Small-pox can be communicated by inoculation with the matter of its pustules, and the resulting disease being rendered milder by this operation, it was formerly much practised to guard the individual against a spoutaneous attack ; since, however, the introduction of vaccination by 1)r. Jenner, the practice has been deservedly abandoned. Vaccination was supposed by its discoverer to secure the individual permanently and effectually from the contagion of the small-pox ; more extended experience bas proved, that although it does not always prevent it, yet it so shortens its duration and moderates its violence, that a death from small-pox after vaccination is a rare occurrence. A dif ference of opinion prevails respecting the character of the eruption which oe.easponaply appears after exposure to variolous infection in persons previously vaccinated. According to many, it is nothing more than chicken-pox ; while others affirm that it is really small-pox, although modified by the controlling influence of the cow-pox. The truth appears to be, that "modified smallpox" resembles the chicken-pox in its mildness and duration, but differs from it in its originating from the " variolous germ," and in its power of commu nicating the true small-pox to others, as well by inoculation as by infection.
The history of the different epidemics of small-pox shows the mor tality to be one in four of those attacked who had not been vaccinated ; whilst of those who had undergone vaccination the proportion was not one in 450. From the register kept at the Small-Pox Hospital in London, it appears that the mortality at this institution is consider ably greater than one in four, having averaged during the last fifty years 30 per cent., the extremes being 18 and 41. From the same source we learn that the greatest number of deaths occurs ou the eighth day. Of ICS fatal cases, there died in the first week 32 ; in the second, 99 ; in the third, 21 ; and in the fourth and after, IC. The causes of deal' at these different periods are the following :—I st week, malignant fever ; 2nd week, affections of the throat, and consequent suffocation ; 3rd week, or during the secondary fever, febrile excite ment, mortification of large portions of the integuments, pneumonia, pleurisy, or laryngitis ; 4th, and following weeks, exhaustion, erysi. vela., or some of the diseases before enumerated as liable to result from small-pox. It was formerly supposed that the eruption of variola was not confined to the akin, but invaded also the internal parts ; this is not the case, the internal affections are simply inflammatory, and do not partake of the specific character of the cutaneous disease.
No peculiar plan of treatment is required for small-pox ; it is that of ordinary fever : cleanliness, free ventilation, an attention to the strength of the patient, and a watchfulness against accidental compli cations, are the principal points to be kept in -view. During the eruptive stage of the disorder, the bowels should be kept moderately open by saline aperients, and the occasional exhibition of a mild mer curial. The temperature of the skin may be regulated by cool air, or by sponging it with tepid vinegar and water ; if there should be much unpleasant effluvium from the surface of the body, washing it with a weak solution of one of the chlorides will be found to correct this. It has been recommended by some writers, and has been long a practice in Eaatern countries, to pierce the pustules with a fine needle ; this procedure, it is said, lessens the violence of the secondary fever, and prevents pitting. M. Serres, with the same object, directs the appli cation of lunar caustic to the pustules on the fourth day. As a general rule, wo should say that venesoction is not admissible at any period of small-pox ; indeed we have no hesitation in affirming that some of the severest consequences of the disease may be averted by a judicious employment of measures of an opposite tendency to blood-letting. The sloughing of the integnments, and the intense ophthalmia, rapidly terminating in entire loss of vision, arc eminently connected with an enfeebled and cachectic state of body ; and the best mode of averting these evils is to have recourse early to those remedies which are meat efficacious in arresting their progress. Hence quinine, combined with the mineral acids, sarsaparilla, wine, brandy, if the powers arc much reduced, and animal food, if the patient can eat it, must be perse veringly administered. It may not be out of place hero to mention that the character of the ophthalmia termed rariaous has only lately been pointed out to the profession by Mr. Masson of the Small-Pox Hospital. It had been supposed that the eye was lost in small-pox from one or more of the pustules of this disease forming on the cornea. Mr. Marson has shown not only that this never takes place, but that the loss of vision is attributable to ulceration or sloughing of the cornea, which comes on generally about the eleventh or twelfth day of the disease. The patient is nearly always in a state of great debility, and requires tonic medicines and nutritious diet to give. him a chance of escaping from the destructive effects of this ophthalmia.