1867.] TJie Public Health. 451 



nation legislation. In England and Wales we have no compulsory- 

 registration of Births, and consequently there are no existing 

 means of ascertaining whether every child born is vaccinated. In 

 some districts in London it is believed that 25 per cent, of the 

 children born are not registered. Yet in spite of this, the legis- 

 lation assumes in its Yaccination Bills that every child born can 

 be easily discovered for the purposes of vaccination. The necessity 

 of compulsory registration in England and Wales has been pressed 

 upon our Home Secretaries, on Poor Law Secretaries, on Presidents 

 and Yice-Presidents of Privy Council for years, and not the slightest 

 effort has been made in Parliament to secure a return of births, upon 

 which alone can be founded any accurate statistics of the relations 

 of birth to death in the kingdom. 



Another reason of the failure of our Yaccination Acts has been 

 the small sum given to public vaccinators for performing the 

 operation of vaccination. The former Acts named Is,, and the 

 present Bill offers Is. 6d. Now our legislature ought to know that 

 this is no payment for professional service, and that an operation 

 requiring skill and attention will never be properly performed for 

 such a payment. The operation thus paid for is entrusted by 

 medical men to their apprentices and assistants, no satisfactory 

 evidence of the operation being properly performed is ever given, 

 and thousands annually undergo a sham operation, and are let 

 loose on society to take and propagate the smallpox. It is a well- 

 known fact that in parishes where higher fees have been given to 

 the public vaccinator than the minimum allowed by the Act, that 

 there smallpox has not been known. Give the medical man an 

 interest in looking after the cases of un vaccinated children and he 

 will do so, and there will be no need for an elaborate system of cer- 

 tificates or inspectors. The fact is, if enough is paid to make it the 

 interest of a respectable medical man to see after unvaccinated 

 children, and also to ascertain that the vaccination has been properly 

 performed, there hardly needs any further legislation. 



In a paper on Yaccination, recently published by Mr. Eumsey, 

 of Cheltenham, whose opinions on State Medicine are always 

 entitled to respect, he states his conviction that no compulsory 

 Yaccination Act will ever succeed in this country. He advocates 

 indirect compulsion by refusing admission into schools, factories, 

 and all kinds of service, unless proof should be given of successful 

 vaccination. He also advocates the removal of the superintendence 

 of vaccination from the hands of the Poor Law authorities, and the 

 placing it in the department of the Medical Officers of Health who 

 are appointed by the vestries. 



Amongst the sanitary subjects demanding the attention of the 

 legislation, is that of sea-scurvy. There is no doubt an increased 

 tendency to the development of this disease on board our mercantile 



