Page:Once a Week Jul - Dec 1859.pdf/535

524 Jenner.’ Soon afterwards, and also by independent experiments, Mr. Badcock, a long-established druggist at Brighton, arrived at the same conclusion as to the origin of small-pox: and from 1840 to the present time, he has constantly been applying his knowledge to its important practical purpose, having within this period again and again derived fresh stocks of vaccine lymph from cows artificially infected by him; having vaccinated with such lymph more than 14,000 persons, and having furnished supplies of it to more than 400 medical practitioners.” In connection with the above statement, Mr. Simon most correctly remarks: “A host of theoretical objections to vaccination might have been met, or, indeed, anticipated, if it could have been affirmed sixty years ago, as it can be affirmed now—''this new process of preventing small-pox is really only carrying people through small-pox in a modified form. The vaccinated are safe against small-pox, because, in fact, they have had it''.”

Real vaccination, therefore, is carrying one through a harmless modification of small-pox. Lord Lyttelton, when he induced the legislature to pass his compulsory vaccination, neglected to make provision for securing, in respect of those operated on, proof of their actually having passed through the disease. Consequently, since as well as before the passing of that law, multitudes have been nominally vaccinated without having been efficiently influenced. The causes of this are easily found. Public vaccinators have been so miserably paid by their union contracts, that they have in too many instances delegated the duty to untaught or careless apprentices. In many more cases, neither principal nor assistant watches the case after the introduction of the lymph. If the mother or a neighbour report that “the arm has taken,” there is many a public vaccinator who forthwith enters the case as a “successful” one, and, for the same, receives, in due course, one shilling and sixpence of public money. The inadequacy of the pecuniary inducement to faithfulness, and the want in nearly all our medical schools of any provision for teaching vaccination, fully explain the fact that multitudes reputed to be vaccinated have been so only nominally, or in virtue of a worthless operation. It is not necessary, then, to say more about the terms “real” and “sham,” except that it is impossible to write or speak with accuracy on the subject of vaccination without frequently employing them, or analogous expressions.

The State having made the neglect of vaccination a punishable offence, is clearly bound, in duty and in common sense, to provide the public with it in an efficient form. This, it is obvious, can only be accomplished by means of new arrangements for teaching vaccination; by the institution of examinations for the testing of the knowledge and practical skill of candidates for employment as vaccinators; by the strict supervision of vaccinators; and by the organisation of such measures as will maintain a constant supply of good lymph. It is to the first two of these points that the new rules and plans of the Privy Council refer.

Arrangements will, if possible, be made with all recognised medical schools for the public teaching of vaccination at the principal vaccination stations in their neighbourhood; and the teachers at those and also many other stations will be authorised to give certificates of proficiency to their pupils after due examination. Such certificates of proficiency will qualify their possessors to be contracted with as public vaccinators by guardians and overseers. Directions are given as to the extent and mode of instruction. The vaccinator of an educational vaccinating station is to exhibit and explain the course and characters of the vaccine vesicles to his pupils, and to teach them in a practical way the best methods of vaccinating and of taking lymph for present or future use. He is also to explain and inculcate the precautions which are necessary with regard to the health of subjects proposed for vaccination, and the selection of lymph. Pupils are to pay a fee not exceeding one guinea, and to attend a teacher’s station for at least six weeks. Persons who have acquired their knowledge elsewhere than at a station, may, on paying one guinea, and passing an examination, receive certificates of competence. The Privy Council specifies a variety of topics upon which candidates are to be examined; and requires that they shall point out among subjects brought for inspection those from whom lymph may properly be taken, giving their reasons for the selection. When practicable, they are to see vaccination vesicles in different stages of progress, and to state in each case the date from vaccination. They are likewise to charge ivory points, or otherwise to prepare lymph for preservation.

The Privy Council, by enforcing the rules of which we have now given a summary, will be able to place national vaccination in the hands of a well-trained, competent staff. This will be an immense gain; but more than this is required to render the system altogether trustworthy. The vaccinators must be placed under such inspection as will make it impossible for them to neglect their duty without detection, and then there must be an absolute certainty that the work is rightly done.

While we inculcate the necessity of an official supervision of vaccinators, we must express our earnest hope that their services are for the future to be better remunerated than in the past. The system of cheap vaccination contracts is, in all its aspects, an injustice and a mistake. As a general rule, work which is inadequately paid for, is inadequately performed. .

are more methods than one of giving novices confidence in the water actually in use in the swimming schools of Paris. It is true, women and children are suspended, as V. describes them, by a rope from the ceiling and a belt round the waist, but there is a gentler method for the same object which is exceedingly amusing to foreigners who first witness it. The novice is still hooked by the belt, but to a rod and line held by the instructor, who plays with his heavy fish as occasion requires,—now giving him entire freedom to swim away if he can, and now preventing him from sinking or tumbling about, by a sustained pull which keeps him on the surface. Boys and men