Chapter II: Part 2

These calculations agree pretty nearly with estimates published in the year 1820, by Sir Gilbert Blane, founded on similar documents. His calculations extend to the parishes not included within the bills of mortality, and he comes to the following conclusion on the subject:—“It appears, therefore, that even under the very imperfect practice of Vaccination, which has taken place in the metropolis, 23,134 lives have been saved in the last fifteen years, according to the best computation that the data afford”—(Sir G. Blane on Vaccination, p. 7). But however remarkable and satisfactory this immense saving of human life, in the country where Vaccination originated, may appear, as an unanswerable evidence of its efficacy, the result has been still more decisive in many foreign countries, where it has been much more generally employed. In proof of this, I shall again quote the very valuable little work of Sir Gilbert Blane, (which, by the way, I should strongly recommend to the attention of the public, as containing much valuable matter and sound argument within a very small compass). He states, (p. 7-8) “In the summer of 1811, the author was called to visit, professionally, Don Francisco de Salazar, who had arrived a few days before in London, on his route from Lima to Cadiz, as a Deputy to the Spanish Cortes. He informed him, that Vaccination had been practised with so much energy and success in Lima, that for the last twelve months there had occurred not only no death from, but no case of, Small Pox: that the new born children, of all ranks, are carried as regularly to the Vaccinating house as to the font of baptism; that the Small Pox is entirely extinguished all over Peru; nearly so in Chili; and that there has been no compulsory interference on the part of the government to promote Vaccination.”

Sir Gilbert goes on to say, that “it is now matter of irrefragable historical evidence, that Vaccination possesses powers adequate to the great end proposed by its meritorious discoverer, in his first promulgation of it in 1798, namely, the total extirpation of Small Pox. The first proof of this was at Vienna, where, in 1804, no cases occurred, except two strangers, who came into the city with the disease upon them. In 1805 there did not occur a single death from it in Copenhagen. Dr. Sacco, the indefatigable superintendent of Vaccination in Lombardy, stated in his annual report, 3d January, 1808, that the Small Pox had entirely disappeared in all the large towns in that country; and that in the great city of Milan it had not appeared for several years. Dr. Odier of Geneva, so favourably known for his high professional, scientific, and literary acquirements, testifies that, after a vigorous perseverance in Vaccination for six years, the Small Pox had disappeared in that city and the whole surrounding district; and that, when casually introduced by strangers, it did not spread, the inhabitants not being _susceptible_. The central committee in Paris testify, in their report of 1809, that the Small Pox had been extinguished at Lyons and other districts of France.”

“These are selected as some of the earliest and most remarkable proofs of the extirpating power. But it is demonstrable, that if at the first moment of this singular discovery, at any moment since, at the present or any future moment, mankind were sufficiently wise and decided to vaccinate the whole of the human species, who have not yet gone through the Small Pox, from that moment would this most loathsome and afflicting of all the scourges of humanity, be instantaneously and for ever banished from the earth.” (p. 8).

These, and such as these, then are the great, the undeniable facts, which must, I think, carry irresistible conviction to every reflecting and unprejudiced mind respecting the true value of Vaccination. And it is these facts which furnish us with an answer to the second question proposed—What influence has Vaccination exerted over the destructive consequences of Small Pox? which it must be truly gratifying to every philanthropic mind to contemplate. In the course of twenty-five years, in our own country, where it has been very partially employed, it has actually been the means of saving a number of lives, amounting to 393,356; and if it be true, as supposed by Sir Gilbert Blane, that Small Pox induced “blindness, deformity, scrofula, or broken constitutions,” in as many who recovered from the disease as died in consequence of it, then have an equal number been saved from these dreadful calamities. But abroad, where it has been more generally employed, Vaccination has, in many places, actually exterminated the Small Pox altogether.

From what has already been said, it will be evident, that Vaccination has produced these very beneficial consequences in two ways. 1. By superseding an efficient cause of the spread of infection, namely, the practice of inoculation for Small Pox. And 2. by essentially interfering with the effect of the infectious virus.

The increased number of deaths, which took place during the period when inoculation for Small Pox was generally employed, is sufficient to prove the influence of Vaccination to have been considerable in the former way; but a formal application having been made to me to inoculate a child for Small Pox, since I commenced these remarks, I think it right to call the attention of the public more decidedly to the pernicious tendencies of the practice.

The attention of the medical profession, and of the public generally, was soon excited by the increasing number of deaths after the introduction of inoculation, and exertions were made to check it, particularly by the establishment of the Small Pox Hospital. This, no doubt, had some effect, by separating a part at least of those to whom Small Pox was artificially communicated from the rest of the community; but the event proved that this was by no means an adequate defence against the factitious causes of infection, which were daily called into action. The Small Pox Hospital still exists, and it is a very remarkable fact, that, for several years after the discovery of Vaccination, out-patients continued to be inoculated at that institution. This, no doubt, contributed to prevent the proportion of deaths from Small Pox in London from diminishing so rapidly as would otherwise have been the case, and as has been the case, since this “unaccountable infatuation,” as Sir Gilbert Blane very justly calls it, has been discontinued. But, as the same eminent physician properly remarks (p. 6), “it was in the rural population that the effect of inoculation in diffusing Small Pox was chiefly felt. In this situation, there is much less intercourse of persons with each other than in towns, so that not only many individuals escaped, from their not being exposed to infection during their whole lives, but whole districts were known to have been exempt from it for a long series of years before it was universally diffused by inoculation.” We may, therefore conclude, that while the number of deaths from Small Pox, within the bills of mortality, was increased in the proportion exhibited in the tables by means of inoculation, in the country the increased mortality from this cause was in a much greater ratio. This supposition is in a great degree confirmed by the effects occasioned by a renewal of the practice of inoculation, in Norfolk, in the year 1819, as recorded by Mr. Cross, in his History of the Epidemic Small Pox, which at that time prevailed in the city of Norwich and the county of Norfolk. Mr. Cross mentions many instances of the disease being introduced into parishes, in which it did not before exist, by means of inoculation, the contagion afterwards spreading in all directions; and affirms (p. 272), that “thirty-eight surgeons, who from various motives, practised it, lost among those to whom they had thus given the disease, twenty-one patients; fourteen surgeons reported, that fifty-five deaths had been occasioned in the same way within their knowledge; and five other surgeons observed, that they had known several who fell a sacrifice to the practice.” It admits then of the most incontestable proof, and it is a fact, which cannot be too deeply impressed upon the minds of the public, that inoculation for Small Pox is a practice attended with very considerable danger to the individual who passes through it, while to society in general, it has been productive of the most pernicious consequences. Is it too much then to affirm, that it cannot be employed without great moral guilt being incurred both by those who may require its performance, and by the medical practitioner who shall be induced to practise it?

But by far the most important mode in which Vaccination has been productive of the equally astonishing and gratifying consequences, which have been proved to have resulted from it, has been by its essential interference with the effect of the infectious matter of Small Pox, either by entirely preventing the occurrence of that disease, or by stripping it of all its dangerous and formidable characteristics—rendering it, in the comparatively few instances in which it has taken place at all after Vaccination, mild in its attack, and perfectly harmless in its consequences.

It very generally happens, when a discovery is made which promises to exert any considerable influence over the happiness of man, that its capabilities cannot for some time be very accurately defined; and that the effects, which a few years’ experience shall prove it to possess the power of producing, will, at the commencement, be either undervalued or overrated. It would not, perhaps, be difficult to adduce instances of both. And it can scarcely excite surprise, that something like this should have been the case with incomparably the most important discovery of modern times, for such we may truly esteem Vaccination, whether we consider it as a means of preserving life, or of obviating effects, perhaps, even more deplorable than the loss of life itself.

If then, the first promoters of Vaccination were led, from their ardour in a cause of such vital interest to the whole human race, and before time had been allowed to afford sufficient data whereon to found a more correct opinion, to conclude that Vaccination would, in every instance, prove an absolute and infallible preventive of future susceptibility of Small Pox infection, let us not, on that account, run into an error incalculably more dangerous in its tendency, and underrate or deny altogether the degree of security which it actually affords. That this is more than sufficient to render it worthy of universal adoption, there cannot be any reasonable doubt; but it would have been strange indeed, if, in the undeviating uniformity of its effects, Vaccination had formed a _single_ exception to the _law of uncertainty_ that attaches to every other agent, which it has, at any time, been permitted to mankind to employ for the promotion or preservation of the health of the human constitution: and, considering the innumerable varieties which prevail in the latter, we ought rather, perhaps, to feel surprise that the influence of Vaccination over all these varieties, should have been proved to be so similar as to have justified us in considering as a _general_, what was at first too hastily concluded to be an _absolute_ rule.

That the great majority of instances in which Vaccination has afforded perfect security against any future attack of Small Pox, fully warrants this conclusion, the results already detailed are sufficient to prove. What proportion these cases bear to the comparatively few, wherein the protection has been less perfect, it will not be possible to discover, because we are unable to ascertain how many hundreds of thousands or millions have passed through the vaccinating process. But little difficulty would be encountered, however, in ascertaining the full amount of the few who have had any thing bearing the slightest resemblance to an attack of Small Pox after Vaccination: these, for the most part, have been carefully recorded, and a degree of importance has certainly been attached to them greater than is warranted, either by their number, their severity, or their results.

It is of still more importance, however, to know, that when Small Pox has occurred after Vaccination, it has been so essentially altered in the severity of its symptoms, and in the degree of danger arising from it, as to have rendered it entirely harmless in almost every instance; and although fatal cases have taken place in a few insulated and peculiar examples, they have been very much more rare than those which have occurred in consequence of inoculated, or even of secondary Small Pox. Sir Gilbert Blane, after describing (p. 10-11) the mild character of the disease as occurring after Vaccination, continues thus—“What forms the strong line of distinction from proper Small Pox is, that, with a few exceptions, it does not advance to maturation and secondary fever, which is the _only period of danger_. I am not prepared to deny that death may have occurred in a few instances; nay, there seems sufficient evidence that it actually has; but then adverse cases are so rare as not to form the shadow of an objection to the expediency of the general practice. A few weeks ago, at a meeting of this (the Medical and Chirurgical) Society, at which forty members and visitors were present, I put the question, whether any of these eminent and extensive practitioners had met with any fatal cases of this kind. Two gentlemen had each seen a _single case_, and two other gentlemen took occasion to say, that they had each seen a case of _second Small Pox_—both of which proved _fatal_.” And Dr. Thomson tells us (Historical Sketch, &c. p. 279), that “since the publication of my ‘Account of the Varioloid Epidemic,’ I have seen above _two hundred_ additional examples of Small Pox in Edinburgh, making in all _eight hundred and thirty-six_ cases of this disease, which have come under my observation since June, 1818. Of the whole number, _two hundred and eighty-one_ have occurred in individuals who had neither had Small Pox nor Cow Pox, and of these fully more than _one_ in _four_ died; _seventy-one_ had previously passed through _Small Pox_, and of these _two_ have died; and _four hundred and eighty-four_ had undergone the process of _Vaccination_, and of this number _one_ only died; results (adds Dr. Thomson) which evince, beyond the power of cavil, the beneficial effects of Vaccination in protecting the human constitution from the dangers of Small Pox, and the great advantages which must ultimately arise from the universal adoption of this practice.”—Perhaps the most fatal epidemic Small Pox, which has occurred of late years, was that which took place at Norwich in 1819. A history of it was published in the following year by Mr. Cross, and the general result was in perfect accordance with Dr. Thomson’s experience of the epidemic at Edinburgh.

Mr. Cross relates that _two_ deaths only took place after Vaccination, and justly observes, that “these can have no weight against the practice of Vaccination compared with 10,000 vaccinated individuals, living in the midst of a contaminated atmosphere; with 530 deaths among little more than 3000 who had neglected to be vaccinated; and with the occasional occurrence of regular Small Pox in those who formerly had the disease.” Of the 10,000 persons thus protected by Vaccination, the Reviewer of Mr. Cross’s History, &c. observes (Edin. Med. and Sur. Journal, Vol. xvii. p. 127), “Had these persons been protected by variolous (Small Pox) inoculation, conducted in the best manner, and in the most favourable circumstances, at least 33 of them (1 in 300) would have died of the process intended to protect them; so that in comparing the advantages of the two methods of protection, we have to weigh 33 deaths _certain_, against _two contingent on the invasion of an epidemic Small Pox_, and then we have to consider, whether there might not be nearly as great a chance of _two persons_ out of 10,000 inoculated for Small Pox, taking a fatal Small Pox on exposure, at a subsequent period of life, to a virulent contagion.” I shall conclude the evidence I think it necessary to bring forward on this part of my subject with the following extract from the Report of the National Vaccine Establishment for 1820. In reference to the occasional cases wherein the protection from Vaccination is not quite complete, the Board observes,—“Yet the value of this important resource is not disparaged in our judgment; for after all, these cases bear a very small proportion to the number of those who are effectually protected by it. The reports of the Vaccinators at the several stations in the metropolis, give only _eight_ cases of Small Pox out of nearly 67,000 vaccinated by them, since the first establishment of this board; and as the Small Pox has prevailed extensively in London, these persons so vaccinated, must have been frequently exposed to contagion, and consequently the protecting effect of Vaccination must have been submitted to as severe a test as can well be imagined. Moreover, we have the most undoubted proofs from experience, that where Vaccination has been performed perfectly, Small Pox, occurring after it, is almost universally a _safe_ disease; and though ushered in by severe symptoms, has hardly ever failed to be cut short before it had reached that period at which it becomes dangerous to life.”

I shall not weaken the force of this evidence by entering into any minor question connected with this great subject—such as the probability of many of those, in whom Small Pox has succeeded to Vaccination, having passed through the latter process imperfectly, either in consequence of the matter employed not having been genuine; of the constitution not having shown adequate signs of being properly influenced by the process; or of the latter having been interfered with in its progress, by the accidental injury of the pustules, &c. No doubt all these causes may have had some effect, in consequence of the carelessness of parents, or of the practice of non-professional inoculators: in a matter of so much importance then, it behoves parents to guard against these causes of failure, which it is now certainly within the power of the poorest to do. Nor shall I detail the arguments by which Professor Thomson has rendered it probable that the pustular eruption, which has been so long known in this country under the name of Chicken Pox, is very nearly related to Small Pox itself, and is in reality the effect of the same infectious virus modified by various incidental circumstances; such as season of the year, the previous existence of Small Pox or of Cow Pox in those affected by it, or some peculiarity in their constitution not sufficiently obvious to be recognised by our senses. When I rest my proof of the power of Vaccination over the destructive consequences of Small Pox on the results which have been detailed, I am satisfied that it is fixed upon a basis too firm to be shaken by argument, and which will long outlive the feeble attacks of ignorance or prejudice.

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CONCLUSION.

The following are the important conclusions which may obviously be deduced from the satisfactory evidence which has been detailed.

1. That Vaccination has, within the space of twenty-five years, been the direct means of preserving, within the London[8] Bills of Mortality alone, a number of lives amounting to 21,127; and that if we extend the ratio of calculation to the whole of Great Britain and Ireland, it will appear that not fewer than 393,356 lives have been saved by this most valuable discovery, while an equal number have been preserved from “blindness, deformity, scrofula, or broken constitutions.”

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Footnote 8:

The following is extracted from the London Medical and Physical
Journal for the present month (December):—“_Influence of Vaccination
upon the mortality of Berlin._ M. Casper has published a long paper,
containing many curious details relative to the above subject; but we
can do no more, at present, than give the result of his
investigations. 1. The Small Pox formerly carried off from the 12th
to the 10th of the population. 2. Formerly, at Berlin, one out of
twelve children born, died of the Small Pox; now the deaths from the
same cause are 1 in 116.”—_Journal Comp. September._ In London, as
has been already shown, the number of deaths from Small Pox has been
diminished from 1 in 10 to 1 in 28. It is obvious, therefore, that,
were Vaccination employed in the latter city to the same proportional
extent as at Berlin, a further saving of more than 500 lives annually
would be effected, within the bills of mortality.

-----

2. That in accomplishing this result, Vaccination has acted in two ways,—1. by superseding the practice of inoculation for Small Pox, which (while it afforded a certain degree of security to the inoculated) has been proved to have materially increased the gross number of deaths, by creating, artificially, many new sources of infection,—and, 2. by rendering the vaccinated entirely insusceptible of Small Pox infection, or the disease produced by it, in almost every instance, mild, harmless, and devoid of danger.

3. That Vaccination is capable, if universally employed, of exterminating the Small Pox altogether, as has been proved by the experience of other countries.

That Vaccination is a process perfectly unattended with danger to the individual who passes through it, and incapable of communicating any noxious infection to those around him, are facts too well known and too generally admitted, to require more than a passing notice; nevertheless it is essential that they should not be lost sight of.

But if these be indeed plain and legitimate conclusions from the facts and arguments which have been adduced—and to myself they appear irresistible ones—then must Vaccination cease to be considered as a matter of policy, or of curious medical research only, for it plainly resolves itself into a momentous moral question. Let it once be admitted that it is capable of eradicating so great an evil as the infection of Small Pox, and it becomes the imperative duty of every individual to promote, to the utmost of his ability, an end so infinitely desirable. The question involves consequences so closely connected with the well-being of individuals and of society in general, and the actual existence of so many thousands annually, that ignorance, or doubt, will scarcely form an admissible apology for the omission of what is alike essential for private and for public security. If then any be ignorant on this momentous subject, let him not delay to obtain information; if any doubt, let him use every exertion to satisfy himself. If he hesitate to confer on his children the advantages, which Vaccination has been proved to be capable of bestowing, let him remember, that it has already been the means of preserving nearly four hundred thousand of his countrymen, and that, perhaps, he owes his own existence at this day, to its salutary influence; that but for Vaccination he might possibly himself, long ago, have fallen a sacrifice to the destructive disease from which it has rescued so many victims, and have been equally unable to call its efficacy in question, or to assist in consummating the grand object, which by means of it alone, appears capable of being accomplished.

It was in our own country, that this most remarkable discovery originated; it was our own countryman, who, with such noble disinterestedness, as soon as he had satisfied himself of its real value, disclosed it to the world, and who sacrificed every personal consideration of pecuniary gain, to the general welfare of mankind. As Englishmen, we have just cause to be proud of both—the discovery and the discoverer; but we may well feel humbled when we remember, that the merits of neither have been adequately acknowledged amongst us; and that while the latter has been more justly estimated and more highly honoured in almost every other part of the world, the former has also been more effectively employed, and with proportionally more decisive results.

It is true, that in some of the continental nations, where Vaccination has been most extensively and successfully employed, it has been made a matter of state policy, and legislative measures have been used to enforce its adoption; while, at home, it has rested with the public to adopt or reject it, as might be agreeable to their opinions or prejudices. Some writers have proposed that a similar mode of enforcing its general employment in England, by legislative compulsion, should be made use of; but, I conceive, such measures would be too little in accordance with the spirit of our government, and too repulsive to the feelings of Englishmen, to render them advisable, notwithstanding the paramount national importance of the object. That the time will presently arrive when this object will be fully accomplished, without any such unpalatable interference of the legislature, but by the irresistible force of truth alone, on the minds of the public, I cannot permit myself to doubt. Means of information on the subject, ample and satisfactory, are within the reach of all who are anxious to enquire; and it cannot be that they should long remain unexplored, or that they will fail to carry conviction to the mind of every candid and intelligent enquirer. But, when I reflect that the early conviction of a single individual, who entertains a doubt of the protective efficacy of Vaccination, or a prejudice against the practice, may be the direct or indirect means of saving the lives of many, I cannot refrain from most earnestly exhorting every one to consider this subject maturely—to be strenuous and unremitting in his enquiries respecting it, until every doubt is satisfied. He will then see one straight forward path of duty before him, which he will feel himself compelled, by every moral and religious obligation, most perseveringly and undeviatingly, to pursue. He will feel that his own personal exertions, in promoting the general use of Vaccination in his own family, amongst his dependents and all those whom he can in any the slightest degree influence, are essential to the accomplishment of the great philanthropic end proposed—the total extinction of Small Pox: a consummation that would prevent a larger portion of human misery, and preserve a larger number of human lives, than any other which it is in the power of imagination to conceive, or of reason to contemplate.

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TABLE I.

The first column of this Table exhibits the total number of deaths,
and the second column the number of deaths from Small Pox,
occurring within the London Bills of Mortality, during every
successive year, for a period of 121 years.

┌───────┬──────────┬────────────┐
│ │ _Total │ _Number of │
│_Year._│number of │deaths from │
│ │ deaths._ │Small Pox._ │
├───────┼──────────┼────────────┤
│ 1703 │ 20,720│ 898│
│ 1704 │ 22,684│ 1,501│
│ 1705 │ 22,097│ 1,095│
│ 1706 │ 19,847│ 721│
│ 1707 │ 21,600│ 1,078│
│ 1708 │ 21,291│ 1,687│
│ 1709 │ 21,800│ 1,024│
│ 1710 │ 24,620│ 3,138│
│ 1711 │ 19,833│ 915│
│ 1712 │ 21,198│ 1,943│
│ 1713 │ 21,057│ 1,614│
│ 1714 │ 26,569│ 2,810│
│ 1715 │ 22,232│ 1,057│
│ 1716 │ 24,436│ 2,427│
│ 1717 │ 23,446│ 2,211│
│ 1718 │ 26,523│ 1,884│
│ 1719 │ 28,347│ 3,229│
│ 1720 │ 25,454│ 1,440│
│ 1721 │ 26,142│ 2,375│
│ 1722 │ 25,750│ 2,167│
│ 1723 │ 29,197│ 3,271│
│ 1724 │ 25,952│ 1,227│
│ 1725 │ 25,523│ 3,188│
│ 1726 │ 29,647│ 1,569│
│ 1727 │ 28,418│ 2,370│
│ 1728 │ 27,810│ 2,105│
│ 1729 │ 29,722│ 2,849│
│ 1730 │ 26,761│ 1,914│
│ 1731 │ 25,262│ 2,640│
│ 1732 │ 23,358│ 1,197│
│ 1733 │ 29,233│ 1,370│
│ 1734 │ 26,062│ 2,688│
│ 1735 │ 23,538│ 1,594│
│ 1736 │ 27,581│ 3,014│
│ 1737 │ 27,823│ 2,084│
│ 1738 │ 25,825│ 1,590│
│ 1739 │ 25,432│ 1,619│
│ 1740 │ 30,811│ 2,725│
│ 1741 │ 32,169│ 1,977│
│ 1742 │ 27,483│ 1,429│
│ 1743 │ 25,200│ 2,029│
│ 1744 │ 20,606│ 1,639│
│ 1745 │ 21,296│ 1,206│
│ 1746 │ 28,151│ 3,236│
│ 1747 │ 25,494│ 1,380│
│ 1748 │ 23,869│ 1,789│
│ 1749 │ 25,516│ 2,625│
│ 1750 │ 23,727│ 1,229│
│ 1751 │ 21,028│ 998│
│ 1752 │ 20,485│ 3,538│
│ 1753 │ 19,276│ 774│
│ 1754 │ 22,696│ 2,359│
│ 1755 │ 21,917│ 1,988│
│ 1756 │ 20,872│ 1,608│
│ 1757 │ 21,313│ 3,296│
│ 1758 │ 17,576│ 1,273│
│ 1759 │ 19,604│ 2,596│
│ 1760 │ 19,830│ 2,187│
│ 1761 │ 21,083│ 1,525│
│ 1762 │ 26,326│ 2,743│
│ 1763 │ 26,143│ 3,582│
│ 1764 │ 23,202│ 2,382│
│ 1765 │ 23,230│ 2,498│
│ 1766 │ 23,911│ 2,334│
│ 1767 │ 22,612│ 2,188│
│ 1768 │ 23,639│ 3,028│
│ 1769 │ 21,847│ 1,968│
│ 1770 │ 22,434│ 1,986│
│ 1771 │ 21,780│ 1,660│
│ 1772 │ 26,053│ 3,992│
│ 1773 │ 21,656│ 1,039│
│ 1774 │ 20,884│ 2,479│
│ 1775 │ 20,514│ 2,669│
│ 1776 │ 19,048│ 1,728│
│ 1777 │ 23,334│ 2,567│
│ 1778 │ 20,399│ 1,425│
│ 1779 │ 20,420│ 2,493│
│ 1780 │ 20,517│ 871│
│ 1781 │ 20,709│ 3,500│
│ 1782 │ 17,918│ 636│
│ 1783 │ 19,020│ 1,550│
│ 1784 │ 17,828│ 1,759│
│ 1785 │ 18,919│ 1,999│
│ 1786 │ 20,454│ 1,210│
│ 1787 │ 19,349│ 2,418│
│ 1788 │ 19,697│ 1,101│
│ 1789 │ 20,749│ 2,077│
│ 1790 │ 18,038│ 1,617│
│ 1791 │ 18,760│ 1,747│
│ 1792 │ 20,213│ 1,568│
│ 1793 │ 21,749│ 2,382│
│ 1794 │ 19,241│ 1,913│
│ 1795 │ 21,179│ 1,040│
│ 1796 │ 18,905│ 3,548│
│ 1797 │ 17,014│ 522│
│ 1798 │ 18,155│ 2,237│
│ 1799 │ 18,134│ 1,111│
│ 1800 │ 23,068│ 2,409│
│ 1801 │ 19,374│ 1,461│
│ 1802 │ 19,379│ 1,579│
│ 1803 │ 19,582│ 1,202│
│ 1804 │ 17,038│ 621│
│ 1805 │ 17,565│ 1,685│
│ 1806 │ 17,938│ 1,158│
│ 1807 │ 18,334│ 1,297│
│ 1808 │ 19,954│ 1,169│
│ 1809 │ 16,680│ 1,163│
│ 1810 │ 19,893│ 1,198│
│ 1811 │ 17,043│ 751│
│ 1812 │ 18,295│ 1,287│
│ 1813 │ 17,322│ 898│
│ 1814 │ 19,783│ 638│
│ 1815 │ 19,560│ 725│
│ 1816 │ 20,316│ 653│
│ 1817 │ 19,968│ 1,051│
│ 1818 │ 19,705│ 421│
│ 1819 │ 19,228│ 712│
│ 1820 │ 19,348│ 792│
│ 1821 │ 18,451│ 508│
│ 1822 │ 18,863│ 604│
│ 1823 │ 20,587│ 774│
└───────┴──────────┴────────────┘

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TABLE II.

This Table is divided into intervals of five years each. It
embraces the same period of 121 years, included in the former,
and is intended to shew the encrease in the average amount of
mortality from Small Pox during the practice of Inoculation,
and the striking diminution which has taken place since the
introduction of Vaccination.

┌────────────────┬──────────┬────────────┬────────────┬───────────┐
│ │ _Total │ _Number of │ _Number of │ _Relative │
│ _Periods of 5 │number of │deaths from │deaths from │ number of │
│years including_│ deaths._ │Small Pox._ │Small Pox in│deaths from│
│ │ │ │ 1000._ │Small Pox._│
├────────────────┼──────────┼────────────┼────────────┼───────────┤
│ 1703 to 1707 │ 106,948│ 5,293│ 49.4│1 in 20.2 │
│ 1708 -- 1712 │ 108,742│ 8,707│ 80.0│1 in 12.4 │
│ 1713 -- 1717 │ 117,740│ 10,119│ 85.9│1 in 11.6 │
│ 1718 -- 1722 │ 132,216│ 11,095│ 84.5│1 in 11.9 │
│ 1723 -- 1727 │ 138,737│ 11,625│ 83.6│1 in 11.9 │
│ 1728 -- 1732 │ 132,913│ 10,705│ 80.5│1 in 11.4 │
│ 1733 -- 1737 │ 134,237│ 10,750│ 80.0│1 in 12.4 │
│ 1738 -- 1742 │ 141,720│ 9,415│ 66.0│1 in 15.0 │
│ 1743 -- 1747 │ 120,753│ 9,484│ 78.0│1 in 12.7 │
│ 1748 -- 1752 │ 114,625│ 10,179│ 89.0│1 in 11.2 ⎫│
│ 1753 -- 1757 │ 106,074│ 10,025│ 95.0│1 in 10.5 ⎪│
│1758 single year│ 17,576│ 1,273│ 72.4│1 in 13.8 ⎪│
│ 1759 -- 1763 │ 112,986│ 12,633│ 111.8│1 in 8.9 ⎪│
│ 1764 -- 1768 │ 116,594│ 13,630│ 116.9│1 in 8.5 ⎪│
│ 1769 -- 1773 │ 113,770│ 10,645│ 93.5│1 in 10.6 ⎬│
│ 1774 -- 1778 │ 104,179│ 10,808│ 103.7│1 in 9.7 ⎪│
│ 1779 -- 1783 │ 98,584│ 9,050│ 91.7│1 in 10.8 ⎪│
│ 1784 -- 1788 │ 96,247│ 8,487│ 88.2│1 in 11.3 ⎪│
│ 1789 -- 1793 │ 99,509│ 9,391│ 94.3│1 in 10.5 ⎪│
│ 1794 -- 1798 │ 94,494│ 9,260│ 96.9│1 in 10.2 ⎭│
│ 1799 -- 1803 │ 99,537│ 7,762│ 77.9│1 in 12.8 ⎫│
│ 1804 -- 1808 │ 90,829│ 5,930│ 65.3│1 in 15.3 ⎪│
│ 1809 -- 1813 │ 89,233│ 5,299│ 59.3│1 in 16.8 ⎬│
│ 1814 -- 1818 │ 99,332│ 3,488│ 35.1│1 in 28.4 ⎪│
│ 1819 -- 1823 │ 96,477│ 3,390│ 35.1│1 in 28.4 ⎭│
└────────────────┴──────────┴────────────┴────────────┴───────────┘

The first Bracket includes the period when Inoculation for Small Pox was in most general use. The second Bracket the period of Vaccination.

------------------------------------------------------------------------

_Lately was published by the same Author, and to be had of
E. Charnley, Price 1s._

HINTS

TOWARDS THE ADOPTION OF AN

IMPROVED PRINCIPLE OF REMUNERATING

The Surgeon Apothecary,

OR,

GENERAL PRACTITIONER IN MEDICINE.

ADDRESSED TO THE

MEMBERS OF THE PROFESSION

AND THE

PUBLIC AT LARGE.

Newcastle; Printed by T. & J. Hodgson,
Union Street

------------------------------------------------------------------------

Transcriber’s note:

Page 4, ‘in-instances’ changed to ‘instances,’ “where three instances had occurred”

Page 14, ‘recal’ changed to ‘recall,’ “who cannot recall many more”

Page 24, double quote moved to after ‘advantages,’ “of some real advantages” (p. 59).”

Page 25, double quote inserted after ‘are,’ “words are” (p. 37),”

Page 59, double quotes added after ‘results’ and before ‘which,’ “results” (adds Dr. Thomson) “which evince”

Page 73, full stop inserted after table heading ‘Year.’

Page 74, ‘8817’ changed to ‘1788,’ “1788 19,697 1,101”