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57
INOCULATIONS AND VACCINATIONS.
As a few Sanitary Authorities are supplying diphtheria antitoxin free of
charge, and a few are selling it at cost price, and some others are being advised
to adopt a similar course, it is opportune to consider the bearings of inoculations
and vaccinations.
The term vaccination is generally applied to the inoculation of vaccine
lymph, but for the sake of uniformity and comparison, it is convenient to drop
the terms "vaccination" and "lymph," and speak merely of the inoculation
of antivariolous fluid in the same manner as the inoculation of any other antidisease
fluid may be spoken of.
Inoculations are of two kinds, curative and preventive, the former being
studied as part of the new branch of therapeutics known as serumtherapy,
and the latter in connection with prophylaxis—that is to say, the former for
curative, and the latter for preventive treatment.
Fluids for inoculation upon man, as distinguished from farm stock, are
being used in connection with the following diseases : Variola (small-pox),
Diphtheria, Streptococcal or Septic Diseases (especially Puerperal Fever and
Erysipelas), Tetanus or Lockjaw, Pneumonia or Inflammation of the Lungs,
Typhoid or Enteric Fever, Plague, and Cholera.
The difference between curative and preventive inoculation fluids is that
whereas the former are used after the diagnosis of the disease is made upon
persons suffering from the disease it is sought to cure, the latter are used
upon healthy persons, or, at least, upon persons not suffering from the disease
it is sought to prevent. It is necessary to make the distinction clear because
Clinicians recommend that curative inoculation fluids should be used early,
strong, and in large doses, and Bacteriologists point out that the earlier the
administration of the fluids at the onset of the disease the greater the effect,
and the later the smaller, showing that, in one sense, the curative effect
may be regarded as preventive, but in this sense the demarcation between cure
and prevention would be destroyed.
Therefore, it is to be understood that a "preventive" inoculation or
injection is employed upon a healthy person as a means of protection against
a disease, and a " curative " inoculation or injection is employed upon a person
sickening for or suffering from a disease.
Protective during Serums Curative before
(the longer the greater the waning) inoculated or injected. (the earlier the more effectual)
10, 12, or more years. Anti-variola. 3rd or 4th day.
3, 6, or more weeks. Anti-diphtheria 1st, 2nd, 3rd or 4th day.
8, 10, or more days. Anti-streptococcus.
1, 2, or more months. Anti-tetanus.
A nti-pneumococcus.
Some months. Anti-typhoid.
Anti-plague. 2nd or 3rd day.
Anti-cholera.
With the exception of the two first, the sera for inoculation or injection
are in more or less experimental stages still, the periods in some are not
ascertained and in others are not sufficiently corroborated, so that they must
not be regarded as reliable, but as merely tentative. In the course of time,
serumtherapy will be more perfected. It would occupy too much space now
to enter into a dissertation upon the merits and demerits of serumtherapy, but
in Veterinary Medicine it is now practised with success in a number of
diseases upon a large scale upon domestic animals.