This epidemic was clearly the same as that which, had prevailed, with somewhat of the same severity, not only in this country, but also over the greater part of the Continent of Europe, two years previously; and hence there can be little doubt that the high rate of mortality by which it was everywhere characterized must have been due to general rather than to local causes. It had the good effect of frightening many of our local health authorities into a more efficient observance of their duty in regard to vaccination; and the result has been that, during the last two years, the reports of the Registrar-General show an almost complete extinction of small-pox in the nineteen great towns, whose aggregate population (about three and three quarter millions) equals that of the metropolis. The fresh outbreak which has taken place during the first half of the present year has been almost entirely restricted to the London area, and evidently points to the importance of a more strict enforcement of the vaccination law, which is at present rendered nugatory, as regards no inconsiderable proportion of the metropolitan population, by the migration of families from one district to another.
The prolonged experience of Dr. Martin, in regard to the facility of keeping up heifer-vaccination continuously from the original stock, altogether confirmatory as it is of what has been reported on this subject from France, Belgium, and St. Petersburg, seems to me to justify the demand that our Government should maintain the requisite establishment on a sufficient scale to meet the requirements of the whole country, so that every vaccination and revaccination may be performed (if desired) with lymph derived from the original cow-stock, without any humanization whatever. The vaccinia of Jenner may be thus maintained in its original efficacy, without the impairment of its protective influence by prolonged "cultivation" in the human subject, and thus only can it be secured against the contaminating influence of human disease, the liability to which furnishes the anti-vaccinationists with their strongest weapon.
No benefit can be reasonably expected from the adoption of any system which is based on the induction of vaccinia in a calf or
- I am assured by Dr. Martin that vaccination with heifer-lymph dried on ivory "points" succeeds in as large a proportion of cases as vaccination with fresh human lymph, provided that it be practiced according to the method which his large experience has led him to adopt as the most effective.
resemblance to the "Black Death" that carried off what was estimated at one third of the population of Europe in the fourteenth century, as to suggest that the latter may have been really a peculiarly malignant small-pox. My friends greatly regretted the want in the United States of a system of "compulsory" vaccination; but said that, when outbreaks of small-pox occurred in their towns, the municipal authorities took the matter in hand, and insisted on the immediate vaccination and revaccination of all dwellers in the infected localities, by which means these outbreaks were brought under control. As there is no registration system in the American Union, I could not obtain any definite information as to the amount of its small-pox mortality; but no one seemed to entertain the least doubt as to the preventive efficacy of vaccination.