See also:

• VACCINATION (from Lat. vacca, a cow)

VACCINATION (from See also:

• LAT

Lat. vacca, a cow)  , the See also:

• TERM

term originally devised for a method of protective inoculation against small-pox, consisting in the intentional transference to the human being of the eruptive disease of See also:

• CATTLE (Norman Fr. catel, from Late Lat. capitale, wealth or property, a word applied in the feudal system to movable property and particularly to live stock, and surviving in its wider meaning as " chattel " or " chattle ")

cattle called cow-pox (vaccinia) . The See also:

• DISCOVERY

discovery of See also:

• VACCINATION (from Lat. vacca, a cow)

vaccination is due to Dr See also:

• EDWARD

Edward See also:

• JENNER, EDWARD (1749-1823)
• JENNER, SIR WILLIAM, BART

Jenner (q.v.), at the See also:

• TIME (0. Eng. Lima, cf. Icel. timi, Swed. timme, hour, Dan. time; from the root also seen in " tide," properly the time of between the flow and ebb of the sea, cf. O. Eng. getidan, to happen, " even-tide," &c.; it is not directly related to Lat. tempus)
• TIME, MEASUREMENT OF
• TIME, STANDARD

time a See also:

• COUNTRY (from the Mid. Eng. contre or contrie, and O. Fr. cuntree; Late Lat. contrata, showing the derivation from contra, opposite, over against, thus the tract of land which fronts the sight, cf. Ger. Gegend, neighbourhood)

country medical practitioner of See also:

• BERKELEY
• BERKELEY, GEORGE (1685–1753)
• BERKELEY, MILES JOSEPH (1803-1889)
• BERKELEY, SIR WILLIAM (c. 1608-1677)

Berkeley, in the vale of See also:

• GLOUCESTER
• GLOUCESTER (abbreviated as pronounced Glo'ster)
• GLOUCESTER, EARLS AND DUKES OF
• GLOUCESTER, GILBERT DE CLARE, EARL OF (1243-1295)
• GLOUCESTER, RICHARD DE CLARE, EARL OF (1222-1262)
• GLOUCESTER, ROBERT, EARL OF (d. 1147)
• GLOUCESTER, THOMAS OF WOODSTOCK, DUKE

Gloucester, whose investigations were first published in 1798 in the See also:

• FORM (Lat. forma)

form of a pamphlet entitled An Inquiry into the Causes and Effects of the Variolae Vaccinae, &c . Many years previously, while he was an apprentice to a medical See also:

• MAN
• MAN, ISLE OF (anc. Mona)

man at Sodbury, near See also:

• BRISTOL
• BRISTOL, EARLS AND MARQUESSES OF
• BRISTOL, GEORGE DIGBY, 2ND EARL OF1 (1612-1677)
• BRISTOL, JOHN DIGBY, 1ST EARL OF 6 (1580-1653)

Bristol, his See also:

• ATTENTION (from Lat. ad-tendo, await, expect; the condition of being " stretched " or " tense ")

attention was directed to a belief, widely prevalent in See also:

• GLOUCESTERSHIRE

Gloucestershire during the latter See also:

• HALF

half of the 18th See also:

• CENTURY (from Lat. centuria, a division of a hundred men)

century, that those persons who in the course of their employment on See also:

• DAIRY

dairy farms happened to See also:

• CONTRACT
• CONTRACT (Lat. contract us, from contrahere, to draw together, to bind)

contract cow-pox were thereby protected from a subsequent attack of small-pox . In particular, his See also:

• INTEREST

interest was aroused by a casual remark made by a See also:

• YOUNG
• YOUNG, A
• YOUNG, ARTHUR (1741-1820)
• YOUNG, BRIGHAM (1801-1877)
• YOUNG, CHARLES MAYNE (1777–1856)
• YOUNG, EDWARD (1683–1765)
• YOUNG, JAMES (1811-1883)
• YOUNG, THOMAS (1773-1829)

young countrywoman who happened to come to the See also:

• SURGERY
• SURGERY (Fr. chirurgie, from Gr. Xetpoupyfa, i.e. hand-work)

surgery one See also:

• DAY (O. Eng. dreg, Ger. Tag; according to the New English Dictionary, " in no way related to the Lat. dies")
• DAY, JOHN (1574-1640?)
• DAY, THOMAS (1748-1789)

day for See also:

• ADVICE (Fr. avis, from Lat. ad, to, and visum, viewed)

advice, and who, on See also:

• HEARING (formed from the verb " to hear," O. Eng. hyran, heron, &c., a common Teutonic verb; cf. Ger. Koren, Dutch hooren, &c.; the O. Tent. form is seen in Goth. hausjan; the initial h makes any connexion with " ear," Lat. audire, or Gr. &Kobew very doub

hearing mention made of small-pox, immediately volunteered the statement that she could not take the disease, as she had had cow-pox . On coming up to See also:

• LONDON

London in 1770, to finish his medical See also:

• EDUCATION

education, Jenner became a See also:

• PUPIL (Lat. pupillus, orphan, minor, dim. of pupus, boy, allied to puer, from root pm- or peu-, to beget, cf. "pupa," Lat. for " doll," the name given to the stage intervening between the larval and imaginal stages in certain insects)

pupil of See also:

• JOHN
• JOHN (1167–1216)
• JOHN (1290-c. 1320)
• JOHN (1296-1346)
• JOHN (1371–1419)
• JOHN (1468-1532)
• JOHN (1801-1873)
• JOHN (Heb. llni')
• JOHN (ZAPOLYA) (1487-1540)
• JOHN, 4TH MARQUESS OF TWEEDDALE (c. 1695-1762)
• JOHN, DON (1545-1578)
• JOHN, DON (1629–1679)
• JOHN, GOSPEL OF ST
• JOHN, or HAYS (1513–1571)
• JOHN, THE APOSTLE
• JOHN, THE EPISTLES OF

John See also:

• HUNTER, JOHN (1728-1793)
• HUNTER, ROBERT MERCER TALIAFERRO (r8o9-1887)
• HUNTER, SIR WILLIAM WILSON (1840-19oo)
• HUNTER, WILLIAM (1718–1783)
• HUNTER, WILLIAM ALEXANDER (1844-1898)

Hunter, with whom he frequently discussed the question of the possibility of obtaining See also:

• PROTECTION

protection against small-pox . On his return to his native See also:

• VILLAGE

village of Berkeley in 1773, to practise as a medical man, he took every opportunity of talking over and investigating, the See also:

• MATTER

matter, but it was not until May 1796 that he actually began to make experiments . His first See also:

• CASE
• CASE, JOHN (d. 1600)

case of vaccination was that of a boy eight years of See also:

• AGE (Fr. age, through late Lat. aetaticum, from aetas)

age, named See also:

• JAMES
• JAMES (Gr. 'IlrKw,l3or, the Heb. Ya`akob or Jacob)
• JAMES (JAMES FRANCIS EDWARD STUART) (1688-1766)
• JAMES, 2ND EARL OF DOUGLAS AND MAR(c. 1358–1388)
• JAMES, DAVID (1839-1893)
• JAMES, EPISTLE OF
• JAMES, GEORGE PAYNE RAINSFOP
• JAMES, HENRY (1843— )
• JAMES, JOHN ANGELL (1785-1859)
• JAMES, THOMAS (c. 1573–1629)
• JAMES, WILLIAM (1842–1910)
• JAMES, WILLIAM (d. 1827)

James Phipps, whom he inoculated in the See also:

• ARM (a common Teutonic word; the Indo-European root is ar, to join or fit; cf. the Lat. armus, shoulder, and the plural word arma, weapons, Gr. apphs, joint, and the reduplicated apapilKSV, to join)

arm with cow-pox matter taken from a sore on the See also:

• HAND
• HAND (a word common to Teutonic languages; cf. Ger. Hand, Goth. handus)
• HAND, FERDINAND GOTTHELF (1786-185r)

hand of Sarah Nelmes, a dairymaid, who had become infected with the disease by milking cows suffering from cow-pox . It was apparently not until 1798 that he made his first See also:

• ATTEMPT (Lat. adtemptare, attentare, to try)

attempt to carry on a See also:

• STRAIN (through O. Fr. straindre, estraindre, mod. i treindre, from Lat. stringere, to draw tight, related to stress, stretch, string, &c.)

strain of See also:

• LYMPH

lymph from arm to arm . In the See also:

• SPRING (from " to spring," " to leap or jump up," " burst out," O. Eng., springau, a common Teut. word, cf. Ger. springer, possibly allied to Gr. QnrFpxecOac, to move rapidly)

spring of that See also:

• YEAR

year he inoculated a See also:

• CHILD
• CHILD, FRANCIS JAMES (1825-1896)
• CHILD, L
• CHILD, LYDIA MARIA (1802-1880)
• CHILD, SIR FRANCIS (1642-1713)
• CHILD, SIR JOHN (d. 1690)
• CHILD, SIR JOSIAH (163o - 1699)

child with matter taken directly from the nipple of a cow, and from the resulting vesicle on the arm of the child first operated upon, he inoculated, or, as it may now be more correctly termed, " vaccinated," another . From this child several others were vaccinated . From one of these a See also:

• FOURTH

fourth remove was success-fully carried out, and finally a fifth . Four of these See also:

• CHILDREN, LAW RELATING TO

children were subsequently inoculated with small-pox—the " variolous test "—without result .

The success of many such experiments, in his own hands and in those of his contemporaries, led Jenner to See also:

• EXPRESS (through the French from the past participle of the Lat. exprimere, to press out, by transference used of representing objects in painting or sculpture, or of thoughts, &c. in words)

express his belief—a mistaken one, as events have proved—that the protective See also:

• INFLUENCE (Late Lat. influentia, from influere, to flow in)

influence of vaccination would be found to last throughout the lifetime of the See also:

• PERSON, OFFENCES AGAINST THE

person operated on . Obviously he did not realize the fact that the data at his disposal were insufficient for the formation of an accurate See also:

• JUDGMENT

judgment on this point, since time alone could _prove the exact duration of the protection originally obtained . Subsequent experience has demonstrated that, as has been well said by a writer in the See also:

• EDINBURGH

Edinburgh See also:

• REVIEW (Fr. revue, from revoir, to see again, Lat. re and videre)

Review, " even after efficient vaccination a slow progress away from safety and towards danger is inevitable, and re-vaccination at least once after childhood is necessary if protection is to be maintained . " In applying to cow-pox the term " variolae vaccinae," Jenner gave expression to his belief that this disease was in Relation- reality nothing more nor less than small-pox of the See also:

• SHIP

ship of cow . But soon it was discovered that if there were small- such a malady as " small-pox of the cow," there pox and was also, as Dr Loy first satisfactorily demonstrated, cow-pox. a small-pox of the See also:

• HORSE (a word common to Teutonic languages in such forms as hors, hros, ros; cf. the Ger. ross)

horse, which, under the name of " grease," was resorted to from time to time as a source of vaccine lymph . Jenner had, indeed, put forward the See also:

• SUGGESTION

suggestion that " grease " was a necessary antecedent to cow-pox; but even taking this term to have been used by him in the sense of horse-pox, he was, in all See also:

• PROBABILITY (Lat. probabilis, probable or credible)

probability, mistaken in his See also:

• ASSUMPTION, FEAST OF

assumption . At the same time, however, there can be little doubt that these two diseases are very closely allied, if indeed they be not identical . As See also:

• EVIDENCE (Lat. evidentia, evideri, to appear clearly)

evidence of a definite relationship between human small-pox and cow-pox, it may be mentioned that whereas, See also:

• PRIOR (from Lat. prior—former, and hence superior, through O. Fr. priour)
• PRIOR, MATTHEW (1664-1721)

prior to the introduction of vaccination, epidemics of these disorders frequently arose See also:

• CON

con-currently, the so-called'" natural " cow-pox has now in See also:

• GREAT

great measure disappeared . There is, moreover, no appreciable difference in the See also:

• MINUTE
• MINUTE (Lat. minutes, small; minuere, to make less)

minute anatomical appearances characteristic of the eruption following on inoculation of one or other of these two affections in the human subject . But of far greater importance in this connexion are the results obtained by numerous observers who, in various parts of the See also:

• WORLD

world, and almost from the time of Jenner onwards, have set themselves the task of attempting, by experimental methods, to solve the problem of the true relationship of variola to vaccinia . As the outcome of this See also:

• WORK

work it may now be definitely stated that small-pox lymph, more especially, as the See also:

• PRESENT

present writer has shown, if obtained from the See also:

• PRIMARY

primary vesicle of a case of the inoculated form of the disease, by passage through the See also:

• SYSTEM

system of the See also:

• CALF
• CALF, THE GOLDEN

calf can be so altered in See also:

• CHARACTER (Gr. xapareri7p, from xap&crew, to scratch)

character as to become deprived of its See also:

• POWER [WILLIAM GRATTAN] TYRONE (1797-1841)

power of causing a generalized eruption, while inducing at the site of inoculation a vesicle indistinguishable from a typical vaccine vesicle; and, more important still, that when transferred again to man, it has by such treatment completely lost its former infectious character . Such being the case, it may fairly be asserted that cow-pox, or rather that artificially inoculated form of the disease which we term vaccinia, is nothing more nor less than variola modified by transmission through the bovine See also:

• ANIMAL
• ANIMAL (Lat. animalis, from anima, breath, soul)

animal .

An outbreak of small-pox, indeed, may be turned to See also:

• ACCOUNT
• ACCOUNT (through O. Fr. acont, Late Lat. comptum, cornputare, to calculate)

account for raising, by appropriate experimental methods, a fresh stock of vaccine lymph . There is much evidence to prove that the results following on vaccination are due to a specific contagium, and, moreover, that the particular micro-organism concerned is capable 9acierlo• of existing, during one See also:

• PERIOD
• PERIOD (Gr. irepioSos, a going or way round, circuit, aepi, round, and &Sis, way, road)

period of its See also:

• LIFE

life-See also:

• CYCLE
• CYCLE (Gr. KUK)^os, a circle)

cycle, in a logy . resting or spore form, in which See also:

• CONDITION (Lat. condicio, from condicere, to agree upon, arrange; not connected with conditio, from condere, conditum, to put together)

condition it is more resistant to the germicidal effects of glycerine than is the case with non-sporing microbes . See also:

• ADVANTAGE

Advantage is taken of this fact, in the method devised by the present writer, and now employed officially in See also:

• ENGLAND
• ENGLAND, THE CHURCH OF

England, as also on the See also:

• CONTINENT (from Lat. continere, "to hold together "; hence " connected," " continuous ")

Continent and in See also:

• AMERICA

America, for ensuring the bacteriological purity of vaccine lymph . Up to the present, unfortunately, no satisfactory method has been discovered by which the micro-organism of vaccinia can be unfailingly cultivated on artificial See also:

• MEDIA

media while still retaining its specific properties . The publication in 1896 of the final See also:

• REPORT (O.Fr. report or raport, modern rapport, from O.Fr. reporter, mod. rap porter, Lat. reportare, to bring back, in poetical use only, of bringing back an account, news, &c.)

report of the See also:

• ENGLISH

English Royal See also:

• COMMISSION (from Lat. commissio, committere)

Commission on Vaccination, in which the various phases of the vaccination question are discussed on the basis of evidence Vaccina- obtained from witnesses of all shades of See also:

• OPINION (Lat. opinio, from opinari, to think)

opinion during Hon Con- a period extending over no less than six years, consider- See also:

• MISSION

mission, ably simplifies the task of dealing with this subject . The '889-96 . Royal Commission, originally numbering fifteen members,' with See also:

• LORD
• LORD (O. Eng. hldford, i.e. hldfweard, the warder or keeper of bread, hlIf, loaf; the word is not represented in any other Teutonic language)
• LORD, JOHN (1810-1894)

Lord See also:

• HERSCHELL, FARRER HERSCHELL, 1ST BARON (1837-1899)

Herschell as See also:

• PRESIDENT (Fr. president, from Lat. praesidens, post-Augustan Lat. for praeses, director, ruler, from praesidere, to sit in front of, preside)

president, was appointed in May 1889, the ' The See also:

• ORIGINAL

original Commissioners were—Lord Herschell, C . See also:

• BRADLAUGH, CHARLES (1833-1891)

Bradlaugh, Dr Bristowe, Dr See also:

• COLLINS, ANTHONY (1676-1729)
• COLLINS, JOHN CHURTON (1848-1908)
• COLLINS, MORTIMER (1827-1876)
• COLLINS, WILLIAM (1721-1759)
• COLLINS, WILLIAM (1787–1847)
• COLLINS, WILLIAM WILKIE (1824–1889)

Collins, See also:

• SIR

Sir C . Dalrymple, J . S . See also:

• DUGDALE, SIR WILLIAM (16o5-1686)

Dugdale, Q.C., Prof .

M . See also:

• FOSTER, GEORGE EULAS (1847– )
• FOSTER, JOHN (177o-1843)
• FOSTER, MYLES BIRKET (1825-1899)
• FOSTER, SIR CLEMENT LE NEVE (1841-1904)
• FOSTER, SIR MICHAEL (1836-r9o7)
• FOSTER, STEPHEN COLLINS (1826-1864)

Foster, Sir E . H . Galsworthy, Sir Guyer Hunter, J.See also:

• HUTCHINSON
• HUTCHINSON, ANNE (c. 1600-1643)
• HUTCHINSON, JOHN (1615-1664)
• HUTCHINSON, JOHN (1674-1737)
• HUTCHINSON, SIR JONATHAN (1828– )
• HUTCHINSON, THOMAS (1711-1780)

Hutchinson, Sir James See also:

• PAGET, SIR JAMES, BART

Paget, J . A . See also:

• PICTON, SIR

Picton, Sir See also:

• WILLIAM
• WILLIAM (1143-1214)
• WILLIAM (1227-1256)
• WILLIAM (1J33-1584)
• WILLIAM (A.S. Wilhelm, O. Norse Vilhidlmr; O. H. Ger. Willahelm, Willahalm, M. H. Ger. Willehelm, Willehalm, Mod.Ger. Wilhelm; Du. Willem; O. Fr. Villalme, Mod. Fr. Guillaume; from " will," Goth. vilja, and " helm," Goth. hilms, Old Norse hidlmr, meaning
• WILLIAM (c. 1130-C. 1190)
• WILLIAM, 13TH

William See also:

• SAVORY, SIR WILLIAM SCOVELL, BART

Savory, S . See also:

• WHITBREAD, SAMUEL (1758-1815)

Whitbread, F . Meadows See also:

• WHITE
• WHITE, ANDREW DICKSON (1832– )
• WHITE, GILBERT (1720–1793)
• WHITE, HENRY KIRKE (1785-1806)
• WHITE, HUGH LAWSON (1773-1840)
• WHITE, JOSEPH BLANCO (1775-1841)
• WHITE, RICHARD GRANT (1822-1885)
• WHITE, ROBERT (1645-1704)
• WHITE, SIR GEORGE STUART (1835– )
• WHITE, SIR THOMAS (1492-1567)
• WHITE, SIR WILLIAM ARTHUR (1824--1891)
• WHITE, SIR WILLIAM HENRY (1845– )
• WHITE, THOMAS (1628-1698)
• WHITE, THOMAS (c. 1550-1624)

White, Q.C . Mr Bradlaugh, Dr Bristowe and Sir William Savory died during the progress of the inquiry . Only one of the vacancies thus caused was filled up, Mr J . A . See also:

• BRIGHT, JOHN (1811-188g)
• BRIGHT, SIR CHARLES TILSTON

Bright having been appointed on the See also:

• DEATH

death of Mr Bradlaugh.terms of reference being as follows: " To inquire and report as to—(s) The effect of vaccination in reducing the prevalence of, and mortality from, small-pox .

(2) What means, other than vaccination, can be used for diminishing the prevalence of small-pox; and how far such means could be relied on in See also:

• PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place of vaccination . (3) The objections made to vaccination on the ground of injurious effects alleged to result therefrom; and the nature and extent of any injurious effects which do, in fact, so result . (4) Whether any, and, if so, what means should be adopted for preventing or lessening the See also:

• ILL

ill effects, if any, resulting from vaccination; and whether, and, if so, by what means, vaccination with animal vaccine should be further facilitated as a See also:

• PART

part of public vaccination . (5) Whether any alterations should be made in the arrangements and proceedings for securing the performance of vaccination, and, in particular, in the provisions of the Vaccination Acts with respect to prosecutions for non-compliance with the See also:

• LAW
• LAW (0. Eng. lagu, M. Eng. lawe; from an old Teutonic root lag, " lie," what lies fixed or evenly; cf. Lat. lex, Fr. loi)
• LAW, JOHN (1671—1729)
• LAW, WILLIAM (1686-1761)

law." The evidence given before the Royal Commission was published at intervals in a See also:

• SERIES (a Latin word from serere, to join)

series of See also:

• BLUE (common in different forms to most European languages)

Blue-books, but, as stated, it was not until See also:

• AUGUST (originally Sextilis)

August 1896 that the final report made its See also:

• APPEARANCE (from Lat. apparere, to appear)

appearance . As regards the effect of vaccination in reducing the prevalence of, and mortality from, small-pox, the following conclusions were arrived at, Dr Collins and Mr Picton alone dissenting: " (1) That it diminishes the liability to be attacked by the disease . (2) That it modifies the character of the disease and renders it (a) less fatal, and (b) of a milder or less severe type . (3) That the protection it affords against attacks of the disease is greatest during the years immediately succeeding the operation of vaccination . It is impossible to See also:

• FIX, THEODORE (180o-1846)

fix with precision the length of this period of highest protection . Though not in all cases the same, if a period is to be fixed, it might, we think, fairly be said to See also:

• COVER (from the Fr. convert, from couvrir, to cover, Lat. cooperire)

cover in See also:

• GENERAL
• GENERAL (Lat. generalis, of or relating to a genus, kind or class)

general a period of nine or ten years . (4) That after the See also:

• LAPSE (Lat. lapses, a slip or departure)

lapse of the period of highest protective potency, the efficacy of vaccination to protect against attack rapidly diminishes, but that it is still considerable in the next quinquennium, and possibly never altogether ceases, (5) That its power to modify the character of the disease is also greatest in the period in which its power to protect from attack is greatest, but that its power thus to modify the disease does not diminish as rapidly as its protective influence against attacks, and its efficacy, during the later periods of life, to modify the disease is still very considerable . (6) That re-vaccination restores the protection which lapse of time has diminished,- but the evidence shows that this protection again diminishes, and that, to ensure the highest degree of protection which vaccination can give, the operation should be at intervals repeated . (7) That the beneficial effects of vaccination are most experienced by those in whose case it has been most thorough .

We think it may fairly be concluded that where the vaccine matter is inserted in three or four places, it is more effectual than when introduced into one or two places only, and that if the vaccination marks are of an See also:

• AREA

area of half a square See also:

• INCH (O. Eng. ynce from Lat. uncia, a twelfthpart; cf. " ounce," and see As)

inch, they indicate a better See also:

• STATE
• STATE, GREAT OFFICERS OF

state of protection than if their area be at all considerably below this." For the evidence, statistical or otherwise, on which these conclusions are based, the Reports of the Royal Commission should he consulted . But reference may here be made to two facts of which See also:

• PROOF (in M. Eng. preove, proeve, preve, &°c., from O. Fr . prueve, proeve, &c., mod. preuve, Late. Lat. proba, probate, to prove, to test the goodness of anything, probus, good)

proof is overwhelming . (1) Small-pox, in pre-vaccination days a disease of See also:

• INFANCY

infancy and childhood—like See also:

• MEASLES, (Morbilli, Rubeola; the M. E. word is maseles, properly a diminutive of a word meaning " spot," O.H.G. m¢sa, cf. " mazer "; the equivalent is Ger. Masern; Fr. Rougeole)

measles at the present day—has in the See also:

• UNITED

United See also:

• KINGDOM

Kingdom become a disease mainly of adults . The shifting of age-incidence can only be accounted for by the See also:

• CUSTOM (from O. Fr. costume, costume or coustume; Low Lat. costuma, a shortened form of consuetudo)

custom of vaccination in infancy . To this day, when small-pox attacks young unvaccinated children, it is found to be as virulent as, or even more virulent than, small-pox in the unvaccinated at higher ages . On the other hand, small-pox is practically unknown among well-vaccinated children . When, quite exceptionally, such children have been attacked, the disease has been so trivial in character as to be liable to See also:

• ESCAPE (in mid. Eng. eschape or escape, from the O. Fr. eschapper, modern echapper, and escaper, low Lat. escapium, from ex, out of, and cappa, cape, cloak; cf. for the sense development the Gr. iichueoOat, literally to put off one's clothes, hence to sli

escape recognition altogether . (2) Medical men, nurses and other persons exposed to the disease habitually protect themselves by efficient re-vaccination, and when this precaution has been taken, never contract small-pox . The clinical activity and bacteriological purity of the lymph employed for vaccination; the skilful performance of the operation itself; the making an adequate number Efficient of insertions of lymph over a sufficient area; the vaccinaobservance of precautions needful for ensuring strict Hon . asepsis, both at the time of vaccination and subsequently until the vaccination wounds are soundly healed—all these are matters to be regarded as essential to " efficient vaccination." Certain principles in respect of them are generally recognized, and in the case of public vaccinators, whose work comes under See also:

• GOVERNMENT
• GOVERNMENT (0. Fr. governement, mod. gouvernement, O. Fr. governer, mod. gouverner, from Lat. gubernare, to steer a ship, guide, rule; cf. Gr. xv(3epvav)

government inspection, a series of instructions on these several points are prescribed by the See also:

• LOCAL

Local Government See also:

• BOARD (O. Eng. bord)

Board . First in regard to lymph . That which is now almost universally employed in Great See also:

• BRITAIN (Gr. Hperavuml vi7vot, Bperravia; Lat. Britannia, rarely Britannia)

Britain is glycerinated See also:

• CAB (shortened about 1825 from the Fr. cabriolet, derived from cabriole, implying a bounding motion)

cab lymph, the use of which has entirely superseded, in public vaccinations, the arm-to-arm method which for many years previously had been employed as the best means then attainable of ensuring the activity and See also:

• COMPARATIVE

comparative purity of the lymph .

Glycerinated lymph, under proper conditions, usually retains its potency for many See also:

• WEEKS, EDWIN LORD (1849-1903)

weeks or months; but nevertheless, in certain circumstances at present imperfectly understood, is liable to become gradually weakened, and even eventually to become altogether inert . Possibly the condition of the calves from which the lymph is obtained, especially as regards their general See also:

• HEALTH

health and the suppleness or the See also:

• REVERSE

reverse of their skins, or exposure of the lymph to the See also:

• ACTION

action of See also:

• LIGHT

light or to a high temperature, are of See also:

• SPECIAL

special importance . Consequently, in See also:

• ORDER
• ORDER (through Fr. ordre, for earlier ordene, from Lat. ordo, ordinis, rank, service, arrangement; the ultimate source is generally taken to be the root seen in Lat. oriri, rise, arise, begin; cf. " origin ")
• ORDER, HOLY

order to ensure the best results from its use, it is not only necessary that great care should be exercised in its manufacture, but it is also advisable that the lymph should be employed for vaccination as soon as possible after bacteriological examination has demonstrated its freedom from suppurative and other extraneous micro-organisms . As regards the carrying out of the operation itself, it is somewhat unfortunate that there exists no See also:

• OFFICIAL (Late Lat. QJicialis, for class. Lat. apparitor, from officium, office, duty)

official See also:

• DEFINITION (Lat. definitio, from de-finire, to set limits to, describe)

definition of what constitutes a " successful vaccination," and in consequence it is open to any practitioner to give a certificate of successful vaccination in cases where but one minute vesicle may have been produced . It is to be feared that such certificates are too frequently given, and it cannot be too strongly urged that vaccination of this sort involves incomplete protection . The See also:

• STANDARD
• STANDARD, BATTLE OF THE

standard laid down by the Local Government Board—the See also:

• PRODUCTION (Lat. productionem, from producere, to pro-duce)

production, namely, of a See also:

• TOTAL

total area of vesiculation of not less than half a square inch, divided among four See also:

• SEPARATE

separate vesicles or See also:

• GROUPS
• GROUPS, THEORY

groups of vesicles, not less than half an inch from one another—has for the most part proved easily attainable in practice, and it is much to be desired that in private as in public work the attainment of this standard should be aimed at in every instance . The protection afforded by a primary vaccination tends gradually to diminish, and eventually to disappear more or less completely, with the lapse of time . In consequence, it is desirable that the operation should be repeated at the age of from seven to ten years, and thereafter, if it be possible, at intervals during later life . The final report of the Royal Commission thus summarizes the evidence as to the value of such additional See also:

• PROCEDURE (Fr. procedure, from Lat. procedere, to go for-ward)

procedure: " Where re-vaccinated persons were attacked by, or died from, small-pox, the re-vaccination had for the most part been performed a considerable number of years before the attack . There were very few cases where a See also:

• SHORT, FRANCIS JOB (1857– )

short period only had elapsed between the re-vaccination and the attack of small-pox . This seems to show that it is of importance, in the case of any persons specially exposed to the See also:

• RISK

risk of contagion, that they should be re-vaccinated, and that in the case even of those who have been twice re-vaccinated with success, if a See also:

• LONG, GEORGE (1800-1879)
• LONG, JOHN DAVIS (1838– )

long See also:

• INTERVAL

interval since the last operation has elapsed, the operation should be repeated for a third, and even a fourth time." It not unfrequently happens that in the case of a re-vaccination the See also:

• PROCESS

process runs a somewhat different course from that witnessed in a typical primary vaccination . In a successful re-vaccination, the site of the operation may be distinctly reddened and some-what irritable by the second day, while papules will probably make their appearance about the third to the fifth day .

The papules may or may not develop further into vesicles and pustules . Occasionally a re-vaccination appears to fail altogether; but, as pointed out by the Royal Commission, it is advisable, as in the case of a primary vaccination, to make further attempts with lymph of known potency before concluding that the individual is really insusceptible . In a certain small proportion of cases the operation of vaccination has been followed, after a longer or shorter inter- val, by various complications, of which by far the most important are those of an inflammatory nature, such as See also:

• ERYSIPELAS

erysipelas, which are not See also:

• PECULIAR

peculiar to vaccina- tion, but which constitute the danger of any local See also:

• LESION (through Fr. from Lat. laesio, injury, laedere, to hurt)

lesion of the skin, however caused . During the many decades in which vaccination from arm to arm was practised, in many millions of children, a few authenticated cases were recorded in which there was See also:

• REASON (Lat. ratio, through French raison)

reason to believe that syphilis could have been invaccinated . Such an occurrence could at no time have happened if proper care had been taken by the vaccinator; and now that the use of calf lymph has become practically x xvii . 27universal, the possibility of such occurrence in the future may be disregarded, since the calf is not capable of contracting this disease . Tubercle in its various forms and leprosy have also been included in the See also:

• LIST (O.E. lisle, a Teutonic word, cf. Dut. lust, Ger. Leiste, adapted in Ital. lista and Fr. lisle)
• LIST, FRIEDRICH (1789-1846)

list of possible complications of vaccination, though without any sufficient proof . The employment of calf lymph, treated with glycerine after the manner first advocated by S . Monckton Copeman, will obviate any such danger, for even if tubercle bacilli or the streptococcus of erysipelas were by See also:

• CHANCE (through the O. Fr. cheance, from the Late Lat. cadentia, things happening, from cadere, to fall out, happen; cf. " case ")

chance present in the lymph material when collected, it has been found experimentally that they are quite unable to survive prolonged exposure to the action of a 5o% See also:

• SOLUTION (from Lat. solvere, to loosen, dissolve)

solution of glycerine in See also:

• WATER

water . Leprosy is not 'communicable to the calf . In view of the frequency of various skin eruptions in infancy, it is to be expected that in a proportion of cases they will appear during the weeks following vaccination . See also:

• ECZEMA (Gr. EKE a, a cutaneous eruption)

Eczema and impetigo in particular have, See also:

• POST

post hoc, been attributed to vaccination, but no See also:

• DIRECT

direct connexion has been proved to exist between the operation and the occurrence of these disorders ..

In See also:

• SECTION
• SECTION (Lat. sectio, cutting, secare, to cut)

section 434 of the final report of the Royal Commission on Vaccination the extent to which other inoculable diseases are liable to complicate vaccination is thus summed up: " A careful examination of the facts which have been brought under our See also:

• NOTICE

notice has enabled us to arrive at the conclusion that although some of the dangers said to attend vaccination are undoubtedly real, and not inconsiderable in See also:

• GROSS

gross amount, yet when considered in relation to the extent of vaccination work done, they are insignificant . There is reason, further, to believe that they are diminishing under the better precautions of the present day, and with the additions of the future precautions which experience suggests, will do so still more in the future:" _ (S . M . C.) Legislation making vaccination compulsory was first introduced in See also:

• BAVARIA (Ger. Bayern)

Bavaria (1807), See also:

• DENMARK
• DENMARK (Danmark)

Denmark (18io), See also:

• SWEDEN
• SWEDEN [Sverige]
• SWEDEN, NORWAY AND

Sweden (1814), Wiirttemburg, See also:

• HESSE
• HESSE (Lat. Hessia, Ger. Hessen)

Hesse and other See also:

• GERMAN
• GERMAN, DUTCH AND SCANDINAVIAN

German states (1818), corns See also:

• PRUSSIA
• PRUSSIA (Ger. Preussen; Lat. Borussia)

Prussia (1835), the United Kingdom' (1853), German puisory See also:

• EMPIRE

empire (1874), See also:

• RUMANIA
• RUMANIA, or ROUMANIA [Romdnia]

Rumania (1874), See also:

• HUNGARY
• HUNGARY (Hungarian Magyarorszdg)

Hungary (1876), See also:

• SERVIA

Servia (1881), See also:

• AUSTRIA
• AUSTRIA, LOWER (Ger. Niederosterreich or Osterreich unter der Enns, " Austria below the river Enns ")
• AUSTRIA, UPPER (Ger. Oberosterreich or Osterreich ob der Enns, " Austria above the river Enns ")

Austria (1886) . But in many cases ton' there had been earlier provisions indirectly making it necessary . In the same way, though there is no federal compulsory law in See also:

• SWITZERLAND

Switzerland, most of the cantons enforce it; and though there is no statutory compulsion in See also:

• FRANCE
• FRANCE, ANATOLE (1844– )

France, See also:

• ITALY
• ITALY (Italia)

Italy, See also:

• SPAIN
• SPAIN (Espana)

Spain, See also:

• PORTUGAL

Portugal, See also:

• BELGIUM
• BELGIUM (Fr. Belgique; Flem. Belgic)

Belgium, See also:

• NORWAY
• NORWAY (Norge)

Norway, See also:

• RUSSIA
• RUSSIA (Rossiya)

Russia or See also:

• TURKEY

Turkey, there are government facilities and indirect pressure, apart from the See also:

• EARLY
• EARLY, JUBAL ANDERSON (1816-1894)

early popularity of vaccination which made it the usual practice . In the United States there is no federal law, but many of the separate states make their own compulsion either directly or indirectly, See also:

• MASSACHUSETTS (an Indian name, originally applied to a tribe of Indians)

Massachusetts starting in 1809 . The benefit of vaccination proved itself in the eyes of the world by its apparent success in stamping out small-pox; but there continued to be See also:

• PEOPLE

people, even of the highest competence, who regarded this as a fallacious See also:

• ARGUMENT

argument—post hoc, ergo propter hoc . The cause of " See also:

• ANTI, or CAMPA

anti-vaccination " has had many followers in England, and their persistence has had important effect in English legislation . Under the provisions of the Vaccination See also:

• ACT (Lat. actus, actum)

Act 1898, and of the Vaccination Order (1898) of the Local Government Board, with some See also:

• MINOR
• MINOR (Lat. for smaller, lesser)
• MINOR, ROBERT CRANNELL (1839-1904)

minor changes in succeeding acts, numerous changes in connexion with vaccina- tion See also:

• ADMINISTRATION (Lat. administrare, to serve)

administration and with the performance of the English operation were introduced, in addition to the super- iegisla- session of arm-to-arm vaccination, by the use of flan. glycerinated calf lymph . Thus, whereas by the Vaccination Acts of 1867 and 1871 the See also:

• PARENT, SIMON NAPOLEON (1855– )

parent or person having the custody of any child was required to procure its vaccination within three months of See also:

• BIRTH (a word common in various forms to Teutonic languages from the root of the verb " to bear ")

birth, this period by the act of 1898 was extended to six months . Again, parents were relieved of any See also:

• PENALTY (Lat. poena, punishment)

penalty under the compulsory clauses of the Vaccination Acts who afforded proof that they had, within four months of the birth of a child, satisfied a stipendiary See also:

• MAGISTRATE (Lat. magistratus, from magister, master, properly a public office, hence the person holding such an office)

magistrate, or two justices in See also:

• PETTY, SIR WILLIAM (1623-1687)

petty sessions, that they conscientiously believed that vaccination would be prejudicial to the health of the child .

Moreover, proceedings were not to be taken more than twice against a defaulting parent, namely, once under section 29 of the act of 1867, and once under section 31 of the same act, provided that the child had reached the age of four years . Finally, the II Alleged injurious effects . public vaccinator was now required to visit the homes of children for the purpose of offering vaccination with glycerinated calf lymph, " or such other lymph as may be issued by the Local Government Board." The operative procedure in public vaccinations was formerly based on the See also:

• NECESSITY (Lat. necessitas)

necessity of carrying on a weekly series of transferences of vaccine lymph from arm to arm; and for the purposes of such arm-to-arm vaccination the See also:

• PROVISION (Lat. provisio)

provision of stations, to which children were brought first for the performance of the operation, and again, after a See also:

• WEEK (from A.S. wicu, Germanic *wikon, probably=change, turn)

week's interval, for inspection of the results, was an essential . The occasional hardships to the mothers, and a somewhat remote possibility of danger to the children, involved in being taken long journeys to a vaccination station in See also:

• BAD, BCD

bad See also:

• WEATHER (O. Eng. weder; the word is common to Teutonic languages; cf. Du. weder, Dan. veir, Icel. ve8r, and Ger. Wetter and Gewitter, storm; the root is wa- to blow, from which is derived " wind ")

weather, or arising from the See also:

• COLLECTING

collecting together in one See also:

• ROOM

room of a number of children and adults, one or more of whom might happen to be suffering at the time from some infectious disorder, are a few of the reasons which appeared to render a See also:

• CHANGE (derived through the Fr. from the Late Lat. cambium, cambiare, to barter; the ultimate derivation is probably from the root which appears in the Gr. «a urmu', to bend)

change in this regulation desirable; as a matter of fact, it would appear that nothing but See also:

• GOOD, JOHN MASON (1764-1827)

good has arisen from the substitution of domiciliary for stational vaccination . There have naturally been some curious discussions before the magistrates as to what is " conscientious" or not, but the working of the so-called " See also:

• CONSCIENCE (Lat. con-scientia, literally " knowledge of a thing shared with another person " or " complete knowledge," and derivatively " consciousness in general)
• CONSCIENCE, HENDRIK (1812-1883)

conscience clause " by no means justified the somewhat gloomy forebodings expressed, both in See also:

• PARLIAMENT (Anglo-Lat. parliamentum, Fr. parlement, from parler, to speak)

Parliament and elsewhere, at the time of its See also:

• INCORPORATION (from Lat. incorporare, to form into a body)

incorporation in the act of 1898 . On the contrary, its operation appeared to tend to the more harmonious working of the Vaccination Acts, by affording a legal method of See also:

• RELIEF

relief to such parents and guardians as were prepared to affirm that they had a conscientious belief that the performance of the operation might, in any particular instance, be prejudicial to the health of the child .