The New Hampshire Gazette And Historical Chronicle

DIRECTIONS
Concerning Inoculation,
With Instructions how to prepare those
who are soonest likely to take the
SMALL-POX in the Natural Way,
Adapted to Town and Country.

The Small-Pox, being a Disease of
universally infectious, and so often
fatal to Mankind, has in every Age,
not only engaged the Attention of
the ablest Physicians, but induced
many of them to favour the World with Dissertations
on it; wherein they have given those
Methods & Practice which they found most successful;
and thereby have, rendered the Treatments
of that Disease, when taken in the natural
Way, perhaps as certain as ever we may expect it
will be, allowing for Difference of Climate,
and other Circumstances, which require the Judgment
of a Physician.

But of all the Improvements, none have been
found equal to that of Inoculation, whereby the
Chance in that Disease has been found to be, at
the least, as One to Seventy, and, in some Instances,
as One to Two Hundred; and Two
Hundred and Sixty even; whereas, in the natural Way,
One in Four to Seven have usually
died; and when there has been but One in Eleven,
it has been thought uncommonly favourable, as
appears by a Pamphlet published in England by
Doctor Heberden: wherein is stated the different
Calculations made in Boston, and other Places
in America, and in the Small-Pox and Foundling
Hospitals in London.

In the Years 1758 and 1759, there were
more Persons inoculated in Pennsylvania, and in
the neighbouring Provinces, than is supposed to
have been from the first Settlement of them, and
with amazing Success considering the Malignity
of it in the natural Way.

As it was not doubted but some Preparations
of Mercury and Antimony were the principal
Medicines used, which was confirmed by the
Manner of Operation of such as were given by
those who pretended to the grand Secret, every
one used such Preparations and Combinations
thereof, as his own Judgment directed; all concurring
in one Thing, to prepare, not only before,
but also between the Inoculation and Eruption,
endeavouring thereby to counteract the variolous
Venom in the Beginning of its Operation on the
Blood, and thus seasonably prevent those direful
Effects it produces, which often terminates in
Death.

What those Medicines are, wherewith Patients
may be best prepared, and the Manner of administering
them, are extracted from two late Publications.---The first of which directs:

The Night before you inoculate, give a
few Grains of Calomel, well levigated with
a like Quantity of diaphoretic Antimony, unwashed;
proportioning the Quantity of Calomel
to the Constitution of your Patient:
from four Grains to ten for a grown Person;
and from one to three for a Child, to be made
up in a Bolus, or small Pill, with a little Conserve
of Roses, or any common Syrup. The
next Morning give a Purge of the Pulvis Cornachini,
made with equal Parts of diaphoretic
Antimony, Scammony, and Cream of Tartar.
Repeat the Bolus or Pill three Times, that is
once every other Night after Inoculation, and
on the fifth Day give a Dose of Boerhave's
Golden Sulphur of Antimony; about four
Grains of it for a grown Person, with two or
three Grains of Calomel made into small Pill,
will operate both as a Vomit and Purge at the
same Time.

In the intermediate Days, give two or three
Papers of the following Powders viz. Diaphoretic
Antimony, ten Grains; Sal Prunel, Six
Grains; and Calomel, one Grain, mixed together,
for a grown Person; and about one
fourth Part of a Paper for a Child. These
Powders are to be continued until the Variolous,
or Small Pox Fever is over.

It appears, by the nearest Calculation, that
under this Treatment, there has not died more
than one Person in 700, and in general, the
Distemper is very light, not above one in an
Hundred has it full; when, in the common Way
of Infection, one dies out of five.

In the second of these Publications, the Method
is thus:

Take of Calomel, finely levigated, two
Parts Sulphur Aurat. Antimonii, one Part;
and with a strong Solution of Gum Arabic, or
Tragacanth, make into a Mass of Pills; which,
for Distinction Sake I will call the Mercurial
or Antimonial Pill.

Take of Stib. Nitrat, or unwashed diaphoretic
Antimony, Cremor Tartar, Sal Polychrest,
and Flor. Sulphur, of each equal Parts; mix
and make a refrigerant Powder, of which 30
or 40 Grains is a Dose for an Adult.

Take the Powder of Jalap, Scammony,
Stib. Nitrat and Cremor Tartar, of each equal
Parts, mix and make a purging Powder.

The Day before Inoculation, give two
Scruples of the purging Powder, with five
Grains of Mercurius Dulcis, to Adult, and to
others in Proportion to their age. The Night
after Inoculation, give a Dose of the Mercurial
Pill (which is ten Grains, or 12 if robust,
to an Adult, diminishing according to the Age,
so as to give to one from 9 to 12 Months two
Grains) and repeat it three nights successively.
The Morning after the third Pill, give a second
Purge; after which repeat the Pills 2 or
3 Nights and then the Purge again. The Pill
frequently purges and vomits the first Time of
taking it. Every Morning, including the Day
of Inoculation, give a Dose of the refrigerant
Powder (except the Day the Purges are administered)
continuing them till the Eruption.

But finding that the Pill was full strong
even for those of six Months, I gave the following
Powder, viz. of testaceous Powder,
and Nitrum Stibiatum, each Half a Drachm:
of Cinnabar of Antimony and Calomel, each
ten Grains, mix and rub them into a fine Powder,
of which give eight Grains to a Child of
six Months, and four or five Grains to one
of six Weeks or two Months old: And to
promote a little Puking, I add to their Purges,
which should be Rhubarb and Calomel, a
small Quantity of Sulphur Aurat. Ant.- e. g.
& Half a Grain for one of six Months old.

Sometimes a universal Rash appears with
the Fever, and alarms those concerned very
much; but it rather portends Good than Ill,
and need not be regarded, unless attended
with other known bad Symptoms, and then
Venesection will be proper, even to Infants.

I have generally used the Powder for Children
in the Form aforesaid; but have occasionally
varied the Proportions a little. I have to some
used only the Pills and Purges, with equal
success. I am also fully satisfied, that it is a
matter of indifference, whether the Incision in
the skin, and the infectious Lint placed therein,
be large or small.
The Authors of both these Methods agree in
Bleeding, once or twice, those that are of a full
Habit of Body, within the first eight Days, viz.
on or about the day of Inoculation, and the Day
you expect them to be seized with the Fever,
which is generally the eighth or ninth; and also
in ordering to abstain entirely from animal food,
and all kinds of Oils or greasy Substances, salt,
spice, or spirituous Liquors, great fatigue and
violent exercise together with all intense thinking,
and application to perplexing Business.

But Vegetables and Acids they may use plentifully.
They should not be closely confined, except
when the Air is cold or moist; and when
the variolous Fever comes, or they should be kept
rather cool than hot. Let their Drinks be cooling,
acescent and laxative, especially Tartar Whey.

If their Mouths and Throats should be sore,
give them a Teaspoonful of flour of Brimstone,
instead of the refrigerant powder, for two or
three times.

As soon as they begin to complain, they should
bathe their Feet in warm Water, for ten or
twelve Minutes Morning and Evening (till the
Eruption is compleat) and if the Head is much
affected, bleed them in the Arms or Foot. and
apply emollient Poultices of Bread and Milk,
and a little Oil or Hog's Lard, to the Feet.

If they should be costive during the eruptive
Fever, especially if very delirious, or have Fits
give an opening Clyster once or twice a Day,
till those Symptoms are removed.

The following general Rules for Inoculation, necessary
to be known; are chiefly taken from Dr. Heberden.

All Seasons of the Year are equally proper.
There is certainly this Advantage
attending warm Weather, that it allows
us to keep the Doors or Windows of the Room
open, whence arises such a constant Renovation
and Purity of the Air, as abundantly makes Amends
for all the Inconveniences arising from
Heat. On the other Hand, the Disadvantages
attending Winter, may be sufficiently remedied
by Fires, and these too will help to make the Air
of the Room constantly fresh; but avoid keeping
so great Fires as to heat the Room very much.

Children are very successfully inoculated at a
Month or six Weeks old; and there is a particular
Advantage in their undergoing it while
they are at the Breast, as they make no Difficulty
of Sucking; and the Milk is the best Food
and Physic which they can take. From the
Time of their being weaned to the tenth Year,
every Year seems equally proper.

After the first ten Years, every Year is, perhaps,
better than the following one; though Inoculation
may always be practised with great
Advantages over the other Ways of receiving
the Small-Pox, at all Ages.

Breeding Women should, on no Consideration,
be inoculated, unless we can suppose an absolute
Certainty of their catching it in the common
Way. It is thought of no great Consequence,
whether the Person from whom the
Matter is taken, has few or many, a good or bad
Sort; though Prudence would direct to take it
from as good a Sort as possible. The proper
Time for taking the Matter is just before it begins
to dry; opening the Pustule with a Lancet
or Needle, and drawing a Thread or Piece of
Lint along one, or more, if necessary, till it is
well wetted with the Matter that oozes out, and
then put into a little Box to dry: it will be stiff
if properly soaked in the Matter. About half an
Inch of such Thread will be sufficient for the
Operation, which is performed by making 3
Make a slight Incision through the Skin, till Blood appears, on the Outside of the Arm, about the Middle between the Elbow and Shoulder, long enough to put the Thread in, and cover it with a Bit of any sticking Plaster, over which a small Compress and Roller is proper to keep it on. After a Day or two the Thread may be removed, and the Plaster continued or not, just as you please. But when it begins to inflame, which it does as the Fever comes on, then apply a fresh Plaster daily of Diapalma, or such like; and if it swells and grows very hard and red, wash it with warm Milk and Water, and apply a Poultice of Bread and Milk twice or thrice a Day, till the Pock is turned a few Days, and then use the Plaster again till it is well; if it keeps an open Sore a Week or two, it is the better.

During the eruptive Fever they may lie in Bed (if they choose it) but should not be covered hot; or it may be best only to lie on the Bed, and lightly clothed*, drinking plentifully of Barley Water, Sage and Balm Tea, or Toast and Water, with Tamarinds; and, when filling, let them use Milk and Water, Panada, Sago, Chocolate, Gruel, Puddings, Greens and Roots. If they are little costive while the Pock is filling, it is no great matter and may generally be prevented by drinking warm Small-Beer, eating a roasted Apple, or a few Tamarinds now and then: but if very costive, at the Turn of the Pock, an opening Clyster of Water-gruel or Milk, with a Spoonful or two of Molasses and Oil in it, will be proper every Day or two. As soon as the Pox are dry they should be purged three or four Times, at two or three Days distance, with the same Purges as at first: And if a Cough or sore Eyes succeeds, bleeding will be proper.

As there may be some Persons who are apprehensive they are in danger of being seized with the Small-Pox in the natural Way, when it breaks out in the Neighbourhood where they live, and choose not to be inoculated, such Persons should follow, as near as they can, the Directions before given, as to their Diet, Drinks, Air, Cloathing and Exercise, both before, and at the coming on of the Fever, by which their Humours will be kept in so temperate a State, as greatly tends to prevent the bad Symptoms, and dangerous Issue of the Disease. And then, as to Medicines, it will be proper to use, before they are taken ill (if they have timely Notice to prepare for it) all, or as many of those before mentioned for inoculated Persons, as they can obtain, or have Resolution to give, only with this Difference, that after every three Pills and a Purge, they may intermit three or four Days, and then begin again, and so go on till they are seized, or the Disease gone out of the Neighbourhood. But if they cannot get these Medicines, or dare not use them, then let them take an Ounce of Ethiops Mineral (which may be bought cheap at any Apothecary's) and dividing it into 8 Parts, give to a grown Person one eighth every Night, going to Bed, in Molasses, Honey, or Sugar and Water, and next Morning a Tea-spoonful of Flour of Brimstone, or Cream of Tartar, or both mixed, if to be had. But if only one of those three Things is to be got, then take the Quantity of that one aforesaid, Morning and Evening; and every five or six Days take any Purge, if it works upwards and downwards the better. But if neither of these can be got, which probably may be the Case, far back in the Country, then it is advised (what is frequently kept in the Country for the Use of the Cattle) to take some common crude Antimony, in as fine Powder as possible, and common Brimstone in Rolls or Lumps, rubbed also into fine Powder, of each of these separate, or of both mixed, let a grown Person take a Tea-spoonful every Morning and Evening, and a Purge once a Week. Thus much for Preparation before the Disease. But when taken ill, it is proper, as soon as you can, to bleed all who are above the Age of Children, or have not been much weakened by some other Disease; and to give for Drink such Things as have been already mentioned, or as many of them as can be got, especially Tartar Whey, which is made by putting two Tea-spoonfuls of Cream of Tartar, powdered, into a Pint of boiling Milk, and then adding as much boiling Water, and when thirsty drink frequently of it: or, if this cannot be had, then give, instead of it, Rennet Whey, with half Water, or, what is thought better still, Whey made by turning Milk with Vinegar, and then diluting it with Water sufficient to make it palatable to the sick Person, keeping the Body open in the first Fever with Clysters, and nourishing it while the Pock fills with Milk, Panada, Gruel, and such like: not forgetting to purge when the Pock is dried, and bleed also, if a Cough or sore Eyes remain.

* If a Vomiting, which is usual at this Time, should be excessive, a few Grains of Ipecacuanha given as a Puke, will check it the most effectually.