Protective vaccinations 457 



diluted and then allowed to sediment or it may be subjected to 

 centrifugalisation. The object of these measures is to rid the 

 "lymph" of the micro-organisms which accompany it. This object 

 is, however, only imperfectly attained and is moreover accompanied 

 by an attenuation of the vaccinal action. On the other hand, pre- 

 cautions are taken to ensure all possible cleanliness during the 

 operation of inoculation and whilst the calves are under treatment. 

 Thus, great care is taken to disinfect the area of inoculation with 

 alcohol or some other antiseptic and to dress the pustules during the 

 course of their development. Similarly the arms of the patient to 

 be vaccinated are well washed ; following in this the rules of asepsis 

 rather than of antisepsis for fear that the vaccinal virus might be 

 destroyed by antiseptic substances. Various instruments are made use 

 of for vaccination and care is taken to sterilise these before they are 

 used. Sometimes the lancet is used, sometimes " plumes k vaccin " 

 or vaccinostyles, or a bistoury of iridio-platinum (Lindenborn) etc. 



When the vaccine is of good quality and the operation of 

 vaccination is well done, there is no doubt as to the protective 

 result obtained against small-pox. The observations that have 

 been collected for a great number of years past, in many countries, 

 place this beyond doubt. There are, indeed, statistics from which 

 it is impossible to draw any precise conclusions because they are 

 founded upon too scanty figures or deal with conditions that are 

 too complex. This is the case with the Swiss vaccinations. Certain 

 cantons (such as Zug and Uri) have made vaccination obligatory, 

 whilst others (Bern, Zurich, Lucerne, etc.) some years ago abolished 

 the law which compels the vaccination of all children in infancy. 

 It happened that for some years small-pox had more victims in the 

 cantons of the first group than in those of the second. The opponents 

 of antivariolic vaccination attempted to use this as an argument 

 against the utility of this method. But a more detailed study of 

 the facts clearly shows that it is impossible to draw from it any 

 conclusion whatever. Even in those cantons where vaccination is 

 supposed to be compulsory this law is not carried out rigorously, 

 and the number of persons vaccinated often does not exceed that in 

 the cantons where it is not obligatory. 



In order to gain some idea of the utility of vaccinations we 

 must collect statistics on a much larger scale than are those obtain- 

 able from the Swiss cantons. Germany furnishes such statistics. 

 Compulsory vaccination was introduced there more than a quarter 



