HC Deb 12 May 1893 vol 12 cc837-64
*MR. HOPWOOD (Lancashire, Middleton)

rose to call attention to the law making vaccination compulsory, and to move— That the law compelling vaccination of infants and young persons is unjustifiable, and ought to be repealed. The hon. Member said that, in proposing this. Resolution, he had undertaken a duty which he knew to be an important one, and he hoped that it would not fail because of the in competency of the advocate. He stood there as the mouthpiece, on this question, of the country, whose voice with regard to it had not for many years found due expression in that House. The House of Commons in past times had been induced by promises expressed by medical opinion which were unfulfilled, and by assertions the truth of which had never been established by proper evidence, to pass a Compulsory Vaccination Act. His first proposition was that it was monstrous to enforce upon the people of the country compliance with a medical rite which was utterly useless as a safeguard against small-pox. During the last century inoculation was just as much favoured and supported by the medical profession as vaccination was in this century. Small-pox was introduced into the system by inoculation under the notion that it prevented further attacks of small-pox. They were surprised when Irishmen made "bulls." When Irishmen said something of an ingenuous kind—something that was paradoxical—they were inclined to laugh. Just see what inoculation meant as an Irishman would put it— "Sure the boy may be liable to an attack of small-pox, and sure the surest way is for me to give it to him straight." In the last century, in order that a man might escape the chance of small-pox, they gave him small-pox. It was the same way with vaccination in this century. In order that a child might escape the chance of a disease they gave it a disease. Generation after generation they put disease into the arms of successive infants—infants that were going to be the fathers and mothers of future families; and they added to the sum and reserve of the diseases of the world an added quantity, of which they knew not the range, the effect, or the result. Vaccination was introduced by Dr. Jenner. He advised anyone who was curious to note how from small beginnings and little shams great things arose in this world to read the history of Dr. Jenner and his system. He would not dwell upon that, but would only say that when vaccination was first propounded to the House of Commons it secured for its fortunate discoverer, or so-called discoverer, £10,000, and a little later a further sum of £20,000, the pretence then being that vaccination afforded a complete and entire safety against small-pox. But why should vaccination be compulsory? He contended that all the evidence was against compulsion. Lord Henry Petty, speaking in 1806, said— I have not the smallest inclination to propose any compulsory measures, being well convinced that, whatever may be our view of any subject of science, this House ought to pause very long indeed, before they prescribe any law to individuals upon matters which relate to their own health, and even on which the very existence of their children may depend. These, indeed, are topics upon which private individuals in society are to be allowed to be the most competent judges. And two years later no less a person than George Canning spoke words of weight in the same sense— Although I consider the discovery of vaccination to be of the very greatest importance, yet I cannot imagine any circumstances whatever that would induce me to follow up the most favourable report of its infallibility with any measure for its compulsory infliction. He would now quote one who was still amongst them—one who was, perhaps, the greatest of all that had gone before or come since—the present First Lord of the Treasury— I regard compulsion and penal provisions such as those of the Vaccination Acts," said the right hon. Gentleman, "with mistrust and misgiving; and were I engaged on an inquiry, I should require very clear proof of their necessity before giving them my approval. John Bright had also declared that the law was "monstrous," and ought to be repealed. He need not remind the House of the expressions used by Jenner himself. It might be answered with some show of plausibility that these were but the too sanguine views of an inventor— these promises which were contained in the original "Inquiry," that— What renders the cow-pox so extremely singular is that the person who has been thus affected is for ever after secure from the infection of the small-pox; neither exposure to the variolous effluvia, nor the insertion of the matter into the skin, producing this distemper. These promises were renewed five years later in Further Observations on the Cow-pox, in which Jenner wrote— The human frame, when once it has felt the influence of the genuine cow-pox in the way that has been described, is never afterwards, at any period of its existence, assailable by the small-pox. That was false. It was now admitted on all hands in the medical profession that that statement was false. Yet it was backed up until late times by the Local Government Board. The Vaccination Department of the Local Government Board was an expensive institution. In that Department they had a body of men who were bound over by their education, by their tendencies, by their interests, to maintain vaccination.

*SIR B. WALTER FOSTER (Derby, Ilkeston)

No, no!

*MR. HOPWOOD

said, the Department got £9,000 for this purpose, and they had no other purpose. He did not mean to say that their views were intentionally wicked, but he submitted that if men were to be engaged to investigate a matter of controversy, the tendency was to choose men who were not committed one way or the other; and he thought that if vaccination was to be enforced, the Medical Authority of the Local Government Board was not an authority that the House should be exclusively guided by. He should have taken but little note of these expressions of opinion he had quoted were it not that he found them echoed in the words of one who more than all others was instrumental in the enactment and maintenance of our present laws in this matter. He meant the words of Sir John Simon, when he said, in 1857— On the conclusion of this artificial disorder, neither renewed vaccination, nor inoculation with the small-pox, nor the closest, contact nor cohabitation with small-pox patients, will cause him to betray any remnant of susceptibility to infection That, too, had been given up. Sir John Simon was examined before a recent Commission, when he was obliged to say that a great deal of this language was rhetorical, and when he was pressed whether he still maintained his assertion, he gave it up, and every sensible man must give it up. The promise of Sir John Simon had already been anticipated in almost identical terms in the speech in which, in 1853, the Second Reading of the first compulsory Vaccination Bill was moved in that House by Lord Lyttelton, when he declared, on April 12, 1853— It is unnecessary for me to speak of the certainty of vaccination as a preventive of small pox, that being a point on which the whole medical profession have arrived at complete unanimity. Of course, he might be reminded, not without some show of justice, that these claims had now been virtually abandoned in favour of a more moderate position. That more moderate position he was prepared to consider on its merits; but he had at once two things to reply to the objection—first, that the claim could not be truly described as abandoned so long as The Times and Lancet repeatedly declared, as they declared in their leader columns, that "no one need have small-pox unless he or she pleases." That statement was false and misleading— editors of journals, whether political or medical, ought not to propound such statements, which were indefensible. And, secondly, he should repeat with all possible emphasis that it was all very well to now withdraw the claim that vaccination gave an absolute freedom from small-pox, and say now—"It is true that primary vaccination may be of no use, but you must re-vaccinate." There was no obligation, under the law which they were discussing, that a person should be re-vaccinated. All that they were discussing was, whether infants should continue to be destroyed by this horrible Moloch of the medical profession. He called it Moloch, because its victims could be counted by the hundreds—indeed, he was entitled to say, the thousands. This he would prove by the evidence of the Registrar General. Five hundred and odd deaths of infants from vaccination pure and simple had occurred between 1870 and 1880. What did his hon. Friend say to that?

*SIR B. WALTER FOSTER

What are you quoting from?

*MR. HOPWOOD

You can see for yourself, sir, if you do not know. I told you it was the Registrar General. I am ready to-morrow or next day to give you the distinct reference; but if it is not in the hands of your Department, your Department is more incompetent than it should be. But was that the whole total of those who were sacrificed by vaccination? He doubted it. He knew it was very difficult to get a man who had done a fellow-creature to death, either by accident or misadventure under his hands, to state the truth, and they had it from a prominent medical officer that he himself often put into a death certificate that which was not the true cause of death "in order to save vaccination from reproach." "Convulsions" was a convenient cause to assign in registering the deaths of infants who died from the effects of vaccination. Erysipelas was one of the most painful forms of death, and it was a most common sequel of vaccination. There was no disease which brought an anguish more acute. As a rule 14 days at least of this suffering had to be endured before death was merciful, and set the little patient free. It was terrible! It was a responsibility which the House took upon itself every year it insisted on compulsory vaccination. The whole world united in testimony in refutation of that dogma—that vaccination was a sure protection from small-pox. The deaths from small-pox in the confessedly vaccinated were counted by tens, by hundreds of thousands. The Lancet itself calculated, in its issue for July 15, 1871, that in England and Wales, in the course of the one epidemic then raging, more than 122,000 vaccinated persons had suffered from smallpox. In 1881 the Highgate Hospital had 96 per cent. of its patients vaccinated, and this at a time when the highest estimate of the vaccinated in London did not exceed 90 per cent. So that the proportion of vaccinated patients to total patients inside the hospital was even greater than the proportion of vaccinated population to total population outside the hospital. In an outbreak of small-pox in Sunderland, in 1884, reported in the current Lancet of that date, there wore again 96 vaccinated out of a total of exactly 100 cases. In 1881 there was an outbreak at Bromley of 43 cases, and every one of them was a vaccinated case. It was stated before the Royal Commission, on the authority of the Metropolitan Asylums Board, that 41,000 cases occurred of persons admittedly vaccinated between 1870 and 1886. This applied to London alone, and there could be found no other place, either here or abroad, in regard to which the same tale could be told. In the Highgate Hospital, in 1884, there were 474 cases; 447 were vaccinated, and of these 43 died, all vaccinated cases. To quote from the Highgate Hospital again, in 1885 there were 567 cases; of this number 532 were vaccinated, and of that number 82 died. The Metropolitan Asylums Board small-pox hospital ships had in 1890 22 cases, 21 vaccinated, 2 re-vaccinated, and 5 unvaccinated. The only two that died were the two re-vaccinated. In 1891 there were 63 cases, of whom 7died; 53 vaccinated, of whom 2 died; 8 re-vaccinated, of whom 1 died; 10 unvaccinated, of whom 3 died, and 1 death was doubtful. In Prussia, held up in 1871 to a Committee of that House as an example of how a country ought to be vaccinated, the great epidemic of that year attacked 2,240 vaccinated children under 10 years of age, and killed 736 of them. That was a sufficient answer, surely, to those who held that complete security against small-pox could be obtained by a re-vaccination at the age of 12. Dr. Gayton, of the Homerton Small-pox Hospital, who spoke with the experience of more than 10,000 cases of small-pox before the Royal Commission, said— I think primary vaccination is a very fleeting protection indeed. As to the time that primary vaccination lasts I do not know, but I think it is a very short time. In another answer he said— Primary vaccination would not ward off an epidemic. And, in reply to a further question, he said— Post-vaccinal small-pox is of constant occurrence, and brings by far the larger proportion of inmates to the small-pox hospitals. That was the evidence of a man who was in favour of vaccination, and who described his experience as extending over 10,000—he (Mr. Hopwood) believed it extended to as many as 13,000 cases; but, not being quite sure, he took it at 10,000. An hon. Friend reminded him that in June, 1883, he had the honour of standing before the House upon a similar duty he was performing to-night. He stood there under the leadership of as astute a Radical—he would not dwell on the name of Radical, but would say as astute a friend to liberty as ever adorned that House—Mr. Peter Taylor. On that occasion, Dr. Playfair, now Lord Playfair, spoke. He had previously declared that in Scotland they ordered things so that vaccination had stamped out small-pox. The words were hardly out of his mouth when a terrible epidemic ran its course in Scotland, and Dundee and Glasgow answered the speech of Dr. Playfair by a painful refrain. He knew that in Scotland they ordered things very roughly; their notion of the law did not square with his; they carried out the law without much listening to those who had to submit to it. But they had not succeeded in stamping out small-pox, and he would ask the hon. Gentleman who represented Glasgow whether the authorities were not at this moment under considerable tribulation? At this moment they had vaccinated up to 95 or 96 per cent., and yet the small-pox hospitals were filled with vaccinated cases. ["No, no!"] Anyone who said. "No" in face of the facts brought forward it was useless to consider, as there was no hope of converting him, because he had been brought up in the belief that if a man died from small-pox after vaccination he was wrong in so doing, and had offended against the medical body. The usual resource in the case of death from smallpox was to say the patient had not been sufficiently vaccinated. He would like the House to listen to the way in which a witty friend of his illustrated the assertion of that belief in vaccination. His favourite assertion was that his children were washed with Pears' soap. They had not had measles because they had been protected against it by Pears' soap. If they had it slightly the slight-ness was due to Pears' soap; if they had it badly, then it was said—"Oh, yes; but if it had not been for Pears' soap they would have died." If they died they had this reflection—that they had done their duty as parents, but had not used enough of Pears' soap. That was practically the way in which the medical profession had defended this practice of vaccination and supported the compul- sory law. Look where they would they found maintained a tradition of ill-success which commenced with the commencement of the practice itself, an ill-success which could no longer be denied or explained away when Lord Robert Grosvenor, vaccinated in 1801 by Jenner himself, in 1811 barely escaped with his life from an attack of confluent small-pox. Jenner was put to his wits' end; when the child got through he said—"The boy would have surely died but for having been vaccinated." The boy's friends said—"But you covenanted to protect him against the infection; have you succeeded?" "No," said Dr. Jenner, "but you ought to be grateful to me, for he would have died if he had not been vaccinated." So it was by the bedside of one of the most conspicuous of Jenner's failures that there was started the now fashionable doctrine of the vaccinal mitigation of small-pox. It had been enshrined in medical books as a fact not to be disputed; but there were many medical men who did dispute it, though to do so was to doom themselves to ostracism, to blight their future fortunes, to have every road to advancement in their profession stopped against them. There were many such, and nobly and well had they spoken out on behalf of those who had been called fanatics. He did not know why he should be called a fanatic; but he knew that those who started this war against vaccination were not the wealthy, the wise, and the educated—they were the poor who suffered from the use of the vaccinator's implement a use without care, without inquiry, and recklessly practised—and who suffered, as men and women must suffer, acutely in seeing the loss of their offspring. They had talked of mitigation and protection, but was the profession agreed? He thought it would be admitted that this claim of absolute protection had never, from the beginning, been true in fact. But more than that, he submitted, never could be true in theory. The theory had been that vaccinia—cow-pox—and small-pox were really identical diseases; that to vaccinate people was really only to carry them through the small-pox in a new way; that, in the words of Mr. Simon, "the vaccinated are safe against smallpox because they, in fact, have had it." But this theory was unsound at its very foundation. The differences between the two diseases had now been so fully set forth by Dr. Creighton and Professor Crook- shank, and so convincingly laid before the Royal Commission, that few would now care to maintain the identity of the two diseases. Dr. Creighton himself pointed out the fact that, when he gave evidence on this point, no cross-examination of him was attempted. The Commission let him alone; they knew that he knew more than they did, and therefore they did not venture to handle him. Dr. Creighton on this topic said the two were not identical; and if that were so, what was the case for enforcing vaccination? He had just a word to say about the Royal Commission. It was sot up by the late Government four years ago, and it would take another year before it arrived at a conclusion. He would tell them why they should not accept with implicit submission all they said. The contrary, because there was not a single avowed anti-vaccinator put upon it, though the people whose fears were to be allayed, and whose claims were to be heard, were those who had remonstrated on the ground of their disbelief in vaccination. He knew they added Mr. Charles Bradlaugh; but he was not an anti-vaccinator, though what he might have become afterwards he did not know, as he believed that what he saw and heard had a very great effect upon him. The names of several anti-vaccinators wore put before Mr. Ritchie; but, acting on the advice of his Medical Department, he declined to place any of them on the Commission. Why should that be—were they afraid of the truth? On the question of efficacy he would quote Professor Crookshank, who thus concluded his work on the History and Pathology of Cow-pox— Unfortunately, a belief in the efficacy of vaccination has been so enforced in the education of the medical practitioner that it is hardly probable that the futility of the practice will be generally acknowledged in our generation, though nothing would more redound to the credit of the profession and give evidence of the advance made in pathology and sanitary science. It is more probable that when, by means of notification and isolation, small-pox is kept under control, vaccination will disappear from practice, and will retain only an historical interest. Could they tell him a name that stood higher than Professor Crookshank's, or ask him to assign any evidence more weighty? The practice of vaccination varied; they might vaccinate in any number of marks they pleased, from a single one advocated by Dr. Lee to the four which were recommended by our Local Government Board. In the Estimates that were passed every year, there was a considerable sum included as premiums paid by the Local Government Board to the medical profession not for care shown in the vaccination of unhappy infants, but for the cruel scars or "stars" produced on their arms; as to the lymph, they might try humanised lymph—arm to arm vaccination it was called—and in that way it was admitted that the ghastly risk of receiving disease was incurred. For long years the medical profession had denied the possibility of disease being inoculated by vaccination. This testimonial to the benignant nature of the operation was not merely general; it condescended to particulars. They were assured that the communication of syphilis by vaccination was not merely unknown, but impossible. Who could endorse that premise now? He should like to show the House what was the attitude maintained by the Local Government Board in this matter. He held in his hand a pamphlet, entitled, Facts for Heads of Families, and stated on its title page to be "Revised by the Local Government Board, and issued with their sanction," and in it I read— The fear that a foul disease may be implanted by vaccination is an unfounded one. Such mischief could only happen through the most gross and culpable carelessness on the part of the vaccinator; and as all medical men now receive special training in vaccination, no risk of this kind need be at all apprehended. Of course, vaccination, like everything else, requires a reasonable amount of care in its performance. The alleged injury arising from vaccination is. indeed, disproved by all medical experience. There were several gross misrepresentations in this pamphlet; they had been brought to the attention of the Local Government Board, and he should like to know why such monstrous falsehoods continued to be conveyed to the public. He invited his right hon. Friend who was at the head of the Department, and who was not accustomed to this sort of official behaviour in reference to the public, to read this publication and set the matter right. To say that "The fear that foul disease may be implanted by vaccination is an unfounded one" was a direct falsehood. It was known beyond doubt that disease had been conveyed by vaccination over and over again. Why, then, was this statement allowed to be flaunted before the people of England as being issued with the authority of the Local Government Board? They were told that Such mischief could only happen through the most gross and culpable carelessness on the part of the vaccinator, and as all medical men now receive special training in vaccination no risk of the kind need be at all apprehended … The alleged injury arising from vaccination is, indeed, disproved by all medical experience. Was that true? Had the Local Government Board a right to say that? If they had not it was a falsehood, and that, too, by a Department on which they ought to he able to rely implicitly. First of all, it was stated that mischief could only happen through gross carelessness. He could show them how Mr. Hutchinson, the great surgeon and syphilographer, expressed himself on this matter. In his work, Archives of Surgery, Mr. Hutchinson said— It is absurd to assert that inherited syphilis is always to be detected, and it is a cruel injustice to imply that all accidents have been the result of carelessness. What was the course pursued by the Local Government Board in this matter? They had appointed a gentleman named Mr. Albert Bridges Farn to examine all the lymph on behalf of the Local Government Board—that was to say, all the supplies that were sent up from the public vaccinators all over the country before being reissued. Mr. Farn was examined before the Royal Commission, and he was asked about the investigation he made. He stated that he had to examine all the supplies of lymph on behalf of the Local Government Board from all the public vaccinators. What did he say? He said that his examination of the lymph was mainly directed to the detection of blood corpuscles, though he did not say that blood was more likely to be the vehicle of disease than any other of the contents of the body; that he could not call it possible to distinguish between lymph which was syphilitic and lymph which was not. nor between that which was inflammatory and that which was not; and that no power he could bring to bear would be capable of detecting any of the bacteria of disease, even if they were present. And, finally, when he was at last asked whether he had ever guaranteed any lymph as pure, he replied that he had not. Here were, the words of Mr. Farn in his examination before the Royal Commission— Question 4173. Having regard to what you have told us, do you think it would be possible, from the microscopical examination you made, to guarantee that any lymph was pure? — No; I should not undertake to say whether it would be a guarantee that the lymph was pure. I do not know that you could do it. It was insisted upon that every child should be vaccinated, or that the parent should be subjected to the loss of goods or sent to gaol or treated as a felon. Yet here it was admitted on the highest authority that there were no means of telling when there was true lymph or spurious lymph, which might contain the germs of disease. He begged the House to believe that if he left his case at that stage unfinished, it was but a fragment of that which he could place before them. But it was almost impossible, before what he would be excused for calling an uneducated audience in these matters, to compress into an hour and a quarter's speech all the evidence and the knowledge which had been accumulated in the course of 10 or 12 years. He was content to leave it to the House under these circumstances. Meantime, this system he had condemned went on; its martyrs were renewed from year to year; and he asked the House, in defence of these little ones, and in defence of the best interests of medical science, which concerned them all, to release the medical profession from the trammels of a law which stereotyped a remedy which was no remedy, which forbade future investigation, which bound hundreds and thousands of that profession in the bonds of self-interest to be content with that which had fallen to their lot, and muzzled or dulled their capacity for investigation. He begged to move the Resolution which stood in his name.

MR. ARTHUR O'CONNOR (Donegal, E.)

begged to second the Motion, and remarked that after the somewhat exhaustive exposition which had been placed before the House, he felt that the best thing he could do was to make his remarks as condensed and as abbreviated as possible. When his hon. and learned Friend paid him the compliment of asking him to second the Motion, as he shared his hon. Friend's views to the full, he did not feel that he could refuse. But had his hon. and learned Friend consulted him before putting his notice on the Paper, he would have ven- tured to submit to his judgment whether it was opportune, seeing that a Royal Commission was sitting inquiring into the whole question, that that Commission, so far at least, had not moved in what his hon. Friend would consider a wrong direction, because the Government itself had so far manifested a complete readiness to fall in with the recommendations of that Commission, and, finally, because he could quite understand the House of Commons itself would be unwilling to anticipate by a vote one way or another the ultimate decision at which that Commission was likely to arrive. For the same reason he would suggest that it would scarcely be advisable for his hon. and learned Friend to force his Motion to a Division. At the same time, he should be glad, personally, if there was any real prospect of securing an overwhelming and decisive majority in favour of the Resolution which he ventured to second. It seemed to him there was a great deal to be said for this Resolution, and there was very little to be said for the existing law. The law appeared to him to be unreasonable, unequal, cruel, and, therefore, unjust and inexpedient. It was unreasonable, because at the best it was founded on mere presumption, and on presumption the more it was examined the weaker it appeared to be. On the one hand, it must be admitted that vaccination, apart from its supposed influence on small-pox, was an evil, and a cruel evil, to a reluctant parent. It was often a very cruel and very loathsome injury to the health of a child, and against this assured evil they had only the presumption of defence against a disease which attacked only a very small portion of mankind, and which the overwhelming majority of mankind escaped. This presumption of defence against a disease was, as he had said, getting weaker and weaker the more it was examined. The claims which were put forward on behalf of vaccination in the time of Dr. Jenner were of the extremes character. It was declared that vaccination was a complete and permanent protection and preventive of small-pox. After a while that position had to be abandoned, until now they found its advocates scarcely venturing to say more than that it was a possible, a temporary, and an occasional mitigant of the evils of small-pox. In view of the fact that even 'among the advocates of vaccination them- selves there was an absence of any fixed or definite view, it was an unreasonable thing to make this medical rite compulsory upon a reluctant population. Some medical men contended that the danger from vaccination was small, others that it was great. One medical authority said that vaccination once was enough; another that the operation of vaccination ought, to be repeated every 10 years; another every seven years, and others stated that to be really secure one ought to get vaccinated every year. Again, one medical man was of opinion that one mark was sufficient, another required two, and others from three to six, and even 12, whilst one medical man declared that the more marks there were the better, and the more frequent vaccination took place the better. It was something like those patent pills of which the advertiser said that the more you took of them the better. With regard to the lymph itself, there were contradictions and disagreements. One medical man considered that calf lymph alone should he used, and another wanted it to be humanised. Until medical men were agreed on all these points the lay population might be excused if they revolted against the proposal as to vaccination for the future. He protested against medical men setting themselves up as exclusive judges in this matter. There was absolutely nothing in the subject which required any scientific knowledge, and medical men themselves at last were driven back into statistics, and precious statistics some of them were! If they examined the statistics which had been recently compiled, and looked upon them fairly, he ventured to put forward the opinion that they made not in favour of vaccination, hut against it. He thought the House would observe that statistics on this question told against vaccination rather than in favour of it. Unless a person started on their consideration with a preconceived opinion he would be absolutely driven to that conviction. He had no hesitation in committing himself to the opinion that, in the midst of a small-pox epidemic, an unvaccinated person was at least just as safe as one who had been vaccinated. Figures compiled by a Gorman medical man showed that, in the small-pox epidemic in Germany in 1872–3, among a largo number of cases that came under the observation of himself and his staff, a much larger number of vaccinated cases proved fatal than of unvaccinated cases. It was apparent, too, the law was unequal as well as unreasonable. It was unequal not only as between the rich and the poor, but as between different unions in the same county. And how was the law observed? In Gloucester 79 per cent. of the population were defaulters under the Vaccination Laws, in Oldham 71 per cent., in Luton 64, in Northampton 63, in Halifax 60, in Eastbourne 54, and in Banbury 46 per cent. A great deal more than half the children in these towns were not vaccinated; and, though he could not say that these towns were entirely free from small-pox, yet he could say that they were more free than any other towns of similar size in the country. What was the case with regard to London, where 90 per cent. of the population were vaccinated? In the epidemic of 1871, of the number of patients admitted to hospital, 91 per cent. were vaccinated; and in 1881 96 per cent. There had been three epidemics of smallpox during the last 30 or 40 years. In that which prevailed from 1857 to 1859 there were 14,000 deaths; in that of 1863–64–65 there were 20,000 deaths. While the population had increased 7 per cent., the deaths from small-pox had increased by 50 per cent. In the epidemic of 1870–71–72 the number of deaths, again, increased by 12 per cent. He held in his hand statistics derived from Indian and German sources which established the proposition that vaccination afforded no real protection against small-pox. He merely rose to second the Motion and not to detain the House, but he could not help drawing attention to these important facts. The Reports to which he referred proved conclusively that there was no protection. He asked the Government to bear in mind the Report, for instance, of Dr. Keller—a Report which contained very interesting figures. The law as it stood upon this subject was founded upon a mere presumption. The fact that so many persons were vaccinated was a proof of the weakness of human nature and the proneness of people to follow their leaders rather than an indication of a real belief in the efficacy of vaccination. But, even if they took the opposite view, and said the community had a right to protect itself, he had to say that there was no justification for forcing vaccina- tion on those who did not believe in its efficacy and who resented its being practised upon them. He was perfectly well aware that numbers who were opposed to vaccination obeyed the law by having their children vaccinated. That, however, was a poor argument. He believed that before many years they would see that vaccination was not adequate to cope with the evil of smallpox, and he thought they would look back with amazement at the time when this system was resorted to by a people like theirs. He had pleasure in seconding the Motion of his hon. and learned Friend.

Amendment proposed, To leave out from the word "That," to the end of the Question, in order to add the words "the Law compelling vaccination of infants and young persons is unjustifiable, and ought to be repealed,"—(Mr. Hopwood,) —instead thereof.

Question proposed, "That the words proposed to be left out stand part of the Question."

*THE SECRETARY TO THE LOCAL GOVERNMENT BOARD (Sir B. WALTER FOSTER,) Derby, Ilkeston

From 35 years' experience as a practising physician, I have long been aware that the most difficult person to convince is the amateur doctor, and I am afraid the observation applies to other professions. I am sorry that the hon. and learned Gentleman who introduced the Motion has imputed interested motives in this matter to Government officials and to the medical profession. It must be manifest that the medical profession has much more to gain by epidemics of small-pox than by the small fees from vaccination, and the Medical Officers of the Local Government Board could certainly earn more in practice than they received for their official work. I must warn the House against accepting some of the statistics brought forward by the Seconder of the Motion. The figures of one authority (Dr. Keller) were thoroughly exposed in 1887 by Herr Korosi, who found that Dr. Keller had falsified the Returns in favour of the anti-vaccination side. Figures were discovered to have been altered, such as 68 to 38; and a Medical Committee, which also investigated the figures of Dr. Keller for the International Medical Congress held at Washington in 1887, arrived at the conclusion that they had been "falsified in such a manner as to raise the mortality from small-pox amongst the vaccinated, while that of the unvaccinated was lessened."

*MR. HOPWOOD

wished to know whether the hon. Gentleman was aware that Korosi had himself been shown up?

MR. A. O'CONNOR

said, he was not aware of any alleged exposure of Dr. Keller.

*SIR W. FOSTER

I fear that when doctors disagree charges are sometimes hurled back from one to another. I regard the Motion as inopportune, inconvenient, and injudicious. The late Government appointed a Royal Commission, on which they placed the ablest men they could obtain, to investigate this question. That Commission has displayed, during the four years it has been sitting, the greatest patience. It has devoted two years to hearing the anti-vaccination side, and has now approached within measurable distance of the time when it may report. At such a time a Resolution which directly attacks one of the main References of the Commission is inopportune, as it is evidently premature to express an opinion before there is an opportunity of considering the Evidence and the Report of the Commissioners. It is inconvenient, because many Members are pledged to await the Report of the Royal Commission. It is also injudicious, because whatever the hon. and learned Gentleman gets from the Resolution will do him very little good in the face of the Report of the Commission. He has entered on an unprofitable task, and it is injudicious on his part to challenge the vote of the House at the present time. Another point is that the Government are acting in perfect good faith in the matter, for they recognise and promise to act on the Report of the Commission as regards repeated penalties. Well, Sir, I think my hon. Friend will be better advised if he waits for the final Report of the Royal Commission. I do not myself believe in unwise compulsion. There is no heresy so foolish that it cannot be made important by persecution. In the present case a few martyrs to repeated penalties are sufficient to keep going the agitation against vaccination. I do not accept the hon. Member's conclusions in reference to the usefulness of this particular remedy. I regard it as useful in the prevention of disease, and I am bound on three or four grounds to defend the action of the Department I represent in reference to it. In the first place, I defend vaccination because I believe it is a great means of saving life. I would ask the attention of the House to a few figures in connection with this contention. We have means of obtaining a fair and approximate knowledge of the ravages of small-pox before vaccination was invented and practised. It is calculated that before the use of vaccine smallpox killed in London about 3,000 per 1,000,000 of living people. [Cries of "Oh!"] That is the estimate of statisticians who have no interest to serve by misrepresentation, and it is similar to estimates made in foreign countries.

MR. PICTON (Leicester)

Will the hon. Gentleman tell us on what he bases these figures?

*SIR W. FOSTER

They are based on the estimated population of London and on the bills of mortality. The hon. Gentleman can, of course, say this is only an estimate; but I will give other figures which cannot be questioned in the same manner. Well, 3,000 per 1,000,000 was the estimated death-rate from small-pox in London before the use of vaccination, and the rate had fallen between 1872 and 1890 to 178 per l,000,000. That is an enormous decrease. In England generally, putting the estimate much lower than many statisticians put it, it is calculated that the deaths from small-pox were 2,000 per 1,000,000 before the days of vaccination, whilst between 1872 to 1890 they had fallen to 90 per 1,000,000. These comparisons are open to the objection that the death-rate before 1838, when the registration of deaths was taken up, may be wrong. I will, therefore, go to a country where there has been registration of deaths both before and after vaccination came into use—namely, Sweden. If Englishmen are liable to small-pox, Swedes may be supposed to be not less liable. Registration has been in force in Sweden since 1774. In the pre-vaccination days the Swedish death-rate from small-pox was 2,008 per 1,000,000 of living persons, whilst, since vaccination, the average during the last 70 years has been 173 per 1,000,000. In Copenhagen, where they have known the number of the population and the deaths from smallpox since 1750, the death-rate from small-pox was 3,567 per 1,000,000 before vaccination was used, whilst during the last 73 years it has been, on the average, 130 per 1,000,000. You may read these figures in another fashion. In London 1 person dies now for every 17 who died before the use of vaccination; in England 1 dies for every 22 who died formerly, in Sweden 1 for every 12, and in Copenhagen 1 for every 27. The figures I have, also refer to epidemics of small-pox at different periods. Epidemics have been defined by a very high medical authority as a condition of things in which 10 per cent. of all the deaths are due to a particular disease. Taking that as the definition, during 48 years of the 17th century there were 10 such epidemics; in the 18th century there were 32 such epidemics, whilst in the 19th century there has not been one. I think that is a complete answer to the allegations respecting the epidemic diffusion of small-pox in the present day. The decline in the death-rate has had a curious relation to the progress of vaccination. The more completely vaccination has been enforced, the greater has been the decline in the death-rate. According to the Registrar General's Returns during the years 1847–53, when vaccination was merely permissive, the total number of deaths in England from small-pox was 305 per 1,000,000 of living persons. During the next series of years, from 1854 to 1871, when vaccination was compulsory but not enforced by penalties, the death-rate fell to 223 per 1,000,000. Between 1871 and 1891, when the compulsory system was enforced by penalties, the death-rate fell to 89 per 1,000,000. Thus, as I have said, there is a progressive decline of small-pox as vaccination is more and more enforced. That decline has occurred in spite of conditions which are above all likely to make a disease like small-pox more and more fatal. Smallpox most probably spreads through the atmosphere, and is certainly communicated by persons being brought into close proximity with those who suffer from it. We have gathered together in this city at the present time such a mass of people as the world has never seen gathered together in a single spot before, whilst the communication that takes place between them is vastly greater than was the case in olden times. Therefore, if the same condition of things existed, we might expect an infinitely greater mortality from small-pox now than we had in pre-vaccination years. It may be said that sanitation has improved, and I admit that it has; but I say that sanitation has had nothing whatever, or comparatively little, to do with the matter. [Cries of "Oh!"] If hon. Gentlemen will be patient I will give them figures which, I think, will show that such is the case. Before, however, I pass away from the present point, I want to point out that the mortality has decreased amongst certain portions of the population more than amongst others. The Motion deals specially with infants and young persons. Amongst infants under five years old the decline is no less than 89 per cent., whilst amongst children between the ages of five and 10 it is no less than 72 per cent. The decrease of deaths, therefore, is greatest amongst those who have been most recently vaccinated, although, before the days of vaccination, according to calculations based on nearly 250,000 cases, 90 per cent. of the total number of deaths from small-pox were those of children under five years of age. There is another point I must deal with. In very recent times we have had an experience of a serious epidemic of smallpox in the town of Sheffield. I admit that that was a great epidemic in a vaccinated population. A great many figures have been brought out this evening showing the number of people who were vaccinated and yet suffered from smallpox. But, of course, if you have 95 or 98 per cent. of your people vaccinated, and there is an epidemic, the larger number of those who take the disease must be vaccinated persons. Well, I find that in Sheffield, if the vaccinated children under ten had died at the same, rate as the unvaccinated, judging by the behaviour of unvaccinated under 10, there would have been, instead of nine deaths of vaccinated children, no fewer than 4,400 such deaths. In other words, the unvaccinated children under 10 in Sheffield had a death-rate 480 times greater than the vaccinated children.

*MR. HOPWOOD

Will the hon. Gentleman allow me to ask him whether the gentleman from whom he gets these figures admitted before the Commission that there was a defect in his calculation? Had he not taken the Vaccination Census nearly a year afterwards, and after a considerable amount of vaccination had taken place?

COLONEL HOWARD VINCENT (Sheffield, Central)

Before the hon. Gentleman answers, may I ask him whether it is not a fact that no re-vaccinated person in Sheffield died during the epidemic?

*SIR W. FOSTER

I am not quite sure about the point put to me by the hon. Member for Sheffield, and I hope my hon. Friend (Mr. Hopwood) will excuse me if I do not answer his question, as I do not recollect whether any such admission was made. I have every confidence, however, that the gentleman referred to took every care in the preparation of his statistics. I know the statement is not absolutely true in the form in which my hon. Friend puts it.

*MR. HOPWOOD

I assure you it is.

*SIR W. FOSTER

It may be partly true. However, if my hon. Friend objects to these figures, there are others which are sufficiently conclusive. We may put Sheffield aside for a moment, and take England and Wales during the years between 1872 and 1891. If we examine the figures respecting the vaccinated and the unvaccinated while compulsory vaccination was in force, and compare them during a period when permissive vaccination was in force, we find that there has been an enormous saving of life. If between 1872 and 1891 people of all ages had died of smallpox at the same rate as they died of that disease between 1847 and 1853 (when there was no compulsory vaccination) there would have occurred annually 7,940 deaths from small-pox instead of 2,316. In other words, over 5,600 lives have been saved, on the average, every year. If between 1872 and 1891 children under five years of age had died of small-pox at the same rate as they died of the disease in 1847–53, when there was no compulsory vaccination, there would have occurred annually 5,400 small-pox deaths amongst these children, instead of 591. Thus every year the enormous number of over 4,800 young lives have been saved from this disease. I do not want to dwell longer than I can help on this particular portion of the case. I think the figures I have given show that there is a considerable saving of life by vaccination in connection with small-pox. Next, I say that small-pox is lessened in severity by the use of vaccination. Small-pox occurs in different forms. I will not use the scientific terms, but will simply speak of mild and severe attacks. In the Sheffield epidemic of 1887–8 I find that 17.2 per cent. of the eases were severe amongst the vaccinated persons, whilst amongst the unvaccinated persons the percentage of severe cases was 81: the chances of a bad attack amongst the unvaccinated as compared with the vaccinated being nearly 5 to 1. Amongst children under 10 years of age the percentage of severe cases was 9 in the vaccinated and 78 in the unvaccinated, the chances of a bad attack being thus 8 to I amongst the unvaccinated as compared with the vaccinated. In Leicester, which is a town in which the anti-vaccination movement Nourishes, they recently had 146 cases of small-pox, and I congratulate Leicester on having escaped so lightly and on the rigour with which the authorities carried out their isolation hospital system. I have always watched their method with the greatest interest, because I should be glad of having two methods instead of one of stamping out small-pox. Eighty-nine adults were attacked, 82 of whom were vaccinated. Of the 82 cases, only 6, or 7 per cent. of the whole, were severe. Seven unvaccinated adults were attacked, and all the cases, or 100 per cent., were severe. Of the children attacked, 50 were unvaccinated, as against 7 who were vaccinated; 44, or 88 per cent., of the unvaccinated had severe attacks, while all the 7 vaccinated children had mild attacks, 5 of the cases being absolutely abortive, the patients only having a few pocks. A similar state of things is witnessed at the present time in Manchester. There have been over 500 cases altogether; 21 per cent. of those who are vaccinated have been severely attacked, and 68 per cent. of the unvaccinated; while 5½ per cent. of the vaccinated, and 19 per cent. of the unvaccinated, have died. There is another interesting way of showing the, influence of vaccination in lessening the severity of attacks. Some years ago an inquiry was made respecting children in Board and other schools in London, and over 53,000 children were examined. The examination was made with the view of finding out how many of them were pitted with small-pox, pitting indicating a comparatively severe attack. It was found that 360 per 1,000 of the children who were unvaccinated were pitted; that seven per 1,000 of those with defective marks, showing bad vaccination, were pitted, and that two per 1,000 of those with good marks were pitted. These are very remarkable figures as showing how the fair skins and faces of these little ones are saved from disfigurement and mutilation by this beneficent method of treatment. I now pass to the question of the use of vaccination in protecting people from attacks of smallpox. The protective qualities of vaccination are, I think, undoubted. We do not for a moment deny that small-pox will attack a vaccinated person, or that a single vaccination is not protective during the whole of a life. I find that the percentage of children under five years of age who die from smallpox now, as compared with the times when vaccination was not enforced, has declined 89 per cent., whilst in the case of children under 10 years of age it has declined 72 per cent. I think these figures show that, at all events, the protection extends over 10 years. A special investigation was made at Sheffield on this point. A certain number of houses were taken in which small-pox occurred among some of the inhabitants, and it was found that between 18,000 and 19,000 persons lived in such houses. Of these persons 18,020 were vaccinated, and 736 unvaccinated. They were all living under the same sanitary conditions. Of the 18,020 vaccinated persons, 4,151, or 23 per cent., caught the disease, whilst of the 736 unvaccinated persons, 502, or 75 per cent., caught it. Thus the unvaccinated were attacked more than three times as frequently as the vaccinated. Taking the whole of Sheffield, which has 98 per cent. of its population vaccinated, I find that 1½ per cent. of the vaccinated of all ages, and 9.7 per cent. of the unvaccinated, were attacked by the disease. There was a six-fold immunity from attack on the part of the vaccinated of all ages, and a 20-fold immunity amongst children under 10. I do not think you can have figures that are more conclusive.

MR. PICTON

They are disputed.

*SIR W. FOSTER

Well, a very good test on this point is afforded by the case of those who spend more or less of their time in small-pox hospitals—I mean the nurses and attendants. The figures I can give with regard to them are exceedingly interesting, and I do not think hon. Members will be inclined to dispute them as they dispute the last I have given. I find that of 734 nurses and attendants at the Metropolitan Asylums Board Hospitals, 79 had had small-pox. Of the remaining 655, 645 had been re-vaccinated, and of these not one contracted small-pox, whilst every one of the remaining 10 have been attacked by it. The 10 performed the same duties and were under exactly the same sanitary conditions as the 645. I think these figures are conclusive as regards the preventive properties of vaccination, and also as regards the sanitation argument. There are more striking figures still. At Newcastle-upon-Tyne 14 nurses were in attendance on cases of typhus fever; nine were attacked with typhus and two died. Sanitation did not seem to help them much. The nurses attending the small-pox hospital were all re-vaccinated, except one, who had recently had smallpox. Not one of them contracted smallpox, but one did contract typhus. Thus in two hospitals with two sets of nurses under the same sanitary conditions, the one set suffered badly from typhus, while the other escaped small-pox by aid of vaccination. At Leicester, at the present time, the same kind of thing is going on: 22 of the attendants were either re-vaccinated or protected by having had small-pox, and Dot one of them has been attacked; six refused to be re-vaccinated, and of these four have been attacked and one has lied. I think, therefore, the figures show very closely and conclusively that vaccination, at all events, has a protective power. I could give other figures that are almost equally conclusive. In the case of a small-pox ship, where possibly contact is even closer than in a London hospital, 90 nurses and attendants were employed, and they all escaped except one housemaid, who had refused to be re-vaccinated. The Epidemiological Society have reported that, out of 1,500 hospital nurses and attendants, 43 caught small-pox, and not one of them had been re-vaccinated. There are other indications of the protective power of vaccination. Taking some figures given by Dr. Gayton, we find that the protection afforded varies with the effectiveness of the vaccination. Amongst children under five there were no deaths in cases where the vaccination marks were good, whilst the death per 100 were 56.5 where the children were not vaccinated. Amongst children of between five and 10 the deaths were 0.9 per 100 attacks where the marks were good, and 35 per 100 where there were no marks; whilst amongst children of between 10 and 15 the deaths were 1.1 per 100 where the marks were good, and 23 per 100 where there were no marks. I agree with every word my hon. Friend has said about the horror of the communication of foul diseases through vaccination. If that argument were to any extent based upon truth, I admit that it would be terrible and conclusive. If the communication of disease is at all common, a case is at once made out, not only for inquiry, but for an alteration of the law. My hon. Friend said a certain number of cases of that kind occurred. The figures on the point are more or less interesting and meet the apprehensions he has expressed. The disease that is specially dreaded as a consequence of vaccination is syphilis. What are the facts? I find that in Scotland, where children are not vaccinated till they are six months old, 65 per cent. of the deaths from syphilis take place before the age of vaccination, and in the second half of the first year of life they fall to 11.6, less than one-fifth of the pre-vaccination half year. In England, where children are vaccinated at the age of three mouths and upwards the same figures hold good. In both cases some 65 per cent. of the deaths occur before the age of vaccination. The increase shown in recent years in the prevalence of infantile syphilis is a matter, we think, of improved diagnosis. At Leicester infantile vaccination has been for a long time in abeyance; and if syphilis and vaccination were at all associated, we should expect to find in that town a lower syphilitic death-rate among children than in other towns; but, as a matter of fact, we find that in England and Wales generally the syphilitic death-rate has gone up in the last 20 years in England and Wales some 25 per cent., but has gone up still more in Leicester.

MR. PICTON

Is that on a comparison with the town population or with the whole population of the country?

SIR W. FOSTER

It is on a comparison with the population of the whole of England and Wales— not with the urban population. Mr. Hutchinson's experience in that respect is entirely confirmatory of that of the Local Government Board, and it remains true to this day that, although 750,000 children are annually vaccinated, no case of unquestionable communication of the disease has come under the observation of the Board. Another disease which is said to be communicated by vaccination is erysipelas. What do we find in reference to that disease? Why, that in the last eight years the infantile mortality from erysipelas of infants has gone down by 17 per cent.; but in Leicester, where there is no infantile vaccination, the disease has increased in infants 41 per cent. It is calculated, as regards deaths, that only 1 death from primary vaccination occurred in 14,159 operations. What is the alternative? If compulsory vaccination is done away with, 4 out of 5 children under 5 years of age in houses invaded by small-pox— according to the Sheffield statistics —will catch small-pox, and 2 out of the 5 of them will die. On account of a dread of the communication of disease, a dread which may be lessened by the introduction of improved methods, we ought not, in my opinion, to relax our faith in the use of this great preventive of small-pox. With reference to the interference with the liberty of the subject, I do not think it necessary to say much; but this I will say, that I believe that in the complexity of our social conditions we are bound to do more and more in that direction, when it is for the good of others. The only justification for interfering with the liberty of the subject is when it is for the good of others. Thus we vaccinate children to protect the population amongst whom we live. Personal experience is another test, and from my own personal experience of three severe epidemics of small-pox I can assure the House that it is the greatest possible relief, when in charge of a small-pox hospital, to see the vaccination marks well-defined. We know then that there is a hope of sawing the life of the patient. Dr. Russell, of Glasgow, has written words corroborating this. Finally, let me say that the care of the public health is the highest duty of the State, and with the advance of civilisation and the increased complexity of our social con- ditions, the care of health is less and less within the control of the individual, and he must rely more and more upon State guidance and State aid. Holding these views, we must try to exercise them for the greatest good of the greatest number. To accede to the Motion would he hurtful to the public health, retrograde in policy, and injurious by multiplying enormously the baleful and fatal influences of a disease which is at once loathsome, disfiguring, and destructive.

*MR. HUDSON (Herts, Hitchin)

said, he was in Canada in 1885, in the October and November of that year, when a very severe small-pox epidemic occurred, and where no fewer than 2,800 died from the disease. The death rate amongst the English part of the population amounted to only 13 per cent., and after the French took to being vaccinated the number of deaths among them greatly diminished. Had either the Mover or Seconder of the Resolution they were debating been in Montreal at that time, he believed that in the first week they would have rushed to a medical man to be re-vaccinated. In many cases a great deal of harm had been done with human lymph, and he thought the Government ought to adopt the American plan of keeping a farm, where medical men could always rely on obtaining fresh lymph from the cows. There was in The Times of that day a letter from the highest authority in England, the Royal College of Surgeons, in which they advocated the great benefits derived from vaccination. He was connected with the management of two hospitals, and he had often asked the staff's of those hospitals their opinion on the subject, and they always maintained that vaccination was of the greatest possible use. Statistics had been laid before them as to the number of vaccinated persons who had been attacked by small-pox, but his reply was that no one suggested that the effects of one vaccination lasted a lifetime. In his opinion, vaccination ought to take place every seven years. He should vote against the Motion.

DR. CLARK (Caithness)

said, that while listening to his hon. Friend the Secretary to the Local Government Board, he came to the conclusion that nothing was more misleading than statistics. He ventured to suggest that the figures quoted on each side were equally unreliable. It was often impossible to tell whether or not a man or a child had been vaccinated, yet every doubtful case was returned as unvaccinated. He should vote for the Motion, because he thought it was just as reasonable for the State to compel the baptism of a child as to compel its vaccination. He was prepared to say from experience that vaccination did modify small-pox; but if they wanted to be logical, at all events they should compel vaccination every seven years. Towards the end of the '60's Professor Cowan was examiner to a large Insurance Company, and one man who wanted to insure for £2,000 was told that he must be re-vaccinated. He submitted to the process, and eight months afterwards died from small-pox. In Leicester, as the law was not enforced, the town was badly vaccinated, yet there had been no smallpox epidemic there; although Sheffield was one of the best vaccinated towns, the people had almost been decimated by the disease. Let them draw their own conclusions from that. He could only say he believed that when the Report of the Royal Commission was issued the Motion of his hon. Friend would receive much more support.

Mr. Hopwood rose in his place, and claimed to move, "That the Question be now put;" but Mr. Speaker withheld his assent, and declined then to put that Question.

Debate resumed.

DR. FARQUHARSON (Aberdeenshire, W.)

said, he should very much prefer re-vaccination. As a medical man he had given considerable attention to the question, and he was perfectly satisfied with the speech of the Secretary to the Local Government Board, who had put the case with clearness, fairness, and unanswerable truth.

Question put.

The House divided:—Ayes 136; Noes 70.—(Division List, No. 82.)

Main Question proposed, "That Mr. Speaker do now leave the Chair."

Motion, by leave, withdrawn.

Supply—Committee upon Monday next.

House adjourned at a quarter after Twelve o'clock till Monday next.