Vaccination and revaccination : the results of five years' experience in the Kingdom of Wirtemberg.

Date:
1839
Catalogue details

Licence: Public Domain Mark

Credit: Vaccination and revaccination : the results of five years' experience in the Kingdom of Wirtemberg. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    day after the revaccination, transparent pustules,surrounded with a dusky blueish redness, in which the characteristic marks of the genuine protec- tive pock were absent; in this form swelling of the arm and of the axillary glands, and marked fever always prevailed. These pustules commonly burst on the seventh or eighth day, leaving a painful, easily bleeding ulcer, a line in depth and varying in size, which in the course of from fourteen to twenty days became covered with a dry adherent crust. Other varieties were also observed which we cannot here particularize. Another report mentions that, in corpulent, strong men of dusky com- plexion, the inflammation ran high and the pocks were very full, becoming purulent as early as the eighth day. The inflammation of the skin was so extensive, that the individuals were unable to continue at their work, and were obliged to remain in bed. The same circumstances were also observed in the district of Oehringen; the fever was so severe that the patients were obliged to lie in bed; and the greater the interval between the first and second inoculations, the more perfect were the pocks, and the more severe the fever. It seems to have been very generally observed, that the shorter the interval between the two vaccinations, the less was the amount of the success which attended the second insertion of the lymph; while usually, and only with very few exceptions, was the revac- cination entirely without effect when performed from five to six years after the first inoculation. It succeeded also, according to Dr. Rosier, in adults more certainly with lymph taken from adults, while with lymph taken from children it was frequently of no avail. We have no great confidence in the correctness of this last observation, for it has been disproved again and again under our own inspection, until we have been tired of renewing the experiment; but the former alleged fact, touching the better development of the secondary vaccine vesicle in proportion to the distance of time that has elapsed from the first insertion of the virus, is, we believe, quite correct in the main, though liable, of course, to many modifications and exceptions. This has always appeared to us a fact of great importance, tending to establish the doctrine of a gradual impairment of vaccine protection. Various degrees of modification in the revaccination process were observed in different places. In the district of Boblingen occurred several cases of this description: — 1. The pocks formed sooner, or their progress was earlier completed, than in the genuine affection. 2. Although they put on the same form they did not attain the same size as the genuine pocks, which was particularly evident in the incrustation. 3. They filled after their appearance with a thin lymph, which remained as clear as water and limpid to the seventh or eighth day. 4. The areola was paler than in the genuine pocks and seldom round, and attained its greatest limit towards the eighth or ninth day, after which it usually disappeared rapidly. 5. The deeply seated induration accompanying this inflamma- tory circle was always less than in the true pock. 6. From the third to the seventh or eighth day the modified cow-pox was always accompanied with painful sensations in the axillary glands, attended by marked shiver- ings and occasional headach. In the district of Waiblingen the progress of the vaccinoid affection was observed to be quicker than the genuine cow-pox; usually there was itching in the wound a few hours after the revaccination, which about the third day became almost unbearable.