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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    pox : in this case the infant should, if possible, be kept under observation until the arm is healed. There are two obvious sources of danger in vaccinating very young infants. i. A considerable number of the children born in our workhouses, infirmaries, and lying-in charities are born under circumstances which entail distress and disgrace on the mother; consequently they are often feeble, and. sometimes diseased. ii. The mother may take her discharge and leave the institution just at the time when the child’s arm is most inflamed; thus she may return to conditions of life which cannot fail to be harmful to the child. If, on account of the prevalence of small-pox, it be necessary to vaccinate newly-born children, it is unreasonable and probably harmful to vaccinate in four or five places1—to give, that is, the same dose of the virus to a newly-born infant as would be given to an adult man ; such a procedure is contrary to sound principles of therapeutics. Yet it may be inadvisable that a child, vaccinated in one place only, should receive a certificate of successful vaccination ; and a parent, whose infant was thus vaccinated, might be required to have it vaccinated fully at the expiration of a year from the first operation. Previous health of child.—In many cases which I have inquired into, the child, previous to its vaccination, had been suffering from some ailment which could not fail to affect its general health. Among these may be mentioned convulsions, diarrhoea and vomiting, scrofulous glands, eczema, and so forth. Again in several cases the child had just been weaned, or put on some new kind of food, fed on unsuitable food, or fed insufficiently. The vaccination of such children is contrary to the regulations issued by the Local Government Board. Care must be taken to select children for vaccination; and not to perform the operation, as sometimes is the case, on children who are obviously unfit. If the time limit for vaccination be extended to six months it will give vaccinators more freedom in this selection, and enable them to defer the operation in cases in which the child’s health is uncertain. Circumstances.2—There is considerable risk (a) in bringing children to be vaccinated from houses in which there are cases of acute infectious disease : (b) in bringing them at the time of vaccination into direct or indirect contact with infectious disease : (c) in exposing them to possible infection from sloughing or open wounds, purulent ophthalmia, or dis¬ charges of any kind : (d) in subjecting them after vaccination to un¬ healthy conditions such as result from gross sanitary defects. Cases of vaccinal injury resulting presumably from each of these causes have been investigated and recorded. No open wound would be expected to pursue a normal course under such conditions; but persons responsible for the care of children among the poor often, from ignorance or negligence, disregard the most ordinary precautions. 1 Final Report R.C.V. p. 115, par. 441. 2 Ibid. par. 445.