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(450) A second inspection in the third week after vaccination
should be obligatory, and parents should have the right of
summoning the public vaccinator in case of any unfavourable
symptoms prior to the time fixed for inspection.
D.—As to what means other than vaccination can he used
for diminishing the prevalance of small-pox, and how far such
means could be relied on in place of vaccination.
The. Commission thus sums up the first part of this inquiry:—
(499) We think that a complete system of notification of the
disease, accompanied by an immediate hospital isolation of
the person attacked, together with a careful supervision or,
if possible, isolation for sixteen days of those who had been
in immediate contact with them, could not but be of very
high value 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 arrangement 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.
Of course, also, thorough disinfection, and measure,
calculated to promote the public health, the prevention of
overcrowding in dwellings or on areas, cleanliness, the
removal of definite insanitary conditions, &c.
Tlie latter part of the question is thus answered:—
(503) 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 system of dealing with small-pox, and that
which had been substituted for vaccination proved ineffectual
to prevent the spread of disease (it is not suggested that it
could diminish its severity in those attacked), it is impossible
to contemplate the consequences without dismay.