The Leicester method of dealing with small-pox / by C. Killick Millard.

  • Charles Killick Millard, 1870?1952.
Date:
1904
Catalogue details

Licence: In copyright

Credit: The Leicester method of dealing with small-pox / by C. Killick Millard. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    household can be protected by vaccination, and the disease will prob- ably go no farther. The same explanation holds good also in the case of unvaccinated adults. Indeed, under modern conditions of small-pox prevention it seems probable that there is less risk of the infection being spread by well-marked cases of the disease than by very slight and easily overlooked cases. Now the former is the type of case usually met with in unvaccinated persons, whilst the latter is common in the vaccinated. Hence, it is possible that, so far from the unvacci- nated being the real danger to the community, it is rather the vaccinated who are so. It may be urged'in reply to this, that very slight and easily-overlooked cases do sometimes occur in un vaccinated subjects. This is true, but it is relatively very much less common than amongst the vacci- nated. Moreover, it only happens (as a rule) provided the prevailing type of the disease is very mild, so that even if spread does occur the consequences are much less serious. This raises rather an impoftant consideration. I put it forward with some diffidence, because at present it is merely a suggestion, but it is only by looking at every possible aspect of a question that we are likely to arrive at the whole truth. The point I would submit for consideration is this : Is it possible that the type or “ strain ” of disease propagated by vaccinated cases of small-pox differs at all from that propagated by unvaccinated cases ? } We know that the severity of an attack of small-pox varies greatly in the same epidemic in different individuals. This, no doubt, is due to differences in the “ soil,” i.e., the constitution of the individual. But beyond this, the severity of different epidemics, or, as we say, the “ prevailing type ” of the disease, varies greatly even in the same locality and amongst the same population. This, no doubt, is'chiefly due to differences in the “ seed.” It is obviously of the highest importance that the type of the disease should be kept as mild as possible. The experience gained in the days of inoculation taught that a careful selection of very mild cases from which to obtain the infective matter with which to inoculate, was of much importance in securing a mild type of the disease in the person inoculated. At the present day, as we have seen, infection is very largely spread by slight unrecognized cases. Now, such cases occurring in un vacci- nated subjects implies the very mildest type or “ strain ” of the disease which it is possible to obtain, just the kind of case which we should choose if we could select our source of infection. On the oth^r hand, slight unrecognized cases occurring in vaccinated