Vaccination considered in relation to the public health : with inquiries and suggestions thereon. A letter addressed to the Right Honourable the Lord Viscount Morpeth, First Commissioner of Her Majesty's Woods & Forests. / By John Marshall.

  • Marshall, John, 1818-1891.
Date:
MDCCCXLVII
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    28 relative position of the metropolis and the country is reversed, and that in this respect the Jews suffer most of all. The per centage of cases of this kind amongst the Jews is 89, being double what it reaches in the country, viz., 44, and one-half more than it is in the remaining metropolitan schools, viz., 60. Now, this increased liability to small pox, experienced by the unprotected in London generally, and especially, it would seem, in Houndsditcli, is unquestionably due to the overcrowd¬ ing of the population, the pernicious effects of which are hereby incidentally illustrated. It is a very remarkable fact, however, that with regard to the protected class, this condensation of abode has not an equally injurious influence,— nay, seems to be accompanied by a greater security. But the mischief inevitably inflicted on the unvaccinated of a densely crowded neighbour¬ hood or a town, is a genuine and unmixed result, whereas the apparent security of the vaccinated, under like circumstances, may be owing to a combination of causes. The most obvious, and, I believe, the true cause, is the greater efficiency with which individual vaccination is performed in a town, as compared with the country. The progress and results of cases are more care¬ fully watched, and failure in the operation is more likely to lead to its repetition, amongst a crowded than amongst a scattered population. Imperfect cases (which are often set down as perfect in the mind of a parent) are accordingly more rare. In the instance of the Jewish children, it was observed at the time of examination, that the cicatrices upon the arms were unusually perfect and distinct, as if the operation had always been carefully performed. The aggravated powers of small¬ pox in over-crowded quarters, which must,- in former times, have been especially felt by the Jews, may, in part, supply an explanation of their present intelligent care. At any rate, it forcibly suggests the necessity for exertions to vaccinate all who reside in towns; whilst the apparent insecurity in the country from imperfections in the operation itself, demands additional care in its actual performance. Lastly, it is interesting to find, on comparing the figures in the third column, which show the proportion of all the cases of small-pox (occurring in the protected and unprotected classes together) to the whole number of children, that the balance of
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