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6
Regarding the invasion of the disease, I can only say what I have
said many times before, that I consider it due to neglect of vaccination
and re-vaccination, and the inefficient performance of primary
vaccination. As regards the neglect of vaccination, I have not
much to say—the Vaccination Acts are, I believe, acting satisfactorily,
and at the present time I have reason to hold the opinion that a
very small per centage of children escape vaccination entirely. The
protection afforded, however, by this first vaccination is not lifelong,
and for a person to be thoroughly protected, he should undergo
the operation a second time, at or about the period of puberty.
I am not stating the fact too strongly, when I say that a
person properly vaccinated in infancy, and re-vaccinated at
puberty, is practically Smallpox proof for life. With regard to
inefficient vaccination, I may state here, that I consider no vaccination
efficient unless it has been performed in at least four places.
Dr. Gayton, the Medical Superintendent of the Homerton
Smallpox Hospital, writing of the epidemic, says: "The great
contrast between the vaccinated and the unvaccinated is unmistakable
and incontrovertible, and the same remark holds good as
regards the vaccinated also, the difference in the latter being, that
in some of them, the disease is of a mild form, in others, most
severe, sometimes terminating in death." Thus, of 183 having
one good mark, 19 died; of 461 with two good marks, 17 died;
of 331 with three good marks, 10 died; of 222 with four or more
good marks, 4 died, giving an average rate of mortality of 10.38 per
cent., 3.68 per cent., 3.20 per cent., and 1.80 per cent, respectively,
or taking all good cicatrices together, whether they be one, two,