ited as coinciding perfectly with the other parts of the general system-as possessing the same spiritual and holy character;-let the fact be shown, that where they are neglected in the ministrations of the pulpit, the bible ceases to be "the power of God unto salvation," and that where they are enforced, the same transforming influence is apparent which attended the preaching of apostles; and we shall very soon witness a diminution of the number of believing infidels. Men would find themselves reduced to the necessity of receiving truth as the word of God reveals it, instead of making their own views and feelings the standard of appeal; or of throwing off the garb under which they now seek disguise, and renouncing christianity altogether. While, therefore, in maintaining the divine origin of our religion, the authenticity and inspiration of its scriptures, and the entire system of its peculiar doctrines, we avail ourselves of the external evidence, so perfect in its kind, with which we are supplied, let it never be forgotten, that truth, by her own features, may always be distinguished ;--that the beauty of heaven is impressed upon her brow, and simplicity and purity engraven on her hands.

ART. V.-REVIEW ON THE VARIOLOID AND SMALL Pox; AND ON THE MORAL EFFECTS OF PREVALENT MALIGNANT DIS

EASES.

Dr Minn

Report of the Committee of the Philadelphia Medical Society, appointed to collect facts in relation to the recent occurrence of Small Pox in this city. American Medical Recorder: Philadelphia, April, 1828. See also, most of the medical journals of the same year.

ABOUT twenty years ago, a very malignant disease prevailed extensively in one of the most populous inland towns in this State. A large proportion of the families were visited with sickness, and few of them escaped without one or more deaths. Their minister, who is one of our most valued friends, has frequently remarked, that notwithstanding the solemn and affecting nature of this dispensation of Providence, he was able to mention but a single instance, in which it appeared to have any directly beneficial effect upon the survivors. One man only, of the hundreds who were in mourning, considered the death of his wife as the means of exciting him to reflection, and to a hopeful preparation for his own great change. A particular instance of sudden mortality has often been known to awaken the careless and secure; but it very rarely if ever happens, that any peculiar attention to religion, is either the attendant or the immediate consequence, of extensive and fatal sickness, or of any other general calamity. Neither great public prosperity, nor great

public adversity, appears to produce directly beneficial effects, in morals or religion, among the people who are its subjects. More generally, on the contrary, is their influence of such a kind, as to require years to remedy their pernicious consequences.

Nor is mere indifference to the concerns of religion the only evil, which is superinduced upon the community, by the prevalence of general sickness or distress; too frequently it is a period of irritation, discord, and contention. Instead of submitting with meekness, humility, and resignation, to the chastisements of Providence, and uniting in the attempt to stay the plague by all proper means, the public mind, at such seasons, is too often distracted by controversies, and embittered by party feeling. It is an interesting inquiry, therefore, what can be done by the patriotic, the pious, and the benevolent, in such circumstances, to lessen this accumulation of moral and physical evils.

As the first measure, it is necessary that the subject should be well understood; for in this, as in many other very important concerns, a great proportion of the errors originate in prejudice, ignorance, or misapprehension. Those who are the least informed are generally the most officious, in disturbing the public, and adding to the general confusion, by diffusing their own crude and incorrect opinions. In a period of ordinary health, the body of mankind feel too little interest, to investigate the laws of epidemic disease; and during the prevalence of mortal sickness, the public mind is too much distracted by rumors, alarms, and suspicions, to judge accurately of the subject.

As it is now a time of very general health, and of exemption from any peculiar public calamity, it is thought, if we can succeed in so treating the subject as to excite the attention of the reader, that we may profitably devote a few pages to the consideration of dangerous epidemic diseases, with their moral effects upon the community; and more particularly to the means of their prevention, mitigation, or extinction. The field is too extensive to be accurately surveyed, in one essay, or in one volume. By directing our remarks in the present article, principally to the Small Pox, with a notice of two or three topics intimately connected with it, and to the measures proper to arrest its depredations, we shall embrace a prominent portion of the subject, which will be universally acknowledged to be a matter of high importance, for the consideration of every friend of humanity.

The doctrines of Mahomet, and the ravages of his arms and of those of his successors, were not the only calamities which he brought upon christendom. It seems, that wherever the Saracens went, they carried with them and diffused a disease, which has probably destroyed more lives than the sword. The small pox was as new to the christian world, as the doctrines of its invaders. Af

ter having existed from time immemorial in China and India, it appears to have been first noticed in Arabia and Egypt, about the beginning of the seventh century. By means of the Saracens, it was introduced, and by the crusades it was probably spread over all Europe. Most families lost from a fourth to a third of their children, and often a greater proportion, by this fatal disease. There can be but little doubt, that in the countries in which this malady was unrestrained, it was the occasion of greater mortality, than any one cause that can be named. The re-discovery of the anti-phlogistic or cool regimen by Sydenham, in the seventeenth century, and the introduction of inoculation in the eighteenth, considerably mitigated the evil. But these benefits were principally confined to the rich and the well informed; for the poor and ignorant in Europe, were so strongly attached to their ancient habits and prejudices, that they generally despised both these improvements. The small pox, therefore, still continued its ravages, with very little abatement, as respects the great body of the people on the eastern continent, till the close of the last century.

In the year 1798, Dr. Edward Jenner first published his discovery of the efficacy of vaccination. The knowledge of this important process, with its establishment upon a firm, and, as we believe, immutable basis, forms a new and more important era, than perhaps any other in the annals of medicine. Like the antiphlogistic regimen and inoculation, and indeed, in common with almost every new and important discovery or improvement in the healing art, it had to encounter the bitterest opposition, and the severest trials; but after the most rigid scrutiny, and upon the most incontestable evidence, it soon rapidly and extensively triumphed. In a few years, the small pox appeared to be nearly extinct in several of the kingdoms of Europe, and in those parts where it was occasionally seen, the number of deaths from it was comparatively trifling. The United States, except in a few of the large cities, by keeping the small pox restrained, and by the early and successful adoption of inoculation, had suffered much less from this disease, than most parts of the eastern continent. Vaccination was introduced among us, at an early period, by Dr. Waterhouse, and in our turn we reaped its advantages, in their fullest extent.

In this situation things remained, about fifteen years from Jenner's great discovery. The small pox had nearly lost its terrors. Vaccination, from its being so common and so simple, had in a considerable degree ceased to interest the public, and a general feeling of security and indifference had begun to prevail.

About the year 1813, the small pox appeared again at Edinburgh, in its most malignant form, and nearly at the same time it raged violently at Norwich in England. Cotemporaneous accounts soon reached us, that it had also excited alarm in France. The

first that we recollect of having any notice of a new sensation being produced by it in this country, was a verbal account, perhaps twelve or fifteen years ago, that a virulent and unmanageable variety of small pox had appeared in the State of New York, whither it had been brought by some European families, that had emigrated thither through Canada. This rumor soon subsided; but within a few years, this disease was found to be again prevalent in our cities, and the bills of mortality recorded numbers of deaths by the small pox.

But the re-appearance of the small pox was not all. It was soon observed to be more virulent and more contagious, than had been previously supposed, and that to have had the disease itself before, was not always a sure guard against its future attack; and to add still more to the public apprehensions, Vaccination, which had been popularly considered as an absolute preventive, was found, in many instances, not to be an entire protection against all the effects of the small pox.

This re-appearance of the small pox, and the anomalous symptoms with which it was attended, at first produced alarm and doubts, with their usual effects, controversy and irritation; but these seem at present to be at an end. The consequence has been, that the medical profession have had a thorough re-examination of the subject, and have viewed it in all its bearings; so that the various facts appear now to be well ascertained, and a correct knowledge of them may be easily acquired, by all who will take the pains to consult the proper authorities.

It is ever a difficulty with the majority of mankind, that they are inclined to generalize too readily, and to draw extensive conclusions from too small a number of facts. They readily notice resemblances, but do not discriminate differences with accuracy. They learn the general rule, but do not study the exceptions. In respect to a disease, inost people judge chiefly from its name; and are inclined to imagine, that it is always attended with the same phenomena, as those which have occurred to their own limited, personal observation. The consequence is, that when a particular disease is more severe and fatal than common, and prevails to an unusual extent, the public are taken by surprise.

The imperfection of the healing art, and the fact that no specific or certain remedy, or preventive of a single severe disease, has hitherto been discovered, are points universally allowed by every able physician. Small pox, measles, chicken pox, and whooping cough, generally attack the same person but once; but there is the most decisive evidence, that each of these diseases has been known to affect, in its full force, particular individuals a second time. The same general law applies to vaccination, as a preventive of small pox. It usually destroys the susceptibility of the system to VOL. II.

10

any future impressions from the variolous virus; and in the few cases where there is a subsequent infection, the disease appears to be always modified, and essentially milder and of shorter duration, than the original small pox. The fact that vaccination does not, in every instance, prove to be so absolutely a preventive as could be wished, was well known to Jenner, and had from the first been noticed. But though cases of occasional failure, were known to all intelligent physicians, they were yet so rare as not to attract the attention of the public, who had imbibed the opinion, that those who had been properly vaccinated, were absolutely secure; till they were surprised by some striking examples to the contrary at Edinburgh, Norwich, and also in France.

ry.

Our limits do not allow us to notice all the hypotheses that have been suggested, in order to account for the recent anomalies in the small pox; and for the vaccine disease proving to be less complete as a preventive, than it was the first fifteen years after its discoveWe have conclusive evidence, that the vaccine virus has not degenerated, from having passed so frequently, and so long a time, through the human system. The difficulty does not lie in vaccination; though liable to be somewhat modified by circumstances, its powers are evidently as great and as extensive as ever. It is from the new and irregular form which the small pox has assumed, that our embarrassment arises. The small pox has been more virulent and more contagious, than usual. This is the fact; and here we are to look for the solution of the difficulty. That this opinion is well founded is evident, from the small pox having lately occurred a second time in the same subject, much more frequently than had been known for centuries before. A second attack of the small pox, however, had never been so rare an occurrence as is usually imagined. Louis XVth died of this disease, though he had been previously a subject of it in his youth. Rhases, the Arabian, the earliest writer extant who describes the small рох, notices cases of a second and a third infection. These, and similar facts, are mentioned by several authors.

All acute diseases have been observed to vary very considerably in different years, and in different localities. The measles is sometimes so mild, as scarcely to confine the patient to the house; at others, it is attended with a malignant fever, and then of consequence is always dangerous, and often fatal. The same is the fact with dysentery. The fevers which, at the present day, are denominated typhus, admit of every variety and gradation. Darwin very justly observes, of what is often called malignant sore throat, that it appears in every degree, from a flea-bite to the plague. These different forms and different degrees of severity, not only belong to different cases, but they are often characteristic of whole epidemics, for many years in succession. Particular diseases have