In their Final Report the Commissioners give the statistics of small-pox mortality in the Army and Navy from 1860 to 1894, and, although the latest order for the vaccination of the whole force in the Navy was only made in 1871, there can be no doubt that, practically, the whole of the men had been revaccinated long before that period;[15] but certainly since 1873 all without exception, both English and foreign, were revaccinated; and in the Army every recruit has been revaccinated since 1860 (see 2nd Report, Q. 3,453, 3,455; and for the Navy, Q. 2,645, 6, 3,212-13, and 3,226-3,229). Brigade-Surgeon William Nash, M.D., informed the Commission that the vaccination and revaccination of the Army was “as perfect as endeavours can make it,” and that he can make no suggestion to increase its thoroughness (Q. 3,559, 3,560).
Turning now to the [diagram (No. XI.)] which represents the official statistics, the two lower solid lines show the small-pox death-rate per 100,000 of the force of the Army and Navy for each year, from 1860 to 1894. The lower thick line shows the Army mortality, the thin line that of the Navy. The two higher lines show the total death-rate from disease of the Navy, and of the Home force of the Army, as the tables supplied do not separate the deaths by disease of that portion of the Army stationed abroad.
Looking first at these upper lines, we notice two interesting facts. The first is, the large and steady improvement of both forces as regards health-conditions during the thirty-five years; and the second is the considerable and constant difference in the disease mortality of the two services, the soldiers having throughout the whole period a much higher mortality than the sailors. The decrease of the general mortality is clearly due to the great improvements that have been effected in diet, in ventilation, and in general health-conditions; while the difference in health between the two forces is almost certainly due to two causes, the most important being that the sailors spend the greater part of every day in the open-air, and in air of the maximum purity and health-giving properties, that of the open sea; while soldiers live mostly in camps or barracks, often in the vicinity of large towns, and in a more or less impure atmosphere. The other difference is that soldiers are constantly subject to temptations and resulting disease, from which sailors while afloat are wholly free.
Turning now to the lower lines, we see that, as regards small-pox mortality, the Navy suffered most down to 1880, but that since that period the Army has had rather the higher mortality. This has been held to be due to the less perfect vaccination of the Navy in the earlier period, but of that there is no proof, while there is evidence as to the causes of the improvement in general health. Staff-Surgeon T. J. Preston, R.N., stated them thus: “Shorter sea-voyages; greater care not to overcrowd; plentiful and frequent supplies of fresh food; the introduction of condensed water; and the care that is now taken in the general economy and hygiene of the vessels” (Q. 3,253). These seem sufficient to have produced also the comparative improvement in small-pox mortality, especially as the shorter voyages would enable the patients to be soon isolated on shore. The question we now have to consider is, whether the amount of small-pox here shown to exist in both Army and Navy demonstrates the “full security” that revaccination is alleged to give; whether as a matter of fact our soldiers and sailors, when exposed to the contagion of intense small-pox, do suffer to “any appreciable degree”; and lastly, whether they show any immunity whatever when compared with similar populations who have been either very partially or not at all revaccinated. It is not easy to find a fairly comparable population, but after due consideration it seems to me that Ireland will be the best available, as the statistics are given in the Commissioners’ Reports, and it can hardly be contended that it has any special advantages over our soldiers and sailors,—rather the other way. I have therefore given a [diagram, XII.], in which a dotted line shows the small-pox mortality of the Irish people of the ages 15 to 45 in comparison with the Army and the Navy mortality for the same years. (The figures for this diagram, as regards Ireland, have been calculated from the table at p. 37 of the Final Report, corrected for the ages 15 to 45 by means of Table J. at p. 274 of the Second Report.)
This dotted line shows us that, with the exception of the great epidemic of 1871, when for the bulk of the Irish patients there was neither isolation nor proper treatment, the small-pox mortality of the Irish population of similar ages has been on the average below that of either the Army or the Navy; while if we take the mean mortality of the three for the same period (1864-1894) inclusive, the result is as follows:
| Army, mean of the | annual small-pox death rate, | 58 | per million. |
| Navy ” | ” ” ” | 90 | ” |
| Ireland (ages 15-45) | ” ” ” | 65·8 | ”[16] |
If we combine the Army and Navy death-rates in the proportion of their mean strength so as to get the true average of the two forces, the death-rate is 64·3 per million, or almost exactly the same as that of Ireland.
Now if there were no other evidence which gave similar results, this great test case of large populations compared over a long series of years, is alone almost conclusive; and we ask with amazement,—Why did not the Commissioners make some such comparison as this, and not allow the public to be deceived by the grossly misleading statements of the medical witnesses and official apologists for a huge imposture? For here we have on one side a population which the official witnesses declare to be as well vaccinated and revaccinated as it is possible to make it, and which has all the protection that can be given by vaccination. It is a population which, we are officially assured, can live in the midst of the contagion of severe small-pox and not suffer from the disease “in any appreciable degree.” And on comparing this population of over 200,000 men, thus thoroughly protected and medically cared for, with the poorest and least cared for portion of our country—a portion which the official witness regarding it declared to be badly vaccinated, while no amount of revaccination was even referred to—we find the less vaccinated and less cared for community to have actually a much lower small-pox mortality than the Navy, and the same as that of the two forces combined. The only possible objections that can be taken, or that were suggested during the examination of the witnesses are, that during the early portion of the period, the Navy was not wholly and absolutely revaccinated; and secondly, that troops abroad, and especially in India and Egypt, are more frequently subjected to infection. As to the first objection, even if revaccination were not absolutely universal in the Navy prior to 1873, it was certainly very largely practised, and should have produced a great difference when compared with Ireland. And the second objection is simply childish. For what are vaccination and revaccination for, except to protect from infection? And under exposure to the most intense infection they have been officially declared “not appreciably to suffer”!
But let us make one more comparison comprising the period since the great epidemic of 1871-2, during which the Navy as well as the Army are admitted to have been completely revaccinated, both English and foreign. We will compare this (supposed) completely protected force with Leicester, an English manufacturing town of nearly the same population, by no means especially healthy, and which has so neglected vaccination that it may now claim to be the least vaccinated town in the kingdom. The average annual small-pox death-rate of this town for the twenty-two years 1873-94 inclusive is thirteen per million (see 4th Report, p. 440); but in order to compare with our Army and Navy we must add one-ninth for the mortality at ages 15-45 as compared with total mortality, according to the table at p. 155 of the Final Report, bringing it to 14·4 per million, when the comparison will stand as follows: