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of all eases of this nature which have occurred during the last
six years. There have very likely been many cases which have
not come to our knowledge, where the inflammation set up has
been more than usual, and some where a slight attack of
erysipelas has resulted. But when we consider that the fact that
we were engaged upon this inquiry has been thoroughly well
known, and that active organisations and zealous individuals
were at work, searching out cases in which the results of vaccination
had been abnormal, with a view to bring them under our
notice, and that some of those which we were asked to investigate
turned out to be of a trifling or unsubstantial nature, we think we
are able to form a fairly accurate estimate of the amount of
injury which can be plausibly attributed to vaccination. A
consideration of all the circumstances has led us to the conclusion
that, as regards the non-fatal cases with which we are now
dealing, serious injury cannot have resulted in any considerable
number of cases.
An examination of the analysis of the fatal maladies connected
with vaccination during the period 1886 to 1891, made by Dr.
Ogle, shows that erysipelas is credited with almost one-half of
the total number of deaths. To these a considerable number is
to be added, where inflammed arms occurred, but in which the
disease did not receive the name of erysipelas, though it was
probably allied to it. Next in number conies the class, which
includes pyaemia, septicaemia, and blood poisoning. If this class
be added to cases of erysipelas and maladies allied to it, they
account altogether for two-thirds of the cases in which the cause
of death has been connected with vaccination. An examination
of the particulars of the cases of alleged deaths and injury from
vaccination, to which our attention has been called during the
last six years, shows that the death or injury has been attributed
in the great majority of cases to one or other of these diseases,
and chiefly to erysipelas.
It must not be forgotten that the introduction into the system
of even a mild virus, however carefully performed, is necessarily
attended by the production of local inflammation and of febrile
illness. If these results did not in some measure follow, the
practice would probably fail in its protective influence. As a
rule, the inflammation and illness are of a trifling character ; in
exceptional cases, however, they may exhibit more severity,
and, as certain facts submitted to us in evidence have shown,
there are cases, though these are rare, where a general eruption
may follow vaccination.
In many of the cases which we have had to investigate, where
vaccination has been followed by erysipelas, the disease has been
present in the immediate vicinity, it cannot therefore be asserted
with certainty that in such cases the child would have escaped
erysipelas if it had not been vaccinated. Erysipelas may be
acquired without any lesion. We do not intend to represent
that the wound made in vaccination may not cause an attack of
erysipelas, where, if there were no lesion there would be no such
attack, but only to suggest that caution is necessary, and that it
would be an error to refer all cases of erysipelas, or allied
diseases, occurring after vaccination to that operation as their
cause.