A System of Medicine. By Many Writers. Edited by Thomas
Clifford Allbutt. Vol. IL (Macmillan and Co.)—This second volume has been retarded in its appearance by the delay in issuing the Report of the Commission on Vaccination. Special interest, of course, attaches to the articles affected by this Report, and to their bearing upon it. In the article on small-pox (which in modern Greek by a curious euphemism is called eirAcryia, the "blessing") by Dr. J. MacCombie, we find the following state- ments :—" Black small-pox rarely occurs in vaccinated subjects under the age of puberty." "I have not met with a case in any one who had a third of a square inch of well-foveated vaccination cicatrix, and who bad been successfully revaccinated." Black small-pox is invariably fatal. But the subject of 'vaccination is specially treated by Drs. T. Dyke Acland, Monkton Copeman, and Ernest Hart. It is to the last of these three that the task of showing the benefit of vaccination has been committed. In prevaccination days two-thirds of the children born in Europe were attacked by it, and one-twelfth died. In England the mortality was 3 in 1,000 annually, and would amount, with our increased population, to 80,000. Nor do the deaths tell all the story. Two-thirds of those that applied for relief at the Hospital of the Indigent Blind bad lost their sight in this way. In India, where vaccination is defective, 90 per cent. of the blindness is due to this cause. In 1870-71 the German Army of a million, which was well vaccinated, lost 459 by small-pox ; the ill-vaccinated French, with, say. 700,000, lost 23,400. But to come to the most recent case, the Gloucester epidemic of 1896, here are striking figures :-706 under ten were attacked ; 26 had been vaccinated, and of these one died; of the 680 unvaccinated, 279—not far off one-half—died ; 1,273 over ten were attacked. Of these 88 were unvaccinated (the agitation against the practice dated from 1886), and of these just two fifths died ; of the 1,185 vaccinated, just one-tenth,—i.e., the mortality was four times greater in the unvaccinated. We quote these figures, but without any hope that they will convince Though thou bray a fool in a mortar, yet will not his folly depart from him.
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