* Vaccination*
« 0*pt
Dr. Joseph F. Edwards.
 
NLM001223955 
-«2

 
 
VACCINATION. 
VALUABLE  BOOKS.
BY THE  AUTHOR OF  VACCINATION.
MALARIA.    WHAT  IT  MEANS   AND  HOW
  AVOIDED.  Its Causes, Consequences, etc.  i2mo.  Cloth.
  Price 75 cents.
DYSPEPSIA,  AND  HOW  TO  AVOID  IT.  i2mo.
    Cloth.   Price 75 cents.
HOW A PERSON THREATENED OR AFFLICTED
  WITH BRIGHT'S DISEASE OUGHT TO  LIVE.
  Second Edition.  i2mo.   Cloth.  Price 75 cents.
CONSTIPATION  PLAINLY TREATED WITHOUT
  THE USE OF DRUGS.   Now Ready, Second Edition,
  with additions.   i2mo.   Cloth.  Price 75 cents.
  The author of these little books believes that the many slight
ailments of  mankind can  be prevented if people only under-
stood  their nature, and the proper way of living.  The books
are  written in  plain,  untechnical  language, and the thousands
sold testify to their popularity and  usefulness.
  For sale by all booksellers, or will be sent, postpaid, upon
receipt of price.  See page  two of catalogue at back of this vol-
ume.
             P.  BLAKISTON, SON & CO.,
        PUBLISHERS  AND  BOOKSELLERS,
                 1012 Walnut St.,  Philadelphia. 
VACCINATION:   J
ARGUMENTS PRO AND CON.
WITH A CHAPTER
THE HYGIENE OF SMALLPOX.
JOSEPH F. EDWARDS, M.D.,
AUTHOR OF " HOW A PERSON THREATENED OR AFFLICTED WITH BRIGHT's
 DISEASE OUGHT TO LIVE," CONSTIPATION PLAINLY TREATED AND RE-
  LIEVED WITHOUT THE USE OF DRUGS," " DYSPEPSIA, AND HOW TO
  AVOID IT," " MALARIA : WHAT IT MEANS AND HOW AVOIDED."
   ASSISTANT EDITOR MEDICAL AND SURGICAL REPORTER,
            ETC., ETC.
V
gconG£"rjT
                 V r
      PHILADELPHIA:    v> "I "'-£»_ *--;----v*
P. BLAKISTON, SON & CO.,
    IOI2 WALNUT STREET.
1882. 
       W(3H


F''**  c?^f   Z/C-*~   |
Entered according to the Act of Congress, in the year 1882, by
         P. BLAKISTON, SON & CO.,
in the Office of the Librarian of Congress, at Washington, D. C. 
CONTENTS.
                   PART FIRST.

VACCINATION—WHAT IT IS—HOW DISCOVERED—WHAT IT
    DOES,.........9

                  PART  SECOND.

ARGUMENTS IN FAVOR OF VACCINATION—HOW TO VACCI-
    NATE,    .........23

                   PART THIRD.

ARGUMENTS AGAINST VACCINATION,                   50

                  PART FOURTH.

HOW TO OVERCOME THESE OBJECTIONS,     .     .    .   60

                   PART FIFTH.

HYGIENE OF SMALLPOX,......68 
\ 
PREFACE.
   In a few simple words will be given* the reasons
 why this little book has been written.  The fact that
 certain persons, more particularly in the Old World,
 have recently attempted  to  cast vaccination  into
 disrepute, and have, by numerous devices, sought to
 prevent persons from resorting to it  as a preventive
 against smallpox,  has induced the author to make an
 impartial study of the question.
   Information has been gathered from all  available
 sources, and the question has  been viewed  carefully
 and from an impartial standpoint,  with the result
 of convincing the author that in vaccination properly
 performed, and in this measure alone, can we find
 immunity from this terrible disease.
  The reasons that have led  him to this belief will
be given, so that the reader may form his own con-
clusions.
                      vii 
viii                  PREFACE.
  It has seemed wise to " take the bull by the  horns,
as it were," and to anticipate the opposition which
is as yet  only in its incipiency in this  country, but
which, if not checked in the bud, may blossom into
dangerous fruit.
  After  discussing the question  of  vaccination, a
short chapter will be found on the hygiene of small-
pox.
  It is sincerely hoped and confidently trusted that
the questions herein  discussed and the  facts stated
may result  in convincing all who read of the efficacy
of vaccination. 
VACCINATION.
               PART  FIRST,
VACCINATION--WHAT IT IS--HOW DISCOVERED—WHAT
                   IT DOES.
  Most  persons have  only a hereditary and very
illy-defined notion of vaccination.  They regard it
as a something, as a mysterious operation, which if
successful, if it takes, confers upon them  immunity
from  smallpox; but what it really means,  how it
originated, why it protects or how it acts, they know
not; no one has ever told them.  Their parents before
them have been vaccinated, and so when an epidemic
of smallpox comes around, off they run to the doctor
and  are vaccinated, because they have  the idea,
gained in some vague way from  parents or friends,
that this little operation has some mysterious power
to protect them from the disease.  But they know not
how to reason for themselves concerning it, and how
to determine whether  or not they  are receiving a
benefit from it.
  Therefore they are ready to receive the conclusions
  b                   9 
10
VACCINATION.
of anti-vaccinators, if perchance they happen to know
of a single instance of unfortunate results from vaccin-
ation among  their  friends,  without being able to
intelligently reason for or against the operation.
   If they know all about it they are better prepared
to use their intelligence so as to determine for them-
selves  whether or not the operation should be per-
formed upon them.  In this belief, I deem it wise to
place the whole question before the thinking public.
   I will  now, for a brief space, in plain words, tell
you  what vaccination means.
   Vaccination consists in an  operation by which the
system of man is so impressed by the introduction of
a foreign substance, and  the blood so altered by
changes which this matter produces therein, that even
though the successfully vaccinated person may there-
after be  exposed to the  influence of the smallpox
poison, yet it  will not find  in his system the con-
ditions necessary for the development of the disease.
This is, in a small compass, a comprehensive defini-
tion of vaccination, and it is  my purpose in this little
book to be  brief;  I  do not  intend to waste any
words, but to give you, in as short a space and as con-
cisely as possible, the principal points  of the subject 
HOW DISCOVERED.
11
under consideration.  By doing so, I feel that you
will read it, while, were I to be tiresomely verbose, you
would cast it aside, and  my purpose in preparing it
would be defeated.
  The interesting points touching the discovery of
vaccination  next claim our attention.  Some  of the
most wonderful and important discoveries of the world
have been, as it were, the result of accident, of chance;
that is  to say, chance has brought to the notice of
some master mind capable of utilizing and develop-
ing them, the phenomena or material from which great
discoveries have  been made.  Vaccination is a re-
markable illustration of  this proposition.
  Towards the close of the last century, a young man
named Jenner was studying medicine in  the house of
Mr. Ludlow, a surgeon of Sodbury, near Bristol.  It
was customary for the young student  to be  present
when his master was treating patients, in order that
he might become practically familiar with the means
of detecting and  curing disease.   One day, a young
country woman came to the office of Mr. Ludlow for
treatment, and while  there, the question  of small-
pox  coming up, she  innocently  and thoughtlessly
made the remark, '' / cannot take that disease, because 
 iz                VACCINATION.
 / have had cowpox.''   She little thought that by this
 simple  remark she was laying the foundation for  a
 discovery  that  would  electrify  the  world.  The
 active, penetrating mind of Jenner was struck by the
 remark.   He treasured  it  in  his memory, and never
 missed  an opportunity of verifying the truth of this
 carelessly uttered statement.
   He found  it to be a  common belief among dairy-
 maids, that those who had once had  cowpox en-
 joyed an  immunity  from  smallpox.  Observation
 convinced him that  this  belief was more than a
 superstitious notion ; he soon saw that there was much
 truth in  it, and he commenced to reason something
 after this fashion.
  If cowpox naturally produced does give immunity
 from  smallpox,  why  will  not the  same  disease
 artificially  developed confer the  same protection.
 He was laughed at and ridiculed, as  all  great dis-
coverers  ever have been.  He  was, however, firm in
 his  belief of the truth  of his  idea,  and, nothing
daunted, pushed forward in his good work, that was
destined to make his name immortal.
  For more than twenty-five years Jenner and his
theory were sneered at.   The public paid no attention 
                 HOW DISCOVERED.              13
 to it or him, while physicians pooh-poohed the idea
 as preposterous.   Finally, Jenner's  triumphal day
 came.  The day  that should be  forever celebrated,
 throughout the civilized world, as the one on which
 was made  public and demonstrated as  potent  the
 greatest discovery in preventive  medicine that  has
 ever occurred in the history of the world.
   On the fourteenth day of May,  i/p6, Jenner vac-
 cinated  James Phipps, and with all the  nervous
 anxiety of Fulton waiting to see his little boat move
 when  the  steam was turned   on, he  waited and
 watched.
  To his unspeakable joy, he  saw all the different
 stages of  vaccinia  or cowpox  occur regularly and
 perfectly, when, with an exultant shout, he cried out
 to his hitherto sneering confreres, " Behold the con-
 summation of my dream.''
  Still he had many trials  yet to  endure before his
 newly discovered and demonstrated fact became a
 generally accepted  one.  Just  as we declared  our
 independence from Great  Britain in 1776, and then
passed through eight years of doubt and uncertainty
before this declaration became  an accomplishment,
so poor Jenner was doomed  to  undergo many tribu- 
14                VACCINATION.
lations before his ridiculed  announcement of  1796
became an  enthusiastically accepted  fact in 1799.
In 1798 he wrote and published a work containing
the evidence he  had accumulated  concerning vac-
cination, which, though very convincing, still left
many in doubt, so conservative were the  physicians
of Great Britain and so indisposed  to  believe in his
wonderful discovery.  The truth must always prevail,
however, and finally, in 1799, about seventy of the
most distinguished physicians and surgeons in London
signed a declaration of their entire  confidence in the
benefits and advantages of his discovery.   When
once accepted, it was but a short time before this dis-
covery became known everywhere,  and the name of
Jenner was  enrolled  prominently  among the great
men of the world.  Honors were now heaped  upon
him; he was made an honorary member of  all the
principal learned societies of  the  world, while the
English Parliament voted  him grants aggregating
one hundred and fifty thousand dollars.
  It will now be in order to  examine into the manner
of action of vaccination,  and  to ask  how it  affords
protection.
  In this connection, it will be possible only  for us 
  I


                  WHAT IT  DOES.               15
to understand the facts;  the minute questions and
reasons why these facts are facts, will, I fear, ever
remain an impenetrable mystery.
  Smallpox belongs  to a class of diseases known  to
the physicians as " Zymotic diseases.''  This means a
disease that is produced by a species of fermentation
in the blood.   The active poisonous agent is  intro-
duced into the body, and meeting in the blood with
some necessary elements (the nature of  which we
know not) a sort of fermentative change takes  place,
and  the resultant product of  this process  is the
particular disease under consideration.
  For this change to be produced it is necessary that
the poison introduced from without should find some
suitable elements, a favorable condition of the blood,
for its development into the disease.  If this con-
dition is not present the disease cannot be produced,
no matter how much of the poison may be  intro-
duced.  It falls upon barren ground, as it were, and
its power for evil becomes absolutely nil.
  This will  explain to you the apparently mysterious
fact that while a given  number  of persons  may  be
exposed to contagion, yet only a limited number are
afflicted with the disease, since the blood of the rest 
16
VACCINATION.
happens to be  in such a condition that it will not
furnish the necessary elements for development of the
poison.
  Thus, then, you will be prepared to understand that
for the development of smallpox in  an individual,
two conditions are absolutely essential, and without
them the disease cannot exist,
  First, the poison must enter the system, and sec-
ondly, having gained access to the blood it must find
therein conditions for its growth and development.
It must be planted in good soil,  suitable to produce
a crop  of smallpox,  as it  were,  else, like vegetables
planted in unsuitable ground, you will never see any
more of it.   What these conditions are, of course, we
do not  know ; science has not yet been able to pene-
trate this mystery, and we can only determine  the
presence of this state of the blood in one of two
ways,  either by  exposing ourselves  to  smallpox,
when,  if they exist, we will take the disease—a very
bad and not to be desired  test—or by vaccination.
  You will now be almost prepared to anticipate me
when I say that vaccination confers immunity from
smallpox by  so altering the condition of  the blood
that when the poison of the disease is introduced sub- 
                  WHAT IT  DOES.                17
 sequently, it falls upon uncongenial soil; it does not
 find the necessary conditions, and  the disease is not
 developed.  So thought Jenner, and such  has  sub-
 sequent experience proven to be the case.
   When  a person  is vaccinated  successfully,   the
 matter placed on the abraded surface is absorbed into
 the blood and produces a constitutional disease known
 as vaccinia.  It circulates throughout every portion of
 the  body,  and hunting  up the  various  elements
 necessary for the development of smallpox, alters or
 destroys them.  It is  at the present time a mooted
 question whether vaccinia is a distinct disease ox is a
 modified form of smallpox.  This, however, is of no
 practical   moment,  since we  do   know   that  it
 possesses  the  alterative  or  destructive  power  de-
 scribed, and this is what we desire.  It may be a
 matter of scientific interest or curiosity to determine
 the identity or non-identity of the  two diseases, but
 for all practical purposes we  know now  as  much  as
we require.
  So, then, vaccination affords protection*from small-
pox, by producing in  the body a constitutional  dis-
ease, which runs a regular course,  that is similar to
and possibly identical  with smallpox itself, but of a 
18                VACCINATION.
character so mild as to be utterly and entirely harm-
less, but which so alters the condition of the blood
as to render the development of the disease itself in
its more virulent form almost an  impossibility and
certainly a very great rarity.
  For many years previous to  Jenner's  great  dis-
covery an operation   for protection against smallpox
was resorted to, which was known as inoculation.   It
consisted of inserting beneath the skin  some  of  the
matter from a smallpox sore, which produced in  the
person so  inoculated true smallpox, but of a type so
mild as to prove but very rarely dangerous, while at
the  same time, it afforded, in the large majority of
cases, protection  against  a subsequent  and  more
severe attack  of the  disease.   This practice of in-
oculation was in vogue in very  early  days.   The
Chinese had resorted to it  more than twelve hundred
years ago, and according to Collinson * it was in use
in  Persia,  Armenia  and  Georgia  many centuries
since.
   But since inoculation really produced smallpox,
it proved  to  be more of an evil  than a  benefit,
because  when  one  man,  say,  was inoculated  and
  * Smallpox and Vaccination Historically and Medically Considered. 
                  WHAT IT DOES.               19
 received smallpox, he might be  the means of com-
 municating the disease, in  an aggravated and  fatal
 form, to many who had not been inoculated; because,
 as you can understand, the  man  who had been in-
 oculated successfully had smallpox as truly and com-
 pletely as  any one could have it, only it developed
 less dangerous symptoms, and was much less likely
 to prove fatal than when contracted in the ordinary
 way.   Still it was and is a fact, that a man with a
 walking case of smallpox can communicate a  fatal
 attack of the disease to some neighbor.  Hence these
 inoculated persons were deadly enemies going about
 among their fellows, and carrying disease and death
 to all who had  not been  inoculated.  Had every
 person been inoculated, then indeed would this pro-
 cedure  have been  a  blessing, and  surely would it
 have prevented the ravages  of smallpox.  But  such
 not being the case, inoculation became more of an
 evil than a blessing,  since  it tended to  perpetuate
and even  to increase  the  afflictions of  smallpox.
Hence  inoculation was unsatisfactory,   and being
pronounced injurious, fell into disuse :-L-
  Soon  after the  true  danger of  inoculation was
recognized, Jenner made his great discovery, which 
20
VACCINATION.
in substance is  as follows, as stated by Jenner him-
self in his " Inquiry into the causes and effects of the
 Vatiola Vaccina," published in 1798 : —
   1st.  This disease (vaccinia) communicated to man
has the power of rendering him insusceptible to small-
pox.
   2d.  That the cowpox or vaccinia might and can
be communicated from the cow to man.
   3d.  That the cowpox  once ingrafted on  the hu-
man subject might be continued from individual to
individual by successive transmissions, conferring on
each the same immunity from smallpox as was en-
joyed by the one first infected direct from the cow.
  In other words,  it was and is believed that the
artificial production of cowpox  in the  individual so
alters some  of  the  constituents of the  blood, that
even though the poison of true smallpox  may be
introduced therein,  it will not find the elements and
conditions  there necessary for  the  development of
the disease, since the poison of cowpox has destroyed
or altered these elements or conditions.  So, then,
vaccination confers immunity from smallpox by alter-
ing the condition of the blood from that favorable to
its development to a state in which its production is 
WHAT IT DOES.
21
 impossible.   In this belief the world was happy for
 many years,  believing,  as it  had good reasons to,
 that at last  had been discovered a means by which
 this terrible disease could be driven out of existence.
 They were undoubtedly right in this belief, if subse-
 quent experience is to be relied upon.
   Human  nature is ever restless and uneasy, how-
 ever, and some one must always be agitating and dis-
 cussing every question that exists,while,unfortunately,
 there are and ever have been  many narrow-minded
 men, who,  viewing a subject only from  their own
 standpoint, and neglecting to go around and  inspect
 the other side of the question, have judged partially
 and unjustly, when, I am sorry to say it, they  find all
 too many men ready to blindly follow the erroneous
 and pernicious  doctrines that they promulgate.
   For many  years vaccination was  accepted  by the
 universal world as an  almost  absolute  protection
 against  smallpox.  Lately, within a very short time,
 some German physicians have raised a hue and cry
against  this  beneficent  and  divine  discovery, and
have attempted to cast it into disrepute.
  The agitation has been taken up  in  England and
has gained  many adherents,  while  in  this country
the anti-vaccination fever has but just commenced, 
22
VACCINATION.
and will require heroic treatment to throttle it in its
infancy, ere it gains strength and vigor.
  The anti-vaccinators have undoubtedly some good
reasons for their course, but they fail to make a dis-
tinction between the end to be  acquired and the
means by which this end is accomplished.   Because
vaccination does in some cases, and, unfortunately, in
a good many, produce worse evils than  smallpox
itself would or could, therefore they reason that vac-
cination is  wrong and  should be abolished.  They
condemn  the entirety  without  considering or  en-
deavoring to correct the particulars that make  this
entirety dangerous.
  That there are certain dangers to be dreaded, that
certain evil results can and do occur from vaccina-
tion as practiced to-day, no reasonable man will or
can deny.   Whosoever has had experience with vac-
cination must oft and again have found this to be too
true.  The fault, however, does not lie with vaccina-
tion, but is to be found  in the vaccinators,  who per-
form their work incorrectly  and with improper  ma-
terial.  Many good things have fallen into disrepute
and disuse through the fault of man, and not through
any inherent short-coming in the thing itself.  Vac-
cination is  a remarkable illustration of this truth. 
DOES IT PROTECT ?
                 PART SECOND.

    ARGUMENTS IN FAVOR OF VACCINATION—HOW TO
                     VACCINATE.

     " To vaccinate or not, that is the question !
       Whether 'tis better for a man to suffer
       The painful pangs and lasting scars of smallpox,
       Or to bare arms before the surgeon's lancet,
       And, by being vaccinated, end them.  Yes !
       To feel the tiny point, and say we end
       The chance of many a thousand awful scars
       That flesh is heir to—'tis a consummation
       Devoutly to be wished.  Ah !  soft, you, now,
      The Vaccinator !   Sir, upon thy rounds
      Be my poor arm remembered."           —Punch,

   Our humorous friend,  Punch, concisely puts the
question that is to-day agitating medical minds, when
he says "To vaccinate or not."
   We will now see whether vaccination does  really
afford protection  against  smallpox.   In  order to
form a correct estimate of the subject, we will select
from current  medical  literature  the  opinions  and
experiences relating to the  question, and allow you
to draw your own  deductions from them.
   The British Medical Journal says:  "The wicked- 
24
VACCINATION.
ness of encouraging the anti-vaccination agitation
could not, it is opportunely pointed out by the Globe,
be  more strikingly  proved than by  an account  it
printed of an outbreak  of smallpox at Rotherhite.
' A leading anti-vaccinator,  Escott by name, who
had none of his children vaccinated, has lost his wife
and two children by smallpox, and four others have
had the disease.    Escott borrowed a  suit  of mourn -
ing from a friend, named Angus, to attend his wife's
funeral, and returned the clothes without disinfection,
with the result, that the lender caught smallpox and
died.   Since then, nearly every house in  the neigh-
borhood has been attacked, and sixteen patients have
been  removed to the hospital.' "  This is a striking
case, but I will give you so many more, that I imag-
ine I will make out a conclusive and convincing case
in favor of vaccination.
   Dr.  E. S. Snow, of Providence, commenting,  in
the Medical and Surgical Reporter, of Philadelphia,
on the prevalence of smallpox in our city during
1881 says : " No principle of sanitary science is more
positively established  than this,  that there is  an
absolutely certain individual  preventive of smallpox,
which is easily obtainable and easily applied.  The 
                  DOES IT PROTECT ?             25
  whole question of the arrest of this disease, at any
  time and in any place, is simply the question of the
  faithful  application of this  preventive, with other
  suitable  well-known sanitary measures."  This indi-
  vidual preventive is none other than vaccination with
  suitable  virus.
    Dr. Schuyler  reports the  careful records of one
  hundred and ninety-nine cases of smallpox treated
  by him in the Troy Hospital.   Of this number, only
  seventeen had been vaccinated, and of this seventeen
  only two died.    While of one hundred  and five
 who  had  not been vaccinated, thirty-three died.   He
 notes that not a single case, having a. recent vaccination,
 was admitted  during his service, and concludes by
 expressing his belief in the absolute protective power
 of vaccination.
   I will  now produce  a strong  argument from the
 home of  an ti-vaccination.  In consequence of the
 aggressive action of the  Belgian Anti-vaccination
 League, the Belgian Academy of Medicine appointed
 a committee of three members for the purpose of
undertaking an exhaustive examination of the whole
subject.   At the conclusion  of their  labors,  M.
Warlomont summed up  the results as follows :__
    c 
26
VACCINATION.
  i. Without vaccination,  hygienic measures  and
means, whether public or private, are powerless in
preserving mankind from smallpox.
  2. The belief in the danger of vaccinating and re-
vaccinating  during the presence of a variolous epi-
demic, is not justified.  We can  no more cultivate
variola by sowing vaccinia, than  we can barley by
sowing wheat.
  3. Vaccination  is always an  inoffensive operation
when practiced with proper care on healthy subjects.
It gives rise  to fewer and  less serious accidents than
simple piercing of the ears.
  4, It  is highly  desirable, in the interests of  the
health and lives of our countrymen, that vaccination
should be rendered compulsory.
  You will notice that this report does not claim that
vaccination never does harm, but it is careful to say that
" when properly performed, it gives rise to fewer and
less serious accidents," etc.   No just man will claim
that this operation never does harm, because some-
times it unquestionably does, but we  can claim that
the instances in which it is injurious are  so infinitely
few, compared with the large number in which it does
good, that they cannot constitute a valid  objection 
                 DOES IT PROTECT?             27
 to  its use.   Railroads  often  cause serious  acci-
 dents,  yet   they  are  so  clearly to the  benefit
 of  the  large  mass  of  mankind,   that  they are
 encouraged.   So, although  vaccination may,  even
 when properly performed, very  occasionally prove
 disastrous, yet  in  such  a very  large majority of
 instances does it do good that  it ought  to be en-
 couraged.
  From far-off India comes a most convincing argu-
 ment,  which  I   quote from a   medical   journal.
 "Although  the  epidemic of  smallpox Visited the
 northwestern provinces of India in a fearful manner
 causing 58,800 deaths in the  single year of 1878, all
 attempts at introducing vaccination as a protective
 measure  were resisted by  the superstitious natives.
 They looked upon smallpox  as  a visitation  from  a
 Deity, called by  them Sitta,  whose anger had to be
 appeased with special  sacrifices  and  plagues.  The
 faithful Hindoos  considered it an act of impiety to
 still  further incite the wrath of this deity by  the
administration of unholy medicines or vaccination.
In spite  of all this, however, vaccination, although
under  peculiar circumstances, was gradually intro-
duced among the natives.  The Thakers, a tribe that 
28
VACCINATION.
still  practices infanticide to a horrible extent, first
allowed their female children to be vaccinated, being
convinced of its fatal termination, and hoping thereby
to get rid of this superfluous progeny.  All the sons,
however, were carefully guarded against vaccination.
Smallpox broke out in four of their villages a  short
time afterwards, which carried off nearly all the boys,
whilst the girls escaped the disease.   This unlooked-
for termination induced the natives to  resort to the
opposite practice, compelling the boys  to  be vac-
cinated, whilst the girls were left unprotected. Besides
this, a large number of cases  were observed where
children were concealed by  their families from the
vaccinators; in  almost  all instances these died,
whilst those vaccinated escaped smallpox."  Even
one such remarkable and unanswerable illustration as
this should convince every one of the utility of vac-
cination, but I have only commenced my arguments,
and will continue to give you many more interesting
ones.
   Dr. Welch, physician-in-charge  of the Municipal
(smallpox)  Hospital of Philadelphia, in the  course of
an  address  on vaccination  says:    "In   Sweden,
during the  pre-vaccinal period, from  1774  to  1801, 
                 DOES IT PROTECT?              29
 the annual average of deaths per million of inhabitants,
 from smallpox, was 1973; after vaccination was  in-
 troduced,  but was not  obligatory,  1802-1816, the
 annual average per million inhabitants was 479; and
 after vaccination was made compulsory, during the
 period from 1817  to  1879,  tfte  annual average of
 deaths from smallpox per million of inhabitants was
 only 181.  This shows an annual saving of life of
 1792 persons  out of every million of the population
 by vaccination, and fully justifies the law making it
 compulsory.''
   Statistics collected by Mr. Marson during a service
 of thirty years in the Smallpox Hospital of London,
 show that out of 15,000 cases  the unvaccinated died
 at the rate of thirty-five per cent., while among those
 who had been vaccinated the death rate was only six
 and one half per cent.
   Again, in Dr. Welch's experience of four thousand
 cases, the unvaccinated died at the rate of sixty per
cent., while among those who had been protected by
vaccination the death rate was only ten per cent.
Still further, he says: " During the last twelve months
I have had under my care at the  hospital  twelve
hundred  cases of smallpox, and of this  number only 
30
VACCINATION.
one had been recently vaccinated, and this case termi-
nated in recovery."
   In Germany vaccination is regulated by law, and
when a man enters  the  army he  is re-vaccinated.
During the Franco-Prussian war, when  the German
army was  double  the  strength of  the  French,
there were only two hundred and  sixty-three  deaths
from smallpox among the Germans, while among the
French (with whom vaccination was not compulsory)
the loss from this disease aggregated the  enormous
total of twenty three thousand three hundred and sixty-
eight.   A very striking example of the value of re-
vaccination  is furnished in the  British  Medical
Journal.  Some  years ago, when smallpox was very
prevalent, the surgeon of a large sailing vessel  dis-
covered, when a few  days out at sea, that the captain
had secretly conveyed on board  the  vessel his  son,
who was suffering from  confluent smallpox.   The
surgeon at once procured all the vaccine lymph that
he could, and re-vaccinated as many of the crew as
possible,  One-third or  one-fourth  of  the crew
remained unvaccinated.  Of  the re-vaccinated not a
single one caught the  disease, while among those who
were not vaccinated all, or all but one or two, caught
the disease, and  three died. 
DOES  IT PROTECT ?
31
  Dr. John L. Atlee, of  Lancaster, bears  testimony
to the  wonderful  power  of  vaccination  in  the
following statement,  conveyed in a  letter  to  his
son,  Dr.  Walter  F. Atlee, of  this  city.   He
says:  "I have  tested the  efficacy"  (of vaccina-
tion) " by inoculating for smallpox after vaccination ;
have  taken  patients  after vaccination to cases  of
malignant smallpox in small and hot stove rooms, and
exposed them to the foul atmosphere  for fifteen or
twenty minutes, secure from danger.  In one  case of
a mother, with six unvaccinated children,  one at the
breast, who had a severe attack of smallpox, as soon
as I discovered the nature of the case, I vaccinated
all the children and they all  took the vaccine disease.
The  room—it was in February—was a  small  ten  by
twelve feet room, with a  hot ten-plate stove, and but
one  bed, on  which they all slept, and which was
saturated with smallpox contagion; yet these children
picked off the scabs from  their mother's body and the
baby nursed at her breast,  and  no  one  took  the
smallpox."
  Owing to the violent opposition  displayed  by the
anti-vaccinators in  London, the National  Health
Society has issued and distributed  twenty thousand 
32
VACCINATION.
pamphlets, and are sending out more, in which con-
clusive evidence is furnished of the following points:
  i. That vaccination is the only available means of
protection against smallpox.
  2. That with  due  care in the  performance of the
operation, no risk of injurious effects from it need be
run.
  3. That before its discovery  the mortality  from
smallpox was forty times greater than it is now.
  4. That in the London Smallpox Hospital the
records show a rate of mortality of less than one per
cent,  for well vaccinated persons, against  a rate of
thirty-five per cent, for the unvaccinated.
  Sir John Pope Hennessey,  Governor  of Hong
Kong, says that while no port  is more liable to the
introduction of smallpox, yet it never spreads there ;
and this  blessing he attributes  to  the fact that the
Chinese so firmly believe in and so faithfully practice
vaccination.   The native  doctors  of the Tung-wa
Hospital not only vaccinate their countrymen in the
colony  itself, but actually send traveling vaccinators
over the adjoining provinces of China, so firm is their
belief in its protective power.
  The North Carolina Medical Journal for June, 1881, 
                DOES IT PROTECT?             33
 furnishes a  striking illustration of  the  protective
 power of vaccination, and although you may consider
 that I am furnishing too many illustrations, yet I
 desire to give all the important information I  can
 gather on the subject, in  order that the question may
 be completely and  thoroughly put before you.   It
 says:  " Few commercial towns  for a long time
 escape visitations of smallpox, notwithstanding that
 it is the most preventable of all diseases, and small-
 pox having  once made its  appearance, is  seldom
 limited to the introduced case.
   "An example of complete success in limiting small-
 pox to the original  case (or cases, we  should say)
 came under our observation recently.  A vessel from
 New York, loaded with guano, had a case  of small-
 pox on board.   The disease made its appearance at
 sea, in the person of a son of the captain. The
 young  man was taken into  the cabin  and  nursed
 there by his  brother, who was a mate,  and  by  the
 steward.   Arriving  at  the Cape  Fear quarantine
station, the vessel was made to set the signal for  the
quarantine officer, for the steward, who had acute
rheumatism.  In the meantime, the case of smallpox
was convalescent, and the eruption on the face and 
34
VACCINATION.
hands was accounted for by the action of the guano
fumes.   The  vessel was permitted to come to Wil-
mington,  and  the  steward  was  admitted to  the
Marine Hospital with rheumatism.  The convalescent
smallpox patient did not come under the observation
of any  medical man.  For, as  the  friends of the
patient afterwards declared, having passed the quar-
antine  physician at  Smithville, they assumed that
the case was not smallpox but chickenpox, and con-
sequently the young  man  attended church and
enjoyed unrestricted intercourse.   About the tenth
day afterthe admission of the Steward,for rheumatism,
he was  seized  with  fever and pain  in  the  back,
followed by eruption on the forehead.   The Super-
intendent of Health was notified within an hour after
the eruption  was noticed, and deciding that  it was
smallpox, preparation was made  for the  removal of
the patient to the smallpox hospital, four miles  below
the city.   In the ward where  the disease made  its
appearance  there  were  eleven  other patients,  of
Scandinavian and German nationality,  except  one
elderly  negro.   It is  well known  that vaccination
among   the  Germans  and  Norwegians  is  most
thoroughly done,  and  so  the  vaccine  cicatrices 
DOES IT PROTECT ?
35
  indicated in these cases.  Nevertheless,  it was con-
• sidered necessary to revaccinate  all of them with
  Animal  Virus, this being designated by the law of
  the State.    All the vaccinations took, with but one
  exception.    In the  Seaman's  Home,  a building
  connected with the  hospital by an entrance-way,
  there is  a boarding house.   Every one there  was
  carefully vaccinated.  To provide against the  risk
  of an outbreak resulting from the intercourse of the
  convalescent case of smallpox with his friends on
  shore, the Superintendent of Health vaccinated un-
  sparingly.   The case at the smallpox hospital resulted
  favorably, and the whole affair terminated without
  the occurrence of another case."
    An  editorial in  thi  Chicago Medical Review of
  November 5, 1881, thus bears testimony to the effi-
  cacy  of  vaccination:  "It is almost unnecessary to
  say that  cleanliness in person or surroundings has
  no influence on smallpox infection.  The doctrine
  that cleanliness  is more important  than  vaccination
  has been expounded  by some of the medical lights
  of this neighborhood.   They,  however, forget, or
  never have been acquainted with, the history of mod-
  ern epidemics.   The experience  of Andersonville 
36                VACCINATION.
prison, where  something like sixty thousand prison-
ers were confined in a filth appalling  in character •
and  extent, demonstrates this  position.  Smallpox
was  twice  introduced into  that pen, but extensive
and  thorough vaccination at the date of enlistment
prevented  the spread of  the  disease.   Not  more
'than a  dozen deaths occurred.  In modern Euro-
pean armies the same facts have been observed.   In
successful vaccination, and in vaccination alone,  their
safety lies."
   While this  editorial rather belittles the influence
which filth exerts indirectly on  smallpox production
and perpetuation, yet it is, in the main, correct, since
no matter how clean and pure a person or locality
may be,yet without vaccination, smallpox is more than
a possibility; it is indeed a probability.  The Louis-
ville Medical News of March 19, 1881, tells us that
"Dr. Turner Anderson delivered a child while the
neck and face of the mother were  covered by the
eruption of smallpox.  He vaccinated it immedi-
ately, on both arms.  The result was  most favor-
able."
   Among other  conclusions on this subject arrived
at by the Academie de Meclecine  of France is the 
DOES IT PROTECT ?
37
important  one, that "without vaccination, hygienic
measures (isolation, disinfection, etc.) are of them-
selves insufficient for preservation from smallpox."
   From another source I learn the astounding but
satisfactory and comforting fact that Dr. Buchanan,
the  medical  officer  of  the  London  Government
Board,  has issued  his statistics,  which show that the
smallpox death rate among adult persons vaccinated
is ninety to a million ; whereas among  those unvac-
cinated it  is 3350 to  a million.   Among vaccinated
children under five years of age forty and one-half
per million ; whereas among unvaccinat ed children
of the same age it is 5950 per million.
   The  lower classes  in  the Island of  Madeira are
exceedingly hostile to the practice of vaccination,
and the Pacific Medical and Surgical Journal tells us
that six years ago smallpox prevailed there and car-
ried off one thousand persons out of a population of
one hundred and thirty thousand.
   Macaulay  thus  graphically  describes  the rav-
ages of this disease, at the close of the seventeenth
century : " The smallpox was always present, filling
the  churchyards with  corpses,  leaving  on  those
whose lives it spared the  hideous traces of  its power, 
38
VACCINATION.
•
turning the babe into a  changeling at which  the
mother shuddered, and making the eyes and cheeks
of the betrothed maiden  objects  of horror  to  the
lover.''  How vaccination has changed this picture
every one knows full well.
  Still, the Public Ledger recently said, editorially,
" The world is getting on pretty near the close of the
nineteenth century, and yet it appears  to be neces-
sary for skilled  physicians and sanitarians to make
formal argument  before  a committee of our city
Councils to convince Councils that vaccination  is a
safeguard against the fatal  ravages of smallpox!   A
hundred years of accumulated experience seems to
have gone for nothing.''
  One of the foremost physicians of America,  Dr.
N. S. Davis, of Chicago, believes that an immediate
re-vaccination is the surest test of a successful vac-
cination, since if it does not take the second time it
is sufficient  proof that the first has been successful,
and he considers that if this precaution were  ob-
served " not one in a million  would take smallpox."
He  adds  that if compulsory re-vaccination were
enforced it would stamp out the disease.
  Have I not adduced sufficient  evidence  to con- 
DOES  IT PROTECT ?
39
 clusively prove  that when properly and successfully
 performed vaccination does  afford immunity from
 smallpox?  If  I  have, how, then,  can  any  one
 have the hardihood to deny himself this  immense
 protection, to be procured from  so trivial an opera-
 tion.
   Is it that we do not thoroughly realize the dangers
 and the horrors of the disease, or is it that we are
 careless about means  of preserving our  health until
 that valuable health becomes impaired ? I am in-
 clined to think that both of these elements conspire
 to produce the  comparative apathy existing among
 the public in connection with this protective opera-
 tion.  The general mass  of the  people see so little
 of the  ravages of the disease, unless it happens to
 enter their own  household, that they do not realize
 its horrors.   They are so  little acquainted with the
 infinite number of avenues of contagion that they
 do not fear, half as much as they  ought  to, that they
 may themselves take  the  disease, and until  it is
brought very near home to them they  fail to  avail
themselves of the  immunity which vaccination con-
fers.
  I will relate  three  instances, which,  kept before 
40
VACCINATION.
your minds, will assist you to realize the horrors and
the dangers of the disease.
   i. A man in Jersey City  recently died  of  small-
pox.  When  the Health Officer went  to  examine
the house  he found the widow lying on a bundle of
rags on the floor, and she,  too, was dying from the
same disease.  On her right hand lay a boy of seven,
dead, while on her left was the dead body of  a girl
of five.   In the corner were two more  children sick
with smallpox.   Can  you conceive a more horrible
sight ?  None of this family had been  vaccinated.
Now, contrast this case with that alluded to as re-
ported by Dr. Atlee, in  which six successfully  vac-
cinated  children slept  in the same bed with their
mother, when she was suffering from confluent small-
pox, and none of them ever  took the disease.   This
illustrates the horrors of smallpox.   The next cases
will illustrate its contagion.
   2.  Two ladies in  Philadelphia kept a  boarding
house; one of them was taken sick with smallpox;
she died.  Ten days subsequently  the  servant who
nursed her was  taken sick and died.
   3. Recently, at the town of Gratz, near Harrisburg,
a prominent citizen died of smallpox ; the nature of 
                  DOES IT PROTECT?             41
  the malady having been kept secret, the funeral was
  largely attended ; in a few days three children were
  taken with the disease, and  in a very short time
  seventeen  of those  who attended the  funeral were
  down with the disease and new cases were being
  reported.
    Of all diseases, smallpox  is, probably, the  most
  violently  contagious,  and, unlike  other  terrible
 diseases, it is not content with  killing many persons
 and destroying many happy homes, but upon those
 whose lives it  spares it forever  leaves its ineffacable
 warning to others ;  a warning that  speaks  louder
 than words, a caution so strong that it ought to do
 more  in favor of vaccination  than the  greatest
 eloquence  of  the most wonderful  orators, or the
 written accumulations of the most  facile and con-
 vincing pens.
   It would  really seem as though men  valued their
 live stock at a higher rate than they  do their own
 flesh and blood.  Recently M. Pasteur, a distinguished
scientist, has discovered a method of vaccination by
which  sheep, hogs, horses  and other live stock can
be  given immunity against a very fatal  disease that
is oftentimes very prevalent among them.  When his 
42                VACCINATION.
discovery was made known, farmers from  all about
came flocking to him in large numbers, to have their
animals vaccinated, so that in a short time more than
fifty thousand were  thus  given protection in the
suburbs and near vicinity of Paris alone.
  And yet,  these  very men, who feared lest they
might lose some money by the death of their sheep,
and  who so hastily and greedily availed themselves
of protective vaccination for their stock, are evidently
so careless about the welfare of their human stock, of
their own children, that in this very country, where
such a prodigious number of the lower animals have
been protected, it has been found necessary to compel
human vaccination by legislative enactments.
   What  a commentary on human nature,  when  a
civilized and enlightened nation like France, though
 verbally denying the  indictment, yet  by action
admits  that  to  them,  money, and  live  stock, as
representing money, are   of more  value,  are in
reality nearer and  dearer to their hearts,  than their
own offspring.
   Does it not seem almost incredible and beyond the
possibility of belief, that in this enlightened age of
mental and material progress it should become neces- 
                 DOES IT  PROTECT?              43
 sary to compel persons to avail themselves of the pro-
 tection which my arguments must tend to show vac-
 cination  does confer.   I doubt not that if you were
 to ask any man if he would not consider it a great bless-
 ing if some means could be devised by which smallpox
 could be eradicated, he would answer, indeed I do,
 most emphatically, and without the  slightest hesita-
 tion.   Yet, when  such a  means  has been devised,
 does exist and  is to be so  easily  procured, they
 keep putting off until it is too late.
   I feel confident  that if the most devout and per-
 sistent  anti-vaccinator in the world were laid up on
 his back with a virulent case of confluent  smallpox,
 if he told the truth, he would cry out, from the very
 innermost recesses of his soul, his regret for having
 neglected the protection he could so easily have pro-
 cured.  You all know the old saying, "  When the
 devil was sick, etc"  This is applicable to the anti-
 vaccinators in a marked degree.
  While they have some arguments  for their side,
 (which  I will fairly present) yet I  cannot bring my-
self to believe that any one of  them, who is sincere,
really does  not  believe in the protective  power of
vaccination.  If they would confine  their agitation 
44
VACCINATION.
to the endeavor  to  reform the evils of the present
system of vaccination, they would receive the hearty
support and co-operation of the respectable medical
profession and of every honest, thinking man.  But
when they endeavor to  create  an  absolute disbelief
in this protective power, or when they endeavor to
maintain that vaccination does more harm than good,
they assume the relation that Don Quixote once held
to a windmill;  they are  battering against  an im-
pregnable barrier  in their endeavor to reach  their
goal; they are fighting  an invulnerable  and invin-
cible foe, since they will ever  find arrayed between
them and the consummation   of their  iconoclastic
campaign a solid and impassable phalanx, composed
of nearly the universal  medical profession of the
world, supported by the mass  of intelligent, think-
ing laymen, who will keep vaccination  alive and
afloat till this storm of prejudice and misrepresenta-
tion shall have  expended its fury, when they will
guide it  into port, to be welcomed once again by
the hosannahs and  the  hallelujahs of a grateful and
eager world.
   I doubt  not that some persons may say that they
thought  that vaccination was very universally re- 
DOES IT PROTECT?             45
sorted to, and  that  they  do not understand why I
should take such a position.
   A few words will disabuse them of this erroneous
idea, and may perhaps enlist their co-operation in
making it universal.   It is true that the anti-vaccina-
tion storm has not yet reached our country in its full
force, but  its advance agents are already among us,
and  unless we  show  them  by  a very  determined
stand that  such ideas are obnoxious and will not be
entertained, we will soon have the anti-vaccination
agitation in full force among us.
   The present epidemic of smallpox, taken in  con-
nection with the arguments adduced in favor of the
protective power of vaccination, is one proof that it
is not universally resorted  to, else,  if it  were, we
would not  have  this epidemic.
   Still more, I recently received a pamphlet, written
by a physician, in which  he  endeavors to show that
vaccination not  only does not afford protection from
smallpox, but he even goes so far as to say that this
operation is productive of more evil even than small-
pox  itself.   This is  one  of  the forerunners of the
anti-vaccination  storm.   Some of  his arguments
are good as far as they go, but they do not go far
enough.  He and those who agree with him fall into 
46
VACCINATION.
the error  of universally condemning an  entirety,
without looking into and endeavoring to correct the
faulty  particulars that make this entirety seem dan-
gerous.   Some  of his  objections  will be   noted
and explained away in  the next part of this book.
  It will  seem strange,  no doubt, to many of my
readers who already firmly  believe in vaccination,
that so much skepticism should exist concerning it;
but the fact is that  such  doubt does obtain, and we
might  as well stare it in the face, admit its existence
and endeavor to stifle  it  in its infancy.   How to do
this I will suggest further on.
  A few words on how to vaccinate will now be in
order,  but  only  a very few,  since, entering  upon
this question, I am encroaching upon the territory  of
the physician, which I have neither the right nor the
inclination  to do in a popular treatise.
   The essential  principle  of the  vaccine  virus
gains  entrance to the system  in  the operation by
being  absorbed  from the  abraded  surface of the
skin.   Grossly  speaking,   the   skin   consists  of
two layers.  In the operation for  vaccination the
outer  layer  is scraped off, leaving  exposed  a raw
surface or space on the lower layer or true skin, which
possesses the power of absorption.  The vaccine 
                HOW  PERFORMED.              47
material mixed with water is then placed on this raw
surface, from which it  is  absorbed into  the system.
It  matters not  how this  abrasion  is secured, the
point  being  to  remove the outer skin.   It is not
necessary to bring blood, indeed, it would be better
not, since it  is possible that the blood may clot on
the surface and offer a mechanical impediment  to the
absorption of the vaccine matter,  though this  latter
is not likely.   But to repeat and impress  on you, the
essential consideration  in  the operation  is to secure
the removal of the outer skin.
  It matters not what portion of the body is selected
for the operation ; one is as good as another, so far as
the efficacy is concerned.   The left arm above the
elbow  is  usually  selected, but simply as  a matter of
convenience, since that portion can  be more easily
given the rest and quiet so essential to an inflamed
and sore spot.
  It must be remembered that a successful vaccina-
tion will  sometimes produce very marked constitu-
tional symptoms, and will oftentimes make a person
so sick as to  compel him to go to bed.   It will also
produce a very painful local sore,  with much inflam-
mation, that will require absolute rest of the part and
the application of soothing lotions.  Some parts of 
48                VACCINATION.
the body can, of course, be more readily placed at
rest than others, hence they should be chosen, since
a disregard of this  precept  may  give  rise, in some
cases, to very troublesome and  painful complications.
A prominent operatic singer was recently vaccinated
in the West.  She objected to having  the operation
performed on her arm, on account of the disfigure-
ment which the subsequent scar  would  entail;  the
thigh was decided upon and the operation was there
performed.   She was cautioned to be very careful of
the limb and to exercise it as little as possible.  The
vaccination took.   For some days the lady was very
careful ;  but one  night,  receiving  an enthusiastic
reception from a very large audience, she was carried
away, and  forgetting her  caution, endeavored to
act her best, with the result that she was laid up in
bed for two days with a very sore limb.
  Therefore I would advise all to follow these few
simple directions.    Select that portion of the body
which you are  sure you can keep most  at rest,  and
when the vaccination commences to take, if the arm
or part is very sore, keep applied to it a rag smeared
with  some greasy substance;  you may use  for this
purpose cosmoline, vaseline or  even plain lard, which
will do as well as anything. 
                 HOW  PERFORMED.              49
   It will be well, before concluding these remarks in
 favor  of vaccination,  to  summarize the  points we
 have given, so that  you may, if you so desire, com-
 mit the digest of them to memory, and have ever
 ready, at your tongue's end, the conclusions of the
 majority of physicians, with which you may answer
 the arguments of  anti-vaccinators, or confirm  the
 wavering of any  friends who may have a tendency to
 take up with their views.  These, then, are the con-
 clusions of the advocates  of vaccination.    That in
 the large majority  of  cases, when successfully per-
 formed with proper virus, it does afford  protection
 from smallpox.   That  in  those few cases, compara-
 tively speaking, in which it does not afford absolute
 immunity, it so modifies the intensity of the disease
 that it rarely proves fatal.    That pure bovine virus
 is to be  preferred  to that from  the human subject,
 since it absolutely prevents the passage of extraneous
 diseases from one to another.   That the proportion
of cases in which this operation  proves a benefit  is
so greatly in excess of those in which it is  injurious,
that it becomes, not only justifiable, but greatly to be
desired. 
50
VACCINATION.
                PART THIRD.
        ARGUMENTS AGAINST VACCINATION.
  After presenting such overwhelmingly strong argu-
ments  in  its favor, it will now be in order to ask,
why does any  one attempt to  cast disrepute  and
obloquy upon such a self-evident benefit to mankind,
and upon  what  ground can anti-vaccinators stand ?
  They have, indeed, very strong arguments,  and so
far  as  they  go,  very sensible  ones; but, as  I have
already intimated,  the validity  of their objections
can be upheld  only when they condemn the usual
methods of vaccinating, and are valueless when they
attack the protective power of  properly performed
vaccination.  The platform upon which anti-vaccina-
tors stand has, in reality, only two props or supports,
and I hope to be able to demolish  them and drop
the platform, with its occupants, into a belief in vac-
cination.  These two points are—
   i. The fact  that, in  some  instances, vaccination
does not confer immunity from smallpox.
   2. That various diseases can be transmitted  from 
ARGUMENTS AGAINST IT.
51
unhealthy persons, through the medium of vaccination,
to those previously healthy.
   These two  objections undoubtedly do exist, and
are strong points as far as they go; but when viewed
impartially, and in connection  with the  favorable
evidence I have  furnished, they only tend to prove
that the fault lies not with vaccination itself, but with
the vaccinator.
   We will take them up in turn and see the correct-
ness of this proposition.
   i.  Undoubtedly, vaccination does, in many cases,
fail  to  afford  immunity from  smallpox;  for  two
reasons.
   (a) There is no universal rule in nature.  There is
no law without its exception.   Every sensible man
knows,  realizes  and  daily  experiences  this  fact.
Neither Jenner nor his most ardent disciples ever
claimed that vaccination would, in every case, protect
from smallpox.   There must and ever will be excep-
tions to this,  as to every other natural  law.   But
they  do claim,  and  experience  substantiates  this
claim,  that in  the vast majority  of  cases, when
properly performed, with good material, and it is suc-
cessful,  it does afford protection. 
52
VACCINATION.
   (b) Great  carelessness and even  criminal fraud
exists, to an inexcusable extent, in the production and
selection of vaccine virus, and in the performance of
the operation.
   The story is told of a physician, who, when visited
in his office by a stranger, to be vaccinated, not hav-
ing any virus on  hand, and fearing  to lose his fee,
mixed  up some  gum  arabic,  and vaccinated  his
unsuspecting victim with it, telling him that if it did
not take in a week, to return, and he would do it over
again.   No  doubt  similar  cases  have  repeatedly
occurred, and since, in some persons, the mere scratch-
ing of the arm might make a sore with a  subsequent
scab,  and since the  general  public does  not know
how to  recognize  a successful vaccination, believing
that a  mere sore arm is sufficient proof that  it  has
taken, they consider themselves protected, do  not
return to the doctor,  and subsequently taking small-
pox, another case is  added to the list of unsuccessful
vaccinations.
   This same insufficiency in the protective power of
the material used,  from various causes, unnecessary to
mention here, has tended to cast distrust upon vacci-
nation,  when the fault really lies with the physician. 
              ARGUMENTS AGAINST IT.           53
   It is unnecessary, and would be tiresome, to here de-
 tail the numerous reasons why some virus possesses no
 protective power.  Suffice it to say that such is  an
 unquestioned fact, and to suggest a remedy, which I
 will do further on.
   2d. That various diseases have been and can be
 transmitted from one to another, through the medium
 of the  vaccine  virus,  is a pretty generally accepted
 proposition.  But here again the fault lies with the
 material and the carelessness or criminality in its
 propagation and supply, and not with the operation
 itself.
   When a conscientious physician  desires to procure
 a supply of vaccine virus, he goes to some druggist,
 in  whom he has confidence, and  buys some ivory
 points  coated with bovine virus, or he  procures
 from some brother physician (also conscientious) a
 scab  taken from  a child who was believed by this
 doctor to be perfectly  healthy.  In many instances,
 indeed in nearly all, the material thus procured  will
be pure and efficient, will confer immunity from small-
pox, and will not  contain the seeds  of any foreign
disease.  But it is impossible for  the most careful
druggist to avoid occasionally receiving some impure 
54
VACCINATION.
 points.  The desire for money and to make it easily,
 to derive unnaturally large  profits  from all business
 operations,  is so  inherent  in human  nature,  that
 adulteration, in order that  expense may be lessened
 and profit increased, has even entered into the busi-
 ness of supplying  vaccine virus.
   In order not to be too personal I will make no
 mention of  locality or names in the story I am now
 going to tell,  but will assure you that it is true.
   I have been informed  by reliable authority that a
 physician of this city is in the habit of collecting all
 the scabs from vaccinated  persons that he can get
 and  forwarding them to a neighboring city,  near
 which are several vaccine  farms.  Of  course, I do
 not know what is there done with them, but it would
 not require  a very great stretch of the imagination-
 to suppose that they are mixed with water, and  ivory
 points, coated with the  mixture, dried  and shipped
 over  the country as  "genuine  bovine virus direct
from  the cow."   Still worse,  I  have  been  in-
 formed  on  good   authority that an extensive and
 generally-considered reliable drug firm in this city
 buy scabs directly from physicians, and in their own
 establishment mix them with water, coat ivory points 
              ARGUMENTS  AGAINST IT.            55
 with the mixture, and sell  the same to unsuspecting
 physicians  (upon whom they fawn and into whose
 good  graces  they insinuate  themselves, by a miser-
 able, cringing sycophancy)  as, pure bovine virus, di-
 rect from the vaccine farm.   This firm, by a num-
 ber of years of plausible catering to physicians, have
 worked into their confidence and built up  an exten-
 sive trade, so that any material  coming from their
 store is generally considered irreproachable.
   Is it any wonder, when  such  outrageous practices
 are resorted  to, that vaccination meets with opposi-
 tion.   It is enough to make  the blood  of an honest
 man fairly boil with indignation when he hears that a
 firm making more than fifty  thousand dollars a year
 will resort  to  such  a contemptible device to add a
 few dollars  to their profits.  Neither is it a harmless
 device, since, as we will see further on,  this firm and
 such other mean, contemptible puppies as they are,
 may be the means  of spreading abroad the most
 loathsome diseases among their unsuspecting fellow
 citizens.  We will be charitable enough to trust that
 they do not realize the true nature of their nefarious
traffic, else how could they sleep of nights.
  Again, it  is a  fact, that  many persons contain in 
56
VACCINATION.
their systems the seeds of some disease, when to all
outward appearances  they  are perfectly healthy.   A
scab derived from such a person, and honestly believed
to be perfectly harmless and efficient, may, unfortu-
nately, in  the person vaccinated with it, develop some
terrible disease.
  Again, in the medical profession, as in every other
calling, the majority  of men are not  hampered with
any  too  much  conscience.   They   want  to make
money, and are not  overly particular how they get
it; the end, in their imagination, justifies the means.
Hence, any scab or any virus is good enough for them.
They are  not  very particular as to its purity or effi-
ciency.  In  this  way, no doubt, much  misery is
caused and very much undeserved  censure  and con-
demnation is heaped upon vaccination.
  Here, then, we have concisely  and illustratively
stated the two arguments upon  which anti-vaccina-
tors base their case.   To sum up:  The facts that, in
some cases, because  of carelessness  in selection  of
material, vaccination  fails  to confer protection, and
in other cases produces disease nearly or quite as bad
as smallpox itself.
  These two arguments, as far as they go, we must 
              ARGUMENTS AGAINST  IT.           57
and do cheerfully concede  to the  anti-vaccinators.
But they are very weak, and prove nothing for their
case.  The fact is sufficiently answered by the admis-
sion made, that no law is so absolute and universal as
to  be without  an exception—unless, may be, as is
popularly said, in the cases of taxes and death, and
we might add the law that a note will be protested if
you fail to pay it.  The second argument constitutes
one of the abuses of vaccination, and has no weight
to  prove  anything more than the  corrupt and mer-
cenary  nature  of that portion of mankind who are
depraved  enough to resort to such base and villainous
practices.
   The fact that the instances  in which  vaccination
fails to afford protection  are the exceptions, has been
sufficiently  demonstrated  by the arguments already
adduced.
   Therefore, at the risk of repetition, we must regard
the arguments of those  who  oppose vaccination as
being based upon wrong premises, since they use the
exceptional  cases and  the abuses of the practice to
point their arguments.
  One other argument, which  probably ought  to  be
mentioned, upon which our opponents base their case,
     E 
58                YACCT NATION.
is that vaccination is prone to produce erysipelas.  In
answer, we might admit that erysipelas is produced in
every successful vaccination.  The disease means an
inflammation of what we call connective tissue, that
is, the tissue beneath the skin. Now, since successful
vaccination does produce  a violent inflammation of
the skin about the seat of the operation, it is but fair
to infer that this  inflammation  may extend  to the
tissue beneath and produce a local inflammation of
it,  or  a localized erysipelas, which is trivial and
perfectly  harmless.   As  for its  ever producing a
genuine and dangerous  attack of  the  disease, I  can
quote the statement  of  a  New York physician, who
had vaccinated two  thousand persons and  had never
seen a resultant attack of erysipelas ;  and can also
say that, after a careful examination of all the medical
literature of the past year, I have  found but one  re-
ported case of erysipelas  following vaccination, and
in this single instance the disease could not be clearly
traced to the operation,  since  other  causes  for its
development existed.
   Here, then, I have concisely, honestly, and con-
scientiously, stated the arguments advanced by anti-
vaccinators, and have endeavored to refute them.  I 
             ARGUMENTS AGAINST  IT.           59
have carefully scanned all the most  recent literature,
and  these have been the only arguments worthy of
notice that I could find.
  Since there are strong  objections, and since they
do qualify and modify the benefits to be expected,
and that can be derived from vaccination, we will go
on to  our next subject and  endeavor to suggest  a
means by which" these defects may be remedied, and
the full, free, and unalloyed protection that vaccina-
tion is capable of conferring be vouchsafed to all. 
60
VACCINATION.
               PART FOURTH.
       HOW TO OVERCOME THESE OBJECTIONS.
  It seems conclusively established that were vaccina-
tion and revaccination to become absolutely universal,
smallpox could  in  time be exterminated.  This is
truly a consummation most devoutly to be wished for.
But how can it be brought about ?  Only in one way,
namely, by legislation.
  I will suggest a  form of legislation,  which,  if
carried into effect, would demolish the platform  of
anti-vaccinators, and would, beyond doubt, if perse-
vered in, eventually eradicate smallpox.   And this
suggestion I will make  in the form of some points or
hints  for a bill to be presented to, and acted upon, by
the legislatures of our various States.
  I would suggest  the establishment of a  " State
Board of  Vaccination," who  should be  given  the
authority  to compel,  under penalty of fine and
imprisonment, the vaccination of every man,  woman
and child, in the State.   The members of this Board
should be elected for life, or good  behavior, by the 
             PROPOSED LEGISLATION FOR.         61
  State Medical Society, and any vacancies that might
  occur by resignation, death or removal, be filled by
  the same Society in annual session.  By this method
  of organizing the Board,  the damning influence of
  politics would be kept as remote as possible from the
  groundwork of our plan.   An annual appropriation
  should  be made, sufficiently large to enable this
  Board to thoroughly carry  on its good work.
   This  Board  should commence its  work by the
 establishment of  a State vaccine farm;  the Superin-
 tendent  of which should  be  a physician,  and be
 elected by the Board.  The State should be divided
 into vaccine districts, and an inspector appointed for
 each, whose duty it  should be to constantly watch
 over  the persons in his  district, and  to  report all
 who had  not been vaccinated within the prescribed
 time to the vaccine physician, who should forthwith
 cause a notice to be served on such person to call at
 his office at once, and be vaccinated.  A vaccine
 physician for each district should be elected by the
 State Board,  whose duty it should be  to  vaccinate
every man, woman and child, in his district.  These
physicians should be supplied with virus direct from
the State farm,  free  of cost, under the following 
62
VACCINATION.
conditions :   Once a week, they  should  each make
requisition upon the Superintendent of the farm for
as many points as they may require, and should at
this time return all unused points  in their possession.
Each lot of points sent out should have a distinctive
mark on each point, and a careful record kept of the
destination of each  lot,  as well as  the source from
which the virus has been  derived.  ' When a person is
vaccinated, the point used should be  given to him
with its  distinctive  mark.   Thus, if any  accidents
occurred, if any disease  was  communicated by vac-
cination, it would  be a very simple matter to place
the responsibility, through the physician using the
virus which has proved  disastrous, to the Superin-
tendent of the farm, and  if negligence or carelessness
on his part could be substantiated, he should be severely
punished, besides being removed from office. It should
be made a penitentiary offence for any physician, other
than the duly elected and authorized vaccine physician
of the district, to perform vaccination.  No charge
should be made for his  services.   The vaccine phy-
sician should be required  to keep careful and complete
records  of all  cases vaccinated, and  should make
monthly reports to the superintendent of  the farm, 
PROPOSED LEGISLATION FOR.         63
 who should in turn make an jmnual statistical report
 to the State Board.
   It  should  be  made compulsory for every man,
 woman and child to be vaccinated every five years.
 When vaccinated, each person should receive a card
 like the following: —

  This certifies that John  Blank has been vaccinated by me,
 on February ist, 1882.        James Brown, m. d.,
                               Vaccine Physician,
               1st Vaccine District, State of Pennsylvania.
  February 8, 1882.—John Blank has been seen by me, and
 his  vaccination, performed February ist,  1882,  has been suc-
 cessful.                    James Brown, m. d.,
                               Vaccine Physician,
               1st Vaccine District, State of Pennsylvania.
  The  District  Inspectors should be allowed  the
 authority to  inspect this card  at any time, and  any
 person Jnot possessing one should be compelled to
 call on  the  district J physician and be  vaccinated.
 It should  be made an offence as great as counter-
 feiting United States bank notes for any one to frau-
 dulently print one of these  cards, and as criminal
as forgery for him  to  write  himself, or get any  one
else to write, the name of the duly authorized vaccine
physician to it.   As much care should be exercised 
64
VACCINATION.
in the prevention of counterfeiting these cards as is
used to prevent the  counterfeiting of money.
  It should be compulsory on all to  be vaccinated
every five  years,  and  a severe  penalty should be
visited upon all who neglected this provision.
  This  system of vaccination, when once fairly in-
augurated,  would  work smoothly, and ought not to
meet with  any opposition.  The intelligent classes
would have no reason to object  to it, since  they
would have the assurance that they were  being vacci-
nated with  pure virus and by competent physicians,
while such opposition as might be encountered from
the  ignorant ought to be neutralized by the strong
arm of the law, since,  when  people are so foolish
as to object to that  which would be undoubtedly
for their good, then indeed does it become necessary
to force these  foolish people to take care of them-
selves.
  In addition to these measures  by the  different
State governments the National  Government would
have to do something.  I would  suggest that Con-
gress empower the  National Board of Health to ap-
point a vaccine physician  for every Port of entry,
whose imperative duty it would be to vaccinate every 
PROPOSED LEGISLATION FOR.          65
emigrant arriving  in  the country and every native
returning from a  foreign trip, unless he could pro-
duce evidence  (in the  shape of the vaccine  card
already  referred to) that  he had  been  vaccinated
successfully within  five  years.  A  card,  similar  to
the one referred to, should be furnished to each  emi-
grant, and it should be  a  part of the police duty of
every city and town to note the arrival of every new
person, to notify the vaccine inspectors  of such ar-
rival, and they in turn should take the precaution to
ascertain  whether or not  the new arrival had been
successfully vaccinated,  and so report to the vaccine
physician.
   All these officers should be liberally paid, and no
charge should be made for vaccination,  so  that no
one could have the excuse " of want of means  "  to
offer in extenuation of non-compliance with the law.
   Such  is,  in  a crude  form,  the only method by
which smallpox can be eradicated.  It really means
universal vaccination, and by this universality, and
by it alone, can this disease be stamped out of exist-
ence, and by it, if  faithfully and persistently carried
out, can this disease be  rendered a thing of the
past. 
66                VACCINATION.
  Does it  not seem  strange and almost  incredible
that human nature can be so blind to its own inter-
ests as to neglect securing the wonderful  immunity
from a terrible disease that is conferred by so trivial
an operation?  Still,  it is true that many persons do
neglect to  be vaccinated,  and since  they  are so
careless, it  becomes the paramount duty of our law-
makers to force them  to protect themselves.
  Let me urge all classes  to seriously  consider  and
act on these suggestions.   Let me beg you all to
invoke the  mighty power of legislation to drive from
the haunts  of men forever this  ghastly spectre that
makes desolate so many  homes and ruins so many
faces.
  I will ask the father as he gazes on his innocent and
beautiful children, the  young man  admiring  his
sweetheart's beautiful  skin,  the wife  her  husband's
manly beauty, and the  brother who  takes pride in
his  sister's  comeliness, to agitate this question.   Go
and see your representatives in the legislature ;  it is
your votes  that send them there; they must do as you
desire, else you can send  some others who will do
your bidding in their places; insist with them that
they must so legislate that you and your  neighbors 
            PROPOSED LEGISLATION FOR.          67
can  be protected from this terrible  disease,  when
protection is so easily attainable.
   Do  not rest satisfied until you have accomplished
this purpose.  As surely as the sun rises, smallpox can
be exterminated, but it can only be done by universal
vaccination with pure material.
   When the Almighty has allowed the mind of man
to furnish to us such  a wonderful and yet such  a
simple means  of preserving health and beauty, does it
not  seem terribly negligent in us that we  do not all
avail ourselves of it.
   Let  us hope that the day is  not far distant  when
from the legislative halls of every commonwealth  in
this  great country shall  go forth the glad tidings,
" vaccination  is  compulsory."   Then  can we   con-
fidently trust that the medical historians of the future
will  refer to  smallpox as one  of the ancient and
extinct diseases, as we of to-day are wont to speak of
leprosy, and then can we hope that  the one  disease
will be as rarely  met with as the other. 
68
VACCINATION.
                PART FIFTH.
             HYGIENE OF  SMALLPOX.
  Under this heading I propose to give a few hints
concerning the means of prevention  (besides vacci-
nation) as well as the hygienic treatment of one sick
with the disease, and the best means of controlling
and  preventing  its spread.   The  subject will  be
divided into two parts.   The  first  will give some
hints as to what might  be called public hygiene, or
the duties that  devolve upon city and state officials,
while the second will sketch the  part that the indi-
vidual must take in preventing the spread of smallpox.
  i.  Public  hygiene.   The College and  Clinical
Record of August  15,  1881, contained  an editorial
from which  I  will make some selections as pertinent
to the subject under consideration.  It says:  '' Should
any  of our readers or correspondents be in need of a
good illustration of the way in which a large, wealthy
and  comparatively  enlightened community, in  a
position, as  regards  social  and material  advantages
other than sanitary, second to none in this country, 
               HYGIENE OF SMALLPOX.           69
 can mismanage an epidemic of smallpox, we invite
 their attention to the history of the present epidemic
 in  Philadelphia,  which, commencing in  1879,  s^
 drags its length  along, with every prospect, during
 the coming fall and winter, of being as virulent as at
 any time in the history of the city.''  This prediction
 we all know has been  verified.  "Not a  month has
 passed  for  nearly two years without  furnishing its
 quota of cases, with a  large aggregate of deaths.  No
 one doubts  that  smallpox  is a preventable  disease,
 and that epidemics cease under proper sanitary  pre-
 cautions.   Some  of the causes of a want of efficient
 management of  the epidemic have been, first, the
 want of sufficient appropriations  for the purpose;
 second, the want of a proper sanitary  organization,
 clothed with necessary power, and finally, a want of
 moral support from the community, who have been
 kept in ignorance of the true condition of affairs, by
 the secular  press, lest the  publication of the  facts
 might cause the mercantile interests of the city to
suffer.  Free vaccination is very good, when actively
carried on, and proper precautions are taken to insure
the use of  true  vaccine virus.  But vaccination is
not all.  Systematic and  rigorous isolation  of all 
70                VACCINATION.
cases  of  smallpox,  as well as convalescents and
attendants  upon  the sick until they are free  from
infection.  Under the present administration  of
affairs smallpox patients, with  the eruption still out
upon them, are  to be met with at public dispensa-
ries, in doctors' offices, in stores, in public schools,
in the street cars; in short, anywhere where people
congregate.  Even the visitors to the Smallpox Hos-
pital go and return in the public conveyances.  Not
long ago  a smallpox bed was deposited on a vacant
lot down town, in front of a row of new and clean
dwellings; no  less than twenty-five cases of small-
pox occurred in the  local outbreak which followed.
In New  York  a corps of physicians  has been or-
ganized  for  systematic house to  house visitation,
prompt isolation of the sick, disinfection of prem-
ises and the reporting of sanitary defects in dwelling
houses.''   These are all just accusations and crying
shames.   If, as the Board of Health claims, they are
prevented  from carrying out  proper sanitary meas-
ures, by the refusal  of  Councils to appropriate suf-
ficient money, the people have it in their power  fo
force them to do so,  by refusing to send to Councils
any representatives until they have clearly and thor- 
               HYGIENE OF SMALLPOX.            71
 oughly  pledged themselves to  support  liberally  all
 measures looking to the public  health.
   Again, the Public Health Organization of Phila-
 delphia at  least, and of any other cities where it is
 similarly organized, is faulty.   The Health Officer,
 whose supposed duty it is to carry out the directions
 of the Board of Health, is entirely independent of
 them, being  a  politician, appointed to office bythe
 Governor.   He may do what the Board tells him or
 he may not, as he pleases,  and they can do nothing
 with him.    A  recent  striking illustration of  the
 faulty organization of our  Health Department will
 be interesting.   A prominent  physician was called
 on a  Friday evening, to a sick lady.  On  Sunday
 smallpox was developed.   As the Health Office was
 closed, it was the obvious duty  which this physician
 owed  to society, to  visit the  Health Officer at his
 residence and report the case.   Instead of doing so,
 he claims that  he sent him  an informal notice by
 mail, which  could not  have been  delivered  until
 Monday morning.  In  the absence of the physician
the Health Board passed a vote of censure and fined
him the paltry  sum of fifty dollars.  The doctor,
learning  of  this  action, asked  for a hearing, which 
72
VACCINATION.
was granted.   He then,  in  addition  to  what has
been already said, stated that  on Sunday morning he
received, by mail, a formal blank, to be filled in; he
filled  it in  and returned  it by mail, and it reached
the Health Office Wednesday morning, three days af-
ter the nature of the disease had become known to him.
The, Health Officer was asked  whether he  had re-
ceived the communication of Sunday night, when he
nonchalantly  replied that he  did  not  recollect.
Whereupon the Board remitted  the  fine,  but re
tained the vote of censure, and the culpable doctor
departed, happy.   In the meantime the patient died,
and her dead  and poisonous body was allowed to re-
main in a room in a crowded boarding house for three
days.  This in the enlightened  city of Philadelphia,
with a Board  of Health counting several prominent
physicians among  its members.   Such carelessness on
the part of physicians and health authorities, when
viewed in the light of probable evil it entails, is most
censurable, if not criminal, and ought not to be toler-
ated.  If Councils cannot be forced to appropriate
enough money to prevent the ravages of a disease
that we know how to control, surely there are enough
rich and  public-spirited citizens, who annually give 
              HYGIENE  OF SMALLPOX.           73
 away large sums of money, who, by uniting, could
 give, and hardly miss, more than enough to stay the
 worst epidemic of smallpox.
   The public duty in this matter of prevention can
 be summed up under three heads: Universal vaccin-
 ation, complete isolation, and thorough disinfection.
 It will be unnecessary to discuss  these points in de-
 tail, since, if the requisite  amount of money is forth-
 coming, there are many gentlemen  thoroughly con-
 versant with the subject and amply competent to sat-
 isfactorily carry them into effect.
   I have heard it said  that "smallpox attacks the
 poorer classes, and that the rich care but little about
 vaccination and have but little fear of the disease.''
 If this is  so,  it is  a most  fatal error.   Smallpox
 makes no  distinction;  it would  as  soon enter the
 palace of the King as the house of  the pauper.   In
 support of the belief  that the rich are careless about
 protecting themselves from smallpox, and to demon-
 strate that  they are suffering from this carelessness,
the conclusions derived from an elaborate statistical
table which I have  compiled from our Health Re-
ports will be of value.
  On one hand I have selected the three most aristo-
    F 
74                VACCINATION.
cratic wards  of our  city, into  which, owing to  the
presumed intelligence of the inhabitants, the health
authorities but rarely penetrate, leaving  preventive
measures, in  a large  degree, to the individual action
of the  citizens.   On the other hand will be found
the three plebeian wards, into which, owing  to their
crowded  condition, and the  filth,  carelessness  and
disregard of sanitary laws of the  inhabitants,  the
chief energies  of the  Health  Board are expended.
What do we find ?
   In 1861  the three  aristocratic wards contributed
^only two and a half per cent,  to  the total deaths
 from smallpox.  While during six subsequent years,
 during which I made my investigations,  they  con-
 tributed more than four  per cent., a loss  of  over one
 and one-half per cent.
   In  1861  the  three  plebeian  wards contributed
 twenty-seven per cent, of the total deaths, while dur-
 ing the  six subsequent  years their proportion was
 only fourteen per cent., a clear gain of  thirteen per
 cent., which,  added to  the  loss in the aristocratic
 wards would give a comparative gain of over  four-
 teen and one-half per cent, in favor of the plebeians.
    This  clearly demonstrates  that it will not  do to 
HYGIENE OF SMALLPOX.
75
trust to individual efforts.   It shows  plainly the effi-
cacy of well-directed public efforts,  and it forces us
to conclude that the rich as well as the poor must be
subjected  to  them, if we  would hope to eradicate
smallpox.
   So much, then, for public hygiene.
   2. Private or personal hygiene.  The same cardinal
points  are here to be  observed.  Vaccination, isola-
tion and disinfection.
   Vaccination has been already sufficiently discussed.
Isolation and disinfection now claim our attention.
The ignorant classes must be isolated by law, since
argument and persuasion  have very little influence
on them.   There are  two  classes of intelligent per-
sons to whom some advice concerning this question
ought  to be  addressed.   The first  class consists of
those who  are  keeping house, and the second  of
those who are boarding.   When a case of smallpox
occurs  among the first class, if it is desired that the
patient shall  remain at  home,  the  physician  in
charge should notify the  Health Officer, who ought
to send an inspector to examine into the conditions
and surroundings of  the patient,  and  to  decide
whether or not it would  be dangerous to others to 
76
VACCINATION.
 allow the sufferer to remain where he  is.   If he de-
 cides in the affirmative, then all members of the fam-
 ily should be  vaccinated and sent away, save,  per-
 haps, one, who may insist, even after being acquainted
 with the peril of doing so, on remaining  to nurse
 the sick one, as  in the case of  husband and wife or
 mother and child.   The patient should be removed
 to an upper  room, and absolutely  no one should
 have access to him or her, save  the physician and
 nurse.  Every article that is removed from the room
 should be disinfected beforehand.  Sheets should be
 hung in  the door and window ways, which  should
 be kept constantly saturated with some disinfecting
 solution, the nature of which  I will leave to the in-
 telligent physician, since there are so many to choose
 from. Thus would be reduced to the minimum the dan-
 ger of any of the poisonous emanations being wafted
 by the wind to other portions of the house or to the out-
 side world. It would be well to keep the air of the room
 constantly saturated with  disinfectant vapors, which
 can be accomplished with the aid of a small portable
 steam  atomizer.  All clothing removed from  the
 patient or the bed  should be thoroughly washed in a
disinfecting  solution  before being removed from the 
              HYGIENE OF  SMALLPOX.            77
room, while any scabs that may fall from  the body
should be  immediately placed in the same  liquid.
Absolutely  no intercourse should be had by the nurse
with  the  outside  world,  until  the  physician  has
declared all danger of contagion to have passed.
  When  this  period has arrived, and before any of
the family  are allowed to return, the sick room must
be thoroughly disinfected, and for this purpose you
should employ only persons who have been thoroughly
protected  from smallpox by a recent attack of the
disease, or  by a recent successful vaccination.   The
floor should be scrubbed,over and over again,with the
strongest possible disinfectant solution.   The paper
should be  torn from the walls, and they should be
washed, as the floor, and repapered.   The wood-work
should all be repainted ; and in the case of very rich
persons, this process should be extended to the whole
house.  Every article, including even the bedstead,
should be burned; indeed, were it possible, it would be
the safest course to burn the whole house, and I am
almost tempted to say, to cremate the patient himself.
In  this holocaust must be included  all  wearing
apparel used by the nurse.
  The second  class, those who live in boarding-houses 
78
VACCINATION.
or hotels, can be settled in a few words.  They should
be at once removed, either to some private house,
whose inmates  are willing to  have  them, subject to
the  terms  and conditions already laid  down  for
private houses,  or they should  be taken to the Small-
pox  Hospital.  They have no right to remain in a
house full of people  who do not care for them, and
to endanger the lives of their fellow-boarders.   If
they do not, of themselves, realize this, they must be
made to do so.
  They need not  fear the Municipal Hospital.   It
should be so ruled  that they would there be allowed
the  nurse and  doctor of their own choosing, and
when  they once have the disease, their  chances of
recovery  will  not  be lessened by removal  to  the
Smallpox Hospital (providing they are allowed their
own nurse and doctor), while the danger of infecting
others will be very much reduced.
   The necessity for  this very great caution will be
understood, when  you learn that  the scabs from a
convalescing smallpox patient may retain their con-
tagious or infectious powers for a long time.
   Some  years  ago,  a patient recovering from  an
attack of  smallpox wrote a letter to a friend in a  city 
              HYGIENE OF SMALLPOX.           79
three hundred and fifty miles distant.   When lean-
ing over the paper, writing, a  small piece of scab from
his face fell, unnoticed on the paper ; the letter was
folded, sealed, directed and  forwarded.    When re-
ceived, the friend noticed this spec in one of the folds
of the letter, but supposing it to be merely some dirt
or imperfection in the paper, or perhaps not consid-
ering  it  at  all,   put the  letter  in  his   pocket
with this scab still  in it.   Result: in a short time
this man was taken with smallpox and died, and his
death  was  followed  by  a  local  epidemic  of  the
disease.
   Does not this one case, which is a true one, drawn
from  life  and  not  imaginative, sufficiently  demon-
strate the property which  smallpox scabs may possess
and retain for along time, of transmitting the disease
to great distances, and may  it  not serve  to  explain
the sometimes apparently mysterious origin of an
outbreak where no case of the disease has previously
existed ?
  I have now reviewed the question of vaccination as
comprehensively as  is  possible  in so small  a book.
The main points in each question involved have been
concisely stated, the  arguments for and against vac-
cination have been impartially and fairly stated ; and 
80
-  VACCINATION.
the decision of the question has been left to the judg-
ment of the intelligent portion of my readers.
  I commenced the study of this subject as a believer
in vaccination, and I have concluded it a much firmer
believer than before.
  I fully recognize and admit the dangers that may
arise from the abuses of vaccination, but I find suffi-
cient evidence to convince me that these abuses can
be remedied.
  From the evidence, I have been led to conclude
that smallpox can be  entirely eradicated  by the
universal and faithful practice of the three require-
ments, Vaccination—Isolation—Disinfection.
  Should my suggestions in this brochure  meet with
favor I will at some future time furnish  conclusive
and unquestioned proof that the money necessary to
procure these desired conditions would be  a most
excellent  national  or  state investment,  since the
increase in the national wealth from the  number of
lives saved by them would be so enormous that the
expense incurred  would be  but as a drop in the
bucket.
  In the meantime, I will be very glad to hear from
my readers any undoubted instances either favorable
or opposed to  vaccination. 
   " Mr. Blakiston deserves the thanks of the public for the remarkably interesting
and valuable series of works on Hygiene which he has recently issued. They are
all written in a popular style, and contain information of great value to every reader.
They are cheap, and can scarely fail to save their cost many times over in any family,
if the directions given in them are carried out."—From a Leading Canada Journal.
Catalogue No. 5.


Select  List  of  Books


      FOR GENERAL AND SCIENTIFIC READERS,

                   INCLUDING WOKKS ON

 THE CARE  AND MANAGEMENT OF  OUR  HEALTH;
    nursing; THE PROPER  CARE  OF children;
       PERSONAL AND DOMESTIC CLEANLINESS;
         HOW TO PREVENT DISEASES;  DRAIN-
           AGE OF HOUSES AND LANDS, ETC.,
                         AND
   CHEMISTRY, MICROSCOPY, AND POPULAR SCIENCE.

                     PUBLISHED BY

           P. BLAKISTON, SON &  CO.,

   SCIENTIFIC,  MEDICAL AND CHEMICAL BOOKS,

        1012  Walnut Street, Philadelphia.


 JKW'Any of the books in this Catalogue will be sent, postpaid, upon receipt of the price
or they can be procured of most booksellers throughout the United States and Canada.
Seepages 14 and 15 for SPECIAL  OFFEIt. 
2                 P. Blakiston, Son & Co.'s
       NEW     BOOKS
                               BY

                DR. J. F. EDWARDS.
            "Plain and straightforward."—Baltimore Sun.

VACCINATION AND  SMALLPOX.  Showing  the reasons
   why we should  be Vaccinated and the fallacy of the arguments ad-
   vanced against  It, with hints as to the management  and oare  of
   smallpox patients. 32mo.  Cloth.                   Price 60 cents.

MALARIA: Where Found ;  Its Symptoms and How to Avoid
   It.  Cloth.                                       prl0e 75 oent8>
  " A forcible, logical, and sensible little book."—Philadelphia Timet.

DYSPEPSIA.   How to Avoid It.   By Joseph F. Edwards, m.d.
   Discusses food  and  digestion.  States how food should be  cooked,
   and plainly shows how and what we ought to eat.  Second Edition.
   16mo.   Cloth.                                     Price 75 cents.
«." A™ongtne adm|rable publications of Presley Blakiston, there is none
that will Be more welcome than Dr. Joseph F. Edwards'little treatise on
 Dyspepsia.' It is, in fact, a handbook of cooking and eating, practical and
exoellent in every way."—Boiton Globe.

CONSTIPATION,   Plainly Treated and Relieved without the
   Use of Drugs.  By Joseph F. Edwards.  18mo.  Cloth.  Price 75 cents.
ni'f'i8,00.! ofTtno!e  useful little books which every one ought to read."—
Philadelphia Inquirer.                               B     »»««*•

BRIGHT'S DISEASE.   How Persons Threatened or Afflicted
   with this Disease Ought to Live. By J. F. Edwards, *.d.  Second
   Edition, lemo.  93 pages.  Cloth.                   Price 75 cents.
  " It encourages the sufferer as well as instructs him."— Congregationalut.
trthnMnniSi }8hdoInK a eood w°rkIn tnese volumes, and their wide dls-
niifhil^Tngtnepi,opleicanbutt)e Productive of  the best results; he
?-H.hi?^mploy1Ilor 5dJ0Cates an7 qaadk methods or treatment, but planly
ffiS£p3S»2L,,0wt0 ^ °F aU6Viate BUfferin* *°* <"*ePase."Z
  Any of the above sent by mail, postpaid, upon receipt of price. 
Select Lid oj Books.                     3
  THE  MANAGEMENT  OF  CHILDREN  in  Health  and
      Disease.  By Mrs. Amie M. Hale, m.d.  A book for Mothers.  Second
      Edition.  12mo.  Cloth.  Price 75 cents.

                   THB PRJCS8 COMMEND IT AS FOLLOWS:
    " Altogether, it is a book which ought to be put into every baby basket
  even if some lace-trimmed finery U left out, and should certainly stand on
  every nursery bureau."—Philadelphia Public Ledger.

    "Admirable coinmon-sense advice.which mothers would do well to have "
  Southern Churchman.
    " Contains invaluable instruction."—Evening News, Detroit.
    "The importance of this book cannot be over estimated."—tf. E  Journal
  of Education.

    " A work for mothers, full of wisdom."— Congregationalism
    "Ought to be the means of saving many a young life."—Phila Inquirer.
    * Abounds in valuable information."— Therapeutic Gazette.
    " Emphatically a book  for mothers, and cannot fail to be useful to all
  who read it."—Indiana Farmer.

    " Admirably simple, clear, sensible, and safe in its teachings."— Friends1
  Review.

    " It should be upon every household table."—Nashville Jour. Med. and Sur.

 BIBLE HYGIENE ;  or, Health Hints.  By a Physician.  This
     book  has been written, first, to impart in a popular and condensed form
     the elements of Hygiene. Second, to show how varied and important
     are the Health Hints  contained in the Bible, and third, to prove that
     the secondary trendings of modern philosophy run in a parallel direction
    with the primary light of the Bible. 12mo.  Cloth. Price il.OO.  PaDer
    covers 60 cents                                                *

                        NOTICES OF THE PRESS.
  " The anonymous English author of this volume has written a decidedly
 readable and wholesome book."—Philadelphia Press.
  " The scientific treatment of the subject is quite abreast of the present
 day, and is so clear and free from unnecessary technicalities that readers
 of all classes may peruse it with satisfaction and advantage."— Edinburgh
 Medical Journal.

 DRAINAGE FOR HEALTH; Or,  Easy  Lessons  in  Sanitary
    Science, with numerous Illustrations.  By Joseph Wilson, m. d.. Late
    Medical Director, United States Navy.  One vjl. Octavo.  Price $l.o».
  "Dr. Wilson is favorably known as one of the leading American writers
on  hygiene and public health.  The book deserves  popularity."—Medical
and Surgical Reporter.

NAVAL HYGIENE and Human  Health :  the  Means of Pre-
    venting Disease.  By Joseph  Wilson, m.i>.. Late Medical Director U
    S. Navy.  Illustrated.   8vo.  Cloth.  Price $3.00. 
P. Blakiston, Son &  Co.'s
 THE AMERICAN HEALTH  PRIMERS.  Edited by W. W.
    Keen, m.d.  Bound in  Cloth.  Price  60 cents each.  Paper covers 3^
    cents each.

     The Twelve Volumes, in Handsome Cloth Box, $6.00.

      I. Hearing and  How to Keep It. With illustrations. By
          Chas. H. Burnett, m.d., of Philadelphia, Aurist to the Presby-
          terian Hospital, etc.
     II. Long JLire, and How to Reach It.   By J. G. Richardson,
          m.d., of Philadelphia, Protessor of Hygiene In the University of
          Pennsylvania.
    III. The Summer and Its Diseases. By James C. Wilson, m.d.,
          of Philadelphia, Lecturer on Physical Diagnosis in Jefferson
          Medical College.
     IV. Eyesight, and How to Care for It. With Hlustrations.
          By G-eorge O. Harlan, m.d., of Philadelphia, Surgeon to the
          Wills (Eye) Hospital.
     V. The Throat and  the Voice.  With illustrations.   By J.
          Solis Cohen, m.d., of Philadelphia, Lecturer on Diseases of the
          Throat in Jefferson Medical College, etc.
    VI. The Winter and Its Dangers. By Hamilton Osgood, m.d.,
          of Boston, Editorial Staff Boston Medical and Surgical Journal.
    VII. The Month and  the  Teeth.  With illustrations.  By J. W.
          White, m.d., d.d.s., of Philadelphia, Editor  of the  Dental
          Cosmos.
  VIII. Brain Work  and Overwork.  By H. O. Wood, Jr., m.d.,
          ot Philadelphia, Clinical Protessor of Nervous Diseases in the
          University of Pennsylvania, etc.
    IX. Our  Homes.  With  illustrations.   By Henry Hartshorne,
          m.d., of  Philadelphia, formerly Professor of Hygiene in  the
          University of Pennsylvania.
     X. Tbe Skin In Health and  Disease. By L. D. Bulkley,
          m.d., of New York, Physician to the Skin Department of the
          Deinilt Dispensary and of the New York Hospital.
    XI. Sea Air and Sea Bathing. By John H. Packard, m.d., of
          Philadelphia, Surgeon to the Episcopal Hospital.
   XII.  School and Industrial Hygiene. By D. F. Lincoln, m.d.,
          of Boston, Mass., Chairman Department of Health, American
          Social Science Association.

  This series of American Health Primers is prepared to diffuse as widely
and cheaply as possible, among all classes, a Knowledge of the elementary
facts of Preventive Medicine,  and the bearings  and applications of the
latest and best  researches in every branch of Medical and Hygienic Sci-
ence.  They  are intended incidentally to assist in curing disease, and to
teach people how to take care of themselves, their children, pupils, em-
ployes, etc.
  They are wrltt«n from an Amerioan standpoint, with especial reference
to our Climate, Sanitary Legislation and Modes of Life. 
Select List of Books.                   ) 5
                        NOTICES or THE PRESS.
   " As each little volume of this series has reached  our hands we have
 found each in turn practical and well-written."—New York  School Journal.
   " Each volume of the 'American Health Primers' The Inter-Ocean has had
 the pleasure to commend.  In their  practical teachings,  learning, and
 sound sense, these volumes are worthy of all the compliments they have
 received.  They teach what every man and woman  should know,  and yet
 what nine-tenths of the intelligent class are ignorant of, or at best, have hut
 a smattering knowledge of."—Chicago Inter-Ocean.
   "The series of American Health  Primers deserves hearty commenda-
 tion.  These handbooks of practical suggestion are prepared by men whose
 professional competence is beyond question, and, for the  most  part, by
 those who have  made the subject treated the specific study of their lives.
 Such was the little manual on 'Hearing,' compiled by  a well-known aurist,
 and we now have a companion treatise, in Eyesight and How to Care for It,
 by Dr.  George C. Harlan,  surgeon to the Wills Eye Hospital. The
 author has contrived to make his theme intelligible and even interesting
 to the young by  a judicious avoidance of technical  language, and the
 occasional introduction of historical  allusion.   His simple and felicitous
 method of handling a difficult subject is  conspicuous in the discussion
 of the  diverse  optical  defects,  both  congenital  and  acquired,  and
 of those injuries and diseases by which the eyesight may be impaired or lost.
 We are of the opinion  that this little work will prove of special utility to
 parents and all persons intrusted with the care of the eyes."—New York Sun.
   "The series of American  Health  Primers  (now  entirely completed)
 is presenting a large body of sound advice on various  subjects, in a form
 which is at once attractive and serviceable.  The several writers  seem to
 hit the happy mean between the too technical and the  too popular. They
 advise in a general way, without talking in such a manner as to make their
 readers begin to  feel their own pulses, or  to tinker their bodies  without
 medical advice."—Sunday-school Times.
   " Brain  Work and Overwork, by Dr. H. C. Wood, Clinical Professor of
 Nervous Diseases in the University  of Pennsylvania, to city people, will
 prove the most valuable  work of the series.  It gives, in a condensed and
 practical form, just that information which is of such vital importance to
 sedentary men.  It treats the whole subject of brain work and overwork,
 of rest, and recreation, and exercise in a plain and practical way, and yet
 with the authority of thorough  and  scientific knowledge.  No man who
 values his health and his working power should fail to  supply himself with
 this valuable little book."—State Gazette, Trenton, N. J.
  " An unexceptional household library."—Boston Journal of Chemistry.
  " Every  family should have the entire series; and  every man, woman,
 and child should carefully read each book."—Alabama  Baptist.

  " Everybody knows that It Is uncomfortable to be cold, but few know that
undue exposure to cold shortens life, and still fewer the nature of the safe-
guards that ought to be taken against it. .   .  .  This little book, Winter
and Its Dangers, contains a mass of well digested and practical Informa-
tion."— St. Louis Globe Democrat, In a twcwjolumn review, Nov. 24th, 1881.
  "The whole series is a particularly useful one, and  should be added to
the reference books  of Academies and High Schools."—Zum'j  Herald,
Boston. 
6
P. Blakiston, Son &  Co.'s
WHAT TO DO FIRST in Accidents and Poisoning.   By Charles
    W. Dulles, m.d. Illustrated.  18mo.  Cloth.  Price 50 cents.

                              PREFACE.
  Whoever has seen how invaluable, in the presence of an accident, is the
man or woman with a cool head, a steady hand, and some knowledge of
what is best to be done, will not fail to appreciate the desirability of possess-
ing these qualifications.  To have them in an emergency one must acquire
them before it arises, and it is  with  the hope of aiding any who wish to
prepare themselves for such demands  upon their own resources that the
following suggestions have been put together.

                             OPINIONS.
  " Of special  praotical value, and we  commend it to alL"—Lutheran Ob-
server.
   " Ought to be in everybody's hands."— Timet, Philadelphia.

WATER ANALYSIS For Sanitary Purposes; With  Hints for
   the Interpretation of Results.  By E. Frankland, fed., d.o.l.  With
   Illustrations, Tables, etc., etc.  12mo.   Cloth.  $1.00.
  " The name of the author, who is a distinguished Chemist, and has had
great experience in sanitary matters, is a  sufficient testimonial to its ac-
curacy and its great practical value."—Boston Journal of Chemistry.
EYESIGHT, GOOD AND BAD.   The Preservation of Vision.
   By Robert Brudenel Carter, m.d., f.r.c.s.  Second Edition. With many
   explanatory Illustrations.  12mo.  Price: pap sr covers, 75c; cloth, $1.26.

                              PREFACE.
  A large portion of the time of every ophthalmle surgeon is occupied, day
after  day, in repeating to successive patients precepts  and injunctions
which ought to be universally known and  understood.  The  following
pages contain an endeavor to make these precepts and  injunctions, and
the reasons for them, plainly intelligible to those who are most ooncerned In
their observance.
                      WHAT 18 THOUGHT OF IT.
  " A very valuable  book, and  should be in everybody's hands."— North
American.
  " A valuable book for all who are interested In  the  best use and preser-
vation of the vision."— N. E. Journal of Education.
  " A compact volume, full of information to all classes of people."— Book-
seller and Stationer.
  "A  comprehensive treatise, well calculated to educate the public."__
Kansas City Review.
  " Gives excellent ad vice."—Chicago Journal.
  " To teachers particularly the book is of interest and importance "—
Educational Weekly. 
Select List of Books.
7
 ON  SLIGHT  AILMENTS.   Their  Nature  and  Treatment.
    By Lionel S. Beale, m.d.  Large 12mo. Cloth.  Price .
  Among civilized nations a perfectly healthy individual seems to be the
 exception rather than the rule ; almost every one has experienced very fre-
 quent departures, of one kind or another, from the healthy state; in most
 instances these derangements are slight, though perhaps showing very
 grave symptoms, needing a plain but quick remedy.
                     CONDENSATION OF CONTENTS.
  The Tongue  in Health and Slight Ailments, Appetite, Nausea, Thirst,
 Hunger, Indigestion, its Nature and  Treatment, Dyspepsia, Constipation,
 and its Treatment, Diarrhoea, Vertigo, Giddiness,  Biliousness, Sick Head-
 ache, Neuralgia, Rheumatism, on the Feverish and Inflammatory State,
 the Changes in Fever and Inflammation, Common Forms of Slight Inflam-
 mation, Nervousness, Wakefulness, Restlessness, etc., etc.
                              OPINIONS.
  " It abounds in information and advice, and is written for popular use."—
 Philadelphia Bulletin.
  " Singularly clear and felicitous."—Sanitarian.
  "A valuable work for the family library."—Boston Transcript.
  " A thoroughly practical  work for non-professional as  well as medical
 readers."—Cincinnati Gazette.
  " A scholarly book, singularly free from all technicalities, and almost as
 valuable to  general readers as to the profession."—Chicago  Inter-Ocean.
  "Clear, practical, and a valuable instructor and guide."—Baltimore Ga-
 zette.
  " The advice given as to  treatment is so excellent, that no student or
 young practitioner should neglect to read it."—Med. and Surgical Reporter.
  " In a very important sense, a popular book."—Chicago Advance.
  "An admirable treatise upon the  minor ills  which  flesh Is heir to."—
 Springfield Republican.

WHAT EVERY MOTHER SHOULD KNOW.  By Edward
    Ellis, m.d., Author of a Practical Manual on the Diseases  of Children.
    16mo.  Cloth. Price 75 cents.
  " As it is only too true that oar children have to dodge through the early
part of life as through a sort of pathological labyrinth, we must be thank-
ful to meet with such a sensible  guide for them as  Dr. Ellis. He ia emi-
nently a practitioner among doctors,  and a doctor among practitioners;
that is to say, he is learned and well knows  what is  known, can do what
should be done, and can put what he has to say in plain and comprehensive
language."—Pall Mall  Gazette.
  " The author has a faculty of sketching out the characteristics  of dis-
eases and their treatment In  striking  outlines, and of making his  points
very clear and impressive."—y. F. Medical Record. 
8                 P. Blakiston, Son &  Co.'s
DRUGS  THAT ENSLAVE.  The Opium, Morphine, Chloral,
    and Hashisch Habits.  By H. H. Kane, m.d., of New York City.  One
    volume. 12mo.  With Illustrations.  Price $1.60.
  A curse that is daily spreading, that is daily rejoicing in an increased
number of victims, that entangles in its hideous meshes such great men as
Coleridge, De Quincey, William Blair, Robert  Hall, John Randolph, and
William Wilberforce, besides thousands of others whose vice is unknown,
should demand a searching and scientific examination.
  " A vivid and startling expose of the increase of this form of Intemper-
ance, and  the terrible sufferings endured by those trying to  free them-
Belves from this habit."—Pittsburg Telegraph.          ,
  " It is well that  such a warning as is contained in this book should be
sounded."—Albany Evening Journal.
  "The volume seems to be a summary of the results of the most approved
practice, both In Europe and this country."—New York World.
  " A work of more than ordinary ability and careful research.  . .  .  For
the first time, reliable statistics on the use of chloral are classified and
published. .  .  .  And it is shown that the use of chloral causes a more
complete and rapid ruin of mind and body than either opium or morphine."
 —Druggists'' Circular and Gazette.
  " The effects of the habits described are set forth boldly and clearly, and
the book must have a beneficial effect.  It will do still better service in de-
terring persons from experimenting 'to see  what it is like.'"—Charleston
(S. C.) Newt and Courier.
  " The subject of the chloral habit has not been Investigated by any one,
we believe, so thoroughly as by Dr. Kane."—Medical Record.
  " There is ground lor a now temperance movement here.  The book Is a
valuable one.  It Is written  in a practical manner, and has nothing of a
sensational character."—Philadelphia Ledger.

THE  OCEAN AS A  HEALTH  RESORT.   A  handbook oi
    Practical information  as to Sea Voyages, for the use of Tourists and
    Invalids.   By Wm. S. Wilson, l.r.c.p..   Lond , m r.c.s.e.  With a
    Chart showing the Ocean Routes, and Illustrating the Ph; sical Geo,
    grapby of the Sea.  Crown 8vo.  Price $2.50.

HEALTH  RESORTS.   Health Resorts for the Treatment of
   Chronlo Diseases.  A Hand-Book, the result of the author's own obser-
   vations during several years of health travel  in many lands; contain-
   ing also remarks on climatology and the use  of mineral waters.  By T.
   M. Madden, m.d.  8vo.  Price $2.60.
 " Rarely have we encountered a book containing so much information for
both invalids and pleasure seekers."— The Sanitarian.
ON NURSING.   A Manual for Hospital Nnrses and all engaged
   in attending to the sick.  4th  Edition.  With Recipes  for Sick Room
   Cookery, etc.  Price 75 cents.
  Gives complete directions for the management of the sick room, for feed-
ing, washing and  dosing patients, about  accidents and operations, use of
Uterometer, cupping, etc., etc, ete. 
Select List of  Books.
9
                 HOW   TO    LIVE.
         A GUIDE TO HEALTH AND HEALTHY HOMES.
 By GEORGE WILSON, M.D.   Second  Edition.  Edited by Joseph G.  Richardson,
 „, „ _,      Professor of Hygiene University of Pennsylvania.
 814 Pages.   Price, cloth, 81.00;  Paper covers,  75 Cents.
                    SCOPE OF THE WORK.
   The object of the author in writing this book is to advance the art of
 preserving health; that is, of obtaining  the  most perfect action of body
 and mind during as long a period as is consistent with the laws of nature
 Though many books have been written analogous to the subject there is
 none like this; sufficiently simple, and at the same time systematic and
 comprehensive.  A glance at the table of contents will convince the reader
 of its completeness and reliability  as a guide to all those wishing to lead a
 happy, healthy and long life.
   Chapter I is a general introduction to the whole  surject, giving a few
 statistics in regard to death rates, and remarks showing the great number
 of preventable diseases and the  possibility of reducing the many early
 deaths by a proper regard of simple health rules   Chapter II  is explana,
 tory of the different functions of the  human body, for the more thorough
 understanding of the following chapters.  Chapter III is headed Causes
 of Disease, self induced and social; treating of intemperance in  food as
 well as drink and tobacco, mental overwork, immorality, idleness, irregular
 modes of  living, sleep and clothing, contagious  diseases, consumption, etc.;
 unsound  food,  impure air, etc., et*.  Chapter IV is more  particularly
 devoted to food and diet, their proper choice, digestive qualities and prepar-
 ation.   Chapter V treats the subjects of cleanliness and clothing,   ft  is
 astounding, the Ignorance displayed  by the majority of people on these
  Solnts, and Dr. Wilson gives many useful hints invaluable to every one.
  hapter VI  is on Exercise,  Recreation, etc., giving the proper amount of
 exercise  to be taken by boys and girls,  young and old, explaining its
 necessity and good effects ;  details are also given lor the proper training
 for racing  and  athletic sports as  recommended at  various  universities.
 Chapter VII treats of the more general theme of the Home and its  sur-
 roundings, drainage, water supply, ventilation, warming, outside premises.
 and Innumerable hints of value about choosing or building a new home, and
 the alteration and healthful arrangement of  an old one.   Chapter VIII,
 Diseases and their prevention, and  concluding remarks.
  Only an outline of the scope of this book can be had from these few gen-
eral headings, but it would De Impossible  to give in so limited a space the
thousand and one subjects  handled, popular errors corrected, and useful
hints given by  Dr. Wilson, in these three  hnndred  and fourteen closely
printed pages.  A general index completes the volume, and the well known
name or Prof. Richardson on the title page, as editor, is an additional guar-
antee of its trustworthiness as a guide in all things relative to health and
How we should live.
      <*                PRESS  NOTICES.
  " The book aims at the prevention of Disease.   It abounds in sensible
suggestions, and will prove a reliable guide."— Churchman.
  " A most useful and, In every way, acceptable book."— New York Herald
  " Full of good sense and sound advice.'1— Educational Weekly.
  " Deserves wide and general circulation."— Chicago Tribune 
10
P. Blakiston, Son & Co.'s
ON  HEADACHES.  The Nature, Causes, and Treatment of
    Headaches. By Wm. H. Day, if .d. Third Edition. Illustrated.
                            Price, In paper covers, 76 cents; cloth, $1.26
  "The work is one that will be read with interest by those who are called,
on to treat the disease—and even more by those who are at the same time'
personally acquainted with its tortures."— Ohio Medical Recorder.

THE  MANUFACTURE  OF PERFUMES,  POWDERS,
    Soaps, etc.  The Art of Perfumery ; or, the Methods of Obtaining the
    Odors of Plants,  and Instruction for the Manufacture of Perfumery,
    Dentifrices, Soap, Scented Powders, Odorous  Vinegars and Salts,
    Snuff, Cosmetics, etc., etc.   By  G. W. Septimus Piesse.  Fourth Edi-
    tion.  Enlarged.  366 Illustrations.   8vo.  Cloth.           Price $5.60
  " An excellent book "—Commercial Advertiser.
  " It is the best book on Perfumery yet published."—Scientific American.
  " Exceedingly useful."—Journal of Chemistry.
  " Is in the fullest sense comprehensive."—Medical Record.

POISONS AND  THEIR ANTIDOTES.   A Memoranda  of
    Poisons and their Antidotes and Tests.  By Dr. Thomas Hawkes Tan-
    ner.  Fourth Edition. Revised  and Enlarged.         Price 76 cents.
  This most complete manual should be within reaoh of all; for, as an addi-
tion to every family library it would be the means of saving life and allay-
ing pain when the delay of sending for a physician would  prove fatal.  It
shows at a glance the treatment to be adopted in each particular instance
of poisoning.

INTERMARRIAGE.  A Scientific Inquiry into the Causes why
    Beauty, Health, and Intellect result from certain- unions, and Deform-
    ity, Disease, and Insanity from others.  By Alexander walker.  Illus-
    trated.  12mo.  Cloth.                                   Price $1.00
  The work is not  of that empiric character which its title mightlead some
readers to suppose ; but a careful philosophical treatise.  It Is  entitled to
great consideration; and even  if the author's  theory as applied to the hu-
man species be wrong, the facts here accumulated, on the  subject of cross
breeding, etc., cannot fail to be of high value and interest to stock farmers
and others.  There is nothing indelicate In the work, to an enlightened
reader.

MARRIAGE, In its Social,  Moral  and Physical Relations.  By
    Dr. Michael Ryan, Member of the Royal College of Physicians and Sur-
    geons, London. l2mo.  Cloth.                            Price $1.00

DANGERS  TO  HEALTH. <• A  Pictorial Guide to Sanitary
    Defects, showing the many defects  in Sewers,  Drain Pipes, etc, and
    how they may be detected.  By T.  Prldgin  Teale. 8vo.  Illustrated.
                                                          Price $3 60
  With 70 illustrations, most of them colored, showing In the clearest way
the dangers to health arising from carelessly laid drains and old  sewers. If
any testimony is needed to show the increasing interest taken by the public
In such commonplace matters as drains and waste pipes, it is to be found in
the fact that two large editions of this book have already been sold. 
Select List of Books.
11
LONG LIFE.  The Art of Prolonging Life.   By  C. W.  Hufe-
    land. New Edition. Edited by Erasmus Wilson, m.d. 12mo. Price 81.00
  " We wish all doctors and all their intelligent clients would read it, for
Burely Its persual would be attended with pleasure and benefit."—Ameri-
can Practitioner.
  " We all desire long life, and the attainment of that object, as far as it
can be accomplished by an adherence to the laws prescribed by nature,
may be furthered by a perusal of Dr. Hufeland's book, which is written in
a style so perspicuous and free from technicalities as to be readily compre-
hended by non-professional readers."— Philadelphia Evening Bulletin.
  "The work is a rational and well  ordered presentment on  a subject of
moment to all.  It prescribes no panacea, but puts in requisition instru-
mentalities that are in everyone's reach.   It should be read by all. "—North
American.

ALCOHOL AND TOBACCO. Alcohol;  its  Place and Power.
    By James Miller, p.r.o.8.; and, Tobacco; its Use and  Abuse.  By
    John Idzars, m.a.  The two essays in one volume.   Cloth, Price $1.00
    Either essay separately.                              Price 50 cents.
  " A perusal of this work rather startles a smoker and chewer, and gives
one an idea of the silent work going on in the system.  It certainly shows
that a man must sooner or later feel the  pernicious influences of alcohol
and tobacco.  Let smokers and absorbers read it, and then make their cal-
culations on the length of time they will last under a continuation of the
evils,  and whether it is not best to need the facts there laid down and ' mod-
erate' a little."—Californian.
  " They are full of good, strong, medical sense, and ought to be very influ-
ential agents against the vices they assault."—Congregationalism
  "We have seldom read an abler appeal against the demon of intemper-
ance, or one enforced by more cogent arguments. "—Philadelphia Inquirer.

THE MENTAL  CULTURE AND TRAINING  OF  CHIL-
    dren.  By Pye Henry Chavasse.  12mo.  Price $1.00; paper cover, 60 cts.
  The mental culture and training of children is of immense Importance.
Many children are so wretchedly trained, or rather, not trained at all, and
so mismanaged, that a few thoughts on this subject cannot be thrown
away, even upon the most careful.

ON INDIGESTION.   Indigestion: What It Is ; What It Leads
    To; and a New Method of Treating It.  By John Beadnell Gill, m.d.
    Second Edition. 12mo.                                  Price $1.25
  " Indigestion, pure and simple, is responsible for almost all the other dis-
eases that flesh is heir to.  Rheumatism  and gout are the direct conse-
quences of this disorder, as well as heart and  lung  troubles.  To cure this
diseased state of digestive and assimilating organs Dr. Gill, a distinguished
English physician, has written this able treatise.  He has summed up some
eighty-eight cases and their natural remedies, besides a system of eliminants
and tonics.  Great stress is laid on proper bathing, as a curative agent, and
on drinking hot  water and  Its other uses.  The fact  of a  second edition
being  required within a few months of the first, needs no  comment, and
points the demand."—Philadelphia Ledger. 
12 r-
P. Blakiston, Son & Co.'s
C
RULES  OF  ORDER;  A  LEGISLATIVE  MANUAL.
   Rules for Conducting Business in Meetings of Societies, Legislative
   Bodies,  Town and Ward Meetings, etc.  By Benj. Mathlas,  a.m.
   Seventeenth Edition.  16mo.  Cloth.                    Price 60 cts.

DOMESTIC MEDICINE.   A Condensed Compend of Domes-
   tic Medicine, and Companion to the Medicine Cheat.  By Drs. Savory and
   Moore.  Illustrated.  32mo.  Cloth.                  Price 60 cents.

ON  HEADACHES.   Ninth  Thousand.   Headaches,  Their
   Causes, Nature and Treatment  By Henry  O. Wright, m.d.  Cloth.
                                                     Price 60 cents.

CHEMISTRY PRIMER.   A Primer of  Chemistry, including
   Analysis.  By Arthur Vacher.  18mo.  Cloth.          Price 60 cents.

PRACTICAL MINERALOGY.   Practical Mineralogy,  Assay-
   ing and Mining, with a description of the  Useful Minerals, and in-
   structions for Assaying and Mining according to the simplest  methods.
   By Frederick Overman.  12mo.  Cloth.                   Price $1.00

ON  COPPER.  The Chemistry and Metallurgy of Copper; the
   art of mining and  preparing ores for market, and  the  various pro-
   cesses of Copper Smelting, etc. By A. Snowden  Plggott, Analytical
   and Consulting Chemist.  Illustrated.  l2mo.  Cloth.     Price  $1.00

THE  MICROSCOPIST. A Manual  of  Microscopy, and Com-
   pendium of Microscopic Sciences. Micro-Mineralogy, Micro-Chemistry,
   Biology, Histology, etc.  By Joseph H. Wythe, a m., m.d.  Fourth
   Edition.  25.; Hlustrations.         Price, Cloth, $6.oo; Leather, $6.00
  " Its text is well written, concise and comprehensive, but its chief value Is
to be found In the two hundred and five illustrations, whose scope  embraces
almost every class of subjects the amateur is likely to desire knowledge
upon."—Philadelphia Medical Times.
  " The work is clearly written and its matter presented systematically and
in very judicious proportions.  It contains a great number of beautifully
colored plates, which will prove helpful to the student."—Popular  Science
Monthly.

HOSPITALS AND  THEIR MANAGEMENT.  Pay Hospi-
   tals and Paying Wards throughout the World. Facts in support of a
   system  of medical relief.  By Henry O. Burdett, m.d.  8vo.  Cloth.
                                                         Price $2.26
                        BY SAME AUTHOR.

PROGRESS, MANAGEMENT AND WORK OF COTTAGE
   Hospitals;  with many Plans and Illustrations.  Demi 8vo.  Cloth.
                                                        Price $1.60
  " Mr. Burdett displays and discusses the whole scheme of hospital accom-
modation, with a comprehensive understanding of its nature and extent."—
American Practitioner.

DEAFNESS, GIDDINESS,  ETC.   Deafness,  Giddiness,  and
   Noises in the Head.  By Edward Woakee, m.d.  Illustrated.  12mo.
                                                         Price $2.60 
Select List of Books.
13
LIFE THEORIES.   Life Theories and  their  Influence  upon
   Religious  Thought. By Lionel S. Beale, m.d.  Six colored  plates.
   12mo.                                                Price $2 00
                        BY  SAME AUTHOR.
PROTOPLASM ; or.  Matter and  Life.  Third Edition.   En-
   larged.  16 Colored PI *tes.  Cloth.                       Price $3.00

BIOPLASM.  An Introduction to the Physiology of Life.  Illus-
   trated.  12mo.                                        Price $2.25

THE  MICROSCOPE  AND  ITS  REVELATIONS.  The
   most Complete Text-Book on the Use  of the Microscope.  By W.  B.
   Carpenter, m.d.. f.r.s.  Sixth Edition.  Enlarged.  600  Illustrations
   (some colored).  882pages.  Cloth.                       Price $5.60

WATER ANALYSIS.  Potable Water;  How to form a Judg-
   ment on Water for Drinking Purposes.  By Chas. Ekin.  Second Edi-
   tion.  12mo.                                       Price 76 cents.

PRACTICAL HYGIENE.  A Complete Text-Book  of Practical
   Hygiene.  By Edward Park*s, m.d.  Fifth Enlarged Edition.  Illus-
   trated.  Thick Octavo. Cloth.                          Price $6.00
  "Altogether it is the most complete work on hygiene which we have
Been."—New York Medical Record.
  "We find that it never fails to throw light on any hygienic question which
may be proposed."— Boston Medical and Surgical Journal.
  "We commend the book heartily to all needing instruction (and who
does not) in hygiene."—Chicago Medical Journal.

A HANDBOOK OF  SANITARY SCIENCE.  Hygiene and
   Sanitary Science.  By George Wilson, m.d.. Medical Oftlcer of Health.
   With  Illustrations.   Fourth  Edition Revised.  Demi  8vo.  Cloth.
                                                        Price $2.76

CHEMISTRY FOR  BEGINNERS.  Progressive Exercises in
   Practical  Chemistry.  By  Chas. L. Bloxam.  89 Illustrations.  Cloth.
                                                         Price $1.76
  This book Is intended for those commencing the study of Chemistry.
  " A great amount of practical information Is here condensed, such as only
a practical teacher could prepare."—New England Journal of Education.

CHEMISTRY, ORGANIC AND INORGANIC.   A Complete
   Text-Book.  By  Prof. Charles L. Bloxam.  Fourth Edition.  Nearly
   300 Illustrations.  8vo. Cloth.                            Price S4 on
  Recommended at  many schools and colleges throughout the  United
States.
  j&~ These Books can be procured from Booksellers generally, or will be
sent, postage paid, upon receipt of the price by the Publishers. 
14
P. Blakiston, Son & Co.'s
POPULAR SCIENTIFIC  BOOKS.

  8®"Either of the following books sent, postpaid, to any address,
upon receipt of
            oisTE  x>o:l,:luA.:r,-

     ANY SIX  BOOKS FOR FIVE DOLLARS.
HOW TO PROLONG LIFE.  By C. W. Hufeland.  Cloth.
DRAINAGE  FOR HEALTH.  Excellent advice about the
  draining of land  and dwellings, pipes to be used, etc  Cloth.
WATER ANALYSIS, for Sanitary Purposes.  A  practical ex-
  position of the subject.  By Prof. Ed. Frankland.   Cloth.
INTERMARRIAGE.  Why beauty, health and intellect result
  from certain unions, and deformity, disease and insanity, from
  others. Cloth.
BIBLE  HYGIENE. The relation between the Laws of Moses
  and other Biblical writers and the Hygiene of the present. Cloth.
COPPER; Its Chemistry and Metallurgy.  Piggott.  Cloth.
MENTAL CULTURE AND  TRAINING OF CHILDREN.
  By Henry Chavasse.  Cloth.
MARRIAGE; Its  History and Philosophy. By Dr. Michael Ryan.
  Cloth.
HOW TO LIVE.  A useful home book, containing many valu-
  able suggestions.   Wilson. Cloth.
PRACTICAL MINERALOGY. Assaying and Mining.  Over-
  man.   Cloth.
ALCOHOL AND TOBACCO.  Their Use and Abuse.  Miller
  and Lizars.  Cloth.
  8^*" Either of the following books sent, postpaid, to any address,
upon receipt of
  SE^TEnSTTY-IFirVE OZEHSTTS-
Any Six Books for Three Dollars and Seventy-five Cents.
HEADACHES; Their Causes, Nature  and Treatment. Dr. Day.
  Paper.
POISONS AND  THEIR ANTIDOTES.  Should be in every
  family library.  Tanner.  Cloth.
DYSPEPSIA; HOW TO AVOID  IT. Directions  for the
 "* proper cooking and eating of food.  Edwards.  Cloth. 
Select List of Books.                 15
HOW TO  LIVE.  A useful  home book, containing many valu-
  able suggestions.  Wilson.  Paper.
INFANTS; Their proper Management in Health and Disease.
  Hale.   Cloth.
MALARIA ; Where Found, its Symptoms, and How to Avoid it.
  Edwards.   Cloth.
GOOD  AND BAD EYESIGHT.  A popular exposition  of the
  physiology of vision.   Illustrated.  Carter.   Paper.
CONSTIPATION. Its relief by habits of living, eating, and
  6X6TC1S6*  Edwiirds   C^lotTi
DISEASES OF CHILDREN.  What every mother should know
  about them ; in plain, comprehensive language.  Ellis.  Cloth.
WATER. ^  How to form a judgment on the suitableness of water
  for drinking and cooking.  Ekin.   Cloth.
BRIGHT'S DISEASE.   How persons afflicted with this disease
  ought to live.   Edwards.   Cloth.
NURSING OF THE SICK, with Rules  for Diet, Hygiene, In-
  valid  Cooking, etc.   Domville.   Cloth.
  1®"'Either of the following books sent, postpaid, to any address,
upon receipt of
             FIFTY  OEN7TS.
    Any Six Books fop Two Dollars and Fifty Cents.

A PRIMER OF  CHEMISTRY.  Vacher.   Cloth.
RULES  OF ORDER, for Conducting Business in Meetings of
  Societies,  Legislative Bodies, Town and Ward  Meetings, etc.
  Mathias.  Cloth.
AMERICAN HEALTH  PRIMERS. (See special list.)   Cloth.
ALCOHOL, Its Place and Power.  Miller.  Cloth.
EMERGENCIES.  What to do first in accidents,  poisoning, etc.
  Dulles.  Cloth.
BIBLE  HYGIENE.  The relation  between the Laws of  Moses
  and other Biblical writers and  the Hygiene of the present. Paper.
COMPEND OF DOMESTIC   MEDICINE.   By Savory &
  Moore.  Cloth.
HEADACHES ; Their Causes and Treatment.  Wright.   Ninth
  Thousand.  Cloth.
TOBACCO. Its Use and Abuse.   Lizars.   Cloth.
VACCINATION  AND SMALLPOX.   Edwards.  Cloth. 
16
Select List of Books.
      VACCINATION
                             AND

                  SMALLPOX.

              A NEW BOOK BY DB. JOS. F. EDWARDS.

      32mo,  CLOTH.   PRICE  50  CENTS.

  This is a most timely monograph, for, owing to the spread of this dread
disease, the subject is of interest to every one.  Tlie author's aim is to sho v
the advantages of being vaccinated and the fallacy of the arguments used
by those opposing it, with advice as to the caro and management of Small-
pox patients.



      BIBLE    HYGIENE;

                              OR,

            HEALTH   H INTS.

                      BY A  PHYSICIAN.

      ISmo, Cloth.  Price &I.OO.  Paper, 50 cts.

  This is a most curious book, interesting in an historical as well as a theo-
logical and sanitary light.
  It has a threefold purpose: First: To impart, in a popular and easily
understood form, those elements of health preservation which are fast
taking the place of medicines.  Second: To show the importance of the
health hints contained in the Bible.   Third: To prove that modern ideas
on the preservation of disease run  in a parallel direction with the laws of
Moses and other Biblical writers.  The author has consulted many books
and ditferent editions of the Bible in preparing his work, compressing into
the volume a great amount of valuable information and the conclusions
of many  other writers.

Any book in this Catalogue will be sent, postage prepaid, upon
   receipt of price.  See pp. 14 and 15 for SPECIAL OFFER.
        Money should  be sent by Draft,  Post Office
              Money Order, or Registered  Letter.

  The publishers have an extensive stock of  books in all branches of Medi-
cine and Science.  Catalogues furnished  upon  application, correspond-
ence solicited.

             P.  BLAKISTON, SON & CO.,
   BOOKSELLERS, PUBLISHERS AND IMPORTERS,

        1012   WALNUT  ST.,  PHILADELPHIA. 
 

 
*1^ 
NLM001223955