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proof thatJenner used a mixture ofvaccine and smallpox matter. In fact, Razzell traces the provenance of Jenner's vaccine to a London physician by name of Woodville who had first approached Jenner for a supply of his cowpox lymph and had subsequently contaminated it with actual smallpox matter. Whether this contamination occurred deliberately or accidentally by means of unclean lancets cannot now be established. At any rate, Woodville and several other physicians had previously worked in inoculating hospitals where patients, or rather "customers ," went to "buy the smallpox," that is, to become intentionally infected in order to achieve life-long immunity, and could there have contaminated his lancets. It is evident that in these inoculation hospitals the lymph was derived from patient to patient and thus became attenuated and only rarely led to severe illness or death; nevertheless, smallpox by inoculation—even though relatively mild—was contagious and could lead to an epidemic. From his own records, it became evident that Woodville vaccinated 200 patients with the lymph he had obtained from Jenner directly. However, those of the vaccinated patients who did not show eruptions in the first 5 days were given "booster doses" of variolation, whereupon they not only showed the customary eruption on the site of the vaccination but also pustular eruptions all over the body which strongly resembled smallpox. Jenner evidently was quite aware that the contamination of his vaccine had taken place, and, according to Razzell, Jenner knowingly used for many years Woodville's lymph that had been dried on a thread. This lymph had been taken from the arm of one of Woodville's vaccination patients who had produced 310 pustules, all of which had suppurated . According to Razzell, the thread of Woodville's lymph was the source ofJenner 's main stock of vaccine throughout his lifetime as a vaccinator. Even though medical historians are inclined to adhere to the "medical myth" of Jenner's vaccination having ended the threat of smallpox in Europe and other parts of the world, they will not be able to disregard Razzell's thesis, which impugns the perfection of the medical hero, Edward Jenner. While both books are endowed with references and indexes, that is, the customary scholarly apparatus, the reader cannot help but be taken aback by the awareness of the author's evident bias, which he skillfully supports with suitable charts and quotations. ILZa VeITH Department of the History ofHealth Sciences University of California, San Francisco Handbook of Physiology's Section 9: Reactions to Environmental Agents. Edited by D. H. K. Lee, H. L. Falk, S. D. Murphy, and S. R. Geiger. Baltimore: Waverly Press, 1977. Pp. viii+659. $80.00. This volume continues the authoritative and critical style of the eight previous publications of this series. The material includes up-to-date information (ca. 1975-1976) on each subject and gives adequate references so that one entering the field may efficiently become current in his reading. It will be obvious that more is to be learned about the matters concerned, and the authors point out the 456 Book Reviews directions toward which fruitful research might be directed and where further information will be necessary to set standards. The first section deals with responses to physical agents, including sound, heat, microwaves, and ionizing radiation. The second section considers the nature, origin, and distribution of chemical agents that might come from the air, from occupational sources (complete as to type, but impossible to include all individual substances), food additives, medicines and drugs (again general, not all individual substances), and cigarette smoke. The third section describes the reactions and determinants of ports of entry which affect the respiratory system, the skin, and the alimentary tract. The fourth section gives the current status of knowledge of transportation and transformation of chemical agents within the body. This portion treats the changes from the points of view of physical chemistry, enzymology, and biochemistry. The fifth part portrays distribution and excretion of chemical agents and their derivatives, including storage in and release from bone and fat, as well as excretion through kidneys, gut, and lungs. The last section tells of mechanisms of cellular injury, including effects on cell membranes , covalent binding to cellular...


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