It was Mr Simon, the late medical officer of the Privy Council, who published three admirable Reports on the subject, and probably brought together more practical truths on vaccination than had ever before been collected, that gave an impetus some few years ago to further inquiry. It was stated at that time, and with every appearance of truth, that the vaccine lymph becomes enfeebled in its protective power by a long course of transmissions from arm to arm. It was therefore proposed that means should be taken for establishing a well-devised system of renewal, which would be likely to give greater certainty of results and afford more permanent protection. Various attempts and suggestions were made in this country to introduce vaccine matter from its original source, the cow, or, better still, from the calf; and Mr Ceeley, a medical gentleman, who, like Jenner, worked hard at the subject amidst the worries and anxieties of a private practice, made many experiments, and did much to popularise the idea.
Early in 1882, the local government Board set up a small establishment in London for the purpose of affording facilities for vaccination directly from the animal. Some time previously, a case of spontaneous cowpox was accidentally discovered at Bordeaux, and from this case our government procured the virus which they are now imparting to a regular succession of healthy calves, each of which, before undergoing the ordeal, is carefully examined by a Privy-council veterinary officer, to insure its being in perfect health. The animal is then weighed, and led away for a few days to a comfortable stall, and fed on sweet hay, new milk, and oil-cake. An animal taken in on Monday would on Thursday be led into the vaccinating-room, and securely strapped to the top of a table which is ingeniously constructed to tip down into a vertical position. The top of the table is then thrown over and secured horizontally, the calf lying upon its side, and presenting the under surface of its body conveniently for the surgical part of the proceeding. The hair is first shaved off, and then some slight incisions about an inch long are made in the skin, and the virus introduced. This operation is performed in one part of a large room divided by a wooden partition. To the other part of the room, parents will in a few days bring their children, and have them vaccinated directly from the animal thus prepared, and may thus escape whatever evils, real or imaginary, pertain to the practice of arm-to-arm vaccination. The calf having done its involuntary service to humanity, is, before dismissal, again weighed, and is usually found to have increased considerably—not, it may be presumed, in consequence of vaccination, but from the good feeding it has received.
The practical results of vaccination from the animal direct, are in some respects somewhat dubious. Belgium and Holland have long been familiar with it; but still there appears to be a lack of trustworthy records as to the efficacy of the process as compared with the arm-to-arm system. Whether the animal lymph is as potent a protector from smallpox as that which has been passed through the human system, cannot as yet be determined, though there would seem to be no ground for any reasonable doubt upon the subject. That the humanising process does in some way, at present quite inscrutable, affect it, seems evident from the fact that the vaccine from the calf loses its efficacy somewhat sooner than that from the human subject. It cannot be stored for so long a time as the humanised lymph, and this renders its distribution somewhat difficult. The best authorities, however, are now inclined to the opinion that the difference in this respect is not after all so great as was at first supposed. The two scientific men in charge of this station are, however, enthusiasts in this department of medical investigation, and it may be hoped that with the enlarged sphere of operations which government is understood to be contemplating, and aided by a well-appointed laboratory in connection with this establishment, an important advance may soon be made in their knowledge of the subject.
Compulsory vaccination has done much in other countries to free them for long periods from this loathsome disease. Sweden and Denmark enjoyed absolute immunity for twenty years; and in Austria, where very stringent measures of compulsion are resorted to, they succeeded in extirpating smallpox for long periods.
It was in 1853 that compulsion was first established in this country, and as at first nearly every one obeyed the law, it was attended with very beneficial results. At the registration of a birth, the registrar has to give notice of the necessity of having the child vaccinated within four months, and the penalty for neglect. From the registrar’s return, it is seen at the local government Board if a medical certificate attesting the vaccination as duly performed, has been returned. Assuming that every child is registered, this system no doubt would answer well; but there is much reason to fear that many children in London escape being registered, and these do not come within the cognisance of the local government Board. It is a question whether some return should not be required from medical men of every child born alive, with the address of its parents.
Absolute care in vaccination and its universal adoption, combined with a compulsory re-vaccination on arriving at the age of puberty, would without doubt have by this time fulfilled Jenner’s most sanguine expectations, and smallpox would have become extinct. At the same time, if the government make vaccination compulsory, they have a most important duty to the public to perform. In the first place, they should undoubtedly ascertain that every known precaution is taken by all public vaccinators to protect from harm, or disease likely to arise from vaccination, those whom they compel to undergo the operation. Secondly, none but properly certified practitioners should be appointed to the stations. It is not alone sufficient that they be skilful vaccinators, they should also be able to take lymph skilfully from the vesicles without the admixture of the minutest particle of blood. An ignorant or careless vaccinator may do more harm than it is possible to trace. Thirdly, no lymph whatever should be used but that which is microscopically examined by one who thoroughly understands his work, and the public should be permitted to have a choice of either the humanised lymph or lymph direct from the calf. If these precautions were conscientiously carried out, we should soon have less objection to compulsion, and we should be in a fair way to seeing smallpox stamped out.
In America, according to the Asclepiad, the subject has received careful attention. The Report of Dr Joseph Jones, President of the Board of Health, of the State of Louisiana, extends to four hundred pages, and embraces everything connected with smallpox, vaccination, and spurious vaccination; while drawings are freely interspersed to illustrate, from point to point, the author’s histories, views, or conclusions. Amongst the general conclusions which the author draws at the close of his treatise, the following are some of the most important: (a) Vaccination, when carefully performed on Jenner’s method, is as complete a protection from smallpox now as it was in the early part of the century; (b) Without vaccination, the application of steam and navigation and land travel would have, during the past fifty years, scattered smallpox in every part of the habitable globe; (c) Vaccination has not impaired the strength and vigour of the human race, but has added vastly to the sum of human life, happiness, and health; (d) Inoculation for smallpox, which preceded vaccination, induced a comparatively mild and protective disease, but multiplied the foci of contagion, kept smallpox perpetually alive, and increased its fatal ravages among mankind.
BY MEAD AND STREAM.
CHAPTER XLVII.—UNDER-CURRENTS.
Shield had not been so perfectly frank with Philip as the latter believed him to be. For instance, he had not mentioned that when Coutts came to him with affected concern on account of the position in which his brother might be placed by the forged bill, he had not admitted to him that the signature was a forgery.