the latter none. Now I cannot conceive of opium that if it is not a very efficacious drug, it will prove altogether inert: I think if it does not do good, it must do mischief, in the large doses which Dr. S. recommends: hence the necessity of pointing out with great precision the cases in which it may be safely employed. I To the Editors of the Medical and Physical Journal. GENTLEMEN, AM desired by the Board of the National Vaccine Establishment to request that you will insert in your next publication the enclosed Report of the Board printed by order of the House of Commons, in order that the same may be as extensively known as possible. I am, Gentlemen, Sun Court, Cornhill, July 14, 1813. Your most obedient Servant, Secretary. REPORT of the NATIONAL VACCINE ESTABLISHMENT, Dated April 22, 1813. To the Right Hon. Viscount Sidmouth, Principal Secretary of State, Home Department, &c. &c. &c. MY LORD, National Vaccine Establishment, Leicester-square, April 22, 1813. The Board of the National Vaccine Establishment have the honor of informing your Lordship, that during the year 1812, the surgeons appointed by their authority to the nine stations in London, have vaccinated 4521 persons, and have distributed 23,219 charges of vaccine lymph to the public. The number vaccinated this year exceeds that of 1811 by 1373, and the demand for lymph has been often so great that it could not without difficulty be supplied. The Board had last year reason to think that nearly two-thirds of the children born in the metropolis, were vaccinated by charitable institutions or private practitioners. There is now reason to believe that three-fourths of those born are submitted to that salutary operation. But though the prejudices against the cow pock, which have been artfully encouraged by ignorant and interested men, appear generally to decline in the metropolis, as well as in other parts of these dominions, yet it is with concern that the Board have noticed the increase of mortality from small-pox in this city last year, to the number of 1287. NO. 174. Previous Previous to the discovery of vaccination, the average number of deaths from small-pox, within the bills of mortality, was 2000; and, though in the last ten years 133,189 persons were added to the population of this great city, yet in 1811, by the benefit of vaccination, the mortality was reduced to 751. The increase in the last year we have reason to ascribe to the rash and inconsiderate manner in which great numbers are still inoculated for the small-pox, and afterwards required to attend two or three times a-week, at the place of inoculation, in every stage of their illness. This practice of inoculation, and of promiscuous intercourse of the patients at the same time with society, is the great means by which this disease is kept in existence, and its infection propagated to persons and places where it would not otherwise be seen. This is not only the opinion of this Board, founded on observation, but it is a fact confirmed by communications to them from the best authorities, and by the most unprejudiced characters. The respectable College of Surgeons of Dublin allege that the practice of inoculation not only supplies a constant source of infection, but prevents the extinction of the disease, for even a short interval. In The populous city of Norwich was never free from it till the discovery of vaccination, but since that period it has experienced occasional remissions from its ravages. 1807, after its disappearance for some time, the disorder was brought into that city by a vagrant from London, who, before the magistrates were apprised of it, or before the salutary advice given by the faculty to provide a place where such person might be secluded from intercourse with the inhabitants could be adopted, communicated the contagion. Of 1200 who took the infection, 203 died. At that period, viz. 1807, the prejudices against vaccination had not subsided. But in 1812, when that city was threatened with a similar visitation, by the appearance of the small-pox in the neighbourhood, the magistrates, the faculty, and the clergy, concurred in recommending vaccination. Between the 10th of August, and 22d of October following, 1316 persons were vaccinated. The result was, that though one gentleman, whose child the faculty refused to inoculate, procured matter of small-pox, which he applied himself, and from this source seven persons took the infection, yet by means of this seasonable vaccination not a life was lost. This result, so different from the events of 1807, cannot but make an impression on every mind open to conviction: when vaccination was not performed, 1200 persons took the small-pox, of which number 203 died: when speedy recourse was was had to vaccination, there was not a single victim to the disease. But it is not at home only that lessons, so much to the credit of this new art, may be learned. The Board have abundant communications from every quarter of the world equally to its advantage. To detail all the evidence which they may have received as to its efficacy, not only in preventing the small-pox, but its power to suppress its ravages under the most unfavorable and threatening circumstances, would extend this Report to an improper and an unusual length. They will content themselves with mentioning a few particulars, which they trust will recommend it to the favor and confidence of their countrymen, and to the fostering care of government. On the continent of India, vaccination has been hailed as the greatest blessing, and has been practised with the greatest success, and in the most extensive manner. In the islands of Ceylon and Bourbon it has been received in a manner no less favorable, and been practised with an effect no less beneficial. In the isle of Ceylon, since its first introduction, more than 200,000 persons have been vaccinated; 30,491 in the year 1811 only, as appears by the account from Mr. Anderson, the Superintendant General, to whom but one case of failure, in preventing the small-pox, (and the circumstances of this case render it very doubtful) has occurred, in the great numbers which he has seen. At the Cape of Good Hope the small-pox is dreaded as much as the plague, and it has proved there little less destructive to human life. Lord Caledon, the late governor, established at Cape Town a Vaccine Institution, which was soon called into activity under his successor Sir J. Cradock. The colony consists of a population of 80 or 100,000 individuals, of which number it was supposed 15,000 were subject to take the infection of the small-pox, which appeared there on the 12th of March, 1812. Between that time and the 4th of July following, 233 persons caught the disease, of which number 100 died. The remaining part of the inhabitants liable to the disorder were preserved by an active vaccination, in which all the faculty in the place, as well as the regimental and garrison surgeons, strenuously exerted themselves. From the various details with which the Board have been favored, we think it our duty to select one instance, as tending to show in a most pointed manner the power of the vaccine lymph to arrest the contagion of the small-pox. Four hundred negroes from Mosambique were, on the 1st of March, landed at Cape Town, one of whom, a woman, was on the 5th succeeding afflicted with the confluent smallpox in its most virulent form. This female was at that time inhabiting a large room in common with 200 more of her companions, not separated either by day or by night. On the report of this case, the whole of these victims of avarice and cupidity," as the surgeon terms them, were immediately subjected to vaccination, and on the following day removed to a small island (Paarden Island) at a little distance from the town. A few days after this the woman fell a sacrifice to the most aggravated character of that dreadful disease. Of the aggregate number of negroes, 78 individuals received the vaccine disorder, and underwent the regular course of its action. From these subjects the remaining portion were vaccinated. They remained on the island fifty days, during which no further case of small-pox made its appearance, although they had been exposed to the whole strength of the contagious atmosphere; nor is there a single instance wherein any of this large proportion of persons became subject to the small-pox. It is added by the professional gentleman who writes this account, that throughout the entire course of this " arduous struggle" (the general vaccination) not a single instance had come to his knowledge of the failure of vaccination in protecting the individual from the small-pox, where the former was ascertained to have taken effect. At the Havannah, by the account written by Dr. Thomas Romey, Secretary to the Committee of Vaccination 13,447 persons were vaccinated in 1810; 9315 of these persons had been vaccinated in the City of Havannah alone, with so good an effect, that for two years not a single person had been interred in the public burying ground of that city who died of the small-pox, which before was a great cause of mortality in it. In the Caraccas, and in Spanish America, the small-pox has been extinguished by vaccination. For the means which were taken by the Spanish government, and its subjects, we must refer to the subjoined papers, furnished by some Spanish gentlemen now in London. The accounts from various parts of Europe are almost as favorable. In the Report of last year it was observed, that the small-pox was extinguished at Milan, and at Vienna, in which latter place for many years the average mortality from it had amounted to 800. From Malta information has been received that not only his Majesty's ships are supplied with lymph to vaccinate such such sailors as may not have had the small-pox, but, that the children of the artificers of the dock-yard, and nearly 3000 Maltese children, have been vaccinated by the Institution there (gratis): and it is added by Mr. Allen, the surgeon of the Dock-yard, that during a residence of seven years at Malta, he has never known an instance of one of them being afterwards afflicted with the small-pox. Russia has likewise participated in the benefit of vaccination. It was introduced into the Russian empire in 1804; and since that time, in its various provinces, 1,235,637 have been vaccinated; and so uniformly successful has vaccination been, that it has been termed, in the language of that country, the pock of surety. Dr. Crighton, Physician to the Emperor of all the Russias, observes, supposing (according to a well-founded rule of calculation) that before the introduction of vaccination every seventh child died annually of the small-pox, vaccination has saved the lives, in the Russian Empire, of 176,519 children, since the year 1804. The government of France appears to have taken the greatest pains to secure to the people all the advantages which could be derived from this discovery. A central institution was soon established at Paris, to encourage and to promote the practice of vaccination, and a similar plan for the same purpose was adopted in every considerable provincial town. These provincial institutions were not long ago ordered to make a return to the government of the state of vaccination in their several districts. From these documents a Report has been drawn up by M. Berthollet, Percé, and Halle, philosophers of the first reputation, and submitted to the class of Physical Sciences of the Imperial Institute; in which it is affirmed, that of 2,671,662 subjects, properly vaccinated in France, only seven cases appear of patients having afterwards taken the small-pox; which is as 1 to 381,666. It is added, that the well-authenticated instances of persons taking the small-pox after inoculation for that disease had perfectly succeeded, are proportionably far more numerous; and also that in Geneva, Rouen, and several other large cities, where the Jennerian system has not been circumscribed by popular prejudice, the small-pox is no longer known; and the Registers exhibit strong evidence of consequent increasing popu lation. The Report concludes with expressing great hopes that this pestilential disorder will ultimately disappear from society. This object will doubtless be greatly forwarded by the line of conduct adopted by the Royal College of Surgeons in London, in which city, notwithstanding the artifices prac 3 tised, |