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136
two bedrooms and a living room. There was no overcrowding,
according to the usual standard, but it must be admitted that the
whole of the family came into such close relation with one another
that the presence of anything of an infectious nature attacking one
member of the family would almost certainly be transmitted to the
other members of the family, unless some protective power was at
work. At any rate, no family arrangements could be made which
would better favour the spread of infection amongst the various
members of the family when once introduced. All at once a case
of smallpox, one of the most infectious and virulent of fevers, occurs
in this family. The patient is nursed by his mother; all members
of the family had access to the patient's room, for they were assured
the disease was not infectious; as a matter of fact, on my visit to
see him on the eve of the 27th February I found the patient with
his father, brother and sister together in their small sitting-room,
taking their evening meal.
How does it come about that only Mrs. B. in this family was
infected? This circumstance must be puzzling to those sceptical
as to the value of vaccination; but the incident is really an objectlesson
of its protective value.
What was the condition of the members of this family with
respect to vaccination? Mrs. B. was forty-three years old, and had
been vaccinated in infancy. The immunity afforded by this vaccination
had greatly diminished, but its effect had not altogether
vanished. It was still sufficient to cause her attack to be very mild,
leaving very few hardly recognisable scars. The two younger
children, aged nine and twelve years, had been vaccinated in infancy.
These two children had been exposed to constant infection for four
weeks, but they escaped. The immunity afforded by their vaccination
was still strong enough to protect them from infection. The
father had also been vaccinated in infancy, but he had also been
re-vaccinated in 1902. The firm for whom he then worked insisted
upon their workpeople being re-vaccinated in that year, whilst the