REMARKS 
ON 
VACCINATION 
BY 
WM. H. HINGSTON. M.O., D.C.L., L.R.C.S. ED1NR. 
Member of the Imperial Leopold Academy ; Societe Medicale All. of Palis ; 
Pollichia of Bavaria; Hon. Mom. Gynecological Society of Boston, 
Ac., Ac., 
Surgeon to Hotel-Dieu Hospital; Consulting Surgeon to 
Woman’s Hospital and Montreal Dispensary; 
President Canadian Medical Association ; 
V.-P. Internat. Medical Congress. 
Chairman of the Board of Health. 
MONTREAL: 
PRINTED BY LOUIS PERRAULT & CO. 
87 St. James Street. 
1,1876. VACCINATION. 
A ddr ess by His Worship the Mayor, Wm. hi. 
Kingston, M.D., Chairman of the Board of Health, 
to the Public Vaccinators, and other Physicians and 
Citizens, on Friday the 20th October, 1876: 
Grentlemen: The prevalence of smallpox in 
this city, disturbing its tables of mortality ; affecting 
its reputation ; and injuring its trade ; has rendered it 
necessary that more than usual efforts should be made 
to eliminate it from our midst. Large and airy hospi- 
tals are established, where every care and attention 
are secured to those who are admitted. It is hoped 
personal and selfish,(if not patriotic motives alone) will 
induce those afflicted with the disease to isolate them- 
selves, and seek comfort and alleviation within their 
portals ; and not continue to be sources of danger to 
others. But such isolation as can be secured is un- 
equal to arrest the progress of the malady without the 
prophylactic means which science has secured to us. 
Your services, gentlemen, have been invited for that 
purpose, and to you is entrusted the important task 
of vaccinating throughout the city generally. 
While having every confidence in your thorough 
fitness for the important work ; that you may pursue 
a common course of action I have prepared a tew 
rules for your guidance. They have received the 
sanction of the Board ol Health to which I sub- 
mitted them at our meeting two days ago; and will, 
I venture to hope, be found sufficiently clear and 
distinct for the purpose for which they are intended. BOARD OF HEALTH. 
INSTRUCTIONS TO VACCINATORS. 
1. Do not act by deputy, but vaccinate, cither by yourself, or by some 
fully qualified medical practitioner as your substitute. 
2. Vaccinate only subjects who are in good health, with prima via in 
good order ; and with no eruption behind the ears, or elsewhere 
on the skin ; nor any febrile state. 
3. Do not vaccinate a subject to whom, from the state of health, 
vaccination may prove injurious. 
4. The Board is responsible for the purity of the lymph furnished in 
the first instance ; but as you are strictly responsible for the 
quality of whatever lymph you gather for further vaccination, be 
careful to take it only from subjects who are in good health, and 
free from eruptions on the skin. 
N.B.—Good lymph is liquid, clear, limpid, translucent, sometimes 
slightly yellow, and moderately viscid, and should flow slowly from 
the punctured vesicle as a syrup, and collect into a globule. 
5. Take lymph only from well characterised uninjured vesicles, and 
not from cases of re vaccination. 
6. Take it when the vesicles are plump, (this is usually on the 8th 
day) and within twenty-four hours after the areola has begun to 
form. 
7. Avoid draining any vesicle which is punctured. 
8. If any undue local irritation arises in more than one case vacci- 
nated from the same lymph, desist from employing it any further. 
9. If the supply of lymph ceases or becomes unsuitable, procure a 
new supply from the cases already vaccinated, or from the Board 
of Health. 
10. Vaccinate from arm to arm when practicable. 
11. If the crust be used, it should not be taken from the arm before 
the 21st day : or better still, wait till it is quite loose. 
N.B.—The crust should be of a dark amber color, and semi- 
transparent. It should not be too thin nor brittle, but should cut 
easily, and without fracture, and be the product of an undrained or 
uninjured vesicle. 12. The Lancet used for vaccinating must not be employed for any 
other surgical operation. 
13. Note particularly, in each case, the source from which vaccina- 
tion is done. 
14. The system should be throughly protected by the production of at 
least four vaccine vesicles. 
15. Carefully fill up the blank Certificate furnished, of those vaccina- 
ted ; or furnish a card to be forwarded to the Health Office 
for those willing to be vaccinated, hut who prefer their family 
Physician ; or note name and address for the information of the 
Board of those unwilling to be vaccinated by any one. 
5 
WM. H. KINGSTON, M.D., 
Chairman. 
I. C. RADFORD, 
Sec retar;/. 6 
It has been suggested to me by some of your body, 
that, in addition to the above, something might be said 
to meet the objections urged by those active, but mis- 
taken writers, against the practice ot vaccination. Had 
similar articles been written against the practice of set- 
ting fractures ; of reducing dislocations ; or ot remov- 
ing dead parts from living bodies, I should have 
thought it useless to reply : for if surgeons contend 
that a dislocated bone should be reduced, the profession 
—I speak of its more experienced members—is almost 
equally unanimous in favor of the practice which 
some so persistently, and so unfortunately, denounce. 
It is something to array oneself against the general 
belief. To follow quietly in the footsteps of those 
who, in all things else, medical, are our guides, brings 
with it, to the mind, less eclat, than to take up arms 
in what may be considered a safe warfare — safe, 
perhaps, to the combatant, but fraught with terrible 
mischief to those moM interested. To prove to the 
unprejudiced that vaccination exerts a protective 
influence over the economy would be an easy task, 
for the writings ol thousands, from the time of .Tenner 
to our own day, are before us for the purpose ; but 
to attempt to convince those who persistently close 
their eyes to the overwhelming evidence of almost 
every country and government in the world, includ- 
ing our own, would be as fruitless as was the effort 
o 
to convince the disbeliever in matter of the reality of 
the missile which almost knocked off his too unyield- 
ing head. In deference, however, to wishes expressed, 
and suggestions offered at a meeting on Wednesday 
last, I venture some observations on this disease, 
now unhappiely too prevalent, and on the means 
which science has furnished for its prevention. 
iSmall-pox has its periods of dormancy, and its 7 
periods of activity, at one moment overspreading a 
district, and at another disappearing. It is fatal in 
direct ratio to its epidemic character. Cases occuring* 
sporadically (here and there in spots), are not so fatal. 
It is the most contagious of all diseases ; and this is a 
point on which I wish to insist; for some industriously 
endeavor to circulate the belief that small-pox drops 
upon individuals as rain drops from heaven—touch- 
ing this one and sparing that! It is communicable 
in every way : by inoculation, by breathing a 
contaminated atmosphere, by the contact or vicinity 
of fomites. It is infectious in the early febrile stage; 
infectious before and during the eruption; and infec- 
tious “ so long as any of the dry scrabs resulting 
from the original eruption remain adherent to the 
body ” It may be caught, therefore, from the living 
body ; it may be caught from the dead body ; or it 
may be caught from clothing and furniture near the 
living or the dead body. So much has this foul 
disease been dreaded, that different nations in times 
past endeavored to mitigate.the malady by communi- 
cating it artificially. The Brahmins in India en- 
grafted the virus; so also did the Turks; and the 
Chinese were in the habit of putting some of the 
crusts into the nostrils. The practice of inoculating 
with small-pox virus became more or less general in 
Europe; and its efficacy in mitigating the severity 
and the danger of the disease was considered to be 
very great. While it is estimated that one third of 
those who take the natural small-pox die, not more 
than three or four in a thousand are destroyed by the 
ingrafted disease. (Curschman states it to have been 
about two per cent.) But the time for small-pox in- 
oculation is past, the law having wisely forbidden if. 8 
Eighty years ago a chance observation was ma- 
tured into a rational and scientific form by a mind 
deeply imbued with the best principles of sound 
philosophy ; and a disease, mild in form, and safe in 
character, was substituted for the inoculation of the 
Turks and Chinese. In 1798, .Tenner published his 
first important paper. In 1799 the first public insti- 
tution for vaccination was established in London ; 
in the following year it was introduced into 
France and Germany; and the practice of vaccina- 
tion has now become general over the whole educated 
world. Here and there, as might be expected, it has 
met with opposition ; but every ob|ection that has 
been urged by the anti-vaccinator has been answered 
again and again bv the leading minds of the profes- 
sion. So much is this the case that I feel I owe 
something like an apology to my medical brethren 
for writing affirmatively of a practice which most of 
them endorse. I spoke a moment ago of Jenner as a 
discoverer; but Jenner did not discover vaccine any 
more than Watt discovered steam. He noticed the 
prevalent belief among the peasantry in the immu- 
nity from small pox enjoyed by farm servants and milk 
maids ; and little by little he drew the conclusion 
which has been so pregnant with benefit to mankind. 
The belief in the existence of a vaccine virus was not 
confined to England. Cow-pox and its relations to 
small-pox had been noticed long before on the con- 
tinent of Europe ; * and in France and Germany nu- 
merous experiments had been made, prior to the time 
of Jenner, to show that persons affected by natural 
•Doctor Michea published an article some years ago proving that 
Vaccination was known to, and practised by the Hindoo physicians : and 
gave an extract from the Satega Grantham (a sacred book attributed 
to Dhanwantari) in support of his assertion. 9 
vaccine virus were not susceptible to the small-pox 
influence. .Tenner’s merit consisted chiefly in produc- 
ing the virus at will, and in diffusing it, at pleasure, 
for our advantage And how slowly and how cau- 
tiously he advanced his every statement, may be 
gathered from the fact that twenty-two years elapsed 
between his first experiment and the promulgation 
of his theory. He was assailed then, as his memory 
is to-day; but with more excuse then than now, for 
no one having the leisure and the disposition to read, 
and having access to the records of medical observers, 
has now the shadow of an excuse for rejecting the the- 
ory then advanced, the critical acuteness of which, 
says Curschmann, may serve as a model. But we do 
things differently now a days, and a harangue in a 
market place or public square, by gentlemen who 
may, ’tis true, be authorities in law, but cannot be 
accepted as such in medicine, is deemed sufficient to 
introduce the uninitiated to a knowledge of 
one of the most difficult and abstruse subjects in the 
whole range of medical science. I shall not 
allude to the members of my own profession who 
have chosen so far to forget what is due to their own 
dignity, and the dignity of their calling, as to select 
such an arena for the dissemination of their fatal 
errors. 
As the times are as pregnant with mischief, 
as the air is with the disease, I proceed to ask and 
to answer questions asked and answered a thousand 
times: 
1st. Does vaccination confer a certain degree of 
protection against small-pox ? 
2nd. Are the effects of vaccination permanent ? 
3rd. Is there risk of lighting up local inflam 
matory action'{ 10 
4th. Is there risk, when vaccinating, of inocul- 
ating the system with scrofula, or other hereditary 
disease ? 
5th. Is there risk of contaminating the system 
with syphilis, or other acquired disease ? 
The answ'ers to these questions will, I think, 
cover the ground gone over by the anti-vaccinists. 
1st. A simple assertion that vaccination does 
confer a certain degree ot protection against an attack 
of small-pox would at once be met by a counter 
assertion that it does not. The question, therefore, 
will be answered inferentially, and from authors the 
most trustworthy, though a desire to economize space 
prevents me from citing them at length. 
And first for England. In the first thirty years 
of the last century, when inoculation of small-pox 
wras unknown, the mortality in London from that 
disease was 7.4, and at the close it was 9.5 per cent, 
inoculation having been introduced in the interval. 
A Committee of the Epidemiological Society have 
compiled tables to show the ratio of mortality from 
sinall-pox in London before and since vaccination 
was introduced, and the following are the results: 
For the fifty years, from 1759 to 1800, the average 
number of deaths from small-pox, out of every 1,000 
deaths from all causes, was 96or nearly ten per cent; 
while during the first half of the present century (the 
halfcentury succeeding the introduction of vaccination) 
the mortal ty was 39. In the whole of England, accord- 
ing to official returns, the estimated death-rate from 
sinall-pox alone at the end of the last century was 3,000 
per million, while from the same returns the present 
death-rate from the.same cause is only 200 per million ! 
An analysis of the latter is most interesting. Vacci- 
nation has, in Great Britain as elsewhere, had its 11 
opponents, bnt the practice has become more and 
more general, (and the opposition to it less and less,) 
till now it is quite general. What is the result? 
During the first ten years of the present century, the 
mortality from small-pox in every thousand deaths 
from all causes was 64; in the second decade, 
42; in the third, 32; in the fourth, 23; and in the 
fifth decade it was 16. Let the anti-vaccinators ex- 
plain this as best they may. Not only has the aver 
age of deaths from small pox diminished in the above 
ratio, but epidemics of the discease have become less 
frequent. Before vaccination it was as 48; during 
vaccination it was as 14. The inference from all 
this is thus drawn by Sir Thomas Watson (the ablest 
medical writer in London): “ Where vaccination is, 
the contagion of small pox need never come.” 
Dr. Robert Thomas, author of the “ Practice of 
Physic,” which serves as a text book for students and 
physicians, after a long and careful analysis of the 
vaccine question, and giving to every objection the 
most patient consideration, thus sums up: “ the intro- 
duction of vaccination, notwithstanding all the abate- 
ments which must be made in the estimate of its 
powers, is still one of the greatest boons that science 
ever conferred upon mankind. Compare the ravages 
committed by small pox, before and after this impor- 
tant epoch; and we may in the first place, appeal to 
general experience in the words of the Report of the 
National Vaccine Establishment, where the rarity of 
an example of disfigurement by small pox now 
to be found in theatres, in churches, or any large as- 
sembly of the people, is adduced in proof of the con- 
tinued protective property of the lymph employed.” 
After a long and laborious analysis of the bills of 
mortality, and of the observations of Christian of 12 
Liverpool, Percivall of Manchester, Monro, Ceely, 
Gregory, Thomson, Curtis and others, he says : “ if 
these conclusions, derived as they are from somewhat 
extensive data, be at all near the truth, they will go 
far to prove Mr. Curtis’s assertion, where he says of 
vaccination, that its value is much greater than that 
of any known remedy for any known disease at all 
comparable to small pox in mischief to the human race. 
How is it in Wales ? Dr. Hughes, of Mold, states : 
“ no child born in the Mold district, and alive at the 
date of the registration of its birth, has died of small- 
pox during fourteen years, yet small-pox has prevailed 
on various occasions all around it.” 
How is it in Ireland, where vaccination has been 
compulsory for the last fifteen years ? The immunity 
afforded by vaccination there has been such as to in- 
duce a wide-spread belief in its efficacy among the 
people. Vaccination is practiced generally all over 
that country, and the children of the soil carrying 
with them an entire confidence in the practice, are 
always the most willing to be vaccinated. The results 
are seen in the following ligures, from which it ap- 
pears, says an official document, that the Irish physi- 
cians have banished small-pox from their island, as 
8>aint Patrick is said to have banished the snakes. In 
the periods 1830 40, 1840-50 and 1850-00, before vac- 
cination was general, the respective annual average 
mortalities had been 5,800, 3,827, and 1,272. In the 
years 1864, 5, 0, 7, 8, they were 854, 347, 187, 20 and 
19, respectively. In the first half of 1869, the whole 
number was three ! The remarkable immunity from 
small-pox conferred by vaccination, induced a laxity 
in the practice, and a few cases occurred subsequent- 
ly to 1869, but they were supposed to have been im- 
ported. In Montreal there are comparatively few 13 
children of Irish parentage unvaccinated, and our 
tables of mortality—to which I beg to refer—show 
how very few of that nationality die of small-pox. 
What is thought in Scotland of the protective 
influence of vaccination V I quote again only our me- 
dical teachers—those from whom we are content to 
receive our medical knowledge. One of the most dis- 
tinguished medical philosophers that Scotland— 
and Scotland is prolific in medical philosophers 
—has produced ; and one who graced, for a great 
number of years, the chair of medecine in the Uni- 
versity of Edinburgh, writes thus : “ The first ques- 
tion is whether or not we have, at this time, in the 
matter of cow-pox, a power at our command capable, 
if duly employed, of depriving the poison of small- 
pox of all fatal influence over an immense majority 
of mankind. And on this subject there has been quite 
sufficient information collected, since the date of the 
papers which were held decisive of the question fifty 
years ago, to show that the same inference is still 
inevitable, and that he who disputes it is equally un- 
reasonable as he who opposes, in like manner, any pro- 
position in Euclid. Of course, when 1 say there has 
been ample evidence to decide this question statistical- 
ly, I mean to refer to cases where we have not only the 
negative evidence of large numbers of persons duly 
vaccinated, having been subsequently, most of them 
repeatedly, or for a long time together, exposed to the 
contagion of small-pox —i. <?., placed in the same cir- 
cumstances in which un vaccinated people have been 
generally affected, and many of them died of small- 
pox ; these vaccinated persons have nevertheless 
escaped, most of them without any indication of 
disease. To show that this is the light in which I 
have always regarded such collections of facts, I quote 14 
one sentence from my own lectures, written as long 
ago as 1820-1821, and repeated almost every winter 
since then :—“ You will remember that the question 
is, not how many vaccinated persons never take 
small pox, but how many vaccinated persons are fully 
exposed to the contagion of small pox and escape 
without any disease ; and our assertion is that, so far 
as is yet known, absolute protection of the human 
constitution is the rule, and the occurence of any 
disease is the exception.” Those who, like me, have 
had the advantage of listening to that most pro- 
foundly logical and conscientious medical teacher, 
well know the care and thought he gave to his every 
utterance. Dr. Alison has passed away, and what 
says Dr. I. Hughes Bennett, his successor in the pro- 
fessorial chair ? “ We have no remedy (for small-pox) 
but vaccination ! ” 
Let us now proceed to the Continent, and what 
do we find ? And first to France— ever foremost in 
all researches having science for their foundation. 
M. Bousquet, in his Trails de fa Vaccine, gives most 
accurate and interesting details of an Epidemic of 
Small-Pox which visited Marseilles in 1825. The 
population of Marseilles amounting to 40,000, might 
be divided into three classes, of which the respective 
numbers stood thus : 80,000 vaccinated ; 8,000 neither 
vaccinated nor variolated ; and 2,000 variolated—that 
is who had the small-pox either naturally or by ino- 
culation. Of the 30,000 vaccinated, about 2,000 were 
seized with the prevalent small-pox epidemic, of 
which number 20 died or 1 for every 100 affected. 
Of the 2,000 variolated, 20 were attacked and 4 died ; 
or 1 in every five cases. Of the 8,000 non-vaccinated, 
4,000 were affected, and of this number 1,000 died or 
1 out of every 4 cases. From this it follows 15 
that one-half of the non-vaccinated, 1-loth of thd 
vaccinated and only 1-lOOth of the variolated took the 
disease. But such was the difference in the compa- 
rative severity of the attack in the vaccinated and 
variolated, that while the variolated part of the popu- 
lation were cut off in the proportion of 1 out of every 
500, the vaccinated part ol the population only lost 1 
out of every 1500; or in other words, of an equal 
number of variolated and vaccinated cases, 3 vario- 
lated died from the second attack, for every one who 
died of the disease after vaccination ! 
Gaultier de Glaubry states—and his statement is 
confirmed by others—that while, in 18-11, small-pox in 
France carried off' more than a seventh of those 
attacked by it who had not been vaccinated, the 
mortality was only one in a hundred among those 
who had contracted the disease after having been 
vaccinated. 
La vaccination peut etre pratiquee avec succes, 
says Bouvier, en toute saison ; en tout temps d’epi- 
demie on doit vacciner les enfants le plus tot possible 
apres leur naissance ; les re-vaccinations sont neces- 
saires pour mettre a l’abri de la petite verole ; elles 
sont sans danger et particulierement utiles pendant 
la duree d une epidemie quelle que soit l’epoque de 
la precedente inoculation du vaccin. 
There are, in every country, men who stand out 
in bold relief even among their compeers; and high 
among the ablest medical writers of France, or of the 
world, is the name of Grisolle—cette ame a la vieille 
marque. There are some so bold,— and I am one of 
them—as to place his “ Patliologie Interne,” among the 
greatest productions of genius—a work in which no 
unstable theories however brilliant—no baseless spe- 
culations, however fascinating—find place—a work 16 
which reached its 9th edition in about twice as many 
years, and which, during that period was, and still is, 
the standard authority upon a most important de- 
partment of medicine. M. G-risolle says : “ Les recher- 
ches de .Tenner lui ont assigne une place eminente 
parmi les plus grands bienfaiteurs de l’humanite. 
La vaccine a donne lieu en France a des travaux 
importants. On peut vacciner dans toutes les sai- 
sons et a tout age. On attend generalement que 
les enlants soient ages de deux on trois mois pour 
les inoculer; mais cette pratique, que rien ne jmlijie, 
n’a aucun avantage ; ce retard a ete cause que 
beaucoup ont eu une variole presque toujours 
mortelle, et qu’on aurait pu leur epargner. J’ai 
inocule mes deux lilies des la tin de leur premiere 
semaine. C’est ainsi que nous devons agir pour nos 
enlants, plus exposes sans nul doute que les autres 
a la contagion mediate. On devrait memo inoculer 
aussitot apres la naissance, si Ton etait en temps 
d’epidemie varioleuse, ou si les individus vivaient 
dans un milieu infecte ; c’est ce que j’ai Tait maintes 
Ibis a l’hopital sans aucune espece d’inconvenient. 11 
n’y a aucune preparation a Taire subir aux sujets 
qu’on doit vacciner. L’Qperation de la* vaccine est 
fort simple. J1 est certain, en effet, que laplupart des 
vaccines sont (Mfinitivement a I'nlrri d'une atteinte dt 
variole. II est certain du moins que la vaccine rend 
la variole benigne que la mori en est rarement le 
r&sultat.” I have quoted at length from Gtrissolle ; as 
he may be said to bear the relationship to medicine, 
in France, that Blackstone does to law in England. 
In Copehagen, the fatality from small-pox is but an 
eleventh part of what it w7as before the introduction 
of vaccination ; “in Sweden it is a little over one- 
thirteenth ; in Berlin, in Prussia, and in large parts 17 
of Austria, but a twentieth ; in Westphalia but a 
twenty-fifth ! !” In Bohemia, Moravia, and Silesia it 
has been reduced from 4,000 in every million of 
deaths to 200 per million ! Not only is it satisfactorily 
established that vaccination is an effectual safeguard 
against small-pox, it is, according to some, more effec- 
tual in preventing small-pox than is small-pox itself. 
This was thoroughly tested in Hanover, where it was 
found that out of a hundred soldiers re-vaccinated, 
sixty-two per cent failed altogether in producing a 
vaccine vesicle; and twenty-seven per cent were 
only partly successful. Soldiers who had already had 
small-pox were operated upon in the same way, and 
with precisely the same result. 
Taking Europe as a whole, the conclusion arrived 
at by Berard and DeLavit, of Montpelier; Hodenpyl, 
of Rotterdam ; and Thompson, of Edinburgh, after a 
close observation, and especially of the epidemic of 
small-pox in 1816, 17 and 18, in (1) the vaccinated ; 
in (2) the variolated ; and in (3) those who had neither 
been vaccinated nor had small pox was, according to 
Dr. Stark, thus : Of those who had neither had cow- 
pox nor small-pox, one out of every four who were 
seized with the disease, died ; of those who had small 
pox naturally, or by inoculation, one of every twenty- 
live to one in seventy-five died; while of those who 
had been vaccinated, and were afterwards seized with 
small-pox, not more than one in three hundred and 
thirty cases died ; thus showing the great superiority 
of vaccination, even to the small pox itself, in protect- 
ing the system from the fatal effects of a second 
attack. 
Such information as I could glean from different 
sources leads me to the conclusion that an attack of 
small-pox and vaccination confer the same degree of 18 
immunity from an attack of small pox ; but that 
subsequent fatal small-pox follows more frequently 
alter small-pox than alter vaccination. 
How is the practice of vaccination regarded in 
the United Stales? Gentlemen : it would be an end- 
less matter to quote the opinions of the many medical 
observers in the adjoining Union, but I shall introduce 
the substance of everyone’s remarks as furnished to 
the State. Several of the States of the adjoining Repub- 
lic have their State Board of Health; and each Board 
may be considered to reflect the opinion of the medical 
minds in the State. The State Board of Health for 
1871 says :—“ No amount of disinfectants can cope 
with this dire disease. The only way to thoroughly 
drive it from the United States is by a national law, 
as in England, requiring every parent to duly register 
his child after having been duly vaccinated.” The 
experience of Massechusetts is summed up in the 
report from which I quote : that small-pox has appear- 
ed here and there, but where it has appeared spora- 
dically it has always been in places where vaccination 
had been neglected. The town of Holyoke, in the 
Connecticut valley, was an illustration. One-fifth of all 
the deaths from small-pox occuringin the whole State 
took place there. The people in Holyoke had not been 
vaccinated as elsewhere. Dr. Geo. Darby, of Boston, 
Secretary of the State Board of Health, summarises 
for his Board as follows (and his summary receives 
the sanction of the Board) ; vaccination “ invests the 
human body with an armour which may hardly be 
penetrated'by this subtle poison.” A year later (an 
epidemic of small pox having passed over Connecti- 
cut) he writes : The present epidemic is of such 
intensity, that it is quite common for persons who 
have had small pox in former years to nowr have it 19 
again. Such occurrences have been previously rare. 
Vaccination, whether from the cow or from ihe hu- 
man body, “takes” readily ; and re-vaccinations prove 
abundantly the extraordinary susceptibility to the 
vaccine disease now prevailing, and never before 
existing. In view of these facts, with which physi- 
cians and intelligent persons, of whatever calling, are 
now familiar, let us thank Grod for Jenner’s great 
discovery, without which our homes would be desola- 
ted, and our peace and happiness destroyed. The 
imagination can hardly picture the horror which 
would to day pervade Massachusetts, were the present 
epidemic unchecked by vaccination.” A year later 
(1874)the epidemic being over, the same authority, and 
the same Board, report inter alia : One year ago * * 
we were in the midst of an epidemic of small-pox of 
extraordinary intensity * * * the protective power 
of vaccine has been proved beyond all question, and 
the absolute need of careful vaccination is equally evi- 
dent. From September 6th to the close ol the year, 
not a single death from small pox has been reported 
to us from the cities or state.” I received the last 
“ State Board of Health ” report, a few days ago, an 
interesting document of nearly four hundred pages, 
and so completely had vaccine done its work that the 
report contains no allusion to the dreaded disease. 
Thankful lor the immunity afforded, the reporter 
from whom 1 quote writes : “ Vaccination needs no 
defence from us. Nothing, however beneficent, can 
escape the criticism of the times in which we live. 
But this criticism of vaccination, often passionate and 
violent, relates chiefly to points which, however in- 
teresting they may be, leave the main question un- 
affected. Let any one read the history of the ravages 
of small pox before Jenner’s discovery, and compare 20 
it with the mortality of Massachusetts from this cause 
in the present generation, and ask himself the reason 
of this change. There can be but one answer. We 
may speculate about the possibility of the potency of 
vaccine being exhausted in the human family ; we 
may be surprised to iind that people with good 
vaccine scars sometimes have small-pox ; we may 
dispute as much as we please about the average pe- 
riod when re-vaccination may be considered a pru- 
dent safeguard ; we may even conjecture (what no 
man has proved) that other diseases than that of the 
cow may be communicated by humanized vaccine ; 
we may turn the vaccination question with ingenious 
skill, so that its many facets shall reflect a multitude 
of curious lights, and after all we find that we rest in 
a security against this most horrid pestilence unknown 
to former generations. The disease is the same now 
as then, for we see its effect among barbarous tribes; 
but because Dr. .Tenner lived, and made the greatest 
of all discoveries in preventive medecine, we are 
almost completely safe.” I have quoted from a public 
document which received the sanction of a learned 
deliberative body—and the approval of the Govern- 
ment of the State—the most generally intelligent 
State in the adjoining Union. What says the Ohio 
Board of Health ? “ While sister cities of Ohio have 
been recently afflicted with small-pox, Cleveland has 
enjoyed an exemption far exceeding that of former 
years. * * * * Our comparative immunity 
from this loathsome and terrible disease conclusively 
demonstrates the preventive power of vaccination, 
and must impress every thoughtful mind with the 
munificence of the legacy the immortal .Tenner left 
the human race.” 21 
I have purposely quoted at greater length 
from Continental than from British authorities, 
because it has been asserted by a certain orator 
who inveighed against vaccination at public 
gatherings in this city, that it was an “ English reme- 
dy, and that Englishmen had a pride in engrafting 
their “ beastly” virus on the Christian children of fair 
Canada”—an assertion reflecting but little credit 
upon the head, and less upon the heart of the one who 
advanced it. But American authority, quo ad the vac- 
cine question, cannot be suspected of partiality. I 
have singled out no individual writer on the subject 
(I might have quoted a thousand American writers 
in favour of the practice of vaccination) but have 
confined myself to State documents containing the 
deliberate expressions of deliberative bodies, reflecting 
the condensed thoughts of the best medical minds in 
the United States. 1 turn with little pleasure to this 
my own country, and especially to this my own city, 
and I find anti-vaccination views advocated, and dis- 
seminated by a small but ceaselessly active section of 
medical and legal thought. I find from personal 
knowledge a deeply rooted prejudice against what 
the scientific world generally has sanctioned; and I 
find disease, disfigurement, and death following in 
the wake of those teachings ; teachings to the disse- 
mination of which a portion of the daily press has 
lent its columns. I readily admit that small-pox has 
its periods of dormancy and its periods of activity, 
and that, every now and then, at irregular intervals, 
it overspreads a district or country as if epidemic, 
but why should it press so lightly elsewhere ? 
Dr. Russell, President of the College of Physicians 
and Surgeons, residing in Quebec, gives the reason :— 
“We have rerv little small-pox here. We are all 
vaccinated.” The table prepared by the skilled House 22 
Surgeon ol' the Marine and Emigrant Hospital, of 
Quebec, Dr. Catellier, is a crushing and unanswera- 
ble argument against the anti-vaccinators. There 
were 131 cases admitted into the establishment be- 
tween the months of May, 1874, and July, 1875, and of 
these the vaccinated numbered 54, one alone died. In 
69 cases of un-vaceinated patients 32 were discharged 
cured, but somewhat disfigured, and 37 died. In 8 
cases where it was doubtful if vaccination had or had 
not been performed, 6 were cured and 2 died. 
These computations afford us the following start- 
ling percentages, which every man and woman 
valuing the healthy future of their progeny ought 
to carefully note. The death-rate in vaccinated cases, 
is only 1.8 per cent. ; in unvaccinated 53.6 per cent.; 
in doubtful cases 25 per cent Can anything tend to 
expose and confirm the claims of this practice upon 
the people better than these data ? Why does small- 
pox pass so lightly over Three Rivers ? Dr. Badeau, 
the Doyen of the profession there, explains:—On 
n'a pas de pi cole ici. On se fail vacciner,” The same may 
be said for Toronto. And why does the disease visit 
Montreal so severelyWe nurse it. In Quebec,Three- 
Rivers and Toronto no one writes against, or attacks 
the principles of vaccination—the only prophylactic 
for small pox. That the converse is true in Montreal 
is evident from the circumstance that the mortality is 
immensely greater among that nationality whose beau- 
tiful language has been made to serve as a vehicle for 
the dissemination of a most fatal error. Dr. Osier 
has kindly handed me the records of the Small- 
pox Department of the General Hospital from Dec. 
14, 1873, to July 21, 1875, the period during which 
it was under the charge of Dr. Simpson and himself. 
There were admitted during that period 261 cases, 23 
and there were 73 deaths. But how Was the 
death-rate distributed ? In the unvaccinated, 58.8 
per cent.; in the vaccinated 17.09 per. cent.! I)r. 
Simpson furnished the following additional tacts: 
“ All the unvaccinated sinall-pox patients, except two, 
had the confluent form i. e. the serious form of the 
disease. Of the whole number of the vaccinated 
admitted with small-pox only two had more than two 
good vaccination marks upon the arm, and only two 
had been successfully re-vaccinated. These latter 
two were so sligtly affected by the disease, that 
except as a precautionary measure, they might have 
continued to follow their daily occupations.” We 
have now two civic hospitals in Montreal for small- 
pox ; one presided over by the Sisters of Providence; 
the other by Miss Chambers. What is the experience 
of these ladies? 1 give the questions put to the ma- 
trons of both establishments, and their answers :— 
“ Have you noticed any difference between the vac- 
cinated and noil-vaccinated inmates of the hospital ?” 
Sister Nativity states, in French :—“ There is no 
comparison betwreen the effects of small-pox on the 
vaccinated and non-vaccinated ; the vaccinated, as a 
rule, are not affected; and w'hen they are they have it 
slightly; the deaths are amongthe unvaccinated.” Miss 
Chambers’ experience is precisely to the same effect. 
What more convincing evidence than this, coming, 
as it does, from sources whose trustworthiness is 
beyond doubt or question. But the register of the 
Civic Hospital, (and for the accuracy of wrhich I can 
vouch) is even more painfully eloquent: 24 
Patients admitted from 7th November 1874 to 
1st November 1876, 564. 
. Protestant. Catholic. 
Of these were 168 396 
Of the above, recovered 134 269 
“ died 34 127 
168 396 
The deaths among non-vaccinated... 25 89 
“ with 1 vaccine mark 7 32 
“ “2 .... 2 6 
“ “ 3 or 4 “ 0 0 
Total, 34 127 
Of the patients who had three, four or five 
vaccine marks (and there were many in each institu- 
tion) not one died in either !! 
I 
Dr. Laroccjue obligingly analysed the above for 
me, and gives the following as the percentage of 
deaths in the various divisions. 
DEATH RATE PER CENT. 
PROTESTANTS. 
Total received 168, Died 34 or 20-23 per cent. 
Unvaccinated “ 54, “ 25 or 46-29 “ 
Vaccinated “ 114, “ 9 or 7-89 “ 
CATHOLICS. 
Total received 396, Died 127 or 32-07 per cent. 
Unvaccinated “ 165, “ 89 or 53-93 “ 
Vaccinated “ 231, “ 38 or 16-45 4< 25 
Total received 564, Died 161 or *28-54 per cent. 
Unvaccinated “ ‘219, “ 117 or 53-42 
Vaccinated “ 345, “ 47 or 13-62 “ 
Surely Grentlemen, comment is unnecessary on 
the above. 
I do not quote from the physicians of the 
city, who, with a very small exception, have again 
and again expressed, and may yet again express, 
their entire belief in the prophylactic power of 
vaccination. Volume after volume has been written 
to the claim of vaccine, and my table, as I 
write, is covered with documentary evidence, the 
magnitude of which alone prevents its introduction 
here. Sufficient, however, has been adduced to 
warrant an answer to the first question in the affir- 
mative : “ that, vaccination confers a greater or less 
degree of protection against small-pox.” 
2nd. Are the effect* oj vaccination permanent ? 
As a rule the answer may be: yes; but the except- 
ions are so numerous that 1 must admit the partial truth 
of what is claimed by some writers that the protec- 
tion which vaccination affords against small-pox is 
only of limited duration.” During what time is there 
absolute immunity ? This varies in different indi- 
viduals ; but 1 have long been of opinion, and that 
opinion is shared by those who have given attention 
to the matter, that the manner in which vaccination 
has been done in the first instance has much to do 
with the degree and period of that immunity. Al- 
though ten or twelve years are said to be the aver- 
age period, the thoroughly vaccinated have an immu- 
nity of much greater duration. In a large, a very 
large number, unfortunately, vaccination is not per- 
formed with anything like approximate thoroughness. 
IN BOTH HOSPITALS 26 
This has been noticed in the Small-pox Hospital here, 
where an examination of the arms of the inmates has 
rarely discovered marks of a true Jennerian vesicle. 
But if there is doubt, as to the continued immunity 
afforded by vaccination, there can be none when it 
has been properly performed a second time. Re- 
vaccination, when successful, affords entire immu- 
nity, and in support of this assertion 1 shall cite 
but one or two proofs from among a thousand. It has 
been an imperative rule for the last thirty-five years 
at, the London Small-pox Hospital that every jiurse 
and other servant of the Hospital should, on entering 
the service, be vaccinated. In their case it is generally 
re-vaccination ; and it is never afterwards repeated. 
These nurses live in the closest daily and nightly atten- 
dance upon small-pox patients; and the other servants 
are constantly exposed to the profuse contagion : yet in 
no single instance, during these thirty-five years, 
has any one of these servants and nurses been affected 
with small-pox. Surely no stronger proof than this 
can be imagined, that re-vaccination, in the adult, is 
an absolute protection against small-pox, and need 
not be repeated. Up to the age of puberty, a child 
properly vaccinated may be considered 6afe,—but so 
many of those vaccinated have cicatrices deficient 
in number, and of a character not strikingly good, 
that re-vaccination should be resorted to where there 
is more than usual exposure to small-pox. I have 
instanced the London Small-pox Hospital as evidence 
of the advantages of re-vaccination, and shall cite from 
official sources evidence of the immunity conferred 
by it on some of the continental armies of Europe. 
In five years, says Seaton, there occurred in 14,384 
re-vaccinated soldiers in Wurtemburg, only owe inst- 
ance of varioloid; and among 30,000 re-vaccinated 27 
persons in civil practice only two cases of varioloid 
(one of which was probably really a case of chicken 
pox), though during these years small-pox had pre- 
vailed in 844 localities, producing 1,674 cases ol mo 
dified or unmodified small pox among the not re- 
vaccinated, and in part not vaccinated, population of 
863,298 persons, in those places in which it had 
prevailed. In the Prussian army, since the introd- 
uction of systematic re-vaccination in 1834, the cases 
reported as “varioloid,” and still more those called 
“ variola,” have been, nearly all oi them, among that 
portion of recruits whose term for re-vaccination had 
not come, or whose re-vaccination had not been 
successful, or who were incubating small-pox when 
they were re-vaccinated. -In the 20 years which 
immediately succeeded the adoption ol this system 
there occurred altogether but forty deaths from small 
pox in this large army—(or an average of two deaths 
per annum)-only four of the entire forty being in per- 
sons,who,it is said,had been successfully re-vaccinated. 
So also in the Bavarian army, in which there had been 
compulsory re-vaccination since 1843, there had not, 
from that date up to the time of a report made by the 
Minister of War in 1855, been a single case of unmo- 
dified small-pox ; and only a very few cases of modi 
lied small-pox, without any deaths. While, therefore, 
1 answer the second question in the negative, as to 
themvariable permanency of primary vaccination, the 
statistics quoted from official sources, with the almost 
universal collateral concurrence ol medical practitio- 
ners,warrant the statement that, after successful re-vac 
cination, small-pox, even of the most slight or modi- 
fied kind, is rarely met with; and that when the post 
vaccinal small-pox is met with, of a severe character, 
it is due to the want of care in the performance of 28 
Vaccination in the iirst instance ; or to want of prepar- 
edness in the system when primary vaccination had 
been performed. From what has been said, a question 
of vast moment to adults necessarily presents itself. 
As all those who have been vaccinated but once run 
more or less risk of contracting the disease ; and as it 
is admitted that re-vaccination renews, or adds to, 
the security against small-pox, common prudence 
would suggest the course to be pursued by those 
who wish to guard against this malady. 
Grrisolle, in advising re-vaccination, says : 
La pratique des re-vaccinations est generalement 
adoptee dans les pays du Nord; elle tend aussi a se 
repandre en France. On peut invoquer en sa faveur 
qu’une foule d’epidemies de variole, sevissant chez 
des vaccines, se sont tout a coup arretees des qu’on 
eut soumis a la re-vaccination les individus exposes a 
la contagion. Ces faits sont desormais acquis a la 
science. C’est a 1’aide de la re-vaccination, appliquee 
comme methode generate, qu’on a presque complete- 
ment eteint la variole dans les armies Prussienne et 
Wurtembergeoise,” * 
Although it forms no part of my present subject, 
yet, &s an impression prevails with some, that persons 
exposed to small-pox contagion incur additional risk 
in being vaccinated, and of having one disease en- 
grafted on another, it is well to state that such a view 
* Dr. Cuignct recently made the following statement at the 
Societe des Medecins du Departement du Nord : “ With regard to the 
influence of revaccination as a preservative against small-pox, I will 
direct your attention to the quite special condition in which the 
soldiers of the Guard of Paris are placed in this respect. There is not 
a corps in the entire army in which revaccinations have been so fre- 
quently and so carefully performed ; and during seventy years no case 
of variola has been met with among them, in spite of the epidemics 
which have on several occasions decimated the populous quarters of 
Paris." 29 
is entirely erroneous. If vaccination is performed 
sufficiently early, so that the areola may have time to 
form, it will prevent small-pox ; if later, it will modi- 
fy that disease. M. March illustrates this rule thus 
“ suppose an unvaccinated person to inhale the germ 
of variola on a Monday, if he be vaccinated as late as 
on the following Tuesday, the vaccination will be in 
time to prevent small-pox from being developed. If 
it be put off till Thursday, the small-pox will appear, 
but will be modified. If the vaccination be delayed 
till Friday it will be of no use.” Sir John Watson, 
p- 888, adds :—“ Should the person have been for- 
merly vaccinated, re-vaccination will be effectual two 
days later than this, because in re-vaccinated persons 
the stage of areola is reached two or three days 
sooner than in persons vaccinated for the first time. 
3rd. Is there risk of vaccination fighting' up focal 
inflammatory action ? 
When we consider the disposition, the tempe- 
rament, the condition of health, of those vacci- 
nated ; and the period of life at which vaccination 
is usually—and the period of the year at which it, 
is sometimes—performed, it is a matter of surprise 
that local irritation, or erysipelatous action, is not 
more frequently lit up. At certain seasons of cer- 
tain years any abrasure of the skin, however slight 
even without vaccine lymph, is apt to cause erysipel- 
atous inflammation. What medical man has not 
sometimes seen erysipelas to follow a slight bruise, 
or the scratch of a needle or of a thorn 7 The accidents 
ot this kind following vaccination are very few— 
not by any means as many as have been seen to follow 
the pulling of a tooth. Yet who ever advised that 
an aching tooth should be left alone because it had 
happened sometime, somewhere, and in the hands 30 
of some one, that hemorrhage from the tooth socket 
had taken place ; that erysipelas—fatal erysipelas— 
had sometimes followed ; or that the bones of the 
jaw had been splintered ? These are accidental ; 
and so rare are they that they should not enter into 
one’s calculations. So convinced am [ of the safety 
of vaccination, that I have no hesitation in saying 
that a vaccinator, who knows his business, would 
vaccinate a thousand children with fewer unpleasant 
results, than a competent deatist would have in ex- 
tracting the same number of teeth * There are, ’tis true, 
precautions to be taken, just as there are common sense 
precautions to be used by every one in eating, in 
drinking, in travelling. But these occurrences would 
be rare indeed if vaccinators exercised care and judg- 
ment in the selection of the lymph (which should be 
pure, taken at the proper time, and without admit- 
ture either of decayed epidermis or of pus) and in the 
selection of their subjects (who should be neither too 
young, too feeble nor too sickly) ; and with these 
precautions, severe local inflammation would be rare 
indeed. But it is not to be expected that some degree 
of irritation will not be produced. On the contrary, 
children vaccinated with the purest lymph will 
manifest, during the few days that the pustules are 
at the highest development, a certain febrile distur 
bailee of the general system, during which the tem- 
perature of the body sometimes reaches 104° F. But 
* As this is passing through the press some time after its actual 
delivery, I have the satisfaction of stating in illustration, that upwards 
of 6000 children have been vaccinated in this City within the past few 
weeks by the gentlemen named by the Board of Health; and that the 
alleged cases of severe irritation following, were only two, in that large 
number. They were both Been by me and presented nothing unusual— 
the children being now quite well. Emphlysis coniformis occurred in 
one house where vaccination had recently been performed, and all the 
children had it; bqt vaccination had nothing, whatever, to do with it 31 
in certain constitutions, and in certain states of the 
atmosphere, and especially when the crust is decayed 
and with it there happens to be, either through care 
lessness or ignorance, decayed epithelium or dried 
pus or both ; or even the purest lymph with an unclean 
instrument, the constitutional derangement above allu- 
ded to, and which was still within the range of health, 
assumes a morbid character, and more or less severe 
loC'il or constitutional disturbance is the result. The 
third question, therefore, may be answered thus : 
moderate local inflammatory action may sometimes 
be lit up. but the severer forms are, as a rule, due to 
want of care in the selection of the crust; to inatten. 
tion to the age or health of the subject; to careless- 
ness in the use of the sacrificator ; or to atmospheric 
influence ; or to all combined. 
4th. Is there risk, when vaccinating, of inoculating 
the system with scrofula, or other hereditary disease ?— 
If my answers to the previous questions were neces- 
sarily qualified, this one is not, and I emphatically 
answer: no. It would be an utter waste of time to 
proceed to discuss what has already been disposed of 
to the satisfaction of every unprejudiced mind. That 
vaccination induces scrofula, or other newr disease, is 
an absurdity, notw ithstanding the wonderful tales 
of a Verde de Lisle, that it has caused mental and phy- 
sical degeneration of the human species ; diminish- 
ing men’s stature; incapacitating them for the fatigue 
of military service; or even of the exercise of dancing. 
One wTord as to the first: the tallest, strongest and 
heaviest men in Europe, according to Professor J. 
T). Forbes, are the Irish ; yet Ireland is one of the, 
if not the, most thoroughly vaccinated countries in 
the wTorld. 
And as to the second, if vaccination induces dis- 
ease, where are the results of those diseases ? 32 
Instead of vaccination inducing scrofula or other 
hereditary disorder, it is claimed to diminish that ten- 
dency. Universal death, it is not denied, is the law 
of our nature. Though we must all die, yet life may 
be prolonged in particular instances; and particular 
instances go to make up the general result. The 
tables of mortality of a country are the data on which 
Life Assurance is built It is upon a knowledge of 
these tables that the premium rate or percentage to be 
charged in different countries is regulated. Mr. 
Babbage in his work on Life Assurance, says : “ it has 
been shown by Mr. Davillard, (a french writer) that 
the introduction of vaccination has increased the mean 
duration of human life by about three years and a 
half.” And the premium rates are influenced accor- 
dingly. At the end of the last century the rate of mor- 
tality in London was one in every thirty.—One half 
century later, and the rate of mortality was one in 
forty-one! Yet during that interval vaccination had 
been introduced, and the practice had become general. 
It greatly strengthens, says Thomas, our argument in 
lavour of vaccination, to find that the general mortali- 
ty, in comparison with which that from small-pox has 
undergone so marked a diminution, has itself also nota- 
bly decreased in proportion to the existing population. 
In this connection I am happy to be able to cite 
Dr. Henri Cotin, author of the Guide Medical, who 
says : “ On se preoceupe beaucoup dans le rnonde de 
l’id6e que le vaccin pris sur des enfants inalsains 
peut communiquer la maladie de l’individu. Cette 
id6e est completement erron6e ; jamais aucune maladie 
na 616 inocul6 aver, le vaccin, et ce dernier pris sur l’en- 
fant le plus malingre, pourvu qu’il ait les qualit6s 
physiques que nous avons indiquGes, est tout aussi 
bon que «elui qui proviant du plus bel enfant.” 33 
1 shall not do more than allude to that absurd 
paradox advanced by a mathematician, and suppor- 
ted by two or three physicians as paradoxical as him 
self, that vaccination has transformed small pox into 
typhoid fever ! and that, in causing the disappearance 
of the former, it had increased the frequency and viru- 
lence of the latter ! There may be an excuse for a 
mathematician—knowing nothing of medicine—to 
hold such a view; but there can be none for phy- 
sicians, as it could only be the offspring of profound 
ignorance of the merest elementary literature of the 
profession. Every physician should know that typhoid 
fever is not a recent disease— but that for centuries 
bofore the introduction of vaccine it had the same 
hideousness it has now—and will have so long as 
sanitary laws are set at defiance. 
5 th.—Is there risk, when vaccinating, of inoculating 
with syphilis err other acquired diseases ? The allegation 
has been made by some in the affirmative; but when 
it is borne in mind the strong temptations to employ 
false pretexts, it is a matter of surprise that vaccina- 
tion has not been more generally “ pitched upon by 
persons in search of an apology for their syphilitic 
children.” For ray own part, not only have I never 
seen a case of vaccination of syphilis, but have never 
met a medical practitioner who had seen a case, either 
in his own practice or in that of another. We all know 
how the slightest scratch or cut is apt to develop in- 
tractable ulceration in a child having latent syphilis ; 
and how the ulceration thus produced requires the 
local and constitutional treatment of a syphilitic sore. 
A slight scratch, required for vacination, may assume 
a specific character with the purest lymph, when 
conjugal infidelity, and not the vaccination, is the 
cause. Sores somewhat resembling syphilitic sores 34 
have occasionally appeared after vaccination, and 
even in this city have been taken for syphilis. But 
their early healing1 without specific treatment, apart 
from their appearance,forbids the assumption that they 
were syphilitic sores. These are what are called by 
Rayer, Auzias Turenne and others vaccinelle or vac 
cinoide, and may arise from : 1st the vaccination of a 
syphilitic child, or 2nd the vaccination of a child who 
had already been vaccinated, or who had had small 
pox or who manifested an inaptitude for the vaccine 
influence That vaccine lymph does not carry with it 
the syphilitic virus, even in cases of undoubted sy- 
philis, may be fairly inferred from the experiments 
which have been performed on a large scale on the 
continent of Europe, where, in not one of those expe- 
riments, has anything like syphilis resulted. The 
British Public Health Report published by authority 
of Government, and presented pursuant to act of Par- 
liament is so germane to this part of my subject that T 
shall quote from it at considerable length. M. Taupin, 
of the Children’s Hospital in Paris, in order to settle 
such questions as these, had, in a large number ot 
cases, deliberately vaccinated from the arms of chil- 
dren who (while under vaccination) were sick with 
all other sorts of communicable diseases, including 
syphilis; but had never, on any occasion, seen any of 
these affections communicated in his vaccinations : 
“ dans aucun cas, nous y insistons a dessein, le virus n a 
rien communique que la vaccine toute seuleDr. Schreier 
of Ratisbon had similarly, on two occasions, experi- 
mented with vaccine lymph from syphilitic children 
and, like M. Taupin, had got no syphilitic results. 
Professor Heim of the Wirtemberg military service, 
had done similar experiments, with similarly negative 
results. Dr. Heymann had, as seen the habitual 35 
practice in Java, that children having scrofula, syphi 
lis, itch, the endemic framboasia, and other com- 
plaints, were used indifferently with others as sources 
of vaccine lymph ; and that no evidence ever appeared 
of any of the complaints being so communicated. 
And to this former negative testimony, from several 
independent experimenters, I may now add the simi- 
lar testimony of Professor Boeck of Christiania; testi- 
mony which has peculiar value because of Dr. Boeck’s 
very eminent relation to contemporary studies of 
syphilis. Dr. Boeck reports that, having under his 
observation two men affected with elephantiasis, two 
men who had never had syphilis, and whom their 
elephantiasis of course would not have rendered in- 
susceptible of it, he, on three different occasions far 
apart, vaccinated these two men from children having 
well developed hereditary syphilis, that in one of the 
six vaccinations, live normal vesicles resulted, but in 
the others, none, nor any other local change; that 
“ these two patients were observed daily during three 
years, and never presented a single symptom of sy- 
philis.’’ 
With well attested experiments like the above 
standing on record, we are obliged to doubt whether 
vaccination (i.e. genuine and simple inoculation with 
vaccine lymph) from however syphilitic a subject, can 
possibly communicate syphilis; or, at the very least 
whether some stage of the vaccine vesicle more ad- 
vanced than vaccination rules allow to be proper for 
lymph supply, or some admixture, which fastidious 
vaccinators never permit, of blood with the vaccine 
lymph, must not be a condition for such possibility. 
That some ignorant quack salver, pretending to vac- 
cinate, but neither knowing the aspects of a vaccine 
vesicle, nor caring from what sort of body he draws 36 
Lis supposed lymph, may take as his “ healthy source 
for lymph supply” an infant all maculated or ulcered 
with syphilitic skin disease, and may from its spots 
or sores transfer infective material to some victim of 
his mis-called vaccination, is of course evident; for 
syphilis does not cease to be syphilis because noodle 
or knave calls it vaccinia; but facts of this kind can- 
not in any reasonable sense be counted against vac- 
cination, any more than we should count it a fact 
against Quinine that some grocer had dispensed 
Strychnine in mistake for it. Finally, too. 1 permit 
myself this general remark : that, in proportion as any 
alleged fact contradicts an otherwise universal expe- 
rience, the individual witness must be regarded as 
making larger and larger demands on us for belief; 
and that in matters like the present, where sources of 
fallacy are so abundant, the witness’s accuracy of obser- 
vation requires to be most thoroughly guaranteed. 
Dans le monde, says Grisolle, les parents se pr6- 
occupent beaucoup de l’idee que leurs enfants pour- 
raient etre vaccines avec du inauvais vaccin, c’est-a- 
dire provenant de sujets malsains. Quoiqu’il 11’y ait 
pas plusieurs qualites de vaccin, quoique le viius 
qu’on retire d’un enfant fort ou faible, d’un individu 
ayant le syphilis, les scrofules, etc., ait en general la 
meme efficacite, cependant il y a toujours interet A 
prendre du vaccin chez des sujets vigoureux, attendu- 
que, chez les individus faibles, on voit le virus dege- 
n6rer promptement v 
Relativement a la syphilis, il est certain aussi que 
le vaccin fourni par un verole tie peut transmellre que la 
vaccine lorsqu'il est pur, cest-d-dire sans melange de sang: 
il n’en est plus de meme lorsque la pointe de la lancette 
qui est chargee du vaccin, est salie par la plus minime 
quan tite de sang. 37 
The cases of supposed inoculation of syphilis 
with the vaccine virus are not many, and an analysis 
reduces them to very few—and those few are still 
further reduced by the fact that the grossest ignor- 
ance and misconduct were, in some instances at least? 
imputed to the vaccinators. The few cases that have 
been published in the past seventy years, chiefly from 
Continental sources, are utterly insignificant in num- 
bers and importance, and lead us to ask the same 
question as Mr. Simon : “ if our ordinary current 
vaccination propagates syphilis, where is the syphilis 
that it propagates ? Who sees it ? The experience of 
the department is an entire blank on the subject. 
For the last ten years we have been in incessant inti- 
mate communication with the different parts of Eng- 
land on details of public vaccination, and during these 
years, every one of the about 350 vaccination districts 
into which England is divided has been visited three 
or four times by an inspector specially charged with 
the duty of minutely investigating the local practice 
of vaccination ; yet from this systematic and extreme- 
ly detailed search for all that has to be said on the 
subject of vaccination in England, no inspector has 
ever reported any local accusation or suspicion that 
a vaccinator had communicated syphilis. Again, our 
national vaccine establishment has been in existence 
for more than 60 years, vaccinating at its own stations 
every year several thousands of applicants, and trans- 
mitting to other stations supplies of lymph, with 
which every year very many (at present 50 or 60) 
other thousands are vaccinated, who in their turn, 
become sources of vaccination to others; but this vast 
experience does not, so far as I can ascertain, include 
knowledge of even one solitary case in which it has 
been alleged that the lymph has communicated 38 
syphilis. Is it conceivable that these negative expe- 
riences could be adduced if the vaccine lymph of 
children with latent hereditary syphilis were an ap- 
preciable danger to the public health ? Thirteen 
years ago it devolved upon me (as medical officer of 
the Board of Health), to make the widest possible en- 
quiries, both of scores of public departments and 
institutions, and also of many hundreds of individual 
practitioners, in our own country and on the conti- 
nent of Europe, with a view to elicit all existing ex- 
perience on the validity of objections which had been 
alleged against vaccination; and on that occasion I, 
of course, gave great prominence to the point which 
is here raised. One of the four questions which I 
circulated was the following :—“ Have you any rea- 
son to believe that lymph from a true Jennerian ve- 
sicle, has ever been a vehicle of syphilitic, scrofulous, 
or other constitutional affection, to the vaccinated 
person; or that unintentional inoculation with some 
other disease, instead of the proposed vaccination, 
has occurred in the hands of a duly educated medical 
practitioner?” The answers which 1 received on 
this, as on each of my other points, from 542 mem- 
bers of my profession, are, as regards syphilitic inocu- 
lation, only just short of being an absolutely uniform 
“No.’’ The alleged cases (of inoculation) were thrown 
into real insignificance by their relation to the main 
body of testimony. Men of the oldest and largest 
consulting pratice in the United Kingdom ; men who 
were believed to have seen every variety of disease 
and accident to which the human body is liable; our 
leaders who had taught medicine and surgery to the 
mass of the profession ; physicians and surgeons of 
our largest metropolitan and provincial hospitals, in 
England and Scotland and Ireland ; physicians who 39 
specially studied the diseases of infancy ; surgeons 
who had specially studied the inoculative diseases ; 
pathologists of distinguished insight and learning,— 
men of all these sorts, scores on scores of them, had 
never in their experience “ had reason to believe or 
suspect any such occurrence as my question des- 
cribed.-’ In the alphabatical series to which I have 
referred there may be read all the most eminent 
British names of thirty years ago, certifying to such 
negative experiences ; there may be read, too, that 
equally negative in Paris had been the vast experience 
of Chomel and Moreau, Rayer and Ricord, and Ros 
tan and Velpeau; equally negative at Vienna that 
of Hebra and Oppolzer, and Sigmund. And in here 
recurring to that very remarkable mass of testimony. 
I may repeat the remark which my former review of 
it suggested to me : “ Obviousely one at least of two 
conclusions is inevitable; either it is that with repre- 
hensible carelessness as to the source of lymph, 
vaccination (so long as in any sense of the word it is 
vaccination) cannot be the means of communicating 
any second infection ; or else it is the case that in 
the world of vaccinators care is almost universally 
taken to exclude that possibility of danger. To the 
public, perhaps, it matters little which of these con- 
clusions is true. Though it would be the merest 
idleness to take again, now, the sort of formal census 
of medical opinion which I took thirteen years ago, 
I may state that ever since that time 1 have felt it 
among my strictest duties to be generally watchful 
and interrogative on the present subject ; all the 
more so as the period has been one of extraordinary 
pathological and especially has brought to 
light very important new knowledge concerning 
svphilh ; and I have every reason to believe that a 40 
present census of personal experience in this country 
would give just the same practical results as those 
which accrued from the former enquiry. Indeed, 
in a few very important directions I am satisfied my- 
self that it does so. I may mention, for instance, that 
the Army Medical Department has, during the last 
eleven years, had cognizance of 151, 316 (adult) vac- 
cinations and re-vaccinations performed on the sol- 
diers and recruits of Her Majesty’s service, where, 
from the nature of the case, the subjects of the pro- 
ceedings are persons who afterwards permanently 
remain under medical observation, and in whom, 
therefore, no syphilitic consequences of vaccination 
could possibly escape notice ; where, moreover, the 
chances of latent constitutional syphilis in subjects 
furnishing the lymph must be about the same as 
among our civil population, but in all this vast and 
critical experience, so far as is known to Dr. Balfour 
(the eminent and laborious reporter on the diseases of 
the British army) no single case has ever been alleged 
of a soldier St/philized by vaccination ! Indisputable 
certainties, which any one can verify for himself, 
are :—first, that year by year millions of vaccinations 
are performed in Europe with scarcely a solitary ac- 
cusation transpiring that syphilis has been commu- 
nicated by any of them; and, secondly, that physicians 
and surgecns who could not fail to see such cases in 
abundance, if such abundance were a reality, concur 
with almost absolute uniformity, hundreds of 
them together, in declaring that they had “ never in 
their experience seen even a single case of the kind.” 
Surely for every practical purpose,’ certainties like 
these are our best guides ; and with such certainties 
in our knowledge it would be the merest pedantry 
to insist on infinitesimal speculative uncertainties.” 41 
One terse observation from the Board of Health 
of Ohio, and I have done ; “ When properly vaccinated 
by an intelligent physician, no disease could be pro- 
duced by inoculation other than vaccinia, the one to 
be desired.” 
It may be some satisfaction to the learned and 
laborious writers, from whom I have quoted above, 
to learn that their views are fully coincided in 
by most of the leading minds of the profession in 
Montreal. On Friday, of last week, 1 submitted the 
following questions to the members of the Medico- 
Chirurgical Society of this city. Doctors are said 
to differ, but the unanimity of view on the follow- 
ing was most noteworthy. The meeting was an 
unusually large one, called for another purpose, and 
the secretary (Dr. Bell) has kindly furnished me 
with the accompanying extract from the minutes, 
with the permission of the Society for its publication : 
Meeting of the Medico-Ohirurgical Society of Montreal, on the 
13th October, 1876. 
Twenty three members present. 
Moved by Dr. Hingston, seconded by Dr. R. P. Howahd.—1st. 
That vaccination confers a certain degree of immunity from small-pox, 
by either preventing or modifying that disease. 
2nd.—That such immunity is not always permanent, but may be 
rendered so by re-vaccination. 
3rd.—That vaccination may produce, in some instances, a certain 
degree of inflammatory action, which may be modified, increased, or 
diminished, by the age, constitution or condition of the patient, or 
by the state of the atmosphere. 
4th.—That vaccination does not, in any instance, produce scrofula 
or other hereditary disease. 
5th.—That neither the evidence hitherto furnished to, nor the 
experience of, the members of this Society, is of a character to lead to 
the conclusion that syphilis is ever inoculated with vaccine lymph. 
Carried unanimously. 42 
In concluding I may add : As it will be some- 
what difficult for you to obtain a sufficient supply of 
lymph to continue your vaccinations, owing to the 
circumstance that many mothers, while solicitous 
regarding the physical condition of the child who has 
the honour of furnishing vaccine lymph to their chil- 
dren, refuse, in turn, to render the same service 
to others, under a pretext that it disturbs or fatigues 
their precious offspring. Explain to such mothers, 
please, that they do an act of injustice ; that as they 
received immunity on the one hand, they are obliged, 
in justice, to dispense it on the other; that had other 
mothers acted as selfishly, the supply could not have 
been kept up for their advantage. Some mothers refuse, 
under the belief that puncturing a vaccine vesicle, and 
receiving a portion of its contents, will diminish the 
protective influence intended to be gained by the 
vaccination in the first instance. But this is an error, 
and should not be permitted as an excuse to those 
who are slow to do for others what has been done for 
them. A mother should never hesitate to permit her 
child to be the source of safety to other children, not 
less dear to their mothers. You can assure them more- 
over, with confidence : that the removal of a portion, 
or even of the whole—(which is never done—see 
Clause 7 of Instructions) of a vaccine vesicle, in no 
way impairs the protective influence, or produces any, 
even the slightest inconvenience or suffering 
Gentlemen : 1 have detained you much longer 
than I intended, and beg to thank you, and my many 
medical friends and fellow citizens who have honoured 
me with their presence this afternoon, for their and 
your most patient attention. APPENDIX. 
Since the foregoing was delivered, many of my 
medical friends, some not members of the Medico-Chi- 
rurgical Society of Montreal, and some not present at 
the meeting in question, expressed a desire to 
have an opportunity afforded them of recording 
their opinion on the questions submitted to, and una- 
nimously adopted by that Society on the 13th October 
last, and referred to on page 42. 1 willingly acceded to 
their request, and have been furnished with the follow- 
ing list, not at all complete, 1 am informed, of medical 
gentlemen practising in this City supporting those 
resolutions. Their names are published in exlenso, 
as it has been industriously circulated that those 
who practice vaccination are unsustained by medi- 
cal opinion here. The reader will perceive the re- 
markable unanimity of thought, as expressed by the 
very large number, on a matter of such vital mo- 
ment ; and will recognize among that number our 
most distinguished physicians—French and English ; 
nearly all the physicians at our hospitals; nearly all 
the physicians at our dispensaries; nearly all the 
professors in our medical schools and colleges; nearly 
all our oldest and ablest men in private practice, with 
a life long experience to appeal to, and without motive 
to mislead ; nearly all our middle aged practitioners 
engaged in large and lucrative practice; nearly all 
our young men fresh from their studies, and familiar 
with the most advanced views of trans atlantic medi- 
cal minds—some of them just returned from Europe 
where they have had opportunities of learning the 
thoughts and opinions of the most eminent in our 44 
profession there; not, perhaps, the views of such men 
as might well be astonished to find themselves 
quoted as authorities three thousand miles away. I 
thank my medical friends for their readiness in ex- 
pressing their opinion on this important question ; 
and much doubt if there is any other topic or point in 
controversy on medicine, surgery or pathology 
upon which so unanimous an expression of medical 
thought could be obtained in this city. In matters of 
lav:, judges differ; but the decision of the majority is, 
after all, the decision of the court, and litigants 
must abide by it. Respect for a majority, so well pro- 
nounced, of competent medical judges will, in this in- 
stance, I hope —considering the contingency in events 
—lead to a cessation of those ill timed attempts to 
interfere with the efforts that are now being made to 
check a loathsome disease by the only prophylactic 
which science has yet discovered 
Pronunciamento of Physicians of Montreal, in 
favour of Vaccination. 
Gr. M. Abbott, M.D. 
T. J. Alloway, “ 
P. A. Allard, “ 
G-. Archambault, “ 
P. Beaubien, “ 
J. Bell, 
F. Barnes, “ 
D. Baynes, “ 
G-. A. Baynes, “ 
J. E. Berthelot, “ 
J. Gr. Bibaud, “ 
A. Bondy, f‘ 
S. Lachapelle, M.D. 
L. Laberge, “ 
Jos. Leduc, “ 
B. H. Leblanc, “ 
A. Laraarche, . “ 
H. Lemery, “ 
J. A. A. L6onard, “ 
J. L. Leprohon. “ 
D. C. MacCallum, “ 
A. C. Macdonnell, “ 
W. Macdonald, 
D. McCallum, “ 45 
R. Brodeur, M.I). 
F. Buller, “ 
Gr. 0. Beaudry, “ 
W. E. Bessey, “ 
A. A. Browne, “ 
Gr. A. S. Brunelle, “ 
E. J. Bourque, 
W. H. Burland, 
W. B. Burland, “ 
Gr. W. Campbell, 
F. W. Campbell, “ 
P. F. Casgrain, “ 
J. C. Cameron, “ 
R. Craik, “ 
A. Chamberland, “ 
J. D. Cline, “ 
J. 0. Coutu, “ 
A. H. David, “ 
F. Demers, “ 
S. Duval, 
J. J. Dugdale, 
P. L. J.Desrosiers, “ 
Gr. H. Desjardins, “ 
A. A. Duhamel, “ 
L. A. E. Desjardins, “ 
Th. E. D’Orsonnens, “ 
J. M. Drake, “ 
A. Deschamps, 
W. A. Duckett, 
Chas. Dansereau, 
J. H. A. Matte, M.D. 
L. J. A. McMillan, “ 
W. H. Mondelet, “ 
E. P. Mount, “ 
F. Muller, “ 
R. L. Macdonnell, “ 
J. B. McConnell, “ 
Gr. W. Major, 
A. W. Marston, “ 
A. Mathieu, “ 
Gr. H. Merrill, 
H. Merrill, “ 
A. Meunier, “ 
P. B. Mignault, “ 
W. A. Molson, “ 
C. J. Morse, “ 
J. W. Mount, “ 
W. Nelson, “ 
,T. Nichol,, “ 
P. O’Leary, “ 
W. Osier, “ 
H. Peltier, “ 
E. A. Paquet, “ 
Jas. Perrigo, “ 
A. Piche, “ 
Jos. C. Poitevin, “ 
E. K. Patton, “ 
P. E. Picault, 
P. E. Plante, “ 
Alex. Proudfoot, “ 46 
Chs. Dansereau, Jr. M.D- 
0. Dubuc, “ 
(). C. Edwards, 
J. Eneas, “ 
O. P. Etn, 
E. G. Fenwick, 
J. T. Finnic, “ 
W. Fuller, 
A. FJsher, “ 
R. T. Godfrey, “ 
G. P. Girdwood, ‘ 
J. Gagnon, “ 
W. Gardner, “ 
F. L. Genand, 
R. F. Godfrey, “ 
F. H. Girard, “ 
Thos. E. Hayes, 
R. P. Howard, “ 
T. Hughes, 
W. H. Hingston, “ 
H Howard, “ 
E. H. Hurtubise, “ 
R. Kennedy, “ 
W. J. Kearney, “ 
A. H Kollmyer, “ 
A. B. Larocque, “ 
.1. A. Laramee, “ 
A. Latour, “ 
H. T. Latour, 
N. Loverin, “ 
P. E. Lachapelle, “ 
J. P. Rottof, M.lh 
.T. Reddy, “ 
A. Ricard, “ 
T. H. Richelieu, “ 
T. G. Roddick, 
T. D. Reed, 
Ed. Robillard, “ 
N. Robillard, “ 
Thos. A. Rodger, “ 
G. Ross, 
F. Rourk, “ 
Gr. F. Slack, 
S. B. Schmidt, “ 
F. J. Shepherd, “ 
T. Simpson, “ 
W. P. Smith, 
G. B. Shaw, 
W. E. Scott, “ 
E. H. Trudel, “ 
F. X. Trudel, “ 
F. Z. Tass6, “ 
R. Thompson, “ 
E. H. Trenholme, “ 
Ls. Turgeon, v “ 
J. R. Wanless, “ 
J. Wanless, “ 
Jos. T. S. Webb, 
M. O’B. Ward, “ 
Th. Wheeler, “ 
Geo. Wilkins, “ 
W. Wright, “