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THE PURIFICATION OF VACCINE LYMPH.
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to explain the deformity and restriction of rotation. 5. Radiographic confirmation of cervical displaceSome years ago an American surgeon, ment. G. L. Walton, found that traction was useless for reduction of cervical displacements and advocated manipulation in which, by extending the head diagonally in the direction between the backward line and the lateral line on the side of the convexity, the lateral process and the lamina furnish a fulcrum by means of which the misplaced articular process is lifted. A slight rotary movement completes the reduction. In the present series of cases this method proved successful, but in two reduction Dr. Fitzsimmons contook place spontaneously. cluded that rotary cervical displacement is much more common than is supposed, and is sometimes confounded with torticollis. From this it may be distinguished by observing that the muscles on the side towards which the twist exists are relaxed.
reduced to half that required in Blaxall’s original method. This is of practical importance, since the vaccine is less fluid and its activity is preserved for many months. Those interested in the subject will find a communication in Il Policlinico, Oct. 24th (Practical Section), by Professor L. M. Spolverini, of Rome, describing the effect of the use of vaccine lymph thus prepared on 300 children in comparison with that in which ordinary glycerinated lymph was used. All the various samples of lymph used, even when more than 6-7 months old, were found to be active. Samples of ordinary caused marked local reaction, nearly always lymph a rise of temperature, occasionally as much as 38° to 38’50 C., and evident glandular swelling. On the other hand, clove-treated vaccine caused a less intense local reaction, hardly ever any glandular reaction, and only slight rise of temperature. No complications were noticed with either kind of lymph, either immediate or subsequent.
THE PURIFICATION OF VACCINE LYMPH. VENOUS BLOOD PRESSURES IN CARDIAC ONE of the most valid arguments on which antiDISEASE. vaccinationists rely for the propagation of their IN view of the fact that clinical estimations campaign against compulsory vaccination is that of of arterial blood pressure have been so generally impurity, in a bacteriological sense, of the lymph studied and found to be it is someuseful, used. This impurity constitutes the most common that what little attensurprising comparatively cause of possible complications, some of them tion has been given to the consideration of fantastic, which accompany or follow the practice venous This pressures in health and disease. of vaccination. It must be admitted that this, has been carefully studied by Dr. question especially in the past, has been a definite objection Admont H. Clark, of Baltimore, who has pubput forward by antivaccinationists, because it is lished his conclusions in an interesting paper based on the occurrence of certain facts such as, in the Archives of Internal Medicine of Oct. 15th. for example, post-vaccinal eruptions or anaemia, The employed in these observations was notwithstanding that such occurrences are open to that apparatus devised by Hooker/ It consists of a small argument as to whether they are the direct result of hemispherical shape, 2 cm. in diameter of the vaccine lymph or due to quite extraneous glass cup and 1 cm. in depth, which is sealed to the skin causes. Those responsible for the supply of lymph over a suitable vein on the back of the hand have, therefore, been aware of the importance of a rim of collodion. This is connected to a by this question, and been occupied in the search of water manometer by a rubber tube, and the methods leading to the production of a lymph air pressure in the cup can be increased by which should be at the same time both perfectly a bulb connected with the manocompressing pure and active, with the object of eliminating any meter. It is recommended that the vein be possible complication or any harmful action, how- observed by oblique illumination, the point where ever slight, on the human organism. The universal oscillations of pressure cause the vein practice at the present time for the purification and slight shadow to come and go promptly just before the preservation of vaccine lymph is based on the vessel is completely collapsed being the most action of glycerine, to which attention was first one to read off the manometer pressure called in 1894 by Professor 0. Leoni, of Rome. The satisfactory at. The so-called " heart level"was adopted for addition of a 20 per cent. watery solution of glycerine the position of the hand when the observations in the proportion of 3 or 4 to 1 of lymph had been were made-that is, " the midpoint of the anteromade use of since 1870, but merely with the object diameter of the body at the costal angle." posterior of preserving the lymph. Leoni, however, showed The necessary conditions for observations are that that while pure lymph contained numerous microthe vein must stand out sufftciently from the skin organisms, the glycerinated form after one to four level to give a distinct shadow on oblique illuminamonths not only remained specifically active but the vein wall must be collapsible, and the tion, presented a marked diminution of these extraneous patient must be lying quietly in bed. Observation of germs. Moreover, S. M. Copeman, in this country, cases to discover what is the diurnal variation who made extensive investigations on the bacterio- eight of venous pressures both in cardiac and other cases logy of vaccine lymph, advocated the storage of showed that it might be as much as 8, or even glycerinated lymph in a low temperature and in 12 cm. of water. In answer to the question as the dark. It is easy to understand that this method, to what should be regarded as a pathological though constituting a striking advance in the venous Dr. Clark takes 20 cm. of practical means of preserving and purifying the water aspressure, the limit of the normal, in upper vaccine lymph, is still far from the ideal from Hooker. He divided his this with Dr. agreeing the point of view of the absolute sterilisation cardiac cases into "compensating" and "decomof extraneous micro-organisms. Blaxall’s method of adding essence of cloves to the lymph pensating" groups, and found that in the former has been recently improved upon by De Blasi, the average venous pressure readings never went who introduced a modification by which the above 20 cm. of water, while in the latter the never went below 20 cm. Dr. Clark, essence of clove, the glycerine, and the lymph are average that a pressure above 20 cm. gives a suggests mixed in the proportion of 1, 3, 1. By this means the quantity of water added to the lymph is 1 Hooker: American Journal of Physiology, xxxv., p. 73, 1914.
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— — — — — — —
to explain the deformity and restriction of rotation. 5. Radiographic confirmation of cervical displaceSome years ago an American surgeon, ment. G. L. Walton, found that traction was useless for reduction of cervical displacements and advocated manipulation in which, by extending the head diagonally in the direction between the backward line and the lateral line on the side of the convexity, the lateral process and the lamina furnish a fulcrum by means of which the misplaced articular process is lifted. A slight rotary movement completes the reduction. In the present series of cases this method proved successful, but in two reduction Dr. Fitzsimmons contook place spontaneously. cluded that rotary cervical displacement is much more common than is supposed, and is sometimes confounded with torticollis. From this it may be distinguished by observing that the muscles on the side towards which the twist exists are relaxed.
reduced to half that required in Blaxall’s original method. This is of practical importance, since the vaccine is less fluid and its activity is preserved for many months. Those interested in the subject will find a communication in Il Policlinico, Oct. 24th (Practical Section), by Professor L. M. Spolverini, of Rome, describing the effect of the use of vaccine lymph thus prepared on 300 children in comparison with that in which ordinary glycerinated lymph was used. All the various samples of lymph used, even when more than 6-7 months old, were found to be active. Samples of ordinary caused marked local reaction, nearly always lymph a rise of temperature, occasionally as much as 38° to 38’50 C., and evident glandular swelling. On the other hand, clove-treated vaccine caused a less intense local reaction, hardly ever any glandular reaction, and only slight rise of temperature. No complications were noticed with either kind of lymph, either immediate or subsequent.
THE PURIFICATION OF VACCINE LYMPH. VENOUS BLOOD PRESSURES IN CARDIAC ONE of the most valid arguments on which antiDISEASE. vaccinationists rely for the propagation of their IN view of the fact that clinical estimations campaign against compulsory vaccination is that of of arterial blood pressure have been so generally impurity, in a bacteriological sense, of the lymph studied and found to be it is someuseful, used. This impurity constitutes the most common that what little attensurprising comparatively cause of possible complications, some of them tion has been given to the consideration of fantastic, which accompany or follow the practice venous This pressures in health and disease. of vaccination. It must be admitted that this, has been carefully studied by Dr. question especially in the past, has been a definite objection Admont H. Clark, of Baltimore, who has pubput forward by antivaccinationists, because it is lished his conclusions in an interesting paper based on the occurrence of certain facts such as, in the Archives of Internal Medicine of Oct. 15th. for example, post-vaccinal eruptions or anaemia, The employed in these observations was notwithstanding that such occurrences are open to that apparatus devised by Hooker/ It consists of a small argument as to whether they are the direct result of hemispherical shape, 2 cm. in diameter of the vaccine lymph or due to quite extraneous glass cup and 1 cm. in depth, which is sealed to the skin causes. Those responsible for the supply of lymph over a suitable vein on the back of the hand have, therefore, been aware of the importance of a rim of collodion. This is connected to a by this question, and been occupied in the search of water manometer by a rubber tube, and the methods leading to the production of a lymph air pressure in the cup can be increased by which should be at the same time both perfectly a bulb connected with the manocompressing pure and active, with the object of eliminating any meter. It is recommended that the vein be possible complication or any harmful action, how- observed by oblique illumination, the point where ever slight, on the human organism. The universal oscillations of pressure cause the vein practice at the present time for the purification and slight shadow to come and go promptly just before the preservation of vaccine lymph is based on the vessel is completely collapsed being the most action of glycerine, to which attention was first one to read off the manometer pressure called in 1894 by Professor 0. Leoni, of Rome. The satisfactory at. The so-called " heart level"was adopted for addition of a 20 per cent. watery solution of glycerine the position of the hand when the observations in the proportion of 3 or 4 to 1 of lymph had been were made-that is, " the midpoint of the anteromade use of since 1870, but merely with the object diameter of the body at the costal angle." posterior of preserving the lymph. Leoni, however, showed The necessary conditions for observations are that that while pure lymph contained numerous microthe vein must stand out sufftciently from the skin organisms, the glycerinated form after one to four level to give a distinct shadow on oblique illuminamonths not only remained specifically active but the vein wall must be collapsible, and the tion, presented a marked diminution of these extraneous patient must be lying quietly in bed. Observation of germs. Moreover, S. M. Copeman, in this country, cases to discover what is the diurnal variation who made extensive investigations on the bacterio- eight of venous pressures both in cardiac and other cases logy of vaccine lymph, advocated the storage of showed that it might be as much as 8, or even glycerinated lymph in a low temperature and in 12 cm. of water. In answer to the question as the dark. It is easy to understand that this method, to what should be regarded as a pathological though constituting a striking advance in the venous Dr. Clark takes 20 cm. of practical means of preserving and purifying the water aspressure, the limit of the normal, in upper vaccine lymph, is still far from the ideal from Hooker. He divided his this with Dr. agreeing the point of view of the absolute sterilisation cardiac cases into "compensating" and "decomof extraneous micro-organisms. Blaxall’s method of adding essence of cloves to the lymph pensating" groups, and found that in the former has been recently improved upon by De Blasi, the average venous pressure readings never went who introduced a modification by which the above 20 cm. of water, while in the latter the never went below 20 cm. Dr. Clark, essence of clove, the glycerine, and the lymph are average that a pressure above 20 cm. gives a suggests mixed in the proportion of 1, 3, 1. By this means the quantity of water added to the lymph is 1 Hooker: American Journal of Physiology, xxxv., p. 73, 1914.
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