542 



NA TURE 



[October 6, 1898 



that he writes in a manner well calculated to attract the 

 attention of his readers. Apparently he is one of those 

 who think that everything has been arranged for the 

 best in this best of possible worlds. For example, after 

 stating that, owing to its parasitic habits, maledictions 

 are poured down on the devoted head of the cowbird by 

 all, he proceeds as follows :— 



"This may be to an extent warranted, but the fact 

 that the great laws of nature have developed a necessity 

 for such a bird seems to bespeak for it at least patient 

 and careful consideration. There are few, if any, un- 

 mixed evils allowed to survive in the great struggle for 

 existence, but the good results are not always patent 

 even to the most careful student." 



With the exception of undue weight, owing to the 

 employment of heavily clayed paper, the style in which 

 the book is produced is worthy of all praise, and renders 

 it an attractive addition to the library or drawing- 

 room table. Probably its circulation in this country will 

 be somewhat limited ; but in the land of its birth the 

 volume should command an extensive sale, which we 

 may hope will be sufficient to induce the author to favour 

 the public with its promised companion. R. L. 



THE CASE AGAINST VACCINATION. 

 A Century of Vaccination^ and what it teaches. By W. 

 Scott Tebb, M.A., M.D. (Cantab), D.P.H. (London : 

 Swan Sonnenschein and Co., Ltd., 1898.) 



DR. TEBB says that on the assumption that the 

 father of a family ought to be able to form a judg- 

 ment upon vaccination, a practice established and enforced 

 by law, he will attempt in the work before us to discuss a 

 great question in an unbiassed fashion. In this attempt 

 he is not altogether successful. After stating that he 

 does not reject, or even attack the belief that a certain 

 degree of immunity in the case of certain diseases is con- 

 ferred by a first attack, he goes on to draw a distinction 

 between the immunity conferred by small-pox and that 

 conferred by cow-pox. He appears to beg the whole 

 question by accepting, as conclusively proved by Dr. 

 Creighton and Prof. Crookshank, the proposition that 

 cow-pox is a disease radically different from that from 

 which it is said to protect. This point is one, however, 

 that no amount of asseveration can settle, and most 

 people prefer to be guided by the results of recent 

 experiments rather than by polemical statement. 



In a piece of rather clever special pleading. Dr. Tebb 

 makes a statement that 



" should there be an epidemic in a locality where 

 85 per cent, of the population are vaccinated, it is 

 obvious that the 95 per cent, of the population should 

 escape the epidemic, assuming, as before indicated, 

 that a maximum of 5 per cent, attacked by it will largely 

 coincide with the 85 per cent, vaccinated, and thus 

 vaccination gains credit, but it will be objected if the 5 

 per cent, attacked coincide, in however small a degree, 

 with the 1 5 per cent, unvaccinated, this is strong testimony 

 to the risk of being unvaccinated, and so no doubt it would 

 be but for the fact that in localities where the vaccination 

 law is vigorously carried out the unvaccinated as a class 

 will be found to consist largely of the outcasts of society, 

 nomads whom the law has failed to reach, and of weakly 

 children who, on account of their health, have been 

 excused the operation. This class, therefore, is likely to 



NO. 1510, VOL. 58] 



furnish a disproportionate nun'.ber of the victims of the 

 epidemic ; and thus again the prophylactic acquires 

 reputation." 



This, as we have said, is nothing more than special 

 pleading, especially when Dr. Tebb attributes bias to 

 those who have to do with the collection and arrange- 

 ment of the statistics on which vaccination arguments 

 are based. It is for this reason that we refer to 

 the bias imported into this controversy by Dr. Tebb 

 at the very outset. Further, one cannot help feeling 

 that the imputation by the author of the term " public 

 endowment practice" indicates a state of mind not 

 conducive to the calm and dispassionate consideration 

 of this very important question. For example, he speaks 

 of a "body of officials ostensibly paid to promote 

 the practice of vaccination, but also, partly at least, paid 

 to vindicate it theoretically and to explain away its 

 failures and its accompanying disasters." " Take away," 

 he says, " first the compulsory law, and then take away 

 (if vested interest is not too strong for you) the endow- 

 ment of the practice, and when this has been done 

 medical men will find themselves, for the first time since 

 1803, free to discuss the vaccination question as a scien- 

 tific one on its own merits." This is imputing motives 

 with a vengeance — motives of a most sordid character. 

 When an author holds such an opinion, no question with 

 which he deals can be reasonably or profitably discussed. 



After going carefully over " A Century of Vaccination," 

 and granting the absolute accuracy of every stated fact 

 put forward in this work, we are compelled (and we 

 believe that most people will agree with us on this point) to 

 come to the conclusion that Dr. Scott Tebb, if he started 

 in an absolutely unfettered condition of mind, has been 

 very easily brought to his present position, and that his 

 marshalling of facts has been of such a one-sided char* 

 acter, that he has been enabled to argue far too readily 

 from the special and the isolated to the general. He has 

 placed his isolated facts in one scale and has left out the 

 accumulated knowledge of all kinds that appears to tell 

 against his theory, and has then struck a balance, of course 

 in favour of the argument for which he is contending. So 

 convinced are we on this pomt, that we are confident that 

 it would be a safe plan for those who believe in the efficacy 

 of vaccination to place this work in the hands of most 

 anti-vaccinators, and ask them to read it on the condition 

 that they would also read the context of many of the 

 quoted passages ; we believe such a course could have 

 but one result. It may be stated generally that in the 

 summary and conclusion Dr. Scott Tebb entirely misses 

 or ignores the position taken up by those who are in 

 favour of vaccination. He mixes up the risk to the indi- 

 vidual with the risk to the community— a good system of 

 vaccination with a system carelessly carried out ; he bases 

 the statement that it is valueless entirely on the assump- 

 tion that cow-pox and small-pox are in no way generically 

 related ; and, putting aside the question of immunity as 

 the result of an attack of small-pox, he contends that 

 cow-pox is a specifically different disease, and can there- 

 fore exert no protective influence against small-pox. 

 However, as we have already stated, those who read Dr 

 Tebb's book will, unless we are much mistaken, remain 

 vaccinators ; whilst those who are already convinced in 

 the opposite direction may be brought to consider the 



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