Vaccinia in man : a clinical study / by Theodore D. Acland.

  • Acland, Theodore D. (Theodore Dyke), 1851-1931.
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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    of the cases the mother had been vaccinated as early as the 5th month. These facts are corroborated by an observation made by Depaul (18), that variola may be transmitted from the mother to the foetus in utero, and also by some observations recorded in the Trans¬ actions of the Epidemiological Society (1885-86, vol. v. N.S. p. 166), from which it appears that vaccination failed in three infants whose mothers had suffered from small-pox more than 16 days previous to their confine¬ ments, but was successfully performed on three children whose mothers sickened with the disease less than 8 davs before the onset of labour. Some experiments of Straus, Chambon, and Menard (55) have, a bearing on this point. They found that the blood serum of a calf, taken before the pocks were healed, produced immunity in other animals of the same species when infused into the venous system. Chauveau has also demonstrated that a generalisation, manifested by an eruption capable of reproducing the ordinary results of vaccination, could be excited by infection of horses through the digestive, circulatory, and respiratory systems, as well as by injection into the subcutaneous tissue (8). These observations, which are in agreement with the clinical facts, prove that the results of vaccination may be obtained without the production of the local pock : and under given conditions the diffusion of the virus is occasionally demonstrated by the appearance of a cutaneous eruption similar to that which occurs in the acute exanthems, even if it is not entirely analogous to them. Vaccinia generalised by auto-inoculation.—Allied to spontaneous generalised vaccinia are those sequels of vaccination which are caused by the more or less wide distribution of vaccinal pocks by auto¬ inoculation. These supernumerary pocks may be caused by scratching with the nails after they have been in contact with the vaccine pocks; or by accidental contamination of surfaces denuded of epithelium by any such cause as eczema or impetigo : they may be produced in any part of the body accidentally brought into contact with virus from the vaccine vesicles. Such cases are common, and references may be found to them in the papers already referred to, especially Dauchez, Longet, and Poole : drawings of remarkable cases are given in my paper in the Clinical Society’s Transactions, 1893, ii. p. 114, pi. ii., and in Dietter’s paper, “Drei Falle von generalisierter vaccine,” Munchen, 1893. The number of pocks varies from one or two upwards; and in the cases in which the eruption has become confluent the number is often very great. The majority of these cases are unimportant, and result only in a little temporary inconvenience, even if the eruption occur on the cheek, lips, tongue, buttocks, or breast; instances of all these cases have been placed on record.1 Such accidental inoculations have been brought about by the use of handkerchiefs, sponges, ointments, baths and beds which have been used for recently vaccinated infants; and they may 1 Felkin, R. W., “ Note upon Nine Cases of Accidental Vaccination, ” Edinburgh Obstetrical Transactions, vol. xvi. p. 107. See also for references, Sub. “Vaccine Ophthalmie,” Fiirst’s Die Patliologie der Schutzpocken-Impfung, p. 104.