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21
It does not appear logical that precautions which are regarded as necessary
to prevent the introduction of Plague, Yellow Fever, and Cholera into this
country should not be equally applied in the case of other dangerous infectious
disorders, to wit, Small-pox and Scarlet Fever.
VACCINATION.
It cannot be too strongly urged on everyone, in view of the present epidemic,
the importance of vaccination. It is not commonly realised that vaccination is
protective against vaccinia, and it seems that almost every person on
contemplating vaccination is convinced that they will have a " bad arm."
This is not a fact. I vaccinate myself personally once every year, and have
done so three times within the last six months.
In no case have I been able to raise more than a very immature form of
papule, which has caused me not the slightest inconvenience. I have performed
the operation with lymph at the time of vaccinating other people, who, being
unprotected by previous recent vaccination, have in due course exhibited
symptoms of more or less severe vaccinia, so that there has been no doubt that
the lymph used was active.
It may, therefore, be stated as an axiom that the severity of the results
of vaccination is directly proportional to the unprotected condition of the
patient against Small-pox, and is an indication of the liability to contract
Small-pox if exposed to the risk of infection.
It is interesting in relation to this question to point to the training ship
Cornwall," which is moored on the opposite shore of the River to the
Small-pox ship, at a distance of less than 600 yards. The vessel is occupied
by 255 boys, and is exposed to aerial and other infection of Small-pox, there
having been over 70 cases in the village and neighbourhood immediately
adjacent to the ship. Notwithstanding this, and the fact that the age of the
boys is most favourable to infection, not one case of Small-pox has occurred
on this ship during the present epidemic, nor for many years past. Every
boy is vaccinated as soon as possible after joining the ship, and in my opinion
the immunity enjoyed by the inmates is a good object lesson in the protection
afforded by vaccination.
On other training ships where similar precautions have been adopted no
cases of Small-pox have occurred.
To ensure success in vaccination it is important that the lymph be of recent
date, and it must not be assumed in the case of a person vaccinated in infancy
that because no result is obtained immunity is assured. It is probable in
these cases that the lymph is inert. The active properties of the lymph are
readily destroyed by exposure to light and heat. Vessels take on board a
supply at the commencement of a voyage, and it is almost certain that in a
voyage, say through the Red Sea, or one occupying a protracted period, the
lymph has become inert, and in this way may be explained many of the
failures of so-called vaccination.