twenty. Mr. Marson, of the Highgate Hospital, reported that 870 out of 950 of his patients were vaccinated in 1871; and he freely allowed that he looked forward to the time when all would enter as vaccinated-the law of compulsory primary vaccination being universally obeyed. How the primitive vaccinators would have started back in dismay could they have foreseen such an issue from their vaunted practice, warranted to confer perpetual immunity upon those who once received into their veins the benign virus! That early faith is now surrendered. It is said boldly that we can no longer hope to be secure from small-pox unless we are vaccinated periodically; and that until re-vaccination is systematically enforced throughout the land, it is idle to look for the extirpation of small-pox. As there is no probability that Parliament will pass a Compulsory Revaccination Act, and as primary vaccination is confessedly ineffective, would it not be good policy to cease from the attempt to enforce the vaccination of infants, with all the attendant irritation and expense, and leave those who please to fortify themselves at discretion? Those who think they can be so fortified cannot complain that their safety is endangered by those who do not share their faith. tinued prevalence of small-pox in London is most clearly due to the persistence of a large unvaccinated residuum." Most clearly due, is it? How, then, does he account for the outbreak of smallpox at Bromley, within the metropolitan district, ascribed to a bale of rags from Italy? None unvaccinated were attacked, but instead the vaccinated and the revaccinated. He further draws attention to the fact that, whilst London has been suffering from an epidemic of small-pox, and at the same time enjoying singularly good health with a low death-rate, nineteen English towns, whose aggregate population about equals that of London, have been almost exempt from the disease. To what purpose is the observation? Is it only in London that an unvaccinated residuum is to be found? Is Dr. Carpenter ignorant of the fact that he merely draws attention to a well-known and persistent phenomenon? The early vaccinators assumed that London small-pox was the measure of English small-pox, and even of the world's, and drew therefrom a variety of startling conclusions, alike as to the magnitude of the disorder and the miracles they proposed to work with their infallible specific. But their reckoning was wildly illusory. London small-pox was neither the measure of English small-pox, nor of that of the world. Many a year when small-pox was bad in London during last century, there was, precisely as at the present day, little or no smallpox in the towns and counties of England. WROTH is the Lancet over Mr. Taylor's exposure of the fable of the hospital nurses protected from small-pox by re-vaccination; but abuse, though it may serve for a time, will not permanently avail in this question. The editor of the Lancet knows very well that the general immunity of nurses from small-pox did not set in with the practice of re-vaccination, but was recognised and wondered over before vaccination was heard of. So far as immunity exists, the true explanation is that the nurses are middle WE would draw the especial attention of our readers to Mr. P. A. Taylor's reply to Dr. W. B. Carpenter, of which a very large edition has been printed and put into circulation, and would ask them to extend that circulation by every means in their power. Our opinion of Dr. Carpenter as a controversialist is a very low one: he is inexact, he is credulous, and he is absurdly conceited; but, having identified himself with the circle of fallacies that are vulgarly accepted as proofs of the advantages of vaccination, it is convenient to deal with him as their representative. We make bold to say that no one will rise from the perusal of Mr. Taylor's pamphlet without having his faith shaken in vaccination, and without a sense of humiliation that it has been possible to impose a prac-aged women, past the time of life in which smalltice on the public with so much audacious impudence, and so little warrant from verified experience. It is not unusual to hear vaccination described as "a triumph of modern science;" but our complaint is that science, in the sense of trained and accurate observation, has never been applied to it; and that the practice, such as it is, has been formulated by men like Jenner, whose intelligence was of "the professional average," or on a level with that of respectable monthly nurses. pox finds the majority of its victims. If we had the list of the nurses in any small-pox hospital, with their ages specified, the force of this explanation would be manifest. Again, there is something to be attributed to what may be called acclimatisation. If a woman engaged as a nurse endures the hospital atmosphere for a week unaffected, she may be taken as proof against small-pox for any term, the confidence and courage acquired from immunity constituting an additional safeguard. lf, on the contrary, DR. CARPENTER is incorrigible. We have just she succumbs, she is not reckoned among nurses, seen a letter in which he observes: but takes rank as a patient, and in the event of "The con convalescence she may, if suitable, resume office, the mischief and folly of vaccination as the opbut as a fresh band. We thus see how the possi-pressive and iniquitous administration of the com bility of nurses having small-pox is hedged round and limited, and how artfully contrived for deception is their asserted immunity. To establish the virtue of revaccination as a protection of nurses from small-pox would require an investigation and comparison of a breadth and nicety that has never been attempted, nor ever will be: for some of those chiefly concerned in the assertion know too well what would be the issue. "The nurse fable," as it is justly stigmatised, serves its purpose ad captandum vulgus, and was never designed for esoteric credence. The Lancet merely perpetuates the dreary game of make-believe, when it refers Mr. Taylor to the deaths of nurses from typhus as proof that nurses might equally die of small-pox if unprotected. It should be unnecessary to point out that typhus attacks a wider range of ages than small-pox, that it is far more infectious, and that a true comparison would run rather with nurses in contact with scarlet fever, whoopingcough, and measles. LORD CLIFTON's contention that sec. 31 of the Act 30 and 31 Vic., cap. 34, was intended to apply to unvaccinated children born between Dec. 31, 1853, and Dec. 31, 1867, is in our opinion perfectly valid. The evidence is clear, and ought to be decisive. That Lord Chief Justice Cockburn should have conferred on the section a universal application can only be accounted for by his extravagant faith in vaccination, and persuasion that whatever extended its influence and repressed and harassed its adversaries was for good. That such was his temper was obvious from his demeanour and utterances on the bench. He did not even affect impartiality, but showed his sense of annoyance that the time of the Court should be wasted in hearing the arguments of a parcel of fools and fanatics. It was Cockburn who described an unvaccinated infant as "a centre of contagion," which Bompas, Q.C., straightway developed into a flaming firebrand " that vaccination quenched. The more sensible officials at the Local Government Board would willingly see the oppression of the Vaccination Act reduced, the proposal made by the Government last year to set a limit to prosecutions and fines having their cordial support "in the interests of vaccination itself;" and if only the law were interpreted in the sense Lord Clifton sets forth the end desired might be attained without resort to Parliament. It is not for us to disdain any amelioration of the law, although at the same time we must confess that nothing has so effectually opened many eyes to pulsory Acts. The active and scientific opposition to vaccination may be said to date from the enactment of compulsion, and, set a-going, will never cease until the last warrant for the practice is wiped from the Statute-Book. Thus it is that good springs from evil, and is hastened by the intensity of the evil. An Act for Compulsory Re-Vaccination, which is so eagerly demanded in certain medical coteries, would speedily lead to that consummate victory which we so earnestly desire and work for. CAUTIOUS folk must view with some apprehension the manner in which M. Pasteur's expectations Lubbock at the British Association to the Daily are treated as performances, from Sir John News, which newspaper presents an estimate of the saving that will accrue to the owners of sheep and cattle from the new vaccination, as, in contempt of etymology, it is styled. Strange to say M. Pasteur does not appear to shrink from the responsibility thus recklessly imposed upon him. Having disposed of cholera in chickens and splenic fever in herds, he is about make an end of hydrophobia, and to tackle yellow-fever itself. Still further, the Daily News, which has a penchant for scientific sensation, announces that a gentleman has communicated to the Academy of Sciences in Paris the discovery of a mode of vaccinating vines as a defence against the attacks of the phylloxera! It does not require much prescience to foretell that if M. Pasteur does not mind what he is about he will wreck his reputation. He bases his claim for the acceptance of his various inoculations upon the success of vaccination in preventing small-pox, taking that success as something granted and indisputable; but if the inoculations prove no more effective against their several analogues than does vaccination against small-pox, he is assuredly committing himself to a course of humbug that will terminate in disaster and dishonour. WE find from an article in the Journal d'Hygiène, of August 25, that Dr. Desjardins, of Nice, in a letter to the editor of the Akhbar, gives a complete confirmation of the syphilisation of the fifty-eight French soldiers in Algeria, on Dec. 30 last, the particulars of which we have already set before our readers. The most cautious silence, we are informed, is preserved by the military authorities; and not without reason, if vaccination is to retain its hold on popular credulity. The writer demands that the recruits be dismissed from a service to which they will be a useless appendage, and proposes to solace them with pensions for injuries which the Government cannot redress. The letter concludes with a recommendation that calf-lymph be adopted in future. It is proclaimed, apparently by an inversion of the famous line, "A rose by any other name would smell as sweet," that numerous re-vaccinations have lately been made in the garrisons of Paris and Vincennes with "lymph from the calf." INTRODUCTION OF VACCINATION TO INDIA AND THE EAST. THE furore for cow-pox in England was reproduced with access among the English in India. It is always so. What is the fashion at home is an intenser fashion abroad. When we say India, we speak as of a country when we are dealing with a continent-of not one but many peoples, of races numerous and tongues various: wherefore, in naming India, we would be understood as limiting our remarks to the portion designated and to the population affected by English influence. In several parts of India small-pox was endemic -begotten in permanently unwholesome conditions of life, and cultivated and propagated by inoculation. When, therefore, it was heard that cow-pox might be substituted for small-pox, and that the mild served every purpose of the severe disease, there arose a demand among the English for the virus, alike for their own and for native use. Dr. Underwood, writing to Jenner from Madras, Feb. 28, 1801, observed: "I have read with very great pleasure your publications on cow-pox, and feel particularly anxious to introduce and extend it in this country under the greatest confidence that it would save many lives. I have hitherto embraced every opportunity of inoculating with variolous matter, but the loss of a beautiful little patient has humbled me, and I confess I never now take up a lancet but with fear and trembling."* It was easier to ask than to obtain. There was no cow-pox to be heard of in India, and the long voyage round the Cape and the tropical heat were fatal to its transmission. Repeated attempts were made, but all ended in failure. Jenner proposed to place a number of picked men on board an East Indiaman, and to have them successively vaccinated in the course of the voyage so as to land with virus fresh in Bombay or Calcutta ; but the East India Company declined the proposal. An attempt was then made to raise a subscription for the purpose, Jenner putting his name down for 1,000 guineas; though it was difficult to imagine where the 1,000 guineas were to come from unless out of the pocket of some ardent admirer.† De Carro accepted the commission with alacrity. He had already had an application from Bagdad, and, dismissing the vehicles which had been tried and failed, such as lancets of steel, silver, gold, and ivory, and threads enclosed in quills, he saturated lint with virus, and, placing it between glasses, in one of which was a cavity for its reception, tied them together, sealed the edges, and, taking them to a wax chandler, had them dipped until enclosed in a ball of wax, which was packed in a box stuffed with shreds of paper. In this manner the virus was conveyed through Constantinople, across the deserts to Bagdad, where it was received March 31, 1802, still liquid, and was used "with complete success. The like success was reported from Bussora, Muscat, and Bushire. From Bussora the virus was conveyed to Bombay, arriving, after a three weeks' voyage, early in June. Twenty or thirty were inoculated with the Vienna virue, but only one took," namely, Anna Dusthall, a child about three years of age, who was operated upon by Dr. Helenus Scott. The progress of the case was watched with intense anxiety, and correspondent satisfaction when the symptoms developed according to the recognised description. On the eighth day five children were vaccinated from Dusthall's arm, and loud was the rejoicing when it was known that for India was secured the genuine Variola Vaccine. From Bombay "the precious fluid" was in due course conveyed to Ceylon, Madras, Calcutta, and wherever English influence prevailed. De Carro was naturally elated with his The virus he transmitted was originally obtained from the stock of Dr. Sacco, of Milan, who had it off some Lombard cows." success. 66 Jenner wrote to De Carro to congratulate him, March 28, 1803: "Since the commencement of our correspondence, great as my satisfaction has been in the perusal of your letters, I do not recollect when you have favoured me with one that has afforded me pleasure equal to the last. The regret I have experienced at finding that every endeavour to send the vaccine virus to India in perfection has again and again failed, is scarcely to be described to you; judge, then, what pleasure you convey in assuring me that my wishes are accomplished. I am confident that had not the opponents in this country to my ideas of the origin of the disease been so absurdly clamorous (particularly the par nobile fratrum +), the Asiatics would long since have enjoyed the blessings of vaccination, and many a victim been rescued from an untimely grave. The decisive ex the tongues of these gentlemen for ever." These efforts were, however, superseded by the energy and ingenuity of Dr. De Carro, of Vienna. Lord Elgin, British ambassador to the Porte, had made acquaintance with De Carro, and had received virus from him with which his infant son and others were vaccinated at Constantinople.periments of Dr. Loy on this subject have silenced The news spreading abroad, Lord Elgin was entreated to meet the Indian demand, sending the vaccine overland to Bombay by way of Bagdad and Bussora. He made several futile attempts, and thereon determined to place the matter in the hands of De Carro; and for that purpose addressed himself to the Hon. Arthur Paget, British ambassador at Vienna, saying— "I have so many applications for vaccine virus from Bussora, the East Indies, and Ceylon, that I beg you will immediately apply to Dr. De Carro, and request him to send some by every courier." Baron's "Life of Jenner," vol. i., p. 410. How the denial that cow-pox originated in horse-grease prevented "the blessings of vaccination" from reaching the Asiatics, he did not condescend to explain. Perhaps he thought that in the absence of cow-pox, the English might have discovered and used horse-grease for inoculation in India, after the manner of Dr. Loy. Or if it was that he fancied that horse-grease might have borne transmission better than cow-pox, why did "Histoire de la Vaccination en Turquie et l'Orient." Par Jean de Carro. Vienne: 1804. + Pearson and Woodville. Baron's "Life of Jenner," vol. i., p. 428. he not send it? What was there in the clamorous opposition to hinder ? The imported cow-pox was diffused and recommended with energy and with fraud. Jenner, writing to Dunning, Nov. 2, 1804, says:— "Conceiving it might be a gratification to you to see how systematically they manage vaccine affairs in India, I have sent you a copy of a paper just transmitted to me from the India House. Would to Heaven we could boast of such arrangements here!" Here is the paper which sets forth the energetic policy pursued: "Fort William, Jan. 13, 1804. "With a view of extending the practice of vaccine inoculation throughout the East India Company's territories in India, the GovernorGeneral in Council of Bengal has appointed a Superintendent-General of Vaccine Inoculation at the Presidency, and established subordinate superintendents at several of the interior stations of the country; namely, at Dacca, Moorshedabad, Patna, Benares, Allahabad, Cawnpore, and Farruckabad. These superintendents are the surgeons of the stations, and are to act under the orders of the Superintendent - General in whatever regards vaccine inoculation. The civil surgeons also at the several judicial and revenue stations are to cooperate with these superintendents for the purpose of forwarding the general object. "Vaccine inoculation has also been introduced with success into Prince of Wales Island, and it is intended to extend the practice to Malacca and other places to the eastward; and a confident expectation is entertained that the benefits of this valuable discovery will be diffused throughout Asia. It is even in contemplation to extend it to China; but as the suspicious disposition of the Chinese might possibly ascribe any attempt to introduce this novel practice to sinister motives, it has been postponed until the opinion of the Company's servants there can be obtained." Much of this policy was due to the Marquis Wellesley, the Governor-General, whose habit it was to convert conviction without delay into performance. To what extent it was found practicable to substitute vaccination for variolation among the natives does not clearly appear. It was comparatively easy to operate upon those immediately dependent upon their conquerors; but it was a different matter to disarm the aver sion of the external myriads. Supposing the variolaters preferred their ancient practice because it was more lucrative, a number of them were brought to Calcutta, and inquiry made as to the amount of their gains, which ascertained, they were offered double pay if they would adopt vaccination. The offer was readily accepted, and other variolators, hearing of it, volunteered their services on similar terms, and were instructed and enrolled as official vaccinators. A declaration was drawn up and signed by twenty-six of these converted variolators, recommending vaccination to the Eastern world. The declaration was published in the Calcutta Gazette, printed in four languages, and widely circulated throughout India. "The History and Practice of Vaccination." By James Moore. London: 1817. P. 236. So much was possible to Government; but other means of persuasion were not neglected It was at first imagined that pox from the cow would exactly suit people who held that animal in reverence; but, on the contrary, the fact was converted by the Brahmins into an argument against its use, they contending, and justly, that cow-pox was impure. To meet this difficulty, various pious frauds were attempted. It was pretended that vaccination was no novelty in India, and that it was known, sanctioned, and practised from time immemorial. Baron, Jenner's biographer, relates these details without animadversion: "A native physician of Bareilly put into the hands of Mr. Gillman, who was surgeon at that station, some leaves purporting to be an extract from a Sanscrit work on medicine, entitled 'Sud'ha Sangreha,' by a physician named Mahadeva, to this effect "Take the matter of pustules, which are naturally produced on the teats of cows, carefully preserve it, and before the breaking out of small-pox make with a fine instrument a small puncture (like that made by a gnat) in a child's limb, and introduce into the blood as much of that matter as is measured by a quarter of a ratti. Thus the wise physician renders the child secure from the eruption of the small-pox.'" The Sanscrit work from which this passage was asserted to be taken was never forthcoming, and by competent authorities was pronounced "nothing more than a well-meant device for the reduction of ignorant prejudices," the native physician who put the leaves into the hands of Mr. Gillman being included in the fiction. Baron continues : "In order to overcome these native prejudices the late Mr. Ellis, of Madras, who was well versed in Sanscrit literature, actually composed a short poem in that language on vaccination. The poem was written on old paper, and was said to have been found, that the impression of its antiquity might assist the effect intended to be produced on the minds of the Brahmins while tracing the prevention to their sacred cow. "The late Mr. Anderson, of Madras, adopted the very same expedient, in order to deceive the Hindoos into a belief that vaccination was an ancient practice of their own. It is scarcely necessary to observe that had any authentic record of such a practice existed these gentlemen would never have resorted to such contrivances to gain their object."* These impostors were not priests, but medical men; not Jesuits, but Protestants; not Levantines, but Englishmen in the service of the Hon. East India Company. To what extent their frauds were operative is not related. They were probably too contemptuous of native acumen. For good and for evil the Hindoo listens to English advice courteously and without contradiction, but persists in his accustomed way of life with the equanimity of indifference. That vaccination was an ancient practice in India came to be repeated in Europe and seriously believed, when, Jenner's originality being impugned, the truth came out, that old Indian vaccination was a * Baron's "Life of Jenner," vol. i., pp. 556–559. device limited to Indian circumstances, and never designed for Western acceptance. In Madras vaccination was practised with much energy. Jenner, writing on May 7, 1808, says: "Wonderful to relate, the numbers vaccinated in that Presidency in the course of last year amount to 243,175."* In Bombay it was claimed that small-pox was extirpated, Dr. Helenus Scott reporting, Dec. 5, 1806, that "in this island, swarming with mankind, no loss from small-pox has been suffered for several years since the introduction of vaccine inoculation."+ It was not pretended that all the inhabitants of Bombay had been vaccinated, cr even a considerable portion of them; but the early vaccinators appear to have regarded vaccination as a sort of charm, the possession of which kept off small-pox; that by the vaccination, say, of one-tenth of any given population, the unvaccinated nine-tenths were protected. This faith in the vicarious efficacy of vaccination was not expressly avowed, but was implied in the numerous reports of extirpated small-pox in circumstances where no attempt was made, or was indeed possible, to effect universal vaccination. Confuted and frustrated in England, it was Jenner's habit to sigh, and turn from his ungrateful country to the vast realms of Europe, and Asia, and America. Writing to Dunning, December 23, 1804, he observed : "Foreigners hear, with the utmost astonishment, that in some parts of England there are persons who still inoculate for small-pox.' It must, indeed, excite their wonder when they see that disease totally exterminated in some of their largest cities and in wide-extended districts around them." Mark the words-Small-pox totally exterminated in some of the largest cities in 1804; that was to say, after, at the utmost, five years' acquaintance with vaccination! A miraculous time-was it not? Jenner proceeds : "Let us not, my friends, vex ourselves too much at what we see here. Let us consider this country as but a speck when compared with the wide surface of our planet, over which, thank God! Vaccinia has everywhere shed her influence. From the potentate to the peasant, in every country but this, she is received with grateful and open arms. What an admirable arrangement is that made by the Marquis Wellesley, the Governor General of India, for extermination of the small-pox in that quarter of the globe! Contrasted with our efforts here, what pygmies we appear!"‡ Omne ignotum pro magnifico est. What inference worth a straw could Jenner, or anyone else, draw from the introduction of vaccination to India? The number of the various Indian peoples was unknown; and the periods and prevalence of small-pox among them; also the extent to which they practised variolation. In the absence of such elementary information, tales of the triumphs of vaccination in India were as so much romance. So far as vaccination displaced variolation, it might be taken as the substitution of a less evil Baron's "Life of Jenner," vol. ii., P. 359. † Ib., vol. ii., p. 92. Ib., vol. ii., p. 24. for a greater; and much is accounted for in some of the early records of vaccination, when it is remembered that the new practice was welcomed as a deliverance from the inconveniences and horrors of the old; and that the discredited practice was frequently abandoned without resort to its successor. A cessation of variolation was a cessation of the culture and diffusion of small-pox; and vaccination had often the credit of the reduction of small-pox when the credit was due to the abatement of variolation. As to the propagation of small-pox by variolation, no one was more emphatic than Jenner, as for example "Where variolous inoculation is put in practice, the disease must necessarily spread."* 66 Small-pox will never be subdued so long as men can be hired to spread the contagion by inoculation."+ spread small-pox wherever practised, can it be fair to omit the consideration of the consequences of its abatement when estimating the results of the introduction of vaccination? Yet scarcely an advocate of vaccination permits the fact to enter into his reckoning! If then it be taken as conceded, that variolation The gratitude of the English in India to Jenner did not evaporate without substantial expression. A subscription was started, and between 1806 and 1812 he received remittances to the amount of £7,383, the contributors being— An amusing instance of Jenner's ignorance of India is found in a letter to Dunning, March 14 1807, wherein he ascribes his English money from India to the gratitude of Hindoo women : "You will be pleased to hear," he writes, "that the dingy Hindoo ladies are convincing me of their grateful remembrance, not merely by words, but by a tangible offering, while my fair Christian countrywomen pass me urheeded by."‡ Calcutta, for the first remittance of cash in 1806, Jenner, in returning thanks to Dr. Fleming, of took occasion to communicate some English news, which is not without interest at this day. He wrote: "To say the truth, this country has been dreadfully supine in the matter of vaccination hitherto. Some pamphlets, full of the grossest misrepre sentations and forgeries, have been spread; and the common people became so terrified, particularly when told that their children, if vaccinated, would take the similitudes of bulls and cows, that a great dislike to the practice has arisen among them; and these accounts have been circulated through the country with peculiar industry. The conseinoculation, which has produced an epidemic smallquence has been the re-introduction of variolous pox through the metropolis and the whole island, except in those parts where vaccination had previously been so generally adopted as to forbid its approach. This, now too late, has opened their eyes, and they see the powers of the cow-pox. The folly of the oppositionists has gone so far as to exhibit prints of children undergoing trans Letter to Dunning, Dec. 23, 1804. + Letter to Worthington, May 4, 1810. Baron's "Life of Jenner," vol. ii., p. 356. |