A letter in reply to the report of the surgeons of the Vaccine Institution, Edinburgh : with an appendix, containing a variety of interesting letters on the subject of vaccination, and including a correspondence with Dr. Duncan, Dr. Lee, and Mr. Bryce : from which also the public will be able to appreciate the authority of the surgeons of the Vaccine Institution, and to form a correct opinion of the whole subject / by Thomas Brown.

Date:: 1809

Credit: A letter in reply to the report of the surgeons of the Vaccine Institution, Edinburgh : with an appendix, containing a variety of interesting letters on the subject of vaccination, and including a correspondence with Dr. Duncan, Dr. Lee, and Mr. Bryce : from which also the public will be able to appreciate the authority of the surgeons of the Vaccine Institution, and to form a correct opinion of the whole subject / by Thomas Brown. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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advanced period of the small-pox inoculated pustule, that it as- sumes this appeiirance. I apprehend, however, from Mr Bryce's anxiety in cinijloying the terms Tesicle and pustule, he means to convey, not only that there is a material dilTerence in their struc- ture, but also in their contents, and seems anxious to infer, that the vaccine vesicle may possess very remarkable properties, from its very singular and uncommon organization. 1 confess, however, with the most careful examination by the best glasses, and the most minute attention to the subject, 1 can see no grounds for this distinction, from the structure, and but very little from the contents of the two pustules. The skin may be safely described as consisting of secreting, exhaling, and inhaling tubes, surrounded with mucus, nerves, and blood-vessels, over all which the thin cuticle is expanded, and, upon being examined with good glasses, gives the appearance of cells, as it were, sealed hermetically by the cuticle. If, upon the introduction of either vaccine or variolous virus, an inflamed point is produced, this account of the formation of the external part of the skin becomes very evident, and little vesicular points are now distinctly perceived, all separated from each other, and as yet forming no distinct vesicle, but gradually extending them- selves from the punctured point, to the extremity of the inflamed spot. In a little time, generally from the third to the fifth day, these vesications become large and distinct, and unite into a clus- ter, forming at last a vesicle or pustule, by being considerably enlarged, and elevated above the rest of the inflamed spot. During the whole of this progress, the point where the lancet was intro- duced appears not to be altered in the smallest degree, but re- mains, as it were, firmly tied down, by the adhesion produced from the puncture, and preserves this appearance through the whole progress of the vesicle and pustule. It is this cause that produces the pit, or depression in the centre ; it is from this point, that the ])ustule or vesicle begins to decay, and, in the appear- ance of a crust, gradually extends itself over the whole. This account applies both to the formation of the vacciiie and vario- lous inoculated pustule; and in no instance have I ever fouud either of them to vary, unless they had sustained some injury*. But besides what we have already described, we shall find, that they also agree in many other respects. At no period can * In some cases of both vesicle and pustule, (but more especially of the pustule) where they are large, and the inflammation severe and extensive, the punctured point seems disengaged from its situation, and they assume the appearance of a sac or absce«s ; but this, too, only at the latter period of the process.

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