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DIRECTIONS CONCERNING INOCULATION, Chiefly collected from the late Pieces on that Subject.

WITH INSTRUCTIONS how to prepare those who are soonest likely to take the SMALL-POX in the Natural Way.

The Whole being carefully adapted to TOWN and COUNTRY, By a Person properly Qualified.

First Published, this Year, by FRANKLIN and HALL, of Philadelphia; and now Re-printed and Sold by B. Mecom, at the New Printing-Office, near the Town­House, in BOSTON. 1760.

[Price Six Coppers.]

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PREFACE.

AS Inoculation is a very interesting Affair, and, if prudently ma­naged, may probably become universal in America, it having been much more used of late than ever; what follows, it is hoped, will greatly contribute to pro­mote so useful a Practice. It is chiefly collected from the late Pieces that have appeared on that Subject; the Authors of which, I am well assured, are of Cha­racter sufficient to give all due Weight to their Performances; and the other Directions are added by a Person pro­perly qualified, and are particularly adapted to the Cases and Circumstances of such, who have no Practicioner near them, and are settled too far back in the Country to be able to get the properest Me­dicines when wanted; which Directions, if well followed, will prepare them so as to have a much greater Chance of having it milder in the natural Way. Therefore I advise my Readers to keep this little Piece as a Production of great Value, that may even be the Means, by the Blessing of GOD, of preserving their Childrens Children.

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THE Small-Pox, being a Dis­ease so 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 of Practice which they found most successful; and thereby have rendered the Treatment 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-seven; [Page 6]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.

Since the Small-Pox last appeared among us, within these two or three Years past, more have been inoculated here, 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 & Antim. 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, [Page 7]every one used such Preparations and Combinations thereof, as his own Jud­ment 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 terminate in Death.

What those Medicines are, where­with Patients may be best prepared, and the Manner of administring 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 [Page 8]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 Boer­haave's Golden Sulphur of Antimo­ny; about four Grains of it for a grown Person, with two or three Grains of Calomel, made into a 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.

[Page 9]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.

[Page 10] 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 Adults, and to others in Proportion to their Age. The Night after Inoculation, give a Dose of the Mercurial Pill (which is ten Grains, or twelve, if robust, to an Adult, diminishing according to the Age, so as to give to one from nine to twelve 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 administred) conti­nuing them till the Eruption.

[Page 11]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 may be proper, even to Infants. I have generally used the Powder for Child­ren [Page 12]in the Form abovesaid, 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 Oil 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 [Page 13]the Air is cold or moist; and when the variolous Fever comes on, 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 Arm 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.

[Page 14]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 Inconve­niencies 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 [Page 15]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 [Page 16]is well wetted with the Matter that ouzes 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 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 stiking Plaister, 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 Plaister 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 Plaister 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 Plaister again till it is well; if it keeps an [Page 17]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 cloathed , 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, Sagoe, Chocolate, Gruel, Puddings, Greens and Roots. If they are a little costive while the Pock is filling, it is no great Matter, & 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 Melasses and Oil in it, will be proper every Day or two. As soon [Page 18]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.

Upon the Whole, if the Chance were only as two to one in Favour of the Practice among Children, would it not be sufficient to induce a tender Pa­rent to lay hold of the Advantage? But when it is so much greater, as it appears to be by these Accounts (in some even as Thirty to One) surely Parents will no longer refuse to accept and thankfully use a Discovery God in his Mercy has been pleased to bless Mankind with; whereby some Check may now be put to the Ravages that cruel Disease has been accustomed to make, and the human Species be again suffered to increase as it did before the Small-Pox made its Appearance.

The above Account of Inoculation, Manner of performing the Operation, [Page 19]& Method of Treatment, while it tends greatly to encourage it, and assist those who are inclined, is mostly adapted to those who are somewhat versant in Practice, or are near enough to some publick Places where they can be sup­plied with the necessary Medicines, and timely Assistance, in Case of Dan­ger, should they have Resolution suf­ficient to perform it themselves.— But there are many Parts of this Country where they neither have any Practicioner near them, nor can be supplied with Medicines, but those of the most ordinary and common Sort; by which Means they are not likely to get their Families inoculated by others, or to do it themselves; either for Want of Resolution to perform it, or admi­nister the Medicines, if to be got; or perhaps from Prejudice and real Scruples of Conscience. To such, it is thought, some familiar Method proposed might be of more Service than a long Dissertation on Inocula­tion.

[Page 20]Let it therefore be observed first, that those who are likely soon to be seized with the Small Pox in the na­tural Way, from its being in the Neighbourhood, or in the same House, 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 [Page 21]these Medicines, or dare not use them, then let them take an Ounce of AEthi­ops 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 Melasses, Honey, or Sugar and Water, and next Morning a Tea­spoonful of Flour of Brimstone, or Cremor 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 [Page 22]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 Teaspoonful 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 Tea­spoonfuls of Cremor Tartar, powder­ed, into a Pint of boiling Milk, and then adding as much boiling Water, and when strained, 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 [Page 23]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.

FINIS.

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