recommend a reversion to inoculation with smallpox. A like scepticism as to the virtue of vaccination with a like disposition to return to variolous inoculation, is exhibited by Dr. Copland in his Dictionary of Practical Medicine, 1844-58-a work of high repute, and the standard of medical opinion for the time. In short, vaccination was subject to general distrust; every claim made for it had been belied; and except for its endowment by the State, and the determination of sundry adventurers to have that endowment enlarged, the practice would gradually have fallen into disuse.

The same absence of confidence in vaccination was conspicuous in the school of sanitary reformers. It was of the essence of their revelation that smallpox was as preventible as other fevers, and by the same methods. I might, indeed, challenge any one to produce aught from the utterances of the early apostles of sanitation in deliberate or explicit praise of vaccination. The prescription might not be formally condemned; it might even be cursorily approved; but it was foreign to the tenor of their doctrine, and its recommendation must have died in their throats. Dr. Southwood Smith delivered two lectures in Edinburgh in 1855 on the Prevention of Epidemics, but of smallpox as preventible by vaccination he said not a word. On the contrary, this was his testimony, his all inclusive testimony

Overcrowding we can prevent; the accumulation of filth in towns and houses we can prevent; the supply of light, air, and water, together with the several other appliances included in the all-comprehensive word CLEANLINESS, we can secure. To the extent to which it is in our power to do this, it is in our power to prevent epidemics.

The human family have now lived in communities more than six thousand years, yet they have not learnt to make their habitations clean. At last we are beginning to learn the lesson. When we shall have mastered it, we shall have conquered epidemics.

Among the upper and middle classes distrust in vaccination was general. How, indeed, could it be otherwise? All were vaccinated, yet whenever smallpox was epidemic, recipients of the rite enjoyed no immunity. In

one of Miss Mitford's letters we find an experience and a judgment which were far from uncommon. Writing, 1st February, 1850, she observed

About two months ago, my man, a very steady and respectable servant, was seized with Smallpox after Vaccination. He was very, very ill, delirious nearly a fortnight, and not a nurse could be had for love or money. I have lost all faith in Vaccination, either as preventing or mitigating Smallpox. I know of thirty severe cases this winter, five of them fatal, in my own immediate neighbourhood, and in Reading it has been a pestilence.*

Vaccination among the poor was (as it is) detested. Coaxed or forced into its reception without consideration or preparation, like sheep or cattle, they realised its mischiefs and misery in full measure; and naturally, whenever pressure was relaxed, avoided its acquaintance.

How then did vaccination come to be imposed upon a community thus affected? The answer is the usual one, illustrated continually in English politics: an organised interest, possessed with a definite intention, can always prevail over the public-careless, uninstructed, and without positive conviction. Under such circumstances, it is a mere question of management what may be achieved in Parliament at variance with the common welfare. Those there get, who know how to take.

All trades and professions fulfil the law of their being in striving after advantage and extension. The clergy and the clerically-minded laity are persuaded that to multiply churches and provide stipends, is to prepare for the millennium, and nothing save hopelessness prevents demands upon the national exchequer for the purpose. The sacrifices the army and navy would exact on their own behalf for security from foreign aggression are only limited by the public incredulity. The commercial classes are free-traders in principle; but if a protective bounty could be had for any manufacture, it would be instantly grasped at by those concerned, and most ingenious reasons invented to justify that particular departure from the rule of justice. This tendency of interests to aggrandise

Memoirs. By C. Boner. Vol. i. p. 176.

themselves, per fas et nefas, at the public expense, is recognised by all statesmen, and is only kept in check by perpetual vigilance.

What is true of all, is true of the medical profession, crowded with competitors eager for employment. Vaccination as a branch of business, capable of development and endowment at the public cost, was certain of vigorous promotion whenever there was opportunity; but not until 1853 did the way open for the compulsory infliction of the Jennerian rite. The undertaking was hazardous. The opposition to which Canning and Peel had given expression, had to be circumspectly encountered. It was a job that might easily be wrecked; and therefore it was considered inexpedient that the medical corporations should appear too openly in the transaction. Instead, a committee was formed in 1850 under the title of "The Epidemiological Society for the Investigation of Epidemic Diseases," with a number of suitable decoys, and ostensible occupation; but chiefly designed as an instrument wherewith to operate on Parliament for the better establishment and more liberal endowment of vaccination.

It was resolved to proceed tentatively-to secure if possible the affirmation of compulsion, allowing the shock of innovation to subside before going on to provide the effective means of espionage and persecution. As it turned out, the caution exercised was superfluous. Much more might have been demanded and conceded of the ignorance and indifference of the legislature. Lord Lyttelton was selected to introduce what was called the Vaccination Extension Bill, and in moving the second reading in the House of Lords on 12th April, he ingenuously disowned any qualification for the task, saying—

I have no scientific knowledge of the subject myself, and for my information I am indebted to some able and learned persons belonging to the Epidemiological Society

Adding in proof of the manner in which he had been crammed by the said "able and learned persons"

It is unnecessary for me to speak of the certainty of Vaccination as a preventive of Smallpox, that being a point on which the whole medical profession have arrived at complete unanimity!

The statistics with which Lord Lyttelton supported the necessity for compulsion are interesting as indicating the extent and irregularity of vaccination among the English people. He said

We are told that the number of births registered in England and Wales in the year ending 29th September, 1852, was 601,839, and the number vaccinated under the Act of 1840 was 397,128; so that, in round numbers, 400,000 were vaccinated by the machinery in force, leaving only 200,000, or one-third of the whole number, to be treated by private vaccination. There are several fallacies in that statement. The general result is by no means the consequence of anything like a uniform system throughout the country. I have before me a detailed statement of the extent of Vaccination in various parts of England in 1851, which shows there is great want of uniformity in certain districts. In towns where people have a shorter distance to go to get their children vaccinated, the result is more favourable than in the rural districts. For example, in Birmingham, on the total number of births in 1851, the vaccinations were 91 per cent.; in Leicester they were only 41 per cent.; and in Loughborough only 18 per cent. The contrast between the manufacturing and the rural districts is favourable on the side of the former. In Bideford, the vaccinations were only 11 per cent. upon the births; in West Ashford in Kent, they were only 22 per cent.; and in Winchcomb only 6 per cent. While the general average is lower in the agricultural than in the manufacturing districts, some contrary instances are found. Thus in Derby the vaccinations are only 42 per cent.; while at Watford, which is a rural district, the vaccinations were 126 per cent. upon the births in 1851-which included, of course, the vaccination of children born in previous years. But in London, and in no less a parish than that of St. James, Westminster, it is reported that in 1851 on 973 births only 44 vaccinations took place; while in Wellingborough Union, where there were 800 births in 1851, no vaccination at all is reported!

Strange to say, Lord Lyttelton made no attempt to complete his argument. He ought to have shown that in the places where vaccination was least practised there was most smallpox, and where most practised there was least smallpox. Had he made the attempt, his eyes might have been opened to the untrustworthy character of "the able and learned persons" by whom he had been mendaciously primed.

Lord Shaftesbury, in supporting the measure, adduced similar instances of neglected vaccination as follows

He, too, forgot to show that these places were "decimated" (that's the word) with smallpox, whilst other places where vaccination was generally practised enjoyed exemption. On the contrary, with curious inconsequence, he went on to recommend a sure prescription of his own, namely, improved dwellings for the poor. These were his words

It is perfectly true that Smallpox is chiefly confined to the lowest classes of the population; and I believe that with improved lodginghouses, the disease might be all but exterminated.

Not a doubt of it; but if improved lodging-houses would "all but exterminate smallpox," why resort to such a superfluity as vaccination?

"

There was no adverse discussion-indeed, no discussion whatever. Lord Ellenborough observed of the Epidemiological Society, under whose direction they were legislating, that he would not adventure upon the extraordinary name by which the members are designated." The bill was read for the third time, nem. diss., on 18th April, and was introduced to the House of Commons on 5th May, where its course was as uninterrupted as in the Lords. Sir John Pakington, in moving the second reading on 20th July, pleaded like Lord Lyttelton his own ignorance, and the evidence and authority of the Society with "the extraordinary name," thus stating the

case

An Act was passed in 1840, by which Boards of Guardians were authorised to defray the expenses of Vaccination in their respective unions. The Poor Law Board have done all in their power to carry out the provisions of the Act; but still the grave fact remains, that the system is voluntary: that in many places the people are prejudiced; that a large proportion of the population is not vaccinated; and that mortality from Smallpox exists to a very great extent.