EPIDEMIC SMALL-FOX AND VACCINE PROTECTION. By J. WILSON

JOHNSTON, M.D.,

Civil Suhgeon, Loodiaxa. It may seem eccentric to postulate that in the major portion of the Punjab vaccination has produced hut an unappreciable effect; wary scrutiny, however, leads to the cardinal conclusion no positive protective advance is being attained. The statistics of two districts declare only a mortal ratio of five per cent, to the debit of vaccination. Epidemic small-pox has made terrible havoc this year, raging as violently and fatally as if Jcnner's immortal discovery, sixty-six years ago, was un-^ heard of. Ono cannot recall too often that zymotic disease generators are ever in hypothetical existence, and only tarry for the favored moment of extreme sanitative neglect, which tends to determine specific decomposition of excrement (Simon). Few of our citics are suitably scavenged ; sweating fulzie contaminates the circum-ambient air; drainage is a vox et prceterea nihil. Is it passing strange, then, since no animal contagion is so strong and sure as that of small-pox, none that operates at so great a distance (Watson), that this loathsome malady still

that

THE INDIAN MEDICAL GAZETTE.

254

gauntly stalks amongst us, surcharging the torrent of the circulation with effete organic eremacausia, rapidly running to vesicular gangrene, hoemoptoe, colliquative diarrhoea, congestive pneumonia, death. Progressive improvements commend themselves to municipal committees, but conservation of health and protection from What would become of us, were it vies and periodic sirocco blasts, scorching up germ pores, evolved with a tendency to change and perish, the gods alone forfend ! Eyes disgusted by vile nuisance, nostrils incensed by tainted exhalation, and the general otium cum dignitate incensed and recrowd

not

poisoning

is

for Nature's

ignored. careering

sea

vulsed at human retirades, usque ad nauseam in every quiet nook and corner, are daily letters patent for a rattling epidemic

zymosis. Small-pox manifests itself with intense rigor wherever careless sanitation exists; it is pre-eminently a disease, transported and aggravesced by social neglect; this is the only specialty of its late virulence. At a minimum count small-pox has swept 25,000 Punjabees away during the past six months.* It has been most fatal in the Ivurnaul, Sirsa, Umballa, and Mooltan districts ; an equivalent to regiments of Native Infantry has been decimated each month. Why have we no Inspector of Nuisance to cast the aegis of his protection around us ? Better apply the " Mulbah" to ward off an uninvited guest, than entertain a passing stranger. The district officer must become the martador, empower a conservative establishment, deprive Cloacina cf her city revelry, enforce rigid nuisance laws, and protect us from community pollution. Until then we cannot hope for victory over morbific influence; until then small-pox will reign unchecked, or only yield before the roll of a major epidemic wave. Expense is a veto, but the octroi would cover all. Surely a tax levied on the ingesta of a community cannot be more fittingly applied than in conserving

Vaccination has exerted

[September 1, an

1866.

uncalculated and unforeseen pro-

phylaxis, checking the development of the scrofulous diathesis, and limiting equally the number and violence cf miasmatic and exanthemic disease. The general death ratio from these affections is lessened, wherever thorough protective vaccination proceeds apace (Farr) : a strong argument for compulsory vaccination. A

paltry cicatrix, recently variola; the eruption on the face was coherent; each pock was lanced and cauterized with a forty-grain solution of nitrate of silver ; not a scar was left; the application must not be delayed beyond the third day of the eruption when the papule is passing into the vesicle, when the ducts of the cuticular glandular appendages the umbilicus just are still bound to the areolar tissue, and apparent. Should the ducts slough and the bricle rupture, no protection can be hoped for. It subsequently appeared that two of the ayah's children were suffering, respectively, from small-pox and measles ; she, escaping either, had been the mediate agent of transporting the infection of both. * European child, protected by

suffered from

a

a

combined attack of roseola and

its eg esta.

To return,?anatomizing vaccine operations exhibit a maxiof scrubby cicatrices, and the populace finding little virtue in it rail against it. A step in the right direction has been taken; mum

the

General of Vaccination is authorized to

Inspector

proceed, district, vaccinating from arm to arm; take untold years to accomplish, for what is one among

seriatim, to every this will so

many ? To endow vaccine returns with

a

claim to

it is in-

veracity,

dispensable? To expunge doubtful, retain only successful and unrecord all unsuccessful, unless the vaccinator produces a scab at least one-third of an inch in diameter. 1.

successful,

2. A double record should be kept, showing [a) the proportion of thoroughly protected to vaccinated ; (b) the absolute number vaccinated, compared with the positive number of births. 3. 'The Assistant or Sub-Assistant Surgeon should yearly tour the zillah, and vaccinate from arm to arm ; then shall we

make progress and

carve success with every lancet point. Inoculation in the hill ranges frequently affords protection with slight risk. It is illegal and punitive by fine and

impriwhy should the Legislature not go ahead, and enforce vaccination by a modification of Lord Lyttleton's Act ? Prejudice cannot now be advanced. If vaccination be offensive, sonment ;

ovination is

equally efficacious (Saccho).

Yaccinc four being

complete,

protection a

is in the inverse ratio of discrete three a good, and one a lame to variolous

incomplete cicatrix, moreover, predisposes as re-vaccination, after a primary shabby scab, complete defence (Simon.) *

vesicles, guard; an reception,

never

affords

fide Return submitted to Punjab Government by the General of Dispensaries, published, in Punjab Gazette of 12th Inspector July. small-pox mortality to May, 21,503; estimated average for June,

T