Bakewell. — On Vaccination. 639 



children to be vaccinated from any vaccinifer in whose family 

 any member was a leper. And then, to my astonishment and 

 dismay, I found that there was hardly a Creole family in the 

 island — white, coloured, or black — free from the taint of 

 leprosy. 



The evidence accumulated by Mr. Tebb and contained in 

 the Third Eeport of the Vaccination Commission is most inter- 

 esting and valuable. He quotes from many medical men of 

 experience in support of his views. Dr. Arning, formerly of 

 Honolulu, says: " The unusually rapid spread of the disease 

 about thirty years ago may possibly be attributed to the great 

 amount of indiscriminate vaccination carried on about that 

 period. ... I attach far more importance to an instance 

 of an increase of leprosy soon after vaccination on a much 

 smaller scale and during a much more recent period than the 

 above." Then he alludes to a " very remarkable new crop of 

 leprosy" which had "sprung up at one of the islands in the 

 year 1871-72, about a year after most careless vaccination 

 had been practised." 



That bacilli exist in both leprosy and tubercle is beyond all 

 dispute ; that the bacilli of these diseases may be grown and 

 cultivated in suitable media is ascertained as a fact respecting 

 one of them — tubercle — and, although not experimentally 

 proved as regards the bacillus of leprosy, '■= yet is almost beyond 

 doubt. Artificial nutrient materials have hitherto failed, and 

 it is not allowable to try the only natural medium — the blood 

 and tissues of a person living under conditions likely to 

 develope leprosy. I have no doubt, from seeing the origin of 

 leprosy cases, and studying several hundred cases of the 

 disease, that it is not only inoculable, but that it spreads by 

 inoculation or absolute contiguity, and I have no hesitation, 

 after twenty years' consideration of the subject, in affirming 

 again the opinion given before the Committee of the House of 

 Commons. 



Inoculation of Tubercle. — Considering the great abund- 

 ance of tuberculous diseases, and the infinitely various ways by 

 which the tubercle bacillus may be introduced into the system, 

 it may seem hardly worth while to guard against the small 

 chance of inoculating with lymph from a tuberculous child. 

 Yet the same objection would lie about the inoculation from a 

 syphilitic child. Inoculation in either case would almost 

 certainly give the disease. 



Having now as briefly as possible considered the essential 

 and accidental dangers of vaccination, we have to answer the 

 practical question, " Is it expedient to make vaccination com- 



* Since this paper was read, it is reported that the Bacillus lc;prcz has 

 been cultivated in India. 



