Protective vaccinations 501 



treatment. Future researches undertaken in this direction alone can 

 give us information on this subject. 



In 1896 the vaccinations in Heubner's wards were discontinued, 

 but the reappearance of diphtheria in 1897 1 rendered their recom- 

 mencement necessary. 500 children were vaccinated each with 200 

 immunising units. Following this no case of diphtheria broke out. 

 The eruptions were rare and slight. 



The increasing extension of the use of antidiphtheria serum for the 

 cure of the disease after it has broken out has led to a greater de- 

 velopment in its use as a preventive measure. Thus, in the countries 

 where diphtheria is endemic, vaccinations by serum are now practised 

 very extensively. In Russia, which is one of the great hotbeds of this 

 disease, vaccinations by antidiphtheria serum are frequently practised. 



At the Congress of Russian doctors at Kasan in 1896, Vissotsky 

 communicated the result of 2,185 vaccinations which gave a morbidity 

 of 1*3%, a morbidity that must be regarded as very low indeed. 

 A well-known Russian physician for children's diseases, Rauchfuss 2 , 

 who cites these figures, has collected several other facts concerning 

 the prophylactic injections of antidiphtheria serum followed by good 

 results. In the government of Woronetz, according to the state- 

 ments of Ouspensky 3 , out of 738 vaccinated persons diphtheria 

 occurred in 2'2 per cent., which again may be considered a favourable 

 result, especially if we take into account the great extension of 

 diphtheria in this country. In Podolia, out of 537 children vacci- 

 nated in 1895, only four cases of diphtheria occurred, a morbidity 

 of 0*74 %. In the government of Kherson, one of the great centres 

 of diphtheria in southern Russia, the results appear to be less 

 favourable : out of 543 children which received a protective inocu- 

 lation, 21 contracted the disease (or 4*6 per cent.), of which five died. 

 If we study these statistics more closely 4 it will be seen that these 

 results are far from being unfavourable. The protective inoculations [525] 

 were made only once and with somewhat small doses, nevertheless 

 many of the cases of diphtheria broke out only at a late period, some- 

 times more than nine months after the injections had been made. 

 Now, it is proved that these injections, although very efficacious, 



1 See Slawyk., Deutsche med. Wchnschr., Leipzig, 1898, S. 35. 



2 "Les progres dans Tapplication du serum antidiphtherique," St Petersbourg, 

 1898, p. 105 in Russian). 



3 Vrach, St Petersbourg, 1900, p. 1178 (in Russian). 



4 Chron. med. d. gouvern. de Kherson, 1896, No. 5, p. 160 (in Russian). 



