Page:Transactions of the Provincial Medical and Surgical Association, volume 4.djvu/268

 166 part of this paper. In the close, ill-ventilated, and dirty tenements, in the poverty and deficiency of food and clothing, and in the mental depression consequent thereon, we may find ample causes of fever, although scarcely any of the usual sources of malarious influence are to be traced in the district,—a fact still more strikingly demonstrated by the almost total absence of intermitting and remitting fevers. This is a circumstance deserving the attention of those who are disposed, with the late Dr. Armstrong, to look to terrestrial miasmata for the cause of all our fevers.

Small-pox.—The tables in the preceding section, my own observation, and the concurrent testimony of the medical practitioners and old inhabitants of the district generally, demonstrate the gratifying fact, that in spite of the still existing prejudices against vaccination, and the numerous failures of its protecting influence, the immortal discovery of Jenner has been productive here, as elsewhere, of a great diminution of the prevalence, and consequent mortality, of small-pox. During the period of my residence in Cornwall, the disease was several times epidemic. It was propagated partly by casual infection, partly by the evil activity of some rustic inoculators; but the sphere of its influence and fatality was greatly contracted by vaccination, which had been generally practised by the surgeons for many years previously. The prejudice against vaccination is still strong among the common people here as elsewhere, and continues to be strengthened by the occasional occurrence of cases of secondary small-pox. In weak compliance with this prejudice,