Report of Dr. Sidney Coupland on the outbreak of small-box in the Dewsbury Union in 1891-2.

  • Sidney Coupland
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Report of Dr. Sidney Coupland on the outbreak of small-box in the Dewsbury Union in 1891-2. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    It will be seen from Table LXXXIV. that the number of scars mostly varied inversely as the ages of the subjects, the per-centage being:— Number of Marks. Under 10 Years. 10 to 30 Years. 30 years and Under. At all Ages. Per Per Per Per cent. cent. cent. cent. Four or more 17-8 9-3 7- 9-1 Three 53-5 62-7 30- 45-5 Two - 17-8 33- 51-7 38- One - 10-7 4-8 11-1 7-3 Foveation of Scars.—A well-defined and characteristic mark of vaccination should be regular in outline, white in colour, and stippled with minute depressions. There is abundant scope for variation in the degree of such foveation. and for the purposes of analysis one may group the cases into series according as all the marks are (o) plain and well foveated, (b) some foveated, others not, or in which the foveation and outline of the scar are indistinct, (c) those marks which present no foveation, but either a smooth surface, and perhaps a faint appearance; or else composed of more or less radiate cicatricial tissue, causing a mark of great prominence and irregular outline. It is sometimes difficult to determine in cases of this group whether the scars have been produced by vaccination or not. When they are thick and irregular, often of large area, they indicate that the vaccination has been accom- panied by extensive and perhaps deep ulceration. Of the 416 cases, of which the records are given, one may place 294 amongst the first group, 32 in the second, and 90 in the third, but it must be remarked that the classification is an arbitrary one, and too much stress cannot be laid on the conclusions drawn from an analysis based upon it. TABLE LXXXV. Foveation of Scars. Foveate. Part (or faint) Foveate. Smooth and faint Scars. Not Eecorded. Total. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Under 1 year - - - 1 to 5 years - - - .5 to 10 „ - 10 to 15 „ - 15 to 20 „ - 20 to 30 „ - 30 to 40 „ - 40 to 50 „ - 50 to 60 „. - 60 to 70 „ - 70 and over - - - Age not ascertained - 4 ]2 26 49 118 54 21 8 1 1 1 1 1 1 8 4 10 7 1 2 1 6 3 14 11 14 24 9 2 4 1 1 1 1 6 12 16 33 68 41 17 10 3 1 4 1 1 1 5 1 1 1 16 27 64 97 210 126 48 22 8 2 6 1 2 3 7 1 2 294 4 32 90 2 211 10 627 16 Having foveate marks, 294 ; 4 died, or \'3 per cent. ,, partly or faintly foveate marks, 32 ; none died. „ smooth, faint or thick scars, 90; 2 died; 22 per cent. And as regards age, the four fatal cases amongst the foveated class occur in each of the four periods, 15 to 20, 20 to 30, 30 to 40, and 50 to 60; whilst the two fatal cases in the scarred class occurred amongst the ages 20 to 30, and 30 to 40. Excluding two of whom the ages were not ascertained, the per-centage proportion of the various qualities of scars at each of those age periods is as follows {see Table LXXXV.):— Under 10 Years. 10 to 30 Years. 30 Years and upwards. All ages. Per cent. Per cent. Per cent. Per cent. Plain foveate - 61-5 75-9 62-7 70-7 Partly (or faintly) 8-6 7-4 7-7 fo-veate. Smooth, faint or thiick 38-5 15-3 29-9 21-5 Eores. Area of Scars.—The classification of the vaccination scars aceordmg to their areas here adopted is that em- ployed in the statistical tables of the Metropolitan Asylums Board, upon the basis of which Table LXXXIII. has been constructed. The groups are three in number, viz., Class A', having marks the total area of which measures one half or more than one square inch; Class A^, in which the total area of marks is one third Oi less than one half square inch; and Class A^, in which the total area is less than one-third square inch. The area was obtained in 290 cases,* of which 246 fall into Class A' (three deaths, mortality 1 per cent.) ; 27 into Class A (one death, mortality 37 per cent.); and 17 into Class A^ (one death, mortality 5'8 per cent.;. The three fatal cases in Class A' fell into periods 30 to 40, two cases; and 50 Co 60, one case ; the one fatal case in Class A^ was in period 15 to 20; and the one in Class A' was in perioa 30 to 40 years. • It may be added that this and other details were obtained as regards the vaccination of several of the inmates ol: the houses visited who did not have small-pox ; but the facts so obtained do not seem of sufficient value to be subjeoted to analysis.