302 PROTECTIVE INOCULATIONS. 



of the protective value of the inoculations. Iii view of the great importance 

 of this whole subject, I have determined to place these statistics in this report 

 for the benefit of the readers of the English language, in order that they mav 

 judge for themselves of the facts as they appear to be recorded. 



"From the Government statistics of cholera throughout the province of 

 Valencia, it appears that among the villages invaded there were 62 attacks 

 per one thousand of the population, and 31 deaths per thousand, which gives 

 a mortality of 50 per cent of those attacked. It appears from analysis of 

 the published official statistics of cholera in 22 towns where inocula- 

 tion was performed the inhabitants were divided as follows: 104,561 not 

 inoculated ; 30,491 inoculated. Of the latter there were 387 attacks of cholera, 

 or 12 per thousand, and 104 deaths, or 3 per thousand ; the mortality of those 

 attacked being 25 per cent. Of the former there were 8,406 attacks, 

 or 77 per thousand, and 3,512 deaths, or 33 per thousand, being a mortality 

 of those attacked of 43 per cent. It appears, therefore, that among 

 the population of villages wherein anti-choleraic inoculations had been more 

 or less extensively performed the liability of the inoculated to attacks of 

 cholera was 6.06 times less than that of the non-inoculated, whilst the liability 

 of the inoculated to death by cholera was 9.87 times less than that of the 11011- 

 inoculated. These figures are based exclusively upon the data furnished by 

 inoculations, the reiiioculatioiis being left out of consideration, because they 

 are much less numerous, although from the records of the inoculations it 

 would seem that the liability of attack, and especially of death by cholera, is 

 many times less among them than among those inoculated a single time. 



'The charge has also been made with respect to the published records of 

 the inoculations that the hygienic and physical condition of the subjects of 

 inoculation have not been sufficiently indicated in the records, and that the 

 vast majority of those profiting by the opportunity to receive the aiiti- 

 choleraic inoculations were of the middle and upper classes, and therefore 

 not of that class of inhabitants who are notoriously most liable to attack and 

 death from cholera. This criticism may have some justness as respects some, 

 perhaps many, of the villages where inoculations were performed ; but there 

 are certainly many of the villages wherein the results of the inoculation 

 seemed to be most positively in favor of the claim of Ferran where this 

 criticism cannot hold. I refer to villages wherein three-fourths or four- 

 fifths of the inhabitants were inoculated, leaving only the fraction of the 

 population non-inoculated. Even in the absence of any special notes indi- 

 cating the social conditions and hygienic surroundings of the inoculated in 

 these villages, it is ridiculous to assume that the vast majority of these were 

 people of the middle and upper classes, and were therefore but little liable to 

 attack and death by cholera. Any one acquainted with the character of the 

 Spanish population as it exists in the rural villages will admit at once that 

 the vast majority of this population consists of the wretched and the poor, 

 who live under the most unhygienic and unsalubrious conditions, and there- 

 fore are of that class most liable to suffer from cholera. 



"There is still another result of the preventive inoculations of Ferran 

 apparently shown by these statistics. I refer to the apparent marked short- 

 ening of the course of the epidemic after a large percentage of the inhabitants 

 had become inoculated. It would seem, therefore, from analysis of the 

 official statistics, that the practice of the an ti -choleraic inoculation after the 

 method of Ferran, besides giving the subject inoculated a considerable im- 

 munity from attack and death by cholera, furnishes a means of bringing an 

 epidemic rapidly to an end." 



With reference to Haffkine's method of inoculation we cannot do 

 better than to quote from a lecture which lie gave in London, in 1893 : 



"In the research that I have done at the Pasteur Institute on vaccination 

 against Asiatic cholera I have chosen for my starting-point the inoculation 



