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196
death from small-pox in the vaccinated, yet the vaccinated are
relatively to the unvaccinated in a superior position both as
regards the liability to be attacked and the chance of the disease
assuming a severe or fatal form.
Restricting our attention, in the first instance, to the question
of liability to attack, it is right to state that in the earlier part of
the century, when cases of the failure of vaccination began to
multiply, it was urged that, inasmuch as small-pox itself did not
invariably prevent a second attack, it was unreasonable to expect
that vaccination could accomplish more. The view appeared to
receive support when experiments seemed to show that the cowpox
was merely the small-pox of the cow, and it was said the
vaccinated are protected against small-pox because they have in
fact had it. Indeed, the Select Committee of the House of Commons,
which inquired into the operation of the Vaccination Act in
1871 reported that they had no doubt "that the almost universal
opinion of medical science and authority is, in accordance with
Dr. Gull, when he states that vaccination is as protective against
small-pox as small-pox itself.
We have already shown that such protection is by no means
absolute, but we cannot recall a single witness who has been
examined by us on this question who has not admitted that whatever
may be the amount of protection afforded by vaccination,
it is at any rate less than that conferred by a previous attack of
small-pox.
The Registrar-General, in his 43rd Annual Report, thus
states the view of "the best authorities" on this point; he says,
"it is pretty generally recognised, and this on good grounds, that
the immunity derived from vaccination is both less perfect and
less permanent than that conferred by small-pox itself; its
efficacy diminishing with the lapse of time, while the protective
influence of small-pox remains practically unaltered."
Dr. Ogle thinks there is no doubt that the protection by
previous small-pox is greater than that of vaccination.