Account of a Cafe of Intermitting Fever, cured by a copious Bleeding from the Nofe.

DEAR SIR,

STRASBURG, February 27th, 1805.

AM prompted to relate a cafe of intermittent fever, for your Museum. The fon of Mr. I. M. aged fifteen years, was attacked in the month of Auguft, 1804, with a violent intermittent. The father not being fond of much doctoring (as he expreffed himfelf), an emetic only was ufed: the difeafe continued about three months, with daily paroxyfms, during which time, the patient became much emaciated, when a nafal hæmorrhage intervened, and I was called upon to fave the young man from bleeding to death.

Being made acquainted with his fituation, I fuffered the hæmorrhage to continue, until three pounds and an half of blood were loft in three days, the last of which would have scarcely tinged a linen cloth. The patient from this time recovered rapidly, without a return of the disease, notwithstanding relapfes were more common last season in this neighbourhood, than had been hitherto known.

How is it that tonics and depletives produce the fame effect? This may deferve fome confideration.

TO DR. JOHN R. COXE.

Some Obfervations on the Introduction and Progress of the Small Pox, at Dumfries (Virginia) during November and December 1804, and January 1805, accompanied with further Evidence in Proof of the prophylactic Power of the Cow-Pock: communicated in a Letter from DR. JOHN SPENCE, to the Editor, dated, Dumfries, March 30th, 1805.

THIS day received a Richmond newfpaper, entitled the Enquirer, dated the 28th inftant, in which I find the following extract from the London Monthly Magazine for December 1804, under the head of "Notices of Works in hand to be published:"-" Mr. Goldfon of Portsmouth has made feve ral experiments to afcertain the effect of vaccination in the hand, and has uniformly produced a vesicle distinctly different from that, from the fame matter in the arm, having every resemblance both in refpect to fize and the peculiar blue tint to that, which takes place in the cafual disease. The result of these experiments, with further facts and observations on small pox fubfequent to vaccination, will be sent to the prefs in a few days."

From this notice it would appear that a fecond attack is meditated by this gentleman against the efficacy of the cow-pock; but if it be as feeble as his firft, the friends of vaccination have little to dread. But when fo much uneafinefs is excited by these attempts in the public mind, and fo much clamour raised against one of the greatest discoveries ever made in the healing art, it is certainly the duty of every real friend to the new practice, to step forward promptly with fuch additional evidence, as he may poffefs, in its favour. I therefore beg leave to fubmit to your confideration, the following statement of facts.

When I applied to you about the beginning of last winter for a fupply of vaccine matter, I informed you of the alarm excited in this town and its vicinity by the fudden and unexpected appearance of the small pox. A runaway negro belonging to a gentleman in this county, was brought here from Phi

ladelphia early in November laft, and confined in the jail of this town. He was foon afterwards taken very ill, and from the violence of the fever, and the pains he complained of, the phyfician who attended him, fuppofing that these inflammatory fymptoms proceeded from a severe cold, directed bleeding and the ufual antiphlogistic remedies; for there was no fufpicion of the disease being the small pox, until the eruption had assumed its characteristic appearance. The disease proved to be of the confluent kind, and terminated fatally about the fourteenth day. Although this patient was confined in the upper story of the jail, and great circumfpection obferved to prevent all intercourse with him, a negro girl living in a family adjoining the jail, broke out with the small pox about the middle of December, upon which a meeting of the magiftrates was fummoned, who, notwithstanding the extreme inclemency of the weather, ordered this girl, with the whole family, to be removed to a folitary houfe in the country, and directed a phyfician to attend them. The children of this family were there inoculated with matter taken from a puftule of this girl, and paffed through the small pox very favourably. About ten days after this, information was brought to town, that another negro man, who had been hired here, but who declared he had had no communication with the jail or any infected perfon, broke out with the small pox, when on a visit to his master's plantation about seven miles from this place, and excited thereby a degree of confternation among the inhabitants of that neighbourhood, which is undefcribable. On this plantation (the property of Mr. Storke) there were more than thirty perfons, all strangers to the fmall pox, except Mrs. Storke, the mistress of the family, a lady confiderably advanced in years. During the fummer of 1802, when vaccination was prevalent here, two negroes of Mr. Storke's, anxious to be vaccinated, had the operation performed, and paffed through the disease without the knowledge of their mafter. Fortunately one of these negroes was the mother of the man who was attacked with the fmall pox. This woman attended her fon day and night

during the whole of the difeafe, which proved fevere, and was affifted at all times by the other negro who had passed through the vaccine. Both of them were not only thus expofed to the ⚫ variolous contagion, during every stage of the disease, but were alfo inoculated with fresh matter taken from the patient they -nurfed, without its producing any effect. These striking cases of the preventive power of the cow-pock soon spread far and wide, and had the happiest effects in making converts to the new inoculation. Mr. Storke and his whole family were immediately vaccinated with fome of the virus you fent me, all of whom paffed through the disease in the mildest manner. From his plantation, the vaccine inoculation was conveyed to the neighbouring ones, and is ftill carried on in that part of the country with every degree of fuccefs that could be wished for.

On the removal of the infected family from town, by order of our magiftrates, it was fondly hoped by the inhabitants that no further danger was to be apprehended from the fmall pox; but this hope was of fhort duration; for on the 30th of December, it was afcertained that the difeafe had broke out in the natural way in the family of Mr. Adams, whose house is fituated nearly in the centre of the town. How his daughter, a girl of about thirteen years of age, caught the contagion, has never been accounted for, and the numerous puftules with which he was covered, had advanced confiderably in their progrefs, before the nature of the eruption was discovered, for her parents, fearful of being compelled to remove their family from town, at a feason of the year fo unusually rigorous, carefully concealed her diforder. Early in the ensuing month, her brother, who caught the contagion from his sister, also broke out, had the disease in the most malignant form, and died. From the extreme anxiety of these parents to conceal the fmall pox, an anxiety proceeding, no doubt, from the rigour of our laws, no medical aid had been called in, until this boy's life was defpaired of: at that time, two black children in the kitchen were inoculated for the fmall pox by one of the family, and passed fafely through the difeafe. Since that peri

od, which now nearly exceeds nine weeks, no cases of small pox have occurred. Of the five perfons who had the small pox in the natural way, two died; feven children were inoculated for the small pox, fome of whom had a heavy eruption,

but all recovered.

Having given this brief history of the introduction and progrefs of the fmall pox among us, I fhall now add a few words on the mode in which vaccination was conducted.

On the 22d of December, I fucceeded in exciting the genuine vaccine puftule from the cruft you had the goodness to fend me, in a family where there existed the greatest danger; I mean in the family of the deputy-fheriff, whose duty it is to fuperintend the jail, to fupply the prifoners with provifions, and who, from the neceffary intercourfe that took place between his fervants and the deceafed runaway, was very apprehenfive of the small pox. From this fource we had abundance of the fresh transparent fluid, and the new inoculation fpread rapidly. But the folicitude for vaccination was displayed moft remarkably, on the appearance of the fmall pox at the houfe in the centre of the town, as has been already stated; for then, those who "were indifferent about it in 1801 and 1802, and even many perfons who still had doubts of its efficacy, eagerly embraced the opportunity now offered.

Although the fmall pox prevailed in this town and its neighbourhood, more than two months, there did not occur a folitary inftance of a vaccine patient having been feized with that difeafe, either when tefted by inoculation or otherwife; and it is proper to observe, that no variolous inoculation has been permitted in this quarter, fince the fpring of 1791, a lapfe nearly of fourteen years.

But, as repeated expofures of vaccine patients to the natural fmall pox, may have greater influence with fome than fimple inoculation with variolous matter, I beg leave to felect a few well attefted cafes. The firft cafe which occurred, and which made confiderable impreffion, was that of a blackfmith who was employed to remove the irons from the runaway, in jail,

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