THE NEW ZEALAND GAZETTE. 297

sign which tests the efficiency and purity of your
lymph. Note any case wherein the vaccine vesicle
is unduly hastened or otherwise irregular in its de-
velopment, or wherein any undue local irritation
arises; and if similar results ensue in other cases
vaccinated with the same lymph, desist at once from
employing it. Consider that your lymph ought to
be changed, if your cases, at the usual time of inspec-
tion on the day week after vaccination, have not, as
a rule, their vesicles entirely free from areolæ.
9. Keep in good condition the lancets or other
instruments which you use for vaccinating, and do
not use them for other surgical operations. When
you vaccinate, have water and a napkin at your side,
with which invariably to cleanse your instrument
after one operation before proceeding to another.
JOHN SIMON.

N.B.-Supplies of lymph are furnished to medical
practitioners on personal application at 3, Parliament
Street, London, S.W., between the hours of 12 and
2; or by letter (unstamped) addressed as follows:-
To the Medical Officer,
Local Government Board,
3, Parliament Street,
London, S.W.

National Vaccine
Establishment.

MEDICAL DEPARTMENT OF THE PRIVY COUNCIL
OFFICE.

I.—Re-Vaccination.

By vaccination in infancy, if thoroughly well-per-
formed and successful, most people are completely
insured, for their whole lifetime, against an attack
of small-pox; and in the proportionately few cases
where the protection is less complete, small-pox, if
it be caught, will, in consequence of the vaccination,
generally be so mild a disease as not to threaten
death or disfigurement. If, however, the vaccination
in early life have been but imperfectly performed, or
have from any other cause been but imperfectly
successful, the protection against small-pox is much
less satisfactory; neither lasting so long, nor while
it lasts being nearly so complete, as the protection
which first-rate vaccination gives. Hitherto, unfor-
tunately, there has always been a very large quantity
of imperfect vaccination; and in consequence the
population always contains very many persons who,
though nominally vaccinated and believing themselves
to be protected against small-pox, are really liable to
infection, and may in some cases contract as severe
forms of small-pox as if they had never been vacci-
nated. Partly because of the existence of this large
number of imperfectly vaccinated persons, and partly
because also even the best infantine vaccination
sometimes in process of time loses more or less of its
effect, it is advisable that all persons who have been
vaccinated in infancy should, as they approach adult
life, undergo RE-VACCINATION. Generally speaking,
the best time of life for re-vaccination is about the
time when growth is completing itself, say from 15
to 18 years of age, and persons in that period of life
ought not to delay their re-vaccination till times when
there shall be special alarm of small-pox. In propor-
tion, however, as there is prevalence of small-pox in
any neighbourhood, or as individuals are from
personal circumstances likely to meet chances of
infection, the age of 15 needs not be waited for;
especially not by young persons whose marks of
previous vaccination are unsatisfactory. In circum-
stances of special danger, every one past childhood, on
whom re-vaccination has not before been successfully
performed, ought without delay to be re-vaccinated.
Re-vaccination, once properly and successfully per-
formed, does not appear ever to require repetition. The
nurses and other servants of the Small-Pox Hospital
when they enter the service (unless it be certain that
they have already had small-pox) are invariably sub-
mitted to vaccination, which in their case generally
is re-vaccination, and is never afterwards repeated;
and so perfect is the protection, that though the
nurses live in the closest and most constant attend-
ance on small-pox patients, and though also the
other servants are in various ways exposed to special
chances of infection, the Resident Surgeon of the
Hospital, during his thirty-four years of office there,
has never known small-pox affect any one of these
nurses or servants.

Legal provisions for re-vaccination are made in the
8th section of "The Vaccination Act, 1867," and in
section IV. of the Regulations which the Lords of
the Council, under authority of the Act, issued in
their Order of February 18th, 1868. Under these
provisions, re-vaccination is now performed by all
Public Vaccinators at their respective Vaccinating
Stations; and, so far as is not inconsistent with the
more imperative claims for primary vaccination, any
person who ought to be re-vaccinated may, on applying
to the Public Station of the District in which he resides,
obtain re-vaccination at the public expense.

II.—Lymph Supply for Re-Vaccination.

At any time when exceptional claims for re-vacci-
nation are arising, it becomes essential clearly to
understand how the lymph for such re-vaccination is
to be supplied.

In regard of lymph supply, re-vaccination unfor-
tunately differs from primary vaccination, in that it
contributes nothing to its own support, but that each
case of re-vaccination, while requiring to draw lymph
from a case of primary vaccination, will itself furnish
no available lymph in return; for, even when good
vesicles result from re-vaccination, their lymph
cannot properly be used for other vaccinations or
re-vaccinations. Thus, no wholesale re-vaccination
is possible which does not have for its basis a large
system of primary vaccination; and as, in England,
such a system exists in the hands of the Public
Vaccinators, but, with very rare individual exceptions,
not in any other hands, so our essential security for
means of re-vaccination (as well as for means of
primary vaccination) is in the system of Public
Vaccinating Stations established by law.

At these stations a large majority of all the infan-
tine vaccinations of the country are performed in
successive weekly groups; the cases of each vaccin-
ating day returning a week afterwards to furnish
lymph for the arm-to-arm vaccination of a new group.
Each well-frequented station is thus a continuous
source of primary lymph supply, and is able, not only
to maintain its own weekly performances of vaccina-
tion and re-vaccination, but also to contribute more
or less towards the requirements of places where the
public stations are too ill-frequented for the main-
tenance of a continuous supply, and towards the
similar requirements of private practitioners. From
certain of such stations, carefully selected and
superintended, the Medical Department of the Privy
Council Office receives regular contributions of lymph
preserved dry on ivory points, or liquid in capillary
tubes; and out of the stock thus contributed, the
Department answers day by day the demands which
are made on it for lymph; demands, emanating not
only from among the many thousand vaccinators,
public and private, of the civil population of England,
and the other divisions of the United Kingdom, but
also from Her Majesty's army and navy in all parts
of the world, and from the Diplomatic and other
Foreign Services, and from the Colonies.

It is essential for the objects which have to be
accomplished that this National Vaccine Establish-