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18
and 100 are not—a vaccination default found in the London District
for years—and in each class there were 20 cases of Small Pox, this
number would represent 20 per cent. of the unvaccinated and rather
more than 2 per cent. of the vaccinated; so that, although the actual
number of cases of Small Pox in the two classes were the same, the
fact would be that, proportionately, about 10 times as many of the
unvaccinated would be attacked as of the vaccinated
Again, supposing the conditions were altered, and that the
community was badly vaccinated, so that there were equal numbers of
unvaccinated and vaccinated; if the ratio of attack were the same as
before, there would be about 100 cases amongst the unvaccinated and
10 amongst the vaccinated. This is the clue to the solution of the
difficulty. In Gloucester the vaccination default between 1885 and
1894 varied from 10 to 85.1 per cent. Middlesborough was well
vaccinated. In the former town there were 680 eases of Small Pox
with 279 deaths amongst the unvaccinated, and 26 attacks and 1 death
amongst the vaccinated ; in the latter town there were 62 attacks and
29 deaths amongst the unvaccinated, and 43 without one death amongst
the vaccinated. In London, where the default of vaccination was
intermediate between the two, there were 95 attacks and 52 deaths
amongst the unvaccinated, to 12 attacks with no deaths amongst the
vaccinated
The frightful mortality amongst the unvaccinated children
attacked—(namely in round numbers 46, 41, and 58 per cent.)—shows
that in these outbreaks amongst the infected children, at any rate,
Small Pox had lost none of its virulence; the mortality amongst
children which occurred in pre-vaccination times may be gathered from
the two diagrams 4 and 5 at the end of this book, which I have
expressly given for the purpose of the comparison. They show the
total number of deaths from Small Pox at each age up to 10; at
Pudsey, from 1776 to 1810 (Hunter), and at Kilmarnock, from 1728
to 1763 (McVail).
The tables which have been quoted all tell the same tale in
different ways. They show (1) that the vaccinated are less liable to
attack on exposure to Small Pox; (2) that they are less liable to suffer
severely or to die if attacked; and (3) where the ages are specified
they show that the maximum protection amongst the vaccinated is
found in the early years of life, and that the maximum incidence of
Small Pox amongst the unvaccinated is in childhood. If, in fact, the
diminution in the mortality from Small Pox amongst children is due
to the effect of vaccination, it should be possible to show that it is
coincident with and proportionate to the efficient performance of the
operation. This is comparatively easy. Diagram 6 gives the