726 



Y.UYLNATIOX. 



The procuring of pure racctnc is the most important 

 practical point eOBMOted with vaccination, and upon 

 tli is too inurli stress cannot In; laid ; tin- difficult; of 

 obtuitiing it is in fact at the Uiltom of all promt op- 

 iHiMiioti tn humanized virus (rxtvpt, of coir 

 lew non-believers ill the win ill- subject (if vaccination). 

 and in this country bovine virus has nearly mpenedea 

 the use of the old-time "scab" or "i-m-t " and "vac- 

 cine tubes." Quite recently (l.sST) .John H. Buist, 

 M l> , F. U. S. E., in his book. Vaccinia mid ]'ariuln. 

 a Stinly a/ Their Life llistan/, says : "Tlie difficulty 

 which is encountered in determining tlu> cause of many 



infective diseases lies in the circumstance that leli- 



niu- bacteric lurm peculiar to them can lie isolated ; 

 and this is occasioned by the minute forms in which 

 Mich contagia generally exists. Improved methods of 

 histologies! investigation, by BMM of different st:>i-i- 

 jng materials and improved magnifying and illuminat- 

 ing apparatus, have now made it possible to define 

 forms which were formerly beyond the range of hu- 

 man vi.-i<in .... Experimental vaccination tppeare to 

 prove that the potency of vaccine materials varies in a 

 remarkable decree, in proportion to the quantity and 

 quality of their active principle .... The form 

 of bacterium present in clear vaccine lymph is a 

 very minute spore, .!5//in diameter, and if the lymph 

 be dried immediately the further development of the 

 spore is prevented. Its activity can be revived by 

 moistening the dried film of lymph with water, and 

 this mati-rial. when properly employed, produces per- 

 fect vaccination. Between this minute body and the 

 large torula (2 n to :> u) cell in opaque lymph, there is 

 apparently no more connection than there is bciwccn 

 an acorn and an owk, but there are certain close analo- 

 gies between vaccine lymph and yeast. In (In at 

 Britain, "clear vaccine lymph, carefully taken from 

 typical vesicles in healthy subjects (arm-to-arui vaccina- 

 tions), is regarded by the authorities of the National 

 Vaccine Establishment as the most perfect material for 

 vaccination that can be obtained. Opaque or opales- 

 cent lymph is regarded as an inferior or imperfect ma- 

 terial for vaccination, on the ground that complaints 

 used to be frequent, on account of its too energetic 

 qualities. Vaccine lymph is .said to be clear when it 

 shows no opalcscciice by reflected or obliquely trans- 

 mitted light, and when it is free from blood or other 

 impurities. It is said to be opaque when it appears 

 slightly milky, or opalescent when tested in the same 

 way. One of the great difficulties of vaccination is the 

 propagation of a material which remains perfectly 

 for a time after being stored .... It is 

 found that vaccine lymph is most certain in its action 

 when transferred directly from the aim of one child to 

 that of another, good vesicles being easily produced by 

 a single or a double scratch thus : If this same ma- 

 terial be stored in a tube for even half an hour, it is 

 found that the same result cannot be produced unless 

 the operation is dune thus : , and the lymjih well 

 rubbed in it. This explains why many vaccinations 

 fail with clear lymph, especially if they are in the 

 habit of vaccinating from arm to arm. The material 

 has changed in potency, and a more severe operation 

 is required for its successful insertion. AVhcn a cover- 

 glass preparation of clear lymnh is examined micro- 

 scopically, it show.- minute isolated spherical organisms, 

 about. 15 p in diameter. This is the true bacieiic form 

 of the perfect vaccine material, which docs not eon- 

 tain any larger organisms. When the lymph is dried. 

 these organisms are preserved from developmental 

 changes, and the material undergoes no other change 

 in quality than is common to stored lymph generally. 

 . . . Opaque vaccine lymph, unless originally clear 

 and carefully stored in well-filled sterilized tube's, from 

 which the air has been expelled during the sealing pro 

 cess, must be warded as an imperfect material for 

 vaccination. .. . Experience teaches that opaque lymph 

 w an imperfect vaccine material. It is more i i 

 locally than clear lymph, and in former times eruptions 



' were frequently produced by its use, especially when 



the lymph was taken too I 



ttm/ to the supposed deterioration of humanized 

 lymph (/'. c.. Vaccine obtained Jrum previous vac - 

 lions) and the opposition to il.- u-c by manv who fc :ir 

 the introduction of other diseases, bovine lymph has 

 almost entirely superseded its employment in this 

 country. The " Bcaugency stock," impoitcd to the 

 United States in l>7o. by Dr. Henry A. .Martin, of 

 Boston, is perpetuated through - inoculations 



of heifers, being lir.-t obtained from a cow at , 

 gcncy. I 1 ' ranee, in ISM, in which a "spontaneous" 

 appearanecof cow-pox was observed. The inoculation 

 of heifers is performed by securing the animal upon 

 its back, in a frame made for that purpose, shaving 

 the parts adjacent to the udder, and introducing the 

 vims at many points over the denuded surface, which 

 is first thoroughly cleansed. The scarifications ;oe 

 :<-d by fastening a cloth over the parts, and ill 

 due time the vesicles appear. When filled with lymph, 

 on the seventh or eighth day, the calf is again seemed 

 as In-fore, and ivory points or quills are "charged" 

 with tin; virus as rapidly as possible, dried, and her- 

 metically sealed, or othenvi.se protected from the air. 

 It is a remarkable fact that bovine virus docs not 

 retain its potency as long as the humanized, and for 

 llii. rt ason the ivory points or quills are not guaranteed 

 by those furnishing them beyond two or three wciks. 

 iSo lancet is required in the operation, as each point 

 or quill n sharpened at the end sufficiently to scaiily 

 the place of inoculation, care being taken to first dip it 

 in water to liquefy the virus. Simply removing tin- 

 outer or scarf-skin with the ivory point, or making 

 uts thus , with a lancet, without drawing 

 hi ..... 1. is deemed the best practice. It is claimed that 

 better protection results if more than one, Ray four or 

 five vaccinations, are made (see table below), 'and that 

 the inconvenience or discomfort from inflammatory 

 action, etc., is not thereby increased ; this applies 

 more particularly to humanized vaccine. 



The follow ing classification of f>(KM> patients extend- 

 ing over twenty years afflicted with small-pox. shows 

 the percentage of deaths in each class represented 

 (..Maison) : 



Percent, ofdratha. 

 I. I'nviirriiintml ................................... 3o.OO 



II. StMtefl to have been vaccinated, but 



showing no cicatrix ....................... 23./17 



III. Vaccinated n, one riratrix ............... 7.73 



i, two cicatrices ............. 4.70 



r, llirco " ............ 1.95 



" d, fnurormorccicatriceg.. 0.65 



n, w.-ll-marked " .. 2.52 



ily " " K82 



IV. Having previously Imil small-pox ....... 19.00 



The history of the introduction of vaccination into 

 this country shows the same bitter opposition by loth 

 the medical profession and the people as marked its 

 early introduction in other countries. I>r. Benjamin 

 WtterhoOM. of ( 'amhrid!:e (formerly of Newport ), and 

 l>r. .lames Smith, of Baltimore, are each given the 

 credit of the first vaccinations in the 1'nited Slates. 

 In June, IsOII, \Vatci house, who was then professor 

 of theory and practice of medicine in Harvard, and 

 who had obtained all the information pnssi|,]e regarding 

 .Jcliner's great discovery, succeeded alter several fruit- 

 less efforts in obtaining upon a cotton thread a small 

 quantity of pure vaccine from Kngland, and on July 8 

 inoculated one of his sons, then five years of are. 

 This he followed in a few days by vaccinating others 

 in his family, six in all. among them an infant of one 

 year. He then applied the crucial test by sending the 

 children to the small-pox hospital at Brookline. within 

 two months after tl-ir vaccination, where they were 

 not only freely exposed to the contagion of small-pox 

 but also inoculated with variolons matter, the only 

 result observed being a very slight irritation at the 



