Report from the Select Committee on the Vaccination Act (1867) : together with the proceedings of the Committee, minutes of evidence, appendix and index.

Great Britain. Parliament. House of Commons. Select Committee on Vaccination Act (1867)

Date:: 1871

Credit: Report from the Select Committee on the Vaccination Act (1867) : together with the proceedings of the Committee, minutes of evidence, appendix and index. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

72/558 (page 48)

$Mr. C. T. Pearce, M.D. 7 March 1871. from small-pox, from 1850 to 1852, all occurred with vaccinated persons? —It is said so, 740. Where is it said so?—It is said at least to have occurred in a well-vaccinated country, where the law is exceedingly stringent, and where no person can hold office, or even get married, as I said just now, without a certificate of vaccination, as in Bavaria. 741. But would it not be a very dangerous argument to use, that those deaths occurred in a well-vaccinated country, when you have children under two years of age as to whom there is no compulsion with respect to vaccination; and might not the deaths have occurred at a very early age? —I have a list of the ages at which the deaths occurred in Sweden. 742. With respect to Sweden, do you know whether there is any system of re-vaccination ?— I do not. 743. Mr. Muntz.~\ With regard to those sta- tistics, what do you call Sweden ?—Do you include Norway?—No, it is exclusive of Nor- way. 744. Do you include Finland?—It excepts Finland. 745. ('hairman.~\ You have some statistics of the ages at which the deaths took place in Swe- den ; will you give those statistics?—In the 30th Annual Report of the .Registrar General, at page 243, we have, in Table 22, the relative mor- tality of men and women, at different ages, in England in the years 1851 to 1860, in the 64 healthy districts in England in the years 1849 to 1853, and in Sweden in the years of 1830 to 1835, and in this Table the ages are given as follows: the annual mortality from all causes to 1,000 living (which is better than the actual number of deaths), for ages from 15 to 25, in England was 7‘68 ; in Sweden it was 6-55, show- ing that among young lives the mortality was less in Sweden. From 25 to 35, in England it was 9'55 ; in Sweden it was 1F50. From 35 to 45, in England it was 126 ; in Sweden it was 16'45. Fi ’om the ages of 45 to 55, in England it was 17'59 ; in Sweden it was 25*0. From 55 to 65, in England it was 30 35; in Sweden it was 40-28. From 65 to 75, the mortality was 66'82 in England, and in Sweden it was 78-26. 746. Have you no statistics with reference to the younger ages ?—No ; they are not given under 15 years of age, and that is a great misfortune; I request attention to this Table of Dr. Farr’s, because I think it demonstrates that, to 1,000 living, the ratio of deaths is, especially after 30 years of age, vastly greater in Sweden than in England, and that exclusively in young lives is there an advantage in favour of Sweden. Taking the deaths from 35 to 55 in England, the death- rate to 1,000 living is 15*10, while in Sweden it is 20-72. Taking the average of the six divisions of life in the Table, in England the death-rate is 24-10, according to Dr. Farr, and in Sweden it is 29-67. What advantage is there, then, in vaccination ? In no country, so far as I am aware, is the law of vicarious mortality (upon which I have as yet only touched) more mani- festly operative than in Sweden. 747. Are you aware whether re-vaccination is carried out in that country or not?—I believe it is, but I will not speak positively. 748. Dr. Brewer.] The question which I thought was before us was a relative question with regard to the amount of small-pox before vaccination and after vaccination in Sweden. The two questions were distinctly thus: Flow many persons in each million of the population died annually of small-pox before the use of vac- cination ; how many persons in each million of the population have annually died of small-pox since the use of vaccination, taking large numbers of years? During the early period there used to die of small-pox out of each million of the Swedish population 2,050 annually ; during the later period the small pox deaths had annually averaged 158 ; are you acquainted with those statistics ?—In reply to that, I would say that I have no reason to dispute the figures; but what I maintain is, that small-pox forms no excejition to the mortality from all diseases which were more fatal in the last century than in the present one; but what I affirm is, that with that difference of mortality from small-pox per se, there has been no saving of life, but that other diseases have taken the place of small-pox. 749. Chairman.] But you do not dispute the Honourable Member’s account ?—No, I do not dispute that the plague used to carry off thousands of victims in London. The incompleteness of nearly all the statistics contained in Mr. Simon’s papers, excepting those' from Prague (I allude here to the absence of the whole mortality and causes of death from other diseases, I do not attribute this to Mr. Simon), renders it imprac- ticable to deduce from foreign sources an exact statement of relative mortality. From Sweden, however, we can derive some information which will serve the purpose of illustrating the law of displacement, or substitution of one disease for another. Let us take the relation of small-pox to typhus in Sweden': in the year 1825 there died of small-pox in Sweden 1,243, and of typhus 3,962. In the year 1829, four years afterwards, when the epidemic of small-pox had subsided, only 53 died of small-pox, but the deaths from typhus went up from 3,962 to 9,264, from the law of displacement. 750. Dr. Lyon Playfair.] You have given two years; but in the year 1784 the number of deaths from small-pox was 12,453, and the number of cases of typhus was 6,494 ; if you go down from that 3’ear to the year you named, you will find 20 arguments for you and 20 arguments against you; why do you not take a number of years rather than select only one or two ?—I will take a num- ber of years, if you please : in 1789, when small- pox diminished to 7,064, then typhus went up to 14,226 ; the same in the following year ; you have an epidemic of typhus for two years. One more illustration from Sweden: the following table shows that when small-pox was in abeyance the general mortality was high, and when small-pox was at its highest mortality the general mortality was low. The relations of small-pox to general mortality in Sweden, in 1829, were that only 53 died of small-pox, and there died of all causes 82,719. Four years afterwards, when the epi- demic returned, 1,145 died of small-pox, and the deaths from all causes were diminished by nearly 20,000, to 63,947. Now go to 1846, a year in which the mortality from small-pox was only two, and when it was said to have been stamped out ; the deaths from all causes were in that year 72,683. Then in 1851, when the epidemic returned (as it will to Ireland, and has already in fact) 2,488 died of small-pox, and the deaths from all causes were 72,506, less actually, and in a larger population, than in 1846, when small-pox was absent. Coming back to England, I might$