In Holland, inoculation was begun at Amsterdam in 1748, by Dr. Tronchin, in his own family. It was not, however, brought into general flu our in that country till 1764. It was afterwards greatly promoted in the Low Countries by the favourable accounts of the American Ino culation, as given by Dr. 'Pelmet, an American student, in his Thesis published at Leyden, in which he stated, that of 8,327 persons who had been inoculated in Pennsylvania and the neighbouring pronvices, only 19 (making one in 438.) had died. In Denmark, it was introduced by Dr. D. Ar gent, and in Sweden by Haartman. In both of these coun tries, its progress was greatly accelerated by the paternal encouragement of their respective courts.
In Switzerland and Italy, it was introduced about the year 1754. In Germany, it was begun at Hanover almost as soon as in England. The Prussian and Austrian states were the last in which it was received, as it was opposed by De Iliten of Vienna, and discouraged by the occurrence of three fatal cases in the beginning of Professor Mechel's inoculations at Berlin.
It was in 1768 that it was first known at St. Petersburg!), though the small-pox had destroyed too millions of per sons annually in the Russian empire. In that year, it was established in the Russian dominions by Dr. Dimsdale, who was sent from England for that express purpose, and re turned to his native country loaded with wealth and honours for his services. It was first established in Spain in 1771, though it had been practised for many years before at lad rique, an obscure town of that kingdom.
The principal writings by which this subject was eluci dated in our country, were those of Dr. Kirkpatrick, Mr. Burgess, and Dr. Munro. Dr. Kirkpatrick published a second edition of his work, with large additions, in 1761. In 1764, Dr. Munro published his account of the inocu lation of small-pox in Scotland. The number then inocu lated in this part of the kingdom, was 5554, of whom 72 died, i. c. one in 78. In the most northern isles, 112 had been inoculated in the middle of winter, and though they went abroad bare-footed in snow and ice, not one of them died.
The public attention was long and powerfully excited by the Suttonian method of inoculation. This was intro duced by Daniel Sutton, an eminent surgeon in Ingateston, Essex. It consisted chiefly in shortening the period of medicinal preparation of the patients for the operation, from a month to a few days, and in keeping them in the open air during the whole progress of the distemper. In this he succeeded to his wishes. The advantages of his plan attracted so many patients, that in the first year he cleared 2000, and in the second 6000 guineas by his fees. In 1767, he removed to London, but did not meet with proportional encouragement. The medical success of his practice was greatly exaggerated by his friends. It was maintained that he had a secret medicine which gave him perfect command over the number of pustules produced, and ren dered the inoculation absolutely exempt from danger. The few deaths which occurred were ascribed to causes inde pendent of the disease. His plan of preparation consisted
of abstinence from animal food and fermented liquors for a fortnight. A dose of a powder, which appears to have been mercurial, was given three several evenings during this fortnight, and next day a dose of cathartic salts, dur ing the operation of which (and then only) fruit was pro hibited. The months of May, June, July, and August, were preferred as the most seasonable for the inoculation of delicate subjects. The autumn was reckoned the most unfavourable season ; and aguish habits the least safe. Scorbutic constitutions he considered as not objectionable. Ile inoculated with recent moist matter, introduced under piece of elevated cuticle ; and he is said to have often inoculated with a lymph taken from the arm of another inoculated patient, before the eruption of the small-pox. A pill was given on the night following the operation, and every second night till the eruptive fever made its appear ance. The same diet used during preparation was con tinued in the course of the disease. During the fever, if there was no !lei spiration, drops were administered which brought on profuse sweating. In cases of high fever, he gave a powerful powder or pill, the composition of which lie concealed ; cold water to allay dry febrile heat ; and balm tea during the desired perspiration. When the sweat abated, and the eruption appeared, he ordered ex ercise in the open air, and milk gruel in unlimited quan tity. The diet was kept low in proportion to the symp toms of local inflammation. Sir George Baker, who inter ested himself in some inquiries into the Suttonian practice, ascribed the success attending it chiefly to the free and cool air, which formed part of the regimen, and corre sponded with the plan, which Sydenham had found most successful in the natural small-pox. Others ascribed the success of this plan to the preparatory steps by which the patient was predisposed to perspiration, and the profuse perspiration afterwards induced, previously to the variolous eruption. Mr. Sutton's most partial advocate, the Rev. Mr. Moulton, (who was a chaplain settled under that gen tleman's patronage, at the place where his inoculations were conducted,) maintained that the whole process was unknown to all except the discoverer himself. Mr. Chan dler asserted, that the success of Mr. Sutton arose from his taking the matter at a very early stage, before it had been ultimately variolated by the succeeding fever. Baron Dimsdale explained, in perspicuous language, free from mystery, what he considered as the most eligible way of conducting inoculation. This author preferred matter taken during the eruptive fever, as the most active ; and he preferred it taken from the place of inoculation, rather than from the other pustules. He describes the appear ances at the different stages, with the corresponding prog nosis, and appropriate treatment, the basis of which was the same with that of Mr. Sutton.