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taking duty, is to the same effect. The efficiently
vaccinated escape attack, the others, sooner or later,
pay the penalty for their temerity.
If sanitation were the prime, or even an important
factor in producing the diminished mortality from this
disease, it would be reasonable to expect that the
reduction would affect all ages equally, or nearly so.
As a matter of fact, the change in the incidence of
the mortality of smallpox is most striking and
unparalleled in epidemiology. In the " good old
days," smallpox was as much a disease of infancy as
are measles or whooping-cough at the present time, and
the mortality fell particularly on the earlier years of
life. Now the disease is rare among the very young
in well vaccinated communities, and the mortality falls
chiefly on those at the more advanced ages of life.
In substitution for compulsory vaccination, the
dissentient Members of the Commission recommend
quarantine and hospital isolation, both to be of the
most compulsory character possible. They do not
suggest how the officials necessary for enforcing such
measures are to be protected from themselves taking
the disease, or from spreading the infection to others.
It is to be presumed that only those who have had
smallpox at some earlier age would be thus employed,
and for the securing of such officials a most extravagant
waste of life and the infliction of much unnecessary
suffering would be inevitable. Compulsory quarantine