NATURE'S SCHOOL AT GLOUCESTER.
IN the Times of Saturday last there was a lengthy summary of the statement put in by Mr. J. A. Picton and Dr. W. J. Collins of their reasons for dissenting from the conclusions of their eleven colleagues on the Vaccina- tion Commission, on whose Report we commented on the same day. Prominent in this manifesto of the two dis- sentient Commissioners are references to the strength and wide diffusion of local opposition to vaccination, and it is emphatically asserted that the origin of that opposition, notably at Leicester, was the growth of disbelief in the operation as a prophylactic against small-pox. Experience of the outbreak in 1893-94, we are assured, has not changed Leicester opinion on the subject. On the contrary, it is alleged there that the cessation of vaccination, together with the adoption of sanitary and isolation measures, has been much more effective in saving life than was the en- forcement of the vaccination law at the time of the epidemic of 1873, when the town was held to be well- vaccinated. Similar views, it is said, prevail in many other places. The replies to a circular issued by the Vaccination Commissioners in 1891 to all Boards of Guardians in England and Wales, showed that in about fifty unions the enforcement of the vaccination laws had been altogether abandoned, and in about thirty more it was in abeyance pending the Report of the Commission ; and there is hitherto no sign whatever, in view of the evidence published by the Commissioners from time to time, of any change in the local opinion of the unions in question, "except in the rare cases where epidemics of small-pox have occasioned panic." "The rare cases where epidemics of small-pox have occasioned panic." It is a precious phrase, for which we thank the two dissentient Commissioners, or the summary writer who has thus conveyed their mental attitude. It stands for a world of resolute, though doubtless uncon- scious, refusal to learn Nature's lessons. She has held her school of late years in many towns, Leicester included,. where the value of Jenner's discovery has been derided, and the eleven sagacious and eminently representative signatories to the Report of the Vaccination Commission,. as our readers are already aware, are agreed, as the result of very careful study, that she has emphatically condemned the mockers. Their detailed analysis of these courses of instruction is not even yet before us. But in last Tuesday's. Times there was a clear and most impressive account,. from an obviously well-informed correspondent, of the case of Gloucester, where, during the first six months of 1896, Nature took in hand a community which had con- temned her faithful servant and interpreter, even within a, few miles of the scene of his beneficent labours, and reduced it to penitent and practical recognition of his worth. It is an intensely and painfully interesting story throughout.. Somewhere about 1875 a vigorous anti-vaccination cam- paign was begun at Gloucester by persons who not only denied the efficacy of vaccination as a protection against small-pox, but denounced it as dangerous to health, a de- grading superstition, and a practice which was supported by the doctors only for their own pecuniary benefit. Un- fortunately, according to the Times' correspondent, the members of the medical profession felt their "hands tied by the imputation made against their honesty," and as no one else knew (or perhaps cared) enough about the subject to frame a reply to the anti-vaccination literature with which the city was flooded, no antidote to its pernicious influence was provided except in the occasional reports of medical officers of health, who doubtless were regarded as holding a brief for the law. It seems to us- that silence on the part of local doctors in such circum- stances implies a gravely mistaken regard for the dictates of etiquette or amour propre, in preference to those of civic duty. What would be thought of the civil engineere resident in any place who were agreed that the banks of a reservoir higher up the valley showed serious signs of giving way and letting forth a destructive deluge, but who felt unable to issue a manifesto on the subject because some irresponsible persons had said that the reservoir was perfectly safe, and that only engineers who wanted a job would say otherwise ? However that may be, the effect of the unresisted anti-vaccination campaign at Gloucester was that when, in the course of a few years, a kind of census of the city was taken on the question whether the vaccination law should be enforced or not„ the "Noes" were declared to have it, "which," adds the Times' correspondent, "they very probably had, as a large number of persons, who did not care to be parties to. such a form of procedure, did not fill up their papers at all." Here again we have the too common apathy of the- intelligent and moderate citizen in presence of dangerous agitation. The anti-vaccinators, to do them justice, were not apathetic. They left no stone unturned to further, their object. And they had their reward. One political. party was bullied into allowing non-enforcement of the vaccination law to be made a test question at the election. of Poor-law Guardians, and the other followed suit. Cananything more humiliating be imagined ? And se "a sufficient number of the City members of the Board of Guardians were in time nobbled,' and the opposi- tion of the rural members, who, to do them justice,. have been generally advocates of vaccination, was over- come." By a narrow, but sufficient, majority the Board of Guardians resolved in 1887 that the enforcement of the vaccination laws should be suspended, and in. 1888 the appointment of the Royal Commission was regarded as justifying an indefinite continuance of the suspension.
The result was that a very large proportion of the children born in Gloucester during the last nine years were not vaccinated, and it is said that some nine thou- sand were known to be in that condition in the city and its suburbs about the middle of last year. Nature's school was opened soon after. In the closing months of 1895, the infection of small-pox was introduced, no one knows how, and was established, owing to the fact that a. case of that disease in an unvaccinated child had been concealed and treated as measles ; and before its true- nature was declared a number of new centres had been established. Some three hundred and seventy persons were vaccinated in 1895, largely in consequence of the influence which, as we understand, the medical men of the city at last felt themselves justified in exercising. But what were they among so many ? In the month of January last the eases of small-pox notified in Gloucester, which had been .only thirty during the whole of 1895, ran up to fifty. And then the Sanitary Committee of this place, whose in- habitants had been taught to believe in isolation and sanitation rather than vaccination, "isolated" as many as possible of the rapidly growing numbers of small-pox patients in a temporarily enlarged hospital, surrounded by new streets of semi-detached villas and continuous rows of houses which had been steadily growing up during the last twenty years, and with three large day-schools within less than half a mile. "Small need for wonder," says the narrator, "that the full force of the pestilence made itself first and worst felt in this portion of the city. How rapid was the spread of infection may be appreciated from the fact that in February the number of cases notified in the city and suburbs was 150, in March 653, and in April the high-water level of 791 was reached." But before that time what we suppose Dr. Collins and Mr. Picton would call a "panic" had set in. We should put it that common-sense had reasserted itself, and massacre was therefore stopped. The Sanitary Committee of the City Council asked the local doctors what ought to be done to • save the people, and the response was that the sick must be effectively isolated, and that all who were not properly protected against small-pox must be immediately vaccinated or revaccinated. The accommodation of the "isolation" hospital was at once enlarged—in the circum- stances a decidedly mixed blessing—and on March 24th the Board of Guardians, by 31 votes to 22, resolved that the vaccination laws should be enforced. That was so far good, but a special machinery was needed to deal with the results of the accumulated neglect of ten years. It was not, accordingly, till the end of April or early in May that the demon of pestilence was fairly grappled with. Then a special Vaccination Committee having been appointed, a large special vaccinating staff was set to work, and the public were informed of the facilities afforded them for obtaining protection. "From first to last upwards of 36,000 vaccinations and revaccinations were effected and though a considerable number of adults still held out, the majority of children were operated upon." And the result was that the progress of the loathsome plague was at cnce &a; el, and by the end of July it was stamped out altogether.
Gloucester had suffered terribly for its disregard of Nature's lessons. Out of its population of a little over 40,000, 2,036 persons were attacked by small-pox, and 443 of that number, or more than one-fifth, perished. But, as we have seen, a return to obedience was at once rewarded. We may fairly ask that Parliament, in any action it may take on the Report of the Royal Com- mission, shall be very careful to secure that the indulgence which the Commissioners would give to the scruples of conscientiously objecting parents shall not lend itself to the development of situations such as that from which Gloucester has just emerged. We are not sure that such parents ought to be fined or imprisoned. But we are sure that nothing whatever should be done to make things easy for them, or for those whose consciences can be induced, under a little pressure to provide them with reasons for -disobeying the law. It would not be unfair, we should say, to require the conscientious objector to vaccination to give security that he will contribute to the cost of the isolation of his child if it should contract small-pox, and that he will submit himself and the rest of his family to every measure which, in that event, may be deemed necessary by the local authority to prevent risk to law- abiding citizens. On the other hand, we gladly support the recommendations of the Commission in regard to steps for making vaccination as easily obtainable and as free from risk as possible. The State should do all it can to facilitate the acceptance of Nature's teachings by ignorant citizens, and the more enlightened members of the community should actively co-operate, as, happily, they seem now to be doing in Gloucester- shire, to counteract mischievous misrepresentations and to set forth the true value of one of the greatest of medical discoveries.
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