A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 8).
- James Copland
- Date:
- 1834-59
Licence: Public Domain Mark
Credit: A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 8). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
![[It appears from the British army statistics that in eight years, from 1844 to 1851, out of a total number of 1,125,854 soldiers, only 745 cases of small-pox occurred, or 66 to every 100,000 men ; while among 363,370 sailors there were 417 cases of small-pox, or 115 in every 100,000 men. The deaths from small-pox were only 130 in nearly 1,500,000 men. Among the boys in the military asylum, who are all vaccinated, or have had small-pox, there were only 30 cases and 4 deaths among 31,705 ; and it appears also that almost as many of these cases occurred in boys who had had small-pox as among those who had been simply vaccinated. All the four deaths were in boys who had had small-pox.—J. G. Balfour, surgeon to the Royal Military Asylum, Chelsea. Of 268 cases of admission for small-pox into the Philadelphia Small-pox Hospital, in 1840-1- 2, there were, according to Dr. Stewardson, 161 of small-pox, of which 41 died ; 73 of varioloid, of which none died ; and 32 doubtful, of which 3 died. Of these, 79 were whites, of whom 22 died ; and 82 blacks, of whom 19 died—the pro- portionate mortality being very similar. Of the whole number, 113 were unprotected, of whom 30 died; 99 had been vaccinated, of whom 4 died ; 51 doubtful, of whom 10 died. The vari- olous disease was mild, and the pocks few in number.—Am. Journ. of Med. Set., vol. v., N. S., P-80.] 92. The susceptibility of infection exists in all persons who have not had the disease, and who have not been vaccinated, but in various degrees : it is greatest in infancy and childhood, and least in advanced age. Dr. Gregory, however, thinks that this greater mortality from small-pox does not depend upon a greater susceptibility of infec- tion, but because the disease is usually contract- ed on the first exposure to the infectious miasm. There can be no doubt of this being the case, but it is chiefly owing to the susceptibility being so remarkable at this age. Numerous excep- tions have, however, been remarked to this gen- eral susceptibility. Both before and after the in- troduction of inoculation, many persons were fre- quently exposed to infection without experien- cing the disease ; and this circumstance, which is common to all infectious and pestilential mala- dies, was most ignorantly urged by non-conta- gionists as an argument against the existence of an infectious property ; they either not adverting to, or concealing the fact, that many of those who thus appeared quite unsusceptible of infection had the disease communicated to them by inocu- lation. A lady, in 1804, was successfully in- oculated for small-pox at the age of 83, and lived several years afterward. She had brought up a large family, most of whom she had attended in attacks of small-pox, but had never taken it her- self. I shall have to show in another place the Northern and Northwestern Dispensaries of New York show that of five hundred and forty-nine variolous cases (variola and varioloid) treated in those institutions, ninety-three, or 17 per cent., were one year old or under ; one hundred and sixty-three, or 30 per cent., from one year to five ; one hundred and twenty-six, or 23 per cent., from five to ten years ; one hundred and four, or 19 per cent., from ten to twenty ; fifty-four, or 10 per cent., from twenty to forty ; seven, or 1.3 per cent., from forty to six- ty ; and two, or 0.6 per cent., over sixty ; showing that 47 per cent, were five years old or under. Taking the whole city of New York, sixty-four per cent, of small-pox deaths, during the past five years, have been under the age of five.] that the susceptibility which, in vaccinated per- sons, is destroyed for some years, returns with advancing age, and becomes greater as life ad- vances. 93. B. The several causes which predispose the system to the infection of other pestilential maladies have a similar effect in spreading small- pox. Of these the most manifest are diathesis, or peculiarity of constitution ; humid and warm seasons and states of the air ; a close and stag- nant, or impure atmosphere ; fear of infection ; an endemic or epidemic constitution, favourable to the diffusion or operation of the poison : ar- rival from a pure and healthy air into a locality in which the malady is prevalent; and the con- stitution of the Negro and dark races. — a. A delicate conformation and susceptibility of the nervous system, a scrofulous or other diathesis existing in families, and exhaustion or depres- sion by previous disease or other causes, either predispose the frame to infection or render the malady more severe.—b. A high range of tem- perature,* especially when conjoined with hu- midity, stillness, and impurities, arising from ani- mal or vegetable decomposition, both predispose the frames of those who are subjected to these causes, and concentrate the poisonous miasm emanating from the sick, and spread this miasm in a wider sphere.—c. Fear of being attacked, by depressing vital power, lays the body more open to the invasion, as in all other pestilential mala- dies.—d. There is something in the state of the stationary epidemic constitution which certainly influences variola and other epidemic distempers, and which we are unable to demonstrate other- wise than in the characters of its results; but although the epidemic prevalence of small-pox may be limited to a particular place, or extended over a whole country, either in cold seasons or weather, or in warm seasons and countries, yet it is most severely and generally prevalent in these latter circumstances.—c. The constitution of the dark races evinces a remarkable susceptibility of * Boerhaave, one of the ablest illustrators of the pa- thology of small-pox, states, Est ut plurimum epidemi- cus, verno tempore primo incipiens, .-estate crescens, lan- guens autumno, hyeme sequente fere cedens, vere iterum eodem ordine rediturus. The truth of this was shown in the course of the Norwich epidemic of 1819, when a few cases only were observed in the preceding winter, and the greatest prevalence and mortality were in June and July. Small-pox was introduced, also, into the town of Lynn at the commencement of this year, but did not spread with rapidity until summer. A knowledge of this circum- stance induces the native inoculators in the East to inoc- ulate the small-pox in the cool season. [There is no good reason for believing that the weather or seasons have such influence on this disease, as stated by Dr. C. Taking the mortality from small-pox in New York, from 1816 to 1853 inclusive, the result shows for January, 661 deaths ; February, 531 ; March, 559 ; April, 309 ; June, 380 ; July, 288; August, 243 ; September, 194 ; October, 269; November, 370; December, 521. Spring, 1217 ; Summer, 911; Autumn, 833 ; Winter, 1713. Show- ing that the greatest mortality is in the winter, and suc- cessively less in the remaining seasons ; the deaths dur- ing the autumnal months not being half as great as during the winter. Though we have had occasional mild epi- demics of small-pox in the summer, those attended with much fatality have uniformly commenced in the fall, or at the beginning of winter. The same is observed by Syd- enham as occurring in his time. The contrary, how- ever, has been observed in some instances. At present, there is every reason to believe that small-pox is quite in- dependent of cognizable climatic conditions, such as the temperature, density, and humidity of the atmosphere. There doubtless are unknown atmospheric conditions, es- pecially as connected with its electrical state, &c, which influence the susceptibility to variolous contagion, but what they are must be determined by future observa- tions.]](https://iiif.wellcomecollection.org/image/b21111066_0051.jp2/full/800%2C/0/default.jpg)
