§ EARL GRANVILLE,in putting a Question to the noble Marquess the President of the Council, as to whether any regulations had been issued by the Privy Council in respect to Vaccination under the second clause of the Act of last Session said, that it was now fifty years since the King, by an Order in Council, requested 1342 the College of Physicians to report on Vaccination; and their Report, in answer, was replete with evidence in its favour; and, since then, and especially in 1857, that testimony had received the fullest confirmation. Notwithstanding, we were yet far behind many of the smaller nations of Europe in the facilities which were afforded for putting it into practice. The report of the Registrar General showed that in ten districts in England one quarter of the deaths proceeded from small-pox; and in that very district of London there had been 228 cases of death from small-pox within the last seventeen weeks, whereas in the preceding eighteen months there had only been 225 cases. In 130 districts small-pox was now prevalent in a greater or less degree. There was very little doubt that the increasing number of cases of small-pox was attributable to neglect of vaccination and to bad vaccination. It was clear that after the compulsory Act passed the proportion of children vaccinated to the number of births increased very largely indeed. The percentage in 1854 was sixty-five; but in 1855 it fell to fifty-six; in 1856 it fell to fifty-four; and in 1857 it fell to fifty-two. There was no return which showed the result last year. With regard to the neglect of vaccination, it was owing to the apathy of the parish officers, to the apathy of the public vaccinators, and to the apathy of the population, of whom no penalties were demanded. With regard to the badness of vaccination, Dr. Jenner had stated that, although the art was very easy to learn, unless it was properly learnt, vaccination was absolutely good for nothing. Mr. Marson, of the Small-pox Hospital, stated that in the course of sixteen years, of 3,098 cases of small-pox Which had been brought under his notice, he found only 268 cases in which the marks of the best vaccination appeared, and of those 268 cases three only terminated fatally. It was a proof of the valve of good vaccination; and, at the same time, of the prevalence of bad vaccination. He would suggest that the Privy Council should provide some means of instruction to those medical men who wished to become public vaccinators, and require from them, before being appointed public vaccinators, some proof of their being well informed of the matter with which they would have to deal. It would be of the greatest advantage if some general regulations and instructions were issued under the authority of the Privy Council as to 1343 the mode of performing the operation, and if steps were taken to ensure a supply of good lymph. It would also be very desirable if the district vaccinators informed the Privy Council when cases of small-pox occurred, and if the Privy Council sent immediately to such a district a competent medical authority to examine into the mode of vaccination and to stimulate the population to avail themselves of so great a benefit. It was unnecessary for him to urge upon his noble Friend the necessity of having a certain remedy for so dangerous, and, in very many cases, so fatal a disease, applied in the best manner. The expense of what he (Earl Granville) suggested would not be great. What he would deprecate was delay; and he should, therefore, be happy to learn that the attention of the Government had already been turned to this important subject. The noble Earl concluded by putting his Question to the noble Marquess.
THE MARQUESS OF SALISBURYconcurred in thinking it a most important, though almost exclusively a medical question. The Privy Council had had their attention directed to the subject. They had been in communication with the Poor Law Board, and with their assistance were about to take measures to prevent any but properly qualified vaccinators to become contractors for vaccination. They further intended to apply to the Medical Council to make the knowledge of vaccination one of the qualifications for obtaining a diploma. They had taken measures to secure a supply of pure lymph and the more general practice of vaccination. He regretted that the proportion of cases of vaccination had diminished. In 1849 the number of persons vaccinated was 345,315; of persons successfully vaccinated, 333,248; of registered births, 558,102. In 1854 the number vaccinated was 698,935; of successful vaccinations, 677,886; of registered births, 623,699. In 1858 the number of persons vaccinated had diminished to 468,008; successful vaccinations, 455,004; registered births, 654,914. In November, 1858, the National Vaccine Board called the attention of the Privy Council to the increasing deficiency of the supply of vaccine lymph, stating that in 1838 the number of vaccinations performed by their establishment was 18,659; that the average number in 1850, 1851, and 1852 was 10,713; and the average of 1854, 1855, and 1856, 8,207; while in 1857 1344 the number was only 6,327, adding that ordinarily that board distributed about 215,000 charges of lymph; but that under peculiar circumstances the demand had risen (and might again rise) to about 320,000 charges—an amount nearly 60 per cent higher than was supplied in 1838, when the sources of supply were nearly three times as numerous as at present, and suggesting an inquiry into the state of vaccination in certain large towns. At the end of the year 1858, the medical officer of the Privy Council proceeded to Liverpool and Manchester, and made arrangements in the latter place, which would ensure a supply of from 20,000 to 30,000 charges of reliable lymph. Communications subsequently addressed to the Metropolitan Boards of Guardians would, it was hoped, enable their Lordships to secure a further large increase of trustworthy lymph. As soon as the Registrar General's Returns were completed up to the end of the year, their Lordships directed communications to be addressed to those Boards of Guardians in whose unions there appeared to be a considerable disproportion between the number of births registered and the number of certificates of successful vaccination received by the registrars of districts: 194 letters were accordingly written on the 22nd of February to call attention to the disproportion, and to urge the Boards to use their utmost efforts to diffuse the benefits of vaccination.
§ THE EARL OF SHAFTESBURYwas understood to observe, that it was most frightful in this civilized country that so many deaths should occur from the effects of small-pox, which might be prevented if the practice of vaccination had been enforced. The deaths that took place from this cause were not, however, the extent of the evil, for even in those cases where death did not ensue, the seeds of decay and established disorder were laid, which gradually undermined the constitutions of the sufferers, and occasioned early and premature deaths. It was extraordinary that there should still be such strong prejudice in the minds of some people against vaccination. Those persons believed either that the operation was wholly inefficient, or that other disorders were communicated by vaccination as bad as the disease itself which it was the object of the system to guard against. That prejudice still remained, and in many cases neutralized the intentions of the Act, although it was com- 1345 pulsory, and imposed certain penalties for non-compliance with its provisions. A friend had told him that morning of a case in which a man was visited with a penalty fur refusing to allow his child to be vaccinated. The father said he had no confidence in vaccination, and he did not believe that the lymph itself was pure. He trusted that measures would be taken to satisfy the people of the purity of the lymph, and that the compulsory provisions of the law would be carried out.
§ LORD REDESDALEsaid, that there was no doubt that the regulations of the Act had been very much neglected. The Act had been almost inoperative. It arose from the objections of people in the country to the mode in which the regulations were carried out, as he could state from his own experience. If the child of a neighbour was vaccinated, and the lymph was obtained from it, there was no objection to it; but they did not like lymph that had been brought by the medical man from some strange child, of which they knew nothing, to be used for their children. The disease was one that was very liable to spread, and adults were even more liable to it than children, and therefore they were very much afraid of having strange lymph introduced.
§ EARL GRANVILLEsaid, that it was a pity that the powers given by the Act to the Privy Council were not carried out, and that the penalties remained in abeyance. If necessary, he thought that they ought to have come to the Parliament for more Powers.