WE will now proceed to discuss the alleged value of vaccination by means of the best and widest statistical evidence at our command; and in doing so we shall be able to show that the medical experts, who have been trusted by the Government and by the general public, are no less deficient in their power of drawing accurate conclusions from the official statistics of vaccination and small-pox mortality than they have been shown to be in their capacity for recording facts and quoting figures with precision and correctness.

In the elaborate paper by Sir John Simon, on the History and Practice of Vaccination, presented to Parliament in 1857 and reprinted in the First Report of the Royal Commission, he tells us that the earlier evidence of the value of vaccination was founded on individual cases, but that now "from individual cases the appeal is to masses of national experience." And the marginal reference is, "Evidence on the protectiveness of vaccination must now be statistical." If this was true in 1857, how much more must it be so now, when we have forty years more of "national experience" to go upon. Dr. Guy M.D., F.R.S., enforces this view in his paper published by the Royal Statistical Society in 1882. He says: "Is vaccination a preventive of small-pox? To this question there is, there can be, no answer except such as is couched in the language of figures." But the language of figures, otherwise the science of statistics, is not one which he who runs may read. It is full of pitfalls for the unwary, and requires either special aptitude or special training to avoid these pitfalls and deduce from the mass of figures at our command what they really teach.

A commission or committee of enquiry into this momentous question should have consisted wholly, or almost wholly, of statisticians, who would hear medical as well as official and independent evidence, would have all existing official statistics at their command, and would be able to tell us, with some show of authority, exactly what the figures proved, and what they only rendered probable on one side and on the other. But instead of such a body of experts, the Royal Commission, which for more than six years was occupied in hearing evidence and cross-examining witnesses, consisted wholly of medical men, lawyers, politicians, and country gentlemen, none of whom were trained statisticians, while the majority came to the enquiry more or less prejudiced in favour of vaccination. The report of such a body can have but little value, and I hope to satisfy my readers that it (the Majority Report) is not in accordance with the facts; that the reporters have lost themselves in the mazes of unimportant details; and that they have fallen into some of the pitfalls which encumber the path of those who, without adequate knowledge or training attempt to deal with great masses of figures.

But before proceeding to discuss the statistical evidence set forth in the reports of the Commission, I have again the disagreeable task of showing that a very large portion of it, on which the Commissioners mainly rely to justify their conclusions, is altogether untrustworthy, and must therefore be rejected whenever it is opposed to the results of the great body of more accurate statistical evidence. I allude of course to the question of the comparative small-pox mortality of the VACCINATED and the UNVACCINATED. The first point to be noticed is, that existing official evidence of the greatest value has never been made use of for the purposes of registration, and is not now available. For the last sixteen years the Registrar-General gives the deaths from small-pox under three headings. Thus, in the year 1881 he gives for London (Annual Summary, p. xxiv.):

Small-pox.          Vaccinated             524 deaths
     ,,                    Not vaccinated       962
     ,,                    No statement         885

And in the year 1893, for England figures are (Annual Report, p. xi.):

Small-pox.      Vaccinated            150 deaths
      "               Unvaccinated        253
      "               No statement      1054

Now such figures as these, even if those under the first two headings were correct, are a perfect farce, and are totally useless for any statistical purpose. Yet every vaccination is officially recorded — since 1873 private as well as public vaccinations—and it would not have been difficult to trace almost every small-pox patient to his place of birth and get the official record of his vaccination if it exists. As the medical advisers of the Government have not done this, and give us instead partial and local statistics, usually under no official sanction and often demonstrably incorrect, every rule of evidence and every dictate of common sense entitle us to reject the fragmentary and unverified statements which they put before us. Of the frequent untrustworthiness of such statements it is necessary to give a few examples.

In Notes on the Small-pox Epidemic at Birkenhead, 1877 (p. 9), Dr. F. Vacher says: "Those entered as not vaccinated were admittedly unvaccinated, or without the faintest mark. The mere assertions of patients or their friends that they were vaccinated counted for nothing." Another medical official justifies this method of making statistics as follows: "I have always classed those as ‘unvaccinated,’ when no scar, presumably arising from vaccination, could be discovered. Individuals are constantly seen who state that they have been vaccinated, but upon whom no cicatrices can be traced. In a prognostic and a statistic point of view, it is better, and, I think, necessary, to class them as unvaccinated" (Dr. Gayton’s Report for the Homerton. Hospital for 1871—2—3).

The result of this method, which is certainly very general though not universal, is such a falsification of the real facts as to render them worthless for statistical purposes. It is stated by so high an authority as Sir James Paget, in his lectures on Surgical Pathology, that "cicatrices may in time wear out"; while the Vaccination Committee of the Epidemiological Society, in its Report for 1885—6, admitted that "not every cicatrice will permanently exist." Even more important is the fact that in confluent small-pox the cicatrices are hidden, and large numbers of admissions to the hospitals are in the later stages of the disease. Dr. Russell, in his Glasgow Report (1871—2, p. 25), observes, "Sometimes persons were said to be vaccinated, but no marks could be seen, very frequently because of the abundance of the eruption. In some of those cases which recovered, an inspection before dismission discovered vaccine marks sometimes very good."

In many cases private enquiry has detected errors of this kind. In the Second Report of the Commission, pp. 219—20, a witness declared that out of six persons who died of small-pox and were reported by the medical officer of the Union to have been unvaccinated, five were found to have been vaccinated, one being a child who bad been vaccinated by the very person who made the report, and another a man who had been twice revaccinated in the militia (Q. 6730—42). One other case may be given. In October, 1883, three unvaccinated children were stated in the Registrar-General’s weekly return of deaths in London to have died of small-pox, "being one, four, and nine years of age, and all from 3, Medland Street, Stepney." On enquiry at the address given (apparently by oversight in this case) the mother stated that the three children were hers, and that "all had been beautifully vaccinated." This case was investigated by Mr. J. Graham Spencer, of 33, Rigault Road, Fulham Park Gardens, and the facts were published in the local papers and also in The Vaccination Inquirer of December, 1883.

Several other cases were detected at Sheffield, and were adduced by Mr. A. Wheeler in his evidence before the Commission (6th Report, p. 70); and many others are to be found throughout the Anti-Vaccination periodicals. But the difficulty of tracing such misstatements is very great, as the authorities almost always refuse to give information as to the cases referred to when particular deaths from small-pox are recorded as "unvaccinated." Why this effort at secrecy in such a matter if there is nothing to hide? Surely it is to the public interest that official statistics should be made as correct as possible; and private persons who go to much trouble and expense in order to correct errors should be welcomed as public benefactors and assisted in every way, not treated as impertinent intruders on official privacy, as is too frequently the case.

The result of this prejudiced and unscientific method of registering small-pox mortality is the belief of the majority of the medical writers on the subject that there is an enormous difference between the mortality of the vaccinated and the unvaccinated, and that the difference is due to the fact of vaccination or the absence of it. The following are a few of the figures as to this point given in the Reports of the Royal Commission:

Authority.                       Death rate of vaccinated         Death rate of unvaccinated
Dr. Gayton   7.45 43
Dr. Barry 8.1 32.7
Sir John Simon   0-12.5 14.5--60
Mr Sweeting, MRCS 8.92 46.08

Now an immense body of statistics of the last century compiled by disinterested persons who had no interest to serve by making the severity of small-pox large or small, gives an average of from 14 to 18 per cent.’ as the proportion of small-pox deaths to cases; and we naturally ask, How is it that, with so much better sanitary conditions and greatly improved treatment, nearly half the unvaccinated patients die, while in the last century less than one-fifth died? Many of the supporters of vaccination, such as. Dr. Gayton (2nd Ren., p. 1856), have no explanation to offer. Others, such as Dr. Whitelegge (6th Rep., p. 533), believe that small-pox becomes more virulent periodically, and that one of its maxima of virulence caused the great epidemic of 1870—72, which, after more than half a century of vaccination equalled some of the worst epidemics of the pre-vaccination period.

It is, however, a most suggestive fact that, considering small-pox mortality per Se, without reference to vaccination—the records of which are, as have been shown, utterly untrustworthy—We find the case-mortality to agree closely with that of the last century. Thus the figures given in the Reports of the Hampstead, Homerton, and Deptford small-pox hospitals at periods between 1876 and 1879 were, 19, 18.8, and 17 per cent. respectively (3rd Report, p. 205). If we admit that only the worst cases went to the hospitals, but also allow something for better treatment now, the result is quite explicable; whereas the other result, of a greatly increased fatality in the unvaccinated so exactly balanced by an alleged greatly diminished fatality in the vaccinated is not explicable, especially when we remember that this diminished fatality applies to all ages, and it is now almost universally admitted that the alleged protective influence of vaccination dies out in ten or twelve years. These various opinions are really self-destructive. If epidemic small-pox is now much more virulent than in the last century, as shown by the greater mortality of the unvaccinated now than then, the greatly diminished or almost vanishing effect of primary vaccination in adults cannot possibly have reduced their fatality to one-fifth or one-sixth of that of the other class.

Again, it is admitted by many pro-vaccinist authorities that the unvaccinated, as a rule, belong to the poorer classes, while they also include most of the criminal classes, tramps, and generally the nomad population. They also include all those children whose vaccination has been deferred on account of weakness, or of their suffering from other diseases, as well as all those under vaccination age. The unvaccinated as a class are therefore especially liable to zymotic disease of any kind, small-pox included; and when, in addition to these causes of a higher death-rate from small-pox, we take account of the proved untrustworthiness of the statistics, wholly furnished by men who are prejudiced in favour of vaccination (as instanced by the declaration of Dr. Gayton, that when the eruption is so severe as on the third day to hide the vaccination marks, it affords prima facie evidence of non-vaccination (2nd Report, Q. 1790), we are fully justified in rejecting all arguments in favour of vaccination supported by such fallacious evidence. And this is the more rational course to be adopted by all unprejudiced enquirers, because, as I shall now proceed to show, there is an abundance of facts of a more accurate and more satisfactory nature by which to test the question. [ ‘The same view is taken even by some advocates of vaccination in Germany. In an account of the German Commission for the Consideration of the Vaccination Question in the British Medical Journal, August 29, 1885 (p. 408), we find it stated:
"In the view of Dr. Koch, no other statistical material than the mortality from small-pox can be relied upon; questions as to the vaccinated or unvaccinated condition of the patient leaving too much room for error."]

One more point may be referred to before quitting this part of the subject, which is, that the more recent official hospital-statistics themselves afford a demonstration of the non-protective influence of vaccination, and thus serve as a complete refutation of the conclusions drawn from the statistics we have just been dealing with. Dr. Munk stated before the Hospital Commission, that the percentage of vaccinated patients in the London small-pox hospital had increased from 40 per cent. in 1838 to 94.6 per cent. in 1879 (3rd Report of Royal Comm., Q. 9090). This evidence was given in 1882; but Mr, Wheeler stated that according to the Reports of the Highgate hospital, the vaccinated patients had long been over 90 per cent of the whole, and are now often even 94 or 95per cent. The hospitals of the Metropolitan Asylums Board, which take in mostly pauper patients, give a lower percentage—the Homerton hospital 85 per cent., the Deptford hospital 87 per cent, and the Hampstead hospital 75 per cent.—in the two latter cases adding the "doubtful" class to the vaccinated, as the facts already given prove that we have a right to do and still probably give too high a proportion of unvaccinated. As the proportion of the London population that is vaccinated cannot be over 90 per cent. (see Minority Report, pp. 173—4), and is probably much lower, and considering the kind of patients the unvaccinated include (see back, p. 29), there remains absolutely nothing for the effects of vaccination. We have already seen that the total case-mortality of these hospitals agrees closely with that of the last century; the two classes of facts taken together thus render it almost certain that vaccination has never saved a single human life.

[Index] [Chapter 3]