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Imperial Airways The Birth of the British Airline
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Other documents randomly have
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The Project Gutenberg eBook of A Statement of
Facts Tending to Establish an Estimate of the
True Value and Present State of Vaccination
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Title: A Statement of Facts Tending to Establish an Estimate of the

True Value and Present State of Vaccination

Author: Sir Gilbert Blane

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*** START OF THE PROJECT GUTENBERG EBOOK A STATEMENT OF

FACTS TENDING TO ESTABLISH AN ESTIMATE OF THE TRUE VALUE
AND PRESENT STATE OF VACCINATION ***
 A

STATEMENT OF FACTS,

TENDING TO

ESTABLISH AN ESTIMATE OF THE TRUE VALUE

AND

PRESENT STATE

OF

VACCINATION.

By SIR GILBERT BLANE, Bart.

F.R.S. of London, Edinburgh, and Göttingen; Member of the Imperial Academy of St.
Petersburgh; and Physician in Ordinary to the King.

FROM THE TENTH VOLUME OF THE MEDICO-CHIRURGICAL TRANSACTIONS, PUBLISHED BY THE MEDICAL AND
CHIRURGICAL SOCIETY OF LONDON;

WITH ADDITIONS.

LONDON:
PRINTED FOR THOMAS AND GEORGE UNDERWOOD, 32, FLEET
STREET.

1820.
 J. MOYES, GREVILLE STREET, LONDON.

Transcriber’s Note:

The cover image was created by the transcriber and is placed in the
public domain.
 A

STATEMENT OF FACTS,
TENDING TO ESTABLISH AN ESTIMATE OF THE TRUE VALUE AND
PRESENT STATE OF

VACCINATION.
By SIR GILBERT BLANE, Bart. F.R.S. Lond. &c.
Physician in Ordinary to the King.

Read Nov. 10, 1819.

I t is now twenty-one years since Vaccination was promulgated in this

country by Dr. Jenner, and fifteen years since it began to produce a
sensible effect in diminishing the mortality from Small Pox. In regard
to the latter period, it is coeval with this Society; yet, though no
discovery in nature nor in medicine has been more important to the
interests of humanity, nor any which has ever so rapidly and
universally won the assent and practical adoption of mankind, there
are no notices of it on our records, except in our second volume, in an
article by Dr. Bateman, in which he relates a case of a mother who
was affected with the Small Pox a second time, by being exposed to
infection, from some of her own children who had caught it casually;
while her other children, who had been vaccinated, resisted it. As it is
to be hoped that our labours will prove to posterity some of the
principal sources of reference regarding the medical and chirurgical
discoveries and improvements of the age; as it is one of the
reproaches of our country, that it has not availed itself so much as any
other of the benefits of Vaccination; and as there are writers among
us who still allege that the failures are so numerous that the value of
the discovery is very ambiguous, it seems one of the duties of the
Society to lend its aid in placing these important points in their true
light.
It seems almost needless to premise, that the Small Pox is of all
maladies that, which, during the last thousand years, has destroyed
the largest portion of the human species, and been productive of the
largest share of human misery. There is, perhaps, no disease over
which medical art has less power; and this power, such as it is, has
consisted more in abolishing pernicious practices, than in ascertaining
any positive methods of controlling its fatality, unless we except the
inoculation of it with its own virus. But, though the beneficial effect of
this on those on whom it is actually practised is undeniable, it has no
tendency like Vaccination to extirpate the disease; and from the
impossibility of rendering it universal, it has actually been found to add
to the general mortality of Small Pox, by opening a new source for the
diffusion of its virus.
It ought to be stated also, with a view to a decision on this question,
that Vaccination itself is attended with no danger, and frequently takes
effect without any visible disturbance in the system. There is even
reason to believe, that in its process it wards off other diseases, by
pre-occupying the constitution.
In order to bring this matter to the test of calculation, in order also to
institute a comparison of the mortality of Small Pox as influenced by
Vaccination, as well as by Inoculation from itself, I have selected from
the bills of mortality four periods, each of fifteen years, for the
purpose of exhibiting the mortality of Small Pox in each of these series
in regard to each other. These are thrown into the form of Tables, and
annexed to this article.
The first series, is the fifteen years immediately preceding the
introduction of Inoculation; that is, from 1706 to 1720, both included.
Previous to this period, no account that could be depended upon
regarding the Small Pox, could be derived from the bills of mortality;
for down to the beginning of last century such was their imperfect
construction, that Small Pox, Measles, and Flux were blended under
one head. Exception may be taken against the accuracy of these bills,
even in this improved state, particularly with regard to the
discrimination of diseases. This objection, however, is certainly less
applicable to Small Pox than any other disorder, its character being so
striking as not to be mistaken by the most ignorant and careless
observer.
The second series is taken at the middle of the last century, when
Inoculation had made considerable progress; that is, from 1745 to
1759, both included. In comparing this with the preceding series, with
regard to absolute numbers, it ought to be taken into account, that
eleven parishes were added to the bills of mortality, between the years
1726 and 1745, both included: so that the progressive improvement of
general salubrity ought to be estimated still higher than what is
indicated by the diminished mortality, as it stands in the Tables.
The third series comprises the fifteen years previous to the
introduction of Vaccination, when Inoculation had made still greater
progress; that is, from 1785 to 1798, both included.
The fourth series comprises the time in which the vaccine Inoculation
has been so far diffused as to produce a notable effect on the
mortality of Small Pox; that is, from 1804 to 1818, both included.
The result of these computations stands as follows:—

Ratio of the Mortality of Small Pox to the total Mortality.

From 1706 to 1720, one in 12.7; that is, 78 in 1000.

From 1745 to 1759, one in 11.2; that is, 89 in 1000.
From 1785 to 1798, one in 10.6; that is, 94 in 1000.
From 1804 to 1818, one in 18.9; that is, 53 in 1000.

Fractions are not noticed in the last column of numbers.

It appears from this statement, that the proportion of deaths from

Small Pox to the total mortality, increased in the course of last
century; so that Inoculation appears to have added to the mortality. It
is but fair to mention, however, that this total mortality is not quite a
just scale whereby to measure the relative mortality of Small Pox; for
in the course of that century, the general mortality itself was greatly
diminished in relation to the population. This diminution of general
mortality was chiefly owing to the diminished mortality of children
under two years of age, which, at the time when the account began to
be kept, 1729, averaged about 9000; but at the end of the century not
more than 5000[1]; also to the decrease of fevers, and still more of
fluxes. The relation of the mortality of Small Pox to the population,
would therefore be a more fair criterion of its increase or decrease. In
this view it might, at first sight, be thought that it had decreased; for
the population of the metropolis nearly doubled in the course of the
last century. But it is to be remarked, that there has been little
increase of population in that portion of the metropolis which is
included in the bills of mortality; the great increase having been in the
parishes of Mary-le-bone and St. Pancras, which are not included in
these bills. It is computed in the remarks subjoined to the last
parliamentary returns of population, that the population of London,
within the walls, had decreased more than three-fifths in the course of
last century, from the widening of streets, the erection of public
buildings and warehouses, and, it might have been added, from the
migration of mercantile families to the west end of the town. As a set-
off to this, there has certainly been a great addition, in the same time,
to those parishes within the bills, which stand on the verge of the
metropolis, such as St. George’s Hanover Square, St. George’s
Bloomsbury, Poplar, and Stepney. But the addition to the population, if
any, within the bills of mortality, does not seem to be so considerable
as to affect the computation. And, if this is admitted, the absolute
numbers of the deaths from Small Pox, estimated in relation to the
population, that is, exactly as they stand on the Tables, afford a fair
comparative statement of the mortality in the last century, and seem
to prove that Inoculation has not added so much to it as has been
alleged. It was in the rural population that the effect of Inoculation in
diffusing Small Pox was chiefly felt. In this situation there is much less
intercourse of persons with each other than in towns, so that not only
many individuals escaped from their not being exposed to infection
during their whole lives, but whole districts were known to have been
exempt from it for a long series of years, before it was universally
diffused by Inoculation.
But the truly important result from these statements consists in the
clear, undeniable, and great diminution of it since the introduction of
Vaccination. It appears, that in the last fifteen years, the mortality
from Small Pox, in the bills of mortality, has not been much more than
one-half of what it was in the two like series of years in the middle
and latter end of the last century. Nor does this comprise the whole
benefit derived from this discovery in the metropolis; for, besides that
the sixth part of it lies without the bills, it was found, in levying the tax
on burials for the last six months of 1794, that the number of
unregistered deaths, chiefly those of dissenters, amounted in that half
year to 3148; and the reporter of the parliamentary enumeration
thinks that, as besides these there were undiscovered interments, the
unregistered deaths may be computed at one-third of the total
mortality, that is, about 7000. (See Abstract of the Parish Registers,
1811, printed by authority of Parliament, page 200.)
Assuming, therefore, that Vaccination had not been practised the last
fifteen years, and that the mortality from Small Pox, within the bills,
had in that time, that is, from 1804 to 1818, been the same as from
1784 to 1798, that is, 27,569 in place of 14,716; and assuming that
there has been the same proportional diminution of deaths in the
districts without the bills, and among the unregistered subjects, the
account of lives saved in this metropolis by Vaccination in the fifteen
years, will stand as follows:—
Within the bills of mortality 12,853
Without the bills of mortality 2,570
Unregistered cases 7,711
------
Total 23,134
The first of these numbers is found by subtracting the amount of
deaths by Small Pox, in the bills of mortality, during the practice of
Vaccination, from the amount of them, during the same number of
years, immediately before the discovery of Vaccination.
The second number is found by dividing the first by 5. The population
of the metropolis without the bills is stated at one-sixth of the whole,
which is evidently one-fifth of that within the bills.
The third number is found by dividing the sum of the two others by 2;
the unregistered cases being, as before stated, one-third of the whole.
It appears, therefore, that, even under the very imperfect practice of
Vaccination which has taken place in this metropolis, 23,134 lives have
been saved in the last fifteen years, according to the best computation
that the data afford. It will be seen, by an inspection of the Table, that
in that time there have been great fluctuations in the number of
deaths. This has been owing partly to the Small Pox Inoculation of
out-patients having, by an unaccountable infatuation, been kept up at
the Small Pox Hospital for several years after the virtue of Vaccination
had been fully confirmed. The greater number of deaths in 1805 may
chiefly be referred to this cause. Since the suppression of this practice,
the adoption of Vaccination, though in a degree so incomplete, in
consequence of public prejudice, created entirely by mischievous
publications, has been unable to prevent a considerable, though
fluctuating, mortality from Small Pox. The late mortality from Small
Pox, though little more than one half of what it was in former times,
might have been entirely saved, if Vaccination had been carried to the
same extent as in many cities and whole districts on the continent of
Europe, in Peru, and Ceylon.
In the summer of 1811 the author was called to visit, professionally,
Don Francisco de Salazar, who had arrived a few days before in
London, on his route from Lima to Cadiz, as a deputy to the Spanish
Cortes. He informed him, that Vaccination had been practised with so
much energy and success in Lima, that for the last twelve months
there had occurred, not only no death from, but no case of, Small Pox;
that the new-born children of all ranks are carried as regularly to the
Vaccinating House as to the font of baptism; that the Small Pox is
entirely extinguished all over Peru; nearly so in Chili; and that there
has been no compulsory interference on the part of the government to
promote Vaccination.
It is now matter of irrefragable historical evidence, that Vaccination
possesses powers adequate to the great end proposed by its
meritorious discoverer, in his first promulgation of it in 1798, namely,
the total extirpation of Small Pox. The first proof of this was at Vienna,
where, in 1804, no cases occurred, except two strangers who came
into the city with the disease upon them. In 1805 there did not occur
a single death from it in Copenhagen[2]. Dr. Sacco, the indefatigable
superintendent of Vaccination in Lombardy, stated, in his Annual
Report, 3d January, 1808, that the Small Pox had entirely disappeared
in all the large towns in that country; and that in the great city of
Milan it had not appeared for several years. Dr. Odier, of Geneva, so
favourably known for his high professional, scientific, and literary
acquirements, testifies, that, after a vigorous perseverance in
Vaccination for six years, the Small Pox had disappeared in that city
and the whole surrounding district; and that, when casually introduced
by strangers, it did not spread, the inhabitants not being susceptible.
The Central Committee in Paris testify, in their Report of 1809, that the
Small Pox had been extinguished at Lyons and other districts of
France.
These are selected as some of the earliest and most remarkable
proofs of the extirpating power. But it is demonstrable, that if at the
first moment of this singular discovery, at any moment since, at the
present or any future moment, mankind were sufficiently wise and
decided to vaccinate the whole of the human species who have not
gone through the Small Pox, from that moment would this most
loathsome and afflicting of all the scourges of humanity be
instantaneously, and for ever, banished from the earth.
It is farther manifest, that extirpation being the ultimate aim of this
discovery, and there being the fullest historical and practical evidence
of its being capable of accomplishing this end, all other questions with
regard to its expediency must be futile and irrelevant. It is in the
nature of all morbid phenomena to be liable to exception. One of the
most essential and characteristic laws of Small Pox itself, namely, that
of its affecting the human subject but once in life, is found in rare
cases to be violated. It is, therefore, perfectly conformable to analogy,
and naturally to be expected, that it may not in all cases be a
complete security against Small Pox. But it is obvious, that, admitting
these exceptions to be very frequent, much more so than the
recurrence of Small Pox after Small Pox, this can constitute no
objection to the practice, as long as the extirpating power remains
unimpaired and unimpeached. Nay, it is obviously so far from an
objection, that it ought to operate as a powerful additional incentive
on every benevolent mind, to push Vaccination to the utmost, as
rapidly as possible, in order that those who are still susceptible, either
from peculiar natural constitution, or from the unskillful manner of
conducting the operation, or from defective matter, may not, by any
possibility, catch it; for, in the event of its extirpation, it could nowhere
be met with. And in order to stimulate the good and the wise to aim
strenuously at this consummation, let it be constantly borne in mind,
that the adversary they are contending with is the greatest scourge
that has ever afflicted humanity. That it is so, all history, civil and
medical, proclaims: for, though the term Plague carries a sound of
greater horror and dismay, we should probably be within the truth, if
we were to assert, that Small Pox has destroyed a hundred for every
one that has perished by the Plague.
It is true that in its last visitation of this metropolis, one hundred and
fifty-four years ago, it carried off 70,000 victims in a few months; but
since that time, the deaths from Small Pox, recorded in the bills of
mortality, have amounted to more than 300,000; and a like number of
the survivors have been afflicted with blindness, deformity, scrofula, or
broken constitutions, which is not the case with the survivors of the
Plague. It appears, by a Report of the Hospital for the Indigent Blind,
that two thirds of those who apply for relief have lost their sight by the
Small Pox. It is alleged by some of the soundest Political Economists
that Small Pox does not diminish the numbers of mankind, nor
Vaccination increase them; for population is determined by
subsistence, and the indefinite powers of procreation soon repair the
ravages of disease. But, however true this may be, the miseries
incident to so many of those who survive Small Pox, whereby they
become a burden to themselves, their families, and to society, render
this disease uncontrovertibly an evil of the first magnitude, not to
mention the intense sufferings and afflictions inseparable from it; and
in this view of the matter the objection seriously adduced against
Vaccination by one of its opponents[3], that Small Pox is a merciful
dispensation of Providence for the poor man, by diminishing the
burden of his family, will not hold good, for the burden is not
removed.
And when it is considered that there are large portions of the globe,
India, China, even one whole quarter of it (North and South America),
besides all the tropical and arctic regions, in which the Plague has
never been known; and that in all the countries liable to it, it seldom
appears but at one season of the year, and in some at long intervals,
the ravage which it makes is trifling when compared with the
unceasing havoc of Small Pox, which spares no nation in any climate,
or at any season. Yet the Legislative Regulations for excluding and
checking the Plague are of the most harsh and despotic description,
while the law touches upon Small Pox comparatively with the most
lenient hand. It ought to be generally known, however, that in a late
trial and conviction, it was laid down by the judge to be the law of the
land, that a medical practitioner who neglects to exclude the person
whom he inoculates from communication with others, is liable to fine
and imprisonment. Morally considered, indeed, it is difficult to
conceive a higher degree of flagitious turpitude than that of a
professional person, in the present state of knowledge, exposing his
fellow-creatures, from sordid motives, to one of the most grievous
calamities of which human nature is susceptible.
The preceding reasoning is grounded on the supposition of
extirpation: but, however demonstrable the possibility of extirpation
may be, it may not in all communities be practicable; and may not
these alleged failures so operate, as, in such circumstances, to render
the expediency of the practice questionable?
In order to decide this, let the nature and amount of these failures be
ascertained and estimated.
The description of those cases of Small Pox, (if they can be called so,)
which occur in vaccinated subjects, is shortly as follows:—The invasion
and eruption in every respect resembles that of the genuine Small
Pox. I have seen it attended with high fever and a thick crowded crop
of papulæ, such as precedes the most severe and dangerous cases of
the confluent kind. This runs on till the fifth day from the eruption,
both days included, at which time some of the papulæ begin to be
converted into small sized pustules. The disorder then abruptly stops
short. On the following day the fever is found to have subsided, with a
shrivelling and desiccation of the eruption, and recovery proceeds
without the least danger or inconvenience. The face is marked, for
some time after, with brown spots, but without pits. It should never be
forgotten, that all morbid phænomena are full of varieties and
exceptions. Accordingly, though the fifth day is the most common limit
of this disorder, it sometimes stops short on the third; sometimes not
till the sixth or seventh; and, in a very few cases, it has been known to
run the common course of Small Pox. What forms the strong line of
distinction from proper Small Pox, is that, with a few exceptions, it
does not advance to maturation and secondary fever, which is the only
period of danger. I am not prepared to deny that death may not have
occurred in a few instances; nay, there seems sufficient evidence that
it actually has; but these adverse cases are so rare, as not to form the
shadow of an objection to the expediency of the general practice. A
few weeks ago at a meeting of this Society, at which forty members
and visitors were present, I put the question whether any of these
eminent and extensive practitioners had met with any fatal cases of
this kind. Two gentlemen had each seen a single case, and two other
gentlemen took occasion to say that they had each seen a case of
second Small Pox, both of which proved fatal. It is evident, therefore,
that according to that maxim which guides mankind in the conduct of
life, namely, that of acting on a general rule and average, and not on
exceptions, these adverse instances ought not to have the least
influence on practice, even though they were much more numerous.
Nor indeed do they, except in the very rare cases here cited, deserve
the name of failures; for, though they fail in preventing Small Pox, they
do not fail to prevent Death. And let me here, in the name of
humanity, beseech practitioners not to be forward in publishing single
cases of failures, real or supposed; for, when the weak minded and
uninformed hear of these failures, without hearing at the same time
that there are hundreds of cases of permanent security for every
single case of failure, they are guided by the exception, which
becomes to them the rule; their judgments being thereby most fatally
perverted.
As it is of the utmost consequence to establish the strong and
important distinction between Small Pox, properly so called, and that
which takes place after Vaccination, which may be called the
mitigated, or five day Small Pox, a few of the most impressive
testimonies respecting the safe nature of the latter may be here
recited. Mr. Brown[4], of Musselburgh, gives the detail of forty-eight
cases, in none of which did the secondary fever nor death occur. Here
was a saving of at least eight lives, at the lowest computation; for this
is the number which, by the average mortality of natural Small Pox,
would have died if the constitutions of these forty-eight persons had
not been modified by previous Vaccination. Dr. Dewar, of Edinburgh,
hearing that many vaccinated subjects had been affected with Small
Pox at Cupar in Fife, where the natural Small Pox at the same time
prevailed, he most laudably repaired to the spot to investigate the
subject. He found that fifty-four vaccinated subjects had caught the
Small Pox. All these, except one, had the mitigated or five day
eruptive fever, and livid. The fatal case was that of a child, who had a
complication of other disorders, and having died on the fifth day, the
Small Pox, according to its ordinary course of fatality, could not of
itself be the cause of death. All the rest were safe; while of sixteen
cases of the natural Small Pox at the same time and place, six died; so
that, if these fifty-three cases had not undergone the mitigating
process of Vaccination, nineteen or twenty would have perished.
Between thirty and forty cases of the same kind have occurred at
Carlisle, on the testimony of Dr. Barnes, a respectable practitioner of
that city[5]. Many proofs might be adduced from the oral testimony of
private practitioners, which would overswell this article. The only other
to be mentioned is from the Report of the Central Committee of
Vaccination at Paris, made in December last, in which the description
of the disease occurring after Vaccination corresponds exactly with the
mitigated five day cases which have occurred in Britain. They refuse
the name of Small Pox to it; but as I know from my own observation,
as well as from the testimony of others, that the matter from it does
by Inoculation give the Small Pox, we can hardly, perhaps, with
propriety deny it that name; but it should be distinguished by some
strong discriminating epithet, such as is suggested above.
As the attack of Small Pox in subjects who have undergone
Vaccination, generally occurs after a long interval, it becomes a
question whether this is owing merely to the chance of such subjects
not having been exposed to variolous contagion, or to the effect of
time in diminishing the antivariolous virtue of vaccination. The former
is certainly conceivable; but when we consider the numberless severe
proofs to which the recently vaccinated were experimentally exposed
in the early part of this practice all over Europe, from which the most
satisfactory evidence resulted; and when it is considered that, in the
great majority of cases, Small Pox has not occurred till several years
after vaccination, it seems by far most probable that the virtue of it is
weakened by time. When parents, therefore, become anxious and
apprehensive regarding the risk of Small Pox after a lapse of years, it
seems quite reasonable that they should be indulged in having the
operation repeated.
Let all this be applied to the case of a community, in which the total
eradication of Small Pox is quite hopeless. Let it be admitted that such
occurrences as have been described do frequently occur: let it even be
admitted, for argument’s sake, that every vaccinated case whatever
must of necessity and unavoidably at some time or other in future life
be affected with this mitigated species of Small Pox, would it not even
under this great abatement be one of the greatest boons that could be
conferred on humanity, being an instrument or remedy which would
disarm Small Pox of its danger? Would not the next greatest benefit to
the total extirpation of Small Pox, be the stripping it of its terrors by
rendering it safe and harmless?
It may be further remarked, that the benefit derivable from the
different proportions of the persons vaccinated to the total population,
advances in a considerably higher progression than the simple
arithmetical. It is evident that the smaller the relative number of the
vaccinated, the greater their chance of meeting with Small Pox
infection, and that though the disease which they may catch is of a
mitigated nature, it would nevertheless be desirable to avoid it on its
own account, but still more on account of the prejudice it creates.
This, in the eye of general benevolence, constitutes an additional,
though secondary motive for extending the vaccine inoculation as
widely as possible, even though the attainment of the maximum, that
is, total extirpation, should be impracticable and hopeless.
It is of the highest importance to society, that this subject should be
seen in its true light, and in all its bearings; for the frequent
occurrence of these cases of Small Pox, however safe in themselves,
have had a most pernicious effect on the credulous and ignorant, by
giving a check to the practice of Vaccination. It ought never to be
forgot that the power of Vaccination in extirpating Small Pox being
established, the question of its expediency is completely set at rest.
How many parents are there now who, from a weak distrust in the
virtue of Vaccination, have to lament the loss of a child from Small
Pox, either casual or inoculated? Many such are known to myself. It is
pleasing, however, to observe, that though this unmerited discredit
into which Vaccination had fallen, swelled the number of deaths in
London from Small Pox to 1051 in 1817, good sense is likely still to
prevail, for last year (1818) the deaths have fallen lower than they
have ever been known since the institution of the bills of mortality, the
total number being only 421[6].
On the whole matter, I believe I am speaking the language of every
man of good principles and feelings, capable of reflecting seriously
and considerately on the subject, when I say, that whenever he
applies his mind to it, he finds some new and increasing cause of
complacency and satisfaction. Viewed as a mere physical fact in the
natural history of the animal kingdom, the virtue of the vaccine virus
in resisting the action of the variolous, is, by its novelty and
singularity, highly striking and interesting to every one whose taste
leads him to take delight in contemplating and exploring the devious
ways and varied forms of Nature, as curious exceptions to the
uniformity and constancy of her laws. One can hardly contemplate
with sufficient astonishment, the extraordinary fact that a morbid
poison taken from a domestic animal should, when inserted into the
human body, shield it against the assault of one of the most fatal and
cruel maladies to which it is incident. But the importance of this, as a
physical curiosity, vanishes to nothing when the unexampled benefits
of it to mankind are fairly weighed; benefits which could never have
been dreamt of by the most sanguine philanthropist, who, in
contemplating it, finds himself lost in astonishment, at a boon to
mankind almost beyond the grasp of his mind duly to appreciate: so
that what seems at first sight merely a sportive aberration from the
usual course of things, has, by the wise dispensation of Providence,
become subservient to the most beneficent purposes: and how many
more useful discoveries may there yet be in reserve for the alleviation
of human misery, from obscure and undetected facts still lurking under
the very surface of Nature! It will in the eyes of future ages be
deemed an epocha in the destinies of the world, and one of the
highest boasts of the country in which it took its rise, with a sense of
unrequitable obligation to the individual[7] who first disclosed and
promulgated the secret, by drawing it from the dark recesses of rural
tradition, and rendering it available to the whole human race.
Such are the sentiments which must fill every well constituted mind;
and it behoves the whole medical profession, which has already done
itself so much honour by the zealous and disinterested encouragement
afforded to it, to continue its efforts in eradicating every remaining
prejudice against it. It becomes Englishmen, in particular, to cherish it,
not only as the native offspring of their country, of which they have
reason to be proud, but to redeem the character of the nation from
the reproach of having, of all others, whether savage or civilized, done
the least justice to this noble discovery. It is somewhat humiliating to
reflect, that while there is no country which has received more striking
and unambiguous benefits from this discovery, there is none which
has prized it less, nor availed itself of it so little. I here allude to the
unspeakable advantage of it to the public service, both by sea and
land, in the late war, so eventful and portentous in its course, and so
glorious in its termination. Formerly, Small Pox was one of the greatest
embarrassments to the operations of armies; and ships of war were
occasionally under the necessity of quitting the sea, from the
prevalence of this disorder among their crews. Those lately at the
head of the navy and army, with that vigilant wisdom and humanity
which become those who direct the affairs of a great and enlightened
nation, recommended and enforced the practice of Vaccination in both
these departments, to the great furtherance of the public service.
Their example has by no means been followed among the civil
population of England. This is chiefly imputable to the abuse of the
press, the general licentiousness of which may be denounced as one
of the most grievous evils of this age and country, in regard to other
subjects interesting to humanity and public happiness, as well as this;
the votaries of error and depravity being more successful, because
they find more encouragement in disseminating their principles, than
the advocates of truth, virtue, and good order. There is no maxim
more true, than that the best things do become by abuse the worst,
and that in proportion to their excellence. What a mortifying contrast
does England form with Peru, where it was adopted instantly, in
consequence of a flash of conviction from the light of evidence! and
was not this conviction fully justified by the immediate disappearance
of Small Pox from that whole region? To those nations who may feel
an envy of the glory attached to our country by this discovery, it must
be no small consolation to perceive that a large proportion of the
English nation has hitherto been so besotted as not to know how to
appreciate it, nor how to avail themselves of it, and that it has
encountered more opposition among ourselves than in all the world
besides.
 TABLE I.
Years. Total Mortality Proportion. Proportion
Mortality. from to 1000.
Small
Pox.
1706 22,097 1094 1 in 20 50
1707 21,600 1078 1 20 50
1708 21,291 1687 1 12- 79
1/2
1709 21,800 1024 1 21 49
1710 24,620 3138 1 8 127
1711 19,833 915 1 21- 46
1/2
1712 21,198 1943 1 11 92
1713 21,057 1614 1 13 77
1714 26,569 2810 1 9- 106
1/2
1715 22,232 1057 1 21 47
1716 24,436 2427 1 10 100
1717 23,446 2211 1 10- 94
1/2
1718 26,523 1884 1 14 71
1719 28,347 3229 1 8- 114
3/4
1720 25,454 1440 1 17- 56
1/2
Total—350,503 27,557 1 12.7 78

In this series it appears that the deaths from Small Pox are, to the total mortality, as
1 in 12.7; that is, 78 in 1000.
 TABLE II.
Years. Total Mortality Proportion. Proportion
Mortality. from to 1000.
Small
Pox.
1745 21,296 1206 1 in 17- 56
3/4
1746 28,157 3236 1 8- 115
3/4
1747 25,494 1380 1 18- 54
1/2
1748 23,869 1789 1 13- 75
1/2
1749 25,516 2625 1 9- 103
3/4
1750 23,727 1229 1 19- 52
1/4
1751 21,028 998 1 21 48
1752 20,485 3538 1 5- 172
3/4
1753 19,276 774 1 25 40
1754 22,696 2359 1 9- 104
1/2
1755 21,917 1988 1 11 91
1756 20,872 1608 1 13 77
1757 21,313 3296 1 6- 155
1/2
1758 17,576 1273 1 13- 73
3/4
1759 19,604 2596 1 7- 132
1/2
Total—332,826 29,895 1 11.2 89
In this series it appears that the proportion of deaths from Small Pox is, to the total
mortality, as 1 in 11.2; that is, 89 in 1000.
 TABLE III.
Years. Total Mortality Proportion. Proportion
Mortality. from to 1000.
Small
Pox.
1784 20,454 1210 1 in 17 59
1785 18,919 1999 1 9- 106
1/2
1786 20,445 1210 1 17 59
1787 19,349 2418 1 8 125
1788 19,697 1101 1 17- 56
3/4
1789 20,749 2077 1 10 100
1790 18,038 1617 1 11- 89
1/4
1791 18,760 1747 1 10- 93
3/4
1792 20,313 1568 1 13 77
1793 21,749 2382 1 9 11
1794 19,241 1913 1 10 99
1795 21,179 1040 1 20- 49
1/4
1796 19,288 3548 1 54 18
1797 17,014 512 1 33- 30
1/2
1798 18,155 2237 1 8 123
Total—293,350 26,579 1 11 90.9

In this series it appears that the proportion of deaths from Small Pox to the total
mortality is 1 in 11, that is, 90.9 in 1000.
 TABLE IV.
Years. Total Mortality Proportion. Proportion
Mortality. from to 1000.
Small
Pox.
1804 17,038 622 1 in 27- 36
1/2
1805 17,565 1685 1 10- 96
1/2
1806 18,334 1297 1 14 71
1807 17,938 1158 1 15- 65
1/2
1808 19,964 1169 1 17- 58
1/4
1809 16,680 1163 1 14- 70
1/4
1810 19,893 1198 1 16- 60
1/2
1811 17,043 751 1 22- 44
3/4
1812 18,295 1287 1 14- 70
1/4
1813 17,322 898 1 19- 52
1/4
1814 19,783 638 1 31 32
1815 19,560 725 1 27 37
1816 20,316 653 1 31- 32
1/4
1817 19,968 1051 1 19 53
1818 19,705 421 1 47 21
Total—279,404 14,716 1 18.9 53
In this series it appears that the proportion of deaths from Small Pox to the total
mortality is 1 in 18.9, that is, 53 in 1000.
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