Part 2

Concerning the third interdicted article, they allege, that under _that_ is implied a prohibition of all fat and oily substances, as their qualities are nearly similar with those of fish, and similar in their effects of fouling the first passages in a high degree above any other aliment that is taken into them; that they soon acquire an acrimony in the course of digestion, and convey the same into the blood and juices; these premises being granted, which I think can hardly be denied, there appears sufficient cause for prohibiting the use of the whole tribe; the more especially, as ghee and oil are the essential ingredients used in cooking their vegetable diet.

Thus far the system of practice pursued by the Bramins will, I imagine, appear rational enough, and well founded; but they have other reasons for particularly prohibiting the use of these three articles, which to some may appear purely speculative, if not chimerical. They lay it down as a _principle_, that the _immediate_ (or instant) cause of the Small Pox exists in the mortal part of every human and _animal_ form[2]; that the _mediate_ (or second) _acting_ cause, which stirs up the _first_, and throws it into a state of fermentation, is multitudes of _imperceptible animalculæ_ floating in the atmosphere; that these are the cause of all epidemical diseases, but more particularly of the Small Pox; that they return at particular seasons in greater or lesser numbers; that these bodies, imperceptible as they are to the human organs of vision, imprison the most malignant tribes of the _fallen angelic Spirits_: That these animalculæ touch and adhere to every thing, in greater or lesser proportions, according to the nature of the surfaces which they encounter; that they pass and repass in and out of the bodies of all animals in the act of respiration, without injury to themselves, or the bodies they pass through; that such is not the case with those that are taken in with the food, which, by mastication, and the digestive faculties of the stomach and intestines, are crushed and assimulated with the chyle, and conveyed into the blood, where, in a certain time, their malignant juices excite a fermentation peculiar to the _immediate_ (or _instant_) cause, which ends in an eruption on the skin. That they adhere more closely, and in greater numbers, to glutinous, fat, and oily substances, by which they are in a manner taken prisoners; that _fish_, _milk_, and _ghee_, have these qualities in a more eminent and dangerous degree, and attach the animalculæ, and convey them in greater quantities into the blood; and for these reasons, added to those before assigned, they are forbid to be taken in food during the preparative course. They add, that the Small Pox is more or less epidemical, more mild or malignant, in proportion as the air is charged with these animalculæ, and the quantity of them received with the food. That though we all receive, with our aliment, a portion of them, yet it is not always sufficient in quantity to raise this peculiar ferment, and yet may be equal to setting the seeds of other diseases in motion; hence the reason why any epidemical disorder seldom appears alone. That when once this _peculiar_ ferment, which produces the Small Pox, is raised in the blood, the _immediate (instant) cause_ of the disease is totally expelled in the eruptions, or by other channels; and hence it is, that the blood is not susceptible of a second fermentation of the same kind. That Inoculating for this disease was originally hinted by the _Divinity_ presiding over the _immediate (instant) cause_, the thought being much above the reach of human wisdom and foresight. That the great and obvious benefit accruing from it, consists in this, that the fermentation being excited by the action of a small portion of matter (similar to the _immediate_ cause) which _had already passed through_ a state of fermentation, the effects must be moderate and benign; whereas the fermentation raised by the malignant juices of the animalculæ received into the blood with the aliment, gives necessarily additional force and strength to the first efficient cause of the disease.

That noxious animalculæ, floating in the atmosphere, are the cause of all pestilential, and other epidemical disorders, is a doctrine the Bramins are not singular in; however, some of the conclusions drawn from it, are purely their own. A speculative genius may amuse itself by assigning this or that efficient cause, or first principle of this disease; but the best conjecture which the wisdom of man can frame, will appear vague and uncertain; nor is it of much moment, in the present case, to puzzle the imagination, by a minute enquiry into the essence of a cause hidden from us, when the effects are so visible, and chiefly call for our regard: but if we must assign _a cause_, why every part of the globe, _at particular seasons_, is more liable to peculiar malignant epidemical diseases, than _at others_, (which experience manifests) I see no one that so much wears the complexion of probability, as that of pestilent animalculæ, driven by stated winds, or generated on the spot by water and air in a state of stagnation, (and consequently in a state of putrefaction favourable to their propagation,) and received into the habit with our food and respiration. We yearly see, in a greater or lesser degree, the baneful effects of these insects in blights, although at their first seizure of a plant they are invisible, even with the assistance of the best glasses; and I hope I shall not be thought to refine too much on the argument, if I give it as my opinion, that epidemical blights, and epidemical diseases of one kind or other, may be observed to go often hand in hand with each other, from the same identical cause. But to proceed in our analysis.

The mode by which the Eastern Inoculators convey the variolous taint into the blood, has nothing uncommon in it, unless we except the preceding friction upon the part intended for Inoculation, and moistening the saturated pledget, before the application of it; for this practice they alledge the following reasons; that by _friction_ the circulation in the small sanguinary vessels is accelerated, and the matter being _diluted_ by a small portion of _Ganges water_, is, from both causes, more readily and eagerly received, and the operation at the same time sanctified. The friction and dilution of the matter, has certainly the sanction of very good common sense; and the Ganges water, I doubt not, may have as much efficacy as any other _holy water_ whatsoever. This last circumstance, however, keeps up the piety and solemnity with which the operation is conducted from the beginning to the end of it; it tends also to give confidence to the patient, and so far is very laudable. The reasons they assign for giving the preference to matter of the _preceding year_, are singular and judicious; they urge, it is more certain in its effects; that necessity first pointed out the fact, (the variolous matter some years not being procurable,) and experience confirmed it: they add, that when the matter is effectually secured from the air, it undergoes at the return of the season an _imperceptible fermentation_, which gives fresh vigour to its action. It is no uncommon thing to inoculate with matter four or five years old, but they generally prefer that of a year old, conceiving that the fermentation which constitutes its superiority over fresh matter, is yearly lessened, and consequently the essential spirit of action weakened, after the first year.

The next article of the Eastern practice, which offers in the course of our discussion, is their sluicing their patients over head and ears, morning and evening, with cold water, until the fever comes on; in which the inoculating Bramins are, beyond controversy, singular: but before we can penetrate the grounds and reasons for this practice, it becomes necessary to bestow a few words on the usual manner of cold bathing in the East, when medically applied, which is simply this; the water is taken up over night, in three, four, or five vessels, before described, (according to the strength of the patient,) and left in the open air, to receive the dews of the night, which gives it an intense coldness; then in the morning, before the sun rises, the water is poured without intermission, by two servants, over the body, from the distance of six or twelve inches above the head. This mode of cold bathing has been adopted from the Eastern professors of Physic, by all the European practitioners, and by constant experience found abundantly more efficacious than that by immersion, in all cases where that very capital remedy was indicated; notwithstanding it has been ever the received opinion, that the success of cold bathing, is as much, or rather more, owing to the weight and pressure of the circumambient body of water, than _the shock_. The remarkable superior efficacy of this Eastern method of cold bathing, can only be accounted for, from _the shock_ being infinitely greater, and of longer continuance, than that received by immersion; which is a fact indisputable, as will be acknowledged by every one who goes through a course of both methods; the severity of the one being nothing comparable to the other: this I assert from my own personal feelings; and I never had a patient that did not aver the same, who had undergone both trials: indeed, the shock of this Eastern method is so great, that, in many cases, when the subject was deeply exhausted and relaxed, I have found it absolutely necessary to begin the course only with _a quart_ of water.

If the known effects of cold bathing are attended to, and its sovereign virtues duly considered, in the very different circumstances of Palsies, Rheumatisms, general relaxation of the solids, and particular relaxation of the stomach and intestines, we shall not be long at a loss to account for this part of the Eastern practice in the course of Inoculation: They allege in defence of it, that by the sudden shock of the cold water, and consequent increased motion of the blood, all offensive principles are forcibly driven from the heart, brain, and other interior parts of the body, towards the extremities and surface, and at the same time the intended fermentation is thereby more speedily and certainly promoted; (hence it probably is, that the fever generally commences so early as about the close of the sixth day.) When the fever appears, they desist from the use of the cold water, because when the fermentation is once begun, the blood should not, they say, receive any additional commotion until the eruption appears, when they again resume the cold water, and continue it to the end of the disease; asserting, that the use of it alone, by the daily fresh _impetus_ it gives to the blood, enables it utterly to expel and drive out the remainder of the _immediate_ cause of the disease into the pustules. I have been myself an eye-witness to many instances of its marvelous effect, where the pustules have sunk, and the patient appeared in imminent danger, but almost instantly restored by the application of three or four collans of cold water, which never fails of filling the Pock, as it were by enchantment; and so great is the stress laid by the Eastern Practitioners on this preparative, (for as the three interdicted articles in food is preparative to the Inoculation, so this may be deemed preparative to the eruption,) that when they are called in, and find, upon enquiry, that circumstance (and opening the pustules) has not been attended to, they refuse any further attendance.

The next and last article of the Eastern practice, which falls under our consideration, is that just abovementioned, viz. the opening of the Pustules, whilst the matter continues in a fluid state. That a circumstance so important, so self-evidently rational and essential, should have been so long unthought of, appears most wonderful! and if my memory fails me not, HELVETIUS is the only writer upon the subject of the Small Pox, that hinted it in practice before Doctor TISSOT; this accurate and benevolent Physician has enforced it with such strength of judgment and argument, that he leaves little room (except facts) to add to his pathetic persuasive; in this he is supported by his learned and elegant Commentator and Translator Doctor KIRKPATRICK, (page 226 and 227,) and I am not without hopes it will, contrary to Doctor TISSOT'S expectation, "become a general practice;" the more especially, when it is found to have invariable success, and venerable antiquity, for its sanction.

So great is the dependence which the Eastern Practitioners have on opening the Pustules, in every malignant kind of the disease, that where the fluid state of the matter has been suffered to elapse without being evacuated, they pronounce the issue fatal, and it generally proves so; they order it in every kind, even the most distinct; for although in these it should seem scarcely necessary, yet they conceive it effectually prevents inflammation and weakness of the eyes, biles, and other eruptions and disorders, which so commonly succeed the disease, however benign; in very critical cases, they will not trust the operation of opening the Pustules to the nurses or relations, but engage in it themselves, with amazing patience and solicitude; and I have frequently known them thus employed for many hours together; and when it has been zealously persevered in, I hardly ever knew it fail, of either intirely preventing the _second fever_, or mitigating it in such sort, as to render it of no consequence; in various instances, which I have been a witness to, in my own, and others practice, I have seen the Pustules in the _contiguous_ kind, upon being successively opened, fill again to the fourth and fifth, and in the _confluent_, to the sixth, seventh, and eighth time; in the very distinct sort they will not fill again more than once or twice, and sometimes not at all, which was a plain indication, that the whole virus of the disease was excelled in the first eruption.

The Eastern Practitioners, with great modesty, arraign the European practice of Phlebotomy and Cathartics in any stage of the disease, but more particularly when designed to prevent, or mitigate the second fever; alledging, that the _first_ weakens the natural powers, and that the _latter_ counteracts the regular course of _nature_, which in this disease invariably tends to throw out the offending cause _upon the skin_; that she often proves unequal to the intire expulsion of the enemy, in which case, her wise purposes are to be assisted by art, in that track, which she herself points out, and not by a diversion of the usual crisis into another chanel; that this assistance can only be attempted with propriety, by emptying the Pustules, as thereby fresh room is given in them for the reception of the circulating matter still remaining in the blood, and which could not be contained in the first eruption; by which means every end and purpose of averting, or subduing the _second fever_ is obtained, with a moral certainty; whilst Phlebotomy and Cathartics, administered with this view, are both irrational and precarious; as being opposite to the constant operation of Nature in her management of this dreadful disease.

It remains only that I add a word or two upon the Eastern manner of opening the Pustules, which (as before mentioned) is directed to be done with a very fine sharp pointed thorn: Experience has established the use of this natural instrument in preference to either the scissars, launcet, or needle; the Practitioners perforate the most prominent part of the Pustule, and with the sides of the thorn press out the pus; and having opened about a dozen, they absorb the matter with a callico rag, dipt in warm water and milk; and proceed thus until the whole are discharged: the orifice made by the thorn is so extremely small, that it closes immediately after the matter is pressed out, so that there is no admission of the external air into the Pustule, which would suddenly contract the mouths of the excretory vessels, and consequently the further secretion of the variolous matter from the blood would be thereby obstructed; for this consideration, the method recommended by Doctor TISSOT, of clipping the Pustules with sharp pointed scissars, is certainly liable to objection, as the aperture would be too large; when in the true confluent kind, no distinct Pustules present, they perforate the most prominent and promising parts, in many places, at the distance of a tenth of an inch, usually beginning at the extremities; and I have often seen the Pustules in the _contiguous_, and the perforated parts in the _confluent_ kind, fill again before the operation has been half over; yet they do not repeat the opening until a few hours elapse, conceiving it proper that the matter should receive some degree of concoction in the Pustules before it is again discharged.

If the foregoing Essay on the Eastern mode of treating the Small Pox, throws any new and beneficial lights upon this cruel and destructive disease, or leads to support and confirm the present successful and happy method of Inoculation, in such wise as to introduce, into _regular and universal practice, the cool regimen and free admission of Air_, (the contrary having proved the bane of millions,) I shall, in either case, think the small time and trouble bestowed in putting these facts together most amply recompensed.

_Chilton Lodge, Wilts_,

_September 1, 1767_.

FINIS.

Footnote 1:

The instrument they make use of, is of iron, about four inches and a half long, and of the size of a large crow quill, the middle is twisted, and the one end is steeled and flatted about an inch from the extremity, and the eighth of an inch broad; this extremity is brought to a very keen edge, and two sharp corners; the other end of the instrument is an ear-picker, and the instrument is precisely the same as the Barbers of Indostan use to cut the nails, and depurate the ears of their customers, (for in that country, we are above performing either or these operations ourselves.) The Operator of Inoculation holds the instrument as we hold a pen, and with dextrous expedition gives about fifteen or sixteen minute scarifications (within the compass abovementioned) with one of the sharp corners of the instrument, and to these various little wounds, I believe may be ascribed the discharge which almost constantly flows from the part in the progress of the disease. I cannot help thinking that too much has been said (pro and con) about nothing, respecting the different methods preferred by different Practitioners of performing the operation; provided the matter is thrown into the blood, it is certainly a consideration of most trivial import by what means it is effected; if any claims a preference, I should conclude it should be that method which bids fairest for securing a plentiful discharge from the ulcer.

Footnote 2:

In an epidemic season of the confluent Small Pox, Turkeys, Chittygong Fowls, Madrass Capons, and other poultry, are carried off by the disease in great numbers; and have the symptoms usually accompanying every stage of the distemper. I had a favourite Parrot that died of it in the year 1744; in him I had a fair opportunity of observing the regular progress of the disorder; he sickened, and had an ardent fever full two days before the eruption, and died on the seventh day of the eruption; on opening him, we found his throat, stomach, and whole channel of the first passages, lined as thick with the pustules as the surface of his body, where, for the most part, they rose contiguous, but in other places they ran together.

Transcriber's Notes.

This Book is 300 years old and the advice given has been superceded by more modern methods and is of historical value only.

The original spellings and punctuation have been retained.

Italicized words and phrases are presented by surrounding the text with underscores.