“I inoculated with the cow-pox matter from the eleventh to the latter part of April, twenty-five persons, including women and children.  Some on the eleventh were inoculated with the matter Mr. Shrapnell (surgeon to the regiment) had from you, the others with matter taken from these.  The progress of the puncture was accurately observed, and its appearance seemed to differ from the smallpox in having less inflammation around its basis on the first days—­that is, from the third to the seventh; but after this the inflammation increased, extending on the tenth or eleventh day to a circle of an inch and a half from its centre, and threatening very sore arms; but this I am happy to say was not the case; for, by applying mercurial ointment to the inflamed part, which was repeated daily until the inflammation went off, the arm got well without any further application or trouble.  The constitutional symptoms which appeared on the eighth or ninth day after inoculation scarcely deserved the name of disease, as they were so slight as to be scarcely perceptible, except that I could connect a slight headache and languor, with a stiffness and rather painful sensation in the axilla.  This latter symptom was the most striking—­it remained from twelve to forty-eight hours.  In no case did I observe the smallest pustule, or even discolouration of the skin, like an incipient pustule, except about the part where the virus has been applied.

“After all these symptoms had subsided and the arms were well, I inoculated four of this number with variolous matter, taken from a patient in another regiment.  In each of these it was inserted several times under the cuticle, producing slight inflammation on the second or third day, and always disappearing before the fifth or sixth, except in one who had the cow-pox in Gloucestershire before he joined us, and who also received it at this time by inoculation.  In this man the puncture inflamed and his arm was much sorer than from the insertion of the cow-pox virus; but there was no pain in the axilla, nor could any constitutional affection be observed.

“I have only to add that I am now fully satisfied of the efficacy of the cow-pox in preventing the appearance of the smallpox, and that it is a most happy and salutary substitute for it.  I remain, etc.,

“M.  J. Tierny.”

Although the susceptibility of the virus of the cow-pox is, for the most part, lost in those who have had the smallpox, yet in some constitutions it is only partially destroyed, and in others it does not appear to be in the least diminished.

By far the greater number on whom trials were made resisted it entirely; yet I found some on whose arm the pustule from inoculation was formed completely, but without producing the common efflorescent blush around it, or any constitutional illness, while others have had the disease in the most perfect manner.  A case of the latter kind having been presented to me by Mr. Fewster, Surgeon, of Thornbury, I shall insert it: