This most misleading, unscientific, and unfair proceeding, of giving certain figures of small-pox mortality among the well vaccinated, and then, without any adequate comparison, asserting that they afford a proof of the value of vaccination, may be here illustrated by another example. In the original paper by Sir John Simon on the History and Practice of Vaccination, presented to Parliament in 1857, there is, in the Appendix, a statement by Dr. T. Graham Balfour, surgeon to the Royal Military Asylum for Orphans at Chelsea, as to the effects of vaccination in that institution—that since the opening of the Asylum in 1803 the Vaccination Register has been accurately kept, and that every one who entered was vaccinated unless he had been vaccinated before or had had small-pox; and he adds: “Satisfactory evidence can therefore, in this instance, be obtained that they were all protected.” Then he gives the statistics, showing that during forty-eight years, from 1803 to 1851, among 31,705 boys there were thirty-nine cases and four deaths, giving a mortality at the rate of 126 per million on the average number in the Asylum, and concludes by saying: “The preceding facts appear to offer most conclusive proofs of the value of vaccination.” But he gives no comparison with other boys of about the same age and living under equally healthy conditions, but who had not been so uniformly or so recently vaccinated; for it must be remembered that, as this was long before the epoch of compulsory vaccination, a large proportion of the boys would be unvaccinated at their entrance, and would therefore have the alleged benefit of a recent vaccination. But when we make the comparison, which both Dr. Balfour and Sir John Simon failed to make, we find that these well vaccinated and protected boys had a greater small-pox mortality than the imperfectly protected outsiders. For in the First Report of the Commission (p. 114, Table B) we find it stated that in the period of optional vaccination (1847-53) the death-rate from small-pox of persons from ten to fifteen years[12] was 94 per million! Instead of offering “most conclusive proofs of the value of vaccination,” his own facts and figures, if they prove anything at all, prove not only the uselessness but the evil of vaccination, and that it really tends to increase small-pox mortality. And this conclusion is also reached by Professor Adolf Vogt, who, in the elaborate statistical paper sent by him to the Royal Commission, and printed in their Sixth Report, but not otherwise noticed by them, shows by abundant statistics from various countries that the small-pox death-rate and fatality have been increased during epidemics occurring in the epoch of vaccination.
One more point deserves notice before leaving this part of the inquiry, which is the specially high small-pox mortality of great commercial seaports. The following table, compiled from Dr. Pierce’s Vital Statistics for the Continental towns and from the Reports of the Royal Commission for those of our own country, is very remarkable and instructive.
| Name of Town. | Year. | Small-pox Death-rate per Million. |
|---|---|---|
| Hamburgh | 1871 | 15,440 |
| Rotterdam | 1871 | 14,280 |
| Cork | 1872 | 9,600 |
| Sunderland | 1871 | 8,650 |
| Stockholm | 1874 | 7,916 |
| Trieste | 1872 | 6,980 |
| Newcastle-on-Tyne | 1871 | 5,410 |
| Portsmouth | 1872 | 4,420 |
| Dublin | 1872 | 4,330 |
| Liverpool | 1871 | 3,890 |
| Plymouth | 1872 | 3,000 |
The small-pox death-rate in the case of the lowest of these towns is very much higher than in London during the same epidemic, and it is quite clear that vaccination can have had nothing to do with this difference. For if it be alleged that vaccination was neglected in Hamburgh and Rotterdam, of which we find no particulars, this cannot be said of Cork, Sunderland, and Newcastle. Again, if the very limited and imperfect vaccination of the first quarter of the century is to have the credit of the striking reduction of small-pox mortality that then occurred, as the Royal Commissioners claim, a small deficiency in the very much more extensive and better vaccination that generally prevailed in 1871, cannot be the explanation of a small-pox mortality greater than in the worst years of London when there was no vaccination. Partial vaccination cannot be claimed as producing marvellous effects at one time and less than nothing at all at another time, yet this is what the advocates of vaccination constantly do. But on the sanitation theory the explanation is simple. Mercantile seaports have grown up along the banks of harbours or tidal rivers whose waters and shores have been polluted by sewage for centuries. They are always densely crowded owing to the value of situations as near as possible to the shipping. Hence there is always a large population living under the worst sanitary conditions, with bad drainage, bad ventilation, abundance of filth and decaying organic matter, and all the conditions favourable to the spread of zymotic diseases and their exceptional fatality. Such populations have maintained to our day the insanitary conditions of the last century, and thus present us with a similarly great small-pox mortality, without any regard to the amount of vaccination that may be practised. In this case they illustrate the same principle which so well explains the very different amounts of small-pox mortality in Ireland, Scotland, England, and London, with hardly any difference in the quantity of vaccination.
The Royal Commissioners, with all these facts before them or at their command, have made none of these comparisons. They give the figures of small-pox mortality, and either explain them by alleged increase or decrease of vaccination, or argue that, as some other disease—such as measles—did not decrease at the same time or to the same amount, therefore sanitation cannot have influenced small-pox. They never once compare small-pox mortality with general mortality, or with the rest of the group of zymotics, and thus fail to see their wonderfully close agreement—their simultaneous rise and fall, which so clearly shows their subjection to the same influences and proves that no special additional influence can have operated in the case of small-pox.
CHAPTER IV
TWO GREAT EXPERIMENTS WHICH ARE CONCLUSIVE AGAINST VACCINATION
Those who disbelieve in the efficacy of vaccination to protect against small-pox are under the disadvantage that, owing to the practice having been so rapidly adopted by all civilized people, there are no communities who have rejected it while adopting methods of general sanitation, and who have also kept satisfactory records of mortality from various causes. Any such country would have afforded what is termed a “control” or test experiment, the absence of which vitiates all the evidence of the so-called “variolous test” in Jenner’s time, as was so carefully pointed out before the Commission by Dr. Creighton and Professor Crookshank. We do, however, now possess two such tests on a limited, but still a sufficient, scale. The first is that of the town of Leicester, which for the last twenty years has rejected vaccination till it has now almost vanished altogether. The second is that of our Army and Navy, in which, for a quarter of a century, every recruit has been revaccinated, unless he has recently been vaccinated or has had small-pox. In the first we have an almost wholly “unprotected” population of nearly 200,000, which, on the theory of the vaccinators, should have suffered exceptionally from small-pox; in the other we have a picked body of 220,000 men, who, on the evidence of the medical authorities, are as well protected as they know how to make them, and among whom, therefore, small-pox should be almost or quite absent, and small-pox deaths quite unknown. Let us see, then, what has happened in these two cases.
Perhaps the most remarkable and the most complete body of statistical evidence presented to the Commission was that of Mr. Thomas Biggs, a sanitary engineer and a town councillor of Leicester. It consists of fifty-one tables exhibiting the condition of the population in relation to health and disease from almost every conceivable point of view. The subject is further illustrated by sixteen diagrams, many of them in colours, calculated to exhibit to the eye in the most clear and simple manner the relations of vaccination and sanitation to small-pox and to the general health of the people, and especially of the children, in whose behalf it is always alleged vaccination is enforced. From this wealth of material I can give only two diagrams exhibiting the main facts of the case, as shown by Mr. Biggs’ statistics in the Fourth Report of the Royal Commission, all obtained from official sources.