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increases it, tends to destroy other organisms. If it be the fact
that the efficacy of the lymph remains unimpaired, its storage
in glycerine would largely diminish the difficulties connected with
the use of calf-lymph, which are inseparable from calf to arm
vaccination. The investigation has not yet reached a point at
which it is possible to pronounce with certainty whether the
anticipated results would be obtained. And it was at one time
suggested that the introduction of glycerine was likely to be
mischievous. The question is one a further investigation of
which is obviously desirable.
If lymph is to be preserved in glycerine, due care would be
requisite to ensure its purity and the absence of contamination
in its introduction. We think that, whether mixed with glycerine
or not, each tube should contain only sufficient lymph for the
vaccination of one person.
Another precaution which ought to be insisted on is that no
instrument should be used for the operation which has not been
boiled or otherwise sterilised for the purpose ; and the simpler
the instrument employed the better.
Care should be exercised, too, not to place the insertions too
near together, so as to injure the vitality of the tissues between
them.
We think the time at present fixed for inspection of the vaccinated
arm is somewhat too early, and that some time during
the second week after vaccination should be substituted for the
eighth day; and, moreover, that another inspection should be
obligatory in the third week after vaccination. If summoned by
the parent on account of any unfavourable symptoms prior to
the time fixed for inspection, the vaccinator should be bound to
attend, and notice should be given to parents of their right thus
to summon the public vaccinator.
The amount of the fee to be received by the vaccinator would,
of course, require to be determined with reference to the duties
which it is proposed to impose upon him. We think the fee
should be adequate to cover all these duties.
In any case where a child requires medical attendance owing
to illness supervening on vaccination, we think it should be the
duty of the vaccinator to render such attendance if required by
the parent, and that he should receive a fee in respect thereof.
In our opinion, if the precautions we have suggested were
adopted, untoward incidents of vaccination, already rare, would
become much rarer.
With regard to
(D) As to what means, other than vaccination, can be used for
diminishing the prevalence of small-pox; and how far
such means could be relied on in place of vaccination.
The means other than the inoculation of small-pox or cow-pox,
which have been referred to by witnesses as being capable of
diminishing the prevalence of small-pox, are such means as have
been employed against infectious diseases generally ; they may
be summarised as—1. Measures directed against infection, e.g..