It is, of course, assumed to be the official duty within a fortnight. 4. Fourteen days after his of the Medical Department to warn the people death his landlady (vaccinated) was attacked against dangerous plagues of all kinds, no matter (recovered); and a few days following her son how unusually healthy the season may happen to (vaccinated) was attacked Monday, and died be. Thus, although 60 per cent. of the small-pox Saturday. 5. A brother of patient No. 2, living deaths, in this six months, occurred during the on the same spot, vaccinated and re-vaccinated, three months of April, May, and June, during was attacked a fortnight after the death of his that quarter "the annual death-rate did not brother, and died in a week. 6. And one more exceed 18.6.per thousand-the lowest recorded in death (vaccinated) occurred in the same locality. the second quarter of any year in England and Here the evidence goes to prove that the cases Wales since the establishment of civil registration originated either directly from vaccination or in 1837." And in the previous quarter "so low from local causes-probably a combination of the a death-rate (21.8) in the first quarter of the two year -a new comer, previously out of health, has not been recorded since 1856." + being the first to succumb (in the set of 5), as is usually the case with the unacclimated. In the several parishes of the district, 57 cases, and 13 deaths in all, occurred in a population of 20,015, or 6 hundredths per cent.; yet hundreds have been rushing to be re-vaccinated. A young lady resident about eight miles from the place, re-vaccinated with the rest of the family, died within twenty-four hours after the pure lymph had been inserted-a parallel case to that vouched by Dr. Skinner, in 1871, at Liverpool, where a "blooming girl of 15" succumbed a fortnight after re-vaccination. The principle of Dr. Lettsom, which these official gentlemen seem to have adopted, is that the deaths from small-pox in London, multiplied by the difference in population, will furnish the small-pox deaths throughout the Kingdom, e.g., in London, six months, 1869, "or" (Lettsom) 15,000 in England and Wales; the actual number, exclusive of London, being only 308. Following this method, the department urges the dwellers in Belgravia, court precincts, palatial squares, and leafy suburbs; Bath, Cheltenham, Leamington, and Buxton, one and all, to arm themselves against the wolf springing forth (though unable to surmount the filthy barriers) in Shoreditch and Bethnal Green, Hackney and Whitechapel.‡ The following are a few examples of the panic which has thus been officially created, as the natural consequence of alarming placards posted all over the Kingdom, by the Guardians of the several Poor Law Unions, under the direct authority of the Local Government Board, inspired by the medical officers of the department. All persons have been urged to get themselves, their children, and their dependants, re-vaccinated, in view of the terrible scourge with which they are said to be threatened; simply because less than one in a thousand dwellers in the Metropolis alone have died of small-pox instead of some other malady, Near a small town, 30 miles from London, six deaths in all have occurred from small-pox, all vaccinated, and two of them re-vaccinated. 1. An infant four or five months old was vaccinated, and within a few days it was attacked by smallpox and died.§ Its mother (vaccinated) was sent prematurely to hospital, and subsequently only had small-pox, but recovered after severe illness. The father was re-vaccinated from the infant, and got small-pox ten days afterwards, but recovered. 2. A young man about 20 arrived May 27 at a dirty locality, unwell, but the doctor did not know what was the matter with him. On June 3 he was pronounced to have small-pox, of which, twelve days after, he died. 3. A boy of 16 coming to the house, June 4, was re-vaccinated the 6th, and was attacked and died Quarterly Report of the Registrar-General, No. 130, p. iv. + Report, No. 129. + London districts abounding in slums." During July, August, and September, out of 461 small-pox deaths, 391 occurred in six only of the 29 larger districts into which London is divided. § The London return, July 23, records the death from smallpox of an infant two weeks old, that had been vaccinated at birth, because the mother was then suffering from small-pox: and return Sept. 17, one aged 17 days, from variola seven days, vaccinated successfully fourth day! At Cheltenham a lady of 40 was, during the recent panic, induced by her nerves to be revaccinated. She died within a few weeks. There has been but one single death (and that several months previously) from small-pox in the county of Gloucester, at a place many miles distant from Cheltenham. An eminent man recently died in London of erysipelas, produced by blood poisoning, but as to what caused the poisoning, the authorities professed themselves ignorant. No scientific physiologist will hesitate to affirm that poison received into the blood may lie latent, as it were, for an indefinite period, and its fatal results may be exhibited even after the lapse of years. Thus, although Sir Culling Eardley, in 1863, died of pyæmia a fortnight, only after re-vaccination, the fact that a much longer period (if such was the case) elapsed before the subject in the instance before us fell a victim to similar violence, does not diminish the probability that to re-vaccination, either directly or in a highly contributory degree, can this untoward death, at 66, of a man of singularly spare and temperate habit, be truly asscribed. Especially when it is well known that his most intimate personal friends are ardent advisers of repeated vaccination whenever smallpox happens to be prevalent. I was intensely pained to find that a beautiful girl of my acquaintance, whose parents had every means of informing themselves of the fearful risk, had been lately submitted to this insane operation. My horror was not lessened by the circumstance that, just previously, the recent Algerian catastrophe had been brought to my notice, where out of fifty-eight soldiers, re-vaccinated from one infant, several died, and not one escaped the communication of the most horrible of diseases! Every survivor of them ruined for life, and worse than murdered. But such is the infatuation of panic stricken humanity, which will sacrifice life, truth, liberty, everything, to dastard fear. One other case I will mention. In the West of England an old gentleman of 90, for fifty years a teacher of religion from the same pulpit, lately going from home to a neighbouring part of the country, got himself re-vaccinated, lest he should run the risk of premature death from small-pox on his way; and yet, during the London epidemical six months, not a single case had been registered in the county in which he resides, or in that which he was about to visit! London, Sept., 1881. THOMAS BAKER. A PROBLEM IN In a paper recently read at Owens College, Manchester, by Dr. Henry Tomkins, Medical Superintendent of the Fever Hospital at Monsall, certain statements were made which seemed well worthy the attention of inquirers into the vaccination question. Dr. Tomkins stated that while he had charge of the Monsall Fever Hospital, more than a thousand cases of small-pox passed under his care, yet no servant, nurse, porter, or other person engaged there had, after re-vaccination, taken the disease. A laundress who had escaped re-vaccination died of small-pox; a nurse who, having had small-pox some years before, was considered protected, nevertheless took the disease mildly; an unvaccinated painter, who worked on the premises, had a rather severe attack; and a servant, who had by an oversight been allowed to work three days before being vaccinated, had a trifling attack before the vaccination ran its course. Again, all the students attending the hospital for the past two years had been vaccinated before entering the small-pox wards, and none had taken the disease. Dr. Tomkins defied any one to produce even half-adozen unprotected persons, and expose them as these students had been exposed, without some of the number catching the infection. Facts such as these he thought should cure the most ardent anti-vaccinator of his folly. Being desirous of sifting Dr. Tomkins's evidence, I wrote to him with a number of questions, to which he courteously returned prompt answers. These I shall present, in analysing his evidence as a whole. I desire first to direct attention to difficulties in the testimony already quoted. 1. In the case of two women who took smallpox, it is explained that one had "escaped" revaccination, and the other had, "by an oversight," been allowed to go to work before being vaccinated. I make no charge whatever against Dr. Tomkins's good faith when I say that these cases, which he seems to regard as veritable exceptions proving the rule, cast doubt on the value of his evidence. It is impossible to feel sure that none of the other nurses who have escaped smallpox have not likewise escaped vaccination. The supervision has obviously not been rigorous. 2. The case of the nurse who took small-pox a second time must be a puzzle to Dr. Tomkins himself, for he tells me that, though he considers vaccination as good a protection as the disease itself against subsequent attacks, he does not think it a better. If we are to accept his evi dence, we must believe it is better. Does he not then, on his own showing, prove too much? In order that the full strength of Dr. Tomkins's position may be shown, I should mention that he tells me none of the present staff of nurses have had small-pox; and that he can only find that one of the nurses employed during the past three years had ever had an attack. Now for the immunity of the students. Several of these gentlemen have had scarlet fever, but none typhus. Dr. Tomkins informs me that the nurses and the hospital staff have not been equally fortunate. Five nurses have died during the last two years of typhus, and he himself has had a severe attack. He also states that half-a-dozen medical acquaintances have caught the disease from patients. (This by way of refuting the proposition that doctors escape small-pox through being inured to the infection.) He accounts for the students escaping typhus by their custom of standing at a safe distance from the patients, which the nurses cannot do. How closely the students approach small-pox patients I have no means of knowing. So far, then, the evidence goes to show, if we overlook two awkward difficulties, that nurses, at least, are protected against small-pox by vaccination, and not through being inured to the infection, as they readily succumb to typhus. The inquiry must now take another direction. I learn from Dr. Tomkins that during the past. three years the number of cases of the more common infectious diseases treated in the hospital have been as follows: It is instantly obvious that these figures do not lend themselves to the theory Dr. Tomkins supports. They, in fact, absolutely nullify the former evidence. We find that whereas among the outside public small-pox proves more infectious than typhus in the proportion of nearly eight cases to one, these proportions are entirely reversed among the attendants in the hospital. It will be observed that on the inurement theory, the nurses in Monsall Hospital are more likely to be safe from small-pox than from typhus, seeing that the more frequent the contact the more complete would be the protection. I am not here concerned, however, to support that theory, neither will I lay any stress on the argument against vaccination furnished by Dr. Tomkins's figures on the surface. The central problem before us is, Why does typhus, which is, comparatively speaking, so slightly infectious outside the hospital, become so contagious inside, while small-pox, which, among an extensively "protected" population, is far more catching than typhus, affects the nurses so little in comparison? This question, it seems to me, is one for the hospital authorities to answer. I have, I think, raised it fairly, being sincerely desirous of getting at the truth. I submit that, so far as the facts before us go, Dr. Tomkins has not so much demonstrated the virtues of vacci nation as the dangers of his hospital. Of that institution I know nothing personally, but I confess. I should be reluctant to be treated for typhus in it if I could find no satisfactory solution of the problem above stated. If the hospital authorities cannot explain, the matter might profitably be investigated by medical men. J. ROBERTSON. "It should be borne in mind that it cannot be shown that there is no risk of transmitting diseases from the calf to the infant. The very fact that vaccinia itself is so readily communicated is a presumption that danger of this kind does exist-not probably greater than that of communicating disease from infant to infant, but, for anything we know, not less." The Calf Lymphers, led by Dr. Cameron, M.P., meet with little encouragement in Scotland. Their true answer is, that the cow-pox they recommend was known to be impotent against small-pox by Jenner; and, unless they claim to have made a new discovery, and that Jenner was mistaken, they are operating under false pretences. It is of great importance to hold this position firmly and to prevent it being obscured. MR. HERBERT BURROWS. In a letter addressed to Mr. George Bone, dated Oct. 22, 1881, Mr. Burrows observes: I am not an anti-vaccinator, but I am opposed to vaccination. By that paradox I mean that I oppose vaccination on one broad ground, that it is a sin against humanity to introduce extraneous disease into the human body. To me this is not a question of statistics. (1) I do not pretend to have made a study of this special question, but for many years I have had to make a special study of all kinds of statistics, and my deliberate opinion is this, that they can be so handled by men of adverse views as to prove absolutely contrary things. On one point, so far as I can see, facts are against you. I mean as to the general evil effects of vaccination. I suppose that a large portion of the children and people I meet are vaccinated, but I do not see the evidence of the ill effects. (2) My three children were vaccinated (I was not opposed to vaccination then), and have certainly suffered nothing; neither have I. But this is beside my point. If there were not one case of after evil effects, my position is the same-health should be secured by good food, pure water, pure air, an abstemious life, and the best possible sanitary conditions; and anything which (as, in my opinion, vaccination does) tends to distract public attention from these is harmful. (3) I know, of course, that there are many cases of after evil effects from vaccination; and I can give you a very striking one. When I was Cambridge University, a very clever friend of mine was reading for the Mathematical Tripos. Some years before he had been vaccinated, and had skin disease ever after, and close study made the disease fly to his eyes. consequence, he was unable to read for a great part of the time; he lost ground in his studies, took a considerably lower place in the examination than he would otherwise have done, and was handicapped for life. Doctors, I know, tell us that such mishaps could be avoided. Perhaps they could; but here, again, my position is, I believe, impregnable. In This rage for inoculation-to use a general term, is becoming almost ludicrous. You know, of course, that in Norway and Sweden inoculation for syphilis is practised. Pasteur's late experiments have made this sort of thing the fashion, and I see that now it is proposed to inoculate vines so as to protect them from the ravages of the phylloxera. REMARKS ON FOREGOING OBSERVATIONS. 1. The objection of Mr. Burrows to statistics is an objection that applies to all matters of fact; but while facts may be so handled by men of adverse views as to prove absolutely contrary things, yet outsiders with perspicacious and judicial minds may be trusted to distinguish truth from sophistry. Particular evidence for and against vaccination may be adduced to endless extent; but when we have masses of evidence impartially collected and classified in the form of statistics, we have material for argument and conviction which cannot be . dispensed with. 2. As to the general evil effects of vaccination, how can they be eliminated and specified? Dr. Richardson says he has never seen a healthy child, and no adults enjoy perfect health; and how much of the deduction from the standard of perfection may not be attributed to vaccination? Who can say? We are content to affirm that if vaccination produces that constitutional disturbance which its advocates assert is requisite to ensure immunity from small-pox, it necessarily stands for an injury to health, and an assault upon vitality. The mischief may not be obvious, and may be surmounted in the more vigorous, but it is none the less certain, and, in numerous instances, is alike certain and obvious. 3. Mr. Burrows' chief objection to vaccination is that it distracts attention from those sanitary measures which really make for the public health, and save not only from small-pox, but from kindred forms of zymotic disease. Therein he is supported by Mr. Edwin Chadwick, who points out that such has become the rage for vaccination, that in the medical department of the Local Government Board it is the chief thing thought of, and if only the deathrate from small-pox happens to be low, there is little concern displayed as to other modes of mortality. To reduce the general death-rate of a town represents thought, contrivance, and battle; but any set of boobies are equal to the job of vaccination; and although it does not keep away smallpox, it is always possible to say the outbreak would have been much worse save for their supreme exer tions, and that the attacks would have been infinitely more virulent and fatal save for their liberal exhibition of the Jennerian sacrament. SOLVITUR AMBULANDO.-KEIGHLEY. I HAVE gone through the books to find the amount of money paid by our Union for vaccination in 1871 and 1881. The first year for which the percentage of vaccination in Keighley is given in the returns of the Local Government Board is 1872, when 78.04 of the births were reported as "successfully vaccinated," whilst London stood at 82-20, and England and Wales at 80-41. Last year our vaccination officer had to report that in Keighley township only 9 per cent. of the children born were vaccinated. The saving to the Union in the matter of money by the decrease of public vaccination is thus repre sented : No account is here taken of the fees saved from private practice, which must at least represent an equal sum. We have to-day been arranging for the purchase of a farm of 24 acres. The payments, with interest, are to extend over thirty years, and will be met almost exactly by what we save from public vaccination. No one would grudge the expenditure of £100 a year for the reduction of disease and mortality, and some may think that what we gain in cash we shall lose in small-pox. So far nothing has occurred to warrant such a surmise. On the contrary; in the six years prior to 1875 there were 188 deaths from small-pox in the town of Keighley; whilst in the six years subsequent to 1875 there has not been a single death from small-pox-not one! Between 1870 and 1880 the Registrar-General's returns show that 60,038 persons died in this country of small-pox, being the heaviest variolous death-rate of any decade in the present century, representing on an average one death per annum from the disease in every 6,600 persons. For the assumed prophylaxy of vaccination, Mr. Ernest Hart estimates the medical profession receives privately £130,000 yearly, and from the returns, imperial and local, an equal amount appears to be expended on public vaccination. Thus not less than £250,000 a year is expended in securing the people from small-pox; and yet are they not secured! Keighley, Jan. 18, 1882. R. A. MILNER. MR. JAMES MITCHELL, of Notting-hill, being summoned before Mr. Partridge at Hammersmith for the non-vaccination of his child, was told by Mr. Partridge that as he conscientiously objected to the operation, he should only fine him 5s. and costs. This is an improvement on metropolitan practice. When Mr. Tebb used to appear at Marylebone, the magistrates, after expressing their sense of respect for his convictions, always ended in imposing the extreme penalty, professing, most untruly, that they were left without discretion. WHY DO YOU OBJECT TO BY WILLIAM HITCHMAN, M.D., M.R.C.S., &c. HUNDREDS upon hundreds of times has this question been put to me in the course of the last poison the people, or taint the blood of their chiltwenty years, during which I have ceased to dren with an ineradicable malady, whether called virus, not "pure lymph," conveys a disease to-day scrofula, syphilis, or bovine tubercle. Vaccine by a compulsory statute. of Queen, Lords, and Commons, that is loathsome, morally, socially, and physically, in the nature and extent of its healthdestroying agency, as now witnessed in the loss of vigour and strength in so large a proportion of generally. Vaccination is precisely one of those the inhabitants of Liverpool and Lancashire particular subjects which it is the solemn duty of every man and woman to examine justly for themselves. It is indeed a saddening. spectacle, if not an appalling feature of the literature of pro-vaccinators, that in proportion as scientific knowledge of life, health, and disease in nations and individuals is more extensive, true, and .exact, the more deep become the bigotry of official despots, and their coadjutors of the dominant medical presseverywhere seeking, as they are, to uphold the odious doctrine that compulsory vaccination, or State blood-poisoning, must for ever continue an inseparable accompaniment of human progress, or advancing civilisation, as well as a fixed article of faith in the stereotyped creeds of the Faculty of Medicine, at home and abroad. I object to vaccination by force, or fine and imprisonment, because it is an intolerable aggression upon the righteous liberty of every intelligent person in this country, or out of it, to invade the sanctity of home and parents, and compel them to offer their children as a sacrifice on the altar of Quacks and Quackery, whose alleged preventiveof small-pox, whether derived from horse-grease, cow-disease, or human corruption, the most corrupt of all, not only does not prevent its recurrent outbreak throughout the world, but has, besides, the power to disfigure or destroy its victims from generation to generation. Vaccination, if worthy of respect, would need no compulsion for its acceptance, but, worse still, its own cooked statistics prove it to be an imposture, cheat, and pretence, within the pale only of the charlatan, the empiric, and the mountebank. What is the state of the public health in Liverpool and Lancashire in January, 1882? I affirm that now, as for thirty years past, within my own personal experience and observation, vaccination has proved itself a curse rather than a blessing, causing, primarily or secondarily, more deaths than any other disease of childhood. Rickets, scrofulosis, and tuberculosis are often but modifications of vaccine syphilis, leading on to softening and other morbid mental and bodily import, in form of diseased alterations of bones, consequent deformities, of enlargements of brain and skull, chronic hydrocephalus, in fact; and terminating in premature death, by means of pulmonary collapse, spasmodic croup, convulsions, eruptions on the skin, together with the exudation of albumen-like matter throughout the substance of the liver, spleen, blights the infant in the womb, its Protean form eludes detection by experienced eyes, and contaminates the very milk, as you have seen, drawn by the child from its mother's breast. These are the conclusions of scientific men, whose knowledge and experience of vaccination qualify them beyond interested ex-officio advocates to judge rightly of both sides of this national question. And so awful and hopeless becomes the physical and moral welfare of the coming race, if you do not rise in rebellion of heart and soul against the eternal procession of future generations of human beings through the same circle of sin and suffering, that it is calculated to destroy the faith of Liberals even in a "Liberal Government," and make us henceforth sink into the vortex of a desolate and paralysing scepticism, and no longer. believe that England will ever be in harmony with those free and holy institutions that are alone compatible with the character and enlightenment of an advancing people. [The foregoing was part of a recent speech of Dr. Hitchman's on "Medical Freedom v. Official Despotism"; and as several of his American friends are importuning him for articles wherewith to encounter the small-pox scare, and "run" upon vaccination throughout the Union, he earnestly desires them to reproduce in the press his testimony thus delivered.] CEELY'S SMALL-POX COW-POX. Ar a meeting of the Royal Medical and Chirurgical Society, held on Jan. 26, 1841, Mr. Ceely, being questioned as to his newly - introduced small-pox cow-pox, replied:— and lymphatic glands. "Why do you object to vaccination ?" rings frequently in one's ear, and with this result in my mind. Why do not men think, read, and judge for themselves? As a matter of common sense and common honesty, no reasoner possessed of an impartial spirit, or with a true discernment of catholic logical inquiry, would hesitate to admit that whatever tends to deteriorate the constitution of healthy solids or liquids, is favourable to the formation of hydramic or watery blood; in short, the tubercular products of vaccination, now figuring statistically in the nosological classes of the Registrar-General as scrofula, tabes mesenterica, phthisis, and hydrocephalus. Consumption consists of the presence of tubercle, not rarely of vaccine or bovine origin, and the destructive suppuration which thereby ensues in the lungs, or in those abdominal glands through which the chyle passes, and by which it is more highly organised before it enters the blood; whilst water in the head results, often simultaneously, from bovine deposits within the skull, on the brain, or its membranes. "Why do you object to vaccination? Aye, verily, for a thousand and one reasons, scientific, ethical, and social; and had I none other it were sufficient to say, in sight of Truth and Justice, or the Religion of Humanity, that I have proved for myself, demonstratively, by numerous experiments, that the blood or lymph of a tainted person applied to a wound on a healthy one is capable of corrupting his whole system. I protest, therefore, that it is inevitable that all the secretions of sufferers from scrofula, consumption, and syphilis are truly poisonous, and this fact enables you and me to understand how and why compulsory vaccination has become a contaminatory process, formidable or abominable to all concerned. Not only do skin diseases, cough, diarrhoea, head-symptoms, and other disturbances follow vaccination ordinarily, but provaccinators convey the venereal poison from • unseen sores of syphilitic children to those that are perfectly healthy, by daily taking "vaccine lymph" from the arm of the one, and inserting it in the arm of the other, unconsciously. And even this calamity, alas, does not complete the tragedy. The newly-tainted child dies, when a few months old, of constitutional syphilis. When sucking its pabulum from the unfortunate mother, it infects her system through the nipples, and she, too, dies a miserable death, sooner or later, from the most loathsome malady with which humanity is afflicted; for, compared with vaccine syphilis, now made compulsory, directly tion in the forthcoming number of the North or indirectly, small-pox itself, a remote contingency, that possibly may never happen at all, especially to those who appreciate good sanitary conditions, and lead wise and virtuous lives, Small-pox, I repeat, when compared with constitutional syphilis, as propagated by vaccination, is like the sweetest and loveliest blossom, that was ever washed with morning dew, or embalmed in the tears of the fairest rose! State-quackery attacks, by preference, the young and newlyborn; neither purity nor innocence is defended from its wholesale, indiscriminate, corrupting influence; the strength of youth if often reduces to weakness; the healthy blood of the blooming virgin it converts to contagious poison; it | 66 In my own practice I have found no difference between the effects of the. variolo-vaccine and the old vaccine matter; nor do I believe that the differences, when they do occur, depend on anything but the characters of the patients. I have been amused by the different accounts sent to me by various practitioners whom I have supplied with the new lymph. Some haye written to me, saying they can discern no difference whatever between the effects of the new and old matter; others, that they find the new lymph more active and violent in its effects; while others, again, think its action even milder. I have no doubt that they are all right, and that the difference each has met with is due to the peculiarity of the soil in which the variolo-vaccine has been implanted." MR. HENRY BERGH will have an answer to Dr. Austin Flint's article in favour of vaccina American Review. MR. W. J. COLLINS, M.B., in the course of the past month, has again brought the question of vaccination before the Abernethian Society. He also introduced a discussion on the same subject at the Birkbeck Institution, and carried the audience with him by a large majority. We wish we could convey to our readers an adequate idea of the wide and accurate information, the freshness, readiness, perspicuity, candour, and tact wherewith the advocacy of Mr. Collins is characterised. He meets and overthrows his antagonists fairly and indisputably, and with perfect goodhumour. |