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.

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    diphtheritic and others; and again that the date of their appear¬ ance and the absence of any distinctive characteristic are opposed to the deduction that they are in any way allied to syphilis. There does not seem to be adequate ground for concluding that, with the exception of generalised vaccinia, any of the eruptions enumerated above are peculiar to vaccination, or are an essential part of it. Their occurrence in a small number of cases is undoubted; in some instances they certainly depend on extraneous and therefore removable causes, and in others they depend on peculiarities in the individual which are often unsuspected at the time of operation, and cannot be foreseen. Nothing would be gained by discussing in detail all the various forms of eruption which may follow vaccination. None of them has any peculiar significance in vaccination; many of them are unimportant, and are only mentioned because they are sometimes a cause of anxiety to Fig. 1.—Supernumerary vesicles. Stage i. Discrete. Drawing made on 9th day after vaccination with lymph, 46th remove from the calf, and 4th remove from H. T. (vide Fig. 5, p. 16). For details, see Case 214, Appendix ix. to Final Report R.C.V., p. 402, No. 500. those who are unacquainted with their harmless character. The more important eruptions, and some of the more troublesome,—such as eczema, impetigo, herpes,—require further notice; erysipelas, syphilis, tubercle, and leprosy, etc., will be considered later in detail. From a clinical point of view the eruptions peculiar to vaccination are without doubt the most interesting and important; for if there be any connection between vaccinia and variola, it might be expected that cases would occur from time to time in which the symptoms following vaccination would more closely resemble inoculated variola than the merely local phenomena which are generally associated with vaccination. Such cases do in fact occur; and, though the instances are rare in which vaccination is followed by a general eruption of pocks like those at the point of inoculation, it is (judging from my own experience) by no means very uncommon to find the original insertions surrounded by supernumerary pustules, cf. Figs. 1, 2, 3, so that the appearances closely resemble the drawings of inoculated small-pox by Kirtland, reproduced in the British Medical