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twice." At the present time cases of second attacks of the
disease are usually met with in every outbreak of any extent, and
it would seem reasonable to conclude that the protection afforded
by a previous attack, though considerable, is by no means
absolute. Moreover, experience, though of limited amount,
appears to show that no mitigating influence is exerted by the
first upon a second attack, should it occur.
Notwithstanding the extensive practice of inoculation, or, as
has been alleged, in consequence of it, Small-Pox continued
throughout the eighteenth century to be endemic in London, and
severely epidemic, often at frequent interval in many towns and
villages in this country and abroad. During the latter half of the
century attention was called by many writers to the serious evil
to society of partial and indiscriminate inoculation. It was shown
that, whatever advantages might result to the inoculated by way
of protection from attack, the practice had frequently been the
means of introducing the disease into towns and villages that were
previously free from it, and that it could only be worked at an
intolerable cost of life.
Attention was also, about this time, called to the restrictive
influence which might be exerted upon outbreaks of SmallPox
by separating the sick from the healthy. The part played
by contagion in the propagation of epidemics had, since the
adoption of inoculation, come to be clearly recognised, and
measures were suggested for stamping out Small-Pox on the lines
of methods employed against the plague.
Some, like Haygarth, suggested the combination of general
and systematic inoculation at stated intervals with measures of
isolation. Others, like Rast, Faust, and Cappel, advocated
hospital isolation of the infected, and regarded inoculation as not
only superfluous, but dangerous, and opposed in principle to the
proper method of exterminating the infectious poison.
It was at this juncture that the value of the Cow-Pox as a