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being, during this Quarter, 4 per cent. above the normal rate of the badlyvaccinated
cases, it is manifest that vaccination is very badly performed.
It therefore behoves those in authority to consider what further measures are
necessary not only for enforcing the universal practice of vaccination, but
for securing a greater degree of success in vaccination than at present
prevails ; and here I venture to suggest to the medical profession whether
the lack of success is not largely due to the inability of private practitioners
to secure " arm to arm vaccination," and whether iu the public interest
many practitioners might not be disposed to give up the practice of vaccination,
and refer their patients to the public vaccinator of the District.
It may be a sacrifice to some medical practitioners, especially to those
who have a large practice, and who have always a good supply of
lymph, to yield to my suggestion; but wheD such facts as I have brought
under public notice relating to the imperfect manner in which vaccination is
performed are known, I am persuaded that, for the public good, many will
make that sacrifice.
The two points for consideration which are suggested by the returns
of the Registrar-General, are 1st, as to the best means to be adopted for
inducing parents to get their children vaccinated, and, 2nd, as to the
securing of the best means for the better performance of vaccination. As
regards the first, I feel disposed to suggest that a small voluntary association
should be formed in every District, for the purpose of visiting the
inhabitants of the poorer localities during the prevalence of small-pox. Any
one member of this association who would address a few words of kindness
to the mother of a family, and explain to her the law relating to vaccination
and the importance of it as being the only known means of averting the
disease, would confer a greater amount of benefit on the community than
now results from the visits of the public Vaccination Officer. Not, however,
that the visits of the one should supercede the visits of the other; but it is
not improbable that if the visits of the proposed voluntary association
were made in the manner suggested, the visits of the paid officer would
be the less necessary. As regards the second, if private medical
practitioners should not feel disposed to make so great a sacrifice as
my suggestions imply, there can, in my opinion, be very little objection
in requiring every medical practitioner who vaccinates a child, not only
to state that the operation has been "successfully" performed, but to
insert in the certificate the number of places in which the operation
has been successful, and such certificates should be sent to a public office
and there kept for inspection and reference.
In my two last Quarterly Reports I made favorable comments on the
manner in which the Public Vaccinator, Mr. Charles Blackman, and the
Vaccination Officer, Mr. COOMBES, respectively perform their duties; and
the beneficial result of their labours is shown in the relatively small mortality