Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1845-6 / by C. West.

  • Charles West
Date:
1847
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Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1845-6 / by C. West. Source: Wellcome Collection.

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    1st. That the preservative power of vaccination is almost always permanent, and that when it is not so the period of immunity varies greatly according to individual peculiarities. 2d. That the vaccine virus does undergo a positive deterioration by transmission through successive individuals. 3d. It is there¬ fore desirable to obtain fresh lymph frequently, which might be done by taking it annually from the cow, by which we should be much more sure of succeeding than by retrovaecination or any similar means. 4th. There is no necessary connexion between the intensity of the local phenomena of vacci¬ nation and its preservative power, but there is such a relation between the preservative power and the amount of constitutional disturbance. 5th. Revaccination is desirable not because it is always necessary, but because we have no means of distinguishing the cases where it is needed from those in which it is superfluous. A very elaborate collection of statistics, intended to illustrate the same questions as are treated of by Dr. Steinbrenner, has been made by Dr. Lane,* but is not of a kind to admit of abstract. In an account of an epidemic of smallpox at Heidelberg, and of revacci¬ nations which he practised there, Dr. Hoeflet makes an assertion which is opposed to general experience. He asserts that he found the pustules of re vaccination bear to those of primary vaccination just the same relation as those of a second attack of variola bear to those of a first attack. He slates, moreover, that he observed this modification, although he never employed revaccine lymph, and though he always vaccinated directly from arm to arm. M. Legendrej has related the particulars of some chronic affections of the shin which were cured by the appearance of the eruption of smallpox. The cases which underwent improvement were either papular, vesicular, or pustular, while an eruption of porrigo favosa of the scalp was not in the least benefited by a copious eruption of smallpox. DYSCRASIiE, ETC. Gangrene. Dr. Battersby§ describes a case of gangrene of the skin in a female child, aged 10 months. The disease began with the appearance on the limbs of several vesicles, a good deal like those of varicella, but larger, the cutis beneath some of them being black and gangrenous. The child lived for a fortnight, during which time no attempt took place at separation of the dead parts, and the gangrene extended from the thigh to the vulva, and partly up the abdomen. Dr. Battersby mentions a similar case recorded by Dr. Hutton in 4 Dublin Journal,’ xvii. p. 485. [A case is mentioned by Rilliet and Barthez, * Maladies des Enfans,’ ii p. 195; references to others are given by Richter, £ Ueber den Brand der Kinder,’ pp. 9-12; and one instance of it came under the notice of the writer of this Report, in which the skin of the face was affected.] Scrofula. Mr. Phillips’s Treatise on Scrofula [j contains a very large amount of valuable statistical information. The grand objects of the work, however, is to prove the non-identity of phthisis and scrofula. He confesses the apparent identity of the deposit, however tested ; but in scrofula inflammatory change in the gland precedes the deposit; while the lung is unaltered around a simple deposit of tubercle. Further, the two diseases are not prevalent in the same districts, nor in the same sex, nor at the same age, and 18 out of 20 phthisical patients show no sign of scrofula; from all which facts taken together Mr. Phillips draws the conclusion that though allied they are not identical diseases. * American Journal of Med. Sci., July, 1846. + Gaz. Med., April 25, 1846. X Op. cit., p. 439-449. § Dublin Hospital Gazette, March 15, 1846. || Scrofula,—its Nature, its Causes, its Prevalence, and the Principles of Treatment. 8vo, London, 1846. C. ANDJ. ABLAflD, PR1 NTE11S, BAICIHOLOM E\V CLOSE.