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New Observations on Inoculation/An Account of a Series of Experiments/Appendix

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APPENDIX.

THE following event being in my opinion very extraordinary, and having a relation to the subject-matter of these papers, I think it highly deserving to be communicated to the public. In order to this I have prevailed upon Mr. Oborne, a worthy friend of mine, who for many years was a very reputable surgeon and apothecary at Clerkenwell, and who attended the person, the subject of this account, to recollect every particular worthy notice relating to it, which he has been so obliging as to do, and of which the following is the history.

Jane Brown, aged twenty-three, a poor young woman, was seized with the small-pox and committed to the care of a nurse who used to take in indigent persons under that disease, and lived not far from the New River at Islington. Though the small-pox were come out, she was still delirious, and the nurse being gone out upon some little affairs of her own, the patient, during this absence, got out of bed, ran through the garden, and threw herself into the New River. This was between twelve and one at noon, November 21, 1741.

She was first discovered floating on her face by an old man, who was accidentally passing by on the opposite side of the river. He went round as fast as he could to alarm the people at the nearest house, which was the Crown Ale-house, and which was at some distance from the river. How long she had been in this position is uncertain; but when she was taken out, and laid on the grass, there was not the least appearance of life.

This part of the New-River, though at Islington, being in the parish of Clerkenwell, notice was sent of this event from Islington, after much altercation which of the two parishes ought to be at the expence of burying her, to one of the overseers of the poor, who gave an order for the parish-bearers to bring her to the workhouse at St. James's Clerkenwell. Accordingly one William Stevens, the parish gravedigger, who is now alive and near eighty years old, and Thomas Bull, a parish-bearer, since dead, were sent for this purpose.

As they were bringing her in a coffin across the fields to Clerkenwell, Bull's foot, it being frosty weather, slipped from under him; and he not being able to recover himself, let her fall on the ground.

While they were lifting her up again on their shoulders, they fancied they heard a faint sort of groan, which was related to the people, when they brought her to the work-house. Here she was laid upon the lid of the parish coffin, under an open arch going into the infirmary, the usual repository for the dead before interment. But while some people were looking on her with much attention, they discovered some little motion in her upper lip; and as this seemed to corroborate the former circumstance of her supposed groaning, the master of the work-house ordered her to be removed into one of the wards, and put to bed; and, besides, directed Mr. Oborne to be sent for. He went immediately, and found this poor creature extremely cold, and to all appearance dead. Her pulse was imperceptible, and her stomach much swelled. He saw some spots upon her face and breast of a livid colour; but these were then disregarded. This was between three and four o'clock; about three hours after she had thrown herself into the water.

Mr. Oborne first attempted her relief by pouring down her throat, at different times, a spoon-full of warm water well impregnated with spirit of hartshorn. She was smartly rubbed with coarse cloths, and rolled backwards and forwards upon her stomach and sides. While this was doing, an odd croaking noise was heard, and immediately followed by a sudden gust of wind and water. She was then instantly turned on her stomach with her head reclining over the side of the bed, in order to facilitate the discharge of water, which in this situation ran freely from her mouth on the floor.

When this was over, she was turned on her back, with her head raised a little. The distention of her stomach was quite abated. As Mr. Oborne had no other medicine with him than spirit of hartshorne, he boiled a little ginger sliced in some water, and after straining it, added thereto about an equal part of mountain wine. This whole time she was to all appearance dead.

Just as the ginger and wine, as just now mentioned, were got ready, Mr. Oborne and the people about her perceived a trembling motion in the under jaw. He then got down three or four spoonfulls of this warm mixture, and directed a flannel petticoat to be made hot, and laid over her stomach and bowels; not doubting but there were now some hopes. This had, in a short time, a particular effect, by creating a surprizing kind of rumbling in the stomach and bowels, which was succeeded by a powerful discharge of wind from her stomach. After this, she had a little motion in one arm. He got down more of the ginger and wine, and sent home for a mixture with Raleigh's confection, salt of hartshorn, and tincture of cardamoms.

It was now for the first time he began to discover a low creeping pulse; her stomach was a little warm, but her extremities were still cold. He ordered her limbs to be wrapped in warm flannel, and gave her three spoonfulls of the mixture with Raleigh's confection, and left her.

About eight in the evening, Mr. Oborne sent his servant to see her; she could then turn herself in the bed, was grown much warmer, and had taken a little broth and some bread.

Early in the morning Mr. Oborne visited her, after having been informed by one of the nurses of the workhouse that she was alive, but was broke out all over; and that she was sure it was the small-pox. This indeed heightened his curiosity, as he was hitherto unapprized of her having that disease; and upon examination found the nurse's suggestions strictly true. She had a considerable number of small-pox all over her, but mostly in her face. They were of a small sort but perfectly distinct.

Her pulse was now finely raised; she had made a large quantity of limpid urine in the night, complained of being sore all over, and was so very hoarse, she could scarce be understood. He directed some pectoral drink, and continued the mixture with Raleigh's confection, omitting the salt of hartshorn.

The next day the pustules looked well: she had had some sleep in the night, and had drank plentifully of pectoral drink, panada, and such like. The hoarseness was better, and he found her sitting up in bed. He visited her every day, and on the fourth the pustules began to suppurate kindly. The interstices were of a good colour. Her upper eye-lids were swelled from a few pustules on each. The nurse had given her some boiled mutton and turnep, which she had eaten heartily. Every thing went on so well, that he had very little trouble afterwards.

By the seventh day all the pustules were turned; she was surprizingly hearty, and had been for the last four or five days in a temperate degree of heat. The weather was at this time very cold; there were no curtains to her bed and as she had been so much chilled by a long continuance in water, and therefrom the powers of life in a very torpid state, Mr. Oborne was not apprehensive of his being able to raise too much fever; on the contrary, he was rather jealous of her not having heat enough to expel the variolous matter: but he was agreeably mistaken; for within two or three days after, she was walking about the ward, being naturally of a robust constitution, and had no other complaint but that of extreme hunger.

This instance of recovering from drowning is, with several others of the same kind, well authenticated, an argument of the expediency of always attempting to recover persons taken out of the water, however lifeless they may appear, unless their eyes are sunk, or putrefaction actually begun. The method above made use of, proved successful: but that had not been attempted, had it not been for the small degree of motion, observed by persons casually there, in her upper lip. This was no more than what is usually seen in many parts, particularly in the abdominal integuments of slaughtered beasts, even after the head has been severed from the body a considerable time. The sort of groan, which had been heard by the bearers, after she had fallen from their shoulders in bringing her to the work-house, had been paid so little attention to, that the drowned person was in very cold weather, placed upon the lid of a coffin under an open arch, exposed to the air; no very proper place for one in such circumstances, whose recovery was proposed to be attempted.

But that which makes this history uncommonly singular is, that she should throw herself into the water in the febrile delirium attendant upon the eruption the small-pox, and even after several pustules had appeared; as Mr. Oborne, when he first saw her at the work-house, observed livid spots upon the face and breast; thou he then, not at that time thinking them of importance enough to be attended to, disregarded them. The cold regimen during the course of the small-pox, so much recommended Sydenham, especially in the febrile state of this disease; and put in practice by many persons in our time in an extraordinary manner[1], was never, by the boldest of them, carried so far as in this instance: nevertheless, though here, from lying in the water, life for some hours seemed extinguished, the small-pox was only for a time interrupted by it; for upon the powers of life returning, the disease went on and completed its natural course in the most desirable manner, and without any supervening accident. The cold water, though in this instance a most violent remedy, had cured both the fever and its attendant delirium; as neither of them returned upon her coming to herself, nor after: and though the variolous eruption had been checked at the most critical time, and in the most forcible manner, the constitution did not suffer by it, as might have been feared: no spasms, fits, or other nervous symptoms, frequently the consequence of other kinds of eruptions repelled, supervening in this case.

This person was discharged from the work-house perfectly well, and at her own request, on December 12, 1741.

The earl of Breadalbane has done me the honour of informing me, that, in the middle of the severe winter 1739-40, one Thomas Smith, a servant belonging to his lordship, had the natural small-pox in vast numbers during the frosty weather. The delirium continued after the eruption was far advanced. The servant was put to a nurse near Conduit-street in Swallow-street; but his lordship lived then in Henrietta-street near Cavendish-square. During this delirium, and when the pustules were near maturation, while the nurse was asleep, this man, about two o'clock in the morning, got out of bed, went down flairs, and walked naked except his shirt, to his lordship's house in Henrietta-street, whither he was followed by the watchman, who supposed him lunatic, on account of his walking in the condition he saw him, through the frozen streets. He knocked loud at the door and raised the family, who were not a little alarmed at his coming there in so unexpected and unseasoable a manner. In some time after he had been in the house, his delirium abated; and he told the people about him, that he really thought, when at the nurse's, he had heard his lady's bell ring. By his lord's orders Mr. Leyson the apothecary, now living in Marylebone-street, was sent for; and by his direction he was wrapped in a blanket, and conveyed in a chair back into Swallow-street.

Besides walking through the streets, he was a considerable time knocking at lord Breadalbane's door before he was admitted; and when admitted, was obliged to wait in the hall, till his lord was awaked, and his directions received in relation to the disposal of him. He was all this time in his shirt; nevertheless he received no apparent injury from this extraordinary ramble, but, considering the vast number of pustules with which he was loaded, he went through the disease very well, recovered perfectly, and, Mr. Leyson believes, is yet alive.

 

Lincoln's-Inn-Fields
Feb. 11, 1768.

 

FINIS.

  1. I am informed by a lady of distinction, and I give her own words, "that her daughter had used the cold bath ever since she was six months old: that at the age of two years and seven months, she was inoculated; and at the inoculator's request, the use of the cold bath was continued during the whole process of preparation, and even when the eruption appeared; without omitting it, except one day, when she was thought visibly worse for such omission. She was therefore bathed next day by this inoculator's express orders, and was from that time free from all feverish and disagreeable symptoms" Dr. Glass, in his Letter to Dr. Baker, in relation to the small-pox, page 6, mentions, in giving some account of a liquor given to inoculated patients, a lad, who had tumbled into a pond of water a little before the turn of the small-pox, i. e. juft as the pustules became purulent. He received no harm from this accident, which was attributed to the putting him to bed in a flannel shirt, giving him this liquor, and sweating him plentifully for five or fix hours.