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Arrangements were made for the patient to be admitted to the Lewisham
Hospital.
In investigating the source of infection it was found that many cows were
suffering from a vesicular eruption and accordingly arrangements were made for
them to be examined by a veterinary surgeon on the staff of the London County
Council. Mr. R. Bryden, F.R.C.V.S., examined them the next day and
found that over 40 cows, out of a total of 78, were suffering from cow-pox or recovering
from it.
While in the Lewisham Hospital the patient was seen by Dr. J. E. McCartney,
Director of Research and Pathological services, London County Council. He
investigated the case and very kindly supplied the following notes:—
" On January 14th, 1932, material was taken from a typical pock from this patient.
The pock was on the dorsum of the left hand near the angle of the thumb and first
finger, and was definitely purulent. The epithelium over the pock was cleansed with
alcohol, and a small quantity of thick purulent material was withdrawn by means of a
capillary pipette.
" The hair from the flank of a young rabbit 'A' was removed with a depilating
powder and the smooth skin scarified and the pock material inoculated on to it. The
rabbit developed the typical appearance of vaccinia, with scab formation. Material
from the scabs at the seventh day after inoculation was transferred to the scarified skin
of a second rabbit ' B ' which resulted in the development of typical vaccinia lesions.
" The same day that the human material was obtained, a visit was paid to the farm
and the herd of cow-pox cows examined. There were extensive lesions on the teats
of many of the cows but these had been treated with an ointment and were in process
of healing. From one of the cows purulent material from under a scab, and some
flakes of scab, were obtained. These materials were inoculated by scarification on the
shaved flanks of rabbit ' C.' Typical vaccinia lesions were produced and at the
seventh day material from these lesions was transferred to the scarified skin of rabbit' D '
which in turn developed vaccinia. On February 3rd, i.e., three weeks after the original
inoculation of human and bovine material, rabbits ' A,' ' B,' ' C' and ' D,'
which had recovered from the cow-pox lesions, were again shaved and the scarified
skin inoculated with vaccine lymph obtained from the Government Lymph establishment.
As a control, a normal rabbit ' E ' was shaved, scarified, and inoculated with
the same calf lymph. The previously inoculated rabbits ' A,' ' B,' ' C ' and ' D '
showed ' no take,' while the control rabbit developed typical vaccinia lesions.
These experiments show the condition in both the human and bovine subjects to
be cow-pox, as smallpox material is not pathogenic to rabbits, and the recovered
animals showed complete immunity to a known vaccine virus which was potent for a
normal rabbit."
1 he patient was in Lewisham Hospital until the 22nd February when he was
discharged perfectly well.
A chart showing the distribution of the rash and photographs showing the lesions
at different stages of development appear on adjoining pages.
I am greatly indebted to the gentlemen mentioned above for their kindness and
assistance in the matter of investigating this case.