in the summer. As soon as she became calm and composed, we returned to her son.

On interrogating him, he informed me that in the beginning of July last there were two dogs fighting desperately in the street, opposite his mother's house; and he, observing one of them had one of his eyes torn out, and the other dog likely to kill him, endeavoured to part them; but on taking hold of the dog he wished to rescue from the fury of the other, he received a bite from him on his right hand. Two of the dog's teeth penetrated the outside of the hand, but the palm of the hand was considerably wounded. This wound was dressed with Friar's balsam and poulticed, and was cured in a week or ten days.

I examined his hand. There was a small degree of reduess remaining, but no heat, or pain, where the wound had been in the palm of his hand, and no vestige whatever on the outside where the teeth had been. There was nothing observable in his throat, differing from its natural state; nor any increase of saliva. Pulse 88, rather feeble, and not quite regular. He had no thirst. He told me his choaking seemed to him as arising from wind; and that he always discharged a great deal from his throat whenever he attempted to swallow. He said he took some dill-seed water last night, and thought it relieved him; but never could get down more than a tea-spoonfull at a time, and that with great difficulty. In one attempt to swallow some of this water, he was so choaked and convulsed, that he would have fallen into the fire, his mother told me, if she had not saved him. I gave him some water in a pint pot twice; each time he swallowed about a tea-spoonfull,

and both times was choaked and convulsed, with a wild staring in his eyes, and a trembling all over him and immediately after the effort of swallowing, he made a hideous noise. The second time I gave him the water, I was much alarmed; I thought it would have occasioned a fatal co vulsion. It is impossible to describe a sound; and I can compare the noise he made, which was from repeated spasmodic contractio of the organs of respiration, to nothing but to that sort of stifled barking which dogs sometimes make when disturbed in their sleep; or to the hoarse short barking of a drover's dog. When he took the pot in his hand, he fell into a tremor, held down his head, and was in great distress; he kept the pot in his hand a few seconds before he could summon courage to lift it to his mouth; after which I took it from him, as from his agony he could not hold it. He bore the sight of the water in the pot, while it was in my hand, when it was not offered him to drink; but when I brought a large bason filled with water, and put it before his eyes, he seemed frightened; and when I agitated the water near him, he was instantly at tacked with what he called "the wind rising in his throat," trembling, and that hoarse faucial noise before mentioned. He entreated me not to order any medicine for him in a liquid form, as he said he could not take it; and the attempt, he was certain, would kill him. He said he could swallow any solid substance. I put this to the proof; and, as he had been costive for several days, I gave him four aperient pills, which he swallowed one at a time, but with some difficulty. He had now been with me three quarters of an hour, when he and Mrs. Metcalf left Al

bany,

pany, with the best advice I could give, and walked back to Comptonstreet. From his appearance and conversation, no person would have thought there was any indisposition about him. His voice and speech bad suffered no alteration. He was in the eighteenth year of his age; a fine youth, in mind as well as in person. His humanity here was his misfortune. With what grief did I see him depart from Albany with his poor mother, knowing, as I did, that he had but a few hours to live! I visited him at eight o'clock in the evening. Pulse 110, and very feeble. I gave him some water. In attempting to drink, the usual consequences -choaking, wildness in the eyes, and the noise in the throat, followed. The pills operated about nine o'clock, several times. About ten o'clock he became so violently convulsed, that four young men, his brothers, could scarcely keep him in his bed; but he made no attempt to bite any person. He began also to foam at the mouth, with white froth. The quantity of this froth was so great, as to require many towels and handkerchiefs, in wiping it from his mouth. At this period he likewise became delirious at intervals, but at times in his perfect senses; and complained, though in a very warm room, of being cold, and begged to be kept warm. In this condition he continued until one o'clock on the following morning, when, from his violent convulsive exertions and struggling, he was entirely exhausted, and remained calm and quiet afterwards. He expired at a quarter before two, 18 weeks from the accident; 46 hours from the commencement of the hydrophobia, and ten hours after I first saw him. R. M.

Report of the Royal College of Physicians of London, on Vaccination. Presented to the House of Commons.

The royal college of physicians of London, having received his majesty's commands, in compliance with an address from the house of commons, "to inquire into the state of vaccine inoculation in the United Kingdom, to report their opinion and observations upon that practice, upon the evidence which has been adduced in its support, and upon the causes which have hitherto retarded its general adoption;" have applied themselves diligently to the business referred to them.

Deeply impressed with the importance of an enquiry which equally involves the lives of individuals, and the public prosperity, they have made every exertion to investigate the subject fully and impartially. In aid of the knowledge and experience of the members of their own body, they have applied separately to each of the licentiates of the college; they have corresponded with the colleges of physicians of Dublin and Edinburgh; with the colleges of surgeons of London, Edinburgh, and Dublin; they have called upon the societies established for vaccination, for an account of their practice, to what extent it has been carried on, and what has been the result of their experience; and they have, by public notice, invited individuals to contribute whatever information they had severally collected. They have in consequence been furnished with a mass of evidence communicated with the greatest readiness and candour, which enables them to speak with confidence 303

upon

upon all the principal points re

ferred to them.

1. During eight years which have elapsed since Dr. Jenner made his discovery public, the progress of vaccination has been rapid, not only in all parts of the United Kingdom, but in every quarter of the civilized world. In the British islands some hundred thousands have been vaccinated, in our possessions in the East Indies upwards of 800,000, and among the nations of Europe the practice has become general. Professional men have submitted it to the fairest trials, and the public have, for the most part, received it without prejudice. A few indeed

have stood forth the adversaries of vaccination, on the same grounds as their predecessors who opposed the inoculation for the small-pox, falsely led by hypothetical reasoning in the investigation of a subject which must be supported, or rejected, upon facts and observation only. With these few exceptions, the testimony in favour of vaccination has been most strong and satisfactory, and the practice of it, though it has received a check in some quarters, appears still to be upon the increase in most parts of the United Kingdom.

II. The college of physicians, in giving their observations and opinions on the practice of vaccination, think it right to premise, that they advance nothing but what is supported by the multiplied and unequivocal evidence which has been brought before them, and they have not considered any facts as proved but what have been stated from actual observation.

Vaccination appears to be in generat perfectly safe; the instances

to the contrary being extremely rare. The disease excited by it is slight, and seldom prevents those under it from following their ordinary occupations. It has been communi cated with safety to pregnant wo nien, to children during dentition, and in their earliest infancy; in alt which respects it possesses material advantages over inoculation for the small-pox; which, though productive of a disease generally mild, yet sometimes occasions alarming symptoms, and is in a few cases fatal.

The security derived from vaccination against the small-pox, if not absolutely perfect, is as nearly so as can perhaps be expected from any human discovery; for amongst several hundred thousand cases, with the results of which the college have been made acquainted, the number of alleged failures has been surprizingly small; so much so, as to form certainly no reasonable objection to the general adoption of vaccmation; for it appears, that there are not nearly so many failures, in a given number of vacci naled persons, as there are deaths in an equal number of persons inoculated for the small-pox. Nothing can more clearly demonstrate the superiority of vaccination over the inoculation of the small-pox, than this consideration; and it is a most important fact, which has been confirmed in the course of this inquiry, that in almost every case, where the small-pox has succeeded vaccination, whether by inoculation or by casual infection, the disease has varied much from its ordinary course; it has neither been the same in the violence, nor in the duration of its symptoms; but has,

The testimonies before the college of physicians are very decided in declaring, that vaccination does less mischief to the constitution, and less frequently gives rise to other diseases, than the small-pox, either natural or inoculated.

The college feel themselves called upon to state this strongly, because it has been objected to vaccination, that it produces new, unheard-of, and monstrous diseases. Of such assertions no proofs have been produced; and, after diligent inquiry, the college believe them to have been either the inventions of designing, or the mistakes of ignorant men. In these respects, then, in its mildness, its safety, and its consequences, the individual may look for the peculiar advantages of vaccination. The benefits which flow from it to society are infinitely more considerable; it spreads no infection, and can be communicated only by inoculation. It is from a consideration of the pernicious effects of the small-pox, that the real value of vaccination is to be estimated. The natural small pox has been supposed to destroy a sixth part of ail whom it attacks; and that even by inoculation, where that has been general in parishes and towns, about one in three hundred has usually died. It is not sufficiently known, or not adverted to, that nearly onetenth, some years more than onetenth, of the whole mortality in London is occasioned by the small pox; and however beneficial the inoculation of the small-pox may have been to individuals, it appears

to have kept up a constant source of contagion, which has been the means of increasing the number of deaths by what is called the natural disease. It cannot be doubted t't this mischief has been extended by the inconsiderate manner in which great numbers of persons, even since the introduction of vaccination, are still every year inoculated with the small-pox, and afterwards required to attend two or three times a week at the places of inoculation, through every stage of their illness.

From this, then, the public are to expect the great and uncontroverted superiority of vaccination, that it communicates no casual infection, and, while it is a protection to the individual, it is not prejudicial to the public.

II. The college of physicians, in reporting their observations and opiions on the evidence adduced in support of vaccination, feel themselves authorized to state that a body of evidence so large, so temperate, and so consistent, was perhaps never before collected upon any medical question. A discovery so novel, and to which there was nothing analogous known in nature, though resting on the experimental observations of the inventor, was at first received with diffidence: it was not, however, difficult for others to repeat his experiments, by which the truth of his observations was confirmed, and the doubts of the cautions were gradually dispelled by extensive experience. At the commencement of the practice, almost all that were vaccinated were afterwards submitted to the inoculation of the small-pox; many underwent this operation a second, and even a third time, and the uniform suc304

cess of these trials quickly bred confidence in the new discovery. But the evidence of the security derived from vaccination against the sall-pox does not rest alone upon those who afterwards underwent various inoculation, although amounting to many thousands; for it appears, from numerous observations communicated to the college, that those who have been vaccinated are equally secure againt the contagion of epidemic small-pox. Towns indeed, and districts of the country, in which vaccination had been general, have afterwards had the smallpox prevaleut on all sides of them without suffering from the coutagiou. There are also in the evidence a few examples of epidemic small-pox having been subdued by a general vaccination. I will not, therefore, appear extraordinary that nauy who have communicated their observations should state, that, though at first they thought unfavourably of the practice, experience had now removed all their doubts.

It has been already mentioned, that the evidence is not universally favourable, although it is in truth nearly so, for there are a few who entertain sentiments differing widely from those of the great majority of their brethren. The college, therefore, deemed it their duty, in a particular manner, to enquire upon what grounds and evidence the op, posers of vaccination rested their opinions. From personal examination, as well as from their writings, they endeavoured to learn the full extent and weight of their objections. They found them without experience in vaccination, supporting their opinions by hearsay information, and hypothetical reasoning;

and, upon investigating the facts which they advanced, they found them to be either misapprehended or misrepresented; or that they fell under the description of cases of imperfect small-pox, before noticed, and which the college have endea voured fairly to appreciate.

The practice of vaccination is but of eight years standing, and its promoters, as well as opponents, must keep in mind that a period so short is too limited to ascertain every point, or to bring the art to that perfection of which it may be capa ble. The truth o: this will readily be admitted by those acquainted with the history of inoculation for the small-pox. Vaccination is now, however, well understood, and its character accurately described. Some deviations from the usual course have occasionally occurred, which the author of the practice has called spurious cow-pox; by which the public have been misleit, as if there were a true and a false cowpox; but it appears, that nothing more was meant, than to express irregularity or difference from that common form and progress of the vaccine pustule from which its efficacy is inferred. Those who perform vaccination ought therefore to be well instructed, and should have watched with the greatest care the regular progress of the pustule, and learnt the most proper time for taking the matter. There is little doubt that some of the failures are to be imputed to the inexperience of the early vaccinators, and it is not unreasonable to expect that farther observation will yet suggest many improvements that will reduce the number of anomalous cases, and furnish the means of determining, with greater precision, when the

vaccine