704 The Sanitary Millennium. [November, 
to 1825 there was not a single epidemic of small-pox in 
England. Yet, according to a report published by the 
College of Physicians in 1807, only about ijper cent, of the 
population were vaccinated. Now if we admit that the 
immunity gained by this operation is absolute and per- 
manent, how is it possible that 3 vaccinated persons out of 
every 200 would protect the remaining 197 ? At the present 
time about 97 per cent, of the population are supposed to 
be vaccinated. Yet so far from being able to protect, the 
residual 3 per cent it is considered that they are imperilled 
by the obstinacy or negleCt of this small minority. We 
have the lamentable fa 6 t that, whilst vaccination has become 
all but universal, small-pox has reappeared among us not in 
isolated cases but in epidemics, succeeding each other at 
short intervals, and each more deadly than the foregoing. 
Thus in the epidemic of 1857-58-59 the deaths were 14,244; 
in that of 1863-64-65 20,059, and in that of 1880-71-72 
44.840. Thus in the first interval the deaths from this 
cause had increased 50 per cent, whilst the population had 
grown only 7 per cent. In the second interval the deaths 
from small-pox have risen by 120 per cent, but the popula- 
tion only 10 per cent. Another ugly faCt is that the 
number of persons who have been vaccinated but who are 
subsequently attacked with small-pox is steadily on the 
increase. At the Highgate small-pox hospital from 1835 
to 1851 the previously-vaccinated formed 53 per cent of ‘the 
total small-pox cases admitted. In 1851-2 it rose to 667 
percent; in 1854-5-6 to 71*2 percent; in 1859-60 to 72 ; 
in 1866 to 8ri and in 1868 to 84 per cent. How are such 
fads to be reconciled with the orthodox theory that vaccina- 
tion is a safeguard against small-pox ? What would be the 
conclusion formed by an unprejudiced statistician if these 
figures were laid before him ? If a grows more common as 
b increases in number and general distribution no man in 
his senses will argue that b is a hindrance to a. The very 
opposite conclusion, that b is causally connected with a 
would seem more legitimate. How the credit of vaccination 
is to be saved is not apparent. We cannot cut the knot by 
supposing that modern medical practitioners are lesscaieful 
and skilled in the performance of the operation or less scru- 
pulous in the selection of vaccine lymph. There remains, 
then, merely the conclusion that small-pox, too, has had 
a period of cessation during the latter part of the past 
century and the first quarter of the present ; that the 
apparent success of vaccination was mainly due to its 
coincidence with this temporary lull, and that the disease is 
