Vaccinia in man : a clinical study / by Theodore D. Acland.

  • Theodore Dyke Acland
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Vaccinia in man : a clinical study / by Theodore D. Acland. Source: Wellcome Collection.

    14/94 (page 6)
    c. Variations in contents cl. Variations in evolution . e. Variations in involution /. Variations in healing and of scar. Watery. Purulent. Haemorrhagic. Acceleration. Retardation. Abortion. Recrudescence. Persistence. Inflammation. Suppuration. Ulceration. Gangrene. formation Delayed healing. Induration. Keloid. a. Variations in number.—This subject, which is necessarily of some length, will be more conveniently considered under the heading of generalised vaccinia (q.v. p. 15). b. Variations in size.—Two, three, or four of the compound vesicles resulting from ordinary vaccination, may coalesce to form one large pock, the size of which may be almost indefinitely increased by the development of supernumerary pocks in the immediate neighbourhood of the primary vesicles; an example has been recorded by myself (1) in which the sore on the arm thus produced measured 4 inches by 4J inches. These cases as a rule are not serious; with cleanliness and protec¬ tion of the arm from injury, the sores heal well and quickly. c. Variations in contents. — Under certain conditions, the most im¬ portant of which are a cachectic state of the vaccinated child, the use of contaminated lymph, or the improper treatment of the vesicles (vide Vaccinal Ulceration, p. 60), the contents of the pocks, instead of being clear and bright at the end of the first week, may be watery and unhealthy, or pus may have formed early, or the contents of the vesicles may be haemorrhagic : any one of these conditions may be of grave importance. d. Variations in evolution.—(i.) The development of the pocks may be accelerated by the season of the year—it is more rapid in warm weather than in cold—it is influenced by the idiosyncrasy of the individual, and also by the amount and activity of the lymph .used. Their development is also accelerated by the degree of immunity which has been attained by previous vaccinations. Thus Cory (9a) found by vaccinating in series, one insertion being made on each of eleven successive days, that all the successful insertions came to maturity on the ninth day. The insertions made subsequent to this date were ineffectual. He also found (9b) that in cases in which vaccination was performed on super¬ numerary fingers which were removed on the fifth day, vaccination performed in the usual way a month later hurried through its cycle, as happens in the revaccination of individuals in whom immunity has not been completely secured.