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as certain facts submitted to us in evidence have shown, there are
cases, though these are rare, where a general eruption may follow
vaccination.
In order to determine how far the risk of Erysipelas is a
necessary incident of vaccination, what is the extent of that risk,
and how it may best be avoided, it is necessary to consider the
various circumstances which may occasion Erysipelas and allied
diseases in the case of vaccinated children. It is established that
lymph contains organisms, and may contain those which, under
certain circumstances, would be productive of Erysipelas. It is,
therefore, possible that some contagious material (the specific
virus of erysipelas, for instance) may be conveyed at the time of
vaccination, owing either to its presence in the lymph employed,
or to its being conveyed by the vaccinator himself, or by those
with whom the child comes in contact at the time of vaccination.
We believe that the cases in which the virus is conveyed at the
time of vaccination are rare. It has, however, in some instances,
been clearly established, the immediate occurrence of Erysipelas
in several co-vaccinees making it practically certain that some
virus was conveyed at the time of the operation. In some
instances, where this has been the case, and there is every reason
for believing that the contagion was conveyed through the medium
of the lymph; it is, nevertheless, in evidence that the vaccinifer
did not display anything more than a slightly inflamed arm. The
scrupulous avoidance of inflamed arms in vaccinifers will do much
to reduce the risk of conveying erysipelas, in the act of vaccination
(a risk which, as we have seen, has been proved to be a very
slight one), but it is possible it would not wholly remove it.
Where the contagious matter which produces Erysipelas, or
blood poisoning, has not been conveyed at the time of
vaccination, the disease must have resulted, when it afterwards
displays itself, from a subsequent introduction or development of
the poison. It is not always easy to determine whether vaccination
has been the cause of, or has contributed to, subsequent