durable, ephemeral, or variable? By what regular characters can it be detected, judged of, and described? And why, if it be a specific contagion, does it occasionally arise from the use of genuine cow pock matter? It appears somewhat remarkable, that many of these points have hitherto been only carelessly adverted to, by persons who have endeavoured to engage the sanction of the public in instituting a vaccine establishment, sounding the alarm and danger of a spurious matter, and ascribing the want of success in vaccinating to the use of it.

Having alluded to the deficiency of proof respecting the existence of a specific spurious vaccine virus, your committee would not be at a loss to substitute opinions and inferences on this subject, apparently more consistent with facts and practical observation, to account for the irregularities or deviations, which have been construed into marks of a spurious disease. They however do not think it proper, at present, to enter into the consideration of that subject, but leave it for a future and more particular investigation.

Professional men should feel it indispensably necessary to conduct the process of vaccination with the greatest possible attention, through all its stages, and until its complete operation on the system has taken place; and they should ever be ready to repeat the process, if any irregularity or deficiency in the first shall have been noticed.

It may be suggested, for the proper discharge of this important duty, left entirely to the responsibility of the physician, that a regular period of attendance should be observed throughout the whole course of the disease; that attention should be especially given on the fifth, seventh, ninth, and twelfth days, or at least three times during the first ten or twelve days of the disease; and lastly, that the unerring test, proposed by Mr. Bryce, should be resorted to whenever it is practicable. The importance of attending to persons who have been vaccinated, is the more sensibly felt by your committee, because in the many instances of suspected or reported failure of vaccination, they have scarcely been enabled to collect any satisfactory medical testimony in relation to the nature and progress of the previous disease.

Your committee have been at great pains to examine into the

history of some of the cases in which small pox is said to have succeeded to the kine pock. They are compelled to state, that in several instances, no other evidence of vaccination could be obtained than the oral and insufficient testimony of the patient or his friends, and that not even the least mark of a kine pock vesicle could be discovered. That in other instances, when a mark in the skin was triumphantly proclaimed as an evidence of previous vaccination, the person's arm had been treated by salves, poultices, and other applications, ordinarily resorted to for the healing of common sores; that in others, the arm had become excessively inflamed, the swelling had extended from the elbow to the shoulder, and the sore had continued to discharge profusely for many weeks; and finally, that in other instances, their attention has been directed to marks on different parts of the body, the consequence of sores, which were supposed to furnish the strongest evidence of the constitutional effect of the vaccine disease; an opinion that is fraught with danger, and is in opposition to the writings of Jenner, and the best authors on this subject, all of whom affirm, that no cutaneous eruption whatever, belongs to the kine pock disease.

Neither is the kine pock a preventive of small pox for a limited time only, nor does it produce new and dangerous diseases, as has been affirmed by its opponents. Already has it proved a security against the small pox for the space of near sixty years; persons having accidentally taken the disease from milking cows in Gloucestershire, in England; where it has been believed, time immemorial, to protect them against the small pox.

On the subject of cutaneous diseases, no authority ever stood higher than that of Dr. Willan, who has said, after the most careful examination, that no new disorders have appeared since the discovery of the kine pock; that he has investigated many cases that were attributed to the kine pock, but found diseases well known and described a thousand years ago; common diseases of the skin, having no connexion whatever with the kine pock. The number of diseases of the skin, instead of increasing, have diminished since the introduction of this preventive; in proof of which, facts were adduced by Dr. Willan and others, who also assert, that the kine pock has a decided VOL. VI. 2 R No. 23.

advantage over the small pox, measles, and scarlet fever, in not exciting any other disease.* In a report of the Royal College of Surgeons of Edinburgh, in 1807, it is said, “ The members of the Royal College have met with no occurrence, in their practice, of cow pock inoculation, which could operate in their minds to its disadvantage; and they beg leave particularly to notice, that they have seen no instance of obstinate eruptions, or of new and dangerous diseases, which they could attribute to the introduction; among mankind, of this mild preventive of the small pox." And in a report of the College of Physicians of London it will be found, that "the testimonies before the College of Physicians are very decided in declaring that vaccination does less mischief to the constitution, and less frequently gives rise to other diseases than the small pox, either natural or inoculated."

To encourage the practice of vaccination among the poor classes of the community, is an indispensable precaution to avert the dreadful effects of future epidemics of the small pox. Your committee have already adverted to the prompt and humane measures taken by the common council, board of health, and city dispensary, in December last, for this purpose; but they would earnestly recommend still more efficient regulations than those which are instituted by Philanthropy, and in consequence of the immediate pressure of a public calamity.

Your committee are informed, that most of the continental nations of Europe have successfully contended against the small pox, by providing for the vaccination of the poor, and at the same time making it a penal offence to inoculate for the small pox. It is a lamentable fact, evinced by experience, that nothing short of compulsory measures is sufficient to oppose the effects of ignorance and prejudice.-To guard against the introduction of the small pox into this populous and commercial city, is an object of great moment, and well worthy attention in revising the health laws. Would it not be advisable to reconsider the propriety of excepting the disease of small pox from among those which are the objects of

* Willan on Vaccination.

quarantine laws? Ought not every vessel infected with the small pox to be interdicted from approaching this large population? And ought not every case of the small pox, occurring in our city, to be immediately reported to the board of health, to apprise the citizens of the danger of approaching it?

Previous to the discovery of the kine pock, it was computed that forty thousand persons died annually from the small pox in Great Britain and Ireland; that in twenty-five years, Europe had lost fifteen millions of inhabitants by that disease, and that in America the natural small pox had proved proportionably still more destructive. Every inoculation therefore, for the small pox, tends to destroy life, and to perpetuate that loathsome disease; whilst every vaccination tends to preserve life, and to extinguish the small pox.

In concluding this report, your committee must advert to the general testimony of the oldest and most skilful professional vaccinators, whose opinions and writings they have been able to consult, and whose discerning minds have not laboured under the acrimony of controversy, or been influenced by prejudice or misapprehension. Their testimony is found to be uniform and unequivocal in favour of the efficiency of the vaccine disease. It must, however, be stated with regret, that there are a few physicians who seem still to entertain some doubts on the subject, and who, by cherishing the popular distrust of it, have, in the opinion of your committee, hazarded their reputation and the public good; but who invariably proclaim, that the small pox is rendered extremely mild in every instance after vaccination.* If a few facts of this kind, and leading to the same conclusion, were admitted for the sake of argument, they would necessarily lose their weight, when artificially or otherwise produced during the prevalence of pustular and anomalous eruptive diseases; some of which are often observed to resemble not only the small pox, but even the itch, the measles, and scarlet fever. An analogous fact has lately occurred in this city, in the appearance of a phlegmonous disease of the glands of the throat, that was frequently mistaken for the mumps.

* A second attack of small pox, which is admitted to have happened frequently, has either proved very violent, or terminated fatally.

Some idea of the perfect efficiency of the kine pock may, in the opinion of your committee, be conveyed to the public mind, by the relation of a fact that has been recently observed. In a former part of this report, it was noticed that the small pox had appeared on board of the United States frigate Guerriere: an enquiry was instituted by the surgeon to ascertain whether any of those infected with that disease, had ever had the kine pock; not one of them had had it! It was found however that there were one hundred and seventy-one who had been vaccinated in various parts of the United States and in Europe, not a single one of whom took the small pox, though constantly exposed to it in a crowded ship.

The society for the propagation of vaccination in France, reported, that nearly four hundred thousand persons were vaccinated in the year 1801, in the French dominions. Many of them were inoculated for the small pox, and others were exposed to it during the prevalence of a severe epidemic small pox, yet all of them resisted its influence; and since that period it is stated in a report to the Imperial Institute of France, that only seven persons took the small pox, out of two millions six hundred and seventy-one thousand six hundred and sixty-two persons that were vaccinated; clearly demonstrating the advantage of the kine pock in increasing population, and the welfare of mankind. By a report from Sir Alexander Chrichton, superintender of vaccination throughout the Russian Empire, it appears, that during the years 1811, 12, 13, nine hundred and sixty-two thousand four hundred and three persons were vaccinated in Russia. In Spain the knowledge of vaccination was received with avidity, and was taken under the protection of the government at an early period. It would be superfluous to adduce other evidence of the kine pock as a preventive of the small pox.

Your committee beg leave to call the attention of the society to one other circumstance only: had the same number of susceptible individuals existed in this populous metropolis, as would perhaps have existed in it, had not the kine pock been discovered, we should, during the last six months, in all human probability, have had to mourn over an immense destruc