Before proceeding to discuss those special test-cases in our own country which still more completely show the impotence of vaccination, it will be well to notice a few Continental States which have been, and still are, quoted as affording illustrations of its benefits.
We will first take Sweden, which has had fairly complete national statistics longer than any other country, and we are now fortunately able to give the facts on the most recent official testimony—the Report furnished by the Swedish Board of Health to the Royal Commission, and published in the Appendix to their Sixth Report (pp. 751-56). Such great authorities as Sir William Gull, Dr. Seaton, and Mr. Marson, stated before the Committee of Enquiry in 1871 that Sweden was one of the best vaccinated countries, and that the Swedes were the best vaccinators. Sir John Simon’s celebrated paper, which was laid before Parliament in 1857 and was one of the chief supports of compulsory legislation, made much of Sweden, and had a special diagram to illustrate the effects of vaccination on small-pox. This paper is reproduced in the First Report of the recent Royal Commission (pp. 61-113), and we find the usual comparison of small-pox mortality in the last and present century which is held to be conclusive as to the benefits of vaccination. He says vaccination was introduced in 1801, and divides his diagram into two halves differently coloured before and after this date. It will be observed that, as in England, there was a great and sudden decrease of small-pox mortality after 1801, the date of the first vaccination in Sweden, and by 1812 the whole reduction of mortality was completed. But from that date for more than sixty years there was an almost continuous increase in frequency and severity of the epidemics. To account for this sudden and enormous decrease Sir John Simon states, in a note, and without giving his authority: “About 1810 the vaccinations were amounting to nearly a quarter of the number of births.” But these were almost certainly both adults and children of various ages, and the official returns now given show that down to 1812, when the whole reduction of small-pox mortality had been effected, only 8 per cent. of the population had been vaccinated. We are told in a note to the official tables that the first successful vaccination in Stockholm was at the end of 1810, so that the earlier vaccinations must have been mainly in the rural districts; yet the earlier Stockholm epidemics in 1807, before a single inhabitant was vaccinated, and in 1825, were less severe than the six later ones, when vaccination was far more general.
Bearing these facts in mind, and looking at [diagram V.], we see that it absolutely negatives the idea of vaccination having had anything to do with the great reduction of small-pox mortality, which was almost all effected before the first successful vaccination in the capital on the 17th December, 1810! And this becomes still more clear when we see that as vaccination increased among a population which, the official Report tells us, had the most “perfect confidence” in it, small-pox epidemics increased in virulence, especially in the capital (shown in the diagram by the dotted peaks) where, in 1874, there was a small-pox mortality of 7,916 per million, reaching 10,290 per million during the whole epidemic, which lasted two years. This was worse than the worst epidemic in London during the eighteenth century.[10]
But although there is no sign of a relation between vaccination and the decrease of small-pox, there is a very clear relation between it and the decrease in the general mortality. This is necessarily shown on a much smaller vertical scale to bring it into the diagram. If it were on the same scale as the small-pox line, its downward slope would be four times as rapid as it is. The decrease in the century is from about 27,000 to 15,000 per million, and, with the exception of the period of the Napoleonic wars, the improvement is nearly continuous throughout. There has evidently been a great and continuous improvement in healthy conditions of life in Sweden, as in our own country and probably in all other European nations; and this improvement, or some special portion of it, must have acted powerfully on small-pox to cause the enormous diminution of the disease down to 1812, with which, as we have seen, vaccination could have had nothing to do. The only thing that vaccination seems to have done is, to have acted as a check to this diminution, since it is otherwise impossible to explain the complete cessation of improvement as the operation became more general; and this is more especially the case in view of the fact that the general death-rate has continued to decrease at almost the same rate down to the present day!
The enormous small-pox mortality in Stockholm has been explained as the result of very deficient vaccination; but the Swedish Board of Health states that this deficiency was more apparent than real, first, because 25 per cent. of the children born in Stockholm die before completing their first year, and also because of neglect to report private vaccinations, so that “the low figures for Stockholm depend more on the cases of vaccination not having been reported than on their not having been effected.” (Sixth Report, p. 754, 1st col., 3rd par.)
The plain and obvious teaching of the facts embodied in this diagram is, that small-pox mortality is in no way influenced (except it be injuriously) by vaccination, but that here, as elsewhere, it does bear an obvious relation to density of population; and also that, when uninfluenced by vaccination, it follows the same law of decrease with improved conditions of general health as does the total death-rate.
This case of Sweden alone affords complete proof of the uselessness of vaccination; yet the Commissioners in the Final Report (par. 59) refer to the great diminution of small-pox mortality in the first twenty years of the century as being due to it. They make no comparison with the total death-rate; they say nothing of the increase of small-pox from 1824 to 1874; they omit all reference to the terrible Stockholm epidemics increasing continuously for fifty years of legally enforced vaccination and culminating in that of 1874, which was far worse than the worst known in London during the whole of the eighteenth century. Official blindness to the most obvious facts and conclusions can hardly have a more striking illustration than the appeal to the case of Sweden as being favourable to the claims of vaccination.
My next [diagram (No. VI.)] shows the course of small-pox in Prussia since 1816, with an indication of the epidemics in Berlin in 1864 and 1871. Dr. Seaton, in 1871, said to the Committee on Vaccination (Q. 5,608), “I know Prussia is well protected,” and the general medical opinion was expressed thus in an article in the Pall Mall Gazette (May 24, 1871): “Prussia is the country where revaccination is most generally practised, the law making the precaution obligatory on every person, and the authorities conscientiously watching over its performance. As a natural result, cases of small-pox are rare.” Never was there a more glaring untruth than this last statement. It is true that revaccination was enforced in public schools and other institutions, and most rigidly in the Army, so that a very large proportion of the adult male population must have been revaccinated; but, instead of cases of small-pox being rare, there had been for the twenty-four years preceding 1871 a much greater small-pox mortality in Prussia than in England, the annual average being 248 per million for the former and only 210 for the latter. A comparison of the two diagrams shows the difference at a glance. English small-pox only once reached 400 per million (in 1852), while in Prussia it four times exceeded that amount. And immediately after the words above quoted were written the great epidemic of 1871-72 caused a mortality in revaccinated Prussia more than double that of England! Now, after these facts have been persistently made known by the anti-vaccinators, the amount of vaccination in Prussia before 1871 is depreciated, and Dr. A. F. Hopkirk actually classes it among countries “without compulsory vaccination.” (See table and diagram opposite p. 238 in the 2nd Report.)
In the city of Berlin we have indicated two epidemics, that in 1864, with a death-rate a little under 1,000 per million, while that in 1871 rose to 6,150 per million, or considerably more than twice as much as that of London in the same year, although the city must have contained a very large male population which had passed through the army, and had therefore been revaccinated.
I give one more [diagram (No. VII.)] of small-pox in Bavaria, from a table laid before the Royal Commission by Dr. Hopkirk for the purpose of showing the results of long-continued compulsory vaccination. He stated to the Commission that vaccination was made compulsory in 1807, and that in 1871 there were 30,742 cases of small-pox, of which 95·7 per cent. were vaccinated. (2nd Report, Q. 1,489.) He then explains that this was because “nearly the whole population was vaccinated”; but he does not give any figures to prove that the vaccinated formed more than this proportion of the whole population; and as the vaccination age was one year, it is certain that they did not do so.[11] He calls this being “slightly attacked,” and argues that it implies “some special protection.” No doubt the small-pox mortality of Bavaria was rather low, about equal to that of Ireland; but in 1871 it rose to over 1,000 per million, while Ireland had only 600, besides which the epidemic lasted for two years, and was therefore very nearly equal to that of England. But we have the explanation when we look at the line showing the other zymotics, for these are decidedly lower than those of England, showing better general sanitary conditions. In Bavaria, as in all the other countries we have examined, the behaviour of small-pox shows no relation to vaccination, but the very closest relation to the other zymotics and to density of population. The fact of 95·7 per cent. of the small-pox patients having been vaccinated agrees with that of our Highgate hospital, but is even more remarkable as applying to the population of a whole country, and is alone sufficient to condemn vaccination as useless. And as there were 5,070 deaths to these cases, the fatality was 16·5 per cent., or almost the same as that of the last century; so that here again, and on a gigantic scale, the theory that the disease is “mitigated” by vaccination, even where not prevented, is shown to be utterly baseless. Yet this case of Bavaria was chosen by a strong vaccinist as affording a striking proof of the value of vaccination when thoroughly carried out, and I cannot find that the Commissioners took the trouble to make the comparisons here given, which would at once have shown them that what the case of Bavaria really proves is the complete uselessness of vaccination.