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MICROSCOPICAL DRAWING FROM A SOLID LYMPH CONE, AS DESCRIBED. a, hairs; b, part of a leaf; c, vegetable fibres; d, amorphous matters.

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Any physician, with an appreciable sense of the dangers of septic poisoning, would never venture to inoculate a patient with such a compound of animal and vegetable matter, liable at any moment, under favorable conditions, to take on putrefactive changes which might render it fatally poisonous.

In the proceedings of the Medical Society of the County of Kings, N. Y., for April, 1881, is an account of a death after using one of the cones obtained from the New England Vaccine Company, occurring to an officer in the U. S. Navy, and reported by the surgeon.

The following are extracts from the ship's medical journal:

March 2d.

Whittaker, Chief Engineer. Left arm very much inflamed from recent vaccination.

March 3d. Whittaker, Chief Engineer. No fever; headache and lumbar pain much moderated; left arm very inflamed and painful; inflammation erysipelatous in appearance.

March 4th Whittaker, Chief Engineer. Not much constitutional disturbance; condition of arm no better; erysipelatous inflammation extends from elbow to shoulder; whole circumference of arm involved; surface of skin exteriorly covered with blebs.

March 5th, 6th, and 7th. At home ashore.

March 8th. Whittaker, Chief Engineer. Febris-sick leave. March 9th. Whittaker, Chief Engineer. Erysipelas. No improvement in the condition of the arm. He is under the care of Dr. S., of Brooklyn.

March 10th. Whittaker, Chief Engineer. Erysipelas. Information was received this morning that Mr. Whittaker grew worse the early part of the evening, and died about 10 o'clock P. M.

The above record leaves little doubt that the virus used in the vaccination was the cause of the erysipelas and death.

The surgeon making the report writes that "this is the only case of erysipelas or disease of any kind which he has observed from vaccination, * * but the Powhatan lying near us had one fatal case some weeks ago."

All the bad results of impure vaccination do not get into print. But it needs but very few such sad events as the above to maintain and intensify the popular prejudice against all vaccination, however prudently and scientifically done.

It is a very serious misfortune, that so good, so safe, and so essential a means of public safety should be questioned and

doubted, and its usefulness limited, because it must share in the public mind all the odium and reproach which justly should attach only to the imperfect, deceptive, spurious, and injurious kinds of vaccination. Yet such will continue to be the fact so long as it is popularly believed that old women, druggists, midwives, clergymen, schoolmasters, etc., are competent properly to perform the operation and pronounce upon its results. Such will continue to be the fact so long as the intense commercial competition in the production of cheap virus attracts venal-minded and mercenary men, of every grade of capacity, who may think it presents a chance for money-making. Such will continue to be the fact, too, so long as physicians culpably neglect fully to inform themselves as to the source and quality of the virus which they use upon their patients, and trust to druggists, instrument-makers, and traders of every sort, who, through their facilities for advertising, can offer them virus at the cheapest rates.

The evils resulting from vaccination are, in the present light of science, almost wholly avoidable. With scarcely an exception, every unfortunate result from vaccination may be justly attributable to ignorance or inexpertness on the part of the vaccinator, or a culpable carelessness in the selection of the virus.

Besides the dangers which may follow the use of poisonous virus, there is a far greater mortality resulting to persons who contract small-pox, while living in supposed security, on account of their vaccinations having been spurious and imperfect. "What is called vaccination," says Dr. Elisha Harris, "is, in a vast number of persons in the United States, only so in name, and not in reality." As Mr. Marson has said concerning vaccination in England, so in the United States: "All persons, amateurs, druggists, old women, midwives, etc., are allowed to vaccinate in any way they may think proper, and the persons operated on are considered to have been vaccinated."

It will probably be a long time before public intelligence will attain to so high a standard as to tolerate the interference of the state or of sanitary authorities with the rights of private citizens to be vaccinated in any manner, and by any one, or with anything, that said citizens may select, and to pay for it and take whatever consequences may ensue. But as the eminent English sanitarian, Mr. Simon, says,-"No principle can be more obvious.

than this, that if the state professes to vaccinate the people,above all, if it compels the people to be vaccinated, it must take every possible security for the excellence of the vaccination which it offers."

The subject is one of such momentous importance to the public welfare, that it is worthy of profound attention. The wide-spread prevalence at this time of small-pox in every direction throughout the whole country will give occasion for a vast deal of vaccinating and revaccinating.

Is it practicable to restrict the use of the vaccine virus, with which the market is flooded by irresponsible producers, by providing, on the part of the state, to all qualified practitioners, a sufficient supply of a quality reliable, safe, and trustworthy, obtained under such official supervision as would insure such quality, and sold at so low a rate as to destroy any competition, while at the same time it should be so carefully produced as to be entitled to the fullest confidence?

Dr. W. M. Welch, physician to the Municipal Small-Pox Hospital of Philadelphia, Pa., speaks as follows on this point: "For better protection against a pestilential disease which is constantly recurring, and which is frequently most destructive to business and commerce, the propagation of animal lymph of perfect quality is of so great importance to the public that it should not be left solely to private enterprise, nor degraded to the level of a commercial trade, but should be under the control of the national or state government, so that lymph of undoubted good quality could always be obtained free of cost."

WHAT ARE THE EVIDENCES OF A SUCCESSFUL VACCINATION?

As has already been observed, large numbers of persons are vaccinated only in name, and not in reality. It is therefore a matter of much importance to know confidently and reliably in which list a person rightfully belongs, that he may govern himself accordingly.

In the early days of vaccination the test was subsequent inoculation with the small-pox. In Jenner's time the protective efficacy of vaccination was very frequently tested in that way. Within two or three years after Jenner announced his discovery, he

reported that upwards of six thousand persons had been inoculated with the virus of cow-pox conveyed through a succession of human subjects, and the far greater part of them had since been inoculated with that of small-pox, and exposed to its infection in every rational way that could be devised, without effect.

Such a test proved beyond question the protective power of vaccination. That fact is no longer in dispute. No fact in medical science is more firmly established. It is in these days, therefore, only needful to know that one has been the subject of a genuine vaccination, to know that he is thereby protected.

Vaccination produces a specific disease, vaccinia, with diagnostic indications so well marked that an expert does not mistake them. The beginning, progress, and termination of the inflammation excited by the inoculation of a person with the virus of cow-pox is so characteristic, when it is undisturbed in its natural course, that it is unlike any other, and can be recognized and identified as a vaccination by an intelligent person of good powers of observation, who has had frequent opportunities of seeing true vaccinations. But without such opportunities, or without the ability to improve them, the diagnosis cannot be made. Such an one has no hesitation in pronouncing every sore arm, following his punctures or his scratches, a successful vaccination, whatever condition it may present, whether spurious or genuine. Not infrequently the sore upon the arm, arising from the insertion of worthless virus, is even more severe than that resulting from the genuine lymph. Hence the dangerous error of entrusting an operation, the success of which one's life may afterwards depend upon, to an unskilled and incompetent person, who cannot distinguish between a common or an erysipelatous inflammation and the specific indications of vaccinia which result from the inoculation of vaccine virus, and which only afford safety from small-pox.

It would serve no good purpose, and is not within the intended scope of this paper, to describe at length and minutely the diagnostic marks of true raccinia. The object is rather to impress upon the reader the serious fact, that vaccination is an event of weighty significance, the influence of which is of such consequence that a large portion and perhaps the whole of his life will be affected by it. The simplicity of the operation, and the inconsid

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