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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    As these figures are and can only be taken as an approximation to the actual facts, it is probable that no serious error will be made in supposing that, of the total 626 cases investigated, some 20 per cent may be set aside as unconnected with vaccination ; leaving 495 cases of death or vaccinal injury which have been adequately inquired into during the last eight years : this gives an annual average of 61*3, or a slightly larger number than that which is arrived at from the Registrar-General’s returns, which refer to cases only in which death has occurred. From these statements it will be seen that, however valuable to the community at large, vaccination is not exempt from that liability to accident which exists in all human affairs. Operations even of a trivial kind sometimes prove fatal; and that most beneficent means of alleviating pain which has been universally adopted—the administration of anaesthetics—is not unattended by risk, and occasionally results in death. The percentage number of deaths which occur annually in England from chloroform is far greater than that which results from vaccination. It is, in fact, nearly seven times as great; and though the risk from ether is much less, the percentage number of deaths per annum traceable directly or indirectly to anaesthetics is appreciably greater than that which follows vaccination,1 while the total number is approximately the same. It cannot be argued that the rare fatalities attendant upon vaccination which occur are sufficient ground for rejecting the practice if it can be proved to be beneficial on the whole. If the practice of vaccination is to be discredited, it must be by showing that the injury thereby inflicted on individuals is out of all proportion to the good which is gained by the community; and not by exaggerating, distorting, and multiplying every isolated instance of injury which occurs. The following pages have been written with the object of stating fairly what is the amount and kind of injury in¬ flicted by vaccination as at present practised; how much of it is inevit¬ able, how much preventable, and by pointing out the dangers, to show incidentally how many of the risks may be avoided. In this, as in other branches of pathology, it is incumbent on the medical profession to impose on itself, as a condition of assenting to any doctrine, the obligation of setting forth conscientiously all that can be said against it, no less than all that can be said in its favour. Erysipelas.—Relative importance of inflammatory complications.—Among the complications of vaccination, those are most to be dreaded which are common to all wounds. The most grave are erysipelas, cellulitis, ulceration, abscess, and septicaemia. None of these are peculiar to vaccination ; they constitute the dangers of any local lesion of the skin; and, considering the age of the children vaccinated, the conditions under which thousands of 1 I am indebted to Dr. Childs, secretary of the Anaesthetics Committee, Brit. Med. Association, and to Mr. G. Rowell of Guy’s Hospital, for the actual figures, which are as follows:—Deaths from anaesthetics recorded: 1891, 46; 1892, 41; 1893, 46; 1894, 66; 1895, 61 ; 1896, 8^ months, 48. The deaths from chloroform are roughly 1 in 2000, and from ether 1 in 20,000. 3