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in diminishing the prevalence of Small-Pox. It would be necessary,
however, to bear constantly in mind as two conditions of
success, first, that no considerable number of Small-Pox patients
should ever be kept together in a hospital situate in a populous
neighbourhood, and secondly, that the ambulance arrangements
should be organised with scrupulous care. If these conditions
were not fulfilled, the effect might be to neutralise or even do more
than counteract the benefits otherwise flowing from a scheme of
isolation.
The question we are now discussing, must, of course, be
argued on the hypothesis that vaccination affords protection
against Small-Pox. Who can possibly say that if the disease
once entered a town, the population of which was entirely or
almost entirely unprotected, it would not spread with a rapidity
of which we have in recent times had no experience, or who can
foretell what call might then be made on hospital accommodation
if all those attacked by the disease were to be isolated ? A priori
reasoning on such a question is of little or no value.
We can see nothing, then, to warrant the conclusion that in
this country vaccination might safely be abandoned, and replaced
by a system of isolation. If such a change were made in our
method of dealing with Small-Pox, and that which had been
substituted for vaccination proved ineffectual to prevent the
spread of the disease (it is not suggested that it could diminish
its severity in those attacked), it is impossible to contemplate the
consequences without dismay.
To avoid misunderstanding, it may be well to repeat that
we are very far from underrating the value of a system of isolation.
We have already dwelt upon its importance. But what it can
accomplish as an auxiliary to vaccination is one thing, whether it
can be relied on in its stead is quite another thing.
Our attention has been drawn to the circumstances that outbreaks
of Small-Pox have not unfrequently had their origin in the