Part 4

Mr. Cross relates that _two_ deaths only took place after Vaccination, and justly observes, that “these can have no weight against the practice of Vaccination compared with 10,000 vaccinated individuals, living in the midst of a contaminated atmosphere; with 530 deaths among little more than 3000 who had neglected to be vaccinated; and with the occasional occurrence of regular Small Pox in those who formerly had the disease.” Of the 10,000 persons thus protected by Vaccination, the Reviewer of Mr. Cross’s History, &c. observes (Edin. Med. and Sur. Journal, Vol. xvii. p. 127), “Had these persons been protected by variolous (Small Pox) inoculation, conducted in the best manner, and in the most favourable circumstances, at least 33 of them (1 in 300) would have died of the process intended to protect them; so that in comparing the advantages of the two methods of protection, we have to weigh 33 deaths _certain_, against _two contingent on the invasion of an epidemic Small Pox_, and then we have to consider, whether there might not be nearly as great a chance of _two persons_ out of 10,000 inoculated for Small Pox, taking a fatal Small Pox on exposure, at a subsequent period of life, to a virulent contagion.” I shall conclude the evidence I think it necessary to bring forward on this part of my subject with the following extract from the Report of the National Vaccine Establishment for 1820. In reference to the occasional cases wherein the protection from Vaccination is not quite complete, the Board observes,—“Yet the value of this important resource is not disparaged in our judgment; for after all, these cases bear a very small proportion to the number of those who are effectually protected by it. The reports of the Vaccinators at the several stations in the metropolis, give only _eight_ cases of Small Pox out of nearly 67,000 vaccinated by them, since the first establishment of this board; and as the Small Pox has prevailed extensively in London, these persons so vaccinated, must have been frequently exposed to contagion, and consequently the protecting effect of Vaccination must have been submitted to as severe a test as can well be imagined. Moreover, we have the most undoubted proofs from experience, that where Vaccination has been performed perfectly, Small Pox, occurring after it, is almost universally a _safe_ disease; and though ushered in by severe symptoms, has hardly ever failed to be cut short before it had reached that period at which it becomes dangerous to life.”

I shall not weaken the force of this evidence by entering into any minor question connected with this great subject—such as the probability of many of those, in whom Small Pox has succeeded to Vaccination, having passed through the latter process imperfectly, either in consequence of the matter employed not having been genuine; of the constitution not having shown adequate signs of being properly influenced by the process; or of the latter having been interfered with in its progress, by the accidental injury of the pustules, &c. No doubt all these causes may have had some effect, in consequence of the carelessness of parents, or of the practice of non-professional inoculators: in a matter of so much importance then, it behoves parents to guard against these causes of failure, which it is now certainly within the power of the poorest to do. Nor shall I detail the arguments by which Professor Thomson has rendered it probable that the pustular eruption, which has been so long known in this country under the name of Chicken Pox, is very nearly related to Small Pox itself, and is in reality the effect of the same infectious virus modified by various incidental circumstances; such as season of the year, the previous existence of Small Pox or of Cow Pox in those affected by it, or some peculiarity in their constitution not sufficiently obvious to be recognised by our senses. When I rest my proof of the power of Vaccination over the destructive consequences of Small Pox on the results which have been detailed, I am satisfied that it is fixed upon a basis too firm to be shaken by argument, and which will long outlive the feeble attacks of ignorance or prejudice.

CONCLUSION.

The following are the important conclusions which may obviously be deduced from the satisfactory evidence which has been detailed.

1. That Vaccination has, within the space of twenty-five years, been the direct means of preserving, within the London[8] Bills of Mortality alone, a number of lives amounting to 21,127; and that if we extend the ratio of calculation to the whole of Great Britain and Ireland, it will appear that not fewer than 393,356 lives have been saved by this most valuable discovery, while an equal number have been preserved from “blindness, deformity, scrofula, or broken constitutions.”

Footnote 8:

The following is extracted from the London Medical and Physical Journal for the present month (December):—“_Influence of Vaccination upon the mortality of Berlin._ M. Casper has published a long paper, containing many curious details relative to the above subject; but we can do no more, at present, than give the result of his investigations. 1. The Small Pox formerly carried off from the 12th to the 10th of the population. 2. Formerly, at Berlin, one out of twelve children born, died of the Small Pox; now the deaths from the same cause are 1 in 116.”—_Journal Comp. September._ In London, as has been already shown, the number of deaths from Small Pox has been diminished from 1 in 10 to 1 in 28. It is obvious, therefore, that, were Vaccination employed in the latter city to the same proportional extent as at Berlin, a further saving of more than 500 lives annually would be effected, within the bills of mortality.

2. That in accomplishing this result, Vaccination has acted in two ways,—1. by superseding the practice of inoculation for Small Pox, which (while it afforded a certain degree of security to the inoculated) has been proved to have materially increased the gross number of deaths, by creating, artificially, many new sources of infection,—and, 2. by rendering the vaccinated entirely insusceptible of Small Pox infection, or the disease produced by it, in almost every instance, mild, harmless, and devoid of danger.

3. That Vaccination is capable, if universally employed, of exterminating the Small Pox altogether, as has been proved by the experience of other countries.

That Vaccination is a process perfectly unattended with danger to the individual who passes through it, and incapable of communicating any noxious infection to those around him, are facts too well known and too generally admitted, to require more than a passing notice; nevertheless it is essential that they should not be lost sight of.

But if these be indeed plain and legitimate conclusions from the facts and arguments which have been adduced—and to myself they appear irresistible ones—then must Vaccination cease to be considered as a matter of policy, or of curious medical research only, for it plainly resolves itself into a momentous moral question. Let it once be admitted that it is capable of eradicating so great an evil as the infection of Small Pox, and it becomes the imperative duty of every individual to promote, to the utmost of his ability, an end so infinitely desirable. The question involves consequences so closely connected with the well-being of individuals and of society in general, and the actual existence of so many thousands annually, that ignorance, or doubt, will scarcely form an admissible apology for the omission of what is alike essential for private and for public security. If then any be ignorant on this momentous subject, let him not delay to obtain information; if any doubt, let him use every exertion to satisfy himself. If he hesitate to confer on his children the advantages, which Vaccination has been proved to be capable of bestowing, let him remember, that it has already been the means of preserving nearly four hundred thousand of his countrymen, and that, perhaps, he owes his own existence at this day, to its salutary influence; that but for Vaccination he might possibly himself, long ago, have fallen a sacrifice to the destructive disease from which it has rescued so many victims, and have been equally unable to call its efficacy in question, or to assist in consummating the grand object, which by means of it alone, appears capable of being accomplished.

It was in our own country, that this most remarkable discovery originated; it was our own countryman, who, with such noble disinterestedness, as soon as he had satisfied himself of its real value, disclosed it to the world, and who sacrificed every personal consideration of pecuniary gain, to the general welfare of mankind. As Englishmen, we have just cause to be proud of both—the discovery and the discoverer; but we may well feel humbled when we remember, that the merits of neither have been adequately acknowledged amongst us; and that while the latter has been more justly estimated and more highly honoured in almost every other part of the world, the former has also been more effectively employed, and with proportionally more decisive results.

It is true, that in some of the continental nations, where Vaccination has been most extensively and successfully employed, it has been made a matter of state policy, and legislative measures have been used to enforce its adoption; while, at home, it has rested with the public to adopt or reject it, as might be agreeable to their opinions or prejudices. Some writers have proposed that a similar mode of enforcing its general employment in England, by legislative compulsion, should be made use of; but, I conceive, such measures would be too little in accordance with the spirit of our government, and too repulsive to the feelings of Englishmen, to render them advisable, notwithstanding the paramount national importance of the object. That the time will presently arrive when this object will be fully accomplished, without any such unpalatable interference of the legislature, but by the irresistible force of truth alone, on the minds of the public, I cannot permit myself to doubt. Means of information on the subject, ample and satisfactory, are within the reach of all who are anxious to enquire; and it cannot be that they should long remain unexplored, or that they will fail to carry conviction to the mind of every candid and intelligent enquirer. But, when I reflect that the early conviction of a single individual, who entertains a doubt of the protective efficacy of Vaccination, or a prejudice against the practice, may be the direct or indirect means of saving the lives of many, I cannot refrain from most earnestly exhorting every one to consider this subject maturely—to be strenuous and unremitting in his enquiries respecting it, until every doubt is satisfied. He will then see one straight forward path of duty before him, which he will feel himself compelled, by every moral and religious obligation, most perseveringly and undeviatingly, to pursue. He will feel that his own personal exertions, in promoting the general use of Vaccination in his own family, amongst his dependents and all those whom he can in any the slightest degree influence, are essential to the accomplishment of the great philanthropic end proposed—the total extinction of Small Pox: a consummation that would prevent a larger portion of human misery, and preserve a larger number of human lives, than any other which it is in the power of imagination to conceive, or of reason to contemplate.

TABLE I.

The first column of this Table exhibits the total number of deaths, and the second column the number of deaths from Small Pox, occurring within the London Bills of Mortality, during every successive year, for a period of 121 years.

┌───────┬──────────┬────────────┐ │ │ _Total │ _Number of │ │_Year._│number of │deaths from │ │ │ deaths._ │Small Pox._ │ ├───────┼──────────┼────────────┤ │ 1703 │ 20,720│ 898│ │ 1704 │ 22,684│ 1,501│ │ 1705 │ 22,097│ 1,095│ │ 1706 │ 19,847│ 721│ │ 1707 │ 21,600│ 1,078│ │ 1708 │ 21,291│ 1,687│ │ 1709 │ 21,800│ 1,024│ │ 1710 │ 24,620│ 3,138│ │ 1711 │ 19,833│ 915│ │ 1712 │ 21,198│ 1,943│ │ 1713 │ 21,057│ 1,614│ │ 1714 │ 26,569│ 2,810│ │ 1715 │ 22,232│ 1,057│ │ 1716 │ 24,436│ 2,427│ │ 1717 │ 23,446│ 2,211│ │ 1718 │ 26,523│ 1,884│ │ 1719 │ 28,347│ 3,229│ │ 1720 │ 25,454│ 1,440│ │ 1721 │ 26,142│ 2,375│ │ 1722 │ 25,750│ 2,167│ │ 1723 │ 29,197│ 3,271│ │ 1724 │ 25,952│ 1,227│ │ 1725 │ 25,523│ 3,188│ │ 1726 │ 29,647│ 1,569│ │ 1727 │ 28,418│ 2,370│ │ 1728 │ 27,810│ 2,105│ │ 1729 │ 29,722│ 2,849│ │ 1730 │ 26,761│ 1,914│ │ 1731 │ 25,262│ 2,640│ │ 1732 │ 23,358│ 1,197│ │ 1733 │ 29,233│ 1,370│ │ 1734 │ 26,062│ 2,688│ │ 1735 │ 23,538│ 1,594│ │ 1736 │ 27,581│ 3,014│ │ 1737 │ 27,823│ 2,084│ │ 1738 │ 25,825│ 1,590│ │ 1739 │ 25,432│ 1,619│ │ 1740 │ 30,811│ 2,725│ │ 1741 │ 32,169│ 1,977│ │ 1742 │ 27,483│ 1,429│ │ 1743 │ 25,200│ 2,029│ │ 1744 │ 20,606│ 1,639│ │ 1745 │ 21,296│ 1,206│ │ 1746 │ 28,151│ 3,236│ │ 1747 │ 25,494│ 1,380│ │ 1748 │ 23,869│ 1,789│ │ 1749 │ 25,516│ 2,625│ │ 1750 │ 23,727│ 1,229│ │ 1751 │ 21,028│ 998│ │ 1752 │ 20,485│ 3,538│ │ 1753 │ 19,276│ 774│ │ 1754 │ 22,696│ 2,359│ │ 1755 │ 21,917│ 1,988│ │ 1756 │ 20,872│ 1,608│ │ 1757 │ 21,313│ 3,296│ │ 1758 │ 17,576│ 1,273│ │ 1759 │ 19,604│ 2,596│ │ 1760 │ 19,830│ 2,187│ │ 1761 │ 21,083│ 1,525│ │ 1762 │ 26,326│ 2,743│ │ 1763 │ 26,143│ 3,582│ │ 1764 │ 23,202│ 2,382│ │ 1765 │ 23,230│ 2,498│ │ 1766 │ 23,911│ 2,334│ │ 1767 │ 22,612│ 2,188│ │ 1768 │ 23,639│ 3,028│ │ 1769 │ 21,847│ 1,968│ │ 1770 │ 22,434│ 1,986│ │ 1771 │ 21,780│ 1,660│ │ 1772 │ 26,053│ 3,992│ │ 1773 │ 21,656│ 1,039│ │ 1774 │ 20,884│ 2,479│ │ 1775 │ 20,514│ 2,669│ │ 1776 │ 19,048│ 1,728│ │ 1777 │ 23,334│ 2,567│ │ 1778 │ 20,399│ 1,425│ │ 1779 │ 20,420│ 2,493│ │ 1780 │ 20,517│ 871│ │ 1781 │ 20,709│ 3,500│ │ 1782 │ 17,918│ 636│ │ 1783 │ 19,020│ 1,550│ │ 1784 │ 17,828│ 1,759│ │ 1785 │ 18,919│ 1,999│ │ 1786 │ 20,454│ 1,210│ │ 1787 │ 19,349│ 2,418│ │ 1788 │ 19,697│ 1,101│ │ 1789 │ 20,749│ 2,077│ │ 1790 │ 18,038│ 1,617│ │ 1791 │ 18,760│ 1,747│ │ 1792 │ 20,213│ 1,568│ │ 1793 │ 21,749│ 2,382│ │ 1794 │ 19,241│ 1,913│ │ 1795 │ 21,179│ 1,040│ │ 1796 │ 18,905│ 3,548│ │ 1797 │ 17,014│ 522│ │ 1798 │ 18,155│ 2,237│ │ 1799 │ 18,134│ 1,111│ │ 1800 │ 23,068│ 2,409│ │ 1801 │ 19,374│ 1,461│ │ 1802 │ 19,379│ 1,579│ │ 1803 │ 19,582│ 1,202│ │ 1804 │ 17,038│ 621│ │ 1805 │ 17,565│ 1,685│ │ 1806 │ 17,938│ 1,158│ │ 1807 │ 18,334│ 1,297│ │ 1808 │ 19,954│ 1,169│ │ 1809 │ 16,680│ 1,163│ │ 1810 │ 19,893│ 1,198│ │ 1811 │ 17,043│ 751│ │ 1812 │ 18,295│ 1,287│ │ 1813 │ 17,322│ 898│ │ 1814 │ 19,783│ 638│ │ 1815 │ 19,560│ 725│ │ 1816 │ 20,316│ 653│ │ 1817 │ 19,968│ 1,051│ │ 1818 │ 19,705│ 421│ │ 1819 │ 19,228│ 712│ │ 1820 │ 19,348│ 792│ │ 1821 │ 18,451│ 508│ │ 1822 │ 18,863│ 604│ │ 1823 │ 20,587│ 774│ └───────┴──────────┴────────────┘

TABLE II.

This Table is divided into intervals of five years each. It embraces the same period of 121 years, included in the former, and is intended to shew the encrease in the average amount of mortality from Small Pox during the practice of Inoculation, and the striking diminution which has taken place since the introduction of Vaccination.

┌────────────────┬──────────┬────────────┬────────────┬───────────┐ │ │ _Total │ _Number of │ _Number of │ _Relative │ │ _Periods of 5 │number of │deaths from │deaths from │ number of │ │years including_│ deaths._ │Small Pox._ │Small Pox in│deaths from│ │ │ │ │ 1000._ │Small Pox._│ ├────────────────┼──────────┼────────────┼────────────┼───────────┤ │ 1703 to 1707 │ 106,948│ 5,293│ 49.4│1 in 20.2 │ │ 1708 -- 1712 │ 108,742│ 8,707│ 80.0│1 in 12.4 │ │ 1713 -- 1717 │ 117,740│ 10,119│ 85.9│1 in 11.6 │ │ 1718 -- 1722 │ 132,216│ 11,095│ 84.5│1 in 11.9 │ │ 1723 -- 1727 │ 138,737│ 11,625│ 83.6│1 in 11.9 │ │ 1728 -- 1732 │ 132,913│ 10,705│ 80.5│1 in 11.4 │ │ 1733 -- 1737 │ 134,237│ 10,750│ 80.0│1 in 12.4 │ │ 1738 -- 1742 │ 141,720│ 9,415│ 66.0│1 in 15.0 │ │ 1743 -- 1747 │ 120,753│ 9,484│ 78.0│1 in 12.7 │ │ 1748 -- 1752 │ 114,625│ 10,179│ 89.0│1 in 11.2 ⎫│ │ 1753 -- 1757 │ 106,074│ 10,025│ 95.0│1 in 10.5 ⎪│ │1758 single year│ 17,576│ 1,273│ 72.4│1 in 13.8 ⎪│ │ 1759 -- 1763 │ 112,986│ 12,633│ 111.8│1 in 8.9 ⎪│ │ 1764 -- 1768 │ 116,594│ 13,630│ 116.9│1 in 8.5 ⎪│ │ 1769 -- 1773 │ 113,770│ 10,645│ 93.5│1 in 10.6 ⎬│ │ 1774 -- 1778 │ 104,179│ 10,808│ 103.7│1 in 9.7 ⎪│ │ 1779 -- 1783 │ 98,584│ 9,050│ 91.7│1 in 10.8 ⎪│ │ 1784 -- 1788 │ 96,247│ 8,487│ 88.2│1 in 11.3 ⎪│ │ 1789 -- 1793 │ 99,509│ 9,391│ 94.3│1 in 10.5 ⎪│ │ 1794 -- 1798 │ 94,494│ 9,260│ 96.9│1 in 10.2 ⎭│ │ 1799 -- 1803 │ 99,537│ 7,762│ 77.9│1 in 12.8 ⎫│ │ 1804 -- 1808 │ 90,829│ 5,930│ 65.3│1 in 15.3 ⎪│ │ 1809 -- 1813 │ 89,233│ 5,299│ 59.3│1 in 16.8 ⎬│ │ 1814 -- 1818 │ 99,332│ 3,488│ 35.1│1 in 28.4 ⎪│ │ 1819 -- 1823 │ 96,477│ 3,390│ 35.1│1 in 28.4 ⎭│ └────────────────┴──────────┴────────────┴────────────┴───────────┘

The first Bracket includes the period when Inoculation for Small Pox was in most general use. The second Bracket the period of Vaccination.

_Lately was published by the same Author, and to be had of E. Charnley, Price 1s._

HINTS

TOWARDS THE ADOPTION OF AN

IMPROVED PRINCIPLE OF REMUNERATING

The Surgeon Apothecary,

OR,

GENERAL PRACTITIONER IN MEDICINE.

ADDRESSED TO THE

MEMBERS OF THE PROFESSION

AND THE

PUBLIC AT LARGE.

Newcastle; Printed by T. & J. Hodgson, Union Street

Transcriber’s note:

Page 4, ‘in-instances’ changed to ‘instances,’ “where three instances had occurred”

Page 14, ‘recal’ changed to ‘recall,’ “who cannot recall many more”

Page 24, double quote moved to after ‘advantages,’ “of some real advantages” (p. 59).”

Page 25, double quote inserted after ‘are,’ “words are” (p. 37),”

Page 59, double quotes added after ‘results’ and before ‘which,’ “results” (adds Dr. Thomson) “which evince”

Page 73, full stop inserted after table heading ‘Year.’

Page 74, ‘8817’ changed to ‘1788,’ “1788 19,697 1,101”