* VACCINE VIRUS. i V TEEMS. "Quill Points," 12 prepared in such a manner that the lymph cannot chip off, and thoroughly charged, .... $1.00 Selected, fresh and perfect " Crusts," securely mounted in Gutta Percha, each, . . . . . . . .1.00 Glass Capillary Tubes, hermetically sealed, containing fluid lymph each, ........ 1.00 I have found that packages transmitted by mail reach thejr destination with great certainty, and much more rapidly, generally, than when sent by express. When sent by mail I pay the postage, and as I have only failed once to receive money by the same channel, remittances to me shall be at my risk. It may be well to state that in cold weather all forms of good lymph are relia- ble, but that in summer that preserved on quill points is, no matter how good it may have been originally, liable to fail. Lymph, particularly on quill points, will now and then prove inefficient, even when fre^, from perfect vesicles, and packed with every precaution. The cause of this is probably generally an expo- sure, however short, to a degree of temperature which destroys the vitality of the virus. When failure follows the use of lymph supplied by me, I shall be happy to remit a fresh supply, if notified within two weeks. Ob, if DEEMED PRE- FERABLE, I WILL RETURN THE MONEY RECEIVED THEREFOR. I shall be perfectly willing to do this, as it is certainly enough annoyance for a physician to fail from using worthless matter, without paying for it. I trust this offer will be accepted as proof, as it certainly is, of confidence in my ability to furnish perfectly reliable ljmph. There is not much risk, however to me, as although every remittance of lymph is accompanied by an urgent request for notification of failure, I have received not more than twenty complaints from nearly one thousand physicians supplied since March, 1859. REFERENCES. Professors Channing and Holmes, M. M., D. D., Harvard University. Professor D Crosby, M. D., Dartmouth College. Professor G. Kimball, M. D., Foimerry of Tittsfield Medical Institution. Dr. Henky Bartlett, Roxbury. Dr Josiah Crosby, Manchester, N. H. For Commendatory Extracts from Letters, see page 8, et seq. Address, Dr. HENRY A. MARTIN, Roxbury, Mass. VACCINATION AND VACCINE VIRUS. The tenor of several letters from correspondents, lead me to apprehend that, through influences into which it is needless to inquire, the impression has been busily circulated that I hive discontinued my enterprise of supplying mem- bers of the profession with material for Vaccination, which should be as perfect in every respect as very extensive facilities, a knowledge of the subject resulting from fifteen years' special attention to it,and the utmost care would ensure; in a word, Lymph, which should be, if pussib'e, more uniformly reliable than that which has been for many years supplied from Boston, has been the very opposite. A demand sufficient to justify the greatly increased and continual labor which is necessary for the proper fulfilment of the promises made by me has been found to exist. Not only his the pecuniary encouragement been very much larger than was at first anticipated, but it is rapidly and steadily increasing. Be- sides this, there have been received very numerous, entirely unsolicited, sponta- neous expressions of gratification both at my having undertaken such an enter- prise, and at the successful results which have followed the employment of lymph which has been furnished by me. I therefore shall continue to give the special attention to the subject of Vaccination which I have done for many years, and shall make the collection and supply of Pure Lymph in every form, a permanent feature of my practice, as it has hitherto been a very pleasant, beneficent, and profitable one. As, notwithstanding a weekly advertisement in the Boston Medi- cal and Surgical Journal, and also one in Braithwaite's Retrospect, I find that many are not aware that I still continue this business, I have concluded by means of the present circular to fully inform the profession that I am and shall hence- forward be at all times prepared and happy to supply their orders for Vaccine Materiel, as well as such information connected with the subject of Vaccination, &c , as an extensive experience of many years in this speculi y may be supposed to enable me to aff./rd. With a view to gaining the confidence of those to whom I am yet unknown, I will make some remarks on the facilities I enjoy for obtaining Urge vaccinating practice, and consequently ample supplies of Lymph; also, a few words in regard to the source in Boston whence the profession have, throughout New England, at 4 any rate, been largely, though very unsatisfactorily, supplied for many years; and a few extracts, taken at random from letters received from correspondents, some of which place in strong contrast the successful results obtained with lymph sup- plied by me, as compared with the failures resulting from that used from other sources. I am aware that it is supposed to be necessary for a person proposing to supply Lymph, to any extent, to reside in a large city, and to hold the office of city or public vaccinating physician thereof, or of some extensive medical charity. Such, at any rate, seems to have been the general opinion throughout New England before the appearance of my advertisement in March, 1859. It certainly is a sine qua non that one should reside in a city or very large and closely inhabited town ; for nowhere else can be found anything like the necessa- rily great number of subjects requisite for the continual and perfectly reliable supply of Lymph at all times and seasons. A physician who proposes to supply virus should have an inexhaustible supply of healthy subjects to vaccinate, and they should be so near his residence as to be easily and frequently accessible; he should also have a thorough knowledge of what constitutes a perfect Vaccine Vesicle as distinguished from the very numerous types of the spurious Vaccinia, —some of them but very slightly variant from the true disease,—Lymph obtained from which is either totally inefficient, more or less unreliable and imperfect, or in many instances, absolutely and even seriously injurious in its effects. If a physician has such facilities, it is quite immaterial how he has them; whether as the resultof successful attention for mmy years to the practice of vac- cination amidst a dense population, or by a judicious gain of the votes of alder- men and members of the common council having secured him the pleasant and profitable office of city vaccinating physician. The advantages in this connection of holding the office alluded to are absurdly over-estimated. It seems to be sup- posed that a great proportion of the vaccinating of the people of Boston is per- formed by its City Physician, and that consequently his opportunities for obtain- ing lymph from the best subjects are continual and unbounded. Such a suppo- sition is entirely erroneous, the vaccination at the city physician's office is gratu- itous, and one hour a day (from 12 M. to 1 P. M.) is devoted to its performance. By a clause in the ordinance establishing the office, it is required that all patients vaccinated shall return in one week that the arm may be examined and an op- portunity afforded for the collection of lymph, if the operation has been success- ful ; of performing it again if it has failed. 5 Although the nominal fee for vaccination is five dollars, and that sum is some- times obtained from the wealthy, much the greater number of fees demanded and soured are under one dollar, fifty cents being all that is paid by a vast number, while some physicians (one particularly) drive a very extensive business in per- forming the operation for twenty-five cents. Many are also vac cinated gratui- tously by the dispensary physicians, and many on the same terms by practition- ers who desire to keep up their stock of lymph. It results from all this that the class which furnishes the subjects for public vaccination is the very lowest and most abjectly poor ; so poor as to be willing to carry their infants at a most in- convenient hour (the usual dinner hour in the city of this class), at least once, or if they comply with the ordinance, twice, to a place very distant from the resi- dences of most of them, even if the operation succeed; and oftener, sometimes much oftener, if it chance to fail — willing to do all this for the sake of saving fifty or even twenty-five cents. It is certainly not among the children of that class — which is the most insuf- ficiently nurtured and housed and clothed, and in which are found the most nu- merous instances of constitutional taint resulting from vicious habits, and their imperfectly treated or totally neglected results — that we are likely to find the healthiest and fittest sources for the supply of vaccine lymph. Nevertheless, if all the infants vaccinated, even of this class, were to be brought back to afford a supply, a certain and sometimes very considerable amount of good lymph could be collected in tubes and on quill points. (As for crusts, they can only be obtained by watching the case and removing them from the arms at the proper time. During the panic last year and perhaps still, police officers were employed to bring the parents with their infants to the office, however reluctant, and also to collect the crusts. These functionaries though excellent in their appropriate sphere, are hardly competent for this vocation ) But the fact is, that but a very small propor- tion ever comes back. If the arm " takes " the parents are satisfied, and the in- stances in which respect for an ordinance (disobedience to which has no pen- alty but the rather paradoxical one of depriving them of a privilegeof which they cannot-be deprived) induces them to send their children to the office, are compar- atively rare. It results from all this that the supply instead of being always unexceptionable in quality and ample in amount, is derived from the lowest classes in the commu- nity, very precarious ; sometimes during a panic, as of last year, being plentiful, 6 but usually from the causes above given and from the carelessness of the lower classes about vaccinating their children, scanty and unctrtain. It is a very com- mon circumstance for Boston practitioners to call on me for lymph, stating theyr repeated failures and paying me in preference to making further attempts with the Hoston lymph, which is afforded to them gratuitously. The professi mal em- inence of the City Physician of Boston, even if deserved, is but a slight guaran- tee for the goodness of the material furnished from his office; this port on of the business of which has been, to a large extent done by students. As to my own facilities, I would state that Roxbury is a city of nearly 25,000 inhabitants, that it is in the immediate vicinity of a number of other large and closely-settled tnvns, and so near Boston as to be continuous with it, and only separated from that city by a conventional line. Its situation is extremely salu- brious ; its population, to a very large extent, of the poor and laboring ilass, but partaking to a large degree of the character of a rural rather than a city population. My peculiar opportunities for the practice of Vaccination have arisen from the fact, that since my establishment in the placp (now 13 years) I have paid par- ticular and continued attention to this specialty. I have thus obtained a repu- tation for successful Vaccination which is not confined to Roxbury, but ex'ends to Boston and the neighboring towns, to such a degree that before I undertook my present enterprise, I have fr quently vaccinated from twenty to thirty in a day ; my annual Vaccination for the whole period having been many hundreds. I may also add, that a large Obstetric prac:ice helps to afford me facilities ; and I have always on hand a list of at least a hundred children to be vaccinated. Even after the panic of last year, when I was obliged to vaccinate large numbers at once, I did not fall short of subjects. I vaccinate every child, very often with fluid matter directly from a vesicle, and almost always with lymph less tt.an an hour old. In this way I secure, I may say, very nearly invariable success, so that it is an extremely rare occurrence for me to be disappointed in my expectation of supply from any subject or subjects on a given day. All my lymph is collected by myself. I never, except during a severe illness in the summer of 1859, trusted its collection to another. Each lot of lymph collected is put into a sepa- rate phial, aad usually the qui'ls supplied to order are from several different sub- jects. Of course, pursuing this plan, I know all about every lot of lymph fur- nished. I have never been for more than three days without a fresh supply, ar.d have never been without reliable lymph even when the orders received amounted 7 to fifty in one week. I have never, since the full trial of my experiment, felt any apprehension of having my stock exhausted in any form, except that of crusts these, from the fact that a vast number of fine vesicles fail, from the friction of clothing and numerous other accidents to result in good scabs, are often very difficult to obtain in large numbers particularly in warm weather, and although I have never yet had my stock of them extiausted, I think it possible that a large and rapid demand for them might temporarily exhaust the supply. In the foregoing remarks I have said more than I had intended about the sources whence New England physicians have been supplied with lymph, but I deemed it important to say what I had to say fully and plainly. I was first induced to enter this business by the very numerous applica- tions made to me for lymph accompanied by complaints of unsatisfactory results from that obtained elsewhere. That these complaints were just, my own experience led me to believe, aid the great number of orders since received by me have ripened that belief into conviction, for almost all my correspondents were formerly supplied elsewhere and would not have tried me had they been sat- isfied. Some may think that I have been unjust and perhaps incorrect in my strictures, all I can say in return is, that I am sure that no one who is satisfied with others will send to me, and if any are not contented, it is no more than fair that they should be informed that there is yet one more source in existence that they may try with perhaps bett r resu'ts. I have invented a slight modification in the "quill point," by me?ns of which the chipping off of the dried lymph from the smooth surf-ice of the quill — a common cause of failure — is entirely avoided ; the lymph being, on the con- trary, as firmly adherent as varnish to wood. The point is also rendered thin and sharp, so as to enter and be retained in the shallowest puncture. This little contrivance is really a very important one, and has been adoptel by others on my suggestion made years since, though I have never yet heard of any acknowl- edgment to that effect. Another trivial but useful invention of mine is that of mounting vaccine crusts in gutta percha. A good crust can be made to afford material for a great num- ber of vaccinations, if properly used; but formerly, when i' was usual to mount them in white wax, sealing wax, &c, or to use them without any mounting, either in the form of chip, powder or mucilage, theie was great waste. Mounted in gutta percha, every atom of the crust can be used ; and with a good one pre- pared in this manner, I have frequently vaccinated from twenty to fifty individ- uals. The Capillary Tubes which I use are made by a skilful artist of Boston, who made to my order the first tubes, as I believe, proper for this purpose, made 8 in America—the few good ones here before having been imported from Edin- burgh and Germany. Notwithstanding their fragility they can be safely sent by mail, no accident having happened to any of those which I have sent, though some of them have gone as far as Georgia, Texas, and Havana. I have, after trying every other method of vaccinating, adopted and partially invented a mode of performing that operation which has been extensively followed in this neighborhood, and which I know, when properly done, to be perfectly painless, taking less time, to be less troublesome, and vastly more certain than any other.* Instructions for vaccinating in this mode accompany each parcel of lymph. Another trifling contrivance, is that of a neat, flat, metallic box, in which the lymph, whether on quills or in crusts or tubes, can be safely packed and sent by mail, and in which the virus can bs very conveniently carried, either in the pocket or pocket-book. * See article " How to Vaccinate," in Boston Medical and Surgical Journal, March 22, 1860. COMMENDATORY REMARKS, &c. From Letters of Correspondents. It is no slight or agreeable task to collate a vast heap of old letters. If I thought it necessary, I could, by doing so, obtain ten times as many extracts as follow. I hope that those I have collected will be sufficient. I would again state that in no instance were these compliments solicited. Also, that they are not confined to any particularly lucky season, but extend over the whole time that I have been engaged in the business. The 7th, 12th, 13th, 14th, 16th, 17th, 20th, and 26th Extracts demand particu- lar attention. (1.) From Dr. W. B. Fifield, Weymouth, Mass. Sept. 25,1859. * * * * " 0ne person aged 70, who had a fine scar of previous vaccination, done perhaps fifty years ago, was vaccinated with one of the scabs you gave me. I have never seen a finer vesicle, even on a young child, than was produced. (2.) From Dr. F. A. Howe, Newburyport, Mass., Oct. 15, 1859. * * * * " The quills you sent me a few months since, all proved good." (3.) From Dr. S. Laughton, Bangor, Me., Dec. 12, 1859. ***»«! ^ave usually obtained my vaccine virus of Dr.-----, but I have so often failed to obt.iin reliable lymph that I have resolved to apply to try you." (4.) From Dr. H. N. James, Kingston, Mass., Jan. 9, 1860. • •*••< The crust you sent me a few months since was perfectly satisfac- tory." (5.) From Dr. B. Joy Jeffries, Boston, Jan. 16, 1860. * * "lam much obliged for the scab and the quills which you sent me. Both were successful." * * (6.) From Dr. L. Parks, Jr., Boston, Jan. 19, 1860. " Matter highly satisfactory." (7.) From Dr. C. Robbins, Charlestown, Mass. Jan. 20,1860. " I am far better pleased ol district (of which there are twelve) and operate on all that wished, and our town officers insisted that all should be vaccinated at their expense. Judge of my feelings, when not a sore was pro- duced, not a crust formed ! The loss of time to me is not the least consideration, and riding over the hills of Connecticut is anything but agreeable in winter, and on a fool's errand beside ; I had not very pleasant thoughts, you will readily con- ceive." * * * (13.) From Dr. Miller's Second Letter. March 9, 1860. Dear Doctor, — Your first very kind letter was received in due time, and I at once made use of the matter, and the results have been entirely satisfactory, as indeed I knew they would be, as soon as I observed the care and neatness which marked your preparations. You have done yourself as well as the profession to which you belong honor, in thus furnishing matter entirely " above reproach," and have forever settled the question that the medical profession have not to de- pend on empirics for this great boon, pure vaccine virus. But again, when I think the matter sent me by Dr.---------, and strongly warranted as pure, and remember that I used it in the vaccination of my two children, words cannot ex- press my indignation. If I did not think it a waste of time and paper, you may rest assured he would enjoy that knowledge. I shudder to think how near 1 came to murdering them. * * * * I cannot forget Dr.------'s treatment; he never hinted that the matter was procured from questionable sources, ar.d indeed he might not have been aware of it himself, yet that does not excuse him in not an- swer ng rny repeated inquiries, or when ascertaining its impurity,* neglecting to . * N 1860. * • * u jne matter which I procured from you some time since was the best I ever used." (23.) From Dr. J. N. Stiles, Windsor, Vt., December 19,1860. • * " That which you sent me last winter, proved satisfactory in every re- spect." (24.) From Dr, W. W. Wellington, Cambridgcport January, 5, 1861. " Please send me some vaccine virus. The last I had of you worked well." (25.) From Dr. I. N. Fisk, Ansable Forks, N Y., Jan. 17, 1861. * u*_" I nave 6e»t to BjDston and obtained quills, but they were worthless." * * (26.) From Dr. L. C. Bean, Lebanon, N. H., Jan. 31, 1861. * * * " I hope you can send me as good a one [crust] as you did before [15th inst.]. It proved very fine indeed; the quills likewise all woiked well." * * * « (27.), From Dr. M. A. Tinker, Burnt Hills, N. Y., Feb. 4, 1861. " I have had vaccine matter from New York City, and it failed to woik. I am inclined to try yours, because if it fail I can get a second supply." HENRY A. MARTIN, Roxbury, Mass. Roxblry, Feb. 10, 1861.