or twelfth day after vaccination,
if the lymph used has been genuine.

5th. Does small-pox prevail there?

6th. Does small-pox prevail there after vaccination?

Small-pox prevails occasionally, and there are instances of its
having occurred even in a confluent form after vaccination: one
genuine instance of this kind came under my notice in the year 1824,
in the person of a liberated African girl, of about sixteen years of
age; vaccination had been performed in this case, by the late Dr.
Nicol, Deputy Inspector of Hospitals, and was considered
satisfactory; the case proved confluent; the secondary fever was
accompanied by a severe diarrhoea, which carried off the patient
about the thirteenth day. Another well authenticated instance of the
same fact, occurred in the early part of the present year, in the
family of a respectable Nova Scotian settler; other cases of a
similar nature have been reported by the inhabitants; but I do not
consider that, in these cases, the proofs of a pure previous vaccine
disease have been satisfactorily established; when vaccination has
been carried on for some time, from the same stock of lymph, the
disease is apt to degenerate and become spurious, from which cause
we require a frequent renewal of lymph from England, in order to
keep it in continuous and successful operation; the spurious
disease, on the fifth day, generally shews itself in the form of a
small globated papula; on the eighth day, it presents sometimes an
ash-coloured pustule, containing purulent matter; at other times,
and less frequently, a brown-coloured scale, having a small quantity
of purulent matter under it, capable of producing, by innoculation,
a disease similar to itself; the great prevalence of a disease among
the negro population, called "craw craw," is considered as
materially influencing that change in the properties of the pure
vaccine lymph, which has been just noticed: that apathy and
indolence of which I have already accused the negro population,
leads them to consider the appearance of disease in the arm, after
vaccination, as the test of safety from small-pox, great as the
difficulty sometimes is, in getting them to bring forward their
children for vaccination, it is still greater to procure the
examinations in its progress and maturation; the mere appearance of
disease in the arm, is supposed to carry along with it immunity from