§ 99. Cow-pox (Variola vaccina, tutoriae.)

Cow-pox runs a regular course, which is so well known, that it is needless to speak of it more particularly. If a morbid disposition which had been latent in the organism previous to vaccination, should be roused into action in consequence of that process, it will have to be met by the remedies indicated by the symptoms.

Vaccination does not afford any protection to individuals that are actually infected with the smallpox contagion. However, inasmuch as the infection is not indicated by any perceptible symptoms, it is impossible to define the period when vaccination will no longer be able to ward off the disease. If the smallpox should have attacked one member of a family and the other members of that family should never have been vaccinated, vaccination will prove inefficient to protect them from the disease. The remaining inhabitants of the place, however, should be vaccinated as speedily as possible, as they may still have a fair chance to be preserved from the infection. If such vaccinated individuals should nevertheless be attacked, the eruption will be somewhat similar to varioloid, but will, according to my experience, never be true smallpox.

The true, genuine cow-pox pustule, which is a reliable proof of the prophylactic virtue of the vaccine, is flat and depressed in the centre, and, on the eighth or ninth day, is surrounded with an inflammatory redness, which is the chief sign that the organism has been thoroughly infected with the vaccine; if the pustule be full and convex, and if it begin to rise three or four days after the vaccination had taken place, the prophylactic power of the virus cannot be relied upon; the vaccine was perhaps too old, or else, if the matter was good, the patient's receptivity was deficient.

On the seventh day after vaccination I have frequently seen a metastasis to glandular organs taking place. Such a metastasis, even if it should take place to the testicles and parotid glands, is not dangerous, and disappears of itself on the ninth or eleventh day, when the nervous and vascular excitement has subsided.

It has frequently happened in my practice, that morbid symptoms which would not yield to any remedy, such as a chronic inflammation of the Meibomian glands, or a discharge of badly-smelling pus from the ears, ceased entirely after vaccination, which, in such a case, ran a regular course, and was accompanied with more fever than usual.

The vaccine which is used in vaccination, should never be taken from children that have been affected with eruptions or glandular diseases, etc. The best kind of vaccine, however, may excite a latent dys-crasia in the patient, which should then be met by appropriate remedies.