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====== An Estimate of the True Value of Vaccination by T.M. Greenhow ======

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<div>
  <h1 class='c000'>An Estimate of the True Value of Vaccination<br />as a Security Against Small Pox</h1>
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<div class='nf-center-c1'>
<div class='nf-center c002'>
    <div>AN</div>
    <div><span class='xlarge'>ESTIMATE,</span></div>
    <div><i>&amp;c. &amp;c.</i></div>
  </div>
</div>

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<div class='lg-container-l c004'>
  <div class='linegroup'>
    <div class='group'>
      <div class='line'>Newcastle; Printed by T. &amp; J. Hodgson,</div>
      <div class='line in11'>Union Street</div>
    </div>
  </div>
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<div class='nf-center-c1'>
<div class='nf-center c004'>
    <div>AN</div>
    <div class='c005'><span class='xlarge'>ESTIMATE</span></div>
    <div class='c005'>OF THE TRUE VALUE OF</div>
    <div class='c005'><span class='xxlarge'>VACCINATION</span></div>
    <div class='c005'>AS A</div>
    <div class='c005'><span class='large'>SECURITY AGAINST SMALL POX.</span></div>
    <div class='c006'>BY</div>
    <div class='c005'><span class='large'>T. M. GREENHOW,</span></div>
    <div class='c005'>MEMBER OF THE ROYAL COLLEGE OF SURGEONS IN LONDON;</div>
    <div>SURGEON TO THE LYING-IN HOSPITAL, TO THE CHARITY</div>
    <div>FOR POOR MARRIED WOMEN LYING IN</div>
    <div>AT THEIR OWN HOUSES, AND TO THE</div>
    <div>INFIRMARY FOR DISEASES OF</div>
    <div>THE EYE, NEWCASTLE.</div>
  </div>
</div>

<div class='titlepage'>

<p class='c007'>“And in order to stimulate the wise and good to aim strenuously
at this consummation (the total extirpation of Small
Pox), let it be constantly borne in mind, that the adversary
they are contending with is the greatest scourge that has ever
afflicted humanity. That it is so, all history, civil and medical,
proclaims; for though the term Plague carries a sound
of greater horror and dismay, we should probably be within
the truth, if we were to assert, that Small Pox has destroyed
a hundred for every one that has perished by the Plague.”</p>
<div class='lg-container-r c008'>
  <div class='linegroup'>
    <div class='group'>
      <div class='line'><i>Sir Gilbert Blane.</i></div>
    </div>
  </div>
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</div>

<div class='nf-center-c1'>
<div class='nf-center c009'>
    <div><span class='large'>LONDON:</span></div>
    <div class='c005'>PRINTED FOR BALDWIN, CRADOCK, AND JOY; AND</div>
    <div>EMERSON CHARNLEY, NEWCASTLE.</div>
    <div class='c005'>1825.</div>
  </div>
</div>

<div class='pbb'>
 <hr class='pb c010' />
</div>
<div class='chapter'>
  <h2 class='c002'>Preface.</h2>
</div>

<div class='preface'>

<p class='c007'>My design, in entering upon the following
little work, has been to collect, and to compress
within as narrow a compass as possible,
the principal facts and evidences upon
which the claims of Vaccination are founded;
that the public may be furnished, in a
concise but comprehensive form, with the
information which is essential to their forming
a correct judgment on this momentous
question.</p>

<p class='c011'>That much misapprehension and some
prejudice prevail on this subject, my recent
observation and experience have convinced
me; and when I reflect on the pernicious
effects, which, in Newcastle and its neighbourhood,
are at this time taking place in
consequence of them, and which they must
continue to produce while they are permitted
to exist, I feel that a collective detail
of the evidence calculated to remove them
is much needed, and that, being sensible of
this, it becomes a duty incumbent upon
myself to endeavour to supply so important
a desideratum.</p>

<p class='c011'>In making this attempt, I have been
desirous of avoiding any unnecessary delay,
and have therefore, perhaps, been obliged
to collect facts, and to deduce arguments
from them, with a degree of haste, which,
while it must have occasioned many imperfections
in the execution of my design, will,
I trust, be admitted as some apology for
such defects: I am willing, however, to
hope that they will not be found of sufficient
magnitude materially to interfere
with the useful tendency of the estimate.</p>

<p class='c011'>The works of those writers whom I have
consulted, and whose authority I have quoted
in support of the efficacy of Vaccination,
are familiar to the Medical Profession,
and, with scarcely an exception I believe,
its members have drawn the same satisfactory
conclusion from the facts which are
detailed in them. But as these works, are,
for the most part, strictly professional, they
have not come before the public in general,
who have not, in consequence, had equal
opportunities of convincing themselves of
the true value of Vaccination. It is, however,
manifestly more important, in proportion
as their relative number is greater, that
the latter should be convinced of this, than
the former only. The present estimate,
therefore, is more particularly intended to
satisfy the doubts, and to remove the apprehensions
of the community at large;
though I trust, should I in any degree
have succeeded in the attempt, it may also
be read by my professional brethren not
without some portion of satisfaction and of
approbation.</p>

<p class='c011'>But, after all, should my object in endeavouring
to convince the more enlightened
parts of the community, (from whom
alone I can hope for a proper consideration
of the evidence I have adduced,) be
attained, much will yet remain to be done:
and I have endeavoured to point out the
necessity of a general co-operation, in
order to give the fullest effect to the
paramount capabilities of Vaccination.—Amongst
the poorest and least informed
classes of society, a written evidence of
this description, can scarcely be expected
either to gain access or to meet with the
requisite consideration; and the ignorance,
the prejudices, and the <i>apathy</i>, which have
been found to exist in some of them, must
therefore be overcome by other means. It
is my wish to direct attention more especially
to the <i>latter</i> difficulty, having myself
witnessed some instances, and having been
informed of many others, wherein the parents
have regarded the health and lives
of their children so little, as not only to
despise the security afforded by Vaccination,
but to omit the most ordinary precautions
against Small Pox infection, and
to reject the gratuitous medical assistance
which was within their reach.<a id='r1' /><a href='#f1' class='c012'><sup>[1]</sup></a></p>

</div>

<hr class='c013' />
<div class='footnote' id='f1'>
<p class='c011'><span class='label'><a href='#r1'>1</a>.&nbsp;&nbsp;</span>Mr. Wilkie (the respectable resident apothecary at the
Dispensary in this town) lately informed me that a woman,
who resides in Sandgate, after losing <i>three children</i> from
Small Pox, during the present prevalence of that disease,
would yet neither use precautions nor remedial measures for
the preservation of the remainder; although she daily witnessed
the efficacy of Vaccination among her neighbours,
even when performed during the existence of Small Pox
itself in other members of the same families.</p>
</div>
<hr class='c013' />

<div class='preface'>

<p class='c011'>But there are links by which all the various
classes of society, from the highest to
the lowest, are connected; and it is through
the medium of these that we must hope
for the removal of the difficulties referred
to. There are few of the rich, who
have not the power of influencing some of
the poor, nor do I believe there are any
of the latter who may not be influenced
by some one or other of the former. Whether
this influence may be exerted through
interest, through persuasion, or through
the conviction of reason, is a matter of less
moment than the attainment of the end in
view—namely, <i>to induce all, without exception,
to have their children vaccinated during
infancy</i>—and were it employed in its fullest
extent, this end might certainly be accomplished.</p>

<p class='c011'>It hence becomes of the utmost importance,
that those should themselves be
convinced of the true value of Vaccination,
who may possess the power, by whatever
means (never omitting, however, when possible,
to do it through the medium of
<i>reason</i>) of extending the operative influence
of their conviction to others. From
the wealthy, the intelligent, and the educated
parts of society then, I venture to
hope that the following Estimate will meet
with some serious consideration, and that,
in whatever degree it may directly contribute
to remove doubt, it may, at least,
excite such a spirit of candid and deliberate
enquiry into the subject of Vaccination, as
may ultimately render its great value universally
acknowledged, and its practice in
every instance adopted.</p>

<div class='lg-container-l c008'>
  <div class='linegroup'>
    <div class='group'>
      <div class='line'><i>Westgate Street, Newcastle,</i></div>
      <div class='line in2'><i>November 20th, 1824.</i></div>
    </div>
  </div>
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</div>

<div class='pbb'>
 <hr class='pb c010' />
</div>

<div class='nf-center-c1'>
<div class='nf-center c004'>
    <div>AN</div>
    <div class='c005'><span class='xlarge'>ESTIMATE,</span></div>
    <div class='c005'><i>&amp;c. &amp;c.</i></div>
  </div>
</div>

<div class='chapter'>
  <h2 class='c002'>INTRODUCTION.</h2>
</div>

<p class='c007'>What reliance may safely be placed on
Vaccination as a means of exemption from
Small Pox?</p>

<p class='c011'>It may be affirmed, without hazard of
contradiction, that no question connected
with the physical well being of mankind
involves considerations of more serious
interest, or consequences of more vital moment,
than that which has just been proposed.
During the last quarter of a century,
it has engaged a degree of attention, both
from medical practitioners and from society
in general, proportionate to the great importance
of the subject; and though among
the former, with very few exceptions, one
pretty uniform opinion may prevail respecting
the true value of the Jennerian discovery,
I have reason to know, that many
doubts and apprehensions still linger in the
minds of not a few of the latter. These
have been cherished or revived by circumstances,
of a nature, it must be admitted,
well calculated to shake their confidence in
Vaccination as an absolute preventive of
Small Pox; which, unfortunately for the
cause, on its first introduction into practice,
it was generally believed and asserted to
be; but which subsequent experience has
proved can no longer be contended for. I
trust, however, to be enabled to prove, to
the satisfaction of every impartial enquirer,
that the value of Vaccination is not essentially
diminished on that account; that an
imperfect knowledge of its effects can alone
have given rise to the doubts and apprehensions
referred to; and that nothing is
required for their entire removal but a more
intimate acquaintance with the subject.
It is the purpose of the present Essay,
then, to bring under review the principal
facts connected with the history of Small
Pox and of Vaccination which, in any way,
bear upon the question proposed; to arrange
them in such order, and to place
them in such lights, as may best elucidate
the subject, and enable those, who have
children not yet protected in any way from
the infection of Small Pox, to form a clear
and satisfactory judgment; a judgment
unbiassed by prejudice, matured by a serious
and candid consideration of the evidence
that will be laid before them, and
on which may depend life itself, or much
that renders life desirable.</p>

<p class='c011'>I have been led to believe that such an
attempt may at this time prove of considerable
service, in consequence of facts which
have lately come under my own observation,
and which have induced me to pay
more attention than I had previously done
to this singularly curious and interesting
subject.</p>

<p class='c011'>The facts to which I allude are—1st.
The prevalence of Small Pox to a considerable
extent in the town and neighbourhood
of Newcastle, by which a number of deaths
among children, <i>who had not been vaccinated</i>,
has been occasioned.—2dly. The occurrence
of the disease in many individuals,
who had gone through the process of Vaccination;
though in every instance as far
as I have been enabled to ascertain, it has
been so mitigated in the violence of the
attack as to preclude any degree of danger,
and has never run the regular course of
the genuine Small Pox.—3dly. The impression,
which these occurrences have
made upon the minds of those in whose
families they have taken place,—an impression
not only unfavourable to Vaccination,
but which has induced some to entertain
the idea of again having recourse to inoculation
for Small Pox.—And, 4thly. The
occurrence of Small Pox itself a second
time in an individual, who bore ample
marks of having already gone through that
disease, which she stated to have taken
place naturally when young: this patient
was a servant in a family where three instances
had occurred after Vaccination,
and, as in them, the disease was of a mild
and modified character.</p>

<p class='c011'>In all the cases of Small Pox after Vaccination
which I have myself witnessed, or of
which I have been enabled to obtain any
distinct account, the disease has been of so
mild a character, and so curtailed in its
duration, that could it have been separated
from the terrific name of <i>Small Pox</i>, it
would have excited no apprehensions in the
minds either of the patients themselves or of
those around them. But it unfortunately
happens that this disease is associated in our
minds with so many terrific accompaniments
(which were once indeed its constant
attendants and consequences, and which
belong to it in its natural form, but which,
after the employment of Vaccination, have
no existence whatever), that it is difficult
for the mind to break through this association,
and to feel satisfied that though Small
Pox may still appear as an occasional visitor,
yet, to the <i>vaccinated</i>, it is completely
stripped of all that rendered it dangerous in
its attack and serious in its effects.</p>

<p class='c011'>I have had repeated opportunities lately
of pointing out this satisfactory distinction
to the parents of children who were affected
with Small Pox, both after Vaccination and
when no such protecting influence had
been employed. The contrast between the
characters of the disease, as evinced in
these different individuals, was too striking
not to carry immediate conviction to the
minds of all present; and I believe it has
been of considerable service in inducing
many to have their children vaccinated,
who would otherwise have omitted it altogether.
These cases occurred among the
lower orders of society; and I feel assured
that this demonstrative proof of the utility
of Vaccination will do more to remove the
prejudices of these people than any abstract
reasoning from facts of which they have not
themselves been witnesses, however numerous
and well authenticated. I should,
therefore, strongly recommend it to every
practitioner to take advantage of any opportunities
that may be afforded him of
pointing out this most marked distinction
between the natural and modified Small
Pox.</p>

<div class='pbb'>
 <hr class='pb c010' />
</div>

<div class='chapter'>
  <h2 class='c002'>CHAP. I.</h2>
</div>

<p class='c007'>We shall best estimate the value of any
means of removing an evil, by enquiring,
in the first place, into the extent of the
effects of the evil which it is our object to
remove. And we shall also form the most
correct estimate of the value of the means
which have been employed for its removal
entirely, or in part, by reverting to its extent
previous to the employment of such
means, and comparing the amount of its
former ill consequences, with those which
are still produced by it.</p>

<p class='c011'>To satisfy ourselves on the subject of the
present enquiry then, it will be useful to
put the following queries:—1st. What were
the destructive consequences of Small Pox
previous to the introduction of Vaccination?
And, 2ndly, What influence has Vaccination
exerted over these consequences—1.
by extensively superseding the cause—and
2. by essentially interfering with the effect?</p>

<p class='c011'>To answer the former question satisfactorily,
it will be necessary to enter, at some
length into the history of Small Pox, before
Vaccination was proposed as a means
of prevention. But it will be remembered,
that previous to that era, a means had been
already long in use, for the purpose of diminishing,
at least, the danger of this terrific
disease; and that for half a century
the Small Pox had been communicated to
thousands annually by inoculation, with
the view of accomplishing this very desirable
end. This will naturally give rise to a
second division of the history of Small
Pox. Our first enquiries will therefore be
directed to the time antecedent to the use
of inoculation for Small Pox, when no artificial
measures were adopted for protecting
mankind from its fatal attacks.</p>

<p class='c011'>Although from the vague accounts which
earlier European writers have given of the
diseases which came under their notice, it is
not always easy to distinguish very accurately
the precise extent to which Small Pox proved
fatal among the nations of Europe, it is yet
pretty certain that for a thousand<a id='r2' /><a href='#f2' class='c012'><sup>[2]</sup></a> years
before inoculation was introduced, it was
one of the most destructive scourges of the
human race, frequently destroying thousands
and tens of thousands, in any district
where it occurred. It was at this time
frequently included under the general term
plague or pestilence, which was applied to
every destructive epidemic that took place.
It is not necessary, however, for my present
purpose to go back to these remote ages;
for, independent of the impossibility of obtaining
sufficiently authentic information
whereon to found any accurate argument, it
is not to be doubted that the fatality of Small
Pox, in common with that of every other
disease, would then be materially greater
than in the present day, in consequence of
the want of cleanliness and ventilation in
our cities and houses, and of good medical
treatment. It will not be difficult, however,
to produce ample proof of the great
mortality occasioned by this disease, at a
period when these disadvantages were less
felt, and when the nature of it was sufficiently
certain. For this purpose I have
drawn up tables from the bills of mortality
of London, comprising a period of 120
years, viz. from 1703 to 1823, which will
form the basis of my arguments.</p>

<hr class='c013' />
<div class='footnote' id='f2'>
<p class='c011'><span class='label'><a href='#r2'>2</a>.&nbsp;&nbsp;</span>According to Mr. Moore, (History of Small Pox, p. 66-7)
the Small Pox was first introduced into Europe during the
invasion of Spain by the Saracens, in the commencement of
the eighth century: after which, the infection rapidly spread
into France and other countries.</p>
</div>
<hr class='c013' />

<p class='c011'>Mr. Moore, in his History of Small Pox,
(p. 243) tells us that “Dr. Jurin took the
lead in replying to the opponents of this
practice (inoculation for Small Pox):
and being a calm man, well skilled in
calculation, his writings were composed
with great good sense and good temper.
He drew his arguments chiefly from an
accurate examination of the London
bills of mortality for forty-two years,
and from accounts collected from a few
large cities: and he compared the numbers
who died of the Small Pox with the
general mortality. From all which he
concluded,</p>

<p class='c011'>“That of all the children that are born
there will, some time or other, die of
the Small Pox, <i>one in fourteen</i>.” And
“that of persons of all ages, taken ill of the
natural Small Pox, there will die of that
distemper <i>one in five or six</i>.”</p>

<p class='c011'>In other countries this disease appears to
have been yet more fatal than in England.
I shall, however, revert to the documents
which I have myself collected on the subject.</p>

<p class='c011'>The tables, which I have constructed,
embrace a period of 20 years before inoculation
was at all employed in this country—the
whole period during which it was
in use—and the time which has elapsed
since the introduction of Vaccination. We
shall thus be enabled, at a single glance, to
compare the mortality of Small Pox under
each of these several circumstances. In
the first column of the table (No. 1.) is
shewn the total number of deaths which
occurred within the bills of mortality during
each successive year, and in the
second column, the number occasioned by
Small Pox alone.</p>

<p class='c011'>The table (No. 2.) is divided into periods
of five years each—it consists of four columns—the
first of which exhibits the total
number of deaths during each period of
five years—the second the number of deaths
from Small Pox—the third shows the proportion
of the latter in each thousand of
the former—and the fourth points out the
relative proportion of deaths from Small
Pox compared with the whole. I am aware
that the two latter columns may be considered
as a repetition of the same statement,
but I think it may appear more striking
when placed in this double form.</p>

<p class='c011'>When we compare the calculation of Dr.
Jurin, which has been quoted above, (published
I believe about the year 1723,) with
the first twenty years of these tables, we
shall find, that, with the exception of the
first five years, it is rather below than above
the results which they exhibit; that, according
to them, for the fifteen years from
1708 to 1723 inclusive, the deaths from
Small Pox exceeded one in twelve of the
whole,—that in 1710 it was about one in
seven, and that in 1719, although the relative
number was not quite so great, being in
the proportion of one in eight only; yet
that the actual number was greater than in
1710, amounting to no fewer than 3229,
the total number of deaths being 28,347.</p>

<p class='c011'>Such was the destructive nature of Small
Pox before the introduction of inoculation.
Its ill effects, however, were not confined
to those whom it precipitated into the
tomb. A very large proportion of the living,
who were fortunate enough to escape
its fatal effects, yet suffered essentially for
the remainder of their lives from its injurious
attacks, not only in the loss of that
beauty of countenance which we all value
both in ourselves and in our friends, but
frequently in the serious injury or total destruction
of one or both eyes,<a id='r3' /><a href='#f3' class='c012'><sup>[3]</sup></a> or of the
general health of the constitution, which
was, in many cases, never afterwards
entirely restored, although death was not
the immediate result.</p>

<hr class='c013' />
<div class='footnote' id='f3'>
<p class='c011'><span class='label'><a href='#r3'>3</a>.&nbsp;&nbsp;</span>“It appears, by a report of the Hospital for the Indigent
Blind, that two-thirds of those who apply for relief, have
lost their sight by Small Pox,”—<i>Sir G. Blane on Vaccination,
p. 9.</i></p>
</div>
<hr class='c013' />

<p class='c011'>Instances, wherein the beauty of the human
countenance has been materially injured
by the occurrence of Small Pox in the early
stages of life, are now happily much more
rare than formerly, especially in the higher
ranks of society, and I trust will, in the
course of another age, become entirely unknown.
There are few of us, however,
who are not still acquainted with some,
and who cannot recall many more: and we
every now and then meet with cases of
blindness, which had succeeded to this
formidable disease. I have myself had
opportunities of seeing several such instances;
and it is but a few weeks
since my opinion was asked respecting a
child, who was recovering from the Small
Pox in its worst form, with a countenance
dreadfully disfigured, and one eye entirely
destroyed.<a id='r4' /><a href='#f4' class='c012'><sup>[4]</sup></a></p>

<hr class='c013' />
<div class='footnote' id='f4'>
<p class='c011'><span class='label'><a href='#r4'>4</a>.&nbsp;&nbsp;</span>Since this was written, I have been consulted on account
of a little girl, of seven years of age, who has just sustained
the same very serious deprivation, in consequence of an attack
of Small Pox.</p>
</div>
<hr class='c013' />

<p class='c011'>That a disease so destructive of human
life, and which frequently entailed on the
living such indelible proofs of its severity,
should have been anticipated with peculiar
feelings of dread and apprehension we can
well believe, and it was natural that any
method, which afforded a probability of
diminishing its danger, and of rendering its
attacks of a milder character, should excite
no ordinary degree of public attention.</p>

<p class='c011'>How far these ends were accomplished
by the artificial communication of Small
Pox by inoculation, we shall now proceed
to inquire.</p>

<div class='pbb'>
 <hr class='pb c010' />
</div>

<div class='chapter'>
  <h2 class='c002'>CHAP. II.</h2>
</div>

<p class='c007'>The first individual in England on whom
the operation of inoculation for Small Pox
was performed, was the daughter of the
celebrated Lady Mary Wortley Montague.
She had witnessed, when in Turkey, the
mildness of this disease as produced by inoculation,
and her son had already passed
through the process with safety. “The
engraftment of her son having succeeded;
after Lady M. W. M. returned to London
in 1722, she sent for Mr. Maitland,
the surgeon, who had attended the boy
at Constantinople; and desired him to
engraft her daughter with Small Pox.
He solicited a delay, on account of the
weather, and entreated that two physicians
should be consulted. These requests
were refused, yet he obeyed her
Ladyship’s injunctions; but when the
fever commenced, an old family apothecary
and three physicians were permitted
to witness the process. As the success was
complete, Dr. Keith, one of the above
physicians, was tempted to request Mr.
Maitland to engraft his child also, which
likewise succeeded; and these cases
were rumoured through the town.”<a id='r5' /><a href='#f5' class='c012'><sup>[5]</sup></a>—An
experiment was afterwards tried, at the
request of the Princess of Wales, upon
“six condemned felons” with success, and
her own children passed through the operation
with safety. After this, inoculation was
partially employed for some years, and was
again discontinued—but, about the middle
of the last century, great exertions were
made to bring it into general use, and with
a considerable degree of success. We shall
presently endeavour to ascertain what influence
it exerted over the prevalence and
fatality of Small Pox. But, in the first
place, I think it will be useful to enquire
into some of the arguments which were
adduced in support of the practice; and,
it may be, to allude to a few which were
opposed to it.</p>

<hr class='c013' />
<div class='footnote' id='f5'>
<p class='c011'><span class='label'><a href='#r5'>5</a>.&nbsp;&nbsp;</span>Moore’s History of Small Pox, p. 228-9.</p>
</div>
<hr class='c013' />

<p class='c011'>The principal arguments, on which the
employment of inoculation for Small Pox
was supported, appear to have been the
following:—</p>

<p class='c011'>1. The infectious nature of the disease,
which was so virulent as to permit few individuals
to pass through life without being
at one time or other affected by it.</p>

<p class='c011'>2. Its fatality—destroying at least one
in five or six of those attacked by it.</p>

<p class='c011'>3. The generally received opinion that
no individual could be affected by it oftener
than once. And</p>

<p class='c011'>4. That, when communicated by inoculation,
it was rendered comparatively mild
and devoid of danger, while it afforded
equal security against any future attack of
the disease.</p>

<p class='c011'>The two former of these positions need
not engage our attention in this place—the
highly infectious nature of Small Pox has
always been admitted; and I have already
brought forward sufficient proof of the
danger to human life which it occasions.</p>

<p class='c011'>The third proposition is of most material
importance; for I am well convinced that
upon a proper understanding of this question
depended the true value of inoculation
as far as regarded <i>individuals;</i> and on it
also rests the true value of Vaccination as
regards <i>society in general</i>.</p>

<p class='c011'>It was unfortunate for the cause of inoculation
that its early advocates maintained
the absolute impossibility of Small Pox
occurring a second time in the same individual.
They thus furnished their opponents
with weapons against themselves, in
the cases, which repeatedly occurred, of
those who had passed through the process
of inoculation being afterwards affected by
the natural Small Pox; and were put to
the necessity of having recourse to expedients
equally unmanly and uncandid—either
of denying that the second disease
was genuine Small Pox, or of asserting that
the inoculating process had been imperfectly
performed. Whereas a little attentive
observation and research into the former
history of Small Pox, might have
satisfied them, that although in a great
majority of cases this formidable disease
did not occur a second time in the same
person, yet that repeated instances took
place wherein it did so occur. And that
while it might be assumed as a general rule
that the same individual would be affected
once only with Small Pox—it was a rule
admitting of exceptions.</p>

<p class='c011'>That a second attack of Small Pox may
take place in the same individual, may be
proved by a mass of evidence which appears
to me to be perfectly irresistible; and
as I consider it very important to the object
of this enquiry that every doubt should
be removed on the subject, I must be permitted
to dwell on it longer perhaps than
may at first sight appear necessary. I
have great pleasure in acknowledging my
obligation to the valuable “Historical
Sketch of Small Pox,” by Professor Thomson
of Edinburgh, for a large share of the
evidence which I shall lay before my readers,
to prove the frequency of the recurrence
of Small Pox. Soon after the introduction
of inoculation into France, “a son
of M. Delatour, about nine years of age,
was inoculated in 1756 for Small Pox, by
Surgeon Martin, under the inspection of
M. Tronchin, and passed through the
disease in a satisfactory manner. This
boy remained in good health for upwards
of two years, when an eruption, supposed
by some to be Small Pox, appeared upon
him, as well as upon four of his companions
in the same boarding-school. The
different opinions formed of the nature of
this eruption by the medical practitioners
who saw it, and who seem to have judged
of it according to the preconceived notions
they entertained with regard to the
possibility of the recurrence of Small Pox,
present (says Dr. Thomson) so true a picture
of what has occurred in similar cases
since the introduction of Vaccination, and
of the manner in which doubtful cases of
varioloid eruptions continue still to be
judged of, that I cannot avoid giving you
an abstract of the discussions to which this
case gave rise.”<a id='r6' /><a href='#f6' class='c012'><sup>[6]</sup></a>—Dr. Thomson goes on
to say, that “M. Gaulard, Physician in ordinary
to the King, was called to see the son
of Delatour on the third day of the eruption,
which he declared to be a mild case of
Small Pox, of the kind commonly called,
he says, though improperly so, Chicken
Pox, and the disease in the boy’s companions
he considered of the same nature.”—Four
physicians were called in to consult
with Mons. Gaulard, who<a id='r7' /><a href='#f7' class='c012'><sup>[7]</sup></a> “gave an account
of the progress of the disease which
contains a description of varioloid eruptions,
very similar to those which have of
late been described under the denomination
of modified Small Pox.</p>

<hr class='c013' />
<div class='footnote' id='f6'>
<p class='c011'><span class='label'><a href='#r6'>6</a>.&nbsp;&nbsp;</span>Dr. Thomson’s Sketch, &amp;c. p. 53.</p>
</div>

<div class='footnote' id='f7'>
<p class='c011'><span class='label'><a href='#r7'>7</a>.&nbsp;&nbsp;</span>Dr. Thomson’s Sketch, &amp;c., p. 54.</p>
</div>
<hr class='c013' />

<p class='c011'>“These gentlemen mention also, that
<i>two</i> of the other children affected, had
previously passed through natural Small
Pox; and conclude with declaring that,
from these circumstances, they believe
that the disease in Delatour and his companions,
<i>was neither the Small Pox nor
the Chicken Pox, but a chrystaline eruption,
with which they were well acquainted</i>.”</p>

<p class='c011'>It is, I think, from this sufficiently evident,
that nothing but the preconceived
opinions of the physicians consulted in these
cases could have prevented their acknowledging
the true nature of the disease; and
there cannot, I conceive, be a doubt, that
it was no other than Small Pox rendered
milder in its character by the previous occurrence
of it in these children. It is of
importance too to remember that they afford
examples of the recurrence of the disease
after both <i>natural</i> and <i>inoculated</i> Small
Pox. Delatour had been inoculated upwards
of two years before, and “two of
the other children affected had previously
passed through natural Small Pox.”
I shall here adduce some further extracts
from Dr. Thomson’s work. He tells us
that “M. Hosty, who had been sent
over to England in 1755, to acquire information
upon the subject of inoculation,”
“enters into a discussion with
respect to the recurrence of secondary
Small Pox, in which he allows that there
are several eruptive diseases with which
a person may be affected, <i>so like the Small
Pox, as scarcely to be distinguishable from
them</i>, and, on that account, liable to
give rise to many mistakes; and he states,
that although he does not deny absolutely
the possibility of the recurrence
of Small Pox, he believes this to be rare,”
(p. 55-6). “To Hosty’s opinion, with
regard to the unfrequency of the occurrence
of secondary Small Pox, Gaulard
replied, that he had at that time under
his charge two unequivocal examples of
secondary natural Small Pox, and that a
nephew of the Archbishop of Paris, had
a month before passed through the Small
Pox, under the care of the celebrated M.
Astruc, although he bore marks on his
body of having formerly undergone the
disease.”—(p. 59.)</p>

<p class='c011'>Gaulard then declares, “that though
reason dictates, and <i>experience actually
demonstrates</i>, that this process (inoculation
for Small Pox) does not infallibly
afford protection against a subsequent
attack of natural Small Pox, he was still
disposed to believe that it may be possessed
of some real advantages” (p. 59).
“Dr. Cantwell, in 1755, published a dissertation
upon inoculation, the avowed
object of which was to <i>undeceive</i> those
who believed in the efficacy of that practice.
In this Essay, a great number of
cases of Small Pox, which had occurred
both after natural and inoculated Small
Pox, are mentioned” (p. 64). “He
(Dr. Cantwell) seems to have been well
acquainted with those varioloid eruptions
which, previous to the introduction
of inoculation, had received a variety
of names, such as Swine Pox, Chicken
Pox, &amp;c. and which were considered
not as specifically different from Small
Pox, but as spurious and bastard species
of that disease. These eruptions, in his
opinion, were nothing else than mild varieties
of the true Small Pox. His own
words are” (p. 37), “after all, what are
the Swine Pox, the Duck Pox, and the
Chicken Pox, which are observed among
the English and the Irish? What is the
<i>petite verole volante</i> which is seen in
France? Many distinguished authors
attest, that they have seen Small Pox occur
twice in the same individual; and
have not we reason to believe that, in
these cases, the second attack was true
Small Pox, of which the infection was
slight, and in which the vital actions
were too weak to carry it to a certain
extent?” All this appears to me
most strictly consistent with truth. But
Dr. Cantwell was arguing against the use
of inoculation. How then did he account
for the fact that “the infection was slight,”
and that “the vital actions were too weak
to carry it to a certain extent,” if it did
not arise from these individuals having
already passed through the disease of Small
Pox?</p>

<p class='c011'>“De Haen (a celebrated physician of
Vienna,)” says Dr. Thomson (p. 68),
“collected into a body the numerous cases
of secondary Small Pox, which are to be
found in the writings of physicians,
who lived previous to, and in the infancy
of, the practice of inoculation in Europe.
Had the number of these cases, and the
respectability of the individuals by whom
they are related, been duly considered,
they surely were more than sufficient to
have satisfied the minds of the most incredulous,
of the possibility, and even of
the frequency of secondary Small Pox.”
De Haen, however, was an opposer of inoculation,
and the facts he adduced were not
permitted to have the weight which they
merited, in consequence of the arguments
he deduced from them.</p>

<p class='c011'>I shall conclude my extracts from the
fund of evidence collected in the work of
Professor Thomson, with the following:—</p>

<p class='c011'>“M. Strack, professor of medicine at
Mayence, in a letter upon inoculation,
addressed to M. Roux in 1765, (Journ.
de Med. tom. xxii.) maintains that natural
Small Pox do not, any more than the
artificial, protect against a second attack.
In proof of his opinion, he mentions six
cases of secondary Small Pox which he
himself had attended. The argument
which he uses in support of inoculation,
in opposition to those who were hostile
to that practice, and who asserted that it
does not protect against a subsequent attack,
though novel at the time it was
employed, has since been sufficiently
confirmed by repeated observation. He
says, that those who have passed through
the Small Pox twice, whether naturally
or artificially, have, in general, escaped
without danger; those patients, he adds,
who have had the Small Pox at two different
periods, are fortunate, because if
the variolous miasma had operated with
its full force during the first attack,
they probably would have fallen victims
to the disease” (p. 77).</p>

<p class='c011'>Mr. Moore remarks (Hist. of Small
Pox, p. 278) that, “besides the foreign
authorities, the English Medical Journals
contain several authentic examples of
persons whose faces were strongly pitted
with Small Pox, and who were afterwards
destroyed by a second attack of
that disease,”—he goes on (p. 279) to relate
“an incident frequently repeated by
the late Dr. Reynolds, Physician to his
Majesty, who was sent for by a lady unknown
to him, and conducted by her
maid, rather mysteriously, into a handsome
bed-chamber; where he saw, lying
in a splendid bed, a lady masked. Being
a good deal surprised, the maid
stifled a laugh, while her mistress, in a
soft toned voice, apologised for concealing
herself even from a professional gentleman.
This (she said) had become proper,
from the peculiarity of her situation. At
present she stood greatly in need of his
superior medical talents, and was extremely
anxious for his opinion on her
case, which she understood from others,
was a very rare one. The doctor being
thus put upon his guard, enquired minutely
into all the symptoms, and examined
critically a pustular eruption
which was spread over the lady’s person:
he then pronounced the disease to be,
without all doubt, the Small Pox. On
which the patient unmasked, and displayed
features seamed with the disorder.”</p>

<p class='c011'>Dr. Thomson (in his Historical Sketch,
p. 279) informs us, that out of <i>eight hundred
and thirteen</i> cases of Small Pox, which
had come under his notice since June, 1818,
“<i>seventy-one</i> had previously passed through
Small Pox.” And in the sequel many
other instances will be referred to.</p>

<p class='c011'>In a late number of the London Medical
Repository, Dr. Carter, of Canterbury, gives
the details of a case of secondary Small
Pox occurring in a girl, which proved fatal.
And a young lady (a family connection of
my own), who had satisfactorily passed
through the disease, from inoculation, when
young, had a second attack of Small Pox,
when on a visit at Liverpool, to which she
very nearly fell a sacrifice. To this mass
of evidence I shall add the case to which I
have before alluded, as having come under
my own notice. In this young woman the
eruption was confined to the shoulders and
face, and was not numerous, but it was
preceded for several days by considerable
feverishness and head-ache; and although
it did not proceed beyond the fourth or
fifth day, I consider the nature of the disorder
as quite unequivocal; if what I conceive
to be the only true test of this be
admitted, namely, that it was produced by
Small Pox infection, and was capable of
communicating it to others. Fortunately
this test was left incomplete in this instance,
no other individuals having become infected
in consequence; but the following facts
which have since come to my knowledge,
seem to warrant the inference, that this
might have happened had any unprotected
persons been allowed to have communication
with the patient.</p>

<p class='c011'>A lady, residing at Gateshead, who passed
through inoculated Small Pox many
years ago, became lately (during her confinement)
affected a second time with this
disease. And notwithstanding that it was
of the same mild character as in the last
case, and that the eruption turned on the
eighth day, her infant caught the infection.
The eruption in the child was of the confluent
kind, and occasioned its death eight
days after the appearance of the disease.</p>

<p class='c011'>Having succeeded, I trust, in proving to
the entire satisfaction of every candid enquirer
the possibility, if not the frequency,
of the occurrence of Small Pox a second
time in the same individual, it would be
both interesting and useful, were it possible
to ascertain what proportion such cases
bear to those who escape a second attack;
but many insurmountable difficulties present
themselves in making such a calculation.
Dr. Thomson tells us (p. 67), that
“according to Tissot, the proportion of
cases of secondary Small Pox, is as 1 in
100; according to Heberden, as 1 in
5000; and, according to Condamine, as 1
in 10,000. How uncertain the data!”—It
is, however, enough to know, that while the
relative number is sufficiently great to prevent
the rule, That no individual can be
affected by Small Pox oftener than once,—from
being considered absolute, it is yet too
small reasonably to shake our confidence in
the fact, that a very large proportion will
escape a recurrence of that disease. One
other fact of considerable importance has,
I trust, been also established by the preceding
enquiry—That when secondary Small
Pox does take place, it is usually a very mild
disease, unattended with danger.</p>

<p class='c011'>The fourth argument in support of
the employment of inoculation for Small
Pox,—that it was rendered comparatively
mild and devoid of danger, while it afforded
equal security against any future attack
of the disease with natural Small
Pox itself, need not detain us long.—The
latter part of the proposition has been
generally admitted; and its truth or falsity
will not affect the object of our present enquiry.
Mr. Moore (History of Small Pox,
p. 302) tells us, that “at the commencement
of inoculation in England, the proportion
of fatal cases appears to have been
fully one in fifty. But after the last improvement
in treatment had been established,
probably not more than one in two
hundred were lost.”—Mr. Moore continues—“of
those who contract the casual
Small Pox, and are treated with medical
care, it has been admitted that generally
about one in six are lost: but in countries
where the medical arts are unknown, the
Small Pox is so fatal a disease that few of
those who are seized with it survive its
malignity.” The immense difference
between these proportions is amply sufficient
to prove the great advantage derived
from inoculation by those on whom it was
practised.</p>

<p class='c011'>Such then were the data on which the
practice of inoculation for Small Pox was
established. But it will be remembered,
that on its introduction, and for many years
after it had been extensively used, it met
with a very warm opposition both from medical
men and others, especially from some
zealous divines, who stigmatised it as “a
diabolical invention of Satan,” and uttered
anathemas against all who should practise
it. I shall not enter into any examination
of the arguments made use of by the opposers
of inoculation; some of them have
been already alluded to, and their fallacy
pointed out. Taken altogether, it is remarkable
how nearly they resembled those
which have been opposed to the introduction
of Vaccination. Now, that distance of
time has enabled us to view the facts of the
case with coolness, and to reason upon
them without prejudice, while we admit
the individual security which arose from
the practice of inoculation, we must in candour
confess its tendency to encrease the
general destruction of life from Small Pox,
by forming so many new sources of infection.
This was the only rational argument
against inoculation, but it was certainly one
of great force, and the actual encrease of
deaths from Small Pox during the prevalence
of inoculation, seems to prove that it
was never sufficiently considered. The
encreased number of deaths from Small
Pox in 1723 and 1725, might fairly be imputed
to this cause, although it was denied
at the time by Dr. Jurin. Mr. Moore
(History of Small Pox, p. 243) very satisfactorily
replies to Dr. Jurin’s argument in
the following extract. “And as in the
year 1723 a great increase of the mortality
by Small Pox took place in London; Dr.
Jurin expressed his opinion that this
ought not be imputed to inoculation, as
the numbers who had been inoculated
did not exceed sixty. This was a very
inadequate answer. A single person may
bring the plague into a town or into a
nation, and be the cause of the destruction
of an innumerable multitude. The
Small Pox is fully as infectious a disease
as the plague; and sixty inoculations
were more than sufficient to account for
the augmented mortality, and were probably
the cause of it.”</p>

<p class='c011'>If we refer to the tables (No. 1 and 2),
we shall find that from the years 1752 to
1798 inclusive (the period during which
inoculation was most extensively employed
in this country), the average mortality from
Small Pox, during periods of five years
each, was occasionally so high as one in
eight of the whole, and rarely less than one
in ten. And that during individual years,
it three times (in 1752, 1781, and 1796)
amounted to nearly one in five; and in
1772 was little less than one in six. This
is surely a fearful encrease on Dr. Jurin’s
calculation—“That of all the children that
are born, there will some time or other
die of Small Pox <i>one in fourteen</i>.” There
can be no doubt, however, that this immense
encrease of mortality from Small
Pox was owing to the extended practice of
inoculation; and until this could have been
pursued more generally, and with greater
precautions, so as at once to diminish the
numbers capable of being infected by the
inoculated, and the hazard of the latter
coming into contact with the unprotected,
I am disposed to think this fact was in itself
sufficient ground for discontinuing inoculation
for Small Pox altogether. Could every
child have been subjected to the process of
inoculation, before any exposure to the infection
of natural Small Pox had taken
place, the case would have been widely
different: but it can scarcely be considered
either just or politic to render one individual
secure at the risk of endangering
many, or with a certainty of destroying
some. It may fairly be concluded, then,
that inoculation for Small Pox, as practised
for the last fifty years of the eighteenth
century, although certainly <i>a great individual
good</i>, was, in reality, without a doubt,
a <i>most serious general evil</i>.</p>

<p class='c011'>From what has been hitherto stated, I
conceive, we are authorised in assuming the
following as facts, which will furnish a satisfactory
answer to the first of the questions
proposed, What were the destructive consequences
of Small Pox previous to the
introduction of Vaccination?</p>

<p class='c011'>1. Small Pox is a disease of so infectious
a nature, that few individuals passed
through life without suffering from an attack
of it.</p>

<p class='c011'>2. It was attended with so much danger
as to occasion the death of one in five or six
of those affected by it in the natural way;
and previous to the use of inoculation, one
in fourteen of the whole number of children
born, at one time or other, died of the
Small Pox.</p>

<p class='c011'>3. Of those who recovered, many suffered
materially from its effects, not only in
the disfigurement of countenance occasioned
by it, but frequently in the loss of one or
both eyes, or in irreparable injury of their
constitutions.</p>

<p class='c011'>4. After having been once affected by
Small Pox, a very considerable proportion
of individuals resist entirely a second attack:
but still in very many instances a
recurrence of the disease is proved to have
taken place.</p>

<p class='c011'>5. Secondary Small Pox is, for the most
part, very mild in its symptoms, and of
shorter duration than a first attack, insomuch
as to have frequently given rise to
doubts respecting the real nature of the
disease.</p>

<p class='c011'>6. Secondary attacks of Small Pox have,
nevertheless, occasionally proved fatal.</p>

<p class='c011'>7. When artificially produced by inoculation,
the Small Pox is rendered materially
milder in its character, so that one in two
hundred only of those to whom the disease
has been thus communicated, have been
found to die in consequence.</p>

<p class='c011'>8. The Small Pox, when communicated
by inoculation, is probably as secure a preventive
of any future attack of the disease
as when it has taken place naturally.</p>

<p class='c011'>9. Notwithstanding the undeniable advantages
which accrued to those who passed
through the process, it was, nevertheless,
the direct effect of inoculation, by multiplying
the sources of infection, materially
to encrease the aggregate mortality occasioned
by Small Pox.</p>

<div class='pbb'>
 <hr class='pb c010' />
</div>

<div class='chapter'>
  <h2 class='c002'>CHAP. III.</h2>
</div>

<p class='c007'>Such having been proved to have been the
destructive consequences of Small Pox,
previous to the introduction of Vaccination,
we are fully prepared to enter upon
the second query proposed,—What influence
has Vaccination exerted over these
consequences—1. by extensively superseding
the cause—and 2. by essentially interfering
with the effect?</p>

<p class='c011'>The name of Dr. Jenner is too intimately
associated with the subject of Vaccination
to admit of the latter being referred to
without some allusion being made to the
former; and I should ill testify my sense
of the truly valuable blessing which Jenner
has been the means of conferring upon
mankind, were I altogether to omit any
expression of my admiration of the superior
perception which enabled him to infer the
probable consequences of facts, which must
have been long familiar to hundreds without
having given rise to any important suggestion,
and of the zeal and ability with
which he prosecuted his enquiries on the
subject, or my high esteem for the generous
disinterestedness with which he made
known to the world his most useful discovery.
“It will,” (to use the words of Sir
Gilbert Blane,) “in the eyes of future ages,
be deemed an epocha in the destinies
of the world, and one of the highest
boasts of the country in which it took
its rise, with a sense of unrequitable obligation
to the individual who first disclosed
and promulgated the secret, by
drawing it from the dark recesses of rural
tradition, and rendering it available
to the whole human race.”</p>

<p class='c011'>It is not, however, my intention to enter
into any detail of the mode in which Vaccination
originated, or of the circumstances
which accompanied its introduction into
practice. It will suffice to state, that its
supposed efficacy in preventing the occurrence
of Small Pox, was founded upon
repeated observation, that the milkers employed
in the great dairies of Gloucestershire
and the neighbouring counties, who
became affected with a disease which prevailed
among the cows, and to which the
name of Cow Pox had been given in consequence,
were very generally rendered insusceptible
of the Small Pox infection, even
when attempted to be communicated by
means of inoculation. Dr. Jenner put this
fact to the test of repeated experiment, and
finding it thus confirmed, proposed introducing
the Cow Pox into the human constitution
artificially, as a means of securing
it against the dangers of Small Pox, and,
in the end, of entirely exterminating the
latter disease; for it must appear very evident,
that if every individual could in any
way be rendered incapable of being infected
by Small Pox, the infection itself must necessarily
become entirely extinct.</p>

<p class='c011'>In prosecuting my enquiries into this
part of my subject I shall, as far as may be,
confine myself to an examination of facts
calculated, as I conceive, to remove every
reasonable doubt respecting the true value
of Vaccination.</p>

<p class='c011'>The first essential fact, to which I would
direct the attention of my readers, is the
very striking diminution in the number of
deaths from Small Pox, which has taken
place within the bills of mortality of London,
since the introduction of Vaccination.
This diminution is equally remarkable,
whether we refer to the actual number of
deaths from this cause, or to the relative
proportion which they bear to the whole
amount of deaths occurring in any given
year or number of years. Thus taking
the averages calculated on periods of five
years each, as is shewn in the table (No.
2), it will appear evident not only that the
amount of diminution has been most gratifying
and satisfactory, but that, in proportion
to the increasing employment of Vaccination,
it has been regularly progressive;
so that the number of deaths from Small
Pox, instead of amounting to one in ten of
the whole, as was the case for the ten years
which preceded the introduction of Vaccination,
has during the last ten years,
actually amounted to less than one in
twenty-eight, or little more than one-third
of the former proportion.</p>

<p class='c011'>If we compare the number of deaths
from Small Pox, which took place during
the twenty-five years (from 1784 to 1798
inclusive) which immediately preceded Vaccination,
amounting to 46,996, with the
number which has taken place during the
twenty-five years which have elapsed since
its introduction (from 1799 to 1823 inclusive),
amounting to 25,869, we shall find
that an actual diminution has taken place
of no fewer than 21,127, or nearly one half
of the whole. It may, therefore, be confidently
assumed, even upon this very simple
calculation, that a number of lives equal
to this diminution has been saved by Vaccination,
within the bills of mortality
alone. And as this diminution in the
amount of mortality from Small Pox is
going on in a progressive ratio, it is probable
that the next twenty-five years will afford
a yet more striking result.</p>

<p class='c011'>If we extend this calculation to the
whole of Great Britain and Ireland, assuming
that the ratio in the diminution of
deaths has been the same over the united
kingdom as within the London bills of
mortality—(and there are various good
reasons for believing that it has been
greater)—we cannot but be struck with
the immense saving of human life which
has already taken place. Sir Gilbert Blane
and Dr. Letsom separately calculated the
annual loss of lives from Small Pox, in
Great Britain and Ireland, during the last
thirty years of the eighteenth century.—One
of these eminent physicians estimated
them at 34,260, and the other at 36,000
(Moore’s History of Small Pox, p. 300):
For our present purpose, we will take a medium
number, as being probably nearest to
the truth. Assuming then, that the number
of deaths from Small Pox, in the United
Kingdom, during each of the twenty-five
years which preceded the introduction of
Vaccination, amounted to 35,000, the
amount, during the whole of that period,
must have been 875,000. But if the diminution
on the whole of this number has
been equal to that which is proved to have
taken place within the London bills of
mortality, during the last twenty-five years,
it must have been reduced to 481,644 only,
and an actual saving of the lives of 393,356
individuals must have been accomplished.</p>

<p class='c011'>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.”</p>

<p class='c011'>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 <i>susceptible</i>. 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.”</p>

<p class='c011'>“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).</p>

<p class='c011'>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.</p>

<p class='c011'>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.</p>

<p class='c011'>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.</p>

<p class='c011'>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?</p>

<p class='c011'>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.</p>

<p class='c011'>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.</p>

<p class='c011'>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 <i>single</i> exception to the
<i>law of uncertainty</i> 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 <i>general</i>,
what was at first too hastily concluded to
be an <i>absolute</i> rule.</p>

<p class='c011'>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.</p>

<p class='c011'>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 <i>only period
of danger</i>. 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 <i>single
case</i>, and two other gentlemen took occasion
to say, that they had each seen a
case of <i>second Small Pox</i>—both of which
proved <i>fatal</i>.” And Dr. Thomson tells
us (Historical Sketch, &amp;c. p. 279), that
“since the publication of my ‘Account of
the Varioloid Epidemic,’ I have seen
above <i>two hundred</i> additional examples
of Small Pox in Edinburgh, making in
all <i>eight hundred and thirty-six</i> cases of
this disease, which have come under my
observation since June, 1818. Of the
whole number, <i>two hundred and eighty-one</i>
have occurred in individuals who had
neither had Small Pox nor Cow Pox, and
of these fully more than <i>one</i> in <i>four</i> died;
<i>seventy-one</i> had previously passed through
<i>Small Pox</i>, and of these <i>two</i> have died;
and <i>four hundred and eighty-four</i> had undergone
the process of <i>Vaccination</i>, and
of this number <i>one</i> 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.</p>

<p class='c011'>Mr. Cross relates that <i>two</i> 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, &amp;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 <i>certain</i>,
against <i>two contingent on the invasion of
an epidemic Small Pox</i>, and then we have
to consider, whether there might not be
nearly as great a chance of <i>two persons</i>
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 <i>eight</i> 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
<i>safe</i> 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.”</p>

<p class='c011'>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, &amp;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.</p>

<div class='pbb'>
 <hr class='pb c010' />
</div>

<div class='chapter'>
  <h2 class='c002'>CONCLUSION.</h2>
</div>

<p class='c007'>The following are the important conclusions
which may obviously be deduced
from the satisfactory evidence which has
been detailed.</p>

<p class='c011'>1. That Vaccination has, within the
space of twenty-five years, been the direct
means of preserving, within the London<a id='r8' /><a href='#f8' class='c012'><sup>[8]</sup></a>
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.”</p>

<hr class='c013' />
<div class='footnote' id='f8'>
<p class='c011'><span class='label'><a href='#r8'>8</a>.&nbsp;&nbsp;</span>The following is extracted from the London Medical
and Physical Journal for the present month (December):—“<i>Influence
of Vaccination upon the mortality of Berlin.</i> 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.”—<i>Journal
Comp. September.</i> 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.</p>
</div>
<hr class='c013' />

<p class='c011'>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.</p>

<p class='c011'>3. That Vaccination is capable, if universally
employed, of exterminating the
Small Pox altogether, as has been proved
by the experience of other countries.</p>

<p class='c011'>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.</p>

<p class='c011'>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.</p>

<p class='c011'>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.</p>

<p class='c011'>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.</p>

<div class='pbb'>
 <hr class='pb c010' />
</div>

<div class='chapter'>
  <h2 class='c002'>TABLE I.</h2>
</div>

<p class='c014'>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.</p>

<div class='tableII'>

<table class='table0' summary=''>
<colgroup>
<col width='26%' />
<col width='33%' />
<col width='40%' />
</colgroup>
  <tr>
 <th class='btt bbt blt brt c015'><i>Year.</i></th>
 <th class='btt bbt brt c016'><i>Total number of deaths.</i></th>
 <th class='btt bbt brt c016'><i>Number of deaths from Small Pox.</i></th>
  </tr>
  <tr>
 <td class='blt brt c015'>1703</td>
 <td class='brt c017'>20,720</td>
 <td class='brt c017'>898</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1704</td>
 <td class='brt c017'>22,684</td>
 <td class='brt c017'>1,501</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1705</td>
 <td class='brt c017'>22,097</td>
 <td class='brt c017'>1,095</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1706</td>
 <td class='brt c017'>19,847</td>
 <td class='brt c017'>721</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1707</td>
 <td class='brt c017'>21,600</td>
 <td class='brt c017'>1,078</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1708</td>
 <td class='brt c017'>21,291</td>
 <td class='brt c017'>1,687</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1709</td>
 <td class='brt c017'>21,800</td>
 <td class='brt c017'>1,024</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1710</td>
 <td class='brt c017'>24,620</td>
 <td class='brt c017'>3,138</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1711</td>
 <td class='brt c017'>19,833</td>
 <td class='brt c017'>915</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1712</td>
 <td class='brt c017'>21,198</td>
 <td class='brt c017'>1,943</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1713</td>
 <td class='brt c017'>21,057</td>
 <td class='brt c017'>1,614</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1714</td>
 <td class='brt c017'>26,569</td>
 <td class='brt c017'>2,810</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1715</td>
 <td class='brt c017'>22,232</td>
 <td class='brt c017'>1,057</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1716</td>
 <td class='brt c017'>24,436</td>
 <td class='brt c017'>2,427</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1717</td>
 <td class='brt c017'>23,446</td>
 <td class='brt c017'>2,211</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1718</td>
 <td class='brt c017'>26,523</td>
 <td class='brt c017'>1,884</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1719</td>
 <td class='brt c017'>28,347</td>
 <td class='brt c017'>3,229</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1720</td>
 <td class='brt c017'>25,454</td>
 <td class='brt c017'>1,440</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1721</td>
 <td class='brt c017'>26,142</td>
 <td class='brt c017'>2,375</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1722</td>
 <td class='brt c017'>25,750</td>
 <td class='brt c017'>2,167</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1723</td>
 <td class='brt c017'>29,197</td>
 <td class='brt c017'>3,271</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1724</td>
 <td class='brt c017'>25,952</td>
 <td class='brt c017'>1,227</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1725</td>
 <td class='brt c017'>25,523</td>
 <td class='brt c017'>3,188</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1726</td>
 <td class='brt c017'>29,647</td>
 <td class='brt c017'>1,569</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1727</td>
 <td class='brt c017'>28,418</td>
 <td class='brt c017'>2,370</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1728</td>
 <td class='brt c017'>27,810</td>
 <td class='brt c017'>2,105</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1729</td>
 <td class='brt c017'>29,722</td>
 <td class='brt c017'>2,849</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1730</td>
 <td class='brt c017'>26,761</td>
 <td class='brt c017'>1,914</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1731</td>
 <td class='brt c017'>25,262</td>
 <td class='brt c017'>2,640</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1732</td>
 <td class='brt c017'>23,358</td>
 <td class='brt c017'>1,197</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1733</td>
 <td class='brt c017'>29,233</td>
 <td class='brt c017'>1,370</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1734</td>
 <td class='brt c017'>26,062</td>
 <td class='brt c017'>2,688</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1735</td>
 <td class='brt c017'>23,538</td>
 <td class='brt c017'>1,594</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1736</td>
 <td class='brt c017'>27,581</td>
 <td class='brt c017'>3,014</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1737</td>
 <td class='brt c017'>27,823</td>
 <td class='brt c017'>2,084</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1738</td>
 <td class='brt c017'>25,825</td>
 <td class='brt c017'>1,590</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1739</td>
 <td class='brt c017'>25,432</td>
 <td class='brt c017'>1,619</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1740</td>
 <td class='brt c017'>30,811</td>
 <td class='brt c017'>2,725</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1741</td>
 <td class='brt c017'>32,169</td>
 <td class='brt c017'>1,977</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1742</td>
 <td class='brt c017'>27,483</td>
 <td class='brt c017'>1,429</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1743</td>
 <td class='brt c017'>25,200</td>
 <td class='brt c017'>2,029</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1744</td>
 <td class='brt c017'>20,606</td>
 <td class='brt c017'>1,639</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1745</td>
 <td class='brt c017'>21,296</td>
 <td class='brt c017'>1,206</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1746</td>
 <td class='brt c017'>28,151</td>
 <td class='brt c017'>3,236</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1747</td>
 <td class='brt c017'>25,494</td>
 <td class='brt c017'>1,380</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1748</td>
 <td class='brt c017'>23,869</td>
 <td class='brt c017'>1,789</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1749</td>
 <td class='brt c017'>25,516</td>
 <td class='brt c017'>2,625</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1750</td>
 <td class='brt c017'>23,727</td>
 <td class='brt c017'>1,229</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1751</td>
 <td class='brt c017'>21,028</td>
 <td class='brt c017'>998</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1752</td>
 <td class='brt c017'>20,485</td>
 <td class='brt c017'>3,538</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1753</td>
 <td class='brt c017'>19,276</td>
 <td class='brt c017'>774</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1754</td>
 <td class='brt c017'>22,696</td>
 <td class='brt c017'>2,359</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1755</td>
 <td class='brt c017'>21,917</td>
 <td class='brt c017'>1,988</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1756</td>
 <td class='brt c017'>20,872</td>
 <td class='brt c017'>1,608</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1757</td>
 <td class='brt c017'>21,313</td>
 <td class='brt c017'>3,296</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1758</td>
 <td class='brt c017'>17,576</td>
 <td class='brt c017'>1,273</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1759</td>
 <td class='brt c017'>19,604</td>
 <td class='brt c017'>2,596</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1760</td>
 <td class='brt c017'>19,830</td>
 <td class='brt c017'>2,187</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1761</td>
 <td class='brt c017'>21,083</td>
 <td class='brt c017'>1,525</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1762</td>
 <td class='brt c017'>26,326</td>
 <td class='brt c017'>2,743</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1763</td>
 <td class='brt c017'>26,143</td>
 <td class='brt c017'>3,582</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1764</td>
 <td class='brt c017'>23,202</td>
 <td class='brt c017'>2,382</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1765</td>
 <td class='brt c017'>23,230</td>
 <td class='brt c017'>2,498</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1766</td>
 <td class='brt c017'>23,911</td>
 <td class='brt c017'>2,334</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1767</td>
 <td class='brt c017'>22,612</td>
 <td class='brt c017'>2,188</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1768</td>
 <td class='brt c017'>23,639</td>
 <td class='brt c017'>3,028</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1769</td>
 <td class='brt c017'>21,847</td>
 <td class='brt c017'>1,968</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1770</td>
 <td class='brt c017'>22,434</td>
 <td class='brt c017'>1,986</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1771</td>
 <td class='brt c017'>21,780</td>
 <td class='brt c017'>1,660</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1772</td>
 <td class='brt c017'>26,053</td>
 <td class='brt c017'>3,992</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1773</td>
 <td class='brt c017'>21,656</td>
 <td class='brt c017'>1,039</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1774</td>
 <td class='brt c017'>20,884</td>
 <td class='brt c017'>2,479</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1775</td>
 <td class='brt c017'>20,514</td>
 <td class='brt c017'>2,669</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1776</td>
 <td class='brt c017'>19,048</td>
 <td class='brt c017'>1,728</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1777</td>
 <td class='brt c017'>23,334</td>
 <td class='brt c017'>2,567</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1778</td>
 <td class='brt c017'>20,399</td>
 <td class='brt c017'>1,425</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1779</td>
 <td class='brt c017'>20,420</td>
 <td class='brt c017'>2,493</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1780</td>
 <td class='brt c017'>20,517</td>
 <td class='brt c017'>871</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1781</td>
 <td class='brt c017'>20,709</td>
 <td class='brt c017'>3,500</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1782</td>
 <td class='brt c017'>17,918</td>
 <td class='brt c017'>636</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1783</td>
 <td class='brt c017'>19,020</td>
 <td class='brt c017'>1,550</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1784</td>
 <td class='brt c017'>17,828</td>
 <td class='brt c017'>1,759</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1785</td>
 <td class='brt c017'>18,919</td>
 <td class='brt c017'>1,999</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1786</td>
 <td class='brt c017'>20,454</td>
 <td class='brt c017'>1,210</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1787</td>
 <td class='brt c017'>19,349</td>
 <td class='brt c017'>2,418</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1788</td>
 <td class='brt c017'>19,697</td>
 <td class='brt c017'>1,101</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1789</td>
 <td class='brt c017'>20,749</td>
 <td class='brt c017'>2,077</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1790</td>
 <td class='brt c017'>18,038</td>
 <td class='brt c017'>1,617</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1791</td>
 <td class='brt c017'>18,760</td>
 <td class='brt c017'>1,747</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1792</td>
 <td class='brt c017'>20,213</td>
 <td class='brt c017'>1,568</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1793</td>
 <td class='brt c017'>21,749</td>
 <td class='brt c017'>2,382</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1794</td>
 <td class='brt c017'>19,241</td>
 <td class='brt c017'>1,913</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1795</td>
 <td class='brt c017'>21,179</td>
 <td class='brt c017'>1,040</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1796</td>
 <td class='brt c017'>18,905</td>
 <td class='brt c017'>3,548</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1797</td>
 <td class='brt c017'>17,014</td>
 <td class='brt c017'>522</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1798</td>
 <td class='brt c017'>18,155</td>
 <td class='brt c017'>2,237</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1799</td>
 <td class='brt c017'>18,134</td>
 <td class='brt c017'>1,111</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1800</td>
 <td class='brt c017'>23,068</td>
 <td class='brt c017'>2,409</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1801</td>
 <td class='brt c017'>19,374</td>
 <td class='brt c017'>1,461</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1802</td>
 <td class='brt c017'>19,379</td>
 <td class='brt c017'>1,579</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1803</td>
 <td class='brt c017'>19,582</td>
 <td class='brt c017'>1,202</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1804</td>
 <td class='brt c017'>17,038</td>
 <td class='brt c017'>621</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1805</td>
 <td class='brt c017'>17,565</td>
 <td class='brt c017'>1,685</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1806</td>
 <td class='brt c017'>17,938</td>
 <td class='brt c017'>1,158</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1807</td>
 <td class='brt c017'>18,334</td>
 <td class='brt c017'>1,297</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1808</td>
 <td class='brt c017'>19,954</td>
 <td class='brt c017'>1,169</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1809</td>
 <td class='brt c017'>16,680</td>
 <td class='brt c017'>1,163</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1810</td>
 <td class='brt c017'>19,893</td>
 <td class='brt c017'>1,198</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1811</td>
 <td class='brt c017'>17,043</td>
 <td class='brt c017'>751</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1812</td>
 <td class='brt c017'>18,295</td>
 <td class='brt c017'>1,287</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1813</td>
 <td class='brt c017'>17,322</td>
 <td class='brt c017'>898</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1814</td>
 <td class='brt c017'>19,783</td>
 <td class='brt c017'>638</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1815</td>
 <td class='brt c017'>19,560</td>
 <td class='brt c017'>725</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1816</td>
 <td class='brt c017'>20,316</td>
 <td class='brt c017'>653</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1817</td>
 <td class='brt c017'>19,968</td>
 <td class='brt c017'>1,051</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1818</td>
 <td class='brt c017'>19,705</td>
 <td class='brt c017'>421</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1819</td>
 <td class='brt c017'>19,228</td>
 <td class='brt c017'>712</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1820</td>
 <td class='brt c017'>19,348</td>
 <td class='brt c017'>792</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1821</td>
 <td class='brt c017'>18,451</td>
 <td class='brt c017'>508</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1822</td>
 <td class='brt c017'>18,863</td>
 <td class='brt c017'>604</td>
  </tr>
  <tr>
 <td class='bbt blt brt c015'>1823</td>
 <td class='bbt brt c017'>20,587</td>
 <td class='bbt brt c017'>774</td>
  </tr>
</table>

</div>

<div class='pbb'>
 <hr class='pb c010' />
</div>

<div class='chapter'>
  <h2 class='c002'>TABLE II.</h2>
</div>

<p class='c014'>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.</p>

<div class='tableII'>

<table class='table1' summary=''>
<colgroup>
<col width='22%' />
<col width='16%' />
<col width='19%' />
<col width='19%' />
<col width='12%' />
<col width='6%' />
<col width='3%' />
</colgroup>
  <tr>
 <th class='btt bbt blt brt c015'><i>Periods of 5 years including</i></th>
 <th class='btt bbt brt c015'><i>Total number of deaths.</i></th>
 <th class='btt bbt brt c015'><i>Number of deaths from Small Pox.</i></th>
 <th class='btt bbt brt c015'><i>Number of deaths from Small Pox in 1000.</i></th>
 <th class='btt bbt brt c015' colspan='3'><i>Relative number of deaths from Small Pox.</i></th>
  </tr>
  <tr>
 <td class='blt brt c015'>1703 to 1707</td>
 <td class='brt c018'>106,948</td>
 <td class='brt c018'>5,293</td>
 <td class='brt c018'>49.4</td>
    <td class='c018'>1 in</td>
    <td class='c018'>20.2</td>
 <td class='brt c019'></td>
  </tr>
  <tr>
 <td class='blt brt c015'>1708 -- 1712</td>
 <td class='brt c018'>108,742</td>
 <td class='brt c018'>8,707</td>
 <td class='brt c018'>80.0</td>
    <td class='c018'>1 in</td>
    <td class='c018'>12.4</td>
 <td class='brt c019'></td>
  </tr>
  <tr>
 <td class='blt brt c015'>1713 -- 1717</td>
 <td class='brt c018'>117,740</td>
 <td class='brt c018'>10,119</td>
 <td class='brt c018'>85.9</td>
    <td class='c018'>1 in</td>
    <td class='c018'>11.6</td>
 <td class='brt c019'></td>
  </tr>
  <tr>
 <td class='blt brt c015'>1718 -- 1722</td>
 <td class='brt c018'>132,216</td>
 <td class='brt c018'>11,095</td>
 <td class='brt c018'>84.5</td>
    <td class='c018'>1 in</td>
    <td class='c018'>11.9</td>
 <td class='brt c019'></td>
  </tr>
  <tr>
 <td class='blt brt c015'>1723 -- 1727</td>
 <td class='brt c018'>138,737</td>
 <td class='brt c018'>11,625</td>
 <td class='brt c018'>83.6</td>
    <td class='c018'>1 in</td>
    <td class='c018'>11.9</td>
 <td class='brt c019'></td>
  </tr>
  <tr>
 <td class='blt brt c015'>1728 -- 1732</td>
 <td class='brt c018'>132,913</td>
 <td class='brt c018'>10,705</td>
 <td class='brt c018'>80.5</td>
    <td class='c018'>1 in</td>
    <td class='c018'>11.4</td>
 <td class='brt c019'></td>
  </tr>
  <tr>
 <td class='blt brt c015'>1733 -- 1737</td>
 <td class='brt c018'>134,237</td>
 <td class='brt c018'>10,750</td>
 <td class='brt c018'>80.0</td>
    <td class='c018'>1 in</td>
    <td class='c018'>12.4</td>
 <td class='brt c019'></td>
  </tr>
  <tr>
 <td class='blt brt c015'>1738 -- 1742</td>
 <td class='brt c018'>141,720</td>
 <td class='brt c018'>9,415</td>
 <td class='brt c018'>66.0</td>
    <td class='c018'>1 in</td>
    <td class='c018'>15.0</td>
 <td class='brt c019'></td>
  </tr>
  <tr>
 <td class='blt brt c015'>1743 -- 1747</td>
 <td class='brt c018'>120,753</td>
 <td class='brt c018'>9,484</td>
 <td class='brt c018'>78.0</td>
    <td class='c018'>1 in</td>
    <td class='c018'>12.7</td>
 <td class='brt c019'></td>
  </tr>
  <tr>
 <td class='blt brt c015'>1748 -- 1752</td>
 <td class='brt c018'>114,625</td>
 <td class='brt c018'>10,179</td>
 <td class='brt c018'>89.0</td>
    <td class='c018'>1 in</td>
    <td class='c018'>11.2</td>
 <td class='brt c019'>⎫</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1753 -- 1757</td>
 <td class='brt c018'>106,074</td>
 <td class='brt c018'>10,025</td>
 <td class='brt c018'>95.0</td>
    <td class='c018'>1 in</td>
    <td class='c018'>10.5</td>
 <td class='brt c019'>⎪</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1758 single year</td>
 <td class='brt c018'>17,576</td>
 <td class='brt c018'>1,273</td>
 <td class='brt c018'>72.4</td>
    <td class='c018'>1 in</td>
    <td class='c018'>13.8</td>
 <td class='brt c019'>⎪</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1759 -- 1763</td>
 <td class='brt c018'>112,986</td>
 <td class='brt c018'>12,633</td>
 <td class='brt c018'>111.8</td>
    <td class='c018'>1 in</td>
    <td class='c018'>8.9</td>
 <td class='brt c019'>⎪</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1764 -- 1768</td>
 <td class='brt c018'>116,594</td>
 <td class='brt c018'>13,630</td>
 <td class='brt c018'>116.9</td>
    <td class='c018'>1 in</td>
    <td class='c018'>8.5</td>
 <td class='brt c019'>⎪</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1769 -- 1773</td>
 <td class='brt c018'>113,770</td>
 <td class='brt c018'>10,645</td>
 <td class='brt c018'>93.5</td>
    <td class='c018'>1 in</td>
    <td class='c018'>10.6</td>
 <td class='brt c019'>⎬</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1774 -- 1778</td>
 <td class='brt c018'>104,179</td>
 <td class='brt c018'>10,808</td>
 <td class='brt c018'>103.7</td>
    <td class='c018'>1 in</td>
    <td class='c018'>9.7</td>
 <td class='brt c019'>⎪</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1779 -- 1783</td>
 <td class='brt c018'>98,584</td>
 <td class='brt c018'>9,050</td>
 <td class='brt c018'>91.7</td>
    <td class='c018'>1 in</td>
    <td class='c018'>10.8</td>
 <td class='brt c019'>⎪</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1784 -- 1788</td>
 <td class='brt c018'>96,247</td>
 <td class='brt c018'>8,487</td>
 <td class='brt c018'>88.2</td>
    <td class='c018'>1 in</td>
    <td class='c018'>11.3</td>
 <td class='brt c019'>⎪</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1789 -- 1793</td>
 <td class='brt c018'>99,509</td>
 <td class='brt c018'>9,391</td>
 <td class='brt c018'>94.3</td>
    <td class='c018'>1 in</td>
    <td class='c018'>10.5</td>
 <td class='brt c019'>⎪</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1794 -- 1798</td>
 <td class='brt c018'>94,494</td>
 <td class='brt c018'>9,260</td>
 <td class='brt c018'>96.9</td>
    <td class='c018'>1 in</td>
    <td class='c018'>10.2</td>
 <td class='brt c019'>⎭</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1799 -- 1803</td>
 <td class='brt c018'>99,537</td>
 <td class='brt c018'>7,762</td>
 <td class='brt c018'>77.9</td>
    <td class='c018'>1 in</td>
    <td class='c018'>12.8</td>
 <td class='brt c019'>⎫</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1804 -- 1808</td>
 <td class='brt c018'>90,829</td>
 <td class='brt c018'>5,930</td>
 <td class='brt c018'>65.3</td>
    <td class='c018'>1 in</td>
    <td class='c018'>15.3</td>
 <td class='brt c019'>⎪</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1809 -- 1813</td>
 <td class='brt c018'>89,233</td>
 <td class='brt c018'>5,299</td>
 <td class='brt c018'>59.3</td>
    <td class='c018'>1 in</td>
    <td class='c018'>16.8</td>
 <td class='brt c019'>⎬</td>
  </tr>
  <tr>
 <td class='blt brt c015'>1814 -- 1818</td>
 <td class='brt c018'>99,332</td>
 <td class='brt c018'>3,488</td>
 <td class='brt c018'>35.1</td>
    <td class='c018'>1 in</td>
    <td class='c018'>28.4</td>
 <td class='brt c019'>⎪</td>
  </tr>
  <tr>
 <td class='bbt blt brt c015'>1819 -- 1823</td>
 <td class='bbt brt c018'>96,477</td>
 <td class='bbt brt c018'>3,390</td>
 <td class='bbt brt c018'>35.1</td>
 <td class='bbt c018'>1 in</td>
 <td class='bbt c018'>28.4</td>
 <td class='bbt brt c019'>⎭</td>
  </tr>
</table>

</div>

<p class='c011'>The first Bracket includes the period when Inoculation for
Small Pox was in most general use. The second Bracket the
period of Vaccination.</p>

<div class='pbb'>
 <hr class='pb c010' />
</div>

<div class='nf-center-c1'>
<div class='nf-center c004'>
    <div><i>Lately was published by the same Author, and to be had of</i></div>
    <div><i>E. Charnley, Price 1s.</i></div>
    <div class='c006'><span class='xlarge'>HINTS</span></div>
    <div class='c005'>TOWARDS THE ADOPTION OF AN</div>
    <div class='c005'>IMPROVED PRINCIPLE OF REMUNERATING</div>
    <div class='c005'><span class='large'>The Surgeon Apothecary,</span></div>
    <div class='c005'>OR,</div>
    <div class='c005'><span class='large'>GENERAL PRACTITIONER IN MEDICINE.</span></div>
    <div class='c005'>ADDRESSED TO THE</div>
    <div class='c005'>MEMBERS OF THE PROFESSION</div>
    <div class='c005'>AND THE</div>
    <div class='c005'>PUBLIC AT LARGE.</div>
  </div>
</div>

<div class='lg-container-l c008'>
  <div class='linegroup'>
    <div class='group'>
      <div class='line'>Newcastle; Printed by T. &amp; J. Hodgson,</div>
      <div class='line in11'>Union Street</div>
    </div>
  </div>
</div>

<div class='pbb'>
 <hr class='pb c010' />
</div>

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