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136
same disease. This affords support to the view that vaccination
is of protective value against a fatal result in the case of persons
attacked by Small-Pox, and that its protective power is greatest
during the early years after vaccination has been performed. We
are unable to see that any satisfactory explanation has been given
of the phenomenon now under consideration except that just
indicated. We are indeed quite unable to appreciate the bearing
of some of the circumstances which have been put forward as
explaining it. As to others, such as improved sanitation, we have
already pointed out that they do not really afford any explanation
of the phenomenon when viewed, as it must be, in connection
with the age-incidence and mortality found to prevail in the case
of other diseases.
There is further strong evidence that where attacks of SmallPox
occur the fatality is far less in the case of the vaccinated than
of the unvaccinated, and that this difference is much more marked
in the first 10 years of life than at a later period. We have given
full effect to all the considerations which have been urged with
the view of showing that the division into vaccinated and unvaccinated
cannot be relied on as accurate. We quite admit that
absolute accuracy may not have been obtained in any of the
instances in which this discrimination has taken place, but looking
at the matter fairly as a whole, we cannot but believe that the
division may for all practical purposes be regarded as substantially
accurate. Indeed, for the most part it would seem to err, if at all,
in representing the vaccinated class as comparing less favourably
than it really ought with the unvaccinated, for all cases of doubtful
or alleged vaccination have been included in the vaccinated class,
and whatever errors there may have been in erroneously
placing vaccinated cases in the unvaccinated class, we think
that they are counterbalanced by errors in the opposite
direction. We think the improbability extreme, indeed it seems
to us to reach the point of incredibility, that the fatality in classes
of persons discriminated on different occasions by so many
different observers, only on the ground that vaccination was