Advice to a Mother on the Management of Her Children

by Pye Henry Chavasse

When he is two months old, as the sooner he is protected the better. Moreover, the older he is the greater will be the difficulty in making him submit to the operation, and in preventing his arm from being rubbed, thus endangering the breaking of the vesicles, and thereby interfering with its effects. If small-pox be prevalent in the neighbourhood, he may, with perfect safety, be vaccinated at the month's end; indeed if the small-pox be near at hand, he must be vaccinated, regardless of his age, and regardless of everything else, for small-pox spares neither the young nor the old, and if a new-born babe should unfortunately catch the disease, he will most likely die, as at his tender age he would not have strength to battle with such a formidable enemy. "A case, in the General Lying-in-Hospital, Lambeth, of small-pox occurred in a woman a few days after her admission, and the birth of her child. Her own child was vaccinated when only four days old, and all the other infants in the house varying from one day to a fortnight and more. All took the vaccination; and the woman's own child, which suckled her and slept with her; and all escaped the small pox." [Footnote: Communicated by Sir Charles Locock to the Author.]

51. Do you consider that taking of matter from a child's arm weakens the effect of vaccination on the system?

Certainly not, provided it has taken effect in more than one place. The arm is frequently much inflamed, and vaccinating other children from it abates the inflammation, and thus affords relief. It is always well to leave one vesicle undisturbed.

52. If the infant have any "breaking out" upon the skin, ought that to be a reason for deferring the vaccination?

It should, as two skin diseases cannot well go on together; hence the cow-pox might not take, or, if it did, might not have its proper effect in preventing small-pox. "It is essential that the vaccine bud or germ have a congenial soil, uncontaminated by another poison, which, like a weed, might choke its healthy growth."—Dendy. The moment the skin be free from the breaking-out, he must be vaccinated. A trifling skin affection, like red gum, unless it be severe, ought not, at the proper age to prevent vaccination. If small-pox be rife in the neighbourhood, the child must be vaccinated, regardless of any "breaking-out" on the skin.

53. Does vaccination make a child poorly?

At about the fifth day after vaccination, and for three or four days, he is generally a little feverish; the mouth is slightly hot, and he delights to have the nipple in his mouth. He does not rest so well at night; he is rather cross and irritable; and, sometimes, has a slight bowel-complaint. The arm, about the ninth or tenth day, is usually much inflamed—that is to say it is, for an inch or two or more around the vesicles, red, hot, swollen, and continues in this state for a day or two, at the end of which time the inflammation gradually subsides. It might be well to state that the above slight symptoms are desirable, as it proves that the vaccination has had a proper effect on his system, and that, consequently, he is more likely to be thoroughly protected from any risk of catching small-pox.

54. Do you approve, either during or after vaccination, of giving medicine, more especially if he be a little feverish?

No, as it would be likely to work off some of its effects, and thus would rob the cow-pox of its efficacy on the system. I do not like to interfere with vaccination in any way whatever (except, at the proper time, to take a little matter from the arm), but to allow the pock to have full power upon his constitution.

What do you give the medicine for? If the matter that is put into the arm be healthy, what need is there of physic! And if the matter be not of good quality, I am quite sure that no physic will make it so! Look, therefore, at the case in whatever way you like, physic after vaccination is not necessary; but, on the contrary, hurtful. If the vaccination produce slight feverish attack, it will, without the administration of a particle of medicine, subside in two or three days.