The first description we have of this dreadful disease is to be found in the writings of Almansor of Rhazes, published about the end of the ninth or the beginning of the tenth century. He, however, quotes an Alexandrian physician of the name of Aaron, who had treated the same subject so early as the year 622. There is no substantial ground to warrant a belief that it was known to the Greeks or Romans. The opinion of Hahn, who considered it to have been their anthrax, is absurd. Had this pestilence prevailed amongst the ancients, and left the traces of its ravages,—which have marked most fearfully so many individuals,—it is probable that these impressions would have been attached to their names, as they were in the habit of designating many of their illustrious personages by their physical peculiarities, either natural or accidental. Hence we find Ovidius Naso, Tullius Cicero, Horatius Cocles, Scipio Nasica, Curius Dentatus.

The term variolÆ, which this disease bears, was first applied to a malady presenting the same symptoms, by Marius, bishop of Avanches, and appears to be derived from varius, spotted. Howbeit, to whatever region we may be indebted for this scourge, it appears that it existed in Asia, and especially in China, long before its introduction into Europe. About the middle of the sixth century, it was supposed to have been carried from India to Arabia by trading vessels, where no doubt the Arabian and Saracenic armies introduced it into the Levant, Spain, and Sicily. In 640, under the caliphate of Omar, the Saracens spread the contagion over Syria, ChaldÆa, Mesopotamia, Egypt, and Persia. Its appearance in Europe may be referred to the eighth century. In the ninth century, as I have stated, we find it described by the Arabian physicians. In the tenth century we find it described by other Arabian writers, chiefly Avicenna and Hali Abbas. In 962, Count Baudouin of Flanders, died from its attack. It appears certain that it prevailed in Gaul long before; we find in the works of Marius, already mentioned, the following passage: “Hoc anno (570) morbus validus, cum profluvio ventris et variolis, Italiam Galliamque valdÈ afflixit.” About the same period we find Dagobert and Clodobert, sons of Chilperic, falling victims to the disorder; and Austregilda, wife of Gontran King of Burgundy, died of it in 580, at the age of thirty-two, so enraged with her physicians, Nicholas and Donet, that she insisted that they should accompany her to the other world, to reward them for causing her untimely end. Her affectionate and disconsolate husband Gontran of course had both their throats cut upon her tomb.

In the eleventh and twelfth centuries we find the smallpox in all the southern parts of Europe. The north was for a long time tolerably exempted from the scourge, until the Holy War introduced it into those regions; and it appears to have been the only trophy that the English and Germans brought home to commemorate their exploits in the Crusades.

In the thirteenth century the Muscovites, Laplanders, and Norwegians were free from the disorder, the progress of which seemed to have been delayed by the cold; although at the same time, according to the relation of Gordon, it was most destructive all over France. Most physicians at this period partook of the opinion of the Arabians, who considered the disease as being in the blood, thrown by it into a state of ebullition, particularly in childhood and youth. According to the Arabian Auaron, or Ahron, it sometimes affected the same individual twice. This doctrine of the boiling up and bubbling forth of the blood to throw out its peccant qualities, tended not a little to increase the mortality and exasperate the disease; as the physicians, to encourage this concoction, were in the habit of wrapping up their patients in warm clothing, and keeping their apartments as hot as possible;—a fatal practice that subsequent experience has rejected as destructive.

In 1517 the Spaniards carried it to St. Domingo, nearly depopulating the country. South America soon received this additional visitation, said to have been carried amongst them by a negro. So terrific were the ravages of this pestilence, that the Americans considered its invasion as one of the data of their melancholy chronicles. The brother of the noble Montezuma was one of its earliest victims; worthy attendant on the Spanish banners, it accompanied their detested hordes in all their conquests.

The northern districts of America were free from the contagion, when the English carried it with their commercial productions amongst the natives of Boston in 1649, and subsequently to Virginia and Carolina, and the remaining provinces. The Spaniards infected Nootka Sound, and the Russians desolated Kamtschatka about the same period.

Inoculation appears nearly as ancient as the disease, if we can credit the missionaries, who were sent into China by the Church of Rome, and who, from their address and insinuation, gained access to the historical records: they have transmitted detailed accounts of the history of the Chinese, and of their knowledge in various branches of science. There is a memoir written on the smallpox by the missionaries at Pekin, the substance of which is extracted from Chinese medical books, and especially from a work published by the Imperial College of Medicine, for the instruction of the physicians of the empire. This book is entitled Teou-tchin-fa, or a treatise from the heart to the smallpox; which states that the disease was unknown in the very early ages, and did not appear until the dynasty of Tcheou, which was about 1122 years before Christ. The Chinese name for the malady is a singular one, Tai-tou, or venom from the mother’s breast; and a description is given of the fever, the eruption of the pustules, their increase, flattening, and crusting. In the same Chinese book there is also an account of a species of inoculation discovered seven centuries previously; but, according to a tradition, it had been revealed in the dynasty of Long, that is, about 590 years before Christ. Father d’Entrecolles, the Jesuit, in his correspondence from China, gives some information respecting the smallpox, which confirms the material part of the above information; for he notices having read some Chinese work which mentions the smallpox as a disease of the earliest ages. He also describes a method of communicating the disease, which was called sowing the smallpox; this was generally performed by planting some of the crusts upon the nose,—an operation which was approved of by some but disapproved by others.

Although the tradition of the smallpox being a disease originally transmitted to man by camels may be fanciful, yet the existence of the vaccine in cows might give some probability to its having been the case. Moore thus expresses himself on the subject: “This notion probably took its rise from the circumstance that land commerce from Egypt to India was only practicable by means of this animal. But such kind of traffic was tedious and difficult, and it is conjectured that no person known to have the smallpox would ever have been suffered to join himself to a caravan.” Now this observation would rather confirm the fact than invalidate it; since, if no individual affected with the malady could have carried the contagion, the disease might have been spread by their camels.

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.