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there are sufficient reasons for placing Typhoid Fever on another footing
altogether. We should be led to think it likely that for some reason or
another, fewer, far fewer children died of Small Pox than ought by
analogy to die, or that it was a disease which was more fatal later in life
and especially between the ages of 20 and 40 (see Table I.). Now there is
no doubt that it is a disease that spares no age and therein differs in degree
at any rate from the other fevers just mentioned, but from the vaccination
statistics we are warranted in concluding that the comparatively small
mortality among children is due to the effect of Vaccination, and that the
large number of deaths between 20 and 40 points to the necessity of
Re-vaccination at some earlier period, preferably between 10 and 15 years
of age, as that is the period when least deaths occur, in other words the
deaths which might have been prevented by Re-vaccination begin to be
more numerous after that period is passed.
Unvaccinated Children under one year old scarcely ever recover from
Small Pox: of unvaccinated children under 5 years of age admitted to various
Hospitals during the late epidemio 61.15 per cent. died, while of the
vaccinated only 19.48 per cent. died; of unvaccinated persons of all ages
44.8 per cent. died, of vaccinated 10.15; this shows us that like the other
contagious fevers, Small Pox is, apart from vaccination, more fatal to
children than to adults; or to put it still more obviously, out of 708
unvaccinated children under 5 years of age, 433 died, or 61.15 per cent.
while out of 2,926 unvaccinated persons of all ages over 5 years, 1195 died,
or 40.84 per cent. The above facts I have gathered from the Report of a
Committee of the Managers of the Metropolitan Asylum District, which
has just been issued: now I also find there some very interesting statistics
showing the effect of inefficient vaccination; among vaccinated persons
the mortality varied gradually from 5.5 per cent. among those who had 5
or more vaccination marks, to 15.2 per cent., among those who had only
one mark, showing conclusively the desirability of vaccination being so
effectively performed as to produce several permanent cicatrices. Another
very interesting fact related in the report is, that of upwards of 14,800
cases received into the Hospitals only four presented proofs of having been
revaccinated. Cases of Small Pox after revaccination are rarer than second
attacks of Small Pox, and are much less severe; this is a result that those
who are most sanguine as to the advantages to be obtained from efficient
vaccination and revaccination could hardly have hoped to obtain.