth, or ninth day of the difeafe, 1 loll not a moment in embracing fo favorable an opportunity, but taking with rr?e two young heakhy fubjecls a boy and a girl, the former about ten, and the later about fourteen years old, both of whom having been inoculated v^idi the vaccine maccer neaily C H 3 nearly a month beforCj had completely pa^fed thro" that difeafe with all its characceridic marks, icnme- diatcly went and vifited hiin. I found him in a fo^all hut, extenf!ed on a cott, having his body ahnoft entirely covered with the fmall Pox eriiption-r-rhe difeafc however did not appear to be of the malignant kind, the puftules I5cing very diQincll and well filk-d, the matter, was thin and of a yellow tinge, and I had every rcafon to fuppofe, it was in a fui'licicntly adive ftate to communicate the diforder. From this patient, the two fubjeds I had brought VJiih me, were immediately inoculated in the pre- fcpce of a number of fpectators, in an open area, to whom being at the ti;ne pretty confidant of fuccclbj I cx[;lair.ed thro' an interpreter, the nature and caufc of tins experiuicrit. Thiols novv the 13th day of inoculation, & 1 am happy to inform you, that no eruption, or any other difagreeable or unplealant fv'mptom, has taken place in either of thefe fabjects, to throw the finalleil dif- credit on this inellim.able difcovery. J liave likev.'ife to acquaint you, that fimilar e?:- perimenishave been m^ide by Mr.Orr of Colombo, v.'ic h the fame facccfs, thcfe no doubt will tend not Onl/ [ 85 1 onlv to overcome all the fcruples which the natives might have entertained, againft the reception of this bieffing. hutalp) induce them to fubmit to a repe- tition of lurh experiments vvhcn necefTiry, to con- vince the ignorant and bigotccd of its efficacy ia prricrvnig tncm from chat foul contagion of the fmall poK, from which the nvuive inhabicancs of this iiland ic3 particular, have n;oll frvertly luffcred." Extract from a Letter publijbed in Ceylon Govern-- went Kjuzetie^ November ^oth i3o2, by -Ihomas Chriftie, I Jq. Mddical Superintendent Geneva!, i he cx^erim^nc of making perfbns who had been vaccinated, Oeep with paticnci labouring un- der fmali-pox, has been lately repi-aicd at Jaffna- parnam with the l^imc fucccfs as at Columbo, and the ruhfcqueni: inoculation with variolous matter con inues to be occafionally pra^tifed, at the dif- ferent Rations on the IQand, without producing any difeale. The proofs of the preventative pov/er of the cow-pox on this Ifiand, are therefore now more than fufficient to fatisfy every reafonable mind^ and I am happy to fay that the inhabitants here of ail ranks, defc.'iptions, and religions, place the utmofb (Confidence in its efficacy. Upwards t S6 ] Upwards of two thoufand perions, have been in* oculated with cow-pox by Mr. Orr alone, and the number of people vaccinated throughout the Iflandjis certainly not lefs than ten thoufand. Of thefe above fix thoufand have been inaculaced in the Columbo dillrid, and the goad cIrTcds of the intro- dudion of the cow-pox are very evident in the Pettah of this place, vvhere faiail-pox is becoming niuch lefs prevalent. Judging from our pad fuccefs, and the great numbers who daily croud to us for the purpofe of being inoculated, we may indulge well grounded hopes, that the vaccine inoculation will very foon hccomc almoll: general here, and that the fmjall- pox contagion will ere long, be expelled for ever from this Ifland, Doctor Pearfon, who next to the immortal Jen- ner, has perhaps difiinguifhed himfelf moft by impartial invelligation, of this fnbjedl, has recorded two cafes in which a fevere difcafe v/as produced, in confequence of theprcfcnce of Pfora, (itch) and as I obferve from a late work of t!^e learned Dr. Thornton on the fubjed: of cov;-pox, that he be- lieves the prefcnce of Pfora ought to form a ground ofexciufion to this^ or any other inoculation^ it may be of importance to mention, that from the great [ 87 ] grht to imprefs on the mind of every perP)n engaged in this purfuit, the necedicy of paying tiie greatcll pof- fible attention to the difcritninacin[; a[;)pc;irances of the difcafe, of frequently infpedling the inocularcd pa tie a ts. [ 100 1 patl^fnts, of noting down every fymptom, and of repeating the inoculation where there is the fiiialleft ground of doubt. After this It is fcarcely neceflary to obferye, that it is impofTible for profeflional men to perform their duty to their patients, by affording them perfed fe- curity againft the fmall pox, unlcfs after inoculati- on, they regularly attend the inoculating Surgeon at the periods he defires, in order that the progrefs of the puftule may be carefully examined, a circum- flance, which I am forry to fay, has been frequent* ]y negle6led by the natives, from a miftaken idea with refpeft to the fimplicity of the difeafe 5 but although the Cow-pox is extremely mild in its na- ture, it certainly requires the niceft attention and difcriminauon to dirtinguifh between the true and fpurious difeafe, particularly in Indians, in whom the darknefs of the fkin renders the areola, the princi- pal diagnoftic, much lefs diftindl, than in Europeans, Thefe circumflances have hitherto prevented my reco^nmending the vaccine inoculanon, to be intruf- tcd to the native Phyficians, but I have reafon to believe that many of chem have taken up the prac- tice of their own accord, particularly in the Galle difxiifb, where 1 aai informed by Dr. Yates, a Ban- dah dah Prieft has been pradicing vaccine inoculauoop with confiderable fucccfs. It affords mc the moll fincerc pleafure to adc}j> that notwithftanding the occurrence of the perverfc accidents above mentioned, and fome malicious reports ip confequence, the pradice of vaccine Ino- culation continues to extend throughout this Ifland, and that the natives in general, place the moft per- fect confidence in its efficacy in preventing the fmall pox. In many villages, almoft every perfon fufceptible of infe(5tion has been inoculated, and at Hambang- totte, a remote ftation which has little communica- tion with other parts of the Ifland, the fmall pox which prevailed there in Odober laft, has been ba- nifhed from the diftrid by the beneficial influence of the Cow-pox inoculation, which laftcircumftance, 1 mud confider as arguing favorably for the fpeedy extirpation of the fmall pox from the Ifland of Cey« Ion, and the whole of India, Copy of a letter from Dr. Meek^ dated Cochin Fe» hruary i/?, 1803, The vaccine inoculation has fucceeded well at Cochin, I have inoculated 1,044 fubjeits ; I have puc [ 102 ] put 25 ^^^f^"^^^ the ted of variolous contagion,' and it is with peculiar fatisfadion I have to Hate, that not one of the whole has fufFcred the fmalled degree of fickncfs or conflitutional derangement, nor further afFcdlion, than a flight inflamation at the pundbured part, the efFeds of which completely dif- appeared in a very few days. Four ofthc children were inoculated wich thread, impregnated with variolous matter, fent to me by the Phvfician General in November laft, the only appearances that followed were fuch as might have been expeded from the introdudion of an extrane- ous body fuch as a piece of thread under ihe cuticle. Soon after ihU four more were inoculated with virus, in a fiill moreadlive frate, fent to me from Callicur, but without being followed by any fymptom of fmall pox. In order however to be more fully fatisfied as to the genuine nature of the difeafe amongft us, I pro* cured a further fjpply of variolous matter from the fame fource, and with ic inoculated a native child of two years of age, that had not had either difeafe, the didind fmall pox followed ; and from this fubjedt the remaining 17 v,/ere inoculated. The matter was taken freih from the arm of t!ie child, and from the priaiary pudule, and the virus carefully inlcrted with t 1=3 3 with a lancet at two pundlures in each. In five of the fubjcdls no apparent topical affedion took place, but in all the others, there fuccceded more or lels of inflammation, but without any eruption or evident difeaie of the fyftem, two of the children were in- mates of the fame houfe with the fmall pox patient, and with equal impunity ; from which happy cir« cumftance I am perfeflly faci^ficd in my own mind, that the difeafe imported into this province^ is of the real Jennerean fort, and from the proofs thus adduc- ed, capable of performing the wonders it is faid to poflcfs. Owing to a miftake in arranging the flrfl: flieetr, the following communications explanatory of the exertions ufed to introduce the vaccine difeafe inta Bagdad and Buflbra, were prevented from appear- ing in their proper place. Extract of a Letter from the Refident at Bagdad to the Governor of Bombay y dated the \%ib Apil 1802. I have the highefl fatisfadion in ann-ouncing, as my public letter of to-day to tl e Refident at Buf- fora will (how, the fuccefs which has attended the operation of vaccination ac Bagdad^ and 1 now moil fervently t 1 fervently hope your philanthrophlc wiflies of m-i troducing the vaccine matter to India, arc in a fair way to be fulfilled. Letter from the Reftdent at Bagdad to Government^ i^th April 1802. To The Hon'ble JONATHAN DrNCAN, Prejident and Go'vernor i5fc* in Council, Political Department, at BOMBAY Hov'blk Sir, &Gentlemen> I beg permiflion to lay before the Hon'blc Board, the enclofed copy of a Letter from me to the Re^ fident at Buflbra, and to fubfcribc myfelf with the greateft rcfped, Hon'ble Sir & Gentlemen, Your moft Obedient humble Servant, (Signed) HARFORD JONES, BAGDAD,^ the 1 8th Apr. 1802. J ^xtra^ of his Letter of the fame date, to the Refi* dent at Bujfcra. It is with the higheft fatisfadlion, I acquaint you> that by the attention and ability of Dodlor Short* the operation of vaccination has been performed with fuccefs at Bagdad, with fome matter which I received from Do6tor de Carro of Vienna, on the 30th ultimo, and I have now the honor to fend you cxprefs. [ ] cxprcfs, vaccine matter taken yefterday from the arm of a child vaccinated at Bagdad. Your philanthropy and public fpirit will lead you, I am certain, to take every means for convey- ing this benefit to India, and to pardon my hinting to youj what Dodtor de Carro recommends when the vaccine is to be conveyed to a diftance, namely, that of conveying the matter as far and as much as pofllble by a(fluai vaccination j I Ihould prcfume, ic might fo happen, that fome of the Lafcars, or Se- poys on board the Cruifcrs you will be on the eve of difpatching, may never have had the finall pox, in which cafe, 1 think, a fucceffion of vaccination performed by the Surgeon on board, could not fail of conveying the matter in a perfefl (late to India. —In fault of thefe means, might it not be pofTiblc by gratification, to procure two or three chrillian children to undertake the voyage to Bombay. Extras of a Letter from Mr, Manefly, to Govern^ ment dated 26tb Jpril 1802. I have the honor to make a reference to the co- pies of a letter from Mr. Jones dated the i8th inf- tant, and of a letter from Mr. Milne of yefterdays date, on the intcrefting fubjed: of the vaccine ino- culation, which are contained in the Diaryj and I forward [ >o6 ] forward a fealed Packet from Mr. Milne, containing an impregnated lancet with Dr. de Carres publica- tion for the Hon*ble the Prefident, and I flatter my- felf, that there now exifis a very reafonable hope of the cow pox being introduced into India. 1)05! or Mikes Letter to Mr. Manefty^ dated the 2^tb Jpnl 1802. To SAMUEL MANESTY, Esquire, Rejident at Biijfora, I have pleafure in acknowledging the receipt of the vaccinated materials which you fent me lafl: night, and beg to inform you, that I have performed the operadon of inoculation this morning on fix dif- ferent fubjc6ls, of whom, three are inhabitants, ofBuflbra, and three belong to the Hon'ble Com- pany's Brig the Viper. I am thus in hopes, of being able with fuch rc^ cent virus, to cftablifh the vaccine influence in thofc parts, and likewife, to enable Lieut, Beaty, with the inftrudions which I have gi^en him, to convey its happy efi^eds to India. I take the liberty of returning you an impregnate cd lancet, contained in a quill, which is covered with Bees wax, and alfo, return you Dodor dc Carros publication for tranfmiflion to the Prefidency —I [ 107 ] —Ifhall fmploy the opportunity of every convey^ ancc, in furnifhing you with frefh materials, as fooa as I am happy enough, to efFecl my purpofe here. I have the honor to be with the greateft refpeifl. Sir, Your very Obdt. Humble Servt, (Signed) JOHN MILNE, BUSSORA, 1 the 25th April 1802. \ Exira^ from Mr, Maneftfs Letter to the Governor in Council i of the t^th of May ^ 1802. I have the pleafure to enclofe a Copy of a fecond Letter from Mr. Surgeon Milne on the fubjed of the vaccine inoculation, to the interefting contents of which, I claim your attention. To SAMUELMANESTY, Esquire, Rejldent at Bzijfora, Sir, I had the pleafure of addrelTing you lafl: on the a5thukimo, and have now the facisfadcion to ac- quaint you, that I have been fo fortunate as to pro- duce the vaccine afFcdion in three of the four cafes whom I in-oculated on the morning after you fent mc the materials received from Bagdad. Underftandin^* [ ic8 ] Underdanding, that it is your intention to dif- patch the Alert this evening, and that it is probable Hie may touch at Bufliire and Mufcat, 1 deem it advifeable, in addition to a frefh fupply of vaccine matter, which I furnifh you with for tranfmiffion to the Prefidency, to provide you alfo, with materials and inQruflions refpc(fling inoculation, which, con- fidering the importance of this happy difcovery, you will, 1 doubt not, be gratified in tranfoiicting to Mr, Bruce and Mr. Seton at thofc places. I have inoculated a boy on board the Alert, and lhall give Mr. Jeakes fuch information as I think will enable him to manage, in communicating the infcdlion to feme of his people who have not yet had the fmall pox, in fupport of the difcafe, if poffible, until his arrival at Bombay. 1 fhall continue to inform you regularly of the progrefs of vaccinadon here, which 1 (liall employ every means to render fpeedily and entenfively be- neficial. I have the honor to be with the greateft refpcft. Sir, Your very Obdt, Humble Servant, JOHN MILNE. BUGSORA* 1 the 5tii May, 1802. i True Copy, SAMUEL MANESTY. Extra^ [ 1 Pxfra^ of a Letter from the Refident at "Bagdad t$ the Governor of Bombay y dated the "jth of Novem<* her 1 802. Doclor Short, who has been relieved by Mr. af- fiHrant Surgeon Hine, now proceeds to the Prefi- dency, and as it was principally owing to his ability and attention, that we were able to produce the cow pox at Bagdad, about which, you were fo much in- tereded, I hope you will pardon the liberty I take, in mentioning it as a circumftance meriting the at- tendon of the Hon'ble Board. ^}ctra5f of the Governor of Bombay's anjwer dated the 22 d March 1803. It affords a very comfortable refleftion, that we have been at laft able, through your affiftance, and that of Lord Elgin, to propogate the vaccine di- feafe throughout India, as well as experimentally to afcertain, that it is of the very belt kind, and per- fedlly fccures thofe who have had it, from the fmall- pox — by which, the lives of millions yet unborn may, and mud indeed, be favcd^ and if our in- fluence in India, has ever entailed evils on the na- tives; this one important a6l of kindnefs on ouf part, ought to be viewed as no inconfiderable or inadequate compenfation. When [ no I Poftfcript When the vaccine difeafe was edabllfhcd at Bom* bay in June i8o2> Government at the recommen- dation of the Medical Board, direded that the important duty of keeping it up, and of furnifhing lupplics of matter for tranfmiffion to different fta- tions, fhould be entrufled to my care. In the difcharge of this arduous duty, I have occafionally experienced a great degree of difficulty in procuring fubjedls for fucceflive inoculation.— Of late however, fince the appearance of the natural fmall pox, the proofs of the efficacy and value of vaccination, have been fo numerous and fatisfac- tory, that the nadves of every defcription, do not any longer entertain doubts on the fubjeft. In July lad, I cftablifficd a flock of matter in the Fort, and another in the Country — I have one in- oculating day every week at each place, and I have carefully guarded againft mixing the two flocks of virus. From the uniform appearances of my pa- tients at both places, a confirmation is afforded of the difeafe having prcferved it's true, or fpecific cha- jauler. 1 inoculate from 30, to 50 fubjed^s at each tlmc^ as well wid^iin the Fort, as in Ihc country j I alfo obtain obtain early notice of the appearance of the fmall pox, and by vaccinating the children near to the Ipot where ic had occurred, I have been enabled to prevent this malady from committing it's ufual ravages. The number on this ifland, that have already gone thro' the vaccine difeafc is very great. I hope however that a fufficient number of fubjcds will not be wanting to fccure a continuance of the bleffing of the difcovery to this ifland, as well as to enable me to afford fupplies to diftant ftations, where the difcafe may be loft, G. K, BOMBAY, March 31ft. 1^03, FINIS. MED. CHIR. SOC, I Keir 1803