REPORT OF THE ROYAL VACCINATION COMMISSION. 673 



Of the cases recorded by Woodville in his Reports, the larger 

 number (about three-fifths)ipresented an important, and, as compared with 

 Jenner's cases, a new feature, in that, in addition to the changes taking 

 place at the seat of inoculation and constituting what Woodville called 

 the "cow-pox tumour," which may here be spoken of as the "vaccine 

 vesicle," an eruption over the body of a greater or less number of 

 pustules was observed. These eruptive pustules occurred in the very 

 first cases : of the seven cases inoculated from the cow, four, and of 

 the five inoculated from the dairymaid, four, had such pustules ; and 

 their appearance is recorded again and again in the series, down to the 

 case which appears last but one in the tabular statement forming part 

 of the Reports. 



Moreover, an eruption of pustules is described in certain of the cases 

 of which accounts were published at about the same time by Pearson 

 and many others. In some of these cases the lymph used was supplied 

 from the Small-pox Hospital by Woodville or Pearson. 



It must be admitted that these pustules were pustules of small-pox,, 

 and that, therefore, Woodville's cases, which did so much to establish 

 the practice of vaccination, were not cases simply of cow-pox but of 

 cow-pox mixed, so to speak, with small- pox. It has indeed been 

 maintained that Woodville's cases were not cases of cow-pox at all 

 that small-pox was inadvertently introduced into the very first cases ; 

 that the history of the whole series is the history of a series of small-pox 

 cases putting on special characters, and that therefore the lymph used 

 and distributed by Woodville and Pearson was in reality not cow-pox 

 lymph but small-pox lymph. A review of all the evidence available 

 leads to no other conclusion than that, however much in Woodville's, 

 Pearson's and other cases cow-pox was mixed up with small-pox, the 

 lymph used and distributed by Woodville and Pearson and called by 

 them cow-pox lymph (excluding of course all the cases, of which there 

 were not a few, in which matter was taken not from the local ;; cow-pox 

 tumour" at the seat of inoculation, but from one of the eruptive 

 pustules) was veritable cow-pox lymph having the true characters of 

 cow-pox lymph only. 



It of course follows that the cases, both in Woodville's practice and 

 in that of others, in which the inoculation of cow-pox matter wa& 

 accompanied by an eruption of pustules, due to small-pox being present 

 as well as cow-pox, when appealed to as showing immunity against 

 small-pox (by the test either of exposure to contagion or of inoculation), 

 furnished false evidence as to that immunity being due to cow-pox ;. 

 it might have been due to the accompanying small-pox. So far then as 

 the adoption of vaccination was assisted by cases of this description, it 

 may be held to have rested' on erroneous data. 



The Decline of Small-pox. 



One effect of the introduction of vaccination was a very great decrease 

 in the practice of inoculation, which had become very prevalent during the 

 later part of the previous century. And the view has been put forward. 



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