II.-Cow-pox, known by Jenner to be ineffective in preventing small-pox, but favoured by the medical profession and the public. III.-Horse-grease (said to have been horsepox) also described by Jenner as ineffective, but used and diffused by him. To which of these did he attribute the success claimed for vaccination? Apparently to all indifferently; but if one were as good as another, why did he not say so, and proceed to explain how it was that cow-pox did not save the Gloucestershire milk-maids, nor horse-grease the farriers from small-pox? Was it that the power to put such questions, and to answer them, does not consist with the quack's intelligence; and that having realised gold and glory he therein rests content? Observe, too, how when credit was to be had for London vaccination, he took it, though at mortal enmity with the chief agents in the work, repudiating Dr. Walker's practice as subversive of principles he considered essential to success. Jenner's final publication in 1822 had nothing to do with vaccination, but was a bid for fame in a new direction.* It was an attempt to originate a new method of cure by irritating the skin with tartarated antimony. He had dabbled with the chemical when a young man, and John Hunter had suggested that his preparation should be sold and puffed as Jenner's Tartar Emetic. In his last years he returned to it, and produced a series of cases to prove how many diseases might be alleviated and removed by using it as a counter-irritant-just as in the Inquiry he recommended cow-pox inoculation with the same intention. The matter does not concern us further than to observe that the pustules and scars produced by tartarated antimony are almost indistinguishable from those of vaccination; and that tartar emetic has on several occasions been used as a substitute for vaccine virus. SHIPS AS HOSPITALS.-What can be more astonishing than the assent of the Local Government Board to the Metropolitan Asylums Board borrowing a hulk of a line-of-battle ship from the Admiralty for use as a small-pox hospital in the Thames? If there be a construction least fitted for nursing small-pox patients on board, in the interests of patients, it is an old hulk; if there be a disease least appropriate to be treated on a hulk it is smallpox.-Lancet, 4th June. THUS THEY CUT ONE ANOTHER UP.-In the Journal of Science for June we read-" Dr. Grawitz has experimentally refuted both the current hypothesis and the protective action of vaccination in the generalised sense of the term. He shows that blood from rabbits which had been inoculated with Aspergillus, if mixed with a further dose of the spores, developed a luxuriant crop of fungus; hence the blood had neither been exhausted of any pabulum nor had any antidote been developed in it."-VIRCHOW's Archiv. für Path. Anatomie. * A Letter to Charles Henry Parry, M.D., on the Influence of Artificial Eruptions in certain diseases incidental to the Human Body; with an Inquiry respecting the probable advantages to be derived from further experiments. By Edward Jenner, M.D., LL.D., F.R.S., M.N.I.F. etc., and Physician to the King. London: 1822. 4to, pp. 68. REASONS AGAINST VACCINATION PERMIT me to say why I do not believe in Lynn, Mass., Feb. 19, 1881. MYSTERY OF THE VACCINATION MIRACLE. What is that change in a living body which gives exemption from a certain disease for the remainder of life, when the individual has once passed through it? Or, yet more specifically-In what physical conditions does A, having had the small-pox, or been vaccinated, differ from himself before such protection was given, or from B who never obtained it? The question is yet unsolved.-SIR H. HOLLAND'S Recollections of Past Life. OAKLAND, CALIFORNIA. ANNUAL REPORT OF DR. WOOLSEY, HEALTH OFFICER, FOR 1880. ANALYSED ANd Abridged BY H. D. DUDGEON. DEATH-RATE, nearly 13 per 1,000 of population. Birth-rate of the two healthiest wards, 19 per 1,000 of the two sickliest wards, 27 in the 1,000. Population 35,000: 21,000 being Americans: 2,000 Chinese: and the remainder English, Irish, Germans, etc. The (adult) Chinese died at eight in the thousand. Births: Chinese, 1; American, 294; Foreigners, 304; mixed, 170. Total: 763 white, 4 black, and 1 copper-768. Death-rate from zymotics, 217 per 100,000 of population, being one half less than the death-rate from these diseases in New York, Boston, Cincinnati, and Chicago. The The principal factor concerned in the production of most zymotic diseases is not climate but filth; and the quantity of filth in a city may be estimated by its death-rate from diseases of this class. occurrence of typhoid fever in certain sections of the city admonishes that the evil of uncleanliness is still lurking: bad drainage, defective sewage, crowded habitations with dark inside sleepingrooms, the drinking of surface well-water, etc. The contamination of the atmosphere within a limited range of the water-front by the prevailing wind from the marsh land, and by the flushing of the sewers in the wrong direction by every inflowing tide, fairly explains the obvious relation between the most unhealthy localities and the filthy accumulations at the outlet of our sewers. All things being equal, the greatest mortality from zymotic diseases will of course occur where small children are most numerous-where there is the most susceptible material. But things sanitary are never equal; and it will be found not only that the highest proportionate mortality from zymotic diseases will occur in the most filthy localities, but that sunshine and pure air are especially favourable to health and longevity. A portion of each day is spent by the Inspector in systematic house-to-house inspections of neighbourhoods in which nuisances were reported or suspected. personal comfort may be altogether dispensed with at the expense of good ventilation. The practice prevails in winter time, even in the best society, of warming sitting-rooms and bed-chambers with foul air; shutting out oxygen on the one hand, and substituting expired breath for wood and coal on the other. Here and elsewhere about nine-tenths of all diarrhoeal diseases occur to children under five. The ventilation of our street sewers is an urgent requirement, for at present the principal escape of the fetid and noxious gases is through the ordinary house-traps into sleeping rooms. The establishment of a system for the removal of garbage from streets and houses-so greatly needed and so long neglected-is already under consideration, and will probably, in the course of a few months, be accomplished. We are of opinion that the primitive privy-vault and cesspool, the relic of a semi-barbarous age, should not be permitted to become fixtures or be tolerated in any enlightened community. The well-water is always more or less contaminated. The most impure water analysed was from a well 26 feet deep, and 30 feet from an open privyvault. The water was quite clear and odourless, and was pronounced by those who were supposed to drink it to be of good quality. It nevertheless contained an unusually large amount of organic matter which in all probability had come from the privy. The foregoing abstract from the Californian Report may be fitly ended with an account of the small-pox epidemic of last summer therein contained. Seven hundred and ten Chinese were congregated under one roof and in one boarding-house; they worked at the jute mills. A case of small-pox, imported from China, was made known among them on the 27th July. The Board has absolute control over Chinamen. The place was quarantined day and night by armed guards, and no one was permitted to leave. in number), and all those in whom the first Every Chinaman was vaccinated (710 experiment failed (110 in number) were reA most excellent opportunity was thus offered for obtaining accurate statistical information. The facts are completely vaccinated. Accurate memoranda of the sewage facilities, water supply, and sanitary conditions of premises visited, were made on the spot, and afterwards recorded in a book. This will be a valuable record. The American Public Health Association in December last, declared that a person proposing to buy or rent a dwelling-house ought to be able on payment of a fee, to obtain from the health officer a certified copy of the sanitary history of the house he proposes to occupy, its connection with sewers, and the number and causes of the deaths that have occurred in it, or in the square in which it is situated. The mortality of children under five was less than one-eighth of the total, which is a splendid showing. The smallest number of zymotic deaths occurred in April, when the gutters were washed and the sewers flushed by the heavy rains. It is to local sanitary conditions that we must look for explanations of the origin and propagation of zymotic diseases. It is the rule here that the colder the weather the greater the mortality; our dry summers are healthier than our wet winters, in which lung and bronchial diseases prevail. The prevalent crime of living and sleeping in illventilated apartments is more deadly than the vice of intemperance. In our Oakland winters, fires for 66 at variance with the old idea that the protective influence of vaccination will last for seven years, and tend to show the fallacy of the prevailing opinion that an attack of small-pox will bring to the individual subsequent immunity from the disease." The virus used was bovine lymph of the best quality that could be procured. The disease appeared in many different sections of the city from August to December 13th. Special policemen were placed as guards at infected houses, and the disease in no single instance spread from an infected house. Among the 710 Chinese there were seven cases, and two died. Fourteen cases occurred in various parts of the city with two deaths. Total, 21 cases and 4 deaths: being nineteen per cent. of cases. Among the Chinamen we are told that the second case "broke out" before vaccination had taken effect. The next confluent case "broke out about the time that vaccination began to act, and the other three cases of August 10th "broke out" during the development of vaccination. The last of the seven Chinese cases "broke out during the desiccation of the vaccine pustule. [The Report places the words "broke out" between inverted commas.] In all of the last four cases referred to, the eruption of the disease was thicker at the site of vaccination than elsewhere on the body. Of the fourteen cases among the white population, twelve had been vaccinated, of whom one died; the other death occurred in an unvaccinated infant four-and-a-half months old. One case was of a person who had been inoculated: two of the patients had been vaccinated within the last six years. Four of the cases occurred in persons under the influence of vaccination. It appears from the Report that all the 710 Chinamen were vaccinated. If this be so, the Chinaman who first fell ill and who died, was vaccinated during his illness. On this point the Report is not quite clear. MR. ERNEST HART TESTIFIES. DR. RENNER, the Paddington Calf Lympher, having written to the British Medical Journal, 4th June, stating how many of his patients are successfully re-vaccinated, proving thereby that their primary vaccination had worn out, Mr. Ernest Hart thereon delivers himself as follows "Our soldiers, sailors, postmen, small-pox nurses, all of whom are re-vaccinated, enjoy an almost absolute immunity from small-pox, even during epidemic periods, and when surrounded with disease. The like immunity may be obtained by every rational member of the community who chooses to submit himself after the age of fifteen to re-vaccination. The present epidemic of small-pox is a lamentable monument of human folly and neglect, which leave out of view a harmless and necessary precaution against so fatal and loathsome a disease. The responsibility of the misguided persons who seek to deter from obtaining this protection is great indeed; and it is difficult to use words of moderation in viewing all the fanatical ignorance and obstinate preversion of the truth of the facts with which they stimulate and maintain their reckless and mischievous crusade." If" fanatical ignorance and obstinate perversion of the truth of the facts" are words of moderation, what might words of immoderation be? Yet the words, such as they are, accurately describe Mr. Ernest Hart's own advocacysupposing it to be sincere; for we have heard it doubted whether he has been re-vaccinated himself; with the additional observation, that he was not fool enough to follow his own prescription. We trust for the credit of human nature that there is no warrant for the insinuation. COMPULSION FOR EVER!-At a meeting of the City Commissioners of Sewers it was recommended to urge the Local Government Board to have an Act passed to enlarge the powers of the Asylums Board; and in the same Act to include provisions for the compulsory notification of infectious diseases, and the compulsory removal to hospitals of persons suffering from such diseases. These facts, Sir, coupled with the additional one that during the twenty-one weeks ending 28th May, 1272 persons have died in London of small-pox, 327 of whom were under five years of age, appear to me to be utterly subversive of the pretensions of vaccination. It is absurd to say in the face of these returns, that vaccination has saved thousands of lives, or that the mortality would have been greater if 95 per cent. had not been vaccinated, or that the deaths accrue from the "unvaccinated residuum," as Dr. W. B. Carpenter would have us believe, seeing that in the first decade when but few, comparatively, were vaccinated the mortality was only about half as great as in the last when 95 per cent. had received the so-called protection of vaccination. WM. YOUNG, M.P.S. 114 Victoria St., 11th June, 1881. Abstract relative to Small-Pox Mortality in London for the year 1880, from the Annual Summary of Births, Deaths, and Causes of Death, issued from the office of the RegistrarGeneral, April 30th, 1881. Diminution of Total Mortality. "The decennium which closed with the year 1880 was one of lower mortality in London than any of the preceding decennial periods, for which trustworthy data are forthcoming." (page vi.) Increase of Small-Pox Mortality. "One disease alone in the class (zymotic) showed exceptionally a rise, and no inconsiderable one. This was small-pox, which, owing to the two great outbreaks of 1871-2 and 1877-8, gave a death-rate nearly 50 per cent. above the previous average. Doubtless there will be persons who will find in this fact a support of their opinion as to the uselessness of vaccination; but to most minds the truer lesson will appear to be, the necessity of enforcing vaccination with greater rigour, and with greater security for its efficiency." (page vii.) Influence of Temperature on Small-Pox Mortality. "It may be concluded that small-pox not only kills more persons, but attacks more per VACCINATION IN HACKNEY. THROUGH Dr. Pearce's activity and the publicity afforded by the Hackney Standard, an extraordinary interest has been excited in the vaccination question throughout that large and populous borough. The great meeting in Dr. Seddon's Tabernacle has been followed by another in Morley Hall, at which the opponents of vaccination have had it "all their own way -the resistance being overpowered by sheer force of evidence. This we may say of vaccination-it can nowhere endure discussion, either in public meetings or in the press. Courteous as he is, vaccinators fare badly under Dr. Pearce's hands, and it is not matter for surprise that medical men who look in at his meetings maintain a judicious silence. DONE TWELVE TIMES! We had supposed Dr. Lionel Beale to be the most vaccinated man in London, but it appears that Mr. Marsham, the magistrate at the Greenwich Police Court, runs him hard. Having Mr. Foster Howe of Lee before him for refusing to have his child vaccinated, he assumed to defend the practice, saying, "the enormous proportion of the unvaccinated who die proves that not sanitation, but vaccination is our true security from the disease. I have myself been vaccinated about twelve times, and I should be again next year if small-pox were about."-If so much vaccination be requisite for safety, many will argue that the protection is more to be dreaded than the penalty. The Lancet says a single re-vaccination is sufficient for life; and if so, is it not somewhat hard that faithful creatures like Mr. Marsham should be so imposed upon? WHO ARE THE UNVACCINATED? THE following letter appeared in the Manchester Examiner and Times "In Dr. Buchanan's Memorandum on Small-pox,' the following passage occurs: 'As no one suggests that the vaccinated and unvaccinated classes live under conditions differing from each other in their influence on small-pox, unless it be this one condition of vaccination, it follows for a first inference that the vaccinated are much less liable to die of small-pox than the unvaccinated.' The expression As no one suggests' is not quite honest in its character. The main instruction given to the public vaccinators connected with the department of which Dr. Buchanan is the head is as follows: 'Vaccinate only subjects who are in good health.' Mr. John Simon, C.B., F.R.S., for many years the chief medical adviser of the Government, as Dr. Buchanan is now, said in his evidence before a Parliamentary Committee in 1871, in answer to Question 3098: But let it be considered, with particular reference to that child who so shows a special liability to be upset by vaccination, what an infinitely greater upset small-pox would be. If the minimised disturbance, if the minimised small-pox, which vaccination is, produces this temporary derangement of health, what would not natural smallpox do to the child?' and in a report issued by Dr. Dixon, medical officer of health for Bermondsey, referred to by Mr. Ernest Hart, in the British Medical Journal of October 23rd, 1880, as an excellent report,' occurs the following: The high death rate in the unvaccinated must not be compared with the lower rate in the vaccinated, nor with the general mortality from small-pox before the discovery of vaccination, without a fair consideration of all the facts which may help to arrive at a just conclusion. There is a great difference in the intensity and virulence of different epidemics, both in small-pox, and in other zymotic diseases. It is probable that a large proportion of unvaccinated persons is to be found among the ignorant, dirty, and wretched inhabitants of the slums of London, and very few indeed, among the educated and better fed members of society. The disease is much intensified by overcrowding.' To those persons who are familiar with the one-sided statements issued by Government officials to bolster up a 'diseased' remedy, the want of candour, to use a mild expression, in Dr. Buchanan's statement will be nothing new. But it is hardly fair that public money should be used to diffuse misleading information. 66 "ENOCH ROBINSON, Surgeon. Chapel Hill, Dukinfield, June 13th.' mains a patent fallacy in Dr. Buchanan's conclusions, which entirely deprives them of all value. Dr. Buchanan starts with the remarkable premiss: No one suggests that the vaccinated and unvaccinated classes live under conditions differing from each other in their influence on small-pox, unless it be this one condition of vaccination.' "The inaccuracy of this assertion has been repeatedly exposed, but it is so obvious that one is surprised that any person in the least conversant with the subject could have fallen into it. It is manifest that the unvaccinated remnant of the community must be expected to show a much higher rate of mortality from any epidemic that may prevail, because they consist of (1) children in so bad a state of health that the doctors dare not vaccinate them; and (2) of children living in the slums of London where medical activity is slow to reach them, suffering under every predisposition to disease, caused by unhealthy dwellings, and by every other insanitary condition; while, as is well-known, vaccination is almost universal amongst the middle and higher classes, whose habits and surroundings are, of course, such as minimise the danger of infection, and secure every chance of recovery. "It follows, therefore, that those who have no faith in vaccination as a factor in small-pox mortality would naturally anticipate that the unvaccinated of our population would suffer in any small-pox epidemic, much about the same as did the whole population in the last century, when probably the sanitary, or rather unsanitary conditions of all London were about on a par with those of our existing worse localities. Such anticipation is curiously confirmed by Dr. Buchanan's figures. Dr. Buchanan places the mortality of what he considers the unprotected part of the population in the present epidemic at 3350 per million living, which is in curious harmony with the mortality in London during the small-pox epidemics of the last centurythe total mortality by that disease of the twelve worst years of the century being 38,827, giving an average of 3235 in a population I believe generally estimated at about one million. P. A. TAYLOR. House of Commons, June 15th, 1881." OF COURSE!-According to Dr. Fisher, the old lady at Sittingbourne who was re-vaccinated and died, did not die in consequence of his operation. Not only had the erysipelas no connection with the spot where the vaccine lymph was inserted, but the vaccination failed. Just so! Some of the worst cases of blood-poisoning are failures in the vaccinator's sense. A BIT OF EXPERIENCE.-Mr. Charles Hanks, of Cullerton Place, Newcastle, writing to the Tyneside Echo of 15th June, says "I had my two eldest children vaccinated, and some time afterwards they broke out with running sores and were under the care of the doctor for six months, who told me they were suffering from the effects of vaccination. Nine years this summer small-pox was raging badly in London. My brother, like hundreds more, was vaccinated (effectually, as the faculty would say). Six weeks afterwards he took small-pox, which caused his death, at the age of twenty-two." "FULL AND EXHAUSTIVE INQUIRY." THE letters which follow have a little history which may interest the readers of the Inquirer. In 1869, my brother Richard having arranged to address a meeting at Bradford, the Bradford Observer published a leading article on the day of meeting, in which it was argued to be absurd for Mr. Gibbs to try to upset a law which had been made only after an exhaustive inquiry into the merits of the practice. In the course of his speech my brother referred to this, and said he supposed the editor must allude to Mr. Simon's "papers," since so well known; but as these were published in 1856 they could not have formed the basis of an Act passed in 1853. The next day the editor in another article stated that he did not refer to Mr. Simon's " papers,' and re-asserted that legislation had been preceded by inquiry. The letters tell the rest. GEORGE S. GIBBS. R. B. GIBBS TO LORD LYTTELTON. July 24th, 1869. My Lord,-The recent controversies respecting the Vaccination Laws have led to a reference to a "full and exhaustive inquiry into the value of vaccination" previous to the introduction by your Lordship of the Vaccination Bill in the House of Lords in 1853. As we are anxious to gather all the information possible on this important subject, I trust your Lordship will pardon the intrusion if I ask what was the nature of the information or data on which your Lordship's Bill of 1853 was founded? -I have the honour to be, etc., R. B. GIBBS. DR. B. W. RICHARDSON wishes it to be understood that he has no sympathy with opposition to vaccination. He writes to Mr. Roberts of Keighley"I have been re-vaccinated four times myself, and all my family have been re-vaccinated, and we are about to be put through the vaccination again. These are, I hope, sufficient evidences of the views I hold, and I do not know how any rumour contrary to them has got abroad."-What Dr. Richardson objects to is the use of the policeman in enforcing vaccination. WHAT IS REASONABLE EXCUSE?-The Vaccination Act provides that reasonable excuse be heard for not obeying the law, but what is reasonable excuse is undefined, and is subject for continual controversy. Mr. George Kidson recently appeared for several friends under prosecution at Royton, and was told that neither disbelief in vaccination, nor evidence as to injuries inflicted by the practice was reasonable excuse; yet what excuse could be more cogent and reasonable? Mr. Kidson had a hard struggle to obtain a hearing, and was compelled to address the bench in severe terms. Magistrates ought to know that parents are entitled to be heard by whoever they please to appoint as their representative, and that they are bound to listen to argument before pronouncing judgment. |