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 oases, 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 m Woodville s practice and 

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

 accompanied by an eruption of pustules, due to small-pox bemg 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 smaU-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 

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

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



