Small-pox is an evil to which one may well apply the old adage: “An ounce of prevention is worth a pound of cure.” This is a truth which has been well established in the late outbreak in the City of Columbus. Some suggestions of practical importance may not be out of place at the present time.
Universal vaccination would, of course, solve the problems, as has been so aptly demonstrated in instances that are so well known as to need no citation, but there are some people who do not, or will not, believe in vaccination. These might be divided into two classes: First, those who hold erroneous ideas concerning vaccination because they are not properly informed on the subject. For this class there is hope, and we find that the number in this group is rapidly diminishing, due to the educational influence that is going on at the present time. Together with the demonstration of the splendid results obtained in the prevention of small-pox by vaccination. The second group might be termed obstinates, who will not listen to reason, and absolutely refuse to give vaccination any consideration. Occasionally the disease strikes in this class in such a way as to bring the truth home, but in no other way are we likely to reach these people unless we have compulsory vaccination under State laws. Wherever it is not possible to obtain universal vaccination, I wish to state to the general practitioner the value and importance of prompt vaccination of all exposures. It is unquestionably true in mild small-pox, at least, that a vaccination may be made three or four days after the exposure, and resulting in a successful take, will protect the exposed persons from small-pox; this is a fact too little recognized by many practitioners. On the other hand, a recognition of this fact should never serve as an excuse for delay in vaccination, because in the more virulent types of small-pox there is not the same margin of safety. One rule should be adopted, that every exposed person should be vaccination without delay. As illustrative of the value of prompt vaccination after exposures, I would cite the following cases recently occurring in this city:\
A young woman in the pustular stage of small-pox spent the evening in the family of Mr. B. It was not known until four days later that the young lady had small-ox. Therefore, four days after exposure, the family of 11 was vaccination, 10 of them never having been vaccinated previously. All of the 10 secured a successful “take,” and escaped small-pox.
In another family (that of Mrs. B.), there were five members, and a boarder made the sixth occupant of the house; the last-mentioned individual fled from the house in the popular stage of the disease, having slept until that time with a young son of the family. He was promptly vaccinated and no infection followed.
A driver for a large firm employing many such workmen had a mild attack of small-pox, and was on his wagon until it was learned that he had the disease. All the other drivers and other workmen were promptly vaccinated by the medical inspector of the city. It so happened that one driver was absent on the day of vaccination, and his absence was overlooked by the firm. This driver was the only man who subsequently developed the disease. His wife, up to the appearance of the eruption, had been unvaccinated. She was promptly vaccinated, and, refusing to be separated from her husband, accompanied him to the contagion hospital, nursing him throughout the disease, and was fully protected by her vaccination.
In another firm a driver had small-pox, and the head of the firm insisted that every driver employed by him be vaccinated or cease his work. All were vaccinated, and no subsequent cases of small-pox appeared.
Small-pox broke out in a family of 10, six of whom were adults, and being called chicken-pox, spread until nine of the 10 had the disease. The trouble was not chicken-pox, but was small-pox, and the only man who escaped was a vaccinated man. The head of the family in this case, a man 40 years of age, had been vaccinated before he was a year old, and not subsequently. He had the disease so mildly that he was not sick, and had only a couple of spots on his face, and very few on his body.
Small-pox having broken out in a saloon, and being unrecognized for a few days, there were exposures covering a considerable section of the city. A number of physicians were promptly sent to that portion of the city and in a house to house canvass vaccinated nearly the entire population of the district. As but two cases developed later in that district, and as there were many hundred vaccinated people had been exposed, the value of vaccination is evident. Of the two cases developing subsequently to this general vaccination, mention should be made in each case. One was a young man who absolutely refused to be vaccinated, although earnestly entreated, two days after his exposure. Two weeks later he was in the contagion hospital with small-pox, regretting that he had refused to be vaccinated. The other case was that of a pregnant woman, whose physician had advised her against vaccination on account of her condition. As she had just been exposed this was a mistake, vaccination should have been done. Result was that the woman gave birth to her child one evening, and the eruption of small-pox appeared the next day. It is expected that this case will prove fatal, the patient suffering from an attack of the semi-confluent type of disease. In this connection it may be stated that the child was vaccinated before it was 24 hours old, and the vaccination now (eight days later), gives every indication that it is going to protect the child from small-pox.\
Illustration of the protective value of vaccination in a nursing child occurred in the case of Mrs. N. She suffered from an attack of small-pox of moderate severity while nursing her six-month’s-old child. The child was vaccinated just as the mother had finished the popular stage. The child continued to nurse, and is yet nursing. The child’s vaccination “took,” and has shown no evidence of the disease.
When such illustrations as these are laid before thinking people, it would seem that prompt vaccination should have no opponents, and it is to be hoped that the general practitioner will bear this in mind and impart such information to his patients as will aid in stamping out small-pox, even though it has gained an entrance into a community.
No comments:
Post a Comment