Papers relating to the history and practice of vaccination.

Great Britain. General Board of Health

Date:: 1857

Credit: Papers relating to the history and practice of vaccination. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

109/300 page 3

$confirmed by their general practice, as well as by that in their own families) appear in the Supplement; nor was it for want of the testimony of several other equally respectable physicians and surgeons, whom the Petitioner was desirous of producing, that many other names are not inserted; b\it because your Committee, after having received so considerable a body of evidence to the same purport, and with so little variation in opinion, thought that his case could sustain no injury in being left to rest upon the concurring depositions of those already examined, who had both the most ample experience of the facts, and the best means of forming a judgment upon them. The testimony, also, of some persons not professional has been admitted, who could speak to occurrences that tend to illustrate particular points connected with the subject. The result, as it appears to your Committee, which may be collected from the oral testimony of these gentlemen (with the exception of three of them) is, that the discovery of vaccine inoculation is of the most general utility, inasmuch as it introduces a milder disorder in the place of the inoculated small-pox, which is not capable of being communicated by contagion ; that it does not excite other humours or disorders in the constitution ; that it has not been known, in any one instance, to prove fatal; that the inoculation may be safely performed at all times of life (which is known not to be the case with regard to the inoculation of the small-pox) in the earliest infancy, as well as during pregnancy, and in old age; and that it tends to eradicate, and, if its use becomes universal, must absolutely extinguish, one of the most destructive disorders by which the human race has been visited. The written evidence which is inserted in the Sup]dement (for your Committee have judged it proper to make a selection, from a great mass, of what appeared most important) is more various, but directed to the same objects: part of it relates to the very extensive and successful practice of this mode of inoculation in every quarter of the globe, the efficacy of which does not seem abated by the cold of the northern, nor by the heat of the southern and tropical climates ; and though there are no means of examining the authors from whence these attestations come, it would be an act of injustice to the Petitioner to exclude such important documents, which show the consideration in which this discovery is held, and the benefit with which it has been attended in so many other countries, to at least as great an extent as in our own. As a comparison between this new practice and the inoculated small-pox forms a principal consideration in the present inquiry, some facts with regard to the latter engaged the attention of your Committee, and in the supplement are inserted (see page 147) statements of the mortality occasioned by the small-pox in 42 years before inoculation was practised in England, and of the 42 years from 1731 to 1772; the result of which appears to be an increase of deaths amounting to 17 in every 1,000 ; the general average giving 72 in every 1,000 during the first 42 years, and 89 in the 42 years ending with 1772, so as to make the whole excess of deaths in the latter period 1,742. The increase of mortality is stated by another witness (No. 10) to be as 95 to 74, comparing the concluding 30 years with the first 30 of the last century, and the average annual mortality from small-pox to have been latterly about 2,000; for though individual lives are certainly preserved, and it is true that a smaller loss happens in equal numbers ■who undergo the small-pox now than there was formerly, yet it must be admitted that the general prevalence of inoculation tends to spread and multiply the disease itself: of which, though the violence be much abated by the present mode of treatment, the contagious quality remains in full force. It deserves also to be noticed, that the deaths under the inoculated sort of small-pox, with all the improvements of modern experience, are not inconsiderable ; it is stated by one of the witnesses at about 1 in every 300 throughout England (Nos. 5 and 7); by another, as about 1 in every 100 in London (No. 15); while the loss in the natural small-pox is probably not less than 1 in 6 (No. 8). Nor ought it to be overlooked, that mistakes have been known to arise in the inoculated small-pox, and instances are cited by some of the witnesses in which persons supposed to have gone through the small-pox by inoculation have caught it afterwards in the natural way (Nos. 28 and 39). The general law of vaccine and variolous disease are extremely similar, and it is not surprising that they should resemble each other in their anomalies. A spurious or imperfect sort of cow-pox having been mentioned in some of the examinations, your Committee have been particularly diligent in their inquiries into every individual case that came within their notice, whei’e suspicions had arisen, or facts were alleged tending to bring into doubt the preventive power of vaccine inoculation; and although, for the reasons before given, they have restricted and abridged the proofs in favour of this practice, they have thought proper to withhold no part of the evidence that has been received relative to the cases that appear to controvert it; of which it will be observed that some (Nos. 6, 17, and 24) evidently resolve themselves into variolous infection, taken previously to the vaccine inoculation; others (Nos. 6 and 23) into the patient not having taken the cow-pox at all; others again (Nos. 10 and 48) from the vaccine matter being, by want of attention in preserving it, decomposed, or mixed with variolous matter (Nos. 38 and 48), or from the fluid being taken at too late a period of the pustule ; to which last cause it seems probable that most of the errors and dubious cases are to be referred (Nos. 10, 11, and 38). All the practitioners agree that there is no difficulty in distinguishing the real disorder from every spurious or imperfect appearance, and that the regular progress of the pustule itself, if attended to, cannot be mistaken. Some cases (Nos. 40 and 42) are not explained in a manner so satisfactory and indisputable as the fore- going, but in leaving them to have such weight as they may appear to deserve, your committee cannot avoid recurring to the multitude of instances in which endeavours have been used to communicate the small-pox to patients who have been known to go through the regular vaccine disease, in which neither repeated A 2$

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