SMALLPOX 217 



5 per thousand, and the unvaccinated in the pro- 

 portion of 101 per thousand. The death-rate among 

 the vaccinated was about one-tenth of one per cent, 

 and among the unvaccinated 44 per cent. Similar 

 and even more favourable statistics could be pre- 

 sented from other parts of England and from all 

 countries where vaccination is systematically practised. 



The total number of deaths reported from small- 

 pox, in the United States, during the last census 

 year was 3484. If the mortality had corresponded 

 with that of England and Wales before the introduc- 

 tion of vaccination it would have amounted to more 

 than 210,000. 



The practical stamping out of smallpox in the Dis- 

 trict of Holguin, Cuba, and in the island of Porto 

 Rico, since the Spanish-American War, by the vac- 

 cination of all the inhabitants, under the direction of 

 the military authorities of the United States, is a 

 matter of record in my annual reports as Surgeon- 

 General of the Army for the years 1899 an< ^ 1900. 

 In my report for 1899 I say : 



" It is understood that the occurrence of smallpox among our 

 troops in the Philippines gave rise in England, where the pro- 

 tective influence of vaccination was under discussion at the time, 

 to the claim that, as vaccination was compulsory in the United 

 States Army, and carried out under military rules, the presence 

 of the disease among our soldiers showed the inefficiency of the 

 process. This claim of the opponents of vaccination is not well 



