occurred in the hands of a duly educated medical practitioner?'

To this all but a very few answered in the negative. The fourth question was—

'Do you (assuming due provisions to exist for a skilful performance of the operation) recommend that, except for special reasons in individual cases, vaccination should be universally performed at early periods of life?'

But what had been the Sir Gilbert Blane had ascertained, the average

All but two were favourable. He thought the House would see this inquiry was as exhaustive and complete as ingenuity could devise. effect on the public health? stated that, so far as could be annual death rate in small pox in England and Wales during thirty years previous to the introduction of vaccination was 3,000 per million of the population. The average of three years (1838 to 1840), when vaccination had become to a great extent diffused, but before any public provision was made for its gratuitous performance, was 770. The average of nine of the years (1841 to 1853) when public vaccination was gratuitously provided, but vaccination was not obligatory, was 304 per million. The average of the ten years (1854 to 1863) during which vaccination had been to a certain extent obligatory, was 171; and if the last year for which returns had been made were included, the rate, instead of 171, would be 190 per million. One reason for these inquiries was the alarming increase which had taken place during the last few years in the deaths by small pox in England and Wales. In 1861 the number of deaths had fallen to 1320, but rose in 1863 to 5,964, and in 1864 to 7,684. The House must recollect that these deaths by no means represented the evil inflicted on society by this dreadful scourge. A distinguished

French physician, M. de la Condamine, in 1756, calIculated that about one-fourth of the human race were suffering more or less from the effects of small pox, which showed themselves in blindness and deafness, entire or partial, scrofula, and other terrible forms of disease. With respect to the mortality among the vaccinated and unvaccinated, the evidence was very complete. Perhaps the most capable witness on this point was Mr. Marson, for very many years in charge of the Small-pox Hospital. Mr. Marson stated his conclusion, the result of 15,000 cases, in these words

'That the fatality of small pox, when it attacks the unvaccinated, is 350 per 1,000; that its fatality to such vaccinated persons as it infects is, taking them indiscriminately, 70 per 1,000; but, distinguishing vaccinated persons into two classes, those (1) who have been vaccinated in the best known manner, and those (2) who have been badly vaccinated, the fatality of small pox, if it infects the former, will be 5 per 1,000; if it infects the latter, 150 per 1,000; that the risk of the one will be thirty times the risk of the other.'

Or, to state it differently, if attacked by small pox, one in three unvaccinated would die; one in seven imperfectly vaccinated; while only one in 200 would die if well vaccinated. But Mr. Marson's observations do far more than establish in a general way, in concurrence with others, the modifying power of vaccination. They have a merit peculiarly their own. They show conclusively that the degree of modifying power is in the exact ratio of the excellence and completeness of the vaccination as shown by the cicatrices; in other words, that it was directly as the amount of vaccinemarking and as the character of the marks. The following would show this at a glance better than any detailed statement :

'Number of deaths per cent. in each class respectively1. Unvaccinated, 37. 2. Stated to have been vaccinated, but having no cicatrix, 23.57. 3. Vaccinated-having one vaccine cicatrix, 7.73; having two vaccine cicatrices, 4.70; having three vaccine cicatrices, 1·95; having four or more vaccine cicatrices, 0.55; having well-marked cicatrices, 2.52; having badly-marked cicatrices, 8-82. 4. Having previously had small pox, 19.'

He thought those facts-and the examinations throughout Europe, very carefully conducted, had been attended by similar results-would establish, not only the immense security which vaccination afforded against small pox, but that, if rendered complete, the security would be still greater; and, therefore, it was the duty of the House to provide for the full advantages of a thoroughly effective system of vaccination."

After explaining in detail the objects and provisions of the Bill, Mr. Bruce added :—

"The proposed amendments of the law would, he believed, conduce to greater efficiency in vaccination, both as to quantity and quality, without unnecessary interference or undue pressure upon the rates. A number of petitions which had been presented did not go so much against the Bill, as against the principle of vaccination. One objection was, that it had been made the means of introducing into the system other diseases than small pox. On this point Dr. Seaton said—

'Those who have had most to do with the performance of vaccination, on the one hand, and those who have been most concerned in the treatment of infantile disease, on the other, concur in the belief of the non-communicability of disease by vaccination. Mr. Marson, in the performance of 50,000 vaccinations and more, "has never seen other diseases communicated with the vaccine disease, nor does he believe in the popular reports that they are so communicated." Such

also was the experience of the late Mr. Leese, whose opportunities of observation were scarcely, if any, less. Dr. W. Jenner stated some years ago that at University College Hospital and at the Hospital for Sick Children, he had had, in six years, more than 13,000 sick adults and children under observation, and that in no case had he reason to believe, or even to suspect, that any constitutional taint had been conveyed from one person to another by vaccination. Dr. West's experience of 26,000 infants and children under his care in seventeen years is to the like effect; in stating that he has seen nothing in that time to make him believe that vaccination excites cutaneous eruptions in any but very exceptional cases, he refers such exceptional cases to a disposition in the children themselves, brought out by the vaccination as it might have been by teething. And Professor Paget, speaking from his large experience among children in the out-patients' room at St. Bartholomew's, and enumerating some of the causes which develop cutaneous diseases in young children, says, "Now, vaccination may do, though I believe it very rarely does, what these several accidents may do-namely, by disturbing for a time the general health, it may give opportunity for the external manifestation and complete evolution of some constitutional affection, which, but for it, might have remained rather longer latent. This is," he adds, "the worst thing that can with any show of reason be charged against vaccination; even this can very seldom be charged with truth."

A statement had been widely circulated that syphilis had been introduced into the system by vaccination. Millions of children had been vaccinated in the last sixty years, but not a single case had occurred in which it had been proved that syphilis had been communicated. A case was alleged to have occurred in France in which a child had been vaccinated from another which inherited syphilis; but the surgeon in that case, in taking lymph from a child covered with syphilitic blotches,

acted in monstrous disregard of common prudence and medical knowledge. No such case, so far as the most careful medical research could discover, had happened in this country. He did not think it necessary to argue the general question of vaccination. He had read many letters objecting to the compulsory system, but the House and the country were in favour of compulsory vaccination, and the only question was as to the best. machinery for enforcing the law."

"The Vaccination Act of 1867 " came into operation on the 1st of January 1868.

Its object, as described in its preamble, was "to consolidate and amend the Statutes relating to vaccination in England" (including Wales); and in furtherance of that object, it repealed, from and after the 1st January 1868, the then existing Statutes which related generally to the subject of Vaccination-namely, 3 & 4 Vict. c. 29; 4 & 5 Vict. c. 32; 16 & 17 Vict. c. 100; and 24 & 25 Vict. c. 59; together with the 7th sec. of the 21 & 22 Vict. c. 25, and the 2nd sec. of the 21 & 22 Vict. c. 97; the first relating to the duties of the Registrar-General, and the last to the powers of the Privy Council, with respect to vaccination.

This repeal, however, even when it took effect, was not absolute and complete, inasmuch as it was qualified by the following exceptions:

"Except in regard to the divisions and districts of unions and parishes previously made, and to all contracts under the said Statutes then in force, and to all acts and proceedings duly commenced under the same, and not then completed, and except in regard to all liabilities and responsibilities incurred under the same,