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particular cause small-pox is taken after
vaccination, it is five or six times less dangerous
than it would otherwise have been. The power of
vaccination in exterminating small-pox, wholly
consists in the fact that it is a small-pox which
is not infectious. In some inscrutable way,
passage through the lower organisation of the
cow so alters the small-pox matter, that it will
produce in the human body, only by immediate
contact wilh the blood, a disorder of the mildest
form, that may be borne at any age, in any state,
and that shall not make the person touched with
it a source of danger to those who come near.
But there are certain conditions of successful
vaccination. At the outset, the right sort of
matter must be taken from the cow; for Jenner
showed that the cow is liable to other pustular
diseases which will communicate sores and raise
vesicles not of the true form, and which give no
protection against small-pox. Then, also, it
should be taken only on the day when it is ripe,
and from a pustule that has not been rubbed
and broken. In taking it from the human body
for dissemination, it is essential to observe this
rule, and to observe also the rule that it must
be taken from a healthy body, and especially
from one that is not affected by a skin disease,
for such disease will often modify the power of
the vaccine matter. Absolute care in vaccination
and universal adoption of it would have
by this time fulfilled Jenner's utmost hope for
the extinction of small-pox. What can be done
is shown by the fact that for twenty years
Sweden and Denmark were kept free from the
disease. The Austrian government went so far
as to order that no child should be admitted
into any public school, have share in any public
institution, or partake of the sacraments of the
Church, unless he had been vaccinated. The
care indicated by such exaggerated measures
did succeed in the extirpation of small-pox for
long periods

But it is said that the vaccine lymph is
enfeebled in power, by a long course of
transmission from arm to arm. We have seen that
the fresh lymph from the cow, obtained in our own
day, reproduces more exactly than the matter
commonly in use, the vaccine pustule described
by Jenner, which so strongly fortified the
constitution. Small-pox after vaccination, or the
power to take vaccination twice, which represents
a power to take small-pox after vaccination,
is by a great deal more common than it
used to be. There is annual vaccination in the
Prussian army, and it is a most instructive fact
that in the old soldiers who were vaccinated thirty
or forty years ago, vaccination will seldom take a
second time, while among the soldiers vaccinated
during the last dozen years, second vacciation
often has an ominous success. About twenty years
ago, Mr. Estlin, whose evidence corresponds
with that of many other witnesses, said of the
Vaccine Institution of Glasgow, that "in forty-
three trials made with lymph newly obtained
from the cow, there had not been a single failure,
whereas in the last preceding forty-three
vaccinations made with a former lymph, there had
been failure in ten cases, and spurious or imperfect
vesicles in nine others."

We may readily suppose that this degeneration
of lymph does not arise from the mere act
of transmission, but from the multiplication of
the chances of imperfect vaccination hurtful to
its quality, by the thousand and one vaccinators
through whose hands it may have passed. Who
can tell the pedigree of a pustule, or answer for
the accidents interfering with the quality of
matter that has been through many hundred
systems? One ignorant or careless vaccinator
who diffuses matter from the vaccinated arm of
a child with skin disease, may cause the
propagation of matter that shall give false
confidence to hundreds of men. It is known that
in the years seventeen, eighteen, and nineteen of
the century, a vast number of vaccinations were
made in different parts of Europe with
inefficient lymph, and that persons vaccinated in
those years have been found among the chief
sufferers from small-pox.

In spite, therefore, of the contrary assertion
of the National Vaccine Establishment, made
six years ago, we must agree with Mr. Simon,
Dr. Watson, and others, that well-devised
arrangements for the periodical renewal of lymph
would give greater certainty and permanence to
the protection it affords.

The next requirement is good vaccination.
Vaccine matter must be taken for use from none
but healthy bodies, always at the right time,
and only from a perfect and true cow-pox vesicle,
and by a vaccinator who has been taught to
recognise its perfect form. No child is vaccinated
properly, upon whose skin at least one vesicle
is not allowed to run its whole natural course,
unopened by the lancet and unbroken by
rubbing. There is need also, of a full and accessible
supply of the best vaccine matter, and of a
good working system of compulsory vaccination.
Give us these, and we may root out small-pox.

Having shown what we want, we may as well
consider what we have. Until eighteen 'forty we
had only the National Vaccine Establishment
for public vaccination, and the free diffusion of
the cow-pock matter. In eighteen 'forty, act of
parliament declared that gratuitous vaccination,
not to be considered parish relief, might be
claimed of the local authorities in all parishes of
England and Wales. For the three years before
this law, the mortality from small-pox was seven
hundred and seventy in a million; for the three
years after this law, three hundred and four in a
million. Still, more than five thousand persons,
chiefly infants and children, perished of
the disease every year. For this reason, in
'fifty-three, an act was passed to compel every
child to be vaccinated within four months of its
birth. At the registration of every birth, the
registrar was to give notice of the legal obligation,
and of the penalty for neglect. At first
the act was readily obeyed, and deaths from
small-pox fell to one hundred and fifty-two in
the million. Then, it was found that nobody was
charged with the enforcement of the law, or