Part 53

In regard to the antiquity of the practice of inoculation amongst the Chinese, I cannot do better than give Mr. Moore's own words on so very interesting a subject. "No account is handed down of the origin of this custom; but the reverence in which agriculture is held by the Chinese may have suggested the name (sowing of the smallpox) and the usual manner of performing the operation: for they took a few full dried smallpox crusts, as if they were seeds, and planted them in the nose; a bit of musk was added in order to correct the virulence of the poison, and the whole was wrapped up in a bit of cotton to prevent it dropping from the nostrils. The crusts employed were always taken from a healthy person who had had the smallpox favourably; and, with the vain hope of mitigating their acrimony, they were sometimes kept in close jars for years, and at other times fumigated with salutary plants. Some physicians beat these crusts into powder, and advised their patients to take a pinch of this snuff; and when they could not prevail upon them, they mixed it with water into a paste, and applied it in that form. In Hindostan, if tradition may be relied upon, inoculation has been practised from remote antiquity. The practice was in the hands of a particular tribe of Brahmins, who were delegated from various religious colleges, and who travelled through the provinces for this purpose. The natives were strictly enjoined to abstain during a preparatory month from milk and butter; and, when the Arabians and Portuguese appeared in that country, they were prohibited from taking animal food also. These were commonly inoculated on the arm; but the girls, not liking to have their arms disfigured, chose that it should be done low on the shoulder: and whatever part was fixed upon was well rubbed with a piece of cloth, which afterwards became a perquisite of the Brahmin. He then made a few slight scratches on the skin with a sharp instrument, and took a bit of cotton, which had been soaked the preceding year in variolous matter, moistened it with a drop or two of the holy water of the Ganges, and bound it upon the punctures. During the whole of this ceremony, the Brahmin always preserved a solemn countenance, and recited the prayers appointed in the _Attharna Veda_, to propitiate the goddess who superintended the smallpox. The Brahmin then gave his instructions, which were regularly observed. In six hours the bandage was to be taken off, and the pledget allowed to drop spontaneously. Early next morning, cold water was to be poured upon the patient's head and shoulders, and this was to be repeated until the fever came on. The ablution was then to be omitted; but, as soon as the eruption appeared, it was to be resumed and persevered in every morning and evening till the crusts should fall off. Confinement to the house was absolutely forbidden; the inoculated were to be freely exposed to every air that blew; but when the fever was upon them, they were sometimes permitted to lie on a mat at the door. Their regimen was to consist of the most refrigerating productions of the climate; as plantains, water-melons, thin gruel made of rice or poppy-seeds, cold water, and rice."

While sowing the disease was thus prevalent in some countries, selling and buying it was adopted in others, when children bartered fruit in exchange for the infection. It does not appear that the faculty took any notice of inoculation until the year 1703, when Dr. Emmanuel Timoni Alpeck wrote an account of his observations in Constantinople, in a letter to Woodward: a Venetian physician, of the name of Pylamus, about the same time noticed the success of the practice in Turkey. Lady Mary Wortley Montagu pursued the inquiry in her voyage to that country, by causing her son Edward to be inoculated by Maitland, surgeon to the embassy, and, on her return to England in 1722, had the operation tried with successful results on her daughter. Still, although two of the princesses of the royal family had also been inoculated with equal benefit, inoculation was furiously opposed by the profession, and even from the pulpit; and so successful was this opposition, that it succeeded in bringing it into disuse both in England and throughout Europe, many cases of smallpox of a confluent character having made their appearance after inoculation, and in 1740 the practice had nearly fallen into disuse. In this virulent controversy, a singular circumstance was observed: while regular practitioners stated the practice to be unsuccessful, whenever it was adopted by quacks, monks, and old women, the result was invariably favourable; and the report that reached Europe of a Carmelite friar having inoculated thousands of Indians, an old woman being equally fortunate in Greece, while at the same time a planter in St. Christopher's inoculated three hundred persons without the loss of a single patient, the practice was again resumed, chiefly in our seaports, and gradually extended over the country. Mead materially assisted its progress by stating that the Circassian ladies chiefly owed their beauty to this salutary preservative. In the year 1763, Daniel Sutton, son of a surgeon in Suffolk, recommended the practice, modified, however, in the treatment of the malady, and brought inoculation into general repute.

It appears, however, that inoculation was by no means a novel introduction even in England, as it had been long practised in Pembrokeshire and several parts of Wales. On the Continent it had been tried at Cleves. Bartholinus mentions it as adopted in Denmark; and traces of its adoption were evident in Auvergne and Perigord.

Various modes of performing this operation were adopted. The Arabians inserted the virus with a pointed instrument between the thumb and the index; the Georgians on the fore-arm; and the Armenians on the thigh. The traveller Motraye mentions a Circassian old woman who used to inoculate with three pins tied together. It appears that this practice was generally prevalent in Turkey in 1673. Trinoni and Pilarini observed that the natural smallpox was generally fatal in Constantinople, while the disease produced artificially was most benign. Bruce relates that from time immemorial inoculation was practised in Nubia by old Negresses or Arabs.

Strange to say, it was only in 1727 that inoculation became general in France; and its adoption was materially forwarded by Voltaire, who also took special care to acquaint the fair sex that it was to this practice that the Circassian and Georgian odalisks owed their beauty.

The terrific mortality that attended this disease was much increased by the injudicious treatment to which patients were submitted. Instead of adopting the natural plan resorted to by eastern nations, and allowing the patients a free current of air, with a refrigerant diet, cordials and a hot regimen were enforced, under which the disorder soon assumed a destructive malignity. Cold affusion, which has also been extolled by modern physicians as a recent improvement in medical practice, we have seen, was also employed centuries ago. Sutton, who is generally, but erroneously, considered as being the introducer of inoculation, did nothing more, as I have already observed, than modify the treatment of the disorder. Thus do we daily see impudence and quackery receiving rewards for supposed discoveries, and the keepers of the public purse on such occasions seem much less careful of it than of their own. In our days, for instance, chain-cables have been decreed a discovery, and their inventor entitled to a national recompence, whereas we read the following passage in Cæsar's Commentaries, when speaking of the shipping of the Gauls,--"Anchoræ, pro funibus, ferreis catenis revinctæ:" any schoolboy could have given this information to our sapient legislators.

The reappearance or supposed increased prevalence of the smallpox after vaccination, for the last few years, may call for some observation. Ever since the year 1804 a belief was entertained by many persons that the cowpox only afforded a temporary security. This doubt, however, never did rest upon any solid foundation. Dr. Jenner maintained in the most strenuous manner, that to render the cowpox efficient, it was absolutely necessary to attend most carefully to the character of the pustule, and the time and quality of the lymph taken from it; on the very same principle inoculation of the smallpox also failed. For it must be clearly understood, that Jenner considered the smallpox and the cowpox as identic maladies, and by no means dissimilar in their nature: on this important subject I feel much gratification in quoting a passage from a late valuable publication,[51] to which I refer the reader. "It was then clearly ascertained, that there were deviations from the usual course of smallpox, which were quite as common and infinitely more disastrous than those which took place in vaccination. These deviations regarded two apparently different states of the constitution. In the one the susceptibility of smallpox, was not taken away by previous infection, while, on the other hand some constitutions seem to be unsusceptible of smallpox infection altogether. It was found, that similar occurrences took place in the practice of vaccination, but as the security which the latter afforded was never more likely to be interfered with by slight causes than the former, it became absolutely necessary that great care should be shown in watching the progress and character of the pustule. Dr. Jenner had from the beginning felt the propriety of this watchfulness; and had distinctly announced that it was possible to propagate an infection by inoculation conveying different degrees of security, according as that affection approached to or receded from the full and perfect standard. He also clearly stated that the cause of the vaccine pustule might be so modified as to deprive it of its efficacy. That inoculation from such a source might communicate an inefficient protection, and that all those who were thus vaccinated were more or less liable to the subsequent smallpox."

Dr. Bacon is of opinion that the cowpox is now what it was at the beginning. There are instances, in which it has passed from one human subject to another for more than thirty years, consequently through fifteen or sixteen hundred individuals, but yet in which no degeneration has taken place. He nevertheless admits that recent lymph from the cow should be preferred, when it can be procured; he is further of opinion that the occurrence of smallpox after inoculation does not exceed in number the cases of smallpox after smallpox. My own experience confirms these views. I was in practice in Bordeaux during the prevalence of what is called smallpox in vaccinated cases,--the cases were rare, doubtful, and very seldom fatal.

There is little doubt that the smallpox would sweep away thousands of our dense population but for the protecting power of vaccination, the failure of which, ought more frequently to be attributed to the vaccinator, or the constitution of the patient, than to Jenner's immortal discovery. Dr. Severn has just published an essay on this most important subject, and it appears by his statistical tables, that such has been the decrease of mortality since the introduction of vaccination, that the number of patients admitted into the smallpox hospital from 1775 to 1800,--were 7017--the deaths 2277--whereas from the year 1800 to the year 1825, the number admitted was 3943, and the deaths 1118--not half the number, although the population of London had doubled during that period. Dr. Severn further calculates that the proportion of failures is 6 in 3000.

We read with feelings of deep regret in his late bibliography, that the man at whose intercession the magic of his name obtained the liberation of Napoleon's prisoners, could not obtain an appointment for the members of his own family from the British Government; nay, the College of Physicians despite the exertions of Dr. Baillie, refused to admit him to a fellowship in their learned body. It was when reflecting on such national ingratitude, that he wrote to a friend, "Never aim, my friend at being a public character, if you love domestic peace." And not long before he terminated his invaluable career he made this remarkable expression: "I am not surprised that men are not thankful to me; but I wonder that they are not grateful to God for the good which he has made me the instrument of conveying to my fellow-creatures."

It is in vain that France with her usual _jactance_ pretends that the first idea of vaccination arose in that country, they have no more claim to the discovery than their Marshals to Wellington's immortal glory.

GENERATIVE ANIMALCULES.

Microscopic experiments daily demonstrate the existence of myriads of animalcules in every substance. They have recently been discovered in the progress of certain crystallizations; and some philosophers maintain that most inorganic bodies are formed of the remains of organic substances. The existence of animalcules in the generative secretion was first noticed by Lewis Hamme, a young German student, and shown by him to Leeuwenhoeck, who published an account of them. Hartzoeken wrote upon the subject the following year, and asserted that he had seen these animalcules three years before they had been observed by Hamme. This curious subject soon attracted the notice, not only of physiologists, but of priests, artists, and even courtiers, for we find our Charles II. making curious inquiries on this investigation. Although many opticians could not discover these creatures, the eyes of courtiers were more keen than theirs, and to gratify their royal master's depravity, described them most minutely. Their length was 3/100000 of an inch, their bulk such as to admit the existence of 216,000 in a sphere whose diameter was the breadth of a hair, and their rate of travelling nine inches in the hour. They saw them in the seminal secretion of every animal; and, what was still more remarkable, they were of a similar size whatever might have been that of the animal: they saw them in the sprat and in the whale; they could distinguish the male from the female; and they all moved along in gregarious harmony like a flock of sheep: nay, more; Dalenpatius actually saw one of them, more impatient than his companions, burst from his ignoble shackles, and actually assume the human form. At other times they were discovered swimming in shoals to given points, turning back, separating, meeting again, and frisking about like golden fish in a pond. Kauw, Boerhaave, Maupertius, Lieuland, Ledermuller, Monro, Nicholas, Haller, and indeed most of the philosophers of Europe, were convinced of their existence.

Buffon, however, and other naturalists, contended that these were not animalcules, but organic particles; and Linnæus imagined them to be inert molecules, thrown into agitation by the warmth of the fluid. Finally, to determine the question, Spallanzani began an assiduous course of observations and experiments. He found these animalcules in the human species to be of an oval form, with a tail tapering to a point. This appendage, by moving from side to side, propelled them forward. They were in constant motion in every direction. In about twenty-three minutes their movements became more languid, and in two or three hours they generally died. The duration of their life, however seemed to depend, in a great measure, on the temperature of the medium: at 2° (Reaumur) they died in three quarters of an hour; while at 7° they lived two hours, and at 12-1/2° three hours and three quarters. If the cold was not too intense, they recovered upon the temperature being raised; when only 3° or 4°, they recovered after a lethargy of fourteen hours; and according to the less intensity of the cold, they might be made to pass from the torpid to the active state more frequently. They were destroyed by river, ice, snow, and rain water; by sulphur, tobacco, camphor, and electricity; even the air was injurious to them: in close vessels their life was prolonged to some days, and their movements were not constant and hurried. They were of various sizes, and perfectly distinct from all species of animalcules found in vegetable infusions, &c. In short, Spallanzani completely confirmed the principal observations of Leeuwenhoeck, and satisfactorily explained the sources of the inaccuracies of other inquirers. Prevost and Dumas have recently confirmed the observations of the Italian physiologist.

This doctrine of life being perpetuated by the transmission of animated particles, or animalcules, is by no means of modern date. We find this theory advanced by Hippocrates, and Aristotle, and Plato. Democritus described worms that assumed, in the progress of their development, the human form; and Lactantius thus refuted his ideas: "Erravit ergo Democritus, qui vermiculorum modo putavit homines effusos esse de terrâ, nullo auctore, nullâque ratione." Hippocrates plainly says, that the seminal secretion was full of animalcules, whose several parts were developed, and grew afresh; that nothing did exist that had not pre-existed; and that what we term birth was nothing more than that transition of these hitherto imperceptible animalcules from darkness to light.

Gesner has endeavoured to prove that the word [Greek: psychê], so frequently found in the writings of Hippocrates, and translated _anima_, was synonymous with _insectum_, _animalculum_, _papilio_. Plato, when expressing himself on this curious subject, compares the matrix to a fertile field, in which animalcules are gradually developed, at first of such a small size that they are imperceptible, but, by taking the food prepared for them, grow in strength until they are brought to light in a state of perfect generation; and St. Augustine thus follows: "Hunc perfectionis modum sic habent omnes ut cum illo concipiantur atque nascuntur; sed habent in ratione, non in mole, sicut ipsa jam membra omnia sunt latenter in semine; cùm etiam natis nonnulla desint, sicut dentes, ac si quid ejusmodi." In the works of Seneca we also find the same notions: "In semine omnis futuri hominis ratio comprehensa est, et legem barbæ et canorum nondum natus infans habet; totius enim corporis, et sequentis ætatis, in parvo occultoque lineamenta sunt."

It may be said that these opinions were similar to those of the _Ovarians_, who, as we have observed already, believed that every thing arose from the egg. Such were Aristotle, Empedocles, and other philosophers: "For the egg is the conception," said the first of these great men, "and after the same manner the animal is created;" but there was a manifest difference in their systems. Harvey, Haller, De Graef, were amongst the most warm advocates of this doctrine, which indeed prevails to the present day, as it would be difficult to find organized beings that did not spring from an original germ.

It thus appears that, notwithstanding the absurd doctrines of generation being founded upon the existence of these animalcules, they clearly do exist. Modern microscopic experiments daily confirm the fact; not only in the generative secretion, but in the other fluids of the body: creatures of an inch to an inch and a quarter in length have been found to inhabit the mesenteric arteries of asses and horses. Mr. Hodgson found them in seven asses out of nine. They have also been found in the blood of female frogs, salamanders, and tadpoles. What wonders are perhaps in store for the microscopic observer and the physiologist! All living matter seems to be animated by particles, by atoms, equally possessed of life. Does the vitality of these constituent molecules hold any influence over our existence? Is their life necessary to the preservation of ours? Is any agency destructive to them injurious or destructive to us? In a former paper I have recorded recent observations, where animalcules of a peculiar description were found in the purulent secretion attending various affections. A morbid condition seems thus to produce a new series of animated beings, or this new series of living atoms perhaps have produced a morbid state. Many eruptive maladies are either caused by the presence of insects, or insects are subsequently developed in their pustules. Wichmann, and many other physicians, have maintained that the itch was produced by an insect of the genus _acarus_, or _tick_.

Latreille has given a minute description of this creature in his _Genera crustaceorum et insectorum_, and calls this offensive species the _sarcoptes scabiei_. Linnæus classed it among the _aptera_, and termed it the _acarus scabiei_. This insect is nearly round, with eight legs; the four fore-legs terminated with a small head, the hind ones with a silky filament. The Arabian Avenzoar had long since observed them, and it was from his writings that Mouffet was induced to pursue the inquiry. Redi, an Italian physician, was the first propagator of this doctrine in modern times, and published, in 1685, a paper of Cestoni of Leghorn, who had frequently observed mendicants and galley-slaves extracting these insects from the pustules of itch with the point of a pin, in the same manner as _chigoes_ are extracted from their cyst in the West Indies.

It was this communication of Cestoni that led to a further and more minute investigation. Curiosity was every where excited, and the most learned and intelligent naturalists and physicians, amongst whom we find the illustrious names of Borelli, Etmuller, Mead, Pringle, Pallas, Bonani, Linnæus, Morgagni, strove with incessant diligence to ascertain this important fact, which certainly was likely to shed a new light on our pathological speculations. The existence of the acarus was established.

The most conclusive experiments on the subject were those of Galès, in 1812. The following is the account of them: "I placed under a microscope a watch-glass with a drop of distilled water, after having carefully ascertained that it did not contain any visible animalcules. I then extracted from an itch pustule a small portion of the virus, which I diluted in the water with the point of a lancet. I watched most attentively for upwards of ten minutes, without having been able to notice any animation. Two similar experiments were equally ineffectual. Disappointed in my expectations, I was about giving up the task, when an idea struck me of submitting the liquid of the first experiment to another trial. I had left it in the watch-glass, exposed to solar heat. I then was not a little surprised when I discovered a perfect insect struggling with its legs to extricate itself from the viscid fluid that confined it. Having succeeded in reaching a more limpid part of the liquor, its form was so distinct that Mr. Patrix, who was with me, was enabled to take an exact drawing of its configuration."

This curious result naturally induced Galès to pursue his inquiries, and he discovered that this insect chiefly occupies the pustules that are filled with a thin serum, and avoids those that contain a thicker secretion. Hence the watery pimples in itch are invariably those that produce the most intolerable prurience.