An incision was made in that part of the arm where issues are usually placed, deep enough to pass through the scarf skin, and just to touch the skin itself,and in length as short as possible, not more than one eighth of an inch. “These methods seem to have been attended with a good measure of success, and in spite of the risk of infecting the patient with virulent smallpox, there was a comparatively small proportion of deaths.

Hero Dust. By James Kemble, Ch. M., F.R.C.S. Methuen & Co., Ltd. 6s. net.


MR. KEMBLE, the eminent surgeon, takes a great interest in the diseases and disorders of historical personages. He wrote a valuable book Idols and Invalids, in which he described the medical history of Henry VIII, Columbus, Judge Jeffreys, Madame de Pompadour, Lord Nelson and others. That book was reviewed in this magazine in July, 1933.

He had followed this book by another volume of medical-historical studies in which he described from the doctors point of view the lives of Mary, Queen of Scots, Epicurus, John Milton, Catherine the Great of Russia, Beau Brummell and Omar Khayyam. This is an exceedingly readable and delightful book. The following pages from the life of Catherine, the Great will undoubtedly interest many readers and will give a general idea of the character of Mr. Kembles writings:.

“Catherine throughout her life enjoyed comparatively good health. She never drank, she had no interest in food, her table was usually a most frugal and unimaginative display. Her major vice was men; her minor vice was snuff.

Following that illness with pneumonia just after her arrival in Russia, she suffered at times from various lesser complaints; she had measles, occasional attacks of headaches, and once had been obliged to leave church in the middle of matins because of violent colic, the inconvenient and embarrassing consequences of a supper of oysters. There were also two other valetudinary occasions which left vivid impressions on Catherines mind, one was a tooth extraction when she was a girl of twenty, and the other was her inoculation against smallpox.

“In her diary, written years afterwards, Catherine says of her tooth:.

I sent for her Majestys physician Boerhaave requesting him to have the tooth which had tormented me so much for the last four or five months extracted. At last he sent for Gyon, my surgeon: I sat on the ground, Boerhave on one side, Tchoglokoff on the other, and Gyon drew the tooth; but the moment he did so, my eyes, nose, and mouth became fountains, whence poured out from my mouth blood, from my eyes and nose water.

Gyon in extracting the tooth, had carried away with it a portion of the lower jaw, to which it was attached. I was put to bed and suffered a great deal during four weeks. I did not leave my room till the middle of January 1750, for the lower part of my cheek still bore, in blue and yellow stains, the impression of the five fingers of Monsieur Gyon..

“If in these her tender years she had been so upset and truly terrified at this minor operation, later in life at the age of thirty-nine when she resolved to be inoculated against smallpox, she showed a very different spirit. Smallpox in Europe, and especially in Russia, was at that time raging in a series of epidemics which caused a most terrible toll of death. In Russia alone some two million people died in a year. Inoculation as a preventive, while it was becoming more and more widely practised in England. had not yet been introduced into Russia.

And therein lay Catherines courage; she was prepared to submit herself for inoculation as the first test case in order to be an example to her subjects. In England the method then in use was the inoculation, just under the cuticle of the skin, of matter from a pustule either taken from a patient actually suffering from smallpox in the natural way, or from one who had been recently inoculated.

The most accomplished performers of the operation were the members of the Sutton family, all of them unqualified practitioners, who had set up an Inoculation House near Ingatestone in Essex. Thomas Dimsdale, M.D., copied and elaborated their method, and soon had both a high reputation and a growing practice. In 1767 he published his book called The Present Method of Inoculation for the Smallpox. In this he sets out his preparatory treatment consisting of abstinence from all animal food and fermented liquors, the administration of a powder composed of calomel, compound powder of crabs claws and tartar emetic, followed by Glaubers salts the next morning. As for the actual operation:.

An incision was made in that part of the arm where issues are usually placed, deep enough to pass through the scarf skin, and just to touch the skin itself,and in length as short as possible, not more than one eighth of an inch. The little wound being then stretched open between the finger and thumb of the operator, the incision is moistened with the matter, by gently touching it with the flat side of the infected lancet. This operation is generally performed in both arms, and sometimes in two places in one arm, a little distant from each other. Neither plaster, bandage, or covering is applied, or in any respect necessary..

James Kemble