1884.] 
Vaccination. 
133 
vaccination to mitigate any more than to protect, they are 
constantly appealed to for proof of the value of vaccination as 
a life-saver from smallpox after attack, because a differential 
fatality is stated for the unvaccinated and the vaccinated. 
Thus Mr. Marson states that the unvaccinated died at the 
rate of 35*55 per cent, and the vaccinated at the rate of 6*76 
per cent ; and the Metropolitan Board state that their un- 
vaccinated patients died at the rate of 44*80 per cent, and 
the vaccinated at the rate of 10*15 P er cent. These figures 
are simply incredible for those who are acquainted with the 
nature and history of the disorder ; for not only is there no 
reason — physiological, pathological, or other — for supposing 
that the vaccination of the vaccinated diminishes their own 
risk when attacked, but, a fortiori, no reason for supposing 
that the operations performed on their bodies could anyhow 
increase the risk of death for those who had not had any 
disease inflicted upon them. 
It has been said that to question their accuracy implies a 
charge of conspiracy to deceive on the part of Smallpox 
Hospital doctors the world over ; but a little consideration 
will show that they are the outcome of a somewhat indolent 
want of thought. 
The disorder of smallpox is one of very various degrees 
of danger, according to the sparseness or abundance of the 
eruption, and the severest and most probably fatal cases are 
those of the kind called confluent, in which the pustules run 
together, and completely cover large portions, or the whole, 
of the body. Yet the classification is made according to the 
rule that evidence of vaccination consists in the visibility of 
marks, — a rule certainly misleading in the case of such a 
disorder, as is clearly pointed out by Dr. Russell, of Glasgow, 
who, in giving some information about Hospital Smallpox 
in that city, states that some (he does not say how many) 
patients who had been recorded on admission as unvac- 
cinated, because of the absence or invisibility of marks, 
when they became convalescent showed marks of vaccina- 
tion, “ some of them very good.” He amended his record 
in consequence, but yet left it erroneous, — a double-thonged 
whip for the Anti-Vaccinists ; for the patients who died, 
died “ unvaccinated,” while those who recovered went to 
swell the list of “ vaccinated ” recoveries. An additional 
proof of the accuracy of this explanation is afforded by the 
introduction into more recent hospital reports of a column 
of “ doubtful,” or “ said to be vaccinated, but having no 
marks ” ; and these classes show, as would be reasonably 
expected, a very high rate of fatality. 
