View report page

10
The subject of vaccination direct from the animal having been referred to me to
report upon, I beg to lay before you a few practical remarks; premising only that the
whole subject is so extensive that I can but briefly touch the principal points. Two
great objections are brought against the system of arm to arm vaccination, viz., 1, that
diseases of various kinds have been, and are likely to be, thereby set up in an otherwise
healthy child; and 2, that the repeated transmission through the human body gradually
impairs the efficiency of the lymph, and so renders vaccination less protective. On the
first head it will be sufficient if I say that I doubt its possibility if pure lymph unmixed'
with blood alone be used. I do not deny that there have been recorded a very few
doubtful cases, which seem to favour the possibility of such a communication; but it
must not be forgotten that these cases can be, as it were, counted on the fingers, whilst
millions of children have been vaccinated successfully—thus in 1872 out of 821,856
births registered, 698,137 (being 85 per cent. of the whole) were vaccinated with success,
78,594 dying before the operation could be performed. It is alleged also that vaccination
produces eruptions of the skin, glandular swellings, &c. That it can do this by
any direct influence of its own is contrary to experience, but that through the disturbance
of the system the seeds of the other ailments may be stimulated into vitality, although
previously quite latent, is not due to vaccination except indirectly, and might occur as
readily without any tangible cause. Mr. Purvis, in his "Statistics of Vaccination at
Greenwich," mentions one very striking case, and I have seen two in whom vaccination
was accidentally deferred for a short time, and in whom severe eruptions about the head
and face occurred before the operation was carried out. Secondly, that lymph does not
lose its power is quite capable of proof; thus Mr. Purvis (before quoted) vaccinated
2,976 cases with only 30 failures, and of these latter 26 were successful on a second trial.
Now, all these were vaccinated with lymph obtained by transmission from two infants,
and many years no doubt had elapsed since the matter was primarily obtained from the
cow. On the other hand, it may be possible that the protective power, though not lost,
may be somewhat lessened, though it is not improbable that want of care in the selection
of the lymph, both as to its source and condition, may in no slight degree have tended
to favour the idea.
The practical deductions to be drawn from these considerations are that arm to-arin
vaccination will be successful in proportion to the care taken in its performance; that if
sickly children are vaccinated without due regard to their actual condition of health—
Children breeding other disorders, children having skin disease, children teething, and
the like—or if children, healthy or unhealthy, are vaccinated with improper materia),
the result must be unsatisfactory; but that if in infancy the operation be carefully performed
it will not only be at least thirty times as protective at its best as compared with
the operation indifferently carried out, but that it will in most cases through life, and in
the others at least until after puberty, afford complete protection against the most loathsome
disease to which we are exposed—or, at all events, most materially modify the
severity of the attack. Out of 4,372 cases admitted into Homerton Hospital, the