WAT UT feks 
341 


THURSDAY, MARCH 2, 1871 

THE SMALL-POX EPIDEMIC 
HE present epidemic of Small-pox in London is the 
most destructive, we are told, that has occurred in 
London during the present century. This isa very painful 
disclosure, when it has been almost demonstrated that, of 
all contagious and epidemic diseases, it is the one over 
which man has the most control. It is a well-known fact 
that when persons have once had the small-pox they 
seldom or never take it again, and that the disease known 
as cow-pox is a modified form of small-pox, and that 
persons who have had this modified form of small-pox 
are as little liable to take this disease as those who have 
had the small-pox itself. This was the great discovery of 
Jenner, and the practice of vaccination has more than 
realised the hopes of its discoverer and his friends. 
Where vaccination has been carried out with energy, and 
communities by wise laws or individual action have seen 
that every child is duly vaccinated, there small-pox has 
not spread. It appears that where communities are 
all properly vaccinated, there, even if an isolated 
case of small-pox does occur, it has no pabulum to 
feed on, and it does not spread. It is only when the 
small-pox contagion is communicated to unvaccinated 
persons that the disease is set up, and has sufficient 
vitality to spread through a community. Forty-five 
millions of persons died in Europe from small-pox in 
the century preceding the introduction of vaccination, 
whilst it is calculated that it has not killed more than two 
millions of persons in Europe since the introduction of 
vaccination. In London, during the last century, one death 
in every fourteen was due to small-pox. Up tothe present 
time in this century not more than one-fiftieth of the per- 
sons who have died in London have died of this disease | 
Greater differences than even this have been observed in. 
some of the cities and towns of the Continent of Europe. 
At Trieste the deaths from small-pox have been seventy- 
five times less than before vaccination; in Moravia, 
twenty-one times less ; in Silesia, twenty-nine times less; 
in Westphalia, twenty-five times less, and in Berlin, nine- 
teen times less.* These instances might be indefinitely 
increased, but we are anxious to show to what extent 
this disease is really controllable. 
Supposing even that it is not demonstrated that small- 
pox can be eradicated by vaccination alone, carefully 
collected statistics show that when small-pox is taken by 
the vaccinated, it is much less fatal than among the un- 
vaccinated. In the epidemic now prevailing in the metro- 
polis, it is found that not more than six per cent. of persons 
who have been vaccinated die of smallpox, whilst about 
thirty-six per cent. of those who have not been vaccinated 
die. 
Small-pox Hospital from 1836 to 1851, so that it will be 
observed that the small-pox has neither lost nor increased 
in malignity. 
There is a question which we ought to allude to here, 
and that is, Does vaccination lose its protective power ? 
The best observers are of opinion that when vac- 
cination has been properly performed, and the system 
* Further facts of this kind are recorded in Dr. Ballard’s Essay on Vacci- 
nation. 1868. 
VOL, III. 
This is the proportion of deaths observed at the | 

brought thoroughly under the influence of the cow- 
pox, a person has no more liability to take the 
small-pox than if he had had the small-pox itself, 
But unfortunately, from various causes, vaccination 
is either improperly performed, or the disease is only 
imperfectly developed, and in such cases it is desir- 
able that re-vaccination should be effected. It is not 
however, possible to say by looking at an arm, whether 
the operation has been properly performed, or the 
disease has perfectly developed. Under these circum- 
stances it is no doubt desirable that every person should 
be re-vaccinated at least once in his life. The best 
time for the performance of this operation, where persons 
have been vaccinated in infancy, is between the twelfth 
and twentieth year. But in times of epidemic every per- 
son in the household should be re-vaccinated who has not 
been so before. 
Thus much with regard to our knowledge of one 
means of averting this disease. That this means has 
not been adopted, arises partly from the ignorance of our 
population, partly from the perversity of our vestries and 
boards of guardians, and partly from the feebleness of 
our legislators. 
The ignorance of our population of the means of pre- 
venting ordinary diseases is astounding, and if left to 
themselves with regard to vaccination, they will do nothing, 
from sheer ignorance of the nature of small-pox or the 
nature of its great antidote. Our coroners’ courts bear 
testimony to this, where poor people have excused them- 
selves for not having their children vaccinated, by not 
being aware of its value or of the measures to be adopted 
| to get the operation performed. Surely this is one of the 
subjects to be embraced by the “relations of man to the 
universe,” recommended by Professor Huxley in his pro- 
gramme of the education of children under the new School 
Board. 
The perversity of vestries and boards of guardians has 
much to do with the present unvaccinated state of London, 
This epidemic has not come on London unanticipated 
The medical officers of health in many districts 
warned their vestries of the coming evil, but, unfor 
tunately, from our wholly exceptional legislation in sani- 
tary matters, the power of looking after small-pox and 
vaccination is given to the Poor Law Board. The 
vestries have therefore thrown on the guardians the bur- 
den of providing for an attack of small-pox ; and in many 
instances little or nothing has been done, either in the way 
of looking up the unvaccinated, putting in force the vacci- 
nation laws, or treating the first cases of small-pox with 
those precautions which the fearful nature of the disease 
imperatively demands. 
With a bundle of Acts of Parliament passed at different 
times with different objects, and giving authority variously 
to the Privy Council, the Poor Law Board, the Home 
Secretary, and other bodies, it is no wonder that our 
Government acts feebly in sanitary matters. There have 
been no vigorous attempts on the part of the Government 
or the Legislature to meet the present outburst of small- 
pox. If cows and sheep had been attacked, it is pro- 
bable that something new would have been done. 
The old machinery has, it is true, been kept in 
motion, There is the Vaccination Act, which 
threatens every person with a fine who does not have 
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