WHEN certain substances are injected into the body after a patient has been taken ill with a certain disease the object of such injection is to counteract the inroads of the disease and, of course, cure the patient. This is known as a bacterial vaccine and in some instances as a serum. As an instance of the last named and one which is known to all is the use of the anti diphtheritic serum which is explained under the title diphtheria as a serum obtained from the blood of a horse which has been inoculated with the poison or toxin of diphtheria and has grown in his own blood an anti toxin which is used in the human body for the cure of diphtheria. Now another vaccine of much older knowledge and which acts in a different way, namely the vaccine of cowpox, is used to prevent a person from acquiring the disease rather than the curing of the disease after it has been acquired. This substance acts by introducing an organism into the blood which has a connection more or less remote with the disease from which the patient is to be protected, and within the person's body this organism is elaborated so that protective substances form to counteract the disease when the person is exposed to it. The vaccination against smallpox is done by inoculating a person with vaccine from a calf which has had the so called cowpox, a mitigated variety of smallpox. This was discovered one hundred or more years ago by Jenner who found that the dairymaids in Switzerland broke out in a more or less general eruption from contact with cows that had a similar eruption; especially if the dairymaids had abrasions on their hands when milking they were liable to become infected. It also was noted that when epidemics of smallpox appeared these dairymaids and they alone did not contract the last disease. From that on, beginning with inoculation from human to human and later from animals to human, the system of immunization against smallpox has been progressive.
There can practically be no danger, one may be abundantly assured, if under proper inspection only healthy cows are inoculated in the first place, and simple, well understood methods followed of cleaning the arm and using sterile instruments to scarify the patient when the vaccination is performed. The operation is so simple in its performance and the protection is so inestimably great that we cannot speak too strongly in the favor it confers on the community.
Instance after instance can be cited to prove the efficacy of the precaution, where one poor result, or possibly fatal result, can be instanced by the opponents of vaccination. Beginning from three to ten days after the arm has been inoculated with the vaccine a small spot shows at the spot which has not been scratched deep enough to cause much blood to run, but only to have a little thin serum start from the scratched skin. The best serum used comes put up in small glass capitulary tubes which by being sealed at their ends cannot be contaminated by other influences, and will hold good for the time stamped on them before they lose their power to protect. If a reddened arm has not appeared by the end of ten days it is assured that the patient is either protected by a former vaccination or an attack of smallpox or varioloid which, of course, immunizes him for the rest of his life or else the strength of the serum was vitiated so that a new inoculation should be done. If the person is going to react to the vaccination, or take, as it is known to us, this small reddened spot increases and has a hard and at times pustular appearance, increasing in size and by the end of a week has reached its greatest development.
It is usually recommended to vaccinate once in five to seven years as the majority of people" run out" in that period. Should an epidemic occur at any time after three or four years from the first vaccination a second vaccination is recommended by the best authorities. At most no harm can be done by the precaution, for should the arm not become sore a second time it will prove that the first vaccination still protects you; while if the arm does become sore it denotes the fact that you would catch smallpox if exposed to the disease and now the vaccination will immunize you from further sickness. It can be almost a matter of assurance that no one who has been vaccinated and reacted to the virus within a sufficiently recent number of years will contract smallpox even if exposed. Should they have been vaccinated at any time in their lives their chance of taking it is very small, and if they take it the disease will be so mitigated by the previous vaccination that the danger of death is practically null, depending somewhat upon how recently or remotely the vaccination was done; while if they have never been vaccinated their chance of recovering is only about fifty per cent. Again, if exposed to smallpox, vaccination by its shorter period of inoculation will influence the disease even if smallpox appears. By that we mean the vaccination will, if performed at once when a person has been exposed to smallpox, protect him to a greater or less degree from the severity of the main disease. This was lately proved in the practice of the writer where a case that had been thought to be measles proved to be smallpox. The writer when called to the case diagnosed the disease as probably smallpox, and desired to vaccinate the members of the household. The patient with the suspected disease was only moderately sick and was at once vaccinated. The other members of the family with the exception of one were vaccinated at the same time and all escaped. The one exception, above noted, left the house between the first visit of the doctor and his return an hour later with vaccine virus, and her whereabouts did not become known until three weeks later when her death occurred several hundred miles from the first place where she had been. Her foolishness resulted in her death and it was never clearly known what the cause of her antagonism to vaccination was due to except she thought the true case of smallpox was measles, and she did not desire to be vaccinated against measles.
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