[Not Available]

Kant's discussion of the ethical implications of smallpox inoculation is presented here. In four fragments Kant analyzes the moral legitimacy of endangering other people in medical practice and especially endangering people who are incapable of giving consent. In addition, we re-evaluate the alleged "success story" of the development of smallpox prevention and review the technical and theoretical difficulties of smallpox inoculation at the time of Kant.

Immunizations for women and infants

The use of vaccines has been instrumental in reducing the incidence and severity of many different diseases. The Healthy People 2000 program lists improving immunization rates as one of its top goals. However, the national immunization rate falls far below the national goal. As health care providers, it is important to understand the age-specific immunization recommendations and contraindications.

[Qiu Xi and vaccination]

Qui-Xi was one of the earliest Chinese who learned cowpox vaccination in the early 19th century. He spent all his life on vaccination career, explained and supplemented the cowpox vaccination by TCM theory, and thus did great contribution to the prevention of smallpox in China. Guangdong, as an early trade window opening to abroad, provided an environment of social thought and economic support to him.

Inoculation in Boston from 1721 to American Independence

In 1721, a smallpox epidemic in Boston occurred and inoculation was introduced. It has been said that the inoculation in Boston was under the influence of England, but it has been shown this is not correct. It was clergyman Mather and surgeon Boylston who promoted inoculation, while doctor Douglass, a graduate from Edinburgh University, strongly opposed inoculation. The selectmen in Boston opened a town-meeting and discussed inoculation, and finally rejected the introduction of inoculation into Boston. The Boston citizens were also strongly opposed to inoculation and they even threw a lighted hand grenade into Mather's room. Since then, controversies over inoculation broke out every time a smallpox epidemic occurred. In 1775, George Washington became the commander of the war of Independence. He took a countermeasure to get rid of the smallpox epidemic in his army and he inoculated all army and recruit members. Meanwhile the English commander Howe, who did not pay attention to smallpox, had to decide to withdraw from Boston, since the smallpox epidemic broke out among the English army. In this paper I tried to clarify the controversies over inoculation in Boston, and the fact that smallpox epidemic and inoculation were related to the success of the immigration of the Puritans and also to the success of the independence of the New World from the British Empire.

Louis Willems (1822-1907) and the immunization against contagious bovine pleuropneumonia. An evaluation

Louis Willems's name is intimately linked with the history of prophylactic immunization in the nineteenth century. When he obtained his medical degree in 1849 contagious bovine pleuropneumonia or lung sickness was raging among the cattle population in most European countries. As the son of a cattle fattener Willems was confronted directly with the problem in his father's stables and decided to study the disease and to search for a remedy to combat it. The disease is caused by Mycoplasma mycoides and subspecies mycoides, but in the middle of the nineteenth century during the battle between the miasmatists and the contagionists, many had doubts about its contagiousness. Willems defended from the start the contagiousness of the disease and noticed that animals who had survived an infection did not contract it a second time. He demonstrated that inoculation of the serous fluid from the lungs or from the pleural cavity of affected animals into healthy cattle led to pronounced local reactions. When these inoculated animals later on came into contact with diseased cattle they were shown to be immune. In his first trials he inoculated at the base of the tail or around the nostrils but this led to very severe reactions and frequently to death. He then started inoculating at the tip of the tail with much better results. Most animals showed a more or less pronounced reaction at the inoculation site and about seven percent lost their tail partially or completely through necrosis, but the mortality remained very limited. The local reactions were caused by the etiological agent itself. The lesions in the connective tissue of the tail showed much resemblance to those in the interlobular septa of the lungs and contained strong accumulations of serous fluid. The tip of the tail was obviously a good choice; this was confirmed later by many authors and the procedure is still being used today in areas where the disease is still prevalent. Inoculation at other sites of the body such as the neck or the dewlap, led to very severe reactions often followed by death. Willems also demonstrated that local inoculation at the tip of the tail not only immunized the animals against infection via the respiratory tract resulting from contact with diseased animals, but also against a second inoculation in the tail, in the neck or elsewhere. Material harvested from the inoculation site in the tail (so-called secondary "virus") could also be used as inoculum. Animals who showed no reaction to the first inoculation received a second one after a few weeks. Immunization as a result of inoculation was proved repeatedly experimentally as well in Willem's lifetime, by himself and by his contemporaries, as later in more recent trials. Failures were usually attributable to inoculation of already infected animals or to the use of badly stored or purulent inocula. Inoculation during the incubation period did not provide protection. Willems' concepts about the mechanisms of immunity were understandably vague and ill-defined. He considered pleuropneumonia as an affection of the whole body with process in the lung in case of natural infection; following inoculation this process took place somewhere else and one created as it were a typical lung infection at another site of the body. Through the introduction of the "virus" a "dynamisation" of the whole body took place by which the blood and other organs became insensitive to reinfection. This explained why the inoculation protected not only the inoculation site, but the whole organism; Willems thought that the infection did not spread from inoculated to non-inoculated animals; this opinion was supported by some other workers in the field but opposed by others. The publication of his results created enormous interest in his country and abroad. In several countries commissions were created, trials were initiated and several foreign observers came to visit Willems in Hasselt. In general his results were confirmed abroad at least

[The long controversy over anti-tuberculosis vaccination in Canada: the Calmette-Guerin bacillus (BCG), 1925-1975]

The focus of this article is the history of Canada's reception of Bacillus Calmette-Guerin (BCG), an anti-tuberculosis vaccine which has almost constantly been plagued with controversy. The article examines this vaccine NRCC sponsored introduction in 1925, which led to the creation of the Associate Committee on Tuberculosis Research, a committee almost unique for its acrimonious debates. It also analyzes the interests at stakes in the ultimate rejection of the BCG by the federal Department of Agriculture veterinary services and, with the exception of Quebec and Newfoundland, by almost all public health authorities in Canada. Based on sources never taped before, this paper sheds a light on the multiple ramifications of a little known episode of the Canadian public health history.

[Not Available]

Under the government of the Lorraine dynasty, in 1756, Doctor Targioni Tozzetti and his colleague Scutellari inoculated six children with some drops of smallpox (taken from a 12 year-old boy who was already ill) as the Ospedale degli Innocenti, the old florentine foundling hospital. This was the first instance of smallpox vaccination in Florence. Under the government of Pietro Leopoldo (Grand Duke of Tuscany from 1765 to 1790 and then emperor of Austria from 1790 to 1792), in 1777 the inoculations were carried out under the responsibility of Doctor Stefano Baci. This time were submitted to vaccination fourteen children and it is interesting to note how many and what changes occurred with respect to the vaccination performed twenty years before.

[The antecedents and creation of the Alfonso XIII Institute of Serotherapy, Inoculation and Bacteriology]

This article studies the establishment of the Alfonso XIII Institute of Serotherapy, Inoculation and Bacteriology in 1899, using the general press and the professional-scientific, medical and pharmaceutical press as its prime source, It aims to highlight the principal factors which led to its gestation and later development, as well as the circumstances which led to its creation, by analyzing the antecedents and orgins of the aforementioned institution.