January 6, 1898] 



NA TORE 



223 



I 



as being sufficient to prevent any outbreak of small-pox 

 assuming serious epidemic proportions. Now, what did 

 Dr. Coupland find at Gloucester ? That a few slight or 

 mild cases in 1895 were followed by a severe epidemic 

 extending from February to April 1896, in which not 

 only was there an increase in the numbers attacked, but 

 there was also an undue proportion of cases of a severe 

 type accompanied by a high rate of mortality. As 

 showing how in a community with a large proportion of 

 unvaccinated children the disease may spread rapidly, 

 we have the fact that there was an " almost simultaneous 

 mvasion of many homes through children who were in- 

 fected whilst attending certain of the public elementary 

 schools." As a result of this sudden outbreak it became 

 impossible to provide hospital accommodation, and, 

 ultimately, all attempts at isolation, of even a modified 

 form, had to be abandoned as utterly impracticable. As 

 a result of the crowding of the hospitals, and of the re- 

 moval of the most severe cases to them, the hospital 

 mortality was comparatively high, and the friends of the 

 patients would soon not permit of the removal of these 

 patients to hospitals ; this, of course, resulting in an 

 utter break-down of the system of isolation. 



Dr. Coupland sums up in the following exceedingly 

 striking passages. He says : "There is no escape from 

 the conclusion that the heightened mortality 

 and the severity of the epidemic were greatly 

 due to so large a proportion of unvaccinated 

 children being attacked ; for ia) the case mor- 

 tality under ten years of age was 39'6 per 

 cent., whilst amongst the vaccinated it was 

 only 39 per cent., leaving a mortality 

 amongst the unvaccinated of 41 per cent. . . . 

 (J)) The disparity is quite as marked when 

 the type of the attack is contrasted, for of 

 507 cases of severe attacks [malignant, con- 

 fluent, indeterminate] there actually occur 

 only three amongst the vaccinated." Froni 

 these and other considerations it follows that 

 in the Gloucester epidemic "the severity of 

 the disease, its high mortality, and its pro- 

 pagation were influenced and promoted by 

 the unduly large proportion of unvaccinated 

 children who were exposed to infection and 

 who were infected." 



To whatever figures or tables we turn, 

 the effect of them is always the same. 

 They tell the same story — vaccination 

 protects ; unvaccinated children are left susceptible 

 to the attacks of the disease, and they not only take 

 the disease more readily, but they take it in a more 

 dangerous and fatal form, and, in most cases at 

 any rate, are a source of greater danger to those with 

 whom they may come, directly or indirectly, in contact. 

 Isolation, good hospital accommodation, and favourable 

 sanitary conditions are useful in the treatment of small- 

 pox in a vaccinated community ; but once let small-pox 

 find its way into an unvaccinated community, the in- 

 efficiency of these "accessory" measures, when used alone, 

 are demonstrated with the most absolute clearness ; and 

 if Gloucester has one lesson more than another to teach, 

 it is that Jenner, by his advocacy of vaccination, did 

 more to limit the spread of small-pox than have all 

 the sanitarians of the century. Small-pox undoubtedly 

 does not come under the class of diseases that can be 

 held in check by ordinary sanitary measures ; these, 

 no doubt, are contributory, but without vaccination they 

 can never be depended upon as bemg fully effective. 



CANADIAN GEOGRAPHY. 



THE reissue of "Stanford's Compendium" now in- 

 cludes Australia and the Pacific Islands in two 

 volumes by separate authors, Asia in two volumes and 



NO. 147 1, VOL. 57] 



Africa in two volumes by the same author, and vol. i. of 

 North America.^ The new issue is in many ways vastly 

 superior to the old ; the cramping influence of the 

 foreign original has disappeared, the illustrations have 

 greatly improved, and, linked by the general title, each 

 of the volumes forms a separate and original work of 

 distinct value. So good, indeed, has " Stanford's Com- 

 pendium " become, that it may now be allowable to subject 

 one of its volumes to criticism of a more searching kind 

 than would have been justified formerly. Then any 

 attempt to form a library of solid geographical works in 

 the English language was worthy of commendation ; 

 now it is possible to set up a higher standard, and it is 

 reasonable to look for those excellencies of grasp and 

 arrangement which one naturally expects in, let us say, 

 a German work of similar scope. 



The morphological unity of the continent is one of the 

 fundamental facts of modern geography. The continent 

 is the natural unit which must be considered in its 

 entirety, with parts subordinated to the whole, and with 

 functional activities of a distinctive kind. It is capable 

 of subdivision, either naturally into regions or artificially 

 into countries, and of aggregation with other continents 

 to form the whole land-surface. The dominant lines of 

 the continent — its axial mountain systems — determine 



Fig. I. — The Bore, Petitcodiak River, Moncton, New Brunswick, August 8, iS 

 Height, 5 feet 4 inches. 



the primitive slopes of the land, and the development of 

 the river systems, subject to the continuous workings of 

 secular uplift or depression and the accumulation of 

 sediment. The resulting configuration modifies the 

 climate as dependent on latitude, and leads to the 

 formation of areas of moderate and of extreme temper- 

 ature, of high rainfall and of aridity. Climate reacts on 

 vegetation, and vegetation and climate together influence 

 the distribution of animals ; and all these varieties of 

 feature and function are framed in the continent. Thus 

 up to the appearance of man a geographical description 

 must be based on the continent as a unit if it is to be 

 really simple and comprehensible. With the advent of 

 man complications arise, but the guiding influence of the 

 main features of continental relief and surface-covering 

 is still to be traced. The deep inlets tempt the adven- 

 turous stranger to penetrate the continent, the easy water- 

 ways lure him into the interior, where products of forest 

 and plain supply an adequate inducement to remain or to 

 return. In time groups of people settle down in habitats 

 more or less distinctly defined by natural features — 

 different tribes frequent the river, the lake, the forest, the 

 plain, the mountain valley, the indented ocean shore. 



1 "Stanford's Compendium of Geography and Travel" (new issue). 

 North America. By S. E. Dawson. Vol. i. Canada and Newfoundland. 

 Maps and illustrations. (London : Edward Stanford, 1897.) 



