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.

    15/94 (page 7)
    (ii.) Retardation of the pocks may be brought about by the con¬ verse of such conditions, the evolution of vesicles being delayed for ten, fifteen, or possibly even thirty days (37a); and some cases have occurred in which vesicles which seemed to have aborted entirely were excited to activity by a revaccination a week or more after the first insertions. (iii.) The recrudescence of a pock and its breaking down after an interval of some weeks has been noted in cases of invaccinated syphilis (p. 62), and should at any rate excite suspicion as to the purity of the lymph. No allusion is here made to those cases of ulceration of pocks which not infrequently result from some mechanical injury to the scabs. (iv.) The non-development or abortion of pocks at the points of vaccination probably depends largely on the quality of the lymph and the experience of the vaccinator. The “ insertion-success ” of skilled vaccinators is very large, amounting to 97-98 per cent. e. Variations in involution.—As has been observed above, a hard and fast line cannot always be drawn between the local manifestations which result from vaccination in a normal case, and those which so far exceed what is necessary or desirable, as to constitute a source of danger to the individual vaccinated. As regards the vesicles it will be found, that besides those departures from the normal which have been indicated above, many of which may be considered as of little consequence, com¬ plications such as severe inflammation round the pocks, ulceration, coalescence of several pocks into one large ulcer, and even local necrosis of the tissues in the region of the pocks, may occasionally occur. Abnormal results in vaccination depend on so many factors—the lymph, the method of vaccination, the treatment of the vesicles, the condition of the individual vaccinated, both previous and subsequent to the opera¬ tion—that it may be by no means easy in a given case to trace their origin, to detect the cause, or to predict their occurrence; such results may however be expected to follow the careless treatment and injury of the vesicles, the vaccination of feeble or sickly children, lack of care, and unsuitable feeding of children during the vaccination period, or the use of lymph which has been improperly stored, or collected from vesicles with obvious inflammation about them. A further cause of danger possibly lies in the vaccination of children who have recently been exposed to, or who are incubating, some acute disease, such as scarlet fever or measles. This enumeration might be prolonged, but these examples will serve to show that a large number of the inflammatory complications which follow vaccination are directly traceable to some extraneous cause, and cannot in any way be considered merely as variations in the involution of the normal vaccine pock. The cases of suppuration, ulceration, and gangrene are, however, of so much importance that they will be considered under the heading of Vaccinal Injuries (p. 31). f. Variations in healing and formation of scar.—Vaccination wounds,