Images de page

indeed, was done so effectually, that even in the tenth century we have it recorded by a resident physician in that city, (Nonus,) that neither the small-pos vor measles was known in Constantinople in his time.

It was not till the commencement of the eighth century, when the whole southern coasts of the Mediterranean had been subdued by the Arabians, that the contagion first visited Europe ; and the landing of an army of Moors in Gibraltar and Spain, conducted by Julian, in order to revenge the outrage committed by Roderick on his daughter, is said to have been the means of introducing the disease in question into this quarter of the world.

• By this invasion,' says Mr. Moore, the small-pos must have been brought into Spain, and the victorious Saracens soon reached the Pyrenees. In the year 731, Abderame crossed these mountains, and inundated the southern provinces of France with an host of Saracens. They were opposed under the walls of Tours by Charles Martel, when Christians and Mahometans fought six days, indecisively, for victory. But in a closer combat on the seventh day, the impetuous yet slender Africans and Asiatics were crushed by the superior strength of the Germanic warriors. The Saracens and the Koran were repelled into Spain, but the small-pox and measles remained in France. No warlike etforts could drive off these infections; and the opportunities of diffusing them had at that time become innumerable. The Saracen fleets were triumphant in the Mediterranean; Sicily and Italy were frequently invaded; many cities of the coast were repeatedly captured, and Rome itself was menaced. It cannot be doubled that so much intercourse with Africa and Asia brought over these maladies, though no direct proof can be adduced. But the circumstantial evidence is sufficiently conclusive.'

It has been maintained by Mead, and since by Baron Dimsdale, that the small-pox was first brought into Europe by the crusaders; but besides that the historians of the holy wars take no notice of the Christian armies having suffered from that malady, it is very properly remarked by Mr. Moore, that the assumption is inconsistent with the fact that so early as the eleventh century treatises were published, both in Spain and Italy, upon the small-pox, as a well known and commoji malady. To the American continent the virus was conveyed by the Spaniards in their invasion of Hispaniola and Mexico, and thus did this destructive pestilence, commencing in Asia, successively visit Africa, Europe, and the New World.

We come now to the origin and progress of inoculation, or the practice of artiticially communicating the virus, in order to render the disease of a less malignant kind and character. It is pretty generally known that this was introduced into England from Constantinople, but, from the extracts already given from Mr. Moore's publication, the artiticial communication of the poison appears to have been established in China long before even the disease itself was heard of in the Byzantine capital.

Inoculation, at whatever time it originated, was most probably founded upon the accidental observation of the comparatively mild nature of the distemper in some, when compared with other instances, for no reasoning à priori would have conducted to the inference that by this mode of imparting the poison, the disease would be mitigated. Whether the suggestion or the discovery was first made by any of the faculty of niedicine does not appear; as far as the imperfect accounts from Chinese records may be relied on, it seems to have been opposed very generally by the professed guardians of the public health.

• No account,' says Mr. Moore, ‘is handed down of the origin of this custom; but the reverence in which agriculture is held by the Chinese, may have suggested the name (sowing the small-pux), and the usual manner of performing the operation. For they took a few dried smallpox crusts, as if they were seeds, and planted them in the nose. A bit of musk was added, in order to correct the virulence of the poison, and perhaps to perfume the crusts, and the whole was wrapped up in a little cotton to prevent its dropping out of the nostril. The crusts employed were always taken from a healthy person who had the small-pox favourably; and with the vain hope of mitigating their acrimony, they were sometimes kept in close jars for years, and at other times were fumigated with salutary plants. Some physicians beat the crusts into powder, and advised their patients to take a pinch of this snuff; and when they could not prevail upon them, they mixed it with water into a paste, and applied it in that form. In Hindostan, if tradition may be relied on, inoculation itself has been practised from remote antiquity. This practice was in the hands of a particular tribe of brahmins, who were delegated from various religious colleges, and who travelled through the provinces for that purpose. The natives were strictly enjoined to abstain during a month preparatory to the operation from milk and butter; and when the Arabians and Portugueze appeared in that country, they were prohibited from taking animal food also. Men were commonly inoculated on the arm; but the girls not liking to have their

arms disfigured, chose that it should be done low on the shoulders. But whatever part was fixed upon, was well rubbed with a piece of cloth, which afterwards became a perquisite of the brahmin; he then made a few slight scratches on the skin with a sharp instrument, and took a bit of coiton, which had been soaked the preceding year in variolous matter, moistened it with a drop or two of the holy water of the Ganges, and bound it upon the punctures. During the whole of this ceremony, the brahmin always preserved a solemn countenance, and recited the prayers appointed in the Attharna Veda, to propitiate the goddess who superintends the small-pos. The brahmin then gave his instructions, which were religiously observed. In six hours the bandage was to be taken off, and the pledge to be allowed to drop spontaneously. Early next morning cold water was to be poured upon the patient's head and

shoulders, Dr. Alpeck wrote an account of his observations to Dr. Woodward, by whom it was inserted in the Philosophical Transactions of the year 1714.

shoulders, and this was to be repeated till the fever came on. The ablution was then to be omitted; but as soon as the eruption appeared, it was to be resumed, and persevered in every morning and evening, till the crusts should fall off. Whenever the pustules should begin to change their colour, they were all to be opened with a fine pointed thorn. Confinement to the house was absolutely forbidden; the inoculated were to be freely exposed to every air that blew; but when the fever was upon them, they were sometimes permitted to be on a mat at the door. This regimen was to consist of the most refrigerating productions of the climate; as plantains, water-melons, their gruel made of rice or poppyseeds, cold water and rice.'

Although it is not our design to engage in any practical discussion, it seems hardly possible to refrain from incidentally remarking the great superiority of these modes of treatment—a treatment founded on the dictates of nature—to those subsequently adopted by the Arabian and European physicians who forsook observation to follow hypothesis ; and it is worthy notice that our modern improvements in the management of febrile and eruptive complaints consist mainly in permitting nature to follow its own course. We revert to ancient simplicity, and are therefore abundantly more successful than our immediate predecessors.

It has already been said that an obscurity hangs over the actual origin of this practice. In the opinion of some it commenced in the Arabian desarts, 'where neither physicians nor priests officiated; the practice being monopolized by old women.' From sowing the small pox, it came in the course of time to be, and perhaps was originally, called buying the disease; which proceeded, it is said, from the circumstance of one child carrying to another a few dates, or raisins, the pretended price of the matter: this custom of buying the small-pos becoming general among the inferior classes along the African coast, at length found its way into Europe, and was even practised in some parts of our island.

Still, however, the faculty took no cognizance of any artificial method of communicating the poison, until the year 1703, when Dr. Emanuel Temoni Alpeck, who had graduated both at Padua and at Oxford, and who was then residing in Constantinople, was struck with the instances which he witnessed of the mitigated nature of the distemper when the virus was thus received into the human frame.*

A Venetian physician also, of the name of Pylarnus, had about the same time made the same observation of the success of the Turkish practice, of which, in 1715, be published a statement at Venice, in a tract entitled Nova et tuta variolas excitandi per transplantationem methodus. In the same year, too, Mr. Kennedy, an English surgeon, who had visited Turkey, endeavoured to excite professional attention to the advantages promised by the plan of engrafting, as he calls it, the small-pox.


It was, however, reserved for another coincidence in point both of time and circumstance, to be the means of rousing the members of the faculty from their apparent indisposition to investigate the merits of inoculation. Lady Mary Wortley Montague accompanied her husband as ambassador to the Ottoman court, and having observed with surprise that it was the custom in Constantinople for a set of old women to 'engraft' children with the small-pos every autumn, and moreover that the children thus infected had invariably a mild disease, she conceived the bold design of having her own son thus treated : this answered every expectation, and on her return to the British capital in 1722, she caused the same experiment to be made on her daughter, which was attended by the same happy results. Still, however, the profession hesitated to accept the proffered good, and notwithstanding that two princesses of the Royal family were successfully subjected to the same process under the influence of Lady Montague, the new practice went on at an exceedingly slow pace. As it was ascertained that the inocillated or ingrafted distemper was equally infectious with the disease when naturally acquired, it became a question in morals how far the individual who had his mind made up with regard to the eligibility of the practice, had a right thus to sow the seeds of the malady among others whose convictions were not in favour of inoculation, and who therefore refused its offers.

In process of time the question of inoculation came to be agitated with just the same virulence and party-spirit that have marked the modern controversy on the subject of vaccination, and it must be allowed to the impugners of the former, that they have a strong point in favour of their cause which the anti-vaccinists are without; since, as we shall speedily see, inoculation has proved a private good at the expense of being a public evil. So successful was the opposition to the practice of engraftment at the times to which we are now alluding, that in spite of the high authority by which it was sanctioned, it fell both in this country and throughout Europe into general disuse, and there seemed little reason to imagine it would be revived.'

• When in this dormant state news was brought that multitudes of Indians in South America had been inoculated with as much success by Carmelite Friars, as the Asiatics had been by the Greek old women: a physician and surgeon also began in the year 1738 to inoculate in South Carolina ; and only lost eight persons out of eight hundred. But a planter in St. Christopher's inoculated three hundred persons without


the loss of one. For it is singular that in those days all inoculations performed by private gentlemen, monks, and old women, were uniformly successful; and empirics afterwards were equally fortunate : none lost patients from inoculation except the regular members of the faculty. The American reports were so encouraging, that about the year 1740, the practice was revived by a few surgeons in Portsmouth, Chichester, Guilford, Petersfield, and Winchester; and gradually extended in the southern counties.'

Mead, too, took up his eloquent pen in the cause; and Mr. Moore tells us that his attributing the beauty of the Circassiau women to the custom of inoculation which had obtained amongst them, had very considerable weight with the British ladies. The practice now very sensibly advanced ainong the higher circles, and for the accommodation of those in the lower walks of life, the Smallpox Hospital was erected in the year 1746. Iu 1754 the London College of Physicians gave their powerful sanction to the practice, by publishing a tract in its favour, and the press now groaned with works on inoculation, and with various plans of treatment.' These complicated modes of management, medicinal and otherwise, served, however, to bring the practice into discredit, which did not therefore become very generally diffused until its simplification and consequent improvement by a very conspicuous character in the Annals of Medicine.

* Daniel Sutton, (says Mr. Moore,) with his secret nostrums, propagated inoculation more in half a dozen years, than both the faculties of medicine and surgery, with the aid of ihe church, and the example of the court had been able to do in balf a century. This man was the son of Robert Sutton, a surgeon at Debenham in Suffolk, and he and his brother assisted their father in his business. But after a time both sons left their father's house, and Daniel was content to serve as an assistant to a surgeon at Oxford. In the year 1763, he rejoined his father, and proposed to make some alterations in his plan of inoculation. These were condemned by the father as highly dangerous, yet Daniel was so confident as to make the experiment, and he found it successful. On this the father and son quarrelled, and the latter set off for Ingatestone, in Essex, where he set up as an empirical inoculator. He pretended to have discovered an intallible secret, and brought himself into public notice by the old and still successful trick of puffing hand-bills and boasting advertisements. Yet, in truth, his pretensions, though extravagant, were not without foundation ; and in a short time such multitudes crowded to Ingatestone to be inoculated, that the town and neighbouring villages were filled with patients. It is much to be regretted, (adds our author,) that Sutton should have stooped to employ such unworthy devices; for his plan of treatment was greatly superior to that of any former practitioner; and bad he followed the correct rules of open professional conduct, his name would have been recorded with honourable distinction. It appears, however, by the


« PrécédentContinuer »