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Smallpox vaccination – just a small cut in the skin

31. May 2021 | Martina Gosteli | Keine Kommentare |

This post is also available in: Deutsch

The history of vaccination starts with smallpox. In 1796, Edward Jenner introduced the cowpox vaccine, which was adopted rapidly all over Europe. The Medical Collection of the University of Zurich keeps various objects allowing us to trace its history. Numerous vaccination lancets and needles are stored in boxes. Dr. Martin Trachsel, research associate, guides us through the material history of vaccination technology.

Interview: Ursula Reis

What is the earliest vaccination instrument in the collection and what do you know about its use?

Martin Trachsel: There is no easy answer to this question. Regular lancets were probabely in use long before there were specific vaccination instruments. Lancets are small, often retractable knives, which were primarly used for bloodletting. The tip is typically double-edged, like a small lance. There are plenty of lancets in our collection. Only on closer inspection, I discovered that some of them were probably intended for vaccination.

Vaccination techniques differed, but they all involved making one or more fine incisions in the skin. Lancets are very suitable for this purpose. The vaccine was applied on those small cuts. Some lancets – which I assume were produced as vaccination instruments – have a small slot or a hollow, which was probabely meant to hold the vaccine to ease its application.

Vaccination lancet with tortoise shell handle, 19th century. Medical collection, University of Zurich.

Another indication that instruments were used for vaccination is the presence of a cover for the blade. Obtaining the vaccine remained a difficulty for doctors until the end of the 19th century. The vaccine was taken from a child vaccinated about a week earlier that had developed a pustule as a standard reaction to the vaccination. The watery fluid inside the pustule – called lymph – was used as vaccine. It was either vaccinated immediately arm-to-arm, i.e. with both children present, or the vaccine was dried.

With a vaccination instrument that had a protective cap or sleeve, the lymph could be dried straight on the blade and used later. In our collection, we have a case containing four lancets with screw-on lids. Presumably, it was intended to keep a small supply of vaccine.

Vaccination lancet with rubber handle and glass container, ca. 1870. The lancet could be screwed to the glass container, which was also used to hold glass tubes with conserved lymph. Medical collection, University of Zurich.

How has vaccination changed, and what were important developments?

Martin Trachsel: As of the middle of the 19th century, it was discovered that the lymph could be kept longer if it was mixed with glycerine solution. The vaccine prepared in this way could be stored in glass tubes or flacons. The longer preservation time meant that the vaccine could be stored and kept available in larger quantities. It became possible to vaccinate entire troops, which first happened in the Franco-German War of 1870/71 on a larger scale.

Various types of vaccination lancets were still in use, often with handles made of tortoiseshell, horn or ivory. Sometimes the instruments were also called needles, but the naming was not consistent. Some instruments had removable tips. Several specimens in our collection have burnt tips. We assume that they were sterilised in the fire.

Lancy-Vaxina vaccination sets, Swiss Serum and Vaccination Institute, around 1900. Medical collection, University of Zurich.

Another important driver of technical development were safety concerns. There were repeated reports of diseases that were transmitted with the humanized vaccine, especially syphilis. At the end of the 19th century, animal vaccine was introduced, which was grown on the skin of cattle under controlled conditions and went through some bacteriological testing. 

When asepsis definitely became established, the old lancets were replaced by new models that could either be sterilised in large numbers or were intended for single use. From the turn of the century, the Swiss Serum and Vaccine Institute marketed its Lancy-Vaxina vaccine with sterile vaccination lancets supplied with it. Each brass container contained a glass tube fused on both sides, filled with glycerinised lymph for 2-3 applications, and a lancet with a detachable tip.

What is known about the origin of the instruments in the collection?

Martin Trachsel: Unfortunately, we know little about the origin of some of the objects. The core of the medical collection has existed since the interwar period and has been rearranged several times. Systematic inventories have only been carried out since 1978. The instruments that were taken over from the surgical clinic of the former Cantonal Hospital are relatively well documented. The situation is different with the holdings from private physicians’ estates.

Some of our vaccination instruments were probabely donated to us by a country doctor from Thurgau. However, he practised in the 1930s and many instruments date from the 19th century. It remains unclear how they came into his possession. Sometimes a stamp on the instrument helps us to determine the maker or we find an illustration in our collection of historical instrument catalogues. Occasionally we find what we are looking for in the more contemporary specialist literature. All too often, however, the research remains without a clear result and we have to rely on comparisons and assumptions.

Vaccination technique 1911
«The technique is extremely simple, but requires the same scrupulous asepsis as any operation. The day before, the child should be given a bath; before the vaccination, the affected area is washed with cotton wool and ether. Usually, four shallow incisions about 1 cm long are made on the outside of the right upper arm, with the upper part of the body undressed, using an vaccination lancet on which a little vaccine has previously been allowed to flow out of the capillary; the distance between the incisions should be 3 cm. The incision should be made so lightly that only a red scratch is visible; any bleeding should be avoided. Rubbing in the vaccine is not necessary. It is best to let the vaccine dry for 10 minutes.»
Source: Emil Feer, Lehrbuch der Kinderheilkunde, 1911, S. 554 (translated from German).

Abgelegt unter: ExhibitionsHistory of MedicineMain Library - Medicine Careum
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