Armstrong – Table of Contents

infections differed in their ability to exercise the immune system; as an example, he noted
that many of the common respiratory diseases apparently gave little specific immunity
and could hardly be expected, therefore, to call forth non-specific protection. In making
this statement, however, Armstrong was handicapped by lack of information developed
20 to 30 years later by his protégé, Robert J. Huebner, his associates and many other
investigators who discovered new groups of respiratory disease viruses with their
multiple, variable immunological and antigenic specificities.
In closing his discussion Armstrong indicated that where primary school
vaccination was practiced, it was probable, that for many children vaccinia was a notable
experience, constituting their first exposure to a disease that gives a solid immunity. He
felt that the evidence he submitted in his presentation suggested the advisability of giving
the child, especially if more than one year old, the benefit of experience with the
nonviable diphtheria toxoid, which, as far as he knew, had not caused encephalitis, before
the child received inoculation with vaccine virus, a living antigen capable of infinite
multiplication. He stated further, that even if no immunity to central nervous system
involvement occurred, the fact that in the 20th century diphtheria had maintained a death
rate seventy times as high as smallpox, would seem to dictate such a change.
Armstrong summarized his recommendations as follows: 1) the only practicable
means so far suggested for the encephalitis occasionally noted following smallpox
vaccination had to do with the vaccination procedure. 2) A suitable vaccination technique
was defined as one using small, multiple, superficial insertions never over one-eighth
inch in greatest diameter and which employed no routine dressing. 3) Infancy was the
best time for performing primary vaccinations insofar as the prevention of