London's Pulse: Medical Officer of Health reports 1848-1972

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Battersea 1896

Report upon the public health and sanitary condition of the Parish of St. Mary, Battersea during the year1896

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163
Besides the non-fatal cases to which we have just referred,
there were amongst those investigated by medical men on our
behalf, in which non-fatal injury had been alleged or suggested to
have been caused by vaccination, 13 cases in which in the course
of the investigation some suspicion of Syphilis was raised in
connexion with the illness which followed vaccination. In none
of these 13 cases, however, is there evidence of any value to show
that Syphilis was communicated by vaccination; one was a case
of inherited Syphilis, and the other 12 were not cases of Syphilis
at all.
The evidence offered to us would lead to the belief that
whilst with ordinary care the risk of communication of Syphilis in
the practice of arm-to-arm vaccination can for the most part be
avoided, no degree of caution can confer an absolute security. The
rejection as vaccinifers of young infants, say below four months of
age (in whom Congenital Syphilis may be as yet undeclared), and
of adults (in whom the disease may possibly have been recently
acquired) are precautions which would probably shut out almost
the whole of the risk. The outbreaks of Syphilis in connexion
with vaccination which have been mentioned to the Commission
(all of which had been previously published) have occurred chiefly
in arm-to-arm vaccination amongst soldiers, or from the use as
vaccinifers of young infants the offspring of parents whose history
was not known to the vaccinator. It must, however, be admitted
that neither the examination of the vaccinifer if taken alone, and
without a knowledge also of the parents, nor the most scrupulous
avoidance of any visible admixture of blood with the lymph, are in
themselves, however valuable, sufficient absolutely to exclude
risk. The evidence given by Dr. Husband, of the Vaccine
Institution of Edinburgh, established the fact that all lymph,
however pellucid, does really contain blood cells. Absolute
freedom from risk of Syphilis can be had only when calf-lymph is
used, though where the antecedents of the vaccinifer are fully
ascertained, and due care is used, the risk may for practical
purposes be regarded as absent.