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contagion, by removing the first patients attacked in a locality to a
hospital or other fitting place for treatment. The first means, namely,
affording the protection of vaccination hardly needs explanation. The
number of persons who still prefer Small-Pox to vaccination is very
small, and their prejudices are opposed to the safety of their neighbours,
and to the laws enacted for the general security. The only question,
then, in reference to this point is, whether the means provided for
vaccinating are sufficient. I submit that the Table laid before you,
showing the progressive fall in the proportion of registered vaccinations
to births from 69 per cent. in 1856 to 40 per cent. in 1862, and 56
deaths from Small-Pox during six months, are proofs beyond dispute of
the need for more extended facilities for vaccination. I felt it my duty,
in a report dated the 30th January, 1863, to submit to the Vestry the
desirability of suggesting to the Board of Guardians the expediency of
appointing additional vaccinators, especially in the more densely-populated
districts. That report was adopted, and the recommendation was
accordingly forwarded to the Board of Guardians. It is fair to state
that a theory has been advanced to the effect that good vaccination is
secured by centralising the stations, and limiting the number of public
vaccinators. This opinion is based on the fact that it requires a
considerable nnmber of children to come yearly under the hands of one
vaccinator, to enable him to keep up a good supply of vaccine lymph.
This consideration is entitled to some weight if applied to sparse rural
districts. But the cases is very different in a thickly-populated town
district like Shoreditch. The great fact that under a too limited number
of official vaccinators, a very large proportion of the children born
remain unvaccinated, is a sufficient proof of its fallacy. If there were
more vaccinators, it is reasonable to conclude that many children who
do not find access to a public vaccinator would be protected.
The use of the second remedy, the removal of patients as soon as
attacked, will be manifest on considering the following facts. If, in a
crowded house or court, containing, as is sure to be the case, many unprotected
persons, one individual is seized with Small-Pox, there is
established a focus of contagion whence the disease will speedily be
propagated. Every fresh patient attacked is an additional centre of
contagion. And this is not all. Every patient fouls and infects a