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where there was an intelligent, careful and attentive watching of the inserted lymph
first, and of the resulting vesicles afterwards, there was scarcely a single instance
of failure, or doubtful case. Of course there were instances in which one or two of
the punctures did not take; but the vesicles that did make their appearance appeared
to me from the severity of their local and constitutional effects, to be quite sufficient
to give the necessary protection from small-pox. In my last report I stated that
animal vaccination was kindly received by the community of Bombay.
There
were a few dissentient voices at the commencement, but they were, before long, all
silenced. This year, however, there has again been a cry against it, strange again
from the Europeans. Their disinclination is, however, simply on the score of
the violence of the effect. Two cases were mentioned to me where the severity
of the local and constitutional irritation had proved all but fatal. In one indeed
it was thought a fortunate circumstance that only one out of four punctures
made had taken, or else in all probability the result would have been fatal.* During
an experience of some 15 months, based as it is on the personal observation of several
hundreds operated upon, and which included not a few children of those nearest and
dearest to me, I came across only three cases, where there really were serious conse-
quences as the result of the operation. In one Erysipelatous inflammation attacked the
arm, and thence extended all over the trunk and lower extremities. In the 2nd the
arm was very much inflamed and swollen, together with the glands in the axilla, and
there was a considerable amount of febrile disturbance for some days. In the 3rd the
child had badly scratched the vesicles and a deep, inflamed sore was the result, and
there was considerable tumifaction of the arm also. All the three, however, got ulti-
mately well without much difficulty. In making these statements, I do not by any
means deny the possibility of serious, nay fatal, consequences attending the use of
animal lymph, in unhealthy and weakly constitutioned children, but it would be more
as the result of the peculiar state of the system than the use of cow-lymph ; and human-
lymph, possessing the necessary amount of effectiveness and activity would, under similar
circumstances, in my opinion, lead to similar results. Bad results from the use of animal
lymph, therefore, would rather prove the carelessness of the operator, who was
remiss in his duty of selecting his subject, and the blame would attach to him more
than to the lymph he had misused. The inference, however, is undeniable—that with
animal vaccination great judgment and discretion shall have to be exercised in the
selection of subjects for the operation, and it would be a dangerous thing in the
hands of unprofessional and ignorant men, such, indeed, as constitute the bulk of
our vaccinators. I have found little infants taking animal vaccination very quietly,
and kindly ; indeed I do not recollect of a single instance in which the effects both
constitutional and local were more severe than what would be expected from the use of
ordinary human lymph of the required activity. This would lead to the conclusion
* I do not think that the constitutional effect would have been much more severe even if
all the insertions had "taken."—J. P.