EXPENSES OF THE BOARD.

The following is a synopsis of the expenses of the Board to the end of the present fiscal year:

All the vouchers of the above are on file at the office of the State Treasurer.

The amount appropriated by the legislature for the use of the Board, for the year, was $3,000.

Unexpended balance, which reverts to the state, $1,504.67.

Respectfully submitted,

IRVING A. WATSON,

Secretary State Board of Health.

VACCINATION.*

BY PROF. C. A. LINDSLEY, M. D.,

MEDICAL DEPARTMENT, YALE COLLEGE, DECEMBER, 1881.

Nothing, however beneficent, can escape the criticism of the times in which we live. The criticism of vaccination, often passionate and violent, relates chiefly to points which, however interesting they may be, leave the main question unaffected. We may speculate about the possibility of the potency of vaccine being exhausted in the human family; we may be surprised to find that people with good vaccine scars sometimes have small-pox; we may dispute as much as we please about the average period when revaccination may be considered a prudent safeguard; but after all, we find that we rest in a security against the horrid pestilence of small-pox unknown to former generations.-Dr. George Derby.

* * *

It is one of the recognized duties of the State Board of Health to acquire and diffuse among the people such information concerning the care and protection of their health as will be of practical use to them.

The fields of study pertaining to public hygiene are wide and varied, and among them all there are few, if any, at the present time, of greater significance than vaccination. There are few, if any, topics which deal with human life at all approximating to the importance of this, respecting which there is so much misinformation and unfounded prejudice in the public mind.

It is, therefore, an eminently proper subject, upon which the people should have correct information, that their unjust prejudices may be removed, and that they may enjoy the best results of this beneficent boon.

It is the purpose of the present paper to state, in brief and plain language, what vaccination has done for the human race, and how it can be employed most safely and effectively.

* See acknowledgments and remarks in "General Report," page 10.

In 1798, more than eighty years ago, it was announced by the great Jenner that the inoculation of vaccinia, or cow-pox, in the human subject was a full and sure protection from small-pox. Probably no single discovery ever made by man has contributed so much to human longevity. The greatness and value of this specific preventive of small-pox can never be successfully controverted.

The claim of Jenner, that vaccination is competent to exterminate small-pox and to wipe out from the list of human ills this loathsome contagion, is now established by the verdict of science, as based on the experience of millions and millions of facts, noticed by the best medical observers and thinkers in the world.

For the very reason that its protective power is so nearly infallible and its use so nearly universal, the present generation are comparatively exempt from small-pox, and therefore cannot and do not adequately appreciate the magnitude of the blessing which Jenner's discovery has conferred upon mankind. Vaccination owes its whole importance to its relations to small-pox. It confers upon the human system no new advantages, but rather is temporarily itself a source of some discomfort and suffering. Its whole value consists in its power of protecting one from that most fatal of human maladies, the small-pox. Its general observance and practice is in obedience to the law, "Of two evils, one should choose the least."

WHAT HAS VACCINATION DONE?

We can best understand the question by inquiring about the prevalence of small-pox in the last and previous centuries as compared with its prevalence now.

In past times, throughout Europe and in other countries, smallpox was universally regarded as one of the greatest scourges of mankind. The bills of mortality during the last half of the last century showed that ninety-six one thousandths, almost one tenth, of all the deaths in London occurred from this sole cause. In the great cities, on an average of a long series of years, it can be shown that one third of all the deaths which took place in children less than ten years old arose from small-pox.

"Not a decade passed in which the disease did not decimate

the inhabitants in one country or another, or over great tracts of country; so that it came to be more dreaded than the plague."

In Berlin, according to Caspar, from 1783 to 1799 small-pox caused one twelfth of the total mortality.

In France, 30,000 persons perished annually of this disease. Medical treatment availed but little to stay its ravages. A proverb of the time illustrated how resignedly the people accepted their fate: "From small-pox and love but few remain free."

Among remote communities, where it had not previously prevailed, and where therefore none were exempt from its contagion by previous suffering, its ravages have been fearful to contemplate.

In 1518 it made complete the depopulation of St. Domingo, previously begun by sword, fire, and famine. Mr. Prescott, in his "Conquest of Mexico," describes an epidemic as sweeping over the land like fire over the prairies, smiting down prince and peasant, and leaving its path strewn with the dead bodies of the natives, who (says another) "perished in heaps like cattle stricken with the murrain." Washington Irving's "Astoria" mentions several epidemics among the American Indians in which "almost entire tribes" were destroyed.

During a single year, about 1560, says De la Condamine, it destroyed, in the province of Quito, upwards of 100,000 Indians. In later days, we have accounts of epidemics raging with no less destructive power over Kamtschatka, Greenland, and Iceland. Its extreme severity in these latter-mentioned instances was due to the infection being suddenly spread among peoples, none of whom were exempt by previous attacks. In civilized countries, where intercommunication was constant, and the contagion continually conveyed about by uninterrupted intercourse, the disease perpetually existed in all communities, but finding subjects only among those who had not already had it, and were so exempted. So general and so contagious was the infection, that very few passed childhood without the consequences of exposure to it; and hence an adult person not pit-marked in the face was the exception to the general rule.

But the deaths from small-pox fall far short of a full realization of its evils. It was not fatal to all its victims. The survivors of the malady were, in many instances, only spared from death to

be lifelong sufferers from various severe physical afflictions, which, if not soon fatal, marred the enjoyment of life, and often abbreviated its duration.

The great English historian, Macauley, eloquently compares the evils of small-pox in England, toward the end of the seventeenth century, with the ravages of the plague. He gave small-pox the preeminence among destructive agencies, calling it "the most terrible of all the ministers of death." "The havoc of the plague," he said, "had been far more rapid; but the plague had visited our shores only once or twice within living memory. The small-pox was always present, filling the churchyards with corpses, leaving in those whose lives it spared the hideous traces of its power, turning the babe into a changeling at which the mother shuddered, and making the eyes and cheeks of the betrothed maiden objects of horror to the lover."

Survivors often found that although life was spared the boon was of questionable value, it was so much shorn of what made life enjoyable.

In many, sight or hearing, or both, were impaired or totally lost; and thus maimed, mutilated, and disfigured, they dragged on a sickly, miserable existence, to become speedy victims to consumption, scrofula, or some other fatal disorder.

Sir Gilbert Blaine stated that the report of the Hospital for the Indigent Blind showed that two thirds of its beneficiaries had lost their sight by small-pox.

The people of the present day have no familiarity with the horrors which small-pox may cause when uncontrolled. In our times, the happy immunity which we enjoy, the almost entire exemption of the present generation from the ravages of this dread destroyer of life and happiness, is wholly due to the protective power of vaccination.

So well is this understood, that in all communities where health boards exist, clothed with adequate authority, and being intelligently alert, small-pox is never permitted to be propagated beyond the first few cases in which it may occur.

Vaccination is therefore a subject of such considerable import as a measure of public hygiene that it deeply concerns every

* History of England, vol. IV, p. 530.