[back] Tuberculosis and smallpox vaccination

[Extracted from] LEICESTER: SANITATION versus VACCINATION BY J.T. BIGGS J.P.

CHAPTER  94: Inoculation  Experiments—Tuberculin and Leprosy.
CHAPTER 95: Vaccination and Tuberculosis.
CHAPTER 96: Diseases Injected, Intensified, and Increased by Vaccination and Inoculation.
CHAPTER 97: Inoculable Diseases—England and Wales.

CHAPTER  94: Inoculation  Experiments—Tuberculin and Leprosy.

"In an article on 'Koch's Tuberculin in Leprosy,' Dr. P. Ferrari gives the conclusions of several observers who have experimented with the tuberculin in leprosy. Dr. Danielssen (of Norway) considers (1) that tuberculin in leprosy gives general and local reactions, the former generally coming on four to six hours after the first injection, but sometimes in twelve hours, and rarely in two or three days—the local reaction is more tardy; (2) that unfavourable consequences ensue to the patient, the disease being aggravated, and that the reactions have some similarity to those produced by the preparations of iodine in lepers ; (3) that the lymph does not kill the bacilli, but seems instead to give them nutriment and favours their reproduction and circulation in the blood; (4) that when immunity to the remedy is established, the disease is in no way arrested, nor the bacilli destroyed.
    " Dr. Ferrari has himself come to the conclusion, from the consideration of the above cases and of those of other observers, that tuberculin exhibits no direct useful action on the leper.     As  in  tuberculosis,  it may act on  the torpid condition of the tissue, not so much by any specific effect as on account of the small resistance of the diseased tissue. He remarks particularly on the outburst of new tubercles during  the  paroxysms  of  fever."—" Journal  of the Leprosy Investigation Committee," No. 4, December, 1891, pages 46 and 47. (Pages 339 and 340.)

Dr. Julius Goldschmidt, Medical Superin­tendent, Lazzaretto Hospital, Madeira, who has made the pathology and treatment of leprosy a special subject of study, sent a communication to the Leprosy Investigation Committee (" Journal," December, 1891), in which he refers to his inoculative experiments with tuberculin and other drugs,  and says :—

"As far back as eleven years,  I tried to inoculate the anaesthetic form on the tubercular one,  without success."    

Mr. Tebb ventured to point out to Dr. Goldschmidt

how medical testimony showed that, while syphilis and leprosy were difficult to inoculate direct from the disease to those free from these diseases, the evidence that these and other diseases were readily inoculable by means of an intermediary host such as vaccine virus was now overwhelming."    (Pages 373 and 374.)

The "Lancet," of 16th April, 1892, had a leading article on the results of the tuberculin treatment of leprosy. Referring to the experiments of Dr. Danielssen  (of Norway), it says: —

"Unfortunately the conclusion drawn was that tuberculin aggravated the disease considerably, and, by setting free the bacilli, started fresh foci of the disease, and made the whole process more active. As in lupus and phthisis, the patients became tolerant of the tuberculin after a time ; but the disease progressed all the same, and fresh symptoms were frequently excited ; many also of the old lesions became red and sensitive. In the anaesthetic form the patches enlarged, became redder and more sensitive, and now patches appeared."

Other instances are given, and in one the Lancet" says :—

" Scores of new tubercles came out all over the body. . . . The above cases do not exhaust the list of experiments, but they are sufficient to show that tuberculin is very uncertain  in  its immediate  effects  on leprosy." (Pages 344 and 345.)

Mr. Tebb visited a Leper Hospital, and saw the fashionable inoculative experimental treatment.   He says:-

"The poor creatures were brought into the surgery one after another ; some brave, and others with a timid, appealing look in their eyes. To enable them to bear the pain of the hypodermic syringe, thrust by the operating physician deep into the flesh, they had a handkerchief between the teeth, while held by the hospital nurse or attendant. The puncture of the instrument is usually the least painful part of the experimental process. The treatment, which is often continued for months, produces sickness, acute headaches, and fever. The rage for experimental research has long since passed the bounds  of decent humanity."    (Page  346.)

In   Mr.   Tebb's   summary   of   conclusions,   the following may be noted here ;—

    " That leprosy has greatly increased during the last half-century, and that it is prevalent in many places where it was formerly unknown."
    " That on one point there is much agreement and hardly any dissent—namely, the inoculability of leprosy—and that the view of leprosy as an inoculable disease, while it is most clear to those who take the malady to be due to a bacillus, is older than the bacteriological evidence, and is not dependent thereon."
    " That the increase of leprosy in the Sandwich Islands, the West Indies, the United States of Columbia, British Guiana, South Africa, and New Caledonia has followed pari passu with the introduction and extension of vaccination, which in nearly all these places, without previous inquiry or demand from the inhabitants, has been made compulsory."
    " That as leprosy is a disease of slow incubation, often taking years to declare itself, and in its incipient stages can be detected only by practitioners of large experience, it follows that, in countries where leprosy exists, there is great danger of extending the disease by arm-to-arm vaccination."
    " That leprosy being one of the most loathsome diseases to which the human race is subject, and being practically incurable, it behoves all interested in the public well-being to do their best to prevent its diffusion, and, as a means thereto, to discourage the practice of vaccination on that ground,  if on no other."    (Pages 350-352.)

Truly the perusal of Mr. Tebb's grail work on " Leprosy and Vaccination " recalls the well-known saying of Burns, "Man's inhumanity to man makes countless thousands mourn." Those who wish to know more about this aspect of the case against vaccination, would do well to obtain a copy of the book referred to, and thus draw direct from the fountain head.

CHAPTER 95: Vaccination and Tuberculosis.

Great efforts are now being made to cope with one of the most fatal maladies to which the human race is subject. The British Congress on Tuberculosis, held in London, in July, 1901, will long be memorable in the annals of public health. The fact that His Majesty King Edward VII. evinced a great personal interest in the proceedings, and that eminent experts from all over the world assembled with a view of concentrating their united wisdom and research upon this supremely important subject— Professor Koch also being present -all combined lo make this Conference distinguished above all others.

It was further memorable for the startling announcement by Professor Koch that, after a considerable investigation, aided by experiments, he  

"felt   justified   in   maintaining   that   human tuberculosis differs from bovine, and cannot be transmitted to cattle."

He proceeded :—

"It seems to me very desirable, however, that these experiments should be repeated elsewhere, in order that all doubt as to the correctness of my assertion may be removed."    He stated that the  German   Government had  appointed  a  Commission to make further inquiries on the subject. Dr.   Koch   next   proceeded   to   discuss   human susceptibility to bovine tuberculosis.    He observed that " this question  is far more important to us than that of the susceptibility of cattle to human tuberculosis,  highly  important  as  that  is  too."

He went on to say,

" It is impossible to give this question a direct answer, because, of course, the experimental investigation of it with human beings is out of the question."

This is rather an amazing statement, coming from the inventor of " Tuberculin," with the aid of which innumerable experiments have been made, and are even now being continued, upon human beings, with fearfully fatal results. Soon after this speech was delivered, "Tuberculin" fell under a cloud, on account of its manifold failures. But it has since, like vaccine lymph, been improved, (!) and its use revived, even—and I record this with some degree of shame and humiliation—in Leicester.

Professor   Koch   also   said,  

" If   the   bacilli   of bovine tuberculosis were able to infect human beings, many cases of tuberculosis caused by the consumption of tubercle-bacilli could not but occur among the inhabitants of great cities, especially the children. And most medical men believe that this is actually the case."

We need not discuss these questions here, as it has been established by the Royal Commission on Tuberculosis that bovine tuberculosis can be transmitted to man. It seems strange that Professor Koch, above all others, should ever doubt it.

It is a singular and sad commentary on human infatuation, as well as upon the supposed advancement of medical science, that we should continue to sow broadcast the seeds of consumption by inoculation, and then, after the crop has matured, to affect surprise and grief. Not long ago it would have been regarded as a cruel crime to suggest that consumptive patients should have outdoor treatment. Now it is all the fashion, and is undoubtedly beneficial. If the Government had abolished vaccination, instead of offering to provide sanatoria for the treatment of consumption, they would have taken the first strong step towards ridding the human race of the devastating scourge of this malady.

The   "Medical   Times   and   Gazette,"   for   1st January,    1854,    stated   that   consumption  

 " has widely spread since the introduction of vaccination, and within ten years (ending 1853), had slain its 68,204 victims in the metropolis alone."

Dr. Bray, in a public speech at Market Rasen, in 1876, stated :

" Facts have accumulated to show that since vaccination had become the law of the land, consumption, which before was comparatively unknown in this country, had, as it were, become an inheritance in certain families. The pure lymph, perhaps obtained from the greasy heels of a dismal old horse, was identical with the matter ejected from the lungs of a consumptive person. . . . Vaccination was applied to the arm, but the poison diffused itself rapidly into the lungs, the blood, the stomach, and even the brain."

In the " British Medical Journal," 13th December, 1879, Dr. Simon says,

" That vaccine lymph may possibly contain the contagion in full vigour, even when the patient has not on his own person any outward activity, and that infection may follow both from tuberculosis and syphilis."

The   " Medical   Times   and   Gazette,"   of   3rd September,    1881,   records   that  

"M.    Toussaint vaccinated a cow in an advanced stage of tuberculosis with lymph absolutely pure. The vesicles progressed normally, and with the lymph obtained from them he vaccinated different animals, all of whom subsequently became tuberculous. The significance of these experiments can scarcely be overrated."

Dr. (now Sir) W. J. Collins, M.D., writing from St. Bartholomew's Hospital, 10th September, 1881, with reference to the communicability of syphilis, erysipelas, pyaemia, and scrofula, says :—

That tubercle or scrofula can be engendered or intensified by vaccination is no new theory. Dr. Squirrell, an anti-vaccinator, suggested it seventy years ago, and now that a belief in the inoculability of tubercle is gaining ground, it will probably not be long before this danger is considered as real as that of vaccino-syphilis."

Recently numerous undeniable proofs have been adduced. In 1906, the " Petit Parisien" published an interview with Professor Vallee on the subject of Dr. Behring's bovo vaccine. The Professor said that he had at first believed in the efficacy of this remedy, but experiments had proved to him that it was no remedy at present for   tuberculosis.     Thus   two   calves   which   had been vaccinated and placed among tuberculous cows contracted tuberculosis, whereas they ought to have remained healthy.    .    .    .

Questioned as to whether bovo vaccine, a tuberculous product, was really harmless, Professor Vallee replied that he tried it on guinea pigs, which became tuberculous. Professor Lignieres, of Buenos Ayres, obtained the same result. Professor  Vallee  said :—

" If  I   had   inoculated  cows with it, not only should I not have vaccinated them, but I should certainly have given them tuberculosis."—Reuter.

The "Keighley Herald," of 8th July, 1910, contained a long article by " Retired Medico," entitled " Consumption's Cause." The writer expounds the view that the modern prevalence of consumption is an aftermath of arm-to-arm vaccination. He also comments on the similar risk attaching to vaccination with calf lymph, and thus concludes:—

"This subject is a grave one for the people, for it entails the vital question of whether we are not doing our best still, through vaccination—I leave the question of the merits and demerits of vaccination to others— to propagate the growth of the greatest twentieth century scourge—consumption."

A paper on " The Great White Plague," read at the fifth annual meeting of the Connecticut Medical Union, in Waterbury, Conn., U.S.A., on 1st June, 1910, by Mr. L. W. Andersen, was printed in the " Sunday Herald," of 12th June, 1910, and the writer expressed the belief

" that tuberculosis will continue to exist and  increase as long as the virus of animals, more or less impregnated with tuberculosis, is injected into the human blood."

Writing on the subject of vaccination and tuberculosis, Dr. Perron, Officier de la Legion d'Honneur, published an article of superlative importance in the " Gazette Hebdomadaire des Sciences Medicales," which was translated and published in the "Vaccination Inquirer," of December, 1890, and January, 1891, and from which the following extracts are taken :—

" The possibility of conveying tuberculosis to man in the act of vaccination was long ago pointed out. Tuberculosis has, in fact, a special predilection for the bovine race which yields us our vaccine. There are few of these animals that escape its attacks; the calf, the heifer, sometimes bear traces of it but a few weeks after their birth."
    " The cow, as we have said, is the tuberculous animal par excellence."
    "If, as announced by Professor Bouchard, the medium created by a vaccination can be destructive to one or several microbic species, we may add that by the law of reciprocity a medium of cultivation may at the same time be favourable to one or several microbes. That is exactly what happens with the cow in respect of tuberculosis and vaccinia, diseases between which the soil of cultivation establishes, as we see, a striking connection."
    " At the very time when we have created in the man the vaccinal soil, we run the risk of having, ipso facto, established that humoral state (terrain Immoral) which is favourable l.o the tuberculous genesis."
    " If we now turn back and examine the events of the last century or so, we can show a constant increase of tuberculosis, a fact never hitherto satisfactorily explained. There was a time when this malady existed only as an exceptional thing; now, actually, in spite of the incessant progress in public and private hygiene, in spite of all the material improvements that have been made, it tends more and more to rise to   the   rank   of   a   pestilence.     It   should   be remarked that it strikes by preference at the young lives—that is, those who are, nevertheless, at the age when the physical resistance to morbific causes is the strongest. Now, a malady which originates in exhaustion, in vital poverty, should display its power in the inverse order, and should fall most heavily on the old."
    " Side by side with this growing extension of tuberculosis, we see developing, pari passu, and in the same period of time—that is to say, since the beginning of the century—the practice of vaccination. We may ask ourselves whether in this double simultaneous evolution there is not a hidden oneness. If tuberculosis, in spite of all sanitary precautions, has multiplied its attacks during the last hundred years, it is, we submit, because vaccination has come to create for it a propitious soil. That would explain not only its advancing growth in all civilised countries, but also its special influence over the young subjects,   who are always more or less recently vaccinated, and consequently more receptive than the others in the presence of the bacillus."
    " In all the European armies vaccination is the order of the day. On their arrival with their corps, the young soldiers are forthwith carefully revaccinated. Now, the military statistics of all countries show an enormous proportion of various forms of tuberculosis among soldiers, especially during the first and second year after their enlistment."
    "Whence, then, can come these attacks of tuberculosis, so sudden, so numerous, upon subjects that, but a few months before, the council of revision rightly declared to be fit for service ? Tuberculosis of the lungs, of the organs, of the joints, of the bones, etc., all these fatal evils show themselves in the garrisons of all countries with a frequency before which one might well despair. We believe that we must simply seek the reason for these facts in the revaccination which awaits the recruits upon their arrival at their corps, and which transforms them forthwith into a medium which is receptive towards these germs of tubercle which swarm in centres of population. This revaccination immediately upon enlistment is all the more regrettable and inopportune since just at that moment the young man, separated from his family, his country, his familiar conditions of life, undergoes, without any period of transition, total and radical changes in his manner of life, and thereby finds himself less well equipped for resistance."
"We must recall the fact that tuberculosis is ' hatched' amongst bovines with very grout facility. . . . Also to the progressive extension of tuberculosis since the end of the last century, and the concomitant extension of the vaccinal practice ; and the inexplicable frequency of the malady amongst young or revaccinated subjects."

Here, then, we have the "rationale" on the growth of consumption, communicated by an eminent pro-vaccinist, who is certainly not at all favourable to the anti-vaccinist view of the question. Dr. Perron writes with the idea of inculcating the exercise of more care in vaccinating, rather than—as one would have thought such risks ought to suggest to these experimenters with human bodies—to the entire abandonment of so dangerous and disease-distributing a practice.

The extraordinary growth of consumption in Japan, where, with increasing vaccination and revaccination, the death-rate from pulmonary tuberculosis has increased more than 50 per cent, from 1886 to 1909; whilst on the other hand, with declining vaccination, the death-rate from the same cause has gone down in inverse ratio both in England and Switzerland, is a striking confirmation of the argument of Dr. Perron. (See Registrar-General's Seventy-Third Annual Report, 1910, Table LXXIX., also the International Tables, pages 112-141.)

CHAPTER 96: Diseases Injected, Intensified, and Increased by Vaccination and Inoculation.

Although the preceding pages deal principally with Vaccination and Leicester, I do not regard them as complete without some reference to the long and growing list of inoculable diseases connected with the practice of vaccination. From the very first, far-seeing medical men were able to detect the tendency and effects of the "new" inoculation. A flood of light was thrown on this gruesome subject by Dr. Makuna's "Vaccination Inquiry," published in 1883. Although it was promised on the cover of the first edition that the second edition would "shortly be published," nearly thirty years have elapsed, but it has not yet seen the light. Like another " Balaam," the inquiry was called to curse the anti-vaccinators, but it eventuated in cursing its promoters. The first batch of evidence proved far too damning to the ''cause of vaccination for a second instalment to be issued.

Of the 384 replies published, nearly all were from out-and-out believers in vaccination. Yet they recorded 53 cases of syphilis, 126 of erysipelas, 64 of eczema, 22 of erythema, 9 of scrofula, and a number of others, making over 40 diseases in all.   What the number would have increased to had the second edition been published, we are left to surmise. Resides this long catalogue, other medical men have experienced similar disasters in their practice. While not proposing to give a complete list, I append the principal of those diseases which have already been published or come to my knowledge :—

Abdominal                  Diseased Joints.                     Phagedenic action.
Phthisis.                      Dyscrasia.                              Phlegmon.
Abscesses.                 Ecthymia.                              Pityriasis.
Adenitis.                     Eczema.                                Plague.
Anaemia.                    Eruptions.                             Pneumonia.
Angeioleucitis.            Erysipelas.                             Prurigo.
Apnaea.                     Erythema.                              Psoriasis.
Arm disease 
(involving amputation)   Foot-and-Mouth Disease         Pyaemia.
Pyrexia.                     Gangrenosa.                          Rickets.
Axillary Bubo.            General Debility.                   Scald Head.
Axillary Gland, enlargement of           Herpes.         Scarlatina.
Impetigo.                   Scrofula.
Blindness                     Inflammation.                       Septicaemia.
Blood poisoning fatal   Latent diseases developed    Skin Disease.
Boils                           Struma intensified.                Leprosy.         
Bronchitis.                   Lichen.                               Syphilis.
Bnllse-                         Lupus.                               Tetanus.
Cancer.                        Marasmus.                        Tuberculosis.
Cellulitis.                     Meningitis.                          Ulceration.
Convulsions.                Mesenteric Disease            Urticaria.
Cowpox.                                   .                         Vaccinia.
Diarrhoea.                   Oedema.                           Varioloid.
Diseased Bones.          Paralysis.

In 1882, a list of 155 testimonies of medical men and medical journals was published by the London Society for the Abolition of Compulsory Vaccination. They record 710 deaths from vaccination, one of which was from an early case of revaccination with calf lymph. Thirty-nine deal with animal lymph, principally from the cow or calf. Of 504 vaccinated cases cited by Dr. William Rowley, M.R.G.P., in England, as early as 1805, nearly all took small-pox, and 75 died. Also, nearly 500 other cases caught small-pox after vaccination, 31 injuries are specifically named, and over 650 additional cases are mentioned, including cancer, erysipelas, leprosy, scrofula, syphilis, tuberculosis, and other diseases. Professor Bartlett, when lecturing at the University, New York, in 1850, quoted, on the authority of two eminent French physicians—Dr. Barthez and Dr. Rilliez—208 vaccinated children, 130 of whom died of tubercular consumption, and the remaining 70 of other inoculable maladies.

Mr. William Tebb presented a list to the Royal Commission of 6,233 cases of injury, and 842 deaths. Mr. Geo. S. Gibbs published, in 1891, the results of a vaccination census at Darlington, which recorded 224 cases of injury, and 79 deaths. The author presented to the Royal Commission a table of 186 injuries, and 109 deaths, in the Leicester district alone. Then we have that long catalogue of about 1,000 vaccino-syphilis cases on page 617 of the Sixth Report of the Royal Commission.

This appalling list could be considerably augmented now, as numerous other cases have come to light since the time of the Royal Commission.

Then there is that terrible total of medically-certified deaths published by the Registrar-General, in his annual reports, which readied no fewer than 1,530 to the end of 1910, and of these, it should be remembered that 251 have occurred since the introduction of glycerinated calf lymph. We must also take into consideration those striking returns to the House of Commons (see Appendix, Tables 54-56) showing that, after the introduction of compulsory vaccination, the deaths from inoculable diseases increased from 63,558 per million in 1853 to 82,189 per million of the population in 1870. It is true this number has gone down since, but so has vaccination ! However, I deal with that subject in the chapter on inoculable diseases. One important point should be borne in mind—that the general death-rate from all causes and at all ages was appreciably declining at the very time that the deaths from all these inoculable diseases were rapidly increasing. In the favourite language of pro-vaccinists, I may ask—To what other cause can this  be  attributed  than   vaccination ?

CHAPTER 97: Inoculable Diseases—England and Wales.

In 1880, the late Mr. Ghas. H. Hopwood, Q.C., M.P., moved in the House of Commons for a return showing the percentage of deaths from small-pox, at certain ages, to the total deaths from that disease ; and also for the number of deaths of infants under one year of age per million births from a number of specified inoculable diseases and all other causes. This was granted, and gave the information for England and Wales, from 1847 to 1878 inclusive. The specified diseases were :—Syphilis, scrofula, tuberculous peritonitis, skin diseases, erysipelas, pyaemia,  bronchitis,  diarrhoea,  and  atrophy.

These returns show an increase in the death-rate from syphilis from 472 per million births in 1847 to 1,851 per million births in 1878. The combined death-rate from the nine enumerated causes, including syphilis, increased from 55,213 per million births in 1847 to 81,280 per million births in 1878.

In 1888, Mr. Francis Channing (now Lord Channing) moved for a similar return for the years 1879 to 1886 inclusive, which also was granted and published.

This second return  shows that the death-rate from syphilis more than maintained its high level, and in the last year (1886) was 1,882 per million births. The combined death-rate from the nine enumerated causes likewise remained at a high level, and increased from 71,013 per million births in 1879 to 84,177 per million births in 1886.

Many things have happened to affect the mortality during the thirty years which have elapsed since the second return appeared, and, in the course of that long period, there has been a marked decrease of vaccination, which set in soon after the great small-pox epidemic of 1871-73, and the passing of the great and beneficent Public Health Act of 1875. In addition to this, the sittings of the Royal Commission covered seven years, during which time prosecutions were largely suspended. Then came the successive Acts of Parliament, in 1898 and 1907, both not only moderating the severity of the compulsory law, but also bringing in the " Conscience Clause," with its army of exemptions, and consequent reduction in the number of defaulters who would otherwise have been liable to be proceeded against. Then, the extension of the age for vaccination from three to six months must have produced some tangible result in reducing the infantile death-rate from all causes.

The consideration of all these circumstances made me feel anxious to know what the actual effect has been, so that I might publish it in this work. I, therefore, asked Mr. J. Ramsay Macdonald, M.P. for Leicester, if he would undertake to move in the House of Commons for the  further return,  from  1887 to  1910.     To this Mr. Macdonald kindly and promptly assented. He moved for the return on 6th March, 1912 ; it was ordered to be printed, and on 22nd March was ready to be issued to the public.

As I fully expected, and the facts warranted, we find a substantial reduction, both for syphilis and for the total of the nine enumerated inoculable diseases. There is a considerable decrease in the death-rate from each of these diseases, with the exception of pyaemia and phlegmon, which are taken together, and show a slight increase -from 153 per million births in 1887 to 212 per million births in 1910. Syphilis has gone down from 1,787 per million births in 1887 to 1,150 per million births in 1910, whilst the combined death-rate of the nine inoculable diseases has declined from 80,411 per million births in 1887 to 53,014 per million births in 1910. (For the full Parliamentary returns, see Tables 54, 55, and 56, Appendix.)

I now give a summary, showing the average annual death-rate from syphilis, and from the combined group of the nine inoculable diseases, with the average annual percentage of vaccina­tions to births, for the different periods, as specified :—

Diagram  D.
ILLUSTRATING  TABLE   35.
INOCULABLE   DISEASES.      ENGLAND   AND   WALES. 1847-1910.
The Small Dark Pyramids show the actual death-rate from syphilis per million births.
The Large Pyramids show the death-rate from nine inoculable diseases, including syphilis, per million births.
                                 (One-tenth only shown to accommodate size of diagram.)
The Black Dotted Curve shows the death-pate from all other causes per million births.
                                (One-tenth only shown to accommodate size of diagram.)
The Red Curve shows the percentage of vaccinations to births.
                                (Proportionally increased to accommodate size of diagram.)

TABLE 35.     (See Diagram D.) INOCULABLE   DISEASES.
Table showing, for ENGLAND AND WALES, the death-rate per million births from Syphilis; from the total of nine inoculable diseases (including Syphilis) ; from all other causes; the percentage of vaccinations to births; and the conditions as to vaccination prevailing during the several groups of years. (See Parliamentary Returns, Tables 54, 55, and 56, Appendix.)

It will be seen that as the practice of vaccination lessens, the mortality from all these diseases also decreases. That from syphilis is falling rapidly, and in 1909-10 is less than any other of the periods, excepting the first, whilst the death-rate from the nine inoculable diseases combined   (including   syphilis),   after   rising   by   an increase of nearly 26 per cent, to a maximum of close upon 80,000 per million in the period of highest vaccination, is now plunging downward with decreased vaccination, and has reached the lowest recorded mortality since registration began in 1847.

The fall is a very remarkable one, being nearly 32 per cent.—from 79,336 per million to only 54,124 per million.

No unbiased mind can examine these figures and resist the conclusion that the synchrony between enforced vaccination and the increased death-rate, and also that between the decline and less rigorous enforcement of vaccination and the lessened death-rate, is much more than a coincidence—is, indeed, direct cause and effect.