On general and partial Inoculations in the country.

The preceding translated treatises having been calculated for Russia, which in many circumstances differs from England, and in particular that the will of the Sovereign there is most implicitly obeyed, cannot be expected to contain all that may be necessary to be considered, and attended to in this country.

Nevertheless, the general principle of the regulation, so far as it relates to public Inoculation in towns and villages, may be attended to, and of such places I mean to treat first, and of London and other populous places afterwards, for reasons that will be sufficiently evident in the sequel.

In order to be fully acquainted with the subject, it seems necessary to take into consideration, the mode of conducting this affair in the country, which I do not remember to have ever seen circumstantially published; those who have wrote on the subject, having for the most part contented themselves with representations of their success only.

In the county of Hertford, there have been two methods of public or general Inoculation, one to inoculate, at a low price, as many of the inhabitants of any small town or village, as could be persuaded to submit to it, and at the same time were able to pay, refusing all those who had it not in their power to procure the money demanded.

The other method has been, where the inhabitants of a town, or district, of all denominations, have agreed to be inoculated at the same time, the parish officers, or some neighbouring charitably disposed persons, having first promised to defray the expence, and provide subsistence for such of the poor, as were unable to pay for themselves.

The partial method first mentioned has been attended by much mischief, and sufficiently refuted the absurd opinion endeavoured to be propagated by interested persons, that inoculated persons do not communicate infection; innumerable are the instances which have happened of the disease being caught from the inoculated, and too evident to be denied; and so many of these have died, that an opinion not less absurd than the former prevails in Hertfordshire, that those who take the Small Pox from the inoculated rarely recover.

The method of inoculating every one in the same neighbourhood together has succeeded so happily, that it seems only necessary to determine what is the most reasonable and frugal way of conducting the business; and if joined to this consideration proper attention is paid to airing and cleansing the patients, their cloaths and habitations, as much as possible, from the power of infection, all the benefit that can be derived from general Inoculation will be effected, many valuable lives will be preserved to the community, and the inhabitants made happy, on being released from the apprehensions of a visit from this cruel disease.

As I can from considerable experience speak with some confidence on this subject, I shall proceed to relate the observations that have occurred to me. Assisted by my learned friend Dr. Ingenhouz and my two sons, I inoculated, at different times, the neighbouring parishes of East Berkhamsted, Hertingfordbury, Bayford, and the liberty of Brickenden; in each of these places the whole number of poor were inoculated, with the exception of those who were objectionable. I do not at present remember the exact number, I believe they might be more than 600; but know that they succeeded happily, though there were several very old persons, and women in different periods of gestation; and this mode of practice, as I have been informed, has been also used successfully by many others in different parts of England.

So far as has come to my knowledge, general Inoculations have hitherto been confined to small towns and villages; yet as the further extension is very much to be wished, it may not be improper to relate some particulars of what passed in Hertford, which is doubtless the largest, and most populous town, that has submitted to the experiment of inoculating at the same time the whole number of its inhabitants.

In a former publication, I gave an account of the occasion and success of a general Inoculation at this place; from that time the town was released from any apprehensions of the disease, until the year 1770, when it appeared again, and two or three having died, a few persons were inoculated, and excited an alarm. On this occasion, the poor in my neighbourhood flocked in numbers, beseeching me to extend to them the same charitable assistance, they had formerly experienced; having then my two sons with me to assist, I complied without hesitation.

Nothing shews the increase and state of population so clearly, as an experiment of this kind; we had then upwards of two hundred and fifty patients, some of whom were new inhabitants, but the rest consisted for the most part of very young children. Necessity has often produced useful discoveries; the Inoculation was begun on Midsummer-day, and though the weather proved very hot, I observed no inconvenience from it; they had the free use of air, and seemed as much benefited by it as at any other season of the year; and every one recovered.

In the year 1774 the disease appeared a third time; the same request was renewed, and with the same assistance afforded, the whole town was inoculated once more, and now the number amounted only to about one hundred and twenty; from that time we have heard nothing of Small Pox, and I verily believe, that within these ten years not six persons have died in Hertford of this disease; whereas before the practice was so generally adopted, the Small Pox has frequently been epidemic and destroyed a great number of the inhabitants, besides injuring the market and trade of the town for a considerable time.

The inferences one may fairly draw from these premises are, that in small towns or villages, if some are inoculated and others excluded, unless more precautions are used than may reasonably be apprehended, the consequence will be, that the disease will spread through the vicinage, and be fatal to many.

On the contrary, if by general consent a public Inoculation is agreed on, and the poor are supplied with necessaries, the happiest consequences may be reasonably expected; and further, the good effect of repeated general Inoculations in the town of Hertford demonstrate, that large towns may with great advantage avail themselves of the same means, and, by occasionally repeating the practice, be secured from the ravages of this justly dreaded disease.