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tain, according as the fever is more violent and permanent, and especially as the marks and symptoms of putrescency are more evident.

When the putrid disposition is very great, the disease sometimes proves fatal before the eighth day; but in most cases it is on the eleventh that death happens, and sometimes it is put off till the fourteenth or seventeenth day.

Though the small-pox should not be immediately fatal, the more violent kinds are often followed by a morbid state of the body, of various kind and event. These consequences, as I judge, may be imputed sometimes to an acrid matter produced by the preceding disease, and deposited in different parts; and sometimes to an inflammatory diathesis produced, and determined to particular parts of the body.

594. It is, I think, agreed among practitioners, that, in the different cases of small-pox, the difference chiefly depends upon the appearance of distinct or confluent; and, from the above description of these kinds, it will appear, that they chiefly. differ in the period of the eruption, in the number of pustules produced, in the form of the pustules, in the state of the matter contained in them, in the continuance of the fever, and, lastly, in the danger of the disease.

595. Upon inquiring into the causes of these

differences, we might readily suspect, that they depended upon a difference of the contagion producing the disease. This, however, is not probable for there are innumerable instances of the contagion, arising from a person labouring under the small-pox of the distinct kind, producing the confluent; and on the contrary. Since the practice of inoculation became frequent, we have known the same variolous matter produce in one person the distinct, and in another the confluent smallpox. It is therefore highly probable, that the dif ference of the small-pox does not depend upon any difference of the contagion, but upon some difference in the state of the persons to whom it is applied, or in the state of certain circumstances concurring with the application of the contagion.

596. To find out wherein the difference in the state of the persons to whom the contagion of the small-pox is applied consists, I observe, that the difference between the distinct and confluent smallpox consists especially in the number of pustules produced; which, in the distinct, are generally few; in the confluent, always many. If, therefore, we shall be able to discover what, in the state of different persons, can give occasion to more or fewer pustules, we shall probably be able to account for all the other differences of the distinct and confluent small-pox.

597. It is evident, that the contagion of the small-pox is a ferment with respect to the human fluids, and assimilates a great part of them to its own nature; and it is probable, that the quantity thus assimilated, is, in proportion to the bulk of their several bodies, nearly the same in different persons. This quantity passes again out of the body, partly by insensible perspiration, and partly by being deposited in pustules; but if the quantities generated be nearly equal, the quantities passing out of the body by the two ways mentioned are very unequal in different persons; and, therefore, if we can explain the causes which determine more to pass by the one way than by the other, we may thereby discover the causes which give occasion to more pustules in one person than in another.

598. The causes which determine more of the variolous matter to pass by perspiration, or to form pustules, are probably certain circumstances of the skin, that determine more or less of the variolous matter to stick in it, or to pass freely through it,

599. The circumstance of the skin, which seems to determine the variolous matter to stick in it, is a certain state of inflammation, depending much upon the heat of it. Thus we have many instances of parts of the body, from being more heated,

having a greater number of pustules than other parts. In the present practice of inoculation, in which few pustules are produced, much seems to be owing to the care that is taken to keep the skin cool. Parts covered with plasters, especially with those of a stimulant kind, have more pustules than other parts. Further, certain circumstances, such as adult age, and full living, determining to a phlogistic diathesis, seem to produce a greater number of pustules; while, the contrary circumstances have contrary effects.

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600. It is therefore probable, that an inflammatory state of the whole system, and more particularly of the skin, gives occasion to a greater number of pustules and the causes of this may likewise produce most of the other circumstances of the confluent small pox; such as the period of èruption; the continuance of the fever; the effusion of a more putrescent matter, and less fit to be converted into pus; and, what arises from thence, the form and other circumstances of the pustules..

601. Having thus attempted to account for the chief difference which occurs in the state of the small-pox, we shall now try the truth of our doctrine, by its application to practice.

602. In considering the practice, we view it first, in general, as suited to render the disease

more generally benign and safe, and this by the practice of inoculation.

603. It is not necessary here to describe the operation of inoculating; and what we name the practice of inoculation, comprehends all the several measures which precede or follow that operation, and are supposed to produce its salutary effects. These measures are chiefly the following:

1, The choosing for the subject of inoculation persons otherwise free from disease, and not liable, from their age or other circumstances, to any incidental disease;

2, The choosing a person at the time of life most favourable to a mild disease;

3, The choosing for the practice a season the most conducive to the mildness of the disease;

4, The preparing the person to be inoculated, by abstinence from animal food for some time before inoculation;

5, The preparing the person by courses of mercurial and antimonial medicines;

6, The taking care, at the time of inoculation, to avoid cold, intemperance, fear, or other circumstances which might aggravate the future disease;

7, After these preparations and precautions, the choosing a fit matter to be employed in inoculation, by taking it from a person of a sound constitution, and free from any disease or suspicion

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