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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$lation, this absence of fever has been particularly noticed, it be. ing remarked, that by far the greater number of them pass through all the stages ef cow-pox, without any sickness or fever being observed. If the affection of cow-pox at the part inocu- lated has proceeded regularly through all its different stages, and if each stage has been clearly and distinctly marked, we think ourselves authorised, from the united testimony of many eminent in the medical profession, to conclude, that the general affection, and, consequently, theantivariolous process has taken place in the constitution, even although no fever may have been detected. But in many instances these different stages are not regular, neither are they distinctly marked ; and how far these irregularities may take place without frustrating the purpose of the inoculation, and what may be the exact degree of the size of the vesicle, or of the surrounding inflammation and hardness, which is to mark a con- stitutional affection, or to assure us that the antivariolous pro- cess has bceen accomplished, zse must confess we have no certain rule to determine. On this point, then, assuredly the most im- portant to be ascertained in the progress of the symptoms of the cow-pox, every person is left to form his opinion, from a com- parison, in his own mind, of the case under consideration, with what he may have read in the writings of authors, or with what he may have observed in other cases, Avhich, to his own know- ledge, had proved effectual. But it will be allowed, that a judg. ment thus formed must often be very inaccurate, and thus bring disappointment, or worse, to all concerned, as well as discredit upon the new inoculation.—See Practical Observations by Mr Bryce, p. 137 to 140. From the very first time that I had occasion to conduct the inoculation for cow-pox, the uncertainty of the desired change being operated upon the constitution, partly from the apparent slightness of the affection at the part inoculated, but chiefly from a want of some well-detiued mark whereby to judge of a general affection, very forcibly presented itself to my mind; and after having carefully attended to upwards of six hundred cases which have fallen under my immediate care, 1 am thoroughly convinced, that some clear and well-defined mark of a constitutional affection in cow-pox, different from what has hitherto been observed by those who have writtei\ on this subject, is still to be regarded as the grand desideratum in conducthig this new inoculation ; for, until this be established, our judgment of the efficacy of the qow- pox inoculation in preventing small-pox must often be formed with doubt and anxiety, and too frequently prove ultimately er- roneous. The truth of these remarks will be best known to tliose ini)st conversant with the cow-gox inoculation, and who are ac-$

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