Protective vaccinations 459 



of vaccine distributed has increased considerably. This quantity, 

 however, is not adequate because small-pox has again made its 

 appearance in London in the form of a pretty serious epidemic 1 . 



In France a law is being framed which will render infant vac- 

 cination compulsory. Up to the present this has not been the 

 case, and small-pox from time to time causes considerable ravages, 

 as we may see at this moment in Paris. During recent years the 

 mortality from small-pox in France has been from 90 to 100 times 

 greater than in Germany. It is greater amongst the female popula- 

 tion than amongst males ; this constitutes a fresh argument in favour 

 of vaccination. Although not compulsory for the whole of the 

 French population, it is so for soldiers and for children who carry on 

 their studies in schools, and it is for this reason that small-pox is 

 rarer amongst males. The most complete demonstration of this is 

 found in the incidence of small-pox in the French army. In spite 

 of a less numerous contingent of troops (451,941 457,677) the 

 mortality from small-pox was greater during the period when 

 vaccination was not yet carried out generally (18851887) than 

 during the period (1889 1896) when it was rigorously enforced 

 on a much larger number of soldiers (524,733 564,643). From 

 13*6 fatal cases per year in the first period the annual figure 

 fell to 6. 



It follows, when we take into consideration the whole of the very 

 numerous data at our disposal, that the usefulness of vaccination 

 followed by revaccination after some (5 7) years cannot be seriously 

 called in question. As to the inconveniences that may be caused, 

 they are observed in very rare cases, and then most frequently when 

 impure vaccines are used, or when the vaccinated skin becomes 

 contaminated. According to the German statistics there were 

 registered in the space of 13 years (1885 1897), in 32 millions 

 of vaccinations, 113 fatal cases as the result of infection of the 

 wounds. In forty-six of these it was proved that the small wound 

 had been contaminated by impurities introduced by those attending 

 on them. The remaining 67 fatal cases could be ascribed to the 

 vaccines themselves. We must, however, still regard these cases as too 

 numerous and as being readily avoidable by the adoption of rigorous 

 asepsis. To sum up, the anti-variolous vaccination by the virus of 

 cow-pox constitutes a method of very great value in the prevention of [482] 

 one of the most dreaded of infective diseases, but it is evident that 

 1 Lancet, London, 1901, Vol. n, p. 796. 



