VACCINATION. 67 



and he wishes lu- n>uld persuade- his readers to adopt the same custom, which is a 

 common one among members of the medical profession. 



Vaccination, is a very simple operation, and is j)erformed upon healthy children 

 at the age of three months. The left arm is selected, and the surface should be 

 lightly scratched in four or five places with the jxnnt of a lancet or even an ordinary 

 dan ling-needle. The scratching should be done very lightly (across and across like 

 the " cross-hatching " of an artist), so as to cause a very very slight oozing of blood. 

 To these patches the vaccine matter is applied. It is applied either from little ivory 

 points (which have been previously dipped in the ripe vaccine vesicle of a healthy 

 child), which may be wiped on the oozing surface, or from fine glass tubes filled with 

 vaccine lymph, from which the lymph readily flows when the ends are broken off. 

 .\o jHj'tut or tn.be which /MS any blood upon, it, or which is yellow and mattery, should 

 on any account be used. It is from using such points that the danger of inoculating 

 the child with some disease other than vaccinia is incurred. After the lymph has 

 been applied to the arm, care must be taken that it is not removed again by rubbing 

 or washing. If too much blood be drawn, the lymph is apt to be washed away in 

 the stream. 



For two days after the performance of vaccination the parts remain quiet. At 

 the end of the second or on the third day a little raised pimple, or papule, appears 

 at each of the spots which have been inoculated. 



On the fifth or sixth day the vesicle makes its appearance, and it is perfect by 

 the eighth day that is, the day week on which the vaccination was performed. 

 The perfect vesicle is a little bluish-white pearl-coloured bladder, which has a 

 cup-like depression usually in the centre. The eighth day is the time, before the 

 contents of the vesicle become yellow and mattery, at which points or tubes may be 

 charged for the vaccination of others. After the eighth day, the areola begins to 

 form round the vesicle. The areola is a red circle of inflammation, and its formation 

 is usually accompanied by swelling of the arm, enlargement and tenderness of the 

 glands in the armpit, and occasionally considerable constitutional disturbance. At 

 this time the contents of the vesicle may become mattery. On the tenth day the 

 areola begins to fade and the vesicle to diy. At the end of a fortnight a scab forms, 

 which falls off in about another week. The scar left by vaccination endures for 

 ever, and is highly characteristic and unmistakable, and resembles a depression 

 made with the top of a thimble more than anything else. 



Vaccination, if properly performed, is a protection against small pox for the 

 whole of life, probably, but its protective power seems to weaken with the lapse of 

 time, so that it is advisable to repeat the operation at intervals. Every seven yeans 

 has been mentioned as the period after which it is advisable to repeat the operation, 

 but the number seven has more association with superstition than with science, 

 probably. We think, however, and should strongly advise that re-vaccination should be 

 performed whenever small pox becomes epidemic. The agitation against vaccination 

 has been partly based also on the fear which many people entertain of inoculating 

 other diseases (and notably syphilis) with the vaccine matter. That such cases have 

 occurred there can be no doubt, but their number is infinitely small when compared 

 with the millions of cases of vaccination which occur throughout Europe in the 



