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Title: Vaccination a Delusion - Its Penal Enforcement a Crime, Proved by the Official - Evidence in the Reports of the Royal Commission
Author: Wallace, Alfred Russel
Language: English
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Transcriber’s Note: Vaccination is not a delusion. Thanks to vaccination,
killer diseases such as small-pox, polio and tetanus have been more
or less eliminated. The supposed link between vaccination and autism
comes from one fraudulent study which actively falsified its data (BMJ
2011; 342:c7452). If you’re reading this with the aim of justifying not
vaccinating yourself or members of your family, stop right there and go
and read some modern-day science instead.



                         VACCINATION A DELUSION

                     Its Penal Enforcement a Crime:

             PROVED BY THE OFFICIAL EVIDENCE IN THE REPORTS
                         OF THE ROYAL COMMISSION

                                   BY
                          ALFRED RUSSEL WALLACE
                 LL.D. DUBL., D.C.L. OXON., F.R.S., ETC.

                             [Illustration]

                                 London
                     SWAN SONNENSCHEIN & CO., LIMD.
                           PATERNOSTER SQUARE
                                  1898

                            BUTLER & TANNER,
                       THE SELWOOD PRINTING WORKS,
                           FROME, AND LONDON.



PREFACE


This Essay has been written for the purpose of influencing Parliament,
and securing the speedy abolition of the unjust, cruel, and pernicious
Vaccination laws. For this purpose it has been necessary to speak plainly
of the ignorance and incompetence displayed by the Royal Commission,
proofs of which I give from their “Final Report” and the evidence they
have collected and printed.

I most solemnly urge upon our Legislators that this is a question not
only of the _liberties_ of Englishmen, but one affecting the _lives_ of
their children, and the _health_ of the whole community; and that they
will be individually responsible if they do not inquire into this matter
for _themselves_,—not accept the statements or opinions of others.

In order that they may do this with a minimum expenditure of time
and labour, I have put before them the _essential facts_, in almost
every case taken from the Reports of the Royal Commission or of the
Registrar-General, and with references to page, question, or paragraph,
so that they can themselves verify every statement I make. I thus
abundantly prove, first, that in all previous legislation they have been
misled by facts and figures that are untrue and by promises that have
been all unfulfilled; and that similar misstatements have characterised
the whole official advocacy of Vaccination from the time of Jenner down
to this day. I claim, therefore, that all official statements as to
Vaccination are _untrustworthy_.

I then show that _all_ the statistics of small-pox mortality, whether
of London; of England, Scotland, and Ireland; of the best vaccinated
Continental States; of unvaccinated Leicester; or of the revaccinated
Army and Navy, without any exception, prove the _absolute inutility
of Vaccination_; and I feel confident that every unprejudiced person
who will carefully read these few pages, and will verify such of my
statements as seem to them most incredible, will be _compelled_ to come
to the same conclusion.

I appeal from the medical and official apologists of Vaccination to the
intelligence and common sense of my fellow-countrymen, and I urge them
to insist upon the immediate abolition of all legislation enforcing or
supporting this useless and dangerous operation.



CONTENTS


  CHAPTER                                                           PAGE

    I. VACCINATION AND SMALL-POX                                       5

   II. MUCH OF THE EVIDENCE ADDUCED FOR VACCINATION IS WORTHLESS      23

  III. THE GENERAL STATISTICS OF SMALL-POX MORTALITY IN RELATION
         TO VACCINATION                                               31

   IV. TWO GREAT EXPERIMENTS WHICH ARE CONCLUSIVE AGAINST
         VACCINATION                                                  54

    V. CRITICAL REMARKS ON THE “FINAL REPORT”                         70

   VI. SUMMARY AND CONCLUSION                                         80



CHAPTER I

VACCINATION AND SMALL-POX


Among the greatest self-created scourges of civilized humanity are the
group of zymotic diseases, or those which arise from infection, and
are believed to be due to the agency of minute organisms which rapidly
increase in bodies offering favourable conditions, and often cause
death. Such diseases are: plague, small-pox, measles, whooping-cough,
yellow fever, typhus and enteric fevers, scarlet fever and diphtheria,
and cholera. The conditions which especially favour these diseases
are foul air and water, decaying organic matter, overcrowding, and
other unwholesome surroundings, whence they have been termed “filth
diseases.” The most terrible and fatal of these—the plague—prevails
only where people live under the very worst sanitary conditions as
regards ventilation, water supply, and general cleanliness. Till about
250 years ago it was as common in England as small-pox has been during
the present century, but a very partial and limited advance in healthy
conditions of life entirely abolished it, its place being to some extent
taken by small-pox, cholera, and fevers. The exact mode by which all
these diseases spread is not known; cholera, typhus, and enteric fever
are believed to be communicated through the dejecta from the patient
contaminating drinking water. The other diseases are spread either by
bodily contact or by transmission of germs through the air; but with all
of them there must be conditions favouring their reception and increase.
Not only are many persons apparently insusceptible through life to some
of these diseases, but all the evidence goes to show that, if the whole
population of a country lived under thoroughly healthy conditions as
regards pure air, pure water, and wholesome food, none of them could ever
obtain a footing, and they would die out as completely as the plague and
leprosy have died out, though both were once so prevalent in England.

But during the last century there was no such knowledge, and no general
belief in the efficacy of simple, healthy conditions of life as the only
effectual safeguard against these diseases. Small-pox, although then, as
now, an epidemic disease and of very varying degrees of virulence, was
much dreaded, because, owing chiefly to improper treatment, it was often
fatal, and still more often produced disfigurement or even blindness.
When, therefore, the method of inoculation was introduced from the East
in the early part of the eighteenth century, it was quickly welcomed,
because a mild form of the disease was produced which rarely caused death
or disfigurement, though it was believed to be an effectual protection
against taking the disease by ordinary infection. It was, however,
soon found that the mild small-pox usually produced by inoculation was
quite as infectious as the natural disease, and became quite as fatal
to persons who caught it. Towards the end of the last century many
medical men became so impressed with its danger that they advocated
more attention to sanitation and the isolation of patients, because
inoculation, though it may have saved individuals, really increased the
total deaths from small-pox.

Under these circumstances we can well understand the favourable reception
given to an operation which produced a slight, _non-infectious_ disease,
which yet was alleged to protect against small-pox as completely as did
the inoculated disease itself. This was Vaccination, which arose from the
belief of farmers in Gloucestershire and elsewhere that those who had
caught cow-pox from cows were free from small-pox for the rest of their
lives. Jenner, in 1798, published his _Inquiry_, giving an account of
the facts which, in his opinion, proved this to be the case. But in the
light of our present knowledge we see that they are wholly inconclusive.
Six of his patients had had cow-pox when young, and were inoculated
with small-pox in the usual way from twenty-one to fifty-three years
afterwards, and because they did not take the disease, he concluded
that the cow-pox had preserved them. But we know that a considerable
proportion of persons in middle age are insusceptible to small-pox
infection; besides which even those who most strongly uphold vaccination
now admit that its effects die out entirely in a few years—some say
four or five, some ten—so that these people who had had cow-pox so long
before were certainly _not_ protected by it from taking small-pox.
Several other patients were farriers or stable men who were infected by
horse-grease, not by cow-pox, and were also said to be insusceptible to
small-pox inoculation, though not so completely as those who had had
cow-pox. The remainder of Jenner’s cases were six children, from five to
eight years old, who were vaccinated, and then inoculated a few weeks
or months afterwards. These cases are fallacious from two causes. In
the first place, any remnant of the effects of the vaccination (which
were sometimes severe), or the existence of scurvy, then very prevalent,
or of any other skin-disease, might prevent the test-inoculation from
producing any effect.[1] The other cause of uncertainty arises from the
fact that this “variolous test” consisted in inoculating with small-pox
virus obtained from the _last_ of a series of successive patients in
whom the effect produced was a minimum, consisting of very few pustules,
sometimes only one, and a very slight amount of fever. The results of
this test, whether on a person who had had cow-pox or who had not had it,
was usually so slight that it could easily be described by a believer
in the influence of the one disease on the other as having “no effect”;
and Dr. Creighton declares, after a study of the whole literature of
the subject, that the description of the results of the test is almost
always loose and general, and that in the few cases where more detail is
given the symptoms described are almost the same in the vaccinated as in
the unvaccinated. Again, no careful tests were ever made by inoculating
at the same time, and in exactly the same way, two groups of persons
of similar age, constitution, and health, the one group having been
vaccinated the other not, and none of them having had small-pox, and
then having the resulting effects carefully described and compared by
independent experts. Such “control” experiments would now be required in
any case of such importance as this; but it was never done in the early
days of vaccination, and it appears never to have been done to this
day. The alleged “test” was, it is true, applied in a great number of
cases by the early observers, especially by Dr. Woodville, physician to
a small-pox hospital; but Dr. Creighton shows reason for believing that
the lymph he used was contaminated with small-pox, and that the supposed
vaccinations were really inoculations. This lymph was widely spread all
over the country, and was supplied to Jenner himself, and we thus have
explained the effect of the “vaccination” in preventing the subsequent
“inoculation” from producing much effect, since both were really mild
forms of small-pox inoculation. This matter is fully explained by Dr.
Creighton in his evidence before the Royal Commission, printed in the
Second Report. Professor E. M. Crookshank, who has made a special
study of cow-pox and other animal diseases and their relation to human
small-pox, gives important confirmatory evidence, to be found in the
Fourth Report.

This brief statement of the early history of vaccination has been
introduced here in order to give what seems to be a probable explanation
of the remarkable fact that a large portion of the medical profession
accepted, as proved, that vaccination protected against a subsequent
inoculation of small-pox, when in reality there was no such proof, as
the subsequent history of small-pox epidemics has shown. The medical and
other members of the Royal Commission could not realize the possibility
of such a failure to get at the truth. Again and again they asked the
witnesses above referred to to explain how it was possible that so
many educated specialists could be thus deceived. They overlooked the
fact that a century ago was, as regards the majority of the medical
profession, a pre-scientific age; and nothing proves this more clearly
than the absence of any systematic “control” experiments, and the
extreme haste with which some of the heads of the profession expressed
their belief in the lifelong protection against small-pox afforded
by vaccination, only four years after the discovery had been first
announced. This testimony caused Parliament to vote Jenner £10,000 in
1802.

Ample proof now exists of the fallacy of this belief, since vaccination
gives no protection whatever, as will be shown later on. But there was
also no lack of proof of this failure to protect in the first ten
years of the century; and had it not been for the unscientific haste
of the medical witnesses to declare that vaccination protected against
small-pox during a whole lifetime—a fact of which they had not and
could not possibly have any evidence—this proof of failure would have
convinced them and have prevented what is really one of the scandals of
the nineteenth century. These early proofs of failure will be now briefly
indicated.

Only six years after the announcement of vaccination, in 1804, Dr.
B. Moseley, Physician to Chelsea Hospital, published a small book on
the cow-pox, containing many cases of persons who had been properly
vaccinated and had afterwards had small-pox; and other cases of severe
illness, injury, and even death resulting from vaccination; and these
failures were admitted by the Royal Jennerian Society in their Report
in 1806. Dr. William Rowley, Physician to the St. Marylebone Infirmary,
in a work on _Cow-pox Inoculation_ in 1805, which reached a third
edition in 1806, gave particulars of 504 cases of small-pox and injury
after vaccination, with seventy-five deaths. He says to his brother
medical men: “Come and see. I have lately had some of the worst species
of malignant small-pox in the Marylebone Infirmary, which many of the
faculty have examined and know to have been vaccinated.” For two days he
had an exhibition in his Lecture Room of a number of children suffering
from terrible eruptions and other diseases after vaccination.

Dr. Squirrel, formerly Resident Apothecary to the Small-pox and
Inoculation Hospital, also published in 1805 numerous cases of small-pox,
injuries, and death after vaccination.

John Birch, a London surgeon, at first adopted vaccination and
corresponded with Jenner, but soon, finding that it did not protect from
small-pox and that it also produced serious and sometimes fatal diseases,
he became one of its strongest opponents, and published many letters and
pamphlets against it up to the time of his death in 1815.

Mr. William Goldson, a surgeon at Portsea, published a pamphlet in
1804, giving many cases in his own experience of small-pox following
vaccination. What made his testimony more important was that he was a
believer in vaccination, and sent accounts of some of his cases to Jenner
so early as 1802, but no notice was taken of them.[2]

Mr. Thomas Brown, a surgeon of Musselburgh, published in 1809 a volume
giving his experiences of the results of vaccination. He had at first
accepted and practised it. He also applied the “variolous test” with
apparent success, and thereafter went on vaccinating in full confidence
that it was protective against small-pox, till 1808, when, during an
epidemic, many of his patients caught the disease from two to eight
years after vaccination. He gives the details of forty-eight cases, all
within his own personal knowledge, and he says he knew of many others.
He then again tried the “variolous test,” and found twelve cases in
which it entirely failed, the result being exactly as with those who
were inoculated without previous vaccination. These cases, with extracts
from Brown’s work, were brought before the Royal Commission by Professor
Crookshank. (See 4th Report, Q. 11,852.)

Again, Mr. William Tebb brought before the Commission a paper by Dr.
Maclean, in the _Medical Observer_ of 1810, giving =535= cases of
small-pox after vaccination, of which =97= were fatal. He also gave
=150= cases of diseases from cow-pox, with the names of ten medical
men, including two Professors of Anatomy, who had suffered in their
own families from vaccination. The following striking passage is
quoted:—“_Doctrine._—Vaccination or Cow-pox inoculation is a perfect
preventive of small-pox during life. (Jenner, etc.) _Refutation._—535
cases of small-pox after cow-pox. _Doctrine._—Cow-pox renders small-pox
milder. It is never fatal. _Refutation._—97 deaths from small-pox after
cow-pox and from cow-pox diseases.”

The cases here referred to, of failure of vaccination to protect even for
a few years, are probably only a small fraction of those that occurred,
since only in exceptional cases would a doctor be able to keep his
patients in view, and only one doctor here and there would publish his
observations. The controversy was carried on with unusual virulence,
hence perhaps the reason why the public paid so little attention to
it. But unfortunately both the heads of the medical profession and the
legislature had committed themselves by recognising the full claims of
Jenner at too early a date and in a manner that admitted of no recall.
In 1802, as already stated, the House of Commons, on the Report of its
Committee, and the evidence of the leading physicians and surgeons of
London—a large number of whom declared their belief that cow-pox was a
perfect security against small-pox—voted Jenner £10,000. When therefore
the flood of evidence poured in, showing that it did _not_ protect, it
was already too late to remedy the mischief that had been done, since
the profession would not so soon acknowledge its mistake, nor would the
legislature admit having hastily voted away the public money without
adequate reason. The vaccinators went on vaccinating, the House of
Commons gave Jenner £20,000 more in 1807, endowed vaccination with £3,000
a year in 1808, and after providing for free vaccination in 1840, made
the operation compulsory in 1855, and enforced it by penalties in 1867.


VACCINATION AND THE MEDICAL PROFESSION

Before proceeding to adduce the conclusive evidence that now exists of
the failure of vaccination, a few preliminary misconceptions must be
dealt with. One of these is, that as vaccination is a surgical operation
to guard against a special disease, medical men can alone judge of its
value. But the fact is the very reverse, for several reasons. In the
first place, they are interested parties, not merely in a pecuniary
sense, but as affecting the prestige of the whole profession. In no
other case should we allow interested persons to decide an important
matter. Whether iron ships are safer than wooden ones is not decided by
ironmasters or by shipbuilders, but by the experience of sailors and by
the statistics of loss. In the administration of medicine or any other
remedy for a disease, the conditions are different. The doctor applies
the remedy and watches the result, and if he has a large practice he
thereby obtains knowledge and experience which no other persons possess.
But in the case of vaccination, and especially in the case of public
vaccinators, the doctor does not see the result except by accident.
Those who get small-pox go to the hospitals, or are treated by other
medical men, or may have left the district, and the relation between the
vaccination and the attack of small-pox can only be discovered by the
accurate registration of all the cases and deaths, with the facts as to
vaccination or revaccination. When these facts are accurately registered,
to determine what they teach is not the business of a doctor but of a
statistician, and there is much evidence to show that doctors are bad
statisticians, and have a special faculty for misstating figures. This
allegation is so grave and so fundamental to the question at issue, that
a few facts must be given in support of it.

The National Vaccine Establishment, supported by Government grants,
issued periodical Reports, which were printed by order of the House of
Commons, and in successive years we find the following statements:

In 1812, and again in 1818, it is stated that “previous to the discovery
of vaccination the average number of deaths by small-pox within the
(London) Bills of Mortality was 2,000 annually; whereas in the last year
only 751 persons have died of the disease, although the increase of
population within the last ten years has been 133,139.”

The number 2,000 is about the average small-pox deaths of the whole
eighteenth century, but those of the last two decades before the
publication of Jenner’s _Inquiry_, were 1,751 and 1,786, showing a
decided fall. This, however, may pass. But when we come to the Report
for 1826 we find the following: “But when we reflect that before the
introduction of vaccination the average number of deaths from small-pox
within the Bills of Mortality was annually about 4,000, no stronger
argument can reasonably be demanded in favour of the value of this
important discovery.”

This monstrous figure was repeated in 1834, apparently quite forgetting
the correct figure for the whole century given in 1818, and also the
fact that the small-pox deaths recorded in the London Bills of Mortality
in any year of the century never reached 4,000. But worse is to come;
for in 1836 we have the following statement: “The annual loss of life
by small-pox in the Metropolis, and within the Bills of Mortality only,
before vaccination was established, exceeded 5,000, whereas in the
course of last year only 300 died of the distemper.” And in the Report
for 1838 this gross error is repeated; while in the next year (1839) the
conclusion is drawn “that 4,000 lives are saved every year in London
since vaccination so largely superseded variolation.”[3]

The Board of the National Vaccine Establishment consisted of the
President and four Censors of the Royal College of Physicians, and the
Master and two senior Wardens of the College of Surgeons. We cannot
possibly suppose that they knew or believed that they were publishing
untruths and grossly deceiving the public. We must, therefore, fall back
upon the supposition that they were careless to such an extent as not
to find out that they were authorizing successive statements of the same
quantity as inconsistent with each other as 2,000 and 5,000.

The next example is given by Dr. Lettsom, who, in his evidence before
the Parliamentary Committee in 1802, calculated the small-pox deaths
of Great Britain and Ireland before vaccination at 36,000 annually; by
taking 3,000 as the annual mortality in London and multiplying by twelve,
because the population was estimated to be twelve times as large. He
first takes a number which is much too high, and then assumes that the
mortality in the town, village, and country populations was the same as
in overcrowded, filthy London! Small-pox was always present in London,
while Sir Gilbert Blane tells us that in many parts of the country it
was quite unknown for periods of twenty, thirty, or forty years. In 1782
Mr. Connah, a surgeon at Seaford, in Sussex, only knew of one small-pox
death in eleven years among a population of 700. Cross, the historian
of the Norwich epidemic in 1819, states that previous to 1805 small-pox
was little known in this city of 40,000 inhabitants, and was for a time
almost extinct; and yet this gross error of computing the small-pox
mortality of the whole country from that of London (and computing it from
wrong data) was not only accepted at the time, but has been repeated
again and again down to the present day as an ascertained fact!

In a speech in Parliament in defence of vaccination, Sir Lyon Playfair
gave 4,000 per million as the average London death-rate by small-pox
before vaccination—a number nearly double that of the last twenty years
of the century, which alone affords a fair comparison. But far more
amazing is the statement by the late Dr. W. B. Carpenter, in a letter to
the _Spectator_ of April, 1881, that “a hundred years ago the small-pox
mortality of London alone, with its then population of under a million,
was often greater in a six months’ epidemic than that of the twenty
millions of England and Wales now is in any whole year.” The facts,
well known to every enquirer, are: that the very highest small-pox
mortality in the last century in a year was 3,992 in 1772, while in 1871
it was =7,912= in London, or more than double; and in the same year, in
England and Wales, it was =23,000=. This amazing and almost incredible
misstatement was pointed out and acknowledged privately, but never
withdrawn publicly!

The late Mr. Ernest Hart, a medical man, editor of the _British Medical
Journal_, and a great authority on sanitation, in his work entitled _The
Truth about Vaccination_, surpasses even Dr. Carpenter in the monstrosity
of his errors. At page 35 of the first edition (1880), he states that
in the forty years 1728-57 and 1771-80, the average annual small-pox
mortality of London was about 18,000 per million living. The actual
average mortality, from the tables given in the Second Report of the
Royal Commission, page 290, was a little over 2,000, the worst periods
having been chosen; and taking the lowest estimates of the population at
the time, the mortality per million would have been under 3,000. This
great authority, therefore, has multiplied the real number by six! In a
later edition this statement is omitted, but in the first edition it was
no mere misprint, for it was triumphantly dwelt upon over a whole page
and compared with modern rates of mortality.

Yet one more official misstatement. About the year 1884 the National
Health Society, with the approval of the Local Government Board, issued a
tract entitled _Facts concerning Vaccination for Heads of Families_, in
which appeared the statement, “_Before the introduction of vaccination,
small-pox killed 40,000 persons yearly in this country._” We have
already shown that Dr. Lettsom’s figure, 36,000, was utterly unfounded,
and probably three or four times greater than the truth. Here we have
a semi-official and widely-distributed statement even more remote from
the truth. In later issues of the same tract this particular statement
is withdrawn, and a different but equally erroneous one substituted.
Thus: “Before its discovery (vaccination) _the mortality from small-pox
in London was forty times greater than it is now_.” This is an altogether
vague and misleading statement. If it means that in _some_ years of the
last century it was forty times greater than in _some_ years of this
century, it is misleading, because even within the last thirty years some
years have a mortality not only forty but eighty and even 200 times as
great as others. (In 1875 there were ten deaths per million, while in
1871 there were 2,420 deaths per million.) If it means on an average of
say twenty years, it is false. For the twenty years 1869-98 the mortality
was about 300 per million, while for the last twenty years before the
discovery of small-pox it was about 2,000 per million, or less than
_seven_ times as much instead of _forty_ times!

This same tract is full of other equally gross misstatements. It tells
us, in large, black type, “_With due care in the performance of the
operation, no risk of any injurious effects from it need be feared._” The
Registrar-General himself shows us that this is false in his Report for
1895, Table 17, p. lii.:

COW-POX AND OTHER EFFECTS OF VACCINATION

    Year.      Deaths.
    1881         58
    1882         65
    1883         55
    1884         53
    1885         52
    1886         45
    1887         45
    1888         45
    1889         58
    1890         43
    1891         43
    1892         58
    1893         59
    1894         50
    1895         56

An average of 52 children officially murdered every year, and officially
acknowledged, is termed “alleged injury,” which need not be feared! And
these cruel falsehoods are spread broadcast over the country, and the
tract bears upon its title-page—

    [_Revised by the Local Government Board, and issued with their
    sanction_].

As the tract bears no date, I cannot tell whether it is still issued; but
it was in circulation up to the time when the Commission was sitting,
and it is simply disgraceful that a Government Department should ever
have given its official sanction to such a tissue of misrepresentations
and palpable false statements. For these 785 deaths in fifteen years,
and 390 in the preceding twenty-two years (classed as from erysipelas
after vaccination), no one has been punished, and no compensation or
even official apology has been given to the thousand sorrowing families.
And we may be sure that these acknowledged deaths are only a small
portion of what have really occurred, since the numbers have increased
considerably in the later period, during which more attention has been
given to such deaths and more inquests held. It is certain that for
every such death acknowledged by the medical man concerned, many are
concealed under the easy method of stating some of the later symptoms
as the cause of death. Thus, Mr. Henry May, Medical Officer of Health,
candidly states as follows: “In certificates given by us voluntarily,
and to which the public have access, it is scarcely to be expected that
a medical man will give opinions which may tell against or reflect upon
himself in any way. In such cases he will most likely tell the truth, but
not the whole truth, and assign some prominent symptom of the disease
as the cause of death. As instances of cases which may tell against the
medical man himself, I will mention erysipelas from vaccination, and
puerperal fever. A death from the first cause occurred not long ago in my
practice; and although I had not vaccinated the child, yet, in my desire
to preserve vaccination from reproach, I omitted all mention of it from
my certificate of death.” (See _Birmingham Medical Review_, Vol III.,
pp. 34, 35.) That such _suppressio veri_ is no new thing, but has been
going on during the whole period of vaccination, is rendered probable by
a statement in the _Medical Observer_ of 1810, by Dr. Maclean. He says:
“Very few deaths from cow-pox appear in the Bills of Mortality, owing to
the means which have been used to suppress a knowledge of them. Neither
were deaths, diseases, and failures transmitted in great abundance
from the country, not because they did not happen, but because some
practitioners were interested in not seeing them, and others who did see
them were afraid of announcing what they knew.”

As an example of the number of cases occurring all over the country, Mr.
Charles Fox, a medical man residing at Cardiff, has published fifty-six
cases of illness following vaccination, of which seventeen resulted in
death. In only two of these, where he himself gave the certificate,
was vaccination mentioned. All of these cases were examined by himself
personally. Among those who survived, several were permanently injured
in health, and some were crippled for life; while in most of the cases
the inflammation and eruptions are so painful, and the sufferings of the
children so great and so prolonged, that the mother endures continuous
mental torture, lasting for weeks, months, or even years. And if _one_
medical man can record such a mass of injury and disease in which
vaccination was the palpable starting-point and certainly a contributory
cause, what must be the total mass of unrecorded suffering throughout
the whole country? Considering this and other evidence, together with
the admitted and very natural concealment by the doctors concerned, “to
save vaccination from reproach,” the estimate of Mr. Alfred Milnes,
a statistician who has paid special attention to the subject, that
the officially admitted deaths must be at least multiplied by twelve
to obtain the real deaths from vaccination, we shall arrive at the
terrible number of over 600 children and adults killed annually by this
compulsory operation; while judging from the proportion of permanent
injury (twenty-eight) in Mr. Fox’s fifty-six cases and seventeen deaths,
about 1,000 persons annually must suffer from it throughout their
lives! As confirmatory of even this large amount, the testimony of Mr.
Davidson, Medical Officer of Health for Congleton, and formerly a Public
Vaccinator, is important. He began an inquiry into the alleged injurious
effects of vaccination, without believing that they were serious. The
outcome of his investigation was startling to him. In his Annual Report
for 1893, he says: “In the investigation of a single vaccination period,
the fact was revealed that in quite fifty per cent. of all vaccinated in
that period (about seventy), the results were abnormal, and, in a large
number of these very grave injuries had been inflicted. That the results
of the practice are the same elsewhere as in Congleton I have no reason
to doubt, for judging from what I have seen of his method of vaccinating,
our Public Vaccinator is as careful as it seems possible for a Public
Vaccinator to be.”

This evidence of Mr. Davidson is especially important, because it reveals
the fact that, as I stated some pages back, neither Public Vaccinators
nor ordinary medical men usually know anything of the injurious effects
of vaccination, except in such individual cases as may occur in their
practice, while all around them there may be a mass of evil results
which, when systematically investigated, proves as unexpected as it is
startling in its amount.

This brief exposition of medical and official misstatements of
facts and figures, always in favour of vaccination, might have been
largely increased, but it is already sufficient to demonstrate the
position I take, which is, that in this matter of Official and
Compulsory Vaccination, both doctors and Government officials, however
highly placed, however eminent, however honourable, are yet utterly
untrustworthy. Beginning in the early years of the century, and
continuing to our own times, we find the most gross and palpable blunders
in figures—but always on the side of vaccination—and, on the testimony
of medical men themselves, a more or less continuous perversion of
the official records of vaccinal injury “in order to save vaccination
from reproach.” Let this always be remembered in any discussion of the
question. The facts and figures of the medical profession, and of
Government officials, in regard to the question of vaccination, _must
never be accepted without verification_. And when we consider that
these misstatements, and concealments, and denials of injury, have been
going on throughout the whole of the century; that penal legislation
has been founded on them; that homes of the poor have been broken up;
that thousands have been harried by police and magistrates, have been
imprisoned and treated in every way as felons; and that, at the rate now
officially admitted, a thousand children have been certainly killed by
vaccination during the last twenty years, and an unknown but probably
much larger number injured for life, we are driven to the conclusion that
those responsible for these reckless misstatements and their terrible
results have, thoughtlessly and ignorantly but none the less certainly,
been guilty of a crime against liberty, against health, and against
humanity, which will, before many years have passed, be universally held
to be one of the foulest blots on the civilization of the nineteenth
century.[4]



CHAPTER II

MUCH OF THE EVIDENCE ADDUCED FOR VACCINATION IS WORTHLESS


We will now proceed to discuss the alleged value of vaccination by
means of the best and widest statistical evidence at our command; and
in doing so we shall be able to show that the medical experts, who
have been trusted by the Government and by the general public, are no
less deficient in their power of drawing accurate conclusions from the
official statistics of vaccination and small-pox mortality than they
have been shown to be in their capacity for recording facts and quoting
figures with precision and correctness.

In the elaborate paper by Sir John Simon, on the History and Practice of
Vaccination, presented to Parliament in 1857 and reprinted in the First
Report of the Royal Commission, he tells us that the earlier evidence of
the value of vaccination was founded on _individual cases_, but that now
“from individual cases the appeal is to masses of national experience.”
And the marginal reference is, “Evidence on the protectiveness of
vaccination must now be statistical.” If this was true in 1857, how
much more must it be so now, when we have forty years more of “national
experience” to go upon. Dr. Guy, M.D., F.R.S., enforces this view in his
paper published by the Royal Statistical Society in 1882. He says: “Is
vaccination a preventive of small-pox? To this question there is, there
can be, no answer except such as is couched in the language of figures.”
But the language of figures, otherwise the science of statistics, is not
one which he who runs may read. It is full of pitfalls for the unwary,
and requires either special aptitude or special training to avoid these
pitfalls and deduce from the mass of figures at our command what they
really teach.

A commission or committee of enquiry into this momentous question should
have consisted wholly, or almost wholly, of statisticians, who would
hear medical as well as official and independent evidence, would have
all existing official statistics at their command, and would be able to
tell us, with some show of authority, exactly what the figures proved,
and what they only rendered probable on one side and on the other. But
instead of such a body of experts, the Royal Commission, which for more
than six years was occupied in hearing evidence and cross-examining
witnesses, consisted wholly of medical men, lawyers, politicians, and
country gentlemen, none of whom were trained statisticians, while the
majority came to the enquiry more or less prejudiced in favour of
vaccination. The report of such a body can have but little value, and
I hope to satisfy my readers that it (the Majority Report) is not in
accordance with the facts; that the reporters have lost themselves in the
mazes of unimportant details; and that they have fallen into some of the
pitfalls which encumber the path of those who, without adequate knowledge
or training, attempt to deal with great masses of figures.

But before proceeding to discuss the statistical evidence set forth in
the reports of the Commission, I have again the disagreeable task of
showing that a very large portion of it, on which the Commissioners
mainly rely to justify their conclusions, is altogether untrustworthy,
and must therefore be rejected whenever it is opposed to the results of
the great body of more accurate statistical evidence. I allude of course
to the question of the comparative small-pox mortality of the VACCINATED
and the UNVACCINATED. The first point to be noticed is, that existing
official evidence of the greatest value has never been made use of for
the purposes of registration, and is not now available. For the last
sixteen years the Registrar-General gives the deaths from small-pox
under three headings. Thus, in the year 1881 he gives for London (Annual
Summary, p. xxiv.):

    Small-pox.    Vaccinated         524 deaths.
         ”        Not vaccinated     962   ”
         ”        No statement       885   ”

And in the year 1893, for England and Wales, the figures are (Annual
Report, p. xi.):

    Small-pox.    Vaccinated         150 deaths.
         ”        Unvaccinated       253   ”
         ”        No statement      1054   ”

Now such figures as these, even if those under the first two headings
were correct, are a perfect farce, and are totally useless for any
statistical purpose. Yet every vaccination is officially recorded—since
1873 private as well as public vaccinations—and it would not have been
difficult to trace almost every small-pox patient to his place of
birth and get the official record of his vaccination if it exists. As
the medical advisers of the Government have not done this, and give
us instead partial and local statistics, usually under no official
sanction and often demonstrably incorrect, every rule of evidence and
every dictate of common sense entitle us to reject the fragmentary
and unverified statements which they put before us. Of the frequent
untrustworthiness of such statements it is necessary to give a few
examples.

In _Notes on the Small-pox Epidemic at Birkenhead_, 1877 (p. 9), Dr.
F. Vacher says: “Those entered as not vaccinated were admittedly
unvaccinated, or without the faintest mark. The mere assertions of
patients or their friends that they were vaccinated counted for nothing.”
Another medical official justifies this method of making statistics as
follows: “I have always classed those as ‘unvaccinated,’ when no scar,
presumably arising from vaccination, could be discovered. Individuals
are constantly seen who state that they have been vaccinated, but upon
whom no cicatrices can be traced. In a prognostic and a statistic
point of view, it is better, and, I think, necessary, to class them
as unvaccinated” (Dr. Gayton’s Report for the Homerton Hospital for
1871-2-3).

The result of this method, which is certainly very general though not
universal, is such a falsification of the real facts as to render
them worthless for statistical purposes. It is stated by so high an
authority as Sir James Paget, in his lectures on Surgical Pathology, that
“cicatrices may in time wear out”; while the Vaccination Committee of the
Epidemiological Society, in its Report for 1885-6, admitted that “not
every cicatrice will permanently exist.” Even more important is the fact
that in confluent small-pox the cicatrices are hidden, and large numbers
of admissions to the hospitals are in the later stages of the disease.
Dr. Russell, in his Glasgow Report (1871-2, p. 25), observes, “Sometimes
persons were said to be vaccinated, but no marks could be seen, very
frequently because of the abundance of the eruption. In some of those
cases which recovered, an inspection before dismission discovered vaccine
marks sometimes very good.”

In many cases private enquiry has detected errors of this kind. In
the Second Report of the Commission, pp. 219-20, a witness declared
that out of six persons who died of small-pox and were reported by the
medical officer of the Union to have been unvaccinated, five were found
to have been vaccinated, one being a child who had been vaccinated by
the very person who made the report, and another a man who had been
twice revaccinated in the militia (_Q._ 6730-42). One other case may
be given. In October, 1883, three unvaccinated children were stated in
the Registrar-General’s weekly return of deaths in London to have died
of small-pox, “being one, four, and nine years of age, and all from 3,
Medland Street, Stepney.” On enquiry at the address given (apparently
by oversight in this one case) the mother stated that the three children
were hers, and that “all had been beautifully vaccinated.” This case was
investigated by Mr. J. Graham Spencer, of 33, Rigault Road, Fulham Park
Gardens, and the facts were published in the local papers and also in
_The Vaccination Inquirer_ of December, 1883.

Several other cases were detected at Sheffield, and were adduced by
Mr. A. Wheeler in his evidence before the Commission (6th Report, p.
70); and many others are to be found throughout the Anti-Vaccination
periodicals. But the difficulty of tracing such misstatements is very
great, as the authorities almost always refuse to give information as to
the cases referred to when particular deaths from small-pox are recorded
as “unvaccinated.” Why this effort at secrecy in such a matter if there
is nothing to hide? Surely it is to the public interest that official
statistics should be made as correct as possible; and private persons
who go to much trouble and expense in order to correct errors should be
welcomed as public benefactors and assisted in every way, not treated as
impertinent intruders on official privacy, as is too frequently the case.

The result of this prejudiced and unscientific method of registering
small-pox mortality is the belief of the majority of the medical writers
on the subject that there is an enormous difference between the mortality
of the vaccinated and the unvaccinated, and that the difference is due to
the fact of vaccination or the absence of it. The following are a few of
the figures as to this point given in the Reports of the Royal Commission:

                                  Death Rate    Death Rate
    Authority.                        of            of
                                  Vaccinated.  Unvaccinated.

    Dr. Gayton, in 2nd Report
      (Table B, p. 245)             7·45           43
    Dr. Barry
      (Table F, p. 249)             8·1            32·7
    Sir John Simon
      (1st Rep., p. 74)            0 to 12½     14½ to 60
    Mr. Sweeting, M.R.C.S.
      (2nd Rep., p. 119)            8·92           46·08

Now an immense body of statistics of the last century compiled by
disinterested persons who had no interest to serve by making the severity
of small-pox large or small, gives an average of from 14 to 18 per
cent.[5] as the proportion of small-pox deaths to cases; and we naturally
ask, How is it that, with so much better sanitary conditions and greatly
improved treatment, nearly half the unvaccinated patients die, while in
the last century less than one-fifth died? Many of the supporters of
vaccination, such as Dr. Gayton (2nd Rep., p. 1856), have no explanation
to offer. Others, such as Dr. Whitelegge (6th Rep., p. 533), believe that
small-pox becomes more virulent periodically, and that one of its maxima
of virulence caused the great epidemic of 1870-72, which, after more than
half a century of vaccination equalled some of the worst epidemics of the
pre-vaccination period.

It is, however, a most suggestive fact that, considering small-pox
mortality _per se_, without reference to vaccination—the records of which
are, as have been shown, utterly untrustworthy—we find the case-mortality
to agree closely with that of the last century. Thus the figures given
in the Reports of the Hampstead, Homerton, and Deptford small-pox
hospitals at periods between 1876 and 1879 were, 19, 18·8, and 17 per
cent. respectively (3rd Report, p. 205). If we admit that only the
worst cases went to the hospitals, but also allow something for better
treatment now, the result is quite explicable; whereas the other result,
of a greatly _increased_ fatality in the unvaccinated so exactly balanced
by an alleged greatly _diminished_ fatality in the vaccinated is not
explicable, especially when we remember that this diminished fatality
applies to all ages, and it is now almost universally admitted that the
alleged protective influence of vaccination dies out in ten or twelve
years. These various opinions are really self-destructive. If epidemic
small-pox is now much more virulent than in the last century, as shown
by the greater mortality of the unvaccinated now than then, the greatly
diminished or almost vanishing effect of primary vaccination in adults
cannot possibly have reduced _their_ fatality to one-fifth or one-sixth
of that of the other class.

Again, it is admitted by many pro-vaccinist authorities that the
unvaccinated, as a rule, belong to the poorer classes, while they also
include most of the criminal classes, tramps, and generally the nomad
population. They also include all those children whose vaccination has
been deferred on account of weakness, or of their suffering from other
diseases, as well as all those under vaccination age. The unvaccinated
as a class are therefore especially liable to zymotic disease of any
kind, small-pox included; and when, in addition to these causes of
a higher death-rate from small-pox, we take account of the proved
untrustworthiness of the statistics, wholly furnished by men who are
prejudiced in favour of vaccination (as instanced by the declaration
of Dr. Gayton, that when the eruption is so severe as on the third
day to hide the vaccination marks, it affords _primâ facie_ evidence
of non-vaccination (2nd Report, Q. 1790)), we are fully justified in
rejecting all arguments in favour of vaccination supported by such
fallacious evidence. And this is the more rational course to be adopted
by all unprejudiced enquirers, because, as I shall now proceed to show,
there is an abundance of facts of a more accurate and more satisfactory
nature by which to test the question.[6]

One more point may be referred to before quitting this part of the
subject, which is, that the more recent official hospital-statistics
themselves afford a demonstration of the non-protective influence of
vaccination, and thus serve as a complete refutation of the conclusions
drawn from the statistics we have just been dealing with. Dr. Munk
stated before the Hospital Commission, that the percentage of vaccinated
patients in the London small-pox hospital had increased from 40 per
cent. in 1838 to 94⁶⁄₁₀ per cent. in 1879 (3rd Report of Royal Comm.,
Q. 9090). This evidence was given in 1882; but Mr. Wheeler stated that
according to the Reports of the Highgate hospital, the vaccinated
patients had long been over 90 per cent. of the whole, and are now
often even 94 or 95 per cent. The hospitals of the Metropolitan Asylums
Board, which take in mostly pauper patients, give a lower percentage—the
Homerton hospital 85 per cent., the Deptford hospital 87 per cent., and
the Hampstead hospital 75 per cent.—in the two latter cases adding the
“doubtful” class to the vaccinated, as the facts already given prove
that we have a right to do and still probably give too high a proportion
of unvaccinated. As the proportion of the London population that is
vaccinated cannot be over 90 per cent. (see Minority Report, pp. 173-4),
and is probably much lower, and considering the kind of patients the
unvaccinated include (see back, p. 29), there remains absolutely nothing
for the effects of vaccination. We have already seen that the total
case-mortality of these hospitals agrees closely with that of the last
century; the two classes of facts taken together thus render it almost
certain that vaccination has never saved a single human life.



CHAPTER III

THE GENERAL STATISTICS OF SMALL-POX MORTALITY IN RELATION TO VACCINATION


Having thus cleared away the mass of doubtful or erroneous statistics
depending on comparisons of the vaccinated and the unvaccinated in
limited areas or selected groups of patients, we turn to the only really
important evidence, those “masses of national experience” which Sir John
Simon, the great official advocate of vaccination, tells us we must now
appeal to for an authoritative decision on the question of the value of
vaccination; to which may be added certain classes of official evidence
serving as test cases or “control experiments” on a large scale. Almost
the whole of the evidence will be derived from the Reports of the recent
Royal Commission.

In determining what statistics really mean the graphic is the only
scientific method, since, except in a few very simple cases, long tables
of figures are confusing; and if divided up and averages taken, as is
often done, they can be manipulated so as to conceal their real teaching.
Diagrams, on the other hand, enable us to see the whole bearing of the
variations that occur, while for comparisons of one set of figures with
another their superiority is overwhelming. This is especially the case
with the statistics of epidemics and of general mortality, because the
variations are so irregular and often so large as to render tables of
figures very puzzling, while any just comparison of several tables with
each other becomes impossible. I shall therefore put all the statistics I
have to lay before my readers in the form of diagrams, which, I believe,
with a little explanation, will enable any one to grasp the main points
of the argument.


LONDON MORTALITY AND SMALL-POX

The first and largest of the diagrams illustrating this question is that
exhibiting the mortality of London from the year 1760 down to the present
day (see end of volume). It is divided into two portions, that from 1750
to 1834 being derived from the old “Bills of Mortality,” that from 1838
to 1896 from the Reports of the Registrar-General.

The “Bills of Mortality” are the only material available for the first
period, and they are far inferior in accuracy to the modern registration,
but they are probably of a fairly uniform character throughout, and
may therefore be as useful for purposes of comparison as if they were
more minutely accurate. It is admitted that they did not include the
whole of the deaths, and the death-rates calculated from the estimated
population will therefore be too low as compared with those of the
Registrar-General, but the _course_ of each death rate—its various
risings or fallings—will probably be nearly true.[7] The years are given
along the bottom of the diagram, and the deaths per million living
are indicated at the two ends and in the centre, the last four years
of the Bills of Mortality being omitted because they are considered to
be especially inaccurate. The upper line gives the total death-rate
from all causes, the middle line the death-rate from the chief zymotic
diseases—measles, scarlet-fever, diphtheria, whooping-cough and, fevers
generally, excluding small-pox, and the lower line small-pox only. The
same diseases, as nearly as they can be identified in the Bills of
Mortality according to Dr. Creighton, are given in the earlier portion
of the diagram from the figures given in his great work, _A History of
Epidemics in Britain_. With the exception of these zymotics the diagram
is the same as that presented to the Royal Commission (3rd Report,
diagram J.), but it is carried back to an earlier date.

Let us now examine the lowest line, showing the small-pox death-rate.
First taking the period from 1760 to 1800, we see, amid great
fluctuations and some exceptional epidemics, a well-marked steady decline
which, though obscured by its great irregularity, amounts to a difference
of 1,000 per million living. This decline continues, perhaps somewhat
more rapidly, to 1820. From that date to 1834 the decline is much less,
and is hardly perceptible. The period of Registration opens with the
great epidemic of 1838, and thenceforward to 1885 the decline is very
slow indeed; while, if we average the great epidemic of 1871 with the
preceding ten years, we shall not be able to discover any decline at
all. From 1886, however, there is a rather sudden decline to a very low
death-rate, which has continued to the present time. Now it is alleged
by advocates of vaccination, and by the Commissioners in their Report,
that the decline from 1800 onwards is due to vaccination, either wholly
or in great part, and that “the marked decline of small-pox in the first
quarter of the present century affords substantial evidence in favour
of the protective influence of vaccination.”[8] This conclusion is not
only entirely unwarranted by the evidence on any accepted methods of
scientific reasoning, but it is disproved by several important facts.
In the first place the decline in the first quarter of the century
is a clear continuation of a decline which had been going on during
the preceding forty years, and whatever causes produced that earlier
decline may very well have produced the continuation of it. Again, in
the first quarter of the century, vaccination was comparatively small
in amount and imperfectly performed. Since 1854 it has been compulsory
and almost universal; yet from 1854 to 1884 there is almost no decline
of small-pox perceptible, and the severest epidemic of the century
occurred in the midst of that period. Yet again, the one clearly marked
decline of small-pox has been in the ten years from 1886 to 1896, and it
is precisely in this period that there has been a great falling off in
vaccination in London from only 7 per cent. less than the births in 1885
to 20·6 per cent. less in 1894, the last year given in the Reports of the
Local Government Board; and the decrease of vaccinations has continued
since. But even more important, as showing that vaccination has had
nothing whatever to do with the decrease of small-pox, is the very close
general parallelism of the line showing the other zymotic diseases, the
diminution of which it is admitted has been caused by improved hygienic
conditions. The decline of this group of diseases in the first quarter
of this century, though somewhat less regular, is quite as well marked
as in the case of small-pox, as is also its decline in the last forty
years of the 18th century, strongly suggesting that both declines are
due to common causes. Let any one examine this diagram carefully and say
if it is credible that from 1760 to 1800 both declines are due to some
improved conditions of hygiene and sanitation, but that after 1800, while
the zymotics have continued to decline from the same class of causes one
zymotic—small-pox—_must_ have been influenced by a new cause—vaccination,
to produce its corresponding decline. Yet this is the astounding claim
made by the Royal Commissioners! And if we turn to the other half of the
diagram showing the period of registration, the difficulty becomes even
greater. We first have a period from 1838 to 1870, in which the zymotics
actually rose; and from 1838 to 1871, averaging the great epidemic with
the preceding ten years, we find that small-pox also rose, or at the best
remained quite stationary. From 1871 to 1875 zymotics are much lower,
but run quite parallel with small-pox; then there is a slight decline in
both, and zymotics and small-pox remain lower in the last ten years than
they have ever been before, although in this last period vaccination has
greatly diminished.

Turning to the upper line, showing the death-rate from all causes,
we again find a parallelism throughout, indicating improved general
conditions acting upon _all_ diseases. The decline of the total
death-rate from 1760 to 1810 is remarkably great, and it continues at a
somewhat less rate to 1830, just as do the zymotics and small-pox. Then
commences a period from 1840 to 1870 of hardly perceptible decline partly
due to successive epidemics of cholera, again running parallel with the
course of the zymotics and of small-pox, followed by a great decline to
the present time, corresponding in amount to that at the beginning of the
century.

The Commissioners repeatedly call attention to the fact that the
mortality from measles has not at all declined and that other zymotics
have not declined in the same proportion as small-pox, and they argue:
“If improved sanitary conditions were the cause of small-pox becoming
less, we should expect to see that they had exercised a similar influence
over almost all other diseases. Why should they not produce the same
effect in the case of measles, scarlet fever, whooping-cough, and indeed
any disease spread by contagion or infection and from which recovery
was possible?” This seems a most extraordinary position to be taken in
view of the well-known disappearance of various diseases at _different_
epochs. Why did leprosy almost disappear from England at so early a
period and plague later on? Surely to _some_ improved conditions of
health. The Commissioners do not, and we may presume cannot, tell us
why measles, of all the zymotic diseases, has rather increased than
diminished during the whole of this century. Many students of epidemics
hold that certain diseases are liable to replace each other, as suggested
by Dr. Watt, of Glasgow, in the case of measles and small-pox. Dr.
Farr, the great medical statistician, adopted this view. In his Annual
Report to the Registrar-General in 1872 (p. 224), he says: “The zymotic
diseases replace each other; and when one is rooted out it is apt to be
replaced by others which ravage the human race indifferently whenever
the conditions of healthy life are wanting. They have this property
in common with weeds and other forms of life: as one species recedes
another advances.” This last remark is very suggestive in view of the
modern germ-theory of these diseases. This substitution theory is
adopted by Dr. Creighton, who in his _History of Epidemics in England_
suggests that plague was replaced by typhus fever and small-pox; and,
later on, measles, which was insignificant before the middle of the
seventeenth century, began to replace the latter disease. In order
to show the actual state of the mortality from these diseases during
the epoch of registration, I have prepared a diagram (II.) giving the
death-rates for London of five of the chief zymotics, from the returns
of the Registrar-General, under the headings he adopted down to 1868—for
to divide fevers into three kinds for half the period, and to separate
scarlatina and diphtheria, as first done in 1859, would prevent any
useful comparison from being made.

The lowest line, as in the larger diagram, shows Small-pox. Above it is
Measles, which keeps on the whole a very level course, showing, however,
the high middle period of the zymotics and two low periods, from 1869
to 1876, and from 1848 to 1856, the first nearly corresponding to the
very high small-pox death-rate from 1870 to 1881; and the other just
following the two small-pox epidemics of 1844 and 1848, thus supporting
the view that it is in process of replacing that disease. Scarlatina and
diphtheria show the high rate of zymotics generally from 1848 to 1870,
with a large though irregular decline subsequently. Whooping-cough shows
a nearly level course to 1882 and then a well-marked decline. Fevers
(typhus, enteric, and simple) show the usual high middle period, but with
an earlier and more continuous decline than any of the other zymotic
diseases. We thus see that all these diseases exhibit common features
though in very different degrees, all indicating the action of general
causes, some of which it is by no means difficult to point out.

In 1845 began the great development of our railway system, and with it
the rapid growth of London, from a population of two millions in 1844
to one of four millions in 1884. This rapid growth of population was
at first accompanied with overcrowding, and as no adequate measures of
sanitation were then provided the conditions were prepared for that,
increase of zymotic disease which constitutes so remarkable a feature
of the London death-rates between 1848 and 1866. But at the latter date
commenced a considerable decline both in the total mortality and in that
from all the zymotic diseases, except measles and small-pox, but more
especially in fevers and diphtheria, and this decrease is equally well
explained by the completion, in 1865, of that gigantic work, the main
drainage of London. The last marked decline in small-pox, in fevers,
and to a less marked degree in whooping-cough, is coincident with a
recognition of the fact that hospitals are themselves often centres of
contagion, and the establishment of floating hospitals for London cases
of small-pox. Perhaps even more beneficial was the modern system of
excluding sewer-gas from houses.

We thus see that the increase or decrease of the chief zymotic diseases
in London during the period of registration, is clearly connected with
adverse or favourable hygienic conditions of a definite kind. During the
greater part of this period small-pox and measles alone showed no marked
increase or decrease, indicating that the special measures affecting
them had not been put in practice, till ten years back the adoption
of an effective system of isolation in the case of small-pox has been
followed by such marked results wherever it has been adopted as to show
that _this_ is the one method yet tried that has produced any large
and unmistakable effect, thus confirming the experience of the town of
Leicester, which will be referred to later on.

The Commissioners in their _Final Report_ lay the greatest stress
on the decline of small-pox at the beginning of the century, which
“followed upon the introduction of vaccination,” both in England, in
Western Europe, and in the United States. They declare that “there is no
proof that sanitary improvements were the main cause of the decline of
small-pox,” and that “no evidence is forthcoming to show that during the
first quarter of the nineteenth century these improvements differentiated
that quarter from the last quarter or half of the preceding century
in any way at all comparable to the extent of the differentiation
in respect to small-pox” (p. 19 par. 79). To the accuracy of these
statements I demur in the strongest manner. There _is_ proof that
sanitary improvements were the main cause of this decline of small-pox
early in the century, viz., that the other zymotic diseases as a whole
showed a simultaneous decline to a nearly equal amount, while the general
death-rate showed a decline to a much greater amount, both admittedly due
to improved hygienic conditions, since there is _no other known cause_
of the diminution of disease; and that the Commissioners altogether
ignore these two facts affords, to my mind, a convincing proof of their
incapacity to deal with this great statistical question. And, as to the
second point, I maintain that there _is_ ample direct evidence, for
those who look for it, of great improvements in the hygienic conditions
of London quite adequate to account for the great decline in the general
mortality, and therefore equally adequate to account for the lesser
declines in zymotic diseases and in small-pox, both of which began in the
last century, and only became somewhat intensified in the first quarter
of the present century, to be followed twenty years later by a complete
check or even a partial rise. This rise was equally marked in small-pox
as in the other diseases, and thus proved, as clearly as anything can
be proved, that its decline and fluctuations are in no way dependent on
vaccination, but are due to causes of the very same general nature as in
the case of other diseases.

To give the evidence for this improvement in London hygiene would,
however, break the continuity of the discussion as to small-pox and
vaccination; but the comparison of the general and zymotic death-rates
with that of small-pox exhibits so clearly the identity of the causes
which have acted upon them all as to render the detailed examination of
the various improved conditions that led to the diminished mortality
unnecessary. The diagram showing the death-rates from these three causes
of itself furnishes a complete refutation of the Commissioners’ argument.
The evidence as to the nature of the improved conditions will be given in
another work to be published shortly.


SMALL-POX AND OTHER DISEASES IN BRITAIN DURING THE PERIOD OF REGISTRATION

We have no general statistics of mortality in England and Wales till the
establishment of the Registration system in 1838, but the results make
up for their limited duration by their superior accuracy. Till the year
1870 no record was kept of the amount of vaccination except as performed
by the public vaccinators, but since 1872 all vaccinations are recorded,
and the numbers published by the Local Government Board. My third diagram
is for the purpose of showing graphically the relation of small-pox to
other zymotic diseases, and to vaccination, for England and Wales. The
lower line shows small-pox, the middle one zymotic diseases, and the
upper the total death-rates. The relations of the three are much the same
as in the London diagram, the beginning of the great decline of zymotics
being in 1871, and that of small-pox in 1872, but the line of small-pox
is much lower, and zymotics somewhat lower than in London, due to a
larger proportion of the inhabitants living under comparatively healthy
rural conditions.

But if the amount of vaccination were the main and almost exclusive
factor in determining the amount of small-pox, there ought to be little
or no difference between London and the country. But here, as in all
other cases, the great factor of comparative density of population in
compared areas is seen to have its full effect on small-pox mortality as
in that of all other zymotic diseases.

This non-relation between vaccination and small-pox mortality is further
proved by the thick dotted line showing the vaccinations per cent. of
births for the last 22 years, as given in the “Final Report” (p. 34). The
diminution of vaccination in various parts of the country began about
1884, and from 1886 has been continuous and rapid, and it is during this
very period that small-pox has been continuously less in amount than has
ever been known before. Both in the relation of London small-pox to that
of the whole country, and in the relation of small-pox to vaccination, we
find proof of the total inefficacy of that operation.


SMALL-POX IN SCOTLAND AND IN IRELAND

In their _Final Report_ the Commissioners give us Tables of the
death-rates from small-pox, measles, and scarlet-fever in Scotland and
Ireland; and from these Tables I have constructed my diagram (IV.),
combining the two latter diseases for simplicity, and including the
period of compulsory vaccination and accurate registration in both
countries.

The most interesting feature of this diagram is the striking difference
in the death-rates of the two countries. Scotland, the richer,
more populous, and more prosperous country having a much greater
mortality, both from the two zymotics and from small-pox, than poor,
famine-stricken, depopulated Ireland. The maximum death-rate by the two
zymotics in Scotland is considerably more than double that in Ireland,
and the minimum is larger in the same proportion. In small-pox the
difference is also very large in the same direction, for although the
death-rate during the great epidemic in 1872 was only one-fourth greater
in Scotland, yet as the epidemic there lasted three years, the total
death-rate for those years was nearly twice as great as for the same
period in Ireland, which, however, had a small epidemic later on in 1878.
Since 1883 small-pox has been almost absent from both countries, as from
England; but taking the twenty years of repeated epidemics from 1864 to
1883, we find the average small-pox death-rate of Scotland to be about
139, and that of Ireland 85 per million, or considerably more than as
three to two. But even Scotland had a much lower small-pox mortality
than England, the proportions being as follows for the three years which
included the epidemic of 1871-3:

    Ireland, 800 per million in the three years.
    Scotland, 1,450 per million in the three years.
    England, 2,000 per million in the three years.

Now the Royal Commissioners make no remark whatever on these very
suggestive facts, and they have arranged the information in tables in
such a way as to render it very difficult to discover them; and this is
another proof of their incapacity to deal with statistical questions.
They seem to be unable to look at small-pox from any other point of view
than that of the vaccinationist, and thus miss the essential features
of the evidence they have before them. Every statistician knows the
enormous value of the representation of tabular statistics by means
of diagrammatic curves. It is the only way by which in many cases the
real teaching of statistics can be detected. An enormous number of such
diagrams, more or less instructive and complete, were presented to them,
and, at great cost, are printed in the Reports; but I cannot find that,
in their _Final Report_, they have made any adequate use of them, or have
once referred to them, and thus it is that they have overlooked so many
of the most vital teachings of the huge mass of figures with which they
had to deal.

It is one of the most certain of facts relating to sanitation that
comparative density of population affects disease, and especially the
zymotic diseases, more than any other factor that can be ascertained.
It is mainly a case of purity of the air, and consequent purification
of the blood; and when we consider that breathing is the most vital and
most continuous of all organic functions, that we must and do breathe
every moment of our lives, that the air we breathe is taken into the
lungs, one of the largest and most delicate organs of the body, and
that the air so taken in acts directly upon the blood, and thus affects
the whole organism, we see at once how vitally important it is that the
air around us should be as free as possible from contamination, either
by the breathing of other people, or by injurious gases or particles
from decomposing organic matter, or by the germs of disease. Hence it
happens that under our present terribly imperfect social arrangements the
death-rate (other things being equal) is a function of the population
per square mile, or perhaps more accurately of the proportion of town to
rural populations.

In the light of this consideration let us again compare these diagrams of
Irish, Scottish, and English death-rates. In Ireland only 11 per cent. of
the population live in the towns of 100,000 inhabitants and upwards. In
Scotland 30 per cent., and in England and Wales 54 per cent.; and we find
the mortality from zymotic diseases to be roughly proportional to these
figures. We see here unmistakable cause and effect. Impure air, with
all else that overcrowding implies on the one hand, higher death-rate
on the other. This explains the constant difference between London and
rural mortality, and it also explains what seems to have puzzled the
Commissioners more than anything else—the intractability of some of the
zymotics to ordinary sanitation, as in the case of measles especially,
and in a less degree of whooping-cough—for in their case the continual
growth of urban as opposed to rural populations has neutralised the
effects of such improved conditions as we have been able to introduce.

But the most important fact for our present purpose is, that small-pox
is subject to this law just as are the other zymotics, while it
pays no attention whatever to vaccination. The statistician to the
Registrar-General for Scotland gave evidence that ever since 1864 more
than 96 per cent. of the children born have been vaccinated or had had
previous small-pox, and he makes no suggestion of any deficiency that
can be remedied. But in the case of Ireland the medical commissioner
for the Local Government Board for Ireland, Dr. MacCabe, told the
Commissioners that vaccination there was very imperfect, and that a large
proportion of the population was “unprotected by vaccination,” this
state of things being due to various causes, which he explained (2nd
Rep., QQ. 3,059-3,075). But neither Dr. MacCabe nor the Commissioners
notice the suggestive, and from their point of view alarming, fact that
imperfectly vaccinated Ireland had had far less small-pox mortality than
thoroughly well-vaccinated Scotland, enormously less than well-vaccinated
England, and overwhelmingly less than equally well-vaccinated London.
Ireland—Scotland—England—London—a graduated series in density of
population, and in zymotic death-rate; the small-pox death-rate
increasing in the same order and to an enormous extent, quite regardless
of the fact that the last three have had practically complete vaccination
during the whole period of the comparison; while Ireland alone, with the
lowest small-pox death-rate by far, has, on official testimony, the least
amount of vaccination. And yet the majority of the Commissioners still
pin their faith on vaccination, and maintain that the cumulative force of
the testimony in its favour is irresistible! And further, that “sanitary
improvements” cannot be asserted to afford “an adequate explanation of
the diminished mortality from small-pox.”

It will now be clear to my readers that these conclusions, set forth as
the final outcome of their seven years’ labours, are the very reverse
of the true ones, and that they have arrived at them by neglecting
altogether to consider, _in their mutual relations_, “those great
masses of national statistics” which alone can be depended on to point
out true causes, but have limited themselves to such facts as the
alleged mortalities of the vaccinated and the unvaccinated, changes of
age-incidence, and other matters of detail, some of which are entirely
vitiated by untrustworthy evidence while others require skilled
statistical treatment to arrive at true results, a subject quite beyond
the powers of untrained physicians and lawyers, however eminent in their
own special departments.[9]


SMALL-POX AND VACCINATION ON THE CONTINENT

Before proceeding to discuss those special test-cases in our own country
which still more completely show the impotence of vaccination, it will be
well to notice a few Continental States which have been, and still are,
quoted as affording illustrations of its benefits.

We will first take Sweden, which has had fairly complete national
statistics longer than any other country, and we are now fortunately
able to give the facts on the most recent official testimony—the Report
furnished by the Swedish Board of Health to the Royal Commission, and
published in the Appendix to their Sixth Report (pp. 751-56). Such great
authorities as Sir William Gull, Dr. Seaton, and Mr. Marson, stated
before the Committee of Enquiry in 1871 that Sweden was one of the best
vaccinated countries, and that the Swedes were the best vaccinators.
Sir John Simon’s celebrated paper, which was laid before Parliament in
1857 and was one of the chief supports of compulsory legislation, made
much of Sweden, and had a special diagram to illustrate the effects
of vaccination on small-pox. This paper is reproduced in the First
Report of the recent Royal Commission (pp. 61-113), and we find the
usual comparison of small-pox mortality in the last and present century
which is held to be conclusive as to the benefits of vaccination. He
says vaccination was introduced in 1801, and divides his diagram into
two halves differently coloured before and after this date. It will be
observed that, as in England, there was a great and sudden decrease of
small-pox mortality after 1801, the date of the _first_ vaccination in
Sweden, and by 1812 the whole reduction of mortality was completed. But
from that date for more than sixty years there was an almost continuous
_increase_ in frequency and severity of the epidemics. To account for
this sudden and enormous decrease Sir John Simon states, in a note, and
without giving his authority: “About 1810 the vaccinations were amounting
to nearly a quarter of the number of births.” But these were almost
certainly both adults and children of various ages, and the official
returns now given show that down to 1812, when the whole reduction of
small-pox mortality had been effected, only 8 per cent. of the population
had been vaccinated. We are told in a note to the official tables that
the first successful vaccination in Stockholm was at the end of 1810,
so that the earlier vaccinations must have been mainly in the rural
districts; yet the earlier Stockholm epidemics in 1807, before a single
inhabitant was vaccinated, and in 1825, were less severe than the six
later ones, when vaccination was far more general.

Bearing these facts in mind, and looking at diagram V., we see that it
absolutely negatives the idea of vaccination having had anything to do
with the great reduction of small-pox mortality, which was almost all
effected _before_ the first successful vaccination in the capital on the
17th December, 1810! And this becomes still more clear when we see that
as vaccination increased among a population which, the official Report
tells us, had the most “perfect confidence” in it, small-pox epidemics
increased in virulence, especially in the capital (shown in the diagram
by the dotted peaks) where, in 1874, there was a small-pox mortality of
7,916 per million, reaching 10,290 per million during the whole epidemic,
which lasted two years. This was worse than the worst epidemic in London
during the eighteenth century.[10]

But although there is no sign of a relation between vaccination and the
decrease of small-pox, there is a very clear relation between it and
the decrease in the general mortality. This is necessarily shown on a
much smaller vertical scale to bring it into the diagram. If it were
on the same scale as the small-pox line, its downward slope would be
four times as rapid as it is. The decrease in the century is from about
27,000 to 15,000 per million, and, with the exception of the period of
the Napoleonic wars, the improvement is nearly continuous throughout.
There has evidently been a great and continuous improvement in healthy
conditions of life in Sweden, as in our own country and probably in all
other European nations; and this improvement, or some special portion
of it, must have acted powerfully on small-pox to cause the enormous
diminution of the disease down to 1812, with which, as we have seen,
vaccination could have had nothing to do. The only thing that vaccination
seems to have done is, to have acted as a check to this diminution,
since it is otherwise impossible to explain the complete cessation of
improvement as the operation became more general; and this is more
especially the case in view of the fact that the general death-rate has
continued to decrease at almost the same rate down to the present day!

The enormous small-pox mortality in Stockholm has been explained as the
result of very deficient vaccination; but the Swedish Board of Health
states that this deficiency was more apparent than real, first, because
25 per cent. of the children born in Stockholm die before completing
their first year, and also because of neglect to report private
vaccinations, so that “the low figures for Stockholm depend more on the
cases of vaccination not having been reported than on their not having
been effected.” (Sixth Report, p. 754, 1st col., 3rd par.)

The plain and obvious teaching of the facts embodied in this diagram
is, that small-pox mortality is in no way influenced (except it be
injuriously) by vaccination, but that here, as elsewhere, it does bear
an obvious relation to density of population; and also that, when
uninfluenced by vaccination, it follows the same law of decrease with
improved conditions of general health as does the total death-rate.

This case of Sweden alone affords complete proof of the uselessness of
vaccination; yet the Commissioners in the _Final Report_ (par. 59) refer
to the great diminution of small-pox mortality in the first twenty years
of the century as being due to it. They make no comparison with the total
death-rate; they say nothing of the increase of small-pox from 1824
to 1874; they omit all reference to the terrible Stockholm epidemics
increasing continuously for fifty years of legally enforced vaccination
and culminating in that of 1874, which was far worse than the worst known
in London during the whole of the eighteenth century. Official blindness
to the most obvious facts and conclusions can hardly have a more striking
illustration than the appeal to the case of Sweden as being favourable to
the claims of vaccination.

My next diagram (No. VI.) shows the course of small-pox in Prussia since
1816, with an indication of the epidemics in Berlin in 1864 and 1871. Dr.
Seaton, in 1871, said to the Committee on Vaccination (Q. 5,608), “I know
Prussia is well protected,” and the general medical opinion was expressed
thus in an article in the _Pall Mall Gazette_ (May 24, 1871): “Prussia
is the country where revaccination is most generally practised, the law
making the precaution obligatory on every person, and the authorities
conscientiously watching over its performance. As a natural result,
cases of small-pox are rare.” Never was there a more glaring untruth
than this last statement. It is true that revaccination was enforced in
public schools and other institutions, and most rigidly in the Army, so
that a very large proportion of the adult male population must have been
revaccinated; but, instead of cases of small-pox being rare, there had
been for the twenty-four years preceding 1871 a much _greater_ small-pox
mortality in Prussia than in England, the annual average being 248 per
million for the former and only 210 for the latter. A comparison of the
two diagrams shows the difference at a glance. English small-pox only
once reached 400 per million (in 1852), while in Prussia it four times
exceeded that amount. And immediately after the words above quoted were
written the great epidemic of 1871-72 caused a mortality in revaccinated
Prussia more than double that of England! _Now_, after these facts have
been persistently made known by the anti-vaccinators, the amount of
vaccination in Prussia before 1871 is depreciated, and Dr. A. F. Hopkirk
actually classes it among countries “without compulsory vaccination.”
(See table and diagram opposite p. 238 in the 2nd Report.)

In the city of Berlin we have indicated two epidemics, that in 1864,
with a death-rate a little under 1,000 per million, while that in 1871
rose to 6,150 per million, or considerably more than twice as much as
that of London in the same year, although the city must have contained
a very large male population which had passed through the army, and had
therefore been revaccinated.

I give one more diagram (No. VII.) of small-pox in Bavaria, from a
table laid before the Royal Commission by Dr. Hopkirk for the purpose
of showing the results of long-continued compulsory vaccination. He
stated to the Commission that vaccination was made compulsory in 1807,
and that in 1871 there were 30,742 cases of small-pox, of which 95·7
per cent. were vaccinated. (2nd Report, Q. 1,489.) He then explains
that this was because “nearly the whole population was vaccinated”; but
he does not give any figures to prove that the vaccinated formed more
than this proportion of the whole population; and as the vaccination
age was one year, it is certain that they did not do so.[11] He calls
this being “slightly attacked,” and argues that it implies “some special
protection.” No doubt the small-pox mortality of Bavaria was rather low,
about equal to that of Ireland; but in 1871 it rose to over 1,000 per
million, while Ireland had only 600, besides which the epidemic lasted
for two years, and was therefore very nearly equal to that of England.
But we have the explanation when we look at the line showing the other
zymotics, for these are decidedly lower than those of England, showing
better general sanitary conditions. In Bavaria, as in all the other
countries we have examined, the behaviour of small-pox shows no relation
to vaccination, but the very closest relation to the other zymotics and
to density of population. The fact of 95·7 per cent. of the small-pox
patients having been vaccinated agrees with that of our Highgate
hospital, but is even more remarkable as applying to the population
of a whole country, and is alone sufficient to condemn vaccination as
useless. And as there were 5,070 deaths to these cases, the fatality
was 16·5 per cent., or almost the same as that of the last century; so
that here again, and on a gigantic scale, the theory that the disease
is “mitigated” by vaccination, even where not prevented, is shown to
be utterly baseless. Yet this case of Bavaria was chosen by a strong
vaccinist as affording a striking proof of the value of vaccination when
thoroughly carried out, and I cannot find that the Commissioners took
the trouble to make the comparisons here given, which would at once have
shown them that what the case of Bavaria really proves is the complete
uselessness of vaccination.

This most misleading, unscientific, and unfair proceeding, of giving
certain figures of small-pox mortality among the well vaccinated, and
then, without any adequate comparison, _asserting_ that they afford a
proof of the value of vaccination, may be here illustrated by another
example. In the original paper by Sir John Simon on the _History and
Practice of Vaccination_, presented to Parliament in 1857, there is, in
the Appendix, a statement by Dr. T. Graham Balfour, surgeon to the Royal
Military Asylum for Orphans at Chelsea, as to the effects of vaccination
in that institution—that since the opening of the Asylum in 1803 the
Vaccination Register has been accurately kept, and that every one who
entered was vaccinated unless he had been vaccinated before or had had
small-pox; and he adds: “Satisfactory evidence can therefore, in this
instance, be obtained that they were all protected.” Then he gives the
statistics, showing that during forty-eight years, from 1803 to 1851,
among 31,705 boys there were thirty-nine cases and four deaths, giving a
mortality at the rate of 126 per million on the average number in the
Asylum, and concludes by saying: “The preceding facts appear to offer
most conclusive proofs of the value of vaccination.” But he gives no
comparison with other boys of about the same age and living under equally
healthy conditions, but who had not been so uniformly or so recently
vaccinated; for it must be remembered that, as this was long before the
epoch of compulsory vaccination, a large proportion of the boys would
be unvaccinated at their entrance, and would therefore have the alleged
benefit of a recent vaccination. But when we make the comparison, which
both Dr. Balfour and Sir John Simon failed to make, we find that these
well vaccinated and protected boys had a _greater_ small-pox mortality
than the imperfectly protected outsiders. For in the First Report of the
Commission (p. 114, Table B) we find it stated that in the period of
optional vaccination (1847-53) the death-rate from small-pox of persons
from ten to fifteen years[12] was 94 per million! Instead of offering
“most conclusive proofs of the value of vaccination,” his own facts and
figures, if they prove anything at all, prove not only the uselessness
but the evil of vaccination, and that it really tends to _increase_
small-pox mortality. And this conclusion is also reached by Professor
Adolf Vogt, who, in the elaborate statistical paper sent by him to the
Royal Commission, and printed in their Sixth Report, but not otherwise
noticed by them, shows by abundant statistics from various countries
that the small-pox death-rate and fatality have been _increased_ during
epidemics occurring in the epoch of vaccination.

One more point deserves notice before leaving this part of the inquiry,
which is the specially high small-pox mortality of great commercial
seaports. The following table, compiled from Dr. Pierce’s _Vital
Statistics_ for the Continental towns and from the Reports of the
Royal Commission for those of our own country, is very remarkable and
instructive.

    +-------------------+-------+--------------+
    | Name of Town.     | Year. | Small-pox    |
    |                   |       | Death-rate   |
    |                   |       | per Million. |
    +-------------------+-------+--------------+
    | Hamburgh          | 1871  |   15,440     |
    | Rotterdam         | 1871  |   14,280     |
    | Cork              | 1872  |    9,600     |
    | Sunderland        | 1871  |    8,650     |
    | Stockholm         | 1874  |    7,916     |
    | Trieste           | 1872  |    6,980     |
    | Newcastle-on-Tyne | 1871  |    5,410     |
    | Portsmouth        | 1872  |    4,420     |
    | Dublin            | 1872  |    4,330     |
    | Liverpool         | 1871  |    3,890     |
    | Plymouth          | 1872  |    3,000     |
    +-------------------+-------+--------------+

The small-pox death-rate in the case of the lowest of these towns is very
much higher than in London during the same epidemic, and it is quite
clear that vaccination can have had nothing to do with this difference.
For if it be alleged that vaccination was neglected in Hamburgh and
Rotterdam, of which we find no particulars, this cannot be said of Cork,
Sunderland, and Newcastle. Again, if the very limited and imperfect
vaccination of the first quarter of the century is to have the credit
of the striking reduction of small-pox mortality that then occurred,
as the Royal Commissioners claim, a small deficiency in the very much
more extensive and better vaccination that generally prevailed in 1871,
cannot be the explanation of a small-pox mortality _greater_ than in the
worst years of London when there was no vaccination. Partial vaccination
cannot be claimed as producing marvellous effects at one time and less
than nothing at all at another time, yet this is what the advocates of
vaccination constantly do. But on the sanitation theory the explanation
is simple. Mercantile seaports have grown up along the banks of harbours
or tidal rivers whose waters and shores have been polluted by sewage
for centuries. They are always densely crowded owing to the value of
situations as near as possible to the shipping. Hence there is always
a large population living under the worst sanitary conditions, with
bad drainage, bad ventilation, abundance of filth and decaying organic
matter, and all the conditions favourable to the spread of zymotic
diseases and their exceptional fatality. Such populations have maintained
to our day the insanitary conditions of the last century, and thus
present us with a similarly great small-pox mortality, without any regard
to the amount of vaccination that may be practised. In this case they
illustrate the same principle which so well explains the very different
amounts of small-pox mortality in Ireland, Scotland, England, and London,
with hardly any difference in the quantity of vaccination.

The Royal Commissioners, with all these facts before them or at their
command, have made none of these comparisons. They give the figures
of small-pox mortality, and either explain them by alleged increase
or decrease of vaccination, or argue that, as some other disease—such
as measles—did not decrease at the same time or to the same amount,
therefore sanitation cannot have influenced small-pox. They never once
compare small-pox mortality with general mortality, or with the rest
of the group of zymotics, and thus fail to see their wonderfully close
agreement—their simultaneous rise and fall, which so clearly shows their
subjection to the same influences and proves that no special additional
influence can have operated in the case of small-pox.



CHAPTER IV

TWO GREAT EXPERIMENTS WHICH ARE CONCLUSIVE AGAINST VACCINATION


Those who disbelieve in the efficacy of vaccination to protect against
small-pox are under the disadvantage that, owing to the practice having
been so rapidly adopted by all civilized people, there are no communities
who have rejected it while adopting methods of general sanitation, and
who have also kept satisfactory records of mortality from various causes.
Any such country would have afforded what is termed a “control” or
test experiment, the absence of which vitiates all the evidence of the
so-called “variolous test” in Jenner’s time, as was so carefully pointed
out before the Commission by Dr. Creighton and Professor Crookshank.
We do, however, now possess two such tests on a limited, but still a
sufficient, scale. The first is that of the town of Leicester, which for
the last twenty years has rejected vaccination till it has now almost
vanished altogether. The second is that of our Army and Navy, in which,
for a quarter of a century, every recruit has been revaccinated, unless
he has recently been vaccinated or has had small-pox. In the first we
have an almost wholly “unprotected” population of nearly 200,000, which,
on the theory of the vaccinators, should have suffered exceptionally
from small-pox; in the other we have a picked body of 220,000 men, who,
on the evidence of the medical authorities, are as well protected as they
know how to make them, and among whom, therefore, small-pox should be
almost or quite absent, and small-pox deaths quite unknown. Let us see,
then, what has happened in these two cases.

Perhaps the most remarkable and the most complete body of statistical
evidence presented to the Commission was that of Mr. Thomas Biggs, a
sanitary engineer and a town councillor of Leicester. It consists of
fifty-one tables exhibiting the condition of the population in relation
to health and disease from almost every conceivable point of view. The
subject is further illustrated by sixteen diagrams, many of them in
colours, calculated to exhibit to the eye in the most clear and simple
manner the relations of vaccination and sanitation to small-pox and to
the general health of the people, and especially of the children, in
whose behalf it is always alleged vaccination is enforced. From this
wealth of material I can give only two diagrams exhibiting the main facts
of the case, as shown by Mr. Biggs’ statistics in the Fourth Report of
the Royal Commission, all obtained from official sources.

The first diagram (No. VIII.) shows in the upper part, by a dotted line,
the total vaccinations, public and private, since 1850.[13] The middle
line shows the mortality per million living from the chief zymotic
diseases—fevers, measles, whooping-cough, and diphtheria—while the lower
line gives the small-pox mortality. We notice here a high mortality from
zymotics and from small-pox epidemics, during the whole period of nearly
complete vaccination from 1854 to 1870. Then commenced the movement
against vaccination, owing to its proved uselessness in the great
epidemic when Leicester had a very much higher small-pox mortality than
London, which has resulted in a continuous decline, especially rapid for
the last fifteen years, till it is now reduced to almost nothing. For
that period not only has small-pox mortality been continuously very low,
but the zymotic diseases have also regularly declined to a lower amount
than has ever been known before.

The second diagram (No. IX.) is even more important, as showing the
influence of vaccination in increasing both the infantile and the
total death-rates to an extent which even the strongest opponents of
that operation had not thought possible. There are four solid lines on
the diagram showing respectively, in five-year averages from 1838-42
to 1890-95, (1) the total death-rate per 1,000 living, (2) the infant
death-rate under five years, (3) the same under one year, and (4), lowest
of all, the small-pox death-rate under five years. The dotted line shows
the percentage of total vaccinations to births.

The first thing to be noted is the remarkable simultaneous rise of
all four death-rates to a maximum in 1868-72, at the same that the
vaccination rate attained its maximum. The decline in the death-rates
from 1852 to 1860 was due to sanitary improvements which had then
commenced; but the rigid enforcement of vaccination checked the decline
owing to its producing a great increase of mortality in children, an
increase which ceased as soon as vaccination diminished. This clearly
shows that the deaths which have only recently been acknowledged as
due to vaccination, directly or indirectly, are really so numerous as
largely to affect the total death-rate; but they were formerly wholly
concealed, and still are partially concealed, by being registered under
such headings as erysipelas, syphilis, diarrhœa, bronchitis, convulsions,
or other proximate cause of death.

Here, then, we have indications of a very terrible fact, the deaths by
various painful and often lingering diseases of thousands of children as
the result of that useless and dangerous operation termed vaccination.
It is difficult to explain the coincidences exhibited by this diagram
in any other way, and it is strikingly corroborated by a diagram of
infant mortality in London and in England which I laid before the Royal
Commission, and which I here reproduce (No. X.). The early part of this
diagram is from a table calculated by Dr. Farr from all the materials
available in the Bills of Mortality, and it shows for each twenty years
the marvellous diminution in infant mortality during the hundred years
from 1730 to 1830, proving that there was some continuous beneficial
change in the conditions of life. The materials for a continuation of the
diagram are not given by the Registrar-General in the case of London,
and I have had to calculate them for England. But from 1840 to 1890 we
find a very slight fall, both in the death-rate under five years and
under one year for England, and under one year for London, although both
are still far too high, as indicated by the fact that in St. Saviour’s
it is 213, and in Hampstead only 123 per 1,000 births. There appear to
have been some causes which checked the diminution in London after 1840,
then produced an actual rise from 1860 to 1870, followed by a slight
but continuous fall since. The check to the diminution of the infant
death-rate is sufficiently accounted for by that extremely rapid growth
of London by immigration which followed the introduction of railways and
which would appreciably increase the child-population (by immigration of
families) in proportion to the births. The rise from 1860 to 1870 exactly
corresponds to the rise in Leicester, and to the strict enforcement of
infant vaccination, which was continuously high during this period;
while the steady fall since corresponds also to that continuous fall
in the vaccination rate due to a growing conviction of its uselessness
and its danger. These facts strongly support the contention that
vaccination, instead of saving thousands of infant lives, as has been
claimed, really destroys them by thousands, entirely neutralising that
great reduction which was in progress from the last century, and which
the general improvement in health would certainly have favoured. It may
be admitted that the increasing employment of women in factories is
also a contributory cause of infant mortality, but there is no proof
that a less proportion of women have been thus employed during the last
twenty years, while it is certain that there has been a great diminution
of vaccination, which is now admitted to be a _vera causa_ of infant
mortality.

Before leaving the case of Leicester it will be instructive to compare it
with some other towns of which statistics are available. And first as to
the great epidemic of 1871-2 in Leicester and in Birmingham. Both towns
were then well vaccinated, and both suffered severely by the epidemic.
Thus:

                                      LEICESTER.  BIRMINGHAM.
    S.P. cases per 10,000 population     327          213
     ”   deaths ”    ”        ”           35           35

But since then Leicester has rejected vaccination to such an extent that
in 1894 it had only seven vaccinations to ten thousand population, while
Birmingham had 240, or more than thirty times as much, and the proportion
of its inhabitants who have been vaccinated is probably less than half
those of Birmingham. The Commissioners themselves state that the disease
was brought into the town of Leicester on twelve separate occasions
during the recent epidemic, yet the following is the result:

                1891-4.               LEICESTER.  BIRMINGHAM.
    S.P. cases per 10,000 population      19           63
     ”   deaths ”     ”       ”            1·1          5

Here we see that Leicester had less than _one-third_ the cases of
small-pox, and less than _one-fourth_ the deaths in proportion to
population than well-vaccinated Birmingham; so that both the alleged
_protection_ from attacks of the disease, and _mitigation_ of its
severity when it does attack, are shown, not only to be absolutely
untrue, but to apply really, in this case, to the absence of vaccination!

But we have yet another example of an extremely well-vaccinated town
in this epidemic—Warrington, an official report on which has just been
issued. It is stated that 99·2 per cent. of the population had been
vaccinated, yet the comparison with unvaccinated Leicester stands as
follows:

    EPIDEMIC OF 1892-3.               LEICESTER.  WARRINGTON.
    S.P. cases per 10,000 population    19·3        123·3
     ”   deaths ”     ”      ”           1·4         11·4

Here then we see that in the thoroughly vaccinated town the cases are
more than six times, and the deaths more than eight times, that of
the almost unvaccinated town, again proving that the most efficient
vaccination does not _diminish_ the number of attacks, and does not
_mitigate_ the severity of the disease, but that both these results
follow from sanitation and isolation.

Now let us see how the Commissioners, in their _Final Report_ deal with
the above facts, which are surely most vital to the very essence of the
enquiry, and the statistics relating to which have been laid before them
with a wealth of detail not equalled in any other case. Practically they
ignore it altogether. Of course I am referring to the Majority Report,
to which alone the Government and the unenlightened public are likely
to pay any attention. Even the figures above quoted as to Leicester and
Warrington are to be found only in the Report of the Minority, who also
give the case of another town, Dewsbury, which has partially rejected
vaccination, but not nearly to so large an extent as Leicester, and in
the same epidemic it stood almost exactly between unvaccinated Leicester
and well-vaccinated Warrington, thus:

    Leicester   had  1·1 mortality per 10,000 living
    Dewsbury     ”   6·7     ”      ”     ”     ”
    Warrington   ”  11·8     ”      ”     ”     ”

Here again we see that it is the unvaccinated towns that suffer least,
not the most vaccinated. The public of course have been terrorised by the
case of Gloucester, where a large default in vaccination was followed
by a very severe epidemic of small-pox. The Majority Report refers to
this in par. 373, intending to hold it up as a warning, but strangely
enough in so important a document, say the reverse of what they mean to
say, giving to it “very little,” instead of “very much” small-pox. This
case, however, has really nothing whatever to do with the question at
issue, because, although anti-vaccinators maintain that vaccination has
not the least effect in preventing or mitigating small-pox, they do _not_
maintain that the _absence_ of vaccination prevents it. What they urge
is, that sanitation and isolation are the effective and only preventives,
and it was because Leicester attended thoroughly to these matters, and
Gloucester wholly neglected them that the one suffered so little and the
other so much in the recent epidemic. On this subject every enquirer
should read the summary of the facts given in the Minority Report,
paragraph 261.

To return to the Majority Report. Its references to Leicester are
scattered over 80 pages, referring separately to the hospital staff,
and the relations of vaccinated and unvaccinated to small-pox; while
in only a few paragraphs (par. 480-486) do they deal with the main
question and the results of the system of isolation adopted. These
results they endeavour to minimise by declaring that the disease was
remarkably “slight in its fatality,” yet they end by admitting that “the
experience of Leicester affords cogent evidence that the vigilant and
prompt application of isolation ... is a most powerful agent in limiting
the spread of small-pox.” A little further on (par. 500) they say, when
discussing this very point—how far sanitation may be relied on in place
of vaccination—“The experiment has never been tried.” Surely a town of
180,000 inhabitants which has neglected vaccination for twenty years,
is an experiment. But a little further on we see the reason of this
refusal to consider Leicester a test experiment. Par. 502 begins thus:
“The question we are now discussing must, of course, be argued on the
hypothesis that vaccination affords protection against small-pox.” What
an amazing basis of argument for a Commission supposed to be enquiring
into this very point! They then continue: “Who can possibly say that if
the disease once entered a town the population of which was entirely
or almost entirely unprotected, it would not spread with a rapidity
of which we have in recent times had no experience?” But Leicester
_is_ such a town. Its infants—the class which always suffers in the
largest numbers—are almost wholly unvaccinated, and the great majority
of its adults have, according to the bulk of the medical supporters of
vaccination, long outgrown the benefits, if any, of infant-vaccination.
The disease has been introduced into the town twenty times before 1884,
and twelve times during the last epidemic (_Final Report_, par. 482 and
483). The doctors have been asserting for years that once small-pox comes
to Leicester it will run through the town like wild-fire. But instead
of that it has been quelled with far less loss than in any of the best
vaccinated towns in England. But the Commissioners ignore _this_ actual
experiment, and soar into the regions of conjecture with, “Who can
possibly say?”—concluding the paragraph with—“_A priori_ reasoning on
such a question is of little or no value.” Very true. But _a posteriori_
reasoning, from the cases of Leicester, Birmingham, Warrington, Dewsbury,
and Gloucester, _is_ of value; but it is of value as showing the utter
uselessness of vaccination, and it is therefore, perhaps, wise for the
professional upholders of vaccination to ignore it. But surely it is
_not_ wise for a presumably impartial Commission to ignore it as it is
ignored in this Report.[14]


THE ARMY AND NAVY AS A CONCLUSIVE TEST

In the Report of the Medical Officer of the Local Government Board for
1884, it is alleged that when an adult is revaccinated “he will receive
the full measure of protection that vaccination is capable of giving
him.” In the same year the Medical Officer of the General Post Office
stated in a circular, “It is desirable, in order to obtain full security,
that the operation (vaccination) should be repeated at a later period of
life”; and the circular of the National Health Society already referred
to states that “soldiers who have been revaccinated can live in cities
intensely affected by small-pox without themselves suffering to any
appreciable degree from the disease.” Let us then see how far these
official statements are true or false.

In their _Final Report_ the Commissioners give the statistics of
small-pox mortality in the Army and Navy from 1860 to 1894, and, although
the latest order for the vaccination of the whole force in the Navy
was only made in 1871, there can be no doubt that, practically, the
whole of the men had been revaccinated long before that period;[15] but
certainly since 1873 all without exception, both English and foreign,
were revaccinated; and in the Army every recruit has been revaccinated
since 1860 (see 2nd Report, Q. 3,453, 3,455; and for the Navy, Q. 2,645,
6, 3,212-13, and 3,226-3,229). Brigade-Surgeon William Nash, M.D.,
informed the Commission that the vaccination and revaccination of the
Army was “as perfect as endeavours can make it,” and that he can make no
suggestion to increase its thoroughness (Q. 3,559, 3,560).

Turning now to the diagram (No. XI.) which represents the official
statistics, the two lower solid lines show the small-pox death-rate per
100,000 of the force of the Army and Navy for each year, from 1860 to
1894. The lower thick line shows the Army mortality, the thin line that
of the Navy. The two higher lines show the total death-rate from disease
of the Navy, and of the Home force of the Army, as the tables supplied do
not separate the deaths by disease of that portion of the Army stationed
abroad.

Looking first at these upper lines, we notice two interesting facts. The
first is, the large and steady improvement of both forces as regards
health-conditions during the thirty-five years; and the second is the
considerable and constant difference in the disease mortality of the two
services, the soldiers having throughout the whole period a much higher
mortality than the sailors. The decrease of the general mortality is
clearly due to the great improvements that have been effected in diet,
in ventilation, and in general health-conditions; while the difference
in health between the two forces is almost certainly due to two causes,
the most important being that the sailors spend the greater part of every
day in the open-air, and in air of the maximum purity and health-giving
properties, that of the open sea; while soldiers live mostly in camps or
barracks, often in the vicinity of large towns, and in a more or less
impure atmosphere. The other difference is that soldiers are constantly
subject to temptations and resulting disease, from which sailors while
afloat are wholly free.

Turning now to the lower lines, we see that, as regards small-pox
mortality, the Navy suffered most down to 1880, but that since that
period the Army has had rather the higher mortality. This has been held
to be due to the less perfect vaccination of the Navy in the earlier
period, but of that there is no proof, while there is evidence as to
the causes of the improvement in general health. Staff-Surgeon T. J.
Preston, R.N., stated them thus: “Shorter sea-voyages; greater care
not to overcrowd; plentiful and frequent supplies of fresh food; the
introduction of condensed water; and the care that is now taken in the
general economy and hygiene of the vessels” (Q. 3,253). These seem
sufficient to have produced also the comparative improvement in small-pox
mortality, especially as the shorter voyages would enable the patients
to be soon isolated on shore. The question we now have to consider is,
whether the amount of small-pox here shown to exist in both Army and Navy
demonstrates the “full security” that revaccination is alleged to give;
whether as a matter of fact our soldiers and sailors, when exposed to the
contagion of intense small-pox, _do_ suffer to “any appreciable degree”;
and lastly, whether they show any immunity whatever when compared with
similar populations who have been either very partially or not at all
revaccinated. It is not easy to find a fairly comparable population, but
after due consideration it seems to me that Ireland will be the best
available, as the statistics are given in the Commissioners’ Reports,
and it can hardly be contended that it has any special advantages over
our soldiers and sailors,—rather the other way. I have therefore given a
diagram, XII., in which a dotted line shows the small-pox mortality of
the Irish people of the ages 15 to 45 in comparison with the Army and
the Navy mortality for the same years. (The figures for this diagram,
as regards Ireland, have been calculated from the table at p. 37 of the
_Final Report_, corrected for the ages 15 to 45 by means of Table J. at
p. 274 of the Second Report.)

This dotted line shows us that, with the exception of the great epidemic
of 1871, when for the bulk of the Irish patients there was neither
isolation nor proper treatment, the small-pox mortality of the Irish
population of similar ages has been on the average below that of either
the Army or the Navy; while if we take the mean mortality of the three
for the same period (1864-1894) inclusive, the result is as follows:

    Army, mean of the annual small-pox death rate, 58 per million.
    Navy     ”           ”         ”        ”      90     ”
    Ireland (ages 15-45) ”         ”        ”      65·8   ”[16]

If we combine the Army and Navy death-rates in the proportion of their
mean strength so as to get the true average of the two forces, the
death-rate is =64·3= per million, or almost exactly the same as that of
Ireland.

Now if there were no other evidence which gave similar results, this
great test case of large populations compared over a long series of
years, is alone almost conclusive; and we ask with amazement,—Why did
not the Commissioners make some such comparison as this, and not allow
the public to be deceived by the grossly misleading statements of the
medical witnesses and official apologists for a huge imposture? For here
we have on one side a population which the official witnesses declare
to be as well vaccinated and revaccinated as it is possible to make it,
and which has all the protection that can be given by vaccination. It
is a population which, we are officially assured, can live in the midst
of the contagion of severe small-pox and not suffer from the disease
“in any appreciable degree.” And on comparing this population of over
200,000 men, thus thoroughly protected and medically cared for, with
the poorest and least cared for portion of our country—a portion which
the official witness regarding it declared to be _badly_ vaccinated,
while no amount of revaccination was even referred to—we find the less
vaccinated and less cared for community to have actually a much lower
small-pox mortality than the Navy, and the same as that of the two forces
combined. The only possible objections that can be taken, or that were
suggested during the examination of the witnesses are, that during the
early portion of the period, the Navy was not _wholly_ and _absolutely_
revaccinated; and secondly, that troops abroad, and especially in India
and Egypt, are more frequently subjected to infection. As to the first
objection, even if revaccination were not absolutely universal in the
Navy prior to 1873, it was certainly very largely practised, and should
have produced a great difference when compared with Ireland. And the
second objection is simply childish. For what are vaccination and
revaccination for, except to protect from infection? And under exposure
to the most intense infection they have been officially declared “not
appreciably to suffer”!

But let us make one more comparison comprising the period since the
great epidemic of 1871-2, during which the Navy as well as the Army
are admitted to have been completely revaccinated, both English and
foreign. We will compare this (supposed) completely protected force with
Leicester, an English manufacturing town of nearly the same population,
by no means especially healthy, and which has so neglected vaccination
that it may now claim to be the least vaccinated town in the kingdom.
The average annual small-pox death-rate of this town for the twenty-two
years 1873-94 inclusive is thirteen per million (see 4th Report, p. 440);
but in order to compare with our Army and Navy we must add one-ninth for
the mortality at ages 15-45 as compared with total mortality, according
to the table at p. 155 of the _Final Report_, bringing it to 14·4 per
million, when the comparison will stand as follows:

                                         Per Million.
    Army (1873-94) small-pox death rate    37[17]
    Navy      ”      ”           ”         36·8
    Leicester ”      ”       ages 15-45    14·4

It is thus completely demonstrated that all the statements by which the
public has been gulled for so many years, as to the almost complete
immunity of the revaccinated Army and Navy, are absolutely false. It
is all what Americans call “bluff.” There is _no_ immunity. They have
_no_ protection. When exposed to infection, they _do_ suffer just as
much as other populations, or even more. In the whole of the nineteen
years 1878-1896 inclusive, unvaccinated Leicester had so few small-pox
deaths that the Registrar-General represents the average by the decimal
0·01 per thousand population, equal to ten per million, while for the
twelve years 1878-1889 there was less than one death per annum! Here we
have _real_ immunity, _real_ protection; and it is obtained by attending
to sanitation and isolation, coupled with the almost total neglect of
vaccination. Neither Army nor Navy can show any such results as this. In
the whole twenty-nine years tabulated in the Second Report the Army had
not one year without a small-pox death, while the Navy never had more
than three consecutive years without a death, and only six years in the
whole period.

Now if ever there exists such a thing as a crucial test, this of the
Army and Navy, as compared with Ireland, and especially with Leicester,
affords such a test. The populations concerned are hundreds of thousands;
the time extends to a generation; the statistical facts are clear and
indisputable; while the case of the Army has been falsely alleged again
and again to afford indisputable proof of the value of vaccination
when performed on adults. It is important, therefore, to see how the
Commissioners deal with these conclusive test-cases. They were appointed
to discover the truth and to enlighten the public and the legislature,
not merely to bring together huge masses of undigested facts.

What they do is, to make no comparison whatever with any other fairly
comparable populations, to show no perception of the crucial test they
have to deal with, but to give the Army and Navy statistics separately,
and as regards the Army piecemeal, and to make a few incredibly weak and
unenlightening remarks. Thus, in par. 333, they say that, during the
later years, as the whole force became more completely revaccinated,
small-pox mortality _declined_. But they knew well that during the same
period it declined over all England, Scotland, and Ireland, with no
special revaccination, and most of all in unvaccinated Leicester! Then
with regard to the heavy small-pox mortality of the wholly revaccinated
and protected troops in Egypt, they say, “We are not aware what is the
explanation of this.” And this is absolutely all they say about it!
But they give a long paragraph to the Post Office officials, and make
a great deal of _their_ alleged immunity. But in this case the numbers
are smaller, the periods are less, and no statistics whatever are
furnished except for the last four years! All the rest is an extract
from a parliamentary speech by Sir Charles Dilke in 1883, stating some
facts, furnished of course by the medical officers of the Post Office,
and therefore not to be accepted as evidence.[18] This slurring over
the damning evidence of the absolute inutility of the most thorough
vaccination possible, afforded by the Army and Navy, is sufficient
of itself to condemn the whole _Final Report_ of the majority of the
Commissioners. It proves that they were either unable or unwilling to
analyse carefully the vast mass of evidence brought before them, to
separate mere beliefs and opinions from facts, and to discriminate
between the statistics which represented those great “masses of national
experience” to which Sir John Simon himself has appealed for a final
verdict, and those of a more partial kind, which may be vitiated by the
prepossessions of those who registered the facts. That they have not done
this, but without any careful examination or comparison have declared
that revaccinated communities have “exceptional advantages” which,
as a matter of fact, the Report itself show they have _not_, utterly
discredits all their conclusions, and renders this _Final Report_ not
only valueless but misleading.



CHAPTER V

CRITICAL REMARKS ON THE “FINAL REPORT”


Before proceeding to sum up the broad statistical case against
vaccination, it may be well here to point out some of the misconceptions,
erroneous statements, vague opinions, and conclusions which are opposed
to the evidence, which abound in this feeble Report.

And first, we have the repetition of an oft-corrected and obviously
erroneous statement as to the absolute identity of the vaccinated and the
unvaccinated, except on the one point of vaccination. The Commissioners
say: “Those, therefore, who are selected as being vaccinated persons
might just as well be so many persons chosen at random out of the total
number attacked. So far as any connection with the incidence of, or the
mortality from, small-pox is concerned, the choice of persons might as
well have been made according to the colour of the clothes they wore”
(_Final Report_, par. 213). But there are tables in the Reports showing
that about one-seventh of all small-pox deaths occur in the first six
months of life, and by far the larger part of this mortality occurs
in the first three months. The age of vaccination varies actually
from three to twelve months, and many children have their vaccination
specially delayed on account of ill-health, so that the “unvaccinated”
always include a large proportion of those who, _merely because they are
infants_, supply a much larger proportion of deaths from small-pox than
at any other age. Yet the Commissioners say the unvaccinated might as
well be chosen at random, or by the colour of their clothes so far as any
liability to small-pox is concerned. One stands amazed at the hardihood
of a responsible body of presumably sensible and truth-seeking men who
can deliberately record as a fact what is so obviously untrue.

Hardly less important is it that the bulk of the unvaccinated, those
who escape the vaccination officers, are the very poor, and the nomad
population of the country—tramps, beggars and criminals, the occupants of
the tenement houses and slums of our great cities, who, being all weekly
tenants, are continually changing their residence. Such were referred
to, in the Report of the Local Government Board for 1882 (p. 309), as
constituting the bulk of the thirty-five thousand of default, under the
heading—“Removed, not to be traced, or otherwise accounted for.”

One of the Commission’s official witnesses, Dr. MacCabe, Medical
Commissioner for Ireland, distinctly affirms this. He says (2nd Report,
Q. 3,073) that he formerly had charge of the Dublin district, and
that “out of a population of a quarter of a million, 100,000 live in
tenement-houses, that is to say, houses that are let out in single rooms
for the accommodation of a family. It is amongst that class, to a very
great extent, that the defaulters exist. The relieving officer, when he
goes to the tenement-dwelling where the birth occurred, finds that the
parents have gone to some other tenement-dwelling and there is no trace
of them.... A great number of these defaulters occur in this way.”

Now weekly tenants do not live in the best and most sanitary parts of
towns, and the records of every epidemic show that such insanitary
districts have an enormously greater proportion of the small-pox deaths
than the healthier districts. Yet the Commissioners declare that there is
“absolutely no difference between the vaccinated and the unvaccinated”
except in respect of vaccination. Again we stand amazed at a statement
so contrary to the fact. But the Commissioners must of course have
believed it to be true, or they would not put it in their _Final Report_,
upon which legislation may be founded affecting the liberties and the
lives of their fellow countrymen.

I submit to my readers with confidence that this statement, so directly
opposed to the clearest and simplest facts and to the evidence of
official witnesses, proves the incapacity of the Commissioners for the
important inquiry they have undertaken. By their treatment of this part
of the subject they exhibit themselves as either ignorant or careless, in
either case as thoroughly incompetent.

The next passage that calls for special notice here is par. 342, where
they say, “We find that particular classes within the community, amongst
whom revaccination has prevailed to an exceptional degree, have exhibited
a position of quite exceptional advantage in relation to small-pox,
although these classes have in many cases been subject to exceptional
risk of contagion.” It seems almost incredible that such a statement as
this could be made as a conclusion from the official evidence before the
Commissioners, and it can only be explained by the fact that they never
made the simplest and most obvious comparisons, and that they laid more
stress on bad statistics than on good ones. They trust, for example, to
the cases of nurses in hospitals,[19] as to which there are absolutely
no _statistics_ in the proper sense of the term, only verbal statements
by various medical men, and they overlook or forget the largest and
only trustworthy body of statistics existing as to revaccination—that
of the Army and Navy! “A position of quite exceptional advantage!!”
When the small-pox mortality of more than 200,000 men, all revaccinated
to the completest extent possible by the medical officials, shows _no
advantage whatever_ over the whole comparable population of Ireland, and
a quite exceptional _disadvantage_ in comparison with almost unvaccinated
Leicester![20] There is only one charitable explanation of such a
“finding” as this—namely, that the Commissioners were by education and
experience wholly incompetent to deal intelligently with those great
masses of national statistics which alone can furnish conclusive evidence
on this question.

At the end of the main inquiry, as to the effect of vaccination on
small-pox (pp. 98, 99) the Commissioners adopt a very hesitating tone.
They say that—“where vaccination has been most thorough the protection
appears to have been greatest,” and that “the revaccination of adults
appears to place them in so favourable a condition as compared with
the unvaccinated.” But why say “appears” in both these cases? It is a
question of fact, founded on ample statistics, which show us clearly and
unmistakably—as in comparing Leicester with other towns—that vaccination
gives _no protection whatever_, and that the best and most thorough
revaccination, as in the Army and Navy, does _not protect at all_! It is
no question of “appearing” to protect. As a fact, it does _not_ protect,
and does not _appear_ to do so. The only explanation of the use of this
word “appears” is that the Commissioners have founded their conclusions,
not upon the statistical evidence at all, but upon the _impressions_ and
_beliefs_ of the various medical officials they examined, who almost all
_assumed_ the protection as an already established fact. Such was the
case of the army-surgeon who declared that the deaths were much fewer
than they would have been without revaccination; and who, on being asked
why he believed so, answered that it was from reading of the small-pox
mortality in pre-vaccination times! He had made no comparisons, and had
no figures to adduce. It was his _opinion_, and that of the other medical
officers, that it was so. And the Commissioners apparently had always
held the same _opinions_, which, being confirmed by the opinions of other
official witnesses, they concluded that comparisons of the revaccinated
Army and Navy with ordinary death-rates were as unnecessary as they would
certainly have been puzzling to them. Hence “appears” in place of “is” or
“does”; and their seven conclusions as to the value and protectiveness of
vaccination all under the heading—“We think,” _not_ “We are convinced,”
or “It has been proved to us,” or “The statistics of the Army and Navy,
of Ireland, of Leicester and of many other places, _demonstrate_ the
(”protectiveness” or “inutility”—as the case may be) of vaccination.” I
trust that I have now convinced my readers that the best evidence—the
evidence to which Sir John Simon and Dr. Guy have appealed—DEMONSTRATES
complete INUTILITY, as against what “appears” to the Commissioners and
what they “think.”

One other matter must be referred to before taking leave of the
Commissioners. I have already shown how completely they ignore the
elaborate and valuable evidence, statistical tables and diagrams,
furnished by those who oppose vaccination, such as were brought before
them by Mr. Biggs of Leicester, Mr. A. Wheeler, and Mr. William Tebb,
who, though all were examined and cross-examined on the minutest details,
might as well never have appeared so far as any notice in the Final
Report is concerned. But there is also a very elaborate paper contributed
by Dr. Adolf Vogt, Professor of Hygiene and Sanitary Statistics in
the University of Berne, who offered to come to London and submit to
cross-examination upon it, which, however, the Commission did not
consider necessary. This paper, a translation of which is printed in the
Appendix to the 6th Report, p. 689, is especially valuable as the work
of a thorough statistician, who, from his position, has access to the
whole body of European official statistics, and his discussion goes to
the very root of the whole question. The treatise is divided into nine
chapters, and occupies thirty-four closely printed pages of the Blue
Book; but, being an elaborate argument founded mainly on a scientific
treatment of statistics, there was probably no member of the Commission
capable of adequately dealing with it. Yet it is of more value than fully
nine-tenths of the remainder of the voluminous reports, with their 31,398
questions and answers. Professor Vogt’s treatise covers almost the whole
ground, medical and statistical, and enforces many of the facts and
arguments I have myself adduced. But there are two points which must be
especially mentioned. His first chapter is headed—“_A Previous Attack of
Small-pox does not Confer Immunity_.” I have long been of opinion that
this was the case, and have by me a brief statement, written six years
since, to show that the rarity of second attacks may in all probability
be fully explained by the doctrine of chances. But I had not statistics
sufficient to prove this. Professor Vogt, however, having the statistical
tables of all Europe at his command, is able to show not only that the
calculus of probabilities itself explains the rarity of a second attack
of small-pox, but that second attacks occur more frequently than they
should do on the doctrine of chances alone, indicating that, instead
of there being any _immunity_, there is really a somewhat increased
_susceptibility_ to a second attack![21] This being the case, it becomes
really ludicrous to read the questions and answers and the serious
discussions as to whether a “good vaccination” protects more or less
than a previous attack of small-pox. Some think the protection is the
same, but the greater number think it is not quite so much. Even the
most ardent vaccinists do not claim a greater protection. But none of
them ever doubt the _fact_ of the protection gained by having had the
disease, and yet none of them, nor any of the Commissioners, thought that
any _evidence_, much less proof, of the fact itself was needed. They took
it for granted. “Everybody knows it.” “Very few people have small-pox
a second time.” No doubt. But very few people suffer from any special
accident twice—a shipwreck, or railway or coach accident, or a house on
fire; yet one of these accidents does not confer immunity against its
happening a second time. The taking it for granted that second attacks
of small-pox, or of any other zymotic disease, are of that degree of
rarity as to _prove_ some immunity or protection indicates the incapacity
of the medical mind for dealing with what is a purely statistical and
mathematical question.

Quite in accordance with this influence of small-pox in rendering the
patient somewhat more liable to catch the disease during any future
epidemic, is the body of evidence adduced by Professor Vogt, showing that
vaccination, especially when repeated once or several times, renders
the persons so vaccinated _more_ liable to take the disease, and thus
actually increases the virulence of epidemics. This has been suspected
by some anti-vaccinators; but it is, I believe, now for the first time
supported by a considerable body of statistics.

The other important feature in Professor Vogt’s memoir is the strong
support he gives to the view that small-pox mortality is really—other
things being approximately equal—a function of density of population. All
the evidence I have adduced goes to show this, especially the enormously
high small-pox death-rate in crowded cities in approximate proportion to
the amount of crowding. Professor Vogt adds some remarkable statistics
illustrating this point, especially a table in which the 627 registration
districts of England and Wales are grouped according to their density
of population, from one district having only sixty-four persons to a
square mile to six which have 20,698 per square mile, another column
showing in how many of the years during the period 1859-1882 there
were any small-pox deaths in the districts. The result shown is very
remarkable. In the most thinly populated district no small-pox death
occurred in _any one_ of the twenty-four years; in the most densely
peopled districts small-pox deaths occurred in _every one_ of the
twenty-four years. And the frequency of the occurrence of small-pox in
all the intervening groups of districts followed exactly the density of
the population. Taking two groups with nearly the same population, the
fourth group of 107 districts, with a total population of 1,840,581,
had small-pox deaths in only five or six out of the twenty-four years
in any of them; while the thirteenth group of thirteen districts, with
a population of 1,908,888, had small-pox deaths in twenty-three out of
the twenty-four years. But the first group had a density of 160 to the
square mile, and the last had 8,350 to the square mile. The Commissioners
dwell upon the alleged fact that neither water-supply, nor drainage,
nor contaminated food produce small-pox, and urge that what is commonly
understood by sanitation has little effect upon it (par. 153). But what
may be termed the fundamental principle of sanitation is the avoidance
of _overcrowding_; and this is shown by an overwhelming body of evidence
invariably to influence small-pox mortality quite irrespective of
vaccination.[22] Yet the remarkable contribution to the mass of evidence
in the “Reports” which brings out this fact most clearly, receives no
notice whatever in the _Final Report_.



CHAPTER VI

SUMMARY AND CONCLUSION


As the diverse aspects of the problem which has been discussed in the
preceding pages are somewhat numerous and complex, owing to the vast mass
of irrelevant but confusing matter with which it has been encumbered at
every step of its progress for nearly a century, a brief summary of the
main points here referred to, and a statement of their bearing on the
essential problem, will now be given.

I have first shown the nature of the tests which seemed to the early
enquirers to establish the protective influence of vaccination, and
have given the facts which the two greatest living specialists on
the subject—Professor Crookshank and Dr. Creighton—consider to prove
the fallacy or insufficiency of all the tests which were applied.
This is followed by a statement of the abundant evidence which in the
first ten years of the century already showed that vaccination had no
protective power (pp. 10-12). But the heads of the medical profession
had accepted the operation as of proved value, and the legislature, on
their recommendation, had voted its discoverer £30,000 of public money,
and had besides, in 1808, endowed a National Vaccine Establishment with
about £3,000 a year. Reputations and vested interests were henceforth at
stake, and those who adduced evidence of the failure or the dangers of
vaccination were treated as fanatics, and have been so treated by the
medical and official world down to the appointment of the last Royal
Commission.

I next give the reasons why doctors are _not_ the best judges of the
effects, beneficial or otherwise, of vaccination, and follow this by
proofs of a special capacity for misstating facts in reference to this
question which has characterized them from the beginning of the century
down to our day. The successive annual reports of the National Vaccine
Establishment give figures of the deaths by small-pox in London in
the eighteenth century, which go on increasing like Falstaff’s men in
buckram; while in our own time the late Dr. W. B. Carpenter, Mr. Ernest
Hart, the National Health Society, and the Local Government Board make
statements or give figures which are absurdly and demonstrably incorrect
(pp. 13-18).[23]

I then show the existence of so unreasoning a belief in the importance
of vaccination that it leads many of those who have to deal, with it
officially to concealments and misstatements which are justified by the
desire to “save vaccination from reproach.” Thus it happened that till
1881 no deaths were regularly recorded as due to vaccination, although an
increasing number of such deaths now appear in the Registrar-General’s
Reports; while a few medical men, who have personally inquired into
these results of vaccination, have found a large amount of mortality
directly following the operation, together with a large percentage of
subsequent disease, often lasting for years or during life, which, except
for such private enquiries, would have remained altogether unknown and
unacknowledged (pp. 18-22).

The same desire to do credit to the practice which they believe to be
so important leads to such imperfect or erroneous statements as to the
_vaccinated_ or _unvaccinated_ condition of those who die of small-pox
as to render all statistics of this kind faulty and erroneous to so
serious an extent that they must be altogether rejected. Whether a person
dies of small-pox or of some other illness is a fact that is recorded
with tolerable accuracy, because the disease, in fatal cases, is among
the most easily recognised. Statistics of “small-pox mortality” may,
therefore, be accepted as reliable. But whether the patient is registered
as vaccinated or not vaccinated usually depends on the visibility or
non-visibility of vaccination-marks, either during the illness or
after death, both of which observations are liable to error, while the
latter entails a risk of infection which would justifiably lead to its
omission. And the admitted practice of many doctors, to give vaccination
the benefit of any doubt, entirely vitiates all such statistics, except
in those special cases where large bodies of adults are systematically
vaccinated or revaccinated. Hence, whenever the results of these
_imperfect_ statistics are opposed to those of the official records of
small-pox _mortality_, the former must be rejected. It is an absolute
law of evidence, of statistics, and of common sense that when two kinds
of evidence contradict each other, that which can be proved to be even
partially incorrect or untrustworthy must be rejected. It will be found
that _all_ the evidence that seems to prove the value of vaccination is
of this untrustworthy character. This conclusion is enforced by the fact
that the more recent hospital statistics show that small-pox occurs among
the vaccinated in about the same proportion as the vaccinated bear to
the whole population; thus again indicating that the earlier figures,
showing that they were proportionately five or six times as numerous, and
the death-rate of the unvaccinated twice or thrice that of the average
of pre-vaccination days, are altogether erroneous, and are due to the
various kinds of error or misstatement which have been pointed out (pp.
25-30).

       *       *       *       *       *

Having thus cleared away some of the misconceptions and fallacies
which have obscured the main question at issue, and having shown that,
by official admission, the only valuable evidence consists of “large
masses of national statistics,” which should have been dealt with by a
commission of trained statisticians, I proceed to show, by a series of
diagrams embodying the official or national statistics brought before the
Commission, or to be found in the Reports of the Registrar-General, what
such statistics really prove; and I ask my readers to look again at those
diagrams as I refer to them.

Diagram I. exhibits the most extensive body of national statistics
available, showing at one view the death-rates from Small-pox, from the
other chief Zymotic Diseases, and the Total Mortality, from 1760 to 1896.
The first portion, from 1760 to 1836, is from the “Bills of Mortality,”
which, though not complete, are admitted to be, on the whole, fairly
accurate as regards the variations at different periods and between
different diseases. The second part, from 1838 onwards, is from the
Reports of the Registrar-General, and is more complete in giving all
deaths whatever. Its lines are, therefore, as it were, on a higher level
than those of the earlier period, and can only be compared with it as
regards proportions of the different mortalities, not so accurately as to
their total amounts. The main teaching of this diagram—a teaching which
the Commissioners have altogether missed by never referring to diagrams
showing comparative mortalities—is the striking correspondence in average
rise and fall of the death-rates of small-pox, of zymotics, and of all
diseases together. This correspondence is maintained throughout the
whole of the first part, as well as through the whole of the second
part, of the diagram; and it proves that small-pox obeys, and always
has obeyed, the same law of subservience to general sanitary conditions
as the other great groups of allied diseases and the general mortality.
Looking at this most instructive diagram, we see at once the absurdity of
the claim that the diminution of small-pox in the first quarter of our
century was due to the partial and imperfect vaccination of that period.
Equally absurd is the allegation that its stationary character from 1842
to 1872, culminating in a huge epidemic, was due to the vaccination
then prevailing, though much larger than ever before, not being quite
universal—an allegation completely disproved by the fact that the
other zymotics as a whole, as well as the general mortality, exhibited
strikingly similar decreases followed by equally marked periods of
average uniformity or slight increase, to be again followed by a marked
decrease. There is here no indication whatever of vaccination having
produced the slightest effect on small-pox mortality.

The second diagram shows that, even taking the Commission’s favourite
method of comparing the zymotics separately with small-pox, all of them
except measles show a similar or a greater decrease during the period of
official registration, and also agree in the periods of slight increase,
again proving the action of the same general causes (which I have pointed
out at p. 37), and leaving no room whatever for the supposed effects of
vaccination.

Diagram III. shows that similar phenomena occurred in England and Wales
as a whole, the other zymotics and the total deaths obeying the same laws
of increase and decrease as small-pox. Comparison with diagram I. shows
the much greater severity of small-pox epidemics in London, illustrating
the fact, which all the statistical evidence of all countries strikingly
enforces, that _small-pox mortality is, other things being equal, a
function of density of population_, while it pays no regard whatever to
vaccination. This is further shown by the short, thick dotted line which
exhibits the total number of vaccinations since 1872, when private as
well as public vaccinations were first officially recorded, and which
proves that the continuous _decrease_ of vaccination since 1882 has been
accompanied by a decided _decrease_, instead of an increase, in small-pox
mortality.

Diagram IV. shows the statistics of mortality in Ireland and Scotland
from small-pox and certain chosen zymotics, from the tables which were
laid before the Commission by the official advocates of vaccination.
These show two striking facts, which the Commissioners failed to
notice in their _Final Report_. First, the smaller amount of small-pox
mortality in Ireland than in Scotland, the latter being alleged to be
well vaccinated, the former imperfectly so; and, secondly, the similar
difference in the two chosen diseases and the general parallelism of the
two. Here again we see clearly the influence of _density of population_,
Scotland having a very much larger proportion of its inhabitants living
in large manufacturing towns.

The next three diagrams, V., VI., and VII., show small-pox mortality in
Sweden, Prussia, and Bavaria—countries which at previous enquiries were
adduced as striking examples of the value of vaccination. They all show
phenomena of the same character as our own country, but far worse as
regards epidemics in the capitals; that of Stockholm, in 1874, causing a
death-rate more than 50 per cent. higher than during the worst epidemic
of the last century in London! The diagram of small-pox and zymotics
in Bavaria is given merely because the statistics were brought before
the Commission as a proof of the beneficial results of vaccination in
well-vaccinated communities. It was _alleged_ by Dr. Hopkirk that almost
the whole of the population were vaccinated, and _admitted_ by him that
of the 30,742 cases of small-pox in 1871 no less than 95·7 per cent. were
vaccinated! The epidemic was, however, less severe than in Prussia, again
showing the influence of density of population, less than one-seventh of
the Bavarians inhabiting towns of over 20,000, while one-fourth inhabit
similar towns in Prussia; but we see that during the latter half of
the period chosen small-pox greatly increased, and the other zymotics
remained very high, indicating general insanitary conditions. And this
case was specially brought before the Commission as a proof of the
_benefits_ of vaccination! In their _Final Report_ the Commissioners omit
to point out that it really indicates the very reverse.

We then come to the two cases that afford most conclusive tests of the
absolute uselessness of vaccination—Leicester and our Army and Navy.

Diagram VIII. shows the death-rates from small-pox and from the other
zymotics in LEICESTER during the period of official registration,
together with the percentage of vaccinations to births. Up to 1872
Leicester was a fairly well-vaccinated town, yet for thirty-four years
its small-pox mortality, in periodical epidemics, remained very high,
corresponding generally with the other zymotics. But immediately after
the great epidemic of 1872, which was much worse than in London, the
people began to reject vaccination, at first slowly, then more rapidly,
till for the last eight years less than 5 per cent. of the births have
been vaccinated. During the whole of the last twenty-four years small-pox
deaths have been very few, and during twelve consecutive years, 1878-89,
there was a total of only eleven small-pox deaths in this populous town.

Diagram IX. is equally important as showing a remarkable correspondence,
if not a causal relation, between vaccination and disease. From 1848
to 1862 there was a considerable decrease of both general and infant
mortality, and also in infant mortality from small-pox. This, Mr. Biggs
tells us, was when important sanitary improvements were in progress.
Then the more thorough enforcement of vaccination set in (as shown
by the dotted line), and was accompanied by an increase of all these
mortalities. But so soon as the revolt against vaccination began, till
the present time, when it has diminished to about 2 or 3 per cent. of
births, all mortalities have steadily decreased, and that decrease has
been especially marked in infant lives. It is very suggestive that the
lines of infant mortality have now reached the position they would have
had if the slow decrease during 1850-60 had been continued, strongly
indicating that some _special cause_ sent them up, and the _removal of
that cause_ allowed them to sink again; and during that very period
_vaccination_ increased and then steadily decreased. I venture to declare
that in the whole history of vaccination there is no such clear and
satisfactory proof of its having saved a single life as these Leicester
statistics afford of its having been the cause of death to many hundreds
of infants.

Diagram X. exhibits the check to the decrease in infant mortality, both
in London and for England, since the enforcement of vaccination (p. 57),
and thus supports and enforces the conclusions derived from the preceding
diagram.


THE ARMY AND NAVY

I next discuss in some detail what is undoubtedly the most complete and
crucial test of the value or uselessness of vaccination to be found
anywhere in the world. Since 1860 in the Army, and 1872 in the Navy,
every man without exception, English or foreign, has been vaccinated on
entering the service, though for long before that period practically
the whole force was vaccinated or revaccinated. Diagrams XI. and XII.
exhibit the result of the statistics presented to the Commission, showing
for the Navy the death-rate from disease and that from small-pox for the
whole force; and for the Army the death-rate from small-pox for the whole
force, and that from disease for the home force only, foreign deaths from
disease not being separately given.

Here we note, first, as in all the other communities we have dealt
with, the general correspondence between the two lines of total disease
mortality and small-pox mortality, resulting from the greater attention
given to sanitation and to general health conditions of both forces
during the last thirty or forty years. But, instead of small-pox
mortality absolutely vanishing with the complete revaccination in the
Army since 1860, it shows but a small improvement as compared with
general disease mortality; just as if some adverse cause were preventing
the improvement. In the Navy the improvement is somewhat greater, and
more nearly comparable with that of general disease mortality. There is,
therefore, as regards proportionate decrease, no indication whatever of
any exceptional cause favourably influencing small-pox.

In diagram XII. I compare the small-pox mortality of the Army and Navy
with that of Ireland from tables given in the _Final Report_ and the
Second Report; and we find that this whole country (at ages 15-45) has
actually a much lower small-pox mortality than the Army, while it is a
little more than in the Navy, although the mortality during the great
epidemic was higher than any that affected the Army or Navy, owing to its
rapid spread by infection in the towns. But the proportionate numbers
dying of small-pox in a series of years is, of course, the final and
absolute test; and, applying this test, we find that these revaccinated
soldiers and sailors have suffered in the thirty-one years during which
the materials for comparison exist, to almost exactly the same extent
as poor, half-starved, imperfectly vaccinated Ireland (p. 65)! Another
and still more striking comparison is given. The town of Leicester is,
and has been for the last twenty years, the least vaccinated town in the
kingdom. Its average population from 1873 to 1894 was about two-thirds
that of the Army during the same period. Yet the small-pox deaths in the
Army and Navy were thirty-seven per million, those of Leicester under
fifteen per million.

Thus, whether we compare the revaccinated and thoroughly “protected” Army
and Navy with imperfectly vaccinated Ireland, or with almost unvaccinated
Leicester, we find them either on a bare equality or _worse off_ as
regards small-pox mortality. It is not possible to have a more complete
or crucial test than this is, and it absolutely demonstrates the utter
uselessness, or worse than uselessness, of revaccination![24]

In the face of this clear and indisputable evidence, all recorded in
their own Reports, the Commissioners make the astounding statement:
“We find that particular classes within the community amongst whom
revaccination has prevailed to an exceptional degree have exhibited
a position of quite exceptional advantage in relation to small-pox,
although these classes have in many cases been subject to exceptional
risk of contagion” (_Final Report_, p. 90, par. 342). And again: “The
fact that revaccination of adults appears to place them in so favourable
a condition as compared with the unvaccinated,” etc. (_Final Report_,
p. 98, sec. 375). What can be said of such statements as these, but
simply that they are wholly untrue. And the fact that the majority of
the Commissioners did not know this, because they never compared the
different groups of facts in their own reports which prove them to be
untrue, demonstrates at once their complete incapacity to conduct such
an inquiry and the utter worthlessness of their _Final Report_.

This is a matter upon which it is necessary to speak plainly. For
refusing to allow their children’s health, or even their lives, to be
endangered by the inoculation into their system of disease-produced
matter, miscalled “lymph,”[25] hundreds and probably thousands of English
parents have been fined or imprisoned and treated as criminals, while
certainly thousands of infants have been officially done to death, and
other thousands injured for life. And all these horrors on account of
what Dr. Creighton has well termed a “grotesque superstition,” which
has never had a rational foundation either of physiological doctrine or
of carefully tested observations, and is now found to be disproved by a
century’s dearly bought experience. This disgrace of our much-vaunted
scientific age has been throughout supported by concealment of facts
telling against it, by misrepresentation, and by untruths. And now a
Royal Commission, which one would have supposed would have striven to
be rigidly impartial, has presented a Report which is not only weak,
misleading, and inadequate, but is also palpably one-sided, in that it
omits in every case to make those comparisons by which alone the true
meaning can be ascertained of those “great masses of national experience”
to which appeal has been made by the official advocate of vaccination
_par excellence_—Sir John Simon.

       *       *       *       *       *

I venture to think that I have here so presented the best of these
statistical facts as to satisfy my readers of the certain and absolute
_uselessness_ of vaccination as a preventive of small-pox; while these
same facts render it in the highest degree probable that it has actually
increased susceptibility to the disease. The teaching of the whole of
the evidence is in one direction. Whether we examine the long-continued
records of London mortality, or those of modern registration for England,
Scotland, and Ireland; whether we consider the “control experiment” or
crucial test afforded by unvaccinated Leicester, or the still more rigid
test in the other direction, of the absolutely revaccinated Army and
Navy, the conclusion is in every case the same: that vaccination is a
gigantic delusion; that it has never saved a single life; but that it has
been the cause of so much disease, so many deaths, such a vast amount of
utterly needless and altogether undeserved suffering, that it will be
classed by the coming generation among the greatest errors of an ignorant
and prejudiced age, and its penal enforcement the foulest blot on the
generally beneficent course of legislation during our century.

To talk of amending such legislation is a mockery. Absolute and
immediate abolition is the only rational course open to us. Every day
the vaccination laws remain in force parents are being punished, infants
are being killed. An Act of a single clause will repeal these vile
laws; and I call upon every one of our legislators to consider their
responsibilities as the guardians of the liberties of the English people,
and to insist that this repeal be effected without a day’s unnecessary
delay.

_The successive Vaccination Acts were passed by means of allegations
which were wholly untrue and promises which have all been unfulfilled.
They stand alone in modern legislation as a gross interference with
personal liberty and the sanctity of the home; while as an attempt to
cheat outraged nature and to avoid a zymotic disease without getting rid
of the foul conditions that produce or propagate it, the practice of
vaccination is utterly opposed to the whole teaching of sanitary science,
and is one of those terrible blunders which, in their far-reaching evil
consequences, are worse than the greatest of crimes._



FOOTNOTES


[1] Professor Crookshank, in his evidence before the Royal Commission
(4th Report, Q. 11,729) quotes Dr. De Haën, a writer on Inoculation,
as saying: “Asthma, consumption, hectic or slow fever of any kind,
internal ulcers, obstructed glands, obstructions of the viscera from
fevers, scrofula, scurvy, itch, eruptions, local inflammations or pains
of any kind, debility, suppressed or irregular menstruation, chlorosis,
jaundice, pregnancy, _lues venerea_, whether in the parent or transmitted
to the child, and a constitution under the strong influence of mercury,
prevented the operation.” There is no evidence that those who applied
the so-called “variolous test” in the early days of vaccination paid
any attention to this long list of ailments, many of which were very
prevalent at the time, and which would, in the opinion of De Haën, and
of the English writer Sanders, who quotes him, have prevented the action
of the virus and thus rendered the “test” entirely fallacious. With
such causes as these, added to those already discussed, it becomes less
difficult to understand how it was that the alleged test was thought to
prove the influence of the previous vaccination without really doing so.

[2] The cases of failure of vaccination here referred to are given in Mr.
William White’s _Story of a Great Delusion_, where fuller extracts and
references will be found.

[3] These extracts from the Reports are given by Mr. White in his _Story
of a Great Delusion_. The actual deaths from small-pox during the last
century are given in the Second Report of the Royal Commission, p. 290.
The above statements have been verified at the British Museum by my
friend Dr. Scott Tebb, and are verbally accurate.

[4] As an example of the dreadful results of vaccination, even where
special care was taken, the following case from the Sixth Report of the
Royal Commission (p. 128) is worthy of earnest attention. It is the
evidence of Dr. Thomas Skinner, of Liverpool:

    _Q._ 20,766. Will you give the Commission the particulars
    of the case?—A young lady, fifteen years of age, living at
    Grove Park, Liverpool, was revaccinated by me at her father’s
    request, during an outbreak of small-pox in Liverpool in 1865,
    as I had revaccinated all the girls in the Orphan Girls’ Asylum
    in Myrtle Street, Liverpool (over 200 girls, I believe), and
    as the young lady’s father was chaplain to the asylum, he
    selected, and I approved of the selection, of a young girl,
    the picture of health, and whose vaccine vesicle was matured,
    and as perfect in appearance as it is possible to conceive.
    On the eighth day I took off the lymph in a capillary glass
    tube, almost filling the tube with clear, transparent lymph.
    Next day, 7th March, 1865, I revaccinated the young lady from
    this same tube, and from the same tube and at the same time I
    revaccinated her mother and the cook. Before opening the tube I
    remember holding it up to the light and requesting the mother
    to observe how perfectly clear and homogeneous, like water,
    the lymph was, neither pus nor blood corpuscles were visible
    to the naked eye. All three operations were successful, and on
    the eighth day all three vesicles were matured “like a pearl
    upon a rose petal,” as Jenner described a perfect specimen.
    On that day, the eighth day after the operation, I visited my
    patient, and to all appearance she was in the soundest health
    and spirits, with her usual bright eyes and ruddy cheeks.
    Although I was much tempted to take the lymph from so healthy a
    vesicle and subject, I did not do so, as I have frequently seen
    erysipelas and other had consequences follow the opening of a
    matured vesicle. As I did not open the vesicle that operation
    could not be the cause of what followed. Between the tenth
    and the eleventh day after the revaccination—that is, about
    three days after the vesicle had matured and begun to scab
    over—I was called in haste to my patient the young lady, whom I
    found in one of the most severe rigors I ever witnessed, such
    as generally precedes or ushers in surgical, puerperal, and
    other forms of fever. This would be on the 18th March, 1865.
    Eight days from the time of this rigor my patient was dead,
    and she died of the most frightful form of blood poisoning
    that I ever witnessed, and I have been forty-five years in
    the active practice of my profession. After the rigor, a low
    form of acute peritonitis set in, with incessant vomiting and
    pain, which defied all means to allay. At last stercoraceous
    vomiting, and cold, clammy, deadly sweats of a sickly odour
    set in, with pulselessness, collapse, and death, which closed
    the terrible scene on the morning of the 26th March, 1865.
    Within twenty minutes of death rapid decomposition set in,
    and within two hours so great was the bloated and discoloured
    condition of the whole body, more especially of the head and
    face, that there was not a feature of this once lovely girl
    recognisable. Dr. John Cameron, of 4, Rodney Street, Liverpool,
    physician to the Royal Southern Hospital at Liverpool, met me
    daily in consultation while life lasted. I have a copy of the
    certificate of death here.

    _Q._ 20,767. To what do you attribute the death there?—I can
    attribute the death there to nothing but vaccination.

In the same Report, fifteen medical men give evidence as to disease,
permanent injury, or death caused by vaccination. Two give evidence of
syphilis and one of leprosy as clearly due to vaccination. And, as an
instance of how the law is applied in the case of the poor, we have the
story told by Mrs. Amelia Whiting (_QQ._ 21,434-21,464). To put it in
brief, it amounts to this:—Mrs. Whiting lost a child, after terrible
suffering, from inflammation supervening upon vaccination. The doctor’s
bill for the illness was £1 12_s._ 6_d._; and a woman who came in to help
was paid 6_s._ After this first child’s death, proceedings were taken for
the non-vaccination of another child; and though the case was explained
in court, a fine of one shilling was inflicted. And through it all, the
husband’s earnings as a labourer were 11_s._ a week.

[5] See Table J, p. 201, 3rd Report, and the Minority Report of the Roy.
Comm., pp. 176-7.

[6] The same view is taken even by some advocates of vaccination in
Germany. In an account of the German _Commission for the Consideration
of the Vaccination Question_ in the _British Medical Journal_, August
29, 1885 (p. 408), we find it stated: “In the view of Dr. Koch, no other
statistical material than the mortality from small-pox can be relied
upon; questions as to the vaccinated or unvaccinated condition of the
patient leaving too much room for error.”

[7] It is always stated that only the deaths of those persons belonging
to the Church of England, or who were buried in the churchyards, are
recorded in the “Bills.” This seems very improbable, because the
“searchers” must have visited the house and recorded the death before the
burial; and as they were of course paid a fee for each death certified by
them, they would not enquire very closely as to the religious opinions
of the family, or where the deceased was to be buried. A friend of mine
who lived in London before the epoch of registration informs me that
he remembers the “searchers’” visit on the occasion of the death of
his grandmother. They were two women dressed in black; the family were
strict dissenters, and the burial was at the Bunhill Fields cemetery for
Nonconformists. This case proves that in all probability the “Bills” did
include the deaths of many, perhaps most, Nonconformists.

[8] _Final Report of Roy. Comm._, p. 20 (85).

[9] As an example of the Commissioners’ statistical fallacies in treating
the subject of changed age-incidence, see Mr. Alexander Paul’s _A Royal
Commission’s Arithmetic_ (King & Son, 1897), and, especially, Mr. A.
Milnes’ _Statistics of Small-pox and Vaccination_ in the Journal of the
Royal Statistical Society, September, 1897.

[10] The highest small-pox mortality in London was in 1772, when 3,992
deaths were recorded in an estimated population of 727,000, or a
death-rate of not quite 5,500 per million. (See Second Report, p. 290.)

[11] The small-pox deaths under one year in England have varied during
the last fifty years from 8·6 to 27 per cent. of the whole. (See _Final
Report_, p. 154.)

[12] This almost exactly agrees with the ages of the boys who are
admitted between nine and eleven, and leave at fourteen. (See Low’s
_Handbook of London Charities_.)

[13] From 1850 to 1873 the private vaccinations have been estimated
according to their proportion of the whole since they have been
officially recorded.

[14] Although the Commission make no mention of Mr. Biggs’ tables and
diagrams showing the rise of infant-mortality with increased vaccination,
and its fall as vaccination diminished, they occupied a whole day
cross-examining him upon them, endeavouring by the minutest criticism
to diminish their importance. Especially it was urged that the increase
or decrease of mortality did not agree _in detail_ with the increase or
decrease of vaccination, forgetting that there are _numerous_ causes
contributing to all variations of death-rate, while vaccination is only
alleged to be a _contributory_ cause, clearly visible in general results,
but not to be detected in smaller variations (see Fourth Report, Q.
17,513-17,744, or pp. 370 to 381). Mr. Bigg’s cross-examination in all
occupies 110 pages of the Report.

[15] It was introduced into the Navy in 1801, and in that year the
medical officers of the fleet presented Jenner with a special gold medal!

[16] These figures (for the Army and Navy) are obtained by averaging the
annual death-rates given in the tables referred to, and are therefore
not strictly accurate on account of the irregularly varying strength of
the forces. But the error is small. In the case of the Navy, from 1864
to 1888 the mortality accurately calculated comes out _more_, by nearly
six per cent. than the mean above given, and in the case of the Army for
the same years about one per cent. more. For Ireland the calculation has
been accurately made by means of the yearly populations given at p. 37
of the _Final Report_, but for the Army and Navy materials for the whole
period included in the diagrams materials are not available in any of the
Reports.

[17] The figures for the Army are obtained from the Second Report, p.
278, down to 1888, the remaining six years being obtained from the _Final
Report_, pp. 86, 87; but this small addition has involved a large amount
of calculation, because the Commissioners have given the death-rates
per 10,000 strength of four separate forces—Home, Colonial, Indian, and
Egyptian, and have not given the figures for the whole Army, so as to
complete the table in the Second Report. The figures for the Navy are
obtained from the _Final Report_, p. 88.

[18] Neither Sir C. Dilke nor the Post Office medical officers of the
period referred to gave evidence before the Commission, and it shows to
what lengths the Commissioners would go to support vaccination when such
unverified verbal statements are accepted in their _Final Report_.

[19] As regards the case of the nurses in small-pox hospitals, about
which so much has been said, I brought before the Commission some
evidence from a medical work, which sufficiently disposes of this part of
the question. In Buck’s _Treatise on Hygiene and the Public Health_, Vol.
II., we find an article by Drs. Hamilton and Emmett on “Small-pox and
other Contagious Diseases,” and on page 321 thereof we read:

“It is a fact fully appreciated by medical men, that persons constantly
exposed to small-pox very rarely contract the disease. In the case of
physicians, health-inspectors, nurses, sisters of charity, hospital
orderlies, and some others, this is the rule; and of over 100 persons who
have been to my knowledge constantly exposed, some of them seeing as many
as 1,000 cases, I have never personally known of more than one who has
contracted the disease; but there are many writers who believe perfect
immunity to be extremely rare. In this connection attention may be called
to the exemption of certain persons who occupy the same room, and perhaps
bed, with the patients, and though sometimes never vaccinated, altogether
escape infection.”

And Mr. Wheeler shows that at Sheffield the hospital staff _did_ suffer
from small-pox in a higher degree than other comparable populations (see
6th Report, Q. 19,907).

[20] It is a common practice of vaccinists to quote the German Army as
a striking proof of the good effects of revaccination; but as our own
Army is as well vaccinated as the Army surgeons with unlimited power can
make it, it is unlikely that the Germans can do so very much better. And
there is some reason to think that _their_ statistics are less reliable
than our own. Lieut.-Col. A. T. Wintle, (late) R.A., has published in the
_Vaccination Inquirer_ extracts from a letter from Germany stating, on
the authority of a German officer, that the Army statistics of small-pox
are _utterly unreliable_. It is said to be the rule for Army surgeons
to enter small-pox cases as skin-disease or some other “appropriate
illness,” while large numbers of small-pox deaths are entered as “sent
away elsewhere.” We had better therefore be content with our own Army and
Navy statistics, though even here there is some concealment. In 1860 Mr.
Duncombe, M.P., moved for a return of the disaster at Shorncliffe Camp,
where, it was alleged, 30 recruits were vaccinated, and six died of the
results, but the return was refused. A letter in the _Lancet_ of July 7,
1860, from a “Military Surgeon” stated that numbers of soldiers have had
their arms amputated in consequence of mortification after vaccination;
and a Baptist minister and ex-soldier, the Rev. Frederick J. Harsant,
gave evidence before the Commission of another Shorncliffe disaster in
1868, he himself, then a soldier, having never recovered, and having
had unhealed sores on various parts of his body for more than 20 years.
Eighteen out of the twenty men vaccinated at the same time suffered; some
were months in hospital and in a much worse condition than himself (6th
Report, p. 207). In the same volume is the evidence of twenty medical
men, all of whom have witnessed serious effects produced by vaccination,
some being of a most terrible and distressing character.

[21] Brief statement of the argument:

The chances of a person having small-pox a second time may be roughly
estimated thus: Suppose the average annual death-rate by small-pox to
be 500 per million, and the average duration of life forty years. Then
the proportion of the population that die of small-pox will be 500 × 40
= 20,000 per million. If the proportion of deaths to cases is one to
five, there will he 100,000 cases of small-pox per million during the
life of that million, so that one-tenth of the whole population will have
small-pox once during their lives.

Now, according to the law of probabilities alone, the chances of a
person having small-pox twice will be the square of this fraction, or
_one-hundredth_: so that on the average only one person in 100 would
have small-pox twice if it were a matter of pure chance, and if nothing
interfered with that chance. But there are interferences which modify
the result. (1) Those that die of the first attack cannot possibly have
it a second time. (2) It is most frequent in the very young, so that the
chances of having it later in life are not equal. (3) It is an especially
_epidemic_ disease, only occurring at considerable intervals, which
reduces the chances of infection to those who have had it once. (4) It
is probable that most persons are only liable to infection at certain
periods of life, having passed which without infection they never take
the disease. It seems probable, therefore, that these several conditions
would greatly diminish the chances in the case of any person who had once
had small-pox, so that perhaps, under the actual state of things, chance
alone would only lead to one person in two hundred having the disease a
second time.

The above is only an illustration of the principle. Professor Vogt goes
more fully into the question, and arrives at the conclusion that out of
every 1,000 cases of small-pox the _probability_ is that ten will be
second attacks. Then by getting together all the European observations
as to the actual number of second attacks during various epidemics,
the average is found to amount to sixteen in 1,000 cases, showing a
considerable surplus beyond the number due to probability. Further, the
proportion of deaths to attacks has from early times been observed to be
high for second attacks; and it has also been observed by many eminent
physicians, whose statements are given, that second attacks are more
common in the case of persons whose first attacks were very severe, which
is exactly the reverse of what we should expect if the first attack
really conferred any degree of immunity.

Now the whole theory of protection by vaccination rests upon the
_assumption_ that a previous attack of the disease is a protection; and
Professor Vogt concludes his very interesting discussion by the remark:
“All this justifies our maintaining that the theory of immunity by a
previous attack of small-pox, whether the natural disease or produced
artificially, must be relegated to the realm of fiction.” If this is the
case, the supposed _probability_ or _reasonableness_ of an analogous
disease, vaccinia, producing immunity wholly vanishes.

[22] It is not alleged that overcrowding, _per se_, is the direct
_cause_ of small-pox, or of any other zymotic disease. It is, perhaps
rather a condition than a cause; but under our present social economy
it is so universally associated with various causes of disease—impure
air, bad drainage, bad water supply, unhealthy situations, unwholesome
food, overwork, and filth of every description in houses, clothing, and
persons—that it affords the most general and convenient indication of an
unhealthy as opposed to a healthy mode of life, and, while especially
applying to zymotic diseases, is also so generally prejudicial to health
as to produce a constant and very large effect upon the total mortality.

[23] To the cases I have already given I may now add two others, because
they illustrate the recklessness in making assertions in favour of
vaccination which scorns the slightest attempt at verification. In
the first edition of Mr. Ernest Hart’s _Truth about Vaccination_ (p.
4), it is stated, on the authority of a member of Parliament recently
returned from Brazil, that during an epidemic of small-pox at the town
of Ceara in 1878 and 1879, out of a population not exceeding 70,000
persons there were 40,000 deaths from small-pox. This was repeated by
Dr. Carpenter during a debate in London, in February, 1882, and only
when its accuracy was called in question was it ascertained that at the
time referred to the population of Ceara was only about 20,000, yet the
M.P. had stated—with detailed circumstance—that “in one cemetery, from
August 1878, to June 1879 27,064 persons who had died of small-pox had
been buried.” Gazetteers are not very recondite works, and it would have
been not difficult to test some portion of this monstrous statement
before printing it. Jenner’s biographer tells us that he had a horror of
arithmetical calculations, due to a natural incapacity, which quality
appears to be a special characteristic of those who advocate vaccination,
as the examples I have given sufficiently prove.

Another glaring case of official misrepresentation occurred in the Royal
Commission itself, but was fortunately exposed later on. A medical
officer of the Local Government Board gave evidence (First Report, Q.
994) that the Board in 1886 “took some pains to get the figures as to
the steamship _Preussen_,” on which small-pox broke out on its arrival
in Australia. He made the following statements: (1) There were 312
persons on board this vessel. (2) 4 revaccinated, 47 vaccinated, 3 who
had small-pox, and 15 unvaccinated were attacked—69 in all. (3) The
case was adduced to show that “sanitary circumstances have little or no
control over small-pox compared with the condition of vaccination or no
vaccination.”

This official statement was quoted in the House of Commons as strikingly
showing the value of vaccination. But, like so many other official
statements, it was all wrong! The reports of the Melbourne and Sydney
inspectors have been obtained, and it is found: (1) That there were on
board this ship 723 passengers and 120 crew—843 in all, instead of 312;
so that the “pains” taken by the Local Government Board to get “the
figures” were very ineffectual. (2) There were 29 cases among the 235
passengers who disembarked at Melbourne, of whom only 1 was unvaccinated.
The crew had _all_ been revaccinated before starting, yet 14 of them
were attacked, and one died. All these in addition to the cases given
by the Local Government Board. Thus 18 revaccinated persons caught the
disease, instead of 4, as first stated, and 69 vaccinated, instead of 48;
while among the 15 cases alleged to be unvaccinated _three_ were infants
under one year old, and _two_ more between five and ten years. (3) The
official reports from Melbourne and Sydney stated that the vessel was
greatly overcrowded, that the sanitary arrangements were very bad, and
the inspector at Sydney declared the vessel to be the “filthiest ship he
had had to deal with”!

Here, then, we have a case in which _all_ the official _figures_, paraded
as being the result of “taking some pains,” are wrong, not to a trifling
extent, but so grossly that they might be supposed to apply to some
quite different ship. And the essential fact of the filthy, overcrowded,
and unsanitary condition of the ship was unknown or concealed; and
the case was adduced as one showing how unimportant is sanitation as
regards small-pox. What the case really proves is, that under unsanitary
conditions neither vaccination nor revaccination has the slightest effect
in preventing the spread of small-pox, since the proportion of the cases
among the revaccinated crew was almost exactly the same as that of the
whole of the cases (omitting the three infants) to the whole population
on the ship.

With this example of officially quoted _facts_ (!) in support of
vaccination, coming at the end of the long series we have given or
referred to in the first part of this work, it is not too much to ask
that all such unverified statements be, once and for ever, ruled out
of court. (See _Final Report_, pp. 205-6; and Second Report, Q.
5,942-5,984.)

[24] So late as 1892 (Jan. 16) the _Lancet_ declared in a leading
article: “No one need die of small-pox; indeed, no one need have it
unless he likes—that is to say, he can be absolutely protected by
vaccination once repeated.” Surely, never before was misstatement so
ignorantly promulgated, or so completely refuted!

[25] “LYMPH, a colourless nutritive fluid in animal bodies” (Chambers’
Dictionary). How misleading to apply this term to a product of _disease_,
used to produce another _disease_, and now admitted to be capable
of transmitting some of the most _horrible diseases_ which afflict
mankind—syphilis and leprosy!



INDEX


  A.

  Air, importance of pure, 42.

  Army and Navy afford a conclusive test, 62.
    statistics of small-pox in, 63.


  B.

  Bavaria, small-pox and vaccination in, 49.
    proves uselessness of vaccination, 50.

  Berlin, severe epidemics in, 49.

  Biggs, Mr. T., statistics of Leicester mortality, 55.
    cross-examination of, 61.

  Bills of mortality and dissenters, 32.

  Birch, John, on failure of vaccination, 10.

  Birmingham and Leicester small-pox, 58.

  Brown of Musselburgh, on small-pox after vaccination, 1809, 11.


  C.

  Certificates of death, often erroneous, 18.

  Commissioners should have been statisticians, 24.
    on decline of small-pox after 1800, 38.
    on Scotch and Irish small-pox, 41.
    not use the diagrams, 42.
    why conclusions wrong, 44.
    not compare small-pox and general mortality, 47.
    illogical reasoning of, 52.
    neglect the method of comparison, 53, 65.
    on case of Leicester, 60.
    on small-pox in Army and Navy, 62.
    on treatment of Army and Navy small-pox mortality, 68, 69.
    put opinions above facts, 75.

  Conclusion, plain speaking justified, 91.

  Continental small-pox, teaching of diagrams of, 86.

  Creighton, Dr., history of epidemics, 33.
    on substitution theory, 36.
    on variolous test, 8, 9.

  Crookshank, Prof., on Inoculation, 7, 9.


  D.

  Davidson, Mr., on injurious effects from vaccination, 20.

  Death from vaccination, a dreadful, 21.

  Death certificates, inaccurate, 18.

  Deaths stated to be of the vaccinated or unvaccinated, why
      untrustworthy, 83.

  Dewsbury, Leicester, and Warrington small-pox, 59.

  Diphtheria and Scarlatina in London, 37.

  Doctors are bad statisticians, 13.
    often misstate figures, 13.


  E.

  English small-pox, 1838-1895, 40.
    teaching of diagram of, 86.

  Epidemics, theory of substitution of, 36.

  Experiments adverse to vaccination, 54.


  F.

  Farr, Dr., on decrease of infant mortality, 57.

  Fevers in London, 37.

  “Final Report” valueless and misleading, 69.
    critical remarks on, 70.
    on advantage of revaccination, 72.
    hesitating tone of, 74.
    on Army and Navy, 90.

  Fox, Mr. C., on 56 cases of illness or death following vaccination, 18.


  G.

  Gloucester epidemic due to insanitation, 60.

  Goldson, William, on small-pox after vaccination, 1804, 11.

  Guy, Dr., figures alone can prove value of vaccination, 23.


  H.

  Hart, Mr. E., on small-pox at Ceara, 81.

  Hospital statistics prove vaccination to be useless, 30.


  I.

  Infant mortality in London and England, 57.

  Inoculation, diseases which prevented, 7.

  Ireland, imperfect vaccination in, 43.
    compared with Army and Navy, 65.


  J.

  Jenner awarded £10,000, 9.
    £20,000 voted by House of Commons in 1807, 12.

  Jenner’s _Inquiry_, 7.


  L.

  _Lancet_ on vaccination disasters, 73.
    the, on revaccination, 90.

  Leicester affords a test experiment, 55.
    vaccination and infant mortality in, 56.
    how dealt with by Commissioners, 60.
    compared with Army and Navy, 67.

  Leprosy and plague in England, 36.

  Local Government Board’s misstatements as to the steamship
      _Preussen_, 81.

  London small-pox, 32.
    small-pox mortality discussed, 33.
    zymotic diseases in, 36.
    growth from 1845, 37.
    main drainage of 1865, 37.
    sanitary advance from 1800, 38.
    small-pox teaching of the diagram of, 84.
    zymotics teaching of diagram of, 85.

  Lymph, erroneous use of the term, 91.


  M.

  MacCabe, Dr., on vaccination in Ireland, 43.
    on the unvaccinated in tenement houses, 71.

  Maclean, Dr., 535 cases of small-pox after vaccination, 97 of them
      fatal, 11.

  Measles, the Commissioners on, 35.
    in London, 36.

  Milnes, Mr. A., estimated deaths from vaccination, 19.

  Misstatements of National Vaccine Establishment in Reports, 13.
    by Dr. Lettsom, 15.
    by Sir Lyon Playfair, 15.
    by Dr. W. B. Carpenter, 15.
    by Mr. Ernest Hart, 16, 81.
    by the National Health Society, 16, 17.
    as to small-pox at Ceara, 81.
    as to steamship _Preussen_, 82.

  Moseley, Dr., on failure of vaccination in 1804, 10.


  N.

  National Health Society’s misstatements, 16.

  Navy, causes of reduction of mortality in, 64.

  Nurses in hospitals, immunity of, 72.


  P.

  Population, density of, affecting disease, 42.
    in Scotland and Ireland, 43.

  Post-office, no real statistics of small-pox mortality in, 68.

  Preston, staff-surgeon on improved health of Navy, 64.

  _Preussen_, steamship, small-pox on, 81.

  Prussia, small-pox in, 48.


  R.

  Revaccination, officials on the value of, 62.
    alleged benefits of, 72.

  Rowley, Dr., on injury and death after vaccination, 1805, 10.

  Royal Commission accepts the variolous test, 9.

  Royal Commissioners should have been Statisticians, 24.


  S.

  Scarlatina and diphtheria in London, 37.

  Seaports, cause of unhealthiness of, 53.

  Simon, Sir John, evidence for vaccination must now be statistical, 23.

  Small-pox in London, 32.
    mortality in London, 33.
    in England during registration, 39.
    in Scotland and Ireland, 40.
    on the Continent, 44.
    in Sweden after vaccination, 45.
    mortality not reduced by vaccination, 47.
    in Prussia, 48.
    in Bavaria, 49.
    in seaports, 52.
    and zymotics follow same laws, 53.
    in Leicester, 55.
    in Leicester and Birmingham, 58.
    in German army, statistics unreliable, 73.
    no immunity against second attack, 76.
    liability to, increased by vaccination, 78.
    and overcrowding, 78.
    in Sweden, Prussia, and Bavaria, 86.
    in Leicester, a test case, 87.
    in army and navy, a crucial test, 88.

  Squirrel, Dr., on injury and death after vaccination, 1805, 10.

  Statistics alone can show value of vaccination, 23.
    of vaccinated and unvaccinated worthless, 25.
    Scientific treatment of, 31.

  Stockholm, first vaccination in 1810, 46.

  Summary of argument, 80.

  Sweden, vaccination and small-pox in, 45.
    shows uselessness of vaccination, 48.


  T.

  Tebb, Mr. W., on 535 cases of small-pox, after vaccination before
      1810, 11.


  U.

  Unvaccinated a different class from the vaccinated, 29.
    evidence as to, not trusted in Germany (note), 29.


  V.

  Vaccinated and unvaccinated, how determined by doctors, 25.
    persons wrongly registered, 26.
    and unvaccinated death-rates of, as given by doctors, 27.
    and unvaccinated death-rates of, as given by doctors in last
      century, 28.
    and unvaccinated, how they differ, 70.

  Vaccination, early history of, 6.
    injury and death from, 10.
    and the medical profession, 12.
    doctors not best judges, 13.
    deaths caused by, 17.
    illness and death from, 19.
    estimated deaths from, 19.
    official evidence of, not trustworthy, 21.
    a dreadful case of death from, 21.
    how it affects the poor, 22.
    evidence for, often worthless, 23.
    can only be proved useful by statistics, 23.
    marks not permanent, 26.
    marks hidden by eruption, 26.
    proved useless by modern hospital statistics, 30.
    in England 1872-95, 40.
    on the Continent, 44.
    in Stockholm from 1810, 46.
    in Stockholm not especially deficient, 47.
    false assertions as to value of, 50.
    uselessness of, proved, 51.
    and small-pox in Leicester, 55.
    and infant mortality in Leicester, 56.
    injuries from increase death-rate, 57.
    disasters at Shorncliffe camp concealed, 73.
    increases liability to small-pox, 78.

  Vacher, Dr., on registration of vaccinated and unvaccinated, 25.

  Variolous test, fallacy of, 7, 9.

  Vogt, Prof. A., on vaccination increasing small-pox, 51.
    no immunity from a previous attack of small-pox, 76.


  W.

  Warrington and Leicester small-pox, 59.

  Whooping-cough in London, 37.


  Z.

  Zymotic diseases in London, 36.
    in Leicester, 55.

  Zymotics in bills of mortality, 33.


[Illustration: DIAGRAM I.

LONDON DEATH-RATES PER MILLION LIVING FROM 1760 TO 1896.

The Upper line shows rates of Death from All Causes.

The Middle line shows rates of Death from Zymotic Diseases, including
Measles, Fevers, Whooping-cough, and Diphtheria.

The Lower line (shaded for distinctness), Small-pox.

The blank four years, 1834-8, are omitted because they are the last of
the old “Bills of Mortality,” and are considered to be very imperfect.

From 1838 onwards is the period of complete Registration.

Each ten years is indicated at the bottom and top of the diagram.

The figures at the sides and centre show the mortality per million.

The Upper line (total mortality) is on a smaller vertical scale, and is
brought lower down to allow of its being included in the diagram.

_Authorities._

The lines in the diagram from 1760 to 1834 are calculated from the
figures given in the Second Report, pp. 289-91, with those for other
diseases from Dr. Creighton’s _History of Epidemics in Britain_; the
population at the different periods being taken from the best available
sources (Maitland, and the 8th Report of the Registrar-General). The
later portion is entirely from the Reports of the Registrar-General.]


[Illustration: DIAGRAM II.

SHOWING DEATH-RATES FROM THE CHIEF ZYMOTIC DISEASES IN LONDON FROM 1838
TO 1896.

From the Registrar-General’s Annual Summary, 1896, Table 14, page
xxxiii., and 1888, Table 12, for first nine years.

These diagrams show the same facts as Dr. Whitelegge’s Diagram E. in the
Sixth Report of the Royal Commission, page 660, but in a simpler form.]


[Illustration: DIAGRAM III.

SMALL-POX, VACCINATIONS, ZYMOTICS, AND TOTAL DEATH-RATE IN ENGLAND AND
WALES.

Small-pox from Final Report, Tab. B. p. 155, and Registrar-General’s
Report, 1895, Table 24.

Vaccinations from Final Report, p. 34.

Zymotic diseases from Registrar-General’s Report (1895), Table 24,
Columns 3 to 9.

Total Death-rate from Registrar-General’s Report, 1895, Table 3.

N.B.—Each of the lines showing Death-rates has its own vertical scale
showing the rate per million living, in order to allow of the four
separate rates being shown on one diagram so that their corresponding
rise or fall may be compared.]


[Illustration: DIAGRAM IV.

COMPARISON OF SCOTLAND AND IRELAND AS REGARDS THEIR DEATH-RATES FROM
SMALL-POX AND TWO ZYMOTICS (MEASLES AND SCARLET-FEVER).

From Tables given in the Roy. Comm. Final Report. (See pages 35, 37, 42,
and 44.)

Solid lines. Small-pox (shaded for distinctness).

Dotted lines. Two Zymotics.

Both per million living.]


[Illustration: DIAGRAM V.

SWEDEN. SMALL-POX AND TOTAL DEATH-RATES, AND STOCKHOLM SMALL-POX
EPIDEMICS.

These death-rates have been calculated by myself from the official tables
of Small-pox and total deaths, and populations in the Sixth Report, pages
752-3.

The portion relating to Small-pox agrees with Diagram D, p. 129, in the
Third Report of the Commission, but comes to a later date. The figures
for the Stockholm epidemics are not given in the Reports of the Royal
Commission except as regards the last and greatest of them. The others
are from the same authority as in my former diagram—Dr. Berg, head of the
Statistical Department at Stockholm, who supplied them to Dr. Pierce as
stated in his _Vital Statistics_.

The Upper line, showing the death-rate from all causes, is from the
five-year average mortality, and is on a smaller vertical scale (as
shown by the figures at the sides) in order to bring it into the same
diagram.]


[Illustration: DIAGRAM VI.

Small-pox death-rates in Prussia ——————

Epidemics in Berlin ------

From the figures appended to the diagram opposite p. 232 of the Second
Report, and the Berlin epidemics from the table at p. 231 of the same
Report.]


[Illustration: DIAGRAM VII.

BAVARIA. MORTALITY FROM SMALL-POX AND OTHER ZYMOTIC DISEASES IN THE YEARS
1858-73.

From Tables in the Second Report, pp. 337-8.

Bavaria is chosen by Dr. Hopkirk to show the advantages of compulsory
vaccination (see Q. 1489, p. 11, and Table facing p. 238, of Second
Report).]


[Illustration: DIAGRAM VIII.

SHOWING THE DEATH-RATES PER MILLION LIVING BY SMALL-POX AND ZYMOTIC
DISEASES, FROM 1838 TO 1896, IN LEICESTER.

The dotted line shows the percentage of Vaccinations to Births.

N.B.—Before 1862 private vaccinations have been estimated.

The Upper Thick line shows the death-rate from the following
diseases:—Measles, Scarlet Fever, Diphtheria, Typhus, Whooping Cough,
Enteric and other Fevers.

The Lower Line, shaded for distinctness, shows the Small-pox death-rate.

Drawn from Mr. Thomas Biggs’ Table 19, at p. 440 of the Fourth Report,
kindly continued by Mr. Biggs to 1896.]


[Illustration: DIAGRAM IX.

THIS DIAGRAM SHOWS VARIOUS DEATH-RATES IN LEICESTER, IN FIVE-YEAR
AVERAGES.

The dotted line shows the percentage of vaccinations to total births.

_Authorities._

The three Death-rates and the Vaccinations are from Table 34 (p. 450) in
the Fourth Report.

The Small-pox death-rate is from Table 45 (p. 461) in same Report.

Figures to continue the diagram to 1896 have been kindly furnished by Mr.
Biggs from official sources.]


[Illustration: DIAGRAM X.

INFANT MORTALITY.

The upper portion of this diagram shows the Infant Mortality of London
from 1730 to 1830, from Dr. Farr’s tables in McCulloch’s _Statistical
Account of the British Empire_, vol. ii., p. 543 (1847). From 1840 to
1890 shows the Infant Mortality of ENGLAND calculated from the Reports of
the Registrar-General (see 3rd Report, p. 197, Table O). Materials for
the continuation of Dr. Farr’s London Table (under 5 years) are not given
by the Registrar-General.

The Lower part of the Table shows, on a larger scale, the Infant
Mortality of London, under _one_ year, as given by the Registrar-General
in his Annual summary for 1891, Table 12, p. xxv., and in his 58th Annual
Report, Table 25, p. xci.]


[Illustration: DIAGRAM XI.

ARMY AND NAVY.

Lower Thick line shows the Small-pox mortality per 100,000 in the Army.

Upper Thick line shows the total Disease Mortality in the Army (Home
Force).

The two Thin lines show the corresponding Mortalities in the Navy.

_Authorities._

Total Disease Mortalities, from the Registrar-General’s 51st Report,
Table 29, and 58th Report, Table 33, for the Army. From Table at p. 254
of Second Report of Roy. Comm. for the Navy.

Small-pox Mortalities from the “Final Report,” pp. 86-88.

N.B.—The higher figures (hundreds) show the Disease mortality; the lower
figures (tens) show the Small-pox mortality; both per 100,000.]


[Illustration: DIAGRAM XII.

SMALL-POX MORTALITY PER 100,000.

The ARMY and NAVY as compared with IRELAND.

From the earliest year given for Ireland in the Reports of the Royal
Commission.

_Authorities._

Army, 2nd Report, Table C., p. 278.

Navy, 2nd Report, Table C., p. 254.

Both supplemented for the last six years by the “Final Report,” pp. 86-88.

Ireland. Table on p. 57 of “Final Report” corrected to ages 15-45 by
adding one-tenth according to the Table J. at p. 274 of 2nd Report.]


Butler & Tanner, The Selwood Printing Works, Frome, and London.



    _To be Published in April, 1898_

    _In One Volume, Crown 8vo_

    The Wonderful Century

    Its Successes and Failures

    BY

    ALFRED RUSSEL WALLACE

    _LL.D., Dubl.; D.C.L., Oxon.; F.R.S., etc._

    The object of this volume is to give a short descriptive sketch
    of the more important mechanical inventions and scientific
    discoveries which are distinctive of the nineteenth century;
    and especially to enable those who have lived only in the
    latter half of it to realise its full significance in the
    history of human progress.

    The author maintains that our century is altogether unique;
    that it differs from the eighteenth or the seventeenth
    centuries, not merely as those differed from the centuries
    which immediately preceded them, but that it has initiated a
    new era, and that it may be more properly compared with the
    whole preceding historical period.

    His estimate of the advances made during the present century
    is, therefore, higher than that of previous writers; but he
    points out that it is almost wholly a material and intellectual
    progress, and that, even intellectually, it is very imperfect.
    The second part of the work discusses the intellectual and
    moral failures of the century, which are shown to be as
    conspicuous and deplorable as its successes are admirable and
    unprecedented.

    SWAN SONNENSCHEIN & CO., LTD., LONDON.





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